2014-11-13T09:51:21-06:00 2013-12-31 990 2013-01-01 113368503 HUNTINGTON HOSPITAL DOLAN FAMILY HEALTH CEN % MICHAEL FAGAN HUNT 6314254262 284 PULASKI ROAD Suite GREENLAWN NY 11740 KEVIN LAWLOR PRES & CEO 2014-10-28 2013 2015-11-30 17:44:51Z KEVIN LAWLOR 284 PULASKI ROAD GREENLAWN NY 11740 7388346 false X N/A X 1995 NY THE HUNTINGTON HOSPITAL DOLAN FAMILY Health CENTER IS A FREE-STANDING HOSPITAL-OWNED FACILITY DEDICATED TO PROVIDING MEDICAL CARE TO THE UNINSURED AND UNDER INSURED. 21 18 57 20 0 40850 44674 6816598 7006208 94968 194155 113582 143309 7065998 7388346 0 0 0 0 5293418 5600631 0 0 6272 2298503 2252112 7591921 7852743 -525923 -464397 8080870 9562196 9019071 10071100 -938201 -508904 THE MISSION OF THE HEALTH CENTER IS TO PROVIDE COMPREHENSIVE CARE & OB SERVICES TO THE MEDICALLY INDIGENT AND UNDERSERVED RESIDENTS FROM NORTHWESTERN SUFFOLK COUNTRY. THE CENTER SERVES AS THE ENTRY POINT INTO THE HEALTH SYSTEM FOR INDIVIDUALS AND FAMILIES SEEKING SUCH CARE. EVERY PATIENT WILL BE PROVIDED COMPREHENSIVE AND CONTINUOUS PREVENTIVE CARE, PRIMARY DIAGNOSTIC AND TREATMENT SERVICES AND EFFECTIVE COORDINATION OF CARE WITH SPECIALISTS AND SERVICES IN THE LARGER HEALTHCARE SYSTEM. false false 7426709 0 7006208 THE HEALTH CENTER IS A COMPREHENSIVE COMMUNITY HEALTH CENTER WHICH PROVIDES PRIMARY, PEDIATRIC, PRENATAL, AND OBSTETRICAL CARE SERVICES TO THE POOR AND UNDERSERVED RESIDENTS IN THE COMMUNITY. IT IS THE ONLY SUCH CENTER BOTH OWNED AND OPERATED BY A HOSPITAL ON LONG ISLAND. ALL PATIENTS HAVE ACCESS TO A SUFFOLK COUNTY FACILITATED ENROLLER FOR MEDICAID MANAGED CARE, CHILD HEALTH PLUS, AND FAMILY HEALTH PLUS THROUGH A PARTNERSHIP WITH THE NASSAU SUFFOLK HOPSITAL COUNCIL. IN ADDITION, THE DOLAN CENTER'S SOCIAL WORK DEPARTMENT ASSISTS PATIENTS WITH ACCESS TO INSURANCE FOR PREGNANT WOMEN THROUGH NEW YORK STATE'S PRENATAL CARE ASSISTANCE PROGRAM. THE DOLAN FAMILY HEALTH CENTER PROVIDED 31,700 PATIENT VISITS IN 2013. 7426709 true true false false false false false false true true false false false true true false true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false true 4 0 true 57 true false false false false false false false false false false X 21 18 false false false false true true true true true false false true true true true true true true true false NY X X MICHAEL FAGAN 6314254262 270 PARK AVENUE HUNTINGTON NY 11743 DANIELLE ASHER BOARD MEMBER 2.0 X 0 0 0 MARGARET BOYD BOARD MEMBER 2.0 X 0 0 0 VIVIAN CAHN BOARD MEMBER 2.0 X 0 0 0 MARTHA CARLSTROM BOARD MEMBER 2.0 X 0 0 0 RONALD J GAUDREAULT BOARD MEMBER 2.0 X 0 0 0 RALPH FENDERSON MD BOARD MEMBER 2.0 X 0 0 0 VICTORIA GREEN BOARD MEMBER 2.0 X 0 0 0 REV LARRY JENNINGS SR BOARD MEMBER 2.0 X 0 0 0 JANET KUSHNICK BOARD MEMBER 2.0 X 0 0 0 KEVIN LAWLOR PRES & CEO HUNTINGOTN 50.0 X X 0 713588 286966 SHIRLEY LEVITT VICE CHAIRWOMAN 2.0 X X 0 0 0 THOMAS G LEDERER BOARD MEMBER 2.0 X X 0 0 0 MARIA O'MALLEY BOARD MEMBER 2.0 X 0 0 0 WILLIAM GEHRHARDT MD MEDICAL DIRECTOR 50.0 X 233308 0 43150 SEAN O'MALLEY BOARD MEMBER 2.0 X 0 0 0 ROXANNE SANDS-RAPELYEA BOARD MEMBER 2.0 X 0 0 0 MIKE SLIPPEN MD BOARD MEMBER 2.0 X 0 0 0 TERENCE SMITH BOARD MEMBER/ADMINISTRATOR 50.0 X 0 181981 43150 LINDA TAYLOR BOARD MEMBER 2.0 X 0 0 0 DOLORES THOMPSON CHAIRPERSON 2.0 X X 0 0 0 JOSEPH VOLAVKA BOARD MEMBER 2.0 X 0 0 0 ROGELIO CO MD PHYSICIAN 50.0 X 215003 0 43150 ROBERTO BLANDO MD PHYSICIAN 50.0 X 195685 0 43150 SAILI DESAI MD PHYSICIAN 50.0 X 149952 0 43150 LISA ROLON PHYSICIAN 50.0 X 204529 0 43150 BRENDA GEORGE PHYSICIAN 50.0 X 144413 0 43150 1142890 895569 589016 12 false true false NONE 0 44674 44674 PATIENT REVENUE 621300 4524272 4524272 SUFFOLK COUNTY CONTRACT 621300 2481936 2481936 7006208 144292 144292 0 0 0 0 0 49863 49863 49863 0 0 0 ELECTRONIC HEALTH RECORD INCOME 900099 84280 84280 RESIDENCY ROTATION 900099 50000 50000 MISCELLANEOUS OTHER 900099 9029 9029 143309 7388346 7149517 144292 0 0 0 0 233308 233308 0 3779359 3561668 214186 3505 41125 38756 2331 38 1279573 1205869 72517 1187 267266 251871 15147 248 0 0 0 0 0 0 681179 641943 38604 632 0 257213 242397 14577 239 0 0 425065 400581 24090 394 7754 7754 0 8445 8445 0 0 73904 69647 4257 287573 287573 BAD DEBT 6217 6217 PURCHASED SERVICES 439480 439480 CENTRALIZED ADMIN EXP 32177 32177 DUES & SUBSCRIPTIONS 1992 1879 113 31113 29321 1763 29 7852743 7426709 419762 6272 450 226746 1310340 2174842 0 0 238336 385086 0 0 0 0 0 0 0 0 0 0 1379887 148286 746245 1231601 5089505 5102168 0 0 0 0 0 0 695994 441753 8080870 9562196 607229 806972 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8411842 9264128 9019071 10071100 X -6027706 -6429621 686582 1517544 4402923 4403173 -938201 -508904 8080870 9562196 -464397 893694 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4402923 250 4403173 4401523 1400 4402923 4399993 1530 4401523 4398363 1630 4399993 4388426 9937 4398363 1.00000 false false 430009 36 429973 760921 122812 638109 66397 5640 60757 122560 19798 102762 1231601 0 EST. NET PAYABLE DUE THIRD PAR 356136 DUE TO AFFILIATES 8907992 9264128 X 7444611 223879 223879 7220732 167614 167614 7388346 7846526 7846526 6217 6217 7852743 PART V, LINE 4 THE INVESTMENT INCOME OF THE ENDOWMENT FUNDS IS UNRESTRIECTED AND IS THEREFORE USED TO HELP SUPPORT THE OPERATION OF THE HUNTINGTON HOSPITAL DOLAN FMAILY HEALTH CENTER. PART X, LINE 2 Certain entities included in the System's consolidated financial statements are taxable entities under Federal or state laws. U.S. generally accepted accounting principles require that the asset and liability method of accounting for income taxes be utilized by these organizations. Under the asset and liability method, deferred income taxes are recognized for the tax consequences of temporary differences by applying enacted statutory tax rates applicable to future years to differences between the financial statement carrying amounts and the tax basis of existing assets and liabilities. The effect on deferred taxes of a change in tax rates is recognized in income in the period of enactment. At December 31, 2013 and 2012, the System has a deferred income tax asset which has been fully offset by a related valuation allowance. A valuation allowance is provided when it is more likely than not that some portion, or all of the deferred tax asset will not be realized. Significant components of the deferred tax asset relate to the allowance for doubtful accounts receivable and net operating loss carry forwards. Certain entities have net operating loss carry forwards aggregating approximately $167,000,000, which expire in varying amounts through 2033, and are available to offset future taxable income. PART XI - LINE 2D AND LINE 4B REVENUE ON BOOKS NOT ON RETURN NET ASSETS RELEASED FROM RESTRICTIONS 230,096 PROVISION FOR BAD DEBT (6,217) TOTAL 223,879 REVENUE ON RETURN NOT ON BOOKS TEMPORARILY/PERMANENTLY RESTRICTED CONTRIBUTIONS 12,664 TEMPORARILY RESTRICTED INVESTMENTS 154,950 TOTAL 167,614 PART XII - LINE 4B PROVISION FOR BAD DEBT 6,217 X X X X X false true false false false false false true false KEVIN LAWLOR PRES & CEO HUNTINGOTN 0 593009 0 71000 0 49579 0 271866 0 15100 0 1000554 0 0 WILLIAM GEHRHARDT MD MEDICAL DIRECTOR 194009 0 0 0 39299 0 28050 0 15100 0 276458 0 0 0 ROGELIO CO MD PHYSICIAN 187624 0 0 0 27379 0 28050 0 15100 0 258153 0 0 0 ROBERTO BLANDO MD PHYSICIAN 187999 0 0 0 7686 0 28050 0 15100 0 238835 0 0 0 SAILI DESAI MD PHYSICIAN 145338 0 0 0 4614 0 28050 0 15100 0 193102 0 0 0 LISA ROLON PHYSICIAN 194279 0 10000 0 250 0 28050 0 15100 0 247679 0 0 0 TERENCE SMITH BOARD MEMBER/ADMINISTRATOR 0 126254 0 9867 0 45860 0 28050 0 15100 0 225131 0 0 BRENDA GEORGE PHYSICIAN 143235 0 0 0 1178 0 28050 0 15100 0 187563 0 0 0 PART I, LINE 4B Certain individuals participate in a Supplemental Executive Retirement Plan ("SERP") which is subject to substantial risk of complete forfeiture. Accordingly, the individual may never actually receive the unvested benefit amount and the amounts outlined herein were properly not reported in each individual's Form W-2, Box 5. These amounts are included in Schedule J, Column C for Kevin Lawlor ($243,816). PART I, LINE 7 On Form 990, Part VII, Section A, line 1A, the organization may provide non-fixed payments, not described on lines 5 and 6, to certain listed persons. The organization bases such payments on many performance based factors. Payments of this type appear on Schedule J, Part II, B (ii). FORM 990 - PART I - LINE 5 PART V - LINE 2A/2B THE STAFF OF THE HEALTH CENTER IS EMPLOYED BY HUNTINGTON HOSPITAL ASSOCIATION (THE "HOSPTIAL") AND THEIR SALARY AND RELATED COSTS ARE ALLOCATED TO THE HEALTH CENTER. NO SALARY COSTS ARE PAID DIRECTLY BY THE HEALTH CENTER. THE W-2S FOR THE NUMBER OF EMPLOYEES LISTED ON THESE LINES ARE ISSUED BY THE HOSPITAL ON BEHALF OF THE HEALTH CENTER. AS SUCH, THE HEALTH CENTER IS NOT REQUIRED TO FILE ANY FEDERAL EMPLOYMENT TAX RETURNS. FORM 990 - PART IV - LINE 12 AND PART XII - LINES 2 B/C THE FINANCIAL STATEMENTS FOR THE HOSPITAL AND THE HEALTH CENTER ARE AUDITED ON A CONSOLIDATED BASIS WITH INDIVIDUAL CONSOLIDATING STATEMENTS FOR EACH ENTITY INCLUDED AS SUPPLEMENTAL SCHEDULES. A RECONCILIATION OF AMOUNTS PER THE CONSOLIDATING STATEMENTS FOR THE HEALTH CENTER INCLUDED IN THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS, TO THE AMOUNTS REPORTED IN THE FORM 990 IS INCLUDED IN THE SUPPLEMENTAL SECTION OF SCHEDULE D. THE HOSPTIAL HAS AN AUDIT COMMITTEE THAT ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS. FORM 990 - PART VI - LINES 6, 7 A/B THE SOLE MEMBER OF THE HEALTH CENTER IS THE HOSPITAL. BOTH THE HEALTH CENTER AND THE HOSPITAL ARE MEMBERS OF THE NORTH SHORE LONG ISLAND JEWISH HEALTH SYSTEM, INC. (THE "SYSTEM"). THE SYSTEM AND ITS MEMBER ORGANIZATIONS AND OTHER AFFILIATED ENTITIES ARE AN INTEGRATED HEALTH DELIVERY SYSTEM IN THE NY METRO AREA. THE SYSTEM IS THE SOLE MEMBER OF THE NORTH SHORE LONG ISLAND JEWISH HEALTH CARE, INC. ("HEALTH CARE, INC."). HEALTH CARE, INC. IS THE SOLE MEMBER OF THE HOSPITAL AND THE SOLE MEMBER OF OTHER HEALTH CARE ORGANIZATIONS THAT ARE NOT PART OF THE HOSPTIAL. THE BOARD OF DIRECTORS FOR THE HEALTH CENTER IS COMPRISED OF THE EXECUTIVE COMMITTEE OF THE BOARD OF THE HOSPTIAL. THE SYSTEM HAS THE RIGHT TO ELECT THE MEMEBERS OF THE HOSPITAL'S BOARD OF DIRECTORS, INCLUDING THE RIGHT TO APPOINT 3 PERSONS TO THE BOARD WHO ARE TRUSTEES OR EMPLOYED CORPORATE OFFICERS OF THE SYSTEM. THE MAJORITY OF THE HOSPITAL'S BOARD OF DIRECTORS MUST BE RESIDENTS OF THE PRIMARY SERVICE AREA SERVED BY THE HOSPITAL. CERTAIN DECISIONS OF THE BOARD REQUIRE THE APPROVAL OF THE SYSTEM AS OUTLINED IN THE CORPORATED BY-LAWS. FORM 990 PART VI - LINE 11A The annual Return of Organization Exempt From Income Tax (Form 990) for North Shore-LIJ Health System Inc. and Affiliated entities are prepared with input from various departments including Corporate Compliance, Finance, Human Resources, and Legal. Before filing the returns, the documents are electronically made available to all trustees through a secure online portal. Members of the Executive Committee are then informed the returns are ready for review. The Executive Committee, which is a committee made up of members from the Board of Trustees, may exercise all of the authority of the Board of Trustees except as such authority is limited by applicable law and except to the extent, if any, that such authority would be inconsistent with any provision of these By-laws or is limited by any resolution to such effect adopted by the Board of Trustees. FORM 990 PART VI - LINE 12 C AS MEMBERS OF THE NORTH SHORE LoNG ISLAND JEWISH HEALTH SYSTEM, THE HEALTH CENTER AND AFFILIATED ENTITIES HAVE SEVERAL CONTROL MECHANISMS TO MITIGATE CONFLICTS OF INTEREST. THE CODE OF ETHICAL CONDUCT POLICY CONTAINS A DETAILED SECTION EDUCATING INDIVIDUALS ABOUT HOW TO AVOID POTENTIAL CONFLICTS OF INTEREST. SPECIFICALLY, THE CODE OF ETHICAL CONDUCT REQUIRES INDIVIDUALS TO CONDUCT BUSINESS IN A MANNER THAT PLACES THE INTEREST OF THE ORGANIZATION AHEAD OF PERSONAL INTERSTS. IN ADDITION, THE ORGANIZATION HAS A CONFLICTS OF INTEREST POLICY STATEMENT FURTHER ELABORATING UPON INDIVIDUAL'S DISCLOSURE AND RECUSAL OBLIGATIONS. INDIVIDUALS THAT ARE IN A POSITION TO INFLUENCE THE BUSINESS OR OTHER DECISIONS ARE REQUIRED TO FILL OUT A CONFLICTS OF INTEREST DISCLOSURE FORM ON A REGULAR BASIS. THE CORPORATE COMPLIANCE OFFICER REVIEWS ALL DISCLOSURES OF POSSIBLE CONFLICTS, INCLUDING MATTERS DISCLOSED IN ANY CONFLICTS OF INTEREST DISCLOSURE REPORT AND TAKES ANY ACTIONS DEEMED REQUIRED OR APPROPRIATE TO MANAGE OR RESOLVE ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. IN APPROPRIATE CASES, THESE DISCLOSURES AND RESPONSIVE ACTIONS WILL BE REPORTED TO THE AUDIT AND CORPORATE COMPLIANCE COMMITTEE AND OTHER APPLICABLE COMMITTEES. IN ADDITION, THE ORGANIZATION PROVIDES TRAINING TO INDIVIDUALS ON AN ANNUAL BASIS REGARDING CONFLICTS OF INTEREST AND OTHER COMPLIANCE RELATED TOPICS. IF AN INDIVIDUAL VIOLATES THE CODE OF ETHICAL CONDUCT OR ANY RELATED POLICY SUCH AS THE CONFLICTS OF INTEREST POLICY STATEMENT, APPROPRIATE DISCIPLINARY ACTIONS IS TAKEN BASED UPON THE FACTS AND CIRCUMSTANCES OF THE SITUATION. FORM 990 - PART VI - LINE 15 THE BOARD OF DIRECTORS OF THE HOSPTIAL APPOINTED A COMPENSATION COMMITTEE WITH THE RESPONSIBILTY FOR REVIEWING AND APPROVING THE WAGES AND BENEFITS OF THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES. THE COMMITTEE CONSITS OF AT LEAST THREE INDIVIDUALS, WHO THEMSELVES ARE MEMBERS OF THE BOARD OF DIRECTORS. THE COMMITTEE DEVELOPED AN EXECUTIVE COMPENSATION POLICY THAT INCLUDES THE USE OF INDEPENDENT COMPENSATION SURVEYS COMPLIED BY INDEPENDENT FIRMS. THE COMMITTEE MEETS AT LEAST ANNUALLY. MINUTES OF THOSE MEETINGS ARE MAINTAINED BY HUMAN RESOURCES. COMPENSATION IS NOT PAID DIRECTLY BY THE HEALTH CENTER. FORM 990 - PART VI - LINE 19 THE HOSPITAL AND THE HEALTH CENTER MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND CONSOLIDATED AUDITED FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE ALSO AVAILABLE ONLINE. HUNTINGTON HOSPITAL ASSOCIATION 270 PARK AVENUE HUNTINGTON NY 11743 111630914 HOSPTIAL NY 501(c)(3) 3 HUNTINGTON false NORTH SHORE LIJ HEALTH SYSTEM 972 BRUSH HOLLOW ROAD WESTBURY NY 11590 113418133 SUPPORTING OR NY 501(c)(3) 11, TYPE 1 NA false NORTH SHORE LIJ HEALTH SYSTEM LABORATORI 972 BRUSH HOLLOW ROAD WESTBURY NY 11590 113412370 SUPPORTING OR NY 501(c)(3) 11, TYPE 1 NSLIJ HS false NORTH SHORE LIJ HEALTH CARE INC 972 BRUSH HOLLOW ROAD WESTBURY NY 11590 112965586 SUPPORTING OR NY 501(c)(3) 11, TYPE 1 NSLIJ HS false false false true false false false false false false true false true true true true false true false NA