PUTNAM HOSPITAL CENTER: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
PUTNAM HOSPITAL CENTER (EIN 14-6019179)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-13
IRS object ID
201223189349304922
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)
Timestamp2012-11-13T19:31:59-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN146019179EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1PUTNAM HOSPITAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% HEALTH QUESTInCareOfName
Name ControlPUTNNameControl
Phone8452795711Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1670 STONELEIGH AVENUEAddressLine1
CityCARMELCity
StateNYState
ZIP Code10512ZIPCode

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)
Gross Receipts168423774GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.putnamhospital.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionPROVIDE ALL ASPECTS OF PATIENT CARE TO THE COMMUNITYActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees1191TotalNbrEmployees
Total Nbr Volunteers218TotalNbrVolunteers
Total Gross UBI8088TotalGrossUBI
Net Unrelated Business Txbl Income-40944NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year2079457ContributionsGrantsPriorYear
Contributions Grants Current Year1245894ContributionsGrantsCurrentYear
Program Service Revenue Prior Year150437550ProgramServiceRevenuePriorYear
Program Service Revenue CY161294799ProgramServiceRevenueCY
Investment Income Prior Year1107828InvestmentIncomePriorYear
Investment Income Current Year2660688InvestmentIncomeCurrentYear
Other Revenue Prior Year3065962OtherRevenuePriorYear
Other Revenue Current Year3222393OtherRevenueCurrentYear
Total Revenue Prior Year156690797TotalRevenuePriorYear
Total Revenue Current Year168423774TotalRevenueCurrentYear
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 Year74962823SalariesEtcPriorYear
Salaries Etc Current Year74193295SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year73678892OtherExpensePriorYear
Other Expenses Current Year78770013OtherExpensesCurrentYear
Total Expenses Prior Year148641715TotalExpensesPriorYear
Total Expenses Current Year152963308TotalExpensesCurrentYear
Revenues Less Expenses Prior Year8049082RevenuesLessExpensesPriorYear
Revenues Less Expenses CY15460466RevenuesLessExpensesCY
Total Assets BOY141401787TotalAssetsBOY
Total Assets EOY151869092TotalAssetsEOY
Total Liabilities BOY83330208TotalLiabilitiesBOY
Total Liabilities EOY90470952TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY58071579NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY61398140NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionPHC IS DEDICATED TO PROVIDING THE HIGHEST QUALITY PATIENT CARE WITH ATTENTION TO SERVICE EXCELLENCE, PATIENT SAFETY, PHYSICIAN COLLABORATION AND INNOVATION TO ASSURE THAT WE MEET THE NEEDS OF THE COMMUNITIES WE SERVE.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense62414502Expense
Revenue86184124Revenue
DescriptionINPATIENT SERVICES: PATIENTS ADMITTED FOR ACUTE CARE - NUMBER OF PATIENTS 6,839; NUMBER OF PATIENT DAYS 31,536 THE HOSPITAL PROVIDED APPROXIMATELY $1,339,282 IN UNCOMPENSATED CARE (AT COST) TO THE REGIONS UN-INSURED AND UNDER-INSURED POPULATION.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense4165804Expense
Revenue5752288Revenue
DescriptionINPATIENT PSYCHIATRIC SERVICES: PSYCHIATRIC PATIENTS ADMITTED FOR TREATMENT - NUMBER OF PATIENTS 611; NUMBER OF PATIENT DAYS 5,792Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense46902583Expense
Revenue66305587Revenue
DescriptionOUTPATIENT SERVICES: PATIENTS WHO RECEIVED MEDICAL EMERGENCY, ASU AND VARIOUS ANCILLIARY SERVICES - TOTAL EMERGENCY VISITS 21,676; TOTAL AMBULATORY SURGERY VISITS 5,861 ALL OTHER VISITS/PROCEDURES 207,902 THE HOSPITAL PROVIDED APPROXIMATELY $1,120,501 IN UNCOMPENSATED CARE (AT COST) TO THE REGIONS UN-INSURED AND UNDER-INSURED POPULATION.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense3326729Expense
Revenue3052800Revenue
DescriptionHome CareDescription
FieldValueIRS element (for citing)
Total Of Other Program Service Exp3326729TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev3052800TotalOfOtherProgramServiceRev
Total Program Service Expense116809618TotalProgramServiceExpense
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 With10968NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees1191NumberOfEmployees
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
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
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 PersonHEALTH QUESTNamePerson
Telephone Number8454759500TelephoneNumber

Address US AddressUS

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

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
JOHN NEUBAUER
MEMBER1.0X
KEIREN M FARQUHAR
CHAIRMAN2.0X
JAMES P DUSENBURY
MEMBER1.0X
KAREN FLEMING
MEMBER1.0X
JEFFREY J REDFIELD
FIRST VICE CHAIRMAN2.0X
PAUL A CAMARDA
SECRETARY2.0X
KEVIN DWYER
MEMBER1.0X
ROBERT P MORINI
SECOND VICE CHAIRMAN2.0X
WAYNE RYDER
MEMBER1.0X
RAYMOND DURKIN
MEMBER1.0X
WILLIAM GERSTNER
MEMBER1.0X
JANUSZ RUDNICKI MD
MEMBER1.0X
LORETTA MOLINARI
MEMBER1.0X
DONNA M MCGREGOR
PHC PRESIDENT/CEO57.5X060766741216
ANTHONY MIRDITA
CFO35.0X016789439798
MAUREEN ZIPPARO
CHIEF OPERATING OFFICER40.0028831841502X
JEFFREY KELLOGG
SVP DEV & COMMUNITY AFFAIRS25.0024965932519X
JEAN CHELALA MD
DIRECTOR OF NEONATOLOGY37.533215458710X
HANNA PENG
PHARMACIST40.018904448270X
SHARON GILCHRIST
REGISTERED NURSE40.017523223229X
JOAQUIN MAXINO
REGISTER NURSE40.016648241402X
MAUREEN PACE
AVP CLINICAL RESOURCE MGMT37.516088910268X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1023801TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1313538TotalReportableCompFrmRltdOrgs
Total Other Compensation336914TotalOtherCompensation
Number Individuals GT100 K5NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Government Grants285359GovernmentGrants
All Other Contributions960535AllOtherContributions
Total Contributions1245894TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
INPATIENT SERVICE REVENUE9000999193641291936412
OUTPATIENT SERVICE REVENUE9000996630558766305587
HOMECARE SERVICE REVENUE62161030528003052800
FieldValueIRS element (for citing)
Total Program Service Revenue161294799TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column840665TotalRevenueColumn
Exclusion$840,665ExclusionAmount

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)
Real2237461Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real2237461Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column2237461TotalRevenueColumn
Exclusion$2,237,461ExclusionAmount

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1820023TotalRevenueColumn
Exclusion$1,820,023ExclusionAmount

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
CAFETERIA AND MEAL TICKET SALES900099568149568149
CARDIO FITNESS CENTER71394068206820
DIETARY CATERING72232012681268

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column408695TotalRevenueColumn
Related Or Exempt Function Income408695RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue984932TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column168423774TotalRevenueColumn
Related Or Exempt Function Income162271643RelatedOrExemptFunctionIncome
Unrelated Business Revenue8088UnrelatedBusinessRevenue
Exclusion$4,898,149ExclusionAmount

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)
Total53894650Total
Program Services46499389ProgramServices
Management And General7395261ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total5128429Total
Program Services4424722ProgramServices
Management And General703707ManagementAndGeneral
Fundraising0Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total11007844Total
Program Services9497381ProgramServices
Management And General1510463ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total4162372Total
Program Services3591224ProgramServices
Management And General571148ManagementAndGeneral
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)
Total4672Total
Program Services0ProgramServices
Management And General4672ManagementAndGeneral
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)
Total652504Total
Program Services484810ProgramServices
Management And General167694ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total550Total
Program Services465ProgramServices
Management And General85ManagementAndGeneral
Fundraising0Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2933543Total
Program Services2153628ProgramServices
Management And General779915ManagementAndGeneral
Fundraising0Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total5550156Total
Program Services182165ProgramServices
Management And General5367991ManagementAndGeneral
Fundraising0Fundraising

Royalties Royalties

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

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3792211Total
Program Services3177023ProgramServices
Management And General615188ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total25491Total
Program Services11106ProgramServices
Management And General14385ManagementAndGeneral
Fundraising0Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

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

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total49422Total
Program Services38426ProgramServices
Management And General10996ManagementAndGeneral
Fundraising0Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total1986963Total
Program Services1664630ProgramServices
Management And General322333ManagementAndGeneral
Fundraising0Fundraising

Payments To Affiliates PaymentsToAffiliates

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

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total8728011Total
Program Services7312118ProgramServices
Management And General1415893ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total1306145Total
Program Services1159764ProgramServices
Management And General146381ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
MEDICAL SUPPLIES211094272110942700
PURCHASED SERVICES207318895734929149969600
BAD DEBT4068182406818200
PHYSICIAN FEES3844720384472000

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total3986127Total
Program Services1855509ProgramServices
Management And General2130618ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total152963308Total
Program Services116809618ProgramServices
Management And General36153690ManagementAndGeneral
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)
BOY190952BOY
EOY141384EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY2603067BOY
EOY9323426EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY18276232BOY
EOY19300449EOY

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)
BOY101836BOY
EOY75794EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1988265BOY
EOY1816272EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY784631BOY
EOY1187123EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis159063434LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec86442684LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY74017482BOY
EOY72620750EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY17359260BOY
EOY18198721EOY

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)
BOY26080062BOY
EOY29205173EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY141401787BOY
EOY151869092EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY21219887BOY
EOY17009603EOY

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)
BOY37511580BOY
EOY36510143EOY

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)
BOY2999620BOY
EOY2431146EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY21599121BOY
EOY34520060EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY83330208BOY
EOY90470952EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY50325657BOY
EOY54276582EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY6922452BOY
EOY6300920EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY823470BOY
EOY820638EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY58071579BOY
EOY61398140EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY141401787BOY
EOY151869092EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses15460466ReconcilationRevenueExpenses
Reconcilation Other Changes-12133905ReconcilationOtherChanges
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$4,672OtherActivitiesAmount
Total Lobbying Expenditures IIB4672TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierSCHEDULE C, PART IIIdentifier
Return ReferenceLOBBYING ACTIVITIESReturnReference
Explanation28.9% OF NORMET DUES PAID BY PUTNAM HOSPITAL CENTER ARE USED FOR POLITICAL EXPENDITURESExplanation

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 Balance823470BeginningOfYearBalance
Investment Earnings Or Losses-2832InvestmentEarningsOrLosses
End Of Year Balance820638EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance821692BeginningOfYearBalance
Investment Earnings Or Losses1778InvestmentEarningsOrLosses
End Of Year Balance823470EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance809499BeginningOfYearBalance
Investment Earnings Or Losses12193InvestmentEarningsOrLosses
End Of Year Balance821692EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance809499BeginningOfYearBalance
End Of Year Balance809499EndOfYearBalance
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 Basis1193282OtherCostOrOtherBasis
Book Value1193282BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis74935043OtherCostOrOtherBasis
Depreciation26137326Depreciation
Book Value48797717BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis80164850OtherCostOrOtherBasis
Depreciation58856653Depreciation
Book Value21187315BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2770259OtherCostOrOtherBasis
Depreciation1448705Depreciation
Book Value1442436BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings72620750TotalOfBookValueLandBuildings

Other Assets OtherAssets (11 entries)

DescriptionDescriptionBook ValueBookValue
DAVITA RESTRICTED CASH632606
REFINANCING FEES71392
INTEREST IN PHC FOUNDATION10001130
DSRF 2007 SERIES B BONDS5551197
DSRF 2007 SERIES C BONDS994078
DUE FROM AFFILIATES8523747
MISC RECEIVABLES129104
DSRF TELP LOAN TDBANK GENERAL1449108
DEF FINANCING 2007 SERIES B1192560
DEF FINANCING 2007 SERIES C163523
2007 SERIES C BOND PREMIUM496728
FieldValueIRS element (for citing)
Total Book Value Other Assets29205173TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (7 entries)

DescriptionDescriptionAmountAmount
RETRO PAYABLE TO 3RD PARTY PAY$3,871,197
PENSION - ACCRUED CURRENT AND$19,568,497
DUE TO AFFILIATES HQ LT$749,088
FIN 47 LIABILTY$471,086
HITNY LIABILITY$1,770,268
MED MALL INSURANCE LIABILITY$7,352,419
DUE TO AFFILIATES$737,505
FieldValueIRS element (for citing)
Total Of Amounts34520060TotalOfAmounts
Total Revenue168423774TotalRevenue
Total Expenses152963308TotalExpenses
Excess Or Deficit For Year15460466ExcessOrDeficitForYear
Net Unrealized GL On Investments-2247542NetUnrealizedGLOnInvestments
Other-$9,886,313OtherAmount
Total Adjustments-12133855TotalAdjustments
Excess Or Deficit Per FS3326611ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt166176232TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-2247542NetUnrealizedGainsInvestments
Revenue Not Rptd F990-2247542RevenueNotRptdF990
Revenue Subtotal168423774RevenueSubtotal
Total Revenue Per Form990168423774TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt152963308TotExpensesEtcAuditedFinclStmt
Expenses Subtotal152963308ExpensesSubtotal
Total Expenses Per Form990152963308TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ADDITIONAL PENSION LIABILITYSCHEDULE D PART XI LINE 8Pension related changes other than net periodic pension costs ($8,730,064)
TRANSFER OF EQUITYSCHEDULE D PART XI LINE 8TRANSFER OF EQUITY ($802,895)
INTEREST IN PHC FOUNDATIONSCHEDULE D PART XI LINE 8INTEREST IN PHC FOUNDATION $270,961
CHANGE IN RESTRICTED CONTRIBUTIONSSCHEDULE D PART XI LINE 8CHANGE IN RESTRICTED CONTRIBUTIONS - ($624,315)
ROUNDINGSCHEDULE D PART XI LINE 8ROUNDING - ($50.00)

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 BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailablefalseReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense4786282TotalCommunityBenefitExpense
Direct Offsetting Revenue2697871DirectOffsettingRevenue
Net Community Benefit Expense2088411NetCommunityBenefitExpense
Percent Of Total Expense0.01370PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense9690992TotalCommunityBenefitExpense
Direct Offsetting Revenue4313627DirectOffsettingRevenue
Net Community Benefit Expense5377365NetCommunityBenefitExpense
Percent Of Total Expense0.03520PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense14477274TotalCommunityBenefitExpense
Direct Offsetting Revenue7011498DirectOffsettingRevenue
Net Community Benefit Expense7465776NetCommunityBenefitExpense
Percent Of Total Expense0.04890PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs11NumberOfActivitiesOrPrograms
Persons Served162059PersonsServed
Total Community Benefit Expense62194TotalCommunityBenefitExpense
Net Community Benefit Expense62194NetCommunityBenefitExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Benefit Expense11452TotalCommunityBenefitExpense
Net Community Benefit Expense11452NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs12NumberOfActivitiesOrPrograms
Persons Served162059PersonsServed
Total Community Benefit Expense73646TotalCommunityBenefitExpense
Net Community Benefit Expense73646NetCommunityBenefitExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs12NumberOfActivitiesOrPrograms
Persons Served162059PersonsServed
Total Community Benefit Expense14550920TotalCommunityBenefitExpense
Direct Offsetting Revenue7011498DirectOffsettingRevenue
Net Community Benefit Expense7539422NetCommunityBenefitExpense
Percent Of Total Expense0.04940PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$1,888,568BadDebtExpenseAmount
Amount Attributable To944284AmountAttributableTo
Amount Reimbursed By Medicare51888513AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare65337319CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-13448806MedicareSurplusOrShortfall

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 Line1PUTNAM HOSPITAL CENTERBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1670 STONELEIGH AVENUEAddressLine1
CityCARMELCity
StateNYState
ZIP Code10512ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1PUTNAM HOSPITAL CENTERBusinessNameLine1
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 (15 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
PART I, LINE 3CN/A
PART I, LINE 6AHEALTH QUEST SYSTEMS, INC PREPARES THE COMMUNITY BENEFIT REPORT, HOWEVER, THE REPORT DOES DETAIL OUR SPECIFIC COMMUNITY BENEFITS FOR EACH FACILITY WITHIN HEALTH QUEST.
PART I, LINE 7, COLUMN FTOTAL BAD DEBT EXPENSE, EXCLUDED FROM COLUMN F PERCENTAGE = $4,068,182
PART I, LINE 7COST TO CHARGE RATIO 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 FINANICALS - FEDERAL AND STATE LAW REQUIRES THE HOSPITALS TO PROVIDE EMERGENCY SERVICES REGARDLESS OF A PATIENT'S ABILITY TO PAY. UNINSURED 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 PATIENT'S 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 SUCH 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 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 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. PUTNAM HOSPITAL IS WORKING TO: A. REDUCE THE SUICIDE RATE IN THE COUNTY BY TRAINING MEDICAL PERSONNEL AND LAYPERSONS IN SAFETALK/CONNECT. OUR GOAL WAS TO TRAIN 30-40 PEOPLE; WE TRAINED 100 PEOPLE IN TWO FULL SESSIONS. B. REDUCE CHILDHOOD OBESITY THROUGH EDUCATION AT OUR ANNUAL KIDS DAY EVENT.CHILDREN RECEIVED INFORMATION ON MY PLATE, PHYSICAL ACTIVITY, WELLNESS AND HEALTHY SNACKS. OUR GOAL WAS TO DISTRIBUTE EDUCATIONAL MATERIAL TO 80% OF PARTICIPANTS. 3,000 ATTENDED AND 1000 RECEIVED LUNCH BAGS WITH INFO, 600 HAD STAMPED "PASSPORTS" FROM ALL STATIONS, AND MORE THAN 300 PARENTS COMPLETED SURVEYS THAT WILL HELP GUIDE OUR EFFORTS NEXT YEAR. C. INCREASE THE USE OF DIABETES SELF-MANAGEMENT ENROLLEES AND SUPPORT GROUP ATTENDEES. WE HAD HOPED TO INCREASE BOTH MEASUREMENTS BY 2% BUT HAVE HAD NO SUCCESS IN GROWING THE POPULATIONS. WE WILL RECONSIDER THIS GOAL IN THE FUTURE. D. INCREASE AWARENESS OF LYME DISEASE AND OTHER TICK-BORNE ILLNESSES, A PARTICULAR CONCERN IN OUR REGION. WE HAVE NO MEASUREMENTS FOR THIS BUT ACHIEVED GOOD SATURATION WITH DISPLAYS INSIDE THE HOSPITAL. E. INCREASE ACCESS TO PRIMARY CARE IN THE COMMUNITY BY SUPPORTING THE OPENING OF A FEDERALLY QUALIFIED HEALTH CLINIC IN PUTNAM COUNTY. WE EXPECT THE CLINIC TO BE OPEN WITHIN THE NEXT FEW MONTHS. 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 VI, 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.AFFILIATED HEALTH CARE SYSTEM
PART VI, LINE 7HEALTH QUEST, THE PARENT COMPANY OF PUTNAM HOSPITAL CENTER, FILES A SYSTEM WIDE COMMUNITY SERVICE PLAN WITH NYS DEPARTMENT OF HEALTH.STATE FILING OF COMMUNITY BENEFITS REPORT

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 (9 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
DONNA M MCGREGOR
045431901062920470560147000265160648883014700
MAUREEN ZIPPARO
02323150222160337870147000268020329820017601
ANTHONY MIRDITA
016203205862000104580293400207692010401
JEAN CHELALA MD
310866212880289742973639086428663
JEFFREY KELLOGG
01905520183070408000126100199090282178015830
HANNA PENG
18904400233552491523731423529
SHARON GILCHRIST
16540898240132171001219846113564
JOAQUIN MAXINO
16648200183732302920788417450
MAUREEN PACE
151609790913710102681711570

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 Price28161751IssuePrice
Description Of PurposeCONSTRUCTION OF FACILITYDescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer
Pool FinancingfalsePoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Amount Retired2165256AmountRetired
Amount Bond Defeased0AmountBondDefeased
Total Proceeds30073873TotalProceeds
Amount In Reserve Fund2021377AmountInReserveFund
Capitalized Interest572477CapitalizedInterest
Refunding Escrow0RefundingEscrow
Issuance Costs From Proceeds387734IssuanceCostsFromProceeds
Credit Enhancement443713CreditEnhancement
Working Capital Expenditures655855WorkingCapitalExpenditures
Capital Expenditures23608165CapitalExpenditures
Other Spent Proceeds0OtherSpentProceeds
Amount Unspent2384553AmountUnspent
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, COLUMNE 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 (12 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
PROGRAM SERVICE ACCOMPLISHMENTSForm 990 Part III Line 4DHome Health care: Provide Homecare to patients in the community. Total Homecare visits: 13,281
GOVERNINGFORM 990 PART VI SECTION A LINE 2A, 6, 7A, 7B, 8A AND 8BLINE 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 PHC IS HEALTH QUEST SYSTEMS, INC LINES 7A AND 7B - Appointment/Election of Directors. Nominees to the Board of Directors of PHC shall be nominated in the following manner: The PHC Executive Committee may prepare a slate of nominees to present to Health Quests Executive Committee for its review and approval not less than thirty (30) days prior to the annual meeting of PHC in the case of vacancies created by the expiration of PHC Directors terms of office, or in the case of all other vacancies, as soon as reasonably possible. The Executive Committee of Health Quest must approve slates of nominees by a majority vote of the entire Executive Committee. Once Health Quests Executive Committee approves the slate of nominees by majority vote, Health Quests Executive Committee shall inform the PHC Board and present the slate of nominees to the Board of Trustees of Health Quest for approval. Manner of Acting. Except as otherwise specified in the certificate of incorporation of PHC or these Bylaws or the bylaws 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. The powers to be exercised by the PHC Board of Directors that are (i) subject to the subsequent approval of Health Quest, or (ii) to be undertaken in collaboration with Health Quest, are set forth in paragraphs (c), (d) and (e) below. The powers set forth in paragraph (f) below require the vote of two-thirds of solely the PHC Board of Directors. Unless otherwise specified, all other actions that require PHC Board approval require a majority vote of solely the PHC Board of Directors.
POLICIESFORM 990 PART VI SECTION B LINE 11A, 12C, 15A/BLINE 11A - A COPY OF THE FORM 990 WAS PROVIDED TO ALL MEMBERS OF THE BOARD . THE CHAIR OF THE EXECUTIVE COMPENSATION COMMITTEE REVIEWED ALL SECTIONS RELATED TO EXECUTIVE COMPENSATION. 3RD PARTIES WERE HIRED TO ASSIST IN THE PREPARATION AND REVIEW OF SCHEDULE H AND SCHEDULE K. LINE 12C - ON AN ANNUAL BASIS OFFICERS, DIRECTOR AND TRUSTEES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST FILING WHICH IS REVIEWED BY THE HQ VP FOR COMPLIANCE AND INTERNAL AUDIT. ALL POTENTIAL CONFLICTS OF INTEREST ARE REVIEWED BY THE HQ BUSINESS ETHICS COMMITTEE ON BEHALF OF PHC. LINE 15A/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 FILING SUCH AS THE 990 AND BOND HOLDER REQUIREMENTS.
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
SCHEDULE KSCHEDULE K PART 1, COLUMN E LINE ATOTAL ISSUE PRICE PER IRS FORM 8038 - $61,974.071.30, ALLOCATED AS FOLLOWS PUTNAM HOSPITAL CENTER - $28,161,750.68 NORTHERN DUTCHESS HOSPITAL - $15,718,407.82 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 5UNREALIZED LOSS - ($2,247,542) ADDITIONAL PENSION LIABILITY - ($8,730,064) TRANSFER OF EQUITY - ($802,895) INTEREST IN FOUNDATION - $270,961 NET ASSETS FROM RESTRICTIONS USED FOR OPERATIONS - ($624,315)
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:DONNA M MCGREGOR TITLE:PHC PRESIDENT/CEO HOURS:5
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:ANTHONY MIRDITA TITLE:CFO HOURS:5
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:MAUREEN ZIPPARO TITLE:CHIEF OPERATING OFFICER HOURS:5
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:JEFFREY KELLOGG TITLE:SVP DEV & COMMUNITY AFFAIRS HOURS:25

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
1351 ROUTE 55LAGRANGEVILLENY12540141678068SUPPORT SERVBOX 9HQ
SEE SCHEDULE O
N/A

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1MOUNT KISCO SURGERY CENTER LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line134 SOUTH BEDFORD ROADAddressLine1
CityMOUNT KISCOCity
StateNYState
ZIP Code10549ZIPCode
FieldValueIRS element (for citing)
EIN134158313EIN
Primary ActivitySURGERY SERVICESPrimaryActivity
Legal Domicile StateNYLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1MKMGBusinessNameLine1
FieldValueIRS element (for citing)
Share Of Total Income261594ShareOfTotalIncome
Share Of EOY Assets-41422ShareOfEOYAssets
Percentage Ownership0.20000PercentageOwnership
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 Involved21240331AmountInvolved
Method Of Amt DeterminationSEE SCHEDULE OMethodOfAmtDetermination

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