Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions. Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
HEALTHSTAR NETWORK INC
Employer identification number
13-3911773
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the supported organization?
................
11g(i)
No
(ii)
A family member of a person described in (i) above?
......................
11g(ii)
No
(iii)
A 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
No
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of monetary support
Yes
No
Yes
No
Yes
No
(A)
WHITE PLAINS HOSPITAL CENTER
131740130
HOSPITAL
Yes
7,525,748
(B)
LAWRENCE HOSPITAL CENTER
131740110
HOSPITAL
Yes
7,473,292
(C)
NORTHERN WESTCHESTER HOSPITAL
131740118
HOSPITAL
Yes
6,918,067
(D)
PHELPS MEMORIAL HOSPITAL ASSOCIATION
131725076
HOSPITAL
Yes
6,801,018
Total
28,718,125
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
4
Total. Add lines 1 through 3
5
The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included
on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6
Public support. Subtract line 5 from line 4.
Section B. Total Support
Calendar year
(or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
7
Amounts from line 4..
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
11
Total support (Add lines 7 through 10).
12
Gross receipts from related activities, etc. (see instructions)
..................
12
13
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.................................................
Section C. Computation of Public Support Percentage
14
Public support percentage for 2013 (line 6, column (f) divided by line 11, column (f))
.........
14
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2013.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
.......................
b
33 1/3% support test—2012.
If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2013.
If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization
.....................................................
b
10%-facts-and-circumstances test—2012.
If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization
................................................
18
Private foundation.
If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions
.....................................................
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2
Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
6
Total. Add lines 1 through 5.
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c
Add lines 7a and 7b..
8
Public support (Subtract line 7c from line 6.)
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
9
Amounts from line 6...
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
..
13
Total support. (Add lines 9, 10c, 11, and 12.)..
14
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public support percentage for 2013 (line 8, column (f) divided by line 13, column (f))
.........
15
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2013.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
........
b
33 1/3% support tests—2012.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
.....
20
Private foundation.
If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information.
Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2013
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
HEALTHSTAR NETWORK INC
Employer identification number
13-3911773
Return Reference
Explanation
FORM 990, PART I, LINE 1
ORGANZIATION'S MISSION HEALTHSTAR NETWORK INC.'S PRIMARY EXEMPT PURPOSE IS TO SUPPORT THE COMMUNITY BY PROVIDING MANAGEMENT AND SUPPORT SERVICES TO ITS AFFILIATED HOSPITAL ORGANIZATIONS.
FORM 990, PART III, LINE 1
ORGANIZATION'S MISSION HEALTHSTAR NETWORK INC. D/B/A STELLARIS HEALTH NETWORK'S PRIMARY EXEMPT PURPOSE IS TO SUPPORT THE COMMUNITY BY PROVIDING MANAGEMENT AND SUPPORT SERVICES TO ITS AFFILIATED HOSPITAL ORGANIZATIONS: NORTHERN WESTCHESTER HOSPITAL ASSOCIATION, LAWRENCE HOSPITAL CENTER, WHITE PLAINS HOSPITAL MEDICAL CENTER AND PHELPS MEMORIAL HOSPITAL ASSOCIATION.
FORM 990, PART III, LINE 4A
IN AUGUST OF 1996 HEALTH STAR NETWORK, INC. (D/B/A STELLARIS HEALTH NETWORK WAS FORMED BY WHITE PLAINS HOSPITAL CENTER (WHITE PLAINS, NY) AND NORTHERN WESTCHESTER HOSPITAL ASSOCIATION, (MT. KISCO, NY). IN RECOGNITION OF DRAMATIC CHANGES OCCURRING IN THE REGIONAL HEALTH CARE MARKETPLACE, HEALTHSTAR WAS CREATED TO PARTNER LIKE-MINDED HEALTHCARE ENTITIES. THESE ORGANIZATIONS RECOGNIZED THE VALUE OF COLLABORATION, SYNERGY, AND LEVERAGE, AND DETERMINED TO FORM AN ALLIANCE TO IMPROVE HEALTH QUALITY AND PERFORMANCE, AND REDUCE COSTS. STELLARIS HEALTH NETWORK, THE REGION'S FIRST COMMUNITY HOSPITAL NETWORK, EVOLVED OUT OF THE MEMBER ORGANIZATIONS' SHARED VISION TO MAINTAIN LOCAL DECISION MAKING AND DELIVERY OF HIGH QUALITY HEALTH CARE SERVICES. IN MARCH, 1997 LAWRENCE HOSPITAL CENTER (BRONXVILLE, NY) JOINED THE NETWORK AND IN OCTOBER 1997 PHELPS MEMORIAL HOSPITAL ASSOCIATION (SLEEPY HOLLOW, NY) FOLLOWED SUIT. IN 2000, THE NETWORK SPONSORED THE FORMATION OF AN EMERGENCY MEDICAL SERVICE (EMS), WHICH PROVIDES MUNICIPAL PARAMEDIC SERVICES TO NEARLY ONE THIRD OF WESTCHESTER COUNTY, NEW YORK. IN ADDITION, STARNET EMERGENCY SERVICES (TRADE NAME-WESTCHESTER EMS) ALSO PROVIDES AMBULANCE AND RELATED SERVICES FOR THE NETWORK, INDIVIDUAL CLIENTS AND OTHER NON-AFFILIATED INSTITUTIONS. IN 2001, HEALTHSTAR NETWORK, INC. BEGAN OPERATING UNDER THE TRADE NAME OF STELLARIS HEALTH NETWORK. STELLARIS REPRESENTS THE STELLAR LEVEL OF CARE AND SERVICES WE STRIVE TO DELIVER, AND, POETICALLY REFER TO THE GROWING CONSTELLATION OF AFFILIATES IN OUR NETWORK. BASED IN ARMONK, NY, STELLARIS HEALTH NETWORK IS MANAGED BY ARTHUR A. NIZZA, PRESIDENT AND CEO. TOGETHER THE ORGANIZATIONS SET AN AGENDA FOR WORKING TOGETHER TO ACCOMPLISH GOALS THAT, ALONE WOULD BE MORE DIFFICULT (OR IMPOSSIBLE) TO ACHIEVE. AMONG THE MOST IMPORTANT INITIATIVES, THE ORGANIZATION ENVISIONED THE DESIGN AND INSTALLATION OF A HIGH QUALITY INFORMATION TECHNOLOGY INFRASTRUCTURE. OTHER CORE OBJECTIVES INCLUDED REDUCTION OF EXPENSES THROUGH SUPPLY CHAIN CENTRALIZATION INITIATIVES, SHARING OF BEST PRACTICES TO IMPROVE THE QUALITY OF SERVICES AND CLINICAL CARE OFFERED TO OUR PATIENTS. STRATEGIC GOALS FOR STELLARIS INCLUDE COST REDUCTION INITIATIVES SUCH AS SUPPLY CHAIN MANAGEMENT OF CONSOLIDATED BUSINESS FUNCTIONS SUCH AS JOINT INSURANCE PROCUREMENT PROGRAMS, HIPAA COMPLIANCE, THE IMPLEMENTATION OF A STATE-OF-THE-ART INFORMATION SYSTEM AND CLINICAL INITIATIVES SUCH AS THE SPONSORSHIP OF AN EMERGENCY MEDICAL SERVICE (EMS).
FORM 990, PART V, LINE 4B
THE BANK ACCOUNTS LISTED ON PART V, LINE 4(B) ARE RELATED TO THE BUSINESS ACTIVITIES OF THE 100% OWNED SUBSIDIARY, NWLP INSURANCE COMPANY, LTD.
FORM 990, PART VI, SECTION A, LINE 2
JOEL SELIGMAN, JON SCHANDLER, EDWARD DINAN, KEITH SAFIAN, AND SHARON LUCIAN ARE ALSO DIRECTORS OF NWLP INSURANCE COMPANY AND, THEREFORE, HAVE A BUSINESS RELATIONSHIP AS DESCRIBED BY THE IRS FOR FORM 990 REPORTING PURPOSES.
FORM 990, PART VI, SECTION B, LINE 11
HEALTHSTAR NETWORK INC D/B/A STELLARIS HEALTH NETWORK'S FORM 990 FOR THE YEAR ENDING DECEMBER 31, 2013 WAS REVIEWED IN DETAIL BY THE ORGANIZATION'S PRESIDENT/CEO. THE BOARD WAS PROVIDED A PAPER DRAFT OF THE FORM 990 PRIOR TO FILING TO REVIEW AND PROVIDE COMMENTS TO THE ORGANIZATION'S TAX PREPARER DELOITTE TAX LLP AT A BOARD MEETING HELD ON 11/4/2014, WHERE THE FORM 990 WAS PRESENTED.
FORM 990, PART VI, SECTION B, LINE 12C
HEALTHSTAR NETWORK INC. D/B/A STELLARIS HEALTH NETWORK'S CONFLICT OF INTEREST POLICY IS DISTRIBUTED TO OFFICERS AND DIRECTORS ANNUALLY ALONG WITH A QUESTIONNAIRE THAT IS COMPLETED BY ALL OFFICERS AND DIRECTORS IN WHICH THEY ARE ASKED SPECIFIC QUESTIONS AND DISCLOSE INFORMATION REGARDING ACTUAL OR POTENTIAL CONFLICTS BETWEEN STELLARIS AND THEMSELVES OR CERTAIN RELATED PARTIES (AS DEFINED IN THE INSTRUCTIONS TO THE FORM 990). THESE QUESTIONNAIRES ARE COLLECTED AND REVIEWED ANNUALLY TO ENSURE COMPLIANCE WITH STELLARIS' CONFLICT OF INTEREST POLICY.
FORM 990, PART VI, SECTION B, LINE 15
HEALTHSTAR NETWORK INC. D/B/A STELLARIS HEALTH NETWORK ENGAGES AN EXECUTIVE COMPENSATION CONSULTANT TO DETERMINE THE COMPENSATION OF ITS PRESIDENT/CEO AND VICE PRESIDENT/CFO. THE CONSULTANT'S ANALYSIS INCLUDES DATA ON COMPENSATION PAID BY COMPARABLE ORGANIZATIONS AND TO OFFICERS SIMILARLY SITUATED (WITH SAME FUNCTIONS/JOB RESPONSIBILITIES). COMPENSATION IS THEN REVIEWED AND APPROVED BY A SEPARATE COMPENSATION COMMITTEE. OTHER THAN THESE TWO INDIVIDUALS, HEALTHSTAR NETWORK INC. D/B/A STELLARIS HEALTH NETWORK DOES NOT HAVE ANY KEY EMPLOYEES AS DEFINED BY THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION C, LINE 19
HEALTHSTAR NETWORK INC. D/B/A STELLARIS HEALTH NETWORK'S FINANCIAL STATEMENTS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST, AND AT THE DISCRETION OF MANAGEMENT.
FORM 990, PART XI, LINE 9:
NWLP INSURANCE COMPANY GAIN/(LOSS) 8,660,442. CONSULTING INCOME WP RADIOLOGY-PREVIOUSLY REPORTED FOR TAX PURPOSES IN 2012 11,781. ROUNDING 12.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.