2014-11-14T08:21:19-06:00 2013-12-31 990 2013-01-01 111562701 NORTH SHORE UNIVERSITY HOSPITAL C/O NORTH SHORE-LIJ HEALTH SYSTEM % NORTH SHORE-LIJ HEALTH SYSTE NORT 5168766061 972 BRUSH HOLLOW ROAD Suite 5TH FL WESTBURY NY 11590 ROBERT S SHAPIRO EXEC VP & CFO 2014-10-28 2013 2015-11-30 17:44:51Z MICHAEL J DOWLING 145 COMMUNITY DRIVE GREAT NECK NY 11021 2402479357 false X WWW.NORTHSHORELIJ.COM X 1955 NY North Shore 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. 124 115 10644 1115 0 -250 20362702 18541976 1750318137 1767323380 16773713 40765401 25669176 46305970 1813123728 1872936727 0 0 0 0 1076075952 1051720949 0 0 1933732 659575504 688692492 1735651456 1740413441 77472272 132523286 1860557321 1952851897 1126727875 1065111867 733829446 887740030 X NORTH SHORE UNIVERSITY HOSPITAL IS PART OF THE NORTH SHORE-LIJ HEALTH SYSTEM ("THE SYSTEM"), WHICH STRIVES TO IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES AND IS COMMITTED TO PROVIDING THE HIGHEST QUALITY CLINICAL CARE; EDUCATING THE CURRENT AND FUTURE GENERATIONS OF HEALTHCARE PROFESSIONALS; SEARCHING FOR NEW ADVANCES IN MEDICINE THROUGH THE CONDUCT OF BIOMEDICAL RESEARCH; PROMOTING HEALTH EDUCATION; AND CARING FOR THE ENTIRE COMMUNITY REGARDLESS OF THE ABILITY TO PAY. false false 838826368 0 1210969899 NORTH SHORE UNIVERSITY HOSPITAL ("NSUH")IS AN 804-BED QUATERNARY CARE TEACHING HOSPITAL THAT SERVES AS THE CLINICAL CAMPUS FOR THE HOFSTRA NORTH SHORE-LIJ SCHOOL OF MEDICINE. NSUH is a major cardiac diagnostic, interventional and open heart surgical center. The hospital offers the largest cancer patient care, medical research and education network on Long Island. In 2013, NSUH had 45,899 inpatient discharges, delivered 5,907 babies, provided 86,170 emergency department visits and performed 22,336 ambulatory surgeries, including endoscopies and outpatient catheterizations. 422408515 0 270166104 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. 92228778 0 100607512 Syosset Hospital is a 103-bed community hospital that maintains a 911 response Emergency Department and inpatient services, including an intensive care unit, and telemetry unit, which serves as a surgical step-down unit. In 2013, the hospital had 3,413 inpatient discharges, provided 15,908 Emergency Department visits and performed 14,097 ambulatory surgeries. 174657736 0 185579865 OTHER 174657736 0 185579865 1528121397 true true false true false false false false false true true false false true true true false true false false true false false false false true true true false false true true false false false false false false false false false false false false false false true true true false false false true 270 3 true 10644 true true true true CJ UK false false false false false false false false false false false X 124 115 true false false false false true true true true false false true true true true true true true true false NY X X NORTH SHORE-LIJ HEALTH SYSTE 5168766061 972 BRUSH HOLLOW RD WESTBURY NY 11590 MICHAEL J DOWLING PRESIDENT & CEO 50.0 X X 0 3117843 1222774 RICHARD D GOLDSTEIN CHAIRMAN 3.0 X X 0 0 0 WILLIAM L MACK VICE CHAIRMAN 2.0 X X 0 0 0 BARRY RUBENSTEIN VICE CHAIRMAN 2.0 X X 0 0 0 ALAN I GREENE TREASURER 2.0 X X 0 0 0 DONALD ZUCKER SECRETARY 2.0 X X 0 0 0 MARK CLASTER CHAIRMAN ELECT 3.0 X X 0 0 0 NON COMPENSATED TRUSTEES SEE SCHEDULE O 2.0 X 0 0 0 RALPH NAPPI TRUSTEE AND PRES NSLIJ FOUND. 50.0 X 0 856799 48881 LAURA PEABODY SVP & CHIEF LEGAL COUNSEL 50.0 X 0 261869 43150 KEVIN F LAWLOR TRUSTEE AND PRES/CEO HUNT HOSP 50.0 X 0 713588 286966 HOWARD GOLD EVP MANAGED CARE, BUSINESS DEV 50.0 X 0 3456217 327498 MARK J SOLAZZO EVP, CHIEF OPERATING OFFICER 50.0 X 0 1894904 325554 ROBERT S SHAPIRO EVP, CHIEF FINANCIAL OFFICER 50.0 X 0 1199086 243156 LAWRENCE G SMITH EVP/PHYSICIAN IN CHIEF 50.0 X 0 913047 707681 KEITH THOMPSON SR VP & GENERAL COUNSEL 50.0 X 0 876784 50350 JEFFREY KRAUT SR VP STRATEGIC PLANNING 50.0 X 0 924283 213431 KATHLEEN GALLO RN PHD SR VP & CHF LEARNING OFFICER 50.0 X 0 2753320 294275 DONNA DRUMMOND SVP, CHIEF ADMIN OFFICER 50.0 X 0 645712 43150 HARRY GINDI ASSISTANT SECRETARY 50.0 X 0 314462 43150 ANDREW SCHULZ ASST SECRETARY, GEN COUNSEL 50.0 X 0 522928 43150 SUSAN SOMERVILLE EXECUTIVE DIRECTOR 50.0 X 934130 0 319450 EUGENE TANGNEY REGIONAL EXECUTIVE DIRECTOR 50.0 X 0 977942 158960 FRANK RIZZO CFO TERTIARY HOSPITAL 50.0 X 606390 0 43150 ALAN HARTMAN MED SCHOOL CHAIR CTS 50.0 X 2020099 0 50350 RAJ NARAYAN MED SCHOOL CHAIR NEUROSURGERY 50.0 X 1494626 0 43150 STANLEY KATZ MED SCHOOL CHAIR CARDIOLOGY 50.0 X 1764446 0 50350 MICHAEL KIM DIR, INTERVENTIONAL CARDIOLOGY 50.0 X 1513721 0 43150 RICK ESPOSITO ASSOC CHAIRPERSON 50.0 X 1644045 0 43150 9977457 19428784 4644876 1794 false true false GE HEALTHCARE 80 E SEAVIEW BLVD PORT WASHINGTON NY 11050 EQUIPMENT SERVICE 5873089 ABLE HEATLH CARE PROFESSIONALS 1240 BROADCAST PL MERRICK NY 11566 HOME HEALTH CARE 3830350 CARING PROFESSIONALS 70-20 AUSTIN ST FOREST HILLS NY 11375 HOME HEALTH CARE 2187635 OLYMPUS AMERICA INC 3500 CORPORATE PKWY CENTER VALLEY PA 18034 MEDICAL SERVICES 1622120 ALLEN HEALTH CARE SERVICE 70-00 AUSTIN ST FOREST HILLS NY 11375 HOME HEALTH CARE 1535712 86 5741229 12708470 92277 18541976 NET PATIENT SERV. 621300 1166267460 1166267460 FACULTY PRACTICE 621300 282556640 282556640 MEDICARE/MEDICAID PAYMENTS 621300 318499280 318499280 1767323380 16187587 16187587 633458 633458 0 13135137 13135137 0 13135137 553354456 118407 529528507 23825949 118407 23944356 0 32474 14123 18351 0 PHARMACY 900099 11535950 11535950 CHARGEBACK REVENUE 900099 7454685 7454685 ELECTRONIC HEALTH RECORD 900099 6138225 6138225 8023622 3570378 4453244 33152482 1872936727 1784486668 32810239 0 0 0 0 1540521 1540521 0 897855710 836352594 60273054 1230062 20699760 19281826 1389575 28359 81917987 76306605 5499154 112228 49706971 46302043 3336829 68099 0 347533 347533 0 0 0 0 42064698 39183266 2823803 57629 1378704 1284263 92552 1889 260181401 242358975 17465977 356449 0 0 50174748 46737778 3368231 68739 3762641 3762641 0 2933150 2933150 11148264 11148264 0 57690625 53738817 3951808 48619098 48619098 PURCHASED SERVICES 63853779 63853779 DUES & SUBSCRIPTIONS 2804312 2612217 192095 CENTRALIZED ADMIN EXP 99965757 99965757 BAD DEBT EXPENSE 36264736 36264736 7503046 6989088 503680 10278 1740413441 1528121397 210358312 1933732 0 0 710874838 723430572 6908950 4724590 194939422 196649156 0 0 0 0 0 0 15928017 18362049 3809992 10099963 914242640 349843134 486635679 564399506 180758430 220282145 0 0 0 0 0 0 260701993 214903916 1860557321 1952851897 215610749 222007226 0 0 0 0 209589968 193814348 0 0 0 0 9170792 7131368 0 0 692356366 642158925 1126727875 1065111867 X 656434035 801461940 57748346 66645046 19647065 19633044 733829446 887740030 1860557321 1952851897 X 132523286 36295098 -14907800 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false true 181800 181800 PART II-B, LINE 1h NORTH SHORE UNIVERSITY HOSPITAL IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION AND OTHER HEALTH CARE ASSOCIATIONS WHICH ENGAGE IN LOBBYING EFFORTS ON BEHALF OF THEIR MEMBER HOSPITALS. 21821155 3448404 477598 24791961 18070718 1396511 2776026 422100 21821155 19157092 38333 -458920 665787 18070718 16999619 518147 2263679 624353 19157092 13001962 219149 4132842 354335 16999618 1.00000 false false 5621276 5621276 508637064 233012128 275624936 8777872 2626930 6150942 234229001 106154459 128074542 156977427 8049617 148927810 564399506 SECURITY DEPOSITS 188111 BOND FINANCING 4837111 INTEREST IN FOUNDATION 23027263 OTHER CURRENT ASSETS 2972233 OTHER ASSETS 8314975 AUXILIARY ASSETS 60418 INSURANCE CLAIMS RECEIVABLE 161423351 DUE FROM AFFILIATE 13921979 OTHER THIRD PARTY RECEIVABLES 158475 214903916 0 EST. PAYABLE TO THIRD PARTY 220763314 ACCRUED RETIREMENT BENEFITS 81621948 MALPRACTICE SELF-INSUR. LIAB. 161670001 INSURANCE CLAIMS LIABILITY 161423351 OTHER LIABILITY 2714538 LEASE INCENTIVE OBLIGATION 5741088 OTHER SHORT TERM BORROWINGS 7500000 SWAP VALUATION ALLOWANCE 1345261 BOND PREM/DISC 6278608 GAAP ADJUSTMENT FOR TELP -6899184 642158925 X 1860136204 34439265 -27643830 6795435 1853340769 19595958 19595958 1872936727 1730639041 1730639041 9774400 9774400 1740413441 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, 2013 and 2012, 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 $167,000,000, which expire in varying amounts through 2033, and are available to offset future taxable income. PART XI, LINE 2D AND LINE 4B REVENUE ON BOOKS NOT ON RETURN PROVISION FOR BAD DEBT (36,264,736) NET ASSETS RELEASED FROM RESTRICTION 8,620,906 TOTAL (27,643,830) REVENUE ON RETURN NOT 0N BOOKS NSUH AUXILLARY (81,600) RESTRICTED INVESTMENT INCOME 1,549,062 RESTRICTED CONTRIBUTIONS 18,128,496 TOTAL 19,595,958 PART XII, LINE 4B ADDITIONAL MINIMUM PENSION LIABILITY (26,490,336) PROVISION FOR BAD DEBTS 36,264,736 TOTAL 9,774,400 PART V, LINE 4 There are various components that encompass the Endowment Fund. In general, their intended use is for teaching, research and training, major modernization, and purchases of equipment. Central America and the Caribbean Investments 331762413 Europe (Including Iceland and Greenland) Investments 38527245 370289658 370289658 false false false false false false 32474 1500 10000 2623 true 1.00000 32474 1500 10000 2623 14123 18351 true false false false NORTH SHORE-LIJ HEALTH SYSTEM 972 BRUSH HOLLOW RD WESTBURY NY 11590 false false true true X true X true X 500. true true true false true true 2 16104 28148719 9944195 18204524 0.01120 2 83193 178192622 111837469 66355153 0.04080 4 99297 206341341 121781664 84559677 0.05200 454 188493 8501859 3718737 4783123 0.00290 188 5075 83863791 35216569 48647222 0.02990 1 9172 3211648 2335555 876093 0.00050 3 250 19585480 19585480 0.01200 57 1612 650174 650174 0.00040 703 204602 115812952 41270861 74542092 0.04570 707 303899 322154293 163052525 159101769 0.09770 3 720 720 2 2 73050 70578 2472 3 450 1403 1403 6 153 3733 3733 9 401 4337 4337 16 247 72632 72632 39 1253 155875 70578 85297 false 12025909 387672962 415059102 -27386140 X true true TRUE NORTH DIALYSIS MEDICAL SERVICES 0.49000 0.00000 0.00000 NS MED ACCELERATOR MEDICAL SERVICES 0.70000 0.00000 0.30000 ENDOSCOPY CENTER LI MEDICAL SERVICES 0.70000 0.00000 0.30000 TRUE NORTH URGENT MEDICAL SERVICES 0.50000 0.00000 0.00000 2 1 NORTH SHORE UNIVERSITY HOSPITAL 300 COMMUNITY DRIVE MANHASSET NY 11030 WWW.NORTHSHORELIJ.COM 2951001H X X X X A 2 SYOSSET HOSPITAL 221 JERICHO TURNPIKE SYOSSET NY 11791 WWW.NORTHSHORELIJ.COM 2951001H X X X X A A true X X X X X X X X X 13 true true true X www.northshorelij.com X X X X X X X X X false false true true 100 true 500. true X X X X X X X true true X X X X X X X true false X X X X X true X false false PART V, SECTION C - SUPPLEMENTAL INFORMATION Part V, Section B, line 1j: N/A Part V, Section B, line 3: 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 4: 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 5d: N/A Part V, Section B, line 6i: N/A Part V, Section B, line 7: 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 10: N/A Part V, Section B, line 11: N/A Part V, Section B, line 12i: The hospital also uses household size. Part V, Section B, line 14g: 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 16e: N/A Part V, Section B, line 17e: N/A Part V, Section B, line 18e: Before initiating any of the actions, the hospital facility sends letters, makes telephone calls and utilizes presumptive eligibility. Part V, Section B, line 19c: N/A Part V, Section B, line 19d: N/A Part V, Section B, line 20d: 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 21: N/A 58 PHYSICIAN AMBULATORY NETWORK SERVICES 865 NORTHERN BOULEVARD GREAT NECK NY 11021 OUTPATIENT PHYSICIAN CLINIC PHYSICIAN AMBULATORY NETWORK SERVICES 450 LAKEVILLE ROAD LAKE SUCCESS NY 11042 OUTPATIENT PHYSICIAN CLINIC PHYSICIAN AMBULATORY NETWORK SERVICES 611 NORTHERN BOULEVARD GREAT NECK NY 11021 OUTPATIENT PHYSICIAN CLINIC CENTER FOR ADVANCED IMAGING 450 LAKEVILLE ROAD LAKE SUCCESS NY 11042 DIAGNOSTIC CENTER JULIA AND ISRAEL WALDBAUM DIALYSIS CENTE 100 COMMUNITY DRIVE GREAT NECK NY 11021 DIALYSIS CENTER PHYSICIAN AMBULATORY NETWORK SERVICES 400 COMMUNITY DRIVE MANHASSET NY 11030 OUTPATIENT PHYSICIAN CLINIC PHYSICIAN AMBULATORY NETWORK SERVICES 850 HICKSVILLE ROAD SEAFORD NY 11783 OUTPATIENT PHYSICIAN CLINIC PHYSICIAN AMBULATORY NETWORK SERVICES 410 LAKEVILLE ROAD NEW HYDE PARK NY 11040 OUTPATIENT PHYSICIAN CLINIC PHYSICIAN AMBULATORY NETWORK SERVICES 1999 MARCUS AVENUE LAKE SUCCESS NY 11042 OUTPATIENT PHYSICIAN CLINIC PHYSICIAN AMBULATORY NETWORK SERVICES 136-17 39TH AVENUE FLUSHING NY 11354 OUTPATIENT PHYSICIAN CLINIC PHYSICIAN AMBULATORY NETWORK SERVICES 225 COMMUNITY DRIVE GREAT NECK NY 11021 OUTPATIENT PHYSICIAN CLINIC PHYSICIAN AMBULATORY NETWORK SERVICES 43 CROSSWAYS PARK DRIVE WEST WOODBURY NY 11797 OUTPATIENT PHYSICIAN CLINIC GREAT SOUTH BAY IMAGING 620 MAIN STREET ISLIP NY 11751 DIAGNOSTIC CENTER IMAGING CENTER AT SYOSSET 100 LAFAYETTE DRIVE SYOSSET NY 11791 DIAGNOSTIC CENTER PHYSICIAN AMBULATORY NETWORK SERVICES 600 NORHTERN BOULEVARD GREAT NECK NY 11021 OUTPATIENT PHYSICIAN CLINIC PHYSICIAN AMBULATORY NETWORK SERVICES 900 NORTHERN BOULEVARD GREAT NECK NY 11021 OUTPATIENT PHYSICIAN CLINIC INSTALL SCOTT KELLY INSTITUTE FOR ORTH & 210 EAST 64TH STREET MANHATTAN NY 11065 OUTPATIENT PHYSICIAN CLINIC PHYSICIAN AMBULATORY NETWORK SERVICES 800 COMMUNITY DRIVE MANHASSET NY 11030 OUTPATIENT PHYSICIAN CLINIC PHYSICIAN AMBULATORY NETWORK 2001 MARCUS AVENUE LAKE SUCCESS NY 11042 OUTPATIENT PHYSICIAN CLINIC PHYSICIAN AMBULATORY NETWORK SERVICES 1554 NORTHERN BOULEVARD MANHASSET NY 11030 OUTPATIENT PHYSICIAN CLINIC GREAT NECK MEDICAL ASSOCIATES 1165 NORTHERN BOULEVARD MANHASSET NY 11030 OUTPATIENT PHYSICIAN CLINIC PHYSICIAN AMBULATORY NETWORK SERVICES 100 COMMUNITY DRIVE GREAT NECK NY 11021 OUTPATIENT PHYSICIAN CLINIC NORTH SHORE-LIJ ORTHOPEDIC INSTITUTE 833 NORTHERN BOULEVARD GREAT NECK NY 11021 OUTPATIENT PHYSICIAN CLINIC IMAGING AT GREAT NECK 611 NORTHERN BOULEVARD GREAT NECK NY 11021 DIAGNOSTIC CENTER NORTH SHORE-LIJ MEDICAL GROUP AT WHITEST 150-55 14TH AVENUE WHITESTONE NY 11357 OUTPATIENT PHYSICIAN CLINIC PHYSICIAN AMBULATORY NETWORK SERVICES 1001 FRANKLIN AVNENUE GARDEN CITY NY 11530 OUTPATIENT PHYSICIAN CLINIC URGENT CARE CENTER CHELSEA 121 WEST 20TH STREET NEW YORK NY 10011 OUTPATIENT PHYSICIAN CLINIC NORTH SHORE-LIJ MEDICAL GROUP URGENT CAR 4300 HEMPSTEAD TURNPIKE BETHPAGE NY 11714 OUTPATIENT PHYSICIAN CLINIC NORTH SHORE SURGICAL SPECIALISTS 310 EAST SHORE ROAD GREAT NECK NY 11023 OUTPATIENT PHYSICIAN CLINIC OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2035 LAKEVILLE ROAD NEW HYDE PARK NY 11040 OUTPATIENT PHYSICIAN CLINIC MASSAPEQUA INTERNAL MEDICINE 896 NORTH BROADWAY MASSAPEQUA NY 11758 OUTPATIENT PHYSICIAN CLINIC PHYSICIAN AMBULATORY NETWORK SERVICES 1000 NORTHERN BOULEVARD GREAT NECK NY 11021 OUTPATIENT PHYSICIAN CLINIC PHYSICIAN AMBULATORY NETWORK SERVICES 801 MERRICK AVENUE EAST MEADOW NY 11544 OUTPATIENT PHYSICIAN CLINIC THE CENTER FOR HUMAN REPRODUCTION SUFFO 285 MIDDLE COUNTRY ROAD SMITHTOWN NY 11787 OUTPATIENT PHYSICIAN CLINIC INTERNAL MEDICINE ASSOCIATIES OF EAST H 70 GLEN COVE ROAD ROSLYN HEIGHTS NY 11577 OUTPATIENT PHYSICIAN CLINIC PHYSICIAN AMBULATORY NETWORK SERVICES 23-22 30TH AVENUE ASTORIA NY 11105 OUTPATIENT PHYSICIAN CLINIC OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 487 LAKE AVENUE ST JAMES NY 11780 OUTPATIENT PHYSICIAN CLINIC LI HYPERTENSION AND NEPHROLOGY 50 SEAVIEW BOULEVARD PORT WASHINGTON NY 11050 OUTPATIENT PHYSICIAN CLINIC LYNBROOK INTERNAL MEDICINE 185 MERRICK ROAD LYNBROOK NY 11563 OUTPATIENT PHYSICIAN CLINIC NORTHERN PULMONARY MEDICAL ASSOCIATES 58-06 FRANCIS LEWIS BOULEVARD BAYSIDE NY 11364 OUTPATIENT PHYSICIAN CLINIC ALL ABOUT WOMEN GYNECOLOGY 200 OLD COUNTRY ROAD MINEOLA NY 11501 OUTPATIENT PHYSICIAN CLINIC SPINE CENTER AT LYNBROOK 306 BROADWAY LYNBROOK NY 11563 OUTPATIENT PHYSICIAN CLINIC STUDENT HEALTH CENTER AT FRANKLIN K LAN 999 JAMAICA AVENUE BROOKLYN NY 11208 OUTPATIENT PHYSICIAN CLINIC MASSAPEQUA HEART GROUP 2857 JERUSALEM AVENUE WANTAGH NY 11793 OUTPATIENT PHYSICIAN CLINIC LONG ISLAND GASTROENTEROLOGY & LIVER 1181 OLD COUNTRY ROAD PLAINVIEW NY 11803 OUTPATIENT PHYSICIAN CLINIC LENOX HILL HUMAN REPRODUCTION 150 EAST 71ST STREET MANHATTAN NY 10021 OUTPATIENT PHYSICIAN CLINIC MASSAPEQUA INTERNAL MEDICINE ASSOCIATES 475 MAIN STREET FARMINGDALE NY 11735 OUTPATIENT PHYSICIAN CLINIC NORTHERN BOULEVARD INTERNAL MEDICINE 170-03 NORTHERN BOULEVARD FLUSHING NY 11358 OUTPATIENT PHYSICIANS CLINIC FAMILY PRACTICE OF PORT WASHINGTON 14 MAPLE STREET PORT WASHINGTON NY 11050 OUTPATIENT PHYSICIAN CLINIC PLAINVIEW SURGERY 25 CENTRAL PARK ROAD PLAINVIEW NY 11802 OUTPATIENT PHYSICIAN CLINIC INTERNAL MEDICINE AT ASTORIA 31-09 NEWTOWN AVENUE ASTORIA NY 11102 OUTPATIENT PHYSICIAN CLINIC IMMEDIATE CARE CENTER FIRE ISLAND 504 BAYBERRY WALK OCEAN BEACH NY 11770 OUTPATIENT PHYSICIAN CLINIC THE CENTER FOR HUMAN REPRODUCTION REGO 95-25 QUEENS BOULEVARD REGO PARK NY 11374 OUTPATIENT PHYSICIAN CLINIC PHYSICIAN AMBULATORY NETWORK SERVICES 2201 HEMPSTEAD TURNPIKE EAST MEADOW NY 11554 OUTPATIENT PHYSICIAN CLINIC THE CENTER FOR REPRODUCTION MINEOLA 300 OLD COUNTRY ROAD MINEOLA NY 11501 OUTPATIENT PHYSICIAN CLINIC THE FAR ROCKAWAY YOUTH CONSULTATION CENT 1045 NAMEOKE STREET FAR ROCKAWAY NY 11691 OUTPATIENT PHYSICIAN CLINIC THE FAR ROCKAWAY YOUTH CONSULTATION CENT 821 BAY 25TH STREET FAR ROCKAWAY NY 11691 OUTPATIENT PHYSICIAN CLINIC CLEFT PALATE CRANIOFACIAL CENTER 225 COMMUNITY DRIVE GREAT NECK NY 11021 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 11.5% 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; E-BRFSS; 2010 US Census data 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 X X X X X false true false true false false false true false MICHAEL J DOWLING PRESIDENT & CEO 0 1366853 0 1700000 0 50990 0 1201724 0 21050 0 4340617 0 0 HOWARD GOLD EVP MANAGED CARE, BUSINESS DEV 0 1032469 0 392000 0 2031748 0 312398 0 15100 0 3783715 0 562264 MARK J SOLAZZO EVP, CHIEF OPERATING OFFICER 0 1166663 0 700000 0 28241 0 310664 0 14890 0 2220458 0 0 ROBERT S SHAPIRO EVP, CHIEF FINANCIAL OFFICER 0 926327 0 242000 0 30759 0 220856 0 22300 0 1442242 0 0 LAWRENCE G SMITH EVP/PHYSICIAN IN CHIEF 0 735582 0 150000 0 27465 0 691006 0 16675 0 1620728 0 0 KEITH THOMPSON SR VP & GENERAL COUNSEL 0 726199 0 112000 0 38585 0 28050 0 22300 0 927134 0 0 JEFFREY KRAUT SR VP STRATEGIC PLANNING 0 720655 0 158000 0 45628 0 198331 0 15100 0 1137714 0 0 KATHLEEN GALLO RN PHD SR VP & CHF LEARNING OFFICER 0 624064 0 97000 0 2032256 0 279175 0 15100 0 3047595 0 534246 DONNA DRUMMOND SVP, CHIEF ADMIN OFFICER 0 510278 0 76000 0 59434 0 28050 0 15100 0 688862 0 0 HARRY GINDI ASSISTANT SECRETARY 0 288687 0 21382 0 4393 0 28050 0 15100 0 357612 0 0 SUSAN SOMERVILLE EXECUTIVE DIRECTOR 794611 0 126000 0 13519 0 304350 0 15100 0 1253580 0 0 0 ALAN HARTMAN MED SCHOOL CHAIR CTS 1974868 0 0 0 45231 0 28050 0 22300 0 2070449 0 0 0 RAJ NARAYAN MED SCHOOL CHAIR NEUROSURGERY 1166739 0 239280 0 88607 0 28050 0 15100 0 1537776 0 0 0 RALPH NAPPI TRUSTEE AND PRES NSLIJ FOUND. 0 675942 0 150000 0 30857 0 28050 0 20831 0 905680 0 0 STANLEY KATZ MED SCHOOL CHAIR CARDIOLOGY 1746655 0 0 0 17791 0 28050 0 22300 0 1814796 0 0 0 MICHAEL KIM DIR, INTERVENTIONAL CARDIOLOGY 1496030 0 0 0 17691 0 28050 0 15100 0 1556871 0 0 0 LAURA PEABODY SVP & CHIEF LEGAL COUNSEL 0 161148 0 100000 0 721 0 28050 0 15100 0 305019 0 0 KEVIN F LAWLOR TRUSTEE AND PRES/CEO HUNT HOSP 0 593009 0 71000 0 49579 0 271866 0 15100 0 1000554 0 0 RICK ESPOSITO ASSOC CHAIRPERSON 1624543 0 0 0 19502 0 28050 0 15100 0 1687195 0 0 0 EUGENE TANGNEY REGIONAL EXECUTIVE DIRECTOR 0 839708 0 127000 0 11234 0 143860 0 15100 0 1136902 0 0 FRANK RIZZO CFO TERTIARY HOSPITAL 515152 0 74366 0 16872 0 28050 0 15100 0 649540 0 0 0 ANDREW SCHULZ ASST SECRETARY, GEN COUNSEL 0 468164 0 33897 0 20867 0 28050 0 15100 0 566078 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 ($1,173,674), Mark J Solazzo ($282,614), Robert S Shapiro ($192,806), Howard Gold ($284,348), Lawrence G Smith ($662,956) Jeffery Kraut ($170,281), Kathleen Gallo ($251,125), Eugene Tangney ($115,810), Susan Sommerville ($276,300) and Kevin Lawlor ($243,816). PART I, LINE 5A Pursuant to the persons listed in Form 990, Part VII, section A, line 1A, there is no contractual obligation to pay or accrue any compensation to officers of the North Shore LIJ Health System based on the revenue of the organization. A listed person(s) that may qualify under this condition could be one or more of the physicians listed as a highly compensated employee. 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). A DORMITORY AUTHORITY OF THE STATE OF NEW YORK 146000293 64983USV3 2003-08-14 40243953 2003 BONDS - CAPITAL EXPENDITURES true false false B DORMITORY AUTHORITY OF THE STATE OF NEW YORK 146000293 64983Q4R7 2006-10-15 79910817 2005 BONDS - CAPITAL EXPENDITURES false false false C DORMITORY AUTHORITY OF THE STATE OF NEW YORK 146000293 649903LC3 2007-05-31 89271702 2007 A&B BONDS-FACILITY RENOVATION true false false D DORMITORY AUTHORITY OF THE STATE OF NEW YORK 146000293 649905QL3 2009-09-17 26646500 2009 A&E BONDS-CAPITAL IMPROV & RE false false false A 29079860 0 41537976 1918444 1509545 0 802332 0 0 23864171 12196952 104758 2008 true false false true B 10568584 0 68134569 4671867 0 0 597509 0 0 2323302 60541891 0 2010 true false true true C 26116396 0 89450018 6057777 1998208 0 883469 0 0 20962482 58573881 11007195 true true false true D 44934 0 26379637 2900783 2060531 0 431955 0 970498 16066192 4365551 0 2012 true false true true A false false true true true true 0.00330 0.00330 false false false true B false false true true true true 0.00370 0.00370 false false false true C false false false false 0 false false false true D false false false false 0 false false false true A false false true true false false 0 true MBIA 29.7 true true true B false false true true false false 0 false 0 false true C false false true true false true Citibank NA 25.9 true false true MBIA 18.1 true true true D false true true false false false 0 false 0 true true A true B true C true D true PART II, LINE 3-TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS. PART IV, LINE 2C-REBATE CALCULATION PERFORMED ON 12/31/2013 FOR 2003 BONDS PART IV, LINE 2C-REBATE CALCULATION PERFORMED ON 9/30/2011 FOR 2005 BONDS PART IV, LINE 2C-REBATE CALCULATION PERFORMED ON 5/31/2012 FOR 2007 BONDS PART IV, LINE 2C-REBATE CALCULATION PERFORMED ON 6/30/2010 FOR TELP, SINCE BOND PROCEEDS HAVE BEEN SPENT, A SPENDING EXCEPTIONS WAS MET A DORMITORY AUTHORITY OF THE STATE OF NEW YORK 146000293 649906UY8 2012-05-03 29074101 2012 A BONDS - REFUND 1998 BONDS false false false B DORMITORY AUTHORITY OF THE STATE OF NEW YORK 146000293 000000000 2008-12-30 8578266 TELP - PURCHASE OF EQUIPMENT false false false A 0 0 33308014 0 0 0 627701 0 0 0 32680313 0 2012 true false true true B 1804367 0 8581141 0 0 0 0 0 0 8581141 0 0 2010 false false true true A false false false false 0 false false false true B false false false false 0 false false false true A false true true false false false 0 false 0 false true B false false true true false false 0 false 0 false true A true B true 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. William Achenbaum has a business relationship with Elise Bloom and Eric and Roger Blumencranz. John Alexander has a business relationship with Laura Lauria and John Shall. Philip Altheim has a business relationship with Eric Blumencranz. Stanley Applebaum has a business relationship with John Shall. Michael Ashner has a business relationship with William Mack and Scott Rudolph. Frank Besignano has a business relationship with Laura Lauria. Elise Bloom has a business relationship with William Achenbaum and Leonard Feinstein. Eric Blumencranz has as a family relationship with Roger Blumencranz. He has a business relationship with Roger Blumencranz, William Achenbaum, Philip Altheim, Arlene Lane Fisher, Richard D. Goldstein, Lloyd Goldman, Alan Greene, Stanley Grey, Richard Guarasci, Richard Horowitz, M. Allan Hyman, Jeffrey Jurick, Arthur Levine, Stuart Levine, David Mack, Bradley Marsh, Charles Merinoff, Ralph Nappi, Dennis Riese, Michael Slade, Nancy Waldbaum, Barbara Hrbek Zucker and Donald Zucker. Roger Blumencranz has a family relationship with Eric Blumencranz. He has a business relationship with Eric Blumencranz, William Achenbaum, Alan Greene, Stanley Grey, Richard D. Goldstein, Richard Horowitz, Jeffrey Jurick, David Mack, Bradley Marsh, Michael Slade, Ralph Nappi, Mark Solazzo, Barbara Hrbek Zucker. David Blumenfeld has a family relationship with Edward Blumenfeld. Edward Blumenfeld has a family relationship with David Blumenfeld. He has a business relationship with William Mack. Steve Braun has a family relationship with Richard Sims. He has a business relationship with Cary Kravet. Robert Chasanoff has a business relationship with Michael Sahn. Alan Chopp has a business relationship with Patrick McDermott. Mark Claster has a business relationship with Richard Goldstein and Robert Rosenthal. Philippe Dauman has a business relationship with Thomas Dooley. Thomas Dooley has a business relationship with Philippe Dauman. Leonard Feinstein has a business relationship with Elise Bloom and William Mack. Arlene Lane Fisher has a business relationship with Eric Blumencranz. Lloyd Goldman has a business relationship with Eric Blumencranz, Richard Goldstein and William Mack. Richard D. Goldstein has a business relationship with Roger Blumencranz, Eric Blumencranz, Mark Claster, Lloyd Goldman and Barry Rubenstein. Joaquin Gonzalez has a business relationship with John Shall. Alan I. Greene has a business relationship with Eric and Roger Blumencranz. Stanley Grey has a business relationship with Eric and Roger Blumencranz. Richard Guarasci has a business relationship with Eric Blumencranz. William Hiltz has a business relationship with Jeff Maurer. Gedale Horowitz has a family relationship with Richard and Seth Horowitz. Richard Horowitz has a family relationship with Gedale and Seth Horowitz. He has a business relationship with Eric and Roger Blumencranz and M. Allan Hyman. Seth Horowitz has a family relationship with Gedale and Richard Horowitz. M. Allan Hyman has a business relationship with Eric Blumencranz, M. Allan Hyman, Richard Horowitz, Saul Katz and Donald Zucker. Jeffrey Jurick has a business relationship with Eric and Roger Blumencranz. David Katz has a family relationship with Saul Katz and Michael Katz. He has a business relationship with Michael Katz, Saul Katz and Seth Lipsay. Michael Katz has a family relationship with Saul Katz and David Katz. He has a business relationship with David Katz, Saul Katz, Curt Launer and Michael Slade. Saul Katz has a family relationship with Michael Katz and David Katz. He has a business relationship with M. Allan Hyman, David Katz, Michael Katz, Curt Launer and Michael Slade. Cary Kravet has a business relationship with Steve Braun. Jeffrey Lane has a business relationship with William Mack. Curt Launer has a business relationship with Michael Katz and Saul Katz. Laura Lauria has a business relationship with John Alexander and Frank Besignano. David Lehr has a business relationship with Ronald Mazzuco. Arthur Levine has a business relationship with Eric Blumencranz. Stuart Levine has a business relationship with Eric Blumencranz. Seth Lipsay has a business relationship with David Katz. David Mack has a family relationship with William Mack. He has a business relationship with William Mack, Eric Blumencranz, and Roger Blumencranz. William Mack has a family relationship with David Mack. He has business relationships with David Mack, Michael Ashner, Edward Blumenfeld, Leonard Feinstein, Lloyd Goldman, Jeffrey Lane, Barry Rubenstein and Roy Zuckerberg. Bradley Marsh has a family relationship with Jack Ross. He has a business relationship with Eric and Roger Blumencranz. Jeff Maurer has a business relationship with William Hiltz. Ronald Mazzucco has a business relationship with David Lehr. F.J. McCarthy has a business relationship with Robert Rosenthal and Emmett Walker. Patrick McDermott has a business relationship with Alan Chopp and John Shall. Charles Merinoff has a business relationship with Eric Blumencranz. Richard Murcott has a business relationship with Barry Rubenstein. Ralph Nappi has a business relationship with Eric and Roger Blumencranz. Dennis Riese has a business relationship with Eric Blumencranz. Robert Rosenthal has a business relationship with Mark Claster, F.J. McCarthy and Nancy Waldbaum. Jack Ross has a family relationship with Bradley Marsh. Barry Rubenstein has a business relationship with Richard Goldstein, William Mack and Richard Murcott. Scott Rudolph has a business relationship with Michael Ashner. Michael Sahn has a business relationship with Robert Chasanoff. John Shall has a business relationship with Patrick McDermott, John Alexander, Stanley Applebaum, and Joaquin Gonzalez. Richard Sims has a family relationship with Steve Braun. Michael Slade has a business relationship with Eric Blumencranz, Saul Katz and Michael Katz. Mark Solazzo has a business relationship with Roger Blumencranz. Nancy Waldbaum has a business relationship with Eric Blumencranz and Robert Rosenthal. Emmett Walker has a business relationship with F.J. McCarthy. Barbara Hrbek Zucker has a family relationship with Donald Zucker. She has a business relationship with Eric and Roger Blumencranz. Donald Zucker has a family relationship with Barbara Hrbek Zucker. He has a business relationship with Eric Blumencranz and M. Allan Hyman. Roy Zuckerberg has a business relationship with William Mack. 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 The North Shore-Long Island Jewish Health System ("Health System") has several control mechanisms to mitigate conflicts of interest. The Health System's Code of Ethical Conduct contains a detailed section educating individuals about how to avoid potential conflicts of interest. Specifically, our Code of Ethical Conduct requires individuals to conduct Health System business in a manner that places the interests of the Health System ahead of their personal interests. In addition, the Health System 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 Health System are required to filled out a conflicts of interest disclosure form on a regular basis. The 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 Health System's Audit and Corporate Compliance Committee and other applicable committees. In addition, the Health System 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 CURRTENTLY 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 Richard S. Abramson J. Joaquin Gonzalez F.J. McCarthy William Achenbaum Michael Gould Patrick F. McDermott John W. Alexander Albert L. Granger, DDSJames McMullen Philip S. Altheim Alan I. Greene Charles Merinoff Stanley A. Applebaum Stanley Grey Richard D. Monti Michael L. Ashner Richard Guarasci, PhD Richard Murcott Beverly VP. Banker Paul B. Guenther Ralph A. Nappi Ralph M. Baruch Amy M. Hagedorn Richard B. Nye Frank J. Besignano Ira Hazan Clyde I. Payne, Ed.D. Elise M. Bloom Linda W. Heaney Arnold S. Penner Eric S. Blumencranz Marlene Hess John J. Raggio Roger A. Blumencranz William O. Hiltz Lewis S. Ranieri David Blumenfeld Gedale B. Horowitz Dennis Riese Edward Blumenfeld Richard A. Horowitz Terry P. Rifkin, M.D. E. Steve Braun Seth R. Horowitz Robert F. Rose Dayton T. Brown, Jr M. Allan Hyman Robert A. Rosen Jonathan S. Canno Mark Jacobson Marcie Rosenberg Michael Caridi Jeffrey Jurick Robert D. Rosenthal Rev. Carolina Sr, Ed.D David M. Katz Bernard M. Rosof, M.D. Robert W. Chasanoff Michael Katz Jack J. Ross Alan Chopp Saul B. Katz Barry Rubenstein Mark Claster Lisa A. Kaufman Herbert Rubin Diana F. Colgate Robert Kaufman Scott Rudolph Daniel M. Crown Cary Kravet Michael H. Sahn Philippe P. Dauman Stanley Kreitman Lois C. Schlissel Daniel C. de Roulet Seth Kupferberg John M. Shall Thomas E. Dewey, Jr. Jeffrey B. Lane Marc V. Shaw Thomas E. Dooley Curt N. Launer Sean G. Simon Michael J. Dowling Laura Lauria Richard Sims Robert N. Downey Kevin F. Lawlor Michael C. Slade Patrick R. Edwards David W. Lehr Phyllis Hill Slater Michael A. Epstein Jonathan W. Leigh Howard D. Stave Leonard Feinstein Arthur S. Levine Peter Tilles Michael E. Feldman Stuart R. Levine Sandra Tytel Arlene Lane Fisher Seth Lipsay Frederick A. Volk Catherine C. Foster David S. Mack Nancy Waldbaum William H. Frazier William L. Mack Emmett F. Walker, Jr Eugene B. Friedman, MD Linda Manfredi Gary Walter William J. Fritz, Ph.D. Bradley Marsh, D.P.M. Barbara Hrbek Zucker Sy Garfinkel Jeffrey S. Maurer Donald Zucker Lloyd M. Goldman Ronald J. Mazzucco Roy J. Zuckerberg Richard D. Goldstein 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, 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 CHANGE IN EQUITY UNDER FAS 136 4,388,713 NET ASSETS RELEASED FROM RESTRICTION (91,924) CHANGE IN FV SWAP AGREEMENT 603,955 TRANSFER TO AFFILIATE (19,808,544) TOTAL (14,907,800) NORTH SHORE-LIJ VENTURES LLC 972 BRUSH HOLLOW RD WESTBURY NY 11590 455221514 MED SERVICES NY 0 0 NSUH NORTH SHORE-LIJ VENTURES GCSC LLS 972 BRUSH HOLLOW RD WESTBURY NY 11590 463279716 MEDICAL SVCS NY 0 0 NSUH NS-LIJ URGENT CARE VENTURES LLC 972 BRUSH HOLLOW RD WESTBURY NY 11590 464822513 URGENT CARE NY 0 0 NSUH NORTH SHORE-LIJ RENAL VENTURES LLC 972 BRUSH HOLLOW RD WESTBURY NY 11590 463869336 MEDICAL SVCS NY 0 0 NSUH 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 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 BRUSH HOLLOW RD WESTBURY NY 11590 111633487 HEALTH CARE NY 501(C)(3) 3 NS-LIJ HCI false FOREST HILLS HOSPITAL 972 BRUSH HOLLOW RD WESTBURY NY 11590 112163522 HEALTH CARE NY 501(C)(3) 3 NS-LIJ HCI false PLAINVIEW HOSPITAL 972 BRUSH HOLLOW RD WESTBURY NY 11590 113241243 HEALTH CARE NY 501(C)(3) 3 NS-LIJ HCI false FRANKLIN HOSPITAL 972 BRUSH HOLLOW RD WESTBURY NY 11590 112296824 HEALTH CARE NY 501(C)(3) 3 NS-LIJ HCI false SOUTHSIDE HOSPITAL 972 BRUSH HOLLOW RD WESTBURY NY 11590 111667761 HEALTH CARE NY 501(C)(3) 3 NS-LIJ HCI false NORTH SHORE-LIJ HEALTH SYSTEM LABS 972 BRUSH HOLLOW RD WESTBURY NY 11590 113412370 SUPPORT NY 501(C)(3) 11, TYPE 1 NS-LIJHS false FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH 972 BRUSH HOLLOW RD WESTBURY NY 11590 112673595 RESEARCH NY 501(C)(3) 4 NS-LIJHS false NORTH SHORE-LIJ HEALTH SYSTEM FOUNDATION 972 BRUSH HOLLOW RD WESTBURY NY 11590 112965575 FUNDRAISING NY 501(C)(3) 7 NS-LIJHS false NSLIJ STERN FAMILY CENTER FOR REHAB 972 BRUSH HOLLOW RD WESTBURY NY 11590 237007485 NURSING HOME NY 501(C)(3) 9 NS-LIJ HCI false LIJ MEDICAL CENTER AT HOME PHARMACY 972 BRUSH HOLLOW RD WESTBURY NY 11590 113251128 SUPPORT NY 501(C)(3) 11, TYPE 1 NS-LIJHS false LIJ FOUNDATION 972 BRUSH HOLLOW RD WESTBURY NY 11590 112661239 SUPPORT NY 501(C)(3) 11, TYPE 1 NS-LIJHS false NORTH SHORE-LIJ MEDICAL CARE CENTERS 972 BRUSH HOLLOW RD WESTBURY NY 11590 113473923 SUPPORT NY 501(C)(3) 11, TYPE 1 NS-LIJHS false SSH INC 972 BRUSH HOLLOW RD WESTBURY NY 11590 112774102 SUPPORT NY 501(C)(3) 11, TYPE 1 SOUTHSIDE false NORTH SHORE COMMUNITY SERVICES INC 972 BRUSH HOLLOW RD WESTBURY NY 11590 237273200 HOUSING NY 501(C)(2) N/A NS-LIJHS false NORTH SHORE UNIVERSITY HOSPITAL HOUSING 972 BRUSH HOLLOW RD WESTBURY NY 11590 112171903 HOUSING NY 501(C)(2) N/A NS-LIJHS false NSUH AT GLEN COVE HOUSING 972 BRUSH HOLLOW RD WESTBURY NY 11590 237010468 HOUSING NY 501(C)(2) N/A NS-LIJHS false HILLSIDE HOSPITAL HOUSES 972 BRUSH HOLLOW RD WESTBURY NY 11590 112113949 HOUSING NY 501(C)(2) 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