2022-11-14T22:56:54-06:00 2021-12-31 861065772 DELOITTE TAX LLP 695 TOWN CENTER DRIVE SUITE 1000 COSTA MESA CA 92626 990 2021-01-01 590624424 MOUNT SINAI MEDICAL CENTER OF FLORIDA INC MOUN 3056742032 4300 ALTON ROAD MIAMI BEACH FL 33140 ALEXANDER MENDEZ EXECUTIVE VP/CFO 3056742032 2022-11-11 1 ALEXANDER MENDEZ XXX-XX-XXXX JOHN W SADOFF JR P00540589 7144367100 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z GINO SANTORIO 4300 ALTON ROAD MIAMI BEACH FL 33140 926781972 0 X WWW.MSMC.COM X 1946 FL TO PROVIDE HIGH QUALITY HEALTH CARE TO OUR DIVERSE COMMUNITY ENHANCED THROUGH TEACHING, RESEARCH, CHARITY CARE AND FINANCIAL RESPONSIBILITY. 25 23 5393 0 132636 0 56033814 11472724 672790544 874137836 2658444 1866267 13095263 14379784 744578065 901856611 150000 150000 0 0 333268585 396047514 0 0 0 407363105 453743947 740781690 849941461 3796375 51915150 825165487 992427664 566513196 691221466 258652291 301206198 X TO PROVIDE HIGH QUALITY HEALTH CARE TO OUR DIVERSE COMMUNITY ENHANCED THROUGH TEACHING, RESEARCH, CHARITY CARE AND FINANCIAL RESPONSIBILITY. 0 0 574086545 150000 746051814 SAFETY NET HOSPITAL OPERATIONSIN 2021, MOUNT SINAI SERVED 25,086 INPATIENT ADMISSIONS, 226,437 OUTPATIENT ADMISSIONS, 51,015 EMERGENCY CARE VISITS IN ITS PRIMARY SERVICE AREA, 18,075 IN ITS SENIOR HEALTH TARGET AREA OF AVENTURA AND 34,212 IN ITS HIALEAH FREE STANDING EMERGENCY DEPARTMENT. MOUNT SINAI PERFORMED 13,360 SURGERIES MEETING SURGICAL CARE STANDARDS AND WELCOMED 2,207 INFANTS WITH HEALTHY BIRTH WEIGHTS. 46681554 46417169 TEACHING & RESEARCHIN 2021, MOUNT SINAI RETAINED ITS OWN TEACHING FACULTY AND 14 ACCREDITED GRADUATE MEDICAL EDUCATION PROGRAMS, TEACHING 205 RESIDENTS AND FELLOWS. MOUNT SINAI PROVIDED A TEACHING CLINICAL ENVIRONMENT FOR PHYSICIANS TO BECOME BOARD CERTIFIED. ADDITIONALLY, TO MEET THE DEMANDS OF THE WORKFORCE, MOUNT SINAI TAUGHT 44 NURSING STUDENTS, 177 MEDICAL STUDENTS AND 114 ALLIED HEALTH STUDENTS FOR HEALTH CARE CAREERS. TO SUPPLEMENT THE ACADEMIC ENVIRONMENT IN 2021, MOUNT SINAI HAD 171 RESEARCH STUDIES APPROVED BY A NATIONAL REVIEW BOARD OR BY A MOUNT SINAI INSTITUTION PEER REVIEW BOARD. MOUNT SINAI HAD 120 CANCER STUDIES, 18 MEMORY DISORDER, 12 CARDIAC, AND 21 OTHER STUDIES. 119901169 81668853 PHYSICIAN NETWORK AND ACCESS TO CAREACCORDING TO THE 2017 UPDATE TO THE AAMC-COMMISSIONED STUDY OF PHYSICIAN SUPPLY AND DEMAND, PHYSICIAN DEMAND IS PROJECTED TO CONTINUE GROWING FASTER THAN THE SUPPLY. (THE COMPLEXITIES OF PHYSICIAN SUPPLY AND DEMAND: PROJECTIONS FROM 2015 TO 2030, IHS MARKET, FEBRUARY 17, 2017) THE STATE OF FLORIDA AGENCY FOR HEALTHCARE, AND THE STATEWIDE MEDICAID RESIDENCY PROGRAM SUPPORTED THE TEACHING OF SPECIALTY CLINICAL PROVIDERS. MOUNT SINAI PROVIDED BOTH ACCESS TO CARE AND SUPPORT FOR THE TEACHING OF 177 MEDICAL STUDENTS AND 205 RESIDENTS AND FELLOWS. MOUNT SINAI SERVICES 13 LOCATIONS IN TWO COUNTIES BY PROVIDING 264,000 PRIMARY OR SPECIALTY CARE VISITS. MOUNT SINAI HAS WIDENED ACCESS TO SPECIALTY CARE IN FLORIDA AND THE STATE MEDICAID PROGRAM. 740669268 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 1 0 0 0 0 0 1 1 1 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 0 1 707 0 1 5393 1 1 1 1 CJ 0 0 0 0 0 0 0 0 1 0 X 25 23 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 0 CA NC X LOURDES DIAZ 3056742032 4300 ALTON ROAD MIAMI BEACH FL 33140 STEVE XYDAS EMPLOYED MD CHIEF, CARDIOTHORACIC SURGERY 60.00 0.00 X 2462365 0 85514 STEVEN SONENREICH PRESIDENT/CEO (END 2/21) 60.50 1.00 X X 1560368 0 80806 ALEXANDER MENDEZ EXECUTIVE VP/CFO 60.00 1.00 X 1326608 0 90489 SAMUEL GOLDSMIT EMPLOYED MD STAFF PHYSICIAN, NEUROSURGERY 60.00 0.00 X 1263719 0 57168 GINO SANTORIO PRESIDENT/CEO (BEG. 2/21) 60.50 1.00 X X 1152304 0 66029 NICOLAS KURITZKY EMPLOYED MD STAFF PHYSICIAN, RADIATION ONCOLOGY 60.00 0.00 X 1008407 0 58485 ROY WILLIAMS EMPLOYED MD CHIEF, THORACIC SURGERY 60.00 0.00 X 945505 0 88781 MIKE CUSNIR EMPLOYED MD CHIEF, HEMATOLOGY & ONCOLOGY 60.00 0.00 X 925770 0 72785 ROBERT GOLDSZER SENIOR VP/CMO 57.00 3.00 X 736002 0 78056 THOMAS GILLETTE SENIOR VP/CIO 60.00 0.00 X 586357 0 88492 ANGEL PALLIN SENIOR VP/COO 57.00 3.00 X 599239 0 69035 WAYNE CHUTKAN SENIOR VP OF FINANCE 60.00 0.00 X 518355 0 92274 WENDY STUART SENIOR VP/CNO 60.00 0.00 X 487022 0 65524 ARI CIMENT MD PRES MED STAFF/TRUSTEE (END 6/21) 50.00 0.00 X 501497 0 41537 MERVYN MILLS VP OF FINANCE 60.00 0.00 X 380468 0 75091 BENJAMIN DAVIS VP FACILITIES/RESOURCE MGT 60.00 0.00 X 411484 0 37944 CHARLENE WELKER SENIOR VP OF SPECIALTY SVC 60.00 0.00 X 372606 0 65049 ARNOLD JAFFEE SENIOR VP/GEN COUNSEL 60.00 2.00 X 327750 0 80805 CATHY MCCLELLAN VP, RISK MGT, INS & PERF I 60.00 0.00 X 269829 0 66382 MARGIE STICKLES VP, SURGICAL SERVICES 60.00 0.00 X 261088 0 55236 GUSTAVO TEJAS VP CRT CARE & EMG SVC 60.00 0.00 X 229110 0 46363 ETHLING HERNANDEZ VICE PRESIDENT (BEG. 2/21) 60.00 0.00 X 199382 0 39292 VANDANA PATHAK VICE PRESIDENT (BEG. 2/21) 60.00 0.00 X 187300 0 44313 LYNDA BARCELO VICE PRESIDENT (BEG. 2/21) 45.00 15.00 X 168648 0 45032 MONICA FELDER FORMER VP/COO 60.00 0.00 X 116502 0 26282 ROBERT POPPITI MD PRES MED STAFF/TRUSTEE (BEG. 7/21) 50.00 0.00 X 25000 0 0 PAUL BLOCH TRUSTEE 2.00 0.00 X 0 0 0 DAVID BLOOM TRUSTEE 2.00 0.00 X 0 0 0 NORMAN BRAMAN TRUSTEE 2.00 0.00 X 0 0 0 WAYNE CHAPLIN TRUSTEE 2.00 0.50 X 0 0 0 DENIS COLE TRUSTEE 2.00 0.50 X 0 0 0 DAPHNA CRAMER TRUSTEE 2.00 0.00 X 0 0 0 EDWARD DAUER MD TRUSTEE 2.00 0.00 X 0 0 0 DAVID DEUTCH TRUSTEE 2.00 0.50 X 0 0 0 MARC FARBSTEIN TRUSTEE 2.00 0.00 X 0 0 0 EUGENE FRENKEL TRUSTEE 2.00 0.00 X 0 0 0 PHILLIP FROST MD TRUSTEE 2.00 0.00 X 0 0 0 JACK GLOTTMANN TRUSTEE 2.00 0.00 X 0 0 0 MARK HALPERN TRUSTEE 2.00 0.00 X 0 0 0 MARK HILDEBRANDT TRUSTEE 2.00 0.50 X 0 0 0 EDIE LAQUER TRUSTEE 2.00 0.00 X 0 0 0 MICHAEL LATNER TRUSTEE 2.00 0.00 X 0 0 0 LAURANS MENDELSON TRUSTEE 2.00 0.50 X 0 0 0 SERGIO ROK TRUSTEE (BEG. 1/21) 2.00 0.00 X 0 0 0 BARRY SIADAT TRUSTEE 2.00 0.00 X 0 0 0 PAUL SINGERMAN TRUSTEE 2.00 0.00 X 0 0 0 BARRY SKOLNICK TRUSTEE 2.00 0.50 X 0 0 0 JAMES TATE TRUSTEE 2.00 0.00 X 0 0 0 WARREN ZINN TRUSTEE 2.00 0.00 X 0 0 0 17022685 0 1616764 602 1 1 0 TRIMEDX PO BOX 636129 CINCINNATI OH 45263 MANAGEMENT SERVICES FOR EQUIPMENT MAINTE 6535417 AYA HEALTHCARE DEPT 3519 PO BOX 123519 DALLAS TX 753123519 NURSING LABOR 2968282 BRILLIANT HEALTHCARE TRAINING INC C/O AMERICAN FUNDING SOLUTIONS PO BLUE SPRINGS MO 640140572 NURSING LABOR 2562441 DVA HEALTHCARE RENAL CARE INC PO BOX 781607 PHILADELPHIA PA 19178 MANAGEMENT OF DIALYSIS PATIENTS 2378855 CCS-CIRCULATORY SUPPORT LLC 45211 HELM STREET PLYMOUTH MI 48170 PERFUSION & ECMO SERVICES 2320306 138 11075215 392090 5419 11472724 PATIENT SERVICE REVENU 621300 683268767 683268767 MEDICARE/MEDICAID REVE 621300 146726842 146726842 GRANT REVENUE 900099 31289941 31289941 OTHER PATIENT REVENUE 621300 11950637 11950637 PARTNERSHIP INCOME 900099 901649 901649 874137836 2056051 2056051 3581039 12870 4003678 0 -422639 12870 -409769 132636 -542405 20558503 173396 20853934 67749 -295431 105647 -189784 -189784 EMERGENCY DEPARTMENT 621400 5499996 5499996 PHARMACY 446110 4102866 4102866 CAFETERIA 722514 1693094 1693094 3493597 3493597 14789553 901856611 874137836 132636 16113415 150000 150000 11528166 9778950 1749216 333341449 282762184 50579265 31319606 26567354 4752252 19858293 16845113 3013180 500431 75932 424499 903602 903602 452200 452200 449756 449756 6782820 6782820 4095077 4095077 24849931 21407580 3442351 10813525 9172745 1640780 357573 303317 54256 1208763 1025352 183411 10912837 9256987 1655850 45419343 38527680 6891663 24823016 21056518 3766498 MEDICAL SUPPLIES 150766947 150318680 448267 PROVISION FOR BAD DEBT 114697929 97294342 17403587 SERVICE CONTRACTS/MAINT 27340252 23191803 4148449 NON-PHYSICIAN SERVICES 6169096 6169096 23200849 19982815 3218034 849941461 740669268 109272193 0 282826731 293360600 1909107 1445857 61880520 91114982 10059874 11534519 9553441 8146672 859206499 446923078 424534145 412283421 11338688 163015116 23062981 11526497 825165487 992427664 74191079 85219113 257534617 404872059 9864931 0 224922569 201130294 566513196 691221466 X 258652291 301206198 258652291 301206198 825165487 992427664 X 51915150 -859053 -8502190 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 424134 0 0 1 25622 449756 0 PART II-B, LINE 1: MOUNT SINAI ENGAGES LOBBYIST TO WORK ON ITS BEHALF TO ENSURE CONTINUED STATE FUNDING TO SUPPORT PATIENT CARE PROGRAMS. A PERCENTAGE OF ANNUAL MEMBERSHIP DUES PAID TO SEVERAL HOSPITAL ORGANIZATIONS ($25,622) IS ATTRIBUTABLE TO LOBBYING EXPENSES AS WELL. 111845000 19552000 445000 10503000 599000 120740000 107821000 13410000 425000 9162000 649000 111845000 94395000 19487000 356000 5472000 945000 107821000 69744000 43482000 552000 18346000 1037000 94395000 45075000 27505000 459000 2262000 1033000 69744000 0.00000 0.05542 0.94458 0 1 1 8357216 8357216 603021643 271238835 331782808 237109093 175684243 61424850 10718547 10718547 412283421 INDIGENT CARE ASSESSMENT 8965907 OTHER CURRENT LIABILITIES 16763554 SELF-INSURED CLAIMS RESERVE 79072000 CAPITAL LEASE -781 DUE TO THIRD PARTIES 19453969 OTHER LONG-TERM LIABILITIES 855948 ADVANCE PAYMENTS 41530975 RIGHT-OF-USE FINANCE LIABILITY - SHORT-TERM 8345508 RIGHT-OF-USE OPERATING LIABILITY - SHORT-TERM 2320660 RIGHT-OF-USE FINANCE LIABILITY - LONG-TERM 15609126 RIGHT-OF-USE OPERATING LIABILITY - LONG-TERM 8213428 201130294 X 811214886 -859053 -80183881 -81042934 892257820 9598791 9598791 901856611 743283461 7748309 7748309 735535152 114406309 114406309 849941461 PART V, LINE 4: THE FOUNDATION'S ENDOWMENT CONSISTS OF APPROXIMATELY 48 INDIVIDUAL FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. THE ENDOWMENT CONSISTS OF DONOR-RESTRICTED FUNDS THAT HAVE BEEN LIMITED BY DONORS TO A SPECIFIC TIME PERIOD OR PURPOSE. AS REQUIRED BY GAAP, NET ASSETS ASSOCIATED WITH ENDOWMENT FUNDS ARE CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OR ABSENCE OF DONOR-IMPOSED RESTRICTIONS. THE ENDOWMENT NET ASSET COMPOSITION BY FUND TYPE AS OF DECEMBER 31, 2021, IS COMPOSED OF THE FOLLOWING: TEMPORARILY RESTRICTED PERMANENTLY RESTRICTED ALZHEIMER'S PROGRAM 3,906,000 0 MSMC 50 YEARS 81,246,000 0 (PATIENT TOWER) MELANOMA RESEARCH 734,000 0 LABOR & DELIVERY 10,568,000 0 SURGICAL ONCOLOGY 2,523,000 0 PSYCHIATRIC RESIDENCY 789,000 0 CANCER RESEARCH 427,000 0 BEHAVIORAL HEALTH 5,000,000 0 CANCER CENTER FACILITY 1,042,000 0 OTHER PROGRAMS 7,814,000 6,691,000 ___________ ____________ TOTAL FUNDS 114,049,000 6,691,000 PART X, LINE 2: THE FOOTNOTE TO THE AUDITED FINANCIAL STATEMENTS FOR MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC. AND SUBSIDIARIES REGARDING ASC 740 READS AS FOLLOWS: THE MEDICAL CENTER IS A NOT-FOR-PROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX EXEMPT AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE IRC. THE IRC PROVIDES FOR TAXATION OF UNRELATED BUSINESS INCOME UNDER CERTAIN CIRCUMSTANCES. MANAGEMENT HAS CONCLUDED THAT THE MEDICAL CENTER HAS NO MATERIAL UNRELATED BUSINESS INCOME. THE MEDICAL CENTER FOLLOWS THE PROVISIONS OF ASC 740-15-2, INCOME TAXES, AND HAS DETERMINED THAT AS OF DECEMBER 31, 2021 AND 2020, THE MEDICAL CENTER HAD NO MATERIAL UNRECOGNIZED TAX BENEFITS. THE MEDICAL CENTER DOES NOT EXPECT THAT UNRECOGNIZED TAX BENEFITS WILL MATERIALLY INCREASE WITHIN THE NEXT 12 MONTHS. IN THE EVENT THE MEDICAL CENTER WERE TO RECOGNIZE INTEREST AND PENALTIES RELATED TO UNCERTAIN TAX POSITIONS, IT WOULD BE RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS AS INCOME TAX EXPENSE. TAX YEARS FROM 2015 THROUGH 2020 ARE SUBJECT TO EXAMINATION BY THE FEDERAL AND STATE TAXING AUTHORITIES. THERE ARE NO INCOME TAX EXAMINATIONS CURRENTLY IN PROCESS. PART XI, LINE 2D - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT -114,406,309. INCOME FROM MT SINAI MEDICAL OFFICE BLDG II, INC 149,423. INCOME FROM MSMC FOUNDATION 34,073,005. PART XI, LINE 4B - OTHER ADJUSTMENTS: NET ASSETS RELEASED FROM RESTRICTION 13,397,409. RENTAL EXPENSES -4,003,678. INCOME FROM MIAMI JEWISH HOME HEALTH AGENCY 205,060. PART XII, LINE 2D - OTHER ADJUSTMENTS: AMOUNTS REPORTED SEPARATELY 3,744,631. RENTAL EXPENSES 4,003,678. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT 114,406,309. CENTRAL AMERICA & THE CARIBBEAN PROGRAM SERVICES INSURANCE PREMIUM 411249 0 0 0 0 0 0 411249 0 411249 1 0 1 0 0 0 PART III ACCOUNTING METHOD: PART IV, LINE 3 MOUNT SINAI MEDICAL CENTER OF FLORDA, INC.'S INTEREST IN A FOREIGN CORPORATION IS A WHOLLY OWNED INTEREST IN MOUNT SINAI MEDICAL CENTER OF FLORIDA GUARANTEE CORPORATION, A CORPORATION INCORPORATED IN THE CAYMAN ISLANDS. 1 1 X 1 X 1 X 1 1 1 0 1 1 42866381 7007201 35859180 0.04880 14078034 4521536 9556498 0.01300 60645457 26674546 33970911 0.04620 117589872 38203283 79386589 0.10800 1745805 1745805 0.00240 35174565 10885608 24288957 0.03300 88971165 56332595 32638570 0.04440 10086577 9841675 244902 0.00030 150000 150000 0.00020 136128112 77059878 59068234 0.08030 253717984 115263161 138454823 0.18830 449756 449756 0.00060 6867816 6867816 0.00930 7317572 7317572 0.00990 0 26065780 309903467 375433181 -65529714 X 1 0 1 1 MOUNT SINAI MEDICAL CENTER OF FL INC 4300 ALTON ROAD MIAMI BEACH FL 33140 X X X X X MOUNT SINAI MEDICAL CENTER OF FL INC 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X WWW.MSMC.COM/ABOUT-MSMC/COMMUNITY-HEALTH-NEEDS-ASSESSMENT-2020/ X X 1 21 1 SEE PART V, PAGE 8 0 1 X 200.000000000000 200.000000000000 X X X X X 1 1 X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X 1 X 0 X 1 X 0 0 MOUNT SINAI MEDICAL CENTER OF FL, INC. PART V, SECTION B, LINE 5: PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY THE PATIENT PROTECTION AND AFFORDABLE CARE ACT REQUIRES, IN IRC SECTION 501(R)(3), THAT WHEN ASSESSING COMMUNITY HEALTH NEEDS, MOUNT SINAI CONSULT WITH AND RECEIVE INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY. THIS INCLUDES, BUT IS NOT LIMITED TO, THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH AND AT A MINIMUM:1) AT LEAST ONE STATE, LOCAL, TRIBAL, OR REGIONAL GOVERNMENTAL PUBLIC HEALTH DEPARTMENT (OR EQUIVALENT DEPARTMENT OR AGENCY) WITH KNOWLEDGE, INFORMATION, OR EXPERTISE RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY2) MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS IN THE COMMUNITY, OR INDIVIDUALS OR ORGANIZATIONS SERVING OR REPRESENTING THE INTERESTS OF SUCH POPULATIONS3) WRITTEN COMMENTS RECEIVED ON THE HOSPITAL FACILITY'S MOST RECENTLY CONDUCTED CHNA AND MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY.TO RECEIVE THIS INPUT AND DATA, MOUNT SINAI SOUGHT INFORMATION FROM THE STATE REGIONAL HEALTHCARE PLANNING AGENCY, THE HEALTH COUNCIL OF SOUTH FLORIDA, AND THE LOCAL CITY OF MIAMI BEACH HEALTHCARE ADVISORY COMMITTEE. ADDITIONALLY, THE HOSPITAL MET WITH FOCUS GROUPS THAT REPRESENT EACH GEOGRAPHIC SERVICE AREA OF THE CITY, REPRESENTING A VARIETY OF INCOMES AND DEMOGRAPHICS. MOUNT SINAI SOUGHT INDIVIDUAL INPUT FROM NOTED AND LEADING MEMBERS OF THE HEALTHCARE INDUSTRY IN ITS PRIMARY SERVICE AREA INCLUDING MEDICAL PROVIDERS, SMALL AND LARGE ANCILLARY BUSINESS OWNERS, NURSING HOME STAFF AND RESIDENTS AND OTHER SPECIAL SENIOR HEALTH RELATED PROFESSIONS OR PATIENTS REPRESENTING THE UNINSURED AND NEW OR UNDOCUMENTED RESIDENTS. FOCUS MEETINGS WERE ALSO HELD IN ENGLISH AND SPANISH TO ACCOMMODATE THE BROAD NEED OF A MULTILINGUAL COMMUNITY.PUBLIC HEALTH EXPERT INPUT AND GUIDANCE COMMUNITY HEALTH ANALYSISTHE COMMUNITY HEALTH PRIORITIES ARE BASED ON AN ANALYSIS OF DEMOGRAPHIC, ENVIRONMENTAL, STATISTICAL, AND BEHAVIORAL PUBLIC HEALTH DATA ABOUT MIAMI-DADE COUNTY, AND WHEN POSSIBLE ABOUT MIAMI BEACH. THE DATA IS REVIEWED BY NUMEROUS STAFF MEMBERS AT MOUNT SINAI INCLUDING CLINICAL, RESEARCH AND COMMUNITY HEALTH WORKERS. MEMBERS OF THE COMMUNITY, NURSES AND PHYSICIANS AND BUSINESSES OWNERS PROVIDE INPUT.CITY OF MIAMI BEACH HEALTH ADVISORY COMMITTEE. MOUNT SINAI MAINTAINS A SEAT AND LEAD ROLE ON THE HEALTH ADVISORY COMMITTEE OF THE CITY OF MIAMI BEACH, ALONG WITH THE MIAMI BEACH COMMUNITY HEALTH CENTER AND THE HEALTH COUNCIL OF SOUTH FLORIDA. THE MIAMI BEACH HEALTH ADVISORY COMMITTEE IS A CITY COMMISSION APPOINTED BODY OF LOCAL REPRESENTATIVES THAT MEET TO ADDRESS MIAMI BEACH HEALTH ISSUES IN A PUBLICLY ADVERTISED MEETING FORUM. THIS ORGANIZATION SERVES THE MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS AMONGST OTHERS IN THE CITY.THE HEALTH COUNCIL OF SOUTH FLORIDA. MOUNT SINAI CONTRACTS WITH THE HEALTH COUNCIL OF SOUTH FLORIDA TO OBTAIN FEDERAL PREVENTION QUALITY INDICATOR DATA, WHICH TRACKS LOCAL HOSPITAL ADMISSIONS BY CHRONIC DISEASES AND CONDITIONS. MOUNT SINAI ALSO RECEIVES LEADING CAUSES OF DEATH DATA FOR THE MIAMI BEACH SERVICE AREA. THIS ORGANIZATION ALSO HAS MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS IN THE COMMUNITY AND SERVES THE SAME POPULATIONS. PUBLIC HEALTH AGENCIES FROM WHICH DATA OR INPUT WAS SOUGHT:- U.S. AGENCY FOR HEALTHCARE QUALITY & RESEARCH- CENTERS FOR DISEASE CONTROL & PREVENTION- NATIONAL COMMITTEE ON VITAL AND HEALTH STATISTICS- U.S. CENSUS BUREAU- TRUST FOR AMERICA'S HEALTH- KAISER FAMILY FOUNDATION- AGENCY FOR HEALTHCARE ADMINISTRATION- FLORIDA DEPARTMENT OF HEALTH- HEALTH COUNCIL OF SOUTH FLORIDA- MIAMI-DADE COUNTY HEALTH DEPARTMENT- FLORIDA HOSPITAL ASSOCIATION- MIAMI BEACH HEALTH ADVISORY COMMITTEE MOUNT SINAI MEDICAL CENTER OF FL, INC. PART V, SECTION B, LINE 7D: THE CHNA REPORT IS AVAILABLE VIA E-MAIL. MOUNT SINAI MEDICAL CENTER OF FL, INC. PART V, SECTION B, LINE 11: 2021 WAS A CHALLENGING YEAR WITH CONTINUED EFFECTS OF THE COVID-19 PANDEMIC. DURING THE HEIGHT OF COVID-19 MOUNT SINAI WAS FORCED TO SCALE BACK ON ITS STANDARD COMMUNITY SERVICES AS THE NATION WENT INTO QUARANTINE AND WAS DIRECTED TO SOCIAL DISTANCE. MOUNT SINAI WAS ON THE FRONTLINE OFFERING COVID TESTING/SCREENINGS AT OUR THREE EMERGENCY ROOMS AS WELL AS TREATING COVID ADMISSIONS. ONCE THE COVID VACCINE WAS AVAILABLE, MOUNT SINAI WAS QUICK TO GET A CLINIC OPERATIONAL TO OFFER VACCINES BEGINNING WITH FRONTLINE WORKERS AND FIRST RESPONDERS, THEN TO THE COMMUNITY. IN 2021, MOUNT SINAI ONCE AGAIN BEGAN TO OFFER FREE HEALTH LECTURES (LIVE AND VIRTUAL) ON TOPICS SUCH AS CARDIOVASCULAR HEALTH, UROLOGY, NUTRITION AND EXERCISE AND CANCER DEVELOPMENTS. THESE LECTURES WERE OFFERED THROUGHOUT MIAMI-DADE COUNTY AND IN MONROE COUNTY. MOUNT SINAI ALSO OFFERED BLOOD PRESSURE, GLUCOSE, AND/OR MELANOMA SCREENING EVENTS.PRIOR TO COVID-19, MOUNT SINAI CONTINUED TO FOCUS ON THE CHNA AND THE FOUR COMMUNITY HEALTH NEEDS TO BE ADDRESSED WITHIN ITS PURVIEW AS AN ACUTE CARE ACADEMIC MEDICAL CENTER AND ACCESSIBLE TEACHING PHYSICIAN NETWORK THAT PROVIDES PRIMARY AND SPECIALTY CARE ON PAR WITH ALMOST ALL MEDICAID PLANS IN ITS REGION.THE FOUR COMMUNITY HEALTH PRIORITIES ARE:1) LEADING CAUSES OF DISEASE-RELATED DEATH2) ACCESS TO CARE3) ENVIRONMENTAL HEALTH4) BEHAVIORAL HEALTHPRIORITY #1: LEADING CAUSES OF DISEASE-RELATED DEATHTHE TOP FIVE DISEASE-RELATED CAUSES OF DEATH IN MOUNT SINAI'S SERVICE AREA ARE HEART DISEASE, CANCER, STROKE, CHRONIC LOWER RESPIRATORY DISEASE, AND ALZHEIMER'S DISEASE.HEART DISEASE: MOUNT SINAI IS STRIVING TO MEET THE CARDIOVASCULAR HEALTH NEEDS WITHIN ITS PRIMARY SERVICE AREAS THROUGH THE COLUMBIA UNIVERSITY AFFILIATED MOUNT SINAI HEART INSTITUTE AND PARTICIPATING IN CARDIAC RESEARCH TRIALS AIMED AT BRINGING CUTTING-EDGE TREATMENTS TO PATIENTS.CANCER:IN ORDER TO MEET THE NEEDS OF PATIENTS WITH CANCER, MOUNT SINAI'S COMPREHENSIVE CANCER CENTER ON THE MAIN CAMPUS AND THE CANCER CARE AND DIAGNOSTIC CENTER IN AVENTURA USE A COLLABORATIVE APPROACH TO THE DIAGNOSIS AND TREATMENT OF CANCER. MOUNT SINAI OFFERS FREE OR DISCOUNTED SCREENING MAMMOGRAMS TO THE PUBLIC DURING MAY AND OCTOBER AT THE CCC AND AVENTURA BREAST CENTERS. FREE LECTURES ON CANCER PREVENTION AND EARLY DETECTION ARE GIVEN THROUGHOUT MOUNT SINAI'S SERVICE AREA. MOUNT SINAI IS AT THE FOREFRONT AMONG CANCER INSTITUTIONS IN THE UNITED STATES WITH ACTIVE CLINICAL CANCER TRIALS. EMOTIONAL SUPPORT FOR PATIENTS AND FAMILIES IS ALSO IMPORTANT IN THE TREATMENT OF CANCER. MOUNT SINAI HOSTS SUPPORT AND ACTIVITY GROUPS FOR CANCER PATIENTS; AND FOR FAMILIES, CAREGIVER SUPPORT AND BEREAVEMENT GROUPS ARE ALSO AVAILABLE.STROKE:MOUNT SINAI'S COMPREHENSIVE STROKE CENTER OFFERS ROUND-THE-CLOCK CARE TO QUICKLY AND ACCURATELY DIAGNOSE AND TREAT STROKE PATIENTS. WITH ACCESS TO THE LATEST DIAGNOSTIC AND THERAPEUTIC TREATMENT ADVANCES, THE COMPREHENSIVE STROKE CENTER HAS THE WIDEST RANGE OF OPTIONS TO STOP A STROKE IN PROGRESS AND TO MINIMIZE POTENTIAL DAMAGE. THE EMERGENCY DEPARTMENTS AT MIAMI BEACH, AVENTURA, AND HIALEAH HAVE STATE-OF-THE-ART CT SCANNERS ALLOWING PHYSICIANS TO DIAGNOSE A STROKE QUICKLY. MOUNT SINAI ALSO OFFERS HEALTH SCREENINGS AND LECTURES THROUGHOUT MIAMI-DADE COUNTY TO ASSIST THE PUBLIC IN RECOGNIZING THE SIGNS OF STROKE AND IDENTIFYING THEIR RISK FACTORS IN ORDER TO MAKE INFORMED DECISIONS ABOUT THEIR HEALTH.CHRONIC LOWER RESPIRATORY DISEASE ("CLRDS"): CLRDS AFFECTS THE AIRWAYS AND THE LUNGS. THE PULMONARY SPECIALISTS AT MOUNT SINAI'S LUNG CENTER PROVIDE A WIDE ARRAY OF CUTTING-EDGE CARE OPTIONS TO PATIENTS WITH PULMONARY DISORDERS SUCH AS COPD, ASTHMA, AND PULMONARY HYPERTENSION. SERVICES INCLUDE A FULLY ACCREDITED SLEEP LAB FOR EVALUATING AND TREATING SLEEP APNEA AND OTHER SLEEP DISORDERS, A PULMONARY FUNCTION LABORATORY OFFERING MULTIPLE DIAGNOSTIC TESTING OPTIONS FOR EVALUATING ADULTS AND CHILDREN WITH UNEXPLAINED SHORTNESS OF BREATH, AND A WEEKLY PULMONARY HYPERTENSION CLINIC WITH SOUTH FLORIDA'S ONLYMULTIDISCIPLINARY TEAM SPECIALIZING IN TREATING PULMONARY HYPERTENSION.ALZHEIMER'S DISEASE: THROUGH THE WEIN CENTER FOR ALZHEIMER'S DISEASE AND MEMORY DISORDERS, MOUNT SINAI IS ABLE TO OFFER PATIENTS AND CAREGIVERS A MULTIDISCIPLINARY APPROACH TO DIAGNOSIS AND TREATMENT OF ALZHEIMER'S AS WELL AS EDUCATION AND SUPPORT FOR THOSE FACING THE UNIQUE CHALLENGES OF CARING FOR AN INDIVIDUAL WITH ALZHEIMER'S DISEASE. THE WEIN CENTER IS A LEADING PARTICIPANT IN NATIONAL AND INTERNATIONAL CLINICAL TRIALS FOR TREATMENT AND PREVENTION OF ALZHEIMER'S DISEASE, AS WELL AS MAINTAINING THE STATES BRAIN BANK. TO FURTHER AID THE COMMUNITY, THE WEIN CENTER OFFERS FREE MEMORY SCREENINGS FOR INDIVIDUALS AGED 50 AND UP WHO MAY BE EXHIBITING SIGNS OF A MEMORY DISORDER. MOUNT SINAI OFFERS FREE LECTURES GIVEN BY OUR PHYSICIANS ON A VARIETY OF TOPICS RELATED TO ALZHEIMER'S DISEASE-IDENTIFYING ALZHEIMER'S RISK FACTORS, DIAGNOSIS AND TREATMENT OF THE DISEASE, AND ADVANCEMENTS IN RESEARCH. THROUGH THE WIEN CENTER, MOUNT SINAI OFFERS EDUCATIONAL WORKSHOPS, TRAINING OPPORTUNITIES, AND SUPPORT GROUPS FOR FAMILY MEMBERS AND CAREGIVERS OF INDIVIDUALS WITH ALZHEIMER'S DISEASE AND OTHER DEMENTIAS.PRIORITY #2: ACCESS TO CAREMOUNT SINAI IDENTIFIED THE FOLLOWING KEY AREAS THAT NEED ADDRESSING WITHIN THE PRIMARY SERVICE AREAS: BARRIERS TO CARE, PHYSICIAN SHORTAGE, SAFETY NET SERVICES FOR THE UNINSURED, AND MATERNITY AND PRENATAL MEDICINE. BARRIERS TO CARE: DURING MOUNT SINAI'S ASSESSMENT OF COMMUNITY NEEDS, THE MAIN BARRIERS TO CARE WITHIN THE PRIMARY SERVICE AREAS WERE DETERMINED TO BE (1) INCOME LEVEL AND INSURANCE COVERAGE, (2) TRANSPORTATION, (3) CULTURAL/ETHNIC FACTORS, AND (4) COORDINATION BETWEEN HEALTHCARE PROVIDERS. MOUNT SINAI OFFERS A NUMBER OF WAYS TO ASSIST PATIENTS IN OVERCOMING THESE BARRIERS. MOUNT SINAI ASSISTS PATIENTS WITH NO INSURANCE COVERAGE APPLY FOR MEDICAID OR MOUNT SINAI'S FINANCIAL ASSISTANCE PROGRAM. FOR PATIENTS WITH NO ACCESS TO A VEHICLE OR PUBLIC TRANSPORTATION, MOUNT SINAI ASSISTS IN COORDINATING TRANSPORTATION THROUGH INSURANCE PROVIDERS, LOCAL CHAPTERS OF THE AMERICAN CANCER SOCIETY, OR LOCAL PARATRANSIT SERVICES IN MIAMI-DADE AND BROWARD COUNTIES. MOUNT SINAI HAS WIDENED ACCESS TO PRIMARY AND SPECIALTY CARE BY ITS EXPANSION OF SATELLITE CENTERS NOW OPEN THROUGHOUT MIAMI-DADE COUNTY AND IN MONROE COUNTY AND THE OPENING OF THE HIALEAH FREESTANDING EMERGENCY DEPARTMENT. IN 2021, MOUNT SINAI PROVIDED PRIMARY AND SPECIALTY CARE VISITS AND EMERGENCY SERVICES IN MIAMI BEACH, AVENTURA AND HIALEAH.PHYSICIAN SHORTAGE: MOUNT SINAI'S EFFORTS TO MEET PHYSICIAN WORKFORCE DEMANDS ARE ON-GOING. DURING 2021, MOUNT SINAI TAUGHT 177 MEDICAL STUDENTS. IN TOTAL, MOUNT SINAI TRAINED 204 RESIDENTS OR FELLOWS IN 18 (13 ACCREDITED, 5 NON-ACCREDITED) MEDICAL EDUCATION PROGRAMS DURING 2021. IN ADDITION TO EFFORTS TO MEET PHYSICIAN SHORTAGES, MOUNT SINAI PROVIDED A CLINICAL TEACHING ENVIRONMENT TO EDUCATE OTHER CRUCIAL COMPONENTS OF THE HEALTHCARE WORKFORCE NOT WITHIN A TRADITIONAL PHYSICIAN RESIDENCY PROGRAM. IN 2021, MOUNT SINAI TAUGHT NURSING STUDENTS AND ALLIED HEALTH STUDENTS FOR HEALTH CARE CAREERS.SAFETY NET SERVICES FOR THE UNINSURED:IN 2021, MOUNT SINAI PROVIDED $188,626,046 IN CHARITY AND UNCOMPENSATED CARE. ADDITIONALLY, MOUNT SINAI IS THE ONLY HOSPITAL PROVIDER IN THE PRIMARY SERVICE AREA.MATERNITY AND PRENATAL MEDICINE:MOUNT SINAI COLLABORATES WITH THE MIAMI BEACH COMMUNITY HEALTH CENTER TO PROVIDE PREVENTATIVE AND ACUTE OB/GYN CARE FOR ALL INCOMES, RACES, AND ETHNICITIES REGARDLESS OF NATIONAL ORIGIN OR DOCUMENTATION. IN 2021, MOUNT SINAI WELCOMED 2,207 INFANTS TO THE COMMUNITY. PART V, SECTION B, LINE 11 (CONTINUED): PRIORITY #3: ENVIRONMENTAL HEALTHMOUNT SINAI IDENTIFIED THREE MAIN CONCERNS IN RELATION TO ENVIRONMENTAL HEALTH: ULTRAVIOLET RADIATION AND SUN EXPOSURE, MOSQUITO-BORNE DISEASES, AND BEACH WATER QUALITY. TO ENCOURAGE SAFER SUN EXPOSURE, MOUNT SINAI HAS PROVIDED THE CITY OF MIAMI BEACH WITH SUNSCREEN DISPENSERS FOR ALL WHO VISIT MIAMI BEACH TO USE FOR FREE. THESE DISPENSERS CONTAIN A BROAD SPECTRUM, WATER-RESISTANT SPF 30 LOTION AND ARE PLACED AT PUBLIC POOLS, PARKS, AND BEACH ACCESS POINTS NEAR LIFEGUARD STANDS. REGARDING MOSQUITO-BORNE ILLNESSES AND BEACH WATER QUALITY: THERE ARE NO ACTIVE WARNINGS FOR ZIKA OR OTHER MOSQUITO-BORNE ILLNESSES OR FOR RED TIDE AND BLUE-GREEN ALGAE; THEREFORE, THESE CONCERNS HAVE A LOWER PRIORITY ASSIGNED BECAUSE THEY ARE BEING ADDRESSED AT THE COUNTY AND STATE LEVELS.PRIORITY #4: BEHAVIORAL HEALTHTWO PRIMARY AREAS OF CONCERN RELATED TO BEHAVIORAL HEALTH ARE MENTAL ILLNESS AND ADULT AUTISM.MENTAL ILLNESS: MENTAL HEALTH PLAYS A ROLE IN A PERSON'S ABILITY TO MAINTAIN THEIR PHYSICAL HEALTH. DEPRESSION CAN AFFECT THE ABILITY TO PARTICIPATE IN HEALTH-PROMOTING BEHAVIORS; AND PHYSICAL HEALTH PROBLEMS, SUCH AS CHRONIC DISEASE, CAN ALSO IMPACT MENTAL HEALTH AND DECREASE THE PARTICIPATION IN TREATMENT AND RECOVERY. TO ADDRESS THESE NEEDS, MOUNT SINAI OFFERS INPATIENT AND OUTPATIENT PSYCHIATRIC CARE ON ITS MAIN CAMPUS. FOR PATIENTS NEEDING MORE INTENSIVE OUTPATIENT THERAPY BUT DO NOT REQUIRE AN OVERNIGHT STAY IN THE HOSPITAL, MOUNT SINAI OFFERS A PARTIAL HOSPITALIZATION PROGRAM AND INTENSIVE OUTPATIENT PROGRAM.ADULT AUTISM: MOUNT SINAI IS STRIVING TO MEET THE NEEDS OF ADULTS IN THE COMMUNITY WITH AUTISM WITH THE MOUNT SINAI ADULT AUTISM CLINIC. THE STAFF HAS BEEN TRAINED BY THE CENTER FOR AUTISM AND RELATED DISABILITIES (CARD) TO MEET THE SPECIAL MEDICAL NEEDS OF ADULTS WITH ASD AND CAN HELP ADULTS TRANSITION FROM PEDIATRIC AUTISM SPECIALISTS TO OTHER FORMS OF HEALTH CARE. THE ADULT AUTISM CLINIC OFFERS PRIMARY AND SPECIALTY MEDICAL CARE, DIAGNOSTIC SERVICES, AND CARE MANAGEMENT AND SUPPORT FOR PATIENTS AND THEIR FAMILIES/CARETAKERS.COMMUNITY HEALTHCARE RESOURCES WITHIN THREE MILE RADIUS:MOUNT SINAI MEDICAL CENTER IS THE ONLY ACUTE CARE HOSPITAL LOCATED IN THE CITY OF MIAMI BEACH. THERE ARE FOUR PUBLIC HEALTH CENTERS, INCLUDING THREE FEDERALLY QUALIFIED HEALTH CENTERS: THE MIAMI BEACH COMMUNITY HEALTH CENTER (TWO LOCATIONS), CARE RESOURCE COMMUNITY HEALTH CENTER, AND THE BORINQUEN HEALTH CARE CENTER. FOR SUBSTANCE AND MENTAL HEALTH ISSUES, THERE ARE TWO RESIDENTIAL TREATMENT CENTERS. FOR GERIATRIC RESIDENTIAL SERVICES, THERE ARE FIVE NURSING HOMES AND FIVE ASSISTED LIVING FACILITIES.EMERGENCY SERVICES AND DISASTER RESPONSE:THE ISLAND GEOGRAPHY OF MIAMI BEACH AND CAUSEWAY VEHICLE ACCESS COUPLED WITH THE AREA'S INTERNATIONAL POPULARITY EMPHASIZES THE RESPONSIBILITY FOR MOUNT SINAI'S ROLE IN THE FIRST RESPONSE AND EMERGENCY MANAGEMENT NETWORKS FOR THE ISLAND COMMUNITIES. IN CONJUNCTION WITH THE CITY OF MIAMI BEACH AND THE STATE OF FLORIDA, MOUNT SINAI COMPLETED A $275 MILLION PROJECT TO BRING EMERGENCY SERVICES AND UPGRADED DISASTER RESPONSE HEALTH SERVICES TO THE BEACH. THE NEW EMERGENCY CENTER AND SURGICAL TOWER OPENED IN FEBRUARY 2019.MOUNT SINAI'S NEW TOWER HOUSES A 40,000 SQUARE FOOT EMERGENCY CENTER WITH MORE THAN 50 TREATMENT ROOMS ALONG WITH A CITY OF MIAMI BEACH COMMAND CENTER AND CRITICAL OPERATIONS HUB FOR ACTIVATION DURING TIMES OF EMERGENCY. THE COMMAND CENTER WILL PROVIDE JOINT EMERGENCY OPERATIONS FOR CITY STAFF, POLICE, FIRE, AND MEDICAL STAFF DURING A DECLARED COMMUNITY CRISIS. THE EMERGENCY DEPARTMENT WILL ESSENTIALLY TRIPLE THE SIZE OF THE EXISTING FACILITY. THE CURRENT EMERGENCY DEPARTMENT WAS OPENED IN 1972 AND BUILT AT A TIME WHEN THERE WERE THREE OTHER HOSPITALS ON MIAMI BEACH. IT WAS BUILT FOR 20,000 PATIENT VISITS A YEAR. MOUNT SINAI CURRENTLY DOES 50,000 PATIENT VISITS, AND THE NEW FACILITY CAN ACCOMMODATE 100,000 PATIENT VISITS.THE NEW SURGICAL TOWER INCLUDES 12 STATE-OF-THE-ART OPERATING ROOMS WHICH WILL PROVIDE PATIENTS WITH ACCESS TO NEW AND INNOVATIVE LIFESAVING PROCEDURES. THE SURGICAL SUITES ARE LOCATED ON THE SECOND FLOOR OF THE NEW TOWER WHILE THE MECHANICAL OPERATIONS ARE LOCATED ON THE THIRD FLOOR. THIS WILL RELOCATE CRITICAL SERVICES ABOVE THE FLOOD PLAN IN A SPECIAL HAZARD FLOOD ZONE. THE RAISED HEIGHT WILL HELP TO PROVIDE EMERGENCY SERVICES FOR THE STATE'S SECOND LARGEST TOURISM AREA, WHICH IS ALSO A HIGH VELOCITY HURRICANE ZONE.ADDITIONALLY, WORK WAS COMPLETED ON 12 NEW DUAL FUEL (DIESEL/NATURAL GAS) GENERATORS IN THE ENERGY CENTER WHICH WILL SUPPLY CRITICAL POWER TO THE MEDICAL CENTER.THERE ARE THREE BRANCHES OF POWER:1) LIFE SAFETY (I.E. EMERGENCY LIGHTING, FIRE ALARM DEVICES, AND FIRE PROTECTION SYSTEMS)2) CRITICAL (I.E. RED EMERGENCY OUTLETS)3) EQUIPMENT (I.E. UTILITY SYSTEMS, HVAC, ELEVATORS, ETC.)MOUNT SINAI ACTS AS A MEDICAL MANAGEMENT DISASTER SHELTER FOR OXYGEN AND ELECTRIC DEPENDENT RESIDENTS, INCLUDING THOSE IN INTENSIVE CARE THAT CANNOT EVACUATE. THE FACILITY REMAINS ACCESSIBLE DURING TIMES WHEN BRIDGES ARE IN LOCK DOWN BY PROVIDING SAFE HELIPAD SERVICE AND ACCESS BY BOAT. MOUNT SINAI ALSO SERVES AS A NATIONAL STOCKPILE DROP LOCATION FOR COUNTER-TERRORISM MEASURES. WITH THE ADDITION OF THE SURGICAL TOWER, EMERGENCY DEPARTMENT, AND POWER PLANT, MOUNT SINAI HAS, IN ESSENCE, CREATED A HURRICANE/STORM PROOF MEDICAL CENTER.HIALEAH FREE-STANDING EMERGENCY DEPARTMENT AND MEDICAL OFFICES:MOUNT SINAI COMPLETED THE CONSTRUCTION OF ITS NEW FREE-STANDING EMERGENCY DEPARTMENT AND MEDICAL OFFICES IN HIALEAH. IT OPENED IN NOVEMBER 2018. THE 63,000 SQUARE FOOT BUILDING HOUSES AN EMERGENCY DEPARTMENT WITH 24 TREATMENT BAYS AND OFFERS PHYSICIAN AND CLINICAL OFFICE SPACES ON THE SECOND AND THIRD FLOORS.STATISTICS SHOW THAT RESIDENTS OF HIALEAH ARE PROGRESSIVELY LEAVING THEIR HOME ZIP CODE AREA TO SEEK EMERGENCY CARE ELSEWHERE. MOUNT SINAI'S 2015 COMMUNITY HEALTH NEEDS ASSESSMENT TARGETED THE NEED FOR HEART HOSPITALS AND EMERGENCY CARE. THE REPORT INDICATED THAT HOSPITALIZATIONS DUE TO CONGESTIVE HEART FAILURE WERE SUBSTANTIALLY HIGHER IN THE PRIMARY HIALEAH ZIP CODES AS COMPARED TO THE AVERAGE FOR MIAMI-DADE COUNTY. HEART DISEASE REMAINS A SIGNIFICANT RISK FACTOR IN THE PRIMARY HIALEAH ZIP CODES.THE ADDITION OF THIS FACILITY WILL PROVIDE HIALEAH RESIDENTS WITH ACCESS TO BETTER CARE CLOSE TO HOME.OTHER COMMUNITY HEALTH NEEDS:SPECIALIZED AIDS/HIV SERVICES ARE NOT WITHIN THE IMPLEMENTATION STRATEGY OF MOUNT SINAI; HOWEVER, WE DO HAVE A TEAM OF DOCTORS THAT PROVIDE THESE SERVICES. IN ADDITION TO MOUNT SINAI'S SPECIALIZED CARE, AIDS/HIV SERVICES ARE ALSO PROVIDED WITHIN THE SERVICE AREA BY THE MIAMI BEACH COMMUNITY HEALTH CENTERS, THE BORINQUEN HEALTH CARE CENTER, JACKSON MEMORIAL HEALTH CENTER, AND THE MIAMI-DADE COUNTY HEALTH DEPARTMENT'S OFFICE OF HIV/AIDS. PART V, SECTION B, LINE 10A, IMPLEMENTATION STRATEGY WEBSITE WWW.MSMC.COM/ABOUT-MSMC/COMMUNITY-HEALTH-NEEDS-ASSESSMENT-2020/ PART V, LINE 16A, FAP WEBSITE: WWW.MSMC.COM/PATIENT-INFO/FINANCIAL-ASSISTANCE-INFORMATION PART V, LINE 16B, FAP APPLICATION: WWW.MSMC.COM/PATIENT-INFO/FINANCIAL-ASSISTANCE-INFORMATION PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE WWW.MSMC.COM/PATIENT-INFO/FINANCIAL-ASSISTANCE-INFORMATION PART I, LINE 7: A RATIO OF PATIENT CARE COST TO PATIENT CARE CHARGES WAS APPLIED TO GROSS WRITE-OFFS TO ARRIVE AT AN ESTIMATED PROGRAM COST. ANY APPLICABLE PROGRAM REVENUES RECEIVED WERE OFFSET AGAINST GROSS COST TO ARRIVE AT THE NET COST OR SHORTFALL OF THE PROGRAM. PART I, LINE 7G: MOUNT SINAI'S TEACHING PHYSICIAN NETWORK IS A NOT FOR PROFIT CLINICAL PHYSICIAN AND PROVIDER NETWORK THAT OPERATES AT A LOSS. THE NETWORK PROVIDES A WIDE RANGE OF MEDICAID ELIGIBLE TREATMENT FOR UNDERSERVED PATIENTS. IT ALSO TRAINS PROVIDERS IN ADVANCED SPECIALTIES THAT ARE DOCUMENTED BY THE STATE OF THE FLORIDA TO BE IN SUPPLY-DEMAND DEFICIT. THE GOAL IS TO ALLEVIATE THE HEALTHCARE CRISIS FOR ALL RESIDENTS BUT ESPECIALLY FOR THE UNINSURED, UNDERINSURED AND MEDICAID PATIENTS. BECAUSE OF THE LACK OF CAPACITY, THE STATE OF FLORIDA HAS SHARED THE RESPONSIBILITY OF REMEDYING THE PHYSICIAN SHORTAGE WITH TEACHING HOSPITALS IN FLORIDA. MOUNT SINAI IS ONE OF TWO MIAMI-DADE COUNTY HOSPITALS THAT IS AN AHCA MEDICAID ESSENTIAL PROVIDER FOR ADULT CARE BECAUSE OF ITS ROLE IN TEACHING AND TRAINING FLORIDA'S HEALTHCARE WORKFORCE UNDER THE STATEWIDE MEDICAID RESIDENCY PROGRAM (SMRP).THE COMMUNITY BENEFIT METHOD FOR SUBSIDIZED HEALTH SERVICES IS TAKEN FROM THE PROFIT AND LOSS DETAIL FOR THE MOUNT SINAI TEACHING PHYSICIAN NETWORK. THE EXPENSES REPRESENT DIRECT CLINICAL EXPENSES WHICH GENERATE PRIMARY CARE AND SPECIALTY CARE PATIENT REVENUE IN MIAMI-DADE COUNTY AND MONROE COUNTY. THESE COSTS INCLUDE, BUT ARE NOT LIMITED TO PATIENT CARE SERVICES, UTILITIES, DEPARTMENTAL SUPPLIES AND OTHER EXPENSES ASSOCIATED WITH A MEDICAL OFFICE. THE METHODOLOGY USED IS A MORE ACCURATE COST ACCOUNTING THAN THE COST TO CHARGE RATIO BASED PRIMARILY ON INPATIENT AND OUTPATIENT HOSPITAL CARE. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 114,697,929. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING ACTIVITIES:1. WORKFORCE DEVELOPMENT PROJECTS TO RECRUIT HEALTHCARE WORKERS, INCLUDING PHYSICIANS, NURSES AND ALLIED HEALTH PROFESSIONALS2. WORKFORCE HOUSING APPROVED BY THE CITY'S STATE HOUSING INITIATIVE PROGRAM (SHIP) AND THE FLORIDA HOUSING FINANCE CORPORATION (FHFC) PART III, LINE 2: A RATIO OF PATIENT CARE COST TO PATIENT CARE CHARGES WAS APPLIED TO BAD DEBT GROSS WRITE-OFFS TO ARRIVE AT AN ESTIMATED BAD DEBT EXPENSE AT COST. PART III, LINE 4: THE FOOTNOTE TO THE AUDITED FINANCIAL STATEMENTS FOR MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC. AND SUBSIDIARIES REGARDING BAD DEBT EXPENSE READS AS FOLLOWS:THE MEDICAL CENTER RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARDRATES FOR SERVICES PROVIDED (OR ON THE BASIS OF DISCOUNTED RATES, IF NEGOTIATED OR PROVIDED BY POLICY). CONSISTENT WITH ITS MISSION, THE MEDICAL CENTER PROVIDES CARE TO ITS PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. HISTORICALLY, A SIGNIFICANT PORTION OF THE MEDICAL CENTER'S UNINSURED PATIENTS WILL BE UNABLE TO PAY FOR THE SERVICES PROVIDED. AS SUCH, THE MEDICAL CENTER RECORDS A SIGNIFICANT REDUCTION TO PATIENT SERVICE REVENUE FOR PRICE CONCESSIONS TO UNINSURED PATIENTS AND PATIENTS WITH OTHER INSURED BALANCES, SUCH AS COPAYS AND DEDUCTIBLES, IN THE PERIOD THE SERVICES ARE PROVIDED.THE MEDICAL CENTER ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH DEDUCTIBLES AND COINSURANCE AND FROM THOSE WHO ARE UNINSURED BASED ON HISTORICAL EXPERIENCE AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS. THE IMPLICIT PRICE CONCESSIONS INCLUDED IN ESTIMATING THE TRANSACTION PRICE REPRESENT THE DIFFERENCE BETWEEN THE AMOUNTS BILLED TO THE PATIENT AND THE AMOUNTS THE MEDICAL CENTER EXPECTS TO COLLECT. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. PART III, LINE 8: A RATIO OF PATIENT CARE COST TO PATIENT CARE CHARGES WAS APPLIED TO MEDICARE REVENUES AND ALLOWABLE COSTS TO ARRIVE AT AN ESTIMATED MEDICARE EXPENSE AT COST. THE HOSPITAL DOES NOT TREAT ANY MEDICARE SHORTFALL AMOUNTS AS COMMUNITY BENEFIT. PART III, LINE 9B: PATIENTS ARE FIRST SCREENED TO SEE IF THEY ARE ELIGIBLE FOR MEDICAID OR CHARITY WHEN THEY COME IN THROUGH THE ER. THE HOSPITAL DETERMINES WHICH PATIENTS QUALIFY FOR CHARITY BASED ON A VERIFIABLE PROCESS REQUIRED BY THE AGENCY HEALTH CARE ADMINISTRATION USING THE FOLLOWING CRITERIA:O PATIENT IS ELIGIBLE IF THE PATIENT'S FAMILY AGGREGATE INCOME DURING THE 12 MONTHS PRECEDING THE DETERMINATION DATE IS AT OR BELOW 200% OF THE THEN CURRENT FEDERAL POVERTY GUIDELINES.O IF PATIENT IS ELIGIBLE FOR CHARITY THE AMOUNT OF ELIGIBLE CHARGES ARE REDUCED ON A SLIDING SCALE BASED ON WHERE THEY FALL IN RELATION TO THE FEDERAL POVERTY GUIDELINES.O MEDICAID PATIENTS WITH BENEFITS EXHAUSTED MAY APPLY FOR CHARITY.O PATIENTS WITH DOCUMENTATION THAT A THIRD PARTY BENEFIT HAS BEEN DENIED OR EXHAUSTED MAY APPLY FOR CHARITY.ALL OPPORTUNITIES FOR PAYMENT OF HOSPITAL DEBT WILL BE INVESTIGATED PRIOR TO APPROVAL INCLUDING A COMPLETE REVIEW OF THE FINANCIAL INFORMATION PROVIDED IN THE UNCOMPENSATED CARE APPLICATION.THE BUSINESS OFFICE'S ROLE IN CHARITY CARE DEALS WITH THE FINAL REVIEW AND APPROVAL OF ELIGIBLE PATIENTS. BUSINESS OFFICE IS RESPONSIBLE FOR ADJUSTING ACCOUNT CHARGES/BALANCES AFTER REVIEWING SEARCH AMERICA'S RESULTS, AND/OR ANY RED FLAGS ON THE ACCOUNT THAT WOULD SUGGEST THE POSSIBILITY OF ALTERNATE METHODS OF PAYMENT. THESE PRACTICES SET FORTH IN THE POLICY WOULD ONLY APPLY TO PATIENTS WHO MAY QUALIFY FOR CHARITY CARE. PART VI, LINE 2: NEEDS ASSESSMENT:COMMUNITY HEALTH NEEDS WERE IDENTIFIED THROUGH A RECOGNIZED HEALTH PLANNING ASSESSMENT PROCESS. THE ASSESSMENT INCLUDED, BUT WAS NOT LIMITED TO, AN ANALYSIS OF DEMOGRAPHIC, ENVIRONMENTAL, STATISTICAL AND BEHAVIORAL PUBLIC HEALTH DATA, ORGANIZING PUBLIC DISCUSSIONS ON HEALTH TOPICS, AND CONDUCTING A SURVEY OF CURRENT HEALTH TOPICS TO EXPLORE THE HEALTH NEEDS OF THE PRIMARY, NEIGHBORING AND COUNTYWIDE SERVICE AREAS OF MOUNT SINAI MEDICAL CENTER. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:MOUNT SINAI'S COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIES INCREASING ACCESS TO CARE AND REMOVING CULTURAL BARRIERS TO CARE AS IMPORTANT GOALS. THE FINANCIAL ASSISTANCE POLICY / APPLICATION PROCESS IS ONE WAY THAT MOUNT SINAI HAS ADDRESSED THIS NEED. MOUNT SINAI HAS PIONEERED AN EFFICIENT AND CULTURALLY SENSITIVE FINANCIAL ASSISTANCE POLICY / APPLICATION PROCESS THAT ADDRESSES THE KEY OBSTACLES OF FINANCIAL ANXIETY AND LACK OF FAMILIARITY OF THE AMERICAN HEALTHCARE SYSTEM.MOUNT SINAI'S FINANCIAL ASSISTANCE POLICY, APPLICATION, AND PLAIN-LANGUAGE SUMMARY ARE AVAILABLE ON MOUNT SINAI'S WEBSITE AT HTTPS://WWW.MSMC.COM/PATIENT-INFO/FINANCIAL-ASSISTANCE-INFORMATION AS WELL AS IN PERSON AT THE MOUNT SINAI BUSINESS OFFICE, IN THE REGISTRATION AND ADMITTING DEPARTMENTS, UPON REQUEST IN ANY OTHER DEPARTMENT OR IN ANY OTHER PUBLIC SPACE. MOUNT SINAI'S FINANCIAL ASSISTANCE POLICY, APPLICATION AND PLAIN-LANGUAGE SUMMARY ARE AVAILABLE FREE OF CHARGE IN ENGLISH, SPANISH, AND RUSSIAN, THE PRIMARY LANGUAGES SPOKEN BY THE LOCAL POPULATIONS AND, UPON REQUEST, CAN BE TRANSLATED INTO OTHER LANGUAGES SUCH AS FRENCH, GERMAN, YIDDISH, CREOLE AND ITALIAN, AS NEEDED.THIS APPLICATION PROCESS IS UNIQUE IN THAT IT DOES NOT REQUIRE AN UPFRONT PAPER DOCUMENT SUBMISSION, ALTHOUGH A WRITTEN APPLICATION IS MADE AVAILABLE ON OUR WEBSITE. A PROSPECTIVE APPLICANT SCHEDULES AN IN PERSON COUNSELING SESSION USING THE CONTACT INFORMATION AVAILABLE IN PLAIN LANGUAGE AT HTTPS://WWW.MSMC.COM/PATIENT-INFO/FINANCIAL-ASSISTANCE-INFORMATION. WHILE SCHEDULING THE MEETING, THE APPLICANT RECEIVES INFORMATION ALSO POSTED ONLINE ABOUT HELPFUL FINANCIAL DOCUMENTATION TO SHOW FINANCIAL STATUS THAT WILL BE REVIEWED AND INPUT INTO A MOUNT SINAI MEDICAL CENTER FINANCIAL ASSISTANCE FORM BY A MOUNT SINAI FINANCIAL ASSISTANT TOGETHER WITH THE APPLICANT AT THE FINANCIAL COUNSELING SESSION. FOR PATIENTS WITHOUT HEALTH INSURANCE, MOUNT SINAI WILL DETERMINE ELIGIBILITY USING PUBLIC INFORMATION ABOUT THE PATIENT'S AVAILABLE ASSETS, AND ALL OTHER FINANCIAL RESOURCES THAT THE PATIENT SUPPLIES AS WELL AS A REVIEW OF THE PATIENT'S ACCOUNT HISTORY. MOUNT SINAI WILL FIRST SCREEN FOR APPLICANT ELIGIBILITY FOR MEANS TESTED PROGRAMS AND LOCALLY AVAILABLE GRANTS. IF INELIGIBLE FOR THESE PROGRAMS, MOUNT SINAI PROVIDES AN AUTOMATIC REDUCTION TO GROSS CHARGES BASED UPON THE "LOOK BACK" METHOD. ALL PROSPECTIVE AND RETROSPECTIVE MEDICALLY NECESSARY PATIENT CARE WILL BE CONSIDERED, THOUGH CHARITY CARE IS FIRST FOCUSED ON PATIENTS WHOSE INCOME FOR THE 12 MONTHS PRECEDING THE DETERMINATION IS LESS THAN OR EQUAL TO 200 PERCENT OF THE FEDERAL POVERTY LEVEL FOR THE PATIENT'S FAMILY SIZE, UNLESS THE AMOUNT OF HOSPITAL CHARGES FROM THE PATIENT WILL OR DO EXCEED 25 PERCENT OF THE ANNUAL FAMILY INCOME. INDIVIDUALS MAY OBTAIN FREE, WRITTEN INFORMATION ON THE DETERMINATION OF AMOUNT OF FINANCIAL ASSISTANCE BY CONTACTING THE BUSINESS OFFICE AT (305) 674-2130, MONDAY-FRIDAY 9:00AM-4:00PM. MOUNT SINAI PROVIDES A RIGHT TO APPEAL AND RECEIVE ASSISTANCE IN ALL PARTS OF THE APPLICATION. THE PATIENT MUST WRITE A LETTER WHICH CAN BE POST MAILED OR EMAILED TO THE BUSINESS OFFICE DIRECTOR TO EXPLAIN WHY THE DECISION MADE BY MOUNT SINAI MEDICAL CENTER WAS INAPPROPRIATE. THE APPEAL LETTER WILL BE REVIEWED BY MOUNT SINAI MEDICAL CENTER AND A FINAL DECISION WILL BE SENT TO THE PATIENT WITHIN 30 DAYS OF THE RECEIPT OF THE REQUEST FOR APPEAL. PART VI, LINE 4: COMMUNITY INFORMATION:MOUNT SINAI IS THE ONLY ACUTE CARE HOSPITAL AND EMERGENCY CARE PROVIDER ON THE NORTHEASTERN BARRIER ISLANDS OF MIAMI-DADE COUNTY. MOUNT SINAI PRIMARILY SERVICES A DENSELY POPULATED DIVERSE URBAN AREA ENCOMPASSING THE BARRIER ISLAND CITIES OF MIAMI BEACH, SURFSIDE, NORTH BAY VILLAGE, BAL HARBOUR, AND BAY HARBOR ISLANDS. THE NEIGHBORING MAINLAND OR SECONDARY SERVICE AREA INCLUDES SECTIONS OF THE CITIES OF MIAMI, NORTH MIAMI, AND NORTH MIAMI BEACH. MOUNT SINAI'S HEALTH NEEDS TARGET AREAS INCLUDE SECTIONS OF THE UPPER BARRIER ISLAND CITY OF SUNNY ISLES BEACH AND THE MAINLAND CITIES OF AVENTURA, HIALEAH, AND CORAL GABLES. THERE ARE THREE DESIGNATED MEDICALLY UNDERSERVED AREAS IN THE PRIMARY SERVICE AREA REPRESENTED BY MUAS FEDERAL ID# 5031, 511 AND 7474. PART VI, LINE 5: AS SOUTH FLORIDA'S LARGEST INDEPENDENT TEACHING HOSPITAL, MOUNT SINAI'S NOT-FOR-PROFIT MISSION IS TO PROVIDE HIGH QUALITY HEALTH CARE TO OUR DIVERSE COMMUNITY ENHANCED THROUGH TEACHING, RESEARCH, CHARITY CARE, AND FINANCIAL RESPONSIBILITY. WE MAINTAIN OUR NOT FOR PROFIT MISSION USING A TWO-TIER STRATEGY, FOCUSING, FIRST, ON SAFETY NET SERVICES AND, SECOND, ON ADDRESSING HEALTH RISKS RELATED TO HEART DISEASE, CANCER, NEUROLOGICAL, PULMONARY AND OTHER DISEASES THAT POSE SERIOUS COMMUNITY HEALTH RISKS.THIS NOT FOR PROFIT COMMUNITY DRIVEN MISSION IS DETAILED FURTHER IN SCHEDULE O. WE HAVE BRIEFLY DISCUSSED IT BELOW.TIER ONE - PROVIDE A WIDE RANGE OF SAFETY NET SERVICES- TRAINING TO ADDRESS FLORIDA'S PHYSICIAN AND HEALTHCARE WORKER SHORTAGE - CHARITY CARE FOR THE UNINSURED AND UNDERINSURED- DISASTER FIRST RESPONSE HEALTH SERVICES AND REGIONAL LEADERSHIP- EMERGENCY MEDICAL SERVICES- ADULT PSYCHIATRIC AND BEHAVIORAL CARE- INTENSIVE GERIATRIC / SENIOR CARE- MATERNITY SERVICES AND NEONATAL EMERGENT CARE- HEALTH AND DISEASE PREVENTION EDUCATION- INTERVENTIONAL AND COMMUNITY HEALTH SCREENINGSTIER TWO - MISSION DRIVEN COMMUNITY HEALTH PRIORITIESMOUNT SINAI FOCUSES RESOURCES ON PROVIDING ACCESS TO CARE WHILE TREATING AND PREVENTING THE LEADING DISEASE RELATED CONDITIONS FOR ALL INCOMES IN THE COMMUNITY BY SUBSIDIZING A NONPROFIT TEACHING AND COMMUNITY PHYSICIAN NETWORK.TIER ONE - PROVIDE A WIDE RANGE OF SAFETY NET SERVICESTO ADDRESS FLORIDA'S PHYSICIAN AND HEALTHCARE WORKER SHORTAGE, MOUNT SINAI RETAINED ITS OWN TEACHING FACULTY AND 13 ACCREDITED AND 5 NON-ACCREDITED GRADUATE MEDICAL EDUCATION PROGRAMS, TEACHING 204 RESIDENTS OR FELLOWS. MOUNT SINAI ALSO PROVIDED A TEACHING CLINICAL ENVIRONMENT FOR BOTH ITS ACUTE CARE AND SPECIALTY CARE PHYSICIAN TEACHING NETWORK FOR PHYSICIANS TO BECOME BOARD CERTIFIED AND TO EDUCATE THE OTHER CRUCIAL COMPONENTS OF THE HEALTHCARE WORKFORCE NOT WITHIN A TRADITIONAL CMS RESIDENCY PROGRAM. IN 2021, MOUNT SINAI TAUGHT NURSING STUDENTS, MEDICAL STUDENTS, AND ALLIED HEALTH STUDENTS FOR HEALTH CARE CAREERS. IN 2021, MOUNT SINAI SERVED 25,086 INPATIENT ADMISSIONS AND 226,437 OUTPATIENT ADMISSIONS.TO ADDRESS CHARITY CARE FOR THE UNINSURED AND UNDERINSURED, MOUNT SINAI PROVIDED $188,626,046 IN CHARITY AND UNCOMPENSATED CARE IN 2021. ADDITIONALLY, IN ITS PRIMARY SERVICE AREA, MOUNT SINAI IS THE ONLY PROVIDER OF MEDICAID HOSPITAL SERVICES.TO PROVIDE DISASTER FIRST RESPONSE HEALTH SERVICES AND REGIONAL LEADERSHIP, IN CONJUNCTION WITH THE CITY OF MIAMI BEACH AND THE STATE OF FLORIDA, MOUNT SINAI HAS COMPLETED A $275 MILLION REGIONAL EMERGENCY SERVICES AND TOWER PROJECT. THIS PROJECT WILL PROVIDE A JOINT EMERGENCY OPERATIONS CENTER FOR THE CITY STAFF, POLICE, FIRE, AND MEDICAL STAFF DURING DECLARED COMMUNITY CRISIS. IT WILL RELOCATE OPERATING ROOMS ABOVE THE FLOOD PLAIN IN A SPECIAL HAZARD FLOOD ZONE, PROVIDE EMERGENCY CARE SERVICES FOR THE STATE'S SECOND LARGEST TOURISM AREA IN HIGH VELOCITY HURRICANE ZONE, PROVIDE A MEDICAL MANAGEMENT DISASTER SHELTER FOR OXYGEN AND ELECTRIC DEPENDENT RESIDENTS INCLUDING THOSE IN INTENSIVE CARE THAT CANNOT EVACUATE, ENSURE THAT ALL PATIENT CARE FOR REGIONAL FACILITY MEETS A MODERN LEVEL OF CARE, PROVIDE SAFE HELIPAD SERVICE AND BOAT ACCESS TO THE ISLAND WHEN BRIDGES ARE LOCKED DOWN AND SERVE AS A NATIONAL STOCKPILE DROP LOCATION FOR COUNTER TERRORISM MEASURES.TO ADDRESS THE NEED FOR EMERGENCY MEDICAL SERVICES AS THE SOLE HOSPITAL ON THE BARRIER ISLANDS OF MIAMI-DADE COUNTY, IN 2021, MOUNT SINAI PROVIDED EMERGENCY SERVICES FOR 51,015 VISITS IN THE PRIMARY SERVICE AREA OF MIAMI BEACH AND FOR AN ADDITIONAL 18,075 IN ITS SENIOR AND GERIATRIC TARGET AREA OF AVENTURA AND 34,212 VISITS IN HIALEAH.TO ADDRESS INTENSIVE GERIATRIC/SENIOR CARE, MOUNT SINAI MAINTAINS THE WEIN CENTER FOR ALZHEIMER'S CARE, THE STATE OF FLORIDA'S LEADING MEMORY DISORDER CLINIC. IT ALSO SERVES AS THE MIAMI-DADE COUNTY COORDINATOR FOR THE STATE-AUTHORIZED CAREGIVER SUPPORT AND SILVER ALERT PROGRAMS, AND PROVIDES INBOUND SENIOR VISITS THROUGH ITS STATE-AUTHORIZED GERIATRIC HOUSE CALL PROGRAM.TO ADDRESS MATERNITY SERVICES AND NEONATAL EMERGENT CARE, MOUNT SINAI PARTNERS WITH THE MIAMI BEACH COMMUNITY HEALTH CENTER TO PROVIDE PREVENTATIVE AND ACUTE OB/GYN CARE FOR ALL INCOMES, RACES, AND ETHNICITIES REGARDLESS OF NATIONAL ORIGIN OR DOCUMENTATION. IN 2021, MOUNT SINAI WELCOMED 2,207 INFANTS TO THE COMMUNITY.TO ADDRESS HEALTH EDUCATION AND COMMUNITY HEALTH SCREENINGS AND EDUCATION, MOUNT SINAI PROVIDES COMMUNITY HEALTH LECTURES AND MEDICAL SCREENINGS. 0 MIAMI BEACH COMMUNITY HEALTH CENTER 11645 BISCAYNE BLVD SUITE 207 MIAMI FL 33181 591829984 501(C)(3) 150000 0 ASSIST THE CITY WITH PROVIDING PRIMARY CARE 1 0 PART I, LINE 2: MOUNT SINAI OVERSEES THE SCHEDULING AND CLINICAL OPPORTUNITIES PROVIDED TO RESIDENTS WHILE SERVING THE PATIENTS AT THE COMMUNITY HEALTH CENTER. X 1 1 X X X X X 1 0 0 0 0 0 0 0 0 STEVE XYDAS EMPLOYED MD CHIEF, CARDIOTHORACIC SURGERY 1947823 0 500000 0 14542 0 46312 0 39202 0 2547879 0 0 0 STEVEN SONENREICH PRESIDENT/CEO (END 2/21) 876359 0 524146 0 159863 0 52850 0 27956 0 1641174 0 0 0 ALEXANDER MENDEZ EXECUTIVE VP/CFO 679221 0 294116 0 353271 0 52850 0 37639 0 1417097 0 0 0 SAMUEL GOLDSMIT EMPLOYED MD STAFF PHYSICIAN, NEUROSURGERY 659457 0 600000 0 4262 0 46350 0 10818 0 1320887 0 0 0 GINO SANTORIO PRESIDENT/CEO (BEG. 2/21) 1143125 0 0 0 9179 0 31427 0 34602 0 1218333 0 0 0 NICOLAS KURITZKY EMPLOYED MD STAFF PHYSICIAN, RADIATION ONCOLOGY 533137 0 475000 0 270 0 46350 0 12135 0 1066892 0 0 0 ROY WILLIAMS EMPLOYED MD CHIEF, THORACIC SURGERY 934550 0 0 0 10955 0 50536 0 38245 0 1034286 0 0 0 MIKE CUSNIR EMPLOYED MD CHIEF, HEMATOLOGY & ONCOLOGY 623976 0 300000 0 1794 0 52850 0 19935 0 998555 0 0 0 ROBERT GOLDSZER SENIOR VP/CMO 447283 0 99814 0 188905 0 52850 0 25206 0 814058 0 0 0 THOMAS GILLETTE SENIOR VP/CIO 407766 0 92585 0 86006 0 52850 0 35642 0 674849 0 0 0 ANGEL PALLIN SENIOR VP/COO 387392 0 130633 0 81214 0 46350 0 22685 0 668274 0 0 0 WAYNE CHUTKAN SENIOR VP OF FINANCE 356333 0 83055 0 78967 0 52850 0 39424 0 610629 0 0 0 WENDY STUART SENIOR VP/CNO 310742 0 105000 0 71280 0 33350 0 32174 0 552546 0 0 0 ARI CIMENT MD PRES MED STAFF/TRUSTEE (END 6/21) 351227 0 150000 0 270 0 20800 0 20737 0 543034 0 0 0 MERVYN MILLS VP OF FINANCE 262515 0 62272 0 55681 0 46350 0 28741 0 455559 0 0 0 BENJAMIN DAVIS VP FACILITIES/RESOURCE MGT 290979 0 63337 0 57168 0 31150 0 6794 0 449428 0 0 0 CHARLENE WELKER SENIOR VP OF SPECIALTY SVC 254562 0 60592 0 57452 0 52850 0 12199 0 437655 0 0 0 ARNOLD JAFFEE SENIOR VP/GEN COUNSEL 245435 0 60000 0 22315 0 46850 0 33955 0 408555 0 0 0 CATHY MCCLELLAN VP, RISK MGT, INS & PERF I 179650 0 45895 0 44284 0 52850 0 13532 0 336211 0 0 0 MARGIE STICKLES VP, SURGICAL SERVICES 189252 0 23690 0 48146 0 52850 0 2386 0 316324 0 0 0 GUSTAVO TEJAS VP CRT CARE & EMG SVC 184391 0 42841 0 1878 0 33350 0 13013 0 275473 0 0 0 ETHLING HERNANDEZ VICE PRESIDENT (BEG. 2/21) 198724 0 0 0 658 0 19629 0 19663 0 238674 0 0 0 VANDANA PATHAK VICE PRESIDENT (BEG. 2/21) 187139 0 0 0 161 0 25393 0 18920 0 231613 0 0 0 LYNDA BARCELO VICE PRESIDENT (BEG. 2/21) 168475 0 0 0 173 0 24747 0 20285 0 213680 0 0 0 MONICA FELDER FORMER VP/COO 0 0 0 0 116502 0 22750 0 3532 0 142784 0 0 0 PART I, LINE 1A GROSS-UP PAYMENTS FOR DISABILITY INSURANCE POLICIES WERE PROVIDED TO TWO OFFICERS AND ELEVEN KEY EMPLOYEES. GROSS-UP PAYMENTS FOR LIFE INSURANCE POLICIES WERE PROVIDED TO TWO OFFICERS AND TEN KEY EMPLOYEES. SUCH AMOUNTS WERE TREATED AS TAXABLE COMPENSATION AND INCLUDED IN THE W-2 WAGES FOR SUCH EMPLOYEES. PART I, LINE 1B THE DECISION-MAKING PROCESS FOR THE GROSS-UP PAYMENTS MADE PURSUANT TO THE LIFE INSURANCE AND DISABILITY POLICIES FOLLOWED THE SAME COMPENSATION PROCESS OUTLINED IN THE DISCLOSURE FOR FORM 990, PART VI, LINE 15, INCLUDING APPROVAL BY THE COMPENSATION COMMITTEE AND REVIEW BY AN INDEPENDENT CONSULTANT. APPROVAL FOR THE GROSS-UP PAYMENTS IS ALSO OUTLINED IN THE PLAN DOCUMENTS. PART I, LINE 4A MONICA FELDER, A FORMER KEY EMPLOYEE RECEIVED A SEVERANCE PAYMENT DURING 2021 IN THE AMOUNT OF $116,502. A CITY OF MIAMI BEACH HEALTH FACILITIES AUTHORITY 650372870 593211DY8 2012-09-11 141194667 CURRENT REFUND BONDS ISSUED 12/22/98 & 5/24/01 1 0 0 B CITY OF MIAMI BEACH HEALTH FACILITIES AUTHORITY 650372870 593211EZ4 2014-09-04 181289212 CURRENT REFUND BOND ISSUED 4/28/04 & CAPITAL IMPROVEMENTS 0 0 0 C CITY OF MIAMI BEACH HEALTH FACILITIES AUTHORITY 650372870 000000000 2021-02-25 31775000 CURRENT REFUND BONDS ISSUED 9/4/2014 0 0 0 D CITY OF MIAMI BEACH HEALTH FACILITIES AUTHORITY 650372870 593211FQ3 2021-09-21 162464714 CONSTRUCT OUTPATIENT ONCOLOGY CENTER 0 0 0 A 58805000 65695000 141194667 70945812 141194667 1 0 1 1 B 39845000 181914236 662978 2358111 110221427 69334698 2019 1 0 1 1 C 31775000 8972 322970 31452030 1 0 1 1 D 162474665 798645 1770129 159905891 0 0 0 1 B 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 1 1 B 0 0 0 1 0 0 0 1 1 C 0 1 0 0 1 0 0 0 1 D 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 D 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CITY OF MIAMI BEACH HEALTH FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 09/10/2017 ISSUER NAME: CITY OF MIAMI BEACH HEALTH FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 09/14/2019 PART II, LINE 4, COL A THE AMOUNT SHOWN HERE CONSISTS OF $1,520,435 IN A DEBT SERVICE RESERVE FUND, PLUS $681,758 OF DEBT SERVICE FUND DEPOSITS, PLUS $68,743,619 IN A DEFEASANCE ESCROW (A SINKING FUND). PART II, LINE 4, COL B AND C THE AMOUNT SHOWN HERE CONSISTS SOLELY OF DEBT SERVICE FUND DEPOSITS. PART II, LINE 3, COL B AND D DIFFERENCES BETWEEN THE AMOUNT SHOWN HERE AND THE ISSUE PRICE REPORTED IN PART I, COLUMN (E) ARE DUE TO ACCUMULATED INTEREST EARNINGS. PART IV, LINE 6, COL A AND B SUCH AMOUNTS WERE APPROPRIATELY YIELD RESTRICTED. CAROL HERNANDEZ MSMC EMPLOYEE & SISTER OF ETHLING HERNANDEZ, MSMC KEY EMPLOYEE 97301 ETHLING HERNANDEZ'S SISTER, CAROL HERNANDEZ, WAS AN EMPLOYEE OF THE HOSPITAL AND IN 2021 SHE EARNED WAGES IN THE AMOUNT OF $97,301. 0 FORM 990, PART VI, SECTION A, LINE 2 TRUSTEES MARK H. HILDEBRANDT AND LAURANS A. MENDELSON HAVE A BUSINESS RELATIONSHIP. TRUSTEES SERGIO ROK AND JAMES TATE HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11B THE PROCESS FOR REVIEW OF THE FORM 990 BY MEMBERS OF THE GOVERNING BODY AND MANAGEMENT IS AS FOLLOWS: THE MEMBERS OF THE GOVERNING BODY, MANAGEMENT, AND THE INDEPENDENT TAX CONSULTANTS WILL MEET AND REVIEW IN DETAIL THE COMPLETED FORM 990. A FINAL DRAFT OF FORM 990 IS PROVIDED TO ALL VOTING MEMBERS OF THE ORGANIZATION BEFORE THE FINAL FORM IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY: MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC. AND SUBSIDIARIES (THE "MEDICAL CENTER") FORMALLY IMPLEMENTED A WRITTEN CONFLICT OF INTEREST POLICY (THE "POLICY") IN MARCH 2006 TO PROTECT THE MEDICAL CENTER AND ENSURE THAT THE DELIBERATIONS AND DECISIONS MADE ON BEHALF OF THE MEDICAL CENTER ARE MADE IN THE BEST INTEREST OF THE MEDICAL CENTER. THE TERM "CONFLICT OF INTEREST" AS DEFINED BY THIS POLICY REFERS TO SITUATIONS IN WHICH FINANCIAL OR OTHER PERSONAL CONSIDERATIONS MAY COMPROMISE, OR HAVE THE APPEARANCE OF COMPROMISING, THE JUDGMENT OF SOMEONE CHARGED WITH THE RESPONSIBILITY TO ACT ON BEHALF OF THE MEDICAL CENTER. THIS POLICY IS REVIEWED PERIODICALLY BUT NOT LESS THAN ONCE A YEAR BY THE AUDIT COMMITTEE OF THE BOARD OF TRUSTEES TO BETTER MEET ITS OBJECTIVES. IT IS INTENDED TO SUPPLEMENT BUT NOT REPLACE ANY APPLICABLE LAWS GOVERNING CONFLICTS OF INTEREST IN NONPROFIT AND CHARITABLE ORGANIZATIONS. PERSONS COVERED UNDER THIS POLICY INCLUDE: (1) ANY CURRENT OR FORMER TRUSTEE, OFFICER, OR MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS FOR THE MEDICAL CENTER; (2) MEMBERS OF MANAGEMENT AND ANY EMPLOYEE OF THE MEDICAL CENTER WHO: A) RECEIVES COMPENSATION FROM THE MEDICAL CENTER IN EXCESS OF $150,000 ANNUALLY, WHETHER AS A FULL- OR PART-TIME EMPLOYEE, INDEPENDENT CONTRACTOR, OR OTHERWISE, AND, B) HAS RESPONSIBILITIES, POWER OF INFLUENCE OVER AN ACTIVITY OF THE MEDICAL CENTER SIMILAR TO THAT OF AN OFFICER OR TRUSTEE AND WHICH REPRESENTS MORE THAN 10% OF THE ACTIVITIES, ASSETS, INCOME OR EXPENSES OF THE MEDICAL CENTER, AND C) IS ONE OF THE TWENTY EMPLOYEES WITH THE HIGHEST COMPENSATION FROM THE MEDICAL CENTER. (3) ANY PERSON(S) WHO SERVE AS A MEMBER OF THE MEDICAL CENTER'S MEDICAL STAFF AS A CHAIRPERSON OF A DEPARTMENT, CHIEF OF A CLINICAL SERVICE, OR MEMBER OF THE MEDICAL EXECUTIVE COMMITTEE. MONITORING AND COMPLIANCE: AN IMPORTANT STEP IN MONITORING AND ENFORCING COMPLIANCE WITH A CONFLICT OF INTEREST POLICY INCLUDES MANAGEMENT'S EDUCATION EFFORTS TO MAKE INTERESTED PERSONS AWARE OF THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. TO THAT END, MANAGEMENT HAS INCLUDED IN ITS CODE OF CONDUCT (THE "CODE") A SECTION ON CONFLICTS OF INTEREST WHICH HAS TO BE SIGNED AND RETURNED BY EVERY INTERESTED PERSON TO ACKNOWLEDGE AND ATTEST THAT THEY READ THE CODE INCLUDING THE CONFLICT OF INTEREST SECTION. ANNUALLY, INTERESTED PERSONS ALSO RECEIVE A REFRESHER TRAINING SESSION ON ETHICS AND CONFLICTS OF INTEREST. IN ADDITION, THE AUDIT COMMITTEE OF THE BOARD OF TRUSTEES HAS CREATED A SUBCOMMITTEE ON CONFLICTS OF INTEREST ("CONFLICTS COMMITTEE") TO ADMINISTER AND MONITOR COMPLIANCE WITH THIS POLICY. THE CONFLICTS COMMITTEE REQUIRES A STATEMENT FROM EACH INTERESTED PERSON NOT LESS FREQUENTLY THAN ONCE A YEAR SETTING FORTH ALL BUSINESS AND OTHER AFFILIATIONS THAT RELATE IN ANY WAY TO THE BUSINESS AND OTHER ACTIVITIES OF THE MEDICAL CENTER. INTERNAL AUDIT COMPILES AND SUMMARIZES ALL THE DISCLOSURES RECEIVED FROM INTERESTED PERSONS TO FACILITATE THEIR REVIEW BY THE CONFLICTS COMMITTEE. THE CONFLICTS COMMITTEE INDIVIDUALLY DISCUSSES EACH DISCLOSURE TO EVALUATE WHETHER A CONFLICT OF INTEREST EXISTS AND DETERMINES THE APPROPRIATE COURSE OF ACTION TO TAKE. NEITHER THE BOARD NOR ANY COMMITTEE OF THE BOARD SHALL VOTE UPON ANY PROPOSED TRANSACTION OR ARRANGEMENT IN CONNECTION WITH A POTENTIAL CONFLICT OF INTEREST UNTIL SUCH TIME AS THE CONFLICTS COMMITTEE HAS DETERMINED WHETHER A CONFLICT OF INTEREST EXISTS. WHERE THE CONFLICTS COMMITTEE HAS CONCLUDED THAT A CONFLICT OF INTEREST EXISTS, THE CHAIRMAN OF THE CONFLICTS COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO A PROPOSED TRANSACTION, CONTRACT, OR ARRANGEMENT. IF THE CONFLICTS COMMITTEE DETERMINES THAT THE MEDICAL CENTER CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THEN THE MEDICAL CENTER SHALL NOT ENTER INTO THE TRANSACTION THAT INVOLVES THE CONFLICT OF INTEREST. IF A TRANSACTION OR ARRANGEMENT MORE ADVANTAGEOUS IS NOT REASONABLY ATTAINABLE UNDER THE CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THEN THE BOARD OR COMMITTEE, AS APPLICABLE, SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED TRUSTEES WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE MEDICAL CENTER'S BEST INTEREST AND WHETHER IT IS FAIR AND REASONABLE TO THE MEDICAL CENTER, AND SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH SUCH DETERMINATION. FAILURE BY AN INTERESTED PERSON TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST UNDER THE CONFLICT OF INTEREST POLICY IS CONSIDERED A SERIOUS MATTER AND MAY CONSTITUTE "CAUSE" FOR REMOVAL OR TERMINATION OF A TRUSTEE, OFFICER, OR THE TERMINATION OF ANY CONTRACTUAL OR EMPLOYMENT RELATIONSHIP THE MEDICAL CENTER MAY HAVE WITH AN INTERESTED PERSON OR OTHER PARTY. FORM 990, PART VI, SECTION B, LINE 15 ON AN ANNUAL BASIS, THE MOUNT SINAI MEDICAL CENTER COMPENSATION COMMITTEE CONTRACTS WITH AN INDEPENDENT CONSULTANT TO PREPARE AN OPINION REGARDING THE REASONABLENESS AND COMPARABILITY OF THE TOTAL COMPENSATION PROVIDED TO ITS SENIOR OFFICERS AND KEY EMPLOYEES. THE COMPENSATION COMMITTEE INFORMS THE INDEPENDENT CONSULTANT THAT THE INDEPENDENT CONSULTANT'S OPINION WILL BE PART OF THE COMMITTEE'S PROCEDURE FOR ESTABLISHING THE REBUTTABLE PRESUMPTION OF REASONABLENESS DESCRIBED IN THE INCOME TAX REGULATIONS. THE INDEPENDENT CONSULTANT'S DETERMINATION OF REASONABLENESS IS MADE AFTER A THOROUGH REVIEW OF ALL THE ELEMENTS OF THE TOTAL COMPENSATION COMPRISED OF: CASH COMPENSATION, HEALTH AND WELFARE BENEFITS, RETIREMENT BENEFITS, EXECUTIVE BENEFITS AND PERQUISITES, AND OTHER ELEMENTS OF COMPENSATION INCLUDING SEVERANCE ARRANGEMENTS. THE OPINION EXPRESSED BY THE INDEPENDENT CONSULTANT IS THEN PRESENTED TO THE MSMC COMPENSATION COMMITTEE IN A REPORT FORM FOR THEIR REVIEW. THE OPINION REPORT IS REFERRED TO BY THE COMPENSATION COMMITTEE WHEN DETERMINING AND APPROVING THE ANNUAL COMPENSATION FOR ITS SENIOR OFFICERS AND KEY EMPLOYEES. THE EXECUTIVE BOARD OF TRUSTEES OF MSMC HAS AUTHORIZED ITS COMPENSATION COMMITTEE TO SET ANNUAL COMPENSATION FOR MSMC'S SENIOR OFFICERS AND KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS THAT ARE REQUIRED TO BE OPEN FOR PUBLIC INSPECTION ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: INCOME FROM MIAMI JEWISH HOME HEALTH AGENCY -205,060. AMOUNT REPORTED SEPARATELY 2,066,692. NET ASSETS TRANSFERRED FROM MSMC FDN -13,397,409. INCOME FROM MOB 149,423. NET ASSETS RELEASED FROM RESTRICTION 2,884,164. 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