2017-11-12T12:28:31-06:00 2016-12-31 ERNST & YOUNG US LLP 5 TIMES SQUARE NEW YORK NY 10036 990 2016-01-01 462916938 MONTEFIORE MOUNT VERNON HOSPITAL % EVAN RESNICK MONT 9143498455 12 NORTH SEVENTH AVENUE MOUNT VERNON NY 105502026 COLLEEN M BLYE EXEC V.P. & C.F.O. 7189207602 2017-11-10 true CHRISTOPHER B BOGGS P00032493 2127733000 108.206.163.59 26308520173165000006 2017-11-12 P 723A92BD6066970D9DF2371F65DCD51A2FC70B05 582F47EFACDD6166E52205D1FBFEA2601660FA18 2016 2017-02-10 21:41:12Z STEVEN SAFYER MD 111 EAST 210TH STREET BRONX NY 104672401 94874067 false X http://www.montefiorehs.org X 2013 NY TO HEAL, TO TEACH, TO DISCOVER AND TO ADVANCE THE HEALTH OF THE COMMUNITIES WE SERVE. 44 43 675 75 0 14884265 26345293 63113094 67917403 0 0 2676017 611371 80673376 94874067 0 0 0 0 49764814 50489123 0 0 0 33452812 34514873 83217626 85003996 -2544250 9870071 27231414 27887014 37551939 32893825 -10320525 -5006811 MISSION: TO HEAL, TO TEACH, TO DISCOVER AND TO ADVANCE THE HEALTH OF THE COMMUNITIES WE SERVE. VALUES: HUMANITY, INNOVATION, TEAMWORK, DIVERSITY AND EQUITY - OUR VALUES DEFINE OUR PHILOSOPHY OF CARE. THEY SHAPE OUR ACTIONS AND MOTIVATE AND INSPIRE US TO PURSUE EXCELLENCE AND ACHIEVE OUR GOALS. false false 77595878 0 67917403 Montefiore Mount Vernon Hospital is a 176-bed, community-based, teaching hospital that has been serving the medical needs of the community and region. Montefiore Mount Vernon provides inpatient, critical care and ambulatory services to residents of lower Westchester County. The hospital is part of Montefiore Health System, the University hospital for the Albert Einstein College of Medicine. MONTEFIORE MOUNT VERNON HOSPITAL BEGAN OPERATIONS ON NOVEMBER 6, 2013. MONTEFIORE MOUNT VERNON'S MISSION IS TO HEAL, TO TEACH, TO DISCOVER AND TO ADVANCE THE HEALTH OF THE COMMUNITIES IT SERVES. To this mission Montefiore Mount Vernon brings a unique synergy of strengths and resources that has helped define healthcare delivery in the area and have earned Mount Vernon the distinction of being a designated New York stroke and HIV/aids Center. Mount Vernon hospital is also home to the Beale Chronic Wound treatment and hyperbaric center and the Montefiore School of Nursing. During, 2016 Montefiore Mount Vernon hospital had 3,332 admissions and provided 53,243 ambulatory visits. 77595878 true true false true false false false false false false true false false true true false false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true true false false true 16 0 true 675 true false false false false false false false false false false X 44 43 false false false false true true true true true false false true true true true true true false false false NY X EVAN RESNICK 9143498455 555 SO BROADWAY BLDG A FL 1 TARRYTOWN NY 105916301 ODED ABOODI VICE CHAIRMAN & TREASURER 0.3 2.2 X 0 0 0 JAY B ABRAMSON TRUSTEE 0.3 2.2 X 0 0 0 MARGARET HAYES ADAME TRUSTEE 0.2 1.8 X 0 0 0 GEORGE ASCH TRUSTEE 0.2 1.3 X 0 0 0 JOSEPH W BARTLETT TRUSTEE 0.2 1.3 X 0 0 0 PATRICIA BAUMAN TRUSTEE 0.2 1.3 X 0 0 0 JAMES M BUTLER TRUSTEE 0.3 2.7 X 0 0 0 GEORGE CAMPBELL JR PHD TRUSTEE(trustee emeritus 6-16) 0.2 1.3 X 0 0 0 BRUCE DONIGER TRUSTEE 0.2 1.3 X 0 0 0 RUTH L GOTTESMAN EDD TRUSTEE 0.2 1.8 X 0 0 0 BARRY W GRAY TRUSTEE 0.2 1.3 X 0 0 0 PATRICIA GREEN TRUSTEE 0.2 1.3 X 0 0 0 THOMAS L HARRISON TRUSTEE 0.2 1.3 X 0 0 0 JOHN HEFFER TRUSTEE 0.3 2.2 X 0 0 0 LEWIS HENKIND SECRETARY 0.3 3.2 X 0 0 0 HELEN A JOHNSON TRUSTEE 0.3 2.2 X 0 0 0 DAVID B KEIDAN TRUSTEE 0.2 1.3 X 0 0 0 ALAN M KLEIN TRUSTEE 0.4 3.1 X 0 0 0 STACEY R LANE TRUSTEE 0.3 2.2 X 0 0 0 JAY B LANGNER TRUSTEE/CHAIRMAN EMERITUS 0.2 1.3 X 0 0 0 MARGARET S NATHAN TRUSTEE 0.2 1.3 X 0 0 0 PETER J NEUFELD TRUSTEE 0.2 1.3 X 0 0 0 GAYLE F ROBINSON TRUSTEE 0.2 1.3 X 0 0 0 JON W ROTENSTREICH TRUSTEE 0.2 1.3 X 0 0 0 HON FELICIA K SHEA TRUSTEE 0.2 1.3 X 0 0 0 EDWIN H STERN III TRUSTEE 0.2 1.3 X 0 0 0 DAVID A TANNER CHAIRMAN 0.2 8.05 X 0 0 0 CYNTHIA KING VANCE TRUSTEE 0.3 2.2 X 0 0 0 JIDE J ZEITLIN TRUSTEE 0.2 1.3 X 0 0 0 JENNIE EMIL TRUSTEE 0.2 1.3 X 0 0 0 JONATHAN A LIPTON TRUSTEE 0.2 1.3 X 0 0 0 ZITA G ROSENTHAL TRUSTEE 0.2 1.3 X 0 0 0 GREGG S HYMOWITZ TRUSTEE 0.2 1.3 X 0 0 0 NATHAN GANTCHER TRUSTEE 0.2 1.8 X 0 0 0 CATHERINE KLEMA TRUSTEE 0.2 1.3 X 0 0 0 MELISSA CERIALE TRUSTEE 0.4 3.1 X 0 0 0 MARK MLOTEK TRUSTEE (resigned 6/14/16) 0.2 1.3 X 0 0 0 BARRY S BLATTMAN TRUSTEE 0.2 1.3 X 0 0 0 MARK E BROSSMAN TRUSTEE 0.2 1.3 X 0 0 0 MATTHEW H NORD TRUSTEE 0.2 1.3 X 0 0 0 MICHAEL A STOCKER MD TRUSTEE 0.3 2.7 X 0 0 0 ROGER EINIGER TRUSTEE 0.2 1.8 X 0 0 0 JOEL BRAUN TRUSTEE (ELECTED 10/18/16) 0.2 1.3 X 0 0 0 EMANUEL CHIRRICO TRUSTEE (ELECTED 10/18/16) 0.2 1.3 X 0 0 0 W NORMAN MILNER TRUSTEE (ELECTED 2/9/16) 0.2 1.3 X 0 0 0 STEVEN M SAFYER MD PRESIDENT & CEO 1.0 59.0 X X 0 4327957 51831 PHILIP O OZUAH MDPHD EXECUTIVE VP & COO 1.0 59.0 X 0 2492636 538092 CHRISTOPHER S PANCZNER SENIOR VP & GENERAL COUNSEL 1.0 59.0 X 0 1041654 187726 JOEL A PERLMAN EXEC VP & CFO(resigned 1/6/16) 1.0 59.0 X 0 1454254 51654 COLLEEN BLYE EXEC VP & CFO (ELECTED 1/6/16) 1.0 59.0 X 0 1313840 429032 SUSAN GREEN-LORENZEN RN SENIOR VP-OPERATIONS 1.0 59.0 X 0 1163388 366879 LYNN RICHMOND Executive Vice President 1.0 59.0 X 0 1393009 420068 Jaccel Kouns VP/Executive Director 60.0 0.0 X 0 358239 51863 Bentley A Ogoke MD Anesthesiologist 60.0 0.0 X 469830 0 31909 BALASA PRASAD MD CHAIRMAN-ANESTHESIA 60.0 0.0 X 461260 0 6800 FRANCIS AGBONKPOLO MD ANESTHESIOLOGIST 60.0 0.0 X 393064 0 24415 Nadeem Hussain Psychiatrist 60.0 0.0 X 303434 0 23508 CLAUS P VON SCHORN MD PHYSICIAN 60.0 0.0 X 323870 0 14544 1951458 13544977 2198321 92 false true false Fastaff Inc PO Box 911452 DENVER CO 802911452 Temporary Nurses 1401063 Excel Emergency Physician Services 484 Temple Hill Road Suite 102 NEW WINDSOR NY 12553 Physician Services 1236043 Radiology Advantage New JerseyPA 3805 East Bell Road Suite 5500 PHOENIX AZ 85032 Radiology Services 844470 CSS Building Services 846 Livingstone Avenue NORTH BRUNSWICK NJ 08902 Cleaning Services 797634 Healogics Wound Care Hyperbaric 3087 Momentum Place CHICAGO IL 60689 Hyperbaric Services 637522 20 26274793 70500 26345293 INPATIENT SERVICES 623000 46162915 46162915 0 0 OUTPATIENT SERVICES 621400 20209018 20209018 0 0 RENTAL INCOME FROM EXEMPT AFFILIATE 531120 1308000 1308000 0 0 OTHER HEALTH CARE SERVICES REVENUE 621999 237470 237470 0 0 67917403 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 CAFETERIA/COFFEE SHOP & VENDING INCOME 722514 221712 0 221712 NON-INVESTMENT PROPERTY RENTAL INCOME 531120 193000 193000 PARKING INCOME 812930 127686 127686 68973 0 68973 611371 94874067 67917403 0 611371 0 0 0 0 0 0 39080283 36029833 3050450 0 2405462 2209179 196283 0 6164772 5661823 502949 0 2838606 2607020 231586 0 69392 69392 0 0 66505 0 66505 0 75000 0 75000 0 21293 21293 0 0 0 0 8271296 7371653 899643 0 1564 1564 0 0 4768188 4447923 320265 0 1463105 1103192 359913 0 0 4245781 3279857 965924 0 58454 53338 5116 0 0 24422 23898 524 0 640326 640326 0 0 0 1782522 1489701 292821 0 3530763 3494870 35893 0 MEDICAL SUPPLIES 7347677 7347677 0 0 MEMBERSHIP DUES 682155 478355 203800 0 TRANSCRIPTION SERVICES 235891 235891 0 0 BILLING & COLLECTION 167319 0 167319 0 1063220 1029093 34127 85003996 77595878 7408118 0 2901909 650 0 399082 0 2041505 10471688 4414064 0 0 0 0 0 0 1888444 1262344 126205 252112 17275487 4276236 11843168 12999251 0 0 0 0 0 0 0 0 0 6518006 27231414 27887014 11317072 17713928 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26234867 15179897 37551939 32893825 X -10320525 -5006811 0 0 0 0 -10320525 -5006811 27231414 27887014 9870071 -4556357 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false false true 21293 false false 21293 false PART II-B, LINE B THE HOSPITAL'S LOBBYING EXPENDITURES included $222 of Health System Membership dues paid for staff compensation spent on calls, meetings, letters, memos and other communications with elected and other governmental officials in an attempt to influence certain health care outcomes. Part II-B, Line G THE HOSPITAL'S LOBBYING EXPENDITURES ARE A PERCENTAGE OF MEMBERSHIP DUES PAID TO THE GREATER NEW YORK HOSPITAL ASSOCIATION, THE HEALTH CARE ASSOCIATION OF NYS, 1199/SEIU - GNYHA Health Education Project and Montefiore Medicine Academic Health System, Inc. THAT ARE USED FOR LOBBYING EFFORTS. 0 0 0 5894169 650789 5243380 9863342 3625427 6237915 1517956 1517956 12999251 DUE FROM AFFILIATES 6518006 6518006 0 LOANS PAYABLE - PARENT 12623724 DUE TO THIRD PARTY PAYORS 2356332 MALPRACTICE INSURANCE LIABILITIES 199841 15179897 true true X true X true X 500. true true true false true true 2973022 7612163 0 0.00000 35214591 20208095 15006496 0.17650 38187613 27820258 15006496 0.17650 482799 0 482799 0.00570 6202844 2638190 3564654 0.04190 6300955 3636171 2664784 0.03130 12986598 6274361 6712237 0.07890 51174211 34094619 21718733 0.25540 false 657836 624944 14107805 11038857 3068948 X true true 1 1 Montefiore Mount Vernon Hospital 12 North Seventh Avenue Mount Vernon NY 10550 www.montefiorehealthsystem.org 5903001H X X X X Montefiore Mount Vernon Hospital 1 false false true X X X X X X X X 14 true false false true X See Part V - Section C X true 14 true See Part V - Section C false true X 100 500. X X true true X X X true X See Part V - Section C X See Part V - Section C X See Part V - Section C X X X X X X true X false X X X X true X false false Schedule H, PART V, SECTION B, LINE 5 The process to identify the needs of the community involved the collection of both secondary and primary data. Multiple conversations and meetings were convened internally and with external partners and a thorough review of the data was conducted. Multiple data sources were used to support the identification and selection of the priority items which were identified, selected and reviewed with the partners. The collection of primary data from a sample of the Westchester County residents was an important element of the development of the Community Health Needs Assessment. Montefiore engaged with the Westchester County Department of Health's online Community Resident and Provider Health Surveys to facilitate the implementation of the primary data collection process for the Community Health Needs Assessment for Westchester County and to assist in the facilitation of these community level connections thereby alleviating additional surveying overload. in addition to collaborative input from the local Department of Health, Montefiore worked closely with it communities including the Mount Vernon Community Advisory Board, organized partnerships and collaboratives and other providers in lower Westchester as well as extensive work with representatives of the affected communities to help Montefiore to identify health care needs and determine the appropriate configuration of services. Schedule H, Part V, Section B, Line 6A MONTEFIORE MOUNT VERNON HOSPITAL CHNA WAS CONDUCTED ALONG WITH MONTEFIORE NEW ROCHELLE HOSPITAL. Schedule H, Part V, Section B, Line 7a The CHNA report is available to the public on Montefiore Mount Vernon Hospital's website: http://montefioremit.com/documents/communityservices/Comprehensive-MV-CHNA -IR-2014.pdf Schedule H, Part V, Section B, Line 10a The hospital facility's most recently adopted implementation strategy is posted on the website: http://montefioremit.com/documents/communityservices/Comprehensive-MV-CHNA -IR-2014.pdf Schedule H, Part V, Section B, Line 11 Montefiore Mount Vernon Hopital's most recently conducted CHNA illuminated two major categories of health needs that were important across the population surveyed, reflected in the data as critical, and in alignment with the New York State Prevention Agenda. The two priority areas identified were (1)Preventing Chronic Disease and (2)Promoting Healthy Women, Infants and Children. As part of the submission for the New York State Health Improvement Plan for 2016-2018, required by the New York State Department of Health, Montefiore has elected to retain these two priority areas, Prevent Chronic Disease and Promote Healthy Women, Infants and Children and has selected three broad focus areas to implement programs. These broad focus areas are (1)reducing obesity in children and adults, (2)Increase access to high quality chronic disease Preventive care and management in both clinical and community settings and (3) Improving maternal and infant Health. Across these focus areas, various goals, with specific interventions, performance measures and time frames, were delineated; - Create community environments that promote and support healthy food and beverage choices and physical activity; - Increase screening rates for cardiovascular disease, diabetes and breast, cervical and colorectal cancers, especially among disparate populations. - Reduce premature births. Schedule H, Part V, Section B, Line 13H Family size is factored into the eligibility criteria for financial assistance. Schedule H, Part V, Section B, Lines 16a-16c The direct website where the FAP is publicized: http://www.montefiorehealthsystem.org/body.cfm?id=68 3 MONTEFIORE MT VERNON METHADONE PROGRAM 3 SOUTH SIXTH AVENUE MOUNT VERNON NY 10550 SUBSTANCE ABUSE EXTENSION CLINIC MONTEFIORE MT VERNON ID CLINIC 16 GUION PLACE NEW ROCHELLE NY 10801 SPECIAL CARE EXTENSION CLINIC MONTEFIORE MT VERNON HOSP ACT PROGRAM 3 SOUTH SIXTH AVENUE MOUNT VERNON NY 10550 MENTAL HEALTH CLINIC 1. REQUIRED DESCRIPTIONS: PART I, LINE 7: THE COST-TO-CHARGE RATIO METHODOLOGY WAS UTILIZED TO CALCULATE THE AMOUNT INCLUDED IN THE TABLE. THE CALCULATION OF THIS RATIO WAS DERIVED FROM RATIO OF PATIENT CARE COSTS-TO-CHARGES. PART III, SECTION A, LINE 2: THE COST OF BAD DEBT EXPENSE WAS ESTIMATED BASED ON THE CHARGES, APPLIED TO THE RATIO OF TOTAL PATIENT CARE EXPENSES TO TOTAL CHARGES FOR ALL SERVICES RENDERED. ANY PAYMENTS OR DISCOUNTS ARE EXCLUDED FROM BAD DEBT EXPENSE. PART III, SECTION A, LINE 3: THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE (AT COST) ATTRIBUTED TO PATIENTS UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS BASED ON RESULTS OF PREDICTIVE ANALYSIS. BAD DEBT SHOULD BE INCLUDED AS A COMMUNITY BENEFIT BECAUSE THE ORGANIZATION PROVIDES MUCH NEEDED HEALTH CARE SERVICES INDISCRIMINATELY TO THE COMMUNITY-AT-LARGE WITHOUT REGARD TO WHETHER OR NOT THE PATIENT HAS INSURANCE AND IF THE BILL WILL EVER BE PAID. PART III, SECTION A, LINE 4: AS REPORTED IN MONTEFIORE HEALTH SYSTEM'S AUDITED CONSOLIDATED FINANCIAL STATEMENTS, BAD DEBT EXPENSE IS DESCRIBED AS FOLLOWS: "THE COLLECTION OF PATIENT SERVICE REVENUE DUE FROM PATIENTS, INCLUDING COPAYMENTS AND DEDUCTIBLES, FROM THOSE WHO ARE INELIGIBLE FOR CHARITY CARE, IS SUBJECT TO UNCERTAINTY. THE Health System RECORDS BAD DEBT EXPENSE IN THE PERIOD SERVICES ARE RENDERED BASED ON PAST EXPERIENCE, TO ACCOUNT FOR AMOUNTS THAT PATIENTS MAY ULTIMATELY BE UNABLE OR UNWILLING TO PAY. FOR SELF-PAY PATIENTS, WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH COPAYMENTS AND DEDUCTIBLES AFTER THIRD-PARTY COVERAGE, THE HOSPITAL RECORDS AN ESTIMATE FOR BAD DEBT EXPENSE IN THE CURRENT PERIOD BASED ON PAST EXPERIENCE. AMOUNTS ULTIMATELY WRITTEN OFF AS UNCOLLECTIBLE AND RECOVERIES OF SUCH AMOUNTS ARE DEDUCTED FROM, OR ADDED TO, THE ALLOWANCE FOR DOUBTFUL ACCOUNTS." PART III, SECTON B, LINE 8: MEDICARE REVENUE AND ALLOWABLE COSTS REPORTED IN PART III, SECTION B, WERE DERIVED FROM THE MEDICARE COST REPORT. MEDICARE ALLOWABLE COSTS REPORTED ON PART III, LINE 6, PER SCHEDULE H INSTRUCTIONS, WERE DERIVED USING THE MEDICARE COST REPORT COST-FINDING METHODOLOGY, WHICH APPORTIONS ROUTINE COSTS TO MEDICARE USING DAYS AND ANCILLARY COSTS TO MEDICARE USING DEPARTMENTAL RATIOS OF COSTS TO CHARGES. THE FOLLOWING TABLE REPRESENTS A RECONCILIATION OF MEDICARE REVENUE AND COSTS INCLUDED ON LINES 5, 6, AND 7 IN PART III TO THE TOTAL ACTUAL MEDICARE REVENUE AND COSTS OF THE HOSPITAL. AS HIGHLIGHTED IN THIS TABLE, INCLUDING THE ADJUSTMENTS DESCRIBED BELOW WOULD HAVE RESULTED IN A MEDICARE Surplus OF $1,315,960. REVENUE ALLOWABLE COST Surplus PART III, LINE 5-7: $14,107,805 $11,038,857 $3,068,948 ADD: MED. CENTERS COSTS: 449,682 (449,682) ADD: MEDICARE DME: 749,199 1,727,504 (978,305) ADD: MED. CENTER EMPL. PHY.: 393,000 362,644 30,356 ADD: MED. SUBSID. HLTH. 785,351 1,140,708 (355,357) TOTAL OVERALL MEDICARE SURPLUS:$16,035,355 $14,719,395 $1,315,960 PART III, SECTION C, LINE 9B: FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE, ALL COLLECTION ACTIVITY IS HALTED AND THE PATIENT IS REFERRED FOR FINANCIAL AID. IF AN ACCOUNT IS IN COLLECTION AND THE PATIENT REQUESTS FINANCIAL AID OR IF THE AGENCY DETERMINES THAT THE PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE, THE ACCOUNT IS REFERRED BACK TO THE HOSPITAL WHERE THE PATIENT IS PROVIDED ASSISTANCE WITH COMPLETING AN APPLICATION FOR ASSISTANCE. 2. NEEDS ASSESSMENT: MONTEFIORE participates in a variety of organized partnership and collaborative, working with other providers in Westchester County, including the Westchester County Department of Health, community-based organizations and members of the community in planning and developing initiatives aimed at improving the health of the people of Westchester County. The process to identify the needs of the community also involved the collection of both primary and secondary data. Through multiple conversations and meetings with external partners, the data is reviewed and analyzed in the development of implementation strategies tailored to best serve the changing needs of the community. 3. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: ALL INTAKE, REGISTRATION, AND COLLECTION AGENCY STAFF IS TRAINED ON THE HOSPITAL'S FINANCIAL AID POLICY AND HOW TO PROVIDE PATIENTS WITH ASSISTANCE. MONTEFIORE MOUNT VERNON HOSPITAL HAS A POLICY THAT ESTABLISHES GUIDELINES FOR THE BILLING OFFICE TO FOLLOW WHEN WORKING WITH INDIVIDUALS WHO ARE HAVING DIFFICULTY PAYING THEIR MEDICAL BILLS. A REFERRAL IS MADE TO THE HOSPITAL'S FINANCIAL AID OFFICE AND A FINANCIAL COUNSELOR WILL HELP THE PATIENT APPLY FOR FREE OR LOW-COST INSURANCE. IF THE FINANCIAL COUNSELOR DETERMINES THAT THE PATIENT DOES NOT QUALIFY FOR LOW-COST INSURANCE, THE COUNSELOR WILL HELP THE PATIENT APPLY FOR A FINANCIAL AID DISCOUNT BASED ON INCOME LEVEL. THE HOSPITAL MAKES ITS FINANCIAL AID POLICY KNOWN TO THE PUBLIC BY PROVIDING WRITTEN INFORMATION AVAILABLE IN BOTH ENGLISH AND SPANISH, INCLUDING BROCHURES AT ALL PATIENT SERVICE AREAS, INFORMATION POSTED ON THE INTRANET AND INTERNET, AND INFORMATION SENT OUT ON PATIENTS' BILLS. THERE ARE ALSO SIGNS POSTED AT THE MAIN ENTRANCE TO THE HOSPITAL IN ENGLISH AND SPANISH ADVISING PATIENTS OF THE ROOM LOCATION FOR ASSISTANCE WITH FINANCIAL AID. 4. COMMUNITY INFORMATION: The city of Mount Vernon has the highest proportion of Black/African American residents in Westchester County at 66%, with 34% of all residents being foreign born. Additionally, it is the seat of Westchester County's homeless services and senior services programs housing a disporportionate number of economically challenged residents. The City is 4.4 square miles located north of the Bronx and is the 8th largest city and 2nd most populated city in the state of New York. The city has one of the highest percentage of resident living below poverty in Westchester County. The poverty reate is 17.1% compared to 9.7% countywide and the median income is $49,395 compared to $84,220 countywide. 22% of Mount Vernon children are living below poverty; higher than the countywide percentage of 13.3%. 5. PROMOTION OF COMMUNITY HEALTH: MONTEFIORE HEALTH SYSTEM, INC. IS A LEADER IN COMMUNITY HEALTH AND HAS A LONG HISTORY OF DEVELOPING INNOVATIVE APPROACHES TO CARE AND CREATING PROGRAMS TO BEST SERVE THE CHANGING NEEDS OF ITS COMMUNITY. MONTEFIORE's Office of Community & Population Health has a dedicated community educator who spearheads initiatives in the city of Mt Vernon. These events are focused on a variety of issues, ranging from chronic disease management and prevention, cancer screenings and promotion of healthy food consumption. Events range from farmers market walks, workshops in the community, walkathons, health fair and community-based health screens. The Mount Vernon Facility has focused its engagement across multiple health indicators; diabetes, breast, cervical and colorectal cancers while addressing cardiovascular disease in the older adult population. To increase screening rates for cardiovascular disease the team coordinates screening services and educational workshops to older adults at frequently occurring points of congregation, including senior centers and naturally occurring retirement communities. These workshops provide a gateway to engage the community in health programming that ensures that our work is targeted towards high needs/high impact activities. 6. AFFILIATED HEALTH CARE SYSTEM: MONTEFIORE MOUNT VERNON HOSPITAL IS AN AFFILIATE OF MONTEFIORE HEALTH SYSTEM, INC. 7. STATE FILING OF COMMUNITY BENEFIT REPORT: MONTEFIORE MOUNT VERNON HOSPITAL FILES A COMMUNITY SERVICE PLAN WITH THE STATE OF NEW YORK. false true false false false false false false false PHILIP O OZUAH MDPHD EXECUTIVE VP & COO 0 1549814 0 806800 0 136022 0 503897 0 34195 0 3030728 0 0 CHRISTOPHER S PANCZNER SENIOR VP & GENERAL COUNSEL 0 700000 0 320100 0 21554 0 187726 0 0 0 1229380 0 0 JOEL A PERLMAN EXEC VP & CFO(resigned 1/6/16) 0 748920 0 483300 0 222034 0 17000 0 34654 0 1505908 0 0 Bentley A Ogoke MD Anesthesiologist 468798 0 0 0 1032 0 6800 0 25109 0 501739 0 0 0 BALASA PRASAD MD CHAIRMAN-ANESTHESIA 461260 0 0 0 0 0 6800 0 0 0 468060 0 0 0 FRANCIS AGBONKPOLO MD ANESTHESIOLOGIST 392032 0 0 0 1032 0 6800 0 17615 0 417479 0 0 0 Nadeem Hussain Psychiatrist 303434 0 0 0 0 0 6800 0 16708 0 326942 0 0 0 CLAUS P VON SCHORN MD PHYSICIAN 322286 0 0 0 1584 0 6800 0 7744 0 338414 0 0 0 SUSAN GREEN-LORENZEN RN SENIOR VP-OPERATIONS 0 789754 0 351600 0 22034 0 333825 0 33054 0 1530267 0 0 LYNN RICHMOND Executive Vice President 0 884855 0 486600 0 21554 0 387008 0 33060 0 1813077 0 0 COLLEEN BLYE EXEC VP & CFO (ELECTED 1/6/16) 0 938840 0 375000 0 0 0 396934 0 32098 0 1742872 0 0 STEVEN M SAFYER MD PRESIDENT & CEO 0 1779978 0 1231200 0 1316779 0 17000 0 34831 0 4379788 0 0 Jaccel Kouns VP/Executive Director 0 270879 0 75000 0 12360 0 17000 0 34863 0 410102 0 0 PART I LINES 3, 4B & PART II - COLUMNS (B)(I), (II) AND (III) As it relates to Compensation from Montefiore Medicine Academic Health System, Inc. and Montefiore Health System, Inc. The Compensation Committee reviews and approves all forms of compensation and benefits provided to each executive with the assistance of a national independent compensation consulting firm. The consulting firm assists the Compensation Committee with its decision-making process to ensure executive compensation levels are reasonable and appropriate relative to those of other similar organizations. Base salaries in Column B(i) are determined based on competitive market practices for comparable positions with similar size organizations and scope of responsibilities. Bonus and incentive compensation in Column B(ii) is based on the achievement of performance goals. The executives' compensation program has a significant pay-at-risk component to ensure the alignment of pay and organizational performance. Goals are set in advance in areas such as quality of care, patient satisfaction, community services and financial performance. Compensation is at risk if the goals established by the Compensation Committee are not met. Other reportable compensation in column B(III) includes distributions from the supplemental executive retirement plan. In a manner designed to qualify for the "rebuttable presumption of reasonableness" the Compensation Committee of the Board of Trustees expressly reviewed and approved these retirement benefit arrangements for senior executives in a manner that qualified under the intermediate sanctions rules of the Federal tax law, and in recognition of (a) the executives' years of service to the organization and (b) the significant contributions to enhancing the ability of the organization to achieve its charitable mission in a manner consistent with financial solvency. Accordingly, this benefit should be viewed as applying to years of service for the organization. Steven Safyer, MD - Pooled Supplemental Executive Retirement Plan distribution of $1,309,525 based on more than 30 years of service at Montefiore. Supplemental Executive Retirement Plan accrued and unpaid service costs: Christopher Panczner - $170,726 Philip O. Ozuah, MD, PH.D - $486,897 Susan Green Lorenzen, RN - $316,825 Lynn Richmond - $370,008 Colleen Blye - $396,934. The Officers and Key Employees listed in Part II, Column A are not employees of this filing organization, Montefiore Mount Vernon Hospital. These individuals are employed and their compensation is paid by either Montefiore Medicine Academic Health System, Inc., EIN 47-1582973, or Montefiore Health System, Inc., EIN 20-1615393. FORM 990, PART VI, SECTION A, LINE 6: MONTEFIORE HEALTH SYSTEM, INC IS THE SOLE MEMBER OF MONTEFIORE MOUNT VERNON HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A: THE BOARD OF TRUSTEES OF MONTEFIORE HEALTH SYSTEM, INC., THE SOLE MEMBER OF MONTEFIORE MOUNT VERNON HOSPITAL, HAS THE AUTHORITY TO APPOINT THE BOARD OF TRUSTEES OF MONTEFIORE MOUNT VERNON HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B: THE BOARD OF TRUSTEES OF MONTEFIORE HEALTH SYSTEM, INC., THE SOLE MEMBER OF MONTEFIORE MOUNT VERNON HOSPITAL, HAS THE AUTHORITY TO APPROVE THE OPERATING AND CAPITAL BUDGETS OF MONTEFIORE MOUNT VERNON HOSPITAL. FORM 990, PART VI, SECTION B, LINE 11B: THE FORM 990 WAS PREPARED BY MONTEFIORE HEALTH SYSTEM'S FINANCE DEPARTMENT WITH THE ASSISTANCE OF VARIOUS DEPARTMENTS. THE FORM 990 WAS REVIEWED AND APPROVED BY THE VICE PRESIDENT-FINANCE, ACCOUNTING AND FINANCIAL REPORTING AND THE HOSPITAL'S SENIOR LEADERSHIP TEAM INCLUDING THE CHIEF FINANCIAL OFFICER. IN ADDITION, AN INDEPENDENT ACCOUNTING FIRM WAS ENGAGED TO REVIEW THE FORM 990. UPON COMPLETION OF THE VARIOUS REVIEWS, THE FORM 990 WAS PRESENTED TO THE FINANCE COMMITTEE OF THE BOARD OF TRUSTEES FOR REVIEW AND APPROVAL. ONCE APPROVED BY THE FINANCE COMMITTEE OF THE BOARD OF TRUSTEES, THE FORM 990 WAS PROVIDED TO ALL MEMBERS OF MONTEFIORE MOUNT VERNON HOSPITAL'S GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 12C: ORGANIZATION COMPLIANCE POLICY MONITORING AND ENFORCEMENT: THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICTS OF INTEREST POLICY BY MEANS OF A SURVEY THAT WAS DEVELOPED BY MONTEFIORE'S COUNSEL. MONTEFIORE MOUNT VERNON HOSPITAL'S BOARD OF TRUSTEES ADOPTED A POLICY THAT COMPORTS TO FEDERAL AND STATE CONFLICTS OF INTEREST REQUIREMENTS. THE GENERAL APPROACH WHEN A POTENTIAL CONFLICT OF INTEREST ARISES IS TO DISCLOSE THE POSSIBLE CONFLICT TO THE COMPLIANCE OFFICER. THE COMPLIANCE OFFICER WILL MAKE EVERY EFFORT TO PROVIDE GUIDANCE TO PERMIT RESOLUTION OF ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. THE COMPLIANCE OFFICER WILL TAKE APPROPRIATE ACTIONS, INCLUDING ADVISING MONTEFIORE MOUNT VERNON HOSPITAL'S BOARD OF TRUSTEES REGARDING PARTICULAR CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15A & 15B: All officers and key employees are employed and paid by either Montefiore Medicine Academic Health System, Inc. or Montefiore Health System, Inc., The parent Company of Montefiore Health Sytem, Inc. and Montefiore Mount Vernon Hospital, respectively. Montefiore Health System, Inc. is committed to ensuring that its executive compensation program adheres to the highest standards of regulatory compliance and best corporate governance. The Board of Trustees has charged the Compensation Committee of the Board (which is comprised of independent Board members with no conflicts of interest in regards to executive compensation) with making all decisions related to compensation for officers and key employees. All decisions made by the Compensation Committee are appropriately and timely documented in meeting minutes. The compensation committee's review process follows the Intermediate Sanctions guidelines for qualifying for the rebuttable presumption of reasonableness. The Committee retains an independent compensation consultant to assist it with this process. Compensation levels are established considering data for comparable organizations, an assessment of management performance (including the services provided to the community), and other business judegment factors, consistent with Montefiore's executive compensation philosophy. The Committee's decisions are made in the best interest of Montefiore, and are intended to ensure the recruitment and retention of key executive talent, consistent with the market practices of other not-for-profit healthcare organizations of comparable scope, mission and complexity. On an annual basis, the Committee provides the full Board of Trustees with a description of the committee's review and approval process and its decisions. FORM 990, PART VI, SECTION C, LINE 19: THE CONFLICTS OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. MMC Corporation 111 East 210th Street Bronx NY 10467 133430322 Real Estate NY 501(C)(3) 12A TYPE I MMC true Montefiore Medical Center 111 East 210th Street Bronx NY 10467 131740114 acad med ctr NY 501(C)(3) 3 MHS true Montefiore Hospital Housing Sect IIInc 3450 Wayne Avenue Bronx NY 10467 237160641 Staff Housing NY 501(C)(2) MMC true Montefiore North Amb Care Ctr Inc 4234 Bronx Boulevard Bronx NY 10466 010796859 Amb Services NY 501(C)(3) 3 MHS true Mosholu Preservation Corporation 3400 Reservoir Oval East Bronx NY 10467 133109387 Community Ser NY 501(C)(3) 12B TYPE II MMC true Gun Hill MRI PC 200 EAST GUNHILL ROAD BRONX NY 10467 133734486 DIAG SERVICES NY 501(C)(3) 12A TYPE I MMC true Montefiore Health System Inc 555 SOUTH BROADWAY TARRYTOWN NY 10591 201615393 Support Serv NY 501(C)(3) 12B Type II MMAHS true Montefiore Residential Corp 1 Inc 3411 Wayne Avenue Bronx NY 10467 911943271 Staff Housing NY 501(C)(2) MMC true Schaffer Extended Care Center 16 Guion Place New Rochelle NY 10801 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Foundation 41 East Post Road Davis Avenue White Plains NY 10601 133281507 Fundraising NY 501(C)(3) 12A Type I WPHMC true Nyack Hospital Foundation 160 North Midland Avenue Nyack NY 10960 133245804 Fundraising NY 501(C)(3) 7 NYACK HOSP true The Winifred Masterson Burke Rehab Hosp 785 Mamaroneck Avenue White Plains NY 10605 131739937 Rehab Hosp NY 501(c)(3) 3 MHS true St Luke's Cornwall Hospital 70 Dubois Street Newburgh NY 125504851 141340054 Hospital NY 501(c)(3) 3 MHS true Hudson Vista Medical PC 70 Dubois Street Newburgh NY 125504851 452526738 Healthcare NY 501(c)(3) 12A Type I SLCH true Hudson Vista Physician Services PC 70 Dubois Street Newburgh NY 125504851 272020746 Healthcare NY 501(c)(3) 12A Type I SLCH true St Luke's Cornwall Health System Inc 70 Dubois Street Newburgh NY 125504851 223026261 Holding Comp NY 501(c)(3) 12A Type I MHS true St Luke's Cornwall Health Sys Foundation 70 Dubois Street Newburgh NY 125504851 223026263 Fundraising NY 501(c)(3) 7 SLCHS true Amos and Sarah Holden Home 70 Dubois Street Newburgh NY 125504851 141365995 Asst Living NY 501(c)(3) PF SLCHS true Goldsmith D and Mary B Johnes Home 70 Dubois Street Newburgh NY 125504851 141364666 Home for Aged NY 501(c)(3) 10 SLCHS true UNIVERSITY BEHAVIORAL ASSOCIATES INC 111 EAST 210TH STREET BRONX NY 10467 133877781 MGMT SERVICES NY NA C Corp true THE MONTEFIORE IPA INC 111 EAST 210TH STREET BRONX NY 10467 134114915 Integ Provr Assoc NY NA C CORP true MMC GI HOLDINGS EAST INC 111 EAST 210TH STREET BRONX NY 10467 721610013 HOLDING COMPANY NY NA C CORP true MMC GI HOLDINGS WEST INC 111 EAST 210TH STREET BRONX NY 10467 721610015 HOLDING COMPANY NY NA C CORP true MONTEFIORE BEHAVIORAL CARE IPA NO 1INC 111 EAST 210TH STREET BRONX NY 10467 133952750 INTEG PROVR ASSOC NY NA C CORP true BRONX ACCOUNTABLE CARE NETWORK IPA INC 111 EAST 210TH STREET BRONX NY 10467 300689571 Integ Provr Assoc NY NA C CORP true Montefiore Consolidated Ventures Inc 111 East 210th Street Bronx NY 10467 611728539 Holding Company NY NA C Corp true Montefiore Insurance Company Inc 111 East 210th Street Bronx NY 10467 320436594 Inactive NY NA C Corp true Hudson Valley IPA Inc 111 East 210th Street Bronx NY 10467 383978087 Inactive NY NA C CORP true Montefiore Innovations Inc 111 East 210th Street Bronx NY 10467 475106910 Inactive NY NA C CORP true Highland Medical PC 160 North Midland Nyack NY 10960 134034481 Healthcare Serv NY NA C CORP true 8 Longview Development Corp Davis Avenue at East Post Road White Plains NY 10601 263321278 HOUSING NY NA C CORP true White Plains Medical Diagnostic Service 41 East Post Road White Plains NY 10601 453164626 Healthcare Serv NY NA C CORP true Cancer and Blood Medical Services of NY 41 East Post Road White Plains NY 10601 462021804 Healthcare Serv NY NA C CORP true Davis Avenue Corp Davis Avenue at East Post Road White Plains NY 10601 133331643 Inactive NY NA C CORP true White Plains Management Co Inc 41 East Post Road White Plains NY 10601 133331641 Inactive NY NA C CORP true WPHC Building Corp 41 East Post Road White Plains NY 10601 133676932 Inactive NY NA C CORP true White Plains Medical Services Davis Avenue at East Post Road White Plains NY 10601 815369152 Healthcare Serv NY NA C Corp true White Plains Physician Services Davis Avenue at East Post Road White Plains NY 10601 815309615 Healthcare Serv NY NA C Corp true Charitable Remainder Trust (5) Char Remr Trust NY NA Trust true SLCH Corporation 70 Dubois Street Newburgh NY 122504851 141765661 inactive NY NA C Corp true false false false false true false false false false true true true true false false true false true false MONTEFIORE HEALTH SYSTEM INC E 2408979 COST MONTEFIORE HEALTH SYSTEM INC K 821448 COST Montefiore Health System Inc M 1057962 COST MONTEFIORE Health System Inc R 819647 COST Montefiore Medical Center M 2684523 cost Montefiore Medical Center P 535768 Cost Montefiore New Rochelle Hospital J 1308000 Cost Montefiore New Rochelle Hospital M 2476334 Cost Montefiore Medicine Academic Health System M 456408 Cost THE MONTEFIORE IPA INC L 1663508 COST