2020-11-09T15:05:41-06:00 2019-12-31 BDO USA LLP 100 PARK AVENUE NEW YORK NY 100175001 990 2019-01-01 111704595 BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER % B FARRELL VP/CFO BROO 6316547100 101 HOSPITAL ROAD PATCHOGUE NY 11772 BRENDA FARRELL CFO 6316547100 2020-10-30 true Kristin Ruffini P00741491 2128858000 71.249.96.48 26308920203145000018 2020-11-09 P 39C0125CC38244DCDF9016B1ED97A2DB16F09D4F 39C0125CC38244DCDF9016B1ED97A2DB16F09D4F 2019 2021-01-29 14:40:06Z LONG ISLAND COMMUNITY HOSPITAL R T MARGULIS CEO 101 HOSPITAL ROAD PATCHOGUE NY 11772 273055433 false X WWW.LICOMMUNITYHOSPITAL.ORG X 1947 NY TO DELIVER ACCESSIBLE HIGH-QUALITY HEALTH SERVICES IN A FOCUSED CARING AND TEACHING ENVIRONMENT WHILE PROVIDING HEALTH ADVOCACY FOR THE COMMUNITY AND PEOPLE WE SERVE. 24 18 2586 102 0 0 2596868 1744487 267827731 267567973 3192490 957758 3024149 2785215 276641238 273055433 0 0 0 0 168832287 170052658 0 0 23506 102446713 101415620 271279000 271468278 5362238 1587155 228133137 240864197 135939115 143837719 92194022 97026478 X TO DELIVER ACCESSIBLE HIGH-QUALITY HEALTH SERVICES IN A FOCUSED CARING AND TEACHING ENVIRONMENT WHILE PROVIDING HEALTH ADVOCACY FOR THE COMMUNITY AND PEOPLE WE SERVE. false false 140167868 0 152922766 INPATIENT CARE SERVICES - INCLUDES MEDICAL/SURGICAL PROCEDURES, ICU, CCU, ROUTINE AND PSYCHIATRIC CARE. TOTAL 2019 INPATIENT DAYS: 63,842 43687468 0 51631401 EMERGENCY ROOM SERVICES - AVAILABLE TO THE COMMUNITY 24 HOURS, 7 DAYS A WEEK. TOTAL 2019 TREAT AND RELEASE VISITS: 54,812 23941471 0 25220330 AMBULATORY SURGERY SERVICES - AVAILABLE TO THE COMMUNITY. TOTAL 2019 PROCEDURES: 6,224 46755492 0 40001451 254552299 true true false true false false false false false true true true false false true true true true false false false false false false false false true true false false true true false false false false false false false false true false false false false false false true false false false true 241 0 true 2586 true false false false false false false false false false false false false X 24 18 true false false false true true false true true false false true true true true true true true true true false NY X B FARRELL VPCFO 6316547175 101 HOSPITAL ROAD PATCHOGUE NY 11772 X R T MARGULIS PRESIDENT & CEO/DIRECTOR 40.0 0.5 X X 856629 0 55086 F SCONZO PHYSICIAN 40.0 0.0 X 726574 0 31375 B FARRELL VP FINANCE, CFO 39.5 0.5 X 474078 0 43986 W WEHBEH VP, CQMO 40.0 0.0 X 446091 0 27032 M HAGGAG PHYSICIAN 40.0 0.0 X 341000 0 29255 R GUPTA PHYSICIAN 40.0 0.0 X 302792 0 26244 M PEDDIE VP, CIO 40.0 0.0 X 294019 0 26196 D GRIMM VP, CNO 40.0 0.0 X 304280 0 9657 F DESORMEAUX MD PHYSICIAN 40.0 0.0 X 267010 0 28447 A PALLAS VP, COO 40.0 0.0 X 271511 0 3193 T DEKHYAR PHYSICIAN ASSISTANT 40.0 0.0 X 259814 0 11390 E KORMYLO DPM DIRECTOR 0.5 0.5 X 37000 0 0 M MULHOLLAND CHAIRMAN 0.5 0.5 X X 0 0 0 E P SMITH VICE CHAIRMAN 0.5 0.5 X X 0 0 0 P MOLONEY 2ND VICE CHAIRMAN 0.5 0.5 X X 0 0 0 F GRUCCI JR TREASURER 0.5 0.5 X X 0 0 0 M KNAPP SECRETARY 0.5 0.5 X X 0 0 0 R BERMAN MD DIRECTOR 0.5 0.5 X 0 0 0 F C BRAUN III DIRECTOR 0.5 0.5 X 0 0 0 G BROWN DIRECTOR 0.5 0.5 X 0 0 0 T CULLEN DIRECTOR 0.5 0.5 X 0 0 0 W LADICK DIRECTOR 0.5 0.5 X 0 0 0 J MAIORINO DIRECTOR 0.5 0.5 X 0 0 0 J MAYER DIRECTOR 0.5 0.5 X 0 0 0 M MENNELLA DIRECTOR 0.5 0.5 X 0 0 0 C PARKER DIRECTOR 0.5 0.5 X 0 0 0 S NORTON REMMER DIRECTOR 0.5 0.5 X 0 0 0 L ROSE DIRECTOR 0.5 0.5 X 0 0 0 C ROTHBERG FROM 012 PRESIDENT OF MEDICAL STAFF 0.5 0.5 X 0 0 0 E RUSSO DIRECTOR 0.5 0.5 X 0 0 0 K SCHWARTZ MD DIRECTOR 0.5 0.5 X 0 0 0 R W SCHWARZ DIRECTOR 0.5 0.5 X 0 0 0 J SULLIVAN DIRECTOR 0.5 0.5 X 0 0 0 S TAITZ DIRECTOR 0.5 0.5 X 0 0 0 4580798 0 291861 297 false true false SOUND PHYSICIANS OF NY PLLC 1498 PACIFIC AVENUE SUITE 400 TACOMA WA 98402 COLLECTION SERVICES 2777988 PROGRESSIVE EMERGENCY PHYSICIANS 1236 RXR PLAZA UNIONDALE NY 11556 MANAGEMENT SERVICES 1853799 AMITYVILLE PULMONOLOGY 317 BROADWAY SUITE A AMITYVILLE NY 11701 ON CALL PHYSICIANS 894992 ST CHARLES HOSPITAL 200 BELLE TERRE ROAD PORT JEFFERSON NY 11777 PHYSICAL THERAPY 830150 MEDICAL SOLUTIONS 1010 N 102ND STREET SUITE 300 OMAHA NE 68114 TEMPORARY STAFFING 751193 53 733362 62878 948247 1744487 NET PATIENT SERVICE REVENUE 624200 269483253 269483253 PROVISION FOR UNCOLLECTIBLES, NET 624200 -1915280 -1915280 267567973 944318 944318 0 0 150774 150774 0 150774 150774 13440 13440 13440 13440 0 0 0 0 0 0 0 0 0 PURCHASE DISCOUNTS AND VENDORS REBATES 900099 1124945 1124945 AMBULANCE SUPPLY REVENUE 900099 1083030 1083030 CAFETERIA INCOME 722514 263234 263234 163232 163232 2634441 273055433 269775948 1534998 0 0 0 0 2848758 2848758 523799 523799 119164823 113627666 5520124 17033 9669007 9141281 524884 2842 28436760 26859313 1575119 2328 9409511 8874289 533919 1303 4333380 4086893 246487 1706490 1706490 103500 103500 111582 111582 0 0 17741609 16750968 990641 845859 797746 48113 1073787 1012709 61078 405565 382496 23069 0 5749791 5422737 327054 54565 51461 3104 0 82332 77649 4683 2481879 2340707 141172 0 11629985 10968460 661525 3337830 3147971 189859 MEDICAL SUPPLIES 32397944 32397944 PROV FOR PRACTICE UNCOLLECT 6217812 6217812 REPAIRS AND MAINTENANCE 5161956 4868339 293617 OTHER SERVICES 3942868 3718594 224274 4036886 3807264 229622 271468278 254552299 16892473 23506 106943 6418697 17672168 25775260 0 0 38631545 33534024 0 0 0 0 0 0 4772120 5387457 1810167 1425266 310500223 172051186 134578926 138449037 0 0 21356363 23803045 0 0 49987 33319 9154918 6038092 228133137 240864197 49056398 49275719 0 0 0 0 44507030 42483828 0 0 0 0 424160 326314 0 0 41951527 51751858 135939115 143837719 X 85987230 90790739 6206792 6235739 92194022 97026478 228133137 240864197 X 1587155 356832 2888469 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 111582 111582 false false PART II-B, LINE 1I: LONG ISLAND COMMUNITY HOSPITAL PAYS DUES TO AMERICAN HOSPITAL ASSOCIATION (AHA), NASSAU-SUFFOLK HOSPITAL COUNCIL (NSHC), HEALTH CARE ASSOCIATION (HCA), AND HEALTHCARE ASSOCIATION OF NEW YORK STATE (HANYS). IN ACCORDANCE WITH CODE SECTION 6033(E) OF THE INTERNAL REVENUE CODE, AND AS REPORTED BY AHA, NSHC, HCA AND HANYS, A PORTION OF THESE DUES ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES. THE LOBBYING ACTIVITIES APPLICABLE TO 2019 WERE: AHA................$10,304 NSHC...............$ 3,492 HCA................$ 2,060 HANYS..............$11,726 During 2019 The Medical Center also paid Desmond Ryan $60,000 and MCB Consulting $24,000 for consulting services for political people and powers. 900000 100000 1000000 900000 900000 900000 900000 900000 900000 900000 900000 1.00000 false false 1531487 1531487 117357407 41937609 75419798 3282758 2291764 990994 176868344 123847950 53020394 11460227 3973863 7486364 138449037 INVESTMENTS IN LICH-HCS FOUND. 21803045 F INVESTMENTS IN GSB ENDOSCOPY 2000000 F 23803045 0 CAPITAL LEASE OBLIGATIONS 11041470 ACCRUED PENSION COSTS 10145236 ESTIMATED MALPRACTICE LIABILITY 23094649 CHANGE IN VALUATION OF SWAP 1983743 NET 3728118 ASBESTOS ABATEMENT 1758642 51751858 X 276300734 356832 2888469 3245301 273055433 273055433 271468278 271468278 271468278 PART V, LINES 1 AND 4: Long Island Community Hospital's endowment fund consists of a donor-restricted endowment fund that has been initially established by a donor in 1969 for various purposes and has been classified within net assets with donor restrictions. The organization is entitled to the income earned on the trust, as per the donor agreement, and is allowed to spend 5% of the prior three years total value, as mandated by a past court decision. PART X, LINE 2: Long Island Community Hospital has not taken an unsubstantiated tax position that would require provision of a liability under ASC 740, "Income Taxes." Under ASC 740, an organization must recognize the tax benefit associated with tax positions taken for tax return purposes when it is more likely than not that the position will be sustained. The organization does not believe there are any material uncertain tax positions and, accordingly, has not recognized any liability for unrecognized tax benefits. The organization has filed IRS Form 990, as required, and all other applicable returns in jurisdictions where it is required. For the year ended December 31, 2019, there were no interest or penalties recorded or included in the financial statements. The organization believes it is no longer subject to income tax examinations for the years prior to 2016, which is the statute of limitation look-back period. PART XI, LINE 2D: change in minimum pension liability.....................$1,027,114. change in net assets of LICH-HCS Foundation............$2,446,682. appropriation of temporary restricted net assets for operations..............................................$ (585,327.) Total...................................................$2,888,469. true true X true X true X 425. true true true false true true 8043 5942717 5942717 0.02190 28598 23541578 7736648 15804930 0.05820 36641 29484295 7736648 21747647 0.08010 297482 297482 0.00110 4196747 4196747 0.01550 4494229 4494229 0.01660 36641 33978524 7736648 26241876 0.09670 true 7669197 68137102 74532311 -6395209 X true true 12 1 BROOKHAVEN MEMORIAL HOSPITAL MED CTR 101 HOSPITAL ROAD EAST PATCHOGUE NY 11772 X A 2 HOME HEALTH CARE 103 WEST MAIN STREET PATCHOGUE NY 11772 X A 3 BROOKHAVEN MEMORIAL HOSP DIALYSIS CTR 109 WEST MAIN STREET PATCHOGUE NY 11772 X A 4 CTR FOR WOUND CARE & HYPERBARIC MEDIC 33 MEDFORD AVENUE PATCHOGUE NY 11772 X A 5 HOSPICE 105 WEST MAIN STREET PATCHOGUE NY 11772 X A 6 OUT PATIENT IMAGING 100 HOSPITAL ROAD PATCHOGUE NY 11772 X A 7 WOMEN'S IMAGING SERVICES CENTER 100 HOSPITAL ROAD PATCHOGUE NY 11772 X A 8 CARDIO REHABILITATION CENTER 100 HOSPITAL ROAD PATCHOGUE NY 11772 X A 9 BROOKHAVEN BELLPORT PRIMARY CARE CTR 515 BELLPORT AVENUE BELLPORT NY 11713 X A 10 CTR FOR WOUND CARE & HYPERBARIC MED 300 KENNEDY DRIVE HAUPPAUGE NY 11788 X A 11 OUTPATIENT CHEM DEPEND SRVCS EAST 550 MONTAUK HIGHWAY SHIRLEY NY 11967 X A 12 OUTPATIENT CHEM DEPEND SRVCS WEST 365 EAST MAIN STREET PATCHOGUE NY 11772 X A BROOKHAVEN MEMORIAL HOSPITAL MEDICAL false false true X X X X X X X X 19 true true true true X WWW.LICOMMUNITYHOSPITAL.ORG X true 19 true SEE PART V FOR URL false true X 200. 425. X X true true X X X true X WWW.LICOMMUNITYHOSPITAL.ORG X WWW.LICOMMUNITYHOSPITAL.ORG X WWW.LICOMMUNITYHOSPITAL.ORG X X X X X X true X false X X X X true X false false PART V, SECTION B, LINE 5: the hospital HAS ESTABLISHED A LEADERSHIP POSITION IN HEALTH PROMOTION, PREVENTION AND EDUCATION THROUGHOUT THE COMMUNITY. REGIONAL HEALTH PLANNING IS ACCOMPLISHED THROUGH A NUMBER OF AGENCY CONTACTS INCLUDING THE SUFFOLK COUNTY DEPARTMENT OF HEALTH, MENTAL HEALTH AGENCIES AND THE NEW YORK STATE DEPARTMENT OF HEALTH. IN ADDITION, THE HOSPITAL WORKS CLOSELY WITH THE SUFFOLK COUNTY POLICE DEPARTMENT. LONG ISLAND COMMUNITY HOSPITAL IS DEDICATED TO COMMUNICATING WITH KEY STAFF AND COMMUNITY MEMBERS, AS THE HOSPITAL PREPARES TO PLAN FOR THE FUTURE HEALTH CARE NEEDS OF THE PEOPLE WE SERVE. FOCUS GROUPS ARE HELD PERIODICALLY, WHICH INCLUDE MEETING WITH THE MEDICAL STAFF, MEMBERS OF THE BOARD OF DIRECTORS, COMMUNITY MEMBERS, THE WEST ISLIP BREAST CANCER COALITION, THE SOUTHAMPTON BREAST CANCER COALITION, HOSPITAL ADVISORY COUNCIL, WHO ARE THE VOICE OF THE COMMUNITY AND HOLD POSITIONS ON VARIOUS COMMUNITY BASED SERVICE GROUPS. THESE CONSTITUENTS HAVE THE ABILITY TO COLLECT INFORMATION FROM VARIED PERSPECTIVES. THE HOSPITAL'S ABILITY TO COLLECT INFORMATION FROM THESE GROUPS AND TRANSLATE THE DIALOG INTO A NEEDS ASSESSMENT IS A VALUABLE RESOURCE TO THE HOSPITAL AS WELL AS THE COMMUNITY. PART V, SECTION B, LINE 6A & 6B: In 2016, Long Island Community Hospital along with all Long Island Hospitals and both County Departments of Health on Long Island convened to work collaboratively on the community health needs assessment. Over time, this syndicate grew into an expansive membership of academic partners, community-based organizations, physicians and other community leaders who hold a vested interest in improving community health and supporting the NYS Department of Health Prevention Agenda. Designated The Long Island Health Collaborative, this multi-disciplinary entity has been meeting monthly to work collectively toward improving health outcomes for Long Islanders. The Long Island Health Collaborative was awarded the Population Health Improvement Program (PHIP) grant by the New York State Department of Health. The PHIP is a data-driven entity, pledged to pursue the New York State of Health's Prevention Agenda, making the program a natural driver for the Community Health Needs Assessment cycle. Data analysis efforts were coordinated through the Population Health Improvement Program, with the PHIP serving as the centralized data return and analysis hub. The Community Service Plan is available on the hospital's website at https://licommunityhospital.org/about-long-island-community-hospital/commu nity-service-plan/ PART V, SECTION B, LINE 7D: OUR COMMUNITY AGENCIES AND PARTNERS WILL ALSO DISTRIBUTE OUR COMMUNITY SERVICE PLAN TO THEIR PARTICIPANTS. PART V, SECTION B, LINE 10A: The Community Service Plan is available on the hospital's website at https://licommunityhospital.org/about-long-island-community-hospital/commu nity-service-plan/ PART V, SECTION B, LINE 11: The focus of LONG ISLAND COMMUNITY HOSPITAL's 2019 Community Service Plan is to deliver accessible, high quality health services in a focused caring and teaching environment while providing health advocacy for the community and people served. In 2019 these needs were addressed through various hospital initiatives and community events, including but not limited to: - THE HOSPITAL PARTICIPATED IN VARIOUS COMMUNITY HEALTH FAIRS INCLUDING: Live Well Play Well Medical Lecture Series Several free to the community lectures held throughout the year on topics such as: Nutrition, Diabetes, Bariatric Surgery, and Heart Health. - Coat Drive 2019 donated to Lighthouse Mission - Food Drive 2019 donated collected nonperishable food for the Lighthouse mission. - Salvation Army Angel Program- collected toys and clothing for the 59 children donated to the Salvation Army - National Day of Dance held in July at the Boys and Girls Club of Bellport promoted Heart Health through movement of dance. Collaborated with local dance companies and provided health education and health cooking demo. CPR & AED emergency training provided. - Community First Aid Emergency Training Night held at the Bayport Fire House open to community members and collaborated with Bayport Blue Point Chamber of commerce. Provided emergency training in CPR & AED, Stop the Bleed, stroke awareness, Bicycle helmet safety through the Patchogue Pilot club. - NY Blood Bank- Blood Drives Arranged and facilitated three at LI Community Hospital for 2019 - Brookhaven Senior Picnic Wellness Fair educational material provided - Retired Senior Volunteer Program Luncheon and Fair educational material - Sayville Summerfest B/P screening provided and educational material offered - Patchogue YMCA Wellness fair - Live Well Play Well -2019 Community Wellness Event at Patchogue YMCA - Patchogue Wellness Walk- participated with other health aligned facilities - Bellport National Night Out- B/P Screening and health education provided - Bellport Day Festival B/P screening and educational material provided - Patchogue St. Patricks Day parade LI Community Hospital Team participated - Patchogue New Village Fair-B/P screening provided along with educational material - Sayville Rotary -Veterans Luncheon- Donated to Veterans General Needs Program - Hosted Several Rotary, Chamber & Brookhaven Fire Place Literary Club Meetings at LI Community Hospital with demonstrations of Life saving CPR instruction - Brookhaven Senior Clubs- Several free presentations arranged offering classes such as: Life Saving CPR & AED instruction, Nutrition on a budget and Cooking demos. - TOPs senior weight watching club Diabetes and Cardiac focused cooking demos and lectures provided to the club members A)DIABETES PREVENTION PROGRAM is on going and included 9 classes a year are held and ongoing. The classes are American Diabetes Association recognized. It is an insurance based program and needs a physician referral. 10 hours of education time broken down as follows: 1 hour consult 8 hours classes: held 3 consecutive Tuesdays --- First 2 classes are 3 hours and last class is 2 hours 1 hour follow up 3-4 months after classes are done - Support group for Type 1 and Type 2 Diabetes - Lectures for Type 1 and type 2 Diabetes - Walking Club - Diabetes Prevention Program (sponsored by the SCDOH) B)BROOKHAVEN BREAST CANCER SURVIVORSHIP COALITION - PARTNERSHIP WITH MONDAY AND RACINES- A HAIR SALON IN ISLIP WHICH OFFERS FREE SERVICES TO WOMEN CURRENTLY UNDERGOING CANCER TREATMENT. PARTNERSHIP WITH "STRENGTH FOR LIFEEIGHT WEEK EXERCISE PROGRAM FOR FIGHTING CANCER. SUPPORT GROUP FOR PEOPLE DIAGNOSED, GOING THROUGH TREATMENT, AND SURVIVORSHIP. LECTURES: BREAST CANCER AWARENESS & STATE OF THE ART PROCEDURES, BREAST HEALTH & NATURAL MEDICINE, INTEGRATIVE HEALING THROUGH SOUND, COPING WITH LIFE LESSONS THROUGH MEDITATION. WOMEN'S SYMPOSIUM HELD WITH A PANEL OF PHYSICIANS was heled at the Mastic Beach Fire Department in October 2019. C)HIA TRADE SHOW PROVIDING WOUND CARE INFORMATION AND EDUCATION. D)LEARN TO BE TOBACCO FREE PROGRAM. E)VETERANS SUPPORT GROUP. F)ONGOING SBIRT (SCREENING, BRIEF INTERVENTION, AND REFERRAL TO TREATMENT) PROGRAM, AN EVIDENCE-BASED APPROACH TO IDENTIFYING PATIENTS WHO USE ALCOHOL AND OTHER DRUGS WHO ARE AT RISK FOR HEALTH CONSEQUENCES, ACCIDENTS OR INJURIES. THE GOAL IS TO SCREEN PATIENTS IN HOSPITAL EMERGENCY ROOMS AND OTHER MEDICAL FACILITIES IN ORDER TO PROVIDE OPPORTUNITY FOR EARLY INTERVENTION BEFORE MORE SERIOUS CONSEQUENCES OCCUR. G)LONG ISLAND COMMUNITY HOSPITAL PARTICIPATES IN DSRIP AND CONTINUES TO WORK ON AN 'OUTREACH' PLAN TARGETING EDUCATION AND PREVENTION FOR YOUTH IN THE SURROUNDING COMMUNITY. PART V, SECTION B, LINE 23: THE HOSPITAL WILL BILL ALL UNINSURED PATIENTS AT GROSS CHARGES. ALL UNINSURED PATIENTS ARE GIVEN THE OPPORTUNITY TO APPLY FOR FINANCIAL ASSISTANCE. PRIOR TO ANY EXTENUATING COLLECTION EFFORTS, PATIENTS WHO HAVE NOT APPLIED FOR FINANCIAL ASSISTANCE ARE SCREENED FOR PRESUMPTIVE CHARITY CARE. PART V, SECTION B, LINE 24: NO, ALL INDIVIDUALS DEEMED ELIGIBLE FOR THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM ARE BILLED AT MEDICARE PROSPECTIVE RATES. 10 HOME HEALTH CARE 103 WEST MAIN STREET PATCHOGUE NY 11772 OUTPATIENT BROOKHAVEN MEMORIAL HOSP DIALYSIS CTR 109 WEST MAIN STREET PATCHOGUE NY 11772 OUTPATIENT CENTER FOR WOUND CARE & HYPERBARIC MEDIC 33 MEDFORD AVENUE PATCHOGUE NY 11772 OUTPATIENT HOSPICE 105 WEST MAIN STREET PATCHOGUE NY 11772 HOSPICE OUT PATIENT IMAGING 100 HOSPITAL ROAD PATCHOGUE NY 11772 OUTPATIENT WOMEN'S IMAGING SERVICES CENTER 285 SILLS ROAD BUILDING 5-6 BELLPORT NY 11772 OUTPATIENT CARDIO REHABILITATION CENTER 100 HOSPITAL ROAD PATCHOGUE NY 11772 OUTPATIENT BROOKHAVEN BELLPORT PRIMARY CARE CTR 515 BELLPORT AVENUE BELLPORT NY 11713 OUTPATIENT CTR FOR WOUND CARE & HYPERBARIC MED 300 KENNEDY DRIVE HAUPPAUGE NY 11788 OUTPATIENT SCHOOL BASED HOSPITAL EXTEN CLINIC 350 MAPLE AVENUE BELLPORT NY 11713 OUTPATIENT PART I, LINE 3B: The percent of FPG used by LONG ISLAND COMMUNITY HOSPITAL to calculate discounted care starts at 201% (90% discount) and goes to 425% (10% discount). PART III, LINE 2: The explanation of the methodology used to estimate the provision for bad debts can be found in footnote (2) on page 13 and footnote 4 on pages 21 through 23 of the attached Audited financial statements. PART III, LINE 4: The text of the footnote that describe bad debt expense can be found on page 13 and footnote 4 on pages 21 through 23 of the attached Audited financial statements. PART III, LINE 8: 1) All of the shortfall on Part III, Line 7 Section B, Line 8 should be considered a community benefit. 2) Medicare allowable costs are calculated on the HCFA 2552 Medicare cost report worksheet E, Part A. PART III, LINE 9B: LONG ISLAND COMMUNITY HOSPITAL has a financial assistance policy. The hospital further maintains a collection policy to use outside professional collection agencies only as a last resort to settle delinquent patient accounts. The Hospital financial assistance policy is to provide care to uninsured/underinsured patients who meet certain criteria under the Hospital's Charity Care Policy without charge or at amounts less than current established rates. Patient eligibility for partial charity care is calculated based on a sliding fee scale of family income adjusted for the size of the family. The Hospital's Patient Financial Services Department makes a written determination of eligibility after reviewing applications and information submitted to support family income reported. Based upon income and family size, The Hospital may determine that patients may qualify for Medicaid benefits, and may first need to apply for Medicaid or Child Health Plus program for the uninsured before a determination will be made under our charity care policy. The Hospital's charity care policy is to provide free or discounted emergent and non-emergent necessary care for uninsured and underinsured patients residing in Suffolk and Nassau Counties, as well as emergentcare to patients residing in all other areas of New York State. If financial assistance is approved following the application process, a clear explanation of balance due and how the decision was derived is supplied. Monthly payment plans can be arranged, not to exceed 10% of the applicant's monthly gross income. If the applicant defaults on a financial agreement with the hospital, the account in question will be considered delinquent and may be referred to a collection agency/legal action. Applicant has the right to appeal the hospital's decision on eligibility of Charity Care within 30 days of notification of noneligibility. Part VI, Line 2: Needs Assessment In 2013, Long Island Community Hospital along with all Long Island Hospitals and both County Departments of Health on Long Island convened to work collaboratively on the community health needs assessment. Over time, this syndicate grew into an expansive membership of academic partners, community-based organizations, physicians and other community leaders who hold a vested interest in improving community health and supporting the NYS Department of Health Prevention Agenda. Designated The Long Island Health Collaborative, this multi-disciplinary entity has been meeting monthly to work collectively toward improving health outcomes for Long Islanders. The Long Island Health Collaborative was awarded the Population Health Improvement Program (PHIP) grant by the New York State Department of Health. The PHIP is a data-driven entity, pledged to pursue the New York State of Health's Prevention Agenda, making the program a natural driver for the Community Health Needs Assessment cycle. Data analysis efforts were coordinated through the Population Health Improvement Program, with the PHIP serving as the centralized data return and analysis hub. As directed by the data results, community partners selected Chronic Disease as the Priority Area with a focus on (1) Obesity and (2) Preventive Care and Management for the 2016-2018 cycle. The group also agreed that Mental Health should be highlighted as an area of overlay within all intervention strategies. This area, Mental Health, is being addressed through attestation and visible commitment to the DSRIP. There are four PPS Domain projects (4.a.i, 4.a.ii, 4.a.iii) aligned with addressing these issues. Priorities selected in 2016 remain unchanged from the 2016 selection; however, a stronger emphasis has been placed on the need to integrate Mental Health throughout Intervention Strategies. Mental health has been highlighted as a focus area of growing need, which will be addressed by the Nassau Queens Performing Provider System and Suffolk Care Collaborative, DSRIP Performing Provider Systems as they integrate Domain 4 projects. Primary data sources collected and analyzed include the Long Island Community Health Assessment Survey, Qualitative Data from Community-Based Organization Summit events and the LIHC Wellness survey. Secondary, publically-available data sets have been reviewed to determine change in health status and emerging issues within Suffolk County. Sources of secondary data include: Statewide Planning and Research Cooperative System (SPARCS), New York State Prevention Agenda dashboard, County Health Rankings, Behavioral Risk Factor Surveillance System (BRFSS), Extended Behavioral Risk Factor Surveillance System (eBRFSS) and New York State Vital Statistics. The broad community was engaged in assessment efforts through distribution and completion of the Prevention Agenda Community-Member Survey (Appendix). This tool was developed in consensus by community partners from the Long Island Health Collaborative and designed using the Prevention Agenda framework. Available in both online and hardcopy format, this survey was translated into certified Latin American-Spanish language. LIHC community partners have displayed an exemplary commitment to distributing and promoting the survey to a diverse-range of community members at a variety of locations. Distribution and promotion of this survey is occurring throughout a wide-range of social service locations including hospitals, doctor's offices, health departments, libraries, schools, insurance enrollment sites, community-based organizations and beyond. Long Island Health Collaborative member organizations are spearheading community engagement strategies by ensuring that their front-line service departments are handing surveys out to community members. In addition, Long Island Community Hospital promoted the survey through social media efforts, posted links on their website and distributed surveys at health Center, Community Outreach has long been a mainstay for LONG ISLAND COMMUNITY HOSPITAL. LICH's outreach program participates in community health fairs, with senior and community centers, as well as civic associations throughout the region. LONG ISLAND COMMUNITY HOSPITAL is also an active member of eight Chambers of Commerce in the community. Membership with these chambers affords LICH the opportunity to learn of the needs of the workforce and business leaders in the community. LI Community Hospital has a strong presence in the civic and service Clubs,(e.g. Kiwanis, Rotary Club, Lions,) houses of worship, the YMCA and Boys and Girls Club, local government health and social service programs, the social service agencies, senior living communities and public libraries. Through its Emergency Management program, LONG ISLAND COMMUNITY HOSPITAL communicates on a regular basis with the 28 voluntary EMS, EMT and Fire Departments in its service area. These volunteer departments provide an invaluable service to the community. As the 911 responders in the community, they are intimately familiar with the needs of the community. Through regular dialogue, Long Island Community Hospital learns of the unmet needs in the community and is able to assess its ability to meet those needs or provide connections to available services. To collect input from community members, and measure the community-perspective as to the biggest health issues in Suffolk County, the LIHC developed a regional survey called the Long Island Community Health Assessment Survey. This survey was distributed via survey monkey and hard copy formats. The survey was written with adherence to Culturally and Linguistically Appropriate Standards (CLAS). It was translated into certified Spanish language and large print copies were available to those living with vision impairment. Survey distribution began among LIHC members in January 2016, with 3,910 surveys collected from Suffolk County residents. Based upon the total population of Suffolk County, survey totals assume a confidence level of 95% and confidence interval of 1.57. Initial analysis took place in March 2016, a secondary analysis took place in June 2016, and a third analysis took place in November 2016. LIHC members have played an integral role in ensuring surveys are distributed while maintaining validity and reliability among responses. Long Island Community Health Assessment Surveys were distributed both by paper, and electronically through Survey Monkey, to community members. On March 21st 2016, June 2nd 2016, and November 1st 2016, the PHI P data analyst downloaded results from each of the Survey Monkey collectors. Data Findings by Survey Question: When asked what the biggest ongoing health concerns in the community where you live are: 1. Suffolk County respondents felt that Drugs and Alcohol Abuse, Cancer, and Obesity/Weight Loss were the top three concerns. These three choices represented roughly 46% of the total responses 2. When asked what the biggest ongoing health concerns for yourself are: Suffolk County respondents felt that Obesity/Weight Loss, Women's Health and Wellness, and Cancer were the top three concerns. These three choices represented roughly 40% of the total responses. Findings from Questions 1 and 2 of the Long Island Community Health Assessment Survey served as one data-driver for selection of the priority areas for the 2016-2018 Community Health Needs Assessments. An additional focus of this survey tool explored barriers to care, community needs and education or health services. The next question sought to identify potential barriers that people face when getting medical treatment: 3. Suffolk County respondents felt that No Insurance, Inability to pay co-pays or deductibles, and fear were the most significant barriers. These choices received roughly 55% of the total responses. 4. When asked what was most needed to improve the health of your community: Suffolk County respondents felt that Drug and Alcohol Rehabilitation Services, Healthier Food Choices, and Job Opportunities were most needed. These choices accounted for 40% of the total responses. 5. When asked what health screenings or education services are needed in your community: Suffolk County respondents felt that Drug and Alcohol, Mental Health/Depression, and Exercise/Physical Activity services were most needed. Summary of Findings: The Distinct and Cumulative Prevention Areas by ranking tables, displayed below, outline the New York State Prevention Agenda Priority Areas ranked in order from highest to lowest rate of marked significance of concern among participants. Summit participants reported Chronic Disease as the most significant health problem seen within the communities they serve in Suffolk County. In looking at distinct Prevention Agenda Categories, 30.9% of quotations indicated Chronic Disease being a priority area. Distinct Prevention Areas by Ranking reflects the number of quotations where the focus area is mentioned at least once and counted Part VI, Line 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE Financial Assistance signs are posted in both English and Spanish in Patient Financial Services, the Emergency Room, and OutPatient registration areas. Applications and Financial Assistance policy are part of the admission/discharge packets for uninsured patients, supplied in direct response to inquiries made to Patient Financial Service department, is referenced on bills sent to all self-pay patients/guarantors. Part VI, Line 4: COMMUNITY INFORMATION The community health assessment covers Suffolk County, New York. Suffolk County's service area is situated east of the Nassau County Border, extending through the eastern forks of Long Island. It comprises ten towns: Babylon, Huntington, Islip, Smithtown, Brookhaven, Southampton, Riverhead, East Hampton, Shelter Island and Southold. Suffolk County is an area of growing diversity, cultures and population characteristics. LONG ISLAND COMMUNITY HOSPITAL serves the needs of 28 towns and villages in Suffolk County. LI Community Hospitals primary and secondary service area census is 375,000 persons. It includes Brookhaven (one of the fastest growing towns in New York), and expands from west to east from Sayville to Moriches and north to Coram and Selden. Currently the highest number of hospital visits originate from the town of Patchogue, which is ethnically diverse and includes a high number of minorities. The individual median income that on average is 25 percent less than other Suffolk County residents. Census data notes an unemployment rate for the 28 communities of 6.73% with several areas over 10% including Brookhaven, West Sayville, and Mastic Beach. The poverty rate for our community is at 7.69% which is well above State and County averages with several communities with rates in excess of 10 percent including Bellport at 16.9%, Mastic Beach at 17.5%, Mastic at 13.2%, Patchogue at 12.4% and Yaphank at 11.1%. While the County has areas of wealth, the population served by the Medical Center contains 7 out of 10 communities with the lowest median income in Suffolk County. Approximately 102,000 individuals in Suffolk County live below the federal poverty level. With 28,800 living in our catchment area that approximates 28% of the total. Data presented within CHNA report demonstrates the existence of vast health disparities stemming from a wide range of socioeconomic factors. Our findings indicate the reality of the linkage of health disparities to a variety of social factors including race, ethnicity, gender, language, age, disabilities, and financial security among others. Elimination of such disparities is a priority throughout the Long Island region as bridging of gaps and services will ultimately improve health outcomes and quality of life for community members. As noted previously the socioeconomic environment of our catchment area shows unemployment and poverty rates well above the Long Island and Suffolk County averages. The Mastic beach area has an unemployment rate of 10.8%, Poverty rate of 17.5% and 17.8% of their residence are receiving cash public assistance and or food stamps. Bel!port is another community in need with unemployment at 6.1% but the poverty level is at 16.9% and Household assistance need is at 11.64%. The Brookhaven Bellport Primary Care Center was opened to support the needs of this community and we are working with community groups, the Boys and Girls Club as well as many area churches and organizations to publicize our presence. Plans are being developed to establish a similar facility in the Shirley/Mastic area. Source U.S. Census Bureau: State and County QuickFacts. Data derived from Population Estimates, American Community Survey, Census of Population and Housing, State and County Housing Unit Estimates, County Business Patterns, Non-employer Statistics, Economic Census, Survey of Business Owners, Building Permits. Part VI, Line 5: PROMOTION OF COMMUNITY HEALTH LONG ISLAND COMMUNITY HOSPITAL (LICH) is a voluntary, not-for-profit community hospital in Patchogue, Suffolk County, New York. Long Island Community Hospital has maintained a commitment to providing access to quality health care since its founding in 1956. Long Island Community Hospital has grown from a 100-bed hospital founded to meet the needs of the Village of Patchogue, to a Medical Center with an operating license for 306 beds that serves the lives of more than 375,000 people living in 28 different communities. The 2019-2021 Community Service Plan will provide an overview of the hospital, its cooperation with the Long Island Health Collaborative, Suffolk County Department of Health, Nassau Suffolk Hospital Council and the hospitals of Suffolk County to develop a systematic approach to developing plans for providing access to care for the community for the upcoming years. We provide care through a 306-bed acute-care hospital that's part of a multidisciplinary, multi-campus, state-of-the-art healthcare complex, designed to meet the evolving needs of the 28 Suffolk County communities we serve. LICH is in the process opening a state-of-the-art cardiac care center (Knapp Cardiac Care Center) that will further enhance the services and meet the needs of our community. While much has changed since we first opened our doors to the community in 1956, our patient-centered approach to healthcare remains as strong as ever. Today, we are home to some of the finest centers for specialized care along with a Level III Trauma Center/Emergency Room, two Community Behavioral/Chemical Dependency Health Centers in cooperation with Hudson River Health, and more. The Medical Center also was the first in the county to establish a Certified Home Health Care Department, a Hospice and an outpatient Hemodialysis unit and is a leader in health education throughout the community. LONG ISLAND COMMUNITY HOSPITAL was founded by a community focused Board of Directors and continues with more than 25 members from the community who serve on the governing Board. In addition, the hospital established an Advisory Council to receive further input to the needs of the community's residents. There are more than 30 members on the Advisory Council. Members are typically active in other areas of the community and including: civic leaders, members of the clergy, school representatives, public health advocates, business leaders and service club members. In 2013, Long Island Community Hospital along with all Long Island Hospitals and both County Departments of Health on Long Island convened to work collaboratively on the community health needs assessment. Over time, this syndicate grew into an expansive membership of academic partners, community-based organizations, physicians and other community leaders who hold a vested interest in improving community health and supporting the NYS Department of Health Prevention Agenda. Designated The Long Island Health Collaborative, this multi-disciplinary entity has been meeting monthly to work collectively toward improving health outcomes for Long Islanders. The Long Island Health Collaborative was awarded the Population Health Improvement Program (PHIP) grant by the New York State Department of Health. The PHIP is a data-driven entity, pledged to pursue the New York State of Health's Prevention Agenda, making the program a natural driver for the Community Health Needs Assessment cycle. Data analysis efforts were coordinated through the Population Health Improvement Program, with the PHIP serving as the centralized data return and analysis hub. As directed by the data results, community partners selected Chronic Disease as the Priority Area with a focus on (1) Obesity and (2) Preventive Care and Management for the 2016-2018 cycle. In 2019, members of the Long Island Health Collaborative reviewed extensive data sets selected from both primary and secondary data sources to identify and confirm Prevention Agenda priorities for the 2019-2021 Community Health Needs Assessment cycle. Data analysis efforts were coordinated through the Long Island Health Collaborative, which served as the centralized data return and analysis hub. As directed by the data results, community partners selected: 1. Prevent Chronic Disease Focus Area 4: Chronic Disease Preventive Care and Management 2. Promote Well-Being and Prevent Mental and Substance Use Disorders Focus Area 2: Mental and Substance Use Disorders Prevention The health disparity in which partners are focusing their efforts rests on the inequities experienced by those in low-income neighborhoods. As such, low-income one social determinant of health precludes members from low-income communities from accessing preventive and/or medical care due to their difficulty to afford co-payments/deductibles (if insured) or care at all if they are uninsured. Additionally, financially-stressed individuals have difficulty affording nutritious foods, leaving them more vulnerable to poorer chronic disease management outcomes, since nutrition and diet play a pivotal role in almost every chronic disease. Priorities selected in 2019 remain unchanged from the 2016 selection; however, for 2019, a specific priority regarding mental health and substance use was selected, as opposed to placing an overarching emphasis on these two issues as was done in the previous cycle. This is in response to the raging opioid crisis in both counties. New York State Department of Health statistics report that for 2016 in Suffolk County there were 344 deaths from any opioid, 129 heroin overdose deaths, and 192 deaths from synthetic opioids (other than methadone). There is also a surge in mental health issues and suicides, particularly among the youth population. Priorities selected in 2013 remain unchanged from the 2016 selection; however, a stronger emphasis has been placed on the need to integrate Mental Health throughout Intervention Strategies. Mental health has been highlighted as a focus area of growing need, which will be addressed by the Nassau Queens Performing Provider System and Suffolk Care Collaborative, DSRIP Performing Provider Systems as they integrate Domain 4 projects. Primary data sources collected and analyzed include the Long Island Community Health Assessment Survey, Qualitative Data from Community-Based Organization Summit events and the LIHC Wellness survey. Secondary, publically-available data sets have been reviewed to determine change in health status and emerging issues within Suffolk County. Sources of secondary data include: Statewide Planning and Research Cooperative System (SPARCS), New York State Prevention Agenda dashboard, County Health Rankings, Behavioral Risk Factor Surveillance System (BRFSS), Extended Behavioral Risk Factor Surveillance System (eBRFSS) and New York State Vital Statistics. The following entities will collaborate with LICH to assist with attainment of goals and objectives of the public health priorities: LICH - Diabetes Wellness Center: In partnership with The New York State Diabetes Prevention Program (NYS DPP), LICH hosts free education programs provided by the Suffolk County Department of Health Services. Pre-diabetes is a serious health condition that can lead to diabetes, heart disease, and stroke. Most people with pre-diabetes don't know that they have the condition. In 2006, LICH developed the Diabetes Wellness Center with the support of the Suffolk County Lions Diabetes Education Foundation sclionsdiabetes.org and Lions International. The Center has a Diabetes Self-Management Education Program and offers a series of educational programs "Living Well While Managing Your Diabetes" for those learning to manage with diabetes in their life. The classes are held at LI Community Hospital Diabetes Wellness Center located 109 W. Main Street, Patchogue, NY 11772. For more information please call 631.687.4188. Long Island Conmmunity Hospital - Bellport Primary Care Center: LICH has opened a primary care center in Bellport which is close to the main hospital. This primary care center has a strong focus on prevention and education, especially in the areas of diabetes, hypertension, tobacco cessation, obesity, mental health and substance abuse, women's health and cardiovascular education. Located in close proximity to the Bellport Primary Care Center is the Boys and Girls Club of Bellport Area facility. BPPC and the Club collaborate to provide better health and lifestyle choices for the residents of the community. Community-Based Patient Advisory Council: LICH realizes the tremendous value of having a community-based Patient Advisory Council (PAC). In 2014, LICH selected a diverse group of community members who can provide us information and feedback about the programs and services offered. LI Community Hospital Breast Cancer Survivorship Coalition: LICH recognizes the impact that Breast cancer can have on not just the patient but the family and is working with community members to support Part VI, Line 6: AFFILIATED HEALTH CARE SYSTEM Not applicable. X X X X false false false false false false false false false R T MARGULIS PRESIDENT & CEO/DIRECTOR 849922 0 0 0 6707 0 33096 0 21990 0 911715 0 0 0 B FARRELL VP FINANCE, CFO 470079 0 0 0 3999 0 24100 0 19886 0 518064 0 0 0 A PALLAS VP, COO 271511 0 0 0 0 0 1700 0 1493 0 274704 0 0 0 W WEHBEH VP, CQMO 446091 0 0 0 0 0 7300 0 19732 0 473123 0 0 0 F SCONZO PHYSICIAN 726574 0 0 0 0 0 10100 0 21275 0 757949 0 0 0 R GUPTA PHYSICIAN 302792 0 0 0 0 0 7300 0 18944 0 329036 0 0 0 D GRIMM VP, CNO 304280 0 0 0 0 0 7300 0 2357 0 313937 0 0 0 M PEDDIE VP, CIO 294019 0 0 0 0 0 7300 0 18896 0 320215 0 0 0 F DESORMEAUX MD PHYSICIAN 267010 0 0 0 0 0 9699 0 18748 0 295457 0 0 0 M HAGGAG PHYSICIAN 341000 0 0 0 0 0 10100 0 19155 0 370255 0 0 0 T DEKHYAR PHYSICIAN ASSISTANT 259814 0 0 0 0 0 9961 0 1429 0 271204 0 0 0 A TOWN OF BROOKHAVEN INDUSTRIAL DEVELOPMENT AGENCY 521299559 2006-12-21 20000000 REFINANCE SERIES 2000 BONDS false false false B TOWN OF BROOKHAVEN LOCAL DEVELOPMENT CORPORATION 272768182 2014-03-27 35000000 SEE PART VI false false false A 7625000 0 23290341 0 0 0 0 0 0 117836 23172505 0 2006 false true true true B 3917134 0 35029860 0 1931390 0 800451 0 0 19818920 12479100 0 2017 true false true true A false false false false 0 false false false true B false false false false 0 false false false true A false false true true true true Commerce Bank 23.9 true false false 0 false false B false false true true true false 0 false 0 false false A false B false PART I, LINE B, COLUMN (F): REFUND PRIOR LOANS AND CONSTRUCT AND RENOVATE FACILITIES. PART II, LINE 3: THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN(E) DUE TO INVESTMENT EARNINGS. PART IV, ARBITRAGE, COLUMN(A), LINE 2C: THE REBATE COMPUTATION WAS LAST PERFORMED ON 6/21/2007. AS NO REBATABLE ARBITRAGE WAS EARNED ON THE ADVANCE REFUNDING ESCROW AND THE DEBT SERVICE FUND WAS OPERATED ON A BONA FIDE BASIS, NO FURTHER REBATE ANALYSIS IS NECESSARY. PART IV, ARBITRAGE, COLUMN(B), LINE 2C: The rebate computation was last performed on 5/1/2017. Since the bond proceeds have been spent and the debt service fund was operated on a bona fide basis, no further rebate calculations are necessary. T CULLEN SEE PART V 21327 VENDOR false F GRUCCI III SEE PART V 202454 EMPLOYMENT false J DUDEK SEE PART V 183098 EMPLOYMENT false L B MCDOWELL SEE PART V 138247 EMPLOYMENT false PART IV: 1) T. CULLEN, DIRECTOR, IS OWNER & PRESIDENT OF CROWN ADVERTISING & MARKETING, INC. WHICH PROVIDED ADVERTISING SERVICES TO THE ORGANIZATION. 2) F. GRUCCI, III IS THE SON OF F. GRUCCI, JR. TREASURER. 3) J. DUDEK IS THE SISTER OF J. MAYER, DIRECTOR. 4) L. B. MCDOWELL IS THE DAUGHTER OF R. W. SCHWARZ, DIRECTOR. FORM 990, PART III, LINE 4D: 1) RENAL DIALYSIS - TOTAL VISITS: 32,795. TOTAL EXPENSES: $14,582,823. TOTAL REVENUE: $10,719,246. 2) HOME HEALTH AGENCY - PROVIDES CERTIFIED HOME HEALTH AND LONG TERM CARE TO THE COMMUNITY. TOTAL VISITS: 17,666. TOTAL EXPENSES: $5,523,540. TOTAL REVENUE: $2,982,474. 3) MENTAL HEALTH AND CHEMICAL DEPENDENCY OUTPATIENT CLINICS - TOTAL VISITS: 5,548. TOTAL EXPENSES: $2,429,721. TOTAL REVENUE: $511,011. 4) REFERRED AMBULATORY - SERVICES AVAILABLE TO THE COMMUNITY. TOTAL VISITS: 15,025. TOTAL EXPENSES: $2,113,318. TOTAL REVENUE: $3,736,876. 5) HOSPICE - TOTAL DAYS: 7,514. TOTAL EXPENSES: $1,875,705. TOTAL REVENUE: $1,583,191. 6) HOME PROGRAM DIALYSIS (CAPD) - TOTAL VISITS: 576. TOTAL EXPENSES: $575,792. TOTAL REVENUE: $365,686. 7) ALL OTHER CLINICS (WOUND CARE, HYPERBARIC, SLEEP, CARDIAC CATH, CARDIAC REHAB, PULMONARY REHAB, AND BELLPORT PRIMARY). TOTAL VISITS: 21,982. TOTAL EXPENSES: $19,654,593. TOTAL REVENUE: $20,102,967. FORM 990, PART VI, SECTION A, LINE 2: L. ROSE AND F. ROSE ARE BOARD MEMBERS AND HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINES 6 AND 7A: Long Island Community Hospital Health Care Services Foundation (Brookhaven Health Care Services Corporation) is the sole member of Long Island Community Hospital (Brookhaven Memorial Hospital Medical Center). Long Island Community Hospital Health Care Services Foundation elects the board of Long Island Community Hospital and appoints the President of Long Island Community Hospital. FORM 990, PART VI, SECTION B, LINE 11B: DRAFT FORM 990 WAS PROVIDED TO MANAGEMENT FROM BDO. A FINAL DRAFT WAS PRESENTED TO JOINT MEETING OF FINANCE AND AUDIT COMMITTEES FOR REVIEW, AND THEN PROVIDED TO ALL BOARD MEMBERS, VIA THE BOARD PORTAL, WITH AN OPPORTUNITY FOR THEM TO COMMENT OR MAKE INQUIRY BEFORE IT WAS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C: Members of the Board of Directors, Administrators, Department Heads and medical staff working for or on behalf of LONG ISLAND COMMUNITY HOSPITAL are required to complete and sign the Conflict of Interest Disclosure Statement annually and whenever new information or changes arise that may require different responses from those included in the previous Conflict of Interest Disclosure Statement. Individuals are required to notify the Compliance Officer when they believe changes in the responses may be necessary or when they believe a transaction may involve an actual or potential conflict of interest. The Hospital By-Laws require that anyone with an actual or potential conflict of interest immediately disclose this fact to the Board of Directors or to a designated board committee for their review and evaluation. Further, the by-laws prohibit any individual or entity deemed to have an actual or potential conflict of interest from participating in any evaluation or decision making process regarding products or services provided by or through that individual or entity or from using this relationship to obtain goods or services on terms that are not available to individuals who are not affiliated with the hospital. The Board of Directors is responsible for enforcement of the aforementioned policy and report any conduct that it believes in good faith to be a violation of the Conflict of Interest Policy. FORM 990, PART VI, SECTION B, LINES 15A AND 15B: The Executive Compensation Committee is comprised of the Chief Executive Officer, the Chairperson of the Board of Directors and selected Members of the Board of Directors. An Executive Compensation Consultant is invited to present data and trends to this Committee for their review and evaluation of the current salaries and fringe benefits of the CEO and other officers and key employees of LICH as compared to otherorganizations. In setting compensation levels for each executive, the Committee compares each base salary and total cash compensation level to market comparison data (based on healthcare systems with comparably sized operational budgets), organizational success against predetermined objectives, and individual performance against predetermined operational goals, as well as the data provided by the Consultant. The CEO, will be excused from the meeting of the Executive Compensation Committee, for a review of the CEO's compensation. Again, the Committee will use Industry Standards from comparably sized operational budgets, organizational success against predetermined objectives, and individual performance against predetermined operational goals, to establish the CEO's compensation. The Executive Compensation Committee will make recommendations for all compensation. The information is presented to the Overall LONG ISLAND COMMUNITY HOSPITAL Board, subject to ratification of the Board of Directors. FORM 990, PART VI, SECTION C, LINE 19: UPON REQUEST, THE ORGANIZATION WILL MAKE AVAILABLE ONLY THOSE DOCUMENTS REQUIRED TO BE DISCLOSED UNDER THE PUBLIC INSPECTION LAWS. FORM 990, PART XI, LINE 9: change in minimum pension liability.....................$1,027,114. changes in net assets of LICH-HCS Foundation............$2,446,682. appropriation of temporary restricted net assets for operations..............................................$ (585,327.) Total...................................................$2,888,469. BROOKHAVEN HEALTH CARE SERVICES CORP 101 HOSPITAL ROAD PATCHOGUE NY 11772 112950196 SUPPORT NY 501(c)(3) 7 false Brookhaven Physician Services 100 HOSPITAL ROAD PATCHOGUE NY 11772 260628913 PHYSICIAN OFFICE NY NA C 0 0 0.00000 false Brookhaven Surgical Services PC 100 Hospital ROAD Patchogue NY 11772 260885844 PHYSICIAN OFFICE NY NA C 0 0 0.00000 false LI Orthopedic & Spine Specialist PC 100 Hospital ROAD patchogue NY 11772 274670754 PHYSICIAN OFFICE NY NA C 0 0 0.00000 false false false true true true false false false false true false false true true true false true false false