2018-11-19T08:40:19-06:00 2017-12-31 990 2017-01-01 111633487 GLEN COVE HOSPITAL C/O NORTHWELL HEALTH INC % NORTHWELL HEALTH INC GLEN 5163216058 972 BRUSH HOLLOW ROAD 5TH FL WESTBURY NY 11590 MICHELE L CUSACK SVP & CFO 5163216058 2018-11-01 69.27.229.128 11751820183195000000 2018-11-15 P 64888C196846E503F90B13161ED1827B039267C6 0CD7CF4964C06A5C296622734294A70AD3EA8837 2017 2019-02-21 02:37:17Z MICHAEL J DOWLING 2000 MARCUS AVENUE NEW HYDE PARK NY 11042 183561236 false X WWW.NORTHWELL.EDU X 1956 NY Glen Cove strives to improve the health of the communities it serves and is committed to providing the highest quality of care for the community regardless of ability to pay. 31 26 1236 90 0 33028 308316 129774020 141127929 2161095 2927027 2306566 1900093 134274709 146263365 0 0 0 0 94051280 102057357 0 0 12476 47607648 50096381 141658928 152153738 -7384219 -5890373 157552741 153706183 83807878 77277056 73744863 76429127 GLEN COVE HOSPITAL IS PART OF NORTHWELL HEALTH, INC. ("NORTHWELL"), WHICH STRIVES TO IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES AND IS COMMITTED TO PROVIDING THE HIGHEST QUALITY CLINICAL CARE; EDUCATING THE CURRENT AND FUTURE GENERATIONS OF HEALTHCARE PROFESSIONALS; SEARCHING FOR NEW ADVANCES IN MEDICINE THROUGH THE CONDUCT OF BIOMEDICAL RESEARCH; PROMOTING HEALTH EDUCATION; AND CARING FOR THE ENTIRE COMMUNITY REGARDLESS OF THE ABILITY TO PAY. false false 113927246 117720049 Glen Cove Hospital (GCH) is a 247-bed community hospital that offers inpatient medical/surgical, intensive and cardiac care, orthopedics, gynecology, pediatrics, and psychiatry. GCH offers state of the art inpatient and outpatient orthopedic rehabilitation services, including total joint replacement, spinal procedures and sports medicine. GCH has established itself as a national and international center for orthopedic surgery and joint replacement. GCH is also a NYS DOH - designated Stroke Center. In 2017, the hospital had 4,830 inpatient discharges, provided 18,692 emergency department visits and performed 2,811 ambulatory surgeries, including endoscopies. 23854812 18248330 Glen Cove Hospital is an affiliated member of Northwell Health ("Northwell") and part of Northwell's medical group and ambulatory lines of service. It strives to make a measurable difference in the health status of the communities it serves by providing comprehensive health care regardless of ability to pay. 4570132 5159550 North Shore-LIJ Imaging at Glen Cove provides a full range of diagnostic radiology services. Extensive imaging capabilities support multiple diagnostic goals, including primary diagnosis, the tracking of treatment process, pre-surgical testing and post-operative analysis. Exams are performed by certified technologist that use state of the art equipment coupled with the very latest advances in imaging techniques to ensure consistent high quality images, expert analysis and uncompromised quality. 142352190 true true false true false false false false false true true false false true true true 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 18 0 true 1236 true false false false false false false false false false false false false false false false X 31 26 true false false false false true true true true false false true true true true true true true true false NY X X NORTHWELL HEALTH INC 5163216058 972 BRUSH HOLLOW ROAD 5TH FL WESTBURY NY 11590 MICHAEL J DOWLING PRESIDENT & CEO 0.0 50.0 X X 0 4041927 54840 RICHARD D GOLDSTEIN IMMEDIATE PAST CHAIRMAN 0.0 2.0 X X 0 0 0 WILLIAM L MACK VICE CHAIRMAN 0.0 2.0 X X 0 0 0 BARRY RUBENSTEIN VICE CHAIRMAN 0.0 2.0 X X 0 0 0 ALAN I GREENE TREASURER 0.0 2.0 X X 0 0 0 DONALD ZUCKER SECRETARY 0.0 2.0 X X 0 0 0 MARK CLASTER CHAIRMAN 0.0 3.0 X X 0 0 0 RALPH NAPPI TRUSTEE & EVC 0.0 50.0 X X 0 995438 48848 NON-COMPENSATED TRUSTEES SEE SCHEDULE O 0.0 2.0 X 0 0 0 HOWARD B GOLD EVP, CHIEF MGD CARE 0.0 50.0 X 0 1779494 48495 MARK J SOLAZZO EVP, CHIEF OPERATING OFFICER 0.0 50.0 X 0 2473309 782518 ROBERT S SHAPIRO EVP & CFO 0.0 50.0 X 0 1649071 48848 LAWRENCE G SMITH MD EVP/PHYSICIAN-IN-CHIEF 0.0 50.0 X 0 1329674 50048 JEFFREY KRAUT SVP, STRATEGY ANALYTICS 0.0 50.0 X 0 1310075 557633 KATHLEEN GALLO RN PHD svp CHF LEARNING OFFICER 0.0 50.0 X 0 934879 48848 EUGENE TANGNEY SVP, CHIEF ADMIN OFFICER 0.0 50.0 X 0 1260472 300149 HARRY GINDI ASSISTANT SECRETARY 0.0 50.0 X 0 356152 48821 DONNA DRUMMOND SVP, CONSOLIDATED SERVICES 0.0 50.0 X 0 951732 254399 Laura Peabody SVP & Chief Legal Officer 0.0 50.0 X 0 1058897 222944 ANTHONY FERRERI EVP/CHF AFFILIATION OFF 0.0 50.0 X 0 1204847 48848 MICHELE CUSACK SVP & CFO 0.0 50.0 X 0 1071679 149487 RICHARD MILLER EVP & Chf Business Strategy Of 0.0 50.0 X 0 1109260 218236 LAURENCE KRAEMER SVP, Interim Chf Lgl Of 0.0 50.0 X 0 879404 58123 MARK GLOADE SVP Deputy GnCnsl & Asst Sec 0.0 50.0 X 0 576726 58123 SUSAN KWIATEK EXECUTIVE DIRECTOR 50.0 0.0 X 599910 0 58081 KEVIN BEINER SVP REG EXEC DIR 0.0 50.0 X 0 802100 39574 JOHN DANGELO SVP EMERGENCY SERVICES 50.0 0.0 X 961866 0 58082 MICHAEL GRIECO PHYSICIAN 50.0 0.0 X 573363 0 48848 BRADLEY SHERMAN MEDICAL DIRECTOR (SITE) 50.0 0.0 X 503520 0 58123 STEVEN WECK RADIOLOGIST 50.0 0.0 X 436052 0 58123 JOHN COLLETTA CHAIRPERSON 50.0 0.0 X 465158 0 50700 3539869 23785136 3370739 207 false true false Rolands Electric Inc 307 Suburban Ave DEER PARK NY 11729 Maintenance Services 705573 Empire General Contracting Corp 74 Main Street STE 2 TICKAHOE NY 10707 General Contractor 676996 STAPLES ADVANTAGE 500 STAPLES DRIVE FRAMINGHAM MA 01702 Printing Services 399152 Cross Country Staffing PO Box 404674 ATLANTA GA 30384 Facilities Services 333225 PW Grosser Consulting Inc 630 Johnson Ave BOHEMIA NY 11716 Consulting Services 332718 12 308316 308316 NET PATIENT SERVICE REVENUE 621300 79188631 79188631 PHYSICIAN PRACTICE REVENUE 621300 18467673 18467673 MEDICARE/MEDICAID PAYMENTS 621300 43471625 43471625 141127929 1301484 1301484 2620 2620 0 505673 26750 478923 0 478923 38894044 37271121 1622923 1622923 0 0 0 0 0 0 0 0 0 CAPITATION INCOME 900099 335390 335390 RESIDENCY ROTATION 900099 460277 460277 CAFETERIA SALES 900099 450993 450993 174510 169459 5051 1421170 146263365 142093055 1760148 0 0 0 0 599908 599908 0 81066892 77243567 3815266 8059 5205898 4960374 245006 518 9558908 9108085 449873 950 5625751 5360426 264766 559 192551 192551 0 0 0 0 0 1136304 1082713 53478 113 47949 45687 2257 5 19850136 18913952 934211 1973 0 0 2758384 2628298 129812 274 83759 83759 0 257007 257007 281717 281717 0 6202334 5909816 292518 2664631 2664631 MEDICAL & OTHER PURCHASED SERV 10183950 10183950 BAD DEBT 2004068 2004068 CENTRALIZED ADMIN EXP 3116446 3116446 BILLING & COLLECTIONS 1079868 1079868 237277 226081 11171 25 152153738 142352190 9789072 12476 4527 11178 77699436 72073022 0 0 13051434 14259549 0 0 0 0 0 0 1057214 1268343 155824 197047 93660510 49178567 46166303 44481943 4388285 5094142 0 0 0 0 0 0 15029718 16320959 157552741 153706183 16967641 16938971 0 0 0 0 7098327 6349091 0 0 0 0 0 0 0 0 59741910 53988994 83807878 77277056 X 61886327 62692367 8990295 10894021 2868241 2842739 73744863 76429127 157552741 153706183 X -5890373 7135831 1438806 X false true X true true true X false false false false false false false true 2864 false 2864 false false SCHEDULE C, PART 11-B, line 1 h GLEN COVE HOSPITAL IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION AND OTHER HEALTH CARE ASSOCIATIONS WHICH ENGAGE IN LOBBYING EFFORTS ON BEHALF OF THEIR MEMBER HOSPITALS. 3819186 100 709873 25603 4503556 3786158 33028 302964 302964 3819186 3773141 43098 -30081 0 3786158 3593291 35454 156873 12477 3773141 3105645 37797 487646 37797 3593291 1.00000 false false 174043 174043 67477544 37289912 30187632 22549347 11627578 10921769 3459577 261077 3198499 44481943 INTEREST IN FOUNDATION,UNREST. 5674328 BOND FINANCING 35610 DEPOSITS ON EQUIPMENT 16973 OTHER ASSETS 2362494 AUXILIARY 36658 INSURANCE CLAIMS RECEIVABLE 8194896 16320959 0 ESTIMATED PAYABLE TO 3RD PARTY 6218591 OTHER LIABILITIES 950218 MALPRACTICE INSURANCE 13676376 PENSION 14621606 BOND PREM/DISC 292141 INSURANCE CLAIMS LIABILITY 8194896 DUE TO AFFILIATES 10035166 53988994 X 150218749 6681481 -2522827 4158654 146060095 203270 203270 146263365 149416244 26750 26750 149389494 2764244 2764244 152153738 PART X, LINE 2 Certain entities included in Northwells consolidated financial statements are taxable entities under Federal or state laws. U.S. generally accepted accounting principles require that the asset and liability method of accounting for income taxes be utilized by these organizations and for unrelated business activities for the tax-exempt entities. Under the asset and liability method, deferred income taxes are recognized for the tax consequences of temporary differences by applying enacted statutory tax rates applicable to future years to differences between the financial statement carrying amounts and the tax basis of existing assets and liabilities. The effect on deferred taxes of a change in tax rates is recognized in income in the period of enactment. At December 31, 2017 and 2016, Northwell has a deferred income tax asset OF approximately $123,000,000 and $142,000,000, respectively, both of which have been fully offset by a related valuation allowance. A valuation allowance is provided when it is more likely than not that some portion or all of the deferred tax asset will not be realized. Significant components of the deferred tax asset relate to the allowance for doubtful accounts and net operating loss carryforwards. Certain entities have net operating loss carryforwards aggregating approximately $573,000,000, which expire in varying amounts through 2037, and are available to offset future taxable income. PART V, LINE 4 There are various components that encompass the Endowment Fund. In general, their intended use is for teaching, research and training, major modernization, and purchases of equipment. PART XI, LINE 2D PROVISION FOR BAD DEBTS (2,004,068) NONOPERATING NET PERIODIC BENEFIT COST (518,759) Total (2,522,827) PART XI, LINE 4B TEMP RESTRICTED CONTRIBUTIONS (25,503) RESTRICTED INVESTMENT INCOME 255,522 rental Expense (26,750) Total 203,270 PART XII, LINE 2d Rental expense 26,750 PART XII, LINE 4B ADDITIONAL MINIMUM LIABILITY ON PENSION 241,417 NONOPERATING NET PERIODIC BENEFIT COST 518,759 PROVISION FOR BAD DEBT 2,004,068 total 2,764,244 true true X true X true X 500. true true true false true true 4436874 1242946 3193927 0.02130 22006269 13463577 8542692 0.05690 26443143 14706523 11736619 0.07820 568076 568076 0.00380 3034886 1373127 1661759 0.01110 71699 71699 0.00050 12218 12218 0.00010 105031 105031 0.00070 3791910 1373127 2418783 0.01620 30235053 16079650 14155402 0.09440 9714 9714 0.00010 24991 24991 0.00020 29319 29319 0.00020 6 6 1305 1305 65335 65335 0.00050 false 348129 46776616 53398893 -6622277 X true true 1 1 GLEN COVE HOSPITAL 101 ST ANDREWS LANE GLEN COVE NY 11542 WWW.NORTHWELL.EDU X X X X GLEN COVE HOSPITAL 1 false false true X X X X X X X X X 16 true true true true X WWW.NORTHWELL.EDU X true 16 true WWW.NORTHWELL.EDU/ABOUT/OUR-ORGANIZATION/OFFI false true X 100 500. X X X X true true X X X true X WWW.NORTHWELL.EDU X WWW.NORTHWELL.EDU X WWW.NORTHWELL.EDU X X X X X X X true X false X X X X X true X false false Part V, Section C, Supplemental Information Part V, Section B, line 2: N/A Part V, Section B, line 3j: N/A Part V, Section B, line 5: The CHNA was facilitated by committees established within each county served by Northwell and its hospitals. These were comprised of participants such as Departments of Health; community based organizations (CBOs); the Northwell; local businesses; and faith-based organizations; and a voice of the community (i.e. the communitys perception of need). Qualitative data was collected from diverse community organizations that serve the population-at-large, as well as those communities with significant health disparities. Community partners were invited to participate via surveys and key informant interviews. Emphasis was placed on the following populations: minorities/underserved communities, seniors, women and children, special populations, and individuals with disease-specific conditions. Primary data was obtained through qualitative analysis of CBO informant interviews, CBO surveys, individual community member surveys, and participation in the collaborative partner listening sessions. For further detail go to web link: Part V, Section B, line 6a: For a detailed listing of other hospital facilities go to web link: https://www.northwell.edu/about/our-organization/office-community-and-publ ic-health/reports Part V, Section B, line 6b: For a detailed listing of other hospital facilities go to web link: https://www.northwell.edu/about/our-organization/office-community-and-publ ic-health/reports Part V, Section B, line 7d: N/A Part V, Section B, line 11: The hospital identified and addressed primary needs based on an assessment of the highest ranked health priorities of the community, regulatory input (i.e. the NYC Department of Health prevention priority agenda), and resources available. For further information go to web link: https://www.northwell.edu/about/our-organization/office-community-and-publ ic-health/reports Part V, Section B, line 13b: N/A Part V, Section B, line 13h: The hospital also uses household size. Part V, Section B, line 15e: N/A Part V, Section B, line 16j: The policy is included in the hospitals Community Service Plan and provided at health fairs and presentations open to the community at no cost, in addition to mailing financial policy summary brochures. Part V, Section B, line 18e: N/A Part V, Section B, line 19e: N/A Part V, Section B, line 20e: Before initiating any of the actions, the hospital facility sends letters, makes telephone calls and utilizes presumptive eligibility. Part V, Section B, line 21c: N/A Part V, Section B, line 21d: N/A Part V, Section B, line 23: N/A Part V, Section B, line 24: N/A 5 Northwell Health Physician Partners 10 Medical Plaza Ste 208 Glen Cove NY 11542 Outpatient Physician Clinic North Shore - LIJ Imaging at Glen Cove 10 Medical Plaza Ste 106 Glen Cove NY 11542 Diagnostic Center School Street Family Medicine 1 School Street Ste 203 Glen Cove NY 11542 Outpatient Physician Clinic Family Medicine at Oyster Bay 70 West Main Street Oyster Bay NY 11771 Outpatient Physician Clinic Orthopaedic Associates of Great Neck 825 Northern Boulevard Ste 300 Great Neck NY 11021 Outpatient Physician Clinic PART VI - SUPPLEMENTAL INFORMATION Question 1: Part I, Line 3c: This hospital is an affiliated entity of Northwell Health Inc. (Northwell). Northwell uses FPG to determine eligibility and utilizes the New York State Department of Health (NYSDOH) guidelines regarding the consideration of assets. Asset tests cannot be used to deny financial assistance, but only to upgrade a patients level of obligation, up to the legal maximum permitted under the financial assistance law. Part I, Line 6a: The Community Benefit report is prepared by the hospital, in conjunction with an affiliated entity (Northwell) of the hospital. The Community Benefit Report is accessible to the public and can be accessed on the Northwell website: https://www.northwell.edu/about/our-organization/office-community-and-publ ic-health/reports. Part I, 7: Row (a) The cost of charity care was determined by utilizing the ratio of cost to charges (RCC) calculated on Worksheet 2 applied to gross charges written off for patients qualifying for charity under the hospitals financial assistance policy. Bad Debt was not reported in any row of Part I, Line 7. Row (b) The Ratio of Cost to Charges method (or RCC) is used to determine the cost of ancillary services. A RCC is developed from these costs, and that RCC is applied to total Medicaid gross ancillary services charges to determine the cost of services provided to Medicaid patients. Row (e) Costs associated with Community Health Improvement Services were determined by adding indirect or overhead costs to the direct costs of the activity. Indirect costs were calculated as a percentage of direct costs. Direct costs for staff expenses were calculated using average system hourly rates, and were adjusted to account for fringe benefits, using a blended rate based on the ratio of total employee benefit expenses to total salary and wages. Row (f) The Bad Debt Expense that appears on Form 990, Part IX, Line 25 column (A), but not included for purposes of calculating the percentage in this column is equal to the amount reported on Form 990, Part X. The costs related to health professions education were determined by utilizing the step down method of cost finding. Row (h) Costs associated with research activities were determined by adding indirect, or overhead, costs to the direct costs of the activity. Indirect costs were calculated as a percentage of costs. Row (i) The cost of in-kind contributions to community groups is comprised of the direct costs of personnel whose compensated time was donated to various charities and community groups. The salaries and wages were adjusted to include benefits using a rate based on the ratio of total employee benefit expenses to total salary and wages. Indirect costs were calculated as a percentage of direct costs. Column (f) for Rows (c)-(k) The percentage of Net Community Benefit Expense divided by Total Expense for the hospital (to calculate the percent of total expense). Note: For the entire Northwell Health Inc. and affiliates, Part I, Line 7 (Row K, Column F) is approximately 11.96 as a percentage of expenses. Part II: All community building activities improve access to health services and address federal, state, or local public health priorities, as well as leverage public health department activities, and in doing so, they provide relief of government burden. These activities broadly serve low-income, underserved patients, and include: collaboration with various community coalitions, system-wide recycling initiative, organizational response to worldly disasters, and bioterrorism efforts. Northwells bioterrorism & disaster preparedness includes Center for Emergency Medical Services, has a designated Bioterrorism Resource Center, and has conducted staff training for more than 100 hospitals and area first responders and invested heavily in the infrastructure needed for large-scale emergencies. During catastrophes (both natural and terrorism), Northwell provides a safe haven for thousands of patients, outside nursing home residents, and community members seeking shelter. Northwell assists with the transport of patients and stand ready to contribute food, medicine, and blankets for both affiliated and non-affiliated hospital patients. Investment in a field hospital has furthered the public health infrastructure needed for mass casualties that could result from a terrorist attack, natural attack, or large-scale emergency. Part III, Line 2: For patients who were determined by Northwell to have the ability to pay but did not, the uncollected amounts are recorded as bad debt expense. The amount of gross charges written off is reduced by any charity care or other discounts provided to the patient, as well as any payments received. Bad debt expense reported on this line is reported net of governmental or private offsetting funds. Part III, Line 3: N/A Part III, Line 4: For patients who were determined by Northwell to have the ability to pay but did not, the uncollected amounts are recorded as bad debt expense. Part III, Line 8: Medicare costs are determined utilizing a combination of the step down method of cost findings and a cost per unit of service. Cost per unit of service is used to calculate the routine cost of services provided to Medicare patients. The Ratio of Cost to Charges method (or RCC) is used to determine the cost of ancillary services. An RCC is developed from these costs, and that RCC is applied to total Medicare gross ancillary services charges to determine the cost of services provided to Medicare patients. Part III, Line 9b: The organizations collection policy is standard to all accounts regardless of insurance status (e.g. insured, underinsured, and uninsured). The hospitals collection policy states that they will not send patient accounts to collection if a decision on a financial assistance application is pending, or if a patient is determined to be eligible for Medicaid at the time services were rendered and for which services Medicaid payment is available. Question 2: NEEDS ASSESSMENT: The Community Health Needs Assessment (CHNA) is performed on an ongoing basis. Northwell conducts and participates in population, demographic, and health status evaluations of our respective hospitals service areas based on county regions and the communities we serve. There is a special effort to include individuals with health disparities and organizations who serve these communities in the CHNA process. The CHNA includes the analysis of primary and secondary data. Multi-year analyses, trends and projections are developed, which identify areas of need for the continuum of health care services. Primary data is obtained through a combination of qualitative analysis of community-based organization (CBO), informant interviews and surveys, individual community member surveys, and participation in collaborative partner meetings. These meetings include representatives from the Departments of Health, CBOs, academic institutions, government agencies, and hospitals. Ongoing input concerning our communities needs is also obtained through: our Board of Trustees/Directors who are all area residents and leaders in their respective communities; facility based advisory boards and councils, and; the feedback received by our facility administrators and clinicians that serve on local community agency boards. Secondary data analysis includes: internal hospital data, including Prevention Quality Indicators (PQI); Department of Health Community Health Assessments; local regional NYS Prevention Agenda data sources; and Statewide Planning and Research System (SPARCS) data. The Committee on Community Health, a committee of the Board of Trustees, provides recommendations that concern Northwells community health priorities and interventions based on the CHNA. Committee discussions focus on New York State (NYS) Prevention Agenda Priority Areas, including strategies and intervention outcomes related to chronic disease prevention, women and childrens health, healthy safe environments, health access, mental health and substance abuse, HIV/AIDS/STDs and community immunizations. Regional departments of health (I.E. Nassau County Department of Health, Suffolk County Department of Health Services, and NYC Department of Health and Mental Hygiene) perform additional community health assessments (CHA) with the input of hospital and community stakeholders. These regional partners use strategies such as community member surveys, CBO surveys, and public listening sessions to solicit information on community needs. Together with other healthcare organizations and CBOs, Northwell participates in meetings organized by these regional departments of health academic organizations to discuss the shared responsibility of public health planning within the NYS Prevention Agenda. These meetings provide an opportunity for general discussion regarding the public health goals of the NYS Prevention Agenda and the selection of shared priorities for collaborative regional planning. T X X X X X false true false true false false false true false MICHAEL J DOWLING PRESIDENT & CEO 0 1474558 0 2543853 0 23516 0 29700 0 25140 0 4096767 0 0 HOWARD B GOLD EVP, CHIEF MGD CARE 0 1076639 0 670464 0 32391 0 29700 0 18795 0 1827989 0 0 MARK J SOLAZZO EVP, CHIEF OPERATING OFFICER 0 1444332 0 1000000 0 28977 0 770985 0 11533 0 3255827 0 0 ROBERT S SHAPIRO EVP & CFO 0 1171054 0 421415 0 56602 0 29700 0 19148 0 1697919 0 0 LAWRENCE G SMITH MD EVP/PHYSICIAN-IN-CHIEF 0 1003732 0 297751 0 28191 0 29700 0 20348 0 1379722 0 0 JEFFREY KRAUT SVP, STRATEGY ANALYTICS 0 917461 0 344037 0 48577 0 530377 0 27256 0 1867708 0 0 KATHLEEN GALLO RN PHD svp CHF LEARNING OFFICER 0 670899 0 230549 0 33431 0 29700 0 19148 0 983727 0 0 EUGENE TANGNEY SVP, CHIEF ADMIN OFFICER 0 997983 0 251479 0 11010 0 271726 0 28423 0 1560621 0 0 HARRY GINDI ASSISTANT SECRETARY 0 304506 0 47201 0 4445 0 29700 0 19121 0 404973 0 0 DONNA DRUMMOND SVP, CONSOLIDATED SERVICES 0 684675 0 235506 0 31551 0 225976 0 28423 0 1206131 0 0 RALPH NAPPI TRUSTEE & EVC 0 720899 0 243445 0 31094 0 29700 0 19148 0 1044286 0 0 SUSAN KWIATEK EXECUTIVE DIRECTOR 419686 0 136662 0 43562 0 29700 0 28381 0 657991 0 0 0 Laura Peabody SVP & Chief Legal Officer 0 707941 0 282134 0 68822 0 203936 0 19008 0 1281841 0 0 JOHN DANGELO SVP EMERGENCY SERVICES 763414 0 122690 0 75762 0 29700 0 28382 0 1019948 0 0 0 MICHAEL GRIECO PHYSICIAN 474922 0 0 0 98441 0 29700 0 19148 0 622211 0 0 0 ANTHONY FERRERI EVP/CHF AFFILIATION OFF 0 92419 0 278561 0 833867 0 29700 0 19148 0 1253695 0 0 BRADLEY SHERMAN MEDICAL DIRECTOR (SITE) 413808 0 65620 0 24092 0 29700 0 28423 0 561643 0 0 0 STEVEN WECK RADIOLOGIST 388196 0 7500 0 40356 0 29700 0 28423 0 494175 0 0 0 KEVIN BEINER SVP REG EXEC DIR 0 643230 0 130184 0 28686 0 29700 0 9874 0 841674 0 0 MICHELE CUSACK SVP & CFO 0 775211 0 284418 0 12050 0 121106 0 28381 0 1221166 0 0 RICHARD MILLER EVP & Chf Business Strategy Of 0 777892 0 299893 0 31475 0 198971 0 19265 0 1327496 0 0 LAURENCE KRAEMER SVP, Interim Chf Lgl Of 0 632884 0 204756 0 41764 0 29700 0 28423 0 937527 0 0 MARK GLOADE SVP Deputy GnCnsl & Asst Sec 0 469518 0 67744 0 39464 0 29700 0 28423 0 634849 0 0 JOHN COLLETTA CHAIRPERSON 411897 0 26719 0 26542 0 29700 0 21000 0 515858 0 0 0 PART I, LINE 4B Certain individuals participate in a Supplemental Executive Retirement Plan ("SERP") which is subject to substantial risk of complete forfeiture. Accordingly, the individual may never actually receive the unvested benefit amount and the amounts outlined herein were properly not reported in each individual's Form W-2, Box 5. These amounts are included in Schedule J, Column C for Mark J Solazzo ($741,285), Jeffrey Kraut ($500,677), Michele L. Cusack ($91,406), Richard Miller ($169,271), Donna Drummond ($196,276), Eugene Tangney ($242,026), and Laura Peabody ($174,236). PART I, LINE 5A Pursuant to the persons listed in Form 990, Part VII, section A, line 1A, there is no contractual obligation to pay or accrue any compensation to officers of the Northwell Health, Inc. based on the revenue of the organization. A listed person(s) that may qualify under this condition could be one or more of the physicians listed as a highly compensated employee. PART I, LINE 7 On Form 990, Part VII, Section A, line 1A, the organization may provide non-fixed payments, not described on lines 5 and 6, to certain listed persons. The organization bases such payments on many performance based factors. Payments of this type appear on Schedule J, Part II, B (ii). Schedule J, Part II, Column (F) The amount reported in Schedule J, Part II, Column (F) includes SERP amounts which were previously reported on Form 990, Schedule J, Part II, Column (C) in prior years. In accordance with the IRS instructions, these amounts were originally reported when contributions were made to the SERP plan and are now being reported for a second time upon receipt of distribution from the SERP plan. A DORMITORY AUTHORITY OF THE STATE OF NEW YORK 146000293 649903LC3 2007-05-31 1238184 2007 A&B Bonds-CAP IMPROV & REFUND true false false B DORMITORY AUTHORITY OF THE STATE OF NEW YORK 146000293 649905QL3 2009-09-17 1412648 2009 A&E BONDS - CAP IMPROV & REFI true false false C DORMITORY AUTHORITY OF THE STATE OF NEW YORK 146000293 649906UY8 2012-05-03 2967249 2012 A BONDS-REFUNDING 1998 BONDS false false false D DORMITORY AUTHORITY OF THE STATE OF NEW YORK 146000293 64990BNL3 2015-06-23 3087445 2015 A BONDS - REFUND 2005 false false false A 6338240 0 7157676 79397 107800 0 72297 0 0 1715424 5262156 0 2009 true true true true B 602322 4150880 6077075 95586 473601 0 99282 0 223063 4277733 1003396 0 2012 true false true true C 1293510 0 3399354 0 0 0 64062 0 0 0 3335292 0 2012 true false true true D 80919 0 3398307 0 19461 1313453 30889 0 0 365793 1595366 0 true true false true A false false true true true true 0.00460 0.00460 false false false true B false false false false 0 false false false true C false false false false 0 false false false true D false false false 0 false false false true A false false true true false true Citibank NA 25.9 true false true MBIA 18.1 true true true B false false true true false false 0 false 0 true true C false false true true false false 0 false 0 false true D false true true false false false 0 false 0 false true A true B true C true D true PART II, LINE 3 - PROCEEDS, THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO INVEST EARNINGS & TRANSFERRED PROCEEDS PART IV, LINE 2C - REBATE CALCULATION PERFORMED ON 11/3/2012 FOR 2012 BOND , SINCE BOND PROCEEDS HAVE BEEN SPENT A SPENDING EXCEPTION WAS MET PART VI, SECTION A - GOVERNING BODY, LINE 2 All transactions with Northwell Health entities are as follows: (1) negotiated at arms length; (2) all purchases are at fair market value; and (3) all products or services are rendered on an as needed basis. Roger Blumencranz has a business relationship with Richard D. Goldstein, Alan Greene, Saul Katz, Ralph Nappi, Mark Solazzo and Donald Zucker. Mark Claster has a business relationship with Robert Rosenthal. Lloyd Goldman has a business relationship with Richard Goldstein and William Mack. Richard D. Goldstein has a business relationship with Roger Blumencranz, Lloyd Goldman, William Mack and Barry Rubenstein. Alan Greene has a business relationship with Roger Blumencranz, Seth Lipsay, F.J. McCarthy, and Robert Rosenthal. Saul Katz has a business relationship with Roger Blumencranz, Seth Lipsay, and F.J. McCarthy Jeffrey Lane has a business relationship with William Mack. Seth Lipsay has a business relationship with Saul Katz and Robert Rosenthal. William Mack has business relationships with Lloyd Goldman, Richard Goldstein, Jeffrey Lane, Barry Rubenstein and Roy Zuckerberg. F.J. McCarthy has a business relationship with Saul Katz and Robert Rosenthal. Ralph Nappi has a business relationship with Roger Blumencranz. Robert Rosenthal has a business relationship with Mark Claster, Seth Lipsay and F.J. McCarthy. Barry Rubenstein has a business relationship with Richard Goldstein and William Mack. PART VI, SECTION B - POLICIES, LINE 11 The annual Return of Organization Exempt From Income Tax (Form 990) for Northwell Health, Inc. and Affiliated entities are prepared with input from various departments including Corporate Compliance, Finance, Human Resources, and Legal. Before filing the returns, the documents are electronically made available to all trustees through a secure online portal. Members of the Executive Committee are then informed the returns are ready for review. The Executive Committee, which is a committee made up of members from the Board of Trustees, may exercise all of the authority of the Board of Trustees except as such authority is limited by applicable law and except to the extent, if any, that such authority would be inconsistent with any provision of these By-laws or is limited by any resolution to such effect adopted by the Board of Trustees. PART VI, SECTION B-POLICIES, LINE 12C Northwell Health, Inc. ("Northwell") has several control mechanisms to mitigate conflicts of interest. Northwells Code of Ethical Conduct contains a detailed section educating individuals about how to avoid potential conflicts of interest. Specifically, our Code of Ethical Conduct requires individuals to conduct Northwell business in a manner that places the interests of Northwell ahead of their personal interests. In addition, Northwell has a Conflicts of Interest Policy Statement further elaborating upon individuals' disclosure and recusal obligations. Individuals that are in a position to influence the business or other decisions of Northwell are required to fill out a conflicts of interest disclosure form on a regular basis. The Corporate Compliance Office reviews all disclosures of possible conflicts, including matters disclosed in any conflicts of interest disclosure report and takes any actions deemed required or appropriate to manage or resolve any actual or potential conflicts of interest. In appropriate cases these disclosures and responsive actions will be reported to Northwells Audit and Corporate Compliance Committee and other applicable committees. In addition, Northwell provides training to individuals on an annual basis regarding conflicts of interest and other compliance related topics. If an individual violates the Code of Ethical Conduct or any related policy such as the Conflicts of Interest Policy Statement, appropriate disciplinary action is taken based upon the facts and circumstances of the situation. PART VI, SECTION B-POLICIES, LINE 15 The by-laws of Northwell Health, Inc. ("Northwell") create a committee of the board with full powers of the board to review and approve the compensation of officers and other key employees. The committee consists of approximately 6 trustees who have no connection to Northwell except as trustees and they have no conflicts as to matters they consider. The committee meets several times a year as needed but always meets in November/December to review and determine officer and key employee compensation for the following year. For purposes of their review the committee considers the recommendations of the CEO for all persons other than the CEO. For purposes of the review each year the committee receives information from an outside independent compensation consultant as to compensation for comparable positions in comparable organizations and makes its decisions on this basis, with the overall objective of paying base salary at the 50th percentile. Any contracts or other compensation for officers or key employees are separately considered and normally only approved after receipt of a "fairness opinion" from the independent consultant. All the work and process of the committee is structured to fall within the applicable safe harbor regulations. PART VI, SECTION C-DISCLOSURES, LINE 19 CURRENTLY THE ORGANIZATION MAKES IT GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. PART VII, SECTION A - LINE 1A Frank J. Besignano Alan I. Greene Patrick F. McDermott Roger A. Blumencranz Paul B. Guenther Ralph A. Nappi Robert W. Chasanoff William O. Hiltz Richard B. Nye Mark. Claster Nancy Karch Sharon Patterson Michael J. Dowling Saul B. Katz Lewis S. Ranieri Michael A. Epstein Cary Kravet Robert D. Rosenthal Michael E. Feldman Jeffrey B. Lane Barry Rubenstein Catherine C. Foster Seth Lipsay Richard J. Sinni L. Keith Friedlander William L. Mack Donald Zucker Lloyd M. Goldman F.J. McCarthy Roy J. Zuckerberg Richard D. Goldstein PART VII, SECTION A - LINE 1A, COLUMN (B) This organization is affiliated with Northwell Health, Inc. ("Northwell"). The Officers, Directors and Trustees listed on Schedule J hold similar positions with both this organization and other affiliates of Northwell, and they do not separately allocate their time to this organization and such other affiliates. The hours shown for all such persons reflect time devoted to Northwell and its affiliates, including this organization. For Directors and Trustees, the hours shown reflect the estimated average weekly time. For officers, Key Employees and Highest Compensated Employees, the hours shown reflect the weekly hours used when determining compensation payments for services rendered and are, generally, less than the actual weekly hours devoted to Northwell and its affiliates. PART VI, SECTION A - GOVERNING BODY, LINE 7 Northwell Healthcare, Inc. ("Northwell Healthcare") is the sole corporate member of the organization. Northwell Healthcare has the right to elect or appoint member of the organization's governing body and has the right to approve or ratify certain corporate decisions. This organization and Northwell Healthcare are part of Northwell Health, Inc., an integrated health care delivery system. PART XI, LINE 9 CHANGE IN EQUITY UNDER FAS 136 1,374,910 TRANSFER FROM AFFILIATES 73,372 DECREASE IN AUXILIARY ASSETS (9,476) TOTAL 1,438,806 NORTHWELL HEALTH INC 972 BRUSH HOLLOW RD WESTBURY NY 11590 113418133 SUPPORT ORG NY 501(C)(3) 12, TYPE I NA false NORTHWELL HEALTHCARE INC 972 BRUSH HOLLOW RD WESTBURY NY 11590 112965586 SUPPORT ORG NY 501(C)(3) 12, TYPE I NW HEALTH false NORTH SHORE UNIVERSITY HOSPITAL 972 BRUSH HOLLOW RD WESTBURY NY 11590 111562701 HEALTH CARE NY 501(C)(3) 3 NW HEALTHCAR false LONG ISLAND JEWISH MEDICAL CENTER 972 BRUSH HOLLOW RD WESTBURY NY 11590 112241326 HEALTH CARE NY 501(C)(3) 3 NW HEALTHCAR false PLAINVIEW HOSPITAL 972 BRUSH HOLLOW RD WESTBURY NY 11590 113241243 HEALTH CARE NY 501(C)(3) 3 NW HEALTHCAR false SOUTHSIDE HOSPITAL 972 BRUSH HOLLOW RD WESTBURY NY 11590 111667761 HEALTH CARE NY 501(C)(3) 3 NW HEALTHCAR false NORTHWELL HEALTH LABORATORIES 972 BRUSH HOLLOW RD WESTBURY NY 11590 113412370 SUPPORT ORG NY 501(C)(3) 12, TYPE I NW HEALTH false FEINSTEIN 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