KINGSBROOK JEWISH MEDICAL CENTER INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization: KINGSBROOK JEWISH MEDICAL CENTER INC (EIN 11-1631759)
Tax period: 2014-01-01 to 2014-12-31
Filed: 2015-11-16
IRS object ID: 201513209349307181
Schema version: 2014v5.0
Source: Download XML · Original 990 at ProPublica

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

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2015-11-16T13:05:29-06:00	ReturnTs
Tax Period End	2014-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	420714325	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	RSM US LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	1185 AVENUE OF THE AMERICAS	AddressLine1Txt
City	NEW YORK	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	100362602	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2014-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	111631759	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	KINGSBROOK JEWISH MEDICAL CENTER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	KING	BusinessNameControlTxt
Phone	7186045532	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	585 SCHENECTADY AVENUE	AddressLine1Txt
City	BROOKLYN	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	11203	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	JOHN SCHMITT	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	7186045532	PhoneNum
Signature	2015-11-16	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	STEVEN LAPSKER	PreparerPersonNm
PTIN	P00850484	PTIN
Phone	2123721000	PhoneNum

Field	Value	IRS element (for citing)
Tax	2014	TaxYr
Build TS	2016-02-25 16:41:14Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	LINDA BRADY MD	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	585 SCHENECTADY AVENUE	AddressLine1Txt
City	BROOKLYN	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	11203	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$194,105,682	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.KINGSBROOK.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1926	FormationYr
Legal Domicile State	NY	LegalDomicileStateCd
Activity Or Mission	OUR MISSION IS TO PARTNER WITH OUR CULTURALLY DIVERSE COMMUNITIES TO PROVIDE A CONTINUUM OF OUTSTANDING HEALTH CARE SERVICES TO INDIVIDUALS AND FAMILIES THROUGH A CARING AND TRUSTWORTHY STAFF.	ActivityOrMissionDesc
Voting Members Governing Body	13	VotingMembersGoverningBodyCnt
Voting Members Independent	11	VotingMembersIndependentCnt
Total Employee	2668	TotalEmployeeCnt
Total Volunteers	171	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	-$1,501	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$4,502,772	PYContributionsGrantsAmt
CY Contributions Grants	$26,042,299	CYContributionsGrantsAmt
PY Program Service Revenue	$176,268,481	PYProgramServiceRevenueAmt
CY Program Service Revenue	$166,247,875	CYProgramServiceRevenueAmt
PY Investment Income	$86,942	PYInvestmentIncomeAmt
CY Investment Income	$165,751	CYInvestmentIncomeAmt
PY Other Revenue	$1,952,884	PYOtherRevenueAmt
CY Other Revenue	$1,649,757	CYOtherRevenueAmt
PY Total Revenue	$182,811,079	PYTotalRevenueAmt
CY Total Revenue	$194,105,682	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$127,146,890	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$120,658,351	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$181,255	CYTotalFundraisingExpenseAmt
PY Other Expenses	$61,511,037	PYOtherExpensesAmt
CY Other Expenses	$59,691,286	CYOtherExpensesAmt
PY Total Expenses	$188,657,927	PYTotalExpensesAmt
CY Total Expenses	$180,349,637	CYTotalExpensesAmt
PY Revenues Less Expenses	-$5,846,848	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$13,756,045	CYRevenuesLessExpensesAmt
Total Assets BOY	$125,228,842	TotalAssetsBOYAmt
Total Assets EOY	$147,408,847	TotalAssetsEOYAmt
Total Liabilities BOY	$97,056,494	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$108,870,001	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$28,172,348	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$38,538,846	NetAssetsOrFundBalancesEOYAmt
Mission	OUR MISSION IS TO PARTNER WITH OUR CULTURALLY DIVERSE COMMUNITIES TO PROVIDE A CONTINUUM OF OUTSTANDING HEALTH CARE SERVICES TO INDIVIDUALS AND FAMILIES THROUGH A CARING AND TRUSTWORTHY STAFF.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$157,046,020	ExpenseAmt
Revenue	$166,247,875	RevenueAmt
Desc	THE KINGSBROOK JEWISH MEDICAL CENTER ("KJMC") IS A 303-BED MULTI-SPECIALTY TEACHING HOSPITAL BASED IN BROOKLYN, NY. KJMC PROVIDES A WIDE RANGE OF INPATIENT AND OUTPATIENT SERVICES, MEDICAL AND SURGICAL DIAGNOSTIC TREATMENT SERVICES, PHYSICAL MEDICINE AND REHABILITATION, GERIATRIC PSYCHIATRIC MEDICINE, AS WELL AS AN AMBULATORY SURGERY CENTER, A 24-HOUR EMERGENCY ROOM, AND OUTPATIENT GENERAL AND SPECIALTY CLINICS.	Desc
Total Program Service Expenses	$157,046,020	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	0	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	0	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	0	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	221	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	2668	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	13	GoverningBodyVotingMembersCnt
Independent Voting Member	11	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	0	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	NY	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	JOHN SCHMITT	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	7186045532	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	585 SCHENECTADY AVENUE	AddressLine1Txt
City	BROOKLYN	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	11203	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
VICTOR AYALA PHD
BOARD TRUSTEE	2.00	3.00	Yes (X)	$0	$0	$0
LINDA BRADY MD
PRESIDENT & BOARD DIRECTOR	35.00	13.50	Yes (X)	$888,644	$0	$67,642	Yes (X)
VALERIE BYNOE-KASDEN ESQ
BOARD TRUSTEE	1.00	1.00	Yes (X)	$0	$0	$0
PATRICK COONAN RN EDD
BOARD TRUSTEE	1.00		Yes (X)	$0	$0	$0
JEFFREY DUNSTON
BOARD TRUSTEE	1.00		Yes (X)	$0	$0	$0
SEEMA GOLDSTEIN
SECRETARY	1.50	2.00	Yes (X)	$0	$0	$0	Yes (X)
ERICA GRUEN
BOARD TRUSTEE	1.00		Yes (X)	$0	$0	$0
EDWARD LIEBERSTEIN
BOARD TRUSTEE	1.00	3.00	Yes (X)	$0	$0	$0
LEIBESH NASH
BOARD TRUSTEE	1.00		Yes (X)	$0	$0	$0
GEOFFREY PATRICE MD
BOARD TRUSTEE	1.00		Yes (X)	$7,466	$0	$0
MICHAEL PORETSKY
TREASURER	2.00	1.00	Yes (X)	$0	$0	$0
ROBERT REISS
BOARD TRUSTEE	1.50	2.00	Yes (X)	$0	$0	$0
HENNA WHITE
BOARD CHAIR	3.00	5.50	Yes (X)	$0	$0	$0	Yes (X)
JOHN SCHMITT CPA
ASSISTANT TREASURER & CFO	35.00	13.50		$364,468	$0	$67,642	Yes (X)
MICHAEL MCDERMOTT THRU 52014
ASS'T SECRETARY & GENERAL COUNSEL	35.00	13.50		$107,005	$0	$27,578	Yes (X)
HAROLD MCDONALD THRU 42014
COO	35.00	12.00		$155,140	$0	$941	Yes (X)
SIBTE BURNEY MD
CHIEF MEDICAL OFFICER	40.00			$414,154	$0	$60,827		Yes (X)
KURT KODROFF
VICE PRESIDENT	40.00			$421,117	$0	$69,574		Yes (X)
ROBERT DUBICKI
SENIOR VP	40.00			$348,579	$0	$63,752		Yes (X)
JANE LEDERER
CHIEF NURSING OFFICER	40.00			$234,440	$0	$43,430		Yes (X)
MARC ROSS MD
DIR REHAB MED	40.00			$499,319	$0	$67,642			Yes (X)
WILLIAM LOIS
DIRECTOR SURGERY	40.00			$461,898	$0	$60,827			Yes (X)
VIJAY AKKAPEDDI
CHAIR EMERGENCY DEPT	40.00			$424,731	$0	$67,642			Yes (X)
LEON VALBRUN
PSYCHIATRIST	40.00			$292,346	$0	$61,001			Yes (X)
ADRIAN CRISTIAN
DEPUTY MED DIR, REHAB MEDICINE	40.00			$286,437	$0	$61,687			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$4,905,744	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$720,185	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	260	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
NORTH AMERICAN PARTNERS IN ANESTHESIA L
68 SOUTH SERVICE ROAD SUITE 350	MELVILLE	NY	11747	MEDICAL SERVICE - ANESTHESIA	$1,442,375
BIK ORTHOPEDICS PC
585 SCHENECTADY AVENUE	BROOKLYN	NY	11203	MEDICAL SERVICE - ORTHOPEDICS	$1,127,279
ASPEN ADVISORS LLC
22337 MEADOW VIEW ROAD	MORRISON	CO	80465	CONSULTING SERVICE	$794,778
NEW YORK RADIOLOGY ALLIANCE
25983 NETWORK PLACE	CHICAGO	IL	606731259	MEDICAL SERVICE - RADIOLOGY	$597,755
JZANUS CONSULTING INC
515 HEMPSTEAD TURNPIKE	WEST HEMPSTEAD	NY	11552	REVENUE CYCLE - CODING SERVICES	$594,336

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	52	CntrctRcvdGreaterThan100KCnt
Government Grants	$25,566,449	GovernmentGrantsAmt
All Other Contributions	$475,850	AllOtherContributionsAmt
Total Contributions	$26,042,299	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE	621300	$161,281,354	$161,281,354
AFFIL INCOME - AUA MEDICAL	900099	$2,927,617	$2,927,617
AFFIL INCOME - ST. GEORGE U	900099	$1,047,850	$1,047,850
INCENTIVE INCOME	900099	$825,531	$825,531
AFFIL INCOME - MED STUDENT	900099	$135,027	$135,027

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$30,496	TotalRevenueColumnAmt
Related Or Exempt Func Income	$30,496	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$166,247,875	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$7,051	TotalRevenueColumnAmt
Exclusion	$7,051	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$435,120	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$435,120	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$435,120	TotalRevenueColumnAmt
Exclusion	$435,120	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$158,700	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$158,700	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$158,700	TotalRevenueColumnAmt
Exclusion	$158,700	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	MISC. INCOME	Desc
Business	900099	BusinessCd
Total Revenue Column	$1,214,637	TotalRevenueColumnAmt
Exclusion	$1,214,637	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$1,214,637	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$194,105,682	TotalRevenueColumnAmt
Related Or Exempt Func Income	$166,247,875	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$1,815,508	ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$3,258,541	TotalAmt
Program Services	$2,867,516	ProgramServicesAmt
Management And General	$391,025	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$85,124,261	TotalAmt
Program Services	$74,765,382	ProgramServicesAmt
Management And General	$10,214,911	ManagementAndGeneralAmt
Fundraising	$143,968	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$5,407,517	TotalAmt
Program Services	$4,749,636	ProgramServicesAmt
Management And General	$648,902	ManagementAndGeneralAmt
Fundraising	$8,979	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$19,882,588	TotalAmt
Program Services	$17,485,780	ProgramServicesAmt
Management And General	$2,385,911	ManagementAndGeneralAmt
Fundraising	$10,897	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$6,985,444	TotalAmt
Program Services	$6,137,924	ProgramServicesAmt
Management And General	$838,253	ManagementAndGeneralAmt
Fundraising	$9,267	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$3,210,727	TotalAmt
Program Services	$2,462,628	ProgramServicesAmt
Management And General	$748,099	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	-$40,952	TotalAmt
Management And General	-$40,952	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$362,926	TotalAmt
Program Services	$278,364	ProgramServicesAmt
Management And General	$84,562	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$12,243,200	TotalAmt
Program Services	$9,359,124	ProgramServicesAmt
Management And General	$2,884,076	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$576,011	TotalAmt
Program Services	$433,656	ProgramServicesAmt
Management And General	$134,211	ManagementAndGeneralAmt
Fundraising	$8,144	FundraisingAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$3,929,433	TotalAmt
Program Services	$3,013,875	ProgramServicesAmt
Management And General	$915,558	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$132,159	TotalAmt
Program Services	$101,366	ProgramServicesAmt
Management And General	$30,793	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$571,625	TotalAmt
Program Services	$438,436	ProgramServicesAmt
Management And General	$133,189	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$7,746,242	TotalAmt
Program Services	$5,941,368	ProgramServicesAmt
Management And General	$1,804,874	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$688,198	TotalAmt
Program Services	$527,848	ProgramServicesAmt
Management And General	$160,350	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL & PHARMACEUTICA	$16,401,557	$16,401,557
MAINT & REPAIRS	$6,271,066	$4,809,908	$1,461,158
BAD DEBT EXPENSE	$3,315,508	$3,315,508
FOOD COSTS	$2,220,707	$2,220,707

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$2,062,879	TotalAmt
Program Services	$1,735,437	ProgramServicesAmt
Management And General	$327,442	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$180,349,637	TotalAmt
Program Services	$157,046,020	ProgramServicesAmt
Management And General	$23,122,362	ManagementAndGeneralAmt
Fundraising	$181,255	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$167,324	BOYAmt
EOY	$5,373,836	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$5,288,578	BOYAmt
EOY	$2,867,225	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$19,754,720	BOYAmt
EOY	$20,998,867	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$2,837,926	BOYAmt
EOY	$2,796,804	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$2,501,620	BOYAmt
EOY	$2,068,042	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$213,184,847	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$171,832,150	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$37,094,698	BOYAmt
EOY	$41,352,697	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$620,443	BOYAmt
EOY	$620,443	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$56,963,533	BOYAmt
EOY	$71,330,933	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$125,228,842	BOYAmt
EOY	$147,408,847	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$46,785,493	BOYAmt
EOY	$47,878,077	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$177,031	BOYAmt
EOY	$121,110	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$5,268,820	BOYAmt
EOY	$3,697,653	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$5,181,815	BOYAmt
EOY	$4,472,950	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$39,643,335	BOYAmt
EOY	$52,700,211	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$97,056,494	BOYAmt
EOY	$108,870,001	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$28,172,348	BOYAmt
EOY	$38,538,846	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$28,172,348	BOYAmt
EOY	$38,538,846	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$125,228,842	BOYAmt
EOY	$147,408,847	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$13,756,045	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	-$3,389,547	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	Yes (1)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (1)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	Yes (1)	DirectContactLegislatorsInd
Direct Contact Legislators	$217,636	DirectContactLegislatorsAmt
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$145,290	OtherActivitiesAmt
Total Lobbying Expenditures	$362,926	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	OTHER ACTIVITIES DESCRIPTION: KINGSBROOK JEWISH MEDICAL CENTER PAYS DUES TO THE HEALTHCARE ASSOCIATION OF NEW YORK STATE (HANYS), GREATER NY HOSPITAL ASSOCIATION AND THE LEAGUE OF VOLUNTEER HOSPITALS. IN ACCORDANCE WITH SECTION 6033(E) OF THE INTERNAL REVENUE CODE, AND AS REPORTED BY THE DUES RECIPIENTS, A PORTION OF THESE DUES ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES. THE LOBBYING ACTIVITIES APPLICABLE TO THE 2014 ANNUAL DUES WAS $145,290. ADDITIONALLY, THE ORGANIZATION HAS CONTRACTS WITH LOBBYISTS WHO WERE ENGAGED TO LOBBY LEGISLATORS ON BEHALF OF THE ORGANIZATION REGARDING POLICIES WHICH IMPACT THE ORGANIZATION'S EXEMPT PURPOSE AND WHICH PERTAIN TO PUBLIC HEALTH CARE. DURING 2014 KINGSBROOK JEWISH MEDICAL CENTER PAID $217,636 IN CONNECTION WITH THESE SERVICES.	ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,129,749	OtherCostOrOtherBasisAmt
Book Value	$1,129,749	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$64,016,819	OtherCostOrOtherBasisAmt
Depreciation	$40,656,035	DepreciationAmt
Book Value	$23,360,784	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$48,226,301	OtherCostOrOtherBasisAmt
Depreciation	$43,307,803	DepreciationAmt
Book Value	$4,918,498	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$99,811,978	OtherCostOrOtherBasisAmt
Depreciation	$87,868,312	DepreciationAmt
Book Value	$11,943,666	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$41,352,697	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDesc	Book ValueBookValueAmt
DUE FROM RELATED ORGANIZATION	$65,772,934
DEBT SERVICE RESERVE FUND	$2,434,589
RECEIVABLE - INV. IN HEALTHFIRST	$67,937
OTHER RECEIVABLES	$1,102,806
INTEREST IN KJMC FOUNDATION	$1,952,667

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$71,330,933	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)

DescDesc	AmtAmt
SELF INSURANCE LIABILITIES	$18,847,000
ESTIMATED THIRD PARTY SETTLEMENTS	$19,446,636
FIN 47 LIABILITY	$2,125,994
INCENTIVE/RETENTION LIABILITY	$931,851
SECURITY DEPOSITS - OTHER	$2,250,394
ACCRUED POSTRETIREMENT BENEFIT COST	$1,877,896
ACCRUED PENSION LIABILITY	$7,220,440

Field	Value	IRS element (for citing)
Total Liability	$52,700,211	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART X, LINE 2:	FormAndLineReferenceDesc
Explanation	THE COMPANY IS EXEMPT FROM INCOME TAXES UNDER SECTIONS 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE"). ADDITIONALLY, THE COMPANY, AS A NONPROFIT ENTITY, IS SUBJECT TO UNRELATED BUSINESS INCOME TAX ("UBIT"), IF APPLICABLE. FOR THE TAX YEARS ENDED DECEMBER 31, 2014 AND 2013, THE COMPANY DID NOT OWE ANY UBIT. MANAGEMENT EVALUATED THE COMPANY'S TAX POSITIONS FOR ALL OPEN TAX YEARS AND HAS CONCLUDED THAT THE COMPANY HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF FINANCIAL ACCOUNTING STANDARDS BOARD ("FASB") ACCOUNTING STANDARDS CODIFICATION ("ASC") 740, ACCOUNTING FOR INCOME TAXES. GENERALLY, THE COMPANY IS SUBJECT TO U.S. FEDERAL AND STATE EXAMINATIONS BY TAX AUTHORITIES FOR FISCAL YEARS ENDED DECEMBER 31, 2011 AND THEREAFTER. PER THE REQUIREMENT TO ASSESS FOR TAX UNCERTAINTY, MANAGEMENT HAS DETERMINED THAT IT DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS REQUIRED TO BE REPORTED.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent300	Yes (X)	Percent300Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	0	FinancialAssistanceBudgetInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,346,967	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,261,862	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,085,105	NetCommunityBenefitExpnsAmt
Total Expense	0.01710	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$54,205,253	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$58,945,182	DirectOffsettingRevenueAmt
Net Community Benefit Expns	-$4,739,929	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$59,552,220	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$61,207,044	DirectOffsettingRevenueAmt
Net Community Benefit Expns	-$1,654,824	NetCommunityBenefitExpnsAmt
Total Expense	0.01710	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$16,248,938	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$16,248,938	NetCommunityBenefitExpnsAmt
Total Expense	0.09010	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$13,101,569	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$10,048,935	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,052,634	NetCommunityBenefitExpnsAmt
Total Expense	0.01690	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$472,500	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$472,500	NetCommunityBenefitExpnsAmt
Total Expense	0.00260	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$29,823,007	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$10,048,935	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$19,774,072	NetCommunityBenefitExpnsAmt
Total Expense	0.10960	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$89,375,227	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$71,255,979	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$18,119,248	NetCommunityBenefitExpnsAmt
Total Expense	0.12670	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$64,335	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$64,335	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$64,335	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$64,335	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$3,315,508	BadDebtExpenseAmt
Reimbursed By Medicare	$65,291,071	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$64,985,086	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$305,985	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	KINGSBROOK JEWISH MEDICAL CENTER	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	585 SCHENECTADY AVENUE	AddressLine1Txt
City	BROOKLYN	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	11203	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.KINGSBROOK.ORG	WebsiteAddressTxt
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Teaching Hospital	Yes (X)	TeachingHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	KINGSBROOK JEWISH MEDICAL CENTER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
CHNA Conducted	13	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	0	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (1)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	WWW.KINGSBROOK.ORG	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	14	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	SEE PART V	StrategyWebsiteURLTxt
Strategy Attached	0	StrategyAttachedInd
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300.000000000000	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
FAP Notice Displayed	Yes (X)	FAPNoticeDisplayedInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Collection Activities	0	CollectionActivitiesInd
FAP Notified Upon Admission	Yes (X)	FAPNotifiedUponAdmissionInd
FAP Notified Before Discharge	Yes (X)	FAPNotifiedBeforeDischargeInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Medicare Rates	Yes (X)	MedicareRatesInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
KINGSBROOK JEWISH MEDICAL CENTER	PART V, SECTION B, LINE 5: ENGAGING THE COMMUNITYAS IN PRIOR YEARS, KINGSBROOK JEWISH MEDICAL CENTER ("KINGSBROOK") DID A REVIEW OF ITS PATIENT DATABASE AND DETERMINED THAT TO BEST MEET THE NEEDS OF ITS COMMUNITY, THE HOSPITAL WOULD CONTINUE TO FOCUS ON THE AREAS WHERE THE MAJORITY OF THE PATIENTS RESIDE. AS SUCH, THE IMMEDIATE CATCHMENT AREA OF THE HOSPITAL CONTINUED TO CONSIST OF THE FOLLOWING NEIGHBORHOODS OF BROOKLYN - CROWN HEIGHTS (11213), BROWNSVILLE (11212), FLATBUSH (11203) AND CANARSIE (11236). THIS AFFIRMATION OF THE CATCHMENT AREA WAS DONE IN CONSULTATION WITH THE KJMC COMMUNITY ADVISORY BOARD AS WELL AS THE HEALTH ASSESSMENT NEEDS REPORT DEVELOPED BY COMMUNITY BOARDS 9 AND 17 (BROOKLYN).ONCE ITS CATCHMENT AREA WAS DETERMINED, KINGSBROOK REVIEWED THE LATEST HEALTH, SOCIOECONOMIC AND SOCIO-DEMOGRAPHIC INFORMATION FROM THE 2010 CENSUS. THAT INFORMATION, ALONG WITH REPORTS PRODUCED BY THE NEW YORK STATE DEPARTMENT OF HEALTH ("NYS DOH") AND THE NEW YORK CITY DEPARTMENT OF HEALTH ("NYC DOH") SUCH AS THE COUNTY HEALTH RANKINGS FOR KINGS COUNTY 2013, ALLOWED KINGSBROOK TO IDENTIFY KEY AREAS ON WHICH TO FOCUS. THE RESULT OF THIS ASSESSMENT GAVE US THE FOLLOWING STATISTICAL INFORMATION: 1. 12% OF OUR COMMUNITY MEMBERS LIVE WITH DIABETES2. IN OUR CATCHMENT AREA OF CENTRAL BROOKLYN, 35% OF HIV DIAGNOSES ARE LATE STAGE3. 32% OF THE RESIDENTS IN OUR CATCHMENT AREA HAVE BEEN DIAGNOSED WITH HIGH BLOOD PRESSURE4. 26% OF THE RESIDENTS IN OUR CATCHMENT AREA HAVE BEEN DIAGNOSED WITH HIGH CHOLESTEROLBASED UPON THESE FACTS, KINGSBROOK WORKED WITH THE FOLLOWING GROUPS TO BEST DETERMINE THE NEEDS OF OUR COMMUNITY1. CARIBBEAN WOMEN'S HEALTH ASSOCIATION, INC. (CWHA) THIS ASSOCIATION WAS FOUNDED IN 1982. FOR OVER TWENTY YEARS CWHA HAS SERVED AS AN ADVOCACY GROUP AND SERVICE PROVIDER IN THE COMMUNITY. CWHA STRONGLY RELIES ON COMMUNITY INVOLVEMENT IN PLANNING, IMPLEMENTATION AND EVALUATION OF PROGRAMS THAT MEET THE HEALTH AND SOCIAL SUPPORT NEEDS OF THE COMMUNITY. THERE IS CONTINUOUS INTERACTION WITH THE COMMUNITY TO REVIEW THE APPROPRIATENESS OF THE EDUCATIONAL AND PROMOTIONAL MATERIALS PRODUCED BY CWHA. CWHA IS ACCREDITED BY THE UNITED NATIONS ECONOMIC AND SOCIAL COUNCIL. THE AGENCY'S EXCELLENCE IN SERVICE DELIVERY IS WIDELY ACCLAIMED AND RECOGNIZED FOR THE QUALITY, BREADTH AND IMPACT OF ITS WORK. THIS ORGANIZATION IS LOCATED IN KINGSBROOK'S PRIMARY SERVICE AREA. 2. BROOKLYN PERINATAL NETWORK (BPN) ESTABLISHED IN 1988 FROM A COMMUNITY TASK FORCE TO ADDRESS HIGH INFANT MORTALITY, THE PURPOSE OF THE ORGANIZATION IS TO PREVENT AND REDUCE INFANT/MATERNAL ILLNESS AND DEATH, WHICH FOR SEVERAL YEARS HAVE BEEN EXCESSIVELY HIGH IN THE COMMUNITY. BY ENABLING AT-RISK RESIDENTS TO ACCESS VITAL INFORMATION, COORDINATE CARE, SUPPORTIVE HEALTH AND SOCIAL SUPPORTIVE SERVICES AND ASSISTING FAMILIES TO SECURE PUBLIC HEALTH BENEFITS AND RESOURCES NEEDED TO MAINTAIN HEALTH. THE ORGANIZATION HAS SEEN A SIGNIFICANT REDUCTION IN INFANT DEATH AND IMPROVED MATERNAL AND CHILD HEALTH STATUS. BPN IS A NETWORK OR COLLABORATIVE OF SEVERAL COMMUNITY ORGANIZATIONS THAT PROVIDE MEDICAL CARE, OFFERING A WIDE RANGE OF PRIMARY PREVENTATIVE AN CLINICAL SERVICES INCLUDING PREGNANCY, OB/GYN CARE, PEDIATRIC, ADOLESCENT HEALTH CARE, GENERAL FAMILY PRACTICE AND ADULT MEDICINE; AS WELL AS SPECIALTY CARE IN AREAS SUCH AS MENTAL HEALTH, FAMILY PLANNING, SUBSTANCE ABUSE TREATMENT AND COUNSELING, HIV/AIDS CARE AND MORE. THIS ORGANIZATION IS LOCATED IN KINGSBROOK'S PRIMARY SERVICE AREA. 3. BROWNSVILLE MULTI SERVICE CENTER (BMS) A COMMITMENT TO TREATING THE "WHOLE PERSON" IS REFLECTED IN BMS' "INTEGRATED PRIMARY CARE COMMUNITY BASED HEALTH SERVICE MATRIX;" A MODEL OF PRIMARY CARE THAT IS PATTERNED ON A PROGRESSIVE PRIVATE PRACTICE. EACH MEDICAL TEAM TAKES AN INTERDISCIPLINARY AND INTEGRATIVE APPROACH TO COORDINATE THE PATIENT'S CARE. THE ON-SITE CLINICAL AREAS INCLUDE: ADULT INTERNAL MEDICINE, INFECTIOUS DISEASE, PEDIATRICS, OB/GYN, DENTISTRY, PSYCHOLOGY, PSYCHIATRY, SOCIAL SERVICES. THIS ORGANIZATION IS LOCATED IN KINGSBROOK'S PRIMARY SERVICE AREA. ON A WEEKLY BASIS, KINGSBROOK STAFFS AN HOURLY PULMONARY/ASTHMA CLINIC WITH ONE OF OUR STAFF PHYSICIANS.4. BROOKLYN DISTRICT PUBLIC HEALTH OFFICE (DPHO), NYC DOH THE MISSION OF THIS OFFICE IS TO REDUCE HEALTH DISPARITIES AND PROMOTE HEALTHY EQUITY BY TARGETING RESOURCES, PROGRAMS AND ATTENTION TO HIGH-NEED NEIGHBORHOODS IN NORTH AND CENTRAL BROOKLYN. 5. BROOKLYN HEALTHCARE IMPROVEMENT PROJECT (BHIP) SINCE 2009, KINGSBROOK HAS PARTNERED WITH SUNY DOWNSTATE AND SEVERAL OTHER REGIONAL MEDICAL FACILITIES TO FORM A COALITION OF 29 MEMBERS FOCUSED ON LOCAL HEALTH PLANNING INITIATIVES. MEMBERS RANGE FROM HOSPITALS AND COMMUNITY BOARDS TO COMMUNITY-BASED ORGANIZATIONS AND HEALTH INSURANCE PLANS. THIS FORUM FOCUSES ON THE CREATION OF A UNIQUE AND CURRENTLY UNAVAILABLE INVENTORY OF PRIMARY CARE SERVICES PROVIDERS AND A UTILIZATION DATABASE FOR CENTRAL BROOKLYN. THIS PROJECT SUPPORTS EFFECTIVE COMMUNITY LEVEL PLANNING AND WILL PROVIDE THE COALITION WITH THE NECESSARY INFORMATION TO MAKE RECOMMENDATIONS TO THE NEW YORK STATE DOH ON THE SERVICES NEEDED IN OUR COMMUNITIES.WORKING IN CONJUNCTION WITH THE NYS DOH AND THE AFOREMENTIONED GROUPS, KINGSBROOK HAS FOCUSED ITS RESOURCES ON TWO MAIN AREAS. FIRST, IS TO WORK ON THE PREVENTION OF CHRONIC DISEASE BY INCREASING THE ACCESS TO HIGH QUALITY CHRONIC DISEASE PREVENTION CARE AND MANAGEMENT IN BOTH CLINICAL AND COMMUNITY SETTINGS. THIS IS DONE THROUGH THE HOSPITAL'S CLINICS. SECOND IS THE PREVENTION OF INFECTIOUS DISEASE AND THE CONTINUING CARE OF CURRENTLY INFECTED HIV PATIENTS. THIS IS BEING DONE TO HELP DECREASE HIV MORBIDITY AND INCREASE EARLY ACCESS TO AND RETENTION OF HIV CARE THROUGH OUR DESIGNATED AIDS CENTER (DAC).
KINGSBROOK JEWISH MEDICAL CENTER	PART V, SECTION B, LINE 11: AREAS WHERE KJMC'S IMPLEMENTATION STRATEGY IS NOT ADDRESSING ALL OF THE NEEDS ADDRESSED IN THE MOST RECENTLY CONDUCTED CHNA AND WHY:COMMUNITY SCREENINGS/CHRONIC DISEASE PREVENTION - IN THE COMMUNITY SETTING:THE OVERALL SCOPE OF OUR PROGRAM HAS REMAINED TE SAME. THE CURRENT ECONOMY HAS ALTERED OUR ABILITY TO GROW OUR FOUNDATIONAL SUPPORT FOR NO-COST SCREENING EFFORTS.KINGSBROOK/DAILY NEWS PROSTATE CANCER INITIATIVES:THE PROGRAM HAS BEEN GREATLY IMPACTED BY THE NATIONAL SCRUTINY OF PSA TESTING WHICH QUESTIONS THE ACCURACY AND POTENTIAL FALSE POSITIVES TEST CAN POTENTIALLY GENERATE. AS SUCH, THE NEW YORK DAILY NEWS HAS DISCONTINUED THE PROGRAM AS OF 2013, DUE TO THE LACK OF SUPPORT FROM HOSPITAL PARTNERS IN THE REGION.CANCER SERVICES PROGRAM PREVIOUSLY KNOWN AS THE BROOKLYN HEALTHY LIVING PARTNERSHIP:KINGSBROOK'S PARTNERSHIP WITH THE CANCER SERVICE PROGRA (CSP), PROVIDED FREE MAMMOGRAPHY SERVICES TO OVER 200 WOMEN FROM MARCH 2012 - APRIL 2013. THE FUNDING FOR THIS PROGRAM HAS DECREASED ANNUALLY SINCE 2007.ADDITIONAL INFORMATION IS INCLUDED IN THE FULL IMPLEMENTATION STRATEGY ATTACHED TO THIS RETURN.
SCHEDULE H, PART V, SECTION B, LINE 10	IMPLEMENTATION STRATEGY WEBSITE URL:WWW.KINGSBROOK.ORG/ABOUT-US/COMMUNITY-IMPLEMENTATION-REPORT.ASPX
SCHEDULE H, PART V, SECTION B, LINE 16	FAP WEBSITE:WWW.KINGSBROOK.ORG/FOR-PATIENTS-VISITORS/FINANCIAL-ASSISTANCE-PROGRAM.ASPX
PART V, SECTION B, LINE 16	FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY
KINGSBROOK JEWISH MEDICAL CENTER PART V, SECTION B, LINE 16A WEBSITE:	SEE PART V

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 3C:	NOT APPLICABLE
PART I, LINE 7G:	24 HOUR EMERGENCY ROOM, 911 AMBULANCE SERVICES AND CLINICS
PART I, LN 7 COL(F):	KINGSBROOK JEWISH MEDICAL CENTER'S COSTING METHODOLOGY WAS BASED UPON THE 2014 NEW YORK STATE INSTITUTIONAL COST REPORT AND THE 2014 (FORM 2552)COST REPORT. THESE COST REPORTS ARE FILED WITH THE NEW YORK STATE DEPARTMENT OF HEALTH AND THE APPLICABLE CMS INTERMEDIARY, RESPECTIVELY. THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT COST-TO-CHARGE, WAS USED FOR THE VARIOUS SUB-LINE ITEMS OF LINE 7.
PART III, LINE 4:	EXPLANATION OF FINANCIAL STATEMENT FOOTNOTES THAT DESCRIBES BAD DEBT EXPENSE:SEE ATTACHED FINANCIAL STATEMENTS FOOTNOTE 3, PP. 12-14.
PART III, LINE 8:	COSTING METHODOLOGY:THE AMOUNT REPORTED ON LINE 7 WAS DERIVED BY USING THE MEDICARE ALLOWABLE COSTS AS REPORTED ON THE HOSPITAL'S NEW YORK STATE INSTITUTIONAL COST REPORT AND THE APPLICABLE ADJUSTMENT FROM WORKSHEET B.
PART III, LINE 9B:	PROVISION ON COLLECTION PRACTICES FOR QUALIFIED PATIENTSPOLICY:IT IS THE POLICY OF KINGSBROOK JEWISH MEDICAL CENTER TO PROVIDE COMPREHENSIVE QUALITY HEALTH CARE AND MEDICALLY ESSENTIAL SERVICES WITHOUT REGARD TO A PATIENT'S ABILITY TO PAY. KINGSBROOK JEWISH MEDICAL CENTER HAS IMPLEMENTED A FINANCIAL ASSISTANCE PROGRAM WHICH EVALUATES THOSE WHO ARE UNDERINSURED, HAVE EXHAUSTED THEIR INSURANCE BENEFITS OR ARE FULLY UNINSURED. CURRENT CLINIC PATIENTS WITHOUT ADEQUATE FINANCIAL RESOURCES CAN RECEIVE CARE IN OUR PRIMARY / SPECIALTY CLINICS FOR FEE SCHEDULES BASED ON THEIR INCOME AND FAMILY SIZE. A DETERMINATION WILL BE MADE IF THE PATIENT IS ELIGIBLE FOR REDUCED FEES. NON-CLINIC PATIENTS SEEN IN THE EMERGENCY DEPARTMENT, INPATIENT, OR FOR OUTPATIENT SERVICES CAN APPLY FOR ASSISTANCE, BASED ON FINANCIAL NEED, THROUGH THE FINANCIAL ASSISTANCE PROCESS IN PATIENT ACCOUNTS, PATIENT ACCESS SERVICES/FINANCIAL COUNSELING OR AMBULATORY CARE.PROCEDURE:ESTABLISHED CLINIC PATIENT- THE FINANCIAL ASSISTANCE FEE SCHEDULE MUST BE USED TO ESTABLISH A FEE SCALE FOR NEW CLINIC PATIENTS WHO HAVE NO APPLICABLE INSURANCE COVERAGE.- PATIENTS ARE INFORMED, AT THE TIME OF SCHEDULING, TO BRING THE FOLLOWING DOCUMENTATION, AS AVAILABLE OR APPLICABLE, TO THEIR FIRST VISIT IN ORDER TO BE ASSIGNED A FEE SCALE:- PICTURE IDENTIFICATION- PROOF OF ADDRESS (LETTER/BILL MAILED TO THE PATIENT AT THEIR ADDRESS)- INCOME TAX 1040 (TO VERIFY DEPENDENTS)- PROOF OF INCOME- 4 MOST RECENT PAY STUBS (OR)- A LETTER FROM THE PATIENT'S EMPLOYER (OR)- A STATEMENT FROM THE PATIENT STATING INCOME (OR)- IF THE PATIENT DOES NOT WORK, A LETTER FROM THE PERSON SUPPORTING THEM- THE HIGHEST INCOME LEVEL ON THE FINANCIAL ASSISTANCE FEE SCHEDULE IS 300% OF THE FEDERAL POVERTY LEVEL.- WHEN AN EXISTING CLINIC PATIENT PRESENTS FOR THEIR FIRST VISIT UNDER THIS POLICY, THE REGISTRAR WILL FEE SCALE THE PATIENT USING THE FINANCIAL ASSISTANCE FEE SCHEDULE AND INPUT "CHC" AS THE REGISTRATION FINANCIAL CLASS AND COMMENT IN GNE NOTES.- ALL FEE SCALES FOR CLINIC PATIENTS MUST BE RE-EVALUATED ANNUALLY USING THE FINANCIAL ASSISTANCE FEE SCHEDULE.- A FEE SCALE APPROVAL IS GOOD FOR 1 YEAR FROM THE DATE OF APPLICATION AND MUST BE NOTED AS SUCH IN THE INSURANCE COMMENTS BY THE APPROVING CLINIC REGISTRAR.- MOST ANCILLARY TESTING RELATED TO A CLINIC VISIT IS INCLUDED IN THE KJMC FINANCIAL ASSISTANCE PROGRAM. EXCLUSIONS ARE PET SCANS, MRI'S, CT SCANS AND ULTRASOUNDS.- ALL ANCILLARY TESTING RELATED TO A CLINIC VISIT, PERFORMED ON THE SAME DAY AS THE CLINIC VISIT, MUST BE PUT ON THE CLINIC ACCOUNT.- ALL ANCILLARY TESTING DONE ON A DAY BESIDES THE CLINIC VISIT, THE REGISTRAR WILL PERFORM A DISTINCT P/A REGISTRATION AND ASSIGN THE "CHC" FINANCIAL CLASS AND ADD IN GNE NOTES THE DATE OF THE RELATED CLINIC VISIT. CLINIC PATIENTS (WITH ESTABLISHED FEE SCALES) SCHEDULED FOR AMBULATORY SURGERY PROCEDURES - WHEN A CLINIC PATIENT, WHO IS ALREADY QUALIFIED FOR FINANCIAL ASSISTANCE, SCHEDULES AN AMBULATORY SURGERY PROCEDURE THE PATIENT IS RESPONSIBLE FOR A PERCENTAGE OF THE ESTIMATED SELF-PAY/MEDICAID RATE. THE RATES ARE AS FOLLOWS:- ALL AMBULATORY SURGICAL PROCEDURES = $2,500.00- COLONOSCOPY, ENDOSCOPY, BRONCHOSCOPY = $1,000.00 - THE PERCENTAGE OF THE MEDICAID RATE THE PATIENT WILL BE RESPONSIBLE FOR IS DETERMINED BY THE PATIENT'S FAMILY SIZE AND TOTAL FAMILY INCOME.- EXISTING CLINIC PATIENTS, WHO ARE ALREADY QUALIFIED FOR FINANCIAL ASSISTANCE AND WHOSE INCOME AND FAMILY SIZE ARE ABOVE 300% OF THE POVERTY LEVEL WILL BE RESPONSIBLE FOR THE HIGHEST PERCENTAGE (35%) OF THE SELF-PAY/MEDICAID RATE.- THE CLINIC STAFF ARRANGING THE AMBULATORY SURGERY PROCEDURE WILL FILL OUT A RESPONSIBILITY CONTRACT AND INDICATE THE QUALIFIED LEVEL OF FINANCIAL ASSISTANCE THE PATIENT IS ELIGIBLE FOR AND FORWARD A COPY TO PATIENT ACCESS SERVICES. THE ORIGINAL FORM WILL BE KEPT ON FILE IN THE ORIGINATING CLINIC.- AT THE TIME OF PRE-REGISTRATION OR REGISTRATION FOR THE PROCEDURE, THE PATIENT ACCESS SCHEDULED IV STAFF WILL CONFIRM THE PATIENT'S CHARITY CARE STATUS AS A REGISTERED CLINIC PATIENT WITH A CURRENT VALID FINANCIAL ASSISTANCE PROGRAM APPROVAL.- THE PATIENT WILL BE REGISTERED WITH THE "CHC" FINANCIAL CLASS AND THE APPROPRIATE PAYMENT AMOUNT COLLECTED AT THE TIME OF SERVICE.- IF THERE IS NO RESPONSIBILITY CONTRACT ON FILE, THE PRE-REGISTRATION/REGISTRATION STAFF WILL REFER THE PATIENT TO PATIENT ACCESS FINANCIAL COUNSELING FOR A FINANCIAL ASSISTANCE ELIGIBILITY SCREEN.- THE PATIENT ACCESS FINANCIAL COUNSELING STAFF WILL REVIEW AND ENTER THEIR COMMENTS IN THE GNE NOTES. - IF QUALIFIED, THE STAFF WILL REGISTER THAT PATIENT WITH FINANCIAL CLASS "CHC" AND NOTE THE SAME IN GNE. - THE REGISTRATION STAFF WILL ASK THE PATIENT FOR THE REDUCED PAYMENT AMOUNT AT THE TIME OF THE PROCEDURE/PST.- WHEN THE PATIENT HAS BEEN REGISTERED, THE REGISTRATION STAFF WILL FORWARD A COPY OF THE REGISTRATION FACE SHEET TO THE RESPECTIVE INPATIENT OR OUTPATIENT PATIENT FINANCIAL SERVICES MANAGER, WITH A COPY TO THE DIRECTOR OF PATIENT FINANCIAL SERVICES.- WHEN THE PROCEDURE HAS BEEN CODED, PATIENT ACCOUNTS WILL CONFIRM THE ALLOWANCE ON THE ACCOUNT TO THE PERCENTAGE OF THE MEDICAID RATE APPROVED.- THE BILL WILL GO OUT TO THE PATIENT AT THE REDUCED RATE.
PART VI, LINE 2:	DESCRIPTION OF HOW KINGSBROOK JEWISH MEDICAL CENTER ASSESSESS THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES:AS IN PRIOR YEARS, KINGSBROOK JEWISH MEDICAL CENTER ("KINGSBROOK") DID A REVIEW OF ITS PATIENT DATABASE AND DETERMINED THAT TO BEST MEET THE NEEDS OF ITS COMMUNITY, THE HOSPITAL WOULD CONTINUE TO FOCUS ON THE AREAS WHERE THE MAJORITY OF THE PATIENTS RESIDE. AS SUCH, THE IMMEDIATE CATCHMENT AREA OF THE HOSPITAL CONTINUED TO CONSIST OF THE FOLLOWING NEIGHBORHOODS OF BROOKLYN - CROWN HEIGHTS (11213), BROWNSVILLE (11212), FLATBUSH (11203) AND CANARSIE (11236). THIS AFFIRMATION OF THE CATCHMENT AREA WAS DONE IN CONSULTATION WITH THE KJMC COMMUNITY ADVISORY BOARD AS WELL AS THE HEALTH ASSESSMENT NEEDS REPORT DEVELOPED BY COMMUNITY BOARDS 9 AND 17 (BROOKLYN).ONCE ITS CATCHMENT AREA WAS DETERMINED, KINGSBROOK REVIEWED THE LATEST HEALTH, SOCIOECONOMIC AND SOCIO-DEMOGRAPHIC INFORMATION FROM THE 2010 CENSUS. THAT INFORMATION, ALONG WITH REPORTS PRODUCED BY THE NEW YORK STATE DEPARTMENT OF HEALTH ("NYS DOH") AND THE NEW YORK CITY DEPARTMENT OF HEALTH ("NYC DOH") SUCH AS THE COUNTY HEALTH RANKINGS FOR KINGS COUNTY 2013, ALLOWED KINGSBROOK TO IDENTIFY KEY AREAS ON WHICH TO FOCUS. THE RESULT OF THIS ASSESSMENT GAVE US THE FOLLOWING STATISTICAL INFORMATION: 1. 12% OF OUR COMMUNITY MEMBERS LIVE WITH DIABETES2. IN OUR CATCHMENT AREA OF CENTRAL BROOKLYN, 35% OF HIV DIAGNOSES ARE LATE STAGE3. 32% OF THE RESIDENTS IN OUR CATCHMENT AREA HAVE BEEN DIAGNOSED WITH HIGH BLOOD PRESSURE4. 26% OF THE RESIDENTS IN OUR CATCHMENT AREA HAVE BEEN DIAGNOSED WITH HIGH CHOLESTEROLBASED UPON THESE FACTS, KINGSBROOK WORKED WITH THE FOLLOWING GROUPS TO BEST DETERMINE THE NEEDS OF OUR COMMUNITY1. CARIBBEAN WOMEN'S HEALTH ASSOCIATION, INC. (CWHA) THIS ASSOCIATION WAS FOUNDED IN 1982. FOR OVER TWENTY YEARS CWHA HAS SERVED AS AN ADVOCACY GROUP AND SERVICE PROVIDER IN THE COMMUNITY. CWHA STRONGLY RELIES ON COMMUNITY INVOLVEMENT IN PLANNING, IMPLEMENTATION AND EVALUATION OF PROGRAMS THAT MEET THE HEALTH AND SOCIAL SUPPORT NEEDS OF THE COMMUNITY. THERE IS CONTINUOUS INTERACTION WITH THE COMMUNITY TO REVIEW THE APPROPRIATENESS OF THE EDUCATIONAL AND PROMOTIONAL MATERIALS PRODUCED BY CWHA. CWHA IS ACCREDITED BY THE UNITED NATIONS ECONOMIC AND SOCIAL COUNCIL. THE AGENCY'S EXCELLENCE IN SERVICE DELIVERY IS WIDELY ACCLAIMED AND RECOGNIZED FOR THE QUALITY, BREADTH AND IMPACT OF ITS WORK. THIS ORGANIZATION IS LOCATED IN KINGSBROOK'S PRIMARY SERVICE AREA. 2. BROOKLYN PERINATAL NETWORK (BPN) ESTABLISHED IN 1988 FROM A COMMUNITY TASK FORCE TO ADDRESS HIGH INFANT MORTALITY, THE PURPOSE OF THE ORGANIZATION IS TO PREVENT AND REDUCE INFANT/MATERNAL ILLNESS AND DEATH, WHICH FOR SEVERAL YEARS HAVE BEEN EXCESSIVELY HIGH IN THE COMMUNITY. BY ENABLING AT-RISK RESIDENTS TO ACCESS VITAL INFORMATION, COORDINATE CARE, SUPPORTIVE HEALTH AND SOCIAL SUPPORTIVE SERVICES AND ASSISTING FAMILIES TO SECURE PUBLIC HEALTH BENEFITS AND RESOURCES NEEDED TO MAINTAIN HEALTH. THE ORGANIZATION HAS SEEN A SIGNIFICANT REDUCTION IN INFANT DEATH AND IMPROVED MATERNAL AND CHILD HEALTH STATUS. BPN IS A NETWORK OR COLLABORATIVE OF SEVERAL COMMUNITY ORGANIZATIONS THAT PROVIDE MEDICAL CARE, OFFERING A WIDE RANGE OF PRIMARY PREVENTATIVE AN CLINICAL SERVICES INCLUDING PREGNANCY, OB/GYN CARE, PEDIATRIC, ADOLESCENT HEALTH CARE, GENERAL FAMILY PRACTICE AND ADULT MEDICINE; AS WELL AS SPECIALTY CARE IN AREAS SUCH AS MENTAL HEALTH, FAMILY PLANNING, SUBSTANCE ABUSE TREATMENT AND COUNSELING, HIV/AIDS CARE AND MORE. THIS ORGANIZATION IS LOCATED IN KINGSBROOK'S PRIMARY SERVICE AREA. 3. BROWNSVILLE MULTI SERVICE CENTER (BMS) A COMMITMENT TO TREATING THE "WHOLE PERSON" IS REFLECTED IN BMS' "INTEGRATED PRIMARY CARE COMMUNITY BASED HEALTH SERVICE MATRIX;" A MODEL OF PRIMARY CARE THAT IS PATTERNED ON A PROGRESSIVE PRIVATE PRACTICE. EACH MEDICAL TEAM TAKES AN INTERDISCIPLINARY AND INTEGRATIVE APPROACH TO COORDINATE THE PATIENT'S CARE. THE ON-SITE CLINICAL AREAS INCLUDE: ADULT INTERNAL MEDICINE, INFECTIOUS DISEASE, PEDIATRICS, OB/GYN, DENTISTRY, PSYCHOLOGY, PSYCHIATRY, SOCIAL SERVICES. THIS ORGANIZATION IS LOCATED IN KINGSBROOK'S PRIMARY SERVICE AREA. ON A WEEKLY BASIS, KINGSBROOK STAFFS AN HOURLY PULMONARY/ASTHMA CLINIC WITH ONE OF OUR STAFF PHYSICIANS.4. BROOKLYN DISTRICT PUBLIC HEALTH OFFICE (DPHO), NYC DOH THE MISSION OF THIS OFFICE IS TO REDUCE HEALTH DISPARITIES AND PROMOTE HEALTHY EQUITY BY TARGETING RESOURCES, PROGRAMS AND ATTENTION TO HIGH-NEED NEIGHBORHOODS IN NORTH AND CENTRAL BROOKLYN. 5. BROOKLYN HEALTHCARE IMPROVEMENT PROJECT (BHIP) SINCE 2009, KINGSBROOK HAS PARTNERED WITH SUNY DOWNSTATE AND SEVERAL OTHER REGIONAL MEDICAL FACILITIES TO FORM A COALITION OF 29 MEMBERS FOCUSED ON LOCAL HEALTH PLANNING INITIATIVES. MEMBERS RANGE FROM HOSPITALS AND COMMUNITY BOARDS TO COMMUNITY-BASED ORGANIZATIONS AND HEALTH INSURANCE PLANS. THIS FORUM FOCUSES ON THE CREATION OF A UNIQUE AND CURRENTLY UNAVAILABLE INVENTORY OF PRIMARY CARE SERVICES PROVIDERS AND A UTILIZATION DATABASE FOR CENTRAL BROOKLYN. THIS PROJECT SUPPORTS EFFECTIVE COMMUNITY LEVEL PLANNING AND WILL PROVIDE THE COALITION WITH THE NECESSARY INFORMATION TO MAKE RECOMMENDATIONS TO THE NEW YORK STATE DOH ON THE SERVICES NEEDED IN OUR COMMUNITIES.WORKING IN CONJUNCTION WITH THE NYS DOH AND THE AFOREMENTIONED GROUPS, KINGSBROOK HAS FOCUSED ITS RESOURCES ON TWO MAIN AREAS. FIRST, IS TO WORK ON THE PREVENTION OF CHRONIC DISEASE BY INCREASING THE ACCESS TO HIGH QUALITY CHRONIC DISEASE PREVENTION CARE AND MANAGEMENT IN BOTH CLINICAL AND COMMUNITY SETTINGS. THIS IS DONE THROUGH THE HOSPITAL'S CLINICS. SECOND IS THE PREVENTION OF INFECTIOUS DISEASE AND THE CONTINUING CARE OF CURRENTLY INFECTED HIV PATIENTS. THIS IS BEING DONE TO HELP DECREASE HIV MORBIDITY AND INCREASE EARLY ACCESS TO AND RETENTION OF HIV CARE THROUGH OUR DESIGNATED AIDS CENTER (DAC).
PART VI, LINE 3:	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:IT IS THE POLICY OF KINGSBROOK JEWISH MEDICAL CENTER TO PROVIDE COMPREHENSIVE QUALITY HEALTH CARE AND MEDICALLY ESSENTIAL SERVICES WITHOUT REGARD TO A PATIENT'S ABILITY TO PAY OR THEIR IMMIGRATION STATUS. KINGSBROOK JEWISH MEDICAL CENTER RECOGNIZES THAT THERE ARE TIMES WHEN PATIENTS IN NEED OF MEDICAL CARE MAY HAVE DIFFICULTY PAYING FOR THE SERVICES PROVIDED. KINGSBROOK JEWISH MEDICAL CENTER'S FINANCIAL ASSISTANCE PROGRAM PROVIDES DISCOUNTS TO QUALIFYING INDIVIDUALS BASED ON YOUR INCOME. IN ADDITION, WE CAN HELP YOU APPLY FOR FREE OR LOW-COST INSURANCE IF YOU QUALIFY. PLEASE CONTACT OUR FINANCIAL COUNSELOR'S AT (718) 604-5499 OR GO TO THE ADMISSIONS DEPARTMENT (PATIENT ACCESS SERVICES DEPARTMENT), LOCATED IN THE KATZ BUILDING, FIRST FLOOR FOR FREE, CONFIDENTIAL ASSISTANCE.WHO QUALIFIES FOR A DISCOUNT?KINGSBROOK JEWISH MEDICAL CENTER HAS IMPLEMENTED A FINANCIAL ASSISTANCE PROGRAM WHICH EVALUATES THOSE WHO ARE UNDERINSURED, HAVE EXHAUSTED THEIR INSURANCE BENEFITS OR ARE FULLY UNINSURED. CURRENT CLINIC PATIENTS WITHOUT ADEQUATE FINANCIAL RESOURCES CAN RECEIVE CARE IN OUR PRIMARY / SPECIALTY CLINICS FOR FEE SCHEDULES BASED ON THEIR INCOME AND FAMILY SIZE. A DETERMINATION WILL BE MADE IF THE PATIENT IS ELIGIBLE FOR REDUCED FEES. NON-CLINIC PATIENTS SEEN IN THE EMERGENCY DEPARTMENT, INPATIENT, OR FOR OUTPATIENT SERVICES CAN APPLY FOR ASSISTANCE, BASED ON FINANCIAL NEED, THROUGH THE FINANCIAL ASSISTANCE PROCESS IN PATIENT ACCOUNTS, PATIENT ACCESS SERVICES/FINANCIAL COUNSELING OR AMBULATORY CARE.EVERYONE IN NEW YORK STATE WHO NEEDS EMERGENCY SERVICES CAN RECEIVE CARE AND GET A DISCOUNT IF THEY MEET THE INCOME LIMITS. ANY INDIVIDUALS RESIDING IN KINGSBROOK JEWISH MEDICAL CENTER'S PRIMARY SERVICE AREA, WHICH IS DEFINED AS: EAST FLATBUSH, FLATBUSH, CANARSIE, FLATLANDS, BEDFORD-STUYVESANT, CROWN HEIGHTS AND/OR EAST NEW YORK (ZIP CODES 11203, 11236, 11213, 11226, 11212, 11208, 11207, 11225, 11216), CAN GET A DISCOUNT ON NON-EMERGENCY, MEDICALLY NECESSARY SERVICES AT KINGSBROOK JEWISH MEDICAL CENTER IF THEY MEET THE INCOME LIMITS. KINGSBROOK JEWISH MEDICAL CENTER WILL NEVER DENY MEDICALLY NECESSARY CARE BECAUSE YOU MAY NEED FINANCIAL ASSISTANCE. YOU MAY APPLY FOR A DISCOUNT REGARDLESS OF YOUR IMMIGRATION STATUS.WHAT ARE THE INCOME LIMITS?THE AMOUNT OF THE DISCOUNT VARIES BASED ON YOUR INCOME AND THE SIZE OF YOUR FAMILY. KINGSBROOK JEWISH MEDICAL CENTER'S FINANCIAL ASSISTANCE PROGRAM IS BASED UPON UP TO 300% OF THE JANUARY 2013 DEPARTMENT OF HEALTH AND HUMAN SERVICES FEDERAL POVERTY GUIDELINES. (CHART PROVIDED)WHAT IF I DO NOT MEET THE INCOME LIMITS?IF YOU CANNOT PAY YOUR BILL, KINGSBROOK JEWISH MEDICAL CENTER OFFERS AN EXTENDED, INTEREST-FREE, PAYMENT PLAN TO THOSE PATIENTS THAT MEET THE INCOME LIMITS. THE AMOUNT OF YOUR PAYMENT INSTALLMENT DEPENDS ON AMOUNT OF YOUR INCOME AND ABILITY TO PAY.CAN SOMEONE EXPLAIN THE DISCOUNT? CAN SOMEONE HELP ME APPLY?YES, FREE, CONFIDENTIAL HELP IS AVAILABLE. PLEASE CONTACT OUR FINANCIAL COUNSELOR'S AT (718) 604-5499 OR GO TO THE ADMISSIONS DEPARTMENT (PATIENT ACCESS SERVICES DEPARTMENT, LOCATED IN THE KATZ BUILDING, FIRST FLOOR FOR FREE, CONFIDENTIAL ASSISTANCE. IF YOU DO NOT SPEAK ENGLISH, SOMEONE WILL HELP YOU IN YOUR OWN LANGUAGE. THE FINANCIAL COUNSELOR CAN TELL YOU IF YOU QUALIFY FOR FREE OR LOW-COST INSURANCE, SUCH AS MEDICAID, CHILD HEALTH PLUS AND FAMILY HEALTH PLUS. IF THE FINANCIAL COUNSELOR FINDS THAT YOU DON'T QUALIFY FOR LOW-COST INSURANCE OR MEDICAID, THEY WILL ASSIST YOU IN ACCESSING THE MEDICAL CENTER'S FINANCIAL ASSISTANCE PROGRAM FOR ANY APPLICABLE DISCOUNTS, INCLUDING HELPING YOU WITH THE APPROPRIATE FORMS AND DOCUMENTATION REQUIREMENTS.WHAT DO I NEED TO APPLY FOR A DISCOUNT?PATIENTS ARE REQUESTED TO PROVIDE THE FOLLOWING DOCUMENTATION, AS AVAILABLE OR APPLICABLE, IN ORDER TO BE EVALUATED FOR FINANCIAL ASSISTANCE:- PICTURE IDENTIFICATION- PROOF OF ADDRESS (LETTER/BILL MAILED TO THE PATIENT AT THEIR ADDRESS)- INCOME TAX 1040 (TO VERIFY DEPENDENTS)- PROOF OF INCOME? FOUR (4) MOST RECENT PAY STUBS (AND/OR)? A LETTER FROM THE PATIENT'S EMPLOYER (AND/OR)? A STATEMENT FROM THE PATIENT STATING INCOME (AND/OR) ? IF THE PATIENT DOES NOT WORK, A LETTER FROM THE PERSON SUPPORTING THEMIF YOU CANNOT PROVIDE ANY OF THESE DOCUMENTS, PLEASE LET US KNOW SO WE CAN DETERMINE HOW TO HELP YOU APPLY FOR FINANCIAL ASSISTANCE.WHAT SERVICES ARE COVERED?ALL MEDICALLY NECESSARY SERVICES PROVIDED BY KINGSBROOK JEWISH MEDICAL CENTER ARE COVERED BY THE FINANCIAL ASSISTANCE PROGRAM. THIS INCLUDES OUTPATIENT SERVICES, EMERGENCY CARE AND INPATIENT ADMISSIONS. CHARGES FROM PRIVATE DOCTORS WHO PROVIDE SERVICES IN THE HOSPITAL MAY NOT BE COVERED BY THIS PROGRAM. YOU SHOULD TALK TO PRIVATE DOCTORS TO SEE IF THEY OFFER A DISCOUNT OR PAYMENT PLAN. HOW MUCH DO I HAVE TO PAY?THE AMOUNT FOR OUTPATIENT SERVICE OR THE EMERGENCY ROOM STARTS FROM $43.60 TO $501.60, DEPENDING ON YOUR FINANCIAL ASSISTANCE QUALIFICATION CATEGORY. OUR FINANCIAL COUNSELOR WILL GIVE YOU THE DETAILS ABOUT YOUR SPECIFIC DISCOUNT(S) ONCE YOUR APPLICATION IS PROCESSED. HOW DO I GET THE DISCOUNT? YOU HAVE TO FILL OUT AN APPLICATION FORM. AS SOON AS WE HAVE PROOF OF YOUR INCOME, WE CAN PROCESS YOUR APPLICATION FOR A DISCOUNT ACCORDING TO YOUR INCOME LEVEL. YOU CAN APPLY FOR A DISCOUNT BEFORE YOU HAVE AN APPOINTMENT, WHEN YOU COME TO THE HOSPITAL TO GET CARE, OR WHEN THE BILL COMES IN THE MAIL.SEND THE COMPLETED FORM AND SUPPORTING DOCUMENTATION TO OUR FINANCIAL COUNSELOR'S IN THE PATIENT ACCESS SERVICES (ADMISSIONS) DEPARTMENT OR BRING IT TO THE PATIENT ACCESS SERVICES (ADMISSIONS) DEPARTMENT, LOCATED IN THE KATZ BUILDING, FIRST FLOOR.HOW WILL I KNOW IF I WAS APPROVED FOR THE DISCOUNT?KINGSBROOK JEWISH MEDICAL CENTER WILL SEND YOU A LETTER, WITHIN 30 BUSINESS DAYS, AFTER RECEIPT OF YOUR COMPLETED APPLICATION AND SUPPORTING DOCUMENTATION, TELLING YOU IF YOU HAVE BEEN APPROVED FOR FINANCIAL ASSISTANCE AND THE LEVEL OF DISCOUNT YOU ARE ELIGIBLE FOR. WHAT IF I RECEIVE A BILL WHILE I'M WAITING TO HEAR IF I CAN GET A DISCOUNT?YOU CANNOT BE REQUIRED TO PAY A HOSPITAL BILL WHILE YOUR APPLICATION FOR A DISCOUNT IS BEING CONSIDERED. IF YOUR APPLICATION IS TURNED DOWN, KINGSBROOK JEWISH MEDICAL CENTER WILL TELL YOU WHY AND PROVIDE YOU WITH A WAY TO APPEAL THIS DECISION TO A HIGHER LEVEL WITHIN THE HOSPITAL.WHAT IF I HAVE A PROBLEM I CANNOT RESOLVE WITH THE HOSPITAL?YOU MAY CALL THE NEW YORK STATE DEPARTMENT OF HEALTH COMPLAINT HOTLINE AT 1-800-804-5447.
PART VI, LINE 4:	DESCRIPTION OF COMMUNITY INFORMATION:KINGSBROOK JEWISH MEDICAL CENTER ("KINGSBROOK") IS LOCATED IN BROOKLYN, NEW YORK. KINGSBROOK IS DEDICATED TO MEETING THE HEALTHCARE NEEDS OF ONE OF BROOKLYN'S MOST CULTURALLY DIVERSE COMMUNITIES. LOCATED IN THE EAST FLATBUSH SECTION OF CENTRAL BROOKLYN, KINGSBROOK WAS FOUNDED IN 1925 AS A CHRONIC CARE FACILITY TO SERVE THE JEWISH COMMUNITY WITHIN A CULTURAL CONTEXT. WHILE STILL RETAINING TIES TO THE SURROUNDING SHRINKING JEWISH COMMUNITY, KINGSBROOK HAS EXPANDED ITS PROGRAMS AND SERVICES TO MEET THE NEEDS OF THE LARGE IMMIGRANT AND ETHNIC MINORITY POPULATION IN ITS CATCHMENT AREA, INCLUDING A SIGNIFICANT NUMBER OF CARIBBEAN AND AFRICAN-AMERICANS.KINGSBROOK'S CURRENT SERVICE AREA CONSISTS OF THE FOLLOWING ZIP CODES: 1) 11203 - FLATBUSH; 2) 11212 - BROWNSVILLE; 3) 11213 - CROWN HEIGHTS; 4) 11236 - CANARSIE. BASED UPON UPDATED DEMOGRAPHICS INFORMATION TAKEN FROM THE 2009-2013 AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES ON THE US CENSUS BUREAU-AMERICAN FACTFINDER WEBSITE , THIS CATCHMENT AREA HAS A TOTAL POPULATION OF 323,368 PEOPLE, WHICH BREAKS DOWN TO 8.7% WHITE, 84.7% BLACK AND 6.6% OTHER. ADDITIONALLY, 22.3% OF THIS POPULATION IS SHOWN AS BEING BELOW THE FEDERAL POVERTY LEVEL.CENTRAL BROOKLYN RESIDENTS EXPERIENCE MORE BARRIERS TO HEALTH CARE ACCESS THAN THOSE IN NYC OVERALL. ADDITIONALLY, THE UNDERINSURED POPULATION IN THIS REGION HAS NEARLY DOUBLED WITHIN THE PAST FEW YEARS. LIMITED ACCESS TO HEALTHCARE SERVICES CONTRIBUTE TO THE OVERWHELMING DISEASE RATES, WHICH ARE MORE THAN DOUBLE THE STATE AND NATIONAL AVERAGES FOR THE LOWER INCOME RACIALLY DIVERSE RESIDENTS OF CENTRAL BROOKLYN. REPORTS, SUCH AS "TAKE CARE NEW YORK" PREPARED BY NEW YORK CITY DEPARTMENT OF HEALTH IDENTIFY MANY OF THE KEY ISSUES CONCERNING HEALTHCARE IN CENTRAL BROOKLYN. THE AFOREMENTIONED REPORT SHOWS THAT CENTRAL BROOKLYN RESIDENTS EXPERIENCE MORE BARRIERS TO HEALTHCARE ACCESS THAN THOSE IN NYC OVERALL, WITH NEARLY 3 IN 10 RESIDENTS NOT HAVING A REGULAR DOCTOR.BASED UPON OUR 2014 UPDATED CHNA, WITHIN OUR PRIMARY SERVICES AREAS (CENTRAL BROOKLYN, EAST NEW YORK AND FLATBUSH) CLOSE TO 12% OF ADULTS HAVE DIABETES. ADDITIONALLY, 29% OF THE ADULT POPULATION IN CENTRAL BROOKLYN IS CONSIDERED OBESE WHICH CAN ALSO LEAD TO A VARIETY OF HEALTH PROBLEMS INCLUDING HEART DISEASE AND DIABETES. THE HIV RELATED DEATH RATE IN THIS REGION IS STILL MORE THAN TWICE BOTH THE BROOKLYN AND NEW YORK CITY OVERALL RATES. IN TOTAL, THERE ARE OVER 7,000 PERSONS LIVING WITH HIV/AIDS IN OUR PRIMARY SERVICE AREA. ADDITIONALLY, HIGH BLOOD PRESSURE AND HIGH CHOLESTEROL CONTRIBUTE TO HEART DISEASE. AS SUCH, 32% OF RESIDENTS WITHIN OUR PRIMARY SERVICE AREA HAVE BEEN DIAGNOSED WITH HIGH BLOOD PRESSURE AND 26% WITH HIGH CHOLESTEROL. IN AN EFFORT TO COMBAT THESE DISPARITIES, OUR CENTRAL FOCUSES ARE ACCESS TO QUALITY HEALTH CARE, CHRONIC DISEASE MANAGEMENT AND INFECTIOUS DISEASE COUNSELING.
PART VI, LINE 5:	DESCRIPTION OF COMMUNITY HEALTH PROMOTION:PROMOTION OF COMMUNITY HEALTH - ACCESS TO QUALITY HEALTH CARERESIDENTS IN OUR SERVICE REGION OF CENTRAL BROOKLYN FACE HEALTH DISPARITIES THAT SURPASS STATE AND NATIONAL AVERAGES IN THE AREAS OF DIABETES, STROKE, HYPERTENSION AND ASTHMA. ADDITIONALLY, THE UNDERINSURED POPULATION IN THIS REGION HAS DOUBLED WITHIN THE PAST FEW YEARS. IN ORDER TO ADDRESS THIS HEALTH CRISIS, KINGSBROOK, INDEPENDENTLY AND SOMETIMES IN CONJUNCTION WITH LOCAL COMMUNITY ORGANIZATIONS, OFFERS A NUMBER OF SCREENING AND PREVENTIVE SERVICES TO HELP ALLEVIATE SOME OF THE PRESSING HEALTHCARE ISSUES. OUR EFFORTS INCLUDE OFF-SITE EVENTS IN PARTNERSHIP WITH LOCAL CLERGY, SCHOOLS AND COMMUNITY BASED ORGANIZATIONS, AS WELL AS ON-SITE EVENTS BASED ON A PUBLISHED YEAR-LONG SCREENING CALENDAR, WITH SERVICES PROVIDED AT OUR MAIN HOSPITAL CAMPUS AS WELL AS OUR OFF-SITE PIERRE TOUSSAINT FAMILY HEALTH CENTER. FINALLY, KINGSBROOK HAS INITIATED A PATIENT PORTAL PROGRAM WHICH ALLOWS OUR PATIENT ACCESS TO THEIR MEDICAL RECORD AND OTHER PERTINENT INFORMATION.SCREENINGINCREASED SCREENING AND EDUCATIONAL OPPORTUNITIES FOR OUR COMMUNITY RESIDENTS IS VITAL TO THE TREATMENT AND MANAGEMENT OF CHRONIC DISEASE. ALL KJMC FREE SCREENINGS SPEAK TO THE CHRONIC DISEASE ISSUES MOST PREVALENT IN OUR COMMUNITY WHICH INCLUDE HYPERTENSION, DIABETES, CHOLESTEROL, STROKE, ASTHMA AND PROSTATE. TO ACHIEVE THESE OBJECTIVES, KINGSBROOK COLLABORATES WITH OTHER COMMUNITY PROVIDERS, NOT-FOR- PROFIT ENTITIES, MEDIA OUTLETS AND FOUNDATIONS TO PROVIDE THESE SCREENING AND PREVENTATIVE TREATMENT SERVICES TO ITS COMMUNITY MEMBERS. UNDERSTANDING THE NEED FOR ADDITIONAL EARLY DETECTION SERVICES AND HEALTH CARE INFORMATION, THE PUBLIC AFFAIRS DIVISION AT KINGSBROOK WORKS TO PROVIDE A CONSISTENT SCHEDULE OF SCREENINGS THROUGHOUT THE YEAR. SCREENINGS ARE COORDINATED MONTHLY VIA OUR ON-SITE AND OFF-SITE AMBULATORY CARE CENTERS. ADDITIONALLY, FOR THOSE IN THE COMMUNITY WHO ARE UNABLE TO ATTEND THE SCHEDULED SCREENINGS EFFORTS, WE OFFER AN ON-LINE FREE SCREENING COUPON. THIS COUPON ALLOWS FOR PRIVATE SCREENING APPOINTMENTS VIA OUR AMBULATORY CARE DIVISION, COORDINATED IN CONJUNCTION WITH THE DEPARTMENT OF PUBLIC AFFAIRS. LASTLY, KINGSBROOK PARTICIPATES IN BETWEEN 50-60 HEALTH FAIRS, EDUCATIONAL SESSIONS AND COMMUNITY EVENTS ANNUALLY WITH A MYRIAD OF SCREENING OPTIONS. THESE EVENTS ARE COORDINATED BY OUR COMMUNITY PARTNERS, LOCAL CLERGY AND ELECTED OFFICIALS. THESE EFFORTS ALLOW US A BROADER ARENA BY WHICH TO PROVIDE EARLY DETECTION AND HEALTH EDUCATION SERVICES. ADDITIONALLY, WE HAVE ENGAGED ADDITIONAL COMMUNITY PARTNERS TO HELP DRIVE THIS PREVENTION AGENDA FOCUS AND ASSIST US IN CO-PARTNERING EFFORTS TO EXTEND OUR REACH FOR CHRONIC DISEASE EARLY DETECTION SERVICES. THESE PARTNERSHIPS HAVE PROVIDED US THE ABILITY TO OFFER BREAST CANCER WORKSHOPS, EXTERNAL EDUCATIONAL EFFORTS FOR DIABETES, STROKE, HYPERTENSION AND KIDNEY DISEASE. OUR GOAL IS TO CONTINUE EXTENDING THESE PARTNERSHIP OPPORTUNITIES WITHIN THE COMMUNITY. SOME OF THE CURRENT GROUPS AND EVENTS WHICH WE HAVE PARTNERED WITH INCLUDE: WOMEN IN NEED, GIRLS SCOUTS OF AMERICA, PS 326, PS 316, PS 243, BROOKLYN ADULT LEARNING CENTER, EAST NEW YORK LEARNING CENTER, BROOKLYN ADULT LEARNING CENTER, ST. GABRIEL'S SENIOR CENTER, MARTIN LUTHER KING CONCERT SERIES, BETHEL TABERNACLE, NEW DIMENSION, NEW GENESIS CHRISTIAN CHURCH, 25TH STREET BLOCK ASSOCIATION, GLENWOOD SENIOR CENTER, VICTORIOUS CHURCH GOD, CHRISTIAN CULTURAL CENTER, PANAMANIAN ASSOCIATION, BEULAH CHURCH OF NAZARENE, CHURCH OF ST. MARK'S, ST. STEPHENS CHURCH, WOMEN OF FAITH, ANGLICAN CHURCH, ST. AUGUSTINE'S, BEDFORD CENTRAL PRESBYTERIAN, MT. OLIVES, AND GOD'S BATTALION OF PRAYER. IN 2014, KINGSBROOK PROVIDED EARLY DETECTION OPPORTUNITIES TO OVER 4,175 INDIVIDUALS. SCREENINGS FOR ASTHMA, STROKE DIABETES, HYPERTENSION, HIV, PROSTATE AND BREAST CANCER WERE OF SPECIAL FOCUS. DESPITE THE EVER GROWING FINANCIAL CHALLENGES FOR HEALTHCARE ORGANIZATIONS, KINGSBROOK HAS BEEN ABLE TO MAINTAIN ITS AGGRESSIVE OUTREACH AND ANNUAL SCREENING SCHEDULE FACILITATING A NUMBER OF PRIVATE AND PARTNERED EVENTS IN EFFORT TO ADDRESS THE COMMUNITY'S ACCESS TO QUALITY CARE AND INTERVENTION FOR CHRONIC DISEASES, AS WE HAVE DETAILED OUT FURTHER BELOW. PATIENT-CENTERED MEDICAL HOME (PCHM) MODULEKINGSBROOK HAS ADOPTED THE NCQA 'S PATIENT-CENTERED MEDICAL HOME (PCMH) MODULE, AN INNOVATIVE PROGRAM FOR IMPROVING PRIMARY CARE; ESPECIALLY AS IT PERTAINS TO OUR CHRONIC DISEASE TREATMENT, VIA A SET OF STANDARDS THAT DESCRIBE CLEAR AND SPECIFIC CRITERIA, THE PROGRAM GIVES PRACTICES INFORMATION ABOUT ORGANIZING CARE AROUND PATIENTS, WORKING IN TEAMS AND COORDINATING AND TRACKING CARE OVER TIME. THE NCQA PATIENT-CENTERED MEDICAL HOME STANDARDS STRENGTHEN AND ADD TO THE ISSUES ADDRESSED BY NCQA'S ORIGINAL PROGRAM. AS SUCH, WE WILL BE COMMITTED TO THIS MODEL BEYOND 2017. THE PATIENT CENTERED MEDICAL HOME IS A HEALTH CARE SETTING THAT FACILITATES PARTNERSHIPS BETWEEN INDIVIDUAL PATIENTS AND THEIR PERSONAL PHYSICIANS, AND WHEN APPROPRIATE, THE PATIENT'S FAMILY. CARE IS FACILITATED BY REGISTRIES, INFORMATION TECHNOLOGY, HEALTH INFORMATION EXCHANGE AND OTHER MEANS TO ASSURE THAT PATIENTS GET THE INDICATED CARE WHEN AND WHERE THEY NEED AND WANT IT IN A CULTURALLY AND LINGUISTICALLY APPROPRIATE MANNER.THE OVERALL GOAL FOR KINGSBROOK'S HOSPITAL-MEDICAL HOME (H-MH) DEMONSTRATION PROGRAM IS TO IMPROVE THE QUALITY AND CONTINUITY OF CARE THAT MEDICAID BENEFICIARIES RECEIVE WHILE ENHANCING THE AMBULATORY TRAINING EXPERIENCE OF THE PRIMARY CARE RESIDENTS. TO MEET THESE GOALS, THIS PROGRAM WILL IMPROVE THE CONTINUITY TRAINING EXPERIENCE FOR RESIDENT PHYSICIANS AND SUPPORT IMPROVEMENTS IN THE INTEGRATION AND COORDINATION OF CARE WHILE REDUCING AVOIDABLE INPATIENT HARM. THE PROVISION OF SUPPORT FOR TRANSFORMING DELIVERY SYSTEMS TO DELIVER A PATIENT CENTERED MEDICAL HOME CARE MODEL, PLACING A FOCUS ON MEASUREABLE IMPROVEMENTS IN QUALITY AND SAFETY, IS A CENTRAL STRATEGY OF THIS PROGRAM. CHRONIC DISEASE FOCUSES INCLUDE: COMPREHENSIVE DIABETES CARE: BLOOD PRESSURE/NEPHROPATHY MONITORING/HBA1 CONTROL/, MONITORING COLORECTAL CANCER SCREENINGS, MU TOBACCO USE/SMOKING CESSATION, CERVICAL CANCER SCREENING, MU BREAST CANCER SCREENING, POST-SPECIALTY CARE VISITS/WAIT TIMES, REFERRALS & INADEQUATE DOCUMENTATION. COMMUNICATION TO ENHANCE ACCESSIN 2014, KINGSBROOK WORKED IN COLLABORATION WITH SEVERAL COMMUNITY ORGANIZATIONS TO DISCUSS OPTIONS FOR EDUCATION, OUTREACH, EARLY DETECTION AND WAYS BY WHICH TO INCREASE COMMUNITY HEALTH AWARENESS. DURING 2014, OVER 1,110 PEOPLE ATTENDED OUR EVENTS. THE PARTNERSHIPS PRODUCED COLLABORATIVE EVENTS THAT INCLUDED THE FOLLOWING: - AIDS AWARENESS DAY - FEATURING A WEALTH OF INFORMATION ON THE DAC CENTERS SUPPORT SERVICES, WHICH INCLUDES; MEDICAL CARE COORDINATION, OUTPATIENT CASE MANAGEMENT, INPATIENT CASE MANAGEMENT, CASE MANAGEMENT PROGRAM OPERATIONS, SUPPORT GROUPS, FAMILY & INDIVIDUAL COUNSELING AND SUBSTANCE ABUSE COUNSELING (REFERRAL TO DETOX).- CARIBBEAN WOMEN'S HEALTH ASSOCIATION/BREAST HEALTH EDUCATION PARTNERSHIP - TARGETING SPECIAL FOCUS GROUPS ORGANIZED BY THIS LOCAL HEALTH ORGANIZATION, KINGSBROOK'S BREAST HEALTH TEAM COORDINATED SEVERAL EDUCATIONAL SEMINARS ON BREAST CANCER AND HELPED GUIDE WOMEN IN NEED TOWARD PROGRESSIVE TESTING AND TREATMENT. - 5TH ANNUAL GOSPEL FEST - TARGETING THE LARGER SPIRITUAL COMMUNITY OF CENTRAL BROOKLYN, THIS EVENT FOCUSED ON THE IMPORTANCE OF PHYSICAL AND SPIRITUAL WELLNESS IN ONES OVERALL HEALTH. SCREENINGS AND INFORMATION WERE PROVIDED ALONG WITH A THREE HOUR CONCERT LINE UP DRAWING OVER 300 PERSONS. SCREENINGS AND EDUCATION FOR DIABETES, HYPERTENSION AND ASTHMA WERE AVAILABLE FOR GUESTS. THIS EVENT WAS HELD ON OCTOBER 12TH 2014.- PIERRE TOUSSAINT OPEN HOUSE EVENTS - IN AN EFFORT TO TARGET MORE VOLUME IN OUR AMBULATORY CARE DIVISIONS, PIERRE TOUSSAINT HELD SEVERAL OPEN HOUSE EVENTS TO THE COMMUNITY OFFERING FREE SCREENINGS SUCH AS: DIABETES, HIV/AIDS, HYPERTENSION AND ASTHMA. - THE BEST HEALTH SCHOOL - IN 2014, KJMC OFFERED A NEW COMMUNITY PROGRAM CALLED THE BEST HEALTH SCHOOL. THIS PROGRAM IS A NEW PREVENTION AND WELLNESS INITIATIVE THAT PROVIDES A FREE, YEAR-LONG HEALTH AND WELLNESS CURRICULUM FOR THE COMMUNITY. THIS UNIQUE MODEL PROVIDES A WIDE RANGE OF WELLNESS EDUCATION TO CHOOSE FROM, INCLUDING ESSENTIAL CLASSES FOR CPR AND STROKE AWARENESS. THE PROGRAM IS DESIGNED TO BUILD A HEIGHTENED AWARENESS TO HEALTH DISPARITIES AND RISK FACTORS, AND IT OFFERS A CERTIFICATE OF COMPLETION TO PARTICIPANTS. THIS EFFORT IS SUPPORTED AND CHAMPIONED BY KINGSBROOK'S COMMUNITY LEADERSHIP COUNCIL, WHICH IS COMPRISED OF MEMBERS OF THE COMMUNITY, FAITH LEADERS, AND HEALTH PARTNERS WHO SHARE OUR MISSION OF PROVIDING THE VERY BEST PREVENTION AND WELLNESS MODULES TO OUR COMMUNITY. WE OFFER CLASSES ON SITE AS WELL AS IN THE COMMUNITY AND ORGANIZATIONS UPON REQUEST. DURING 2014, KJMC OFFERED 16 DIFFERENT CLASSES WITH TOPICS RANGING FROM OBESITY, DIABETIC FOOT CARE, STRESS MANAGEM
PART VI, LINE 6:	AFFILIATED HEALTH CARE SYSTEM:KINGSBROOK JEWISH MEDICAL CENTER IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM.
PART VI, LINE 7, REPORTS FILED WITH STATES	NY
CONTINUATION OF DESCRIPTION OF COMMUNITY HEALTH PROMOTION	MYKINGSBROOK PORTALIN AUGUST 2014, THE KINGSBROOK IT DEPARTMENT ROLLED OUT A NEW SERVICE THAT ALLOWS OUR PATIENTS TO ACCESS AND STAY IN CONTROL OF THEIR PERSONAL MEDICAL RECORD INFORMATION. THIS SERVICE, CALLED MYKINGSBROOK PORTAL, ALLOWS OUR PATIENT TO VIEW LAB RECORDS, REQUEST PRESCRIPTION REFILLS, AND SEND EMAILS TO REQUESTS APPOINTMENTS AND REFERRALS. KJMC HAD IT STAFF GO OUT ONTO THE HOSPITAL FLOORS TO SIGN PATIENTS UP, INCLUDING HELPING PATIENTS SET UP THEIR OWN EMAIL ACCOUNT IF THEY DID NOT PREVIOUSLY HAVE ONE. SINCE THIS PROGRAM WAS ROLLED OUT, KJMC HAS SIGNED UP APPROXIMATELY 1700 PATIENTS.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	0	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
LINDA BRADY MD
PRESIDENT & BOARD DIRECTOR	$800,153	$0	$0	$0	$88,491	$0	$24,700	$0	$42,942	$0	$956,286	$0	$0	$0
JOHN SCHMITT CPA
ASSISTANT TREASURER & CFO	$341,434	$0	$0	$0	$23,034	$0	$24,700	$0	$42,942	$0	$432,110	$0	$0	$0
HAROLD MCDONALD THRU 42014
COO	$153,453	$0	$0	$0	$1,687	$0	$0	$0	$941	$0	$156,081	$0	$0	$0
SIBTE BURNEY MD
CHIEF MEDICAL OFFICER	$398,499	$0	$0	$0	$15,655	$0	$24,700	$0	$36,127	$0	$474,981	$0	$0	$0
KURT KODROFF
VICE PRESIDENT	$419,430	$0	$0	$0	$1,687	$0	$24,700	$0	$44,874	$0	$490,691	$0	$0	$0
ROBERT DUBICKI
SENIOR VP	$328,876	$0	$0	$0	$19,703	$0	$24,700	$0	$39,052	$0	$412,331	$0	$0	$0
JANE LEDERER
CHIEF NURSING OFFICER	$232,753	$0	$0	$0	$1,687	$0	$22,772	$0	$20,658	$0	$277,870	$0	$0	$0
MARC ROSS MD
DIR REHAB MED	$497,632	$0	$0	$0	$1,687	$0	$24,700	$0	$42,942	$0	$566,961	$0	$0	$0
WILLIAM LOIS
DIRECTOR SURGERY	$460,211	$0	$0	$0	$1,687	$0	$24,700	$0	$36,127	$0	$522,725	$0	$0	$0
VIJAY AKKAPEDDI
CHAIR EMERGENCY DEPT	$423,044	$0	$0	$0	$1,687	$0	$24,700	$0	$42,942	$0	$492,373	$0	$0	$0
LEON VALBRUN
PSYCHIATRIST	$292,346	$0	$0	$0	$0	$0	$21,365	$0	$39,636	$0	$353,347	$0	$0	$0
ADRIAN CRISTIAN
DEPUTY MED DIR, REHAB MEDICINE	$286,437	$0	$0	$0	$0	$0	$23,264	$0	$38,423	$0	$348,124	$0	$0	$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6	MEMBERS OR STOCKHOLDERS: KINGSBROOK HEALTHCARE SYSTEM ("KHS") IS THE SOLE MEMBER OF KINGSBROOK JEWISH MEDICAL CENTER.
FORM 990, PART VI, SECTION A, LINE 7A	MEMBERS OF THE GOVERNING BODY: MEMBERS MAY ELECT AND APPOINT MEMBERS OF THE GOVERNING BOARD AND BOARD OFFICERS OF THE CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7B	DECISIONS OF THE GOVERNING BODY: KHS IS THE SOLE MEMBER OF KINGSBROOK JEWISH MEDICAL CENTER, AND IT HAS RESERVED POWERS THAT ARE DELINEATED IN THE BYLAWS OF KINGSBROOK JEWISH MEDICAL CENTER.
FORM 990, PART VI, SECTION B, LINE 11	REVIEW PROCESS FOR FORM 990: THE CFO HAS CONDUCTED A DETAIL REVIEW OF FORM 990 WITH THE HOSPITAL'S TAX ACCOUNTANT AND ALL APPROPRIATE CHANGES HAVE BEEN MADE. FORM 990 IS THEN REVIEWED WITH THE CEO FOR ANY ADDITIONAL COMMENTARY, OBSERVATIONS, OR RECOMMENDATIONS. FORM 990 IS THEN REVIEWED WITH THE CHAIRMAN OF THE AUDIT AND COMPLIANCE COMMITTEE AND THEN PRESENTED TO THE AUDIT AND COMPLIANCE COMMITTEE FOR REVIEW FOR ANY ADDITIONAL COMMENTARY, OBSERVATIONS, OR RECOMMENDATIONS. ONCE COMPLETED AND FILED, FORM 990 IS MADE AVAILABLE TO THE FULL BOARD BY THE CHAIRMAN OF THE AUDIT AND COMPLIANCE COMMITTEE.
FORM 990, PART VI, SECTION B, LINE 12C	CONFLICT OF INTEREST POLICY ALL CONFLICTS OF INTEREST ARE REVIEWED BY THE COMPLIANCE OFFICER. ANY POTENTIAL CONFLICTS INVOLVING BOARD MEMBERS ARE REFERRED TO THE AUDIT AND COMPLIANCE COMMITTEE FOR REVIEW AND/OR ACTION, AS NECESSARY.
FORM 990, PART VI, SECTION B, LINE 15	COMPENSATION POLICY CONSISTENT WITH BEST PRACTICES IN GOVERNANCE AND FIDUCIARY OVERSIGHT OF TAX EXEMPT FUNDS, KINGSBROOK JEWISH MEDICAL CENTER (KJMC) HAS INSTITUTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY AND COMPENSATION COMMITTEE CHARTER. THE COMPENSATION COMMITTEE IS AUTHORIZED BY THE BOARD TO DEVELOP AND RECOMMEND FOR BOARD APPROVAL THE COMPENSATION OF THE PRESIDENT AND CEO AND MEMBERS OF SENIOR MANAGEMENT (SENIOR VICE PRESIDENTS, VICE PRESIDENTS AND ASSISTANT VICE PRESIDENTS). ONLY INDEPENDENT MEMBERS OF THE BOARD SHALL PARTICIPATE IN COMPENSATION DELIBERATIONS AND DECISIONS (I.E., EMPLOYEES, MEMBERS OF THE MEDICAL STAFF AND CONSULTANTS ARE NOT DEEMED INDEPENDENT FOR THESE PURPOSES). ALL EXECUTIVE COMPENSATION DECISIONS ARE BASED ON COMPETITIVE MARKET DATA, ORGANIZATIONAL AND INDIVIDUAL PERFORMANCE RESULTS, AND ALIGNMENT WITH KJMC'S EXECUTIVE COMPENSATION PHILOSOPHY. THE BOARD'S COMPENSATION COMMITTEE REVIEWS AND APPROVES ALL EXECUTIVE COMPENSATION TO ENSURE LEGAL AND REGULATORY COMPLIANCE AND ADHERENCE TO GOVERNANCE BEST PRACTICES AND PROPER FIDUCIARY OVERSIGHT AS STEWARDS OF TAX EXEMPT ASSETS. THE EXECUTIVE COMPENSATION PHILOSOPHY STATES ITS INTENT IS TO MAINTAIN A COMPETITIVE EXECUTIVE COMPENSATION PROGRAM IN ORDER TO ATTRACT, RETAIN AND MOTIVATE QUALIFIED EMPLOYEES TO SUPPORT THE MISSION AND BUSINESS GOALS OF KJMC. THE COMPENSATION COMMITTEE RETAINS OUTSIDE LEGAL COUNSEL WHO REVIEWS COMPLIANCE WITH TAX AND REGULATORY REQUIREMENTS AS WELL AS THE SERVICES OF AN INDEPENDENT QUALIFIED COMPENSATION CONSULTANT WHO COMPILES AND ANALYZES PUBLISHED SURVEY DATA, ON AN ANNUAL BASIS, FOR BASE SALARIES AND TOTAL COMPENSATION PROVIDED BY TAX EXEMPT HOSPITALS AND MEDICAL CENTERS SIMILAR TO KJMC IN SIZE, OPERATIONS AND LOCATION. THE COMMITTEE'S REVIEW OF COMPENSATION OCCURS ANNUALLY SUCH THAT EXECUTIVE COMPENSATION AND BENEFITS CONTINUE TO BE COMPETITIVE AND REASONABLE. BY FOLLOWING THE PRECEDING GOVERNANCE AND FIDUCIARY PRACTICES, THE COMMITTEE QUALIFIES FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERMEDIATE SANCTIONS REGULATIONS OF THE INTERNAL REVENUE CODE SUCH THAT THE TOTAL COMPENSATION PROVIDED TO THE EXECUTIVES IS COMPARED TO WHAT IS "ORDINARILY PAID FOR LIKE SERVICES BY LIKE ENTERPRISES UNDER LIKE CIRCUMSTANCES", AS DEFINED IN THE INTERMEDIATE SANCTIONS REGULATIONS. BASE PAY FOR EACH EXECUTIVE IS EASED ON FACTORS INCLUDING MARKET DATA, TENURE, EXPERIENCE, AND INDIVIDUAL AND ORGANIZATIONAL PERFORMANCE. EXECUTIVE BASE PAY IS REVIEWED AND SET ANNUALLY BY THE INDEPENDENT MEMBERS OF THE COMPENSATION COMMITTEE OF THE INDEPENDENT DIRECTORS OF KINGSBROOK JEWISH MEDICAL CENTER [KJMC], BASED ON THE EXECUTIVE COMPENSATION PHILOSOPHY AND COMPENSATION COMMITTEE CHARTER. AS DESCRIBED IN KJMC'S EXECUTIVE COMPENSATION PHILOSOPHY AND COMPENSATION COMMITTEE CHARTER, KJMC SUPPORTS PERFORMANCE BASED COMPENSATION AND THEREFORE HAS IMPLEMENTED AN ANNUAL INCENTIVE PAY PROGRAM (EXECUTIVE MANAGEMENT ANNUAL INCENTIVE PLAN) FOR THE EXECUTIVES, WHICH IS CURRENTLY SUSPENDED, AND A LONG TERM INCENTIVE PAY PROGRAM (ANNUALIZED STRATEGIC PERFORMANCE INCENTIVE) FOR THE PRESIDENT AND CEO. THE ANNUAL AND LONG-TERM INCENTIVE PAY PROGRAMS ARE DESIGNED TO SUPPORT THE ATTAINMENT OF ANNUAL AND STRATEGIC PERFORMANCE OBJECTIVES AND REFLECT A COMBINATION OF FORMULAIC WEIGHTINGS PROVIDING FOR THRESHOLD, TARGET AND MAXIMUM BONUS LEVELS AND DISCRETIONARY JUDGMENT AS DETERMINED BY THE COMPENSATION COMMITTEE. THE PERFORMANCE MEASURES ARE SET PRIOR TO THE BEGINNING OF EACH PLAN YEAR AND PLAN PAYMENTS ARE DETERMINED BASED ON AUDITED FINANCIAL RESULTS AND OTHER MEASURES. FORM 990, PART VI, LINE 15B COMPENSATION REVIEW THE PROCESS USED FOR DETERMINING THE COMPENSATION OF THE CEO ALSO APPLIES TO MEMBERS OF THE EXECUTIVE STAFF, DEPARTMENT CHAIRS AND OTHER HIGHLY COMPENSATED STAFF EXCEPT THAT THE PRESIDENT AND CEO MAKES COMPENSATION RECOMMENDATIONS TO THE COMPENSATION SUBCOMMITTEE FOR THOSE EMPLOYEES.
FORM 990, PART VI, SECTION C, LINE 19	DOCUMENTS AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST, THE ORGANIZATION WILL MAKE AVAILABLE ONLY THOSE DOCUMENTS REQUIRED TO BE DISCLOSED UNDER THE PUBLIC INSPECTION LAWS.
FORM 990, PART VII	THE COMPENSATION RECEIVED BY DR. PATRICE WAS ON-CALL PAY FOR NEPHROLOGY COVERAGE. HE WAS NOT COMPENSATED FOR HIS BOARD SERVICE.
FORM 990, PART XI, LINE 9:	PENSION RELATED CHANGES OTHER THAN NET PERIODIC PENSION COSTS -3,389,547.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd	Direct Controlling NADirectControllingNACd
RUTLAND NURSING HOME INC
585 SCHENECTADY AVENUE	BROOKLYN	NY	11203	112164674	NURSING HOME	NY	501(C)(3)	LINE 9	KHS	0
KINGSBROOK JEWISH MEDICAL CENTER AUXILIARIES
585 SCHENECTADY AVENUE	BROOKLYN	NY	11203	113016121	SUPPORT ORG	NY	501(C)(3)	LINE 11A, I	KJMC	0
KINGSBROOK HEALTHCARE SYSTEM INC (KHS)
585 SCHENECTADY AVENUE	BROOKLYN	NY	11203	030464734	SUPPORT ORG	NY	501(C)(3)	LINE 11A, I		0	N/A
KINGSBROOK HEALTHCARE FOUNDATION INC
585 SCHENECTADY AVENUE	BROOKLYN	NY	11203	112845058	SUPPORT ORG	NY	501(C)(3)	LINE 11A, I	KHS	0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct
KSI INC
585 SCHENECTADY AVENUE	BROOKLYN	NY	11203	562327654	INACTIVE	NY	KHS	C	0
SINGULAB INC
585 SCHENECTADY AVENUE	BROOKLYN	NY	11203	562327669	INACTIVE	DE	KSI INC	C	0
ATM NURSE REGISTRY
585 SCHENECTADY AVENUE	BROOKLYN	NY	11203	562327649	INACTIVE	NY	KSI INC		0
KINGSBROOK LTACH INC
585 SCHENECTADY AVENUE	BROOKLYN	NY	11203	800712226	INACTIVE	NY	KHS	C	0
KINGSBROOK MEDICAL ASSOCIATES PC
585 SCHENECTADY AVENUE	BROOKLYN	NY	11203	452351859	BILLING & COLLECTION	NY	KJMC	C	Yes (1)	$6,847,386	$64,717	1.00000

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (1)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	0	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	Yes (1)	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	0	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	0	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	0	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	0	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (1)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	Yes (1)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
KINGSBROOK MEDICAL ASSOCIATES PC
S	$3,878,000	ACTUAL AMOUNT
KINGSBROOK MEDICAL ASSOCIATES PC
D	$2,074,000	ACTUAL AMOUNT