2022-11-15T10:50:38-06:00 2021-12-31 366055558 GRANT THORNTON LLP 757 THIRD AVENUE 3RD FLOOR NEW YORK NY 100172013 990 2021-01-01 131740274 CALVARY HOSPITAL INC CALV 7185182000 1740 EASTCHESTER ROAD BRONX NY 104612392 ANDREW GRECO VICE PRESIDENT & CFO 7185182069 2022-11-15 1 ANDREW GRECO XXX-XX-XXXX SCOTT THOMPSETT P00741490 2125990100 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z FRANK CALAMARI 1740 EASTCHESTER ROAD BRONX NY 104612392 130872300 0 0928 X WWW.CALVARYHOSPITAL.ORG X 1899 NY CALVARY HOSPITAL PROVIDES PALLIATIVE CARE FOR TERMINALLY ILL CANCER PATIENTS. 18 16 1180 92 0 0 29344812 10871600 107004500 115735000 784337 1487200 1107051 1275200 138240700 129369000 0 0 0 0 97169001 98686401 0 0 0 39316966 36857799 136485967 135544200 1754733 -6175200 124160500 108684200 95086500 71850400 29074000 36833800 X CALVARY HOSPITAL IS A FULLY ACCREDITED ACUTE CARE SPECIALTY HOSPITAL PROVIDING PALLIATIVE CARE FOR TERMINALLY ILL CANCER PATIENTS IN THE UNITED STATES. 0 0 93275178 0 87385300 TERMINALLY ILL CANCER CARE INPATIENT - CALVARY SERVES ABOUT 23.7% OF ALL INDIVIDUALS WHO DIE OF CANCER IN THE NEW YORK METROPOLITAN AREA EACH YEAR. PATIENTS ARE REFERRED TO CALVARY FROM EVERY MAJOR HOSPITAL AND MEDICAL CENTER IN NEW YORK CITY. IN 2021, CALVARY CARED FOR MORE THAN 2,772 PATIENTS AND FAMILIES AS INPATIENT ADMISSIONS IN OUR 200-BED BRONX CAMPUS AND OUR 25-BED SATELLITE AT NYU LANGONE HOSPITAL IN BROOKLYN. THE AVERAGE LENGTH OF INPATIENT STAY IS 27.6 DAYS. 23346887 0 28348500 SEE SCHEDULE O.CALVARY HOSPITAL HOSPICE IS A MEDICARE-CERTIFIED HOSPITAL-BASED HOSPICE PROGRAM, WHICH PROVIDES AN INTERDISCIPLINARY CARE TEAM FOR PATIENTS WITH A TERMINAL PROGNOSIS FOR ALL END-STAGE DISEASES. CALVARY HOSPITAL HOSPICE EMBRACES AND IMPLEMENTS THE BASIC ASSUMPTIONS OF THE HOSPICE CONCEPT, INCLUDING THE FOLLOWING:- HOSPICE PROVIDES PALLIATIVE MEDICAL CARE, TREATING THE PHYSICAL, EMOTIONAL AND SPIRITUAL PAIN OF THE PATIENT AND FAMILY. - HOSPICE TREATS THE PATIENT AND LOVED ONES TOGETHER AS A WHOLE UNIT OF CARE AND OFFERS BEREAVEMENT COUNSELING FOR SURVIVING CAREGIVERS AFTER THE PATIENT'S DEATH. - HOSPICE PATIENTS REMAIN IN THE FAMILIAR, COMFORTING SURROUNDINGS OF HOME, WHETHER IT'S A PRIVATE RESIDENCE, NURSING HOME, HOSPITAL OR AN ASSISTED LIVING FACILITY. - HOSPICE CARE PROVIDES THE FOLLOWING FOUR LEVELS OF CARE: ROUTINE CARE, GENERAL INPATIENT CARE (IF NEEDED), CONTINUOUS CARE (DURING A CRISIS), AND RESPITE CARE.HOSPICE SERVICES - NURSING CARE, AS NECESSARY TO MAINTAIN THE PATIENT AT HOME - 24 HOURS A DAY, 7 DAYS A WEEK ON-CALL NURSE PHYSICIAN SERVICES - MEDICAL SOCIAL SERVICES- PASTORAL CARE- COUNSELING SERVICES - NUTRITIONAL COUNSELING- SHORT-TERM INPATIENT AND RESPITE CARE - MEDICAL SUPPLIES RELATED TO TERMINALLY ILL - PERSONAL CARE PROVIDED BY CERTIFIED HOME HEALTH AIDES - THERAPIES (E.G., PHYSICAL, OCCUPATIONAL AND SPEECH) - MEDICATIONS FOR SYMPTOM MANAGEMENT AND PAIN CONTROL RELATED TO THE TERMINALLY ILL- BEREAVEMENT COUNSELING FOR FAMILY MEMBERS - VOLUNTEER SERVICES 542635 0 1200 SEE SCHEDULE O. CALVARY'S HOME HEALTH AGENCY SERVES PATIENTS IN THE BRONX, QUEENS, NORTHERN MANHATTAN, AND SOUTHERN WESTCHESTER COUNTY. CALVARY OFFERS HOME CARE TO PATIENTS WITH ALL DIAGNOSES. MOST PATIENTS RETURN TO PRE-ILLNESS FUNCTION AND ARE DISCHARGED TO SELF-CARE WITHIN SIX TO EIGHT WEEKS. ALL OF OUR PATIENTS WHO WE CARE FOR AT HOME GET THE SAME LEVEL OF HIGH-QUALITY AND UNIQUE "CALVARY CARE" AS ALL OF OUR INPATIENTS.THE FOLLOWING SERVICES ARE AVAILABLE TO PATIENTS AND THEIR FAMILIES THROUGH CALVARY'S CERTIFIED HOME HEALTH AGENCY: NURSING SERVICES - OUR COMMUNITY HEALTH NURSES PROVIDE NURSING VISITS TO PATIENTS IN THEIR HOMES. - SPECIALIZED NURSING IS AVAILABLE SUCH AS ENTEROSTOMAL THERAPY. - 24-HOUR TELEPHONE ACCESS TO RN (REGISTERED NURSE) ON-CALL.HOME HEALTH AIDE - PROVIDES ASSISTANCE WITH PERSONAL CARE AND OTHER ACTIVITIES RELATED TO HEALTH CARE. NUTRITIONAL SERVICES - CALVARY'S DIETITIANS ARE AVAILABLE BY PHONE TO HELP IN PLANNING THERAPEUTIC NUTRITIONAL MANAGEMENT.THERAPY SERVICES - PHYSICAL THERAPY- OCCUPATIONAL THERAPY - SPEECH THERAPYMEDICAL CARE - CALVARY HOME CARE STAFF WILL WORK CLOSELY WITH THE PATIENT'S OWN PHYSICIAN TO MEET HOME HEALTH NEEDS. - OUR STAFF HAS EXTENSIVE KNOWLEDGE OF PAIN MANAGEMENT.MEDICAL SOCIAL WORK A FULL RANGE OF SOCIAL WORK SERVICES ARE AVAILABLE TO HELP PATIENTS AND FAMILIES COPE WITH THE PROBLEMS OF ILLNESS. - ASSISTANCE IN MEDICAID APPLICATION - ASSISTANCE IN LONG-TERM PLANNINGREFERRING PATIENTS - REFERRALS MAY BE MADE BY PATIENTS FAMILY MEMBERS, FRIENDS, HOSPITALS, CLINICS, PHYSICIANS, OTHER HEALTH CARE PROFESSIONALS AND COMMUNITY AGENCIES. - PART OF THE CALVARY CONTINUUM FACILITATE ADMISSION TO INPATIENT CARE FOR SYMPTOM MANAGEMENT - REFERRAL TO OUTPATIENT AND WOUND CARE CLINICS - PROVIDE INFORMATION ON CALVARY PROGRAMS INCLUDING BEREAVEMENT SUPPORT 117164700 1 1 0 1 0 0 0 0 1 1 1 1 1 0 1 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 123 0 1 1180 1 0 0 0 0 0 0 0 0 0 0 0 0 X 18 16 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X ANDREW GRECO 7185182069 1740 EASTCHESTER ROAD BRONX NY 104612069 SCOTT P LA RUE PRESIDENT/CEO OF ARCHCARE 1.00 37.00 X 0 1410218 353773 MANFRED ALTSTADT DIRECTOR EMERITUS (NON-VOTING) 0.50 0.50 X 0 0 0 STEVEN J GOLUB DIRECTOR EMERITUS (NON-VOTING) 0.50 1.00 X 0 0 0 JOHN P BERTSCH DIRECTOR EMERITUS (NON-VOTING) 0.50 0.00 X 0 0 0 DR MARC PRAGER DIRECTOR 0.50 0.00 X 0 0 0 THOMAS G FERRARA DIRECTOR 0.50 0.00 X 0 0 0 MARYANN JULIA POPIEL MD DIRECTOR 1.00 0.50 X 0 0 0 CARLOS HERNANDEZ DIRECTOR 0.50 1.00 X 0 0 0 JOSEPH A TARANTINO DIRECTOR 1.00 0.50 X 0 0 0 JOSEPH L DEMARZO DIRECTOR 1.00 0.00 X 0 0 0 AMIT SIKDAR DIRECTOR 0.50 0.00 X 0 0 0 RENA M MURTHA RN DIRECTOR 1.00 0.00 X 0 0 0 REV ERIC P CRUZ MDIV MNA DIRECTOR 1.00 0.00 X 0 0 0 DANIEL S GURRELL MD DIRECTOR 0.50 0.00 X 0 0 0 JOHN A DECINA CHAIRMAN (AS OF 7/2021) 0.50 0.50 X X 0 0 0 ANNE COTE TAYLOR SECRETARY 1.00 0.00 X X 0 0 0 THOMAS J FAHEY JR MD CHAIRMAN (THRU 7/2021)/DIRECTOR 2.00 1.00 X X 0 0 0 EDWARD D HEBEN TREASURER 1.00 0.50 X X 0 0 0 JAMES O'HARA DIRECTOR 0.50 0.00 X 0 0 0 RICHARD CARDILLO DIRECTOR 0.50 0.00 X 0 0 0 DIAL HEWLETT MD DIRECTOR 0.50 0.00 X 59752 0 0 CHRISTOPHER COMFORT MD COO 37.00 0.00 X 530028 0 38507 ANDREW V GRECO VICE PRESIDENT & CFO 37.00 0.00 X 396308 0 55685 FRANK A CALAMARI PRESIDENT/EXECUTIVE DIRECTOR 37.00 0.00 X 744984 0 33887 ROBERT SIEGEL MEDICAL DIRECTOR (THRU 9/2021) 37.00 0.00 X 309191 0 57593 NANCY D'AGOSTINO RN VP OF COMMUNITY PATIENT SVCS 37.00 0.00 X 275257 0 42398 MARGARET PELKOWSKI VP FOR PATIENT CARE SERVICE 37.00 0.00 X 244341 0 27854 ANDREW ZARETSKY MD ATTENDING PHYSICIAN 37.00 0.00 X 419506 0 45259 DEVMANI JAITLY MD ATTENDING PHYSICIAN 37.00 0.00 X 575354 0 38506 MUHAMMAD AMIR SHAHID ATTENDING PHYSICIAN 37.00 0.00 X 368507 0 58616 MARGARET SQUILLACE ATTENDING PHYSICIAN - HOSPICE 37.00 0.00 X 350899 0 30731 ROBERT BRESCIA MD DIR. PALLIATIVE CARE INST 37.00 0.00 X 366800 0 30185 MICHAEL J BRESCIA MD EXECUTIVE DIRECTOR EMERITUS 37.00 0.00 X 334682 0 0 4975609 1410218 812994 208 1 1 0 NAVIN HAFTY & ASSOCIATES LLP PO BOX 735736 DALLAS TX 753735736 IT CONSULTING 931034 FORT GROUP 100 CHALLENGER ROAD 7TH FLOOR RIDGEFIELD NJ 07660 ADVERTISING SERVICES 858778 CLOUDWAVE 100 CROWLEY DRIVE MALBOROUGH MA 01752 IT SERVICES 521585 SPIRE WORKFORCE SOLUTIONS 1600 PARKWOOD CIRCLE SUITE 1600 ATLANTA GA 30339 NURSING SERVICES 425874 ADP PO BOX 842875 BOSTON MA 022842875 PAYROLL SERVICES 423697 29 1905000 5551000 3415600 10871600 PATIENT SERVICE REVENUE 900099 115735000 115735000 115735000 271200 271200 2719300 1503300 1216000 1216000 1216000 INSURANCE PROCEEDS 900099 750000 750000 RELATED PARTY REIMBURSEMENTS 900099 139200 139200 CAFETERIA INCOME 900099 133555 133555 252445 252445 1275200 129369000 115735000 0 2762400 2867682 1202298 1665384 230769 96752 134017 70529808 65769097 4760711 5303332 4841951 461381 14621755 13349686 1272069 5133055 4686488 446567 2640256 2640256 421586 421586 381348 381348 128992 128992 8017109 8017109 1135949 690644 445305 2401767 1460247 941520 490825 298416 192409 2329697 1609942 719755 289859 176231 113628 45780 27834 17946 31500 31500 5507500 5141025 366475 1099293 1099293 PHARMACEUTICALS 5590951 5590951 MAINTENANCE AND REPAIRS 1575040 957606 617434 FOOD EXPENSE 963105 585557 377548 LEASES 812740 758659 54081 2994502 1872707 1121795 135544200 117164700 18379500 0 20000 21700 18970500 11371800 20585800 21551200 965900 310600 360100 222900 116110200 101302600 18825000 14807600 16910700 18979000 8745300 8218300 26052800 30985800 12724400 2215300 124160500 108684200 14537300 15212000 4784000 2167000 126200 0 1042000 388900 74597000 54082500 95086500 71850400 X -10687000 -8289200 39761000 45123000 29074000 36833800 124160500 108684200 X -6175200 694000 13241000 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 104752 0 1 24240 128992 0 PART II-B, LINE 1: CALVARY HOSPITAL ENGAGES TWO INDIVIDUALS TO DIRECTLY LOBBY CONGRESS AND OTHER GOVERNMENTAL AGENCIES ON ITS BEHALF. THE TOTAL AMOUNT PAID TO THESE EXTERNAL CONSULTANTS IN CALENDAR YEAR 2021 IS $56,278. CALVARY HOSPITAL INCURS INDIRECT LOBBYING EXPENDITURES FROM ITS MEMBERSHIP IN VARIOUS HEALTHCARE ASSOCIATIONS. THE $22,128 REPORTED ON SCHEDULE C, PART II-B, LINE 1(I) INCLUDES THE PORTION OF ITS MEMBERSHIP DUES ATTRIBUTABLE TO LOBBYING ENDEAVORS THAT THE HOSPITAL PAYS TO THE FOLLOWING MEMBERSHIP ASSOCIATIONS: - THE HOSPITAL ASSOCIATION OF NEW YORK STATE (HANYS) - THE GREATER NEW YORK HOSPITAL ASSOCIATION (GNYHA) 0 1 X 39761000 2044600 5481300 2163900 45123000 35867300 2216800 3250500 1573600 39761000 29283900 3309900 5215300 1941800 35867300 30643900 1807200 -1112700 2054500 29283900 26805300 1725600 4295000 2182000 30643900 0.00000 0.04000 0.96000 0 0 538000 538000 38700800 31796070 6904730 72386400 65479532 6906868 4485000 4026998 458002 14807600 ALTERNATIVE INVESTMENTS 8218300 F 8218300 BENEFICIAL INTEREST ASSETS OF CALVARY FUND 30985800 F 30985800 ACCRUED PENSION LIABILITY 48853500 DUE TO THIRD PARTY PAYORS 4020400 ESTIMATED MALPRACTICE LIABILITY 1208600 54082500 X 143304000 694000 13241000 13935000 129369000 0 129369000 135544200 0 135544200 0 135544200 PART IV, LINE 2B: THE HOSPITAL MAINTAINS CUSTODIAL ACCOUNTS FOR ITS PATIENTS AND VARIOUS AUXILIARY GROUPS. PART X, LINE 2: THE HOSPITAL FOLLOWS GUIDANCE THAT CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN, INCLUDING ISSUES RELATING TO FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT. THIS GUIDANCE PROVIDES THAT THE TAX EFFECTS FROM AN UNCERTAIN TAX POSITION CAN ONLY BE RECOGNIZED IN THE FINANCIAL STATEMENTS IF THE POSITION IS MORE-LIKELY-THAN-NOT TO BE SUSTAINED IF THE POSITION WERE TO BE CHALLENGED BY A TAXING AUTHORITY. THE ASSESSMENT OF THE TAX POSITION IS BASED SOLELY ON THE TECHNICAL MERITS OF THE POSITION, WITHOUT REGARD TO THE LIKELIHOOD THAT THE TAX POSITION MAY BE CHALLENGED. THE HOSPITAL IS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3), THOUGH IT IS SUBJECT TO TAX ON INCOME UNRELATED TO ITS EXEMPT PURPOSE, UNLESS THAT INCOME IS OTHERWISE EXCLUDED BY THE IRS. THE HOSPITAL HAS PROCESSES PRESENTLY IN PLACE TO ENSURE THE MAINTENANCE OF ITS TAX-EXEMPT STATUS; TO IDENTIFY AND REPORT UNRELATED INCOME; TO DETERMINE ITS FILING AND TAX OBLIGATIONS IN JURISDICTIONS FOR WHICH IT WAS NEXUS; AND TO IDENTIFY AND EVALUATE OTHER MATTERS THAT MAY BE CONSIDERED TAX POSITIONS. THE HOSPITAL HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: PENSION BENEFIT ADJUSTMENT DUE TO CHANGE IN ACTUARIAL VALUATION 8,835,000. CHANGE IN BENEFICIAL INTEREST IN NET ASSETS OF CF 4,406,000. 1 1 X 1 X 300.000000000000 1 X 1 1 0 1 1 161507 161507 0.00120 8020762 9528629 0 0.00000 8182269 9528629 161507 0.00120 8182269 9528629 161507 0.00120 11 639069 639069 0.00470 1 8000 8000 0.00010 1 2600 2600 0.00000 2 5122 5122 0.00000 15 654791 654791 0.00480 1 6075000 54450600 57295358 -2844758 X 1 1 2 1 CALVARY HOSPITAL INC 1740 EASTCHESTER ROAD BRONX NY 10461 CALVARYHOSPITAL.ORG X EXTENDED NEOPLASTIC DISEASE CARE A 2 CALVARY HOSPITAL INC (BROOKLYN CAMPUS) 1740 EASTCHESTER ROAD BRONX NY 10461 CALVARYHOSPITAL.ORG X EXTENDED NEOPLASTIC DISEASE CARE A CALVARY HOSPITAL INC 0 0 1 X X X X X X X X X X 20 1 0 0 1 X CALVARYHOSPITAL.ORG X 1 20 1 CALVARYHOSPITAL.ORG 0 1 X 300.000000000000 1 1 X X X 1 X CALVARYHOSPITAL.ORG X CALVARYHOSPITAL.ORG X CALVARYHOSPITAL.ORG X X X X X 1 X 0 X X X X 0 X X 0 0 SCHEDULE H, PART V, SECTION B, LINE 11: CALVARY HOSPITAL ASSESSED THE NEEDS OF THE COMMUNITY THROUGH THE LENSES OF THE SPECIALIZED SERVICES IT IS EQUIPPED TO PROVIDE. THE JOINT COMMISSIONS STEERING COMMITTEE AND QUALITY COMMITTEES OF THE BOARD OF DIRECTORS ARE RESPONSIBLE FOR EVALUATING THE DATA AND PRIORITIZING THE NEEDS. CALVARY HOSPITAL USED SECONDARY AND QUALITATIVE DATA TO DETERMINE THREE TOP HEALTH ISSUES BASED ON CAPACITY, RESOURCES, COMPETENCIES, AND NEEDS SPECIFIC TO THE POPULATIONS IT SERVES. ALL NEEDS ARE A PRIORITY WITH PALLIATIVE CARE SERVICES BEING THE MOST SIGNIFICANT NEED. THESE ISSUES ARE WITHIN THE HOSPITAL'S SCOPE, COMPETENCY AND RESOURCES TO IMPACT IN A MEANINGFUL MANNER. CALVARY HOSPITAL'S END OF LIFE PALLIATIVE CARE IS THE WORLD'S MOST COMPREHENSIVE. FOR MORE THAN A CENTURY, IT HAS BEEN TREATING NOT ONLY THE PHYSICAL PAIN, BUT HAS ALSO BEEN PROVIDING ENORMOUS EMOTIONAL RELIEF, TO BOTH THE PATIENT AND THE FAMILY. CALVARY ELIMINATES THE STRESS AND ANXIETY AT A TIME WHEN PEOPLE ARE MOST VULNERABLE. THE HOSPITAL IDENTIFIED THREE PRIMARY SIGNIFICANT NEEDS WITHIN ITS COMMUNITY NEEDS ASSESSMENT:1. PALLIATIVE CARE SERVICES2. BEREAVEMENT SERVICES3. PALLIATIVE CARE PROVIDER EDUCATIONTHE HOSPITAL'S COMMUNITY NEEDS ASSESSMENT PROVIDES TREMENDOUS DETAIL AS TO HOW THE HOSPITAL ADDRESSES THESE NEEDS. PLEASE REFER TO THE HOSPITAL'S WEBSITE AT HTTPS://WWW.CALVARYHOSPITAL.ORG/WP-CONTENT/UPLOADS/2019/11/CH_CHNA_BROCHURE_FINAL-11-12-19-1.PDF PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: CALVARY HOSPITAL, INC., - FACILITY 2: CALVARY HOSPITAL, INC. (BROOKLYN CAMPUS) CALVARY HOSPITAL, INC. PART V, SECTION B, LINE 11: CALVARY HOSPITAL ASSESSED THE NEEDS OF THE COMMUNITY THROUGH THE LENSES OF THE SPECIALIZED SERVICES IT IS EQUIPPED TO PROVIDE. THE JOINT COMMISSIONS STEERING COMMITTEE AND QUALITY COMMITTEES OF THE BOARD OF DIRECTORS ARE RESPONSIBLE FOR EVALUATING THE DATA AND PRIORITIZING THE NEEDS. CALVARY HOSPITAL USED SECONDARY AND QUALITATIVE DATA TO DETERMINE THREE TOP HEALTH ISSUES BASED ON CAPACITY, RESOURCES, COMPETENCIES, AND NEEDS SPECIFIC TO THE POPULATIONS IT SERVES. ALL NEEDS ARE A PRIORITY WITH PALLIATIVE CARE SERVICES BEING THE MOST SIGNIFICANT NEED. THESE ISSUES ARE WITHIN THE HOSPITAL'S SCOPE, COMPETENCY AND RESOURCES TO IMPACT IN A MEANINGFUL MANNER. CALVARY HOSPITAL'S END OF LIFE PALLIATIVE CARE IS THE WORLD'S MOST COMPREHENSIVE. FOR MORE THAN A CENTURY, IT HAS BEEN TREATING NOT ONLY THE PHYSICAL PAIN, BUT HAS ALSO BEEN PROVIDING ENORMOUS EMOTIONAL RELIEF, TO BOTH THE PATIENT AND THE FAMILY. CALVARY ELIMINATES THE STRESS AND ANXIETY AT A TIME WHEN PEOPLE ARE MOST VULNERABLE. THE HOSPITAL IDENTIFIED THREE PRIMARY SIGNIFICANT NEEDS WITHIN ITS COMMUNITY NEEDS ASSESSMENT:1. PALLIATIVE CARE SERVICES2. BEREAVEMENT SERVICES3. PALLIATIVE CARE PROVIDER EDUCATIONTHE HOSPITAL'S COMMUNITY NEEDS ASSESSMENT PROVIDES TREMENDOUS DETAIL AS TO HOW THE HOSPITAL ADDRESSES THESE NEEDS. PLEASE REFER TO THE HOSPITAL'S WEBSITE AT HTTPS://WWW.CALVARYHOSPITAL.ORG/WP-CONTENT/UPLOADS/2019/11/CH_CHNA_BROCHURE_FINAL-11-12-19-1.PDF PART V, SECTION B, LINE 22D: THE MAXIMUM AMOUNT THAT CALVARY HOSPITAL WILL CHARGE FAP-ELIGIBLE PATIENTS IS 15% OF GROSS CHARGES; THIS REFLECTS AN AMOUNT THAT IS BELOW OUR LOWEST PAYOR. PART I, LINE 3C: CALVARY HOSPITAL INC. USES THE FEDERAL POVERTY GUIDELINES (FPG) TO DETERMINE ELIGIBILITY FOR DISCOUNTED CARE TO LOW-INCOME PATIENTS. PART I, LINE 6A: CALVARY HOSPITAL COMPLETED ITS MOST RECENT FULL COMMUNITY BENEFIT REPORT/COMMUNITY HEALTH NEEDS ASSESSMENT IN DECEMBER OF 2020. THIS REPORT IS POSTED ON CALVARY HOSPITAL'S WEBSITE.CALVARY ROUTINELY RECEIVES INPUT FROM ALL HOSPITALS AND HEALTH SYSTEMS IN ITS CATCHMENT AREA; THROUGH ITS PALLIATIVE CARE INSTITUTE, CALVARY WORKS DIRECTLY WITH THE MEDICAL SCHOOLS IN THE NEW YORK AREA, NYC EMS SERVICES AND THE NATIONAL CANCER INSTITUTE. THE TOTALITY OF THIS INPUT ENABLES CALVARY TO PRODUCE A THOROUGH AND TARGETED COMMUNITY SERVICE PLAN EACH YEAR. DURING THE COVID PANDEMIC THESE PROGRAMS WERE SCALED BACK AS COMPARED WITH PRIOR YEARS. PART I, LINE 7: CALVARY HOSPITAL IS UNIQUE IN THE HEALTHCARE ENVIRONMENT IN THAT IT PROVIDES SERVICES TO A VERY SPECIFIC SET OF PATIENTS: THE TERMINALLY ILL. PATIENTS IN-HOSPITAL CARE AT CALVARY IF THEY HAVE BEEN DIAGNOSED WITH ADVANCED CANCER AND OTHER TERMINAL ILLNESSES, WHICH HAVE NOT RESPONDED TO CURATIVE TREATMENTS AND REQUIRE CONTINUOUS SUPERVISION BY A MEDICAL TEAM. THEY HAVE SEVERE SYMPTOMS RELATED TO THEIR ILLNESS, SUCH AS INFECTIONS, COMPLEX WOUND CARE NEEDS, NAUSEA, SEVERE WEIGHT LOSS, PAIN, OR CONFUSION, OR DUE TO THE SEVERITY OF THEIR SYMPTOMS, CARE AT HOME IS NOT POSSIBLE. DURING THE COVID PANDEMIC, CALVARY CARED FOR COVID RECOVERING PATIENTS. FROM ITS INCEPTION IN 1899, CALVARY HOSPITAL HAS BEEN FAITHFULLY DEVOTED TO PROVIDING PALLIATIVE CARE TO ADULT PATIENTS IN THE ADVANCED STAGES OF CANCER, AND OTHER LIFE-LIMITING ILLNESSES ADDRESSING THE SYMPTOMS OF THE DISEASE, NOT ITS CURE. A VOLUNTARY, NOT-FOR-PROFIT HOSPITAL, OPERATED IN CONNECTION WITH THE ARCHDIOCESE OF NEW YORK, CALVARY CONTINUES TO EMBODY THIS TRADITION OF CARING THROUGH THE SERVICES AND PROGRAMS OFFERED BY AND THROUGH THE DEDICATION AND CONCERN SHOWN BY ITS STAFF MEMBERS.THE HOSPITAL WILL CONTINUE TO BE FAITHFUL TO THIS TRADITION THROUGH A TWOFOLD COMMITMENT. CALVARY WILL STRIVE PRIMARILY TO EXPAND ITS PROGRAMS AND SERVICES TO MEET THE EMERGING PHYSICAL, PSYCHOSOCIAL, AND SPIRITUAL NEEDS OF BOTH PATIENTS AND FAMILIES THROUGH THE PROVISION OF ACUTE INPATIENT, CALVARY HOSPICE AND A BROOKLYN CAMPUS. IN ADDITION, THROUGH THE PALLIATIVE CARE INSTITUTE, THE HOSPITAL ENDEAVORS TO TRANSMIT TO OTHER HEALTH CARE PROFESSIONALS, THROUGH RESEARCH AND EDUCATION, THE KNOWLEDGE AND COMPETENCE WHICH IT HAS DEVELOPED IN THE CARE OF ADULT PATIENTS WITH ADVANCED CANCER AND OTHER LIFE LIMITING ILLNESSES. THROUGH THIS TWOFOLD COMMITMENT, CALVARY HOSPITAL WILL DEEPEN AND STRENGTHEN THE PHILOSOPHY OF COMPASSIONATE CARE WHICH HAS BEEN THE CORNERSTONE OF ITS PROGRAM OF SERVICE, AND WILL OFFER TO THOSE IN OUR EXPANDED COMMUNITY AND OTHERS, A TRADITION OF SUCCESSFUL EXPERIENCE IN THE CARE OF THE ADVANCED CANCER PATIENT.CALVARY HOSPITAL IS THE ONLY FULLY ACCREDITED EXTENDED NEOPLASTIC DISEASE CARE HOSPITAL PROVIDING PALLIATIVE CARE FOR ADVANCED CANCER PATIENTS IN THE UNITED STATES. WITH 225 BEDS IN THE BRONX AND BROOKLYN AND 1180 EMPLOYEES, CALVARY SERVES MORE THAN 2734 PATIENTS ANNUALLY THROUGH ITS HOME CARE AND HOSPICE PROGRAM. CALVARY PROVIDES PALLIATIVE CARE, WHICH IS THE ACTIVE TREATMENT OF THE SYMPTOMS, NOT THE CURE OF THE DISEASE, IN ORDER TO MAKE OUR PATIENTS AS COMFORTABLE AS POSSIBLE. CALVARY'S PROGRAMS INCLUDE INPATIENT CARE CASE MANAGEMENT, CALVARY HOSPICE AND HOMECARE SUPPORT PROGRAMS FOR FAMILIES AND FRIENDS. AS CALVARY APPROACHES THE FUTURE WITH A SENSE OF HOPE AND PROMISE, CALVARY IS EVER MINDFUL OF THE LEGACY OF OUR FOUNDERS, THE WOMEN OF CALVARY, TO PROVIDE COMPREHENSIVE CARE WHILE RECOGNIZING THE INDIVIDUALITY AND DIGNITY OF EVERY PATIENT. AT THE SAME TIME, CALVARY WILL CONTINUE TO DEVELOP NEW PROGRAMS AND SERVICES TO MEET THE NEEDS OF TODAY'S WORLD.ACCORDINGLY, CALVARY HOSPITAL IS NOT SUITED TO PROVIDING THE TYPE OF COMMUNITY BENEFITS THAT OTHER TRADITIONAL HOSPITALS PROVIDE.CALVARY REPORTS IN PART VII THE VALUE OF ANY MEDICAID SERVICES IT PROVIDES AS WELL AS FINANCIAL ASSISTANCE COSTS. TO ARRIVE AT THE CHARITY CARE AMOUNTS REPORTED IN PART VII, CALVARY UTILIZES NET REALIZABLE VALUE OF THE SERVICES RENDERED. THIS REPORTING IS CONSISTENT TO WHAT IS PRESENTED IN CALVARYS COST REPORT WITH THE NEW YORK STATE DEPARTMENT OF HEALTH. PART II, COMMUNITY BUILDING ACTIVITIES: CALVARY HOSPITAL MAKES A NUMBER OF DIFFERENT SUPPORT GROUPS AVAILABLE TO THE COMMUNITY. THESE SUPPORT GROUPS ARE ADVERTISED ON CALVARY HOSPITAL'S WEBSITE, WWW.CALVARYHOSPITAL.ORG, ON ITS CALENDAR OF EVENTS. IN ADDITION, THE HOSPITAL PUBLISHES "CALVARY IN TOUCH", A QUARTERLY NEWSLETTER ABOUT BEREAVEMENT ISSUES THAT IS AVAILABLE THROUGH THE HOSPITAL'S WEBSITE, SOCIAL MEDIA CHANNELS AND IS CIRCULATED IN HARD COPY BY MAIL.CALVARY HOSPITAL PROVIDES BEREAVEMENT SUPPORT FOR ADULTS WHO HAVE LOST LOVED ONES AT CALVARY HOSPITAL OR CALVARY HOSPICE OR CALVARY HOMECARE, AND THOSE FROM THE COMMUNITY AT LARGE WHO HAVE LOST SOMEONE BECAUSE OF ILLNESS, ACCIDENTS VIOLENCE, OR ANY OTHER CAUSE. GROUPS ARE OFFERED IN THE BRONX, BROOKLYN AND MANHATTAN. DURING THE COVID PANDEMIC, SINCE THESE GROUPS COULD NOT MEET IN-PERSON, THEY MET VIRTUALLY USING ON-LINE TECHNOLOGY.THE HOSPITAL ALSO OFFERS AGE-APPROPRIATE SUPPORT GROUPS FOR CHILDREN, AGES 6 THROUGH 11, AND FOR ADOLESCENTS, AGES 12 TO 18, AND FOR YOUNG ADULTS, AGES 18 TO 25. THESE COMMUNITY SUPPORT GROUPS WHICH WERE PROVIDED VIRTUALLY, INCLUDE BUT ARE NOT LIMITED TO: - SUPPORT GROUPS FOR BEREAVED PARENTS - MINDFULNESS AND MOVEMENT THROUGH GRIEF GROUP- PRECIOUS MOMENTS SUPPORT GROUP FOR CHILDREN AGES 6 TO 9 - TWEEN BEREAVEMENT GROUPS FOR TWEENS AGES 10 TO 12- TEEN BEREAVEMENT GROUPS FOR TEENS AGES 13-17- YOUNG ADULTS AGES 18-25- DEATH OF A SPOUSE/PARTNER BEREAVEMENT GROUPS - DEATH OF A PARENT BEREAVEMENT GROUPS - MEN DISCUSSION GROUP- COVID LOSS GROUPS- SUPPORTIVE CONNECTIONS GROUP (FOR GUARDIANS OF BEREAVED CHILDREN)- CAMP COMPASS DAY CAMP FOR BEREAVED CHILDREN OPEN TO ALL CHILDREN WHO HAVE ATTENDED OUR GROUPS ARE FREE OF CHARGE, AND ARE LED BY CALVARY HOSPITAL STAFF AND STAFF HIRED JUST FOR THIS WEEK LONG EVENT. CALVARY HOSPITAL ALSO MAKES AVAILABLE A NUMBER OF DIFFERENT WELLNESS ACTIVITIES TO THE COMMUNITY. THESE WELLNESS ACTIVITIES INCLUDE BUT ARE NOT LIMITED TO ZUMBA (PROVIDED TO STAFF VIA ZOOM), STAFF DRUMMING CLASSES, RECREATIONAL THERAPY AND PET THERAPY AND A FACILITY DOG ON STAFF. CALVARY HOSPITAL'S THERAPEUTIC RECREATION AND MUSIC THERAPY PROGRAMS WERE CREATED TO GIVE PATIENTS A SENSE OF ACCOMPLISHMENT AND TO RELIEVE THE SUFFERING OF OUR PATIENTS AND THEIR FAMILIES. DURING THE COVID PANDEMIC, THESE IN-PERSON PROGRAMS WERE PLACED ON-HOLD. CALVARY'S MUSIC THAT HEALS PROGRAM WAS ADDED IN 2021. THERAPEUTIC RECREATION ACTIVITIES INCLUDES DRAWING, SCULPTURE, AND CERAMICS PROJECTS; HORTICULTURE; A GAMES AND DISCUSSION HOUR; AND HOLIDAY PARTIES. MUSIC THERAPY OFTEN HELPS SOOTHE PATIENTS AND HELPS THEM FOCUS ON LIFE. OUR BOARD CERTIFIED MUSIC THERAPISTS USE MUSIC THERAPY INTERVENTIONS TO SOOTHE PATIENTS, RELIEVE ANXIETY, REMINISCE, AND EASE PAIN AND SUFFERING. MUSIC THERAPY INTERVENTIONS MAY ALSO PROVIDE RELEASE IN THE LAST HOURS OR MOMENTS OF LIFE. PATIENTS RECEIVING MUSIC THERAPY SOMETIMES WRITE SONGS ASSISTED BY THE MUSIC THERAPISTS TO LEAVE FOR LOVED ONES, OR FIND OTHER WAYS TO OPEN THEIR HEARTS THROUGH MUSIC. OUR CLINICIANS REPORT THAT IN SOME CASES, THE ONLY TIME A PATIENT LAUGHS OR SMILES IS DURING A MUSIC THERAPY SESSION. WE ALSO FIND THAT MUSIC THERAPY IS AVAILABLE AT BOTH INPATIENT LOCATIONS AND IS ALSO ONE OF THE SERVICES WE OFFER THROUGH CALVARY HOSPICE AND HOMECARE. IN 2021, THE THERAPEUTIC RECREATION STAFF PROVIDED A BOX OF 6 GOURMET CUPCAKES TO EACH PATIENT TO SHARE WITH THEIR VISITORS IN CELEBRATION OF THANKSGIVING. IN CELEBRATION OF CHRISTMAS, EACH PATIENT WAS GIVEN A HOLIDAY MUG FILLED WITH CANDY.IN KEEPING WITH OUR MISSION TO SHARE OUR KNOWLEDGE AND EXPERIENCE WITH OTHERS, CALVARY OFFERS INTERNSHIP PROGRAMS IN THE FOLLOWING AREAS: SOCIAL WORK, BEREAVEMENT, PALLIATIVE CARE AND MUSIC THERAPY, WHICH IS RECOGNIZED AS A NATIONAL CLINICAL TRAINING SITE BY THE AMERICAN MUSIC THERAPY ASSOCIATION. IN 2021, THE EDDIE HIGGINS SCHOLARSHIP WAS AWARDED TO ITS EDDIE HIGGINS RECIPIENTS THROUGH THE SCHOLARSHIP PROGRAM, CALVARY HOSPITAL PROVIDES LEADERSHIP DEVELOPMENT AND TRAINING. THE EDDIE HIGGINS SCHOLARSHIP IS NAMED AFTER A CHERISHED MEMBER OF THE CALVARY FAMILY WHO CAME TO THE HOSPITAL AS A YOUNG BOY. EDDIE WAS HOSPITALIZED INTERMITTENTLY FOR 15 YEARS AT CALVARY UNTIL HIS DEATH IN 1982 AT THE AGE OF 29. EDDIE IS REMEMBERED FOR HIS LOVE OF GOD AND HIS REMARKABLE COURAGE DESPITE HIS ILLNESS. CALVARY HAS GIVEN THE ANNUAL SCHOLARSHIP SINCE 1985. IN 2021 THE ANNUAL MENTORS THROUGH MOURNING WORKSHOP WAS PLACED ON HOLD. THIS IS NORMALLY PROVIDED FREE OF CHARGE, FOR SCHOOL PROFESSIONALS TO EDUCATE THEM ON THE GRIEF PROCESS OF CHILDREN. ALSO OFFERED IS AN 11 WEEK ANNUAL COURSE THAT WE CHARGE $50/SESSION, WHICH IS OFFERED IN THE BRONX AND BROOKLYN. IN 2021, THE PANDEMIC PROMPTED US TO OFFER THIS REMOTELY. PART III, LINE 2: THE METHODOLOGY THAT CALVARY HOSPITAL EMPLOYS TO ESTIMATE ITS BAD DEBT EXPENSE IS CAPTURED IN ITS AUDITED FINANCIAL STATEMENTS. THE FOOTNOTE IS REPRODUCED BELOW:ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS RECEIVABLE. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS RECEIVABLE AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS RECEIVABLE. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS RECEIVABLE. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS RECEIVABLE, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS RECEIVABLE. PART III, LINE 4: THE HOSPITAL'S BAD DEBT FOOTNOTE IS REPORTED THUSLY IN ITS AUDITED FINANCIAL STATEMENTS: THE HOSPITAL RECOGNIZES PATIENT SERVICE REVENUE ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY PAYOR COVERAGE ON THE BASIS OF CONTRACTUAL RATES FOR THE SERVICES RENDERED. FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, THE HOSPITAL RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARD RATES FOR SERVICES PROVIDED (OR ON THE BASIS OF DISCOUNTED RATES, IF NEGOTIATED OR PROVIDED BY POLICY). ON THE BASIS OF HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF THE HOSPITAL'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED.THUS, THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS RECEIVABLE RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. THE HOSPITAL ALSO RECORDS A PROVISION FOR UNCOLLECTIBLE ACCOUNTS TO COVER THE ESTIMATED WRITE-OFFS RESULTING FROM INSURED PATIENTS WHOSE BENEFITS ARE SUBSEQUENTLY DETERMINED TO HAVE BEEN EXHAUSTED DURING THEIR HOSPITALIZATION OR WHOSE COVERAGE IS DENIED BY THE INSURER.PART III, LINE 5: CALVARY HOSPITAL DOES NOT TRADITIONALLY TREST THE SHORTFALL ON ITS MEDICARE REIMBURSEMENT AS CHARITY CARE AND DOES NOT REPORT IT AS SUCH IN ITS AUDITED FINANCIAL STATEMENTS. PART III, LINE 7: CALVARY HOSPITAL INC. HAS REPORTED A SHORTFALL IN PART III SECTION B LINE 7. THE EXPENSES, REVENUES AND SHORTFALL REPORTED IN PART III LINES 5-7 WERE DEVELOPED FROM THE 2021 CALVARY HOSPITAL, INC. COST REPORTS FILED WITH THE NYS DOH AND NATIONAL GOVERNMENT SERVICES (MEDICARE INTERMEDIARY). PART III, LINE 9B: CALVARY HOSPITAL, INC.'S FINANCIAL ASSISTANCE POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. CALVARY HOSPITAL'S COLLECTION POLICY IS THAT ALL REASONABLE EFFORTS WILL BE MADE BY PATIENT ACCOUNTS REPRESENTATIVES TO OBTAIN PAYMENT AND TO SETTLE PATIENT ACCOUNTS RECEIVABLE ON A CONSISTENT BASIS. THE PATIENT ACCOUNTING SYSTEM WILL BEAR ENTRIES OF SUCH ATTEMPTS, INCLUDING THE DATE AND THE REPRESENTATIVE'S INITIALS. ACCOUNTS RESISTING SETTLEMENT MAY BE REFERRED TO A COLLECTION AGENCY. PART VI, LINE 2: CALVARY HOSPITAL IS THE ONLY FULLY ACCREDITED EXTENDED NEOPLASTIC DISEASE CARE HOSPITAL PROVIDING PALLIATIVE CARE FOR ADULT PATIENTS WITH ADVANCED CANCER AND OTHER LIFE-LIMITING ILLNESSES IN THE UNITED STATES.CALVARYCARE MAY BE OBTAINED AT OUR 200-BED BRONX CAMPUS OR 25-BED BROOKLYN CAMPUS. THROUGHCALVARY HOSPICE AND HOMECARE, CARE IS ALSO PROVIDED EACH DAY IN HUNDREDS OF PRIVATE HOMES, SKILLED NURSING AND ASSISTED LIVING FACILITIES IN NEW YORK CITY, WESTCHESTER, NASSAU, AND ROCKLAND COUNTIES. THE PALLIATIVE CARE CONSULTATION SERVICE HAS BEEN ADDED TO THE EXISTING HOMECARE PROGRAMS WHICH INCLUDE A CERTIFIED HOME HEALTH AGENCY AND CERTIFIED HOSPICE (HOSPITAL-BASED). THE PALLIATIVE CARE CONSULTATION PROGRAM IS DESIGNED TO MEET THE NEEDS OF PATIENTS WHO, DUE TO CHRONIC ILLNESSES AND ADVANCING DISEASE, DO NOT MEET HOSPICE CRITERIA BUT CAN BENEFIT FROM INTERVENTIONS DIRECTED AT SYMTION MANAGEMENT, ADVANCE CARE PLANNING AND INTERMITTENT OVERSIGHT. WHEN PATIENTS AT HOME REQUIRE SHORT TERM INPATIENT CARE, WE CAN SEAMLESSLY TRANSFER TO THEM TO CALVARY HOSPITAL OR AS WELL AS TO THE DAWN GREENE HOSPICE AT MARY MANNING WALSH HOME IN MANHATTAN AND OR THE OZANAM HALL OF QUEENS. THROUGH THE CALVARY HOSPICE PROGRAM, CALVARY ALSO PROVIDES INPATIENT CARE TO SELECT PATIENTS AT NYP COLUMBIA MEDICAL CENTER, NYP CORNELL MEDICAL CENTER, NYP LOWERMANHATTAN HOSPITAL, NUP ALLEN HOSPITAL AND THE BROOKLYN HOSPITAL. CALVARY TREATS PATIENTS BOTH AS INPATIENT AND HOMECARE AND HOSPICE THROUGH THE CALVARY HOSPICE AND HOMECARE PROGRAM. CALVARY HOSPITAL USES A VARIETY OF METHODS AND SERVICES TO GATHER COMMUNITY INPUT TO ASSESS THE NEEDS OF THE COMMUNITY, AND TO ASSURE INPUT IN THE COMMUNITY SERVICE PLAN. SOME OF THESE METHODS ARE:A. COMMUNITY OUTREACH SERVICES: COMMUNITY OUTREACH SERVICES FUNCTIONS AS A LIAISON WITH THE COMMUNITY, REFERRERS, PHYSICIANS, PATIENTS, AND FAMILIES AND FACILITATES ADMISSION TO CALVARY. THE DEPARTMENT OUTREACHES THROUGH THE TRI-STATE REGION AND EDUCATES THE HEALTH CARE AND PATIENT COMMUNITIES AS TO THE CONTINUUM OF SERVICES CALVARY PROVIDES (INPATIENT, CALVARY HOSPICE AND HOMECARE), THROUGH ON-SITE VISITS, PUBLIC PRESENTATIONS AND PARTICIPATION IN COMMUNITY AND PROVIDER ACTIVITIES, THE OUTREACH STAFF CONTINUALLY ASSESSES THE NEEDS OF THE COMMUNITY. THE BEREAVEMENT DEPARTMENT ALSO FACILITATES A COMMUNITY OUTREACH TO EDUCATE MENTAL HEALTH AGENCIES AND SCHOOLS ABOUT GRIEF AND BEREAVEMENT AS WELL AS PROVIDE SUPPORT TO AGENCIES THAT ARE EXPERIENCING A DEATH IN THEIR COMMUNITY. B. PROFESSIONAL ADVISORY BOARD: THE PROFESSIONAL ADVISORY BOARD WAS ESTABLISHED IN 1992 TO OBTAIN INPUT FROM THE COMMUNITY. THE ADVISORY BOARD MEETS AT LEAST ANNUALLY AND IS COMPRISED OF PHYSICIANS, NURSES, AND SOCIAL WORKERS, REPRESENTING HOSPITALS, AND HOME CARE AGENCIES, AS WELL AS THE COMMUNITY. THIS GROUP HAS CONTRIBUTED A VARIETY OF IDEAS FOR ENHANCING SERVICES TO THE COMMUNITY. IN 2021, THERE WERE AT LEAST THREE SUCH MEETINGS BEFORE THE QUARANTINE AND ONE FULL MEETING VIA ZOOM. C. COMMUNITY PLANNING BOARD: EACH YEAR THE HOSPITAL INVITES THE HEALTH COMMITTEE OF COMMUNITY PLANNING BOARD *11 TO VISIT THE HOSPITAL. DUE TO THE PANDEMIC, IN 2021, CALVARY WAS UNABLE TO EXTEND SUCH INVITATION. D. OUTREACH REPRESENTATION FOR HEALTH CARE PROFESSIONALS: COMMUNITY OUTREACH PARTICIPATES IN THE EDUCATION OF STAFF IN SURROUNDING HOSPITALS INCLUDING DOCTORS, NURSES, CASE MANAGERS AND SOCIAL WORKERS. CALVARY HOSPITAL, INC. ALSO HAS PUBLIC PARTICIPATION IN THE EXTENDED COMMUNITY THROUGH PARTICIPATION IN: - GREATER NEW YORK HOSPITAL ASSOCIATION - HOSPITAL ASSOCIATION OF NEW YORK STATE- AMERICAN HOSPITAL ASSOCIATION - NEW YORK CITY DEPARTMENT OF HEALTH - NEW YORK STATE DEPARTMENT OF HEALTH- CATHOLIC HEALTHCARE ASSOCIATION - CMSTHROUGH ONGOING PARTICIPATION IN THE GROUPS ABOVE, CALVARY HOSPITAL CONTINUALLY MONITORS THE TRENDS IN THE HEALTHCARE NEEDS OF THE LARGER COMMUNITY. ALTHOUGH THE NATURE OF ITS SERVICES IS LIMITED BY ITS SPECIALIZED MISSION, CALVARY HAS IDENTIFIED A VARIETY OF ACTIVITIES TO PARTICIPATE IN IMPROVING THE HEALTH OF ITS EXTENDED COMMUNITY. X 0 1 X X X X 1 1 0 0 0 0 0 1 0 SCOTT P LA RUE PRESIDENT/CEO OF ARCHCARE 0 988763 0 281992 0 139463 0 330725 0 23048 0 1763991 0 291706 FRANK A CALAMARI PRESIDENT/EXECUTIVE DIRECTOR 521594 0 63480 0 159910 0 21750 0 12137 0 778871 0 0 0 DEVMANI JAITLY MD ATTENDING PHYSICIAN 252005 0 0 0 323349 0 21750 0 16756 0 613860 0 0 0 CHRISTOPHER COMFORT MD COO 407845 0 20000 0 102183 0 21750 0 16757 0 568535 0 0 0 ANDREW ZARETSKY MD ATTENDING PHYSICIAN 205341 0 3000 0 211165 0 21750 0 23509 0 464765 0 0 0 ANDREW V GRECO VICE PRESIDENT & CFO 307289 0 3000 0 86019 0 21750 0 33935 0 451993 0 0 0 MUHAMMAD AMIR SHAHID ATTENDING PHYSICIAN 224005 0 3000 0 141502 0 21750 0 36866 0 427123 0 0 0 ROBERT BRESCIA MD DIR. PALLIATIVE CARE INST 338553 0 3000 0 25247 0 21750 0 8435 0 396985 0 0 0 MARGARET SQUILLACE ATTENDING PHYSICIAN - HOSPICE 172517 0 1041 0 177341 0 15058 0 15673 0 381630 0 0 0 ROBERT SIEGEL MEDICAL DIRECTOR (THRU 9/2021) 210228 0 0 0 98963 0 21727 0 35866 0 366784 0 0 0 MICHAEL J BRESCIA MD EXECUTIVE DIRECTOR EMERITUS 0 0 0 0 334682 0 0 0 0 0 334682 0 0 0 NANCY D'AGOSTINO RN VP OF COMMUNITY PATIENT SVCS 258001 0 3000 0 14256 0 18889 0 23509 0 317655 0 0 0 MARGARET PELKOWSKI VP FOR PATIENT CARE SERVICE 229066 0 3000 0 12275 0 16375 0 11479 0 272195 0 0 0 PART I, LINE 1A EFFECTIVE JUNE 1, 1998, THE HOSPITAL ESTABLISHED THE CALVARY HOSPITAL SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) TO PROVIDE PENSION BENEFITS FOR WAGES EARNED BY CERTAIN PHYSICIANS AND SENIOR EXECUTIVE STAFF WITH COMPENSATION IN EXCESS OF THE IRS LIMITS AND ALSO ESTABLISHED THE CALVARY HOSPITAL KEY EMPLOYEE SHARE OPTION PLAN(KEYSOP) TO PROVIDE ADDITIONAL AND ALTERNATIVE FORMS OF COMPENSATION TO KEY EMPLOYEES. PRIOR TO 2002, THE HOSPITAL UTILIZED THE KEYSOP TO FUND THE SERP. AS A RESULT OF THE IRS 457 REGULATIONS WHICH WERE ISSUED DURING 2002, THE UTILIZATION OF THE KEYSOP TO FUND THE SERP BECAME UNFEASIBLE. AFTER CONSIDERATION OF VARIOUS REPLACEMENT OPTIONS, IN 2003, CALVARY HOSPITAL CHOSE THE TAX GROSS-UP OPTION, WHEREBY, INDIVIDUAL PARTICIPANTS' DEFERRALS WOULD BE GROSSED-UP TO DUPLICATE THE BENEFITS HE WOULD RECEIVE IN A TAX-DEFERRED ARRANGEMENT AND PAID THEM OUT DIRECTLY TO THE PARTICIPANTS. THE FOLLOWING EXECUTIVES RECEIVED TAX GROSS-UP PAYMENTS IN 2021 IN ORDER TO DUPLICATE A TAX DEFERRED VEHICLE: (THE AMOUNTS WERE CALCULATED BY FRANK J. WALTERS ASSOCIATES, INC. UTILIZING EXPECTED TAX RATES TO CALCULATE THE NET AMOUNTS.) ANDREW GRECO, CHIEF FINANCIAL OFFICER, RECEIVED A GROSS-UP FOR TAXES ON HIS SERP DISTRIBUTION. THE TAX GROSS-UP IS REPORTED IN SCHEDULE J, PART II, COLUMN (B)(III). PART I, LINES 4A-B FORMER EXECUTIVE DIRECTOR, MICHAEL BRESCIA, M.D., AND MEDICAL DIRECTOR, ROBERT SIEGEL, M.D., RECEIVED A SEVERANCE PAYMENT IN CALENDAR YEAR 2021 IN THE AMOUNT OF $220,121 AND $70,769 RESPECTIVELY. THE SEVERANCE PAYMENT IS INCLUDED IN FORM 990, SCHEDULE J, PART II, COLUMN (B)(III) THE FOLLOWING CALVARY HOSPITAL OFFICERS PARTICIPATE IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN AND RECEIVED THE FOLLOWING DISTRIBUTIONS (WHICH ARE INCLUDED IN COLUMN (B)(III) OTHER REPORTABLE COMPENSATION: FRANK CALAMARI - $95,976 ANDREW GRECO - $65,834 GROSS *INCLUDES TAX GROSS-UP $29,428 PRESIDENT & CEO OF ARCHCARE, SCOTT P. LA RUE, PARTICIPATES IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN AND RECEIVED A DISTRIBUTION OF $139,463 FROM THE PLAN IN CALENDAR YEAR 2021. THIS DISTRIBUTION IS REPORTED AS CURRENT YEAR WAGES IN SCHEDULE J, PART II, COLUMN (B)(III) AND IS LIKEWISE REPORTED IN COLUMN (F) TO REFLECT THE PAYOUT OF PREVIOUSLY DEFERRED WAGES. THE BALANCE OF COMPENSATION REPORTED IN COLUMN (F) REPRESENTS THE PAYOUT OF A DEFERRED BONUS THAT WAS REPORTED IN COLUMN (C) ON PREVIOUS FORMS 990. PART I, LINE 7 CALVARY HOSPITAL ENGAGED THE SERVICES OF AN INDEPENDENT COMPENSATION CONSULTING FIRM THAT SPECIALIZES IN HEALTHCARE EXECUTIVE COMPENSATION TO DESIGN ITS EXECUTIVE INCENTIVE COMPENSATION PLAN. AS PART OF THE PLAN, THE CALVARY EXECUTIVE TEAM DEVELOPS A NUMBER OF STRATEGIC GOALS THAT EXECUTIVES MUST MEET TO PARTICIPATE IN THE INCENTIVE PROGRAM; THESE GOALS ARE THEN REVIEWED AND APPROVED ANNUALLY BY THE COMPENSATION COMMITTEE OF THE BOARD. AT YEAR END, CALVARY'S CEO PRESENTS THE RESULTS FROM THE PREVIOUS YEAR IN TERMS OF WHICH GOALS WERE ACHIEVED BY THE EXECUTIVE TEAM. THE COMPENSATION COMMITTEE OF THE BOARD THEN CONVENES WITH INDEPENDENT COMPENSATION CONSULTING FIRM TO DETERMINE AND APPROVE THE BONUSES THAT ARE DISTRIBUTED TO EACH EXECUTIVE. FORM 990, PART VI, SECTION A, LINE 2 MICHAEL J BRESCIA MD AND ROBERT BRESCIA MD HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 PURSUANT TO CALVARY HOSPITAL'S BYLAWS, CATHOLIC HEALTH CARE SYSTEM ("ARCHCARE") IS ITS SOLE CORPORATE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A CALVARY HOSPITAL IS A FULL PARTICIPATING MEMBER OF CATHOLIC HEALTH CARE SYSTEM ("ARCHCARE"), A HEALTH CARE DELIVERY SYSTEM IN NEW YORK STATE. THE CALVARY HOSPITAL BYLAWS RESERVE CERTAIN RIGHTS TO CATHOLIC HEALTH SYSTEM AS THE SOLE MEMBER. ONE OF THOSE RIGHTS, IN ARTICLE IV, IS THE POWER TO APPOINT AND REMOVE BOARD MEMBERS (AS WELL AS THE CHAIRMAN OF THE BOARD). FORM 990, PART VI, SECTION A, LINE 7B PROVIDENCE HEALTH SERVICES IS THE SOLE MEMBER OF CATHOLIC HEALTH CARE SYSTEM ("ARCHCARE"), WHICH IS, IN TURN, SOLE MEMBER OF CALVARY HOSPITAL. PROVIDENCE IS THE SPONSOR OF CALVARY HOSPITAL (AND ITS RELATED ENTITIES) AND AS SUCH HAS BEEN RESERVED CERTAIN POWERS IN CALVARY HOSPITAL'S BYLAWS, EXERCISED IN CONJUNCTION WITH RECOMMENDATIONS MADE BY CALVARY HEALTH CARE SYSTEM (AS SOLE CORPORATE MEMBER). THESE POWERS ARE AS FOLLOWS: 1. RIGHT TO AMEND BYLAWS; 2. RIGHT TO CHANGE CALVARY HOSPITAL'S MISSION; 3. RIGHT TO APPROVE ANY MERGER, JOINT VENTURE, OR DISSOLUTION OF THE FUND; 4. APPROVAL WITH RESPECT TO CERTAIN REAL PROPERTY TRANSACTIONS; 5. APPROVAL OF ANY LEASES EXPECTED TO EXCEED A PERIOD OF 9 YEARS; 6. APPROVAL OF THE FUND ENTERING INTO ANY DEBT INSTRUMENTS; 7. APPROVAL ON THE DISPOSITION OF ANY SIGNIFICANT HISTORICAL ARTIFACTS. AS NOTED ABOVE, THE SOLE MEMBER, CATHOLIC HEALTH CARE SYSTEM HAS BEEN RESERVED THE RIGHT TO MAKE RECOMMENDATIONS TO PROVIDENCE ABOUT ANY OF THE ABOVE ACTIONS. FORM 990, PART VI, SECTION B, LINE 11B THE 2021 FORM 990 OF CALVARY HOSPITAL WAS PREPARED BY GRANT THORNTON LLP WITH THE ASSISTANCE OF CALVARY ACCOUNTING PERSONNEL. THE DRAFT FORM 990 WAS REVIEWED BY GRANT THORNTON LLP, THE DIRECTOR OF FINANCE AND THE CFO OF CALVARY HOSPITAL BEFORE DISTRIBUTION OF THE FULL VERSION OF THE FINAL DRAFT TO THE BOARD. A COPY OF THE FORM 990 DRAFT WAS PROVIDED TO EACH MEMBER OF THE CALVARY HOSPITAL BOARD OF DIRECTORS ON NOVEMBER 8, 2022 PRIOR TO ITS FILING WITH THE INTERNAL REVENUE SERVICE IN ELECTRONIC FORMAT. FORM 990, PART VI, SECTION B, LINE 12C EACH OFFICER, DIRECTOR, TRUSTEE AND KEY EMPLOYEE IS REQUIRED TO ANNUALLY DISCLOSE ANY CONFLICTS OF INTEREST THAT ARISE BY VIRTUE OF THEIR EMPLOYMENT AND POSITION WITH CALVARY HOSPITAL OR CALVARY FUND. CALVARY MONITORS COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY THROUGH AN ANNUAL QUESTIONNAIRE SUBMITTED TO THESE INDIVIDUALS. POTENTIAL CONFLICTS ARE INVESTIGATED IMMEDIATELY AND, IF ANY ARE UNCOVERED, THERE ARE POLICIES IN PLACE TO ENSURE THAT THOSE INDIVIDUALS RECUSE THEMSELVES FROM PARTICIPATING IN ANY DECISION MAKING RELATED TO SUCH CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 CALVARY HOSPITAL, INC. UNDERTAKES A RIGOROUS PROCESS TO ENSURE THAT THE EXECUTIVE COMPENSATION IT PAYS TO ITS TOP MANAGEMENT OFFICIALS AND ALL OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION IS REASONABLE. IN RELEVANT PART, THE BOARD OF DIRECTORS HAS ESTABLISHED A COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT PERSONS THAT HAVE NO PERSONAL INTEREST IN THE PROPOSED COMPENSATION ARRANGEMENT. THE BOARD OF DIRECTORS USES AN INDEPENDENT COMPENSATION CONSULTANT TO HELP ADVISE ON THE APPROPRIATE COMPENSATION LEVELS FOR THE AFOREMENTIONED INDIVIDUALS. THAT COMPENSATION CONSULTANT WILL USE COMPARABILITY OR BENCHMARKLNG DATA (BASED ON INDUSTRY SURVEYS) THAT DOCUMENTS THE COMPENSATION OF PERSONS HOLDING SIMILAR PERSONS IN SIMILAR ORGANIZATIONS. THE HOSPITAL COMMISSIONED ITS MOST RECENT INDEPENDENT COMPENSATION STUDY IN FEBRUARY OF 2021. ONCE THE COMPENSATION CONSULTANT HAS MADE ITS RECOMMENDATIONS, THE CALVARY COMPENSATION COMMITTEE MUST APPROVE THE COMPENSATION, WITHOUT INPUT OR VOTING PARTICIPATION BY THE PERSON WHOSE COMPENSATION IS BEING APPROVED OR BY ANY OTHER INDIVIDUAL WITH A CONFLICT OF INTEREST. THE FINAL DETERMINATION IS THEN DOCUMENTED IN COMMITTEE MINUTES. THOSE MINUTES WILL CONTAIN THE TERMS OF THE PROPOSED COMPENSATION, THE DECISIONS OF THOSE INDIVIDUALS WHO VOTED ON THE COMPENSATION, AND THE COMPARABILITY DATA THAT WAS RELIED UPON. FORM 990, PART VI, SECTION C, LINE 19 CALVARY HOSPITAL MAKES ITS FORM 990 AVAILABLE TO THE PUBLIC BY RETAINING A COPY AT THE ADDRESS LISTED ON PAGE 1 OF THIS RETURN. ANY INDIVIDUAL REQUESTING A COPY OF THESE DOCUMENTS IS PROVIDED THAT COPY ON THE SAME BUSINESS DAY. THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST AND AT MANAGEMENT'S DISCRETION. IMPACT OF THE COVID-19 PANDEMIC: IN MARCH 2020, THE WORLD HEALTH ORGANIZATION DECLARED COVID-19, THE DISEASE CAUSED BY THE NOVEL CORONAVIRUS, A PANDEMIC, WHICH STARTED TO AND CONTINUES TO SPREAD THROUGHOUT THE UNITED STATES. AS A RESULT OF THE COVID-19 PANDEMIC, THE HOSPITAL EXPERIENCED A DECLINE IN PATIENT VISITS AND RELATED REVENUES. ADDITIONALLY, IN RESPONSE TO THE PANDEMIC, THE HOSPITAL INCURRED ADDITIONAL COSTS FOR TESTING, PERSONAL PROTECTIVE EQUIPMENT, THIRD-PARTY CONTRACT SERVICES AND OTHER OPERATING COSTS ASSOCIATED WITH ENSURING EMPLOYEE AND PATIENT SAFETY WHILE OPERATING DURING A PANDEMIC. THE HOSPITAL HAS RECENTLY SEEN INCREASES IN ITS PATIENT VISITS, HOWEVER, VOLUMES HAVE NOT RETURNED TO PRE-PANDEMIC LEVELS. MANAGEMENT IS ACTIVELY MONITORING OPERATING REVENUES AND EXPENSES AND BASED ON THE CONTINUING UNCERTAINTIES OF COVID-19, IS UNABLE TO DETERMINE IF IT WILL HAVE A MATERIAL IMPACT ON ITS OPERATIONS FOR THE YEAR ENDING DECEMBER 31, 2022. THE HOSPITAL RECEIVED GRANT PAYMENTS, WHICH ARE CONSIDERED NONEXCHANGE TRANSACTIONS, FROM THE FEDERAL GOVERNMENT DISTRIBUTED UNDER THE CORONAVIRUS AID, RECOVERY AND ECONOMIC SECURITY ("CARES") ACT IN THE AMOUNT OF $25,019,960. AT DECEMBER 31, 2021 AND 2020, $4,784,000 AND $20,235,690 WAS INCLUDED IN OTHER REVENUE IN THE STATEMENT OF OPERATIONS, RESPECTIVELY. THE CARES ACT PAYMENTS ARE SUBJECT TO AUDIT AND COMPLIANCE WITH FEDERAL REGULATIONS AND FUTURE GRANT PAYMENTS ARE UNCERTAIN AT THIS TIME. THE CARES ACT ALSO PROVIDED FOR AN EXPANSION OF THE MEDICARE ACCELERATED AND ADVANCE PAYMENT PROGRAM (MEDICARE ADVANCES) FOR PATIENT SERVICES. UNDER THE PROGRAM, THE HOSPITAL RECEIVED $9,202,800 IN APRIL 2020, AND AT DECEMBER 31, 2020 RECORDED THESE PAYMENTS IN ESTIMATED SETTLEMENTS DUE TO THIRD-PARTY PAYORS IN THE STATEMENT OF FINANCIAL POSITION. IN 2021, ALL MEDICARE PAYMENTS AND BI-WEEKLY PERIODIC INTERIM PAYMENTS WERE OFFSET BY 25%. AT DECEMBER 31, 2021, THIS AMOUNT HAS BEEN FULLY RECOUPED BY NATIONAL GOVERNMENT SERVICES, THE MEDICARE INTERMEDIARY AND THE BALANCE IS ZERO. FORM 990, PART XI, LINE 9: PENSION BENEFIT ADJUSTMENT DUE TO CHANGE IN ACTUARIAL VALUATION 8,835,000. RECLASS GRANTS TO AFFILIATE 4,406,000. CALVARY PALLIATIVE CARE NETWORK LLC 1740 EASTCHESTER ROAD BRONX NY 10461 HEALTHCARE NY 0 0 CHC CALVARY NETWORK INDEP PRACTICE ASSN 1740 EASTCHESTER ROAD BRONX NY 10461 HEALTHCARE NY 0 0 CPCN CALVARY NETWORK MANAGEMENT SERVICES LLC 1740 EASTCHESTER ROAD BRONX NY 10461 HEALTHCARE NY 0 0 CHC CALVARY FUND INC 1740 EASTCHESTER ROAD BRONX NY 10461 133259649 FUNDRAISING NY 501(C)(3) 12A CHC 0 CALVARY HOLDING COMPANY 1740 EASTCHESTER ROAD BRONX NY 10461 061531426 MANAGEMENT NY 501(C)(3) 12A ARCHCARE 0 ARCHCARE 155 EAST 56TH STREET FLOOR 2 NEW YORK NY 10022 133896624 MANAGEMENT NY 501(C)(3) 1 N/A 0 0 1 1 1 1 0 0 0 0 0 0 1 1 1 1 1 1 0 0 PART I, LINE 1 & 3, COLUMN (F): CHC - CALVARY HOLDING COMPANY PART I, LINE 2, COLUMN (F): CPCN - CALVARY PALLIATIVE CARE NETWORK, INC. PART II, LINE 2, COLUMN (F): CHCS - CATHOLIC HEALTH CARE SYSTEM