2015-11-16T10:35:53-06:00 2014-12-31 WithumSmithBrown PC 465 South St Ste 200 Morristown NJ 079606497 990 2014-01-01 272020746 HUDSON VISTA PHYSICIAN SERVICES PC % THOMAS J GIBNEY CPA HUDS 8455614400 70 DUBOIS STREET NEWBURGH NY 12550 SCOT BLACKSTONE HILL MD OFFICER 9738989494 2015-11-16 true Scott J Mariani P00642486 9738989494 2014 2016-04-25 22:37:26Z SCOT BLACKSTONE HILL MD 70 DUBOIS STREET NEWBURGH NY 12550 7273995 false X WWW.STLUKESCORNWALLHOSPITAL.ORG X 2010 NY TO PROVIDE EMERGENCY PHYSICIAN SERVICES AND OTHER LICENSED HEALTHCARE PROFESSIONAL SERVICES TO ST. LUKE'S CORNWALL HOSPITAL PATIENTS. 1 0 38 0 0 0 791199 335562 10893085 6938433 0 0 0 0 11684284 7273995 0 0 0 0 6411102 6314421 0 0 0 5273182 959574 11684284 7273995 0 853445 757865 853445 757865 0 0 TO PROVIDE EMERGENCY PHYSICIAN SERVICES AND OTHER LICENSED HEALTHCARE PROFESSIONAL SERVICES TO ST. 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IN ADDITION, CERTAIN PHYSICIANS INCLUDED IN SCHEDULE J, PART II, RECEIVED PAYMENTS RELATED TO THE SATISFATION OF CERTAIN METRICS ASSOCIATED WITH CLINICAL CODING AND OTHER ADMINISTRATIVE FACTOR. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT. CORE FORM, PART VI, SECTION A; QUESTION 6 & 7 ST. LUKE'S CORNWALL HOSPITAL ("SLCH") IS THE SOLE MEMBER OF THIS ORGANIZATION WHICH EXISTS THROUGH A PHYSICIAN NOMINEE AGREEMENT DUE TO STATE OF NEW YORK CORPORATE PRACTICE OF MEDICINE PROHIBITION RULES AND REGULATIONS. HUDSON VISTA CORPORATION ("HVC") IS THE SOLE OF MEMBER OF SLCH. THEREFORE, HVC HAS THE ULTIMATE AUTHORITY AND RIGHT TO ELECT THE MEMBERS OF THIS ORGANIZATION'S BOARD OF TRUSTEES AND HAS CERTAIN RESERVED POWERS AS DEFINED IN THIS ORGANIZATION'S BYLAWS. CORE FORM, PART VI, SECTION B; QUESTION 11B THE ORGANIZATION IS AN AFFILIATE WITHIN ST. LUKE'S CORNWALL HOSPITAL AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THIS ORGANIZATION'S FEDERAL FORM 990 WAS PROVIDED TO THE SOLE VOTING MEMBER OF ITS GOVERNING BODY (ITS BOARD OF TRUSTEES) PRIOR TO THE FILING WITH THE INTERNAL REVENUE SERVICE ("IRS"). IN ADDITION, THE ORGANIZATION'S SOLE VOTING MEMBER HAS BEEN DELEGATED THE RESPONSIBILITY TO OVERSEE AND COORDINATE THE FEDERAL FORM 990 PREPARATION, REVIEW AND FILING PROCESS. AS PART OF THE TAX RETURN PREPARATION PROCESS THE ORGANIZATION HIRED A PROFESSIONAL CPA FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION TO PREPARE THE FEDERAL FORM 990. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE HOSPITAL'S CHIEF FINANCIAL OFFICER, CONTROLLER AND FINANCE PERSONNEL ("INTERNAL WORKING GROUP") TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE ORGANIZATION'S INTERNAL WORKING GROUP FOR REVIEW. THE ORGANIZATION'S INTERNAL WORKING GROUP REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE ORGANIZATION'S INTERNAL WORKING GROUP FOR FINAL REVIEW AND APPROVAL. FOLLOWING THIS REVIEW, THE FINAL FEDERAL FORM 990 WAS PROVIDED TO THE SOLE VOTING MEMBER OF THE ORGANIZATION PRIOR TO THE FILING WITH THE IRS. CORE FORM, PART VI, SECTION B; QUESTION 12 THE ORGANIZATION IS AN AFFILIATE WITHIN ST. LUKE'S CORNWALL HOSPITAL AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE ORGANIZATION AND THE SYSTEM REGULARLY MONITOR AND ENFORCE COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. ANNUALLY ALL MEMBERS OF THE BOARD OF TRUSTEES, OFFICERS/SENIOR MANAGEMENT PERSONNEL, CERTAIN MEDICAL STAFF MEMBERS AND ANYONE RESPONSIBLE FOR MAKING FINANCIAL DECISIONS ARE REQUIRED TO REVIEW THE EXISTING CONFLICT OF INTEREST POLICY AND COMPLETE A QUESTIONNAIRE. THE COMPLETED QUESTIONNAIRES ARE RETURNED TO THE HOSPITAL'S DIRECTOR OF COMPLIANCE & MANAGED CARE FOR REVIEW. THEREAFTER, A SUMMARY OF THE COMPLETED QUESTIONNAIRES WHICH CONTAINS INFORMATION DISCLOSED ON AN INDIVIDUAL BY INDIVIDUAL BASIS IS PREPARED. ANY POTENTIAL CONFLICTS ARE DISCLOSED AND REPORTED TO THE ORGANIZATION'S BOARD OF TRUSTEES FOR ITS REVIEW AND DISCUSSION WITH RESPECT TO ANY POTENTIAL MITIGATING BEHAVIOR. CORE FORM, PART VI, SECTION B; QUESTION 15 THE ORGANIZATION IS AN AFFILIATE WITHIN ST. LUKE'S CORNWALL HOSPITAL AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). ANNUALLY THE MANAGER OF COMPENSATION IN HUMAN RESOURCES EVALUATES THE COMPENSATION OF ALL EXECUTIVE LEVEL POSITIONS. THE MANAGER REVIEWS EACH POSITION AND USES PUBLISHED EXTERNAL SALARY SURVEYS TO DETERMINE FAIR AND EQUITABLE SALARIES. POSITIONS ARE EVALUATED AGAINST HOSPITALS WITH SIMILIAR BED SIZES, FULL-TIME EQUIVALENTS AND REVENUE SIZE IN THE NORTHEAST AND GREATER NEW YORK REGION. ADDITIONALLY, THE SYSTEM HIRES AN INDEPENDENT OUTSIDE FIRM TO REVIEW ALL SALARY PACKAGES FOR THE PRESIDENT/CHIEF EXECUTIVE OFFICER, SENIOR VICE PRESIDENT/CHIEF FINANCIAL OFFICER AND OTHER SENIOR MANAGEMENT. THE INDEPENDENT OUTSIDE CONSULTANTS EVALUATE THE SALARIES AGAINST COMPARABLE MARKET DATA FOR COMPARABLE POSITIONS WITHIN THE REGION AND NATIONALLY. RESULTS OF THE ANALYSIS FOR THE PRESIDENT/CHIEF EXECUTIVE OFFICER AND THE SENIOR VICE PRESIDENT/CHIEF FINANCIAL OFFICER ARE SHARED WITH THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES FOR REVIEW AND APPROVAL EACH YEAR. CERTAIN OFFICERS OR KEY EMPLOYEES ARE EVALUATED INTERNALLY. COMPENSATION PACKAGES ARE DERIVED USING EXTERNAL COMPARABLE DATA WITHIN THE REGION AND NATIONALLY. ONCE THE COMPENSATION PACKAGE HAS BEEN DETERMINED IT IS REVIEWED BY THE PRESIDENT/CHIEF EXECUTIVE OFFICER AND CERTAIN SENIOR VICE PRESIDENTS FOR APPROVAL. CORE FORM, PART VI, SECTION C; QUESTION 19 THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE STATE OF NEW YORK. ADDITIONALLY, THE ORGANIZATION PROVIDES CERTAIN GOVERNING DOCUMENTS, ITS CONFLICT OF INTEREST POLICY AND AUDITED FINANCIAL STATEMENTS TO THE PUBLIC UPON REQUEST. CORE FORM, PART VII AND SCHEDULE J PART VII AND SCHEDULE J REFLECT A BOARD MEMBER AND OFFICERS WHO RECEIVED COMPENSATION AND BENEFITS from THIS ORGANIZATION OR a related organization. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OF THIS ORGANIZATION OR A related organization AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OF THIS ORGANIZATION'S BOARD OF TRUSTEES. CORE FORM, PART VII, SECTION A, COLUMN B THE ORGANIZATION IS AN AFFILIATE WITHIN ST. LUKE'S CORNWALL HOSPITAL AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM INCLUDES BOTH FOR-PROFIT AND NOT FOR-PROFIT ORGANIZATIONS. CERTAIN BOARD OF TRUSTEE MEMBERS, OFFICERS AND/OR DIRECTORS LISTED ON CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 MAY HOLD SIMILAR POSITIONS WITH BOTH THIS ORGANIZATION AND OTHER AFFILIATES WITHIN THE SYSTEM. THE HOURS SHOWN ON THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE NO COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, REPRESENT THE ESTIMATED HOURS DEVOTED PER WEEK FOR THIS ORGANIZATION. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF TRUSTEES OF OTHER RELATED ORGANIZATIONS IN THE SYSTEM, THEIR RESPECTIVE HOURS PER WEEK PER ORGANIZATION ARE APPROXIMATELY THE SAME AS REFLECTED IN PART VII OF THIS FORM 990. THE HOURS REFLECTED ON PART VII OF THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, PAID OFFICERS AND KEY EMPLOYEES, REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF THE SYSTEM; NOT SOLELY THIS ORGANIZATION. CORE FORM, PART VII AND SCHEDULE J ROBERT S. ROSS, PRESIDENT/CHIEF EXCECUTIVE OFFICER IS STILL EMPLOYED WITHIN ST. LUKE'S CORNWALL HOSPITAL AND SUBSIDIARIES. HOWEVER, HIS ROLE IS LIMITED TO SERVING AS THE PRESIDENT/CHIEF EXCECUTIVE OFFICER OF ST. LUKE'S CORNWALL HOSPITAL; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. ACCORDINGLY, HE IS NO LONGER REPORTED ON THIS FORM 990 AS HE IS NOT DEEMED TO BE AN OFFICER OF THIS ORGANIZATION. CORE FORM, PART XII; QUESTION 2 THE ORGANIZATION IS AN AFFILIATE WITHIN ST. LUKE'S CORNWALL HOSPITAL AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM'S TAX-EXEMPT PARENT ENTITY IS HUDSON VISTA CORPORATION. AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF ST. LUKE'S CORNWALL HOSPITAL AND SUBSIDIARIES FOR THE YEARS ENDED DECEMBER 31, 2014 AND DECEMBER 31, 2013; RESPECTIVELY. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAIN CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. THE INDEPENDENT CPA FIRM ISSUED AN UNQUALIFIED OPINION WITH RESPECT TO THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS EACH YEAR. THE FINANCE COMMITTEE OF ST. LUKE'S CORNWALL HOSPITAL HAS BEEN DELEGATED RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE CONSOLIDATED FINANCIAL STATEMENTS, WHICH INCLUDES THIS ORGANIZATION, AND THE SELECTION OF AN INDEPENDENT AUDITOR. ST LUKE'S CORNWALL HOSPITAL 70 DUBOIS STREET NEWBURGH NY 12550 141340054 HEALTH SVCS. NY 501(C)(3) HOSPITAL HVC false HUDSON VISTA CORPORATION 70 DUBOIS STREET NEWBURGH NY 12550 202286782 HEALTH SVCS. NY 501(C)(3) 509(A)(3) NA false ST LUKE'S CORNWALL HEALTH SYSTEM INC 70 DUBOIS STREET NEWBURGH NY 12550 223026261 HEALTH SVCS. NY 501(C)(3) 509(A)(3) HVC false ST LUKE'S CORNWALL HEALTH SYSTEM FDN 70 DUBOIS STREET NEWBURGH NY 12550 223026263 FUNDRAISING NY 501(C)(3) 509(A)(1) SLCHS false AMOS F & SARAH L HOLDEN HOME AGED WOMEN 70 DUBOIS STREET NEWBURGH NY 12550 141365995 HEALTH SVCS. NY 501(C)(3) PF SLCHS false GOLDSMITH D AND MARY B JOHNES HOME 11-15 BALMVILLE ROAD NEWBURGH NY 12550 141364666 HEALTH SVCS. NY 501(C)(3) 509(A)(2) SLCHS false HUDSON VISTA MEDICAL PC 70 DUBOIS STREET NEWBURGH NY 12550 452526738 HEALTH SVCS. NY 501(C)(3) 509(A)(3) SLCH false SLCH CORPORATION 70 DUBOIS STREET NEWBURGH NY 12550 141765661 INACTIVE NY NA C CORP false SLCH INSURANCE CO LTD 3 GORMAN ROAD 3RD FLOOR HAMILTON BD HM 08 FINANCIAL VEHICLE BD NA C CORP false false false true false false false false false false false false false false false true false false false true ST LUKE'S CORNWALL HOSPITAL C 335562 COST SCHEDULE R, PART V THE ORGANIZATION IS AN AFFILIATE WITHIN ST. LUKE'S CORNWALL HOSPITAL AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). ST. LUKE'S CORNWALL HOSPITAL ROUTINELY PAYS EXPENSES FOR VARIOUS AFFILIATES WITHIN THE SYSTEM IN THE ORDINARY COURSE OF BUSINESS. THESE RELATED PARTY TRANSACTIONS ARE RECORDED ON THE REVENUE/EXPENSE AND BALANCE SHEET STATEMENTS OF THIS ORGANIZATION AND ITS AFFILIATES. THESE ENTITIES WORK TOGETHER TO DELIVER HIGH QUALITY HEALTHCARE AND WELLNESS SERVICES TO THE COMMUNITIES IN WHICH THEY ARE SITUATED.