2014-11-17T08:22:41-06:00 2013-12-31 Charles A Barragato & Co LLP 950 Third Avenue - 20th FL New York NY 10022 990 2013-01-01 111665825 Episcopal Health Services Inc % EPISCOPAL HEALTH SERVICES EPIS 5163494643 700 Hicksville Road 210 Suite Bethpage NY 11714 WILLIAM MOORE CFO CFO 2123714446 2014-11-15 true Angelo Pirozzi CPA P00446022 2123714446 2013 2015-11-30 17:44:51Z RICHARD BROWN 700 Hicksville RD Suite 210 Bethpage NY 11714 188397000 false X WWW.EHS.ORG X 1852 NY TO PROVIDE QUALITY HEALTH CARE THROUGH ITS HOSPITAL, AMBULATORY CARE HOSPITAL, AMBULATORY CARE FACILITIES, NURSING HOMES AND EDUCATION, RECOGNIZING THE EMERGING LIFE-CARE NEEDS OF THE COMMUNITIES SERVED. 9 7 1818 69 0 0 2585000 2668000 178900000 171274000 1242000 6349000 14869000 8106000 197596000 188397000 0 0 0 0 125695000 127900000 0 0 0 68643000 69667000 194338000 197567000 3258000 -9170000 142636000 139831000 118366000 124271000 24270000 15560000 X THE MISSION OF EPISCOPAL HEALTH SERVICES INC. OF THE DIOCESE OF LONG ISLAND IS TO PROVIDE QUALITY HEALTH CARE WITH AN EMPHASIS ON PATIENT SAFETY THROUGH ITS HOSPITAL, AMBULATORY CARE FACILITIES, NURSING HOMES AND CONTINUING MEDICAL EDUCATION, RECOGNIZING THE EMERGING LIFE-CARE NEEDS OF THE COMMUNITIES SERVED. false false 176875000 173986000 ST.JOHN'S EPISCOPAL HOSPITAL PROVIDED THE FOLLOWING SERVICES TO RESIDENTS OF ITS LOCAL COMMUNITY IN 2013: 10,500 DISCHARGES 49,300 ADULT AND PEDIATRIC MEDICAL AND SURGICAL DAYS OF CARE TO 7,800 PATIENTS. 114,800 DAYS OF BEHAVIORAL HEALTHCARE TO 750 PATIENTS. 720 BABIES WERE DELIVERED. 29,800 PATIENTS WERE TREATED AND RELEASED FROM THE 24 HR EMERGENCY ROOM. 15,200 VISITS TO THE CHRONIC DIALYSIS SERVICE. 76,300 VISITS TO THE AMBULATORY AND BEHAVIORAL HEALTH CLINICS. BISHOP CHARLES WALDO MACLEAN NURSING HOME PROVIDED THE FOLLOWING EXEMPT PURPOSE SERVICES IN 2013: 55,400 DAYS OF LONG TERM NURSING HOME CARE WERE FURNISHED TO PATIENTS. In August 2012, EHS entered into asset purchase agreements with unrelated parties to sell Bishop MacLean Nursing Home (the Home) and believes the sale will close in 2014 after the completion of regulatory approvals and other matters. As a result, EHS determined that the criteria for held for sale classification of certain of the Home assets and liabilities were met in August 2012. Under the agreements, assets and liabilities to be transferred or assigned to the buyers include those used in operations and personal properties of the Home facilities. Effective July 1, 2012 the buyers began operating the Homes under an employment agreement intended to capitalize on their specific expertise regarding long term care operation. Managerial oversight by the Board of Trustees has continued from the inception of the employment agreement, and will continue to effective through final closing of the sale. Subsequent to initiation of the employment agreement, the aforementioned asset purchase agreement was entered into shortly afterward, outlining the fundamentals of the proposed transaction. 176875000 true true false true false false false false false true true false false true true false false true false false true false false false false false true true false false true false false false false false false false false false false false false false true true true false false true 213 0 true 1818 true false false false false false false false false false false false false X 9 7 false true false false false false false true false false false true true true true true true true true false X EPISCOPAL HEALTH SERVICES 5163494643 700 HICKSVILLE ROAD - SUITE 210 BETHPAGE NY 11714 REVEREND LAWRENCE C PROVENZANO PRESIDENT & CHAIRMAN 10.0 1.0 X X 60000 0 0 MARGARET O CARPENTER SECOND VP 1.0 X X 0 0 0 REVEREND JOHN E WALKER III SECRETARY 1.0 X X 0 0 0 RONALD O COLE TREASURER 1.0 X X 25081 0 0 KATHLEEN E LECADRE BOARD MEMBER 1.0 X 0 0 0 VENERABLE JEROME J NEDELKA CHAIRMAN - PASTORAL CARE 1.0 X 0 0 0 REVEREND J MASTINE NISBETT BOARD MEMBER 1.0 X 0 0 0 REVEREND DARRYL F JAMES BOARD MEMBER 1.0 X 0 0 0 REVEREND THEODORE W BEAN JR BOARD MEMBER - TERMED 8/2013 1.0 X 0 0 0 DANIEL A KASLE BOARD MEMBER 1.0 X 0 0 0 OWEN C THOMPSON BOARD MEMBER - TERMED 7/2013 1.0 X 0 0 0 NELSON TOEBBE CEO - PITTS MGMT -TERMED 11/13 40.0 X 0 0 0 RICHARD BROWN CEO EFFECTIVE 12/1/2013 37.0 3.0 X 0 0 0 WILL MOORE CFO EFFECTIVE 12/1/2013 37.0 X 0 0 0 CHERIAN T PALATHRA CONTROLLER - TERM 9/13 40.0 X 130394 30192 ROBERT BLAKE PHYSICIAN 26.0 14.0 X 189010 74098 18873 SHELDON MARKOWITZ CHAIR - DEPT OF MEDICINE 40.0 X 261428 42580 MANMOHN MAHADKAR CHAIR- OB/GYN-TERM 11/13 40.0 X 333463 42563 RAJIV PRASAD CHAIR - EMERGENCY SERVICES 32.0 X 346324 5952 RAYMOND PASTORE MD CHIEF MEDICAL OFFICER 38.0 2.0 X 275659 6725 LOKESH REDDY MD CHIEF OF PSYCHIATRY 40.0 X 289316 30162 Kelly Barland Chief Information Officer 38.0 X 223668 0 Krishna Kishore Bezwada Chief - Psychiatry 40.0 X 259751 29755 Richard Sarli VP Finance 37.0 3.0 X 273190 2500 Natalie Schwartz VP Reglatory Affairs 40.0 X 257379 42478 SHAKIRA GORDON VP HUMAN RESOURCES 40.0 X 144417 25269 GWENDOLYN SEYMORE-PINCKNEY VP REGULATORY AFFAIRS 40.0 X 145855 27275 GILBERT MAKABALI MD CHAIRMAN - SURGERY 40.0 X 261769 44848 ALAN STEINBERG MD CHAIRMAN - PEDIATRICS 40.0 X 267742 31401 James Henry MD CHIEF OF ORTHOPEDICS 40.0 X 328365 25432 Ronald Brenner Chair-Psychiatry 64.0 X 232082 29616 Imelda Canlas Anesthesiologist 40.0 X 248532 0 4553425 74098 435621 194 false true false PITTS MANAGEMENT ASSOCIATES INC 7946 GOODWOOD BLVD BATON ROUGE LA 70806 DAILY MANAGEMENT SVC 2501210 Advanced Care Staffing 545 Broadway BROOKLYN NY 11206 Temporary Staffing 2111322 NSLIJHS Laboratory 10 Nevada Drive LAKE SUCCESS NY 11042 Laboratory Services 2100097 Queens County Medical Serivces LLC 5665 New Northside Drive STE 320 ATLANTA GA 30328 Physician Services 1782000 Morrison Management Specialist Inc PO Box 102289 ATLANTA GA 303682289 Dietary Management 1560759 49 2141000 527000 2668000 NET PATIENT SERVICE REV 621300 172275000 172275000 PHYSICIAN BILLING REVENUE 621110 1640000 1640000 PROVISION FOR BAD DEBTS 621300 -2641000 -2641000 171274000 6347000 6347000 0 0 86000 86000 0 86000 86000 2000 2000 2000 2000 0 0 0 HEALTHFIRST INVEST INCOME 523000 4627000 4627000 I&R AND NON I&R ROTATION INCOME 900099 2712000 2712000 ALL OTHER REVENUE 900099 681000 681000 8020000 188397000 173986000 11743000 0 0 0 0 3555139 3555139 0 89215986 84579000 4636986 0 7512762 6944000 568762 20685113 19139000 1546113 6931000 6340000 591000 3753000 3753000 840000 768000 72000 466000 466000 19000 17000 2000 0 0 11284000 10323000 961000 153000 140000 13000 346000 317000 29000 702000 642000 60000 0 3958000 3621000 337000 95000 87000 8000 0 111000 102000 9000 238000 218000 20000 0 7020000 6422000 598000 9618000 8799000 819000 MEDICAL SUPPLIES 8580000 7849000 731000 OTHER MATERIALS & EXPENSES 10113000 9251000 862000 PURCHASE SERVICE EXPENSE 8327000 7618000 709000 DRUGS 4044000 3699000 345000 197567000 176875000 20692000 0 2390000 7239000 426000 677000 0 0 21549000 14121000 0 0 0 0 0 0 349000 749000 10393000 5340000 159407000 120605000 40530000 38802000 0 0 0 0 0 0 0 0 66999000 72903000 142636000 139831000 35649000 38907000 0 0 0 0 0 0 0 0 0 0 5290000 5267000 0 0 77427000 80097000 118366000 124271000 X 22396000 13311000 466000 841000 1408000 1408000 24270000 15560000 142636000 139831000 X -9170000 252000 208000 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 19502 19502 false false FORM 990, SCHEDULE C, PART II-B, LINE 1(i) Episcopal Health Services Inc. pays dues to The Healthcare Association of New York State (HANYS) and The Greater New York Hospital Association (GNYHA). In accordance with section 6033 (e) of the Internal Revenue Code, and as reported by HANYS and GNYHA a portion of these dues payments are attributable to lobbying activities. The lobbying activity costs attributable in 2013 to HANYS and GNYHA annual dues payments was $16,742, and $2,760 respectively. 1408000 91 91 1408000 1408000 5 5 1408000 1408000 8 8 1408000 1408000 8 8 1408000 1408000 11 11 1408000 1.00000 false false 0 929000 929000 49136000 34314000 14822000 2997000 2447000 550000 102477000 83844000 18633000 3868000 3868000 38802000 ASSETS WHOSE USE IS LIMITED 8924000 DUE FROM THIRD-PARTY PAYORS 5502000 HEALTHFIRST INVESTMENT 12024000 INV IN & HLD BY CAPTIVE INS CO 24062000 OTHER ASSETS 1575000 PHSP INVESTMENT - COST 5642000 INSURANCE RECOVERABLE 4806000 MACLEAN ASSETS HELD FOR SALE 5301000 DUE FROM RELATED ORGANIZATIONS 5067000 72903000 0 DUE TO THIRD PARTY PAYORS 33795000 OTHER LIABILITIES 0 PROFESSIONAL & SELF INSURED LI 43199000 MACLEAN LIABILITIES HELD FOR S 3103000 80097000 PART V, LINE 4 - INTENDED USES OF ENDOWMENT FUND INCOME FROM ENDOWMENT FUNDS ARE TO BE USED TO FURTHER SUPPORT THE MISSION OF THE ORGANIZATION. ENDOWMENT FUND ASSETS ARE REQUIRED TO BE HELD IN PERPETUITY BY DONOR RESTRICTION. Central America and the Caribbean Investments CAPTIVE INSURANCE CO. 28869000 28869000 28869000 true false true false false false ACTIVITIES PER REGION THE HOSPITAL IS A PARTIAL OWNER OF CAPTIVE FOREIGN INSURANCE COMPANIES. THE HOSPITAL'S INVESTMENTS IN THE FOREIGN INSURANCE COMPANIES ARE REPORTED AT FAIR MARKET VALUE OR COST. true true X true X true X true true false true true 1613872 1253366 360506 0.00180 78057560 50509433 27548127 0.13940 79671432 51762799 27908633 0.14120 780287 780287 24478672 17165152 7313520 0.03700 21643370 6228722 15414648 0.07800 46902329 23393874 23508455 0.11500 126573761 75156673 51417088 0.25620 82609 82609 0.00040 82609 82609 0.00040 true 2641000 402699 69391992 50392665 18999327 X true true 1 1 St John's Episcopal Hospital 327 Beach 19th Street Far Rockaway NY 11691 X X X X St Johns Episcopal Hospital 1 true X X X X X X X X 13 true false true X www.EHS.org X X X false false true true 100 true 400. true X X X X X X true true X X X X X X true false true X false false Schedule H. Part V SEC B, Line 7 THE HOSPITAL RECOGNIZES THERE IS A NEED TO ADDRESS ALL IDENTIFIED HEALTH CONCERNS. DUE TO LIMITATIONS IN STAFFING AND RESOURCES, THE HOSPITAL FOCUSED ITS EFFORTS ON THOSE PRIORITIES THAT APPEARED TO BE OF THE MOST NEED AND HAD THE STAFFING AND RESOURCES TO COMMIT TO A THREE-YEAR PLAN OF IMPLEMENTATION. HIV AND AIDS SERVICES ARE CURRENTLY OFFERED AT THE JOSEPH P ADDABO FAMILY HEALTH CENTER THE COMMUNITY HEALTH PRIORITIES THAT THE HOSPTAL IDENTIFIED IN ITS HEALTH NEEDS ASSESSMENT BUT DOES NOT INTEND TO MEET ARE: CANCER; RESPIRATORY DISEASE; HIV AND AIDS; MATERNAL CHILD HEALTH. Schedule H, Part V SEC B, Line 20D DURING 2013, THE HOSPITAL DETERMINED THAT THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS WAS A FLAT FEE PLUS A PERCENTAGE OF ANCILLARY CHARGES BASED ON FEDERAL POVERTY LEVEL THE INDIVIDUAL QUALIFIED FOR. 1 BISHOP WALDO MACLEAN NURSING HOME 1711 BROOKHAVEN AVENUE FAR ROCKAWAY NY 11691 SKILLED NURSING FACILITY SCHEDULE H, PART I, LINE 7 ST. JOHN'S EPISCOPAL HOSPITAL 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. SCHEDULE H, PART III, LINE 3 St. John's Hospital utilizes the estimated percentage of patients living at or below the federal poverty level 20.4% and the self pay percentage 85.1646% to arrive at the amount of bad debt that is potentially attributable to patients eligible under the organization's financial assistance policy. SCHEDULE H, PART III, LINE 4 THE AMOUNT REPORTED ON LINE 2 IS EQUAL TO THE PROVISION FOR BAD DEBTS SHOWN IN THE AUDITED FINANCIAL STATEMENTS ("AFS"). THE EXPLANATION OF THE METHODOLOGY USED TO ESTIMATE IS EXCERPTED BELOW: Accounts receivable are also reduced by an allowance for doubtful accounts. In evaluating the collectability of accounts receivable, the Corporation analyzes its past history and identifies trends for each of its major payer sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for bad debts. Management regularly reviews data about these major payer sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the Corporation analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for bad debts, if necessary (for example, for payers who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients, which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill, the Corporation records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between discounted rates and the amounts actually collected after all reasonable collection efforts have been exhausted is charged to the allowance for doubtful accounts. SCHEDULE H, PART III, LINE 5 Included in the calculation of the Medicare revenue of $69,391,992 is $12,257,485 of Disproportionate Share (DSH) payments and $11,005,092 of Indirect Medical Education (IME) payments which total $23,262,577 Resulting in true patient service revenue of $46,129,415. SCHEDULE H, PART III, LINE 5 & 6 Pursuant to the instructions included in Medicare Revenue Received on Part III Section B Line 5 is Reimbursement for Indirect Medical Education (IME) of $10.1 million. There are $0 cost included in Part III Line 6 Medicare Allowable Cost related to IME. SCHEDULE H, PART III, LINE 7 The Medicare surplus shown of $18,999,327 includes the additional items of Medicare revenue detailed in the explanation for Line 5 above without inclusion of additional costs related to them. Had these amounts not been received the operating Medicare shortfall would have been $4,263,250. Losses on treating Medicare beneficiaries should be included as a community benefit in their entirety. St. John's Episcopal Hospital incurred this operating Medicare loss of $4.3 million to deliver care to Medicare patients. This represents the amount by which costs to deliver care to Medicare recipients exceeds the level of payment. St. John's Episcopal Hospital bears the burden of not only providing the best and most advanced medical care possible to the community, but also doing so with no recourse to obtain payment for the cost of providing care in excess of the Medicare payment. As Medicare revenue declines and the cost to provide cutting edge care to the community increases, the Hospital will carry the burden as a participating provider and a charitable organization. Like all patients those on Medicare, the majority of whom are elderly OR disabled, are not turned away, so St. John's Episcopal Hospital will continue to bear the loss in providing the best care possible to the local community. SCHEDULE H, PART III, LINE 8 the Medicare revenue and allowable costs shown in Part III Section B Lines 5 and 6, respectively, were derived from the as-filed 2013 CMS-2552 (Medicare Cost Report). Medicare revenue is based on the Medicare Provider Statistical and Reimbursement Report and Medicare costs were developed utilizing a ratio of Medicare allowable costs to charges methodology. FINANCIAL ASSISTANCE - SCHEDULE H, PART III, LINE 9B The charity care and financial assistance policies of St. John's Episcopal Hospital (which are further summarized in Schedule H Part VI Line 3) ensure that every effort is made to identify patients that are eligible for financial assistance and/or charity care. Included below is a summary of the billing and collection procedures followed by St. John's Episcopal Hospital: - The forced sale of or foreclosure on the patient's primary residence is prohibited - Sending an account to collection if the patient has submitted a completed application for financial assistance, including any required documentation, while the application is pending is prohibited - Provide written notification to a patient at least 30 days before an account is sent to collection (written notice can be included on a bill). - Require the collection agency to have the hospital's written consent prior to starting a legal action for collection. - Require all hospital staff that interacts with patients or have responsibility for billing and collection to be trained in the hospital's policies. - Have a way of measuring the hospital's compliance with its policies. - Require any collection agency under contract with the hospital to follow the hospital's financial assistance policy and provide information to patients on how to apply, where appropriate. - Prohibit collection activity if the patient is determined eligible for Medicaid for the services that were rendered and the hospital is able to collect Medicaid payment. SCHEDULE H, PART VI LINE 2 St. John's Episcopal Hospital (the "Hospital" or "St. John's") is a 257 licensed bed acute care hospital located in Far Rockaway, New York. St. John's, together with the Bishop Henry B. Hucles Nursing Home, Inc.; the Bishop Waldo MacLean Nursing Home; St. John's Emergency Services PC; St. John's Medical Services PC, form the patient care services of Episcopal Health Services, Inc., which is sponsored by the Episcopal Diocese of Long Island. This discussion relates to the Hospital only as required in Form 990 Schedule H. As the result of several meetings with community groups, a comprehensive Community Health Needs Assessment (CHNA) for the Hospital community was developed. The document addresses only St. John's, as the aforementioned nursing homes are currently involved in a transaction that will ultimately transfer ownership to an unrelated third party. The report fulfills the requirements of the new Federal statute established within the Patient Protection and Affordable Care Act (PPACA) requiring non-profit hospitals to conduct CHNAs every three years. The CHNA process undertaken by the Hospital utilized extensive input from persons who represent the broad interests of the community. In addition, this document satisfies the requirements set forth by the New York State Department of Health (DOH) relative to the preparation of a three year Community Service Plan (CSP). The overlapping nature of these requirements enabled the Hospital to complete one comprehensive document. New York's relevant statute, Section 2803-1 of the Public Health Law, requires voluntary non-profit hospitals to submit a comprehensive CSP to the State Department of Health (DOH) every three years that includes a solicitation of the views of the communities served by the Hospital on service priorities; demonstrates the Hospital's operational and financial commitment to meet community health needs; provision of charity care; and improving access by the underserved, among other elements. In submitting their CSPs, hospitals are required to take steps that include: - Reaffirming organizational mission statements; - Defining the service area used for community and local health planning and describing the methods used to determine such service area; - Identifying all participants involved in assessing community health needs and describing and summarizing the hospital's public input sessions; - Discussing the identified public health priorities, including the criteria used to select priorities and the status of priorities; - Establishing an evolving plan of action; and - Disseminating a written summary of the CSP to the public through various channels. The statutory CSP requirements were recently enhanced by DOH's Prevention Agenda initiative, a process that asks hospitals to work with local public 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 the hospital's CSP update submitted to DOH. St. John's has incorporated the Prevention Agenda into its three year plan. To advance the goals of the New York State Prevention Agenda 2013-2017 and Healthy People 2020 in its Service Area, St. John's reached out and partnered with numerous community-based organizations and other stakeholders to identify community health needs and develop plans to address these needs. The participating organizations included: -St. John's Episcopal Hospital Community Advisory Board -Joseph P. Addabbo Family Health Center -NAACP of Rockaway -Rockaway Beach Channel Long Term Recovery -Rockaway United -Community Board 14 -Deerfield Area Civic Association -Rockaway Development and Revitalization Corp. -Visiting Nurse Service of New York -Rockaway Manor Home Care -Queens County Perinatal Council -Doctors of the World -SCO Family of Services -Met Council -Queens Public Library -Lucille Rose Day Care -Safe Space -Rockaway Beach Civic Association -New York State Assemblyman Phillip Goldfeder Two initial community meetings were held to gather input from the public on the health concerns of the community, the application of the New York State Department of Health Prevention Agenda 2013-2017 to their community and their views of health data gathered by the Hospital. At those meetings participants were then asked to give their opinion on the two highest priorities in the Rockaways. In this manner a sampling of the community opinion was conducted. The meetings were held on July 9, 2013 at 6 pm at the Peninsula Preparatory Charter School (34 attendees); and July 16, 2013 at 6 pm at the Knights of Columbus Rockaway Council #2672 (55 attendees). The meetings were publicized through a variety of ways including four full-page color advertisements in the local newspapers, the "Wave", the "Rockaway Pointer", and the "Five Towns Jewish Press"; a community email blast; social media; and the St. John's website. SCHEDULE H, PART VI, LINE 3 St. John's Hospital is committed to providing access to quality health care services with compassion, dignity and respect for all patients, particularly the poor and the underserved in our community. Accordingly, St. John's Hospital has implemented a Charity Care and Financial Assistance Process to help facilitate the provision of much needed care. This process includes: - Providing patient care regardless of the ability to pay for services; - Assisting patients who cannot pay for part or all of the care they receive; - Financial counselors will confidentially review the situation to see if patients quality for some form of government or other financial assistance; - Balancing needed financial assistance for some patients with the broader fiscal responsibilities in order to sustain viability and provide the quality and quantity of services residents in the community need; and - Offer installment plans to allow patients to pay over time without the imposition of interest charges. SCHEDULE H, PART VI, LINE 4 The Rockaway Peninsula is a narrow strip of land bordered by the Atlantic Ocean and Jamaica Bay and is a part of Queens County, New York City and also borders Nassau County on Long Island. Superstorm Sandy had a devastating impact on the Rockaway Peninsula. Much of the community was without gas and electric for weeks following the storm. Homes and businesses were in ruin, some claimed by the sea, others by fire, entire blocks in Belle Harbor and Rockaway Park were engulfed in flames, a considerable portion of Breezy Point literally burned to the ground. Debris and sand were everywhere, including the inside of homes. Cars that had been flooded were scattered throughout the streets of the community. The rebuilding has been extremely slow, and is an ongoing process, with many displaced residents having still not returned to their homes. Many nursing homes and adult homes - sources of admissions to the Hospital, as well as other local businesses never reopened. Transportation between the peninsula and the mainland is a long time commitment for residents as the peninsula is connected to New York City by two toll bridges, the Marine Park Bridge and the Cross Bay Bridge, and by the "A" subway line of the New York City Metropolitan Transit Authority, which was out of commission until late Summer 2013. Throughout the two weeks after the storm St. John's was like a beacon in the darkness for Far Rockaway and the surrounding communities. Running on generator power for 12 days, the Hospital was a place where shelter, warmth, light and food could be found. People stopped in to charge cell phones, and found electricity to power much needed medical devices. Many residents lost everything they had, carrying what they could of their prized possessions. Ongoing recovery assistance was also provided by the Hospital. Collections were made to help employees defray some of the costs of recovery, and clothing drives put much needed clothes on the backs of local residents. ST. JOHN'S HAS SERVED THE COMMUNITY FOR MORE THAN 100 YEARS. AS A NOT-FOR-PROFIT FAITH-BASED INSTITUTION THAT IS DEEPLY AWARE OF THE COMMUNITY'S GEOGRAPHIC ISOLATION AND VULNERABILITIES, IT IS DEEPLY COMMITTED TO CONTINUING TO SERVE THE COMMUNITY WELL INTO THE FUTURE. IT IS ALSO COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITY AND CONTINUING TO OFFER A WIDE RANGE OF SERVICES, AS WELL AS COMMUNITY OUTREACH AND HEALTH. While "community" can be defined in many ways, the Hospital defined its Service Area as the 6 zip codes from which approximately 70% discharges came, namely Far Rockaway; Inwood; Arverne; Rockaway Beach; Belle Harbor; and Breezy Point. In 2013 the Rockaways had a population totaling over 123,000 with almost 30% of the Service Area's population under the age of 20, and almost 13% over the age of 65. More than 20% live under the federal poverty level, while the overall Queens county rate is just below 14%. The percentage of the Service Area population who are deemed to be minorities is 65.4%, with African Americans comprising 38% of the population. A large population of Hispanics resides in Inwood, which is the most northeast boundary of the Service Area. population. A large population of Hispanics resides in Inwood, which is the most northeast boundary of the Service Area. SCHEDULE H, PART VI, LINE 5 Overall health status continues to be lacking, with 25% of residents of the Rockaways considering themselves to be in poor or fair health. In addition, 21% of Queens County residents do not have health insurance coverage, which is higher than the statewide rate of 14%. Lack of health insurance is also a significant barrier to accessing health care. Due to these existing demographic factors, St. John's is constantly working to educate and improve the overall health and well being of those that live in the communities we serve. In preparation of the attached Community Health Needs Assessment (CHNA) the Hospital met with community members over the course of several meetings in an effort to determine the health needs and concerns of the areas served. The following are the areas the Hospital has determined to require primary attention: -PROMOTE MENTAL HEALTH AND PREVENT SUBSTANCE ABUSE -Prevention of chronic diseases -Community based diabetes program; -Increase cardiovascular screening rates; -Obesity - Creating a community environment that promotes healthy food and beverage choices In addition to the initiatives outlined in the CHNA, the Hospital has undertaken numerous community focused initiatives. Opened just weeks before Superstorm Sandy, the Belle Harbor Family Practice office was established to service the residents on the western end of the peninsula. The storm effectively wiped out the office, and fortunately it was rebuilt and reopened again on May 1, 2013. Over two dozen health fairs and other events were either sponsored by the Hospital or were participated in throughout 2013. Blood pressure, cholesterol and glucose screenings were among the tests provided to community members attending these events. In addition, presentations were given to further educate residents in the area on health issues affecting them. While health care is the primary service delivered by St. John's it is also important to assist the community in other ways. Annually the Hospital sponsors a children's holiday party where community children meet Santa and are provided toys for the holiday. A community baby shower allows new mothers to receive baskets filled with necessary items for a newborn. Also, Thanksgiving food baskets have been distributed to local families in need allowing them to enjoy a full traditional holiday meal thanks to the generosity of the hospital staff. SCHEDULE H, PART VI, LINE 5 St. John's Episcopal Hospital plays an important role in the local community as a provider of needed medical services. St. John's is the only hospital on the peninsula and is also the largest non-governmental employer in the local community. In addition to providing high quality medical services, St. John's is also an active member of the local community, participating in various health fairs, screenings, and educational sessions and events to local residents at no cost. Many of the various programs and initiatives that St. John's Hospital has identified to demonstrate our commitment to further its exempt purpose and promote the health care of the local community have been highlighted previously in this form. St. John's Hospital has an active Community Advisory Board comprised of local residents and business people who meet with Hospital leadership quarterly to discuss at a high level the overall operations of the Hospital, demographics and health needs of the Rockaway community. St. John's extends medical staff privileges to all qualified physicians in its community for the various services provided by the Hospital. The Hospital's medical staff is a large diverse group of highly trained professionals numbering approximately 450 members. In addition, St. John's overall responsiveness to the needs of our community is evidenced by our willingness to participate in a range of coalitions, panels, advisory groups, commissions and boards, including Ready Rockaway, which is a coalition of community based organizations that recognize the need for planning for emergencies such as Superstorm Sandy which severely impacted the Rockaway peninsula in October. In addition, St. John's has internal emergency and disaster drills throughout the year to ensure the Hospital is prepared to meet the needs of its local community and the surrounding areas. SCHEDULE H, PART VI, LINE 6 NOT APPLICABLE SCHEDULE H, PART VI, LINE 7 NEW YORK. X X true false false false false false false false false CHERIAN T PALATHRA CONTROLLER - TERM 9/13 97354 33040 5095 0 25097 0 160586 0 ROBERT BLAKE PHYSICIAN 188794 74098 216 6338 0 12535 0 207883 74098 SHELDON MARKOWITZ CHAIR - DEPT OF MEDICINE 257618 3810 6931 0 35649 0 304008 0 MANMOHN MAHADKAR CHAIR- OB/GYN-TERM 11/13 279894 25000 28569 6923 0 35640 0 376026 0 RAJIV PRASAD CHAIR - EMERGENCY SERVICES 342048 4276 5952 0 0 0 352276 0 GILBERT MAKABALI MD CHAIRMAN - SURGERY 259297 2472 6699 0 38149 0 306617 0 ALAN STEINBERG MD CHAIRMAN - PEDIATRICS 265762 1980 5533 0 25868 0 299143 0 RAYMOND PASTORE MD CHIEF MEDICAL OFFICER 273187 2472 6725 0 0 0 282384 0 LOKESH REDDY MD CHIEF OF PSYCHIATRY 286164 3152 4302 0 25860 0 319478 0 James Henry MD CHIEF OF ORTHOPEDICS 327675 690 6680 0 18752 0 353797 0 Kelly Barland Chief Information Officer 222978 690 0 0 0 0 223668 0 Krishna Kishore Bezwada Chief - Psychiatry 259481 270 7494 0 22261 0 289506 0 Richard Sarli VP Finance 272500 690 0 0 2500 0 275690 0 Natalie Schwartz VP Reglatory Affairs 256089 1290 6829 0 35649 0 299857 0 Ronald Brenner Chair-Psychiatry 230102 1980 6247 0 23369 0 261698 0 Imelda Canlas Anesthesiologist 248532 0 0 0 0 0 0 248532 0 SHAKIRA GORDON VP HUMAN RESOURCES 144117 300 5538 0 19731 0 169686 0 GWENDOLYN SEYMORE-PINCKNEY VP REGULATORY AFFAIRS 145275 580 5310 0 21965 0 173130 0 Schedule J, Part I, Line 4A CHERIAN PALATHRA, CORPORATE CONTROLLER, RECEIVED SEVERANCE PAYMENTS TOTALLING $31,847 IN 2013. UPON MR. PALATHRA'S SEPERATION OF EMPLOYMENT WITH EHS, HE WAS PROVIDED A ONE-YEAR SEVERANCE AGREEMENT IN RECOGNITION OF HIS 30 YEAR EMPLOYMENT HISTORY WITH THE ORGANIZATION. SCHEDULE J, PART II THE CHIEF EXECUTIVE OFFICER, CHIEF OPERATING OFFICER AND CHIEF FINANCIAL OFFICER WAS PROVIDED THROUGH A MANAGEMENT CONTRACT WITH PITTS MANAGEMENT ASSOCIATES (PMA) THROUGH NOVEMBER 30, 2013. EFFECTIVE DECEMBER 1, 2013, THE CHIEF OPERATING OFFICER WAS NAMED THE CHIEF EXECUTIVE OFFICER AND MADE AN EMPLOYEE OF THE ORGANIZATION ON DECEMBER 1, 2013, THE CHIEF FINANCIAL OFFICER WAS ALSO MADE AN EMPLOYEE OF THE ORGANIZATION. FORM 990, PART VI, LINE 3 EPISCOPAL HEALTH SERVICES INC. ENGAGED THE SERVICES OF PITTS MANAGEMENT ASSOCIATES INC. (PMA), AN UNRELATED COMPANY, TO PROVIDE DAY-TO-DAY MANAGEMENT CONSULTING SERVICES. REMUNERATION PAID TO PMA DURING 2013 ARE REPORTED IN PART VII, SECTION B - INDEPENDENT CONTRACTORS. THE APPLICABLE NAMES AND TITLES OF PMA PERSONNEL ARE DISCLOSED ON PART VII - SECTION A - OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES. THE CONTRACT WITH PMA TERMINATED 11/30/13 AND THE COO AND THE CFO WERE MADE EMPLOYEES OF EHS. FORM 990, PART VI, LINE 8B THERE ARE NO SEPARATE COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, LINE 11B THE FORM 990 AND APPROPRIATE SCHEDULES, AS REQUIRED (FORM 990), IS COMPLETED BY THE ACCOUNTING AND FINANCE STAFF OF THE ORGANIZATION AND REVIEWED INTERNALLY BY MANAGEMENT. IT IS THEN REVIEWED BY OUTSIDE TAX ADVISORS AND ANY NECESSARY ADJUSTMENTS ARE MADE, AFTER WHICH TIME IT IS CONSIDERED AN initial DRAFT. THE DRAFT OF THE FORM 990 IS THEN PRESENTED TO THE EPISCOPAL HEALTH SERVICES AUDIT COMMITTEE (THE COMMITTEE) OF THE BOARD OF TRUSTEES(THE BOARD), WHICH HAS BEEN DELEGATED THE DETAILED REVIEW FUNCTION BY THE BOARD. ONCE THE Committee'S REVIEW IS COMPLETE THE FORM 990 IS THEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD. FORM 990, PART VI, LINE 12C THE HR DEPARTMENT GATHERS ALL ANNUAL CONFLICT OF INTEREST QUESTIONNAIRES AND FORWARDS THEM TO THE CORPORATE COMPLIANCE DEPARTMENT WHERE THEY ARE REVIEWED. WHERE POSITIVE RESPONSES ARE INDICATED ADDITIONAL INFORMATION IS GATHERED TO DETERMINE IF A CONFLICT ACTUALLY EXISTS. IF A CONFLICT EXISTS, APPROPRIATE ACTION IS TAKEN TO ELIMINATE THE CONFLICT, INCLUDING SUCH STEPS AS NOTIFYING THE BOARD, REASSIGNMENT OF RESPONSIBILITIES OR ESTABLISHMENT OF PROTECTIVE AGREEMENTS. IF A MATTER INVOLVES A BOARD MEMBER OR OFFICER, APPROPRIATE ACTION, INCLUDING RECUSAL AND ADDITIONAL DISCLOSURES, WILL BE DETERMINED BY THE BOARD. FORM 990, PART VI, LINE 15A THE CHIEF EXECUTIVE OFFICER AND OTHER KEY MANAGEMENT OFFICIALS WERE PROVIDED THROUGH A MANAGEMENT CONTRACT WITH PITTS MANAGEMENT ASSOCIATES INC.(PMA) THROUGH 11/30/2013. EFFECTIVE 12/1/2013 THE CEO AND CFO WERE MADE EMPLOYEES OF THE ORGANIZATION AND THE COMPENSATION REVIEW & APPROVAL PROCESS INCLUDED A COMPARISON OF COMPENSATION RATES PAID THROUGH THE MANAGEMENT COMPANY AS WELL AS COMPARABLE POSITIONS IN THE ORGANIZATION'S REGION. COMPENSATION WAS REVIEWED AND APPROVED BY THE ORGANIZATION'S BOARD OF DIRECTORS. BOARD DECISIONS ARE CONTEMPORANEOUSLY DOCUMENTED IN BOARD MINUTES. FORM 990, PART VI, LINE 15B THE COMPENSATION OF KEY EMPLOYEES IS DETERMINED AND/OR APPROVED AFTER COMPARISON TO CURRENT COMPENSATION RATES PAID FOR COMPARABLE POSITIONS IN THE ORGANIZATION'S REGION. BOARD DECISIONS ARE CONTEMPORANEOUSLY DOCUMENTED IN BOARD MINUTES. FORM 990, PART VI, LINE 19 UPON REQUEST, THE ORGANIZATION WILL MAKE AVAILABLE THOSE DOCUMENTS REQUIRED TO BE DISCLOSED UNDER THE PUBLIC INSPECTION LAWS. FORM 990, PART XI, LINE 9 - OTHER CHANGES IN NET ASSETS CHANGE IN PENSION LIABILITY. . . . . . . . . . . . . . . $1,808,000 DISCONTINUED OPERATIONS . . . . . . . . . . . . . . . . 297,000 Net Assets Transferred to Related Party . . . . . . . . -1,897,000 TOTAL $ 208,000 BISHOP HENRY B HUCLES NURSING HOME 700 HICKSVILLE ROAD SUITE 210 Bethpage NY 11714 113277961 Nursing/Rehab NY 501(C)(3) LINE 9 NA true CHURCH CHARITY CORPORATION AND SUB 700 HICKSVILLE ROAD SUITE 210 BETHPAGE NY 11714 112797706 CHARITY NY 501(C)(3) NA true ST JOHN'S EMERGENCY MEDICAL SERVICE 700 HICKSVILLE ROAD SUITE 210 BETHPAGE NY 11714 262884115 ER SERVICES NY 501(C)(3) LINE 11A NA true ST JOHN'S MEDICAL SERVICE PC 700 HICKSVILLE ROAD SUITE 210 BETHPAGE NY 11714 542164621 MEDICAL SVCS NY 501(C)(3) LINE 11A NA true BEACH REINSURANCE CORP PO BOX 1109 GRAND CAYMAN CJ INSURANCE CJ CCC C CORP false false true false false false false false false false false false false true true false false true true BISHOP HENRY B HUCLES NURSING HOME INC O 388672 COST BISHOP HENRY B HUCLES NURSING HOME INC N 1413895 COST ST JOHN'S EMERGENCY MEDICAL SERVICES PC R 274676 COST ST JOHN'S MEDICAL SERVICES PC S 1658407 COST Bishop Henry B Hucles Bursing Home Inc B 1896782 Cost