2017-11-14T10:15:10-06:00 2016-12-31 990 2016-01-01 111667761 SOUTHSIDE HOSPITAL c/o NORTHWELL HEALTH INC % NORTHWELL HEALTH INC SOUT 5163216025 972 BRUSH HOLLOW ROAD WESTBURY NY 11590 ROBERT S SHAPIRO EXEC VP & CFO 5163216025 2017-11-03 69.27.229.129 11751920173185000000 2017-11-14 P 64888C196846E503F90B13161ED1827B039267C6 08A1259C5F1059ABDC7B7C0B44F2F73D70A20910 2016 2017-02-10 21:41:12Z MICHAEL J DOWLING 2000 MARCUS AVENUE NEW HYDE PARK NY 11042 535870234 false X WWW.NORTHWELL.EDU X 1975 NY Southside strives to improve the health of the communities it serves and is committed to providing the highest quality clinical care and caring for the entire community. 32 27 3603 287 246825 -88933 86482 70747 474529769 526186792 153634 68652 4112746 4811327 478882631 531137518 0 0 0 0 314254680 341145019 0 0 291994 182135636 197098143 496390316 538243162 -17507685 -7105644 297324490 322191360 387033143 417239230 -89708653 -95047870 SOUTHSIDE HOSPITAL IS PART OF NORTHWELL HEALTH ("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 361384841 438008097 Southside Hospital is a 339-bed tertiary hospital with the following inpatient services: medical/surgical, intensive and cardiac care unit, OB/GYN with a Level II Perinatal service, pediatrics, medical rehabilitation, brain injury and psychiatry. The Emergency Department is a designated Area Trauma Center and provides the Paramedic First Responder Program to the Town of Islip Residents. In 2016, Southside Hospital had 20,206 inpatient discharges, delivered 2,430 babies, provided 65,971 emergency department visits and performed 13,124 ambulatory surgeries, including endoscopies and cardiac catheterizations. 116354709 85302182 Southside 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. 2567040 2876513 Southside Hospital is a participant in New York State's Delivery System Reform Incentive Payment (DSRIP) program. The program's goals include reducing avoidable hospitalizations and ensuring that patients with Medicaid switch to a community-based care system that emphasizes preventative care over reliance on the emergency room. Among dozens of participants in DSRIP, Southside embodies the core values of this life-changing opportunity for hundreds of thousands of patients, many of whom live in lower-income and underserved communities where health and wellness can be improved. 480306590 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 true false false false false false false false false true true false false false false true true true false false false true 154 0 true 3603 true true true 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 WESTBURY NY 11590 MICHAEL J DOWLING PRESIDENT & CEO 0.0 50.0 X X 0 4026026 51426 RALPH NAPPI TRUSTEE & EVC BOARD 0.0 50.0 X X 0 947428 45453 MARK CLASTER CHAIRMAN 0.0 3.0 X X 0 0 0 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 NON-COMPENATED TRUSTEES SEE SCHEDULE O 0.0 2.0 X 0 0 0 MARK J SOLAZZO EVP, CHIEF OPERATING OFFICER 0.0 50.0 X 0 2398244 600022 ROBERT S SHAPIRO EXEC VP & CFO 0.0 50.0 X 0 3571801 373568 HOWARD GOLD EVP CHF MANAGED CARE & BUS DEV 0.0 50.0 X 0 1812973 37583 LAWRENCE G SMITH MD EVP/PHYSICIAN IN CHIEF 0.0 50.0 X 0 1287293 46028 JEFFREY KRAUT EVP, STRATEGY & ANALYTICS 0.0 50.0 X 0 1272461 413713 KATHLEEN GALLO RN PHD SR VP, CHIEF LEARNING OFFICER 0.0 50.0 X 0 903337 45453 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 SVP & GENERAL COUNSEL 0.0 50.0 X 0 1093281 53304 EUGENE S TANGNEY SVP, CHIEF ADMIN OFFICER 0.0 50.0 X 0 1224832 247944 HARRY GINDI ASST SECRETARY 0.0 50.0 X 0 376124 45417 ANTHONY FERRERI EVP/CHF AFFILIATION OFF 0.0 50.0 X 0 3231532 369606 KEVIN BEINER REGIONAL EXECUTIVE DIRECTOR 0.0 50.0 X 0 629990 37602 DONNA MORAVICK EXECUTIVE DIRECTOR 50.0 0.0 X 915660 0 45453 HAROLD FERNANDEZ Director 50.0 0.0 X 1995041 0 53250 BENJAMIN SCHWARTZ Chf, OB/GYN 50.0 0.0 X 1620264 0 44352 MICHAEL NETT Coord (MD) 50.0 0.0 X 1327240 0 53250 EDWARD HALLAL PHYSICIAN 50.0 0.0 X 1081545 0 37583 JED POLLACK Chairperson 50.0 0.0 X 899475 0 53304 7839225 24827479 3101353 659 false true false NEW YORK PAIN CONSULTANTS LLC 500 WEST MAIN STEET SUITE 116 BABYLON NY 11702 PHYSICIAN SERVICES 3112134 GE HEALTHCARE 80 E SEAVIEW BLVD PORT WASHINGTON NY 11050 CONSULTING SERVICES 1686604 CROSS COUNTRY STAFFING PO BOX 404674 ATLANTA GA 303844674 NURSING SERVICES 1345215 UNITEX TEXTILE RENTAL 155 SOUTH TERRACE AVE MOUNT VERNON NY 10550 LINEN SERVICES 1308599 PERSANTE SLEEP CARE INC 130 GAITHER DRIVE SUITE 124 MT LAUREL NJ 08054 SLEEP CARE SERVICES 904587 93 67822 2925 70747 PATIENT SERVICE 621300 307998477 307998477 PHYSICIAN BILLING 621300 87309935 87309935 MEDICARE/MEDICAID PAYMENTS 621300 128001867 128001867 DSRIP PAYMENTS 621300 2876513 2876513 526186792 539 539 186127 186127 0 0 0 0 4614702 4698761 33955 -84059 -33955 -118014 0 0 0 0 0 0 0 0 0 CAFETERIA 900099 1348794 1348794 ELECTRONIC HEALTH RECORD INCOME 900099 700000 700000 RENTAL INCOME 561000 645110 645110 2117423 1870598 246825 4811327 531137518 529402500 246825 1535460 0 0 0 0 915660 915660 0 267834742 250023732 17632900 178110 19680582 18371823 1295671 13088 36142023 33738579 2379410 24034 16572012 15469974 1091018 11020 725862 677592 47787 483 65857 65857 0 0 0 0 9448649 8820314 622052 6283 189133 176555 12452 126 86489432 81075116 5360173 54143 0 0 6558941 6122771 431808 4362 478639 478639 0 1098583 1098583 1789388 1789388 0 14770276 13788053 982223 12342902 12342902 BAD DEBT EXPENSE 7895853 7895853 OTHER PURCHASED SERVICES 24067522 24067522 BILLING & COLLECTION 4656877 4347195 309682 CENTRALIZED ADMIN EXPENSE 25560693 25560693 959536 895727 63464 345 538243162 480306590 57644578 291994 1290 38107 0 0 0 0 50447689 57949572 0 0 0 0 0 0 5945606 6518156 397771 600236 270938532 84170818 148634775 186767714 33823587 18507393 0 0 0 0 0 0 58073772 51810182 297324490 322191360 63819167 58978359 0 0 2394048 5631178 71720000 70640000 0 0 0 0 0 0 0 0 249099928 281989693 387033143 417239230 X -112542078 -118188576 22833425 23140706 0 0 -89708653 -95047870 297324490 322191360 X -7105644 346822 1419605 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false true 23303 false 23303 false false LOBBYING ACTIVITY SOUTHSIDE 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. 4729646 4729646 98171369 40709444 57461925 385479 59571 325908 90340249 41694897 48645353 77311790 1706908 75604882 186767714 OTHER ASSETS 1388616 INTEREST IN FOUNDATION 22626050 SECURITY DEPOSITS 40163 INSURANCE CLAIMS RECEIVABLE 27755353 51810182 0 DUE TO AFFILIATES 83388716 DUE TO THIRD PARTY PAYORS 46365996 ACCRUED RETIREMENT BENEFITS 71581851 ESTIMATED MALPRACTICE LIABILIT 51726608 OTHER LONG-TERM LIABILITIES 549834 BOND PREM/DISCOUNT 1704534 INSURANCE CLAIMS LIABILITY 27755353 DEFERRED FINANCING -1083199 281989693 X 523594913 346822 -7818680 -7471858 531066771 70747 70747 531137518 532020482 532020482 6222680 6222680 538243162 PART X, LINE 2 - FIN 48 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 XI, LINE 2D & 4B - RECONCILIATION OF REVENUE INCLUDED ON BOOKS NOT ON RETURN PROVISION FOR BAD DEBT (7,895,853) NET ASSETS RELEASED FROM RESTRICTIONS 77,173 TOTAL NOT INCLUDED ON 990 (7,818,680) INCLUDED ON RETURN NOT ON BOOKS TEMP RESTRICTED CONTRIBUTIONS 70,747 TOTAL 70,747 PART XII, LINE 4B - RECONCILIATION OF EXPENSES PROVISION FOR BAD DEBTS 7,895,853 ADDITIONAL MINIMUM PENSION ADJUSTMENT (1,673,717) TOTAL 6,222,680 true true X true X true X 500. true true true false true true 7800559 1296420 6504139 0.01220 115222064 83341547 31880517 0.05990 123022623 84637967 38384656 0.07210 2133543 87500 2046043 0.00380 12802476 2459022 10343454 0.01940 4491 4491 355207 355207 0.00070 15295717 2546522 12749195 0.02390 138318340 87184489 51133851 0.09600 143460 143460 0.00030 518 518 51942 51942 0.00010 7927 7927 71388 71388 0.00010 275235 275235 0.00050 false 3532437 124635145 137898727 -13263582 X true true 1 1 SOUTHSIDE HOSPITAL 301 EAST MAIN STREET BAY SHORE NY 11706 WWW.NORTHWELL.EDU 5154000H X X X X SOUTHSIDE 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 26 Suffolk County Brentwood Family Health C 1869 Brentwood Road Brentwood NY 11717 Family Health Center Women's Healthcare Of Suffolk 3001 Expressway Drive North Islandia NY 11749 Outpatient Physician Clinic Long Island Lung 370 Main Street Bayshore NY 11706 Outpatient Physician Clinic Pediatric Consultation Center at Babylon 500 West Main Street Babylon NY 11702 Outpatient Physician Clinic Neurosurgery at Southside 270 East Main Street Bayshore NY 11706 Outpatient Physician Clinic North Shore - LIJ Orthopaedic Institute 217 East Main Street Bayshore NY 11706 Outpatient Physician Clinic Northwell Health Physician Partners 250 E Main Street Bayshore NY 11706 Outpatient Physician Clinic Southside Cardiology 280 East Main Street Bayshore NY 11706 Outpatient Physician Clinic Orthopaedic Institute At Babylon 200 West Main Street Babylon NY 11702 Outpatient Physician Clinic Diabetes and Endocrinology Center of Suf 1723 North Ocean Avenue Medford NY 11763 Outpatient Physician Clinic Dermatology Group PC 332 East Main Street Bayshore NY 11706 Outpatient Physician Clinic Northwell Health Physician Partners 180 East Main Street Bayshore NY 11706 Outpatient Physician Clinic Nassau Suffolk Family Practice 120 Route 109 West Babylon NY 11704 Outpatient Physician Clinic Oakdale ObGyn 971 Montauk Highway Oakdale NY 11769 Outpatient Physician Clinic South Shore Family Practice 369 East Main Street East Islip NY 11730 Outpatient Physician Clinic Suffolk Internal Medicine Associates 500 Montauk Highway West Islip NY 11795 Outpatient Physician Clinic Urogynecology at Suffolk 200 Motor Parkway Hauppauge NY 11788 Outpatient Physician Clinic Northwell Health Physician Partners 31 Main Road Riverhead NY 11901 Outpatient Physician Clinic Western Suffolk Gastroenterology 375 East Main Street Bayshore NY 11706 Outpatient Physician Clinic Islip Terrace Family Practice 2915 Sunrise Highway Islip Terrace NY 11752 Outpatient Physician Clinic Brightwaters Internal Medicine 200 Howells Road Bayshore NY 11706 Outpatient Physician Clinic Islip Medicine 260 Main Street Islip NY 11751 Outpatient Physician Clinic Lawrence D Campbell MD 32 East Main Street Bayshore NY 11706 Outpatient Physician Clinic Berlin GYN MD 2330 Union Boulevard Islip NY 11751 Outpatient Physician Clinic Myron Kleiner MD 285 Sills Road East Patchogue NY 11772 Outpatient Physician Clinic Dr Kami Quinn MD 76 Southhaven Avenue Medford NY 11763 Outpatient Physician Clinic 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 MARK J SOLAZZO EVP, CHIEF OPERATING OFFICER 0 1368841 0 1000000 0 29403 0 589158 0 10864 0 2998266 0 0 ROBERT S SHAPIRO EXEC VP & CFO 0 1167747 0 371250 0 2032804 0 357265 0 16303 0 3945369 0 1195740 HOWARD GOLD EVP CHF MANAGED CARE & BUS DEV 0 1079110 0 701250 0 32613 0 29150 0 8433 0 1850556 0 0 LAWRENCE G SMITH MD EVP/PHYSICIAN IN CHIEF 0 933759 0 324675 0 28859 0 29150 0 16878 0 1333321 0 0 JEFFREY KRAUT EVP, STRATEGY & ANALYTICS 0 918272 0 320625 0 33564 0 389559 0 24154 0 1686174 0 0 KATHLEEN GALLO RN PHD SR VP, CHIEF LEARNING OFFICER 0 671809 0 196875 0 34653 0 29150 0 16303 0 948790 0 0 DONNA DRUMMOND SVP, CONSOLIDATED SERVICES 0 653272 0 196875 0 61313 0 212571 0 24154 0 1148185 0 0 LAURA PEABODY SVP & CHIEF LEGAL OFFICER 0 888245 0 239063 0 13389 0 191309 0 19008 0 1351014 0 0 ANDREW SCHULZ SVP & GENERAL COUNSEL 0 743505 0 317969 0 31807 0 29150 0 24154 0 1146585 0 0 EUGENE S TANGNEY SVP, CHIEF ADMIN OFFICER 0 960697 0 253125 0 11010 0 223790 0 24154 0 1472776 0 0 HARRY GINDI ASST SECRETARY 0 296913 0 74884 0 4327 0 29150 0 16267 0 421541 0 0 RALPH NAPPI TRUSTEE & EVC BOARD 0 719676 0 196875 0 30877 0 29150 0 16303 0 992881 0 0 ANTHONY FERRERI EVP/CHF AFFILIATION OFF 0 856309 0 303750 0 2071473 0 353303 0 16303 0 3601138 0 1468574 KEVIN BEINER REGIONAL EXECUTIVE DIRECTOR 0 483179 0 118125 0 28686 0 29150 0 8452 0 667592 0 0 DONNA MORAVICK EXECUTIVE DIRECTOR 713036 0 190059 0 12565 0 29150 0 16303 0 961113 0 0 0 HAROLD FERNANDEZ Director 1975106 0 0 0 19935 0 29150 0 24100 0 2048291 0 0 0 BENJAMIN SCHWARTZ Chf, OB/GYN 1501717 0 100000 0 18547 0 29150 0 15202 0 1664616 0 0 0 MICHAEL NETT Coord (MD) 1308721 0 0 0 18519 0 29150 0 24100 0 1380490 0 0 0 EDWARD HALLAL PHYSICIAN 1025744 0 0 0 55801 0 29150 0 8433 0 1119128 0 0 0 JED POLLACK Chairperson 888822 0 6462 0 4191 0 29150 0 24154 0 952779 0 0 0 PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN 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), Jeffrey Kraut ($360,409), Donna Drummond ($183,421),Laura Peabody ($162,159), Eugene Tangney ($194,640) and Anthony Ferreri ($324,153). PART I, LINE 5A - COMPENSATION CONTINGENT ON REVENUES 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 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 - BONUS AND INCENTIVE COMPENSATION 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). PART II, COLUMN (F) - SERP PAYOUT 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 649906JT2 2011-10-06 42795000 2011 BONDS - CONSTRUCT FACILITY & false false false B DORMITORY AUTHORITY OF THE STATE OF NEW YORK 146000293 64990BNL3 2015-06-23 33120000 2015 A BONDS - CONSTRUCT FACILITY false false false A 4727964 0 43539818 2332885 361028 0 770395 0 0 13759341 26316170 0 2013 true true false true B 424160 0 36252086 0 208766 22721226 331355 0 0 3313510 8286231 5711101 true true false true A false false false false 0 false false false true B false false false false 0 false false false true A false false true true false false 0 false 0 false true B false true true false false false 0 false 0 false true A true B true PART II, LINE 3 - PROCEEDS, THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE price in Part I, Column (E) due to Invest earning & transferred proceeds. PRISCILLA PIROLO-MORAVICK FAMILY MEMB: D. MORAVICK 90055 EMPLOYEE false JUSTIN MORAVICK FAMILY MEMB: D. MORAVICK 45834 EMPLOYEE false PART VI, SECTION A - GOVERNING BODY, LINE 2 All transactions with Northwell Health entities are as follows: (1) negotiated at arms 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 PROVIDES GOVERNANCE DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS 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 L. 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. 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