2022-11-09T11:31:27-06:00 2021-12-31 346565596 ERNST & YOUNG US LLP 1 MANHATTAN AVE WEST NEW YORK NY 10001 990 2021-01-01 133746997 THE NEW YORK GRACIE SQUARE HOSPITAL INC NEWY 2124345300 420 EAST 76 STREET NEW YORK NY 10021 PHILIP J WILNER MD PRESIDENT AND CEO 2022-11-09 false PHILIP J WILNER MD 999009999 NICOLE SOKOLOWSKI P01683199 2127733000 2021 2022-09-23 18:48:47Z PHILIP J WILNER MD 420 EAST 76 STREET NEW YORK NY 10021 72320328 false X WWW.NYGSH.ORG X 1958 NY OUR MISSION IS TO PROVIDE THE HIGHEST QUALITY, STATE-OF-THE ART MENTAL HEALTH AND CHEMICAL DEPENDENCY TREATMENT IN A WARM, HEALING ENVIRONMENT. 9 5 522 0 0 0 19398061 10623835 46947580 61549736 29046 52821 98642 93936 66473329 72320328 27455 94850 0 0 47161404 49628056 90000 66000 66000 15635853 16157491 62914712 65946397 3558617 6373931 56066655 62924626 48040944 48475552 8025711 14449074 OUR MISSION IS TO PROVIDE THE HIGHEST-QUALITY, STATE-OF THE-ART MENTAL HEALTH AND CHEMICAL DEPENDENCY TREATMENT IN A WARM, HEALING ENVIRONMENT. OUR CARING, COMPASSIONATE TEAM PREPARES OUR PATIENTS TO RETURN TO THEIR FAMILIES AND COMMUNITIES AND ENGAGE IN PRODUCTIVE AND FULFILLING LIVES. WE SERVE THE DIVERSE RESIDENTS OF THE GREATER NEW YORK METROPOLITAN AREA THROUGH TREATMENT, EDUCATION AND HEALTH PROMOTION. false false 56311734 94850 61549736 As described in the needs assessment above during 2015 the hospital embarked upon a revitalization program to improve the quality of patient care and the way we provide it; with the goal of providing the highest quality, state-of-the-art mental health and chemical dependency treatment in a warm and healing environment. This program included improving staffing ratios, quality and safety monitoring, plant renovations, its infrastructure, and the implementation of an electronic health record. The following describes some of the changes to our mission, culture and values, programs, and healthcare team that began in 2015 and have continued since that time. Gracie Square Hospital has provided advanced, patient-centered inpatient behavioral health services since 1959. We are committed to providing patients with compassionate and comprehensive care in a warm and welcoming environment in order to facilitate their recovery and return to their families and communities. Gracie Square Hospital, a psychiatric inpatient facility located on a quiet side street on the upper east side of Manhattan, is now experiencing a period of extraordinary transformation and revitalization. Through our affiliation with NewYork-Presbyterian, one of the nation's premier academic healthcare delivery systems. Gracie Square Hospital is undergoing renovations, growing its staff, and enhancing services and programs. Under new leadership, the hospital is focused on providing the highest quality of care, evidence-based treatments, education, and training. Patient Care Programs Gracie Square Hospital has dedicated and specialized inpatient care programs tailored to meet the needs of patients from different cultural and religious backgrounds and age groups and those suffering from specific diagnoses. Based on a comprehensive and personalized assessment upon arrival at our hospital, we match patients with exceptional care providers equipped with the expertise, tools, and resources to provide compassionate short-term, individualized treatment in a caring and safe environment. During each patient's hospital stay, our expert social workers plan for the transition to outpatient care and facilitate connections with community resources to promote recovery. Gracie Square Hospital's multifaceted interdisciplinary and targeted approach incorporates medications; individual, milieu, and group therapy; and/or therapeutic activities into treatment plans. We work together to promote wellness while providing patients with skills to reduce the risk of relapse and enhance function and independence. Specialized patient care programs include: Crisis Stabilization Program for patients with mood and anxiety disorders, post-traumatic stress disorders, and other psychiatric syndromes and who are in distress. Affective (Mood) Disorders Program for patients with mood disorders such as depression and bipolar disorder. Psychotic Disorders Program for individuals with acute symptoms of schizophrenia and schizoaffective disorders, as well as those with bipolar disorder with psychotic features. Dual Focus Program for people with significant emotional or psychiatric problems plus abuse challenges. Many of these patients suffer from two co-existing illnesses. They may be treated either in mental health or addiction systems, or shuttled back and forth between them - an often unsuccessful approach. The Dual Focus Program addresses both psychiatric and addiction components through customized treatment plans. The team includes addiction-trained social workers. Asian Psychiatry Program provides culturally appropriate services to members of Chinese, Korean, Japanese, and other Asian communities in need of inpatient mental health care. The program is directed by a culturally diverse clinical team and support staff who speak Mandarin, Cantonese, Chinese ethnic dialects, Korean, Japanese, and other Asian languages. Activities incorporate Asian influences and the unit is decorated with Asian art. Patients are served Chinese food and tea, and educational materials and newspapers are available in both English and Asian languages. Young Adult Program for young adults ages 18-25 with emerging psychiatric disorders. Symptoms of major psychiatric disorders, including affective and psychotic disorders, often begin in the late teens or early 20s. The sooner treatment begins, the better outcomes will be. Older Adult Program (Geriatric Service) for people age 65 and older with psychiatric disorders that require inpatient treatment. Team members have training in the care of older adults. Psychiatrists and internists on this unit are also knowledgeable about co-existing medical conditions that may cause psychiatric symptoms. They manage patients' psychiatric and non-psychiatric medications and pay careful attention to drug interactions. Healthcare Team Patients at Gracie Square Hospital benefit from a multidisciplinary care team specially trained to meet their personal needs. We call upon specialists from other areas of medicine as needed, ensuring that our patients benefit from the comprehensive range of healthcare services available through the NewYork-Presbyterian network. Our treatment team includes: Certified occupational therapists. Our certified occupational therapists focus on enabling individuals to re-engage in meaningful occupations through a variety of skill sets such as skills development, establishing positive habits and routines, setting therapy goals, using cognitive-behavioral techniques (CBT), and understanding underlying physiological influences. They help our patients develop, recover, improve, and maintain the skills needed for daily living and working. Certified alcoholism and substance abuse counselor. These professionals provide care and support for patients dealing with co-occurring disorders, such as alcohol and/or drug use and a mental health condition. Internist or family nurse practitioner. After conducting thorough physical and neurological examinations, the primary care provider orders any needed diagnostic testing, identifies medical conditions present, and designs medical treatment plans. Nursing aides. Our aides help provide for the comfort and safety of our patients through assistance with activities of daily living and education. They support our patients, family members, and other caregivers. Nutritionist. A nutritionist with experience in behavioral health care evaluates each patient and creates an individualized dietary plan. In addition, patients and their families receive nutritional guidance, education on food and drug interactions, and information about dietary supplements. Registered professional psychiatric nurse. Our nurses work at the top of their professional licensure via the utilization of a professional governance structure. Through collaboration, our nurses ensure optimal patient care delivery while driving highly reliable quality outcomes. Psychiatrist or psychiatric nurse practitioner. The psychiatrist or psychiatric nurse practitioner has expertise in the patient's diagnosis. This professional serves as a patient's team leader and coordinates and implements the patient's comprehensive treatment plan. Psychologist. Licensed clinical psychologists provide individual and group therapy using approaches such as CBT, acceptance and commitment therapy (ACT), dialectical behavioral therapy (DBT) skills training, and short-term psychodynamic therapy. Social workers. Our clinicians conduct psychosocial assessments which incorporate all resources available to inform an individualized treatment plan that will lead to a timely and successful discharge to community resources. Physical therapist. For patients who may need assistive devices for mobility (walkers, wheelchairs, etc.), and for those recovering from a recent injury who are in need of a rehabilitation assessment. 56311734 true true false true false false false false false true false false false true false true false false false false false false true false false true true true true true false false false false false false false false false false false false false true false false false true 48 0 true 522 true false false false false false false false false false false false false X 9 5 false false false false true true true true true false false true true true true true true true true false NY X SANDY KWONG 2124345300 420 EAST 76 STREET NEW YORK NY 10021 DAVID WYMAN BOARD MEMBER/PRESIDENT (THRU 5/2021) 60.0 0.0 X X 437930 344575 53740 GARY J ZUAR BOARD MEMBER/ASS'T TREASURER 2.0 58.0 X X 0 1349002 170828 PHILIP J WILNER CHAIRMAN (THRU 5/2021)/ PRESIDENT (FROM 6/2021) 15.0 45.0 X X 0 0 0 ADAM OWETT SR BOARD MEMBER 2.0 0 X 0 0 0 BRIAN K REGAN BOARD MEMBER 2.0 58.0 X 0 458401 64167 JOHN ZIRINSKY BOARD MEMBER 2.0 0 X 0 0 0 JOSEPH PEYRONNIN BOARD MEMBER 2.0 0 X 0 0 0 KAREN WESTERVELT BOARD MEMBER/ CHAIRMAN (FROM 6/2021) 2.0 58.0 X 0 1372771 57958 LORINDA DE ROULET BOARD MEMBER 2.0 0 X 0 0 0 NAZIM B MALATYALI BOARD MEMBER 2.0 58.0 X 0 722625 61725 JOHN V CAMPANO SECRETARY 2.0 58.0 X 0 628480 78685 KATHLEEN M BURKE ASS'T SECRETARY 1.0 59.0 X 0 434266 67606 MELISSA E WELCH ASS'T SECRETARY 1.0 34.0 X 0 180133 32096 MICHAEL P BRESLIN TREASURER 1.0 59.0 X 0 2192989 73403 DONNA T ANTHONY CHIEF MEDICAL OFFICER 60.0 0 X 409878 0 41796 MARGARET MANCUSO CHIEF ADMINISTRATIVE OFFICER 60.0 0 X 289472 0 29965 MICHAEL RADOSTA CHIEF NURSING & QUAL. OFFICER 34.0 26.0 X 191365 233716 44811 NATASHA BOWMAN CHIEF HR OFFICER 60.0 0 X 268842 0 49572 AMY PARIKH PER DIEM PSYCH 37.5 0 X 221603 0 11080 BORIS AVEZBAKIYEV PER DIEM MD 37.5 0 X 176813 0 10609 DOUGLAS SAPHIER PER DIEM PSYCH 37.5 0 X 215408 0 12924 FRANCINE FAKIH DIRECTOR OF NURSING 37.5 0 X 191315 0 45422 NIESHA WESTMORELAND PER DIEM PSYCH 37.5 0 X 257460 0 12873 PHYLLIS R LANTOS FORMER OFFICER 0.0 0.0 X 0 1227272 21053 2660086 9144230 940313 83 true true false G-NET CONSTRUCTION 360 TARGEE STREET STATEN ISLAND NY 10304 CONSTRUCTION 1689062 BATSKA CONSULTING GROUP LLC 54 WEST 40TH STREET NEW YORK NY 10018 CONSULTING 1348995 ARAMARK 600 EAST LUZERNE STREET PHILADELPHIA PA 19124 FOOD SERVICE 1100142 DOOLEY ELECTRIC CO INC 4014 3RD AVENUE BROOKLYN NY 12232 ELECTRICAN 1064236 HM HUGHES 323 EAST 65TH STREET NEW YORK NY 10065 CONSTRUCTION 775347 21 8943803 1536021 144011 1293 10623835 PATIENT REVENUE 621110 61549736 61549736 0 0 0 0 61549736 52821 52821 59550 59550 0 59550 59550 0 0 OTHER MISCELLANEOUS 900099 34386 34386 0 0 0 0 34386 72320328 61549736 0 146757 10000 10000 84850 84850 0 0 1927544 1927544 34310777 30072137 4238640 2360909 2069250 291659 8585288 7524690 1060598 2443538 2141671 301867 89558 89558 286000 286000 1319 1319 66000 66000 4836174 4407991 428183 0 243756 213643 30113 3865209 3387714 477495 978955 858018 120937 1193545 1121608 71937 13553 13553 22315 22315 81955 77017 4938 3066201 2881395 184806 603939 595228 8711 MEDICAL & PHARMACY SUPPLIES 806290 806290 DUES & MEMBERSHIP 64829 56820 8009 Permits/License 3893 3412 481 0 0 0 0 65946397 56311734 9568663 66000 41883 9500 4338198 6507721 254651 133583 7003227 8561622 0 0 0 0 52991 52943 1473508 591114 61076559 15474589 42121473 45601970 0 0 780724 1466173 56066655 62924626 13139783 9955115 0 0 13113710 4868779 21787451 33651658 48040944 48475552 X 7772060 14145991 253651 303083 8025711 14449074 56066655 62924626 X 6373931 49432 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 1319 1319 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY MEMBERSHIP DUES PAID TO INDEPENDENT THIRD PARTY ASSOCIATIONS AND 1199 EMPLOYER CONTRIBUTIONS THAT ARE ALLOCATED FOR LOBBYING PURPOSES TO EDUCATE POLICYMAKERS AND STATE AND FEDERAL LEGISLATORS ON THE COMPLEXITIES AND CONSTRAINTS HOSPITALS FACE IN DELIVERING CARE. GRACIE SQUARE HOSPITAL'S PRO-RATED SHARE OF MEMBERSHIP DUES FOR 2021 IS 1,045 AND HEP-1199 LOBBYING EXPENSES FOR 2021 IS 274. 34253261 11529816 22723445 9812795 3944773 5868022 17010503 17010503 45601970 DUE TO RELATED ORGANIZATIONS 31875549 INSURANCE RECOVERIES 1468880 DUE TO THIRD PARTY PROVIDERS OPERATING LEASE LIABILITY 307229 33651658 63376525 0 0 63376525 8943803 8943803 72320328 65946397 0 0 65946397 0 0 65946397 Schedule D, Part XI, Line 4(b) Other revenues in form 990 not in audited financial statements NET ASSET TRANSFER FROM NEW YORK PRESBYTERIAN HOSPITAL - 8943803 X X X true COMMUNITY COUNSELING FUNDRAISING SERVICES CO LLC 527 MADISON AVE 5TH FLOOR NEW YORK NY 10022 FUNDRAISING COUNSEL false 66000 -66000 0 66000 -66000 NY Schedule G, Part I, Line 2b(v) payment of fees or payment of expenses COMMUNITY COUNSELING FUNDRAISING SERVICES CO., LLC-COMMUNITY COUNSELLING SERVICES CO, LLC (CCS) HAS A TWELVE MONTH AGREEMENT(JAN 1 - DEC 31, 2021) FOR A FEE OF $66,000.; true true X true X true X true true true false true true 1453231 0 1453231 0.0220 0 0 0 0.0 0 0 0 0.0 0 0 1453231 0 1453231 0.0220 1855 87120 0 87120 0.0013 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 1855 87120 0 87120 0.0013 0 1855 1540351 0 1540351 0.0234 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 true 998134 59629 6538245 6999565 -461320 X true true 1 1 THE NEW YORK GRACIE SQUARE HOSPITAL 420 EAST 76TH STREET NEW YORK NY 10021 WWW.NYGSH.ORG 8713070 X PSYCHIATRIC HOSPITAL THE NEW YORK GRACIE SQUARE HOSPITAL 1 false false true X X X X X X X X X 19 true false false true X https://www.nygsh.org/community-health-needs.html X true 19 true https://www.nygsh.org/community-health-needs.html false true X 100.0 400.0 X X X X true true X X X X true X https://www.nygsh.org/admissions-and-insurance.html X https://www.nygsh.org/admissions-and-insurance.html X https://www.nygsh.org/admissions-and-insurance.html X X X X X X true X false X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - THE NEW YORK GRACIE SQUARE HOSPITAL, INC.. AS PART OF OUR COMMUNITY BENEFIT STRATEGY, GRACIE SQUARE HOSPITAL CONTINUOUSLY STRIVES TO MAINTAIN AND IMPROVE THE QUALITY OF OUR SERVICES PROVIDED TO OUR PATIENTS THROUGH QUALITY IMPROVEMENT STUDIES AND PATIENT SATISFACTION SURVEYS. WE VIEW THESE TOOLS AS A WAY OF TRULY HEARING OUR PATIENTS' VOICES AND THEIR OPINIONS ABOUT OUR SERVICES. GRACIE SQUARE HOSPITAL HAS CONTRIBUTED TO A VARIETY OF KEY STAKEHOLDERS, NETWORKS AND COALITIONS IN THE CITY, INCLUDING THE NY COALITION FOR QUALITY ASSISTED LIVING (WE ARE A GOLD MEMBER), THE CHINESE AMERICAN FUND, THE BROOKLYN CHINESE AMERICAN FUND, AND CHINATOWN HEALTH. OUR CONNECTIONS WITH THESE GROUPS HELP TO ENSURE THAT OUR INPATIENT BEHAVIORAL HEALTH SERVICES ARE TAILORED TO MEET THE NEEDS OF THESE SPECIALIZED COMMUNITIES, MOST NOTABLY THOSE IN OUR ASIAN AND GERIATRIC PSYCHIATRY PROGRAMS. FURTHER, BY COLLABORATING WITH AND CONTRIBUTING TO THESE GROUPS YEAR AFTER YEAR THE COMMUNITY'S AWARENESS OF GRACIE SQUARE HOSPITAL AND OUR SERVICES HAS INCREASED, HELPING TO FACILITATE THE TRANSITION INTO OUR CARE DURING A CRISIS REQUIRING ACUTE PSYCHIATRIC CARE AND TO REGAIN A SENSE OF EMPOWERMENT AND TO REGAIN A SENSE OF EMPOWERMENT AND COMPETENCY THAT IS OFTEN COMPROMISED BY THE INDIVIDUAL'S STRUGGLE WITH HIS/HER BEHAVIORAL HEALTH ISSUES. DATA GATHERED AS PART OF THE MOST RECENT CHNA WAS FROM SURVEYS AND MORE IN DEPTH STUDIES CONDUCTED OVER THE COURSE OF 2019. THIS INFORMATION IS USED TO IDENTIFY ANY AREAS OF UNMET NEED OR WAYS TO IMPROVE OUR SERVICES. WE OFTEN ALSO DISCOVER OPPORTUNITIES THAT WE CAN IMPROVE THE CULTURAL COMPETENCE OF OUR SERVICES THROUGH THESE METHODS. FURTHER, BY ENSURING THAT EACH OF OUR CONSUMERS HAS THE CHANCE TO SHARE THEIR THOUGHTS AND FEELINGS ABOUT THEIR EXPERIENCE WITH US, WE HELP THEM TO REGAIN A SENSE OF EMPOWERMENT AND COMPETENCY THAT IS OFTEN COMPROMISED BY THE INDIVIDUAL'S STRUGGLE WITH HIS/HER BEHAVIORAL HEALTH ISSUES. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - THE NEW YORK GRACIE SQUARE HOSPITAL, INC.. THE HOSPITAL IS LICENSED BY THE NEW YORK STATE OFFICE OF MENTAL HEALTH AS AN ARTICLE 31 FREE STANDING PSYCHIATRIC HOSPITAL AND AS SUCH IS LIMITED IN REGARDS TO PROVIDING ADDITIONAL MEDICAL SERVICES. OUR MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT INDICATED THE HOSPITAL WAS MEETING THE BEHAVIORAL HEALTH NEEDS OF THE COMMUNITY. FOR NEARLY SIX DECADES, GRACIE SQUARE HOSPITAL HAS BEEN A MAINSTAY OF THE UPPER EAST SIDE, PROVIDING THE HIGHEST QUALITY AND MOST COMPASSIONATE CARE TO ADULTS 18 YEARS AND OLDER WITH BEHAVIORAL HEALTH NEEDS WHO CAN BENEFIT FROM INPATIENT HOSPITALIZATION. THE HOSPITAL OFFERS INDIVIDUALS A WARM AND WELCOMING ENVIRONMENT IN WHICH TO RECEIVE STATE-OF-THE-ART TREATMENT TO FACILITATE A HEALTHY RECOVERY. THROUGH GRACIE SQUARE HOSPITAL'S AFFILIATION WITH NEWYORK- PRESBYTERIAN, ONE OF THE NATION'S PREMIER ACADEMIC HEALTHCARE DELIVERY SYSTEMS, WE ARE COMMITTED TO PROVIDING HIGH-QUALITY, PATIENT-CENTERED MENTAL HEALTH AND CHEMICAL DEPENDENCY TREATMENT SERVICES TO INDIVIDUALS LIVING IN THE GREATER NEW YORK CITY METROPOLITAN AREA. ONE OF THE NATION'S PREMIER ACADEMIC HEALTHCARE DELIVERY SYSTEMS, WE ARE COMMITTED TO PROVIDING HIGH-QUALITY, PATIENT-CENTERED MENTAL HEALTH AND CHEMICAL DEPENDENCY TREATMENT SERVICES TO INDIVIDUALS LIVING IN THE GREATER NEW YORK CITY METROPOLITAN AREA. Schedule H, Part V, Section B, Line 15 Facility , 1 Facility , 1 - THE NEW YORK GRACIE SQUARE HOSPITAL, INC.. THE HOSPITAL HAS A FINANCIAL ADVOCACY PROGRAM STAFFED BY REPRESENTATIVES WHO REACH OUT TO PATIENTS TO PROVIDE INFORMATION REGARDING MEDICAID, EXCHANGE PLANS, FINANCIAL AID AND TO ASSIST THOSE PATIENTS WHO NEED HELP TO APPLY TO SUCH PROGRAMS. Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - THE NEW YORK GRACIE SQUARE HOSPITAL, INC.. PLEASE REFER TO THE DISCLOSURES IN PART VI REGARDING GRACIE SQUARE HOSPITAL'S EFFORTS TO REVITALIZE THE WAY IT INFORMS PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE. PLEASE REFER TO THE DISCLOSURES IN PART VI REGARDING GRACIE SQUARE HOSPITAL'S EFFORTS TO REVITALIZE THE WAY IT INFORMS PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE. 0 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance Description: BAD DEBT PRICE CONCESSIONS ARE OFFSET AGAINST REVENUE AND NOT INCLUDED IN EXPENSES. THE FOLLOWING IS A DETAIL OF THE SOURCES USED FOR DETERMINING THE AMOUNTS REPORTED ON SCHEDULE H: LINE 7A - COST TO CHARGE RATIO LINE 7E - ACTUAL EXPENSES Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount Description: THE COSTS TO PROVIDE CARE WHICH HAS BECOME UNCOLLECTIBLE OR BAD DEBT, HAS BEEN CALCULATED UTILIZING A COST TO CHARGE RATIO. PAYMENTS, DISCOUNTS AND FINANCIAL ASSISTANCE EXCLUDE FROM AMOUNTS CONSIDERED TO BE BAD DEBT. Schedule H, Part III, Line 3 Bad Debt Expense Methodology Description: THE AMOUNT AT COST INCLUDED REPRESENTS PATIENTS WHO QUALIFY FOR CHARITY CARE/FINANCIAL ASSISTANCE AND HAVE A BAD DEBT WRITE-OFF. BAD DEBT PRICE CONCESSIONS ASSOCIATED WITH PATIENTS THAT RECEIVED CHARITY CARE/FINANCIAL ASSISTANCE IS REPRESENTED IN THIS $59,629. THESE PATIENTS WENT THROUGH OUR CHARITY CARE/FINANCIAL ASSISTANCE PROCESS AND WERE DETERMINED TO HAVE FINANCIAL NEED. AS A RESULT, WE PROVIDED THEM WITH A DISCOUNT BASED ON OUR SLIDING SCALE CHARITY CARE POLICY. IF THEY WERE UNABLE TO PAY THE REDUCED BALANCES, THEY WERE WRITTEN OFF AS BAD DEBT PRICE CONCESSIONS AND INCLUDED AS A COMMUNITY BENEFIT. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote Description: AUDITED FINANCIAL STATEMENTS SEE PAGE 12. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs MEDICARE ALLOWABLE COSTS ARE DETERMINED PURSUANT TO THE LAWS AND REGULATIONS APPLICABLE TO ALLOWABLE COSTS AND MEDICARE'S STEP DOWN METHODOLOGY. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance Description: THE PURPOSE OF THE COLLECTION POLICY (POLICY) IS TO PROMOTE PATIENT ACCESS TO QUALITY HEALTH CARE WHILE MINIMIZING BAD DEBT AT GRACIE SQUARE HOSPITAL (HOSPITAL). THIS POLICY PLACES REQUIREMENTS UPON HOSPITAL AND THOSE AGENCIES AND ATTORNEYS UNDERTAKING DEBT COLLECTION ACTIVITIES THAT ARE CONSISTENT WITH THE CORE MISSION, VALUES, AND PRINCIPLES OF HOSPITAL INCLUDING, BUT NOT LIMITED TO, CHARITY CARE POLICY. PROCEDURES: GENERAL GUIDELINES 1. HOSPITAL, COLLECTION AGENCIES (AGENCY), AND LAWYERS AND LAW FIRMS (OUTSIDE COUNSEL) WILL COMPLY WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND ACCREDITING AGENCY REQUIREMENTS GOVERNING THE COLLECTION OF DEBTS INCLUDING, BUT NOT LIMITED TO, THE FAIR DEBT COLLECTION PRACTICES ACT (FDCPA), THE FAIR CREDIT BILLING ACT, THE CONSUMER CREDIT PROTECTION ACTS, PUBLIC HEALTH LAW SECTION 2807-K-9-A, INTERNAL REVENUE SERVICE CODE 501(R), ARTICLE 52 OF THE NEW YORK CIVIL PRACTICE LAW AND RULES, AND THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA). HOSPITAL, AGENCY AND OUTSIDE COUNSEL WILL ALSO COMPLY WITH HOSPITAL'S CHARITY CARE POLICY. TO THE EXTENT THAT THERE ARE ANY INCONSISTENCIES BETWEEN HOSPITAL'S COLLECTION POLICY AND CHARITY CARE POLICY, THE CHARITY CARE POLICY SHALL SUPERSEDE AND CONTROL. 2. HOSPITAL SHALL ENTER LEGALLY BINDING WRITTEN AGREEMENTS WITH ANY PARTIES (INCLUDING AGENCY OR OUTSIDE COUNSEL) TO WHICH IT REFERS AN INDIVIDUAL'S DEBT RELATED TO CARE THAT ARE REASONABLY DESIGNED TO PREVENT EXTRAORDINARY COLLECTION ACTIONS (ECAS) FROM BEING TAKEN TO OBTAIN PAYMENT FOR THE CARE, UNTIL REASONABLE EFFORTS HAVE BEEN MADE TO DETERMINE WHETHER THE INDIVIDUAL IS ELIGIBLE FOR CHARITY CARE. Schedule H, Part V, Section B, Line 16a FAP website - THE NEW YORK GRACIE SQUARE HOSPITAL: Line 16a URL: https://www.nygsh.org/admissions-and-insurance.html; Schedule H, Part V, Section B, Line 16b FAP Application website - THE NEW YORK GRACIE SQUARE HOSPITAL: Line 16b URL: https://www.nygsh.org/admissions-and-insurance.html; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - THE NEW YORK GRACIE SQUARE HOSPITAL: Line 16c URL: https://www.nygsh.org/admissions-and-insurance.html; Schedule H, Part VI, Line 2 Needs assessment GRACIE SQUARE IS DEEPLY COMMITTED TO THE COMMUNITY MEMBERS RESIDING IN NYC AND THE SURROUNDING AREAS BY DELIVERING A RANGE OF HIGH QUALITY INPATIENT PSYCHIATRIC SERVICES. THE COMMUNITY HEALTH NEEDS ASSESSMENT CHNA) PROCESS IS UNDERTAKEN EVERY THREE YEARS TO DETERMINE THE HIGH DISPARITY COMMUNITIES AND HEALTH NEEDS THAT CAN BE MOST POSITIVELY IMPACTED BY FOCUSED INTERVENTIONS AND INITIATIVES. THE CHNA ALIGNS WITH THE NEW YORK STATE 2019-2024 PREVENTION AGENDA (NYS PA) PRIORITIES TO IMPROVE HEALTH EQUITY FOR ALL NEW YORKERS THROUGH PARTNERSHIPS WITH COMMUNITY ORGANIZATIONS TO ADDRESS SOCIAL DETERMINANTS OF HEALTH (SDOH) AND INTERVENTIONS TO REDUCE INEQUALITIES IN HEALTH INDICATORS. THROUGH THE NYS PA ALIGNMENT WITH THE CHNA PROCESS, NYS HAS IMPROVED ITS OVERALL NATIONAL RANKING FROM 28TH TO 10TH HEALTHIEST STATE SINCE 2008. OUR COMMITMENT AS AN INPATIENT PSYCHIATRIC FACILITY WITHIN NEW YORK STATE IS TO ALIGN OUR EFFORTS WITH THAT OF THE STATE AND TO STRATEGICALLY INVEST IN OPPORTUNITIES TO IMPROVE THE HEALTH OF THE PATIENTS WITHIN OUR COMMUNITY. GRACIE SQUARE HOSPITAL (GRACIE SQUARE) COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO IDENTIFY THE NEEDS OF THE COMMUNITY AND DEVELOP A COMMUNITY SERVICE PLAN (CSP) AND DETAILED IMPLEMENTATION PLAN TO ADDRESS THE AREAS OF HIGHEST NEED. THE COMMUNITY, SPANNING 168 NEW YORK CITY NEIGHBORHOOD TABULATION AREAS (NTAS) IN KINGS, QUEENS, BRONX, AND NEW YORK COUNTIES REPRESENT A BROAD DIVERSITY OF DEMOGRAPHICS, SOCIOECONOMICS AND HEALTH SERVICE UTILIZATION NEED, AND REQUIRES A CUSTOM APPROACH TO COMMUNITY SERVICE PLANNING TO ENSURE ALIGNMENT WITH THE NEEDS OF SUCH A DIVERSE POPULATION. THERE WERE ALSO FIVE ZIP CODES ORIGINATING IN THE SOUTHERN PORTION OF WESTCHESTER COUNTY THAT WERE PART OF THE DEFINED COMMUNITY. DUE TO THE LACK OF PUBLICLY AVAILABLE DATA AT THE ZIP CODE LEVEL FOR WESTCHESTER, THIS CHNA FOCUSED SOLELY UPON THE NEW YORK CITY COMMUNITY. THE LEADERS OF GRACIE SQUARE ARE DEDICATED TO OUR COMMUNITY WITH A MISSION TO BE THE PREMIER HEALTHCARE INSTITUTION SERVING OUR GREATER COMMUNITY BY PROVIDING EXCELLENCE IN INPATIENT PSYCHIATRIC CARE. A PRIORITIZATION PROCESS WAS CREATED TO ANALYZE THE QUANTITATIVE AND QUALITATIVE DATA INPUTS COLLECTED THROUGH THE CHNA PROCESS. THE PROCESS HAD SEVERAL LAYERS IN WHICH THE DATA WAS INPUT AND PRIORITIZED TO ARRIVE AT THE FINAL PRIORITY INDICATORS. THE DATA IDENTIFICATION AND PRIORITIZATION PROCESS FOR GRACIE SQUARE RESULTED IN NUMEROUS INDICATORS. AT A HIGH LEVEL, THESE INDICATORS CAN GENERALLY BE GROUPED INTO: 1 MENTAL HEALTH & SUBSTANCE ABUSE 2 HIV 3 CHRONIC DISEASE & OBESITY 4 WOMEN'S HEALTH / MATERNAL HEALTH THE TOP PRIORITIES ALLOWED THE GRACIE SQUARE LEADERSHIP TO DEVELOP FOCUSED EFFORTS TO ENSURE IT CAN CONTRIBUTE TO A DIRECT IMPACT OF IMPROVEMENT FOR THE COMMUNITY. THE CSP FOCUS WILL ALLOW GRACIE SQUARE TO INVEST IN NEW OPPORTUNITIES. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Description: WRITTEN MATERIALS, INCLUDING THE APPLICATION, FULL POLICY, AND PLAIN LANGUAGE SUMMARY (SUMMARY), SHALL BE AVAILABLE TO PATIENTS IN THE HOSPITAL'S PRIMARY LANGUAGES, UPON REQUEST AND WITHOUT CHARGE, FROM THE ADMITTING DEPARTMENT AT THE HOSPITAL DURING THE INTAKE AND REGISTRATION PROCESS, AT DISCHARGE AND/OR BYMAIL. ADDITIONALLY, THOSE MATERIALS SHALL BE AVAILABLE ON THE HOSPITAL'S WEBSITE(WWW.NYGSH.ORG) AND BY CALLING (212) 434-5315. ALSO, NOTIFICATION TO PATIENTS REGARDING THIS POLICY SHALL BE MADE THROUGH CONSPICUOUS POSTING OF LANGUAGE-APPROPRIATE INFORMATION IN THE ADMITTING DEPARTMENT OF THE HOSPITAL, AND INCLUSION OF INFORMATION ON BILLS AND STATEMENTS SENT TO PATIENTS EXPLAINING THAT FINANCIAL AID MAY BE AVAILABLE TO QUALIFIED PATIENTS AND HOW TO OBTAIN FURTHER INFORMATION. Schedule H, Part VI, Line 4 Community information Description: THE COMMUNITY DEFINITION FOR GRACIE SQUARE HOSPITAL WAS DERIVED USING 80% OF ZIP CODES FROM WHICH GRACIE SQUARE'S PATIENTS ORIGINATE AND ADDING ZIP CODES NOT AMONG THE ORIGINAL PATIENT ORIGIN TO CREATE CONTINUITY IN GEOGRAPHICAL BOUNDARIES, RESULTING IN A TOTAL OF 148 COMMUNITY ZIP CODES MAINLY WITHIN NYC. 7.8+M PEOPLE - THE DEFINED COMMUNITY COVERS A GEOGRAPHY OF APPROXIMATELY 7.8+M PEOPLE 2.6% GROWTH POPULATION FORECASTED TO GROW FASTER, 2.6%, THAN THE STATE AVERAGE,1.5%, BETWEEN 2019-2024. 14.0% 65+ POPULATION IS SLIGHTLY YOUNGER WITH ONLY 14.0% OF THE POPULATION AGED 65+ COMPARED TO 16.3%. $99,251 HOUSEHOLD INCOME THE AVERAGE HOUSEHOLD INCOME, $99,251, IS LOWER THAN THE AVERAGE OF NEW YORK STATE, $101,507. 18.0% UNEMPLOYMENT RATE THE UNEMPLOYMENT RATE, 18.0%, IS HIGHER THAN THE NEW YORK STATE BENCHMARK, AND THERE ARE 2% FEWER WHITE-COLLAR WORKERS THAN THE STATE AVERAGE. HIGHER MINORITY POPULATION HIGHER NON-WHITE POPULATION, 70.2%, THAN THE STATE 45.6%, DRIVEN BY HISPANICS, 31.6%, AND AFRICAN AMERICANS, 21.1%. TO ENSURE THAT WE ARE IMPLEMENTING INITIATIVES THAT WILL IMPACT THE COMMUNITIES WITH THE HIGHEST DISPARITIES WITH THIS COMMUNITY SERVICE PLAN, GRACIE SQUARE UNDERTOOK ADDITIONAL ANALYSIS OF COMMUNITY HEALTH NEED AND RISK OF HIGH RESOURCE UTILIZATION AT THE NEIGHBORHOOD TABULATION AREA (NTA) GEOGRAPHY BASED UPON A COMPOSITE OF 29 DIFFERENT INDICATORS. INDICATORS WERE CAREFULLY SELECTED, ACROSS FIVE DOMAINS: DEMOGRAPHICS, INCOME, INSURANCE, ACCESS TO CARE AND NEW YORK STATE DEPARTMENT OF HEALTH PREVENTION AGENDA PRIORITIES. THE OBJECTIVE WAS TO IDENTIFY THE SPECIFIC NYC NTAS WHERE THERE IS A HIGHER HEALTH NEED AND/OR A HIGHER EXPECTATION OF REQUIRED RESOURCES. THE DEFINED COMMUNITY'S 148 ZIP CODES WERE CROSS WALKED TO 168 NEW YORK CITY NTAS (MOSTLY IN KINGS, QUEENS, BRONX, AND NEW YORK COUNTIES) AND CATEGORIZED INTO FOUR QUARTILES. ADDITIONAL ANALYSIS WAS UNDERTAKEN FOR THE 84 NTAS OF HIGHER DISPARITY THAT FELL INTO QUARTILES 3 AND 4. GRACIE SQUARE HOSPITAL FOCUSED HIGH DISPARITY COMMUNITY: 4.1+M PEOPLE THE DEFINED COMMUNITY COVERS A GEOGRAPHY OF APPROXIMATELY 4.1+M PEOPLE. 15.9% UNINSURED HIGHER PERCENTAGE OF UNINSURED POPULATION AT 15.9% COMPARED TO NYC AVERAGE OF 13.5%. 27.7% LIVING IN POVERTY THERE ARE MORE LIVING IN POVERTY, ALL AGES 27.7%, THAN THE NYC AVERAGE, 20.6%. 43.3% MEDICAID ENROLLMENT NUMEROUS NEIGHBORHOODS ALSO HAVE A HIGHER THAN AVERAGE MEDICAID ENROLLMENT, OVERALL 43.3%, NYC 37.0%. 32.1% RECEIVING SNAP BENEFITS AN ESTIMATED 32.1% RECEIVE SNAP BENEFITS, IN COMPARISON TO THE NYC AVERAGE OF 7.9%. 87.7% MINORITY POPULATION HIGHER NON-WHITE POPULATION, 87.7% AS COMPARED TO NYC AVERAGE OF 67.3%. ACKNOWLEDGING THAT THERE WAS VARIATION ACROSS THE NTAS AND COUNTIES AMONG SPECIFIC MEASURABLE INDICATORS FOR DEMOGRAPHICS, SOCIOECONOMICS, SOCIAL DETERMINANTS OF HEALTH (SDOH), HEALTH STATUS AND UTILIZATION THAT EACH REQUIRE A CUSTOM APPROACH TO COMMUNITY SERVICE PLANNING, THERE WERE SPECIFIC COMMUNITIES THAT FREQUENTLY SHOWED MORE NEED THAN THE OTHERS. WITH SUCH A LARGE COMMUNITY, COVERING ALL FIVE BOROUGHS OF NEW YORK CITY, THERE ARE MANY NEIGHBORHOODS THAT FELL INTO THE HIGH DISPARITY (3RD AND 4TH QUARTILES) COMMUNITIES BASED ON THE ANALYSIS AND PRIORITIZATION OR THE QUANTITATIVE AND QUALITATIVE DATA COLLECTED FOR THE CHNA. THE GRACIE SQUARE COMMUNITY IS DIVERSE IN ITS GEOGRAPHY WITH THE NYC NTAS HAVING A YOUNGER, MORE MINORITY, AND ECONOMICALLY CHALLENGED POPULATION. THE SDOH CONCERNS ARE CONCENTRATED UPON LANGUAGE, SAFETY, FOOD INSECURITY, HIGH COST OF HOUSING, AND PUBLIC TRANSPORTATION. BEHAVIORAL RISK FACTORS SUCH AS SMOKING, DRINKING, AND CONSUMING FRUITS AND VEGETABLES VARY AMONG THE NTAS BUT ARE PROBLEMATIC FOR THOSE IN HIGH-DISPARITY NEIGHBORHOODS. Schedule H, Part VI, Line 5 Promotion of community health Description: THE DATA OUTLINED ALLOWED US TO IDENTIFY A COMMUNITY OF FOCUS AS WELL AS PRIORITY AREAS TO IMPACT THE HEALTHCARE OF THE MOST VULNERABLE POPULATIONS. BACKGROUND SUMMARY: MENTAL HEALTH FIRST AID (MHFA) IS AN INTERNATIONAL TRAINING PROGRAM PROVEN TO BE AN EFFECTIVE INTERVENTION FOR MENTAL HEALTH EDUCATION, PREVENTION AND ADDRESSING STIGMA. PEER-REVIEWED STUDIES SHOW THAT INDIVIDUALS TRAINED IN THE PROGRAM ACHIEVE THE FOLLOWING OUTCOMES: 1 GROW THEIR KNOWLEDGE OF SIGNS, SYMPTOMS, AND RISK FACTORS OF MENTAL ILLNESSES AND ADDICTIONS. 2 CAN IDENTIFY MULTIPLE TYPES OF PROFESSIONAL AND SELF-HELP RESOURCES FOR INDIVIDUALS WITH A MENTAL ILLNESS OR ADDICTION. 3 INCREASE THEIR CONFIDENCE IN AND LIKELIHOOD TO HELP AN INDIVIDUAL IN DISTRESS. 4 SHOW INCREASE MENTAL WELLNESS THEMSELVES. MENTAL HEALTH FIRST AID USA IS LISTED IN THE SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION'S NATIONAL REGISTRY OF EVIDENCE-BASED PROGRAMS AND PRACTICES . BACKGROUND SUMMARY: BASED ON THE EXPERTISE THAT GRACIE SQUARE HOSPITAL (GSH) CAN BRING TO THE BEHAVIORAL HEALTH PRIORITY AREA, WE WILL PARTNER WITH NEWYORK-PRESBYTERIAN HOSPITAL (NYPH) TO INVEST AND CONCENTRATE EFFORTS TO DIRECTLY IMPACT THE NYPH TARGETED COMMUNITIES WITH A SPECIAL FOCUS BY GSH IN WASHINGTON HEIGHTS AND LOWER EAST SIDE NEIGHBORHOODS. GRACIE SQUARE HOSPITAL CONTINUES TO WORK AND COORDINATE WITH NYPH AND PROVIDE SERVICES AS A REFERRAL SOURCE. PROGRESS TRACKING WILL BE MAINTAINED QUARTERLY BY THE GRACIE SQUARE LEADERSHIP TEAM. QUARTERLY FINDINGS WILL BE USED AS A QUALITY PERFORMANCE IMPROVEMENT PROCESS TO REFINE PROCESSES AND PROGRAM DEVELOPMENTAL EFFORTS TO ENSURE NEEDS OF THE POPULATION ARE MET. THE QUARTERLY UPDATES WILL THEN TO BE USED TO COMPILE AN ANNUAL REPORT TO MEET BOTH THE STATE AND FEDERAL EXPECTATIONS OF REPORTING. Schedule H, Part VI, Line 6 Affiliated health care system Description: GRACIE SQUARE HOSPITAL IS A MEMBER OF THE NEW YORK-PRESBYTERIAN HEALTHCARE SYSTEM. THE NEW YORK-PRESBYTERIAN HEALTHCARE SYSTEM IS A FEDERATION OF TOP-QUALITY HOSPITALS, SPECIALTY INSTITUTES, AND CONTINUING CARE CENTERS. IT WAS FOUNDED TO BRING ABOUT A POSITIVE CHANGE IN THE WAY HEALTHCARE IS DELIVERED TO THE COMMUNITY. THE NEW YORK-PRESBYTERIAN HEALTHCARE SYSTEM IS DEDICATED TO IMPROVING PATIENT CARE, MEDICAL EDUCATION AND RESEARCH THROUGHOUT THIS REGION OF THE UNITED STATES. Schedule H, Part VI, Line 7 State filing of community benefit report NY true LIFEFORCE IN LATER YEARS INC PO BOX 250402 NEW YORK NY 10025 800401075 501(C)(3) 6500 SUPPORT 1 0 DIRECT ASSISTANCE 1833 84850 COST Medication, Transportation & Clothing Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. PRIOR TO AWARDING ASSISTANCE TO ORGANIZATIONS, AN ASSESSMENT IS MADE ON THE USE OF THE FUNDS. FINAL DETERMINATION IS BASED ON WHETHER FUNDS WILL BE USED TO FURTHER OUR MISSION. X X X X X false true false false false false false true false DAVID WYMAN BOARD MEMBER/PRESIDENT (THRU 5/2021) 240865 316798 188940 0 8125 27777 8700 17400 5029 22611 451659 384586 0 0 GARY J ZUAR BOARD MEMBER/ASS'T TREASURER 0 718491 0 473153 0 157358 0 132290 0 38538 0 1519830 0 12259 NAZIM B MALATYALI BOARD MEMBER 0 444091 0 228762 0 49772 0 19877 0 41848 0 784350 0 0 BRIAN K REGAN BOARD MEMBER 0 306365 0 119130 0 32906 0 33275 0 30892 0 522568 0 0 KAREN WESTERVELT BOARD MEMBER/ CHAIRMAN (FROM 6/2021) 0 727605 0 555655 0 89511 0 20679 0 37279 0 1430729 0 0 PHYLLIS R LANTOS FORMER OFFICER 0 27184 0 0 0 1200088 0 17253 0 3800 0 1248325 0 0 MICHAEL P BRESLIN TREASURER 0 1170753 0 888010 0 134226 0 21250 0 52153 0 2266392 0 0 KATHLEEN M BURKE ASS'T SECRETARY 0 299170 0 102232 0 32864 0 44620 0 22986 0 501872 0 0 JOHN V CAMPANO SECRETARY 0 371763 0 152498 0 104219 0 38701 0 39984 0 707165 0 0 MELISSA E WELCH ASS'T SECRETARY 0 171362 0 8625 0 146 0 17052 0 15044 0 212229 0 0 DONNA T ANTHONY CHIEF MEDICAL OFFICER 336419 0 73459 0 0 0 29000 0 12796 0 451674 0 0 0 NATASHA BOWMAN CHIEF HR OFFICER 216493 0 52349 0 0 0 13764 0 35808 0 318414 0 0 0 MARGARET MANCUSO CHIEF ADMINISTRATIVE OFFICER 231419 0 58053 0 0 0 17400 0 12565 0 319437 0 0 0 MICHAEL RADOSTA CHIEF NURSING & QUAL. OFFICER 128795 199455 62570 30000 0 4261 5801 16172 2018 20820 199184 270708 0 0 BORIS AVEZBAKIYEV PER DIEM MD 176813 0 0 0 0 0 10609 0 0 0 187422 0 0 0 FRANCINE FAKIH DIRECTOR OF NURSING 189315 0 2000 0 0 0 9836 0 35586 0 236737 0 0 0 AMY PARIKH PER DIEM PSYCH 221603 0 0 0 0 0 11080 0 0 0 232683 0 0 0 DOUGLAS SAPHIER PER DIEM PSYCH 215408 0 0 0 0 0 12924 0 0 0 228332 0 0 0 NIESHA WESTMORELAND PER DIEM PSYCH 257460 0 0 0 0 0 12873 0 0 0 270333 0 0 0 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: GARY ZUAR: $98,632 SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN AS REPORTED ON THE W-2: GARY ZUAR: $73,937 PHYLLIS R. LANTOS: $1,183,467 PART I LINE 4B: LEGACY NONQUALIFIED RETIREMENT PLAN REPORTED ON THE W2: JOHN CAMPANO: $64,158 Schedule J, Part I, Line 7 Non-fixed payments ALL BONUSES ARE GRANTED AT THE DISCRETION OF AND APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES; THEY ARE BASED ON THE ACHIEVEMENT OF PREDETERMINED GOALS AND OBJECTIVES. Schedule J, Part I PART VII AND SCHEDULE J SUPPLEMENTAL INFORMATION CERTAIN EMPLOYEES OF THE NEW YORK PRESBYTERIAN HOSPITAL THAT ARE IDENTIFIED IN PART VII AS OFFICERS OR TRUSTEES OF THE NEW YORK GRACIE SQUARE HOSPITAL INC. ARE RESPONSIBLE FOR EXECUTING THE MISSION AND MANAGEMENT OF THE NEW YORK PRESBYTERIAN HOSPITAL (NYP) AND ITS AFFILIATED ENTITIES. COMPENSATION FOR 2021 OF THESE UPPER LEVEL EXECUTIVES INCLUDES THE PAYOUT OF AN ANNUAL INCENTIVE PLAN AND A LONG-TERM INCENTIVE PLAN. THIS PERFORMANCE-ORIENTED PROGRAM CONDITIONS PAYMENTS UPON THE ACHIEVEMENT OF MULTIPLE INDIVIDUAL AND GROUP PERFORMANCE MEASURES. MEASURES TO MONITOR PERFORMANCE INCLUDE OPERATIONAL AND FINANCIAL STRENGTH, PATIENT QUALITY AND SAFETY, PATIENT SATISFACTION, ADVANCEMENT OF PATIENT CARE, AND PEOPLE DEVELOPMENT AND PARTNERSHIP. INCENTIVE AWARDS MAY ONLY BE GRANTED IF THE ORGANIZATION ACHIEVES A FINANCIAL SURPLUS. EVEN IF ALL RELEVANT PERFORMANCE MEASUREMENTS ARE ACHIEVED, THE NYP BOARD OF TRUSTEES RETAINS FULL DISCRETION TO MAKE OR NOT MAKE ANY INCENTIVE AWARDS, OR TO REDUCE THE AMOUNT OF ANY INCENTIVE AWARD. THIS INITIATIVE IS CRITICAL TO ASSURING THAT NYP HAS THE REQUISITE LEADERSHIP TO CREATE AND MANAGE A HIGHLY MOTIVATED AND ENGAGED WORKFORCE, DRIVE SUPERIOR PERFORMANCE THROUGHOUT THE ORGANIZATION, AND ACHIEVE TOP TIER MEDICAL CENTER STATUS. AS A SEPARATE MATTER, DUE TO RESTRICTIONS IMPOSED BY THE INTERNAL REVENUE CODE, UPPER LEVEL EXECUTIVES ARE LIMITED IN THE AMOUNT OF BENEFITS RECEIVED UNDER A TAX-QUALIFIED RETIREMENT PLAN. LIKE MANY EMPLOYERS, NYP SUPPLEMENTS THESE EXECUTIVES' PENSION BENEFITS THROUGH A SUPPLEMENTAL ("NONQUALIFIED") RETIREMENT PLAN. THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IS SUBJECT TO A MULTI-YEAR VESTING REQUIREMENT (COMMENCING AFTER FIVE YEARS OF PARTICIPATION IN THE SERP, IN PRORATED AMOUNTS THROUGH AGE 65) WHICH PLACES AN EXECUTIVE'S SUPPLEMENTAL RETIREMENT BENEFIT AT RISK OF FORFEITURE IF THE VESTING REQUIREMENTS ARE NOT SATISFIED. ONCE VESTED, HOWEVER, PROVISIONS OF THE INTERNAL REVENUE CODE REQUIRE THAT THE VESTED EXECUTIVE INCLUDE IN CURRENT INCOME THE VALUE OF HIS OR HER VESTED SUPPLEMENTAL RETIREMENT BENEFIT. NOTWITHSTANDING THE LEGAL REQUIREMENT TO RECOGNIZE THE VESTED VALUE OF THE SUPPLEMENTAL RETIREMENT BENEFIT AS CURRENT INCOME, THE SUPPLEMENTAL RETIREMENT BENEFIT WILL NOT BE DISTRIBUTED TO THE EXECUTIVE UNTIL THE EXECUTIVE ACTUALLY RETIRES FROM NYP (ALTHOUGH, AS PERMITTED BY THE INTERNAL REVENUE CODE, THE SUPPLEMENTAL RETIREMENT PLAN WILL EFFECT A DISTRIBUTION OF AN AMOUNT NECESSARY TO SATISFY THE EXECUTIVE'S TAX LIABILITY RESULTING FROM THE INCOME RECOGNITION UPON VESTING). AS NOTED, THIS SUPPLEMENTAL RETIREMENT BENEFIT WILL NOT BE DISTRIBUTED TO THE EXECUTIVE UNTIL THE EXECUTIVE ACTUALLY RETIRES FROM NYP. THERE ARE CONSTANTLY CHANGING LEGAL, TAX, ACCOUNTING, AND PUBLIC DISCLOSURE RULES FOR A SERP (SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN) IN NOT-FOR-PROFIT ORGANIZATIONS. THE EXECUTIVE COMPENSATION COMMITTEE CONTINUOUSLY MONITORS THESE CHANGES AND INCORPORATES ANY CHANGES INTO THE OVERALL SERP PLAN DESIGN. AS IN PAST YEARS, THE EXECUTIVE COMPENSATION COMMITTEE OF NYP REQUIRES A THIRD PARTY TO COMPLETE A REVIEW OF THE ORGANIZATION'S COMPENSATION PROGRAM TO ENSURE ITS EFFECTIVENESS IN TERMS OF GOVERNMENT REGULATIONS, MARKET CONDITIONS, AND THE NEED TO CONTINUALLY ELEVATE ORGANIZATIONAL PERFORMANCE. THE REPORT ALSO SERVES TO MEET THE REGULATORY OBLIGATIONS TO ENSURE THAT ALL ELEMENTS OF THE EXECUTIVE COMPENSATION PROGRAMS ARE REASONABLE. THE INDIVIDUALS LISTED IN PART VII THAT ARE COMPENSATED BY NEW YORK PRESBYTERIAN HOSPITAL DEVOTE AN AVERAGE OF SIXTY HOURS PER WEEK TO PERFORM THEIR RESPONSIBILITIES FOR THE NEW YORK PRESBYTERIAN HOSPITAL AND OTHER RELATED ORGANIZATIONS IN THE AGGREGATE. THE INDIVIDUALS LISTED IN PART VII THAT ARE COMPENSATED BY THE NEW YORK GRACIE SQUARE HOSPITAL, UNLESS OTHERWISE INDICATED, DEVOTE AN AVERAGE OF SIXTY HOURS PER WEEK TO PERFORM THEIR RESPONSIBILITIES FOR THE NEW YORK GRACIE SQUARE HOSPITAL. Form 990, Part VI, Line 6 Classes of members or stockholders THE NEW YORK GRACIE SQUARE HOSPITAL (GSH), INC. IS A MEMBERSHIP CORPORATION, WHOSE MEMBERS ARE APPOINTED BY NEW YORK-PRESBYTERIAN HEALTHCARE SYSTEM, INC. ("SYSTEM INC."). SYSTEM INC. IS A TAX-EXEMPT ORGANIZATION WHOSE MEMBERS ARE APPOINTED BY NEW YORK-PRESBYTERIAN FOUNDATION, INC., WHICH IS ALSO A TAX-EXEMPT ORGANIZATION. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body The Members shall have the sole authority to establish from time to time the number of Trustees to be elected at large, to elect Trustees to be elected at large and Honorary Trustees, and to elect the Chairman of the Board (the "Chairman"). Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders The approval of the Members shall be required for: (1) the removal by the Board of the President the "President"), Chief Financial Officer, Chief Medical Officer and Chief Information Officer, if any, or any other corporate officer whose powers and duties include those which usually appertain to such offices. (2) the amendment of the Certificate of Incorporation or By-Laws of the Corporation, (3) the disposition of all or substantially all of the assets of the Corporation, (4) the merger or consolidation of the Corporation with another entity or (5) the dissolution of the Corporation. Except as may be limited by applicable law governing health care institutions, the Members shall have such other powers and authority as are afforded to the Members under the Corporation's Certificate of Incorporation or generally to members of not-for-profit corporations under the laws of the State of New York. Form 990, Part VI, Line 11b Review of form 990 by governing body MEMBERS OF THE NEWYORK-PRESBYTERIAN HOSPITAL (NYPH) FINANCE DEPARTMENT (FINANCE) COORDINATED AND COMPLETED ALL OF THE INFORMATION REQUIRED FOR FORM 990, ACCESSING VARIOUS RESOURCES INCLUDING, LEGAL, HUMAN RESOURCES, CORPORATE COMPLIANCE, DEVELOPMENT, AND OTHER DEPARTMENTS AS NEEDED. THE COMPLETED FORM 990 IS FORWARDED TO ERNST & YOUNG U.S. LLP (EY) FOR REVIEW. EY PERFORMS REVIEW PROCEDURES DESIGNED TO EVALUATE THE CORRECTNESS AND MECHANICAL ACCURACY OF THE RETURN. UPON COMPLETION OF THEIR REVIEW PROCEDURES, A DRAFT OF THE FORM 990 WILL BE PROVIDED TO SENIOR MANAGEMENT FOR REVIEW. A DRAFT 990 IS THEN PROVIDED TO ALL MEMBERS OF THE BOARD OF DIRECTORS. THE CORPORATION FILES THE FORM 990 WITH THE IRS UPON FINAL REVIEW BY THE BOARD. Form 990, Part VI, Line 12c Conflict of interest policy THE HOSPITAL ADHERES TO A CONFLICT OF INTEREST (COI) POLICY THAT WAS APPROVED BY THE AUDIT AND CORPORATE COMPLIANCE COMMITTEE OF THE BOARD OF TRUSTEES. THE POLICY STATES IN PART: "EACH BOARD MEMBER, OFFICER OR KEY PERSON OF A NEW YORK-PRESBYTERIAN ORGANIZATION SHALL COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE PRIOR TO BECOMING A BOARD MEMBER, OFFICER OR KEY PERSON OF THE NEW YORK-PRESBYTERIAN ORGANIZATION AND ANNUALLY THEREAFTER." THE POLICY ALSO STATES THAT "EACH BOARD MEMBER, OFFICER, OR KEY PERSON SHALL PROMPTLY ADVISE THE CHIEF EXECUTIVE OFFICER OF THE NEWYORK-PRESBYTERIAN ORGANIZATION, OR HIS OR HER DESIGNEE, OF ANY CHANGES TO THE INFORMATION PROVIDED IN THAT INDIVIDUAL'S LAST COMPLETED CONFLICT OF INTEREST QUESTIONNAIRE." THE CHIEF EXECUTIVE OFFICER OF NEW YORK-PRESBYTERIAN HOSPITAL, OR HIS OR HER DESIGNEE, SHALL REVIEW ALL COMPLETED QUESTIONNAIRES AND ALL SUBSEQUENT ADVICE OF CHANGES AND SHALL TAKE SUCH ACTION AS IS DEEMED APPROPRIATE TO ELIMINATE POTENTIALS FOR CONFLICTS OF INTEREST, INCLUDING SUCH STEPS AS REASSIGNMENT OF RESPONSIBILITIES OR ESTABLISHMENT OF PROTECTIVE ARRANGEMENTS. ALL DISCLOSURES OF INTERESTS IN COMPLETED QUESTIONNAIRES OR SUBSEQUENT ADVICE, UNLESS CLEARLY IRRELEVANT OR IMMATERIAL, SHALL BE COMPILED AND REPORTED BY MANAGEMENT TO THE AUDIT AND CORPORATE COMPLIANCE COMMITTEE OF THE BOARD OF NEW YORK- PRESBYTERIAN HOSPITAL, TOGETHER, IN EACH CASE, WITH RESPONSE OR RECOMMENDATION OF MANAGEMENT. THE AUDIT AND CORPORATE COMPLIANCE COMMITTEE SHALL DETERMINE WHETHER THE REPORTED RESOLUTION OF ISSUES RAISED BY THE DISCLOSURES IS SATISFACTORY AND, IF NOT, SHALL REQUIRE SUCH FURTHER ACTION AS IT DEEMS APPROPRIATE. Form 990, Part VI, Line 15a Process to establish compensation of top management official THE HOSPITAL'S EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES (THE "COMMITTEE") OVERSEES MATTERS CONCERNING COMPENSATION AND BENEFITS FOR OFFICERS AND OTHER EXECUTIVES. THE MEMBERS OF THE COMMITTEE INCLUDE INDEPENDENT TRUSTEES. PART OF THE COMMITTEES DELIBERATION AND DECISION PROCESS INCLUDES REVIEW OF COMPARABLE AND CONTEMPORANEOUS DATA. Form 990, Part VI, Line 15b Process to establish compensation of other employees SEE DESCRIPTION FOR FORM 990, PART VI, LINE 15A. Form 990, Part VI, Line 19 Required documents available to the public INSPECTION OF THE HOSPITAL'S FORM 990, GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS WILL BE ARRANGED UPON REQUEST. Form 990, Part XI, Line 9 Other changes in net assets or fund balances RESTRICTED CONTRIBUTION AND NET ASSETS RELEASED FROM RESTRICTION, NET - 49432; COVID 19 DISCLOSURE AT GRACIE SQUARE HOSPITAL, GUIDANCE FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) WAS FOLLOWED AND SAFETY MEASURES WERE STANDARDIZED ON ALL UNITS. THESE INCLUDED: MONITORING THE CDC WEBSITE FOR UPDATED INFORMATION, PREPARING A MULTIDISCIPLINARY TEAM OF MEDICINE AND PSYCHIATRY, ATTENDING TO THE EXISTING INFECTION CONTROL GUIDELINES FOR ENHANCING HAND HYGIENE AND DISINFECTION, APPLYING SOCIAL DISTANCING STRATEGIES TO INCREASE SPACE AMONG PATIENTS AND AMONG STAFF, SCREENING PATIENTS FOR COVID-19 AT TIME OF ADMISSION, RESTRICTING VISITATION TO LIMIT THE POTENTIAL TRANSMISSION FROM VISITORS, USING PERSONAL PROTECTIVE EQUIPMENT (PPE), CREATING A TEMPERATURE MONITORING PROTOCOL FOR ALL PATIENTS, IDENTIFYING PATIENTS WHO ARE AT INCREASED RISK FOR SEVERE SYMPTOMS FROM COVID-19 SECONDARY TO MEDICAL COMORBIDITIES, ISOLATING PATIENTS WITH SUSPECTED OR CONFIRMED COVID-19, AND QUARANTINING THE CLOSE CONTACTS. WHILE IMPLEMENTING THE CDC RECOMMENDATIONS, WE FACED CHALLENGES CONCERNING PSYCHIATRIC PATIENTS. ACCORDINGLY, GRACIE SQUARE HOSPITAL CONVERTED ONE OF ITS GENERAL PSYCHIATRIC UNITS INTO A PSYCHIATRIC COVID UNIT. THE UNIT WAS DEDICATED ENTIRELY TO TREATING COVID-19 PATIENTS WHO NEED PSYCHIATRIC CARE WITH THE GOAL OF MINIMIZING THE RISK OF EXPOSURE TO PATIENTS AND STAFF. THIS CONVERSION PROCESS WAS EXECUTED IN A TIMELY MANNER CONSIDERING THE RAPIDLY EVOLVING OUTBREAK. THE HOSPITAL DESIGNATED A MULTIDISCIPLINARY TEAM TO MEETING THE COMPLEX NEEDS OF THIS UNIQUE PATIENT POPULATION. MOREOVER, THE DEPARTMENT OF INFECTION PREVENTION AND CONTROL (IPC) AT NYP WAS PROVIDING ONGOING CLINICAL ADVICE INCLUDING CLINICAL PROTOCOLS AND CONSULTATION ON INDIVIDUAL PATIENT CASES. THE COVID-19 PANDEMIC HAS DRAMATICALLY CHANGED PSYCHIATRIC PRACTICE OVER A SHORT PERIOD OF TIME GIVEN THE LEVEL OF CLINICAL UNCERTAINTY AND UNIQUE CIRCUMSTANCES. NEW YORK-PRESBYTERIAN FOUNDATION INC 525 E 68TH ST BOX 156 NEW YORK NY 10065 134153668 SUPPORT ORG. 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