2016-11-09T08:45:32-06:00 2015-12-31 ERNST & YOUNG US LLP 5 TIMES SQUARE NEW YORK NY 10036 990 2015-01-01 462931956 MONTEFIORE NEW ROCHELLE HOSPITAL % DAVID INGBER MONTEFIORE MONT 9143498400 16 Guion Place New Rochelle NY 10801 COLLEEN M BLYE EXECUTIVE VP & CFO 7189207602 2016-11-06 CHRISTOPHER B BOGGS P00032493 2127733000 2015 2017-02-10 21:41:12Z STEVEN SAFYER MD 111 East 210th Street Bronx NY 10467 163342614 false X http://www.montefiorehs.org/landing.cfm?id=16 X 2013 NY TO HEAL, TO TEACH, TO DISCOVER AND TO ADVANCE THE HEALTH OF THE COMMUNITIES WE SERVE. 43 42 1332 52 0 25217422 17224007 128551048 136088535 539127 900250 3942313 4105290 158249910 158318082 0 0 0 0 100220479 103743099 0 0 14406 69835229 69138430 170055708 172881529 -11805798 -14563447 72229883 71255961 69497711 84203018 2732172 -12947057 MISSION: TO HEAL, TO TEACH, TO DISCOVER AND TO ADVANCE THE HEALTH OF THE COMMUNITIES WE SERVE. VALUES: HUMANITY, INNOVATION, TEAMWORK, DIVERSITY AND EQUITY - OUR VALUES DEFINE OUR PHILOSOPHY OF CARE. THEY SHAPE OUR ACTIONS AND MOTIVATE AND INSPIRE US TO PURSUE EXCELLENCE AND ACHIEVE OUR GOALS. MONTEFIORE NEW ROCHELLE HOSPITAL IS A 223-BED, COMMUNITY-BASED TEACHING HOSPITAL OFFERING PRIMARY, ACUTE AND EMERGENCY CARE TO THE RESIDENTS OF SOUTHERN WESTCHESTER. MONTEFIORE NEW ROCHELLE HOSPITAL PROVIDES FOR THE DIVERSE MEDICAL NEEDS OF THE COMMUNITIES AND REGION IT SERVES. THE HOSPITAL IS PART OF MONTEFIORE HEALTH SYSTEM, THE UNIVERSITY HOSPITAL SYSTEM FOR ALBERT EINSTEIN COLLEGE OF MEDICINE. MONTEFIORE NEW ROCHELLE HAS A NUMBER OF LEADING-EDGE SERVICES AND PROGRAMS THAT HAVE EARNED DISTINCTION BY STATE AND NATIONAL ORGANIZATIONS FOR ACHIEVING AND MAINTAINING THE HIGHEST QUALITY OF CARE WITHIN THE SPECIALTY, INCLUDING: - DESIGNATED AS A CENTER OF EXCELLENCE BY THE AMERICAN SOCIETY OF METABOL false false 106673672 92577602 MONTEFIORE NEW ROCHELLE HOSPITAL IS THE ONLY HOSPITAL IN THE CITY OF NEW ROCHELLE, WITH 223-BEDS, THE HOSPITAL IS COMPRISED OF 164 MEDICAL/SURGICAL BEDS, 8 CORONARY CARE BEDS, 12 INTENSIVE CARE BEDS, 24 MATERNITY BEDS, 10 NEOTATAL INTENSIVE CARE BEDS, AND 5 PEDIATRICS BEDS. MONTEFIORE NEW ROCHELLE IS A COMMUNITY-BASED TEACHING HOSPITAL OFFERING PRIMARY, ACUTE AND EMERGENCY CARE TO THE RESIDENTS OF SOUTHERN WESTCHESTER REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. ANNUALLY, THE HOSPITAL HAS APPROXIMATELY 8,060 INPATIENT ADMISSIONS. 50136005 43510933 MONTEFIORE NEW ROCHELLE HOSPITAL HAD 94,898 AMBULATORY VISITS DURING CALENDAR YEAR 2015, COMPRISED OF 27,917 PRIVATE REFERRED VISITS , 32,823 EMERGENCY DEPARTMENT VISITS, 27,938 ADULT AND PEDIATRIC MEDICAL, SPECIALTY CLINIC VISITS AND 6,220 AMBULATORY SURGERY VISITS. 156809677 true true false true false false false false false true true true false false true false false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true true false false true 40 0 true 1332 true false false false false false false false false false false X 43 42 true false false false true true true true true false false true true true true true true false false false NY X DAVID INGBER MONTEFIORE 9143498400 HLTH SYS INC 555 S BDWY TARRYTOWN NY 10591 ODED ABOODI VICE CHAIRMAN & TREASURER 0.2 2.3 X 0 0 0 JAY B ABRAMSON TRUSTEE 0.2 2.3 X 0 0 0 MARGARET HAYES ADAME TRUSTEE 0.2 1.8 X 0 0 0 GEORGE ASCH TRUSTEE 0.2 1.3 X 0 0 0 JOSEPH W BARTLETT TRUSTEE 0.2 1.3 X 0 0 0 PATRICIA BAUMAN TRUSTEE 0.2 1.3 X 0 0 0 JAMES M BUTLER TRUSTEE 0.2 2.3 X 0 0 0 GEORGE CAMPBELL JR PHD TRUSTEE 0.2 2.3 X 0 0 0 BRUCE DONIGER TRUSTEE 0.2 1.3 X 0 0 0 RUTH L GOTTESMAN EDD TRUSTEE 0.2 1.3 X 0 0 0 DAVID C GOTTLIEB TRUSTEE (resigned 6/15) 0.2 1.3 X 0 0 0 BARRY W GRAY TRUSTEE 0.2 1.3 X 0 0 0 PATRICIA GREEN TRUSTEE 0.2 1.3 X 0 0 0 JOHN H GUTFREUND TRUSTEE(trustee emeritus 6/15) 0.2 1.3 X 0 0 0 THOMAS L HARRISON TRUSTEE 0.2 1.3 X 0 0 0 JOHN HEFFER TRUSTEE 0.2 2.3 X 0 0 0 LEWIS HENKIND SECRETARY 0.2 3.3 X 0 0 0 HELEN A JOHNSON TRUSTEE 0.2 2.3 X 0 0 0 DAVID B KEIDAN TRUSTEE 0.2 1.3 X 0 0 0 BRUCE J KLATSKY TRUSTEE (resigned 2/15) 0.2 1.3 X 0 0 0 ALAN M KLEIN TRUSTEE 0.2 3.3 X 0 0 0 STACEY R LANE TRUSTEE 0.2 2.3 X 0 0 0 JAY B LANGNER TRUSTEE/CHAIRMAN EMERITUS 0.2 1.3 X 0 0 0 CHRISTOPHER D MCFADDEN TRUSTEE (resigned 11/15) 0.2 1.3 X 0 0 0 MARGARET L NATHAN TRUSTEE 0.2 1.3 X 0 0 0 PETER J NEUFELD TRUSTEE 0.2 2.3 X 0 0 0 GAYLE F ROBINSON TRUSTEE 0.2 1.3 X 0 0 0 JON W ROTENSTREICH TRUSTEE 0.2 1.3 X 0 0 0 HON FELICE K SHEA TRUSTEE 0.2 1.3 X 0 0 0 EDWIN H STERN III TRUSTEE 0.2 1.3 X 0 0 0 DAVID A TANNER CHAIRMAN 0.2 7.8 X 0 0 0 CYNTHIA KING VANCE TRUSTEE 0.2 2.3 X 0 0 0 JIDE J ZEITLIN TRUSTEE 0.2 1.3 X 0 0 0 JENNIE EMIL TRUSTEE 0.2 1.3 X 0 0 0 JONTHAN A LIPTON THRUSTE 0.2 1.3 X 0 0 0 ZITA G ROSENTHAL TRUSTEE 0.2 1.3 X 0 0 0 GREGG S HYMOWITZ TRUSTEE 0.2 1.3 X 0 0 0 NATHAN GANTCHER TRUSTEE 0.2 1.3 X 0 0 0 CATHERINE KLEMA TRUSTEE 0.2 1.3 X 0 0 0 MELISSA CERIALE TRUSTEE 0.2 1.3 X 0 0 0 MARK MLOTEK TRUSTEE 0.2 1.3 X 0 0 0 BARRY S BLATTMAN TRUSTEE 0.2 1.3 X 0 0 0 MARK E BROSSMAN TRUSTEE 0.2 1.3 X 0 0 0 MATTHEW H NORD TRUSTEE 0.2 1.3 X 0 0 0 MICHAEL A STOCKER MD TRUSTEE 0.2 1.3 X 0 0 0 ROGER EINIGER TRUSTEE 0.2 1.3 X 0 0 0 STEVEN M SAFYER MD PRESIDENT & CEO 1.5 58.5 X X 0 4283893 51255 PHILIP O OZUAH MD PHD EXECUTIVE VP & COO 1.5 58.5 X 0 2285645 697133 CHRISTOPHER S PANCZNER SENIOR VP & GENERAL COUNSEL 1.5 58.5 X 0 1110866 232140 JOEL A PERLMAN EXECUTIVE VICE PRESIDENT & CFO 1.5 58.5 X 0 1529529 51011 SUSAN GREEN-LORENZEN RN SENIOR VP-OPERATIONS 1.5 58.5 X 0 1194177 296068 LYNN RICHMOND Executive Vice President 1.5 58.5 X 0 1256752 282642 JOHN OLSEWSKI MD ORTHOPEDIC SURGEON 60.0 0.0 X 519869 0 33410 STEVEN B ZELICOF MD CHIEF, ORTHOPEDIC SURGERY 60.0 0.0 X 549890 0 30899 MADHU RANGRAJ MD DIRECTOR, SURGERY 60.0 0.0 X 522853 0 30792 PATRICIA DEVINE MD DIRECTOR OF OB/GYN 60.0 0.0 X 383608 0 30860 STEPHEN JESMAJIAN MD CHIEF & RESIDENT PROG DIRECTOR 60.0 0.0 X 375420 0 33410 2351640 11660862 1769620 209 false true false Allscripts LLC 24630 Network Place CHICAGO IL 60673 Information 2886706 Fastaff Inc PO Box 911452 DENVER CO 80291 Traveling nurses 2018460 Cauldwell Windgate Co LLC 380 Lexington Avenue NEW YORK NY 10168 Construction 1913045 National Government Services Inc PO Box 809366 CHICAGO IL 60680 Administrator 1270673 Quest Diagnostics Inc 7402 Collection Center Drive CHICAGO IL 60693 Medical lab testing 1262541 64 17180196 43811 17224007 INPATIENT REVENUE 623000 92577601 92577601 0 OUTPATIENT REVENUE 621400 43510934 43510934 0 136088535 394751 394751 0 0 0 0 0 5530032 5024532 505500 505499 505499 0 0 0 MISCELLANEOUS INCOME 900099 1362844 0 1362844 SCHOOL OF NURSING TUITION 611430 1392177 0 1392177 CAFETERIA/COFFEE SHOP & VENDING INCOME 722514 480709 0 480709 869560 0 869560 4105290 158318082 136088535 0 5005540 0 0 0 0 0 0 79583668 71764793 7816554 2321 0 18312300 16036073 2275455 772 5847131 5262418 584713 1082982 1047935 35047 38129 38129 269745 269745 31488 31488 0 119468 119468 5601880 5540726 61154 31867 17375 14492 11562584 10293683 1267326 1575 0 0 7464190 6773961 682846 7383 92329 81203 11126 0 83399 79123 4276 1915940 1915940 0 2502906 2502906 11023121 11023121 MEDICAL SUPPLIES & EXPENSES 23794607 22599166 1193086 2355 MEMBERSHIP DUES 1337679 1271254 66425 APARTMENT RENTAL (TRVL NURSE) 378251 378251 COLLECTION FEES 1804865 600000 1204865 3000 3000 172881529 156809677 16057446 14406 2367956 1379563 0 0 0 0 33694262 28117113 0 0 0 0 0 0 1798442 2401324 324687 931935 26047930 4539060 15026881 21508870 0 0 17867096 16826130 0 0 0 0 1150559 91026 72229883 71255961 31759064 33308583 0 0 5667587 4434363 0 0 0 0 0 0 0 0 0 0 32071060 46460072 69497711 84203018 X -14362875 -30073543 0 31439 17095047 17095047 2732172 -12947057 72229883 71255961 X -14563447 -1147221 31439 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true 31488 false false 31488 PART II-B, LINE G THE HOSPITAL'S LOBBYING EXPENDITURES INCLUDES A PERCENTAGE OF MEMBERSHIP DUES PAID TO THE GREATER NEW YORK HOSPITAL ASSOCIATION, AMERICAN HOSPITAL ASSOCIATION AND THE HEALTH CARE ASSOCIATION OF NYS, THAT ARE USED FOR LOBBYING EFFORTS. 17095047 17095047 17095047 17095047 1.00000 false false false 19600114 4539060 15061054 6447816 6447816 21508870 EQUITY SECURITIES 2473763 F FIXED INCOME SECURITIES 2777853 F REAL ESTATE 10673264 F COMMODITIES 136450 F CASH & SHORT TERM INVESTMENTS 764800 F 16826130 0 EQUIPMENT LOAN PAYABLE TO PARENT 20661682 DUE TO AFFILIATES 5167084 REVOLVING LOAN FROM PARENT 19110372 RETIREE HEALTH LIABILITY 1520934 46460072 FORM 990, SCHEDULE D, PART V, LINE 4: The organization's endowments were established pursuant to donor gifts transferred from the bankrupt Sound Shore Medical Center Estate. The earnings can provide support to the Montefiore New Rochelle Hospital general activities, specifically treatment, hospitalization and care of needy patients as designated by individual donors. true true X true X true X 500. true true true false true true 4806852 4774390 32462 0.00020 49867588 30328889 19538699 0.11310 54674440 35103279 19571161 0.11330 13626642 9810312 3816330 0.02210 14891190 9465575 5425615 0.03140 28517832 19275887 9241945 0.05350 83192272 54379166 28813106 0.16680 false 2440462 2220820 46110656 43259089 2851567 X true true 1 1 Montefiore New Rochelle Hospital 16 Guion Place New Rochelle NY 10801 www.montefiorehealthsystem.org 5904001H X X X X Montefiore New Rochelle Hospital 1 false false true X X X X X X X X 13 true false false true X MONTEFIORE.ORG X true 13 true MONTEFIORE.ORG false false true X 100 500. true true X true X www.montefiorehealthsystem.org X (same as above) X (same as above) X X X X true X false X X X X true X false false PART V, SECTION B, LINE 5: Montefiore New Rochelle Hospital WIC Community Advisory Group was utilized to gather input from community stakeholders on the health of the community. This key stakeholder group is made up of consumer participants as well as a select number of members from civic, municipal and non-governmental service providers, leaders in the business and faith communities and non-affiliated community residents. The community advisory group participated in an extensive data review session examining over 400 data categories specifically related to the indicators overall health status as well as indicators of the social, environmental, and economic determinants of health. Montefiore New Rochelle Hospital also met with the Deputy Commissioner, Dr. Cheryl Archibald to gain a greater understanding of the process for the county in selecting health priorities. PART V, SECTION B, LINE 11: The two areas of most significant need that were identified in the CHNA were following: (1) The prevention of chronic disease. (2) The promotion of healthy women, Infants, and children. Prevention of Chronic Disease: Montefiore New Rochelle Hospital has selected to focus on reducing the racial disparities by decreasing the percentage of Blacks and Hispanics dying prematurely from heart related diseases by concentrating on reducing tobacco and nicotine consumption among these populations in the service area. Tobacco and nicotine consumption, among these populations in the service area is a leading causal indicator in heart related disease. The strategic plan is to increase screening rates for cardiovascular disease as well as for diabetes, breast, cervical, and colorectal cancers. In conjunction with the screening process the plan is to influence patients to quit smoking and to reduce the prevalence of smoking in the service area. By providing 100% of the inpatient population with information on the New York State Quit Line, by expanding the smoke free campus to all locations, and by being an ardent supporter of supplemental nicotine replacement therapy there is a strong likelihood of reducing the racial disparity of rates of premature death from heart related and other diseases. Promotion of Healthy Women, Infants, and Children: The increase in the proportion of infants that are exclusively breastfed for the first six months of life is an important factor in the promotion of healthy women, infants, and children. The Montefiore Westchester Hospitals are committed to achieving the goals of the Baby Friendly Hospital initiative. The following objectives have been identified to achieve this initiative: 1. Enforcement of New York State Hospital regulation to not supplement breastfeeding infants with formula feeding unless medically indicated and documented within the infant's medical record. 2. Provide physical restrictions to infant formula by hospital staff including the tracking of infant formula distribution with the Health Department. 3. Discontinue the distribution of free promotional formula 4. Prohibit the display and distribution of infant formula promotion materials in any hospital location. Montefiore New Rochelle Hospital will support the New Rochelle commitment to support mothers who choose to breastfeed by providing additional resources to breastfeeding mothers and to minimize practices that can interfere with that choice such as supplementing breastfeeding infants with formula, unless medically indicated or at the mother's specific request. PART V, SECTION B, LINE 22D: CONSISTENT WITH THE PROVISIONS OF THE JUNE 22, 2012 IRS RULE REGARDING THE ESTABLISHMENT AND IMPLEMENTATION OF FINANCIAL AID POLICIES (FAPS) UNDER SECTION 501 (R) OF THE INTERNAL REVENUE CODE, THE HOPITAL USES THE LOOK-BACK METHOD TO CALCULATE A SEPARATE AMOUNTS GENERALLY BILLED (AGB) PERCENTAGE FOR EACH CATEGORY OF CARE PROVIDED TO FAP-ELIGIBLE INDIVIDUALS. THE HOSPITAL LIMITS THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE AT THE FOLLOWING LEVELS: - FOR PATIENTS BELOW 100% OF THE FEDERAL POVERTY LEVEL (FPL) - CAPPED AT THE LOWER OF THE AMOUNTS GENERALLY BILLED OR NOMINAL PAYMENT AMOUNT SET FORTH IN THE NEW YORK STATE HOSPITAL FINANCIAL ASSISTANCE LAW (HFAL) PURSUANT TO SUBDIVISION 9-A OF SECTION 2807-K OF THE NEW YORK PUBLIC HEALTH LAW. - FOR PATIENTS BETWEEN 100% AND 300% OF FEDERAL POVERTY LEVEL - CAPPED AT THE LOWER OF THE AGB OR SLIDING FEE SCALE AMOUNTS RANGING FROM 20% TO 100% OF THE AVERAGE MEDICAID RATE CONSISTENT WITH THE PROVISIONS OF THE NEW YORK STATE HOSPITAL FINANCIAL ASSISTANCE LAW. - FOR PATIENTS BETWEEN 300% AND 500% OF FEDERAL POVERTY LEVEL (FPL) - CAPPED AT THE AMOUNTS GENERALLY BILLED. 1. Required Description: PART I, LINE 7: THE COST-TO-CHARGE RATIO METHODOLOGY WAS UTILIZED TO CALCULATE THE AMOUNT INCLUDED IN THE TABLE. THE CALCULATION OF THIS RATIO WAS DERIVED FROM RATIO OF PATIENT CARE COSTS-TO-CHARGES. PART III, SECTION A, LINE 2: THE COST OF BAD DEBT EXPENSE WAS ESTIMATED BASED ON THE CHARGES, APPLIED TO THE RATIO OF TOTAL PATIENT CARE EXPENSES TO TOTAL CHARGES FOR ALL SERVICES RENDERED. ANY PAYMENTS OR DISCOUNTS ARE EXCLUDED FROM BAD DEBT EXPENSE. PART III, SECTION A, LINE 3: THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE (AT COST) ATTRIBUTED TO PATIENTS UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS BASED ON RESULTS OF PREDICTIVE ANALYSIS. BAD DEBT SHOULD BE INCLUDED AS A COMMUNITY BENEFIT BECAUSE THE ORGANIZATION PROVIDES MUCH NEEDED HEALTH CARE SERVICES INDISCRIMINATELY TO THE COMMUNITY-AT-LARGE WITHOUT REGARD TO WHETHER OR NOT THE PATIENT HAS INSURANCE AND IF THE BILL WILL EVER BE PAID. PART III, SECTION A, LINE 4: AS REPORTED IN MONTEFIORE HEALTH SYSTEM'S AUDITED CONSOLIDATED FINANCIAL STATEMENTS, BAD DEBT EXPENSE IS DESCRIBED AS FOLLOWS: "THE COLLECTION OF PATIENT SERVICE REVENUE DUE FROM PATIENTS, INCLUDING COPAYMENTS AND DEDUCTIBLES, FROM THOSE WHO ARE INELIGIBLE FOR CHARITY CARE, IS SUBJECT TO UNCERTAINTY. THE HOSPITAL RECORDS BAD DEBT EXPENSE IN THE PERIOD SERVICES ARE RENDERED BASED ON PAST EXPERIENCE, TO ACCOUNT FOR AMOUNTS THAT PATIENTS MAY ULTIMATELY BE UNABLE OR UNWILLING TO PAY. FOR SELF-PAY PATIENTS, WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH CO-PAYMENTS AND DEDUCTIBLES AFTER THIRD-PARTY COVERAGE, THE HOSPITAL RECORDS AN ESTIMATE FOR BAD DEBT EXPENSE IN THE CURRENT PERIOD BASED ON PAST EXPERIENCE. AMOUNTS ULTIMATELY WRITTEN OFF AS UNCOLLECTIBLE AND RECOVERIES OF SUCH AMOUNTS ARE DEDUCTED FROM, OR ADDED TO, THE ALLOWANCE FOR DOUBTFUL ACCOUNTS." PART III, SECTION B, LINE 8: MEDICARE REVENUE AND ALLOWABLE COSTS REPORTED IN PART III, SECTION B, WERE DERIVED FROM THE MEDICARE COST REPORT. MEDICARE ALLOWABLE COSTS REPORTED ON PART III, LINE 6, PER SCHEDULE H INSTRUCTIONS, WERE DERIVED USING THE MEDICARE COST REPORT COST-FINDING METHODOLOGY, WHICH APPORTIONS ROUTINE COSTS TO MEDICARE USING DAYS AND ANCILLARY COSTS TO MEDICARE USING DEPARTMENTAL RATIOS OF COSTS TO CHARGES(RCCS). THE FOLLOWING TABLE REPRESENTS A RECONCILIATION OF MEDICARE REVENUE AND COSTS INCLUDED ON LINES 5, 6, AND 7 IN PART III TO THE TOTAL ACTUAL MEDICARE REVENUE AND COSTS OF THE HOSPITAL. AS HIGHLIGHTED IN THIS TABLE, INCLUDING THE ADJUSTMENTS DESCRIBED BELOW WOULD HAVE RESULTED IN A MEDICARE SHORTFALL OF $6,953,188. REVENUE ALLOWABLE SURPLUS COSTS (SHORTFALL) PART III, LINES 5-7: $46,110,656 $43,259,089 $2,851,567 ADD: MED. CENTERS COSTS: - 3,633,757 (3,633,757) ADD: MEDICARE DME: 5,712,021 7,021,907 (1,309,886) ADD: MED. CENTER EMPL. PHY.: 1,135,751 3,128,703 (1,992,952) ADD: MED. SUBSID. HLTH. SERV.: 2,059,238 4,927,398 (2,868,160) TOTAL OVERALL MEDICARE SHORTFALL:$55,017,666 $61,970,854 (6,953,188) PART III, SECTION C, LINE 9B: FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE, ALL COLLECTION ACTIVITY IS HALTED AND THE PATIENT IS REFERRED FOR FINANCIAL AID. IF AN ACCOUNT IS IN COLLECTION AND THE PATIENT REQUESTS FINANCIAL AID OR IF THE AGENCY DETERMINES THAT THE PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE, THE ACCOUNT IS REFERRED BACK TO THE HOSPITAL WHERE THE PATIENT IS PROVIDED ASSISTANCE WITH COMPLETING AN APPLICATION FOR ASSISTANCE. 2. NEEDS ASSESSMENT: MONTEFIORE NEW ROCHELLE HOSPITAL INITIATED OPERATIONS ON NOVEMBER 6, 2013. AS A NEW FACILITY, BOTH A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT AND A NEW YORK COMMUNITY SERVICE PLAN OUTLINING COMMUNITY NEEDS WERE DEVELOPED AND COMPLETED BY DECEMBER 31, 2014. 3. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: ALL INTAKE, REGISTRATION, AND COLLECTION AGENCY STAFF IS TRAINED ON THE HOSPITAL'S FINANCIAL AID POLICY AND HOW TO PROVIDE PATIENTS WITH ASSISTANCE. MONTEFIORE NEW ROCHELLE HOSPITAL HAS A POLICY THAT ESTABLISHES GUIDELINES FOR THE BILLING OFFICE TO FOLLOW WHEN WORKING WITH INDIVIDUALS WHO ARE HAVING DIFFICULTY PAYING THEIR MEDICAL BILLS. A REFERRAL IS MADE TO THE HOSPITAL'S FINANCIAL AID OFFICE AND A FINANCIAL COUNSELOR WILL HELP THE PATIENT APPLY FOR FREE OR LOW-COST INSURANCE. IF THE FINANCIAL COUNSELOR DETERMINES THAT THE PATIENT DOES NOT QUALIFY FOR LOW-COST INSURANCE, THE COUNSELOR WILL HELP THE PATIENT APPLY FOR A FINANCIAL AID DISCOUNT BASED ON INCOME LEVEL. THE HOSPITAL MAKES ITS FINANCIAL AID POLICY KNOWN TO THE PUBLIC BY PROVIDING WRITTEN INFORMATION AVAILABLE IN BOTH ENGLISH AND SPANISH, INCLUDING BROCHURES AT ALL PATIENT SERVICE AREAS, INFORMATION POSTED ON THE INTRANET AND INTERNET, AND INFORMATION SENT OUT ON PATIENTS' BILLS. THERE ARE ALSO SIGNS POSTED AT THE MAIN ENTRANCE TO THE HOSPITAL IN ENGLISH AND SPANISH ADVISING PATIENTS OF THE ROOM LOCATION FOR ASSISTANCE WITH FINANCIAL AID. 4. COMMUNITY INFORMATION: THE DETAILED IDENTIFICATION OF THE COMMUNITY'S DEMOGRAPHICS AND SPECIFIC NEEDS ARE DOCUMENTED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. 5. PROMOTION OF COMMUNITY HEALTH: MONTEFIORE HEALTH SYSTEM, INC. IS A LEADER IN COMMUNITY HEALTH AND HAS A LONG HISTORY OF DEVELOPING INNOVATIVE APPROACHES TO CARE AND CREATING PROGRAMS TO BEST SERVE THE CHANGING NEEDS OF ITS COMMUNITY. MONTEFIORE NEW ROCHELLE HOSPITAL'S COMMUNITY HEALTH PROGRAMS ARE IN DEVELOPMENT WITH THE OVERALL COMMUNITY HEALTH NEEDS ASSESSMENT. 6. AFFILIATED HEALTH CARE SYSTEM: MONTEFIORE NEW ROCHELLE HOSPITAL IS AN AFFILIATE OF MONTEFIORE HEALTH SYSTEM, INC. 7. STATE FILING OF COMMUNITY BENEFIT REPORT: MONTEFIORE NEW ROCHELLE HOSPITAL FILES A COMMUNITY SERVICE PLAN WITH THE STATE OF NEW YORK. false true false false false false false false false PHILIP O OZUAH MD PHD EXECUTIVE VP & COO 0 1539345 0 619200 0 127100 0 663122 0 34011 0 2982778 0 0 CHRISTOPHER S PANCZNER SENIOR VP & GENERAL COUNSEL 0 697112 0 392200 0 21554 0 232140 0 0 0 1343006 0 0 JOEL A PERLMAN EXECUTIVE VICE PRESIDENT & CFO 0 1018981 0 507500 0 3048 0 17000 0 34011 0 1580540 0 0 SUSAN GREEN-LORENZEN RN SENIOR VP-OPERATIONS 0 785243 0 386900 0 22034 0 263986 0 32082 0 1490245 0 0 LYNN RICHMOND Executive Vice President 0 782898 0 446300 0 27554 0 249178 0 33464 0 1539394 0 0 JOHN OLSEWSKI MD ORTHOPEDIC SURGEON 518837 0 0 0 1032 0 6800 0 26610 0 553279 0 0 0 STEVEN B ZELICOF MD CHIEF, ORTHOPEDIC SURGERY 548858 0 0 0 1032 0 6800 0 24099 0 580789 0 0 0 MADHU RANGRAJ MD DIRECTOR, SURGERY 519805 0 0 0 3048 0 6800 0 23992 0 553645 0 0 0 PATRICIA DEVINE MD DIRECTOR OF OB/GYN 383056 0 0 0 552 0 6800 0 24060 0 414468 0 0 0 STEPHEN JESMAJIAN MD CHIEF & RESIDENT PROG DIRECTOR 373836 0 0 0 1584 0 6800 0 26610 0 408830 0 0 0 STEVEN M SAFYER MD PRESIDENT & CEO 0 1768651 0 1203200 0 1312042 0 17000 0 34255 0 4335148 0 0 PART 1 LINES 3, 4B & PART II - COLUMNS (b)(i), (ii) AND (iii) As it relates to Compensation from Montefiore Health System, Inc. The Compensation Committee reviews and approves all forms of compensation and benefits provided to each executive with the assistance of a national independent compensation consulting firm. The consulting firm assists the Compensation Committee with its decision-making process to ensure executive compensation levels are reasonable and appropriate relative to those of other similar organizations. Base salaries in Column B(i) are determined based on competitive market practices for comparable positions with similar size organizations and scope of responsibilities. Bonus and incentive compensation in Column B(ii) is based on the achievement of performance goals. The executives' compensation program has a significant pay-at-risk component to ensure the alignment of pay and organizational performance. Goals are set in advance in areas such as quality of care, patient satisfaction, community services and financial performance. Compensation is at risk if the goals established by the Compensation Committee are not met. Other reportable compensation in column B(III) includes distributions from the supplemental executive retirement plan. In a manner designed to qualify for the "rebuttable presumption of reasonableness" the Compensation Committee of the Board of Trustees expressly reviewed and approved these retirement benefit arrangements for senior executives in a manner that qualified under the intermediate sanctions rules of the Federal tax law, and in recognition of (a) the executives' years of service to the organization and (b) the significant contributions to enhancing the ability of the organization to achieve its charitable mission in a manner consistent with financial solvency. Accordingly, this benefit should be viewed as applying to years of service for the organization. Steven Safyer, MD - Pooled Supplemental Executive Retirement Plan distribution of $1,300,859 based on over 30 years of service at Montefiore. Christopher Panczner - Accrued and unpaid service costs of $215,140. Philip O. Ozuah, MD, PHD. - Accrued and unpaid service costs of $646,122. Susan Green Lorenzen, RN - Accrued and unpaid service costs of $246,986. Lynn Richmond - Accrued and unpaid service costs of $232,178. The Directors, Officers and Key Employees listed in Part II Lines 1(ii), 2(ii), 3(ii), 4(ii), 5(ii) and 11(ii) are not employees of this filing organization, Montefiore New Rochelle Hospital. These individuals are employed and their compensation is paid by Montefiore Health System, Inc. EIN 20-1615393. FORM 990, PART VI, SECTION A, LINE 2: David C. Gottlieb (trustee - resigned 6/15) is related to Jay B. Langner (trustee) - Family relationship. FORM 990, PART VI, SECTION A, LINE 6: MONTEFIORE HEALTH SYSTEM, INC. IS THE SOLE MEMBER OF MONTEFIORE NEW ROCHELLE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A: THE BOARD OF TRUSTEES OF MONTEFIORE HEALTH SYSTEM, INC., THE SOLE MEMBER OF MONTEFIORE NEW ROCHELLE HOSPITAL, HAS THE AUTHORITY TO APPOINT THE BOARD OF TRUSTEES OF MONTEFIORE NEW ROCHELLE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B: THE BOARD OF TRUSTEES OF MONTEFIORE HEALTH SYSTEM, INC., THE SOLE MEMBER OF MONTEFIORE NEW ROCHELLE HOSPITAL, HAS THE AUTHORITY TO APPROVE THE OPERATING AND CAPITAL BUDGETS OF MONTEFIORE NEW ROCHELLE HOSPITAL. FORM 990, PART VI, SECTION B, LINE 11B: THE FORM 990 WAS PREPARED BY THE HOSPITAL'S FINANCE DEPARTMENT WITH THE ASSISTANCE OF VARIOUS DEPARTMENTS. THE FORM 990 WAS REVIEWED AND APPROVED BY THE VICE PRESIDENT-FINANCE, ACCOUNTING AND FINANCIAL REPORTING AND THE HOSPITAL'S SENIOR LEADERSHIP TEAM INCLUDING THE CHIEF FINANCIAL OFFICER. IN ADDITION, AN INDEPENDENT ACCOUNTING FIRM WAS ENGAGED TO REVIEW THE FORM 990. UPON COMPLETION OF THE VARIOUS REVIEWS, THE FORM 990 WAS PRESENTED TO THE FINANCE COMMITTEE OF THE BOARD OF TRUSTEES FOR REVIEW AND APPROVAL. ONCE APPROVED BY THE FINANCE COMMITTEE OF THE BOARD OF TRUSTEES, THE FORM 990 WAS PROVIDED TO ALL MEMBERS OF MONTEFIORE NEW ROCHELLE HOSPITAL'S GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 12C: ORGANIZATION COMPLIANCE POLICY MONITORING AND ENFORCEMENT: THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICTS OF INTEREST POLICY BY MEANS OF A SURVEY THAT WAS DEVELOPED BY MONTEFIORE'S COUNSEL. MONTEFIORE NEW ROCHELLE HOSPITAL'S BOARD OF TRUSTEES ADOPTED A POLICY THAT COMPORTS TO FEDERAL AND STATE CONFLICTS OF INTEREST REQUIREMENTS. THE GENERAL APPROACH WHEN A POTENTIAL CONFLICT OF INTEREST ARISES IS TO DISCLOSE THE POSSIBLE CONFLICT TO THE COMPLIANCE OFFICER. THE COMPLIANCE OFFICER WILL MAKE EVERY EFFORT TO PROVIDE GUIDANCE TO PERMIT RESOLUTION OF ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. THE COMPLIANCE OFFICER WILL TAKE APPROPRIATE ACTIONS, INCLUDING ADVISING MONTEFIORE NEW ROCHELLE HOSPITAL'S BOARD OF TRUSTEES REGARDING PARTICULAR CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15A & 15B: DETERMINATION OF COMPENSATION: The Officers presented in Part VII and Schedule J are not employed and paid by the organization rather are employed and paid by Montefiore Health System, INC. Montefiore Health System, Inc. is committed to ensuring that its executive compensation program adheres to the highest standards of regulatory compliance and best corporate governance. The Board of Trustees has charged the Compensation Committee of the Board (which is comprised of independent Board members with no conflicts of interest in regards to executive compensation) with making all decisions related to compensation for officers and key employees. All decisions made by the Compensation Committee are appropriately and timely documented in meeting minutes. The compensation committee's review process follows the Intermediate Sanctions guidelines for qualifying for the rebuttable presumption of reasonableness. The Committee retains an independent compensation consultant to assist it with this process. Compensation levels are established considering data for comparable organizations, an assessment of management performance (including the services provided to the community), and other business judgement factors, consistent with Montefiore's executive compensation philosophy. The Committee's decisions are made in the best interest of Montefiore, and are intended to ensure the recruitment and retention of key executive talent, consistent with the market practices of other not-for-profit healthcare organizations of comparable scope, mission and complexity. On an annual basis, the Committee provides the full Board of Trustees with a description of the committee's review and approval process and its decisions. FORM 990, PART VI, SECTION C, LINE 19: THE CONFLICTS OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: THE OTHER CHANGE IN NET ASSETS OF $31,439 WAS RELATED TO THE RECEIPT OF A SETTLEMENT BETWEEN THE ESTATE OF THE BANKRUPT SOUND SHORE MEDICAL CENTER AND TRANSFER TO MONTEFIORE NEW ROCHELLE HOSPITAL. MMC Corporation 111 East 210th Street Bronx NY 10467 133430322 Real Estate NY 501 (C)(3) 11 TYPE I MMC true Montefiore Medical Center 111 East 210th Street Bronx NY 10467 131740114 Acad Med Ctr NY 501 (C)(3) 3 MHS true MMC Residential Corp I Inc 3411 Wayne Avenue Bronx NY 10467 911943271 Staff Housing NY 501 (C)(2) MMC true Montefiore Hospital Housing Sect IIInc 3450 Wayne Avenue Bronx NY 10467 237160641 Staff Housing NY 501 (C)(2) MMC true Montefiore North Amb Care Ctr Inc 4234 Bronx Boulevard Bronx NY 10466 010796859 Amb. Services NY 501 (C)(3) 3 MHS true Mosholu Preservation Corporation 3400 Reservoir Oval East Bronx NY 10467 133109387 Community Ser NY 501 (C)(3) 11 TYPE II MMC true GUN HILL MRI PC 200 EAST GUN HILL ROAD BRONX NY 10467 133734486 DIAG SERVICES NY 501 (C)(3) 11 TYPE I MMC true MONTEFIORE HEALTH SYSTEM INC 555 SOUTH BROADWAY TARRYTOWN NY 10591 201615393 PARENT CO. NY 501(C)(3) 11 TYPE III MMAHS false MONTEFIORE MOUNT VERNON HOSPITAL 12 NORTH SEVENTH AVENUE MOUNT VERNON NY 10550 462916938 HOSPITAL NY 501(C)(3) 3 MHS true SCHAFFER EXTENDED CARE CENTER 16 GUION PLACE NEW ROCHELLE NY 10801 462929888 NURSING HOME NY 501(C)(3) 3 MHS true Albert College of Medicine Inc 111 East 210th Street Bronx NY 10467 472209056 Inactive NY 501(c)(3) 2 MMAHS false Montefiore Medicine Acad Hlth Sys Inc 555 South Broadway Tarrytown NY 10591 471582973 SYS PARENT NY 501(c)(3) 11 Type III NA false The Nyack Hospital 160 North Midland Avenue NYACK NY 10960 131740119 Hospital NY 501(c)(3) 3 MHS true Montefiore Foundation INC 111 East 210th Street Bronx NY 10467 471600439 INACTIVE NY 501(c)(3) 11 TYPE I MHS true White Plains Hospital Medical Center 41 East Post Road White Plains NY 10601 131740130 HOSPITAL NY 501 (C)(3) 3 MHS true Einstein College of Med Housing Co Inc 1300 Morris Park Avenue Bronx NY 10461 237075620 STAFF HOUSING NY 501(C)(2) MMAHS false Montefiore CERC Operations Inc 111 East 210th Street Bronx NY 10467 474853506 REHAB CENTER NY 501 (c)(3) II TYPE I MMC true White Plains Hospital Center Foundation 41 East Post Road Davis Avenue White Plains NY 10601 133281507 FOUNDATION NY 501 (C)(3) 7 WPH false Nyack Hospital Foundation 160 North Midland Avenue Nyack NY 10960 133245804 FOUNDATION NY 501 (C)(3) 7 NYACK HOSP false UNIVERSITY BEHAVIORAL ASSOCIATES INC 111 EAST 210TH STREET BRONX NY 10467 133877781 MGMT SERVICES NY NA C Corp true THE MONTEFIORE IPA INC 111 EAST 210TH STREET BRONX NY 10467 134114915 MANAGED CARE NY NA C CORP true MMC GI HOLDINGS EAST INC 111 EAST 210TH STREET BRONX NY 10467 721610013 HOLDING COMPA NY NA C CORP true MMC GI HOLDINGS WEST INC 111 EAST 210TH STREET BRONX NY 10467 721610015 HOLDING COMPA NY NA C CORP true MONTEFIORE BEHAVIORAL CARE IPA NO 1INC 111 EAST 210TH STREET BRONX NY 10467 133952750 INTEG PROV AS NY NA C CORP true BRONX ACCOUNTABLE CARE NETWORK IPA INC 111 EAST 210TH STREET BRONX NY 10467 300689571 MANAGED CARE NY NA C CORP true Montefiore Consolidated Ventures Inc 111 East 210th Street Bronx NY 10467 611728539 Holding Compa NY NA C Corp true MMC Contract Management Org No 1 Inc 111 East 210th Street Bronx NY 10467 133859895 Contract Mgmt NY NA C Corp true Montefiore Insurance Company Inc 111 East 210th Street Bronx NY 10467 320436594 INS COMPANY NY NA C Corp true Montefiore Community Network LLC 111 East 210th Street Bronx NY 10467 461374475 COMM NETWORK NY NA C Corp true Hudson Valley IPA Inc 111 East 210th Street Bronx NY 10467 383978087 MANAGED CARE NY NA C CORP true Montefiore Innovations Inc 111 East 210th Street Bronx NY 10467 475106910 HOLDING COMPANY NY NA C CORP true Highland Medical PC 160 North Midland Nyack NY 10960 134034481 PHYSICIAN SERV NY NA C CORP true 8 Longview Development Corp Davis Avenue at East Post Road White Plains NY 10601 263321278 HOUSING NY NA C CORP true White Plains Medical Diagnostic Service 41 East Post Road White Plains NY 10601 453164626 PROFESSIONAL SERV NY NA C CORP true Cancer and Blood Medical Services of NY 41 Post Road White Plains NY 10601 462021804 PROFESSIONAL SERV NY NA C CORP true NH Management Services Inc 160 N Midland Avenue Nyack NY 10960 134026486 MANAGEMENT SERV. NY NA C CORP true Davis Avenue Corp Davis Avenue at East Post Road White Plains NY 10601 133331643 HEALTHCARE SERV NY NA C CORP true Post Development Corporation Davis Avenue at East Post Road White Plains NY 10601 222605281 REAL ESTATE NY NA C CORP true White Plains Management Co Inc 41 East Post Road White Plains NY 10601 133331641 MANAGEMENT SERV NY NA C CORP true WPHC Building Corp 41 East Post Road White Plains NY 10601 133676932 REAL ESTATE NY NA C CORP true false false false false true true false false false false true false true true false true true false true MONTEFIORE HEALTH SYSTEM INC E 1822655 COST MONTEFIORE HEALTH SYSTEM INC K 3471036 COST MONTEFIORE HEALTH SYSTEM INC M 3265021 COST MONTEFIORE MEDICAL CENTER M 2880326 COST MONTEFIORE MEDICAL CENTER P 1269217 COST