NORTHERN DUTCHESS HOSPITAL: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
NORTHERN DUTCHESS HOSPITAL (EIN 14-1338467)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-11
IRS object ID
201123159349303647
Schema version
2010v3.4
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)
Timestamp2011-11-11T22:07:30-06:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN141338467EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1NORTHERN DUTCHESS HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlNORTNameControl
Phone8458763001Phone

US Address USAddress

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

Officer Officer

FieldValueIRS element (for citing)
NameMARYANN KEEPLEName
TitleHQ CFOTitle
Date Signed2011-11-11DateSigned
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

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

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO BOX 5112AddressLine1
CityRHINEBECKCity
StateNYState
ZIP Code12572ZIPCode
FieldValueIRS element (for citing)
Gross Receipts66745234GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.HEALTH-QUEST.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE COMPREHENSIVE PRIMARY HEALTH CARE SERVICESActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees587TotalNbrEmployees
Total Nbr Volunteers137TotalNbrVolunteers
Total Gross UBI117557TotalGrossUBI
Net Unrelated Business Txbl Income-24470NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year714458ContributionsGrantsPriorYear
Contributions Grants Current Year1574942ContributionsGrantsCurrentYear
Program Service Revenue Prior Year62377597ProgramServiceRevenuePriorYear
Program Service Revenue CY63792298ProgramServiceRevenueCY
Investment Income Prior Year45726InvestmentIncomePriorYear
Investment Income Current Year116635InvestmentIncomeCurrentYear
Other Revenue Prior Year692593OtherRevenuePriorYear
Other Revenue Current Year1261359OtherRevenueCurrentYear
Total Revenue Prior Year63830374TotalRevenuePriorYear
Total Revenue Current Year66745234TotalRevenueCurrentYear
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 Year27418125SalariesEtcPriorYear
Salaries Etc Current Year26696117SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year32102467OtherExpensePriorYear
Other Expenses Current Year33664819OtherExpensesCurrentYear
Total Expenses Prior Year59520592TotalExpensesPriorYear
Total Expenses Current Year60360936TotalExpensesCurrentYear
Revenues Less Expenses Prior Year4309782RevenuesLessExpensesPriorYear
Revenues Less Expenses CY6384298RevenuesLessExpensesCY
Total Assets BOY60594597TotalAssetsBOY
Total Assets EOY60451425TotalAssetsEOY
Total Liabilities BOY32228140TotalLiabilitiesBOY
Total Liabilities EOY29388489TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY28366457NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY31062936NetAssetsOrFundBalancesEOY
Mission DescriptionTHE NORTHERN DUTCHESS HOSPITAL'S MISSION IS TO MEET THE HEALTH NEEDS OF PEOPLE WHO RESIDE IN OR VISIT OUR PRIMARY SERVICE REGION, WHICH INCLUDES THE COMMUNITIES OF NORTHERN DUTCHESS AND SOUTHERN COLUMBIA COUNTIES AND PARTS OF ULSTER COUNTY, NEW YORK. OUR COMMITMENT TO THESE COMMUNITIES SHALL BE EVIDENCED BY OUR PERFORMANCE AS PROVIDERS, EDUCATORS, AND ADVOCATES. WE SHALL PROVIDE COMPREHENSIVE, PRIMARY HEALTH CARE SERVICES AND PROGRAMS TO INDIVIDUALS IN THE COMMUNITY REGARDLESS OF THEIR ECONOMIC OR SOCIAL STATUS. WE SHALL ACT AS A RESOURCE IN PROVIDING EDUCATIONAL OPPORTUNITIES AND HEALTH PROMOTION PROGRAMS TO THE COMMUNITY AND ALSO ADVANCE THE MEDICAL AND TECHNICAL SKILLS OF OUR HOSPITAL STAFF THROUGH REGULAR IN-SERVICE TRAINING. WE SHALL ADVOCATE FOR, AND TAKE ACTION WHERE POSSIBLE, TO MEET THE NEEDS OF OUR ELDERLY, FOR THOSE INITIATING FAMILY LIFE AND, ALWAYS, FOR THE DISADVANTAGED.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense25403887Expense
Revenue36352522Revenue
DescriptionINPATIENT SERVICES: PATIENTS ADMITTED FOR ACUTE CARE - NUMBER OF PATIENTS 4,176; NUMBER OF PATIENT DAYS 16,504 THE HOSPITAL PROVIDED APPROXIMATELY $210,901 IN UNCOMPENSATED CARE (AT COST) TO THE REGIONS UN-INSURED AND UNDER-INSURED POPULATIONDescription

Activity2 Activity2

FieldValueIRS element (for citing)
Expense19164336Expense
Revenue27439775Revenue
DescriptionOUTPATIENT SERVICES: EMERGENCY VISITS 13,711 ALL OTHER VISTIS/PROCEDURES 59,769 THE HOSPITAL PROVIDED APPROXIMATELY $490,015 IN UNCOMPENSATED CARE (AT COST) TO THE REGIONS UN-INSURED AND UNDER-INSURED POPULATIONDescription
FieldValueIRS element (for citing)
Total Program Service Expense44568223TotalProgramServiceExpense
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 AttachedfalseFinancialStmtAttached
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 RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10963NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees587NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocstrueChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChapterstrueLocalChapters
Policies Reference ChapterstruePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonHEALTHQUESTNamePerson
Telephone Number8454748500TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11351 ROUTE 55 SUITE 200AddressLine1
CityLAGRANGEVILLECity
StateNYState
ZIP Code12540ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeReportable Comp From OrganizationReportableCompFromOrganization
MARK O'SULLIVAN
CHAIRMAN2.0X
JAMES BRUDVIG
FIRST VICE CHAIRMAN2.0X
JOHN R MARVIN ESQ
MEMBER1.0X
SUE CRANE
MEMBER1.0X
DRAYTON GRANT
MEMBER1.0X
LEWIS RUGE
MEMBER1.0X
GEORGE VERRILLI MD
MEMBER1.0X
JAMES WING MD
MEMBER1.0X
M NADER KAYAL JR MD
MEMBER1.0X
EVAN MELTZER
SECOND VICE CHAIRMAN2.0X
WILLIAM CARROLL
MEMBER1.0X
SUSAN KOCHANOWSKI
MEMBER1.0X
JOHN HORISZNY MD
MEMBER1.0X
KEVIN M SHEEHAN
MEMBER1.0X
DENISE GEORGE
PRESIDENT/CEO55.0X37496636846
ALAN MOSSOFF
NDH CFO45.0X15049411652
JOHN SABIA MD
CMO40.020814134093X
GAIL RICHARDSON
DIRECTOR OF SURGICAL SERVICES52.030618X120198
CONNIE REGAN
PHARMACY CLINICAL COORDINATOR40.011249X147855
BOGUMILA LANG
PHARMACIST40.026904X119765
VERONICA WINTERS
REGISTERED NURSE40.024208X129808
PAUL KING
DIRECTOR OF DIAGNOSTIC SERV48.0931X122881
FieldValueIRS element (for citing)
Total Reportable Comp From Org640507TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs733601TotalReportableCompFrmRltdOrgs
Total Other Compensation176501TotalOtherCompensation
Number Individuals GT100 K17NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Government Grants365832GovernmentGrants
All Other Contributions1209110AllOtherContributions
Total Contributions1574942TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET INPATIENT REVENUE9000993635252336352523
NET OUTPATIENT REVENUE9000992743977527439775
FieldValueIRS element (for citing)
Total Program Service Revenue63792298TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column60998TotalRevenueColumn
Exclusion$60,998ExclusionAmount

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)
Real240254Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real240254Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column240254TotalRevenueColumn
Exclusion$240,254ExclusionAmount

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column55637TotalRevenueColumn
Exclusion$55,637ExclusionAmount

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 ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenueRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
WELLNESS CENTER900099117557117557
CAFETERIA SALES900099294980294980
AFFILIATE REVENUE900099462499462499

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column146069TotalRevenueColumn
Related Or Exempt Function Income146069RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue1021105TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column66745234TotalRevenueColumn
Related Or Exempt Function Income64695846RelatedOrExemptFunctionIncome
Unrelated Business Revenue117557UnrelatedBusinessRevenue
Exclusion$356,889ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total20258693Total
Program Services17479758ProgramServices
Management And General2778935ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1016129Total
Program Services876744ProgramServices
Management And General139385ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3812469Total
Program Services3289503ProgramServices
Management And General522966ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1608826Total
Program Services1388139ProgramServices
Management And General220687ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total1652Total
Management And General1652ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total2695848Total
Program Services2509673ProgramServices
Management And General186175ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total12037652Total
Program Services11105323ProgramServices
Management And General932329ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1312307Total
Program Services1012662ProgramServices
Management And General299645ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total40629Total
Program Services26428ProgramServices
Management And General14201ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total369Total
Program Services369ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total773117Total
Program Services596588ProgramServices
Management And General176529ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total3703818Total
Program Services2858108ProgramServices
Management And General845710ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total547797Total
Program Services547797ProgramServices

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
RENTAL/MAINTENANCE387825188025199800
BAD DEBT13300711330071
LICENSES & TAXES3744384261370177
OTHER PURCHASED SERVICES88311865606588270528
PHYSICIAN FEES1017176739757277419

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total610934Total
Program Services54359ProgramServices
Management And General556575ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total60360936Total
Program Services44568223ProgramServices
Management And General15792713ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY333881BOY
EOY333750EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY2019486BOY
EOY1001548EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY5857259BOY
EOY5072008EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY376993BOY
EOY120050EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1149960BOY
EOY1113090EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY309687BOY
EOY340043EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis81013682LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec44760626LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY31563178BOY
EOY36253056EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY2637000BOY
EOY2969760EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY1691BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY16345462BOY
EOY13248120EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY60594597BOY
EOY60451425EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY15461845BOY
EOY10461107EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY14694830BOY
EOY13974384EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1289893BOY
EOY1654625EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY781572BOY
EOY3298373EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY32228140BOY
EOY29388489EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY23815969BOY
EOY26998133EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY3055084BOY
EOY2569399EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1495404BOY
EOY1495404EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY28366457BOY
EOY31062936EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY60594597BOY
EOY60451425EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses6384298ReconcilationRevenueExpenses
Reconcilation Other Changes-3687819ReconcilationOtherChanges
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

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierSCHEDULE C, PART IIIdentifier
Return ReferenceLOBBYING ACTIVITIESReturnReference
Explanation26.7% OF NORMET ASSOCIATION DUES WERE ALLOCATED TO POLITICAL ACTIVITIES, RELATED TO LOBBYING.Explanation

Schedule D IRS990ScheduleD

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

Current Year CurrentYear

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

Current Year Minus1 Year CurrentYearMinus1Year

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

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1495000BeginningOfYearBalance
End Of Year Balance1495000EndOfYearBalance
FieldValueIRS element (for citing)
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Land Land

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

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis37053292OtherCostOrOtherBasis
Depreciation17679326Depreciation
Book Value19373966BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis42087047OtherCostOrOtherBasis
Depreciation26173220Depreciation
Book Value15913827BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1763413OtherCostOrOtherBasis
Depreciation908080Depreciation
Book Value855333BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings36253056TotalOfBookValueLandBuildings

Other Assets OtherAssets (9 entries)

DescriptionDescriptionBook ValueBookValue
DUE FROM AFFILIATES6632481
DEFERRED COMPENSATION ASSET1367532
DEFERRED FINANCING545324
2007 SERIES B BONDS PREMIUM717326
2007 DSRF SERIES B BONDS1630969
MISC RECEIVABLES182227
DSRF TELP LOAN TDBANK GENERAL330054
INTEREST IN NDH FOUNDATION LT1839532
DEF FINANCING TELP LOAN2675
FieldValueIRS element (for citing)
Total Book Value Other Assets13248120TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
HITNY LIABILITY$723,319
DEFERRED COMP LIABILITY$590,661
FIN 47 LIABILITY$265,699
RETRO PAYABLE TO 3RD PARTY PAY$1,718,694
FieldValueIRS element (for citing)
Total Of Amounts3298373TotalOfAmounts
Total Revenue66745234TotalRevenue
Total Expenses60360936TotalExpenses
Excess Or Deficit For Year6384298ExcessOrDeficitForYear
Net Unrealized GL On Investments227752NetUnrealizedGLOnInvestments
Other-$3,915,572OtherAmount
Total Adjustments-3687820TotalAdjustments
Excess Or Deficit Per FS2696478ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt66972986TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments227752NetUnrealizedGainsInvestments
Revenue Not Rptd F990227752RevenueNotRptdF990
Revenue Subtotal66745234RevenueSubtotal
Total Revenue Per Form99066745234TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt60360936TotExpensesEtcAuditedFinclStmt
Expenses Subtotal60360936ExpensesSubtotal
Total Expenses Per Form99060360936TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierRECONCILIATION OF CHANGE IN NET ASSETSIdentifier
Return ReferenceSCHEDULE D PART XI LINE 8ReturnReference
ExplanationTRANSFER OF EQUITY - $(3,429,887) CONTRIBUTIONS - $723,425 NET ASSETS RELEASED FROM RESTRICTIONS USED FOR CAPITAL EXP - ($1,209,110)Explanation

Schedule H IRS990ScheduleH

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

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense1869831TotalCommunityBenefitExpense
Direct Offsetting Revenue1350071DirectOffsettingRevenue
Net Community Benefit Expense519760NetCommunityBenefitExpense
Percent Of Total Expense0.00860PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense4511391TotalCommunityBenefitExpense
Direct Offsetting Revenue3244241DirectOffsettingRevenue
Net Community Benefit Expense1267150NetCommunityBenefitExpense
Percent Of Total Expense0.02100PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense6381222TotalCommunityBenefitExpense
Direct Offsetting Revenue4594312DirectOffsettingRevenue
Net Community Benefit Expense1786910NetCommunityBenefitExpense
Percent Of Total Expense0.02960PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs10NumberOfActivitiesOrPrograms
Persons Served6479PersonsServed
Total Community Benefit Expense32463TotalCommunityBenefitExpense
Net Community Benefit Expense32463NetCommunityBenefitExpense
Percent Of Total Expense0.00060PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs10NumberOfActivitiesOrPrograms
Persons Served6479PersonsServed
Total Community Benefit Expense32463TotalCommunityBenefitExpense
Net Community Benefit Expense32463NetCommunityBenefitExpense
Percent Of Total Expense0.00060PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs10NumberOfActivitiesOrPrograms
Persons Served6479PersonsServed
Total Community Benefit Expense6413685TotalCommunityBenefitExpense
Direct Offsetting Revenue4594312DirectOffsettingRevenue
Net Community Benefit Expense1819373NetCommunityBenefitExpense
Percent Of Total Expense0.03020PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense656TotalCommunityBuildingExpense
Net Community Building Expense656NetCommunityBuildingExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense656TotalCommunityBuildingExpense
Net Community Building Expense656NetCommunityBuildingExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$665,986BadDebtExpenseAmount
Amount Attributable To332993AmountAttributableTo
Amount Reimbursed By Medicare20803477AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare25444457CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-4640980MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1NORTHERN DUTCHESS HOSPITALBusinessNameLine1

Address Address

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

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

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

Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
PART I, LINE 3CN/A
PART I, LINE 6AHEALTH QUEST SYSTEMS PREPARES A COMMUNITY BENEFIT REPORT, HOWEVER THE REPORT DOES DETAIL OUR SPECIFIC COMMUNITY BENEFITS FOR EACH FACILITY WITHIN HEALTH QUEST.
PART I, LINE 7GN/A
PART I, LINE 7 COLUMN FTOTAL BAD DEBT EXPENSE EXCLUDED FROM COLUMN F PERCENTAGE - $1,330,071
PART I, LINE 7COST TO RATIO PERCENTAGE WAS USED AS THE COSTING METHODOLOGY. WORKSHEET #2 WAS USED TO DERIVE THE PERCENTAGE.
PART III, LINE 4BAD DEBT EXPENSE WAS GROSSED UP TO GROSS CHARGES AND THEN THE COST TO CHARGE RATIO PERCENTAGE DERIVED FROM WORKSHEET #2 WAS USED TO CALCULATE THE VALUE AT COST. SELF PAY ACCOUNTS, ONCE DETERMINED A LACK OF INSUFFICIENCY OF INSURANCE AND ONCE THE PATIENT HAS RECEIVED GOVERNMENT PAYOR DENIAL, THE ACCOUNTS ARE ADJUSTED DOWN TO THE HIGHEST VOLUME COMMERCIAL PAYOR RATE. AFTER THE ACCOUNT IS DEEMED UNCOLLECTIBLE, THE ACCOUNT IS WRITTEN OFF TO BAD DEBT EXPENSE AT ADJUSTED CHARGES LESS ANY PAYMENTS MADE ON THE ACCOUNT. 50% OF THESE PATIENTS WOULD MOST LIKELY QUALIFY FOR CHARITY CARE IF THEY WERE COOPERATIVE IN FILING THE PAPERWORK, ASSOCIATED WITH GOVERNMENT ASSISTANCE. FOOTNOTE ON AUDITED FINANCIALS - FEDERAL AND STATE LAW REQUIRES THE HOSPITALS TO PROVIDE EMERGENCY SERVICES REGARDLESS OF A PATIENT'S ABILITY TO PAY. UNINSURED PATIENTS SEEN IN THE EMERGENCY DEPARTMENT, INCLUDING PATIENTS SUBSEQUENTLY ADMITTED FOR INPATIENT SERVICES, OFTEN DO NOT PROVIDE INFORMATION NECESSARY TO ALLOW THE HOSPITAL TO QUALIFY SUCH PATIENTS FOR CHARITY CARE. UNCOLLECTIBLE AMOUNTS DUE FROM SUCH UNINSURED PATIENTS REPRESENT THE SUBSTANTIAL PORTION OF THE PROVISION FOR BAD DEBTS REFLECTED IN THE ACCOMPANYING STATEMENT OF OPERATIONS.
PART III, LINE 8COST TO CHARGE RATIO - USED WORKSHEET #2
PART III, LINE 9BHEALTH QUEST MAY CHOOSE TO SEND ANY DELIQUENT ACCOUNT TO A COLLECTION AGENCY, HOWEVER, BEFORE REFERRING A DELIQUNET ACCOUNT TO A COLLECTION AGENCY, HEALTH QUEST WILL REVIEW THE ACCOUNT TO DETERMINE WHETHER THE PATIENT HAS APPLIED FOR A DISCOUNT UNDER THE CHARITY CARE POLICY AND THE STATUS OF THE APPLICATION. IF THE PATIENT HAS APPLIED FOR A DISCOUNT, THE ACCOUNT MAY NOT BE REFERRED TO A COLLECTION AGENCY UNTIL A FINAL DETERMINATION OF SUCH APPLICATION IS MADE AND IF ANY APPEAL OF SUCH DETERMINATION IS PROVIDED FOR IN THE CHARITY CARE POLICY, A FINAL DETERMINATION HAS BEEN MADE WITH RESPECT TO SUCH APPEAL. PATIENTS MAY STILL APPLY FOR A DISCOUNT UNDER THE CHARITY CARE POLICY EVEN AFTER THE ACCOUNT HAS BEEN SENT TO A COLLECTION AGENCY.
PART V, LINE 19THE HOSPITAL FACILITY USES THE HIGHEST VOLUME COMMERCIAL PAYOR RATE TO BILL INDIVIDUALS WHO DO NOT HAVE INSURANCE.
PART VI, LINE 2IN THE HUDSON VALLEY, THE LOCAL HEALTH DEPARTMENTS FORMED A COALITION WHICH SPREADHEADED THE COMMUNITY HEALTH ASSESSMENTS. HEALTH QUEST HOSPITALS PARTICIPATED IN THE PLANNING SESSION ALONG WITH NUMEROUS COMMUNITY AGENCIES, ALL OF WHICH MET IN A PLANNING SESSION IN 2010. IN ADDITION, UNDER THE NEW GOVERNANCE MODEL OF THE HOSPITALS, THE BOARDS WILL FOCUS ON COMMUNITY NEEDS ASSESSMENT, PRIORITIZATION AND PROGRAM DEVELOPMENT. HEALTH QUEST WILL BE FOCUSED ON THE FOLLOWING - 1 - ACCESS TO CARE, WITH A FOCUS ON OPENING A FEDERALLY FUNDED HEALTH FACILITY IN PUTNAM COUNTY AND BRINGING NEW SPECIALISTS INTO THE AREA. 2 - DIABETES AWARENESS AND MANAGEMENT, INCLUDING BRINGING NEEDED ENDOCRINOLOGISTS INTO THE AREA. 3 - HEALTHY AGING, ESPECIALLY IN THE NORTHERN PART OF DUTCHESS COUNTY WHERE THE POPULATION DEMANDS IT. 4 - MENTAL HEALTH, AS OUR PUTNAM HOSPITAL HAS AN INPATIENT UNIT AND IS A CENTER HUB OF COMMUNITY MENTAL HEALTH TREATMENT. 5 - TICK BORNE ILLNESSES, WHICH OCCUR IN HIGH RATES IN BOTH DUTCHESS AND PUTNAM COUNTIES.NEEDS ASSESSMENT
PART VI, LINE 3FINANCIAL ASSISTANCE POSTERS ARE HUNG UP IN VARIOUS AREAS OF THE HOSPITAL. FOR PATIENTS THAT INQUIRE ABOUT FINANCIAL ASSISTANCE, THE POLICY IS PROVIDED TO THE PATIENT ALONG WITH ASSISTANCE IN COMPLETING THE APPLICATIONS.PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE
PART IV, LINE 4APPLIES TO ALL HOSPITAL SERVICE AREAS - PREDOMINATELY WHITE AND SKEWING SLIGHTLY OLDER THAN THE NATIONAL AVERAGES. HIGHER PERCENTAGE OF COLLEGE DEGREES THAN THE NATIONAL AVERAGE, WITH AVERAGE HOUSEHOLD INCOMES SIGNIFICANTLY HIGHER THAN NATIONAL INCOME.COMMUNITY INFORMATION
PART IV, LINE 5ALL HOSPITALS SERVE AS COMMUNITY LEADERS IN HEALTH RELATED FUNDRAISERS, SUCH AS RELAY FOR LIFE AND THE MARCH OF DIMES. EXECUTIVES AND EMPLOYEES VOLUNTEER AND SERVE ON THE BOARDS OF MANY COMMUNITY ORGANIZATIONS AND USE HOSPITAL RESOURCES TO ASSIST COALITIONS AND MEET A BROAD DEFINITION FOR HEALTH WHICH INCLUDES EDUCATION AND HOUSING. ALL HOSPITALS OFFER SCREENING AND LECTURES TO EDUCATE THE COMMUNITY AND ENCOURAGE PREVENTATIVE MEDICINE.PROMOTION OF COMMUNITY HEALTH
PART VI, LINE 6HEALTH QUEST SYSTEMS, INC (DBA HEALTH QUEST) IS THE ACTIVE PARENT COMPANY TO ALL AFFILIATED HOSPITALS. HEALTH QUEST ACTS ON BEHALF OF THE HOSPITALS IN SOME COMMUNITY ASSESSMENT ACTIVITIES. HEALTH QUEST HAS TRANSITIONED TO A MODEL IN WHICH IT WILL SUPERVISE BOARD COMMITTEES AT EACH HOSPITAL AS THEY ASSESS COMMUNITY NEEDS, PLAN APPROPRIATE PROGRAMS AND MONITOR THEM FOR EFFECTIVENESS.AFFILIATE HEALTH CARE SYSTEM
PART VI, LINE 7HEALTH QUEST, THE PARENT COMPANY OF NORTHERN DUTCHESS HOSPITAL, FILES A SYSTEM WIDE COMMUNITY SERVICE PLAN WITH NYS DEPARTMENT OF HEALTHSTATE FILING OF COMMUNITY BENEFIT REPORT
PART V, LINE 13FINANCIAL ASSISTANCE POSTERS ARE HUNG UP IN VARIOUS AREAS OF THE HOSPITAL STATING WHO TO CONTACT REGARDING THE POLICY. FOR PATIENTS THAT INQUIRE ABOUT FINANCIAL ASSISTANCE, THE POLICY IS PROVIDED TO THE PATIENT ALONG WITH ASSISTANCE IN COMPLETING THE APPLICATIONS.PART V, LINE 13

Schedule J IRS990ScheduleJ

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

Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgsBase Compensation Filing OrgBaseCompensationFilingOrgBonus Filing OrgBonusFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgComp Report Prior990 Filing OrgCompReportPrior990FilingOrg
DENISE GEORGE
27215883120196881470022146411812310316
JOHN SABIA MD
1912091693201470019393242234188385
GAIL RICHARDSON
112883731509615210031508160
CONNIE REGAN
1454590239694541795159104147690
ALAN MOSSOFF
1344051558350628928760162146140754
VERONICA WINTERS
12980800973514473154016125419

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

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

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Amount Retired845312AmountRetired
Amount Bond Defeased0AmountBondDefeased
Total Proceeds16420697TotalProceeds
Amount In Reserve Fund1130887AmountInReserveFund
Capitalized Interest319526CapitalizedInterest
Refunding Escrow0RefundingEscrow
Issuance Costs From Proceeds216413IssuanceCostsFromProceeds
Credit Enhancement247657CreditEnhancement
Working Capital Expenditures0WorkingCapitalExpenditures
Capital Expenditures12196261CapitalExpenditures
Other Spent Proceeds0OtherSpentProceeds
Amount Unspent2309952AmountUnspent
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
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC
Gross Proceeds InvestedtrueGrossProceedsInvested
Exception To RebatefalseExceptionToRebate

Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)

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

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
LEWIS RUGE
PARTNER SPRINGBROOK REALT65247RENT TO HQMP AFFILIATEfalse
JAMES WING MD
EMPLOYED BY AFFILIATE354542PHYSICIAN SERVICES FOR HQMPfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
RELATED TAX EXEMPT ORGANIZATIONSSCHEDULE R - RELATED TAX EXEMPT ORGANIZATIONSEntity Tax ID# Primary Activity Legal Domicile Exempt Code Status Public Charity Status Directo controlling Entity Vassar Brothers Medical Center 14-1338586 Hospital NY 501c3 Box 3 HQ The Foundation for Vassar Brothers Medical Center 14-1736429 Fundraising NY 501c3 Box 9 HQ Riverside Diversified Services, Inc (Parent) 14-1675545 Education NY 501c3 Box 9 HQ Alamo Ambulance Service, Inc 14-1745417 Transport NY 501c3 Box 9 HQ Hudson Valley Home Care, Inc (Certified) 14-1788412 Home Health NY 501c3 Box 9 HQ Hudson Valley Home Care, Inc (Licensed) 14-1788410 Home Health NY 501c3 Box 9 HQ Northern Duchess Hospital 14-1338467 Hospital NY 501c3 Box 3 HQ Northern Dutchess Residential Health Care Facility 22-3129608 Nursing Home NY 501c3 Box 9 HQ NDH Foundation 14-1776208 Fundraising NY 501c3 Box 9 HQ Putnam Hospital Center 14-6019179 Hospital NY 501c3 Box 3 HQ Putnam Hospital Center Foundation 06-1399319 Fundraising NY 501c3 Box 9 HQ
GOVERNINGFORM 990 PART VI SECTION A LINE 4, 6, 7A AND 7BLINE 4 - Health Quest Systems, Inc. ("HQ") - Bylaw Amendments - Summary of Changes. HQ / Hospitals - 2010 Bylaw Amendments. HQ amended its bylaws on July 19, 2010 in order to streamline HQ's governance and promote management and operational efficiencies. In addition, bylaw amendments were made by each of HQ's affiliated hospitals (Vassar Brothers Medical Center ("VBMC" - 5/14/2010), Northern Dutchess Hospital ("NDH" - 5/25/2010), and Putnam Hospital Center ("PHC" - 6/30/2010) (collectively referred to as the "Hospitals"). Key Elements of Hospital / HQ Bylaw Changes. The bylaw amendments made several key changes: first, they confirm and enable HQ's existing and available powers under New York law as the sole member and active parent of the Hospitals; second, they focus each Hospital's board on patient safety, quality of care, and community health needs including through the elimination of all but three (3) required Hospital committees (i.e., the (i) Executive, (ii) Quality, Patient Satisfaction and Medical Staff Credentialing and (iii) Community Health Needs Committees); and third, other governance streamlining changes are implemented through the HQ and Hospital Bylaw changes (for example, several HQ committees are combined, many Hospital committees are being eliminated, and HQ's role and power as the sole member and active parent of each Hospital has been confirmed and further enabled). LINE 6 - THE SOLE MEMBER OF NDH IS HEALTH QUEST SYSTEMS, INC. LINE 7A - APPOINTMENT/ELECTION OF DIRECTORS NOMINEES TO THE BOARD OF DIRECTORS OF NDH SHALL BE NOMINATED IN THE FOLLOWING MANNER: NDH'S EXECUTIVE COMMITTEE MAY PREPARE A SLATE OF NOMINEES TO PRESENT TO THE HEALTH QUEST EXECUTIVE COMMITTEE FOR ITS REVIEW AND APPROVAL NOT LESS THAN THIRTY DAYS PRIOR TO THE ANNUAL MEETING OF NDH IN THE CASE OF VACANCIES CREATED BY THE EXPIRATION OF NDH DIRECTORS TERMS OF OFFICE, OR IN THE CASE OF ALL VACANCIES, AS SOON AS REASONABLY POSSIBLE. THE EXECUTIVE COMMITTEE OF HEALTH QUEST MUST APPROVE SLATES OF NOMINEES BY A MAJORITY VOTE OF THE ENTIRE HEALTH QUEST EXECUTIVE COMMITTEE. ONCE HEALTH QUESTS EXECUTIVE COMMITTEE APPROVES THE SLATE OF NOMINEES BY MAJORITY VOTE, HEALTH QUEST'S EXECUTIVE COMMITTEE SHALL INFORM THE NDH BOARD OF DIRECTORS AND PRESENT THE SLATE OF NOMINEES TO THE BOARD OF TRUSTEES OF HEALTH QUEST FOR APPROVAL. LINE 7B - MANNER OF ACTING/VOTE REQUIRED FOR CERTAIN SPECIFIC ACTIONS EXCEPT AS OTHERWISE SPECIFIED IN THE CERTIFICATE OF INCORPORATION OF NDH OR THESE BY LAWS OR THE BY LAWS OF HEALTH QUEST, OR PROVIDED BY LAW, THE ACTS OF A MAJORITY OF THE DIRECTORS PRESENT AND VOTING AT A MEETING AT WHICH A QUORUM IS PRESENT SHALL BE THE ACTS OF THE BOARD OF DIRECTORS. THERE SHALL BE NO VOTING BY PROXY. THE POWERS TO BE EXERCISED BY THE NDH BOARD OF DIRECTORS THAT ARE (I) SUBJECT TO THE SUBSEQUENT APPROVAL OF HEALTH QUEST, OR (II) TO BE UNDERTAKEN IN COLLABORATION WITH HEALTH QUEST. THE POWERS SET FORTH IN PARAGRAPH (F) BELOW REQUIRE THE VOTE OF TWO-THIRDS OF SOLELY THE NDH BOARD OF DIRECTORS. UNLESS OTHERWISE SPECIFIED, ALL OTHER ACTIONS THAT REQUIRE NDH BOARD APPROVAL REQUIRE A MAJORITY VOTE OF SOLELY THE NDH BOARD OF DIRECTORS.
POLICIESPART VI SECTION B LINE 11A, 12C AND LINE 15LINE 11A - A COPY OF THE FORM 990 WAS PROVIDED TO ALL MEMBERS OF THE BOARD. THE CHAIR OF THE HQ EXECUTIVE COMPENSATION COMMITTEE REVIEWED ALL SECTIONS RELATED TO EXECUTIVE COMPENSATION. A 3RD PARTY WAS HIRED TO ASSIST IN THE PREPARATION AND REVIEW OF SCHEDULE H AND SCHEDULE K. LINE 12C - ON AN ANNUAL BASIS OFFICERS, DIRECTORS AND TRUSTEES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST FILING WHICH IS REVIEWED BY THE HQ VP OF COMPLIANCE AND INTERNAL AUDIT. ALL POTENTIAL CONFLICTS OF INTEREST ARE REVIEWED BY THE HQ BUSINESS ETHICS COMMITTEE ON BEHALF OF NDH. LINE 15 A/B - COMPENSATION OF THE CEO, TOP MANAGEMENT AND OTHER KEY EMPLOYEES IS ESTABLISHED BY THE HQ EXECUTIVE COMPENSATION COMMITTEE BASED ON INFORMATION AND RECOMMENDATIONS OF AN INDEPENDENT THIRD PARTY.
DISCLOSUREFORM 990 PART VI SECTION C LINE 19LINE 19 - POLICIES AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE DOCUMENTS ARE PROVIDED EITHER ELECTRONICALLY OR PAPER COPIES. IN ADDITION, CERTAIN FINANCIAL INFORMATION IS AVAILABLE ON VARIOUS WEBSITES DUE TO REGULATORY FILINGS SUCH AS THE 990 AND BOND HOLDER REQUIREMENTS.
SCHEDULE KPART 1, COLUMN E, LINE ATOTAL ISSUE PRICE PER IRS FORM 8038 - $61,974,071.30, ALLOCATED AS FOLLOWS NORTHERN DUTCHESS HOSPITAL - $15,718,407.82 PUTNAM HOSPITAL CENTER - $28,161,750.86 VASSAR BROTHERS MEDICAL CENTER - $18,093,912.82
SCHEDULE K (2)PART II, COLUMN C, LINE 5ISSUANCE COSTS $228,964.15, CREDIT ENHANCEMENT FEE - $247,657.41
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

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Direct Controlling Entity NADirectControllingEntityNA
HEALTH QUEST SYSTEMS INC
45 READE PLACEPOUGHKEEPSIENY12601141678068SUPPORT SERV501C3BOX 9HQ
SEE SCHEDULE O
N/A
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1HEALTH QUEST SYSTEMS INCBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeOTransactionType
Amount Involved8091472AmountInvolved

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