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KINGSBROOK HEALTHCARE FOUNDATION INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
KINGSBROOK HEALTHCARE FOUNDATION INC (EIN 11-2845058)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-11-13
IRS object ID
201933179349303043
Schema version
2018v3.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2019-11-13T10:58:44-06:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN420174325PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1RSM US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14 TIMES SQUAREAddressLine1Txt
CityNEW YORKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10036ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN112845058EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1KINGSBROOK HEALTHCARE FOUNDATION INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlKINGBusinessNameControlTxt
Phone7186045532PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1585 SCHENECTADY AVENUEAddressLine1Txt
CityBROOKLYNCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11203ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOHN SCHMITTPersonNm
Person TitleCFOPersonTitleTxt
Phone7186045532PhoneNum
Signature2019-11-12SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTAMAR PLOTZKERPreparerPersonNm
PTINP02047230PTIN
Phone2123721000PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address100.1.193.187IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-11-12IPDt
IP Tm12:38:54IPTm
IP TimezoneESIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device Id1101CBF66FFAA2599057FE7F4407BFB8CB39BD08AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-04-17 16:48:07ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerLINDA BRADY MDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1585 SCHENECTADY AVENUEAddressLine1Txt
CityBROOKLYNCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11203ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$209,386GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1987FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionKINGSBROOK HEALTHCARE FOUNDATION, INC. FUNCTIONS AS THE CHARITABLE AND EDUCATIONAL ARM OF THE KINGSBROOK JEWISH MEDICAL CENTER AND RUTLAND NURSING HOME.ActivityOrMissionDesc
Voting Members Governing Body2VotingMembersGoverningBodyCnt
Voting Members Independent1VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers1TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$268,789PYContributionsGrantsAmt
CY Contributions Grants$186,700CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$1,370PYInvestmentIncomeAmt
CY Investment Income$845CYInvestmentIncomeAmt
PY Other Revenue-$79,510PYOtherRevenueAmt
CY Other Revenue-$38,904CYOtherRevenueAmt
PY Total Revenue$190,649PYTotalRevenueAmt
CY Total Revenue$148,641CYTotalRevenueAmt
PY Grants And Similar Paid$1,034,000PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$1,128,000CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$6,773PYOtherExpensesAmt
CY Other Expenses$3,814CYOtherExpensesAmt
PY Total Expenses$1,040,773PYTotalExpensesAmt
CY Total Expenses$1,131,814CYTotalExpensesAmt
PY Revenues Less Expenses-$850,124PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$983,173CYRevenuesLessExpensesAmt
Total Assets BOY$1,278,046TotalAssetsBOYAmt
Total Assets EOY$231,873TotalAssetsEOYAmt
Total Liabilities BOY$63,000TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,215,046NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$231,873NetAssetsOrFundBalancesEOYAmt
MissionKINGSBROOK HEALTHCARE FOUNDATION, INC. FUNCTIONS AS THE CHARITABLE AND EDUCATIONAL ARM OF THE KINGSBROOK JEWISH MEDICAL CENTER AND RUTLAND NURSING HOME.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$1,128,000ExpenseAmt
Grant$1,128,000GrantAmt
DescKINGSBROOK HEALTHCARE FOUNDATION, INC. FUNCTIONS AS THE CHARITABLE AND EDUCATIONAL ARM OF THE KINGSBROOK JEWISH MEDICAL CENTER AND RUTLAND NURSING HOME.Desc
Total Program Service Expenses$1,128,000TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo ContributionsYes (1)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (1)QuidProQuoContriDisclInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members2GoverningBodyVotingMembersCnt
Independent Voting Member1IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of Committees0MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy0ConflictOfInterestPolicyInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JOHN SCHMITTBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7186045532PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1585 SCHENECTADY AVENUEAddressLine1Txt
CityBROOKLYNCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11203ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (3 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
HENNA WHITE
BOARD CHAIR0.501.00Yes (X)Yes (X)$0$0$0
LINDA BRADY MD
PRESIDENT & BOARD DIRECTOR0.50Yes (X)Yes (X)$0$1,128,371$37,417
JOHN SCHMITT
ASSISTANT TREASURER & CFO0.5048.10Yes (X)$0$389,930$61,416
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,518,301TotReportableCompRltdOrgAmt
Total Other Compensation$98,833TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Fundraising$186,700FundraisingAmt
Total Contributions$186,700TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$845TotalRevenueColumnAmt
Exclusion$845ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$21,841FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$186,700ContriRptFundraisingEventAmt
Fundraising Direct Expenses$60,745FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$38,904TotalRevenueColumnAmt
Exclusion-$38,904ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$148,641TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion-$38,059ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$1,128,000TotalAmt
Program Services$1,128,000ProgramServicesAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescBANK FEES AND CHARGESDesc
Total$3,814TotalAmt
Management And General$3,814ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,131,814TotalAmt
Program Services$1,128,000ProgramServicesAmt
Management And General$3,814ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,250,972BOYAmt
EOY$205,051EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$27,074BOYAmt
EOY$26,822EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,278,046BOYAmt
EOY$231,873EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$63,000BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$63,000BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,215,046BOYAmt
EOY$231,873EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,215,046BOYAmt
EOY$231,873EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,278,046BOYAmt
EOY$231,873EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$983,173ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
Supported Organizations2SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp (2 entries)

EINEINOrganization TypeOrganizationTypeCdGoverning Document ListedGoverningDocumentListedIndSupportSupportAmtOther SupportOtherSupportAmt
KINGSBROOK JEWISH MEDICAL CENTER
1116317593Yes (1)$1,128,000$0
RUTLAND NURSING HOME INC
11216467410Yes (1)$0$0
FieldValueIRS element (for citing)
Supported Organizations Total2SupportedOrganizationsTotalCnt
Support Sum$1,128,000SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (1)ListedByNameGoverningDocInd
Suprt Org No IRS Determination0SuprtOrgNoIRSDeterminationInd
Supported Org Section C4560SupportedOrgSectionC456Ind
Supported Org Not Organized US0SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org0OrganizationChangeSuprtOrgInd
Support Non Supported Org0SupportNonSupportedOrgInd
Payment Substantial Contribtr0PaymentSubstantialContribtrInd
Loan Disqualified Person0LoanDisqualifiedPersonInd
Controlled Disqualified Prsn0ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int0DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int0DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules0ExcessBusinessHoldingsRulesInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

FieldValueIRS element (for citing)
Power Appoint Majority Dir TrstYes (1)PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt Org0OperateBenefitNonSuprtOrgInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationCONSOLIDATED FOOTNOTE: THE COMPANY IS EXEMPT FROM INCOME TAXES UNDER SECTIONS 501(C)(3) AND 509(A)(3) OF THE INTERNAL REVENUE CODE (THE CODE). ADDITIONALLY, THE COMPANY, AS A NONPROFIT ENTITY, IS SUBJECT TO UNRELATED BUSINESS INCOME TAX (UBIT), IF APPLICABLE. FOR THE TAX YEAR ENDED DECEMBER 31, 2018, THE COMPANY WAS SUBJECT TO UBIT OF APPROXIMATELY $81 RELATED TO FRINGE BENEFITS PROVIDED TO EMPLOYEES. MANAGEMENT EVALUATED THE COMPANY'S TAX POSITIONS FOR ALL OPEN TAX YEARS AND HAS CONCLUDED THAT THE COMPANY HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES. GENERALLY, THE COMPANY IS SUBJECT TO U.S. FEDERAL AND STATE EXAMINATIONS BY TAX AUTHORITIES FOR FISCAL YEARS ENDED DECEMBER 31, 2016, AND THEREAFTER. PER THE REQUIREMENT TO ASSESS FOR TAX UNCERTAINTY, MANAGEMENT HAS DETERMINED THAT IT DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS REQUIRED TO BE REPORTED.ExplanationTxt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GOLF OUTINGEvent1Nm
Gross Receipts Event1$208,541GrossReceiptsEvent1Amt
Charitable Contri Event1$186,700CharitableContriEvent1Amt
Gross Revenue Event1$21,841GrossRevenueEvent1Amt
Rent Facility Costs Event1$47,693RentFacilityCostsEvent1Amt
Food And Beverage Event1$2,800FoodAndBeverageEvent1Amt
Other Direct Expenses Event1$10,252OtherDirectExpensesEvent1Amt
Gross Receipts Total$208,541GrossReceiptsTotalAmt
Charitable Contributions Tot$186,700CharitableContributionsTotAmt
Gross Revenue Total Events$21,841GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events$47,693RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$2,800FoodAndBeverageTotalEventsAmt
Oth Direct Expnss Total Events$10,252OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$60,745DirectExpenseSummaryEventsAmt
Net Income Summary-$38,904NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1KINGSBROOK JEWISH MEDICAL CENTERBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1585 SCHENECTADY AVENUEAddressLine1Txt
CityBROOKLYNCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11203ZIPCd
FieldValueIRS element (for citing)
Recipient EIN111631759RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$1,128,000CashGrantAmt
Purpose Of GrantTO SUPPORT CAPITAL PROJECTSPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationALL FUNDING PROVIDED BY THE FOUNDATION IS USED FOR THE SOLE SUPPORT OF KINGSBROOK JEWISH MEDICAL CENTER (KJMC) AND IS MONITORED BY THE DEVELOPMENT AND FINANCE DEPARTMENTS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
LINDA BRADY MD
PRESIDENT & BOARD DIRECTOR$0$1,128,285$0$0$0$86$0$0$0$37,417$0$1,165,788$0$0
JOHN SCHMITT
ASSISTANT TREASURER & CFO$0$376,578$0$0$0$13,352$0$24,000$0$37,416$0$451,346$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6MEMBERS OF THE ORGANIZATION: KINGSBROOK HEALTHCARE SYSTEM, INC. ("KHS") IS THE SOLE MEMBER OF KINGSBROOK HEALTHCARE FOUNDATION, INC.
FORM 990, PART VI, SECTION A, LINE 7AELECTION OF THE GOVERNING BODY: MEMBERS MAY ELECT AND APPOINT MEMBERS OF THE GOVERNING BODY AND BOARD OFFICERS OF THE CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7BDECISIONS OF THE GOVERNING BODY: KHS IS THE SOLE MEMBER OF KINGSBROOK HEALTHCARE FOUNDATION, INC. AND IT HAS RESERVED POWERS THAT ARE DELINEATED IN THE BYLAWS OF KINGSBROOK HEALTHCARE FOUNDATION, INC.
FORM 990, PART VI, SECTION A, LINE 8BKINGSBROOK HEALTHCARE FOUNDATION, INC. HAS NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 11BREVIEW PROCESS: THE CFO HAS CONDUCTED A REVIEW OF THE 990 WITH THE HOSPITAL'S TAX ACCOUNTANT AND ALL APPROPRIATE CHANGES HAVE BEEN MADE. DRAFT RETURNS WERE THEN PROVIDED TO THE BOARD MEMBERS OF THE FINANCE AUDIT AND COMPLIANCE COMMITTEE (FACC) FOR THEIR REVIEW FOR ANY ADDITIONAL COMMENTARY, OBSERVATIONS, OR RECOMMENDATIONS.
FORM 990, PART VI, SECTION B, LINE 12CONFLICT OF INTEREST POLICY: KINGSBROOK HEALTHCARE FOUNDATION, INC. FOLLOWS KINGSBROOK JEWISH MEDICAL CENTER'S CONFLICT OF INTEREST POLICY. AT KINGSBROOK JEWISH MEDICAL CENTER, ALL CONFLICTS OF INTEREST ARE REVIEWED BY THE COMPLIANCE OFFICER. ANY POTENTIAL CONFLICTS INVOLVING BOARD MEMBERS ARE REFERRED TO THE AUDIT AND COMPLIANCE COMMITTEE FOR REVIEW AND/OR ACTION, AS NECESSARY.
FORM 990, PART VI, SECTION B, LINE 15COMPENSATION REVIEW AND APPROVAL PROCESS: KINGSBROOK HEALTHCARE FOUNDATION, INC. DID NOT PAY COMPENSATION DIRECTLY FOR ITS EMPLOYEES. THE COMPENSATION AND BENEFITS ARE PAID THROUGH KINGSBROOK JEWISH MEDICAL CENTER'S PAYROLL SYSTEM AND ARE RECORDED ON THE FORM 941 FILED BY KINGSBROOK JEWISH MEDICAL CENTER UNDER THE EMPLOYER IDENTIFICATION NUMBER 11-1631759. THE COMPENSATION OF THE EXECUTIVE OFFICERS IS REVIEWED ANNUALLY BY KINGSBROOK JEWISH MEDICAL CENTER (KJMC). FOLLOWING BELOW PROCESS: CONSISTENT WITH BEST PRACTICES IN GOVERNANCE AND FIDUCIARY OVERSIGHT OF TAX-EXEMPT FUNDS, KINGSBROOK JEWISH MEDICAL CENTER (KJMC) HAS INSTITUTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY AND COMPENSATION COMMITTEE CHARTER. THE COMPENSATION COMMITTEE IS AUTHORIZED BY THE BOARD TO DEVELOP AND RECOMMEND FOR BOARD APPROVAL THE COMPENSATION OF THE PRESIDENT AND CEO AND MEMBERS OF SENIOR MANAGEMENT (SENIOR VICE PRESIDENTS, VICE PRESIDENTS AND ASSISTANT VICE PRESIDENTS). ONLY INDEPENDENT MEMBERS OF THE BOARD SHALL PARTICIPATE IN COMPENSATION DELIBERATIONS AND DECISIONS (I.E., EMPLOYEES, MEMBERS OF THE MEDICAL STAFF AND CONSULTANTS ARE NOT DEEMED INDEPENDENT FOR THESE PURPOSES). ALL EXECUTIVE COMPENSATION DECISIONS ARE BASED ON COMPETITIVE MARKET DATA, ORGANIZATIONAL AND INDIVIDUAL PERFORMANCE RESULTS, AND ALIGNMENT WITH KJMC'S EXECUTIVE COMPENSATION PHILOSOPHY. THE BOARD'S COMPENSATION COMMITTEE REVIEWS AND APPROVES ALL EXECUTIVE COMPENSATION TO ENDURE LEGAL AND REGULATORY COMPLIANCE AND ADHERENCE TO GOVERNANCE BEST PRACTICES AND PROPER FIDUCIARY OVERSIGHT AS STEWARDS OF TAX EXEMPT ASSETS. THE EXECUTIVE COMPENSATION PHILOSOPHY STATES ITS INTENT IS TO MAINTAIN A COMPETITIVE EXECUTIVE COMPENSATION PROGRAM IN ORDER TO ATTRACT, RETAIN AND MOTIVATE QUALIFIED EMPLOYEES TO SUPPORT THE MISSION AND BUSINESS GOALS OF KJMC. THE COMPENSATION COMMITTEE RETAINS OUTSIDE LEGAL COUNSEL WHO REVIEWS COMPLIANCE WITH TAX AND REGULATORY REQUIREMENTS AS WELL AS THE SERVICES OF AN INDEPENDENT QUALIFIED COMPENSATION CONSULTANT WHO COMPILES AND ANALYZES PUBLISHED SURVEY-DATA FOR BASE SALARIES AND TOTAL COMPENSATION PROVIDED BY TAX EXEMPT HOSPITALS AND MEDICAL CENTERS SIMILAR TO KJMC IN SIZE, OPERATIONS AND LOCATION. THE COMMITTEE'S REVIEW OF COMPENSATION OCCURS ANNUALLY SUCH THAT EXECUTIVE COMPENSATION AND BENEFITS CONTINUE TO BE COMPETITIVE AND REASONABLE BY FOLLOWING THE PRECEDING GOVERNANCE AND FIDUCIARY PRACTICES, THE COMMITTEE QUALIFIES FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERMEDIATE SANCTIONS REGULATIONS OF THE INTERNAL REVENUE CODE SUCH THAT THE TOTAL COMPENSATION PROVIDED TO THE EXECUTIVES IS COMPARED TO WHAT IS ORDINARILY PAID FOR LIKE SERVICES BY LIKE ENTERPRISES UNDER LIKE CIRCUMSTANCES," AS DEFINED IN THE INTERMEDIATE SANCTIONS REGULATIONS. BASE PAY FOR EACH EXECUTIVE IS BASED ON FACTORS INCLUDING MARKET DATA, TENURE, EXPERIENCE, AND INDIVIDUAL AND ORGANIZATIONAL PERFORMANCE. EXECUTIVE BASE PAY IS REVIEWED AND SET ANNUALLY BY THE INDEPENDENT MEMBERS OF THE COMPENSATION COMMITTEE OF THE INDEPENDENT DIRECTORS OF KINGSBROOK JEWISH MEDICAL CENTER (KJMC), BASED ON THE EXECUTIVE COMPENSATION PHILOSOPHY AND COMPENSATION COMMITTEE CHARTER. AS DESCRIBED IN KJMC'S EXECUTIVE COMPENSATION PHILOSOPHY AND COMPENSATION COMMITTEE CHARTER, KJMC SUPPORTS PERFORMANCE BASED COMPENSATION AND THEREFORE HAS IMPLEMENTED AN ANNUAL INCENTIVE PAY PROGRAM (EXECUTIVE MANAGEMENT ANNUAL INCENTIVE PLAN) FOR THE EXECUTIVES, WHICH IS CURRENTLY SUSPENDED, AND A LONG-TERM INCENTIVE PAY PROGRAM (ANNUALIZED STRATEGIC PERFORMANCE INCENTIVE) FOR THE PRESIDENT AND CEO. THE ANNUAL AND LONG-TERM INCENTIVE PAY PROGRAMS ARE DESIGNED TO SUPPORT THE ATTAINMENT OF ANNUAL AND STRATEGIC PERFORMANCE OBJECTIVES AND REFLECT A COMBINATION OF FORMULAIC WEIGHTINGS PROVIDING FOR THRESHOLD, TARGET AND MAXIMUM BONUS LEVELS AND DISCRETIONARY JUDGMENT AS DETERMINED BY THE COMPENSATION COMMITTEE. THE PERFORMANCE MEASURES ARE SET PRIOR TO THE BEGINNING OF EACH PLAN YEAR AND PLAN PAYMENTS ARE DETERMINED BASED ON AUDITED FINANCIAL RESULTS AND OTHER MEASURES. THE PROCESS USED FOR DETERMINING THE COMPENSATION OF THE CEO ALSO APPLIES TO MEMBERS OF THE EXECUTIVE STAFF, DEPARTMENT CHAIRS AND OTHER HIGHLY COMPENSATED STAFF EXCEPT THAT THE PRESIDENT AND CEO MAKES COMPENSATION RECOMMENDATIONS TO THE COMPENSATION SUBCOMMITTEE FOR THOSE EMPLOYEES.
FORM 990, PART VI, SECTION C, LINE 19DOCUMENTS AVAILABLE FOR PUBLIC INSPECTION: THE ORGANIZATION MAKES ITS FORM 1023 AND FORM 990 AVAILABLE UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D).
FORM 990, PART VI, LINE 13WHISTLEBLOWER POLICY: KINGSBROOK JEWISH MEDICAL CENTER HAS A WRITTEN WHISTLEBLOWER POLICY WHICH APPLIES TO THE ACTIVITIES OF KINGSBROOK HEALTHCARE FOUNDATION, INC.
FORM 990, PART VI, LINE 14DOCUMENT RETENTION POLICY: KINGSBROOK JEWISH MEDICAL CENTER'S DOCUMENT RETENTION AND DESTRUCTION POLICY APPLIES TO ALL BOOKS AND RECORDS HELD BY KINGSBROOK HEALTHCARE FOUNDATION, INC.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
KINGSBROOK JEWISH MEDICAL CENTER (KJMC)
585 SCHENECTADY AVENUEBROOKLYNNY11203111631759HOSPITALNY501(C)(3)LINE 3ONE BROOKLYN HEALTH SYSTEM INC0
KINGSBROOK JEWISH MEDICAL CENTER AUXILIARIES
585 SCHENECTADY AVENUEBROOKLYNNY11203113016121SUPPORT ORGNY501(C)(3)LINE 12A, IKJMC0
KINGSBROOK HEALTHCARE SYSTEM INC (KHS)
585 SCHENECTADY AVENUEBROOKLYNNY11203030464734SUPPORT ORGNY501(C)(3)LINE 12A, I0N/A
RUTLAND NURSING HOME INC
585 SCHENECTADY AVENUEBROOKLYNNY11203112164674NURSING HOMENY501(C)(3)LINE 10ONE BROOKLYN HEALTH SYSTEM INC0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
KSI INC
585 SCHENECTADY AVENUEBROOKLYNNY11203562327654INACTIVENYONE BROOKLYN HEALTH SYSTEM INCC0
SINGULAB INC
585 SCHENECTADY AVENUEBROOKLYNNY11203562327669INACTIVEDEKSI INCC0
ATM NURSE REGISTRY
585 SCHENECTADY AVENUEBROOKLYNNY11203562327649INACTIVENYKSI INC0
KINGSBROOK LTACH INC
585 SCHENECTADY AVENUEBROOKLYNNY11203800712226INACTIVENYONE BROOKLYN HEALTH SYSTEM INCC0
KINGSBROOK MEDICAL ASSOCIATES PC
585 SCHENECTADY AVENUEBROOKLYNNY11203452351859BILLING & COLLECTIONNYC0N/A
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd