2012-12-13T12:12:51-06:00 2011-12-31 990 2011-01-01 113368503 HUNTINGTON HOSPITAL DOLAN FAMILY HEALTH CEN % MICHAEL FAGAN HUNT 6314254262 284 PULASKI ROAD GREENLAWN NY 11740 KEVIN LAWLOR 2012-12-12 2011 2016-02-24 21:20:13Z KEVIN LAWLOR 284 PULASKI ROAD GREENLAWN NY 11740 6689945 false X N/A X 1995 NY THE HUNTINGTON HOSPITAL DOLAN FAMILY HEALTH CENTER ("THE HEALTH CENTER") IS A FREE-STANDING HOSPITAL-OWNED FACILITY DEDICATED TO PROVIDING MEDICAL CARE TO THE UNINSURED AND UNDER INSURED. 17 13 57 20 0 285245 108015 6717107 6533233 443595 38329 0 9213 7445947 6688790 0 0 0 0 5025659 4831382 0 0 5695 2037901 2306487 7063560 7137869 382387 -449079 8246895 7625643 8655572 8577076 -408677 -951433 THE MISSION OF THE HEALTH CENTER IS TO PROVIDE COMPREHENSIVE CARE & OB SERVICES TO THE MEDICALLY INDIGENT AND UNDERSERVED RESIDENTS FROM NORTHWESTERN SUFFOLK COUNTRY. THE CENTER SERVES AS THE ENTRY POINT INTO THE HEALTH SYSTEM FOR INDIVIDUALS AND FAMILIES SEEKING SUCH CARE. EVERY PATIENT WILL BE PROVIDED COMPREHENSIVE AND CONTINUOUS PREVENTIVE CARE, PRIMARY DIAGNOSTIC AND TREATMENT SERVICES AND EFFECTIVE COORDINATION OF CARE WITH SPECIALISTS AND SERVICES IN THE LARGER HEALTHCARE SYSTEM. false false 6693855 0 6533233 THE HEALTH CENTER IS A COMPREHENSIVE COMMUNITY HEALTH CENTER WHICH PROVIDES PRIMARY, PEDIATRIC, PRENATAL, AND OBSTETRICAL CARE SERVICES TO THE POOR AND UNDERSERVED RESIDENTS IN THE COMMUNITY. IT IS THE ONLY SUCH CENTER BOTH OWNED AND OPERATED BY A HOSPITAL ON LONG ISLAND. ALL PATIENTS HAVE ACCESS TO A SUFFOLK COUNTY FACILITATED ENROLLER FOR MEDICAID MANAGED CARE, CHILD HEALTH PLUS, AND FAMILY HEALTH PLUS THROUGH A PARTNERSHIP WITH THE NASSAU SUFFOLK HOPSITAL COUNCIL. IN ADDITION, THE DOLAN CENTER'S SOCIAL WORK DEPARTMENT ASSISTS PATIENTS WITH ACCESS TO INSURANCE FOR PREGNANT WOMEN THROUGH NEW YORK STATE'S PRENATAL CARE ASSISTANCE PROGRAM. THE DOLAN FAMILY HEALTH CENTER PROVIDED 31,044 PATIENT VISITS IN 2011. 6693855 true true false false false false false false true true false false true true true 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 57 true false false false false false false false false false false X 17 13 false false false false true true true true true false false true true true true true true true true false NY X X MICHAEL FAGAN 6314254262 270 PARK AVENUE HUNTINGTON NY 11743 X CARMELA ANGLIM 1.0 X 0 0 0 MICHAEL ABOFF 1.0 X 0 0 0 MICHAEL J DOWLING 50.0 X 0 2521221 742813 NICK FITTERMAN MD 50.0 X 0 438364 48226 WILLIAM FRAZIER 1.0 X 0 0 0 L KEITH FRIEDLANDER ESQ 1.0 X 0 0 0 ANTHONY GIACCONE 1.0 X 0 0 0 ROSALYN GORDON 1.0 X 0 0 0 THOMAS LEDERER 1.0 X 0 0 0 EUGENE LEVITT ESQ 1.0 X 0 0 0 HARRY MARIANI 1.0 X 0 0 0 JOHN MCCUSKER 1.0 X 0 0 0 LEWIS MELTZER ESQ 1.0 X 0 0 0 ROBERT MYERS 1.0 X 0 0 0 BERNARD M ROSOF MD 1.0 X 0 0 0 KEVIN LAWLOR 50.0 X X 0 744807 313444 MICHAEL GROSSO 50.0 X X 0 442520 48226 MARTHA CARLSTROM 1.0 X 0 0 0 FRED BUCKHOLZ 1.0 X X 0 0 0 TERENCE SMITH 37.5 X 177680 0 33059 WILLIAM GEHRHARDT MD 37.5 X 216347 0 45173 ROGELIO CO MD 37.5 X 197160 0 43433 ROBERTO BLANDO MD 37.5 X 195383 0 17716 SAILI DESAI MD 37.5 X 149725 0 13576 KATHY GIFFUNI 37.5 X 131652 0 37948 1067947 4146912 1343614 11 false true false NONE 0 108015 108015 PATIENT REVENUE 621300 3920670 3920670 SUFFOLK COUNTY CONTRACT 621300 2612563 2612563 6533233 39484 39484 0 0 0 1155 -1155 -1155 0 0 0 MURCOTT CENTER FEE 900099 6170 6170 MEDICAL RECORDS 900099 2771 2771 MISCELLANEOUS OTHER 900099 272 272 9213 6688790 6542446 39484 0 0 0 0 177680 177680 0 3504417 3302562 198605 3250 136305 128454 7725 126 927818 874376 52582 860 85162 80257 4826 79 0 0 87416 87416 0 0 0 875080 824675 49593 812 0 209401 197340 11867 194 0 0 393129 370484 22280 365 8382 8382 0 18222 18222 0 0 49712 46849 2863 213000 213000 BAD DEBT 3736 3736 PURCHASED SERVICES 438496 438496 DUES & SUBSCRIPTIONS 875 825 49 1 OTHER EXPENSES 9038 8517 513 8 7137869 6693855 438319 5695 200 450 383683 185458 0 0 237904 279008 0 0 0 0 0 0 0 0 0 0 751245 74382 715426 676863 3208935 5723248 2542079 0 0 0 0 0 1158668 760616 8246895 7625643 633777 536294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8021795 8040782 8655572 8577076 X -5498422 -6029449 689752 676494 4399993 4401522 -408677 -951433 8246895 7625643 X -449079 -93677 X false true false X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4399993 1530 4401523 4398363 1630 4399993 4388426 9937 4398363 4372670 15756 4388426 1.00000 false false 751245 74382 676863 676863 SUFFOLK COUNTRY CONTRACT 760616 760616 0 ADVANCED FROM HUNTINGTON HOSPT 7945200 EST. NET PAYABLE DUE THIRD PAR 95582 8040782 6688790 7137869 -449079 -93677 -93677 -542756 6595992 -93677 39359 -54318 6650310 38480 38480 6688790 7137869 7137869 7137869 USES OF ENDOWMENT FUNDS PART V, LINE 4 THE INVESTMENT INCOME OF THE ENDOWMENT FUNDS IS UNRESTRIECTED AND IS THEREFORE USED TO HELP SUPPORT THE OPERATION OF THE HUNTINGTON HOSPITAL DOLAN FMAILY HEALTH CENTER. FIN 48 PART X, LINE 2 Certain organizations included in the System's consolidated financial statements are taxable entities under Federal or state laws. Generally accepted accounting principles require that the asset and liability method of accounting for income taxes be utilized by these organizations. Under the asset and liability method, deferred income taxes are recognized for the tax consequences of temporary differences by applying enacted statutory tax rates applicable to future years to differences between the financial statement carrying amounts and the tax basis of existing assets and liabilities. The effect on deferred taxes of a change in tax rates is recognized in income in the period of enactment. At December 31, 2011 and 2010, the System has a deferred income tax asset which has been fully offset by a related valuation allowance. A valuation allowance is provided when it is more likely than not that some portion, or all of the deferred tax asset will not be realized. Significant components of the deferred tax asset relate to the allowance for doubtful accounts receivable and net operating loss carry forwards. The System has net operating loss carry forwards of approximately $113,555,000, which expire in varying amounts through 2031, and are available to offset future taxable income. REVENUE RECONCILIATION PART XII - LINE 2D AND LINE 4B REVENUE ON BOOKS NOT ON RETURN NET ASSETS RELEASED FROM RESTRICTIONS 39,359 REVENUE ON RETURN NOT ON BOOKS TEMPORARILY/PERMANENTLY RESTRICTED CONTRIBUTIONS 38,480 false true false false false false false false false MICHAEL J DOWLING 0 1173096 0 1328000 0 20125 0 721638 0 21175 0 3264034 0 0 NICK FITTERMAN MD 0 418319 0 20000 0 45 0 22215 0 26011 0 486590 0 0 KEVIN LAWLOR 0 597817 0 119000 0 27990 0 296193 0 17251 0 1058251 0 0 MICHAEL GROSSO 0 378718 0 38212 0 25590 0 22215 0 26011 0 490746 0 0 TERENCE SMITH 168837 0 5033 0 3810 0 16111 0 16948 0 210739 0 0 0 WILLIAM GEHRHARDT MD 211391 0 0 0 4956 0 19617 0 25556 0 261520 0 0 0 ROGELIO CO MD 191093 0 0 0 6067 0 17877 0 25556 0 240593 0 0 0 ROBERTO BLANDO MD 189529 0 0 0 5854 0 17716 0 0 0 213099 0 0 0 SAILI DESAI MD 147523 0 0 0 2202 0 13576 0 0 0 163301 0 0 0 KATHY GIFFUNI 125934 0 4605 0 1113 0 11937 0 26011 0 169600 0 0 0 PART 1 - LINE 4B Certain individuals participate in a Supplemental Executive Retirement Plan ("SERP") which is subject to substantial risk of complete forfeiture. Accordingly, the individual may never actually receive the unvested benefit amount and the amounts outlined herein were properly not reported in each individual's Form W-2, Box 5. These amounts are included in Schedule J, Column C for Kevin Lawlor 457(F)($273,978)and Michael J. Dowling 457(F)($694,688). PART 1 - LINE 3 COMPENSATION OF THE PRESIDENT AND CEO IS PAID BY HUNTINGTON HOSPITAL WHICH UTILIZES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE CEO: A) COMPENSATION COMMITTEE B) INDEPENDENT COMPENSATION CONSULTANT C) WRITTEN EMPLOYMENT CONTRACTS D) COMPENSATION SURVEY OR STUDY E) APPROVAL BY THE BOARD FORM 990 - PART I - LINE 5 PART V - LINE 2A/2B THE STAFF OF THE HEALTH CENTER IS EMPLOYED BY HUNTINGTON HOSPITAL ASSOCIATION (THE "HOSPTIAL") AND THEIR SALARY AND RELATED COSTS ARE ALLOCATED TO THE HEALTH CENTER. NO SALARY COSTS ARE PAID DIRECTLY BY THE HEALTH CENTER. THE W-2S FOR THE NUMBER OF EMPLOYEES LISTED ON THESE LINES ARE ISSUED BY THE HOSPITAL ON BEHALF OF THE HEALTH CENTER. AS SUCH, THE HEALTH CENTER IS NOT REQUIRED TO FILE ANY FEDERAL EMPLOYMENT TAX RETURNS. FORM 990 - PART IV - LINE 12 AND PART XII - LINES 2 B/C THE FINANCIAL STATEMENTS FOR THE HOSPITAL AND THE HEALTH CENTER ARE AUDITED ON A CONSOLIDATED BASIS WITH INDIVIDUAL CONSOLIDATING STATEMENTS FOR EACH ENTITY INCLUDED AS SUPPLEMENTAL SCHEDULES. A RECONCILIATION OF AMOUNTS PER THE CONSOLIDATING STATEMENTS FOR THE HEALTH CENTER INCLUDED IN THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS, TO THE AMOUNTS REPORTED IN THE FORM 990 IS INCLUDED IN THE SUPPLEMENTAL SECTION OF SCHEDULE D. THE HOSPTIAL HAS AN AUDIT COMMITTEE THAT ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS. FORM 990 - PART VI - LINES 6, 7 A/B THE SOLE MEMBER OF THE HEALTH CENTER IS THE HOSPITAL. BOTH THE HEALTH CENTER AND THE HOSPITAL ARE MEMBERS OF THE NORTH SHORE LONG ISLAND JEWISH HEALTH SYSTEM, INC. (THE "SYSTEM"). THE SYSTEM AND ITS MEMBER ORGANIZATIONS AND OTHER AFFILIATED ENTITIES ARE AN INTEGRATED HEALTH DELIVERY SYSTEM IN THE NY METRO AREA. THE SYSTEM IS THE SOLE MEMBER OF THE NORTH SHORE LONG ISLAND JEWISH HEALTH CARE, INC. ("HEALTH CARE, INC."). HEALTH CARE, INC. IS THE SOLE MEMBER OF THE HOSPITAL AND THE SOLE MEMBER OF OTHER HEALTH CARE ORGANIZATIONS THAT ARE NOT PART OF THE HOSPTIAL. THE BOARD OF DIRECTORS FOR THE HEALTH CENTER IS COMPRISED OF THE EXECUTIVE COMMITTEE OF THE BOARD OF THE HOSPTIAL. THE SYSTEM HAS THE RIGHT TO ELECT THE MEMEBERS OF THE HOSPITAL'S BOARD OF DIRECTORS, INCLUDING THE RIGHT TO APPOINT 3 PERSONS TO THE BOARD WHO ARE TRUSTEES OR EMPLOYED CORPORATE OFFICERS OF THE SYSTEM. THE MAJORITY OF THE HOSPITAL'S BOARD OF DIRECTORS MUST BE RESIDENTS OF THE PRIMARY SERVICE AREA SERVED BY THE HOSPITAL. CERTAIN DECISIONS OF THE BOARD REQUIRE THE APPROVAL OF THE SYSTEM AS OUTLINED IN THE CORPORATED BY-LAWS. FORM 990 PART VI - LINE 11A THE 990 IS COMPLETED BY THE FINANCE DEPARTMENT OF THE HOSPITAL WITH INPUT FROM SENIOR MANAGEMENT AND OTHERS WITHIN THE ORGANIZATION. A COPY OF THE 990 IS MADE AVAILABLE TO SENIOR MANAGMENT AND THE BOARD OF DIRECTORS PRIOR TO FILING, FOR THEIR REVIEW AND COMMENTS. FORM 990 PART VI - LINE 12 C AS MEMBERS OF THE NORTH SHORE LING ISLAND JEWISH HEALTH SYSTEM, THE HEALTH CENTER AND AFFILIATED ENTITIES HAVE SEVERAL CONTROL MECHANISMS TO MITIGATE CONFLICTS OF INTEREST. THE CODE OF ETHICAL CONDUCT POLICY CONTAINS A DETAILED SECTION EDUCATING INDIVIDUALS ABOUT HOW TO AVOID POTENTIAL CONFLICTS OF INTEREST. SPECIFICALLY, THE CODE OF ETHICAL CONDUCT REQUIRES INDIVIDUALS TO CONDUCT BUSINESS IN A MANNER THAT PLACES THE INTEREST OF THE ORGANIZATION AHEAD OF PERSONAL INTERSTS. IN ADDITION, THE ORGANIZATION HAS A CONFLICTS OF INTEREST POLICY STATEMENT FURTHER ELABORATING UPON INDIVIDUAL'S DISCLOSURE AND RECUSAL OBLIGATIONS. INDIVIDUALS THAT ARE IN A POSITION TO INFLUENCE THE BUSINESS OR OTHER DECISIONS ARE REQUIRED TO FILL OUT A CONFLICTS OF INTEREST DISCLOSURE FORM ON A REGULAR BASIS. THE CORPORATE COMPLIANCE OFFICER REVIEWS ALL DISCLOSURES OF POSSIBLE CONFLICTS, INCLUDING MATTERS DISCLOSED IN ANY CONFLICTS OF INTEREST DISCLOSURE REPORT AND TAKES ANY ACTIONS DEEMED REQUIRED OR APPROPRIATE TO MANAGE OR RESOLVE ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. IN APPROPRIATE CASES, THESE DISCLOSURES AND RESPONSIVE ACTIONS WILL BE REPORTED TO THE AUDIT AND CORPORATE COMPLIANCE COMMITTEE AND OTHER APPLICABLE COMMITTEES. IN ADDITION, THE ORGANIZATION PROVIDES TRAINING TO INDIVIDUALS ON AN ANNUAL BASIS REGARDING CONFLICTS OF INTEREST AND OTHER COMPLIANCE RELATED TOPICS. IF AN INDIVIDUAL VIOLATES THE CODE OF ETHICAL CONDUCT OR ANY RELATED POLICY SUCH AS THE CONFLICTS OF INTEREST POLICY STATEMENT, APPROPRIATE DISCIPLINARY ACTIONS IS TAKEN BASED UPON THE FACTS AND CIRCUMSTANCES OF THE SITUATION. FORM 990 - PART VI - LINE 15 THE BOARD OF DIRECTORS OF THE HOSPTIAL APPOINTED A COMPENSATION COMMITTEE WITH THE RESPONSIBILTY FOR REVIEWING AND APPROVING THE WAGES AND BENEFITS OF THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES. THE COMMITTEE CONSITS OF AT LEAST THREE INDIVIDUALS, WHO THEMSELVES ARE MEMBERS OF THE BOARD OF DIRECTORS. THE COMMITTEE DEVELOPED AN EXECUTIVE COMPENSATION POLICY THAT INCLUDES THE USE OF INDEPENDENT COMPENSATION SURVEYS COMPLIED BY INDEPENDENT FIRMS. THE COMMITTEE MEETS AT LEAST ANNUALLY. MINUTES OF THOSE MEETINGS ARE MAINTAINED BY HUMAN RESOURCES. COMPENSATION IS NOT PAID DIRECTLY BY THE HEALTH CENTER. FORM 990 - PART VI - LINE 19 THE HOSPITAL AND THE HEALTH CENTER MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND CONSOLIDATED AUDITED FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE ALSO AVAILABLE ONLINE. RECONCILIATION OF NET ASSETS PART XI, LINE 5 OTHER CHANGES NET UNREALIZED GAINS ON INVESTMENTS HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:CARMELA ANGLIM TITLE:BOARD MEMBER HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MICHAEL ABOFF TITLE:BOARD MEMBER HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MICHAEL J. DOWLING TITLE:BOARD MEMBER/NSLIJHS PRES &CEO HOURS:50 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:NICK FITTERMAN, MD TITLE:BOARD MEMBER HOURS:50 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:WILLIAM FRAZIER TITLE:TREASURER HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:L. KEITH FRIEDLANDER, ESQ. TITLE:BOARD MEMBER HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ANTHONY GIACCONE TITLE:BOARD MEMBER HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ROSALYN GORDON TITLE:BOARD MEMBER HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:THOMAS LEDERER TITLE:BOARD MEMBER HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:EUGENE LEVITT, ESQ. TITLE:BOARD MEMBER HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:HARRY MARIANI TITLE:SECRETARY HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JOHN MCCUSKER TITLE:BOARD MEMBER HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:LEWIS MELTZER, ESQ. TITLE:BOARD MEMBER HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ROBERT MYERS TITLE:BOARD MEMBER HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:BERNARD M. ROSOF, MD TITLE:CHAIRMAN HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:KEVIN LAWLOR TITLE:PRESIDENT & CEO HOURS:50 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MICHAEL GROSSO TITLE:SENIOR VP OF MEDICAL AFFAIRS HOURS:50 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MARTHA CARLSTROM TITLE:BOARD MEMBER HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:FRED BUCKHOLZ TITLE:TREASURER HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:TERENCE SMITH TITLE:ADMINSTRATOR HOURS:38 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:WILLIAM GEHRHARDT, MD TITLE:PHYSICIAN HOURS:38 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ROGELIO CO, MD TITLE:PHYSICIAN HOURS:38 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ROBERTO BLANDO, MD TITLE:PHYSICIAN HOURS:38 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SAILI DESAI, MD TITLE:PHYSICIAN HOURS:38 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:KATHY GIFFUNI TITLE:NURSE MANAGER HOURS:38 HUNTINGTON HOSPITAL ASSOCIATION 270 PARK AVENUE HUNTINGTON NY 11743 111630914 HOSPTIAL NY 501(c)(3) 3 NA false NORTH SHORE LIJ HEALTH SYSTEM 972 BRUSH HOLLOW ROAD WESTBURY NY 11590 113418133 SUPPORTING OR NY 501(c)(3) 11, TYPE 1 NA false NORTH SHORE LIJ HEALTH SYSTEM LABORATORI 972 BRUSH HOLLOW ROAD WESTBURY NY 11590 113412370 SUPPORTING OR NY 501(c)(3) 11, TYPE 1 NA false NORTH SHORE LIJ HEALTH CARE INC 972 BRUSH HOLLOW ROAD WESTBURY NY 11590 112965586 SUPPORTING OR NY 501(c)(3) 11, TYPE 1 NA false false false true false false false false false false true false true true true true false true false NA