2015-11-13T14:57:29-06:00 2014-12-31 Charles A Barragato & Co LLP 950 Third Avenue - 20th FL New York NY 10022 990 2014-01-01 111665825 Episcopal Health Services Inc % EPISCOPAL HEALTH SERVICES EPIS 5163494643 700 Hicksville Road 210 Bethpage NY 11714 STEVEN GUIDO CFO 2123714446 2015-11-15 true Angelo Pirozzi CPA P00446022 2123714446 2014 2016-03-07 17:11:31Z GERALD WALSH 700 Hicksville RD Suite 210 Bethpage NY 11714 177986527 false X WWW.EHS.ORG X 1852 NY TO PROVIDE QUALITY HEALTH CARE THROUGH ITS HOSPITAL, AMBULATORY CARE HOSPITAL, AMBULATORY CARE FACILITIES, NURSING HOMES AND EDUCATION, RECOGNIZING THE EMERGING LIFE-CARE NEEDS OF THE COMMUNITIES SERVED. 10 6 1776 48 0 0 2668000 2155478 171274000 165755881 6349000 846279 8106000 9133119 188397000 177890757 0 0 0 0 127900000 123898366 0 0 0 69667000 58323995 197567000 182222361 -9170000 -4331604 139831000 143765723 124271000 135419813 15560000 8345910 X THE MISSION OF EPISCOPAL HEALTH SERVICES INC. OF THE DIOCESE OF LONG ISLAND IS TO PROVIDE QUALITY HEALTH CARE WITH AN EMPHASIS ON PATIENT SAFETY THROUGH ITS HOSPITAL, AMBULATORY CARE FACILITIES, NURSING HOMES AND CONTINUING MEDICAL EDUCATION, RECOGNIZING THE EMERGING LIFE-CARE NEEDS OF THE COMMUNITIES SERVED. false false 160908432 172475235 ST.JOHN'S EPISCOPAL HOSPITAL PROVIDED THE FOLLOWING SERVICES TO RESIDENTS OF ITS LOCAL COMMUNITY IN 2014: 8,908 DISCHARGES 42,341 ADULT AND PEDIATRIC MEDICAL AND SURGICAL DAYS OF CARE TO 7,381 PATIENTS. 13,977 DAYS OF BEHAVIORAL HEALTHCARE TO 844 PATIENTS. 683 BABIES WERE DELIVERED. 33,352 PATIENTS WERE TREATED AND RELEASED FROM THE 24 HR EMERGENCY ROOM. 16,278 VISITS TO THE CHRONIC DIALYSIS SERVICE. 104,009 VISITS TO THE AMBULATORY AND BEHAVIORAL HEALTH CLINICS. BISHOP CHARLES WALDO MACLEAN NURSING HOME PROVIDED THE FOLLOWING EXEMPT PURPOSE SERVICES IN 2014: 44,794 DAYS OF LONG TERM NURSING HOME CARE WERE FURNISHED TO PATIENTS. In August 2012, EHS entered into asset purchase agreements with an unrelated party (the "buyer") to sell Bishop Hucles and Bishop MacLean (the "Homes"). EHS determined that the criteria for held for sale classification of the Homes' assets and liabilities were met in August 2012. On July 16, 2014, the sale of Bishop Hucles was closed for a sales price of $29.5 million. On October 31, 2014, the sale of Bishop MacLean was closed for a sales price of $4 million. No impairment of assets resulted from the sale of the Homes. 160908432 true true false true false false false false false true true false false true true false false true false false true false false false false false true true false false true false false false false false false false false false false false false false true true true false false true 270 0 true 1776 true false false false false false false false false false false false false X 10 6 false false false false false false false true false false false true true true true true true true true false X EPISCOPAL HEALTH SERVICES 5163494643 700 HICKSVILLE ROAD - SUITE 210 BETHPAGE NY 11714 X REVEREND LAWRENCE C PROVENZANO PRESIDENT & CHAIRMAN 10.0 1.0 X X 90000 0 0 MARGARET O CARPENTER SECOND VP 2.5 1.0 X X 0 0 0 REVEREND JOHN E WALKER III SECRETARY - THROUGH 7/14 2.5 0.0 X X 0 0 0 RONALD O COLE TREASURER/SECRETARY 5.0 0.0 X X 30031 0 0 KATHLEEN E LECADRE BOARD MEMBER - THROUGH 7/14 2.5 0.0 X 0 0 0 VENERABLE JEROME J NEDELKA BOARD MEMBER- THROUGH 7/14 2.5 0.0 X 0 0 0 REVEREND J MASTINE NISBETT BOARD MEMBER THROUGH 7/14 2.5 0.0 X 0 0 0 REVEREND DARRYL F JAMES BOARD MEMBER 2.5 0.0 X 0 0 0 DANIEL A KASLE BOARD MEMBER 2.5 0.0 X 0 0 0 RICHARD BROWN CEO 37.0 3.0 X X 1018583 0 0 REV DR NORMAN WHITMIRE JR BOARD MEMBER - EFFECTIVE 7/14 2.5 0.0 X 0 0 0 REV T DIANE BRITT BOARD MEMBER - EFFECTIVE 7/14 2.5 0.0 X 0 0 0 PATRICK GUY BOARD MEMBER 2.5 0.0 X 0 0 0 DR ALBERT STROGEN BOARD MEMBER 34.0 0.0 X 312020 0 0 WILL MOORE CFO 37.0 3.0 X 899950 0 0 SHELDON MARKOWITZ CHAIR - DEPT OF MEDICINE 40.0 0.0 X 258401 0 46144 RAJIV PRASAD CHAIR - EMERGENCY SERVICES 40.0 1.0 X 349673 0 6995 RAYMOND PASTORE MD CHIEF MEDICAL OFFICER 40.0 2.0 X 273373 0 0 LOKESH REDDY MD CHIEF OF PSYCHIATRY 40.0 0.0 X 304797 0 47496 James Henry MD CHIEF OF ORTHOPEDICS 30.0 0.0 X 334000 0 8500 Kelly Barland Chief Information Officer 37.5 0.0 X 219922 0 7308 Richard Sarli VP Finance - THROUGH 9/14 37.5 0.0 X 246476 0 8923 Natalie Schwartz VP REGULATORY AFFAIRS 40.0 0.0 X 239350 0 46144 SHAKIRA GORDON VP HUMAN RESOURCES 37.5 0.0 X 142181 0 28975 GWENDOLYN SEYMORE-PINCKNEY CHIEF NURSING OFFICER 37.5 0.0 X 165504 0 46085 IBIS YARDE MEDICAL DIRECTOR OF EDUCATION 40.0 0.0 X 252081 0 10793 FRANCINE NIGRELLO CHIEF COMPLIANACE OFFICER 37.5 0.0 X 191109 0 877 DONALD MORRISH PHYSICIAN 40.0 0.0 X 309250 0 46093 ALAN STEINBERG MD CHAIRMAN - PEDIATRICS 40.0 0.0 X 231677 0 35173 HERSCH ORNER PHYSICIAN 40.0 0.0 X 242200 0 0 Imelda Canlas Anesthesiologist 40.0 0.0 X 232038 0 0 MARGARITA CHUDNER PHYSICIAN 40.0 0.0 X 217565 0 25561 CHERIAN T PALATHRA CONTROLLER - TERM 9/13 40.0 0.0 X 106987 0 19827 6667168 0 384894 178 true true false MODERN CONTRACTING INC 157 22 POWELS COVE BLVD BEECHHURST NY 11357 CONSTRUCTION CONTRAC 6374277 MORRISON MANAGEMENT SPECIALIST INC 90 BOX 102289 ATLANTA GA 30368 DIETARY MANAGEMENT 3375909 NSLIJHS Laboratory 10 Nevada Drive LAKE SUCCESS NY 11042 Laboratory Services 2718095 Queens County Medical Serivces LLC 5665 New Northside Drive STE 320 ATLANTA GA 30328 Physician Services 1782000 PRECYSE SOLUTIONS LLC 545 BROADWAY 3RD FLOOR BROOKLYN NY 11206 HEALTH INFORMATION 1381074 43 2005662 149816 2155478 NET PATIENT SERVICE REV 621300 170185456 170185456 PHYSICIAN BILLING REVENUE 621110 965881 965881 PROVISION FOR BAD DEBTS 621300 -5395456 -5395456 165755881 843353 843353 0 0 86919 86919 0 86919 86919 98696 95770 2926 2926 2926 0 0 0 I&R AND NON I&R ROTATION INCOME 900099 2423400 2423400 NYS IAAF FUNDS 900099 2044408 2044408 MEANINGFUL USE REVENUE 900099 1927991 1927991 2650401 323555 2326846 9046200 177890757 172475235 3260044 0 0 0 0 5585692 5585692 0 86831345 85522239 1309106 6256861 5084504 1172357 18370705 14933732 3436973 6853763 5513193 1340570 227704 227704 802916 228129 574787 273661 273661 0 0 0 12471089 10396608 2074481 179256 176134 3122 336029 311516 24513 854070 687017 167053 0 4675204 3492093 1183111 55132 38481 16651 0 116891 73578 43313 179271 178217 1054 0 7305978 5876956 1429022 391921 -16968 408889 MEDICAL SUPPLIES 8433922 8433922 0 0 OTHER MATERIALS & EXPENSES 8187781 6807434 1380347 0 PURCHASE SERVICE EXPENSE 8243758 7582235 661523 0 DRUGS 5385725 5385725 0 0 203687 203687 182222361 160908432 21313929 0 7239000 5930086 677000 796173 0 341162 14121000 14241213 0 0 0 0 0 0 749000 731935 5340000 5185750 169475141 126899003 38802000 42576138 0 0 0 0 0 0 0 0 72903000 73963266 139831000 143765723 38907000 44135591 0 0 0 5278387 0 0 0 0 0 0 5267000 7210103 0 0 80097000 78795732 124271000 135419813 X 13311000 6563654 841000 374075 1408000 1408181 15560000 8345910 139831000 143765723 X -4331604 93123 -2975609 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 16840 16840 false false SCHEDULE C SUPPLEMENTAL INFO Episcopal Health Services Inc. pays dues to The Healthcare Association of New York State (HANYS) and The Greater New York Hospital Association (GNYHA). In accordance with section 6033 (e) of the Internal Revenue Code, and as reported by HANYS and GNYHA a portion of these dues payments are attributable to lobbying activities. The lobbying activity costs attributable in 2014 to HANYS and GNYHA annual dues payments was $13,553 and $3,287 respectively. 1408181 26583 26583 1408181 1408181 91 91 1408181 1408181 5 5 1408181 1408181 8 8 1408181 1408181 8 8 1408181 1.00000 false false 929366 929366 52050937 35071602 16949335 83827 43505 40322 104114653 89376159 14768494 12296358 2407737 9888621 42576138 ASSETS WHOSE USE IS LIMITED 19656868 DUE FROM THIRD-PARTY PAYORS 3579741 HEALTHFIRST INVESTMENT 10808094 INV IN & HLD BY CAPTIVE INS CO 24637099 OTHER ASSETS 1397485 PHSP INVESTMENT - COST 6093144 INSURANCE RECOVERABLE 6233901 DUE FROM RELATED ORGANIZATIONS 1556934 73963266 0 DUE TO THIRD PARTY PAYORS 35664812 OTHER LIABILITIES 7002322 PROFESSIONAL & SELF INSURED LI 33979757 ACCRUED PENSION LIABILITY 2148841 78795732 PART V, LINE 4 - INTENDED USES OF ENDOWMENT FUND INCOME FROM ENDOWMENT FUNDS ARE TO BE USED TO FURTHER SUPPORT THE MISSION OF THE ORGANIZATION. ENDOWMENT FUND ASSETS ARE REQUIRED TO BE HELD IN PERPETUITY BY DONOR RESTRICTION. Central America and the Caribbean Investments CAPTIVE INSURANCE CO. 30871000 30871000 30871000 true false true false false false SCHEDULE F, PART I, LINE 3, COLUMN F THE HOSPITAL IS A PARTIAL OWNER OF CAPTIVE FOREIGN INSURANCE COMPANIES. THE HOSPITAL'S INVESTMENTS IN THE FOREIGN INSURANCE COMPANIES ARE REPORTED AT FAIR MARKET VALUE OR COST. true true X true X true true true false true true 73114588 57000544 16114044 0.08840 73114588 57000544 16114044 0.08840 808003 808003 0.00440 28737813 20278184 8459629 0.04640 18349955 3883309 14466646 0.07940 47895771 24161493 23734278 0.13020 121010359 81162037 39848322 0.21860 85292 0 85292 0.00050 15029 0 15029 0.00010 52138 0 52138 0.00030 152459 0 152459 0.00090 true 5395000 785749 57316997 44286011 13030986 X true true 1 1 St John's Episcopal Hospital 327 Beach 19th Street Far Rockaway NY 11691 X X X X St Johns Episcopal Hospital 1 false false true X X X X X X X X 13 true false false true X www.EHS.org X true 13 true www.EHS.org false false true X 100 400. X X X X X true true X X X X true X X X X X X X X X X X true X false X X true X false false Schedule H, Part V SEC B, Line 5 PUBLIC PARTICIPATION To advance the goals of the New York State Prevention Agenda 2013-2017 and Healthy People 2020 in its Service Area, St. John's Episcopal Hospital reached out and partnered with numerous community-based organizations and other stakeholders to identify community health needs and develop plans to address these needs. The participating organizations included: Participating Organizations -St. John's Episcopal Hospital Community Advisory Board -Joseph P. Addabbo Family Health Center -NAACP of Rockaway -Rockaway Beach Channel Long Term Recovery -Rockaway United -Community Board 14 -Deerfield Area Civic Association -Rockaway Development and Revitalization Corp. -Visiting Nurse Service of New York -Rockaway Manor Home Care -Queens County Perinatal Council -Doctors of the World -SCO Family of Services -Met Council -Queens Public Library -Lucille Rose Day Care -Safe Space -Rockaway Beach Civic Association -New YOrk State Assemblyman Phillip Goldfeder Community Meetings: Sampling Public Opinion Two initial community meetings were held to gather input from the public on the health concerns of the community, the application of the New York State Department of Health Prevention Agenda 2013-2017 to their community and their views of health data gathered by the Hospital. At those meetings participants were then asked to give their opinion on the two highest priorities in the Rockaways. In this manner a sampling of the community opinion was conducted. The meetings were held on: -July 9, 2013 at 6 pm at the Peninsula Preparatory Charter School - 34 attendees -July 16, 2013 at 6 pm at the Knights of Columbus Rockaway Council #2672- 55 attendees The meetings were publicized through a variety of ways including four full-page color advertisements in the local newspapers, the "Wave", the "Rockaway Pointer", and the "Five Towns Jewish Press"; a community email blast; social media; and St. John's website. Coalition Meetings: Ongoing Community Health Task Force Following the public Community Meetings, two subsequent meetings were held. Representatives of Community-Based Organizations who had attended the public meetings were contacted by email and telephone. At this meeting the health priorities public opinion sampling, combined action on these priorities and the need for continued meetings on a quarterly basis were discussed. These meetings were held at St. John's on: -Monday, August 12 at 6 pm -Thursday, August 22 at 6 pm Discussion at these meetings also included: the need for additional mental health services with more of a personal touch; the Hospital's crowded Emergency Room; coordination of services; education and the need for more teen services; dialysis services on the Rockaways; need for diabetes services; need for participation of elected officials; need for trauma services on the Rockaways; more primary care; need for urgent care on the west end of the peninsula; concern with closure of mental health services; requests for copies of the data presented. Selection of Public Health Priorities The Hospital convened the aforementioned open meetings to present the draft Community Health Needs Assessment and, based on the data; gather public input on the selection of health priorities for the community. The sampling showed that the community was most concerned about Chronic Disease, especially diabetes and high blood pressure, and Mental Health and Substance Abuse. Schedule H, Part V SEC B, Line 11 THE HOSPITAL RECOGNIZES THERE IS A NEED TO ADDRESS ALL IDENTIFIED HEALTH CONCERNS. DUE TO LIMITATIONS IN STAFFING AND RESOURCES, THE HOSPITAL FOCUSED ITS EFFORTS ON THOSE PRIORITIES THAT APPEARED TO BE OF THE MOST NEED AND HAD THE STAFFING AND RESOURCES TO COMMIT TO A THREE-YEAR PLAN OF IMPLEMENTATION. HIV AND AIDS SERVICES ARE CURRENTLY OFFERED AT THE JOSEPH P ADDABO FAMILY HEALTH CENTER THE COMMUNITY HEALTH PRIORITIES THAT THE HOSPTAL IDENTIFIED IN ITS HEALTH NEEDS ASSESSMENT BUT DOES NOT INTEND TO MEET ARE: CANCER; RESPIRATORY DISEASE; HIV AND AIDS; MATERNAL CHILD HEALTH. Schedule H, Part V SEC B, Line 22D During 2014, the Hospital deetermined that the maximum amount that can be charged to FAP-eligible individuals was a flat fee plus the following, based on the federal poverty level the individual qualified for: - Percentage of the APR-DRG Rate - Percentage of the APG Rate - Percentage of the Ancillary Charges - Percentage of the Ancillary Charges 1 BISHOP WALDO MACLEAN NURSING HOME 1711 BROOKHAVEN AVENUE FAR ROCKAWAY NY 11691 SKILLED NURSING FACILITY EXPLANATION OF COSTING METHODOLOGY ST. JOHN'S EPISCOPAL HOSPITAL COSTING METHODOLOGY WAS BASED UPON THE 2014 NEW YORK STATE INSTITUTIONAL COST REPORT AND THE 2014 MEDICARE (FORM 2552) COST REPORT. THESE COST REPORTS ARE FILED WITH THE NEW YORK STATE DEPARTMENT OF HEALTH AND THE APPLICABLE CMS INTERMEDIARY, RESPECTIVELY. THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGE, WAS USED FOR THE VARIOUS SUB-LINE ITEMS OF LINE #7. BAD DEBT EXPENSE St. John's Hospital utilizes the estimated percentage of patients living at or below the federal poverty level 20.4% and the self pay percentage 85.1646% to arrive at the amount of bad debt that is potentially attributable to patients eligible under the organization's financial assistance policy. BAD DEBT EXPENSE THE AMOUNT REPORTED ON LINE 2 IS EQUAL TO THE PROVISION FOR BAD DEBTS SHOWN IN THE AUDITED FINANCIAL STATEMENTS ("AFS"). THE EXPLANATION OF THE METHODOLOGY USED TO ESTIMATE IS EXCERPTED BELOW: Accounts receivable are also reduced by an allowance for doubtful accounts. In evaluating the collectability of accounts receivable, the Corporation analyzes its past history and identifies trends for each of its major payer sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for bad debts. Management regularly reviews data about these major payer sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the Corporation analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for bad debts, if necessary (for example, for payers who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients, which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill, the Corporation records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between discounted rates and the amounts actually collected after all reasonable collection efforts have been exhausted is charged to the allowance for doubtful accounts. MEDICARE REVENUE Included in the calculation of the Medicare revenue of $57,316,997 is $8,428,431 of Disproportionate Share (DSH) payments and $9,452,491 of Indirect Medical Education (IME) payments which total $17,880,922 Resulting in true patient service revenue of $39,436,075. MEDICARE REVENUE Pursuant to the instructions included in Medicare Revenue Received on Part III Section B Line 5 is Reimbursement for Indirect Medical Education (IME) of $9.5 million. There are $0 cost included in Part III Line 6 Medicare Allowable Cost related to IME. MEDICARE SURPLUS/SHORTFALL The Medicare surplus shown of $13,030,986 includes the additional items of Medicare revenue detailed in the explanation for Line 5 above without inclusion of additional costs related to them. Had these amounts not been received the operating Medicare shortfall would have been $4,849,936. Losses on treating Medicare beneficiaries should be included as a community benefit in their entirety. St. John's Episcopal Hospital incurred this operating Medicare loss of $4.8 million to deliver care to Medicare patients. This represents the amount by which costs to deliver care to Medicare recipients exceeds the level of payment. St. John's Episcopal Hospital bears the burden of not only providing the best and most advanced medical care possible to the community, but also doing so with no recourse to obtain payment for the cost of providing care in excess of the Medicare payment. As Medicare revenue declines and the cost to provide cutting edge care to the community increases, the Hospital will carry the burden as a participating provider and a charitable organization. Like all patients those on Medicare, the majority of whom are elderly OR disabled, are not turned away, so St. John's Episcopal Hospital will continue to bear the loss in providing the best care possible to the local community. COSTING METHODOLOGY the Medicare revenue and allowable costs shown in Part III Section B Lines 5 and 6, respectively, were derived from the as-filed 2014 CMS-2552 (Medicare Cost Report). Medicare revenue is based on the Medicare Provider Statistical and Reimbursement Report and Medicare costs were developed utilizing a ratio of Medicare allowable costs to charges methodology. COLLECTION PRACTICES TO BE FOLLOWED RELATIVE TO PATIENTS THAT QUALIFY FOR The charity care and financial assistance policies of St. John's Episcopal Hospital (which are further summarized in Schedule H Part VI Line 3) ensure that every effort is made to identify patients that are eligible for financial assistance and/or charity care. Included below is a summary of the billing and collection procedures followed by St. John's Episcopal Hospital: - The forced sale of or foreclosure on the patient's primary residence is prohibited - Sending an account to collection if the patient has submitted a completed application for financial assistance, including any required documentation, while the application is pending is prohibited - Provide written notification to a patient at least 30 days before an account is sent to collection (written notice can be included on a bill). - Require the collection agency to have the hospital's written consent prior to starting a legal action for collection. - Require all hospital staff that interacts with patients or have responsibility for billing and collection to be trained in the hospital's policies. - Have a way of measuring the hospital's compliance with its policies. - Require any collection agency under contract with the hospital to follow the hospital's financial assistance policy and provide information to patients on how to apply, where appropriate. - Prohibit collection activity if the patient is determined eligible for Medicaid for the services that were rendered and the hospital is able to collect Medicaid payment. NEEDS ASSESSMENT St. John's Episcopal Hospital (the "Hospital" or "St. John's") is a 257 licensed bed acute care hospital located in Far Rockaway, New York. St. John's, together with the Bishop Henry B. Hucles Nursing Home, Inc.; the Bishop Waldo MacLean Nursing Home; St. John's Emergency Services PC; St. John's Medical Services PC, form the patient care services of Episcopal Health Services, Inc., which is sponsored by the Episcopal Diocese of Long Island. This discussion relates to the Hospital only as required in Form 990 Schedule H. As the result of several meetings with community groups, a comprehensive Community Health Needs Assessment (CHNA) for the Hospital community was developed. The document addresses only St. John's, as the aforementioned nursing homes are currently involved in a transaction that will ultimately transfer ownership to an unrelated third party. The report fulfills the requirements of the new Federal statute established within the Patient Protection and Affordable Care Act (PPACA) requiring non-profit hospitals to conduct CHNAs every three years. The CHNA process undertaken by the Hospital utilized extensive input from persons who represent the broad interests of the community. In addition, this document satisfies the requirements set forth by the New York State Department of Health (DOH) relative to the preparation of a three year Community Service Plan (CSP). The overlapping nature of these requirements enabled the Hospital to complete one comprehensive document. New York's relevant statute, Section 2803-1 of the Public Health Law, requires voluntary non-profit hospitals to submit a comprehensive CSP to the State Department of Health (DOH) every three years that includes a solicitation of the views of the communities served by the Hospital on service priorities; demonstrates the Hospital's operational and financial commitment to meet community health needs; provision of charity care; and improving access by the underserved, among other elements. In submitting their CSPs, hospitals are required to take steps that include: - Reaffirming organizational mission statements; - Defining the service area used for community and local health planning and describing the methods used to determine such service area; - Identifying all participants involved in assessing community health needs and describing and summarizing the hospital's public input sessions; - Discussing the identified public health priorities, including the criteria used to select priorities and the status of priorities; - Establishing an evolving plan of action; and - Disseminating a written summary of the CSP to the public through various channels. The statutory CSP requirements were recently enhanced by DOH's Prevention Agenda initiative, a process that asks hospitals to work with local public health departments and community partners to assess community health needs, jointly develop plans to address two or three of the identified needs, and include this collaborative work in the hospital's CSP update submitted to DOH. St. John's has incorporated the Prevention Agenda into its three year plan. To advance the goals of the New York State Prevention Agenda 2013-2017 and Healthy People 2020 in its Service Area, St. John's reached out and partnered with numerous community-based organizations and other stakeholders to identify community health needs and develop plans to address these needs. The participating organizations included: -St. John's Episcopal Hospital Community Advisory Board -Joseph P. Addabbo Family Health Center -NAACP of Rockaway -Rockaway Beach Channel Long Term Recovery -Rockaway United -Community Board 14 -Deerfield Area Civic Association -Rockaway Development and Revitalization Corp. -Visiting Nurse Service of New York -Rockaway Manor Home Care -Queens County Perinatal Council -Doctors of the World -SCO Family of Services -Met Council -Queens Public Library -Lucille Rose Day Care -Safe Space -Rockaway Beach Civic Association -New York State Assemblyman Phillip Goldfeder Two initial community meetings were held to gather input from the public on the health concerns of the community, the application of the New York State Department of Health Prevention Agenda 2013-2017 to their community and their views of health data gathered by the Hospital. At those meetings participants were then asked to give their opinion on the two highest priorities in the Rockaways. In this manner a sampling of the community opinion was conducted. The meetings were held on July 9, 2013 at 6 pm at the Peninsula Preparatory Charter School (34 attendees); and July 16, 2013 at 6 pm at the Knights of Columbus Rockaway Council #2672 (55 attendees). The meetings were publicized through a variety of ways including four full-page color advertisements in the local newspapers, the "Wave", the "Rockaway Pointer", and the "Five Towns Jewish Press"; a community email blast; social media; and the St. John's website. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE St. John's Hospital is committed to providing access to quality health care services with compassion, dignity and respect for all patients, particularly the poor and the underserved in our community. Accordingly, St. John's Hospital has implemented a Charity Care and Financial Assistance Process to help facilitate the provision of much needed care. This process includes: - Providing patient care regardless of the ability to pay for services; - Assisting patients who cannot pay for part or all of the care they receive; - Financial counselors will confidentially review the situation to see if patients quality for some form of government or other financial assistance; - Balancing needed financial assistance for some patients with the broader fiscal responsibilities in order to sustain viability and provide the quality and quantity of services residents in the community need; and - Offer installment plans to allow patients to pay over time without the imposition of interest charges. COMMUNITY INFORMATION The Rockaway Peninsula is a narrow strip of land bordered by the Atlantic Ocean and Jamaica Bay and is a part of Queens County, New York City and also borders Nassau County on Long Island. Superstorm Sandy had a devastating impact on the Rockaway Peninsula. Much of the community was without gas and electric for weeks following the storm. Homes and businesses were in ruin, some claimed by the sea, others by fire, entire blocks in Belle Harbor and Rockaway Park were engulfed in flames, a considerable portion of Breezy Point literally burned to the ground. Debris and sand were everywhere, including the inside of homes. Cars that had been flooded were scattered throughout the streets of the community. The rebuilding has been extremely slow, and is an ongoing process, with many displaced residents having still not returned to their homes. Many nursing homes and adult homes - sources of admissions to the Hospital, as well as other local businesses never reopened. Transportation between the peninsula and the mainland is a long time commitment for residents as the peninsula is connected to New York City by two toll bridges, the Marine Park Bridge and the Cross Bay Bridge, and by the "A" subway line of the New York City Metropolitan Transit Authority, which was out of commission until late Summer 2013. Throughout the two weeks after the storm St. John's was like a beacon in the darkness for Far Rockaway and the surrounding communities. Running on generator power for 12 days, the Hospital was a place where shelter, warmth, light and food could be found. People stopped in to charge cell phones, and found electricity to power much needed medical devices. Many residents lost everything they had, carrying what they could of their prized possessions. Ongoing recovery assistance was also provided by the Hospital. Collections were made to help employees defray some of the costs of recovery, and clothing drives put much needed clothes on the backs of local residents. ST. JOHN'S HAS SERVED THE COMMUNITY FOR MORE THAN 100 YEARS. AS A NOT-FOR-PROFIT FAITH-BASED INSTITUTION THAT IS DEEPLY AWARE OF THE COMMUNITY'S GEOGRAPHIC ISOLATION AND VULNERABILITIES, IT IS DEEPLY COMMITTED TO CONTINUING TO SERVE THE COMMUNITY WELL INTO THE FUTURE. IT IS ALSO COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITY AND CONTINUING TO OFFER A WIDE RANGE OF SERVICES, AS WELL AS COMMUNITY OUTREACH AND HEALTH EDUCATION. While "community" can be defined in many ways, the Hospital defined its Service Area as the 6 zip codes from which approximately 70% discharges came, namely Far Rockaway; Inwood; Arverne; Rockaway Beach; Belle Harbor; and Breezy Point. In 2013 the Rockaways had a population totaling over 123,000 with almost 30% of the Service Area's population under the age of 20, and almost 13% over the age of 65. More than 20% live under the federal poverty level, while the overall Queens county rate is just below 14%. The percentage of the Service Area population who are deemed to be minorities is 65.4%, with African Americans comprising 38% of the population. A large population of Hispanics resides in Inwood, which is the most northeast boundary of the Service Area. population. A large population of Hispanics resides in Inwood, which is the most northeast boundary of the Service Area. PROMOTION OF COMMUNITY HEALTH Community Health Fairs and Events St. John's medical staff and residents held blood pressure screenings and health education sessions at 10 health fairs and community events throughout 2014 in schools, community based non-profits, clubs and houses of faith, interacting with a minimum of 100 participants per event. Brochures were handed out on a variety of topics, including diabetes care, hypertension and heart health, obesity, health pregnancy, breastfeeding and smoking prevention. St. John's Health Fairs St. John's Episcopal Hospital hosted two community-wide health fairs in June and September of 2014. At both, St. John's medical staff and residents provided blood pressure screenings, and attendees were involved in a variety of educational sessions focused on services provided by the Hospital. Mammography and breast health, health pregnancy and childbirth, breastfeeding, heart health and hypertension, emergency services, living well with diabetes, wound care, St. John's behavioral health services and the importance of mental health. Residents received informational brochures to support their learning. St. John's Clinical Nutrition Staff provided Nutritional Information on various topics including: My Plate, How to Eat Healthy, Reducing Sodium in the Diet, Low Cholesterol Tips and How to Make Meals More Healthy. At the September Fair, Nutrition program information also covered healthy eating for children through the teen years in addition to the general nutrition information provided. At both events healthy snacks such as granola bars and samples of Truvia were distributed. St. John's Executive Chef conducted cooking demonstrations at the September Health Fair, and the hospital received news coverage on these healthy cooking demos. Members of the Hospital's Community Advisory Board were present to talk about how community residents can become involved with learning about the Hospital's services and representing the Hospital within their neighborhoods as well as across the Hospital's primary service area. In addition, community based organizations from across the Rockaway Peninsula had tables and presented information about their services, including New Horizons Community Support Services, Peninsula Nursing & Rehabilitation Center, Rockaway Walks, Ready Rockaway, St. John's Sandy Connect and Family Resource Center offices. Both Fairs had community attendance of 700 plus residents. Preventative Services Dr. Natalie Schwartz, Senior Vice President of Quality and PI at St. John's, wrote a research proposal entitled "Reducing the Risk of Developing Diabetes in Obese High School Students." The New York City Department of Education Institutional Review Board (NYCDOE IRB) approved this proposal, which focuses on going into the schools to develop an obesity program. Ongoing discussions with area high school[s] focus on putting in place processes and procedures to support this study. For several years now, St. John's has partnered with the Queens Quits smoking cessation program established through the NYCDOH. Patients are asked about smoking habits and their desire to quit. With their consent, smokers' contact information is forwarded to Queens Quits and a smoking cessation counselor then reaches out to them to provide tips for quitting and support services to do so. Representatives from the program come to St. John's throughout the year to meet with physicians, residents and staff to review the program. Mental Health and Substance Abuse Screenings: -St John's Community Mental Health Center - 440 patients screened; 50 patients identified as having substance abuse issues and treated within the CMHC; 6 patients having substance abuse issues were referred to a local appropriate substance abuse treatment program. -St. John's Continuing Day Treatment Program - 45 patients screened; 2 referred to 21 day inpatient substance abuse treatment; 27 having substance abuse and mental illness dual diagnosis treated within the CDTP. -St. John's Family Resource Center - 391 patients screened; 1 needing substance abuse treatment, refused referral to local treatment program. -St. John's Home Based Crisis Intervention Program - 59 patients screened; 6 needing substance abuse treatment referred to local outpatient treatment; 3 refused treatment, one did not make appointment, one seen at residential program, one in process of referral. -St. John's Blended Case Management Program - 60 patients screened; 7 identified as needing substance abuse treatment, four refused treatment, three made appointments with outpatient treatment programs. -Surfside Manor Adult Home On-Site Mental Health Clinic - 180 patients screened at the on-site adult home outpatient mental health clinic at Surfside Manor adult home. None identified as having substance abuse issues that required referral or even treatment within the clinic setting at the home. EXPLANATION OF HOW ORGANIZATION FURTHERS ITS EXEMPT PURPOSE St. John's Episcopal Hospital plays an important role in the local community as a provider of needed medical services. St. John's is the only hospital on the peninsula and is also the largest non-governmental employer in the local community. In addition to providing high quality medical services, St. John's is also an active member of the local community, participating in various health fairs, screenings, and educational sessions and events to local residents at no cost. Many of the various programs and initiatives that St. John's Hospital has identified to demonstrate our commitment to further its exempt purpose and promote the health care of the local community have been highlighted previously in this form. St. John's Hospital has an active Community Advisory Board comprised of local residents and business people who meet with Hospital leadership quarterly to discuss at a high level the overall operations of the Hospital, demographics and health needs of the Rockaway community. St. John's extends medical staff privileges to all qualified physicians in its community for the various services provided by the Hospital. The Hospital's medical staff is a large diverse group of highly trained professionals numbering approximately 450 members. In addition, St. John's overall responsiveness to the needs of our community is evidenced by our willingness to participate in a range of coalitions, panels, advisory groups, commissions and boards, including Ready Rockaway, which is a coalition of community based organizations that recognize the need for planning for emergencies such as Superstorm Sandy which severely impacted the Rockaway peninsula in October. In addition, St. John's has internal emergency and disaster drills throughout the year to ensure the Hospital is prepared to meet the needs of its local community and the surrounding areas. AFFILIATED HEALTH CARE SYSTEM ROLES AND PROMOTION NOT APPLICABLE STATES WHERE COMMUNITY BENEFIT REPORT IS FILED NEW YORK. X X true false false false false false false false false RICHARD BROWN CEO 849895 0 108696 0 59992 0 0 0 1018583 0 WILL MOORE CFO 731262 0 108696 0 59992 0 0 0 899950 0 CHERIAN T PALATHRA CONTROLLER - TERM 9/13 0 0 0 0 106987 0 425 0 19402 0 126814 0 SHELDON MARKOWITZ CHAIR - DEPT OF MEDICINE 254591 0 0 3810 0 7000 0 39144 0 304545 0 RAJIV PRASAD CHAIR - EMERGENCY SERVICES 345029 0 4644 6995 356668 0 DONALD MORRISH PHYSICIAN 304382 0 0 0 4868 0 7000 0 39093 0 355343 0 ALAN STEINBERG MD CHAIRMAN - PEDIATRICS 229697 0 0 0 1980 0 7000 0 28173 0 266850 0 RAYMOND PASTORE MD CHIEF MEDICAL OFFICER 273167 0 0 206 0 0 0 273373 0 LOKESH REDDY MD CHIEF OF PSYCHIATRY 304797 0 0 0 6769 0 40727 0 352293 0 James Henry MD CHIEF OF ORTHOPEDICS 332500 0 0 1500 0 7000 0 1500 0 342500 0 Kelly Barland Chief Information Officer 219232 0 0 690 0 7308 0 0 227230 0 Richard Sarli VP Finance - THROUGH 9/14 245958 0 0 518 0 7000 0 1923 0 255399 0 Natalie Schwartz VP REGULATORY AFFAIRS 238060 0 0 1290 0 7000 0 39144 0 285494 0 HERSCH ORNER PHYSICIAN 242200 0 0 0 0 0 0 0 0 0 242200 0 0 0 Imelda Canlas Anesthesiologist 232038 0 0 0 0 0 0 0 0 0 232038 0 SHAKIRA GORDON VP HUMAN RESOURCES 141881 0 300 6000 22975 171156 0 GWENDOLYN SEYMORE-PINCKNEY CHIEF NURSING OFFICER 164814 0 0 690 0 6941 0 39144 0 211589 0 0 DR ALBERT STROGEN BOARD MEMBER 312020 0 0 0 0 0 312020 0 0 IBIS YARDE MEDICAL DIRECTOR OF EDUCATION 251706 0 0 375 0 1085 0 9708 0 262874 0 0 FRANCINE NIGRELLO CHIEF COMPLIANACE OFFICER 190000 0 0 1109 0 877 0 0 191986 0 0 MARGARITA CHUDNER PHYSICIAN 217375 0 0 0 190 0 2154 0 23407 0 243126 0 0 Part I, Line 4a CHERIAN PALATHRA, CORPORATE CONTROLLER - UPON MR. PALATHRA'S SEPERATION OF EMPLOYMENT WITH EHS, HE WAS PROVIDED A ONE-YEAR SEVERANCE AGREEMENT IN RECOGNITION OF HIS 30 YEAR EMPLOYMENT HISTORY WITH THE ORGANIZATION. PART II DR. ALBERT STROGEN IS COMPENSATED FOR SERVICES RENDERED AS A PHYSICIAN OF THE HOSPITAL AND NOT AS A MEMBER OF THE BOARD. DR. STOGEN DEVOTES 2.5 HOURS PER WEEK ON AVERAGE TO THE BOARD AND 32 HOURS PER WEEK AS A PHYSICIAN AT THE HOSPITAL. FORM 990, PART VI, LINE 8B THERE ARE NO SEPARATE COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, LINE 11B THE FORM 990 AND APPROPRIATE SCHEDULES, AS REQUIRED (FORM 990), IS COMPLETED BY THE ACCOUNTING AND FINANCE STAFF OF THE ORGANIZATION AND REVIEWED INTERNALLY BY MANAGEMENT. IT IS THEN REVIEWED BY OUTSIDE TAX ADVISORS AND ANY NECESSARY ADJUSTMENTS ARE MADE, AFTER WHICH TIME IT IS CONSIDERED AN initial DRAFT. THE DRAFT OF THE FORM 990 IS THEN PRESENTED TO THE EPISCOPAL HEALTH SERVICES AUDIT COMMITTEE (THE COMMITTEE) OF THE BOARD OF TRUSTEES(THE BOARD), WHICH HAS BEEN DELEGATED THE DETAILED REVIEW FUNCTION BY THE BOARD. ONCE THE Committee'S REVIEW IS COMPLETE THE FORM 990 IS THEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD. FORM 990, PART VI, LINE 12C The Corporate Compliance and Privacy Office distributes, gathers and reviews all annual conflict of interest questionnaires. Where positive responses are indicated additional information is gathered to determine if a conflict actually exists. If a conflict exists, appropriate action is taken to eliminate the conflict, including such steps as notifying the board, reassignment of responsibilities or establishment of protective agreements. If a matter involves a board member or officer, appropriate action, including recusal and additional disclosures, will be determined by the board. FORM 990, PART VI, LINE 15A THE COMPENSATION REVIEW & APPROVAL PROCESS INCLUDED A COMPARISON OF COMPENSATION RATES PAID THROUGH THE MANAGEMENT COMPANY AS WELL AS COMPARABLE POSITIONS IN THE ORGANIZATION'S REGION. COMPENSATION WAS REVIEWED AND APPROVED BY THE ORGANIZATION'S BOARD OF DIRECTORS. BOARD DECISIONS ARE CONTEMPORANEOUSLY DOCUMENTED IN BOARD MINUTES. FORM 990, PART VI, LINE 15B THE COMPENSATION OF KEY EMPLOYEES IS DETERMINED AND/OR APPROVED AFTER COMPARISON TO CURRENT COMPENSATION RATES PAID FOR COMPARABLE POSITIONS IN THE ORGANIZATION'S REGION. BOARD DECISIONS ARE CONTEMPORANEOUSLY DOCUMENTED IN BOARD MINUTES. FORM 990, PART VI, LINE 19 UPON REQUEST, THE ORGANIZATION WILL MAKE AVAILABLE THOSE DOCUMENTS REQUIRED TO BE DISCLOSED UNDER THE PUBLIC INSPECTION LAWS. FORM 990, PART VII, SECTION A DR. ALBERT STROGEN IS COMPENSATED FOR SERVICES RENDERED AS A PHYSICIAN OF THE HOSPITAL AND NOT AS A MEMBER OF THE BOARD. DR. STOGEN DEVOTES 2.5 HOURS PER WEEK ON AVERAGE TO THE BOARD AND 32 HOURS PER WEEK AS A PHYSICIAN AT THE HOSPITAL. FORM 990, PART XI, LINE 9 - OTHER CHANGES IN NET ASSETS CHANGE IN PENSION LIABILITY. . . . . . . . . . . . . . . ($2,284,258) LOSS FROM DISCONTINUED OPERATIONS. . . . . . . . . . . . ($2,801,045) GAIN ON SALE OF ASSETS HELD FOR SALE. . . . . . . . . . $2,109,694 TOTAL. . . . . . . . . . . . . . . . . . . . . . . . . . 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