2015-11-16T10:18:55-06:00 2014-12-31 221478099 COHNREZNICK LLP 1212 AVENUE OF THE AMERICAS NEW YORK NY 10036 990 2014-01-01 113316802 MEDISYS HEALTH NETWORK INC MEDI 7182066291 8900 VAN WYCK EXPRESSWAY JAMAICA NY 11418 MOUNIR DOSS EXEC VP & CFO 7182066291 2015-11-13 1 THOMAS LANNING P00851654 2122970400 2014 2016-04-25 22:37:26Z MOUNIR DOSS 8900 VAN WYCK EXPRESSWAY JAMAICA NY 11418 5164289 0 X WWW.JAMAICAHOSPITAL.ORG X 1996 NY TO SUPPORT THE OPERATIONS OF THE JAMAICA HOSPITAL MEDICAL CENTER, FLUSHING HOSPITAL MEDICAL CENTER AND OTHER ORGANIZATIONS LISTED IN SCHEDULE R, PART II, WHICH ARE HOSPITALS TAX EXEMPT UNDER IRC SECTION 501(C)(3). 12 10 2 0 0 0 0 0 4542837 4949485 202358 178654 1743108 36150 6488303 5164289 0 0 0 0 924204 942083 0 0 0 3741834 2700292 4666038 3642375 1822265 1521914 96474950 108810741 71211829 82528758 25263121 26281983 TO SUPPORT THE OPERATIONS OF THE JAMAICA HOSPITAL MEDICAL CENTER, FLUSHING HOSPITAL MEDICAL CENTER, AND OTHER ORGANIZATIONS LISTED IN SCHEDULE R, PART II, WHICH ARE HOSPITAL TAX EXEMPT UNDER IRC SECTION 501(C)(3). 0 0 1401152 4936503 MEDISYS HEALTH NETWORK PROVIDES SERVICES TO SUPPORT AND BENEFIT JAMAICA HOSPITAL MEDICAL CENTER, FLUSHING HOSPITAL MEDICAL CENTER AND IT'S RELATED HEALTHCARE ORGANIZATIONS. 1401152 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 140 0 1 2 1 0 0 0 0 0 0 0 0 0 0 X 12 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X MANZAR SASSANI 7182066291 8900 VAN WYCK EXPRESSWAY JAMAICA NY 11418 X ANTHONY DIMARIA MD SECRETARY 1.00 42.00 X X 0 235698 30797 ANTONIETTA MORISCO MD DIRECTOR 1.00 2.00 X 0 0 0 DOUGLAS W SINGER DIRECTOR 1.00 3.00 X 0 0 0 GEOFFREY DOUGHLIN MD 2ND VICE CHAIRMAN 1.00 41.00 X X 0 411197 31554 GERALDINE M CHAPEY PHD DIRECTOR 1.00 2.00 X 0 0 0 HON ARCHIE SPIGNER ASSISTANT SECRETARY 1.00 2.00 X X 0 0 0 HON TIMOTHY J DUFFICY DIRECTOR 1.00 2.00 X 0 0 0 JOSEPH FERRARA ASSISTANT TREASURER 1.00 3.00 X X 0 0 0 JOSEPH LIANA DIRECTOR 1.00 2.00 X 0 0 0 NEIL FOSTER PHILLIPS CHAIRMAN 1.00 3.00 X X 0 0 0 PHILIPPA L KARTERON DIRECTOR 1.00 2.00 X 0 0 0 ROBERT W KOOP FIRST VICE CHAIRMAN & TREASURER 1.00 3.00 X X 0 0 0 BRUCE FLANZ PRESIDENT & CEO 10.00 55.00 X 566001 822357 30393 MOUNIR DOSS EXECUTIVE VP & CFO 10.00 55.00 X 346363 584517 30393 912364 2053769 123137 2 0 1 0 EBS MASTER LLC 3055 LEBANON PIKE BEVERLY MA 01915 DATA PROCESSING 373735 HAFETZ NECHELES & ROCCO LLP 60 EAST 42ND STREET 36TH FLOOR NEW YORK NY 10165 LEGAL 337111 NABIL A RAB BUSINESS CONSULTING LLC 74 RITA DRIVE EAST MEADOW NY 11554 CONSULTING 135225 PSEG LONG ISLAND LLC 111 EIGHTH AVENUE 13TH FLOOR NEW YORK NY 10011 CONSTRUCTION 130095 4 MGMT FEES-FHMC 900099 2499996 2499996 CHARGE BACK REVENUE/BH 900099 1393417 1393417 RENTAL INCOME 900099 1056072 1056072 4949485 178654 178654 INCOME FROM CHN 900099 17593 17593 K-1 INCOME 900099 12254 12254 PAPER/RECYCLE REVENUE 900099 6303 6303 36150 5164289 4985635 0 178654 912364 350969 561395 29719 11432 18287 617376 237493 379883 448 172 276 101919 39206 62713 269475 103662 165813 1020311 392494 627817 CHARGE BACKS 637082 245073 392009 REPAIRS AND MAINTEANCE 31639 12171 19468 AUTO EXPENSES 4841 1862 2979 TRAINING EXPENSES 2265 871 1394 14936 5747 9189 3642375 1401152 2241223 0 49241 11152 4801 0 84534 84535 39602487 23548849 15150088 16053638 4227355 4521661 150000 76958931 87989755 96474950 108810741 3629179 6608764 11812904 2260884 55769746 73659110 71211829 82528758 X 25263121 26281983 25263121 26281983 96474950 108810741 X 1521914 127731 -630783 X 0 0 0 X X 2 JAMAICA HOSPITAL MEDICAL CENTER 111631788 3 1 0 0 FLUSHING HOSPITAL MEDICAL CENTER 111631781 3 1 0 0 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1619400 1619400 18372705 10185782 8186923 7427973 4689602 2738371 6609977 6031436 578541 5572432 2642029 2930403 16053638 SECURITY DEPOSITS 37988 DUE FROM RELATED PARTIES 87951767 87989755 ACCRUAL PENSION PAYABLE 1876883 DUE TO RELATED PARTY 70160648 CASH OVERDRAFT 1571641 EXCHANGE 49938 73659110 X X X X 0 1 0 0 0 0 0 0 0 ANTHONY DIMARIA MD SECRETARY 0 222772 0 0 0 12926 0 5743 0 27788 0 269229 0 0 GEOFFREY DOUGHLIN MD 2ND VICE CHAIRMAN 0 411197 0 0 0 0 0 6500 0 27788 0 445485 0 0 BRUCE FLANZ PRESIDENT & CEO 566001 722063 0 0 0 100294 0 6500 0 26627 566001 855484 0 0 MOUNIR DOSS EXECUTIVE VP & CFO 346363 551627 0 0 0 32890 0 6500 0 26627 346363 617644 0 0 PART I, LINE 4B CERTAIN SENIOR MANAGEMENT OFFICIALS PARTICIPATE IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. DURING 2014 THERE WERE NO CONTRIBUTIONS TO THE PLAN. SCHEDULE J PART II: BRUCE FLANZ RECEIVED A TAXABLE PAYMENT FOR SUPPLEMENTAL LIFE AND DISABILITY FOR 69,849. THIS AMOUNT IS INCLUDED IN SCHEDULE J PART II, COLUMN B(III) AND WAS TAXABLE ON HIS 2014 W-2. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 AND APPROPRIATE SCHEDULES, AS REQUIRED (FORM 990), IS PREPARED BY OUTSIDE ACCOUNTANT AND REVIEWED INTERNALLY BY MANAGEMENT, AT WHICH TIME IT IS CONSIDERED THE FINAL DRAFT. THE FINAL DRAFT OF THE FORM 990 IS PRESENTED TO THE TRUSTEES VIA EMAIL AND OR A BOARD MEETING. ONCE THE REVIEW OF THE FORM 990 HAS BEEN COMPLETED TO THE BOARD'S SATISFACTION, IT IS FINALIZED AND SUBSEQUENTLY FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C DISCLOSURE IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY BY EMPLOYEES THAT SATISFY THE CRITERIA TO BE CONSIDERED AN "INTERESTED PERSON" IS SUBMITTED UPON HIRING AND ANNUALLY THEREAFTER. THE COMPLIANCE OFFICERS REVIEW THE SUBMISSIONS FOR CONFLICTS AND REPORTS THEM TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMPENSATION POLICY - THE BOARD OF MEDISYS HEALTH NETWORK HAS CREATED AN INDEPENDENT COMPENSATION COMMITTEE WHOSE CHARGE IS TO REVIEW AND APPROVE THE COMPENSATION OF ALL INDIVIDUALS WHO MEET THE REQUIREMENTS OF A DISQUALIFIED PERSON FOR INTERMEDIATE SANCTIONS. THIS COMMITTEE IS EMPOWERED TO APPROVE COMPENSATION FOR ALL ENTITIES WITHIN THE MEDISYS HEALTH NETWORK SYSTEM. THE COMMITTEE HAS RETAINED AN INDEPENDENT COMPENSATION CONSULTANT TO APPLY ITS STANDARD METHODOLOGY FOR DETERMINATION OF APPROPRIATE EXECUTIVE COMPENSATION AND BENEFIT LEVELS FOR EXECUTIVES. IT IS POLICY TO TARGET THE TOTAL COMPENSATION (BASE SALARY, INCENTIVE COMPENSATION AND BENEFITS) OF EXECUTIVES AT THE MEDIAN OF THE DEFINED MARKETPLACE FOR SIMILARLY SITUATED EXECUTIVES IN CONSULTATION WITH AN INDEPENDENT COMPENSATION CONSULTANT IN A MANNER THAT COMPLIES WITH THE INTERMEDIATE SANCTIONS REGULATIONS AND OTHER FEDERAL AND STATE LAWS AND REGULATIONS. THE COMMITTEE SHALL APPROVE BASE SALARIES FOR EXECUTIVES AND ANY DISQUALIFIED INDIVIDUALS BASED UPON THE AMOUNTS PAID TO SIMILARLY SITUATED EXECUTIVES WITHIN THE RELEVANT MARKETPLACE, WITH POSSIBLE ADJUSTMENTS MADE FOR SPECIAL SKILL, EXPERIENCE, COMPETENCE AND PERFORMANCE, INCLUDING CONTRIBUTION TO THE SYSTEM AS A WHOLE. THE CEO SHALL RECOMMEND TO THE COMPENSATION COMMITTEE ANY ADJUSTMENTS TO THE BASE SALARIES OF EXECUTIVES. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS - CERTIFICATE OF INCORPORATION FILED WITH THE NYS DEPARTMENT OF STATE; CONFLICT OF INTEREST POLICY IS NOT PUBLICLY AVAILABLE. FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION A, LINE 1B: ANTHONY DIMARIA, M.D., RECEIVED COMPENSATION FOR THE PERFORMANCE OF SERVICES TO THE JAMAICA HOSPITAL NURSING HOME WORKING ABOUT 40 HOURS PER WEEK. ANTHONY DIMARIA, M.D., DID NOT RECEIVE COMPENSATION AS A TRUSTEE FOR JAMAICA HOSPITAL MEDICAL CENTER, MEDISYS HEALTH NETWORK, OR THE JAMAICA HOSPITAL MEDICAL CENTER DIAGNOSTIC AND TREATMENT CENTER FOR EACH OF WHICH HE WORKED ABOUT 1 HOUR PER WEEK. GEOFFREY DOUGHLIN M.D., RECEIVED COMPENSATION FOR THE PERFORMANCE OF SERVICES TO THE JAMAICA HOSPITAL MEDICAL CENTER WORKING ABOUT 40 HOURS PER GEOFFREY DOUGHLIN M.D., DID NOT RECEIVE COMPENSATION AS A TRUSTEE FOR THE JAMAICA HOSPITAL MEDICAL CENTER DIAGNOSTIC AND TREATMENT CENTER OR MEDISYS HEALTH NETWORK FOR EACH OF WHICH HE WORKED ABOUT 1 HOUR PER WEEK. FOR BRUCE FLANZ, PRESIDENT & CEO, MOUNIR DOSS, EXECUTIVE VICE PRESIDENT & CFO, THE HOURS REPORTED BELOW REFLECT THE TOTAL TIME WORKED AS OFFICERS FOR ALL OF THE RELATED ORGANIZATIONS SHOWN ON SCHEDULE R. TOTAL COMPENSATION IS REPORTED ON EACH ENTITY'S FORM 990. COST ALLOCATION AMONG THE ENTITIES IS PERFORMED CONSISTENTLY WITH ACCOUNTING RULES AND APPLICABLE COST ALLOCATION METHODOLOGIES. ESTIMATED NUMBER OF HOURS WORKED PER WEEK FOR RELATED ORGANIZATIONS IS AS FOLLOWS: MEDISYS HEALTH NETWORK - 10 HOURS PER WEEK FLUSHING HOSPITAL MEDICAL CENTER - 15 HOURS PER WEEK JAMAICA HOSPITAL MEDICAL CENTER - 30 HOURS PER WEEK OTHER RELATED ENTITIES LISTED ON SCHEDULE R - 10.0 HOURS PER WEEK FORM 990, PART XI, LINE 9: PENSION ACUTARIAL LOSSES -618,529. K-1 INCOME NOT RECORDED ON BOOKS -12,254. ADVANCED CENTER FOR PSYCHOTHERAPY 89-06 135TH STREET JAMAICA NY 11418 111864871 HEALTHCARE NY 501(C)(3) 9 MEDISYS HEALTH NETWORK 0 ALLIED HEALTH FOUNDATION OF QUEENS INC 4500 PARSONS BLVD FLUSHING NY 11355 112813535 INACTIVE NY 501(C)(3) 9 MEDISYS HEALTH NETWORK 0 FLUSHING HOSPITAL MEDICAL CENTER 4500 PARSONS BLVD FLUSHING NY 11355 111631781 HOSPITAL NY 501(C)(3) 3 MEDISYS HEALTH NETWORK 0 INTERNATIONAL ASSOCIATION OF MEDICAL BIKE UNITS INC 8900 VAN WYCK EXPY JAMAICA NY 11418 113483140 INACTIVE NY 501(C)(3) 9 MEDISYS HEALTH NETWORK 0 JAMAICA HOSPITAL MEDICAL CENTER 8900 VAN WYCK EXPY JAMAICA NY 11418 111631788 HEALTHCARE NY 501(C)(3) 3 MEDISYS HEALTH NETWORK 0 JAMAICA HOSPITAL NURSING HOME 90-28 VAN WYCK EXPY JAMAICA NY 11418 237216197 HEALTHCARE NY 501(C)(3) 3 MEDISYS HEALTH NETWORK 0 MEDISYS AMBULANCE SERVICE 8900 VAN WYCK EXPY JAMAICA NY 11418 542124788 HEALTHCARE NY 501(C)(3) 9 MEDISYS HEALTH NETWORK 0 THE JAMAICA HOSPITAL DIAG AND TREAT CTR 8900 VAN WYCK EXPY JAMAICA NY 11418 113340969 HEALTHCARE NY 501(C)(3) 3 MEDISYS HEALTH NETWORK 0 VWE PROPERTIES CORPORATION 8900 VAN WYCK EXPY JAMAICA NY 11418 113485165 PARKING GARAGE NY 501(C)(3) 11A MEDISYS HEALTH NETWORK 0 NHP HOLDINGS LLC 521 FIFTH AVE 3RD FLOOR NEW YORK NY 10175 203418837 HOLDING COMPANY NY N/A FRR RECOVERY SERVICES 80 MARCUS DRIVE MELVILLE NY 11747 113454555 COLLECTION AGENCY NY N/A C 0 HI TECH MEDICAL EQUIPMENT 103-51 101 ST OZONE PARK NY 11416 113313334 DURABLE MEDICAL EQUIPMENT COMPANY NY N/A C 0 JAMAICA RX 8900 VAN WYCK EXPRESSWAY JAMAICA NY 11418 205292781 RETAIL PHARMACY NY N/A C 0 MEDISYS HOME CARE SERVICE INC 8900 VAN WYCK EXPRESSWAY JAMAICA NY 11418 030474027 HOME CARE STAFFING/INACTIVE NY N/A C 0 MEDISYS IPA 8900 VAN WYCK EXPRESSWAY JAMAICA NY 11418 113452476 PHYSICIAN CONTRACTING/INACTIVE NY N/A C 0 MEDISYS SERVICE CORPORATION 8900 VAN WYCK EXPRESSWAY JAMAICA NY 11418 113479920 HOLDING COMPANY NY N/A C 0 MEDISYS VENTURES 111 STEWART AVE HICKSVILLE NY 11801 113431792 HOLDING COMPANY NY MEDISYS HEALTH NETWORK C 20549201 27247907 1.00000 0 MHN REALTY 8900 VAN WYCK EXPRESSWAY JAMAICA NY 11418 113458286 REAL ESTATE/INACTIVE NY N/A C 0 SECOND CENTURY SERVICE CORPORATION 4500 PARSONS BLVD FLUSHING NY 11355 112843101 RETAIL PHARMACY NY N/A C 0 1 0 0 0 0 0 0 0 0 1 0 1 1 1 1 1 1 0 0 FRR RECOVERY J 348036 COST