2014-11-14T14:08:18-06:00 2013-12-31 KPMG LLP 345 Park Avenue New York NY 101540102 990 2013-01-01 146049030 CATSKILL REGIONAL MEDICAL CENTER % CATSKILL REGIONAL MEDICAL CE CATS 8457943300 PO BOX 800 Suite HARRIS NY 12742 GERARD GALARNEAU CEO/CMO 8457943300 2014-11-13 true KPMG LLP P00431862 8457943300 2013 2015-11-30 17:44:51Z GERARD J GALARNEAU C/O CRMC PO BOX 800 HARRIS NY 12742 128114854 false X WWW.CRMCNY.ORG X 1967 NY THE MISSION OF CATSKILL REGIONAL MED. CTR IS TO IMPROVE THE HEALTH OF THE COMMUNITY BY PROVIDING EXCEPTIONAL HEALTH CARE OVER A BROAD RANGE OF QUALITY HEALTHCARE SERVICES 9 8 897 85 233022 -33920 1405522 15909626 95205019 96315351 260500 741562 69849 473319 96940890 113439858 0 0 0 0 55898954 52039039 0 0 0 43960566 41986093 99859520 94025132 -2918630 19414726 70587643 60736540 64013847 34331128 6573796 26405412 X SEE SCHEDULE O false false 35575911 0 44555933 EXPENSES INCURRED WHILE PROVIDING INPATIENT MEDICAL SURGICAL SERVICES, OBSTETRICS, NEWBORN CARE SERVICES, AND BIO-CHEMICAL DEPENDENCY CARE SERVICES TO 4,149 PATIENTS IN THE SURROUNDING COMMUNITY. 17941011 0 16775810 CRMC PROVIDES REFERRED AMBULATORY SERVICES SUCH AS LABORATORY, IMAGING, CANCER SCREENING, CARDIAC CARE, AND REHABILITATION THERAPY SERVICES TO PATIENTS IN THE SURROUNDING COMMUNITY. EXPENSES INCURRED WHILE PROVIDING 48,914 REFERRED AMBULATORY SERVICES. 5608209 0 5253745 CRMC PROVIDES OUTPATIENT CLINICAL SERVICES THROUGHOUT ITS CLINICS SPECIALIZED IN CARDIOLOGY, ENDOCRINOLOGY, WOUND CARE, ONCOLOGY/ HEMATOLOGY, FAMILY HEALTH AND WOMEN'S HEALTH SERVICES. EXPENSES INCURRED WHILE PROVIDING 13,952 CLINICAL SERVICES TO PATIENTS. 21579174 0 29729863 80704305 true true false true false false false false false true true false true true true true true false false false false false false false true false true true false false true false false false false false false true true false false false false false true false false false true 154 0 true 897 true true true false false false false true true false false false false X 9 8 true false false false true true true true true false false true true true true true true true true false NY X CATSKILL REGIONAL MEDICAL CE 8457943300 PO BOX 800 HARRIS NY 12742 MARC BAEZ SECRETARY 1.0 2.0 X X 0 0 0 BARBARA BLAKEY DIRECTOR 1.0 2.0 X 0 0 0 RICHARD LANDER DIRECTOR 1.0 2.0 X 0 0 0 JOSEPH LOUGHLIN VICE CHAIRMAN 1.0 2.0 X X 0 0 0 ANDREW PAVLOFF TREASURER 1.0 2.0 X X 0 0 0 JACQUELINE RICCIANI DIRECTOR 1.0 2.0 X 0 0 0 GERALD SKODA DIRECTOR 1.0 2.0 X 0 0 0 DARREL SUPAK CHAIRMAN 1.0 2.0 X X 0 0 0 MICHAEL WASCHITZ DIRECTOR 1.0 2.0 X 0 0 0 LOUIS RODRIGUES MD DIRECTOR UNTIL 7/1/13 1.0 2.0 X 0 0 0 ROLLAND V BOJO VP PATIENT CARE AND CNO 40.0 X 159212 0 28092 GERARD J GALARNEAU CEO AND CMO 40.0 2.0 X 288842 0 30780 BARBARA GENTILE CNO UNTIL 5/21/13 40.0 X 70507 0 12804 FREDERICK H KURIGER CEO UNTIL 5/21/13 40.0 X 346846 0 18212 PETER PANZARINO CMO UNTIL 1/1/13 40.0 X 62954 0 3775 MITCHELL AMADO VP FINANCE/CFO UNTIL 4/30/13 10.0 50.0 X 0 627473 59205 JOSEPH M ANESI VP/GENERAL COUNSEL 10.0 50.0 X 0 387560 48935 ROSEMARY A BACZEWSKI VP QUALITY AND HIM 10.0 50.0 X 0 258555 37371 SCOTT BATULIS PRESIDENT 10.0 55.0 X 0 1184993 64114 DEBORAH CARR VP HR UNTIL 12/31/13 10.0 50.0 X 0 302215 61711 GERARD DUNLAVEY EXE. DIR., GHVHS MEDICAL GROUP 10.0 50.0 X 0 289563 58478 JEFFREY F LIETO CPSO UNTIL 8/15/13 10.0 50.0 X 0 439108 46238 JOHN LYNCH CIO 10.0 50.0 X 0 284449 31270 STEPHEN SUGRUE VP COMPLIANCE 10.0 50.0 X 0 266171 52677 JOANNE HUBER-STURANS CHIEF HUMAN RESOURCES OFFICER 10.0 50.0 X 0 200920 9160 SANDRA IBERGER VP OPERATION 10.0 53.0 X 0 356198 61116 ROBERT KAHN PHYSICIAN 40.0 X 200385 0 25166 MOHAMMAD S KHAN PHYSICIAN 40.0 X 326908 0 35332 KHIN M MYO PHYSICIAN 40.0 X 245724 0 15381 ABDUL SHAHZAD PHYSICIAN 40.0 X 410419 0 35332 KHIN M SOE PHYSICIAN 40.0 X 211476 0 13674 2323273 4597205 748823 48 false true false CRYSTAL RUN HEALTHCARE LLP 155 CRYSTAL RUN ROAD MIDDLETOWN NY 10940 MEDICAL SERVICES 1882584 MORRISON MANAGEMENT SPECIALISTS PO BOX 102289 ATLANTA GA 30368 FOOD SERVICE 1380575 MCKESSON INFORMATION SOLUTIONS PO BOX 98347 CHICAGO IL 606938347 COMPUTER SERVICES 941816 FERRARI SONS INC 220 OVERROCKER ROAD POUGHKEEPSIE NY 12603 CONSTRUCTION SERV. 541591 CROTHAL HEALTHCARE INC 13028 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 HOUSEKEEPING SERV. 517330 47 71490 45017 15741097 52022 15909626 INPATIENT REVENUE 623990 37311088 37311088 SNU INPATIENT REVENUE 623000 5337600 5337600 PSYCH INPATIENT REVENUE 623000 3943341 3943341 INDIGENT CARE POOL REVENUE 623000 6862055 6862055 OUTPATIENT REVENUE 621990 34133026 33900004 233022 8728241 8728241 96315351 637414 637414 0 0 67980 3726 64254 0 64254 64254 14734862 6691 14637405 97457 6691 104148 104148 37303 71490 33865 3438 3438 0 0 LITIGATION SETTLEMENTS 900099 183960 183960 REBATES & REFUNDS 900099 221667 221667 405627 113439858 96082329 233022 1214881 0 0 0 0 1022024 934859 87165 81621 74660 6961 37727406 34509740 3217666 2789638 2551717 237921 7191022 6577720 613302 3227328 2952078 275250 4793374 3874615 918759 171048 171048 296820 296820 16674 16674 0 0 7206355 5489725 1716630 257822 102713 155109 3327303 853942 2473361 0 0 2014294 1985449 28845 41425 30970 10455 0 0 431821 354385 77436 0 4071533 3341409 730124 460870 460870 MEDICAL SUPPLIES 10410180 10387370 22810 BAD DEBTS 5487829 5487829 POSTAGE AND SHIPPING 77923 36376 41547 OTHER EXPENSES 2920822 1158748 1762074 0 94025132 80704305 13320827 0 4990421 6563165 2565882 413102 536506 1806898 12866917 11739377 0 0 0 0 0 0 1360073 1390941 131381 545464 125442098 100521443 24703351 24920655 13767860 1015974 0 0 2721178 3138914 0 0 6944074 9202050 70587643 60736540 15781764 15729128 0 0 0 0 34506040 0 0 0 0 0 0 5636531 1455390 984419 12270653 11981050 64013847 34331128 X 3545640 23010908 1069451 1435799 1958705 1958705 6573796 26405412 70587643 60736540 X 19414726 -128104 544994 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 16674 16674 false PART II-B, LINE 1I PERCENTAGE OF DUES PAID TO THE HOSPITAL ASSOCIATION OF NEW YORK (HANYS), NORTHERN METROPOLITAN HOSPITAL ASSOCIATION (NORMET) AND 1199 SEIU ALLOCATED TO LOBBYING. 1958705 1958705 1458705 500000 1958705 1457705 1000 1458705 1457705 1457705 1457705 1457705 1.00000 false true true 888426 888426 30732603 26765313 3967290 15166084 2819851 12346233 70691248 63982296 6708952 7963736 6953982 1009754 24920655 INTEREST IN CRMC FOUNDATION 3138914 F 3138914 DEFERRED FINANCING FEES 92430 INSURANCE RECEIVABLE 4835748 THIRD PARTY RECEIVABLE 2144365 OTHER RECEIVABLE 2129507 9202050 0 DUE TO THIRD PARTY PAYORS 4361425 ESTIMATED MALPRACTICE LIABILITY 7274851 OTHER LIABILITY 344774 11981050 X 113890613 -128104 578859 450755 113439858 113439858 94058997 33865 33865 94025132 94025132 SCHEDULE D PART V LINE 4 INTENDED USE OF ENDOWMENT FUNDS. THE ORGANIZATION HAS A PERMANENT ENDOWMENT FUND. THE INTEREST EARNED ON THIS FUND, IF ANY, CAN BE USE TO PURCHASE PATIENT EQUIPMENT. SCHEDULE D PART X LINE 2 - FIN 48 FOOTNOTE THE CENTER IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND IS EXEMPT FROM FEDERAL, STATE, AND LOCAL INCOME TAXES PURSUANT TO SECTION 501(A) OF THE CODE. THERE ARE CERTAIN TRANSACTIONS THAT COULD BE DEEMED "UNRELATED BUSINESS INCOME" AND WOULD RESULT IN A TAX LIABILITY. MANAGEMENT REVIEWS TRANSACTIONS TO ESTIMATE POTENTIAL TAX LIABILITIES USING A THRESHOLD OF MORE-LIKELY THAN-NOT OF BEING SUSTAINED. IT IS MANAGEMENT'S ESTIMATION THAT THERE ARE NO MATERIAL TAX LIABILITIES THAT NEED TO BE RECORDED. SCHEDULE D PART XI LINE 2D SPECIAL EVENTS DIRECT EXPENSES $33,865 CHANGE IN THE INTEREST IN NET ASSETS OF THE CRMC FOUNDATION,INC $417,736 EQUITY ADJUSTMENT FOR NET ASSET RELEASE FROM RESTRICTION $127,258 -------- TOTAL $578,859 SCHEDULE D PART XII LINE 2D: SPECIAL EVENTS DIRECT EXPENSES: $33,865 HEART-A-THON 57350 57350 RISE 39272 6000 33272 1022 1840 4 12171 8140 4031 901 3300 26802 108793 71490 37303 1923 3300 28642 33865 3438 true true X true X true X true false true true 4029881 953993 3075888 0.03270 23175217 19765124 3410094 0.03630 27205098 20719117 6485982 0.06900 47691 47691 0.00050 17398 17398 0.00020 4927173 1291751 3635422 0.03870 24420 24420 0.00030 5016682 1291751 3724931 0.03970 32221780 22010868 10210913 0.10870 true 1965499 19854 26920980 34058946 -7137966 X true true 2 1 CATSKILL REGIONAL MEDICAL CTR-HARRIS 68 HARRIS-BUSHVILLE ROAD HARRIS NY 12742 X GEN.& MEDI. SURGICAL ER - 24 HOURS SOLE COMMUNITY HOSP. 2 CATSKILL REGIONAL MEDICAL CTR-GROVER ROUTE 97 CALLICOON NY 12723 X CRITICAL ACCESS HOS. ER - 24 HOURS CATSKILL REGIONAL MEDICAL CTR-HARRIS 1 true X X X X X X 13 true true true X WWW.CRMCNY.ORG X X X X X false false true true 200. true 201. true X X X X X true true X X X X X true false X X X X X true X false false CATSKILL REGIONAL MED CTR-GROVER HER 2 true X X X X X X 13 true true true X WWW.CRMCNY.ORG X X X X X false false true true 200. true 201. true X X X X X true true X X X X X true false X X X X X true X false false SECTION B LINES 3 AND 4: IN 2013 CRMC, IN CONJUNCTION WITH ORANGE REGIONAL MEDICAL CENTER, CONTRACTED WITH HOLLERAN, AN INDEPENDENT RESEARCH AND CONSULTING FIRM LOCATED IN LANCASTER, PENNSYLVANIA TO CONDUCT RESEARCH IN SUPPORT OF THE CHNA. A COMPREHENSIVE CHNA WAS CONDUCTED AND INCLUDED A VARIETY OF QUANTITATIVE AND QUALITATIVE RESEARCH SOMPONENTS. THESE COMPONENTS INCLUDED THE FOLLOWING: 1. SECONDARY STATISTICAL DATA PROFILE OF ORANGE AND SULLIVAN COUNTIES 2. FOCUS GROUP DISCUSSIONS WITH 25 COMMUNITY STAKEHOLDERS 3. DATA COLLECTION SESSIONS WITH 175 COMMUNITY RESIDENTS 4. PRIORITIZATION OF COMMUNITY NEEDS 5. IMPLEMENTATION STRATEGY HOLLERAN COMPILED A SECONDARY DATA PROFILE USING DATA COLLECTED FROM SOURCES SUCH AS THE U.S. CENSUS BUREAU, NEW YORK STATE DEPARTMENT OF HEALTH, AND CENTERS FOR DISEASE CONTROL AND PREVENTION, AMONG OTHERS. THE REPORT DEPICTS THE MOST RECENT YEAR'S HEALTH INDICATORS, CENSUS FIGURES, HOUSEHOLD STATISTICS, MORBIDITY AND MORTALITY RATES, AND SOCIOECONOMIC MEASURES. HOLLERAN CONDUCTED FOUR DATA COLLECTION SESSIONS THAT WERE HELD WITH A TOTAL OF 125 COMMUNITY MEMBERS (53 PARTICIPANTS FROM ORANGE COUNTY AND 72 PARTICIPANTS FROM SULLIVAN COUNTY). PARTICIPANTS WERE ADMINISTERED A CUSTOMIZED SURVEY TOOL TO CAPTURE HEALTH BEHAVIORS AND PREFERENCES. RESPONSES WERE COLLECTED THROUGH WIRELESS KEYPAD TECHNOLOGY. THESE SESSIONS WERE ADVERTISED IN THE NEWSPAPER, DISTRIBUTED TO MEDIA VIA A PRESS RELEASE, EMAIL ANNOUNCEMENTS, FLYERS TO LOCAL ORGANIZATIONS, PUBLICIZED ON THE HOSPITAL WEBSITE AND SOCIAL MEDIA CHANNELS. HOLLERAN ALSO FACILITATED TWO FOCUS GROUPS THAT WERE HELD WITH 25 KEY STAKEHOLDERS IN JUNE 2013. ATTENDEES INCLUDED REPRESENTATIVES OF PUBLIC HEALTH AND MEDICAL SERVICES, NON-PROFIT AND SOCIAL ORGANIZATIONS, CHILDREN AND YOUTH AGENCIES, AND THE BUSINESS COMMUNITY. SECTION B LINE 7: A PRIORITIZATION SESSION WAS HELD ON OCTOBER 21, 2013. APPROXIMATELY TEN INDIVIDUALS PARTICIPATED IN THE SESSION WITH REPESENTATIVES FROM ORANGE REGIONAL MEDICAL CENTER, CATSKILL REGIONAL MEDICAL CENTER, THE ORANGE AND SULLIVAN COUNTY HEALTH DEPARTMENTS, COMMUNITY AGENCIES AND ORGANIZATIONS. RESULTS OF THE 2013 CHNA WERE REVIEWED AND PRIORITIES OF THE KEY HEALTH NEEDS WERE LISTED. ORMC AND CRMC DEVELOPED AN IMPLEMENTATION STRATEGY TO OUTLINE WHAT COMMUNITY HEALTH NEEDS IT PLANS TO ADDRESS, AS WELL AS SPECIFIC GOALS AND MEASURES TO EVALUATE COMMUNITY HEALTH IMPROVEMENT INITIATIVES. ORMC AND CRMC WILL NOT FOCUS OF THE FOLLOWING TOPICS: " Promote Healthy and Safe Environments - the hospital will support area organizations in addressing this need; however, the hospital feels that other organizations have more resources and expertise in environmental influences and therefore will not focus on this priority area. " Prevent HIV, STDs, vaccine-preventable diseases and healthcare associated infections - As a way to coordinate efforts, the hospital has aligned with the needs being addressed by County Department of Health, which does not include this focus area. However, the hospital will continue to monitor these trends and other services to support this need. " Mental Health and Substance Abuse - the hospital will continue to expand primary care presence in the community to encourage preventative care for those with mental and behavioral health needs. We will also work toward the possibility of coordinating mental health assessment tools used throughout the County to better serve residents across providers. SECTION B LINE 12i: OTHER FACTORS - CALCULATION OF FINANCIAL ASSISTANCE ELIGIBILITY WAS BASED ON FAMILY SIZE. SECTION B LINE 18e: OTHER BILLING AND COLLECTIONS EFFORTS - FINANCIAL ASSISTANCE POLICY POSTED ON CRMC WEBSITE. SECTION B LINE 20d: THE HOSPITAL FACILITY USED PERCENTAGE OF MEDICAID RATES WHEN CALCULATING THE MAXIMUM AMOUNTS THAT CAN BE CHARGED. PART VI - SUPPLEMENTAL INFORMATION PART I LINE 7: COSTING METHODOLOGY USED TO CALCULATE THE AMOUNT REPORTED ON THE PART I, LINE 7 TABLE WAS THE RATIO OF COST TO CHARGES. PART I, LINE 7A: BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COL. (A) BUT EXCLUDED FOR PURPOSES OF CALCULATING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST WAS $5,487,829. PART I LINE 7G - CATSKILL REGIONAL MEDICAL CENTER (CRMC) IS REPORTING AS SUBSIDIZED HEALTH SERVICES THE LOSSES FROM VARIOUS PHYSICIAN CLINICS NECESSARY TO PROMOTE HEALTH IN OUR RURAL AREA. WITHOUT THESE CLINICS, THE ACCESS TO HEALTH SERVICES WOULD BE EXTREMELY LIMITED OR NON-EXISTENT. PART II - COMMUNITY BUILDING ACTIVITIES: N/A PART III LINE 2 - BAD DEBT EXPENSES - COSTING METHODOLOGY USED TO CALCULATE BAD DEBT EXPENSES WAS THE RATIO OF COST TO CHARGES. PART III LINE 3 - ESTIMATE BAD DEBT EXPENSE OF 1,985,353 - COSTING METHODOLOGY USED TO CALCULATE BAD DEBT EXPENSES WAS THE RATIO OF COST TO CHARGES AND RATIO OF FINANCIAL APPLICATIONS SUBMITTED WITH AN INCOMPLETE STATUS PART III LINE 4 (AFS FOOTNOTE 1O PAGE 1) - CRMC PROVIDES CHARITY CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY, TO PATIENTS WHO ARE UNINSURED, AND TO PATIENTS WHO ARE UNDERINSURED AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE CRMC DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE. FEDERAL AND STATE LAW REQUIRES THAT HOSPITALS PROVIDE EMERGENCY SERVICES REGARDLESS OF A PATIENT'S ABILITY TO PAY. UNINSURED PATIENTS SEEN IN THE EMERGENCY DEPARTMENT, INCLUDING PATIENTS SUBSEQUENTLY ADMITTED FOR INPATIENT SERVICES, OFTEN DO NOT PROVIDE NECESSARY INFORMATION TO ALLOW CRMC TO QUALIFY SUCH PATIENTS FOR CHARITY CARE. UNCOLLECTIBLE AMOUNTS DUE FROM SUCH UNINSURED PATIENTS REPRESENT A SUBSTANTIAL PORTION OF THE PROVISION FOR BAD DEBTS REFLECTED IN THE ACCOMPANYING STATEMENTS OF OPERATIONS. PART III LINE 6 - MEDICARE ALLOWABLE COST WERE CALCULATED USING THE MEDICARE REIMBURSEMENT METHODOLOGY AS REQUIRED FOR THE MEDICARE 2552 ANNUAL COST REPORT. PART III, LINE 8 - MEDICARE INDIVIDUALS UTILIZE HOSPITAL SERVICES AS A PRIMARY CARE PROVIDER HOWEVER, MEDICARE REIMBURSEMENT DOES NOT COVER THE ACTUAL OPERATING COSTS FOR PROVIDING CARE FOR MEDICARE PATIENTS. THEREFORE, ANY SHORTFALL REPORTED ON SCHEDULE H, PART III, LINE 7, SHOULD BE TREATED AS COMMUNITY BENEFIT AS IT IS THE HOSPITAL'S MISSION TO PROVIDE QUALITY CARE TO ALL PATIENTS REGARDLESS OF THEIR INSURANCE COVERAGE AND ABILITY TO PAY. THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED ON WAS THE COST TO CHARGE RATIO. PART III LINE 9B - ALL PATIENTS WHO ARE UNCERTAIN ABOUT THEIR ABILITY TO PAY FOR THE HOSPITAL SERVICES THEY RECEIVE ARE ENCOURAGED TO APPLY FOR FINANCIAL ASSISTANCE. CRMC SHALL ENSURE THAT NOTIFICATION OF THE FINANCIAL ASSISTANCE POLICY BE INSERTED IN RELEVANT BILLINGS. PATIENTS WHO HAVE NOT RECEIVED FINANCIAL ASSISTANCE AND DO NOT PAY THEIR BILLS ARE EVENTUALLY SUBJECT TO A COLLECTION PROCESS THAT MAY INVOLVE THE USE OF AN OUTSIDE COLLECTION AGENCY AND MAY AFFECT THE PATIENT'S PERSONAL CREDIT RATING. IN ADDITION, THE PATIENT MUST CONSENT TO APPLY FOR MEDICAID COVERAGE AND TAKE ALL STEPS NECESSARY TO PREPARE A COMPLETE AND ACCURATE MEDICAID APPLICATION. CONSIDERATION WILL BE GIVEN TO PROVIDING FINANCIAL ASSISTANCE ON A CASE BY CASE BASIS TO PATIENTS WHO HAVE EXHAUSTED THEIR INSURANCE BENEFITS AND/OR WHO EXCEED FINANCIAL ELIGIBILTY CRITERIA BUT FACE EXTRAORDINARY MEDICAL COSTS. FINANCIAL ASSISTANCE IS NOT A SUBSITUTE FOR EMPLOYER-SPONSORED, PUBLIC, OR INDIVIDUALLY PURCHASED INSURANCE. PATIENTS WHO DO NOT PAY THEIR BIILS WHO HAVE BEEN NOTIFIED OF THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY AND EITHER FAIL TO APPLY FOR ASSISTANCE OR APPLIED FOR ASSISTANCE BUT HAVE BEEN DETERMINED INELIGIBLE FOR ASSISTANCE, EVENTUALLY MAY BE SUBJECT TO A COLLECTION PROCESS THAT MAY INVOLVE THE USE OF AN OUTSIDE COLLECTION AGENCY AND MAY AFFECT THE PATIENT'S PERSONAL CREDIT RATING. SECTION A PART V THE POLICIES FOR BOTH HOSPITAL FACILITIES ARE THE SAME AND THE DISCLOSURE RELATES TO BOTH CATSKILL REGIONAL MEDICAL CENTER - HARRIS AND CATSKILL REGIONAL MEDICAL CENTER - GROVER SECTION B PART V LINE 12I: OTHER FACTORS - CALCULATION OF FINANCIAL ASSISTANCE ELIGIBILITY WAS BASED ON FAMILY SIZE. SECTION B LINE 18E: OTHER BILLING AND COLLECTIONS EFFORTS - FINANCIAL ASSISTANCE POLICY POSTED ON CRMC WEBSITE. SECTION B PART V LINE 20D: THE HOSPITAL FACILITY USED PERCENTAGE OF MEDICAID RATES WHEN CALCULATING THE MAXIMUM AMOUNTS THAT CAN BE CHARGED. PART VI, LINE 2: NEEDS ASSESSMENT: SEE CHNA ASSESSMENT IN PART V, SECTION B PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILTY FOR ASSISTANCE: HOSPITAL POSTS SIGNS DESCRIBING THE FINANCIAL ASSISTANCE PROGRAM. ALL PATIENTS WITH NO INSURANCE ARE ASKED TO APPLY FOR MEDICARE AND/OR FINANCIAL ASSISTANCE. PART VI, LINE 4: COMMUNITY INFORMATION: THE CATSKILL REGIONAL MEDICAL CENTER'S SERVICE AREA FOR COMMUNITY/LOCAL HEALTH PLANNING INCLUDES ALL FIFTEEN TOWNSHIPS WITHIN RURAL SULLIVAN COUNTY, NEW YORK. THE HOSPITAL'S SERVICE AREA WITHIN SULLIVAN COUNTY IS INTO PRIMARY AND SECONDARY SERVICE AREAS. THE PRIMARY SERVICE AREAS ARE THOSE SULLIVAN COUNTY TOWNSHIP AND ZIP CODES WHICH ARE EITHER CLOSER TO CRMC THAN ANY OTHER HOSPITAL FACILITY OR WHERE CRMC HAS A PREDOMINANT MARKET SHARE. THE SULLIVAN COUNTY TOWNSHIPS IN THE PRIMARY SERVICE AREA ARE BETHEL, CALLICOON, COCHECTON, DELAWARE, FALLSBURG, FORESTBURGH, FREMONT, LIBERTY, NEVERSINK, ROCKLAND, THOMPSON AND TUSTEN. THE FOLLOWING DEMOGRAPHICS CHARACTERIZE SULLIVAN COUNTY'S RURAL SERVICE AREA: (1) EXTENSIVE AND GROWING GERIATRIC POPULATION; (2) HIGHER PROPORTIONS OF BLACK AND HISPANIC POPULATIONS WHEN COMPARED WITH MOST UPSTATE NEW YORK RURAL COMMUNITIES; (3) VILLAGES OF MONTICELLO AND LIBERTY SURROUNDED BY GEOGRAPHICALLY DISPERSED RURAL POPULATIONS; (4) ECONOMIC BASE PREDOMINANTELY COMPRISED OF AGRICULTURE AS WELL AS SERVICES FOCUSING UPON HEALTH CARE, TOURISM, GOVERNMENT AND EDUCATION AND; (5) EXTENSIVE MEDICALLY INDIGENT POPULATION WITH HIGH PROPORTION OF INDIVIDUALS EITHER ON MEDICAID OR TOTALLY LACKING HEALTH INSURANCE COVERAGE. PART VI, LINE 5: OTHER INFORMATION: CRMC HAS SHOWN ITS ONGOING COMMITMENT TOWARDS ENHANCING THE HEALTH STATUS OF SULLIVAN COUNTY IN SEVERAL WAYS. THE OVERWHELMING MAJORITY OF CRMC'S BOARD OF DIRECTORS ARE COMPRISED OF LOCAL HEALTH CARE CONSUMERS WHO PROVIDE EXPERTISE IN IDENTIFYING SULLIVAN COUNTY HEALTH CARE NEEDS AND PRIORITIES. CRMC'S MEDICAL STAFF IS AN OPEN MEDICAL STAFF WHEREBY ANY JUSTIFIED SULLIVAN COUNTY PHYSICIAN IS ENCOURAGED TO APPLY, AND OVER 90% OF LOCAL PHYSICIAN RETAIN MEDICAL STAFF MEMBERSHIP. THE HOSPITAL'S HEALTH SCIENCE LIBRARY SUBSIDIZED FROM CRMC OPERATIONAL FUNDING PROVIDES BOTH COMMUNITY HEALTH EDUCATION TO SULLIVAN COUNTY CONSUMERS AND PATIENTS, AS WELL AS MEDICAL EDUCATION TO LOCAL PHYSICIANS. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM: The Greater Hudson Valley Health System (GHVHS) is currently the active parent company for two member hospitals-Catskill Regional Medical Center and Orange Regional Medical Center. The GVHS is dedicated to developing specialty services, medical programs and needed healthcare services that allow residents to remain close to home to receive quality care. Providing healthcare to nearly 450,000 residents in Orange, Sullivan and Ulster Counties, the GHVHS was designed to improve the quality, stability and efficiency of healthcare services in the mid-Hudson and Catskill regions. Services provided by more than 3,300 employed professionals and over 850 medical staff members, makes the GHVHS one of the largest healthcare providers in the tri-county area. The System has three hospital campuses plus several outpatient facilities, offering a broad spectrum of care. Catskill Regional Medical Center has two hospital facilities serving patients in Sullivan and Ulster Counties. Catskill Regional Medical Center-Harris is a community hospital; while, Catskill Regional Medical Center- Callicoon is a critical access hospital. Orange Regional Medical Center opened a new hospital facility during 2011 and serves patients in the tri-county area. PART VI, LINE 7: STATE FILING OF COMMUNITY BENEFIT REPORT - CRMC PERFORMS A COMMUNITY SERVICE PLAN EVERY THREE YEARS. STATE FILING OF COMMUNITY BENEFIT REPORT - CRMC PERFORMS A COMMUNITY SERVICE PLAN EVERY THREE YEARS. X X X X X true true false false false false false true false ROLLAND V BOJO VP PATIENT CARE AND CNO 159212 0 0 0 0 0 9769 0 18323 0 187304 0 0 0 GERARD J GALARNEAU CEO AND CMO 271342 0 0 0 17500 0 13846 0 16934 0 319622 0 0 0 ROBERT KAHN PHYSICIAN 182885 0 0 0 17500 0 11829 0 13337 0 225551 0 0 0 MOHAMMAD S KHAN PHYSICIAN 309904 0 0 0 17004 0 15000 0 20332 0 362240 0 0 0 FREDERICK H KURIGER CEO UNTIL 5/21/13 303398 0 27500 0 15948 0 11834 0 6378 0 365058 0 0 0 KHIN M MYO PHYSICIAN 245724 0 0 0 0 0 14703 0 678 0 261105 0 0 0 ABDUL SHAHZAD PHYSICIAN 393415 0 0 0 17004 0 15000 0 20332 0 445751 0 0 0 KHIN M SOE PHYSICIAN 188476 0 0 0 23000 0 12667 0 1007 0 225150 0 0 0 MITCHELL AMADO VP FINANCE/CFO UNTIL 4/30/13 0 155329 0 142514 0 329630 0 50197 0 9008 0 686678 0 17104 JOSEPH M ANESI VP/GENERAL COUNSEL 0 297547 0 89328 0 685 0 25205 0 23730 0 436495 0 0 ROSEMARY A BACZEWSKI VP QUALITY AND HIM 0 202216 0 55577 0 762 0 21558 0 15813 0 295926 0 0 SCOTT BATULIS PRESIDENT 0 851416 0 250000 0 83577 0 40450 0 23664 0 1249107 0 81338 DEBORAH CARR VP HR UNTIL 12/31/13 0 224644 0 77084 0 487 0 43848 0 17863 0 363926 0 0 GERARD DUNLAVEY EXE. DIR., GHVHS MEDICAL GROUP 0 219210 0 70040 0 313 0 34814 0 23664 0 348041 0 0 JEFFREY F LIETO CPSO UNTIL 8/15/13 0 250406 0 44155 0 144547 0 29902 0 16336 0 485346 0 22938 JOHN LYNCH CIO 0 253568 0 29826 0 1055 0 15699 0 15571 0 315719 0 0 STEPHEN SUGRUE VP COMPLIANCE 0 200706 0 65280 0 185 0 29013 0 23664 0 318848 0 0 JOANNE HUBER-STURANS CHIEF HUMAN RESOURCES OFFICER 0 189190 0 11606 0 124 0 0 0 9160 0 210080 0 0 SANDRA IBERGER VP OPERATION 0 264334 0 91481 0 383 0 37452 0 23664 0 417314 0 0 LINE 4A FILING ORGANIZATION: FREDERICK H KURIGER, CEO, MITCHELL AMADO, VP FINANCE, JEFFREY LIETO, CHIEF PHYSICIAN STRATEGY OFFICER, RECEIVED $123,197, $228,662, $121,009, RESPECTIVELY IN SEVERANCE COMPENSATION FOR 2013. PART 1 LINE 4B SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN THE FOLLOWING PAYMENTS WERE MADE FROM GREATER HUDSON VALLEY HEALTH SYSTEM, A RELATED TAX-EXEMPT ORGANIZATION: MITCHELL AMADO 17,104 SCOTT BATULIS 81,338 JEFFREY LIETO 22,938 PART I, LINE 7 DURING THE TAX YEAR THE ORGANIZATION PAID BONUSES TO ITS OFFICERS AND EMPLOYEES. THE NAME AND AMOUNTS ARE PROPERLY DISCLOSED ON SCHEDULE J, PART II, COLUMN B(II) JUDITH SKORDINSKI SEE SCHEDULE L PART V 81621 EMPLOYMENT false JOSEPH LOUGHLIN SEE SCHEDULE L PART V 88889 CONTRACTED SERVICES false PART IV COLUMN B JUDITH SKORDINSKI IS A FAMILY MEMBER OF LOUIS RODRIGUES. JOSEPH LOUGHLIN - BUSINESS RELATIONSHIP WITH M.L. ZAGER P.C. - OWNS 50% OF THE LAW FIRM. FORM 990 PART III - ORGANIZATION'S MISSION LINE 1: THE CATSKILL REGIONAL MEDICAL CENTER (CRMC) MISSION STATEMENT IS TO IMPROVE THE HEALTH OF OUR COMMUNITY BY PROVIDING EXCEPTIONAL HEALTH CARE. CRMC'S VISION IS THAT WE ARE CARING PROFESSIONALS DRIVEN BY STANDARDS OF EXCELLENCE WHO GO ABOVE AND BEYOND TO PROVIDE AN EXCEPTIONAL PATIENT CARE EXPERIENCE. CRMC'S VALUES REFLECT OUR MISSION AND VISION BY FOCUSING ON PATIENTS AND FAMILIES FIRST, HONESTY, INTEGRITY AND TRANSPARENCY IN ACTION, OPERATIONAL EXCELLENCE, TEAMWORK, COLLABORATION AND COMMUNICATION, ACCOUNTABILITY AND AN IMPECCABLE HEALING ENVIRONMENT. FORM 990 PART III - OTHER PROGRAM SERVICES DESCRIPTIONS LINE 4D: EXPENSES ARE INCURRED WHILE PROVIDING OTHER SERVICES SUCH AS LONG TERM CARE, MENTAL HEALTH CARE, ADULT DAY CARE PROGRAM AND A 24/7 EMERGENCY ROOM TO 35,370 RESIDENTS AND VISITORS IN THE SURROUNDING COMMUNITY. FORM 990 PART VI - BUSINESS AND FAMILY RELATIONSHIPS LINE 2 JOSEPH LOUGHLIN - BUSINESS RELATIONSHIP WITH M.L. ZAGER P.C. - OWNS 50% OF THE LAW FIRM. FORM 990 PART VI LINE 6 - EXPLANATION OF CLASSES OF MEMBERS OR SHAREHOLDERS: GREATER HUDSON VALLEY HEALTH SYSTEM INC, AN ORGANIZATION EXEMPT FROM INCOME TAX UNDER IRC SECTION 501 (C)(3) IS THE SOLE MEMBER OF CATSKILL REGIONAL MEDICAL CENTER. FORM 990 PART VI LINE 7A AND 7B - ELECTION OF MEMBERS GREATER HUDSON VALLEY HEALTH SYSTEM, INC., AS SOLE MEMBER, APPROVES ALL APPOINTMENTS TO THE CRMC BOARD OF DIRECTORS UPON RECOMMENDATION FROM CRMC BOARD OF DIRECTORS. GREATER HUDSON VALLEY HEALTH SYSTEM'S BOARD OF DIRECTORS APPROVES DECISIONS OF CATSKILL REGIONAL MEDICAL CENTER'S BOARD OF DIRECTORS INCLUDING: " APPOINTMENT OF DIRECTORS " APPROVAL OF CERTIFICATE OF NEED APPLICATIONS " APPROVAL OF ANNUAL STRATEGIC PLAN " APPROVAL OF AMENDMENTS TO THE BYLAWS OR CERTIFICATE OF INCORPORATION " APPROVAL OF OPERATING AND CAPITAL BUDGETS " APPROVAL OF ANY BORROWINGS, GUARANTEES OR LEASES VALUED IN EXCESS OF $5 MILLION EACH OR IN THE ANNUAL AGGREGATE " APPROVAL OF ANY MERGER, CONSOLIDATION OR NON-JUDICIAL DISSOLUTION " APPROVAL OF ANY AFFILIATION OR MANAGEMENT CONTRACT WITH ANOTHER ENTITY FORM 990 PART VI LINE 11A - BOARD REVIEW OF FORM 990 THE FORM 990 IS PREPARED BY THE FINANCE DEPARTMENT AND SUBMITTED TO CRMC'S TAX PREPARER FOR PROCESSING. THE INITIAL DRAFT RETURN PROVIDED BY THE TAX PREPARER IS REVIEWED BY MEMBERS OF EXECUTIVE MANAGEMENT, THE CORPORATE COMPLIANCE OFFICER, AND THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS. THE FINAL VERSION OF THE ORGANIZATION'S FORM 990 IS PROVIDED TO ALL VOTING MEMBERS OF THE BOARD OF DIRECTORS PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE. FORM 990 PART VI LINE 12C - EXPLANATION OF MONITORING AND ENFORCEMENT OF CONFLICTS CATSKILL REGIONAL MEDICAL CENTER'S CONFLICT OF INTEREST (COI) POLICY APPLIES TO ALL DIRECTORS, COMMITTEE MEMBERS AND ALL EMPLOYEES WHO ARE IN A POSITION TO INFLUENCE ANY SUBSTANTIVE BUSINESS DECISION BY THE HOSPITAL OR ANY ENTITY CONTROLLED BY THE HOSPITAL. THE HOSPITAL HAS INSTITUTED A CORPORATE COMPLIANCE PROGRAM TO ENSURE THAT ALL OF ITS BUSINESS PRACTICES ARE IN COMPLIANCE WITH APPLICABLE CIVIL AND CRIMINAL LAWS, RULES AND REGULATIONS. THE CONFLICT POLICY REQUIRES ALL DIRECTORS AND COVERED EMPLOYEES TO READ AND UNDERSTAND THE POLICY AND REVIEW IT AT LEAST ANNUALLY IN ORDER TO BE ALERT TO SITUATIONS THAT COULD CREATE A CONFLICT OF INTEREST OR OTHERWISE BE CONTRARY TO HOSPITAL POLICY. THEY ARE ALSO REQUIRED ANNUALLY TO SIGN A CONFLICTS POLICY DISCLOSURE FORM. THE COMPLIANCE OFFICER MONITORS THE COI DISCLOSURES, AND IS PRESENT AT ALL BOARD MEETINGS TO ASSIST WITH ANY POTENTIAL CONFLICT ISSUES AND PROVIDE ADVICE ON ABSTENTION, RECUSAL, ETC. A SUMMARY OF THE COI DISCLOSURES IS PRODUCED FOR THE BOARD, AS IS ANNUAL UPDATES TO THE COI POLICY. FORM 990 PART VI LINE 15A/B - COMPENSATION REVIEW & APPROVAL PROCESS FOR OFFICERS & KEY EMPLOYEES IN DETERMINING COMPENSATION FOR CEO, CRMC UTILIZES ONE OR MORE OF THE FOLLOWING - A COMPENSATION COMMITTEE MADE UP OF INDEPENDENT MEMBERS OF THE EXECUTIVE COMMITTEE OF THE BOARD, AN INDEPENDENT COMPENSATION CONSULTANT, AND COMPENSATION SURVEYS OR STUDIES. THESE SURVEYS INCLUDE HEALTHCARE PROVIDERS WITH COMPARABLE NET REVENUE AND IN COMPARABLE GEOGRAPHIC REGIONS. FOLLOWING THE RECOMMENDATIONS OF THE BOARD OF DIRECTORS, CRMC LOOKS TO HIRE AT APPROXIMATELY THE 50TH PERCENTILE OF THE MARKET. THIS IS DETERMINED BY USING THE PREVIOUSLY MENTIONED DATA RESOURCES. BASED UPON PARAMETERS DETERMINED BY THE COMPENSATION COMMITTEE, THE CEO IS PERMITTED TO MAKE COMPENSATION DECISIONS FOR SALARIES WITHIN THE 50TH-75TH PERCENTILE. ANY PROPOSED SALARY ABOVE THE 75TH PERCENTILE WOULD REQUIRE PRIOR COMMITTEE APPROVAL. A FULL REVIEW OF CEO SALARY WAS PERFORMED IN 2010 AND UPDATED IN 2011 BASED ON THESE PARAMETERS. IN ADDITION, THE CHIEF EXECUTIVE OFFICER AND HIS COMPENSATION MUST BE APPROVED BY THE COMPENSATION COMMITTEE. THE REVIEW PROCESS IS DOCUMENTED CONTEMPORANEOUSLY IN THE MINUTES OF THE COMPENSATION COMMITTEE. FORM 990. PART VI LINE 19 - OTHER ORGANIZATION DOCUMENTS PUBLICLY AVAILABLE ONCE A REQUEST IS MADE FOR THE CATSKILL REGIONAL MEDICAL CENTER TAX RETURN, A COPY IS SENT TO THE PERSON(S) REQUESTING THE DATA OR AS REQUIRED FOR VARIOUS STATE AND FEDERAL FILINGS THROUGH THE ADMINISTRATION OFFICE. PART IX - RECONCILIATION OF NET ASSETS LINE 9 - OTHER CHANGES IN NET ASSETS OR FUND BALANCES CHANGE IN THE INTEREST IN NET ASSETS OF THE CRMC FOUNDATION, INC: $417,736 EQUITY ADJUSTMENT FOR NET ASSET RELEASE FROM RESTRICTION 127,258 -------- TOTAL $544,994 ======== CRMC FOUNDATION INC PO BOX 800 HARRIS NY 12742 141742176 SUPPORT ORG. NY 501(C)(3) II TYPE 1 NA false ORANGE REGIONAL MEDICAL CENTER 60 PROSPECT AVENUE MIDDLETOWN NY 10940 141364536 HEALTHCARE NY 501(C)(3) 3 GHVHS false GREATER HUDSON VALLEY HEALTH SYSTEM C/O ORMC 60 PROSPECT MIDDLETOWN NY 10940 061488219 HEALTHCARE NY 501(C)(3) II TYPE 1 NA false EAST MAIN STREET MANAGEMENT 60 PROSPECT AVENUE MIDDLETOWN NY 10940 203168346 ADMIN. SERVIC NY ORMC C CORP. 0 0 false THE ALPHA NETWORK INC 707 EAST MAIN STREET MIDDLETOWN NY 10940 061509147 MGD CARE NY ORMC C CORP 0 0 false GHVHS MEDICAL GROUP PC GHVHS 0 0 false false true false false false false false false false false true true false true false true false false