2015-11-13T11:49:58-06:00 2014-12-31 990 2014-01-01 131624070 Lenox Hill Hospital C/O NORTH SHORE-LIJ HEALTH SYSTEM % NORTH SHORE- LIJ HEALTH SYST LENO 5164658339 972 BRUSH HOLLOW ROAD WESTBURY NY 11590 ROBERT S SHAPIRO EXEC VP & CFO 2015-10-30 2014 2016-03-07 17:11:31Z MICHAEL J DOWLING 145 COMMUNITY DRIVE GREAT NECK NY 11021 1084860253 false X www.lenoxhillhospital.org X 1861 NY LENOX HILL STRIVES TO IMPROVE THE HEALTH of the communities it serves and is committed to providing the highest quality of care for the COMMUNITY REGARDLESS OF ABILITY TO PAY. 118 108 5246 251 0 -6461 8485922 8042143 775859010 900905140 8445619 8354607 10102229 8219045 802892780 925520935 0 0 0 0 351086638 664417271 0 0 521774 312118299 373721165 663204937 1038138436 139687843 -112617501 1235702954 1264097250 578513240 698157564 657189714 565939686 X LENOX HILL HOSPITAL IS PART OF THE NORTH SHORE-LIJ HEALTH SYSTEM ("THE SYSTEM"), WHICH STRIVES TO IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES AND IS COMMITTED TO PROVIDING THE HIGHEST QUALITY CLINICAL CARE; EDUCATING THE CURRENT AND FUTURE GENERATIONS OF HEALTHCARE PROFESSIONALS; SEARCHING FOR NEW ADVANCES IN MEDICINE THROUGH THE CONDUCT OF BIOMEDICAL RESEARCH; PROMOTING HEALTH EDUCATION; AND CARING FOR THE ENTIRE COMMUNITY REGARDLESS OF THE ABILITY TO PAY. false false 693719749 0 734753385 LENOX HILL HOSPITAL ("LHH") IS A 632-BED ACUTE CARE TEACHING HOSPITAL THAT HAS A TRADITION OF PROVIDING OUTSTANDING PATIENT CARE AND INNOVATIVE MEDICAL AND SURGICAL TREATMENT. IN 2014, LHH HAD 28,768 DISCHARGES, DELIVERED 3,771 BABIES, PROVIDED 55,854 EMERGENCY DEPARTMENT VISITS AND PERFORMED 25,266 AMBULATORY SURGERIES. 156113249 0 92820568 North Shore-LIJ Medical Group is an affiliated member of the North Shore-LIJ Health System ("the System") and part of the System's medical group and ambulatory lines of service. It strives to make a measurable difference in the health status of the communities it serves by providing comprehensive health care regardless of ability to pay. 57370720 0 65142193 MANHATTAN EYE, EAR & THROAT HOSPITAL (MEETH) WAS ESTABLISHED IN 1869 AND IS INTERNATIONALLY RECOGNIZED FOR ITS ACCOMPLISHMENTS IN OPHTHALMOLOGY, OTOLARYNGOLOGY, ORTHOPEDICS, PLASTIC SURGERY AND MANY OTHER SERVICES. 14470480 0 8188994 OTHER 14470480 0 8188994 921674198 true true false true false false false false true true false false true true true false true false false true false false false false false true true false false true true false false false false false false false false true false false false false false false true true false false false true 225 0 true 5246 true true true true CJ UK false false false false false false false false false X 118 108 true false false false false true true true true false false true true true true true true true true true true NY X X NORTH SHORE- LIJ HEALTH SYST 5168766061 972 BRUSH HOLLOW RD Westbury NY 11590 Richard D Goldstein IMMEDIATE PAST CHAIRMAN 0.0 2.0 X X 0 0 0 Michael J Dowling President & CEO 0.0 50.0 X X 0 9627815 477742 Mark Claster CHAIRMAN 0.0 3.0 X X 0 0 0 William L Mack Vice Chairman 0.0 2.0 X X 0 0 0 Barry Rubenstein Vice Chairman 0.0 2.0 X X 0 0 0 Paul B Guenther Chairman of Exec Com 0.0 2.0 X X 0 0 0 LLOYD GOLDMAN Vice Chairman of Exec Com 0.0 2.0 X X 0 0 0 RICHARD B NYE Treasurer/VICE CHAIR EXEC COMM 0.0 2.0 X X 0 0 0 Michael Gould Assistant Treasurer 0.0 2.0 X X 0 0 0 Catherine C Foster Secretary 0.0 2.0 X X 0 0 0 Jim McMullen Assistant Secretary 0.0 2.0 X X 0 0 0 Ralph Nappi TRUSTEE/EV CHAIR 0.0 50.0 X X 0 857296 43700 Kevin F Lawlor TRUSTEE AND PRES/CEO HUNT HOSP 0.0 50.0 X 0 700935 43700 NON-COMPENSATED TRUSTEES SEE SCHEDULE O 0.0 2.0 X 0 0 0 Lawrence G Smith MD EVP, PHYSICIAN IN CHIEF 0.0 50.0 X 0 2975330 624823 Mark J Solazzo EVP & COO 0.0 50.0 X 0 1900416 353288 Howard B Gold EVP, Managed Care 0.0 50.0 X 0 1848050 43700 Jeffrey A Kraut SVP, Strategic Planning 0.0 50.0 X 0 908621 266659 Robert S Shapiro EVP/CFO 0.0 50.0 X 0 1193192 294070 DONNA DRUMMOND SVP, SHARED SERVICES 0.0 50.0 X 0 646640 43700 Harry E Gindi Assistant Secretary 0.0 50.0 X 0 313880 43700 LAURA PEABODY SVP & CHIEF LEGAL OFFICER 0.0 50.0 X 0 919339 185412 ANDREW SCHULZ ASST SECRETARY, GEN COUNSEL 0.0 50.0 X 0 683675 43700 EUGENE TANGNEY SVP, CHIEF ADMIN OFFICER 0.0 50.0 X 0 980206 171715 Anthony C Ferreri REGIONAL EXECUTIVE DIRECTOR 0.0 50.0 X 0 1088789 289204 DENNIS CONNORS EXECUTIVE DIRECTOR 50.0 0.0 X 772068 0 309707 KONSTANTINE COSTALES REGIONAL CFO 50.0 0.0 X 404264 0 43700 DAVID SAMADI CHAIRPERSON 50.0 0.0 X 5617493 43700 NIRAV PATEL ASSOC CHAIRPERSON 50.0 0.0 X 2373637 0 43700 ROBERT ROSEN CHF, PEDS INTRVNT & VASC SVC 50.0 0.0 X 1982576 0 43700 Varinder Singh Interim Chair 50.0 0.0 X 2271008 0 43700 GREGORY FONTANA CHAIRPERSON 50.0 0.0 X 2992782 0 43700 16413828 24644184 3497020 951 false true false AXIS CONSTRUCTION CO 125 LASER CT HAUPPAUGE NY 11788 CONSTRUCTION 8094453 CAULDWELL WINGATE COMPANY LLC 380 LEXINGTON AVENUE NEW YORK NY 10168 CONSTRUCTION 6486918 CROSS COUNTRY STAFFING PO BOX 404674 ATLANTA GA 30384 STAFFING SERVICE 3568845 UNITEX TEXTILE RENTAL 155 SOUTH TERRACE AVE MOUNT VERNON NY 10550 LINEN SERVICES 2110414 STARCOM COMMUNICATIONS SERVICES INC 41 CENTRAL DRIVE FARMINGDALE NY 11735 COMMUNICATION SVCS 1903364 52 7495986 524398 21759 8042143 NET PATIENT SERVICE REVENUE 900099 624288880 624288880 PHYSICIAN REVENUE 900099 97996317 97996317 MEDICARE/MEDICAID PAYMENTS 900099 178619943 178619943 900905140 4546288 4546288 0 0 3870383 5598936 -1728553 0 -1728553 157548701 0 153732054 8328 3816647 -8328 3808319 0 0 0 INCOME FROM SURGICARE 900099 1646845 1646845 CAFETERIA REVENUE 900099 1602462 1602462 EHR INCOME 900099 2892458 2892458 3805833 3408122 397711 9947598 925520935 910455027 4943999 0 0 0 0 1176332 1176332 0 447258175 420691040 26301464 265671 133292218 125374660 7838382 79176 56865952 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-1815399 23182872 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false true 78089 false 78089 false false LOBBYING ACTIVITY LENOX HILL HOSPITAL IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION AND OTHER HEALTH CARE ASSOCIATIONS WHICH ENGAGE IN LOBBYING EFFORTS ON BEHALF OF THEIR MEMBER HOSPITALS. 98290902 13742329 1416218 20089758 93359691 95260849 3570999 4402342 4943288 98290902 89858030 8392702 3543964 6533847 95260849 67453000 19774644 2829820 199434 89858030 65677000 2077000 1374000 1675000 67453000 0.68000 0.32000 false false 529808545 529808545 244338279 48509500 195828779 107574 30371 77203 168659902 64803587 103856315 102186389 4978146 97208243 926779085 INTEREST IN FOUNDATION 11783285 SECURITY DEPOSITS 540263 INVESTMENT IN OTHER 8222700 NET BOND ISSUANCE COSTS 2665620 INTANGIBLE ASSETS 11000000 INSURANCE CLAIMS RECEIVABLE 79254319 OTHER ASSETS 5353151 118819338 0 DUE TO AFFILIATES 34389611 DUE TO THIRD PARTY PAYORS 130331323 INSURANCE CLAIMS LIABILITY 79254319 OTHER LIABILITY 1826029 MALPRACTICE INSURANCE 48356125 ACCRUED PENSION LIABILITY 161577599 BOND PREMIUM/DISCOUNT 3218952 CAPITAL LEASE PAYABLE 3290031 462243989 X 921277557 -1255759 -155450 -1411209 922688766 2832169 2832169 925520935 915751662 5598936 5598936 910152726 127985710 127985710 1038138436 Part V, Line 4 The Hospital has adopted an investment policy for endowment assets that attempts to provide a predictable stream of funding to programs supported by its endowment while seeking to maintain the purchasing power of the endowment assets. The Hospital's endowment includes donor-restricted endowment funds. Net assets associated with endowment funds are classified and reported based on the existence or absence of door-imposed restrictions. PART X, LINE 2 - FIN 48 Certain entities included in the System's consolidated financial statements are taxable entities under Federal or state laws. U.S. generally accepted accounting principles require that the asset and liability method of accounting for income taxes be utilized by these organizations. Under the asset and liability method, deferred income taxes are recognized for the tax consequences of temporary differences by applying enacted statutory tax rates applicable to future years to differences between the financial statement carrying amounts and the tax basis of existing assets and liabilities. The effect on deferred taxes of a change in tax rates is recognized in income in the period of enactment. At December 31, 2014 and 2013, the System has a deferred income tax asset which has been fully offset by a related valuation allowance. A valuation allowance is provided when it is more likely than not that some portion, or all of the deferred tax asset will not be realized. Significant components of the deferred tax asset relate to the allowance for doubtful accounts receivable and net operating loss carry forwards. Certain entities have net operating loss carry forwards aggregating approximately $165,000,000, which expire in varying amounts through 2034, and are available to offset future taxable income. PART XI, LINE 2D & 4B - REVENUE RECONCILIATION REVENUE ON BOOKS NOT ON RETURN NON-OPERATING GAINS 9,933,752 PROVISION FOR BAD DEBT (15,404,368) NET ASSETS RELEASED 5,315,166 TOTAL ( 155,450) REVENUE ON RETURN NOT ON BOOKS Restricted Investment 1,975,857 Restricted Contributions 6,448,676 Book/Tax Adjustment 6,572 Rental Expense (5,598,396) Total 2,832,169 PART XII, LINE 2D & 4B - EXPENSE RECONCILIATION EXPENSE ON BOOKS NOT ON RETURN RENT EXPENSE ALLOCATION 5,598,936 TOTAL 5,598,936 EXPENSE ON RETURN NOT ON BOOK PROVISION FOR BAD DEBTS 15,404,368 Additional Minimum Pension Liability 112,581,342 TOTAL 127,985,710 Central America and the Caribbean Investments 9405873 Europe (Including Iceland and Greenland) Investments 1491264 10897137 10897137 false false false false false false true true X true X true X 500. true true true false true true 1 14573 15542054 4950305 10591749 0.01170 1 35297 96325709 61514252 34811457 0.03860 2 49870 111867763 66464557 45403206 0.05030 201 285857 1975133 1975133 0.00220 94 1764 69719265 18696930 51022335 0.05650 2 28788 8370358 5881616 2488742 0.00280 1 1573383 1573383 0.00170 69 8711 686715 686715 0.00080 367 325120 82324854 24578546 57746308 0.06400 369 374990 194192617 91043103 103149514 0.11430 3 5177 64758 64758 0.00010 6 695 584 584 30 2949 7684 7684 3 246 7389 7389 5 113 15889 15889 47 9180 96304 96304 0.00010 false 9364904 171266031 199532042 -28266011 true true SURGICARE OF MANHATT MEDICAL SERVICES 0.25000 0.00000 0.75000 1 1 LENOX HILL HOSPITAL 100 EAST 77TH STREET NEW YORK NY 10075 WWW.LENOXHILLHOSPITAL.ORG X X X X LENOX HILL HOSPITAL 1 false false true X X X X X X X X X 13 true true true true X www.northshorelij.com X true 13 true www.northshorelij.com/sites/default/files/nsl false false true X 100 500. X X X X true true X X X true X X X X X X X X X true X false X X X X X true X false false PART V, SECTION C - SUPPLEMENTAL INFORMATION Part V, Section B, line 2: N/A Part V, Section B, line 3j: N/A Part V, Section B, line 5: The CHNA was facilitated by committees established within each county served by NSLIJ and its hospitals. These were comprised of participants such as Departments of Health; community based organizations (CBOs); the NSLIJ Health System; local businesses; and faith-based organizations; and a "voice of the community" (i.e. the community's perception of need). Qualitative data was collected from diverse community organizations that serve the population-at-large, as well as those communities with significant health disparities. Community partners were invited to participate via surveys and key informant interviews. Emphasis was placed on the following populations: minorities/underserved communities, seniors, women and children, special populations, and individuals with disease-specific conditions. Primary data was obtained through qualitative analysis of CBO informant interviews, CBO surveys, individual community member surveys, and participation in the collaborative partner listening sessions. For further detail go to web link: http://www.northshorelij.com/hospitals/about-us/about-us-community-service -plans-benefit-report Part V, Section B, line 6a: For a detailed listing of other hospital facilities go to web link: http://www.northshorelij.com/hospitals/about-us/about-us-community-service -plans-benefit-report Part V, Section B, line 6b: For a detailed listing of other than hospital facilities go to web link: http://www.northshorelij.com/hospitals/about-us/about-us-community-service -plans-benefit-report Part V, Section B, line 7d: N/A Part V, Section B, line 11: The hospital identified and addressed primary needs based on an assessment of the highest ranked health priorities of the community, regulatory input (I.E. the NYC Department of Health prevention priority agenda), and resources available. For further information go to web link: http://www.northshorelij.com/hospitals/about-us/about-us-community-service -plans-benefit-report Part V, Section B, line 13b: N/A Part V, Section B, line 13h: The hospital also uses household size. Part V, Section B, line 15e: N/A Part V, Section B, line 16i: The policy is included in the hospital's Community Service Plan and provided at health fairs and presentations open to the community at no cost, in addition to mailing financial policy summary brochures. Part V, Section B, line 18d: N/A Part V, Section B, line 19d: N/A Part V, Section B, line 20e: Before initiating any of the actions, the hospital facility sends letters, makes telephone calls and utilizes presumptive eligibility. Part V, Section B, line 21c: N/A Part V, Section B, line 21d: N/A Part V, Section B, line 22d: The hospital used a blended Medicaid rate as a criterion during the tax year to determine the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care. Under NYS Health Law Section 2807-k (9a) indigent care pool requires a sliding fee scale from qualifying patients. A reduction from gross charges must result in an expected payment that does not exceed the amount paid for the same services by the hospital's highest volume payer (i.e. Medicare or Medicaid) Part V, Section B, line 23: N/A Part V, Section B, line 24: N/A 21 LENOX HEALTH GREENWICH VILLAGE 30 7TH AVENUE NEW YORK NY 10011 OUTPATIENT PHYSICIAN CLINIC PHYSICIAN AMBULATORY NETWORK SERVICES 130 EAST 77TH STREET NEW YORK NY 10075 OUTPATIENT PHYSICIAN CLINIC PHYSICIAN AMBULATORY NETWORK SERVICES 210 EAST 64TH STREET NEW YORK NY 10065 OUTPATIENT PHYSICIAN CLINIC PHYSICIAN AMBUALTORY NETWORK SERVICES 110 EAST 59TH STREET NEW YORK NY 10065 OUTPATIENT PHYSICIAN CLINIC PHYSICIAN AMBULATORY NETWORK SERVICES 186 EAST 76TH STREET NEW YORK NY 10021 OUTPATIENT PHYSICIAN CLINIC MANHATTAN EYE EAR & THROAT 210 EAST 64TH STREET NEW YORK NY 10065 OUTPATIENT PHYSICIAN CLINIC PARK EAST CARDIOLOGY ASSOCIATES PC 158 EAST 84TH STREET NEW YORK NY 10028 OUTPATIENT PHYSICIAN CLINIC PHYSICIAN AMBULATORY NETWORK SERVICES 178 EAST 85TH STREET NEW YORK NY 10028 OUTPATIENT PHYSICIAN CLINIC LENOX HILL HEART AND VASCULAR AT YORKTOW 2649 STRANG BOULEVARD YORKTOWN HEIGHTS NY 10598 OUTPATIENT PHYSICIAN CLINIC LENOX HILL HEART AND VASCULAR AT YORKTOW 2649 STRANG BOULEVARD YORKTOWN HEIGHTS NY 10598 OUTPATIENT PHYSICIAN CLINIC PROGRESSIVE MEDICAL ASSOCIATES- CARDIOLO 90 EAST END AVENUE NEW YORK NY 10028 OUTPATIENT PHYSICIAN CLINIC LENOX HILL MEDICINE ASSOCIATES AT 927 PA 927 PARK AVENUE NEW YORK NY 10028 OUTPATIENT PHYSICIAN CLINIC PHYSICIAN AMBULATORY NETWORK SERVICES 30-16 30TH DRIVE ASTORIA NY 11102 OUTPATIENT PHYSICIAN CLINIC PHYSICIAN AMBULATORY NETWORK SERVICES 111 EAST 77TH STREET NEW YORK NY 10075 OUTPATIENT PHYSICIAN CLINIC PHYSICIAN AMBULATORY NETWORK SERVICES 1085 PARK AVENUE NEW YORK NY 10028 OUTPATIENT PHYSICIAN CLINIC NEW YORK HEAD AND NECK INSTITUTE 501 SEAVIEW AVENUE STATEN ISLAND NY 10305 OUTPATIENT PHYSICIAN CLINIC PROGRESSIVE MEDICAL ASSOCIATES - CARDIOL 161 MADISION AVENUE NEW YORK NY 10016 OUTPATIENT PHYSICIAN CLINIC LENOX HILL MEDICINE ASSOCIATES 1080 FIFTH AVENUE NEW YORK NY 10128 OUTPATIENT PHYSICIAN CLINIC LENOX HILL MEDICINE ASSOCIATES 178 EAST 85TH STREET NEW YORK NY 11028 OUTPATIENT PHYSICIAN CLINIC LENOX HILL MEDICINE AT MEDICAL ASSOCIATE 220 EAST 69TH STREET NEW YORK NY 10021 OUTPATIENT PHYSICIAN CLINIC PHYSICIAN AMBULATORY NETWORK SERVICES 1080 FIFTH AVENUE NEW YORK NY 10128 OUTPATIENT PHYSICIAN CLINIC PART VI - SUPPLEMENTAL INFORMATION Question 1: Part I, Line 3c: This hospital is an affiliated entity of the North Shore-LIJ Health System ("North Shore-LIJ" or "the System"). North Shore-LIJ uses FPG to determine eligibility and utilizes the New York State Department of Health (NYSDOH) guidelines regarding the consideration of assets. Asset tests cannot be used to deny financial assistance, but only to "upgrade" a patient's level of obligation, up to the legal maximum permitted under the financial assistance law. Part I, Line 6a: The Community Benefit report is prepared by the hospital, in conjunction with an affiliated entity (North Shore-Long Island Jewish Health System) of the hospital. The Community Benefit Report is accessible to the public and can be accessed on the North Shore-LIJ website: http://www.northshorelij.com. Part I, 7: Row (a) The cost of charity care was determined by utilizing the ratio of cost to charges (RCC) calculated on Worksheet 2 applied to gross charges written off for patients qualifying for charity under the hospital's financial assistance policy. Bad Debt was not reported in any row of Part I, Line 7. Row (b) The Ratio of Cost to Charges method (or RCC) is used to determine the cost of ancillary services. A RCC is developed from these costs, and that RCC is applied to total Medicaid gross ancillary services charges to determine the cost of services provided to Medicaid patients. Row (e) Costs associated with Community Health Improvement Services were determined by adding indirect or overhead costs to the direct costs of the activity. Indirect costs were calculated as a percentage of direct costs. Direct costs for staff expenses were calculated using average hospital facility hourly rates, and were adjusted to account for fringe benefits, using a blended rate based on the ratio of total employee benefit expenses to total salary and wages. Row (f) The Bad Debt Expense that appears on Form 990, Part IX, Line 25 column (A), but not included for purposes of calculating the percentage in this column is equal to the amount reported on Form 990, Part X. The costs related to health professions education were determined by utilizing the step down method of cost finding. Row (h) Costs associated with research activities were determined by adding indirect, or overhead, costs to the direct costs of the activity. Indirect costs were calculated as a percentage of costs. Row (i) The cost of in-kind contributions to community groups is comprised of the direct costs of personnel whose compensated time was donated to various charities and community groups. The salaries and wages were adjusted to include benefits using a rate based on the ratio of total employee benefit expenses to total salary and wages. Indirect costs were calculated as a percentage of direct costs. Column (a) The number of activities or programs was determined by counting unique community benefit activities or programs conducted throughout the year. Each activity or program may include multiple occurrences. In Part I line 7a-k, column (a) represents the total number of unique community benefit activities and programs; not the number of occurrences for each activity and program. Column (b) Persons served were determined by the unique number of community members that encountered a specific community benefit activity or program. Persons were reported multiple times when engaged in services in different categories of activity or program. Column (f) for Rows (a)-(k) The percentage of Net Community Benefit Expense divided by Total Expense for the hospital (to calculate the percent of total expense). Note: For the entire North Shore-LIJ Health System, Part I, Line 7 (Row K, Column F) is approximately 12.08 as a percentage of expenses. Part II: All community building activities improve access to health services and address federal, state, or local public health priorities, as well as leverage public health department activities, and in doing so, they provide relief of government burden. These activities broadly serve low-income, underserved patients, and include: collaboration with various community coalitions, system-wide recycling initiative, organizational response to worldly disasters, and bioterrorism efforts. The System's bioterrorism & disaster preparedness includes Center for Emergency Medical Services, which is a state and federal planning resource on weapons of mass destruction, and a designated a Bioterrorism Resource Center. The System has conducted staff training for more than 100 hospitals and area first responders and invested heavily in the infrastructure needed for large-scale emergencies. During catastrophes, (i.e. Super storm Sandy), North Shore-LIJ provides a safe haven for thousands of patients, outside nursing home residents, and community members seeking shelter. North Shore-LIJ ambulances assists with the transport of patients throughout the metropolitan area and stand ready to contribute food, medicine and blankets to numerous individuals who may lose power in their homes, and assist both affiliated and non-affiliated hospital patients. Investment in a field hospital has furthered the public health infrastructure needed for mass casualties that could result from a terrorist attack, natural attack, or large-scale emergency. Part III, Line 2: For patients who were determined by the System to have the ability to pay but did not, the uncollected amounts are recorded as bad debt expense. The amount of gross charges written off is reduced by any charity care or other discounts provided to the patient, as well as any payments received. Bad debt expense reported on this line is reported net of governmental or private offsetting funds. Part III, Line 3: N/A Part III, Line 4: For patients who were determined by the System to have the ability to pay but did not, the uncollected amounts are recorded as bad debt expense. Part III, Line 8: Medicare costs are determined utilizing a combination of the step down method of cost findings and a cost per unit of service. Cost per unit of service is used to calculate the routine cost of services provided to Medicare patients. The Ratio of Cost to Charges method (or RCC) is used to determine the cost of ancillary services. An RCC is developed from these costs, and that RCC is applied to total Medicare gross ancillary services charges to determine the cost of services provided to Medicare patients. Part III, Line 9b: The organization's collection policy is standard to all accounts regardless of insurance status (e.g. insured, underinsured, and uninsured). The hospital's collection policy states that they will not send patient accounts to collection if a decision on a financial assistance application is pending, or if a patient is determined to be eligible for Medicaid at the time services were rendered and for which services Medicaid payment is available. Question 2: NEEDS ASSESSMENT: The Community Health Needs Assessment (CHNA) is performed on an ongoing basis. North Shore-LIJ conducts and participates in population, demographic, and health status evaluations of our respective hospitals' service areas based on county regions and the communities we serve. There is a special effort to include individuals with health disparities and organizations who serve these communities in the CHNA process. The CHNA includes the analysis of primary and secondary data. Multi-year analyses, trends and projections are developed, which identify areas of need for the continuum of health care services. Primary data is obtained through a combination of qualitative analysis of community-based organization (CBO), informant interviews and surveys, individual community member surveys, and participation in collaborative partner meetings. These meetings include representatives from the Departments of Health, CBOs, academic institutions, government agencies, and hospitals. Ongoing input concerning our communities' needs is also obtained through: our Board of Trustees/Directors who are all area residents and leaders in their respective communities; facility based advisory boards and councils, and; the feedback received by our facility administrators and clinicians that serve on local community agency boards. Secondary data analysis includes: internal hospital data, including Prevention Quality Indicators (PQI); Department of Health Community Health Assessments; local regional NYS Prevention Agenda data sources; and Statewide Planning and Research System (SPARCS) data. The Committee on Community Health, a committee of the Board of Trustees, provides recommendations that concern North Shore-LIJ's community health priorities and interventions based on the CHNA. Committee discussions focus on New York State (NYS) Prevention Agenda Priority Areas, including strategies and intervention outcomes related to chronic disease prevention, women and children's health, healthy safe environments, health access, mental health and substance abuse, HIV/AIDS/STDs and community immunizat X X X X X false true false false false false false true false Michael J Dowling President & CEO 0 1373402 0 1728000 0 6526413 0 456717 0 21025 0 10105557 0 5095760 Lawrence G Smith MD EVP, PHYSICIAN IN CHIEF 0 735253 0 309000 0 1931077 0 608710 0 16113 0 3600153 0 1302490 Mark J Solazzo EVP & COO 0 1172927 0 700000 0 27489 0 338188 0 15100 0 2253704 0 0 Howard B Gold EVP, Managed Care 0 1079764 0 737000 0 31286 0 28600 0 15100 0 1891750 0 0 Jeffrey A Kraut SVP, Strategic Planning 0 720927 0 157000 0 30694 0 251559 0 15100 0 1175280 0 0 Robert S Shapiro EVP/CFO 0 925430 0 236000 0 31762 0 278970 0 15100 0 1487262 0 0 DONNA DRUMMOND SVP, SHARED SERVICES 0 510427 0 77000 0 59213 0 28600 0 15100 0 690340 0 0 Harry E Gindi Assistant Secretary 0 288540 0 21136 0 4204 0 28600 0 15100 0 357580 0 0 Ralph Nappi TRUSTEE/EV CHAIR 0 673335 0 150000 0 33961 0 28600 0 15100 0 900996 0 0 Anthony C Ferreri REGIONAL EXECUTIVE DIRECTOR 0 890130 0 177000 0 21659 0 274104 0 15100 0 1377993 0 0 Kevin F Lawlor TRUSTEE AND PRES/CEO HUNT HOSP 0 594131 0 57000 0 49804 0 28600 0 15100 0 744635 0 0 DENNIS CONNORS EXECUTIVE DIRECTOR 639255 0 102000 0 30813 0 294607 0 15100 0 1081775 0 0 0 LAURA PEABODY SVP & CHIEF LEGAL OFFICER 0 763150 0 111000 0 45189 0 170312 0 15100 0 1104751 0 0 ANDREW SCHULZ ASST SECRETARY, GEN COUNSEL 0 570660 0 84320 0 28695 0 28600 0 15100 0 727375 0 0 DAVID SAMADI CHAIRPERSON 5617450 0 0 0 43 0 28600 0 15100 0 5661193 0 0 0 NIRAV PATEL ASSOC CHAIRPERSON 1854792 0 500000 0 18845 0 28600 0 15100 0 2417337 0 0 0 ROBERT ROSEN CHF, PEDS INTRVNT & VASC SVC 1799000 0 180000 0 3576 0 28600 0 15100 0 2026276 0 0 0 Varinder Singh Interim Chair 1975082 0 200000 0 95926 0 28600 0 15100 0 2314708 0 0 0 KONSTANTINE COSTALES REGIONAL CFO 378160 0 25033 0 1071 0 28600 0 15100 0 447964 0 0 0 GREGORY FONTANA CHAIRPERSON 2490428 0 500000 0 2354 0 28600 0 15100 0 3036482 0 0 0 EUGENE TANGNEY SVP, CHIEF ADMIN OFFICER 0 840427 0 128000 0 11779 0 156615 0 15100 0 1151921 0 0 PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN Certain individuals participate in a Supplemental Executive Retirement Plan ("SERP") which is subject to substantial risk of complete forfeiture. Accordingly, the individual may never actually receive the unvested benefit amount and the amounts outlined herein were properly not reported in each individual's Form W-2, Box 5. These amounts are included in Schedule J, Column C for Michael J Dowling ($428,117), Mark J Solazzo ($309,588), Robert S Shapiro ($250,370), Lawrence G Smith ($580,110), Jeffrey Kraut ($222,959), Laura Peabody ($141,712), Eugene Tangney ($128,015), Anthony C Ferreri ($245,504) and Dennis Connors($266,007). PART I, LINE 7 - BONUS AND INCENTIVE COMPENSATION On Form 990, Part VII, Section A, line 1A, the organization may provide non-fixed payments, not described on lines 5 and 6, to certain listed persons. The organization bases such payments on many performance based factors. Payments of this type appear on Schedule J, Part II, B (ii). PART II, COLUMN (F) - SERP PAYOUT The amount reported in Schedule J, Part II, Column (F) includes SERP amounts which were previously reported on Form 990, Schedule J, Part II, Column (C) in prior years. In accordance with the IRS instructions, these amounts were originally reported when contributions were made to the SERP plan and are now being reported for a second time upon receipt of distribution from the SERP plan. A DORMITORY AUTHORITY OF THE STATE OF NEW YORK 146000293 649906JT2 2011-10-06 108475000 2011 BONDS - CONSTRUCT FACILITY & false false false A 8026376 0 110331003 5891227 915118 0 1952765 0 0 26787657 66705142 0 2013 true true false true A false false false false 0 false false false true A false true true false false false 0 false 0 false true A true PART II, LINE 3 - PROCEEDS, THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO INVEST EARNINGS & TRANSFERRED PROCEEDS CINDY CLASTER FAMILY MEM: MARK CLASTER 51785 EMPLOYEE false PART VI, SECTION A - GOVERNING BODY, LINE 2 All transactions with North Shore-LIJ Health System entities are as follows: (1) negotiated at arm's length; (2) all purchases are at fair market value; and (3) all products or services are rendered on an "as needed" basis. William Achenbaum has a business relationship with Elise Bloom and Eric and Roger Blumencranz. John Alexander has a business relationship with Laura Lauria and John Shall. Philip Altheim has a business relationship with Eric Blumencranz. Michael Ashner has a business relationship with William Mack. Frank Besignano has a business relationship with Laura Lauria. Elise Bloom has a business relationship with William Achenbaum, Leonard Feinstein and Lewis Ranieri. Eric Blumencranz has as a family relationship with Roger Blumencranz. He has a business relationship with Roger Blumencranz, William Achenbaum, Philip Altheim, Arlene Lane Fisher, Richard D. Goldstein, Lloyd Goldman, Alan Greene, Richard Horowitz, M. Allan Hyman, Jeffrey Jurick, Arthur Levine, Stuart Levine, David Mack, Bradley Marsh, Charles Merinoff, Ralph Nappi, Dennis Riese, Michael Slade, Nancy Waldbaum, Barbara Hrbek Zucker and Donald Zucker. Roger Blumencranz has a family relationship with Eric Blumencranz. He has a business relationship with Eric Blumencranz, William Achenbaum, Arlene Lane Fisher, Richard D. Goldstein, Alan Greene, Stanley Grey, Richard Horowitz, M. Allan Hyman, Jeffrey Jurick, Stuart Levine, David Mack, Bradley Marsh, Ralph Nappi, Michael Slade, Mark Solazzo, Barbara Hrbek Zucker and Donald Zucker. David Blumenfeld has a family relationship with Edward Blumenfeld. He has a business relationship with M. Allan Hyman and William Mack. Edward Blumenfeld has a family relationship with David Blumenfeld. He has a business relationship with M. Allan Hyman and William Mack. Steve Braun has a family relationship with Richard Sims. He has a business relationship with Cary Kravet. Robert Chasanoff has a business relationship with Michael Sahn. Alan Chopp has a business relationship with Patrick McDermott. Mark Claster has a business relationship with Richard Goldstein and Robert Rosenthal. Philippe Dauman has a business relationship with Thomas Dooley. Thomas Dooley has a business relationship with Philippe Dauman. Leonard Feinstein has a business relationship with Elise Bloom and William Mack. Arlene Lane Fisher has a business relationship with Eric Blumencranz and Roger Blumencranz. Lloyd Goldman has a business relationship with Eric Blumencranz, Richard Goldstein and William Mack. Richard D. Goldstein has a business relationship with Roger Blumencranz, Eric Blumencranz, Mark Claster, Lloyd Goldman, William Mack and Barry Rubenstein. Joaquin Gonzalez has a business relationship with John Shall. Alan I. Greene has a business relationship with Eric Blumencranz and Roger Blumencranz. Stanley Grey has a business relationship with Roger Blumencranz. William Hiltz has a business relationship with Jeff Maurer. Gedale Horowitz has a family relationship with Richard and Seth Horowitz. Richard Horowitz has a family relationship with Gedale and Seth Horowitz. He has a business relationship with Eric Blumencranz and Roger Blumencranz. Seth Horowitz has a family relationship with Gedale and Richard Horowitz. M. Allan Hyman has a business relationship with Eric Blumencranz, Roger Blumencranz, David Blumenfeld, Edward Blumenfeld, David Katz, Michael Katz, Saul Katz, Stanely Kreitman and Donald Zucker. Jeffrey Jurick has a business relationship with Eric and Roger Blumencranz. David Katz has a family relationship with Saul Katz and Michael Katz. He has a business relationship with M. Allan Hyman, Michael Katz, Saul Katz and Seth Lipsay. Michael Katz has a family relationship with Saul Katz and David Katz. He has a business relationship with M. Allan Hyman, David Katz, Saul Katz, Curt Launer and Michael Slade. Saul Katz has a family relationship with Michael Katz and David Katz. He has a business relationship with M. Allan Hyman, David Katz, Michael Katz, Curt Launer, F.J. McCarthy and Michael Slade. Cary Kravet has a business relationship with Steve Braun. Stanley Kreitman has a business relationship with Allan Hyman. Jeffrey Lane has a business relationship with William Mack. Curt Launer has a business relationship with Michael Katz and Saul Katz. Laura Lauria has a business relationship with John Alexander and Frank Besignano. Arthur Levine has a business relationship with Eric Blumencranz. Stuart Levine has a business relationship with Eric Blumencranz and Roger Blumencranz. Seth Lipsay has a business relationship with David Katz. David Mack has a family relationship with William Mack. He has a business relationship with William Mack, Eric Blumencranz, and Roger Blumencranz. William Mack has a family relationship with David Mack. He has business relationships with David Mack, Michael Ashner, Edward and David Blumenfeld, Leonard Feinstein, Lloyd Goldman, Richard Goldstein, Jeffrey Lane, Barry Rubenstein and Roy Zuckerberg. Bradley Marsh has a family relationship with Jack Ross. He has a business relationship with Eric Blumencranz and Roger Blumencranz. Jeff Maurer has a business relationship with William Hiltz. F.J. McCarthy has a business relationship with Saul Katz, Robert Rosenthal and Emmett Walker. Patrick McDermott has a business relationship with Alan Chopp and John Shall. Charles Merinoff has a business relationship with Eric Blumencranz. Ralph Nappi has a business relationship with Eric Blumencranz and Roger Blumencranz. John J. Raggio has a family relationship with John V. Raggio. John V. Raggio has a family relationship with John J. Raggio. Lewis Ranieri has a business relationship with Elise Bloom. Dennis Riese has a business relationship with Eric Blumencranz. Robert Rosenthal has a business relationship with Mark Claster, F.J. McCarthy and Nancy Waldbaum. Jack Ross has a family relationship with Bradley Marsh. Barry Rubenstein has a business relationship with Richard Goldstein and William Mack. Michael Sahn has a business relationship with Robert Chasanoff. John Shall has a business relationship with Patrick McDermott, John Alexander, and Joaquin Gonzalez. Richard Sims has a family relationship with Steve Braun. Michael Slade has a business relationship with Eric Blumencranz and Roger Blumencranz, Saul Katz and Michael Katz. Mark Solazzo has a business relationship with Roger Blumencranz. Nancy Waldbaum has a business relationship with Eric Blumencranz and Robert Rosenthal. Emmett Walker has a business relationship with F.J. McCarthy. Barbara Hrbek Zucker has a family relationship with Donald Zucker. She has a business relationship with Eric Blumencranz and Roger Blumencranz. Donald Zucker has a family relationship with Barbara Hrbek Zucker. He has a business relationship with Eric Blumencranz, Roger Blumencranz and M. Allan Hyman. Roy Zuckerberg has a business relationship with William Mack. PART VI, SECTION A - GOVERNING BODY, LINE 7 North Shore Long Island Jewish Health Care, Inc. ("Health Care") is the sole corporate member of the organization. Health Care has the right to elect or appoint members of the organization's governing body and has the right to approve or ratify certain corporate decisions. This organization and Health Care are part of the North Shore Long Island Jewish Health System, an integrated health care delivery system. PART VI, SECTION B - POLICIES, LINE 11 The annual Return of Organization Exempt From Income Tax (Form 990) for North Shore-LIJ Health System Inc. and Affiliated entities are prepared with input from various departments including Corporate Compliance, Finance, Human Resources, and Legal. Before filing the returns, the documents are electronically made available to all trustees through a secure online portal. Members of the Executive Committee are then informed the returns are ready for review. The Executive Committee, which is a committee made up of members from the Board of Trustees, may exercise all of the authority of the Board of Trustees except as such authority is limited by applicable law and except to the extent, if any, that such authority would be inconsistent with any provision of these By-laws or is limited by any resolution to such effect adopted by the Board of Trustees. PART VI, SECTION B - POLICIES, LINE 12C The North Shore-Long Island Jewish Health System ("Health System") has several control mechanisms to mitigate conflicts of interest. The Health System's Code of Ethical Conduct contains a detailed section educating individuals about how to avoid potential conflicts of interest. Specifically, our Code of Ethical Conduct requires individuals to conduct Health System business in a manner that places the interests of the Health System ahead of their personal interests. In addition, the Health System has a Conflicts of Interest Policy Statement further elaborating upon individuals' disclosure and recusal obligations. Individuals that are in a position to influence the business or other decisions of the Health System are required to fill out a conflicts of interest disclosure form on a regular basis. The Corporate Compliance Office reviews all disclosures of possible conflicts, including matters disclosed in any conflicts of interest disclosure report and takes any actions deemed required or appropriate to manage or resolve any actual or potential conflicts of interest. In appropriate cases these disclosures and responsive actions will be reported to the Health System's Audit and Corporate Compliance Committee and other applicable committees. In addition, the Health System provides training to individuals on an annual basis regarding conflicts of interest and other compliance related topics. If an individual violates the Code of Ethical Conduct or any related policy such as the Conflicts of Interest Policy Statement, appropriate disciplinary action is taken based upon the facts and circumstances of the situation. PART VI, SECTION B - POLICIES, LINE 15 The by-laws of the Health System create a committee of the Board with full powers of the Board to review and approve the compensation of officers and other key employees. The committee consists of approximately 6 trustees who have no connection to the System except as trustees and they have no conflicts as to matters they consider. The committee meets several times a year as needed but always meets in November/December to review and determine officer and key employee compensation for the following year. For purposes of their review the committee considers the recommendations of the CEO for all persons other than the CEO. For purposes of the review each year the committee receives information from an outside independent compensation consultant as to compensation for comparable positions in comparable organizations and makes its decisions on this basis, with the overall objective of paying base salary at the 50th percentile. Any contracts or other compensation for officers or key employees are separately considered and normally only approved after receipt of a "fairness opinion" from the independent consultant. All the work and process of the committee is structured to fall within the applicable safe harbor regulations. PART VI, SECTION C - DISCLOSURES, LINE 19 CURRTENTLY THE ORGANIZATION PROVIDES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. PART VII, SECTION A - LINE 1A Richard S. Abramson Michael Gould F.J. McCarthy William Achenbaum Albert L. Granger, DDS Patrick F. McDermott John W. Alexander Alan I. Greene James McMullen Philip S. Altheim Stanley Grey Charles Merinoff Michael L. Ashner Paul B. Guenther Richard D. Monti Ralph M. Baruch Amy M. Hagedorn Richard Murcott Frank J. Besignano Ira Hazan Ralph A. Nappi Elise M. Bloom Linda W. Heaney Raffiq A. Nathoo Eric S. Blumencranz Marlene Hess Richard B. Nye Roger A. Blumencranz William O. Hiltz Clyde I. Payne, Ed.D. David Blumenfeld Gedale B. Horowitz Arnold S. Penner Edward Blumenfeld Richard A. Horowitz John J. Raggio E. Steve Braun Seth R. Horowitz John V. Raggio Dayton T. Brown, Jr M. Allan Hyman Lewis S. Ranieri Jonathan S. Canno Mark Jacobson Dennis Riese Michael Caridi Jeffrey Jurick Terry P. Rifkin, M.D. Robert W. Chasanoff David M. Katz Robert A. Rosen Alan Chopp Michael Katz Marcie Rosenberg Mark Claster Saul B. Katz Robert D. Rosenthal Diana F. Colgate Lisa A. Kaufman Bernard M. Rosof, M.D. Daniel M. Crown Robert Kaufman Jack J. Ross Philippe P. Dauman Cary Kravet Barry Rubenstein Thomas E. Dewey, Jr. Stanley Kreitman Herbert Rubin Thomas E. Dooley Seth Kupferberg Michael H. Sahn Michael J. Dowling Jeffrey B. Lane Lois C. Schlissel Robert N. Downey Curt N. Launer John M. Shall Patrick R. Edwards Laura Lauria Marc V. Shaw Michael A. Epstein Kevin F. Lawlor Richard Sims Leonard Feinstein David W. Lehr Michael C. Slade Michael E. Feldman Jonathan W. Leigh Phyllis Hill Slater Arlene Lane Fisher Arthur S. Levine Howard D. Stave Catherine C. Foster Stuart R. Levine Peter Tilles William H. Frazier Seth Lipsay Paula Dunn Tropello,EdD Eugene B. Friedman,MD David S. Mack Sandra Tytel William J. Fritz,PhD William L. Mack Frederick A. Volk Sy Garfinkel Linda Manfredi Nancy Waldbaum Lloyd M. Goldman Bradley Marsh, D.P.M. Emmett F. Walker, Jr Richard D. Goldstein Jeffrey S. Maurer Barbara Hrbek Zucker J. Joaquin Gonzalez Ronald J. Mazzucco Donald Zucker Roy J. Zuckerberg PART VII, SECTION A - LINE 1A, COLUMN (B) This organization is affiliated with the North Shore Long Island Jewish Health System (the "Health System"). The Officers, Directors and Trustees listed on Schedule J hold similar positions with both this organization and other affiliates of the Health System, and they do not separately allocate their time to this organization and such other affiliates. The hours shown for all such persons reflect time devoted to the entire Health System and its affiliates, including this organization. For Directors and Trustees, the hours shown reflect the estimated average weekly time. For officers, Key Employees and Highest Compensated Employees, the hours shown reflect the weekly hours used when determining compensation payments for services rendered and are, generally, less than the actual weekly hours devoted to the Health System and its affiliates. PART XI, LINE 9 - RECONCILIATION OF NET ASSETS, LINE 9 NON-OPERATING GAINS 9,993,752 CHANGE IN EQUITY UNDER FAS 136 7,293,653 BOOK/TAX ADJUSTMETN (6,572) TRANSFER TO AFFILIATES 5,962,039 TOTAL 23,182,872 LHH Corporation 100 East 77th Street New York NY 10021 133272016 SUPPORT NY 501(C)(3) 11, Type 1 NS-LIJHS false North Shore-LIJ Health System 972 Brush Hollow Road Westbury NY 11590 113418133 SUPPORT NY 501(C)(3) 11, Type 1 NA false North Shore-LIJ Health Care Inc 972 Brush Hollow Road Westbury NY 11590 112965586 SUPPORT NY 501(C)(3) 11, Type I NS-LIJHS false North Shore University Hospital 972 Brush Hollow Road Westbury NY 11590 111562701 Health Care NY 501(C)(3) 3 NS-LIJ HCI false Long Island Jewish Medical Center 972 Brush Hollow Road Westbury NY 11590 112241326 Health Care NY 501(C)(3) 3 NS-LIJ HCI false Glen Cove Hospital 972 Brush Hollow Road Westbury NY 11590 111633487 Health Care NY 501(C)(3) 3 NS-LIJ HCI false Forest Hill Hospital 972 Brush Hollow Road Westbury NY 11590 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Fundraising NY 501(C)(3) 7 NS-LIJ HCI false Staten Island University Hospital 475 Seaview Avenue Staten Island NY 10305 112868878 Health Care NY 501(C)(3) 3 NS-LIJ HCI false Staten Island University Hospital Founda 360 Seaview Avenue Staten Island NY 10305 870765787 Fundraising NY 501(C)(3) 7 SIUH false The Heart Institute 475 Seaview Avenue Staten Island NY 10305 311757254 INACTIVE NY 501(C)(3) 11, TYPE 1 NA false CHAPS Community Health Center Inc 1 Edgewater Plaza 6th Floor Staten Island NY 10305 113345477 Inactive NY 501(C)(3) 9 SIUH false Hospice Care Network 99 Sunnyside Blvd Woodbury NY 11797 112925757 Hospice NY 501(C)(3) 9 NA false Huntington Hospital 270 Park Avenue Huntington NY 11743 111630914 Health Care NY 501(C)(3) 3 NS-LIJ HCI false Huntington Hospital Dolan Family Health 284 Pulaski Road Greenlawn NY 11740 113368503 Health Care NY 501(C)(3) 3 Huntington false Physicians of University Hospital PC 1 Edgewater Plaza 6th Floor Staten Island NY 10305 200096809 Health Care NY 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