2011-11-15T15:30:02-06:00 2010-12-31 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2010-01-01 133519617 THE BRONX-LEBANON HIGHBRIDGE WOODYCREST CENTER INC BRON 7182933200 936 WOODYCREST AVENUE BRONX NY 10452 VICTOR DEMARCO 7182933200 2011-11-15 1 FREDERICK H ROTHMAN 2128674000 2010 2016-03-07 17:11:31Z VICTOR DEMARCO 936 WOODYCREST AVENUE BRONX NY 10452 14953509 0 X WWW.HIGHBRIDGEWOODYCREST.ORG X 1989 NY TO PROVIDE RESIDENTIAL CARE FOR PERSONS WITH AIDS OR HIV 3 2 111 6 0 0 0 0 15557596 14898208 5213 43981 10338 11320 15573147 14953509 0 0 0 0 7461980 7191981 0 0 0 8086795 7392883 15548775 14584864 24372 368645 19007788 21563863 14726076 16913506 4281712 4650357 TO PROVIDE RESIDENTIAL CARE FOR PERSONS WITH AIDS AND HIV. 0 0 12666514 14898208 HIGHBRIDGE WOODYCREST CENTER PROVIDES MEDICAL CARE AND OTHER RESIDENTIAL SERVICES FOR 90 RESIDENTS WITH AIDS OR HIV. 12666514 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 6 0 1 111 1 0 0 0 0 0 0 0 0 0 0 X 3 2 0 0 0 0 1 1 0 1 1 0 0 0 1 1 1 1 1 1 0 0 NY X VICTOR DEMARCO 7182933200 936 WOODYCREST AVENUE BRONX NY 10452 X MS BARBARA LOWE RN MPH 0.50 X X 0 0 0 MR ANTONIO SIRVENT 0.50 X X 0 0 0 MR MIGUEL A FUENTES JR 1.00 X X 0 2431100 31301 MR VICTOR G DEMARCO 1.00 X 0 839292 30825 MR OCTAVIO MARIN 1.00 X 0 422111 30705 MR LUDOMIR CZYNSKI 40.00 X 175516 0 14535 MS DENISE ROSEMOND 40.00 X 139897 0 13124 MR JULIO MARTINEZ 40.00 X 101793 0 9111 417206 3692503 129601 3 0 1 0 ARAMARK HEALTHCARE PO BOX 33170 NEWARK NJ 07188 FOOD SERVICE 704976 ESSEN MEDICAL ASSOCIATES 2015 GRAND CONCOURSE BRONX NY 10453 MEDICAL SERVICES 495662 BRONX-LEBANON HOSPITAL CENTER 1276 FULTON AVENUE BRONX NY 10456 MANAGEMENT COMPANY 442116 OPTIMUM MEDICAL STAFFING INC 2 W 46TH STREET 805 NEW YORK NY 10036 STAFFING 368651 MODERN FACILITIES SERVICES INC 733 RIDGEDALE AVE EAST HANOVER NJ 07936 HOUSEKEEPING 140847 6 RESIDENT SERVICE REVEN 623000 14898208 14898208 14898208 43981 43981 OTHER INCOME 900000 11320 11320 11320 14953509 14898208 0 55301 190051 163840 26211 5096769 4373016 723753 279122 240663 38459 1230823 1081837 148986 395216 340708 54508 1390286 1198538 191748 46816 46816 46406 46406 242664 210058 32606 2882704 2484230 398474 166599 143622 22977 429867 370580 59287 4090 3526 564 842536 726333 116203 82308 70956 11352 NY STATE CASH ASSESSMEN 961967 961967 BAD DEBT 296640 296640 14584864 12666514 1918350 0 294496 27587 5663052 9484079 2247230 1790725 22050271 12420028 10243061 9630243 559949 631229 19007788 21563863 1169432 1526996 5311248 5055600 400000 383400 7845396 9947510 14726076 16913506 X 4281712 4650357 4281712 4650357 19007788 21563863 368645 0 X X 0 1 1 X 0 X 20366 20366 14861581 16280242 16602054 15557596 14898208 78199681 14881947 16280242 16602054 15557596 14898208 78220047 0 0 0 78220047 27187 38729 11640 5213 43981 126750 27187 38729 11640 5213 43981 126750 94598 51287 11052 10338 11320 178595 15003732 16370258 16624746 15573147 14953509 78525392 0.99610 0.99350 0.00160 0.00420 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: OTHER REVENUE 500000 500000 17507581 8850287 8657294 3832218 3415110 417108 210472 154631 55841 9630243 DUE TO THIRD PARTY PAYORS 9909688 DUE TO BRONX-LEBANON SPECIAL CARE CENTER 14757 RESIDENT PERSONAL FUNDS 23065 9947510 14953509 14584864 368645 0 368645 14953509 0 14953509 0 14953509 14584864 0 14584864 0 14584864 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE CENTER HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PERIODS ENDING DECEMBER 31, 2007 AND SUBSEQUENT REMAIN SUBJECT TO EXAMINATION BY APPLICABLE TAXING AUTHORITIES. 0 1 0 0 0 0 0 1 0 MR MIGUEL A FUENTES JR 0 986899 0 430038 0 1014163 0 21935 0 9366 0 2462401 0 0 MR VICTOR G DEMARCO 0 529954 0 290000 0 19338 0 21459 0 9366 0 870117 0 0 MR OCTAVIO MARIN 0 295593 0 125000 0 1518 0 21459 0 9246 0 452816 0 0 MR LUDOMIR CZYNSKI 160000 0 15000 0 516 0 5379 0 9156 0 190051 0 0 0 MS DENISE ROSEMOND 126484 0 13000 0 413 0 3978 0 9146 0 153021 0 0 0 PART I, LINE 4B MIGUEL A. FUENTES, JR. $1,006,841 PART I, LINE 7 OFFICERS, HIGHLY COMPENSATED, AND KEY EMPLOYEES RECEIVED A BONUS BASED UPON ACHIEVEMENT OF GOALS SET AT THE BEGINNING OF THE YEAR WITH MR. FUENTES. PHYSICIAN BONUSES ARE DETERMINED BY THE DEPARTMENT CHAIRMAN BASED UPON THE INDIVIDUALS CONTRIBUTION TO THE DEPARTMENT. SUPPLEMENTAL INFORMATION PART III SCHEDULE J, PART II, MR. MIGUEL A. FUENTES, JR. INCLUDED IN COLUMN B (II), IS $430,038 REPRESENTING AN ANNUAL BONUS IN RECOGNITION OF THE SIGNIFICANT CONTRIBUTIONS MADE BY MR. FUENTES IN 2009. THIS BONUS IS BASED ON HIS SUCCESS IN ACHIEVING SPECIFIC TARGETS RELATED TO THE HOSPITAL'S OPERATING PROFIT, CONTROL OF GROWTH IN PAYROLL AND MEDICAL QUALITY PERFORMANCE. INCLUDED IN COLUMN B (III), OTHER COMPENSATION IS $1,006,841, REPRESENTING THE 2010 CONTRIBUTION TO THE ORGANIZATION'S SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN FOR MR. FUENTES. THIS SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN WAS AUTHORIZED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES IN RECOGNITION OF MR. FUENTES' 29 YEARS OF SERVICE AND HIS CONTRIBUTION TO ENHANCING THE CLINICAL AND FINANCIAL PERFORMANCE OF THE ORGANIZATION. THE PLAN BENEFIT IS ACTUARIALLY CALCULATED TO PROVIDE A LUMP SUM PAYMENT IN 2011. IT SHOULD ALSO BE NOTED THAT THESE SUPPLEMENTAL RETIREMENT BENEFITS ARE PART OF A RETIREMENT PROGRAM THAT PROVIDES RETIREMENT INCOME FOR ALL YEARS OF SERVICE THAT THE EMPLOYEE PROVIDES TO THE ORGANIZATION. ANY RETIREMENT BENEFITS SHOULD BE VIEWED AS APPLYING TO THE ENTIRE LENGTH OF THE EMPLOYEE'S SERVICE FOR THE ORGANIZATION. BONUS AMOUNTS FOR VICTOR G. DEMARCO AND OCTAVIO MARIN INCLUDE PAYMENT OF A BONUS FOR 2009 AND FOR 2010. NEW YORK CITY INDUSTRIAL DEVELOPMENT AGENCY 133479996 64971C2B9 2004-07-01 9245000 REFINANCE 0 0 0 9245000 11146 9233854 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE BRONX LEBANON HOSPITAL CENTER IS THE SOLE MEMBER OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE CHIEF EXECUTIVE OFFICER APPOINTS ALL BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 11 THE 990 WILL BE DISTRIBUTED TO THE BOARD OF DIRECTORS AT THE NEXT BOARD MEETING AFTER THE SUBMISSION OF THE 990 TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ALL PERSONS ARE COVERED UNDER THE POLICY. THE INTERNAL AUDITOR REVIEWS CONFLICT OF INTEREST STATEMENTS AND INVESTIGATES POTENTIAL CONFLICTS. LEGAL OPINIONS ARE SOUGHT WHEN NECESSARY. PERSONS WITH A CONFLICT ARE PROHIBITED FROM PARTICIPATING IN DELIBERATIONS AND DECISIONS IN RELATED TRANSACTIONS. FORM 990, PART VI, SECTION B, LINE 15A ALL ELEMENTS OF COMPENSATION AND BENEFITS PROVIDED TO THE CHIEF EXECUTIVE OFFICER ARE REVIEWED AND APPROVED IN ADVANCE BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES OF THE BRONX-LEBANON HOSPITAL CENTER, AND THIS REVIEW AND APPROVAL PROCESS IS CONDUCTED IN A MANNER THAT QUALIFIES FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERMEDIATE SANCTIONS RULES OF FEDERAL INCOME TAX LAW. THE COMMITTEE CONSISTS OF THREE INDEPENDENT MEMBERS OF THE BOARD, THEY RECEIVE AND RELY ON APPROPRIATE COMPARABILITY DATA GATHERED BY AN INDEPENDENT COMPENSATION CONSULTANT FOR FUNCTIONALLY SIMILAR POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS, AND THEY PREPARE A CONTEMPORANEOUS AND THOROUGH WRITTEN RECORD OF THEIR DELIBERATIONS AND DECISIONS. THIS REBUTTABLE PRESUMPTION PROCESS IS CONDUCTED ANNUALLY WITH RESPECT TO ALL ELEMENTS OF THE CEO'S COMPENSATION AND BENEFITS, INCLUDING THE PORTION OF TOTAL COMPENSATION AND BENEFITS PROVIDED BY RELATED ORGANIZATIONS AND REPORTED ON THE FORM 990 AS SUCH. THE LAST TIME THIS WAS DONE WAS IN 2010. THE COMMITTEE REVIEWS AND APPROVES IN ADVANCE THE INCENTIVE COMPENSATION GOALS FOR THE CEO, AND ASSURES THAT TOTAL CASH COMPENSATION, INCLUDING THE INCENTIVE COMPENSATION OPPORTUNITY, IS REASONABLE. THE COMMITTEE HAS EXPRESSLY DETERMINED THAT THE TOTAL COMPENSATION AND BENEFITS PROVIDED TO THE CEO ARE REASONABLE, BASED ON THE REVIEW OF THE MARKET DATA PRESENTED BY THE INDEPENDENT COMPENSATION CONSULTANT AND ON THE REVIEW OF ALL OTHER RELEVANT FACTS AND CIRCUMSTANCES. FORM 990, PART VI, SECTION C, LINE 19 ONLY FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. MS. BARBARA LOWE, RN, MPH DEVOTED 2.5 HOURS FOR RELATED ORGANIZATIONS. MR. ANTONIO SIRVENT DEVOTED 2.5 HOURS FOR RELATED ORGANIZATIONS. MR. MIGUEL A. FUENTES, JR. DEVOTED 45 HOURS FOR RELATED ORGANIZATIONS. MR. VICTOR G. DEMARCO DEVOTED 45 HOURS FOR RELATED ORGANIZATIONS. MR. OCTAVIO MARIN DEVOTED 42 HOURS FOR RELATED ORGANIZATIONS. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. MARTIN LUTHER KING JR HEALTH CENTER 1265 FRANKLIN AVENUE BRONX NY 10456 132707945 OUTPATIENT MEDICAL SERVICES NY 501 (C) (3) 9 BRONX LEBANON HOSPITAL CENTER 0 BRONX LEBANON HOSPITAL CENTER 1276 FULTON AVENUE BRONX NY 10456 133974191 HOSPITAL NY 501 (C) (3) 3 N/A 0 BRONX LEBANON HOSPITAL NEW DIRECTIONS FUND 1276 FULTON AVENUE BRONX NY 10456 133183084 FUNDRAISING NY 501 (C) (3) 7 BRONX LEBANON HOSPITAL CENTER 0 1650 BLHC SERVICES CORP 1276 FULTON AVENUE BRONX NY 10456 201841933 RENTAL APARTMENT BUILDING NY 501 (C) (3) 11A BRONX LEBANON HOSPITAL CENTER 0 1770 BLHC SERVICES CORP 1276 FULTON AVENUE BRONX NY 10456 202031443 RENTAL APARTMENT BUILDING NY 501 (C) (3) 11A BRONX LEBANON HOSPITAL CENTER 0 BRONX LEBANON SPECIAL CARE CENTER 1265 FRANKLIN AVENUE BRONX NY 10456 133479996 SKILLED NURSING HOME NY 501 (C) (3) 9 BRONX LEBANON HOSPITAL CENTER 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 1 0