2017-11-12T12:06:59-06:00 2016-12-31 ERNST & YOUNG US LLP 5 TIMES SQUARE NEW YORK NY 100366527 990 2016-01-01 462931956 MONTEFIORE NEW ROCHELLE HOSPITAL % EVAN RESNICK MONT 9143498400 16 GUION PLACE NEW ROCHELLE NY 108015502 COLLEEN M BLYE EXEC V.P. & C.F.O. 7189207602 2017-11-10 true CHRISTOPHER B BOGGS P00032493 2127733000 108.206.163.59 26308520173165000003 2017-11-12 P 723A92BD6066970D9DF2371F65DCD51A2FC70B05 582F47EFACDD6166E52205D1FBFEA2601660FA18 2016 2021-01-29 14:40:06Z STEVEN SAFYER MD 111 EAST 210TH STREET BRONX NY 104672401 174440106 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 1309 95 0 17224007 24748007 136088535 147484409 900250 977547 4105290 1230143 158318082 174440106 0 16800 0 0 103743099 99256267 0 0 0 69138430 75539735 172881529 174812802 -14563447 -372696 71255961 74333511 84203018 87949080 -12947057 -13615569 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 146906145 16800 136586932 Patient Care Montefiore New Rochelle Hospital is a 242-bed, community based teaching hospital offering primary, acute and emergency care to the residents of southern Westchester that has been providing for the diverse Medical need of the communities that it serves. Montefiore New Rochells has a number of leading-edge services and programs that have earned distinction by State and National organizations for achieving and maintaining the highest quality of care within the specialty. Among its distinctions: - Designated as a center of excellence by the American Society of Metabolic and Bariatric Surgery; - New York State desinated stroke center; - Designated as a New York perinatal hospital with a level 3 neonatal intensive care unit that provides state-of-the-art care for fragile newborns; - Receipt of American College of Surgeons Commission of Cancer (COC) cancer program accreditation and; - Gold Seal of approval from the Joint Commission as a certified center of excellence in both hip and knee joint replacement. MONTEFIORE NEW ROCHELLE HOSPITAL, part of the Montefiore Health System, the university hospital system for the Albert Einstein College of Medicine, IS THE ONLY HOSPITAL IN THE CITY OF NEW ROCHELLE. In 2016, THE HOSPITAL HAd 7,782 INPATIENT ADMISSIONS and 94,158 ambulatory visits. 14554894 0 10897477 Medical Education The Department of Medicine at New Rochelle Hospital offers training programs for residents and students that reflects a deep institutional and departmental commitment to medical education in a supportive community-based environment that provides a full spectrum of care to a diverse patient population. As the University hospital for Albert College of Medicine, Montefiore consistently breaks ground with innovative treatments, procedures and approaches to patient care with a focus on producing stellar outcomes and raising the bar for medical centers in the region and around the world. Montefiore also operates a School of Nursing Program based in Mount Vernon, New York that offers a two year associate's degree. Graduates are eligible to sit for the National Council Licensure Examination for registered nurses and the school is accredited by the Accreditation Commission for Education in Nursing, Inc. Though a strong theoretical and clinically based program, Montefiore School of Nursing graduates receive the skills and confidence to provide the community with competent, quality nursing care. Learning in a hospital environment prepares our students to work in a variety of clinical settings. Our nurses secure employment in hospitals, home healthcare, education, long-term care, public health administration, forensic nursing, occupational health and research. Montefiore School of Nursing provides the foundation for nurses who are committed to excellence and are prepared to embark on a career that provides a professional challenge and a personal sence of satisfaction. 161461039 true true false true false false false false false true true false false false true false false true false false false false false false false false true true true false true false false false false false false false false false false false false false true true true false false true 51 0 true 1309 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 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X 0 0 0 JENNIE EMIL TRUSTEE 0.2 1.3 X 0 0 0 JONTHAN A LIPTON THRUSTE 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 MD PHD 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 Anthony Alfano Vice President 60.0 0.0 X 0 428652 49245 JOHN OLSEWSKI MD ORTHOPEDIC SURGEON 60.0 0.0 X 742577 0 33199 STEVEN B ZELICOF MD CHIEF, ORTHOPEDIC SURGERY 60.0 0.0 X 549211 0 29323 MADHU RANGRAJ MD DIRECTOR, SURGERY 60.0 0.0 X 531862 0 30792 Roger Coron MD Chief of Gastroenterology 60.0 0.0 X 557022 0 29284 Mark Liss MD Attending Gastroentrology 60.0 0.0 X 392727 0 31732 2773399 13615390 2248857 227 false true false Cauldwell Wingate Co LLC 380 Lexington Avenue NEW YORK NY 10168 Boiler Replacement 4823245 Fastaff Inc PO Box 911452 DENVER CO 80291 Temporary Nurses 2088225 Radiology Advantage New Jersey PA 3805 East Bell Road Suite 5500 PHOENIX AZ 85032 Radiology Services 1407749 Jzanus LTD 170 Jericho Turnpike FLORAL PARK NY 11001 Collection Fees 933140 Allegiance Billing and ConsultingL 333 Jericho Turnpike Suite 102 JERICHO NY 11753 Collection fees 693556 52 24661232 86775 24748007 INPATIENT REVENUE 623000 97070452 97070452 0 0 OUTPATIENT REVENUE 621400 47511820 47511820 0 0 MEDICAL/NURSING EDUCATION 611699 2560505 2560505 0 0 OTHER HEALTH CARE SERVICES 621999 341632 341632 0 0 147484409 457541 0 457541 0 0 0 0 0 520006 520006 520006 0 520006 0 0 0 0 0 0 0 0 0 CAFETERIA/COFFEE SHOP & VENDING INCOME 722514 501646 0 0 501646 NON-INVESTMENT PROPERTY RENTAL INCOME 531120 435432 0 435432 ANTIQUE SHOP REVENUE 453310 178938 0 178938 114127 0 0 114127 1230143 174440106 147484409 0 2207690 16800 16800 0 0 0 0 0 77444096 72109909 5334187 0 4496695 4186761 309934 0 11895199 11075441 819758 0 5420277 5046741 373536 0 42000 0 42000 0 183684 43522 140162 0 150000 0 150000 0 33513 33513 0 0 0 98485 0 98485 0 11066955 9781370 1285585 0 18151 18151 0 0 9627338 8571437 1055901 0 3519011 2663256 855755 0 0 10816371 9547456 1268915 0 117796 108185 9611 0 42714 39846 2868 0 2117688 2117688 0 0 0 2886479 2827157 59322 0 10163082 10090687 72395 MEDICAL SUPPLIES 19957505 19950664 6841 0 MEMBERSHIP DUES 2119637 1524216 595421 0 BAD DEBT-STUDENT NURS LOANS 856439 856439 0 0 BILLING & COLLECTIONS 705173 0 705173 0 1017714 851800 165914 174812802 161461039 13351763 0 1379563 1083 0 1770001 0 5752858 28117113 18952272 0 0 0 0 0 177006 2401324 2637025 931935 991364 35599996 7425094 21508870 28174902 0 15877000 16826130 0 0 0 0 0 91026 0 71255961 74333511 33308583 45942055 0 0 4434363 326487 0 0 0 0 0 0 0 0 0 0 46460072 41680538 84203018 87949080 X -30073543 -29943905 31439 31439 17095047 16296897 -12947057 -13615569 71255961 74333511 -372696 502333 -798149 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false false true 33513 false false 33513 PART II-B, LINE B THE Organization's LOBBYING EXPENDITURES INCLUDED $458 OF HEALTH SYSTEM MEMBERSHIP DUES THAT WERE 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 INCLUDES A PERCENTAGE OF MEMBERSHIP DUES PAID TO THE GREATER NEW YORK HOSPITAL ASSOCIATION, AMERICAN HOSPITAL ASSOCIATION, THE HEALTH CARE ASSOCIATION OF NYS and Montefiore Medicine Academic Health System, Inc. THAT ARE USED FOR LOBBYING EFFORTS. 17095047 798150 16296897 17095047 17095047 17095047 17095047 1.00000 false false 18274074 1417555 16856519 13541660 6007539 7534121 3784262 3784262 28174902 0 LOAN PAYABLE TO PARENT 36103129 DUE TO AFFILIATES 637706 DUE TO THIRD PARTIES PAYORS 2893797 MALPRACTICE INSURANCE LIABILITIES 2045906 41680538 FORM 990, SCHEDULE D, PART V, LINE 4: The organization's endowments were established pursuant to donor gifts transferred from the bankrupt Sound Shore Medical Center Estate. The earnings can provide support to the Montefiore New Rochelle Hospital general activities, specifically treatment, hospitalization and care of needy patients as designated by individual donors. true true X true X true X 500. true true true false true true 5040651 7216927 0 0.00000 41349666 28700537 12649129 0.07240 46390317 35917464 12649129 0.07240 5814913 3407463 2407450 0.01380 14554894 10897477 3657417 0.02090 15718969 13047996 2670973 0.01530 36088776 27352936 8735840 0.05000 82479093 63270400 21384969 0.12240 false 1329726 1263240 49613572 44010676 5602896 X true true 1 1 Montefiore New Rochelle Hospital 16 Guion Place New Rochelle NY 10801 www.montefiorehealthsystem.org 5904001H X X X X Montefiore New Rochelle Hospital 1 false false true X X X X X X X X 14 true true 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, 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. PART V, SECTION B, LINE 11: A review of the results from the primary and secondary data collection in Montefiore New Rochelle Hospital most recent 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 6A Montefiore New Rochelle Hospital's CHNA was conducted along with Montefiore Mount Vernon Hospital. Schedule H, Part V, Section B, Line 7a The website that the hospital facility makes its CHNA report widely available to the public: https://www.montefiore.org/documents/communityservices/Comprehensive-NR-CH NA-IR-2014.pdf Schedule H, Part V, Section B, Line 10a The website that the hospital facility's most recently adopted implementation strategy is posted: https://www.montefiore.org/documents/communityservices/Comprehensive-NR-CH NA-IR-2014.pdf Schedule H, Part V, Section B, Lines 11 A review of the results from the primary and secondary data collection in Montefiore New Rochelle Hospital's most recent 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 FAP was publicized on the hospital facility's direct website: http://www.montefiorehealthsystem.org/body.cfm?id=68 1. Required Description: 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 CO-PAYMENTS 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, SECTION 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(RCCS). 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 SHORTFALL OF $2,547,410. REVENUE ALLOWABLE COSTS SHORTFALL PART III, LINES 5-7: $49,613,572 $44,010,676 5,602,896 ADD: MED. CENTERS COSTS: - 5,168,315 (5,168,315) ADD: MEDICARE DME: 3,491,152 4,451,894 (960,742) ADD: MED. CENTER EMPL. PHY.: 1,114,000 1,892,471 (778,471) ADD: MED. SUBSID. HLTH. SERV.: 2,807,653 4,050,431 (1,242,778) TOTAL OVERALL MEDICARE SHORTFALL:$57,026,377 $59,573,787 (2,547,410) 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 involves 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 NEW ROCHELLE 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 New Rochelle is the anchor city for the Long Island Sound region in Westchester County and has approximately 78,400 residents. New Rochelle is ethnically diverse. Its population is 28.5% Hispanic, 17.8% African-American, 69.6% white, 4% Asian and 7% other. Almost one-third (26.3%) of its residents are foreign-born. Among these immigrants, more people speak only English at home than any other language. New Rochelle is one of Westchester County's more affuent cities. 1% of New Rochelle households are on public assistance; less than Westchester County (2.2%) and New York State (3.4%) percentage. About 10% of New Rochelle's population lives below the poverty line and the median income is $66,656 compared to $77,293 countywide. There are 12.2% of New Rochelle children living below poverty. 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 collaborates with the Director of WIC initiatives for events in New Rochelle. These events are focused on a variety of issues, ranging from chronic disease management and prevention, cancer screenings and promotion of healthy food comsumption. Events range from farmers market walks, workshops in the community, walkathons, health fair and community-based health screens. Engaging local community members in our efforts enables us to employ the health care institution and the community in the activities of national health advocacy organizations, including walks, festivals, and other awaremess-raising activities for health issues that impact the community. 6. AFFILIATED HEALTH CARE SYSTEM: MONTEFIORE NEW ROCHELLE HOSPITAL IS AN AFFILIATE OF MONTEFIORE HEALTH SYSTEM, INC. 7. STATE FILING OF COMMUNITY BENEFIT REPORT: MONTEFIORE NEW ROCHELLE HOSPITAL FILES A COMMUNITY SERVICE PLAN WITH THE STATE OF NEW YORK. true UNITED HEBREW GERIATRIC CENTER 391 PELHAM ROAD NEW ROCHELLE NY 10805 131663975 501(C)(3) 9500 SPONSORSHIP 1 0 PART 1, LINE 2 THE ORGANIZATION PROVIDES SUPPORT TO VARIOUS CHARITABLE ORGANIZATIONS AS PART OF ITS MANY LOCAL COMMUNITY HEALTH AND BUILDING PROGRAMS INITIATIVES. THESE DONATIONS ARE AWARDED TO LOCAL ESTABLISHED 501(C)(3) ORGANIZATIONS AS PART OF Montefiore New Rochelle Hospital CHARITABLE MISSION TO IMPROVE THE HEALTH AND WELFARE OF THE COMMUNITITIES THAT IT SERVES. false true false false false false false false false PHILIP O OZUAH MD PHD 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 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 JOHN OLSEWSKI MD ORTHOPEDIC SURGEON 741545 0 0 0 1032 0 6800 0 26399 0 775776 0 0 0 STEVEN B ZELICOF MD CHIEF, ORTHOPEDIC SURGERY 548179 0 0 0 1032 0 6800 0 22523 0 578534 0 0 0 MADHU RANGRAJ MD DIRECTOR, SURGERY 528814 0 0 0 3048 0 6800 0 23992 0 562654 0 0 0 Roger Coron MD Chief of Gastroenterology 556806 0 0 0 216 0 6800 0 22484 0 586306 0 0 0 Mark Liss MD Attending Gastroentrology 392727 0 0 0 0 0 6800 0 24932 0 424459 0 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 Anthony Alfano Vice President 0 350660 0 75000 0 2992 0 17000 0 32245 0 477897 0 0 PART 1 LINES 3, 4B & PART II - COLUMNS (b)(i), (ii) AND (iii) As it relates to Compensation from either Montefiore Medicine Academic Health System, Inc. or 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 over 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 New Rochelle Hospital. These individuals are employed and their compensation is paid by either Montefiore Medicine Academic Health System, Inc., EIN 47-1582973, or by 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 NEW ROCHELLE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A: THE BOARD OF TRUSTEES OF MONTEFIORE HEALTH SYSTEM, INC., THE SOLE MEMBER OF MONTEFIORE NEW ROCHELLE HOSPITAL, HAS THE AUTHORITY TO APPOINT THE BOARD OF TRUSTEES OF MONTEFIORE NEW ROCHELLE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B: THE BOARD OF TRUSTEES OF MONTEFIORE HEALTH SYSTEM, INC., THE SOLE MEMBER OF MONTEFIORE NEW ROCHELLE HOSPITAL, HAS THE AUTHORITY TO APPROVE THE OPERATING AND CAPITAL BUDGETS OF MONTEFIORE NEW ROCHELLE HOSPITAL. FORM 990, PART VI, SECTION B, LINE 11B: THE FORM 990 WAS PREPARED BY THE HOSPITAL'S FINANCE DEPARTMENT WITH THE ASSISTANCE OF VARIOUS DEPARTMENTS. THE FORM 990 WAS REVIEWED AND APPROVED BY THE VICE PRESIDENT-FINANCE 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 NEW ROCHELLE 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 NEW ROCHELLE 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 NEW ROCHELLE 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 System, Inc. and Montefiore New Rochelle Hospital, respectively. The Montefiore Health System 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 judgement 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 MMC Residential Corp I Inc 3411 Wayne Avenue Bronx NY 10467 911943271 Staff Housing NY 501 (C)(2) MMC 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 GUN HILL 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 MOUNT VERNON HOSPITAL 12 NORTH SEVENTH AVENUE MOUNT VERNON NY 10550 462916938 HOSPITAL NY 501(C)(3) 3 MHS true SCHAFFER EXTENDED CARE CENTER 16 GUION PLACE NEW ROCHELLE NY 10801 462929888 NURSING HOME NY 501(C)(3) 3 MHS true Albert Einstein College of MedicineInc 1300 Morris Park Avenue Bronx NY 10461 472209056 Med College NY 501(c)(3) 2 MMAHS true Montefiore Medicine Acad Hlth Sys Inc 555 South Broadway Tarrytown NY 10591 471582973 SYS PARENT NY 501(c)(3) 12B Type II NA true The Nyack Hospital 160 North Midland Avenue NYACK NY 10960 131740119 Hospital NY 501(c)(3) 3 MHS true Montefiore Foundation INC 111 East 210th Street Bronx NY 10467 471600439 INACTIVE NY 501(c)(3) 7 MHS true White Plains Hospital Medical Center 41 East Post Road White Plains NY 10601 131740130 HOSPITAL NY 501(C)(3) 3 MHS true AECOM Staff Housing Co Inc 1300 Morris Park Avenue Bronx NY 10461 237075620 STAFF HOUSING NY 501(C)(2) AECOM true Montefiore CERC Operations Inc 111 East 210th Street Bronx NY 10467 474853506 REHAB CENTER NY 501(c)(3) 3 MMC true White Plains Hospital Center 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 Prof Services NY NA C CORP true Cancer and Blood Medical Services of NY 41 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 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