2019-11-14T15:43:55-06:00 2018-12-31 990 2018-01-01 141338467 NORTHERN DUTCHESS HOSPITAL % ROBERT FRIEDBERG PRESIDENT NORT 8454759500 PO BOX 5112 RHINEBECK NY 12572 ROBERT FRIEDBERG PRESIDENT 8454759500 2019-11-14 64.72.65.146 14417020193185000004 2019-11-14 P 240A1E5F0EC940BDBCF5BA8D2EEA68CDC626CD36 73568967A6026A6DA95E58AA80AE98ECD706EE6E 2018 2020-03-31 21:24:44Z DENISE GEORGE PRESIDENT PO BOX 5112 RHINEBECK NY 12572 143142202 false X WWW.HEALTHQUEST.ORG X 1924 NY TO PROVIDE COMPREHENSIVE PRIMARY HEALTH CARE SERVICES 14 12 833 150 103723 -103131 619076 1665979 128573348 138173083 1050430 1396777 1733633 1906363 131976487 143142202 32550 34875 0 0 48685182 51993463 0 0 0 60824485 67119125 109542217 119147463 22434270 23994739 174976095 190058711 67429450 70805108 107546645 119253603 THE MISSION STATEMENT OF THE HEALTH QUEST SYSTEM AND ITS AFFILIATED ORGANIZATIONS IS TO DELIVER EXCEPTIONAL HEALTHCARE TO THE COMMUNITIES WE SERVE BY PURSUING THE HIGHEST STANDARDS OF QUALITY, SAFETY, SERVICE AND COMPASSION. false false 50774883 73243865 INPATIENT SERVICES: PATIENTS ADMITTED FOR ACUTE CARE - NUMBER OF PATIENTS 6,194; NUMBER OF PATIENT DAYS 22,967 THE HOSPITAL PROVIDED APPROXIMATELY $367,369 IN UNCOMPENSATED CARE (AT COST) TO THE REGIONS UN-INSURED AND UNDER-INSURED POPULATION 44612143 34875 64353979 OUTPATIENT SERVICES: EMERGENCY VISITS 20,858; AMBULATORY SURGERY VISITS 2,351 ALL OTHER VISTIS/PROCEDURES 144,378 THE HOSPITAL PROVIDED APPROXIMATELY $773,769 IN UNCOMPENSATED CARE (AT COST) TO THE REGIONS UN-INSURED AND UNDER-INSURED POPULATION 398773 575239 AFFILIATE RENTAL INCOME 95785799 true true false true false false false false true true false false true true false false true false false false false false false false false true true false false true true false false false false false false false false false false false false false false false true false false false true 0 0 833 true true true false false false false false false false false false false false false false false X 14 12 false false false false true true true true true false true true true true true true true true true true false NY X ROBERT FRIEDBERG PRESIDENT 8454759500 1351 ROUTE 55 SUITE 200 LAGRANGEVILLE NY 12540 LEWIS RUGE TRUSTEE 1.0 0.0 X 0 0 0 EVAN MELTZER IMMEDIATE PAST CHAIR 1.0 0.0 X 0 0 0 WILLIAM CARROLL TRUSTEE 1.0 0.0 X 0 0 0 JOHN HORISZNY MD TRUSTEE & HQMP PHYSICIAN 1.0 40.0 X 0 478169 44757 KEVIN M SHEEHAN CHAIR 1.0 0.0 X 0 0 0 FRANCIS FLYNN FIRST VICE CHAIR 1.0 0.0 X 0 0 0 EDWARD PRUITT TRUSTEE 1.0 0.0 X 0 0 0 CHRISTY CARIDI PHD TRUSTEE 1.0 0.0 X 0 0 0 KAREN GIEK SECRETARY/TREASURER 1.0 0.0 X 0 0 0 DOUGLAS HART DVM TRUSTEE 1.0 0.0 X 0 0 0 KELLY MOSHER SECOND VICE CHAIR 1.0 0.0 X 0 0 0 JAMES WING MD TRUSTEE 1.0 0.0 X 0 0 0 JAMES SCADUTO MD PRES MED STAFF, HQMP PHYSICIAN 1.0 40.0 X 0 453956 44758 DENISE GEORGE NDH PRESIDENT 0.0 40.0 X 0 622184 39494 KATHERINE BACHER HQ SVP & CFO/ASST TREASURER 0.0 40.0 X 0 641026 57938 MICHAEL HOLZHUETER GEN COUNSEL/ASST. SECRETARY 0.0 40.0 X 0 956997 95358 CHERYL BOOTH ASSISTANT SECRETARY 0.0 40.0 X 0 121070 10394 JOHN SABIA MD VP MEDICAL AFFAIRS - NDH 40.0 0.0 X 493218 0 37607 CONNIE REGAN PHARMACY CLINICAL COORDINATOR 40.0 0.0 X 210667 0 35763 PAUL KING DIRECTOR OF DIAGNOSTIC SVCS 40.0 0.0 X 183588 0 7060 PAMELA RHODES CNO/VP PATIENT CARE SVCS 40.0 0.0 X 275663 0 18555 TIMOTHY GOVEL PHARMACIST 40.0 0.0 X 162669 0 33065 CATHERINE LEONARD DIRECTOR THERAPY SERVICES 40.0 0.0 X 163595 0 31257 JOHN L MCGUINNESS FORMER HQ CEO 0.0 8.0 X 0 350004 0 1489400 3623406 456006 6 true true false 0 198767 1467212 1665979 NET INPATIENT REVENUE 900099 73243865 73243865 NET OUTPATIENT REVENUE 900099 64353979 64353979 AFFILIATE RENTAL INCOME 900099 575239 575239 0 138173083 1379273 1379273 0 0 297673 297673 0 297673 297673 17504 17504 0 0 0 0 0 0 0 0 0 QUALITY INCENTIVE PROGRAM 900099 424567 424567 REBATES & REFUNDS 900099 203501 203501 CAFETERIA REVENUE 900099 560224 560224 420398 316675 103723 1608690 143142202 139678050 103723 1694450 34875 34875 0 0 0 0 0 0 493218 443896 49322 0 0 0 0 0 39654527 35717294 3937233 0 1416947 1276248 140699 0 7432729 6694681 738048 0 2996042 2698544 297498 0 0 0 0 0 0 0 0 0 0 0 0 0 5700 0 5700 0 0 0 0 0 0 0 152045 127863 24182 0 0 0 0 0 3166724 2093989 1072735 0 166165 161981 4184 0 0 0 0 0 1804688 1572136 232552 0 36129 26612 9517 0 0 0 0 0 40172 34214 5958 0 2011138 1751983 259155 0 0 0 0 0 6427880 5599585 828295 0 1225374 1067473 157901 0 MEDICAL SUPPLIES 22287000 22287000 0 0 PURCHASED SERVICES 20637758 6273377 14364381 0 PHYSICIAN FEES 6040882 6040882 0 0 MAINTENANCE AND SVC CONTRACTS 1932416 1159104 773312 0 1185054 724062 460992 119147463 95785799 23361664 0 36007219 37716283 0 0 0 0 17763927 24331227 0 0 0 0 0 0 1607737 1727243 1112461 1174113 159913961 82960979 77588115 76952982 19030715 18005454 0 0 0 0 0 0 21865921 30151409 174976095 190058711 9799306 10761209 0 0 0 0 44487575 44157530 0 0 0 0 3 0 0 0 13142566 15886369 67429450 70805108 X 99798978 112542868 6252263 5215331 1495404 1495404 107546645 119253603 174976095 190058711 X 23994739 -2368016 -9919765 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true 2850 true 2850 false 5700 false SCHEDULE C PART II-B LINE 1J - LOBBYING EXPENDITURES A PORTION OF THE NORMET MEMBERSHIP PAID BY NORTHERN DUTCHESS HOSPITAL, WAS USED FOR LOBBYING EXPENDITURES ON BEHALF OF THE HOSPITAL INDUSTRY. LOBBYING EXPENDITURES ON BEHALF OF THE HOSPITAL INDUSTRY. 1495404 1495404 1495404 1495404 1495404 1495404 1495404 1495404 1495404 1495404 1.00000 false false 405162 405162 94417238 31971250 62445988 60936991 49764005 11172986 4154571 1225725 2928846 76952982 DUE FROM AFFILIATES 15979344 RETIREMENT INVESTMENTS 138423 MISC RECEIVABLES 705585 ESTIMATED THIRD PARTY ADJMNTS 379349 INTEREST IN NDH FOUNDATION LT 5028849 DUE FROM AFFILIATE LT 6702753 DSRF 2014 CONSTRUCTION FUND 274 DSRF 2014 CAP INTEREST 41 DSRF 2016A BOND INTEREST 135032 DSRF 2016A BOND PRINCIPAL 35947 DSRF 2014 INTEREST 1045812 30151409 0 RETIREMENT INVESTMENTS 139115 FIN 47 LIABILITY 1679851 RETRO PAYABLE TO 3RD PARTY PAY 3611088 DUE TO AFFILIATES 3366301 DUE TO HQ L/T 394767 MED MALPRACTICE INSURANCE LIAB 6695247 15886369 SCHEDULE D PART V LINE 4 - ENDOWMENT FUNDS THE ORIGINAL CONTRIBUTION IS BEING HELD FOR THE BENEFIT OF THE HOSPITAL. true true X true X true X true true false true true 2032360 1023941 1008419 0.00850 16045300 10752976 5292324 0.04440 18077660 11776917 6300743 0.05290 19 3953 33293 33293 0.00030 19 3953 33293 33293 0.00030 19 3953 18110953 11776917 6334036 0.05320 true 2562878 52462832 55055165 -2592333 X true true 1 1 NORTHERN DUTCHESS HOSPITAL 6511 SPRINGBROOK AVENUE RHINEBECK NY 12572 WWW.HEALTHQUEST.ORG X X X NORTHERN DUTCHESS HOSPITAL 1 false false true X X X X X X X X X 16 true true true true X WWW.HEALTHQUEST.ORG/COMMUNITY X X true 17 true WWW.HEALTHQUEST.ORG/COMMUNITY false true X 200. 300. true true X X X true X WWW.HEALTHQUEST.ORG X WWW.HEALTHQUEST.ORG X WWW.HEALTHQUEST.ORG X X X X X X true X false X X X X true X false false PART V, SECTION B, LINE 5 Dutchess County embraces an inclusive and collaborative process for community planning. The Dutchess County Department of Behavioral & Community Health partnered with Health Quest, Mid-Hudson Regional Hospital and local health practices to conduct a community health improvement stakeholder forum on October 18, 2016. Nearly one hundred representatives from healthcare agencies, behavioral health services, county agencies, and community organizations took part in the event to discuss community health priorities and review CHIP strategies. Agency and organizational partners also participate in ongoing dialogue through active workgroups and coalitions like the Dutchess County Chronic Disease Coalition, the Dutchess County Substance Abuse Workgroup, Dutchess County Tick Task Force, and Hudson Valley Region Population Health Improvement Program. PART V, SECTION B, LINE 6A The NDH CHNA was conducted in conjunction with Vassar Brothers Medical Center and Mid-Hudson Regional Medical Center. PART V, SECTION B, LINE 6B The NDH CHNA was conducted with the Dutchess County Department of Behavioral & Community Health. PART V, SECTION B, LINE 7D The CHNA was also printed and distributed throughout the hospital, including the main lobby, patient waiting areas and hospital administration offices. It is also available by request in the Health Quest administrative offices. PART V, SECTION B, LINE 11 The Dutchess County Department of Behavioral & Community Health confirmed the following Prevention Agenda priorities and disparity focus areas for the 2016-2018 period: . Prevent Chronic Disease . Promote Mental Health & Prevent Substance Abuse . Promote a Safe & Healthy Environment (Reduce burden of tick-borne disease) Based on these priorities, Vassar Brothers Medical Center and Northern Dutchess Hospital's Community Health Needs Committees identified the following two priorities for their NYS Community Service Plan: 1. Prevent Chronic Diseases 2. Promote a Healthy and Safe Environment (Reduce Fall Risks Among Vulnerable Populations) County Priorities Not Formally Addressed 1. Reduce Tick and Insect-Related Diseases - While we did not select this as a priority this year, it was a priority for both VBMC and NDH in our prior Community Service Plan (2013-2016). We will continue to support this initiative through our ongoing partnership with the Dutchess County Department of Behavioral and Community Health. Health Quest representatives sit on the tick-borne disease prevention workgroup hosted by the Dutchess County Department of Behavioral and Community Health. Health Quest also continues to educate the community about tick- and insect-related diseases through social media campaigns, the financial support of tick removal kits that are distributed at no cost to the public at various outreach events, and public educational lectures by clinical providers on our medical staff. 2. Prevent Substance Abuse - While this issue was undoubtedly of great importance to our committees, VBMC and NDH elected not to address this with a formal initiative at this time because we do not have licensed substance abuse beds. Mid-Hudson Regional Hospital of Westchester Medical Center has licensed behavioral and substance abuse beds and provides services to Dutchess County residents. The hospitals continuously look for ways to support the County with this initiative, such as providing space for training, providing physician speakers to lecture about substance abuse preventive measures, and hosting medication take-back days. PART V, SECTION B, LINE 9 The hospitals conducted their most recent CHNA, in conjunction with their County Health Department, in tax year 2016. The implementation strategies were approved and adopted by the Hospital Boards in 2016, and were implemented in calendar year 2017. PART I, LINE 7 THE COST TO CHARGE RATIO PERCENTAGE, BASED ON THE MEDICARE COST REPORT, WAS USED AS THE COSTING METHODOLOGY IN DETERMINING THE AMOUNTS REPORTED. PART III, SECTION A, LINE 2, 3 AND 4 LINE 2 - NDH FOLLOWS GENERALLY ACCEPTED ACCOUNTING PRINCIPLES IN ITS RECOGNITION OF BAD DEBT EXPENSE. PATIENT ACCOUNT BALANCES WERE ONLY CONSIDERED FOR BAD DEBT AFTER APPLYING ALL CONTRACTUAL DISCOUNTS AND PAYMENTS, AND SCREENING FOR CHARITY ELIGIBILITY. LINE 3 - NDH DOES RECOGNIZE THAT THERE WAS SOME BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO WERE ELIGIBLE UNDER THE ORGANIZATION'S CHARITY POLICY. WE DID NOT HAVE A REASONABLE BASIS FOR ESTIMATING THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY. PATIENTS WHO WERE ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY WERE ACCOUNTED FOR UNDER CHARITY CARE RATHER THAN BAD DEBT. LINE 4 - FOOTNOTE ON AUDITED FINANCIALS - THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE CAN BE FOUND ON PAGE 18 OF THE HEALTH QUEST SYSTEMS CONSOLIDATED AUDITED FINANCIAL STATEMENTS. FEDERAL AND STATE LAW REQUIRES THAT HOSPITALS PROVIDE EMERGENCY SERVICES REGARDLESS OF A PATIENT'S ABILITY TO PAY. UNINSURED PATIENTS SEEN IN THE EMERGENCY DEPARTMENT, INCLUDING PATIENTS SUBSEQUENTLY ADMITTED FOR INPATIENT SERVICES, OFTEN DO NOT PROVIDE INFORMATION NECESSARY TO ALLOW THE COMPANY TO QUALIFY SUCH PATIENTS FOR CHARITY CARE. UNCOLLECTIBLE AMOUNTS DUE FROM SUCH UNINSURED PATIENTS REPRESENT THE SUBSTANTIAL PORTION OF THE PROVISION FOR BAD DEBTS REFLECTED IN THE ACCOMPANYING CONSOLIDATED STATEMENTS OF OPERATIONS. PART III, SECTION B, LINE 8 THE MEDICARE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT BECAUSE THE ORGANIZATION IS RELIEVING A GOVERNMENT BURDEN BY PROVIDING CARE IN EXCESS OF THE COMPANY'S COSTS FOR THE PATIENTS IN THE COMMUNITY. THE COSTING METHODOLOGY USED TO CALCULATE THE SHORTFALL WAS THE COST TO CHARGE RATIO FROM THE MEDICARE COST REPORT. PART III, SECTION C, LINE 9B BEFORE A DELINQUENT ACCOUNT WAS REFERRED TO A COLLECTION AGENCY, THE ACCOUNT WAS REVIEWED TO DETERMINE WHETHER THE PATIENT QUALIFIED FOR CHARITY CARE, OR FINANCIAL ASSISTANCE UNDER OUR CHARITY CARE POLICY. IF IT WAS DETERMINED THAT THE PATIENT WAS ELIGIBLE FOR CHARITY CARE, OR FINANCIAL ASSISTANCE, THE ACCOUNT WAS ADJUSTED TO CHARITY, AND WAS NOT PURSUED WITH A COLLECTION AGENCY. IF A PATIENT APPEALLED THE DETERMINATION, THE ACCOUNT WAS NOT REFERRED TO A COLLECTION AGENCY UNTIL A FINAL DETERMINATION HAD BEEN MADE WITH RESPECT TO THE APPEAL. PATIENTS STILL HAD THE OPPORTUNITY TO APPLY FOR A DISCOUNT UNDER THE CHARITY CARE POLICY EVEN AFTER THE ACCOUNT HAD BEEN SENT TO A COLLECTION AGENCY. PART VI LINE 2 NEEDS ASSESSMENT In addition to the CHNAs conducted every three years, the hospital has a Community Health Needs Committee that meets regularly to access any additional health care needs in the community. The committee provides oversight to the hospital's community health priorities, including needs assessments, community health improvement plans and other population health initiatives. They help guide priority issues for action to improve community health and help inform, guide and share successful programs and strategies that address health and wellness throughout the community. PART VI LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE We have a Health Quest wide financial assistance policies and procedures that has been in place at each hospital. The HQ Financial Assistance policy/worksheet is displayed on the back of each patient statement, there are financial assistance posters hanging within the registration areas, and the HQ Financial Assistance policy is displayed on the HQ website. In addition, the financial counselors, at each hospital, attempt to contact each self-pay patient to screen the patient for Financial Assistance and make the patient aware of their options. The folder given to each patient in the ED contains literature about the financial assistance policy. Our customer service reps are all educated on the Financial Assistance policy and explain this to the patients if they ask. PART IV LINE 4 COMMUNITY INFORMATION Northern Dutchess Hospital's service area includes Dutchess County from Hyde Park north. It also includes several adjacent zip codes in Ulster County and some of the southernmost towns in Columbia County to the north. Individuals who live in the area served by Northern Dutchess Hospital are aging - the highest growth is projected for individuals 65 years and older. Individuals between the ages of 0 years and 24 years are projected to decrease, whereas individuals between the ages of 55 years and 64 years as well as individuals age 65 years and older are projected to increase. The majority of individuals served by Northern Dutchess Hospital are white non-Hispanic (81.3%), which is higher than that of individuals across the United States (60.8%). Hispanic individuals make up 8% of the served population. PART IV LINE 5 PROMOTION OF COMMUNITY HEALTH NDH is a 68-bed community hospital. Its board of trustees is composed of prominent citizens who live and work in the community. Medical staff privileges in the hospital are available to all qualified physicians in the area, consistent with the size and nature of the facility. NDH currently rents space in its hospital to physicians. NDH opened a medical office building with additional space for doctors in early 2016. Any member of its active medical staff has the privilege of leasing available office space. Rent is derived from a fair market value analysis provided by an independent party. The hospital operates a 24 hour emergency room where no one requiring medical attention is denied care. Any income over expenses is reinvested into the hospital, its staff and the community. NDH realizes this is necessary to achieve and maintain high quality standards, keep up with the rapid advancement in technology, provide start-up capital for new programs, and expand existing facilities and programs in order to provide quality care to the community. The new Northern Dutchess Hospital Martin and Toni Sosnoff patient pavilion, which opened in February 2016, has turned a 111-year old hospital into a modern medical facility. The 87,000 square foot pavilion advances the clinical care available to local residents. From the spacious, private rooms to the state-of-the-art surgical suites equipped with minimally invasive technology, patients and their families no longer need to travel outside of the area for advanced medical care. With the new patient pavilion, Northern Dutchess Hospital has created a healing environment where modern medicine meets compassionate care. PART VI LINE 6 AFFILIATE HEALTH CARE SYSTEM Health Quest is a nonprofit organization dedicated to the wellbeing of the communities it serves. Health Quest was formed through an affiliation of three local hospitals: Northern Dutchess Hospital (Rhinebeck, NY), Putnam Hospital Center (Carmel, NY) and Vassar Brothers Medical Center (Poughkeepsie, NY). In 2017, Sharon Hospital (Sharon, CT) joined Health Quest. In addition to these hospitals, Health Quest also counts among its many partners a residential skilled nursing facility, a free-standing radiation oncology center, urgent care centers, a multi-specialty medical practice including the Hudson Valley's largest cardiology practice, and a home care service. Together, they provide the healthcare needs of the entire Hudson Valley and northwest Connecticut region. Representatives from Health Quest's hospitals meet on a regular basis with community agencies and stakeholders. Each hospital has a board comprised of staff and community members who oversee the Community Health Needs Committee. Each committee oversees the development of community health needs assessments and health improvement plans. Health Quest participates in many community-based health fairs and events throughout the year. Hospital staff provides information on a variety of health topics including heart health, stroke prevention, diabetes prevention, nutrition, tobacco cessation, and injury prevention. A cardiologist within the Health Quest system participated in the American Heart Association's Go Red for Women Luncheon Health Expo to discuss the latest blood pressure guidelines and best practices to maintain a healthy cardiovascular system. The health system was also present at New York State Senator Sue Serino's Golden Gathering where two neurologists with the Movements Disorders Program at Vassar Brothers Medical Center informed the public about cutting-edge medical and surgical options for patients with Parkinson's disease, Huntington's disease, Tourette syndrome, essential tremors and more. Throughout the year, Health Quest actively sponsors a number of health-related fundraisers for other nonprofit organizations, including regional chapters of the American Heart Association, American Cancer Society and Alzheimer's Association. In addition, there are numerous local organizations Health Quest supports both monetarily and with employee engagement. Employees are active members of their communities and are happy to volunteer and serve on the local boards of various agencies, in addition to performing public benefit outreach initiatives on behalf of Health Quest. One such organization is Sparrow's Nest, a 501(c)(3) charity that provides meals free of charge to families who recently learned about a loved one's cancer diagnosis. Health Quest not only provides Sparrow's Nest with a monetary sponsorship each year, but provides the organization with employee volunteers who visit the Sparrow's Nest facility to produce meals for the families who are Sparrow's Nest's beneficiaries. In 2014, Health Quest launched a fitness challenge, partnering with the Walkway Over the Hudson, to offer the public the Get Fit Hudson Valley initiative in both the spring and fall. In 2015, the program was expanded to include the Putnam County Trailway. By 2016, the program grew to 74 allies (check-in sites) in the community. The program urges residents to exercise for at least 30 minutes as many times as possible during the six-week challenge. Participants check in at our community partners to track their exercise. In 2018, 1,120 unique participants took part in the challenge, logging more than 16,500 entries of 30+ minutes of exercise. In total, 495,000 minutes of exercise was logged in 2018. Health Quest also partners with physicians who are on the medical staff at the hospitals to offer public lecture series in the spring and fall. The seminars engage participants on a variety of medical topics from prevention to the latest treatment options and to learn from leading doctors in their field. Health Quest partners with local organizations such as Marist's Center for Lifetime Study, Vassar's Lifelong Learning Institute and the Town of Poughkeepsie's Senior Center to bring relevant health programming free of charge to those audiences. In addition, Health Quest partnered with the Dutchess County Office of the Aging to provide expert resources for their Matter of Balance Clinic. This award-winning program is designed to reduce the fear of falling and increase the activity levels of older adults who have concerns about falls. Health Quest employees donate time as volunteer coaches to teach the eight two-hour sessions. PART VI LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT - NEW YORK false false false false false false false false false DENISE GEORGE NDH PRESIDENT 0 458653 0 106879 0 56652 0 16500 0 22994 0 661678 0 16200 JOHN SABIA MD VP MEDICAL AFFAIRS - NDH 434481 0 58737 0 0 0 16500 0 21107 0 530825 0 16200 0 CONNIE REGAN PHARMACY CLINICAL COORDINATOR 189661 0 20208 0 798 0 13641 0 22122 0 246430 0 12998 0 JOHN HORISZNY MD TRUSTEE & HQMP PHYSICIAN 0 422499 0 55670 0 0 0 16500 0 28257 0 522926 0 16200 PAUL KING DIRECTOR OF DIAGNOSTIC SVCS 165926 0 17010 0 652 0 5488 0 1572 0 190648 0 4979 0 JOHN L MCGUINNESS FORMER HQ CEO 0 350004 0 0 0 0 0 0 0 0 0 350004 0 2958 KATHERINE BACHER HQ SVP & CFO/ASST TREASURER 0 530001 0 54500 0 56525 0 56500 0 1438 0 698964 0 34085 MICHAEL HOLZHUETER GEN COUNSEL/ASST. SECRETARY 0 652307 0 209375 0 95315 0 66469 0 28889 0 1052355 0 79739 PAMELA RHODES CNO/VP PATIENT CARE SVCS 244536 0 28200 0 2927 0 16364 0 2191 0 294218 0 15218 0 TIMOTHY GOVEL PHARMACIST 162669 0 0 0 0 0 10028 0 23037 0 195734 0 9914 0 CATHERINE LEONARD DIRECTOR THERAPY SERVICES 147162 0 16433 0 0 0 10337 0 20920 0 194852 0 0 0 JAMES SCADUTO MD PRES MED STAFF, HQMP PHYSICIAN 0 402939 0 51017 0 0 0 16500 0 28258 0 498714 0 0 SCH J PART I LINE 3 NDH RELIED ON HEALTH QUEST SYSTEMS, A RELATED TAX EXEMPT ORGANIZATION, WHICH USED AN EXECUTIVE COMPENSATION COMMITTEE, AND AN INDEPENDENT THIRD PARTY TO GATHER COMPARABLE DATA TO APPROVE AND DETERMINE COMPENSATION FOR THE CEO, TOP MANANGEMENT AND OTHER KEY EMPLOYEES. A DUTCHESS COUNTY LOCAL DEVELOPMENT CORPORATION 273106797 267045GD8 2016-07-07 7613993 REFUND PRIOR ISSUE (9/6/2007) false false false B DUTCHESS COUNTY LOCAL DEVELOPMENT CORPORATION 273106797 267045DW9 2014-05-14 33770225 ACQUIRE, CONSTRUCT & EQUIP FACILIT false false false A 439110 0 7658318 0 0 0 104507 0 17039 7534380 0 2392 2008 false true false true B 0 0 33791365 0 1936554 0 477697 0 0 31377114 0 0 2016 false false true true A false false false false 0 B false false false false 0 A false true false false false false 0 false 0 false true B false false false true false false 0 false 0 false true A false B false BONDS PART I, LINE B, COLUMN E - TOTAL ISSUE PRICE PER IRS FORM 8038 - $438,672,525.55 ALLOCATED BETWEEN THREE ORGANIZATIONS. PROCEEDS PART II, LINE 3 - THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN E DUE TO INVESTMENT EARNINGS. ARBITRAGE SCHEDULE K, PART IV, ARBITRAGE, LINE 2C (A) ISSUER NAME: DUTCHESS COUNTY LOCAL DEVELOPMENT CORPORATION DATE THE REBATE COMPUTATION WAS PERFORMED: 07/01/2016 NOTE REGARDING THE 07/01/2016 REBATE COMPUTATION: 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. SCHEDULE R PART II - RELATED TAX EXEMPT ORGANIZATIONS ENTITY TAX ID# PRIMARY ACTIVITY LEGAL DOMICILE EXEMPT CODE STATUS PUBLIC CHARITY STATUS DIRECT CONTROLLING ENTITY VASSAR BROTHERS MEDICAL CENTER 14-1338586 HOSPITAL NY 501C3 BOX 3 HQ THE FOUNDATION FOR VASSAR BROTHERS MEDICAL CENTER 14-1736429 FUNDRAISING NY 501C3 BOX 9 HQ RIVERSIDE DIVERSIFIED SERVICES, INC (PARENT) 14-1675545 EDUCATION NY 501C3 BOX 9 HQ ALAMO AMBULANCE SERVICE INC. 14-1745417 TRANSPORT NY 501C3 BOX 9 HQ HEALTH QUEST HOME CARE, INC. (CERTIFIED) 14-1788412 HOME HEALTH NY 501C3 BOX 9 HQ HEALTH QUEST HOME CARE, INC. (LICENSED) 14-1788410 HOME HEALTH NY 501C3 BOX 9 HQ NORTHERN DUTCHESS HOSPITAL 14-1338467 HOSPITAL NY 501C3 BOX 3 HQ NORTHERN DUTCHESS RESIDENTIAL HEALTH CARE FACILITY 22-3129608 NURSING HOME NY 501C3 BOX 9 HQ NDH FOUNDATION 14-1776208 FUNDRAISING NY 501C3 BOX 9 HQ PUTNAM HOSPITAL CENTER 14-6019179 HOSPITAL NY 501C3 BOX 3 HQ PUTNAM HOSPITAL CENTER FOUNDATION 06-1399319 FUNDRAISING NY 501C3 BOX 9 HQ HEALTH QUEST MEDICAL PRACTICE, PC 56-2669185 MEDICAL CARE NY 501C3 BOX 3 HQ HEALTH QUEST URGENT MEDICAL PRACTICE, PC 80-0152047 MEDICAL CARE NY 501C3 BOX 3 HQ HUDSON VALLEY CARDIOVASCULAR PRACTICE, PC 46-3756713 MEDICAL CARE NY 501C3 BOX 3 HQ VBH INSURANCE CO. LTD. 98-1083868 CAPTIVE INSURANCE CAYMAN ISLANDS HQ WELLS MANOR HOUSING DEVELOPMENT FUND CORPORATION 11-2611902 LOW INCOME HOUSING NY 501C3 BOX 3 HQ VASSAR HEALTH CONNECTICUT INC. 81-5056290 HOSPITAL CT APPLYING FOR 501C3 STATUS HQ VASSAR HEALTH QUEST MEDICAL PRACTICE OF CONNECTICUT INC 82-1466583 MEDICAL CARE CT APPLYING FOR 501C3 STATUS HQ FORM 990 PART VI SECTION A LINE 6 AND 7A - GOVERNING LINE 6 - THE SOLE MEMBER OF NDH IS HEALTH QUEST SYSTEMS, INC. LINE 7A - APPOINTMENT/ELECTION OF GOVERNING BODY 6.01 Officers. The Officers of NDH shall be a Chair, First Vice-Chair, Second Vice-Chair, Secretary/Treasurer, and Hospital President. From time to time, the Board of Trustees may appoint such other Officers with powers and duties not inconsistent with these Bylaws. Any two or more offices may be held by the same person, except the offices of Chair, Hospital President and Secretary/Treasurer. 6.02 Election. The Chair of the Board, First Vice-Chair, Second Vice-Chair and the Hospital President shall be elected by Health Quest. The Secretary/Treasurer and other Officers shall be elected by a vote of the majority of the entire Board of Trustees at a meeting of the Board of Trustees. All Officers shall serve for a term of two (2) years until successors are elected and qualified, such term commencing at the close of the meeting at which they are elected. Officers may be elected for no more than one (1) term. 6.03 Vacancies. A vacancy occurring in any office during the year may be filled by a vote of a majority of the entire Board of Trustees for the remainder of the term thereof at the next Annual Meeting or any regular meeting of the Board or at a special meeting called for such purpose, provided that a vacancy in the office of Chair of the Board, First Vice-Chair, Second Vice-Chair or Hospital President may be filled only by Health Quest. 6.04 Removal. Any Officer may be removed from office, with or without cause, by an affirmative vote of two-thirds (2/3) of the entire Board of Trustees at any meeting of the Board, except the Chair of the Board, First Vice-Chair, Second Vice-Chair and the Hospital President may be removed only by Health Quest. 6.05 Duties and Responsibilities. (a) Chair. The Chair shall preside at all meetings of the Board of Trustees. In accordance with Articles VII and VIII, the Chair also shall (i) appoint the Committee Chairs and members of all Committees of the Board (except the Executive Committee) and ad hoc committees, (ii) serve as an ex-officio member, with vote, on each Committee, (iii) serve as the Chair of the Executive Committee. The Chair shall perform such other duties as may be provided for by law, these Bylaws, or resolution of the Board of Trustees. No employee of the Corporation shall serve as Chair nor hold any other title with similar responsibilities. (b) First Vice-Chair. In the absence of the Chair, the First Vice-Chair shall preside at meetings of the Board of Trustees. When so acting as Chair, the First Vice-Chair shall have all the powers and authority of the Chair. The First Vice-Chair shall perform such other duties as may be provided for by the Board of Trustees. (c) Second Vice-Chair. In the absence of the Chair and First Vice-Chair, the Second Vice-Chair shall preside at meetings of the Board of Trustees. When so acting as Chair, the Second Vice-Chair shall have all the powers and authority of the Chair. The Second Vice-Chair shall perform such other duties as may be provided for by the Board of Trustees. (d) Secretary/Treasurer. (i) The Secretary/Treasurer shall be responsible for such books, documents, and papers as the Board may determine. The Secretary/Treasurer shall cause minutes to be kept for all meetings of the Board of Trustees, may sign any contracts or agreements with the Chair, the Hospital President, the First Vice-Chair or Second Vice-Chair in the name of NDH if so authorized or ordered by the Board, and may affix the seal of NDH to written instruments when so authorized or ordered by the Board. The Secretary/Treasurer shall perform such other duties as shall be assigned by the Board of Trustees and as are incidental to the office of secretary of a not-for-profit corporation. (ii) The Secretary/Treasurer shall either personally perform, or ensure that appropriate employees of NDH perform, the following functions: receive and care for all monies and properties belonging to NDH and dispose of the same under the direction of the Board of Trustees, receive and give receipts for all amounts due to NDH, endorse checks in its name and on its behalf, receive full discharge for the same in accordance with these Bylaws, and perform such other duties as assigned by the Board of Trustees and as are incidental to the office of treasurer of a not-for-profit corporation. (e) Hospital President. The Hospital President shall serve as the chief executive officer of NDH and shall have the authority and responsibility to manage and operate NDH in all its activities, subject to these Bylaws, the Certificate of Incorporation, and such policies as may be adopted from time to time by the Board of Trustees or Health Quest. The Hospital President's responsibilities shall include, but are not limited to, the following: (i) Acting under the direction of and being accountable to the Board of Trustees of NDH and Health Quest; (ii) Providing effective liaison between the Board of Trustees and management; (iii) Appointing (either personally or through delegation to responsible subordinates), and NDH shall employ, such personnel as may be required to conduct the affairs of NDH; (iv) Ensuring that all activities are properly organized, directed and accounted for as established by the Board of Trustees; (v) Providing reports to the Board of Trustees to keep the Board fully informed of the affairs of NDH; (vi) Performing all duties required by law; and (vii) Unless otherwise provided for herein, performing (either personally or through delegation to responsible subordinates) all acts and executing all documents necessary to carry out the duties of the position of Hospital President. PART VI SECTION B LINE 11B, 12C, 15A AND 15B - POLICIES LINE 11B - PRIOR TO FILING, A DRAFT OF THE COMPLETED FORM 990 WAS REVIEWED BY INTERNAL MANAGEMENT. AFTER THAT REVIEW WAS COMPLETE, THE FORM 990 WAS PROVIDED TO THE BOARD OF DIRECTORS OF HQ (PARENT OF THE FILING ORGANIZATION) FOR ADITIONAL REVIEW AND COMMENT. CONTACT INFORMATION WAS PROVIDED SHOULD QUESTIONS ARISE. A 3RD PARTY WAS HIRED TO PREPARE SCHEDULE K. LINE 12C - ON AN ANNUAL BASIS OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST FILING WHICH IS REVIEWED BY THE HQ VP OF COMPLIANCE AND INTERNAL AUDIT. ALL POTENTIAL CONFLICTS OF INTEREST ARE REVIEWED BY THE HQ BUSINESS ETHICS COMMITTEE ON BEHALF OF NDH. LINE 15 A/B - COMPENSATION OF THE CEO, TOP MANAGEMENT AND OTHER KEY EMPLOYEES IS ESTABLISHED BY THE HQ EXECUTIVE COMPENSATION COMMITTEE BASED ON INFORMATION AND SUPPORT OF AN INDEPENDENT THIRD PARTY. FORM 990 PART VI SECTION C LINE 19 - DISCLOSURE LINE 19 - POLICIES AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE DOCUMENTS ARE PROVIDED EITHER ELECTRONICALLY OR PAPER COPIES. IN ADDITION, CERTAIN FINANCIAL INFORMATION IS AVAILABLE ON VARIOUS WEBSITES DUE TO REGULATORY FILINGS SUCH AS THE 990 AND BOND HOLDER REQUIREMENTS. SCHEDULE R PART V LINE 2 (1) - ALLOCATION METHODOLOGY FOR HQ ALLOCATION OF SUPPORT SERVICES SHARED EXPENSES CASH FUNDING GENERAL: THE FOLLOWING SERVICES ARE CONSIDERED SHARED SERVICES FOR HEALTH QUEST AFFILIATES AND THE COST TO PROVIDE THESE SERVICES ARE ALLOCATED TO EACH ENTITY WHICH BENEFITS FROM THE SERVICE BASED ON A PRE DEFINED ALLOCATION METHODOLOGY: 1. SPECIALTY STAFFING A. VBMC SURGICAL B. RADIOLGOY C. ONCOLOGY D. VBMC SLEEP LAB E. PT/OT/ST F. CARDIAC REHAB 2. CLINICAL MANAGEMENT A. EMERGENCY ROOM B. ONCOLOGY 3. REVENUE CYCLE INCLUDING HEALTH INFORMATION MANAGEMENT, BUDGETS AND REIMBURSEMENT, REVENUE INTEGRITY, SYSTEM BUSINESS OFFICE, PATIENT ACCESS OVERSIGHT, FINANCIAL CLEARANCE CENTER, MANAGED CARE AND DECISION SUPPORT 4. FACILITIES INCLUDING COURIER SERVICE, CONSTRUCTION, PROPERTY MANAGEMENT, FACILITY OPERATIONS, FOOD SERVICE MANAGEMENT AND SECURITY MANAGEMENT 5. BUSINESS DEVELOPMENT INCLUDING STRATEGIC PLANNING, MARKETING AND PUBLIC RELATIONS, ANSWERING SERVICE AND COMMUNITY EDUCATION 6. CORPORATE FINANCE INCLUDING ACCOUNTS PAYABLE, PAYROLL, GENERAL ACCOUNTING, PURCHASING, SUPPLY CHAIN AND MAILROOM, PRACTICE MANAGEMENT BILLING AND MANAGEMENT ENGINEERING 7. INTERNAL AUDIT AND COMPLIANCE 8. PRACTICE MANAGEMENT OPERATIONS INCLUDING PHYSICIAN RECRUITMENT, PHYSICIAN MANAGEMENT ENGINEERING 9. HUMAN RESOURCES AND LEARNING AND DEVELOPMENT 10. ADMINISTRATIVE INCLUDING EXECUTIVE OFFICE, HOSPITAL SUPPORT AND RISK MANAGEMENT 11. LEGAL COUNSEL 12. INFORMATION TECHNOLOGY AND MEDICAL TECHNOLOGY WERVICES (MTS) DESCRIPTION OF SERVICES: 1. SPECIALTY STAFFING A. PROVIDES NON UNION STAFFING SERVICES FOR VARIOUS SPECIALTIES TO THE HOSPITALS, OFFSITE ANCILLARY LOCATIONS AND THE FISHKILL MEDICAL MALL 2. CLINICAL MANAGEMENT INCLUDES MANAGEMENT OVERSIGHT TO SYSTEM CONSOLIDATED CLINICAL SERVICES 3. REVENUE CYCLE A. HEALTH INFORMATION MANAGEMENT FUNCTIONS INCLUDES CODING AND TRANSCRIPTION OF MEDICAL RECORDS FOR ALL 3 HOSPITALS B. BUDGET FUNCTIONS INCLUDE PREPARATION OF ANNUAL BUDGETS, VARIANCE REPORTING AND MAINTENANCE OF THE BUDGET MODULE. REIMBURSEMENT FUNCTIONS INCLUDE PREPARATION OF ANNUAL COST REPORTS, ANALYSIS OF THIRD PARTY RATE ACCOUNTS AND THRID PARTY AUDITS. C. REVENUE INTEGRITY FUNCTIONS INCLUDE CHARGE MASTER ANALYSIS AND DEVELOPMENT OF REVENUE PRODUCTIN CHARGES, COMPLIANCE WITH CPT CODING AND ESTABLISHMENT OF APPROPRIATE CHARGES D. SYSTEM BUSINESS OFFICE SERVICES INCLUDES PRODUCING CLAIMS FOR THIRD PARTY PAYERS AND PRIVATE PAY PATIENTS, PAYMENT PROCESSING, PERIODIC REPORTING, ACCOUNTS RECEIVABLE ANALYSIS, CHARITY CARE APPLICATION PROCESS, DENIAL MANAGEMENT, COLLECTION AND FOLLOW UP FOR THE HOSPITALS. PATIENT ACCESS AND FINANCIAL CLEARANCE CENTER INCLUDES OVERSIGHT OF ALL CENTRALIZED REGISTRATION AREAS AT THE HOSPITALS AND PRE-AUTHORIZATION FOR NUMEROUS HOSPITAL SERVICES TO INSURE COMPLIANCE WITH THIRD PARTY REGULATIONS E. MANAGED CARE FUNCTIONS INCLUDE CONTRACT NEGOTIATIONS AND ANALYSIS OF CONTRACT TERMS F. DECISION SUPPORT FUNCTIONS INCLUDE COST ACCOUNTING REPORTING, MAINTENANCE OF HBI (HORIZON BUSINESS INSIGHT) REPORTING AND THE CONTRACT MANAGEMENT SYSTEM 4. FACILITIES A. COURIER SERVICE PROVIDES DELIVERY SERVICES INTERNALLY THROUGHOUT THE HQ SYSTEM AND BANK DEPOSIT DROP OFFS B. CONSTRUCTION AND PROPERTY MANAGEMENT FUNCTIONS INCLUDE CONTRACTING SERVICES FOR HEALTH QUEST PROJECTS AND PROPERTY MANAGEMENT OF ALL HQ FACILITIES C. FACILITY OPERATIONS INCLUDE MANAGEMENT OVERSIGHT OF THE ENGINEERING DEPARTMENTS FOR THE HOSPITALS D. FOOD SERVICE MANAGEMENT INCLUDES MANAGEMENT OVERSIGHT OF FOOD AND NUTRITION DEPARTMENTS FOR THE HOSPITALS E. SECURITY FUNCTIONS INCLUDE MANAGEMENT OVERSIGHT OF ALL FACILITIES TO ENSURE THE SAFEST ENVIRONMENT 5. BUSINESS DEVELOPMENT A. STRATEGIC PLANNING FUNCTIONS INCLUDE CON SUBMISSIONS, MARKET DATA ANALYSIS AND ASSISTANCE WITH BUSINESS PLANS B. MARKETING INCLUDES ADVERTISING SERVICES, COORDINATION OF HEALTH QUEST ADVERTISEMENTS AND MANAGEMENT OF THE HQ WEBSITE CONTENT C. PUBLIC RELATIONS FUNCTIONS INCLUDE COORDINATION OF HEALTH QUEST COMMUNICATION TO EXTERNAL CUSTOMERS, PATIENTS AND MEDIA D. OVERSIGHT OF THE OUTSOURCED ANSWERING SERVICES FOR PHYSICIANS AFFILIATED WITH THE HOSPITALS AND HQMP E. COMMUNITY EDUCATION FUNCTIONS INCLUDE TRAINING CLASSES SPECIFIC TO LIFE SAVING TECHNIQUES 6. FINANCE A. ACCOUNTS PAYABLE FUNCTIONS INCLUDE SCHEDULING VENDOR PAYMENTS, INSURING FLOW OF GOODS AND SERVICES, MAINTAINING DAYS CASH ON HAND GOALS AND MAINTAINING DAYS IN ACCOUNTS PAYABLE B. PAYROLL FUNCTIONS INCLUDE BI-WEEKLY EMPLOYEE PAYMENTS AND TAX FILINGS IN ACCORDANCE WITH HUMAN RESOURCES AND PAYROLL POLICIES C. GENERAL ACCOUNTING FUNCTIONS INCLUDE PREPARATION OF FINANCIAL STATEMENTS, ACCOUNT ANALYSIS, CONTRACT RECONCILIATION, TAX FILINGS, INVESTMENT COORDINATION, AND COORDINATION OF INTERNAL AND EXTERNAL AUDIT FUNCTIONS D. PURCHASING, SUPPLY CHAIN AND MAILROOM FUNCTIONS INCLUDE PROCUREMENT SERVICES, CONTRACT NEGOTIATIONS, PRICE NEGOTIATIONS, CAPITAL PURCHASE NEGOTIATINS, MANAGEMENT/DISTRIBUTION OF HOSPITAL INVENTORY, AND CENTRAL MAILROOM MANAGEMENT E. PRACTICE MANAGEMENT BILLING FUNCTIONS INCLUDE PRODUCING ALL CLAIMS FOR THIRD PARTY PAYERS AND PRIVATE PAY PATIENTS, PAYMENT PROCESSING, PERIODIC REPORTING, ACCOUNTS RECEIVABLE ANALYSIS, CHARITY CARE APPLICATION PROCESS, DENIAL MANAGEMENT, COLLECTION AND FOLLOW UP SERVICES FOR ALL EMPLOYED HQ PHYSICIANS F. MANAGMENT ENGINEERING FUNCTIONS INCLUDE EVALUATING EACH AREA WITHIN HQ TO ENSURE COMPLIANCE WITH VARIOUS PRODUCTIVITY BENCHMARKS OPTIMIZING STAFFING RATIOS 7. INTERNAL AUDIT AND COMPLIANCE INCLUDES OVERSIGHT OF THE CORPORATE COMPLIANCE PROGRAM, INTERNAL AUDIT, HIPAA COMPLIANCE, CONTRACT REVIEW AND COMPLIANCE 8. HUMAN RESOURCE AND LEARNING AND DEVELOPMENT FUNCTIONS INCLUDE RECRUITMENT, COMPENSATION, BENEFIT ADMINISTRATION AND EMPLOYEE TRAINING 9. PHYSICIAN MANAGEMENT OPERATIONS FUNCTIONS INCLUDE OVERSIGHT OF ALL HQ PHYSICIAN PRACTICES, PHYSICIAN RECRUITMENT FUNCTIONS, AND THE CENTRALIZED SCHEDULING OFFICE 10. ADMINISTRATIVE FUNCTIONS INCLUDE OVERSIGHT OF THE HEALTH QUEST SYSTEM, HOSPITAL MANAGEMENT AND RISK MANAGEMENT 11. LEGAL COUNSEL FUNCTIONS INCLUDE INTERNAL LEGAL SERVICES FOR HQ AND COORDINATION OF ALL OUTSOURCED LEGAL INITIATIVES 12. INFORMATION TECHNOLOGY AND MTS A. IT PROVIDES INFORMATION TECHNOLOGY SUPPORT FOR ALL APPLICATIONS AND TELEPHONY SUPPORT WITHIN HQ. IN ADDITION, PROVIDES PROJECT MANAGEMENT SERVICES FOR ALL NEW AND UPGRADES TO CURRENT IT APPLICATIONS B. MTS/BIOMED INCLUDES TECHNICAL SERVICES PROVIDED TO EACH HOSPITAL FOR EQUIPMENT REPAIR AND MAINTENANCE SHARED EXPENSES. IN ADDITION TO SERVICES PROVIDED BY SUPPORT DEPARTMENTS, CERTAIN INSURANCE POLICIES ARE CONSOLIDATED FOR ALL HEALTH QUEST ENTITES. THESE INCLUDE PROPERTY INSURANCE, TRAVEL, CRIME, ENVIRONMENTAL, CYBER RISK AND DIRECTORS AND OFFICERS INSURANCE ALLOCATION METHODOLOGY: NET REVENUE - LAB MANAGEMENT, BUDGETS, REVENUE CYCLE, MANAGED CARE, DECISION SUPPORT, ALL FACILITIES (EXCLUDING CONSTRUCTION), BUSINESS DEVELOPMENT, GENERAL ACCOUNTING, MANAGEMENT ENGINEERING, INTERNAL AUDIT AND COMPLIANCE, EXECUTIVE OFFICE, LEGAL, INFORMATION TECHNOLOGY AND MTS # OF VISITS/PROCEDURES - STAFFING SPECIALTIES HISTORICAL TRENDS - HEALTH INFORMATION MANAGEMENT, CLINICAL MANAGEMENT AND HOSPITAL SUPPORT CASH COLLECTIONS - PATIENT ACCOUNTING AND THE FINANCIAL CLEARANCE CENTER # OF FTE'S - PAYROLL AND HUMAN RESOURCES NON PAYROLL EXPENSES - ACCOUNTS PAYABLE AND PURCHASING PROJECT BASED - CONSTRUCTION # OF FTE'S ALLOCATED TO PHYSICIAN SITES - PRACTICE MANAGEMENT BILLING, OPERATIONS AND PHYSICIAN PRACTICE MANAGEMENT SYSTEM BENEFITS: 1. FINANCIAL PLANNING 2. REVENUE ENHANCEMENT 3. IMPROVED CASH COLLECTIONS 4. ENHANCED MANAGED CARE CONTRACT RATES 5. OPTIMIZED MEDICAL RECORDS CODING 6. SAVINGS FOR SUPPLIES, CONTRACTS, INSURANCE AND CAPITAL PURCHASES 7. STAFFING REDUCTION THROUGH SHARED SERVICES 8. ENHANCED EMPLOYEE BENEFIT PROGRAMS FORM 990 PART XI LINE 9 - RECONCILIATION OF NET ASSETS TRANSFER OF EQUITY - ($8,882,829); CHANGE IN RESTRICTED CONTRIBUTIONS ($1,036,936) FORM 990 PART XII LINE 3A - OMB CIRCULAR A-133 AUDIT NORTHERN DUTCHESS HOSPITAL DID NOT RECEIVE MORE THAN $750,000 IN FEDERAL AWARDS IN 2018, AND DID NOT QUALIFY FOR AN A-133 AUDIT. SCHEDULE R PART V LINE 4 - ALLOCATION METHODOLOGY FOR HQMP The hospital pays administrative fees and subsidies to Health Quest Medical Practice PC. These fees are for expenses incurred by the medical practice while providing the following services to NDH at cost. Hospitalists: The physicians employed by the Hospitalist program admit and provide care to inpatients at NDH allowing the patient's private/primary community physician to remain in their office. The care is provided on a continuous basis to the patient throughout the day, night and weekends. The specific requirements of the group are detailed below: 24/7 coverage, Medical Director administrative time: 18 hours per week includes: scheduling, payroll, recruitment, evaluation of growth, review financial records. Night coverage: 15 hour shift. 6 hours are spent on billable patient care, while the remaining 9 hours (63 hours per week) are involved with covering existing team and being available for ER evaluations or new consults. These hours are critical for excellent care and are not billable. Day MD administrative time: filling out forms, conferences with patients/family/staff beyond E/M billable time, signing charts. 1 hour each per provider or 3 hours per day- 21 hours per week, Case management advisor participates in QI programs at the hospital, and Chair of information management committee. Nursing Education directs and coordinates all clinical matters. Develop cost effective care, cost containment measures, assist in operating and capital budgets, including projections of revenue and expenditures, ensure the consistency and quality of services provided. Analyze clinical outcomes, and identify deficiencies. Resolve patient problems with the quality of services. Maintain written reports to outline goals, objectives and standards for services. Scheduling providers participate in community outreach programs and community education. Review financial reports and ensures that all providers are compliant. Intensivists: The physicians employed by the Intensivist (triple boarded) program provide care to critically ill patients in the intensive care and critical care units at VBMC. The appropriate level of care warranted by the acuity of the patient is provided on a continuous basis to the patient throughout the day, night and the weekends. The specific requirements of the group are detailed below: 24/7 coverage for code stats. Lead team, intubate, place lines, emergency pacemakers, etc. 24/7 rapid consultations available for medical staff. 24/7 availability to triage patients moving into, or out of, intensive care. 24/7 coverage of ED evaluations and urgent/emergent advice of critically ill adults. Mandated coverage for an average of 15 ICU patients/day, and direct and coordinate all clinical matters. Develop cost effective care, cost containment measures, assist in operating and capital budgets including projections of revenue and expenditures, and ensure the consistency and quality of services provided. Analyze clinical outcomes, and identify deficiencies. Resolve patient problems with the quality of services. Maintain written reports to outline goals, objectives and standards for services. Scheduling providers participate in community outreach programs and community education. Review financial reports and ensures that all providers are compliant. Surgical PA Program: The Physician Assistants employed by the Surgical PA program assist during surgical procedures at NDH. This service is extremely important to the community of surgeons due to a shortage (and aging) of general surgeons in Dutchess County. This program reduces the need for surgeons to double-up during procedures. The specific requirements of the group are detailed below: Direct and coordinate all clinical matters. Develop cost effective care, cost containment measures, assist in operating and capital budgets including projections of revenue and expenditures to ensure the consistency and quality of services provided. Analyze clinical outcomes, and identify deficiencies. Resolve patient problems with the quality of services. Recommends employment and termination of non-physician personnel. Maintain written reports to outline goals, objectives and standards for services. Scheduling providers participate in community outreach programs and community education. Review financial reports to ensure that all providers are compliant. CT Surgeons: The physicians and physician assistants employed by HQMP provide care for cardiac patients on both an outpatient basis (office visits) and an inpatient basis for surgical procedures and the associated post-operative care. The specific requirements of the group are detailed below: Direct and coordinate all clinical matters. Develop cost effective care, cost containment measures, assist in operating and capital budgets including projections of revenue and expenditures to ensure the consistency, quality of services provided. Analyze clinical outcomes, and identify deficiencies. Resolve patients and problems with the quality of services. Recommends employment and termination of non-physician personnel. Maintains written reports to outline goals, objectives and standards for services. Scheduling providers participate in community outreach programs and community education. Review financial reports to ensure that all providers are compliant. FORM 990 PART VI SECTION A LINE 7B - GOVERNING BODY LINE 7B - 4.01 Powers of the Board of Trustees. The business and property of NDH shall be managed by NDH's Board of Trustees and Health Quest, as the co-established operator of NDH. Although Health Quest may elect from time to time to delegate to and/or act jointly with the NDH Board of Trustees, Health Quest has the authority to exercise independently its established powers and rights in its capacity as the co-established operator. Any such delegated authority shall at all times remain subject to the oversight, modification or repeal of Health Quest as the co-established operator of NDH. Without limiting the foregoing powers, Health Quest will consult with the Chair of the NDH Board of Trustees before modifying or repealing any joint operating authority delegated under Section 4.02. 4.02 Joint Operating Authority Delegated to NDH. Subject to Sections 2.02 and 4.01, the Board of Trustees of NDH shall have the following operating authority as delegated by Health Quest: (a) Quality Assurance. Apply and execute the quality assurance standards and any quality assurance policies and plans adopted by Health Quest. (b) Medical Staff Credentialing and Bylaws. Apply and execute the Medical Staff credentialing standards and any policies adopted by Health Quest, which includes being responsible for: (i) Appointing the members of the Medical Staff; (ii) Approving any Medical Staff appointments such as Medical Staff officers or department chairs requiring Board approval; (iii) Pursuant to the procedures set forth in the Bylaws of the Medical Staff, dismissing any member of the Medical Staff, and approving, rejecting or modifying any corrective action taken or recommended by the Medical Staff for any member of the Medical Staff; and (iv) Approving the Medical Staff Bylaws, Rules and Regulations. (c) Strategic Planning. Provide input to the system-wide strategic planning process and NDH-specific strategic plan, as requested and approved by Health Quest, and monitor the implementation of such plan. (d) Statements of Deficiency and Legal Compliance. Respond to any statements of deficiency issued by any regulatory or accrediting authority and take all appropriate and necessary action to monitor and restore compliance with deficiencies in NDH's compliance with statutory, regulatory or accreditation requirements, including but not limited to monitoring the submission and implementation of all plans of correction. (e) Conflicts of Interest. Implement and comply with the written Conflict of Interest Policy as approved by Health Quest and as interpreted and directed by the Compliance and Audit Committee of Health Quest. (f) Community Health Needs. Implement the statement of mission approved by Health Quest by developing a Community Service Plan tailored specifically to the work of NDH in the community it serves and monitoring performance thereof. (g) Budgets and Financial Performance. Assist in developing and monitoring the budgets for NDH, as requested by Health Quest and, as approved, monitor the financial performance of NDH. (h) Physician Arrangements. Review and approve physician financial arrangements in accordance with and as permitted by a system-wide policy adopted by Health Quest. (i) Evaluation of the Board of Trustees. Develop an annual action plan for NDH's Board of Trustees, perform an annual self-evaluation of the Board of Trustees, comparing performance to the goals set forth in the annual action plan, and execute a Board education plan developed and approved by Health Quest. (j) Evaluation of Hospital President. Monitor and provide input to NDH and Health Quest concerning the performance of the President of NDH. (k) Nominations for Trustee and Officer Positions. Recommend to the Health Quest Executive Committee, acting as the Governance and Nominating Committee, candidates for consideration for NDH Trustee and Officer positions. (l) Minutes. Cause written minutes to be maintained of meetings of the Board of Trustees of NDH and its committees including a record of attendance, which minutes shall be signed by the Secretary of NDH and retained as a permanent record in the offices of NDH. HEALTH QUEST SYSTEMS INC 45 READE PLACE POUGHKEEPSIE NY 12601 141678068 SUPPORT SERV BOX 9 HQ SEE SCHEDULE O N/A true false false false false false false false false false false false false false true true false false HEALTH QUEST SYSTEMS INC P 18478069 SEE SCHEDULE O HEALTH QUEST MEDICAL PRACTICE PC A 466004 RENT AT FMV HEALTH QUEST MEDICAL PRACTICE PC P 4613518 SEE SCHEDULE O HV CARDIOVASCULAR PRACTICE PC A 109235 RENT AT FMV HEALTH QUEST MEDICAL PRACTICE PC Q 7737 COST NORTHERN DUTCHESS HOSPITAL FOUNDATION A 4000 RENT AT FMV THOMPSON HOUSE Q 59160 COST HV CARDIOVASCULAR PRACTICE PC P 40000 COST VASSAR HEALTH CONNECTICUT INC P 26312 COST VASSAR BROTHERS MEDICAL CENTER P 154639 COST