STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

SOUTHAMPTON HOSPITAL ASSOCIATION: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
SOUTHAMPTON HOSPITAL ASSOCIATION (EIN 11-1667765)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-08-16
IRS object ID
201632299349300518
Schema version
2015v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2016-08-16T09:01:31-05:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BDO USA LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1100 PARK AVENUEAddressLine1Txt
CityNEW YORKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP100175001ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN111667765EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SOUTHAMPTON HOSPITAL ASSOCIATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% CHRISTOPHER SCHULTHEISInCareOfNm
Business Name ControlSOUTBusinessNameControlTxt
Phone6317268301PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1240 MEETING HOUSE LANEAddressLine1Txt
CitySOUTHAMPTONCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11968ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCHRISTOPHER SCHULTHEISPersonNm
Person TitleCFOPersonTitleTxt
Phone6314234580PhoneNum
Signature2016-08-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonPaul HammerschmidtPreparerPersonNm
PTINP01384178PTIN
Phone2128858000PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerROBERT S CHALONERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1240 MEETING HOUSE LANEAddressLine1Txt
CitySOUTHAMPTONCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11968ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$150,453,706GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.southamptonhospital.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1909FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionTO PROVIDE AND ENSURE THE HIGHEST QUALITY OF HEALTHCARE SERVICES FOR ITS ENTIRE COMMUNITY.ActivityOrMissionDesc
Voting Members Governing Body22VotingMembersGoverningBodyCnt
Voting Members Independent21VotingMembersIndependentCnt
Total Employee1227TotalEmployeeCnt
Total Volunteers25TotalVolunteersCnt
Total Gross UBI$3,263,661TotalGrossUBIAmt
PY Contributions Grants$11,272,875PYContributionsGrantsAmt
CY Contributions Grants$5,486,201CYContributionsGrantsAmt
PY Program Service Revenue$130,907,809PYProgramServiceRevenueAmt
CY Program Service Revenue$138,558,938CYProgramServiceRevenueAmt
PY Investment Income$1,094,544PYInvestmentIncomeAmt
CY Investment Income$813,291CYInvestmentIncomeAmt
PY Other Revenue$941,126PYOtherRevenueAmt
CY Other Revenue$1,012,662CYOtherRevenueAmt
PY Total Revenue$144,216,354PYTotalRevenueAmt
CY Total Revenue$145,871,092CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$83,145,144PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$89,750,094CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$51,888,924PYOtherExpensesAmt
CY Other Expenses$55,128,284CYOtherExpensesAmt
PY Total Expenses$135,034,068PYTotalExpensesAmt
CY Total Expenses$144,878,378CYTotalExpensesAmt
PY Revenues Less Expenses$9,182,286PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$992,714CYRevenuesLessExpensesAmt
Total Assets BOY$112,332,163TotalAssetsBOYAmt
Total Assets EOY$120,793,141TotalAssetsEOYAmt
Total Liabilities BOY$82,418,298TotalLiabilitiesBOYAmt
Total Liabilities EOY$92,946,090TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$29,913,865NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$27,847,051NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE VISION OF SOUTHAMPTON HOSPITAL ASSOCIATION IS TO MEET THE EVOLVING HEALTHCARE NEEDS OF ITS EASTERN LONG ISLAND COMMUNITY BY PROVIDING ACCESS TO A CONTINUUM OF HIGH QUALITY CLINICAL SERVICES. TO ACHIEVE THIS, THE HOSPITAL WILL FOCUS RESOURCES ON CONTINUOUSLY IMPROVING CLINICAL OUTCOMES, PATIENT SAFETY, SERVICE EXCELLENCE AND PROMOTING EDUCATIONAL OUTREACH AND PROFESSIONAL DEVELOPMENT OF ITS STAFF. THE ORGANIZATION IS A MEMBER OF THE EAST END HEALTH ALLIANCE, THE ARTICLE 28 PARENT OF EASTERN LONG ISLAND HOSPITAL, PECONIC BAY MEDICAL CENTER AND SOUTHAMPTON HOSPITAL. CONSISTENT WITH THE MISSION OF THE ORGANIZATION, THE GOALS OF THE ALLIANCE ARE AS FOLLOWS: 1) TO COLLABORATIVELY DEVELOP HIGH QUALITY, COMPREHENSIVE AND ACCESSIBLE HEALTH CARE SERVICES TO MEET THE NEEDS OF THE COMMUNITY SERVED; 2) TO RATIONALIZE HEALTH CARE SERVICES ACROSS THE SYSTEM; AND 3) TO REALIZE MANAGEMENT EFFICIENCIES. SOUTHAMPTON HOSPITAL IS CURRENTLY AFFILIATED WITH STONY BROOK MEDICINE. THE TWO INSTITUTIONS AREMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$122,966,280ExpenseAmt
Grant$0GrantAmt
Revenue$135,295,277RevenueAmt
DescSOUTHAMPTON HOSPITAL ASSOCIATION OFFERS A FULL CONTINUUM OF AMBULATORY AND INPATIENT SERVICES RANGING FROM PRIMARY MEDICAL CARE TO SPECIALIZED SURGICAL PROCEDURES, AND IS STAFFED BY MORE THAN 280 PHYSICIANS, DENTISTS AND ALLIED HEALTH PROFESSIONALS REPRESENTING 44 MEDICAL SPECIALTIES. THE ORGANIZATION has developed numerous services and outreach, detailed below, to respond to the needs of its patients, including recruiting additional primary care and specialty physicians, RNs, NPs, and PAs. The graduate medical education program is training physicians for primary and family practice, as well as surgery, and a gratifying number of these doctors are staying within the Hospital's service area. It is anticipated that the Affordable Care Act and the insurance exchanges will result in many more people accessing primary care and the Hospital continues to prepare for this inevitability through its medical education program. SINCE THE ORGANIZATION'S SERVICE AREA EXTENDS FROM WESTHAMPTON BEACH TO MONTAUK, THE HOSPITAL HAS A NUMBER OF SATELLITE OFFICES TO PROVIDE CONVENIENT, SPECIALIZED CARE TO THESE COMMUNITIES. THESE INCLUDE: A) MEETING HOUSE LANE MEDICAL PRACTICE - the practice continues to add new offices in primary, internal medicine, and specialty care on the South Fork. Specialty care services include rheumatology, nephrology, neurology, allergy/asthma, pulmonology, psychiatry, infectious disease, gastroenterology, as well as nutritional and diabetes education. In Southampton, an office was added to the four existing sites, bringing the total to five and a surgical specialty office was also opened in 2015, offering general, orthopedic and bariatric surgery. Other offices include locations in Amagansett, East Hampton (two offices), Hampton Bays (three offices), Montauk, Riverhead, Sag Harbor, Wainscott, and Water Mill. B) WESTHAMPTON PRIMARY CARE CENTER - PROVIDING CARE FOR THE WESTHAMPTON, WESTHAMPTON BEACH, QUOGUE, AND REMSENBURG COMMUNITIES. C) LABORATORY AND IMAGING SERVICES - PROVIDING SERVICES IN EAST HAMPTON, HAMPTON BAYS AND SOUTHAMPTON. D) REGIONAL DIALYSIS CENTER - SERVICE TO DIALYSIS PATIENTS IS PROVIDED BY A DEDICATED INTERDISCIPLINARY TEAM OF BOARD-CERTIFIED NEPHROLOGISTS, CERTIFIED DIALYSIS RNS, LPNS AND DIALYSIS TECHNICIANS, CERTIFIED SOCIAL WORKERS, AND A NYS REGISTERED DIETITIAN. 24-HOUR EMERGENCY SERVICE IS ALSO AVAILABLE. E) CENTER FOR PHYSICAL THERAPY AND SPORTS REHABILITATION - PROVIDING CARE FOR THE WESTHAMPTON, WESTHAMPTON BEACH, EAST QUOGUE, QUOGUE, AND REMSENBURG COMMUNITIES. F) THE SHINNECOCK INDIAN HEALTH CLINIC - SINCE APRIL OF 1995, SOUTHAMPTON HOSPITAL HAS WORKED WITH THE SHINNECOCK NATION TO PROVIDE SERVICES AT THE SHINNECOCK INDIAN HEALTH CLINIC THROUGH A CONTRACT WITH THE NEW YORK STATE DEPARTMENT OF HEALTH. ON AN ANNUAL BASIS, THE CLINIC PROVIDES APPROXIMATELY 2,100 MEDICAL AND 1,000 DENTAL VISITS FOR ELIGIBLE MEMBERS OF THE SHINNECOCK NATION. DENTAL SERVICES, INCLUDING COMMUNITY EDUCATION, SCREENING, RADIOLOGICAL EXAMS, DENTAL HYGIENE AND RESTORATIVE CARE ARE PROVIDED THROUGH A SUBCONTRACT WITH STONY BROOK UNIVERSITY SCHOOL OF DENTAL MEDICINE. CURRENTLY, DENTAL SERVICES ARE AVAILABLE EIGHT DAYS PER MONTH FOR ADULTS AND TWO DAYS FOR CHILDREN. IN ADDITION TO PRIMARY CARE, DENTAL SERVICES, NUTRITIONAL COUNSELING, PRENATAL CARE AND ENDOCRINE SERVICES, THE CLINIC PROVIDES MENTAL HEALTH AND SUBSTANCE ABUSE COUNSELING. HEALTH SCREENING DAY IS ALSO HELD ANNUALLY IN COLLABORATION WITH LOCAL HEALTHCARE PROVIDERS AND INSTITUTIONS. G) THE DAVID E. ROGERS CENTER FOR HIV/AIDS CARE (DRC) provides comprehensive HIV medical care, with 24/7 on call service; mental health counseling; psychiatry care; medical case management with treatment adherence; nutritional counseling; Hepatitis C treatment; Pre-Exposure Prophylaxis (PrEP) care; Post-Exposure Prophylaxis (PEP) care; free HIV testing; help with advocacy, case management, entitlements, and legal service; Wellness Fund, financial support for patient's special needs; and other support services to people living with HIV/AIDS. The Center also provides education and outreach to affected friends and families. From initial diagnosis of HIV through all stages of illness, our medical team of credentialed HIV specialists provides state-of-the-art care. SINCE 1994 THE DRC HAS PROVIDED HIV CARE TO RESIDENTS OF THE EAST END OF LONG ISLAND, A GEOGRAPHIC AREA PREVIOUSLY UNDERSERVED DESPITE A HIGH HIV PREVALENCE RATE. FROM ITS INCEPTION, THE DRC HAS ENJOYED THE COOPERATIVE EFFORTS OF ITS PARTNER ORGANIZATIONS SOUTHAMPTON HOSPITAL AND THE STONY BROOK UNIVERSITY MEDICAL CENTER AS WELL AS THE SUPPORT OF THE COMMUNITIES OF THE EAST END. THE CENTER HAS MET ITS OBJECTIVES BY PROVIDING CONTINUITY AND ACCESSIBILITY OF CARE BY ESTABLISHING LINKAGES BETWEEN THE HOSPITALS AND WITH COMMUNITY BASED ORGANIZATIONS AND THE COMMUNITY AT LARGE. THE DRC DEPENDS ON THE COOPERATIVE EFFORTS OF ALL HEALTH & HUMAN SERVICE AGENCIES FOR OUTREACH, TO ENSURE A CONTINUITY OF CARE FOR OUR PATIENTS, AND TO PROVIDE SERVICES FOR THE EAST END COMMUNITY. Annually the DRC provides approximately: 844 Medical visits; 56 Hepatitis C visits; 561 Mental Health/Social Work visits; 229 Psychiatry visits; 32 Nutritional Counseling visits; 21 HIV Testing visits; 14 Pre-Exposure Prophylaxis (PrEP) visits; 4 Occupational Exposure visits; 10 Post Exposure Prophylaxis (PEP) visits; for a total of 1,771 visits provided for 219 active patients. H) CENTER FOR PRENATAL CARE - THE CENTER FOR PRENATAL CARE AT GREENPORT PROVIDES COMPREHENSIVE PRENATAL, GYNECOLOGIC AND FAMILY PLANNING SERVICES FOR WOMEN AND IS AN IMPORTANT OUTREACH ACTIVITY THAT PERMITS THE HOSPITAL TO TAILOR ITS PROGRAMS TO COMMUNITY NEEDS. THE CENTER'S STAFF PROVIDES EXTENSIVE EDUCATION AND COUNSEL TO THEIR PATIENTS IN THE AREAS OF NUTRITION, CHILDBIRTH EDUCATION, DOMESTIC VIOLENCE, AS WELL AS DRUG AND ALCOHOL ABUSE, WHILE ALSO PROVIDING IMMEDIATE ACCESS TO MEDICAID ASSISTANCE, FOR MOTHERS MEETING THE ELIGIBILITY REQUIREMENTS, THROUGH THE PRENATAL CARE ASSISTANCE PROGRAM (PCAP). THE CENTER HAS SUCCESSFULLY WORKED WITH THE LOCAL TOWN GOVERNMENT TO OBTAIN THE AGREEMENT OF LOCAL GROCERS TO ACCEPT WIC VOUCHERS. STAFF ALSO UTILIZES FLYERS, BROCHURES, AND POSTERS TO INCREASE AWARENESS OF HOSPITAL SERVICES AND OFFERS TRANSLATION SERVICES TO THE SIGNIFICANT NUMBER OF HISPANIC WOMEN SEEKING CARE AT THE CENTER. THE CENTER RECENTLY STARTED IMPLEMENTING GENETIC SCREEING, WHICH IS AVAILABLE TO ALL ITS PATIENTS AND CAN BE PERFORMED AT 10 WEEKS GESTATION. THE SCREENING INCLUDES TESTING FOR DOWN SYNDROME CF, AS WELL AS PROVIDING THE SEX OF THE CHILD. THE CENTER PROVIDES PRENATAL CARE TO APPROXIMATELY 50 MOTHERS ANNUALLY IN AN UNDERSERVED AND GEOGRAPHICALLY REMOTE AREA. ALL OF THESE BABIES ARE BORN AT SOUTHAMPTON HOSPITAL. IN ADDITION, THE ORGANIZATION IS PROUD OF THE EXCEPTIONAL SPECIALTY SERVICES IT PROVIDES TO THE COMMUNITY. THESE INCLUDE: 1) Audrey and Martin Gruss Heart & Stroke Center - opened in April 2015, providing vascular surgery and diagnostics in a state-of-the-art operating suite. This is particularly critical to the Hospital's service area since the nearest tertiary medical center is 46 miles away in Stony Brook, NY. 2) Tick-Borne Disease Resource Center - established in 2014, was created in response to a growing concern for diseases that are prevalent in the East End population due to several varieties of ticks found in the area. The Resource Center educates the public, promotes collaboration in the medical community, and facilitates access to diagnosis and treatment of tick-borne diseases. We maintain a dedicated phone "help" line for advice, include information about the complex set of tick-borne diseases on the Hospital website, and raise public awareness by presenting educational programs throughout the East End community. 3) THE ELLEN HERMANSON BREAST CENTER - OFFERS A WIDE SPECTRUM OF BREAST HEALTH SERVICES, INCLUDING EDUCATION, EARLY DETECTION SCREENINGS, SURGERY, BREAST CANCER TREATMENT AND SUPPORT. ACCREDITED BY THE AMERICAN COLLEGE OF RADIOLOGY, THE CENTER UTILIZES STATE-OF-THE-ART DIAGNOSTIC TECHNIQUES, INCLUDING COMPUTER-ASSISTED MAMMOGRAPHY, TOMOSYNTHESIS, ULTRASOUND AND BREAST BIOPSY. 4) THE ED & PHYLLIS DAVIS WELLNESS INSTITUTE - OFFERS THE ONLY HOSPITAL-BASED INTEGRATIVE MEDICINE ON LONG ISLAND'S EAST END. INTEGRATIVE MEDICINE COMBINES MODERN SCIENCE, PSYCHOLOGY, NUTRITION, AND EXERCISE TO ENHANCE THE NATURAL HEALING CAPACITY OF THE BODY. SPECIAL PROGRAMS ARE AVAILABLE FOR PATIENTS SUFFERING FROM CHRONIC ILLNESS. CLASSES IN YOGA, TAI CHI, PILATES, ZUMBA, ARE AVAILABLE. PROGRAMS IN STRESS MANAGEMENT, NUTRITIONAL AND WEIGHT LOSS COUNSELING, SMOKING CESSATION, MASSAGE THERAPY, AND ACUPUNCTURE ARE ALSO AVAILABLE. 5) THE JENNY AND JOHN PAULSON DEPARTMENT OF EMERGENCY MEDICINE - SERVES MORE THAN 25,000 EMERGENCY PATIENTS ANNUALLY AND IS THE ONLY HOSPITAL-BASED EMERGENCY CARE ON THE SOUTH FORK OF LONG ISLAND. STAFFED 24/7 BY BOARD-CERTIFIED EMERGENCY PHYSICIANSDesc
Total Program Service Expenses$122,966,280TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (true)ReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document286IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee1227EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members22GoverningBodyVotingMembersCnt
Independent Voting Member21IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedurefalseWrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonCHRISTOPHER SCHULTHEISPersonNm
Phone6317268301PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1240 MEETING HOUSE LANEAddressLine1Txt
CitySOUTHAMPTONCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11968ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (34 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
ROBERT S CHALONER
PRESIDENT & CEO38.50.5Yes (X)Yes (X)$679,836$0$40,186
KENNETH B WRIGHT
CHAIRMAN1.250.0Yes (X)Yes (X)$0$0$0
RICHARD J HIEGEL ESQ
VICE CHAIR1.250.0Yes (X)Yes (X)$0$0$0
STANLEY D FRIEDMAN THRU 715
VICE PRESIDENT1.250.0Yes (X)Yes (X)$0$0$0
LAWRENCE A WILLIS
TREASURER1.250.0Yes (X)Yes (X)$0$0$0
PATRICIA STEWART
SECRETARY1.250.0Yes (X)Yes (X)$0$0$0
GEORGE F BIONDO ESQ
TRUSTEE1.250.0Yes (X)$0$0$0
BARBARA BORSACK
TRUSTEE1.250.0Yes (X)$0$0$0
RICHARD BRUCE
TRUSTEE1.250.0Yes (X)$0$0$0
JEAN FITZSIMMONS THRU 1215
TRUSTEE1.250.0Yes (X)$0$0$0
JAMES FORBES
TRUSTEE1.250.0Yes (X)$0$0$0
RALPH M GIBSON MD THRU 515
TRUSTEE1.250.0Yes (X)$0$0$0
DAVID GILLESPIE
TRUSTEE1.250.0Yes (X)$0$0$0
GILBERT W HARRISON
TRUSTEE1.250.0Yes (X)$0$0$0
GEORGE P KAZDIN
TRUSTEE1.250.0Yes (X)$0$0$0
LISA CLARE KOMBRINK ESQ
TRUSTEE1.250.0Yes (X)$0$0$0
JAY K LEVINE
TRUSTEE1.250.0Yes (X)$0$0$0
DOROTHY LEWIS THRU 1215
TRUSTEE1.250.0Yes (X)$0$0$0
HOWARD M LORBER
TRUSTEE1.250.0Yes (X)$0$0$0
R TIMOTHY MARAN
TRUSTEE1.250.0Yes (X)$0$0$0
JOHN MCGOWAN
TRUSTEE1.50.0Yes (X)$0$0$0
FLORENCE ROLSTON MD
TRUSTEE1.250.0Yes (X)$0$0$0
STEPHEN H SHAPOFF
TRUSTEE1.250.0Yes (X)$0$0$0
MICHAEL F SMITH
TRUSTEE1.250.0Yes (X)$0$0$0
JOHN WAMBOLD
TRUSTEE1.250.0Yes (X)$0$0$0
DARIN G WIGGINS MD
TRUSTEE1.250.0Yes (X)$0$0$0
CHIRSTOPHER J SCHULTHEIS
CHIEF FINANCIAL OFFICER37.50.5Yes (X)$308,833$0$40,331
FREDERIC I WEINBAUM
CHIEF MEDICAL OFFICER & COO37.50.0Yes (X)$495,145$0$43,614
PATRICIA A DARCEY
CHIEF NURSING OFFICER37.50.0$231,013$0$41,596Yes (X)
STEVEN GEORGOPOULOS
PHYSICIAN37.50.0$766,622$0$43,372Yes (X)
KRISTIN P NASO
PHYSICIAN37.50.0$499,465$0$43,372Yes (X)
NEEMA POURTAHERI
PHYSICIAN37.50.0$458,045$0$43,372Yes (X)
MICHAEL ELLIS
PHYSICIAN37.50.0$428,325$0$38,399Yes (X)
EDNA KAPENHAS
DIRECTOR/BREAST SURGEON37.50.0$399,396$0$40,967Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$4,266,680TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$375,209TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K128IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
E4 SERVICES LLC
60 NORTH CAROLINA AVENUESINKING SPRINGSPA19608HEALTHCARE SERVICES$1,193,958
EW HOWELL CO LLC
245 NEWTOWN ROAD SUITE 600PLAINVIEWNY11803CONSTRUCTION$1,052,130
MORRISON HEALTHCARE
PO BOX 102289ATLANTAGA30368FOOD SERVICES$606,441
HAMPTONS GYNECOLOGY OB
595 HAMPTON ROADSOUTHAMPTONNY11968MEDICAL$507,500
HIM ON CALL
1033 HAMILTON ROADALLENTOWNPA18101CONSULTING$308,930
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K28CntrctRcvdGreaterThan100KCnt
Federated Campaigns$154,999FederatedCampaignsAmt
Related Organizations$3,836,837RelatedOrganizationsAmt
Government Grants$1,337,758GovernmentGrantsAmt
All Other Contributions$156,607AllOtherContributionsAmt
Total Contributions$5,486,201TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
INPATIENT SERVICES624200$71,097,679$71,097,679
OUTPATIENT SERVICES624200$69,793,025$69,793,025
LABORATORY EXTENDED SERVICES621500$2,825,351$2,825,351
LESS: PROVISION FOR UNCOLLECTIBLES, NET624200-$6,400,000-$6,400,000
LABORATORY REVENUE621500$675,848$675,848

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$567,035TotalRevenueColumnAmt
Related Or Exempt Func Income$128,725RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$438,310UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$138,558,938TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$262,256TotalRevenueColumnAmt
Exclusion$262,256ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$851,116RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$851,116RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$851,116TotalRevenueColumnAmt
Exclusion$851,116ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$5,133,649SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$4,582,614SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$551,035SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$551,035TotalRevenueColumnAmt
Exclusion$551,035ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
SHINNECOCK 3RD PARTY900099$34,388$34,388
VENDOR REBATES900099$6,940$6,940
FILM COPIES900099$5,816$5,816

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$114,402TotalRevenueColumnAmt
Exclusion$114,402ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$161,546OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$145,871,092TotalRevenueColumnAmt
Related Or Exempt Func Income$135,295,277RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$3,263,661UnrelatedBusinessRevenueAmt
Exclusion$1,825,953ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,880,554TotalAmt
Management And General$1,880,554ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$65,418,405TotalAmt
Program Services$56,914,012ProgramServicesAmt
Management And General$8,504,393ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$4,875,532TotalAmt
Program Services$4,241,713ProgramServicesAmt
Management And General$633,819ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$12,869,163TotalAmt
Program Services$11,196,172ProgramServicesAmt
Management And General$1,672,991ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$4,706,440TotalAmt
Program Services$4,094,603ProgramServicesAmt
Management And General$611,837ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$841,623TotalAmt
Program Services$732,212ProgramServicesAmt
Management And General$109,411ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$620,724TotalAmt
Management And General$620,724ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$310,362TotalAmt
Management And General$310,362ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$27,711TotalAmt
Program Services$24,108ProgramServicesAmt
Management And General$3,603ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$104,955TotalAmt
Management And General$104,955ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$5,884,315TotalAmt
Program Services$5,119,354ProgramServicesAmt
Management And General$764,961ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$6,979TotalAmt
Program Services$6,072ProgramServicesAmt
Management And General$907ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$17,731,744TotalAmt
Program Services$15,426,617ProgramServicesAmt
Management And General$2,305,127ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$2,105,230TotalAmt
Program Services$1,831,550ProgramServicesAmt
Management And General$273,680ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,832,595TotalAmt
Program Services$1,594,358ProgramServicesAmt
Management And General$238,237ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$323,800TotalAmt
Management And General$323,800ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$6,258TotalAmt
Management And General$6,258ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,501,747TotalAmt
Program Services$1,306,520ProgramServicesAmt
Management And General$195,227ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$6,954,633TotalAmt
Program Services$6,050,531ProgramServicesAmt
Management And General$904,102ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$2,443,424TotalAmt
Program Services$2,125,779ProgramServicesAmt
Management And General$317,645ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
OTHER PURCHASE SERVICES$10,113,736$8,798,950$1,314,786
UTILITIES$1,981,661$1,724,045$257,616
OTHER DIRECT EXPENSES$1,652,136$1,437,358$214,778
MISCELLANEOUS$684,651$342,326$342,325

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$144,878,378TotalAmt
Program Services$122,966,280ProgramServicesAmt
Management And General$21,912,098ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$3,966,458BOYAmt
EOY$1,032,639EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,979,735BOYAmt
EOY$5,682,148EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$18,825,248BOYAmt
EOY$18,258,115EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$2,178,899BOYAmt
EOY$3,088,612EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$553,011BOYAmt
EOY$838,534EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$178,298,208LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$119,503,786LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$57,061,494BOYAmt
EOY$58,794,422EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$26,787,892BOYAmt
EOY$26,118,484EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$979,426BOYAmt
EOY$6,980,187EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$112,332,163BOYAmt
EOY$120,793,141EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$21,142,884BOYAmt
EOY$25,155,912EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$33,500,000BOYAmt
EOY$33,500,000EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$6,794,600BOYAmt
EOY$8,344,501EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$20,980,814BOYAmt
EOY$25,945,677EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$82,418,298BOYAmt
EOY$92,946,090EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$26,211,281BOYAmt
EOY$24,209,575EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$868,566BOYAmt
EOY$803,459EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,834,018BOYAmt
EOY$2,834,017EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$29,913,865BOYAmt
EOY$27,847,051EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$112,332,163BOYAmt
EOY$120,793,141EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$992,714ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$745,749NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$2,313,779OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsYes (true)GrantsOtherOrganizationsInd
Grants Other Organizations$27,711GrantsOtherOrganizationsAmt
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesfalseOtherActivitiesInd
Total Lobbying Expenditures$27,711TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind
Form4720 Filed4912 TaxfalseForm4720Filed4912TaxInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1F:FormAndLineReferenceDesc
ExplanationSOUTHAMPTON HOSPITAL ASSOCIATION PAYS MEMBERSHIP DUES TO THE BELOW MENTIONED ORGANIZATIONS. A PERCENTAGE OF THESE DUES ARE THEN USED TO REIMBURSE THE ORGANIZATION FOR THE COST OF LOBBYING ACTIVITIES PERFORMED ON BEHALF OF THE HOSPITAL. THE FUNDS ARE USED FOR LOBBYING PURPOSES IN CONNECTION WITH NEW YORK STATE AND FEDERAL POLICY ISSUES. MEMBERSHIP DUES PAID TO OTHER ORGANIZATIONS AND USED FOR LOBBYING PURPOSES: Healthcare Association of New York State........$ 9,757. American Hospital Association...................$ 6,616. Nassau Suffolk Hospital Council.................$ 1,897. Greater NY Hospital Association.................$ 8,494. 1199 HEP FUND...................................$ 947. Total...........................................$27,711.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$11,858,782BeginningYearBalanceAmt
Investment Earnings Or Losses-$20,898InvestmentEarningsOrLossesAmt
Other Expenditures$407,500OtherExpendituresAmt
End Year Balance$11,430,384EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$10,808,731BeginningYearBalanceAmt
Contributions$698,598ContributionsAmt
Investment Earnings Or Losses$351,153InvestmentEarningsOrLossesAmt
End Year Balance$11,858,482EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,527,461BeginningYearBalanceAmt
Contributions$5,500,000ContributionsAmt
Investment Earnings Or Losses$781,270InvestmentEarningsOrLossesAmt
End Year Balance$10,808,731EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,115,379BeginningYearBalanceAmt
Investment Earnings Or Losses$412,082InvestmentEarningsOrLossesAmt
End Year Balance$4,527,461EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,213,766BeginningYearBalanceAmt
Investment Earnings Or Losses-$98,387InvestmentEarningsOrLossesAmt
End Year Balance$4,115,379EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.75210BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.24790PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,683,775OtherCostOrOtherBasisAmt
Book Value$1,683,775BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$44,563,894OtherCostOrOtherBasisAmt
Depreciation$39,245,620DepreciationAmt
Book Value$5,318,274BookValueAmt
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovementsGrp

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$115,447,847OtherCostOrOtherBasisAmt
Depreciation$79,322,382DepreciationAmt
Book Value$36,125,465BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$16,602,692OtherCostOrOtherBasisAmt
Depreciation$935,784DepreciationAmt
Book Value$15,666,908BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$58,794,422TotalBookValueLandBuildingsAmt
Financial DerivativesFinancialDerivativesGrp
Closely Held Equity InterestsCloselyHeldEquityInterestsGrp

Other Securities OtherSecuritiesGrp (4 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
SHORT TERM INVESTMENTS$9,040,008F
RESTRICTIONS$3,637,476F
INVESTMENTS IN SHA PROPERTIES$6,300,000C
MALPRACTICE SELF INSURANCE-FD$7,141,000F
FieldValueIRS element (for citing)
Total Book Value Securities$26,118,484TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
DUE FROM AFFILIATE$3,127,067
DUE TO THIRD-PARTY PAYORS$3,033,025
BOND ISSUANCE COSTS, NET$807,617
OTHER ASSETS$12,478
FieldValueIRS element (for citing)
Total Book Value Other Assets$6,980,187TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
ACCRUED PENSION LIABILITY$8,757,894
DUE TO THIRD-PARTY PAYORS, NET$7,046,783
MALPRACTICE SELF-INSURANCE LIABILITY$7,141,000
DUE TO AFFILIATE$3,000,000
FieldValueIRS element (for citing)
Total Liability$25,945,677TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$142,770,986TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$745,749NetUnrealizedGainsInvstAmt
Other Revenue-$2,249,402OtherRevenueAmt
Revenue Not Reported-$2,995,151RevenueNotReportedAmt
Revenue Subtotal$145,766,137RevenueSubtotalAmt
Investment Expenses Not Incld$104,955InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$104,955RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$145,871,092TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$144,773,423TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$144,773,423ExpensesSubtotalAmt
Investment Expenses Not Incld2$104,955InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt$104,955ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$144,878,378TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:SOUTHAMPTON HOSPITAL ASSOCIATION CURRENTLY REPORTS ENDOWMENT FUNDS WITHIN ITS DECEMBER 31, 2015 FINANCIAL STATEMENTS. THE GOVERNING BODY INTENDS TO USE THESE FUNDS TO OFFSET THE COST OF INDIGENT CARE, EMERGENCY SERVICES AND NURSING EDUCATION.
PART X, LINE 2:SOUTHAMPTON HOSPITAL ASSOCIATION (THE "REPORTING ORGANIZATION") HAS NOT TAKEN AN UNSUBSTANTIATED TAX POSITION THAT WOULD REQUIRE PROVISION OF A LIABILITY UNDER ASC 740. UNDER ASC 740, AN ORGANIZATION MUST RECOGNIZE THE TAX BENEFIT ASSOCIATED WITH TAX POSITIONS TAKEN FOR TAX RETURN PURPOSES WHEN IT IS MORE-LIKELY-THAN-NOT THAT THE POSITION WILL NOT BE SUSTAINED UPON EXAMINATION. THE REPORTING ORGANIZATION DOES NOT BELIEVE THERE ARE ANY MATERIAL UNCERTAIN TAX POSITIONS AND, ACCORDINGLY, HAS NOT RECOGNIZED ANY LIABILITY FOR UNRECOGNIZED TAX BENEFITS. THE REPORTING ORGANIZATION HAS FILED IRS FORM 990 TAX RETURNS, AS REQUIRED, AND ALL OTHER APPLICABLE RETURNS IN JURISDICTIONS WHEN IT IS REQUIRED. FOR THE YEAR ENDED DECEMBER 31, 2015, THERE WAS NO INTEREST OR PENALTIES RECORDED OR INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE REPORTING ORGANIZATION BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE YEARS PRIOR TO 2012, WHICH IS THE STATUTE OF LIMITATION LOOK BACK PERIOD.
PART XI, LINE 2D:CHANGE IN UNFUNDED PENSION OBLIGATION

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other400.FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentfalseFreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Persons Served277PersonsServedCnt
Total Community Benefit Expns$2,395,332TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue-$2,175,885DirectOffsettingRevenueAmt
Net Community Benefit Expns$219,447NetCommunityBenefitExpnsAmt
Total Expense0.00150TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$22,714,149TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,283,622DirectOffsettingRevenueAmt
Net Community Benefit Expns$11,430,527NetCommunityBenefitExpnsAmt
Total Expense0.07890TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Persons Served277PersonsServedCnt
Total Community Benefit Expns$25,109,481TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,107,737DirectOffsettingRevenueAmt
Net Community Benefit Expns$11,649,974NetCommunityBenefitExpnsAmt
Total Expense0.08040TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,808,652TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,094,856DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,713,796NetCommunityBenefitExpnsAmt
Total Expense0.03250TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs4ActivitiesOrProgramsCnt
Total Community Benefit Expns$46,041,659TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$35,628,461DirectOffsettingRevenueAmt
Net Community Benefit Expns$10,413,199NetCommunityBenefitExpnsAmt
Total Expense0.08110TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs4ActivitiesOrProgramsCnt
Total Community Benefit Expns$54,850,311TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$39,723,317DirectOffsettingRevenueAmt
Net Community Benefit Expns$15,126,995NetCommunityBenefitExpnsAmt
Total Expense0.11360TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs4ActivitiesOrProgramsCnt
Persons Served277PersonsServedCnt
Total Community Benefit Expns$79,959,792TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$48,831,054DirectOffsettingRevenueAmt
Net Community Benefit Expns$26,776,969NetCommunityBenefitExpnsAmt
Total Expense0.19400TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$64,129TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$64,129NetCommunityBenefitExpnsAmt

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$64,129TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$64,129NetCommunityBenefitExpnsAmt
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$6,400,000BadDebtExpenseAmt
Bad Debt Expense Attributable$2,624,314BadDebtExpenseAttributableAmt
Reimbursed By Medicare$38,092,076ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$43,044,006CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$4,951,930MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost Accounting SystemYes (X)CostAccountingSystemInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

FieldValueIRS element (for citing)
Business Name Line1MEETINGHOUSE LN PRACBusinessNameLine1Txt
FieldValueIRS element (for citing)
Primary ActivitiesPRIMARY/SPECIALTYPrimaryActivitiesTxt
Org Profit Or Ownership1.0OrgProfitOrOwnershipPct
FieldValueIRS element (for citing)
Hospital Facilities14HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (14 entries)

FacilityFacilityNumAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdLicensed HospitalLicensedHospitalIndFacility Reporting GroupFacilityReportingGroupCdGeneral Medical And SurgicalGeneralMedicalAndSurgicalIndOtherOtherDesc
SOUTHAMPTON HOSPITAL ASSOCIATION
1240 MEETINGHOUSE LANESOUTHAMPTONNY11968Yes (X)A
DIALYSIS CENTER
2184 W MONTAUK HIGHWAYHAMTPON BAYSNY11946BYes (X)DIALYSIS TREATMENT FACILITY
GREENPORT PRENATAL
3300 ATLANTIC AVENUEGREENPORTNY11944BYes (X)PRENATAL/WOMEN'S SERVICES
LAB EAST
4200 PANTIGO PLACEEAST HAMPTONNY11944BYes (X)LABORATORY SERVICES
IMAGING - EH
5200 PANTIGO PLACEEAST HAMPTONNY11937BYes (X)RADIOLOGY SERVICES
WESTHAMPTON PRIMARY CARE
672 OLD RIVERHEAD ROADWESTHAMPTON BEACHNY11978BYes (X)PRIMARY CARE PRACTICE
WESTHAMPTON SPORTS REHAB
774 OLD RIVERHEAD ROADWESTHAMPTON BEACHNY11978BYes (X)SPORTS REHAB/ PHYSICAL THERAPY SERVICES
LAB SOUTH
8325 MEETINGHOUSE LANESOUTHAMPTONNY11968BYes (X)LABORATORY SERVICES
ATRIUM LAB
9182 W MONTAUK HIGHWAYHAMPTON BAYSNY11946BYes (X)LABORATORY SERVICES
DAVID ROGERS CENTER
10335 D MEETINGHOUSE LANESOUTHAMPTONNY11968BYes (X)HIV/AIDS CARE
SHINNECOCK HEALTH
11CHURCH STREETSOUTHAMPTONNY11968BYes (X)PRIMARY CARE/DENTAL SERVICES
SOUTHAMPTON CARE CENTER
12240 MEETINGHOUSE LANESOUTHAMPTONNY11968BYes (X)NURSING HOME (FACILITY CLOSED)
IMAGING - HAMPTON BAYS
13182 W MONTAUK HIGHWAYHAMPTON BAYSNY11946BYes (X)RADIOLOGY SERVICES
MEETINGHOUSE LANE PRACTICE
14PO BOX 2340SOUTHAMPTONNY11968BYes (X)PRIMARY/SPECIALTY PHYSICIAN PATIENT CARE

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (2 entries)

FacilityFacilityNumFirst Licensed CY Or PYFirstLicensedCYOrPYIndTax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYIndCHNA ConductedCHNAConductedIndCommunity DefinitionCommunityDefinitionIndCommunity DemographicsCommunityDemographicsIndExisting ResourcesExistingResourcesIndHow Data ObtainedHowDataObtainedIndCommunity Health NeedsCommunityHealthNeedsIndOther Health IssuesOtherHealthIssuesIndCommunity Hlth Needs Id ProcessCommunityHlthNeedsIdProcessIndConsulting ProcessConsultingProcessIndInformation GapsInformationGapsIndCHNA ConductedCHNAConductedYrTake Into Account Others InputTakeIntoAccountOthersInputIndCHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsIndCHNA Conducted With Non FcltsCHNAConductedWithNonFcltsIndCHNA Report Widely AvailableCHNAReportWidelyAvailableIndRpt Available On Own WebsiteRptAvailableOnOwnWebsiteIndOwn Website URLOwnWebsiteURLTxtPaper Copy Public InspectionPaperCopyPublicInspectionIndImplementation Strategy AdoptImplementationStrategyAdoptIndImplementation Strategy AdptImplementationStrategyAdptYrStrategy Posted WebsiteStrategyPostedWebsiteIndStrategy Website URLStrategyWebsiteURLTxtStrategy AttachedStrategyAttachedIndOrganization Incur Excise TaxOrganizationIncurExciseTaxIndElig Criteria ExplainedEligCriteriaExplainedIndFPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePctFPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePctInsurance Status CriteriaInsuranceStatusCriteriaIndUnderinsurance Stat CriteriaUnderinsuranceStatCriteriaIndExplained BasisExplainedBasisIndApp Financial Asst ExplnAppFinancialAsstExplnIndDescribed InfoDescribedInfoIndProvided Hospital ContactProvidedHospitalContactIndProvided Nonprofit ContactProvidedNonprofitContactIndIncludes Publicity MeasuresIncludesPublicityMeasuresIndFAP Available On WebsiteFAPAvailableOnWebsiteIndFAP Available On Website URLFAPAvailableOnWebsiteURLTxtFAP App Available On WebsiteFAPAppAvailableOnWebsiteIndFAP App Available On Website URLFAPAppAvailableOnWebsiteURLTxtFAP Summary On WebsiteFAPSummaryOnWebsiteIndFAP Avlbl On Request No ChargeFAPAvlblOnRequestNoChargeIndFAP App Avlbl On Request No ChrgFAPAppAvlblOnRequestNoChrgIndFAP Sum Avlbl On Request No ChrgFAPSumAvlblOnRequestNoChrgIndFAP Notice DisplayedFAPNoticeDisplayedIndCommuntity Notified FAPCommuntityNotifiedFAPIndFAP Actions On NonpaymentFAPActionsOnNonpaymentIndCollection ActivitiesCollectionActivitiesIndNondis Emergency Care PolicyNondisEmergencyCarePolicyIndMedicare RatesMedicareRatesIndAmounts Generally BilledAmountsGenerallyBilledIndGross ChargesGrossChargesInd
A
1falsefalseYes (true)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)15Yes (true)falsefalseYes (true)Yes (X)WWW.SOUTHAMPTONHOSPITAL.ORGYes (X)Yes (true)14Yes (true)WWW.SOUTHAMPTONHOSPITAL.ORGfalsefalseYes (true)400.400.Yes (X)Yes (X)Yes (true)Yes (true)Yes (X)Yes (X)Yes (X)Yes (true)Yes (X)WWW.SOUTHAMPTONHOSPITAL.ORGYes (X)0Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (true)falseYes (true)Yes (X)falsefalse
B
falsefalsefalsefalseYes (true)400.400.Yes (X)Yes (X)Yes (true)Yes (true)Yes (X)Yes (X)Yes (X)Yes (true)Yes (X)WWW.SOUTHAMPTONHOSPITAL.ORGYes (X)0Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (true)falseYes (true)Yes (X)falsefalse

Supplemental Information SupplementalInformationGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, SECTION B, LINE 4:THE HOSPITAL CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") FOR THE PERIOD 2015 - 2017. THE CHNA WAS DEEMED CONDUCTED IN 2015 WHEN IT WAS MADE "WIDELY AVAILABLE" TO THE PUBLIC AND THE WRITTEN REPORT AND IMPLEMENTATION STRATEGY WERE FINALIZED, APPROVED, AND ACCEPTED BY THE HOSPITAL'S GOVERNING BODY, IN ACCORDANCE WITH IRS NOTICE 2011-52.
PART V, SECTION B, LINE 5:SEE SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT LANGUAGE.

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:THERE ARE TWO LEVELS OF CHARITY CARE COVERAGE: PRIMARY SERVICE AREA AND NON-PRIMARY SERVICE AREA. A PRIMARY SERVICE AREA PATIENT IS A PATIENT WHO RESIDED IN NEW YORK STATE WITHIN THE COUNTIES OF SUFFOLK OR NASSAU AT THE TIME OF SERVICE. A NON-PRIMARY SERVICE AREA PATIENT IS A PATIENT WHO RESIDED IN NEW YORK STATE BUT NOT WITHIN THE COUNTIES OF SUFFOLK OR NASSAU AT THE TIME OF SERVICE. ELIGIBLE SERVICES FOR A PRIMARY SERVICE AREA PATIENT: A PRIMARY SERVICE AREA PATIENT WHO MEETS THE FINANCIAL REQUIREMENTS IS ELIGIBLE FOR THE FOLLOWING MEDICALLY NECESSARY SERVICES: INPATIENT, AMBULATORY, EMERGENCY ROOM, EMERGENCY TRANSFERS UNDER THE EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA), OUTPATIENT, AND DIAGNOSTIC CARE. UNDERINSURED PRIMARY SERVICE AREA PATIENTS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE ON MEDICARE AND COMMERCIAL INSURANCE CARRIER CO-INSURANCES FOR ALL ABOVE LISTED SERVICES. ELIGIBLE SERVICES FOR A NON-PRIMARY SERVICE AREA PATIENT: A NON-PRIMARY SERVICE AREA PATIENT WHO MEETS THE FINANCIAL REQUIREMENTS IS ELIGIBLE FOR THE FOLLOWING MEDICALLY NECESSARY SERVICES: EMERGENCY ROOM, EMERGENT ADMISSIONS, AND EMERGENCY TRANSFERS UNDER THE EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA). UNDERINSURED NON-PRIMARY SERVICE AREA PATIENTS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE ON MEDICARE AND COMMERCIAL INSURANCE CARRIER CO-INSURANCES FOR ALL ABOVE LISTED SERVICES. INELIGIBLE SERVICES: THE FOLLOWING SERVICES AND/OR ITEMS ARE NOT COVERED BY CHARITY CARE FOR ANY PATIENT: NOT MEDICALLY NECESSARY SERVICES AS DETERMINED BY MEDICARE(E.G. COSMETIC SURGERY, BARIATRIC SURGERY), INSURANCE CO-PAYMENTS/CO-INSURANCES/DEDUCTIBLES, MEDICAID SPEND-DOWN AMOUNTS, NON-COVERED SERVICES AS DETERMINED BY THE PATIENT'S INSURANCE CARRIER, PRIVATE ROOM RATES, AND PRIVATE PHYSICIAN FEES WHICH ARE NOT BILLED BY SOUTHAMPTON HOSPITAL (E.G. RADIOLOGY, PATHOLOGY, ANESTHESIOLOGY, EMERGENCY). FAMILY INFORMATION REQUIREMENTS: A PATIENT MUST PROVIDE ON THEIR CHARITY CARE APPLICATION A LIST OF THE FAMILY/HOUSEHOLD MEMBERS AND OR DEPENDENTS WITH WHOM THE PATIENT RESIDES. IF THE PATIENT IS AN ADULT, THE PATIENT MUST LIST THEIR SPOUSE OR DOMESTIC PARTNER, CHILDREN UNDER THE AGE OF 21, AND ANY CLAIMED DEPENDENTS OR OTHER HOUSEHOLD MEMBERS THAT LIVE WITH THE PATIENT. IF THE PATIENT IS A CHILD UNDER THE AGE OF 21, THE APPLICANT MAY LIST THE PATIENT'S PARENTS, SIBLINGS UNDER THE AGE OF 21, AND ANY CLAIMED DEPENDENTS OR OTHER HOUSEHOLD MEMBERS THAT LIVE WITH THE PATIENT. A CLAIMED DEPENDENT IS DEFINED AS A PERSON WHO IS LISTED OR WOULD BE LISTED AS A DEPENDENT FOR THE PURPOSES OF AN INCOME TAX SUBMISSION TO THE IRS. FINANCIAL REQUIREMENTS: TO BE FINANCIALLY ELIGIBLE TO RECEIVE CHARITY CARE, A PATIENT MUST HAVE A GROSS FAMILY/HOUSEHOLD INCOME LESS THAN OR EQUAL TO 400% OF THE FEDERAL POVERTY LEVEL GUIDELINE (FPG). ELIGIBLE INCOME: THE FOLLOWING INCOME ITEMS WILL BE USED TO DETERMINE A PATIENT'S INCOME: EARNINGS FROM EMPLOYMENT, UNEMPLOYMENT COMPENSATION, WORKERS COMPENSATION, DISABILITY, SOCIAL SECURITY, ANNUITIZED PENSION PLAN, CHILD SUPPORT, ALIMONY, DIVIDENDS, INTEREST, RENTALS, ESTATES, TRUSTS, SALE OF ASSETS, AND OTHER MISCELLANEOUS INCOME. SOLE PROPRIETORSHIP, PARTNERSHIP, AND S CORPORATION INCOME WILL BE CALCULATED BY ITS GROSS PROFIT OR TOTAL INCOME PRIOR TO EXPENSES AND DEDUCTIONS; HOWEVER, COST OF GOODS SOLD MAY BE DEDUCTED FROM GROSS SALES. SALE OF ASSETS, SUCH AS REPORTED ON A SCHEDULE D OR ITS EQUIVALENT, WILL BE CALCULATED BY THEIR SALE PRICE AND NOT BY THEIR GAIN OR LOSS. FINANCIAL DOCUMENTATION REQUIREMENTS: A PATIENT MUST PROVIDE FINANCIAL DOCUMENTATION TO SUPPORT THEIR CURRENT STATED INCOME. THE FOLLOWING DOCUMENTS ARE ACCEPTABLE AS PROOF: COPIES OF RECENT PAY STUBS (SEVERAL CONSECUTIVE ARE PREFERRED WHEN AVAILABLE), A RECENT UNEMPLOYMENT OR DISABILITY STATEMENT, A LETTER FROM AN EMPLOYER, OR A SELF-ATTESTATION LETTER. A PATIENT MAY BE REQUIRED TO SUBMIT ADDITIONAL DOCUMENTATION AT SOUTHAMPTON HOSPITAL'S REQUEST IN ORDER TO SUBSTANTIATE THEIR STATED INCOME. IF A PATIENT IS CLAIMING ZERO INCOME, THE PATIENT WILL BE REQUIRED TO SUBMIT A VERIFICATION OF NON-FILING LETTER FROM THE IRS. THIS LETTER IS OBTAINED THROUGH IRS FORM 4506-T WHICH WILL BE MADE AVAILABLE TO THE PATIENT UPON REQUEST. THE PATIENT MUST ALSO SUBMIT A LETTER DESCRIBING THE MEANS BY WHICH THEY ARE SUPPORTED. IF THE PATIENT IS UNABLE TO FILE IRS FORM 4506-T DUE TO NOT HAVING A SOCIAL SECURITY NUMBER, THE PATIENT MUST SUBMIT THE ABOVE-MENTIONED LETTER. APPLICABLE RATES: THE APPLICABLE RATE FOR AN INPATIENT VISIT IS THE MEDICARE DIAGNOSIS RELATED GROUP (DRG) RATE FOR THAT VISIT. THE APPLICABLE RATE FOR AN AMBULATORY, EMERGENCY ROOM, OUTPATIENT, OR DIAGNOSTIC CARE VISIT IS THE MEDICARE HCPCS/CPT PAYMENT PLUS MINIMUM UNADJUSTED CO-PAYMENT FOR THAT VISIT. THE APPLICABLE RATE FOR LAB TESTS ON OUTPATIENT AND EMERGENCY ROOM VISITS WILL BE 10% OF THE CHARGE PER TEST. SELF-PAY DISCOUNT: SOUTHAMPTON HOSPITAL OFFERS A SELF-PAY DISCOUNT TO UNINSURED PATIENTS FOR SERVICES AND PROCEDURES PROVIDED AND BILLED BY SOUTHAMPTON HOSPITAL. A) ELIGIBLE SERVICES - THE FOLLOWING SERVICES PERFORMED BY SOUTHAMPTON HOSPITAL ARE ELIGIBLE FOR A SELF-PAY DISCOUNT: INPATIENT, AMBULATORY, EMERGENCY ROOM, EMERGENCY TRANSFERS UNDER THE EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA), OUTPATIENT, AND DIAGNOSTIC CARE. B) INELIGIBLE SERVICES - THE FOLLOWING SERVICES AND ITEMS ARE NOT ELIGIBLE FOR A SELF-PAY DISCOUNT: OUTPATIENT CARDIAC REHABILITATION, OUTPATIENT NUTRITIONAL COUNSELING, WELLNESS CENTER SERVICES/PROGRAMS, OUTPATIENT PHYSICAL THERAPY, PRIVATE PHYSICIAN FEES NOT BILLED BY SOUTHAMPTON HOSPITAL (E.G. RADIOLOGY, PATHOLOGY, ANESTHESIOLOGY, EMERGENCY). C) DISCOUNT - SELF-PAY ACCOUNTS ARE DISCOUNTED AT A RATE OF 75% OFF TOTAL CHARGES. A. AUTOMATIC DISCOUNTING - THE SELF-PAY DISCOUNT WILL BE CALCULATED AND APPLIED TO THE PATIENTS' ACCOUNT AUTOMATICALLY BY THE HOSPITAL INFORMATION SYSTEM (HIS). B. MANUAL DISCOUNTING - THE SELF-PAY DISCOUNT MAY NEED TO BE MANUALLY CALCULATED AND APPLIED IN CERTAIN CIRCUMSTANCES (E.G. LATE CHARGES) AND WILL BE HANDLED BY PATIENT FINANCIAL SERVICES. D) ADDITIONAL FINANCIAL ASSISTANCE - PATIENTS WHO ARE UNABLE TO PAY FOR A SELF-PAY DISCOUNTED BILL MAY STILL APPLY FOR OTHER TYPES OF FINANCIAL ASSISTANCE SUCH AS CHARITY CARE. APPLYING FOR ANOTHER TYPE OF FINANCIAL ASSISTANCE WILL NOT RESULT IN THE LOSS OF THE OFFERED SELF-PAY DISCOUNT, HOWEVER, IF ACCEPTED INTO ANOTHER FINANCIAL ASSISTANCE PROGRAM, THAT PROGRAMS CALCULATION METHODOLOGY WILL BE DONE INDEPENDENTLY OF THE SELF-PAY DISCOUNTED AMOUNT (I.E. FINANCIAL ASSISTANCE PROGRAMS ARE MUTUALLY EXCLUSIVE).
PART III, LINE 3:SOUTHAMPTON HOSPITAL UTILIZED THE AUDITED FINANCIAL STATEMENT AMOUNT REPORTED FOR BAD DEBT OF $6,400,000 AS ITS STARTING POINT. THIS AMOUNT WAS MULTIPLIED BY A COST TO CHARGE RATIO OF 100% (DETERMINED ON SCHEDULE H WORKSHEET 2) RESULTING IN A COST OF BAD DEBT OF $6,400,000. THIS COST WAS THEN MULTIPLIED BY 41.0049% - THE SELF PAY PERCENTAGE AS DETERMINED BY THE 2015 INSTITUTIONAL COST REPORT. THIS RESULTED IN A COST OF BAD DEBT FOR PATIENTS ELIGIBLE UNDER THE HOSPITAL'S CHARITY CARE POLICY OF $2,624,314.
PART III, LINE 4:THE ORGANIZATION DETERMINE EXPECTED BAD DEBT WRITE-OFFS BASED ON ACTUAL ACCOUNTS, NET OF AN EXPECTED RATE OF RECOVERY. IT'S NOT BASED ON A PERCENTAGE OF REVENUE.
PART III, LINE 8:SOUTHAMPTON HOSPITAL UTILIZED THE 2552 COST REPORT PREPARED ANNUALLY FOR MEDICARE TO DETERMINE THE TOTAL REVENUE RECEIVED FROM MEDICARE, AS WELL AS THE MEDICARE ALLOWABLE COSTS RELATING TO THE REVENUE REPORTED. MEDICARE ALLOWABLE COSTS OF $43,044,006 ARE GREATER THAN THE TOTAL MEDICARE REVENUE OF $38,092,076 FOR 2015; THEREFORE THE SHORTFALL OF $4,951,930 MAY BE DEEMED A COMMUNITY BENEFIT.
PART III, LINE 9B:ACCOUNTS WITH UNCOLLECTABLE BALANCES ARE ACCOUNTS FOR A PATIENT (GUARANTOR) WHO HAS NOT RESPONDED TO REQUESTS FOR PAYMENT OR WHO HAS DEMONSTRATED AN EXEMPTION FROM PAYMENT. THE REQUEST FOR PAYMENT &/OR THE EXEMPTION MUST MEET THE FOLLOWING CRITERIA: 1. AT LEAST FOUR (4) CONSECUTIVE 120-DAY BILLS MUST HAVE BEEN GENERATED (OR NO LESS THAN 120 DAYS FROM FIRST BILL) AND SENT WITHOUT RESPONSE FROM THE PATIENT (GUARANTOR) BEFORE BEING SENT TO A COLLECTION AGENCY; OR 2. THE PATIENT (GUARANTOR) HAS DECLARED BANKRUPTCY (DISCHARGE OF DEBT OR MUST HAVE BEEN RECEIVED); OR 3. THE ESTATE OF THE PATIENT (GUARANTOR) HAS BEEN SETTLED AND THERE WERE NO FUNDS FOR PAYMENT LEFT IN THE ESTATE; OR 4. MAIL HAS BEEN RETURNED AND OTHER METHODS OF CONTACTING THE PATIENT (GUARANTOR) HAVE FAILED. THE ACCOUNT IS THEN CONSIDERED AND HANDLED AS A BAD DEBT ACCOUNT. PATIENT FINANCIAL SERVICES MAY ELECT TO SEND THE ACCOUNT TO AN OUTSIDE AGENCY, UP TO AND INCLUDING LEGAL ACTION. BAD DEBT ACCOUNTS ARE PURE SELF PAY ACCOUNTS FOR A PATIENT (GUARANTOR) WHO HAS NOT RESPONDED TO REQUESTS FOR PAYMENT. THE REQUEST FOR PAYMENT MUST MEET THE FOLLOWING CRITERIA: AT LEAST FOUR (4) CONSECUTIVE 30-DAY BILLS MUST HAVE BEEN GENERATED AND SENT WITHOUT RESPONSE FROM THE PATIENT (GUARANTOR); OR MAIL HAS BEEN RETURNED AND ALL OTHER METHODS OF CONTACTING THE PATIENT(GUARANTOR) HAVE FAILED. ONCE IT IS DETERMINED AN ACCOUNT BALANCE CANNOT BE COLLECTED BY PATIENT FINANCIAL SERVICES, THE ACCOUNT MAY BE TURNED OVER FOR COLLECTION BY AN OUTSIDE AGENCY, UP TO AND INCLUDING LEGAL ACTION. THE OUTSIDE COLLECTION AGENCY, AFTER DUE DILIGENCE, MAY DETERMINE THE BALANCE ON AN ACCOUNT CANNOT BE COLLECTED, THE ACCOUNT BALANCE MAY BE WRITTEN OFF USING THE APPROPRIATE CODE FOR THE ACCOUNT.
PART VI, LINE 2:Online Key Informant Survey: To solicit input from key informants, those individuals who have a broad interest in the health of the community, an Online Key Informant Survey was also implemented as part of this process. A list of recommended participants was provided by Southampton Hospital; this list included names and contact information for physicians, public health representatives, other health professionals, social service providers, and a variety of other community leaders. Potential participants were chosen because of their ability to identify primary concerns of the populations with whom they work, as well as of the community overall. Key informants were contacted by email, introducing the purpose of the survey and providing a link to take the survey online; reminder emails were sent as needed to increase participation. In all, 133 community stakeholders took part in the Online Key Informant Survey, as outlined below: Online Key Informant Survey Participation Key Informant Type Number Invited Number Participating Physician 24 11 Public Health Representative 2 2 Other Health Provider 63 28 Social Services Provider 61 18 Community/Business Leader 144 74 Final Participation included representatives of the organizations outlined below: 91 Hill LLC; Adele Macmillan, LCSW-R, Private Practitioner; Amaden Gay Agencies; Barth Counseling; Bartky HealthCare Center; Bellringer Communications, Inc.; Blumenfield & Fleming, LLC; Bridgehampton Citizens Advisory Committee; Bridgehampton UFSD; Brookhaven Memorial Hospital Outpatient Behavioral Health; Coalition for Women's Cancers at Southampton Hospital; David E. Rogers Center; Development Officer; East End Clinical Connections; East End Counseling; East End DBT; East End Pediatrics; East End Regional Intervention Court; East Hampton Family Medicine; East Hampton Healthcare Foundation; East Hampton Lions Club Foundation; East Hampton Town Police Department; East Hampton Union Free School District; East Hampton Village Ambulance Association; East Quogue Fire Department; Eastern Suffolk BOCES Employee Assistance Program; ELIHO; Family Service League; Fighting Chance; First Presbyterian Church; Hampton Bays Public Library; Hampton Counseling; Hamptons Gynecology and Obstetrics; Indian Health/ACS; I-TRI Inspirational Triathlon Racing International; Maggie Bloomfield, LCSW, CASAC, MFA; Montauk Fire Department; Montauk Library; OLA of Eastern Long Island; Our Lady of the Hamptons School; Peer Recovery Services; Private Provider; Public Library; Remsenburg-Speonk UFSD; Retired Educator; Rogers Memorial Library; School District; Seafield Center; Shelter Island School; Shinnecock Indian Health Service; Southampton Business Alliance; Southampton Hospital; Southampton Pediatric Associates; Southampton Town Police Department; Southampton Volunteer Ambulance; Suffolk County Department of Health Services; The Retreat; Town of East Hampton Department of Human Services; Town of Southampton Youth Bureau; Tuckahoe Common School District; Village of Southampton; Westhampton Beach Police Department; Westhampton Primary Care. Through this process, input was gathered from several individuals whose organizations work with low-income, minority populations (including abused families, African-Americans, Asians, Caribbean Islanders, Central Americans, children with learning disabilities, Columbians, the disabled, Eastern Europeans, Ecuadorians, Hispanics, immigrants, LGBT community, low income residents, Medicaid/Medicare beneficiaries, Native Americans, non-English speaking individuals, Portuguese people, South Americans, undocumented persons, the uninsured/underinsured, and veterans), or other medically underserved populations (including African-Americans, cancer patients, children, children and young adults, the disabled, the elderly, Hispanics, HIV positive individuals, The homeless, immigrants, LGBT community, those living alone, low income residents, Medicaid/Medicare beneficiaries, the mentally ill, Native Americans, non-English speaking individuals, pregnant teens, substance abusers, undocumented persons, unemployed residents, the uninsured/underinsured, veterans, women, and young adults). In the online survey, key informants were asked to rate the degree to which various health issues are a problem in their own community. Follow-up questions asked them to describe why they identify problem areas as such, and how these might be better addressed. Results of their ratings, as well as their verbatim comments, are included throughout this report as they relate to the various other data presented. NOTE: These findings represent qualitative rather than quantitative data. The Online Key Informant Survey was designed to gather input from participants regarding their opinions and perceptions of the health of the residents in the area. Thus, these findings are based on perceptions, not facts. Benchmark Data: New York Risk Factor Data - Statewide risk factor data are provided where available as an additional benchmark against which to compare local survey findings; these data are reported in the most recent BRFSS (Behavioral Risk Factor Surveillance System) Prevalence and Trend Data published by the Centers for Disease Control and Prevention and the US Department of Health & Human Services. Nationwide Risk Factor Data - Nationwide risk factor data, which are also provided in comparison charts, are taken from the 2013 PRC National Health Survey; the methodological approach for the national study is identical to that employed in this assessment, and these data may be generalized to the US population with a high degree of confidence. Healthy People 2020 - Healthy People provides science-based, 10-year national objectives for improving the health of all Americans. The Healthy People initiative is grounded in the principle that setting national objectives and monitoring progress can motivate action. For three decades, Healthy People has established benchmarks and monitored progress over time in order to: - Encourage collaborations across sectors. - Guide individuals toward making informed health decisions. - Measure the impact of prevention activities. Healthy People 2020 is the product of an extensive stakeholder feedback process that is unparalleled in government and health. It integrates input from public health and prevention experts, a wide range of federal, state and local government officials, a consortium of more than 2,000 organizations, and perhaps most importantly, the public. More than 8,000 comments were considered in drafting a comprehensive set of Healthy People 2020 objectives. Determining Significance - Differences noted in this report represent those determined to be significant. For survey-derived indicators (which are subject to sampling error), statistical significance is determined based on confidence intervals (at the 95 percent confidence level) using question-specific samples and response rates. Information Gaps - While this assessment is quite comprehensive, it cannot measure all possible aspects of health in the community, nor can it adequately represent all possible populations of interest. It must be recognized that these information gaps might in some ways limit the ability to assess all of the communitys health needs. For example, certain population groups - such as homeless, instutionalized persons, or those who only speack a language other than English or Spanish - are not represented in the survey data. Other population groups - for example, pregnant women, lesbian/gay/bisexual/transgender residents, undocumented residents, and members or certain racial/ethnic or immigrant groups - might not be identifiable or might not be represented in numbers sufficient for independent analyses. In addition, this assessment does not include secondary data from existing sources which can provide relevant data collected through death certificates, birth certificates, or notifications or infectious disease cases in the community. In terms of content, this assessment was designed to provide a comprehensive and broad picture of the health of the overall community. However, there are certainly a great number of medical conditions that are not specifically addressed. Prioritization of Health Needs - On December 11, 2015, more than 30 individuals (representing local health providers, social service providers, and community leaders, as well as Southampton Hospital senior leaders and other internal stakeholders) met to evaluate, discuss and prioritize health issues for the community, based on findings of the 2015 PRC Community Health Needs Assessment (CHNA). Professional Research Consultants, Inc. (PRC) began the meetings with a presentation of key findings from the CHNA, highlighting the significant health issues identified from the research (see Areas of Opportunity above). Following the data review, PRC answered any questions and facilitated a group dialogue, allowing participants to advocate for any of the h
PART VI, LINE 3:FINANCIAL AID PROGRAM: SOUTHAMPTON HOSPITAL'S COMMITMENT AND DETERMINATION TO PROVIDE QUALITY HEALTHCARE AT AFFORDABLE RATES HAS LEAD US TO DESIGN A CHARITY CARE PROGRAM THAT GOES "ABOVE AND BEYOND" THE EXPECTATIONS AND MINIMUM REQUIREMENTS SET FORTH BY NEW YORK STATE LAW. IT IS THE HOSPITAL'S "ABOVE AND BEYOND" ATTITUDE THAT IS OUR PROGRAMS GREATEST STRENGTH AND CAN BEST BE SEEN IN OUR POLICY TO PROVIDE CHARITY CARE DISCOUNTED RATES TO PATIENTS MAKING UP TO 400% OF THE FEDERAL POVERTY LEVEL GUIDELINE (FPG) RATHER THAN THE MINIMUM REQUIREMENT OF 300% FPG. IN ADDITION, THE HOSPITAL INCLUDES A FORM TO APPLY FOR CHARITY CARE IN EVERY SELF-PAY BILL TO BE RETURNED TO PATIENT FINANCIAL SERVICES. SELF-PAY PATIENTS ARE GIVEN A 75% DISCOUNT OF CHARGES, AS WELL. SOUTHAMPTON HOSPITAL CONTINUES TO FACE FINANCIAL CHALLENGES INCLUDING CONTINUED REDUCTIONS IN NEW YORK STATE AND FEDERAL REIMBURSEMENT RATES AT THE SAME TIME THAT HOSPITAL FACES THE INCREASING COST OF PROVIDING CARE, INCLUDING DOUBLE DIGIT EXPENSES INCREASES IN SOME CATEGORIES. WHILE THE HOSPITAL WAITS TO UNDERSTAND THE IMPACT ON ITS CHARITY POLICIES THAT MAY RESULT FROM EXPANDING RESIDENT ACCESS TO HEALTH CARE INSURANCE THAT IS PART OF HEALTH CARE REFORM, THE HOSPITAL REMAINS CONCERNED THAT A SIGNIFICANT PART OF THE INDIGENT CARE THE HOSPITAL PROVIDES TO UNDOCUMENTED WORKERS WILL NOT BE COVERED.
PART VI, LINE 4:Southampton's Service area extends from Montauk to the East to Westhampton Beach to the West and the Southern area of Riverhead in the center of the East End of Long Island. The service area accounts for approximately eight-five (85) percent of total admissions to the Hospital and includes the following zip codes: Amagansett (11930); East Hampton (11937); Bridgehampton (11932); Southampton (11968); Hampton Bays (11946); Sag Harbor (11963); Sagaponack (11962); Montauk (11954); Riverhead (11901); East Quogue (11942); Quogue (11959); Remsenburg (11960); Water Mill (11976); Westhampton Beach (11978); and Westhampton (11977). In addition, the Hospital's service area is home to the Shinnecock Nation. Since April of 1995, Southampton Hospital has worked with the Nation to provide services at the Shinnecock Indian Health Clinic through a contract with the NYS Department of Health. On an annual basis, the Clinic provides approximately 2,100 medical and 1,000 dental visits for eligible members of the Shinnecock Nation. Southampton Hospital's service area has a year-round population of approximately 102,689 residents. The population in the Hospital's service area, a resort destination, more than doubles during the summer season when tourists and seasonal residents from all over the world come to the South Fork of Long Island. AS THE TABLE BELOW INDICATES, THIS SERVICE AREA HAS A YEAR ROUND POPULATION OF APPROXIMATELY 70,000 RESIDENTS. THE AREA IS PROJECTED TO SEE A SIGNIFICANT INCREASE IN POPULATION, MORE THAN 4 PERCENT OVER THE NEXT FIVE YEARS. DEMOGRAPHIC CHARACTERISTICS SELECTED AREA USA 2010 TOTAL POPULATION............65,013............308,745,538 2015 TOTAL POPULATION............66,786............319,459,991 2020 TOTAL POPULATION............68,584............330,689,365 % CHANGE 2015 - 2020...............2.7%...................3.5% AVERAGE HOUSEHOLD INCOME.......$115,280................$74,165 THE POPULATION ON THE HOSPITAL'S SERVICE AREA, A RESORT DESTINATION, MORE THAN DOUBLES DURING THE SUMMER SEASON WHEN TOURISTS FROM ALL OVER THE WORLD VISIT THE SOUTH FORK OF LONG ISLAND. AS A RESULT, DEMAND FOR SOUTHAMPTON HOSPITAL SERVICES INCREASES SIGNIFICANTLY DURING THE SUMMER, IN PARTICULAR DEMAND FOR THE HOSPITAL'S EMERGENCY SERVICES. THE HOSPITAL HAS RESPONDED TO THIS NEED BY MAKING A CAPITAL INVESTMENT IN EXPANDING AND RENOVATING THE EMERGENCY DEPARTMENT AND IMPLEMENTING A STATE-OF-THE-ART EMERGENCY DEPARTMENT INFORMATION SYSTEMS THAT PERMITS THE HOSPITAL TO TRACK PATIENTS, AND READ AND INTERPRET LABORATORY AND RADIOLOGICAL RESULTS. AS THE TABLE BELOW INDICATES, THE SERVICE AREA HAS A SIGNIFICANT PERCENTAGE OF THEIR POPULATION AGED FIFTY-FIVE (55) AND OVER, A POPULATION THAT HAS GREATER NEED FOR HEALTH CARE SERVICES. AGE DISTRIBUTION: USA 2015 AGE GROUP 2015 % OF TOTAL 2020 % OF TOTAL % OF TOTAL 0-14 10,755 16.1% 10,655 15.5% 19.1% 15-17 2,349 3.5% 2,456 3.6% 4.0% 18-24 5,159 7.7% 5,506 8.0% 9.9% 25-34 7,278 10.9% 7,254 10.6% 13.3% 35-54 18,112 27.1% 17,130 25.0% 26.3% 55-64 9,903 14.8% 10,584 15.4% 12.7% 65+ 13,230 19.8% 14,999 21.9% 14.7% TOTAL 66,786 100.0% 68,584 100.0% 100.0% THERE ARE NO FIRM ESTIMATES OF THE NUMBER OF MIGRANT AGRICULTURAL WORKERS THAT COME INTO THIS AREA. AGRICULTURE IS ONE OF SUFFOLK COUNTY'S LEADING INDUSTRIES. ITS SUCCESS RELIES ON WORKERS WHO MOVE THROUGH THE EASTERN UNITED STATES IN RESPONSE TO THE AVAILABILITY OF SEASONAL WORK. SOUTHAMPTON HOSPITAL RECOGNIZES THAT THIS POPULATION PRESENTS SERIOUS HEALTH PROBLEMS AND IS COMMITTED TO PROVIDING CARE FOR ITS CULTURALLY DIVERSE PATIENT POPULATION. MANY OF THESE INDIVIDUALS ARE UNINSURED AND UNABLE TO SPEAK ENGLISH. THEY RELY ON THE HOSPITAL'S EMERGENCY DEPARTMENT, AS WELL AS THE SUFFOLK COUNTY HEALTH CLINIC, LOCATED ON THE HOSPITAL'S CAMPUS, FOR HEALTH CARE. AS ARESULT, THE HOSPITAL'S OFFICE OF CULTURAL DIVERSITY PROVIDES TRANSLATION AND INTERPRETATION SERVICES, AS WELL AS COUNSELING ON MEDICAL INSURANCE AND BILLING FOR THOSE INDIVIDUALS WHO DO NOT SPEAK ENGLISH. THE HOSPITAL PROVIDES BI-LINGUAL PUBLICATIONS AND SIGNAGE AND ACTIVELY ASSISTS THE CULTURALLY DIVERSE COMMUNITIES IT CARES FOR. RACE/ETHNICITY: RACE/ETHNICITY DISTRIBUTION RACE/ETHNICITY 2015 POP % OF TOTAL USA % OF TOTAL WHITE NON-HISPANIC 45,479 68.1% 61.8% BLACK NON-HISPANIC 1,917 2.9% 12.3% HISPANIC 16,945 25.4% 17.6% ASIAN & PACIFIC IS. 899 1.3% 5.3% ALL OTHERS 1,546 2.3% 3.1% TOTAL 66,786 100.0% 100.0%
PART VI, LINE 5:SOUTHAMPTON HOSPITAL SPONSORS "FOCUS ON SOUTHAMPTON HOSPITAL" ON SEA-TV, A MONTHLY PUBLIC ACCESS INTERVIEW PROGRAM FOR THE TOWNS OF EAST HAMPTON AND SOUTHAMPTON THAT COVERS HEALTH-RELATED INFORMATION OF INTEREST TO THE COMMUNITY AND PROVIDES INFORMATION ON HEALTHCARE SERVICES AVAILABLE AT SOUTHAMPTON HOSPITAL. THE HOSPITAL HAS DEVELOPED NUMEROUS SERVICES AND OUTREACH TO RESPOND TO THE NEEDS OF THESE PATIENTS, INCLUDING RECRUITING ADDITIONAL PRIMARY CARE PHYSICIANS AND IMPLEMENTING A GRADUATE MEDICAL EDUCATION PROGRAM THAT WILL HOPEFULLY ATTRACT THESE YOUNG PHYSICIANS TO STAY AND PRACTICE IN THE COMMUNITY. THE HOSPITAL'S WEBSITE, WWW.SOUTHAMPTONHOSPITAL.ORG, PROVIDES INFORMATION ON HOSPITAL SERVICES, SPECIAL PROGRAMS AND EVENTS. THE SITE ENABLES PATIENTS TO FIND PHYSICIANS IN DIFFERENT SPECIALTIES, ALLOWS ON-LINE INQUIRIES THAT ARE ANSWERED DAILY, AND PROVIDES ACCESS TO AVAILABLE EMPLOYMENT OPPORTUNITY AND JOB APPLICATIONS. SERVICES FOR SHORT-TERM AND LONG-TERM CARE FOR CHRONIC AND ACUTE ILLNESS ARE CONTINUALLY EVALUATED THROUGH STATISTICAL DATA THAT INCLUDE QUALITY INDICATORS AND PATIENT OUTCOMES. THIS DATA IS COMPARED NATIONALLY WITH OTHER HEALTH FACILITIES AND INFORMS THE HOSPITAL'S STRATEGIC PLAN AND COMMUNITY SERVICE PLAN. THE HOSPITAL'S STRATEGIC PLANNING COMMITTEE INCLUDES COMMUNITY MEMBERS, HOSPITAL STAFF AND HOSPITAL AND FOUNDATION BOARD MEMBERS WHO WORK COLLABORATIVELY TO ASSESS COMMUNITY NEEDS AND DEVELOP STRATEGIES TO MEET THESE NEEDS. THE HOSPITAL'S PUBLIC AFFAIRS COMMITTEE IS RESPONSIVE TO COMMUNITY INTERESTS AND CONCERNS. MEMBERSHIP IS A CROSS-SECTION OF PHYSICIANS, HOSPITAL MANAGEMENT, BOARD MEMBERS AND HOSPITAL EMPLOYEES. BASED ON THE HOSPITAL'S ASSESSMENT OF INTEREST IN THE COMMUNITY, A NUMBER OF HEALTH LECTURES AND PROGRAMS ARE PROVIDED THROUGHOUT THE YEAR. THESE PROGRAMS ARE SOMETIMES SPONSORED THROUGH OUR PARTNERSHIPS WITH LOCAL ORGANIZATIONS INCLUDING FIGHTING CHANCE, NEW YORK ORGAN DONOR NETWORK, COMMUNITY LIBRARIES, AND SERVICE CLUBS (LIONS, KIWANIS, ELKS). THE 2015 OUTREACH SCHEDULE INCLUDED THE FOLLOWING PROGRAMS AT: A) SOUTHAMPTON'S ROGERS MEMORIAL LIBRARY - Heart Health-Know Your Numbers; Heart Health Exercise is Medicine; Natural Sleep Solutions B) WESTHAMPTON FREE LIBRARY - Key to a Healthy Heart; Shingles- What Vaccines Do Adults Need; Help with Shoulder Injuries and Arthritis; Back Pain; Healthy Kidneys-Healthy You; Lyme and Tick-Borne Disease; Baby Fair; Acupuncture Can Reveal Your True Self; Spa Days; Healthy At Any Age; Relax and Heal Using Therapeutic Massage; Breast Cancer Awareness; Living with Osteoporosis. C) HAMPTON BAYS LIBRARY - LIVING WITH OSTEOPOROSIS; HEALTHY KIDNEYS-HEALTHY YOU. D) QUOGUE LIBRARY - TREATMENTS FOR VARICOSE VEINS; LIVING WITH ARTHRITIS; KEY TO A HEALTHY HEART. E) HAMPTON LIBRARY IN BRIDGEHAMPTON - OH MY ACHING BACK! F) SHELTER ISLAND LIBRARY - TICK-BORNE DISEASE G) SAG HARBOR'S JOHN JERMAIN LIBRARY - HEART HEALTH - EXERCISE IS MEDICINE; DEFINING REFLEXOLOGY. H) CUTCHOGUE/NEW SUFFOLK LIBRARY - HEALTHY EYES, HEALTHY VISION; HEELAND FOOT PAIN; HYPNOSIS FOR PEAK PERFORMANCE, BEHAVIOR MODIFICATION, AND BETTER NIGHT'S SLEEP; HAND THERAPY FOR ARTHRITIS; LYME AND TICK-BORNE DISEASE. I) MATTITUCK/LAUREL LIBRARY - PREVENTING LYME AND TICK-BORNE DISEASE; LIVING WITH ARTHRITIS. J) SHINNECOCK INDIAN RESERVATION - STROKE AWARENESS K) CHILDREN'S MUSEUM OF THE EAST END IN BRIDGEHAMPTON - TRAIN YOUR EYES TO BE TICKWISE; PECONIC FAMILY FUND DAY TICK EDUCATION L) D.A.R. SOUTHAMPTON CHAPTER - HEALTHY AT ANY AGE M) ROTARY CLUB SOUTHAMPTON - TICK-BORNE DISEASE EDUCATION AND PREVENTION N) SOUTHAMPTON HOSPITAL - CAR SEAT SAFETY INSPECTON DAY IN CONJUNCTION WITH SOUTHAMPTON POLICE DEPARTMENT O) TICK-BORNE DISEASE PUBLIC EDUCATION - BAY STREET THEATER, SOUTHAMPTON HOSPITAL'S PARRISH HALL, EAST HAMPTON HEALTH FAIR P) EASTPORT ATLANTIC SHORES SENIOR COMMUNITY - RELAX AND HEAL USING THERAPEUTIC MASSAGE. PUBLIC INFORMATION: Southampton Hospital understands the importance of educating the community about its available services. Brochures detailing these services are distributed and displayed on every floor of the hospital, at community and school health fairs, and at hospital satellite facilities and physician offices across the North and South Forks. In addition, this information, along with the Hospitals 2015-17 Community Service Plan, is available on the Hospitals website, www.southamptonhospital.org.
GENERAL INFORMATION:PATIENT SATISFACTION SURVEYS: IN ADDITION, SOUTHAMPTON HOSPITAL CONTINUALLY SOLICITS PATIENT INPUT THROUGH ITS PATIENT SATISFACTION SURVEY PROCESS, WHICH INCLUDES EVERY INPATIENT, AMBULATORY SURGERY PATIENT AND EMERGENCY ROOM PATIENT. THE DATA COLLECTED FROM THESE COMPREHENSIVE SURVEYS PROVIDES VALUABLE INFORMATION ON A WIDE RANGE OF QUALITY INDICATORS AND AREAS OF INTEREST TO THE HOSPITAL'S PATIENTS. RESULTS FROM THESE SURVEYS ARE REGULARLY DISTRIBUTED TO HOSPITAL AND MEDICAL STAFFS AND THE BOARD OF DIRECTORS. THE QUALITY MANAGEMENT AND PUBLIC AFFAIRS DEPARTMENTS, AS WELL AS THE OFFICE OF THE PRESIDENT, CAREFULLY REVIEW CORRESPONDENCE FROM PATIENTS AND THE COMMUNITY AT LARGE. A MEMBER OF THE HOSPITAL STAFF PERSONALLY ANSWERS ALL CORRESPONDENCE.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Housing Allowance Or ResidenceYes (X)HousingAllowanceOrResidenceInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ROBERT S CHALONER
PRESIDENT & CEO$510,000$0$127,500$0$42,336$0$15,900$0$24,286$0$720,022$0$0$0
CHIRSTOPHER J SCHULTHEIS
CHIEF FINANCIAL OFFICER$254,392$0$47,636$0$6,805$0$15,264$0$25,067$0$349,164$0$0$0
FREDERIC I WEINBAUM
CHIEF MEDICAL OFFICER & COO$399,389$0$59,908$0$35,848$0$15,900$0$27,714$0$538,759$0$0$0
PATRICIA A DARCEY
CHIEF NURSING OFFICER$231,364$0$0$0-$351$0$13,882$0$27,714$0$272,609$0$0$0
STEVEN GEORGOPOULOS
PHYSICIAN$707,308$0$0$0$59,314$0$15,900$0$27,472$0$809,994$0$0$0
KRISTIN P NASO
PHYSICIAN$500,000$0$0$0-$535$0$15,900$0$27,472$0$542,837$0$0$0
NEEMA POURTAHERI
PHYSICIAN$434,423$0$0$0$23,622$0$15,900$0$27,472$0$501,417$0$0$0
MICHAEL ELLIS
PHYSICIAN$393,923$0$0$0$34,402$0$15,900$0$22,499$0$466,724$0$0$0
EDNA KAPENHAS
DIRECTOR/BREAST SURGEON$400,000$0$0$0-$604$0$15,900$0$25,067$0$440,363$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1A:Southampton Hospital Association provides the following special allowances/perquisites to the President & CEO, as well as to certain key executives. These allowances for housing and automobile are stipulated in the executives Employment Agreement/terms at time of hire. All payments of these perquisites are made on a bi-weekly basis with the employees regular paycheck and they are made in accordance with the guidelines of a non-accountable expense plan. Annual allowances are as listed below: 1) ROBERT CHALONER, PRESIDENT & CEO - Housing Allowance: $38,000. 2) FREDRIC WEINBAUM, MD, EVP, COO & CMO - Housing Allowance: $30,000. Auto Allowance: $7,000. 3) CHRISTOPHER J. SCHULTHEIS, CFO & VP of Finance - AUTO ALLOWANCE: $8,400. 4) NEEMA POURTAHERI, PHYSICIAN - HOUSING ALLOWANCE: $22,157. 5) MICHAEL ELLIS, PHYSICIAN - HOUSING ALLOWANCE: $36,000.
PART II, COLUMN (B)(II):THE PRESIDENT & CEO, EXECUTIVE VICE PRESIDENT/CHIEF MEDICAL OFFICER, AND CFO OF SOUTHAMPTON HOSPITAL WERE ELIGIBLE FOR A PERFORMANCE BONUS IN 2015 WHICH WAS BASED UPON CRITERIA THAT THE EXECUTIVE COMMITTEE OF THE BOARD ESTABLISHED. THE PRESIDENT & CEO'S BONUS IS AN ANNUAL BONUS SET FORTH IN HIS EMPLOYMENT AGREEMENT AND IS DETERMINED AFTER A REVIEW OF HOW WELL HE PERFORMED IN THE PRIOR YEAR AGAINST GOALS AND OBJECTIVES ESTABLISHED BY THE EXECUTIVE COMMITTEE. THE EXECUTIVE VICE PRESIDENT/CHIEF MEDICAL OFFICER AND CFO WERE AWARDED A PERFORMANCE BONUS BASED UPON THE RECOMMENDATION OF THE PRESIDENT & CEO AS WELL AS A REVIEW OF THEIR PERFORMANCE AGAINST GOALS AND OBJECTIVES ESTABLISHED BY THE PRESIDENT AND THE EXECUTIVE COMMITTEE.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1SUFFOLK COUNTY ECONOMIC DEVELOPMENT CORPORATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN273722095BondIssuerEIN
Bond Issued2014-10-02BondIssuedDt
Issue Price$33,500,000IssuePriceAmt
Purposerefinance series 1999a and 1999bPurposeDesc
DefeasedfalseDefeasedInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Pool FinancingfalsePoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$0RetiredAmt
Bond Defeased$0BondDefeasedAmt
Total Proceeds$33,500,000TotalProceedsAmt
In Reserve Fund$0InReserveFundAmt
Capitalized Interest$0CapitalizedInterestAmt
Refunding Escrow$28,644,501RefundingEscrowAmt
Issuance Costs From Proceeds$607,619IssuanceCostsFromProceedsAmt
Credit Enhancement$0CreditEnhancementAmt
Working Capital Expenditures$0WorkingCapitalExpendituresAmt
Capital Expenditures$3,931,601CapitalExpendituresAmt
Other Spent Proceeds$823,269OtherSpentProceedsAmt
Unspent$0UnspentAmt
Current RefundingYes (true)CurrentRefundingInd
Advance RefundingfalseAdvanceRefundingInd
Final Allocation MadefalseFinalAllocationMadeInd
Adequate Books And Rec MaintYes (true)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed PropertyfalseOwningBondFinancedPropertyInd
Any Lease ArrangementsfalseAnyLeaseArrangementsInd
Mgmt Contract Bond Fincd PropfalseMgmtContractBondFincdPropInd
Any Research AgreementsfalseAnyResearchAgreementsInd
Private Bus Use By Others0PrivateBusUseByOthersPct
Private Bus Concerning UBI0.01400PrivateBusConcerningUBIPct
Total Private Business Use0.01400TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt TestfalseBondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed PropfalseChangeInUseBondFinancedPropInd
Remedial Action TakenfalseRemedialActionTakenInd
Procs Nonqualified Bond RemdtdfalseProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T FiledfalseForm8038TFiledInd
Rebate Not Due YetYes (true)RebateNotDueYetInd
Exception To RebatefalseExceptionToRebateInd
No Rebate DuefalseNoRebateDueInd
Variable Rate IssuefalseVariableRateIssueInd
Hedge Identified In Bks And RecfalseHedgeIdentifiedInBksAndRecInd

Hedge Provider Name HedgeProviderName

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1Txt
FieldValueIRS element (for citing)
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGICInd

GIC Provider Name GICProviderName

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1Txt
FieldValueIRS element (for citing)
Gross Proceeds InvestedfalseGrossProceedsInvestedInd
Written Proc To Monitor ReqsfalseWrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionfalseProceduresCorrectiveActionInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINES 6, 7A AND 7B:THE ORGANIZATION'S SOLE MEMBER IS EAST END HEALTH ALLIANCE, A NOT-FOR-PROFIT CORPORATION THAT CAN ELECT ONE OR MORE MEMBERS OF THE HOSPITAL'S GOVERNING BODY. THE EAST END HEALTH ALLIANCE, THE ARTICLE 28 PARENT OF EASTERN LONG ISLAND HOSPITAL, PECONIC BAY MEDICAL CENTER AND SOUTHAMPTON HOSPITAL, WAS CREATED IN RESPONSE TO THE RECOMMENDATIONS OF THE COMMISSION ON HEALTH CARE IN THE 21ST CENTURY. CONSISTENT WITH THE MISSION OF SOUTHAMPTON HOSPITAL, THE GOALS OF THE ALLIANCE ARE AS FOLLOWS: A) TO COLLABORATIVELY DEVELOP HIGH QUALITY, COMPREHENSIVE AND ACCESSIBLE HEALTH CARE SERVICES TO MEET THE NEEDS OF THE COMMUNITY SERVED; B) TO RATIONALIZE HEALTH CARE SERVICES ACROSS THE SYSTEM; AND C) TO REALIZE MANAGEMENT EFFICIENCIES. THE FOLLOWING DECISIONS MADE BY THE GOVERNING BODY OF SOUTHAMPTON HOSPITAL REQUIRE EAST END HEALTH ALLIANCE APPROVAL: ADOPTION OF OPERATING AND CAPITAL BUDGETS, APPLICATION FOR NEW CERTIFICATES OF NEED, AND CERTAIN BORROWING TRANSACTIONS.
FORM 990, PART VI, SECTION B, LINE 11B:SOUTHAMPTON HOSPITAL ASSOCIATION HAS ITS FORM 990 PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND HAS ESTABLISHED THE FOLLOWING REVIEW PROCESS TO ENSURE THAT THE INFORMATION REPORTED IS COMPLETE AND ACCURATE. UPON COMPLETION, THE FORM 990 IS REVIEWED BY MANAGEMENT AND IS THEN FORWARDED ELECTRONICALLY TO THE MEMBERS OF THE BOARD OF TRUSTEES FOR THEIR REVIEW. ANY QUESTIONS OR ISSUES ARE THEN ADDRESSED BY THE APPROPRIATE PARTIES PRIOR TO THE FILING OF THE RETURN.
FORM 990, PART VI, SECTION B, LINE 12C:SOUTHAMPTON HOSPITAL CURRENTLY HAS A CONFLICT OF INTEREST POLICY AND A PROCEDURE FOR ANNUAL DISCLOSURE BY KEY EMPLOYEES, PHYSICIAN LEADERS, AND SENIOR MANAGEMENT. WHEN NEW/POTENTIAL CONFLICTS/RELATIONSHIPS ARE IDENTIFIED, THEY ARE INVESTIGATED BY THE CORPORATE COMPLIANCE OFFICER AND ANY RECOMMENDATIONS AND/OR CORRECTIVE ACTIONS ARE PRESENTED TO THE PRESIDENT AND CEO. AS APPROPRIATE, THESE POTENTIAL CONFLICTS/DISCLOSURES ARE ALSO REVIEWED WITH THE CFO AND MEDICAL DIRECTOR/COO. WHEN A POTENTIAL CONFLICT IS IDENTIFIED, THE STAFF MEMBER IS PROHIBITED FROM TAKING PART IN ANY HOSPITAL DECISIONS THAT MAY RELATE TO THE INTEREST OR RELATIONSHIP, UNTIL THE REVIEW IS COMPLETED AND A DETERMINATION IS MADE THAT THERE IS NO CONFLICT. SIMILARLY, ON AN ANNUAL BASIS, ALL MEMBERS OF THE BOARD OF DIRECTORS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST FORM. ALL POTENTIAL CONFLICTS OF INTEREST THAT MAY EXIST MUST BE DISCLOSED. IF A POTENTIAL OR ACTUAL CONFLICT OF INTEREST EXISTS, THE AFFECTED MEMBER WILL BE NOTIFIED AND THE EXECUTIVE COMMITTEE OF THE BOARD WILL INVESTIGATE AND MAKE THE DETERMINATION AS TO WHAT, IF ANY RECUSAL OR OTHER CORRECTIVE ACTION MAY BE REQUIRED TO AVOID ANY POTENTIAL CONFLICT. THE RESULTS OF THE INVESTIGATION WILL THEN BE REPORTED TO THE GOVERNING BODY. IF AN ACTUAL CONFLICT OF INTEREST EXISTS, THE AFFECTED MEMBER WILL BE NOTIFIED OF THIS DETERMINATION AND THEIR PARTICIPATION IN RELATED MATTERS AND/OR VOTING RIGHTS, PERTAINING TO THE AREA OF CONFLICT, WILL BE RELINQUISHED.
FORM 990, PART VI, SECTION B, LINES 15A AND 15B:Southampton Hospital has established an Executive Compensation Policy which sets forth the terms and criteria for the review of the compensation of the President & CEO, the Chief Medical Officer/COO and the Vice President of Finance/CFO as well as other executive leaders. The policy outlines the procedures and criteria the Executive Committee will follow in evaluating the CEO's, the CMO/COO's, and the CFOs performance against established goals. It also outlines the Executive Committees' role and responsibility in determining all aspects of the CEO's, Chief Medical Officer/COO's, and CFOs compensation including any incentive or bonus compensation. The Committee reviews contract terms which cover compensation and benefits including, but not limited to, housing allowances, automobile allowances, severance or change of control payments. On a periodic basis, the Executive Committee meets to review the terms of compensation and reviews external compensation data and studies to ensure that compensation decisions are reasonable and consistent with fair market value. The Committee documents the full terms of compensation approved and includes date of the decision, details of the comparability data obtained and relied upon, and how the data was obtained. Members of the Executive Committee must be free from any conflict of interest that may relate to the arrangement. All members of the Committee who were present during the discussion of the arrangement will be documented in the Meeting minutes along with their votes. The compensation review process for the President & CEO, Chief Medical Officer and CFO was last undertaken September 17, 2015.
FORM 990, PART VI, SECTION C, LINE 19:SOUTHAMPTON HOSPITAL'S FORM 990, AS WELL AS ITS FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY, ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST, AS REQUIRED UNDER SECTION 6104 OF THE INTERNAL REVENUE CODE. INTERESTED PARTIES MAY REQUEST THE DOCUMENTS AT 240 MEETINGHOUSE LANE, SOUTHAMPTON, NY 11968 OR BY CALLING THE ORGANIZATION DIRECTLY AT (631)726-8200.
FORM 990, PART XI, LINE 9:PENSION OBLIGATION..................................$(2,249,402) CHARITABLE REALIZED GAINS/LOSSES & DISTRIBUTIONS....$ (64,377) TOTAL...............................................$(2,313,779)

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtControlled OrganizationControlledOrganizationInd
SOUTHAMPTON CARE CENTER
240 MEETING HOUSE LANESOUTHAMPTONNY11968112658403NURSING HOMENY501(c)(3)9false
THE SOUTHAMPTON HOSPITAL FOUNDATION
240 MEETING HOUSE LANESOUTHAMPTONNY11968113466516SRVC PROVIDERNY501(C)(3)7false
MEETINGHOUSE LANE MEDICAL PRACTICE
PO BOX 2340SOUTHAMPTONNY11968208853938PATIENT CARENY501(C)(3)11false

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationInd
SHA PROPERTIES
240 MEETING HOUSE LANESOUTHAMPTONNY11968112563612REAL ESTATENYNAC$0$13,1621.00000Yes (true)
OLD TOWN MEDICAL PRACTICE PC
240 MEETING HOUSE LANESOUTHAMPTONNY11968452430883MEDICAL PRACTICENYNAC$0$01.00000Yes (true)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (true)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (true)LoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd