2021-12-17T08:29:59-06:00 2020-12-31 221478099 COHNREZNICK LLP 1301 AVENUE OF THE AMERICAS NEW YORK NY 10019 990 2020-01-01 111631746 BROOKDALE HOSPITAL MEDICAL CENTER BROO 7182405000 ONE BROOKDALE PLAZA BROOKLYN NY 11212 ROBERT PALERMO CHIEF FINANCIAL OFFICER 7182405000 2021-12-15 1 ROBERT PALERMO 999009999 LORI ROTHE YOKOBOSKY CPA P01273422 2122970400 2021-12-15 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z LARAY BROWN ONE BROOKDALE PLAZA BROOKLYN NY 11212 629044069 0 X WWW.BROOKDALEHOSPITAL.ORG X 1914 NY WE PROVIDE GREATER ACCESS TO HIGH QUALITY MEDICAL CARE AND KEEP OUR COMMUNITIES HEALTHY THROUGH AN INTEGRATED CARE SYSTEM THAT RESPECTS THE DIVERSITY OF OUR COMMUNITIES AND ADDRESSES BOTH THE HEALTH NEEDS AND UNIQUE FACTORS THAT SHAPE THEM. 19 19 3798 184 0 0 154923087 197085343 426636158 417314585 1119722 4720280 9163332 9923861 591842299 629044069 0 0 0 0 379882923 409717339 0 0 0 216488261 214083251 596371184 623800590 -4528885 5243479 234701592 345668977 497136248 660000231 -262434656 -314331254 WE PROVIDE GREATER ACCESS TO HIGH QUALITY MEDICAL CARE AND KEEP OUR COMMUNITIES HEALTHY THROUGH AN INTEGRATED CARE SYSTEM THAT RESPECTS THE DIVERSITY OF OUR COMMUNITIES AND ADDRESSES BOTH THE HEALTH NEEDS AND UNIQUE FACTORS THAT SHAPE THEM. 0 0 573312851 426133885 THE BROOKDALE HOSPITAL MEDICAL CENTER WAS CREATED FOR THE PURPOSE OF OPERATING A 530 BED HOSPITAL IN BROOKLYN, NEW YORK. IN 2020, BROOKDALE HOSPITAL MEDICAL CENTER LOGGED 14,448 ADMISSIONS, 14,459 PATIENT DISCHARGES, AND 54,716 OUTPATIENT EMERGENCY ROOM VISITS WHICH RESULTED IN 183,689 OTHER OUTPATIENT SERVICE VISITS. 573312851 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 1 1 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 496 0 1 3798 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 19 19 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X ROBERT PALERMO CFO 7182405773 101-01 AVENUE D BROOKLYN NY 11236 ALEX ROVT CHAIRMAN 0.05 0.95 X X 0 0 0 ANTHONY CLEMENZA SR TRUSTEE 0.05 0.95 X 0 0 0 BISHOP HUGH NELSON TRUSTEE 0.05 0.95 X 0 0 0 DR JOSEPH CUIFFO TRUSTEE 0.05 0.95 X 0 0 0 DR K TORIAN EASTERLING TRUSTEE 0.05 0.95 X 0 0 0 DR SOFIA NOVAK TRUSTEE 0.05 0.95 X 0 0 0 EDNA WELLS-HANDY TRUSTEE 0.05 0.95 X 0 0 0 HENNA WHITE SECRETARY/TREASURER 0.05 0.95 X X 0 0 0 HOPE MASON TRUSTEE 0.05 0.95 X 0 0 0 MARK SHELTON TRUSTEE 0.05 0.95 X 0 0 0 MAURICE A REID TRUSTEE 0.05 0.95 X 0 0 0 MICHAEL IRWIN TRUSTEE 0.05 0.95 X 0 0 0 MICHAEL L NAIRNE TRUSTEE 0.05 0.95 X 0 0 0 MICHAEL SCAGNELLI TRUSTEE 0.05 0.95 X 0 0 0 NUSIN SHTERN TRUSTEE 0.05 0.95 X 0 0 0 RABBI ARYEH KATZIN TRUSTEE 0.05 0.95 X 0 0 0 REV WATERMAN VICE-CHAIRPERSON 0.05 0.95 X X 0 0 0 RICHARD E GREEN TRUSTEE 0.05 0.95 X 0 0 0 VICTOR AYALA TRUSTEE 0.05 0.95 X 0 0 0 DOMINICK STANZIONE PRESIDENT AND CEO 40.00 5.40 X 1195530 0 20781 GENEVIEVE SORENSEN VICE PRESIDENT 40.00 5.40 X 350523 0 6358 REGINALD BULLOCK ASSISTANT SECRETARY 40.00 5.40 X 394431 0 35126 ROBERT PALERMO CHIEF FINANCIAL OFFICER 40.00 5.40 X 622889 0 42892 CHARLES SALVO SR. VICE PRESIDENT PHYSICIAN PRACTIC 40.00 5.40 X 538460 0 34492 DR DAVID ROSE CHIEF MEDICAL OFFICER 40.00 X 664467 0 18031 DR GARY STEPHENS CHIEF OF ACADEMIC AFFAIRS 40.00 5.40 X 484154 107080 4308 WILLIAM BIFULCO SR. VP CLINICAL ADMINISTRATION 40.00 X 303753 0 40672 CYRUS O MCCALLA DIRECTOR, OBS/GYN 40.00 X 681844 0 33834 LUCIO FLORIS MD CHIEF OF VASCULAR SURGERY 40.00 X 718651 0 26529 WILLIAM WIRCHANSKY DIRECTOR OF NEUROSURGERY 40.00 X 802674 0 31550 ROGER KIM NEONATOLOGIST 40.00 X 725165 0 28560 ANTHONY TORTOLANI MD CHAIRPERSON, MD 40.00 X 627901 0 24190 8110442 107080 347323 1003 0 1 0 UNIVERSITY PHYSICIANS OF BKLN 185 MONTAGUE ST STE 4 BROOKLYNN NY 11201 PHYSICIAN SERVICES 7221562 VELOCITY TECHNOLOGY SOLUTIONS 1887 W COOK ROAD MANSFIELD OH 44906 IT- SERVICES AND SUPPORT 5486542 FASTAFF LLC 5700 S QUEBEC ST STE 300 GREENWOOD VILLAGE CO 80111 NURSING STAFFING AGENCY 2611979 ON-LINE RADIOLOGY MEDICAL GRP 28062 BAXTER RD MURRIETA CA 92563 RADIOLOGY INTERPRETATION FEES 2345481 LOCUM TENENSCOM LLC 2575 NORTHWINDS PKWY ALPHARETTA GA 30009 PHYSICIAN SERVICES 1344299 101 195865046 1220297 197085343 NET PATIENT REVENE 621400 337348021 337348021 OTHER PATIENT REVENUE 621400 31086007 31086007 SVCS FOR RELATED ORGS 621400 25679874 25679874 PHARMACY 621400 21626202 21626202 TEACHING 621400 935920 935920 638561 638561 417314585 4720280 4720280 401735 0 401735 401735 401735 SERVICE & LEASING AGREEMENT 900099 4334612 4334612 REBATES AND REFUNDS 621110 4000352 4000352 CAFETERIA 900099 687301 687301 499861 484336 15525 9522126 629044069 426133885 0 5824841 4755967 4368353 387614 301998047 277384418 24613629 20874282 19172200 1702082 53615380 49248367 4367013 28473663 26151930 2321733 9717549 7891293 1826256 1551143 380311 1170832 309340 309340 65237 65237 42784291 37103475 5680816 136396 136396 3076907 2191694 885213 9503662 9101087 402575 5069003 5069003 368853 367042 1811 255370 250431 4939 2582557 2582557 8236221 8236221 14077646 12226264 1851382 MEDICAL SUPPLIES 74020110 74020110 BAD DEBT EXPENSE 23233307 23233307 EQUIPMENT RENTAL & MAIN 13662367 9017781 4644586 FOOD 2982233 2982233 2451059 1889038 562021 623800590 573312851 50487739 0 18030258 42736663 6650307 6642164 37988625 34926357 6482915 6865167 3672645 7440831 385717148 345218624 39712921 40498524 122163921 206559271 234701592 345668977 95675567 106376372 37600468 132235878 177957443 269224803 338065948 497136248 660000231 X -262434656 -314331254 -262434656 -314331254 234701592 345668977 X 5243479 -57140077 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 65237 65237 0 PART II-B, LINE 1: BROOKDALE HOSPITAL MEDICAL CENTER IS A MEMBER OF THREE ASSOCIATIONS OF WHICH SOME OF THEIR DUES ARE ALLOCATED TO GRASS ROOTS LOBBYING IN REGARD TO THEIR NEEDS IN SERVICING AND PROVIDING HEALTHCARE TO THE PUBLIC. COST SPENT ON LOBBY ACTIVITIES FOR THE YEAR: 1199/GREATER NEW YORK HOSPITAL ASSOCIATION $65,237 1068657 1068657 97304740 80092508 17212232 99504102 90108339 9395763 187839649 175017777 12821872 40498524 DUE FROM THIRD PARTY PAYORS 13246005 INSURANCE RECEIVABLES 80197237 ASSETS WHOSE USE IS LIMITED 91029793 DUE FROM AFFILIATES 13462487 SECURITY DEPOSITS 188823 OTHER RECEIVABLES 8434926 206559271 MALPRACTICE INSURANCE PAYABLE 168116504 DUE TO THIRD PAYORS 21784472 WORKERS COMPENSATION PAYABLE 26574384 ACCRUED PENSION PAYABLE 60002872 EXECUTIVE POST RETIREMENT BENEFITS 853096 DEFRRED LEASE OBLIGATION 60734620 338065948 X PART X, LINE 2: MANAGEMENT REVIEWS TRANSACTIONS TO ESTIMATE POTENTIAL TAX LIABILITIES USING A THRESHOLD OF MORE LIKELY THAN NOT OF BEING SUSTAINED. IT IS MANAGEMENT'S ESTIMATION THAT THERE ARE NO MATERIAL LIABILITIES THAT NEED TO BE RECORDED AS OF DECEMBER 31, 2020. 0 CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, INVESTMENTS 5247497 0 0 0 0 0 0 5247497 0 5247497 0 0 1 0 0 0 PART III ACCOUNTING METHOD: 1 1 1 X 1 X 1 1 1 0 1 1 20014449 10295133 9719316 0.01560 253321381 133831608 119489773 0.19160 2027301 483990 1543311 0.00250 275363131 144610731 130752400 0.20970 5832508 4000661 1831847 0.00290 64487774 22356022 42131752 0.06750 52189515 24487253 27702262 0.04440 122509797 50843936 71665861 0.11480 397872928 195454667 202418261 0.32450 1 4115869 2862994 46309378 36196086 10113292 X 1 1 1 1 BROOKDALE HOSPITAL MEDICAL CENTER ONE BROOKLYN PLAZA BROOKLYN NY 11236 X BROOKDALE HOSPITAL MEDICAL CENTER 0 0 1 X X X X X X X X X 19 1 0 0 1 X WWW.BROOKDALEHOSPITAL.ORG X 1 16 1 WWW.BROOKDALEHOSPITAL.ORG 0 1 X 100.000000000000 300.000000000000 X X X X 1 1 X X 1 X WWW.BROOKDALEHOSPITAL.ORG X WWW.BROOKDALEHOSPITAL.ORG X WWW.BROOKDALEHOSPITAL.ORG X X X X 1 X 0 X 1 0 1 BROOKDALE HOSPITAL MEDICAL CENTER PART V, SECTION B, LINE 5: IN 2018, AT THE RECOMMENDATION OF THE NEW YORK STATE DEPARTMENT OF HEALTH (NYSDOH), THE BROOKDALE HOSPITAL MEDICAL CENTER ("BROOKDALE") AND TWO OTHER AREA SAFETY-NET HOSPITALS (THE INTERFAITH MEDICAL CENTER (IMC) AND KINGSBROOK JEWISH MEDICAL CENTER (KHMC)) FORMALLY JOINED TOGETHER TO OPERATE UNDER A NEW PARENT ORGANIZATION ONE BROOKLYN HEALTH SYSTEM ("OBHS"). LEGALLY, BROOKDALE IS CONSIDERED AN "AFFILIATE" OF OBHS AND THE TWO OTHER HOSPITALS. THIS AFFILIATION IS INTENDED TO ENSURE THAT ALL THREE HOSPITALS GET BACK TO FISCAL STABILITY AND SUSTAINABILITY, TO CONTINUE PROVIDING HEALTHCARE FOR THE THOUSANDS OF RESIDENTS IN THE PREDOMINANTLY LOW INCOME COMMUNITIES OF CENTRAL AND EAST BROOKLYN. IN 2019, ALL THREE OBHS MEMBER HOSPITALS WORKED TOGETHER TO DEVELOP ONE COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), CONDUCTING A BROAD SURVEY OF THE HEALTHCARE NEEDS OF RESIDENTS IN ALL THE ZIP CODES SERVED BY EACH HOSPITAL IN BOTH PRIMARY, SECONDARY AND TERTIARY SERVICE AREAS, AS LISTED IN CHART THAT FOLLOWS. NOTE THAT SERVICE AREAS WERE DEFINED BASED ON OBHS HOSPITALS' DISCHARGE DATA. PATIENT ORIGIN ZIP CODES WERE RANKED BY FREQUENCY; PRIMARY SERVICE AREA WAS DEFINED USING A CUTOFF OF 50%, I.E. 50% OF PATIENTS CAME FROM THE ZIP CODES COVERED BY THE PRIMARY SERVICE AREA. THE CUT OFFS FOR SECONDARY AND TERTIARY SERVICE AREA WERE 75% AND 85% RESPECTIVELY.YES, IN CONDUCTING THE 2019 CHNA, OBHS TOOK INTO ACCOUNT INPUT FROM REPRESENTATIVES OF A BROAD CROSS-SECTION OF THE COMMUNITIES SERVED, INCLUDING THOSE WITH EXPERTISE IN PUBLIC HEALTH. THE PROCESS OF DEVELOPING A CHNA, AND A COMMUNITY SERVICE PLAN (CSP) (REQUIRED BY THE NYS DEPARTMENT OF HEALTH (NYS DOH)), IS AN INTEGRAL PART OF OBHS' ONGOING STRATEGIC PLANNING DISCUSSIONS, AND INVOLVES OBHS AND BROOKDALE'S SENIOR LEADERSHIP, MEDICAL STAFF, COMMUNITY RESIDENTS, PUBLIC HEALTH OFFICIALS, ELECTED OFFICIALS, AND MANY OTHER KEY COMMUNITY STAKEHOLDERS. THE 2019 CHNA CONDUCTED AGGREGATED AND ANALYZED FINDINGS FROM A VARIETY OF PRIMARY AND SECONDARY DATA SOURCES AS FOLLOWS:(I) ANALYSES OF CLINICAL DIAGNOSIS AND TREATMENT DATA FOR OBHS' PATIENT POPULATION.(II) PAR RESEARCH STUDIES CONDUCTED BY OBHS IN COLLABORATION WITH COMMUNITY PARTNERS IN 2016-2018. (III) "THE BROOKLYN STUDY: RESHAPING THE FUTURE OF HEALTHCARE," A COMPREHENSIVE ASSESSMENT OF EAST BROOKLYN'S HEALTHCARE NEEDS, THE VIABILITY OF AREA HOSPITALS (INCLUDING BROOKDALE), AND SYSTEM-WIDE TRANSFORMATION RECOMMENDATIONS. THIS ASSESSMENT, CONDUCTED BY NORTHWELL HEALTH IN 2016, WAS COMMISSIONED BY NYS DOH, AND RESULTED IN THE FORMATION OF OBHS IN 2018. (IV) THE NYC DOH COMMUNITY PROFILES FOR INDIVIDUAL COMMUNITY DISTRICTS PUBLISHED IN 2018. FOLLOWING IS LIST OF SOME OF THE INDIVIDUALS AND ENTITIES WITH WHICH OBHS COORDINATED, TO DEVELOP THE 2019-2021 CHNA:- NEW YORK CITY DEPARTMENT OF HEALTH CENTER FOR HEALTH EQUITY IN EAST NY DR. TORIAN EASTERLING- NYS DEPARTMENT OF HEALTH SYLVIA PIRANI, DIRECTOR OF PUBLIC HEALTH PRACTICE- THE GREATER NEW YORK HOSPITAL ASSOCIATION AMY OSARIO- NORTHWELL VENTURES, INC.- DR. DAVID ROSE, CHIEF MEDICAL OFFICER AT BROOKDALE - KHARI EDWARDS VP OF EXTERNAL AFFAIRS- LOCAL CHURCHES AND CBOS - COMMUNITY ADVISORY BOARDS- ELECTED OFFICIALS SANDRA PERSAUD AND LATRICE WALKER- OBHS BOARD STRATEGIC PLANNING COMMITTEE BROOKDALE HOSPITAL MEDICAL CENTER PART V, SECTION B, LINE 11: THE ESTABLISHMENT OF OBHS IS INTENDED TO HELP BROOKDALE AND ITS AFFILIATES WORK TOGETHER TO SECURE MORE FUNDING AND OTHER RESOURCES THAT ARE DESPERATELY NEEDED TO MEET THE HIGH DEMAND FOR HEALTHCARE SERVICES AND TO ADDRESS ANY NEEDS IDENTIFIED, WHICH ARE NOT CURRENTLY BEING ADDRESSED. MOVING FORWARD AS A PART OF OBHS, BROOKDALE NOW HAS THE ADDED CAPACITY TO PARTNER WITH ITS AFFILIATE HOSPITALS AND A BROADER ARRAY OF COMMUNITY STAKEHOLDERS, TO LEVERAGE RESOURCES AND HEALTHCARE INNOVATIONS THAT WILL IMPROVE HEALTHCARE DELIVERY ACROSS THE OBHS HEALTHCARE SERVICES CONTINUUM. BROOKDALE CONTINUES TO BRING A FULL COMPLEMENT OF HEALTHCARE SERVICES TO ITS PATIENT POPULATION, MAKING AVAILABLE A VARIETY OF SPECIALTY AND SUB-SPECIALTY CLINICS/SERVICES TO ADDRESS A WIDE RANGE OF DISEASES THAT DISPROPORTIONATELY IMPACT ITS PATIENT POPULATION (HEART DISEASE, CANCER, ASTHMA, HIV/AIDS, DIABETES, OBESITY). BROOKDALE'S HEALTHCARE DELIVERY MODEL INCLUDES INPATIENT CARE, AMBULATORY CARE, LONG-TERM CARE, SENIOR LIVING AND EMERGENCY MEDICINE. CORE ASSETS THAT SUPPORT THE DELIVERY OF CARE INCLUDE: - APPROXIMATELY 50 SURGICAL AND SUBSPECIALTY CARE CLINICS/SERVICES;- 530 CERTIFIED ACUTE-CARE BEDS;- AN EMERGENCY DEPARTMENT, WHICH IS A NYS-DESIGNATED LEVEL-1TRAUMA CENTER, AND ONE OF THE BUSIEST IN THE REGION; - A 448-BED SKILLED-NURSING FACILITY, AND AN 86-UNIT ASSISTED-LIVING AND INDEPENDENT-LIVING FACILITY, WHICH BOTH OPERATE AT A 95% OR HIGHER OCCUPANCY RATE; - SIX PRIMARY CARE FACILITIES;- A COMPREHENSIVE ADULT DAY CARE CENTER;- A LEVEL-3 PERINATAL CENTER;- A MENTAL AND BEHAVIORAL HEALTH CENTER;- AN AMBULATORY SURGERY CENTER;- A 16-CHAIR DENTAL SUITE THAT SUPPORTS DENTAL AND ORAL SERVICES;- AN HIV CENTER; AND- AN URGENT CARE CENTER.(I) ADDRESSING THE PREVALENT DISEASES IDENTIFIED IN 2019 CHNA: FOLLOWING ARE SUMMARIES OF HOW BROOKDALE IS ADDRESSING SOME OF THE PREVALENT DISEASES:- HIV/AIDS BROOKDALE FORMED A PARTNERSHIP WITH SUNY DOWNSTATE TO OPERATE THE TREATMENT FOR LIFE CENTER HIV SERVICES AT BROOKDALE. THIS PARTNERSHIP HAS EXPANDED THE RESOURCE AND EXPERTISE POOL, RESULTING IN SIGNIFICANT ENHANCEMENTS IN HIV DIAGNOSIS AND PATIENT TREATMENT. THE COMMUNITIES WE SERVE STILL LEAD IN THE NUMBER OF HIV CASES DIAGNOSED AND PEOPLE LIVING WITH HIV.- HEART DISEASE AND HYPERTENSION - BROOKDALE HAS A CARDIOLOGY DEPARTMENT THAT IS FOCUSED ON TREATING CARDIAC DISEASE IN ADULTS AND CHILDREN. A HYPERTENSION CLINIC TREATS PATIENTS WHO HAVE BEEN DIAGNOSED WITH HYPERTENSION. IN ADDITION, ALL CLINICIANS IN OUR PRIMARY CARE NETWORK ARE TRAINED TO TREAT PATIENTS WITH HYPERTENSION AT POINT OF SERVICE. - CANCER BROOKDALE HAS AN ONCOLOGY DEPARTMENT THAT IS FOCUSED ON DIAGNOSING AND TREATING CANCER IN ADULTS AND CHILDREN, WITH LIMITED RESOURCES TO OPTIMIZE CARE AT THE MOMENT. ONLY ABOUT 30% OF PATIENTS DIAGNOSED WITH CANCER AT BROOKDALE STAY FOR TREATMENT. MOST PATIENTS ARE REFERRED TO OR OPT TO SEEK TREATMENT AT OTHER FACILITIES WITH MORE ADVANCED TREATMENT PROTOCOLS. - ASTHMA BROOKDALE'S PULMONARY DEPARTMENT TREATS PATIENTS WITH ASTHMA. SINCE ASTHMA IS THE MOST FREQUENTLY OCCURRING EMERGENCY DIAGNOSIS, BROOKDALE'S HAS A DEDICATED SPACE IN THE EMERGENCY DEPARTMENT THAT IS FULLY-EQUIPPED TO TREAT ASTHMA PATIENTS IN A TIMELY MANNER.- DIABETES BROOKDALE'S OUTPATIENT CLINICS PROVIDE CARE FOR PATIENTS THAT HAVE BEEN DIAGNOSED WITH DIABETES, SUPPORTED BY A CUTTING-EDGE ELECTRONIC HEALTH RECORDS SYSTEM THAT IS EQUIPPED TO PROMPT PRIMARY CARE DOCTORS TO REFER PATIENTS TO THE CRITICAL CONTINUUM OF SPECIALTY CARE TYPICALLY RECOMMENDED FOR DIABETIC PATIENTS (OPHTHALMOLOGY, PODIATRY, ETC.). - ALCOHOLISM AND DRUG ADDICTION BROOKDALE DOES NOT HAVE AN OASAS LICENSE TO PROVIDE SERVICES DIRECTLY TO THE ADDICTED POPULATION. HOWEVER, THE HOSPITAL PROVIDES CARE AND TREATMENT FOR ADDICTIONS UNDER ITS ARTICLE 28 LICENSE (INPATIENT) AND ITS NYS OFFICE OF MENTAL HEALTH (OMH)-ISSUED LICENSE FOR OUTPATIENTS WITH MENTAL ILLNESS AND SUBSTANCE PROBLEMS. IN ADDITION, SEVERAL OASAS LICENSED CLINICS IN THE AREA ADD TO THE CARE CONTINUUM. (II) ADDRESSING THE BARRIERS TO CARE IDENTIFIED IN THE CHNA:AS PART OF OBHS, BROOKDALE IS ADAPTING ITS SERVICE DELIVERY MODEL AND ACTIVELY SEEKING OUT THE COMMUNITY COLLABORATIONS AND RESOURCES THAT WILL HELP ADDRESS SOME OF THE BARRIERS TO CARE IDENTIFIED. IN 2018, OBHS RECEIVED A $664 MILLION CAPITAL GRANT FROM NEW YORK STATE TO IMPROVE THE CAPITAL INFRASTRUCTURE OF BROOKDALE AND THE TWO OTHER AFFILIATE HOSPITALS. FUNDING IS BEING USED TO PURCHASE MORE TECHNOLOGICALLY ADVANCED EQUIPMENT, AND TO RENOVATE AND BUILD NEW FACILITIES THAT WILL SUPPORT BETTER HEALTHCARE DELIVERY. FOLLOWING IS A DESCRIPTION OF HOW BROOKDALE IS CURRENTLY ADDRESSING THE BARRIERS TO CARE THAT WERE IDENTIFIED IN OUR 2019 CHNA: - DISPROPORTIONATE IMPACT OF SOCIAL DETERMINANTS OF HEALTH THE COMMUNITIES THAT WE SERVE ARE DISPROPORTIONATELY IMPACTED BY CRIME, A LACK OF ADEQUATE HOUSING AND HOMELESSNESS, MENTAL HEALTH, LACK OF ACCESS TO HEALTHY FOODS, AND A NUMBER OF SOCIAL FACTORS THAT HAVE BEEN IDENTIFIED AS HAVING AN IMPACT ON HEALTH OUTCOMES. OBHS IS WORKING WITH COMMUNITY-BASED ORGANIZATIONS AND OTHER KEY STAKEHOLDERS IN OUR SERVICE AREAS TO HIGHLIGHT THE CONNECTION BETWEEN THESE SOCIAL FACTORS AND HEALTH, AND DO FACILITATE THE COMMUNITY DIALOGUE THAT WILL RESULT IN POSITIVE CHANGE. - LACK OF PRIMARY CARE/ACCESS TO CARE BROOKDALE HAS A NETWORK OF SIX SEPARATE PRIMARY CARE FACILITIES AND OTHER AMBULATORY CARE SITES THAT ARE STRATEGICALLY LOCATED TO ENSURE THAT THOUSANDS OF PATIENTS FROM ALL SOCIO-ECONOMIC AND ETHNIC BACKGROUNDS HAVE ACCESS TO PRIMARY CARE. BROOKDALE'S URGENT CARE CENTER OFFERS PATIENTS GREATER FLEXIBILITY IN ACCESSING CARE. DESIGNED TO SERVE AS AN ALTERNATIVE TO THE EMERGENCY ROOM FOR PATIENTS WHO NEED CARE FOR NON-LIFE-THREATENING CONDITIONS, THE CENTER IS OPEN TO THE COMMUNITY EVERY DAY FOR LONGER HOURS THAN MOST PRIMARY CARE SERVICES, TO ACCOMMODATE WORKING FAMILIES. IN ADDITION, BROOKDALE IS CHANGING THE SERVICE DELIVERY MODEL OF ITS SIX PRIMARY CARE SITES, TO OFFER PATIENTS MORE FLEXIBILITY IN CARE. - NEED FOR DISEASE PREVENTION MODELS THROUGH THE NEW YORK STATE-FUNDED DELIVERY SYSTEM REFORM INCENTIVE PAYMENT ("DSRIP") PROGRAM, BROOKDALE HAS LAUNCHED PREVENTION MODELS THAT FOCUS ON DISEASES LIKE HYPERTENSION AND HEART DISEASE. - A LACK OF SPECIALTY CARE WHILE BROOKDALE'S CAPACITY IN NOT ADEQUATE TO MEET THE SPECIALTY CARE DEMAND IN ITS SERVICE AREAS, AND WE ARE WORKING CLOSELY WITH AFFILIATE HOSPITALS TO RECONFIGURE AND CONSOLIDATE AREAS OF SPECIALTY, FOR OPTIMAL PATIENT CARE AND ECONOMIES OF SCALE. CURRENTLY, BROOKDALE PROVIDES AN ARRAY OF MEDICAL AND SURGICAL SPECIALTY AND SUBSPECIALTY CARE FOR ITS PATIENT POPULATION. THE SUBSPECIALTY CLINICS PROVIDE CARE FOR PATIENTS WITH COMPLICATED DISEASES THAT REQUIRE HIGHLY TRAINED SPECIALIST, AND WORK IN CLOSE COLLABORATION WITH PRIMARY CARE PROVIDERS. AREAS OF MEDICAL AND SURGICAL CARE INCLUDE: - BARIATRIC SURGERY;- OPHTHALMOLOGY;- NEUROLOGICAL SURGERY;- HAND SURGERY;- BREAST SURGERY;- ORTHOPEDIC SURGERY;- PEDIATRIC SURGERY;- VASCULAR SURGERY;- EAR, NOSE AND THROAT SURGERY;- UROLOGICAL SURGERY FOR MEN, WOMEN AND CHILDREN;- COMPREHENSIVE WOMEN'S SPECIALTY HEALTH CARE, INCLUDING GYNECOLOGY FOR ADULTS AND ADOLESCENTS, MATERNAL-FETAL MEDICINE, GYNECOLOGICAL ONCOLOGY, PRENATAL CARE, HIGH RISK PREGNANCY CARE AND POSTPARTUM CARE;- MEDICAL SUBSPECIALTY CARE INCLUDES: ALLERGY; DERMATOLOGY; NEPHROLOGY; HEMATOLOGY/ONCOLOGY; NEUROLOGY; PULMONARY; CARDIOLOGY; AND ENDOCRINOLOGY, TO NAME A FEW; AND - MEDICATION MANAGEMENT SERVICES FOR PATIENTS WITH COMPLICATED CONDITIONS THAT REQUIRE MULTIPLE MEDICATIONS. - LINGUISTIC ISOLATION GIVEN THE DIVERSITY OF THE COMMUNITIES THAT WE SERVE, WITH IMMIGRANTS FROM MANY AREAS OF THE WORLD, LINGUISTIC ISOLATION CAN BE A SOCIAL DETERMINANT OF HEALTH THAT CONTRIBUTES TO POOR HEALTH OUTCOMES. BROOKDALE OFFERS A VARIETY OF LANGUAGE ASSISTANCE SERVICES TO NON-ENGLISH AND LIMITED ENGLISH PROFICIENT (LEP) PATIENTS AND THEIR FAMILIES TO FACILITATE CARE. LANGUAGE SERVICES INCLUDE: - SIGNAGE AND FORMS SIGNAGE AND DOCUMENTS THAT ARE STANDARD TO CARE ARE AVAILABLE IN SEVERAL LANGUAGES THROUGHOUT THE HOSPITAL;- LANGUAGE BANK EMPLOYEES HAVE ACCESS TO A LANGUAGE BANK WHICH IS COMPRISED OF MORE THAN 150 INTERPRETERS WHO ARE SKILLED IN INTERPRETING IN A WIDE VARIETY OF LANGUAGES;- MANUALS - A VARIETY OF MANUALS WHICH CONTAIN COMMUNICATION POLICIES AND PROCEDURES, A LISTING OF ALL HOSPITAL QUALIFIED MEDICAL AND NON-MEDICAL INTERPRETERS, AND TOOLS FOR THE HEARING AND VISUALLY IMPAIRED ARE AVAILABLE TO STAFF. BROOKDALE HOSPITAL MEDICAL CENTER PART V, SECTION B, LINE 18E: UTILIZED TRANSUNION TO PROVIDE DATA ON PATIENTS CREDIT HISTORY AND PROPENSITY TO PAY DATA TO ASSIST BROOKDALE HOSPITAL IN DETERMINING FINANCIAL AID. BROOKDALE HOSPITAL MEDICAL CENTER PART V, SECTION B, LINE 20E: UTILIZED TRANSUNION TO PROVIDE DATA ON PATIENTS CREDIT HISTORY AND PROPENSITY TO PAY DATA TO ASSIST BROOKDALE HOSPITAL IN DETERMINING FINANCIAL AID. BROOKDALE HOSPITAL MEDICAL CENTER PART V, SECTION B, LINE 24: ALL PATIENTS ARE INFORMED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE POLICY AT THE TIME OF REGISTRATION. PATIENTS WHO DO NOT HAVE ANY INSURANCE COVERAGE WILL BE ELIGIBLE FOR AN AUTOMATIC DISCOUND REDUCTION. THIS WILL BE CACULATED BASED ON THE MEDICAID REIMBURSEMENT FOR THE SERVICE PROVIDED. THIS AMOUNT WILL BE CONSIDERED A "CHARITY ADJUSTMENT", BASED ON THE MEAN INCOME IN BHMC'S GEOGRAPHIC AREA. PART III, LINE 4: THE MEDICAL CENTER ANALYZES ITS PAST COLLECTION HISTORY AND IDENTIFIES TRENDS BY EACH OF ITS MAJOR PAYOR SOURCES OF PATIENT SERVICE REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS, IF ANY. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THE MAJOR PAYOR SOURCES OF PATIENT SERVICE REVENUE IN EVALUATING THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE MEDICAL CENTER ANALYZES CONTRACTUAL AMOUNTS DUE FROM PATIENTS WHO HAVE THIRD-PARTY COVERAGE AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF ANY. FOR PATIENT ACCOUNTS RECEIVABLE ASSOCIATED WITH SELF-PAY PATIENTS, WHICH INCLUDES THOSE PATIENTS WITHOUT INSURANCE COVERAGE AND PATIENTS WITH DEDUCTIBLES AND COPAYMENT BALANCES FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR A PORTION OF THE BILL, THE MEDICAL CENTER RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS FOR PATIENTS THAT ARE UNABLE OR UNWILLING TO PAY FOR THE PORTION OF THE BILL REPRESENTING THEIR FINANCIAL RESPONSIBILITY IN ACCORDANCE WITH CHARITY CARE POLICY (NOTE 2(E)). ACCOUNT BALANCES ARE CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AFTER ALL MEANS OF COLLECTION HAVE BEEN EXHAUSTED. PART III, LINE 8: THE METHOD USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS OF CARE RELATING TO PAYMENTS ON LINE 5 WAS THE 2020 MEDICARE COST REPORT. PART III, LINE 9B: THERE IS NO ACCELERATOR OR SIMILAR CLAUSES UNDER WHICH A HIGHER RATE OF INTEREST IS TRIGGERED. WHEN A PATIENT FAILS TO MAKE A REGULAR MONTHLY SCHEDULED PAYMENT, THE HOSPITAL INCLUDES A WRITTEN NOTICE ON PATIENTS' BILLS AND STATEMENTS AT LEAST 30 DAYS PRIOR TO REFERRING THE ACCOUNT TO COLLECTION. THE HOSPITAL REQUIRES THAT ANY COLLECTION AGENCIES WITH WHICH THEY CONTRACT FOLLOW THE FINANCIAL ASSISTANCE POLICIES OF THE HOSPITAL. THE HOSPITAL DOES NOT FORCE THE SALE OR FORECLOSURE OF A PATIENT'S PRIMARY RESIDENCE TO COLLECT ON AN OUTSTANDING BILL. COLLECTION IS PROHIBITED AGAINST ANY PATIENT WHO WAS ELIGIBLE FOR MEDICAID AT THE TIME SERVICES WERE RENDERED. FINALLY, THE CONTRACTED COLLECTION AGENCIES MUST OBTAIN THE HOSPITAL'S WRITTEN CONSENT BEFORE COMMENCING ANY LEGAL ACTION. PART VI, LINE 2: THE ONE BROOKLYN HEALTH SYSTEM ("OBHS") WAS FORMED IN APRIL 2018, IN RESPONSE TO A DIRECTIVE FROM NEW YORK STATE (NYS), AS AN EFFORT TO SAVE THREE FINANCIALLY-DISTRESSED SAFETY-NET HOSPITALS AND THEIR AFFILIATED HEALTHCARE FACILITIES IN EAST BROOKLYN, WHICH INCLUDE: THE BROOKDALE HOSPITAL MEDICAL CENTER, KINGSBROOK MEDICAL CENTER, INTERFAITH MEDICAL CENTER, SCHULMAN SCHACHNE NURSING HOME, RUTLAND NURSING HOME, AND A NUMBER OF OFF-SITE HEALTHCARE DELIVERY FACILITIES. ALL THREE HOSPITALS AND ASSOCIATED FACILITIES NOW EXIST UNDER THE UMBRELLA ORGANIZATION, OBHS, ADOPTING ONE MISSION, AS FOLLOWS: "WE PROVIDE GREATER ACCESS TO HIGH QUALITY MEDICAL CARE AND KEEP OUR COMMUNITIES HEALTHY THROUGH AN INTEGRATED CARE SYSTEM THAT RESPECTS THE DIVERSITY OF OUR COMMUNITIES AND ADDRESSES BOTH THE HEALTH NEEDS AND UNIQUE FACTORS THAT SHAPE THEM." OBHS HOSPITALS AND OTHER FACILITIES, WHICH SERVE AS VITAL LIFELINES FOR THE MOST VULNERABLE POOR FAMILIES IN CENTRAL AND EAST BROOKLYN, HAVE BEEN FINANCIALLY DISTRESSED FOR THE PAST DECADE, STRUGGLING TO STAY AFLOAT IN THE FACE OF A RAPIDLY CHANGING HEALTHCARE LANDSCAPE. DURING THE PAST THREE YEARS, OBHS SENIOR LEADERSHIP HAS WORKED HAND IN HAND WITH NYS GOVERNMENT, ELECTED OFFICIALS, COMMUNITY LEADERS AND MANY KEY STAKEHOLDERS TO EMBARK UPON THE WORK OF TRANSFORMING HEALTHCARE FOR THE UNDERSERVED COMMUNITIES OF OBHS SERVICE AREAS. OBHS PROVIDES A FULL SCOPE OF MEDICAL SERVICES RANGING FROM PEDIATRIC TO SENIOR CARE, TO A BROAD GEOGRAPHIC AREA WITH A POPULATION OF APPROXIMATELY 1.2 MILLION. ALL THREE OBHS HOSPITALS TOGETHER RECEIVE APPROXIMATELY 170,000 EMERGENCY ROOM AND HALF A MILLION OUTPATIENT VISITS ANNUALLY. THE FORMATION OF OBHS IS FACILITATING THE REDESIGN AND MERGING OF OPERATIONS, EFFORTS THAT ARE EXPECTED TO LEAD TO FISCAL VIABILITY AND THE CREATION OF A HEALTHCARE SYSTEM THAT IS INNOVATIVE AND RESPONSIVE TO THE NEEDS OF THE BROOKLYN COMMUNITIES SERVED. NEW YORK STATE IS WORKING CLOSELY WITH OBHS TO PROVIDE THE FINANCIAL GUIDANCE AND SUPPORT NEEDED TO RESTRUCTURE THE SYSTEM, COVERING BUDGET SHORTFALLS, AND PROVIDING GRANT FUNDING TO REPLACE OUTDATED CRITICAL MEDICAL EQUIPMENT. OBHS HOSPITALS ARE VITAL TO THE HEALTH OF BROOKLYN RESIDENTS, ESPECIALLY DURING THIS TIME OF CRISIS HAD ANY OF THE THREE HOSPITALS SUCCUMBED TO CLOSURE PRIOR TO THIS COVID-19 PANDEMIC, THE OUTCOMES FOR BROOKLYN RESIDENTS WOULD HAVE BEEN FAR MORE DEVASTATING. COVID-19 PANDEMIC RESPONSETHE COVID-19 PANDEMIC BROUGHT SEVERE FINANCIAL AND OPERATIONAL CAPACITY CHALLENGES TO ALL OBHS HOSPITALS AND AFFILIATE FACILITIES. ON MARCH 7, 2020, NEW YORK STATE GOVERNOR ANDREW CUOMO ISSUED EXECUTIVE ORDER NUMBER 202, WHICH DECLARED A STATE DISASTER EMERGENCY FOR THE ENTIRE STATE OF NEW YORK, DUE TO THE COVID-19 PANDEMIC. ALL FIVE NEW YORK CITY BOROUGHS WERE IMPACTED BY THE PANDEMIC, WITH THE BOROUGHS OF BROOKLYN AND QUEENS BEARING THE BRUNT OF IMPACT AND RECOGNIZED AS GROUND ZERO FOR THE PANDEMIC. THE OBHS HOSPITALS AND ITS SATELLITE LOCATIONS WERE IN THE EPICENTER FROM THE ONSET. FROM EARLY MARCH 2020 TO MAY 2020, ALL HOSPITALS IN THE BOROUGH OF BROOKLYN EXPERIENCED A SUSTAINED SURGE OF PATIENTS SEEKING EMERGENCY MEDICAL CARE FOR COVID-19 SYMPTOMS. OBHS DATA ANALYSIS SHOWS THAT ALL THREE OBHS HOSPITALS WERE IMMEDIATELY OVERWHELMED WITH THE DEMAND FOR EMERGENCY DEPARTMENT TRIAGE, INTAKE AND COVID-19 TESTING, HOSPITALIZATION AND CARE OF COVID-19 PATIENTS, AND THE NEED FOR INTENSIVE CARE UNIT BEDS FOR SEVERELY ILL PATIENTS. TO MEET THE SUDDEN SURGE IN DEMAND, HOSPITALS HAD TO UTILIZE AND DEPLETE THEIR STOCK OF PERSONAL PROTECTIVE EQUIPMENT (PPE), PHARMACEUTICAL AND OTHER NECESSARY MEDICAL SUPPLIES SUCH AS COVID-TESTING CAPACITY, AS WELL AS INTENSIVE CARE UNIT BEDS, WHICH WERE DEEMED NECESSARY TO MANAGE THE PANDEMIC AND CARE FOR COVID PATIENTS. HOSPITALS ALSO HAD TO SEEK ADDITIONAL STAFFING THROUGH TEMPORARY EMPLOYMENT AGENCIES TO IMMEDIATELY EXPAND THEIR WORKFORCE (DOCTORS, NURSES, RESPIRATORY THERAPISTS, AND OTHER CRITICAL MEDICAL PROFESSIONALS, AS WELL AS MAINTENANCE STAFFING). MORE BED CAPACITY WAS ALSO URGENTLY NEEDED. THE TOTAL CERTIFIED BED CAPACITY OF ALL OBHS HOSPITALS IS 1,120. IN A SUBSEQUENT EXECUTIVE ORDER ISSUED BY THE GOVERNOR DURING THE MONTH OF MARCH, ALL HOSPITALS WERE ASKED TO RAMP UP THEIR BED CAPACITY BY 100%, AND THEIR STAFFING CAPACITY TO MATCH. THIS MEANT THAT EACH OF OUR THREE HOSPITALS HAD TO SCRAMBLE TO RE-ORIENT 100% OF THEIR HEALTHCARE DELIVERY OPERATIONS TO TREAT COVID PATIENTS EXCLUSIVELY; ALL ELECTIVE SURGERIES AND ALL AMBULATORY CARE VISITS HAD TO BE CANCELLED. IN ADDITION TO THE HIGH USAGE OF PPE AND OTHER MEDICAL SUPPLIES, HOSPITALS ADMINISTRATION HAD TO WORK TIRELESSLY TO PURCHASE ADDITIONAL BEDS, HEPA FILTERS, IV POLES, STRETCHERS, VENTILATORS, AND A WIDE RANGE OF NECESSARY MEDICAL EQUIPMENT NEEDED TO TREAT PATIENTS. AT THE HEIGHT OF THE FIRST SURGE OF THE PANDEMIC, BETWEEN MARCH 7 AND APRIL 20, THE NEW YORK CITY DEPARTMENT OF HEALTH AND MENTAL HYGIENE (NYCDOHMH) REPORTED THAT THE BOROUGH OF BROOKLYN HAD 35,775 CASES OF COVID-19, THE SECOND HIGHEST NUMBER OF POSITIVE COVID-19 CASES AMONG THE FIVE BOROUGHS. DURING THIS PERIOD, A TOTAL OF 2,807 COVID-19 DEATHS WERE RECORDED IN THE BOROUGH, CLOSE TO 30% OF ALL DEATHS IN THE FIVE BOROUGHS MOST OF THOSE DEATHS OCCURRED WITHIN THE SHORT TIME PERIOD OF FIVE WEEKS. ALL THREE HOSPITALS HAD TO RAMP UP MORGUE OPERATIONS TO PROCESS THE DECEASED. THIS MEANT RENTING REFRIGERATED TRUCKS, PURCHASING BODY BAGS, AND OTHER NECESSARY ITEMS, IN ADDITION TO HIRING STAFF TO HANDLE THIS WORK. FROM THE BEGINNING OF THE PANDEMIC IN EARLY MARCH THROUGH DECEMBER 31, THE TOTAL NUMBER OF COVID-19 CASES RECORDED IN NYC (ALL FIVE BOROUGHS) IS APPROXIMATELY 625,000, AND THE TOTAL NUMBER OF CONFIRMED DEATHS STAND AT APPROXIMATELY 27,000. THE ADDED PATIENT LOAD AND BED CAPACITY BROUGHT SEVERE STRAIN ON FINANCIAL RESOURCES, ESPECIALLY GIVEN OBHS' FRAIL FINANCIAL STATE PRIOR TO COVID. TWO FACTORS COMPOUNDED THE DEVASTATING IMPACT OF COVID-19 FOR ALL THREE HOSPITALS AND OUR PATIENT POPULATION AND ADDED EXTREME PRESSURE ON ALL ASPECTS OF OPERATIONS. THE FIRST IS THE FACT THAT THE SERVICE AREAS SERVED BY ALL THREE HOSPITALS ARE DENSELY POPULATED; BROOKLYN HAS A POPULATION OF 2.533 MILLION PEOPLE. THE SECOND IS THE FACT THAT OUR PATIENT POPULATION (70% AFRICAN AMERICAN, 20% HISPANIC) IS PLAGUED WITH THE UNDERLYING HEALTH CONDITIONS LIKE OBESITY, HEART DISEASE, HYPERTENSION, ASTHMA AND DIABETES, WHICH, ACCORDING TO THE CDC, WORSEN THE IMPACT OF THE DISEASE, AND GENERALLY LEAD TO VERY POOR OUTCOMES AND AN INCREASED LIKELIHOOD OF DEATH.IN THE AFTERMATH OF THE FIRST COVID-19 SURGE, AND WHILE CURRENTLY DEALING WITH ANOTHER RESURGENCE, OBHS REMAINS IN A STATE OF FLUX. SIMILAR TO OTHER HOSPITALS, OBHS EXPERIENCED A TREMENDOUS DISRUPTION OF BUSINESS AND INCOME LOSS FROM MARCH TO JULY DUE TO THE CANCELING OF REGULAR HOSPITAL BUSINESS (ELECTIVE SURGERIES) THE CLOSURE OF REHAB AND PSYCHIATRY UNITS, AND A CLOSURE OF OUTPATIENT CLINICS. POST COVID-19, PATIENTS REMAIN RELUCTANT TO VISIT OUR HEALTHCARE POINTS OF ACCESS, FEARFUL OF CONTRACTING THE DISEASE, AND ARE DELAYING FOLLOW-UP VISITS AS MUCH POSSIBLE. WHILE OBHS IS DOING ALL IT CAN TO ACHIEVE A SUSTAINABLE LEVEL OF BUSINESS, INCLUDING ADDING TELEHEALTH TECHNOLOGY TO OUR HEALTHCARE MODEL, WE ANTICIPATE THAT IT WILL BE A LONG ROAD AHEAD TO GET BACK TO FINANCIAL STABILITY. ON TOP OF THE DISRUPTION TO ITS REVENUE STREAM, OBHS NOW HAS THE ADDED FINANCIAL BURDEN OF BUDGETING FOR MORE PPE AND OTHER MEDICAL SUPPLIES LIKE PHARMACEUTICAL AND CLEANING SUPPLIES, AND PURCHASING ITEMS THAT ARE SPECIFIC TO CONTROLLING THE COVID INFECTION RATE AMONG STAFF AND PATIENTS I.E. COVID TESTING CAPACITY, SPECIAL PROTECTIVE SHIELDS, FACE SHIELDS, SCREENING EQUIPMENT ETC AS WELL AS MANDATED TESTING OF ALL NURSING HOME PATIENTS AND STAFF ON A WEEKLY BASIS. AND BECAUSE OF THE INCREASED DEMAND FOR THESE SERVICES, THESE ITEMS ARE BEING PURCHASED AT SIGNIFICANTLY HIGHER COSTS. TO HELP ALLEVIATE THE FINANCIAL STRESS EXPERIENCED BY HEALTHCARE FACILITIES IN DEALING WITH THE COVID PANDEMIC, THE FEDERAL GOVERNMENT PASSED THE CORONAVIRUS AID, RELIEF, AND ECONOMIC SECURITY ACT, ALSO KNOWN AS THE CARES ACT. THIS ACT WAS A $2.2 TRILLION ECONOMIC STIMULUS BILL WHICH IN PART PROVIDED FUNDS TO HELP HEALTHCARE FACILITIES DEAL WITH THE NUMEROUS FINANCIAL DIFFICULTIES CAUSED BY THE PANDEMIC. THE DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS) WAS PLACED IN CHARGE OF DISTRIBUTING THESE FUNDS AND HAS ISSUED GUIDANCE AS TO HOW THESE FUNDS CAN BE USED. OBHS RECEIVED APPROXIMATELY $24.3 MILLION AND $185.6 MILLION IN GENERAL AND TARGETED DISTRIBUTIONS, RESPECTIVELY, OF THE PRF FOR A TOTAL OF APPROXIMATELY $209.9 MILLION. PART VI, LINE 3: PER FAP POLICY. PART VI, LINE 4: BASED ON THE RECOMMENDATIONS IN NORTHWELL HEALTH'S "THE BROOKLYN STUDY: RESHAPING THE FUTURE OF HEALTHCARE", IN 2016, BROOKDALE, INTERFAITH AND KINGSBROOK APPLIED FOR AND RECEIVED APPROVAL FROM THE NYS PUBLIC HEALTH AND PLANNING COUNCIL TO ESTABLISH ONE BROOKLYN HEALTH SYSTEM (OBHS), WHICH WILL SERVE AS AN INTEGRATED, CENTRAL HEALTH CARE DELIVERY SYSTEM THAT WILL PRESERVE AND ENHANCE HEALTH CARE SERVICES IN CENTRAL AND NORTHEAST BROOKLYN.1 OBHS MEMBER HOSPITALS HAVE COME TOGETHER TO CREATE THIS COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY SERVICE PLAN; THE COLLABORATING FACILITIES ARE ALL LOCATED IN KINGS COUNTY (BROOKLYN) AND HAVE DEFINED THEIR COMMUNITY ASSESSED AS CENTRAL AND NORTHEASTERN BROOKLYN, DEMARCATED BY SHARED PRIMARY AND SECONDARY NEIGHBORHOODS AND ZIP CODES.SERVICE AREA WAS DETERMINED BASED ON OBHS HOSPITALS' DISCHARGE DATA. PATIENT ORIGIN ZIP CODES WERE RANKED BY FREQUENCY; PRIMARY SERVICE AREA WAS DEFINED USING A CUTOFF OF 50%, I.E. 50% OF PATIENTS CAME FROM THE ZIP CODES COVERED BY THE PRIMARY SERVICE AREA. THE CUT OFFS FOR SECONDARY AND TERTIARY SERVICE AREA WERE 75% AND 85% RESPECTIVELY.THE DATA AND DISCUSSION FOR THE FOLLOWING SECTIONS HAVE BEEN COMPILED FROM THE NEW YORK CITY DEPARTMENT OF HEALTH AND MENTAL HYGIENE (NYC DOHMH) COMMUNITY HEALTH PROFILES 2018.3 THE OBHS PRIMARY AND SECONDARY SERVICE AREA ZIP CODES ARE: 11212, 11207, 11208, 11233, 11236, 11203, 11213, 11216, 11238, 11225, 11226 AND 11221. THESE CORRESPOND TO BROOKLYN'S COMMUNITY DISTRICTS 3, 5, 8, 9, 14, 16, 17 AND 18. THE COMMUNITY HEALTH PROFILES FOR THESE COMMUNITY DISTRICTS WERE USED TO ASSESS THE COMMUNITY HEALTH STATUS AND COMPARE THEM TO BROOKLYN AND NEW YORK CITY OVERALL. PART VI, LINE 5: OBHS HAS A ROBUST COMMUNITY OUTREACH AND ENGAGEMENT AGENDA ACROSS THE HOSPITAL SYSTEM TO ENSURE ACCOUNTABILITY AND PARTNERSHIP OPPORTUNITIES WITH THESE COMMUNITY HEALTH PARTNERS. FOR EXAMPLE, BROOKDALE'S COMMUNITY ADVISORY BOARD IS CHARGED WITH ENSURING THAT THE VOICE OF THE COMMUNITY IS REPRESENTED IN BROOKDALE'S DECISION MAKING PROCESS. STAFF WORK WITH DEPARTMENTS ACROSS BROOKDALE TO COORDINATE COMMUNITY MEETINGS, HEALTH EDUCATION FAIRS, DISEASE PREVENTION AND WELLNESS EVENTS, YOUTH INITIATIVES, AND OTHER ACTIVITIES DESIGNED TO SEEK COMMUNITY INPUT, DISSEMINATE HEALTH INFORMATION ABOUT HEALTH ISSUES AND INITIATIVES, AND INFORM THE COMMUNITY ABOUT TREATMENT AND CARE OPTIONS. SIMILARLY, THE COALITION TO TRANSFORM INTERFAITH CONVENES REGULARLY TO PROVIDE A COMMUNITY FORUM FOR UPDATES ON INTERFAITH'S ONGOING TRANSFORMATION AND SPONSOR OR PUBLICIZE COMMUNITY HEALTH INITIATIVES. AT THESE MONTHLY AND REGULAR MEETINGS, PREVENTION AGENDA PROGRESS AND SUCCESS WILL BE REPORTED ON TO ENABLE FURTHER COMMUNITY COLLABORATION AND ALSO IDENTIFYING MID-COURSE CORRECTIONS OR ENHANCEMENTS TO OBHS' COMMUNITY HEALTH WORK. PART VI, LINE 6: AS MENTIONED EARLIER (PART V QUESTION #5), IN 2018, AT THE RECOMMENDATION OF THE NEW YORK STATE DEPARTMENT OF HEALTH, BROOKDALE AND TWO OTHER AREA SAFETY-NET HOSPITALS (INTERFAITH MEDICAL CENTER (IMC) AND KINGSBROOK JEWISH MEDICAL CENTER (KHMC)) JOINED TOGETHER TO OPERATE UNDER A NEW PARENT ORGANIZATION ONE BROOKLYN HEALTH SYSTEM ("OBHS"). LEGALLY, IMC IS CONSIDERED AN "AFFILIATE" OF OBHS AND THE TWO OTHER HOSPITALS. THIS AFFILIATION IS INTENDED TO ENSURE THAT ALL THREE HOSPITALS GET BACK TO FISCAL STABILITY AND SUSTAINABILITY, TO CONTINUE PROVIDING HEALTHCARE TO THEIR PREDOMINANTLY LOW-INCOME PATIENT POPULATION. THE ESTABLISHMENT OF OBHS IS ALLOWING IMC TO PARTNER WITH ITS AFFILIATE HOSPITALS AND A BROADER ARRAY OF COMMUNITY STAKEHOLDERS TO LEVERAGE RESOURCES AND HEALTHCARE INNOVATIONS THAT WILL IMPROVE HEALTHCARE DELIVERY FOR THE UNDERSERVED COMMUNITIES THAT EACH HOSPITAL HAS BEEN SERVING FOR DECADES. IN 2018, OBHS RECEIVED A $664 MILLION CAPITAL GRANT FROM NEW YORK STATE TO IMPROVE THE CAPITAL INFRASTRUCTURE OF BROOKDALE AND THE TWO OTHER AFFILIATE HOSPITALS. FUNDS WILL BE USED TO PURCHASE MORE TECHNOLOGICALLY ADVANCED EQUIPMENT, RENOVATE AND BUILD NEW FACILITIES THAT WILL SUPPORT BETTER HEALTHCARE DELIVERY. PART VI, LINE 7, REPORTS FILED WITH STATES NY PART VI, LINE 2, ASSESSMENT OF COMMUNITY HEALTH NEEDS CONTINUED: BECAUSE OF THE PANDEMIC AND ITS EFFECTS TO THE CATCHMENT AREA WHICH OBH SERVICES, SEVERAL OF OUR NORMAL OUTREACH PROGRAMS TO THE COMMUNITY WERE EITHER CANCELLED OR SEVERELY CURTAILED. FOR EXAMPLE, DUE TO NEW YORK STATE DEPARTMENT OF HEALTH GUIDANCE, OBH FACILITIES WERE NOT ABLE TO OFFER FREE SCREENINGS TO THE COMMUNITY AS OUR CLINICS WERE CLOSED TO OUTSIDE VISITORS. ONCE THESE PROHIBITIONS WERE LIFTED, OBH STILL EXPERIENCED A SIGNIFICANT DECREASE IN OUR OVERALL BUSINESS SUCH AS ER AND CLINIC VISITS. OBH CONTINUES TO WORK WITH THE LOCAL COMMUNITY AS WELL AS ITS POLITICAL AND RELIGIOUS LEADERS TO REMIND PEOPLE THAT IT IS STILL IMPORTANT FOR THEM TO TAKE ADVANTAGE OF OUR FREE SCREENINGS AND TO NOT DEFER THEIR HEALTHCARE VISITS. WHILE OBH LOOKS TO REESTABLISH OUR FREE SCREENINGS AND OTHER CHARITABLE ENDEAVORS WITHIN THE COMMUNITY IN 2021, WE HAVE WORKED WITH FEMA AND THE NYS DOH TO SET UP A VACCINATION PROGRAM FOR OUR EMPLOYEES AND THE COMMUNITY SO THAT FREE AND READY ACCESS WAS AVAILABLE TO ALL SO THAT WE CAN HELP VACCINATE THE LOCAL POPULATION AND HELP COMBAT THE SPREAD OF COVID. THIS VACCINATION PROGRAM STARTED IN LATE DECEMBER AND CONTINUED INTO 2021. X X 0 0 0 0 0 0 0 0 0 DOMINICK STANZIONE PRESIDENT AND CEO 1191720 0 0 0 3810 0 0 0 20781 0 1216311 0 0 0 WILLIAM WIRCHANSKY DIRECTOR OF NEUROSURGERY 802674 0 0 0 0 0 0 0 31550 0 834224 0 0 0 ROGER KIM NEONATOLOGIST 719626 0 0 0 5539 0 0 0 28560 0 753725 0 0 0 LUCIO FLORIS MD CHIEF OF VASCULAR SURGERY 713517 0 0 0 5134 0 0 0 26529 0 745180 0 0 0 CYRUS O MCCALLA DIRECTOR, OBS/GYN 678143 0 0 0 3701 0 0 0 33834 0 715678 0 0 0 DR DAVID ROSE CHIEF MEDICAL OFFICER 658287 0 0 0 6180 0 0 0 18031 0 682498 0 0 0 ROBERT PALERMO CHIEF FINANCIAL OFFICER 620567 0 0 0 2322 0 0 0 42892 0 665781 0 0 0 ANTHONY TORTOLANI MD CHAIRPERSON, MD 625334 0 0 0 2567 0 0 0 24190 0 652091 0 0 0 DR GARY STEPHENS CHIEF OF ACADEMIC AFFAIRS 482011 106564 0 0 2143 516 0 0 3318 990 487472 108070 0 0 CHARLES SALVO SR. VICE PRESIDENT PHYSICIAN PRACTIC 537650 0 0 0 810 0 0 0 34492 0 572952 0 0 0 REGINALD BULLOCK ASSISTANT SECRETARY 392692 0 0 0 1739 0 0 0 35126 0 429557 0 0 0 GENEVIEVE SORENSEN VICE PRESIDENT 346959 0 0 0 3564 0 0 0 6358 0 356881 0 0 0 WILLIAM BIFULCO SR. VP CLINICAL ADMINISTRATION 303195 0 0 0 558 0 0 0 40672 0 344425 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 ONE BROOKLYN HEALTH SYSTEM, INC., A NEW YORK NOT-FOR-PROFIT ORGANIZATION, IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A ONE BROOKLYN HEALTH SYSTEM, INC., AS SOLE MEMBER OF THE ORGANIZATION, HAS THE AUTHORITY TO APPOINT AND REMOVE THE TRUSTEES OF THE ORGANIZATION, AND OTHER AUTHORITIES AS DEFINED IN THE BYLAWS OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 AND APPROPRIATE SCHEDULES, AS REQUIRED, IS PREPARED BY OUTSIDE ACCOUNTANTS AND REVIEWED INTERNALLY BY MANAGEMENT AND COUNSEL, AT WHICH TIME IT IS CONSIDERED THE FINAL DRAFT. THE FINAL DRAFT OF THE FORM 990 IS MADE AVAILABLE TO THE BOARD PRIOR TO IT BEING FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C DISCLOSURE IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY BY EMPLOYEES AND BOARD MEMBERS THAT SATISIFY THE CRITERIA TO BE CONSIDERED "INTERESTED PERSONS' IS SUBMITTED UPON HIRING AND ANNUALLY THEREAFTER. THE AUDIT AND COMPLIANCE COMITTEE REVIEWS THE SUBMISSIONS FOR CONFLICTS AND THE OFFICE OF THE COMPLIANCE OFFICER MANAGES THE PROCESS. FORM 990, PART VI, SECTION B, LINE 15 THE HOSPITAL'S BYLAWS PROHIBIT TRUSTEES FROM RECEIVING ANY COMPENSATION FOR SERVICES PERFORMED IN THEIR CAPACITY AS A TRUSTEE. ALSO PURSUANT TO THE HOSPITAL'S BYLAWS A TRUSTEE SERVING IN ANOTHER CAPACITY MAY RECEIVE REASONABLE COMPENSATION, THEREFORE, AS AUTHORIZED BY THE BOARD OF TRUSTEES. IT IS THE HOSPITAL'S PRACTICE TO TARGET TOTAL EXECUTIVE COMPENSATION (BASE SALARY, INCENTIVE COMPENSATION AND BENEFITS) AS THE MEDIAN OF THE RELEVANT MARKETPLACE FOR SIMILARLY SITUATED EXECUTIVES, WITH APPROPRIATE ADJUSTMENTS FOR SPECIAL SKILL, EXPERIENCE, COMPETENCE, AND PERFORMANCE. THE BOARD OF TRUSTEES HAS AN EXECUTIVE COMPENSATION COMMITTEE THAT REVIEWED THE COMPENSATION OF CERTAIN OFFICERS IN 2017. FORM 990, PART VI, SECTION C, LINE 19 THE DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST -11,236,048. TRANSFER FROM AFFILIATE -46,405,785. COMPONENT OF PENSION COST 501,756. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PART VII, SECTION A: IN 2020, THERE WAS A TRANISITION OF THIS OUTSOURCED CHIEF FINANCIAL MANAGEMENT POSITION FROM TONEYKORF TO A HIRED EMPLOYED CHIEF FINANCIAL OFFICER. ALL COMPENSATION PAID IN CONNECTION WITH THE ABOVE SERVICES WERE PAID DIRECTLY TO TONEYKORF PARTNERS, LLC, RESPECTIVELY, BY THE BROOKDALE HOSPITAL MEDICAL CENTER, A RELATED ENTITY OF THE ORGANIZATION. 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