2011-11-14T11:10:19-06:00 2010-12-31 DELOITTE TAX LLP TWO JERICHO PLAZA JERICHO NY 11753 990 2010-01-01 131740274 CALVARY HOSPITAL INC CALV 7185182069 1740 EASTCHESTER ROAD BRONX NY 104612392 ANDREW V GRECO 7185182069 2011-11-11 1 5169187000 2010 2016-03-07 17:11:31Z FRANK A CALAMARI 1740 EASTCHESTER ROAD BRONX NY 10461 115733793 0 0928 X WWW.CALVARYHOSPITAL.ORG X 1899 NY CALVARY HOSPITAL IS A FULLY ACCREDITED ACUTE CARE SPECIALTY HOSPITAL EXCLUSIVELY PROVIDING PALLIATIVE CARE FOR ADVANCED CANCER PATIENTS IN THE UNITED STATES. 16 15 1029 170 0 0 6352838 3916697 93606436 96290400 993253 4983798 814008 898098 101766535 106088993 0 0 0 0 74039100 76677997 0 0 0 30246900 30597606 104286000 107275603 -2519465 -1186610 98734242 102903101 41688016 41466701 57046226 61436400 X CALVARY HOSPITAL IS A FULLY ACCREDITED ACUTE CARE SPECIALTY HOSPITAL EXCLUSIVELY PROVIDING PALLIATIVE CARE FOR ADVANCED CANCER PATIENTS IN THE UNITED STATES. 0 0 78053461 78340100 ADVANCED CANCER CARE INPATIENT - CALVARY SERVES ABOUT 12% OF ALL INDIVIDUALS WHO DIE OF CANCER IN THE NEW YORK METROPOLITAN AREA EACH YEAR. PATIENTS ARE REFERRED TO CALVARY FROM EVERY MAJOR HOSPITAL AND MEDICAL CENTER IN NEW YORK CITY. IN 2010, CALVARY CARED FOR MORE THAN 5,300 PATIENTS AND FAMILIES AS INPATIENTS IN OUR 200-BED BRONX CAMPUS AND OUR 25-BED SATELLITE AT LUTHERAN MEDICAL CENTER IN BROOKLYN, AS OUTPATIENTS, THROUGH OUR CENTER FOR CURATIVE AND PALLIATIVE WOUND CARE; AND THROUGH HOSPICE AND HOME CARE. THE AVERAGE LENGTH OF INPATIENT STAY IS 23 DAYS.OUR PATIENTS CAME FROM ACROSS THE NEW YORK TRI-STATE AREA: THE BRONX, QUEENS, MANHATTAN WESTCHESTER, BROOKLYN, AND LONG ISLAND AS WELL AS FROM OTHER LOCATIONS. THEY RANGED IN AGE FROM 20 TO 108, WITH A MAJORITY (82%) OVER AGE THE AGE OF 55. MINORITIES (INCLUDING ASIAN, AFRICAN AMERICAN, AND HISPANIC) MADE UP 46% OF ALL INPATIENTS. 13445725 15654200 CALVARY HOSPITAL HOSPICE IS A MEDICARE-CERTIFIED HOSPICE PROGRAM, WHICH PROVIDES AN INTERDISCIPLINARY CARE TEAM FOR PATIENTS WITH A TERMINAL PROGNOSIS FOR ALL END-STAGE DISEASES. CALVARY HOSPITAL HOSPICE EMBRACES AND IMPLEMENTS THE BASIC ASSUMPTIONS OF THE HOSPICE CONCEPT, INCLUDING THE FOLLOWING:- HOSPICE PROVIDES PALLIATIVE MEDICAL CARE, TREATING THE PHYSICAL, EMOTIONAL AND SPIRITUAL PAIN OF THE PATIENT AND FAMILY.- HOSPICE TREATS THE PATIENT AND LOVED ONES TOGETHER AS A WHOLE UNIT OF CARE AND OFFERS BEREAVEMENT COUNSELING FOR SURVIVING CAREGIVERS AFTER THE PATIENT'S DEATH.- HOSPICE PATIENTS REMAIN IN THE FAMILIAR, COMFORTING SURROUNDINGS OF HOME, WHETHER IT'S A PRIVATE RESIDENCE, NURSING HOME, HOSPITAL OR AN ASSISTED LIVING FACILITY.- HOSPICE CARE PROVIDES THE FOLLOWING FOUR LEVELS OF CARE: ROUTINE CARE, GENERAL INPATIENT CARE (IF NEEDED), CONTINUOUS CARE (DURING A CRISIS), AND RESPITE CARE.HOSPICE SERVICES- NURSING CARE, AS NECESSARY TO MAINTAIN THE PATIENT AT HOME- 24 HOURS A DAY, 7 DAYS A WEEK ON-CALL NURSE- PHYSICIAN SERVICES- MEDICAL SOCIAL SERVICES- PASTORAL CARE- COUNSELING SERVICES- NUTRITIONAL COUNSELING- SHORT-TERM INPATIENT AND RESPITE CARE- MEDICAL SUPPLIES RELATED TO TERMINALLY ILL- PERSONAL CARE PROVIDED BY CERTIFIED HOME HEALTH AIDES- THERAPIES (E.G., PHYSICAL, OCCUPATIONAL AND SPEECH)- MEDICATIONS FOR SYMPTOM MANAGEMENT AND PAIN CONTROL RELATED TO THETERMINALLY ILL- BEREAVEMENT COUNSELING FOR FAMILY MEMBERS- VOLUNTEER SERVICES 2863603 1539500 CALVARY'S HOME HEALTH AGENCY SERVES PATIENTS IN THE BRONX, QUEENS, NORTHERN MANHATTAN, AND SOUTHERN WESTCHESTER COUNTY. CALVARY OFFERS HOME CARE TO PATIENTS WITH ALL DIAGNOSES. MOST PATIENTS RETURN TO PRE-ILLNESS FUNCTION AND ARE DISCHARGED TO SELF-CARE WITHIN SIX TO EIGHT WEEKS. ALL OF OUR PATIENTS WHO WE CARE FOR AT HOME GET THE SAME LEVEL OF HIGH-QUALITY AND UNIQUE "CALVARY CARE" AS ALL OF OUR INPATIENTS.THE FOLLOWING SERVICES ARE AVAILABLE TO PATIENTS AND THEIR FAMILIES THROUGH CALVARY'S CERTIFIED HOME HEALTH AGENCY:NURSING SERVICES- OUR COMMUNITY HEALTH NURSES PROVIDE NURSING VISITS TO PATIENTS IN THEIR HOMES.- SPECIALIZED NURSING IS AVAILABLE SUCH AS ENTEROSTOMAL THERAPY.- 24-HOUR TELEPHONE ACCESS TO RN (REGISTERED NURSE) ON-CALL.HOME HEALTH AIDE- PROVIDES ASSISTANCE WITH PERSONAL CARE AND OTHER ACTIVITIES RELATED TO HEALTH CARE.NUTRITIONAL SERVICES- CALVARY'S DIETITIANS ARE AVAILABLE BY PHONE TO HELP IN PLANNINGTHERAPEUTIC NUTRITIONAL MANAGEMENT.THERAPY SERVICES- PHYSICAL THERAPY- OCCUPATIONAL THERAPY- SPEECH THERAPYMEDICAL CARE- CALVARY HOME CARE STAFF WILL WORK CLOSELY WITH THE PATIENT'S OWN PHYSICIAN TO MEET HOME HEALTH NEEDS.- OUR STAFF HAS EXTENSIVE KNOWLEDGE OF PAIN MANAGEMENT.MEDICAL SOCIAL WORKA FULL RANGE OF SOCIAL WORK SERVICES ARE AVAILABLE TO HELP PATIENTS AND FAMILIES COPE WITH THE PROBLEMS OF ILLNESS.- ASSISTANCE IN MEDICAID APPLICATION- ASSISTANCE IN LONG-TERM PLANNINGREFERRING PATIENTS- REFERRALS MAY BE MADE BY PATIENTS, FAMILY MEMBERS, FRIENDS, HOSPITALS, CLINICS, PHYSICIANS, OTHER HEALTH CARE PROFESSIONALS AND COMMUNITY AGENCIES.- TO MAKE A REFERRAL OR TO LEARN MORE ABOUT OUR SERVICES, PLEASE CALL (718) 430-9540.PART OF THE CALVARY CONTINUUM- FACILITATE ADMISSION TO INPATIENT CARE FOR SYMPTOM MANAGEMENT- REFERRAL TO OUTPATIENT AND WOUND CARE CLINICS- PROVIDE INFORMATION ON CALVARY PROGRAMS INCLUDING BEREAVEMENT SUPPORT 2291579 906403 ADVANCED CANCER CARE OUTPATIENT/OTHER PROGRAMSTHE OUTPATIENT CLINIC PROVIDES CARE THROUGH A MULTIDISCIPLINARY APPROACH, WHICH ENCOMPASSES THE PHYSICAL, EMOTIONAL AND SPIRITUAL NEEDS OF THE PATIENT AND THEIR FAMILY. THE AIM OF THE CLINIC IS TO PROVIDE COMPREHENSIVE HEALTH CARE FOR THE ADVANCED CANCER PATIENT.OUTPATIENT SERVICES1. THE OUTPATIENT CLINIC SPECIALIZES IN PAIN CONTROL, WOUND CARE AND OTHER SERVICES SPECIFIC TO THE ADVANCED CANCER PATIENT.2. EACH PATIENT IS ASSIGNED A PRIMARY PHYSICIAN, REGISTERED NURSE, SOCIAL WORKER AND DIETITIAN.3. THE SERVICES OF PASTORAL CARE, THERAPEUTIC RECREATION, RADIOLOGY, LABORATORY, ENTEROSTOMAL THERAPY AND OTHER SERVICES ARE AVAILABLE IF NEEDED.4. THE OUTPATIENT NURSES PROVIDE ADDITIONAL SUPPORT TO PATIENTS AND FAMILIES THROUGH FREQUENT TELEPHONE CALLS.5. ASSISTANCE WITH TRANSPORTATION ARRANGEMENTS WILL BE PROVIDED IF NEEDED.6. TWENTY-FOUR HOUR TELEPHONE COVERAGE WITH A NURSE AND PHYSICIAN FOR ADVICE OR REASSURANCE IS AVAILABLE.7. CONSULTATION WITH MEDICAL SPECIALISTS CAN BE ARRANGED AND COORDINATED.8. COORDINATION OF SERVICES IS PROVIDED AMONG THE PATIENT'S PHYSICIAN, HOME CARE AGENCY AND OTHER PROVIDERS TO ASSURE APPROPRIATE AND CONTINUAL CARE. 2291579 906403 96654368 1 1 0 1 0 0 0 0 1 1 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 70 0 1 1029 1 0 0 0 0 0 0 0 0 0 0 X 16 15 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X ANDREW GRECO 7185182069 1740 EASTCHESTER ROAD BRONX NY 104612069 MANFRED ALTSTADT 2.00 X 0 0 0 JOHN P BERTSCH 2.00 X 0 0 0 JOHN A DECINA 2.00 X 0 0 0 THOMAS J FAHEY JR MD 2.00 X 0 0 0 THOMAS G FERRARA 2.00 X 0 0 0 TERENCE GALLAGHER-EMERITUS 2.00 X 0 0 0 STEVEN J GOLUB 2.00 X 0 0 0 EDWARD D HEBEN 2.00 X 0 0 0 RALPH V JOHNSON 2.00 X 0 0 0 MSGR EDWARD H BARRY 2.00 X 0 0 0 JAMES E INTRONE 2.00 X 0 795861 8935 RENA M MURTHA RN 2.00 X 0 0 0 AMIT SIKDAR 2.00 X 0 0 0 MINTO L SOARES 2.00 X 0 0 0 JOSEPH A TARANTINO 2.00 X 0 0 0 ANNE COTE TAYLOR 2.00 X 0 0 0 RICHARD E MEYER 2.00 X 0 0 0 MICHAEL J BRESCIA MD 36.00 X 464817 0 23897 FRANK A CALAMARI 36.00 X 868487 0 35503 CHRISTOPHER COMFORT MD 36.00 X 410970 0 50883 RICHARD KUTILEK 36.00 X 330651 0 48723 FRANK J LOCAPARRA 36.00 X 130673 0 40573 ANDREW V GRECO 36.00 X 252861 0 23438 SALLY UMBRO RN 26.00 X 214115 0 40025 ANTHONY TARANTO 36.00 X 170168 0 28497 NANCY D'AGOSTINO RN 36.00 X 191495 0 46523 ROBERT BRESCIA MD 36.00 X 337386 0 33502 DEVMANI JAITLY MD 36.00 X 463217 0 48883 GAIL CHRZANOWSKI MD 36.00 X 264405 0 41369 OSCAR ALVAREZ PHD 36.00 X 241693 0 48676 SREENIVASA PATIBANDLA MD 36.00 X 335486 0 25670 4676424 795861 545097 108 0 1 0 AMERISOURCEBERGEN CORP PO BOX 5188 NEW YORK NY 100875188 PHARMACEUTICAL VENDOR 1983173 MMS PO BOX 643925 CINCINNATI OH 45264 MEDICAL SUPPLIES 1033524 FARRELL MEDIA GROUP 887 KINDERKAMACK RD 1ST FL RIVER EDGE NJ 07661 ADVERTISING 988778 US FOOD SERVICE INC PO BOX 642554 PITTSBURGH PA 152642554 FOOD VENDOR 575161 EXTENDED CARE CONCEPTS 125 NEWTOWN RD SUITE 300 PLAINVIEW NY 11803 HOME HEALTH AIDE AGENCY 489011 52 1370003 2546694 3916697 MEDICARE REVENUE 900099 66725637 66725637 MEDICAID REVENUE 900099 16792314 16792314 PATIENT SERVICE REVENU 900099 12772449 12772449 96290400 1040098 1040098 42000 42000 42000 42000 13588500 9621500 23300 3967000 -23300 3943700 3943700 PARKING LOT REVENUE 900099 249095 249095 CAFETERIA 900099 231497 231497 MISCELLANEOUS INCOME 900099 225703 225703 149803 149803 856098 106088993 96440203 0 5732093 3066439 2762831 303608 52361361 47177063 5184298 6397697 5764325 633372 10975600 9888906 1086694 3876900 3493048 383852 962000 962000 391600 391600 316000 316000 5528800 5528800 1293800 1165701 128099 2657400 2394291 263109 2429200 2188685 240515 3847100 3466199 380901 558800 503473 55327 OTHER ANCILLARY MED EXP 5751300 5751300 PROVISION FOR BAD DEBT 2160800 2160800 MISCELLANEOUS 2092100 1924577 167523 MAINTENANCE AND REPAIRS 1255800 1131463 124337 FOOD EXPENSE 962200 962200 390706 390706 107275603 96654368 10621235 0 -821062 -1791088 4699285 2900297 18641313 19021098 30699 192799 412047 399297 77551200 61177300 16980700 16373900 21390483 24099496 17200200 19899515 20200577 21807787 98734242 102903101 15085633 15111098 26602383 26355603 41688016 41466701 X 34129640 35702000 21122386 23901500 1794200 1832900 57046226 61436400 98734242 102903101 X -1186610 5576784 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 23232 23232 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: CALVARY HOSPITAL, INC. DOES NOT ENGAGE IN ANY DIRECT LOBBYING ACTIVITIES; HOWEVER, IT DOES BEAR INDIRECT COSTS THAT HAVE LOBBYING IMPLICATIONS. THE $23,232 REPORTED ON PART II-B, LINE 1(I) REPRESENTS THAT PORTION OF ITS MEMBERSHIP DUES THE HOSPITAL PAYS TO THE HOSPITAL ASSOCIATION OF NEW YORK STATE (HANYS) AND THE GREATER NEW YORK HOSPITAL ASSOCIATION (GNYHA) THAT RELATES TO LOBBYING EXPENSES. THIS AMOUNT HAS BEEN DETERMINED IN ACCORDANCE WITH MEDICARE PROVIDER REIMBURSEMENT MANUAL, PART I, SECTION 2139. 22916700 1901600 2815700 1899600 25734400 20492500 1747600 2610800 1934200 22916700 0.00000 0.07120 0.92880 0 0 538000 538000 27751100 19948800 7802300 3552800 2440600 1112200 45669000 38787900 6881100 40300 40300 16373900 BENEFICIAL INTEREST IN NET ASSETS OF CALVARY FUND 19899515 F 19899515 DUE FROM THIRD PARTIES 620000 CAPITAL IMPROVEMENTS 5072700 SELF INSURANCE FUND ASSETS 2060500 EQUIPMENT ESCROW FUND 7540100 DONOR RESTRICTED ASSETS 4837100 DEFERRED COMPENSATION ASSET 1481900 OTHER ASSETS 10487 DUE FROM AFFILIATES 185000 21807787 ACCRUED PENSION LIABILITY 20507500 DUE TO THIRD PARTIES 4731303 MALPRACTICE LIABILITY 1116800 26355603 106088993 107275603 -1186610 525900 5050884 5576784 4390174 106614900 525900 7 525907 106088993 0 106088993 107275600 0 107275600 3 3 107275603 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: AT DECEMBER 31, 2010, TEMPORARILY RESTRICTED NET ASSETS WERE AS FOLLOWS: BUILDING FUNDS $ 7,425,800 SPECIFIC PURPOSE FUNDS 7,379,000 HOSPITAL PROGRAMS 9,096,700 TOTAL $ 23,901,500 NET ASSETS DESIGNATED AS A BUILDING FUNDS ARE RESTRICTED FOR THE PURPOSE OF CAPITAL ADDITIONS. NET ASSETS DESIGNATED AS SPECIFIC-PURPOSE FUNDS ARE DESIGNATED FOR THE OPERATIONAL SUPPORT OF HOSPITAL-SPONSORED PROGRAMS, INCLUDING COMMUNITY OUTREACH, BEREAVEMENT, AND PALLIATIVE EDUCATION. DURING 2010, NET ASSETS WERE RELEASED FROM DONOR RESTRICTIONS BY INCURRING EXPENSES SATISFYING THE FOLLOWING: MEDIA ADVERTISING $ 1,217,400 PALLIATIVE CARE INSITUTE PROGRAMS 41,300 HOME HEALTH AND HOSPICE PROGRAMS 120,000 WOUND CLINIC 200,000 PASTORAL CARE 80,000 MISCELLANEOUS PROGRAM EXPENSES 240,900 TOTAL $ 1,899,600 PERMANENTLY RESTRICTED NET ASSETS AT DECEMBER 31, 2010, ARE RESTRICTED TO THE FOLLOWING: INVESTMENTS HELD IN PERPETUITY - THE INCOME TO WHICH IS EXPENDABLE TO SUPPORT HEALTH CARE SERVICES $ 850,000 BENEFICIAL INTEREST IN NET ASSETS OF CALVARY FUND, INC. 982,900 TOTAL $ 1,832,900 PERMANENTLY RESTRICTED NET ASSETS ARE ENDOWMENT INVESTMENTS TO BE HELD IN PERPETUITY, THE INCOME OF WHICH IS EXPENDABLE TO SUPPORT HEALTH SERVICES AS IS REPORTED AS NONOPERATING GAINS IN THE STATEMENT OF OPERATIONS. THE BOARD OF DIRECTORS HAS DETERMINED THAT DONOR-RESTRICTED ENDOWMENT FUNDS WILL BE GOVERNED BY SPECIFIC POLICIES WITH THE OBJECTIVE THAT THE ORIGINAL GIFT SHALL BE PROTECTED IN PERPETUITY AS THE ENDOWED CORPUS AND DISTRIBUTIONS WILL NOT BE MADE IF THEY WILL BRING THE VALUE BELOW THAT THRESHOLD. POLICIES HAVE BEEN DEVELOPED REGARDING THE EXPENDITURE OF FUNDS IN ACCORDANCE WITH DONOR-IMPOSED RESTRICTIONS. 1 0 1 X 1 X 1 1 0 1 1 117100 117100 0.00110 821526 821526 0.00780 938626 938626 0.00890 938626 938626 0.00890 16 228979 0 228979 0.00220 1 2000 2000 0.00000 1 5000 5000 0.00000 3 65628 65628 0.00060 21 301607 301607 0.00280 2160800 0 41650838 43843844 -2193006 X 1 1 2 1 CALVARY HOSPITAL INC

1740 EASTCHESTER ROAD BRONX NY 10461

X X X 2 CALVARY HOSPITAL INC (BROOKLYN CAMPUS)

150 55TH STREET BROOKLYN NY 11220

X X X NA 1 0 0 0 0 0 0 0 0 0 0 0 PART I, LINE 3C: CALVARY HOSPITAL, INC. USES THE FEDERAL POVERTY GUIDELINES (FPG) TO DETERMINE ELIGIBILITY FOR DISCOUNTED CARE TO LOW-INCOME PATIENTS. PART I, LINE 6A: CALVARY HOSPITAL, INC. IS REQUIRED TO PREPARE AN ANNUAL COMMUNITY SERVICE PLAN (CSP) A.K.A., THE COMPREHENSIVE COMMUNITY SERVICE PLAN FOR THE NYS DEPARTMENT OF HEALTH. THIS REPORT IS FILED WITH THE NYS DOH. THE COMMUNITY SERVICE PLAN IS AVAILABLE ON THE ORGANIZATION'S WEB SITE (WWW.CALVARYHOSPITAL.ORG). ADDITIONALLY, CALVARY POSTS INFORMATION REGARDING FINANCIAL ASSISTANCE PROGRAMS AND HAS A CALENDAR ON PROGRAMMATIC INFORMATION AS IT BECOMES AVAILABLE REGARDING BEREAVEMENT GROUPS AND SUPPORT NETWORKS ON THE ORGANIZATION'S WEB SITE. PART I, LINE 7: CALVARY HOSPITAL, INC. HAS UTILIZED NET REALIZABLE VALUE OF THE SERVICES RENDERED FOR THE CHARITY CARE AMOUNT LISTED ON PART I LINE 7. CALVARY UTILIZED THE AMOUNT REPORTED IN ITS COST REPORT PREPARED FOR THE NYS DOH. PART I, LINE 7G: CALVARY HOSPITAL, INC. HAS INCLUDED CHARITY CARE SERVICES IN THE AMOUNT OF $117,100 ON THE FORM 990, PART VIII, LINE 2G. THIS AMOUNT IS EXCLUDED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN SCHEDULE H, PART I, LINE 7(F) AS PER THE INSTRUCTIONS.CALVARY HOSPITAL, INC. IS A NOT-FOR PROFIT SPECIALTY HOSPITAL THAT PROVIDES SERVICES FOR THE CARE OF TERMINALLY ILL CANCER PATIENTS. CALVARY HOSPITAL, INC. IS OPERATED IN CONNECTION WITH THE ROMAN CATHOLIC ARCHDIOCESE OF NEW YORK.THE MISSION OF CALVARY HOSPITAL, INC. IS AS FOLLOWS:FROM ITS INCEPTION IN 1899, CALVARY HOSPITAL HAS BEEN FAITHFULLY DEVOTED TO PROVIDING PALLIATIVE CARE TO ADULT PATIENTS IN THE ADVANCED STAGES OF CANCER, ADDRESSING THE SYMPTOMS OF THE DISEASE, NOT ITS CURE. A VOLUNTARY, NOT-FOR-PROFIT HOSPITAL, OPERATED IN CONNECTION WITH THE ARCHDIOCESE OF NEW YORK, CALVARY CONTINUES TO EMBODY THIS TRADITION OF CARING THROUGH THE SERVICES AND PROGRAMS OFFERED BY AND THROUGH THE DEDICATION AND CONCERN SHOWN BY ITS STAFF MEMBERS.THE HOSPITAL WILL CONTINUE TO BE FAITHFUL TO THIS TRADITION THROUGH A TWOFOLD COMMITMENT. CALVARY WILL STRIVE PRIMARILY TO EXPAND ITS PROGRAMS AND SERVICES TO MEET THE EMERGING PHYSICAL, PSYCHOSOCIAL, AND SPIRITUAL NEEDS OF BOTH PATIENTS AND FAMILIES THROUGH THE PROVISION OF ACUTE INPATIENT, OUTPATIENT, HOME CARE, HOSPICE, AND SATELLITE SERVICES. IN ADDITION, THROUGH THE THE PALLIATIVE CARE INSTITUTE, THE HOSPITAL ENDEAVORS TO TRANSMIT TO OTHER HEALTH CARE PROFESSIONALS, THROUGH RESEARCH AND EDUCATION, THE KNOWLEDGE AND COMPETENCE WHICH IT HAS DEVELOPED IN THE CARE OF THE ADVANCED CANCER PATIENT.THROUGH THIS TWOFOLD COMMITMENT, CALVARY HOSPITAL WILL DEEPEN AND STRENGTHEN THE PHILOSOPY OF COMPASSIONATE CARE WHICH HAS BEEN THE CORNERSTONE OF ITS PROGRAM OF SERVICE, AND WILL OFFER TO THOSE IN OUR EXPANDED COMMUNITY AND OTHERS, A TRADITION OF SUCCESSFUL EXPEDRIENCE IN THE CARE OF THE ADVANCED CANCER PATIENT.CALVARY HOSPITAL IS THE ONLY FULLY ACCREDITED ACUTE CARE SPECIALTY HOSPITAL EXCLUSIVELY PROVIDING PALLIATIVE CARE FOR ADVANCED CANCER PATIENTS IN THE UNITED STATES. WITH 225 BEDS IN THE BRONX AND BROOKLYN AND MORE THAN 1029 EMPLOYEES, CALVARY SERVES MORE THAN 5,500 PATIENTS ANNUALLY. CALVARY PROVIDES PALLIATIVE CARE, WHICH IS THE ACTIVE TREATMENT OF THE SYMPTOMS, NOT THE CURE OF THE DISEASE, IN ORDER TO MAKE OUR PATIENTS AS COMFORTABLE AS POSSIBLE. CALVARY'S PROGRAMS INCLUDE INPATIENT CARE, CASE MANAGEMENT, OUTPATIENT CARE, HOSPICE, HOME CARE AND SUPPORT PROGRAMS FOR FAMILIES AND FRIENDS.AS CALVARY APPROACHES THE FUTURE WITH A SENSE OF HOPE AND PROMISE, CALVARY IS EVER MINDFUL OF THE LEGACY OF OUR FOUNDERS, THE WOMEN OF CALVARY, TO PROVIDE COMPREHENSIVE CARE WHILE RECOGNIZING THE INDIVIDUALITY AND DIGNITY OF EVERY PATIENT. AT THE SAME TIME, CALVARY WILL CONTINUE TO DEVELOP NEW PROGRAMS AND SERVICES TO MEET THE NEEDS OF TODAY'S WORLD. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 2160800. PART II: CALVARY HOSPITAL MAKES A NUMBER OF DIFFERENT SUPPORT GROUPS AVAILABLE TO THE COMMUNITY. THESE SUPPORT GROUPS ARE ADVERTISED ON CALVARY HOSPITAL'S WEBSITE, WWW.CALVARYHOSPITAL.ORG, ON ITS CALENDAR OF EVENTS. ALL GROUPS ARE FREE AND ARE OPEN TO THE COMMUNITY.CALVARY HOSPITAL PROVIDES BEREAVEMENT SUPPORT FOR ADULTS WHO HAVE LOST LOVED ONES AT CALVARY HOSPITAL OR CALVARY@HOME, AND THOSE FROM THE COMMUNITY AT LARGE WHO HAVE LOST SOMEONE BECAUSE OF ILLNESS, ACCIDENTS, VIOLENCE, OR ANY OTHER CAUSE. GROUPS ARE OFFERED IN THE BRONX AND BROOKLYN.THE HOSPITAL OFFERS AGE-APPROPRIATE SUPPORT GROUPS FOR CHILDREN, AGES 6 THROUGH 11, AND FOR ADOLESCENTS, AGES 12 TO 18.CALVARY IN TOUCH, A BI-MONTHLY NEWSLETTER ABOUT BEREAVEMENT ISSUES IS AVAILABLE THROUGH THE HOSPITAL'S WELBSITE.THESE COMMUNITY SUPPORT GROUPS INCLUDE BUT ARE NOT LIMITED TO:- SUPPORT GROUPS FOR BEREAVED PARENTS- PRECIOUS MOMENTS SUPPORT GROUP FOR CHILDREN AGES 6 TO 11- TEEN BEREAVEMENT GROUP- DEATH OF A SPOUSE BEREAVEMENT GROUP- DEATH OF A PARENT BEREAVEMENT GROUP- CAMP COURAGEOUS DAY CAMP FOR BEREAVED CHILDRENGROUPS ARE OPEN TO ALL, ARE FREE OF CHARGE, AND ARE LED BY CALVARY HOSPITAL STAFF. REGISTRATION IN ADVANCE OF PARTICIPATION IS REQUIRED.CALVARY HOSPITAL ALSO MAKES AVAILABLE A NUMBER OF DIFFERENT WELLNESS ACTIVITIES TO THE COMMUNITY. THESE WELLNESS ACTIVITIES INCLUDE BUT ARE NOT LIMITED TO YOGA CLASSES AND RECREATIONAL THERAPY.CALVARY HOSPITAL'S THERAPEUTIC RECREATION AND MUSIC THERAPY PROGRAMS WERE CREATED TO GIVE PATIENTS A SENSE OF ACCOMPLISMENT AND TO RELIEVE THE SUFFERING OF OUR OUR PATIENTS AND THEIR FAMILIES. THERAPEUTIC RECREATION ACTIVITIES INCLUDE DRAWING, SCULPTURE, AND CERAMICS PROJECTS; HORTICULTURE; A GAMES AND DISCUSSION HOUR; AND HOLIDAY PARTIES. MUSIC THERAPY OFTEN HELPS SOOTHE PATIENTS AND HELPS THEM FOCUS ON LIFE.OUR BOARD CERTIFIED MUSIC THERAPISTS USE MUSIC THERAPY INTERVENTIONS TO SOOTHE PATIENTS, RELIEVE ANXIETY, REMINISCE, AND EASE PAIN AND SUFFERING. MUSIC THERAPY INTERVENTIONS MAY ALSO PROVIDE RELEASE IN THE LAST HOURS OR MOMENTS OF LIFE. PATIENTS RECEIVING MUSIC THERAPY SOMETIMES WRITE SONGS ASSISTED BY THE MUSIC THERAPISTS TO LEAVE FOR LOVED ONES, OR FIND OTHER WAYS TO OPEN THEIR HEARTS THROUGH MUSIC. OUR CLINICIANS REPORT THAT IN SOME CASES, THE ONLY TIME A PATIENT LAUGHS OR SMILES IS DURING A MUSIC THERAPY SESSION. WE ALSO FIND THAT MUSIC THERAPY IS AVAILABLE AT BOTH INPATIENT LOCATIONS AND IS ALSO ONE OF THE SERVICES WE OFFER THROUGH CALVARY@HOME.IN KEEPING WITH OUR MISSION TO SHARE OUR KNOWLEDGE AND EXPERIENCE WITH OTHERS, CALVARY OFFERS INTERNSHIP PROGRAMS IN THE FOLLOWING AREAS: PALLIATIVE CARE AND MUSIC THERAPY, WHICH IS RECOGNIZED AS A NATIONAL CLINICAL TRAINING SITE BY THE AMERICAN MUSIC THERAPY ASSOCIATION.THROUGH ITS EDDIE HIGGINS SCHOLARSHIP PROGRAM, CALVARY HOSPITAL PROVIDES LEADERSHIP DEVELOPMENT AND TRAINING. THE EDDIE HIGGINS SCHOLARSHIP IS NAMED AFTER A CHERISHED MEMBER OF THE CALVARY FAMILY WHO CAME TO THE HOSPITAL AS A YOUNG BOY. EDDIE WAS HOSPITALIZED INTERMITTENTLY FOR 15 YEARS AT CALVARY UNTIL HIS DEATH IN 1982 AT THE AGE OF 29. EDDIE IS REMEMBERED FOR HIS LOVE OF GOD AND HIS REMARKABLE COURAGE DESPITE HIS ILLNESS. CALVARY HAS GIVEN THE ANNUAL SCHOLARSHIP SINCE 1985.CALVARY HOSPITAL IS VERY ACTIVE IN THE COMMUNITY AND PARTICIPATES IN ANNUAL EVENTS SUCH AS THE COMMUNITY COLUMBUS DAY PARADE AND THE ANNUAL ORCHARD BEACH BREAST CANCER WALK. PART III, LINE 4: THE CALVARY HOSPITAL, INC. AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE REGARDING BAD DEBT.COSTING METHODOLOGY USED FOR BAD DEBT:THE METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED IN LINE 2 IS BASED ON THE HOSPITAL'S COLLECTION/BAD DEBT WRITE-OFF POLICY WHICH STATES THAT ALL REASONABLE EFFORTS WILL BE MADE TO OBTAIN PAYMENTS AND TO SETTLE PATIENT ACCOUNTS RECEIVABLE ON A CONSISTENT BASIS. COLLECTION EFFORTS ARE MADE ON THE NET REALIZABLE AMOUNT. PART III, LINE 8: CALVARY HOSPITAL, INC. HAS REPORTED A SHORTFALL IN PART III SECTION B LINE 7. THE EXPENSES, REVENUES AND SHORTFALL REPORTED IN PART III LINES 5-7 WERE DEVELOPED FROM THE 2010 CALVARY HOSPITAL, INC. COST REPORTS FILED WITH THE NYS DOH AND NATIONAL GOVERNMENT SERVICES (MEDICARE INTERMEDIARY). PART III, LINE 9B: CALVARY HOSPITAL, INC.'S FINANCIAL ASSISTANCE POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE.CALVARY HOSPITAL'S COLLECTION: BAD DEBT WRITE-OFFS POLICY INDICATES THAT ALL REASONABLE EFFORTS WILL BE MADE BY PATIENT ACCOUNTS REPRESENTATIVES TO OBTAIN PAYMENT AND TO SETTLE PATIENT ACCOUNTS RECEIVABLE ON A CONSISTENT BASIS. THE PATIENT ACCOUNTING SYSTEM WILL BEAR ENTRIES OF SUCH ATTEMPTS, INCLUDING THE DATE AND THE REPRESENTATIVE'S INITIALS. ACCOUNTS RESISTING SETTLEMENT MAY BE REFERRED TO A COLLECTION AGENCY. PART V, SECTION A: CALVARY HOSPITAL, INC. IS A NOT-FOR-PROFIT SPECIALTY HOSPITAL THAT PROVIDES SERVICES FOR THE CARE OF TERMINALLY ILL CANCER PATIENTS. ARCHCARE, A NOT-FOR-PROFIT CORPORATION, IS THE SOLE CORPORATE MEMBER OF THE HOSPITAL.THE HOSPITAL HAS TWO LOCATIONS, THE MAIN LOCATION IN THE BRONX, NEW YORK, AND THE BRANCH LOCATION IN BROOKLYN, NEW YORK. THE AUDITED FINANCIAL STATEMENTS FOR CALVARY HOSPITAL, INC. CONTAIN THE OPERATIONS OF BOTH LOCATIONS AND ONE TAX RETURN IS FILED.CALVARY HOSPITAL, INC. IS AFILIATED WITH CALVARY HOLDING COMPANY, INC., A NOT-FOR-PROFIT CORPORATION ORGANIZED UNDER SECTION 402 OF THE NOT-FOR-PROFIT CORPORATION LAW OF THE STATE OF NEW YORK. THE COMPANY IS RECOGNIZED AS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE IRC AND ENGAGES IN CHARITABLE, SCIENTIFIC, AND MEDICAL ACTIVITIES TO SUPPORT CALVARY HOSPITAL AND ITS AFFILIATED ORGANIZATIONS. THIS ENTITY RECEIVES A SEPARATE FINANCIAL STATEMENT AND FILES A SEPARATE TAX RETURN.THE CALVARY FUND, INC. WAS INCORPORATED ON JANUARY 7, 1985, AS A NOT-FOR PROFIT CORPORATION UNDER THE LAWS OF THE STATE OF NEW YORK. THE FUND'S PURPOSE IS TO SOLICIT, ACCEPT AND RECEIVE REAL AND PERSONAL PROPERTY AND TO COLLECT INCOME THEREFROM TO BE APPLIED EXCLUSIVELY FOR ANY HEALTH-RELATED CHARITABLE ORGANIZATION OR CORPORATION AFFILIATED WITH THE ROMAN CATHOLIC ARCHDIOCESE OF NEW YORK. HOWEVER, THE CURRENT AND HISTORIC INTENT HAS BEEN TO PROVIDE EXCLUSIVE SUPPORT TO CALVARY HOSPITAL, INC. THIS ENTITY RECEIVES A SEPARATE FINANCIAL STATEMENT AND FILES A SEPARATE TAX RETURN. PART VI, LINE 2: CALVARY HOSPITAL IS THE ONLY FULLY ACCREDITED ACCUTE CARE SPECIALTY HOSPITAL EXCLUSIVELY PROVIDING PALLIATIVE CARE FOR ADULT ADVANCED CANCER PATIENTS IN THE UNITED STATES, LOCATED IN THE BRONX AND BROOKLYN.CALVARY HOSPITAL USES A VARIETY OF METHODS AND SERVICES TO GATHER COMMUNITY INPUT, ASSESS THE NEEDS OF THE COMMUNITY, AND TO ASSURE INPUT IN THE COMMUNITY SERVICE PLAN. SOME OF THESE METHODS ARE:A. COMMUNITY OUTREACH SERVICES -COMMUNITY OUTREACH SERVICES FUNCTIONS AS A LIAISON WITH THE COMMUNITY, REFERRERS, PHYSICIANS, PATIENTS, AND FAMILIES AND FACILITATES ADMISSION TO CALVARY HOSPITAL. THE DEPARTMENT OUTREACHES THROUGH THE TRI-STATE REGION AND EDUCATES THE HEALTH CARE AND PATIENT COMMUNITIES AS TO THE CONTINUUM OF SERVICES CALVARY PROVIDES (INPATIENT, OUTPATIENT, HOME CARE, HOSPICE, NURSING HOME HOSPICE, AND WOUND CARE). THROUGH ON-SITE VISITS, PUBLIC PRESENTATIONS AND PARTICIPATION IN COMMUNITY AND PROVIDER ACTIVITIES, THE OUTREACH STAFF CONTINUALLY ASSESSES THE NEEDS OF THE COMMUNITY.B. PROFESSIONAL ADVISORY BOARD -THE PROFESSIONAL ADVISORY BOARD WAS ESTABLISHED IN 1992 TO OBTAIN INPUT FROM THE COMMUNITY. THE ADVISORY BOARD MEETS AT LEAST ANNUALLY AND IS COMPRISED OF PHYSICIANS, NURSES, AND SOCIAL WORKERS, REPRESENTING HOSPITALS, AND HOME CARE AGENCIES, AS WELL AS THE COMMUNITY. THIS GROUP HAS CONTRIBUTED A VARIETY OF IDEAS FOR ENHANCING SERVICES TO THE COMMUNITY.C. COMMUNITY PLANNING BOARD -EACH YEAR THE HOSPITAL INVITES THE HEALTH COMMITTEE OF COMMUNITY PLANNING BOARD #11 AND #10 TO VISIT THE HOSPITAL AND MEET WITH SENIOR STAFF.D. OUTREACH REPRESENTATION (OPEN HOUSE) FOR HEALTH CARE PROFESSIONALS -COMMUNITY OUTREACH HOSTS OPEN HOUSES AT BOTH THE BRONX AND BROOKLYN LOCATIONS TO PROVIDE INFORMATION TO AND RECEIVE INFORMATION FROM ITS REFERRERS.CALVARY HOSPITAL, INC. ALSO HAS PUBLIC PARTICIPATION IN THE EXTENDED COMMUNITY THROUGH PARTICIPATION IN:- GREATER NEW YORK HOSPITAL ASSOCIATION- HOSPITAL ASSOCIATION OF NEW YORK STATE- AMERICAN HOSPITAL ASSOCIATION- NEW YORK CITY DEPARTMENT OF HEALTH- NEW YORK STATE DEPARTMENT OF HEALTH- CATHOLIC HEALTHCARE ASSOCIATION- CMSTHROUGH ONGOING PARTICIPATION IN THE GROUPS ABOVE, CALVARY HOSPITAL CONTINUALLY MONITORS THE TRENDS IN THE HEALTHCARE NEEDS OF THE LARGER COMMUNITY. ALTHOUGH THE NATURE OF ITS SERVICES IS LIMITED BY ITS SPECIALIZED MISSION, CALVARY HAS IDENTIFIED A VARIETY OF ACTIVITIES TO PARTICIPATE IN IMPROVING THE HEALTH OF ITS EXTENDED COMMUNITY. PART VI, LINE 3: EACH PERSON REQUESTING CALVARY'S SERVICES MUST BE MADE AWARE OF CALVARY'S UNCOMPENSATED (FREE) SERVICES OR DISCOUNTED SERVICES PROGRAM AS FOLLOWS:1. DISTRIBUTE AN INDIVIDUAL NOTICE TO EACH PERSON WHO IS SEEKING SERVICES ON BEHALF OF HIMSELF OR ANOTHER. THIS NOTICE IS PASSED TO THE INDIVIDUAL USUALLY AT THE POINT OF ADMISSION OR REGISTRATION WHEN FINANCIAL ARRANGEMENTS ARE BEING DISCUSSED. THE "NOTICE OF AVAILABILITY OF UNCOMPENSATED (FREE) SERVICES OR DISCOUNTED SERVICES" IS UPDATED ANNUALLY.2. POST SIGNS PROVIDED BY THE DEPARTMENT OF HEALTH AND HUMAN SERVICES CONSPICUOUSLY IN THE ADMITTING OFFICE, BUSINESS OFFICE, CLINICS, HOME HEALTH AGENCY, AND HOSPICE AREAS. THE SIGNS ARE TO BE IN ENGLISH AND SPANISH. ADDITIONALLY, CALVARY HAS ACCESS TO A LANGUAGE TELEPHONE SERVICE THAT ADDS 58 ADDITIONAL LANGUAGES TO ENGLISH AND SPANISH.3. PUBLISH NOTICE OF HILL-BURTON UNCOMPENSATED SERVICES OBLIGATION ANNUALLY IN LOCAL NEWSPAPER IN SERVICE AREA (NEW YORK TIMES LEGAL). PART VI, LINE 4: CALVARY HOSPITAL'S MAIN CAMPUS IS LOCATED IN THE BRONX, NY. THE BRONX IS CONSIDERED THE PRIMARY COMMUNITY FOR THE PURPOSES OF PUBLIC HEALTH PLANNING, AND 59% OF ITS EMPLOYEES RESIDE IN THE PRIMARY SERVICE AREA. IN ADDITION, AS A TERTIARY REFERRAL CENTER FOR ADVANCED DISEASE, CALVARY HOSPITAL SERVES THE ENTIRE TRI-STATE REGION. THE SECONDARY SERVICE IS DETERMINED BASED ON CURRENT REFERRAL PATTERNS.THE PRIMARY REFERRAL SOURCES FOR ADMISSIONS CONTINUE TO BE THE ACUTE CARE HOSPITALS. CURRENTLY 76% OF ADMISSIONS ARE REFERRED BY HOSPITALS LOCATED WITHIN THE BOROUGHS OF NEW YORK CITY, ROCKLAND, AND WESTCHESTER COUNTIES, LONG ISLAND, AND THE STATES OF NEW JERSEY AND CONNECTICUT. OTHER REFERRAL SOURCES ARE CALVARY HOSPITAL HOME CARE, HOSPICE, AND OTHER HOME CARE AND HOSPICE AGENCIES. CALVARY OUTPATIENT SERVICES, FAMILIES, PHYSICIANS, NURSING HOMES, AND COMMUNITY AGENCIES.IN 2001, CALVARY EXPANDED ITS SERVICES WITH THE OPENING OF CALVARY HOSPITAL - THE BROOKLYN CAMPUS, AT LUTHERAN MEDICAL CENTER. REPORTS FILED WITH STATES PART VI, LINE 7 NY X X 0 1 X X X X 0 1 0 0 0 0 0 0 0 JAMES E INTRONE 0 651968 0 30000 0 113893 0 0 0 8935 0 804796 0 0 MICHAEL J BRESCIA MD 388563 0 20000 0 56254 0 16170 0 7727 0 488714 0 0 0 FRANK A CALAMARI 435335 0 30000 0 403152 0 25670 0 9833 0 903990 0 0 0 CHRISTOPHER COMFORT MD 329230 0 17500 0 64240 0 25670 0 25213 0 461853 0 0 0 RICHARD KUTILEK 251994 0 17500 0 61157 0 25670 0 23053 0 379374 0 0 0 FRANK J LOCAPARRA 24876 0 0 0 105797 0 25670 0 14903 0 171246 0 0 0 ANDREW V GRECO 239600 0 0 0 13261 0 0 0 23438 0 276299 0 0 0 SALLY UMBRO RN 210024 0 0 0 4091 0 23677 0 16348 0 254140 0 0 0 ANTHONY TARANTO 161542 0 0 0 8626 0 20771 0 7726 0 198665 0 0 0 NANCY D'AGOSTINO RN 187830 0 0 0 3665 0 22270 0 24253 0 238018 0 0 0 ROBERT BRESCIA MD 301957 0 17500 0 17929 0 25670 0 7832 0 370888 0 0 0 DEVMANI JAITLY MD 457276 0 0 0 5941 0 25670 0 23213 0 512100 0 0 0 GAIL CHRZANOWSKI MD 260172 0 0 0 4233 0 25670 0 15699 0 305774 0 0 0 OSCAR ALVAREZ PHD 237187 0 0 0 4506 0 25463 0 23213 0 290369 0 0 0 SREENIVASA PATIBANDLA MD 332428 0 0 0 3058 0 25670 0 0 0 361156 0 0 0 PART I, LINE 1A EFFECTIVE JUNE 1, 1998, THE HOSPITAL ESTABLISHED THE CALVARY HOSPITAL SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) TO PROVIDE PENSION BENEFITS FOR WAGES EARNED BY CERTAIN PHYSICIANS AND SENIOR EXECUTIVE STAFF WITH COMPENSATION IN EXCESS OF THE IRS LIMITS AND ALSO ESTABLISHED THE CALVARY HOSPITAL KEY EMPLOYEE SHARE OPTION PLAN (KEYSOP) TO PROVIDE ADDITIONAL AND ALTERNATIVE FORMS OF COMPENSATION TO KEY EMPLOYEES. PRIOR TO 2002, THE HOSPITAL UTILIZED THE KEYSOP TO FUND THE SERP. AS A RESULT OF THE IRS 457 REGULATIONS WHICH WERE ISSUED DURING 2002, THE UTILIZATION OF THE KEYSOP TO FUND THE SERP BECAME UNFEASIBLE. AFTER CONSIDERATION OF VARIOUS REPLACEMENT OPTIONS, IN 2003, CALVARY HOSPITAL CHOSE THE TAX GROSS-UP OPTION, WHEREBY, INDIVIDUAL PARTICIPANTS' DEFERRALS WOULD BE GROSSED-UP TO DUPLICATE THE BENEFITS HE WOULD RECEIVE IN A TAX-DEFERRED ARRANGEMENT AND PAID THEM OUT DIRECTLY TO THE PARTICIPANTS. THE FOLLOWING EXECUTIVES RECEIVED TAX GROSS-UP PAYMENTS IN 2010 IN ORDER TO DUPLICATE A TAX DEFERRED VEHICLE: (THE AMOUNTS WERE CALCULATED BY DELOITTE CONSULTING LLP UTILIZING EXPECTED TAX RATES TO CALCULATE THE NET AMOUNTS.) THE FOLLOWING TAX EXECUTIVES ALSO RECEIVED KEYSOP DIVIDENDS AS TAX GROSS-UP PAYMENTS IN 2010: - FRANK A. CALAMARI - RICHARD KUTILEK THE ORGANIZATION PROVIDED SOCIAL CLUB DUES IN 2010 FOR FRANK CALAMARI AND THE DUES WERE INCLUDED AS TAXABLE COMPENSATION. PART I, LINE 4B THE FOLLOWING CALVARY HOSPITAL OFFICERS PARTICPATE IN A NOW-DEFUNCT SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: FRANK CALAMARI, MICHAEL BRESCIA, FRANK LOCAPARRA, AND RICHARD KUTILEK. FORM 990, PART VI, SECTION A, LINE 6 .THE SOLE MEMBER OF CALVARY HOSPITAL IS ARCHCARE FORM 990, PART VI, SECTION A, LINE 7A THE CALVARY HOSPITAL BYLAWS RESERVE CERTAIN RIGHTS TO ARCHCARE AS THE SOLE MEMBER OF THE HOSPITAL. THESE RIGHTS ARE ENUMERATED IN ARTICLE IV AND INCLUDE THE RIGHT TO AMEND THE HOSPITAL'S BYLAWS AND ORGANIZING DOCUMENTS, APPOINT AND REMOVE BOARD MEMBERS AND APPROVE CERTAIN DECISIONS OF THE HOSPITAL'S BOARD OF DIRECTORS, INCLUDING BUT NOT LIMITED TO, THE ADOPTION OF A STRATEGIC PLAN, ACQUISITION OF ANOTHER ORGANIZATION, REAL ESTATE TRANSACTIONS EXCEEDING A CERTAIN DOLLAR THRESHOLD, ADOPTION OF CRITERIA FOR MANAGED CARE CONTRACTING, AND ADOPTION OF SYSTEM-WIDE MEASURES. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 WAS PRESENTED AND DRAFTS WERE MADE AVAILABLE TO THE BOARD OF DIRECTORS ON 10/05/2011. A COPY OF THE FORM 990 WAS PROVIDED TO EACH MEMBER OF THE CALVARY HOSPITAL BOARD OF DIRECTORS PRIOR TO ITS FILING WITH THE INTERNAL REVENUE SERVICE IN ELECTRONIC FORMAT. FORM 990, PART VI, SECTION B, LINE 12C EACH OFFICER, DIRECTOR, TRUSTEE AND KEY EMPLOYEE IS REQUIRED TO ANNUALLY DISCLOSE ANY CONFLICTS OF INTEREST THAT ARISE BY VIRTUE OF THEIR EMPLOYMENT AND POSITION WITH CALVARY HOSPITAL OR CALVARY FUND. CALVARY MONITORS COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY THROUGH AN ANNUAL QUESTIONNAIRE SUBMITTED TO THESE INDIVIDUALS. POTENTIAL CONFLICTS ARE INVESTIGATED IMMEDIATELY AND, IF ANY ARE UNCOVERED, THERE ARE POLICIES IN PLACE TO ENSURE THAT THOSE INDIVIDUALS RECUSE THEMSELVES FROM PARTICIPATING IN ANY DECISIONMAKING RELATED TO SUCH CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 CALVARY HOSPITAL, INC UNDERTAKES A RIGOROUS PROCESS TO ENSURE THAT THE EXECUTIVE COMPENSATION IT PAYS TO ITS TOP MANAGEMENT OFFICIALS AND ALL OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION IS REASONABLE. IN RELEVANT PART, THE BOARD OF DIRECTORS HAS ESTABLISHED A COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT PERSONS THAT HAVE NO PERSONAL INTEREST IN THE PROPOSED COMPENSATION ARRANGEMENT. THE BOARD OF DIRECTORS USES AN INDEPENDENT COMPENSATION CONSULTANT TO HELP ADVISE ON THE APPROPRIATE COMPENSATION LEVELS FOR THE AFOREMENTIONED INDIVIDUALS. THAT COMPENSATION CONSULTANT WILL USE COMPARABILITY OR BENCHMARKLNG DATA (BASED ON INDUSTRY SURVEYS) THAT DOCUMENTS THE COMPENSATION OF PERSONS HOLDING SIMILAR PERSONS IN SIMILAR ORGANIZATIONS. ONCE THE COMPENSATION CONSULTANT HAS MADE ITS RECOMMENDATIONS, THE CALVARY COMPENSATION COMMITTEE MUST APPROVE THE COMPENSATION, WITHOUT INPUT OR VOTING PARTICIPATION BY THE PERSON WHOSE COMPENSATION IS BEING APPROVED OR BY ANY OTHER INDIVIDUAL WITH A CONFLICT OF INTEREST THE FINAL DETERMINATION IS THEN DOCUMENTED IN COMMITTEE MINUTES THOSE MINUTES WILL CONTAIN THE TERMS OF THE PROPOSED COMPENSATION, THE DECISIONS OF THOSE INDIVIDUALS WHO VOTED ON THE COMPENSATION, AND THE COMPARABILITY DATA THAT WAS RELIED UPON. FORM 990, PART VI, SECTION C, LINE 19 CALVARY HOSPITAL MAKES ITS FORM 990 AVAILABLE TO THE PUBLIC BY RETAINING A COPY AT THE ADDRESS LISTED ON PAGE 1 OF THIS RETURN. ANY INDIVIDUAL REQUESTING A COPY OF THESE DOCUMENTS IS PROVIDED THAT COPY ON THE SAME BUSINESS DAY. THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST AND AT MANAGEMENT'S DISCRETION. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 525,900. PENSION-RELATED ADJUSTMENTS 2,352,000. INTEREST IN NET ASSETS OF CALVARY FUND, INC. 2,699,300. ROUNDING -416. TOTAL TO FORM 990, PART XI, LINE 5: 5,576,784. CALVARY PALLIATIVE CARE NETWORK LLC 1740 EASTCHESTER ROAD BRONX NY 10461 HEALTHCARE NY 0 0 N/A NETWORK INDEPENDENT PRACTICE ASSOCIATION 1740 EASTCHESTER ROAD BRONX NY 10461 HEALTHCARE NY 0 0 N/A CALVARY NETWORK MANAGEMENT SERVICES LLC 1740 EASTCHESTER ROAD BRONX NY 10461 MGMT SERVICES NY 0 0 N/A CALVARY FUND INC 1740 EASTCHESTER ROAD BRONX NY 10461 133259649 FUNDRAISING NY 501(C)(3) LINE 11A, I N/A 0 CALVARY HOLDING COMPANY 1740 EASTCHESTER ROAD BRONX NY 10461 061531426 HOLDING CO NY 501(C)(3) LINE 9 N/A 0 ARCHCARE 155 EAST 56TH STREET FLOOR 2 NEW YORK NY 10022 133896624 HEALTHCARE NY 501(C)(3) LINE 9 N/A 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0