2015-11-20T08:15:48-06:00 2014-12-31 990 2014-01-01 111630914 Huntington Hospital Association % NS-LIJ HEALTH SYSTEM HUNT 5164658339 972 BRUSH HOLLOW ROAD WESTBURY NY 11590 ROBERT S SHAPIRO EVP & CFO 2015-10-30 2014 2016-03-07 17:11:31Z X MICHAEL J DOWLING 145 COMMUNITY DRIVE GREAT NECK NY 11021 401706452 false X WWW.NORTHSHORELIJ.COM X 1916 NY Huntington 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. 40 36 2422 771 0 2380923 130763 316595598 333689924 2327970 3441701 4274384 5695358 325578875 342957746 0 0 0 0 142563462 272723771 0 0 14612 121310284 125361862 263873746 398085633 61705129 -55127887 355325466 374509895 213311472 279521083 142013994 94988812 THE HUNTINGTON HOSPITAL ASSOCIATION'S (THE "HOSPITAL") MISSION IS TO PROVIDE A FULL RANGE OF INPATIENT, OUTPATIENT AND SPECIALIZED HEALTHCARE SERVICES, REGARDLESS OF A PATIENT'S ABILITY TO PAY, WITHIN AN ENVIRONMENT NURTURED BY RESPECT AND SAFETY. THE HOSPITAL IS COMMITTED TO GIVING ITS PATIENTS HIGH QUALITY AND TECHNOLOGICALLY ADVANCED CARE BY COMPETENT PROFESSIONALS IN ORDER TO MAINTAIN AND IMPROVE THE HEALTH AND WELL-BEING OF THE COMMUNITY. false false 301419901 288514384 A member of the North Shore-LIJ Health System, Huntington Hospital is a 408 bed community hospital, with the following inpatient services; medical/surgical, pediatrics, intensive and critical care, maternity, Level II Perinatal service and psychiatry. The Hospital is a NYS Dept of Health Designated Stroke Center and a recipient of the American Heart Association Get With The Guidelines Stroke Gold Plus Award in 2011. In 2014, the Hospital had 14,550 inpatient discharges, delivered 1,347 babies, provided 50,426 Emergency Department visits and performed 9,225 ambulatory surgeries, including endoscopies and outpatient cardiac catheterizations. 54421975 45175541 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. 355841876 true true false true false false false false true true false false true true true false true false false false false false false false false true true false false true true false false false false false false false false true true false false false false false true true false false false true 125 0 true 2422 true false false false false false false false false false false false X 40 36 true false false false true true true true true false false true true true true true true true true false NY X X NS-LIJ HEALTH SYSTEM 6318766061 972 BRUSH HOLLOW ROAD WESTBURY NY 11590 KEVIN F LAWLOR PRESIDENT/CEO 50.0 0.0 X X 700935 0 43700 MICHAEL GROSSO MD VP MEDICAL AFFAIRS 50.0 0.0 X X 444318 0 43700 MICHAEL ABOFF BOARD MEMBER 2.0 0.0 X 0 0 0 CARMELA ANGLIM BOARD MEMBER 2.0 0.0 X 0 0 0 MICHAEL ALESANDRO BOARD MEMBER 2.0 0.0 X 0 0 0 CHRISTOPHER BARBER BOARD MEMBER 2.0 0.0 X 0 0 0 MICHAEL BROWN BOARD MEMBER 2.0 0.0 X 0 0 0 FRED BUCKHOLTZ ASST TREASURER 2.0 0.0 X X 0 0 0 MICHAEL J DOWLING BOARD MEMBER/CEO NSLIJ 0.0 50.0 X 0 9627815 477742 WILLIAM H FRAZIER TREASURER 0.0 2.0 X X 0 0 0 LKEITH FRIEDLANDER ESQ BOARD MEMBER 2.0 0.0 X 0 0 0 CLIFFORD FRIEDMAN BOARD MEMBER 2.0 0.0 X 0 0 0 J RONALD GAUDREAULT Board Member 2.0 0.0 X 0 0 0 ANTHONY GIACCONE BOARD MEMBER 2.0 0.0 X 0 0 0 ROSALYN C GORDON VICE CHAIRWOMAN 2.0 0.0 X X 0 0 0 JOHN KEAN BOARD MEMBER 2.0 0.0 X 0 0 0 THOMAS G LEDERER Board Member 2.0 0.0 X 0 0 0 SHIRLEY LEVITT BOARD MEMBER 2.0 0.0 X 0 0 0 BRIAN MCNALLY BOARD MEMBER 2.0 0.0 X 0 0 0 LEWIS MELTZER ESQ VICE CHAIRPERSON 2.0 0.0 X X 0 0 0 RICHARD MURCOTT Board Member 0.0 2.0 X 0 0 0 ROBERT MYERS BOARD MEMBER 2.0 0.0 X 0 0 0 MARTHA CARLSTROM BOARD MEMBER 2.0 0.0 X 0 0 0 PATRICIA PETERSEN BOARD MEMBER 2.0 0.0 X 0 0 0 BERNARD M ROSOF MD Chairman 0.0 3.0 X X 0 0 0 DOLORES THOMPSON BOARD MEMBER 2.0 0.0 X 0 0 0 IRVING KLEIN BOARD MEMBER 2.0 0.0 X 0 0 0 NOAH FINKEL MD Board Member 2.0 0.0 X 0 0 0 CARY KRAVET BOARD MEMBER 0.0 2.0 X 0 0 0 JOHN R RICONDA BOARD MEMBER 2.0 0.0 X 0 0 0 RICHARD KLEINKNECHT BOARD MEMBER 2.0 0.0 X 0 0 0 G MORGAN BROWNE BOARD MEMBER 2.0 0.0 X 0 0 0 EUGENE J LEVITT ESQ BOARD MEMBER 2.0 0.0 X 0 0 0 DOUGLAS A BYRNES MD BOARD MEMBER 2.0 0.0 X 0 0 0 HARRY F MARIANI SECRETARY 2.0 0.0 X X 0 0 0 JOHN MCCUSKER BOARD MEMBER 2.0 0.0 X 0 0 0 EDNA FETKOWITZ BOARD MEMBER 2.0 0.0 X 0 0 0 NICK FITTERMAN MD BOARD MEMBER/MEDICAL DIRECTOR 0.0 50.0 X 0 503683 43700 VIRGINIA PATRICK BOARD MEMBER 2.0 0.0 X 0 0 0 ROBERT STACKLER BOARD MEMBER 2.0 0.0 X 0 0 0 MICHAEL FAGAN VP FINANCE/CFO 50.0 0.0 X 400078 0 43700 WINIFRED MACK REGIONAL EXECTUIVE DIRECTOR 0.0 50.0 X 0 2859179 218325 LAWRENCE ONG DIR CARDIOLOGY 50.0 0.0 X 747629 0 43700 NEERAJ KATRIYAR INTENSIVIST 50.0 0.0 X 563279 0 43700 DAVID BUCHIN PHYSICIAN 50.0 0.0 X 1017710 0 43700 DAVID RIVADENEIRA VICE CHAIRPERSON 50.0 0.0 X 1339683 0 43700 ROBERT KERR PHYSICIAN 50.0 0.0 X 675821 0 43700 MICHAEL QUARTIER FORMER VP ADMINISTRATION 0.0 2.0 X 349133 0 0 6238586 12990677 1089367 402 true true false BOTTO MECHANICAL CORP 95 COMMERCIAL STREET PLAINVIEW NY 118032470 GENERAL CONTRACTOR 1990779 CANNON DESIGN 360 MADISON AVENUE NEW YORK NY 10017 GENERAL CONTRACTOR 1397171 HUNTER ROBERTS CONSTRUCTION GROUP 55 WATER STREET 51ST FLR NEW YORK NY 10041 GENERAL CONTRACTOR 1140421 CROSS COUNTRY STAFFING PO BOX 404674 ALTANDA GA 303844674 MEDICAL SERVICES 895122 UNITEX TEXTILE RENTAL 155 SOUTH TERRACE AVENUE MT VERNON NY 10550 LINEN SERVICES 872375 25 112255 18508 130763 PATIENT SVC - HOSPITAL 621300 185092577 185092577 PATIENT SVC-PHYS INC 621300 47463097 47463097 MEDICARE/MEDICAID 621300 101134250 101134250 333689924 1713893 1713893 0 0 373264 373264 0 373264 60476514 58748706 1727808 1727808 0 0 0 ELECTRONIC HEALTH RECORD INCOME 900099 1832041 1832041 CAPITATION INCOME 900099 1108794 1108794 CAFETERIA INCOME 900099 972557 972557 1408702 1140728 267974 5322094 342957746 337771487 2954424 0 0 0 0 1545331 1545331 0 168502913 153850519 14646807 5587 74454833 67980514 6471850 2469 17491815 15970791 1520444 580 10728879 9795935 932588 356 0 103842 103842 381864 381864 0 0 0 5455426 4981042 474203 181 94603 86377 8223 3 64510951 58901316 5607496 2139 0 0 5429880 4957718 471982 180 173290 173290 0 264332 241346 22977 9 2057796 2057796 0 15819754 14444126 1375628 9249856 9249856 BAD DEBT EXPENSES 4145920 4145920 OTHER PURCHASED SERVICES 6430097 6430097 CENTRALIZED ADMIN EXPENSE 7862490 7859492 2998 DUES & SUBSCRIPTIONS 530644 484501 46125 18 2851117 2603197 247828 92 398085633 355841876 42229145 14612 11960188 8495103 113279744 121177367 410121 0 38057722 45171961 0 0 0 0 0 0 3329588 3375188 2278514 1227362 214056049 85494731 127191851 128561318 28073261 22947121 0 0 0 0 0 0 30744477 43554475 355325466 374509895 41533928 46335819 0 0 0 0 41525000 40425000 0 0 0 0 0 0 0 0 130252544 192760264 213311472 279521083 X 137240789 87360583 3609830 6464854 1163375 1163375 142013994 94988812 355325466 374509895 X -55127887 2544387 5558318 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false true 12863 false 12863 false false LOBBYING ACTIVITY HUNTINGTON HOSPITAL ASSOCIATION IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION AND OTHER HEALTH CARE ASSOCIATIONS WHICH ENGAGE IN LOBBYING EFFORTS ON BEHALF OF THEIR MEMBER HOSPITALS. 1163375 1163375 1163375 1163375 1163375 1163375 1159948 3427 22421 22421 1163375 1159948 1159948 1.00000 false false 3404936 3404936 104812047 40604122 64207925 241181 188820 52361 95708408 44470494 51237914 9889477 231296 9658182 128561318 INSURANCE CLAIMS RECEIVABLE 27244645 BOND FINANCING 1078137 OTHER ASSETS 259624 DUE FROM AFFILIATE 8380069 INTEREST IN FOUNDATION 6592000 43554475 0 ACCRUED PENSION LIABILITY 108318795 EST THIRD PARTY PAYOR LIBILITE 27263791 ACCRUED MALPRACTICE LIAB 28785000 INSURANCE CLAIMS PAYABLE 27244677 ACCRUED ASSET RETIREMENT OBLIG 136780 BOND PREM/DISCOUNT 983320 OTHER LIABILITY 27901 192760264 X 344045313 2544387 -1456820 1087567 342957746 342957746 329050981 329050981 69034652 69034652 398085633 Part V - Line 4 The investment income on the permanently restricted endowment funds are unrestricted and used to help support the operations of the Hospital. PART XI-LINE 2D AND 4B, PART XII, LINE 2D AND 4B PART XI - LINE 2D NET ASSETS RELEASED FROM RESTRICTIONS 67,764 NONOPERATING GAIN/LOSS 2,621,337 PROVISION FOR BAD DEBTS (4,145,920) TOTAL (1,456,820) PART XII - LINE 4B Additional Minimum Pension Adjustment 64,888,732 PROVISION FOR BAD DEBTS 4,145,920 Total 69,034,652 Part X, LINE 2 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. true true X true X true X 500. true true true false true true 1 5707 6258866 929929 5328937 0.01620 1 21004 49407046 24806447 24600599 0.07480 2 26711 55665912 25736376 29929536 0.09100 104 73545 755546 755546 0.00230 47 536 1871993 499566 1372427 0.00420 2 37202 37202 0.00010 8 1185 95031 95031 0.00020 161 75266 2759772 499566 2260206 0.00680 163 101977 58425684 26235942 32189742 0.09780 6 1401 29004 23975 5029 3 5222 30784 30784 0.00010 12 10605 4913 4913 3 420 645 645 1 50 324 324 1 16 2278 2278 26 17714 67948 23975 43973 0.00010 false 3883539 101166008 129115574 -27949566 true true 1 1 HUNTINGTON HOSPITAL 270 PARK AVENUE HUNTINGTON NY 11743 WWW.NORTHSHORELIJ.COM X X X X HUNTINGTON 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 9 NSLIJ MEDICAL GROUP CARDIOLOGY CONSULTAN 43 CROSSWAYS PARK DRIVE WOODBURY NY 11797 OUTPATIENT PHYSICAN CLINIC NORTH SHORE-LIJ MEDICAL GROUP AT SMITHTO 9 BROOKSITE DRIVE SMITHTOWN NY 11787 OUTPATIENT PHYSICIAN CLINIC QUEENS WTC HEALTH PROGRAM 97-77 QUEENS BOULEVARD REGO PARK NY 11374 OUTPATIENT PHYSICIAN CLINIC LONG ISLAND OBESITY SURGERY 224 WALL STREET HUNTINGTON NY 11743 OUTPATIENT PHYSICIAN CLINIC DOLAN FAMILY HEALTH CENTER 284 PULASKI ROAD GREENLAWN NY 11740 FAMILY HEALTH CENTER BREAST SURGERY ASSOCIATES PC 270 PULASKI ROAD GREENLAWN NY 11740 OUTPATIENT PHYSICIAN CLINIC PHYSICIAN AMBULATORY NETWORK SERVICES 755 NEW YORK AVENUE HUNTINGTON NY 11743 OUTPATIENT PHYSICIAN CLINIC PHYSICIAN AMBULATORY NETWORK SERVICES 158 EAST MAIN STREET HUNTINGTON NY 11743 OUTPATIENT PHYSICIAN CLINIC HUNTINGTON MEDICAL GROUP 180 EAST PULASKI ROAD HUNTINGTON NY 11743 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 KEVIN F LAWLOR PRESIDENT/CEO 594131 0 57000 0 49804 0 28600 0 15100 0 744635 0 0 0 MICHAEL GROSSO MD VP MEDICAL AFFAIRS 384055 0 15098 0 45165 0 28600 0 15100 0 488018 0 0 0 MICHAEL J DOWLING BOARD MEMBER/CEO NSLIJ 0 1373402 0 1728000 0 6526413 0 456717 0 21025 0 10105557 0 5095760 MICHAEL FAGAN VP FINANCE/CFO 346410 0 13886 0 39782 0 28600 0 15100 0 443778 0 0 0 LAWRENCE ONG DIR CARDIOLOGY 725791 0 0 0 21838 0 28600 0 15100 0 791329 0 0 0 MICHAEL QUARTIER FORMER VP ADMINISTRATION 0 0 0 0 349133 0 0 0 0 0 349133 0 0 0 NEERAJ KATRIYAR INTENSIVIST 231391 0 70049 0 261839 0 28600 0 15100 0 606979 0 0 0 DAVID BUCHIN PHYSICIAN 999190 0 0 0 18520 0 28600 0 15100 0 1061410 0 0 0 DAVID RIVADENEIRA VICE CHAIRPERSON 1163078 0 157500 0 19105 0 28600 0 15100 0 1383383 0 0 0 NICK FITTERMAN MD BOARD MEMBER/MEDICAL DIRECTOR 0 491340 0 0 0 12343 0 28600 0 15100 0 547383 0 0 WINIFRED MACK REGIONAL EXECTUIVE DIRECTOR 0 728079 0 96000 0 2035100 0 203225 0 15100 0 3077504 0 910842 ROBERT KERR PHYSICIAN 628027 0 0 0 47794 0 28600 0 15100 0 719521 0 0 0 PART I, LINE 4B 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) AND WINIFRED MACK ($174,625). PART I, LINE 7 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) 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 46673460 2011 BONDS - CAPITAL IMPROVEMENTS false false false A 3212030 0 44152744 2357577 366216 0 781466 0 0 10720002 26694356 1132033 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 Contemporary Computer Services J Riconda, BD Member 264582 Purchased Computer Services false Patrice Piretti Daughter of BD Member 128253 Hospital Employee false PART VI, SECTION A - GOVERNING BODY AND MANAGEMENT, 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. Michael Brown has a business relationship with Thomas Lederer. Ron Gaudreault has a business relationship with Bernard Rosof, MD. Thomas Lederer has a business relationship with Michael Brown. Lewis Meltzer, Esq has a business relationship with John Riconda and Bernard Rosof, MD. John Riconda has a business relationship with Lewis Meltzer, Esq. Bernard Rosof, MD has a business relationship with Ron Gaudreault and Lewis Meltzer, Esq. 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 As a member of the North Shore-Long Island Jewish Health System, the Hospital has several control mechanisms to mitigate conflicts of interest. The Code of Ethical Conduct contains a detailed section educating individuals about how to avoid potential conflicts of interest. Specifically, the Code of Ethical Conduct requires individuals to conduct Hospital business in a manner that places the interests of the Hospital ahead of personal interests. In Addition, the Hospital 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 Hospital are required to fill out a conflicts of interest disclosure form on a regular basis. The system's 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 Hospital's Audit and Corporate Compliance Committee and other applicable committees. In addition, the Hospital 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 CURRENTLY 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, 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 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 XI, LINE 9 - NET ASSET RECONCILIATION NON OPERATING GAIN/LOSS 2,621,336 CHANGE IN EQUITY UNDER FAS 136 6,592,126 TRANSFERS TO AFFILIATES (3,654,519) NET ASSETS RELEASED (625) TOTAL CHANGE IN NET ASSETS 5,558,318 North Shore LIJ Health System 972 Brush Hollow Rd Westbury NY 11590 113418133 SUPPORT NY 501(C)(3) 11, Type 1 NA false North Shore LIJ Health Care Inc 972 Brush Hollow RD Westbury NY 11590 112965586 SUPPORT NY 501(C)(3) 11, Type 1 NS-LIJHS false North Shore LIJ Health Sys Laboratories 972 Brush Hollow Rd Westbury NY 11590 113412370 SUPPORT NY 501(C)(3) 11, Type 1 NS-LIJHS false Huntington Hosp Dolan Family HLTH Center 284 Pulaski Road Greenlawn NY 11740 113368503 Health Care NY 501(C)(3) 3 Huntington true North Shore University Hospital 972 Brush Hollow Rd Westbury NY 11590 111562701 Health Care NY 501(C)(3) 3 NS-LIJ HCI false Long Island Jewish Medical Center 972 Brush Hollow Rd Westbury NY 11590 112241326 Health Care NY 501(C)(3) 3 NS-LIJ HCI false Glen Cove Hospital 972 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Brush Hollow Road Westbury NY 11590 320257193 SUPPORT NY NS-LIJHS C false Vivohealth Inc 972 Brush Hollow Road Westbury NY 11590 264118016 Inactive NY NSH ENTERPRISE C false Autoimmune Research Therapeutics 972 Brush Hollow Road Westbury NY 11590 270701489 Inactive NY NSH ENTERPRISE C false North Shore Radiology at Glen Cove PC 972 Brush Hollow Road Westbury NY 11590 113301179 MEDICAL SERVI NY NSUH C false North Shore-LIJ Radiology Service PC 972 Brush Hollow Road Westbury NY 11590 223970667 MEDICAL SERVI NY NSUH C false North Shore-LIJ Medical Group at Syosset 972 Brush Hollow Road Westbury NY 11590 273957752 MEDICAL SERVI NY NSUH C false North Shore-LIJ Medical Group PC 972 Brush Hollow Road Westbury NY 11590 274384249 MEDICAL SERVI NY NSUH C false NS-LIJ Medical Group at Huntington PC 972 Brush Hollow Road Westbury NY 11590 274384049 MEDICAL SERVI NY NSUH C false NS-LIJ Medical Group at North Nassau PC 972 Brush Hollow Road Westbury NY 11590 274384146 MEDICAL SERVI NY NSUH C false 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10305 331010283 MEDICAL SERVI NY SIUH C false Lenox Hill Physicians Hospital Organizat 122 East 76th St Suite 3-A New York NY 100212834 133775996 Managed Care NY LENOX HILL C false Lenox Otolaryngology Head & Neck Surgery 186 East 76th Street 2nd Floor New York NY 10021 208784395 MEDICAL SERVI NY LENOX HILL C false Lenox Hill Interventional Cardiac & Vasc 130 East 77th Street 9th Floor New York NY 10021 201435770 MEDICAL SERVI NY LENOX HILL C false Lenox Hill Pathology PC 100 East 77th Street New York NY 10021 133644370 MEDICAL SERVI NY LENOX HILL C false Park Lenox Emergency Medicine PC 100 East 77th Street New York NY 10021 262661082 MEDICAL SERVI NY LENOX HILL C false NS-LIJ INTERNAL MEDICINE AT LYNBROOK 972 Brush Hollow Rd Westbury NY 11590 463475908 Medical SVC NY NSUH C false NSLIJ INTERNAL MEDICINE AT NEW HYDE PARK 972 Brush Hollow Rd Westbury NY 11590 462822879 Medical Servi NY NSUH C false NS-LIJ OB-GYN AT GARDEN CITY PC 972 Brush Hollow Rd Westbury NY 11590 462886776 Medical Servi NY NSUH C false NS-LIJ HEALTH PLAN HOLDING INC 972 Brush Hollow Rd Westbury NY 11590 462478147 INSURANCE NY NSLIJ HCI C false NS-LIJ CARECONNECT INSURANCE AGENCY 972 Brush Hollow Rd Westbury NY 11590 462270382 INSURANCE NY HEALTH PLN HLDG C false Lenox Hill Hospital Medical PC 972 Brush Hollow Rd Westbury NY 11590 452661543 Medical Servi NY LENOX HILL C false NS-LIJ Occupational Medicine PC 972 Brush Hollow Rd Westbury NY 11590 451004103 Medical Servi NY NSUH C false NORTH SHORE-LIJ OB-GYN PC 972 BRUSH HOLLOW RD WESTBURY NY 11590 461382916 MEDICAL SERVI NY LIJ C false NORTH SHORE-LIJ ANESTHESIOLOGY PC 972 BRUSH HOLLOW RD WESTBURY NY 11590 461617561 MEDICAL SERVI NY SOUTHSIDE C false NORTH SHORE MEDICAL ACCELERATOR PC 972 BRUSH HOLLOW ROAD WESTBURY NY 11590 112945979 MEDICAL SERVI NY NSUH S false TRUE NORTH HEALTH PHARMACY INC 972 BRUSH HOLLOW ROAD WESTBURY NY 11590 471020508 INACTIVE NY NSUH C false NORTH SHORE-LIJ CARECONENCT INSURANCE AG 972 BRUSH HOLLOW ROAD WESTBURY NY 11590 471994548 INSURANCE AGENCY NY GROUP HOLDING C false CARECONNECT GROUP HOLDING COMPANY INC 972 BRUSH HOLLOW ROAD WESTBURY NY 11590 472478692 HOLDING CO NY HPLAN HOLDING C false NORTH SHORE-LIJ PEDIATRICS OF SUFFOLK CO 972 BRUSH HOLLOW ROAD WESTBURY NY 11590 465746956 MEDICAL SERVICES NY NSUH C false NORTH SHORE-LIJ URGENT CARE PC 972 BRUSH HOLLOW ROAD WESTBURY NY 11590 471758444 MEDICAL SERVICES NY NSUH C false NORTH SHORE-LIJ MATERNAL FETAL MEDICINE 972 BRUSH HOLLOW ROAD WESTBURY NY 11590 465495054 MEDICAL SERVICES NY NSUH C false false true false false false false false false true false true false true true true true false true Huntington Hospital Dolan Family HLTH Center J 245234 AT COST