2014-11-17T14:40:14-06:00 2013-12-31 Charles A Barragato & Co LLP 950 Third Avenue - 20th FL New York NY 10022 990 2013-01-01 131740119 Nyack Hospital % RONALD RATIGAN NYAC 8453486522 160 North Midland Avenue Suite Nyack NY 10960 RONALD RATIGAN DIRECTOR OF FINANCE 2123714446 2014-11-15 true Angelo Pirozzi CPA P00446022 2123714446 2013 2015-11-30 17:44:51Z JOHN VOLANTO VP COO 160 North Midland Avenue Nyack NY 10960 222431540 false X NYACKHOSPITAL.ORG X 1895 NY THE MISSION OF NYACK HOSPITAL IS TO PROVIDE COMPETENT, INNOVATIVE AND ACCESSIBLE EMERGENCY AND ACUTE CARE SERVICES FOR THE RESIDENTS OF ROCKLAND COUNTY, NEW YORK. 21 16 1936 224 0 597716 6982671 199080508 208577272 28873 110369 8299063 6761228 208006160 222431540 0 0 0 0 126390992 129002476 0 0 0 77162472 90226240 203553464 219228716 4452696 3202824 75738732 76763439 77314617 69803597 -1575885 6959842 X THE MISSION OF NYACK HOSPITAL IS TO PROVIDE COMPETENT, INNOVATIVE AND ACCESSIBLE EMERGENCY, BEHAVIORAL HEALTH AND ACUTE CARE SERVICES FOR THE RESIDENTS OF ROCKLAND COUNTY, NEW YORK. false false 197305844 210633272 NYACK HOSPITAL IS COMMITTED TO MEETING THE HEALTH CARE NEEDS OF THE RESIDENTS OF ROCKLAND COUNTY, NEW YORK AND OTHER SURROUNDING AREAS. NYACK HOSPITAL IS DEDICATED TO PROVIDING THE HIGHEST QUALITY HEALTHCARE SERVICES TO THE ROCKLAND COMMUNITY. DURING 2013, NYACK HOSPITAL PROVIDED HIGH QUALITY HEALTHCARE SERVICES FOR 14,522 ADMISSIONS, ACCOUNTING FOR 63,969 DAYS OF PATIENT CARE. NYACK HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. CONTINUED ON SCHEDULE O. 197305844 true true false true false false false false false true true false false false true false false true false false false false false false false false true true false false true false false false false false false true false false false false false false true true true false false true 119 0 true 1936 true false false false false false false false false false false X 21 16 false false false false true true true true true false false true true true true true true true true false NY X RONALD RATIGAN 8453486522 160 NORTH MIDLAND AVENUE NYACK NY 10960 X RICHARD KOHLHAUSEN CHAIR 1.0 X X 0 LISA HAYES VICE CHAIR 1.0 1.0 X X JOHN MECCHELLA VICE CHAIR 1.0 X X DAVID H FREED PRESIDENT & CEO 40.0 1.0 X X 638630 28394 KEVIN CONWAY SECRETARY 1.0 X X MARY K SHINICK ASSISTANT SECRETARY 40.0 X X 265935 37848 MARISA S BARBIERI BOARD MEMBER 1.0 X HOWARD J FELDFOGEL DO BOARD MEMBER 1.0 X 103250 ALAN FELDSTEIN BOARD MEMBER 1.0 X RICHARD GEMMING BOARD MEMBER 1.0 59.0 X 0 455987 37916 JAMES GERSTLEY BOARD MEMBER 1.0 X RICHARD A GOLDMAN BOARD MEMBER 1.0 X KEVIN HOBBS BOARD MEMBER 1.0 X MARK JACOBS BOARD MEMBER 1.0 1.0 X MARC J LEVINE MD HONORARY BOARD MEMBER X MICHAEL L MCNEE BOARD MEMBER 1.0 X WAYNE M OSTEN BOARD MEMBER 1.0 59.0 X 0 1282443 39032 ENRIQUE PABON BOARD MEMBER 1.0 X WILLIAM SHUM BOARD MEMBER 1.0 X Cathy Shea Board Member 1.0 X ROBERT VAN CURA BOARD MEMBER 1.0 X GERALD WALSH BOARD MEMBER 1.0 X MICHAEL RADER MD VP & MEDICAL DIRECTOR 40.0 X 421192 38359 JOHN S BURKE VP & CFO 40.0 1.0 X 395081 40633 JOHN VOLANTO VP & CHIEF INFORMATION OFFICER 40.0 X 290971 28366 DENISE ZBAR VP - Physician Practice Mgmt 40.0 X 220987 45118 CELESTE BETHON CHIEF NURSING OFFICER 40.0 X 168192 21128 RONALD RATIGAN DIRECTOR OF FINANCE 40.0 X 183527 43101 ALFREDO WALDRON ADMIN OF PATIENT FINANCIAL SVC 40.0 X 177079 32467 ALICE VALLEN CRONIN CH SYS & REENGINEERING OFFICER 40.0 X 168252 41969 PATRICIA JOSEPH MD DIRECTOR OF WOMEN'S HEALTH 40.0 X 300528 46835 BRIAN BOATMAN MD CHF MED INFORMATICS OFFICER 40.0 X 249752 29835 JOSEPH VITTORIO MD MEDICAL DIRECTOR RECOVERY CTR 40.0 X 198076 13762 DAVID SEITZ MD DIRECTOR - RECOVERY CENTER 40.0 X 184744 35893 JOSEPH PINTO DIRECTOR OF PHARMACY 40.0 X 164554 35588 4130750 1738430 596244 226 false true false INPATIENT MEDICAL ASSOCIATES OF NY 3 CENTURY DRIVE PARSIPPANY NJ 07054 HOSPITALIST MD SVCS 3014376 HUDSON VALLEY OBSTETRICAL 258 HIGH AVENUE NYACK NY 10960 OBSTETRIC MD SERVICE 1732160 White Plains Hospital 41 East Post Road WHITE PLAINS NY 10601 NEONATAL MD SERVICES 522424 EPSTEIN BECKER GREEN PO BOX 30036 NEW YORK NY 10087 ATTORNEY FEES 468531 ERNST YOUNG PO BOX 640382 PITTSBURGH PA 15264 AUDIT SERVICES 424074 12 6945672 36999 6982671 PATIENT SERVICE REVENUE 621300 216888415 216888415 PROVISION FOR BAD DEBT 621300 -8311143 -8311143 208577272 97458 97458 0 0 588467 588467 0 588467 588467 12911 12911 12911 12911 0 0 0 EHR MEANINGFUL USE INCOME 900099 2056000 2056000 INSURANCE REFUNDS 900099 1539167 1539167 FOUNDATION INCOME 900099 383575 383575 2194019 2194019 6172761 222431540 210633272 4815597 0 0 0 0 3390479 3390479 0 0 92098097 85525150 6572947 6452636 5917694 534942 19674831 17918671 1756160 7386433 6647790 738643 6642117 5977905 664212 1878498 1690648 187850 375714 338143 37571 18681 16813 1868 0 0 9113086 8294701 818385 275988 248389 27599 9235882 8312294 923588 3088081 2779273 308808 0 2423978 2181580 242398 193408 174067 19341 0 310106 279095 31011 471556 424400 47156 334666 301199 33467 7265623 6539061 726562 1163405 1047064 116341 MEDICAL SUPPLIES 16373884 14736496 1637388 PHARMACEUTICAL 18361341 16525207 1836134 OTHER PURCHASED SERVICES 5485467 4936920 548547 LOSS FROM HPMC 4155474 3739927 415547 3059285 2753357 305928 219228716 197305844 21922872 0 0 0 2006675 1707538 0 2616244 24991762 23592950 0 0 0 0 0 0 2492246 3001400 403230 583433 170797368 129293692 38492113 41503676 0 0 0 0 0 0 0 0 7352706 3758198 75738732 76763439 35832753 35624363 0 0 1879776 2251864 0 0 0 0 0 0 9265436 7239192 0 0 30336652 24688178 77314617 69803597 X -1795384 6740343 0 0 219499 219499 -1575885 6959842 75738732 76763439 X 3202824 5332903 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 18681 18681 PART II-B, LINE 1I - OTHER ACTIVITIES DESCRIPTION NYACK HOSPITAL PAID DUES TO THE LOCAL 1199 - HEALTHCARE EDUCATION PROJECT (HEP), THE HEALTHCARE ASSOCIATION OF NEW YORK STATE (HANYS) AND THE HOME CARE ASOCIATION OF NYS (HCA). IN ACCORDANCE WITH SECTION 6033 (E) OF THE INTERNAL REVENUE CODE, AND AS REPORTED BY HEP, HANYS, NORMET AND HCA, A PORTION OF THESE DUES ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES. THE LOBBYING ACTIVITIES APPLICABLE TO 2013 HEP, HANYS and HCA ANNUAL DUES WAS $457, $15,866 AND $2,358 RESPECTIVELY. 219499 219499 219499 219499 219499 219499 219499 219499 219499 219499 1.00000 false false 651548 651548 49298164 25518970 23779194 153145 153145 109805975 101431914 8374061 10888536 2342808 8545728 41503676 0 ACCRUED POST RETIREMENT BENEFI 595900 MALPRACTICE LIABILITY 8654000 OTHER LIABILITIES 4366067 PENSION LIABILITY 6358729 THIRD PARTY LIABILITIES 4713482 24688178 PART V, LINE 4 - INTENDED USES OF ENDOWMENT FUND THE INTENDED USE OF THE HOSPITAL'S ENDOWMENT FUNDS IS TO PROVIDE FUNDS TO BE USED FOR UNINSURED WOMEN. true true true X true X true true true false true true 4564747 2269210 2295537 0.01050 46364025 31396936 14967089 0.06830 50928772 33666146 17262626 0.07880 84000 84000 0.00040 14800 14800 0.00010 28770492 22033638 6736854 0.03070 28869292 22033638 6835654 0.03120 79798064 55699784 24098280 0.11000 500 500 3000 3000 3500 3500 true 8311143 69159485 67038472 2121013 true true 1 1 Nyack Hospital 160 North Midland Ave Nyack NY 10960 http://www.nyackhospital.org/ X X X Nyack Hospital 1 true X X X X X X X X 13 true true true X X X X X X X X X true false true true 100 true 400. true X X X X X true true X X X X true false true X false false Part V, Line 3 Input from persons who represent the community Nyack Hospital works closely with the local Health Department in identifying the Prevention Agenda Priorities. Nyack Hospital is an active memember of the Rockland County Health Care Priorities Steering Committee which represnets twenty-two local community based organizations. Nyack Hospital and other members of this group conducted surveys and focus groups to obtain feedback from community members to identify unmet healthcare needs. Nyack Hospital collaborated with Rockland County Health Deparment's epidemiologist, who is responsible for developing the overall Rockland County Department of Health ("RCDOH") Community Health Needs Assessment to further define current status of hospital activiites addressing all five prevention agenda items and identifying further opportunities to improve the health of our community. Part V, Line 4 Other hospitals: Good Samaritan Hospital and Summit Park Hospital PART I, LINE 7 NYACK HOSPITAL'S COSTING METHODOLOGY WAS BASED UPON THE 2013 NEW YORK STATE INSTITUTIONAL COST REPORT AND THE 2013 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. PART III, LINES 2 and 4 THE AMOUNT REPORTED ON LINE 2 IS EQUAL TO THE PROVISION FOR BAD DEBTS PER THE AUDITED FINANCIAL STATEMENTS ("AFS"). THE EXPLANATION OF THE METHODOLOGY USED TO ESTIMATE THIS AMOUNT CAN BE FOUND IN FOOTNOTE 2 ON PAGE 10 OF THE ATTACHED AFS. PART III, LINE 8 THE AMOUNT REPORTED ON LINE 6 WAS DERIVED BY USING THE MEDICARE ALLOWABLE COSTS AS REPORTED ON THE HOSPITAL'S NEW YORK STATE INSTITUTIONAL COST REPORT AND THE APPLICABLE ADJUSTMENTS FROM WORKSHEET B. PART III, LINE 9B PURPOSE: TO RELIEVE THE ACCOUNTS RECEIVABLE OF ACCOUNTS DEEMED UNCOLLECTIBLE BY INTERNAL OR EXTERNAL PRE-COLLECTION PROCESSES. POLICY: TO REFER APPROPRIATE ACCOUNTS TO COLLECTION AGENCIES AND/OR THIRD PARTY BILLING AGENCIES AND TO INSURE AGENCY PRODUCTIVITIES IN ACCORDANCE WITH HOSPITAL POLICY. PROCEDURES: SECTION 1 -SMALL BALANCE WRITE OFF TO RELIEVE THE ACCOUNTS RECEIVABLE OF BALANCES WHICH ARE UNPROFITABLE TO PURSUE ON A MONTHLY BASIS. A. SMALL BALANCES IS DEFINED AS AN AMOUNT OF $24.99 AND LESS THAT IS CONSIDERED PATIENT LIABILITY. B. SMALL BALANCES MUST EXIST FOR 30 DAYS BEFORE THEY QUALIFY FOR WRITE-OFF. C. PATIENT MUST HAVE RECEIVED AT LEAST ONE STATEMENT. D. SMALL BALANCE INCLUDES CREDIT BALANCES OF $24.99 OR LESS (THIS AMOUNT WILL BE WRITTEN OFF SYSTEMATICALLY UNLESS PATIENT REQUESTS A REFUND). E. AT MONTH END SMALL BALANCE WRITE-OFF REPORT WILL BE PRODUCED FROM THE PARAGON SYSTEM FOR ALL ACCOUNTS SELECTED. F. A SEPARATE REPORT IS TO BE GENERATED FROM THE SYSTEM USING THE TRIAL BALANCE TO IDENTIFY ACCOUNTS NOT SELECTED SYSTEMATICALLY BY THE SYSTEM. SECTION 2 - BAD DEBT WRITE OFF PROCESS A. PATIENTS MUST RECEIVE A PRESCRIBED NUMBER OF STATEMENTS BEFORE BEING REFERRED TO COLLECTION (MINIMUM 3 STATEMENTS IN 120 DAYS UNLESS RETURNED MAIL FOR BAD ADDRESS OR PATIENT IS DECEASED). B. ACCOUNT BALANCE MUST RESIDE IN PATIENT BUCKET TO QUALIFY FOR BAD DEBT WRITE-OFF. C. A POTENTIAL BAD DEBT WRITE OFF REPORT IS PRODUCED ON A MONTHLY BASIS FOR ACCOUNTS THAT MAY BE MANUALLY TRANSFERRED TO THE BAD DEBT FILE. THIS LIST IS REVIEWED ACCOUNT BY ACCOUNT TO DELETE INAPPROPRIATE REFERRALS PRIOR TO WRITE OFF. D. PRE APPROVAL OF HIGH BALANCE WRITE-OFFS: GREATER THAN $5000.00 APPROVED BY SUPERVISOR, GREATER THAN $10,000.00 APPROVED BY MANAGER AND GREATER THAN $25,000.00 APPROVED BY ADMINISTRATOR. E. ACCOUNTS ARE REDUCED TO A SELF PAY RATE AND ARE REFERRED TO AGENCIES AT THIS RATE UNLESS OTHERWISE NOTED BASED ON DISCUSSIONS WITH THE PATIENT OR DESIGNATED REPRESENTATIVE. F. AT MONTH END, A CUMULATIVE BAD DEBT REPORT CONTAINING ALL WRITE-OFFS IN THAT CALENDAR MONTH WILL BE CREATED ALONG WITH AGENCY REFERRAL FILE. G. THE CUMULATIVE WRITE OFF TOTAL FOR ANY CALENDAR MONTH MUST BE APPROVED BY THE MANAGER IN CONJUNCTION WITH THE ADMINISTRATORS OF PATIENT FINANCIAL SERVICES AND FINANCE. SECTION 3 -COLLECTION AGENCY A. REFERRALS 1. ACCOUNTS ARE REFERRED SYSTEMATICALLY AND BY ALPHA BREAKDOWN WITHIN PATIENT TYPE TO AGENCIES ON AN EQUITABLE DISTRIBUTION. THE AGENCIES RECEIVE A FILE AND ALSO A COMPUTER GENERATED LIST OF ACCOUNTS. 2. ACCOUNTS REFERRED TO AGENCIES MAY BE AT THE SELF-PAY RATES ESTABLISHED IN THE CHARITY CARE POLICY. 3. SECONDARY REFERRALS MAY BE ASSIGNED TO SELECTED AGENCIES AFTER PRIMARY AGENCY CLOSEOUT. 4. AGENCIES MUST ADHERE TO HOSPITAL FINANCIAL ASSISTANCE (CHARITY CARE) POLICIES. 5. AGENCIES WILL PERFORM ASSET TEST ON ALL ACCOUNTS EXCEEDING $1,500. B. REPORTING 1. AGENCIES SEND ACKNOWLEDGEMENT REPORTS, WHICH ARE RECONCILED AGAINST THE REFERRALS (NUMBER OF ACCOUNTS, DOLLAR AMOUNT). 2. AGENCIES SUBMIT STATUS REPORTS ON A MONTHLY BASIS, WHICH ARE RECONCILED TO DETAILED REPORT TO INSURE THE ACCURACY OF THE BAD DEBT FILE. 3. A REMITTANCE REPORT ACCOMPANIES THE CHECK THE AGENCY SENDS WHICH REPORTS ALL PAYMENTS COLLECTED. THIS IS RECONCILED TO THE PAYMENTS POSTED TO THE PARAGON SYSTEM IN THE BAD DEBT FILE. 4. CLOSE OUT REPORT IS A LIST OF ALL THE ACCOUNTS THAT THE AGENCIES DEEM UNCOLLECTIBLE. WE ASSIGN SECONDS FROM THE CLOSE OUT REPORT OR WE CLOSE OUT THE ACCOUNTS. 5. IF AN ACCOUNT IS REFERRED BY A COLLECTION AGENCY FOR LEGAL ACTION, IT MUST BE APPROVED BY THE MANAGER OR ADMINISTRATOR OF THE PATIENT FINANCIAL SERVICES DEPARTMENT. 6. A RECONCILIATION REPORT MAY BE REQUESTED TO CORRELATE OUR A/R AGAINST AGENCY A/R. 7. A PLACEMENT ANALYSIS REPORT IS REQUIRED ON A MONTHLY BASIS FROM EACH AGENCY DETAILING ITS COLLECTION PERFORMANCE YEAR TO DATE BY REFERRAL DATE AND PRODUCT LINE (I.E.: INPATIENT, OUTPATIENT, INPATIENT SECONDS, ETC.), FOR THE CURRENT CALENDAR YEAR AND THE PRIOR YEARS CALENDAR REFERRALS. SECTION 4 -DEPARTMENTAL WORKFLOWS A. ACCOUNTS ARE REFERRED TO BAD DEBT SYSTEMATICALLY (ALPHA BREAKDOWN WITHIN PATIENT TYPE). B. THE REPRESENTATIVE DESIGNATED AS THE LIAISON WITH THE COLLECTION AGENCIES, AND REVIEWS APPROPRIATELY ADDRESSED OR REFERRED TO AGENCY CORRESPONDENCE PERTAINING TO BAD DEBT. C. AGENCY LIAISON SCREENS PATIENT INQUIRIES RELATING TO BAD DEBT ACCOUNTS AND REFERS TO APPROPRIATE AGENCY. SECTION 5 -LIAISON INTERDISCIPLINARY WORKFLOWS A. INTERACTS WITH AGENCIES TO OBTAIN ACCOUNT STATUS. B. INTERACTS WITH OTHER PATIENT FINANCIAL SERVICE SECTIONS TO INSURE THE ACCURACY OF THE BAD DEBT FILE. C. REVIEWS AND RECONCILES ALL AGENCY REPORTS INCLUDING REMITTANCE REPORT; SUPPORTS AND DIRECTS ACTIVITY OF AGENCY LIAISON. SECTION 6 -END OF MONTH REPORTS A. CUMULATIVE BAD DEBT WRITE OFF FROM ACCOUNTS RECEIVABLE TO BAD DEBT BY AGENCY. B. CUMULATIVE BAD DEBT WRITE OFF FROM ACCOUNTS RECEIVABLE TO BAD DEBT BY FINANCIAL CLASS. C. COLLECTION AGENCY STATISTIC REPORT FOR THE FILE. D. TAPE GENERATED BY INFORMATION TECHNOLOGY GIVEN TO AGENCIES. PART V, LINE 20 WE USE MEDICAID RATES FOR INPATIENT MEDICARE RATES FOR OUTPATIENT. PART VI PURSUANT TO NEW YORK STATE PUBLIC HEALTH LAW SECTION 2803-L, NYACK HOSPITAL ("NYACK") IS REQUIRED TO FILE A COMPREHENSIVE COMMUNITY SERVICE PLAN ("CSP") WITH THE NEW YORK STATE DEPARTMENT OF HEALTH ("DOH") EVERY 3 YEARS. A COPY OF NYACK'S CSP CAN BE FOUND ON THE HOSPITAL'S WEBSITE AT WWW.NYACKHOSPITAL.ORG UNDER THE "ABOUT US" TAB. THE COMPREHENSIVE DATA AND INFORMATION CONTAINED IN THIS CSP WILL EXHAUSTIVELY ADDRESS PART VI OF THIS SCHEDULE H, AND ITS CONTENTS ARE INCORPORATED HEREIN BY REFERENCE. SPECIFICALLY, THE NYACK CSP WILL ADDRESS THE PART VI (2) NEEDS ASSESSMENT; PART VI (3) PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE; PART VI (4) COMMUNITY INFORMATION; PART VI (5) COMMUNITY BUILDING ACTIVITIES AND PART VI (6) TO (7), AS APPLICABLE. THE TEXT OF NEW YORK STATE PUBLIC HEALTH LAW SECTION 2803-L IS AS FOLLOWS: COMMUNITY SERVICE PLANS. (1) THE GOVERNING BODY OF A VOLUNTARY NON-PROFIT GENERAL HOSPITAL MUST ISSUE AN ORGANIZATIONAL MISSION STATEMENT IDENTIFYING AT A MINIMUM THE POPULATIONS AND COMMUNITIES SERVED BY THE HOSPITAL AND THE HOSPITAL'S COMMITMENT TO MEETING THE HEALTH CARE NEEDS OF THE COMMUNITY. (2) THE GOVERNING BODY MUST AT LEAST EVERY THREE YEARS: (I) REVIEW AND AMEND AS NECESSARY THE HOSPITAL MISSION STATEMENT; (II) SOLICIT THE VIEWS OF THE COMMUNITIES SERVED BY THE HOSPITAL ON SUCH ISSUES AS THE HOSPITAL'S PERFORMANCE AND SERVICE PRIORITIES; (III) DEMONSTRATE THE HOSPITAL'S OPERATIONAL AND FINANCIAL COMMITMENT TO MEETING COMMUNITY HEALTH CARE NEEDS, TO PROVIDE CHARITY CARE SERVICES AND TO IMPROVE ACCESS TO HEALTH CARE SERVICES BY THE UNDERSERVED; AND (IV) PREPARE AND MAKE AVAILABLE TO THE PUBLIC A STATEMENT SHOWING ON A COMBINED BASIS A SUMMARY OF THE FINANCIAL RESOURCES OF THE HOSPITAL AND RELATED CORPORATIONS AND THE ALLOCATION OF AVAILABLE RESOURCES TO HOSPITAL PURPOSES INCLUDING THE PROVISION OF FREE OR REDUCED CHARGE SERVICES. (3) THE GOVERNING BODY MUST AT LEAST ANNUALLY PREPARE AND MAKE AVAILABLE TO THE PUBLIC AN IMPLEMENTATION REPORT REGARDING THE HOSPITAL'S PERFORMANCE IN MEETING THE HEALTH CARE NEEDS OF THE COMMUNITY, PROVIDING CHARITY CARE SERVICES, AND IMPROVING ACCESS TO HEALTH CARE SERVICES BY THE UNDERSERVED. (4) THE GOVERNING BODY SHALL FILE WITH THE COMMISSIONER ITS MISSION STATEMENT, ITS ANNUAL IMPLEMENTATION REPORT, AND AT LEAST EVERY THREE YEARS A REPORT DETAILING AMENDMENTS TO THE STATEMENT AND REFLECTING CHANGES IN THE HOSPITAL'S OPERATIONAL AND FINANCIAL COMMITMENT TO MEETING THE HEALTH CARE NEEDS OF THE COMMUNITY, PROVIDING CHARITY CARE SERVICES, AND IMPROVING ACCESS TO HEALTH CARE SERVICES BY THE UNDERSERVED. THE ABOVE-REFERENCED CSP REQUIREMENT WAS ENHANCED BY THE DOH'S PREVENTION AGENDA INITIATIVE. THIS INITIATIVE IS A PROCESS THAT ASKS HOSPITALS SUCH AS NYACK TO WORK WITH LOCAL 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 NYACK'S CSP UPDATE SUBMITTED TO DOH. INFORMATION ON THE NEW YORK STATE DOH PREVENTION AGENDA CAN BE FOUND AT WWW.HEALTH.STATE.NY.US/PREVENTION/PREVENTION_AGENDA. PART VI ALL PATIENTS RECEIVE A FINANCIAL AID SUMMARY THAT EXPLAINS NYACK HOSPITAL'S FINANCIAL AIDE PROGRAM. ALTHOUGH OBLIGATED TO OFFER ASSISTANCE TO PATIENTS WITH INCOMES LESS THEN 300% OF THE FEDERAL POVERTY LEVEL (FPL), NYACK HOSPITAL CONSIDERS ALL PATIENTS WHO RECEIVE EMERGENCY OR MEDICALLY NECESSARY NON-EMERGENCY CARE WITH INCOMES LESS THAN 400% OF THE FEDERAL POVERTY LEVEL. NYACK HOSPITAL WILL CONSIDER PATIENTS FOR FIANANCIAL AID WHO RESIDE OUTSIDE OF ITS SERVICE AREA ON AN EXCEPTION BASIS. PART VI NYACK HOSPITAL DEFINES ITS TOTAL SERVICE AREA FOR THE PURPOSES OF COMMUNITY/LOCAL HEALTH PLANNING AS ALL OF ROCKLAND, WESTCHESTER, ORANGE AND PUTNAM COUNTIES. NINE ROCKLAND, COMMUNITIES COMPRISE THE HOSPITAL'S PRIMARY SERVICE AREA. SEE COMMUNITY SERVICE PLAN FOR DELINEATION OF PRIMARY AND SECONDARY SERVICE AREAS. PART VI NYACK HOSPITAL WAS A MAJOR PARTICIPANT IN THE COMMUNITY HEALTH ASSESSMENT (CHA) PROCESS CONDUCTED BY ROCKLAND COUNTY. THE ADMINISTRATOR OF HOME CARE AND COMMUNITY SERVICES AND THE COORDINATOR OF PATIENT/COMMUNITY EDUCATION ARE STANDING MEMBERS OF THE ROCKLAND COUNTY PUBLIC HEALTH PRIORITIES (PHP) STEERING COMMITTEE. THE PURPOSE OF THIS COMMITTEE IS TO DETERMINE THE EXTENT TO WHICH EXISTING PRIORITIES ARE BEING MET, TO ASSESS THE NEED FOR NEW/REVISED PRIORITIES, AND TO COLLABORATE WITH OTHER HEALTH PROVIDERS/ORGANIZATIONS IN ORDER TO IMPLEMENT PROGRAMS AND SERVICES THAT WILL MEET THE IDENTIFIED NEEDS. THE COMMITTEE SERVES AS A GUIDE TO THE DEVELOPMENT OF THE CHA. THE PHP COMMITTEE IS COMPOSED OF REPRESENTATIVES FROM: -COUNTY DEPARTMENTS OF HEALTH, SOCIAL SERVICES, MENTAL HEALTH, AS WELL AS THE OFFICES FOR AGING, COMMUNITY RELATIONS, AND PEOPLE WITH DISABILITIES. -COMMUNITY BASED AGENCY REPRESENTATIVES FROM THE AMERICAN CANCER SOCIETY, IMMIGRATION COALITION, VOLUNTEER COUNSELING SERVICES, AMERICAN HEART ASSOCIATION AND A NUMBER OF OTHER NON-PROFITS. -LOCAL HOSPITALS (NYACK, GOOD SAMARITAN) -4 FEDERALLY QUALIFIED HEALTH CENTERS -2 LOCAL COLLEGES (DOMINICAN AND ROCKLAND COUNTY COMMUNITY) THE FULL COMMITTEE MEETS MONTHLY AND SUB-COMMITTEE MEETINGS ARE HELD AS NEEDED. AN OUTCOME OF THIS COMMITTEE WAS A 2008 COUNTY NEEDS ASSESSMENT, WHICH SERVED AS A STARTING POINT FOR THE COUNTY'S 2010-2013 COMMUNITY HEALTH ASSESSMENT. IN ADDITION TO HAVING REPRESENTATIVES ACTIVELY PARTICIPATE ON THE PHP COMMITTEE, NYACK HOSPITAL COLLABORATED WITH THE COUNTY HEALTH DEPARTMENT TO IMPLEMENT 3 PROVIDER AND CONSUMER FOCUS GROUPS AS PART OF THE CHA PROCESS. DETAILS ARE PROVIDED IN THE COMMUNITY SERVICE PLAN. PART VI NEW YORK. X X X X X X false true false false false false false false false DAVID H FREED PRESIDENT & CEO 530352 19469 88809 15300 0 13094 0 667024 0 0 0 MARY K SHINICK ASSISTANT SECRETARY 217202 8533 40200 15300 0 22548 0 303783 0 0 0 RICHARD GEMMING BOARD MEMBER 0 356121 0 80766 0 19100 0 17474 0 20442 0 493903 WAYNE M OSTEN BOARD MEMBER 0 526570 0 342419 0 413454 0 17699 0 21333 0 1321475 0 205555 MICHAEL RADER MD VP & MEDICAL DIRECTOR 338716 14629 67847 15300 0 23059 0 459551 0 0 0 JOHN S BURKE VP & CFO 340874 12676 41531 7650 0 32983 0 435714 0 0 0 JOHN VOLANTO VP & CHIEF INFORMATION OFFICER 230901 10656 49414 15300 0 13066 0 319337 0 0 0 DENISE ZBAR VP - Physician Practice Mgmt 190442 9000 21545 12868 0 32250 0 266105 0 0 0 RONALD RATIGAN DIRECTOR OF FINANCE 148035 0 35492 11070 0 32031 0 226628 0 0 0 CELESTE BETHON CHIEF NURSING OFFICER 140328 7616 20248 9040 0 12088 0 189320 0 0 0 ALFREDO WALDRON ADMIN OF PATIENT FINANCIAL SVC 148400 0 28679 10628 0 21839 0 209546 0 0 0 ALICE VALLEN CRONIN CH SYS & REENGINEERING OFFICER 148061 0 20191 10124 0 31845 0 210221 0 0 0 PATRICIA JOSEPH MD DIRECTOR OF WOMEN'S HEALTH 254970 0 45558 15300 0 31535 0 347363 0 0 0 BRIAN BOATMAN MD CHF MED INFORMATICS OFFICER 195566 0 54186 7500 0 22335 0 279587 0 0 0 JOSEPH VITTORIO MD MEDICAL DIRECTOR RECOVERY CTR 187759 0 10317 11862 0 1900 0 211838 0 0 0 DAVID SEITZ MD DIRECTOR - RECOVERY CENTER 164364 0 20380 5562 0 30331 0 220637 0 0 0 JOSEPH PINTO DIRECTOR OF PHARMACY 135660 0 28894 4965 0 30623 0 200142 0 0 0 PART III - ADDITIONAL INFORMATION Certain officers and key employees of the New York Presbyterian Hospital that are identified in part VII as officers or trustees of Nyack Hospital are responsible for executing the mission and management of the New York Presbyterian Hospital (NYP) and its affiliated entities. Compensation for 2013 of these upper level executives includes the payout of an annual incentive plan and a long-term incentive plan. This performance-oriented program conditions payments upon the achievement of multiple individual and group performance measures. Measures to monitor performance include: operational and financial strength, patient quality and safety, patient satisfaction, advancement of patient care, and people development and partnership. Incentive awards may only be granted if the organization achieves a financial surplus. Even if all relevant performance measurements are achieved, the NYP Board of Trustees retains full discretion to make or not make any incentive awards, or to reduce the amount of any incentive award. This initiative is critical to assuring that NYP has the requisite leadership to create and manage a highly motivated and engaged workforce, to drive superior performance throughout the organization and to achieve top tier medical center status. As a separate matter, due to restrictions imposed by the Internal Revenue Code, upper level executives are limited in the amount of benefits received under a tax-qualified retirement plan. Like many employers, NYP supplements these executives' pension benefits through a supplemental ("nonqualified") retirement plan. The supplemental executive retirement plan (SERP) is subject to a multi-year vesting requirement (commencing after five years of participation in the SERP, in prorated amounts through age 65) which places an executive's supplemental retirement benefit at risk of forfeiture if the vesting requirements are not satisfied. Once vested, however, provisions of the Internal Revenue Code require that the vested executive include in current income the value of his or her vested supplemental retirement benefit. Notwithstanding the legal requirement to recognize the vested value of the supplemental retirement benefit as current income, the supplemental retirement benefit will not be distributed to the executive until the executive actually retires from NYP (although, as permitted by the Internal Revenue Code, the supplemental retirement plan will effect a distribution of an amount necessary to satisfy the executive's tax liability resulting from the income recognition upon vesting). As noted, this supplemental retirement benefit will not be distributed to the executive until the executive actually retires from NYP. There are constantly changing legal, tax, accounting, and public disclosure rules for a SERP (supplemental executive retirement plan) in not-for-profit organizations. The executive Compensation Committee continuously monitors these changes and incorporates any changes into the overall SERP plan design. As in past years, the executive Compensation Committee of NYP requires a third party complete a review of the organization's compensation program to ensure its effectiveness in terms of government regulations, market conditions and the need to continually elevate organizational performance. The report also serves to meet the regulatory obligations to ensure that all elements of the executive compensation programs are reasonable. The individuals listed in part VII that are compensated by New York Presbyterian Hospital devote an average of sixty hours per week to perform their responsibilities for the New York Presbyterian Hospital and other related organizations in the aggregate. HOLT CONSTRUCTION TRUSTEE SPOUSE IS PRESIDE 703404 Construction Project false FORM 990, PART VI, LINE 6 NYACK HOSPITAL (THE "ORGANIZATION") IS A MEMBERSHIP CORPORATION, WHOSE MEMBERS ARE APPOINTED BY NEW YORK-PRESBYTERIAN HEALTHCARE SYSTEM, INC.("SYSTEM INC."). SYSTEM INC. IS A TAX-EXEMPT ORGANIZATION WHOSE MEMBERS ARE APPOINTED BY NEW YORK PRESBYTERIAN FOUNDATION,INC., WHICH IS ALSO A TAX-EXEMPT ORGANIZATION. THE MEMBERS OF THE ORGANIZATION ELECT THE ORGANIZATION'S BOARD OF TRUSTEES. FORM 990, PART VI, LINE 7A AS SOLE CORP MEMBER, NEW YORK-PRESBYTERIAN HEALTHCARE SYSTEM, INC. DESIGNATED THE INITIAL MEMBERS, THEREAFTER, MEMBERS SHALL BE APPOINTED IN ACCORDANCE WITH THE NYACK BYLAWS. FORM 990, PART VI, LINE 7B NEW YORK-PRESBYTERIAN HEALTHCARE SYSTEM, INC. ("SYSTEM INC.") IS THE SOLE MEMBER OF NYACK HOSPITAL. SYSTEM INC. HAS THE RESPONSIBILITY TO PROVIDE OVERSIGHT AND TO ASSIST IN THE LONG TERM PLANNING FOR THE BENEFIT OF BOTH NYACK HOSPITAL AND SYSTEM INC. SUCH POWERS AND RESPONSIBILITIES INCLUDE THE PERIODIC REVIEW OF NYACK HOSPITAL'S FINANCIAL POSITION, ITS COMPLIANCE WITH LEGAL AND REGULATORY REQUIREMENTS, AND EVALUATION OF ITS PROGRAMS IN AN EFFORT TO ENSURE THE EXEMPT PURPOSE OF BOTH SYSTEM INC. AND NYACK HOSPITAL ARE BEING FULFILLED. SYSTEM INC. AND NYACK HOSPITAL WILL ALSO COORDINATE EFFORTS TO RECRUIT AND MAINTAIN SELECT KEY MANAGEMENT PERSONNEL AND PHYSICIANS. IN THE EVENT OF A VACANCY, SYSTEM INC. WILL BE PROVIDED THE OPPORTUNITY TO ASSIST IN A SEARCH COMMITTEE TO FILL SUCH VACANCY. ALL DAILY OPERATING AND MANAGEMENT DECISIONS ARE RETAINED BY NYACK HOSPITAL. FORM 990, PART VI, LINE 11B THE ACCOUNTING MANAGER, DIRECTOR OF FINANCE, AND THE ENTIRE FINANCE TEAM ARE VERY INVOLVED IN THE PREPARATION AND REVIEW OF THE FORM 990. ONCE THE DIRECTOR OF FINANCE HAS COMPLETED HIS REVIEW, THE CFO REVIEWS THE FORM 990 IN DETAIL, INCLUDING ALL SCHEDULES. THE FORM 990 WAS THEN UPLOADED TO THE NYACK HOSPITAL WEBSITE FOR THE FULL BOARD REVIEW IN THE "BOARD ONLY" SECTION. ONLY BOARD MEMBERS CAN ACCESS WITH A PASSWORD. FORM 990, PART VI, LINE 12C IN AN EFFORT TO ENSURE THAT ALL TRANSACTIONS OCCURRING BETWEEN THE ORGANIZATION AND A THIRD PARTY DO NOT INURE TO THE BENEFIT OF ANY INDIVIDUAL OR CORPORATION, NYACK HOSPITAL MAINTAINS A CONFLICT OF INTEREST POLICY. UNDER THIS POLICY, OFFICERS, TRUSTEES AND EMPLOYEES MUST DISCLOSE ANY RELATIONSHIPS THAT MAY RESULT IN CONFLICT DUE TO TRANSACTIONS OCCURRING BETWEEN THE ORGANIZATION AND AN INDIVIDUAL. ALL EMPLOYEES AND TRUSTEES HAVE A DUTY TO DISCLOSE ANY FINANCIAL INTEREST WHICH MAY POSE A CONFLICT WITH THEIR HOSPITAL RESPONSIBILITIES. THIS DISCLOSURE IS CONFIRMED BY THE DISTRIBUTION OF A QUESTIONNAIRE ON AN ANNUAL BASIS. IN COMPLETING THE QUESTIONNAIRE, THE EMPLOYEE OR TRUSTEE IS RESPONSIBLE FOR DISCLOSING HIS OR HER RELATIONSHIP TO ANY ENTITY DOING BUSINESS WITH THE ORGANIZATION UNLESS SUCH INTEREST DOES NOT REPRESENT A SIGNIFICANT PORTION OF THE INDIVIDUAL'S NET WORTH. ADDITIONALLY, SHOULD THE EMPLOYEE OR TRUSTEE BECOME AWARE OF SUCH A RELATIONSHIP SUBSEQUENT TO THE ADMINISTRATION OF THE OUESTIONNAIRE, HE OR SHE SHOULD DISCLOSE THE RELATIONSHIP TO THE APPROPRIATE DEPARTMENT HEAD OR COMMITTEE CHAIRPERSON. IN THE EVENT OF A POTENTIAL CONFLICT, THE INDIVIDUAL IS ASKED TO ABSTAIN FROM PARTICIPATING IN ANY DECISIONS RELATED TO THE TRANSACTION IN QUESTION UNTIL THE ORGANIZATION CAN DETERMINE IF A CONFLICT OF INTEREST EXISTS AND MAKES AN APPROPRIATE DECISION TO DETERMINE HOW THE CONFLICT WILL BE RESOLVED. FORM 990, PART VI, LINE 15A THE COMPENSATION OF THE CHIEF EXECUTIVE OFFICER AND SENIOR EXECUTIVES IS REVIEWED ANNUALLY BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. AN INDEPENDENT OUTSIDE CONSULTANT WITH EXPERTISE IN HOSPITAL EXECUTIVE COMPENSATION ASSESSES THE EXECUTIVE COMPENSATION AS COMPARED TO SIMILAR POSITIONS IN THE NEW YORK AREA AND RECOMMENDS A RANGE. THE COMMITTEE SETS THE EXECUTIVE COMPENSATION FOR THE COMING YEAR WITHIN THE FAIR MARKET VALUE RANGE RECOMMENDED BY THE CONSULTANT. BOARD DECISIONS ARE CONTEMPORANEOUSLY DOCUMENTED IN BOARD MINUTES. FORM 990, PART VI, LINE 15B THE COMPENSATION OF THE OFFICERS AND KEY EMPLOYEES IS REVIEWED ANNUALLY BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. AN INDEPENDENT OUTSIDE CONSULTANT WITH EXPERTISE IN HOSPITAL EXECUTIVE COMPENSATION ASSESSES THE COMPENSATION AS COMPARED TO SIMILAR POSITIONS IN THE NEW YORK AREA AND RECOMMENDS A RANGE. THE COMMITTEE SETS THE COMPENSATION FOR THE COMING YEAR WITHIN THE RANGE RECOMMENDED BY THE CONSULTANT. BOARD DECISIONS ARE CONTEMPORANEOUSLY DOCUMENTED IN BOARD MINUTES. FORM 990, PART VI, LINE 19 UPON REQUEST, THE ORGANIZATION WILL MAKE AVAILABLE ONLY THOSE DOCUMENTS REQUIRED TO BE DISCLOSED UNDER THE PUBLIC INSPECTION LAWS. FORM 990, PART VII Certain officers and key employees of the New York Presbyterian Hospital that are identified in part VII as officers or trustees of Nyack Hospital are responsible for executing the mission and management of the New York Presbyterian Hospital (NYP) and its affiliated entities. Compensation for 2013 of these upper level executives includes the payout of an annual incentive plan and a long-term incentive plan. This performance-oriented program conditions payments upon the achievement of multiple individual and group performance measures. Measures to monitor performance include: operational and financial strength, patient quality and safety, patient satisfaction, advancement of patient care, and people development and partnership. Incentive awards may only be granted if the organization achieves a financial surplus. Even if all relevant performance measurements are achieved, the NYP Board of Trustees retains full discretion to make or not make any incentive awards, or to reduce the amount of any incentive award. This initiative is critical to assuring that NYP has the requisite leadership to create and manage a highly motivated and engaged workforce, to drive superior performance throughout the organization and to achieve top tier medical center status. As a separate matter, due to restrictions imposed by the Internal Revenue Code, upper level executives are limited in the amount of benefits received under a tax-qualified retirement plan. Like many employers, NYP supplements these executives' pension benefits through a supplemental ("nonqualified") retirement plan. The supplemental executive retirement plan (SERP) is subject to a multi-year vesting requirement (commencing after five years of participation in the SERP, in prorated amounts through age 65) which places an executive's supplemental retirement benefit at risk of forfeiture if the vesting requirements are not satisfied. Once vested, however, provisions of the Internal Revenue Code require that the vested executive include in current income the value of his or her vested supplemental retirement benefit. Notwithstanding the legal requirement to recognize the vested value of the supplemental retirement benefit as current income, the supplemental retirement benefit will not be distributed to the executive until the executive actually retires from NYP (although, as permitted by the Internal Revenue Code, the supplemental retirement plan will effect a distribution of an amount necessary to satisfy the executive's tax liability resulting from the income recognition upon vesting). As noted, this supplemental retirement benefit will not be distributed to the executive until the executive actually retires from NYP. There are constantly changing legal, tax, accounting, and public disclosure rules for a SERP (supplemental executive retirement plan) in not-for-profit organizations. The executive Compensation Committee continuously monitors these changes and incorporates any changes into the overall SERP plan design. As in past years, the executive Compensation Committee of NYP requires a third party complete a review of the organization's compensation program to ensure its effectiveness in terms of government regulations, market conditions and the need to continually elevate organizational performance. The report also serves to meet the regulatory obligations to ensure that all elements of the executive compensation programs are reasonable. The individuals listed in part VII that are compensated by New York Presbyterian Hospital devote an average of sixty hours per week to perform their responsibilities for the New York Presbyterian Hospital and other related organizations in the aggregate. OTHER CHANGES IN NET ASSETS OR FUND BALANCES Change in pension and postretirement liabilities other than net periodic benefit cost $ 5,332,903. FORM 990, PART III, LINE 4A - PROGRAM SERVICES CONTINUED FROM 990, PAGE 2: FOR THE YEAR ENDED DECEMBER 31, 2013, NYACK HOSPITAL PROVIDED $18,590,669 IN INDIGENT AND CHARITY WRITE-OFFS UNDER ITS CHARITY CARE POLICY. NYACK HOSPITAL ALSO PROVIDES 24 HOUR EMERGENCY DEPARTMENT SERVICES. FOR 2012, NYACK HOSPITAL HAD 59,163 EMERGENCY DEPARTMENT VISITS. 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