2013-02-01T14:05:19-06:00 2011-12-31 HUR SANDY FEMA 4085-DR Charles A Barragato & Co LLP 950 Third Avenue - 20th FL New York NY 10022 990 2011-01-01 133245804 NYACK HOSPITAL FOUNDATION % RONALD RATIGAN NYAC 8453486520 160 NORTH MIDLAND AVENUE NYACK NY 10960 JOHN BURKE 2013-02-01 true Angelo Pirozzi CPA 2123714446 2011 2016-02-25 16:41:14Z DAVID H FREED 160 NORTH MIDLAND AVENUE NYACK NY 10960 4299738 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. 14 11 0 11 0 441799 4118650 0 0 10063 2045 86652 93686 538514 4214381 0 0 0 0 71340 115150 0 0 176747 1201170 693624 1272510 808774 -733996 3405607 2111299 5568417 101103 148529 2010196 5419888 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 632027 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 2011 THE FOUNDATION DISTRIBUTED $624,551 TO NYACK HOSPITAL. 632027 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 14 0 true 0 false false false false false true true false false false false X 14 11 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 X MARK JACOBS 1.0 X X MITCHELL D COHN MD 1.0 X X JOHN S BURKE 1.0 X X 0 410815 36335 EDWARD S FISHER DDS 1.0 X X DAVID H FREED DHA 1.0 X X 0 687565 24812 JILL GARLAND 1.0 X X 0 116650 25410 VINCENT ABBATECOLA 1.0 X LISA HAYES 1.0 X MICHAEL E RADER MD 1.0 X 0 451685 32796 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 1666715 119353 0 false true true 0 34308 4084342 4118650 0 1704 1704 0 0 341 341 341 341 179043 34308 85357 93686 93686 0 0 0 4214381 95731 0 0 0 0 0 0 0 93562 93562 0 21588 21588 0 0 0 0 0 0 0 0 0 26284 26284 0 0 0 2134 2134 0 3450 3450 0 0 0 0 DISTRIBUTION TO AFFILIATES 624551 624551 PRINTING & PUBLICATION 16863 16863 OTHER PURCHASED SERVICES 8356 8356 MISCELLANEOUS 7476 7476 4510 4510 808774 632027 0 176747 1281549 2490064 70127 73302 198536 2443052 0 0 0 0 0 0 0 0 0 0 0 0 0 150936 151848 0 0 0 0 0 0 410151 410151 2111299 5568417 10562 17621 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90541 130908 101103 148529 X 1712468 1760884 97728 3459004 200000 200000 2010196 5419888 2111299 5568417 X 3405607 4085 X false true true X false X 1602883 897173 563211 441799 4118650 7623716 1602883 897173 563211 441799 4118650 7623716 3124258 4499458 77933 82558 52925 10063 1704 225183 630481 238140 157290 230983 179043 1435937 9284836 0.48460 0.62130 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 200000 200000 200000 200000 200000 200000 200000 200000 1.00000 false false CSV OF INSURANCE POLICIES 410151 410151 0 DUE TO AFFILIATES 130908 130908 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 170812 33518 137294 37710 15005 5K/10K RACE 18985 790 18195 9941 1 23554 23554 4374 1300 17027 213351 34308 179043 42084 1300 41973 85357 93686 false false false false false false false false false JOHN S BURKE 0 296276 0 65484 0 49055 0 10391 0 25944 0 447150 0 0 DAVID H FREED DHA 0 476616 0 102309 0 108640 0 14700 0 10112 0 712377 0 0 JILL GARLAND 0 104888 0 0 0 11762 0 0 0 25410 0 142060 0 0 MICHAEL E RADER MD 0 333280 0 66404 0 52001 0 14700 0 18096 0 484481 0 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. 2011 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. 2011 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. OTHER CHANGES IN NET ASSETS OR FUND BALANCES FORM 990, PART XI, LINE 5 NET UNREALIZED GAINS OR LOSSES ON INVESTMENTS $ 4,085. HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MARK JACOBS TITLE:CHAIRMAN HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MITCHELL D. COHN, M.D. TITLE:VICE CHAIR HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOHN S. BURKE TITLE:TREASURER HOURS:40 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DAVID H. FREED, D.H.A. TITLE:PRESIDENT & CEO NYACK HOSPITAL HOURS:40 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:LISA HAYES TITLE:TRUSTEE HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MICHAEL E. RADER, M.D. TITLE:TRUSTEE HOURS:40 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:WILLIAM M. TRUST, JR. 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