Form990
Click to see attachment
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
A For the 2019 calendar year, or tax year beginning 01-01-2018 , and ending 12-31-2018
BCheck if applicable:
CName of organization
ST JOHNS RIVERSIDE HOSPITAL
ANDRUS PARKCARE & DOBBS FERRY
% DENNIS KEANE
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
967 NORTH BROADWAY
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
YONKERS, NY107013497
D Employer identification number

13-1740126
E Telephone number

G Gross receipts $ 272,002,018
F Name and address of principal officer:
RON CORTI
967 NORTH BROADWAY
YONKERS,NY10701
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.RIVERSIDEHEALTH.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1870
M State of legal domicile: NY
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: THE HOSPITAL IS DEDICATED TO PROVIDING COMPREHENSIVE MEDICAL AND NURSING CARE IN A COMPASSIONATE, PROFESSIONAL, RESPECTFUL AND ETHICAL MANNER TO EVERY PATIENT.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 26
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 22
5 Total number of individuals employed in calendar year 2018 (Part V, line 2a) ...... 5 2,239
6 Total number of volunteers (estimate if necessary) ............. 6 240
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 1,744
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 215,272
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 7,069,212 7,026,938
9 Program service revenue (Part VIII, line 2g) ......... 232,377,546 243,771,492
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 1,263,987 3,061,282
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 3,461,132 4,623,397
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 244,171,877 258,483,109
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 0
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) 164,110,828 173,213,167
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet67,857    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 97,034,429 108,605,149
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 261,145,257 281,818,316
19 Revenue less expenses. Subtract line 18 from line 12....... -16,973,380 -23,335,207
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 126,563,737 113,721,365
21 Total liabilities (Part X, line 26)............. 174,831,965 176,973,372
22 Net assets or fund balances. Subtract line 21 from line 20..... -48,268,228 -63,252,007
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
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Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2018)
Form 990 (2018)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: THE HOSPITAL IS DEDICATED TO PROVIDING COMPREHENSIVE MEDICAL AND NURSING CARE IN A COMPASSIONATE, PROFESSIONAL, RESPECTFUL AND ETHICAL MANNER TO EVERY PATIENT.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 241,779,968 including grants of $   ) (Revenue $ 203,031,087 )
IN 2018, ST. JOHN'S TREATED 10,234 INPATIENTS, THROUGH 47,671 PATIENT DAYS, WITH A LARGE PROPORTION (56%) BEING MEDICARE AND MEDICAID PATIENTS. THE HOSPITAL'S INPATIENT AND OUTPATIENT SPECIALTY SERVICES INCLUDE BARIATRIC SURGERY, BEHAVIORAL HEALTH SERVICES, BREAST CARE, CANCER CARE, CARDIOLOGY SERVICES, DIAGNOSTIC IMAGING, EMERGENCY SERVICES, HOLISTIC CARE SERVICES, HOPE CENTER, HYPERBARIC OXYGEN TREATMENT, MATERNITY, ORTHOPEDIC SURGERY CENTER, PHYSICAL THERAPY, RESPIRATORY THERAPY SERVICES, SLEEP SERVICES, SURGICAL SERVICES AND WOUND HEALING.
4b (Code:   ) (Expenses $ 13,006,677 including grants of $   ) (Revenue $ 37,896,884 )
IN 2018, ST. JOHN'S PROVIDED 46,480 DAYS OF INPATIENT DRUG AND ALCOHOL SUBSTANCE ABUSE SERVICES TO 7,931 PATIENTS. OUTPATIENT FOLLOW-UP TREATMENT AND SUPPORT SERVICES PROVIDED FOR 66,031 CLIENT VISITS. THE INPATIENT REHABILITATION PROGRAM IS BASED UPON THE 12 STEP PHILOSOPHY AND PROVIDES A COMPREHENSIVE ARRAY OF SERVICES TO MEN AND WOMEN IN SEPARATE, GENDER-SPECIFIC UNITS. PATIENTS WITH CO-OCCURRING PSYCHIATRIC DISORDERS AND THOSE WITH A HISTORY OF RELAPSE ARE WELCOMED. OUTPATIENT TREATMENT PROGRAMS INCLUDE A DAY REHABILITATION PROGRAM AND A CLINIC PROGRAM. FOR MORE INFORMATION, SEE SCHEDULE O.
4c (Code:   ) (Expenses $ 2,253,689 including grants of $   ) (Revenue $ 1,438,683 )
ST. JOHN'S OPERATES THE COCHRAN SCHOOL OF NURSING, AN ASSOCIATE DEGREE PROGRAM WHOSE PURPOSE IS TO TRAIN NURSES. IN 2018, 135 STUDENTS WERE ENROLLED AT THE SCHOOL. FOUNDED IN 1894 AT ST. JOHN'S RIVERSIDE HOSPITAL, THE COCHRAN SCHOOL OF NURSING IS THE OLDEST HOSPITAL-BASED SCHOOL OF NURSING IN THE METROPOLITAN REGION. THE SCHOOL OFFERS A REGISTERED NURSE (RN) CURRICULUM LEADING TO A DEGREE OF ASSOCIATE IN APPLIED SCIENCE. FOR MORE INFORMATION, SEE SCHEDULE O.
(Code:   ) (Expenses $ 1,370,766 including grants of $   ) (Revenue $ 2,007,241 )
TOTAL OTHER PROGRAM EXPENSES
(Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
ST. JOHN'S RIVERSIDE HOSPITAL OPERATES A
(Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
METHADONE MAINTENANCE PROGRAM SEVEN DAYS A
(Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
WEEK, 365 DAYS A YEAR TO ENABLE CLIENTS
(Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
SUFFERING NARCOTIC ADDICTION TO CONTINUE
(Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
PRODUCTIVE LIVES. IN 2018, THE CLINIC HAD
(Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
99,597 VISITS.
4d Other program services (Describe in Schedule O.)
(Expenses $ 1,370,766 including grants of $   ) (Revenue $ 2,007,241 )
4e Total program service expensesMediumBullet258,411,100
Form 990 (2018)
Form 990 (2018)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment..............
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment.................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment..................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part IIIClick to see attachment.............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I(see instructions) ....Click to see attachment
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............ Click to see attachment
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................Click to see attachment
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....
21
 
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........
22
 
No
Form 990 (2018)
Form 990 (2018)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I............ Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I...................Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II................Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L,
Part IV........................Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV.....................Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I.
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II...........
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
167
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2018)
Form 990 (2018)
Page 5
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
2,239
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
Yes
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? .........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? If "Yes," see instructions and file Form 4720, Schedule N .....
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income?
If "Yes," complete Form 4720, Schedule O ................
16
 
No
Form 990 (2018)
Form 990 (2018)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
26
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
22
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
NY
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletDENNIS KEANE967 NORTH BROADWAY   YONKERS,NY107013497 (914) 964-4340
Form 990 (2018)
Form 990 (2018)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(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) 		(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
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) RICHARD F KOMOSINSKI......................................................................
CHAIRMAN
 1.0
.................
0.25 		X   X       0 0 0
(2) WM LEE KINNALLY JR......................................................................
First Vice Chairman
 1.0
.................
0.0 		X   X       0 0 0
(3) JAMES R LETSEN......................................................................
Second Vice Chairman
 1.0
.................
0.0 		X   X       0 0 0
(4) LENORE A MINERVA......................................................................
SECRETARY
 1.0
.................
0.0 		X   X       0 0 0
(5) IYAD ANNABI MD......................................................................
ASSISTANT SECRETARY
 1.0
.................
0.0 		X   X       98,996 0 22,054
(6) ROBERT C MURRAY......................................................................
TREASURER
 1.0
.................
0.25 		X   X       0 0 0
(7) DOMINICK P ARTUSO MD......................................................................
CHAIR DOBBS FERRY MED EXEC COM
 1.0
.................
0.0 		X           0 0 0
(8) PAMELA BARNES......................................................................
BOARD MEMBER
 1.0
.................
0.0 		X           0 0 0
(9) JONATHAN BAUMAN MD......................................................................
BOARD MEMBER
 1.0
.................
0.0 		X           0 0 0
(10) JIM BOSTIC......................................................................
BOARD MEMBER
 1.0
.................
0.0 		X           0 0 0
(11) MELVINA M CARTER......................................................................
BOARD MEMBER
 1.0
.................
0.0 		X           0 0 0
(12) JIM CASTRO-BLANCO ESQ......................................................................
BOARD MEMBER
 1.0
.................
0.0 		X           0 0 0
(13) STEVE CENTRILLO......................................................................
BOARD MEMBER
 1.0
.................
0.0 		X           0 0 0
(14) Robert DeMatteo......................................................................
CHIEF OF STAFF
 1.0
.................
0.0 		X           0 0 0
(15) JOSEPH A DISALVO ESQ......................................................................
BOARD MEMBER
 1.0
.................
0.0 		X           0 0 0
(16) ANNA T DOLAN MD......................................................................
BOARD MEMBER (DECEASED 1/18)
 1.0
.................
0.0 		X           0 0 0
(17) HON LAWRENCE H ECKER......................................................................
BOARD MEMBER (END 3/18)
 1.0
.................
0.0 		X           0 0 0
Form 990 (2018)
Form 990 (2018)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(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) 		(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
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) KEVIN T FAY........................................................................
BOARD MEMBER
 1.0
.......................0.25 		X           0 0 0
(19) GREGORY M FISK........................................................................
BOARD MEMBER
 1.0
.......................0.25 		X           0 0 0
(20) MARK HERRMANN........................................................................
BOARD MEMBER
 1.0
.......................0.0 		X           0 0 0
(21) ANN KACHMAR........................................................................
BOARD MEMBER
 1.0
.......................0.0 		X           0 0 0
(22) THOMAS T LEE MD........................................................................
BOARD MEMBER
 1.0
.......................0.25 		X           0 0 0
(23) GERALD T MALONE........................................................................
BOARD MEMBER
 1.0
.......................0.25 		X           0 0 0
(24) JEANNE MARTINELLI........................................................................
BOARD MEMBER
 1.0
.......................0.0 		X           0 0 0
(25) MICHAEL SCHREIBER MD........................................................................
FORMER CHIEF OF STAFF
 1.0
.......................0.25 		X           129,331 0 20,702
(26) CECILE D SINGER........................................................................
BOARD MEMBER
 1.0
.......................0.25 		X           0 0 0
(27) Dr Victoria R Sirota........................................................................
Board Member
 1.0
.......................0.0 		X           0 0 0
(28) Jay M Stein........................................................................
Board Member
 1.0
.......................0.0 		X           0 0 0
(29) RONALD CORTI........................................................................
PRESIDENT/CEO
 37.5
.......................0.35 		    X       812,694 0 135,419
(30) DENNIS KEANE........................................................................
VP FINANCE/CFO
 37.5
.......................0.35 		    X       592,452 0 51,833
(31) DONNA MCGREGOR........................................................................
VP Chief Operating Officer
 37.5
.......................0.25 		    X       529,364 0 38,494
(32) PAUL ANTONECCHIA MD........................................................................
Physician-Vice President
 37.5
.......................0.35 		    X       449,413 0 38,314
(33) GLADYS ATTANASIO........................................................................
ASSISTANT VP REVENUE CYCLE
 37.5
.......................0.0 		      X     218,871 0 34,826
(34) LAURA FANNING........................................................................
AVP Surgical Services
 37.5
.......................0.0 		      X     180,587 0 18,918
(35) TARA CURTIN........................................................................
VP Nursing Services
 37.5
.......................0.0 		      X     282,708 0 38,039
(36) Susan Franzino........................................................................
AVP Ancillary Services
 37.5
.......................0.0 		      X     179,660 0 39,361
(37) PRASERT ITHARAT MD........................................................................
PHYSICIAN
 37.5
.......................0.0 		        X   316,515 0 50,319
(38) MICHAEL DIGIORNO MD........................................................................
PHYSICIAN - NEPHROLOGY
 37.5
.......................0.0 		        X   320,565 0 37,016
(39) NIRAV PATEL DO........................................................................
PHYSICIAN
 37.5
.......................0.0 		        X   489,314 0 36,857
(40) Christopher Digiorno MD........................................................................
PHYSICIAN
 37.5
.......................0.0 		        X   348,418 0 14,296
(41) Michel-Ange Camille MD........................................................................
PHYSICIAN
 37.5
.......................0.0 		        X   283,361 0 16,381
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 5,232,249 0 592,829
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet371
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
DOBBS FERRY EMERGENCY MEDICINE,
33 RANDOM FARMS DRIVE
CHAPPAQUA,NY10514 		ER SERVICES 4,448,986
SYMPHONY MEDICAL PC,
27 S WASHINGTON AVENUE
DOBBS FERRY,NY10522 		INTENSIVISTS 3,753,197
PULMONARY DISEASE GROUP OF WESTCHES,
970 N BROADWAY
YONKERS,NY10701 		PULMONARY DIS SVCS 675,000
Healthcare Radiology Diagnostic,
122 Maple Ave
WHITE PLAINS,NY10601 		Radiology Services 480,000
Medmetrix LLC,
9 Entin RD 3rd FL
PARSIPPANY,NJ07054 		Denial Appeal 473,959
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet32
Form 990 (2018)
Form 990 (2018)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c 280,781
d Related organizations1d  
e Government grants (contributions)1e 6,099,636
f All other contributions, gifts, grants, and similar amounts not included above1f 646,521
g Noncash contributions included in lines 1a - 1f:$  
h Total. Add lines 1a-1f.......MediumBullet 7,026,938
Program Service RevenueAmt Business Code
2a NET PATIENT SERVICE REVENUE 623000 232,443,573 232,443,573    
b UNCOMPENSATED CARE SUBSIDIZED 623000 7,389,206 7,389,206    
c STUDENT TUITION ADMISSIONS 900099 1,414,383 1,414,383    
d PHYSICIAN BILLING 900099 2,524,330 2,524,330    
e
f All other program service revenue.        
g Total. Add lines 2a–2f ....MediumBullet 243,771,492
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 369,485   1,744 367,741
4 Income from investment of tax-exempt bond proceedsMediumBullet 0      
5 Royalties...........MediumBullet 0      
(ii) Personal (i) Real
6a Gross rents   1,333,206
b Less: rental expenses    
c Rental income or (loss) 0 1,333,206
d Net rental income or (loss)......MediumBullet 1,333,206     1,333,206
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory   16,031,900
b Less: cost or other basis and sales expenses   13,340,103
c Gain or (loss)   2,691,797
d Net gain or (loss).....MediumBullet 2,691,797     2,691,797
8a Gross income from fundraising events (not including $ 280,781of contributions reported on line 1c). See Part IV, line 18 ....
a 122,495
b Less: direct expenses ...b 158,000
c Net income or (loss) from fundraising events..MediumBullet -35,505   -35,505
9a Gross income from gaming activities.
See Part IV, line 19 ...
a 0
b Less: direct expenses ...b 0
c Net income or (loss) from gaming activities..MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances ..
a 52,523
b Less: cost of goods sold ..b 20,806
c Net income or (loss) from sales of inventory..MediumBullet 31,717     31,717
Business Code Miscellaneous Revenue
11a CAFETERIA 900099 353,747     353,747
b MISCELLANEOUS REVENUE 900099 2,940,232     2,940,232
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 3,293,979
12 Total revenue. See Instructions......MediumBullet 258,483,109 243,771,492 1,744 7,682,935
Form 990 (2018)
Form 990 (2018)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
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 0  
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, line 15 and 16. 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 3,912,036 3,912,036    
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 120,209 120,209    
7 Other salaries and wages 119,997,126 109,714,536 10,282,590  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 15,883,226 14,554,918 1,328,308  
9 Other employee benefits ....... 24,210,589 22,166,724 2,043,865  
10 Payroll taxes ........... 9,089,981 8,333,710 756,271  
11 Fees for services (non-employees):        
a Management ...... 3,472,464 2,455,107 1,017,357  
b Legal ......... 647,701   647,701  
c Accounting ........... 450,000   450,000  
d Lobbying ........... 78,000   78,000  
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 14,274   14,274  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 30,841,682 29,087,277 1,754,405  
12 Advertising and promotion .... 1,175,300   1,162,722 12,578
13 Office expenses ....... 44,160,570 42,623,058 1,537,512  
14 Information technology ...... 1,104,635 102,318 1,002,317  
15 Royalties .. 0      
16 Occupancy ........... 5,763,965 5,606,652 157,313  
17 Travel ............ 18,904 17,636 1,268  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials . 0      
19 Conferences, conventions, and meetings .... 254,428 159,147 95,281  
20 Interest ........... 2,218,328 2,218,328    
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization .. 10,296,533 10,296,533    
23 Insurance ... 2,913,059 2,913,059    
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 DUES, BOOKS, SUBSCRIPTIONS 406,305 337,856 68,449  
b COLLECTION FEES 1,349,202 1,111,050 238,152  
c AUXILIARY EXPENSES 55,279     55,279
d ALL OTHER EXPENSES 3,384,520 2,680,946 703,574  
e All other expenses        
25 Total functional expenses. Add lines 1 through 24e 281,818,316 258,411,100 23,339,359 67,857
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 MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2018)
Form 990 (2018)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 1,204,995 1 2,673,571
2 Savings and temporary cash investments ......... 342,755 2 384,287
3 Pledges and grants receivable, net ...... 8,825 3 4,500
4 Accounts receivable, net ............. 24,068,586 4 24,434,556
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 .... 1,169,233 7 1,137,635
8 Inventories for sale or use ........ 3,377,996 8 3,545,554
9 Prepaid expenses and deferred charges ...... 1,742,910 9 1,145,064
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 283,715,621
b Less: accumulated depreciation 10b 240,864,310 45,966,036 10c 42,851,311
11 Investments—publicly traded securities . 25,398,741 11 11,454,079
12 Investments—other securities. See Part IV, line 11 ..... 1,050,761 12 0
13 Investments—program-related. See Part IV, line 11 .. 0 13 0
14 Intangible assets ............... 1,953,594 14 2,158,512
15 Other assets. See Part IV, line 11 ........... 20,279,305 15 23,932,296
16 Total assets. Add lines 1 through 15 (must equal line 34)... 126,563,737 16 113,721,365
Liabilities 17 Accounts payable and accrued expenses ..... 37,393,579 17 47,167,951
18 Grants payable ... 0 18 0
19 Deferred revenue ......... 0 19 0
20 Tax-exempt bond liabilities ......... 18,230,149 20 17,453,268
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 .. 6,776,655 23 5,496,805
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 112,431,582 25 106,855,348
26 Total liabilities. Add lines 17 through 25.. 174,831,965 26 176,973,372
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets -52,766,501 27 -67,796,057
28 Temporarily restricted net assets ........... 2,368,636 28 2,414,413
29 Permanently restricted net assets 2,129,637 29 2,129,637
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet 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 ........... -48,268,228 33 -63,252,007
34 Total liabilities and net assets/fund balances ........ 126,563,737 34 113,721,365
Form 990 (2018)
Form 990 (2018)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
258,483,109
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
281,818,316
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-23,335,207
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
-48,268,228
5
Net unrealized gains (losses) on investments ...............
5
-2,525,346
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
10,876,774
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
-63,252,007
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2018)
Form 990 (2018)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
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.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
Name of the organization
ST JOHNS RIVERSIDE HOSPITAL
ANDRUS PARKCARE & DOBBS FERRY
Employer identification number

13-1740126
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 12, check only one box.)
1
2
3
4
5
6
7
8
9

10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 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) right arrow (a) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..            
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) right arrow (a) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (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  
12
12
 
13
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
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) right arrow (a) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (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) right arrow (a) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (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.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
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.
1
 
 
2
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).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
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.
3b
 
 
c
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.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.
4a
 
 
b
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.
4b
 
 
c
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.
4c
 
 
5a
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).
5a
 
 
b
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?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) 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.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).
8
 
 
9a
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.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9a) 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.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
 
b
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
 
 
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
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
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
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
 
 
Section B. Type I Supporting Organizations
Yes
No
1
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.
1
 
 
2
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.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
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).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
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).
2
 
 
3
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.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
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.
2a
 
 
b
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.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
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.
3a
 
 
b
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.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
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
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)
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 2018 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-2018 		(iii)
Distributable
Amount for 2018
1 Distributable amount for 2018 from Section C, line
6 		 
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI).
See instructions.		  
3 Excess distributions carryover, if any, to 2018:
a From 2013.......  
b From 2014.......  
c From 2015.......  
d From 2016.......  
e From 2017.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2018 distributable amount  
i Carryover from 2013 not applied (see
instructions) 		 
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2018 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2018 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2018, if any. Subtract lines 3g and 4a from line 2.
If the amount is greater than zero, explain in Part VI.
See instructions.		  
6 Remaining underdistributions for 2018. Subtract
lines 3h and 4b from line 1. If the amount is greater
than zero, explain in Part VI. See instructions.		  
7 Excess distributions carryover to 2019. Add lines
3j and 4c.		  
8 Breakdown of line 7:
a Excess from 2014......  
b Excess from 2015.....  
c Excess from 2016.....  
d Excess from 2017.....  
e Excess from 2018.....  
Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018
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) 2018


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Name of the organization
ST JOHNS RIVERSIDE HOSPITAL
ANDRUS PARKCARE & DOBBS FERRY
Employer identification number

13-1740126
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




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
Special Rules
......... Arrow Bullet $  
Caution. An organization that isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2018)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2
Name of organization
ST JOHNS RIVERSIDE HOSPITAL
ANDRUS PARKCARE & DOBBS FERRY 		Employer identification number
13-1740126
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


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
Page 3
Name of organization
ST JOHNS RIVERSIDE HOSPITAL
ANDRUS PARKCARE & DOBBS FERRY 		Employer identification number

13-1740126
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) (2018)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
Page 4
Name of organization
ST JOHNS RIVERSIDE HOSPITAL
ANDRUS PARKCARE & DOBBS FERRY 		Employer identification number

13-1740126
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 (c) Use 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 (c) Use 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 (c) Use 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 (c) Use 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) (2018)

Additional Data


Software ID:  
Software Version:  
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 BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
If the organization answered "Yes" on 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" on 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" on 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
ST JOHNS RIVERSIDE HOSPITAL
ANDRUS PARKCARE & DOBBS FERRY
Employer identification number

13-1740126
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

2
Political campaign activity expenditures (see instructions) ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities (see instructions) ..................................................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 ................................SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 .......................SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................
4a
Was a correction made? ......................................................................................................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b...........SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
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-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2018

Schedule C (Form 990 or 990-EZ) 2018
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 Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(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? ...................................................................................................................

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) 2015 (b) 2016 (c) 2017 (d) 2018 (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) 2018


Schedule C (Form 990 or 990-EZ) 2018
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 on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(b)
Amount
1
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:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
Yes
 
c
Media advertisements? ...................................................................................................
Yes
 
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
Yes
 
78,000
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
 
j
Total. Add lines 1c through 1i ....................................................................................................
78,000
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
 
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
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
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
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."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
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? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) .........................................
5
 
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
PART II-B LOBBYING EXPENSES CONTACT WITH MEMBERS OF THE NYS LEGISLATURE ON SALE OF NURSING HOME AND GRANT FUNDING AND INCREASE THE HOSPITAL'S PRESENCE AND PROFILE WITH LOCAL GOVERNMENT LEADERS AND STATE LEGISLATORS. ALSO, A SMALL PORTION OF PENSION FUND CONTRIBUTIONS ARE ALLOCABLE TO HEALTHCARE EDUCATION PROJECT LOBBYING.
Schedule C (Form 990 or 990EZ) 2018


Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on 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.
SchDMd Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
ST JOHNS RIVERSIDE HOSPITAL
ANDRUS PARKCARE & DOBBS FERRY
Employer identification number

13-1740126
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on 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 ........    
5
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? ............
6
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? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
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.
Held at the End of the 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 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
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)? .............................
9
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" on Form 990, Part IV, line 8.
1a
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.
b
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 on Form 990, Part VIII, line 1 .........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
2
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:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
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) 2018

Schedule D (Form 990) 2018
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
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):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
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?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
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" on Form 990, Part IV, line 10.
(a)Current year (b)Prior year (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance .... 26,449,502 28,524,162 27,436,832 29,107,717 37,262,626
b Contributions ...          
c Net investment earnings, gains, and losses 523,434 3,089,272 1,387,516 151,048 1,537,571
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ... 		15,504,583 5,097,200 231,125 1,692,047 9,654,046
f Administrative expenses .... 14,274 66,732 69,061 129,886 38,434
g End of year balance ...... 11,454,079 26,449,502 28,524,162 27,436,832 29,107,717
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet61.000 %
b
Permanent endowment SchDMd Bullet18.600 %
c
Temporarily restricted endowment SchDMd Bullet20.400 %
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations .................
3a(i)
 
No
(ii) related organizations .................
3a(ii)
 
No
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
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" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis
(investment) 		(b) Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .....   1,185,006 1,185,006
b Buildings ....   122,690,044 101,883,703 20,806,341
c Leasehold improvements   7,382,575 5,103,633 2,278,942
d Equipment ....   151,954,251 133,876,974 18,077,277
e Other .....   503,745   503,745
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 42,851,311
Schedule D (Form 990) 2018

Schedule D (Form 990) 2018
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered "Yes" on 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........    
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' on 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
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) DUE FROM THIRD PARTY PAYORS 10,695,568
(2) OTHER NON-CURRENT ASSETS 5,620,579
(3) OTHER RECEIVABLES 2,817,586
(4) PROFESSIONAL INSURANCE - RCVBL 4,798,563
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 23,932,296
Part X
Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes 0
DUE TO AFFILIATE-CAPTIVE INSUR 2,059,464
DUE TO THIRD PARTY PAYORS 422,949
ACCRUED POSTRETIREMENT BENEFIT 83,470,722
OTHER LT LIAB-DEF ASBESTOS 15,999,506
MALPRACTICE LIABILITY 4,902,707
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 106,855,348
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) 2018

Schedule D (Form 990) 2018
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on 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' on 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
INTENDED USE OF ENDOWMENT FUNDS FORM 990, SCHEDULE D, PART V, LINE 4 THE ENDOWMENT FUND OF THE HOSPITAL HAS BEEN ESTABLISHED TO PROVIDE FUNDING FOR PROGRAMS SUPPORTED BY ITS ENDOWMENT OR TO PROVIDE EMERGENCY FUNDS FOR USAGE TO BE APPROVED BY THE FINANCE COMMITTEE ON AN EMERGENCY BASIS.
ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES FORM 990, SCHEDULE D, PART X, LINE 2 THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE CODE, AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES PURSUANT TO SECTION 501(A) OF THE CODE. THERE ARE CERTAIN TRANSACTIONS THAT COULD BE DEEMED "UNRELATED BUSINESS INCOMEWOULD RESULT IN A TAX LIABILITY. MANAGEMENT REVIEWS TRANSACTIONS TO ESTIMATE POTENTIAL TAX LIABILITIES USING A THRESHOLD OF MORE LIKELY THAN NOT OF BEING SUSTAINED. IT IS MANAGEMENT'S ESTIMATION THAT THERE ARE NO MATERIAL TAX LIABILITIES THAT NEED TO BE RECORDED.
Schedule D (Form 990) 2018


Additional Data


Software ID:  
Software Version:  




SCHEDULE G (Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrowAttach to Form 990 or Form 990-EZ.
right arrowGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
ST JOHNS RIVERSIDE HOSPITAL
ANDRUS PARKCARE & DOBBS FERRY
Employer identification number

13-1740126
Part I
Fundraising Activities. Complete if the organization answered "Yes" on Form 990, Part IV, line 17.
Form 990-EZ filers are not required to complete this part.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.


(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
CHANGING OUR WORLD PLANNING   No      
             
             
             
             
             
             
             
             
             
Total . . . . . . . . . . . . . . . . . . . . right arrow      
3
List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2018
Schedule G (Form 990 or 990-EZ) 2018
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.




VerticalRevenue
(a) Event #1

GOLF OUTING
(event type) 		(b) Event #2

GOLF OUTING
(event type) 		(c) Other events

0
(total number) 		(d) Total events
(add col. (a) through col. (c))

1
Gross receipts . . . . .
185,531
217,745
 
403,276

2
Less: Contributions . . . .
126,361
154,420
 
280,781
3 Gross income (line 1 minus
line 2) . . . . . .
59,170
63,325
 
122,495



VerticalDirectExpenses
4 Cash prizes . . . . .        
5 Noncash prizes . . . . 5,602 9,340   14,942
6 Rent/facility costs . . . . 62,046 71,828   133,874
7 Food and beverages . . .        
8 Entertainment . . . .        
9 Other direct expenses . . . 4,887 4,297   9,184
10 Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . . right arrow 158,000
11 Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . . right arrow -35,505
Part III
Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue
(a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (add col.(a) through col.(c))

1
Gross revenue . . . . .
 
 
 
 
VerticalDirectExpenses

2
Cash prizes . . . . .
 
 
 
 

3
Noncash prizes . . . .
 
 
 
 

4
Rent/facility costs . . . .
 
 
 
 

5
Other direct expenses . . .
 
 
 
 


6

Volunteer labor . . . .
%
%
%


7
Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow
 

8
Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow
 

9
Enter the state(s) in which the organization conducts gaming activities:
a
Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .
b
If "No," explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .
b
If "Yes," explain:
 
Schedule G (Form 990 or 990-EZ) 2018
Schedule G (Form 990 or 990-EZ) 2018
Page 3
11
Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? . . . . . . . . . . . . . . . . .
13
Indicate the percentage of gaming activity conducted in:
a
The organization's facility . . . . . . . . . . . . . . . . . .
13a
%
b
An outside facility . . . . . . . . . . . . . . . . . . . .
13b
%
14
Enter the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? . . . . . . . . . . . . . . . . . . . . . . . .
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address of the third party:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? . . . . . . . . . . . . . . . . . . .
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions.
Return Reference Explanation
Schedule G (Form 990 or 990-EZ) 2018
Additional Data


Software ID:  
Software Version:  
SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
ST JOHNS RIVERSIDE HOSPITAL
ANDRUS PARKCARE & DOBBS FERRY
Employer identification number

13-1740126
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
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.
3
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.
a
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:
3a
Yes
 
%
b
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: . . . . . . . .
3b
Yes
 
%
c
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.
4
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"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
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? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
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) . . . 		    812,000 115,708 696,292 0.250 %
b Medicaid (from Worksheet 3, column a) . . . . .     82,217,427 74,139,338 8,078,089 2.870 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     83,029,427 74,255,046 8,774,381 3.120 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     1,096,206   1,096,206 0.380 %
f Health professions education (from Worksheet 5) . . .     7,882,377 7,091,492 790,885 0.280 %
g Subsidized health services (from Worksheet 6) . . . .            
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .            
j Total. Other Benefits . .     8,978,583 7,091,492 1,887,091 0.660 %
k Total. Add lines 7d and 7j .     92,008,010 81,346,538 10,661,472 3.780 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
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
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
17,699,865
3
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. ......
3
5,514,651
4
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
5
Enter total revenue received from Medicare (including DSH and IME).....
5
62,205,386
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
59,742,823
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
2,462,563
8
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:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
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 .........................

9b

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) 2018
Schedule H (Form 990) 2018
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?3Name, 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) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 SJR HOSPITAL ANDRUS PAVILION
967 NORTH BROADWAY
YONKERS,NY10701
WWW.RIVERSIDEHEALTH.ORG 		X X   X     X     A
2 SJR PARK CARE PAVILION
2 PARK AVENUE
YONKERS,NY10703
WWW.RIVERSIDEHEALTH.ORG 		X X   X           A
3 SJR DOBBS FERRY PAVILION
128 ASHFORD AVE
DOBBS FERRY,NY10522
WWW.RIVERSIDEHEALTH.ORG 		X X   X     X     A
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 4
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)
A
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): 		13
Yes No
Community Health Needs Assessment
1 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?........................ 1   No
2 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............... 2   No
3 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...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 16
5 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 ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b 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. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 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. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 16
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 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   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2018
Schedule H (Form 990) 2018
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
A
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 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):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 6
Part VFacility Information (continued)

Billing and Collections
A
Name of hospital facility or letter of facility reporting group  
Yes No
17 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 nonpayment?.................................. 17 Yes  
18 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:
a
b
c
d
e
f
19 Did the hospital facility or other authorized 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
A
Name of hospital facility or letter of facility reporting group  
Yes No
22 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.
a
b
c
d
23 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? ............................... 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 8
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, 16j, 18e, 19e, 20e, 21c, 21d, 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
ALL PART V DESCRIPTIONS RELATE TO EACH HOSPITAL FACILITY PART V, LINES 5 & 6 The St. John's Riverside Hospital (SJRH) Community Health Needs Assessment {CHNA) was conducted to include its three hospital sites: the Andrus, Park Care and Dobbs Ferry Pavilions, and a joint report was issued. The facilities serve a diverse population in Westchester County and share an authorized body which adopted the assessment in 2018. The St. John's CHNA was developed during 2016 in collaboration with the Westchester County Department of Health's 'Health and Hospital Planning Teamthe Montefiore Hudson Valley Collaborative Performing Provider System (PPS) Hospital Group, and referenced the 'One Region, One CNA' - An Eight County Community Needs Assessment Undertaken in Collaboration With: Westchester Medical Center, Montefiore Medical Center, Refuah Health Center and Health Alliance of the Hudson Valley, December 2016. The Westchester County Department of Health (WCDOH), http://health.westchestergov.com/, and the Montefiore Hudson Valley Collaborative PPS, http://www.montefiore.org/hudson-valley-collaborative, Community Health Needs Assessments, which meet both IRS and NYS needs assessment and service plan requirements, contain more detailed information and data on the health status of the population and distribution of health issues based on analysis of demographic factors and identification of the main health challenges facing the community; as well as a discussion of the contributing causes of these challenges, including broad determinants of health. Our partner sessions gave the opportunity for area hospitals to discuss NYS Prevention Agenda priorities, feedback from their public needs assessments, services provided, gaps in service and best practices. While all hospitals in Westchester County share the same priorities, each hospital selected priorities that aligned with their mission, were attainable, and created a program that best suited its institution and patient service area. The public input process also encompassed collaboration with the following partners: City of Yonkers/SJRH's Healthy Yonkers Initiative and the SJRH community advisory committee. A multidisciplinary group was involved in assessing community health needs in Westchester County with public participation solicited via a survey sponsored by the WCDOH and community partners. The collaborative process was beneficial in researching current health data, conducting health needs assessments within our communities, sharing of best practice interventions and leveraging of resources. To determine the most pressing health needs of our community, we surveyed members of the medically underserved, low-income, and minority population in the SJRH service area, who represent the health interests of our patients and their families. St. John's leadership also considered its own resources, strengths, and abilities in the selection of SJRH's priority community needs. To help support and coordinate this collaboration, the WCDOH invited all Westchester hospitals to attend a kick-off meeting in April 2017. To support in the selection of priorities the WCDOH's Health and Hospital Planning Team held collaborative meetings from April through November 2017. The collection of primary data from a sample of the Westchester County residents was an important element of the development of the Community Health Needs Assessment. SJRH engaged with the WCDOH's on-line Community Resident and Provider Health Surveys to facilitate the implementation of the data collection process. We identified the following partners to help implement interventions identified in our community health needs ASSESSMENT: Hudson River HealthCare FQHC, Hudson Community Health Alliance's Local IMPACT Initiative, primary practice offices, Cancer Coalition of Westchester, Healthy Yonkers Initiative, SJRH Behavioral Health Services, SJRH Community Advisory Team, Westchester County Department of Health and the Montefiore Hudson Valley Collaborative. Our planning team also conducted a survey of selected stakeholders representing health care and service-providing agencies within the county. The purpose of the study was to provide feedback from community service providers in order to: 1) guide strategic planning, 2) highlight topics for increased public awareness, 3) identify areas for training, and 4) inform the statewide Prevention Agenda. The survey was developed through a collaborative effort by an eighteen-member survey committee representing county public health department and local hospitals during the spring-summer of 2017. A total of 1,318 community surveys and 218 provider surveys were conducted May 16 to June 30, 2017. To ensure a broad assessment of our community health needs, we engaged a variety of participants including, but not limited to, the community-at-large through local residents participating in SJRH speaker's bureau's health education programs. We shared health data and sought feedback through the following SJRH groups: community advisory committee, pastoral care committee, physician alignment committee, radiology advisory committee, wellness committee, board of trustees and our employees. SJRH also gathered information from external sources by conducting public forums at the Cross County Shopping Center in Yonkers, New York and other health sessions held at select locations to address the community that represented the diverse population that we serve. We plan to provide ongoing opportunities for hospitals and other stakeholders, i.e. community-based organizations, to strategize on how to address health priorities. We will also work with partners to provide more refined data to track and evaluate progress in achieving goals related to selected priorities. SJRH will continue to communicate with other community-based organizations regarding advocacy, participation in local community events, and exchange of referral information. Engaging local community members in our efforts enables us to involve our health care institution and the community in the activities of national health advocacy organizations, including walks, fairs, and other awareness-raising activities for health issues that impact the community. PART V, LINES 7 AND 10 (CHNA PUBLICATION) THE ST. JOHN'S RIVERSIDE HOSPITAL (SJRH) COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS WAS CONDUCTED DURING THE 2016 PERIOD AND APPROVED BY ITS BOARD OF TRUSTEES ON DECEMBER 12, 2017. THE FINAL APPROVED CHNA REPORT WAS UPLOADED TO THE SJRH PUBLIC WEBSITE WWW.RIVERSIDEHEALTH.ORG ON DECEMBER 30, 2017, SHARED WITH COMMUNITY PARTNERS AND A PAPER COPY WAS MADE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST AND WITHOUT CHARGE AT THE HOSPITAL FACILITY. A PRESS RELEASE WAS SENT TO ALL LOCAL MEDIA FOR PUBLICATION, THAT THE REPORT IS AVAILABLE FOR THE PUBLIC TO REVIEW. ALL HOSPITAL ADMINISTRATIVE OFFICES ARE GIVEN A COPY OF THE REPORT TO PRODUCE UPON REQUEST. THE COMMUNITY RECEIVED COMMUNICATION THROUGH OUR PRINT NEWSLETTER, "RIVERSIDE". SJRH EMPLOYEES, PHYSICIANS AND COMMUNITY PARTNERS RECEIVED NOTIFICATION THROUGH THEIR EMAIL NEWSLETTERS WITH A LINK TO CONNECT THEM TO OUR WEBSITE. NOTIFICATION WAS ALSO POSTED ON THE SJRH FACEBOOK PAGE. EMPLOYEES CAN ALSO ACCESS THE REPORT THROUGH THE HOSPITAL INTRANET AND COPIES CAN BE OBTAINED BY CALLING THE HOSPITAL'S PUBLIC RELATIONS OFFICE. DIRECT URL TO CHNA: http://riversidehealth.org/Portals/0/2016/St.%20John's%20Riverside%20Hospi tal%202016-2018%20CSP%20-%20Post-ilovepdf-compressed.pdf PART V, LINE 11 (ADDRESSING COMMUNITY NEEDS) THE AFFORDABLE CARE ACT REQUIRES NOT-FOR-PROFIT HOSPITALS TO ASSESS AND ADDRESS THE HEALTH NEEDS OF THE COMMUNITIES THEY SERVE THROUGH THE DEVELOPMENT OF A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IMPLEMENTATION STRATEGY (I/S). ACCORDINGLY, ST. JOHN'S RIVERSIDE HOSPITAL (SJRH) HAS TAKEN INTO ACCOUNT THE BROAD INTERESTS OF ITS COMMUNITY MEMBERS, ANALYZED HEALTH DATA AND SUBSEQUENTLY ADOPTED A PLAN TO PRIORITIZE AND MEET THE HEALTH NEEDS IDENTIFIED. THE SJRH CHNA PROVIDES A REPORT OF THE PROCESS AND RESULTS OF A COMPREHENSIVE ASSESSMENT OF THE NEEDS OF ITS COMMUNITY SERVED. THE SJRH I/S ADDRESSES THE SIGNIFICANT COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE CHNA AND DELINEATES THE METRICS TO BE USED TO EVALUATE THE IMPACT OF THESE INITIATIVES. THE SJRH CHNA WAS DEVELOPED BASED UPON BOTH FEDERAL AND NEW YORK STATE (NYS) GUIDELINES. THE NYS GUIDELINES WERE DESIGNED TO MEET THE FEDERAL HEALTHY PEOPLE 2020 GOALS AND ENCOMPASS THE NYS DEPARTMENT OF HEALTH PREVENTION AGENDA 2013-2018 (MARCH 2015), AND PREVENTION AGENDA 2013-2018 ACTION PLAN RE-FRESH CHART (DECEMBER 2015). SJRH has considered the CHNA and Prevention Agenda documents along with the dialogue of its Community Partners in the establishment of its three-year action plan that includes two Prevention Agenda priorities; both of which address a health disparity in the community and involves ongoing collaboration and engagement with partners to achieve health improvement. The SJRH CHNA is an outcome
PART V, LINE 13G & 13H AMOUNTS CHARGED TO PATIENTS THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY PROVIDES ASSISTANCE TO INDIVIDUALS IN THE FOLLOWING GEOGRAPHIC AREAS: 1. FOR EMERGENCY CARE SERVICES: ALL NEW YORK STATE RESIDENTS. 2. FOR MEDICALLY NECESSARY NON-EMERGENT INPATIENT, AMBULATORY SURGERY, AND OUTPATIENT SERVICES (INCLUDING CLINICS), THE HOSPITAL'S PRIMARY SERVICE AREA (PSA) INCLUDES ALL PATIENTS RESIDING IN THE FOLLOWING COUNTIES: WESTCHESTER, ORANGE, PUTNAM, ROCKLAND, BRONX, MANHATTAN (NEW YORK), BROOKLYN (KINGS) AND QUEENS. PART V, LINE 16A THE FINANCIAL ASSISTANCE POLICY (FAP) CAN BE FOUND AT THE FOLLOWING WEBSITE: http://riversidehealth.org/PatientsVisitors/PayingForYourCare.aspx PART V, LINE 16B THE FINANCIAL ASSISTANCE POLICY APPLICATION CAN BE FOUND AT THE FOLLOWING WEBSITE: http://riversidehealth.org/Portals/0/2016/2016%20Health%20Solutions%20Appl ication%20(Merged).pdf PART V, LINE 16C A PLAIN LANGUAGE SUMMARY OF THE SJRH FAP CAN BE FOUND AT THE FOLLOWING WEBSITE: HTTP://WWW.RIVERSIDEHEALTH.ORG/PATIENTSVISITORS/PATIENTFINANCIALSERVICES.A SPX PART V, LINE 16I PUBLICATION OF FINANCIAL ASSISTANCE POLICY SEE SUPPLEMENTAL INFORMATION, PART VI, LINE 3 FOR MORE INFORMATION.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 9
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) 2018
Schedule H (Form 990) 2018
Page 10
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 3A AND PART V, LINE 13 FREE CARE AS OUTLINED IN THE NEW YORK STATE HOSPITAL FINANCIAL ASSISTANCE LAW, UNINSURED INDIVIDUALS WITH DOCUMENTED INCOME AND FAMILY SIZE LEVELS THAT FALL AT OR BELOW 100% FPL WILL BE ENTITLED TO PAY THE AMOUNTS SPECIFIED UNDER THE STATE'S NOMINAL PAYMENT GUIDELINES (AS SHOWN BELOW AND INCLUDED IN THE HOSPITAL'S FINANCIAL AND CHARITY CARE PROGRAM POLICY): I. INPATIENT SERVICES - $150/DISCHARGE II. AMBULATORY SURGERY - $150/PROCEDURE III. ALL ANCILLARY SERVICES - $150/PROCEDURE IV. ADULT ER/CLINIC SERVICES - $15/VISIT V. PRENATAL AND PEDIATRIC ER/CLINIC SERVICES - NO CHARGE PART I, LINE 6A THE HOSPITAL SUBMITTED A COMMUNITY SERVICE PLAN (CSP) TO NEW YORK STATE IN 2016 AND PREPARED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) REPORT IN 2016, BOTH OF WHICH ARE MADE AVAILABLE TO THE PUBLIC THROUGH POSTING ON THE HOSPITAL'S WEBSITE AND UPON REQUEST. THE HOSPITAL'S MISSION STATEMENT HAS NOT CHANGED SINCE THE SUBMISSION OF THE 2016 CSP. THE HOSPITAL IS CURRENTLY INVOLVED IN A STRATEGIC PLANNING PROCESS WHICH HAS LED TO A FOCUSED EFFORT ON ADDRESSING QUALITY OF CARE, CUSTOMER SATISFACTION, ACCESS TO CARE, MARKET SHARE AND PHYSICIAN ALIGNMENT. PLEASE NOTE, THE HOSPITAL'S PRIMARY SERVICE AREA UTILIZED IN COMMUNITY SERVICE PLANNING IS THE SAME AS REPORTED IN THE 2017 CSP. PART I, LINE 7 THE COST-TO-CHARGE RATIO METHODOLOGY WAS UTILIZED TO CALCULATE THE AMOUNTS INCLUDED IN THE TABLE. THE CALCULATION OF THIS RATIO WAS DERIVED FROM THE MEDICARE COST REPORT. PART III, LINES 2 & 4 THE HOSPITAL REGULARLY REVIEWS ITS PAST COLLECTION HISTORY AND PAYMENT TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF PATIENT SERVICE REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. FOR PATIENT ACCOUNTS RECEIVABLE ASSOCIATED WITH SELF-PAY PATIENTS, WHICH INCLUDES THOSE PATIENTS WITHOUT INSURANCE COVERAGE AND PATIENTS WITH DEDUCTIBLES AND COPAYMENT BALANCES FOR WHICH THIRD-PARTY coverage exists for a portion of the bill, THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS FOR PATIENTS THAT ARE UNABLE OR UNWILLING TO PAY FOR THE PORTION OF THE BILL REPRESENTING THEIR FINANCIAL RESPONSIBILITY. ACCOUNT BALANCES ARE CHARGED OFF AGAINST THE ALLOWANCES FOR DOUBTFUL ACCOUNTS AFTER ALL MEANS OF COLLECTION HAVE BEEN EXHAUSTED. The 2018 consolidated audited financial statements contain a patient accounts receivable footnote on Page 10 and a charity care and uncompensated care footnote on Page 13. PART III, LINE 3 The hospital is dedicated to providing comprehensive medical and nursing care in a compassionate, professional, respectful and ethical manner to every patient regardless of ability to pay. The amount of $5,514,651 represents the hospital's bad debt expense attributable to patients eligible under the Hospital Financial Assistance policy and is comprised of the dollar value of the discounts made available to patients under the Hospital Financial Assistance policy as well as the uncompensated care provided to the members of our community that we serve who are in need of emergency and medically necessary care and do not have the ability to pay. PART III, LINE 8 TO DETERMINE THE MEDICARE ALLOWABLE COSTS OF CARE ON PART III, LINE 6, MEDICARE CHARGES WERE MULTIPLIED BY THE COST TO CHARGE RATIO, AS DERIVED FROM THE MEDICARE COST REPORT.
PART III, LINE 9B 1. PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE HEALTH SOLUTION PROGRAM WILL HAVE THEIR OPEN ACCOUNTS ADJUSTED TO THE AMOUNT DUE BASED ON THE LEVEL OF ASSISTANCE THEY RECEIVE, SO THAT BILLS AND STATEMENTS WILL REFLECT THE DISCOUNTED AMOUNT DUE. PATIENTS WILL THEN BE EXPECTED TO PAY THE ADJUSTED AMOUNT DUE. 2. PATIENTS WHO ARE UNABLE TO PAY THE ADJUSTED AMOUNT DUE WILL BE OFFERED PAYMENT PLANS. 3. PAYMENT PLANS WILL NOT REQUIRE A PATIENT TO PAY MORE THAN 10% OF THEIR MONTHLY GROSS INCOME TOWARDS MONTHLY INSTALLMENT PAYMENTS. IF THE HOSPITAL ELECTS TO CONSIDER OTHER NON-EXCLUDED ASSETS IN DETERMINING FINANCIAL ASSISTANCE ELIGIBILITY, THEN MONTHLY PAYMENTS MAY EXCEED 10%. 4. THE HOSPITAL WILL NOT COLLECT FROM A PATIENT WHO IS DETERMINED TO BE ELIGIBLE FOR MEDICAID, OR WHO IS ELIGIBLE FOR MEDICAID AT THE TIME SERVICES WERE RENDERED. 5. IF A PATIENT OR RESPONSIBLE PARTY DEFAULTS ON ITS PAYMENT OBLIGATIONS, OR FAILS TO MEET THE TERMS OF ANY FINANCIAL AGREEMENT, THE ACCOUNT IN QUESTION WILL BE CONSIDERED DELINQUENT, AND MAY BE REFERRED TO A COLLECTION AGENCY BASED ON THE HOSPITAL'S COLLECTION POLICY. 6. THE HOSPITAL WILL NOT SEND AN ACCOUNT TO COLLECTION IF THE PATIENT HAS SUBMITTED A COMPLETED APPLICATION FOR FINANCIAL AID, INCLUDING REQUIRED SUPPORTING DOCUMENTATION, WHILE THE HOSPITAL DETERMINES THE PATIENT'S ELIGIBILITY FOR SUCH AID, OR DURING THE PROCESS WHERE THE PATIENT HAS APPEALED AN ELIGIBILITY DETERMINATION. 7. THE HOSPITAL WILL REVIEW ALL ACCOUNTS DETERMINED TO BE REFERRED TO OUTSIDE COLLECTION TO ENSURE THAT ITS FINANCIAL POLICY AND PROCEDURES WERE FOLLOWED. 8. THE HOSPITAL WILL PROVIDE WRITTEN NOTIFICATION AND A NOTICE ON THE PATIENT'S BILL LESS THAN 30 DAYS PRIOR TO REFERRING THE ACCOUNT TO OUTSIDE COLLECTION. 9. THE HOSPITAL WILL SEND EACH OF ITS COLLECTION AGENCIES A COPY OF ITS FINANCIAL ASSISTANCE POLICY AND PROCEDURES, AND WILL INSTRUCT THE AGENCY TO FOLLOW THESE PROCEDURES WHEN INSTRUCTING THE PATIENT HOW TO APPLY FOR SUCH AID. 10. COLLECTION AGENCIES MUST OBTAIN THE HOSPITAL'S WRITTEN CONSENT PRIOR TO COMMENCING A LEGAL ACTION ON A PATIENT'S ACCOUNT. 11. LEGAL ACTION MAY INCLUDE GARNISHMENT OF WAGES WHERE THERE IS EVIDENCE THAT THE PATIENT OR RESPONSIBLE PARTY HAS INCOME AND/OR ASSETS TO MEET HIS/HER FINANCIAL OBLIGATION UNDER THIS POLICY. 12. THE HOSPITAL WILL NOT PERMIT THE FORCED SALE OR FORECLOSURE OF A PATIENT'S PRIMARY RESIDENCE IN ORDER TO COLLECT AN OUTSTANDING MEDICAL BILL.
2. NEEDS ASSESSMENT ST. JOHN'S RIVERSIDE HOSPITAL (SJRH) LOCATED IN THE HUDSON VALLEY REGION WITHIN WESTCHESTER COUNTY, SERVES THE CITY OF YONKERS AND THE RIVERTOWN AREAS AND ACTIVELY WORKS WITH THE FOLLOWING PARTNERS TO ASSESS THE COMMUNITIES' HEALTH CARE NEEDS: LOCAL COMMUNITY-BASED ORGANIZATIONS, BUSINESSES, CITY PLANNING COUNCILS, SCHOOLS, THE WESTCHESTER COUNTY HEALTH DEPARTMENT, OTHER HEALTH CARE ORGANIZATIONS AND THE HOSPITALS' COMMUNITY ADVISORY COMMITTEE. WE ALSO PARTNER WITH THE AMERICAN CANCER SOCIETY, DIABETES AND HEART ASSOCIATIONS, FEMA, MARCH OF DIMES, CABRINI IMMIGRANT SERVICES AND OTHERS TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY THAT WE SERVE. THIS IS ACCOMPLISHED THROUGH SHARED DATA FOR PLANNING PURPOSES, AWARENESS OF SERVICES OFFERED BY OUR PARTNERS, COLLABORATIVE PROGRAM PLANNING, IMPLEMENTATION AND EVALUATION, AND COORDINATED HEALTH OUTREACH AND PROMOTION. THESE EFFORTS HAVE RESULTED IN ST. JOHN'S PROVIDING ON-GOING EDUCATION AND GUIDANCE TO THE YONKERS PTA COORDINATING COUNCIL AND THE LOCAL YMCA'S HEALTH INITIATIVE RELATIVE TO HEALTH CARE ISSUES. THE COMMUNITY SERVICE PLAN AGENDA WAS ESTABLISHED BASED ON A COMPREHENSIVE HEALTH NEEDS ASSESSMENT AND ITS FINDINGS. SEVERAL SURVEYS AND COMMUNITY FOCUS GROUPS WERE ALSO CONDUCTED TO GATHER DATA. THE RESPONSES OF THE PARTICIPANTS AS TO WHAT HEALTH CARE EDUCATION IS NEEDED WAS ONE OF THE KEY COMMUNITY INPUTS TO SETTING THE FRAMEWORK FOR PLANNING EDUCATIONAL PROGRAMS FOR THE COMMUNITY. SJRH IS A LEADER IN COMMUNITY COLLABORATION AND HAS A LONG HISTORY OF DEVELOPING INNOVATIVE APPROACHES TO CARE AND TAILORING PROGRAMS TO BEST SERVE THE CHANGING NEEDS OF ITS COMMUNITY. THESE INCLUDE, BUT ARE NOT LIMITED TO THE FOLLOWING: ST. JOHN'S COMMUNITY ADVISORY TEAM, HEALTHY YONKERS INITIATIVE PARTNERSHIP, DISEASE MANAGEMENT PROGRAMS, COMPREHENSIVE LAY AND CLINICAL PATIENT NAVIGATION PROGRAMS, COMMUNITY HEALTH OUTREACH WORKERS AND A SPEAKER'S BUREAU. THE INTEGRATION OF THESE INNOVATIVE APPROACHES SUPPORTS SJRH WELL IN ITS PROVISION OF SERVICES TO ITS COMMUNITY. SJRH PROMOTES WELLNESS IN ADDITION TO TREATING DISEASE AND ADDRESSES NEEDS RANGING FAR BEYOND MEDICAL CARE. WE EXTEND THIS RESPONSIBILITY TO THE CARE OF OUR EMPLOYEES AND MEDICAL STAFF, MANY OF WHOM LIVE IN THE SURROUNDING COMMUNITY. SJRH SERVES A DIVERSE COMMUNITY AND HAS BEEN A FORERUNNER OF PROGRAMS THAT IMPROVE PATIENTS' ACCESS TO CULTURALLY APPROPRIATE SERVICES. ITS PROGRESSIVE FINANCIAL AID POLICY AND ROBUST ENTITLEMENT AND ENROLLMENT PROGRAM THROUGH OUR FINANCIAL ASSISTANCE UNIT, SUPPORTS ACCESS TO CARE FOR THOSE IN NEED. HISTORICALLY, SJRH HAS VIEWED COMMUNITY SERVICE AND COMMUNITY HEALTH IMPROVEMENT AS AN INTEGRAL PART OF ITS HOSPITAL MISSION, REACHING OUT TO SERVE THE UNDERSERVED. SERVICES TO THE COMMUNITY ARE AN EXPLICIT AND ESSENTIAL COMPONENT OF SJRH'S MISSION AND ONE OF ITS MOST VALUED TRADITIONS. WE REACH BEYOND THE WALLS OF OUR CAMPUSES TO IDENTIFY AND MEET THE NEEDS OF THE COMMUNITY, NOT JUST MEDICALLY, BUT SOCIALLY, ECONOMICALLY AND ENVIRONMENTALLY. SJRH PARTICIPATES IN A VARIETY OF ORGANIZED PARTNERSHIPS AND COLLABORATIONS, WORKING WITH OTHER PROVIDERS IN WESTCHESTER COUNTY, INCLUDING THE WESTCHESTER COUNTY DEPARTMENT OF HEALTH, COMMUNITY-BASED ORGANIZATIONS AND MEMBERS OF THE COMMUNITY IN PLANNING AND DEVELOPING INITIATIVES AIMED AT IMPROVING THE OVERALL HEALTH OF THE PEOPLE OF WESTCHESTER COUNTY.
3. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE THE ST. JOHN'S FINANCIAL ASSISTANCE UNIT EDUCATES PATIENTS AND THE PUBLIC ABOUT THEIR RIGHTS, RESPONSIBILITIES AND OPTIONS TO ATTAIN SOME COVERAGE OF COSTS FOR THEIR HEALTH CARE. ST. JOHN'S RIVERSIDE HOSPITAL EDUCATES OUR PATIENTS ABOUT OUR CHARITY CARE PROGRAM CALLED HEALTH SOLUTION* IN THE FOLLOWING MANNER: A. THE HOSPITAL WEB SITE HAS THE COMPLETE HEALTH SOLUTION SUMMARY. THE SUMMARY DESCRIBES THE RESIDENTIAL AREAS WE COVER, THE TYPE OF SERVICES THAT ARE NOT COVERED, WHERE TO APPLY, THE PHONE NUMBER TO OBTAIN INFORMATION, THE FEDERAL POVERTY GUIDELINES INCOME LEVEL AND HOW TO APPEAL THE APPLICATION DECISION. B. THERE ARE POSTED NOTICES IN ALL REGISTRATION AND CASHIER AREAS WITHIN THE HOSPITAL. C. THE HEALTH SOLUTION SUMMARY IS INCLUDED IN THE REGISTRATION PACKET THAT IS GIVEN TO ALL PATIENTS. D. THE FINANCIAL ASSISTANT UNIT STAFF WHEN VISITING PATIENT ROOMS WILL DISCUSS THE HEALTH SOLUTION PROGRAM. * HEALTH SOLUTION, OFFERED SINCE 2000, IS AN OPTION FOR PATIENTS WITH A FINANCIAL NEED. PATIENTS WHO APPLY ARE ASSESSED TO DETERMINE ELIGIBILITY TO PAY DOWN HEALTHCARE BILLS WITHIN THEIR BUDGET. HEALTH SOLUTION IS A CHARITY CARE PROGRAM WHERE PAYMENTS BY PATIENTS CAN BE MADE OVER TIME. ELIGIBILITY FOR MEDICAID IS DETERMINED FIRST. WHEN ELIGIBLE, HEALTH SOLUTION PAYMENTS CAN ALSO BE USED TO PAY INSURANCE DEDUCTIBLES.
4. COMMUNITY INFORMATION ST. JOHN'S RIVERSIDE HOSPITAL (SJRH), A NOT-FOR-PROFIT, NEW YORK STATE DEPARTMENT OF HEALTH (NYSDOH) LICENSED 378-BED ACUTE CARE COMMUNITY HEALTH SYSTEM, OPERATES THREE {3) CAMPUSES: ANDRUS PAVILION {225 BEDS), PARK CARE PAVILION (141 BEDS}, AND DOBBS FERRY PAVILION (12 BEDS). THE ANDRUS PAVILION, PROVIDES EMERGENCY SERVICES, GENERAL ACUTE AND CANCER CARE, WITH A FULL RANGE OF INPATIENT AND OUTPATIENT SERVICES; IS DESIGNATED BY THE NYSDOH AS A STROKE CENTER AND LEVEL II PERINATAL CENTER, AND IS THE ONLY PROVIDER OF MATERNITY SERVICES IN THE CITY OF YONKERS. THE PARK CARE PAVILION PROVIDES INPATIENT AND OUTPATIENT SUBSTANCE ABUSE SERVICES AND IS DESIGNATED BY NYSDOH AS AN AIDS CENTER. THE DOBBS FERRY PAVILION, PROVIDES INPATIENT AND PRIMARY MEDICAL CARE, AMBULATORY SURGERY AND EMERGENCY SERVICES, AND IS THE HUB FOR CENTERS OF EXCELLENCE IN BREAST AND ORTHOPEDIC CARE. AT ST. JOHN'S, OVER 600 MEDICAL AND ALLIED HEALTH PROFESSIONALS PROVIDE A WIDE RANGE OF AMBULATORY AND INPATIENT SERVICES; AND OVER 250,000 INDIVIDUALS ARE SERVED ANNUALLY WITHIN OUR NETWORK. SJRH, GOVERNED BY A VOLUNTARY TWENTY-SIX MEMBER BOARD OF TRUSTEES, IS A SAFETY-NET HOSPITAL SERVING THE URBAN, ETHNICALLY DIVERSE AND ECONOMICALLY DISADVANTAGED COMMUNITY OF SOUTHWEST YONKERS, NEW YORK. AS A DESIGNATED NYS 'ESSENTIAL COMMUNITY PROVIDER', WE SERVE PREDOMINANTLY LOW-INCOME MEDICALLY UNDERSERVED INDIVIDUALS. THE ST. JOHN'S RIVERSIDE HOSPITAL PRIMARY SERVICE AREA INCLUDES THE CITY OF YONKERS, VILLAGE OF DOBBS FERRY AND THE SURROUNDING TOWNS AND VILLAGES OF HASTINGS-ON-HUDSON, ARDSLEY, IRVINGTON, TARRYTOWN, ELMSFORD, TUCKAHOE, BRONXVILLE, AND SCARSDALE WITHIN WESTCHESTER COUNTY, NEW YORK. WITHIN THE CITY OF YONKERS AND DOBBS FERRY, THE SJRH FACILITIES ARE THE LARGEST HEALTH SERVICE PROVIDERS AND IT IS WITHIN THIS GEOGRAPHIC AREA THAT THESE SJRH FACILITIES HAVE THEIR COMMUNITY-BASED PRIMARY CARE AND SPECIALTY AMBULATORY SERVICES. OUR ANDRUS AND PARK CARE PAVILIONS ARE LOCATED IN AND PRIMARILY SERVE THE CITY OF YONKERS. THE DOBBS FERRY PAVILION SERVES THE RIVERTOWN COMMUNITIES OF DOBBS FERRY, HASTINGS-ON-HUDSON, ARDSLEY AND IRVINGTON. THE RESIDENT POPULATION OF THE CITY OF YONKERS COMPRISES ONE-THIRD OF THE HOSPITAL'S SERVICE AREA AND DEPENDING ON ZIP CODE ACCOUNTS FOR BETWEEN 30 TO SO PERCENT OF ITS ADMISSIONS. THE COMMUNITIES SERVED BY OUR HEALTH SYSTEM ARE WIDESPREAD AND DIVERSE. ST. JOHN'S PROVIDES CONVENIENT ACCESS TO HIGH QUALITY ACUTE, PRIMARY AND SPECIALTY CARE TO INDIVIDUALS AND FAMILIES LIVING IN A PRIMARY SERVICE AREA OF FOURTEEN (14) ZIP CODES SURROUNDING ITS LOCATION. THE ZIP CODES THAT WE MOST COMMONLY PROVIDE SERVICES FOR ARE: 10701, 10703, 10704, 10705, 10706, 10707, 10708, 10710, 10502, 10522, 10523, 10533, 10583, AND 10591. FIVE ZIP CODE AREAS IN SOUTHWEST YONKERS (10701, 10703, 10704, 10705, AND 10710) HAVE BEEN FEDERALLY DEFINED AS MEDICALLY UNDERSERVED AREAS. AS SUCH, IT IS A KEY EMERGENCY MEDICAL SERVICE (EMS) PARTICIPANT OPERATING IN ITS TWO HOSPITALS WITH 50,272 EMERGENCY VISITS IN 2017. YONKERS IS THE LARGEST CITY IN WESTCHESTER AND THE 4TH LARGEST CITY IN NEW YORK STATE, WITH A 2015 POPULATION ESTIMATE OF 201,116 AS PER THE U.S. CENSUS BUREAU. IT IS AN AGING INDUSTRIAL CITY WITH NEEDS OFTEN OVERLOOKED IN A COUNTY DOMINATED BY AFFLUENT SUBURBS. YONKERS BORDERS THE BRONX AND SHARES MANY OF NEW YORK CITY'S URBAN PROBLEMS; AND ACCOMPANYING ITS DIVERSITY, ARE SIGNIFICANT INEQUITIES IN HEALTH STATUS. ONE IN FIVE FAMILIES' LIVES IN POVERTY AND OVER ONE THIRD OF THESE FAMILIES ARE HEADED BY FEMALES. ST. JOHN'S ECONOMICALLY, CULTURALLY AND ETHNICALLY DIVERSE SERVICE AREA ENCOMPASSES NEIGHBORHOODS WITH LARGE NUMBERS OF HISPANIC AND AFRICAN-AMERICAN RESIDENTS, INCLUDING HAITIAN AND DOMINICAN IMMIGRANTS. YONKERS HAS THE HIGHEST PROPORTION OF HISPANIC RESIDENTS IN WESTCHESTER COUNTY, MANY OF WHOM ARE RECENT IMMIGRANTS WITH LIMITED FLUENCY IN ENGLISH. PUERTO RICANS AND MEXICANS ARE THE TWO LARGEST HISPANIC COMMUNITIES. ENGLISH AND SPANISH ARE THE DOMINANT LANGUAGES, ALTHOUGH THERE ARE A SIGNIFICANT NUMBER OF RESIDENTS WHO SPEAK ITALIAN, PORTUGUESE AND ARABIC. THE PROFILE OF THIS AREA INCLUDES HIGH UNEMPLOYMENT, LARGE NUMBERS OF HIGH SCHOOL DROPOUTS, OVERCROWDED HOUSING, AND FAMILIES AND CHILDREN IN POVERTY. YONKERS IS FEDERALLY DESIGNATED AS A HIGH INTENSITY DRUG TRAFFICKING AREA. THERE IS A HIGH RATE OF TEEN PREGNANCY, LACK OF PRENATAL CARE, VACCINE PREVENTABLE DISEASE, TUBERCULOSIS, AND HIV/AIDS. THE CITY HAS THE HIGHEST CONCENTRATION OF HIV/AIDS IN THE COUNTRY. OUR SUBSTANCE ABUSE TREATMENT AND TRAINING CENTER IS NEW YORK'S LARGEST PROVIDER OF SUBSTANCE ABUSE SERVICES. THE DOBBS FERRY FACILITY IS THE ONLY HOSPITAL LOCATED IN THE VILLAGE OF DOBBS FERRY, APPROXIMATELY 7 MILES FROM ITS SJRH SISTER FACILITIES IN YONKERS. THE TOTAL POPULATION OF THIS SERVICE AREA IS APPROXIMATELY 124,000. A POPULATION THAT IS LARGELY WHITE AND AFFLUENT DEFINES THIS AREA. WESTCHESTER COUNTY IS A LARGE COUNTY LOCATED JUST TO THE NORTH OF NEW YORK CITY IN THE HUDSON VALLEY; WESTCHESTER COVERS AN AREA OF 450 SQUARE MILES (1,200 SQUARE KM) AND CONSISTS OF 48 MUNICIPALITIES. THE COUNTY INCLUDES URBAN, SUBURBAN AND RURAL GEOGRAPHIES. IN 2015, THE ESTIMATED POPULATION OF WESTCHESTER COUNTY WAS 976,396, UP 6.6% FROM 915,916 IN 2005. THE COUNTY SEAT OF WESTCHESTER IS THE CITY OF WHITE PLAINS (56,853) AND OTHER MAJOR CITIES INCLUDE YONKERS (195,976), NEW ROCHELLE (77,062) AND MOUNT VERNON (67,292). IN 2015, THE MEDIAN HOUSEHOLD INCOME FOR WESTCHESTER WAS $86,108, 4TH HIGHEST IN NEW YORK STATE, AFTER NASSAU, PUTNAM AND SUFFOLK COUNTIES. WESTCHESTER COUNTY IS THE 5TH HEALTHIEST COUNTY IN NEW YORK STATE, ACCORDING TO THE COUNTY HEALTH RANKINGS, PRODUCED BY THE ROBERT WOOD JOHNSON FOUNDATION AND UNIVERSITY OF WISCONSIN. DESPITE ITS OVERALL HIGH RANKING. THERE IS CONSIDERABLE ROOM TO BOTH IMPROVE POPULATION HEALTH AND REDUCE HEALTH DISPARITIES IN WESTCHESTER COUNTY. SEVERAL OF ITS INDIVIDUAL MUNICIPALITIES CONTINUE TO MAINTAIN SIGNIFICANT HEALTH GAPS, WITH PORTIONS OF LOWER WESTCHESTER SPECIFICALLY, MOUNT VERNON, YONKERS, NEW ROCHELLE AND WHITE PLAINS SERVING "HOT SPOTS" FOR ASTHMA, HIV, AND ILLICIT DRUG USE IN THE COUNTY. THESE AREAS ALSO DEMONSTRATE EXCESS MORTALITY RATES FROM HEART DISEASE, STROKE, AND DIABETES COMPARED TO COUNTY AND NEW YORK AVERAGES. MORTALITY RATES: ACCORDING TO THE NEW YORK STATE DEPARTMENT OF HEALTH'S (NYSDOH} VITAL STATISTICS OF NEW YORK STATE REPORT IN 2011, WESTCHESTER COUNTY HAS AN AGE-ADJUSTED MORTALITY RATE OF 713.4 PER 100,000; SIMILAR TO THE STATEWIDE RATE OF 753.1. ACCORDING TO THE COMMUNITY HEALTH RANKINGS IN 2014, WESTCHESTER COUNTY RANKED AS NUMBER 3 OUT OF 62 NY COUNTIES TO HAVE THE LOWEST MORTALITY RATE IN NEW YORK STATE. THE LEADING CAUSE OF DEATH AMONG WESTCHESTER COUNTY RESIDENTS IS DUE TO CORONARY HEART DISEASE (219.7 PER 100,000).
5. PROMOTION OF COMMUNITY HEALTH ST. JOHN'S CONTINUES TO ADDRESS THE HEALTH CARE NEEDS OF OUR POPULATION THROUGH A VARIETY OF SOURCES. OUR COMMUNITY ADVISORY COMMITTEE IS A KEY FORUM FOR ACCESS TO INFORMATION ON COMMUNITY HEALTH CARE NEEDS AND RESIDENT SATISFACTION WITH THE HEALTH CARE THAT THEY RECEIVE. ADVISORY MEMBERS ALSO PROVIDE ACCESS TO LOCAL COMMUNITY BASED ORGANIZATIONS AND BUSINESSES FOR HEALTH PROMOTION. THE HEALTH YONKERS INITIATIVE (HYI) IS A COLLABORATION OF OVER THIRTY COMMUNITY/HEALTH/FAITH-BASED ORGANIZATIONS, BUSINESSES, SCHOOLS AND RESIDENTS, LED BY ST. JOHN'S AND THE CITY OF YONKERS. IT IS AN INTEGRAL COMPONENT OF OUR OUTREACH EFFORTS. THE HYI PARTNERS MEET QUARTERLY, PLAN HEALTH OUTREACH ACTIVITIES, SHARE INFORMATION AND PROVIDE ACCESS TO RESIDENTS AND PLANNED ORGANIZATION COMMUNITY EVENTS. A SPEAKER'S FORUM PROVIDES PHYSICIANS TO EDUCATE ON KEY HEALTH TOPICS IN THE COMMUNITY. FUNDS AVAILABLE THROUGH GRANTS ALSO PROVIDE THE ABILITY TO PROVIDE A HOST OF PREVENTION AND WELLNESS ACTIVITIES. SOME OF OUR KEY ACTIVITIES HAVE ENHANCED HEALTH CARE ACCESS, PROVIDED PATIENT NAVIGATION AND A HOST OF SUPPORT SERVICES FOR OUR PATENTS. OUR COMMUNITY, OUTPATIENT, INPATIENT AND CLINICAL PATIENT NAVIGATION SERVICES PROVIDE COMMUNITY HEALTH EDUCATION, COORDINATE SCREENINGS, DEMYSTIFY TREATMENT OPTIONS, UN-COMPLICATE THE PROCESS FROM DIAGNOSIS TO TREATMENT, FACILITATE SCREENING AND DIAGNOSTIC TEST AND HEALTH AND PSYCHOSOCIAL SUPPORT SERVICES. BARRIERS TO CARE AND ACCESS TO TECHNOLOGICAL ADVANCEMENTS IN TREATING DISEASE ARE CONTINUALLY ADDRESSED FOR THE UNDERINSURED/UNDERSERVED POPULATION. OUR BREAST HEALTH PROGRAM IS DESIGNED TO REDUCE THE RATE OF LATE DIAGNOSIS AMONG MINORITY POPULATIONS, PARTICULARLY AFRICAN AMERICAN, WHO ARE MORE LIKELY TO BE DIAGNOSED AT LATER STAGES. WE COORDINATE CLINICAL BREAST EXAMS THAT LEAD TO MAMMOGRAMS, DIAGNOSTIC SERVICES, DIAGNOSIS AND TREATMENT. FOLLOW-UP SERVICES AND CLINICAL PATIENT NAVIGATION PROVIDED FREE OF CHARGE TO PATIENTS, IS AN EXTENSION OF THE HOSPITAL STAY FOR DISCHARGED PATIENTS WHO ARE FREQUENTLY AT RISK FOR READMISSION. TYPICALLY, THESE ARE CHRONICALLY ILL PATIENTS THAT ARE READMITTED BECAUSE OF THEIR UNIQUE FRAILTIES AND LACK OF SUPPORT FOR FOLLOW UP CARE REGIMENT. THEY HAVE LONGER PATIENT STAYS AND SIGNIFICANT AFTERCARE NEEDS. AS A RESULT, PATIENTS WELCOME THE ADDITIONAL CARE AND SUPPORT PROVIDED. GRANT FUNDS ACQUIRED DURING 2017 WERE UTILIZED TO SUPPORT PREVENTION AND HEALTH PROMOTION PROGRAMS AND SUPPORT SERVICES FOR THE COMMUNITY.
6. AFFILIATED HEALTH CARE SYSTEM AFTER SEVERAL YEARS OF AFFILIATION WITH MOUNT SINAI MEDICAL CENTER IN MANHATTAN, NEW YORK, ST. JOHN'S CHANGED AFFILIATION TO MONTEFIORE MEDICAL CENTER IN BRONX, NEW YORK TO STRENGTHEN ITS MISSION TO PROVIDE A COMPREHENSIVE PROGRAM OF CLINICAL ACCESS AND HEALTH EDUCATION FOR THE ST. JOHN'S COMMUNITY. THE GEOGRAPHICAL PROXIMITY TO MONTEFIORE, SIMILAR DEMOGRAPHICS AND COLLABORATION WITH THEIR TERTIARY CARE PROFESSIONALS, IS AN ASSET TO HEALTH PROMOTION ACTIVITIES AND QUALITY CARE FOR OUR GROWING COMMUNITIES. THE OFFICIAL AFFILIATION OCCURRED IN NOVEMBER OF 2014 AND BOTH ORGANIZATIONS FORMALLY ANNOUNCED THROUGH PRESS RELEASE IN MAY 2015.
7. STATE FILING OF COMMUNITY BENEFIT REPORT ST. JOHN'S RIVERSIDE HOSPITAL FILES A COMMUNITY BENEFIT REPORT WITH THE STATE OF NEW YORK ONLY.
Schedule H (Form 990) 2018
Additional Data


Software ID:  
Software Version:  
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" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
ST JOHNS RIVERSIDE HOSPITAL
ANDRUS PARKCARE & DOBBS FERRY
Employer identification number

13-1740126
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
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 .........
1b
 
 
2
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? ..
2
 
 
3
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.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
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.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported on 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 ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2018

Schedule J (Form 990) 2018
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 on 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 on prior Form 990
(i) Base
compensation 		(ii) Bonus & incentive
compensation 		(iii) Other reportable compensation
1MICHAEL SCHREIBER MD
FORMER CHIEF OF STAFF 		(i)

(ii)		 129,331
-------------
0 		0
-------------
0 		0
-------------
0 		20,702
-------------
0 		0
-------------
0 		150,033
-------------
0 		0
-------------
0
2RONALD CORTI
PRESIDENT/CEO 		(i)

(ii)		 738,526
-------------
0 		0
-------------
0 		74,168
-------------
0 		113,395
-------------
0 		22,024
-------------
0 		948,113
-------------
0 		74,168
-------------
0
3DENNIS KEANE
VP FINANCE/CFO 		(i)

(ii)		 484,052
-------------
0 		100,000
-------------
0 		8,400
-------------
0 		30,087
-------------
0 		21,746
-------------
0 		644,285
-------------
0 		0
-------------
0
4DONNA MCGREGOR
VP Chief Operating Officer 		(i)

(ii)		 521,564
-------------
0 		0
-------------
0 		7,800
-------------
0 		16,500
-------------
0 		21,994
-------------
0 		567,858
-------------
0 		0
-------------
0
5PAUL ANTONECCHIA MD
Physician-Vice President 		(i)

(ii)		 443,413
-------------
0 		0
-------------
0 		6,000
-------------
0 		16,500
-------------
0 		21,814
-------------
0 		487,727
-------------
0 		0
-------------
0
6GLADYS ATTANASIO
ASSISTANT VP REVENUE CYCLE 		(i)

(ii)		 218,871
-------------
0 		0
-------------
0 		0
-------------
0 		13,584
-------------
0 		21,242
-------------
0 		253,697
-------------
0 		0
-------------
0
7LAURA FANNING
AVP Surgical Services 		(i)

(ii)		 180,587
-------------
0 		0
-------------
0 		0
-------------
0 		18,309
-------------
0 		609
-------------
0 		199,505
-------------
0 		0
-------------
0
8PRASERT ITHARAT MD
PHYSICIAN 		(i)

(ii)		 316,515
-------------
0 		0
-------------
0 		0
-------------
0 		29,635
-------------
0 		20,684
-------------
0 		366,834
-------------
0 		0
-------------
0
9MICHAEL DIGIORNO MD
PHYSICIAN - NEPHROLOGY 		(i)

(ii)		 320,565
-------------
0 		0
-------------
0 		0
-------------
0 		16,178
-------------
0 		20,838
-------------
0 		357,581
-------------
0 		0
-------------
0
10NIRAV PATEL DO
PHYSICIAN 		(i)

(ii)		 489,314
-------------
0 		0
-------------
0 		0
-------------
0 		16,500
-------------
0 		20,357
-------------
0 		526,171
-------------
0 		0
-------------
0
11TARA CURTIN
VP Nursing Services 		(i)

(ii)		 282,708
-------------
0 		0
-------------
0 		0
-------------
0 		16,500
-------------
0 		21,539
-------------
0 		320,747
-------------
0 		0
-------------
0
12Susan Franzino
AVP Ancillary Services 		(i)

(ii)		 179,660
-------------
0 		0
-------------
0 		0
-------------
0 		18,464
-------------
0 		20,897
-------------
0 		219,021
-------------
0 		0
-------------
0
13Christopher Digiorno MD
PHYSICIAN 		(i)

(ii)		 348,418
-------------
0 		0
-------------
0 		0
-------------
0 		6,000
-------------
0 		8,296
-------------
0 		362,714
-------------
0 		0
-------------
0
14Michel-Ange Camille MD
PHYSICIAN 		(i)

(ii)		 283,361
-------------
0 		0
-------------
0 		0
-------------
0 		16,025
-------------
0 		356
-------------
0 		299,742
-------------
0 		0
-------------
0
Schedule J (Form 990) 2018

Schedule J (Form 990) 2018
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
NONQUALIFIED DEFERRED COMPENSATION PLAN PART I, LINE 4B AND PART II, COLUMNS (B)(III),(C) & (F) AMOUNTS INCLUDED IN COLUMNS (B)(III) AND (F) FOR RON CORTI INCLUDE A TAXABLE DISTRIBUTION OF $74,168 FROM A 457(F) DEFERRED COMPENSATION ARRANGEMENT, AND AMOUNTS REPORTED IN COLUMN (C) INCLUDE A $74,168 DEFERRAL UNDER THE ARRANGEMENT.
Schedule J (Form 990) 2018
Additional Data


Software ID:  
Software Version:  
Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletGo to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
ST JOHNS RIVERSIDE HOSPITAL
ANDRUS PARKCARE & DOBBS FERRY
Employer identification number

13-1740126
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2018
Schedule L (Form 990 or 990-EZ) 2018
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) RIVERSIDE HEALTH CARE SYS BERMUDA SEE PART V 2,007,200 INSURANCE PREMIUMS   No
(2) EMPRESS AMBULANCE SERVICE SEE PART V 343,605 AMBULANCE SERVICE   No
(3) NANCY ANNABI SEE PART V 120,209 COMPENSATION   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
BUSINESS TRANSACTIONS SCHEDULE L, PART IV (1) IN 2018, SJRH PAID INSURANCE PREMIUMS TO A RELATED, TAXABLE ENTITY RIVERSIDE HEALTH CARE SYSTEMS BERMUDA. RHCS BERMUDA IS A 35% CONTROLLED ENTITY OF RIVERSIDE HEALTH CARE SYSTEM, INC., WHICH IS THE SOLE MEMBER OF AND A SUPPORTING ORGANIZATION OF ST. JOHN'S RIVERSIDE HOSPITAL. SJRH and RCHS Bermuda share one board member, Kevin T. Fay. (2) IN 2018, EMPRESS AMBULANCE SERVICE PROVIDED SERVICES TO SJRH. EMPRESS AMBULANCE SERVICE IS OWNED BY THE SONS OF LENORE MINERVA, SJRH BOARD MEMBER. (3) NANCY ANNABI IS AN EMPLOYEE OF SJRH AND IS THE WIFE OF SJRH BOARD MEMBER, DR. IYAD ANNABI.
Schedule L (Form 990 or 990-EZ) 2018


Additional Data


Software ID:  
Software Version:  




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 Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
Name of the organization
ST JOHNS RIVERSIDE HOSPITAL
ANDRUS PARKCARE & DOBBS FERRY
Employer identification number

13-1740126
Return Reference Explanation
NET UNRELATED BUSINESS TAXABLE INCOME FORM 990, PART I, LINE 7B LINE 7B INCLUDES 512(A)(7) amounts that are not revenue from a separate trade or business and, therefore, not REPORTED AS SUCH ON FORM 990. VOLUNTEERS FORM 990, PART I, LINE 6 THE VOLUNTEER PROGRAM AT ST. JOHN'S RIVERSIDE HOSPITAL IS CURRENTLY COMPRISED OF 214 ACTIVE VOLUNTEERS, INTERNS AND STUDENTS. VOLUNTEER RECORDS AND HOURS ARE TRACKED THROUGH A COMPUTER PROGRAM LOCATED IN THE VOLUNTEER OFFICE AT ST. JOHN'S ANDRUS PAVILION. OFFSITE VOLUNTEERS COMPLETE TIME SHEETS AT THEIR RESPECTIVE FACILITY/DEPARTMENT AND SUBMIT THOSE REPORTS TO THIS OFFICE ON A MONTHLY BASIS FOR INCLUSION IN THE VOLUNTEER WORKS COMPUTER PROGRAM. ADDITIONALLY, 26 NON-COMPENSATED INDIVIDUALS SERVED ON THE BOARD DURING 2018. MISSION STATEMENT FORM 990, PART III, LINE 1 ST. JOHN'S RIVERSIDE HOSPITAL IS DEDICATED TO PROVIDING COMPREHENSIVE MEDICAL AND NURSING CARE IN A COMPASSIONATE, PROFESSIONAL, RESPECTFUL AND ETHICAL MANNER TO EVERY PATIENT. BY OFFERING EXCELLENCE IN MEDICAL CARE, NURSING, STATE-OF-THE-ART TECHNOLOGIES, CONTINUING EDUCATION AND PREVENTIVE SERVICES, WE ARE COMMITTED TO IMPROVING THE CARE WE PROVIDE WITHIN EACH OF OUR INSTITUTIONS AND THE QUALITY OF LIFE IN OUR COMMUNITY. WE ARE OPEN TO NEW IDEAS, DIRECTIONS AND INITIATIVES THAT MOST EFFECTIVELY RESPOND TO COMMUNITY HEALTH CARE NEEDS.
PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4B THE DAY PROGRAM INCLUDES INTENSIVE, MEDICALLY SUPERVISED SERVICES FOR UP TO FIVE DAYS PER WEEK, FOUR HOURS PER DAY WITH INDIVIDUAL AND GROUP THERAPY PSYCHIATRIC ASSESSMENT, 12 STEP PROGRAMMING, VOCATIONAL AND EDUCATIONAL SERVICES, AND RECREATION THERAPY. THE CLINIC PROGRAM HAS SERVICES AVAILABLE FOR UP TO FOUR TIMES PER WEEK. FLEXIBLE DAY AND EVENING HOURS FOR THOSE WHO WORK, GO TO SCHOOL OR NEED A STEP-DOWN LEVEL OF CARE. TARGETED SERVICES FOR ADOLESCENTS AND FOR FAMILY MEMBERS IMPACTED BY ALCOHOLISM AND DRUG DEPENDENCE. FORM 990, PART III, LINE 4C TO DATE, THERE ARE OVER 135 STUDENTS ENROLLED IN THE PROFESSIONAL NURSING PROGRAM. IN 1999 THERE WERE NO MORE THAN 50 STUDENTS ENROLLED AND NOW THE SCHOOL PROUDLY COUNTS MORE THAN 2,500 GRADUATES WHO HAVE SERVED PATIENTS AND HEALTH CARE THROUGHOUT THE UNITED STATES AND AROUND THE WORLD. DUE TO OUR GROWTH, THE SCHOOL HAS GROWN ITS WEBSITE WHICH ENABLES APPLICANTS TO QUICKLY COMPLETE ONLINE FORMS, ONLINE APPLICATIONS, AND SURVEYS. THE COCHRAN SCHOOL OF NURSING IS ACCREDITED BY THE NATIONAL LEAGUE FOR NURSING. FORM 990, PART III, LINE 4D ST. JOHN'S RIVERSIDE HOSPITAL OPERATES A METHADONE MAINTENANCE PROGRAM SEVEN DAYS A WEEK, 365 DAYS A YEAR TO ENABLE CLIENTS SUFFERING NARCOTIC ADDICTION TO CONTINUE PRODUCTIVE LIVES. IN 2018, THE CLINIC HAD 99,597 VISITS.
BUSINESS RELATIONSHIP FORM 990, PART VI, SECTION A, LINE 2 CECILE SINGER, SJRH BOARD MEMBER, GREG HOLCOMBE, SJRH BOARD MEMBER AND RON CORTI, SJRH PRESIDENT/CEO HAVE A BUSINESS RELATIONSHIP.
MEMBERS/STOCK HOLDERS FORM 990, PART VI, SECTION A, LINE 6 ST. JOHN'S RIVERSIDE HOSPITAL HAS A SOLE MEMBER - RIVERSIDE HEALTHCARE SYSTEM, INC., A SECTION 501(C)(3) ENTITY.
FORM 990, PART VI, SECTION A, LINE 7 A AND B THE FOLLOWING POWERS ARE RESERVED TO RIVERSIDE HEALTH CARE SYSTEM (RHCS): 1. APPOINTMENT AND REMOVAL OF THE CHIEF EXECUTIVE OFFICER OF ST. JOHN'S UPON CONSULTATION WITH THE BOARD OF TRUSTEES; 2. REVIEW AND APPROVAL OF THE CAPITAL AND OPERATING BUDGETS OF ST. JOHN'S PROVIDED THAT RHCS MAY ONLY APPROVE OR REJECT A CAPITAL OR OPERATING BUDGET IN ITS ENTIRETY; 3. APPROVAL OF ANY SALE OF ACQUISITION BY ST. JOHN'S OF ASSETS VALUED IN EXCESS OF ONE MILLION DOLLARS ($1,000,000), PROVIDED THAT RHCS APPROVAL SHALL NOT BE REQUIRED FOR SALES OR ACQUISITIONS OF MEDICAL EQUIPMENT (INCLUDING, WITHOUT LIMITATION, MAGNETIC RESONANCE IMAGING AND COMPUTERIZED TOMOGRAPHY EQUIPMENT, OPERATING ROOM EQUIPMENT, AND EQUIPMENT FOR ENDOSCOPY AND DELIVERY SUITES); AND 4. APPROVAL OF ANY AMENDMENTS TO THE CONSTITUTION, THE BYLAWS OR THE CERTIFICATE OF INCORPORATION OF ST. JOHN'S WHICH WOULD MODIFY, LIMIT OR IN ANY WAY RESTRICT THE RIGHT AND POWERS OF RHCS AS THE SOLE CORPORATE MEMBER.
BOARD OF TRUSTEES' REVIEW OF FORM 990 FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS DRAFTED BY THE FINANCE DEPARTMENT OF ST. JOHN'S RIVERSIDE HOSPITAL AND REVIEWED BY THE DIRECTOR OF FINANCE AND CHIEF FINANCIAL OFFICER OF THE HOSPITAL. THE DRAFT FORM 990, AND WORKPAPER SUPPORT, IS PROVIDED TO THE HOSPITAL'S TAX PREPARER TO PREPARE A FINAL VERSION OF THE FORM 990. THE FINAL VERSION OF THE FORM 990 IS THEN REVIEWED BY THE HOSPITAL'S FINANCE COMMITTEE MEMBERS OF THE GOVERNING BOARD OF TRUSTEES AND THEN A COPY IS PROVIDED TO THE ENTIRE BOARD OF TRUSTEES PRIOR TO SUBMISSION TO THE IRS.
CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12C ALL MEMBERS OF THE BOARD OF TRUSTEES AND ALL PERSONNEL OF THE ORGANIZATION WHO ARE IN A POSITION TO INFLUENCE ANY PURCHASING DECISION OR BUSINESS TRANSACTION MUST COMPLETE A CONFLICT OF INTEREST STATEMENT. THIS INCLUDES ADMINISTRATIVE STAFF, DEPARTMENT HEADS AND MEMBERS OF THE MEDICAL BOARD. THE STATEMENTS ARE DISTRIBUTED BY THE COMPLIANCE OFFICER ANNUALLY IN NOVEMBER WITH THE EXPECTATION THAT THEY BE RETURNED TO THE COMPLIANCE OFFICER IN JANUARY OF THE FOLLOWING YEAR. WHEN RETURNED, THESE STATEMENTS ARE REVIEWED BY THE COMPLIANCE OFFICER. ALL INFORMATION IS KEPT CONFIDENTIAL AND STATEMENTS ARE MAINTAINED IN THE COMPLIANCE OFFICE. THE COMPLIANCE OFFICER WILL CONSULT WITH OUTSIDE COUNSEL AS NECESSARY CONCERNING ANY POTENTIAL PROBLEMS OR POSSIBLE CONFLICTS OF INTEREST. THE COMPLIANCE OFFICER WILL REPORT ANY CONFLICTS OF INTEREST OR POSSIBLE CONFLICTS OF INTEREST TO THE AUDIT AND CORPORATE COMPLIANCE COMMITTEE AND TO THE FINANCE COMMITTEE OF THE BOARD OF TRUSTEES. IN CASES WHERE A CONFLICT OF INTEREST EXISTS, BOARD MEMBERS WITH A CONFLICT ARE PROHIBITED FROM PARTICIPATING IN THE GOVERNING BODY'S DELIBERATIONS AND DECISIONS IN THE TRANSACTION.
COMPENSATION REVIEW FORM 990, PART VI, SECTION B, LINE 15A AND 15B THE ORGANIZATION CONTRACTS WITH AN INDEPENDENT THIRD PARTY TO BRING THE COMPENSATION LEVELS TO A COMPETITIVE LEVEL IN THE MARKET AREA. A REQUEST FOR PROPOSAL FOR AN EXECUTIVE COMPENSATION SURVEY IS INITIATED BY HUMAN RESOURCES TO FIND A VENDOR WHO COULD PROVIDE A COMPREHENSIVE REVIEW AND COMPARISON OF THE SALARY AND BENEFITS RIVERSIDE HEALTH CARE SYSTEMS INC. SHOULD BE PROVIDING ITS EXECUTIVES WHILE MEETING ALL LEGAL AND ANTI-TRUST REQUIREMENTS. THIS SURVEY IS TO IDENTIFY THE BASE COMPENSATION, INCENTIVE COMPENSATION AND NON-CASH COMPENSATION FOR LIKE POSITIONS IN THE COMPETING WESTCHESTER COUNTY, NEW YORK AREA. THE AREAS THAT WOULD BE EVALUATED INCLUDE: CHIEF EXECUTIVE OFFICER, CHIEF OPERATING OFFICER, CHIEF FINANCIAL OFFICER, NURSING HOME ADMINISTRATOR, VICE PRESIDENT NURSING, VICE PRESIDENT COCHRAN SCHOOL OF NURSING, VICE PRESIDENT BEHAVIORAL HEALTH, VICE PRESIDENT STRATEGIC CORPORATE DEVELOPMENT, VICE PRESIDENT PERFORMANCE IMPROVEMENT & RISK MANAGEMENT, AND VICE PRESIDENT HUMAN RESOURCES. THE REQUEST FOR PROPOSAL GETS SENT TO EIGHT COMPANIES WITH A KNOWN TRACK RECORD IN COMPENSATION CONSULTING. EACH OF THE VENDORS RESPONDS WITH THE DETAILED ANALYSIS THAT THEY WILL PROVIDE AND THE COST ASSOCIATED WITH THE PROCESS. BASED ON THE TIMEFRAME AND THE COST, A VENDOR IS CHOSEN TO PERFORM THE EXECUTIVE COMPENSATION SURVEY. A PROPOSAL IS PRESENTED TO INDEPENDENT MEMBERS OF THE BOARD OF TRUSTEES PERSONNEL AND COMPENSATION COMMITTEE FOR APPROVAL. THE PERSONNEL AND COMPENSATION COMMITTEE CONTEMPORANEOUSLY DOCUMENTS ITS FINDINGS IN ITS MINUTES. INDEPENDENT MEMBERS OF THE BOARD OF TRUSTEES MAKE THE DECISION ON APPROVING THE SALARY CHANGES. AN EXECUTIVE COMPENSATION REVIEW TOOK PLACE IN SPRING 2013 AND A REVIEW WAS COMPLETED IN 2018.
PUBLIC DISCLOSURE FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. NET ASSETS FORM 990, PART X, LINES 27-29 In August 2016, the FASB issued ASU 201614, Presentation of Financial Statements of Not-for-Profit Entities (Topic 958). ASU 201614 reduces the number of net assets from three to two: net assets without donor restrictions, previously reported as unrestricted net assets, and net assets with donor restrictions, which was previously reported as temporarily restricted net assets and permanently restricted net assets. THE 2018 FORM 990, PART X WAS NOT UPDATED TO REFLECT THE CHANGE IN NET ASSET CLASS TERMINOLOGY; THEREFORE, SJRH HAS REPORTED NET ASSETS WITHOUT DONOR RESTRICTION AS UNRESTRICTED NET ASSETS AND NET ASSETS WITH DONOR RESTRICTIONS AS TEMPORARILY RESTRICTED NET ASSETS AND PERMANENTLY RESTRICTED NET ASSETS.
OTHER CHANGES IN NET ASSETS FFORM 990, PART XI, LINE 9 Grant purchases of PPE 537,810 FAS 158 Pension Adjustment 10,138,964 Reserve for Affiliate transfer MALOTZ 200,000 ----------------- 10,876,774
FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN FEES TOTAL FEES:9339888
FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:12570494
FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES - NURSERY TOTAL FEES:1234023
FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES - LAB TOTAL FEES:318048
FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES - AMBULANCE TOTAL FEES:361091
FORM 990 PART IX LINE 11G DESCRIPTION:SERVICE CONTRACTS TOTAL FEES:6911759
FORM 990 PART IX LINE 11G DESCRIPTION:MICROFILMING/ARCHIVING TOTAL FEES:72448
FORM 990 PART IX LINE 11G DESCRIPTION:TAXI SERVICES TOTAL FEES:24765
FORM 990 PART IX LINE 11G DESCRIPTION:CENTURY 21 FEES TOTAL FEES:9166
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2018


Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
ST JOHNS RIVERSIDE HOSPITAL
ANDRUS PARKCARE & DOBBS FERRY
Employer identification number

13-1740126
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?
Yes No
(1)RIVERSIDE HEALTH CARE SYSTEMSINC (RHCS)
967 NORTH BROADWAY

YONKERS,NY10701
13-3237215 		MANAGEMENT NY 501(C)(3) 11A II NA
 
 
No












For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
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



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(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?



 		(k)
Percentage
ownership
Yes No 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
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) RIVERSIDE MANAGEMENT SERVICES ORG (RMSO)

967 NORTH BROADWAY
YONKERS,NY10701
13-3846601 		MANAGEMENT NY RMI
  		C CORP         No
(2) RIVER MANAGEMENT CO INC

967 N BROADWAY ANDRUS PAVIL
YONKERS,NY10701
13-3474004 		MANAGEMENT NY RHCS
  		C CORP         No
(3) RHCS BERMUDA LTD

967 NORTH BROADWAY
YONKERS,NY10701
13-3237215 		INSURANCE BD RHCS
  		C CORP         No
(4) SJR MEDICAL PC

967 NORTH BROADWAY
YONKERS,NY10701
13-4185781 		MED. SERVICE NY SJRH
  		C CORP 96,885 0 100.000 % Yes  
(5) FDN FOR COMM HOSPITAL AT DOBBS FERRY

128 ASHFORD AVE
DOBBS FERRY,NY10522
13-3971735 		FUNDRAISING NY SJRH
  		C CORP 7 3,581 100.000 % Yes  




Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
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
No
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 .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
 
No
d Loans or loan guarantees to or for related organization(s) ............................
1d
Yes
 
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
 
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
2
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) SJR MEDICAL PC

 O 2,570,888 FMV





Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
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) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(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? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
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) 2018

Additional Data


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