2017-11-14T17:33:13-06:00 2016-12-31 861065772 DELOITTE TAX LLP TWO JERICHO PLAZA JERICHO NY 11753 990 2016-01-01 111352310 SOUTH NASSAU COMMUNITIES HOSPITAL INC SOUT 5166323000 ONE HEALTHY WAY OCEANSIDE NY 115721551 MARK BOGEN SVP/CFO 5166323000 2017-11-14 1 CHRISTINE KAWECKI P00743140 5169187000 167.219.88.217 2017-11-14 16:16:41 ES P C480D75481081CD51D3F364BCA6513B468288B36 C480D75481081CD51D3F364BCA6513B468288B36 2016 2017-02-10 21:41:12Z MARK BOGEN ONE HEALTHY WAY OCEANSIDE NY 115721551 689315980 0 5611 X WWW.SOUTHNASSAU.ORG X 1927 NY SEE SCHEDULE O 23 22 3820 289 4602353 -108686 20363708 12070588 433893573 451772130 8689683 5560670 4856775 4139332 467803739 473542720 0 0 0 0 247085519 260918607 0 0 681117 175831457 178793422 422916976 439712029 44886763 33830691 495648485 610707748 294292485 392657331 201356000 218050417 X NONE 0 0 279523002 306815099 SEE SCHEDULE O 46839216 46063427 SEE SCHEDULE O 40693508 43090121 SEE SCHEDULE O 19272061 53211571 ADDITIONAL OUTPATIENT SERVICES OFFERED BY SOUTH NASSAU COMMUNITIES HOSPITAL ARE: WOUND CARE; FAMILY MEDICINE; SPORTS MEDICINE AND REHABILITATION THERAPY; BEHAVIORAL HEALTH SERVICES; OUTPATIENT DIALYSIS; PARENT-CHILD EDUCATION; PRIMARY MEDICAL CARE; CARDIAC REHABILITATION; WEIGHT & LIFE MANAGEMENT; HOME HEALTH CARE; CANCER SERVICES; GAMMA KNIFE SERVICES; BREAST/GYN HEALTH; OTHER CARDIOVASCULAR SERVICES; RADIOLOGY SERVICES; WOMEN'S IMAGING; SLEEP MEDICINE; AND FAMILY MEDICINE AT LONG BEACH.THE HOSPITAL PROVIDED OVER 270,000 SERVICES RELATED TO THE OTHER OUTPATIENT SERVICES IN 2016. THESE SERVICES WERE PROVIDED TO THE MEMBERS OF THE COMMUNITY ON AN ELECTIVE. THE HOSPITAL PROVIDES CHARITY CARE AND DISCOUNTS TO PATIENTS THAT ARE UNABLE TO A PAY FOR THESE SERVICES.IN 2016, THE HOSPITAL PROVIDED CHARITY CARE OF APPROXIMATELY $2.6 MILLION (CHARGES) FOR OTHER OUTPATIENT SERVICES. 19272061 53211571 386327787 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 1 0 0 1 369 0 1 3820 1 1 1 0 0 0 0 1 1 0 0 0 0 X 23 22 1 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X MARK BOGEN - FINANCE DEPT 5166323965 ONE HEALTHY WAY OCEANSIDE NY 115721551 JOHN ALOIA MD DIRECTOR 1.00 1.00 X 0 0 0 DAVID G BONAGURA DIRECTOR 1.00 1.00 X 0 0 0 PETER C BREITSTONE TREASURER 1.00 1.00 X 0 0 0 ANTHONY CANCELLIERI DIRECTOR 1.00 1.00 X 0 0 0 JOHN CATALANO DIRECTOR 1.00 0.00 X 0 0 0 MARILYN COHEN DIRECTOR 1.00 1.00 X 0 0 0 MIHAI DIMANCESCU MD DIRECTOR 1.00 1.00 X 0 0 0 JOSEPH J FENNESSY CHAIRMAN 1.00 2.00 X 0 0 0 LOWELL FREY ASSISTANT SECRETARY 1.00 1.00 X 0 0 0 JEFFREY FRISCH DIRECTOR 1.00 1.00 X 0 0 0 STEVEN GOLD DIRECTOR 1.00 1.00 X 0 0 0 HARRY KASSEL VICE CHAIRMAN 1.00 1.00 X 0 0 0 BERNARD KENNEDY DIRECTOR 1.00 1.00 X 0 0 0 WAYNE LIPTON DIRECTOR 1.00 2.00 X 0 0 0 HAROLD MAHONY ESQ IMMEDIATE PAST CHAIRMAN 1.00 1.00 X 0 0 0 RICHARD J MURPHY PRESIDENT AND CEO 35.50 2.00 X X 1082707 0 184717 STEVEN SAUER DIRECTOR 1.00 1.00 X 0 0 0 MICHAEL SCHAMROTH VICE CHAIRMAN 1.00 1.00 X 0 0 0 GEORGE A SCHIEREN VICE CHAIRMAN 1.00 1.00 X 0 0 0 JOEL SCHNEIDER DIRECTOR 1.00 1.00 X 0 0 0 EDWARD SCOTT DIRECTOR 1.00 1.00 X 0 0 0 HARRIET P THAYER DIRECTOR 1.00 1.00 X 0 0 0 SALLY VALENTI DIRECTOR 1.00 1.00 X 0 0 0 JOHN A VITALE DIRECTOR (THRU JUNE 2016) 1.00 1.00 X 0 0 0 HELENA WILLIAMS DIRECTOR (THRU JAN. 2016) 1.00 1.00 X 0 0 0 WILLIAM ALLISON CHIEF OPERATING OFFICER 36.50 1.00 X 547678 0 24993 MARK BOGEN CHIEF FINANCIAL OFFICER 36.50 1.00 X 543449 0 48351 JOHN MERTZ CHIEF INFORMATION OFFICER 37.50 0.00 X 299632 0 48413 SUSAN PENQUE CHIEF NURSING OFFICER 36.50 0.00 X 338829 0 22544 ADHI SHARMA CHIEF MEDICAL OFFICER 37.50 0.00 X 462469 0 40429 JASON FREEMAN DIRECTOR OF INTERNAL CARDIO 37.50 0.00 X 982772 0 29914 ALAN GARELY CLINICAL CHAIR OB/GYN 22.00 15.50 X 1052928 0 35477 LAWRENCE KANNER DIRECTOR OF ELECTROPHYSIOLOGY 36.50 1.00 X 946575 0 36467 ASIF REHMAN ASSOC DIRECTOR INTERNAL CARDIO 37.50 0.00 X 771382 0 34638 MATTHEW RIFKIN CHAIR OF RADIOLOGY DEPT 18.80 18.70 X 656809 0 32900 7685230 0 538843 448 0 1 0 AXIS CONSTRUCTION CORP 125 LASER COURT HAUPPAUGE NY 11788 CONSTRUCTION SERVICE 6979840 SODEXO INC & AFFILIATES PO BOX 360170 PITTSBURG PA 152516170 FOOD SERVICES 5171980 BARR & BARR INC 460 WEST 34TH STREET NEW YORK NY 10001 CONSTRUCTION SERVICE 3419737 ISLAND EMERGENCY MEDICAL SERVICES 350 MOTOR PKWY HAUPPAUGE NY 11788 PHYSICIANS SERVICE 2706588 C A N CONTRACTING CORP 100 ANDERSON AVE N BABYLON NY 11703 CONSTRUCTION SERVICE 2680382 88 1307387 8248802 2514399 102145 12070588 NET PATIENT REVENUE 622110 445727769 445727769 REFERENCE LAB 621500 4602353 4602353 RENTAL INCOME - RELATE 523200 1442008 1442008 451772130 1851832 1851832 216702271 2303283 215030280 266436 1671991 2036847 3708838 3708838 415342 1307387 476544 -61202 -61202 COFFEE, GIFT SHOP & CA 900099 2190093 2190093 REBATES & DISCOUNT 900099 1111232 1111232 MEDICAL STUDENT TRAINI 900099 310014 310014 589195 589195 4200534 473542720 449180218 4602353 7689561 3644213 3644213 212635364 183013147 29461854 160363 12804201 11059294 1744907 15760079 13612356 2147723 16074750 13884145 2190605 1458143 1259433 198710 486350 486350 428954 428954 572967 572967 39817227 33533706 6283521 2674389 2299975 374414 2309728 1994967 314761 3088571 2667672 420899 2415787 2086573 329214 284513 245741 38772 1189754 1027619 162135 3593286 3103607 489679 1060480 915962 144518 27377191 23621884 3755307 4826738 4701288 125450 MEDICAL SUPPLIES 68659356 68659356 EQUIPMENT RENTAL 6276052 5420776 855276 SUPPLIES OTHERS 5759450 4736547 1022903 CATERING EXPENSES 4889326 4204820 684506 1625160 634706 469700 520754 439712029 386327787 52703125 681117 13994793 12747562 2439051 9060123 50208462 57207705 6156434 5654716 4101478 2782724 581486870 292165754 264194546 289321116 108585460 120880762 8378215 9154440 37590046 103898600 495648485 610707748 72822026 87342542 71461183 87740053 82391771 8480000 20000000 25000000 113730406 117981835 294292485 392657331 X 199581303 214235063 746621 2787278 1028076 1028076 201356000 218050417 495648485 610707748 X 33830691 6892166 -24028440 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 428954 428954 0 PART II-B, LINE 1 THE HOSPITAL IS A MEMBER OF MULTIPLE HEALTHCARE ASSOCIATIONS WHICH INCLUDE THE AMERICAN HOSPITAL ASSOCIATION, HEALTHCARE ASSOCIATION OF NEW YORK, THE NASSAU SUFFOLK HOSPITAL COUNCIL, AND THE HOME CARE ASSOCIATION OF NEW YORK STATE. THESE ORGANIZATIONS LOBBY ON BEHALF OF THE HEALTHCARE INDUSTRY. SOUTH NASSAU IS ALSO A MEMBER OF THE LONG ISLAND HEALTH NETWORK ("LIHN") WHICH IS A NETWORK OF TEN HOSPITALS. LIHN LOBBIES ON BEHALF OF ITS HOSPITAL NETWORK MEMBERS. THE HOSPITAL ALSO EMPLOYS VARIOUS LOBBYING CONSULTING FIRMS ON HOSPITAL SPECIFIC ISSUES. 1774697 2161697 121040 3815354 2010535 8398283 8634121 1774697 1627563 1719985 1337013 2010535 1506045 1838970 1717452 1627563 3054046 709949 2257950 1506045 0.27000 0.73000 0 0 24239480 24239480 311092306 155312655 155779651 9996418 7997854 1998564 192327043 128855245 63471798 43831623 43831623 289321116 OTHER CURRENT ASSETS NET OF PREPAID & INVENTORY 1987617 OTHER LONG TERM ASSETS 215581 DUE FROM SUBSIDIARIES 26739883 ASSETS WHOSE USED IS LIMITED 73351833 ACCRUED INTEREST RECEIVABLE 168081 INSURANCE RECEIVABLE 1435605 103898600 OTHER CURRENT LIABILITIES 7750000 ACCRUED PENSION PAYABLE 56902515 ACCRUED POST RETIREMENT BENEFITS 3161000 ESTIMATED PROFESSIONAL & GENERAL LIABILITIES 46800030 OTHER LIABILITIES 1932685 INSURANCE CLAIMS PAYABLE 1435605 117981835 PART V, LINE 4: USE OF ENDOWMENT FUNDS RESTRICTED NET ASSETS AND NET ASSETS RELEASED FROM RESTRICTION TWO FUNDS EXIST AT THE HOSPITAL, THE ANNUAL IMPROVEMENT FUND AND THE SPECIAL PURPOSE FUND. THESE FUNDS ARE RESTRICTED AS TO THEIR PURPOSE OR TIME AS IS STIPULATED BY THE DONOR'S REQUEST. THE MONEY IS KEPT IN SEPARATE INVESTMENT VEHICLES FOR EACH FUND. UNRESTRICTED DONATIONS ARE KEPT IN THESE TEMPORARY FUNDS ALSO. PERMANENTLY RESTRICTED NET ASSETS HAVE BEEN RESTRICTED BY DONORS AND ARE TO BE MAINTAINED BY THE HOSPITAL IN PERPETUITY. THESE ASSETS CONSIST OF INVESTMENTS TO BE HELD IN PERPETUITY, THE INCOME FROM WHICH MAY BE RESTRICTED FOR SPECIFIC HOSPITAL ACTIVITIES OR MAY BE UNRESTRICTED AS TO USE. IF A DONATION IS MADE FOR A SPECIAL PROGRAM, IT IS PLACED INTO A TEMPORARILY RESTRICTED CATEGORY. WHEN THE EXPENDITURE IS INCURRED TO FULFILL THE REQUIREMENTS OF THIS PROGRAM/DONATION, THE FUNDS ARE TRANSFERRED FROM TEMPORARILY RESTRICTED STATUS AND ARE EXPENDED. CARNATION BALL 725401 616689 108712 67624 118953 GOLF OUTING 364355 271505 92850 81557 60186 4 632973 419193 213780 41445 106779 1722729 1307387 415342 190626 285918 476544 -61202 1 1 1 X 1 X 1 1 0 1 1 1 2591 2920717 1225567 1695150 0.00440 1 73311 80201920 54054274 26147646 0.06770 2 75902 83122637 55279841 27842796 0.07210 142 12153 380729 0 380729 0.00100 3 91 10083211 5366772 4716439 0.01220 5 65227 39044829 28212779 10832050 0.02800 150 77471 49508769 33579551 15929218 0.04120 152 153373 132631406 88859392 43772014 0.11330 27 17751 72392 0 72392 0.00020 3 1184 261878 0 261878 0.00070 30 18935 334270 334270 0.00090 0 12662626 823087 145948804 159607554 -13658750 X 1 1 1 1 SOUTH NASSAU COMMUNITIES HOSPITAL ONE HEALTHY WAY OCEANSIDE NY 115721551 2950001H X X X SOUTH NASSAU COMMUNITIES HOSPITAL 1 0 0 1 X X X X X X X X X 16 1 1 1 1 X HTTPS://WWW.SOUTHNASSAU.ORG/MAIN/COMMUNITY-SERVICE-PLAN.ASPX X X 1 16 1 HTTPS://WWW.SOUTHNASSAU.ORG/MAIN/COMMUNITY-SERVICE-PLAN.ASPX 0 1 X 100.000000000000 300.000000000000 X X X X X 1 1 X X X 1 X HTTPS://WWW.SOUTHNASSAU.ORG/MAIN/FINANCIAL-ASSISTANCE-PROGRAM.ASPX X HTTPS://WWW.SOUTHNASSAU.ORG/MAIN/FINANCIAL-ASSISTANCE-PROGRAM.ASPX X HTTPS://WWW.SOUTHNASSAU.ORG/MAIN/FINANCIAL-ASSISTANCE-PROGRAM.ASPX X X X X X 1 X 0 X X X X 1 X 0 0 SOUTH NASSAU COMMUNITIES HOSPITAL PART V, SECTION B, LINE 5: LINE 6A, AND LINE 6B:THE HOSPITAL PARTICIPATED IN A SERIES OF COLLABORATIVE CHNA PLANNING AND IMPLEMENTATION MEETINGS WITH REPRESENTATION AND INPUT FROM PUBLIC HEALTH EXPERTS, FROM LOCAL ACADEMIC PARTNERS, THE NASSAU COUNTY DEPARTMENT OF HEALTH, THE SUFFOLK COUNTY DEPARTMENT OF HEALTH AND HOSPITALS AND MULTIPLE COMMUNITY-BASED ORGANIZATIONS LOCATED THROUGHOUT NASSAU AND SUFFOLK COUNTIES. THE LONG ISLAND HEALTH COLLABORATIVE, CONSISTING OF OVER ONE HUNDRED ENTITIES, DEVELOPED THE HEALTH NEEDS ASSESSMENT AND THEN DISTRIBUTED IT TO THE PUBLIC VIA THE INTERNET, LOCAL COMMUNITY BASED ORGANIZATIONS, THE PARTICIPATING HOSPITALS AND COMMUNITY MAILINGS. FOR A COMPLETE LIST OF GREATER THAN 100 MEMBERS OF THE LONG ISLAND HEALTH COLLABORATIVE PLEASE SEE APPENDIX 1 OF THE CHNA REPORT, AVAILABLE AT HTTPS://WWW.SOUTHNASSAU.ORG/MAIN/COMMUNITY-SERVICE-PLAN.ASPX. SOUTH NASSAU COMMUNITIES HOSPITAL PART V, SECTION B, LINE 7D: THE HOSPITAL ADVERTISED THE NEW COMMUNITY SERVICE PLAN (CSP) WHICH WAS BASED ON THE COMMUNITY HEALTH NEEDS ASSESSMENT, IN OUR COMMUNITY NEWSLETTER CALLED "HEALTHY OUTLOOK" WHICH REACHES OVER 320,000 PEOPLE. THERE COMMUNITY MEMBERS CAN FIND WHERE TO PICK UP A COPY OF THE CSP OR WHERE TO VIEW AN ELECTRONIC VERSION. SOUTH NASSAU COMMUNITIES HOSPITAL PART V, SECTION B, LINE 11: DETAILS ON HOW SOUTH NASSAU COMMUNITIES HOSPITAL, INC. IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA ARE IDENTIFIED IN THE HOSPITAL'S COMPREHENSIVE 2016-2018 COMMUNITY SERVICE PLAN (CSP), AVAILABLE ON OUR WEBSITE AT HTTPS://WWW.SOUTHNASSAU.ORG/MAIN/COMMUNITY-SERVICE-PLAN.ASPX. THIS 3 YEAR PLAN EXPLAINS IN DETAIL THE MANY WAYS WE ARE COMMITTED TO THE HEALTH OF THE COMMUNITIES WE SERVE BY OFFERING COMMUNITY PROGRAMS (I.E. 5-WEEK SMOKING CESSATION PROGRAM), LECTURES (I.E. DIABETES PREVENTION, CARDIOVASCULAR HEALTH, FALL PREVENTION) AND FREE HEALTH SCREENINGS (I.E. CHOLESTROL, BLOOD PRESSURE, PSA).THE SIGNIFICANT HEALTH NEEDS BEING ADDRESS ARE: 1) REDUCING OBESITY IN CHILDREN AND ADULTS, AND 2) INCREASING PREVENTIVE CARE AND INCREASING MANAGEMENT OF CHRONIC DISEASE. MENTAL HEALTH WAS ALSO IDENTIFIED AS A HEALTH CARE NEED AND SOUTH NASSAU COMMUNITIES HOSPITAL INCLUDED THIS FOCUS AS AN OVERLAY TO BOTH AGENDAS. THEREFORE, YOU WILL SEE THAT THE EFFECTS OF STRESS ON BOTH MENTAL AND PHYSICAL HEATLH WERE INCORPORATED IN THE PLANNED COMMUNITY STRATEGIES AND INTERVENTIONS IN THE COMMUNITY SERVICE PLAN.SOCIAL DETERMINANTS OF HEALTH WHICH WILL NOT BE ADDRESSED DIRECTLY IN OUR CSP INCLUDE ACCESS TO HEALTHY FOOD, UNSAFE LIVING ENVIRONMENTS, LACK OF CHILDCARE FUNDING FOR LOW-INCOME WORKERS, AND HIV/STD SCREENING AND PREVENTION. THE REASONS FOR NOT ADDRESSING THESE AREAS OF NEED INCLUDE LACK OF FUNDING, LACK OF QUALIFIED PERSONNEL AND/OR LIMITED ABILITY AS AN INSTITUTION TO IMPACT THE IDENTIFIED ISSUES. 12 1 - SNCH - OUTPATIENT BEHAVIORAL HEALTH 2277 GRAND AVE BALDWIN NY 11510 OUTPATIENT 2 - SNCH - FAMILY PRACTICE CENTER 196 MERRICK ROAD OCEANSIDE NY 11572 OUTPATIENT 3 - SNCH - RADIATION ONCOLOGY THERAPY CNTR ONE SOUTH CENTERAL AVE VALLEY STREAM NY 11580 OUTPATIENT 4 - SNCH - OUTPATIENT DIALYSIS CENTER 3618 OCEANSIDE ROAD OCEANSIDE NY 11572 OUTPATIENT 5 - SNCH - OUTPATIENT ANNEX 440 MERRICK ROAD OCEANSIDE NY 11572 OUTPATIENT 6 - SNCH - SLEEP CENTER 1420 BROADWAY HEWLETT NY 11557 OUTPATIENT 7 - SNCH - HOMECARE AGENCY 2277 GRAND AVE BALDWIN NY 11510 OUTPATIENT 8 - SNCH - LONG TERM HOMECARE AGENCY 2277 GRAND AVE BALDWIN NY 11510 OUTPATIENT 9 - SNCH - FAMILY MEDICINE AT LONG BEACH 761 FRANKLIN BLVD LONG BEACH NY 11561 OUTPATIENT 10 - SNCH - OFF CAMPUS EMERGENCY DEPARTMENT A 325 EAST BAY DRIVE LONG BEACH NY 11561 OUTPATIENT 11 - SNCH - MENTAL HEALTH AT HEMPSTEAD 175 FULTON AVE HEMPTEAD NY 11550 OUTPATIENT 12 - SNCH - DIABETES EDUCATION CENTER 519 MERRICK RD ROCKVILLE CENTRE NY 11570 OUTPATIENT PART I, LINE 6A: THE HOSPITAL FILED A 2016-2018 COMMUNITY SERVICE PLAN ("CSP"), WHICH INCLUDED A COMMUNITY BENEFIT REPORT, WITH THE NYS DEPARTMENT OF HEALTH ("DOH") ON OCTOBER 27, 2016. PART I, LINE 7: IN LIEU OF A COST ACCOUNTING SYSTEM, THE COST TO CHARGE RATIO WAS GENERATED FROM THE 2016 INSTITUTIONAL COST REPORT STEP-DOWN. THIS METHODOLOGY APPLIES COSTS TO EACH UNIT BY SERVICE. THE COST TO CHARGE RATIO WAS UTILIZED TO DERIVE THE COSTS. PART I, LINE 7G: INCLUDED IN THE TOTAL COMMUNITY BENEFIT EXPENSE ARE LOSSES RELATED TO THE SNCH FAMILY HEALTH CENTER, INPATIENT AND OUTPATIENT RENAL DIALYSIS, INPATIENT PEDIATRIC, INPATIENT PSYCHIATRIC, AND TRANSITIONAL CARE UNIT PROGRAMS. PART I, LN 7 COL (F): DISTINGUISHING BAD DEBT EXPENSE FROM CHARITY CARE REQUIRES JUDGMENT; TOGETHER, THEY REPRESENT UNCOMPENSATED CARE. THE HOSPITAL'S POLICY REGARDING CHARITY CARE IS TO PROVIDE A SIGNIFICANT AMOUNT OF CARE WITHOUT REGARD TO THE PATIENTS' ABILITY TO PAY FOR SERVICES RENDERED; THIS INCLUDES FREE CARE AND A SLIDING FEE SCALE, BASED ON THE PATIENTS' ABILITY TO PAY WHICH IS DEFINED AS UP TO 300% OF THE POVERTY LEVEL.THE HOSPITAL UTILIZES A CREDIT VERIFICATION FIRM TO ASSIST IN DETERMINING IF UNINSURED PATIENTS MEET THE HOSPITAL'S CHARITY CRITERIA. THIS PROCESS IDENTIFIES UNINSURED PATIENTS THAT WERE UNDER THE POVERTY LEVEL BUT DID NOT APPLY FOR CHARITY CARE. PART III, LINE 2: THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS FOR LINE 2 AND LINE 3 USES TOTAL GROSS BAD DEBT CHARGES MULTIPLIED BY THE AMOUNT OF THE HOSPITAL'S OVERALL RATIO OF COSTS TO CHARGES (CALCULATED USING THE INSTITUTIONAL COST REPORT). PART III, LINE 3: THE AMOUNT REPORTED IN PART III LINE 3 WAS RELATED TO THE EMERGENCY ROOM'S BAD DEBT AT COST. THE FIGURE WAS DERIVED USING THE EMERGENCY ROOM'S BAD DEBT GROSS CHARGES AND MULTIPLYING THIS AMOUNT BY THE EMERGENCY'S ROOMS SPECIFIC RCC TO COME UP WITH THE BAD DEBT EXPENSE AT COST FOR THE EMERGENCY ROOM. WE DID NOT INCLUDE ANY AMOUNTS OF BAD DEBT IN PART I LINE 7. WE BELIEVE THE ENTIRE AMOUNT SHOULD BE CONSIDERED CHARITY CARE. EMTALA AND OTHER REGULATIONS REQUIRE THAT THE HOSPITAL PROVIDE EMERGENCY SERVICES TO INDIVIDUALS BEFORE DISCUSSING FINANCIAL INFORMATION.CHARITY CARE IS USUALLY RELATED TO PATIENTS WHO WE DEFINE AS LACKING THE ABILITY TO PAY. A HOSPITAL'S INABILITY TO COLLECT FROM A PATIENT WHO HAS THE MEANS TO PAY IS BAD DEBT EXPENSE.OUR REGISTRATION DEPARTMENT DOES NOT HAVE THE ABILITY TO DETERMINE THE EMERGENCY ROOM PATIENT FINANCIAL STATUS BEFORE CARE IS DELIVERED AND IN MANY CASES, THE INFORMATION PROVIDED BY THE PATIENTS IS INACCURATE. SINCE WE RENDERED CARE WITHOUT REGARD TO THE PATIENT'S ABILITY TO PAY WE BELIEVE THAT THESE PATIENTS ARE SIMILAR TO CHARITY CARE AND NOT BAD DEBT. PART III, LINE 4: BAD DEBT EXPENSE IS DESCRIBED IN PAGE 20 OF THE ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: SOUTH NASSAU COMMUNITIES HOSPITAL CONSIDERS THE MEDICARE SHORTFALL AS A BENEFIT PROVIDED TO THE COMMUNITY. IF IT WAS ALLOWED TO BE INCLUDED IN THE SHORTFALL, THE COMMUNITY BENEFIT PERCENTAGE WOULD BE 14.87%. THE AMOUNT REPORTED IN PART III, LINE 6 WAS RELATED TO MEDICARE'S ALLOWABLE COSTS. THE FIGURE WAS DERIVED USING THE MEDICARE CHARGES AS REPORTED ON THE ANNUAL INSTITUTIONAL COST REPORT AND MULTIPLYING THAT AMOUNT BY THE RATIO OF COST TO CHARGE (RCC). PART III, LINE 9B: UPON APPLYING FOR CHARITY CARE, THE PATIENT IS ADVISED TO DISREGARD ALL BILLS SENT BY THE HOSPITAL UNTIL A FINAL DECISION HAS BEEN MADE. A PATIENT THAT RECEIVES PARTIAL CHARITY CARE IS SUBJECT TO THE HOSPITAL COLLECTION POLICY EXCEPT THAT:1) THE PATIENT WILL BE PROVIDED WITH A WRITTEN NOTICE 30 DAYS PRIOR TO THE ACCOUNT GOING TO COLLECTION.2) THE HOSPITAL WILL NOT PLACE A LIEN ON THE PATIENT'S ASSETS. PART VI, LINE 2: IN AN EFFORT TO IDENTIFY THE NEEDS OF PATIENTS AND COMMUNITIES, SOUTH NASSAU UTILIZES TOOLS AND COLLABORATES WITH LOCAL AND STATE GOVERNMENTS, CIVIC ASSOCIATIONS AND OTHER COMMUNITY GROUPS TO ESTABLISH THE NEEDS OF THE COMMUNITY THE HOSPITAL SERVICES. - THE HOSPITAL PARTICIPATES IN THE CENTER FOR MEDICARE AND MEDICAID SERVICES PATIENT SATISFACTION SURVEY (KNOWN AS HCAHPS) BY USING HEALTHSTREAM RESEARCH, WHICH CONDUCTS A PHONE SURVEY, CONTACTING A STATISTICALLY VALID SAMPLE OF INPATIENTS AFTER DISCHARGE. SURVEY QUESTIONS INQUIRE ABOUT PATIENTS' SATISFACTION WITH THE QUALITY OF CARE DURING THEIR STAY AND PERSONAL SATISFACTION WITH THE DOCTORS, NURSES AND HOSPITAL SERVICES. ONCE THE QUARTERLY SURVEY RESULTS ARE REVIEWED BY THE ADMINISTRATIVE TEAM, MANAGERIAL STAFF AND HOSPITAL STAFF, SOUTH NASSAU'S PATIENT SATISFACTION STEERING COMMITTEE PRIORITIZES AND DEVELOPS ACTION PLANS TO IMPROVE PATIENT SATISFACTION.- SOUTH NASSAU'S BOARD, WHICH IS COMPOSED OF LOCAL INDIVIDUALS WHO RESIDE IN THE COMMUNITIES SERVED BY THE HOSPITAL AND INCLUDES A CROSS-SECTION OF REPRESENTATIVES SUCH AS CLERGY, BUSINESS PEOPLE AND PHYSICIANS, MEETS REGULARLY. WHILE THE MEMBERS OF SOUTH NASSAU COMMUNITIES HOSPITAL'S BOARD OF DIRECTORS ACCEPT RESPONSIBILITY FOR GOVERNANCE OF THE HOSPITAL, THEY ARE ALSO COMMUNITY ADVOCATES. AS SUCH, THEY ARE ABLE TO SPEAK ON BEHALF OF THE COMMUNITY AND RAISE ISSUES WITH THE HOSPITAL OR CONSIDER ACTIONS THAT AFFECT HOSPITALS PLANS AND OPERATIONS. THE BOARD HAS ESTABLISHED A NUMBER OF COMMITTEES THAT ARE RESPONSIBLE FOR OVERSIGHT AND COORDINATION OF HOSPITAL ACTIVITIES IN REGARDS TO COMMUNITY ADVOCACY. - SOUTH NASSAU SOLICITS THE COMMUNITY'S FEEDBACK FOLLOWING FREE PUBLIC CONFERENCES IT SPONSORS EACH YEAR. SURVEYS YIELD VALUABLE INFORMATION SUCH AS COMMUNITY PREFERENCE FOR SEMINAR CONTENT AND FORMAT AND REQUESTS FOR EXPANDED PROGRAMS AND SERVICES. - DEPARTMENTS HOSPITAL-WIDE HAVE RELATIONSHIPS WITH INDIVIDUALS AND GROUPS WHO HAVE SPECIAL NEEDS, SUCH AS PHYSICAL HANDICAPS, LANGUAGE BARRIERS AND CULTURAL ISSUES. THESE DEPARTMENTS ENCOURAGE COMMENTS AND SUGGESTIONS FROM THESE POPULATIONS. THEIR FEEDBACK IS USED TO ASSESS THE EFFECTIVENESS OF EXISTING PROCEDURES AND PROGRAMS. - SOUTH NASSAU'S ADMINISTRATION MAINTAINS AN OPEN-DOOR POLICY AND ANY MEMBER OF THE COMMUNITY IS WELCOME TO COMMENT. ANY REASONABLE ISSUE RAISED IS ADDRESSED AND CARE IS TAKEN TO RESPOND IN A TIMELY AND SATISFACTORY FASHION.- SOUTH NASSAU MAINTAINS THREE WEBSITES: WWW.SOUTHNASSAU.ORG; WWW.LIGAMMA.ORG; AND WWW.SOUTHNASSAUBARIATRICS.ORG. THE WEBSITES OFFER AN AVENUE FOR PEOPLE TO E-MAIL QUESTIONS AND REQUESTS FOR INFORMATION TO THE HOSPITAL. THEY ALSO SERVE AS A COMPREHENSIVE SOURCE OF INFORMATION ON THE HOSPITAL'S SERVICES, SPECIALTY CENTERS, PHYSICIANS, NEW DEVELOPMENTS AND EMPLOYMENT OPPORTUNITIES.- SOUTH NASSAU'S ADMINISTRATION IS IN CONSTANT COMMUNICATION WITH LOCAL AND GOVERNMENT LEADERS IN DETERMINING THE NEEDS OF THE COMMUNITIES. THE ADMINISTRATIVE TEAMS ALSO ARE INVOLVED WITH HOSPITAL ASSOCIATIONS AND OTHER HEALTHCARE ASSOCIATES WHICH TARGET THE NEEDS OF THE COMMUNITIES THE HOSPITAL SERVES. NEW YORK STATE'S DEPARTMENT OF HEALTH ALSO WORKS VERY CLOSELY WITH THE HOSPITAL TO HELP ASSESS THE NEEDS OF THE COMMUNITY SERVED.- SOUTH NASSAU'S FOUR ACTIVE AUXILIARIES ACT AS LIAISONS BETWEEN THE HOSPITAL AND THE COMMUNITIES THEY REPRESENT.- THE HOSPITAL COLLECTS DATA WITH REGARDS TO ECONOMIC, SOCIAL, CULTURAL AND GEOGRAPHIC BARRIERS THAT EXIST. PART VI, LINE 3: THE HOSPITAL INFORMS AND EDUCATES PATIENTS ON A VARIETY OF FINANCIAL ASSISTANCE PROGRAMS. IT HAS A FULLY STAFFED FINANCIAL ASSISTANCE SERVICES DEPARTMENT STAFFED WITH TRANSLATION CAPABILITIES THAT HELP EDUCATE AND PROVIDE ASSISTANCE IN APPLYING FOR MEDICAID, CHILD HEALTH PLUS, FAMILY HEALTH PLUS, CHARITY CARE AND DISCOUNTED CARE. LARGE POSTERS ARE DISPLAYED IN PROMINENT LOCATIONS (INCLUDING THE EMERGENCY ROOM, BILLING OFFICE, ADMITTING, FAMILY PRACTICE CENTER, ACCOUNT SERVICES, MENTAL HEALTH CENTER, OUTPATIENT REGISTRATION, DIALYSIS CENTER, HOME CARE, CARDIAC REHABILITATION, PHYSICAL THERAPY, WOUND CARE) AND OTHER REGISTRATION AREAS SHOWING THE AVAILABILITY OF CHARITY CARE IN ENGLISH AND SPANISH.THE HOSPITAL POSTS THE AVAILABILITY OF FINANCIAL AID INCLUDING CHARITY CARE ON ITS EXTERNAL WEBSITE: SOUTHNASSAU.ORG DIRECTING THEM TO THE FINANCIAL ASSISTANCE DEPARTMENT.THE HOSPITAL EDUCATES ALL EMPLOYEES THAT INTERACT WITH PATIENTS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE INCLUDING CHARITY CARE AND WHERE TO FIND INFORMATION ON THESE PROGRAMS. FINANCIAL ASSISTANCE AND CHARITY CARE INFORMATION IS INCLUDED IN PATIENT GUIDES AND SERVICE LINE GUIDES THAT ARE PROVIDED TO PATIENTS. PATIENT BILLS SENT OUT INCLUDE A NOTE ABOUT THE EXISTENCE OF THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. ON THE BACK OF THE BILL IS A CHARITY CARE APPLICATION.BILLING AND ACCOUNT SERVICES DEPARTMENTS ARE EDUCATED ABOUT THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AND INFORMS PATIENTS OF THIS POLICY. ANY PATIENT CAN REQUEST AN APPLICATION FOR CHARITY CARE FROM THE ABOVE REGISTRATION AREAS, BILLING OFFICE AND ACCOUNT SERVICES DURING REGULAR BUSINESS HOURS AND VIA TELEPHONE. PART VI, LINE 4: SOUTH NASSAU IS LOCATED ON THE SOUTH SHORE OF LONG ISLAND IN NASSAU COUNTY, NEW YORK, IN THE TOWN OF OCEANSIDE. NASSAU COUNTY HAS A POPULATION OF APPROXIMATELY 1.37 MILLION (BASED ON 2016 ESTIMATE US CENSUS DATA) WITH APPROXIMATELY 800,000 PEOPLE FALLING INTO THE HOSPITAL'S SERVICE AREA. NASSAU COUNTY'S MEDIAN HOUSEHOLD INCOME IS $99,465 (ACCORDING TO 2011-2015 CENSUS DATA) AND $43,206 PER CAPITA (2011-2015 CENSUS ESTIMATES). ACCORDING TO THE 2011-2015 CENSUS ESTIMATES, NASSAU COUNTY'S POVERTY LEVEL WAS 6.1%, WITH MORE OF THE POORER AREAS LOCATED ON THE SOUTH SHORE OF NASSAU COUNTY AND FALLING INTO THE HOSPITAL'S SERVICE AREA. HISPANICS, ALONG WITH OTHER MINORITIES, ARE CONCENTRATED IN SOUTH SHORE COMMUNITIES SUCH AS BALDWIN, FREEPORT, HEMPSTEAD, ROOSEVELT AND INWOOD, WITH MANY OF THESE COMMUNITIES' MEMBERS BEING UNINSURED OR INSURED BY MEDICAID.BASED ON 2016 PATIENTS SERVED AT SOUTH NASSAU, PATIENT DEMOGRAPHICS BASED ON VISITS (OUTPATIENT) ARE MEDICARE 37% MEDICAID 24% SELF PAY 2% AND CHARITY CARE 1%.OTHER HOSPITALS THAT ALSO SERVICE THESE COMMUNITIES ARE FRANKLIN HOSPITAL-NORTHWELL HEALTH AND MERCY MEDICAL CENTER. PART VI, LINE 5: THE HOSPITAL HAS ESTABLISHED A COMMUNITY ADVOCACY COMMITTEE THAT IS COMPOSED OF MEMBERS OF A NUMBER OF COMMUNITY ORGANIZATIONS, AND REPRESENTATIVES FROM HOSPITAL ADMINISTRATION, STAFF AND BOARD. THIS GROUP MEETS FOUR TIMES A YEAR TO IDENTIFY NEEDS OF THEIR RESPECTIVE COMMUNITIES AND TO DISCUSS ISSUES OR RECOMMEND ACTIONS IN THE INTEREST OF IMPROVED SERVICE TO THOSE COMMUNITIES. THIS INFORMATION IS THEN PRESENTED TO THE BOARD OF DIRECTORS FOR CONSIDERATION.IN ADDITION TO THE COMMUNITY ADVOCACY COMMITTEE, SOUTH NASSAU'S DEPARTMENT OF COMMUNITY EDUCATION IS A VALUED COMMUNITY RESOURCE. THIS DEPARTMENT PROVIDES HEALTH EDUCATION, COMMUNITY OUTREACH, FREE HEALTH SCREENINGS, AND REFERRAL SERVICES TO THE COMMUNITIES WE SERVE. IN KEEPING WITH POPULATION HEALTH INITIATIVES, THE DEPARTMENT'S GOALS FOCUS ON PROMOTING WELLNESS AND PREVENTING OR MANAGING CHRONIC DISEASE. IN 2016, OUR COMMUNITY-WIDE EFFORTS TOUCHED THE LIVES OF 15,838 INDIVIDUALS. FEEDBACK FROM PROGRAM PARTICIPANTS AS WELL AS COMMUNITY PARTNERS CONTINUES TO BE OVERWHELMINGLY POSITIVE WHICH HAS BEEN EVIDENT IN POST-PROGRAM EVALUATIONS AND FOLLOW-UP. OUR SCREENINGS FOR THE YEAR TOTALED 1,378 AND INCLUDED ASTHMA, BALANCE, BLOOD PRESSURE, BMI, CHOLESTEROL, COLORECTAL CANCER, HEAD AND NECK CANCER, PROSTATE CANCER, SKIN CANCER, AND SLEEP ASSESSMENT. ADDITIONALLY, IN PARTNERSHIP WITH THE ALZHEIMER'S FOUNDATIONOF AMERICA, SOUTH NASSAU HELD ITS FIRST MEMORY SCREENING EVENT FOR 56 ATTENDEES. THE MISSION OF THE DEPARTMENT OF COMMUNITY EDUCATION IS TO IMPROVE THE HEALTH OF OUR COMMUNITIES THROUGH EDUCATION, AWARENESS, OUTREACH, PREVENTION AND SCREENING SERVICES. THROUGH ITS COMMUNITY-BASED INITIATIVES, THE DEPARTMENT STRIVES TO SUPPORT THE HOSPITAL'S PERFORMANCE TARGETS IN THE AREAS OF QUALITY, PATIENT SAFETY, AND SERVICE EXCELLENCE. THE DEPARTMENT PARTNERS WITH COMMUNITY-BASED ORGANIZATIONS SUCH AS LOCAL LIBRARIES AND SCHOOLS, COMMUNITY CENTERS, SENIOR CENTERS AND CHURCHES TO PROVIDE EDUCATIONAL PROGRAMS, PRESENTATIONS AND SCREENINGS TO WHERE PEOPLE LIVE, WORK, AND PLAY. EXAMPLES OF THESE COMMUNITY PARTNERS ARE THE ROCKVILLE CENTRE SENIOR CENTER, CIRCULO DE LA HISPANIDAD CENTER, HEWLETT HOUSE 1 IN 9 CANCER SUPPORT CENTER, THE ALZHEIMER'S FOUNDATION OF AMERICA, NEW YORK POISON CONTROL CENTER, AND THE OCEANSIDE JEWISH COMMUNITY CENTER. ADDITIONALLY, THE DEPARTMENT OF COMMUNITY EDUCATION OFFERS CPR CLASSES TO THE COMMUNITY AND BLS AND ACLS TO THE STAFF. THE DEPARTMENT RECOGNIZES THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES' NATIONAL HEALTH OBSERVANCES WITH INFORMATION AND PRESENTATIONS ON THE MONTH'S CHOSEN TOPICS. COMMUNITY EDUCATION IS ALSO RESPONSIBLE FOR SIXTEEN FREE SUPPORT GROUPS RANGING FROM BARIATRIC SUPORT TO BREAST CANCER TO BEREAVEMENT. THE ACTIVITIES OF THE DEPARTMENT OF COMMUNITY EDUCATION ARE REPORTED REGULARLY TO THE BOARD OF DIRECTORS AS WELL AS THE COMMUNITY ADVOCACY COMMITTEE. PART VI, LINE 6: THE HOSPITAL IS PART OF WINTHROP SOUTH NASSAU HEALTH SYSTEM WHICH IS A MEMBER OF THE LONG ISLAND HEALTH NETWORK ("LIHN"). THE LONG ISLAND HEALTH NETWORK CONSISTS OF 10 HOSPITALS JOINED TOGETHER IN 1998 TO IMPROVE THEIR CLINICAL QUALITY, ENHANCE THEIR OPERATIONAL EFFICIENCY, AND EXPAND ACCESS TO CARE FOR THE 2.8 MILLION RESIDENTS OF NASSAU AND SUFFOLK COUNTIES. THE GOAL OF THE LONG ISLAND HEALTH NETWORK IS TO PROVIDE A HIGH LEVEL OF MEDICAL CARE, NO MATTER WHICH HOSPITAL YOU CHOOSE IN THE NETWORK. THIS HAS BEEN ACCOMPLISHED THROUGH A SINGLE INTEGRATED APPROACH TO MEASURING AND IMPROVING THE QUALITY OF HEALTHCARE THROUGHOUT OUR 10 MEMBER HOSPITALS. IN AN ERA WHEN HEALTHCARE IS INCREASINGLY DOMINATED BY LARGE, CENTRALLY GOVERNED HOSPITAL SYSTEMS, LIHN HOSPITALS CONTINUE THEIR FOCUS ON DELIVERING COMMUNITY-BASED CARE AND COLLABORATING WITH INSURERS' EFFORTS TO EXPAND LOCAL ACCESS TO AFFORDABLE HEALTH INSURANCE PRODUCTS. PART VI, LINE 7, REPORTS FILED WITH STATES NY X X X X X 0 1 0 0 0 0 0 1 1 1 RICHARD J MURPHY PRESIDENT AND CEO 802257 0 226287 0 54163 0 146602 0 38115 0 1267424 0 0 0 WILLIAM ALLISON CHIEF OPERATING OFFICER 434757 0 106681 0 6240 0 16785 0 8208 0 572671 0 0 0 MARK BOGEN CHIEF FINANCIAL OFFICER 431968 0 106681 0 4800 0 20142 0 28209 0 591800 0 0 0 JOHN MERTZ CHIEF INFORMATION OFFICER 265554 0 31078 0 3000 0 22004 0 26409 0 348045 0 0 0 SUSAN PENQUE CHIEF NURSING OFFICER 293889 0 43020 0 1920 0 12566 0 9978 0 361373 0 0 0 ADHI SHARMA CHIEF MEDICAL OFFICER 399919 0 57750 0 4800 0 14981 0 25448 0 502898 0 0 0 JASON FREEMAN DIRECTOR OF INTERNAL CARDIO 747772 0 235000 0 0 0 9519 0 20395 0 1012686 0 0 0 ALAN GARELY CLINICAL CHAIR OB/GYN 959428 0 93500 0 0 0 14692 0 20785 0 1088405 0 0 0 LAWRENCE KANNER DIRECTOR OF ELECTROPHYSIOLOGY 684874 0 261701 0 0 0 13269 0 23198 0 983042 0 0 0 ASIF REHMAN ASSOC DIRECTOR INTERNAL CARDIO 771382 0 0 0 0 0 13846 0 20792 0 806020 0 0 0 MATTHEW RIFKIN CHAIR OF RADIOLOGY DEPT 525559 0 131250 0 0 0 12115 0 20785 0 689709 0 0 0 PART I, LINE 4B SOUTH NASSAU COMMUNITIES HOSPITAL MAINTAINS A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") FOR THE HOSPITAL'S CHIEF EXECUTIVE OFFICER. THE SERP IS DESIGNED TO PROVIDE RICHARD MURPHY WITH SUPPLEMENTAL RETIREMENT INCOME THROUGH ANNUAL HOSPITAL FUNDED CONTRIBUTIONS OF $111,200. SENIOR EXECUTIVE POSITIONS, WHO ARE IMPACTED BY LIMITS UNDER THE HOSPITAL'S TAX-QUALIFIED RETIREMENT PLAN THAT DO NOT LIMIT OTHER EMPLOYEES, ALSO HAVE A SUPPLEMENTAL PLAN. THE SUPPLEMENTAL PLAN IS INTENDED ONLY TO MAKE UP FOR SUCH LIMITS AND CONTAINS VESTING SCHEDULES DESIGNED TO RETAIN THE EXECUTIVE UNTIL RETIREMENT. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THIS PLAN IN 2016, WITH THE SUPPLEMENTAL RETIREMENT INCOME INCLUDED IN DEFERRED COMPENSATION: WILLIAM ALLISON - SUPPLEMENTAL RETIREMENT OF $8,513 MARK BOGEN - SUPPLEMENTAL RETIREMENT OF $10,216 RICHARD MURPHY - SUPPLEMENTAL RETIREMENT OF $25,219 SUSAN PENQUE - SUPPLEMENTAL RETIREMENT OF $1,379 ADHI SHARMA, MD - SUPPLEMENTAL RETIREMENT OF $6,963 PART I, LINE 7 THE HOSPITAL MAINTAINS AN INCENTIVE COMPENSATION PROGRAM THAT PAYS VARIABLE COMPENSATION BASED ON THE SATISFACTION BY THE HOSPITAL AND THE EXECUTIVES OF PRE-ESTABLISHED QUALITY OF CARE, PROGRAM, FINANCIAL AND SIMILAR GOALS ESTABLISHED AT THE BEGINNING OF THE YEAR PRIOR TO PAYMENT. SOME EMPLOYEES RECEIVE ADDITIONAL COMPENSATION BASED ON VARIOUS PRODUCTIVITY MEASURES. PART I, LINE 8 DURING 2016, THE HOSPITAL'S PRESIDENT AND CHIEF EXECUTIVE OFFICER WAS COMPENSATED AND PROVIDED WITH BENEFITS PURSUANT TO AN EMPLOYMENT AGREEMENT SATISFYING THE INITIAL CONTRACT EXCEPTION DESCRIBED IN REGS. SECTION 53.4958-4(A)(3). SCHEDULE J, ADDITIONAL DISCLOSURE INCLUDED IN THE CHIEF EXECUTIVE OFFICER'S COMPENSATION IS A BONUS OF $226,287, WHICH RELATES TO SERVICES PERFORMED BY HIM AS CHIEF EXECUTIVE OFFICER IN 2015. SCHEDULE J, ADDITIONAL DISCLOSURE THE COMPENSATION REPORTED ON BOTH PART VII AND SCHEDULE J OF THE FORM 990 FOR CERTAIN OFFICERS AND KEY PERSONNEL REPRESENTS AMOUNTS PAID FOR SERVICES RENDERED TO SOUTH NASSAU COMMUNITES HOSPITAL ("SNCH") AND ITS AFFILIATED ORGANIZATIONS. THE FORM 990 REQUIRES COMPENSATION TO BE REPORTED BASED ON THE ORGANIZATION THAT PROVIDES THE OFFICER HIS OR HER W-2, HOWEVER, REPORTING COMPENSATION IN THIS FASHION DOES NOT TAKE INTO ACCOUNT THE INTEGRATED RELATIONSHIPS WITHIN A HEALTH SYSTEM THAT REQUIRE OFFICERS AND EMPLOYEES TO ALLOCATE THEIR TIME AND SERVICES AMONG MANY ORGANIZATIONS. A NASSAU COUNTY LOCAL ECONOMIC ASSISTANCE CORP 274291221 63166LBT7 2012-10-23 100932698 REFUND PRIOR BONDS ISSUED 8/22/01 & 8/7/03-CONSTRUCTION & EQUIP. PURCHASE 0 0 0 A 13815000 100932698 1890650 1667774 1454576 27110685 70699662 2015 1 1 0 1 A 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: NASSAU COUNTY LOCAL ECONOMIC ASSISTANCE CORP DATE THE REBATE COMPUTATION WAS PERFORMED: 01/13/2017 PART II, LINE 4 THE AMOUNT SHOWN HERE CONSISTS OF DEPOSITS TO A BONA FIDE DEBT SERVICE FUND. PART III, LINE 2 CERTAIN PROPERTY FINANCED BY THE BONDS IS LEASED TO AFFILIATED 501(C)(3) ORGANIZATIONS; SUCH LEASES DO NOT GIVE RISE TO PRIVATE BUSINESS USE. PART IV, LINE 6 THIS QUESTION IS BEING ANSWERED WITHOUT REGARD TO A YIELD RESTRICTED REFUNDING ESCROW FINANCED WITH PROCEEDS OF THE BONDS. SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 6979840 CONSTRUCTION SERVICES 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 5171980 FOOD SERVICES 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 3419737 CONSTRUCTION SERVICES 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 2706588 MEDICAL SERVICES 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 2680382 CONSTRUCTION SERVICES 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 2562503 REVENUE CYCLE SERVICES 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 2553420 MARKETING SERVICES 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 1260351 ELECTRICAL SERVICES 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 1169933 LEGAL SERVICES 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 981244 REAL ESTATE SERVICES 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 667901 ARCHITECTURAL SERVICES 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 593193 MEDICAL SERVICES 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 513588 LEGAL SERVICES 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 489586 ACADEMIC AFFILIATION, PROFESSIONAL AND PATIENT CARE SERVICES 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 421945 LEGAL SERVICES 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 328387 LEGAL SERVICES 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 237397 LEGAL SERVICES 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 190108 MEDICAL SERVICES 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 180000 CONSULTING SERVICES 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 142093 LEGAL SERVICES 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 125113 LEGAL SERVICES 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 122948 MEDICAL SERVICES 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 112293 LEGAL SERVICES 0 X 5 98471 COST OR SELLING PRICE 0 1 0 PART I, COLUMN (B): THERE WERE 5 CONTRIBUTORS WITH A TOTAL OF 14 CONTRIBUTIONS. FORM 990, PART I, LINE 1 AND PART III, LINE 1 SOUTH NASSAU COMMUNITIES HOSPITAL IS COMMITTED TO PROVIDING QUALITY, COMPREHENSIVE AND EASILY ACCESSIBLE HEALTHCARE SERVICES TO ALL RESIDENTS OF THE SOUTH SHORE COMMUNITIES IN A MANNER THAT REFLECTS A CULTURE OF EXCELLENCE, PERSONALIZED, CULTURALLY COMPETENT CARE AND INNOVATION. FORM 990, PART III, LINE 4A MEDICAL AND SURGICAL INPATIENT SERVICES: THE HOSPITAL IS CERTIFIED FOR 329 MEDICAL SURGICAL BEDS. THESE BEDS INCLUDE A 36-BED ORTHOPEDIC SPECIALTY UNIT, A 38-BED ONCOLOGY (CANCER) UNIT, A 23-BED STEP-DOWN PROGRESSIVE CARE UNIT INCLUDING AN 8-BED BARIATRIC SURGERY UNIT AND 89 BEDS FOR TELEMETRY OR OTHERS WITH LESS THAN ACUTE CORONARY PROBLEMS. THE HOSPITAL ALSO HAS A 20 BED TRANSITIONAL CARE UNIT. THE HOSPITAL'S OPERATING ROOMS CONSISTS OF 15 SUITES WHICH ARE AVAILABLE FOR BOTH INPATIENT AND OUTPATIENT SURGICAL PROCEDURES. A FULL RANGE OF SURGICAL SPECIALTIES ARE PERFORMED WHICH INCLUDE ORTHOPEDICS, SPINE SURGERY, PLASTIC SURGERY, NEUROSURGERY, GYNECOLOGIC SURGERY, GASTROINTESTINAL SURGERY, LAPAROSCOPIC BARIATRIC SURGERY (MINIMALLY INVASIVE SURGERY FOR WEIGHT LOSS), UROLOGY, OPHTHALMOLOGY, VASCULAR SURGERY, THORACIC SURGERY, PERMANENT PACEMAKERS, IMPLANTABLE DEFIBRILLATORS, PODIATRIC SURGERY, PEDIATRIC SURGERY, EAR, NOSE AND THROAT SURGERY, AND GENERAL SURGERY. THE HOSPITAL ADMITTED 16,666 MEDICAL SURGICAL PATIENTS IN 2016. PEDIATRICS SERVICES: THE HOSPITAL PROVIDES COMPREHENSIVE GENERAL AND SPECIALIZED PEDIATRIC CARE FOR CHILDREN AND TEENAGERS IN NEED OF SURGICAL OR PREVENTIVE SERVICES OR CARE FOR INFECTIOUS DISEASES, SERIOUS ILLNESSES OR COMPLEX MEDICAL CONDITIONS. THIS UNIT FEATURES SPECIALISTS IN PEDIATRIC CARDIOLOGY, ENDOCRINOLOGY, GASTROENTEROLOGY, GENETICS, HEMATOLOGY-ONCOLOGY, NEUROLOGY, PULMONARY MEDICINE AS WELL AS A PEDIATRIC SURGEON, NEONATOLOGIST AND ANESTHESIOLOGIST. A SPECIAL CARE PEDIATRIC UNIT EQUIPPED WITH THE LATEST PEDIATRIC MEDICAL TECHNOLOGY AND MONITORING SYSTEM, CAN EFFECTIVELY MANAGE AND TREAT ALMOST ANY EMERGENCY OR SERIOUS ILLNESS. THE UNIT FEATURES A MULTI-PURPOSE TREATMENT ROOM TO PERFORM MINOR PROCEDURES, WHETHER SURGICAL OR NON-SURGICAL. A TEAM OF SPECIALLY TRAINED NURSING STAFF AND PEDIATRICIANS, INCLUDING NURSING STAFF TRAINED IN PEDIATRIC ADVANCE LIFE SUPPORT (PALS), WITH SPECIALISTS ON-CALL AROUND THE CLOCK. THE HOSPITAL ADMITTED 433 PEDIATRIC PATIENTS IN 2016. MATERNITY AND NURSERY SERVICES: THE HOSPITAL HAS STATE-OF-THE-ART LABOR/DELIVERY ROOMS WHICH CREATE A COMFORTING ENVIRONMENT WHILE PROVIDING ALL THE NECESSARY EQUIPMENT AND CLINICAL SUPPORT FOR MOTHER AND BABY. ALL 26 POSTPARTUM BEDS OFFER PRIVATE ACCOMMODATIONS. THE HOSPITAL PROVIDES SPECIALIZED SERVICES FOR WOMEN WITH HIGH-RISK PREGNANCIES. THE UNIT IS STAFFED BY SOME OF THE AREA'S LEADING SPECIALISTS IN HIGH-RISK PREGNANCIES. SOUTH NASSAUPROVIDES A COMPREHENSIVE PACKAGE OF SERVICES, INCLUDING PERINATOLOGY, FETAL MONITORING, GENETICS COUNSELING, AND DIAGNOSTIC CARE FOR ALL STAGES OF HIGH-RISK PREGNANCIES INCLUDING AMNIOCENTESIS AND ULTRASOUND. THE HOSPITAL ADMITTED 3,864 MATERNITY PATIENTS (INCLUDING NEWBORNS) IN 2016. NEONATAL SERVICES: THE HOSPITAL ALSO HAS A LEVEL II NEONATAL INTENSIVE CARE UNIT FOR PREMATURE BABIES. PREMATURE DELIVERIES AND NEWBORNS WITH DEVELOPMENTAL COMPLICATIONS OR CONDITIONS RECEIVE THE SPECIALIZED CARE THEY NEED IN THE NEONATAL INTENSIVE CARE UNIT. STAFFED BY HIGHLY TRAINED, BOARD-CERTIFIED NEONATOLOGISTS AND NURSES, THE NURSERY PROVIDES INTENSIVE ONE-TO-ONE CARE AND IS EQUIPPED WITH DEDICATED MEDICAL TECHNOLOGY FOR PREMATURE DELIVERIES AND NEWBORNS WITH SPECIAL NEEDS. THE NURSERY ALSO FEATURES A STATE-OF-THE-ART MONITORING SYSTEM. THE HOSPITAL ADMITTED 104 NEONATES IN 2016. IN-PATIENT PSYCHIATRIC SERVICES: IN OUR 36-BED SHORT-TERM INPATIENT BEHAVIORAL HEALTH UNIT, WE PROVIDE RAPID STABILIZATION FOR A WIDE RANGE OF ACUTE PSYCHIATRIC CONDITIONS. PATIENTS RECEIVE PSYCHIATRIC AND PSYCHOLOGICAL CONSULTATION DURING THEIR HOSPITAL STAY TO ALLEVIATE DISTRESS AND PAIN. THE HOSPITAL ADMITTED 1,031 PSYCHIATRIC PATIENTS IN 2016. TRANSITIONAL CARE UNIT: THIS 20 BED UNIT PROVIDES "TRANSITIONAL" CARE FOR PATIENTS WHO HAVE COMPLETED THEIR ACUTE STAY IN THE HOSPITAL YET STILL REQUIRE SKILLED NURSING AND OTHER SUPPORTIVE CARE BEFORE RETURNING TO HOME OR OTHER LIVING ARRANGEMENTS. THE HOSPITAL ADMITTED 582 PATIENTS IN 2016. SUMMARY: THE HOSPITAL ADMITTED A TOTAL OF 22,680 PATIENTS IN 2016 FOR INPATIENT SERVICES. THESE SERVICES WERE PROVIDED TO THE MEMBERS OF THE COMMUNITY ON AN ELECTIVE BASIS OR EMERGENCY BASIS. THE HOSPITAL PROVIDES CHARITY CARE AND DISCOUNTS TO PATIENTS THAT ARE UNABLE TO PAY FOR THE SERVICES PROVIDED. THE HOSPITAL PROVIDED CHARITY CARE OF APPROXIMATELY $2.7 MILLION (CHARGES) FOR INPATIENTS SERVED IN 2016. FORM 990, PART III, LINE 4B AMBULATORY SURGERY: SOUTH NASSAU AMBULATORY SURGERY SERVICE LINE CONSISTS OF OUTPATIENT SURGICAL, ENDOSCOPY, PAIN MANAGEMENT AND CARDIAC SERVICES. SEE DETAILS OF THE SERVICES THAT COMPRISE AMBULATORY SURGERY BELOW: OUTPATIENT SURGERIES: SOUTH NASSAU'S AMBULATORY SURGERY UNIT (ASU) FEATURES 10 SEMI-PRIVATE PRE-OPERATIVE PATIENT SUITES WHERE THE PATIENT IS ADMITTED PRIOR TO SURGERY AND 16 SEMI-PRIVATE POSTOPERATIVE ROOMS WHERE PATIENTS COMPLETE PHASE TWO OF THEIR RECOVERY, RECEIVE PAIN MEDICATION AND POST-OPERATIVE TEACHING PRIOR TO BEING DISCHARGED FROM THE HOSPITAL. THE ASU POST-OPERATIVE UNIT IS OPEN 24 HOURS A DAY. THE HOSPITAL PERFORMED 5,268 OUTPATIENT SURGICAL PROCEDURES IN 2016. ENDOSCOPY: SOUTH NASSAU COMMUNITIES HOSPITAL'S ENDOSCOPY UNIT PROVIDES STATE-OF-THE-ART PATIENT CARE FOR BOTH INPATIENTS AND OUTPATIENTS REQUIRING UPPER OR LOWER GASTROINTESTINAL STUDIES. THE SERVICE OFFERS E.R.C.P. (ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY) STUDIES OF THE GALL BLADDER, PANCREAS AND BILE DUCTS. ALSO OFFERED ARE ENDOSCOPIC ULTRASOUND, WHICH EXAMINES THE WALLS AND THE SURROUNDING STRUCTURES OF THE GI SYSTEM; GASTROSCOPY AND COLONOSCOPY, A MINIMALLY INVASIVE PROCEDURE TO VIEW THE GASTROINTESTINAL SYSTEM INCLUDING THE ESOPHAGUS, STOMACH AND COLON; AND LIVER BIOPSIES. THE ENDOSCOPY UNIT ALSO PERFORMS PH AND MOTILITY STUDIES USING THE "BRAVO" CAPSULE. THE HOSPITAL PERFORMED 2,839 OUTPATIENT ENDOSCOPY PROCEDURES IN 2016. PAIN MANAGEMENT: SOUTH NASSAU'S PAIN MANAGEMENT UNIT PROVIDES CARE TO BOTH INPATIENTS AND OUTPATIENTS REQUIRING INTERVENTIONAL PAIN MANAGEMENT PROCEDURES. THE PAIN MANAGEMENT ANESTHESIOLOGISTS, WHO ARE ASSISTED BY HIGHLY SKILLED REGISTERED NURSES, ARE TRAINED IN CUTTING-EDGE INTERVENTIONAL PAIN MANAGEMENT MODALITIES. THE HOSPITAL PERFORMED 2,538 OUTPATIENT PAIN MANAGEMENT PROCEDURES IN 2016. CARDIAC SERVICES: CARDIAC CATHETERIZATION LABORATORY: THE HOSPITAL'S CARDIAC CATHETERIZATION LABORATORIES IN THE CENTER FOR CARDIOVASCULAR HEALTH USE STATE-OF-THE-ART DIGITAL IMAGING CAMERAS FOR THE HIGHEST POSSIBLE RESOLUTION AND IMAGE QUALITY. THIS PROVIDES PRECISE RESULTS FOR CARDIAC PROCEDURES WHILE SIGNIFICANTLY REDUCING THE PATIENT'S EXPOSURE TO RADIATION. SOUTH NASSAU WAS APPROVED BY THE DEPARTMENT OF HEALTH TO PERFORM ELECTIVE ANGIOPLASTY. THIS ALLOWS SOUTH NASSAU TO PERFORM DIAGNOSTIC CARDIAC CATHETERIZATIONS AS WELL AS BOTH ELECTIVE AND EMERGENT CORONARY ANGIOPLASTY PROCEDURES. THE CARDIAC CATHETERIZATION LAB AND THE CARDIAC SERVICES ADMITTING/RECOVERY UNIT ARE STAFFED BY SPECIALLY TRAINED REGISTERED NURSES, NURSE PRACTITIONERS, PHYSICIAN'S ASSISTANTS AND EXPERIENCED INTERVENTIONAL CARDIOLOGISTS WHO RANK AMONG THE BEST IN THE STATE. THE HOSPITAL PERFORMED 742 OUTPATIENT CATHETERIZATION PROCEDURES IN 2016. ELECTROPHYSIOLOGY LABORATORY: THE HOSPITAL'S ELECTROPHYSIOLOGY AND ARRHYTHMIAS LAB SPECIALIZES IN THE DIAGNOSIS AND TREATMENT OF LIFE-THREATENING HEART RHYTHM DISORDERS. THE RECENTLY RENOVATED ELECTROPHYSIOLOGY LAB USES STATE-OF-THE-ART 3-D CARDIAC ANATOMIC MAPPING WHICH ALLOWS FOR THE PRECISE LOCATION OF IRREGULAR HEARTBEATS. THE ELECTROPHYSIOLOGY AND ARRHYTHMIAS LAB TEAM IS COMPOSED OF BOARD-CERTIFIED ELECTROPHYSIOLOGISTS TOGETHER WITH SPECIALLY TRAINED PHYSICIAN ASSISTANTS AND REGISTERED NURSES. THE LAB IMPLANTS PERMANENT PACEMAKERS, CARDIAC DEFIBRILLATORS, BIVENTRICULAR DEVICES AND LOOP RECORDERS AND PROVIDES ELECTROPHYSIOLOGY PROCEDURES SUCH AS TABLE TESTING, CARDIAC ABLATIONS, CARDIOVERSIONS, TRANSESOPHAGEAL ECHOCARDIOGRAMS AND DIAGNOSTIC ELECTROPHYSIOLOGY STUDIES. PATIENTS RECEIVING PERMANENT PACEMAKERS OR DEFIBRILLATORS HAVE THE DEVICE INTERROGATIONS PERFORMED IN THE ELECTROPHYSIOLOGY LAB FOLLOWING THE IMPLANTATION AND AT ROUTINE INTERVALS. THE HOSPITAL PERFORMED 640 OUTPATIENT EP STUDIES IN 2016. SUMMARY: AMBULATORY SURGERY SERVICES WERE PROVIDED TO 12,708 MEMBERS OF THE COMMUNITY ON AN ELECTIVE BASIS. THE HOSPITAL PROVIDED CHARITY CARE OF APPROXIMATELY $800 THOUSAND (CHARGES) FOR AMBULATORY PATIENTS SERVED IN 2016. FORM 990, PART III, LINE 4C EMERGENCY SERVICES: OCEANSIDE: THE EMERGENCY ROOM IS OPERATED ON A FULL TIME BASIS (24 HOURS 365 DAYS A WEEK). OUR EMERGENCY ROOM IS ONE OF THE BUSIEST ON THE SOUTH SHORE OF NASSAU COUNTY. THE EMERGENCY ROOM IS THIS AREA'S LEADING CENTER OF SPECIALIZED EMERGENCY CARE, WITH A SOLID REPUTATION FOR DEVELOPING AND IMPLEMENTING INNOVATIONS IN EMERGENCY HEALTH CARE SERVICES. THE EMERGENCY ROOM IS STAFFED BY A TEAM OF DEDICATED PROFESSIONALS, INCLUDING BOARD-CERTIFIED, RESIDENCY-TRAINED EMERGENCY MEDICINE PHYSICIANS (ONE OF FEW HOSPITALS IN NEW YORK WITH SUCH STAFFING), AS WELL AS NURSES, NURSE PRACTITIONERS AND PHYSICIANS' ASSISTANTS WHO HAVE BEEN SPECIALLY-TRAINED IN EMERGENCY MEDICAL CARE. THE EMERGENCY ROOM IS ALSO A LEVEL II TRAUMA CENTER, EQUIPPED WITH THE ADVANCED MEDICAL TECHNOLOGY AND SKILLED SPECIALISTS REQUIRED TO PERFORM EMERGENCY TRAUMA PROCEDURES. IT HAS ALSO BEEN DESIGNATED AS A STROKE CENTER BY THE NEW YORK STATE DEPARTMENT OF HEALTH BECAUSE WE OFFER THE RAPID ASSESSMENT AND ADVANCED THERAPIES AND PROCEDURES THAT CAN MAKE A DIFFERENCE FOR STROKE PATIENT. THE HOSPITAL PROVIDES CHARITY CARE AND DISCOUNTS TO PATIENTS RECEIVING EMERGENCY ROOM SERVICES CONSISTENT WITH OUR POLICY. THE HOSPITAL EXPERIENCED 63,556 EMERGENCY ROOM VISITS IN 2016 OF WHICH 16,066 PATIENTS WERE ADMITTED. IN 2016, THE HOSPITAL PROVIDED CHARITY CARE OF APPROXIMATELY $4.2 MILLION (CHARGES) TO INDIVIDUALS WHO RECEIVED EMERGENCY SERVICES. LONG BEACH: IN AUGUST 2015, THE HOSPITAL OPENED A HOSPITAL BASED FREE STANDING EMERGENCY DEPARTMENT IN LONG BEACH. THE FREE STANDING EMERGENCY DEPARTMENT, WHICH OPERATES ON A FULL TIME BASIS (24 HOURS A DAY, 365 DAYS A YEAR), IS STAFFED WITH CERTIFIED EMERGENCY NURSES AND PHYSICIANS BOARD CERTIFIED IN EMERGENCY MEDICINE, AND HAS THE SAME FEATURES AND DIAGNOSTIC EQUIPMENTS AS A TRADITIONAL EMERGENCY DEPARTMENT WITH THE EXCEPTION BEING THAT IT IS NOT LOCATED ON THE HOSPITAL'S MAIN CAMPUS. ANY PATIENTS REQUIRING CONTINUED HOSPITAL CARE OR ADMISSION ARE TRANSFERRED TO THE MAIN CAMPUS VIA A SOUTH NASSAU AMBULANCE. THESE TRANSFERS ARE PAID FOR BY THE HOSPITAL. IN 2016, THE LONG BEACH EMERGENCY DEPARTMENT EXPERIENCED 10,419 VISITS, OF WHICH 1,297 PATIENTS WERE TRANSFERRED TO THE HOSPITAL'S MAIN CAMPUS RESULTING IN 875 ADMISSIONS. THE HOSPITAL PROVIDED CHARITY CARE OF APPROXIMATELY $500,000 (CHARGES) TO INDIVIDUALS WHO RECEIVED EMERGENCY SERVICES. FORM 990, PART IV, LINE 28C SOUTH NASSAU COMMUNITIES HOSPITAL (SNCH) HAD BUSINESS TRANSACTIONS WITH SEVERAL SUBSTANTIAL CONTRIBUTORS WHICH REQUIRED DISCLOSURE IN SCHEDULE L. THE CHECKLIST QUESTIONS RELATED TO SCHEDULE L HAVE NOT BEEN UPDATED TO REFLECT THE UPDATES TO REQUIRED DISCLOSURES IN SCHEDULE L, THEREFORE SNCH HAS RESPONDED YES TO QUESTION 28C SOLELY TO INDICATE THAT SCHEDULE L, PART IV IS REQUIRED. THESE ARE THE ONLY BUSINESS TRANSACTIONS REQUIRED TO BE REPORTED IN SCHEDULE L. FORM 990, PART VI, SECTION A, LINE 2 TWO OR MORE OF THE PERSONS LISTED IN THIS FORM 990 PART VII HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER BY VIRTUE OF SITTING ON ONE OR MORE BOARDS OF DIRECTORS OR BY SERVING IN AN EMPLOYMENT RELATIONSHIP WITH ONE OR MORE ENTITIES IN THE SNCH GROUP OF AFFILIATED ENTITIES. FORM 990, PART VI, SECTION A, LINE 4 DURING 2016, SNCH MADE THE FOLLOWING SIGNIFICANT CHANGES TO ITS CURRENT BYLAWS: - UPDATES TO THE COMPOSITION OF THE BOARD OF DIRECTORS OF THE HOSPITAL, REMOVAL OF TERM LIMITS, AND CLASSIFICATION OF DIRECTORS INTO THREE GROUPS FOR STAGGERED TERMINATIONS, AS WELL AS UPDATES TO QUORUM. - UPDATES TO SPECIAL MEETINGS OF THE BOARD OF DIRECTORS, WHICH INCLUDE DETAILS REGARDING WRITTEN CONSENT AND TELEPHONE/VISUAL MEDIA APPROVAL. - UPDATES TO STREAMLINE SNCH'S CONFLICTS OF INTEREST AND WHISTLEBLOWER POLICIES. - UPDATES TO REMOVE, RENAME, AND ADD CERTAIN NEW OF COMMITTEES OF BOARD OF DIRECTORS, AS WELL AS UPDATES TO THE MAKEUP, RESPONSIBILITIES, AND TASKS OF VARIOUS COMMITTEES. FORM 990, PART VI, SECTION A, LINE 6 WINTHROP SOUTH NASSAU UNIVERSITY HEALTH SYSTEM IS THE SOLE MEMBER OF SOUTH NASSAU COMMUNITIES HOSPITAL. THE SYSTEM IS ORGANIZED AS A NOT FOR PROFIT CORPORATION UNDER FEDERAL AND NEW YORK STATE LAWS. FORM 990, PART VI, SECTION A, LINE 7A WINTHROP SOUTH NASSAU UNIVERSITY HEALTH SYSTEM IS THE SOLE MEMBER OF SOUTH NASSAU COMMUNITIES HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B IN ADDITION TO SUCH AUTHORITY RESERVED TO THE TAXPAYER'S SOLE MEMBER, WINTHROP SOUTH NASSAU UNIVERSITY HEALTH SYSTEM, INC. ("WSN"), PURSUANT TO THE NEW YORK NOT-FOR-PROFIT CORPORATION LAW, SUCH AS THE AUTHORITY TO (I) ELECT AND REMOVE MEMBERS OF THE TAXPAYER'S GOVERNING BOARD, (II) APPROVE AMENDMENTS TO THE TAXPAYER'S CERTIFICATE OF INCORPORATION AND BYLAWS, AND (III) APPROVE SIGNIFICANT CORPORATE TRANSACTIONS SUCH AS MERGERS, CONSOLIDATIONS, THE DISSOLUTION OF THE TAXPAYER AND THE SALE, LEASE, MORTGAGE,PLEDGE OR OTHER TRANSFER OF SIGNIFICANT ASSETS OF THE TAXPAYER, THE APPROVAL OF THE FOLLOWING MATTERS HAVE BEEN SPECIFICALLY RESERVED TO WSN, IN ITS CAPACITY AS THE TAXPAYER'S SOLE MEMBER, PURSUANT TO THE TAXPAYER'S CERTIFICATE OF INCORPORATION AND BYLAWS: (A) APPROVAL OF THE TAXPAYER'S MISSION AND PHILOSOPHY; (B) ESTABLISHING THE SIZE OF THE TAXPAYER'S GOVERNING BOARD; (C) SELECTION AND REMOVAL OF THE CHAIRPERSON OF THE TAXPAYER'S GOVERNING BOARD; (D) ESTABLISHING CRITERIA FOR EVALUATING PERFORMANCE OF THE TAXPAYER'S CHIEF EXECUTIVE OFFICER; (E) APPROVAL OF THE TAXPAYER'S OPERATING AND CAPITAL BUDGETS AND BUSINESS PLAN; (F) APPROVAL OF THE ESTABLISHMENT OF A HEALTH MAINTENANCE ORGANIZATION BY THE TAXPAYER; (G) APPROVAL OF THE INITIATION OF ANY JOINT VENTURE OR PARTNERSHIP BY THE TAXPAYER; (H) APPROVAL OF THE ESTABLISHMENT OF ANY MATERIAL NEW LINES OF BUSINESS BY THE TAXPAYER THAT IS NOT OTHERWISE CONTEMPLATED WITHIN A PREVIOUSLY APPROVED BUSINESS PLAN OF THE TAXPAYER; (I) APPROVAL OF ANY TRANSACTION THAT RESULTS IN THE TAXPAYER BECOMING THE SOLE MEMBER OR SHAREHOLDERS OF ANY OTHER CORPORATION THAT OWNS OR OPERATES A LICENSED HOSPITAL; (J) APPROVAL OF ANY TRANSACTION THAT RESULTS IN A THIRD PARTY BECOMING ENTITLED TO APPOINT MEMBERS OF THE TAXPAYER'S GOVERNING BOARD; (K) INITIATION BY THE TAXPAYER OF A BANKRUPTCY OR INSOLVENCY ACTION; (L) APPROVAL OF ANY ACTION THAT WOULD RESULT IN THE COMPLETE CLOSURE OR CONVERSION OF THE USE OF THE TAXPAYER'S FROM A GENERAL ACUTE CARE HOSPITAL; (M) APPROVAL OF THE ISSUANCE OF LONG-TERM DEBT IN EXCESS OF $2.0 MILLION BY THE TAXPAYER OR THE INCURRENCE OF ANY OTHER DEBT BY THE TAXPAYER THAT IS IN EXCESS OF $1.0 MILLION AND NOT PART OF THE TAXPAYER'S APPROVED BUDGETS AND THAT IS NOT NECESSARY TO FINANCE THE COST OF COMPLIANCE WITH OPERATIONAL OR PHYSICAL PLANT STANDARDS REQUIRED BY LAW; (N) APPROVAL OF LITIGATION SETTLEMENTS INVOLVING THE TAXPAYER THAT EXCEED APPLICABLE COMMERCIAL OR SELF-INSURANCE COVERAGE; (O) APPROVAL OF THE SUBMISSION OF ANY CERTIFICATE OF NEED APPLICATIONS BY OR ON BEHALF OF THE TAXPAYER WITH ANY REGULATORY AUTHORITY; (P) APPROVAL OF THE INITIATION BY THE TAXPAYER OF A NEW CLINICAL SERVICE OR THE DISCONTINUANCE OR SUBSTANTIAL CHANGE IN AN EXISTING CLINICAL SERVICE; AND (Q) APPROVAL OF THE EXPENDITURE BY THE TAXPAYERS OF MORE THAN $2.0 MILLION IN CONNECTION WITH A SINGLE TRANSACTION RELATED TO HEALTH SERVICE DELIVERY. NOTE THAT IN ACCORDANCE WITH THE TAXPAYER'S AND WSN'S CERTIFICATE OF INCORPORATION AND BYLAWS, WSN DOES NOT HAVE THE AUTHORITY TO EXERCISE CONTROL OVER CERTAIN OF THE FOREGOING MATTERS TO THE EXTENT THAT (I) AUTHORIZATION OF A PARTICULAR MATTER BY THE TAXPAYER IS NECESSARY TO ENSURE THAT ACTIONS TAKEN BY THE TAXPAYER CONFORM WITH THE TAXPAYER'S MISSION AND PHILOSOPHY, AND (II) WSN IS NOT THEN CURRENTLY ESTABLISHED OR LICENSED UNDER ARTICLE 28 OF THE NEW YORK STATE PUBLIC HEALTH LAW TO EXERCISE SUCH APPROVAL AUTHORITY. FORM 990, PART VI, SECTION B, LINE 11B THE POLICY OF SOUTH NASSAU COMMUNITIES HOSPITAL FOR REVIEWING AND APPROVING THE IRS FORM 990 IS THE FOLLOWING: THE AUDIT COMMITTEE, A SUB-COMMITTEE OF THE BOARD OF DIRECTORS, IS ASSIGNED TO REVIEW AND APPROVE THE IRS FORM 990 THAT IS FILED ON BEHALF OF THE ORGANIZATION, BEFORE IT IS FILED WITH THE IRS. THE AUDIT COMMITTEE WILL NOTIFY THE BOARD OF DIRECTORS WHEN THE IRS FORM 990 IS APPROVED BY THE AUDIT COMMITTEE. ONCE THE 990 IS APPROVED, THE BOARD OF DIRECTORS WILL RECEIVE A COPY (ELECTRONICALLY OR HARDCOPY) BEFORE IT IS ULTIMATELY FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C SOUTH NASSAU COMMUNITIES HOSPITAL HAS A WRITTEN CONFLICT OF INTEREST POLICY THAT IS UPDATED ON AN ANNUAL BASIS WITH MEMBERS OF THE CORPORATE COMPLIANCE COMMITTEE (A SUB-COMMITTEE OF THE BOARD OF DIRECTORS) AND WITH LEGAL COUNSEL. THE POLICY IS UPDATED FOR ANY NEW/UPDATED LEGAL AND GOVERNANCE ISSUES AND DISTRIBUTED TO BOARD MEMBERS, OFFICERS, KEY EMPLOYEES AND MANAGEMENT ON AN ANNUAL BASIS. ALONG WITH THE POLICY, A QUESTIONNAIRE IS PROVIDED TO ALL BOARD MEMBERS, OFFICERS, KEY EMPLOYEES AND MANAGEMENT REQUESTING ACKNOWLEDGEMENT THAT THEY RECEIVED THE FORM, ASKING THEM TO DISCLOSE ALL KNOWN RELATIONSHIPS AND RETURN THE SIGNED FORM TO THE CORPORATE COMPLIANCE DEPARTMENT. THE CORPORATE COMPLIANCE DEPARTMENT FOLLOWS UP WITH ANY BOARD MEMBER, OFFICERS, KEY EMPLOYEES OR MANAGEMENT STAFF WHEN A POTENTIAL CONFLICT EXISTS. THIS INFORMATION IS THEN REPORTED BACK TO THE CORPORATE COMPLIANCE COMMITTEE WHICH THEN REPORTS TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 15 (A) -SOUTH NASSAU COMMUNITIES HOSPITAL HAS A COMPENSATION COMMITTEE (A SUB-COMMITTEE OF THE BOARD OF DIRECTORS) WHICH DETERMINES THE OFFICERS' COMPENSATION. THE COMPENSATION COMMITTEE, COMPRISED EXCLUSIVELY OF DISINTERESTED DIRECTORS, UTILIZES A VARIETY OF SOURCES IN DETERMINING THE OFFICERS OVERALL COMPENSATION. THESE SOURCES INCLUDE A COMPENSATION STUDY PERFORMED BY AN INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEYS AND THE OFFICERS' HISTORICAL SALARIES. THE COMPENSATION CONSULTANT PERIODICALLY RENDERS AN OPINION THAT THE TOTAL PROPOSED COMPENSATION FOR THE OFFICERS ARE "REASONABLE" WITH RESPECT TO THE INTERNAL REVENUE SERVICE (IRS) INTERMEDIATE SANCTIONS REGULATIONS AND THAT THE SAFE-HARBOR DESCRIBED THEREIN IS SATISFIED. THIS INDEPENDENT CONSULTANT UTILIZES PUBLISHED SURVEYS AND RELEVANT MARKET DATA TO DETERMINE RANGES FOR THE OFFICERS' SALARY TO REACH ITS OPINION. 15 (B) -COMPENSATION FOR THE OTHER OFFICERS (NOT MENTIONED ABOVE) AND KEY EMPLOYEES IS BASED ON A VARIETY OF SOURCES WHICH INCLUDE THIRD PARTY COMPENSATION SURVEYS AND STUDIES, THE ORGANIZATION'S HISTORICAL SALARY RATES, OTHER COMPENSATION WITHIN THE ORGANIZATION FOR SIMILAR TITLES AND POSITIONS, AND THE CURRENT LABOR MARKET. ALL SALARIES FOR EMPLOYEES MUST BE APPROVED BY THE CHIEF EXECUTIVE OFFICER AND/OR THE CHIEF OPERATING OFFICER AND THE SENIOR VICE PRESIDENT OF HUMAN RESOURCES. FORM 990, PART VI, SECTION C, LINE 19 THE PUBLIC CAN OBTAIN A COPY OF THE 990, 990T, AUDITED FINANCIAL STATEMENTS VIA A WRITTEN OR VERBAL REQUEST THROUGH THE HOSPITAL'S OFFICE OF EXTERNAL AFFAIRS, 2277 GRAND AVE., BALDWIN, NY 11510. THE BYLAWS, ARTICLES OF INCORPORATION AND THE CONFLICT OF INTEREST POLICY OF THE HOSPITAL CAN BE OBTAINED AT MANAGEMENT'S DISCRETION VIA A WRITTEN REQUEST THROUGH THE HOSPITAL'S OFFICE OF EXTERNAL AFFAIRS, 2277 GRAND AVE., BALDWIN, NY 11510. PHONE NUMBER: (516) 377-5370. THE HOSPITAL'S PREVIOUS YEARS' 990 CAN BE FOUND ON THE WEBSITE, WWW.GUIDESTAR.ORG. FORM 990, PART XI, LINE 9: TRANSFER TO AFFILIATES -15,676,250. PENSION & OTHER POSTRETIREMENT LIABILITY ADJUSTMENTS -5,253,183. TRANSFER TO SELF INSURANCE FUND -3,099,007. FORM 990, PART XII, LINE 2C: SOUTH NASSAU COMMUNITIES HOSPITAL RECEIVED A CONSOLIDATED AUDITED FINANCIAL STATEMENT FOR THE YEAR ENDING DECEMBER 31, 2016. THE CONSOLIDATED FINANCIAL STATEMENTS ARE PREPARED IN ACCORDANCE WITH ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA ("GAAP"). THE CONSOLIDATED FINANCIAL STATEMENTS INCLUDE THE ACCOUNTS OF SOUTH NASSAU COMMUNITIES HOSPITAL AND ALL OF ITS AFFILIATED ORGANIZATIONS WHICH IN SOME CASES FILE SEPARATE RETURNS WITH THE IRS. FORM 990, PAGE 1, BOX H THE HOSPITAL AND GROUP AFFILIATED ORGANIZATIONS ARE SECTION 501(C)(3) ORGANIZATIONS. THE ORGANIZATIONS ARE EXEMPT FROM INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(A) AND THEIR INCOME IS GENERALLY NOT SUBJECT TO FEDERAL OR NEW YORK STATE INCOME TAXES. SN HEALTHCARE AND SOUTH NASSAU SN, LLC ARE TAXABLE ENTITIES, WHICH ARE NOT INCLUDED IN THE GROUP REUTRN. SOUTH NASSAU SELF-INSURANCE TRUST AND SIBS PLACE, INC. ARE ALSO NOT INCLUDED IN THE GROUP RETURN AND FILE A SEPARATE FEDERAL FORM 990. AFFILIATES INCLUDED IN GROUP RETURN SUBORDINATE ORGANIZATIONS OF SOUTH NASSAU COMMUNITIES HOSPITAL (EIN: 27-2843521) GROUP EXEMPTION NUMBER 5611: RADIOLOGICAL ASSOCIATES OF LONG ISLAND, P.C., - EIN: 11-2462030 SN SERVICES CORPORATION, - EIN: 11-2727976 SOUTH NASSAU NEONATAL SERVICES, P.C., - EIN: 11-3319620 SOUTH NASSAU FAMILY MEDICINE, P.C., -EIN: 11-3565450 SOUTH NASSAU PRIMARY MEDICAL CARE, P.C., - EIN: 11-3581988 OCEANSIDE COUNSELING CENTER -EIN: 23-7062966 SOUTH NASSAU PHYSICIAN PRACTICE, P.C., - EIN: 26-2692377 SOUTH NASSAU ONCOLOGY, P.C., - EIN: 27-3857309 SN RADIOLOGICAL PRACTICE, P.C., - EIN: 27-4344388 203 MERRICK ROAD HOLDING CORP, - EIN: 27-5368294 SOUTH NASSAU CARDIOVASCULAR PRACTICE, P.C., - EIN: 38-3843950 SOUTH NASSAU MEDICAL GROUP, P.C., - EIN: 45-4799159 SOUTH NASSAU OBSTETRICS AND GYNECOLOGY, P.C., - EIN: 45-5272144 SOUTH NASSAU ONCOLOGY PRACTICE, P.C., - EIN: 46-2905667 SNCH COMMUNITY DEVELOPMENT CORPORATION - EIN: 47-1303599 SOUTH NASSAU PHYSICIANS, P.C., - EIN: 47-1545515 SOUTH NASSAU PHYSICIAN GROUP, PC, - EIN: 47-4961193 SOUTH NASSAU UROLOGY, P.C. - EIN: 47-5071498 WINTHROP SOUTH NASSAU UNIVERSITY HEALTH SYSTEM ONE HUNTINGTON QUADRANGLE MELVILLE NY 11747 066427908 DELIVER CARE NY 501(C)(3) LINE 11A, I N/A 0 WINTHROP UNIVERSITY HOSPITAL 259 FIRST STREET MINEOLA NY 11501 111633486 HOSPITAL NY 501(C)(3) LINE 3 WINTHROP SOUTH NASSAU UNIVERSITY HEALTH SYSTEM 0 SOUTH NASSAU COMMUNITIES HOSPITAL ONE HEALTHY WAY OCEANSIDE NY 11572 111352310 HOSPITAL NY 501(C)(3) LINE 3 WINTHROP SOUTH NASSAU UNIVERSITY HEALTH SYSTEM 0 SIBS PLACE INC 1420 BROADWAY HEWLETT NY 11557 813485876 SUPPORT PROGRAM NY 501(C)(3) LINE 7 SOUTH NASSAU COMMUNITIES HOSPITAL 0 SOUTH NASSAU SN LLC ONE HEALTHY WAY OCEANSIDE NY 11572 450541270 INACTIVE NY N/A C 1.00000 0 SN HEALTHCARE SERVICES ONE HEALTHY WAY OCEANSIDE NY 11572 113571538 INACTIVE NY N/A C 5000 1.00000 0 SN HEALTHCARE REGISTRY ONE HEALTHY WAY OCEANSIDE NY 11572 260228658 INACTIVE NY N/A C 1.00000 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 SOUTH NASSAU FAMILY MEDICINE PC S 865000 CASH BASIS SOUTH NASSAU FAMILY MEDICINE PC N 502044 CASH BASIS SOUTH NASSAU FAMILY MEDICINE PC B 338003 CASH BASIS SN NEONATAL PC R 800000 CASH BASIS SN NEONATAL PC N 54480 CASH BASIS SN NEONATAL PC C 298195 CASH BASIS SN OBGYN PC R 1740000 CASH BASIS SN OBGYN PC N 172422 CASH BASIS SN OBGYN PC B 478387 CASH BASIS SN ONCOLOGY PC S 690000 CASH BASIS SN ONCOLOGY PC N 73368 CASH BASIS SN ONCOLOGY PC B 800456 CASH BASIS SN PHYSICIAN PRACTICE PC S 1320000 CASH BASIS SN PHYSICIAN PRACTICE PC N 418776 CASH BASIS SN PHYSICIAN PRACTICE PC B 1486698 CASH BASIS SN RADIOLOGY PC R 3350000 CASH BASIS SN RADIOLOGY PC N 89136 CASH BASIS SN RADIOLOGY PC B 484764 CASH BASIS RADIOLOGICAL ASSOCIATES OF LONG ISLAND S 2235000 CASH BASIS RADIOLOGICAL ASSOCIATES OF LONG ISLAND N 224552 CASH BASIS RADIOLOGICAL ASSOCIATES OF LONG ISLAND B 484764 CASH BASIS SOUTH NASSAU PRIMARY MEDICAL PC R 740000 CASH BASIS SOUTH NASSAU PRIMARY MEDICAL PC N 69030 CASH BASIS SOUTH NASSAU PRIMARY MEDICAL PC B 1119545 CASH BASIS SN MEDICAL GROUP PC R 535000 CASH BASIS SN MEDICAL GROUP PC B 5674088 CASH BASIS SN ONCOLOGY PRACTICE PC R 10960000 CASH BASIS SN ONCOLOGY PRACTICE PC B 219545 CASH BASIS 203 MERRICK ROAD HOLDING CORP C 34295 CASH BASIS SN SERVICES CORPORATION C 1023906 CASH BASIS OCEANSIDE COUNSELING CENTER INC Q 157579 CASH BASIS SN PHYSICIAN PC (DR DATTA) R 475000 CASH BASIS SN PHYSICIAN PC (DR DATTA) B 690173 CASH BASIS SN PHYSICIAN PC (DR DATTA) N 59820 CASH BASIS SN UROLOGY PC B 1762578 CASH BASIS SN UROLOGY PC S 552000 CASH BASIS FORM 990, SCHEDULE R, PART V, LINE 2 VALUE OF THE SERVICES ARE DONE ON A CASH BASIS.