KINGSBROOK JEWISH MEDICAL CENTER INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: KINGSBROOK JEWISH MEDICAL CENTER INC (EIN 11-1631759)
Tax period: 2012-01-01 to 2012-12-31
Filed: 2013-11-14
IRS object ID: 201343189349302119
Schema version: 2012v2.1
Source: Download XML · Original 990 at ProPublica

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

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

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-11-14T09:50:15-06:00	Timestamp
Tax Period End Date	2012-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	420714325	EIN

Preparer Firm Business Name PreparerFirmBusinessName

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

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	1185 AVENUE OF THE AMERICAS	AddressLine1
City	NEW YORK	City
State	NY	State
ZIP Code	100362602	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	111631759	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	KINGSBROOK JEWISH MEDICAL CENTER	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	KING	NameControl
Phone	7186045532	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	585 SCHENECTADY AVENUE	AddressLine1
City	BROOKLYN	City
State	NY	State
ZIP Code	11203	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	JOHN SCHMITT	Name
Title	CFO	Title
Phone	7186045532	Phone
Date Signed	2013-11-14	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	STEVEN LAPSKER	Name
PTIN	P00850484	PTIN
Phone	2123721000	Phone

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2016-03-07 17:11:31Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	LINDA BRADY MD	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	585 SCHENECTADY AVENUE	AddressLine1
City	BROOKLYN	City
State	NY	State
ZIP Code	11203	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	201897148	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.KINGSBROOK.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1926	YearFormation
State Legal Domicile	NY	StateLegalDomicile
Activity Or Mission Description	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.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	12	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	10	NbrIndependentVotingMembers
Total Nbr Employees	2822	TotalNbrEmployees
Total Nbr Volunteers	333	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	4268470	ContributionsGrantsPriorYear
Contributions Grants Current Year	4245543	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	191253206	ProgramServiceRevenuePriorYear
Program Service Revenue CY	193724883	ProgramServiceRevenueCY
Investment Income Prior Year	88198	InvestmentIncomePriorYear
Investment Income Current Year	197351	InvestmentIncomeCurrentYear
Other Revenue Prior Year	2271843	OtherRevenuePriorYear
Other Revenue Current Year	3519103	OtherRevenueCurrentYear
Total Revenue Prior Year	197881717	TotalRevenuePriorYear
Total Revenue Current Year	201686880	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	0	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	131066270	SalariesEtcPriorYear
Salaries Etc Current Year	133337661	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	171303	TotalFundrsngExpCurrentYear
Other Expense Prior Year	55418283	OtherExpensePriorYear
Other Expenses Current Year	60951742	OtherExpensesCurrentYear
Total Expenses Prior Year	186484553	TotalExpensesPriorYear
Total Expenses Current Year	194289403	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	11397164	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	7397477	RevenuesLessExpensesCY
Total Assets BOY	123843997	TotalAssetsBOY
Total Assets EOY	132899915	TotalAssetsEOY
Total Liabilities BOY	100449784	TotalLiabilitiesBOY
Total Liabilities EOY	101583573	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	23394213	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	31316342	NetAssetsOrFundBalancesEOY
Mission Description	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.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	167457118	Expense
Revenue	193724883	Revenue
Description	THE KINGSBROOK JEWISH MEDICAL CENTER ("KJMC") IS A 326-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.	Description
Total Program Service Expense	167457118	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	0	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	1	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	1	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	0	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	0	TaxExemptBonds
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	0	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	1	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	1	RelatedOrgControlledEntity
Transaction Related Entity	0	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	352	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	2822	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	0	UnrelatedBusinessIncome
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	1	QuidProQuoContributions
Quid Pro Quo Disclosure	1	QuidProQuoDisclosure
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	12	NbrVotingGoverningBodyMembers
Number Independent Voting Members	10	NumberIndependentVotingMembers
Family Or Business Relationship	0	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	1	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	1	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	0	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
States Where Copy Of Return Is Filed	NY	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

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

Field	Value	IRS element (for citing)
Telephone Number	7186045532	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	585 SCHENECTADY AVENUE	AddressLine1
City	BROOKLYN	City
State	NY	State
ZIP Code	11203	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Average Hours Per Week RelatedAverageHoursPerWeekRelated	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee
HENNA WHITE
BOARD CHAIR	3.00	5.50	X	X	0	0	0
LINDA BRADY MD
PRESIDENT & BOARD DIRECTOR	35.00	13.50	X	X	1264636	0	60530
SEEMA GOLDSTEIN
SECRETARY	1.50	2.00	X	X	0	0	0
EDWARD LIEBERSTEIN
BOARD TRUSTEE	1.00	3.00	X		0	0	0
ERICA GRUEN
BOARD TRUSTEE	1.00		X		0	0	0
JEFFREY DUNSTON
BOARD TRUSTEE	1.00		X		0	0	0
LEIBESH NASH
BOARD TRUSTEE	1.00		X		0	0	0
MICHAEL PORETSKY
BOARD TRUSTEE	2.00		X		0	0	0
RAFIQUE CHAUDHRY MD
BOARD TRUSTEE	1.00	1.00	X		1110766	0	0
ROBERT REISS
BOARD DIRECTOR	1.50	2.00	X		0	0	0
VALERIE BYNOE-KASDEN ESQ
BOARD TRUSTEE	1.00	1.00	X		0	0	0
VICTOR AYALA PHD
BOARD TRUSTEE	2.00	3.00	X		0	0	0
JOHN SCHMITT CPA
ASSISTANT TREASURER & CFO	35.00	12.00		X	636105	0	145505
MICHAEL MCDERMOTT
GENERAL COUNSEL	35.00	13.50		X	239487	0	60179
ROBERT DUBICKI
COO	35.00	13.00		X	466804	0	49748
SIBTE BURNEY MD
CMO	40.00				410026	0	57568	X
KIRAN BATHEJA
VICE PRESIDENT	35.00				376272	0	26118	X
KURT KODROFF
VICE PRESIDENT	40.00				492860	0	110613	X
JANE LEDERER
CHIEF NURSING OFFICER	40.00				273603	0	85167	X
HAROLD MCDONALD
SENIOR VP	35.00	12.00			411294	0	27002	X
MOHAMMAD ZAHIR MD
DIRECTOR MED	40.00				767109	0	35527		X
MARC ROSS MD
DIR REHAB MED	40.00				443857	0	60530		X
CHARLES LAWRENCE
PHYSICIAN	40.00				381825	0	54742		X
MARK SMITH
PHYSICIAN	40.00				319678	0	57525		X
WILLIAM LOIS
PHYSICIAN	40.00				366892	0	57568		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	7961214	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	888322	TotalOtherCompensation
Number Individuals GT100 K	235	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
SIEMENS MEDICAL SOLUTIONS
51 VALLEY STREAM PARKWAY	MALVERN	PA	19175	EMR UPGRADE AND IT/RADIOLOGY CONSULTING	2301505
EMPIRE GENERAL CONTRACTING
74 MAIN STREET SUITE 2	TUCKAHOE	NY	10707	CONSTRUCTION	1791579
AUTOMATED LOGIC-BTG INC
100 DELAWANNA AVENUE SUITE 400	CLIFTON	NJ	07014	CONSTRUCTION	1225920
BROOKLYN KINGS HIGHWAY
2002 GREEN PLACE	BALDWIN	NY	11510	MEDICAL SERVICES - ANESTHESIA	1110766
BIK ORTHOPEDICS
234 BRIARWOOD CROSSING	LAWRENCE	NY	11559	MEDICAL SERVICES - ORTHOPEDICS	1085139

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	61	NumberOfContractorsGT100K
Fundraising Events	134014	FundraisingEvents
Government Grants	4039427	GovernmentGrants
All Other Contributions	72102	AllOtherContributions
Total Contributions	4245543	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICE REVENUE	621300	189172628	189172628
INCENTIVE INCOME	900099	2407192	2407192
AFFIL INCOME - AUA MEDICAL	900099	1550326	1550326
AFFIL INCOME - ST. GEORGE U	900099	328700	328700
AFFIL INCOME - NY DOWNTOWN	900099	266037	266037

Field	Value	IRS element (for citing)
Total Program Service Revenue	193724883	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	28834	TotalRevenueColumn
Exclusion	$28,834	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	349121	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	0	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	349121	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	349121	TotalRevenueColumn
Exclusion	$349,121	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	168517	Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	0	Securities

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	168517	Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	168517	TotalRevenueColumn
Exclusion	$168,517	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	210268	GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events	134014	CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses	210268	FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc

Field	Value	IRS element (for citing)
Description	MISC. INCOME	Description
Business Code	900099	BusinessCode
Total Revenue Column	3169982	TotalRevenueColumn
Exclusion	$3,169,982	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	3169982	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	201686880	TotalRevenueColumn
Related Or Exempt Function Income	193724883	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$3,716,454	ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	4955860	Total
Program Services	4276907	ProgramServices
Management And General	678953	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	94632177	Total
Program Services	81536178	ProgramServices
Management And General	12964608	ManagementAndGeneral
Fundraising	131391	Fundraising

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	6832095	Total
Program Services	5887903	ProgramServices
Management And General	935997	ManagementAndGeneral
Fundraising	8195	Fundraising

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	20251080	Total
Program Services	17468998	ProgramServices
Management And General	2774398	ManagementAndGeneral
Fundraising	7684	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	6666449	Total
Program Services	5746674	ProgramServices
Management And General	913304	ManagementAndGeneral
Fundraising	6471	Fundraising

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	3911766	Total
Program Services	3000325	ProgramServices
Management And General	911441	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	91009	Total
Management And General	91009	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	170361	Total
Program Services	130667	ProgramServices
Management And General	39694	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	12120050	Total
Program Services	9348320	ProgramServices
Management And General	2754168	ManagementAndGeneral
Fundraising	17562	Fundraising

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	1886630	Total
Program Services	1608321	ProgramServices
Management And General	278309	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	3975896	Total
Program Services	3049512	ProgramServices
Management And General	926384	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	228477	Total
Program Services	175242	ProgramServices
Management And General	53235	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	744669	Total
Program Services	571161	ProgramServices
Management And General	173508	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	6914566	Total
Program Services	5303472	ProgramServices
Management And General	1611094	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	650650	Total
Program Services	499049	ProgramServices
Management And General	151601	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
MEDICAL & PHARMACEUTICA	15624693	15624693
BAD DEBT EXPENSE	5609011	5609011
MAINT & REPAIRS	4778670	3665240	1113430
FOOD COSTS	2369120	2369120

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	1876174	Total
Program Services	1586325	ProgramServices
Management And General	289849	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	194289403	Total
Program Services	167457118	ProgramServices
Management And General	26660982	ManagementAndGeneral
Fundraising	171303	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	4133753	BOY
EOY	4691365	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	10654671	BOY
EOY	7893078	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	26142083	BOY
EOY	26482335	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	2505774	BOY
EOY	2266717	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	2125992	BOY
EOY	2496486	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	196569435	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	158383109	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	38023835	BOY
EOY	38186326	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	620421	BOY
EOY	620429	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	39637468	BOY
EOY	50263179	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	123843997	BOY
EOY	132899915	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	58911014	BOY
EOY	50845146	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	288957	BOY
EOY	232980	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	8204919	BOY
EOY	6776220	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	5559651	BOY
EOY	4054957	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	27485243	BOY
EOY	39674270	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	100449784	BOY
EOY	101583573	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	23394213	BOY
EOY	31316342	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	23394213	BOY
EOY	31316342	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	123843997	BOY
EOY	132899915	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	7397477	ReconcilationRevenueExpenses
Reconcilation Other Changes	524652	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Consolidated	X	FinancialStatementConsolidated

Field	Value	IRS element (for citing)
Audit Committee	1	AuditCommittee
Federal Grant Audit Required	1	FederalGrantAuditRequired
Federal Grant Audit Performed	1	FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

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

Contributor Address US ContributorAddressUS

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)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	Volunteers
Paid Staff Or Management	0	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	0	GrantsOtherOrganizations
Direct Contact Legislators	1	DirectContactLegislators
Direct Contact Legislators	$150,050	DirectContactLegislatorsAmount
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	1	OtherActivities
Other Activities	$20,311	OtherActivitiesAmount
Total Lobbying Expenditures IIB	170361	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	EXPLANATION OF LOBBYING ACTIVITIES:	Identifier
Return Reference	PART II-B, LINE 1:	ReturnReference
Explanation	OTHER ACTIVITIES DESCRIPTION KINGSBROOK JEWISH MEDICAL CENTER PAYS DUES TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE HEALTHCARE ASSOCIATION OF NEW YORK STATE (HANYS). IN ACCORDANCE WITH SECTION 6033(E) OF THE INTERNAL REVENUE CODE, AND AS REPORTED BY AHA AND HANYS, A PORTION OF THESE DUES ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES. THE LOBBYING ACTIVITIES APPLICABLE TO 2012 AHA AND HANYS ANNUAL DUES WAS $4,901 AND $15,411, RESPECTIVELY. 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 2012 KINGSBROOK JEWISH MEDICAL CENTER PAID $150,050 IN CONNECTION WITH THESE SERVICES.	Explanation

Schedule D IRS990ScheduleD

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	241071	OtherCostOrOtherBasis
Book Value	241071	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	53999438	OtherCostOrOtherBasis
Depreciation	36897820	Depreciation
Book Value	17101618	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	139862904	OtherCostOrOtherBasis
Depreciation	120815666	Depreciation
Book Value	19047238	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	2466022	OtherCostOrOtherBasis
Depreciation	669623	Depreciation
Book Value	1796399	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	38186326	TotalOfBookValueLandBuildings

Other Assets OtherAssets (5 entries)

DescriptionDescription	Book ValueBookValue
DUE FROM RELATED ORGANIZATION	41880218
DEBT SERVICE RESERVE FUND	3304553
RECEIVABLE - INV. IN HEALTHFIRST	738271
OTHER RECEIVABLES	2831769
INTEREST IN KJMC FOUNDATION	1508368

Field	Value	IRS element (for citing)
Total Book Value Other Assets	50263179	TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (7 entries)

DescriptionDescription	AmountAmount
SELF INSURANCE LIABILITIES	$17,169,905
ESTIMATED THIRD PARTY SETTLEMENTS	$8,543,491
FIN 47 LIABILITY	$2,132,724
LTIP & SERP LIABILITY	$1,718,612
SECURITY DEPOSITS - OTHER	$1,993,919
ACCRUED POSTRETIREMENT BENEFIT COST	$1,528,785
ACCRUED PENSION LIABILITY	$6,586,834

Field	Value	IRS element (for citing)
Total Of Amounts	39674270	TotalOfAmounts
Footnote In Part XIII	X	FootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

Field	Value	IRS element (for citing)
Identifier	DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:	Identifier
Return Reference	PART X, LINE 2:	ReturnReference
Explanation	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. THE COMPANY IS SUBJECT TO U.S. FEDERAL AND STATE EXAMINATIONS BY TAX AUTHORITIES FOR FISCAL YEARS ENDED DECEMBER 31, 2009 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.	Explanation

Schedule G IRS990ScheduleG

Events Information EventsInformation

Field	Value	IRS element (for citing)
Name Of Event1	GOLF OUTING	NameOfEvent1
Gross Receipts Event1	165193	GrossReceiptsEvent1
Charitable Contributions Event1	86913	CharitableContributionsEvent1
Gross Revenue Event1	78280	GrossRevenueEvent1
Non Cash Prizes Event1	4863	NonCashPrizesEvent1
Rent Facility Costs Event1	61858	RentFacilityCostsEvent1
Other Direct Expenses Event1	11559	OtherDirectExpensesEvent1
Name Of Event2	DINNER	NameOfEvent2
Gross Receipts Event2	179089	GrossReceiptsEvent2
Charitable Contributions Event2	47101	CharitableContributionsEvent2
Gross Revenue Event2	131988	GrossRevenueEvent2
Non Cash Prizes Event2	4306	NonCashPrizesEvent2
Rent Facility Costs Event2	61476	RentFacilityCostsEvent2
Other Direct Expenses Event2	66207	OtherDirectExpensesEvent2
Gross Receipts Total	344282	GrossReceiptsTotal
Charitable Contributions Total	134014	CharitableContributionsTotal
Gross Revenue Total Events	210268	GrossRevenueTotalEvents
Non Cash Prizes Total Events	9169	NonCashPrizesTotalEvents
Rent Facility Costs Total Events	123334	RentFacilityCostsTotalEvents
Other Direct Expenses Total Events	77766	OtherDirectExpensesTotalEvents
Direct Expense Summary Events	210269	DirectExpenseSummaryEvents
Net Income Summary	-1	NetIncomeSummary

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
FPG Reference Free Care	1	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent300	X	Pcent300
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	0	AmountsBudgetedForCharityCare
Annual Community Benefit Report	1	AnnualCommunityBenefitReport
Report Publically Available	1	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	6544788	TotalCommunityBenefitExpense
Direct Offsetting Revenue	2281648	DirectOffsettingRevenue
Net Community Benefit Expense	4263140	NetCommunityBenefitExpense
Percent Of Total Expense	0.02190	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	48927505	TotalCommunityBenefitExpense
Direct Offsetting Revenue	34281126	DirectOffsettingRevenue
Net Community Benefit Expense	14646379	NetCommunityBenefitExpense
Percent Of Total Expense	0.07540	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	55472293	TotalCommunityBenefitExpense
Direct Offsetting Revenue	36562774	DirectOffsettingRevenue
Net Community Benefit Expense	18909519	NetCommunityBenefitExpense
Percent Of Total Expense	0.09730	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	195933	TotalCommunityBenefitExpense
Direct Offsetting Revenue	135890	DirectOffsettingRevenue
Net Community Benefit Expense	60043	NetCommunityBenefitExpense
Percent Of Total Expense	0.00030	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	12859670	TotalCommunityBenefitExpense
Direct Offsetting Revenue	12518879	DirectOffsettingRevenue
Net Community Benefit Expense	340791	NetCommunityBenefitExpense
Percent Of Total Expense	0.00180	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	13055603	TotalCommunityBenefitExpense
Direct Offsetting Revenue	12654769	DirectOffsettingRevenue
Net Community Benefit Expense	400834	NetCommunityBenefitExpense
Percent Of Total Expense	0.00210	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	68527896	TotalCommunityBenefitExpense
Direct Offsetting Revenue	49217543	DirectOffsettingRevenue
Net Community Benefit Expense	19310353	NetCommunityBenefitExpense
Percent Of Total Expense	0.09940	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	1	BadDebtExpenseReported
Bad Debt Expense	$5,609,010	BadDebtExpenseAmount
Amount Reimbursed By Medicare	65291071	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	64985086	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	305985	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	ProvisionForCharityCare
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	KINGSBROOK JEWISH MEDICAL CENTER	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	585 SCHENECTADY AVENUE	AddressLine1
City	BROOKLYN	City
State	NY	State
ZIP Code	11203	ZIPCode

Field	Value	IRS element (for citing)
Website Address	WWW.KINGSBROOK.ORG	WebsiteAddress
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Teaching Hospital	X	TeachingHospital
Er24 Hours	X	Er24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	KINGSBROOK JEWISH MEDICAL CENTER	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
Eligibility Criteria Explained	1	EligibilityCriteriaExplained
Uses FPG Free	1	UsesFPGFree
FPG Free Percent	200.000000000000	FPGFreePercent
Uses FPG Discounted	1	UsesFPGDiscounted
FPG Discount Percent	300.000000000000	FPGDiscountPercent
Explains Basis	1	ExplainsBasis
Income Level	X	IncomeLevel
Medicaid Medicare	X	MedicaidMedicare
Explains Application Method	1	ExplainsApplicationMethod
Includes Publicity Measures	1	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Posted In Emergency Room	X	PostedInEmergencyRoom
Posted In Admission Office	X	PostedInAdmissionOffice
Provided On Admission	X	ProvidedOnAdmission
Available On Request	X	AvailableOnRequest
Actions On Nonpayment	1	ActionsOnNonpayment
Collection Activities	0	CollectionActivities
Notify Upon Admission	X	NotifyUponAdmission
Notify Before Discharge	X	NotifyBeforeDischarge
Notified All Patients	X	NotifiedAllPatients
Nondiscrim Emergency Care Policy	1	NondiscrimEmergencyCarePolicy
Medicare Rate	X	MedicareRate
Amounts Generally Billed	0	AmountsGenerallyBilled
Gross Charges	0	GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (17 entries)

ExplanationExplanation	IdentifierIdentifier	Return ReferenceReturnReference
PART I, LINE 3C: NOT APPLICABLE
PART I, L7 COL(F): KINGSBROOK JEWISH MEDICAL CENTER'S COSTING METHODOLOGY WAS BASED UPON THE 2012 NEW YORK STATE INSTITUTIONAL COST REPORT AND THE 2012 (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:NET PATIENT AND RESIDENT SERVICE REVENUE, ACCOUNTS RECEIVABLE AND ALLOWANCE FOR DOUBTFUL ACCOUNTSKINGSBROOK JEWISH MEDICAL CENTER HAS AGREEMENTS WITH THIRD-PARTY PAYORS THAT PROVIDE FOR PAYMENTS TO THE MEDICAL CENTER AT AMOUNTS DIFFERENT FROM ITS ESTABLISHED RATES (I.E., GROSS CHARGES). PAYMENT ARRANGEMENTS INCLUDE PROSPECTIVELY DETERMINED RATES PER DISCHARGE, REIMBURSED COSTS, DISCOUNTED CHARGES, AND PER DIEM PAYMENTS.BILLINGS RELATING TO SERVICES RENDERED ARE RECORDED AS NET PATIENT SERVICE REVENUES IN THE PERIOD IN WHICH THE SERVICE IS PERFORMED, NET OF CONTRACTUAL AND OTHER ALLOWANCES WHICH REPRESENT DIFFERENCES BETWEEN GROSS CHARGES AND THE ESTIMATED RECEIPTS UNDER SUCH PROGRAMS. NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYORS. RETROACTIVE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS AS FINAL SETTLEMENTS ARE DETERMINED.ACCOUNTS RECEIVABLE ARE ALSO REDUCED FOR ALLOWANCES FOR DOUBTFUL ACCOUNTS. THE PROCESS FOR ESTIMATING THE ULTIMATE COLLECTION OF RECEIVABLES INVOLVES SIGNIFICANT ASSUMPTIONS AND JUDGMENTS. ACCOUNT BALANCES ARE WRITTEN OFF AGAINST THE ALLOWANCE WHEN MANAGEMENT DETERMINES IT IS PROBABLE THE RECEIVABLE WILL NOT BE RECOVERED. HISTORICAL COLLECTION AND PAYOR REIMBURSEMENT EXPERIENCE IS AN INTEGRAL PART OF THE ESTIMATION PROCESS RELATED TO RESERVES FOR UNCOLLECTIBLE ACCOUNTS. REVISIONS IN RESERVE FOR DOUBTFUL ACCOUNTS ESTIMATES ARE RECORDED AS AN ADJUSTMENT TO THE PROVISION FOR BAD DEBTS.FEDERAL AND STATE LAW REQUIRES THAT HOSPITALS PROVIDE EMERGENCY SERVICES REGARDLESS OF A PATIENT'S ABILITY TO PAY. UNINSURED PATIENTS SEEN IN THE EMERGENCY DEPARTMENT, INCLUDING PATIENTS SUBSEQUENTLY ADMITTED FOR INPATIENT SERVICES, OFTEN DO NOT PROVIDE INFORMATION NECESSARY TO ALLOW THE MEDICAL CENTER TO QUALIFY SUCH PATIENTS FOR CHARITY CARE. UNCOLLECTIBLE AMOUNTS DUE FROM SUCH UNINSURED PATIENTS REPRESENT THE SUBSTANTIAL PORTION OF THE PROVISION FOR BAD DEBTS REFLECTED IN THE ACCOMPANYING COMBINED STATEMENTS OF OPERATIONS. THE MEDICAL CENTER RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED.A SUMMARY OF THE PAYMENT ARRANGEMENTS WITH MAJOR THIRD-PARTY PAYORS IS AS FOLLOWS:- MEDICARE: INPATIENT ACUTE CARE AND CERTAIN NONACUTE CARE SERVICES AND OUTPATIENT SERVICES RENDERED TO MEDICARE PROGRAM BENEFICIARIES ARE PAID AT PROSPECTIVELY DETERMINED RATES. THESE RATES VARY ACCORDING TO A PATIENT CLASSIFICATION SYSTEM THAT IS BASED ON CLINICAL, DIAGNOSTIC, AND OTHER FACTORS. CERTAIN INPATIENT NONACUTE SERVICES AND DEFINED MEDICAL EDUCATION COSTS RELATED TO MEDICARE BENEFICIARIES ARE PAID BASED ON A COST REIMBURSEMENT METHODOLOGY. THE COMPANY IS REIMBURSED FOR COST REIMBURSABLE ITEMS AT A TENTATIVE RATE WITH FINAL SETTLEMENT DETERMINED AFTER SUBMISSION OF ANNUAL COST REPORTS AND AUDITS THEREOF BY THE MEDICARE FISCAL INTERMEDIARY.- NON-MEDICARE PAYMENTS: THE NEW YORK HEALTH CARE REFORM ACT OF 1996, AS UPDATED, GOVERNS PAYMENTS TO HOSPITALS IN NEW YORK STATE. UNDER THIS SYSTEM, HOSPITALS AND ALL NON-MEDICARE PAYORS, EXCEPT MEDICAID, WORKERS' COMPENSATION AND NO-FAULT INSURANCE PROGRAMS, NEGOTIATE HOSPITALS' PAYMENT RATES. IF NEGOTIATED RATES ARE NOT ESTABLISHED, PAYORS ARE BILLED AT HOSPITALS' ESTABLISHED CHARGES. MEDICAID, WORKERS' COMPENSATION AND NO-FAULT PAYORS PAY HOSPITAL RATES PROMULGATED BY THE NEW YORK STATE DEPARTMENT OF HEALTH ON A PROSPECTIVE BASIS. ADJUSTMENTS TO CURRENT AND PRIOR YEARS' RATES FOR THESE PAYORS WILL CONTINUE TO BE MADE IN THE FUTURE.THERE ARE VARIOUS PROPOSALS AT THE FEDERAL AND STATE LEVELS THAT COULD, AMONG OTHER THINGS, REDUCE PAYMENT RATES AND INCREASE MANAGED CARE PENETRATION, INCLUDING MEDICAID. THE ULTIMATE OUTCOME OF THESE PROPOSALS AND OTHER MARKET CHANGES CANNOT PRESENTLY BE DETERMINED.REVENUE FROM THE MEDICARE AND MEDICAID PROGRAMS ACCOUNTED FOR APPROXIMATELY 36% AND 37% OF THE MEDICAL CENTER'S GROSS PATIENT SERVICE REVENUE FOR THE YEAR ENDED DECEMBER 31, 2012.THE MEDICAL CENTER'S COST REPORT HAS BEEN AUDITED AND FINALIZED BY THE MEDICARE FISCAL INTERMEDIARY THROUGH DECEMBER 31, 2007.THE CURRENT MEDICAID, MEDICARE AND OTHER THIRD-PARTY PAYOR PROGRAMS ARE BASED UPON EXTREMELY COMPLEX LAWS AND REGULATIONS THAT ARE SUBJECT TO INTERPRETATION. AS A RESULT, THERE IS AT LEAST A REASONABLE POSSIBILITYTHAT RECORDED ESTIMATES WILL CHANGE BY A MATERIAL AMOUNT IN THE NEAR TERM. ADDITIONALLY, NONCOMPLIANCE WITH SUCH LAWS AND REGULATIONS COULD RESULT IN REPAYMENT OF AMOUNTS IMPROPERLY REIMBURSED, FINES, PENALTIES AND EXCLUSION FROM SUCH PROGRAMS. KINGSBROOK JEWISH MEDICAL CENTER IS NOT AWARE OF ANY ALLEGATIONS OF NONCOMPLIANCE THAT COULD HAVE A MATERIAL ADVERSE EFFECT ON THE FINANCIAL STATEMENTS AND BELIEVES THAT IT IS IN COMPLIANCE, IN ALL MATERIAL RESPECTS, WITH ALL APPLICABLE LAWS AND REGULATIONS AND IS NOT AWARE OF ANY PENDING OR THREATENED INVESTIGATIONS INVOLVING ALLEGATIONS OF POTENTIAL WRONGDOING.SIMILAR TO MOST HEALTHCARE ORGANIZATIONS, THE COMPANY GRANTS CREDIT WITHOUT COLLATERAL TO ITS PATIENTS, MOST OF WHOM ARE RESIDENTS OF BROOKLYN AND ARE INSURED UNDER THIRD-PARTY PAYOR AGREEMENTS. 2012 PROVISION FOR BAD DEBTS FOR KINGSBROOK JEWISH MEDICAL CENTER 5,609,000 (ROUNDED TO NEAREST THOUSAND)
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.
CLINIC PATIENTS (WITH ESTABLISHED FEE SCALES) SCHEDULED FOR INPATIENT ADMISSION OR ADMITTED VIA EMERGENCY ROOM- ALL CLINIC PATIENTS WHO BECOME INPATIENTS MUST BE EVALUATED BY PATIENT ACCESS FINANCIAL COUNSELING TO SEE IF THEY MAY BE ELIGIBLE FOR MEDICAID FOR THE INPATIENT SERVICE.- IF THE PATIENT WAS ASSESSED FOR MEDICAID AND WAS NOT ELIGIBLE, THE PATIENT ACCESS FINANCIAL COUNSELING STAFF SHOULD ENTER AN ADDITIONAL GNE NOTE STATING "EVALUATED FOR MEDICAID NOT ELIGIBLE." - AT THE TIME OF THE PATIENT ACCESS SCHEDULED IV REVIEW, THE STAFF WILL CONFIRM THE PATIENT IS A REGISTERED CLINIC PATIENT WITH OR WITHOUT CHARITY CARE APPROVAL IN EAGLE AND THEIR FEE SCALE.- WHEN A CLINIC PATIENT IS SCHEDULED FOR AN INPATIENT ADMISSION OR IS ADMITTED THROUGH THE EMERGENCY ROOM, THE PATIENT IS ELIGIBLE FOR A PERCENTAGE OF THE MEDICAID DRG BASE RATE, CASE MIX NEUTRAL, OF $9,000.00, BASED ON 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 PATIENT ACCESS FINANCIAL COUNSELING STAFF WILL VERIFY THE PATIENT'S FAMILY SIZE AND TOTAL FAMILY INCOME. USING THE FINANCIAL ASSISTANCE FEE SCHEDULE, THE STAFF WILL CONFIRM THE FEE SCALE PERCENTAGE OF THE MEDICAID RATE THAT THE PATIENT IS RESPONSIBLE FOR. - THE PATIENT ACCESS FINANCIAL COUNSELING STAFF WILL REVIEW AND ENTER THEIR COMMENTS IN THE GNE NOTES. - WHEN CONFIRMED, THE ADMITTING STAFF WILL ADMIT THE PATIENT WITH FINANCIAL CLASS "CHC." - WHEN THE PATIENT HAS BEEN ADMITTED, THE ADMITTING STAFF WILL FORWARD A COPY OF THE REGISTRATION FACE SHEET TO THE 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.- THE BILL WILL GO OUT TO THE PATIENT AT THE REDUCED RATE.NON-CLINIC PATIENTS SCHEDULED FOR OUTPATIENT / AMBULATORY PROCEDURES AND INPATIENT ADMISSIONS- ALL SELF-PAY PATIENTS WHO BECOME INPATIENTS MUST BE EVALUATED BY PATIENT ACCESS FINANCIAL COUNSELING TO SEE IF THEY MAY BE ELIGIBLE FOR MEDICAID FOR THE INPATIENT SERVICE.- PATIENT ACCESS SCHEDULED IV STAFF WILL REVIEW ALL SELF-PAY PATIENTS SCHEDULED FOR AN ELECTIVE SCHEDULED PROCEDURE. - AT THE TIME OF THE IV REVIEW, THE PATIENT ACCESS STAFF WILL CHECK IF THE PATIENT IS A REGISTERED CLINIC PATIENT WITH OR WITHOUT CHARITY CARE APPROVAL IN EAGLE AND HANDLE ACCORDINGLY.- ONCE IT IS CONFIRMED THAT THE PATIENT IS NOT AN ESTABLISHED CLINIC PATIENT AND STATES THEY ARE UNABLE TO PAY FOR THE PROCEDURE, THE PATIENT ACCESS SCHEDULED IV STAFF WILL ASK THE PATIENT IF THEY HAVE BEEN ASSESSED FOR MEDICAID OR HAVE COMMUNITY MEDICAID PENDING. - IF THE PATIENT RESPONDS "NO" THEN THE CASE MUST BE REFERRED TO THE PATIENT ACCESS FINANCIAL COUNSELING STAFF. THEY WILL REVIEW AND ENTER THEIR COMMENTS IN THE GNE NOTES. - IF QUALIFIED, THE PATIENT ACCESS FINANCIAL COUNSELING STAFF WILL PURSUE A MEDICAID APPLICATION.- IF THE PATIENT WAS ASSESSED FOR MEDICAID AND WAS NOT ELIGIBLE, THE PATIENT ACCESS FINANCIAL COUNSELING STAFF SHOULD ENTER AN ADDITIONAL GNE NOTE STATING "EVALUATED FOR MEDICAID NOT ELIGIBLE."- IF THE PATIENT HAS PREVIOUSLY APPLIED FOR MEDICAID AND IS INELIGIBLE, EXPLAIN THAT KINGSBROOK JEWISH MEDICAL CENTER HAS A FINANCIAL ASSISTANCE PROGRAM FOR PATIENT'S WHO HAVE NO HEALTH INSURANCE OR HAVE EXHAUSTED HEALTH BENEFITS AND ARE WITHOUT FINANCIAL RESOURCES TO PAY FOR MEDICALLY NECESSARY HEALTH CARE NEEDS. - THESE PATIENTS SHOULD THEN BE REFERRED TO THE PATIENT ACCESS FINANCIAL COUNSELING STAFF FOR QUALIFICATION IN THE MEDICAL CENTER'S FINANCIAL ASSISTANCE PROGRAM.- PATIENTS ARE INFORMED, 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 PATIENT ACCESS FINANCIAL COUNSELING STAFF WILL ASK THE PATIENT FOR HIS/HER FAMILY SIZE AND TOTAL FAMILY INCOME. USING THE FINANCIAL ASSISTANCE FEE SCHEDULE, THE STAFF WILL DETERMINE THE PERCENTAGE OF THE MEDICAID RATE WHICH THE PATIENT WILL BE RESPONSIBLE FOR. - WHEN A NON-CLINIC PATIENT, WHO QUALIFIES FOR FINANCIAL ASSISTANCE, IS SCHEDULED FOR AN INPATIENT OR AMBULATORY SURGERY PROCEDURE, THE PATIENT IS RESPONSIBLE FOR A PERCENTAGE OF THE ESTIMATED SELF-PAY/MEDICAID RATE. THE RATES ARE AS FOLLOWS:- INPATIENT MEDICAID DRG BASE RATE, CASE MIX NEUTRAL = $9,000.00,- 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.- FOR A PATIENT THAT IS 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 PATIENT ACCESS FINANCIAL COUNSELING STAFF 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 PATIENT ACCESS.- 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 AND REGISTER THAT PATIENT WITH FINANCIAL CLASS "CHC." - 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.- THE BILL WILL GO OUT TO THE PATIENT AT THE REDUCED RATE.	PROVISIONS ON COLLECTION PRACTICES	SCHEDULE H, PART III, LINE 9B CONTINUED
NON-CLINIC PATIENTS ADMITTED THROUGH THE EMERGENCY DEPARTMENT- ALL SELF-PAY PATIENTS WHO BECOME INPATIENTS MUST BE EVALUATED BY PATIENT ACCESS FINANCIAL COUNSELING STAFF TO SEE IF THEY MAY BE ELIGIBLE FOR MEDICAID FOR THE INPATIENT SERVICE.- PATIENT ACCESS "IV STAFF" WILL REVIEW ALL SELF-PAY PATIENTS ADMITTED VIA THE ED. - AT THE TIME OF THE IV REVIEW, THE PATIENT ACCESS STAFF WILL CHECK IF THE PATIENT IS A REGISTERED CLINIC PATIENT WITH OR WITHOUT CHARITY CARE APPROVAL IN EAGLE AND HANDLE ACCORDINGLY.- IF THE PATIENT IS NOT AN ESTABLISHED CLINIC PATIENT AND STATES THEY DO NOT HAVE INSURANCE COVERAGE, THE PATIENT ACCESS "IV STAFF" WILL ASK THE PATIENT IF THEY HAVE BEEN ASSESSED FOR MEDICAID OR HAVE COMMUNITY MEDICAID PENDING. - IF THE PATIENT RESPONDS "NO" THEN THE CASE MUST BE REFERRED TO THE PATIENT ACCESS FINANCIAL COUNSELING STAFF. THEY WILL REVIEW AND ENTER THEIR COMMENTS IN THE GNE NOTES. - IF QUALIFIED, THE PATIENT ACCESS FINANCIAL COUNSELING STAFF WILL PURSUE A MEDICAID APPLICATION.- IF THE PATIENT WAS ASSESSED FOR MEDICAID AND WAS NOT ELIGIBLE, THE PATIENT ACCESS FINANCIAL COUNSELING STAFF SHOULD ENTER AN ADDITIONAL GNE NOTE STATING "EVALUATED FOR MEDICAID NOT ELIGIBLE."- OR IF THE PATIENT HAS PREVIOUSLY APPLIED FOR MEDICAID AND ARE INELIGIBLE, EXPLAIN THAT KINGSBROOK JEWISH MEDICAL CENTER HAS A FINANCIAL ASSISTANCE PROGRAM FOR PATIENTS WHO HAVE NO HEALTH INSURANCE OR HAVE EXHAUSTED HEALTH BENEFITS AND ARE WITHOUT FINANCIAL RESOURCES TO PAY FOR MEDICALLY NECESSARY HEALTH CARE NEEDS. - THESE PATIENTS SHOULD THEN BE REFERRED TO THE PATIENT ACCESS FINANCIAL COUNSELING STAFF FOR QUALIFICATION IN THE FINANCIAL ASSISTANCE PROGRAM.- PATIENTS ARE INFORMED, 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 PATIENT ACCESS FINANCIAL COUNSELING STAFF WILL ASK THE PATIENT FOR HIS/HER FAMILY SIZE AND TOTAL FAMILY INCOME. USING THE FINANCIAL ASSISTANCE FEE SCHEDULE FOR NON-CLINIC PATIENTS, THE STAFF WILL DETERMINE THE PERCENTAGE OF THE MEDICAID RATE THE PATIENT IS RESPONSIBLE FOR. - THE QUALIFIED PATIENT IS ELIGIBLE FOR A PERCENTAGE OF THE MEDICAID DRG BASE RATE, CASE MIX NEUTRAL, OF $9,000.00, BASED ON THE PATIENT'S FAMILY SIZE AND TOTAL FAMILY INCOME.- THE PATIENT ACCESS FINANCIAL COUNSELING STAFF WILL REVIEW AND ENTER THEIR COMMENTS IN THE GNE NOTES. - IF QUALIFIED, THE STAFF WILL ADMIT THAT PATIENT WITH FINANCIAL CLASS "CHC." - THE ADMITTING STAFF WILL FORWARD A COPY OF THE REGISTRATION FACE SHEET TO PATIENT FINANCIAL SERVICES WITH A COPY TO THE DIRECTOR OF PATIENT FINANCIAL SERVICES IN PATIENT ACCOUNTS.- WHEN THE PROCEDURE HAS BEEN CODED, PATIENT ACCOUNTS WILL CONFIRM THE ALLOWANCE ON THE ACCOUNT TO THE PERCENTAGE OF THE MEDICAID RATE.- THE BILL WILL GO OUT TO THE PATIENT AT THE REDUCED RATE.	PROVISIONS ON COLLECTION PRACTICES	SCHEDULE H, PART III, LINE 9B CONTINUED
PART V, SECTION B, LINE 10: CRITERIA USED TO DETERMINE ELIGIBILITY FOR PROVIDING FREE CARE:DESPITE THE CURRENT ECONOMIC CHALLENGES AND THE NUMEROUS CLOSINGS OF AFFILIATED HEALTH CARE CENTERS, KINGSBROOK REMAINS FLEXIBLE, ESPECIALLY AS IT PERTAINS TO DOCUMENTATION REQUESTS FOR CHARITY CARE ELIGIBILITY. KINGSBROOK'S FINANCIAL ASSISTANCE PROGRAM EVALUATES THOSE WHO ARE UNDERINSURED, HAVE EXHAUSTED THEIR INSURANCE BENEFITS OR ARE FULLY UNINSURED. KINGSBROOK JEWISH MEDICAL CENTER'S FINANCIAL ASSISTANCE PROGRAM IS BASED UPON UP TO 300% OF THE MARCH 2012 DEPARTMENT OF HEALTH AND HUMAN SERVICES FEDERAL POVERTY GUIDELINES CURRENT. CURRENT CLINIC PATIENTS WITHOUT ADEQUATE FINANCIAL RESOURCES CAN RECEIVE CARE IN OUR PRIMARY/SPECIALTY CLINICS FOR FEE SCHEDULES BASED UPON THEIR INCOME AND FAMILY SIZE. A DETERMINATION WILL BE MADE IF THE PATIENT IS ELIGIBLE FOR REDUCED FEES.	KINGSBROOK JEWISH MEDICAL CENTER
PART V, SECTION B, LINE 11: CRITERIA USED TO DETERMINE ELIGIBILITY FOR PROVIDING DISCOUNTED CARE: 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.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 2012 DEPARTMENT OF HEALTH AND HUMAN SERVICES FEDERAL POVERTY GUIDELINES.	KINGSBROOK JEWISH MEDICAL CENTER
PART V, SECTION B, LINE 14G: 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 CENTERS 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 COUNSELORS 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.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 CENTERS 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.	KINGSBROOK JEWISH MEDICAL CENTER
PART VI, LINE 2: DESCRIPTION OF HOW KINGSBROOK JEWISH MEDICAL CENTER ASSESSESS THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES:IN 2012, 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 LAST HEALTH, SOCIOECONOMIC AND SOCIO-DEMOGRAPHIC INFORMATION FROM THE 2000/2010 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"), ALLOWED KINGSBROOK TO IDENTIFY KEY AREAS ON WHICH TO FOCUS. THE RESULT OF THIS ASSESSMENT GAVE US THE FOLLOWING STATISTICAL INFORMATION: 1. 11% 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 PATIENTS 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 KINGSBROOKS PRIMARY SERVICE AREA.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 CENTERS (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.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 CENTERS 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.
PART VI, LINE 4: DESCRIPTION OF COMMUNITY INFORMATIONKINGSBROOK 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 2010 CENSUS INFORMATION, THIS CATCHMENT AREA HAS A TOTAL POPULATION OF 318,318 PEOPLE, WHICH BREAKS DOWN TO 8.2% WHITE, 84.0% BLACK AND 7.8% OTHER. ADDITIONALLY, 21.5% 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.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, 31% OF RESIDENTS WITHIN OUR PRIMARY SERVICE AREA HAVE BEEN DIAGNOSED WITH HIGH BLOOD PRESSURE AND 24% 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: PROMOTION OF COMMUNITY HEALTH: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. ADDITIONALLY, KINGSBROOK HAS PUT MORE EMPHASIS ON THE CHRONIC DISEASES WHICH ARE MORE PREVALENT IN OUR SURROUNDING COMMUNITY. 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 2012, KINGSBROOK PROVIDED EARLY DETECTION OPPORTUNITIES TO OVER 3,000 INDIVIDUALS. SCREENINGS FOR ASTHMA, STROKE DIABETES, HYPERTENSION, HIV, PROSTATE AND BREAST CANCER WERE OF SPECIAL FOCUS. OUR TOTAL COMMUNITY BENEFIT, INCLUDING FREE SCREENINGS, EDUCATION AND MENTORSHIP IMPACTED OVER 7,586 RESIDENTS. 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 AN EFFORT TO ADDRESS THE COMMUNITY'S ACCESS TO QUALITY CARE AND INTERVENTION FOR CHRONIC DISEASES, AS WE HAVE DETAILED OUT FURTHER BELOW. PROSTATEPROSTATE CANCER REMAINS THE 2ND HIGHEST CANCER AMONG MEN IN OUR CATCHMENT REGION. DATA FURTHER REVEALS THAT LACK OF EDUCATION AND MOTIVATION TO PARTICIPATE IN EARLY DETECTION INITIATIVES CONTRIBUTE TO THE HIGH MORTALITY RATE EXPERIENCED BY OUR COMMUNITY. MEN IN OUR PRIMARY SERVICE AREA (ESPECIALLY THOSE OF AFRICAN AMERICAN AND/OR CARIBBEAN DESCENT) EXPERIENCE THE HIGHEST NEW YORK CITY DEATH RATE DUE TO PROSTATE CANCER. THESE STATISTICS ARE ATTRIBUTED TO THE MEN IN OUR COMMUNITY WHO HAVE MIGRATED FROM THE CARIBBEAN. KINGSBROOK'S AMBULATORY CARE PROGRAM PROVIDES FREE PROSTATE CANCER SCREENING EXAMINATIONS TO MEN 40 AND OVER. THESE SCREENINGS ARE AVAILABLE BY APPOINTMENT THROUGHOUT THE YEAR. THESE SCREENINGS ARE PROMOTED AT ALL OF OUR COMMUNITY HEALTH EVENTS WITH FREE SCREENING COUPON HANDOUTS, AS WELL AS ON-LINE VIA OUR FREE SCREENING COUPON OPTION. TO FURTHER PUBLICIZE OUR SCREENINGS AND THE IMPORTANCE OF EARLY DETECTION, KINGSBROOK IN PARTNERSHIP WITH THE NEW YORK DAILY NEWS HAS FOR THE LAST SIX YEARS ADVERTIZED PROSTATE AWARENESS WEEK. WITH THIS WELL ADVERTISED INITIATIVE, KINGSBROOK HAS SOUGHT TO EDUCATE ITS COMMUNITY ABOUT THE BENEFITS OF EARLY DETECTION AND TREATMENT FOR PROSTATE CANCER. IN 2012, KINGSBROOK'S PROSTATE CANCER INITIATIVE SCREENED 800 MEN. OF THAT NUMBER 80 (10%) RESULTED IN ABNORMAL FINDINGS AND WERE REFERRED FOR FOLLOW-UP CARE. BREAST CANCERSINCE THE INCEPTION OF KINGSBROOK BREAST HEALTH EDUCATION PROGRAM IN 2008, KINGSBROOK HAS SUCCESSFULLY EDUCATED 14,000 WOMEN ON THE IMPORTANCE OF BREAST HEALTH. THIS EDUCATION PROGRAM IS BROKEN DOWN INTO TWO COMPONENTS. THESE COMBINED BREAST HEALTH PROGRAMS WERE PACKAGED AND AGGRESSIVELY PROMOTED AS A PART OF OUR COMMUNITY OUTREACH AND EDUCATION THRUST THAT POSITIONED US TO CONTINUE THESE SERVICES INTO THE FUTURE. KINGSBROOK MAINTAINS A BREAST HEALTH EDUCATION PROGRAM FUNDED BY THE SUSAN G. KOMEN BREAST GREATER NEW YORK CITY AFFILIATE RACE FOR THE CURE AND THE AVON FOUNDATION FOR WOMEN. KINGSBROOKS COMMUNITY BREAST CANCER SCREENING ("CBCS") PROGRAM IS DESIGNED TO INCREASE ACCESS TO BREAST HEALTH SERVICES (INCLUDING MAMMOGRAPHY) IN KINGSBROOK'S MEDICALLY UNDERSERVED COMMUNITY. IN AN EFFORT TO FILL THE GAP FOR BREAST CANCER DETECTION, EDUCATION SERVICES AND TREATMENT SERVICES, KINGSBROOK HAS IMPLEMENTED A SOLID OUTREACH SCOPE FOR BREAST CANCER THAT TARGETS WOMEN FROM A BROAD CROSS SECTION OF OUR COMMUNITY, BE THEY INSURED, UNDERINSURED OR NON-INSURED. THE PROGRAM PROVIDES OUTREACH, EDUCATION, SCREENING COORDINATION, AND MAMMOGRAPHY TO HIGH RISK WOMEN AGE 40 AND OLDER. THE PROGRAM IS MODIFIED TO INCLUDE EXTENDED OUTREACH AND EDUCATION TO SPREAD THE WORD ABOUT THE PROGRAMS OFFERINGS AND TO CAPTURE WOMEN IN THIS CATEGORY OF NEED. THE PROGRAM PROVIDED BREAST HEALTH EDUCATION TO 4,386 WOMEN IN 2012. ADDITIONALLY, 684 MAMMOGRAMS WERE GIVEN. KINGSBROOK'S WOMEN'S WELLNESS CENTER HAS MAINTAINED A VALUABLE RELATIONSHIP WITH THE CANCER SERVICE PROGRAM ("CSP"). THIS PARTNERSHIP HELPED TO INCREASE ACCESS TO MAMMOGRAPHY SERVICES TO RESIDENTS OF KINGSBROOK'S COMMUNITY. THE PARTNERSHIP WITH CSP PROVIDES FUNDING FOR FREE OUTREACH, EDUCATION, MAMMOGRAPHY, CLINICAL BREAST EXAMS, PAP TEST, PELVIC EXAMS AND THE TAKE HOME FECAL TEST (FIT OR FOBT) FOR COLORECTAL CANCER SCREENING. KINGSBROOK'S PARTNERSHIP WITH THE CSP, PROVIDED FREE MAMMOGRAPHY SERVICES TO 235 WOMEN IN 2012. THE EFFORTS OF THIS PROGRAM WERE SUPPORTED AND UTILIZED BY THE FOLLOWING COMMUNITY BASED ORGANIZATIONS: BROOKLYN ADULT LEARNING CENTER, ST. AUGUSTINE'S CHURCH, ST. LUKE'S GUILD, WOMEN OF FAITH, DISTRICT 41, ST. BARNABAS, BROOKLYN COLLEGE, NEW TABERNACLE, MARTIN LUTHER KING CONCERT SERIESSENATOR ERIC ADAMS OFFICE, HEALTH & HUMAN SERVICES, GOD'S BATTALION OF PRAYER, CHRISTIAN CULTURAL CENTER, PANAMANIAN AMERICAN ASSOCIATION, BROOKLYN FAITH SEVEN AND BETHEL TABERNACLE.
PART VI, LINE 5: COMMUNICATION TO ENHANCE ACCESSIN 2012, 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. 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).- TAKE YOUR MAN TO THE DOCTOR PART OF THE BROOKLYN BOROUGH PRESIDENTS 11TH ANNUAL INITIATIVE FOR MALE WELLNESS, KINGSBROOK PARTICIPATES ON THE PLANNING COMMITTEE AND THE DAY OF SCREENING ACTIVITIES AT BOROUGH HALL PROVIDING PROSTATE CANCER SCREENINGS. KINGSBROOK CONTRIBUTES PROSTATE, DIABETES AND HYPERTENSION TESTING TO THIS EFFORT. THIS YEAR'S EVENT WAS HELD ON OCTOBER 2ND 2012. - 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. - 3RD 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 14TH 2012.- 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. - WOMEN'S HEALTH FEATURING BREAST HEALTH EDUCATION WITH MT. PISGAH BAPTIST CHURCH & THE LOVE YOURSELF COALITION IN THE SPIRIT OF THE COALITION'S MISSION TO ENCOURAGE RESIDENTS TO TAKE BETTER CARE OF THEIR HEALTH AND COMMUNITIES, KINGSBROOK'S BREAST HEALTH TEAM COORDINATED SEVERAL EDUCATIONAL SEMINARS ON BREAST CANCER SELF-EXAMINATION AND HEALTHY LIVING AND HELPED GUIDE WOMEN IN NEED TOWARD PROGRESSIVE TESTING AND TREATMENT.
PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM:KINGSBROOK JEWISH MEDICAL CENTER IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM.
NY	REPORTS FILED WITH STATES	PART VI, LINE 7

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	0	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	1	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (15 entries)

TitleTitle	Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
LINDA BRADY MD
PRESIDENT & BOARD DIRECTOR	767675	0	404151	0	92810	0	23750	0	36780	0	1325166	0	0	0
RAFIQUE CHAUDHRY MD
BOARD TRUSTEE	0	0	0	0	1110766	0	0	0	0	0	1110766	0	0	0
JOHN SCHMITT CPA
ASSISTANT TREASURER & CFO	318119	0	294943	0	23043	0	108725	0	36780	0	781610	0	0	0
MICHAEL MCDERMOTT
GENERAL COUNSEL	237800	0	0	0	1687	0	23659	0	36520	0	299666	0	0	0
ROBERT DUBICKI
COO	364089	0	77151	0	25564	0	23750	0	25998	0	516552	0	0	0
SIBTE BURNEY MD
CMO	351197	0	47463	0	11366	0	23750	0	33818	0	467594	0	0	0
KIRAN BATHEJA
VICE PRESIDENT	213723	0	160862	0	1687	0	20863	0	5255	0	402390	0	0	0
KURT KODROFF
VICE PRESIDENT	285201	0	199582	0	8077	0	76795	0	33818	0	603473	0	0	0
JANE LEDERER
CHIEF NURSING OFFICER	225066	0	46850	0	1687	0	69186	0	15981	0	358770	0	0	0
HAROLD MCDONALD
SENIOR VP	342686	0	46291	0	22317	0	23750	0	3252	0	438296	0	0	0
MOHAMMAD ZAHIR MD
DIRECTOR MED	738426	0	0	0	28683	0	23750	0	11777	0	802636	0	0	0
MARC ROSS MD
DIR REHAB MED	442170	0	0	0	1687	0	23750	0	36780	0	504387	0	0	0
CHARLES LAWRENCE
PHYSICIAN	381375	0	0	0	450	0	24152	0	30590	0	436567	0	0	0
MARK SMITH
PHYSICIAN	317698	0	0	0	1980	0	20745	0	36780	0	377203	0	0	0
WILLIAM LOIS
PHYSICIAN	365205	0	0	0	1687	0	23750	0	33818	0	424460	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
PART I, LINE 7	THE FOLLOWING INDIVIDUALS RECEIVED BOTH FIXED AND NON-FIXED BONUSES AND INCENTIVE COMPENSATION PAYMENT IN 2012: DR. LINDA BRADY JOHN SCHMITT ROBERT DUBICKI DR. SIBTE BURNEY KIRAN BATHEJA KURT KODROFF JANE LEDERER HAROLD MCDONALD THE TOTAL AMOUNTS OF THESE PAYMENTS, ALONG WITH ANY FIXED RETENTION PAYMENTS, WHICH WERE PAID IN 2012, ARE SHOWN IN SCHEDULE J PART II COLUMN B(II).
PART III	GENERAL COMPENSATION NOTE: RAFIQUE CHAUDHRY, MD - THE COMPENSATION WAS PAID FOR SERVICES PROVIDED AS CHIEF OF ANAESTHESIOLOGY BY KINGSBROOK JEWISH MEDICAL CENTER. NO COMPENSATION WAS PAID FOR BOARD TRUSTEE POSITION.	SUPPLEMENTAL INFORMATION
PART III	PART II, COLUMN (C) RETIREMENT AND OTHER DEFERRED COMPENSATION: THE DEFERRED COMPENSATION REPORTED FOR KINGSBROOK JEWISH MEDICAL CENTER EMPLOYEES JOHN SCHMITT, KURT KODROFF MD, AND JANE LEDERER INCLUDES ACCRUALS FOR THE TRANSITION STABILIZATION PLAN WHICH WAS IMPLEMENTED IN 2012. THE VALUE OF THE PLAN IS SUBJECT TO RISK OF FORFEITURE (PURSUANT TO IRS REGULATIONS) UNTIL THE EMPLOYEES MEET SPECIFIC AND DOCUMENTED FUTURE SERVICE REQUIREMENTS. THE PLAN WAS REVIEWED DISCUSSED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE JOINT BOARD OF TRUSTEES/DIRECTORS TO ENHANCE THE RETENTION OF KEY EXECUTIVES AND TO MAINTAIN LEADERSHIP STABILITY AS KINGSBROOK JEWISH MEDICAL CENTER PURSUES OPPORTUNITIES FOR SUSTAINED VIABILITY. THE PLAN IS CONSISTENT WITH TYPICAL MARKET PRACTICES AND REASONABLE IN THE CONTEXT OF THE EMPLOYEES' TOTAL REMUNERATION, BASED ON ADVICE PROVIDED BY INDEPENDENT EXECUTIVE COMPENSATION CONSULTANTS. THE AGREEMENT EXPIRES 12/31/2014 AND WILL PAID OUT IN JANUARY 2015. THE PAYMENT WILL BE REPORTED AS COMPENSATION IN 2015 AND WILL BE SUBJECT TO ALL APPLICABLE WITHHOLDING AND EMPLOYMENT TAXES.	SUPPLEMENTAL INFORMATION

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	BROOKLYN KINGS HIGHWAY	BusinessNameLine1

Field	Value	IRS element (for citing)
Relationship	ENTITY OWNED BY RAFIQUE CHAUDHRY, MD, BOARD TRUSTEE	Relationship
Amount Of Transaction	1110766	AmountOfTransaction
Description Of Transaction	ANESTHESIOLOGY SERVICES	DescriptionOfTransaction
Sharing Of Revenues	0	SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
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 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 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 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 XI, LINE 9:	PENSION RELATED CHANGES OTHER THAN NET PERIODIC PENSION COSTS 524,652.	CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg	Direct Controlling Entity NADirectControllingEntityNA
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 (KHCF)
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

Form990 Schedule R Part IV Form990ScheduleRPartIV (5 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Type Of EntityTypeOfEntity	Controlled OrgControlledOrg	Share Of EOY AssetsShareOfEOYAssets	Percentage OwnershipPercentageOwnership
KSI INC
585 SCHENECTADY AVENUE	BROOKLYN	NY	11203	562327654	INACTIVE	NY	KHCF INC	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	KHCF INC	C	0
KINGSBROOK MEDICAL ASSOCIATES PC
585 SCHENECTADY AVENUE	BROOKLYN	NY	11203	452351859	BILLING & COLLECTION	NY	KJMC	C	1	14155	1.00000

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	1	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	0	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Dividends Related Organization	0	DividendsRelatedOrganization
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	0	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	0	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	0	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	0	PerformOfServicesByOtherOrgs
Sharing Of Facilities	1	SharingOfFacilities
Sharing Of Paid Employees	1	SharingOfPaidEmployees
Reimbursement Paid To Other Org	1	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	1	OtherTransferToOtherOrg
Other Transfer From Other Org	0	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

Field	Value	IRS element (for citing)
Business Name Line1	KINGSBROOK MEDICAL ASSOCIATES PC	BusinessNameLine1

Field	Value	IRS element (for citing)
Transaction Type	R	TransactionType
Amount Involved	175000	AmountInvolved
Method Of Amt Determination	COST	MethodOfAmtDetermination