2013-01-31T13:08:43-06:00 2011-12-31 861065772 DELOITTE TAX LLP TWO JERICHO PLAZA JERICHO NY 11753 990 2011-01-01 131740274 CALVARY HOSPITAL INC CALV 7185182069 1740 EASTCHESTER ROAD BRONX NY 104612392 ANDREW V GRECO 7185182069 2013-01-31 1 P00743140 5169187000 2013-01-31 2011 2016-02-25 16:41:14Z ANDREW V GRECO 1740 EASTCHESTER ROAD BRONX NY 104612392 120103732 0 X WWW.CALVARYHOSPITAL.ORG X 1899 NY SEE SCHEDULE O. 15 14 1053 150 0 0 3916697 8967700 96290400 100576500 4983798 2386500 898098 858132 106088993 112788832 0 0 0 0 76677997 78363000 0 0 0 30597606 32817400 107275603 111180400 -1186610 1608432 102903101 104925700 41466701 45965300 61436400 58960400 X CALVARY HOSPITAL IS A FULLY ACCREDITED ACUTE CARE SPECIALITY HOSPITAL EXCLUSIVELY PROVIDING PALLIATIVE CARE FOR ADVANCED CANCER PATIENTS IN THE UNITED STATES. 0 0 78143469 79635200 ADVANCED CANCER CARE INPATIENT - CALVARY SERVES ABOUT 7.5% OF ALL INDIVIDUALS WHO DIE OF CANCER IN NEW YORK STATE EACH YEAR. PATIENTS ARE REFERRED TO CALVARY FROM EVERY MAJOR HOSPITAL AND MEDICAL CENTER IN NEW YORK CITY. IN 2011, CALVARY CARED FOR MORE THAN 5,950 PATIENTS AND FAMILIES AS INPATIENTS IN OUR 200-BED BRONX CAMPUS AND OUR 25-BED SATELLITE AT LUTHERAN MEDICAL CENTER IN BROOKLYN, AS OUTPATIENTS, THROUGH OUR CENTER FOR CURATIVE AND PALLIATIVE WOUND CARE; AND THROUGH HOSPICE AND HOME CARE. THE AVERAGE LENGTH OF INPATIENT STAY IS 25.33 DAYS. 14938315 18672300 SEE SCHEDULE O. 2604893 1404900 SEE SCHEDULE O. 3285876 864100 ADVANCED CANCER CARE OUTPATIENT/OTHER PROGRAMS THE OUTPATIENT CLINIC PROVIDES CARE THROUGH A MULTIDISCIPLINARY APPROACH, WHICH ENCOMPASSES THE PHYSICAL, EMOTIONAL AND SPIRITUAL NEEDS OF THE PATIENT AND THEIR FAMILY. THE AIM OF THE CLINIC IS TO PROVIDE COMPREHENSIVE HEALTH CARE FOR THE ADVANCED CANCER PATIENT. OUTPATIENT SERVICES 1. THE OUTPATIENT CLINIC SPECIALIZES IN PAIN CONTROL, WOUND CARE AND OTHER SERVICES SPECIFIC TO THE ADVANCED CANCER PATIENT.2. EACH' PATIENT IS ASSIGNED A PRIMARY PHYSICIAN, REGISTERED NURSE, SOCIAL WORKER AND DIETITIAN.3. THE SERVICES OF PASTORAL CARE, THERAPEUTIC RECREATION, RADIOLOGY, LABORATORY, ENTEROSTOMAL THERAPY AND OTHER SERVICES ARE AVAILABLE IF NEEDED.4. THE OUTPATIENT NURSES PROVIDE ADDITIONAL SUPPORT TO PATIENTS AND FAMILIES THROUGH FREQUENT TELEPHONE CALLS.5. ASSISTANCE WITH TRANSPORTATION ARRANGEMENTS WILL BE PROVIDED IF NEEDED.6. TWENTY-FOUR HOUR TELEPHONE COVERAGE WITH A NURSE AND PHYSICIAN FOR ADVICE OR REASSURANCE IS AVAILABLE.7. CONSULTATION WITH MEDICAL SPECIALISTS CAN BE ARRANGED AND COORDINATED.8. COORDINATION OF SERVICES IS PROVIDED AMONG THE PATIENT'S PHYSICIAN, HOME CARE AGENCY AND OTHER PROVIDERS TO ASSURE APPROPRIATE AND CONTINUAL CARE. 3285876 864100 98972553 1 1 0 1 0 0 0 0 0 1 1 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 64 0 1 1053 1 0 0 0 0 0 0 0 0 0 0 0 X 15 14 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X ANDREW GRECO 7185182069 1740 EASTCHESTER ROAD BRONX NY 104612069 MANFRED ALTSTADT 2.00 X 0 0 0 JOHN P BERTSCH 2.00 X 0 0 0 JOHN A DECINA 2.00 X 0 0 0 THOMAS J FAHEY JR MD 2.00 X 0 0 0 THOMAS G FERRARA 2.00 X 0 0 0 TERENCE GALLAGHER 2.00 X 0 0 0 STEVEN J GOLUB 2.00 X 0 0 0 EDWARD D HEBEN 2.00 X 0 0 0 MSGR EDWARD H BARRY 2.00 X 0 0 0 SCOTT LARUE 2.00 X 457517 0 139344 JAMES INTRONE 2.00 X 993832 0 12506 RENA M MURTHA RN 2.00 X 0 0 0 AMIT SIKDAR 2.00 X 0 0 0 MINTO L SOARES 2.00 X 0 0 0 JOSEPH A TARANTINO 2.00 X 0 0 0 ANNE COTE TAYLOR 2.00 X 0 0 0 MICHAEL J BRESCIA MD 36.00 X 433208 0 24405 FRANK A CALAMARI 36.00 X 694808 0 37918 CHRISTOPHER COMFORT MD 36.00 X 355064 0 52297 RICHARD KUTILEK 36.00 X 311366 0 49864 ANDREW V GRECO 36.00 X 264803 0 53631 SALLY UMBRO RN 36.00 X 214615 0 42435 ANTHONY TARANTO 36.00 X 170631 0 30940 NANCY D'AGOSTINO RN 36.00 X 206034 0 51851 ROBERT BRESCIA MD 36.00 X 312118 0 39818 DEVMANI JAITLY MD 36.00 X 490795 0 52297 GAIL CHRZANOWSKI MD 36.00 X 282165 0 44149 ALMA CARRINGTON 36.00 X 265239 0 43930 SREENIVASA PATIBANDLA MD 36.00 X 367570 0 27570 5819765 0 702955 118 0 1 0 AMERISOURCEBERGEN CORP PO BOX 5188 NEW YORK NY 100875188 PHARMACEUTICAL 2065435 MMS PO BOX 643925 CINCINNATI OH 45264 MEDICAL SUPPLIES 1081054 C&C 125 NEWTON ROAD SUITE 300 PLAINVIEW NY 11803 HOME HEALTH AIDE AGENCY 935794 MBL CONSTRUCTION CORP 2620 ST RAYMOND AVENUE BRONX NY 10461 CONSTRUCTIONS 902095 FARRELL MEDIA GROUP 887 KINDERKAMACK ROAD 1ST FI RIVEREDGE NJ 07661 ADVERTISING 699133 54 5505000 3462700 8967700 MEDICARE REVENUE 900099 68800228 68800228 MEDICAID REVENUE 900099 17923222 17923222 PATIENT SERVICE REVENU 900099 13853050 13853050 100576500 933000 933000 42000 0 42000 42000 42000 8768400 7314900 1453500 1453500 1453500 MISCELLANEOUS INCOME 900099 364386 364386 PARKING LOT REVENUE 900099 233596 233596 CAFETERIA 900099 206017 206017 12133 12133 816132 112788832 100576500 0 3244632 4643397 4643397 51505603 45850177 5655426 6988500 6221148 767352 11303400 10062262 1241138 3922100 3491445 430655 853600 853600 449400 449400 247600 247600 6730200 6730200 1242600 1106160 136440 2614700 2327600 287100 2348200 2090363 257837 229600 204389 25211 4052200 3607260 444940 707300 629637 77663 OTHER ANCILLARY MED EXP 5818400 5818400 0 0 PROVISION FOR BAD DEBT 2360400 2360400 0 0 MAINTENANCE AND REPAIRS 1235300 1099661 135639 0 FOOD EXPENSE 950400 950400 0 0 2977500 1779654 1197846 111180400 98972553 12207847 0 -1791088 -1953400 2900297 6253600 19021098 23083500 192799 193699 399297 585301 80091800 63889200 16373900 16202600 24099496 16776100 19899515 21964000 21807787 21820300 102903101 104925700 15111098 15005800 26355603 30959500 41466701 45965300 X 35702000 30427200 23901500 26698100 1832900 1835100 61436400 58960400 102903101 104925700 X 1608432 -4084432 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 27683 27683 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: PART II-B, LINE 1(I), OTHER LOBBYING ACTIVITIES: CALVARY HOSPITAL, INC. DOES NOT ENGAGE IN ANY DIRECT LOBBYING ACTIVITIES; HOWEVER, IT DOES BEAR INDIRECT COSTS THAT HAVE LOBBYING IMPLICATIONS. THE $27,683 REPORTED ON PART II-B, LINE 1(I) REPRESENTS THAT PORTION OF ITS MEMBERSHIP DUES THE HOSPITAL PAYS TO THE HOSPITAL ASSOCIATION OF NEW YORK STATE (HANYS) AND THE GREATER NEW YORK HOSPITAL ASSOCIATION (GNYHA) THAT RELATES TO LOBBYING EXPENSES. THIS AMOUNT HAS BEEN DETERMINED IN ACCORDANCE WITH MEDICARE PROVIDER REIMBURSEMENT MANUAL, PART I, SECTION 2139. 25734400 2031600 2502900 1735700 28533200 22916700 1901600 2815700 1899600 25734400 20492500 1747600 2610800 1934200 22916700 20492500 20492500 0.00000 0.06430 0.93570 0 0 538000 538000 28658400 21127600 7530800 3688900 2622300 1066600 47206500 40139300 7067200 16202600 BENEFICIAL INTEREST IN NET ASSETS OF CALVARY FUND 21964000 F 21964000 DUE FROM THIRD PARTIES 535000 HELD IN ESCROW UNDER PLEDGE SECURITY AGREEMENT 5173100 SELF INSURANCE FUND ASSETS 2147100 EQUIPMENT ESCROW FUND 7885400 DONOR RESTRICTED ASSETS 4477200 DEFERRED COMPENSATION ASSET 1396000 OTHER ASSETS 35400 DUE FROM AFFILIATES 171100 21820300 ACCRUED PENSION LIABILITY 25488100 DUE TO THIRD PARTIES 4295700 MALPRACTICE LIABILITY 1175700 30959500 112788832 111180400 1608432 -1259100 -2825332 -4084432 -2476000 113265300 -1259100 1735700 476600 112788700 132 132 112788832 115741300 4560900 4560900 111180400 0 111180400 PART XI, LINE 8 - OTHER ADJUSTMENTS: PENSION-RELATED ADJUSTMENTS -4,889,832. BENEFICIAL INTEREST IN NET ASSETS OF CALVARY FUND, INC. 2,064,500. TOTAL TO SCHEDULE D, PART XI, LINE 8: -2,825,332. PART XII, LINE 2D - OTHER ADJUSTMENTS: NET ASSETS RELEASED FROM RESTRICTIONS 1,735,700. PART XII, LINE 4B - OTHER ADJUSTMENTS: ROUNDING 132. PART XIII, LINE 2D - OTHER ADJUSTMENTS: NET ASSETS RELEASED FROM RESTRICTION 1,735,700. BENEFICIAL INTEREST IN NET ASSETS OF CALVARY FUND, INC. -2,064,500. PENSION RELATED ADJUSTMENTS 4,889,700. 1 1 X 1 X 300.000000000000 1 X 1 1 0 1 1 39144 39144 0.00040 1082207 1082207 0.00990 1121351 1121351 0.01030 1121351 1121351 0.01030 14 241581 241581 0.00220 1 2000 2000 0.00000 1 5000 5000 0.00000 1 37146 37146 0.00030 17 285727 285727 0.00250 1 2360400 36757657 38654557 -1896900 X 1 1 2 1 CALVARY HOSPITALINC

1740 EASTCHESTER ROAD BRONX NY 10461

X X X LONG-TERM CARE HOSPITAL 2 CALVARY HOSPITALINC(BROOKLYN CAMPUS)

150 55TH STREET BROOKLYN NY 11220

X X X CALVARY HOSPITAL INC 1 1 1 300.000000000000 1 300.000000000000 1 X X 1 1 X X 0 0 0 X X 0 0 PART I, LINE 3C: CALVARY HOSPITAL INC. USES THE FEDERAL POVERTY GUIDELINES (FPG) TO DETERMINE ELIGIBILITY FOR DISCOUNTED CARE TO LOW-INCOME PATIENTS. PART I, LINE 6A: CALVARY HOSPITAL, INC. IS REQUIRED TO PREPARE AN ANNUAL COMMUNITY SERVICE PLAN (CSP) A.K.A., THE COMPREHENSIVE COMMUNITY SERVICE PLAN FOR THE NYS DEPARTMENT OF HEALTH. THIS REPORT IS FILED WITH THE NYS DOH. THE COMMUNITY SERVICE PLAN IS AVAILABLE ON THE ORGANIZATION'S WEB SITE (WWW.CALVARYHOSPITAL.ORG). ADDITIONALLY, CALVARY POSTS INFORMATION REGARDING FINANCIAL ASSISTANCE PROGRAMS AND HAS A CALENDAR ON PROGRAMMATIC INFORMATION AS IT BECOMES AVAILABLE REGARDING BEREAVEMENT GROUPS AND SUPPORT NETWORKS ON THE ORGANIZATION'S WEB SITE. PART I, LINE 7: CALVARY HOSPITAL, INC. HAS UTILIZED NET REALIZABLE VALUE OF THE SERVICES RENDERED FOR THE CHARITY CARE AMOUNT LISTED ON PART I LINE 7. CALVARY UTILIZED THE AMOUNT REPORTED IN ITS COST REPORT PREPARED FOR THE NYS DOH. PART I, LINE 7G: CALVARY HOSPITAL, INC. HAS INCLUDED CHARITY CARE SERVICES IN THE AMOUNT OF $39,144 ON THE FORM 990, PART VIII LINE 2G. THIS AMOUNT IS EXCLUDED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN SCHEDULE H, PART I, LINE 7(F) AS PER THE INSTRUCTIONS.THE MISSION STATEMENT OF CALVARY HOSPITAL IS AS FOLLOWS:CALVARY HOSPITAL, INC. IS A NOT-FOR PROFIT SPECIALTY HOSPITAL THAT PROVIDES SERVICES FOR THE CARE OF TERMINALLY ILL CANCER PATIENTS. CALVARY HOSPITAL, INC. IS OPERATED IN CONNECTION WITH THE ROMAN CATHOLIC ARCHDIOCESE OF NEW YORK.THE MISSION OF CALVARY HOSPITAL, INC. IS AS FOLLOWS, FROM ITS INCEPTION IN 1899, CALVARY HOSPITAL HAS BEEN FAITHFULLY DEVOTED TO PROVIDING PALLIATIVE CARE TO ADULT PATIENTS IN THE ADVANCED STAGES OF CANCER, ADDRESSING THE SYMPTOMS OF THE DISEASE, NOT ITS CURE. A VOLUNTARY, NOT-FOR-PROFIT HOSPITAL, OPERATED IN CONNECTION WITH THE ARCHDIOCESE OF NEW YORK, CALVARY CONTINUES TO EMBODY THIS TRADITION OF CARING THROUGH THE SERVICES AND PROGRAMS OFFERED BY AND THROUGH THE DEDICATION AND CONCERN SHOWN BY ITS STAFF MEMBERS.THE HOSPITAL WILL CONTINUE TO BE FAITHFUL TO THIS TRADITION THROUGH A TWOFOLD COMMITMENT. CALVARY WILL STRIVE PRIMARILY TO EXPAND ITS PROGRAMSAND SERVICES TO MEET THE EMERGING PHYSICAL, PSYCHOSOCIAL, AND SPIRITUAL NEEDS OF BOTH PATIENTS AND FAMILIES THROUGH THE PROVISION OF ACUTEINPATIENT, OUTPATIENT, HOME CARE, HOSPICE, AND SATELLITE SERVICES. IN ADDITION, THROUGH THE PALLIATIVE CARE INSTITUTE THE HOSPITAL ENDEAVORS TO TRANSMIT TO OTHER HEALTH CARE PROFESSIONALS, THROUGH RESEARCH AND EDUCATION, THE KNOWLEDGE AND COMPETENCE WHICH IT HAS DEVELOPED IN THE CARE OF THE ADVANCED CANCER PATIENT. THROUGH THIS TWOFOLD COMMITMENT, CALVARY HOSPITAL WILL DEEPEN AND STRENGTHEN THE PHILOSOPY OF COMPASSIONATE CARE WHICH HAS BEEN THE CORNERSTONE OF ITS PROGRAM OF SERVICE, AND WILL OFFER TO THOSE IN OUR EXPANDED COMMUNITY AND OTHERS, A TRADITION OF SUCCESSFUL EXPEDRIENCE IN THE CARE OF THE ADVANCED CANCER PATIENT.CALVARY HOSPITAL IS THE ONLY FULLY ACCREDITED ACUTE CARE SPECIALTY HOSPITAL EXCLUSIVELY PROVIDING PALLIATIVE CARE FOR ADVANCED CANCER PATIENTS IN THE UNITED STATES. WITH 225 BEDS IN THE BRONX AND BROOKLYN AND MORE THAN 1053 EMPLOYEES, CALVARY SERVES MORE THAN 5,950 PATIENTS ANNUALLY. CALVARY PROVIDES PALLIATIVE CARE, WHICH IS THE ACTIVE TREATMENT OF THE SYMPTOMS, NOT THE CURE OF THE DISEASE, IN ORDER TO MAKE OUR PATIENTS AS COMFORTABLE AS POSSIBLE. CALVARY'S PROGRAMS INCLUDE INPATIENT CARE CASE MANAGEMENT OUTPATIENT CARE, HOSPICE, HOME CARE AND SUPPORT PROGRAMS FOR FAMILIES AND FRIENDS.AS CALVARY APPROACHES THE FUTURE WITH A SENSE OF HOPE AND PROMISE, CALVARY IS EVER MINDFUL OF THE LEGACY OF OUR FOUNDERS, THE WOMEN OF CALVARY, TO PROVIDE COMPREHENSIVE CARE WHILE RECOGNIZING THE INDIVIDUALITY AND DIGNITYOF EVERY PATIENT. AT THE SAME TIME, CALVARY WILL CONTINUE TO DEVELOP NEWPROGRAMS AND SERVICES TO MEET THE NEEDS OF TODAY'S WORLD.PART I LINE 7 COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990PART IX LINE 25 COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATINGTHE PERCENTAGE IN THIS COLUMN IS $2,360,400 PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 2360400. PART II: CALVARY HOSPITAL MAKES A NUMBER OF DIFFERENT SUPPORT GROUPS AVAILABLE TO THE COMMUNITY. THESE SUPPORT GROUPS ARE ADVERTISED ON CALVARY HOSPITAL'S WEBSITE, WWW.CALVARYHOSPITAL.ORG, ON ITS CALENDAR OF EVENTS. ALL GROUPS ARE FREE AND ARE OPEN TO THE COMMUNITY.CALVARY HOSPITAL PROVIDES BEREAVEMENT SUPPORT FOR ADULTS WHO HAVE LOST LOVED ONES AT CALVARY HOSPITAL OR CALVARY@HOME, AND THOSE FROM THECOMMUNITY AT LARGE WHO HAVE LOST SOMEONE BECAUSE OF ILLNESS ACCIDENTS VIOLENCE, OR ANY OTHER CAUSE. GROUPS ARE OFFERED IN THE BRONX ANDBROOKLYN.THE HOSPITAL OFFERS AGE-APPROPRIATE SUPPORT GROUPS FOR CHILDREN, AGES 6 THROUGH 11, AND FOR ADOLESCENTS, AGES 12 TO 18.CALVARY IN TOUCH, A BI-MONTHLY NEWSLETTER ABOUT BEREAVEMENT ISSUES IS AVAILABLE THROUGH THE HOSPITAL'S WELBSITE. THESE COMMUNITY SUPPORT GROUPS INCLUDE BUT ARE NOT LIMITED TO:- SUPPORT GROUPS FOR BEREAVED PARENTS- PRECIOUS MOMENTS SUPPORT GROUP FOR CHILDREN AGES 6 TO 11- TEEN BEREAVEMENT GROUP- DEATH OF A SPOUSE BEREAVEMENT GROUP- DEATH OF A PARENT BEREAVEMENT GROUP- CAMP COMPASS DAY CAMP FOR BEREAVED CHILDREN GROUPS ARE OPEN TO ALL, ARE FREE OF CHARGE, AND ARE LED BY CALVARY HOSPITAL STAFF. REGISTRATION IN ADVANCE OF PARTICIPATION IS REQUIRED.CALVARY HOSPITAL ALSO MAKES AVAILABLE A NUMBER OF DIFFERENT WELLNESS ACTIVITIES TO THE COMMUNITY. THESE WELLNESS ACTIVITIES INCLUDE BUT ARE NOT LIMITED TO YOGA CLASSES AND RECREATIONAL THERAPY. CALVARY HOSPITAL'S THERAPEUTIC RECREATION AND "MUSIC THERAPY PROGRAMS WERECREATED TO GIVE PATIENTS A SENSE OF ACCOMPLISMENT AND TO RELIEVE THESUFFERING OF OUR PATIENTS AND THEIR FAMILIES. THERAPEUTIC RECREATIONACTIVITIES INCLUDE DRAWING, SCULPTURE, AND CERAMICS PROJECTS;HORTICULTURE; A GAMES AND DISCUSSION HOUR; AND HOLIDAY PARTIES. MUSICTHERAPY OFTEN HELPS SOOTHE PATIENTS AND HELPS THEM FOCUS ON LIFE. OUR BOARD CERTIFIED MUSIC THERAPISTS USE MUSIC THERAPY INTERVENTIONS TOSOOTHE PATIENTS, RELIEVE ANXIETY, REMINISCE, AND EASE PAIN AND SUFFERING.MUSIC THERAPY INTERVENTIONS MAY ALSO PROVIDE RELEASE IN THE LAST HOURS ORMOMENTS OF LIFE. PATIENTS RECEIVING MUSIC THERAPY SOMETIMES WRITE SONGSASSISTED BY THE MUSIC THERAPISTS TO LEAVE FOR LOVED ONES, OR FIND OTHERWAYS TO OPEN THEIR HEARTS THROUGH MUSIC. OUR CLINICIANS REPORT THAT INSOME CASES, THE ONLY TIME A PATIENT LAUGHS OR SMILES IS DURING A MUSICTHERAPY SESSION. WE ALSO FIND THAT MUSIC THERAPY IS AVAILABLE AT BOTHINPATIENT LOCATIONS AND IS ALSO ONE OF THE SERVICES WE OFFER THROUGHCALVARY@HOME.IN KEEPING WITH OUR MISSION TO SHARE OUR KNOWLEDGE AND EXPERIENCE WITHOTHERS, CALVARY OFFERS INTERNSHIP PROGRAMS IN THE FOLLOWING AREAS:PALLIATIVE CARE AND MUSIC THERAPY, WHICH IS RECOGNIZED AS A NATIONALCLINICAL TRAINING SITE BY THE AMERICAN MUSIC THERAPY ASSOCIATION. THROUGH ITS EDDIE HIGGINS SCHOLARSHIP PROGRAM, CALVARY HOSPITAL PROVIDESLEADERSHIP DEVELOPMENT AND TRAINING. THE EDDIE HIGGINS SCHOLARSHIP IS NAMED AFTER A CHERISHED MEMBER OF THE CALVARY FAMILY WHO CAME TO THEHOSPITAL AS A YOUNG BOY. EDDIE WAS HOSPITALIZED INTERMITTENTLY FOR 15YEARS AT CALVARY UNTIL HIS DEATH IN 1982 AT THE AGE OF 29. EDDIE ISREMEMBERED FOR HIS LOVE OF GOD AND HIS REMARKABLE COURAGE DESPITE HISILLNESS. CALVARY HAS GIVEN THE ANNUAL SCHOLARSHIP SINCE 1985.CALVARY HOSPITAL IS VERY ACTIVE IN THE COMMUNITY AND PARTICIPATES INANNUAL EVENTS SUCH AS THE COMMUNITY COLUMBUS DAY PARADE AND THE ANNUALORCHARD BEACH BREAST CANCER WALK. PART III, LINE 4: THE CALVARY HOSPITAL, INC. AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE REGARDING BAD DEBT.COSTING METHODOLOGY USED FOR BAD DEBT:THE METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED IN LINE 2 IS BASED ON THE HOSPITAL'S COLLECTION/BAD DEBT WRITE-OFF POLICY WHICH STATESTHAT ALL REASONABLE EFFORTS WILL BE MADE TO OBTAIN PAYMENTS AND TO SETTLE PATIENT ACCOUNTS RECEIVABLE ON A CONSISTENT BASIS. COLLECTION EFFORTS AREMADE ON THE NET REALIZABLE AMOUNT. PART III, LINE 8: CALVARY HOSPITAL INC. HAS REPORTED A SHORTFALL IN PART III SECTION B LINE 7. THE EXPENSES, REVENUES AND SHORTFALL REPORTED IN PART III LINES 5-7 WERE DEVELOPED FROM THE 2011 CALVARY HOSPITAL, INC. COST REPORTS FILED WITH THE NYS DOH AND NATIONAL GOVERNMENT SERVICES (MEDICARE INTERMEDIARY). PART III, LINE 9B: CALVARY HOSPITAL, INC.'S FINANCIAL ASSISTANCE POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE.CALVARY HOSPITAL'S COLLECTION: BAD DEBT WRITE-OFFS POLICY INDICATES THAT ALL REASONABLE EFFORTS WILL BE MADE BY PATIENT ACCOUNTS REPRESENTATIVES TOOBTAIN PAYMENT AND TO SETTLE PATIENT ACCOUNTS RECEIVABLE ON A CONSISTENT BASIS. THE PATIENT ACCOUNTING SYSTEM WILL BEAR ENTRIES OF SUCH ATTEMPTS,INCLUDING THE DATE AND THE REPRESENTATIVE'S INITIALS. ACCOUNTS RESISTING SETTLEMENT MAY BE REFERRED TO A COLLECTION AGENCY. CALVARY HOSPITAL INC. PART V, SECTION B, LINE 13G: THE HOSPITAL PUBLISHES AVAILABILITY OF CHARITY CARE IN THE NEW YORK TIMES. CALVARY HOSPITAL INC. PART V, SECTION B, LINE 18C: THE HOSPITAL DOES NOT HAVE EMERGENCY ROOM. CALVARY HOSPITAL INC. PART V, SECTION B, LINE 19D: 15% OF GROSS CHARGES WHICH IS BELOW OUR LOWEST PAYER. PART VI, LINE 2: CALVARY HOSPITAL IS THE ONLY FULLY ACCREDITED ACCUTE CARE SPECIALTY HOSPITAL EXCLUSIVELY PROVIDING PALLIATIVE CARE FOR ADULT ADVANCED CANCER PATIENTS IN THE UNITED STATES LOCATED IN THE BRONX AND BROOKLYN.CALVARY HOSPITAL USES A VARIETY OF METHODS AND SERVICES TO GATHER COMMUNITY INPUT, ASSESS THE NEEDS OF THE COMMUNITY, AND TO ASSURE INPUT IN THE COMMUNITY SERVICE PLAN. SOME OF THESE METHODS ARE:A. COMMUNITY OUTREACH SERVICES -COMMUNITY OUTREACH SERVICES FUNCTIONS AS A LIAISON WITH THE COMMUNITY,REFERRERS, PHYSICIANS, PATIENTS, AND FAMILIES AND FACILITATES ADMISSION TOCALVARY HOSPITAL. THE DEPARTMENT OUTREACHES THROUGH THE TRI-STATE REGIONAND EDUCATES THE HEALTH CARE AND PATIENT COMMUNITIES AS TO THE CONTINUUMOF SERVICES CALVARY PROVIDES (INPATIENT, OUTPATIENT, HOME CARE, HOSPICENURSING HOME HOSPICE, AND WOUND CARE). THROUGH ON-SITE VISITS, PUBLICPRESENTATIONS AND PARTICIPATION IN COMMUNITY AND PROVIDER ACTIVITIES, THEOUTREACH STAFF CONTINUALLY ASSESSES THE NEEDS OF THE COMMUNITY. B. PROFESSIONAL ADVISORY BOARD -THE PROFESSIONAL ADVISORY BOARD WAS ESTABLISHED IN 1992 TO OBTAIN INPUTFROM THE COMMUNITY. THE ADVISORY BOARD MEETS AT LEAST ANNUALLY AND ISCOMPRISED OF PHYSICIANS NURSES, AND SOCIAL WORKERS, REPRESENTINGHOSPITALS, AND HOME CARE AGENCIES, AS WELL AS THE COMMUNITY. THIS GROUPHAS CONTRIBUTED A VARIETY OF IDEAS FOR ENHANCING SERVICES TO THECOMMUNITY.C. COMMUNITY PLANNING BOARDEACH YEAR THE HOSPITAL INVITES THE HEALTH COMMITTEE OF COMMUNITY PLANNINGBOARD #11 AND #10 TO VISIT THE HOSPITAL AND MEET WITH SENIOR STAFF.D. OUTREACH REPRESENTATION (OPEN HOUSE) FOR HEALTH CARE PROFESSIONALS - COMMUNITY OUTREACH HOSTS OPEN HOUSES AT BOTH THE BRONX AND BROOKLYNLOCATIONS TO PROVIDE INFORMATION TO AND RECEIVE INFORMATION FROM ITSREFERRERS.CALVARY HOSPITAL, INC. ALSO HAS PUBLIC PARTICIPATION IN THE EXTENDEDCOMMUNITY THROUGH PARTICIPATION IN:- GREATER NEW YORK HOSPITAL ASSOCIATION- HOSPITAL ASSOCIATION OF NEW YORK STATE- AMERICAN HOSPITAL ASSOCIATION- NEW YORK CITY DEPARTMENT OF HEALTH- NEW YORK STATE DEPARTMENT OF HEALTH- CATHOLIC HEALTHCARE ASSOCIATION- CMSTHROUGH ONGOING PARTICIPATION IN THE GROUPS ABOVE, CALVARY HOSPITALCONTINUALLY MONITORS THE TRENDS IN THE HEALTHCARE NEEDS OF THE LARGERCOMMUNITY. ALTHOUGH THE NATURE OF ITS SERVICES IS LIMITED BY ITSSPECIALIZED MISSION, CALVARY HAS IDENTIFIED A VARIETY OF ACTIVITIES TOPARTICIPATE IN IMPROVING THE HEALTH OF ITS EXTENDED COMMUNITY. PART VI, LINE 3: EACH PERSON REQUESTING CALVARY'S SERVICES MUST BE MADE AWARE OF CALVARY'S UNCOMPENSATED (FREE) SERVICES OR DISCOUNTED SERVICES PROGRAM AS FOLLOWS:1. DISTRIBUTE AN INDIVIDUAL NOTICE TO EACH PERSON WHO IS SEEKING SERVICES ON BEHALF OF HIMSELF OR ANOTHER. THIS NOTICE IS PASSED TO THE INDIVIDUALUSUALLY AT THE POINT OF ADMISSION OR REGISTRATION WHEN FINANCIAL ARRANGEMENTS ARE BEING DISCUSSED. THE "NOTICE OF AVAILABILITY OF UNCOMPENSATED (FREE) SERVICES OR DISCOUNTED SERVICES" IS UPDATED ANNUALLY. 2. POST SIGNS PROVIDED BY THE DEPARTMENT OF HEALTH AND HUMAN SERVICES CONSPICUOUSLY IN THE ADMITTING OFFICE, BUSINESS OFFICE, CLINICS, HOME HEALTH AGENCY, AND HOSPICE AREAS. THE SIGNS ARE TO BE IN ENGLISH AND SPANISH. ADDITIONALLY, CALVARY HAS ACCESS TO A LANGUAGE TELEPHONE SERVICE THAT ADDS 58 ADDITIONAL LANGUAGES TO ENGLISH AND SPANISH. 3. PUBLISH NOTICE OF HILL-BURTON UNCOMPENSATED SERVICES OBLIGATION ANNUALLY IN LOCAL NEWSPAPER IN SERVICE AREA (NEW YORK TIMES LEGAL). PART VI, LINE 4: CALVARY HOSPITAL'S MAIN CAMPUS IS LOCATED IN THE BRONX, NY. THE BRONX IS CONSIDERED THE PRIMARY COMMUNITY FOR THE PURPOSES OF PUBLIC HEALTH PLANNING, AND 59% OF ITS EMPLOYEES RESIDE IN THE PRIMARY SERVICE AREA. IN ADDITION, AS A TERTIARY REFERRAL CENTER FOR ADVANCED DISEASE, CALVARY HOSPITAL SERVES THE ENTIRE TRI-STATE REGION. THE SECONDARY SERVICE IS DETERMINED BASED ON CURRENT REFERRAL PATTERNS.THE PRIMARY REFERRAL SOURCES FOR ADMISSIONS CONTINUE TO BE THE ACUTE CARE HOSPITALS. CURRENTLY 76% OF ADMISSIONS ARE REFERRED BY HOSPITALS LOCATEDWITHIN THE BOROUGHS OF NEW YORK CITY, ROCKLAND, AND WESTCHESTER COUNTIES, LONG ISLAND, AND THE STATES OF NEW JERSEY AND CONNECTICUT. OTHER REFERRALSOURCES ARE CALVARY HOSPITAL HOME CARE, HOSPICE, AND OTHER HOME CARE AND HOSPICE AGENCIES. CALVARY OUTPATIENT SERVICES, FAMILIES, PHYSICIANS,NURSING HOMES, AND COMMUNITY AGENCIES.IN 2001, CALVARY EXPANDED ITS SERVICES WITH THE OPENING OF CALVARY HOSPITAL - THE BROOKLYN CAMPUS, AT LUTHERAN MEDICAL CENTER. REPORTS FILED WITH STATES PART VI, LINE 7 NY X X 0 1 X X X X 1 1 0 0 0 0 0 0 0 SCOTT LARUE 457517 0 0 0 0 0 117200 0 22144 0 596861 0 0 0 JAMES INTRONE 993832 0 0 0 0 0 0 0 12506 0 1006338 0 369000 0 MICHAEL J BRESCIA MD 373745 0 0 0 59463 0 16170 0 8235 0 457613 0 0 0 FRANK A CALAMARI 433858 0 0 0 260950 0 27570 0 10348 0 732726 0 0 0 CHRISTOPHER COMFORT MD 331393 0 0 0 23671 0 27570 0 24727 0 407361 0 0 0 RICHARD KUTILEK 251105 0 0 0 60261 0 27570 0 22294 0 361230 0 0 0 ANDREW V GRECO 241816 0 0 0 22987 0 27570 0 26061 0 318434 0 0 0 SALLY UMBRO RN 210524 0 0 0 4091 0 25576 0 16859 0 257050 0 0 0 ANTHONY TARANTO 161542 0 0 0 9089 0 22705 0 8235 0 201571 0 0 0 NANCY D'AGOSTINO RN 202123 0 0 0 3911 0 25174 0 26677 0 257885 0 0 0 ROBERT BRESCIA MD 298206 0 0 0 13912 0 27570 0 12248 0 351936 0 0 0 DEVMANI JAITLY MD 219286 0 0 0 271509 0 27570 0 24727 0 543092 0 0 0 GAIL CHRZANOWSKI MD 219582 0 0 0 62583 0 27570 0 16579 0 326314 0 0 0 ALMA CARRINGTON 211132 0 0 0 54107 0 27570 0 16360 0 309169 0 0 0 SREENIVASA PATIBANDLA MD 164908 0 0 0 202662 0 27570 0 0 0 395140 0 0 0 PART I, LINE 1A EFFECTIVE JUNE 1, 1998, THE HOSPITAL ESTABLISHED THE CALVARY HOSPITAL SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) TO PROVIDE PENSION BENEFITS FOR WAGES EARNED BY CERTAIN PHYSICIANS AND SENIOR EXECUTIVE STAFF WITH COMPENSATION IN EXCESS OF THE IRS LIMITS AND ALSO ESTABLISHED THE CALVARY HOSPITAL KEY EMPLOYEE SHARE OPTION PLAN (KEYSOP) TO PROVIDE ADDITIONAL AND ALTERNATIVE FORMS OF COMPENSATION TO KEY EMPLOYEES. PRIOR TO 2002, THE HOSPITAL UTILIZED THE KEYSOP TO FUND THE SERP. AS A RESULT OF THE IRS 457 REGULATIONS WHICH WERE ISSUED DURING 2002, THE UTILIZATION OF THE KEYSOP TO FUND THE SERP BECAME UNFEASIBLE. AFTER CONSIDERATION OF VARIOUS REPLACEMENT OPTIONS, IN 2003, CALVARY HOSPITAL CHOSE THE TAX GROSS-UP OPTION, WHEREBY, INDIVIDUAL PARTICIPANTS' DEFERRALS WOULD BE GROSSED-UP TO DUPLICATE THE BENEFITS HE WOULD RECEIVE IN A TAX-DEFERRED ARRANGEMENT AND PAID THEM OUT DIRECTLY TO THE PARTICIPANTS. THE FOLLOWING EXECUTIVES RECEIVED TAX GROSS-UP PAYMENTS IN 2011 IN ORDER TO DUPLICATE A TAX DEFERRED VEHICLE: (THE AMOUNTS WERE CALCULATED BY DELOITTE CONSULTING LLP UTILIZING EXPECTED TAX RATES TO CALCULATE THE NET AMOUNTS.): - FRANK A. CALAMARI - RICHARD KUTILEK THE ORGANIZATION PROVIDED SOCIAL CLUB DUES IN 2011 FOR FRANK CALAMARI AND THE DUES WERE INCLUDED AS TAXABLE COMPENSATION. PART I, LINES 4A-B LINE 4A: DIRECTOR JAMES INTRONE RECEIVED PAYMENT OF SEVERANCE IN 2011. THE SEVERANCE PAID FROM JANUARY 1, 2011 THRU DECEMBER, 31, 2011 WAS $554,734 RELATED TO BASE COMPENSATION. LINE 4B: THE FOLLOWING CALVARY HOSPITAL OFFICERS PARTICPATE IN A NOW-DEFUNCT SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: FRANK CALAMARI, MICHAEL BRESCIA, FRANK LOCAPARRA (RETIRED), AND RICHARD KUTILEK. ORGANIZATION'S MISSION FORM 990, PART I, LINE 1 CALVARY HOSPITAL IS A FULLY ACCREDITED ACUTE CARE SPECIALITY HOSPITAL EXCLUSIVELY PROVIDING PALLIATIVE CARE FOR ADVANCES CANCER PATIENTS IN THE UNITED STATES. PROGRAM SERVICE STATEMENT FORM 990, PART III, LINE 4B CALVARY HOSPITAL HOSPICE IS A MEDICARE-CERTIFIED HOSPICE PROGRAM, WHICH PROVIDES AN INTERDISCIPLINARY CARE TEAM FOR PATIENTS WITH A TERMINAL PROGNOSIS FOR ALL END-STAGE DISEASES. CALVARY HOSPITAL HOSPICE EMBRACES AND IMPLEMENTS THE BASIC ASSUMPTIONS OF THE HOSPICE CONCEPT, INCLUDING THE FOLLOWING: - HOSPICE PROVIDES PALLIATIVE MEDICAL CARE, TREATING THE PHYSICAL, EMOTIONAL AND SPIRITUAL PAIN OF THE PATIENT AND FAMILY. - HOSPICE TREATS THE PATIENT AND LOVED ONES TOGETHER AS A WHOLE UNIT OF CARE AND OFFERS BEREAVEMENT COUNSELING FOR SURVIVING CAREGIVERS AFTER THE PATIENT'S DEATH. - HOSPICE PATIENTS REMAIN IN THE FAMILIAR, COMFORTING SURROUNDINGS OF HOME, WHETHER IT'S A PRIVATE RESIDENCE, NURSING HOME, HOSPITAL OR AN ASSISTED LIVING FACILITY. - HOSPICE CARE PROVIDES THE FOLLOWING FOUR LEVELS OF CARE: ROUTINE CARE, GENERAL INPATIENT CARE (IF NEEDED), CONTINUOUS CARE (DURING A CRISIS), AND RESPITE CARE. HOSPICE SERVICES - NURSING CARE, AS NECESSARY TO MAINTAIN THE PATIENT AT HOME - 24 HOURS A DAY, 7 DAYS A WEEK ON-CALL NURSE PHYSICIAN SERVICES - MEDICAL SOCIAL SERVICES - PASTORAL CARE - COUNSELING SERVICES - NUTRITIONAL COUNSELING - SHORT-TERM INPATIENT AND RESPITE CARE - MEDICAL SUPPLIES RELATED TO TERMINALLY ILL - PERSONAL CARE PROVIDED BY CERTIFIED HOME HEALTH AIDES - THERAPIES (E.G., PHYSICAL, OCCUPATIONAL AND SPEECH) - MEDICATIONS FOR SYMPTOM MANAGEMENT AND PAIN CONTROL RELATED TO THE TERMINALLY ILL - BEREAVEMENT COUNSELING FOR FAMILY MEMBERS - VOLUNTEER SERVICES PROGRAM SERVICE STATEMENT FORM 990, PART III, LINE 4C CALVARY'S HOME HEALTH AGENCY SERVES PATIENTS IN THE BRONX, QUEENS, NORTHERN MANHATTAN, AND SOUTHERN WESTCHESTER COUNTY. CALVARY OFFERS HOME CARE TO PATIENTS WITH ALL DIAGNOSES. MOST PATIENTS RETURN TO PRE-ILLNESS FUNCTION AND ARE DISCHARGED TO SELF-CARE WITHIN SIX TO EIGHT WEEKS. ALL OF OUR PATIENTS WHO WE CARE FOR AT HOME GET THE SAME LEVEL OF HIGH-QUALITY AND UNIQUE "CALVARY CARE" AS ALL OF OUR INPATIENTS. THE FOLLOWING SERVICES ARE AVAILABLE TO PATIENTS AND THEIR FAMILIES THROUGH CALVARY'S CERTIFIED HOME HEALTH AGENCY: NURSING SERVICES - OUR COMMUNITY HEALTH NURSES PROVIDE NURSING VISITS TO PATIENTS IN THEIR HOMES. - SPECIALIZED NURSING IS AVAILABLE SUCH AS ENTEROSTOMAL THERAPY. - 24-HOUR TELEPHONE ACCESS TO RN (REGISTERED NURSE) ON-CALL. HOME HEALTH AIDE - PROVIDES ASSISTANCE WITH PERSONAL CARE AND OTHER ACTIVITIES RELATED TO HEALTH CARE. NUTRITIONAL SERVICES - CALVARY'S DIETITIANS ARE AVAILABLE BY PHONE TO HELP IN PLANNING THERAPEUTIC NUTRITIONAL MANAGEMENT. THERAPY SERVICES - PHYSICAL THERAPY - OCCUPATIONAL THERAPY - SPEECH THERAPY MEDICAL CARE - CALVARY HOME CARE STAFF WILL WORK CLOSELY WITH THE PATIENT'S OWN PHYSICIAN TO MEET HOME HEALTH NEEDS. - OUR STAFF HAS EXTENSIVE KNOWLEDGE OF PAIN MANAGEMENT. MEDICAL SOCIAL WORK A FULL RANGE OF SOCIAL WORK SERVICES ARE AVAILABLE TO HELP PATIENTS AND FAMILIES COPE WITH THE PROBLEMS OF ILLNESS. - ASSISTANCE IN MEDICAID APPLICATION - ASSISTANCE IN LONG-TERM PLANNING REFERRING PATIENTS - REFERRALS MAY BE MADE BY PATIENTS FAMILY MEMBERS, FRIENDS, HOSPITALS, CLINICS, PHYSICIANS, OTHER HEALTH CARE PROFESSIONALS AND COMMUNITY AGENCIES. - TO MAKE A REFERRAL OR TO LEARN MORE ABOUT OUR SERVICES, PLEASE CALL (718) 430-9540. PART OF THE CALVARY CONTINUUM FACILITATE ADMISSION TO INPATIENT CARE FOR SYMPTOM MANAGEMENT - REFERRAL TO OUTPATIENT AND WOUND CARE CLINICS - PROVIDE INFORMATION ON CALVARY PROGRAMS INCLUDING BEREAVEMENT SUPPORT FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF CALVARY HOSPITAL IS ARCHCARE. FORM 990, PART VI, SECTION A, LINE 7A THE CALVARY HOSPITAL BYLAWS RESERVE CERTAIN RIGHTS TO ARCHCARE AS THE SOLE MEMBER OF THE HOSPITAL. THESE RIGHTS ARE ENUMERATED IN ARTICLE IV AND INCLUDE THE RIGHT TO AMEND THE HOSPITAL'S BYLAWS AND ORGANIZING DOCUMENTS, APPOINT AND REMOVE BOARD MEMBERS AND APPROVE CERTAIN DECISIONS OF THE HOSPITAL'S BOARD OF DIRECTORS, INCLUDING BUT NOT LIMITED TO, THE ADOPTION OF A STRATEGIC PLAN, ACQUISITION OF ANOTHER ORGANIZATION, REAL ESTATE TRANSACTIONS EXCEEDING A CERTAIN DOLLAR THRESHOLD, ADOPTION OF CRITERIA FOR MANAGED CARE CONTRACTING, AND ADOPTION OF SYSTEM-WIDE MEASURES. FORM 990, PART VI, SECTION A, LINE 7B ARCHCARE HAS THE FOLLOWING POWERS AND RIGHTS WHICH ARE VESTED IN ARCHCARE BY LAW, THE CERTIFICATE OF INCORPORATION AND THE HOSPITAL BYLAWS. SUCH POWERS AND RIGHTS INCLUDE AMENDMENT TO THE BYLAWS AND CERTIFICATE OF INCORPORATION OF THE HOSPITAL, APPOINTMENT AND REMOVAL OF THE MEMBERS OF THE BOARD OF DIRECTORS AND THE CHAIRMAN OF THE BOARD OF DIRECTORS OF THE HOSPITAL, ADOPTION OF THE HOSPITAL BUDGETS, ADOPTION OR AMENDMENT OF THE BUSINESS AND STRATEGIC PLAN FOR THE HOSPITAL, FORMATION OR PURCHASE OF AN ENTITY THAT IS A RELATED ENTITY, CERTAIN REAL ESTATE AND CAPITAL TRANSACTIONS AND APPROVAL OF MANAGEMENT CONTRACTS SUBJECT TO AGREED-UPON THRESHOLDS, PROGRAM OR SERVICE CHANGES BY THE HOSPITAL, APPROVAL OF ANY MERGER, PURCHASE, JOINT OPERATING AGREEMENT OR OTHER AFFILIATION OR WITHDRAWAL FROM, DISPOSITION OF AN INTEREST IN OR DISSOLUTION OF ANY SUCH AFFILIATION. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 WAS PRESENTED AND DRAFTS WERE MADE AVAILABLE TO THE BOARD OF DIRECTORS ON 1/22/2013. A COPY OF THE FORM 990 WAS PROVIDED TO EACH MEMBER OF THE CALVARY HOSPITAL BOARD OF DIRECTORS PRIOR TO ITS FILING WITH THE INTERNAL REVENUE SERVICE IN ELECTRONIC FORMAT. FORM 990, PART VI, SECTION B, LINE 12C EACH OFFICER, DIRECTOR, TRUSTEE AND KEY EMPLOYEE IS REQUIRED TO ANNUALLY DISCLOSE ANY CONFLICTS OF INTEREST THAT ARISE BY VIRTUE OF THEIR EMPLOYMENT AND POSITION WITH CALVARY HOSPITAL OR CALVARY FUND. CALVARY MONITORS COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY THROUGH AN ANNUAL QUESTIONNAIRE SUBMITTED TO THESE INDIVIDUALS. POTENTIAL CONFLICTS ARE INVESTIGATED IMMEDIATELY AND, IF ANY ARE UNCOVERED, THERE ARE POLICIES IN PLACE TO ENSURE THAT THOSE INDIVIDUALS RECUSE THEMSELVES FROM PARTICIPATING IN ANY DECISIONMAKING RELATED TO SUCH CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 CALVARY HOSPITAL, INC UNDERTAKES A RIGOROUS PROCESS TO ENSURE THAT THE EXECUTIVE COMPENSATION IT PAYS TO ITS TOP MANAGEMENT OFFICIALS AND ALL OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION IS REASONABLE. IN RELEVANT PART, THE BOARD OF DIRECTORS HAS ESTABLISHED A COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT PERSONS THAT HAVE NO PERSONAL INTEREST IN THE PROPOSED COMPENSATION ARRANGEMENT. THE BOARD OF DIRECTORS USES AN INDEPENDENT COMPENSATION CONSULTANT TO HELP ADVISE ON THE APPROPRIATE COMPENSATION LEVELS FOR THE AFOREMENTIONED INDIVIDUALS. THAT COMPENSATION CONSULTANT WILL USE COMPARABILITY OR BENCHMARKLNG DATA (BASED ON INDUSTRY SURVEYS) THAT DOCUMENTS THE COMPENSATION OF PERSONS HOLDING SIMILAR PERSONS IN SIMILAR ORGANIZATIONS. ONCE THE COMPENSATION CONSULTANT HAS MADE ITS RECOMMENDATIONS, THE CALVARY COMPENSATION COMMITTEE MUST APPROVE THE COMPENSATION, WITHOUT INPUT OR VOTING PARTICIPATION BY THE PERSON WHOSE COMPENSATION IS BEING APPROVED OR BY ANY OTHER INDIVIDUAL WITH A CONFLICT OF INTEREST THE FINAL DETERMINATION IS THEN DOCUMENTED IN COMMITTEE MINUTES THOSE MINUTES WILL CONTAIN THE TERMS OF THE PROPOSED COMPENSATION, THE DECISIONS OF THOSE INDIVIDUALS WHO VOTED ON THE COMPENSATION, AND THE COMPARABILITY DATA THAT WAS RELIED UPON. FORM 990, PART VI, SECTION C, LINE 19 CALVARY HOSPITAL MAKES ITS FORM 990 AVAILABLE TO THE PUBLIC BY RETAINING A COPY AT THE ADDRESS LISTED ON PAGE 1 OF THIS RETURN. ANY INDIVIDUAL REQUESTING A COPY OF THESE DOCUMENTS IS PROVIDED THAT COPY ON THE SAME BUSINESS DAY. THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST AND AT MANAGEMENT'S DISCRETION. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -1,259,100. PENSION-RELATED ADJUSTMENTS -4,889,832. BENEFICIAL INTEREST IN NET ASSETS OF CALVARY FUND, INC. 2,064,500. TOTAL TO FORM 990, PART XI, LINE 5: -4,084,432. CALVARY PALLIATIVE CARE NETWORK LLC 1740 EASTCHESTER ROAD BRONX NY 10461 NY 0 0 N/A NETWORK INDEPENDENT PRACTICE ASSOCIATION 1740 EATCHESTER ROAD BRONX NY 10461 NY 0 0 N/A CALVARY NETWORK MANAGEMENT SERVICES LLC 1740 EASTCHESTER ROAD BRONX NY 10461 NY 0 0 N/A CALVARY FUND INC 1740 EASTCHESTER ROAD BRONX NY 10461 NY 501(C)(3) LINE 11A, I 0 CALVARY HOLDING COMPANY 1740 EASTCHESTER ROAD BRONX NY 10461 NY 501(C)(3) LINE 9 0 ARCHCARE 155 EAST 56TH STREET FLOOR 2 NEW YORK NY 10022 NY 501(C)(3) LINE 9 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0