SELECT DISTINCT * FROM APPLICATION.PATIENT P join admission a on p.patientkey = a.patientkey
            WHERE not exists (select  * from document d  where d.patientkey = p.patientkey  and d.rubriccode = '0100101003') and a.patientclass = 'I' and a.admissiondate BETWEEN  to_date('20090101','yyyymmdd') and to_date('20100401','yyyymmdd') order by p.patientkey;

IEnumerable<Patient> pat = (from patient in ActiveRecordLinq.AsQueryable<Patient>()
                                       from adm in patient.Admissions                           
                                       where !(from doc in ActiveRecordLinq.AsQueryable<Document>() where doc.RubricCode.Equals("0100101003") select doc.PatientKey).Contains(patient.PatientKey) && adm.PatientClass.Equals("I") && adm.AdmissionDate >= new DateTime(2009, 01, 01) && adm.AdmissionDate <= new DateTime(2010, 01, 01)
                                       select patient).Distinct();

   at System.Linq.Expressions.Compiler.StackSpiller.RewriteExpression(Expression node, Stack stack)
   at System.Linq.Expressions.Compiler.StackSpiller.ChildRewriter.Add(Expression node)
   at System.Linq.Expressions.Compiler.StackSpiller.ChildRewriter.AddArguments(IArgumentProvider expressions)
   at System.Linq.Expressions.Compiler.StackSpiller.RewriteMethodCallExpression(Expression expr, Stack stack)
   at System.Linq.Expressions.Compiler.StackSpiller.RewriteExpression(Expression node, Stack stack)
   at System.Linq.Expressions.Compiler.StackSpiller.ChildRewriter.Add(Expression node)
   at System.Linq.Expressions.Compiler.StackSpiller.ChildRewriter.AddArguments(IArgumentProvider expressions)
   at System.Linq.Expressions.Compiler.StackSpiller.RewriteMethodCallExpression(Expression expr, Stack stack)

var qry = (from doc in ActiveRecordLinq.AsQueryable<Document>() where doc.RubricCode.Equals(typeDocument) select doc.PatientKey).ToArray();
            return (from patient in ActiveRecordLinq.AsQueryable<Patient>()
                    from adm in patient.Admissions
                    where !qry.Contains(patient.PatientKey) && adm.PatientClass.Equals("I") && adm.AdmissionDate >= startDate && adm.AdmissionDate <= endDate
                    select patient).Distinct();