2015-11-13T10:54:18-06:00 2014-12-31 BDO USA LLP 100 PARK AVENUE NEW YORK NY 10017 990 2014-01-01 111704595 BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER % B FARRELL VP/CFO BROO 6316547100 101 HOSPITAL ROAD PATCHOGUE NY 11772 Brenda J Farrell CFO 6316547100 2015-11-11 true Paul Hammerschmidt P01384178 2128858000 2014 2016-03-07 17:11:31Z R T MARGULIS CEO 101 HOSPITAL ROAD PATCHOGUE NY 11772 270210516 false X WWW.BROOKHAVENHOSPITAL.ORG X 1947 NY DELIVER ACCESSIBLE HIGH-QUALITY HEALTH SERVICES IN A FOCUSED CARING AND TEACHING ENVIRONMENT WHILE PROVIDING HEALTH ADVOCACY FOR THE COMMUNITY AND PEOPLE WE SERVE. 25 19 2617 137 0 14342956 10492813 266217141 256716497 210739 190069 3980915 2811137 284751751 270210516 0 0 0 0 175033782 178991002 0 0 42261 96133226 94222851 271167008 273213853 13584743 -3003337 174779370 178250492 137069077 140258489 37710293 37992003 X DELIVER ACCESSIBLE HIGH-QUALITY HEALTH SERVICES IN A FOCUSED CARING AND TEACHING ENVIRONMENT WHILE PROVIDING HEALTH ADVOCACY FOR THE COMMUNITY AND PEOPLE WE SERVE. false false 153838571 0 153211465 INPATIENT CARE SERVICES - INCLUDES MEDICAL/SURGICAL PROCEDURES, PEDIATRICS, ICU, CCU, ROUTINE AND PSYCHIATRIC CARE. TOTAL 2014 INPATIENT DAYS: 80,701 36879312 0 34102773 EMERGENCY ROOM SERVICES - AVAILABLE TO THE COMMUNITY 24 HOURS, 7 DAYS A WEEK. TOTAL 2014 TREAT AND RELEASE VISITS: 69,573 18980156 0 22304181 AMBULATORY SURGERY SERVICES - AVAILABLE TO THE COMMUNITY. TOTAL 2014 CASES: 6,962 39023157 0 48893602 248721196 true true false true false false false false false true true false false true true true true true false false false false false false false false true true false false true true false false false false false false false false true false false false false false false true false false false true 282 0 true 2617 true false false false false false false false false false false X 25 19 true false false false true true false true true false false true true true true true true true true true true NY X B FARRELL VPCFO 6316547175 101 HOSPITAL ROAD PATCHOGUE NY 11772 X R T MARGULIS PRESIDENT & CEO/DIRECTOR 37.5 0.5 X X 687656 0 69384 L ROSE CHAIRWOMAN 0.5 0.5 X X 0 0 0 M MULHOLLAND VICE CHAIRMAN 0.5 0.5 X X 0 0 0 E P SMITH TREASURER 0.5 0.5 X X 0 0 0 P MOLONEY SECRETARY 0.5 0.5 X X 0 0 0 R BERMAN MD DIRECTOR 0.5 0.5 X 0 0 0 F C BRAUN III DIRECTOR 0.5 0.5 X 0 0 0 G BROWN DIRECTOR 0.5 0.5 X 0 0 0 T CULLEN DIRECTOR 0.5 0.5 X 1500 0 0 S GILLERAN DIRECTOR/PRES. OF MED. STAFF 0.5 0.5 X 0 0 0 F GRUCCI JR DIRECTOR 0.5 0.5 X 0 0 0 M KNAPP DIRECTOR 0.5 0.5 X 0 0 0 E KORMYLO DPM DIRECTOR 0.5 0.5 X 21600 0 0 W LADICK DIRECTOR 0.5 0.5 X 0 0 0 W LEHMANN DIRECTOR 0.5 0.5 X 0 0 0 L LOURIE THRU 114 DIRECTOR 0.5 0.5 X 0 0 0 J MAIORINO DIRECTOR 0.5 0.5 X 0 0 0 J MAYER DIRECTOR 0.5 0.5 X 4331 0 0 J MONTEITH DIRECTOR 0.5 0.5 X 0 0 0 S NORTON REMMER DIRECTOR 0.5 0.5 X 0 0 0 F ROSE DIRECTOR 0.5 0.5 X 0 0 0 E RUSSO DIRECTOR 0.5 0.5 X 0 0 0 K SCHWARTZ MD DIRECTOR 0.5 0.5 X 0 0 0 R W SCHWARZ DIRECTOR 0.5 0.5 X 0 0 0 J SULLIVAN DIRECTOR 0.5 0.5 X 0 0 0 S TAITZ DIRECTOR 0.5 0.5 X 0 0 0 B FARRELL VP FINANCE, CFO 37.5 0.0 X 373988 0 35351 R STEPHENSON THRU 714 VP & COO 37.5 0.0 X 190715 0 13272 K MENDEZ THRU 1014 VP CHIEF NURSING OFFICER 37.5 0.0 X 302117 0 31957 A ALCASABAS PHYSICIAN 37.5 0.0 X 304911 0 58366 S WALKER MD THRU 1014 PHYSICIAN 37.5 0.0 X 279380 0 44333 S KLAUSNER MD PHYSICIAN 37.5 0.0 X 260007 0 24973 V IZGUR MD PHYSICIAN 37.5 0.0 X 230598 0 35315 F QUERSHI MD PHYSICIAN 37.5 0.0 X 229485 0 28249 T OCKERS SENIOR DEVELOPMENT OFFICER 0.0 22.5 X 0 313426 66562 2886288 313426 407762 238 true true false ALLIANCE HEALTHCARE PO BOX 96485 CHICAGO IL 60693 RADIOLOGY SERVICES 3559053 SOUND PHYSICIANS OF NY PLLC 1123 PACIFIC AVENUE TACOMA WA 98402 HOSPITALISTS 3463947 WIEDERSUM ASSOCIATES 140 ADAMS AVENUE SUITE B-14 HAUPPAUGE NY 11788 ARCHITECTURAL 1365115 BDO USA LLP PO BOX 642743 PITTSBURGH PA 15264 AUDITING 921633 ST CHARLES HOSPITAL 200 BELLE TERRE ROAD PORT JEFFERSON NY 11777 PHYSICAL THERAPY 878898 43 6196192 2680374 1616247 10492813 NET PATIENT SERVICE REVENUE 624200 247264281 247264281 FEES AND CONTRACTS FROM GOV'T AGENCIES 624200 9452216 9452216 256716497 180644 180644 0 0 0 0 0 9425 9425 9425 9425 0 0 0 PURCHASE DISCOUNTS AND VENDORS REBATES 900099 583627 583627 COFFEE SHOP REVENUE 900099 366868 366868 CAFETERIA INCOME 722514 249450 249450 1611192 1211897 399295 2811137 270210516 258512021 1205682 0 0 0 0 1731871 1731871 415321 415321 123579505 115669141 7891043 19321 14657816 13622366 1028694 6756 29468720 27319636 2149071 13 9137769 8426732 709559 1478 4649650 4287847 361803 499877 499877 168500 168500 219757 219757 0 0 16297758 15032400 1250665 14693 781120 721722 59398 1072438 988988 83450 990053 913014 77039 0 4770836 4399603 371233 100537 92714 7823 0 80109 73875 6234 1506812 1389562 117250 0 10857195 10012364 844831 -224371 -206912 -17459 MEDICAL SUPPLIES 32576892 32576892 PROV FOR NON PTNT UNCOLLECT 5550082 5550082 REPAIRS AND MAINTENANCE 4172835 3848134 324701 OTHER SERVICES 3779402 3485315 294087 6373369 5848046 525323 273213853 248721196 24450396 42261 345737 788379 16361778 13249820 0 0 56282812 38845786 0 0 0 0 0 0 4326057 4378828 1259520 1525363 222807772 126901881 87342861 95905891 0 0 0 0 0 0 133327 116659 8727278 23439766 174779370 178250492 55919789 44780362 0 0 0 0 16755000 51115000 0 0 0 0 13348332 493822 0 0 51045956 43869305 137069077 140258489 X 33467310 33575347 3342983 3516656 900000 900000 37710293 37992003 174779370 178250492 X -3003337 173673 3111374 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true 185000 false true 34757 219757 false false PART II-B, LINE 1G: INCLUDES ALLOCABLE MEMBERSHIP FEES OF 5 ORGANIZATIONS THAT ADVOCATE THE INTERESTS OF ITS MEMBER HOSPITALS BEFORE THE STATE AND FEDERAL LEGISLATURES AND EXECUTIVE BRANCHES. PART II-B, LINE 1I: OTHER (NOT RELATED TO POLITICAL CONSULTING) 900000 900000 900000 900000 3319139 2419139 900000 3648621 -171300 158182 3319139 3404768 414991 171138 3648621 1.00000 false false 1531487 1531487 57041434 32645831 24395603 1182837 726448 456389 139381043 89444611 49936432 23670971 4084991 19585980 95905891 SECURITY DEPOSITS 342160 ASSETS LIMITED TO USE 19665373 ESTIMATED MALPRACTICE REC. 2075000 DEFERRED FINANCING FEES 1220535 ABATEMENT 136698 23439766 0 CAPITAL LEASE OBLIGATIONS 4429332 ACCRUED PENSION COSTS 8518414 ESTIMATED MALPRACTICE LIABILIT 23811996 CHANGE IN VALUATION OF SWAP 3073855 ASBESTOS ABATEMENT 1690227 SETTLEMENT WITH US DEPT. OF JUSTICE 968416 NET 1377065 43869305 X 273495563 173673 3111374 3285047 270210516 270210516 273213853 273213853 273213853 PART V, LINES 1 AND 4: A $1,000,000 trust was initially established by a donor in 1969. Brookhaven Memorial Hospital Medical Center had classified the original value of the gift along with the allocable compounded earnings as permanently restricted net assets to be held in perpetuity. In order to comply with the donor agreement and to fairly represent the classification of restricted net assets, the organization reclassified $2,195,067 from permanently restricted net assets to temporarily restricted net assets during 2012, as this amount represents the 10% interest in the principal amount of the trust the organization will become entitled to in 2019 ($100,000) and the income earned on the fund since inception less amounts appropriated for general purposes. The organization is entitled to the income earned on the trust, as per the donor agreement, and is allowed to spend 5% of the prior three years' total value as mandated by a past court decision. The amount that is reported in permanently restricted net assets of $900,000 represents the portion of the trust to be held in perpetuity. PART X, LINE 2: Brookhaven Memorial Hospital Medical Center has not taken an unsubstantiated tax position that would require provision of a liability under ASC 740, "Income Taxes". Under ASC 740, an organization must recognize the tax benefit associated with tax positions taken for tax return purposes when it is more likely than not that the position will not be sustained. The organization does not believe there are any material uncertain tax positions and, accordingly, has not recognized any liability for unrecognized tax benefits. The organization has filed Internal Revenue Service ("IRS") Form 990, as required, and all other applicable returns in jurisdictions where it is required. For the years ended December 31, 2014 and 2013, there were no interest or penalties recorded or included in the financial statements. The organization believes it is no longer subject to income tax examinations for the years prior to 2011, which is the statute of limitation look back period. PART XI, LINE 2D: change in minimum pension liability.......................$3,784,737 change in valuation of interest rate swap agreement.......$ (673,363) Total.....................................................$3,111,374 true true X true X true X 425. true true true false false 1968 7062718 7062718 0.02590 38941 26618374 26618374 0.09740 40909 33681092 33681092 0.12330 100000 162465 162465 0.00060 2394 3648802 3648802 0.01340 104146 3811267 3648802 162465 0.01400 145055 37492359 3648802 33843557 0.13730 41500 41500 1.00000 41500 41500 1.00000 true 3049333 64999916 71094749 -6094833 X true true 11 1 BROOKHAVEN MEMORIAL HOSPITAL MED CTR 101 HOSPITAL ROAD EAST PATCHOGUE NY 11772 X A 2 HOME HEALTH CARE 103 WEST MAIN STREET PATCHOGUE NY 11772 X B 3 BROOKHAVEN MEMORIAL HOSP DIALYSIS CTR 109 WEST MAIN STREET PATCHOGUE NY 11772 X B 4 CTR FOR WOUND CARE & HYPERBARIC MEDIC 33 MEDFORD AVENUE PATCHOGUE NY 11772 X B 5 HOSPICE 105 WEST MAIN STREET PATCHOGUE NY 11772 X B 6 OUT PATIENT IMAGING 100 HOSPITAL ROAD PATCHOGUE NY 11772 X B 7 WOMEN'S IMAGING SERVICES CENTER 285 SILLS ROAD BUILDING 5-6 PATCHOGUE NY 11772 X B 8 CARDIO REHABILITATION CENTER 100 HOSPITAL ROAD PATCHOGUE NY 11772 X B 9 BROOKHAVEN BELLPORT PRIMARY CARE CTR 515 BELLPORT AVENUE BELLPORT NY 11713 X B 10 CTR FOR WOUND CARE & HYPERBARIC MED 300 KENNEDY DRIVE HAUPPAUGE NY 11788 X B 11 SCHOOL BASED HOSPITAL EXTEN CLINIC 350 MAPLE AVENUE BELLPORT NY 11713 X B A 1 false false true X X X X X 13 true true false true X HTTP://WWW.BROOKHAVENHOSPITAL.ORG X true 13 true HTTP://WWW.BROOKHAVENHOSPITAL.ORG false false true X 200. 425. X X X true true X X true X X false true X X X X X true X false true B false false true X X X X X 13 true true false true X HTTP://WWW.BROOKHAVENHOSPITAL.ORG X true 13 true HTTP://WWW.BROOKHAVENHOSPITAL.ORG false false true X 200. 425. X X X true true X X true X X false true X X X X X true X false true PART V, SECTION B, LINE 5: THE MEDICAL CENTER HAS ESTABLISHED A LEADERSHIP POSITION IN HEALTH PROMOTION, PREVENTION AND EDUCATION THROUGHOUT THE COMMUNITY. REGIONAL HEALTH PLANNING IS ACCOMPLISHED THROUGH A NUMBER OF AGENCY CONTACTS INCLUDING THE SUFFOLK COUNTY DEPARTMENT OF HEALTH, MENTAL HEALTH AGENCIES AND THE NEW YORK STATE DEPARTMENT OF HEALTH. IN ADDITION, THE HOSPITAL WORKS CLOSELY WITH THE SUFFOLK COUNTY POLICE DEPARTMENT. BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER IS DEDICATED TO COMMUNICATING WITH KEY STAFF AND COMMUNITY MEMBERS, AS THE HOSPITAL PREPARES TO PLAN FOR THE FUTURE HEALTH CARE NEEDS OF THE PEOPLE WE SERVE. FOCUS GROUPS ARE HELD PERIODICALLY, WHICH INCLUDE MEETING WITH THE MEDICAL STAFF, MEMBERS OF THE BOARD OF DIRECTORS, EMPLOYEES AND THE EMPLOYEE COUNCIL, COMMUNITY MEMBERS, THE LI2DAY ORGANIZATION, THE WEST ISLIP BREAST CANCER COALITION, THE SOUTHAMPTON BREAST CANCER COALITION, HOSPITAL ADVISORY COUNCIL, WHO ARE THE VOICE OF THE COMMUNITY AND HOLD POSITIONS ON VARIOUS COMMUNITY BASED SERVICE GROUPS, AS WELL AS THE HEALTH CENTER ADVISORY COUNCIL MEMBERS. THESE CONSTITUENTS HAVE THE ABILITY TO COLLECT INFORMATION FROM VARIED PERSPECTIVES. THE HOSPITAL'S ABILITY TO COLLECT INFORMATION FROM THESE GROUPS AND TRANSLATE THE DIALOG INTO A NEEDS ASSESSMENT IS A VALUABLE RESOURCE TO THE HOSPITAL AS WELL AS THE COMMUNITY. PART V, SECTION B, LINE 6A: HOME HEALTH CARE; BROOKHAVEN MEMORIAL HOSPITAL DIALYSIS CENTER; CENTER FOR WOUND CARE AND HYPERBARIC MEDICINE; HOSPICE; OUT PATIENT IMAGING; WOMEN'S IMAGING SERVICES CENTER; CARDIO REHABILITATION CENTER; BROOKHAVEN BELLPORT PRIMARY CARE CENTER; AND SCHOOL BASED HOSPITAL EXTENSION CLINIC. PART V, SECTION B, LINE 7D: OUR COMMUNITY AGENCIES AND PARTNERS WILL ALSO DISTRIBUTE OUR CSP TO THEIR PARTICIPANTS. PART V, SECTION B, LINE 11: The focus of BMHMC's 2013 Community Service Plan is to provide resources and services to at-risk members of the community who are dealing with obesity, diabetes, mental health, substance abuse and other health related issues. In 2014 these needs were addressed through hospital initiatives and various hospital and community events, including but not limited to: a) A free Day of Dance program at the Sun Vet Mall in Holbrook. Over 500 community members attended and health initiatives focused on heart disease, diabetes and obesity were promoted through dance as a form of exercise. Attendees were encouraged to join the program "Managing Cardiac Disease and Diabetes Mall Walking Club"- an initiative started through a partnership between the BMH Cardiac Rehab Program and our Diabetes Wellness Center. Attendees also had the opportunity to speak with Cardiologists, nurses and other clinicians. B/P screenings, Breast self-exam demonstrations, and health educational material were made available to the community, along with dance instructions to help "move to improve" overall health. Local dance companies were engaged and the obesity initiatives promoted through dance as a form of exercise and encouraged attendees to join the program "Managing Cardiac Disease and Diabetes Mall Walking Club". This initiative started through a partnership between our Cardiac Rehab Program and our Diabetes Wellness Center. A scheduled once a month meeting is held for the Mall Walkers and blood pressure screenings were offered as well as education on glucometer readings. b) Health Fairs at various locations including the Boys & Girls Club (Diabetes Education & Nutrition lecture), Brookhaven Senior Picnic, RSVP, St. Joseph College Health Fair, YMCA wellness fair, HIA Trade Show (Wound Care). c) Hospital Based Family Fun Day - Over 3,000 community members attended blood Pressure screenings, diabetes risk assessment screenings, BMI screenings, and nutritional education were just some of the education and screenings made available to them. d) Partnership with other organizations to promote a healthy lifestyle such as BOCES Wellness (Nutrition Education and blood pressure screenings), William Floyd Elementary School (Nutrition Education lecture, Diabetes and Obesity platform "Healthy Eating on a Budget" Lecture attended by 45 parents), YMCA (Diabetes prevention), Sayville Grammar School (hands on activities providing the opportunity for the students to see the dangers to their health from overeating and inactivity which results in obesity). e) Various hospital programs including monthly lectures on a variety of topics, including wellness and prevention programs including diabetes, free weekly educational seminars for the community hosted by one of our bariatric surgeons, and additional educational opportunities were found at the various service, fraternal and business meetings attended regularly by BMHMC Outreach Coordinator representative such as chambers, LIMBA, GIG, and HIA. f) Initiated SBIRT (Screening, Brief Intervention, and Referral to Treatment), an evidence-based approach to identifying patients who use alcohol and other drugs who are at risk for health consequences, accidents or injuries. The goal is to screen patients in Hospital Emergency Rooms and other medical facilities in order to provide opportunity for early intervention before more serious consequences occur. g) BMH participates in DSRIP and continues to work on an 'outreach' plan to target our youth in the area, offering education and prevention, for example in the BOCES School Based Health Center and surrounding community. PART V, SECTION B, LINE 22D: ALL ACCOUNTS ARE BILLED AT GROSS CHARGES. GROSS CHARGES ARE ADJUSTED, IF APPLICABLE, FOR ANY NEGOTIATED RATES WITH INSURANCE PROVIDERS OR AGENCIES. IF IT IS DETERMINED THAT A PATIENT IS ELIGIBLE FOR FREE OR DISCOUNTED CARE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, ADJUSTMENTS WILL BE MADE TO THEIR ACCOUNT. PART V, SECTION B, LINE 23: THE HOSPITAL DID NOT CHARGE PATIENTS IF THEY WERE ELIGIBLE FOR CARE. PART V, SECTION B, LINE 24: THROUGH ALL FISCAL YEARS THERE WILL BE PATIENTS WHO WERE CHARGED AND WHO PAID FACILITY CHARGES FOR THE MEDICALLY NECESSARY CARE PROVIDED TO THE PATIENT. PART I, LINE 3B: The percent of FPG used by BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER to calculate discounted care starts at 201% (90% discount) and goes to 425% (10% discount). PART III, LINE 4: 1) Patient accounts receivable are recorded at the reimbursable or contracted amount and do not bear interest. The allowance for doubtful accounts is the Hospital's best estimate of the amount of probable credit losses in the Hospital's existing accounts receivable. The Hospital determines the allowance based on historical write-off experience. The Hospital reviews its allowance for doubtful accounts monthly. Past due balances are reviewed individually for collectibility. Account balances are charged off against the allowance after all means of collection have been exhausted and the potential for recovery is considered remote. 2) The costing methodology used in determining bad debt at cost is a ratio of patient care costs to charges per IRS schedule H instructions, worksheet 2. PART III, LINE 8: 1) All of the shortfall on Part III, Line 7 Section B, Line 8 should be considered a community benefit. 2) Medicare allowable costs are calculated on the HCFA 2552 Medicare cost report worksheet E, Part A. PART III, LINE 9B: Brookhaven Memorial Hospital Medical Center has a financial assistance policy and a charity care policy. The hospital further maintains a collection policy to use outside professional collection agencies only as a last resort to settle delinquent patient accounts. Brookhaven financial assistance policy is to provide care to uninsured patients who meet certain criteria under the Hospital's Charity Care Policy without charge or at amounts less than current established rates. Patient eligibility for partial charity care is calculated based on a sliding fee scale of family income adjusted for the size of the family. Brookhaven's Patient Financial Services Department makes a written determination of eligibility after reviewing applications and information submitted to support family income reported. Based upon income and family size, Brookhaven may determine that patients may qualify for Medicaid benefits, and may first need to apply for Medicaid or NY State's Family Health Plus or Child Health Plus programs for the uninsured before a determination will be made under our charity care policy. Brookhaven charity care policy is to provide free or discounted emergent and non-emergent necessary care for uninsured and underinsured patients residing in Suffolk and Nassau Counties, as well as emergent care to patients residing in all other areas of New York State. If financial assistance is approved following the application process, a clear explanation of balance due and how the decision was derived is supplied. Monthly payment plans can be arranged, not to exceed 10% of the applicant's monthly gross income. If the applicant defaults on a financial agreement with the hospital, the account in question will be considered delinquent and may be referred to a collection agency/legal action. Applicant has the right to appeal the hospital's decision on eligibility of Charity Care within 30 days of notification of noneligibility. X X X X false false false false false false false false false R T MARGULIS PRESIDENT & CEO/DIRECTOR 542308 0 116381 0 28967 0 47731 0 21653 0 757040 0 0 0 T OCKERS SENIOR DEVELOPMENT OFFICER 0 302000 0 0 0 11426 0 46131 0 20431 0 379988 0 0 B FARRELL VP FINANCE, CFO 307308 0 49134 0 17546 0 14700 0 20651 0 409339 0 0 0 R STEPHENSON THRU 714 VP & COO 164720 0 25995 0 0 0 1700 0 11572 0 203987 0 0 0 K MENDEZ THRU 1014 VP CHIEF NURSING OFFICER 259567 0 42550 0 0 0 14931 0 17026 0 334074 0 0 0 A ALCASABAS PHYSICIAN 304911 0 0 0 0 0 27931 0 30435 0 363277 0 0 0 S WALKER MD THRU 1014 PHYSICIAN 279380 0 0 0 0 0 14907 0 29426 0 323713 0 0 0 S KLAUSNER MD PHYSICIAN 260007 0 0 0 0 0 14700 0 10273 0 284980 0 0 0 V IZGUR MD PHYSICIAN 230598 0 0 0 0 0 7817 0 27498 0 265913 0 0 0 F QUERSHI MD PHYSICIAN 229485 0 0 0 0 0 5391 0 22858 0 257734 0 0 0 A TOWN OF BROOKHAVEN INDUSTRIAL DEVELOPMENT AGENCY 521299559 2006-12-21 20000000 REFINANCE SERIES 2000 BONDS false false false B TOWN OF BROOKHAVEN INDUSTRIAL DEVELOPMENT AGENCY 521299559 2014-03-01 35000000 REFINANCE EXISTING TERM LOANS false false false A 17945000 0 0 0 0 0 117836 0 0 0 0 0 false true true true B 0 0 34199017 0 0 0 800983 0 0 0 0 0 false true true true A false false false false 0 false false false true B false false false false 0 false false false true A false false false true true false 0 false 0 false true B false true false false true false 0 false 0 false true A true B true PART IV, COLUMN A, LINE 2C: 12/21/2011 J DUDEK SEE PART V 150222 EMPLOYMENT false A SINKOFF SEE PART V 71647 EMPLOYMENT false L B SCHWARZ SEE PART V 111194 EMPLOYMENT false P MAYER-RIVETTA SEE PART V 59556 EMPLOYMENT false D KNAPP SEE PART V 22702 EMPLOYMENT false PART IV: 1) J. DUDEK IS THE SISTER OF J. MAYER, DIRECTOR. 2) A. SINKOFF IS THE SISTER OF S. NORTON REMMER, DIRECTOR. 3) L. B. SCHWARZ IS THE DAUGHTER OF R. W. SCHWARZ, DIRECTOR. 4) P. MAYER-RIVETTA IS THE SISTER OF J. MAYER, DIRECTOR. 5) D. KNAPP IS THE STEP-DAUGHTER OF M. KNAPP, DIRECTOR. FORM 990, PART III, LINE 4D: 1) RENAL DIALYSIS - TOTAL VISITS: 29,371 EXPENSES: $10,426,342. REVENUE: $9,130,204. 2) HOME HEALTH AGENCY - PROVIDES CERTIFIED HOME HEALTH AND LONG TERM CARE TO THE COMMUNITY. TOTAL VISITS: 50,583. EXPENSES: $8,200,928. REVENUE: $7,674,628. 3) HOME PROGRAM DIALYSIS (CAPD) - TOTAL VISITS: 660. EXPENSES: $4,929,945. REVENUE: $189,757. 4) REFERRED AMBULATORY - TOTAL VISITS: 26,457. EXPENSES: $3,985,628. REVENUE: $10,110,170. 5) MENTAL HEALTH AND CHEMICAL DEPENDENCY OUTPATIENT CLINICS - TOTAL VISITS: 19,931. EXPENSES: $2,708,820. REVENUE: $1,583,824. 6) HOSPICE - TOTAL DAYS: 9,349. EXPENSES: $1,643,084. REVENUE: $1,854,987. 7) ALL OTHER CLINICS (WOUND CARE, HYPERBARIC, SLEEP, CARDIAC, CATH, AND CARDIAC REHAB). TOTAL VISITS: 12,325. EXPENSES: $7,128,410. REVENUE: $18,350,032. FORM 990, PART VI, SECTION A, LINE 2: L. ROSE AND F. ROSE ARE BOARD MEMBERS AND HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINES 6 AND 7A: The Foundation (Brookhaven Health Care Services Corporation) is the sole member of Brookhaven Memorial Hospital Medical Center. The Foundation elects the board of Brookhaven Memorial Hospital Medical Center and appoints the President of Brookhaven Memorial Hospital Medical Center. FORM 990, PART VI, SECTION B, LINE 11B: A) FIRST DRAFT PROVIDED TO MANAGEMENT FROM BDO. B) FINAL DRAFT PRESENTED TO JOINT MEETING OF FINANCE AND AUDIT COMMITTEES FOR REVIEW. C) FINAL DRAFT POSTED ON BOARD PORTAL. D) FORM 990 REVIEWED AT BOARD MEETING. E) FORM 990 FILED TIMELY. FORM 990, PART VI, SECTION B, LINE 12C: Members of the Board of Directors, Administrators, Department Heads and medical staff working for or on behalf of Brookhaven MEMORIAL HOSPITAL MEDICAL CENTER are required to complete and sign the Conflict of Interest Disclosure Statement annually and whenever new information or changes arise that may require different responses from those included in the previous Conflict of Interest Disclosure Statement. Individuals are required to notify the Compliance Officer when they believe changes in the responses may be necessary or when they believe a transaction may involve an actual or potential conflict of interest. The Hospital By-Laws require that anyone with an actual or potential conflict of interest immediately disclose this fact to the Board of Directors or to a designated board committee for their review and evaluation. Further, the by-laws prohibit any individual or entity deemed to have an actual or potential conflict of interest from participating in any evaluation or decision making process regarding products or services provided by or through that individual or entity or from using this relationship to obtain goods or services on terms that are not available to individuals who are not affiliated with the hospital. The Board of Directors is responsible for enforcement of the aforementioned policy and report any conduct that it believes in good faith to be a violation of the Conflict of Interest Policy. FORM 990, PART VI, SECTION B, LINES 15A AND 15B: The Executive Compensation Committee is comprised of the Chief Executive Officer, the Chairperson of the Board of Directors and selected Members of the Board of Directors. An Executive Compensation Consultant is invited to present data and trends to this Committee for their review and evaluation of the current salaries and fringe benefits of the Executive Team of BMHMC as compared to other "like" organizations. In setting compensation levels for each executive, the Committee compares each base salary and total cash compensation level to market comparison data (based on healthcare systems with comparably sized operational budgets), organizational success against predetermined objectives, and individual performance against predetermined operational goals, as well as the data provided by the Consultant. The CEO, will be excused from the meeting of the Executive Compensation Committee, for a review of the CEO's compensation. Again, the Committee will use Industry Standards from comparably sized operational budgets, organizational success against predetermined objectives, and individual performance against predetermined operational goals, to establish the CEO's compensation. The Executive Compensation Committee will make the final approval of all compensation. The information is presented to the Overall brookhaven memorial hospital medical center Board, subject to ratification of the Board of Directors. FORM 990, PART VI, SECTION C, LINE 19: GOVERNING DOCUMENTS - NOT AVAILABLE TO THE PUBLIC. CONFLICT OF INTEREST POLICY - NOT AVAILABLE TO THE PUBLIC. FINANCIAL STATEMENTS - NOT AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: change in minimum pension liability.......................$3,784,737 change in valuation of interest rate swap agreement.......$ (673,363) Total.....................................................$3,111,374 BROOKHAVEN HEALTH CARE SERVICES CORP 101 HOSPITAL ROAD PATCHOGUE NY 11772 112950196 SUPPORT NY 501(c)(3) 9 false Brookhaven Physician Services 100 HOSPITAL ROAD PATCHOGUE NY 11772 260628913 PHYSICIAN OFFICE NY NA C 0 0 0.00000 false Brookhaven Surgical Services PC 100 Hospital ROAD Patchogue NY 11772 260885844 PHYSICIAN OFFICE NY NA C 0 0 0.00000 false LI Orthopedic & Spine Specialist PC 100 Hospital ROAD patchogue NY 11772 274670754 PHYSICIAN OFFICE NY NA c 0 0 0.00000 false false false true true true false false false false true false false true true true false true false false