2014-11-14T15:01:18-06:00 2013-12-31 131517563 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2013-01-01 111661359 CENTRAL SUFFOLK HOSPITAL CENT 6315486064 1300 ROANOKE AVENUE RIVERHEAD NY 11901 ANDREW MITCHELL PRESIDENT/CEO 6315486064 2014-11-14 1 ISRAEL TANNENBAUM P01589203 2128674000 2013 2015-11-30 17:44:51Z PECONIC BAY MEDICAL CENTER ANDREW MITCHELL 1300 ROANOKE AVENUE RIVERHEAD NY 11901 155416992 0 X WWW.PBMEDICALCENTER.ORG X 1951 NY SEE SCHEDULE OCENTRAL SUFFOLK HOSPITAL (CSH) IS A NOT-FOR-PROFIT HOSPITAL CONSISTING OF 122 ACUTE CARE BEDS, A 60-BED SKILLED NURSING FACILITY AND A CERTIFIED HOME CARE AGENCY. CSH PROVIDES A FULL RANGE OF HEALTH CARE SERVICES TO THE LOCAL COMMUNITY. 28 24 1314 162 0 0 8915623 4026717 133860699 142848353 47893 1158719 798951 3058511 143623166 151092300 0 0 0 0 77138387 80736732 0 0 146701 61178596 66474188 138316983 147210920 5306183 3881380 119049801 124631163 104485885 100700781 14563916 23930382 X CENTRAL SUFFOLK HOSPITAL (CSH) IS A NOT-FOR-PROFIT HOSPITAL CONSISTING OF 122 ACUTE CARE BEDS, A 60-BED SKILLED NURSING FACILITY AND A CERTIFIED HOME CARE AGENCY. CSH PROVIDES A FULL RANGE OF HEALTH CARE SERVICES TO THE LOCAL COMMUNITY. 1 0 113289786 142848353 COMPREHENSIVE HEALTHCARE SERVICES INCLUDING EMERGENCY, SURGICAL, MEDICAL, ICU AND OBSTETRICS/GYNECOLOGICAL. TOTAL PATIENT DAYS FOR ALL INPATIENT SERVICES WERE 49,408. TOTAL OUTPATIENT VISITS WERE 98,209. 113289786 1 1 0 1 0 0 0 1 0 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 1 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 1 0 1 88 1 1 1314 1 0 0 0 0 0 1 1 0 0 0 0 X 28 24 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X MICHAEL F O'DONNELL 6315486074 1300 ROANOKE AVENUE RIVERHEAD NY 11901 ANDREW MITCHELL CHIEF EXECUTIVE OFFICER/PRESIDENT 22.50 15.00 X X 574386 0 54252 GERARD ZUNNO COO / BOARD MEMBER 37.50 X X 246406 0 34055 JESSE R GOODALE PAST CHAIR 1.00 X X 0 0 0 SHERRY PATTERSON CHAIR 15.00 X X 0 0 0 J GORDON HUSZAGH VICE CHAIR 15.00 10.00 X X 0 0 0 CHARLES MASSOUD TREASURER 15.00 X X 0 0 0 ANDREW MENDELSON SECRETARY 15.00 X X 0 0 0 MARC ALESSI BOARD MEMBER 1.00 X 0 0 0 KENN BARRA BOARD MEMBER 1.00 1.00 X 0 0 0 MICHAEL DEMPSEY MD BOARD MEMBER 1.00 X 0 0 0 JAMES R FARRELL BOARD MEMBER 1.00 X 0 0 0 ROBERT GAFFNEY BOARD MEMBER 1.00 X 0 0 0 JOSEPH GERGELA BOARD MEMBER 10.00 X 0 0 0 RICHARD ISRAEL BOARD MEMBER 1.00 1.00 X 0 0 0 JOAN LEVAN BOARD MEMBER 1.00 1.00 X 0 0 0 MARILYN A MCLAUGHLIN MD BOARD MEMBER 1.00 X 0 0 0 RICHARD V MUSTO MD BOARD MEMBER 1.00 X 0 0 0 STEVEN OUZOUNIAN MD BOARD MEMBER 1.00 X 0 0 0 REUVEN PASTERNAK MD BOARD MEMBER 1.00 X 0 0 0 RICHARD RUBENSTIEN MD BOARD MEMBER 1.00 1.00 X 0 0 0 GEORGE RUGGIERO DO BOARD MEMBER 1.00 X 0 0 0 SCOTT B SHEREN MD BOARD MEMBER 10.00 X 0 0 0 WILLIAM SIEMERS BOARD MEMBER 1.00 X 0 0 0 GEORGE SUMMERS BOARD MEMBER 1.00 X 0 0 0 MARY YARUSSO BOARD MEMBER 1.00 X 0 0 0 RICHARD L WINSLOW BOARD MEMBER 1.00 1.00 X 0 0 0 JOSEPH VAN DE WETERING BOARD MEMBER 1.00 1.00 X 0 0 0 STANLEY ZINBERG MD BOARD MEMBER 1.00 1.00 X 0 0 0 ALAN SCHECHTER EXECUTIVE VICE PRESIDENT 37.50 X 445259 0 21525 MICHAEL O'DONNELL CHIEF FINANCIAL OFFICER 37.50 X 268602 0 51583 DEMETRIOS KADENAS CHIEF DEVELOPMENT OFFICER 37.50 X 186065 0 9528 JAY ZUCKERMAN CORPORATE COMPLIANCE OFFIC 37.50 X 210749 0 2775 RONALD MCMANUS COO OF PBHS 37.50 X 212438 0 51583 RICHARD KUBIAK CHIEF MEDICAL OFFICER 37.50 X 328332 0 51583 CHERYL MAKOSKE VP FINANCE 37.50 X 179509 0 22454 PETER SULTAN MD PHYSICIAN 37.50 X 1028568 0 44083 DAVID PRENTISS MD PHYSICIAN 37.50 X 257126 0 13000 MAHMOOD AFGHANI MD PHYSICIAN 37.50 X 232402 0 33789 JANE FRANZ SENIOR VP CHIEF PLANNING OFFICER 37.50 X 236496 0 0 STEPHEN JOHN MD PHYSICIAN 37.50 X 231647 0 20199 4637985 0 410409 107 0 1 0 SIEMENS PO BOX 7777W3580 PHILADELPHIA PA 19175 INFORMATION TECHNOLOGY 3366324 SODEXO PO BOX 81049 WOBURN MA 01813 CAFETERIA SERVICES 1506900 CROTHALL FACILITIES 955 CHESTERBROOK BLVD WAYNE PA 19087 HOUSEKEEPING SERVICES 587117 UNITEX TEXTILE 401 SO MACQUESTEN PKWY MT VERNON NY 10550 LAUNDRY & LINEN 493172 MATTOO & BHAT 23-14 COLLEGE POINT BLVD COLLEGE POINT NY 11356 DIALYSIS SERVICES 485491 13 334891 2469386 1222440 4026717 PATIENT CARE 621400 142691073 142691073 PROVISION OF MEDICAL SERVICES BY 621110 157280 157280 142848353 110054 110054 5243220 4194555 1048665 1048665 1048665 27405 334891 130137 -102732 -102732 MEANINGFUL USE 900099 1989246 1989246 SELF INSURANCE TRUST 900099 416082 416082 CAFETERIA 624210 337020 337020 418895 418895 3161243 151092300 142848353 0 4272077 2951084 2951084 57576405 44416188 13160217 4380650 2749971 1630679 11591148 9857359 1733789 4237445 3261031 976414 739033 739033 177000 177000 10785 10785 65196 65196 11577944 11185252 392692 683062 536361 146701 27888581 20730344 7158237 3336324 3336324 5551426 5551426 123241 94843 28398 208055 208055 5906796 5906796 3317500 3317500 NEW YORK STATE ASSESSME 750229 750229 6139016 4724431 1414585 147210920 113289786 33774433 146701 13350611 15193448 6102830 6148837 3815070 2906560 14969476 14595591 4201170 5651299 3277580 3164225 653411 879896 141581503 78045012 59782553 63536491 4845519 4246607 1270284 8051581 7037925 119049801 124631163 19892668 21678518 38260000 36210000 7550803 8209226 38782414 34603037 104485885 100700781 X 8057925 18915554 5719083 4227920 786908 786908 14563916 23930382 119049801 124631163 X 3881380 75400 65196 5344490 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 10785 10785 0 PART II-B, LINE 1: PORTION OF MEMBERSHIP DUES ASSOCIATED WITH LOBBYING ACTIVITIES X 0 786908 100483 100483 786908 786908 36084 36084 786908 786908 1368 1368 786908 786908 61625 61625 786908 786908 90497 90497 786908 1.00000 0 0 380654 380654 47407313 40570359 6836954 93056889 37402625 55654264 736647 72028 664619 63536491 EQUITY INTEREST IN THE CENTRAL SUFFOLK HOSPITAL FOUNDATION/ DBA PECONIC BAY 2748862 DEFERRED EXPENSES 2329160 ESTIMATED DUE FROM THIRD PARTY PAYORS 1959903 7037925 ESTIMATED MALPRACTICE COSTS 11658989 ESTIMATED DUE TO THIRD-PARTY PAYORS 6481763 DUE TO AFFILIATE 9000000 SWAP LIABILTY 5531826 ACCRUED PENSION COSTS 1930459 34603037 X 156512190 75400 5344490 5419890 151092300 0 151092300 147210920 0 147210920 0 147210920 PART III, LINE 4: THE DONATED ARTWORK PROVIDES A SOOTHING AND CALMING ENVIRONMENT TO THE PATIENTS AND THEIR FAMILIES WHEN THEY ATTEND THE HOSPITAL FOR MEDICAL SERVICES. THE HOSPITAL HOPES THAT WITH A GOOD EXPERIENCE, THEIR PATIENTS CONTINUE TO UTILIZE THE HOSPITAL TO PROVIDE MEDICAL SERVICES. PART V, LINE 4: ENDOWMENT FUNDS HAVE BEEN RESTRICED BY DONORS TO BE MAINTAINED BY CSH IN PERPETUITY, THE INCOME FROM WHICH IS AVAILABLE FOR GENERAL PURPOSES. PART X, LINE 2: CSH HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PERIODS ENDING DECEMBER 31, 2010 AND SUBSEQUENT REMAIN SUBJECT TO EXAMINATION BY APPLICABLE TAXING AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: GAIN ON SWAP AGREEMENT 3,968,892. PENSION ADJUSTMENTS 3,015,080. CHANGE IN EQUITY INTEREST IN CENTRAL SUFFOLK HOSPITAL FOUNDATION -639,482. NET ASSETS RELEASED FROM RESTRICTIONS -1,000,000. ANNUAL BALL 362296 334891 27405 20000 2289 48326 9000 50522 362296 334891 27405 20000 2289 48326 9000 50522 130137 -102732 1 1 1 X 300.000000000000 1 X 1 1 1 0 1 1 2236285 307524 1928761 0.01310 21785805 10140267 11645538 0.07910 24022090 10447791 13574299 0.09220 4994805 2087143 2907662 0.01980 13868016 3509674 10358342 0.07040 18862821 5596817 13266004 0.09020 42884911 16044608 26840303 0.18240 1 5576001 16400002 42917327 52787862 -9870535 X 1 1 1 1 PECONIC BAY MEDICAL CENTER 1300 ROANOKE AVENUE RIVERHEAD NY 11901 X X X X PECONIC BAY MEDICAL CENTER 1 1 X X X X X X X X 13 1 0 1 X WWW.PBMCHEALTH.ORG X X X X X X X X 1 0 1 0 1 300.000000000000 0 1 1 X X X X X X 1 X X X 1 X X X X X X X 1 X 0 0 PECONIC BAY MEDICAL CENTER PART V, SECTION B, LINE 3: THE PRIMARY ORGANIZATIONAL APPROACH THAT CENTRAL SUFFOLK HOSPITAL USES FOR COMMUNITY INVOLVEMENT AND PERSPECTIVE IS THROUGH VARIOUS COMMITTEES AND PARTNERSHIPS. THE NEEDS OF THE COMMUNITY ARE CONTINUALLY ASSESSED BY THE CSH HEALTH BOARD OF DIRECTORS, EAST END HEALTH ALLIANCE BOARDOF TRUSTEES, CSH HEALTH AND THE MEDICAL CENTER MANAGEMENT AND STAFF, VOLUNTEERS, AND LOCAL LEADERS OF LOCAL NOT-FOR-PROFIT ORGANIZATIONS AND GOVERNMENTAL AGENCIES. CSH INFORMS THE PUBLIC ABOUT COMMUNITY PROGRAMS IN A NUMBER OF WAYS: DIRECT MAIL, FLYERS, NEWSLETTERS, SEMINARS, CALENDAR LISTINGS, E-MAIL COMMUNICATIONS, TELEPHONE INFORMATION LINES,NEWSPRINT ADVERTISING, AND LOCAL CABLE TELEVISION. COMMUNITY MEMBERS ARE ENCOURAGED TO GIVE THEIR PERSPECTIVE ON CSH'S COMMUNITY PROGRAMS VIA E-MAIL AND SURVEYS THAT ARE COLLECTED AT MANY OF ITS PUBLIC EVENTS. PECONIC BAY MEDICAL CENTER PART V, SECTION B, LINE 20D: RATES OF THE HIGHEST VOLUME PAYOR. 1 RIVERHEAD MANAGEMENT CORPORATION 1300 ROANOKE AVENUE REVERHEAD NY 11901 MANAGEMENT SERVICE ORGANIZATION PART III, LINE 4: BAD DEBT EXPENSES ON ACCOUNTS RECEIVABLE AND CONTRIBUTIONS RECEIVABLE ARE CHARGED IF THE RECEIVABLE IS DETERMINED TO BE UNCOLLECTIBLE BASED ON PERIODIC REVIEW BY MANAGEMENT. FACTORS USED TO DETERMINE WHETHER AN ALLOWANCE SHOULD BE RECORDED INCLUDE THE AGE OF THE RECEIVABLE AND A REVIEW OF PAYMENTS SUBSEQUENT TO YEAR END. PART III, LINE 9B: PECONIC BAY MEDICAL CENTER TAKES THE DISCOUNTED AMOUNT AFTER CHARITY (SELF PAY BALANCE) AND FOLLOWS THE SAME GUIDELINES AS SELF PAY. PART VI, LINE 2: PECONIC BAY MEDICAL CENTER WAS AN ACTIVE PARTICIPANT IN THE COLLABORATIVE PLANNING PROCESS WITH THE SUFFOLK COUNTY DEPARTMENT OF HEALTH AND COMMUNITY PARTNERS TO ASSESS COMMUNITY HEALTH NEEDS IDENTIFY HEALTH PRIORITIES AND DEVELOP PUBLIC HEALTH PROGRAMS TO MEET THE IDENTIFIED NEEDS. THIS COLLABORATIVE GROUP MET FROM THE FALL OF 2008 THROUGH AUGUST OF 2009, AND SELECTED TOBACCO USE AND UNINTENTIONAL INJURY AS THE TWO HEALTH PRIORITIES IDENTIFIED IN THE NEW YORK STATE PREVENTION AGENDA TOWARD THE HEALTHIEST STATE.SMOKING CESSATION WAS SELECTED BECAUSE THE USE OF TOBACCO IS THE NUMBER ONE UNDERLYING RISK FACTOR FOR MULTIPLE DISEASES. MOREOVER, NASSAU AND SUFFOLK COUNTIES SUFFER FROM SOME OF THE HIGHEST MORTALITY RATES FROM HEART DISEASE IN NEW YORK STATE. UNINTENTIONAL INJURIES WAS SELECTED AS A PRIORITY GIVEN THE FACT THAT SUFFOLK COUNTY HAS A RELATIVELY HIGH MORTALITY RATE FOR UNINTENTIONAL INJURIES WHEN COMPARED TO NEW YORK STATE AND NATIONALLY. THE GROUP ALSO AGREED THAT GIVEN THE SHORTAGE OF RESOURCES AVAILABLE TO ADVANCE PUBLIC HEALTH AGENDAS, IT WAS IMPORTANT TO SELECT PRIORITIES THAT COULD BUILD ON PROGRAMS THAT ARE ALREADY IN PLACE.BOTH SMOKING CESSATION AND PROGRAMS TO REDUCE UNINTENTIONAL INJURIES ACCOMPLISH THIS GOAL. ONE OF THE PRIORITY INITIATIVES FOR THE SUFFOLK COUNTY OFFICE OF HEALTH EDUCATION IS TO DEVELOP AND IMPLEMENT EFFECTIVE ANTI-SMOKING PROGRAMS THAT WILL REDUCE THE RATE OF TOBACCO USE IN SCHOOL-AGED CHILDREN. IN ADDITION, MANY OF THE HOSPITALS IN SUFFOLK COUNTY, INCLUDING PECONIC BAY MEDICAL CENTER HAVE PROGRAMS AND SUPPORT GROUPS IN PLACE TO WORK WITH THEIR EMPLOYEES AND COMMUNITY BASED ORGANIZATIONS TO REDUCE SMOKING. COMMUNITY BASED PROGRAMS AUGMENT COUNTY AND HOSPITAL EFFORTS IN REDUCING TOBACCO USE. THE TOBACCO ACTION COALITION AND HEALTHY MOTHERS/HEALTHY BABY COALITION WILL BE SOUGHT OUT TO ENGAGE IN COLLABORATIVE EFFORTS AS WELL.THERE ARE ALSO A NUMBER OF EXISTING PROGRAMS IN SUFFOLK COUNTY THAT HAVE DEVELOPED STRATEGIES FOR REDUCING THE INCIDENCE OF UNINTENTIONAL INJURIES. THE COUNTY'S BUREAU OF PUBLIC HEALTH NURSING PROVIDES HOME HEALTH CARE SERVICES FOR PATIENTS SUFFERING THE SEQUELAE OF UNINTENTIONAL INJURIES. THE COUNTY ALSO PROVIDES EDUCATION AND SUPPORT TO MOTHERS AND CHILDREN AIMED AT PREVENTING INJURIES FROM BURNS. A PARTNERSHIP BETWEEN ST. JOSEPHS COLLEGE AND THE SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES HAS HELP IDENTIFY THE APPROPRIATE TARGET POPULATION FOR EDUCATION AND INTERVENTIONS TO REDUCE THESE INJURIES. FINALLY, ARTICLE 6 FUNDS CAN BE USED BY THE SUFFOLK COUNTY HEALTH DEPARTMENT CONSISTENT WITH NEW YORK STATE'S HEALTH AGENDA TO REDUCE THESE INJURIES.THESE TWO PRIORITIES WILL BE A MAJOR OPERATIONAL COMMITMENT OF PECONIC BAY MEDICAL CENTER OVER THE NEXT THREE YEARS. THE MEDICAL CENTER WILL CONTINUE TO COLLABORATE WITH THE SUFFOLK COUNTY DEPARTMENT OF HEALTH AND COMMUNITY PARTNERS IN ENSURING THAT WE REACH THE GOALS SET FOR THESE TWO PRIORITY AREAS, MEASURE PROGRESS IN ACHIEVING THESE GOALS AND ELIMINATING RACIAL, ETHNIC AND SOCIOECONOMIC HEALTH DISPARITIES WHERE THEY EXIST.ONCE THE PLANNING GROUP ADOPTED THESE PRIORITIES, REPRESENTATIVES FROM THE SUFFOLK COUNTY DEPARTMENT OF HEALTH, SUFFOLK COUNTY HOSPITALS, INCLUDING PECONIC BAY MEDICAL CENTER AND COMMUNITY REPRESENTATIVES DIVIDED INTO TWO WORK GROUPS. EACH WORK GROUP WAS CHARGED WITH DEVELOPING A SET OF RECOMMENDATIONS TO IMPLEMENT EFFECTIVE STRATEGIES TO ADDRESS BOTH HEALTH CARE PRIORITIES. PART VI, LINE 4: THE MEDICAL CENTER'S PRIMARY SERVICE AREA INCLUDES THE FOLLOWING ZIP CODES: RIVERHEAD (11901); CALVERTON (11933): MANORVILLE (11949). THESE ZIP CODES ACCOUNT FOR FIFTY PERCENT OF THE MEDICAL CENTER'S TOTAL DISCHARGES.THE MEDICAL CENTER'S SECONDARY SERVICE AREA INCLUDES THE FOLLOWING ZIP CODES: HAMPTON BAYS (1946); EAST QUOGUE (11942); MATTITUCK (11952); WESTHAMPTON BEACH (11978); EASTPORT (11941); CENTER MORICHES (11934); EAST MORICHES (11940); WESTHAMPTON (11977); CUTCHOGUE (11935); SHIRLEY (11967); WADING RIVER (11792): SOUTHOLD (11971); RIDGE (11961); MASTIC (11950); GREENPORT (11944); AND LAUREL (11948). THESE ZIP CODES ACCOUNT FOR THIRTY-FIVE PERCENT OF THE MEDICAL CENTER'S TOTAL DISCHARGES.THE SERVICE HAS MORE THAN 191,000 RESIDENTS AND THE POPULATION IS EXPECTED TO GROW BY FIVE PERCENT FROM 2008 TO 2013. AS THE POPULATION OF THIS REGION CONTINUES TO GROW AND IS DRIVING INCREASED DEMAND FOR HEALTH CARE SERVICES, THE MEDICAL CENTER HAS RESPONDED BY MAKING CAPITAL INVESTMENTS IN EMERGENCY ROOM AND SURGICAL SERVICES, AND THE RECRUITMENT OF PHYSICIANS TO BE ABLE TO MEET THESE NEEDS.THE SERVICE AREA HAS A SIGNIFICANTLY HIGHER PERCENTAGE OF ELDERLY THAN SUFFOLK COUNTY, NASSAU COUNTY AND NEW YORK STATE. APPROXIMATELY ONE IN FIVE RESIDENTS OF THE MEDICAL CENTER'S SERVICE AREA ARE OVER THE AGE OF FIFTY-FIVE,THE POPULATION THAT DRIVES HIGHER DEMAND FOR HEALTH CARE SERVICES. MOREOVER, THIS AGE COHORT IS EXPECTED TO INCREASE AS A PERCENTAGE OF THE TOTAL POPULATION OVER THE NEXT FIVE YEARS.THE HOSPITAL HAS DEVELOPED PROGRAMS, ENHANCED ORTHOPEDICS AND NEUROSURGICAL SERVICES, ENHANCED HOME HEALTH CARE AND SKILLED NURSING SERVICES THAT ARE SPECIFICALLY GEARED TOWARDS MEETING THE UNIQUE HEALTH CARE NEEDS OF THIS POPULATION.TO THE EXTENT THAT THERE ARE HEALTH CARE DISPARITIES BASED ON RACE AND ETHNICITY, THE EAST END OF SUFFOLK COUNTY FACES A CHALLENGE WITH A HIGH PROPORTION OF MINORITY RESIDENTS -- AN AVERAGE OF TWENTY PERCENT -- BUT AS HIGH AS THIRTY-THREE PERCENT IN SOME OF THE PRIMARY AND SECONDARY SERVICE AREAS.THERE ARE NO FIRM ESTIMATES OF THE NUMBER OF MIGRANT AGRICULTURAL WORKERS THAT COME INTO THIS AREA. AGRICULTURE IS ONE OF SUFFOLK COUNTY'S LEADING INDUSTRIES. ITS SUCCESS RELIES ON WORKERS WHO MOVE THROUGH THE EASTERN UNITED STATES IN RESPONSE TO THE AVAILABILITY OF SEASONAL WORK. PECONIC BAY MEDICAL CENTER RECOGNIZES THAT THIS POPULATION PRESENTS SERIOUS HEALTH PROBLEMS AND IS COMMITTED TO PROVIDING CARE FOR ITS CULTURALLY DIVERSE PATIENT POPULATION. MANY OF THESE INDIVIDUALS ARE UNINSURED AND UNABLE TO SPEAK ENGLISH. THEY RELY ON THE MEDICAL CENTER'S EMERGENCY DEPARTMENT, AS WELL AS THE SUFFOLK COUNTY HEALTH CLINIC, LOCATED IN RIVERHEAD, FOR HEALTH CARE. THE HOSPITAL PROVIDES BI-LINGUAL PUBLICATIONS AND SIGNAGE AND ACTIVELY ASSISTS THE CULTURALLY DIVERSE COMMUNITIES THAT ARE CARED FOR AT THE MEDICAL CENTER.PUBLIC PARTICIPATION:PECONIC BAY MEDICAL CENTER HAS AN EXTENSIVE PROGRAM OF COMMUNITY OUTREACH THAT IS COMPLEMENTED BY THE EFFORTS OF THE EAST END HEALTH ALLIANCE, THE MEDICAL CENTER'S ACTIVE PARENT. INPUT ON THE COMMUNITY SERVICE PLAN IS RECEIVED FROM BOTH INTERNAL AND EXTERNAL SOURCES. NEEDS ARE ASSESSED ON AN ANNUAL BASIS BY THE BOARD OF TRUSTEES, MEDICAL CENTER MANAGEMENT AND STAFF, VOLUNTEERS, AND LEADERS OF LOCAL NOT-FOR-PROFIT ORGANIZATIONS AND GOVERNMENTAL AGENCIES.COMMUNITY PROGRAMS ARE PUBLICIZED IN A VARIETY OF WAYS: DIRECT MAIL, FLYERS, CALENDAR LISTINGS, E-MAIL COMMUNICATIONS, TELEPHONE INFORMATION LINES, NEWSPRINT ADVERTISING, AND LOCAL CABLE TELEVISION. COMMUNITY MEMBERS ARE ENCOURAGED TO OFFER INPUT ON PECONIC BAY MEDICAL CENTER'S COMMUNITY PROGRAMS BY E-MAIL AND VIA SURVEYS COLLECTED AT PUBLIC EVENTS. THE MEDICAL CENTER'S PRESIDENT AND CHIEF EXECUTIVE OFFICER AND OTHER SENIOR STAFF REGULARLY MEET WITH COMMUNITY GROUPS FROM THE EAST END REGION OF LONG ISLAND TO KEEP AREA RESIDENTS INFORMED ABOUT MEDICAL CENTER PROGRAMS AND TO RECEIVE FEEDBACK AND FIELD QUESTIONS FROM THE COMMUNITY.THE MEDICAL CENTER'S WEB SITE WWW.PBMEDICALCENTER.ORG OFFERS A USER-FRIENDLY FORMAT AND EASY ACCESS TO INFORMATION ON MEDICAL CENTER SERVICES AND PROGRAMS. IN ADDITION, THE SITE ALLOWS FOR PHYSICIAN SEARCHES, ON-LINE INQUIRIES AND ON-LINE JOB APPLICATIONS.SERVICES FOR SHORT-TERM AND LONG-TERM CARE FOR CHRONIC AND ACUTE ILLNESS ARE CONTINUALLY EVALUATED THROUGH STATISTICAL DATA THAT INCLUDE QUALITY INDICATORS AND PATIENT OUTCOMES. THIS DATA IS COMPARED NATIONALLY WITH OTHER HEALTH FACILITIES AND INFORMS THE HOSPITAL'S STRATEGIC PLAN AND COMMUNITY SERVICE PLAN. THE MEDICAL CENTER'S STRATEGIC PLANNING COMMITTEE INCLUDES COMMUNITY MEMBERS, MEDICAL CENTER STAFF AND MEDICAL CENTER AND FOUNDATION BOARD MEMBERS WHO WORK COLLABORATIVELY TO ASSESS COMMUNITY NEEDS AND DEVELOP STRATEGIES TO MEET THESE NEEDS. THE EXTERNAL AFFAIRS COMMITTEE WAS ESTABLISHED TO ENHANCE COMMUNICATION BETWEEN THE MEDICAL CENTER AND THE COMMUNITIES IT SERVES. MEMBERS OF THE COMMITTEE INCLUDE A CROSS-SECTION OF PHYSICIANS, NURSES, MEDICAL CENTER MANAGEMENT, MEDICAL CENTER EMPLOYEES AND COMMUNITY VOLUNTEERS.THE MEDICAL CENTER HAS A LONGSTANDING COMMITMENT AND EXPERIENCE IN OUTREACH HAVING ADMINISTERED THE SUFFOLK COUNTY DEPARTMENT OF HEALTH'S WOMEN'S HEALTH PARTNERSHIP FOR THE PAST FIVE YEARS. THIS PROGRAM PROVIDES NO-COST BREAST CANCER SCREENING AND DIAGNOSTIC SERVICES TO WOMEN WHO ARE UNINSURED, AS WELL AS SCREENING FOR PROSTATE, COLORECTAL AND GYNECOLOGIC ONCOLOGY FOR BOTH MEN AND WOMEN. IT ALSO PROVIDES PATIENT NAVIGATION AND COORDINATION OF SERVICES FOR WOMEN DIAGNOSED WITH BREAST AND CERVICAL CANCER THROUGH THE SCREENING PROGRAM. THE MEDICAL CENTER PROVIDES INFORMATION AND SUPPORT SERVICES IN SPANISH TO ACCOMMODATE THOSE WOMEN WHO ARE NOT PROFICIENT IN ENGLISH. THE PARTNERSHIP MODEL WAS CONCEIVED AND IMPLEMENTED BASED ON THE PRINCIPLE THAT COMMUNITY MEMBERS ARE THE BEST PEOPLE TO IDENTIFY THE NEEDS OF THEIR COMMUNITY AND TO CARRY OUT A PLAY OF ACTION THAT ADDRESSES THOSE NEEDS.RESPONDING TO THE NEEDS OF THE COMMUNITY FOR OBSTETRICAL CARE, INCLUDING THOSE WHO ARE UNDER OR UNINSURED, PECONIC BAY MEDICAL CENTER PROVIDES OBSTETRICAL AND GYNECOLOGICAL SERVICES TO THE SUFFOLK COUNTY HEALTH CENTER. IN ADDITION, A SEPARATE GROUP OF PRIMARY CARE PHYSICIANS PROVIDE CARE TO ANY RIVERHEAD HEALTH CENTER PATIENT WHO NEEDS TO BE ADMITTED TO THE MEDICAL CENTER. IN CONJUNCTION WITH SUFFOLK COUNTY, THE MEDICAL CENTER OPERATES A SECURED FORENSIC UNIT FOR INMATES OF THE SUFFOLK COUNTY JAIL WHO REQUIRE HOSPITALIZATION. THE MEDICAL CENTER PROVIDES FREE FLU SHOTS TO RESIDENTS OF THE COMMUNITY WHO ARE AT HIGH RISK FOR INFLUENZA. THE MEDICAL CENTER ALSO HAS RESPONDED TO COMMUNITY NEEDS BY SPONSORING A NUMBER OF COMMUNITY HEALTH FAIRS OFFERING FREE BLOOD PRESSURE, CHOLESTEROL AND GLUCOSE SCREENINGS AS WELL AS PROVIDING IMPORTANT HEALTH AND WELLNESS INFORMATION. THESE HEALTH FAIRS ALSO CREATE THE OPPORTUNITY FOR MEDICAL CENTER STAFF TO OBTAIN IMPORTANT COMMUNITY FEEDBACK, INFORMATION THAT IS SHARED WITH MEDICAL CENTER LEADERSHIP AND CONSIDERED IN FUTURE COMMUNITY OUTREACH.SUPPORTING THIS EDUCATIONAL OUTREACH AND OPPORTUNITY FOR COMMUNITY INPUT, THE MEDICAL CENTER HAS A SPEAKERS BUREAU THAT PROVIDES PROFESSIONAL INPUT RELATED TO HEALTH AND WELLNESS TOPICS, HEALTH HEART DIET, TREATING OVARIAN CANCER, ETC.BASED ON COMMUNITY INPUT, THE MEDICAL CENTER HAS ALSO LAUNCHED PROJECT CARE IN CONJUNCTION WITH STONY BROOK UNIVERSITY'S SCHOOL OF HEALTH MANAGEMENT AND TECHNOLOGY. THIS PROGRAM PROVIDES IN-HOME MONITORING FOR HIGH-RISK PATIENTS THAT WOULD OTHERWISE HAVE DIFFICULTY ACCESSING CARE. THE MEDICAL CENTER HAS ALSO RESPONDED TO COMMUNITY INPUT FROM THE REGIONS AMBULANCE CORPS AND WITH THE SUPPORT OF STONY BROOK PROVIDES THREE FIRST RESPONDER VEHICLES THAT AUGMENT THE LOCAL EMS DURING PEAK HOURS.PBMC WAS SUCCESSFUL IN OBTAINING FUNDING FOR A PATIENT TRANSPORTATION VAN THAT PROVIDES TRANSPORT ROOM OUR SKILLED NURSING FACILITY FOR MEDICAL SERVICES, AS WELL AS PATIENTS FROM OTHER COMMUNITY NURSING HOMES THAT MAY NEED RADIOLOGY OR LABORATORY TESTING.COMMUNITY ORGANIZATION PARTICIPATION: THE HOSPITAL ALSO ROUTINELY SEEKS FEEDBACK FROM COMMUNITY MEMBERS WHO PARTICIPATE IN OUR COMMUNITY OUTREACH PROGRAMS. PECONIC BAY MEDICAL CENTER HAS SIGNIFICANT REPRESENTATION ON A WIDE-RANGE OF COMMUNITY ORGANIZATIONS THAT FACILITATE INPUT FROM RESIDENTS, CORPORATE AND COMMUNITY LEADERS, PATIENTS AND ALLIED HEALTH PROFESSIONS. THIS PARTICIPATION SUPPORTS EFFECTIVE INPUT FROM THE COMMUNITY THROUGH MEDICAL CENTER STAFF AND MEDICAL CENTER TRUSTEE PARTICIPATION COMPLEMENTED BY A CONTINUAL AND OPEN DIALOGUE WITH RESPECTED COMMUNITY LEADERS. X X X X 1 1 0 1 0 0 0 1 0 ANDREW MITCHELL CHIEF EXECUTIVE OFFICER/PRESIDENT 567112 0 6500 0 774 0 23000 0 31252 0 628638 0 0 0 GERARD ZUNNO COO / BOARD MEMBER 245632 0 0 0 774 0 15000 0 19055 0 280461 0 0 0 ALAN SCHECHTER EXECUTIVE VICE PRESIDENT 85496 0 0 0 359763 0 5899 0 15626 0 466784 0 0 0 MICHAEL O'DONNELL CHIEF FINANCIAL OFFICER 268188 0 0 0 414 0 23000 0 28583 0 320185 0 0 0 DEMETRIOS KADENAS CHIEF DEVELOPMENT OFFICER 185927 0 0 0 138 0 0 0 9528 0 195593 0 0 0 JAY ZUCKERMAN CORPORATE COMPLIANCE OFFIC 48870 0 0 0 161879 0 1525 0 1250 0 213524 0 0 0 RONALD MCMANUS COO OF PBHS 211664 0 0 0 774 0 23000 0 28583 0 264021 0 0 0 RICHARD KUBIAK CHIEF MEDICAL OFFICER 327144 0 0 0 1188 0 23000 0 28583 0 379915 0 0 0 CHERYL MAKOSKE VP FINANCE 179239 0 0 0 270 0 5304 0 17150 0 201963 0 0 0 PETER SULTAN MD PHYSICIAN 417382 0 611006 0 180 0 15500 0 28583 0 1072651 0 0 0 DAVID PRENTISS MD PHYSICIAN 256712 0 0 0 414 0 13000 0 0 0 270126 0 0 0 MAHMOOD AFGHANI MD PHYSICIAN 232258 0 0 0 144 0 5206 0 28583 0 266191 0 0 0 JANE FRANZ SENIOR VP CHIEF PLANNING OFFICER 235308 0 0 0 1188 0 0 0 0 0 236496 0 0 0 STEPHEN JOHN MD PHYSICIAN 206500 0 24900 0 247 0 4301 0 15898 0 251846 0 0 0 PART I, LINE 3 THE HOSPITAL UTILIZES SALARY SURVEYS AND REVIEWS THEM WITH THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE PROCESS WAS PERFORMED IN 2012 PART I, LINES 4A-B ALAN SCHECHTER (SEVERANCE) - $359,763 JAY ZUCKERMAN (SEVERANCE) - $161,879 ANDREW MITCHELL (NON-QUALIFIED RETIREMENT PLAN) - $17,000 PART I, LINE 5 THE MEDICAL CENTER HAS A CONTRACTUAL ARRANGEMENT FOR A PHYSICIAN ENTITLING THE PHYSICIAN TO ADDITIONAL COMPENSATION BASED UPON CASH COLLECTIONS. PART I, LINE 7 PERFORMANCE BASED ON BOARD DISCRETION. AN EMPLOYMENT AGREEMENT IS IN PLACE WITH THE HOSPITAL WITH THE CEO A TOWN OF RIVERHEAD INDUSTRIAL DEVELOPMENT AGENCY 112560077 768765AB5 2006-06-23 35000000 CONSTRUCTION OF FACILITY AND REFUNDING OF PRIOR ISSUE (8/12/1993) 0 0 0 B TOWN OF RIVERHEAD INDUSTRIAL DEVELOPMENT AGENCY 112560077 768765AE9 2007-06-27 12000000 CONSTRUCTION OF FACILITY 0 0 0 A 9695000 36622284 700000 359652 24392812 11169820 2008 1 0 1 1 B 1095000 12350712 5009217 50272 240000 307959 11752481 2009 0 0 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 A 0 0 1 1 1 1 HSBC BANK 25.000000000000 0 0 1 MBIA INC 2.200000000000 1 0 0 B 0 0 0 1 1 1 HSBC BANK 25.000000000000 0 0 0 0 0 A 0 B 0 RICHARD ISRAEL BOARD MEMBER 392567 RENTAL OF PROPERTY 0 STEVEN OUZOUNIAN MD BOARD MEMBER 75000 AGREEMENT FOR DIRECTORSHIP 0 FORM 990, PART III, LINE 2 IN SEPTEMBER 2013, CSH OPENED THE CAMPUS FOR ADVANCED AMBULATORY AND PREVENTIVE CARE IN MANORVILLE, NEW YORK. THE CAMPUS HAS A WALK-IN URGENT CARE CENTER AS WELL AS PRACTICES SPECIALIZING IN FAMILY CARE, PEDIATRICS AND OB/GYN. ANOTHER BUILDING CURRENTLY IN CONSTRUCTION WILL INCLUDE ADVANCED-TECHNOLOGY OFFICE SPACE FOR UROLOGY SERVICES, A DIGESTIVE DISEASE CENTER, AND GENERAL SURGERY. FORM 990, PART VI, SECTION B, LINE 11 THE CHIEF EXECUTIVE OFFICER / PRESIDENT, CHIEF OPERATING OFFICER AND CHIEF FINANCIAL OFFICER REVIEW THE 990. A COPY OF THE 990 IS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW. IN THE EVENT OF ANY ISSUES WITH THE 990, THE MATTERS ARE BROUGHT TO THE ATTENTION OF THE CHIEF FINANCIAL OFFICER. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICTS OF INTEREST POLICY APPLIES TO MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS, VICE PRESIDENTS, ASSISTANT VICE PRESIDENTS, DEPARTMENT HEADS, CLINICAL DIRECTORS OF DEPARTMENTS, AND OTHER EMPLOYEES (INCLUDING PHYSICIANS) WHO ARE IN A POSITION TO INFLUENCE ANY SUBSTANTIVE BUSINESS DECISION BETWEEN THE MEDICAL CENTER AND A VENDOR. THE DIRECTOR OF CORPORATE COMPLIANCE CONTINUOUSLY MONITORS ALL TRANSACTIONS TO DETERMINE IF ANY POTENTIAL CONFLICT EXISTS. IF IT IS DETERMINED THAT A POTENTIAL CONFLICT EXISTS, THE INDIVIDUAL IS PROHIBITED FROM PARTICIPATING IN THE DECISIONS OF THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 CENTRAL SUFFOLK HOSPITAL D/B/A PECONIC BAY MEDICAL CENTER, A RELATED ORGANIZATION, UTILIZES SALARY SURVEYS AND REVIEWS THEM WITH THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE PROCESS WAS LAST PERFORMED IN 2013. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: PENSION ADJUSTMENT TO REFLECT FUNDED STATUS 3,015,080. GAIN ON SWAP AGREEMENT 3,968,892. CHANGE IN EQUITY INTEREST IN CENTRAL SUFFOLK HOSPITAL FOUNDATION -639,482. NET ASSETS RELEASED FROM RESTRICTIONS -1,000,000. FORM 990, PART XI, LINE 2C: THE PROCESS HAS NOT CHANGED FROM PRIOR YEARS. PECONIC BAY MEDICAL CENTER FOUNDATION 1300 ROANOKE AVENUE RIVERHEAD NY 11901 200714587 FUNDRAISING/PHILANTHROPIC NY 501(C)(3) 7 PECONIC BAY HEALTH SYSTEM 0 EAST END HEALTH ALLIANCE 201 MANOR PLACE GREENPORT NY 11944 113407476 PARENT COMPANY OF PBMC, SOUTHAMPTON HOSPITAL, EASTERN LONG ISLAND HOSPITAL NY 501(C)(3) 11, TYPE I N/A 0 PECONIC BAY HEALTH SYSTEMS 1300 ROANOKE AVENUE RIVERHEAD NY 11901 112761795 PARENT COMPANY OF PBMC NY 501(C)(3) 11, TYPE I N/A 0 RIVERHEAD MANAGEMENT CORPORATION 1300 ROANOKE AVENUE RIVERHEAD NY 11901 112800287 MANAGEMENT SERVICE ORGANIZATION NY N/A C 0 0 0 0 1 1 0 0 0 0 1 0 0 1 1 1 1 1 0 0 RIVERHEAD MANAGEMENT CORPORATION D 677747 COST