2017-11-14T10:15:10-06:00 2016-12-31 990 2016-01-01 111633487 GLEN COVE HOSPITAL C/O NORTHWELL HEALTH INC % NORTHWELL HEALTH INC GLEN 5163216025 972 BRUSH HOLLOW ROAD 5TH FL WESTBURY NY 11590 ROBERT S SHAPIRO EVP & CFO 5163216025 2017-11-03 69.27.229.129 11751820173185000000 2017-11-14 P 64888C196846E503F90B13161ED1827B039267C6 08A1259C5F1059ABDC7B7C0B44F2F73D70A20910 2016 2017-02-10 21:41:12Z MICHAEL J DOWLING 2000 MARCUS AVENUE NEW HYDE PARK NY 11042 175541464 false X WWW.NORTHWELL.EDU X 1956 NY Glen Cove strives to improve the health of the communities it serves and is committed to providing the highest quality of care for the community regardless of ability to pay. 32 27 1179 97 0 43098 33028 124822321 129774020 1776365 2161095 1725294 2306566 128367078 134274709 0 0 0 0 94647229 94051280 0 0 1090 43146627 47607648 137793856 141658928 -9426778 -7384219 159709806 157552741 83005196 83807878 76704610 73744863 GLEN COVE HOSPITAL IS PART OF NORTHWELL HEALTH, INC. ("NORTHWELL"), WHICH STRIVES TO IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES AND IS COMMITTED TO PROVIDING THE HIGHEST QUALITY CLINICAL CARE; EDUCATING THE CURRENT AND FUTURE GENERATIONS OF HEALTHCARE PROFESSIONALS; SEARCHING FOR NEW ADVANCES IN MEDICINE THROUGH THE CONDUCT OF BIOMEDICAL RESEARCH; PROMOTING HEALTH EDUCATION; AND CARING FOR THE ENTIRE COMMUNITY REGARDLESS OF THE ABILITY TO PAY. false false 107429272 107671059 Glen Cove Hospital (GCH) is a 247-bed community hospital that offers inpatient medical/surgical, intensive and cardiac care, orthopedics, gynecology, pediatrics, and psychiatry. GCH offers state of the art inpatient and outpatient orthopedic rehabilitation services, including total joint replacement, spinal procedures and sports medicine. GCH has established itself as a national and international center for orthopedic surgery and joint replacement. GCH is also a NYS DOH - designated Stroke Center. In 2016, the hospital had 4,559 inpatient discharges, provided 19,378 emergency department visits and performed 2,414 ambulatory surgeries, including endoscopies. 21728422 16994484 Glen Cove Hospital is an affiliated member of Northwell Health ("Northwell") and part of Northwell's medical group and ambulatory lines of service. It strives to make a measurable difference in the health status of the communities it serves by providing comprehensive health care regardless of ability to pay. 4329087 5108478 North Shore-LIJ Imaging at Glen Cove provides a full range of diagnostic radiology services. Extensive imaging capabilities support multiple diagnostic goals, including primary diagnosis, the tracking of treatment process, pre-surgical testing and post-operative analysis. Exams are performed by certified technologist that use state of the art equipment coupled with the very latest advances in imaging techniques to ensure consistent high quality images, expert analysis and uncompromised quality. 133486781 true true false true false false false false false true true false false true true true false true false false false false false false false false true true false false true true false false false false false false false false false false false false false false false true false false false true 17 0 true 1179 true false false false false false false false false false false false false false false false X 32 27 true false false false false true true true true false false true true true true true true true true false NY X X NORTHWELL HEALTH INC 5168766061 972 BRUSH HOLLOW ROAD 5TH FL WESTBURY NY 11590 MICHAEL J DOWLING PRESIDENT & CEO 0.0 50.0 X X 0 4026026 51426 RICHARD D GOLDSTEIN IMMEDIATE PAST CHAIRMAN 0.0 2.0 X X 0 0 0 WILLIAM L MACK VICE CHAIRMAN 0.0 2.0 X X 0 0 0 BARRY RUBENSTEIN VICE CHAIRMAN 0.0 2.0 X X 0 0 0 ALAN I GREENE TREASURER 0.0 2.0 X X 0 0 0 DONALD ZUCKER SECRETARY 0.0 2.0 X X 0 0 0 MARK CLASTER CHAIRMAN 0.0 3.0 X X 0 0 0 RALPH NAPPI TRUSTEE & EVC 0.0 50.0 X X 0 947428 45453 NON-COMPENSATED TRUSTEES SEE SCHEDULE O 0.0 2.0 X 0 0 0 HOWARD B GOLD EVP, MGD CARE BS DVLP OFFICER 0.0 50.0 X 0 1812973 37583 MARK J SOLAZZO EVP, CHIEF OPERATING OFFICER 0.0 50.0 X 0 2398244 600022 ROBERT S SHAPIRO EVP & CFO 0.0 50.0 X 0 3571801 373568 LAWRENCE G SMITH MD EVP/PHYSICIAN-IN-CHIEF 0.0 50.0 X 0 1287293 46028 JEFFREY KRAUT SVP, STRATEGIC PLANNING & BUS 0.0 50.0 X 0 1272461 413713 KATHLEEN GALLO RN PHD svp CHF LEARNING OFFICER 0.0 50.0 X 0 903337 45453 EUGENE TANGNEY SVP, CHIEF ADMIN OFFICER 0.0 50.0 X 0 1224832 247944 HARRY GINDI ASSISTANT SECRETARY 0.0 50.0 X 0 376124 45417 DONNA DRUMMOND SVP, CONSOLIDATED SERVICES 0.0 50.0 X 0 911460 236725 Laura Peabody SVP & Chief Legal Officer 0.0 50.0 X 0 1140697 210317 Andrew Schulz GEN COUNSEL & ASST SECRETARY 0.0 50.0 X 0 1093281 53304 ANTHONY FERRERI EVP/CHF AFFILIATION OFF 0.0 50.0 X 0 3231532 369606 SUSAN KWIATEK EXECUTIVE DIRECTOR 50.0 0.0 X 555199 0 53250 KEVIN BEINER SVP/DEPUTY REG EXEC DIR 0.0 50.0 X 0 629990 37602 JOHN DANGELO SVP EMERGENCY SERVICES 50.0 0.0 X 968866 0 53304 MICHAEL GRIECO PHYSICIAN 50.0 0.0 X 601456 0 45453 HIRAL SHAH PHYSICIAN - ED 50.0 0.0 X 513413 0 29750 BRADLEY SHERMAN MEDICAL DIRECTOR (SITE) 50.0 0.0 X 479388 0 53304 STEVEN WECK RADIOLOGIST 50.0 0.0 X 439269 0 53304 3557591 24827479 3102526 188 false true false AG LANDSCAPING 3 ST JAMES PL GLEN COVE NY 11542 Maintenance Services 196494 STAPLES ADVANTAGE 500 STAPLES DRIVE FRAMINGHAM MA 01702 Printing Services 151900 SIEMENS MEDICAL SOLUTIONS USA INC PO BOX 7777 W3580 PHILADELPHIA PA 19175 General Contractor 131220 ISLANDWIDE LOCKSMITH INC 130 DUFFY PLACE WEST ISLIP NY 11795 Maintenance Services 117739 LOGIXHEALTH INC 8 OAK PARK DRIVE BEDFORD MA 01730 General Contractor 114879 7 33028 33028 NET PATIENT SERVICE REVENUE 621300 72956939 72956939 PHYSICIAN PRACTICE REVENUE 621300 17228871 17228871 MEDICARE/MEDICAID PAYMENTS 621300 39588210 39588210 129774020 1308991 1308991 2690 2690 0 293855 23271 270584 0 270584 42092898 41243484 849414 849414 0 0 0 0 0 0 0 0 0 CAPITATION INCOME 900099 986445 986445 RESIDENCY ROTATION 900099 426836 426836 CAFETERIA SALES 900099 405519 405519 217182 210798 6384 2035982 134274709 131398099 1723584 0 0 0 0 555199 555199 0 73199378 70392205 2806483 690 6771899 6512199 259636 64 8465936 8141270 324586 80 5058868 4864862 193958 48 240050 240050 0 600 600 0 0 0 941488 905382 36097 9 17992 17302 690 18346390 17642812 703405 173 0 0 2470512 2375769 94720 23 109524 109524 0 184984 184984 307098 307098 0 6416350 6170285 246065 2647007 2647007 MEDICAL & OTHER PURCHASED SERV 9336965 9336965 BAD DEBT 2158204 2158204 CENTRALIZED ADMIN EXP 2946254 2946254 BILLING & COLLECTIONS 1186512 1186512 297718 286300 11415 3 141658928 133486781 8171057 1090 15435 4527 72570516 77699436 0 0 10943305 13051434 0 0 0 0 0 0 1133601 1057214 158183 155824 93907293 47740990 50199173 46166303 4071035 4388285 0 0 0 0 0 0 20618558 15029718 159709806 157552741 18841149 16967641 0 0 0 0 7814510 7098327 0 0 0 0 0 0 0 0 56349537 59741910 83005196 83807878 X 66357981 61886327 7511415 8990295 2835214 2868241 76704610 73744863 159709806 157552741 X -7384219 3242448 1182024 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false true 2780 false 2780 false false SCHEDULE C, PART 11-B, line 1 h GLEN COVE HOSPITAL IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION AND OTHER HEALTH CARE ASSOCIATIONS WHICH ENGAGE IN LOBBYING EFFORTS ON BEHALF OF THEIR MEMBER HOSPITALS. 3786158 33028 302964 302964 3819186 3773141 43098 -30081 0 3786158 3593291 35454 156873 12477 3773141 3105645 37797 487646 37797 3593291 2713081 20454 392564 20454 3105645 1.00000 false false 174043 174043 68473032 35658785 32814250 23004045 11835486 11168559 2256173 246722 2009451 46166303 INTEREST IN FOUNDATION,UNREST. 4480474 BOND FINANCING 51409 DEPOSITS ON EQUIPMENT 16973 OTHER ASSETS 306675 AUXILIARY 46134 INSURANCE CLAIMS RECEIVABLE 10128053 15029718 0 ESTIMATED PAYABLE TO 3RD PARTY 12195837 OTHER LIABILITIES 950218 MALPRACTICE INSURANCE 13321649 PENSION 16318180 BOND PREM/DISC 354427 INSURANCE CLAIMS LIABILITY 10128053 DUE TO AFFILIATES 6473546 59741910 X 135046234 3094029 -2158204 935825 134110409 164300 164300 134274709 137774119 23271 23271 137750848 3908080 3908080 141658928 PART X, LINE 2 Certain entities included in Northwells consolidated financial statements are taxable entities under Federal or state laws. U.S. generally accepted accounting principles require that the asset and liability method of accounting for income taxes be utilized by these organizations and for unrelated business activities for the tax-exempt entities. Under the asset and liability method, deferred income taxes are recognized for the tax consequences of temporary differences by applying enacted statutory tax rates applicable to future years to differences between the financial statement carrying amounts and the tax basis of existing assets and liabilities. The effect on deferred taxes of a change in tax rates is recognized in income in the period of enactment. At December 31, 2016 and 2015, Northwell has a deferred income tax asset which has been fully offset by a related valuation allowance. A valuation allowance is provided when it is more likely than not that some portion or all of the deferred tax asset will not be realized. Significant components of the deferred tax asset relate to the allowance for doubtful accounts and net operating loss carryforwards. Certain entities have net operating loss carryforwards aggregating approximately $408,000,000, which expire in varying amounts through 2036, and are available to offset future taxable income. PART V, LINE 4 There are various components that encompass the Endowment Fund. In general, their intended use is for teaching, research and training, major modernization, and purchases of equipment. PART XI, LINE 2D PROVISION FOR BAD DEBTS (2,158,204) Total (2,158,204) PART XI, LINE 4B RESTRICTED CONTRIBUTIONS 33,028 RESTRICTED INVESTMENT INCOME 154,543 rental Expense (23,271) Total 164,300 PART XII, LINE 2d Rental expense 23,271 PART XII, LINE 4B ADDITIONAL MINIMUM LIABILITY ON PENSION 1,749,876 PROVISION FOR BAD DEBT 2,158,204 total 3,908,080 true true X true X true X 500. true true true false true true 4240580 780407 3460174 0.02510 18930560 11802070 7128490 0.05170 23171140 12582477 10588664 0.07680 692604 79000 613604 0.00450 3079966 1399085 1680881 0.01220 2374 2374 124799 124799 0.00090 3899743 1478085 2421658 0.01760 27070883 14060562 13010322 0.09440 11849 11849 0.00010 15110 15110 0.00010 5143 5143 1128 1128 33230 33230 0.00020 false 1780226 43630524 47492049 -3861525 X true true 1 1 GLEN COVE HOSPITAL 101 ST ANDREWS LANE GLEN COVE NY 11542 WWW.NORTHWELL.EDU 2901000H X X X X GLEN COVE HOSPITAL 1 false false true X X X X X X X X X 16 true true true true X WWW.NORTHWELL.EDU X true 16 true WWW.NORTHWELL.EDU/ABOUT/OUR-ORGANIZATION/OFFI false true X 100 500. X X X X true true X X X true X WWW.NORTHWELL.EDU X WWW.NORTHWELL.EDU X WWW.NORTHWELL.EDU X X X X X X X true X false X X X X X true X false false Part V, Section C, Supplemental Information Part V, Section B, line 2: N/A Part V, Section B, line 3j: N/A Part V, Section B, line 5: The CHNA was facilitated by committees established within each county served by Northwell and its hospitals. These were comprised of participants such as Departments of Health; community based organizations (CBOs); Northwell; local businesses; and faith-based organizations; and a "voice of the community" (i.e. the community's perception of need). Qualitative data was collected from diverse community organizations that serve the population-at-large, as well as those communities with significant health disparities. Community partners were invited to participate via surveys and key informant interviews. Emphasis was placed on the following populations: minorities/underserved communities, seniors, women and children, special populations, and individuals with disease-specific conditions. Primary data was obtained through qualitative analysis of CBO informant interviews, CBO surveys, individual community member surveys, and participation in the collaborative partner listening sessions. For further detail go to web link: https://www.northwell.edu/about/our-organization/office-community-and-publ ic-health/reports Part V, Section B, line 6a: For a detailed listing of other hospital facilities go to web link: https://www.northwell.edu/about/our-organization/office-community-and-publ ic-health/reports Part V, Section B, line 6b: For a detailed listing of other than hospital facilities go to web link: https://www.northwell.edu/about/our-organization/office-community-and-publ ic-health/reports Part V, Section B, line 7d: N/A Part V, Section B, line 11: The hospital identified and addressed primary needs based on an assessment of the highest ranked health priorities of the community, regulatory input (i.e. the NYC Department of Health prevention priority agenda), and resources available. For further information go to web link: https://www.northwell.edu/about/our-organization/office-community-and-publ ic-health/reports Part V, Section B, line 13b: N/A Part V, Section B, line 13h: The hospital also uses household size. Part V, Section B, line 15e: N/A Part V, Section B, line 16j: The policy is included in the hospital's Community Service Plan and provided at health fairs and presentations open to the community at no cost, in addition to mailing financial policy summary brochures. Part V, Section B, line 18e: N/A Part V, Section B, line 19e: N/A Part V, Section B, line 20e: Before initiating any of the actions, the hospital facility sends letters, makes telephone calls and utilizes presumptive eligibility. Part V, Section B, line 21c: N/A Part V, Section B, line 21d: N/A Part V, Section B, line 23: N/A Part V, Section B, line 24: N/A 5 Northwell Health Physician Partners 10 Medical Plaza Ste 208 Glen Cove NY 11542 Outpatient Physician Clinic Orthopaedic Associates of Great Neck 825 Northern Boulevard Ste 300 Great Neck NY 11021 Outpatient Physician Clinic North Shore-LIJ Imaging at Glen Cove 10 Medical Plaza Ste 106 Glen Cove NY 11542 Diagnostic Center School Street Family Medicine 1 School Street Ste 203 Glen Cove NY 11542 Outpatient Physician Clinic Family Health Center 70 West Main Street Oyster Bay NY 11771 Family Health Center PART VI - SUPPLEMENTAL INFORMATION Question 1: Part I, Line 3c: This hospital is an affiliated entity of Northwell Health Inc. ("Northwell"). Northwell uses FPG to determine eligibility and utilizes the New York State Department of Health (NYSDOH) guidelines regarding the consideration of assets. Asset tests cannot be used to deny financial assistance, but only to "upgrade" a patient's level of obligation, up to the legal maximum permitted under the financial assistance law. Part I, Line 6a: The Community Benefit report is prepared by the hospital, in conjunction with an affiliated entity (Northwell) of the hospital. The Community Benefit Report is accessible to the public and can be accessed on the Northwell website: http://www.northwell.com. Part I, 7: Row (a) The cost of charity care was determined by utilizing the ratio of cost to charges (RCC) calculated on Worksheet 2 applied to gross charges written off for patients qualifying for charity under the hospitals financial assistance policy. Bad Debt was not reported in any row of Part I, Line 7. Row (b) The Ratio of Cost to Charges method (or RCC) is used to determine the cost of ancillary services. A RCC is developed from these costs, and that RCC is applied to total Medicaid gross ancillary services charges to determine the cost of services provided to Medicaid patients. Row (e) Costs associated with Community Health Improvement Services were determined by adding indirect or overhead costs to the direct costs of the activity. Indirect costs were calculated as a percentage of direct costs. Direct costs for staff expenses were calculated using average system hourly rates, and were adjusted to account for fringe benefits, using a blended rate based on the ratio of total employee benefit expenses to total salary and wages. Row (f) The Bad Debt Expense that appears on Form 990, Part IX, Line 25 column (A), but not included for purposes of calculating the percentage in this column is equal to the amount reported on Form 990, Part X. The costs related to health professions education were determined by utilizing the step down method of cost finding. Row (h) Costs associated with research activities were determined by adding indirect, or overhead, costs to the direct costs of the activity. Indirect costs were calculated as a percentage of costs. Row (i) The cost of in-kind contributions to community groups is comprised of the direct costs of personnel whose compensated time was donated to various charities and community groups. The salaries and wages were adjusted to include benefits using a rate based on the ratio of total employee benefit expenses to total salary and wages. Indirect costs were calculated as a percentage of direct costs. Column (f) for Rows (c)-(k) The percentage of Net Community Benefit Expense divided by Total Expense for the hospital (to calculate the percent of total expense). Note: For the entire Northwell Health Inc. and affiliates, Part I, Line 7 (Row K, Column F) is approximately 11.29 as a percentage of expenses. Part II: All community building activities improve access to health services and address federal, state, or local public health priorities, as well as leverage public health department activities, and in doing so, they provide relief of government burden. These activities broadly serve low-income, underserved patients, and include: collaboration with various community coalitions, system-wide recycling initiative, organizational response to worldly disasters, and bioterrorism efforts. Northwells bioterrorism & disaster preparedness includes Center for Emergency Medical Services, has a designated Bioterrorism Resource Center, and has conducted staff training for more than 100 hospitals and area first responders and invested heavily in the infrastructure needed for large-scale emergencies. During catastrophes (both natural and terrorism), Northwell provides a safe haven for thousands of patients, outside nursing home residents, and community members seeking shelter. Northwell assists with the transport of patients and stand ready to contribute food, medicine, and blankets for both affiliated and non-affiliated hospital patients. Investment in a field hospital has furthered the public health infrastructure needed for mass casualties that could result from a terrorist attack, natural attack, or large-scale emergency. Part III, Line 2: For patients who were determined by Northwell to have the ability to pay but did not, the uncollected amounts are recorded as bad debt expense. The amount of gross charges written off is reduced by any charity care or other discounts provided to the patient, as well as any payments received. Bad debt expense reported on this line is reported net of governmental or private offsetting funds. Part III, Line 3: N/A Part III, Line 4: For patients who were determined by Northwell to have the ability to pay but did not, the uncollected amounts are recorded as bad debt expense. Part III, Line 8: Medicare costs are determined utilizing a combination of the step down method of cost findings and a cost per unit of service. Cost per unit of service is used to calculate the routine cost of services provided to Medicare patients. The Ratio of Cost to Charges method (or RCC) is used to determine the cost of ancillary services. An RCC is developed from these costs, and that RCC is applied to total Medicare gross ancillary services charges to determine the cost of services provided to Medicare patients. Part III, Line 9b: The organizations collection policy is standard to all accounts regardless of insurance status (e.g. insured, underinsured, and uninsured). The hospitals collection policy states that they will not send patient accounts to collection if a decision on a financial assistance application is pending, or if a patient is determined to be eligible for Medicaid at the time services were rendered and for which services Medicaid payment is available. Question 2: NEEDS ASSESSMENT: The Community Health Needs Assessment (CHNA) is performed on an ongoing basis. Northwell conducts and participates in population, demographic, and health status evaluations of our respective hospitals service areas based on county regions and the communities we serve. There is a special effort to include individuals with health disparities and organizations who serve these communities in the CHNA process. The CHNA includes the analysis of primary and secondary data. Multi-year analyses, trends and projections are developed, which identify areas of need for the continuum of health care services. Primary data is obtained through a combination of qualitative analysis of community-based organization (CBO), informant interviews and surveys, individual community member surveys, and participation in collaborative partner meetings. These meetings include representatives from the Departments of Health, CBOs, academic institutions, government agencies, and hospitals. Ongoing input concerning our communities needs is also obtained through: our Board of Trustees/Directors who are all area residents and leaders in their respective communities; facility based advisory boards and councils, and; the feedback received by our facility administrators and clinicians that serve on local community agency boards. Secondary data analysis includes: internal hospital data, including Prevention Quality Indicators (PQI); Department of Health Community Health Assessments; local regional NYS Prevention Agenda data sources; and Statewide Planning and Research System (SPARCS) data. The Committee on Community Health, a committee of the Board of Trustees, provides recommendations that concern Northwells community health priorities and interventions based on the CHNA. Committee discussions focus on New York State (NYS) Prevention Agenda Priority Areas, including strategies and intervention outcomes related to chronic disease prevention, women and childrens health, healthy safe environments, health access, mental health and substance abuse, HIV/AIDS/STDs and community immunizations. Regional departments of health (I.E. Nassau County Department of Health, Suffolk County Department of Health Services, and NYC Department of Health and Mental Hygiene) perform additional community health assessments (CHA) with the input of hospital and community stakeholders. These regional partners use strategies such as community member surveys, CBO surveys, and public listening sessions to solicit information on community needs. Together with other healthcare organizations and CBOs, Northwell participates in meetings organized by these regional departments of health academic organizations to discuss the shared responsibility of public health planning within the NYS Prevention Agenda. These meetings provide an opportunity for general discussion regarding the public health goals of the NYS Prevention Agenda and the selection of shared priorities for collaborative regional planning. The partnership among local health departments, hospitals and CB X X X X X false true false true false false false true false MICHAEL J DOWLING PRESIDENT & CEO 0 1474510 0 2528000 0 23516 0 29150 0 22276 0 4077452 0 0 HOWARD B GOLD EVP, MGD CARE BS DVLP OFFICER 0 1079110 0 701250 0 32613 0 29150 0 8433 0 1850556 0 0 MARK J SOLAZZO EVP, CHIEF OPERATING OFFICER 0 1368841 0 1000000 0 29403 0 589158 0 10864 0 2998266 0 0 ROBERT S SHAPIRO EVP & CFO 0 1167747 0 371250 0 2032804 0 357265 0 16303 0 3945369 0 1195740 LAWRENCE G SMITH MD EVP/PHYSICIAN-IN-CHIEF 0 933759 0 324675 0 28859 0 29150 0 16878 0 1333321 0 0 JEFFREY KRAUT SVP, STRATEGIC PLANNING & BUS 0 918272 0 320625 0 33564 0 389559 0 24154 0 1686174 0 0 KATHLEEN GALLO RN PHD svp CHF LEARNING OFFICER 0 671809 0 196875 0 34653 0 29150 0 16303 0 948790 0 0 EUGENE TANGNEY SVP, CHIEF ADMIN OFFICER 0 960697 0 253125 0 11010 0 223790 0 24154 0 1472776 0 0 HARRY GINDI ASSISTANT SECRETARY 0 296913 0 74884 0 4327 0 29150 0 16267 0 421541 0 0 DONNA DRUMMOND SVP, CONSOLIDATED SERVICES 0 653272 0 196875 0 61313 0 212571 0 24154 0 1148185 0 0 RALPH NAPPI TRUSTEE & EVC 0 719676 0 196875 0 30877 0 29150 0 16303 0 992881 0 0 SUSAN KWIATEK EXECUTIVE DIRECTOR 403152 0 112159 0 39888 0 29150 0 24100 0 608449 0 0 0 Laura Peabody SVP & Chief Legal Officer 0 888245 0 239063 0 13389 0 191309 0 19008 0 1351014 0 0 Andrew Schulz GEN COUNSEL & ASST SECRETARY 0 743505 0 317969 0 31807 0 29150 0 24154 0 1146585 0 0 JOHN DANGELO SVP EMERGENCY SERVICES 690302 0 201090 0 77474 0 29150 0 24154 0 1022170 0 0 0 MICHAEL GRIECO PHYSICIAN 476848 0 0 0 124608 0 29150 0 16303 0 646909 0 0 0 ANTHONY FERRERI EVP/CHF AFFILIATION OFF 0 856309 0 303750 0 2071473 0 353303 0 16303 0 3601138 0 1468574 HIRAL SHAH PHYSICIAN - ED 104567 0 15000 0 393846 0 29150 0 600 0 543163 0 0 0 BRADLEY SHERMAN MEDICAL DIRECTOR (SITE) 381812 0 65580 0 31996 0 29150 0 24154 0 532692 0 0 0 STEVEN WECK RADIOLOGIST 388809 0 10000 0 40460 0 29150 0 24154 0 492573 0 0 0 KEVIN BEINER SVP/DEPUTY REG EXEC DIR 0 483179 0 118125 0 28686 0 29150 0 8452 0 667592 0 0 PART I, LINE 4B Certain individuals participate in a Supplemental Executive Retirement Plan ("SERP") which is subject to substantial risk of complete forfeiture. Accordingly, the individual may never actually receive the unvested benefit amount and the amounts outlined herein were properly not reported in each individual's Form W-2, Box 5. These amounts are included in Schedule J, Column C for Mark J Solazzo ($560,008), Robert S Shapiro ($328,115), Donna Drummond ($183,421), Jeffrey Kraut ($360,409), Eugene Tangney ($194,640), Laura Peabody ($162,159), and Anthony Ferreri ($324,153). PART I, LINE 5A Pursuant to the persons listed in Form 990, Part VII, section A, line 1A, there is no contractual obligation to pay or accrue any compensation to officers of the Northwell Health, Inc. based on the revenue of the organization. A listed person(s) that may qualify under this condition could be one or more of the physicians listed as a highly compensated employee. PART I, LINE 7 On Form 990, Part VII, Section A, line 1A, the organization may provide non-fixed payments, not described on lines 5 and 6, to certain listed persons. The organization bases such payments on many performance based factors. Payments of this type appear on Schedule J, Part II, B (ii). Schedule J, Part II, Column (F) The amount reported in Schedule J, Part II, Column (F) includes SERP amounts which were previously reported on Form 990, Schedule J, Part II, Column (C) in prior years. In accordance with the IRS instructions, these amounts were originally reported when contributions were made to the SERP plan and are now being reported for a second time upon receipt of distribution from the SERP plan. A DORMITORY AUTHORITY OF THE STATE OF NEW YORK 146000293 649903LC3 2007-05-31 2982870 2007 A&B Bonds-CAP IMPROV & REFUND true false false B DORMITORY AUTHORITY OF THE STATE OF NEW YORK 146000293 649905QL3 2009-09-17 1412648 2009 A&E BONDS - CAP IMPROV & REFI true false false C DORMITORY AUTHORITY OF THE STATE OF NEW YORK 146000293 649906UY8 2012-05-03 2967249 2012 A BONDS-REFUNDING 1998 BONDS false false false D DORMITORY AUTHORITY OF THE STATE OF NEW YORK 146000293 64990BNL3 2015-06-23 3087445 2015 A BONDS - REFUND 2005 false false false A 1774677 1908751 4281646 47499 64491 134907 43251 0 0 1026245 3012752 0 2009 true true true true B 134164 957416 1401700 22047 109238 0 22900 0 51450 986675 231437 0 2012 true false true true C 856579 0 3399354 0 0 0 64062 0 0 0 3335292 0 2012 true false true true D 39540 0 3379418 0 19461 2118072 30889 0 0 308885 772442 0 true true false true A false false true true 0.00460 0.00460 false false false true B false false false false 0 false false false true C false false false false 0 false false false true D false false false false 0 false false false true A false false true true false true CITIBANK NA 25.9 true false true MBIA 18.1 true true true B false false true true false false 0 false 0 true true C false false true true false false 0 false 0 false true D false true true false false false 0 false 0 false true A true B true C true D true PART II, LINE 3 - PROCEEDS, THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO INVEST EARNINGS & TRANSFERRED PROCEEDS PART IV, LINE 2C - REBATE CALCULATION PERFORMED ON 11/3/2012 FOR 2012 BOND , SINCE BOND PROCEEDS HAVE BEEN SPENT A SPENDING EXCEPTION WAS MET PART VI, SECTION A - GOVERNING BODY, LINE 2 All transactions with Northwell health entities are as follows: (1) negotiated at arm's length; (2) all purchases are at fair market value; and (3) all products or services are rendered on an "as needed" basis. Roger Blumencranz has a business relationship with Richard D. Goldstein, Alan Greene, Ralph Nappi, Mark Solazzo and Donald Zucker. Mark Claster has a business relationship with Robert Rosenthal. Lloyd Goldman has a business relationship with Richard Goldstein and William Mack. Richard D. Goldstein has a business relationship with Roger Blumencranz, Lloyd Goldman, William Mack and Barry Rubenstein. Saul Katz has a business relationship with Seth Lipsay, F.J. McCarthy and Robert Rosenthal. Jeffrey Lane has a business relationship with William Mack. Seth Lipsay has a business relationship with Saul Katz and Robert Rosenthal. William Mack has business relationships with Lloyd Goldman, Richard Goldstein, Jeffrey Lane, Barry Rubenstein and Roy Zuckerberg. F.J. McCarthy has a business relationship with Saul Katz and Robert Rosenthal. Ralph Nappi has a business relationship with Roger Blumencranz. Robert Rosenthal has a business relationship with Mark Claster, Saul Katz, Seth Lipsay and F.J. McCarthy. Barry Rubenstein has a business relationship with Richard Goldstein and William Mack. Mark Solazzo has a business relationship with Roger Blumencranz. Donald Zucker has a business relationship with Roger Blumencranz. Roy Zuckerberg has a business relationship with William Mack. PART VI, SECTION B - POLICIES, LINE 11 The annual Return of Organization Exempt From Income Tax (Form 990) for Northwell Health, Inc. and Affiliated entities are prepared with input from various departments including Corporate Compliance, Finance, Human Resources, and Legal. Before filing the returns, the documents are electronically made available to all trustees through a secure online portal. Members of the Executive Committee are then informed the returns are ready for review. The Executive Committee, which is a committee made up of members from the Board of Trustees, may exercise all of the authority of the Board of Trustees except as such authority is limited by applicable law and except to the extent, if any, that such authority would be inconsistent with any provision of these By-laws or is limited by any resolution to such effect adopted by the Board of Trustees. PART VI, SECTION B-POLICIES, LINE 12C Northwell Health, Inc. ("Northwell") has several control mechanisms to mitigate conflicts of interest. Northwells Code of Ethical Conduct contains a detailed section educating individuals about how to avoid potential conflicts of interest. Specifically, our Code of Ethical Conduct requires individuals to conduct Northwell business in a manner that places the interests of Northwell ahead of their personal interests. In addition, Northwell has a Conflicts of Interest Policy Statement further elaborating upon individuals' disclosure and recusal obligations. Individuals that are in a position to influence the business or other decisions of Northwell are required to fill out a conflicts of interest disclosure form on a regular basis. The Corporate Compliance Office reviews all disclosures of possible conflicts, including matters disclosed in any conflicts of interest disclosure report and takes any actions deemed required or appropriate to manage or resolve any actual or potential conflicts of interest. In appropriate cases these disclosures and responsive actions will be reported to Northwells Audit and Corporate Compliance Committee and other applicable committees. In addition, Northwell provides training to individuals on an annual basis regarding conflicts of interest and other compliance related topics. If an individual violates the Code of Ethical Conduct or any related policy such as the Conflicts of Interest Policy Statement, appropriate disciplinary action is taken based upon the facts and circumstances of the situation. PART VI, SECTION B-POLICIES, LINE 15 The by-laws of Northwell Health, Inc. ("Northwell") create a committee of the board with full powers of the board to review and approve the compensation of officers and other key employees. The committee consists of approximately 6 trustees who have no connection to Northwell except as trustees and they have no conflicts as to matters they consider. The committee meets several times a year as needed but always meets in November/December to review and determine officer and key employee compensation for the following year. For purposes of their review the committee considers the recommendations of the CEO for all persons other than the CEO. For purposes of the review each year the committee receives information from an outside independent compensation consultant as to compensation for comparable positions in comparable organizations and makes its decisions on this basis, with the overall objective of paying base salary at the 50th percentile. Any contracts or other compensation for officers or key employees are separately considered and normally only approved after receipt of a "fairness opinion" from the independent consultant. All the work and process of the committee is structured to fall within the applicable safe harbor regulations. PART VI, SECTION C-DISCLOSURES, LINE 19 CURRENTLY THE ORGANIZATION MAKES IT GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. PART VII, SECTION A - LINE 1A Frank J. Besignano Alan I. Greene Charles Merinoff Roger A. Blumencranz Paul B. Guenther Ralph A. Nappi Robert W. Chasanoff William O. Hiltz Richard B. Nye Mark. Claster Nancy Karch Sharon Patterson Michael J. Dowling Saul B. Katz Lewis S. Ranieri Michael A. Epstein Cary Kravet Robert D. Rosenthal Michael E. Feldman Jeffrey B. Lane Barry Rubenstein Catherine C. Foster Seth Lipsay Richard J. Sinni William H. Frazier William L. Mack Donald Zucker Lloyd M. Goldman F.J. McCarthy Roy J. Zuckerberg Richard D. Goldstein Patrick F. McDermott PART VII, SECTION A - LINE 1A, COLUMN (B) This organization is affiliated with Northwell Health, Inc. ("Northwell"). The Officers, Directors and Trustees listed on Schedule J hold similar positions with both this organization and other affiliates of Northwell, and they do not separately allocate their time to this organization and such other affiliates. The hours shown for all such persons reflect time devoted to Northwell and its affiliates, including this organization. For Directors and Trustees, the hours shown reflect the estimated average weekly time. For officers, Key Employees and Highest Compensated Employees, the hours shown reflect the weekly hours used when determining compensation payments for services rendered and are, generally, less than the actual weekly hours devoted to Northwell and its affiliates. PART VI, SECTION A - GOVERNING BODY, LINE 7 Northwell Healthcare, Inc. ("Northwell Healthcare") is the sole corporate member of the organization. Northwell Healthcare has the right to elect or appoint member of the organization's governing body and has the right to approve or ratify certain corporate decisions. This organization and Northwell Healthcare are part of Northwell Health, Inc., an integrated health care delivery system. PART XI, LINE 9 CHANGE IN EQUITY UNDER FAS 136 1,175,916 INCREASE IN AUXILIARY ASSETS 6,108 TOTAL 1,182,024 NORTHWELL HEALTH INC 972 BRUSH HOLLOW RD WESTBURY NY 11590 113418133 SUPPORT ORG NY 501(C)(3) 11, TYPE I NA false NORTHWELL HEALTHCARE INC 972 BRUSH HOLLOW RD WESTBURY NY 11590 112965586 SUPPORT ORG NY 501(C)(3) 11, TYPE I NW HEALTH false NORTH SHORE UNIVERSITY HOSPITAL 972 BRUSH HOLLOW RD WESTBURY NY 11590 111562701 HEALTH CARE NY 501(C)(3) 3 NW HEALTHCAR false LONG ISLAND JEWISH MEDICAL CENTER 972 BRUSH HOLLOW RD WESTBURY NY 11590 112241326 HEALTH CARE NY 501(C)(3) 3 NW HEALTHCAR false PLAINVIEW HOSPITAL 972 BRUSH HOLLOW RD WESTBURY NY 11590 113241243 HEALTH CARE NY 501(C)(3) 3 NW HEALTHCAR false SOUTHSIDE HOSPITAL 972 BRUSH HOLLOW RD WESTBURY NY 11590 111667761 HEALTH CARE NY 501(C)(3) 3 NW HEALTHCAR false NORTHWELL HEALTH LABORATORIES 972 BRUSH HOLLOW RD WESTBURY NY 11590 113412370 SUPPORT ORG NY 501(C)(3) 11, TYPE I NW HEALTH false FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH 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