2015-11-13T08:39:21-06:00 2014-12-31 Charles A Barragato & Co LLP 950 Third Avenue - 20th FL New York NY 10022 990 2014-01-01 133245804 Nyack Hospital Foundation % RONALD RATIGAN NYAC 8463486522 160 North Midland Avenue Nyack NY 10960 JOHN S BURKE CFO 8453486522 2015-11-15 true Angelo Pirozzi CPA P00446022 2123714446 2014 2016-04-25 22:37:26Z MARK GELLER 160 North Midland Avenue Nyack NY 10960 560710 false X 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. 15 13 2 47 0 1006474 354345 0 0 41898 3 106022 145003 1154394 499351 0 0 0 0 174751 170980 0 0 242880 463594 1223400 638345 1394380 516049 -895029 7040046 6152802 13521 13534 7026525 6139268 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 1151500 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 2014, THE FOUNDATION DISTRIBUTED $1,151,500 TO NYACK HOSPITAL. 1151500 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 false false true false false false false false false false false false false false false true true false false false true 8 1 true 2 true false false false false false true true false false false false X 15 13 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 D COHN MD VICE CHAIR 1.0 1.0 X X 0 0 0 JOHN S BURKE TREASURER 1.0 40.0 X X 0 417978 45904 EDWARD S FISHER DDS SECRETARY 1.0 0.0 X X 0 0 0 DAVID H FREED DHA THRU 914 PRESIDENT & CEO NYACK HOSPITAL 1.0 40.0 X X 0 665609 26617 VINCENT ABBATECOLA TRUSTEE 1.0 0.0 X 0 0 0 FRANK BORELLI JR TRUSTEE 1.0 0.0 X 0 0 0 MARK GELLERMD START 1214 PRESIDENT AND CEO NYACK HOSP 1.0 0.0 X X 0 0 0 LISA HAYES TRUSTEE 1.0 1.0 X 0 0 0 DANIEL M JUECHTER TRUSTEE 1.0 0.0 X 0 0 0 PETER E LANG TRUSTEE 1.0 0.0 X 0 0 0 MICHAEL E RADER MD TRUSTEE 1.0 40.0 X 0 449035 41598 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 DANIEL SPITZER MD THRU 914 TRUSTEE 1.0 0.0 X 0 0 0 WILLIAM M TRUST JR TRUSTEE 1.0 0.0 X 0 0 0 0 1532622 114119 0 false true false 0 13084 341261 10000 354345 0 3 3 0 0 0 0 0 0 206362 13084 61359 145003 145003 0 0 0 499351 145006 0 0 0 0 0 0 0 130461 130461 0 40519 40519 0 0 0 0 0 0 0 0 0 11693 11693 8590 8590 0 746 746 0 0 471 471 0 1151500 1151500 0 11 11 OTHER PURCHASED SERVICES 54 54 PRINTING & PUBLICATION 28389 28389 RECOGNITION EXPENSE 6914 6914 DUES & SUBSCRIPTIONS 9581 9581 5451 5451 1394380 1151500 0 242880 3695640 650316 204870 0 2598224 2394887 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2528938 0 0 0 0 0 0 541312 578661 7040046 6152802 3111 270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10410 13264 13521 13534 X 1838108 1651642 4988417 4287626 200000 200000 7026525 6139268 7040046 6152802 -895029 7772 X false true X true false X 441799 4118650 1449626 1006474 334996 7351545 0 0 441799 4118650 1449626 1006474 334996 7351545 4183164 3168381 10063 1704 32277 36439 19352 99835 0 230983 179043 242715 177350 206362 1036453 8487833 0.37328 0.37299 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 200000 200000 200000 200000 200000 200000 200000 200000 200000 200000 1.00000 false false CSV OF INSURANCE POLICIES 501076 DUE FROM AFFILIATE 59585 UNDEPOSITED FUNDS 18000 578661 0 DUE TO AFFILIATES 13264 13264 PART V, LINE 4 - INTENDED USES OF ENDOWMENT FUND THE INTENDED USE OF THE FOUNDATION'S ENDOWMENT IS TO PROVIDE FUNDS TO BE USED FOR INDIGENT CARE BREAST HEALTH. Golf Classic 178712 5065 173647 50972 5K/10K Race 34440 7694 26746 8777 1 6294 325 5969 1610 219446 13084 206362 61359 61359 145003 false false false false false false false false false JOHN S BURKE TREASURER 0 362993 0 0 0 54985 0 7800 0 38104 0 463882 0 0 DAVID H FREED DHA THRU 914 PRESIDENT & CEO NYACK HOSPITAL 0 449581 0 0 0 216028 0 15600 0 11017 0 692226 0 0 MICHAEL E RADER MD TRUSTEE 0 369955 0 0 0 79080 0 15600 0 25998 0 490633 0 0 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 CORP 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. FORM 990, PART VII, LINE 2 NYACK HOSPITAL FOUNDATION DOES NOT DIRECTLY PAY ITS EMPLOYEES. THE COMPENSATION AND BENEFITS ARE ALLOCATED FROM NYACK HOSPITAL. THE COMPENSATION AND BENEFITS ARE RECORDED ON THE FORM 941 FILED BY NYACK HOSPITAL UNDER THE EMPLOYER IDENTIFICATION NUMBER 13-1740119. 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