2016-11-14T12:04:08-06:00 2015-12-31 ERNST & YOUNG US LLP 5 TIMES SQUARE NEW YORK NY 10036 990 2015-01-01 133245804 NYACK HOSPITAL FOUNDATION INC % RONALD RATIGAN NYAC 8463486522 160 North Midland Ave Nyack NY 10960 John S Burke PRESIDENT & CEO 2016-11-09 CHRISTOPHER B BOGGS P00032493 2127733000 2015 2017-02-10 21:41:12Z JOHN S BURKE 160 North Midland Ave Nyack NY 10960 713611 false X https://www.nyackhospital.org X 1984 NY TO RAISE FUNDS FOR NYACK HOSPITAL. THE FOUNDATION ASSISTS THE HOSPITAL IN PURCHASING STATE-OF-THE-ART EQUIPMENT, DEVELOPING PROGRAMS AND SERVICES AND FACILITY IMPROVEMENT. 12 10 2 38 0 354345 563970 0 0 3 55412 145003 35271 499351 654653 0 417781 0 0 170980 160999 0 0 262275 1223400 101276 1394380 680056 -895029 -25403 6152802 6219198 13534 38440 6139268 6180758 TO RAISE FUNDS FOR NYACK HOSPITAL, A RELATED ORGANIZATION EXEMPT UNDER IRC SECTION 501(C)(3). THE FOUNDATION ASSISTS THE HOSPITAL IN PURCHASING STATE-OF-THE-ART EQUIPMENT, DEVELOPING PROGRAMS AND SERVICES, AND AIDING IN FACILITY IMPROVEMENT INITIATIVES. false false 417781 TO RAISE FUNDS FOR NYACK HOSPITAL, A RELATED ORGANIZATION EXEMPT UNDER IRC SECTION 501(C)(3). THE FOUNDATION ASSISTS THE HOSPITAL IN PURCHASING STATE-OF-THE-ART EQUIPMENT, DEVELOPING PROGRAMS AND SERVICES, AND AIDING IN FACILITY IMPROVEMENT INITIATIVES. DURING 2015, THE FOUNDATION DISTRIBUTED $417,781 TO NYACK HOSPITAL. 417781 true true false false false false false false false true false false false true true false false true false false false false false false true false false true false true false false false false false false false false false false false false false true true false false false true 6 0 true 2 true false false false false false true true false false false false X 12 10 false false false false true true false true true false false true true true true true true false false false NY X RONALD RATIGAN 8453486522 160 NORTH MIDLAND AVENUE NYACK NY 10960 MARK JACOBS CHAIRMAN 1.0 1.0 X X 0 0 0 MITCHELL COHN MD VICE CHAIR 1.0 1.0 X X 0 0 0 JOHN S BURKE TREASURER 1.0 40.0 X X 0 419074 47528 EDWARD S FISHER DDS SECRETARY 1.0 0.0 X X 0 0 0 VINCENT ABBATECOLA TRUSTEE 1.0 0.0 X 0 0 0 FRANK BORELLI JR TRUSTEE 1.0 0.0 X 0 0 0 MARK GELLER MD PRESIDENT & CEO NYACK HOSPITAL 1.0 40.0 X X 0 812127 31768 DANIEL M JUECHTER TRUSTEE 1.0 0.0 X 0 0 0 MICHAEL E RADER MD TRUSTEE - TERM 11/2015 1.0 40.0 X 0 436416 66421 ROGER RAICHELSON MD TRUSTEE 1.0 0.0 X 0 0 0 SACHIN J SHAH MD TRUSTEE 1.0 0.0 X 0 0 0 BRIGITTE SIMON TRUSTEE 1.0 0.0 X 0 0 0 WILLIAM M TRUST JR TRUSTEE 1.0 0.0 X 0 0 0 LISA HAYES TRUSTEE - TERM 2/2015 1.0 0.0 X 0 0 0 PETER LANG TRUSTEE - TERM 10/2015 1.0 0.0 X 0 0 0 0 1667617 145717 0 false true false 0 171445 392525 563970 0 25573 25573 0 0 0 0 0 29839 29839 29839 29839 75074 171445 58958 16116 16116 0 0 INSURANCE CASH VALUE 900099 19155 0 19155 19155 654653 0 90683 X 417781 417781 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122353 0 0 122353 0 0 0 0 38646 0 0 38646 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54838 0 0 54838 8413 0 0 8413 0 0 0 0 402 0 0 402 0 0 0 0 0 0 0 200 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 OTHER PURCHASED SERVICES 1856 0 0 1856 PRINTING & PUBLICATIONS 20163 0 0 20163 RECOGNITION EXPENSES 2146 0 0 2146 DUES & SUBSCRIPTIONS 13258 0 0 13258 680056 417781 0 262275 0 650316 1131975 0 0 2394887 1742008 0 0 0 0 0 0 0 0 0 0 0 0 0 2528938 2765300 0 0 0 0 0 0 578661 579915 6152802 6219198 270 5732 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13264 32708 13534 38440 X 1651642 1605597 4287626 4375161 200000 200000 6139268 6180758 6152802 6219198 -25403 66893 0 0 0 0 X false true X true false X 4118650 1449626 1006474 334996 563970 7473716 0 0 4118650 1449626 1006474 334996 563970 7473716 4124273 3349443 1704 32277 36439 19352 44728 134500 0 0 7608216 821586 0.44024 0.37328 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 200000 200000 200000 200000 200000 200000 200000 200000 200000 200000 1.00000 false false CVS OF INSURANCE POLICIES 520381 UNDEPOSITED FUNDS 100 OTHER ASSETS 59434 579915 0 DUE TO AFFILIATES 32708 32708 PART V, LINE 4 INTENDED USE OF ENDOWMENT FUND: THE INTENDED USE OF THE FOUNDATION'S ENDOWMENT IS TO PROVIDE FUNDS TO BE USED FOR INDIGENT CARE BREAST HEALTH. 5K/10K RACE 41546 28845 12701 7415 GOLF CLASSIC 199980 141650 58330 49847 1 4993 950 4043 1696 246519 171445 75074 58958 58958 16116 true NYACK HOSPITAL 160 NORTH MIDLAND AVENUE NYACK NY 10960 131740119 501(c)(3) 417781 GENERAL SUPPORT 1 SCHEDULE I, PART II, LINE 1 FOR 2015, A CONTRIBUTION OF $417,781 WAS MADE TO NYACK HOSPITAL, A RELATED TAX-EXEMPT ORGANIZATION. false false false false false false false false false JOHN S BURKE TREASURER 0 417517 0 0 0 1557 0 7950 0 39578 0 466602 0 0 MARK GELLER MD PRESIDENT & CEO NYACK HOSPITAL 0 808515 0 0 0 3612 0 900 0 30868 0 843895 0 0 MICHAEL E RADER MD TRUSTEE - TERM 11/2015 0 427363 0 0 0 9053 0 39900 0 26521 0 502837 0 0 SCHEDULE J, Part I, Line 3 THE ORGANIZATION'S TOP MANAGEMENT OFFICIALS RECEIVED THEIR COMPENSATION FROM A RELATED ORGANIZATION, WHICH USED ONE OR MORE OF THE METHODS DESCRIBED TO ESTABLISH THE TOP MANAGEMENT OFFICIALS' COMPENSATION. FORM 990, PART VI, LINE 6 THE MEMBERS OF THE NYACK HOSPITAL FOUNDATION SHALL BE THE ELECTED TRUSTEES OF NYACK HOSPITAL. PRIOR TO AUGUST 1, 2014, THE HOSPITAL AND NEW YORK-PRESBYTERIAN HEALTHCARE SYSTEM, INC., A NEW YORK NOT-FOR-PROFIT CORPORATION, HAD A CORPORATE RELATIONSHIP AGREEMENT. UNDER THIS AGREEMENT, THE HOSPITAL WAS A CORPORATE MEMBER OF THE NEW YORK-PRESBYTERIAN HEALTHCARE SYSTEM. THE HOSPITAL AND NEW YORK-PRESBYTERIAN HEALTHCARE SYSTEM, INC. AGREED TO TERMINATE THE CORPORATE RELATIONSHIP AGREEMENT EFFECTIVE JULY 31, 2014. ON AUGUST 1, 2014 (THE ACQUISITION DATE), MONTEFIORE HEALTH SYSTEM, INC. (THE HEALTH SYSTEM) AND ITS MEMBER CORPORATIONS AND OTHER AFFILIATED ENTITIES (COLLECTIVELY ALSO REFERRED TO AS THE HEALTH SYSTEM) ENTERED INTO A MEMBERSHIP TRANSACTION AGREEMENT, WHEREBY THE HEALTH SYSTEM BECAME THE SOLE MEMBER OF THE HOSPITAL. THE HEALTH SYSTEM IS AN INTEGRATED HEALTH CARE DELIVERY SYSTEM IN THE BRONX AND WESTCHESTER COUNTIES IN NEW YORK. THE HOSPITAL ALSO AMENDED ITS CERTIFICATE OF INCORPORATION AND BYLAWS TO REFLECT THE MEMBERSHIP TRANSACTION AGREEMENT. THE HOSPITAL'S MEMBER ELECTS THE HOSPITAL'S BOARD OF TRUSTEES. FORM 990, PART VI, LINE 7A AS SOLE CORPORATE MEMBER, NYACK HOSPITAL DESIGNATED THE INITIAL BOARD MEMBERS, THEREAFTER, BOARD MEMBERS SHALL BE APPOINTED IN ACCORDANCE WITH THE NYACK HOSPITAL FOUNDATION BYLAWS. FORM 990, PART VI, LINE 11B THE ACCOUNTING MANAGER, DIRECTOR OF FINANCE, AND THE ENTIRE FINANCE TEAM ARE INVOLVED IN THE PREPARATION AND REVIEW OF THE FORM 990. ONCE THE DIRECTOR OF FINANCE HAS COMPLETED HIS REVIEW, THE CFO REVIEWS THE FORM 990 IN DETAIL, INCLUDING ALL SCHEDULES. THE FORM 990 WAS THEN UPLOADED TO THE NYACK HOSPITAL WEBSITE FOR THE FULL BOARD REVIEW IN THE "BOARD ONLY" SECTION. ONLY BOARD MEMBERS CAN ACCESS WITH A PASSWORD. FORM 990, PART VI, LINE 12C THE FOUNDATION HAS ADOPTED THE CONFLICT OF INTEREST POLICY MAINTAINED BY NYACK HOSPITAL, THE PARENT ORGANIZATION. ALL MONITORING AND ENFORCEMENT OF THE CONFLICT OF INTEREST POLICY IS PERFORMED BY THE HOSPITAL ON BEHALF OF THE FOUNDATION. IN AN EFFORT TO ENSURE THAT ALL TRANSACTIONS OCCURING BETWEEN THE ORGANIZATION AND A THIRD PARTY DO NOT INURE TO THE BENEFIT OF ANY INDIVIDUAL OR CORPORATION, NYACK HOSPITAL MAINTAINS A CONFLICT OF INTEREST POLICY. UNDER THIS POLICY, OFFICERS, TRUSTEES AND EMPLOYEES MUST DISCLOSE ANY RELATIONSHIPS THAT MAY RESULT IN CONFLICT DUE TO TRANSACTIONS OCCURING BETWEEN THE ORGANIZATION AND AN INDIVIDUAL. ALL EMPLOYEES AND TRUSTEES HAVE A DUTY TO DISCLOSE ANY FINANCIAL INTEREST WHICH MAY POSE A CONFLICT WITH THEIR HOSPITAL RESPONSIBILITIES. THIS DISCLOSURE IS CONFIRMED BY THE DISTRIBUTION OF A QUESTIONNAIRE ON AN ANNUAL BASIS. IN COMPLETING THE QUESTIONNAIRE, THE EMPLOYEE OR THE TRUSTEE IS RESPONSIBLE FOR DISCLOSING HIS OR HER RELATIONSHIP TO ANY ENTITY DOING BUSINESS WITH THE ORGANIZATION UNLESS SUCH INTEREST DOES NOT REPRESENT A SIGNIFICANT PORTION OF THE INDIVIDUAL'S NET WORTH. ADDITIONALLY, SHOULD THE EMPLOYEE OR TRUSTEE BECOME AWARE OF SUCH A RELATIONSHIP SUBSEQUENT TO THE ADMINISTRATION OF THE QUESTIONNAIRE, HE OR SHE SHOULD DISCLOSE THE RELATIONSHIP TO THE APPROPRIATE DEPARTMENT HEAD OR CHAIRPERSON. IN THE EVENT OF A POTENTIAL CONFLICT, THE INDIVIDUAL IS ASKED TO ABSTAIN FROM PARTICIPATING IN ANY DECISIONS RELATED TO THE TRANSACTION IN QUESTION UNTIL THE ORGANIZATION CAN DETERMINE IF A CONFLICT OF INTEREST EXISTS AND MAKES AN APPROPRIATE DECISION TO DETERMINE HOW THE CONFLICT WILL BE RESOLVED. FORM 990, PART VI, LINE 19 UPON REQUEST, THE ORGANIZATION WILL MAKE AVAILABLE ONLY THOSE DOCUMENTS REQUIRED TO BE DISCLOSED UNDER THE PUBLIC INSPECTION LAWS. NYACK HOSPITAL 160 NORTH MIDLAND AVENUE NYACK NY 10960 131740119 HOSPITAL NY 501(C)(3) 3 NA false MONTEFIORE HEALTH SYSTEM INC 555 SOUTH BROADWAY TARRYTOWN NY 10591 201615393 PARENT NY 501(C)(3) 11 TYPE III MMAHS false HIGHLAND MEDICAL PC 160 NORTH MIDLAND AVENUE NYACK NY 10960 134034481 PHYSICIAN SVCS NY NA true NH MANAGEMENT INC 160 NORTH MIDLAND AVENUE NYACK NY 10960 134026486 MANAGEMENT SVCS NY NA true false true false false false false false false false false false false true true false false false false false NYACK HOSPITAL B 417781 COST NYACK HOSPITAL M 58982 COST NYACK HOSPITAL N 161000 COST