2015-11-11T11:46:40-06:00 2014-12-31 861065772 DELOITTE TAX LLP 201 E KENNEDY BLVD STE 1200 TAMPA FL 33602 990 2014-01-01 590624424 MOUNT SINAI MEDICAL CENTER OF FLORIDA INC MOUN 3056742032 4300 ALTON ROAD MIAMI BEACH FL 33140 ALEXANDER MENDEZ CFO/EVPO 3056742032 2015-11-09 1 STEVEN E ROVNER P00648526 8132738355 2014 2016-02-25 16:41:14Z STEVEN D SONENREICH 4300 ALTON ROAD MIAMI BEACH FL 33140 628183232 0 X WWW.MSMC.COM X 1946 FL TO PROVIDE HIGH QUALITY HEALTH CARE TO OUR DIVERSE COMMUNITY ENHANCED THROUGH TEACHING, RESEARCH, CHARITY CARE AND FINANCIAL RESPONSIBILITY. 25 22 3722 434 41927 0 648963 678420 562029613 583190815 3231949 1566296 18812258 14592715 584722783 600028246 0 0 0 0 242142666 258389003 0 0 0 299737314 320205752 541879980 578594755 42842803 21433491 640611544 784014032 392820976 497879671 247790568 286134361 TO PROVIDE HIGH QUALITY HEALTH CARE TO OUR DIVERSE COMMUNITY ENHANCED THROUGH TEACHING, RESEARCH, CHARITY CARE AND FINANCIAL RESPONSIBILITY. 0 0 506891712 583190815 MOUNT SINAI MEDICAL CENTER PROVIDED ACUTE MEDICAL SERVICES TO 19,253 INPATIENTS FOR A TOTAL OF 134,720 PATIENT DAYS. SERVICES WERE ALSO PROVIDED TO 118,765 OUTPATIENTS AND 52,057 EMERGENCY ROOM PATIENTS. SEE THE ATTACHED COMMUNITY SERVICE STATEMENT ON SCHEDULE O. 506891712 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 1 1 0 0 1 901 0 1 3722 1 1 1 1 CJ 0 0 0 0 0 0 0 0 X 25 22 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 0 CA NC X LOURDES DIAZ 3056742032 4300 ALTON ROAD MIAMI BEACH FL 33140 MICHAEL ADLER TRUSTEE 2.00 0.50 X 0 0 0 NORMAN BRAMAN TRUSTEE 2.00 0.00 X 0 0 0 PAUL CHAPLIN MD TRUSTEE 2.00 0.50 X 0 0 0 WAYNE CHAPLIN TRUSTEE 2.00 0.50 X 0 0 0 STANLEY COHEN TRUSTEE 2.00 0.50 X 0 0 0 MARC CSETE MD PHYSICIAN/PRES. MEDICAL STAFF 60.00 0.00 X 0 0 0 EDWARD DAUER MD TRUSTEE 2.00 0.00 X 0 0 0 PHILLIP FROST MD TRUSTEE 2.00 0.00 X 0 0 0 MARK HILDEBRANDT TRUSTEE 2.00 0.50 X 0 0 0 SAMUEL JACOBSON TRUSTEE 2.00 0.00 X 0 0 0 BENNY KLEPACH TRUSTEE 2.00 0.00 X 0 0 0 AMY KNAPP TRUSTEE 2.00 0.00 X 0 0 0 IRA LAMPERT TRUSTEE 2.00 0.50 X 0 0 0 JASON LOEB TRUSTEE 2.00 0.50 X 0 0 0 LAURANS MENDELSON TRUSTEE 2.00 0.50 X 0 0 0 BONNIE SCHAEFER TRUSTEE 2.00 0.00 X 0 0 0 BARRY SIADAT TRUSTEE 2.00 0.00 X 0 0 0 BARRY SILVERMAN MD TRUSTEE 2.00 0.00 X 0 0 0 SYDNEY SILVERMAN TRUSTEE 2.00 0.00 X 0 0 0 PAUL SINGERMAN TRUSTEE 2.00 0.00 X 0 0 0 STEVEN D SONENREICH PRESIDENT/CEO 60.00 1.50 X X 1254070 0 347026 ROBERT STONE TRUSTEE 2.00 0.50 X 0 0 0 STANLEY TATE TRUSTEE 2.00 0.00 X 0 0 0 LEONARD WIEN TRUSTEE 2.00 0.50 X 0 0 0 DR S HOWARD WITTELS MD PHYSICIAN/TRUSTEE 2.00 0.00 X 5000 0 0 ALEXANDER A MENDEZ EXEC VP OF OPERATIONS/CFO 60.00 1.00 X 1009180 0 67612 WAYNE CHUTKAN SENIOR VP OF FINANCE 60.00 0.00 X 321382 0 68345 BENJAMIN DAVIS VP FACILITIES/RESOURCE MGT 60.00 0.00 X 213102 0 28913 STEVEN FINE VP ADMINISTRATION 60.00 0.00 X 253408 0 72883 THOMAS GILLETTE SENIOR VP/ CIO 60.00 0.00 X 396523 0 70379 ROBERT GOLDSZER MD SENIOR VP/ CMO 60.00 0.00 X 579398 0 49604 FREDERICK HAMILTON VP OF COMPLIANCE 60.00 0.00 X 232354 0 42902 ARNOLD JAFFEE SENIOR VP/ GEN COUNSEL 60.00 2.00 X 392048 0 48522 MERVYN MILLS VP OF FINANCE 60.00 0.00 X 216625 0 43313 KAREN MOYER SENIOR VP/ CNO 60.00 0.00 X 391980 0 57788 ANGEL PALLIN SENIOR VP OF OPERATIONS 60.00 0.00 X 317501 0 40531 CHARLENE J WELKER SENIOR VP NETWORK DEVELOPM 60.00 0.00 X 271450 0 55719 ROBERT BEASLEY EMPLOYED MD DIRECTOR OF VASCULAR 60.00 0.00 X 742707 0 70569 ALLEN KANTROWITZ EMPLOYED MD CHIEF, NEUROSURGERY 60.00 0.00 X 799889 0 5540 JOSEPH LAMELAS EMPLOYED MD CHIEF,CARDIOTHORACIC SURG 60.00 0.00 X 2684082 0 71600 TODD M LASNER EMPLOYED MD NEUROSURGERY 60.00 0.00 X 796201 0 12112 MICHAEL A SCHWARTZEMPLOYED MD MEDICAL ONCOLOGY 60.00 0.00 X 764829 0 23750 11641729 0 1177108 260 0 1 0 MCKESSON PO BOX 409521 ATLANTA GA 30384 MEDICATION SUPPLIER 25617797 CARDINAL HEALTH MEDICAL PRODUCTS AND SVC 7000 CARDINAL PLACE DUBLIN OH 43017 MEDICAL SUPPLIER 14457920 MEDTRONIC USAINC 710 MEDTRONIC PKWY NE MINNEAPOLIS MN 55432 MEDICAL SUPPLIER 11974203 ARAMARK CTS INC 12483 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 MANAGEMENT SERVICES 3968036 EPIC SYSTEMS CORPORATION 1979 MILKY WAY VERONA WI 53593 IT & CONSULTING SERVICES 3530964 294 678420 678420 PATIENT SERVICE REVENU 621300 384631739 384631739 MEDICARE/MEDICAID REVE 621300 175439655 175439655 GRANT REVENUE 900009 21868008 21868008 PARTNERSHIP INCOME 900009 921472 936735 -15263 OTHER PATIENT REVENUE 621300 329941 329941 583190815 1809427 1809427 8229780 17820 3807490 0 4422290 17820 4440110 57190 4382920 24096597 7768 24347496 0 -250899 7768 -243131 -243131 EMERGENCY DEPARTMENT 621990 3249996 3249996 CAFETERIA 722210 2136657 2136657 PARKING 812930 1371232 1371232 3394720 3394720 10152605 600028246 583206078 41927 16101821 11641729 11641729 207252417 187009586 20242831 25161098 21496081 3665017 14333759 12245874 2087885 868553 126515 742038 1710251 1710251 534100 534100 6006933 6006933 1843913 8971 1834942 112734129 111864028 870101 12006135 10257311 1748824 862970 737268 125702 6544397 5591127 953270 11422820 9758949 1663871 26048918 22254579 3794339 30402977 25974417 4428560 PROVISION FOR BAD DEBT 71954394 61473370 10481024 SERVICE CONTRACTS/MAINT 21347861 18238302 3109559 CONSULTANT FEES 6855470 5856888 998582 STATE INDIG. TAX ASSESS 5584703 5584703 3477228 2406810 1070418 578594755 506891712 71703043 0 -1482149 7661206 252181104 266625842 650670 1022068 67732267 62804063 7829600 7831223 3565724 11041464 405308494 261520926 155206296 143787568 22122436 122744183 132805596 160496415 640611544 784014032 54439808 67178088 210704005 306916434 14113175 12885858 113563988 110899291 392820976 497879671 X 128804608 149640401 116074000 133582000 2911960 2911960 247790568 286134361 640611544 784014032 X 21433491 -42300 16952602 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 295479 0 1 163340 0 458819 0 32690000 5659000 402000 1244000 784000 36723000 32882000 1779000 413000 1755000 629000 32690000 31392000 4731000 449000 3041000 649000 32882000 34821000 588000 484000 3914000 587000 31392000 33102000 4128000 500000 1326000 1583000 34821000 0.00000 0.14410 0.85590 0 1 1 1090390 1090390 240654660 150201474 90453186 163321730 111319452 52002278 241714 241714 143787568 BOND FINANCING COSTS 3655310 INVESTMENTS IN AFFILIATES 1778125 DEPOSITS 153843 BENEFICIAL INTEREST IN NET ASSETS OF MOUNT SINAI MEDICAL CENTER FOUNDATION, 138872043 CONSTRUCTION IN PROGRESS 15691091 PHYSICIAN GUARANTEES (SHORT-TERM) 346003 160496415 INDIGENT CARE ASSESSMENT 7600859 OTHER CURRENT LIABILITIES 13712118 OTHER LONG-TERM LIABILITIES 267609 SELF-INSURED CLAIMS RESERVE 38540259 CAPITAL LEASE 8941934 DUE TO THIRD PARTIES 18020983 DUE TO AFFILIATES 119353 SELF-INSURED CLAIMS RESERVE (SHORT-TERM) 23696176 110899291 X 529226000 -71875201 -71875201 601101201 -1072955 -1072955 600028246 512755000 6114639 6114639 506640361 71954394 71954394 578594755 PART V, LINE 4: THE FOUNDATION'S ENDOWMENT CONSISTS OF APPROXIMATELY 46 INDIVIDUAL FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. THE ENDOWMENT CONSISTS OF DONOR-RESTRICTED FUNDS THAT HAVE BEEN LIMITED BY DONORS TO A SPECIFIC TIME PERIOD OR PURPOSE. AS REQUIRED BY GAAP, NET ASSETS ASSOCIATED WITH ENDOWMENT FUNDS ARE CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OR ABSENCE OF DONOR-IMPOSED RESTRICTIONS. THE ENDOWMENT NET ASSET COMPOSITION BY FUND TYPE AS OF DECEMBER 31, 2014, IS COMPOSED OF THE FOLLOWING: TEMPORARILY RESTRICTED PERMANENTLY RESTRICTED ALZHEIMER'S PROGRAM 7,013,000 0 MELANOMA RESEARCH 3,440,000 0 CANCER LIFELINE 1,630,000 0 CANCER RESEARCH 2,289,000 0 OTHER PROGRAMS 17,060,000 5,290,000 ------------ ----------- TOTAL FUNDS 31,432,000 5,290,000 PART X, LINE 2: THE FOOTNOTE TO THE AUDITED FINANCIAL STATEMENTS FOR MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC. AND SUBSIDIARIES REGARDING FIN48 READS AS FOLLOWS: THE MEDICAL CENTER FOLLOWS THE PROVISIONS OF ASC 740-15-2, INCOME TAXES, AND HAS DETERMINED THAT AS OF DECEMBER 31, 2014 AND 2013, THE MEDICAL CENTER HAD NO MATERIAL UNRECOGNIZED TAX BENEFITS. THE MEDICAL CENTER DOES NOT EXPECT THAT UNRECOGNIZED TAX BENEFITS WILL MATERIALLY INCREASE WITHIN THE NEXT TWELVE MONTHS. IN THE EVENT THE MEDICAL CENTER WERE TO RECOGNIZE INTEREST AND PENALTIES RELATED TO UNCERTAIN TAX POSITIONS, IT WOULD BE RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS AS INCOME TAX EXPENSE. TAX YEARS FROM 2009 THROUGH 2013 ARE SUBJECT TO EXAMINATION BY THE FEDERAL AND STATE TAXING AUTHORITIES. THERE ARE NO INCOME TAX EXAMINATIONS CURRENTLY IN PROCESS. PART XI, LINE 2D - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT -71,954,394. INCOME FROM MT SINAI MEDICAL OFFICE BLDG II, INC 121,493. UNREALIZED GAINS ON INVESTMENTS -42,300. PART XI, LINE 4B - OTHER ADJUSTMENTS: INCOME FROM PREMIER HEALTHCARE ALLIANCE 1,017,425. EXPENSES NETTED AGAINST REVENUES -2,073,380. CONTRIBUTIONS RELEASED FROM RESTRICTIONS FOR CAPITAL PURPOSES 4,483,000. LOSS ON EXTINGUISHMENT OF DEBT -4,500,000. PART XII, LINE 2D - OTHER ADJUSTMENTS: EXPENSES NETTED AGAINST REVENUE 2,073,380. LOSS ON EXTINGUISHMENT OF DEBT 4,500,000. DISTRIBUTIONS FROM PREMIER HEALTHCARE ALLIANCE -458,741. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT 71,954,394. CENTRAL AMERICA/CARIBBEAN 0 0 PROGRAM SERVICES INSURANCE PREMIUM 471000 0 0 0 0 0 0 471000 0 471000 1 0 1 0 0 0 1 1 X 1 X 1 X 1 1 1 0 1 1 15905614 15905614 0.03140 29072300 23103640 5968660 0.01180 40006462 29529557 10476905 0.02070 84984376 52633197 32351179 0.06390 1583965 15000 1568965 0.00310 32591775 12362762 20229013 0.03990 10387382 7005313 3382069 0.00670 6270295 4528237 1742058 0.00340 371650 371650 0.00070 51205067 23911312 27293755 0.05380 136189443 76544509 59644934 0.11770 7865323 6183850 1681473 0.00330 90000 90000 0.00020 245601 245601 0.00050 2811936 2811936 0.00560 11012860 6183850 4829010 0.00960 0 14668604 227641328 235512673 -7871345 X 1 0 1 1 MOUNT SINAI MEDICAL CENTER OF FL INC 4300 ALTON ROAD MIAMI BEACH FL 33140 X X X X X MOUNT SINAI MEDICAL CENTER OF FL INC 1 0 0 1 X X X X X X X X X 12 1 0 0 1 X WWW.MSMC.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENT-2012 1 12 1 WWW.MSMC.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENT-2012 0 0 1 X 200.000000000000 X X X X X 1 1 X X X 1 X X X X X X X 1 0 1 0 0 MOUNT SINAI MEDICAL CENTER OF FL, INC. PART V, SECTION B, LINE 5: METHODS OF INPUT:DURING 2010 AND 2011, MOUNT SINAI SOUGHT THE INPUT OF THOSE THAT REPRESENT THE HEALTH AND BROAD INTERESTS OF THE COMMUNITY IN A SERIES OF BOTH PUBLICALLY NOTICED AND PRIVATE MEETINGS. OTHER INPUT WAS SOUGHT THROUGH TELEPHONE INTERVIEWS AND A PUBLICALLY ADVERTISED COMMUNITY HEALTH SURVEY.COLLABORATING ORGANIZATIONSMOUNT SINAI SOUGHT THE INPUT OF THOSE THAT REPRESENT THE INTERESTS OF THE COMMUNITY DURING PUBLICALLY NOTICED MEETINGS, PRIVATE MEETINGS AND INTERVIEWS DURING 2010-2011.- HEALTH COUNCIL OF SOUTH FLORIDA - CITY OF MIAMI BEACH ADVISORY BOARD - CITY OF MIAMI BEACH- HEALTHY COMMUNITIES INSTITUTE - MIAMI-DADE OFFICE OF COUNTY-WIDE HEALTH PLANNINGINDIVIDUALS FROM WHOM INPUT WAS SOUGHT:- PRESIDENT AND CEO, MOUNT SINAI MEDICAL CENTER- EXECUTIVE VICE PRESIDENT, MIAMI BEACH COMMUNITY HEALTH CENTERS- INFECTIOUS DISEASES PHYSICIAN- INTERNAL MEDICINE PHYSICIAN- HEALTH ADVISORY COMMITTEE MEMBER- COMMUNITY ADVOCATE- PRESIDENT/CEO, HEALTH COUNCIL OF SOUTH FLORIDA- ADMINISTRATOR, SOUTH POINTE PLAZA ASSISTED LIVING FACILITY- HEALTH COUNCIL OF SOUTH FLORIDA- DIRECTOR, MIAMI-DADE COUNTYWIDE HEALTH PLANNING - EXECUTIVE DIRECTOR, DOUGLAS GARDEN MENTAL HEALTH CENTER MIAMI BEACH- CLINICAL PROFESSOR, SCHOOL OF PUBLIC HEALTH, UC BERKELEY, CEO HEALTHY COMMUNITIES INSTITUTE- RN- HEALTH ADVISORY COMMITTEE MEMBER- EXECUTIVE DIRECTOR, MIAMI BEACH HOUSING AUTHORITY- EMERGENCY MANAGEMENT COORDINATOR, MIAMI-DADE COUNTY DEPARTMENT OF EMERGENCY MANAGEMENT- DIRECTOR, OFFICE OF EMERGENCY OPERATIONS, BROWARD COUNTY HEALTH DEPARTMENT, COORDINATOR OF FLORIDA REGION 5 HOSPITAL MOUNT SINAI MEDICAL CENTER OF FL, INC. PART V, SECTION B, LINE 11: AS SOUTH FLORIDA'S LARGEST INDEPENDENT TEACHING HOSPITAL, MOUNT SINAI USES A TWO-TIER, THREE-YEAR STRATEGY TO MEET COMMUNITY HEALTH NEEDS. TIER ONE - PROVIDE A WIDE RANGE OF SAFETY NET SERVICESFIRST, MOUNT SINAI WILL CONTINUE TO PROVIDE A WIDE VARIETY OF COMMUNITY HEALTH SERVICES IN ITS ROLE AS A TEACHING AND COMMUNITY HOSPITAL, AND SOLE EMERGENCY SERVICES PROVIDER ON THE NORTHEASTERN BARRIER ISLANDS OF MIAMI DADE COUNTY. ADDRESS FLORIDA'S PHYSICIAN SHORTAGE;PROVIDE CHARITY CARE FOR THE UNINSURED;OPERATE EMERGENCY MEDICAL SERVICES;PROVIDE ADULT PSYCHIATRIC CARE;OFFER NATIONALLY RECOGNIZED GERIATRIC CARE;OPERATE MATERNITY SERVICES AND PRENATAL MEDICINE;PRESENT FREE HEALTH EDUCATION AND DISEASE PREVENTION LECTURES; CONDUCT FREE HEALTH SCREENINGS.TIER TWO - FOCUS CENTERS OF EXCELLENCE ON MISSION DRIVEN COMMUNITY HEALTH PRIORITIES;SECOND, MOUNT SINAI IS FOCUSING RESOURCES ON THE LEADING DISEASE RELATED CONDITIONS THAT CAUSE FATALITIES AND OTHER IDENTIFIED LOCAL PRIORITY HEALTH CARE SERVICES AS APPROPRIATE FOR ITS TEACHING MISSION AND FISCAL RESPONSIBILITY. ADDRESS HEART DISEASE;ADDRESS CANCER;ADDRESS STROKE;ADDRESS CHRONIC OBSTRUCTIVE PULMONARY DISEASE;ADDRESS ALZHEIMER'S DISEASEADDRESS COMMUNITY HEALTHCARE SERVICES COMMUNITY HEALTHCARE RESOURCES WITHIN THREE MILE RADIUSWITHIN THREE MILES OF MOUNT SINAI, THERE ARE NO OTHER ACUTE CARE HOSPITALS. THERE ARE 4 PUBLIC HEALTH CENTERS, INCLUDING THREE FEDERALLY QUALIFIED HEALTH CENTERS: THE MIAMI BEACH COMMUNITY HEALTH CENTER (TWO LOCATIONS) AND THE BORINQUEN HEALTH CARE CENTER. FOR SUBSTANCE AND MENTAL HEALTH ISSUES, THERE ARE 0 RESIDENTIAL TREATMENT CENTERS. FOR GERIATRIC RESIDENTIAL SERVICES, THERE ARE 3 NURSING HOMES AND 2 ASSISTED LIVING FACILITIES.COMMUNITY HEALTH NEEDS NOT WITHIN THE IMPLEMENTATION STRATEGYSPECIALIZED AIDS/HIV SERVICES ARE NOT WITHIN THE IMPLEMENTATION STRATEGY. THESE HEALTH SERVICES FOR THE UNINSURED OR UNDERINSURED ARE ALREADY PROVIDED BY THE MIAMI BEACH COMMUNITY HEALTH CENTERS, THE BORINQUEN HEALTH CARE CENTER AND JACKSON MEMORIAL HEALTH CENTER AND THE MIAMI-DADE COUNTY HEALTH DEPARTMENT/OFFICE OF HIV/AIDS. PART V, SECTION B, LINE 16 FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY MOUNT SINAI MEDICAL CENTER OF FL, INC. PART V, SECTION B, LINE 16A WEBSITE: HTTP://WWW.MSMC.COM/PATIENT-INFO/FINANCIAL-ASSISTANCE-INFORMATION MOUNT SINAI MEDICAL CENTER OF FL, INC. PART V, SECTION B, LINE 16C WEBSITE: HTTP://WWW.MSMC.COM/PATIENT-INFO/FINANCIAL-ASSISTANCE-INFORMATION PART I, LINE 7: A RATIO OF PATIENT CARE COST TO PATIENT CARE CHARGES WAS APPLIED TO GROSS WRITE-OFFS TO ARRIVE AT AN ESTIMATED PROGRAM COST. ANY APPLICABLE PROGRAM REVENUES RECEIVED WERE OFFSET AGAINST GROSS COST TO ARRIVE AT THE NET COST OR SHORTFALL OF THE PROGRAM. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 71,954,394. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING ACTIVITIES:1. WORKFORCE DEVELOPMENT PROJECTS TO RECRUIT HEALTHCARE WORKERS, INCLUDING PHYSICIANS, NURSES AND ALLIED HEALTH PROFESSIONALS; 2. WORKFORCE HOUSING APPROVED BY THE CITY'S STATE HOUSING INITIATIVE PROGRAM (SHIP) AND THE FLORIDA HOUSING FINANCE CORPORATION (FHFC). PART III, LINE 2: A RATIO OF PATIENT CARE COST TO PATIENT CARE CHARGES WAS APPLIED TO BAD DEBT GROSS WRITE-OFFS TO ARRIVE AT AN ESTIMATED BAD DEBT EXPENSE AT COST. PART III, LINE 4: THE FOOTNOTE TO THE AUDITED FINANCIAL STATEMENTS FOR MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC. AND SUBSIDIARIES REGARDING BAD DEBT EXPENSE READS AS FOLLOWS:THE MEDICAL CENTER RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARD RATES FOR SERVICES PROVIDED, THEN DISCOUNTED EITHER AS BAD DEBT OR CONTRACTUAL ALLOWANCES DEPENDING ON NEGOTIATED RATES OR POLICY. HISTORICALLY, A SIGNIFICANT PORTION OF THE MEDICAL CENTER'S UNINSURED PATIENTS WILL BE UNABLE TO PAY FOR THE SERVICES PROVIDED. AS SUCH, THE MEDICAL CENTER RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED.PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILIY OF PATIENT ACCOUNTS RECEIVABLE THE MEDICAL CENTER ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR ALL PAYOR TYPES, WHEN THE MEDICAL CENTER CAN NO LONGER REASONABLY ESTIMATE COLLECTIBILITY OF AN ACCOUNT BASED ON THE AGING OF THE BALANCE DUE AND THE VOLATILITY AND UNPREDICTABLE NATURE OF THE AMOUNT, THE MEDICAL CENTER RESERVES SUBSTANTIALLY ALL AMOUNTS DUE. PART III, LINE 8: A RATIO OF PATIENT CARE COST TO PATIENT CARE CHARGES WAS APPLIED TO MEDICARE REVENUES AND ALLOWABLE COSTS TO ARRIVE AT AN ESTIMATED MEDICARE EXPENSE AT COST. THE HOSPITAL DOES NOT TREAT ANY MEDICARE SHORTFALL AMOUNTS AS COMMUNITY BENEFIT. PART III, LINE 9B: PATIENTS ARE FIRST SCREENED TO SEE IF THEY ARE ELIGIBLE FOR MEDICAID OR CHARITY WHEN THEY COME IN THROUGH THE ER. THE HOSPITAL DETERMINES WHICH PATIENTS QUALIFY FOR CHARITY BASED ON A VERIFIABLE PROCESS REQUIRED BY THE AGENCY HEALTH CARE ADMINISTRATION USING THE FOLLOWING CRITERIA:O PATIENT IS ELIGIBLE IF THE PATIENT'S FAMILY AGGREGATE INCOME DURING THE 12 MONTHS PRECEDING THE DETERMINATION DATE IS AT OR BELOW 400% OF THE THEN CURRENT FEDERAL POVERTY GUIDELINES.O IF PATIENT IS ELIGIBLE FOR CHARITY THE AMOUNT OF ELIGIBLE CHARGES ARE REDUCED ON A SLIDING SCALE BASED ON WHERE THEY FALL IN RELATION TO THE FEDERAL POVERTY GUIDELINES.O MEDICAID PATIENTS WITH BENEFITS EXHAUSTED MAY APPLY FOR CHARITY.O PATIENTS WITH DOCUMENTATION THAT A THIRD PARTY BENEFIT HAS BEEN DENIED OR EXHAUSTED MAY APPLY FOR CHARITY.ALL OPPORTUNITIES FOR PAYMENT OF HOSPITAL DEBT WILL BE INVESTIGATED PRIOR TO APPROVAL INCLUDING A COMPLETE REVIEW OF THE FINANCIAL INFORMATION PROVIDED IN THE UNCOMPENSATED CARE APPLICATION.THE BUSINESS OFFICE'S ROLE IN CHARITY CARE DEALS WITH THE FINAL REVIEW AND APPROVAL OF ELIGIBLE PATIENTS. BUSINESS OFFICE IS RESPONSIBLE FOR ADJUSTING ACCOUNT CHARGES/BALANCES AFTER REVIEWING SEARCH AMERICA'S RESULTS, AND/OR ANY RED FLAGS ON THE ACCOUNT THAT WOULD SUGGEST THE POSSIBILITY OF ALTERNATE METHODS OF PAYMENT. THESE PRACTICES SET FORTH IN THE POLICY WOULD ONLY APPLY TO PATIENTS WHO MAY QUALIFY FOR CHARITY CARE. PART VI, LINE 2: NEEDS ASSESSMENT:COMMUNITY HEALTH NEEDS WERE IDENTIFIED THROUGH A RECOGNIZED HEALTH PLANNING ASSESSMENT PROCESS. THE ASSESSMENT INCLUDED, BUT WAS NOT LIMITED TO, AN ANALYSIS OF DEMOGRAPHIC, ENVIRONMENTAL, STATISTICAL AND BEHAVIORAL PUBLIC HEALTH DATA, ORGANIZING PUBLIC DISCUSSIONS ON HEALTH TOPICS, AND CONDUCTING A SURVEY OF CURRENT HEALTH TOPICS TO EXPLORE THE HEALTH NEEDS OF THE PRIMARY, NEIGHBORING AND COUNTYWIDE SERVICES AREAS OF MOUNT SINAI MEDICAL CENTER. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:ONCE IT IS DETERMINED THAT A PATIENT HAS NO INSURANCE OR MEDICAID AND ARE CONSIDERED SELF-PAY, THE ER REP SCREENS THE PATIENT FOR FINANCIAL ASSISTANCE ELIGIBILITY USING THE SCREENING FOR FINANCIAL ASSISTANCE FORM. THE ER REP WILL INFORM THE PATIENT THAT THE HOSPITAL WILL DO A FINANCIAL SCREENING TO DETERMINE IF THEY MAY QUALIFY FOR FINANCIAL ASSISTANCE. PART VI, LINE 4: COMMUNITY INFORMATION:MOUNT SINAI IS THE ONLY ACUTE CARE HOSPITAL AND EMERGENCY CARE PROVIDER ON THE NORTHEASTERN BARRIER ISLANDS OF MIAMI-DADE COUNTY. MOUNT SINAI PRIMARILY SERVICES A DENSELY POPULATED DIVERSE URBAN AREA ENCOMPASSING THE BARRIER ISLAND CITIES OF MIAMI BEACH, SURFSIDE, NORTH BAY VILLAGE, BAL HARBOUR, AND BAY HARBOR ISLANDS. THE NEIGHBORING MAINLAND OR SECONDARY SERVICE AREA INCLUDES SECTIONS OF THE CITIES OF MIAMI, NORTH MIAMI, AND NORTH MIAMI BEACH. MOUNT SINAI'S HEALTH NEEDS TARGET AREAS INCLUDE SECTIONS OF THE UPPER BARRIER ISLAND CITY OF SUNNY ISLES BEACH AND THE MAINLAND CITIES OF AVENTURA, HIALEAH, AND CORAL GABLES. THE NORTHEASTERN BARRIER ISLANDS HAVE 130,309 YEAR ROUND RESIDENTS THAT ARE 51% MALE AND 49% FEMALE. THE POPULATION IS 88% WHITE, 4% BLACK WITH 8% ALL OTHER RACES. 51% OF RESIDENTS REPORT THEIR ETHNICITY AS HISPANIC. THE MEDIAN AGE IS 41.1 YEARS OLD. THE MEDIAN HOUSEHOLD INCOME IS $42,265. THERE ARE THREE DESIGNATED MEDICALLY UNDERSERVED AREAS IN THE PRIMARY SERVICE AREA REPRESENTED BY MUAS FEDERAL ID# 5031, 511 AND 7474. PART VI, LINE 5: AS SOUTH FLORIDA'S LARGEST INDEPENDENT TEACHING HOSPITAL, MOUNT SINAI'S NOT-FOR-PROFIT MISSION IS TO PROVIDE HIGH QUALITY HEALTH CARE TO OUR DIVERSE COMMUNITY ENHANCED THROUGH TEACHING, RESEARCH, CHARITY CARE, AND FINANCIAL RESPONSIBILITY. WE MAINTAIN OUR NOT FOR PROFIT MISSION USING A TWO-TIER STRATEGY, FOCUSING, FIRST, ON SAFETY NET SERVICES AND, SECOND, ON ADDRESSING HEALTH RISKS RELATED TO HEART DISEASE, CANCER, NEUROLOGICAL, PULMONARY AND OTHER DISEASES THAT POSE SERIOUS COMMUNITY HEALTH RISKS.THIS NOT FOR PROFIT COMMUNITY DRIVEN MISSION IS DETAILED FURTHER IN SCHEDULE O. WE HAVE BRIEFLY DISCUSSED IT BELOW.TIER ONE - PROVIDE A WIDE RANGE OF SAFETY NET SERVICESMOUNT SINAI'S ROLE AS NOT-FOR-PROFIT SAFETY NET IS TO OFFER ITS COMMUNITY "SERVICES THAT WOULD FREQUENTLY BE OTHERWISE ABSENT" IF PROFIT MOTIVES WERE CENTRAL TO HOSPITAL OPERATIONS. SAFETY NET HOSPITALS: A VITAL RESOURCE FOR THE UNITED STATES BROADLY DEFINES A SAFETY NET HOSPITAL AS PROVIDING "EMERGENCY SERVICES AND MENTAL HEALTH SERVICES, GRADUATE MEDICAL EDUCATION, CHARITY CARE FOR THE UNINSURED AND BEING PART OF A REGIONAL 'FIRST RESPONSE' IN THE EVENT OF A NATURAL DISASTER OR TERRORIST ATTACK." IMPLEMENTATION STRATEGY - TIER ONE: SAFETY NET SERVICES O TRAINING TO ADDRESS FLORIDA'S PHYSICIAN AND HEALTHCARE WORKER SHORTAGE O CHARITY CARE FOR THE UNINSURED AND UNDERINSURED;O DISASTER FIRST RESPONSE HEALTH SERVICES AND REGIONAL LEADERSHIPO EMERGENCY MEDICAL SERVICES;O ADULT PSYCHIATRIC AND BEHAVIORAL CARE;O INTENSIVE GERIATRIC / SENIOR CARE;O MATERNITY SERVICES AND NEONATAL EMERGENT CARE;O HEALTH AND DISEASE PREVENTION EDUCATION; O INTERVENTIONAL AND COMMUNITY HEALTH SCREENINGS.TIER TWO - FOCUS ON LEADING CAUSES OF DEATH AND OTHER IDENTIFIED HEALTH ISSUESMOUNT SINAI FOCUSES RESOURCES ON THE LEADING CONDITIONS THAT CAUSE FATALITIES AS APPROPRIATE FOR ITS TEACHING MISSION AND FISCAL RESPONSIBILITY. LEADING CAUSES OF DEATH IN MIAMI DADE, HEART DISEASE AND CANCER, REQUIRE A WIDER FOCUS AND GREATER RESOURCES AS THEY ACCOUNT FOR 50% OF ALL FATALITIES. OUR GOAL IS TO HELP OUR ENTIRE MIAMI DADE COUNTY COMMUNITY BEGIN TO REMEDY THESE LEADING ILLNESSES BY FOCUSING PREVENTATIVE PRIMARY CARE HEALTH AND BY SEARCHING FOR WAYS TO CURE OR MITIGATE THESE DISEASES.LEADING CAUSES OF DEATH AND OTHER IDENTIFIED HEALTH ISSUESO ADDRESS HEART DISEASEO ADDRESS CANCER O ADDRESS STROKE O ADDRESS ALZHEIMER'S DISEASEO ADDRESS CHRONIC OBSTRUCTIVE PULMONARY DISEASE X X X X X 0 1 0 0 0 0 0 0 0 STEVEN D SONENREICH PRESIDENT/CEO 821863 0 416861 0 15346 0 321764 0 25262 0 1601096 0 0 0 ALEXANDER A MENDEZ EXEC VP OF OPERATIONS/CFO 581581 0 239484 0 188115 0 42350 0 25262 0 1076792 0 0 0 WAYNE CHUTKAN SENIOR VP OF FINANCE 261527 0 58685 0 1170 0 42350 0 25995 0 389727 0 0 0 BENJAMIN DAVIS VP FACILITIES/RESOURCE MGT 192322 0 20000 0 780 0 20625 0 8288 0 242015 0 0 0 STEVEN FINE VP ADMINISTRATION 224739 0 27481 0 1188 0 47850 0 25033 0 326291 0 0 0 THOMAS GILLETTE SENIOR VP/ CIO 326819 0 68534 0 1170 0 42350 0 28029 0 466902 0 0 0 ROBERT GOLDSZER MD SENIOR VP/ CMO 403007 0 84460 0 91931 0 30450 0 19154 0 629002 0 0 0 FREDERICK HAMILTON VP OF COMPLIANCE 208038 0 23128 0 1188 0 30350 0 12552 0 275256 0 0 0 ARNOLD JAFFEE SENIOR VP/ GEN COUNSEL 323360 0 67500 0 1188 0 30350 0 18172 0 440570 0 0 0 MERVYN MILLS VP OF FINANCE 195013 0 21000 0 612 0 24719 0 18594 0 259938 0 0 0 KAREN MOYER SENIOR VP/ CNO 318224 0 0 0 73756 0 47850 0 9938 0 449768 0 0 0 ANGEL PALLIN SENIOR VP OF OPERATIONS 261721 0 55000 0 780 0 27850 0 12681 0 358032 0 0 0 CHARLENE J WELKER SENIOR VP NETWORK DEVELOPM 220381 0 50295 0 774 0 47850 0 7869 0 327169 0 0 0 ROBERT BEASLEY EMPLOYED MD DIRECTOR OF VASCULAR 562245 0 175000 0 5462 0 47850 0 22719 0 813276 0 0 0 ALLEN KANTROWITZ EMPLOYED MD CHIEF, NEUROSURGERY 796061 0 0 0 3828 0 0 0 5540 0 805429 0 0 0 JOSEPH LAMELAS EMPLOYED MD CHIEF,CARDIOTHORACIC SURG 2470436 0 200000 0 13646 0 47850 0 23750 0 2755682 0 0 0 TODD M LASNER EMPLOYED MD NEUROSURGERY 795031 0 0 0 1170 0 0 0 12112 0 808313 0 0 0 MICHAEL A SCHWARTZEMPLOYED MD MEDICAL ONCOLOGY 570893 0 192142 0 1794 0 0 0 23750 0 788579 0 0 0 PART I, LINE 4B STEVEN D. SONENREICH, PRESIDENT AND CHIEF EXECUTIVE OFFICER OF MSMC, PARTICIPATES IN AN IRC SEC 457(F) PLAN. THE PAYMENT IN 2014 WAS $273,914. A CITY OF MIAMI BEACH HEALTH FACILITIES AUTHORITY 650372870 593211DY8 2012-09-11 141194667 CURRENT REFUND BONDS ISSUED 12/22/98 & 5/24/01 0 0 0 B CITY OF MIAMI BEACH HEALTH FACILITIES AUTHORITY 650372870 593211EZ4 2014-09-04 181289212 CURRENT REFUND BOND ISSUED 4/28/04 & FUND CAPITAL IMPROVEMENTS 0 0 0 A 13015000 141194667 12222174 141194667 1 0 1 1 B 205000 181319418 1147492 1624473 69334698 109626609 1 0 1 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 PART II, LINE 4, COL A THE AMOUNT SHOWN HERE CONSISTS OF $11,235,283 IN A DEBT SERVICE RESERVE FUND, PLUS $986,891 OF DEBT SERVICE FUND DEPOSITS. PART II, LINE 4, COL B THE AMOUNT SHOWN HERE CONSISTS OF BONA FIDE DEBT SERVICE FUNDS OF $774,066 PLUS THE UNSPENT CAPITALIZED INTEREST OF $373,426. PART II, LINE 3, COL B DIFFERENCES BETWEEN THE AMOUNT SHOWN HERE AND THE ISSUE PRICE REPORTED IN PART I, COLUMN (E) ARE DUE TO ACCUMULATED INTEREST EARNINGS. MARC CSETE MDPA SEE PART V 219500 SERVICES 0 MIAMI BEACH ANESTHESIOLOGY SEE PART V 800148 SERVICES 0 MICHAEL B WITTELS MD SEE PART V 186167 SERVICES 0 PART IV, COLUMN B MARC CSETE M.D. P.A.: MARC CSETE, M.D., BOARD MEMBER OF MSMC, IS PRESIDENT OF MARC E. CSETE M.D. P.A., WHICH PROVIDES INTENSIVIST SERVICES TO THE HOSPITAL.MIAMI BEACH ANESTHESIOLOGY: S. HOWARD WITTELS, M.D., BOARD MEMBER, IS PRESIDENT OF MIAMI BEACH ANESTHESIOLOGY, WHICH PROVIDES ANESTHESIA SERVICES TO THE HOSPITAL.MICHAEL B. WITTELS M.D.: FAMILY MEMBER OF S. HOWARD WITTELS, HOSPITAL BOARD MEMBER. FORM 990, PART III, LINE 4A MOUNT SINAI MEDICAL CENTER IS SOUTH FLORIDA'S LARGEST INDEPENDENT, NOT-FOR-PROFIT TEACHING HOSPITAL. MOUNT SINAI PROVIDES ACUTE AND EMERGENCY CARE AS WELL AS CARDIOVASCULAR, REHABILITATION, NEONATAL, MATERNITY AND PSYCHIATRIC SERVICES WHILE REMAINING DEDICATED TO GRADUATE MEDICAL EDUCATION AS ONE OF TEN STATUTORY TEACHING HOSPITALS IN FLORIDA. IN 2014, MOUNT SINAI INVESTED MORE THAN $30 MILLION IN ITS TEACHING PROGRAMS TO TRAIN APPROXIMATELY 160 RESIDENTS AND FELLOWS TO BE DOCTORS IN 19 MEDICAL SPECIALTIES. IN 2014, MOUNT SINAI ALSO TRAINED 341 UNDERGRADUATE MEDICAL STUDENTS, 578 NURSING STUDENTS, 52 PHYSICIAN ASSISTANTS AND 222 ALLIED HEALTH TRAINEES. MOUNT SINAI AFFILIATES WITH OVER 20 EDUCATIONAL INSTITUTIONS AND UNIVERSITIES AND MAINTAINS ITS OWN INDEPENDENT PHYSICIAN RESIDENCY PROGRAM. MOUNT SINAI IS LOCATED ON AND IS THE ONLY HOSPITAL AND EMERGENCY SERVICE PROVIDER ON THE NORTHEASTERN BARRIER ISLANDS OF MIAMI-DADE COUNTY. THESE ARE 32 MANMADE ISLANDS, WHICH FORM A GEOGRAPHIC ENCLAVE TOTALING 10.5 SQUARE LAND MILES. THE CITY OF MIAMI BEACH IS THE LARGEST CENSUS DESIGNATED PLACE ON THE BARRIER ISLANDS. NORTHEASTERN BARRIER ISLAND MUNICIPALITIES: MIAMI BEACH NORTH BAY VILLAGE SURFSIDE BAY HARBOR ISLANDS SUNNY ISLES BEACH INDIAN CREEK GOLDEN BEACH BAL HARBOR MIAMI ISLAND ACCORDING TO INPATIENT USE STATISTICS, APPROXIMATELY 31% OF MOUNT SINAI INPATIENT DISCHARGES WERE RESIDENTS FROM THE CITIES OF MIAMI BEACH. AN ADDITIONAL 19% WERE RESIDENTS FROM THE UPPER BARRIER ISLANDS AND FOUR OTHER NEIGHBORING MAINLAND ZIP CODES. THE REMAINING INPATIENT DISCHARGES WERE EVENLY DISTRIBUTED AMONG THE OTHER 90+ MIAMI-DADE COUNTY ZIP CODES AND OTHER STATES, COUNTIES, AND COUNTRIES. THIS REINFORCES MOUNT SINAI'S HISTORICAL ROLE AS SERVING GREATER MIAMI-DADE COUNTY WITH ITS CORE SPECIALTIES. THE COMMUNITY HEALTH PRIORITIES PRESENTED ARE BASED ON AN ANALYSIS OF DEMOGRAPHIC, ENVIRONMENTAL, STATISTICAL AND BEHAVIORAL PUBLIC HEALTH DATA. LEADING CAUSES OF DISEASE RELATED DEATH: HEART DISEASE CANCER STROKE CHRONIC OBSTRUCTIVE PULMONARY DISEASE MENTAL & BEHAVIORAL DISORDERS, INCLUDING ALZHEIMER'S DISEASE ENVIRONMENTAL HEALTH PRIORITIES: SUN / UV RADIATION DROWNING INJURY/DEATH POPULATION HEALTHCARE SERVICE PRIORITIES: ADDRESSING THE PHYSICIAN SHORTAGE SAFETY NET SERVICES FOR THE UNINSURED GERIATRIC MEDICINE MATERNITY & PRENATAL MEDICINE EMERGENCY MEDICAL SERVICES SPECIALTY COMMUNITY CARE - PREVENTATIVE, INTERVENTIONAL, AND NON ACUTE TREATMENT BEHAVIORAL HEALTH & OTHER PRIORITIES: NUTRITION & PHYSICAL ACTIVITY REDUCING TOBACCO & ALCOHOL USE AIDS/HIV PREVENTION & TREATMENT IMPLEMENTATION STRATEGY AS SOUTH FLORIDA'S LARGEST INDEPENDENT TEACHING HOSPITAL, MOUNT SINAI USES A TWO-TIER, THREE-YEAR STRATEGY TO MEET COMMUNITY HEALTH NEEDS. TIER ONE - PROVIDE A WIDE RANGE OF SAFETY NET SERVICES FIRST, MOUNT SINAI WILL CONTINUE TO PROVIDE A WIDE VARIETY OF COMMUNITY HEALTH SERVICES IN ITS ROLE AS A TEACHING AND COMMUNITY HOSPITAL, AND SOLE EMERGENCY SERVICES PROVIDER ON THE NORTHEASTERN BARRIER ISLANDS OF MIAMI DADE COUNTY. ADDRESS FLORIDA'S PHYSICIAN SHORTAGE; PROVIDE CHARITY CARE FOR THE UNINSURED; OPERATE EMERGENCY MEDICAL SERVICES; PROVIDE ADULT PSYCHIATRIC CARE; OFFER NATIONALLY RECOGNIZED GERIATRIC CARE; OPERATE MATERNITY SERVICES AND PRENATAL MEDICINE; PRESENT FREE HEALTH EDUCATION AND DISEASE PREVENTION LECTURES; CONDUCT FREE HEALTH SCREENINGS. TIER TWO - FOCUS CENTERS OF EXCELLENCE ON MISSION DRIVEN COMMUNITY HEALTH PRIORITIES; SECOND, MOUNT SINAI WILL FOCUS RESOURCES ON THE LEADING DISEASE RELATED CONDITIONS THAT CAUSE FATALITIES AND OTHER IDENTIFIED LOCAL PRIORITY HEALTH CARE SERVICES AS APPROPRIATE FOR ITS TEACHING MISSION AND FISCAL RESPONSIBILITY. ADDRESS HEART DISEASE; ADDRESS CANCER; ADDRESS STROKE; ADDRESS CHRONIC OBSTRUCTIVE PULMONARY DISEASE; ADDRESS ALZHEIMER'S DISEASE ADDRESS COMMUNITY HEALTHCARE SERVICES COMMUNITY HEALTHCARE RESOURCES WITHIN THREE MILE RADIUS WITHIN THREE MILES OF MOUNT SINAI, THERE ARE NO OTHER ACUTE CARE HOSPITALS. THERE ARE 4 PUBLIC HEALTH CENTERS, INCLUDING THREE FEDERALLY QUALIFIED HEALTH CENTERS: THE MIAMI BEACH COMMUNITY HEALTH CENTER (TWO LOCATIONS) AND THE BORINQUEN HEALTH CARE CENTER. FOR SUBSTANCE AND MENTAL HEALTH ISSUES, THERE ARE 0 RESIDENTIAL TREATMENT CENTERS. FOR GERIATRIC RESIDENTIAL SERVICES, THERE ARE 3 NURSING HOMES AND 2 ASSISTED LIVING FACILITIES. COMMUNITY HEALTH NEEDS NOT WITHIN THE IMPLEMENTATION STRATEGY SPECIALIZED AIDS/HIV SERVICES ARE NOT WITHIN THE IMPLEMENTATION STRATEGY. THESE HEALTH SERVICES FOR THE UNINSURED OR UNDERINSURED ARE ALREADY PROVIDED BY THE MIAMI BEACH COMMUNITY HEALTH CENTERS, THE BORINQUEN HEALTH CARE CENTER AND JACKSON MEMORIAL HEALTH CENTER AND THE MIAMI-DADE COUNTY HEALTH DEPARTMENT/OFFICE OF HIV/AIDS. ONGOING GENERAL AND EXPERT COMMUNITY INPUT MOUNT SINAI IS COMMITTED TO RECEIVING INPUT TO BETTER ASSESS COMMUNITY HEALTH NEEDS. COMMUNITY HEALTH NEEDS SURVEY AS PART OF A THREE-YEAR STRATEGY, AN ONLINE HEALTH NEEDS ASSESSMENT SURVEY MODELED ON QUESTIONS USED BY THE NATIONAL CENTER FOR CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION RISK FACTOR SURVEILLANCE SYSTEM WILL COLLECT INPUT FROM THOSE IN THE SERVICE AREA. THE SURVEY INSTRUMENT WILL BE PROMOTED THROUGH ADVERTISING AND MARKETING EFFORTS. HEALTH ADVISORY BOARD MOUNT SINAI MAINTAINS A SEAT AND LEAD ROLE ON THE HEALTH ADVISORY BOARD OF THE CITY OF MIAMI BEACH, ALONG WITH THE MIAMI BEACH COMMUNITY HEALTH CENTER AND HEALTH COUNCIL SOUTH FLORIDA. THIS IS A BODY OF LOCAL REPRESENTATIVES THAT MEET TO ADDRESS THE DEMOGRAPHIC AND HEALTH ISSUES ILLUSTRATED IN THIS REPORT IN PUBLICLY ADVERTISED FORUM FOR ALL PERSONS. COMMUNITY COMMENT ON THIS HEALTH NEEDS ASSESSMENT THIS REPORT WILL BE MADE WIDELY AVAILABLE. PUBLIC COMMENT CAN BE ADDRESSED TO THE MOUNT SINAI MEDICAL CENTER PLANNING DEPARTMENT, 4300 ALTON ROAD, MIAMI BEACH, FLORIDA 33140. FORM 990, PART VI, SECTION A, LINE 2 TRUSTEES WAYNE CHAPLIN AND PAUL CHAPLIN HAVE A BUSINESS AND FAMILY RELATIONSHIP. TRUSTEES MARK H. HILDEBRANDT AND LAURANS A. MENDELSON HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11 THE PROCESS FOR REVIEW OF THE FORM 990 BY MEMBERS OF THE GOVERNING BODY AND MANAGEMENT IS AS FOLLOWS: THE MEMBERS OF THE GOVERNING BODY, MANAGEMENT, AND THE INDEPENDENT TAX CONSULTANTS WILL MEET AND REVIEW IN DETAIL THE COMPLETED FORM 990. THE FOLLOWING MEMBERS OF THE GOVERNING BODY PERFORMED THE REVIEW ALONG WITH EXECUTIVE MANAGEMENT COMPOSED OF THE CHIEF EXECUTIVE OFFICER AND THE CHIEF FINANCIAL OFFICER, AND INDEPENDENT TAX CONSULTANTS: CHAIRMAN OF THE BOARD, VICE-CHAIRMAN OF THE BOARD CHAIRMAN, FINANCE COMMITTEE CHAIRMAN, AUDIT COMMITTEE CHAIRMAN, COMPLIANCE COMMITTEE CHAIRMAN, INVESTMENT COMMITTEE PRESIDENT, FOUNDATION FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY: MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC. AND SUBSIDIARIES (THE "MEDICAL CENTER") FORMALLY IMPLEMENTED A WRITTEN CONFLICT OF INTEREST POLICY (THE "POLICY") ON MARCH 2006 TO PROTECT THE MEDICAL CENTER AND ENSURE THAT THE DELIBERATIONS AND DECISIONS MADE ON BEHALF OF THE MEDICAL CENTER ARE MADE IN THE BEST INTEREST OF THE MEDICAL CENTER. THE TERM "CONFLICT OF INTEREST" AS DEFINED BY THIS POLICY REFERS TO SITUATIONS IN WHICH FINANCIAL OR OTHER PERSONAL CONSIDERATIONS MAY COMPROMISE, OR HAVE THE APPEARANCE OF COMPROMISING, THE JUDGMENT OF SOMEONE CHARGED WITH THE RESPONSIBILITY TO ACT ON BEHALF OF THE MEDICAL CENTER. THIS POLICY IS REVIEWED PERIODICALLY BUT NOT LESS THAN ONCE A YEAR BY THE AUDIT COMMITTEE OF THE BOARD OF TRUSTEES TO BETTER MEET ITS OBJECTIVES. IT IS INTENDED TO SUPPLEMENT BUT NOT REPLACE ANY APPLICABLE LAWS GOVERNING CONFLICTS OF INTEREST IN NONPROFIT AND CHARITABLE ORGANIZATIONS. PERSONS COVERED UNDER THIS POLICY INCLUDE: (1) ANY CURRENT OR FORMER TRUSTEE, OFFICER, OR MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS FOR THE MEDICAL CENTER; (2) MEMBERS OF MANAGEMENT AND ANY EMPLOYEE OF THE MEDICAL CENTER WHO: A) RECEIVES COMPENSATION FROM THE MEDICAL CENTER IN EXCESS OF $150,000 ANNUALLY, WHETHER AS A FULL- OR PART-TIME EMPLOYEE, INDEPENDENT CONTRACTOR, OR OTHERWISE, AND, B) HAS RESPONSIBILITIES, POWER OF INFLUENCE OVER AN ACTIVITY OF THE MEDICAL CENTER SIMILAR TO THAT OF AN OFFICER OR TRUSTEE AND WHICH REPRESENTS MORE THAN 10% OF THE ACTIVITIES, ASSETS, INCOME OR EXPENSES OF THE MEDICAL CENTER, AND C) IS ONE OF THE TWENTY EMPLOYEES WITH THE HIGHEST COMPENSATION FROM THE MEDICAL CENTER. (3) ANY PERSON(S) WHO SERVE AS A MEMBER OF THE MEDICAL CENTER'S MEDICAL STAFF AS A CHAIRPERSON OF A DEPARTMENT, CHIEF OF A CLINICAL SERVICE, OR MEMBER OF THE MEDICAL EXECUTIVE COMMITTEE. MONITORING AND COMPLIANCE: AN IMPORTANT STEP IN MONITORING AND ENFORCING COMPLIANCE WITH A CONFLICT OF INTEREST POLICY INCLUDES MANAGEMENT'S EDUCATION EFFORTS TO MAKE INTERESTED PERSONS AWARE OF THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. TO THAT END, MANAGEMENT HAS INCLUDED IN ITS CODE OF CONDUCT (THE "CODE") A SECTION ON CONFLICTS OF INTEREST WHICH HAS TO BE SIGNED AND RETURNED BY EVERY INTERESTED PERSON TO ACKNOWLEDGE AND ATTEST THAT THEY READ THE CODE INCLUDING THE CONFLICT OF INTEREST SECTION. ANNUALLY, INTERESTED PERSONS ALSO RECEIVE A REFRESHER TRAINING SESSION ON ETHICS AND CONFLICTS OF INTEREST. IN ADDITION, THE AUDIT COMMITTEE OF THE BOARD OF TRUSTEES HAS CREATED A SUBCOMMITTEE ON CONFLICTS OF INTEREST ("CONFLICTS COMMITTEE") TO ADMINISTER AND MONITOR COMPLIANCE WITH THIS POLICY. THE CONFLICTS COMMITTEE REQUIRES A STATEMENT FROM EACH INTERESTED PERSON NOT LESS FREQUENTLY THAN ONCE A YEAR SETTING FORTH ALL BUSINESS AND OTHER AFFILIATIONS THAT RELATE IN ANY WAY TO THE BUSINESS AND OTHER ACTIVITIES OF THE MEDICAL CENTER. INTERNAL AUDIT COMPILES AND SUMMARIZES ALL THE DISCLOSURES RECEIVED FROM INTERESTED PERSONS TO FACILITATE THEIR REVIEW BY THE CONFLICTS COMMITTEE. THE CONFLICTS COMMITTEE INDIVIDUALLY DISCUSSES EACH DISCLOSURE TO EVALUATE WHETHER A CONFLICT OF INTEREST EXISTS AND DETERMINES THE APPROPRIATE COURSE OF ACTION TO TAKE. NEITHER THE BOARD NOR ANY COMMITTEE OF THE BOARD SHALL VOTE UPON ANY PROPOSED TRANSACTION OR ARRANGEMENT IN CONNECTION WITH A POTENTIAL CONFLICT OF INTEREST UNTIL SUCH TIME AS THE CONFLICTS COMMITTEE HAS DETERMINED WHETHER A CONFLICT OF INTEREST EXISTS. WHERE THE CONFLICTS COMMITTEE HAS CONCLUDED THAT A CONFLICT OF INTEREST EXISTS, THE CHAIRMAN OF THE CONFLICTS COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO A PROPOSED TRANSACTION, CONTRACT, OR ARRANGEMENT. IF THE CONFLICTS COMMITTEE DETERMINES THAT THE MEDICAL CENTER CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THEN THE MEDICAL CENTER SHALL NOT ENTER INTO THE TRANSACTION THAT INVOLVES THE CONFLICT OF INTEREST. IF A TRANSACTION OR ARRANGEMENT MORE ADVANTAGEOUS IS NOT REASONABLY ATTAINABLE UNDER THE CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THEN THE BOARD OR COMMITTEE, AS APPLICABLE, SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED TRUSTEES WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE MEDICAL CENTER'S BEST INTEREST AND WHETHER IT IS FAIR AND REASONABLE TO THE MEDICAL CENTER, AND SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH SUCH DETERMINATION. FAILURE BY AN INTERESTED PERSON TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST UNDER THE CONFLICT OF INTEREST POLICY IS CONSIDERED A SERIOUS MATTER AND MAY CONSTITUTE "CAUSE" FOR REMOVAL OR TERMINATION OF A TRUSTEE, OFFICER, OR THE TERMINATION OF ANY CONTRACTUAL OR EMPLOYMENT RELATIONSHIP THE MEDICAL CENTER MAY HAVE WITH AN INTERESTED PERSON OR OTHER PARTY. FORM 990, PART VI, SECTION B, LINE 15 ON AN ANNUAL BASIS, THE MOUNT SINAI MEDICAL CENTER COMPENSATION COMMITTEE CONTRACTS WITH AN INDEPENDENT CONSULTANT TO PREPARE AN OPINION REGARDING THE REASONABLENESS AND COMPARABILITY OF THE TOTAL COMPENSATION PROVIDED TO ITS SENIOR OFFICERS AND KEY EMPLOYEES. THE COMPENSATION COMMITTEE INFORMS THE INDEPENDENT CONSULTANT THAT THE INDEPENDENT CONSULTANT'S OPINION WILL BE PART OF THE COMMITTEE'S PROCEDURE FOR ESTABLISHING THE REBUTTABLE PRESUMPTION OF REASONABLENESS DESCRIBED IN THE INCOME TAX REGULATIONS. THE INDEPENDENT CONSULTANT'S DETERMINATION OF REASONABLENESS IS MADE AFTER A THOROUGH REVIEW OF ALL THE ELEMENTS OF THE TOTAL COMPENSATION COMPRISED OF: CASH COMPENSATION, HEALTH AND WELFARE BENEFITS, RETIREMENT BENEFITS, EXECUTIVE BENEFITS AND PERQUISITES, AND OTHER ELEMENTS OF COMPENSATION INCLUDING SEVERANCE ARRANGEMENTS. THE OPINION EXPRESSED BY THE INDEPENDENT CONSULTANT IS THEN PRESENTED TO THE MSMC COMPENSATION COMMITTEE IN A REPORT FORM FOR THEIR REVIEW. THE OPINION REPORT IS REFERRED TO BY THE COMPENSATION COMMITTEE WHEN DETERMINING AND APPROVING THE ANNUAL COMPENSATION FOR ITS SENIOR OFFICERS AND KEY EMPLOYEES. THE EXECUTIVE BOARD OF TRUSTEES OF MSMC HAS AUTHORIZED ITS COMPENSATION COMMITTEE TO SET ANNUAL COMPENSATION FOR MSMC'S SENIOR OFFICERS AND KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS THAT ARE REQUIRED TO BE OPEN FOR PUBLIC INSPECTION ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 16B: IF THE HOSPITAL JOINS A PARTNERSHIP/JOINT VENTURE ARRANGEMENT, ADMINISTRATION WILL PRESENT IT TO THE BOARD AND THE BOARD MUST APPROVE THE ACTION. FORM 990, PART XI, LINE 9: INCOME FROM PREMIER HEALTHCARE ALLIANCE -558,684. CHANGE IN THE BENEFICIAL INTEREST IN THE NET ASSETS OF MSMC FOUNDATION 17,508,000. AMOUNTS REPORTED SEPARATELY 3,286. 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