NORTHERN DUTCHESS HOSPITAL: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
NORTHERN DUTCHESS HOSPITAL (EIN 14-1338467)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-13
IRS object ID
201223189349305077
Schema version
2011v1.3
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-11-13T19:25:36-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN141338467EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1NORTHERN DUTCHESS HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% HEALTHQUESTInCareOfName
Name ControlNORTNameControl
Phone8458763001Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 5112AddressLine1
CityRHINEBECKCity
StateNYState
ZIP Code12572ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMARYANN KEPPLEName
TitleCFO/TREASURERTitle
Phone8454759500Phone
Date Signed2012-11-13DateSigned
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDENISE GEORGE CEONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO BOX 5112AddressLine1
CityRHINEBECKCity
StateNYState
ZIP Code12572ZIPCode
FieldValueIRS element (for citing)
Gross Receipts72307570GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.HEALTH-QUEST.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE COMPREHENSIVE PRIMARY HEALTH CARE SERVICESActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees594TotalNbrEmployees
Total Nbr Volunteers145TotalNbrVolunteers
Total Gross UBI103090TotalGrossUBI
Net Unrelated Business Txbl Income-42457NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1574942ContributionsGrantsPriorYear
Contributions Grants Current Year706743ContributionsGrantsCurrentYear
Program Service Revenue Prior Year63792298ProgramServiceRevenuePriorYear
Program Service Revenue CY70063121ProgramServiceRevenueCY
Investment Income Prior Year116635InvestmentIncomePriorYear
Investment Income Current Year201578InvestmentIncomeCurrentYear
Other Revenue Prior Year1261359OtherRevenuePriorYear
Other Revenue Current Year1336128OtherRevenueCurrentYear
Total Revenue Prior Year66745234TotalRevenuePriorYear
Total Revenue Current Year72307570TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year26696117SalariesEtcPriorYear
Salaries Etc Current Year28064530SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year33664819OtherExpensePriorYear
Other Expenses Current Year34356215OtherExpensesCurrentYear
Total Expenses Prior Year60360936TotalExpensesPriorYear
Total Expenses Current Year62420745TotalExpensesCurrentYear
Revenues Less Expenses Prior Year6384298RevenuesLessExpensesPriorYear
Revenues Less Expenses CY9886825RevenuesLessExpensesCY
Total Assets BOY60451425TotalAssetsBOY
Total Assets EOY67086872TotalAssetsEOY
Total Liabilities BOY29388489TotalLiabilitiesBOY
Total Liabilities EOY29574328TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY31062936NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY37512544NetAssetsOrFundBalancesEOY
Mission DescriptionTHE NORTHERN DUTCHESS HOSPITAL'S MISSION IS TO MEET THE HEALTH NEEDS OF PEOPLE WHO RESIDE IN OR VISIT OUR PRIMARY SERVICE REGION, WHICH INCLUDES THE COMMUNITIES OF NORTHERN DUTCHESS AND SOUTHERN COLUMBIA COUNTIES AND PARTS OF ULSTER COUNTY, NEW YORK. OUR COMMITMENT TO THESE COMMUNITIES SHALL BE EVIDENCED BY OUR PERFORMANCE AS PROVIDERS, EDUCATORS, AND ADVOCATES. WE SHALL PROVIDE COMPREHENSIVE, PRIMARY HEALTH CARE SERVICES AND PROGRAMS TO INDIVIDUALS IN THE COMMUNITY REGARDLESS OF THEIR ECONOMIC OR SOCIAL STATUS. WE SHALL ACT AS A RESOURCE IN PROVIDING EDUCATIONAL OPPORTUNITIES AND HEALTH PROMOTION PROGRAMS TO THE COMMUNITY AND ALSO ADVANCE THE MEDICAL AND TECHNICAL SKILLS OF OUR HOSPITAL STAFF THROUGH REGULAR IN-SERVICE TRAINING. WE SHALL ADVOCATE FOR, AND TAKE ACTION WHERE POSSIBLE, TO MEET THE NEEDS OF OUR ELDERLY, FOR THOSE INITIATING FAMILY LIFE AND, ALWAYS, FOR THE DISADVANTAGED.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense26681178Expense
Revenue39558662Revenue
DescriptionINPATIENT SERVICES: PATIENTS ADMITTED FOR ACUTE CARE - NUMBER OF PATIENTS 4,205; NUMBER OF PATIENT DAYS 17,057 THE HOSPITAL PROVIDED APPROXIMATELY $193,777 IN UNCOMPENSATED CARE (AT COST) TO THE REGIONS UN-INSURED AND UNDER-INSURED POPULATIONDescription

Activity2 Activity2

FieldValueIRS element (for citing)
Expense20574379Expense
Revenue30504459Revenue
DescriptionOUTPATIENT SERVICES: EMERGENCY VISITS 13,215; AMBULATORY SURGERY VISITS 2,682 ALL OTHER VISTIS/PROCEDURES 98,382 THE HOSPITAL PROVIDED APPROXIMATELY $416,675 IN UNCOMPENSATED CARE (AT COST) TO THE REGIONS UN-INSURED AND UNDER-INSURED POPULATIONDescription
FieldValueIRS element (for citing)
Total Program Service Expense47255557TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10963NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees594NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChapterstrueLocalChapters
Policies Reference ChapterstruePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonHEALTHQUESTNamePerson
Telephone Number8454759500TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11351 ROUTE 55 SUITE 200AddressLine1
CityLAGRANGEVILLECity
StateNYState
ZIP Code12540ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (20 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
JAMES BRUDVIG
CHAIRMAN2.0X
JOHN R MARVIN ESQ
MEMBER1.0X
SUE CRANE
LIFE MEMBER1.0X
DRAYTON GRANT
MEMBER1.0X
LEWIS RUGE
LIFE MEMBER1.0X
GEORGE VERRILLI MD
LIFE MEMBER1.0X
M NADER KAYAL JR MD
LIFE MEMBER1.0X
EVAN MELTZER
FIRST VICE CHAIRMAN2.0X
WILLIAM CARROLL
MEMBER1.0X
SUSAN KOCHANOWSKI
MEMBER1.0X
JOHN HORISZNY MD
MED STAFF PRESIDENT1.0X
KEVIN M SHEEHAN
SECOND VICE CHAIRMAN2.0X
DENISE GEORGE
PRESIDENT/CEO52.5X035436043444
ALAN MOSSOFF
NDH CFO30.0X014819518984
JOHN SABIA MD
CMO40.021189641163X
CONNIE REGAN
PHARMACY CLINICAL COORDINATOR40.016286112299X
BOGUMILA LANG
PHARMACIST40.012494531379X
VERONICA WINTERS
REGISTERED NURSE40.013364628419X
PAUL KING
DIRECTOR OF DIAGNOSTIC SERV45.01344355487X
CAROLYN HEY
REGISTERED NURSE40.012334436544X
FieldValueIRS element (for citing)
Total Reportable Comp From Org679231TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs714451TotalReportableCompFrmRltdOrgs
Total Other Compensation217719TotalOtherCompensation
Number Individuals GT100 K5NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Government Grants223580GovernmentGrants
All Other Contributions483163AllOtherContributions
Total Contributions706743TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET INPATIENT REVENUE9000993955866239558662
NET OUTPATIENT REVENUE9000993050445930504459
FieldValueIRS element (for citing)
Total Program Service Revenue70063121TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column99514TotalRevenueColumn
Related Or Exempt Function Income99514RelatedOrExemptFunctionIncome

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real224853Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real224853Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column224853TotalRevenueColumn
Exclusion$224,853ExclusionAmount

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column102064TotalRevenueColumn
Exclusion$102,064ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
AFFILIATE REVENUE900099611406611406
CAFETERIA SALES900099306918306918
WELLNESS CENTER900099103090103090

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column89861TotalRevenueColumn
Related Or Exempt Function Income89861RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue1111275TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column72307570TotalRevenueColumn
Related Or Exempt Function Income71170820RelatedOrExemptFunctionIncome
Unrelated Business Revenue103090UnrelatedBusinessRevenue
Exclusion$326,917ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total21462961Total
Program Services19036487ProgramServices
Management And General2426474ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1066376Total
Program Services945818ProgramServices
Management And General120558ManagementAndGeneral
Fundraising0Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3910816Total
Program Services3468682ProgramServices
Management And General442134ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1624377Total
Program Services1440734ProgramServices
Management And General183643ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total1939Total
Program Services0ProgramServices
Management And General1939ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total25760Total
Program Services0ProgramServices
Management And General25760ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1794987Total
Program Services961608ProgramServices
Management And General833379ManagementAndGeneral
Fundraising0Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total2434902Total
Program Services58085ProgramServices
Management And General2376817ManagementAndGeneral
Fundraising0Fundraising

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1456878Total
Program Services1194459ProgramServices
Management And General262419ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total37423Total
Program Services29691ProgramServices
Management And General7732ManagementAndGeneral
Fundraising0Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total707026Total
Program Services579674ProgramServices
Management And General127352ManagementAndGeneral
Fundraising0Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total4009418Total
Program Services3287225ProgramServices
Management And General722193ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total697218Total
Program Services634433ProgramServices
Management And General62785ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
MEDICAL SUPPLIES98238829823867150
PURCHASED SERVICES8636840190482267320180
PHYSICIAN FEES1567639156763900
BAD DEBT1321934132193400

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1840369Total
Program Services1000399ProgramServices
Management And General839970ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total62420745Total
Program Services47255557ProgramServices
Management And General15165188ManagementAndGeneral
Fundraising0Fundraising

Total Joint Costs TotalJointCosts

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY333750BOY
EOY65065EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1001548BOY
EOY1604378EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY5072008BOY
EOY7703568EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY120050BOY
EOY2877EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1113090BOY
EOY1058035EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY340043BOY
EOY693636EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis83237689LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec48702590LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY36253056BOY
EOY34535099EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY2969760BOY
EOY3367675EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY13248120BOY
EOY18056539EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY60451425BOY
EOY67086872EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY10461107BOY
EOY6060469EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY13974384BOY
EOY13220195EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1654625BOY
EOY873622EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY3298373BOY
EOY9420042EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY29388489BOY
EOY29574328EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY26998133BOY
EOY33664710EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2569399BOY
EOY2352430EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1495404BOY
EOY1495404EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY31062936BOY
EOY37512544EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY60451425BOY
EOY67086872EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses9886825ReconcilationRevenueExpenses
Reconcilation Other Changes-3437217ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement BothXFinancialStatementBoth
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$1,939OtherActivitiesAmount
Total Lobbying Expenditures IIB1939TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierSCHEDULE C, PART IIIdentifier
Return ReferenceLOBBYING ACTIVITIESReturnReference
Explanation28.9% OF NORMET ASSOCIATION DUES WERE ALLOCATED TO POLITICAL ACTIVITIES, RELATED TO LOBBYING.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance1495404BeginningOfYearBalance
End Of Year Balance1495404EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance1495400BeginningOfYearBalance
End Of Year Balance1495400EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1495000BeginningOfYearBalance
End Of Year Balance1495000EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1495000BeginningOfYearBalance
End Of Year Balance1495000EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis109930OtherCostOrOtherBasis
Book Value109930BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis44605690OtherCostOrOtherBasis
Depreciation19910412Depreciation
Book Value24695278BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis36991069OtherCostOrOtherBasis
Depreciation27841912Depreciation
Book Value9149157BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1531000OtherCostOrOtherBasis
Depreciation950266Depreciation
Book Value580734BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings34535099TotalOfBookValueLandBuildings

Other Assets OtherAssets (9 entries)

DescriptionDescriptionBook ValueBookValue
DUE FROM AFFILIATES11511741
DEFERRED COMPENSATION ASSET1147528
DEFERRED FINANCING489044
2007 SERIES B BONDS PREMIUM716775
2007 DSRF SERIES B BONDS1631150
MISC RECEIVABLES65275
ESTIMATED THIRD PARTY ADJMNTS287022
DSRF TELP LOAN TDBANK GENERAL139836
INTEREST IN NDH FOUNDATION LT2068168
FieldValueIRS element (for citing)
Total Book Value Other Assets18056539TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (7 entries)

DescriptionDescriptionAmountAmount
HITNY LIABILITY$657,897
DEFERRED COMP LIABILITY$244,522
FIN 47 LIABILITY$257,499
RETRO PAYABLE TO 3RD PARTY PAY$1,969,165
DUE TO AFFILIATES$1,031,200
DUE TO HQ L/T$178,820
MED MALPRACTICE INSURANCE LIABILITY$5,080,939
FieldValueIRS element (for citing)
Total Of Amounts9420042TotalOfAmounts
Total Revenue72307570TotalRevenue
Total Expenses62420745TotalExpenses
Excess Or Deficit For Year9886825ExcessOrDeficitForYear
Net Unrealized GL On Investments-266824NetUnrealizedGLOnInvestments
Other-$3,170,393OtherAmount
Total Adjustments-3437217TotalAdjustments
Excess Or Deficit Per FS6449608ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt72040746TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-266824NetUnrealizedGainsInvestments
Revenue Not Rptd F990-266824RevenueNotRptdF990
Revenue Subtotal72307570RevenueSubtotal
Total Revenue Per Form99072307570TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt62420745TotExpensesEtcAuditedFinclStmt
Expenses Subtotal62420745ExpensesSubtotal
Total Expenses Per Form99062420745TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
TRANSFER OF EQUITYSCHEDULE D PART XI LINE 8TRANSFER OF EQUITY - ($2,953,423)
INTEREST IN NDH FOUNDATIONSCHEDULE D PART XI LINE 8INTEREST IN NDH FOUNDATION - $272,265
CHANGE IN RESTRICTED CONTRIBUTIONSSCHEDULE D PART XI LINE 8CHANGE IN RESTRICTED CONTRIBUTIONS - ($489,235)

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailablefalseReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense1688277TotalCommunityBenefitExpense
Direct Offsetting Revenue1278484DirectOffsettingRevenue
Net Community Benefit Expense409793NetCommunityBenefitExpense
Percent Of Total Expense0.00660PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense5151411TotalCommunityBenefitExpense
Direct Offsetting Revenue3350103DirectOffsettingRevenue
Net Community Benefit Expense1801308NetCommunityBenefitExpense
Percent Of Total Expense0.02890PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense6839688TotalCommunityBenefitExpense
Direct Offsetting Revenue4628587DirectOffsettingRevenue
Net Community Benefit Expense2211101NetCommunityBenefitExpense
Percent Of Total Expense0.03550PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs5NumberOfActivitiesOrPrograms
Persons Served3545PersonsServed
Total Community Benefit Expense44360TotalCommunityBenefitExpense
Net Community Benefit Expense44360NetCommunityBenefitExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs5NumberOfActivitiesOrPrograms
Persons Served3545PersonsServed
Total Community Benefit Expense44360TotalCommunityBenefitExpense
Net Community Benefit Expense44360NetCommunityBenefitExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs5NumberOfActivitiesOrPrograms
Persons Served3545PersonsServed
Total Community Benefit Expense6884048TotalCommunityBenefitExpense
Direct Offsetting Revenue4628587DirectOffsettingRevenue
Net Community Benefit Expense2255461NetCommunityBenefitExpense
Percent Of Total Expense0.03620PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$891,741BadDebtExpenseAmount
Amount Attributable To445871AmountAttributableTo
Amount Reimbursed By Medicare23919935AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare26788252CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-2868317MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1NORTHERN DUTCHESS HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line16511 SPRINGBROOK AVENUEAddressLine1
CityRHINEBECKCity
StateNYState
ZIP Code12572ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1NORTHERN DUTCHESS HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent200.FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent300.FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On NonpaymenttrueActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Permit LawsuitXPermitLawsuit
Permit Lien On ResidenceXPermitLienOnResidence
Collection ActivitiestrueCollectionActivities
Report To Credit AgencyXReportToCreditAgency
LawsuitXLawsuit
Lien On ResidenceXLienOnResidence
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
PART I, LINE 3CN/A
PART I, LINE 6AHEALTH QUEST SYSTEMS PREPARES A COMMUNITY BENEFIT REPORT, HOWEVER THE REPORT DOES DETAIL OUR SPECIFIC COMMUNITY BENEFITS FOR EACH FACILITY WITHIN HEALTH QUEST.
PART I, LINE 7GN/A
PART I, LINE 7 COLUMN FTOTAL BAD DEBT EXPENSE EXCLUDED FROM COLUMN F PERCENTAGE - $1,321,934
PART I, LINE 7COST TO RATIO PERCENTAGE WAS USED AS THE COSTING METHODOLOGY. WORKSHEET #2 WAS USED TO DERIVE THE PERCENTAGE.
PART III, LINE 4BAD DEBT EXPENSE WAS GROSSED UP TO GROSS CHARGES AND THEN THE COST TO CHARGE RATIO PERCENTAGE DERIVED FROM WORKSHEET #2 WAS USED TO CALCULATE THE VALUE AT COST. SELF PAY ACCOUNTS, ONCE DETERMINED A LACK OF INSUFFICIENCY OF INSURANCE AND ONCE THE PATIENT HAS RECEIVED GOVERNMENT PAYOR DENIAL, THE ACCOUNTS ARE ADJUSTED DOWN TO THE HIGHEST VOLUME COMMERCIAL PAYOR RATE. AFTER THE ACCOUNT IS DEEMED UNCOLLECTIBLE, THE ACCOUNT IS WRITTEN OFF TO BAD DEBT EXPENSE AT ADJUSTED CHARGES LESS ANY PAYMENTS MADE ON THE ACCOUNT. 50% OF THESE PATIENTS WOULD MOST LIKELY QUALIFY FOR CHARITY CARE IF THEY WERE COOPERATIVE IN FILING THE PAPERWORK, ASSOCIATED WITH GOVERNMENT ASSISTANCE. FOOTNOTE ON AUDITED FINANCIALS - FEDERAL AND STATE LAW REQUIRES THE HOSPITALS TO 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 INFORMATION NECESSARY TO ALLOW THE HOSPITAL TO QUALIFY SUCH PATIENTS FOR CHARITY CARE. UNCOLLECTIBLE AMOUNTS DUE FROM SUCH UNINSURED PATIENTS REPRESENT THE SUBSTANTIAL PORTION OF THE PROVISION FOR BAD DEBTS REFLECTED IN THE ACCOMPANYING STATEMENT OF OPERATIONS.
PART III, LINE 8COST TO CHARGE RATIO - USED WORKSHEET #2
PART III, LINE 9BHEALTH QUEST MAY CHOOSE TO SEND ANY DELIQUENT ACCOUNT TO A COLLECTION AGENCY, HOWEVER, BEFORE REFERRING A DELIQUENT ACCOUNT TO A COLLECTION AGENCY, HEALTH QUEST WILL REVIEW THE ACCOUNT TO DETERMINE WHETHER THE PATIENT HAS APPLIED FOR A DISCOUNT UNDER THE CHARITY CARE POLICY AND THE STATUS OF THE APPLICATION. IF THE PATIENT HAS APPLIED FOR A DISCOUNT, THE ACCOUNT MAY NOT BE REFERRED TO A COLLECTION AGENCY UNTIL A FINAL DETERMINATION OF SUCH APPLICATION IS MADE AND IF ANY APPEAL OF SUCH DETERMINATION IS PROVIDED FOR IN THE CHARITY CARE POLICY, A FINAL DETERMINATION HAS BEEN MADE WITH RESPECT TO SUCH APPEAL. PATIENTS MAY STILL APPLY FOR A DISCOUNT UNDER THE CHARITY CARE POLICY EVEN AFTER THE ACCOUNT HAS BEEN SENT TO A COLLECTION AGENCY.
PART V, LINE 19THE HOSPITAL FACILITY USES THE HIGHEST VOLUME COMMERCIAL PAYOR RATE TO BILL INDIVIDUALS WHO DO NOT HAVE INSURANCE.
PART VI, LINE 2IN THE HUDSON VALLEY, THE LOCAL HEALTH DEPARTMENTS FORMED A COALITION WHICH SPEARHEADED THE COMMUNITY HEALTH ASSESSMENTS. HEALTH QUEST HOSPITALS PARTICIPATED IN THE PLANNING SESSION ALONG WITH NUMEROUS COMMUNITY AGENCIES. HEALTH QUEST WILL BE FOCUSED ON THE FOLLOWING - ACCESS TO QUALITY HEALTH CARE, CHRONIC DISEASE, HEALTHY MOTHERS, HELATHY BABIES, HEALTHY CHILDREN, MENTAL HEALTH AND SUBSTANCE ABUSE, AND PHYSICAL ACTIVITY AND NUTRITION. NORTHERN DUTCHESS HOSPITAL IS WORKING TO: A. PROMOTE HEALTHY AGING BY EXPANDING THE LOCAL HOME INSPECTION PROGRAM AND CREATING A SUPPORT GROUP FOR CAREGIVERS OF SENIORS. WE ARE STILL TRYING TO MOVE THE SENIOR HOME INSPECTIONS OUT OF THE TOWN'S PURVIEW TO INCREASE THE EFFICACY OF THE PROGRAM. THE SUPPORT GROUP HAS STARTED AND HAD FIVE ATTENDEES FOR ITS INITIAL MEETING. METRICS FOR THESE INITIATIVES HAVE NOT YET BEEN SET. B. REDUCE CHILDHOOD OBESITY BY DEVELOPING AN AFTERSCHOOL EXERCISE PROGRAM IN OUR WELLNESS CENTER. THIS INITIATIVE HAS NOT YET BEEN ACHIEVED. C. IMPROVE DIABETES DETECTION AND MANAGEMENT THROUGH LECTURES AND DOCTOR CHATS. ADDITIONALLY, HEALTH QUEST PROVIDED SEVERAL THOUSAND TICK REMOVAL KITS TO THE DUTCHESS COUNTY DEPARTMENT OF HEALTH AFTER THEY LOST THEIR FUNDING STREAM. ALL HQ HOSPITALS CONDUCT SCREENINGS, LECTURES AND CLASSES IN ADDITION TO WHAT IS LISTED ABOVE. UNDER THE NEW GOVERNANCE MODEL, THE HOSPITAL BOARDS WILL FOCUS ON COMMUNITY NEEDS ASSESSMENT, PRIORITIZATION AND PROGRAM DEVELOPMENT.NEEDS ASSESSMENT
PART VI, LINE 3FINANCIAL ASSISTANCE POSTERS ARE HUNG UP IN VARIOUS AREAS OF THE HOSPITAL. FOR PATIENTS THAT INQUIRE ABOUT FINANCIAL ASSISTANCE, THE POLICY IS PROVIDED TO THE PATIENT ALONG WITH ASSISTANCE IN COMPLETING THE APPLICATIONS.PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE
PART IV, LINE 4APPLIES TO ALL HOSPITAL SERVICE AREAS - PREDOMINATELY WHITE AND SKEWING SLIGHTLY OLDER THAN THE NATIONAL AVERAGES. HIGHER PERCENTAGE OF COLLEGE DEGREES THAN THE NATIONAL AVERAGE, WITH AVERAGE HOUSEHOLD INCOMES SIGNIFICANTLY HIGHER THAN NATIONAL INCOME.COMMUNITY INFORMATION
PART IV, LINE 5ALL HOSPITALS SERVE AS COMMUNITY LEADERS IN HEALTH RELATED FUNDRAISERS, SUCH AS RELAY FOR LIFE AND THE MARCH OF DIMES. EXECUTIVES AND EMPLOYEES VOLUNTEER AND SERVE ON THE BOARDS OF MANY COMMUNITY ORGANIZATIONS AND USE HOSPITAL RESOURCES TO ASSIST COALITIONS AND MEET A BROAD DEFINITION FOR HEALTH WHICH INCLUDES EDUCATION AND HOUSING. ALL HOSPITALS OFFER SCREENING AND LECTURES TO EDUCATE THE COMMUNITY AND ENCOURAGE PREVENTATIVE MEDICINE.PROMOTION OF COMMUNITY HEALTH
PART VI, LINE 6HEALTH QUEST SYSTEMS, INC (DBA HEALTH QUEST) IS THE ACTIVE PARENT COMPANY TO ALL AFFILIATED HOSPITALS. HEALTH QUEST ACTS ON BEHALF OF THE HOSPITALS IN SOME COMMUNITY ASSESSMENT ACTIVITIES. HEALTH QUEST HAS TRANSITIONED TO A MODEL IN WHICH IT WILL SUPERVISE BOARD COMMITTEES AT EACH HOSPITAL AS THEY ASSESS COMMUNITY NEEDS, PLAN APPROPRIATE PROGRAMS AND MONITOR THEM FOR EFFECTIVENESS.AFFILIATE HEALTH CARE SYSTEM
PART VI, LINE 7HEALTH QUEST, THE PARENT COMPANY OF NORTHERN DUTCHESS HOSPITAL, FILES A SYSTEM WIDE COMMUNITY SERVICE PLAN WITH NYS DEPARTMENT OF HEALTHSTATE FILING OF COMMUNITY BENEFIT REPORT
PART V, LINE 13FINANCIAL ASSISTANCE POSTERS ARE HUNG UP IN VARIOUS AREAS OF THE HOSPITAL STATING WHO TO CONTACT REGARDING THE POLICY. FOR PATIENTS THAT INQUIRE ABOUT FINANCIAL ASSISTANCE, THE POLICY IS PROVIDED TO THE PATIENT ALONG WITH ASSISTANCE IN COMPLETING THE APPLICATIONS.PART V, LINE 13

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
DENISE GEORGE
02814470527710201420147000287440397804014700
JOHN SABIA MD
19107720819014700264632530590
CONNIE REGAN
1610171832121058517141751609454
BOGUMILA LANG
124945008203231761563247734
ALAN MOSSOFF
0137194010811019008880010104016717902892
VERONICA WINTERS
1336460010148182711620659735
CAROLYN HEY
121481018639643269011598880

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1DORMITORY AUTHORITY - STATE OF NEW YORKBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN146000293IssuerEIN
CUSIP Number649903UK5CUSIPNumber
Date Issued2007-09-06DateIssued
Issue Price15718408IssuePrice
Description Of PurposeREFINANCE FOR CONSTRUCTION/MED EQUDescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer
Pool FinancingfalsePoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Amount Retired1208532AmountRetired
Amount Bond Defeased0AmountBondDefeased
Total Proceeds16419590TotalProceeds
Amount In Reserve Fund1128226AmountInReserveFund
Capitalized Interest319526CapitalizedInterest
Refunding Escrow0RefundingEscrow
Issuance Costs From Proceeds216413IssuanceCostsFromProceeds
Credit Enhancement247657CreditEnhancement
Working Capital Expenditures0WorkingCapitalExpenditures
Capital Expenditures13176836CapitalExpenditures
Other Spent Proceeds0OtherSpentProceeds
Amount Unspent1330932AmountUnspent
Year Of Subst Completion2008YearOfSubstCompletion
Current RefundingfalseCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadefalseFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed PropertyfalseOwningBondFinancedProperty
Any Lease ArrangementsfalseAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Any Research AgreementsfalseAnyResearchAgreements
Prcntge Prvt Business Use By Others0.00000PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.00000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00000TotalPrivateBusinessUse
Post Issuance Compliance ProcdrstruePostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T FiledfalseForm8038TFiled
Variable Rate IssuefalseVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1
FieldValueIRS element (for citing)
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC

Name Of GIC Provider NameOfGICProvider

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1
FieldValueIRS element (for citing)
Gross Proceeds InvestedtrueGrossProceedsInvested
Exception To RebatefalseExceptionToRebate

Form990 Schedule K Part VI Form990ScheduleKPartVI (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
BOND ISSUESPART I, LINE A, COLUMN ETOTAL ISSUE PRICE PER IRS FORM 8038 - $61,974,071.30 ALLOCATED BETWEEN THREE ORGANIZATIONS
PROCEEDSPART II, LINE 3THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN E DUE TO INVESTMENT EARNINGS.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
RELATED TAX EXEMPT ORGANIZATIONSSCHEDULE R - RELATED TAX EXEMPT ORGANIZATIONSEntity Tax ID# Primary Activity Legal Domicile Exempt Code Status Public Charity Status Directo controlling Entity Vassar Brothers Medical Center 14-1338586 Hospital NY 501c3 Box 3 HQ The Foundation for Vassar Brothers Medical Center 14-1736429 Fundraising NY 501c3 Box 9 HQ Riverside Diversified Services, Inc (Parent) 14-1675545 Education NY 501c3 Box 9 HQ Alamo Ambulance Service, Inc 14-1745417 Transport NY 501c3 Box 9 HQ Hudson Valley Home Care, Inc (Certified) 14-1788412 Home Health NY 501c3 Box 9 HQ Hudson Valley Home Care, Inc (Licensed) 14-1788410 Home Health NY 501c3 Box 9 HQ Northern Duchess Hospital 14-1338467 Hospital NY 501c3 Box 3 HQ Northern Dutchess Residential Health Care Facility 22-3129608 Nursing Home NY 501c3 Box 9 HQ NDH Foundation 14-1776208 Fundraising NY 501c3 Box 9 HQ Putnam Hospital Center 14-6019179 Hospital NY 501c3 Box 3 HQ Putnam Hospital Center Foundation 06-1399319 Fundraising NY 501c3 Box 9 HQ
GOVERNINGFORM 990 PART VI SECTION A LINE 4, 6, 7A AND 7BLINE 4 - Health Quest Systems, Inc. ("HQ") - Bylaw Amendments - Summary of Changes. HQ / Hospitals - 2010 Bylaw Amendments. HQ amended its bylaws on July 19, 2010 in order to streamline HQ's governance and promote management and operational efficiencies. In addition, bylaw amendments were made by each of HQ's affiliated hospitals (Vassar Brothers Medical Center ("VBMC" - 5/14/2010), Northern Dutchess Hospital ("NDH" - 5/25/2010), and Putnam Hospital Center ("PHC" - 6/30/2010) (collectively referred to as the "Hospitals"). Key Elements of Hospital / HQ Bylaw Changes. The bylaw amendments made several key changes: first, they confirm and enable HQ's existing and available powers under New York law as the sole member and active parent of the Hospitals; second, they focus each Hospital's board on patient safety, quality of care, and community health needs including through the elimination of all but three (3) required Hospital committees (i.e., the (i) Executive, (ii) Quality, Patient Satisfaction and Medical Staff Credentialing and (iii) Community Health Needs Committees); and third, other governance streamlining changes are implemented through the HQ and Hospital Bylaw changes (for example, several HQ committees are combined, many Hospital committees are being eliminated, and HQ's role and power as the sole member and active parent of each Hospital has been confirmed and further enabled). LINE 6 - THE SOLE MEMBER OF NDH IS HEALTH QUEST SYSTEMS, INC. LINE 7A - APPOINTMENT/ELECTION OF DIRECTORS NOMINEES TO THE BOARD OF DIRECTORS OF NDH SHALL BE NOMINATED IN THE FOLLOWING MANNER: NDH'S EXECUTIVE COMMITTEE MAY PREPARE A SLATE OF NOMINEES TO PRESENT TO THE HEALTH QUEST EXECUTIVE COMMITTEE FOR ITS REVIEW AND APPROVAL NOT LESS THAN THIRTY DAYS PRIOR TO THE ANNUAL MEETING OF NDH IN THE CASE OF VACANCIES CREATED BY THE EXPIRATION OF NDH DIRECTORS TERMS OF OFFICE, OR IN THE CASE OF ALL VACANCIES, AS SOON AS REASONABLY POSSIBLE. THE EXECUTIVE COMMITTEE OF HEALTH QUEST MUST APPROVE SLATES OF NOMINEES BY A MAJORITY VOTE OF THE ENTIRE HEALTH QUEST EXECUTIVE COMMITTEE. ONCE HEALTH QUESTS EXECUTIVE COMMITTEE APPROVES THE SLATE OF NOMINEES BY MAJORITY VOTE, HEALTH QUEST'S EXECUTIVE COMMITTEE SHALL INFORM THE NDH BOARD OF DIRECTORS AND PRESENT THE SLATE OF NOMINEES TO THE BOARD OF TRUSTEES OF HEALTH QUEST FOR APPROVAL. LINE 7B - MANNER OF ACTING/VOTE REQUIRED FOR CERTAIN SPECIFIC ACTIONS EXCEPT AS OTHERWISE SPECIFIED IN THE CERTIFICATE OF INCORPORATION OF NDH OR THESE BY LAWS OR THE BY LAWS OF HEALTH QUEST, OR PROVIDED BY LAW, THE ACTS OF A MAJORITY OF THE DIRECTORS PRESENT AND VOTING AT A MEETING AT WHICH A QUORUM IS PRESENT SHALL BE THE ACTS OF THE BOARD OF DIRECTORS. THERE SHALL BE NO VOTING BY PROXY. THE POWERS TO BE EXERCISED BY THE NDH BOARD OF DIRECTORS THAT ARE (I) SUBJECT TO THE SUBSEQUENT APPROVAL OF HEALTH QUEST, OR (II) TO BE UNDERTAKEN IN COLLABORATION WITH HEALTH QUEST. THE POWERS SET FORTH IN PARAGRAPH (F) BELOW REQUIRE THE VOTE OF TWO-THIRDS OF SOLELY THE NDH BOARD OF DIRECTORS. UNLESS OTHERWISE SPECIFIED, ALL OTHER ACTIONS THAT REQUIRE NDH BOARD APPROVAL REQUIRE A MAJORITY VOTE OF SOLELY THE NDH BOARD OF DIRECTORS.
POLICIESPART VI SECTION B LINE 11A, 12C AND LINE 15LINE 11A - A COPY OF THE FORM 990 WAS PROVIDED TO ALL MEMBERS OF THE BOARD. THE CHAIR OF THE HQ EXECUTIVE COMPENSATION COMMITTEE REVIEWED ALL SECTIONS RELATED TO EXECUTIVE COMPENSATION. A 3RD PARTY WAS HIRED TO ASSIST IN THE PREPARATION AND REVIEW OF SCHEDULE H AND SCHEDULE K. LINE 12C - ON AN ANNUAL BASIS OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST FILING WHICH IS REVIEWED BY THE HQ VP OF COMPLIANCE AND INTERNAL AUDIT. ALL POTENTIAL CONFLICTS OF INTEREST ARE REVIEWED BY THE HQ BUSINESS ETHICS COMMITTEE ON BEHALF OF NDH. LINE 15 A/B - COMPENSATION OF THE CEO, TOP MANAGEMENT AND OTHER KEY EMPLOYEES IS ESTABLISHED BY THE HQ EXECUTIVE COMPENSATION COMMITTEE BASED ON INFORMATION AND RECOMMENDATIONS OF AN INDEPENDENT THIRD PARTY.
DISCLOSUREFORM 990 PART VI SECTION C LINE 19LINE 19 - POLICIES AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE DOCUMENTS ARE PROVIDED EITHER ELECTRONICALLY OR PAPER COPIES. IN ADDITION, CERTAIN FINANCIAL INFORMATION IS AVAILABLE ON VARIOUS WEBSITES DUE TO REGULATORY FILINGS SUCH AS THE 990 AND BOND HOLDER REQUIREMENTS.
SCHEDULE KPART 1, LINE A, COLUMN ETOTAL ISSUE PRICE PER IRS FORM 8038 - $61,974,071.30, ALLOCATED AS FOLLOWS NORTHERN DUTCHESS HOSPITAL - $15,718,407.82 PUTNAM HOSPITAL CENTER - $28,161,750.86 VASSAR BROTHERS MEDICAL CENTER - $18,093,912.82
ALLOCATION METHODOLOGY FOR HQSCH R, PART V, LINE 2 (1)Health Quest Systems, Inc Allocation of Support Services/Shared Expenses/Cash Funding General: The following services are considered shared services for Health Quest affiliates and the cost to provide these services are allocated to each entity which benefits from the service based on a pre defined allocation methodology: 1. Specialty Staffing a. VBMC Surgical b. Radiology c. Oncology d. VBMC Sleep Lab e. PT/OT/ST f. Cardiac Rehab 2. Lab Management 3. Pharmacy 4. Revenue Cycle including health information management, budgets and reimbursement, revenue cycle, system business office, patient access oversight, financial clearance center, managed care and decision support 5. Facilities including courier service, construction, property management, facility operations, hotel management and security 6. Business Development including strategic planning, marketing and public relations, answering service and community education 7. Corporate Finance including accounts payable, payroll, general accounting, purchasing and supply chain, practice management billing and management engineering 8. Internal Audit and Compliance 9. Practice management operations including physician recruitment and physician management 10. Human Resources 11. Administrative including Executive office, Hospital Support and risk management 12. Legal Counsel 13. Information Technology and Medical Technology Services (MTS) Description of Services: 1. Specialty staffing a. Provides non union staffing services for various specialties to the hospitals, offsite ancillary locations and the Fishkill Medical Mall 2. Lab management includes oversight of the outsourced lab services for each hospital 3. Pharmacy management includes oversight of all pharmacy departments 4. Revenue Cycle - a. Health Information Management functions includes coding and transcription of medical records for all 3 hospitals b. Budget functions include preparation of annual budgets, variance reporting and maintenance of the budget module Reimbursement functions include preparation of annual cost reports, analysis of third party rate accounts and third party audits c. Revenue cycle functions include charge master analysis and development of revenue producing charges, compliance with CPT coding and establishment of appropriate charges d. System business office services includes producing claims for third party payers and private pay patients, payment processing, periodic reporting, accounts receivable analysis, charity care application process, denial management, collection and follow up for the hospitals. Patient access and financial clearance center includes oversight of all centralized registration areas at the hospitals and pre-authorization for numerous hospital services to insure compliance with third party regulations e. Managed Care functions include contract negotiations and analysis of contract terms f. Decision Support functions include cost accounting reporting, maintenance of HBI (Horizon Business Insight) reporting and the contract management system 5. Facilities - a. Courier service provides delivery services internally throughout the HQ system and bank deposit drop offs b. Construction and property management functions include contracting services for Health Quest projects and property management of all HQ facilities c. Facility operations include management oversight of the engineering departments for the hospitals d. Hotel Management functions include management oversight of food and nutrition departments for the hospitals e. Security functions include management oversight of all facilities to ensure the safest environment 6. Business Development - a. Strategic Planning functions include CON submissions, market data analysis and assistance with business plans b. Marketing includes advertising services, coordination of joint Health Quest advertisements and reduction of expenses associated with larger campaigns c. Public relations functions include coordination of Health Quest communication to external customers, patients and media d. Oversight of the outsourced answering services for physicians affiliated with the hospitals and HQMP e. Community education functions include training classes specific to life saving techniques 7. Finance - a. Accounts payable functions include scheduling vendor payments, insuring flow of goods and services, maintaining days cash on hand goals and maintaining days in accounts payable b. Payroll functions include biweekly employee payments and tax filings in accordance with Human Resources and Payroll policies c. General Accounting functions include preparation of financial statements, account analysis, contract reconciliation, tax filings, investment coordination, insurance coordination and coordination of internal and external audit functions d. Purchasing and supply chain functions include procurement services, contract negotiations, price negotiations, capital purchase negotiations, including negotiations for maintenance contracts, upgrades to equipment, etc. e. Practice management billing functions include producing all claims for third party payers and private pay patients, payment processing, periodic reporting, accounts receivable analysis, charity care application process, denial management, collection and follow up services for all employed HQ physicians f. Management Engineering functions include evaluating each area within HQ to ensure compliance with various productivity benchmarks optimizing staffing ratios 8. Internal Audit and Compliance includes oversight of the corporate compliance program, internal audit, HIPAA compliance and contract review and compliance 9. Human Resource functions include recruitment, compensation, benefit administration and employee training 10. Physician management operations functions include oversight of all HQ physician practices and physician recruitment functions 11. Administrative functions include oversight of the Health Quest system, hospital management and risk management 12. Legal Counsel functions include internal legal services for HQ and coordination of all outsourced legal initiatives 13. Information Technology and MTS - a. IT provides information technology support for all applications and telephony support within HQ. In addition provides project management services for all new and upgrades to current IT applications. b. MTS/Biomed includes technical services provided to each hospital for equipment repair and maintenance Shared Expenses: In addition to services provided by support departments, certain insurance policies are consolidated for all Health Quest entities. These include property insurance, general and professional liability, cyber insurance and Directors and Officers insurance. Affiliate Cash Shortfalls: Affiliate cash shortfalls are funded by the entity(s) benefiting from the affiliate services. Examples include Health Quest Medical Practice and the Thompson House. The cash shortfall funding is based on the percentage of benefit received (percentage of revenue by division for HQMP and admissions to the Thompson House from the hospitals) Allocation Methodology: Net Revenue - lab management, budgets, revenue cycle, managed care, decision support, all facilities (excluding construction), business development, general accounting, management engineering, internal audit and compliance, executive office, legal, information technology and MTS # of visits/procedures - staffing specialties Historical trends - health information management, pharmacy and hospital support Cash collections - patient accounting and the financial clearance center # of FTE's - payroll and human resources Non payroll expenses - accounts payable and purchasing Project based - construction # of FTE's allocated to physician sites - Practice management billing, operations and physician practice management System Benefits: 1. Financial planning 2. Revenue enhancement 3. Improved cash collections 4. Enhanced managed care contract rates 5. Optimized medical records coding 6. Savings for supplies, contracts, insurance and capital purchases 7. Staffing reduction through shared services 8. Enhanced employee benefit programs
RECONCILIATION OF NET ASSETS990 PART XI LINE 5NET UNREALIZED LOSS ON INVESTMENT - ($266,824) TRANSFER OF EQUITY - ($2,953,423) INTEREST IN FOUNDATION - $272,265 NET ASSETS FROM RESTRICTIONS USED FOR OPERATIONS - ($489,235)
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:DENISE GEORGE TITLE:PRESIDENT/CEO HOURS:5
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:ALAN MOSSOFF TITLE:NDH CFO HOURS:10

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Direct Controlling Entity NADirectControllingEntityNA
HEALTH QUEST SYSTEMS INC
45 READE PLACEPOUGHKEEPSIENY12601141678068SUPPORT SERVBOX 9HQ
SEE SCHEDULE O
N/A
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1HEALTH QUEST SYSTEMS INCBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeOTransactionType
Amount Involved9009610AmountInvolved
Method Of Amt DeterminationSEE SCHEDULE OMethodOfAmtDetermination

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