WYCKOFF HEIGHTS MEDICAL CENTER: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
WYCKOFF HEIGHTS MEDICAL CENTER (EIN 11-1631837)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-15
IRS object ID
201133199349308433
Schema version
2010v3.2
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)
Timestamp2011-11-15T14:53:57-08:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CHARLES A BARRAGATO & CO CPASBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1950 Third AvenueAddressLine1
CityNew YorkCity
StateNYState
ZIP Code100222705ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN111631837EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Wyckoff Heights Medical CenterBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlWYCKNameControl
Phone7182401844Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1374 Stockholm StreetAddressLine1
CityBrooklynCity
StateNYState
ZIP Code11237ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameLeon KozlowskiName
TitleCFOTitle
Date Signed2011-11-15DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameAngelo Pirozzi CPAName
Phone2123714446Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRAJIV GARGNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1860 United Nations PlazaAddressLine1
CityNew YorkCity
StateNYState
ZIP Code10017ZIPCode
FieldValueIRS element (for citing)
Gross Receipts304737230GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web SiteWWW.WyCKOFFHOSPITAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1889YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionTHE MISSION OF WYCKOFF HEIGHTS MEDICAL CENTER IS TO PROVIDE EXCELLENCE IN CARE THROUGH PREVENTION, EDUCATION, AND TREATMENT IN A SAFE ENVIRONMENT.ActivityOrMissionDescription
Nbr Voting Members Governing Body21NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees2261TotalNbrEmployees
Total Nbr Volunteers440TotalNbrVolunteers
Total Gross UBI7382TotalGrossUBI
Contributions Grants Prior Year3311796ContributionsGrantsPriorYear
Contributions Grants Current Year6347135ContributionsGrantsCurrentYear
Program Service Revenue Prior Year255673866ProgramServiceRevenuePriorYear
Program Service Revenue CY260692659ProgramServiceRevenueCY
Investment Income Prior Year468018InvestmentIncomePriorYear
Investment Income Current Year17513InvestmentIncomeCurrentYear
Other Revenue Prior Year26729766OtherRevenuePriorYear
Other Revenue Current Year26561967OtherRevenueCurrentYear
Total Revenue Prior Year286183446TotalRevenuePriorYear
Total Revenue Current Year293619274TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year147089692SalariesEtcPriorYear
Salaries Etc Current Year159077557SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year130536996OtherExpensePriorYear
Other Expenses Current Year136580112OtherExpensesCurrentYear
Total Expenses Prior Year277626688TotalExpensesPriorYear
Total Expenses Current Year295657669TotalExpensesCurrentYear
Revenues Less Expenses Prior Year8556758RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-2038395RevenuesLessExpensesCY
Total Assets BOY144549845TotalAssetsBOY
Total Assets EOY142929719TotalAssetsEOY
Total Liabilities BOY231930236TotalLiabilitiesBOY
Total Liabilities EOY232354294TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-87380391NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-89424575NetAssetsOrFundBalancesEOY
Mission DescriptionTHE MISSION OF WYCKOFF HEIGHTS MEDICAL CENTER IS TO PROVIDE EXCELLENCE IN CARE THROUGH PREVENTION, EDUCATION, AND TREATMENT IN A SAFE ENVIRONMENT.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense208659846Expense
Revenue284805053Revenue
DescriptionWYCKOFF HEIGHTS MEDICAL CENTER PROVIDES INPATIENT MEDICAL, SURGICAL, OBSTETRIC, PEDIATRIC CARE AND OFFERS EMERGENCY, AMBULATORY SURGERY AND OUTPATIENT CLINICAL SERVICES. WYCKOFF HAS BEEN PROVIDING MEDICAL CARE TO THE COMMUNITY SINCE 1889. WYCKOFF SEES AN APPROXIMATE 65,197 VISITS ANNUALLY IN ITS PEDIATRIC/ADULT EMERGENCY DEPARTMENTS, DELIVERS 1,381 BABIES, OFFERS OUTPATIENT SERVICES TO THOUSANDS AT ITS NETWORK OF COMMUNITY AMBULATORY CARE CENTERS AND PRESENTS EXTENSIVE COMMUNITY HEALTH EDUCATION AND SCREENING PROGRAMS. WYCKOFF DISCHARGED 19,839 PATIENTS IN 2010. FOR FURTHER INFORMATION, PLEASE VISIT THE WEBSITE AT WWW.WYCKOFFHOSPITAL.ORG.Description
Total Program Service Expense208659846TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
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 BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPtrueLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationtrueBsnssRltnshpWithOrganization
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 EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096172NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees2261NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Quid Pro Quo DisclosurefalseQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Form720 FiledfalseForm720Filed
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members21NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Policies Reference ChaptersfalsePoliciesReferenceChapters
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
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonLeon KozlowskiNamePerson
Telephone Number7182401844TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1374 STOCKHOLM STREETAddressLine1
CityBrooklynCity
StateNYState
ZIP Code11237ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (28 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekHighest Compensated EmployeeHighestCompensatedEmployeeReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerFormerFormer
WILLIAM L THELMO
DEPT CHAIR35.00X57091300
VITO J DALESSANDRO MD
Trustee24.0011500000X
VINCENT ARCURI
Vice Chairman1.00000XX
VICTORIA COOK ESQ
Trustee1.00000X
RAJIV GARG
CEO33.0066100400XX
Nisha Agarwal
Trustee1.00000X
Marcia Maxwell
Trustee1.00000X
Leon Kozlowski
Treasurer & CFO35.0022398200XX
John H Cook Jr ESQ
Trustee1.00000X
JOHN D RUCIGAY ESQ
Trustee1.00000X
HERMAN HOCHBERG
Trustee1.00000X
GARY GOFFNER
Trustee1.00000X
FRED T HALLER III ESQ
Secretary1.00000XX
FRANK CHIARELLO
Trustee1.00000X
Frances Purcell
Trustee1.00000X
Fran Heaney
COO35.0020518500X
FARAMARZ ZARGHAMI
ONCOLOGY SPECIAL.35.00X38838600
ESWAR SOUNDER
ATTENDING0.00X32210600
EMIL J RUCIGAY ESQ
Chairman1.00000XX
EDMONDO MODICA MD
Trustee1.00000X
Dominick Gio
Past President, CEO0.0092522400X
DAVID HOFFMAN
GENERAL COUNSEL35.00X35175700
CHARLENE VISCONTI
Trustee1.00000X
BUSHAN KHASHU
DEPT CHAIR35.00X33589700
ANDREW BOISSELLE
Trustee1.00000X
ALBERT WILTSHIRE
Trustee1.00000X
ADAM FIGUEROA
Trustee1.00000X
AC RAO MD
Trustee33.0026928500X
FieldValueIRS element (for citing)
Total Reportable Comp From Org4368739TotalReportableCompFromOrg
Number Individuals GT100 K243NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Xtend Healthcare LLC
500 West Main StreetHendersonvilleTN37075Acct Collection SVCS1239119
SODEXHO INC & AFFILIATES
BOX 81049WOBURNMA018131049MANAGEMENT SERVICES1477036
MATTOO & BHAT DIALYSIS SERVICE
23-14 COLLEGE POINT BLVDCOLLEGE POINTNY11356DIALYSIS SERVICE779616
ERICO CARDOSO
249 DEGRAW STREETBROOKLYNNY11231MEDICAL Consult SVCS963920
Arshack Hajek & Lehrman PLLC
1790 BroadwayNew YorkNY10019LEGAL Services894746
FieldValueIRS element (for citing)
Number Of Contractors GT100 K186NumberOfContractorsGT100K
Government Grants6284140GovernmentGrants
All Other Contributions62995AllOtherContributions
Total Contributions6347135TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNet Patient Serv RevDescription
Business Code621300BusinessCode
Total Revenue Column260692659TotalRevenueColumn
Related Or Exempt Function Income260692659RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue260692659TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column6469TotalRevenueColumn
Exclusion$6,469ExclusionAmount

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)
Real130557Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real130557Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column130557TotalRevenueColumn
Exclusion$130,557ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities11129000Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities11117956Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities11044Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column11044TotalRevenueColumn
Exclusion$11,044ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
Student Training90009972027227202722
Physician Billings9000991642486616424866
Miscellaneous9000991829662$1,829,662

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column974160TotalRevenueColumn
Related Or Exempt Function Income484806RelatedOrExemptFunctionIncome
Unrelated Business Revenue7382UnrelatedBusinessRevenue
Exclusion$481,972ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue26431410TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column293619274TotalRevenueColumn
Related Or Exempt Function Income284805053RelatedOrExemptFunctionIncome
Unrelated Business Revenue7382UnrelatedBusinessRevenue
Exclusion$2,459,704ExclusionAmount

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)
Total1474455Total
Program Services1017374ProgramServices
Management And General457081ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total925970Total
Program Services638919ProgramServices
Management And General287051ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total118103068Total
Program Services81491117ProgramServices
Management And General36611951ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total5092120Total
Program Services3513563ProgramServices
Management And General1578557ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total24463147Total
Program Services16879571ProgramServices
Management And General7583576ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total9018797Total
Program Services6222970ProgramServices
Management And General2795827ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1792254Total
Program Services1236655ProgramServices
Management And General555599ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total231310Total
Program Services159604ProgramServices
Management And General71706ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

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)
Total40784900Total
Program Services28141581ProgramServices
Management And General12643319ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total125555Total
Program Services86633ProgramServices
Management And General38922ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total40609083Total
Program Services28020267ProgramServices
Management And General12588816ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total11907544Total
Program Services7445195ProgramServices
Management And General4462349ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total83984Total
Program Services57949ProgramServices
Management And General26035ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total86274Total
Program Services59529ProgramServices
Management And General26745ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1645927Total
Program Services1135690ProgramServices
Management And General510237ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total9444084Total
Program Services6516418ProgramServices
Management And General2927666ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total7847585Total
Program Services5414834ProgramServices
Management And General2432751ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Repairs and Maintenance435130530024001348905
Recruitment Expense15577710748648291
Miscellaneous Expense786754282439
Bad Debt1750666317506663

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total0Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total295657669Total
Program Services208659846ProgramServices
Management And General86997823ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY4636369BOY
EOY10988298EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
EOY167844EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY1351659BOY
EOY1403443EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY37646330BOY
EOY24265391EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY3849685BOY
EOY3678885EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2193669BOY
EOY2313285EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis265504845LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec201418972LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY67397142BOY
EOY64085873EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY134313BOY
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY27340678BOY
EOY36026700EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY144549845BOY
EOY142929719EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY60490465BOY
EOY36722371EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY2042232BOY
EOY4974576EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY99165000BOY
EOY109034597EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY1400000BOY
EOY1000000EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY4683480BOY
EOY3482607EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY64149059BOY
EOY77140143EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY231930236BOY
EOY232354294EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-87380391BOY
EOY-89424575EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-87380391BOY
EOY-89424575EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY144549845BOY
EOY142929719EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-2038395ReconcilationRevenueExpenses
Reconcilation Other Changes-5789ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired
Federal Grant Audit PerformedfalseFederalGrantAuditPerformed

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)
Form4720 Filed4955 TaxfalseForm4720Filed4955Tax
Correction MadefalseCorrectionMade
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$46,323OtherActivitiesAmount
Total Lobbying Expenditures IIB46323TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPart II-B, Line 1iIdentifier
Return ReferencePart II-B, Line 1i - Other Activities DescriptionReturnReference
ExplanationWYCKOFF HEIGHTS MEDICAL CENTER PAYS DUES TO THE GREATER NEW YORK HOSPITAL ASSOCIATION (GNYHA) AND THE HEALTHCARE ASSOCIATION OF NEW YORK STATE (HANYS). IN ACCORDANCE WITH CODE SECTION 6033(E) OF THE INTERNAL REVENUE CODE, AND AS REPORTED BY GNYHA AND HANYS, A PORTION OF THESE DUES ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES. THE LOBBYING ACTIVITIES APPLICABLE TO 2010 GNYHA AND HANYS ANNUAL DUES WAS $34,884 AND $11,439, RESPECTIVELY.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis6075373OtherCostOrOtherBasis
Book Value6075373BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis92816413OtherCostOrOtherBasis
Depreciation60188708Depreciation
Book Value32627705BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1706176OtherCostOrOtherBasis
Depreciation1235800Depreciation
Book Value470376BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis161389471OtherCostOrOtherBasis
Depreciation139994464Depreciation
Book Value21395007BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3517412OtherCostOrOtherBasis
Book Value3517412BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings64085873TotalOfBookValueLandBuildings

Other Assets OtherAssets (6 entries)

DescriptionDescriptionBook ValueBookValue
Other Receivables1314557
Other Long Term Assets125000
Due from Third Party Payors14574929
Due from Related Parties4839000
Deferred Financing Fees418957
Assets limited as to use14754257
FieldValueIRS element (for citing)
Total Book Value Other Assets36026700TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
Estimated Professional Liabilities$36,797,433
Due to Third Party Payors$32,246,977
Due to related organizations$6,262,000
Accrued Interest Payable$1,833,733
FieldValueIRS element (for citing)
Total Of Amounts77140143TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierPart XIdentifier
Return ReferencePart X : FIN48 FootnoteReturnReference
ExplanationThe Medical Center adopted the provisions of FASB ASC Topic 740, Uncertainty in Income Taxes, on January 1, 2009. Under FASB ASC Topic 740, an organization must recognize the tax benefit associated with tax positions taken for tax return purposes when it is more likely than not that the position will be sustained. The implementation of FASB ASC Topic 740 had no impact on the Medical Center's consolidated financial statements. The Medical Center does not believe there are any material uncertain tax positions and, accordingly, it will not recognize any liability for unrecognized tax benefits. The Medical Center has filed for and received income tax exemptions in the jurisdictions where it is required to do so. Additionally, the Medical Center has filed Internal Revenue Service Form 990 tax returns, as required, and all other applicable returns in jurisdictions when it is required. No interest or penalties were accrued at January 1, 2009 as a result of the adoption of FASB ASC Topic 740. For the years ended December 31, 2010 and 2009, there was no interest or penalties recorded or included in the consolidated statements of operations and net asset deficiency.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage300.000000000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense2396052TotalCommunityBenefitExpense
Net Community Benefit Expense2396052NetCommunityBenefitExpense
Percent Of Total Expense0.00810PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense119345909TotalCommunityBenefitExpense
Direct Offsetting Revenue97049998DirectOffsettingRevenue
Net Community Benefit Expense22295911NetCommunityBenefitExpense
Percent Of Total Expense0.07540PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense121741961TotalCommunityBenefitExpense
Direct Offsetting Revenue97049998DirectOffsettingRevenue
Net Community Benefit Expense24691963NetCommunityBenefitExpense
Percent Of Total Expense0.08350PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense6810019TotalCommunityBenefitExpense
Net Community Benefit Expense6810019NetCommunityBenefitExpense
Percent Of Total Expense0.02300PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense24939713TotalCommunityBenefitExpense
Direct Offsetting Revenue21914245DirectOffsettingRevenue
Net Community Benefit Expense3025468NetCommunityBenefitExpense
Percent Of Total Expense0.01020PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense31749732TotalCommunityBenefitExpense
Direct Offsetting Revenue21914245DirectOffsettingRevenue
Net Community Benefit Expense9835487NetCommunityBenefitExpense
Percent Of Total Expense0.03320PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense153491693TotalCommunityBenefitExpense
Direct Offsetting Revenue118964243DirectOffsettingRevenue
Net Community Benefit Expense34527450NetCommunityBenefitExpense
Percent Of Total Expense0.11670PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense2060475TotalCommunityBuildingExpense
Direct Offsetting Revenue1434636DirectOffsettingRevenue
Net Community Building Expense625839NetCommunityBuildingExpense
Percent Of Total Expense0.00210PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Total Community Building Expense197999TotalCommunityBuildingExpense
Net Community Building Expense197999NetCommunityBuildingExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense2258474TotalCommunityBuildingExpense
Direct Offsetting Revenue1434636DirectOffsettingRevenue
Net Community Building Expense823838NetCommunityBuildingExpense
Percent Of Total Expense0.00280PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$7,913,594BadDebtExpenseAmount
Amount Reimbursed By Medicare67641582AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare50258031CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall17383551MedicareSurplusOrShortfall

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 Number0FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1WYCKOFF HEIGHTS MEDICAL CENTERBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1374 STOCKHOLM STREETAddressLine1
CityBROOKLYNCity
StateNYState
ZIP Code11237ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Teaching HospitalXTeachingHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1WYCKOFF HEIGHTS MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA ConductedfalseCHNAConducted
Eligibility Criteria ExplainedfalseEligibilityCriteriaExplained
Uses FPG FreefalseUsesFPGFree
Uses FPG DiscountedfalseUsesFPGDiscounted
Explains BasisfalseExplainsBasis
Explains Application MethodfalseExplainsApplicationMethod
Includes Publicity MeasuresfalseIncludesPublicityMeasures
Actions On NonpaymentfalseActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (9 entries)

Return ReferenceReturnReferenceExplanationExplanation
Part VI - States Where Community Benefit Report FiledNY
Part VI - Explanation Of How Organization Furthers Its Exempt PurposeThe mission of Wyckoff Heights Medical Center is to provide excellence in care through prevention, education and treatment in a safe environment. Wyckoff provides comprehensive primary and secondary level inpatient and outpatient medical, surgical, obstetric/gynecologic and pediatric care services. Wyckoff provides tertiary healthcare services, including renal dialysis, medical oncology services, neurosurgery, genetics, nuclear medicine and radiation oncology. Ambulatory podiatric and dental services are also available. In our commitment to patient-centered care, Wyckoff policy emphasizes ambulatory alternatives to inpatient care when feasible to promote responsibility and patient independence. Expanded community outreach programs and ambulatory centers facilitate patient access, while promoting our many allopathic and osteopathic educational and teaching programs.Wyckoff Heights Medical Center has created the following objectives to help us meet our mission and vision:*Provides the highest level of care for all patients, recognizing the worth and dignity of each individual*Improves the health status of the community by actively participating in an organized, innovative, integrated health care system, using a focus on managed care*Promotes and supports all efforts to provide a safe environment for our patient, employees and visitors*Works in partnership with physicians and all health care providers and employees to encourage professional growth and development, in order to better serve the community and to understand and meet the needs of our culturally diverse population*Is committed to the ongoing employability of our employees through their growth and development, despite the inability to guarantee individual jobs in a changing health care environment, by working together responsibly and respecting each role here.*Fosters a scholarly atmosphere, supporting educational programs and endowments that enhance the competency of all individuals within the system, to promote delivery of health care that is safe, effective, patient-centered, timely, efficient and equitable*Is creating health information systems and networks dedicated to monitoring, streamlining and improving the quality of clinical and service functions, while maintaining patient confidentiality and yet responding to the health care market growth, optimal financial development and wise use of financial assets*Provides modern, progressive health care technologies that improve the quality of care*Provides outreach to members of the community with special needs, including infants, young children and adolescents, persons with disabilities, chronic conditions and life-threatening disorders such as HIV/AIDS and senior citizens*Promotes and supports preventive medicine programs that reduce occurrence of disease through education and proactive measures*Measures success by how well we meet or exceed the expectations of our community and patients*Strives to create a culture of service excellence in every aspect of patient care. By providing outstanding service consistently, we seek to establish lifelong relationship with patients, emphasizing that care for the patient always come firstWyckoff Heights Medical Center's mission and commitment to quality service enables the hospital to become the premier health care provider for the culturally diverse community we serve.
Part VI - Community InformationWyckoff Heights Medical Center is a 324-bed acute care academic medical center committed to the complex mission of patient care, teaching and community service. The hospital has ensured continued Brooklyn and Queens county community participation and outreach activities through linkages with community based organizations, local physician practices, D&T centers, home care agencies and nursing homes. Wyckoff Heights Medical Center's primary and secondary service areas include five primary care Health Professional Shortage Areas (HPSAs); Bushwick, Williamsburg, Bedford-Stuyvesant, East New York and Long Island City. The Hospital is located in Brooklyn near the Brooklyn/Queens border, and serves the Bushwick, Bedford-Stuyvesant, East New York and Greenpoint communities of Brooklyn, as well as the Ridgewood, Glendale, Maspeth and Middle Village communities of Queens. The hospital service areas have a total population of 430,000. 177,000 residents or 41% of the population is Latino and 47,400 residents or 11% of the population is African American. The hospital is located in the 11237 ZIP Code which has a population that is 75% Latino. The service areas also include recent immigrant populations from Latin America, the Caribbean, Eastern/Southern Europe and Asia. More than 100,000 residents are under 18 years of age. In the Bushwick community 33% are 18 or younger. More than 50% of the residents have incomes below the poverty line.
Part VI - Patient Education of Eligibility for AssistanceWyckoff Heights Medical Center is committed to provide access to the highest level of care with compassion, dignity and respect. We are also committed to care all persons regardless of their ability to pay. We not only provide various assistances to patients who can't pay for part or all of the care they receive but also help patients with broader fiscal responsibilities to balance the needed financial assistance.Wyckoff Heights Medical Center currently has the following principals when handling the billing, collection and financial support functions for our patients:*Provide effective communications with patients regarding hospital bills*Make affirmative efforts to help patients apply for public and private financial support programs*Offer financial support to patients with limited resources*Implement policies for assisting low-income patients in a consistent manner*Implement fair and consistent billing and collection practices for all patients with payment obligationsWyckoff Heights Medical Center provides financial counseling to patients about their obligations and hospital bills. Information on hospital policies on financial support and Federal, State and local programs that provide coverage for services is available to patients through hospital's website, hospital posters and flyers. Information is also available in Spanish which is the main language spoken in the community and posted in the waiting areas for the emergency room, the Women's Health, the second floor main clinic area and the offsite clinics. Financial counselors make every effort to help patients apply fro public and private programs for which they may qualify and that may help them obtain and pay for healthcare services. The hospital has onsite Medicaid eligibility representatives and they make bedside visits to determine a patient's eligibility prior to the patient's discharge.Wyckoff Heights Medical Center has developed a written policy for the billing, collection on charity care and is committed to implementing and applying the policy for assisting patients in need in a professional, consistent manner. Wyckoff educates staff members who work closely with patients (including patient registrars, financial investigators, customer service representatives, and billing and collection representatives) about these policies with an emphasis on treating all patients with dignity and respect regardless of their insurance status or ability to pay for services.
Part VI - Needs AssessmentPursuant to New York State Public Health Law Section 2803-L, Wyckoff Heights Medical Center ("WHMC") is required to file a comprehensive community service plan ("CSP") with The New York State Department of Health ("DOH") every 3 years. The text of New York State Public Health Law Section 2803-L is as follows:Community service plans. (1) The governing body of a voluntary non-profit general hospital must issue an organizational mission statement identifying at a minimum the populations and communities served by the hospital and the hospital's commitment to meeting the health care needs of the community. (2) The governing body must at least every three years: (i) review and amend as necessary the hospital mission statement; (ii) solicit the views of the communities served by the hospital on such issues as the hospital's performance and service priorities; (iii) demonstrate the hospital's operational and financial commitment to meeting community health care needs, to provide charity care services and to improve access to health care services by the underserved; and (iv) prepare and make available to the public a statement showing on a combined basis a summary of the financial resources of the hospital and related corporations and the allocation of available resources to hospital purposes including the provision of free or reduced charge services. (3) The governing body must at least annually prepare and make available to the public an implementation report regarding the hospital's performance in meeting the health care needs of the community, providing charity care services, and improving access to health care services by the underserved. (4) The governing body shall file with the commissioner its mission statement, its annual implementation report, and at least every three years a report detailing amendments to the statement and reflecting changes in the hospital's operational and financial commitment to meeting the health care needs of the community, providing charity care services, and improving access to health care services by the underserved.The above-referenced CSP requirement was enhanced by the DOH's Prevention Agenda initiative. This initiative is a process that asks hospitals such as WHMC to work with local health departments and community partners to assess community health needs, jointly develop plans to address two or three of the identified needs and include this collaborative work in the WHMC's CSP update submitted to DOH. Information on the New York State DOH Prevention Agenda can be found at www.health.state.ny.us/prevention/prevention_agenda.WHMC lies in culturally diverse Queens and Kings County of New York City. WHMC determines its community health needs by participating with community groups and local health department activities.The hospital analyzes internal patient survey, utilization data and bulletins and reports from NYS Department of Health, NYS Vital Statistics, GNYHA and HANYS to understand the demographics and unmet needs within the community.WHMC works closely with the local health department and community groups. The hospital is able to constantly meet the emerging health care needs from the community. The hospital identifies the following needs within the community: The need to access advanced quality health care; the need to receive quality care for the underserved by open enrollment of Medicaid and Medicaid Managed Care programs; the need to obtain health education, disease prevention and disease management to improve the health status of the community.In summary, the hospital focus primarily on positively impacting the health of our community with programs that are culturally and linguistically tailored to meet the unmet needs of women, infants, seniors and minorities in our community.
Part III, Line 9b - Provisions On Collection Practices For Qualified PatientsWyckoff Heights Medical Center's ("WHMC") collection policy follows the guidelines established by New York State law. WHMC's collection policy, in conjunction with the hospital's Charity Care and Financial Assistance Policy, ensures that every effort is made to identify patients who are eligible for charity care. WHMC has a written debt collection policy - All self-pay balances are outsourced to a designated self-pay agency for collection. True self-pays will be forwarded on day one from final bill. Self-pay after insurance payment or final insurance denial will be transferred to the outsource company as soon as the account is identified as having a self-pay balance. Accounts will be worked by the outsource (early out) company for one hundred twenty (120) days. The early out agency will also identify accounts that qualify for charity care based on New York guidelines. If unpaid at the end of the cycle the account will be transferred to a designated bad debt collection agency. The Bad Debt agencies will work the accounts for six (6) months. If the agency fails in their collection effort, the account will be returned to the hospital as uncollectible with the exception of accounts with active payment arrangements.Itemized bills will be available to patients upon request.PROCEDURE:1.All patients with a self-pay balance (true self-pay or self-pay balance after insurance) will be transferred to a designated self-pay agency for processing. The agency will:a.Identify and return accounts that qualify for charity care per New York guidelines.b.Process a letter series (three letters) within one hundred twenty (120) days. In addition to written statements, patients will receive a minimum of three (3) phone calls in an attempt to collect upon their open account. c.Identify accounts with return mail/no current phone number that can not be located and return the account to be placed in bad debt.d.After the one hundred twenty (120) day period and there has been no payment received, the account will be returned to the hospital to be reviewed for bad debt placement.Note: Accounts with payment arrangements will remain at the agency until they are paid-in-full. Agency will close and return accounts that have broken payment arrangements.2.A bad debt pre-list will be reviewed weekly and accounts placed with a designated bad debt agency for a period of six (6) months will be changed to BDCLOSED - Bad debt Closed Account identifies the account as having all collection efforts exhausted. The exceptions for returning accounts at six months are accounts with active payment arrangements.3.Accounts returned from the Bad Debt agencies will be reviewed:a.Medicare copay/deductible amounts will be documented. b.Accounts claimed as uncollectible will be coded as 'Bad Debt Returns' (BDCLOSED), which identifies the accounts as having all collection efforts exhausted. 4.Monthly-The Patient Accounts Manager who oversees outsourcing will:a.Reconcile the inventoryb.Conduct an audit on compliance to this policy and report those results to the Associate Vice-President
Part III, Line 8 - Explanation Of Shortfall As Community BenefitThe amount reported on Line 6 was derived by using the Medicare allowable costs as reported on the Hospital's New York State Institutional Cost Report and the applicable adjustments from Worksheet B.
Part III, Line 4 - Bad Debt ExpenseReceivables for Patient Care/Allowance for Doubtful Accounts:The process for estimating the ultimate collection of receivables involves significant assumptions and judgments. Patient accounts receivable are recorded at the reimbursement or contracted amount, and are based upon management's assessmentof historical and expected net collections, business and economic conditions, trends in Medicare and Medicaid health care coverage and other collection indicators. Accounts deemed uncollectible, and written off, are deducted from the allowance for doubtful accounts. Revisions in reserve for doubtful accounts estimates are recorded as an adjustment to bad debt expense.For patients who were determined by Wyckoff Heights Medical Center to have the ability to pay but did not, the uncollected amounts are bad debt expense. The bad debt expense was determined based on actual collection through April for services rendered in the prior year. Wyckoff Heights Medical Center uses Worksheet A to estimate the bad debt expense at cost.Bad debt expense at cost is $7,913,594. Bad debt expense per the audited financial statements is $17,506,663.
Part I, Line 7 - Explanation of Costing MethodologyWyckoff Heights Medical Center's costing methodology was based upon the 2010 New York State Institutional Cost Report and the 2010 Medicare (Form 2552) Cost Report. These cost reports are filed with the New York State Department of Health and the applicable CMS intermediary, respectively. The cost-to-charge ratio derived from The New York State Institutional Cost Report was used for the various sub-line items of line #7.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymenttrueSeverancePayment
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
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
WILLIAM L THELMO
569941972570913
RAJIV GARG
660049955661004
Leon Kozlowski
223721261223982
Fran Heaney
2041651020205185
FARAMARZ ZARGHAMI
387529857388386
ESWAR SOUNDER
321168938322106
Dominick Gio
925224925224
DAVID HOFFMAN
351092665351757
BUSHAN KHASHU
335340557335897
AC RAO MD
2677831502269285

Schedule L IRS990ScheduleL

Loan Table LoanTable

FieldValueIRS element (for citing)
Name PersonWyckoff Funding AssociatesNamePerson
Loan To OrganizationXLoanToOrganization
Original Principal$2,400,000OriginalPrincipalAmount
Balance Due1000000BalanceDue
DefaultfalseDefault
Approved By BoardtrueApprovedByBoard
Written AgreementtrueWrittenAgreement
FieldValueIRS element (for citing)
Total Balance Due1000000TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
Andrew Boisselle
Trustee46678Independent contractorfalse
Gary Goffner
Trustee484806Independent contractorfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Schedule H, Part V, Section BPURSUANT TO IRS ANNOUNCEMENT 2011-37 DATED JUNE 9, 2011, SCHEDULE H PART V SECTION B WAS MADE OPTIONAL FOR 2010. ACCORDINGLY WYCKOFF HEIGHTS MEDICAL CENTER HAS ELECTED NOT TO COMPLETE THIS SECTION. HOWEVER, DUE TO LACERTE SOFTWARE DESIGN LIMITATIONS THE PROGRAM ERRONEOUSLY COMPLETED SECTION B AND COULD NOT BE OVERRIDDEN. ACCORDINGLY SECTION B SHOULD BE DISREGARDED AS WYCKOFF HEIGHTS MEDICAL CENTER HAS ELECTED NOT TO COMPLETE THIS SECTION.
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableUpon request, the organization will make available only those documents required to be disclosed under the public inspection laws.Form 990, Part VI, Line 19
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesExecitive Compensation is reviewed by the Board Executive Compensation Committee which has only outside Board members.Form 990, Part VI, Line 15b
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsBoard of Trustees Audit and Compliance committee reviews all annual conflict of interest questionnaires and makes recommendations, if necessary, to the full board. Positive responses are reviewed and additional information is gathered to determine if a conflict exists. If a conflict exists, appropriate action is taken to eliminate the conflict, including such steps as reassignment of responsibilities or establishment of protective agreements. If a matter involves a board member or officer, appropriate action, including recusal and additional disclosures, will be determined by the board.Form 990, Part VI, Line 12c
Form 990, Part VI, Line 11: Form 990 Review ProcessThe finance director and CFO undertake a detailed review of the 990. In addition, board members undertake a review of the organization's Form 990 and then review with the CFO any commentary, observations, and recommendations, as appropriate.Form 990, Part VI, Line 11
Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, EtEmil Rucigay and John Rucigay have a family relationship.Victoria Cook and John H. Cook, Jr. have a family relationship.Form 990, Part VI, Line 2

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (11 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
Wyckoff Heights Hospital Self Insurance
374 Stockholm StreetBrooklynNY11237112513146inactiveNY501(C)(3)11aWyckoff Heights Medical Centertrue
Wyckoff Orthopaedic PC
374 Stockholm StreetBrooklynNY11237113437602Provide medical services in area of orthopedicsNY501(C)(3)11aWyckoff Heights Medical Centertrue
Wyckoff Neonatal Services PC
374 Stockholm StreetBrooklynNY11237113401138Provide neonatal medical servicesNY501(C)(3)11aWyckoff Heights Medical Centertrue
Wyckoff Medical Services PC
374 Stockholm StreetBrooklynNY11237113459881Provide medical servicesNY501(C)(3)11aWyckoff Heights Medical Centertrue
Wyckoff Imaging Service PC
374 Stockholm StreetBrooklynNY11237861061721Provide medical imaging servicesNY501(C)(3)11aWyckoff Heights Medical Centertrue
Wyckoff Heights Medical Center Foundatio
374 Stockholm StreetBrooklynNY11237113626419Provide support for WHMC and its affiliatesNY501(C)(3)11aWyckoff Heights Medical Centertrue
Wyckoff Heights Dental Services PC
374 Stockholm StreetBrooklynNY11237113440088Provide medical services in area of dentistryNY501(C)(3)11aWyckoff Heights Medical Centertrue
Wyckoff Family Medical Services PC
374 Stockholm StreetBrooklynNY11237113503139Provide medical servicesNY501(C)(3)11aWyckoff Heights Medical Centertrue
Wyckoff Anesthesia Medical Services PC
374 Stockholm StreetBrooklynNY11237113519417Provide medical services in area of anesthesiaNY501(C)(3)11aWyckoff Heights Medical Centertrue
Stockholm Obstetrics & Gynecological Svc
374 Stockholm StreetBrooklynNY11237113318298Provide medical services in area of OB/GYNNY501(C)(3)11aWyckoff Heights Medical Centertrue
Brooklyn Queens Health Care
374 Stockholm StreetBrooklynNY11237311650965Provide support for WHMCNY501(C)(3)11atrueN/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Wyckoff Surgical Services PC
374 Stockholm StreetBrooklynNY11237270837125Provide surgical servicesNYN/AC corp14852148181.00000
Wyckoff Practice Management Corp
374 Stockholm StreetBrooklynNY11237113463990ManagementNYN/AC CORP370967444721.00000
Wyckoff Emergency Medicine Services PC
374 Stockholm StreetBrooklynNY11237113495935Medical SVCSNYN/AC CORP60439441334601.00000
Preferred Health Properties inc
374 Stockholm StreetBrooklynNY11237112974963InactiveNYC CORP29001.00000See Part VII
Preferred Health Ventures Placement
374 Stockholm StreetBrooklynNY11237112973953InactiveNYC CORP1676651.00000See Part VII
Preferred Health Ventures Pharmacy
374 Stockholm StreetBrooklynNY11237112974935InactiveNYC CORP492591.00000See Part VII
Preferred Health Ventures Inc
374 Stockholm StreetBrooklynNY11237112974960InactiveNYN/AC CORP4972001.00000
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 (8 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Wyckoff Emergency Medicine Services PC
o2620200cost
Wyckoff Neonatal Services PC
o389930Cost
Wyckoff Medical Services PC
o404676Cost
Wyckoff Imaging Service PC
o1677200Cost
Wyckoff Heights Dental Services PC
o461800Cost
Wyckoff Family Medical Services PC
o511600Cost
Wyckoff Anesthesia Medical Services PC
o3204154Cost
Stockholm Obstetrics & Gynecological Svc
o1214000Cost

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierPart IV, Column (D) - Direct Controlling EntityIdentifier
ExplanationName of Related Organizations Direct Controlling EntityPreferred Health Ventures Pharmacy: Preferred Health Ventures IncPreferred Health Ventures Placement: Preferred Health Ventures IncPreferred Health Ventures Properties: Preferred Health Ventures IncExplanation

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