2018-11-13T16:34:29-06:00 2017-12-31 BDO USA LLP 100 PARK AVENUE NEW YORK NY 100175001 990 2017-01-01 111704595 BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER % B FARRELL VP/CFO BROO 6316547100 101 HOSPITAL ROAD PATCHOGUE NY 11772 BRENDA FARRELL CFO 6316547100 2018-10-29 true Angelo Pirozzi P00446022 2128858000 24.125.103.209 26308920183175000089 2018-11-13 P 1210560841ADC29080D5D665393427DBF2BE5B27 48C336AAB7D1DE8463E223BE15B361E384766368 2017 2019-02-21 02:37:17Z R T MARGULIS CEO 101 HOSPITAL ROAD PATCHOGUE NY 11772 271400674 false X WWW.BROOKHAVENHOSPITAL.ORG X 1947 NY DELIVER ACCESSIBLE HIGH-QUALITY HEALTH SERVICES IN A FOCUSED CARING AND TEACHING ENVIRONMENT WHILE PROVIDING HEALTH ADVOCACY FOR THE COMMUNITY AND PEOPLE WE SERVE. 26 19 2577 202 0 0 23289621 1665689 263082808 265694634 252225 208171 3341320 3832180 289965974 271400674 0 0 0 0 172290568 175215973 0 0 48541 101485847 103095772 273776415 278311745 16189559 -6911071 246844472 231934665 140844594 142272608 105999878 89662057 X 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 148401263 0 165966343 INPATIENT CARE SERVICES - INCLUDES MEDICAL/SURGICAL PROCEDURES, PEDIATRICS, MATERNITY, ICU, CCU, NURSERY, ROUTINE AND PSYCHIATRIC CARE. TOTAL 2017 INPATIENT DAYS: 70,223 42142471 0 40759236 EMERGENCY ROOM SERVICES - AVAILABLE TO THE COMMUNITY 24 HOURS, 7 DAYS A WEEK. TOTAL 2017 TREAT AND RELEASE VISITS: 63,561 20976049 0 23846773 AMBULATORY SURGERY SERVICES - AVAILABLE TO THE COMMUNITY. TOTAL 2017 PROCEDURES: 5,694 49166100 0 38292070 260685883 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 262 0 true 2577 true false false false false false false false false false false X 26 19 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 37.5 0.5 X X 813425 0 60988 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 N KIRIDLY FROM 117 DIRECTOR/PRES. OF MED. STAFF 0.5 0.5 X 0 0 0 E KORMYLO DPM DIRECTOR 0.5 0.5 X 27500 0 0 W LADICK DIRECTOR 0.5 0.5 X 0 0 0 W LEHMANN 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 1618 0 0 M MENNELLA FROM 117 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 F ROSE DIRECTOR 0.5 0.5 X 0 0 0 L ROSE DIRECTOR 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 B FARRELL VP FINANCE, CFO 37.0 0.5 X 453649 0 45303 A PALLAS VP, COO 37.5 0.0 X 322569 0 28435 W WEHBEH FROM 117 VP, CQMO 37.5 0.0 X 439998 0 21934 K WISDOM THRU 917 VP, CNO 37.5 0.0 X 235770 0 22592 C LINDERFROM 917-THRU 1217 ACTING, CNO 37.5 0.0 X 190001 0 20659 M THOMAS MD PHYSICIAN 37.5 0.0 X 327122 0 44658 R GUPTA PHYSICIAN 37.5 0.0 X 278161 0 28167 F QURESHI PHYSICIAN 37.5 0.0 X 268646 0 11129 N AKHTAR PHYSICIAN 37.5 0.0 X 255641 0 8117 F DESORMEAUX MD PHYSICIAN 37.5 0.0 X 237317 0 29708 3851417 0 321690 258 false true false SOUND PHYSICIANS OF NY PLLC 1123 PACIFIC AVENUE TACOMA WA 98402 COLLECTION SERVICES 3102748 ALLIANCE HEALTHCARE PO BOX 96485 CHICAGO IL 60693 RADIOLOGY SERVICES 2942734 DIVERSIFIED CLINICAL 28525 NETWORK PLACE CHICAGO IL 60673 MANAGEMENT SERVICES 1106713 FASTAFF PO BOX 911452 DENVER CO 80291 TEMPORARY STAFFING 828888 ST CHARLES HOSPITAL 200 BELLE TERRE ROAD PORT JEFFERSON NY 11777 PHYSICAL THERAPY 805679 41 34500 1631189 5489 1665689 NET PATIENT SERVICE REVENUE 624200 273738723 273738723 PROVISION FOR UNCOLLECTIBLES, NET 624200 -8044089 -8044089 265694634 201671 201671 0 0 120013 120013 0 120013 120013 6500 6500 6500 6500 0 0 0 0 0 0 0 0 0 PURCHASE DISCOUNTS AND VENDORS REBATES 900099 1470802 1470802 CAFETERIA INCOME 722514 315873 315873 COFFEE SHOP REVENUE 900099 18933 18933 1906559 1698986 207573 3712167 271400674 268864422 870563 0 0 0 0 2684441 2684441 618072 618072 123802465 116541204 7226130 35131 9285191 8738159 541329 5703 29583468 27852958 1725491 5019 9242336 8700643 539005 2688 5147534 4847247 300287 232787 232787 134000 134000 178573 178573 0 0 17850020 16796325 1053695 854636 804780 49856 1022237 962604 59633 717642 675778 41864 0 4754448 4477092 277356 82460 77650 4810 0 70086 65997 4089 2489612 2344378 145234 0 11558177 10883538 674639 3210601 3023307 187294 MEDICAL SUPPLIES 32389301 32389301 PROV FOR PRACTICE UNCOLLECT 6992555 6992555 REPAIRS AND MAINTENANCE 5039464 4745481 293983 OTHER SERVICES 4550569 4285107 265462 5821070 5481779 339291 278311745 260685883 17577321 48541 183348 260013 16187211 14643567 0 0 43908564 41809611 0 0 0 0 0 0 4307442 4680569 1552594 1244508 293954955 154997180 147078473 138957775 0 0 23624630 22189405 0 0 83323 66655 9918887 8082562 246844472 231934665 48642027 51736904 0 0 0 0 48274925 46435449 0 0 0 0 129607 259076 0 0 43798035 43841179 140844594 142272608 X 94594673 82632197 10505205 6129860 900000 900000 105999878 89662057 246844472 231934665 X -6911071 1015312 -10442062 X false true X true false X false false false false false false false false true 178573 178573 false false PART II-B, LINE 1I: BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER PAYS DUES TO AMERICAN HOSPITAL ASSOCIATION (AHA), LONG ISLAND HEALTH NETWORK (LIHN), 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, LIHN, HCA AND HANYS, A PORTION OF THESE DUES ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES. THE LOBBYING ACTIVITIES APPLICABLE TO 2017 WERE: AHA................$ 9,665 LIHN...............$ 962 NSHC...............$ 3,786 HCA................$ 2,191 HANYS..............$13,469 During 2017 The Medical Center also paid Denton's $37,500, Desmond Ryan $15,000, and Envision Strategy $96,000 for consulting services for political people and powers. 900000 900000 900000 900000 900000 900000 900000 900000 900000 900000 1.00000 false false 1531487 1531487 112726970 38556671 74170299 4137152 2122982 2014170 165523488 109814847 55708641 10035858 4502680 5533178 138957775 INVESTMENTS IN BMH FOUNDATION 22189405 F 22189405 0 CAPITAL LEASE OBLIGATIONS 3816981 ACCRUED PENSION COSTS 11589201 ESTIMATED MALPRACTICE LIABILITY 22618684 CHANGE IN VALUATION OF SWAP 2107334 ASBESTOS ABATEMENT 1940655 NET 1768324 43841179 X 261973924 1015312 -10442062 -9426750 271400674 271400674 278311745 278311745 278311745 PART V, LINES 1 AND 4: A $1,000,000 trust was initially established by a donor in 1969. Brookhaven Memorial Hospital Medical Center had classified the original value of the gift along with the allocable compounded earnings as permanently restricted net assets to be held in perpetuity. In order to comply with the donor agreement and to fairly represent the classification of restricted net assets, the organization reclassified $2,195,067 from permanently restricted net assets to temporarily restricted net assets during 2012, as this amount represents the 10% interest in the principal amount of the trust the organization will become entitled to in 2019 ($100,000) and the income earned on the fund since inception less amounts appropriated for general purposes. 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. The amount that is reported in permanently restricted net assets of $900,000 represents the portion of the trust to be held in perpetuity. PART X, LINE 2: Brookhaven Memorial Hospital Medical Center has not taken an unsubstantiated tax position that would require provision of a liability under ASC 740, "income taxes". Under ASC 740, an organization must recognize the tax benefit associated with tax positions taken for tax return purposes when it is more likely than not that the position will not be sustained. The organization does not believe there are any material uncertain tax positions and, accordingly, has not recognized any liability for unrecognized tax benefits. The organization has filed Internal Revenue Service ("IRS") Form 990, as required, and all other applicable returns in jurisdictions where it is required. For the year ended December 31, 2017, there were no interest or penalties recorded or included in the financial statements. The organization believes it is no longer subject to income tax examinations for the years prior to 2014, which is the statute of limitation look back period. PART XI, LINE 2D: change in minimum pension liability.....................$ 1,349,515. changes in net assets of BMH Foundation.................$ 3,883,188. appropriation of temporary restricted net assets for operations..............................................$ (179,376) transfer of assets from John J. Foley Nursing Home......$(15,495,389) Total...................................................$(10,442,062) true true X true X true X 425. true true true false true true 6352228 6352228 0.02280 28241609 5787706 22453903 0.08680 34593837 5787706 28806131 0.10960 261865 261865 0.00090 4865263 4865263 0.01750 5127128 5127128 0.01840 39720965 5787706 33933259 0.12800 true 8044089 68460136 75057641 -6597505 X true true 13 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 SCHOOL BASED HOSPITAL EXTEN CLINIC 350 MAPLE AVENUE BELLPORT NY 11713 X A 12 SOUTH BROOKHAVEN HEALTH CENTER EAST 550 MONTAUK HIGHWAY SHIRLEY NY 11967 X A 13 SOUTH BROOKHAVEN HEALTH CENTER 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 16 true true true true X HTTP://WWW.BROOKHAVENHOSPITAL.ORG X true 16 true http://www.brookhavenhospital.org/community_s false true X 200. 425. X X true true X X X true X WWW.BROOKHAVENHOSPITAL.ORG X WWW.BROOKHAVENHOSPITAL.ORG X WWW.BROOKHAVENHOSPITAL.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 MEDICAL CENTER 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. BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER 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, EMPLOYEES AND THE EMPLOYEE COUNCIL, COMMUNITY MEMBERS, THE LI2DAY ORGANIZATION, 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, AS WELL AS THE HEALTH CENTER ADVISORY COUNCIL MEMBERS. 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, Brookhaven 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 http://www.brookhavenhospital.org/community_service_plan.cfm. 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 11: The focus of BMHMC's 2016 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 2016 these needs were addressed through various hospital initiatives and community events, including but not limited to: A) THE HOSPITAL PARTICIPATED IN VARIOUS COMMUNITY HEALTH FAIRS INCLUDING: BOYS & GIRLS CLUB, BOCES WELLNESS, BROOKHAVEN SENIOR PICNIC, RSVP, ST. JOSEPH COLLEGE HEALTH FAIR, SAYVILLE WELLVILLE, PATCHOGUE YMCA WELLNESS FAIR, HIA TRADE SHOW (WOUND CARE), SUFFOLK MARATHON, BELLPORT NATIONAL NIGHT OUT- HOSPICE LECTURE SERIES. B) PARTNERED WITH THE PATCHOGUE YMCA WELLNESS FAIR PROVIDING B/P SCREENINGS, DIABETES RISK ASSESSMENT SCREENING, BMI SCREENINGS, AND NUTRITIONAL EDUCATION WERE JUST SOME OF THE EDUCATION AND SCREENINGS MADE AVAILABLE TO THE COMMUNITY. PARTNERSHIP WITH DIABETES PREVENTION PROGRAM AND KNAPP CARDIAC CARE WALKING PROGRAM ON GOING. C) 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. BREAST CANCER AWARENESS TO ACTION LECTURE HELD IN COLLABORATION WITH MONDAYS AT RACINE AT THE BOYS & GIRLS CLUB OF BELLPORT ON JUNE 26. WOMEN'S SYMPOSIUM HELD WITH A PANEL OF PHYSICIANS. D) KNAPP CARDIAC CARE OUTREACH-ART THERAPY WORKSHOPS, AFFILIATED WITH MENDED HEART SUPPORT GROUP DIVISION HOSTED HERE AT BMH, LECTURE SERIES TOPICS INCLUDED: HYPERTENSION, SLEEP APNEA, NUTRITIONAL EDUCATION, CARDIAC TESTING, STROKE & HEART HEALTH, EMOTIONAL IMPACT ON HEART DISEASE, TAI CHI & HEART HEALTH, ANTICOAGULANT & ANTIPLATELET AND THE IMPORTANCE OF MEDICATION COMPLIANCE. FEBRUARY CARDIAC AWARENESS - B/P CHECK STATION IN THE MAIN HOSPITAL LOBBY FOR FOUR CONSECUTIVE FRIDAYS FOR BOTH EMPLOYEES AND VISITORS TO THE HOSPITAL IN RECOGNITION OF CARDIOVASCULAR AWARENESS MONTH. E) HIA TRADE SHOW PROVIDING WOUND CARE INFORMATION AND EDUCATION. F) LEARN TO BE TOBACCO FREE PROGRAM. G) VETERANS SUPPORT GROUP. H) 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. I) BMH 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 BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER to calculate discounted care starts at 201% (90% discount) and goes to 425% (10% discount). PART III, LINE 2: THE AMOUNT REPORTED ON LINE 2 IS EQUAL TO THE PROVISION FOR BAD DEBTS SHOWN IN THE AUDITED FINANCIAL STATEMENTS ("AFS"). The explanation of the methodology used to estimate this amount can be found in footnote (2)(E) on page 11 and footnote 3 on pages 18 through 19 of the attached Audited financial statements. PART III, LINE 4: The text of the footnote that describe bad debt expense can be found on pages 11 and 18 through 19 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: Brookhaven Memorial Hospital Medical Center 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. Brookhaven 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. Brookhaven'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, Brookhaven 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. Brookhaven 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 emergent care 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, Brookhaven 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 hard copy 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, Brookhaven promoted the survey through social media efforts, posted links on their website and distributed surveys at health Center, Health fairs and other consumer-oriented events. Community Outreach has long been a mainstay for Brookhaven Memorial Hospital Medical Center. Brookhaven's outreach program participates in community health fairs, with senior and community centers, as well as civic associations throughout the region. BMHMC is also an active member of eight Chambers of Commerce in the community. Membership with these chambers affords Brookhaven the opportunity to learn of the needs of the workforce and business leaders in the community. Brookhaven 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, Brookhaven Memorial Hospital Medical Center 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, Brookhaven 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 once, d 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. Brookhaven Hospital Medical Center serves the needs of 28 towns and villages in Suffolk County. BHMC's 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 Brookhaven Memorial Hospital Medical Center (BMHMC) is a voluntary, not-for-profit community hospital in Patchogue, Suffolk County, New York. Brookhaven has maintained a commitment to providing access to quality health care since its founding in 1956. Brookhaven 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 2016-18 Community Service Plan will provide an overview of the Medical Center, 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. BMHMC 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. In addition, Brookhaven has recently acquired the former John J. Foley Nursing Rehabilitation Center from the County of Suffolk. Renovation work and enhancements are planned for 2017. The center will operate much needed services to the 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. Brookhaven Memorial Hospital Medical Center 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 Medical Center 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, Brookhaven 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 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 BMHMC to assist with attainment of goals and objectives of the public health priorities: BMHMC - Diabetes Wellness Center: In partnership with The New York State Diabetes Prevention Program (NYS DPP), BMHMC 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, BMHMC 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 the Brookhaven Diabetes Wellness Center located at 33 Medford Ave, Patchogue, NY 11772. For more information please call 631.687.4188. The BOCES - Bellport Academic Center is located within the BMHMC services area. BMHMC has a contractual relationship to provide health care services to the students at the Center. Educational material about diabetes, obesity, mental health and substance abuse will be distributed to the students as a component of BMHMC's outreach program and this Community Service Plan. BMHMC - Bellport Primary Care Center: BMHMC has opened a primary care center in Bellport which is close to the main hospital. This new primary care center will have 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 BPPC is a new Boys and Girls Club facility. BPPC and the Club intend to collaborate to provide better health and lifestyle choices for the residents of the community. Community-Based Patient Advisory Council: BMHMC realizes the tremendous value of having a community-based Patient Advisory Council (PAC). In 2014, BMHMC selected a diverse group of community members who can provide us information and feedback about the programs and services offered. Brookhaven Breast Cancer Survivorship Coalition: BMHMC recognizes the impact that Breast cancer can have on not just the patient but the family and is working with community members to support those in need and to educate the public on the impact and issues of Breast Cancer Knapp Cardiac Care Wellness program: This program offers free blood pressure screenings, art classes, walking and exercise classes, and educational seminars to support heart health Mental Health Family Education: For Family and Friends of people struggling with mental illness and or substance abuse meets twice a month. Other Programs: Annually, Brookhaven offers a free of charge wellness event for the community. This year BMHMC collaborated with the Patchogue YMCA and the Boys & Girls Club of Bellport to provide more than 300 people an interactive experience. Utilizing educational games and creative stations including CPR and AED demonstrations we were able to educate and inform the community about healthy lifestyle choices. Also included were physical activities for adults and children including bounce houses and obstacle courses along with Zumba instruction, all promoting movement to improve health. Brookhaven Hospital offers a variety of medical lectures through our Knapp Cardiac Care Center, Breast Can 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 808392 0 0 0 5033 0 37150 0 23838 0 874413 0 0 0 B FARRELL VP FINANCE, CFO 450002 0 0 0 3647 0 23300 0 22003 0 498952 0 0 0 A PALLAS VP, COO 322569 0 0 0 0 0 7100 0 21335 0 351004 0 0 0 W WEHBEH FROM 117 VP, CQMO 439998 0 0 0 0 0 0 0 21934 0 461932 0 0 0 K WISDOM THRU 917 VP, CNO 235770 0 0 0 0 0 1700 0 20892 0 258362 0 0 0 C LINDERFROM 917-THRU 1217 ACTING, CNO 170001 0 0 0 20000 0 0 0 20659 0 210660 0 0 0 M THOMAS MD PHYSICIAN 327122 0 0 0 0 0 23300 0 21358 0 371780 0 0 0 R GUPTA PHYSICIAN 268161 0 10000 0 0 0 7059 0 21108 0 306328 0 0 0 F QURESHI PHYSICIAN 268646 0 0 0 0 0 9759 0 1370 0 279775 0 0 0 N AKHTAR PHYSICIAN 255641 0 0 0 0 0 6813 0 1304 0 263758 0 0 0 F DESORMEAUX MD PHYSICIAN 237317 0 0 0 0 0 8808 0 20900 0 267025 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 2014-03-01 35000000 SEE PART VI false false false A 5270000 0 23290341 0 0 0 0 0 0 117836 23172505 0 2006 false true true true B 283895 0 35028526 0 1929827 0 800451 0 0 18957398 12479100 861751 true false false 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 true true false 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. T CULLEN SEE PART V 886807 VENDOR false F GRUCCI III SEE PART V 214936 EMPLOYMENT false J DUDEK SEE PART V 142192 EMPLOYMENT false L B SCHWARZ SEE PART V 124700 EMPLOYMENT false M GRUCCI SEE PART V 104818 EMPLOYMENT false D KNAPP SEE PART V 26444 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, TREASURER. 3) J. DUDEK IS THE SISTER OF J. MAYER, DIRECTOR. 4) L. B. SCHWARZ IS THE DAUGHTER OF R. W. SCHWARZ, DIRECTOR. 5) M. GRUCCI IS THE NIECE OF F. GRUCCI, TREASURER. 6) D. KNAPP IS THE STEP-DAUGHTER OF M. KNAPP, SECRETARY. FORM 990, PART III, LINE 4D: 1) RENAL DIALYSIS - TOTAL VISITS: 31,767. TOTAL EXPENSES: $12,183,090. TOTAL REVENUE: $8,766,947. 2) HOME HEALTH AGENCY - PROVIDES CERTIFIED HOME HEALTH AND LONG TERM CARE TO THE COMMUNITY. TOTAL VISITS: 48,613. TOTAL EXPENSES: $8,041,097. TOTAL REVENUE: $5,700,589. 3) HOME PROGRAM DIALYSIS (CAPD) - TOTAL VISITS: 711. TOTAL EXPENSES: $4,942,942. TOTAL REVENUE: $339,180. 4) REFERRED AMBULATORY - TOTAL VISITS: 28,527. TOTAL EXPENSES: $2,968,129. TOTAL REVENUE: $5,575,432. 5) HOSPICE - TOTAL DAYS: 10,824. TOTAL EXPENSES: $2,700,506. TOTAL REVENUE: $1,299,767. 6) MENTAL HEALTH AND CHEMICAL DEPENDENCY OUTPATIENT CLINICS - TOTAL VISITS: 18,652. TOTAL EXPENSES: $2,691,552. TOTAL REVENUE: $1,817,928. 7) ALL OTHER CLINICS (WOUND CARE, HYPERBARIC, SLEEP, CARDIAC CATH, CARDIAC REHAB, PULMONARY REHAB, AND BELLPORT PRIMARY). TOTAL VISITS: 22,629. TOTAL EXPENSES: $15,638,784. TOTAL REVENUE: $14,792,227. 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: The Foundation (Brookhaven Health Care Services Corporation) is the sole member of Brookhaven Memorial Hospital Medical Center. The Foundation elects the board of Brookhaven Memorial Hospital Medical Center and appoints the President of Brookhaven Memorial Hospital Medical Center. 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 Brookhaven MEMORIAL HOSPITAL MEDICAL CENTER 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 BMHMC as compared to other organizations. 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 brookhaven memorial hospital medical center 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.....................$ 1,349,515. changes in net assets of BMH Foundation.................$ 3,883,188. appropriation of temporary restricted net assets for operations..............................................$ (179,376) transfer of assets from John J. Foley Nursing Home......$(15,495,389) Total...................................................$(10,442,062) 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 false Brookhaven Surgical Services PC 100 Hospital ROAD Patchogue NY 11772 260885844 PHYSICIAN OFFICE NY NA C 0 0 false LI Orthopedic & Spine Specialist PC 100 Hospital ROAD patchogue NY 11772 274670754 PHYSICIAN OFFICE NY NA C 0 0 false false false false true true false false false false true false false true true true false true false false