TY 2014 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) JAMES BRUDVIG........................................................................ TRUSTEE	1.0 .......................0.0	X			0	0
(2) DENISE GEORGE........................................................................ NDH PRESIDENT	1.0 .......................40.0	X	X		776,907	45,493
(3) SUE CRANE........................................................................ LIFE TRUSTEE	1.0 .......................0.0	X			0	0
(4) LEWIS RUGE........................................................................ LIFE TRUSTEE AND SECRETARY	1.0 .......................0.0	X			0	0
(5) GEORGE VERRILLI MD........................................................................ LIFE TRUSTEE	1.0 .......................0.0	X			0	0
(6) M NADER KAYAL JR MD........................................................................ LIFE TRUSTEE	1.0 .......................0.0	X			0	0
(7) EVAN MELTZER........................................................................ CHAIRMAN	1.0 .......................0.0	X			0	0
(8) WILLIAM CARROLL........................................................................ TRUSTEE	1.0 .......................0.0	X			0	0
(9) SUSAN KOCHANOWSKI PHD........................................................................ SECOND VICE CHAIRMAN	1.0 .......................0.0	X			0	0
(10) JOHN HORISZNY MD........................................................................ TRUSTEE	1.0 .......................0.0	X			0	0
(11) KEVIN M SHEEHAN........................................................................ FIRST VICE CHAIRMAN	1.0 .......................0.0	X			0	0
(12) FRANCIS FLYNN........................................................................ TRUSTEE	1.0 .......................0.0	X			0	0
(13) EDWARD PRUITT........................................................................ TRUSTEE	1.0 .......................0.0	X			0	0
(14) JOHN L MCGUINNESS........................................................................ HQ CEO	1.0 .......................40.0	X	X		1,422,455	19,503
(15) DOUGLAS KROLL MD........................................................................ TRUSTEE	1.0 .......................0.0	X			0	0
(16) KATHERINE BACHER........................................................................ INTERIM ASSISTANT TREASURER	1.0 .......................40.0		X		294,502	16,923
(17) JOHN SABIA MD........................................................................ CMO	0.0 .......................40.0			X	411,776	42,247

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.	(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	15,840	15,840
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ....	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ............	0
4	Benefits paid to or for members ....	0
5	Compensation of current officers, directors, trustees, and key employees ....	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages ....	24,960,447	23,225,752	1,734,695
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	1,140,752	1,019,197	121,555
9	Other employee benefits .......	5,299,941	4,735,196	564,745
10	Payroll taxes ...........	1,898,480	1,696,184	202,296
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	1,250		1,250
c	Accounting ...........	0
d	Lobbying ...........	775		775
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ....	114,510	114,510
12	Advertising and promotion ....	0
13	Office expenses .......	2,074,369	910,564	1,163,805
14	Information technology ......	60,622	59,095	1,527
15	Royalties ..	0
16	Occupancy ...........	1,620,096	1,380,292	239,804
17	Travel ............	44,579	29,935	14,644
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	5,900	5,900
20	Interest ...........	763,549	650,530	113,019
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	4,051,536	3,451,834	599,702
23	Insurance ..............	990,926	844,251	146,675
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	11,237,667	11,237,667	0	0
b	PURCHASED SERVICES	15,413,504	4,281,936	11,131,568	0
c	PHYSICIAN FEES	2,496,314	2,496,314	0	0
d	BAD DEBT	1,968,539	1,968,539	0	0
e	All other expenses	1,974,270	1,352,719	621,551
25	Total functional expenses. Add lines 1 through 24e	76,133,866	59,476,255	16,657,611	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
	1	Cash–non-interest-bearing .............	13,922,211	1	10,581,858
2	Savings and temporary cash investments .........	0	2	0
3	Pledges and grants receivable, net ...........	0	3	0
4	Accounts receivable, net .............	8,222,576	4	8,328,287
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
		0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
		0	6	0
7	Notes and loans receivable, net .............	0	7	0
8	Inventories for sale or use ..............	1,373,643	8	1,474,024
9	Prepaid expenses and deferred charges ..........	647,785	9	933,542
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	100,378,004
b	Less: accumulated depreciation .....	10b	59,870,459	33,682,048	10c	40,507,545
11	Investments—publicly traded securities ..........	4,529,297	11	5,134,253
12	Investments—other securities. See Part IV, line 11 .....	0	12	0
13	Investments—program-related. See Part IV, line 11 .....	0	13	0
14	Intangible assets ...............	0	14	0
15	Other assets. See Part IV, line 11 ...........	14,012,708	15	59,708,795
16	Total assets. Add lines 1 through 15 (must equal line 34)......	76,390,268	16	126,668,304
	17	Accounts payable and accrued expenses .........	6,213,688	17	6,526,457
18	Grants payable .................	0	18	0
19	Deferred revenue ................	0	19	0
20	Tax-exempt bond liabilities .............	11,600,842	20	49,416,574
21	Escrow or custodial account liability. Complete Part IV of Schedule D..	0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	148,656	23	68,475
24	Unsecured notes and loans payable to unrelated third parties ....	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................	9,668,694	25	9,323,460
26	Total liabilities. Add lines 17 through 25.........	27,631,880	26	65,334,966
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	45,074,896	27	53,722,602
28	Temporarily restricted net assets ...........	2,188,088	28	6,115,332
29	Permanently restricted net assets ...........	1,495,404	29	1,495,404
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	48,758,388	33	61,333,338
34	Total liabilities and net assets/fund balances ........	76,390,268	34	126,668,304

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

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.
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Attach to Form 990 or Form 990-EZ.
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Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization

NORTHERN DUTCHESS HOSPITAL

Employer identification number

14-1338467

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.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

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.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations .............................

Provide the following information about the supported organization(s).

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2014

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) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(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) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(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 VI.)..
11	Total support Add lines 7 through 10.

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2014 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2013 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2014. 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 ....................... right arrow

33 1/3% support test—2013. 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 ..................... right arrow

17a

10%-facts-and-circumstances test—2014. 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 VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2013. 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 VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2014

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) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(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) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(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 VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2014 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2013 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2014 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2013 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2014. 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 ....... right arrow

33 1/3% support tests—2013. 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 .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2014

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations....

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed, (ii) the reasons for each such action, (iii) the authority under the organization's organizing document authorizing such action, and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (a) its supported organizations; (b) individuals that are part of the charitable class benefited by one or more of its supported organizations; or (c) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in IRC 4958(c)(3)(C)), a family member of a substantial contributor, or a 35-percent controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part II of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9(a)) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9(a)) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of IRC 4943 because of IRC 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Schedule A (Form 990 or 990-EZ) 2014

Page 5

Part IV

Supporting Organizations (continued)

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (1) a written notice describing the type and amount of support provided during the prior tax year, (2) a copy of the Form 990 that was most recently filed as of the date of notification, and (3) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2014

Page 6

Part V – Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

1. Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6
7	Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2014

Page 7

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2014 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2014	(iii) Distributable Amount for 2014
1 Distributable amount for 2014 from Section C, line 6
2 Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2014:
a From 2009.......X
b From 2010.......X
c From 2011.......X
d From 2012.......X
e From 2013.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2014 distributable amount
i Carryover from 2009 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2014 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2014 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2015. Add lines 3j and 4c.
8 Breakdown of line 7:
a From 2010.......X
b From 2011.......X
c From 2012.......X
d From 2013.......
e From 2014.......

Schedule A (Form 990 or 990-EZ) (2014)

Schedule A (Form 990 or 990-EZ) 2014

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Name of the organization

NORTHERN DUTCHESS HOSPITAL

Employer identification number

14-1338467

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Page 2

Name of organization NORTHERN DUTCHESS HOSPITAL

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Page 3

Name of organization NORTHERN DUTCHESS HOSPITAL

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Page 4

Name of organization
NORTHERN DUTCHESS HOSPITAL

Employer identification number

14-1338467

Part III

Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10)
that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

$
Use duplicate copies of Part III if additional space is needed.

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

If the organization answered "Yes" to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" to Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

NORTHERN DUTCHESS HOSPITAL

Employer identification number

14-1338467

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ................................... SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b.. SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2014

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......
b	Total lobbying expenditures to influence a legislative body (direct lobbying) .......
c	Total lobbying expenditures (add lines 1a and 1b) ...................
d	Other exempt purpose expenditures ........................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ......................................	Yes No

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2014

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? .........................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Other activities? ..........................

Yes

775

Total. Add lines 1c through 1i ...............................

775

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members .....................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ............................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
SCHEDULE C, PART II-B, LINE 1I - LOBBYING ACTIVITIES	A PORTION OF THE NORMET ASSOCIATION DUES, PAID BY NORTHERN DUTCHESS HOSPITAL, WAS USED FOR LOBBYING EXPENDITURES ON BEHALF OF THE HOSPITAL INDUSTRY.

Schedule C (Form 990 or 990EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

NORTHERN DUTCHESS HOSPITAL

Employer identification number

14-1338467

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ....................	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included in Form 990, Part VIII, line 1 ........................ SchDMd Bullet

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2014

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIII and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII .......

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	b (c)Two years back	(d)Three years back	(e)Four years back
1a	Beginning of year balance ....	1,495,404	1,495,404	1,495,404	1,495,404	1,495,400
b	Contributions ........
c	Net investment earnings, gains, and losses
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......	1,495,404	1,495,404	1,495,404	1,495,404	1,495,400

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

100.000 %

Temporarily restricted endowment SchDMd Bullet

The percentages in lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	109,930		109,930
b	Buildings ................	46,203,964	23,709,611	22,494,353
c	Leasehold improvements ............
d	Equipment ................	44,719,733	35,096,437	9,623,296
e	Other .................	9,344,376	1,064,410	8,279,966
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				40,507,545

Schedule D (Form 990) 2014

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)		(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment		(b) Book value	(c) Method of valuation: Cost or end-of-year market value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) DUE FROM AFFILIATES				5,721,402
(2) RETIREMENT INVESTMENTS				152,549
(3) DEFERRED FINANCING				339,264
(4) 2007 SERIES B BONDS PREMIUM				718,232
(5) 2007 DSRF SERIES B BONDS				1,631,600
(6) MISC RECEIVABLES				161,784
(7) ESTIMATED THIRD PARTY ADJMNTS				1,183,508
(8) INTEREST IN NDH FOUNDATION LT				5,759,327
(9) DUE FROM AFFILIATE LT				5,632,517
(10) 2014 SER A BONDS DEF FINANCING				369,695
(11) 2014 SER B BONDS DEF FINANCING				58,339
(12) DSRF 2014 CONSTRUCTION FUND				35,952,763
(13) DSRF 2014 CAP INTEREST				2,027,815
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				59,708,795

Part X

Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability		(b) Book value
Federal income taxes		0
RETIREMENT INVESTMENTS		152,549
FIN 47 LIABILITY		174,955
RETRO PAYABLE TO 3RD PARTY PAY		2,902,549
DUE TO AFFILIATES		149,618
DUE TO HQ L/T		318,779
MED MALPRACTICE INSURANCE LIAB		5,625,010



Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		9,323,460
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2014

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b.......................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d......................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.......................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
SCHEDULE D PART V LINE 4 - ENDOWMENT FUNDS	THE ORIGINAL CONTRIBUTION IS BEING HELD FOR THE BENEFIT OF THE HOSPITAL.

Schedule D (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the TreasuryInternal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

NORTHERN DUTCHESS HOSPITAL

Employer identification number

14-1338467

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...

Yes

If "Yes," was it a written policy? .......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: .........

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............

Did the organization prepare a community benefit report during the tax year? ..........

If "Yes," did the organization make it available to the public? ..............

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) ..			1,731,190	1,164,565	566,625	0.760 %
b	Medicaid (from Worksheet 3, column a) ....			8,712,414	5,692,398	3,020,016	4.070 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .
d	Total Financial Assistance and Means-Tested Government Programs .			10,443,604	6,856,963	3,586,641	4.830 %
Other Benefits		14	4,401	1,881		1,881
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	14	4,401	1,881		1,881
f	Health professions education (from Worksheet 5) ..
g	Subsidized health services (from Worksheet 6) ..
h	Research (from Worksheet 7)
i	Cash and in-kind contributions for community benefit (from Worksheet 8)	2	60	14,520		14,520	0.020 %
j	Total. Other Benefits ..	16	4,461	16,401		16,401	0.020 %
k	Total. Add lines 7d and 7j .	16	4,461	10,460,005	6,856,963	3,603,042	4.850 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2014

Schedule H (Form 990) 2014

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

1,968,539

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

28,530,621

Enter Medicare allowable costs of care relating to payments on line 5.....

33,052,257

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-4,521,636

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2014

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?1 Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	NORTHERN DUTCHESS HOSPITAL 6511 SPRINGBROOK AVENUE RHINEBECK,NY12572 WWW.HEALTH-QUEST.ORG 1327000H	X	X	X

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	NORTHERN DUTCHESS HOSPITAL
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?.......................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C..........

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12....................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public? ..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): WWW.HEALTHQUEST.ORG

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 14

Is the hospital facility's most recently adopted implementation strategy posted on a website? ........

Yes

If "Yes" (list url): WWW.HEALTHQUEST.ORG

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ...........................

12a

If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ......

12b

If "Yes" to line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

	NORTHERN DUTCHESS HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Financial Assistance Policy (FAP)

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.%
and FPG family income limit for eligibility for discounted care of 300.%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application.

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application.

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process.

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications.

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?.......

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url): X

The FAP application form was widely available on a website (list url):

A plain language summary of the FAP was widely available on a website (list url):

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

	NORTHERN DUTCHESS HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility or other authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?.........

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Section C)

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ................................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2014

Page

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
PART V, SECTION B, LINE 5	Northern Dutchess Hospital was part of the Integrated Community Assessment Workgroup (ICA) which consists of individuals from Dutchess County Department of Health, Dutchess County Community and Family Services, Dutchess County Department of Mental Hygiene, Dutchess County Department of Probation, Dutchess County Department of Planning & Development, Dutchess County Office for the Aging and Dutchess Country Veterans Services, as well as the Mental Health Association, the Dyson Foundation, the Foundation for Community Health, Health Quest and the Mid-Hudson Regional Medical Center (formerly Saint Francis Hospital).
PART V, SECTION B, LINE 6A	The NDH CHNA was conducted in conjunction with Vassar Brothers Medical Center and the Mid-Hudson Regional Medical (formerly Saint Francis Hospital).
PART V, SECTION B, LINE 6B	Northern Dutchess Hospital was part of the Integrated Community Assessment Workgroup (ICA) which consists of individuals from Dutchess County Department of Health, Dutchess County Community and Family Services, Dutchess County Department of Mental Hygiene, Dutchess County Department of Probation, Dutchess County Department of Planning & Development, Dutchess County Office for the Aging and Dutchess Country Veterans Services, as well as the Mental Health Association, the Dyson Foundation, the Foundation for Community Health, Health Quest and the Mid-Hudson Regional Medical Center (formerly Saint Francis Hospital).
PART V, SECTION B, LINE 7D	The CHNA was also printed and distributed throughout the hospital, including the main lobby, patient waiting areas and hospital administration.
PART V, SECTION B, LINE 11	Dutchess County identified four priority areas: 1) reduce childhood obesity, 2) increase access to preventative healthcare and improve management of chronic disease, 3) reduce tick and insect-related disease and 4) reduce substance abuse. NDH elected to focus on vaccination of preventable diseases and tick and insect-borne illnesses. NDH did address obesity and management of chronic diseases through a formal pre-diabetes program, and a robust program of support groups and lectures designed to improve management of chronic disease. The pre-diabetes program launched in 2014 has been so successful that NDH has been identified as a model program for other organizations, and will be used as a reference to other hospitals. There was one session in 2014, and they already have a waiting list for the third session in 2015. Substance abuse was not a priority at the time because the Mid-Hudson Regional Medical Center (formerly Saint Francis Hospital) had licensed substance abuse beds. Vaccination of preventable diseases - NDH focused on education and prevention of the flu among all patients, staff and physicians, especially those 65 and older. They partnered with the Health Quest Medical Practice (HQMP) and Urgent Care locations to promote convenient locations for flu shots. A formal advertising, radio, web and social media campaign kicked off the season with reminders. Internally 91% of employees, 98% of volunteers and 70% of providers received vaccinations, increasing the overall rate to 87% (from 83%, all ages). When developing our implementation strategy, we anticipated coordination with local pharmacies to help us develop baseline information in the community. We ran into multiple roadblocks here with the data available and sales of independent pharmacies to chains, making the information difficult to obtain. We will alter our plan here slightly and will revise for next assessment. Tick and insect-borne illnesses - Due to the extremely high levels of Lyme Disease in our community, NDH identified this as an area of focus. Again, in partnership with HQMP and Health Quest Urgent Care, NDH worked to increase patient education on the disease. Educational posters were hung in the emergency room and every emergency room discharge had received the NYS DOH Guide for Preventing Lyme Disease.

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?
Name and address		Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2014

Page

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
PART I, LINE 6A	NORTHERN DUTCHESS HOSPITAL PREPARED A COMMUNITY SERVICE PLAN IN 2013, AND INITIATED THE IMPLEMENTATION STRATEGIES IN 2014, AND WILL CONTINUE INTO 2015 AND 2016.
PART I, LINE 7 COLUMN F	TOTAL BAD DEBT EXPENSE - $1,968,539
PART I, LINE 7	THE COST TO CHARGE RATIO PERCENTAGE, BASED ON THE MEDICARE COST REPORT, WAS USED AS THE COSTING METHODOLOGY IN DETERMINING THE AMOUNTS REPORTED.
PART III, SECTION A, LINE 2, 3 AND 4	LINE 2 - NDH FOLLOWS GENERALLY ACCEPTED ACCOUNTING PRINCIPLES IN ITS RECOGNITION OF BAD DEBT EXPENSE. PATIENT ACCOUNT BALANCES WERE ONLY CONSIDERED FOR BAD DEBT AFTER APPLYING ALL CONTRACTUAL DISCOUNTS AND PAYMENTS, AND SCREENING FOR CHARITY ELIGIBILITY. LINE 3 - NDH DOES RECOGNIZE THAT THERE WAS SOME BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO WERE ELIGIBLE UNDER THE ORGANIZATION'S CHARITY POLICY. WE DID NOT HAVE A REASONABLE BASIS FOR ESTIMATING THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY. PATIENTS WHO WERE ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY WERE ACCOUNTED FOR UNDER CHARITY CARE RATHER THAN BAD DEBT. LINE 4 - FOOTNOTE ON AUDITED FINANCIALS - THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE CAN BE FOUND ON PAGE 14 OF THE HEALTH QUEST SYSTEMS CONSOLIDATED AUDITED FINANCIAL STATEMENTS. FEDERAL AND STATE LAW REQUIRES THE HOSPITALS TO PROVIDE EMERGENCY SERVICES REGARDLESS OF A PATIENT'S ABILITY TO PAY. UNINSURED PATIENTS SEEN IN THE EMERGENCY DEPARTMENT, INCLUDING PATIENTS SUBSEQUENTLY ADMITTED FOR INPATIENT SERVICES, OFTEN DO NOT PROVIDE INFORMATION NECESSARY TO ALLOW THE COMPANY TO QUALIFY SUCH PATIENTS FOR CHARITY CARE. UNCOLLECTIBLE AMOUNTS DUE FROM SUCH UNINSURED PATIENTS REPRESENT THE SUBSTANTIAL PORTION OF THE PROVISION FOR BAD DEBTS REFLECTED IN THE ACCOMPANYING CONSOLIDATED STATEMENTS OF OPERATIONS.
PART III, SECTION B, LINE 8	THE MEDICARE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT BECAUSE THE ORGANIZATION IS RELIEVING A GOVERNMENT BURDEN BY PROVIDING CARE IN EXCESS OF THE COMPANY'S COSTS FOR THE PATIENTS IN THE COMMUNITY. THE COSTING METHODOLOGY USED TO CALCULATE THE SHORTFALL WAS THE COST TO CHARGE RATIO FROM THE MEDICARE COST REPORT.
PART III, SECTION C, LINE 9B	BEFORE A DELINQUENT ACCOUNT WAS REFERRED TO A COLLECTION AGENCY, THE ACCOUNT WAS REVIEWED TO DETERMINE WHETHER THE PATIENT QUALIFIED FOR CHARITY CARE, OR FINANCIAL ASSISTANCE UNDER OUR CHARITY CARE POLICY. IF IT WAS DETERMINED THAT THE PATIENT WAS ELIGIBLE FOR CHARITY CARE, OR FINANCIAL ASSISTANCE, THE ACCOUNT WAS ADJUSTED TO CHARITY, AND WAS NOT PURSUED WITH A COLLECTION AGENCY. IF A PATIENT APPEALLED THE DETERMINATION, THE ACCOUNT WAS NOT REFERRED TO A COLLECTION AGENCY UNTIL A FINAL DETERMINATION HAD BEEN MADE WITH RESPECT TO THE APPEAL. PATIENTS STILL HAD THE OPPORTUNITY TO APPLY FOR A DISCOUNT UNDER THE CHARITY CARE POLICY EVEN AFTER THE ACCOUNT HAD BEEN SENT TO A COLLECTION AGENCY.
PART VI LINE 2 NEEDS ASSESSMENT	Northern Dutchess Hospital participated in community needs assessments and community health improvement plans with the Dutchess County Department of Health. The Integrated Community Assessment Workgroup (ICA) was established in 2008 by the Integrated Community Planning Workgroup (ICP) to implement a countywide integrated assessment. Its goal is to examine the local health and human services system including all aspects of the local environment - i.e. physical, legal, social, economic, and health. The assessment was achieved by conducting a survey reaching out to a representative sample of Dutchess County residents. The ICP consists of health and human services public agency representatives, and the ICA consists of a smaller group of individuals from the lead agencies - Dutchess County Department of Health, Dutchess County Community and Family Services, Dutchess County Department of Mental Hygiene, Dutchess County Department of Probation, Dutchess County Department of Planning & Development; Dutchess County Office for Aging, Dutchess County Veterans Services; as well as the Mental Health Association, the Dyson Foundation, the Foundation for Community Health, Health Quest, and Mid-Hudson Regional Medical Center (Formerly St Francis Hospital). The ICP has been building upon other community assessment data, including the Many Voices One Valley Report, a project of the Dyson Foundation and the Marist College Institute for Public Opinion to examine residents' priorities for the Mid-Hudson Region (http://www.manyvoicesonevalley.org/). Several independent assessments have been conducted over the years, notably: o An annual countywide data document capturing available economic, educational and health data that impact children, youth, families and adults o A community health assessment report issued every three years for selected indicators In 2009, the County issued its first systematic and integrated assessment, accomplished via survey administration to a representative sample of Dutchess County residents. The results of the 2009 integrated assessment have fed the strategic planning process of each department involved, as well as the ICP. It also ensures that the Health and Human Services planning process is responsive to community strengths and needs and results in a plan that can be implemented successfully, where clear indicators can be tracked and benchmarked. In 2012, members of the ICA reviewed the questions from the 2009 survey. While some questions were discarded and/or added, care was taken to insure that survey results would be compatible with the 2009 results for trending purposes. Once the survey questions were finalized, the group issued an RFP and retained a firm to conduct the survey. The firm made 11,227 calls between November 31, 2012 and January 18, 2013. They achieved a 10% response rate, including both land lines and cell phones. The raw data was submitted to the Dutchess Department of Health, where it was analyzed and compiled by their epidemiologist. On September 17, 2013, the Dutchess County Department of Health hosted a county-wide Community Health Improvement Plan Design Forum. The purpose of the forum was to review the results of the recent survey and develop a locally relevant, comprehensive action plan to improve the health and lives of the residents of Dutchess County. Representatives from various agencies attended, including staff, management and physician representation from Health Quest, VBMC and NDH. As a result of the survey and subsequent analysis, Dutchess County identified the following four priority areas: 1. Reduce Childhood and Adult Obesity 2. Increase Access to Preventative Healthcare and Improve Management of Chronic Disease 3. Reduce Tick and Insect-related Diseases 4. Reduce Substance Abuse While insect-related disease does not appear to fit into any of New York State's Preventive Agenda categories, it was by far the biggest health concern for Dutchess County residents who responded to the survey. We have, in order to be consistent with the Prevention Agenda structure, considered it to be in the Safe and Healthy Environment category. Northern Dutchess Hospital: Three Year Plan of Action 1. Vaccinate Preventable Diseases - Decrease the Burden of Influenza: In choosing its first initiative, Northern Dutchess Hospital deviated slightly from the DCDOH priorities. NDH is a small hospital (68 beds) with limited resources. In NDH's service area, 18% of its population is over 65, a number projected to rise to 23% in the next 10 years. NDH has a strong focus on caring for the senior community, with its affiliated 100-bed skilled nursing facility, its Center for Health Aging, and its commitment to orthopedic and rehabilitative services. The hospital itself is a hub for senior activity and a natural location for outreach to the senior population. While the most recent rates of immunization available meet the NYS 2017 objective, the county lags behind the statewide rate. NDH's implementation plan is designed to build on its existing policy of screening and immunizing all inpatients by expanding screening efforts to the emergency department. It will also gauge the need for community flu clinics, which appear to be less in demand due to inexpensive vaccines being offered by pharmacies. Priority Area: Vaccinate Preventable Diseases Goal: Decrease the burden of influenza disease Increase flu immunization rates by 10%. Disparity: Increase flu immunization rates among residents 65 and older by 10%. Performance Measures Objective 1: Increase screening and vaccination of NDH patients by targeting outpatients The indicators are listed below followed by the source to which it will be measured. Percentage of NDH patients vaccinated for influenza will increase by 20% over three years Internal data Objective 2: Increase community awareness of benefits of vaccine and community resources to receive vaccinations The indicators are listed below followed by the source to which it will be measured. Attendance at community flu clinics will rise 10% over baseline (dependent on community need) over three years Internal data, Regional pharmacy data Action Plan Objective 1 Listed below are the activities, target date of implemenation and any partners. Determine baseline % of NDH patients who have received the flu vaccine 4/31/2014 None required Enact protocols to screen all ED admits for vaccination and provide vaccine according to state recommendations 12/31/2013 VBMC, PHC, DCDOH Increase the percentage of patients who receive the vaccine by 8% 12/31/2014 DCDOH Increase the percentage of patients who receive the vaccine by 14% over baseline (cumulative) 12/31/2015 DCDOH Increase the percentage of patients who receive the vaccine by 20% over baseline (cumulative) 12/31/2016 DCDOH Objective 2 Listed below are the activities, target date of implementation and any partners. Develop at least one patient education campaign in year one 12/31/2014 DCDOH Develop at least one patient education campaign in year two 12/31/2015 DCDOH Develop at least one patient education campaign in year three 12/31/2016 DCDOH Provide outreach to senior groups through lectures, mailings and other forums. Ongoing DCDOH, Office of the Aging, Dutchess Connect Hold at least one community flu clinic in year one (determine baseline attendance) 12/31/2014 DCDOH Collaborate with community partners to offer flu clinics focused on the elderly. 12/31/2014 DCDOH, Office of the Aging, Dutchess Connect Hold at least one community flu clinic in year two, with attendance = 5% over baseline 12/31/2015 DCDOH Hold at least one community flu clinic in year three, with attendance = 10% over baseline 12/31/2016 DCDOH 2. Lyme and Other Insect-Borne Diseases: Dutchess County residents have significantly higher rates of tick-borne diseases than NYS residents overall. In both the 2009 and 2012 Dutchess Community Surveys, Lyme disease and other insect-related diseases were identified by two thirds of respondents as the top environmental concern. While VBMC's initiative focuses on education of providers, NDH will focus on education of the patient. This two-pronged approach is hoped to have a positive impact on awareness and treatment. Priority Area: Promote a Healthy and Safe Environment Goal: Prevent Tick-Borne Diseases in Dutchess County. Promote Use of Evidence-based Care to Manage Insect-borne Disease. Performance Measures Objective 1: Educate NDH patients on tick attachment prevention and treatment options Indicator and Source 90% of people attending educational events will demonstrate increased knowledge of subject matter Pre and post testing Action Plan Objective 1 Listed below are the activities, target date and partners for implementation. Collaborate with DCDOH staff to create or adopt informational pamphlet for patients 12/31/2014 DCDOH, Tick Task Force Develop protocol to disseminate information to all ED patients during tick season 12/31/2013 DCDOH, Tick Task Force Cond
PART VI LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	We have a Health Quest wide financial assistance policies and procedures that has been in place at each hospital. The HQ Financial Assistance policy/worksheet is displayed on the back of each patient statement, there are financial assistance posters hanging within the registration areas, and the HQ Financial Assistance policy is displayed on the HQ website. In addition, the financial counselors, at each hospital, attempt to contact each self-pay patient to screen the patient for Financial Assistance and make the patient aware of their options. The folder given to each patient in the ED contains literature about the financial assistance policy. Our customer service reps are all educated on the Financial Assistance policy and explain this to the patients if they ask.
PART IV LINE 4 COMMUNITY INFORMATION	Northern Dutchess Hospital's service area includes Dutchess County from Hyde Park north. It also includes several adjacent zip codes in Ulster County and some of the southernmost towns in Columbia County to the north. Like the neighboring VBMC service area, population growth is projected to be limited to people aged 65 and older.
PART IV LINE 5 PROMOTION OF COMMUNITY HEALTH	NDH is a 68-bed community hospital. Its board of trustees is composed of prominent citizens who live and work in the community. Medical staff privileges in the hospital are available to all qualified physicians in the area, consistent with the size and nature of the facility. The hospital has 55 doctors on its active staff and 155 doctors on its courtesy staff. NDH currently rents space in its hospital to physicians. NDH is scheduled to open a medical office building with additional space for doctors in early 2016. Any member of its active medical staff has the privilege of leasing available office space. Rent is derived from a fair market value analysis provided by an independent party. The hospital operates a 24 hour emergency room where no one requiring medical attention is denied care. Any income over expenses is reinvested into the hospital, its staff and the community. NDH realizes this is necessary to achieve and maintain high quality standards, keep up with the rapid advancement in technology, provide start-up capital for new programs, and expand existing facilities and programs in order to provide quality care to the community.
PART VI LINE 6 AFFILIATE HEALTH CARE SYSTEM	Health Quest is a nonprofit organization dedicated to the wellbeing of the communities it serves. Health Quest was formed through an affiliation of three local hospitals: Northern Dutchess Hospital (Rhinebeck, NY), Putnam Hospital Center (Carmel, NY) and Vassar Brothers Medical Center (Poughkeepsie, NY). In addition to the hospitals and their foundations, Health Quest also counts among its many partners long-term care facilities, a free-standing radiation oncology center, a cardiology center, urgent care centers, a multi-specialty medical practice, a skilled nursing facility, and a home care service. Together, they provide the healthcare needs of the entire region. Health Quest hospitals meet on a regular basis with community agencies and stakeholders. Each hospital has a board comprised of staff and community members who oversee the Community Health Needs Committee. Each committee oversees the development of community health needs assessments and health improvement plans. Health Quest employees serve as leaders in the promotion of community health. Many regularly venture into the community to provide both educational lectures and health screenings to encourage preventative medicine. Throughout the year, Health Quest actively sponsors a number of health-related fundraisers for other nonprofit organizations, including regional chapters of the American Heart Association, American Cancer Society and Alzheimer's Association. Employees are also active members of their communities volunteering and serving on the local boards of various agencies, in addition to performing public benefit outreach initiatives on behalf of Health Quest. In 2014, Health Quest also launched a fitness challenge partnering with the Walkway Over the Hudson to offer the public the Get Fit initiative in both the spring and fall. The program urged residents to walk, bike and/or run for at least 30 minutes as many times as possible on the Walkway during the six-week challenge. Health Quest also partners with physicians who are on the medical staff at the three hospitals to offer public lecture series in the spring and fall. The seminars engage participants on a variety of medical topics from prevention to the latest treatment options and to learn from leading doctors in their field.
PART VI LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT - NEW YORK

Schedule H (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization
NORTHERN DUTCHESS HOSPITAL

Employer identification number
14-1338467

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section if applicable	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) AMERICAN HEART ASSOCIATION 301 MANCHESTER ROAD SUITE 105 POUGHKEEPSIE,NY12603	13-5613797	501(c)3	6,000	RESEARCH AND DEVELOPMENT OF CARDIAC PROGRAMS

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2014

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a)Type of grant or assistance	(b)Number of recipients	(c)Amount of cash grant	(d)Amount of non-cash assistance	(e)Method of valuation (book, FMV, appraisal, other)	(f)Description of non-cash assistance

Part IV

Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Return Reference

Explanation

PART 1 LINE 2

Sponsorship Policy: Y Criteria for Sponsoring a Community Organization: Health Quest (HQ) recognizes the value and benefits of sponsoring other community organizations throughout the year. The following section outlines the criteria for when it is appropriate to do so: Marketing Opportunity - Health Quest will sponsor community events when the benefits provided to our organization allow for a significant amount of marketing, name recognition and general publicity. The desired amount of marketing for HQ will determine the sponsorship level chosen. Relative to Healthcare - Health Quest will sponsor organizations and their events that directly relate to our mission as a healthcare system. HQ Executive is a member of the Organization's Board - Health Quest will sponsor community events when our Executives serve on the organization's board and feel it is of value to provide support to them. The Honoree of the Event is Linked to HQ - Health Quest will sponsor community events when the honoree(s) of the event are directly related to Health Quest (ie: one of our employees, board members, etc.)

Schedule I (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" to Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

NORTHERN DUTCHESS HOSPITAL

Employer identification number

14-1338467

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....

Yes

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Yes

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ................

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2014

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column(B) reported as deferred in prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1DENISE GEORGENDH PRESIDENT	(i) (ii)	0 ............................... 354,396	0 ............................... 393,023	0 ............................... 29,488	0 ............................... 15,600	0 ............................... 29,893	0 ............................... 822,400	0 ............................... 15,300
2JOHN SABIA MDCMO	(i) (ii)	0 ............................... 382,741	0 ............................... 29,035	0 ............................... 0	0 ............................... 15,600	0 ............................... 26,647	0 ............................... 454,023	0 ............................... 15,300
3CONNIE REGANPHARMACY CLINICAL COORDINATOR	(i) (ii)	178,231 ............................... 0	0 ............................... 0	0 ............................... 0	11,593 ............................... 0	17,547 ............................... 0	207,371 ............................... 0	11,046 ............................... 0
4BOGUMILA LANGPHARMACIST	(i) (ii)	138,115 ............................... 0	0 ............................... 0	0 ............................... 0	9,049 ............................... 0	23,382 ............................... 0	170,546 ............................... 0	8,326 ............................... 0
5MICHAEL T WEBERFORMER CEO	(i) (ii)	0 ............................... 0	0 ............................... 0	0 ............................... 817,449	0 ............................... 0	0 ............................... 0	0 ............................... 817,449	0 ............................... 15,300
6MARYANN KEPPLEFORMER TREASURER	(i) (ii)	0 ............................... 124,022	0 ............................... 225,000	0 ............................... 430,199	0 ............................... 15,600	0 ............................... 1,476	0 ............................... 796,297	0 ............................... 15,300
7TIMOTHY GOVELPHARMACIST	(i) (ii)	143,839 ............................... 0	0 ............................... 0	0 ............................... 0	8,760 ............................... 0	708 ............................... 0	153,307 ............................... 0	1,592 ............................... 0
8TIM CLEARYFORMER INTERIM PRESIDENT/COO	(i) (ii)	0 ............................... 211,049	0 ............................... 31,071	0 ............................... 7,107	0 ............................... 14,527	0 ............................... 26,657	0 ............................... 290,411	0 ............................... 15,300
9JOHN L MCGUINNESSHQ CEO	(i) (ii)	0 ............................... 1,206,923	0 ............................... 0	0 ............................... 215,532	0 ............................... 0	0 ............................... 19,503	0 ............................... 1,441,958	0 ............................... 0
10KATHERINE BACHERINTERIM ASSISTANT TREASURER	(i) (ii)	0 ............................... 281,113	0 ............................... 12,893	0 ............................... 496	0 ............................... 15,600	0 ............................... 1,323	0 ............................... 311,425	0 ............................... 0
11SANDRA HELMESLEAD DIAGNOSTIC MED SONOGRAPHE	(i) (ii)	143,213 ............................... 0	0 ............................... 0	0 ............................... 0	8,600 ............................... 0	8,857 ............................... 0	160,670 ............................... 0	0 ............................... 0

Schedule J (Form 990) 2014

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.

Return Reference	Explanation
SCH J, PART I, LINE 4A	IN 2014, HQ UNDERWENT A MAJOR EXECUTIVE MANAGEMENT RESTRUCTURING. INCLUDED IN THE WAGES LISTED ON SCHEDULE J FOR FORMER EMPLOYEES ARE RETENTION BONUSES, SEVERANCE PAYMENTS (LISTED IN DETAIL BELOW) AND TAX DEFERRED DISTRIBUTIONS. LINE 4A - SEVERANCE PAYMENTS WERE MADE FROM A RELATED ORGANIZATION FOR TWO OFFICERS MICHAEL T. WEBER (HQ CEO)- 24 MONTHS, EFFECTIVE TERM DATE 03/11/2013 - $817,449, PAID IN 2014 MARYANN KEPPLE - 12 MONTHS, EFFECTIVE TERM DATE 3/6/14 - $385,909, PAID IN 2014
SCH J, PART I, LINE 3	NDH RELIED ON HEALTH QUEST SYSTEMS, A RELATED TAX EXEMPT ORGANIZATION, WHICH USED AN EXECUTIVE COMPENSATION COMMITTEE, AND AN INDEPENDENT THIRD PARTY TO GATHER COMPARABLE DATA TO APPROVE AND DETERMINE COMPENSATION FOR THE CEO, TOP MANANGEMENT AND OTHER KEY EMPLOYEES.
SCH J, PART I, LINE 1A	LINE 1A - TRAVEL FOR COMPANIONS AS PART OF RELOCATION EXPENSES FOR AN EXECUTIVE, HQ PAID FOR THEIR SPOUSE TO RELOCATE.

Schedule J (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization
NORTHERN DUTCHESS HOSPITAL

Employer identification number
14-1338467

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	DORMITORY AUTHORITY - STATE OF NEW YORK	14-6000293	649903UK5	09-06-2007	15,718,408	PURCHASE OF EQUIPMENT		X		X		X
B	DUTCHESS COUNTY LOCAL DEVELOPMENT CORPORATION	27-3106797	267045DW9	05-14-2014	33,770,225	ACQUIRE, CONSTRUCT & EQUIP FACILIT		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	2,413,762		0
2 Amount of bonds legally defeased . . . . . . . . . . .	0		0
3 Total proceeds of issue . . . . . . . . . . . . . .	16,420,525		33,773,139
4 Gross proceeds in reserve funds . . . . . . . . . . . .	1,126,150		0
5 Capitalized interest from proceeds . . . . . . . . . . .	319,526		981,548
6 Proceeds in refunding escrows . . . . . . . . . . . .	0		0
7 Issuance costs from proceeds . . . . . . . . . . . .	216,413		477,697
8 Credit enhancement from proceeds . . . . . . . . . . .	247,657		0
9 Working capital expenditures from proceeds . . . . . . . . .	0		0
10 Capital expenditures from proceeds . . . . . . . . . . .	13,176,836		279,223
11 Other spent proceeds . . . . . . . . . . . . . .	0		0
12 Other unspent proceeds . . . . . . . . . . . . . .	1,333,942		32,034,671
13 Year of substantial completion . . . . . . . . . . . .	2008
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .		X		X
15 Were the bonds issued as part of an advance refunding issue? . . . . .		X		X
16 Has the final allocation of proceeds been made? . . . . . . . .		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2014

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .	0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .
6 Total of lines 4 and 5 . . . . . . . . . . . . .
7 Does the bond issue meet the private security or payment test? . . . . .
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? . . . . . . .

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .		X		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .		X	X
b Exception to rebate? . . . . . . . .		X		X
c No rebate due? . . . . . . . .	X			X
If "Yes" to line 2c, provide in Part VI the date the rebate computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . .		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X
b Name of provider . . . . . . . . .	0		0
c Term of hedge . . . . . . . . . .
d Was the hedge superintegrated? . . . .
e Was the hedge terminated? . . . . . .

Schedule K (Form 990) 2014

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .		X		X
b Name of provider . . . . . . . . .	0		0
c Term of GIC . . . . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .	X			X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .	X		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?		X		X

Part VI

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation
BOND ISSUES	PART I, LINE A, COLUMN E - TOTAL ISSUE PRICE PER IRS FORM 8038 - $61,974,071.30 ALLOCATED BETWEEN THREE ORGANIZATIONS.
PROCEEDS	PART II, LINE 3 - THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN E DUE TO INVESTMENT EARNINGS.
ARBITRAGE	SCHEDULE K, PART IV, ARBITRAGE, LINE 2C (A) ISSUER NAME: DORMITORY AUTHORITY - STATE OF NEW YORK DATE THE REBATE COMPUTATION WAS PERFORMED: 12/31/2011

Schedule K (Form 990) 2014

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 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization

NORTHERN DUTCHESS HOSPITAL

Employer identification number

14-1338467

Return Reference	Explanation
SCHEDULE R PART II - RELATED TAX EXEMPT ORGANIZATIONS	Entity Tax ID# Primary Activity Legal Domicile Exempt Code Status Public Charity Status Direct controlling Entity Vassar Brothers Medical Center 14-1338586 Hospital NY 501c3 Box 3 HQ The Foundation for Vassar Brothers Medical Center 14-1736429 Fundraising NY 501c3 Box 9 HQ Riverside Diversified Services, Inc (Parent) 14-1675545 Education NY 501c3 Box 9 HQ Alamo Ambulance Service, Inc 14-1745417 Transport NY 501c3 Box 9 HQ Health Quest Home Care, Inc (Certified) 14-1788412 Home Health NY 501c3 Box 9 HQ Health Quest Home Care, Inc (Licensed) 14-1788410 Home Health NY 501c3 Box 9 HQ Northern Duchess Hospital 14-1338467 Hospital NY 501c3 Box 3 HQ Northern Dutchess Residential Health Care Facility 22-3129608 Nursing Home NY 501c3 Box 9 HQ NDH Foundation 14-1776208 Fundraising NY 501c3 Box 9 HQ Putnam Hospital Center 14-6019179 Hospital NY 501c3 Box 3 HQ Putnam Hospital Center Foundation 06-1399319 Fundraising NY 501c3 Box 9 HQ Health Quest Medical Practice, PC 56-2669185 Medical Care NY 501c3 Box 3 HQ Health Quest Urgent Medical Practice, PC 80-0152047 Medical Care NY 501c3 Box 3 HQ Health Serve Information Technologies, LLC 14-1797086 IT Support NY 501c3 Box 3 HQ Health Quest Laboratory Support Services, LLC 45-4370644 Medical Laboratory NY 501c3 Box 3 HQ One Columbia Street, LLC 46-1626016 Real Estate Mgmt NY 501c3 Box 3 HQ Hudson Valley Cardiovasular Practice, PC 46-3756713 Medical Care NY 501c3 Box 3 HQ
FORM 990 PART VI SECTION A LINE 6, 7A AND 7B - GOVERNING	LINE 6 - THE SOLE MEMBER OF NDH IS HEALTH QUEST SYSTEMS, INC. LINE 7A - APPOINTMENT/ELECTION OF GOVERNING BODY 6.01 Officers. The Officers of NDH shall be a Chair, First Vice-Chair, Second Vice-Chair, Secretary/Treasurer, and President/Chief Operating Officer. From time to time, the Board of Trustees may appoint such other Officers with powers and duties not inconsistent with these Bylaws. Any two or more offices may be held by the same person, except the offices of Chair, President/Chief Operating Officer and Secretary/Treasurer. 6.02 Election. The Chair of the Board, First Vice-Chair, Second Vice-Chair and the President/Chief Operating Officer shall be elected by Health Quest. The Secretary/Treasurer and other Officers shall be elected by a vote of the majority of the entire Board of Trustees at a meeting of the Board of Trustees. All Officers shall serve for a term of two (2) years until successors are elected and qualified, such term commencing at the close of the meeting at which they are elected. Officers may be elected for no more than one (1) term. 6.03 Vacancies. A vacancy occurring in any office during the year may be filled by a vote of a majority of the entire Board of Trustees for the remainder of the term thereof at the next Annual Meeting or any regular meeting of the Board or at a special meeting called for such purpose, provided that a vacancy in the office of Chair of the Board, First Vice-Chair, Second Vice-Chair or President/Chief Operating Officer may be filled only by Health Quest. 6.04 Removal. Any Officer may be removed from office, with or without cause, by an affirmative vote of two-thirds (2/3) of the entire Board of Trustees at any meeting of the Board, except the Chair of the Board, First Vice-Chair, Second Vice-Chair and the President/Chief Operating Officer may be removed only by Health Quest. 6.05 Duties and Responsibilities. (a) Chair. The Chair shall preside at all meetings of the Board of Trustees. In accordance with Articles VII and VIII, the Chair also shall (i) appoint the Committee Chairs and members of all Committees of the Board (except the Executive Committee) and ad hoc committees, (ii) serve as an ex-officio member, with vote, on each Committee, and (iii) serve as the Chair of the Executive Committee. The Chair shall perform such other duties as may be provided for by law, these Bylaws, or resolution of the Board of Trustees. (b) First Vice-Chair. In the absence of the Chair, the First Vice-Chair shall preside at meetings of the Board of Trustees. When so acting as Chair, the First Vice-Chair shall have all the powers and authority of the Chair. The First Vice-Chair shall perform such other duties as may be provided for by the Board of Trustees. (c) Second Vice-Chair. In the absence of the Chair and First Vice-Chair, the Second Vice-Chair shall preside at meetings of the Board of Trustees. When so acting as Chair, the Second Vice-Chair shall have all the powers and authority of the Chair. The Second Vice-Chair shall perform such other duties as may be provided for by the Board of Trustees. (d) Secretary/Treasurer. (i) The Secretary/Treasurer shall be responsible for such books, documents, and papers as the Board may determine. The Secretary/Treasurer shall cause minutes to be kept for all meetings of the Board of Trustees, may sign any contracts or agreements with the Chair, the President/Chief Operating Officer, the First Vice-Chair or Second Vice-Chair in the name of NDH if so authorized or ordered by the Board, and may affix the seal of NDH to written instruments when so authorized or ordered by the Board. The Secretary/Treasurer shall perform such other duties as shall be assigned by the Board of Trustees and as are incidental to the office of secretary of a not-for-profit corporation. (ii) The Secretary/Treasurer shall either personally perform, or ensure that appropriate employees of NDH perform, the following functions: receive and care for all monies and properties belonging to NDH and dispose of the same under the direction of the Board of Trustees, receive and give receipts for all amounts due to NDH, endorse checks in its name and on its behalf, receive full discharge for the same in accordance with these Bylaws, and perform such other duties as assigned by the Board of Trustees and as are incidental to the office of treasurer of a not-for-profit corporation. (e) President/Chief Operating Officer. The President/Chief Operating Officer shall serve as the chief executive officer of NDH and shall have the authority and responsibility to manage and operate NDH in all its activities, subject to these Bylaws, the Certificate of Incorporation, and such policies as may be adopted from time to time by the Board of Trustees or Health Quest. The President/Chief Operating Officer's responsibilities shall include, but are not limited to, the following: (i) Acting under the direction of and being accountable to the Board of Trustees of NDH and Health Quest; (ii) Providing effective liaison between the Board of Trustees and management; (iii) Appointing (either personally or through delegation to responsible subordinates), and NDH shall employ, such personnel as may be required to conduct the affairs of NDH; (iv) Ensuring that all activities are properly organized, directed and accounted for as established by the Board of Trustees; (v) Providing reports to the Board of Trustees to keep the Board fully informed of the affairs of NDH; (vi) Performing all duties required by law; and (vii) Unless otherwise provided for herein, performing (either personally or through delegation to responsible subordinates) all acts and executing all documents necessary to carry out the duties of the position of President/Chief Executive Officer. LINE 7B - 4.01 Powers of the Board of Trustees. The business and property of NDH shall be managed by NDH's Board of Trustees and Health Quest, as the co-established operator of NDH. Although Health Quest may elect from time to time to delegate to and/or act jointly with the NDH Board of Trustees, Health Quest has the authority to exercise independently its established powers and rights in its capacity as the co-established operator. Any such delegated authority shall at all times remain subject to the oversight, modification or repeal of Health Quest as the co-established operator of NDH. Without limiting the foregoing powers, Health Quest will consult with the Chair of the NDH Board of Trustees before modifying or repealing any joint operating authority delegated under Section 4.02. 4.02 Joint Operating Authority Delegated to NDH. Subject to Sections 2.02 and 4.01, the Board of Trustees of NDH shall have the following operating authority as delegated by Health Quest: (a) Quality Assurance. Apply and execute the quality assurance standards and any quality assurance policies and plans adopted by Health Quest. (b) Medical Staff Credentialing and Bylaws. Apply and execute the Medical Staff credentialing standards and any policies adopted by Health Quest, which includes being responsible for: (i) Appointing the members of the Medical Staff; (ii) Approving any Medical Staff appointments such as Medical Staff officers or department chairs requiring Board approval; (iii) Pursuant to the procedures set forth in the Bylaws of the Medical Staff, dismissing any member of the Medical Staff, and approving, rejecting or modifying any corrective action taken or recommended by the Medical Staff for any member of the Medical Staff; and (iv) Approving the Medical Staff Bylaws, Rules and Regulations. (c) Strategic Planning. Provide input to the system-wide strategic planning process and NDH-specific strategic plan, as requested and approved by Health Quest, and monitor the implementation of such plan. (d) Statements of Deficiency and Legal Compliance. Respond to any statements of deficiency issued by any regulatory or accrediting authority and take all appropriate and necessary action to monitor and restore compliance with deficiencies in NDH's compliance with statutory, regulatory or accreditation requirements, including but not limited to monitoring the submission and implementation of all plans of correction. (e) Conflicts of Interest. Implement and comply with the written Conflict of Interest Policy as approved by Health Quest and as interpreted and directed by the Compliance and Audit Committee of Health Quest. (f) Community Health Needs. Implement the statement of mission approved by Health Quest by developing a Community Service Plan tailored specifically to the work of NDH in the community it serves and monitoring performance thereof. (g) Budgets and Financial Performance. Assist in developing and monitoring the budgets for NDH, as requested by Health Quest and, as approved, monitor the financial performance of NDH. (h) Physician Arrangements. Review and approve physician financial arrangements in accordance with and as permitted by a system-wide policy adopted by Health Quest. (i
PART VI SECTION B LINE 11B, 12C, 15A AND 15B - POLICIES	LINE 11B - PRIOR TO FILING, A DRAFT OF THE COMPLETED FORM 990 WAS REVIEWED BY INTERNAL MANAGEMENT. AFTER THAT REVIEW WAS COMPLETE, THE FORM 990 WAS PROVIDED TO THE BOARD OF DIRECTORS OF HQ (PARENT OF THE FILING ORGANIZATION) FOR ADITIONAL REVIEW AND COMMENT. CONTACT INFORMATION WAS PROVIDED SHOULD QUESTIONS ARISE. A 3RD PARTY WAS HIRED TO PREPARE SCHEDULE K. PRICEWATERHOUSE COOPERS WAS CONSULTED IN THE PREPARATION OF SCHEDULE H. LINE 12C - ON AN ANNUAL BASIS OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST FILING WHICH IS REVIEWED BY THE HQ VP OF COMPLIANCE AND INTERNAL AUDIT. ALL POTENTIAL CONFLICTS OF INTEREST ARE REVIEWED BY THE HQ BUSINESS ETHICS COMMITTEE ON BEHALF OF NDH. LINE 15 A/B - COMPENSATION OF THE CEO, TOP MANAGEMENT AND OTHER KEY EMPLOYEES IS ESTABLISHED BY THE HQ EXECUTIVE COMPENSATION COMMITTEE BASED ON INFORMATION AND SUPPORT OF AN INDEPENDENT THIRD PARTY.
FORM 990 PART VI SECTION C LINE 19 - DISCLOSURE	LINE 19 - POLICIES AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE DOCUMENTS ARE PROVIDED EITHER ELECTRONICALLY OR PAPER COPIES. IN ADDITION, CERTAIN FINANCIAL INFORMATION IS AVAILABLE ON VARIOUS WEBSITES DUE TO REGULATORY FILINGS SUCH AS THE 990 AND BOND HOLDER REQUIREMENTS.
SCHEDULE K PART I LINE A COLUMN E	TOTAL ISSUE PRICE PER IRS FORM 8038 - $61,974,071.30, ALLOCATED AS FOLLOWS NORTHERN DUTCHESS HOSPITAL - $15,718,407.82 PUTNAM HOSPITAL CENTER - $28,161,750.86 VASSAR BROTHERS MEDICAL CENTER - $18,093,912.82
SCHEDULE R PART V LINE 2 (1) - ALLOCATION METHODOLOGY FOR HQ	Health Quest Systems, Inc Allocation of Support Services/Shared Expenses/Cash Funding General: The following services are considered shared services for Health Quest affiliates and the cost to provide these services are allocated to each entity which benefits from the service based on a pre defined allocation methodology: 1. Specialty Staffing a. VBMC Surgical b. Radiology c. Oncology d. VBMC Sleep Lab e. PT/OT/ST f. Cardiac Rehab 2. Clinical Management a. Emergency Room b. Pharmacy c. Cardiac d. Oncology 3. Revenue Cycle including health information management, budgets and reimbursement, revenue cycle, system business office, patient access oversight, financial clearance center, managed care and decision support 4. Facilities including courier service, construction, property management, facility operations, food service management and security 5. Business Development including strategic planning, marketing and public relations, answering service and community education 6. Corporate Finance including accounts payable, payroll, general accounting, purchasing, supply chain and mailroom, practice management billing and management engineering 7. Internal Audit and Compliance 8. Practice management operations including physician recruitment, physician management and centralized scheduling 9. Human Resources and learning and development 10. Administrative including Executive office, Hospital Support and risk management 11. Legal Counsel 12. Information Technology and Medical Technology Services (MTS) Description of Services: 1. Specialty staffing a. Provides non union staffing services for various specialties to the hospitals, offsite ancillary locations and the Fishkill Medical Mall 2. Clinical management includes management oversight to system consolidated clinical services 3. Revenue Cycle - a. Health Information Management functions includes coding and transcription of medical records for all 3 hospitals b. Budget functions include preparation of annual budgets, variance reporting and maintenance of the budget module Reimbursement functions include preparation of annual cost reports, analysis of third party rate accounts and third party audits c. Revenue cycle functions include charge master analysis and development of revenue producing charges, compliance with CPT coding and establishment of appropriate charges d. System business office services includes producing claims for third party payers and private pay patients, payment processing, periodic reporting, accounts receivable analysis, charity care application process, denial management, collection and follow up for the hospitals. Patient access and financial clearance center includes oversight of all centralized registration areas at the hospitals and pre-authorization for numerous hospital services to insure compliance with third party regulations e. Managed Care functions include contract negotiations and analysis of contract terms f. Decision Support functions include cost accounting reporting, maintenance of HBI (Horizon Business Insight) reporting and the contract management system 4. Facilities - a. Courier service provides delivery services internally throughout the HQ system and bank deposit drop offs b. Construction and property management functions include contracting services for Health Quest projects and property management of all HQ facilities c. Facility operations include management oversight of the engineering departments for the hospitals d. Food Service management includes management oversight of food and nutrition departments for the hospitals e. Security functions include management oversight of all facilities to ensure the safest environment 5. Business Development - a. Strategic Planning functions include CON submissions, market data analysis and assistance with business plans b. Marketing includes advertising services, coordination of joint Health Quest advertisements and reduction of expenses associated with larger campaigns c. Public relations functions include coordination of Health Quest communication to external customers, patients and media d. Oversight of the outsourced answering services for physicians affiliated with the hospitals and HQMP e. Community education functions include training classes specific to life saving techniques 6. Finance - a. Accounts payable functions include scheduling vendor payments, insuring flow of goods and services, maintaining days cash on hand goals and maintaining days in accounts payable b. Payroll functions include biweekly employee payments and tax filings in accordance with Human Resources and Payroll policies c. General Accounting functions include preparation of financial statements, account analysis, contract reconciliation, tax filings, investment coordination, insurance coordination and coordination of internal and external audit functions d. Purchasing, supply chain and mailroom functions include procurement services, contract negotiations, price negotiations, capital purchase negotiations, management/distribution of hospital inventory, and central mailroom management e. Practice management billing functions include producing all claims for third party payers and private pay patients, payment processing, periodic reporting, accounts receivable analysis, charity care application process, denial management, collection and follow up services for all employed HQ physicians f. Management Engineering functions include evaluating each area within HQ to ensure compliance with various productivity benchmarks optimizing staffing ratios 7. Internal Audit and Compliance includes oversight of the corporate compliance program, internal audit, HIPAA compliance, contract review and compliance 8. Human Resource and learning and development functions include recruitment, compensation, benefit administration and employee training 9. Physician management operations functions include oversight of all HQ physician practices, physician recruitment functions, and the centralized scheduling office 10. Administrative functions include oversight of the Health Quest system, hospital management and risk management 11. Legal Counsel functions include internal legal services for HQ and coordination of all outsourced legal initiatives 12. Information Technology and MTS - a. IT provides information technology support for all applications and telephony support within HQ. In addition provides project management services for all new and upgrades to current IT applications. b. MTS/Biomed includes technical services provided to each hospital for equipment repair and maintenance Shared Expenses: In addition to services provided by support departments, certain insurance policies are consolidated for all Health Quest entities. These include property insurance, travel, crime, environmental, cyber risk and Directors and Officers insurance. Affiliate Cash Shortfalls: Affiliate cash shortfalls are funded by the entity(s) benefiting from the affiliate services. Examples include Health Quest Medical Practice and the Thompson House. The cash shortfall funding is based on the percentage of benefit received (percentage of revenue by division for HQMP and hospital census for the Thompson House from the hospitals) Allocation Methodology: Net Revenue - lab management, budgets, revenue cycle, managed care, decision support, all facilities (excluding construction), business development, general accounting, management engineering, internal audit and compliance, executive office, legal, information technology and MTS # of visits/procedures - staffing specialties Historical trends - health information management, clinical management and hospital support Cash collections - patient accounting and the financial clearance center # of FTE's - payroll and human resources Non payroll expenses - accounts payable and purchasing Project based - construction # of FTE's allocated to physician sites - Practice management billing, operations and physician practice management System Benefits: 1. Financial planning 2. Revenue enhancement 3. Improved cash collections 4. Enhanced managed care contract rates 5. Optimized medical records coding 6. Savings for supplies, contracts, insurance and capital purchases 7. Staffing reduction through shared services 8. Enhanced employee benefit programs Health Quest Laboratory Support Services, LLC provides clinical diagnostic services to affiliate hospitals. NDH covers lab services performed for both their inpatient and outpatient services.
FORM 990 PART XI LINE 9 - RECONCILIATION OF NET ASSETS	TRANSFER OF EQUITY - ($3,991,341); INTEREST IN FOUNDATION - $4,263,724; NET ASSETS FROM RESTRICTIONS USED FOR OPERATIONS - ($336,480); PERM RESTRICTED MISC $15
FORM 990 PART XII LINE 3A - OMB CIRCULAR A-133 AUDIT	NORTHERN DUTCHESS HOSPITAL DID NOT RECEIVE MORE THAN $500,000 IN FEDERAL AWARDS IN 2014, AND DID NOT QUALIFY FOR AN A-133 AUDIT.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

NORTHERN DUTCHESS HOSPITAL

Employer identification number

14-1338467

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) HEALTH QUEST SYSTEMS INC 45 READE PLACE POUGHKEEPSIE,NY12601 14-1678068	SUPPORT SERV			BOX 9	HQ
(2) SEE SCHEDULE O					N/A

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2014

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No

Schedule R (Form 990) 2014

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

Yes

b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .

m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .

o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) HEALTH QUEST SYSTEMS INC	P	11,782,493	SEE SCHEDULE O
(2) HEALTH QUEST LABORATORY SUPPORT SERVICES LLC	P	2,752,406	SEE SCHEDULE O
(3) HEALTH QUEST MEDICAL PRACTICE PC	A	176,760	RENT AT COST

Schedule R (Form 990) 2014

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2014

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2014

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO PROVIDE COMPREHENSIVE PRIMARY HEALTH CARE SERVICES
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	14
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	13
5	Total number of individuals employed in calendar year 2014 (Part V, line 2a) ......	5	614
6	Total number of volunteers (estimate if necessary) .............	6	139
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	77,419
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	-85,282

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	773,164	519,547
9	Program service revenue (Part VIII, line 2g) .........	79,387,151	85,431,540
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	153,961	261,790
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	2,350,784	2,496,344
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	82,665,060	88,709,221
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	11,330	15,840
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	30,280,128	33,299,620
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	41,736,350	42,818,406
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	72,027,808	76,133,866
19	Revenue less expenses. Subtract line 18 from line 12.......	10,637,252	12,575,355
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	76,390,268	126,668,304
21	Total liabilities (Part X, line 26).............	27,631,880	65,334,966
22	Net assets or fund balances. Subtract line 21 from line 20.....	48,758,388	61,333,338

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 34,598,615 including grants of $ ) (Revenue $ 49,697,361 )
	INPATIENT SERVICES: PATIENTS ADMITTED FOR ACUTE CARE - NUMBER OF PATIENTS 4,678; NUMBER OF PATIENT DAYS 17,608 THE HOSPITAL PROVIDED APPROXIMATELY $566,685 IN UNCOMPENSATED CARE (AT COST) TO THE REGIONS UN-INSURED AND UNDER-INSURED POPULATION

4b	(Code: ) (Expenses $ 24,754,582 including grants of $ 15,840 ) (Revenue $ 35,557,419 )
	OUTPATIENT SERVICES: EMERGENCY VISITS 14,777; AMBULATORY SURGERY VISITS 2,485 ALL OTHER VISTIS/PROCEDURES 94,235 THE HOSPITAL PROVIDED APPROXIMATELY $923,644 IN UNCOMPENSATED CARE (AT COST) TO THE REGIONS UN-INSURED AND UNDER-INSURED POPULATION

4c	(Code: ) (Expenses $ 123,058 including grants of $ ) (Revenue $ 176,760 )
	AFFILIATE RENTAL INCOME

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses59,476,255

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)			(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) CONNIE REGAN........................................................................ PHARMACY CLINICAL COORDINATOR	40.0 .......................0.0	X		178,231	0	29,140
(19) BOGUMILA LANG........................................................................ PHARMACIST	40.0 .......................0.0	X		138,115	0	32,431
(20) TIMOTHY GOVEL........................................................................ PHARMACIST	40.0 .......................0.0	X		143,839	0	9,468
(21) PAUL KING........................................................................ DIRECTOR OF DIAGNOSTIC SVCS	40.0 .......................0.0	X		138,925	0	10,255
(22) SANDRA HELMES........................................................................ LEAD DIAGNOSTIC MED SONOGRAPHE	40.0 .......................0.0	X		143,213	0	17,457
(23) MICHAEL T WEBER........................................................................ FORMER CEO	0.0 .......................0.0		X	0	817,449	0
(24) TIM CLEARY........................................................................ FORMER INTERIM PRESIDENT/COO	0.0 .......................0.0		X	0	249,227	41,184
(25) MARYANN KEPPLE........................................................................ FORMER TREASURER	0.0 .......................0.0		X	0	779,221	17,076

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	742,323	4,751,537	281,177

(A) Name and business address	(B) Description of services	(C) Compensation





2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 0

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512-514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d
e	Government grants (contributions)1e		197,433

f	All other contributions, gifts, grants, and similar amounts not included above1f		322,114

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			519,547
			Business Code
2a	NET INPATIENT REVENUE		900099	49,697,362	49,697,362
b	NET OUTPATIENT REVENUE		900099	35,557,418	35,557,418
c	AFFILIATE RENTAL INCOME		900099	176,760	176,760
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			85,431,540
3	Investment income (including dividends, interest, and other similar amounts).......			232,942			232,942
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties...........			0
		(i) Real	(ii) Personal
6a	Gross rents	146,239
b	Less: rental expenses
c	Rental income or (loss)	146,239	0
d	Net rental income or (loss).......			146,239			146,239
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory
b	Less: cost or other basis and sales expenses
c	Gain or (loss)
d	Net gain or (loss)..........			28,848			28,848
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ..
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...			0
10a	Gross sales of inventory, less returns and allowances .
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..			0
Miscellaneous Revenue			Business Code
11a	QUALITY INCENTIVE PROGRAM		900099	98,000	98,000
b	MEANINGFUL USE REVENUE		900099	1,431,665	1,431,665
c	CAFETERIA REVENUE		900099	379,044	379,044
d	All other revenue ....			441,396	363,977	77,419
e	Total. Add lines 11a–11d ......			2,350,105
12	Total revenue. See Instructions......			88,709,221	87,704,226	77,419	408,029


				(A) Beginning of year		(B) End of year
1	Cash–non-interest-bearing .............			13,922,211	1	10,581,858
2	Savings and temporary cash investments .........			0	2	0
3	Pledges and grants receivable, net ...........			0	3	0
4	Accounts receivable, net .............			8,222,576	4	8,328,287
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
				0	6	0
7	Notes and loans receivable, net .............			0	7	0
8	Inventories for sale or use ..............			1,373,643	8	1,474,024
9	Prepaid expenses and deferred charges ..........			647,785	9	933,542
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	100,378,004
b	Less: accumulated depreciation .....	10b	59,870,459	33,682,048	10c	40,507,545
11	Investments—publicly traded securities ..........			4,529,297	11	5,134,253
12	Investments—other securities. See Part IV, line 11 .....			0	12	0
13	Investments—program-related. See Part IV, line 11 .....			0	13	0
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			14,012,708	15	59,708,795
16	Total assets. Add lines 1 through 15 (must equal line 34)......			76,390,268	16	126,668,304
17	Accounts payable and accrued expenses .........			6,213,688	17	6,526,457
18	Grants payable .................			0	18	0
19	Deferred revenue ................			0	19	0
20	Tax-exempt bond liabilities .............			11,600,842	20	49,416,574
21	Escrow or custodial account liability. Complete Part IV of Schedule D..			0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........			0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..			148,656	23	68,475
24	Unsecured notes and loans payable to unrelated third parties ....			0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................			9,668,694	25	9,323,460
26	Total liabilities. Add lines 17 through 25.........			27,631,880	26	65,334,966
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			45,074,896	27	53,722,602
28	Temporarily restricted net assets ...........			2,188,088	28	6,115,332
29	Permanently restricted net assets ...........			1,495,404	29	1,495,404
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances ...........			48,758,388	33	61,333,338
34	Total liabilities and net assets/fund balances ........			76,390,268	34	126,668,304