2016-11-14T08:24:03-06:00 2015-12-31 861065772 DELOITTE TAX LLP TWO JERICHO PLAZA JERICHO NY 11753 990 2015-01-01 111352310 SOUTH NASSAU COMMUNITIES HOSPITAL INC SOUT 5166323000 ONE HEALTHY WAY OCEANSIDE NY 115721551 MARK BOGEN SVP/CFO 5166323000 2016-11-11 1 CHRISTINE KAWECKI P00743140 5169187000 2015 2017-02-10 21:41:12Z MARK BOGEN ONE HEALTHY WAY OCEANSIDE NY 115721551 640385562 0 5611 X WWW.SOUTHNASSAU.ORG X 1927 NY SEE SCHEDULE O 24 23 3756 468 4924348 -82112 16895827 20363708 403051620 433893573 8153589 8689683 7690005 4856775 435791041 467803739 0 0 0 0 229394844 247085519 0 0 528427 160503721 175831457 389898565 422916976 45892476 44886763 499128821 495648485 317332458 294292485 181796363 201356000 X SEE SCHEDULE O 0 0 259534434 295011120 SEE SCHEDULE O 46442464 48290175 SEE SCHEDULE O 33416181 33100158 SEE SCHEDULE O 33584036 55253973 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; FAMILY MEDICINE AND URGENT CARE AT LONG BEACH (THROUGH JULY 2015, AFTER WHICH IT WAS REPLACED BY THE FREE STANDING EMERGENCY ROOM AT LONG BEACH).THE HOSPITAL PROVIDED OVER 260,000 SERVICES RELATED TO THE OTHER OUTPATIENT SERVICES IN 2015. 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 2015, THE HOSPITAL PROVIDED CHARITY CARE OF APPROXIMATELY $2.6 MILLION (CHARGES) FOR OTHER OUTPATIENT SERVICES. 33584036 55253973 372977115 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 1 0 1 323 0 1 3756 1 1 1 0 0 0 0 1 1 0 0 0 0 X 24 23 1 0 0 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 RICHARD STREIM DIRECTOR (THRU 06/09/15) 1.00 1.00 X 0 0 0 ROBERT M WHYTE JR TREASURER (THRU 12/01/15) 1.00 2.00 X 0 0 0 WELQUIS RAIMUNDO LOPEZ DIRECTOR(THRU 06/09/15) 1.00 1.00 X 0 0 0 ADAM K GALEON DIRECTOR (THRU 06/09/15) 1.00 1.00 X 0 0 0 ABBEY DONEGER DIRECTOR (THRU 06/09/15) 1.00 1.00 X 0 0 0 JAMES F CAMPBELL DIRECTOR (THRU 02/02/15) 1.00 1.00 X 0 0 0 HENRY R PUPKE VICE CHAIRMAN (THRU 10/19/15) 1.00 1.00 X 0 0 0 HELENA WILLIAMS DIRECTOR 1.00 1.00 X 0 0 0 JOHN A VITALE DIRECTOR 1.00 1.00 X 0 0 0 SALLY VALENTI DIRECTOR 1.00 1.00 X 0 0 0 HARRIETTE P THAYER DIRECTOR 1.00 1.00 X 0 0 0 EDWARD SCOTT DIRECTOR 1.00 1.00 X 0 0 0 JOEL SCHNEIDER DIRECTOR 1.00 1.00 X 0 0 0 STEVEN SAUER DIRECTOR 1.00 1.00 X 0 0 0 WAYNE LIPTON DIRECTOR 1.00 2.00 X 0 0 0 BERNARD KENNEDY DIRECTOR 1.00 1.00 X 0 0 0 STEVEN GOLD DIRECTOR 1.00 1.00 X 0 0 0 JEFFREY FRISCH DIRECTOR 1.00 1.00 X 0 0 0 MIHAI DIMANCESCU MD DIRECTOR 1.00 1.00 X 0 0 0 MARILYN COHEN DIRECTOR 1.00 1.00 X 0 0 0 JOHN CATALANO DIRECTOR 1.00 1.00 X 0 0 0 ANTHONY CANCELLIERI DIRECTOR 1.00 1.00 X 0 0 0 JOHN ALOIA MD DIRECTOR 1.00 1.00 X 0 0 0 LOWELL FREY ASSISTANT SECRETARY 1.00 1.00 X 0 0 0 PETER C BREITSTONE SECRETARY 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 HARRY KASSEL VICE CHAIRMAN 1.00 1.00 X 0 0 0 HAROLD MAHONY ESQ IMMEDIATE PAST CHAIRMAN 1.00 1.00 X 0 0 0 JOSEPH J FENNESSY CHAIRMAN 1.00 2.00 X 0 0 0 RICHARD MURPHY PRESIDENT & CEO 35.50 2.00 X X 1353812 0 178182 ADHI SHARMA CHIEF MEDICAL OFFICER 36.50 1.00 X 346629 0 36686 SUSAN PENQUE CHIEF NURSING OFFICER 36.50 1.00 X 309027 0 26065 JOHN MERTZ CHIEF INFORMATION OFFICER 37.50 0.00 X 281866 0 47825 MARK BOGEN CHIEF FINANCIAL OFFICER 36.50 1.00 X 527559 0 46055 WILLIAM ALLISON CHIEF OPERATING OFFICER 36.50 1.00 X 393203 0 28300 ALAN GARELY CLINICAL CHAIR OB/GYN 22.00 15.50 X 1057208 0 34063 LAWRENCE KANNER DIR OF ELECTROPHYSIOLOGY 36.50 1.00 X 909125 0 34004 ASIF REHMAN ASSOC DIR INTER CARDIO 37.50 0.00 X 928040 0 27455 JASON FREEMAN DIR OF INTER CARDIO 37.50 0.00 X 852760 0 28754 MATTHEW RIFKIN PRESIDENT 18.75 18.75 X 622282 0 34379 7581511 0 521768 382 0 1 0 SODEXO INC& AFFILIATES 90 MERRICK AVE 210 EAST MEADOW NY 11554 FOOD SERVICES 5032384 WOMEN'S MSO 440 MERRICK RD OCEANSIDE NY 11572 RADIOLOGY 3923793 CAN CONTRACTING CORP 100 ANDERS NO BABYLON NY 11703 CONTRACTOR 3380223 CADUCEUS INC 30 MONGOMERY SUITE 720 JERSEY CITY NJ 07302 COLLECTION SERVICE 2053406 ISLAND EMERGENCY 350 MOTOR PKWY HAUPPAUGE NY 11788 PHYSICIAN SERVICE 1964523 67 1160654 18180683 1022371 20363708 NET PATIENT REVENUE 622110 427544468 427544468 REFERENCE LAB 621500 4924348 4924348 RENTAL INCOME - RELATE 523200 1424757 1424757 433893573 2676761 2676761 178208152 7266 172085613 116883 6122539 -109617 6012922 6012922 482790 1160654 379327 103463 103463 COFFEE, GIFT SHOP & CA 900099 2067111 2067111 EHR INCENTIVES 900099 904854 904854 REBATES & DISCOUNT 900099 834738 834738 946609 946609 4753312 467803739 431655426 4924348 10860257 X 3575050 2857873 717177 196837559 170292067 26198673 346819 13240139 11436305 1803834 20261963 17522620 2739343 13170808 11379947 1790861 1338526 1156524 182002 347560 347560 414214 414214 682141 682141 46193025 39487026 6705999 2801803 2420836 380967 2894394 2500838 393556 3375824 3142124 233700 289056 249752 39304 949281 820205 129076 3539033 3057824 481209 1024586 1024586 25234216 21787177 3447039 5863426 5756100 107326 MEDICAL & SUPPLIES 70762197 70354555 407642 EQUIPMENT RENTAL & MAIN 7152376 6179853 972523 RECRUITMENT 719589 621745 97844 MEMBERSHIP 468715 390864 77851 1781495 1562880 37007 181608 422916976 372977115 49411434 528427 23273519 13994793 7640939 2439051 51361497 50208462 6209474 6156434 2950682 4101478 531222804 267028258 243331029 264194546 120567048 108585460 6354884 8378215 37439749 37590046 499128821 495648485 70285816 72822026 91895459 87740053 13000000 20000000 142151183 113730406 317332458 294292485 X 179785828 199581303 982459 746621 1028076 1028076 181796363 201356000 499128821 495648485 X 44886763 -8218889 -17108237 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 414214 414214 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. 2010535 8398283 8634121 1774697 1627563 1719985 1337013 2010535 1506045 1838970 1717452 1627563 3054046 709949 2257950 1506045 1986741 1700414 633109 3054046 0.57930 0.42070 0 0 24239479 24239479 346944880 176969810 169975070 9968371 7530664 2437707 139857554 82527784 57329770 10212520 10212520 264194546 OTHER CURRENT ASSETS 5477505 LONG TERM ASSETS 1432078 DUE FROM SUBSIDIARIES 27185056 ASSETS WHOSE USE IS LIMITED 3332540 ACCRUED INTEREST INCOME 162867 37590046 CURRENT LIABILITIES 7780000 ACCRUED PENSION PAYABLE 55651807 ACCRUED POST RETIREMENT BENEFITS 3354000 PROFESSIONAL AND CURRENT LIABILITIES 44150000 OTHER LIABILITIES 2794599 113730406 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 679962 480347 199615 66316 84341 GOLF OUTING 313850 232215 81635 86000 53203 4 649632 448092 201540 13098 28243 48125 1643444 1160654 482790 99098 94559 185669 379326 103464 1 1 1 X 1 X 1 1 0 1 1 1 3217 3864563 1975765 1888798 0.00450 1 68230 71433491 46418177 25015314 0.05910 2 71447 75298054 48393942 26904112 0.06360 106 9409 392437 0 392437 0.00090 3 90 9882000 5292979 4589021 0.01090 4 62938 32378721 23010379 9368342 0.02220 113 72437 42653158 28303358 14349800 0.03400 115 143884 117951212 76697300 41253912 0.09760 23 21305 85151 0 85151 0.00020 2 997 234142 0 234142 0.00060 25 22302 319293 319293 0.00080 0 16853097 994125 143432218 153947736 -10515518 X 1 1 1 1 SOUTH NASSAU COMMUNITIES HOSPITAL ONE HEALTHY WAY OCEANSIDE NY 115721551 2950001H X X X SOUTH NASSAU COMMUNITIES HOSPITAL INC 1 0 0 1 X X X X X X X X 13 1 1 1 1 X WWW.SOUTHNASSAU.ORG X 1 15 1 HTTP://WWW.SOUTHNASSAU.ORG/MAIN/COMMUNITY-SERVICE-PLAN.ASPX 0 0 1 X 100.000000000000 300.000000000000 X X X X 1 1 X X X 1 X WWW.SOUTHNASSAU.ORG X WWW.SOUTHNASSAU.ORG X WWW.SOUTHNASSAU.ORG X X X X 1 X 0 X 1 X 0 0 SOUTH NASSAU COMMUNITIES HOSPITAL, INC. PART V, SECTION B, LINE 5: 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, HOSPITALS AND MULTIPLE COMMUNITY-BASED ORGANIZATIONS LOCATED THROUGHOUT NASSAU COUNTY. SOUTH NASSAU COMMUNITIES HOSPITAL, INC. PART V, SECTION B, LINE 6A: THE CHNA FOR SOUTH NASSAU COMMUNITIES HOSPITAL WAS CONDUCTED IN PARTNERSHIP WITH WINTHROP SOUTH NASSAU UNIVERSITY HEALTH SYSTEM, AS WELL AS THE LOCAL HEALTH DEPARTMENT LOCATED IN NASSAU COUNTY. SOUTH NASSAU COMMUNITIES HOSPITAL, INC. PART V, SECTION B, LINE 6B: AMERICAN CANCER SOCIETYAMERICAN DIABETES ASSOCIATIONAMERICAN HEART ASSOCIATIONCATHOLIC CHARITIES - DIOCESE OF ROCKVILLE CENTRECIRCULO DE LA HISPANIDAD, INC.FEGS HEALTH & HUMAN SERVICES (FEDERATION OF EMPLOYMENT AND GUIDANCESERVICES)THE HEALTH AND WELFARE COUNCIL OF LONG ISLANDISLAND HARVESTJEWISH ASSOCIATION SERVING THE AGING (JASA)THE LONG ISLAND GLBT SERVICES NETWORK (GAY, LESBIAN, BISEXUAL,TRANSGENDER)THE LONG ISLAND COUNCIL OF CHURCHESMENTAL HEALTH ASSOCIATION OF NASSAU COUNTY, INC.NASSAU COUNTY PERINATAL SERVICES NETWORKPLANNED PARENTHOOD OF NASSAU COUNTYPROJECT INDEPENDENCE - TOWN OF NORTH HEMPSTEAD(NATURALLY OCCURRINGRETIREMENT COMMUNITY-NORC)SUSTAINABLE LONG ISLANDUNITED WAY OF LONG ISLANDNORTHWELL HEALTH SYSTEMNCDOHADELPHI UNIVERSITYMERCY HOSPITALST. FRANCIS HOSPITALLONG BEACH MEDICAL CENTERCATHOLIC HEALTH SERVICESSUDDEN INFANT & CHILD DEATH RESOURCE CENTER, STONYBROOK UNIVERSITY MEDICALCENTERHOFSTRA UNIVERSITYWINTHROP UNIVERSITY HOSPITALSUNY STONYBROOKNU HEALTH FAMILY HEALTH CENTERSST. JOSEPHNASSAU-SUFFOLK HOSPITAL COUNCILNASSAU COUNTY LIONS CLUB FOUNDATIONFEGS HEALTH & HUMAN SERVICES (FEDERATION OF EMPLOYMENT AND GUIDANCESERVICES)POSITIVE SPACE SOUTH NASSAU COMMUNITIES HOSPITAL, INC. PART V, SECTION B, LINE 11: THE CHNA WAS CONDUCTED IN PARTNERSHIP WITHBOTH HOSPITALS AS WELL AS THE LOCAL HEALTH DEPARTMENT LOCATED IN NASSAUCOUNTY. SURVEY FINDINGS YIELDED CHRONIC DISEASE AS THE #1 HEALTH PRIORITYWITH SPECIFIC CONCERNS REGARDING DIABETES, HEART DISEASE AND CANCER.OBESITY WAS NOTED TO BE THE MOST IMPORTANT RISK FACTOR FOR CHRONICCONDITIONS AND ALONG WITH IMPROVING ACCESS TO HIGH QUALITY, CHRONICDISEASE PREVENTION AND MANAGEMENT IN CLINICAL AND COMMUNITY SETTINGS,THESE HAVE FORMED THE BASIS FOR THE PRIORITY AREAS THAT WILL BE ADDRESSEDBY THE HOSPITAL.OTHER AREAS OF NEED THAT WERE IDENTIFIED BUT WILL NOT BE ADDRESSEDINCLUDED ACCESS TO HEALTHY FOOD, AN INCREASE IN UNSAFE LIVINGENVIRONMENTS, LACK OF CHILDCARE FUNDING FOR LOW-INCOME WORKERS, CONCERNSREGARDING MENTAL HEALTH AND SUBSTANCE ABUSE AND HIV/STD SCREENING ANDPREVENTION. THE REASONS FOR NOT ADDRESSING THESE AREAS OF NEED INCLUDELACK OF FUNDING, LACK OF QUALIFIED PERSONNEL AND/OR LIMITED ABILITY AS ANINSTITUTION TO IMPACT THE IDENTIFIED ISSUES. 10 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 10 FRANKLIN BLVD LONG BEACH NY 11561 OUTPATIENT 10 - SNCH - OFF-CAMPUS ER AT LONG BEACH 325 EAST BAY DRIVE LONG BEACH NY 11561 FREE STANDING EMERGENCY ROOM PART I, LINE 6A: THE HOSPITAL FILED A 2013-2015 COMMUNITY SERVICE PLAN ("CSP"), WHICHINCLUDED A COMMUNITY BENEFIT REPORT, WITH THE NYS DEPARTMENT OF HEALTH("DOH") ON NOVEMBER 15, 2013. PART I, LINE 7: IN LIEU OF A COST ACCOUNTING SYSTEM, THE COST TO CHARGE RATIO WASGENERATED FROM THE 2015 INSTITUTIONAL COST REPORT STEP-DOWN. THISMETHODOLOGY APPLIES COSTS TO EACH UNIT BY SERVICE. THE COST TO CHARGERATIO WAS UTILIZED TO DERIVE THE COSTS. PART I, LINE 7G: INCLUDED IN THE TOTAL COMMUNITY BENEFIT EXPENSE ARE LOSSES RELATED TO THESNCH FAMILY HEALTH CENTER, INPATIENT AND OUTPATIENT RENAL DIALYSIS, ANDTHE INPATIENT PEDIATRIC PROGRAM. PART I, LN 7 COL(F): DISTINGUISHING BAD DEBT EXPENSE FROM CHARITY CARE REQUIRES JUDGMENT;TOGETHER, THEY REPRESENT UNCOMPENSATED CARE. THE HOSPITAL'S POLICYREGARDING CHARITY CARE IS TO PROVIDE A SIGNIFICANT AMOUNT OF CARE WITHOUTREGARD TO THE PATIENTS' ABILITY TO PAY FOR SERVICES RENDERED; THISINCLUDES FREE CARE AND A SLIDING FEE SCALE, BASED ON THE PATIENTS' ABILITYTO PAY WHICH IS DEFINED AS UP TO 300% OF THE POVERTY LEVEL.THE HOSPITAL UTILIZES A CREDIT VERIFICATION FIRM TO ASSIST IN DETERMININGIF UNINSURED PATIENTS MEET THE HOSPITAL'S CHARITY CRITERIA. THIS PROCESSIDENTIFIES UNINSURED PATIENTS THAT WERE UNDER THE POVERTY LEVEL BUT DIDNOT APPLY FOR CHARITY CARE. PART III, LINE 2: THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS FOR LINE 2 ANDLINE 3 USES TOTAL GROSS BAD DEBT CHARGES MULTIPLIED BY THE AMOUNT OF THEHOSPITAL'S OVERALL RATIO OF COSTS TO CHARGES (CALCULATED USING THEINSTITUTIONAL COST REPORT). PART III, LINE 3: THE AMOUNT REPORTED IN PART III LINE 3 WAS RELATED TO THE EMERGENCY ROOM'SBAD DEBT AT COST. THE FIGURE WAS DERIVED USING THE EMERGENCY ROOM'S BADDEBT GROSS CHARGES AND MULTIPLYING THIS AMOUNT BY THE EMERGENCY'S ROOMSSPECIFIC RCC TO COME UP WITH THE BAD DEBT EXPENSE AT COST FOR THEEMERGENCY ROOM. WE DID NOT INCLUDE ANY AMOUNTS OF BAD DEBT IN PART I LINE7. WE BELIEVE THE ENTIRE AMOUNT SHOULD BE CONSIDERED CHARITY CARE. EMTALAAND OTHER REGULATIONS REQUIRE THAT THE HOSPITAL PROVIDE EMERGENCY SERVICESTO INDIVIDUALS BEFORE DISCUSSING FINANCIAL INFORMATION.CHARITY CARE IS USUALLY RELATED TO PATIENTS WHO WE DEFINE AS LACKING THEABILITY TO PAY. A HOSPITAL'S INABILITY TO COLLECT FROM A PATIENT WHO HASTHE MEANS TO PAY IS BAD DEBT EXPENSE.OUR REGISTRATION DEPARTMENT DOES NOT HAVE THE ABILITY TO DETERMINE THEEMERGENCY ROOM PATIENT FINANCIAL STATUS BEFORE CARE IS DELIVERED AND INMANY CASES, THE INFORMATION PROVIDED BY THE PATIENTS IS INACCURATE. SINCEWE RENDERED CARE WITHOUT REGARD TO THE PATIENT'S ABILITY TO PAY WE BELIEVETHAT THESE PATIENTS ARE SIMILAR TO CHARITY CARE AND NOT BAD DEBT. PART III, LINE 9B: UPON APPLYING FOR CHARITY CARE, THE PATIENT IS ADVISED TO DISREGARD ALLBILLS SENT BY THE HOSPITAL UNTIL A FINAL DECISION HAS BEEN MADE. APATIENT THAT RECEIVES PARTIAL CHARITY CARE IS SUBJECT TO THE HOSPITALCOLLECTION POLICY EXCEPT THAT:1) THE PATIENT WILL BE PROVIDED WITH A WRITTEN NOTICE 30 DAYS PRIOR TO THEACCOUNT 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, SOUTHNASSAU UTILIZES TOOLS AND COLLABORATES WITH LOCAL AND STATE GOVERNMENTS,CIVIC ASSOCIATIONS AND OTHER COMMUNITY GROUPS TO ESTABLISH THE NEEDS OFTHE COMMUNITY THE HOSPITAL SERVICES.- THE HOSPITAL PARTICIPATES IN THE CENTER FOR MEDICARE AND MEDICAIDSERVICES PATIENT SATISFACTION SURVEY (KNOWN AS HCAHPS) BY USINGHEALTHSTREAM RESEARCH, WHICH CONDUCTS A PHONE SURVEY, CONTACTING ASTATISTICALLY VALID SAMPLE OF INPATIENTS AFTER DISCHARGE. SURVEY QUESTIONSINQUIRE ABOUT PATIENTS' SATISFACTION WITH THE QUALITY OF CARE DURING THEIRSTAY AND PERSONAL SATISFACTION WITH THE DOCTORS, NURSES AND HOSPITALSERVICES. ONCE THE QUARTERLY SURVEY RESULTS ARE REVIEWED BY THEADMINISTRATIVE TEAM, MANAGERIAL STAFF AND HOSPITAL STAFF, SOUTH NASSAU'SPATIENT SATISFACTION STEERING COMMITTEE PRIORITIZES AND DEVELOPS ACTIONPLANS TO IMPROVE PATIENT SATISFACTION.- SOUTH NASSAU'S BOARD, WHICH IS COMPOSED OF LOCAL INDIVIDUALS WHO RESIDEIN THE COMMUNITIES SERVED BY THE HOSPITAL AND INCLUDES A CROSS-SECTION OFREPRESENTATIVES SUCH AS CLERGY, BUSINESS PEOPLE AND PHYSICIANS, MEETSREGULARLY. WHILE THE MEMBERS OF SOUTH NASSAU COMMUNITIES HOSPITAL'S BOARDOF DIRECTORS ACCEPT RESPONSIBILITY FOR GOVERNANCE OF THE HOSPITAL, THEYARE ALSO COMMUNITY ADVOCATES. AS SUCH, THEY ARE ABLE TO SPEAK ON BEHALF OFTHE COMMUNITY AND RAISE ISSUES WITH THE HOSPITAL OR CONSIDER ACTIONS THATAFFECT HOSPITALS PLANS AND OPERATIONS. THE BOARD HAS ESTABLISHED A NUMBEROF COMMITTEES THAT ARE RESPONSIBLE FOR OVERSIGHT AND COORDINATION OFHOSPITAL ACTIVITIES IN REGARDS TO COMMUNITY ADVOCACY.- SOUTH NASSAU SOLICITS THE COMMUNITY'S FEEDBACK FOLLOWING FREE PUBLICCONFERENCES IT SPONSORS EACH YEAR. SURVEYS YIELD VALUABLE INFORMATION SUCHAS COMMUNITY PREFERENCE FOR SEMINAR CONTENT AND FORMAT AND REQUESTS FOREXPANDED PROGRAMS AND SERVICES. - DEPARTMENTS HOSPITAL-WIDE HAVE RELATIONSHIPS WITH INDIVIDUALS AND GROUPSWHO HAVE SPECIAL NEEDS, SUCH AS PHYSICAL HANDICAPS, LANGUAGE BARRIERS ANDCULTURAL ISSUES. THESE DEPARTMENTS ENCOURAGE COMMENTS AND SUGGESTIONS FROMTHESE POPULATIONS. THEIR FEEDBACK IS USED TO ASSESS THE EFFECTIVENESS OFEXISTING PROCEDURES AND PROGRAMS.- SOUTH NASSAU'S ADMINISTRATION MAINTAINS AN OPEN-DOOR POLICY AND ANYMEMBER OF THE COMMUNITY IS WELCOME TO COMMENT. ANY REASONABLE ISSUE RAISEDIS ADDRESSED AND CARE IS TAKEN TO RESPOND IN A TIMELY AND SATISFACTORYFASHION.- SOUTH NASSAU MAINTAINS THREE WEBSITES: WWW.SOUTHNASSAU.ORG;WWW.LIGAMMA.ORG; AND WWW.SOUTHNASSAUBARIATRICS.ORG. THE WEBSITES OFFER ANAVENUE FOR PEOPLE TO E-MAIL QUESTIONS AND REQUESTS FOR INFORMATION TO THEHOSPITAL. THEY ALSO SERVE AS A COMPREHENSIVE SOURCE OF INFORMATION ON THEHOSPITAL'S SERVICES, SPECIALTY CENTERS, PHYSICIANS, NEW DEVELOPMENTS ANDEMPLOYMENT OPPORTUNITIES.- SOUTH NASSAU'S ADMINISTRATION IS IN CONSTANT COMMUNICATION WITH LOCALAND GOVERNMENT LEADERS IN DETERMINING THE NEEDS OF THE COMMUNITIES. THEADMINISTRATIVE TEAMS ALSO ARE INVOLVED WITH HOSPITAL ASSOCIATIONS ANDOTHER HEALTHCARE ASSOCIATES WHICH TARGET THE NEEDS OF THE COMMUNITIES THEHOSPITAL SERVES. NEW YORK STATE'S DEPARTMENT OF HEALTH ALSO WORKS VERYCLOSELY WITH THE HOSPITAL TO HELP ASSESS THE NEEDS OF THE COMMUNITYSERVED.- SOUTH NASSAU'S FOUR ACTIVE AUXILIARIES ACT AS LIAISONS BETWEEN THEHOSPITAL AND THE COMMUNITIES THEY REPRESENT.- THE HOSPITAL COLLECTS DATA WITH REGARDS TO ECONOMIC, SOCIAL, CULTURALAND GEOGRAPHIC BARRIERS THAT EXIST. PART VI, LINE 3: THE HOSPITAL INFORMS AND EDUCATES PATIENTS ON A VARIETY OF FINANCIALASSISTANCE PROGRAMS. IT HAS A FULLY STAFFED FINANCIAL ASSISTANCE SERVICESDEPARTMENT STAFFED WITH BI-LINGUAL EMPLOYEES THAT HELP EDUCATE AND PROVIDEASSISTANCE IN APPLYING FOR MEDICAID, CHILD HEALTH PLUS, FAMILY HEALTHPLUS, CHARITY CARE AND DISCOUNTED CARE. THE HOSPITAL ALSO CONTRACTED WITHTHE NASSAU COUNTY OFFICE OF MEDICAID TO SITUATE AN EMPLOYEE AT THEHOSPITAL WHO HELPS PATIENTS WITH THE MEDICAID APPLICATION PROCESS.LARGE POSTERS ARE DISPLAYED IN PROMINENT LOCATIONS (INCLUDING THEEMERGENCY ROOM, BILLING OFFICE, ADMITTING, FAMILY PRACTICE CENTER, ACCOUNTSERVICES, MENTAL HEALTH CENTER, OUTPATIENT REGISTRATION, DIALYSIS CENTER,HOME CARE, CARDIAC REHABILITATION, PHYSICAL THERAPY, WOUND CARE) AND OTHERREGISTRATION AREAS SHOWING THE AVAILABILITY OF CHARITY CARE IN ENGLISH ANDSPANISH.THE HOSPITAL POSTS THE AVAILABILITY OF FINANCIAL AID INCLUDING CHARITYCARE ON ITS EXTERNAL WEBSITE: SOUTHNASSAU.ORG DIRECTING THEM TO THEFINANCIAL ASSISTANCE DEPARTMENT.THE HOSPITAL EDUCATES ALL EMPLOYEES THAT INTERACT WITH PATIENTS ABOUT THEAVAILABILITY OF FINANCIAL ASSISTANCE INCLUDING CHARITY CARE AND WHERE TOFIND INFORMATION ON THESE PROGRAMS.FINANCIAL ASSISTANCE AND CHARITY CARE INFORMATION IS INCLUDED IN PATIENTGUIDES AND SERVICE LINE GUIDES THAT ARE PROVIDED TO PATIENTS.PATIENT BILLS SENT OUT INCLUDE A NOTE ABOUT THE EXISTENCE OF THEHOSPITAL'S FINANCIAL ASSISTANCE POLICY. ON THE BACK OF THE BILL IS ACHARITY CARE APPLICATION.BILLING AND ACCOUNT SERVICES DEPARTMENTS ARE EDUCATED ABOUT THE HOSPITAL'SFINANCIAL ASSISTANCE POLICY AND INFORMS PATIENTS OF THIS POLICY.ANY PATIENT CAN REQUEST AN APPLICATION FOR CHARITY CARE FROM THE ABOVEREGISTRATION AREAS, BILLING OFFICE AND ACCOUNT SERVICES DURING REGULARBUSINESS HOURS AND VIA TELEPHONE. PART VI, LINE 4: SOUTH NASSAU IS LOCATED ON THE SOUTH SHORE OF LONG ISLAND IN NASSAUCOUNTY, NEW YORK, IN THE TOWN OF OCEANSIDE. NASSAU COUNTY HAS A POPULATIONOF APPROXIMATELY 1.34 MILLION (BASED ON 2015 ESTIMATE US CENSUS DATA) WITHAPPROXIMATELY 800,000 PEOPLE FALLING INTO THE HOSPITAL'S SERVICE AREA.NASSAU COUNTY'S MEDIAN HOUSEHOLD INCOME IS $98,401 (ACCORDING TO 2010-2014CENSUS DATA) AND $42,949 PER CAPITA (2010-2014 CENSUS ESTIMATES).ACCORDING TO THE 2010-2014 CENSUS ESTIMATES, NASSAU COUNTY'S POVERTY LEVELWAS 6.7%, WITH MORE OF THE POORER AREAS LOCATED ON THE SOUTH SHORE OFNASSAU COUNTY AND FALLING INTO THE HOSPITAL'S SERVICE AREA. HISPANICS,ALONG WITH OTHER MINORITIES, ARE CONCENTRATED IN SOUTH SHORE COMMUNITIESSUCH AS BALDWIN, FREEPORT, HEMPSTEAD, ROOSEVELT AND INWOOD, WITH MANY OFTHESE COMMUNITIES' MEMBERS BEING UNINSURED OR INSURED BY MEDICAID.BASED ON 2015 PATIENTS SERVED AT SOUTH NASSAU, PATIENT DEMOGRAPHICS BASEDON VISITS (OUTPATIENT) ARE MEDICARE 36% MEDICAID 23% SELF PAY 3% ANDCHARITY CARE 1%.OTHER HOSPITALS THAT ALSO SERVICE THESE COMMUNITIES ARE FRANKLINHOSPITAL-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 DEPARTMENTOF COMMUNITY EDUCATION IS THE REGION'S MOST COMPREHENSIVE COMMUNITYMEDICINE PROVIDER. ITS CORE SERVICES INCLUDE MULTIPLE SUPPORT AND DISEASEMANAGEMENT DISCUSSION GROUPS, COMMUNITY-BASED HEALTH CARE LECTURES ANDSEMINARS (SOME OFFERED IN SPANISH), CARDIOPULMONARY RESUSCITATION (CPR),BASIC LIFE SUPPORT (BLS) AND ADVANCED CARDIAC LIFE SUPPORT (ACLS) CLASSES,SPECIFIC HEALTH PROMOTION/IMPROVEMENT INTERVENTIONS, FREE BLOOD PRESSUREAND CANCER SCREENINGS AND FREE FLU VACCINATION PROGRAMS. THE STRUCTURE OFTHESE PROGRAMS ENCOURAGES SIGNIFICANT AND MEANINGFUL INTERACTION BETWEENSOUTH NASSAU AND THE COMMUNITIES IT SERVES.THE MISSION OF THE DEPARTMENT OF COMMUNITY EDUCATION IS TO IMPROVE THEHEALTH OF THE SURROUNDING COMMUNITIES THROUGH EDUCATION, PREVENTION,SCREENING, OUTREACH, AND COALITION BUILDING. BY USING SCIENTIFICMETHODOLOGIES, THE HEALTH CARE NEEDS OF THE COMMUNITY ARE IDENTIFIED ANDPROGRAMS ARE THEN DESIGNED TO ADDRESS THESE NEEDS. ONCE IMPLEMENTED, THEDEPARTMENT OF COMMUNITY EDUCATION CONDUCTS ONGOING MONITORING ANDEVALUATION OF THE INTERVENTION PROCESSES.ADDITIONALLY, THE DEPARTMENT OF COMMUNITY EDUCATION COORDINATES WITHCOMMUNITY AGENCIES SUCH AS THE DEPARTMENT OF HEALTH, THE AMERICAN CANCER SOCIETY, THE 1 IN 9 HEWLETT HOUSE, THE AMERICAN HEART ASSOCIATION, THE AMERICAN DIABETES ASSOCIATION, THE JEWISH ASSOCIATION SERVING THE AGED, THE MARTIN LUTHER KING CENTER, AND LOCAL LIBRARIES, CHURCHES AND SCHOOLS.THE DEPARTMENT OF COMMUNITY EDUCATION HAS INSTITUTED THE CATCH (CHECK-INAND TAKE CHARGE OF YOUR HEALTH) PROGRAM WHICH OFFERS FREE HEALTH EDUCATIONON PREVENTION OF OBESITY AND WEIGHT-RELATED ISSUES, INCLUDING HEARTDISEASE, STROKE AND DIABETES AND PROVIDES FREE SCREENINGS FOR BLOODPRESSURE, CHOLESTEROL, WEIGHT/BMI AND CARDIAC/GENERAL HEALTH RISKASSESSMENT TO MINORITY AND UNDERSERVED COMMUNITIES.BELOW IS A LISTING OF THE DEPARTMENT OUTREACH PROGRAMS FOR THE COMMUNITY:EDUCATION- COMMUNITY AND HOSPITAL-BASED LECTURES ON SPECIFIC HEALTH IMPROVEMENTTOPICS SUCH AS "WHAT YOU NEED TO KNOW ABOUT COLORECTAL CANCER","PREVENTING AND MANAGING DIABETES", AND "EAT HEALTHY, BE ACTIVE".- SPECIAL PROGRAMS DESIGNED TO TARGET SPECIFIC POPULATIONS SUCH AS"CERVICAL CANCER: IMPORTANCE OF SCREENING AND EARLY DETECTION;"RELAXATION AND STRESS REDUCTION; "STAYING PSYCHOLOGICALLY HEALTHY AS YOUAGE; AND "SUN SAFETY".- PARENT-CHILD EDUCATION CLASSES- BASIC CARDIAC LIFE SUPPORT (CPR AND AED)- ADVANCED CARDIAC LIFE SUPPORT (ACLS)- TEDDY BEAR CLINIC TARGETING KINDERGARTEN CHILDREN- SUPPORT GROUPS PROVIDING EMOTIONAL SUPPORT AND EDUCATION (MONTHLY)- LOCAL HEALTH FAIR- AMERICAN HEART ASSOCIATION'S "RED DRESS DAY," EDUCATIONAL PROGRAMS ONWOMEN'S HEART DISEASE AND BLOOD PRESSURE SCREENINGS. LITERATURE IN ENGLISHAND SPANISH WAS DISTRIBUTED.COLON CANCER AWARENESS DAYMELANOMA AWARENESSNATIONAL NUTRITION MONTHSTROKE AWARENESS DAYOBESITY AWARENESS WEEKDIABETES AWARENESSCHOKING PREVENTION CLASSBREAST CANCER AWARENESSSKIN CANCER AWARENESSBREAST CANCER FORUMCOMMUNITY BASED FREE SCREENINGS- ONGOING BLOOD PRESSURE SCREENING AND IDENTIFICATION OF INDIVIDUALS INNEED OF REFERRAL OR FOLLOW-UP.- PROSTATE CANCER SCREENING- SKIN CANCER SCREENING- COLORECTAL CANCER SCREENINGEDUCATIONAL PROGRAMSSOUTH NASSAU'S COMPREHENSIVE APPROACH TO THE TREATMENT OF PATIENTS ISGEARED TOWARD CARING FOR THE WHOLE INDIVIDUAL, BOTH EMOTIONALLY ANDPHYSICALLY, BY HELPING THEM ADJUST AND COPE WITH THEIR ILLNESS THROUGHSUPPORT, EDUCATION AND COUNSELING SERVICES. SUPPORT GROUPS, FEATURINGEXPERT SPEAKERS, ARE OFFERED FREE OF CHARGE TO PATIENTS AND THEIR FAMILIESAND MEMBERS OF THE COMMUNITY. THESE SUPPORT GROUPS INCLUDE:CAREGIVERSUPPORT; BARIATRIC; BEREAVEMENT; DIABETES; AND BREAST CANCERSUPPORT GROUPS, WHICH ARE HELD IN COOPERATION WITH 1 IN 9, HEWLETT HOUSE. PART VI, LINE 6: THE HOSPITAL IS PART OF WINTHROP SOUTH NASSAU HEALTH SYSTEM WHICH IS AMEMBER OF THE LONG ISLAND HEALTH NETWORK ("LIHN"). THE LONG ISLAND HEALTHNETWORK CONSISTS OF 10 HOSPITALS JOINED TOGETHER IN 1998 TO IMPROVE THEIRCLINICAL QUALITY, ENHANCE THEIR OPERATIONAL EFFICIENCY, AND EXPAND ACCESSTO CARE FOR THE 2.8 MILLION RESIDENTS OF NASSAU AND SUFFOLK COUNTIES. THEGOAL OF THE LONG ISLAND HEALTH NETWORK IS TO PROVIDE A HIGH LEVEL OFMEDICAL CARE, NO MATTER WHICH HOSPITAL YOU CHOOSE IN THE NETWORK. THIS HASBEEN ACCOMPLISHED THROUGH A SINGLE INTEGRATED APPROACH TO MEASURING ANDIMPROVING THE QUALITY OF HEALTHCARE THROUGHOUT OUR 10 MEMBER HOSPITALS. INAN ERA WHEN HEALTHCARE IS INCREASINGLY DOMINATED BY LARGE, CENTRALLYGOVERNED HOSPITAL SYSTEMS, LIHN HOSPITALS CONTINUE THEIR FOCUS ONDELIVERING COMMUNITY-BASED CARE AND COLLABORATING WITH INSURERS' EFFORTSTO 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 MURPHY PRESIDENT & CEO 757281 0 221850 0 374681 0 142804 0 35378 0 1531994 0 371870 0 ADHI SHARMA CHIEF MEDICAL OFFICER 324909 0 15000 0 6720 0 14571 0 22115 0 383315 0 0 0 SUSAN PENQUE CHIEF NURSING OFFICER 287107 0 20000 0 1920 0 14847 0 11218 0 335092 0 0 0 JOHN MERTZ CHIEF INFORMATION OFFICER 253866 0 25000 0 3000 0 22829 0 24996 0 329691 0 0 0 MARK BOGEN CHIEF FINANCIAL OFFICER 423981 0 98778 0 4800 0 19259 0 26796 0 573614 0 0 0 WILLIAM ALLISON CHIEF OPERATING OFFICER 362323 0 28000 0 2880 0 19242 0 9058 0 421503 0 0 0 ALAN GARELY CLINICAL CHAIR OB/GYN 955458 0 101750 0 0 0 14692 0 19371 0 1091271 0 0 0 LAWRENCE KANNER DIR OF ELECTROPHYSIOLOGY 686454 0 222671 0 0 0 13269 0 20735 0 943129 0 0 0 ASIF REHMAN ASSOC DIR INTER CARDIO 600213 0 327827 0 0 0 8077 0 19378 0 955495 0 0 0 JASON FREEMAN DIR OF INTER CARDIO 549510 0 303250 0 0 0 9519 0 19235 0 881514 0 0 0 MATTHEW RIFKIN PRESIDENT 517282 0 105000 0 0 0 15008 0 19371 0 656661 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 2015, WITH THE SUPPLEMENTAL RETIREMENT INCOME INCLUDED IN DEFERRED COMPENSATION: WILLIAM ALLISON - SUPPLEMENTAL RETIREMENT OF $4,834 MARK BOGEN - SUPPLEMENTAL RETIREMENT OF $9,703 RICHARD MURPHY - SUPPLEMENTAL RETIREMENT OF $24,465 SUSAN PENQUE - SUPPLEMENTAL RETIREMENT OF $1,092 ADHI SHARMA, MD - SUPPLEMENTAL RETIREMENT OF $3,267 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. SCHEDULE J, PART I, LINE 8: DURING 2015, 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 $221,850 WHICH RELATES TO SERVICES PERFORMED BY HIM AS CHIEF EXECUTIVE OFFICER IN 2014. SCHEDULE J, ADDITIONAL DISCLOSURE THE "OTHER REPORTABLE COMPENSATION" REPORTED FOR RICHARD MURPHY INCLUDES $371,870 OF COMPENSATION PREVIOUSLY REPORTED AS DEFERRED IN PRIOR YEAR RETURNS. 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 ASSSISTANCE CORP 274291221 63166LBT7 2012-10-23 100932698 REFUND PRIOR BONDS ISSUED 8/22/01 & 8/7/03-CONSTRUCTION & EQUIP. PURCHASE 0 0 0 A 10310000 100932698 1960750 1667774 1454576 25738895 70699662 1371790 2015 1 1 0 1 A 0 1 1 1 0 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 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. DONOR NO 23 SUBSTANTIAL CONTRIBUTOR 1390069 LEGAL SERVICES 0 DONOR NO 36 SUBSTANTIAL CONTRIBUTOR 165000 CONSULTING SERVICES 0 DONOR NO 38 SUBSTANTIAL CONTRIBUTOR 2053406 REVENUE CYCLE SERVICES 0 DONOR NO 47 SUBSTANTIAL CONTRIBUTOR 685904 PROFESSIONAL AND PATIENT CARE SERVICES 0 DONOR NO 48 SUBSTANTIAL CONTRIBUTOR 203759 ENGINEERING SERVICES 0 DONOR NO 51 SUBSTANTIAL CONTRIBUTOR 241031 LEGAL SERVICES 0 DONOR NO 57 SUBSTANTIAL CONTRIBUTOR 728449 ARCHITECTURAL SERVICES 0 DONOR NO 59 SUBSTANTIAL CONTRIBUTOR 5032384 FOOD SERVICES 0 DONOR NO 63 SUBSTANTIAL CONTRIBUTOR 1017677 ELECTRICAL SERVICES 0 DONOR NO 64 SUBSTANTIAL CONTRIBUTOR 388018 LEGAL SERVICES 0 DONOR NO 70 SUBSTANTIAL CONTRIBUTOR 785554 CLEANING SERVICES 0 DONOR NO 72 SUBSTANTIAL CONTRIBUTOR 261911 LEGAL SERVICES 0 DONOR NO 74 SUBSTANTIAL CONTRIBUTOR 3380223 CONSTRUCTION SERVICES 0 DONOR NO 76 SUBSTANTIAL CONTRIBUTOR 121440 LEGAL SERVICES 0 X 4 206051 COST OR SELLING PRICE 0 1 0 PART I, COLUMN (B): THERE WERE 4 CONTRIBUTORS WITH A TOTAL OF 16 CONTRIBUTIONS. FORM 990, PART I, 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 1 SOUTH NASSAU COMMUNITIES HOSPITAL'S ("SOUTH NASSAU") MISSION IS TO PROVIDE HIGH QUALITY, COMPREHENSIVE AND EASILY ACCESSIBLE HEALTHCARE 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 40-BED ORTHOPEDIC SPECIALTY UNIT WITH AN ADJACENT AREA FOR REHABILITATION THERAPY, A 40-BED ONCOLOGY (CANCER) UNIT, A 36-BED STEP-DOWN PROGRESSIVE CARE UNIT INCLUDING AN 8-BED BARIATRIC SURGERY UNIT AND 76 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 15,714 MEDICAL SURGICAL PATIENTS IN 2015. 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 648 PEDIATRIC PATIENTS IN 2015. 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 4,088 MATERNITY PATIENTS (INCLUDING NEWBORNS) IN 2015. 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 134 NEONATES IN 2015. 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 1,110 PSYCHIATRIC PATIENTS IN 2015. 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 524 PATIENTS IN 2015. SUMMARY: THE HOSPITAL ADMITTED A TOTAL OF 22,640 PATIENTS IN 2015 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 $4.2 MILLION (CHARGES) FOR INPATIENTS SERVED IN 2015. 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 6,361 OUTPATIENT SURGICAL PROCEDURES IN 2015. 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 2,731 OUTPATIENT ENDOSCOPY PROCEDURES IN 2015. 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 2,837 OUTPATIENT PAIN MANAGEMENT PROCEDURES IN 2015. 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 749 OUTPATIENT CATHETERIZATION PROCEDURES IN 2015. 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 513 OUTPATIENT EP STUDIES IN 2015. SUMMARY: AMBULATORY SURGERY SERVICES WERE PROVIDED TO 13,792 MEMBERS OF THE COMMUNITY ON AN ELECTIVE BASIS. THE HOSPITAL PROVIDED CHARITY CARE OF APPROXIMATELY $700 THOUSAND (CHARGES) FOR AMBULATORY PATIENTS SERVED IN 2015. 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 65,307 EMERGENCY ROOM VISITS IN 2015 OF WHICH 16,355 PATIENTS WERE ADMITTED. IN 2015, THE HOSPITAL PROVIDED CHARITY CARE OF APPROXIMATELY $6.1 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. THE LONG BEACH EMERGENCY DEPARTMENT EXPERIENCED 3,650 VISITS, OF WHICH 428 PATIENTS WERE TRANSFERRED TO THE HOSPITAL'S MAIN CAMPUS RESULTING IN 293 ADMISSIONS. THE HOSPITAL PROVIDED CHARITY CARE OF APPROXIMATELY $12,000 (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 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 11 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.COM. FORM 990, PART IX, LINE 11G PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 16,192,134. MANAGEMENT AND GENERAL EXPENSES 2,596,998. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 18,789,132. COLLECTION FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 300,399. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 300,399. AGENCY FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 331,189. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 331,189. OUTSIDE TESTING: PROGRAM SERVICE EXPENSES 1,197,821. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,197,821. OUTSIDE SERVICE: PROGRAM SERVICE EXPENSES 22,097,071. MANAGEMENT AND GENERAL EXPENSES 3,477,413. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 25,574,484. FORM 990, PART XI, LINE 9: CHANGE IN VALUE -3,192,917. TRANSFER TO AFFILIATES -24,067,757. PENSION & OTHER POSTRETIREMENT LIABILITY ADJUSTMENTS 10,152,437. FORM 990, PART XII, LINE 2C: SOUTH NASSAU COMMUNITIES HOSPITAL RECEIVED A CONSOLIDATED AUDITED FINANCIAL STATEMENT FOR THE YEAR ENDING DECEMBER 31, 2015. 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 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. THE EFFECTS OF INCOME TAXES ARE NOT MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS. 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 OBSTRETRICS 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 SOUTH NASSAU COMMUNITIES HOSPITAL SELF-INSURANCE TRUST FUND ONE HEALTHY WAY OCEANSIDE NY 11572 136749767 INSURANCE NY 501(C)(3) LINE 11B, II SOUTH NASSAU COMMUNITIES HOSPITAL INC 1 WINTHROP UNIVERSITY HOSPITAL - 11-1633486 259 FIRST STREET MINEOLA NY 11501 111633486 HOSPITAL NY 501(C)(3) LINE 3: 170(B)(1)(A) WINTHROP SOUTH NASSAU UNIVERSITY HEALTH SYSTEM 0 WINTHROP SOUTH NASSAU UNIVERSITY HEALTH SYSTEM ONE HUNTINGTON QUADRANGLE MELVILLE NY 11747 066427908 DELIVER CARE NY 501(C)(3) LINE 11, TYPE I: 509 N/A 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 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 SOUTH NASSAU FAMILY MEDICINE PC S 880000 CASH BASIS SOUTH NASSAU FAMILY MEDICINE PC N 502044 CASH BASIS SOUTH NASSAU FAMILY MEDICINE PC B 681518 CASH BASIS SN NEONATAL PC R 380000 CASH BASIS SN NEONATAL PC N 54480 CASH BASIS SN NEONATAL PC B 500505 CASH BASIS SN OBGYN PC R 1523000 CASH BASIS SN OBGYN PC N 172422 CASH BASIS SN OBGYN PC B 502480 CASH BASIS SN ONCOLOGY PC S 730000 CASH BASIS SN ONCOLOGY PC N 73368 CASH BASIS SN ONCOLOGY PC B 2567472 CASH BASIS SN PHYSICIAN PRACTICE PC S 970000 CASH BASIS SN PHYSICIAN PRACTICE PC N 478596 CASH BASIS SN PHYSICIAN PRACTICE PC B 1871564 CASH BASIS SN RADIOLOGY PC R 2720000 CASH BASIS SN RADIOLOGY PC N 89136 CASH BASIS SN RADIOLOGY PC B 948322 CASH BASIS RADIOLOGICAL ASSOCIATES OF LONG ISLAND S 2350000 CASH BASIS RADIOLOGICAL ASSOCIATES OF LONG ISLAND N 218012 CASH BASIS RADIOLOGICAL ASSOCIATES OF LONG ISLAND B 2975381 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 932850 CASH BASIS SN MEDICAL GROUP PC S 285000 CASH BASIS SN MEDICAL GROUP PC R 750000 CASH BASIS SN MEDICAL GROUP PC B 3824399 CASH BASIS SN ONCOLOGY PRACTICE PC R 5870000 CASH BASIS SN ONCOLOGY PRACTICE PC B 826147 CASH BASIS 203 MERRICK ROAD HOLDING CORP R 180000 CASH BASIS 203 MERRICK ROAD HOLDING CORP B 19798 CASH BASIS SN SERVICES CORPORATION B 1269646 CASH BASIS OCEANSIDE COUNSELING CENTER INC Q 155834 CASH BASIS SN PHYSICIAN PC (DR DATTA) R 15000 CASH BASIS SN PHYSICIAN PC B 206411 CASH BASIS FORM 990, SCHEDULE R, PART V, LINE 2 VALUE OF THE SERVICES ARE DONE ON A CASH BASIS.