2013-11-14T13:04:53-06:00 2012-12-31 Charles A Barragato & Co LLP 950 Third Avenue - 20th FL New York NY 10022 990 2012-01-01 133245804 Nyack Hospital Foundation % RONALD RATIGAN NYAC 8453486520 160 North Midland Avenue Suite Nyack NY 10960 RONALD RATIGAN 2123714446 2013-11-15 true 2123714446 2012 2016-02-24 21:20:13Z DAVID H FREED 160 NORTH MIDLAND AVENUE NYACK NY 10960 1752618 false X NYACKHOSPITAL.ORG X 1984 NY TO RAISE FUNDS FOR NYACK HOSPITAL. THE FOUNDATION ASSISTS THE HOSPITAL IN PURCHASING STATE-OF-THE-ART EQUIPMENT, DEVELOPING PROGRAMS AND SERVICES, AND AIDING IN FACILITY IMPROVEMENT INITIATIVES. 17 14 0 49 0 4118650 1449626 0 0 2045 32566 93686 130661 4214381 1612853 0 0 0 0 115150 122344 0 0 207408 693624 507851 808774 630195 3405607 982658 5568417 6542273 148529 62335 5419888 6479938 TO RAISE FUNDS FOR NYACK HOSPITAL, A RELATED ORGANIZATION EXEMPT UNDER IRC SECTION 501(C)(3). THE FOUNDATION ASSISTS THE HOSPITAL IN PURCHASING STATE-OF-THE-ART EQUIPMENT, DEVELOPING PROGRAMS AND SERVICES, AND AIDING IN FACILITY IMPROVEMENT INITIATIVES. false false 422787 TO RAISE FUNDS FOR NYACK HOSPITAL, A RELATED ORGANIZATION EXEMPT UNDER IRC SECTION 501(C)(3). THE FOUNDATION ASSISTS THE HOSPITAL IN PURCHASING STATE-OF-THE-ART EQUIPMENT, DEVELOPING PROGRAMS AND SERVICES, AND AIDING IN FACILITY IMPROVEMENT INITIATIVES. DURING 2012 THE FOUNDATION DISTRIBUTED $417,496 TO NYACK HOSPITAL. 422787 true true false false false false false false false true false false false true true false false true false false false false false false true false false false false true false false false false false false false false false false false false false true false false false false true 12 0 true 0 false false false false false true true false false false false X 17 14 false false false false true true false true true false false true true true true true true true true false NY X RONALD RATIGAN 8453486522 160 NORTH MIDLAND AVENUE NYACK NY 10960 MARK JACOBS 1.0 1.0 X X 0 MITCHELL D COHN MD 1.0 X X JOHN S BURKE 1.0 40.0 X X 426166 34097 EDWARD S FISHER DDS 1.0 X X DAVID H FREED DHA 1.0 40.0 X X 701107 25898 VINCENT ABBATECOLA 1.0 X JILL GARLAND 1.0 40.0 X X 201963 30092 FRANK BORELLI JR 1.0 X MARK GELLER MD 1.0 X LISA HAYES 1.0 1.0 X DANIEL M JUECHTER 1.0 X PETER E LANG 1.0 X MICHAEL E RADER MD 1.0 40.0 X 460865 33650 ROGER RAICHELSON MD 1.0 X SACHIN J SHAH MD 1.0 X BRIGITTE SIMON 1.0 X DANIEL SPITZER MD 1.0 X WILLIAM M TRUST JR 1.0 X 0 1790101 123737 0 false true false 0 101771 1347855 1449626 0 32277 32277 0 0 0 0 0 28000 27711 289 289 289 242715 101771 112054 130661 130661 0 0 0 1612853 163227 0 0 0 0 0 0 0 95580 95580 0 26764 26764 0 0 0 0 0 0 0 0 3935 3935 12172 12172 4228 4228 0 346 346 1591 1591 0 1491 1491 0 417496 417496 0 0 OTHER PURCHASED SERVICES 30710 30710 PRINTING & PUBLICATION 11857 11857 RECOGNITION EXPENSE 11485 11485 DUES & SUBSCRIPTIONS 7249 7249 5291 5291 630195 422787 0 207408 2490064 2467233 73302 155597 2443052 3262536 0 0 0 0 0 0 0 0 0 0 0 0 0 151848 212494 0 0 0 0 0 0 410151 444413 5568417 6542273 17621 6474 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130908 55861 148529 62335 X 1760884 1601017 3459004 4678921 200000 200000 5419888 6479938 5568417 6542273 982658 77392 X false true X true false X 897173 563211 441799 4118650 1449626 7470459 0 0 897173 563211 441799 4118650 1449626 7470459 4110014 3360445 82558 52925 10063 1704 32277 179527 0 238140 157290 230983 179043 242715 1048171 8698157 0.38634 0.48460 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 200000 200000 200000 200000 200000 200000 200000 200000 200000 200000 1.00000 false false CSV OF INSURANCE POLICIES 440163 DUE FROM AFFILIATE 4250 444413 0 DUE TO AFFILIATES 55861 55861 PART V, LINE 4 - INTENDED USES OF ENDOWMENT FUND THE INTENDED USE OF THE FOUNDATION'S ENDOWMENT IS TO PROVIDE FUNDS TO BE USED FOR INDIGENT CARE BREAST HEALTH. Golf Classic 229521 94671 134850 56504 Gala 87225 4025 83200 41743 1 27740 3075 24665 13807 344486 101771 242715 112054 112054 130661 false false false false false false false false false JOHN S BURKE 316887 54436 54843 7500 26597 460263 0 DAVID H FREED DHA 489899 94277 116931 14850 11048 727005 0 JILL GARLAND 145064 32833 24066 4331 25761 232055 0 MICHAEL E RADER MD 340714 62777 57374 14850 18800 494515 0 EXPLANATION OF CLASSES OF MEMBERS OR SHAREHOLDERS FORM 990, PART VI, LINE 6 THE MEMBERS OF THE NYACK HOSPITAL FOUNDATION SHALL BE THE ELECTED TRUSTEES OF NYACK HOSPITAL. HOW MEMBERS OR SHAREHOLDERS ELECT GOVERNING BODY FORM 990, PART VI, LINE 7A AS SOLE CORP MEMBER, NYACK HOSPITAL DESIGNATED THE INITIAL BOARD MEMBERS, THEREAFTER, BOARD MEMBERS SHALL BE APPOINTED IN ACCORDANCE WITH THE NYACK HOSPITAL FOUNDATION BYLAWS. FORM 990 REVIEW PROCESS FORM 990, PART VI, LINE 11B THE ACCOUNTING MANAGER, DIRECTOR OF FINANCE, AND THE ENTIRE FINANCE TEAM ARE INVOLVED IN THE PREPARATION AND REVIEW OF THE FORM 990. ONCE THE DIRECTOR OF FINANCE HAS COMPLETED HIS REVIEW, THE CFO REVIEWS THE FORM 990 IN DETAIL, INCLUDING ALL SCHEDULES. THE FORM 990 WAS THEN UPLOADED TO THE NYACK HOSPITAL WEBSITE FOR THE FULL BOARD REVIEW IN THE "BOARD ONLY" SECTION. ONLY BOARD MEMBERS CAN ACCESS WITH A PASSWORD. EXPLANATION OF MONITORING AND ENFORCEMENT OF CONFLICTS FORM 990, PART VI, LINE 12C THE FOUNDATION HAS ADOPTED THE CONFLICT OF INTEREST POLICY MAINTAINED BY NYACK HOSPITAL, THE PARENT ORGANIZATION. ALL MONITORING AND ENFORCEMENT OF THE CONFLICT OF INTEREST POLICY IS PERFORMED BY THE HOSPITAL ON BEHALF OF THE FOUNDATION. IN AN EFFORT TO ENSURE THAT ALL TRANSACTIONS OCCURING BETWEEN THE ORGANIZATION AND A THIRD PARTY DO NOT INURE TO THE BENEFIT OF ANY INDIVIDUAL OR CORPORATION, NYACK HOSPITAL MAINTAINS A CONFLICT OF INTEREST POLICY. UNDER THIS POLICY, OFFICERS, TRUSTEES AND EMPLOYEES MUST DISCLOSE ANY RELATIONSHIPS THAT MAY RESULT IN CONFLICT DUE TO TRANSACTIONS OCCURING BETWEEN THE ORGANIZATION AND AN INDIVIDUAL. ALL EMPLOYEES AND TRUSTEES HAVE A DUTY TO DISCLOSE ANY FINANCIAL INTEREST WHICH MAY POSE A CONFLICT WITH THEIR HOSPITAL RESPONSIBILITIES. THIS DISCLOSURE IS CONFIRMED BY THE DISTRIBUTION OF A QUESTIONNAIRE ON AN ANNUAL BASIS. IN COMPLETING THE QUESTIONNAIRE, THE EMPLOYEE OR THE TRUSTEE IS RESPONSIBLE FOR DISCLOSING HIS OR HER RELATIONSHIP TO ANY ENTITY DOING BUSINESS WITH THE ORGANIZATION UNLESS SUCH INTEREST DOES NOT REPRESENT A SIGNIFICANT PORTION OF THE INDIVIDUAL'S NET WORTH. ADDITIONALLY, SHOULD THE EMPLOYEE OR TRUSTEE BECOME AWARE OF SUCH A RELATIONSHIP SUBSEQUENT TO THE ADMINISTRATION OF THE QUESTIONNAIRE, HE OR SHE SHOULD DISCLOSE THE RELATIONSHIP TO THE APPROPRIATE DEPARTMENT HEAD OR CHAIRPERSON. IN THE EVENT OF A POTENTIAL CONFLICT, THE INDIVIDUAL IS ASKED TO ABSTAIN FROM PARTICIPATING IN ANY DECISIONS RELATED TO THE TRANSACTION IN QUESTION UNTIL THE ORGANIZATION CAN DETERMINE IF A CONFLICT OF INTEREST EXISTS AND MAKES AN APPROPRIATE DECISION TO DETERMINE HOW THE CONFLICT WILL BE RESOLVED. COMPENSATION REVIEW & APPROVAL PROCESS FOR CEO, EXEC DIRECTOR OR TOP MGMT FORM 990, PART VI, LINE 15A THE COMPENSATION OF THE CHIEF EXECUTIVE OFFICER AND SENIOR EXECUTIVES IS REVIEWED AND APPROVED ANNUALLY BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. AN INDEPENDENT OUTSIDE CONSULTANT WITH EXPERTISE IN HOSPITAL EXECUTIVE COMPENSATION ASSESSES THE EXECUTIVE COMPENSATION AS COMPARED TO SIMILAR POSITIONS IN THE NEW YORK AREA AND RECOMMENDS A RANGE. THE COMMITTEE SETS THE EXECUTIVE COMPENSATION FOR THE COMING YEAR WITHIN THE FAIR MARKET VALUE RANGE RECOMMENDED BY THE CONSULTANT. 2012 Executive Compensation was also reviewed and approved by the full Board. COMPENSATION REVIEW & APPROVAL PROCESS FOR OFFICERS & KEY EMPLOYEES FORM 990, PART VI, LINE 15B THE COMPENSATION OF THE OFFICERS AND KEY EMPLOYEES IS REVIEWED AND APPROVED ANNUALLY BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. AN INDEPENDENT OUTSIDE CONSULTANT WITH EXPERTISE IN HOSPITAL EXECUTIVE COMPENSATION ASSESSES THE COMPENSATION AS COMPARED TO SIMILAR POSITIONS IN THE NEW YORK AREA AND RECOMMENDS A RANGE. THE COMMITTEE SETS THE COMPENSATION FOR THE COMING YEAR WITHIN THE RANGE RECOMMENDED BY THE CONSULTANT. 2012 Executive Compensation was also reviewed and approved by the full Board. OTHER ORGANIZATION DOCUMENTS PUBLICLY AVAILABLE FORM 990, PART VI, LINE 19 UPON REQUEST, THE ORGANIZATION WILL MAKE AVAILABLE ONLY THOSE DOCUMENTS REQUIRED TO BE DISCLOSED UNDER THE PUBLIC INSPECTION LAWS. Form 990, Part VII, Line 2 NYACK HOSPITAL FOUNDATION DOES NOT DIRECTLY PAY ITS EMPLOYEES. THE COMPENSATION AND BENEFITS ARE ALLOCATED FROM NYACK HOSPITAL. THE COMPENSATION AND BENEFITS ARE RECORDED ON THE FORM 941 FILED BY NYACK HOSPITAL UNDER THE EMPLOYER IDENTIFICATION NUMBER 13-1740119. THE NEW YORK METHODIST HOSPITAL 506 SIXTH STREET BROOKLYN NY 11215 111631796 HEALTHCARE NY 501(c)(3) 3 NYP SYS INC true PARK SLOPE MEDICAL SERVICE PC 506 SIXTH STREET BROOKLYN NY 11215 112843882 HEALTHCARE NY 501(c)(3) 11 TYPE I NY METHODIST true BROOKLYN FOOT & ANKLE PC 506 SIXTH STREET BROOKLYN NY 11215 113441502 HEALTHCARE NY 501(c)(3) 11 TYPE I NY METHODIST true PARK SLOPE PHYSICIAN SERVICES PC 506 SIXTH STREET BROOKLYN NY 11215 113231685 HEALTHCARE NY 501(c)(3) 11 TYPE I NY METHODIST true PARK SLOPE PEDIATRIC MEDICINE PC 506 SIXTH STREET BROOKLYN NY 11215 113303499 HEALTHCARE NY 501(c)(3) 11 TYPE I NY METHODIST true PARK SLOPE PATHOLOGY SERVICES PC 506 SIXTH STREET BROOKLYN NY 11215 112843879 HEALTHCARE NY 501(c)(3) 11 TYPE I NY METHODIST true PARK SLOPE MEDICINE PC 506 SIXTH STREET BROOKLYN NY 11215 113362663 HEALTHCARE NY 501(c)(3) 11 TYPE I NY METHODIST true PARK SLOPE HEMOTOLOGY & ONCOLOGY PC 506 SIXTH STREET BROOKLYN NY 11215 113564621 HEMO/ONCOLOGY NY 501(C)(3) 11 TYPE I NY 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0 0 true NYHQ OBGYN PC 56-45 MAIN STREET FLUSHING NY 11358 113395424 MEDICAL SERVI NY NYHMC QUEENS C CORP 0 0 true BMA PC 56-45 MAIN STREET FLUSHING NY 11358 112747259 MEDICAL SERVI NY NYHMC QUEENS C CORP 0 0 true MSO OF KINGS COUNTY LLC 506 SIXTH STREET BROOKLYN NY 11215 272387333 EMPLOY/STAFFING NY METHODIST HOSP C CORP 0 0 true NEW YORK QUEENS MEDICINE AND SURGERY PC 56-45 MAIN ST FLUSHING NY 11358 274719998 MEDICAL SERVI NY NY HOSP QUEENS C CORP 0 0 true false false false false false false false false false false false false false false false false true false NYACK HOSPITAL r 417496 COST