2012-11-14T13:41:12-06:00 2011-12-31 990 2011-01-01 562669185 HEALTH QUEST MEDICAL PRACTICE PC % MARYANN KEPPLE CFO HEAL 8454759500 1351 ROUTE 55 LAGRANGEVILLE NY 12540 MARYANN KEPPLE 8454759500 2012-11-14 2011 2016-02-24 21:20:13Z MICHAEL T WEBER 1351 ROUTE 55 LAGRANGEVILLE NY 12540 49666647 false X N/A X 2007 NY TO IMPROVE THE HEALTH OF THE COMMUNITIES THAT WE SERVE IN THE HUDSON VALLEY BY PROVIDING QUALITY PATIENT CARE BASED ON OUR COMMITMENT TO EXCELLENCE, INNOVATION AND STATE-OF-THE-ART TECHNOLOGIES. 1 0 370 0 0 0 38726404 49589192 11 0 37239 77455 38763654 49666647 0 0 0 0 37020360 40943255 0 0 0 15668753 17951207 52689113 58894462 -13925459 -9227815 13130244 24268660 14069569 23901223 -939325 367437 HEALTH QUEST MEDICAL PRACTICE PROVIDES MULTISPECIALTY PHYSICIAN SERVICES TO PATIENTS. false false 53331871 49593692 TO PROVIDE MULTISPECIALTY HOSPITAL BASED AND RETAIL BASED HEALTH CARE INCLUDING ONCOLOGY, CRITICAL CARE, CARDIOTHORACIC SURGERY, SURGICAL SERVICES, OBGYN, NEWBORN CARE, AND PRIMARY PHYSICIAN CARE TO PATIENTS IN VARIOUS SERVICE AREAS. 53331871 true false false false false false false false false true false false true true false false true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false false true 0 0 370 true false false false false false false false false false false X 1 0 false false false false true true true true true false true true true true true true true true true true false NY X MARYANN KEPPLE CFO 8454759500 1351 ROUTE 55 LAGRANGEVILLE NY 12540 X MARYANN KEPPLE 4.0 X 0 473490 19142 ARUN AGARWAL MD 35.0 X 0 472821 19270 FREDERICK THOMAS 4.0 X 0 325614 17325 MOHAN SARABU MD 80.0 X 1197399 38070 CINDY JACOBS 45.0 X 0 267341 23265 PETER ZAKOW MD 70.0 X 540561 47712 ANGELA KELEHER MD 60.0 X 479517 24309 ROHIT SHAHANI MD 60.0 X 533537 43046 KIMBERLY HELLER MD 60.0 X 461553 37681 ARUN BHUTANI MD 60.0 X 442135 40535 3654702 1539266 310355 6 false true false 0 0 PROVIDE MEDICAL CARE AND SERVICES 31263976 31263976 PROVIDE CLINIC MEDICAL CARE AND SERVICES 717588 717588 ADMINISTRATIVE FEE/SUBSIDY 16997747 16997747 OTHER PROGRAM REVENUE 609881 609881 49589192 0 0 0 70589 70589 70589 70589 0 0 0 0 RETURNED CHECK FEE INCOME 900099 2366 2366 MILLBROOK CENTRAL SCHOOL PHYSICALS REVENUE 4500 4500 6866 49666647 49593692 72955 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35363118 31826806 3536312 0 1070581 963523 107058 0 2593292 2333963 259329 0 1916264 1724638 191626 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195 175 20 0 0 0 0 0 426788 384109 42679 0 0 0 0 0 0 0 0 0 2091820 1882638 209182 0 24408 21967 2441 0 0 0 0 0 216831 195149 21682 0 0 0 0 0 0 0 0 0 1273037 1145733 127304 0 3406497 3065847 340650 0 PURCHASED SERVICES 6862978 6176680 686298 0 BAD DEBT 2528597 2528597 0 0 MEDICAL SUPPLIES 739954 739954 0 0 LICENSES/TAXES 166108 149497 16611 0 213994 192595 21399 58894462 53331871 5562591 0 0 0 0 0 402907 315127 0 0 0 0 4019605 4384989 0 0 0 0 0 0 0 2439 1212392 1230228 7470613 2028258 5590332 5442355 0 0 0 0 0 0 871429 731619 1033579 12161903 13130244 24268660 2323824 2647679 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11745745 21253544 14069569 23901223 X -939325 367437 0 0 0 0 -939325 367437 13130244 24268660 X -9227815 10534577 X false true true X true true X X X false false false VASSAR BROTHERS MEDICAL CENTER 141338586 03 false true true 7456399 PUTNAM HOSPITAL CENTER 061399319 03 false true true 802895 NORTHERN DUTCHESS HOSPITAL 141338467 03 false true true 2274489 3 10533783 1793378 306566 1486812 5525842 1720152 3805690 151393 1540 149853 5442355 DUE FROM AFFILIATES 333871 OTHER RECEIVABLES 122032 SPECIAL INVESTMENTS 412121 INSURANCE RECEIVABLE 11286278 MISCELLANEOUS 7601 12161903 0 DUE TO AFFILIATES 9441732 SPECIAL INVESTMENTS 412121 MEDICAL MALPRACTICE INSURANCE LIABILITY 11286278 DUE TO HITNY 109593 L/T DUE TO HQ 3820 21253544 49666647 58894462 -9227815 10533783 10533783 1305968 49666647 49666647 49666647 58894462 58894462 58894462 PART XI LINE 8 RECONCILIATION OF CHANGE IN NET ASSETS TRANSFER OF EQUITY - $10,533,783 X X X X X false false false false false false false false false MOHAN SARABU MD 1197399 0 0 14700 23370 1235469 14700 PETER ZAKOW MD 540561 0 0 14700 33012 588273 14700 ANGELA KELEHER MD 479517 0 0 14700 9609 503826 14700 ROHIT SHAHANI MD 533537 0 0 14700 28346 576583 14700 KIMBERLY HELLER MD 461553 0 0 14700 22981 499234 1073 ARUN BHUTANI MD 442135 0 0 14700 25835 482670 14700 MARYANN KEPPLE 0 379405 0 58354 0 35731 0 14700 0 4442 0 492632 0 14700 ARUN AGARWAL MD 0 375000 0 65307 0 32514 0 14700 0 4570 0 492091 0 14700 FREDERICK THOMAS 0 294371 0 29324 0 1919 0 14700 0 2625 0 342939 0 14700 CINDY JACOBS 0 258238 0 9103 0 0 0 0 0 23265 0 290606 0 0 RELATED ORGANIZATIONS SCHEDULE R RELATED TAX EXEMPT ORGANIZATIONS Entity 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 Health Quest Urgent Care Medical Practice 80-0152047 Health Care NY 501c3 Box 3 POLICIES FORM 990 PART VI SECTION B LINES 11A 12C AND 15B LINE 11A FORM 990 IS REVIEWED BY THE AVP OF FINANCE FOR HEALTH QUEST SYSTEMS, INC. AND A COPY IS PROVIDED TO DR. AGARWAL THE SINGLE SHAREHOLDER FOR HIS REVIEW. LINE 12 C ALL POTENTIAL CONFLICTS OF INTEREST ARE REVIEWED BY THE HEALTH QUEST BUSINESS ETHICS COMMITTEE ON BEHALF OF THE AFFILIATE. IN ADDITION, CONFLICT OF INTEREST STATEMENTS ARE COMPLETED BY BOARD MEMBERS AND KEY EMPLOYEES ON AN ANNUAL BASIS AND REVIEWED BY THE HEALTH QUEST CORPORATE COMPLIANCE DEPARTMENT. LINE 15 B COMPENSATION FOR THE CEO, TOP MANAGEMENT AND OTHER KEY EMPLOYEES IS ESTABLISHED BY THE HEALTH QUEST EXECUTIVE COMPENSATION COMMITTEE BASED ON INFORMATION AND RECOMMENDATIONS OF AN INDEPENDENT THIRD PARTY. DISCLOSURE FORM 990 PART VI SCETION C LINE 19 LINE 19 POLICIES AND FINANCIAL STATEMENTS FOR THE AFFILIATE 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 AGREEMENTS. TRANSACTIONS WITH HQ SCH R, PART V, LINE 2 (1) Related Transactions with Health Quest Systems, Inc Allocation Methodology 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 TRANSACTIONS WITH HOSPITALS SCH R, PART V, LINE 2 (2) Administrative Fees and Subsidies The administrative fees/subsidies are based on expenses associated with the practice providing the following services to its Affiliated Hospitals at cost. Hospitalists: The physicians employed by the Hospitalist program admit and provide care to inpatients at VBMC, PHC and NDH allowing the patient's private/primary community physician to remain in their office. The care is provided on a continuous basis to the patient throughout the day, night and the weekends. The specific requirements of the group are detailed below: " 24/7 coverage " Medical Director administrative time: 18 hours per week Includes: scheduling, payroll, recruitment, evaluation of growth, review financial records. " Night coverage: 15 hour shift. 6 hours are spent on billable patient care. Remaining 9 hours (63 hours per week) are involved with covering existing team and being available for ER evaluations or new consults. These hours are critical for excellent care and are not billable. " Day MD administrative time: filling our forms, conferences with patients/family/staff beyond E/M billable time, signing charts. 1 hour each per provider or 3 hours per day- 21 hours per week " Case management advisor " Participate in QI programs at the hospital " Chair of information management committee. " Nursing Education. " Direct and coordinate all clinical matters. " Develop cost effective care, cost containment measures, assist in operating and capital budgets including projections of revenue and expenditures " Ensure the consistency, quality of services provided. " Analyze clinical outcomes, and identify deficiencies. " Resolve patients and problems with the quality of services. " Written reports- goals, objectives and standards for services. " Scheduling providers " Participate in community outreach programs and community education. " Review financial report. " Ensures that all providers are compliant Intensivists: The physicians employed by the Intensivist (triple boarded) program provide care to critically ill patients in the intensive care and critical care units at VBMC. The appropriate level of care warranted by the acuity of the patient is provided on a continuous basis to the patient throughout the day, night and for the weekends. The specific requirements of the group are detailed below: " 24/7 coverage for code stats- Lead team, intubate, place lines, emergency pacemakers, etc. " 24/7 rapid consultations available for medical staff. " 24/7 availability to triage patients moving into or out of intensive care " 24/7 coverage of ED evaluations and urgent/emergent advice of critically ill adults. " Mandated coverage for an average of 15 ICU patients/day " Direct and coordinate all clinical matters. " Develop cost effective care, cost containment measures, assist in operating and capital budgets including projections of revenue and expenditures " Ensure the consistency, quality of services provided. " Analyze clinical outcomes, and identify deficiencies. " Resolve patients and problems with the quality of services. " Written reports- goals, objectives and standards for services. " Scheduling providers " Participate in community outreach programs and community education. " Review financial report. " Ensures that all providers are compliant Surgical PA Program The Physician Assistants employed by the Surgical PA program assist during surgical procedures at VBMC, PHC and NDH. This service is extremely important to the community of surgeons due to a shortage (and aging) of general surgeons in the Dutchess County. This program reduces the need for surgeons to double-up during procedures. The specific requirements of the group are detailed below: " Direct and coordinate all clinical matters. " Develop cost effective care, cost containment measures, assist in operating and capital budgets including projections of revenue and expenditures " Ensure the consistency, quality of services provided. " Analyze clinical outcomes, and identify deficiencies. " Resolve patients and problems with the quality of services. " Recommends employment and termination of non-physician personnel " Written reports- goals, objectives and standards for services. " Scheduling providers " Participate in community outreach programs and community education. " Review financial report. " Ensures that all providers are compliant CTPA: The physician assistants employed by the Cardio Thoracic PA program assist during cardiac surgical procedures at VBMC. This service is vital since there are currently only four Cardiothoracic Surgeons at VBMC who cannot provide 24/7 coverage for their patients without this program. The specific requirements of the group are detailed below: " 24/7 coverage ( 8,736 hours per year) for Cardiothoracic patients Women's Health: The physicians employed by the Women's Health program care for patients in the PCAP clinic program of VBMC. The revenue generated by the group comes from two sources for the clinic patients. The PCAP rate VBMC receives is shared with the group as reimbursement for the professional services the physicians provide to the patients in the outpatient clinic. Additionally, the group bills for the procedures and deliveries the physicians perform for patients admitted to VBMC. The specific requirements of the group are detailed below: " Direct and coordinate all clinical matters. " Develop cost effective care, cost containment measures, assist in operating and capital budgets including projections of revenue and expenditures " Ensure the consistency, quality of services provided. " Analyze clinical outcomes, and identify deficiencies. " Resolve patients and problems with the quality of services. " Written reports- goals, objectives and standards for services. " Scheduling providers " Participate in community outreach programs and community education. " Review financial report. " Ensures that all providers are compliant Breast Surgery The physicians employed by the Oncology program provide care for oncology patients on both an outpatient basis (office visits) and an inpatient basis for surgical procedures and the associated post operative care. The specific requirements of the group are detailed below: " Coordinates patient, and OR schedule. " Reviews patient work load and delegate's projects and concerns. " Handles office day to day issues at the practice " Gives lectures on Breast Cancer at VBMC and community events. " Direct and coordinate all clinical matters. " Develop cost effective care, cost containment measures, assist in operating and capital budgets including projections of revenue and expenditures " Ensure the consistency, quality of services provided. " Analyze clinical outcomes, and identify deficiencies. " Resolve patients and problems with the quality of services. " Recommends employment and termination of non-physician personnel " Written reports- goals, objectives and standards for services. " Scheduling providers " Participate in community outreach programs and community education. " Review financial report. " Ensures that all providers are compliant CT Surgeons The physicians and physician assistants employed by HQMP provide care for cardiac patients on both an outpatient basis (office visits) and an inpatient basis for surgical procedures and the associated post operative care. The specific requirements of the group are detailed below: " Direct and coordinate all clinical matters. " Develop cost effective care, cost containment measures, assist in operating and capital budgets including projections of revenue and expenditures " Ensure the consistency, quality of services provided. " Analyze clinical outcomes, and identify deficiencies. " Resolve patients and problems with the quality of services. " Recommends employment and termination of non-physician personnel " Written reports- goals, objectives and standards for services. " Scheduling providers " Participate in community outreach programs and community education. " Review financial report. " Ensures that all providers are compliant GOVERNING FORM 990, PART VI LINE 6, 7A, 7B ARUN AGARWAL, MD IS THE SINGLE SHAREHOLDER FOR HQMP. HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MARYANN KEPPLE TITLE:TREASURER/HQ CFO HOURS:56 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ARUN AGARWAL, MD TITLE:PRESIDENT/CEO HQMP & HQUMCP HOURS:5 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:FREDERICK THOMAS TITLE:CORP SECRETARY/VP HQ LEGAL HOURS:66 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:CINDY JACOBS TITLE:COO HQMP & HQUMCP HOURS:5 HEALTH QUEST SYSTEMS INC 1351 ROUTE 55 LAGRANGEVILLE NY 12540 141678068 SUPPORT SVC BOX 9 HQ SEE SCHEDULE O N/A false false false false false false false false false false false false false false true true false false HEALTH QUEST SYSTEMS INC O 6336460 SEE SCHEDULE O VASSAR BROTHERS MEDICAL CENTER P 14275983 SEE SCHEDULE O PUTNAM HOSPITAL CENTER P 1565117 SEE SCHEDULE O NORTHERN DUTCHESS HOSPITAL P 1156647 SEE SCHEDULE O