2018-11-12T14:24:51-06:00 2017-12-31 ERNST & YOUNG US LLP 5 TIMES SQUARE NEW YORK NY 10036 990 2017-01-01 131624135 NEW YORK SOCIETY FOR THE RELIEF OF THE RUPTURED AND CRIPPLED MAINTAINING THE % MARC GOULD NEWY 2126061000 535 EAST 70TH ST STREET NEW YORK NY 10021 MARC GOULD SVP & CAO 2126061000 2018-11-12 Laura Kielczewski P00740769 2127733000 2018-11-06 75.23.198.254 26308520183165000028 2018-11-12 P 582F47EFACDD6166E52205D1FBFEA2601660FA18 792E0AAC5A27EF8E692221D1D01611EA294E7B56 2017 2019-02-21 02:37:17Z HOSPITAL FOR SPECIAL SURGERY LOUIS SHAPIRO 535 EAST 70TH STREET NEW YORK NY 10021 1319008659 false X www.hss.edu X 1863 NY PROVIDE THE HIGHEST QUALITY PATIENT CARE, IMPROVE MOBILITY, & ENHANCE THE QUALITY OF LIFE FOR ALL, & ADVANCE THE SCIENCE OF ORTHOPEDIC SURG, RHEUMATOLOGY, & THEIR RELATED DISCIPLINES. 49 41 5942 425 495879 -86349 57154844 49923152 982833902 1067053518 10292670 12889317 39946294 39255620 1090227710 1169121607 443950 157500 0 0 573775481 627351327 0 0 0 455154864 483442763 1029374295 1110951590 60853415 58170017 1540915447 1652402940 667722953 691016319 873192494 961386621 THE MISSION OF HOSPITAL FOR SPECIAL SURGERY IS TO PROVIDE THE HIGHEST QUALITY PATIENT CARE, IMPROVE MOBILITY, AND ENHANCE THE QUALITY OF LIFE FOR ALL AND TO ADVANCE THE SCIENCE OF ORTHOPEDIC SURGERY, RHEUMATOLOGY, AND THEIR RELATED DISCIPLINES THROUGH RESEARCH AND EDUCATION. WE DO THIS REGARDLESS OF RACE, COLOR, CREED, SEXUAL ORIENTATION, OR ETHNIC ORIGIN. false false 841031137 157500 1062445349 PATIENT CARE: HOSPITAL FOR SPECIAL SURGERY IS COMMITTED TO PROVIDING WORLD-CLASS CARE TO ITS PATIENTS AND HELPING THEM TO REGAIN THEIR MOBILITY, WHILE ALSO ADVANCING RESEARCH INITIATIVES TO EXPLORE AND IMPROVE TREATMENTS FOR ORTHOPEDIC AND RHEUMATOLOGIC CONDITIONS. HOSPITAL FOR SPECIAL SURGERY OPERATED 215 AND 209 STAFFED BEDS AS OF DECEMBER 31, 2017 AND DECEMBER 31, 2016; AND 39 AND 36 OPERATING ROOMS AS OF DECEMBER 31, 2017 AND DECEMBER 31, 2016. WE PERFORMED 31,824 SURGERIES, AN INCREASE OF 939 OVER THE PRIOR YEAR, WHILE NON-SURGICAL OUTPATIENT VISITS NUMBERED 413,837, 17,343 MORE THAN 2016. HOSPITAL FOR SPECIAL SURGERY PROVIDED INPATIENT CARE TO 16,303 PATIENTS, 511 MORE THAN 2016. OF THOSE IN 2017, 16,037 WERE SURGICAL. TOTAL AMBULATORY SURGICAL CASES NUMBERED 15,787, A INCREASE OF 405 FROM 2016. THE HOSPITAL HAS A DIVERSE PATIENT POPULATION SERVING THOSE WITH PUBLIC INSURANCE (MEDICARE AND MEDICAID), PRIVATE INSURANCE (VARIOUS PAYORS) AND THE UNINSURED. THE HOSPITAL MAINTAINS A FINANCIAL ASSISTANCE PROGRAM TO ASSIST THOSE THAT CANNOT PAY FOR ITS SERVICES AND PROVIDES NUMEROUS OTHER COMMUNITY BENEFIT PROGRAMS. HOSPITAL FOR SPECIAL SURGERY IS ALSO RECOGNIZED AS A MAGNET HOSPITAL FOR EXCELLENCE IN NURSING CARE. THE HOSPITAL IS RECOGNIZED FOR ITS EXCELLENCE IN PATIENT CARE AND IS CONSISTENTLY RANKED BY U.S. NEWS AND WORLD REPORT IN ITS SPECIALTIES. 42170798 0 35524251 RESEARCH: THE RESEARCH DIVISION OF HOSPITAL FOR SPECIAL SURGERY CONTINUED ITS ACTIVITIES IN 2017 TOWARD ENHANCING AND EXPANDING OUR RESEARCH IN MUSCULOSKELETAL DISEASES. RESEARCH AT HOSPITAL FOR SPECIAL SURGERY WORKS TO ADVANCE THE UNDERSTANDING AND TREATMENT OF MUSCULOSKELETAL DISORDERS THROUGH BASIC, TRANSLATIONAL AND CLINICAL RESEARCH AND EDUCATION. THE GOALS ARE TO IDENTIFY GENETIC, ENVIRONMENTAL, CELLULAR, STRUCTURAL AND MOLECULAR MECHANISMS UNDERLYING DISORDERS IMPORTANT IN ORTHOPEDICS, RHEUMATOLOGY AND RELATED DISCIPLINES AND TO DISCOVER EFFECTIVE APPROACHES FOR DIAGNOSIS PREVENTION, AND TREATMENT OF THESE DISORDERS. THE RESEARCH DIVISION IS FUNDED BY AN OPERATING BUDGET OF $42.0 MILLION, SUPPORTED IN PART BY APPROXIMATELY $35.5 MILLION IN EXTRAMURAL FUNDS, INCLUDING $10.2 MILLION FROM FEDERAL GRANTS. THIS RESEARCH RESULTED IN NEARLY 830 PUBLICATIONS FROM 93 SCIENTISTS IN 2017. HIGHLIGHTS FOR 2017 INCLUDE: ADVANCING HSS RESEARCH STRATEGIC PLAN WITH INVESTMENTS IN: 1)SUPPORTING FACULTY WHO REMAIN EXPOSED TO FUNDING UNCERTAINTIES; 2)MENTORING THE NEXT GENERATION OF SCIENTISTS, 3)SUPPORTING THE HSS HEALTHCARE RESEARCH INSTITUTE AND ITS SUPPORT OF OUR PATIENT REGISTRIES AND OUTCOMES RESEARCH, 4)CONTINUED INITIATIVES TO RETAIN OUR MOST PRODUCTIVE FACULTY, 5)CONTINUED INVESTMENT AND EXPANSION OF THE PRECISION MEDICINE INITIATIVE WHICH IS DESIGNED TO IDENTIFY MOLECULES THAT DRIVE DISEASE IN INDIVIDUAL PATIENTS THAT WILL ALLOW US TO CUSTOMIZE TREATMENTS TO TARGET MOLECULAR DRIVERS IN EACH INDIVIDUAL, AND; THE RECRUITMENT OF A TRANSLATIONAL AND CLINICAL RESEARCHERS TO SUPPORT AND ADVANCE THE EXISTING RESEARCH ACTIVITIES OF OUR CLINICIANS AND SURGEONS. 38050599 6982751 EDUCATION INSTITUTE: THE HOSPITAL FOR SPECIAL SURGERY EDUCATION INSTITUTE CONTINUED TO MAKE STRIDES TOWARDS THE MISSION TO BE "THE MOST TRUSTED EDUCATOR" IN THE FIELD OF MUSCULOSKELETAL MEDICINE FOR PATIENTS, PHYSICIANS, ALLIED HEALTH PROFESSIONALS AND THE GENERAL PUBLIC. IN 2017 WE STRENGTHENED STRATEGIC PARTNERSHIPS WITH OUR 26 EDUCATION AND ACADEMIC AFFAIRS ADVISORY COMMITTEES AND INSTITUTIONAL PARTNERS, AS WELL AS FURTHERING EXTERNAL COMMUNITY RELATIONS GLOBALLY. THE HOSPITAL'S EDUCATION & ACADEMIC AFFAIRS DIVISION TRAINED 47 RESIDENTS, 73 FELLOWS, AND 520 MEDICAL STUDENTS AND TRAINEES WHO SPEND PART OF THE YEAR AT HSS. IN ADDITION, HSS RESIDENCY PROGRAM WAS TOP RANKED FOR THE THIRD STRAIGHT YEAR BY PHYSICIAN NETWORK DOXIMITY IN BOTH REPUTATION AND RESEARCH OUTPUT. IN 2017, WE ENGAGED OVER 99,000 PARTICIPANTS THROUGH CUTTING EDGE EDUCATION PROGRAMS, INCLUDING OUR HSS E-ACADEMY (THE HOSPITAL'S DIGITAL PROFESSIONAL EDUCATION PLATFORM), ACGME PROGRAMS, CME ACCREDITED ACTIVITIES, BIOSKILLS EDUCATION LABORATORY SESSIONS, INTERNATIONAL LEARNING AND TRAINING CENTER INITIATIVES, KIM BARRETT MEMORIAL MEDICAL LIBRARY USERS, AND PUBLIC AND PATIENT EDUCATION PROGRAMS. WE CONTINUE TO SET THE HIGHEST STANDARD WITH OUR ACGME ACCREDITED AND NON-ACCREDITED PROFESSIONAL EDUCATION PROGRAMS. ALMOST 60 ONSITE AND LIVE STREAMING PROGRAMS, WEBINARS, GRAND ROUNDS AND CME-APPROVED HSS JOURNAL ARTICLES WERE OFFERED THROUGHOUT THE YEAR. MORE THAN 600 PROFESSIONAL EDUCATION MODULES WERE PROVIDED THROUGH ON-DEMAND FORMAT VIA HSS E-ACADEMY. 921252534 true true false true false false false false false true true true false true true false false true false true true false false false false false true true true false true true false false false false false false false false false true true false false false false true true true false false true 353 0 true 5942 true true true true EI VI CJ false false false false false false false false X 49 41 false false false false true true true true true false false true true true true true true true true true true AK CO FL GA HI IL KS KY MD MA MI MN MS NH NJ NM NY NC ND OK OR PA SC TN UT WA WI X MARC GOULD 2126061323 535 EAST 70TH STREET NEW YORK NY 10021 Todd Albert Member/Surgeon-in-Chief 50.93 1.27 X X 1603159 0 59783 Mary Crow Member/Physician-in-Chief 59.23 0.77 X 899742 1000 39382 Charles Cornell - Left 2017 Member/Attending Physician 46.12 3.88 X 1444977 109262 68857 Steven Haas Member/Attending Physician 14.07 0.4 X 123088 0 42549 Lionel Ivashkiv Member/Chief Scientific Offic. 60.0 0.0 X 747344 0 54523 Bryan Kelly - Left 2017 Member/Attending Physician 28.97 1.17 X 126230 1000 43059 Michael Parks - Start 2017 Member/Attending Physician 9.9 0.77 X 154423 1000 25511 Joel Press - Start 2017 Member/Physiatrist-in-Chief 14.72 0.4 X 817379 0 62536 Thomas Sculco Member/Attending Physician 17.46 0.4 X 71166 0 42008 James M Benson Member 0.37 0.06 X 0 0 0 Daniel C Benton Member 0.43 0.06 X 0 0 0 Herbert Black Member 0.37 0.06 X 0 0 0 Michael Brooks Member 1.61 0.28 X 0 0 0 Kathryn Chenault Member 0.64 0.12 X 0 0 0 Charles Coleman III Member 0.96 0.17 X 0 0 0 Leslie Cornfeld Member 0.86 0.15 X 0 0 0 Cynthia Foster Curry Member 2.34 0.42 X 0 0 0 Barrie M Damson Member 1.97 0.41 X 0 0 0 James G Dinan Member 2.03 0.36 X 0 0 0 Anne Ehrenkranz Member 2.73 0.48 X 0 0 0 Michael Esposito Vice-Chair 5.4 0.96 X X 0 0 0 Marina Kellen French Member 0.59 0.11 X 0 0 0 Craig Ivey Member 1.17 0.21 X 0 0 0 Winfield P Jones Member 0.63 0.11 X 0 0 0 Warren Kanders Member 0.46 0.09 X 0 0 0 Scott Kapnick Member - Start 2017 0.14 0.03 X 0 0 0 Monica Keany Member 3.85 0.68 X 0 0 0 Thomas J Kelly Member 2.29 0.41 X 0 0 0 David H Koch Member 2.24 0.39 X 0 0 0 Sacha Lainovic Member - Start 2017 0.22 0.04 X 0 0 0 Laurie Hodges Lapeyre Member 1.88 0.33 X 0 0 0 Pablo Legorreta Member 0.86 0.15 X 0 0 0 Lara Lerner Member 0.37 0.06 X 0 0 0 Kathy Leventhal Member 1.84 0.33 X 0 0 0 Marylin B Levitt Member 3.07 0.54 X 0 0 0 Thomas Lister Vice-Chair 4.6 0.95 X X 0 0 0 Alan S MacDonald Member 1.89 0.33 X 0 0 0 David McCormick Member - Start 2017 0.29 0.06 X 0 0 0 Richard L Menschel Chairman Emeritus - Left 2017 0.72 0.12 X X 0 0 0 Mary Kathryn Navab Member 0.37 0.06 X 0 0 0 Dean R O'Hare Chairman Emeritus - Left 2017 3.93 1.6 X X 0 0 0 Terrence O'Toole Member 0.56 0.1 X 0 0 0 Aldo Papone Chairman Emeritus - Left 2017 0.72 0.12 X X 0 0 0 Gordon Pattee Member 0.63 0.11 X 0 0 0 Steven Rattner Member 0.56 0.1 X 0 0 0 Susan W Rose Member 0.63 0.11 X 0 0 0 Jonathan Sobel Member 3.97 0.7 X 0 0 0 Deirdre Stanley Vice-Chair 5.69 1.01 X X 0 0 0 Robert K Steel Member 2.8 0.5 X 0 0 0 Patricia Warner Member 5.5 0.97 X 0 0 0 Sanford I Weill Member 0.37 0.06 X 0 0 0 Kendrick R Wilson III Chair 14.52 2.98 X X 0 0 0 Ellen M Wright Member 3.19 0.57 X 0 0 0 Louis A Shapiro President & Chief Exec Officer 45.73 14.27 X X 2348606 587152 75336 Lisa Goldstein Executive VP & COO 51.2 8.8 X 1273229 190253 57470 Stacey Malakoff Exec VP & Chief Fin Officer 48.73 11.27 X 1526611 269402 60707 Irene Koch EXEC VP & CHIEF LEGAL OFFICER 48.92 11.08 X 674466 119023 56550 Ralph Bianco Sr. Vice President, Operation 54.0 6.0 X 461011 51224 62911 Stephanie Goldberg Sr. VP, Patient Care SRV & CNO 60.0 0.0 X 619966 0 44293 Hollis Potter RADIOLOGIST-IN-CHIEF 60.0 0.0 X 1296886 0 67536 Frank Schwab Attending Physician 50.0 0.0 X 3820321 0 58408 Han Jo Kim Associate Attending Physician 50.0 0.0 X 3513618 0 50062 Sheeraz Qureshi Associate Attending Physician 50.0 0.0 X 3236769 0 46902 Ernest Sink Associate Attending Physician 50.0 0.0 X 1943308 0 60958 Amar Ranawat Associate Attending Physician 50.0 0.0 X 1816257 0 64630 28518556 1329316 1143971 1547 false true false PAVARINI NE CONSTRUCTION 30 OAK ST 3FL STAMFORD CT 06905 CONSTRUCTION 15906086 CONSTRUCTION CONTRACTORS OF NY COR 208 RUSSELL PLACE HACKENSACK NJ 07601 CONSTRUCTION 13430297 ROLST CONSTRUCTION CO 192 LEXINGTON AVENUE SUITE 1201 NEW YORK NY 10016 CONSTRUCTION 5596491 EPIC SYSTEMS CORPORATION PO BOX 88314 MILWAUKEE WI 53288 EHR SYSTEM SERVICES 5069899 RIGID ELECTRIC INC 336 37TH STREET BROOKLYN NY 11232 ELECTRICAL SERVICES 3793116 215 2256195 10476711 37190246 1950147 49923152 NET INPATIENT REVENUE 622110 607239367 607239367 NET OUTPATIENT REVENUE 622110 341748280 341748280 PROFESSIONAL FEES 622110 118065871 118065871 1067053518 7447277 7447277 0 425433 425433 0 0 0 155329092 149887052 5442040 5442040 5442040 0 0 0 0 0 0 0 0 0 RECOVERIES-EXPENSES 622110 18984986 18984986 RECOVERIES-MD RELATED EXP 622110 11239855 11239855 MISCELLANEOUS 622110 8605346 7673992 495879 435475 38830187 1169121607 1104952351 495879 13750225 157500 157500 0 0 0 14886475 8853627 6032848 0 479989414 418324934 61664480 28509271 24964625 3544646 73701008 63641039 10059969 30265159 26134055 4131104 14710199 4344738 10365461 7023009 7023009 473500 473500 52000 52000 0 200000 200000 22530027 19239612 3290415 19127957 19127957 34201694 22025136 12176558 11123462 11123462 0 0 54888189 47467475 7420714 3074542 2323257 751285 0 0 9845724 8051938 1793786 0 64994980 51988365 13006615 23712208 19100948 4611260 MEDICAL SUPPLIES & IMPLANT 165392651 165392651 RESEARCH (NET OF RECOVERIES) 17625055 17625055 SPF SUPPLIES 11585659 11585659 BAD DEBT 9164097 9164097 13717810 867823 12849987 1110951590 921252534 189699056 0 87328207 94544606 9028477 0 34352310 24612237 130079497 141496734 0 0 0 0 0 0 8291502 9857755 6911098 8286776 1214908869 634943341 530781800 579965528 392984200 404726687 185236617 215563449 0 0 191000 191000 155730739 173158168 1540915447 1652402940 115891968 124126653 0 0 0 0 183017991 164548286 0 0 0 0 105865914 94372098 0 0 262947080 307969282 667722953 691016319 X 559849394 628648048 181575104 194139994 131767996 138598579 873192494 961386621 1540915447 1652402940 X 58170017 56011673 -25987563 X false true X true true true X 50714338 98164202 68047821 57154844 49923152 324004357 0 0 50714338 98164202 68047821 57154844 49923152 324004357 36707159 287297198 4106575 5447509 7254332 10912208 7872710 35593334 0 384547 426706 450141 470424 435475 2167293 361764984 4786543166 0.79415 0.80843 X Schedule A, Part II The Schedule A, Part II support schedule has been completed to demonstrate that HSS meets the 170(b)(1)(A)(vi) public support test as required to use the Schedule B, Special Rule. HSS is not classified as a 170(b)(1)(A)(vi) entity, as it meets its public charity status requirement as a Hospital under section 170(b)(1)(A)(iii). 0 52000 52000 1110899590 1110951590 1000000 250000 1000000 1000000 1000000 1000000 4000000 6000000 114400 95044 44000 52000 305444 250000 250000 250000 250000 1000000 1500000 0 0 0 0 0 317061760 55313894 28886639 64805060 336457233 302864378 62588933 10841617 59233168 317061760 281958095 66490623 5933317 51517657 302864378 253373684 72825198 9084803 53325590 281958095 230908337 56977831 21678691 56191175 253373684 0.01000 0.41000 0.58000 true false 223403 223403 647673185 329464932 318208253 511137917 305478409 205659508 55874364 55874364 579965528 ALTERNATIVE INVESTMENTS 215563449 F 215563449 INSURANCE CLAIMS RECEIVABLE 77047768 INT IN HSS FUND, INC.-FASB 136 54987278 DUE FROM AFFILIATES -MRKT SEC. 22161395 457B DEFERRED COMP PLAN ASSETS 11189319 DUE FROM AFFILIATES - NET 4777949 INT - HSS WESTSIDE ASC LLC 1516146 INT - HSS ASC OF MANHATTAN LLC -1712020 TI RECEIVABLE WESTCHESTER - LT 1406250 INVESTMENT IN SUTTON HOUSE 820000 INVESTMENT IN IMAGEN 550000 INVESTMENT IN BETTER PT INC 200000 INVESTMENT IN HS2 110000 INVESTMENT IN SCIMAB 57914 GPA HOLDINGS, LLC 46169 173158168 0 DEFINED BENEFIT PENSION PLAN 143860994 INSURANCE CLAIM LIABILITY 77047768 DUE TO THIRD PARTY PAYORS 30149057 LEASEHOLD INCENTIVE 10605070 457B DEFERRED COMP PLAN LIABIL 11189319 DEFERRED RENT 9973171 ACCRUED POST-RETIREMENT HEALTH 6269834 OTHER ACCRUED LIABILITIES 18874069 307969282 SCHEDULE D, PART V, LINE 4 - ENDOWMENT FUNDS THE HOSPITAL'S ENDOWMENTS INCLUDE RESTRICTED (RESEARCH OR SPECIFIC PURPOSE) AND UNRESTRICTED ENDOWMENTS AND ARE USED FOR RESEARCH, EDUCATION, PATIENT NEEDS, OR RELATED ADMINISTRATIVE ACTIVITIES IN ACCORDANCE WITH APPLICABLE DONOR RESTRICTIONS. Central America and the Caribbean Investments 106613852 Central America and the Caribbean Medical Insurance Premium 13545596 Central America and the Caribbean 1 Program Services PT.LIAISON/BUS DEV 78000 Central America and the Caribbean 1 Program Services PT.LIAISON/BUS DEV 36000 Europe (Including Iceland and Greenland) Program Services PT.LIAISON/BUS DEV 6000 2 2 120279448 120279448 APS ACTION YOUNG SCHOLAR AWARD Europe (Including Iceland and Greenland) APS ACTION YOUNG SCHOLAR AWARD East Asia and the Pacific APS ACTION YOUNG SCHOLAR AWARD North America APS ACTION YOUNG SCHOLAR AWARD South Asia true false true true false false Schedule F, Part I, Line 3 - Health Education The Hospital reimburses its executives, physicians and scientists for attending conferences, some of which may be outside of the United States. Schedule F, Part I, Line 3, Column F The accrual method of accounting is used to report expenditures reported on column F. true true X true true X 700. true true true false true true 12993747 1829455 11164292 0.01000 37118896 14775158 22343738 0.02010 50112643 16604613 33508030 0.03010 9560163 1808186 7751977 0.00700 50326432 6818996 43507436 0.03910 49685729 27941949 21743780 0.01950 109572324 36569131 73003193 0.06560 159684967 53173744 106511223 0.09570 true 3915819 0 161018361 223849800 -62831439 X true true HSS ASC OF MANHATTAN HEALTH CARE 0.51 0.49 HSS WEST SIDE ASC HEALTH CARE 0.67 0.33 HS2 LLC SURGEON TALENT MANAGEMENT CO 0.1033 0.1034 0.7933 1 1 HOSPITAL FOR SPECIAL SURGERY 535 EAST 70TH STREET NEW YORK NY 10021 www.hss.edu 7002012H X X X X HOSPITAL FOR SPECIAL SURGERY 1 false false true X X X X X X X X X 16 true false false true X http://www.hss.edu/community.asp X X true 16 true http://www.hss.edu/community.asp false true X 500. 700. X X X true true X X X true X www.hss.edu/financial-assistance X www.hss.edu/financial-assistance.asp X www.hss.edu/financial-assist X X X X X X true X false X X X X false X X false false PART V, LINE 5 A 54-question survey was developed through a collective effort by a five-member HSS CHNA steering committee, community partners, internal stakeholders and the public. The CHNA steering committee identified validated research questions to be addressed, drafted the individual survey questions, and identified community partners and internal stakeholders to review and provide input to survey development. Collaboration with the public, community partners and internal stakeholders was crucial to the success of this survey with valuable feedback provided on survey construction and length. In an effort to reach a culturally diverse community, the survey was translated into Spanish and Chinese using a culturally sensitive back translation approach. Below outlines the list of community partners involved in survey construction: . Arthritis Foundation New York Chapter . Clinical & Translational Science Center (CTSC) Weill Cornell Medicine . Memorial Sloan Kettering Cancer Center . New York Presbyterian Hospital . Lenox Hill Neighborhood House . Medicare Rights Center . NYC DOHMH Office of Policy, Planning and Strategic Data Use . New York City Department of Aging . S.L.E. Lupus Foundation . Self Help Innovative Senior . Isabella Geriatric . Touro College Graduate School of Social Work HSS facilitated systematic, scheduled input and feedback from its varied constituents internal stakeholders, the public, and community partners based on the CHNA results to guide the selection of the health needs and services to address in its community programming. Relevant national, state and city health data and needs assessment results were also utilized to drive community programming. Our approach in identifying, prioritizing and selecting significant health needs is described below: Input from Internal Stakeholders- Recognizing that the development of community health programming requires a concerted effort by all members of the organization, we involved various representatives from HSS departments. The knowledge and experience of physicians, nurses, social workers and other staff that have a vested interest in serving the community was essential in identifying and addressing the communitys health needs. An internal stakeholder meeting was held on May 26, 2016 with 15 HSS staff to discuss identified health priorities and explore areas for implementing initiatives, using results from the CHNA and stakeholders awareness of community needs to guide the discussion. The group discussed focusing on increasing access to high quality, culturally relevant chronic disease preventive care and management of musculoskeletal and rheumatologic conditions and reducing obesity in adults and children, which aligns with the NYSDOH CSP priority areas. Input from Community Partners- Feedback from community partner organizations was critical to driving the assessment and selection of public health priorities for the Hospital. Using results of the CHNA as the basis for discussion, HSS and its partners exchanged valuable information regarding community needs, explored areas for future collaboration, and solidified a mutual commitment to advancing public health. Furthermore, community partner knowledge of their respective community helped to identify gaps in community programming or more specifically, areas where HSS could use its areas of expertise to make a lasting public health impact. Overall, feedback from these meetings solidified the direction for programs that improve the communitys diet and increase physical activity to combat obesity among children and adults, examine specific communities in need of chronic disease preventive care and management of musculoskeletal and rheumatologic conditions, and provide culturally relevant education regarding musculoskeletal and rheumatologic issues. HSS met with the Greater New York Hospital Association (GNYHA), a trade association, to inform the structure and process for selecting its public health priorities. In-person meetings and conference calls with GNYHA were held on 07/21/15, 07/28/15, 01/15/16, 03/11/16, 04/8/16, 04/13/16, 04/28/16, and 05/09/16 to discuss the NYS DOH CSP requirements and federal requirements for the CHNA. HSS also attended one of the 29 community consultations hosted by the NYC DOHMH Take Care New York on January 26, 2016 in Central Harlem to foster continued partnership in improving health needs of New Yorkers. These community consultations provided New Yorkers the opportunity to rank health indicators outlined in the TCNY 2020, and discuss health goals of the community and resources that help meet these goals. Our involvement in this process provided valuable insight into the publics needs and helped in guiding the selection of public health needs to ensure it resonates with the health care needs of New Yorkers. In addressing the NYS prevention agenda, conference calls and in-person meetings were held with the NYCDOH on 03/21/16, 04/18/16 and 06/08/16 to explore areas of partnership. Furthermore, a community partners meeting was held on May 25, 2016. Nine individuals from the community partner organizations attended this meeting at which we shared the CHNA results, elicited feedback and ranked health issues according to the communities they serve. CHNA results were received positively and there was extensive discussion about how results accurately depicted the various communities served and how these results could be used to impact the community at large. Specifically, there were discussions about access to educational programs and ways in which HSS could extend the reach of its programs. Input from the General Public- To further HSS commitment to developing programs that improve community health, obtaining feedback from the public and patient community was also instrumental in driving the Hospitals selection of significant health needs. Our approach in soliciting input from the public is described below. Community Forums- Four community forums were held to allow community members an opportunity to prioritize health needs that provided HSS with the appropriate direction in selecting its public health priorities. The main communication channel for notifying the public about the forums were through flyers distributed at HSS community programs and outpatient clinics and posting on digital media (web, Facebook and twitter). In addition, announcements were made during public and patient programs held at HSS, and a poster was strategically placed in a high traffic area of the Hospital to publicize the meeting. Furthermore, in order to reach at-risk and minority populations, HSS partnered with Senior Centers in Manhattan and Chinatown to advertise community forums to their community members. Specific dates, locations, and attendance for these Community forums were as follows: . May 17, 2016 at Lenox Hill Neighborhood House, Manhattan (11 people present) . May 21, 2016 at the Living Healthy with Lupus Workshop, HSS (50 people present) . May 23, 2016 at Chinatown Community Center, Visiting Nurses Services New York (35 people present) . May 25, 2016 at the Senior Health and Fitness Day, HSS (17 people present) Community members were asked to rank the health needs most important to them and give their perspective on community health issues in an open discussion. Each significant health need identified in the CHNA results were ranked from 1 to 22. All rankings were added together across each location and health issues were re-ranked based on their overall score. Community health needs that were considered significant were ranked among the top five of identified needs, which are . Osteoarthritis/Osteoporosis/Rheumatoid Arthritis . Muscle, Bone and Joint Pain . Fatigue . Falls . Obesity PART V, LINE 7D THE HOSPITAL SUMMARIZED THE RESULTS OF ITS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN ITS COMMUNITY BENEFIT REPORT. THE COMMUNITY BENEFIT REPORT AND CHNA ARE POSTED ON THE HOSPITALS WEBSITE, AT HTTP://WWW.HSS.EDU/COMMUNITY.ASP, AND BOOKLETS ARE ALSO DISTRIBUTED WITHIN THE HOSPITAL. THE COMMUNITY BENEFIT REPORT IS ALSO E-MAIL BLASTED TO OUR COMMUNITY PARTNERS, SELECTED DONORS AND PUBLIC OFFICIALS. PART V, LINE 11 Identified Need 1: Managing Osteoarthritis, Osteoporosis, Rheumatoid Arthritis and Lupus and Related Symptoms - Below outlines the programs specifically designed to address these chronic conditions and related symptoms such as falls, fatigue, stiffness and muscle, bone and joint pain in HSS ethnically diverse, older adult community. Program 1: HSS Nursing Community Education Outreach Initiative This initiative targets underserved older adults living in the community. The programs overall goal is to deliver evidence-based educational content germane to issues appropriate for older adults. The quality educational sessions use teaching strategies and educational principles deigned to improve knowledge, skills and confidence to manage and prevent chronic diseases. Educational lectures are mainly delivered by HSS nursing staff, and topics are selected based upon needs assessment results and participant feedback, such as management of chronic conditions (i.e. osteoarthritis, osteoporosis and rheumatoid arthritis), falls prevention, nutrition and medication safety. The anticipated program impact includes increase in knowledge about managing their chronic conditions, maintaining a healthy lifestyle, identifying increased risk of falls and preventing likelihood of falls. Program 2: Musculoskeletal Health Wellness Initiative (MHI) To address the public health issue of musculoskeletal conditions, HSS developed the Musculoskeletal Health Wellness Initiative (MHI), comprised of educational and exercise programs, to raise awareness, educate and reduce the impact of musculoskeletal conditions in the community. The initiative offers lectures, workshops and webinars about musculoskeletal health specific topics such as osteoarthritis, osteoporosis, and rheumatoid arthritis and some of the symptoms associated with these conditions (falls, fatigue, stiffness, and muscle, bone and joint pain), in addition to maintaining a healthy lifestyle. The exercise component of the initiative is comprised of weekly exercise classes such as Yoga, Pilates, Tai Chi, Dance, and Yogalates specifically designed for individuals that are suffering from or at risk of musculoskeletal and rheumatologic conditions. The anticipated program impact includes improved musculoskeletal health by decreasing musculoskeletal pain, stiffness, fatigue and falls, and increasing frequency of physical activity and self-efficacy. Program 3: Pain and Stress Management Series In response to the lack of confidence in managing chronic conditions, and mental health issues identified in the CHNA, HSS developed the pain and stress management series. This is comprised of educational, and mindfulness based coping techniques to raise awareness, educate and improve the ability to cope with pain and stress. This program offers mind/body workshops, exercises such as Yoga, and expert-guided meditation to help reduce physical and mental stressors. All the educational programs are taught by experienced physicians, nurses, physical and occupational therapists, while Yoga workshops are led by certified yoga instructors. The anticipated program impact includes improving confidence in managing chronic conditions and its symptoms such as pain, and improving ability to cope with stress. Program 4: HSS Asian Community Bone Health Initiative In response to the health needs of the growing number of Asian older adults living in NYCs Chinatown community and the CHNA results where Asians reported that they were told by their doctor to engage in more physical activity, HSS developed the Asian Community Bone Health Initiative (ACBHI). The overall goal of this initiative is to improve Asian seniors management of their chronic musculoskeletal conditions (such as osteoarthritis and osteoporosis) and its symptoms (e.g. falls, stiffness, fatigue, muscle bone and joint pain) while also increasing access to care in this medically underserved community. The ACBHI is comprised of culturally relevant musculoskeletal health lectures and workshops, self-management education, yoga and low impact chair exercise programs. The anticipated program impact includes improved musculoskeletal health by decreasing musculoskeletal pain, stiffness, fatigue and falls, and increasing frequency of physical activity and self-efficacy. Program 5: Resident Geriatric Training Program This program is designed to enhance communication skills of third-year orthopedic surgery residents with older adults that are suffering from or at risk of musculoskeletal and rheumatologic conditions. The program includes meetings with the Program Coordinator, a licensed social worker, for the residents to explore their attitudes toward older patients, weekly resident rounds for selected residents to present and illustrate specific geriatric needs, and presentations to participants of the HSS Greenberg Academy for Successful Aging. Presentations cover topics such as management of musculoskeletal conditions (i.e. osteoarthritis and osteoporosis) and some of the symptoms associated with these conditions (such as muscle, back, bone and joint pain), and falls prevention. The anticipated program impact includes improving the ability of older adults to manage their musculoskeletal conditions and symptoms and improved doctor/patient communication. Program 6: VOICES 60+ Senior Advocacy Program This program was launched in recognition of the multiple challenges older adults face in effectively utilizing high quality chronic disease care to optimize health outcomes, and access needed social support, particularly for those who are from low-income and Spanish speaking communities. VOICES 60+ is designed to enhance the medical care experience of low income, ethnically diverse (primarily Hispanic) HSS patients 60 and older in these areas. The program helps patients to navigate and access support, education and communication resources needed to manage their rheumatologic or musculoskeletal conditions and its symptoms to improve their quality of life. In addition, the program provides services focused on identifying and addressing communication barriers between older adult patients and healthcare providers to optimize health outcomes. Anticipated program impact includes improved provider/patient communication that will enhance communication skills of older adults and management of rheumatologic or musculoskeletal conditions and its symptoms. Program 7: Rheumatoid Arthritis (RA) Support and Education Programs This initiative addresses the psychoeducational needs of community members and their families living with long-standing rheumatoid arthritis, and for people newly diagnosed. These monthly programs feature a lecture on an RA-specific topic its management, presented by healthcare professionals, and are followed by a support group, co-facilitated by a social worker and a rheumatology nurse. Anticipated program impact includes enhancing self-management skills and self-efficacy around managing RA and its symptoms. Program 8: LANtern Lupus Asian Network In response to the CHNA results highlighting health disparities in the Asian community specifically related to lupus, HSS has implemented LANtern, which is a national model for support and education of Asian Americans with lupus and their families. LANtern is the only hospital based support and education program designed specifically for Asians/Asian Americans with lupus. Through its bilingual (Chinese) SupportLine, publications, community and professional programs, and capacity building, the program seeks to enhance awareness, understanding, coping and knowledge for Asian Americans with lupus and their loved ones. Anticipated program impact includes increased knowledge about high quality preventive care for the Asian community and improved clinical management of lupus and its symptoms. Program 9: Charla de Lupus/Lupus Chat The Charla de Lupus/Lupus Chat ("Charla") program addresses health disparities among African Americans and Latinos with lupus according to the CHNA findings. This social work led program engages and trains peer volunteers to become empowering role models by providing culturally relevant strategies to help increase understanding of this complex illness and its treatment, improve medical adherence, and enhance coping and healthy behaviors. Comprehensive bilingual (English/Spanish) services include: the Charla Line, a toll-free national support and education helpline; weekly Onsite Peer Support Outreach at four hospital-based clinics, monthly Charla Teen and Parent Lupus Chat Groups; numerous community, professional education and government collaborations. Anticipated program impact includes increased knowledge and self-management skills of lupus and its symptoms. Identified Need 2: Obesity (Poor Diet and Lack of Physical Activity) Based on significant health needs identified in the CHNA results and community forums, obesity (poor diet and lack of physical activity) was also identified as a key community health need in o PART V, LINE 13C,G PER HOSPITAL POLICY, ASSETS FOR THOSE INDIVIDUALS WITH INCOME ABOVE 500% OF THE POVERTY GUIDELINES MAY BE CONSIDERED IN THE CALCULATION UTILIZED IN DETERMINING DISCOUNTS TO PATIENTS. HOWEVER, IN PRACTICE, ASSETS ARE NOT CONSIDERED IN ANY DETERMINATION. AVAILABLE NET ASSETS WILL NOT BE CONSIDERED FOR ANY INDIVIDUAL WHOSE INCOME LEVEL IS AT 500% OR LESS OF THE FPL. RESIDENTS OF THE UNITED STATES WHOSE GROSS ANNUAL INCOME DOES NOT EXCEED SEVEN TIMES THE MOST CURRENT U.S. HEALTH AND HUMAN SERVICES (HHS) POVERTY GUIDELINES FOR THEIR FAMILY SIZE (TOTAL EXEMPTIONS CLAIMED ON THEIR FEDERAL TAX RETURN) ARE ELIGIBLE TO BE CONSIDERED FOR A PERCENTAGE DISCOUNT OF THEIR HOSPITAL BILL AS OUTLINED IN THIS POLICY, INCLUDING, WHERE APPLICABLE, A DISCOUNT OFF OF THEIR CO-PAYMENTS OR DEDUCTIBLES. NON-RESIDENTS OF THE UNITED STATES MAY BE CONSIDERED FOR A CHARITABLE DISCOUNT. THE POLICY INCLUDES A "SPECIAL ACCESS PROGRAM". INDIVIDUALS WHO DON'T EXCEED 700% OF THE FPL, BUT FAIL THE COVERAGE CRITERIA STATED BELOW, MAY STILL BE ELIGIBLE FOR FINANCIAL ASSISTANCE THROUGH THE SPECIAL ACCESS PROGRAM, BUT ONLY THOSE INDIVIDUALS WHO ARE NOT ANTICIPATED TO REQUIRE SERVICES OUTSIDE OF HSS. THE SPECIAL ACCESS PROGRAM MAKES FINANCIAL ASSISTANCE AVAILABLE TO THE FOLLOWING GROUPS, PROVIDED THE APPLICABLE INDIVIDUALS SATISFY THE FINANCIAL CRITERIA (INCOME AT OR BELOW 700% FPL): U.S. RESIDENTS WHO HAVE MEDICAL INSURANCE THAT DOES NOT PAY FOR SERVICES AT HSS (AND NO OUT-OF-NETWORK COVERAGE IS AVAILABLE), BUT THE SERVICE THE INDIVIDUAL NEEDS IS OF A TYPE THAT IS NOT REASONABLY AVAILABLE (AND COVERED UNDER THE INDIVIDUALS PLAN) NEARER TO THE PATIENTS RESIDENCE THAN HSS. GENERALLY THIS RULE IS INTENDED TO APPLY TO HIGHLY SPECIALIZED CARE THAT IS NOT AVAILABLE AT MOST HOSPITALS, BUT IS AVAILABLE AT HSS. U.S. RESIDENTS WHO HAVE MEDICAL INSURANCE THAT DOES NOT PAY FOR SERVICES AT HSS (AND NO OUT-OF-NETWORK COVERAGE IS AVAILABLE) BUT DO NOT QUALIFY UNDER THE PRECEDING PARAGRAPH (2)(D)(1), AND NON-U.S. RESIDENTS WITH NO APPLICABLE COVERAGE, IN EACH CASE WHO ARE REFERRED TO HSS BY PHYSICIANS WHO ARE PARTICIPANTS IN THE HSS PHYSICIAN HOSPITAL ORGANIZATION (PHO), PROVIDED THAT SUCH REFERRAL IS APPROVED BY HSS. PART V, LINE 16J INFORMATION ABOUT THE AVAILABILITY OF THE FINANCIAL ASSISTANCE PROGRAM IS POSTED IN SIGNAGE IN ALL AREAS OF THE HOSPITAL AND ANCILLARY SERVICE LOCATIONS WHERE A PATIENT IS REGISTERED FOR SERVICES. IN ADDITION, THE FINANCIAL ASSISTANCE POLICY AND SUMMARY OF THE HOSPITAL'S POLICY IS POSTED ON THE HOSPITAL'S WEBSITE. ANY HOSPITAL BILL RECEIVED BY THE PATIENT FOR SERVICE CONTAINS INFORMATION ON THE AVAILABILITY OF THE FINANCIAL ASSISTANCE PROGRAM. ADDITIONALLY, ANY BILL SENT TO A PATIENT BY THE HOSPITAL OR THE HOSPITAL'S COLLECTION SERVICE CONTAINS INFORMATION ON THE AVAILABILITY OF THE FINANCIAL ASSISTANCE PROGRAM. ALL REGISTRATION, CUSTOMER SERVICE, AND PATIENT ACCOUNTING STAFF ARE TRAINED ON THE AVAILABILITY OF THE PROGRAM AND INSTRUCTED ON HOW AND WHEN TO COMMUNICATE THIS INFORMATION. PART V, LINE 21D THE HOSPITAL FOR SPECIAL SURGERY IS A SPECIALTY ORTHOPEDIC HOSPITAL AND DOES NOT OPERATE AN EMERGENCY ROOM. THE HOSPITAL IS AFFILIATED WITH THE NEW YORK PRESBYTERIAN HEALTH SYSTEM, WHICH OPERATES A FULL SERVICE HOSPITAL MAINTAINING AN EMERGENCY ROOM LOCATED ADJACENT TO THE HOSPITAL FOR SPECIAL SURGERY. 14 HSS PHYSIATRY & PAIN MANAGEMENT 429 EAST 75TH STREET NEW YORK NY 10021 OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING, SPECIAL PROCEDURES,& AFFL PHYS OFFICES HSS EAST RIVER PROFESSIONAL BUILDING 523 EAST 72ND STREET NEW YORK NY 10021 OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING & AFFILIATED PHYSICIAN OFFICES HSS SPORTS PERFORMANCE CENTER 525 EAST 71ST BELAIRE BUILDING NEW YORK NY 10021 OUTPATIENT CENTER WITH PHYSICAL THERAPY HSS LONG ISLAND OUTPATIENT CENTER 333 EARLE OVINGTON BLVD UNIONDALE NY 11553 OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING, SPECIAL PROCEDURES,& AFFL PHYS OFFICES HSS STAMFORD OUTPATIENT CENTER 1 BLACHLEY ROAD STAMFORD CT 06902 OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING, SPECIAL PROCEDURES,& AFFL PHYS OFFICES HSS PARAMUS OUTPATIENT CENTER 140 EAST RIDGEWOOD AVENUE PARAMUS NJ 07652 OUTPATIENT CENTER WITH DIADNOSTIC IMAGING, PHYSICAL THERAPY & AFFL PHYS OFFICES HSS AMBULARY CARE CLINIC 475 EAST 72ND STREET NEW YORK NY 10021 OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING, PHYSICAL THERAPY AND CLINIC HSS INTEGRATIVE CARE CENTER 635 MADISON AVENUE NEW YORK NY 10022 OUTPATIENT CENTER WITH PHYSICAL THERAPY AND AFFILIATED PHYSICIAN OFFICES HSS RIVER TERRACE 519 EAST 72ND STREET NEW YORK NY 10021 OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING AND AFFILIATED PHYSICIAN OFFICES HSS ASC OF MANHATTAN 1233 SECOND AVENUE NEW YORK NY 10065 AMBULATORY SURGERY CENTER HSS SPINE THERAPY CENTER 405 EAST 75TH STREET NEW YORK NY 10021 OUTPATIENT CENTER WITH PHYSICAL THERAPY HSS WESTCHESTER OUTPATIENT CENTER 1133 WESTCHESTER AVENUE WHITE PLAINS NY 10604 OUTPATIENT CENTER WITH DIADNOSTIC IMAGING, PHYSICAL THERAPY & AFFL PHYS OFFICES HSS DANA CENTER 510 EAST 73RD STREET NEW YORK NY 10021 OUTPATIENT CENTER WITH MOTION ANALYSIS HSS QUEENS OUTPATIENT CENTER 176-60 UNION TURNPIKE FRESH MEADOWS NY 11366 OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING AND AFFILIATED PHYSICIAN OFFICES PART I, LINE 7, COLUMN F 2017 BAD DEBT EXPENSE PRESENTED ON THE 2017 AUDITED FINANCIAL STATEMENTS WAS $9,164,097. IN ADDITION, TOTAL OPERATING EXPENSE WAS ADJUSTED ACCORDINGLY TO REFLECT THE .35% ($3,443,807) AND 1% ($5,872,961) TAX ASSESSMENTS IMPOSED BY NEW YORK STATE. AS SUCH, THESE FEES WERE ADJUSTED ACCORDINGLY IN LINE 7 AS WELL AS THE TOTAL OPERATING EXPENSE. PART I, LINE 7 The Hospital used the following methodologies to calculate the amounts reported for each line on Schedule H, Line 7: (1)Line 7a "financial assistance at cost" - utilized gross charges written off reflected in the 2017 Medicare Cost Report and reduced to cost by applying the ratio of patient care cost-to-charges. The patient cost to charge ratio is calculated in worksheet 2 with information from the 2017 Medicare Cost Report and HSS's 2017 general ledger trial balance. This cost was offset by the New York State uncompensated care pool revenue. (2)Line 7b "Unreimbursed Medicaid" - utilized the decision support accounting system to identify total cost (direct and indirect) in providing patient service to Medicaid and Medicaid Managed Care patients. In addition, assessments to NYS for indigent care pools are included. (3)Line 7e "community health improvement services" - the Hospital applied actual expenses to derive direct cost and utilize the cost report to derive indirect expenses, applicable to such programs. (4)Line 7f "health profession education" - the medical education cost was obtained from the 2017 Medicare Cost Report for direct and indirect expense. The cost was offset by Medicare and Medicaid Revenue related to Direct GME as well as other direct offsetting revenue related to "Health Profession Education". (5)Line 7h "research" - the 2017 Medicare Cost Report was utilized. PART III, LINES 2, 3, 4 A COST TO CHARGE RATIO OF 42.73% AS CALCULATED PER THE APPLICABLE FORM 990 INSTRUCTIONS WAS APPLIED TO THE BAD DEBT EXPENSE (AT CHARGES) OF $9,164,097 TO CALCULATE THE BAD DEBT EXPENSE OF $3,915,819 AT COST. IN 2017, THE HOSPITAL SCREENED BOTH INPATIENT AND OUTPATIENT ACCOUNTS PRIOR TO BEING CLASSIFED AS BAD DEBT FOR "PRESUMPTIVE ELIGIBILITY" UTILIZING A COMMERCIALLY AVAILABLE INCOME PREDICTOR SOFTWARE. THEREFORE, BASED UPON THIS, $0.00 WAS REMOVED FROM BAD DEBT AND INCLUDED IN THE CALCULATION OF "FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST". THE UNCOMPENSATED CARE TEXT OF THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENT STATES, "AS A MATTER OF POLICY, THE HOSPITAL PROVIDES SIGNIFICANT AMOUNTS OF PARTIALLY OR TOTALLY UNCOMPENSATED PATIENT CARE. FOR ACCOUNTING PURPOSES, SUCH UNCOMPENSATED CARE IS TREATED EITHER AS CHARITY CARE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY OR AS BAD DEBT EXPENSE. THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY ENSURES THE PROVISION OF QUALITY HEALTH CARE TO THE COMMUNITY SERVED WHILE CAREFULLY CONSIDERING AND TAKING INTO ACCOUNT THE ABILITY OF THE PATIENT TO PAY. THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM'S ELIGIBILITY THRESHOLD IS 700% OF THE FEDERAL POVERTY GUIDELINES, WHICH IS IN EXCESS OF THE NEW YORK STATE MINIMUM REQUIREMENTS OF 300%. THE HOSPITAL HAS DEFINED CHARITY CARE FOR ACCOUNTING AND DISCLOSURE PURPOSES AS THE DIFFERENCE BETWEEN ITS CUSTOMARY CHARGES AND THE DISCOUNTED RATES GIVEN TO PATIENTS IN NEED OF FINANCIAL ASSISTANCE. AS THE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY IS NOT PURSUED, SUCH AMOUNTS ARE NOT REPORTED AS REVENUE. PATIENTS WHO DO NOT QUALIFY FOR DISCOUNTED FEES ARE BILLED AT THE HOSPITAL'S ESTABLISHED CHARGES. UNCOLLECTED BALANCES FOR THESE PATIENTS ARE CATEGORIZED AS BAD DEBTS. TOTAL UNCOMPENSATED CARE IN 2017 AND 2016 FOR ALL PATIENT SERVICES AGGREGATED APPROXIMATELY $19.7 MILLION AND $15.8 MILLION RESPECTIVELY. IN ADDITION, THE HOSPITAL OPERATES ITS CLINICS AT A LOSS, TO HELP MEET THE NEEDS OF LOW INCOME AND UNINSURED INDIVIDUALS, AND ALSO OPERATES NUMEROUS OUTREACH AND EDUCATION PROGRAMS WHICH BENEFIT THE COMMUNITIES IT SERVES." PART III, LINE 8 OVER 41% OF THE HOSPITAL'S INPATIENT POPULATION IS REPRESENTED BY MEDICARE. THE MEDICARE SHORTFALL OF $62,831,439 AS REPORTED IN PART III, LINE 7 WAS CALCULATED USING MEDICARE COST REPORTING PRINCIPLES AND A COST TO CHARGE RATIO METHODOLOGY. THE MEDICARE SHORTFALL SHOULD BE CONSIDERED AS A COMMUNITY BENEFIT BECAUSE THE HOSPITAL IS PROVIDING CARE TO THESE PATIENTS WITH FULL KNOWLEDGE THAT THE MEDICARE REIMBURSEMENT WILL NOT COVER THE COST OF PROVIDING CARE TO THESE RESIDENTS OF OUR COMMUNITY. PART III, LINE 9B SELF PAY BALANCES, INCLUDING RESIDUAL BALANCES DUE AFTER PAYMENT FROM AN INSURANCE CARRIER, AS WELL AS BALANCES DUE AFTER FINANCIAL ASSISTANCE DISCOUNTS HAVE BEEN APPLIED, ARE HANDLED ACCORDING TO THE FOLLOWING POLICY: ALL PATIENTS ARE BILLED USING STANDARD CYCLES INCLUDING THE ISSUANCE OF A DETAILED BILL, COLLECTION LETTERS AND/OR TELEPHONE CALLS, AND THEN TRANSFERRED TO A "PRE-COLLECTION STATUS." THESE COLLECTION EFFORTS ARE DOCUMENTED ELECTRONICALLY IN THE PATIENT'S FILE. DURING THE PRE-COLLECTION PHASE, ADDITIONAL TELEPHONE CALLS AND/OR LETTERS ARE MADE TO ATTEMPT TO COLLECT PAYMENT IN FULL. IF UNSUCCESSFUL, THE ACCOUNT IS TRANSFERRED TO A PROFESSIONAL COLLECTION AGENCY, NO LESS THAN 120 DAYS AFTER THE ORIGINAL SELF PAY BILLING DATE. THESE REASONABLE COLLECTION EFFORTS INCLUDE ALL PATIENT ACCOUNTS, FOR BOTH MEDICARE AND NON-MEDICARE PATIENTS. MEDICARE AND NON-MEDICARE ACCOUNTS ARE RECORDED SEPARATELY. ANY PATIENTS EXPRESSING INTEREST IN APPLYING FOR FINANCIAL ASSISTANCE WILL HAVE THEIR BILLS HELD PENDING ELIGIBILITY DETERMINATION. IF PATIENT IS ELIGIBLE, THE ACCOUNT WILL BE REDUCED BASED ON THE APPROPRIATE SLIDING SCALE DISCOUNT AND THE RESULTING BALANCE WILL BE RE-BILLED ACCORDINGLY. PAYMENTS RECEIVED BY THE COLLECTION AGENCY REDUCE THE AMOUNT RECORDED AS BAD DEBT. IT IS THE HOSPITAL'S PRACTICE NOT TO FILE SUIT, ATTACH ASSETS, OR PURSUE LIENS FOR ALL PATIENTS INCLUSIVE OF FAP ELIGIBLE PATIENTS. IN CERTAIN INSTANCES, IN COORDINATION WITH THE HOSPITAL'S INTERNAL LEGAL COUNSEL, THE HOSPITAL MAY TAKE SUCH MEASURES IF DEEMED WARRANTED. PAYMENT ARRANGEMENTS: IF PATIENTS ARE UNABLE TO PAY THE ENTIRE BALANCE IN FULL, PAYMENT ARRANGEMENTS OF MONTHLY PAYMENT WILL BE OFFERED. UNDER SUCH ARRANGEMENTS, ACCOUNTS ARE TYPICALLY PAID IN FULL WITHIN SIX TO TWELVE MONTHS UNLESS OTHERWISE EXTENDED AS PART OF THE FINANCIAL ASSISTANCE PROGRAM. A CONFIRMATION LETTER WILL BE SENT WITHIN 5 DAYS, EXPLAINING THE TERMS OF THE AGREEMENT. IF MONTHLY PAYMENT IS MISSED, THE ACCOUNT WILL PROGRESS TO THE NEXT STAGE IN THE CYCLE. UNDER CERTAIN CIRCUMSTANCES, HSS MAY PROVIDE FINANCIAL ASSISTANCE PRIOR TO, OR WITHOUT, ANY APPLICATION BEING MADE FOR SUCH ASSISTANCE. AT HSS, THIS WILL BE PERFORMED THROUGH A SCREENING PROCESS. UNPAID ACCOUNTS WILL BE SCREENED USING COMMERCIALLY AVAILABLE INCOME PREDICTOR SOFTWARE TO DETERMINE WHETHER INDIVIDUALS MAY QUALIFY FOR FINANCIAL ASSISTANCE BASED ON VARIABLES SUCH AS ADDRESS, AGE AND GENDER (PRESUMPTIVE ELIGIBILITY). HSS WILL ALSO CONDUCT PRESUMPTIVE ELIGIBILITY SCREENINGS ON ACCOUNTS PRIOR TO REFERRAL FOR ANY EXTRAORDINARY COLLECTION ACTIONS (ECA)as defined below in "Collection Activities". PRESUMPTIVE ELIGIBILITY DETERMINATIONS WILL APPLY ONLY TO THE UNPAID BALANCE(S) THAT TRIGGERED THE SCREENING PROCESS. IF THE INDIVIDUAL QUALIFIES UNDER THE PRESUMPTIVE METHODOLOGY WITH RESPECT TO THE UNPAID BALANCE(S), THEN HSS WILL GRANT THE MAXIMUM LEVEL OF ASSISTANCE OTHERWISE PERMITTED WITH RESPECT TO THE UNPAID AMOUNT. INDIVIDUALS WHO ARE GRANTED FINANCIAL ASSISTANCE UNDER PRESUMPTIVE ELIGIBILITY WILL BE PROVIDED NOTICE OF THEIR ABILITY TO APPLY FOR ADDITIONAL ASSISTANCE UNDER THE POLICY. IF PRESUMPTIVE ELIGIBILITY IS AWARDED BASED ON A SCREENING OF UNPAID BALANCES OVER 240 DAYS, INDIVIDUALS MAY, WITHIN THIRTY (30) DAYS FROM THE DATE OF THE GRANTING OF PRESUMPTIVE ELIGIBILITY, APPLY FOR ADDITIONAL FINANCIAL ASSISTANCE FOR THE SERVICES TO WHICH THE PRESUMPTIVE ELIGIBILITY DETERMINATION HAS BEEN APPLIED. In 2017, the hospital conducted no ECAs. PART VI, LINE 2 - NEEDS ASSESSMENT HOSPITAL FOR SPECIAL SURGERY'S NEEDS ASSESSMENT PROCESS INCORPORATES RELEVANT NATIONAL, STATE, AND CITY HEALTH DATA, GOALS, AND PRIORITIES. THE HOSPITAL UTILIZES THE US GOVERNMENT REPORT, HEALTHY PEOPLE 2020, WHICH SETS BROAD-BASED GOALS AND OBJECTIVES TO EXPAND AMERICANS ACCESS TO CARE, AND TO ELIMINATE HEALTH DISPARITIES BY AGE, GENDER, RACE, OR DISABILITIES, AND PAYS SPECIAL ATTENTION TO INFORMATION REGARDING THE NEEDS OF ALL NEW YORKERS. THE HOSPITAL ROUTINELY CONDUCTS NEEDS ASSESSMENTS AMONG KEY GROUPS IN ITS COMMUNITY, ON WHICH TO BASE MULTI-YEAR PROGRAMS. OTHER NEEDS ASSESSMENT DATA IS GATHERED THROUGH A RIGOROUS EVALUATION PROCESS OF PUBLIC PROGRAMS. IN 2016, HSS CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO PROVIDE INSIGHT INTO OUR COMMUNITYS: (1) HEALTH STATUS AND QUALITY OF LIFE; (2) HEALTH BEHAVIOR AND LIFESTYLE; (3) USE OF AND ACCESS TO CARE; AND (4) SOCIO-DEMOGRAPHIC CHARACTERISTICS. IN ADDITION, FOUR COMMUNITY FORUMS WERE HELD TO ALLOW COMMUNITY MEMBERS AN OPPORTUNITY TO PRIORITIZE HEALTH NEEDS THAT PROVIDED HSS WITH THE APPROPRIATE DIRECTION IN SELECTING ITS PUBLIC HEALTH PRIORITIES. COMMUNITY MEMBERS WERE ASKED TO RANK THE HEALTH NEEDS MOST IMPORTANT TO THEM AND GIVE THEIR PERSPECTIVE ON COMMUNITY HEALTH ISSUES IN AN OPEN DISCUSSION. ALL HOSPITAL PUBLIC AND PATIENT EDUCATION PROGRAMS, AND DIAGNOSIS-BASED SUPPORT AND EDUCATION GROUPS INCLUDE PARTICIPANT QUESTIONNAIRES, AND THE FEEDBACK FROM THESE ARE TABULATED, EVALUATED, AND USED IN FORMULATING NEW OR REFINED OFFERINGS FOR THE PUBLIC HEALTH. FURTHER, THE HOSPITAL'S SERVICE EXCELLENCE COUNCIL REVIEWS PRESS GANEY MONTHLY PATIENT COMMENTS AND QUARTERLY REPORTS, AND ALONG WITH DEPARTMENTAL MANAGERS AND MULTIDISCIPLINARY TEAMS DEVELOPS IMPROVEMENTS IN SERVICES BASED ON THIS FEEDBACK OF PATIENTS' NEEDS. FINALLY, TO ENSURE THE RANGE OF NEEDS IS INTERPRETED AT THE HIGHEST LEVEL OF MANAGEMENT, THE BOARD OF TRUSTEES RECEIVES AND REVIEWS ONGOING REPORTS THAT INCLUDE RESULTS OF PATIENTS' SATISFACTION SURVEYS AND A SUMMARY OF THE HOSPITAL-WIDE QUALITY ASSESSMENT AND PERFORMANCE IMPROVEMENT PROGRAM. PART VI, LINE 3 -PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE INFORMATION ABOUT THE AVAILABILITY OF THE FINANCIAL ASSISTANCE PROGRAM IS POSTED IN SIGNAGE IN ALL AREAS OF THE HOSPITAL AND ANCILLARY SERVICE LOCATIONS WHERE A PATIENT IS REGISTERED FOR SERVICES. ANY HOSPITAL BILL RECEIVED BY THE PATIENT FOR SERVICE CONTAINS INFORMATION ON THE AVAILABILITY OF THE FINANCIAL ASSISTANCE PROGRAM. ADDITIONALLY, ANY BILL SENT TO A PATIENT BY THE HOSPITAL OR THE HOSPITAL'S COLLECTION SERVICE CONTAINS INFORMATION ON THE AVAILABILITY OF THE FINANCIAL ASSISTANCE PROGRAM. ALL REGISTRATION, CUSTOMER SERVICE, AND PATIENT ACCOUNTING STAFF ARE TRAINED ON THE AVAILABILITY OF THE PROGRAM AND INSTRUCTED ON HOW AND WHEN TO COMMUNICATE THIS INFORMATION. THE FINANCIAL ASSISTANCE ASSOCIATES EDUCATE, SCREEN, AND MAKE THE ELIGIBILITY DETERMINATION FOR THE HSS FINANCIAL ASSISTANCE PROGRAM. THE ASSOCIATES ARE ALSO AVAILABLE TO ASSIST THE PATIENT IN FILLING OUT ALL FINANCIAL ASSISTANCE RELATED FORMS. PART VI, LINE 4 -COMMUNITY INFORMATION THE HOSPITAL FOR SPECIAL SURGERY'S COMMUNITY IS DEFINED BY THE FIVE BOROUGHS. THE SUBURBAN COUNTIES IN NEW YORK, NEW JERSEY, CONNECTICUT AND LONG ISLAND COMPRISE OUR SECONDARY SERVICE AREA. THE IMMEDIATE COMMUNITY IS DEFINED BY NEW YORK CITY'S COMMUNITY BOARD #8, WHICH EXTENDS FROM 59TH STREET TO 96TH STREET AND EAST FROM FIFTH AVENUE TO THE EAST RIVER. HSS PATIENTS COME FROM MANY COMMUNITIES LOCALLY, REGIONALLY, NATIONALLY, AS WELL AS INTERNATIONALLY. PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH HOSPITAL FOR SPECIAL SURGERY'S COMMUNITY AND PROFESSIONAL OUTREACH BRINGS INFORMATION TO THE COMMUNITY THROUGH COLLABORATION WITH EDUCATIONAL, MULTI-SERVICE SOCIAL SERVICE AGENCIES, FAITH-BASED ORGANIZATIONS, SUPPORT AND EDUCATION GROUPS AND PROGRAMS, COMMUNITY-BASED ORGANIZATIONS, AND ACADEMIC INSTITUTIONS. IN ADDITION, IT PROVIDES EDUCATIONAL OPPORTUNITIES TO THE COMMUNITY THROUGH HEALTH FAIRS, AND PUBLIC EVENTS, AS WELL AS PUBLIC SCHOOLS, HEALTH CLINICS, SENIOR CENTERS, AND COMMUNITY HOSPITAL FORUMS. WE REACH OUT TO UNDERSERVED AND ETHNICALLY DIVERSE POPULATIONS AND SEEK TO SERVE AND COLLABORATE WITH THE ABOVE MENTIONED ORGANIZATIONS TO ENGAGE COMMUNITIES AROUND MAJOR HEALTH ISSUES. IN 2017, THE HOSPITAL SPONSORED VARIOUS COMMUNITY EDUCATION, SUPPORT AND OUTREACH PROGRAMS INCLUDING EDUCATIONAL WORRKSHOPS ON MUSCULOSKELETAL HEALTH AND WELLNESS, INCLUDING OSTEOPOROSIS, LEON ROOT, MD PEDIATRIC OUTREACH PROGRAM, HSS ASIAN COMMUNITY BONE HEALTH INITIATIVE, GREENBERG ACADEMY FOR SUCCESSFUL AGING, SNEAKER (SUPER NUTRITION FOR ALL KIDS TO EAT RIGHT), HSS SPORTS SAFETY PROGRAM, WORKSHOPS ON MUSCULOSKELETAL HEALTH AND WELLNESS AT THE STAMFORD OUTPATIENT CENTER, PAIN & STRESS MANAGEMENT PROGRAM, FEEDING CREATIVITY, LUPUSLINE, LANTERN (LUPUS ASIAN NETWORK) THE SLE WORKSHOP, EARLY RHEUMATOID ARTHRITIS (RA) AND LIVING WITH RA SUPPORT AND EDUCATION GROUPS, VOICES 60+ SENIOR ADVOCACY PROGRAM, THE MYOSITIS SUPPORT AND EDUCATION GROUP, CHARLA DE LUPUS (LUPUS CHAT), VOICES MEDICAID MANAGED CARE EDUCATION PROGRAM AND THE NURSING OUTREACH EDUCATION INITIATIVE. A COMMITTEE OF THE BOARD FOCUSING ON THE HOSPITAL'S COMMUNITY BENEFIT ACTIVITIES AND COMMUNITY SERVICES CONTINUES TO PROVIDE OVERSIGHT ON HSS COMMUNITY EDUCATION, OUTREACH AND SUPPORT PROGRAMS. IN ADDITION, THE HOSPITAL CONTINUES TO IMPLEMENT COMMUNITY PROGRAMMING BASED ON THE RESULTS OF THE 2016 HSS CHNA. THE HSS PUBLIC & PATIENT EDUCATION DEPARTMENT STAFF DELIVERED AN ORAL PRESENTATION ON THE HSS SPORTS SAFETY PROGRAM AND A ROUNDTABLE ON THE 2016 CHNA PROCESS AT THE ANNUAL AMERICAN PUBLIC HEALTH ASSOCIATION MEETING. THE SOCIAL WORK PROGRAMS' DEPARTMENT WAS INVITED TO THE ANNUAL MEETING OF THE AMERICAN COLLEGE OF RHEUMATOLOGY FOR THE SECOND TIME TO PRESENT A STUDY GROUP ON DEVELOPING, IMPLENTING AND ASSESSING EFFECTIVE SUPPORT AND EDUCATION PROGRAMS, AND A SYMPOSIUM TITLED THE PATIENT PROVIDER DANCE: ENHANCING SHARED DECISION MAKING STRATEGIES TO ENSURE CULTURAL RELEVANCE FOR HISTORICALLY UNDERSERVED COMMUNITIES WAS AN INTEGRAL PART OF THESE PRESENTATIONS IN ADDITION TO PROVIDING CLINICIANS TOOLS TO ENGAGE THEIR PATIENTS AS PARTNER IN CARE. THIS IS A PART OF OUR ONGOING EFFORT TO DISSEMINATE SUCCESSFUL EVIDENCE BASED COMMUNITY INTERVENTIONS AS PART OF HSS COMMUNITY SERVICE PLAN. WE CONTINUE TO HAVE WIDE REPRESENTATION OF OUR CSP INITIATIVES THROUGH MULTIPLE PRESENTATIONS SPECIFICALLY IN DIVERSE COMMUNITIES, FOR PATIENTS AND PROVIDERS, ON HEALTH LITERACY FOR BILINGUAL (SPANISH) OLDER ADULTS AND PROFESSIONAL PROVIDERS, LUPUS REAL TALK: TAKING CHARGE OF YOUR HEALTH WITH SPECIFIC MALE SESSION AND EDUCATIONAL PROGRAMS TARGETED TO THE ASIAN AMERICAN COMMUNITY HOSTED IN MANHATTANS CHINATOWN TO ENHANCE LUPUS CARE, COPING AND TO BUILD COMMUNITY CAPACITY WITH PATIENTS AND PROVIDERS. IN ADDITION, THE HOSPITAL HAS CREATED WEBINARS AND EDUCATIONAL VIDEOS FOR WIDE RANGING COMMUNITY BENEFIT TOPICS. THE HOSPITAL ALSO PARTICIPATED IN AND CO-SPONSORED NUMEROUS COMMUNITY-BASED EVENTS WITH VARIOUS ORGANIZATIONS. FOR THE PAST FOUR YEARS IN A ROW THE HOSPITAL HAS BEEN DESIGNATED AS A LEADER IN LGBTQ HEALTH BY THE HUMAN RIGHTS CAMPAIGN AND THIS YEAR PARTICIPATED IN NYC PRIDE MARCH TO DEMONSTRATE OUR COMMITMENT TO SERVING THE LGBTQ+ COMMUNITY IN AN INCLUSIVE AND SENSITIVE WAY. OTHER COMMUNITY PARTNERS WE WORKED WITH INCLUDE THE ARTHRITIS FOUNDATION'S NORTH EAST REGION AND THE NEW YORK CHAPTER, LINCOLN CENTER EDUCATION, THE ALLIANCE FOR LUPUS RESEARCH'S NYC LUPUS WALK, THE ASIAN HEALTH AND SOCIAL SERVICE COUNCIL, THE ANKYLOSING SPONDYLITIS ASSOCIATION, AND THE EAST SIDE COUNCIL ON AGING. IN 2017, WE COLLABORATED WITH OVER THIRTY COMMUNITY ORGANIZATIONS TO MEET EDUCATIONAL NEEDS FOR UNDERSERVED COMMUNITIES IN AREAS SUCH AS MUSCULOSKELETAL HEALTH, NUTRITION AND PHYSICAL ACTIVITY, HEALTH LITERACY, AND DISEASE SELF-MANAGEMENT. THE HOSPITAL HAD OVER 32,000 CONTACTS WITH PATIENTS/PROGRAM PARTICIPANTS THROUGH 900 PROGRAMS AND DISTRIBUTED HEALTH EDUCATION MATERIALS TO NEARLY 637,000 INDIVIDUALS (WHICH INCLUDES OVER 614,000 WEB PAGE VIEWS AND APP DOWNLOADS). THE HOSPITAL IS ALSO PART OF A NATIONAL CLINICAL RESEARCH TRANSLATIONAL CONSORTIUM WHOSE GOAL IS TO ASSESS AND IMPLEMENT THE NEEDS OF UNDERSERVED POPULATIONS IN ORDER TO DEVELOP HEALTH PROGRAMS TO DIVERSE CULTURAL COMMUNITIES IN THE NEW YORK CITY FIVE BOROUGHS. WE ARE ALSO MEMBERS OF NIAMS' NATIONAL MULTICULTURAL OUTREACH INITIATIVE TO REDUCE HEALTH DISPARITIES, THROUGH RELEVANT PUBLIC HEALTH EDUCATIONAL INITIATIVES. THE POSITION OF ASSISTANT DIRECTOR FOR COMMUNITY ENGAGEMENT, DIVERSITY AND RESEARCH, FURTHER ENHANCES RESOURCES AND THE HOSPITALS COMMITMENT TO ADDRESSING HEALTH DISPARITIES AND HEALTH EQUITY, WHILE ENGAGING THE COMMUNITY AND GROUNDING INTERVENTIONS IN EVIDENCE BASED RESEARCH AND PRACTICE. AS THE NATION'S LEADING HOSPITAL FOR ORTHOPEDICS AND MUSCULOSKELETAL CARE, THE HSS COMMUNITY IS NATIONAL IN THAT HSS PLAYS A LEADING ROLE IN PROVIDING RESEARCH AND EDUCATION IN THE TREATMENT OF ORTHOPEDIC AND MUSCULOSKELETAL ILLNESS AND CONDITIONS. PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM The Hospital has a medical and clinical affiliation with New York Presbyterian Hospital (NYPH) where the hospital functions as the principal orthopedic and rheumatology facility for NYPH at its East 68-East 70 Street facility (East Campus). The Hospital also has a Collaboration Agreement with The Stamford Hospital (SH), an acute care hospital in Stamford, Connecticut, and Stamford Health, Inc. (SHI), the sole member of SH. Under the Collaboration Agreement, the Hospital will manage the SH Department of Orthopedic Surgery, including certain discrete orthopedic space and activities within the main building of SH. true ARTHRITIS FOUNDATION NORTHEAST REGION INC 122 E 42ND ST18TH FL NEW YORK NY 10168 800489313 501 (C)(3) 90000 GENERAL SUPPORT The ALS Association Greater NY Chapter 162 W 56th St 405 NEW YORK NY 10019 133616680 501 (C)(3) 12500 GENERAL SUPPORT Healthcare Leaders of New York 28-24 Steinway Street Astoria NY 11103 200866992 501 (C)(6) 10000 GENERAL SUPPORT IONA COLLEGE 715 North Avenue New Rochelle NY 10801 133508093 501 (C)(3) 10000 GENERAL SUPPORT THE HAMPTON CLASSIC PO Box 3013 Bridgehampton NY 11932 112597077 501 (C)(3) 10000 GENERAL SUPPORT 4 1 SCHEDULE I, PART I, LINE 2 THE HOSPITAL FOR SPECIAL SURGERY RAISED FUNDS TO SUPPORT THE CHARITABLE, EDUCATIONAL, AND SCIENTIFIC PURPOSE OF ITS TAX EXEMPTION. THE CONTRIBUTIONS GIVEN TO THE OUTSIDE ORGANIZATIONS ARE FOR GENERAL PURPOSES. X X true true X X X X false false false true false true false false false Todd Albert Member/Surgeon-in-Chief 1183803 0 402750 0 16606 0 20250 0 39533 0 1662942 0 0 0 Mary Crow Member/Physician-in-Chief 614614 0 272942 0 12186 1000 24300 0 15082 0 939124 1000 0 0 Charles Cornell - Left 2017 Member/Attending Physician 868910 65402 0 0 576067 43860 22599 1701 41438 3119 1509014 114082 0 0 Steven Haas Member/Attending Physician 122669 0 0 0 419 0 11700 0 30849 0 165637 0 0 0 Lionel Ivashkiv Member/Chief Scientific Offic. 636485 0 93334 0 17525 0 24300 0 30223 0 801867 0 0 0 Bryan Kelly - Left 2017 Member/Attending Physician 122159 0 0 0 4071 1000 11700 0 31359 0 169289 1000 0 0 Michael Parks - Start 2017 Member/Attending Physician 154423 0 0 0 0 1000 12000 0 13511 0 179934 1000 0 0 Joel Press - Start 2017 Member/Physiatrist-in-Chief 610196 0 20834 0 186349 0 20250 0 42286 0 879915 0 0 0 Louis A Shapiro President & Chief Exec Officer 1025744 256436 1292688 323172 30174 7544 19440 4860 40829 10207 2408875 602219 0 0 Lisa Goldstein Executive VP & COO 766469 114530 478237 71461 28523 4262 21141 3159 28858 4312 1323228 197724 0 0 Stacey Malakoff Exec VP & Chief Fin Officer 920141 162378 578350 102062 28120 4962 20655 3645 30946 5461 1578212 278508 0 0 Irene Koch EXEC VP & CHIEF LEGAL OFFICER 427184 75385 246235 43453 1047 185 17213 3038 30854 5445 722533 127506 0 0 Ralph Bianco Sr. Vice President, Operation 355349 39483 101319 11258 4343 483 21870 2430 34750 3861 517631 57515 0 0 Stephanie Goldberg Sr. VP, Patient Care SRV & CNO 447132 0 163836 0 8998 0 24300 0 19993 0 664259 0 0 0 Hollis Potter RADIOLOGIST-IN-CHIEF 837453 0 435000 0 24433 0 24300 0 43236 0 1364422 0 0 0 Frank Schwab Attending Physician 644312 0 0 0 3176009 0 20250 0 38158 0 3878729 0 0 0 Han Jo Kim Associate Attending Physician 596725 0 0 0 2916893 0 20250 0 29812 0 3563680 0 0 0 Sheeraz Qureshi Associate Attending Physician 278443 0 0 0 2958326 0 20250 0 26652 0 3283671 0 0 0 Ernest Sink Associate Attending Physician 316762 0 0 0 1626546 0 20250 0 40708 0 2004266 0 0 0 Amar Ranawat Associate Attending Physician 406352 0 0 0 1409905 0 24300 0 40330 0 1880887 0 0 0 Schedule J, Part I, Line 1A/B First Class Travel - THE HSS TRAVEL POLICY STATES FOR BUSINESS CLASS TRAVEL PRIOR APPROVAL FROM THE CEO IS REQUIRED AND USUALLY ONLY APPROVED IF THE LENGTH OF THE FLIGHT IS GREATER THAN 5 HOURS. UPGRADE TO FIRST CLASS OCCURS ONLY IF BUSINESS CLASS DOES NOT EXIST. WITH REGARDS TO THE CEO AND SURGEON-IN-CHIEF TRAVEL, THE CEO AND SURGEON-IN-CHIEF HAVE APPROVAL FROM THE COMPENSATION COMMITTEE OF THE BOARD TO FLY BUSINESS CLASS IF THE FLIGHT IS GREATER THAN 5 HOURS, OR FIRST CLASS IF THE FLIGHT IS GREATER THAN 10 HOURS, OR BUSINESS CLASS IS NOT AVAILABLE. THE AUDIT AND CORPORATE COMPLIANCE COMMITTEE OF THE BOARD OF TRUSTEES REVIEWS THE CEO'S AND SURGEON-IN-CHIEF'S EXPENSES ON A QUARTERLY BASIS. BUSINESS CLASS OR FIRST CLASS TRAVEL ARE NOT TREATED AS TAXABLE COMPENSATION. IN 2017, FIRST CLASS TRAVEL WAS REIMBURSED TO THE CEO AND SURGEON-IN-CHIEF. Housing Allowance - Housing allowance was paid to the Physiatrist-in-Chief as per his contract, and was treated as taxable compensation. Schedule J, Part I, Line 5A Certain employed physicians listed on Part VII, Section A, Line 1A receive compensation in part, based on professional service revenue generated from services they personally performed in their individual practices. In 2017, no physician was paid compensation contingent upon the organization's overall revenue or net earnings. Schedule J, Part I, Line 6A Performance based incentive awards are paid to officers and key employees based on a number of important quality, satisfaction, efficiency, and financial measures, of which achieving budget is a factor. Schedule J, Part II An attending physician received payment of $500 and the Physician-in-Chief and two Attending Physicians received $1,000 from MIAC, a related organization, to attend MIAC's board of directors meeting. A DORMITORY AUTHORITY OF THE STATE OF NY 146000293 649905ug9 2009-12-03 86880597 2009 HOSPITAL EXPANSION & EQUIP false false false B DORMITORY AUTHORITY OF THE STATE OF NY 146000293 000000000 2012-10-10 21981569 TAX EXEMPT EQUIPMENT LEASING false false false C DORMITORY AUTHORITY OF THE STATE OF NY 146000293 000000000 2013-07-17 25997726 TAX EXEMPT EQUIPMENT LEASING false false false D DORMITORY AUTHORITY OF THE STATE OF NY 146000293 000000000 2014-05-22 27992584 TAX EXEMPT EQUIPMENT LEASING false false false A 10050000 0 86967216 6670000 6110242 0 1440615 1031004 0 71634372 80983 0 2012 false false true true B 19149569 0 21981569 0 0 0 131569 0 0 21850000 0 0 2013 false false true true C 19303726 0 25997726 0 0 0 147726 0 0 25850000 0 0 2014 false false true true D 16859584 0 27992584 0 0 0 152584 0 0 27840000 0 0 2015 false false true true A false false true true true true 0.00600 0.00000 0.00600 false false false true B false false false true true 0.00280 0.00000 0.00280 false false false true C false false false true true 0.00280 0.00000 0.00280 false false false true D false false false true true 0.00280 0.00280 false false false true A false false false true false false 0 false 0 false true B false false false true false false 0 false 0 false true C false false false true false false 0 false 0 false true D false false false true false false 0 false 0 false true A true B true C true D true PART I & II FOR THE 2009 HOSPITAL EXPANSION & EQUIPMENT ISSUES, TOTAL PROCEEDS (PART II, LINE 3) EXCEEDS THE ISSUE PRICE (PART 1, COLUMN E) DUE TO INVESTMENT INCOME ON GROSS PROCEEDS HELD IN RESERVE FUND INCLUDED IN TOTAL PROCEEDS. PART IV, LINE 2C FOR THE 2009 HOSPITAL EXPANSION & EQUIPMENT ISSUES, THE LAST REBATE COMPUTATION WAS PERFORMED ON 12/31/2014 INDICATING NO REBATE WAS DUE FOLLOWING THE CALCULATION. FOR TAX EXEMPT EQUIPMENT LEASING ISSUES, THE FINANCING DOES NOT GENERATE ANY INVESTMENT INCOME THEREFORE NO CALCULATION WAS PERFORMED AND NO REBATE IS DUE. A DORMITORY AUTHORITY OF THE STATE OF NY 146000293 000000000 2014-08-26 62400000 TAX EXEMPT EQUIPMENT LEASING B DORMITORY AUTHORITY OF THE STATE OF NY 146000293 000000000 2015-06-24 17974978 TAX EXEMPT EQUIPMENT LEASING false false false C Dormitory Authority of the State of NY 146000293 000000000 2016-06-15 19992620 TAX EXEMPT EQUIPMENT LEASING false false false D Dormitory Authority of the State of NY 146000293 000000000 2017-07-14 14979666 TAX EXEMPT EQUIPMENT LEASING false false false A 24299000 0 62400000 0 1632000 0 160000 0 0 60608000 0 0 2016 false false true true B 7549978 0 17974978 0 0 0 129978 0 0 17845000 0 0 2016 false false true true C 5147620 0 19992620 0 0 0 145620 0 0 19847000 0 0 2016 false false true true D 1192666 0 14979666 0 0 0 76089 0 0 14903577 0 0 2017 false false false true A false false false true true 0.00280 0.00280 false false false true B false false false true true 0.00280 0.00280 false false false true C false false false true true 0.00280 0.00280 false false false true D false false false true true 0.00280 0.00280 false false false true A false false false true false false 0 false 0 false true B false false false true false false 0 false 0 false true C false false false true false false 0 false 0 false true D false false false true false false 0 false 0 false true A true B true C true D true Zimmer Biomet Inc SEE PART V 14377893 SEE PART V false DePuy Synthes SEE PART V 3989851 SEE PART V false Exactech Inc SEE PART V 3062210 SEE PART V false Smith Nephew SEE PART V 17894030 SEE PART V false Oplogix SEE PART V 180000 SEE PART V false Don Joy Orthopedics SEE PART V 1584796 SEE PART V false SCHEDULE L, PART IV, (1) - Zimmer Biomet, Inc In July, 2014, Dr. Todd Albert joined HSS Medical Staff as Surgeon-In-Chief and became an ex-officio member of HSS' Board of Trustees. Dr. Albert is an inventor and a design team member for Solitaire Cervical Cage. Dr. Albert is a patent holder for Lineum Cervical System and Polaris Spinal System, products manufactured and sold by Zimmer Biomet. Per HSS policy, Dr. Albert is not allowed to receive royalty payments for these patented products when used on patients at HSS. HSS has had a long-standing business relationship with Zimmer Biomet that preceded the date Dr. Albert became Surgeon-In-Chief and ex-officio member of HSS' Board of Trustees, With the exception of products used in the procedures he personally performs (and for which he does not receive royalties), Dr. Albert plays no role in the consideration or acquisition of Zimmer Biomet products. AMOUNT OF TRANSACTION: $14,377,893 DESCRIPTION OF TRANSACTION: In 2017, HSS paid $14,377,893 to Zimmer Biomet for medical instruments and surgical products. This amount represents all purchases, only a small part of which relates to the Solitaire Cervical Cage, Lineum Cervical System and Polaris Spinal System. SCHEDULE L, PART IV, (2) - DePuy Synthes In July, 2014, Dr. Todd Albert joined HSS Medical Staff as Surgeon-In-Chief and became an ex-officio member of HSS' Board of Trustees. Dr. Albert is a designer of, and receives royalties for, Expedium spine system, and Swift and Eagle anterior cervical fixation systems, products manufactured and sold by DePuy Synthes. Per HSS policy, Dr. Albert is not allowed to receive royalty payments for these patented products when used on patients at HSS. HSS has had a long-standing business relationship with DePuy Synthes that preceded Dr. Albert becoming Surgeon-In-Chief in July, 2014. With the exception of products used in the procedures he personally performs (and for which he does not receive royalties), Dr. Albert plays no role in the consideration or acquisition of DePuy Synthes products. AMOUNT OF TRANSACTION: $3,989,851 DESCRIPTION OF TRANSACTION: In 2017, HSS paid $3,989,851 to DePuy Synthes for medical devices. This amount represents all purchases, a part of which relates to the Expedium spine system and Eagle anterior cervical fixation systems. SCHEDULE L, PART IV, (3) - Exactech, Inc Dr. Thomas Sculco was elected to the HSS' Board of Trustees in 2014 after stepping down as Surgeon-In-Chief and an ex-officio member of HSS' Board of Trustees. Dr. Sculco is a designer of, and receives royalties for, the design of a posterior stabilized knee prosthesis, a product manufactured and sold by Exactech. Per HSS policy, Dr. Sculco is not allowed to receive royalty payments for this patented product when used on patients at HSS. HSS had a business relationship with Exactech in the years prior to Dr. Sculco's term as Surgeon-In-Chief (May, 2003 through June, 2014). With the exception of products used in the procedures he personally performs, Dr. Sculco played no role, in those years or since, in the consideration or acquisition of Exactech's products. AMOUNT OF TRANSACTION: $3,062,210 DESCRIPTION OF TRANSACTION: In 2017, HSS paid $3,062,210 to Exactech for surgical instruments. This amount represents all purchases, a part of which relates to the posterior stabilized knee prosthesis. SCHEDULE L, PART IV, (4) - Smith & Nephew Dr. Steven Haas, a member of the Medical Staff, who was elected to the HSS' Board of Trustees in April, 2016. Dr. Haas is a designer of, and receives royalties for, the design of JOURNEY II BCS knee replacement implants, a product manufactured and sold by Smith & Nephew. Dr. Haas is not allowed to receive royalty payments for this patented product when used on patients at HSS. HSS has had a long-standing business relationship with Smith & Nephew that preceded Dr. Haas' joining the HSS' Board of Trustees in April, 2016. With the exception of products used in the procedures he personally performs (and for which he does not receive royalties), Dr. Haas plays no role in the consideration or acquisition of Smith & Nephew's products. AMOUNT OF TRANSACTION: $17,894,030 DESCRIPTION OF TRANSACTION: In 2017, HSS paid $17,894,030 to Smith & Nephew for medical devices. This amount represents all purchases, a part of which relates to the posterior stabilized knee prosthesis. SCHEDULE L, PART IV, (5) - Oplogix Dr. Steven Haas, a member of the Medical Staff, who was elected to the HSS' Board of Trustees in April, 2016, owns 47.9% of the company, OpLogix, formerly known as Sandance Technology, LLC, in which HSS is also an equity holder. HSS owns 6.8%. OrthoSecure, the name of the software application product developed by Sandance Technology, LLC, is being used at HSS to help automate the implant verification process in the operating room. The decision to purchase this product was made by the vote of the disinterested members of the Board and preceded Dr. Haas' joining HSS' Board of Trustees in April, 2016. Dr. Haas plays no role in the consideration or acquisition of OrthoSecure. In 2017, HSS paid $150,000 for its subscription to the OrthoSecure software and $30,000 for additional services. AMOUNT OF TRANSACTION: $180,000 DESCRIPTION OF TRANSACTION: In 2017, HSS paid $150,000 to OpLogix, for its subscription to the OrthoSecure software and $30,000 for additional services. SCHEDULE L, PART IV, (6) - Don Joy Orthopedics Dr. Douglas Padgett, a member of the Medical Staff, who was elected to the HSS Board of Trustees for a two-year term of April, 2013 through April, 2015, is a designer of and receives royalties for, the design of a total hip replacement system, a product manufactured and sold by Don Joy Orthopedics. Per HSS policy, Dr. Padgett is not allowed to receive royalty payments for these patented products when used on patients at HSS. HSS has had a long-standing business relationship with Don Joy Orthopedics that preceded Dr. Padgett joining HSS' Board of Trustees in April, 2013. With the exception of products used in the procedures he personally performs (and for which he does not receive royalties), Dr. Padgett plays no role in the consideration or acquisition of Don Joy Orthopedics products. AMOUNT OF TRANSACTION: $1,584,796 DESCRIPTION OF TRANSACTION: In 2017, HSS paid $1,584,796 to Don Joy Orthopedics for medical devices. This amount represents all purchases, a part of which relates to the total hip replacement system. X 18 1950147 FMV false true false FORM 990, PART VI, SECTION A - LINE 6 & 7A - "MEMBERSHIP" THE HOSPITAL FOR SPECIAL SURGERY IS A MEMBERSHIP CORPORATION. THERE ARE FIVE MEMBERS OF THE CORPORATION. THREE OF THE FIVE HOSPITAL'S MEMBERS COME FROM THE HOSPITAL'S BOARD OF TRUSTEES (WITH ONE OF THREE ALSO DESIGNATED BY THE HOSPITAL TO SERVE ON THE BOARD OF AN AFFILIATE OF NEW YORK-PRESBYTERIAN HOSPITAL), A FOURTH MEMBER SERVES ON THE BOARD OF THE AFFILIATE OF THE NEW YORK-PRESBYTERIAN HOSPITAL, AND THE FIFTH MEMBER SERVES ON THE BOARD OF TRUSTEES OF WEILL CORNELL MEDICAL COLLEGE. THE FIVE HOSPITAL MEMBERS ELECT THE BOARD OF TRUSTEES OF THE HOSPITAL, UPON THE RECOMMENDATION OF CANDIDATES EITHER BY A MEMBER OR BY THE HOSPITAL BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B - LINE 11B, "REVIEW PROCESS" PRIOR TO SUBMITTING THE FORM 990 TO THE INTERNAL REVENUE SERVICE (IRS), THERE IS AN ESTABLISHED PROCESS FOR REVIEW OF THE DOCUMENT IN ITS ENTIRETY BY THE GOVERNING BODY WHOSE EVALUATIONS ARE MADE IN THE BEST INTEREST OF HSS. THE FORM 990 IS FIRST REVIEWED WITH THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. THE REVIEWED FORM 990 IS THEN SUBMITTED TO THE FULL BOARD OF TRUSTEES. THE TRUSTEES ARE PROVIDED A COPY OF THE FORM 990 VIA COMPACT DISC PRIOR TO SUBMISSION OF THE FORM. IN ADDITION, SIGNIFICANT AREAS OF FORM 990 ARE DISCUSSED AT A BOARD OF TRUSTEES MEETING. FORM 990, PART VI, SECTION B - LINE 12C, "CONFLICT OF INTEREST POLICY" ON AN ANNUAL BASIS, FINANCIAL INTEREST DISCLOSURE STATEMENTS ARE SENT TO ALL BOARD MEMBERS, OFFICERS, MEDICAL STAFF, MANAGEMENT, FELLOWS, RESIDENTS, RESEARCH PROFESSIONAL STAFF, IRB MEMBERS, AND OTHER DESIGNATED GROUPS. OUR CONFLICT OF INTEREST POLICY ALSO REQUIRES THAT ANY CHANGES BE COMMUNICATED TO THE OFFICE OF CORPORATE COMPLIANCE WITHIN 30 DAYS. THE INFORMATION RECEIVED IS ENTERED INTO A DATABASE AND REVIEWED FOR POTENTIAL CONFLICT OF INTEREST. THE DATABASE INFORMATION IS ALSO REVIEWED BY THE EXECUTIVE VICE PRESIDENT FOR LEGAL AFFAIRS, THE CHIEF EXECUTIVE OFFICER, AND THE AUDIT AND CORPORATE COMPLIANCE COMMITTEE OF THE BOARD OF TRUSTEES. SUMMARY INFORMATION IS PROVIDED TO SERVICE CHIEFS SO THAT THEY ARE AWARE OF THE FINANCIAL INTERESTS OF THE MEDICAL STAFF WITHIN THEIR SPECIALTY. IN ADDITION TO SENDING DISCLOSURE STATEMENTS DIRECTLY TO THE GROUP NOTED ABOVE, INDUSTRY WEBSITES ARE MONITORED FOR DISCLOSURES RELATED TO EMPLOYEES OF HSS. THIS INFORMATION IS ENTERED INTO THE DATABASE, AS WELL. HSS HAS A CONFLICT OF INTEREST TASK FORCE THAT MEETS THREE TIMES A YEAR, OR AS NECESSARY, TO REVIEW AND UPDATE THE CONFLICT OF INTEREST POLICIES AND PROCEDURES. HSS' POLICY ON CONFLICT OF INTEREST IN DAY-TO-DAY OPERATIONS STATES THAT IF HSS IS CONTEMPLATING A TRANSACTION WHICH MIGHT POSSIBLY BENEFIT (OR APPEAR TO BENEFIT) A COVERED PERSON OR ANY MEMBER OF HIS/HER IMMEDIATE FAMILY, THEN THE POTENTIAL BENEFIT OR CONFLICT MUST BE DISCLOSED TO, AND APPROVED BY, A DISINTERESTED OFFICER OF HSS BEFORE THE TRANSACTION MAY PROCEED. ACCORDINGLY, A COVERED PERSON MAY NOT PLACE BUSINESS WITH ANY THIRD PARTY (E.G., A VENDOR, COMPETITOR, OR OTHER ORGANIZATION) IN WHICH THAT PERSON OR ANY MEMBER OF HIS/HER IMMEDIATE FAMILY HAS AN INTEREST, UNLESS THAT INTEREST IS DISCLOSED TO, AND THE TRANSACTION IS APPROVED BY, THE VICE PRESIDENT FOR CORPORATE COMPLIANCE AND INTERNAL AUDIT ("CORPORATE COMPLIANCE OFFICER"). FORM 990, PART VI, SECT B - LINE 15A & 15B, "PROCESS FOR DETERMINING COMP" THE HOSPITAL FOR SPECIAL SURGERY(HSS) IS COMMITTED TO ENSURING THAT ITS EXECUTIVE COMPENSATION PROGRAM ADHERES TO THE HIGHEST STANDARDS OF REGULATORY COMPLIANCE AND BEST CORPORATE GOVERNANCE. THE HSS BOARD HAS CHARGED THE COMPENSATION COMMITTEE (WHICH IS COMPOSED OF INDEPENDENT BOARD MEMBERS WITH NO CONFLICTS OF INTEREST IN REGARD TO EXECUTIVE COMPENSATION) WITH MAKING ALL DECISIONS RELATED TO COMPENSATION FOR OFFICERS AND KEY EMPLOYEES. THE COMMITTEE RETAINS AN INDEPENDENT COMPENSATION CONSULTANT TO ASSIST IT IN THIS PROCESS. COMPENSATION LEVELS ARE ESTABLISHED CONSIDERING DATA FOR FUNCTIONALLY COMPARABLE ROLES IN COMPARABLE ORGANIZATIONS, AN ASSESSMENT OF PERFORMANCE, AND OTHER BUSINESS JUDGMENT FACTORS, CONSISTENT WITH HSS'S EXECUTIVE COMPENSATION PHILOSOPHY. THE COMMITTEE'S DECISIONS ARE MADE IN THE BEST INTERESTS OF HSS, AND ARE INTENDED TO ENSURE THE RECRUITMENT AND RETENTION OF KEY EXECUTIVE TALENT, CONSISTENT WITH THE MARKET PRACTICES OF OTHER NOT-FOR-PROFIT HEALTH CARE ORGANIZATIONS OF COMPARABLE MISSION AND COMPLEXITY, CONSIDERING BOTH LOCAL AND NATIONAL MARKET CHALLENGES IN SUCH REGARD. ON AN ANNUAL BASIS (INCLUDING 2017), THE COMMITTEE PROVIDES THE FULL BOARD WITH AN OVERVIEW OF ITS DETERMINATIONS AND PROCESS. HSS ESTABLISHED THIS PROCESS IN AN EFFORT TO COMPLY WITH THE INTERMEDIATE SANCTIONS GUIDELINES FOR QUALIFYING FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS, AS WELL AS BEST CORPORATE GOVERNANCE PRACTICES IN ENSURING THE TRANSPARENCY OF THE EXECUTIVE COMPENSATION DECISION-MAKING PROCESS WITH THE BOARD. FORM 990, PART VI, SECTION B - LINE 19, "DISCLOSURE GOVERNING DOCUMENTS" HOSPITAL FOR SPECIAL SURGERY MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST FROM THE OFFICE OF LEGAL AFFAIRS. HSS ALSO PROVIDES SUMMARIZED FINANCIAL INFORMATION IN ITS ANNUAL REPORT AND WEBSITE. THE ANNUAL REPORT IS DISTRIBUTED THROUGHOUT THE HOSPITAL AND PATIENT WAITING ROOMS, AND ADMINISTRATION OFFICES, AND IS ACCESSIBLE AS A DOWNLOADABLE FILE FROM THE HSS WEBSITE. FOR CALENDAR YEAR 2017, THE ANNUAL REPORT WAS MAILED TO 6,491 DONORS, PUBLIC OFFICIALS, AND OTHER HEALTHCARE PROFESSIONALS AND ORGANIZATIONS. FORM 990, PART XI, LINE 9- "OTHER CHANGES IN NET ASSETS OR FUND BALANCES" INCLUDES INCREASE IN INTEREST OF HSS FUND, INC. $13,276,035, AND DECREASE IN DEFINED PENSION AND POST RETIREMENT PLAN LIABILITIES $39,263,598. 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