2013-11-13T15:55:16-06:00 2012-12-31 232932984 PARENTEBEARD LLC 1650 MARKET STREET SUITE 4500 PHILADELPHIA PA 19103 990 2012-01-01 131740127 ST JOSEPH'S HOSPITAL YONKERS STJO 9143787000 127 SOUTH BROADWAY YONKERS NY 107014006 MICHAEL J SPICER 9143787000 2013-11-12 1 JULIUS GREEN CPA P00350393 2159720701 2012 2016-02-24 21:20:13Z MICHAEL J SPICER 127 SOUTH BROADWAY YONKERS NY 107014006 202463198 0 X WWW.SAINTJOSEPHS.ORG X 1888 NY TO PROVIDE AFFORDABLE MEDICAL CARE TO ITS PATIENTS. 25 23 2161 273 0 0 17188436 25415764 168937686 164173347 302886 213497 8759292 8868179 195188300 198670787 0 0 0 0 127817398 130037686 0 0 175225 67142846 68183227 194960244 198220913 228056 449874 99307133 101073784 94726254 95783578 4580879 5290206 X TO MAKE AVAILABLE OPTIMAL PATIENT CARE WITH CONTINUITY OF SERVICE FOR THE SICK, AND DISABLED AND ALL OTHER WITHOUT REGARD TO RACE, COLOR OR CREED BY MEANS OF PREVENTION, DIAGNOSIS, TREATMENT, REHABILITATION AND/OR HOME CARE FOR HOSPITALIZED AND AMBULATORY PATIENTS AND/OR OTHER HEALTH RELATED FACILITIES. 0 0 37786670 42685070 ANCILLARY SERVICES - THERE WERE 647,593 PROCEDURES INCLUDING RADIOLOGY, LAB, CARDIOLOGY, THERAPY, ETC. IN 2012 29271670 32834669 PSYCHIATRIC INPATIENT & LONG TERM PSYCH - THERE WERE 151 BEDS AVAILABLE FOR THE TREATMENT OF MENTAL PATIENTS, ALCOHOLICS, AND DRUG ADDICTS AND PATIENTS WITH RELATED DISEASES. THIS UNIT HAD 53,309 PATIENT DAYS FOR 2012. APPROXIMATELY 231 MEDICAL PERSONNEL ARE ASSIGNED TO THIS UNIT.THE BREAKDOWN FOR INPATIENT & LONG TERM PSYCH IS AS FOLLOWS: INPATIENT HAD 48,451 PATIENT DAYS AND APPROXIMATELY 227 MEDICAL PERSONNEL. LONG TERM PSYCH HAD 4,858 PATIENT DAYS AND APPROXIMATELY 4 MEDICAL PERSONNEL. 19815012 22984269 MMTP CLINIC. THERE WERE 587,661 VISITS FOR 2012 AND APPROXIMATELY 149 FTE'S. 58474979 73651275 GENERAL SERVICE FACILITIES FOR MEDICAL/SURGICAL PATIENTS (EXPENSES $19,435,374)THE HOSPITAL HAS 149 BEDS AVAILABLE TO THE PUBLIC FOR MEDICAL AND SURGICAL SERVICES IN 2012. THE HOSPITAL HAD 38,569 PATIENT DAYS FOR GENERAL SERVICE. THE HOSPITAL HAS APPROXIMATELY 140 MEDICAL PERSONNEL ASSIGNED TO THIS SERVICE.EMERGENCY SERVICE- (EXPENSES: 13,085,512) THE HOSPITAL HAD 39,509 EMERGENCY VISITS DURING THE YEAR OF WHICH 5,691 ADMITTED INTO THE HOSPITAL. THERE ARE APPROXIMATELY 44 NURSES, AIDES AND PHYSICIANS ASSIGNED.PSYCHIATRIC CLINICS- (EXPENSES: 8,177,078) THERE WERE 67,218 VISITS FOR 2012 AND 56 FTES.OUTPATIENT SERVICES (EXPENSES: 7,555,608) THERE WERE 164,740 VISITS FOR 2012 AND 35 FTES.INTENSIVE CARE UNIT AND CORONARY CARE UNIT- (EXPENSES: 2,666,331) THERE WERE 6 BEDS AVAILABLE. 997 PATIENT DAYS OCCURRED IN 2012 FOR THE COMBINATION OF ICU AND CCU SERVICES. APPROXIMATELY 17 FTES ARE ASSIGNED TO THIS AREA.COMMUNITY SUPPORT SERVICES (EXPENSES: 2,621,303) THERE WERE 5,976 VISITS FOR 2012.RENAL DIALYSIS- (EXPENSES: 2,303,760) THERE WERE 4,548 INPATIENT AND OUTPATIENT TREATMENTS FOR 2012. APPROXIMATELY 12 MEDICAL AND TECHNICAL PERSONNEL ARE ASSIGNED TO THIS UNIT FOR TREATMENT OF KIDNEY DISORDERS.PSYCHIATRIC DAY TREATMENT- (EXPENSES: 1,865,600) THERE WERE 56,761 VISITS IN 2012 AND 17 FTES.PEDIATRIC UNIT- (EXPENSES: 764,413) THERE WERE 4 BEDS AVAILABLE, 164 PATIENT DAYS AND APPROXIMATELY 6 FTES IN 2012. 58474979 73651275 145348331 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 276 0 1 2161 1 0 0 0 0 0 0 0 0 0 0 X 25 23 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X JAMES CURCURUTO CFO 9143787000 127 SOUTH BROADWAY YONKERS NY 107014006 ANDREW J BALINT 1.00 2.00 X 0 0 0 SISTER MARGARET A BRICK 1.00 2.00 X 0 0 0 ERNESTINE CHRISTMAS 1.00 2.00 X 0 0 0 JOAN P CUNNINGHAM 1.00 2.00 X 0 0 0 BARRY M DAVIS 1.00 2.00 X 0 0 0 SISTER JANE IANNUCELLI 1.00 2.00 X 0 0 0 SISTER MIRIAM KEVIN PHILLIPS 1.00 2.00 X 0 0 0 RICHARD J KILSHEIMER 1.00 2.00 X 0 0 0 MICHAEL MCHUGH 1.00 2.00 X 0 0 0 MICHAEL M MINERVA 1.00 2.00 X 0 0 0 CARL E PETRILLO 1.00 2.00 X 0 0 0 SISTER ROSEMARY PETRUCELLI 1.00 2.00 X 0 0 0 STEVEN PONTONE 1.00 2.00 X 0 0 0 WILLIAM T REGAN 1.00 2.00 X 0 0 0 LEONARD N SPANO 1.00 2.00 X 0 0 0 KEVIN M O'CALLAGHAN 1.00 1.00 X 0 0 0 REVEREND SAMI TOTAH 2.00 1.00 X 0 0 0 ALFRED WEISSMAN 1.00 2.00 X 0 0 0 PETER A SMITH 1.00 2.00 X X 0 0 0 DR MARGARET O GRIFFIN PHD 1.00 2.00 X X 0 0 0 JOHN J FLYNN III 1.00 2.00 X X 0 0 0 JAMES J LANDY 1.00 2.00 X X 0 0 0 MICHAEL J SPICER 30.00 5.00 X X 711500 0 194943 BARRY PERLMAN MD 39.00 1.00 X 319425 0 0 JAMES J VENERUSO ESQ 1.00 2.00 X 0 0 0 JAMES CURCURUTO 28.00 7.00 X 380504 0 12013 BERNADETTE KINGHAM-BEZ 35.00 X 381524 0 0 KENNETH PEARSON 28.00 X 163302 0 0 NICHOLAS DEROBERTIS MD 35.00 X 258017 0 0 MELVYN BLEIBERG MD 35.00 X 271372 0 0 RICHARD MILONE MD 35.00 X 332450 0 0 KIM PAGAN 35.00 X 270175 0 0 3088269 0 206956 192 0 1 0 DAVID L ANTENUCCI & SON PLUMBING 216 CHASE AVE YONKERS NY 10703 MAINTENANCE SERVICES 1522959 MED EXCEL ERNER PHY 484 TEMPLE HILL RD NEW WINDSOR NY 12553 MEDICAL SERVICES 1293778 NIXON PEABODY 1100 CLINTON SQUARE ROCHESTER NY 14604 LEGAL SERVICES 824056 YONKERS ATTENDING PHYSICIANS 484 TEMPLE HILL RD NEW WINDSOR NY 12553 MEDICAL SERVICES 745951 EMPIRE GENERAL CONTRACT 74 MAIN STREET TUCHAHOE NY 10707 CONTRACTING SERVICES 696023 41 1135000 22930792 1349972 25415764 INPATIENT 900099 109237276 109237276 CLINIC & PSYCHIATRY 621400 40970213 40970213 EMERGENCY ROOM 900099 6506037 6506037 AMBULATORY SURGERY 621990 6455754 6455754 RENAL 621500 1004067 1004067 164173347 232451 232451 1004951 330744 674207 674207 674207 3442713 3461667 -18954 -18954 -18954 SERVICES SOLD TO N/H 900099 6686223 6686223 PARKING INC(EE,PAT,VIS) 900099 212036 212036 SCHOOL OF RADIOLOGY 611600 194882 194882 1100831 1100831 8193972 198670787 172155283 0 1099740 1636830 1636830 95517220 73691535 21666945 158740 6723572 4690450 2033122 19163977 14785008 4378969 6996087 5397481 1598606 2040460 20134 2020326 151497 151497 13248557 6227758 7011793 9006 284729 284354 375 3042912 1360501 1675720 6691 1758540 1758540 7627347 4449109 3178238 161926 137457 24469 421001 373416 47585 2517148 2517148 5810248 4225133 1585115 1601803 1475917 125886 MEDICAL SUPPLIES 6683603 6683603 PROVISION FOR DOUBTFUL 6434226 6434226 PHARMACEUTICALS 6005895 6005895 NH PURCHASED SERVICES 4033098 4033098 6360237 5357610 1002214 413 198220913 145348331 52697357 175225 10073722 6134773 16555851 16046032 972258 996889 516392 690335 164188849 109311352 48829188 54877497 3944449 3944449 18415273 18383809 99307133 101073784 26019942 27390571 12785000 10460000 27950887 29643611 27970425 28289396 94726254 95783578 X 3258847 3543302 1172032 1596904 150000 150000 4580879 5290206 99307133 101073784 449874 259453 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 150000 150000 150000 150000 150000 150000 1.00000 0 0 12733245 12733245 88171698 57230858 30940840 1974950 1677519 297431 60424451 50402975 10021476 884505 884505 54877497 OTHER RECEIVABLES 2426985 MORTAGE PAYMENT ESCROW 1500000 CAPITAL CAMPAIGN FUND 1368 BOARD DESIGNATED FUND 7865293 MEDICAL MALPRACTICE FUND 2105969 OTHER LIMITED USE ASSETS 798266 DEBT SERVICE RESERVE FUND 3277026 LETTER OF CREDIT/WORKERS COMPENSATION INSURANCE 48455 DUE FROM AFFILIATES 360447 18383809 CAPITALIZED LEASE OBLIGATION 1547812 DUE TO THIRD PARTY PAYORS - NET 17089052 EST LIABILITY SELF-INSURANCE 9158532 ACCRUED ASSET RETIREMENT OBLIGATION 494000 28289396 X 199260984 259453 259453 199001531 -330744 -330744 198670787 198551657 330744 330744 198220913 0 198220913 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: PERMANENTLY RESTRICTED NET ASSETS HAVE BEEN RESTRICTED BY DONOR-IMPOSED STIPULATIONS THAT THEY BE MAINTAINED IN PERPETUITY. IN THE ABSENCE OF DONOR SPECIFICATION THAT INCOME OR GAINS ON DONATED FUNDS ARE RESTRICTED, SUCH INCOME IS REPORTED AS INCOME OF UNRESTRICTED ASSETS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: PART X, LINE 2: THE HOSPITAL IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE HOSPITAL ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN THE FINANCIAL STATEMENTS USING A RECOGNITION THRESHOLD OF MORE LIKELY THAN NOT AS TO WHETHER THE UNCERTAINTY WILL BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. MANAGEMENT DETERMINED THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD. THE HOSPITAL'S FEDERAL EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURNS FOR 2009, 2010 AND 2011 REMAIN SUBJECT TO EXAMINATION BY THE IRS. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSE -330,744. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSE 330,744. 1 1 X 1 X 1 X 1 1 1 0 1 1 7561012 7518169 42843 0.00020 93833037 76250012 17583025 0.09170 101394049 83768181 17625868 0.09190 5792952 2613271 3179681 0.01660 5281797 1815548 3466249 0.01810 11074749 4428819 6645930 0.03470 112468798 88197000 24271798 0.12660 1 4638540 1347597 36670398 28720745 7949653 X 1 1 2 1 ST JOSEPH'S HOSPITAL OF YONKERS NY

127 SOUTH BROADWAY YONKERS NY 10701

X X X 2 ST VINCENT'S HOSPITAL WESTCHESTER

275 NORTH STREET HARRISON NY 10528

X X X ST JOSEPH'S HOSPITAL OF YONKERS NY 1 1 1 150.000000000000 1 300.000000000000 1 X X X X X 1 1 X X X X X 0 0 1 X X 0 0 ST VINCENT'S HOSPITAL WESTCHESTER 2 1 1 150.000000000000 1 300.000000000000 1 X X X X X 1 1 X X X X X 0 0 1 X X 0 0 2 IMMACULATA HALL

90-10 150TH STREET JAMAICA NY 11435

RESIDENTIAL - SUPPORTED HOUSING BISHOP SULLIVAN - ST MARY'S RESIDENCE

1534 PROSPECT PLACE BROOKLYN NY 11213

RESIDENTIAL - SUPPORTED HOUSING PART I, LINE 7: GLOBAL COST TO CHARGE RATIO WAS UTILIZED TO COMPUTE COST OF CHARITY CARE PROVIDED. ALLOWABLE COST DIVIDED BY TOTAL CHARGES PART I, L7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 24, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN IS $6,434,226. PART III, LINE 4: A SUMMARY OF THE PROCESS FOR ESTIMATING THE ULTIMATE COLLECTION OF RECEIVABLES INVOLVES SIGNIFICANT ASSUMPTIONS AND JUDGMENTS. THE HOSPITALS HAVE IMPLEMENTED A MONTHLY STANDARDIZED APPROACH TO ESTIMATE AND REVIEW THE COLLECTIBILITY OF RECEIVABLES BASED ON THE PAYER CLASSIFICATION AND THE PERIOD THE RECEIVABLES HAVE BEEN OUTSTANDING. PAST DUE BALANCES OVER 90 DAYS FROM THE DATE OF BILLING AND OVER A SPECIFIED AMOUNT ARE CONSIDERED DELINQUENT AND ARE REVIEWED INDIVIDUALLY FOR COLLECTABILITY. ACCOUNT BALANCES ARE WRITTEN OFF AGAINST THE ALLOWANCE WHEN MANAGEMENT FEELS IT IS PROBABLE THE RECEIVABLES WILL NOT BE RECOVERED. HISTORICAL COLLECTION AND PAYER REIMBURSEMENT EXPERIENCE IS AN INTEGRAL PART OF THE ESTIMATION PROCESS RELATED TO RESERVES FOR DOUBTFUL ACCOUNTS. IN ADDITION, THE HOSPITALS ASSESS THE CURRENT STATE OF ITS BILLING FUNCTIONS IN ORDER TO IDENTIFY ANY KNOWN COLLECTION OR REIMBURSEMENT ISSUES IN ORDER TO ASSESS THE IMPACT, IF ANY, ON RESERVE ESTIMATES, WHICH INVOLVES JUDGMENT. THE HOSPITALS BELIEVE THAT THE COLLECTABILITY OF ITS RECEIVABLES IS DIRECTLY LINKED TO THE QUALITY OF ITS BILLING PROCESSES, MOST NOTABLY THOSE RELATED TO OBTAINING THE CORRECT INFORMATION IN ORDER TO BILL EFFECTIVELY FOR THE SERVICES PROVIDED. REVISIONS IN RESERVE FOR DOUBTFUL ACCOUNTS ESTIMATES ARE RECORDED AS AN ADJUSTMENT TO PROVISION FOR BAD DEBTS. A SUMMARY OF THE PAYMENT ARRANGEMENTS WITH MAJOR THIRD-PARTY PAYERS FOLLOWS: 1) MEDICARE PAYMENTS. INPATIENT ACUTE CARE SERVICES AND OUTPATIENT SERVICES RENDERED TO MEDICARE PROGRAM BENEFICIARIES ARE PAID AT PROSPECTIVELY DETERMINED RATES. THESE RATES VARY ACCORDING TO A PATIENT CLASSIFICATION SYSTEM THAT IS BASED ON CLINICAL, DIAGNOSTIC, AND OTHER FACTORS. EFFECTIVE OCTOBER 1, 2007, THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) REVISED THE MEDICARE PATIENT CLASSIFICATION SYSTEM. THE NEW MEDICARE SEVERITY ADJUSTED DIAGNOSIS RELATED GROUPS (MS-DRGS) REFLECT CHANGES IN TECHNOLOGY AND CURRENT METHODS OF CARE DELIVERY. CMS HAS EXPANDED THE NUMBER OF DRGS FROM 538 TO 989 AND REQUIRES IDENTIFICATION OF CONDITIONS THAT ARE PRESENT UPON ADMISSION. 2) NON-MEDICARE PAYMENTS. THE NEW YORK HEALTH CARE REFORM ACT OF 1996, AS UPDATED, GOVERNS PAYMENTS TO HOSPITALS IN NEW YORK STATE UNDER THIS SYSTEM, HOSPITALS AND ALL NON-MEDICARE PAYERS, EXCEPT MEDICAID, WORKERS' COMPENSATION AND NO-FAULT INSURANCE PROGRAMS, NEGOTIATE HOSPITAL'S PAYMENT RATES. IF NEGOTIATED RATES ARE NOT ESTABLISHED, PAYERS ARE BILLED AT HOSPITALS ESTABLISHED CHARGES. MEDICAID, WORKER'S COMPENSATION AND NO-FAULT PAYERS PAY HOSPITAL RATES PROMULGATED BY THE NEW YORK STATE DEPARTMENT OF HEALTH ("DOH") ON A PROSPECTIVE BASIS. ADJUSTMENTS TO CURRENT AND PRIOR YEARS' RATES FOR THESE PAYERS WILL CONTINUE TO BE MADE IN THE FUTURE. EFFECTIVE JANUARY 1, 2008 THE DOH UPDATED THE DATA UTILIZED TO CALCULATE THE NYS DRG SERVICE INTENSITY WEIGHTS ("SIWS") IN ORDER TO UTILIZE MORE CURRENT DATA IN DOH PROMULGATED RATES. SIMILAR TYPE OUTPATIENT REFORMS WERE IMPLEMENTED EFFECTIVE DECEMBER 1, 2008. THERE ARE ALSO VARIOUS OTHER PROPOSALS AT THE FEDERAL AND STATE LEVEL THAT COULD, AMONG OTHER THINGS, REDUCE PAYMENT RATES. THE ULTIMATE OUTCOME OF THESE PROPOSALS, REGULATORY CHANGES AND OTHER MARKET CONDITIONS CANNOT PRESENTLY BE DETERMINED. LAWS AND REGULATIONS GOVERNING THE MEDICARE AND MEDICAID PROGRAMS ARE EXTREMELY COMPLEX AND SUBJECT TO INTERPRETATION. AS A RESULT, THERE IS AT LEAST A REASONABLE POSSIBILITY THAT RECORDED ESTIMATES WILL CHANGE BY A MATERIAL AMOUNT IN THE NEAR TERM. THE HOSPITALS HAVE ESTABLISHED ESTIMATES, BASED ON INFORMATION PRESENTLY AVAILABLE, OF AMOUNT DUE TO OR FROM MEDICARE AND NON-MEDICARE PAYERS FOR ADJUSTMENTS TO CURRENT AND PRIOR YEARS' PAYMENT RATES, BASED ON INDUSTRY-WIDE AND HOSPITAL-SPECIFIC DATA. THE HOSPITALS' MEDICARE COST REPORTS HAVE BEEN AUDITED AND FINALIZED BY THE MEDICARE FISCAL INTERMEDIARY THROUGH DECEMBER 31, 2009. ON FEBRUARY 19, 2004, THE SECRETARY OF HEALTH AND HUMAN SERVICES CONFIRMED THAT HOSPITALS CAN PROVIDE DISCOUNTS FOR UNINSURED PATIENTS, WHICH ALLOWED THE HOSPITALS TO IMPLEMENT A DISCOUNT POLICY IN ACCORDANCE WITH STATE LAW. THE HOSPITALS' GOAL WAS TO CREATE A FINANCIAL AID PROGRAM THAT IS CONSISTENT WITH THE MISSION, VALUES AND CAPACITY OF THE HOSPITALS, WHILE CONSIDERING AN INDIVIDUAL'S ABILITY TO CONTRIBUTE TO HIS OR HER CARE. THE HOSPITALS HAVE A DISCOUNT POLICY AND PROVIDES DISCOUNTS TO UNINSURED PATIENTS. UNDER THIS POLICY, THE DISCOUNT OFFERED TO UNINSURED PATIENTS IS REFLECTED AS A REDUCTION TO THE NET PATIENT SERVICE REVENUE AT THE TIME THE UNINSURED BILLINGS ARE RECORDED. NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS AND OTHER SERVICES RENDERED AND INCLUDES ESTIMATED RETROACTIVE REVENUE ADJUSTMENTS DUE TO FUTURE AUDITS, REVIEWS AND INVESTIGATIONS. FEDERAL AND STATE REGULATIONS PROVIDE FOR CERTAIN RETROSPECTIVE ADJUSTMENTS TO CURRENT AND PRIOR YEARS' PAYMENT RATES BASED ON INDUSTRY-WIDE AND HOSPITAL-SPECIFIC DATA. THE HOSPITALS HAVE ESTIMATED THE POTENTIAL IMPACT OF SUCH RETROSPECTIVE ADJUSTMENTS BASED ON INFORMATION PRESENTLY AVAILABLE AND ADJUSTMENTS ARE RENDERED AND ARE ADJUSTED IN FUTURE PERIODS AS ADDITIONAL INFORMATION BECOMES AVAILABLE OR FINAL SETTLEMENTS ARE DETERMINED. AS A RESULT OF SUCH PRIOR YEAR ADJUSTMENT THE 2012 AND 2011 NET PATIENT SERVICE REVENUE INCREASED BY APPROXIMATELY $2,300,000 AND $2,000,000, RESPECTIVELY. AS DISCUSSED ABOVE, THE CURRENT MEDICAID AND MEDICARE PROGRAMS ARE BASED UPON COMPLEX LAWS AND REGULATIONS. NONCOMPLIANCE WITH SUCH LAWS AND REGULATIONS COULD RESULT IN FINES, PENALTIES, AND EXCLUSION FROM SUCH PROGRAMS. THE HOSPITAL IS NOT AWARE OF ANY ALLEGATIONS OF NONCOMPLIANCE THAT COULD HAVE A MATERIAL ADVERSE EFFECT ON THE FINANCIAL STATEMENTS AND BELIEVES THAT IT IS IN COMPLIANCE WITH ALL APPLICABLE LAWS AND REGULATIONS. FOR THE YEARS ENDED DECEMBER 31, 2012 AND 2011, NET INPATIENT REVENUE FOR INDIVIDUAL PAYORS CONSISTED OF THE FOLLOWING: MEDICARE 2012-37%, 2011-42%, MEDICAID 2012-38%, 2011-35%, SELF PAY 2012-1%, 2011-1%, COMMERCIAL, MANAGED CARE AND OTHER 2012-24%, 2011-22%.LINE 2 COSTING METHODOLOGY - THE RATIO OF PATIENT COST TO CHARGE APPLIED TO THE BAD DEBT EXPENSES WAS UTILIZED. THE HOSPITALS ARE LOCATED IN AN IMPOVERISHED AREA IN SOUTHWEST YONKERS, NEW YORK WHICH CONTAINS A LARGE NUMBER OF UNINSURED AND MEDICAID ELIGIBLE PATIENTS. MANY OF THESE PATIENTS ARE INDIGENT AND/OR ILLEGAL IMMIGRANTS WHO ARE UNWILLING TO COOPERATE WITH THE HOSPITALS IN APPLYING FOR GOVERNMENT INSURANCE. AS A RESULT, UNCOLLECTIBLE AMOUNTS ARE RECORDED AS BAD DEBT EVEN THOUGH THESE PATIENTS TYPICALLY DO NOT HAVE THE ABILITY TO PAY DUE TO THEIR SOCIOECONOMIC STATUS. PART III, LINE 8: THE COSTING METHODOLOGY USED FOR ALLOWABLE COSTS IN PART III LINE 6 IS BASED ON THE MEDICARE COSTS INCLUDED IN THE WORKSHEET D SCHEDULES OF THE 2012 MEDICARE COST REPORT. THERE WAS A SURPLUS. PART III, LINE 9B: THE COLLECTION POLICY FOR CHARITY CARE PATIENTS IS THE SAME COLLECTION POLICY FOR THE LARGEST NUMBER OF ITS PATIENTS. THE ORGANIZATION PLANS ON ADOPTING A POLICY IN THE UPCOMING YEAR. ST. JOSEPH'S HOSPITAL OF YONKERS, NY PART V, SECTION B, LINE 12H: THE HOSPITAL LIMITS CHARGES BILLED TO PATIENTS TO THE APPLICABLE MEDICARE PAYMENT RATE FOR INPATIENT SERVICES AND THE MEDICAID PAYMENT RATE FOR EMERGENCY SERVICES. FOR AMBULATORY SURGERY SERVICES, CHARGES BILLED TO PATIENTS ARE LIMITED TO PAYMENTS MADE BY THE INSURANCE PLAN WITH THE LARGEST VOLUME FOR THE SERVICE. ST. VINCENT'S HOSPITAL WESTCHESTER PART V, SECTION B, LINE 12H: THE HOSPITAL LIMITS CHARGES BILLED TO PATIENTS TO THE APPLICABLE MEDICARE PAYMENT RATE FOR INPATIENT SERVICES AND THE MEDICAID PAYMENT RATE FOR EMERGENCY SERVICES. FOR AMBULATORY SURGERY SERVICES, CHARGES BILLED TO PATIENTS ARE LIMITED TO PAYMENTS MADE BY THE INSURANCE PLAN WITH THE LARGEST VOLUME FOR THE SERVICE. ST. JOSEPH'S HOSPITAL OF YONKERS, NY PART V, SECTION B, LINE 20D: THE HOSPITAL LIMITS CHARGES TO FAP-ELIGIBLE INDIVIDUALS TO THE APPLICABLE MEDICAID PAYMENT RATE FOR EMERGENCY SERVICES AND OTHER MEDICALLY NECESSARY SERVICES. PART VI, LINE 2: NEEDS ASSESSMENT - ST. JOSEPH'S IS A PARTICIPANT IN THE HEALTHY YONKERS INITIATIVE WHICH IS A COALITION OF VARIOUS HEALTH CARE PROVIDERS AND SOCIAL SERVICE AGENCIES. THE HEALTHY YONKERS INITIATIVE CONDUCTS PERIODIC FOCUS GROUPS TARGETING BOTH PATIENTS AND THEIR FAMILY MEMBERS TO IDENTIFY UNMET HEALTH CARE NEEDS WITHIN THE COMMUNITY. A RESULT OF A RECENT FOCUS GROUP WAS TO DEVELOP AN INITIATIVE TO EXPAND AND ENHANCE HEALTH CARE SERVICES FOR INDIVIDUALS DIAGNOSED WITH ASTHMA AND/OR NUTRITIONAL DISORDERS. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - ST. JOSEPH'S HOSPITAL MAKES AVAILABLE WRITTEN COMMUNICATIONS IN BOTH ENGLISH AND SPANISH EXPLAINING THE HOSPITAL'S POLICY OF PROVIDING CHARITY CARE AND FINANCIAL ASSISTANCE TO ELIGIBLE PATIENTS. NOTICES ARE POSTED THROUGHOUT THE HOSPITAL IN BOTH ENGLISH AND SPANISH STATING THAT CHARITY CARE AND FINANCIAL ASSISTANCE IS AVAILABLE TO QUALIFYING INDIVIDUALS WHICH INCLUDE A TELEPHONE NUMBER FOR PATIENTS TO CONTACT A FINANCIAL COUNSELOR TO DISCUSS ELIGIBILITY. IN ADDITION, HOSPITAL REPRESENTATIVES INTERVIEW PATIENTS WITHOUT INSURANCE TO DETERMINE IF THEY MAY QUALIFY FOR MEDICAID OR OTHER GOVERNMENTAL INSURANCE PROGRAMS AND WILL ASSIST THEM IN COMPLETING REQUIRED APPLICATIONS. PART VI, LINE 4: COMMUNITY INFORMATION - ST. JOSEPH'S HOSPITAL SERVES A PREDOMINANTLY LOW INCOME, MEDICALLY UNDERSERVED POPULATION WITHIN ITS SERVICE AREA. ST. JOSEPH'S SERVICE AREA POPULATION WHICH INCLUDES SOUTHWEST YONKERS AND THE NORTH BRONX IS A MINORITY ONE WITH ALMOST 1/3 OF THE POPULATION BEING AFRICAN AMERICAN AND ANOTHER 1/3 BEING HISPANIC. MANY OF THE PATIENTS DO NOT HAVE A PRIVATE PHYSICIAN AND USE THE HOSPITAL'S EMERGENCY ROOM AND CLINIC FOR THEIR PRIMARY CARE MEDICAL CARE NEEDS. PART VI, LINE 5: ST. JOSEPH'S HOSPITAL HAS A FAMILY PRACTICE TEACHING PROGRAM WHICH INCLUDES APPROXIMATELY 30 RESIDENTS. THE RESIDENTS SPEND THE MAJORITY OF THEIR TIME PROVIDING MEDICAL CARE UNDER THE SUPERVISION OF FACULTY TO CLINIC PATIENTS MOST OF WHOM EITHER HAVE NO INSURANCE OR ARE MEDICAID PATIENTS. DURING 2012, THE FAMILY HEALTH CENTER, A PRIMARY CARE CLINIC, HAD OVER 29,323 VISITS OF WHICH 84% WERE APPLICABLE TO MEDICAID/MEDICAID HMO AND UNINSURED PATIENTS. PART VI, LINE 6: ST. JOSEPH'S HOSPITAL IS PART OF AN AFFILIATED HEALTH SYSTEM WHICH INCLUDES THE FOLLOWING: SJMC, INC. IS THE PARENT CORPORATION WHICH WAS ESTABLISHED TO COORDINATE, PLAN AND DEVELOP CHARITABLE, EDUCATIONAL AND SCIENTIFIC ACTIVITIES, PROGRAMS AND PROJECTS FOR THE ADVANCEMENT OF QUALITY HEALTH CARE BY AND THROUGH ITS AFFILIATED ENTITIES AND TO PROMOTE AND ADVANCE RELATIONSHIPS AMONG HEALTH CARE INSTITUTIONS AND THE COMMUNITIES THEY SERVE. ST. JOSEPH'S HOSPITAL, YONKERS IS A SUBSIDIARY OF SJMC, INC. IS A 327 BED HEALTH CARE PROVIDER WHICH PROVIDES MEDICAL, PSYCHIATRIC, EMERGENCY AND OUTPATIENT CLINIC SERVICES TO PATIENTS LOCATED THROUGHOUT WESTCHESTER COUNTY AND THE NEW YORK CITY REGION. ST. JOSEPH'S HOSPITAL NURSING HOME OF YONKERS, NEW YORK, INC. IS AN AFFILIATED ENTITY PROVIDING SKILLED NURSING CARE, LONG TERM HOME HEALTH AND ADULT DAY CARE TO PATIENTS. ST. JOSEPH'S HEALTH FUND IS A FUNDRAISING SUBSIDIARY OF SJMC, INC., ITS SOLE BENEFICIARY AND SOLICITS CONTRIBUTIONS FROM THE COMMUNITY FOR USE IN PROMOTING AND/OR EXPANDING HEALTH PROGRAMS AND SERVICES FOR WHICH THERE IS A COMMUNITY NEED. REPORTS FILED WITH STATES PART VI, LINE 7 NY X X X X X 0 1 0 0 0 0 0 0 0 MICHAEL J SPICER 703774 0 0 0 7726 0 194943 0 0 0 906443 0 0 0 BARRY PERLMAN MD 317901 0 0 0 1524 0 0 0 0 0 319425 0 0 0 JAMES CURCURUTO 375000 0 0 0 5504 0 12013 0 0 0 392517 0 0 0 BERNADETTE KINGHAM-BEZ 368000 0 0 0 13524 0 0 0 0 0 381524 0 0 0 KENNETH PEARSON 163302 0 0 0 0 0 0 0 0 0 163302 0 0 0 NICHOLAS DEROBERTIS MD 257501 0 0 0 516 0 0 0 0 0 258017 0 0 0 MELVYN BLEIBERG MD 270580 0 0 0 792 0 0 0 0 0 271372 0 0 0 RICHARD MILONE MD 330905 0 0 0 1545 0 0 0 0 0 332450 0 0 0 KIM PAGAN 269995 0 0 0 180 0 0 0 0 0 270175 0 0 0 PART I, LINE 4B MICHAEL J SPICER AND JAMES CURCURUTO PARTICPATE IN VARIABLE UNIVERSAL EXECUTIVE BONUS LIFE INSURANCE PLANS, BUT NO PAYMENTS WERE MADE IN 2012. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OF THE ORGANIZATION. THE ORGANIZATION HAS A SINGLE MEMBER, THE SISTERS OF CHARITY OF ST. VINCENT DE PAUL OF NEW YORK, WHICH IS A TAX-EXEMPT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A ELECTION OF THE GOVERNING BODY. THE SOLE SINGLE MEMBER, SJMC, INC., ELECTS THE GOVERNING BODY OF THE ORGANIZATION. ALL BOARD MEMBERS HAVE EQUAL VOTING RIGHTS. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF THE GOVERNING BODY THAT REQUIRE APPROVAL BY THE PARENT ORGANIZATION, SJMC, INC. INCLUDE DISPOSITION OF SUBSTANTIALLY ALL OF THE ORGANIZATION'S ASSETS, MERGER OR CONSOLIDATION WITH ANOTHER ENTITY OR SYSTEM, DISSOLUTION OF THE ORGANIZATION, AND CHANGE IN THE CHARACTER OF THE OPERATION OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11 REVIEW PROCESS FOR FORM 990. A DRAFT OF FORM 990 IS COMPLETED BY THE ACCOUNTING STAFF AND PROVIDED TO THE VICE PRESIDENT OF FINANCE FOR REVIEW BY MANAGEMENT. UPON DETERMINATION THAT THE DRAFT IS ACCURATE AND PROPERLY PRESENTS THE STATUS OF THE ORGANIZATION AND AFTER REVIEW BY THE HOSPITAL'S TAX ACCOUNTANTS, A COPY IS PROVIDED TO THE BOARD OF TRUSTEES FOR REVIEW PRIOR TO ISSUANCE. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST FORM ANNUALLY. THE VP OF RISK MANAGEMENT ORGANIZES THE COMPLETION OF THE CONFLICT OF INTEREST STATEMENTS. ANY DISCLOSURE MADE BY AN OFFICER OR TRUSTEE SHALL BE REVIEWED BY ST. JOSEPH'S HOSPITAL, YONKERS BOARD OF TRUSTEES. POTENTIAL CONFLICTS MUST BE RESOLVED AND ANY ACTIONS TAKEN MUST BE DOCUMENTED IN THE BOARD MINUTES. ANY DISCLOSURE MADE BY AN EMPLOYEE SHALL BE REVIEWED BY THE CORPORATE COMPLIANCE COMMITTEE. POTENTIAL CONFLICTS MUST BE RESOLVED BY THE COMMITTEE AND REPORTED TO THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION POLICY THE AMOUNT OF COMPENSATION PAID TO THE HOSPITAL'S CEO, OFFICERS OR KEY EMPLOYEES IS REVIEWED PERIODICALLY BY THE COMPENSATION REVIEW COMMITTEE WHICH IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES. THE AMOUNT OF COMPENSATION IS EVALUATED FOR COMPARABILITY WITH OTHER SIMILAR TYPES OF ORGANIZATIONS USING THE GUIDESTAR COMPENSATION REPORT. FINDINGS OF THE COMPENSATION COMMITTEE ARE REPORTED TO THE BOARD OF TRUSTEES AND DOCUMENTED IN THE MINUTES. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS AVAILABLE FOR PUBLIC INSPECTION. THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. SJMC INC 127 SOUTH BROADWAY YONKERS NY 10701 133497559 PARENT NY 501(C)(3) LINE 7 SRS CHARITY 0 ST JOSEPHS HOSPITAL NURSING HOME YONKERS 127 SOUTH BROADWAY YONKERS NY 10701 132861611 NURSING HOME NY 501(C)(3) LINE 7 SRS CHARITY 0 ST JOSEPHS HEALTH FUND 127 SOUTH BROADWAY YONKERS NY 10701 133833645 FUNDRAISING NY 501(C)(3) LINE 7 SJMC INC 0 SJMC SENIOR HOUSING DEVELOPMENT FUND CO 127 SOUTH BROADWAY YONKERS NY 10701 134103604 SENIOR HOUSING NY 501(C)(3) LINE 7 SJMC INC 0 ST JOSEPHS VENTURE INC 127 SOUTH BROADWAY YONKERS NY 10701 133497550 INACTIVE NY SJMC INC C 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 0 1 1 0 1