SOUTHAMPTON HOSPITAL ASSOCIATION: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization: SOUTHAMPTON HOSPITAL ASSOCIATION (EIN 11-1667765)
Tax period: 2010-01-01 to 2010-12-31
Filed: 2011-11-10
IRS object ID: 201103149349302710
Schema version: 2010v3.4
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2011-11-10T13:53:44-06:00	Timestamp
Tax Period End Date	2010-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	O'CONNOR DAVIES MUNNS & DOBBINS LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	500 MAMARONECK AVENUE - SUITE 301	AddressLine1
City	HARRISON	City
State	NY	State
ZIP Code	105281633	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2010-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	111667765	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	SOUTHAMPTON HOSPITAL ASSOCIATION	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	SOUT	NameControl
Phone	6317238301	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	240 MEETING HOUSE LANE	AddressLine1
City	SOUTHAMPTON	City
State	NY	State
ZIP Code	11968	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	CHRISTOPHER SCHULTHEIS	Name
Title	CFO	Title
Phone	6317238301	Phone
Date Signed	2011-11-10	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	GARRETT M HIGGINS	Name
Phone	9143818900	Phone

Field	Value	IRS element (for citing)
Tax Year	2010	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	CHRISTOPHER SCHULTHEIS	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	240 MEETING HOUSE LANE	AddressLine1
City	SOUTHAMPTON	City
State	NY	State
ZIP Code	11968	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	126341707	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.SOUTHAMPTONHOSPITAL.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1909	YearFormation
State Legal Domicile	NY	StateLegalDomicile
Activity Or Mission Description	SOUTHAMPTON HOSPITAL OFFERS A FULL CONTINUUM OF AMBULATORY AND INPATIENT SERVICES RANGING FROM	ActivityOrMissionDescription
Nbr Voting Members Governing Body	29	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	27	NbrIndependentVotingMembers
Total Nbr Employees	1043	TotalNbrEmployees
Total Nbr Volunteers	33	TotalNbrVolunteers
Total Gross UBI	1091008	TotalGrossUBI
Net Unrelated Business Txbl Income	-90102	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	8456311	ContributionsGrantsPriorYear
Contributions Grants Current Year	4082097	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	99057831	ProgramServiceRevenuePriorYear
Program Service Revenue CY	106304350	ProgramServiceRevenueCY
Investment Income Prior Year	-248465	InvestmentIncomePriorYear
Investment Income Current Year	385561	InvestmentIncomeCurrentYear
Other Revenue Prior Year	1594001	OtherRevenuePriorYear
Other Revenue Current Year	37093	OtherRevenueCurrentYear
Total Revenue Prior Year	108859678	TotalRevenuePriorYear
Total Revenue Current Year	110809101	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	0	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	57652607	SalariesEtcPriorYear
Salaries Etc Current Year	62678644	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	47193085	OtherExpensePriorYear
Other Expenses Current Year	47309251	OtherExpensesCurrentYear
Total Expenses Prior Year	104845692	TotalExpensesPriorYear
Total Expenses Current Year	109987895	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	4013986	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	821206	RevenuesLessExpensesCY
Total Assets BOY	81074223	TotalAssetsBOY
Total Assets EOY	87206773	TotalAssetsEOY
Total Liabilities BOY	83749471	TotalLiabilitiesBOY
Total Liabilities EOY	79512614	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	-2675248	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	7694159	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	THE MISSION OF SOUTHAMPTON HOSPITAL IS TO PROVIDE AND ENSURE THE HIGHEST QUALITY OF HEALTHCARE SERVICES FOR ITS ENTIRE COMMUNITY. [SEE CONTINUATION OF MISSION STATEMENT ON PAGES 73-75 OF SCHEDULE O]	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	93598895	Expense
Revenue	106304350	Revenue
Description	THE SOUTHAMPTON HOSPITAL ASSOCIATION IS A NOT-FOR-PROFIT 125 LICENSED BED ACUTE-CARE FACILITY THAT PROVIDES INPATIENT AND OUTPATIENT SERVICES TO PATIENTS.SOUTHAMPTON HOSPITAL OFFERS A FULL CONTINUUM OF AMBULATORY AND INPATIENT SERVICES RANGING FROM PRIMARY MEDICAL CARE TO SPECIALIZED SURGICAL PROCEDURES, AND IS STAFFED BY MORE THAN 230 PHYSICIANS, DENTISTS AND ALLIED HEALTH PROFESSIONALS REPRESENTING 44 MEDICAL SPECIALTIES.THE HOSPITAL HAS DEVELOPED NUMEROUS SERVICES AND OUTREACH, DETAILED BELOW, TO RESPOND TO THE NEEDS OF THEIR PATIENTS, INCLUDING RECRUITING ADDITIONAL PRIMARY CARE PHYSICIANS AND IMPLEMENTING A GRADUATE MEDICAL EDUCATION PROGRAM THAT WILL HOPEFULLY ATTRACT THESE YOUNG PHYSICIANS TO STAY AND PRACTICE IN THE COMMUNITY.SINCE THE HOSPITAL'S SERVICE AREA EXTENDS FROM WESTHAMPTON BEACH TO MONTAUK, THE HOSPITAL HAS A NUMBER OF SATELLITE CARE OFFICES TO PROVIDE CONVENIENT, SPECIALIZED CARE TO THE COMMUNITY. THESE INCLUDE: WESTHAMPTON PRIMARY CARE CENTER: PROVIDING CARE IN THE WESTHAMPTON, WESTHAMPTON BEACH, QUOGUE, AND REMSENBURG COMMUNITIES.LABORATORY AND IMAGING SERVICES:PROVIDING SERVICES IN EAST HAMPTON, HAMPTON BAYS AND SOUTHAMPTON.CENTER FOR PHYSICAL THERAPY AND REHABILITATION: PROVIDING CARE IN THE WESTHAMPTON, WESTHAMPTON BEACH, QUOGUE, AND REMSENBURG COMMUNITIES.THE SHINNECOCK INDIAN HEALTH CLINIC: SINCE APRIL OF 1995, SOUTHAMPTON HOSPITAL HAS WORKED WITH THE SHINNECOCK NATION TO PROVIDE SERVICES AT THE SHINNECOCK INDIAN HEALTH CLINIC THROUGH A CONTRACT WITH THE NEW YORK STATE DEPARTMENT OF HEALTH. ON AN ANNUAL BASIS, THE CLINIC PROVIDES APPROXIMATELY 1,600 MEDICAL AND 1,500 DENTAL VISITS FOR ELIGIBLE MEMBERS OF THE SHINNECOCK NATION. DENTAL SERVICES, INCLUDING COMMUNITY EDUCATION, SCREENING, RADIOLOGICAL EXAMS, DENTAL HYGIENE AND RESTORATIVE CARE (CROWNS, FILLINGS AND BRIDGES) ARE PROVIDED THROUGH A SUBCONTRACT WITH STONY BROOK UNIVERSITY SCHOOL OF MEDICINE. CURRENTLY, DENTAL SERVICES ARE AVAILABLE EIGHT DAYS PER MONTH FOR ADULTS AND TWO DAYS FOR CHILDREN. THE DAVID E. ROGERS MD CENTER FOR HIV/AIDS CARE: ANOTHER IMPORTANT COLLABORATION BETWEEN SOUTHAMPTON HOSPITAL, STONY BROOK UNIVERSITY MEDICAL CENTER AND TOWN AND COMMUNITY ORGANIZATIONS OF THE EAST END OF LONG ISLAND. MAJOR FUNDING IS PROVIDED THROUGH RYAN WHITE PART A FEDERAL FUNDS AND TO PROVIDE SUPPORT SERVICES AND PREVENTION EDUCATION TO PARTNERS AND FAMILY MEMBERS AFFECTED BY AIDS. THE CENTER IS A MEMBER OF THE PECONIC COMMUNITY COUNCIL, A NOT-FOR-PROFIT COALITION OF ORGANIZATIONS AND INDIVIDUALS DEDICATED TO THE PROMOTION AND PRESERVATION OF HEALTH AND HUMAN SERVICES FOR THE ENTIRE EAST END COMMUNITY.CENTER FOR PRENATAL CARE: LOCATED IN GREENPORT ON THE EASTERN END OF LONG ISLANDS NORTH FORK, THE CENTER PROVIDES PRENATAL CARE TO APPROXIMATELY 50 MOTHERS ANNUALLY IN AN UNDERSERVED AND GEOGRAPHICALLY REMOTE AREA. A MAJORITY OF THESE BABIES ARE BORN AT SOUTHAMPTON HOSPITALS KATHLEEN D. ALLEN MATERNITY CENTER.SOUTHAMPTON HOSPITAL IS PROUD OF THE EXCEPTIONAL SPECIALTY SERVICES IT PROVIDES TO THE COMMUNITY. THESE INCLUDE:THE ELLEN HERMANSON BREAST CENTER OFFERS A WIDE SPECTRUM OF BREAST HEALTH SERVICES, INCLUDING EDUCATION, EARLY DETECTION SCREENINGS AND BREAST CANCER TREATMENT AND SUPPORT. THE CENTER UTILIZES STATE-OF-THE-ART DIAGNOSTIC TECHNIQUES, INCLUDING COMPUTER-ASSISTED MAMMOGRAPHY, ULTRASOUND AND BREAST BIOPSY. THE ED & PHYLLIS DAVIS WELLNESS INSTITUTE OFFERS THE ONLY HOSPITAL-BASED INTEGRATIVE MEDICINE ON LONG ISLAND'S EAST END. INTEGRATIVE MEDICINE COMBINES MODERN SCIENCE, PSYCHOLOGY, NUTRITION, AND EXERCISE TO ENHANCE THE NATURAL HEALING CAPACITY OF THE BODY. SPECIAL PROGRAMS ARE AVAILABLE FOR PATIENTS SUFFERING FROM CHRONIC ILLNESS AND CLASSES IN YOGA, TAI CHI, PILATES, SMOKING CESSATION, STRESS MANAGEMENT, ARE OFFERED, AS WELL AS NUTRITIONAL AND WEIGHT LOSS COUNSELING, MASSAGE THERAPY, AND MUCH MORE.THE JENNY AND JOHN PAUSON DEPARTMENT OF EMERGENCY MEDICINE SERVES MORE THAN 25,000 EMERGENCY PATIENTS ANNUALLY AND IS THE ONLY HOSPITAL-BASED EMERGENCY CARE ON THE SOUTH FORK OF LONG ISLAND. STAFFED 24/7 BY BOARD-CERTIFIED EMERGENCY PHYSICIANS AND SPECIALTY-TRAINED NURSES AND STAFF, IT HAS THE MOST SOPHISTICATED, NON-INVASIVE CARDIAC DIAGNOSTIC AND MONITORING TECHNOLOGY AVAILABLE AND, AS A NEW YORK STATE-DESIGNATED STROKE CENTER, IT IS THE DESTINATION OF AMBULANCES WHEN A HEART ATTACK OR STROKE IS SUSPECTED.	Description
Total Program Service Expense	93598895	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	1	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	0	FinancialStmtAttached
Grants To Organizations	0	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	0	TaxExemptBonds
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	0	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	0	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	1	RelatedOrgControlledEntity
Transaction Related Entity	1	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	186	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	1043	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	1	UnrelatedBusinessIncome
Form990-T Filed	1	Form990-TFiled
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Form8899 Filed	0	Form8899Filed
Form1098 C Filed	0	Form1098CFiled
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	29	NbrVotingGoverningBodyMembers
Number Independent Voting Members	27	NumberIndependentVotingMembers
Family Or Business Relationship	0	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	0	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	1	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	1	InvestmentInJointVenture
Written Policy Or Procedure	1	WrittenPolicyOrProcedure
States Where Copy Of Return Is Filed	NY	StatesWhereCopyOfReturnIsFiled
Other Website	X	OtherWebsite
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	CHRISTOPHER SCHULTHEIS	NamePerson
Telephone Number	6317268301	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	240 MEETING HOUSE LANE	AddressLine1
City	SOUTHAMPTON	City
State	NY	State
ZIP Code	11968	ZIPCode

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	X	InfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (39 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee
PETER M LARSEN
BOARD CHAIRMAN	1.30	X	X	0	0	0
RICHARD J HIEGEL ESQ
BOARD CO-CHAIR	1.30	X	X	0	0	0
KENNETH B WRIGHT
BOARD CO-CHAIR	1.30	X	X	0	0	0
STANLEY D FRIEDMAN
BOARD VP	1.30	X	X	0	0	0
LAWRENCE A WILLIS
BOARD TREASURER	1.30	X	X	0	0	0
PATRICIA STEWART
BOARD SECRETARY	1.30	X	X	0	0	0
JOHN WAMBOLD
TRUSTEE	1.30	X		0	0	0
RICHARD BRUCE
TRUSTEE	1.30	X		0	0	0
JAMES FORBES
TRUSTEE	1.30	X		0	0	0
CHARLES HOLMES
TRUSTEE	1.30	X		0	0	0
MICHAEL B ISRAEL MD
TRUSTEE	38.80	X		177077	0	30055
GEORGE P KAZDIN
TRUSTEE	1.30	X		0	0	0
LISA KOMBRINK
TRUSTEE	1.30	X		0	0	0
JACK LENTZ - TRUSTEE
THRU 07/06/10	1.30	X		0	0	0
JOHN MCGOWAN
TRUSTEE	1.30	X		0	0	0
STEPHEN H SHAPOFF
TRUSTEE	1.30	X		0	0	0
R TIMOTHY MARAN
TRUSTEE	1.30	X		0	0	0
PHILLIP A PIRO JR MD
TRUSTEE	1.30	X		0	0	0
DOROTHY LEWIS
TRUSTEE	1.30	X		0	0	0
JEAN REMMEL FITZSIMMONS
TRUSTEE	1.30	X		0	0	0
JOHN E GRIM III
TRUSTEE	1.30	X		0	0	0
PETER COLLINS
TRUSTEE	1.30	X		0	0	0
STEVEN R GOLDFARB MD
TRUSTEE	1.30	X		0	0	0
FLORENCE ROLSTON MD
TRUSTEE	1.30	X		0	0	0
MARTIN L STONE MD
TRUSTEE	1.30	X		0	0	0
MICHAEL F SMITH
TRUSTEE	1.30	X		0	0	0
GEORGE F BIONDO ESQ
TRUSTEE	1.30	X		0	0	0
JAY K LEVINE
TRUSTEE	1.30	X		0	0	0
ROBERT S CHALONER
PRESIDENT & CEO	38.80	X	X	615461	0	39804
HOWARD M LORBER
TRUSTEE	1.30	X		0	0	0
FREDERIC I WEINBAUM
CHIEF MEDICAL OFFICER & COO	37.50		X	419788	0	36265
CHRISTOPHER J SCHULTHEIS
CHIEF FINANCIAL OFFICER	37.50		X	191863	0	30745
PATRICIA A DARCEY
CHIEF NURSING OFFICER	37.50			192438	0	30495	X
PAUL R DAVIN
DIRECTOR, HUMAN RESOURCES	37.50			190347	0	30261	X
EDNA KAPENHAS-VALDES
DIRECTOR, BREAST SERVICE	37.50			312370	0	34008		X
CHARLES ARCOLEO
DIRECTOR	37.50			247829	0	33694		X
ANGELA SOTERIOU
HOSPITALIST	37.50			193954	0	18637		X
ALEX APONTE
PHYSICIAN	37.50			189736	0	30738		X
TOVIA LENT
HOSPITALIST	37.50			192376	0	29016		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	2923239	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	343718	TotalOtherCompensation
Number Individuals GT100 K	10	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
MORRISON MANAGEMENT SPECIALIST
4721 MORRISON DRIVE STE 300	MOBILE	AL	36609	FOOD SERVICE MGMT & SUPPLIES	928873
HAMPTONS GYNECOLOGY OB
595 HAMPTON ROAD	SOUTHAMPTON	NY	11968	OB COVERAGE & PRECEPTING	896990
CANDESCENT HEALING INC
220 WHITE PLAINS ROAD	TARRYTOWN	NY	10591	OUTPATIENT SERVICES	624614
LONG ISLAND PATHOLOGY PC
PO BOX 2098	SOUTHAMPTON	NY	11968	PATHOLOGY SERVICES	431520
BDO SEIDMAN LLP
PO BOX 642743	PITTSBURGH	PA	152642743	ACCOUNTING	215266

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	17	NumberOfContractorsGT100K
Federated Campaigns	114753	FederatedCampaigns
Related Organizations	2399326	RelatedOrganizations
Government Grants	1409416	GovernmentGrants
All Other Contributions	158602	AllOtherContributions
Total Contributions	4082097	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue
INPATIENT SERVICES	900099	55471355	55471355
EMERGENCY RM & OUTPATI	900099	48729942	48729942
LABORATORY EXTENDED SE	621500	1091008		1091008
LABORATORY REVENUE	900099	607726	607726
BREAST CTR REVENUE	900099	193927	193927

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	210392	TotalRevenueColumn
Related Or Exempt Function Income	210392	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Program Service Revenue	106304350	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	126358	TotalRevenueColumn
Exclusion	$126,358	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	467740	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	436720	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	31020	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	31020	TotalRevenueColumn
Exclusion	$31,020	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	15352531	Securities
Other	2558	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	15095886	Securities

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	256645	Securities
Other	2558	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	259203	TotalRevenueColumn
Exclusion	$259,203	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount
TELEPHONE REVENUE	900099	52601	$52,601
VENDOR REBATES	900099	26775	$26,775
MISCELLANEOUS	900099	17916	$17,916

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	-91219	TotalRevenueColumn
Exclusion	-$91,219	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	6073	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	110809101	TotalRevenueColumn
Related Or Exempt Function Income	105213342	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	1091008	UnrelatedBusinessRevenue
Exclusion	$422,654	ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	1778066	Total
Management And General	1778066	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	45219072	Total
Program Services	38888402	ProgramServices
Management And General	6330670	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	2866444	Total
Program Services	2465142	ProgramServices
Management And General	401302	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	9390533	Total
Program Services	8075858	ProgramServices
Management And General	1314675	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	3424529	Total
Program Services	2945095	ProgramServices
Management And General	479434	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	769587	Total
Program Services	661845	ProgramServices
Management And General	107742	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	140934	Total
Management And General	140934	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	250409	Total
Management And General	250409	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	43486	Total
Program Services	37398	ProgramServices
Management And General	6088	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	11435	Total
Program Services	9834	ProgramServices
Management And General	1601	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	13495240	Total
Program Services	11605906	ProgramServices
Management And General	1889334	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	626592	Total
Program Services	538869	ProgramServices
Management And General	87723	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	2867194	Total
Program Services	2465787	ProgramServices
Management And General	401407	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	158083	Total
Management And General	158083	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	5144	Total
Management And General	5144	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	2897623	Total
Program Services	2491956	ProgramServices
Management And General	405667	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	4171159	Total
Program Services	3587197	ProgramServices
Management And General	583962	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	2347906	Total
Program Services	2019199	ProgramServices
Management And General	328707	ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
BAD DEBTS	8406000	8406000
OTHER PURCHASE SERVICES	4842065	4164176	677889
OTHER PROFESSIONAL SERV	3361298	2890716	470582
OTHER DIRECT EXPENSES	1530845	1316527	214318
MISCELLANEOUS	710526	355263	355263

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	673725	Total
Program Services	673725	ProgramServices

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	109987895	Total
Program Services	93598895	ProgramServices
Management And General	16389000	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	4228363	BOY
EOY	1064887	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	1075153	BOY
EOY	8276962	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	13025057	BOY
EOY	11221858	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	2744016	BOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	1396307	BOY
EOY	1426697	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	198721	BOY
EOY	224215	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	126828225	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	91916023	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	29498686	BOY
EOY	34912202	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	27403543	BOY
EOY	26969470	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	1504377	BOY
EOY	3110482	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	81074223	BOY
EOY	87206773	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	22206091	BOY
EOY	16191326	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	36317011	BOY
EOY	35558409	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	7653718	BOY
EOY	8916102	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	17572651	BOY
EOY	18846777	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	83749471	BOY
EOY	79512614	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	-10420273	BOY
EOY	-374818	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	4911008	BOY
EOY	5234960	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	2834017	BOY
EOY	2834017	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	-2675248	BOY
EOY	7694159	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	81074223	BOY
EOY	87206773	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	821206	ReconcilationRevenueExpenses
Reconcilation Other Changes	9548201	ReconcilationOtherChanges
Info In Schedule O Part XII	X	InfoInScheduleOPartXII
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited
Audit Committee	1	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	Volunteers
Paid Staff Or Management	0	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	1	GrantsOtherOrganizations
Grants Other Organizations	$43,486	GrantsOtherOrganizationsAmount
Direct Contact Legislators	0	DirectContactLegislators
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	0	OtherActivities
Total Lobbying Expenditures IIB	43486	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	EXPLANATION OF OTHER LOBBYING ACTIVITIES:	Identifier
Return Reference	PART II-B, LINE 1I:	ReturnReference
Explanation	SOUTHAMPTON HOSPITAL PAYS MEMBERSHIP DUES TO THE ORGANIZATIONS LISTED BELOW. A PERCENTAGE OF THESE DUES ARE THEN USED TO REIMBURSE THE ORGANIZATION FOR THE COST OF LOBBYING ACTIVITIES PERFORMED ON BEHALF OF THE HOSPITAL. THE FUNDS ARE USED FOR LOBBYING PURPOSES IN CONNECTION WITH NEW YORK STATE AND FEDERAL POLICY ISSUES. MEMBERSHIP DUES PAID TO OTHER ORGANIZATIONS AND USED FOR LOBBYING PURPOSES: HEALTHCARE ASSOCIATION OF NEW YORK STATE $ 14,040 NASSAU SUFFOLK HOSPITAL COUNCIL 1,297 GREATER NY HOSPITAL ASSOCIATION 28,149 --------- $ 43,486 =========	Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	3943577	BeginningOfYearBalance
Investment Earnings Or Losses	371238	InvestmentEarningsOrLosses
Other Expenditures	95021	OtherExpenditures
Administrative Expenses	6028	AdministrativeExpenses
End Of Year Balance	4213766	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	4031782	BeginningOfYearBalance
Investment Earnings Or Losses	73511	InvestmentEarningsOrLosses
Other Expenditures	23873	OtherExpenditures
Administrative Expenses	137843	AdministrativeExpenses
End Of Year Balance	3943577	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	4235635	BeginningOfYearBalance
Investment Earnings Or Losses	-146059	InvestmentEarningsOrLosses
Other Expenditures	30806	OtherExpenditures
Administrative Expenses	26988	AdministrativeExpenses
End Of Year Balance	4031782	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	0.32000	BoardDesignatedEOYBalance
Permanent Endowment EOY Balance	0.68000	PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs	0	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	0	EndowmentsHeldByRelatedOrgs

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1335585	OtherCostOrOtherBasis
Book Value	1335585	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	37906615	OtherCostOrOtherBasis
Depreciation	15718387	Depreciation
Book Value	22188228	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	10854427	OtherCostOrOtherBasis
Depreciation	3086703	Depreciation
Book Value	7767724	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	76731598	OtherCostOrOtherBasis
Depreciation	73110933	Depreciation
Book Value	3620665	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	34912202	TotalOfBookValueLandBuildings

Other Securities OtherSecurities (6 entries)

DescriptionDescription	Book ValueBookValue	Method Of ValuationMethodOfValuation
SHORT TERM INVESTMENTS	1071240	F
ASSETS SUBJECT TO DONOR RESTRICTIONS	8068977	F
DEBT SERVICE RESERVE FUND	5706009	F
MALPRACTICE SELF INSURANCE-FUND	5718000	F
INVESTMENT IN SHA PROPERTIES	6300000	C
INVESTMENT IN JOINT VENTURE - HAMPTON IMAGING LLC	105244	F

Field	Value	IRS element (for citing)
Total Of Book Value Securities	26969470	TotalOfBookValueSecurities

Other Assets OtherAssets (2 entries)

DescriptionDescription	Book ValueBookValue
DUE FROM RELATED PARTY - MEETINGHOUSE LANE MEDICAL PRACTICE	2080612
UNAMORTIZED BOND DISCOUNT & ISSUE COST	1029870

Field	Value	IRS element (for citing)
Total Book Value Other Assets	3110482	TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescription	AmountAmount
MALPRACTICE SELF-INSURANCE	$5,718,000
DUE FROM THIRD PARTY PAYORS	$5,374,442
PENSION LIABILITY	$7,430,050
DUE FROM RELATED PARTY - MEETINGHOUSE LANE MEDICAL PRACTICE	$324,285

Field	Value	IRS element (for citing)
Total Of Amounts	18846777	TotalOfAmounts
Total Revenue	110809101	TotalRevenue
Total Expenses	109987895	TotalExpenses
Excess Or Deficit For Year	821206	ExcessOrDeficitForYear
Net Unrealized GL On Investments	581461	NetUnrealizedGLOnInvestments
Prior Period Adjustments	1390345	PriorPeriodAdjustments
Other	$7,576,395	OtherAmount
Total Adjustments	9548201	TotalAdjustments
Excess Or Deficit Per FS	10369407	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	114293425	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	581461	NetUnrealizedGainsInvestments
Other Revenues	3576588	OtherRevenues
Revenue Not Rptd F990	4158049	RevenueNotRptdF990
Revenue Subtotal	110135376	RevenueSubtotal
Other Revenues Not Included	673725	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	673725	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	110809101	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	109907806	TotExpensesEtcAuditedFinclStmt
Other Expenses Included	593636	OtherExpensesIncluded
Expenses Not Rptd F990	593636	ExpensesNotRptdF990
Expenses Subtotal	109314170	ExpensesSubtotal
Other Expenses Not Included	673725	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	673725	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	109987895	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (8 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:	PART V, LINE 4:	SOUTHAMPTON HOSPITAL CURRENTLY REPORTS ENDOWMENT FUNDS WITHIN ITS DECEMBER 31, 2010 FINANCIAL STATEMENTS. THE GOVERNING BODY INTENDS TO USE THESE FUNDS TO OFFSET THE COST OF INDIGENT CARE, EMERGENCY SERVICES AND NURSING EDUCATION.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:	PART X:	THE HOSPITAL IS INCORPORATED IN THE STATE OF NEW YORK AND IS EXEMPT FROM FEDERAL, STATE AND LOCAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE"), AND THEREFORE HAVE MADE NO PROVISION FOR INCOME TAXES IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE HOSPITAL EARNS INCOME FROM ITS LABORATORY EXTENDED SERVICES PROGRAM. SUCH INCOME IS CLASSIFIED AS UNRELATED BUSINESS INCOME ("UBI") BY THE CODE AND IS SUBJECT TO INCOEM TAXES. UBI IS DEFINED AS INCOME DERIVED FROM AN ACTIVITY THAT CONSTITUTES A TRADE OR BUSINESS THAT IS REGULARLY CARRIED ON AND IS NOT SUBSTANTILALLY RELATED TO THE ORGANIZATION'S TAX-EXEMPT PURPOSE. THE LABORATORY EXTENDED SERVICES PROGRAM HAS BEEN OPERATING AT A LOSS AND, ACCORDINGLY, THERE IS NO UBI TAX RECORDED FOR THE YEAR ENDED DECEMBER 31, 2010. THE HOSPITAL HAVE NOT TAKEN AN UNSUNSTANTIATED TAX POSITION THAT WOULD REQUIRE PROVISION OF A LIABILIOTY UNDER ASC 740-10.
PART XI, LINE 8 - OTHER ADJUSTMENTS:		CHANGE IN MINIMUM PENSION LIABILITY - $1,266,824 NET ASSETS REL FROM RESTRICTIONS - CAPITAL ACQUIS FOUNDATION - $5,993,546 CHANGE IN EXPECTED INTEREST IN TRUSTS CHANGE IN VALUE OF POOLED INCOME FUND OTHER ADJUSTMENTS
PART XII, LINE 2D - OTHER ADJUSTMENTS:		RELATED PARTY INCOME - S.H.A PRPERTIES, INC. - $374,091 INTEREST IN SOUTHAMPTON HOSPITAL FOUNDATION M- $2,441,825 RENTAL EXPENSES REPORTED ON FORM 990, PART VIII, LINE 6B - $436,720 CHANGE IN EXPECTED INEREST IN TRUSTS - $317,933 CHANGE IN VALUE OF POOLED INCOME FUND - $6,019
PART XII, LINE 4B - OTHER ADJUSTMENTS:		NET PATIENT SERVICE REVENUE RECLASSIFICATION - $673,725
PART XIII, LINE 2D - OTHER ADJUSTMENTS:		RENTAL EXPENSES REPORTED ON FORM 990, PART VIII, LINE 6B - $436,720 RELATED PARTY EXPENSES - S.H.A PROPERTIES, INC. - $156,916
PART XIII, LINE 4B - OTHER ADJUSTMENTS:		NET PATIENT SERVICE REVENUE RECLASSIFICATION - $673,725
		PART XI, LINE 7 - EXPLANATION FOR PRIOR PERIOD ADJSUTMENTS: THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS FOR 2009 HAVE BEEN RESTATED TO CORRECT AN UNDERSTATEMENT OF UNRESTRICTED NET ASSETS AS A RESULT OF CONSOLIDATION OF THE MEETING HOUSE LANE MEDICAL PRACTICE PC, WHICH WAS CREATED IN 2008, BUT EXCLUDED FROM THE CONSOLIDATED FINANCIAL STATEMENTS.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	1	FPGReferenceFreeCare

Other Percentage OtherPercentage

Field	Value	IRS element (for citing)
Other	X	Other
Free Other Percentage	400.000000000000	FreeOtherPercentage

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent400	X	Pcent400
Free Disc Care Medically Indigent	0	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	1	ExpensesExceededBudget
Unable To Provide Care	0	UnableToProvideCare
Annual Community Benefit Report	1	AnnualCommunityBenefitReport
Report Publically Available	1	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	703	PersonsServed
Total Community Benefit Expense	2111421	TotalCommunityBenefitExpense
Direct Offsetting Revenue	1274481	DirectOffsettingRevenue
Net Community Benefit Expense	836940	NetCommunityBenefitExpense
Percent Of Total Expense	0.00760	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	10147209	TotalCommunityBenefitExpense
Direct Offsetting Revenue	6064511	DirectOffsettingRevenue
Net Community Benefit Expense	4082698	NetCommunityBenefitExpense
Percent Of Total Expense	0.03720	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	703	PersonsServed
Total Community Benefit Expense	12258630	TotalCommunityBenefitExpense
Direct Offsetting Revenue	7338992	DirectOffsettingRevenue
Net Community Benefit Expense	4919638	NetCommunityBenefitExpense
Percent Of Total Expense	0.04480	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	3396595	TotalCommunityBenefitExpense
Direct Offsetting Revenue	885893	DirectOffsettingRevenue
Net Community Benefit Expense	2510702	NetCommunityBenefitExpense
Percent Of Total Expense	0.02230	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	2	NumberOfActivitiesOrPrograms
Persons Served	543	PersonsServed
Total Community Benefit Expense	580717	TotalCommunityBenefitExpense
Direct Offsetting Revenue	680319	DirectOffsettingRevenue
Net Community Benefit Expense	-99602	NetCommunityBenefitExpense
Percent Of Total Expense	0.00530	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	2	NumberOfActivitiesOrPrograms
Persons Served	543	PersonsServed
Total Community Benefit Expense	3977312	TotalCommunityBenefitExpense
Direct Offsetting Revenue	1566212	DirectOffsettingRevenue
Net Community Benefit Expense	2411100	NetCommunityBenefitExpense
Percent Of Total Expense	0.02760	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	3	NumberOfActivitiesOrPrograms
Persons Served	1246	PersonsServed
Total Community Benefit Expense	16235942	TotalCommunityBenefitExpense
Direct Offsetting Revenue	8905204	DirectOffsettingRevenue
Net Community Benefit Expense	7330738	NetCommunityBenefitExpense
Percent Of Total Expense	0.07240	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	360289	TotalCommunityBuildingExpense
Net Community Building Expense	360289	NetCommunityBuildingExpense
Percent Of Total Expense	0.00350	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Total Community Building Expense	360289	TotalCommunityBuildingExpense
Net Community Building Expense	360289	NetCommunityBuildingExpense
Percent Of Total Expense	0.00350	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	1	BadDebtExpenseReported
Bad Debt Expense	$8,406,000	BadDebtExpenseAmount
Amount Attributable To	0	AmountAttributableTo
Amount Reimbursed By Medicare	139924937	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	102192979	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	37731958	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Cost Accounting System	X	CostAccountingSystem

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (5 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivity	Organization Profit Or OwnershipOrganizationProfitOrOwnership	Officers Etc Profit Or OwnershipOfficersEtcProfitOrOwnership	Physicans Profit Or OwnershipPhysicansProfitOrOwnership
1 HAMPTONS IMAGING
RADIOLOGY SERVICES	0.50000	0.00000	0.00000
2 MEETINGHOUSE LANE PRACTICE
PRIMARY/SPECIALTY PHYSICIAN PATIENT CARE	1.00000	0.00000	0.00000
3 EAST HAMPTON MSO LLC
URGENT CARE PATIENT SERVICES	0.50000	0.00000	0.00000
4 SHA PROPERTIES INC
REAL ESTATE HOLDING COMPANY	1.00000	0.00000	0.00000
5 OLD TOWN MEDICAL PRACTICE PC
PRACTICE OF MEDICINE	1.00000	0.00000	0.00000

Field	Value	IRS element (for citing)
Number Of Hospital Facilities	15	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (15 entries)

Facility NumberFacilityNumber	Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Licensed HospitalLicensedHospital	General Medical And SurgicalGeneralMedicalAndSurgical	OtherOther
SOUTHAMPTON HOSPITAL
1	240 MEETING HOUSE LANE	SOUTHAMPTON	NY	11968	X
DIALYSIS CENTER
2	184 W MONTAUK HIGHWAY	HAMPTON BAYS	NY	11946		X	DIALYSIS TREATMENT FACILITY
GREENPORT PRENATAL
3	300 ATLANTIC AVENUE	GREENPORT	NY	11944		X	PRENATAL/WOMEN'S SERVICES
LAB EAST
4	200 PANTIGO PLACE	EAST HAMPTON	NY	11937		X	LABORATORY SERVICES
IMAGING - EH
5	200 PANTIGO PLACE	EAST HAMPTON	NY	11937		X	RADIOLOGY SERVICES
WESTHAMPTON PRIMARY CARE
6	80 OLD RIVERHEAD ROAD	WESTHAMPTON BEACH	NY	11978		X	PRIMARY CARE PRACTICE
WESTHAMPTON SPORTS REHAB
7	74 OLD RIVERHEAD ROAD	WESTHAMPTON BEACH	NY	11978		X	SPORTS RHAB/PHYSICAL THERAPY SERVICES
LAB SOUTH
8	325 MEETING HOUSE LANE	SOUTHAMPTON	NY	11968		X	LABORATORY SERVICES
ATRIUM LAB
9	182 W MONTAUK HIGHWAY	HAMPTONS BAYS	NY	11946		X	LABORATORY SERVICES
DAVID ROGERS CENTER
10	335 D MEETINGHOUSE LANE	SOUTHAMPTON	NY	11968		X	HIV/AIDS CARE
SHINNECOCK HEALTH
11	CHURCH STREET	SOUTHAMTPON	NY	11968		X	PRIMARY CARE/DENTAL SERVICES
SOUTHAMPTON CARE CENTER
12	240 MEETINGHOUSE LANE	SOUTHAMPTON	NY	11968			NURSING HOME (FACILITY CLOSED)
HAMPTONS IMAGING
13	182 W MONTAUK HIGHWAY	HAMPTONS BAYS	NY	11946		X	RADIOLOGY SERVICES
MEETINGHOUSE LANE PRACTICE
14	PO BOX 2340	SOUTHAMPTON	NY	11968		X	PRIMARY/SPECIALTY PHYSICIAN PATIENT CARE
EAST HAMPTON MSO LLC
15	470 PANTIGO ROAD	EAST HAMPTON	NY	11937		X	URGENT CARE PATIENT SERVICES

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	NOT REQUIRED	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
Eligibility Criteria Explained	0	EligibilityCriteriaExplained
Uses FPG Free	0	UsesFPGFree
Uses FPG Discounted	0	UsesFPGDiscounted
Explains Basis	0	ExplainsBasis
Explains Application Method	0	ExplainsApplicationMethod
Includes Publicity Measures	0	IncludesPublicityMeasures
Actions On Nonpayment	0	ActionsOnNonpayment
Collection Activities	0	CollectionActivities
Nondiscrim Emergency Care Policy	0	NondiscrimEmergencyCarePolicy
Amounts Generally Billed	0	AmountsGenerallyBilled
Gross Charges	0	GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)

ExplanationExplanation
PART I, LINE 3C: THERE ARE TWO LEVELS OF CHARITY CARE COVERAGE: PRIMARY SERVICE AREA AND NON-PRIMARY SERVICE AREA. A PRIMARY SERVICE AREA PATIENT IS A PATIENT WHO RESIDED IN NEW YORK STATE WITHIN THE COUNTIES OF SUFFOLK OR NASSAU AT THE TIME OF SERVICE. A NON-PRIMARY SERVICE AREA PATIENT IS A PATIENT WHO RESIDED IN NEW YORK STATE BUT NOT IN THE COUNTIES OF SUFFOLK OR NASSAU AT THE TIME OF SERVICE. ELIGIBLE SERVICES FOR A PRIMARY SERVICE AREA PATIENT:A PRIMARY SERVICE AREA PATIENT WHO MEETS THE FINANCIAL REQUIREMENTS IS ELIGIBLE FOR THE FOLLOWING MEDICALLY NECESSARY SERVICES: INPATIENT, AMBULATORY, EMERGENCY ROOM, EMERGENCY TRANSFERS UNDER THE EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA), OUTPATIENT, AND DIAGNOSTIC CARE. UNDERINSURED PRIMARY SERVICE AREA PATIENTS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE ON MEDICARE AND COMMERCIAL INSURANCE CARRIER CO-INSURANCES FOR ALL ABOVE LISTED SERVICES. ELIGIBLE SERVICES FOR A NON-PRIMARY SERVICE AREA PATIENT:A NON-PRIMARY SERVICE AREA PATIENT WHO MEETS THE FINANCIAL REQUIREMENTS IS ELIGIBLE FOR THE FOLLOWING MEDICALLY NECESSARY SERVICES: EMERGENCY ROOM, EMERGENT ADMISSIONS, AND EMERGENCY TRANSFERS UNDER THE EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA). UNDERINSURED NON-PRIMARY SERVICE AREA PATIENTS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE ON MEDICARE AND COMMERCIAL INSURANCE CARRIER CO-INSURANCES FOR ALL ABOVE LISTED SERVICES.INELIGIBLE SERVICES:THE FOLLOWING SERVICES AND/OR ITEMS ARE NOT COVERED BY CHARITY CARE FOR ANY PATIENT: NOT MEDICALLY NECESSARY SERVICES AS DETERMINED BY MEDICARE (E.G. COSMETIC SURGERY, BARIATRIC SURGERY), INSURANCE CO-PAYMENTS, INSURANCE DEDUCTIBLES, NON-COVERED SERVICES AS DETERMINED BY THE PATIENT'S INSURANCE CARRIER, PRIVATE ROOM RATES, AND PRIVATE PHYSICIAN FEES WHICH ARE NOT BILLED BY SOUTHAMPTON HOSPITAL (E.G. RADIOLOGY, PATHOLOGY, ANESTHESIOLOGY, EMERGENCY).FAMILY INFORMATION REQUIREMENTS:A PATIENT MUST PROVIDE ON THEIR CHARITY CARE APPLICATION A LIST OF THE FAMILY/HOUSEHOLD MEMBERS AND OR DEPENDENTS WITH WHOM THE PATIENT RESIDES. IF THE PATIENT IS AN ADULT, THE PATIENT MUST LIST THEIR SPOUSE OR DOMESTIC PARTNER, CHILDREN UNDER THE AGE OF 21, AND ANY CLAIMED DEPENDENTS OR OTHER HOUSEHOLD MEMBERS THAT LIVE WITH THE PATIENT. IF THE PATIENT IS A CHILD UNDER THE AGE OF 21, THE APPLICANT MAY LIST THE PATIENT'S PARENTS, SIBLINGS UNDER THE AGE OF 21, AND ANY CLAIMED DEPENDENTS OR OTHER HOUSEHOLD MEMBERS THAT LIVE WITH THE PATIENT. A CLAIMED DEPENDENT IS DEFINED AS A PERSON WHO IS LISTED OR WOULD BE LISTED AS A DEPENDENT FOR THE PURPOSES OF AN INCOME TAX SUBMISSION TO THE IRS. FINANCIAL REQUIREMENTS:TO BE FINANCIALLY ELIGIBLE TO RECEIVE CHARITY CARE, A PATIENT MUST HAVE A GROSS FAMILY/HOUSEHOLD INCOME LESS THAN OR EQUAL TO 400% OF THE FEDERAL POVERTY LEVEL GUIDELINE (FPG) AND HAVE ASSETS LESS THAN OR EQUAL TO THE ALLOWABLE LIMIT AS DESCRIBED IN THE ASSET LEVEL PASSAGE. [SEE ASSETT LEVEL PASSAGE DESCRIBED ON PAGE 40 OF THE TAX RETURN]ELIGIBLE INCOME:THE FOLLOWING INCOME ITEMS WILL BE USED TO DETERMINE A PATIENT'S INCOME: EARNINGS FROM EMPLOYMENT, UNEMPLOYMENT COMPENSATION, WORKERS COMPENSATION, DISABILITY, SOCIAL SECURITY, ANNUITIZED PENSION PLAN, CHILD SUPPORT, ALIMONY, DIVIDENDS, INTEREST, RENTALS, ESTATES, TRUSTS, SALE OF ASSETS, AND OTHER MISCELLANEOUS INCOME. SOLE PROPRIETORSHIP, PARTNERSHIP, AND S CORPORATION INCOME WILL BE CALCULATED BY ITS GROSS PROFIT OR TOTAL INCOME PRIOR TO EXPENSES AND DEDUCTIONS; HOWEVER, COST OF GOODS SOLD MAY BE DEDUCTED FROM GROSS SALES.SALE OF ASSETS, SUCH AS REPORTED ON A SCHEDULE D OR ITS EQUIVALENT, WILL BE CALCULATED BY THEIR SALE PRICE AND NOT BY THEIR GAIN OR LOSS.ASSETS:THE FOLLOWING ASSETS WILL BE CONSIDERED WHEN DETERMINING A PATIENT'S CHARITY CARE ELIGIBILITY: CHECKING ACCOUNTS, SAVINGS ACCOUNTS, NON-PRIMARY RESIDENCES OR PROPERTY, CARS AND/OR VEHICLES NOT USED FOR PRIMARY TRANSPORTATION BY THE PATIENT OR HOUSEHOLD, STOCKS, BONDS, TRUSTS, AND OTHER MISCELLANEOUS ASSETS. THE FOLLOWING ASSETS WILL NOT BE CONSIDERED WHEN DETERMINING A PATIENT'S CHARITY CARE ELIGIBILITY: THE PATIENT'S PRIMARY RESIDENCE, CARS AND/OR VEHICLES REGULARLY USED FOR PRIMARY TRANSPORTATION BY THE PATIENT OR HOUSEHOLD, ASSETS HELD IN A TAX-DEFERRED OR COMPARABLE RETIREMENT SAVINGS ACCOUNT, IRA'S, BULK-PAYMENT PENSIONS, OR COLLEGE SAVINGS ACCOUNTS.ASSET LEVELS:PATIENTS WITH A GROSS FAMILY INCOME AT OR BELOW 150% OF THE FPG MAY NOT HAVE ASSETS TOTALING OVER THE AMOUNT LISTED ON THE CHART BELOW. (EFFECTIVE JANUARY 1, 2009)PATIENTS WITH A GROSS FAMILY INCOME OVER 150% OF THE FPG MAY NOT HAVE ASSETS TOTALING OVER THE AMOUNT LISTED ON THE CHART BELOW. (EFFECTIVE IMMEDIATELY)SIZE OF FAMILY MAX ALLOWABLE ASSETS1 $4,2002 $5,4003 $6,6004 $6,6505 $6,7006 $6,8007 $7,6508 $8,500EACH ADDITIONAL $850ASSET SPEND-DOWN :A PATIENT HAVING LIQUID ASSETS OVER THE ALLOWABLE LIMIT BUT OTHERWISE QUALIFYING FOR CHARITY CARE MAY SPEND-DOWN THEIR ASSET LEVEL TOWARD THEIR SOUTHAMPTON HOSPITAL BILL(S). ONCE THEIR ASSETS ARE WITHIN THE ALLOWABLE LIMITS, THEY WOULD BE FULLY ENTITLED TO THE CHARITY CARE DISCOUNT TO WHICH THEIR FAMILY INCOME LEVEL CORRELATES. FINANCIAL DOCUMENTATION REQUIREMENTS:A PATIENT MUST BE ABLE TO PROVE THEIR STATED FAMILY/HOUSEHOLD INCOME AND ASSET LEVEL. THE FOLLOWING DOCUMENTS ARE ACCEPTABLE AS PROOF: FEDERAL INCOME TAX FORM FOR THE PREVIOUS YEAR, COPIES OF SIX CONSECUTIVE RECENT PAY STUBS (THREE FOR BI-WEEKLY PAY PERIODS), A RECENT UNEMPLOYMENT OR DISABILITY STATEMENT. IF NONE OF THE ABOVE IS AVAILABLE, A STATEMENT ON COMPANY LETTERHEAD FROM THE PERSON'S EMPLOYER MAY BE ACCEPTABLE IN CERTAIN CIRCUMSTANCES AND WILL BE ACCEPTED AT SOUTHAMPTON HOSPITAL'S DISCRETION. A PATIENT MAY BE REQUIRED TO SUBMIT ADDITIONAL DOCUMENTATION AT SOUTHAMPTON HOSPITAL'S REQUEST IN ORDER TO SUBSTANTIATE THEIR STATED INCOME OR ASSET LEVEL SUCH AS BANKING STATEMENTS. A PATIENT'S FAILURE TO SUBSTANTIATE THEIR STATED INCOME OR ASSET LEVEL IS GROUNDS FOR THE DENIAL OF THEIR CHARITY CARE APPLICATION. IF A PATIENT IS CLAIMING ZERO INCOME, THE PATIENT WILL BE REQUIRED TO SUBMIT A VERIFICATION OF NON-FILING LETTER FROM THE IRS. THIS LETTER IS OBTAINED THROUGH IRS FORM 4506-T WHICH WILL BE MADE AVAILABLE TO THE PATIENT UPON REQUEST. THE PATIENT MUST ALSO SUBMIT A LETTER DESCRIBING THE MEANS BY WHICH THEY ARE SUPPORTED. IF THE PATIENT IS UNABLE TO FILE IRS FORM 4506-T DUE TO NOT HAVING A SOCIAL SECURITY NUMBER, THE PATIENT MUST SUBMIT THE ABOVE-MENTIONED LETTER. APPLICABLE RATES:THE APPLICABLE RATE FOR AN INPATIENT VISIT IS THE MEDICARE DIAGNOSIS RELATED GROUP (DRG) RATE FOR THAT VISIT. THE APPLICABLE RATE FOR AN AMBULATORY, EMERGENCY ROOM, OUTPATIENT, OR DIAGNOSTIC CARE VISIT IS THE MEDICARE HCPCS/CPT PAYMENT PLUS MINIMUM UNADJUSTED CO-PAYMENT FOR THAT VISIT. THE APPLICABLE RATE FOR LAB TESTS ON OUTPATIENT AND EMERGENCY ROOM VISITS WILL BE 10% OF THE CHARGE PER TEST. CO-INSURANCE:PATIENTS WHO ARE ELIGIBLE FOR A DISCOUNT ON MEDICARE OR COMMERCIAL INSURANCE CARRIER CO-INSURANCES WILL HAVE THOSE BALANCES REDUCED ACCORDING TO THE FOLLOWING SCALE. PERCENTAGE OF FPG: PERCENT OF CO-INSURANCE RESPONSIBLY :0% TO 100% 0%>100% TO 125% 9%>125% TO 150% 15%>150% TO 175% 21%>175% TO 200% 27%>200% TO 225% 33%>225% TO 250% 39%>250% TO 275% 45%>275% TO 300% 51%>300% TO 325% 57%>325% TO 350% 63%>350% TO 375% 69%>375% TO 400% 75%
PART I, LINE 6A: RELATED PARTY INDENTIFICATION: PLEASE SEE FORM 990, SCHEDULE R FOR MORE RELATED PARTY INFORMATION.(1) SHA PROPERTIES, INC, - 11-2563612(2) SOUTHAMPTON CARE CENTER - 11-2658403(3) THE SOUTHAMPTON HOSPITAL FOUNDATION - 11-3466516(4) EAST HAMPTON MSO LLC C/O 24/7 EMERGENCY CARE PC - 26-2636086(5) HAMPTON IMAGING, LLC - 20-1353646(6) MEETING HOUSE LANE PRACTICE - 20-8853938(7) OLD TOWN MEDICAL PRACTICE, P.C. - 45-2430883
PART I, LINE 7G: HEALTHCARE INFORMATION: SOUTHAMPTON HOSPITAL PROVIDES FREE HEALTH EDUCATION/ INFORMATION PROGRAMS THROUGH ITS WELL-ATTENDED "HEALTH INSIGHTS" PROGRAM. PATIENT SATISFACTION SURVEYS: IN ADDITION, SOUTHAMPTON HOSPITAL CONTINUALLY SOLICITS PATIENT INPUT THROUGH ITS PATIENT SATISFACTION SURVEY PROCESS, WHICH INCLUDES EVERY INPATIENT, AMBULATORY SURGERY PATIENT AND EMERGENCY ROOM PATIENT. THE DATA COLLECTED FROM THESE COMPREHENSIVE SURVEYS PROVIDES VALUABLE INFORMATION ON A WIDE RANGE OF QUALITY INDICATORS AND AREAS OF INTEREST TO THE HOSPITAL'S PATIENTS. RESULTS FROM THESE SURVEYS ARE REGULARLY DISTRIBUTED TO HOSPITAL AND MEDICAL STAFFS AND THE BOARD OF DIRECTORS. THE QUALITY MANAGEMENT AND PUBLIC AFFAIRS DEPARTMENTS, AS WELL AS THE OFFICE OF THE PRESIDENT, CAREFULLY REVIEW CORRESPONDENCE FROM PATIENTS AND THE COMMUNITY AT LARGE. A MEMBER OF THE HOSPITAL STAFF PERSONALLY ANSWERS ALL CORRESPONDENCE. THE DAVID E. ROGERS CENTER FOR HIV/AIDS CARE (DRC): THE DRC IS ANOTHER IMPORTANT COLLABORATIVE EFFORT BETWEEN SOUTHAMPTON HOSPITAL, STONY BROOK UNIVERSITY MEDICAL CENTER AND TOWN AND COMMUNITY ORGANIZATIONS OF THE EAST END OF LONG ISLAND. MAJOR FUNDING FOR THE DRC IS PROVIDED THROUGH RYAN WHITE PART A FEDERAL FUNDS AND PROVIDES SUPPORT SERVICES AND PREVENTION EDUCATION TO PARTNERS AND FAMILY MEMBERS AFFECTED BY AIDS. THE DRC IS A MEMBER OF THE PECONIC COMMUNITY COUNCIL, A NOT-FOR-PROFIT COALITION OF ORGANIZATIONS AND INDIVIDUALS DEDICATED TO THE PROMOTION AND PRESERVATION OF HEALTH AND HUMAN SERVICES FOR THE ENTIRE EAST END COMMUNITY. THE CENTER FOR PRENATAL CARE: THE CENTER FOR PRENATAL CARE AT GREENPORT IS AN IMPORTANT OUTREACH ACTIVITY THAT PERMITS THE HOSPITAL TO TAILOR ITS PROGRAMS TO COMMUNITY NEEDS. THE CENTER REACHES OUT TO THE COMMUNITY THROUGH COLLABORATIVE EFFORTS WITH A NUMBER OF LOCAL ORGANIZATIONS, INCLUDING CAST, A LOCAL SOUTHOLD SOCIAL SERVICE AGENCY, THE PERINATAL COALITION, EASTERN LONG ISLAND HOSPITAL, SUFFOLK COUNTY DEPARTMENT OF HEALTH AND LOCAL CHURCHES. THE CENTER HAS SUCCESSFULLY WORKED WITH THE LOCAL TOWN GOVERNMENT TO OBTAIN THE AGREEMENT OF LOCAL GROCERS TO ACCEPT WIC VOUCHERS. STAFF ALSO UTILIZES FLYERS, BROCHURES, AND POSTERS TO INCREASE AWARENESS OF HOSPITAL SERVICES AND OFFERS TRANSLATION SERVICES TO THE SIGNIFICANT NUMBER OF HISPANIC WOMEN SEEKING CARE AT THE CENTER. COMMUNITY ORGANIZATION PARTICIPATION: THE HOSPITAL ALSO RECEIVES INPUT FROM THE COMMUNITY THROUGH HOSPITAL STAFF AND HOSPITAL TRUSTEE PARTICIPATION ON COMMUNITY SERVICE ORGANIZATIONS AND OPEN DIALOGUE WITH RESPECTED COMMUNITY LEADERS. PARTICIPATION INCLUDES: AMERICAN ACADEMY OF DERMATOLOGY LONG ISLAND BLOOD SERVICES AMERICAN CANCER SOCIETY LUCIA'S ANGELS AMERICAN HEART/LUNG/DIABETES ASSOC. NASSAU-SUFFOLK CARE NETWORK CATHOLIC CHARITIES NASSAU-SUFFOLK HOSPITAL COUNCIL CHAMBERS OF COMMERCE NEW YORK ORGAN DONORS CHILDREN MUSEUM OF EAST END SOUTH FORK BREAST HEALTH COALITION DOMINICAN SISTERS SOUTH FORK COMMUNITY HEALTH INITIATIVE EAST END HOSPICE SOUTHAMPTON SCHOOL BOARD EAST END ONCOLOGY PARTNERSHIP SPECIAL EVENTS SALON (BREAST CANCER) EAST HAMPTON HEALTHCARE FOUNDATION ST. ROSALIE CHARITY CARE ELLEN'S RUN SUFFOLK COMMUNITY COLLEGE ELLEN'S WELL SCDHS EMERGENCY MEDICAL CORPS SUFFOLK COUNTY OFFICE FOR THE AGING FAMILY SERVICE LEAGUE TOWN OF EAST HAMPTON FIGHTING CHANCE TOWN OF SOUTHAMPTON LION'S EYE BANK WOMEN'S HEALTH PARTNERSHIP OF LONG ISLAND ALZHEIMER'S FOUNDATION SUFFOLK COUNTY ROGERS MEMORIAL LIBRARYSOUTHAMPTON HOSPITAL ALSO SPONSORS A MONTHLY PUBLIC ACCESS TELEVISION SHOW ON SEA-TV, FOCUS ON: SOUTHAMPTON HOSPITAL, THAT COVERS INFORMATION RANGING FROM DIALYSIS CARE TO BREAST CARE TO CARDIAC REHABILITATION SERVICES AND OTHER HEALTHCARE SERVICES PROVIDED BY THE HOSPITAL. IN COLLABORATION WITH THE EAST END HEALTH ALLIANCE, THE HOSPITALS HAVE ALSO USED A NUMBER OF RESOURCES TO ASSESS COMMUNITY NEED AND PROVIDED THIS INFORMATION THROUGH A NUMBER OF ORGANIZED ADVISORY BOARDS WITH PARTICIPATION FROM PHYSICIAN GROUPS THAT INCLUDE A STRATEGIC PLANNING COMMITTEE WITH REPRESENTATIVES FROM COMMUNITY TRUSTEES, LEADERSHIP FROM THE HOSPITALS' MEDICAL STAFF, PHYSICIAN TRUSTEES AND CHIEF MEDICAL OFFICERS. THE ALLIANCE ALSO HAS A CANCER ADVISORY COMMITTEE AND A CARDIAC ADVISORY COMMITTEE TO ASSESS COMMUNITY NEEDS AND RECOMMEND STRATEGIES TO ADDRESS THESE HEALTH CARE NEEDS. THE HOSPITALS HAVE PROVIDED THESE GROUPS WITH INFORMATION RELATED TO THE INCIDENCE AND PREVALENCE OF DISEASE IN THE SERVICE AREA, PREVENTABLE QUALITY INDICATORS, PATTERNS OF ACCESSING HEALTH CARE SERVICES AND USE RATES. STRATEGIC PLANNING COMMITTEE THE STRATEGIC PLANNING COMMITTEE HAS BEEN MEETING SINCE THE BEGINNING OF THE FORMATION OF THE EAST END HEALTH ALLIANCE AND ADOPTED A STRATEGIC PLAN THAT FOCUSED ON NEAR AND MID-TERM OPPORTUNITIES FOR IMPROVING MANAGEMENT EFFICIENCIES AND STRATEGIES FOR WORKING MORE CLOSELY WITH OUR RESPECTIVE PHYSICIAN COMMUNITIES. THE STRATEGIES IDENTIFIED IN THE FIRST STRATEGIC PLAN ARE WELL ON THEIR WAY TO COMPLETION. THE COMMITTEE HAS EXPANDED ITS MEMBERSHIP TO INCLUDE MORE TRUSTEE AND PHYSICIAN REPRESENTATION AND HAS BEGUN TO DETERMINE WHAT THE COMMUNITY NEEDS OF THE EAST END HEALTH ALLIANCE'S SERVICE WILL BE OVER THE NEXT THREE YEARS. THE COMMITTEE WILL BE ASSESSING THESE NEEDS THROUGH MEANS OF THE FOLLOWING: ANALYSIS OF SPARCS DATA REVIEW OF PREVENTION QUALITY INDICATORS EVALUATION OF REPORTS FROM COMMUNITY, LOCAL, STATE, AND FEDERAL GOVERNMENT AGENCIES COMMUNICATION AND COLLABORATION WITH THE SUFFOLK COUNTY DEPARTMENT OF HEALTH COMMUNICATION AND COLLABORATION WITH SUFFOLK COUNTY OFFICE FOR HE AGING ASSESSMENT OF INFORMATION SOLICITED FROM PATIENTS THROUGH PATIENT SATISFACTION SURVEYS REVIEW OF HOSPITAL GENERATED STATISTICAL INFORMATION REVIEW OF CURRENT INDUSTRY JOURNALS, PERIODICALS AND NEWSLETTERS ANALYSIS OF TRENDS IDENTIFIED IN HEALTHCARE JOURNALS AND PERIODICALS ONGOING ADMINISTRATIVE STAFF PLANNING SESSION *MONTHLY BOARD OF TRUSTEE MEETINGS
PART I, L7 COL(F): THE ORGANIZATION BASE BAD DEBTS OFF EXPECTED WRITE-OFFS OF ACTUAL ACCOUNTS, NET OF EXPECTED RATE OF RECOVERY. IT'S NOT BASED ON A PERCENTAGE OF REVENUE.
PART II: NEEDS ASSESSMENT/PROMOTION OF COMMUNITY HEALTH SOUTHAMPTON HOSPITAL HAS AN EXTENSIVE PROGRAM OF COMMUNITY OUTREACH, COMPLEMENTED BY THE EAST END HEALTH ALLIANCE, THE HOSPITAL'S ACTIVE PARENT. COMMUNITY SERVICE PLAN INPUT IS RECEIVED FROM BOTH INTERNAL AND EXTERNAL SOURCES. NEEDS ARE ASSESSED ANNUALLY BY THE BOARD OF TRUSTEES, HOSPITAL MANAGEMENT AND STAFF, VOLUNTEERS, AND LEADERS OF LOCAL NOT-FOR-PROFIT ORGANIZATIONS AND GOVERNMENTAL AGENCIES. THE HOSPITAL HAS SIGNIFICANT REPRESENTATION ON A WIDE-RANGE OF COMMUNITY ORGANIZATIONS THAT FACILITATE INPUT FROM RESIDENTS, CORPORATE AND COMMUNITY LEADERS, PATIENTS AND ALLIED HEALTH PROFESSIONS. THESE COMMUNITY PARTNERSHIPS ARE LISTED BELOW. THE HOSPITAL PRESIDENT AND CHIEF EXECUTIVE OFFICER AND OTHER SENIOR STAFF REGULARLY MEET WITH COMMUNITY GROUPS FROM THE EAST END REGION OF LONG ISLAND TO KEEP AREA RESIDENTS INFORMED ABOUT HOSPITAL PROGRAMS AND TO RECEIVE FEEDBACK AND FIELD QUESTIONS FROM THE COMMUNITY. THE HOSPITAL'S SATELLITE CARE CENTERS, INCLUDING THE SHINNECOCK INDIAN HEALTH CLINIC, THE DAVID E. ROGERS, M.D. CENTER FOR HIV/AIDS CARE, THE EAST HAMPTON HEALTHCARE CENTER, AND HOSPITAL REGIONAL DIALYSIS CENTER CLOSELY COLLABORATE WITH COMMUNITY ADVISORY COMMITTEES THAT HELP WITH PLANNING AND DECISION MAKING RELATED TO THE SERVICES OFFERED. THE HOSPITAL'S WEB SITE, "WWW.SOUTHAMPTONHOSPITAL.ORG," PROVIDES INFORMATION ABOUT HOSPITAL SERVICES AND PROGRAMS. THE SITE ALLOWS FOR PHYSICIAN SEARCHES, ON-LINE INQUIRIES AND ON-LINE JOB APPLICATIONS. IN MARCH 2010, THE HOSPITAL LAUNCHED A NEW AND IMPROVED WEBSITE. THE NEW SITE BOASTS A CLEANER DESIGN, GREATER EASE OF NAVIGATION, AND IS A PATIENT-FRIENDLY RESOURCE GUIDE. THE SITE IS UPDATED WEEKLY, AND ENCOURAGES THE END USER TO CONTACT THE HOSPITAL FOR ANY ADDITIONAL INFORMATION NEEDED.SERVICES FOR SHORT-TERM AND LONG-TERM CARE FOR CHRONIC AND ACUTE ILLNESS ARE CONTINUALLY EVALUATED THROUGH STATISTICAL DATA THAT INCLUDE QUALITY INDICATORS AND PATIENT OUTCOMES. THIS DATA IS COMPARED NATIONALLY WITH OTHER HEALTH FACILITIES AND INFORMS THE HOSPITAL'S STRATEGIC PLAN AND COMMUNITY SERVICE PLAN. THE HOSPITAL'S STRATEGIC PLANNING COMMITTEE INCLUDES COMMUNITY MEMBERS, HOSPITAL STAFF AND HOSPITAL AND FOUNDATION BOARD MEMBERS WHO WORK COLLABORATIVELY TO ASSESS COMMUNITY NEEDS AND DEVELOP STRATEGIES TO MEET THESE NEEDS. THE HOSPITAL'S PUBLIC AFFAIRS COMMITTEE WAS ESTABLISHED TO ENHANCE COMMUNICATION BETWEEN THE HOSPITAL AND THE COMMUNITIES IT SERVES. MEMBERS OF THE COMMITTEE INCLUDE A CROSS-SECTION OF PHYSICIANS, NURSES, HOSPITAL MANAGEMENT, HOSPITAL EMPLOYEES AND COMMUNITY VOLUNTEERS. THE HOSPITAL ALSO ROUTINELY SEEKS FEEDBACK FROM COMMUNITY MEMBERS WHO PARTICIPATE IN OUR COMMUNITY OUTREACH PROGRAMS. HEALTH FAIRS: SOUTHAMPTON HOSPITAL'S BREAST HEALTH CENTER PROVIDES EXTENSIVE OUTREACH TO WOMEN IN THE HOSPITAL'S COMMUNITY, INCLUDING BREAST CANCER SURVIVORS, AS DESCRIBED BELOW. THIS OUTREACH IS BASED ON THE HOSPITAL'S ASSESSMENT OF COMMUNITY NEED FROM ANALYSIS OF CANCER INCIDENCE AND FROM INPUT FROM THE COMMUNITY. THE PROGRAMS OUTREACH COORDINATOR REVIEWS RESULTS FROM SURVEYS, COMPLETED BY EVENT PARTICIPANTS, TO IDENTIFY WHAT TYPES OF INFORMATION AND SERVICES WOULD BE HELPFUL. THE HOSPITAL THEN MODIFIES PROGRAMS AS APPROPRIATE BASED ON THIS INPUT. HEALTH FAIR, FITNESS PROGRAM AND LONG ISLAND TWO DAY WALK (JUNE) HEALTH FAIR, LOOK GOOD, FEEL BETTER PROGRAM (APRIL) GENETIC COUNSELING LECTURE, WELLNESS PROGRAM, SPANISH OUTREACH (MARCH) HEALTH FAIR, CELEBRATING SURVIVORSHIP, LOOK GOOD FEEL BETTER PROGRAM (FEBRUARY) HEALTH FAIR, WELLNESS PROGRAM, PINK TUESDAY (JANUARY) ADDITIONAL HEALTH FAIRS WERE HELD AS A PART OF THE HOSPITAL'S INFECTIOUS DISEASE OUTREACH AT THE EAST HAMPTON AND WESTHAMPTON BEACH HIGH SCHOOLS. THE HOSPITAL ALSO SPONSORS A LECTURE SERIES FOR EMS AND OBTAINS FEEDBACK TO RESPOND TO THE NEEDS OF THE LOCAL CORPS. HEALTHCARE INFORMATION: SOUTHAMPTON HOSPITAL PROVIDES FREE HEALTH EDUCATION/ INFORMATION PROGRAMS THROUGH ITS WELL-ATTENDED "HEALTH INSIGHTS" PROGRAM. THIS LECTURE SERIES FOR 2010, DETAILED BELOW, PROVIDES AN IMPORTANT OPPORTUNITY TO PROVIDE THE COMMUNITY WITH RELEVANT INFORMATION AND TO COLLECT INFORMATION PROVIDED BY THE EVALUATION FORMS THAT ARE DISTRIBUTED AFTER EACH LECTURE TO ENSURE THAT THE HOSPITAL IS RESPONDING TO COMMUNITY NEEDS. THE PROGRAM SCHEDULE FOR 2010 IS: MIDWIVES (MARCH)TICK ILLNESS (APRIL)KIDNEYS (APRIL)STROKE (MAY)GENETIC COUNSELING (MAY)SLEEP DISORDERS (MAY)OSTEOPOROSIS (JUNE)*IMPORTANCE OF LIGHT (OCTOBER)THE LECTURE SERIES IS DEVELOPED IN PARTNERSHIP WITH ORGANIZATIONS SUCH AS FIGHTING CHANGE, ELLEN'S RUN, THE AMERICAN HEART ASSOCIATION, EAST HAMPTON LIONS CLUB, NEW YORK ORGAN DONOR NETWORK, AND SOUTHAMPTON'S ROGERS MEMORIAL LIBRARY. THESE ORGANIZATIONS DEMONSTRATE THAT THEY ARE CONNECTED TO THE COMMUNITY AND THEIR NEEDS. PATIENT SATISFACTION SURVEYS: THE HOSPITAL CONTINUALLY SOLICITS PATIENT INPUT THROUGH ITS PATIENT SATISFACTION SURVEY PROCESS, WHICH INCLUDES EVERY INPATIENT, AMBULATORY SURGERY PATIENT AND EMERGENCY ROOM PATIENT. THE DATA COLLECTED FROM THESE COMPREHENSIVE SURVEYS PROVIDES VALUABLE INFORMATION ON A WIDE RANGE OF QUALITY INDICATORS AND AREAS OF INTEREST TO THE HOSPITAL'S PATIENTS. SURVEY RESULTS ARE REGULARLY DISTRIBUTED TO HOSPITAL AND MEDICAL STAFFS AND THE BOARD OF DIRECTORS. THE QUALITY MANAGEMENT AND PUBLIC AFFAIRS DEPARTMENTS, AS WELL AS THE OFFICE OF THE PRESIDENT, CAREFULLY REVIEW CORRESPONDENCE FROM PATIENTS AND THE COMMUNITY AT LARGE. A MEMBER OF THE HOSPITAL STAFF PERSONALLY ANSWERS ALL CORRESPONDENCE.
PART III, LINE 4: THE ORGANIZATION DETERMINE EXPECTED BAD DEBT WRITE-OFFS BASED ON ACTUAL ACCOUNTS, NET OF AN EXPECTED RATE OF RECOVERY. IT'S NOT BASED ON A PERCENTAGE OF REVENUE.
PART III, LINE 8: SOUTHAMPTON HOSPITAL UTILIZED PAYMENTS RECEIVED FROM MEDICARE ($139,924,937) TO CALCULATE THE TOTAL REVENUE RECEIVED FROM MEDICARE. MEDICARE ALLOWABLE COSTS WERE CALCULATED USING MEDICARE GROSS CHARGES (WHICH ARE 300% OF THE MEDICARE FEE SCHEDULE) MULTIPLIED BY A COST TO CHARGE RATIO OF 30%. (TOTAL MEDICARE GROSS CHARGES OF $139,924,937 MULTIPLIED BY 30% TO ARRIVE AT $41,977,481 OF MEDICARE ALLOWABLE COSTS FOR THE CALENDAR YEAR OF 2010.) THEREFORE, THE SHORTFALL OF $4,245,523 MAY BE DEEMED A COMMUNITY BENEFIT.
PART III, LINE 9B: ACCOUNTS WITH UNCOLLECTABLE BALANCES ARE ACCOUNTS FOR A PATIENT (GUARANTOR) WHO HAS NOT RESPONDED TO REQUESTS FOR PAYMENT OR WHO HAS DEMONSTRATED AN EXEMPTION FROM PAYMENT. THE REQUEST FOR PAYMENT &/OR THE EXEMPTION MUST MEET THE FOLLOWING CRITERIA:1. AT LEAST FOUR (4) CONSECUTIVE 120-DAY BILLS MUST HAVE BEEN GENERATED (OR NO LESS THAN 120 DAYS FROM FIRST BILL) AND SENT WITHOUT RESPONSE FROM THE PATIENT (GUARANTOR) BEFORE BEING SENT TO A COLLECTION AGENCY;OR2. THE PATIENT (GUARANTOR) HAS DECLARED BANKRUPTCY (DISCHARGE OF DEBTOR MUST HAVE BEEN RECEIVED); OR3. THE ESTATE OF THE PATIENT (GUARANTOR) HAS BEEN SETTLED AND THERE WERE NO FUNDS FOR PAYMENT LEFT IN THE ESTATE; OR4. MAIL HAS BEEN RETURNED AND OTHER METHODS OF CONTACTING THE PATIENT (GUARANTOR) HAVE FAILED. THE ACCOUNT IS THEN CONSIDERED AND HANDLED AS A BAD DEBT ACCOUNT.PATIENT FINANCIAL SERVICES MAY ELECT TO SEND THE ACCOUNT TO AN OUTSIDE AGENCY, UP TO AND INCLUDING LEGAL ACTION.BAD DEBT ACCOUNTS ARE PURE SELF PAY ACCOUNTS FOR A PATIENT (GUARANTOR) WHO HAS NOT RESPONDED TO REQUESTS FOR PAYMENT. THE REQUEST FOR PAYMENT MUST MEET THE FOLLOWING CRITERIA:AT LEAST FOUR (4) CONSECUTIVE 30-DAY BILLS MUST HAVE BEEN GENERATED AND SENT WITHOUT RESPONSE FROM THE PATIENT (GUARANTOR);ORMAIL HAS BEEN RETURNED AND ALL OTHER METHODS OF CONTACTING THE PATIENT (GUARANTOR) HAVE FAILED.ONCE IT IS DETERMINED AN ACCOUNT BALANCE CANNOT BE COLLECTED BY PATIENT FINANCIAL SERVICES, THE ACCOUNT MAY BE TURNED OVER FOR COLLECTION BY AN OUTSIDE AGENCY , UP TO AND INCLUDING LEGAL ACTION.THE OUTSIDE COLLECTION AGENCY, AFTER DUE DILIGENCE, MAY DETERMINE THE BALANCE ON AN ACCOUNT CANNOT BE COLLECTED, THE ACCOUNT BALANCE MAY BE WRITTEN OFF USING THE APPROPRIATE CODE FOR THE ACCOUNT.
PART VI, LINE 2: ASSESSMENT OF PUBLIC HEALTH PRIORITIES SOUTHAMPTON HOSPITAL WAS AN ACTIVE PARTICIPANT IN THE COLLABORATIVE PLANNING PROCESS WITH THE SUFFOLK COUNTY DEPARTMENT OF HEALTH AND COMMUNITY PARTNERS TO ASSESS COMMUNITY HEALTH NEEDS, TO IDENTIFY HEALTH PRIORITIES, AND TO DEVELOP PUBLIC HEALTH PROGRAMS TO MEET THE IDENTIFIED NEEDS. THIS COLLABORATIVE GROUP MET FROM THE FALL OF 2008 THROUGH AUGUST OF 2009, AND SELECTED TOBACCO USE AND UNINTENTIONAL INJURY AS THE TWO HEALTH PRIORITIES IDENTIFIED IN THE NEW YORK STATE PREVENTION AGENDA TOWARD THE HEALTHIEST STATE. SMOKING CESSATION UPDATEWE OFFER TOBACCO CESSATION PROGRAMS TO THE COMMUNITY AND EMPLOYEES THREE TIMES PER YEAR. THE PROGRAM IS BASED ON THE FORMAT USED BY THE SUFFOLK COUNTY DEPARTMENT OF HEALTH. IT IS A SIX-WEEK PROGRAM THAT INCLUDES CONSULTATION WITH A NURSE PRACTITIONER AND MAKES TOBACCO REPLACEMENT THERAPIES (NICOTINE GUM, LOZENGES, AND PATCHES) AND PRESCRIPTIONS AVAILABLE TO PARTICIPANTS. THE PROGRAMS ARE FREE FOR EMPLOYEES. BY ENCOURAGING OUR EMPLOYEES AND COMMUNITY MEMBERS TO BECOME TOBACCO-FREE AND BY SUPPORTING THEM IN THEIR EFFORTS TO BECOME TOBACCO-FREE, WE FEEL THAT WE ARE CONTRIBUTING TO AN IMPROVEMENT IN COMMUNITY HEALTH BY REDUCING THE RISK ASSOCIATED WITH SMOKING AND EXPOSURE TO SECOND-HAND SMOKE.FALL PREVENTION UPDATESOUTHAMPTON HOSPITAL TREATS A NUMBER OF OUR SENIOR PATIENTS AT HIGH RISK FOR FALLS BOTH WITHIN THE COMMUNITY AND AS INPATIENTS AT THE HOSPITAL. ALL PATIENTS ADMITTED TO SOUTHAMPTON HOSPITAL ARE ASSESSED FOR FALL RISK AND AS NEEDED RECEIVE FALL PREVENTION INFORMATION, PHYSICAL THERAPY AND A DISCHARGE PLAN AIMED AT MEETING THEIR NEEDS. WITHIN THE HOSPITAL SETTING FALL PREVENTION BECAME AN ORGANIZATIONAL OBJECTIVE IN LATE 2006. A MULTIDISCIPLINARY TEAM WAS ESTABLISHED TO DECREASE THE NUMBER OF FALLS AND THE NUMBER OF FALLS WITH INJURY. IN 2008 OUR FALL PREVENTION PROGRAM NOT ONLY SIGNIFICANTLY DECREASED THE NUMBER OF FALLS AND THE NUMBER OF INJURY, IT RECEIVED RESIGNATION AS HONORABLE MENTION FOR THE HANYS PINNACLE AWARD. TODAY OUR PROGRAM CONTINUOUSLY AIMS AT KEEPING OUR PATIENTS SAFE AND IN 2010 WE BEGAN AN IHI MENTOR HOSPITAL FOR FALL PREVENTION.2009 AND PRIOR WORK GROUPSTHESE TWO PRIORITIES WILL BE A MAJOR OPERATIONAL COMMITMENT OF SOUTHAMPTON HOSPITAL OVER THE NEXT THREE YEARS. THE HOSPITAL WILL CONTINUE TO COLLABORATE WITH THE SUFFOLK COUNTY DEPARTMENT OF HEALTH AND COMMUNITY PARTNERS IN ENSURING THAT WE REACH THE GOALS SET FOR THESE TWO PRIORITY AREAS, MEASURE PROGRESS IN ACHIEVING THESE GOALS AND ELIMINATING RACIAL, ETHNIC AND SOCIOECONOMIC HEALTH DISPARITIES WHERE THEY EXIST. ONCE THE PLANNING GROUP ADOPTED THESE PRIORITIES, REPRESENTATIVES FROM THE SUFFOLK COUNTY DEPARTMENT OF HEALTH, SUFFOLK COUNTY HOSPITALS, INCLUDING SOUTHAMPTON HOSPITAL, AND COMMUNITY REPRESENTATIVES DIVIDED INTO TWO WORK GROUPS. EACH WORK GROUP WAS CHARGED WITH DEVELOPING A SET OF RECOMMENDATIONS TO IMPLEMENT EFFECTIVE STRATEGIES TO ADDRESS BOTH HEALTH CARE PRIORITIES. UNINTENTIONAL INJURY WORK GROUP THIS WORK GROUP WAS CHARGED WITH DEVELOPING STRATEGIES TO PREVENT UNINTENTIONAL INJURIES, WITH A FOCUS ON FALL PREVENTION IN THOSE AGED SIXTY-FIVE AND OLDER. THE WORK GROUP ASSIGNED TO DEVELOP A WORK PLAN FOR ADDRESSING UNINTENTIONAL INJURIES HAD THE FOLLOWING MEMBERSHIP: DR. HUMAYUN CHAUDHRY, D.O., COMMISSIONER, SUFFOLK COUNTY DEPARTMENT OF HEALTH JANE CORRARINO, CHAIR, WORKING GROUP, PUBLIC HEALTH NURSE DR. ED NADEL, BIOSTATISTICIAN ADELE H. KLENK, AARP PAMELA ASH, DIRECTOR, DOMINICAN SISTERS FAMILY HEALTH SERVICE MARY JEAN MCKEVENY, COMMUNITY REPRESENTATIVE JULIET FORDELLA, EASTERN LONG ISLAND HOSPITAL (FOR SOUTHAMPTON HOSPITAL) DALE CHAIKIN, NORTH SHORE- LIJ HEALTH SYSTEM JUDY BEIZER, PHARMACIST MIRANDA CORCORAN, ST. CATHERINE'S HOSPITAL BILL HANNIGAN, ST. CHARLES REHABILITATION HOSPITAL LAUREL BREEN, ST. JOSEPH'S COLLEGE DR. CATHERINE NICASTRI, STONY BROOK UNIVERSITY MEDICAL CENTER THE GROUP ADOPTED BY THE FOLLOWING RECOMMENDATIONS FOR ACTION RELATED TO REDUCING UNINTENTIONAL FALLS: I. DESIGN AND DEVELOP HEALTH EDUCATION MATERIALS TO PREVENT FALLS IN THE ELDERLY THAT: A. INCLUDE IDEAS FROM BOTH THE TARGET POPULATION AND FROM EXPERTS AND COMMUNITY MEMBERS B. INCORPORATE STRATEGIES KNOW TO BE EFFECTIVE FOR THOSE WITH LOW LITERACY SKILLS C. DEVELOP COMPANION BOOKLETS, POSTERS AND CALENDARS (WITH PREVENTION STRATEGIES OUTLINED EACH MONTH OF CALENDAR YEAR) D. DEVELOP MATERIALS FOR ALL THE PARTNER AGENCIES WITH SPACE FOR THE LOGO OF A GIVEN ORGANIZATION/AGENCY WHO MAY BE PRINTING THE MATERIALS FOR THEMSELVES TO PROVIDE TO THEIR GIVEN TARGET GROUP OR COMMUNITY E. CONDUCT PRE AND POST-TESTING TO ENSURE THAT EDUCATIONAL INFORMATION IS EFFECTIVE IN INCREASING KNOWLEDGE II. INCORPORATE THESE MATERIALS INTO A COMMUNITY OUTREACH PLAN. THIS PLAN SHOULD BE COMMUNITY FOCUSED, WITH PARTICIPATION FROM ALL HOSPITALS, THE HEALTH DEPARTMENT, AND COMMUNITY AGENCIES AND ORGANIZATIONS III. COORDINATE THE ACTIVITY BETWEEN THE PARTNERS IV. THE OUTREACH PLAN SHOULD INCLUDE A. EDUCATION AT SENIOR CENTERS, MEALS ON WHEELS, ETC. B. EDUCATION OF PROVIDERS (E.G. PHYSICIANS, PHARMACISTS, NURSES, ETC.) C. DISTRIBUTION AND OUTREACH VIA SUPERMARKETS D. PARTICIPATION BY HOME HEALTH AGENCIES, HOSPITAL, ADULT DAY CARE E. ORGANIZATIONAL NEWSLETTERS AND MARKETING PLANS V. DEVELOP A DATA SUBCOMMITTEE THAT WILL ANALYZE PERTINENT SUFFOLK COUNTY DATA REGARDING DEMOGRAPHICS AND HIGH-RISK AREAS, IN ORDER TO TARGET HIGH-RISK AREAS AND SUBPOPULATIONS. SPECIFIC ASSISTANCE AND EXPERTISE FOR MOVING FORWARD WAS OFFERED AS FOLLOWS: DR. NICASRI, FROM STONY BROOK UNIVERSITY MEDICAL CENTER, OFFERED TO OVERSEE MEDICAL RESIDENTS AND FELLOWS WHO WILL BE AVAILABLE TO CONDUCT PROFESSIONAL AND COMMUNITY TEACHING. DR. BELZER OFFERED TO ASSIST WITH SESSION SIMILAR TO "BROWN BAG DAYS" AND "MEDICATION CHATS" THAT SHE CONDUCTS IN OTHER LOCALES. MS. CORRARINO OFFERED TO DESIGN HEALTH EDUCATION MATERIALS. MS. RHODES-TEAGUE OFFERED TO COORDINATE EFFORTS WITH SENIOR CENTERS AND NUTRITION SITES. IN ADDITION, THE GROUP WILL EXPLORE THE ABILITY OF HOME HEALTH AGENCIES TO BILL MEDICARE FOR ALL PREVENTION ACTIVITIES IN THE HOME. THE WORK GROUP WILL CONTINUE TO MEET. THEY WILL MEET IN SEPTEMBER TO REVIEW THE HEALTH EDUCATION MATERIALS THAT HAVE BEEN DEVELOPED AND CONTINUE TO MOVE FORWARD AND SOLIDIFY PLANS. SMOKING CESSATION WORK GROUP THIS GROUP WAS CHARGED WITH DEVELOPING STRATEGIES TO REDUCE THE NUMBER OF SUFFOLK COUNTY RESIDENTS WHO SMOKE. THE GROUP ASSIGNED TO REDUCE TOBACCO USE INCLUDED THE FOLLOWING: GRACE SPARACINO, ST. CHARLES HOSPITAL SABRA BOUGHTON, STONY BROOK UNIVERSITY MEDICAL CENTER JACK HOFFMAN, EASTERN LONG ISLAND HOSPITAL PAT FOLAN, NORTH SHORE-LONG ISLAND JEWISH HEALTH SYSTEM STEPHANIE PERFER, NORTH SHORE-LONG ISLAND JEWISH HEALTH CARE SYSTEM NANCE BODNAR, JOHN T. MATHER HOSPITAL ANN CUCCIA, SOUTHAMPTON HOSPITAL DONNA LOY MURINO, SOUTHSIDE HOSPITAL FELICE JONES LEE, SOUTHSIDE HOSPITAL JULIA MACCHIAROLI, HUNTINGTON HOSPITAL MARTHA KAHAN, EASTERN SUFFOLK BOCES SUSAN KENNEDY, TOBACCO ACTION COALITION OF LONG ISLAND LORI BENINCASA, SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES WENDY D. DARWELL, NASSAU-SUFFOLK HOSPITAL COUNCIL, INC. LORI GINSBERG, NORTH SHORE-LONG ISLAND JEWISH HEALTH SYSTEM CRAIG HOMIS, SOUTHAMPTON HOSPITAL MICHAEL THOM, BROOKHAVEN NATIONAL LABORATORY. THE TOBACCO CESSATION WORKING GROUP DEVELOPED A RECOMMENDED TEMPLATE FOR A TOBACCO CONTROL POLICY TO BE CONSIDERED AND ADOPTED BY THE SUFFOLK COUNTY HOSPITALS. THE TEMPLATE IS AS FOLLOWS: I. POLICY STATEMENT (TO INCLUDE) A. WHY I. COMMITMENT TO HEALTH/STATISTICS - THE COST OF TOBACCO USE IN MORBIDITY, MORTALITY AND FINANCIAL LOSS II. HOSPITALS NEED TO SET EXAMPLE, LEAD THE WAY III. BASELINE DATA. CURRENT POLICIES AND PROCEDURES. RATES OF TOBACCO USE AND/OR CESSATION B. WHO I. POLICY MAY COVER STAFF, PATIENTS, VISITORS, COMMUNITY MEMBERS C. WHERE I. HOSPITAL II. COMPLETE BAN ON GROUNDS OR PARTIAL III. OTHER BUILDINGS AND/OR CLINICS LOCATED OFF SITE IV. EFFECTIVE DATA D. WHAT I. RESTRICTIONS - ALL TOBACCO PRODUCTS? II. PROCEDURES FOR IMPLEMENTATION - BRIEFLY WILL BE COVERED FULLY IN II III. EDUCATIONAL GOALS IV. COMMUNITY OUTREACH II. PROCEDURES A. COMMUNICATION OF POLICY I. EMPLOYEES 1. EXISTING 2. NEW - WILL TOBACCO USE AFFECT HIRING? II. PATIENTS
PART VI, LINE 3: FINANCIAL AID PROGRAM SOUTHAMPTON HOSPITAL'S COMMITMENT AND DETERMINATION TO PROVIDE QUALITY HEALTHCARE AT AFFORDABLE RATES HAS LEAD US TO DESIGN A CHARITY CARE PROGRAM THAT GOES "ABOVE AND BEYOND" THE EXPECTATIONS AND MINIMUM REQUIREMENTS SET FORTH BY NEW YORK STATE LAW. IT IS THE HOSPITAL'S "ABOVE AND BEYOND" ATTITUDE THAT IS OUR PROGRAMS GREATEST STRENGTH AND CAN BEST BE SEEN IN OUR POLICY TO PROVIDE CHARITY CARE DISCOUNTED RATES TO PATIENTS MAKING UP TO 400% OF THE FEDERAL POVERTY LEVEL GUIDELINE (FPG) RATHER THAN THE MINIMUM REQUIREMENT OF 300% FPG. IN ADDITION, THE HOSPITAL INCLUDES A FORM TO APPLY FOR CHARITY CARE IN EVERY SELF-PAY BILL TO BE RETURNED TO PATIENT FINANCIAL SERVICES. DESPITE OUR COMMITMENT AND DETERMINATION, OUR CHARITY CARE POLICY IS NOT WITHOUT ITS CHALLENGES, AND AT TIMES, WEAKNESSES. HOWEVER, OUR GREATEST WEAKNESS IS NOT TREATED AS A WEAKNESS; IT IS TREATED AS A CHALLENGE. OUR GREATEST CHALLENGE IS TO ENSURE THAT ALL PATIENTS AT SOUTHAMPTON HOSPITAL RECEIVE THE SAME LEVEL OF DETAILED SCRUTINY OF THEIR APPLICATION TO KEEP THE PROCESS FAIR AND BALANCED FOR ALL APPLICANTS. THE CHALLENGE IS GREATEST WHEN PROCESSING APPLICATIONS FROM UNDOCUMENTED ALIENS WHOSE STATED INCOME LEVEL IS $0. PUBLIC INFORMATION SOUTHAMPTON HOSPITAL WILL DISSEMINATE A WRITTEN SUMMARY OF THE COMMUNITY SERVICE PLAN TO THE PUBLIC THROUGH PRODUCTION OF EITHER A BROCHURE OR PAMPHLET. THE PLAN WILL BE POSTED BOTH ON THE HOSPITAL'S WEB SITE AND ON THE EAST END HEALTH ALLIANCE'S WEB SITE. THE SUMMARY WILL INCLUDE FINANCIAL DATA THAT DEMONSTRATES OUR CURRENT AND FUTURE COMMITMENT TO PUBLIC HEALTH PROGRAMS AND FINANCIAL ASSISTANCE AND WILL HIGHLIGHT KEY INFORMATION REGARDING OUR PUBLIC HEALTH PROGRAMS, INCLUDING OUR TWO PREVENTION AGENDA PRIORITIES.
PART VI, LINE 4: AS THE MAP BELOW INDICATES, SOUTHAMPTON'S SERVICE AREA EXTENDS FROM MONTAUK TO THE EAST TO WESTHAMPTON BEACH TO THE WEST AND THE SOUTHERN AREA OF RIVERHEAD IN THE CENTER OF THE EAST END OF LONG ISLAND. THE SERVICE AREA ACCOUNTS FOR APPROXIMATELY EIGHT-FIVE (85) PERCENT OF TOTAL ADMISSIONS TO THE HOSPITAL AND INCLUDES THE FOLLOWING ZIP CODES: EAST HAMPTON (11937); BRIDGEHAMPTON (11932); SOUTHAMPTON (11968); HAMPTON BAYS (11946); SAG HARBOR (11963); SAGAPONACK (11962); MONTAUK (11954); RIVERHEAD (11901); EAST QUOGUE (11942); QUOGUE (11959); REMSENBURG (11960); WATER MILL (11976); WESTHAMPTON BEACH (11978); AND WESTHAMPTON (11977). AS THE TABLE BELOW INDICATES, THIS SERVICE AREA HAS A YEAR ROUND POPULATION OF APPROXIMATELY 97,000 RESIDENTS. THE AREA IS PROJECTED TO SEE A SIGNIFICANT INCREASE IN POPULATION, MORE THAN 5.8 PERCENT OVER THE NEXT THREE YEARS. DEMOGRAPHIC CHARACTERISTICS SELECTED AREA USA 2000 TOTAL POPULATION 97,063 281,421,906 2010 TOTAL POPULATION 97,426 309,038,974 2015 TOTAL POPULATION 103,145 321,675,005 % CHANGE 2010 - 2015 5.54% 3.93% AVERAGE HOUSEHOLD INCOME $92,648 $71,071 THE POPULATION ON THE HOSPITAL'S SERVICE AREA, A RESORT DESTINATION, MORE THAN DOUBLES DURING THE SUMMER SEASON WHEN TOURISTS FROM ALL OVER THE WORLD VISIT THE SOUTH FORK OF LONG ISLAND. AS A RESULT, DEMAND FOR SOUTHAMPTON HOSPITAL SERVICES INCREASES SIGNIFICANTLY DURING THE SUMMER, IN PARTICULAR DEMAND FOR THE HOSPITAL'S EMERGENCY SERVICES. THE HOSPITAL HAS RESPONDED TO THIS NEED BY MAKING A CAPITAL INVESTMENT IN EXPANDING AND RENOVATING THE EMERGENCY DEPARTMENT AND IMPLEMENTING A STATE-OF-THE-ART EMERGENCY DEPARTMENT INFORMATION SYSTEMS THAT PERMITS THE HOSPITAL TO TRACK PATIENTS, AND READ AND INTERPRET LABORATORY AND RADIOLOGICAL RESULTS. AS THE TABLE BELOW INDICATES, THE SERVICE AREA HAS A SIGNIFICANT PERCENTAGE OF THEIR POPULATION AGED FIFTY-FIVE (55) AND OVER, A POPULATION THAT HAS GREATER NEED FOR HEALTH CARE SERVICES. AGE DISTRIBUTION AGE GROUP 2010 % OF TOTAL 2015 % OF TOTAL USA 2010 % OF TOTAL 0-14 15,425 15.8% 15,595 15.1% 20.1% 15-17 3,858 4.0% 3,790 3.7% 4.2% 18-24 8,170 8.4% 8,923 8.7% 9.7% 25-34 9,949 10.2% 11,164 10.8% 13.3% 35-54 27,620 28.3% 26,064 25.3% 28.1% 55-64 13,846 14.2% 16,034 15.5% 11.5% 65+ 18,558 19.0% 21,575 20.9% 13.2% TOTAL 97,426 100.0% 103,145 100.0% 100.0% THE HOSPITAL HAS DEVELOPED NUMEROUS SERVICES AND OUTREACH, DETAILED BELOW, TO RESPOND TO THE NEEDS OF THESE PATIENTS, INCLUDING RECRUITING ADDITIONAL PRIMARY CARE PHYSICIANS AND IMPLEMENTING A GRADUATE MEDICAL EDUCATION PROGRAM THAT WILL HOPEFULLY ATTRACT THESE YOUNG PHYSICIANS TO STAY AND PRACTICE IN THE COMMUNITY. THERE ARE NO FIRM ESTIMATES OF THE NUMBER OF MIGRANT AGRICULTURAL WORKERS THAT COME INTO THIS AREA. AGRICULTURE IS ONE OF SUFFOLK COUNTY'S LEADING INDUSTRIES. ITS SUCCESS RELIES ON WORKERS WHO MOVE THROUGH THE EASTERN UNITED STATES IN RESPONSE TO THE AVAILABILITY OF SEASONAL WORK. SOUTHAMPTON HOSPITAL RECOGNIZES THAT THIS POPULATION PRESENTS SERIOUS HEALTH PROBLEMS AND IS COMMITTED TO PROVIDING CARE FOR ITS CULTURALLY DIVERSE PATIENT POPULATION. MANY OF THESE INDIVIDUALS ARE UNINSURED AND UNABLE TO SPEAK ENGLISH. THEY RELY ON THE HOSPITAL,S EMERGENCY DEPARTMENT, AS WELL AS THE SUFFOLK COUNTY HEALTH CLINIC, LOCATED ON THE HOSPITAL'S CAMPUS, FOR HEALTH CARE. AS A RESULT, THE HOSPITAL'S OFFICE OF CULTURAL DIVERSITY PROVIDES TRANSLATION AND INTERPRETATION SERVICES, AS WELL AS COUNSELING ON MEDICAL INSURANCE AND BILLING FOR THOSE INDIVIDUALS WHO DO NOT SPEAK ENGLISH. THE HOSPITAL PROVIDES BI-LINGUAL PUBLICATIONS AND SIGNAGE AND ACTIVELY ASSISTS THE CULTURALLY DIVERSE COMMUNITIES IT CARES FOR. RACE/ETHNICITY RACE/ETHNICITY DISTRIBUTION RACE/ETHNICITY 2010 POP % OF TOTAL USA % OF TOTAL WHITE NON-HISPANIC 70,409 72.3% 64.7% BLACK NON-HISPANIC 6,435 6.6% 12.1% HISPANIC 16,724 17.2% 15.8% ASIAN & PACIFIC IS. 1,271 1.3% 4.5% ALL OTHERS 2,587 2.7% 2.9% TOTAL 97,426 100.0% 100.0% IN ADDITION, THE HOSPITAL'S SERVICE AREA IS HOME TO THE SHINNECOCK NATION. SINCE APRIL OF 1995, SOUTHAMPTON HOSPITAL HAS WORKED WITH THE NATION TO PROVIDE SERVICES AT THE SHINNECOCK INDIAN HEALTH CLINIC THROUGH A CONTRACT WITH THE NEW YORK STATE DEPARTMENT OF HEALTH. ON AN ANNUAL BASIS, THE CLINIC PROVIDES APPROXIMATELY 2,000 MEDICAL, 800 DENTAL AND 400 DENTAL HYGIENE VISITS FOR ELIGIBLE MEMBERS OF THE SHINNECOCK NATION. DENTAL SERVICES, INCLUDING COMMUNITY EDUCATION, SCREENING, RADIOLOGICAL EXAMS, DENTAL HYGIENE AND RESTORATIVE CARE (CROWNS, FILLINGS AND BRIDGES) ARE PROVIDED THROUGH A SUBCONTRACT WITH STONY BROOK SCHOOL OF MEDICINE. CURRENTLY, DENTAL SERVICES ARE AVAILABLE EIGHT DAYS PER MONTH FOR ADULTS AND TWO DAYS PER MONTH FOR CHILDREN. THESE SERVICES INCLUDE DENTAL SCREENING, PREVENTIVE TEACHING AND COMMUNITY EDUCATION, RADIOLOGICAL EXAMS, RESTORATIVE CARE INCLUDING CROWNS, FILLINGS AND BRIDGES AND DENTAL HYGIENE. IN ADDITION TO PRIMARY CARE, DENTAL SERVICES, NUTRITIONAL COUNSELING, PRENATAL CARE AND ENDOCRINE SERVICES, THE CLINIC PROVIDES SOCIAL WORK, MENTAL HEALTH AND SUBSTANCE ABUSE COUNSELING TO THE RESIDENTS OF THE RESERVATION. AN ANNUAL MAMMORAPHY SCREENING DAY WAS ALSO HELD, IN COLLABORATION WITH THE HOSPITAL'S ELLEN HERMANSON BREAST CENTER, AT THE SHINNECOCK NATION DURING SEPTEMBER OF 2010.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Housing Allowance Or Residence	X	HousingAllowanceOrResidence
Written Policy Re T And E Expenses	1	WrittenPolicyReTAndEExpenses
Substantiation Required	1	SubstantiationRequired
Compensation Committee	X	CompensationCommittee
Written Employment Contract	X	WrittenEmploymentContract
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	0	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	0	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)

Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
MICHAEL B ISRAEL MD
176658	0	0	0	419	0	22000	0	8055	0	207132	0	0	0
ROBERT S CHALONER
425000	0	140000	0	50461	0	14700	0	25104	0	655265	0	0	0
FREDERIC I WEINBAUM
334088	0	48700	0	37000	0	14700	0	21565	0	456053	0	0	0
CHRISTOPHER J SCHULTHEIS
188863	0	3000	0	0	0	11400	0	19345	0	222608	0	0	0
PATRICIA A DARCEY
189438	0	3000	0	0	0	11400	0	19095	0	222933	0	0	0
PAUL R DAVIN
183609	0	3000	0	3738	0	11143	0	19118	0	220608	0	0	0
EDNA KAPENHAS-VALDES
312053	0	0	0	317	0	14700	0	19308	0	346378	0	0	0
CHARLES ARCOLEO
240000	0	0	0	7829	0	14400	0	19294	0	281523	0	0	0
ANGELA SOTERIOU
191361	0	0	0	2593	0	11520	0	7117	0	212591	0	0	0
ALEX APONTE
189564	0	0	0	172	0	11510	0	19228	0	220474	0	0	0
TOVIA LENT
170687	0	0	0	21689	0	10320	0	18696	0	221392	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
PART I, LINE 1A	THE HOSPITAL PROVIDES THE SPECIAL HOUSING AND/OR AUTOMOBILE ALLOWANCES/PERQUISITES TO THE PRESIDENT & CEO, AS WELL AS TO CERTAIN KEY EXECUTIVES. THESE ALLOWANCES FOR HOUSING AND AUTOMOBILE ARE STIPULATED IN THE EXECUTIVE'S EMPLOYMENT AGREEMENT AND TERMS AT THE TIME OF HIRE. ALL PAYMENTS OF THESE PERQUISITES ARE MADE IN A BI-WEEKLY BASIS WITH THE EMPLOYEE'S REGULAR PAYCHECK AND THEY ARE MADE IN ACCORDANCE WITH THE GUIDELINES OF A NON-ACCOUNTABLE EXPENSE PLAN.
PART III	PART II, COLUMN (II) BONUS COMPENSATION: THE PRESIDENT / CEO, AND THE EXECUTIVE VICE PRESIDENT / CHIEF MEDICAL OFFICER OF SOUTHAMPTON HOSPITAL WERE BOTH ELIGIBLE FOR A PERFORMANCE BONUS IN 2010 WHICH WAS BASED UPON CRITERIA THAT THE EXECUTIVE COMMITTEE OF THE BOARD ESTABLISHED. THE PRESIDENT / CEOS BONUS IS AN ANNUAL BONUS SET FORTH IN HIS EMPLOYMENT AGREEMENT AND IS DETERMINED AFTER A REVIEW OF HOW WELL HE PERFORMED IN THE PRIOR YEAR AGAINST GOALS AND OBJECTIVES ESTABLISHED BY THE EXECUTIVE COMMITTEE. THE EXECUTIVE VICE PRESIDENT / CMO WAS AWARDED A PERFORMANCE BONUS BASED UPON THE RECOMMENDATION OF THE PRESIDENT / CEO AS WELL AS A REVIEW OF HIS PERFORMANCE AGAINST GOALS AND OBJECTIVES ESTABLISHED BY THE PRESIDENT AND THE EXECUTIVE COMMITTEE. DURING 2010, THE HOSPITAL PRESIDENT / CEO AWARDED BONUSES TO MANAGEMENT / DEPARTMENT HEADS WHO WERE ASSIGNED TO AN OPERATIONAL IMPROVEMENT TEAMS AND WHO SATISFACTORILY COMPLETED THEIR PROJECTS. THE FOCUS AND GOALS OF THESE PROJECTS ARE DEFINED BY THE PRESIDENT AND ARE OVERSEEN AND MONITORED BY AN "EXECUTIVE SPONSOR". THE EXECUTIVE VICE PRESIDENT / CHIEF MEDICAL OFFICER MET PERIODICALLY WITH EACH TEAM TO ENSURE THAT THE PROJECT SCOPE AND OBJECTIVES WERE CLEARLY DEFINED. THE PROGRESS OF THE TEAMS IS MONITORED AND AT THE END OF THE PROJECTS, THE TEAMS ACCOMPLISHMENTS ARE REVIEWED AND VALIDATED BY THE EXECUTIVE VICE PRESIDENT/CMO AS WELL AS THE CHIEF FINANCIAL OFFICER. BONUS PAYMENTS OF BETWEEN $1,000 AND $3,000 WERE AWARDED TO INDIVIDUAL TEAM MEMBERS BASED UPON THE TEAM'S OVERALL RESULTS.	SUPPLEMENTAL INFORMATION
PART III	PART II, COLUMN (III) OTHER REPORTABLE COMPENSATION: SPECIAL PERQUISITES - ALLOWANCES: THE HOSPITAL PROVIDES THE FOLLOWING SPECIAL ALLOWANCES / PERQUISITES TO THE PRESIDENT & CEO, AS WELL AS TO CERTAIN KEY EXECUTIVES. THESE ALLOWANCES FOR HOUSING AND AUTOMOBILE ARE STIPULATED IN THE EXECUTIVES EMPLOYMENT AGREEMENT / TERMS AT TIME OF HIRE. ALL PAYMENTS OF THESE PERQUISITES ARE MADE ON A BI-WEEKLY BASIS WITH THE EMPLOYEES REGULAR PAYCHECK AND THEY ARE MADE IN ACCORDANCE WITH THE GUIDELINES OF A NON-ACCOUNTABLE EXPENSE PLAN. ANNUAL ALLOWANCES ARE AS LISTED BELOW: ROBERT CHALONER, PRESIDENT & CEO HOUSING ALLOWANCE: $38,000 AUTOMOBILE ALLOWANCE: $8,400 FREDRIC WEINBAUM,MD COO AND CMO HOUSING ALLOWANCE: $30,000 AUTOMOBILE ALLOWANCE: $7,000 PAUL DAVIN, VP, HUMAN RESOURCES AUTOMOBILE ALLOWANCE: $3,600	SUPPLEMENTAL INFORMATION

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
SIGNIFICANT ACTIVITES FOR 2010 CONTINUED:	FORM 990, PART I, LINE 1:	PRIMARY MEDICAL CARE TO SPECIALIZED SURGICAL PROCEDURES, AND IS STAFFED BY MORE THAN 230 PHYSICIANS, DENTISTS AND ALLIED HEALTH PROFESSIONALS REPRESENTING 44 MEDICAL SPECIALTIES. THE HOSPITAL HAS DEVELOPED NUMEROUS SERVICES AND OUTREACH, DETAILED BELOW, TO RESPOND TO THE NEEDS OF THEIR PATIENTS, INCLUDING RECRUITING ADDITIONAL PRIMARY CARE PHYSICIANS AND IMPLEMENTING A GRADUATE MEDICAL EDUCATION PROGRAM THAT WILL HOPEFULLY ATTRACT THESE YOUNG PHYSICIANS TO STAY AND PRACTICE IN THE COMMUNITY. SINCE THE HOSPITAL'S SERVICE AREA EXTENDS FROM WESTHAMPTON BEACH TO MONTAUK, THE HOSPITAL HAS A NUMBER OF SATELLITE CARE OFFICES TO PROVIDE CONVENIENT, SPECIALIZED CARE TO THE COMMUNITY. THESE INCLUDE: MEETING HOUSE LANE MEDICAL PRACTICE: PROVIDING PRIMARY CARE AT LOCATIONS IN MONTAUK, SAG HARBOR, SOUTHAMPTON, AND WAINSCOTT. WESTHAMPTON PRIMARY CARE CENTER: PROVIDING CARE IN THE WESTHAMPTON, WESTHAMPTON BEACH, QUOGUE, AND REMSENBURG COMMUNITIES. LABORATORY AND IMAGING SERVICES: PROVIDING SERVICES IN EAST HAMPTON, HAMPTON BAYS AND SOUTHAMPTON. CENTER FOR PHYSICAL THERAPY AND REHABILITATION: PROVIDING CARE IN THE WESTHAMPTON, WESTHAMPTON BEACH, QUOGUE, AND REMSENBURG COMMUNITIES. THE SHINNECOCK INDIAN HEALTH CLINIC: SINCE APRIL OF 1995, SOUTHAMPTON HOSPITAL HAS WORKED WITH THE SHINNECOCK NATION TO PROVIDE SERVICES AT THE SHINNECOCK INDIAN HEALTH CLINIC THROUGH A CONTRACT WITH THE NEW YORK STATE DEPARTMENT OF HEALTH. ON AN ANNUAL BASIS, THE CLINIC PROVIDES APPROXIMATELY 1,600 MEDICAL AND 1,500 DENTAL VISITS FOR ELIGIBLE MEMBERS OF THE SHINNECOCK NATION. DENTAL SERVICES, INCLUDING COMMUNITY EDUCATION, SCREENING, RADIOLOGICAL EXAMS, DENTAL HYGIENE AND RESTORATIVE CARE (CROWNS, FILLINGS AND BRIDGES) ARE PROVIDED THROUGH A SUBCONTRACT WITH STONY BROOK UNIVERSITY SCHOOL OF MEDICINE. CURRENTLY, DENTAL SERVICES ARE AVAILABLE EIGHT DAYS PER MONTH FOR ADULTS AND TWO DAYS FOR CHILDREN. THE DAVID E. ROGERS MD CENTER FOR HIV/AIDS CARE: ANOTHER IMPORTANT COLLABORATION BETWEEN SOUTHAMPTON HOSPITAL, STONY BROOK UNIVERSITY MEDICAL CENTER AND TOWN AND COMMUNITY ORGANIZATIONS OF THE EAST END OF LONG ISLAND. MAJOR FUNDING IS PROVIDED THROUGH RYAN WHITE PART A FEDERAL FUNDS AND TO PROVIDE SUPPORT SERVICES AND PREVENTION EDUCATION TO PARTNERS AND FAMILY MEMBERS AFFECTED BY AIDS. THE CENTER IS A MEMBER OF THE PECONIC COMMUNITY COUNCIL, A NOT-FOR-PROFIT COALITION OF ORGANIZATIONS AND INDIVIDUALS DEDICATED TO THE PROMOTION AND PRESERVATION OF HEALTH AND HUMAN SERVICES FOR THE ENTIRE EAST END COMMUNITY. CENTER FOR PRENATAL CARE: LOCATED IN GREENPORT ON THE EASTERN END OF LONG ISLANDS NORTH FORK, THE CENTER PROVIDES PRENATAL CARE TO APPROXIMATELY 50 MOTHERS ANNUALLY IN AN UNDERSERVED AND GEOGRAPHICALLY REMOTE AREA. A MAJORITY OF THESE BABIES ARE BORN AT SOUTHAMPTON HOSPITALS KATHLEEN D. ALLEN MATERNITY CENTER. SOUTHAMPTON HOSPITAL IS PROUD OF THE EXCEPTIONAL SPECIALTY SERVICES IT PROVIDES TO THE COMMUNITY. THESE INCLUDE: THE ELLEN HERMANSON BREAST CENTER OFFERS A WIDE SPECTRUM OF BREAST HEALTH SERVICES, INCLUDING EDUCATION, EARLY DETECTION SCREENINGS AND BREAST CANCER TREATMENT AND SUPPORT. THE CENTER UTILIZES STATE-OF-THE-ART DIAGNOSTIC TECHNIQUES, INCLUDING COMPUTER-ASSISTED MAMMOGRAPHY, ULTRASOUND AND BREAST BIOPSY. THE ED & PHYLLIS DAVIS WELLNESS INSTITUTE OFFERS THE ONLY HOSPITAL-BASED INTEGRATIVE MEDICINE ON LONG ISLAND'S EAST END. INTEGRATIVE MEDICINE COMBINES MODERN SCIENCE, PSYCHOLOGY, NUTRITION, AND EXERCISE TO ENHANCE THE NATURAL HEALING CAPACITY OF THE BODY. SPECIAL PROGRAMS ARE AVAILABLE FOR PATIENTS SUFFERING FROM CHRONIC ILLNESS AND CLASSES IN YOGA, TAI CHI, PILATES, SMOKING CESSATION, STRESS MANAGEMENT, ARE OFFERED, AS WELL AS NUTRITIONAL AND WEIGHT LOSS COUNSELING, MASSAGE THERAPY, AND MUCH MORE. THE JENNY AND JOHN PAUSON DEPARTMENT OF EMERGENCY MEDICINE SERVES MORE THAN 25,000 EMERGENCY PATIENTS ANNUALLY AND IS THE ONLY HOSPITAL-BASED EMERGENCY CARE ON THE SOUTH FORK OF LONG ISLAND. STAFFED 24/7 BY BOARD-CERTIFIED EMERGENCY PHYSICIANS AND SPECIALTY-TRAINED NURSES AND STAFF, IT HAS THE MOST SOPHISTICATED, NON-INVASIVE CARDIAC DIAGNOSTIC AND MONITORING TECHNOLOGY AVAILABLE AND, AS A NEW YORK STATE-DESIGNATED STROKE CENTER, IT IS THE DESTINATION OF AMBULANCES WHEN A HEART ATTACK OR STROKE IS SUSPECTED.
MISSION STATEMENT CONTINUED:	FORM 990, PART III, LINE 1:	THE VISION OF SOUTHAMPTON HOSPITAL IS TO MEET THE EVOLVING HEALTHCARE NEEDS OF ITS EASTERN LONG ISLAND COMMUNITY BY PROVIDING ACCESS TO A CONTINUUM OF HIGH QUALITY CLINICAL SERVICES. TO ACHIEVE THIS, THE HOSPITAL WILL FOCUS RESOURCES ON CONTINUOUSLY IMPROVING CLINICAL OUTCOMES, PATIENT SAFETY, SERVICE EXCELLENCE AND PROMOTING EDUCATIONAL OUTREACH AND PROFESSIONAL DEVELOPMENT OF ITS STAFF. SOUTHAMPTON HOSPITAL IS A MEMBER OF THE EAST END HEALTH ALLIANCE, THE ARTICLE 28 PARENT OF EASTERN LONG ISLAND HOSPITAL, PECONIC BAY MEDICAL CENTER AND SOUTHAMPTON HOSPITAL. CONSISTENT WITH THE MISSION OF SOUTHAMPTON HOSPITAL, THE GOALS OF THE ALLIANCE ARE AS FOLLOWS: 1. TO COLLABORATIVELY DEVELOP HIGH QUALITY, COMPREHENSIVE AND ACCESSIBLE HEALTH CARE SERVICES TO MEET THE NEEDS OF THE COMMUNITY SERVED; 2. TO RATIONALIZE HEALTH CARE SERVICES ACROSS THE SYSTEM; AND 3. TO REALIZE MANAGEMENT EFFICIENCIES. SOUTHAMPTON HOSPITAL IS ALSO AFFILIATED WITH STONY BROOK UNIVERSITY MEDICAL CENTER, ALONG WITH THE OTHER TWO EAST END HEALTH ALLIANCE HOSPITALS. THE THREE ALLIANCE HOSPITALS ARE ACTIVELY WORKING WITH THE UNIVERSITY TO IDENTIFY OPPORTUNITIES FOR DEVELOPING CLINICAL AND EDUCATIONAL RELATIONSHIPS THAT WILL IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. SOUTHAMPTON HOSPITAL IS A 125-BED, VOLUNTARY, NOT-FOR-PROFIT FACILITY ACCREDITED BY THE JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS. IT HAS RECEIVED 5-STAR RATINGS FROM HEALTHGRADES(TM), AN INDEPENDENT AUDITOR, IN HIP FRACTURE REPAIR, TREATMENT OF PNEUMONIA, AND GASTROINTESTINAL PROCEDURES AND SURGERIES, AND IS A RECIPIENT OF THE HEALTHGRADES PATIENT SAFETY AWARD IN 2008 AND 2010. IN ADDITION, THE HOSPITAL IS A BARIATRIC SURGERY CENTER OF EXCELLENCE. THE HOSPITAL OFFERS A FULL CONTINUUM OF AMBULATORY AND INPATIENT SERVICES RANGING FROM PRIMARY MEDICAL CARE TO SPECIALIZED SURGICAL PROCEDURES, AND IS STAFFED BY MORE THAN 230 PHYSICIANS, DENTISTS AND ALLIED HEALTH PROFESSIONALS REPRESENTING 44 MEDICAL SPECIALTIES. SOUTHAMPTON HOSPITAL HAS BEEN THE HEALTHCARE HEART OF ITS COMMUNITIES SINCE 1909, PROVIDING CRITICAL HEALTH CARE SERVICES FOR A GEOGRAPHICALLY ISOLATED REGION, WITH A POPULATION THAT MORE THAN DOUBLES DURING THE 3-MONTH SUMMER SEASON WITH PART-TIME RESIDENTS AND VISITORS TO THE SOUTH FORK OF LONG ISLAND.
FORM 990, PART VI, SECTION A, LINE 7A		SOUTHAMPTON HOSPITAL BECAME A MEMBER OF THE EAST END HEALTH ALLIANCE DURING 2007. THE EAST END HEALTH ALLIANCE (THE "ALLIANCE"), THE ARTICLE 28 PARENT OF EASTERN LONG ISLAND HOSPITAL, PECONIC BAY MEDICAL CENTER AND SOUTHAMPTON HOSPITAL, WAS CREATED IN RESPONSE TO THE RECOMMENDATIONS OF THE COMMISSION ON HEALTH CARE IN THE 21ST CENTURY. CONSISTENT WITH THE MISSION OF SOUTHAMPTON HOSPITAL, THE GOALS OF THE ALLIANCE ARE AS FOLLOWS: TO COLLABORATIVELY DEVELOP HIGH QUALITY, COMPREHENSIVE AND ACCESSIBLE HEALTH CARE SERVICES TO MEET THE NEEDS OF THE COMMUNITY SERVED; TO RATIONALIZE HEALTH CARE SERVICES ACROSS THE SYSTEM; AND TO REALIZE MANAGEMENT EFFICIENCIES. AS A MEMBER OF THE EAST END HEALTH ALLIANCE, THE MEMBERS OF THE GOVERNING BOARD OF THE HOSPITAL ARE SUBJECT TO CONFIRMATION BY THE ALLIANCE.
FORM 990, PART VI, SECTION A, LINE 7B		THE HOSPITAL BECAME A MEMBER OF THE EAST END HEALTH ALLIANCE DURING 2007. THE EAST END HEALTH ALLIANCE, THE ARTICLE 28 PARENT OF EASTERN LONG ISLAND HOSPITAL, PECONIC BAY MEDICAL CENTER AND SOUTHAMPTON HOSPITAL, WAS CREATED IN RESPONSE TO THE RECOMMENDATIONS OF THE COMMISSION ON HEALTH CARE IN THE 21ST CENTURY. CONSISTENT WITH THE MISSION OF SOUTHAMPTON HOSPITAL, THE GOALS OF THE ALLIANCE ARE AS FOLLOWS: TO COLLABORATIVELY DEVELOP HIGH QUALITY, COMPREHENSIVE AND ACCESSIBLE HEALTH CARE SERVICES TO MEET THE NEEDS OF THE COMMUNITY SERVED; TO RATIONALIZE HEALTH CARE SERVICES ACROSS THE SYSTEM; AND TO REALIZE MANAGEMENT EFFICIENCIES. THE FOLLOWING DECISIONS MADE BY THE GOVERNING BODY OF SOUTHAMPTON HOSPITAL REQUIRE EAST END HEALTH ALLIANCE APPROVAL: ADOPTION OF OPERATING BUDGETS, APPLICATION FOR NEW CERTIFICATES OF NEED, AND CERTAIN BORROWING TRANSACTIONS.
FORM 990, PART VI, SECTION B, LINE 11		SOUTHAMPTON HOSPITAL HAS ITS FORM 990 PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND HAS ESTABLISHED THE FOLLOWING REVIEW PROCESS TO ENSURE THAT THE INFORMATION REPORTED IS COMPLETE AND ACCURATE. UPON COMPLETION, THE FORM 990 IS REVIEWED BY MANAGEMENT AND IS THEN FORWARDED ELECTRONICALLY TO THE MEMBERS OF THE BOARD OF TRUSTEES FOR THEIR REVIEW. ANY QUESTIONS OR ISSUES ARE THEN ADDRESSED BY THE APPROPRIATE PARTIES PRIOR TO THE FILING OF THE RETURN.
	FORM 990, PART VI, SECTION B, LINE 12C	SOUTHAMPTON HOSPITAL CURRENTLY HAS A CONFLICT OF INTEREST POLICY AND A PROCEDURE FOR ANNUAL DISCLOSURE BY KEY EMPLOYEES, PHYSICIAN LEADERS, AND SENIOR MANAGEMENT. WHEN NEW/POTENTIAL CONFLICTS/RELATIONSHIPS ARE IDENTIFIED, THEY ARE INVESTIGATED BY THE CORPORATE COMPLIANCE OFFICER AND ANY RECOMMENDATIONS AND/OR CORRECTIVE ACTIONS ARE PRESENTED TO THE PRESIDENT AND CEO. AS APPROPRIATE, THESE POTENTIAL CONFLICTS/DISCLOSURES ARE ALSO REVIEWED WITH THE CFO AND MEDICAL DIRECTOR/COO. WHEN A POTENTIAL CONFLICT IS IDENTIFIED, THE STAFF MEMBER IS PROHIBITED FROM TAKING PART IN ANY HOSPITAL DECISIONS THAT MAY RELATE TO THE INTEREST OR RELATIONSHIP, UNTIL THE REVIEW IS COMPLETED AND A DETERMINATION IS MADE THAT THERE IS NO CONFLICT. SIMILARLY, ON AN ANNUAL BASIS, ALL MEMBERS OF THE BOARD OF DIRECTORS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST FORM. ALL POTENTIAL CONFLICTS OF INTEREST THAT MAY EXIST MUST BE DISCLOSED. IF A POTENTIAL OR ACTUAL CONFLICT OF INTEREST EXISTS, THE AFFECTED MEMBER WILL BE NOTIFIED AND THE EXECUTIVE COMMITTEE OF THE BOARD WILL INVESTIGATE AND MAKE THE DETERMINATION AS TO WHAT, IF ANY RECUSAL OR OTHER CORRECTIVE ACTION MAY BE REQUIRED TO AVOID ANY POTENTIAL CONFLICT. THE RESULTS OF THE INVESTIGATION WILL THEN BE REPORTED TO THE GOVERNING BODY. IF AN ACTUAL CONFLICT OF INTEREST EXISTS, THE AFFECTED MEMBER WILL BE NOTIFIED OF THIS DETERMINATION AND THEIR PARTICIPATION IN RELATED MATTERS AND/OR VOTING RIGHTS, PERTAINING TO THE AREA OF CONFLICT, WILL BE RELINQUISHED.
	FORM 990, PART VI, SECTION B, LINE 15	SOUTHAMPTON HOSPITAL HAS ESTABLISHED AN EXECUTIVE COMPENSATION POLICY WHICH SETS FORTH THE TERMS AND CRITERIA FOR THE REVIEW OF THE COMPENSATION OF THE PRESIDENT & CEO, THE CHIEF MEDICAL OFFICER / COO AND THE VICE PRESIDENT OF FINANCE / CFO AS WELL AS OTHER EXECUTIVE LEADERS. THE POLICY OUTLINES THE PROCEDURES AND CRITERIA THE EXECUTIVE COMMITTEE WILL FOLLOW IN EVALUATING THE CEO'S AND THE CMO / COO'S PERFORMANCE AGAINST ESTABLISHED GOALS. IT ALSO OUTLINES THE EXECUTIVE COMMITTEES' ROLE AND RESPONSIBILITY IN DETERMINING ALL ASPECTS OF THE CEO'S AND THE CHIEF MEDICAL OFFICER / COO'S COMPENSATION INCLUDING ANY INCENTIVE OR BONUS COMPENSATION. THE COMMITTEE REVIEWS CONTRACT TERMS WHICH COVER COMPENSATION AND BENEFITS INCLUDING, BUT NOT LIMITED TO, HOUSING ALLOWANCES, AUTOMOBILE ALLOWANCES, SEVERANCE OR CHANGE OF CONTROL PAYMENTS. ON A PERIODIC BASIS, THE EXECUTIVE COMMITTEE MEETS TO REVIEW THE TERMS OF COMPENSATION AND REVIEWS EXTERNAL COMPENSATION DATA AND STUDIES TO ENSURE THAT COMPENSATION DECISIONS ARE REASONABLE AND CONSISTENT WITH FAIR MARKET VALUE. THE COMMITTEE DOCUMENTS THE FULL TERMS OF COMPENSATION APPROVED AND INCLUDES DATE OF THE DECISION, DETAILS OF THE COMPARABILITY DATA OBTAINED AND RELIED UPON, AND HOW THE DATA WAS OBTAINED. MEMBERS OF THE EXECUTIVE COMMITTEE MUST BE FREE FROM ANY CONFLICT OF INTEREST THAT MAY RELATE TO THE ARRANGEMENT. ALL MEMBERS OF THE COMMITTEE WHO WERE PRESENT DURING THE DISCUSSION OF THE ARRANGEMENT WILL BE DOCUMENTED IN THE MEETING MINUTES ALONG WITH THEIR VOTES. THE COMPENSATION REVIEW PROCESS FOR THE PRES. & CEO, CHIEF MEDICAL OFFICER AND TOP MANAGEMENT OFFICIALS WAS LAST UNDERTAKEN OCTOBER 21, 2010.
	FORM 990, PART VI, SECTION C, LINE 19	SOUTHAMPTON HOSPITAL'S FORM 990, AS WELL AS ITS FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY, ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST, AS REQUIRED UNDER SECTION 6104 OF THE INTERNAL REVENUE CODE. INTERESTED PARTIES MAY REQUEST THE DOCUMENTS AT 240 MEETINGHOUSE LANE, SOUTHAMPTON, NY 11968 OR BY CALLING THE ORGANIZATION DIRECTLY AT (631)723-8301.
HOURS DESCRIBED FOR RELATED ORGANIZATIONS:	FORM 990, PART VII, SECTION A, AND COLUMN (A):	THE FOLLOWING ORGANIZATION, INCLUDING THE FILING ORGANIZATION, SOUTHAMPTON HOSPITAL ASSOCIATION (THE "HOSPITAL") HAVE SIMILAR INDIVIDUALS, WHO ARE MENTIONED BELOW, SERVING ON THEIR BOARDS: THE SOUTHAMPTON HOSPITAL FOUNDATION, INC. MICHAEL ISRAEL, TRUSTEE OF THE HOSPITAL ALSO SERVES ON THE BOARD OF THE FOUNDATION AS TRUSTEE AND SPENDS ON AVERAGE .50 HOUR PER WEEK DEVOTED TO THIS POSITION. JEAN REMMEL FITZSIMMONS, TRUSTEE OF THE HOSPITAL ALSO SERVES AS SECRETARY OF THE BOARD ON THE FOUNDATION AND SPENDS ON AVERAGE .50 HOUR PER WEEK DEVOTED TO THIS POSITION. JOHN E. GRIM III, TRUSTEE OF THE HOSPITAL ALSO SERVES ON THE BOARD OF THE FOUNDATION AS TRUSTEE AND SPENDS ON AVERAGE .50 HOUR PER WEEK DEVOTED TO THIS POSITION. ROBERT S. CHALONER, PRESIDENT AND CEO OF THE HOSPITAL ALSO SERVES ON THE BOARD OF THE FOUNDATION AS TRUSTEE AND SPENDS ON AVERAGE .50 HOUR PER WEEK DEVOTED TO THIS POSITION. HOWARD M. LORBER, TRUSTEE OF THE HOSPITAL ALSO SERVES ON THE BOARD OF THE FOUNDATION AS TRUSTEE AND SPENDS ON AVERAGE .50 HOUR PER WEEK DEVOTED TO THIS POSITION.
CHANGES IN NET ASSETS OR FUND BALANCES:	FORM 990, PART XI, LINE 5:	NET UNREALIZED GAINS ON INVESTMENTS: 581,461. PRIOR PERIOD ADJUSTMENTS: 1,390,345. CHANGE IN MINIMUM PENSION LIABILITY - $1,266,824 1,266,824. NET ASSETS REL FROM RESTRICTIONS - CAPITAL ACQUIS FOUNDATION - $5,993,546 5,993,546. CHANGE IN EXPECTED INTEREST IN TRUSTS 317,933. CHANGE IN VALUE OF POOLED INCOME FUND 6,019. OTHER ADJUSTMENTS -7,927. TOTAL TO FORM 990, PART XI, LINE 5: 9,548,201.
	FORM 990, PART XI, LINE 2C:	THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Direct Controlling Entity NADirectControllingEntityNA	Controlled OrgControlledOrg
SOUTHAMPTON CARE CENTER
240 MEETING HOUSE LANE	SOUTHAMPTON	NY	11968	112658403	NURSING HOME PATIENT CARE (FACILITY CLOSED)	NY	501(C)(3)	509(A)(2)	N/A	1
THE SOUTHAMPTON HOSPITAL FOUNDATION
240 MEETING HOUSE LANE	SOUTHAMPTON	NY	11968	113466516	TO SUPPORT SOUTHAMPTON HOSPITAL AS IT DELIVERS ITS HEALTHCARE SERVICES	NY	501(C)(3)	509(A)(1)	N/A	1

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Direct Controlling Entity NADirectControllingEntityNA	Predominant Income TypePredominantIncomeType	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Disproportionate AllocationsDisproportionateAllocations	General Or Managing PartnerGeneralOrManagingPartner	Percentage OwnershipPercentageOwnership
EAST HAMPTON MSO LLC CO 247 EMERGENCY CARE PC
10 MONTROSE LANE	WATER MILL	NY	11976	262636086	24/7 EMERGENCY CARE	NY	N/A	RELATED	35639	19613	0	0	0.50000
HAMPTON IMAGING LLC
1333 ROANOKE AVENUE	RIVERHEAD	NY	11901	201353646	RADIOLOGY SERVICES	NY	N/A	RELATED	-67661	261642	0	0	0.50000

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Direct Controlling Entity NADirectControllingEntityNA	Type Of EntityTypeOfEntity	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Percentage OwnershipPercentageOwnership
MEETING HOUSE LANE MEDICAL PRACTICE
PO BOX 2340	SOUTHAMPTON	NY	11968	208853938	PRIMARY/SPECIALTY PHYSICIAN PATIENT CARE	NY	N/A	C	-749893	601152	1.00000
OLD TOWN MEDICAL PRACTICE PC
240 MEETING HOUSE LANE	SOUTHAMPTON	NY	11968	452430883	PRIMARY/SPECIALTY PHYSICIAN PATIENT CARE	NY	N/A	C			1.00000
SHA PROPERTIES INC
240 MEETING HOUSE LANE	SOUTHAMPTON	NY	11968	112563612	REAL ESTATE HOLDING COMPANY	NY	N/A	C	374091	2068394	1.00000

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	0	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	1	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	1	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	0	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	0	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	0	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	0	PerformOfServicesByOtherOrgs
Sharing Of Facilities	0	SharingOfFacilities
Sharing Of Paid Employees	0	SharingOfPaidEmployees
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	0	OtherTransferToOtherOrg
Other Transfer From Other Org	0	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
THE SOUTHAMPTON HOSPITAL FOUNDATION
C	2399326	CASH
MEETING HOUSE LANE MEDICAL PRACTICE
D	100000	CASH