2014-11-14T13:01:59-06:00 2013-12-31 861065772 DELOITTE TAX LLP TWO JERICHO PLAZA JERICHO NY 11753 990 2013-01-01 111352310 SOUTH NASSAU COMMUNITIES HOSPITAL INC SOUT 5166323000 ONE HEALTHY WAY OCEANSIDE NY 115721551 MARK BOGEN SVP/CFO 5166323000 2014-11-11 1 CHRISTINE KAWECKI P00743140 5169187000 2014-11-12 2013 2015-11-30 17:44:51Z MARK BOGEN ONE HEALTHY WAY OCEANSIDE NY 115721551 485374444 0 5611 X WWW.SOUTHNASSAU.ORG X 1927 NY SEE SCHEDULE O. 30 28 3382 375 4314565 0 1795426 3857672 372425573 391702373 6162402 7184271 7099000 7811039 387482401 410555355 0 0 0 0 227691715 217230969 0 0 509261 156839543 162380791 384531258 379611760 2951143 30943595 445310593 476914260 349867594 267427432 95442999 209486828 X SEE SCHEDULE O. 0 0 213458653 220836257 SEE SCHEDULE O. 43946125 49460738 SEE SCHEDULE O. 25374785 26149738 SEE SCHEDULE O. 51068725 98694303 OTHER PROGRAM SERVICES:ADDITIONAL OUTPATIENT SERVICES OFFERED BY SOUTH NASSAU COMMUNITIES HOSPITAL ARE: WOUND CARE; FAMILY MEDICINE; SPORTS MEDICINE AND REHABILITATION THERAPY; BEHAVIORAL HEALTH SERVICES; OUTPATIENT DIALYSIS; PARENT-CHILD EDUCATION; PRIMARY MEDICAL CARE; CARDIAC REHABILITATION; WEIGHT & LIFE MANAGEMENT; HOME HEALTH CARE; LONG TERM HOME HEALTH CARE; CANCER SERVICES; GAMMA KNIFE SERVICES; BREAST/GYN HEALTH; OTHER CARDIOVASCULAR SERVICES; PAIN MANAGEMENT; RADIOLOGY SERVICES; WOMEN'S IMAGING; SLEEP MEDICINE.THE HOSPITAL PROVIDED OVER 280,000 SERVICES RELATED TO THE OTHER OUTPATIENT SERVICES IN 2013. THESE SERVICES WERE PROVIDED TO THE MEMBERS OF THE COMMUNITY ON AN ELECTIVE. THE HOSPITAL PROVIDES CHARITY CARE AND DISCOUNTS TO PATIENTS THAT ARE UNABLE TO A PAY FOR THESE SERVICES.THE HOSPITAL PROVIDED CHARITY CARE OF APPROXIMATELY $4.2 MILLION (CHARGES) FOR OTHER OUTPATIENT SERVICES SERVED IN 2013. 51068725 98694303 333848288 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 1 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 1 1 1 0 1 274 0 1 3382 1 1 1 0 0 0 0 1 1 0 0 0 0 0 X 30 28 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X MARK BOGEN - FINANCE DEPT 5166323965 ONE HEALTHY WAY OCEANSIDE NY 11572 JOSEPH J FENNESSY CHAIRMAN 1.00 2.00 X 0 0 0 HAROLD MAHONY ESQ IMMEDIATE PAST CHAIRMAN 1.00 1.00 X 0 0 0 HARRY KASSEL VICE CHAIRMAN 1.00 2.00 X 0 0 0 HENRY R PUPKE VICE CHAIRMAN 1.00 1.00 X 0 0 0 GEORGE SCHIEREN VICE CHAIRMAN 1.00 1.00 X 0 0 0 ROBERT M WHYTE JR TREASURER 1.00 2.00 X 0 0 0 MICHAEL SCHAMROTH VICE CHAIRMAN 1.00 1.00 X 0 0 0 PETER C BREITSTONE SECRETARY 1.00 1.00 X 0 0 0 LOWELL FREY ASSISTANT SECRETARY 1.00 1.00 X 0 0 0 JOHN F ALOIA MD DIRECTOR 1.00 1.00 X 0 0 0 JAMES F CAMPBELL DIRECTOR 1.00 1.00 X 0 0 0 MARILYN COHEN DIRECTOR 1.00 1.00 X 0 0 0 MIHAI DIMANCESCU MD DIRECTOR 1.00 1.00 X 0 0 0 ABBEY DONEGER DIRECTOR 1.00 1.00 X 0 0 0 ADAM K GALEON DIRECTOR 1.00 1.00 X 0 0 0 STEVEN GOLD DIRECTOR 1.00 1.00 X 0 0 0 REV HARALD K KUEHNE DIRECTOR 1.00 1.00 X 0 0 0 WELQUIS RAIMUNDO LOPEZ DIRECTOR 1.00 1.00 X 0 0 0 STEVEN SAUER DIRECTOR 1.00 1.00 X 0 0 0 SALLY VALENTI DIRECTOR 1.00 1.00 X 0 0 0 RICHARD STREIM DIRECTOR 1.00 1.00 X 0 0 0 HARRIETTE P THAYER DIRECTOR 1.00 1.00 X 0 0 0 RON KAMINER DDS DIRECTOR 1.00 1.00 X 0 0 0 MARVIN WOLF DIRECTOR 1.00 1.00 X 0 0 0 ANTHONY CANCELLIERI DIRECTOR 1.00 1.00 X 0 0 0 WAYNE LIPTON DIRECTOR 1.00 1.00 X 0 0 0 JOEL SCHNEIDER DIRECTOR 1.00 1.00 X 0 0 0 EDWARD SCOTT DIRECTOR 1.00 1.00 X 0 0 0 RICHARD MURPHY PRESIDENT AND CEO 35.50 2.00 X X 798975 0 143291 HELENA WILLIAMS DIRECTOR 1.00 1.00 X 0 0 0 JOSEPH LAMANTIA CHIEF OPERATING OFFICER 36.50 1.00 X 503928 0 34089 MARK BOGEN CHIEF FINANCIAL OFFICER 36.50 1.00 X 410172 0 46389 LINDA EFFEREN CHIEF MEDICAL OFFICER 36.50 1.00 X 357684 0 25228 SUSAN PENQUE CHIEF NURSING OFFICER 37.50 0.00 X 309728 0 54048 JOHN MERTZ CHIEF INFORMATION OFFICER 37.50 0.00 X 215507 0 43197 JASON FREEMAN DIR INTERVENT CARDIOLOGY 37.50 0.00 X 999191 0 27102 ASIF REHMAN ASSOC. DIR. INT. CARDIO 37.50 0.00 X 1096744 0 27102 LAWRENCE KANNER DIR OF ELECTROPHYSIOLOGY 37.50 0.00 X 898420 0 27102 ROBERT KRAMER DIR OF CARDIAC SERVICES 36.50 1.00 X 509896 0 40505 ALAN GARELY CLINICAL CHAIR OB/GYN 12.00 25.50 X 1048767 0 52102 JOSEPH A QUAGLIATA FORMER PRESIDENT AND CEO 16.00 2.00 X 551536 0 0 7700548 0 520155 291 1 1 0 WOMEN'S MSO LLC 440 MERRICK ROAD OCEANSIDE NY 115723008 WOMEN'S IMAGING 4132071 FTI PO BOX 418005 BOSTON MA 022418005 CONSULTING 2133143 GILBANE BUILDING COMPANY 7 JACKSON WALKWAY PROVIDENCE RI 02903 BUILDING CONTRACTOR 1917454 BARTLETT MCDONOUGH MONAGHAN LLC 170 OLD COUNTRY ROAD MINEOLA NY 115012900 LEGAL SERVICES 1642152 PERSONAL WOMEN'S OBGYN CARE PC 2900 HEMPSTEAD TURNPIKE LEVITOWN NY 11756 PHYSICIANS SERVICE 1400000 42 930007 1163884 1763781 49077 3857672 NET PATIENT REVENUE 900099 385933321 385933321 REFERENCE LAB 621500 4314565 4314565 RENTAL INCOME FROM REL 532000 1454487 1454487 391702373 2933400 2933400 78624217 31991 74099186 306151 4525031 -274160 4250871 4250871 471563 930007 413752 57811 57811 EMR INCENTIVES 900099 2513874 2513874 NEW ISLAND SETTLEMENT 900099 1502486 1502486 RECOVERRIES FROM STORM 900099 1426031 1426031 2310837 2310837 7753228 410555355 395141036 4314565 7242082 2942236 2942236 180833630 159206852 21190516 436262 6496366 5641258 855108 13732349 11924778 1807571 13226388 11485416 1740972 685031 594861 90170 362052 362052 219526 219526 531201 531201 22332917 19228120 3104797 6337324 5503150 834174 2199758 1910207 289551 5186997 4703195 483802 254018 220582 33436 685344 595133 90211 3594313 3121198 473115 1265171 1265171 24467569 21246935 3220634 -961717 -1050818 89101 MEDICAL AND SUPPLIES 68027282 67866583 160699 EQUIPMENTAL RENTAL & MA 24207994 21021527 3186467 LOSS LBMC TRANSACTIONS 1638514 1638514 LOSS ON REFINANCING 645187 645187 702310 629311 72999 379611760 333848288 45254211 509261 17182861 26045122 6319435 7382174 49340603 50981960 6876053 6422675 2032696 3110683 436209389 227067366 215431871 209142023 97212389 113752972 6945280 6529366 43969405 53547285 445310593 476914260 57116475 63306547 104703848 0 23049095 118045523 164998176 86075362 349867594 267427432 X 93936954 207859265 477969 599487 1028076 1028076 95442999 209486828 445310593 476914260 X 30943595 10391931 -107871 72816174 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 291526 291526 0 PART II-B, LINE 1: THE HOSPITAL IS A MEMBER OF MULTIPLE HEALTHCARE ASSOCIATIONS WHICH INCLUDE: THE AMERICAN HOSPITAL ASSOCIATION, HEALTHCARE ASSOCIATION OF NEW YORK, THE NASSAU SUFFOLK HOSPITAL COUNCIL, AND THE HOME CARE ASSOCIATION OF NEW YORK STATE. THESE ORGANIZATIONS LOBBY ON BEHALF OF THE HEALTHCARE INDUSTRY. SOUTH NASSAU IS ALSO A MEMBER OF THE LONG ISLAND HEALTH NETWORK ("LIHN"), WHICH IS A NETWORK OF TEN HOSPITALS. LIHN LOBBIES ON BEHALF OF ITS HOSPITAL NETWORK MEMBERS. THE HOSPITAL ALSO EMPLOYS VARIOUS LOBBYING CONSULTING FIRMS ON HOSPITAL SPECIFIC ISSUES. 1506045 1838970 1717452 1627563 3054046 709949 2257950 1506045 1986741 1700414 633109 3054046 1958812 1452850 1424921 1986741 1433452 1048390 523030 1958812 0.37000 0.63000 0 0 8882610 8882610 294334793 150764056 143570737 9859215 6567422 3291793 114031694 69735888 44295806 9101077 9101077 209142023 ASSETS WHOSE USE IS LIMITED 18738218 OTHER LONG TERM ASSETS 1699516 ACCRUED INTEREST RECEIVABLE 143354 DUE FROM AFFILIATES 30366643 OTHER CURRENT ASSETS, NET OF INVENTORY & PREPAID 2599554 53547285 ACCRUED PENSION 23193045 ACCRUED POST RETIREMENT 3957000 ESTIMATED PROFESSIONAL AND GENERAL 37720000 PAYABLE TO THIRD PARTY 19060000 ASSET RETIREMENT OBLIGATION 2145317 86075362 X PART V, LINE 4: USE OF ENDOWMENT FUNDS RESTRICTED NET ASSETS AND NET ASSETS RELEASED FROM RESTRICTION TWO FUNDS EXIST AT THE HOSPITAL, THE ANNUAL IMPROVEMENT FUND AND THE SPECIAL PURPOSE FUND. THESE FUNDS ARE RESTRICTED AS TO THEIR PURPOSE OR TIME AS IS STIPULATED BY THE DONOR'S REQUEST. THE MONEY IS KEPT IN SEPARATE INVESTMENT VEHICLES FOR EACH FUND. UNRESTRICTED DONATIONS ARE KEPT IN THESE TEMPORARY FUNDS ALSO. PERMANENTLY RESTRICTED NET ASSETS HAVE BEEN RESTRICTED BY DONORS AND ARE TO BE MAINTAINED BY THE HOSPITAL IN PERPETUITY. THESE ASSETS CONSIST OF INVESTMENTS TO BE HELD IN PERPETUITY, THE INCOME FROM WHICH MAY BE RESTRICTED FOR SPECIFIC HOSPITAL ACTIVITIES OR MAY BE UNRESTRICTED AS TO USE. IF A DONATION IS MADE FOR A SPECIAL PROGRAM, IT IS PLACED INTO A TEMPORARILY RESTRICTED CATEGORY. WHEN THE EXPENDITURE IS INCURRED TO FULFILL THE REQUIREMENTS OF THIS PROGRAM/DONATION, THE FUNDS ARE TRANSFERRED FROM TEMPORARILY RESTRICTED STATUS AND ARE EXPENDED. PART X, LINE 2: THE HOSPITAL AND THE PRACTICES ARE SECTION 501(C)(3) ORGANIZATIONS EXEMPT FROM INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(A) AND THEIR INCOME IS GENERALLY NOT SUBJECT TO FEDERAL OR NEW YORK STATE INCOME TAXES. SN HEALTHCARE AND SOUTH NASSAU SN, LLC ARE TAXABLE ENTITIES. THE EFFECTS OF INCOME TAXES ARE NOT MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS. FINANCIAL ACCOUNTING STANDARDS BOARD ("FASB") INTERPRETATION NO. 48, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, AN INTERPRETATION OF FASB STATEMENT NO. 109 ("FIN 48"), PROVIDES GUIDANCE FOR HOW UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN THE COURSE OF PREPARING TAX RETURNS TO DETERMINE WHETHER THE TAX POSITIONS ARE MORE-LIKELY-THAN-NOT OF BEING SUSTAINED UPON EXAMINATION BY THE APPLICABLE TAX AUTHORITY, BASED ON THE TECHNICAL MERITS OF THE TAX POSITION, AND THEN RECOGNIZING THE TAX BENEFIT THAT IS MORE-LIKELY-THAN-NOT TO BE REALIZED. TAX POSITIONS NOT DEEMED TO MEET THE MORE-LIKELY-THAN-NOT THRESHOLD WOULD BE RECORDED AS A TAX EXPENSE IN THE CURRENT REPORTING PERIOD. MANAGEMENT HAS EVALUATED THE IMPLICATIONS OF FIN 48 AND DETERMINED THAT ITS IMPACTS ON THE CONSOLIDATED FINANCIAL STATEMENTS IS NOT SIGNIFICANT. CARNATION BALL 658258 480233 178025 59030 8000 106801 GOLF OUTING 240420 181975 58445 58590 42270 3 502892 267799 235093 17390 121671 1401570 930007 471563 58590 76420 8000 270742 413752 57811 1 1 1 X 1 X 500.000000000000 1 1 1 0 1 1 1 5244 7633684 2345139 5288545 0.01390 1 52780 54622105 40187656 14434449 0.03800 0.00000 2 58024 62255789 42532795 19722994 0.05190 73 5843 370298 370298 0.00100 3 85 9073715 3817619 5256096 0.01380 4 20671 18732626 11805506 6927120 0.01820 0.00000 0.00000 80 26599 28176639 15623125 12553514 0.03300 82 84623 90432428 58155920 32276508 0.08490 0.00000 0.00000 0.00000 0.00000 0.00000 29 15364 147105 147105 0.00040 2 1664 305739 305739 0.00080 0.00000 0.00000 31 17028 452844 452844 0.00120 0 13635857 914339 124794874 136452657 -11657783 X 1 1 1 1 SOUTH NASSAU COMMUNITIES HOSPITAL ONE HEALTH WAY OCEANSIDE NY 115721551 X X X SOUTH NASSAU COMMUNITIES HOSPITAL 1 1 X X X X X X X X 13 1 1 1 X WWW.SOUTHNASSAU.ORG X X X X X X X X X 0 0 1 1 200.000000000000 1 500.000000000000 1 X X X X X X 1 1 X X X X X X 1 0 1 X 0 0 SOUTH NASSAU COMMUNITIES HOSPITAL PART V, SECTION B, LINE 3: THE HOSPITAL PARTICIPATED IN A SERIES OF COLLABORATIVE CHNA PLANNING AND IMPLEMENTATION MEETINGS WITH REPRESENTATION AND INPUT FROM PUBLIC HEALTH EXPERTS FROM LOCAL ACADEMIC PARTNERS, THE NASSAU COUNTY DEPARTMENT OF HEALTH, HOSPITALS AND MULTIPLE COMMUNITY-BASED ORGANIZATIONS LOCATED THROUGHOUT NASSAU COUNTY.THE ORGANIZATIONS THAT PARTICIPATED IN THIS PROCESS ARE LISTED AS FOLLOWS: AMERICAN CANCER SOCIETY AMERICAN DIABETES ASSOCIATION AMERICAN HEART ASSOCIATION CATHOLIC CHARITIES DIOCESE OF ROCKVILLE CENTRECIRCULO DE LA HISPANIDAD, INC. FEGS HEALTH & HUMAN SERVICES (FEDERATION OF EMPLOYMENT AND GUIDANCE SERVICES)THE HEALTH AND WELFARE COUNCIL OF LONG ISLAND ISLAND HARVEST JEWISH ASSOCIATION SERVING THE AGING (JASA) THE LONG ISLAND GLBT SERVICES NETWORK (GAY, LESBIAN, BISEXUAL, TRANSGENDER)THE LONG ISLAND COUNCIL OF CHURCHESMENTAL HEALTH ASSOCIATION OF NASSAU COUNTY, INC.NASSAU COUNTY PERINATAL SERVICES NETWORKPLANNED PARENTHOOD OF NASSAU COUNTYPROJECT INDEPENDENCE TOWN OF NORTH HEMPSTEAD(NATURALLY OCCURRING RETIREMENT COMMUNITY-NORC)SUSTAINABLE LONG ISLAND UNITED WAY OF LONG ISLANDNORTH SHORE LIJ HEALTH SYSTEMNCDOHADELPHI UNIVERSITYMERCY HOSPITALST. FRANCIS HOSPITALLONG BEACH MEDICAL CENTERCATHOLIC HEALTH SERVICESSUDDEN INFANT & CHILD DEATH RESOURCE CENTER, STONYBROOK UNIVERSITY MEDICAL CENTERHOFSTRA UNIVERSITYWINTHROP UNIVERSITY HOSPITALSUNY STONYBROOKNU HEALTH FAMILY HEALTH CENTERSST. JOSEPHNASSAU-SUFFOLK HOSPITAL COUNCILNASSAU COUNTY LIONS CLUB FOUNDATIONFEGS HEALTH & HUMAN SERVICES (FEDERATION OF EMPLOYMENT AND GUIDANCE SERVICES)POSITIVE SPACE SOUTH NASSAU COMMUNITIES HOSPITAL PART V, SECTION B, LINE 4: THE CHNA FOR SOUTH NASSAU COMMUNITIES HOSPITAL WAS CONDUCTED IN PARTNERSHIP WITH WINTHROP SOUTH NASSAU UNIVERSITY HEALTH SYSTEM, AS WELL AS THE LOCAL HEALTH DEPARTMENT LOCATED IN NASSAU COUNTY. SOUTH NASSAU COMMUNITIES HOSPITAL PART V, SECTION B, LINE 7: THE CHNA WAS CONDUCTED IN PARTNERSHIP WITH BOTH HOSPITALS AS WELL AS THE LOCAL HEALTH DEPARTMENT LOCATED IN NASSAU COUNTY. SURVEY FINDINGS YIELDED CHRONIC DISEASE AS THE #1 HEALTH PRIORITY WITH SPECIFIC CONCERNS REGARDING DIABETES, HEART DISEASE AND CANCER. OBESITY WAS NOTED TO BE THE MOST IMPORTANT RISK FACTOR FOR CHRONIC CONDITIONS AND ALONG WITH IMPROVING ACCESS TO HIGH QUALITY, CHRONIC DISEASE PREVENTION AND MANAGEMENT IN CLINICAL AND COMMUNITY SETTINGS, THESE HAVE FORMED THE BASIS FOR THE PRIORITY AREAS THAT WILL BE ADDRESSED BY THE HOSPITAL.OTHER AREAS OF NEED THAT WERE IDENTIFIED BUT WILL NOT BE ADDRESSED INCLUDED ACCESS TO HEALTHY FOOD, AN INCREASE IN UNSAFE LIVING ENVIRONMENTS, LACK OF CHILDCARE FUNDING FOR LOW-INCOME WORKERS, CONCERNS REGARDING MENTAL HEALTH AND SUBSTANCE ABUSE AND HIV/STD SCREENING AND PREVENTION.THE REASONS FOR NOT ADDRESSING THESE AREAS OF NEED INCLUDE LACK OF FUNDING, LACK OF QUALIFIED PERSONNEL AND/OR LIMITED ABILITY AS AN INSTITUTION TO IMPACT THE IDENTIFIED ISSUES. SOUTH NASSAU COMMUNITIES HOSPITAL PART V, SECTION B, LINE 18E: NEITHER THE HOSPITAL NOR ANY AUTHORIZED THIRD PARTY TOOK ANY OF THE ACTIONS LISTED IN FORM 990, SCHEDULE H, PART V, SECTION B, QUESTION 17 OR 18. SOUTH NASSAU COMMUNITIES HOSPITAL PART V, SECTION B, LINE 20D: THE HOSPITAL'S LARGEST COMMERCIAL VOLUME PAYOR IS USED TO DETERMINE THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. IN MOST CASES THIS RATE IS THE LOWEST COMMERCIAL RATE. 8 SNCH - OUTPATIENT BEHAVIORAL HEALTH 2277 GRAND AVE BALDWIN NY 11510 OP BEHAVIORAL HEALTH SNCH - FAMILY PRACTICE CENTER 196 MERRICK ROAD OCEANSIDE NY 11572 FAMILY PRACTICE CENTER SNCH - RADIATION ONCOLOGY THERAPY CNTR ONE SOUTH CENTERAL AVE VALLEY STREAM NY 11580 OP CANCER SERVICES SNCH - OUTPATIENT DIALYSIS CENTER 3618 OCEANSIDE ROAD OCEANSIDE NY 11572 OP DIALYSIS CENTER SNCH - OUTPATIENT ANNEX 440 MERRICK ROAD OCEANSIDE NY 11572 VARIOUS OP SERVICES SNCH - SLEEP CENTER 1420 BROADWAY HEWLETT NY 11557 SLEEP DISORDER CLINIC SNCH - HOMECARE AGENCY 2277 GRAND AVE BALDWIN NY 11510 HOMECARE PROGRAM SNCH - LONG TERM HOMECARE AGENCY 2277 GRAND AVE BALDWIN NY 11510 LONG TERM HOMECARE PROGRAM PART I, LINE 6A: THE HOSPITAL FILED A 2013-2015 COMMUNITY SERVICE PLAN ("CSP"), WHICH INCLUDED A COMMUNITY BENEFIT REPORT, WITH THE NYS DEPARTMENT OF HEALTH ("DOH") ON NOVEMBER 15, 2013. PART I, LINE 7: IN LIEU OF A COST ACCOUNTING SYSTEM, THE COST TO CHARGE RATIO WAS GENERATED FROM THE 2013 INSTITUTIONAL COST REPORT STEP-DOWN. THIS METHODOLOGY APPLIES COSTS TO EACH UNIT BY SERVICE. THE COST TO CHARGE RATIO WAS UTILIZED TO DERIVE THE COSTS. PART I, LINE 7G: INCLUDED IN THE TOTAL COMMUNITY BENEFIT EXPENSE ARE LOSSES RELATED TO THE SNCH FAMILY HEALTH CENTER, INPATIENT AND OUTPATIENT RENAL DIALYSIS, AND THE INPATIENT PEDIATRIC PROGRAM. PART I, LN 7 COL(F): DISTINGUISHING BAD DEBT EXPENSE FROM CHARITY CARE REQUIRES JUDGMENT; TOGETHER, THEY REPRESENT UNCOMPENSATED CARE. THE HOSPITAL'S POLICY REGARDING CHARITY CARE IS TO PROVIDE A SIGNIFICANT AMOUNT OF CARE WITHOUT REGARD TO THE PATIENTS' ABILITY TO PAY FOR SERVICES RENDERED; THIS INCLUDES FREE CARE AND A SLIDING FEE SCALE, BASED ON THE PATIENTS' ABILITY TO PAY WHICH IS DEFINED AS UP TO 300% OF THE POVERTY LEVEL.THE HOSPITAL UTILIZES A CREDIT VERIFICATION FIRM TO ASSIST IN DETERMINING IF UNINSURED PATIENTS MEET THE HOSPITAL'S CHARITY CRITERIA. THIS PROCESS IDENTIFIES UNINSURED PATIENTS THAT WERE UNDER THE POVERTY LEVEL BUT DID NOT APPLY FOR CHARITY CARE.THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS FOR LINE 2 AND LINE 3 USES TOTAL GROSS BAD DEBT CHARGES MULTIPLIED BY THE AMOUNT OF THE HOSPITAL'S OVERALL RATIO OF COSTS TO CHARGES (CALCULATED USING THE INSTITUTIONAL COST REPORT). PART III, LINE 3: THE AMOUNT REPORTED IN PART III LINE 3 WAS RELATED TO THE EMERGENCY ROOM'S BAD DEBT AT COST. THE FIGURE WAS DERIVED USING THE EMERGENCY ROOM'S BAD DEBT GROSS CHARGES AND MULTIPLYING THIS AMOUNT BY THE EMERGENCY'S ROOMS SPECIFIC RCC TO COME UP WITH THE BAD DEBT EXPENSE AT COST FOR THE EMERGENCY ROOM. WE DID NOT INCLUDE ANY AMOUNTS OF BAD DEBT IN PART I LINE 7. WE BELIEVE THE ENTIRE AMOUNT SHOULD BE CONSIDERED CHARITY CARE. EMTALA AND OTHER REGULATIONS REQUIRE THAT THE HOSPITAL PROVIDE EMERGENCY SERVICES TO INDIVIDUALS BEFORE DISCUSSING FINANCIAL INFORMATION.CHARITY CARE IS USUALLY RELATED TO PATIENTS WHO WE DEFINE AS LACKING THE ABILITY TO PAY. A HOSPITAL'S INABILITY TO COLLECT FROM A PATIENT WHO HAS THE MEANS TO PAY IS BAD DEBT EXPENSE. OUR REGISTRATION DEPARTMENT DOES NOT HAVE THE ABILITY TO DETERMINE THE EMERGENCY ROOM PATIENT FINANCIAL STATUS BEFORE CARE IS DELIVERED AND IN MANY CASES, THE INFORMATION PROVIDED BY THE PATIENTS IS INACCURATE. SINCE WE RENDERED CARE WITHOUT REGARD TO THE PATIENT'S ABILITY TO PAY WE BELIEVE THAT THESE PATIENTS ARE SIMILAR TO CHARITY CARE AND NOT BAD DEBT. PART III, LINE 9B: UPON APPLYING FOR CHARITY CARE, THE PATIENT IS ADVISED TO DISREGARD ALL BILLS SENT BY THE HOSPITAL UNTIL A FINAL DECISION HAS BEEN MADE. A PATIENT THAT RECEIVES PARTIAL CHARITY CARE IS SUBJECT TO THE HOSPITAL COLLECTION POLICY EXCEPT THAT:1)THE PATIENT WILL BE PROVIDED WITH A WRITTEN NOTICE 30 DAYS PRIOR TO THE ACCOUNT GOING TO COLLECTION.2)THE HOSPITAL WILL NOT PLACE A LIEN ON THE PATIENT'S ASSETS. PART VI, LINE 2: IN AN EFFORT TO IDENTIFY THE NEEDS OF PATIENTS AND COMMUNITIES, SOUTH NASSAU UTILIZES TOOLS AND COLLABORATES WITH LOCAL AND STATE GOVERNMENTS, CIVIC ASSOCIATIONS AND OTHER COMMUNITY GROUPS TO ESTABLISH THE NEEDS OF THE COMMUNITY THE HOSPITAL SERVICES.- THE HOSPITAL PARTICIPATES IN THE CENTER FOR MEDICARE AND MEDICAID SERVICES PATIENT SATISFACTION SURVEY (KNOWN AS HCAHPS) BY USING HEALTHSTREAM RESEARCH, WHICH CONDUCTS A PHONE SURVEY, CONTACTING A STATICALLY VALID SAMPLE OF INPATIENTS AFTER DISCHARGE. SURVEY QUESTIONS INQUIRE ABOUT PATIENTS' SATISFACTION WITH THE QUALITY OF CARE DURING THEIR STAY AND PERSONAL SATISFACTION WITH THE DOCTORS, NURSES AND HOSPITAL SERVICES. ONCE THE QUARTERLY SURVEY RESULTS ARE REVIEWED BY THE ADMINISTRATIVE TEAM, MANAGERIAL STAFF AND HOSPITAL STAFF, SOUTH NASSAU'S PATIENT SATISFACTION STEERING COMMITTEE PRIORITIZES AND DEVELOPS ACTION PLANS TO IMPROVE PATIENT SATISFACTION.- SOUTH NASSAU'S BOARD, WHICH IS COMPOSED OF LOCAL INDIVIDUALS WHO RESIDE IN THE COMMUNITIES SERVED BY THE HOSPITAL AND INCLUDES A CROSS-SECTION OF REPRESENTATIVES SUCH AS CLERGY, BUSINESS PEOPLE AND PHYSICIANS, MEETS REGULARLY. WHILE THE MEMBERS OF SOUTH NASSAU COMMUNITIES HOSPITAL'S BOARD OF DIRECTORS ACCEPT RESPONSIBILITY FOR GOVERNANCE OF THE HOSPITAL, THEY ARE ALSO COMMUNITY ADVOCATES. AS SUCH, THEY ARE ABLE TO SPEAK ON BEHALF OF THE COMMUNITY AND RAISE ISSUES WITH THE HOSPITAL OR CONSIDER ACTIONS THAT AFFECT HOSPITALS PLANS AND OPERATIONS. THE BOARD HAS ESTABLISHED A NUMBER OF COMMITTEES THAT ARE RESPONSIBLE FOR OVERSIGHT AND COORDINATION OF HOSPITAL ACTIVITIES IN REGARDS TO COMMUNITY ADVOCACY.- SOUTH NASSAU SOLICITS THE COMMUNITY'S FEEDBACK FOLLOWING FREE PUBLIC CONFERENCES IT SPONSORS EACH YEAR. SURVEYS YIELD VALUABLE INFORMATION SUCH AS COMMUNITY PREFERENCE FOR SEMINAR CONTENT AND FORMAT AND REQUESTS FOR EXPANDED PROGRAMS AND SERVICES.- DEPARTMENTS HOSPITAL-WIDE HAVE RELATIONSHIPS WITH INDIVIDUALS AND GROUPS WHO HAVE SPECIAL NEEDS, SUCH AS PHYSICAL HANDICAPS, LANGUAGE BARRIERS AND CULTURAL ISSUES. THESE DEPARTMENTS ENCOURAGE COMMENTS AND SUGGESTIONS FROM THESE POPULATIONS. THEIR FEEDBACK IS USED TO ASSESS THE EFFECTIVENESS OF EXISTING PROCEDURES AND PROGRAMS.- SOUTH NASSAU'S ADMINISTRATION MAINTAINS AN OPEN-DOOR POLICY AND ANY MEMBER OF THE COMMUNITY IS WELCOME TO COMMENT. ANY REASONABLE ISSUE RAISED IS ADDRESSED AND CARE IS TAKEN TO RESPOND IN A TIMELY AND SATISFACTORY FASHION.- SOUTH NASSAU MAINTAINS THREE WEB SITES: WWW.SOUTHNASSAU.ORG; WWW.LIGAMMA.ORG; AND WWW.SOUTHNASSAUBARIATRICS.ORG. THE WEB SITES OFFER AN AVENUE FOR PEOPLE TO E-MAIL QUESTIONS AND REQUESTS FOR INFORMATION TO THE HOSPITAL. THEY ALSO SERVE AS A COMPREHENSIVE SOURCE OF INFORMATION ON THE HOSPITAL'S SERVICES, SPECIALTY CENTERS, PHYSICIANS, NEW DEVELOPMENTS AND EMPLOYMENT OPPORTUNITIES. - SOUTH NASSAU'S ADMINISTRATION IS IN CONSTANT COMMUNICATION WITH LOCAL AND GOVERNMENT LEADERS IN DETERMINING THE NEEDS OF THE COMMUNITIES. THE ADMINISTRATIVE TEAMS ALSO ARE INVOLVED WITH HOSPITAL ASSOCIATIONS AND OTHER HEALTHCARE ASSOCIATES WHICH TARGET THE NEEDS OF THE COMMUNITIES THE HOSPITAL SERVES. NEW YORK STATE'S DEPARTMENT OF HEALTH ALSO WORKS VERY CLOSELY WITH THE HOSPITAL TO HELP ASSESS THE NEEDS OF THE COMMUNITY SERVED.- SOUTH NASSAU'S FOUR ACTIVE AUXILIARIES ACT AS LIAISONS BETWEEN THE HOSPITAL AND THE COMMUNITIES THEY REPRESENT.- THE HOSPITAL COLLECTS DATA WITH REGARDS TO ECONOMIC, SOCIAL, CULTURAL AND GEOGRAPHIC BARRIERS THAT EXIST. PART VI, LINE 3: THE HOSPITAL INFORMS AND EDUCATES PATIENTS ON A VARIETY OF FINANCIAL ASSISTANCE PROGRAMS. IT HAS A FULLY STAFFED FINANCIAL ASSISTANCE SERVICES DEPARTMENT STAFFED WITH BI-LINGUAL EMPLOYEES THAT HELP EDUCATE AND PROVIDE ASSISTANCE IN APPLYING FOR MEDICAID, CHILD HEALTH PLUS, FAMILY HEALTH PLUS, CHARITY CARE AND DISCOUNTED CARE. THE HOSPITAL ALSO CONTRACTED WITH THE NASSAU COUNTY OFFICE OF MEDICAID TO SITUATE AN EMPLOYEE AT THE HOSPITAL WHO HELPS PATIENTS WITH THE MEDICAID APPLICATION PROCESS.LARGE POSTERS ARE DISPLAYED IN PROMINENT LOCATIONS (INCLUDING THE EMERGENCY ROOM, BILLING OFFICE, ADMITTING, FAMILY PRACTICE CENTER, ACCOUNT SERVICES, MENTAL HEALTH CENTER, OUTPATIENT REGISTRATION, DIALYSIS CENTER, HOME CARE, CARDIAC REHABILITATION, PHYSICAL THERAPY, WOUND CARE) AND OTHER REGISTRATION AREAS SHOWING THE AVAILABILITY OF CHARITY CARE IN ENGLISH AND SPANISH.THE HOSPITAL POSTS THE AVAILABILITY OF FINANCIAL AID INCLUDING CHARITY CARE ON ITS EXTERNAL WEBSITE: SOUTHNASSAU.ORG DIRECTING THEM TO THE FINANCIAL ASSISTANCE DEPARTMENT.THE HOSPITAL EDUCATES ALL EMPLOYEES THAT INTERACT WITH PATIENTS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE INCLUDING CHARITY CARE AND WHERE TO FIND INFORMATION ON THESE PROGRAMS.FINANCIAL ASSISTANCE AND CHARITY CARE INFORMATION IS INCLUDED IN PATIENT GUIDES AND SERVICE LINE GUIDES THAT ARE PROVIDED TO PATIENTS. PATIENT BILLS SENT OUT INCLUDE A NOTE ABOUT THE EXISTENCE OF THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. ON THE BACK OF THE BILL IS A CHARITY CARE APPLICATION.BILLING AND ACCOUNT SERVICES DEPARTMENTS ARE EDUCATED ABOUT THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AND INFORMS PATIENTS OF THIS POLICY.ANY PATIENT CAN REQUEST AN APPLICATION FOR CHARITY CARE FROM THE ABOVE REGISTRATION AREAS, BILLING OFFICE AND ACCOUNT SERVICES DURING REGULAR BUSINESS HOURS AND VIA TELEPHONE. PART VI, LINE 4: SOUTH NASSAU IS LOCATED ON THE SOUTH SHORE OF LONG ISLAND IN NASSAU COUNTY, NEW YORK, IN THE TOWN OF OCEANSIDE. NASSAU COUNTY HAS A POPULATION OF APPROXIMATELY 1.35 MILLION (BASED ON 2013 ESTIMATE US CENSUS DATA) WITH APPROXIMATELY 800,000 PEOPLE FALLING INTO THE HOSPITAL'S SERVICE AREA. NASSAU COUNTY'S MEDIAN HOUSEHOLD INCOME IS $97,049 (ACCORDING TO 2008-2012 CENSUS DATA) AND $42,286 PER CAPITA (2008-2012 CENSUS ESTIMATES). ACCORDING TO THE 2008-2012 CENSUS ESTIMATES, NASSAU COUNTY'S POVERTY LEVEL WAS 5.8%, WITH MORE OF THE POORER AREAS LOCATED ON THE SOUTH SHORE OF NASSAU COUNTY AND FALLING INTO THE HOSPITAL'S SERVICE AREA. HISPANICS, ALONG WITH OTHER MINORITIES, ARE CONCENTRATED IN SOUTH SHORE COMMUNITIES SUCH AS BALDWIN, FREEPORT, HEMPSTEAD, ROOSEVELT AND INWOOD, WITH MANY OF THESE COMMUNITIES' MEMBERS BEING UNINSURED OR INSURED BY MEDICAID.BASED ON 2013 PATIENTS SERVED AT SOUTH NASSAU, PATIENT DEMOGRAPHICS BASED ON VISITS (OUTPATIENT) ARE MEDICARE 36% MEDICAID 19% SELF PAY 3% AND CHARITY CARE 2%.OTHER HOSPITALS THAT ALSO SERVICE THESE COMMUNITIES IS FRANKLIN HOSPITAL MEDICAL CENTER, LONG BEACH MEDICAL CENTER, AND MERCY MEDICAL CENTER. PART VI, LINE 5: THE HOSPITAL HAS ESTABLISHED A COMMUNITY ADVOCACY COMMITTEE THAT IS COMPOSED OF MEMBERS OF A NUMBER OF COMMUNITY ORGANIZATIONS, INCLUDING SECULAR AND RELIGIOUS ORGANIZATIONS; ETHNOCENTRIC GROUPS; ORGANIZATIONS REPRESENTING PERSONS OF SPECIFIC AGE GROUPS AND/OR WITH SPECIFIC DISABILITIES OR DISEASES; AND REPRESENTATIVES FROM HOSPITAL ADMINISTRATION, STAFF AND BOARD. THIS GROUP MEETS FOUR TIMES A YEAR TO IDENTIFY NEEDS OF THEIR RESPECTIVE COMMUNITIES AND TO DISCUSS ISSUES OR RECOMMEND ACTIONS IN THE INTEREST OF IMPROVED SERVICE TO THOSE COMMUNITIES. THIS INFORMATION IS THEN PRESENTED TO THE BOARD OF DIRECTORS FOR CONSIDERATION.IN ADDITION TO THE COMMUNITY ADVOCACY COMMITTEE, SOUTH NASSAU'S DEPARTMENT OF COMMUNITY EDUCATION IS THE REGION'S MOST COMPREHENSIVE COMMUNITY MEDICINE PROVIDER. ITS CORE SERVICES INCLUDE MULTIPLE SUPPORT AND DISEASE MANAGEMENT DISCUSSION GROUPS, 85 COMMUNITY-BASED HEALTH CARE LECTURES AND SEMINARS (SOME OFFERED IN SPANISH), CARDIOPULMONARY RESUSCITATION (CPR), BASIC LIFE SUPPORT (BLS) AND ADVANCED CARDIAC LIFE SUPPORT (ACLS) CLASSES, SPECIFIC HEALTH PROMOTION/IMPROVEMENT INTERVENTIONS, FREE BLOOD PRESSURE AND CANCER SCREENINGS. THE STRUCTURE OF THESE PROGRAMS ENCOURAGES SIGNIFICANT AND MEANINGFUL INTERACTION BETWEEN SOUTH NASSAU AND THE COMMUNITIES IT SERVES.THE MISSION OF THE DEPARTMENT OF COMMUNITY EDUCATION IS TO IMPROVE THE HEALTH OF THE SURROUNDING COMMUNITIES THROUGH EDUCATION, PREVENTION, SCREENING, OUTREACH, AND COALITION BUILDING. BY USING SCIENTIFIC METHODOLOGIES, THE HEALTH CARE NEEDS OF THE COMMUNITY ARE IDENTIFIED AND ADDRESSED AND PROGRAMS THAT CAN DEMONSTRATE MEASURABLE HEALTH IMPROVEMENT OUTCOMES ARE DESIGNED TO MEET THESE NEEDS. ONCE IMPLEMENTED, THE DEPARTMENT OF COMMUNITY EDUCATION CONDUCTS ONGOING MONITORING AND EVALUATION OF THE INTERVENTION PROCESSES.ADDITIONALLY, THE DEPARTMENT OF COMMUNITY EDUCATION COORDINATES WITH COMMUNITY AGENCIES SUCH AS THE HISPANIC COUNSELING CENTER, THE DEPARTMENT OF HEALTH, THE AMERICAN CANCER SOCIETY, THE BELLMORE/MERRICK WELLNESS COUNCIL, THE AMERICAN HEART ASSOCIATION, THE AMERICAN DIABETES ASSOCIATION, HEALTHY WOMEN PARTNERSHIP TO CONDUCT EDUCATION, PREVENTION AND SCREENING PROGRAMS.THE DEPARTMENT OF COMMUNITY EDUCATION HAS INSTITUTED THE CATCH (CHECK-IN AND TAKE CHARGE OF YOUR HEALTH)PROGRAM WHICH OFFERS FREE HEALTH EDUCATION ON PREVENTION OF OBESITY AND WEIGHT-RELATED ISSUES, INCLUDING HEART DISEASE, STROKE AND DIABETES AND PROVIDES FREE SCREENINGS FOR BLOOD PRESSURE, CHOLESTEROL, WEIGHT/BMI AND CARDIAC/GENERAL HEALTH RISK ASSESSMENT TO MINORITY AND UNDERSERVED COMMUNITIES. BELOW IS A LISTING OF THE DEPARTMENT OUTREACH PROGRAMS FOR THE COMMUNITY:EDUCATION- COMMUNITY AND HOSPITAL-BASED LECTURES ON SPECIFIC HEALTH IMPROVEMENT TOPICS SUCH AS "LOWERING YOUR CHOLESTEROL TO KEEP YOUR HEART HEALTHY", "PREVENTING AND MANAGING DIABETES", AND "EAT HEALTHY, BE ACTIVE".- SPECIAL PROGRAMS DESIGNED TO TARGET SPECIFIC POPULATIONS SUCH AS "STROKE ATTACK ALERT"; "ACT IN TIME TO HEART ATTACK SIGNS"; "BREAST CANCER AND THE IMPORTANCE OF EARLY DETECTION"; AND "HEART-HEALTHY CHOICES & COOKING" ARE REGULARLY SCHEDULED.- PARENT-CHILD EDUCATION CLASSES- BASIC CARDIAC LIFE SUPPORT (CPR AND AED)- ADVANCED CARDIAC LIFE SUPPORT (ACLS)- TEDDY BEAR CLINIC TARGETING KINDERGARTEN CHILDREN- SUPPORT GROUPS PROVIDING EMOTIONAL SUPPORT AND EDUCATION (MONTHLY)- ANNUAL HEALTH FAIR (2,000 PEOPLE ATTENDED) - AMERICAN HEART ASSOCIATION'S "RED DRESS DAY," EDUCATIONAL PROGRAMS ON WOMEN'S HEART DISEASE AND BLOOD PRESSURE SCREENINGS. LITERATURE IN ENGLISH AND SPANISH WAS DISTRIBUTED.COLON CANCER AWARENESS DAYMELANOMA AWARENESSGREAT AMERICAN SMOKE OUT/KICK BUTTS DAYADVANCE DIRECTIVES & ORGAN DONATION DAYDIABETES ALERT DAY: EDUCATIONAL PROGRAM IN COOPERATION WITH THE AMERICAN DIABETES ASSOCIATIONSLEEP AWARENESS WEEKNATIONAL NUTRITION MONTHSTROKE AWARENESS DAYILLNESS PREVENTION - FAMILY & FRIENDS FREE CPR CLASS FOR COMMUNITY MEMBERSCOMMUNITY BASED FREE SCREENINGS - ONGOING BLOOD PRESSURE SCREENING AND IDENTIFICATION OF INDIVIDUALS IN NEED OF REFERRAL FOR FOLLOW-UP- "STROKE ATTACK ALERT" SCREENING PROGRAM IN CONJUNCTION WITH THE AMERICAN HEART ASSOCIATION- PROSTATE CANCER SCREENING- LUNG CANCER SCREENING- SKIN CANCER SCREENING- COLORECTAL CANCER SCREENINGEDUCATIONAL PROGRAMSSOUTH NASSAU'S COMPREHENSIVE APPROACH TO THE TREATMENT OF PATIENTS IS GEARED TOWARD CARING FOR THE WHOLE INDIVIDUAL, BOTH EMOTIONALLY AND PHYSICALLY, BY HELPING THEM ADJUST AND COPE WITH THEIR ILLNESS THROUGH SUPPORT, EDUCATION AND COUNSELING SERVICES. SUPPORT GROUPS, FEATURING EXPERT SPEAKERS, ARE OFFERED FREE OF CHARGE TO PATIENTS AND THEIR FAMILIES AND MEMBERS OF THE COMMUNITY. THESE SUPPORT GROUPS INCLUDE: CAREGIVER SUPPORT; BARIATRIC; BEREAVEMENT; DIABETES; AND BREAST CANCER SUPPORT GROUPS, WHICH ARE HELD IN COOPERATION WITH 1 IN 9, HEWLETT HOUSE. PART VI, LINE 6: THE HOSPITAL IS PART OF WINTHROP SOUTH NASSAU HEALTH SYSTEM WHICH IS A MEMBER OF THE LONG ISLAND HEALTH NETWORK ("LIHN"). THE LONG ISLAND HEALTH NETWORK CONSISTS OF 10 HOSPITALS JOINED TOGETHER IN 1998 TO IMPROVE THEIR CLINICAL QUALITY, ENHANCE THEIR OPERATIONAL EFFICIENCY, AND EXPAND ACCESS TO CARE FOR THE 2.8 MILLION RESIDENTS OF NASSAU AND SUFFOLK COUNTIES. THE GOAL OF THE LONG ISLAND HEALTH NETWORK IS TO PROVIDE A HIGH LEVEL OF MEDICAL CARE, NO MATTER WHICH HOSPITAL YOU CHOOSE IN THE NETWORK. THIS HAS BEEN ACCOMPLISHED THROUGH A SINGLE INTEGRATED APPROACH TO MEASURING AND IMPROVING THE QUALITY OF HEALTHCARE THROUGHOUT OUR 10 MEMBER HOSPITALS. IN AN ERA WHEN HEALTHCARE IS INCREASINGLY DOMINATED BY LARGE, CENTRALLY GOVERNED HOSPITAL SYSTEMS, LIHN HOSPITALS CONTINUE THEIR FOCUS ON DELIVERING COMMUNITY-BASED CARE AND COLLABORATING WITH INSURERS' EFFORTS TO EXPAND LOCAL ACCESS TO AFFORDABLE HEALTH INSURANCE PRODUCTS. PART VI, LINE 7, REPORTS FILED WITH STATES NY 1 X X X X X 0 1 0 0 0 0 0 1 1 1 RICHARD MURPHY PRESIDENT AND CEO 721745 0 0 0 77230 0 111200 0 32091 0 942266 0 0 0 JOSEPH LAMANTIA CHIEF OPERATING OFFICER 448168 0 50000 0 5760 0 10797 0 23292 0 538017 0 0 0 MARK BOGEN CHIEF FINANCIAL OFFICER 360372 0 45000 0 4800 0 19637 0 26752 0 456561 0 0 0 LINDA EFFEREN CHIEF MEDICAL OFFICER 350964 0 0 0 6720 0 21199 0 4029 0 382912 0 0 0 SUSAN PENQUE CHIEF NURSING OFFICER 307808 0 0 0 1920 0 24353 0 29695 0 363776 0 0 0 JOHN MERTZ CHIEF INFORMATION OFFICER 212507 0 0 0 3000 0 19476 0 23721 0 258704 0 0 0 JASON FREEMAN DIR INTERVENT CARDIOLOGY 503668 0 495523 0 0 0 7650 0 19452 0 1026293 0 0 0 ASIF REHMAN ASSOC. DIR. INT. CARDIO 596744 0 500000 0 0 0 7650 0 19452 0 1123846 0 0 0 LAWRENCE KANNER DIR OF ELECTROPHYSIOLOGY 446746 0 451674 0 0 0 7650 0 19452 0 925522 0 0 0 ROBERT KRAMER DIR OF CARDIAC SERVICES 271425 0 238471 0 0 0 21053 0 19452 0 550401 0 0 0 ALAN GARELY CLINICAL CHAIR OB/GYN 951746 0 97021 0 0 0 32650 0 19452 0 1100869 0 0 0 JOSEPH A QUAGLIATA FORMER PRESIDENT AND CEO 341844 0 209692 0 0 0 0 0 0 0 551536 0 0 0 PART I, LINE 4B SOUTH NASSAU COMMUNITIES HOSPITAL MAINTAINS A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") FOR THE HOSPITAL'S CHIEF EXECUTIVE OFFICER. THE SERP IS DESIGNED TO PROVIDE THE CHIEF EXECUTIVE OFFICER WITH SUPPLEMENTAL RETIREMENT INCOME THROUGH ANNUAL HOSPITAL FUNDED CONTRIBUTIONS. PART I, LINE 7 THE HOSPITAL MAINTAINS AN INCENTIVE COMPENSATION PROGRAM THAT PAYS VARIABLE COMPENSATION BASED ON THE SATISFACTION BY THE HOSPITAL AND THE EXECUTIVES OF PRE-ESTABLISHED QUALITY OF CARE, PROGRAM, FINANCIAL AND SIMILAR GOALS ESTABLISHED AT THE BEGINNING OF THE YEAR PRIOR TO PAYMENT. SOME EMPLOYEES RECEIVE ADDITIONAL COMPENSATION BASED ON VARIOUS PRODUCTIVITY MEASURES. PART I, LINE 8 DURING 2013, THE HOSPITAL'S PRESIDENT AND CHIEF EXECUTIVE OFFICER WAS COMPENSATED AND PROVIDED WITH BENEFITS PURSUANT TO AN EMPLOYMENT AGREEMENT SATISFYING THE INITIAL CONTRACT EXCEPTION DESCRIBED IN REGS. SECTION 53.4958-4(A)(3). SCHEDULE J - ADDITIONAL DISCLOSURE THE COMPENSATION REPORTED ON BOTH PART VII AND SCHEDULE J OF THE FORM 990 FOR CERTAIN OFFICERS AND KEY PERSONNEL REPRESENTS AMOUNTS PAID FOR SERVICES RENDERED TO SOUTH NASSAU COMMUNITIES HOSPITAL ("SNCH") AND ITS AFFILIATED ORGANIZATIONS. THE FORM 990 REQUIRES COMPENSATION TO BE REPORTED BASED ON THE ORGANIZATION THAT PROVIDES THE OFFICER HIS OR HER W-2; HOWEVER, REPORTING COMPENSATION IN THIS FASHION DOES NOT TAKE INTO ACCOUNT THE INTEGRATED RELATIONSHIPS WITHIN A HEALTH SYSTEM THAT REQUIRE OFFICERS AND EMPLOYEES TO ALLOCATE THEIR TIME AND SERVICES AMONG MANY ORGANIZATIONS. SCHEDULE J - ADDITIONAL DISCLOSURE INCLUDED IN THE FORMER CHIEF EXECUTIVE OFFICER'S COMPENSATION IS A BONUS OF $209,692 WHICH RELATES TO SERVICES PERFORMED BY HIM AS CHIEF EXECUTIVE OFFICER IN 2012. A NASSAU COUNTY LOCAL ECONOMIC ASSSISTANCE CORP 274291221 63166LBT7 2012-10-23 100932698 REFUND BONDS ISSUED 8/22/2001 & 8/7/2003; CONSTRUCTION & EQUIPMENT PURCHASE 0 0 0 A 4105000 100932698 1691031 748922 1454576 11518539 70699662 16510998 1 1 0 1 A 0 1 1 1 0 0.01130 0.00000 0.01130 0 0 0 A 0 1 0 0 0 0 0 0 1 A 1 PART III, LINE 2 CERTAIN PROPERTY FINANCED BY THE BONDS IS LEASED TO AFFILIATED 501(C)(3) ORGANIZATIONS; SUCH LEASES DO NOT GIVE RISE TO PRIVATE BUSINESS USE PART III, LINE 9 THE ORGANIZATION IS CURRENTLY IN THE PROCESS OF DEVELOPING WRITTEN PROCEDURES AND EXPECT THEY WILL BE IN PLACE IN 2014. PART IV, LINE 6 THIS QUESTION IS BEING ANSWERED WITHOUT REGARD TO A YIELD RESTRICTED REFUNDING ESCROW FINANCED WITH PROCEEDS OF THE BONDS. PART IV, LINE 7 THE PROCEDURES WERE IMPLEMENTED DURING 2013. PART V THE PROCEDURES WERE IMPLEMENTED DURING 2013. ANTHONY CANCELLIERI DIRECTOR 180000 VENDOR PAYMENT 0 X 2 49077 COST OR SELLING PRICE OTHER: 0 0 0 1 0 PART I, COLUMN (B): THERE WERE 2 CONTRIBUTORS WITH A TOTAL OF 2 CONTRIBUTIONS. FORM 990, PART I, LINE 1 SOUTH NASSAU'S MISSION IS TO PROVIDE HIGH QUALITY, COMPREHENSIVE AND EASILY ACCESSIBLE HEALTH CARE TO ALL RESIDENTS OF THE SOUTH SHORE COMMUNITIES. FORM 990, PART III, LINE 1 SOUTH NASSAU COMMUNITIES HOSPITAL'S ("SOUTH NASSAU") MISSION IS TO PROVIDE HIGH QUALITY, COMPREHENSIVE AND EASILY ACCESSIBLE HEALTH CARE TO ALL RESIDENTS OF THE SOUTH SHORE COMMUNITIES IN A MANNER WHICH REFLECTS A CULTURE OF EXCELLENCE, PERSONALIZED, CULTURALLY COMPETENT CARE AND INNOVATION FORM 990,PART III, LINE 4A MEDICAL AND SURGICAL INPATIENT SERVICES: THE HOSPITAL IS CERTIFIED FOR 329 MEDICAL SURGICAL BEDS. THESE BEDS INCLUDE A 40-BED ORTHOPEDIC SPECIALTY UNIT WITH AN ADJACENT AREA FOR REHABILITATION THERAPY, A 40-BED ONCOLOGY (CANCER) UNIT, A 36-BED STEP-DOWN PROGRESSIVE CARE UNIT INCLUDING AN 8-BED BARIATRIC SURGERY UNIT AND 76 BEDS FOR TELEMETRY OR OTHERS WITH LESS THAN ACUTE CORONARY PROBLEMS. THE HOSPITAL'S OPERATING ROOMS CONSISTS OF 15 SUITES WHICH ARE AVAILABLE FOR BOTH INPATIENT AND OUTPATIENT SURGICAL PROCEDURES. A FULL RANGE OF SURGICAL SPECIALTIES ARE PERFORMED WHICH INCLUDE ORTHOPEDICS, SPINE SURGERY, PLASTIC SURGERY, NEUROSURGERY, GYNECOLOGIC SURGERY, GASTROINTESTINAL SURGERY, LAPAROSCOPIC BARIATRIC SURGERY (MINIMALLY INVASIVE SURGERY FOR WEIGHT LOSS), UROLOGY, OPHTHALMOLOGY, VASCULAR SURGERY, THORACIC SURGERY, PERMANENT PACEMAKERS, IMPLANTABLE DEFIBRILLATORS, PODIATRIC SURGERY, PEDIATRIC SURGERY, EAR, NOSE AND THROAT SURGERY, AND GENERAL SURGERY. THE HOSPITAL ADMITTED 16,138 MEDICAL SURGICAL PATIENTS IN 2013 PEDIATRICS SERVICES: THE HOSPITAL PROVIDES COMPREHENSIVE GENERAL AND SPECIALIZED PEDIATRIC CARE FOR CHILDREN AND TEENAGERS IN NEED OF SURGICAL OR PREVENTIVE SERVICES OR CARE FOR INFECTIOUS DISEASES, SERIOUS ILLNESSES OR COMPLEX MEDICAL CONDITIONS. THIS UNIT FEATURES SPECIALISTS IN PEDIATRIC CARDIOLOGY, ENDOCRINOLOGY, GASTROENTEROLOGY, GENETICS, HEMATOLOGY-ONCOLOGY, NEUROLOGY, PULMONARY MEDICINE AS WELL AS A PEDIATRIC SURGEON, NEONATOLOGIST AND ANESTHESIOLOGIST. A SPECIAL CARE PEDIATRIC UNIT EQUIPPED WITH THE LATEST PEDIATRIC MEDICAL TECHNOLOGY AND MONITORING SYSTEM, CAN EFFECTIVELY MANAGE AND TREAT ALMOST ANY EMERGENCY OR SERIOUS ILLNESS. THE UNIT FEATURES A MULTI-PURPOSE TREATMENT ROOM TO PERFORM MINOR PROCEDURES, WHETHER SURGICAL OR NON-SURGICAL. A TEAM OF SPECIALLY TRAINED NURSING STAFF AND PEDIATRICIANS, INCLUDING NURSING STAFF TRAINED IN PEDIATRIC ADVANCE LIFE SUPPORT (PALS), WITH SPECIALISTS ON-CALL AROUND THE CLOCK. THE HOSPITAL ADMITTED 499 PEDIATRIC PATIENTS IN 2013 MATERNITY AND NURSERY SERVICES: THE HOSPITAL HAS STATE-OF-THE-ART LABOR/DELIVERY ROOMS WHICH CREATE A COMFORTING ENVIRONMENT WHILE PROVIDING ALL THE NECESSARY EQUIPMENT AND CLINICAL SUPPORT FOR MOTHER AND BABY. ALL 26 POSTPARTUM BEDS OFFER PRIVATE ACCOMMODATIONS. THE HOSPITAL PROVIDES SPECIALIZED SERVICES FOR WOMEN WITH HIGH-RISK PREGNANCIES. THE UNIT IS STAFFED BY SOME OF THE AREA'S LEADING SPECIALISTS IN HIGH-RISK PREGNANCIES. SOUTH NASSAU PROVIDES A COMPREHENSIVE PACKAGE OF SERVICES, INCLUDING PERINATOLOGY, FETAL MONITORING, GENETICS COUNSELING, AND DIAGNOSTIC CARE FOR ALL STAGES OF HIGH-RISK PREGNANCIES INCLUDING AMNIOCENTESIS AND ULTRASOUND. THE HOSPITAL ADMITTED 3,202 MATERNITY PATIENTS (INCLUDING NEWBORNS) IN 2013. NEONATAL SERVICES: THE HOSPITAL ALSO HAS A LEVEL II NEONATAL INTENSIVE CARE UNIT FOR PREMATURE BABIES. PREMATURE DELIVERIES AND NEWBORNS WITH DEVELOPMENTAL COMPLICATIONS OR CONDITIONS RECEIVE THE SPECIALIZED CARE THEY NEED IN THE NEONATAL INTENSIVE CARE UNIT. STAFFED BY HIGHLY TRAINED, BOARD-CERTIFIED NEONATOLOGISTS AND NURSES, THE NURSERY PROVIDES INTENSIVE ONE-TO-ONE CARE AND IS EQUIPPED WITH DEDICATED MEDICAL TECHNOLOGY FOR PREMATURE DELIVERIES AND NEWBORNS WITH SPECIAL NEEDS. THE NURSERY ALSO FEATURES A STATE-OF-THE-ART MONITORING SYSTEM. THE HOSPITAL ADMITTED 189 NEONATES IN 2013. IN-PATIENT PSYCHIATRIC SERVICES: IN OUR 36-BED SHORT-TERM INPATIENT BEHAVIORAL HEALTH UNIT, WE PROVIDE RAPID STABILIZATION FOR A WIDE RANGE OF ACUTE PSYCHIATRIC CONDITIONS. PATIENTS RECEIVE PSYCHIATRIC AND PSYCHOLOGICAL CONSULTATION DURING THEIR HOSPITAL STAY TO ALLEVIATE DISTRESS AND PAIN. THE HOSPITAL ADMITTED 993 PSYCHIATRIC PATIENTS IN 2013. SUMMARY: THE HOSPITAL ADMITTED A TOTAL OF 21,720 PATIENTS IN 2013 FOR INPATIENT SERVICES. THESE SERVICES WERE PROVIDED TO THE MEMBERS OF THE COMMUNITY ON AN ELECTIVE BASIS OR EMERGENCY BASIS. THE HOSPITAL PROVIDES CHARITY CARE AND DISCOUNTS TO PATIENTS THAT ARE UNABLE TO PAY FOR THE SERVICES PROVIDED. THE HOSPITAL PROVIDED CHARITY CARE OF APPROXIMATELY $9.4 MILLION FOR INPATIENTS SERVED IN 2013. FORM 990, PART III, LINE 4B AMBULATORY SURGERY: SOUTH NASSAU AMBULATORY SURGERY SERVICE LINE CONSISTS OF OUTPATIENT SURGICAL, ENDOSCOPY, PAIN MANAGEMENT AND CARDIAC SERVICES. SEE DETAILS OF THE SERVICES THAT COMPRISE AMBULATORY SURGERY BELOW: OUTPATIENT SURGERIES: SOUTH NASSAU'S AMBULATORY SURGERY UNIT (ASU) FEATURES 10 SEMI-PRIVATE PRE-OPERATIVE PATIENT SUITES WHERE THE PATIENT IS ADMITTED PRIOR TO SURGERY AND 16 SEMI-PRIVATE POSTOPERATIVE ROOMS WHERE PATIENTS COMPLETE PHASE TWO OF THEIR RECOVERY, RECEIVE PAIN MEDICATION AND POST-OPERATIVE TEACHING PRIOR TO BEING DISCHARGED FROM THE HOSPITAL. THE ASU POST-OPERATIVE UNIT IS OPEN 24 HOURS A DAY. THE HOSPITAL PERFORMED 6,762 OUTPATIENT SURGICAL PROCEDURES IN 2013. ENDOSCOPY: SOUTH NASSAU COMMUNITIES HOSPITAL'S ENDOSCOPY UNIT PROVIDES STATE-OF-THE-ART PATIENT CARE FOR BOTH INPATIENTS AND OUTPATIENTS REQUIRING UPPER OR LOWER GASTROINTESTINAL STUDIES. THE SERVICE OFFERS E.R.C.P. (ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY) STUDIES OF THE GALL BLADDER, PANCREAS AND BILE DUCTS. ALSO OFFERED ARE ENDOSCOPIC ULTRASOUND, WHICH EXAMINES THE WALLS AND THE SURROUNDING STRUCTURES OF THE GI SYSTEM; GASTROSCOPY AND COLONOSCOPY, A MINIMALLY INVASIVE PROCEDURE TO VIEW THE GASTROINTESTINAL SYSTEM INCLUDING THE ESOPHAGUS, STOMACH AND COLON; AND LIVER BIOPSIES. THE ENDOSCOPY UNIT ALSO PERFORMS PH AND MOTILITY STUDIES USING THE "BRAVO" CAPSULE. THE HOSPITAL PERFORMED 3,088 ENDOSCOPY PROCEDURES IN 2013. PAIN MANAGEMENT: SOUTH NASSAU'S PAIN MANAGEMENT UNIT PROVIDES CARE TO BOTH INPATIENTS AND OUTPATIENTS REQUIRING INTERVENTIONAL PAIN MANAGEMENT PROCEDURES. THE PAIN MANAGEMENT ANESTHESIOLOGISTS, WHO ARE ASSISTED BY HIGHLY SKILLED REGISTERED NURSES, ARE TRAINED IN CUTTING-EDGE INTERVENTIONAL PAIN MANAGEMENT MODALITIES. THE HOSPITAL PERFORMED 2,461 PAIN MANAGEMENT PROCEDURES IN 2013 CARDIAC SERVICES: CARDIAC CATHETERIZATION LABORATORY: THE HOSPITAL'S CARDIAC CATHETERIZATION LABORATORIES IN THE CENTER FOR CARDIOVASCULAR HEALTH USE STATE-OF-THE-ART DIGITAL IMAGING CAMERAS FOR THE HIGHEST POSSIBLE RESOLUTION AND IMAGE QUALITY. THIS PROVIDES PRECISE RESULTS FOR CARDIAC PROCEDURES WHILE SIGNIFICANTLY REDUCING THE PATIENT'S EXPOSURE TO RADIATION. SOUTH NASSAU HAS AN OPEN HEART SURGICAL PROGRAM APPROVED BY THE DEPARTMENT OF HEALTH TO PERFORM ELECTIVE ANGIOPLASTY. THIS ALLOWS SOUTH NASSAU TO PERFORM DIAGNOSTIC CARDIAC CATHETERIZATIONS AS WELL AS BOTH ELECTIVE AND EMERGENT CORONARY ANGIOPLASTY PROCEDURES. THE CARDIAC CATHETERIZATION LAB AND THE CARDIAC SERVICES ADMITTING/RECOVERY UNIT ARE STAFFED BY SPECIALLY TRAINED REGISTERED NURSES, NURSE PRACTITIONERS, PHYSICIAN'S ASSISTANTS AND EXPERIENCED INTERVENTIONAL CARDIOLOGISTS WHO RANK AMONG THE BEST IN THE STATE. THE HOSPITAL PERFORMED 910 CATHETERIZATION PROCEDURES IN 2013. ELECTROPHYSIOLOGY LABORATORY: THE HOSPITAL'S ELECTROPHYSIOLOGY AND ARRHYTHMIAS LAB SPECIALIZES IN THE DIAGNOSIS AND TREATMENT OF LIFE-THREATENING HEART RHYTHM DISORDERS. THE RECENTLY RENOVATED ELECTROPHYSIOLOGY LAB USES STATE-OF-THE-ART 3-D CARDIAC ANATOMIC MAPPING WHICH ALLOWS FOR THE PRECISE LOCATION OF IRREGULAR HEARTBEATS. THE ELECTROPHYSIOLOGY AND ARRHYTHMIAS LAB TEAM IS COMPOSED OF BOARD-CERTIFIED ELECTROPHYSIOLOGISTS TOGETHER WITH SPECIALLY TRAINED PHYSICIAN ASSISTANTS AND REGISTERED NURSES. THE LAB IMPLANTS PERMANENT PACEMAKERS, CARDIAC DEFIBRILLATORS, BIVENTRICULAR DEVICES AND LOOP RECORDERS AND PROVIDES ELECTROPHYSIOLOGY PROCEDURES SUCH AS TABLE TESTING, CARDIAC ABLATIONS, CARDIOVERSIONS, TRANSESOPHAGEAL ECHOCARDIOGRAMS AND DIAGNOSTIC ELECTROPHYSIOLOGY STUDIES. PATIENTS RECEIVING PERMANENT PACEMAKERS OR DEFIBRILLATORS HAVE THE DEVICE INTERROGATIONS PERFORMED IN THE ELECTROPHYSIOLOGY LAB FOLLOWING THE IMPLANTATION AND AT ROUTINE INTERVALS. THE HOSPITAL PERFORMED 536 EP STUDIES IN 2013. SUMMARY: AMBULATORY SURGERY SERVICES WERE PROVIDED TO 14,163 MEMBERS OF THE COMMUNITY ON AN ELECTIVE BASIS. THE HOSPITAL PROVIDED CHARITY CARE OF APPROXIMATELY $1.5 MILLION FOR AMBULATORY PATIENTS SERVED IN 2013. FORM 990, PART III, LINE 4C EMERGENCY SERVICES: THE EMERGENCY ROOM IS OPERATED ON A FULL TIME BASIS (24 HOURS 365 DAYS A WEEK). OUR EMERGENCY ROOM IS ONE OF THE BUSIEST ON THE SOUTH SHORE OF NASSAU COUNTY. THE EMERGENCY ROOM IS THIS AREA'S LEADING CENTER OF SPECIALIZED EMERGENCY CARE, WITH A SOLID REPUTATION FOR DEVELOPING AND IMPLEMENTING INNOVATIONS IN EMERGENCY HEALTH CARE SERVICES. THE EMERGENCY ROOM IS STAFFED BY A TEAM OF DEDICATED PROFESSIONALS, INCLUDING BOARD-CERTIFIED, RESIDENCY-TRAINED EMERGENCY MEDICINE PHYSICIANS (ONE OF FEW HOSPITALS IN NEW YORK WITH SUCH STAFFING), AS WELL AS NURSES, NURSE PRACTITIONERS AND PHYSICIANS' ASSISTANTS WHO HAVE BEEN SPECIALLY-TRAINED IN EMERGENCY MEDICAL CARE. THE EMERGENCY ROOM IS ALSO A LEVEL II TRAUMA CENTER, EQUIPPED WITH THE ADVANCED MEDICAL TECHNOLOGY AND SKILLED SPECIALISTS REQUIRED TO PERFORM EMERGENCY TRAUMA PROCEDURES. IT HAS ALSO BEEN DESIGNATED AS A STROKE CENTER BY THE NEW YORK STATE DEPARTMENT OF HEALTH BECAUSE WE OFFER THE RAPID ASSESSMENT AND ADVANCED THERAPIES AND PROCEDURES THAT CAN MAKE A DIFFERENCE FOR STROKE PATIENT. THE HOSPITAL PROVIDES CHARITY CARE AND DISCOUNTS TO PATIENTS RECEIVING EMERGENCY ROOM SERVICES CONSISTENT WITH OUR POLICY. THE HOSPITAL EXPERIENCED 63,902 EMERGENCY ROOM VISITS IN 2013 OF WHICH 16,386 PATIENTS WERE ADMITTED. THE HOSPITAL PROVIDED CHARITY CARE OF APPROXIMATELY $12.7 MILLION (CHARGES) TO THE INDIVIDUALS WHO RECEIVED EMERGENCY SERVICES IN 2013. FORM 990, PART VI, SECTION A, LINE 6 WINTHROP SOUTH NASSAU UNIVERSITY HEALTH SYSTEM IS THE SOLE MEMBER OF SOUTH NASSAU COMMUNITIES HOSPITAL. THE SYSTEM IS ORGANIZED AS A NOT FOR PROFIT CORPORATION UNDER FEDERAL AND NEW YORK STATE LAWS. FORM 990, PART VI, SECTION A, LINE 7A WINTHROP SOUTH NASSAU UNIVERSITY HEALTH SYSTEM IS THE SOLE MEMBER OF SOUTH NASSAU COMMUNITIES HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B IN ADDITION TO SUCH AUTHORITY RESERVED TO THE TAXPAYER'S SOLE MEMBER, WINTHROP SOUTH NASSAU UNIVERSITY HEALTH SYSTEM, INC. ("WSN"), PURSUANT TO THE NEW YORK NOT-FOR-PROFIT CORPORATION LAW, SUCH AS THE AUTHORITY TO (I) ELECT AND REMOVE MEMBERS OF THE TAXPAYER'S GOVERNING BOARD, (II) APPROVE AMENDMENTS TO THE TAXPAYER'S CERTIFICATE OF INCORPORATION AND BYLAWS, AND (III) APPROVE SIGNIFICANT CORPORATE TRANSACTIONS SUCH AS MERGERS, CONSOLIDATIONS, THE DISSOLUTION OF THE TAXPAYER AND THE SALE, LEASE, MORTGAGE, PLEDGE OR OTHER TRANSFER OF SIGNIFICANT ASSETS OF THE TAXPAYER, THE APPROVAL OF THE FOLLOWING MATTERS HAVE BEEN SPECIFICALLY RESERVED TO WSN, IN ITS CAPACITY AS THE TAXPAYER'S SOLE MEMBER, PURSUANT TO THE TAXPAYER'S CERTIFICATE OF INCORPORATION AND BYLAWS: (A) APPROVAL OF THE TAXPAYER'S MISSION AND PHILOSOPHY; (B) ESTABLISHING THE SIZE OF THE TAXPAYER'S GOVERNING BOARD; (C) SELECTION AND REMOVAL OF THE CHAIRPERSON OF THE TAXPAYER'S GOVERNING BOARD; (D) ESTABLISHING CRITERIA FOR EVALUATING PERFORMANCE OF THE TAXPAYER'S CHIEF EXECUTIVE OFFICER; (E) APPROVAL OF THE TAXPAYER'S OPERATING AND CAPITAL BUDGETS AND BUSINESS PLAN; (F) APPROVAL OF THE ESTABLISHMENT OF A HEALTH MAINTENANCE ORGANIZATION BY THE TAXPAYER; (G) APPROVAL OF THE INITIATION OF ANY JOINT VENTURE OR PARTNERSHIP BY THE TAXPAYER; (H) APPROVAL OF THE ESTABLISHMENT OF ANY MATERIAL NEW LINES OF BUSINESS BY THE TAXPAYER THAT IS NOT OTHERWISE CONTEMPLATED WITHIN A PREVIOUSLY APPROVED BUSINESS PLAN OF THE TAXPAYER; (I) APPROVAL OF ANY TRANSACTION THAT RESULTS IN THE TAXPAYER BECOMING THE SOLE MEMBER OR SHAREHOLDERS OF ANY OTHER CORPORATION THAT OWNS OR OPERATES A LICENSED HOSPITAL; (J) APPROVAL OF ANY TRANSACTION THAT RESULTS IN A THIRD PARTY BECOMING ENTITLED TO APPOINT MEMBERS OF THE TAXPAYER'S GOVERNING BOARD; (K) INITIATION BY THE TAXPAYER OF A BANKRUPTCY OR INSOLVENCY ACTION; (L) APPROVAL OF ANY ACTION THAT WOULD RESULT IN THE COMPLETE CLOSURE OR CONVERSION OF THE USE OF THE TAXPAYER'S FROM A GENERAL ACUTE CARE HOSPITAL; (M) APPROVAL OF THE ISSUANCE OF LONG-TERM DEBT IN EXCESS OF $2.0 MILLION BY THE TAXPAYER OR THE INCURRENCE OF ANY OTHER DEBT BY THE TAXPAYER THAT IS IN EXCESS OF $1.0 MILLION AND NOT PART OF THE TAXPAYER'S APPROVED BUDGETS AND THAT IS NOT NECESSARY TO FINANCE THE COST OF COMPLIANCE WITH OPERATIONAL OR PHYSICAL PLANT STANDARDS REQUIRED BY LAW; (N) APPROVAL OF LITIGATION SETTLEMENTS INVOLVING THE TAXPAYER THAT EXCEED APPLICABLE COMMERCIAL OR SELF-INSURANCE COVERAGE; (O) APPROVAL OF THE SUBMISSION OF ANY CERTIFICATE OF NEED APPLICATIONS BY OR ON BEHALF OF THE TAXPAYER WITH ANY REGULATORY AUTHORITY; (P) APPROVAL OF THE INITIATION BY THE TAXPAYER OF A NEW CLINICAL SERVICE OR THE DISCONTINUANCE OR SUBSTANTIAL CHANGE IN AN EXISTING CLINICAL SERVICE; AND (Q) APPROVAL OF THE EXPENDITURE BY THE TAXPAYERS OF MORE THAN $2.0 MILLION IN CONNECTION WITH A SINGLE TRANSACTION RELATED TO HEALTH SERVICE DELIVERY. NOTE THAT IN ACCORDANCE WITH THE TAXPAYER'S AND WSN'S CERTIFICATE OF INCORPORATION AND BYLAWS, WSN DOES NOT HAVE THE AUTHORITY TO EXERCISE CONTROL OVER CERTAIN OF THE FOREGOING MATTERS TO THE EXTENT THAT (I) AUTHORIZATION OF A PARTICULAR MATTER BY THE TAXPAYER IS NECESSARY TO ENSURE THAT ACTIONS TAKEN BY THE TAXPAYER CONFORM WITH THE TAXPAYER'S MISSION AND PHILOSOPHY, AND (II) WSN IS NOT THEN CURRENTLY ESTABLISHED OR LICENSED UNDER ARTICLE 28 OF THE NEW YORK STATE PUBLIC HEALTH LAW TO EXERCISE SUCH APPROVAL AUTHORITY. FORM 990, PART VI, SECTION B, LINE 11 THE POLICY OF SOUTH NASSAU COMMUNITIES HOSPITAL FOR REVIEWING AND APPROVING THE IRS FORM 990 IS THE FOLLOWING: THE AUDIT COMMITTEE, A SUB-COMMITTEE OF THE BOARD OF DIRECTORS, IS ASSIGNED TO REVIEW AND APPROVE THE IRS FORM 990 THAT IS FILED ON BEHALF OF THE ORGANIZATION, BEFORE IT IS FILED WITH THE IRS. THE AUDIT COMMITTEE WILL NOTIFY THE BOARD OF DIRECTORS WHEN THE IRS FORM 990 IS APPROVED BY THE AUDIT COMMITTEE. ONCE THE 990 IS APPROVED, THE BOARD OF DIRECTORS WILL RECEIVE A COPY (ELECTRONICALLY OR HARDCOPY) BEFORE IT IS ULTIMATELY FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C SOUTH NASSAU COMMUNITIES HOSPITAL HAS A WRITTEN CONFLICT OF INTEREST POLICY THAT IS UPDATED ON AN ANNUAL BASIS WITH MEMBERS OF THE CORPORATE COMPLIANCE COMMITTEE (A SUB-COMMITTEE OF THE BOARD OF DIRECTORS) AND WITH LEGAL COUNSEL. THE POLICY IS UPDATED FOR ANY NEW/UPDATED LEGAL AND GOVERNANCE ISSUES AND DISTRIBUTED TO BOARD MEMBERS, OFFICERS, KEY EMPLOYEES AND MANAGEMENT ON AN ANNUAL BASIS. ALONG WITH THE POLICY, A QUESTIONNAIRE IS PROVIDED TO ALL BOARD MEMBERS, OFFICERS, KEY EMPLOYEES AND MANAGEMENT REQUESTING ACKNOWLEDGEMENT THAT THEY RECEIVED THE FORM, ASKING THEM TO DISCLOSE ALL KNOWN RELATIONSHIPS AND RETURN THE SIGNED FORM TO THE CORPORATE COMPLIANCE DEPARTMENT. THE CORPORATE COMPLIANCE DEPARTMENT FOLLOWS UP WITH ANY BOARD MEMBER, OFFICERS, KEY EMPLOYEES OR MANAGEMENT STAFF WHEN A POTENTIAL CONFLICT EXISTS. THIS INFORMATION IS THEN REPORTED BACK TO THE CORPORATE COMPLIANCE COMMITTEE WHICH THEN REPORTS TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 15 (A) - SOUTH NASSAU COMMUNITIES HOSPITAL HAS A COMPENSATION COMMITTEE (A SUB-COMMITTEE OF THE BOARD OF DIRECTORS) WHICH DETERMINES THE OFFICERS' COMPENSATION. THE COMPENSATION COMMITTEE, COMPRISED EXCLUSIVELY OF DISINTERESTED DIRECTORS, UTILIZES A VARIETY OF SOURCES IN DETERMINING THE OFFICERS OVERALL COMPENSATION. THESE SOURCES INCLUDE A COMPENSATION STUDY PERFORMED BY AN INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEYS AND THE OFFICERS' HISTORICAL SALARIES. THE COMPENSATION CONSULTANT PERIODICALLY RENDERS AN OPINION THAT THE TOTAL PROPOSED COMPENSATION FOR THE OFFICERS ARE "REASONABLE" WITH RESPECT TO THE INTERNAL REVENUE SERVICE (IRS) INTERMEDIATE SANCTIONS REGULATIONS AND THAT THE SAFE-HARBOR DESCRIBED THEREIN IS SATISFIED. THIS INDEPENDENT CONSULTANT UTILIZES PUBLISHED SURVEYS AND RELEVANT MARKET DATA TO DETERMINE RANGES FOR THE OFFICERS' SALARY TO REACH ITS OPINION. 15 (B) - COMPENSATION FOR THE OTHER OFFICERS (NOT MENTIONED ABOVE) AND KEY EMPLOYEES IS BASED ON A VARIETY OF SOURCES WHICH INCLUDE THIRD PARTY COMPENSATION SURVEYS AND STUDIES, THE ORGANIZATION'S HISTORICAL SALARY RATES, OTHER COMPENSATION WITHIN THE ORGANIZATION FOR SIMILAR TITLES AND POSITIONS, AND THE CURRENT LABOR MARKET. ALL SALARIES FOR EMPLOYEES MUST BE APPROVED BY THE CHIEF EXECUTIVE OFFICER AND/OR THE CHIEF OPERATING OFFICER AND THE VICE PRESIDENT OF HUMAN RESOURCES. FORM 990, PART VI, SECTION C, LINE 19 THE PUBLIC CAN OBTAIN A COPY OF THE 990, 990T, AUDITED FINANCIAL STATEMENTS VIA A WRITTEN OR VERBAL REQUEST THROUGH THE HOSPITAL'S OFFICE OF EXTERNAL AFFAIRS, 2277 GRAND AVE., BALDWIN, NY 11510. THE BYLAWS, ARTICLES OF INCORPORATION AND THE CONFLICT OF INTEREST POLICY OF THE HOSPITAL CAN BE OBTAINED AT MANAGEMENT'S DISCRETION VIA A WRITTEN REQUEST THROUGH THE HOSPITAL'S OFFICE OF EXTERNAL AFFAIRS, 2277 GRAND AVE., BALDWIN, NY 11510. PHONE NUMBER: (516) 377-5370. THE HOSPITAL'S PREVIOUS YEARS' 990 CAN BE FOUND ON THE WEB SITE, WWW.GUIDESTAR.COM. FORM 990, PART XI, LINE 9: TRANSFER TO AFFILIATES -7,868,540. PENSION AND POST RETIREMENT LIAB ADJUSTMENTS 80,684,714. FORM 990, PART XII, LINE 2C SOUTH NASSAU COMMUNITIES HOSPITAL RECEIVED A CONSOLIDATED AUDITED FINANCIAL STATEMENT FOR THE YEAR ENDING DECEMBER 31, 2013. THE CONSOLIDATED FINANCIAL STATEMENTS ARE PREPARED IN ACCORDANCE WITH ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA ("GAAP"). THE CONSOLIDATED FINANCIAL STATEMENTS INCLUDE THE ACCOUNTS OF SOUTH NASSAU COMMUNITIES HOSPITAL AND ALL OF ITS AFFILIATED ORGANIZATIONS WHICH IN SOME CASES FILE SEPARATE RETURNS WITH THE IRS. FORM 990, PAGE 1, BOX H AFFILIATES INCLUDED IN GROUP RETURN SUBORDINATE ORGANIZATIONS OF SOUTH NASSAU COMMUNITIES HOSPITAL (EIN: 27-2843521) GROUP EXEMPTION NUMBER 5611: - SOUTH NASSAU PRIMARY MEDICAL CARE, P.C. EIN: 11-3581988 - SOUTH NASSAU FAMILY MEDICINE, P.C. EIN: 11-3565450 - OCEANSIDE COUNSELING CENTER INC. EIN: 23-7062966 - S.N. SERVICES CORP EIN: 11-2727976 - SOUTH NASSAU NEONATAL SERVICES, P.C. EIN: 11-3319620 - SOUTH NASSAU PHYSICIAN PRACTICE, P.C. EIN: 26-2692377 - SOUTH NASSAU ONCOLOGY, P.C. EIN: 27-3857309 - SOUTH NASSAU CARDIOVASCULAR PRACTICE, P.C. EIN: 38-3843950 - 203 MERRICK ROAD EIN: 27-5368294 - SN RADIOLOGICAL PRACTICE, P.C. EIN: 27-4344388 - SOUTH NASSAU MEDICAL GROUP, P.C. EIN: 45-4799159 - SOUTH NASSAU OBSTETRICS AND GYNECOLOGY, P.C. EIN: 45-5272144 - RADIOLOGICAL ASSOCIATES OF LONG ISLAND, P.C. EIN: 11-2462030 SOUTH NASSAU MALPRACTICE TRUST ONE HEALTHY WAY OCEANSIDE NY 11572 136749767 INSURANCE NY 4797 (A) (1) N/A 1 WINTHROP UNIVERSITY HOSPITAL - 11-1633486 259 FIRST STREET MINEOLA NY 11501 111633486 HOSPITAL NY 501(C)(3) LINE 3: 170(B)(1)(A) N/A 0 WINTHROP SOUTH NASSAU UNIVERSITY HEALTH SYSTEM ONE HUNTINGTON QUADRANGLE MELVILLE NY 11747 066427908 DELIVER CARE NY 501(C)(3) LINE 11, TYPE I: 509 N/A 0 SOUTH NASSAU SN LLC ONE HEALTHY WAY OCEANSIDE NY 11572 450541270 INACTIVE NY N/A C 1.00000 0 SN HEALTHCARE SERVICES ONE HEALTHY WAY OCEANSIDE NY 11572 113571538 INACTIVE NY N/A C 5000 1.00000 0 SN HEALTHCARE REGISTRY ONE HEALTHY WAY OCEANSIDE NY 11572 260228658 INACTIVE NY N/A C 1.00000 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 1 SOUTH NASSAU PRIMARY MEDICAL PC B 518769 SOUTH NASSAU PRIMARY MEDICAL PC S 245000 SN CARDIOVASCULAR PRACTICE PC B 805578 SN CARDIOVASCULAR PRACTICE PC R 500000 SN NEONATAL PC B 210452 SN NEONATAL PC S 700000 SN NEONATAL PC N 54480 SN PHYSICIANS PRACTICE PC B 1487225 SN PHYSICIANS PRACTICE PC R 1110000 SN PHYSICIANS PRACTICE PC N 478596 203 MERRICK ROAD S 104871 SOUTH NASSAU FAMILY MEDICINE PC B 483920 SOUTH NASSAU FAMILY MEDICINE PC R 795000 SOUTH NASSAU FAMILY MEDICINE PC N 502044 SN ONCOLOGY PC B 566837 SN ONCOLOGY PC R 420000 SN ONCOLOGY PC N 73368 SN RADIOLOGY PC B 118621 SN RADIOLOGY PC S 60000 SN OBGYN PC B 131906 SN OBGYN PC S 1763000 SN OBGYN PC N 172422 SN MEDICAL GROUP PC B 1414499 SN MEDICAL GROUP PC R 796000 SN RADIOLOGICAL PC B 247228 SN RADIOLOGICAL PC R 995000 SN SERVICES B 1163924 OCEANSIDE COUNSELING CENTER INC Q 53365 FORM 990, SCHEDULE R, PART II SN NEONATAL PROVIDES MEDICAL SERVICES RELATED TO NEONATES. FORM 990, SCHEDULE R, PART V, LINE 2 VALUE OF THE SERVICES ARE DONE ON A CASH BASIS.