2017-01-12T13:39:22-06:00 2016-02-29 KPMG LLP 345 Park Avenue New York NY 101540102 990 2015-03-01 060655139 SILVER HILL HOSPITAL INC % Heidi A Leatherman SILV 2039661380 208 VALLEY RD NEW CANAAN CT 06840 SIGURD ACKERMAN MD president 2017-01-11 true Mary-Evelyn Antonetti P00431862 2127589700 2017-01-10 2015 2021-01-29 14:40:06Z SIGURD H ACKERMAN 208 VALLEY RD NEW CANAAN CT 06840 46613947 false X WWW.SILVERHILLHOSPITAL.ORG X 1934 CT SEE SCHEDULE O 20 17 406 254 -220270 -220270 1661854 1735934 40053257 40363349 419111 413695 -268957 -220957 41865265 42292021 20500 27150 0 0 24665030 25039444 0 0 642980 12872519 13732233 37558049 38798827 4307216 3493194 57401543 58734143 12130093 10984697 45271450 47749446 X THE MISSION OF SILVER HILL HOSPITAL IS TO PROVIDE OUR PATIENTS WITH THE BEST AVAILABLE TREATMENT OF MENTAL ILLNESS AND ADDICTION; AND TO OFFER CONTINUING SUPPORT, COUNSELING AND EDUCATION TO OUR PATIENTS AND FAMILIES IN EVERY PHASE OF ILLNESS AND RECOVERY. false false 15364244 15094881 INPATIENT TREATMENT IS THE MOST INTENSIVE FORM OF CARE, INDICATED FOR A PHASE OF ILLNESS THAT REQUIRES A GREAT DEAL OF NURSING AND MEDICAL INTERVENTION. BECAUSE PATIENTS ARE USUALLY ACUTELY ILL DURING THIS PHASE OF CARE, OUR INPATIENT TREATMENT PLANS EMPHASIZE DIAGNOSTIC ASSESSMENT, SYMPTOM REDUCTION, AND STABILIZATION. THE HOSPITAL TREATED APPROXIMATELY 1,510 INPATIENTS DURING FISCAL YEAR 2016. 15115534 27150 23691370 SILVER HILL HOSPITAL'S TRANSITIONAL LIVING PROGRAMS PROVIDE HIGHLY STRUCTURED INTENSIVE TREATMENT FOR PATIENTS WHO ARE READY FOR MORE PSYCHOLOGICAL AND BEHAVIORAL INTERVENTIONS. SET IN RESIDENTIAL, HOME-LIKE SETTINGS, THE TRANSITIONAL PROGRAMS HELP PATIENTS CONTINUE THEIR RECOVERY PROCESS UNTIL THEY ARE READY TO RETURN HOME FOR FURTHER COMMUNITY-BASED TREATMENTS. PATIENTS FOCUS ON DEVELOPING A PSYCHOLOGICAL UNDERSTANDING OF THEIR ILLNESS, OBTAINING INFORMATION ABOUT THEIR ILLNESS, AND DEVELOPING NEW BEHAVIORAL SKILLS TO MANAGE THEIR RECOVERY PROCESS. THE HOSPITAL TREATED APPROXIMATELY 735 TRANSITIONAL LIVING PATIENTS DURING FISCAL YEAR 2016. 500697 1871226 INTENSIVE OUTPATIENT PROGRAMS - SEE SCHEDULE O. 30980475 true true false true false false false false false true true false false false true true true false false false false false false false true false true true true false true false false false false false false false true true false false false false false false false false true 186 0 406 true true true false false false false true true false false false false X 20 17 false false false false false false false true true false false true true true true true true true true false CT NY X Heidi A Leatherman 2038012230 208 Valley Rd New Canaan CT 06840 X PETER ORTHWEIN CHAIRMAN 5.0 0.0 X 0 0 0 DEANN MURPHY CO-CHAIR 2.0 0.0 X 0 0 0 WARD F CLEARY CO-CHAIR 1.0 0.0 X 0 0 0 LINDA AUTORE DIRECTOR 1.0 0.0 X 0 0 0 RICHARD CANNING DIRECTOR 1.0 0.0 X 0 0 0 MICHAEL COMINOTTO DIRECTOR (THRU 12/2015) 1.0 0.0 X 0 0 0 SPERRY DECEW SECRETARY & DIRECTOR 1.0 0.0 X 0 0 0 FREDERICK FEINER MD DIRECTOR 3.0 0.0 X 0 0 0 JUDITH FREEDMAN DIRECTOR (THRU 4/2015) 1.0 0.0 X 0 0 0 RICHARD GANNON TREASURER & DIRECTOR 1.0 0.0 X 0 0 0 HANK HARTONG DIRECTOR (EFFECTIVE 11/2015) 1.0 0.0 X 0 0 0 TED HERMAN DIRECTOR 1.0 X 0 0 0 TODD HOLLANDER DIRECTOR 1.0 0.0 X 0 0 0 DAVID HUNT DIRECTOR (EFFECTIVE 5/15) 1.0 0.0 X 0 0 0 ROBERT KIELY DIRECTOR (EFFECTIVE 5/15) 1.0 0.0 X 0 0 0 CLAUDETTE KUNKES DIRECTOR 1.0 0.0 X 0 0 0 PAUL LAMBDIN DIRECTOR 1.0 0.0 X 0 0 0 LANCE LUNDBERG DIRECTOR 1.0 0.0 X X 0 0 0 CHERYL WIESENFELD DIRECTOR (EFFECTIVE 5/15) 1.0 0.0 X X 0 0 0 LAURIE WILLIAMSON DIRECTOR (THRU 4/2015) 1.0 0.0 X X 0 0 0 SIGURD ACKERMAN MD PRESIDENT, MEDICAL DIRECTOR 40.0 0.0 X X 597824 0 42363 ERIC COLLINS MD CHIEF MED. OFFICER & DIRECTOR 40.0 0.0 X X 420899 0 36601 ELIZABETH MOORE CHIEF OP. OFFICER & DIRECTOR 40.0 0.0 X X 364217 0 31526 MARK CERBONE MD PHYSICIAN 40.0 0.0 X 279042 0 6500 ANRI KISSILENKO MD PHYSICIAN 40.0 0.0 X 232555 0 47885 ROCCO MAROTTA MD PHYSICIAN 40.0 0.0 X 233499 0 40999 ANITA CHU MD PHYSICIAN 40.0 0.0 X 238783 0 11950 JOHN MEYERS MD PHYSICIAN 40.0 0.0 X 238048 0 5610 RUURD LEEGSTRA CFO (THRU 2/28/15) 0.0 0.0 X 54519 0 19177 2659386 0 242611 34 true true false PAC GROUP LLC 126 SOUTH MAIN STREET SUITE 200 TORRINGTON CT 06790 GENERAL CONTRACTOR 336012 UNIDINE CORPORATION ONE GATEWAY CENTER SUITE 751 NEWTON MA 02458 FOOD SERVICES 1366603 RICHARD TURLINGTON ARCHITECTS 244 MAPLE STREET NEW HAVEN CT 06511 ARCHITECT 754447 PHARMACY AND THERAPEUTICS CONSULTAN 300 CHURCH ST WALLINGFORD CT 06492 PHARMACY MANAGEMENT 357149 HOFFMAN LANDSCAPES INC 647 DANBURY RD WILTON CT 06897 LANDSCAPING SERVICES 203437 16 989358 746576 167114 1735934 INPATIENT PROGRAM 623000 15024483 15024483 TRANSITIONAL LIVING PROGRAM 623000 23467640 23467640 OUTPATIENT SERVICES 623000 1871226 1871226 40363349 427455 427455 0 0 186087 452796 -266709 0 -266709 -220270 -46439 3377327 3391087 -13760 -13760 -13760 132900 989358 452261 -319361 -319361 0 41120 25782 15338 15338 CAFETERIA REVENUE 900099 73437 17790 55647 TUTORING REVENUE 900099 106200 106200 ALL OTHER REVENUE 900099 170138 170138 349775 42292021 40657477 -220270 118880 X 27150 27150 0 0 0 1512606 817445 560970 134191 0 18561004 16568330 1656542 336132 728775 577146 142761 8868 2935238 2309424 569755 56059 1301821 1116015 166863 18943 0 397629 14558 383071 112332 112332 30000 30000 0 57456 57456 4182193 3807714 362311 12168 669750 634830 21853 13067 1781151 1310086 435899 35166 64071 60857 2949 265 0 961373 711181 245438 4754 167934 140154 22774 5006 0 24152 12361 11791 15442 15442 0 2407335 2162808 241331 3196 1039244 72335 966909 PHARMACY 318025 318025 BAD DEBT 253739 253739 PROGRAM DEVELOPMENT EXPENSES 204599 204599 OTHER EXPENSE 1045808 115457 915186 15165 38798827 30980475 7175372 642980 1900 1900 3166213 4800237 27950 39950 3213858 2884200 0 0 0 0 0 0 93498 97508 1473257 1588676 62957775 24439276 36847531 38518499 10077573 9753556 0 0 0 0 0 0 2499763 1049617 57401543 58734143 7715939 6796610 0 0 0 0 0 0 0 0 0 0 4233504 3982243 0 0 180650 205844 12130093 10984697 X 44187921 46302472 870529 1233974 213000 213000 45271450 47749446 57401543 58734143 3493194 -1015198 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true 30000 false false 30000 false SCHEDULE C PART II-B LINE 1I: LOBBYING DESCRIPTION IN FY 2015, THE HOSPITAL ENGAGED A CONSULTANT TO LOBBY THE STATE OF CONNECTICUT TO REVISIT RECENT LEGISLATION WHICH REQUIRES PSYCHIATRIC HOSPITALS TO REPORT ANYONE WHO IS VOLUNTARILY ADMITTED TO THE DEPARTMENT OF MENTAL HEALTH & ADDICTION SERVICES. CONSULTANT SERVICES ENDED IN APRIL 2015. 213000 213000 213000 6903 6903 213000 213000 1690 1690 213000 213000 3158 3158 213000 213000 1062 1062 213000 1.00000 false false 2192966 2192966 43275788 16451984 26823804 9873614 6165283 3708331 7615407 1822009 5793398 38518499 0 EMPLOYEE FSA PAYABLE 184080 UNCLAIMED PROPERTY 15715 OTHER 6049 205844 X 41677277 -1015198 319361 -695837 42373114 43695 -124788 -81093 42292021 39199281 697887 697887 38501394 43695 253738 297433 38798827 SCHEDULE D, PART V, LINE 4 INTENDED USE OF ENDOWMENT FUNDS DONORS HAVE STIPULATED THAT ANY INCOME FROM THE ENDOWMENT FUNDS IS TO BE USED FOR ADOLESCENT AND CHEMICAL DEPENDENCY PROGRAMS. SCHEDULE D, PART X, LINE 2 THE HOSPITAL IS QUALIFIED AS A TAX EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE ("THE CODE"), AND AS SUCH, NO PROVISION FOR INCOME TAXES HAS BEEN RECORDED. THE INTERNAL REVENUE SERVICE INFORMED THE HOSPITAL BY A LETTER DATED JUNE 23, 1937 THAT THE HOSPITAL'S OPERATIONS ARE DESIGNED IN ACCORDANCE WITH SUCH SECTION OF THE CODE. THERE ARE CERTAIN TRANSACTIONS THAT COULD BE DEEMED "UNRELATED BUSINESS INCOMEWOULD RESULT IN A TAX LIABILITY. MANAGEMENT REVIEWS TRANSACTONS TO ESTIMATE POTENTIAL TAX LIABILITIES. THE HOSPITAL RECOGNIZES INCOME TAX POSITIONS WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINABLE BASED ON THE MERITS OF THE POSITION. MANAGEMENT HAS CONCLUDED THAT THERE ARE NO UNCERTAIN TAX POSITIONS THAT NEEDED TO BE RECORDED AT FEBRUARY 29, 2016 AND FEBRUARY 28, 2015. SCHEDULE D, PART XI, LINE 2D AMOUNTS INCLUDED ON AUDITED FINANCIALS BUT NOT ON FORM 990, PART VIII SPECIAL EVENT EXPENSES $319,361 SCHEDULE D, PART XI, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART VIII BUT NOT AUDITED FINANCIAL STATEMENTS GIFT SHOP COST OF GOODS SOLD ($ 25,782) RENTAL INCOME $ 93,087 OTHER GAINS $ 6,965 BAD DEBT EXPENSE $253,738 RENTAL EXPENSE - DEPRECIATION AND INTEREST ($452,796) _________ TOTAL ($124,788) AMOUNTS INCLUDED ON AUDITED FINANCIAL STATEMENTS BUT NOT FORM 990 SCHEDULE D, PART XII, LINE 2D GIFT SHOP COST OF GOODS SOLD $ 25,782 RENTAL INCOME ($ 93,087) OTHER GAINS ($ 6,965) SPECIAL EVENT EXPENSES $319,361 RENTAL EXPENSE - DEPRECIATION AND INTEREST $452,796 _________ TOTAL $697,887 AMOUNTS INCLUDED ON FORM 990 BUT NOT AUDITED FINANCIAL STATEMENTS SCHEDULE D, PART XII, LINE 4B BAD DEBT EXPENSE $253,738 GALA FUNDRAISER 1122258 989358 132900 117396 43756 291109 0 1122258 989358 132900 117396 43756 291109 452261 -319361 true true true X 600. true false true false false 740400 740400 0.00000 740400 740400 0.00000 137709 450 137259 0.00330 31828 31828 0.00080 16554105 15024483 1529621 0.03640 27150 27150 0.00060 16750792 15024933 1725858 0.04110 17491192 15765333 1725858 0.04110 true 192082 120970 51652 69318 X true true None 1 1 SILVER HILL HOSPITAL INC 208 VALLEY RD NEW CANAAN CT 06840 WWW.SILVERHILLHOSPITAL.ORG H-0006 X SILVER HILL HOSPITAL INC 1 false false true X X X X X X X X 14 true false false true X WWW.SILVERHILLHOSPITAL.ORG true 14 true WWW.SILVERHILLHOSPITAL.ORG false true X 600. 900. X true true X true X true X false true X false false SCHEDULE H, PART V, LINE 5 THE HOSPITAL CONDUCTED PRIMARY AND SECONDARY DATA RESEARCH AND INTERVIEWED OVER 20 COMMUNITY STAKEHOLDERS TO DEVELOP THE COMMUNITY NEEDS ASSESSMENT AS WELL AS THE IMPLEMENTATION PLAN. COMMUNITY STAKEHOLDERS INCLUDED LINDA AUTORE, PRESIDENT AND CEO OF LAUREL HOUSE, ALAN BERRY, COMMISSIONER OF SOCIAL SERVICES FOR THE TOWN OF GREENWICH, CT, DAN WARTENBERG, CHIEF EXECUTIVE OFFICER OF THE SOUTHWEST CONNECTICUT MENTAL HEALTH SYSTEM (SWCMHS), KATE MATTIAS, EXECUTIVE DIRECTOR OF THE CONNECTICUT CHAPTER OF NAMI, JACQUELINE D'LOUGHY, DIRECTOR OF YOUTH AND FAMILY SERVICES FOR THE TOWN OF NEW CANAAN, THE HISPANIC ADVISORY COUNCIL OF GREATER STAMFORD, MARGARET WATT, EXECUTIVE DIRECTOR OF THE SOUTHWEST CT REGIONAL MENTAL HEALTH BOARD, BILL PIPER, CEO OF THE WAVENY CARE NETWORK, AND INGRID GILLESPIE, DIRECTOR OF THE LOWER FAIRFIELD COUNTY REGIONAL ACTION COUNCIL (LFCRAC). SCHEDULE H, PART V, LINE 11 AT THE END OF FY 2015, THE HOSPITAL IMPLEMENTED AN OUTPATIENT ADDICTION PROGRAM, WHICH INCLUDED OUTPATIENT DETOXIFICATION AND AN INTENSIVE OUTPATIENT PROGRAM. THE HOSPITAL ALSO OPENED AN INTENSIVE OUTPATIENT TREATMENT PROGRAM FOR ADOLESCENTS. AT THE END OF 2016, THE HOSPITAL OPENED A 9 BED TRANSITIONAL LIVING PROGRAM FOR EATING DISORDERS. THE HOSPITAL'S COMMUNITY LIAISON HAS CONTINUED HER WORK WITH THE NEIGHBORING TOWNS OF DARIEN, GREENWICH, NORWALK, NEW CANAAN, RIDGEFIELD, STAMFORD, WESTPORT AND WILTON TO PROVIDE INFORMATION REFERRALS AS WELL AS FACILITATE EDUCATION SESSIONS DESIGNED TO ADDRESS THE CURRENT MENTAL HEALTH AND SUBSTANCE ABUSE NEEDS OF THE COMMUNITY. SCHEDULE H, PART V, LINE 16I DURING FISCAL YEAR 2016, THE HOSPITALS FAP WAS AVAILABLE UPON REQUEST. THE SCHOLARSHIP PROGRAM IS REFERENCED ON THE SILVER HILL HOSPITAL WEBSITE. SCHEDULE H, PART V, LINE 22D IT IS THE POLICY OF THE HOSPITAL THAT PATIENTS ASSESSED TO BE SUFFERING FROM A BEHAVIORAL EMERGENCY MEDICAL CONDITION WILL BE ADMITTED, REGARDLESS OF THEIR INSURANCE STATUS OR ABILITY TO PAY, AS REQUIRED BY THE EMERGENCY MEDICAL TREATMENT AND ACTIVE LABOR ACT (EMTALA). UPON DISCHARGE, THE HOSPITAL WORKS WITH THESE PATIENTS TO DETERMINE AN APPROPRIATE PAYMENT AMOUNT GIVEN THEIR FINANCIAL SITUATION. PART I, LINE 6A: DURING FY 16, THE HOSPITAL WAS NOT REQUIRED TO FILE A COMMUNITY BENEFIT REPORT WITH THE STATE OF CONNECTICUT. PART I, LINE 7: A COST TO CHARGE RATIO, DERIVED FROM WORKSHEET 2 RATIO OF PATIENT CARE COST TO CHARGES, WAS USED TO DETERMINE CHARITY CARE COSTS REPORTED. A COST TO CHARGE RATIO FOR INPATIENT SERVICES WAS USED TO DETERMINE THE AMOUNT OF INPATIENT CARE THAT WAS SUBSIDIZED IN FISCAL 2016. ALL OTHER EXPENSES REPORTED ARE ACTUAL COSTS. PART I, LINE 7, COLUMN(F) TOTAL EXPENSES FROM PART IX, LINE 25 WERE REDUCED BY BAD DEBT EXPENSE OF $253,738 IN CALCULATING TOTAL EXPENSES FOR COLUMN (F). PART II: N/A PART III LINE 2: BAD DEBT METHODOLOGY BAD DEBT EXPENSE IS ESTIMATED BASED ON HISTORICAL AND EXPECTED WRITE-OFFS AND NET COLLECTIONS, AS WELL AS AGING STATUS. A COST TO CHARGE RATIO FROM WORKSHEET 2 WAS APPLIED TO BAD DEBT EXPENSE REPORTED IN THE AUDITED FINANCIALS IN ORDER TO DETERMINE THE BAD DEBT EXPENSE REPORTED ON PART III, LINE 2. PART III, LINE 3: N/A PART III, LINE 4: EXCERPT FROM AUDITED FINANCIAL STATEMENT FOOTNOTE 2 - NET PATIENT SERVICE REVENUE AND ACCOUNTS RECEIVABLE; AUDITED FINANCIAL STATEMENT PAGES 10,11: PATIENT SERVICE REVENUE, NET OF CONTRACTUAL ALLOWANCES, IS REDUCED BY THE PROVISION FOR BAD DEBTS, AND PATIENTS ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. THESE AMOUNTS ARE BASED ON HISTORICAL AND EXPECTED WRITE-OFFS AND NET COLLECTIONS AS WELL AS AGING STATUS. BASED ON HISTORICAL EXPERIENCE, A PORTION OF THE HOSPITAL S SELF-PAY PATIENTS WHO DO NOT QUALIFY FOR CHARITY CARE WILL BE UNABLE OR UNWILLING TO PAY FOR SERVICES PROVIDED. THUS, THE HOSPITAL RECORDS A PROVISION FOR BAD DEBTS RELATED TO THESE PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. THE HOSPITAL WROTE OFF $387,155 AND $317,742 IN BAD DEBTS, NET OF RECOVERIES, IN FISCAL YEARS 2016 AND 2015, RESPECTIVELY. PART III, LINE 8: N/A PART III LINE 9B: WRITTEN DEBT COLLECTION POLICY THE HOSPITAL COLLECTION POLICY STATES "THIS POLICY IS APPLICABLE TO ALL PATIENTS RECEIVING SERVICES AT SILVER HILL HOSPITAL (SHH) WHO ARE CONSIDERED SELF-PAY (AS DEFINED IN THIS POLICY) AND ARE JUDGED TO BE ABLE TO PAY; THAT IS, THIS POLICY APPLIES TO THOSE WHO ARE NOT ELIGIBLE FOR THE FINANCIAL ASSISTANCE PROGRAM (SEE POLICY ON SCHOLARSHIP PROGRAM)." PART VI, LINE 2: NEEDS ASSESSMENT IN ADDITION TO THE CHNA ASSESSMENT, THE HOSPITAL STAFF ASSESSES THE NEED FOR PROGRAMMING BASED ON SERVICE AVAILABILITY FOR OUR DISCHARGING POPULATION. THE HOSPITAL ALSO RECEIVES INPUT FROM COMMUNITY-BASED CLINICIANS TO IDENTIFY NEEDS WITHIN THE COMMUNITY. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SOCIAL WORKERS HAVE A COMPREHENSIVE VIEW OF A PATIENT'S FINANCIAL AND SOCIAL SITUATION AND ARE KNOWLEDGEABLE ABOUT THE ELIGIBILITY CRITERIA FOR ENTITLEMENT PROGRAMS. IT IS THE ASSIGNED RESPONSIBILITY OF THE SOCIAL WORKER TO INFORM PATIENTS AND THEIR FAMILIES ABOUT ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE OR LOCAL GOVERNMENT PROGRAMS. PATIENTS WHO DO NOT HAVE THE FINANCIAL ABILITY TO PAY FOR SERVICES, ARE EDUCATED ABOUT SHH'S SCHOLARSHIP PROGRAM BY A SPECIALLY TRAINED STAFF MEMBER. THE STAFF MEMBER PROVIDES PATIENTS AND THEIR FAMILIES WITH THE FINANCIAL GUIDELINES AND SUPPORTING DOCUMENTATION REQUIRED FOR OBTAINING A SCHOLARSHIP FOR THE PROGRAM. PART VI, LINE 4: COMMUNITY INFORMATION APPROXIMATELY 41% OF THE PATIENT POPULATION IS FROM CONNECTICUT, 40% FROM NEW YORK, 19% FROM OTHER AREAS INCLUDING NEW JERSEY AND MASSACHUSETTS. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH SILVER HILL HOSPITAL FURTHERS ITS EXEMPT PURPOSE OF PROMOTING HEALTH OF THE COMMUNITY THROUGH A DIVERSE BOARD OF DIRECTORS WHOSE MEMBERS CONTRIBUTE THROUGH THEIR UNIQUE TALENTS AND RESOURCES TOWARD THE HOSPITAL'S MISSION OF HEALING AND THE CARE OF ITS PATIENTS. PART VI, LINE 6: AFFILIATED HEALTH SYSTEMS N/A PART VI, LINE 7: STATE FILING OF COMMUNITY BENEFIT REPORT N/A true NEW CANAAN POLICE DEPARTMENT 174 SOUTH AVE NEW CANAAN CT 06840 066002043 New Caanan 10000 NEW CANAAN VOLUNTEER AMBULANCE CORP 182 SOUTH AVE NEW CANAAN CT 06840 237300265 501(c)(3) 10000 2 SCHEDULE I, PART I, LINE 2 THE AMOUNTS REPORTED ON SCHEDULE I ARE CONTRIBUTIONS TO SUPPORT THE EXEMPT PURPOSE OF THE 501(C)(3) ORGANIZATIONS. THEY DO NOT REPRESENT GRANTS. X X X X false false false false false false false true false SIGURD ACKERMAN MD PRESIDENT, MEDICAL DIRECTOR 438489 0 150000 0 9335 0 19500 0 22863 0 640187 0 0 0 ERIC COLLINS MD CHIEF MED. OFFICER & DIRECTOR 345618 0 75000 0 281 0 6500 0 30101 0 457500 0 0 0 ELIZABETH MOORE CHIEF OP. OFFICER & DIRECTOR 287605 0 75000 0 1612 0 19500 0 12026 0 395743 0 0 0 RUURD LEEGSTRA CFO (THRU 2/28/15) 53616 0 0 0 903 0 19177 0 0 0 73696 0 0 0 MARK CERBONE MD PHYSICIAN 265922 0 12416 0 704 0 6500 0 0 0 285542 0 0 0 ANRI KISSILENKO MD PHYSICIAN 221687 0 10587 0 281 0 17784 0 30101 0 280440 0 0 0 ROCCO MAROTTA MD PHYSICIAN 221168 0 10514 0 1817 0 11824 0 29175 0 274498 0 0 0 ANITA CHU MD PHYSICIAN 235999 0 2634 0 150 0 0 0 11950 0 250733 0 0 0 JOHN MEYERS MD PHYSICIAN 229278 0 8510 0 260 0 5610 0 0 0 243658 0 0 0 PART I, LINE 7: THE CHIEF EXECUTIVE OFFICER, CHIEF OPERATING OFFICER, CHIEF FINANCIAL OFFICER AND PHYSICIAN-IN-CHIEF ARE ELIGIBLE FOR INCENTIVE COMPENSATION BASED ON THE ACHIEVEMENT OF PERFORMANCE GOALS ESTABLISHED AND APPROVED BY THE BOARD OF DIRECTORS. IN CALENDAR YEAR 2015, THE AFOREMENTIONED INDIVIDUALS RECEIVED COMPENSATION FOR ACHIEVEMENT OF INCENTIVE GOALS RELATED TO THE FISCAL YEAR ENDING FEBRUARY 28, 2015. THESE AMOUNTS ARE REPORTED IN SCHEDULE J, PART II, COLUMN (B)(II). CONTRIBUTOR 17 SUBSTANTIAL CONTRIBUTOR 3136111 GENERAL CONTRACTOR/CONSTR false CONTRIBUTOR 22 SUBSTANTIAL CONTRIBUTOR 365007 MEDICAL RECORD SOFTWARE V false X 6 89614 STOCK MARKET VALUE X Gala Auction Items 4 77500 VALUE OF AUCTION BID false true false PART I, COLUMN (B) THE HOSPITAL IS REPORTING THE NUMBER OF NON CASH CONTRIBUTIONS MADE DURING THE FISCAL YEAR. FORM 990, PART 1, LINE 1: MISSION STATEMENT THE MISSION OF SILVER HILL HOSPITAL IS TO PROVIDE OUR PATIENTS WITH THE BEST AVAILABLE TREATMENT OF MENTAL ILLNESS AND ADDICTION; AND TO OFFER CONTINUING SUPPORT, COUNSELING AND EDUCATION TO OUR PATIENTS AND THEIR FAMILIES IN EVERY PHASE OF ILLNESS AND RECOVERY. FORM 990, PART III, LINE 4C: PROGRAM SERVICE INTENSIVE OUTPATIENT PROGRAMS (IOPS) TYPICALLY MEET FOR THREE HOURS A DAY, THREE DAYS PER WEEK. THE HOSPITAL PROVIDES TWO DIALECTICAL BEHAVIOR THERAPY IOPS FOR PATIENTS EXPERIENCING DIFFICULTY REGULATING INTENSE EMOTIONS, IMPULSIVITY AND HARMFUL BEHAVIORS. THESE PROGRAMS TEACH PATIENTS THE CORE DBT SKILLS OF MINDFULNESS, EMOTION REGULATION, INTERPERSONAL EFFECTIVENESS SKILLS AND DISTRESS TOLERANCE. THE HOSPITAL ALSO PROVIDES A WOMEN'S DBT AND HEALTH RELATIONSHIPS IOP FOR WOMEN WHO STRUGGLE WITH ADDICTION TO LEARN SAFE COPING SKILLS TO MAINTAIN SOBRIETY, AS WELL AS TO EXPLORE UNDERLYING INTERPERSONAL ISSUES INCLUDING RELATIONSHIP DIFFICULTIES, ABUSE, CODEPENDENCY AND BOUNDARIES. IN ADDITION, THE HOSPITAL PROVIDES AN ADDICTION/DUAL DIAGNOSIS IOP WHICH IS APPROPRIATE FOR PATIENTS DIAGNOSED WITH EITHER AN ADDICTION OR DUAL DISORDER. GROUPS INCLUDE RELAPSE PREVENTION, FAMILY DISEASE AND RELAPSE WARNING SIGNS, UNDERSTANDING EMOTIONS, AND SELF-ESTEEM. THIS PROGRAM ALSO TEACHES PATIENTS DIALECTICAL BEHAVIOR THERAPY SKILLS SUCH AS DISTRESS TOLERANCE. FORM 990, PART VI, LINE 11B: 990 REVIEW BY ORGANIZATION THE FORM 990 OF THE ORGANIZATION IS PREPARED BY THE FINANCE DEPARTMENT OF SILVER HILL HOSPITAL BASED ON THE BOOKS AND RECORDS OF THE ORGANIZATION. THE DRAFT RETURN AND ALL SUPPORTING DOCUMENTATION ARE PROVIDED TO THE ORGANIZATION'S INDEPENDENT ACCOUNTANTS FOR REVIEW AND FINAL PREPARATION OF THE RETURN. THE FINAL VERSION OF THE FORM 990 IS THEN REVIEWED BY THE CONTROLLER, COO, AND PRESIDENT & MEDICAL DIRECTOR. THE FINAL VERSION OF THE FORM 990 IS PROVIDED TO ALL MEMBERS OF THE GOVERNING BODY FOR THEIR REVIEW AND COMMENTS BEFORE FILING THE FORM WITH THE INTERNAL REVENUE SERVICES. FORM 990, PART VI, LINE 12C: COMPLIANCE WITH CONFLICT OF INTEREST POLICY THE HOSPITAL REQUIRES THE BOARD OF DIRECTORS AND OFFICERS TO COMPLETE A NOTIFICATION OF COMPLIANCE QUESTIONNAIRE AT THE END OF EACH FISCAL YEAR. THE FINANCE DEPARTMENT REVIEWS THE QUESTIONNAIRES FOR DETERMINATION OF POTENTIAL CONFLICTS OF INTEREST. ANY POTENTIAL CONFLICTS OF INTEREST ARE MADE KNOWN TO THE BOARD FOR RESOLUTION. FORM 990, PART VI, LINES 15A & 15B:COMPENSATION DETERMINATION EACH YEAR, OR WHEN OTHERWISE REQUIRED, THE BOARD OF DIRECTORS APPOINTS A COMPENSATION SUB-COMMITTEE OF INDEPENDENT DIRECTORS TO REVIEW THE COMPENSATION OF THE PRESIDENT AND MEDICAL DIRECTOR, CHIEF OPERATING OFFICER, CHIEF FINANCIAL OFFICER, PHYSICIAN IN CHIEF, AND KEY EMPLOYEES. THE SUB-COMMITTEE REVIEWS THE FORM 990'S OF SIMILAR ORGANIZATIONS AS WELL AS AMERICAN HOSPITAL ASSOCIATION SURVEYS, AND MAKES RECOMMENDATIONS TO THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. ANY DELIBERATIONS AND DECISIONS OF THE COMPENSATION SUB-COMMITTEE ARE DOCUMENTED IN THE MEETING MINUTES OF THE COMPENSATION SUB COMMITTEE. FORM 990, PART VI, LINE 19: GOVERNING DOCUMENTS AVAILABILITY THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC ON REQUEST. FORM 990 PART IX LINE 11G DESCRIPTION:DIETARY SERVICES TOTAL FEES:1517042 FORM 990 PART IX LINE 11G DESCRIPTION:BILLING SERVICES TOTAL FEES:554596 FORM 990 PART IX LINE 11G DESCRIPTION:PAYROLL SERVICES TOTAL FEES:159340 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:644009 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PROFESSIONAL SERVICES TOTAL FEES:1307206