2017-11-09T10:08:55-06:00 2014-12-31 221478099 COHNREZNICK LLP 1301 AVENUE OF THE AMERICAS NEW YORK NY 10019 990 2014-01-01 111631746 BROOKDALE HOSPITAL MEDICAL CENTER BROO 7182405000 ONE BROOKDALE PLAZA BROOKLYN NY 11236 JAMES R PORTER CHIEF FINANCIAL OFFICER 7182405186 2017-11-02 1 THOMAS LANNING P00851654 2122970400 2017-11-02 2014 2021-01-29 14:40:06Z X JAMES R PORTER ONE BROOKDALE PLAZA BROOKLYN NY 11236 588324544 0 X WWW.BROOKDALEHOSPITAL.ORG X 1914 NY THE BROOKDALE HOSPITAL MEDICAL CENTER OPERATES A 530 BED HOSPITAL IN BROOKLYN, NEW YORK. 13 10 3692 623 0 0 27133556 158811730 405510739 395712041 8650851 4731113 131888684 29069660 573183830 588324544 0 0 0 0 291567642 318743812 0 0 321800 277527414 197327562 569095056 516071374 4088774 72253170 192999650 198574585 494134369 455080751 -301134719 -256506166 THE BROOKDALE HOSPITAL MEDICAL CENTER WAS CREATED FOR THE PURPOSE OF OPERATING A 530 BED HOSPITAL IN BROOKLYN, NEW YORK. 0 0 440683634 417731232 THE BROOKDALE HOSPITAL MEDICAL CENTER WAS CREATED FOR THE PURPOSE OF OPERATING A 530 BED HOSPITAL IN BROOKLYN, NEW YORK. IN 2014, BROOKDALE HOSPITAL MEDICAL CENTER LOGGED 16,548 ADMISSIONS, 16,555 PATIENT DISCHARGES, AND 98,693 OUTPATIENT EMERGENCY ROOM VISITS WHICH RESULTED IN 14,261 ADMISSIONS AND 205,101 OTHER OUTPATIENT SERVICE VISITS. 440683634 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 1 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 483 0 1 3692 1 0 0 0 0 0 0 0 0 0 0 X 13 10 1 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X JAMES R PORTER CFO 7182405186 101-01 AVENUE D BROOKLYN NY 11236 ALEX ROVT TRUSTEE/CHAIRMAN 1.00 5.40 X X 0 0 0 ANTHONY CLEMENZA TRUSTEE 1.00 5.40 X 0 0 0 ASCHER MESTEL MD TRUSTEE 1.00 5.40 X 0 0 0 BISHOP HUGH NELSON TRUSTEE 1.00 5.40 X 0 0 0 ESTEVEN GARCIA MD TRUSTEE/EX-OFFICIO 40.00 X 543157 0 27894 IRINA BENFIELD TRUSTEE/SECRETARY 1.00 5.40 X X 0 0 0 ISAAC KREIZMAN MD TRUSTEE 1.00 5.40 X 0 0 0 LEWIS MARSHALL MD TRUSTEE/EX-OFFICIO 40.00 5.40 X 394904 0 27894 LOWELL M RUBIN TRUSTEE/VICE CHAIRMAN 1.00 5.40 X X 0 0 0 MICHAEL SCAGNELLI TRUSTEE 1.00 5.40 X 0 0 0 MICHAEL SPIEGEL TRUSTEE 1.00 5.40 X 0 0 0 RICHARD RADUTZKY TRUSTEE/SECRETARY 1.00 5.40 X X 0 0 0 STEPHEN PLOTNICK TRUSTEE 1.00 5.40 X 0 0 0 ARTHUR J FRIED ASSISTANT SECRETARY 44.40 1.00 X 0 0 0 JAMES R PORTER CHIEF FINANCIAL OFFICER 44.44 1.00 X 0 0 0 LUCIO FLORES MD CHIEF OF VASCULAR SURGERY 40.00 X 595772 0 26867 MARK E TONEY PRESIDENT AND CEO 44.40 1.00 X 0 0 0 REGINALD BULLOCK ASSISTANT SECRETARY 44.40 1.00 X 243910 0 29367 STEVEN R KORF CHIEF OPERATING OFFICER 44.40 1.00 X 0 0 0 SUNIL ABROL MD CHIEF OF SURGERY 40.00 X 601242 0 111 ERIC MINKIN MD RADIOLOGIST 40.00 X 494956 0 28674 FREDERICK GULMI MD UROLOGY CHAIRMAN 40.00 X 497712 0 25117 KECIA GAITHER MD MATERNAL FETAL MEDICINE 40.00 X 598449 0 11742 MAYANK SHUKLA MD PEDIATRICIAN 40.00 X 465195 0 19776 SAUL ARBER MD DIRECTOR OF RADIATION AND ONCOLOGY 40.00 X 601242 0 111 5036539 0 197553 584 0 1 0 GRANT THORNTON LLP 666 THIRD AVENUE NEW YORK NY 10017 RESTRUCTURING SERVICES 10702166 VELOCITY TECHNOLOGY SOLUTIONS 850 THIRD AVENUE 10TH FLOOR NEW YORK NY 10022 INFORMATION TECHNOLOGY 8416942 TONEYKORF PARTNERS LLC 1595-14 NORTH CENTRAL AVENUE VALLEY STREAM NY 11580 MANAGEMENT SERVICES 2944152 MEDISYS MANAGEMENT LLC 8900 VAN WYCK EXPRESSWAY JAMAICA NY 11418 MEDICAL BILLING 2479362 EPSTEIN BECKER & GREEN 250 PARK AVENUE NEW YORK NY 10177 LEGAL FEES 2163419 74 156869066 1942664 158811730 NET PATIENT REVENE 621400 310281375 310281375 PATIENT SERVICES PROVIDED TO OTHE 621400 34608338 34608338 OTHER PATIENT BILLINGS 621400 29204191 29204191 PHARMACY 621400 14398967 14398967 CAPITATION REVENUE 621400 5465000 5465000 1754170 1754170 395712041 3439113 3439113 5738900 0 5738900 5738900 5738900 1292000 0 1292000 1292000 1292000 FORGIVENESS OF DEBT 900099 13230417 13230417 INSURANCE REFUND 621110 5759933 5759933 SETTLEMENT 900099 2546281 2546281 1794129 1736841 57288 23330760 588324544 417731232 0 11781582 1310241 1217753 91659 829 240679613 223675139 16835763 168711 14572371 13552305 1020066 40790243 37934926 2855317 21391344 19893960 1497384 12945147 12945147 3164603 2531682 632921 544617 544617 26568329 21773138 4685333 109858 93912 81195 12717 1997827 1594426 398606 4795 11614140 9291312 2322828 9860456 8022122 1838334 2135191 1708153 427038 27289 21831 5458 2770068 2269060 501008 12726762 10128404 2598358 1406395 1125116 281279 MEDICAL & PHARMACY SUPP 58111036 55125546 2962230 23260 PROVISION FOR BAD DEBT 36383197 14814529 21568668 0 EQUIPMENT 8875777 7931010 943137 1630 FOOD 4391862 4391862 0 0 3710954 3600165 110789 516071374 440683634 75065940 321800 8396681 9956204 19417270 20857374 28856183 37167781 3603790 5161036 12991377 11535944 349477873 279986884 70606953 69490989 7350786 3850566 41776610 40554691 192999650 198574585 102122472 104610276 146828406 91303264 29694480 55685641 215489011 203481570 494134369 455080751 X -301134719 -256506166 -301134719 -256506166 192999650 198574585 X 72253170 -27624617 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 32014 32014 0 PART II-B, LINE 1: BROOKDALE HOSPITAL MEDICAL CENTER IS A MEMBER OF THREE ASSOCIATIONS OF WHICH SOME OF THEIR DUES ARE ALLOCATED TO GRASS ROOTS LOBBYING IN REGARD TO THEIR NEEDS IN SERVICING AND PROVIDING HEALTHCARE TO THE PUBLIC. COST SPENT ON LOBBY ACTIVITIES FOR THE YEAR: HEALTHCARE ASSOCIATION OF NEW YORK STATE $19,551 GREATER NEW YORK HOSPITAL ASSOCIATION $9,876 CONTINUING CARE LEADERSHIP COALITION $2,587 TOTAL COST $32,014 1068657 1068657 81951622 67978140 13973482 258412689 210558365 47854324 8044905 1450379 6594526 69490989 DUE FROM THIRD PARTY PAYORS 11045025 CAPITATION RECEIVABLE 11318963 INSURANCE RECOVERIES 18047149 DEFERRED FINANCE CHARGES 143554 40554691 MALPRACTICE INSURANCE PAYABLE 156073149 DUE TO THIRD PAYORS 17698595 WORKERS COMPENSATION PAYABLE 20127000 OTHER CURRENT LIABILITIES 25825 OTHER NON-CURRENT LIABILITIES 937005 DUE TO AFFILIATES 8619996 203481570 X 567750082 -20574462 -20574462 588324544 0 588324544 495496912 0 495496912 20574462 20574462 516071374 PART X, LINE 2: THE BROOKDALE HOSPITAL MEDICAL CENTER IS EXEMPT FROM INCOME TAXES UNDER SECTION 501 (C) (3) OF THE INTERNAL REVENUE CODE AND ITS INCOME IS GENERALLY NOT SUBJECT TO FEDERAL, STATE OR LOCAL INCOME TAXES. PART XI, LINE 2D - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT -14,814,529. COSTS RELATED TO CAPITATION REVENUE -5,759,933. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT 14,814,529. COSTS RELATED TO CAPITATION REVENUE 5,759,933. CENTRAL AMERICA AND THE CARIBBEAN 0 0 INSURANCE N/A 70171 0 0 0 0 0 0 70171 0 70171 0 0 1 0 0 0 1 1 1 X 1 X 1 1 1 0 1 1 17091536 14661790 2429746 0.00480 211987820 136845249 75142571 0.14990 229079356 151507039 77572317 0.15470 6687530 4496240 2191290 0.00440 50179754 20590180 29589574 0.05900 35971753 30000809 5970944 0.01190 521762 521762 93360799 55608991 37751808 0.07530 322440155 207116030 115324125 0.23000 1 14814529 8434177 42468984 37383779 5085205 X 1 1 1 1 BROOKDALE HOSPITAL MEDICAL CENTER ONE BROOKLYN PLAZA BROOKLYN NY 11236 X BROOKDALE HOSPITAL MEDICAL CENTER 0 0 1 X X X X X X X 13 1 0 0 1 X WWW.BROOKDALEHOSPITAL.ORG X 1 13 1 WWW.BROOKDALEHOSPITAL.ORG 0 0 1 X 100.000000000000 300.000000000000 X X X X 1 1 X X 1 X WWW.BROOKDALEHOSPITAL.ORG X WWW.BROOKDALEHOSPITAL.ORG X WWW.BROOKDALEHOSPITAL.ORG X X X X 1 0 X 1 X 0 0 BROOKDALE HOSPITAL MEDICAL CENTER PART V, SECTION B, LINE 5: THE CHNA PLANNING PROCESS CONDUCTED IN 2013 WAS AN OPPORTUNITY TO SEEK THE INVOLVEMENT OF A DIVERSE GROUP OF STAKEHOLDERS, OBTAIN HONEST FEEDBACK, AND CONSTRUCTIVE RECOMMENDATIONS. A BROOKDALE HOSPITAL WORKING GROUP (THE "WORKING GROUP"), COMPRISED OF A CROSS-SECTION OF STAFF FROM BROOKDALE HOSPITAL, LED CHNA DESIGN AND IMPLEMENTATION EFFORT. WORKING GROUP PARTICIPANTS: EXTERNAL: CAMELLIA MORTEZAZADEH NYC DEPARTMENT OF HEALTH; JUDY WESSLER - COMMUNITY HEALTH POLICY ADVOCATE; DR. ALETHA MAYBANK - ASSISTANT COMMISSIONER, NYC DEPARTMENT OF HEALTH; NGOZI MOSES - BROOKLYN PERINATAL NETWORK; LLOYD BISHOP SENIOR VICE PRESIDENT, GREATER NEW YORK HOSPITAL ASSOCIATION; AMY OSORIO - GREATER NEW YORK HOSPITAL ASSOCIATION.INTERNAL: DR. LEWIS MARSHALL, CHAIRPERSON OF OUTPATIENT SERVICES; WAYNE GIETZ - FORMER VICE PRESIDENT OF OUTPATIENT SERVICES; KHARI EDWARDS - VICE PRESIDENT FOR EXTERNAL AFFAIRS; DR. CHERYL CRONEY - FORMER DIRECTOR OF THE TREATMENT FOR LIFE CENTER; DR. SARITA DHUPER - DIRECTOR OF PEDIATRIC CARDIOLOGY; STEVE PHILLIPS - FORMER ADMINISTRATIVE COORDINATOR, TREATMENT FOR LIFE CENTER.WORKING GROUP RESPONSIBILITIESTHE WORKING GROUP UNDERTOOK THE FOLLOWING ACTIVITIES: - ENGAGED STAKEHOLDERS IN THE CHNA PLANNING PROCESS.- IDENTIFIED PUBLIC HEALTH OFFICIALS AND COMMUNITY STAKEHOLDERS WHO WOULD SUPPORT BROOKDALE'S WORK.- OBTAINED INPUT FROM BROOKDALE'S HEALTHCARE PROFESSIONALS WHO ARE ON THE FRONTLINE OF HEALTHCARE DELIVERY. - DESIGNED AND CONDUCTED TWO SURVEYS (BOTH IN ENGLISH AND SPANISH), TO OBTAIN THE PERSPECTIVE OF COMMUNITY RESIDENTS. THE FIRST, A MULTIPLE CHOICE FORMAT, GAUGED RESIDENTS' PERCEPTION OF PERSONAL AND COMMUNITY HEALTH. THE SECOND, AN INTERACTIVE SURVEY, WAS DESIGNED TO ELICIT RESIDENTS' VISION FOR HEALTHCARE IN THE COMMUNITY.- COORDINATED AND PARTICIPATED IN NUMEROUS PLANNING AND INFORMATIONAL MEETINGS AND EVENTS WITH A VARIETY OF ORGANIZATIONS, INCLUDING THE GREATER NEW YORK HOSPITAL ASSOCIATION (GNYHA), NYC DEPARTMENT OF HEALTH AND MENTAL HYGIENE (NYC-DOH), AND THE BROOKLYN PERINATAL NETWORK. A LIST OF MEETING ACTIVITIES IS INCLUDED AS AN APPENDIX. THE WORKING GROUP LED THE EFFORT TO SECURE THE QUALITATIVE AND QUANTITATIVE DATA NEEDED TO DEVELOP THE CHNA. BEGINNING IN FEBRUARY 2013, THE WORKING GROUP INITIATED PLANNING ACTIVITIES, AGREED ON THE SCOPE OF THE REPORT AND A STRATEGY TO ENSURE THAT BROOKDALE MET ALL OF THE REPORTING CRITERIA. A COMMUNITY NEEDS SURVEY AND AN INTERACTIVE SURVEY, BOTH DESIGNED BY THE WORKING GROUP, PROVIDED QUALITATIVE DATA. THE COMMUNITY NEEDS SURVEY ENABLED THE CAPTURE OF THE PERSPECTIVE OF 563 RESIDENTS FROM OUR PRIMARY SERVICE AREA, ON VARIOUS HEALTH TOPICS. THE INTERACTIVE SURVEY GAVE THE PERSPECTIVE OF ANOTHER 70 RESIDENTS. A REPRESENTATIVE SAMPLE OF THE SERVICE AREA PARTICIPATED IN BOTH OF SURVEYS I.E. MALE AND FEMALE ADULTS, SENIOR CITIZENS, IMMIGRANTS, AND NON-IMMIGRANTS. BROOKDALE ALSO REVIEWED THE FINDINGS FROM THREE SEPARATE ASSESSMENTS OF THE BROOKLYN HEALTHCARE SYSTEM, CONDUCTED BY THE BROOKLYN HEALTHCARE IMPROVEMENT PROJECT (B-HIP), SENATOR JOHN SAMPSON'S BROOKLYN HEALTHCARE WORKING GROUP (BHWG), AND THE BROOKLYN MRT HEALTH SYSTEMS REDESIGN WORK GROUP (THE "WORK GROUP"). BROOKDALE STAFF PARTICIPATED IN THE FIRST TWO OF THE AFOREMENTIONED EFFORTS. BROOKDALE HOSPITAL MEDICAL CENTER PART V, SECTION B, LINE 11: THE CHNA CONDUCTED IN 2013 CONFIRMED THE OVERWHELMING HEALTHCARE NEEDS OF BROOKDALE'S PRIMARY AND SECONDARY SERVICE AREAS. THE DISEASE BURDEN FOR THE PRIMARY COMMUNITIES OF BROWNSVILLE AND EAST NEW YORK IS AMONG THE HIGHEST IN NYC, WITH CHRONIC DISEASES LIKE OBESITY, HIV/AIDS, AND DIABETES BEING DISPROPORTIONATELY PREVALENT. BROOKDALE IDENTIFIED A MYRIAD OF HEALTHCARE BARRIERS THAT ARE TYPICALLY LINKED TO THE HIGH DISEASE BURDEN, WHICH TOGETHER, RESULT IN MAJOR HEALTH DISPARITIES FOR ITS PATIENT POPULATION. BROOKDALE IS COMMITTED TO MAKING THE CHANGES TO SERVICE DELIVERY, INVESTMENTS IN INFRASTRUCTURE, AND BUILDING THE STRATEGIC COLLABORATIONS WITH COMMUNITY PARTNERS, PUBLIC HEALTH OFFICIALS AND OTHER STAKEHOLDERS, TO REVERSE THE NEGATIVE HEALTHCARE TRENDS, AND ACHIEVE HEALTH EQUITY FOR THE COMMUNITIES SERVED. ALTHOUGH BROOKDALE'S FISCAL STRUGGLES AND THE LACK OF FINANCIAL RESOURCES IN ITS SERVICE AREAS MAKE IT CHALLENGING TO MEET THE HIGH DEMAND FOR HEALTHCARE SERVICES AND TO ADDRESS THE NEEDS IDENTIFIED IN THE 2014 CHNA, BROOKDALE IS COMMITTED TO BEING RESOURCEFUL AND INNOVATIVE. BROOKDALE CONTINUES TO WORK WITH AFFILIATES, AND A BROAD NETWORK OF PUBLIC AND NON-PROFIT PARTNERS, TO BRING A FULL COMPLEMENT OF HEALTHCARE SERVICES TO ITS PATIENT POPULATION. BROOKDALE CURRENTLY HAS MANY SPECIALTY AND SUB-SPECIALTY CLINICS/SERVICES TO ADDRESS A WIDE RANGE OF DISEASES THAT IMPACT ITS PATIENT POPULATION. BROOKDALE'S HEALTHCARE DELIVERY MODEL INCLUDES: INPATIENT CARE, AMBULATORY CARE, LONG-TERM CARE, SENIOR LIVING AND EMERGENCY MEDICINE. CORE ASSETS THAT SUPPORT THE DELIVERY OF CARE INCLUDE: - APPROXIMATELY 50 SURGICAL AND SUBSPECIALTY CARE CLINICS/SERVICES;- 530 CERTIFIED ACUTE-CARE BEDS;- AN EMERGENCY DEPARTMENT, WHICH IS A NYS-DESIGNATED LEVEL-1TRAUMA CENTER, AND ONE OF THE BUSIEST IN THE REGION; - A 448-BED SKILLED-NURSING FACILITY, AND AN 86-UNIT ASSISTED-LIVING AND INDEPENDENT-LIVING FACILITY, WHICH BOTH OPERATE AT A 95% OR HIGHER OCCUPANCY RATE; - SIX PRIMARY CARE FACILITIES;- A COMPREHENSIVE ADULT DAY CARE CENTER;- A LEVEL-3 PERINATAL CENTER;- A MENTAL AND BEHAVIORAL HEALTH CENTER;- AN AMBULATORY SURGERY CENTER;- A 16-CHAIR DENTAL SUITE THAT SUPPORTS DENTAL AND ORAL SERVICES;- AN HIV CENTER; AND- AN URGENT CARE CENTER.PRIORITIZATION OF HEALTHCARE NEEDS BROOKDALE CATEGORIZED THE MAJOR HEALTHCARE NEEDS FOUND IN ITS SERVICE AREAS AS: (I) PREVALENT DISEASES; AND (II) BARRIERS TO HEALTHCARE. (I) PREVALENT DISEASES - FOLLOWING ARE SUMMARIES OF HOW EACH PREVALENT DISEASE IS BEING ADDRESSED: - OBESITY BROOKDALE IS IN THE PROCESS OF ROLLING OUT A COMPREHENSIVE THREE-YEAR PLAN (2014-2016) TO ADDRESS OBESITY, AS PART OF NEW YORK STATE-MANDATED COMMUNITY SERVICE PLAN (CSP). - HIV/AIDS BROOKDALE IS IN THE PROCESS OF ROLLING OUT A COMPREHENSIVE THREE-YEAR (2014-2016) PLAN TO ADDRESS HIV/AIDS, AS PART OF CSP REFERENCED ABOVE. - HEART DISEASE AND HYPERTENSION - BROOKDALE HAS A CARDIOLOGY DEPARTMENT THAT IS FOCUSED ON TREATING CARDIAC DISEASE IN ADULTS AND CHILDREN. A HYPERTENSION CLINIC TREATS PATIENTS WHO HAVE BEEN DIAGNOSED WITH HYPERTENSION. IN ADDITION, ALL CLINICIANS IN OUR PRIMARY CARE NETWORK ARE TRAINED TO TREAT PATIENTS WITH HYPERTENSION AT POINT OF SERVICE. SINCE HEART DISEASE AND HYPERTENSION ARE SECONDARY CONDITIONS THAT ARE ASSOCIATED WITH OBESITY, OUR FOCUS ON OBESITY IS LIKELY TO HAVE A POSITIVE IMPACT ON THE RATES OF BOTH DISEASES.- CANCER BROOKDALE HAS AN ONCOLOGY DEPARTMENT THAT IS FOCUSED ON TREATING CANCER IN ADULTS AND CHILDREN. THE MOST COMMONLY DIAGNOSED ADULT CANCERS ARE BREAST, LUNG, PROSTATE AND COLON. APPROXIMATELY 3,000 BREAST CANCER SCREENINGS AND 4,000 MAMMOGRAMS ARE PERFORMED EACH YEAR. SOME OF THE MOST COMMONLY DIAGNOSED CANCERS IN CHILDREN ARE LEUKEMIA, LYMPHOMA-HODGKINS AND NON-HODGKINS, AND BRAIN TUMORS. ONLY ABOUT 30% OF PATIENTS DIAGNOSED WITH CANCER AT BROOKDALE STAY FOR TREATMENT. MOST PATIENTS ARE REFERRED TO OR OPT TO SEEK TREATMENT AT OTHER FACILITIES WITH MORE ADVANCED TREATMENT PROTOCOLS. - ASTHMA BROOKDALE'S PULMONARY DEPARTMENT TREATS PATIENTS WITH ASTHMA. SINCE ASTHMA IS THE MOST FREQUENTLY OCCURRING EMERGENCY DIAGNOSIS, BROOKDALE'S HAS A DEDICATED SPACE IN THE EMERGENCY DEPARTMENT THAT IS FULLY-EQUIPPED TO TREAT ASTHMA PATIENTS IN A TIMELY MANNER.- DIABETES BROOKDALE'S OUTPATIENT CLINICS PROVIDE CARE FOR PATIENTS THAT HAVE BEEN DIAGNOSED WITH DIABETES, SUPPORTED BY A CUTTING-EDGE ELECTRONIC HEALTH RECORDS SYSTEM THAT IS EQUIPPED TO PROMPT PRIMARY CARE DOCTORS TO REFER PATIENTS TO THE CRITICAL CONTINUUM OF SPECIALTY CARE TYPICALLY RECOMMENDED FOR DIABETIC PATIENTS (OPHTHALMOLOGY, PODIATRY, ETC.). SINCE DIABETES IS ONE OF THE SECONDARY CONDITIONS ASSOCIATED WITH OBESITY, THE FOCUS ON OBESITY IS LIKELY TO HAVE A POSITIVE IMPACT ON THE PATIENTS WHO SUFFER WITH THE DISEASE.- ALCOHOLISM AND DRUG ADDICTION BROOKDALE DOES NOT HAVE AN OASAS LICENSE TO PROVIDE SERVICES DIRECTLY TO THE ADDICTED POPULATION. INSTEAD, THE HOSPITAL PROVIDES CARE AND TREATMENT FOR ADDICTIONS UNDER ITS ARTICLE 28 LICENSE (INPATIENT) AND ITS NYS OFFICE OF MENTAL HEALTH (OMH)-ISSUED LICENSE FOR OUTPATIENTS WITH MENTAL ILLNESS AND SUBSTANCE PROBLEMS. IN ADDITION, SEVERAL OASAS LICENSED CLINICS IN THE AREA ADD TO THE CARE CONTINUUM. (II) BARRIERS TO HEALTHCARE - THE BARRIERS TO HEALTHCARE IDENTIFIED INCLUDE: POVERTY; A LACK OF PRIMARY CARE FACILITIES; A LACK OF PRIMARY CARE FACILITIES WITH FLEXIBLE SCHEDULES TO ACCOMMODATE WORKING FAMILIES; A LACK OF SPECIALTY CLINICS, ESPECIALLY THOSE THAT TARGET THE PREVALENT DISEASES IDENTIFIED; A LACK OF INTEGRATED TREATMENT MODULES TO IMPROVE OUTCOMES FOR PATIENTS; A LACK OF DISEASE PREVENTION PROGRAMS; AND LINGUISTIC AND CULTURAL ISOLATION. BROOKDALE REMAINS COMMITTED TO ADAPTING ITS SERVICE DELIVERY MODEL AND DEVELOPING THE COMMUNITY COLLABORATIONS THAT WILL HELP ADDRESS SOME OF THESE BARRIERS. TO DATE, SPECIFIC ACTIONS TAKEN INCLUDE: - FINANCIAL RESOURCES BROOKDALE SENIOR MANAGEMENT IS WORKING DILIGENTLY WITH COMMUNITY PARTNERS, LOCAL ELECTED OFFICIALS AND NEW YORK STATE TO SECURE THE FINANCIAL RESOURCES NEEDED TO ENSURE THE FISCAL VIABILITY OF THE HOSPITAL. FUNDING WILL SUPPORT THE IMPLEMENTATION OF NECESSARY SYSTEM-WIDE CHANGES THAT WILL ENHANCE AND EXPAND THE SCOPE OF OUR HEALTHCARE SERVICES, TO ENSURE THE CONTINUITY OF HEALTHCARE FOR THE RESIDENTS OF EAST BROOKLYN. - PRIMARY CARE FOCUS BROOKDALE HAS A NETWORK OF SIX PRIMARY CARE FACILITIES AND OTHER AMBULATORY CARE SITES THAT ARE STRATEGICALLY LOCATED IN ITS SERVICE AREAS, TO ENSURE THAT PATIENTS FROM ALL SOCIO-ECONOMIC AND ETHNIC BACKGROUNDS HAVE ACCESS TO PRIMARY CARE. TOGETHER, THESE CLINICS RECEIVE APPROXIMATELY 100,000 PATIENT VISITS ANNUALLY. BROOKDALE IS PLANNING EXPANSION AND DEVELOPMENT OF NEW SITES TO ACCOMMODATE DEMAND FOR PRIMARY CARE. - ACCESS TO CARE THROUGH BROOKDALE'S WIDE NETWORK OF PRIMARY CARE FACILITIES, THE FOCUS REMAINS ON PRIMARY CARE EXPANSION AND ACCESS. NEW FACILITIES LIKE AN URGENT CARE CENTER (UCC) OPENED IN DECEMBER 2013, ARE INCREASING ACCESS TO CARE FOR BROOKDALE'S PATIENT POPULATION. THE UCC IS DESIGNED TO SERVE AS AN ALTERNATIVE TO THE EMERGENCY ROOM FOR PATIENTS WHO NEED CARE FOR NON-LIFE-THREATENING CONDITIONS, AND IS OPEN TO THE COMMUNITY EVERY DAY FOR LONGER AND MORE FLEXIBLE HOURS THAN MOST PRIMARY CARE SERVICES, TO ACCOMMODATE WORKING FAMILIES. IN ADDITION, BROOKDALE HAS A FOCUS ON CO-LOCATING SPECIALTY CARE AT PRIMARY CARE SITES, TO IMPROVE ACCESS FOR PATIENTS IN NEED OF SPECIALTY CARE SERVICES. - PREVENTION MODELS PREVENTION MODELS LIKE LIVE LIGHT LIVE RIGHT, BROOKDALE'S ANTI-OBESITY PROGRAM, WORK WITH COMMUNITY PARTNERS TO HAVE A POSITIVE IMPACT ON PATIENT HEALTH. LLLR HAS SERVED THOUSANDS OF CHILDREN DURING THE PAST 10 YEARS. BROOKDALE SEEKS OUT OPPORTUNITIES TO DEVELOP PREVENTION MODELS IN COLLABORATION WITH COMMUNITY PARTNERS ON AN ONGOING BASIS, AS FUNDING AND RESOURCES PERMIT.-SPECIALTY CARE WHILE SPECIALTY CARE CAPACITY IS NOT ADEQUATE TO MEET THE HEALTHCARE DEMAND, BROOKDALE PROVIDES A RANGE OF MEDICAL AND SURGICAL SPECIALTY AND SUBSPECIALTY CARE FOR ITS PATIENT POPULATION. SUBSPECIALTY CLINICS PROVIDE CARE FOR PATIENTS WITH COMPLICATED DISEASES THAT REQUIRE HIGHLY TRAINED SPECIALIST, AND WORK IN CLOSE COLLABORATION WITH PRIMARY CARE PROVIDERS. SUBSPECIALTY AREAS INCLUDE: BARIATRIC SURGERY; OPHTHALMOLOGY; NEUROLOGICAL SURGERY; HAND SURGERY; BREAST SURGERY; ORTHOPEDIC SURGERY; VASCULAR SURGERY; EAR, NOSE AND THROAT SURGERY; UROLOGICAL SURGERY; AND WOMEN'S HEALTH. - LINGUISTIC ISOLATION BROOKDALE OFFERS A VARIETY OF LANGUAGE ASSISTANCE SERVICES TO NON-ENGLISH AND LIMITED ENGLISH PROFICIENT (LEP) PATIENTS AND THEIR FAMILIES, TO FACILITATE CARE. BROOKDALE HOSPITAL MEDICAL CENTER PART V, SECTION B, LINE 22D: PATIENTS AUTOMATICALLY QUALIFY FOR OUR GLOBAL CHARITABLE DISCOUNT WHICH IS BASED ON MEDICAID'S REIMBURSEMENT RATES FOR SERVICES PROVIDED. SCHEDULE H, PART V, QUESTION 5: IN CONDUCTING ITS MOST RECENT CHNA, DID THE HOSPITAL FACILITY TAKE INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH? IF "YES," DESCRIBE IN SECTION C HOW THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY, AND IDENTIFY THE PERSONS THE HOSPITAL FACILITY CONSULTED.THE CHNA PLANNING PROCESS CONDUCTED IN 2013 WAS AN OPPORTUNITY TO SEEK THE INVOLVEMENT OF A DIVERSE GROUP OF STAKEHOLDERS, OBTAIN HONEST FEEDBACK, AND CONSTRUCTIVE RECOMMENDATIONS. A BROOKDALE HOSPITAL WORKING GROUP (THE "WORKING GROUP"), COMPRISED OF A CROSS-SECTION OF STAFF FROM BROOKDALE HOSPITAL, LED CHNA DESIGN AND IMPLEMENTATION EFFORT. WORKING GROUP PARTICIPANTS: EXTERNAL: CAMELLIA MORTEZAZADEH - NYC DEPARTMENT OF HEALTH; JUDY WESSLER - COMMUNITY HEALTH POLICY ADVOCATE; DR. ALETHA MAYBANK - ASSISTANT COMMISSIONER, NYC DEPARTMENT OF HEALTH; NGOZI MOSES - BROOKLYN PERINATAL NETWORK; LLOYD BISHOP - SENIOR VICE PRESIDENT, GREATER NEW YORK HOSPITAL ASSOCIATION; AMY OSORIO - GREATER NEW YORK HOSPITAL ASSOCIATION.INTERNAL: DR. LEWIS MARSHALL, CHAIRPERSON OF OUTPATIENT SERVICES; WAYNE GIETZ - FORMER VICE PRESIDENT OF OUTPATIENT SERVICES; KHARI EDWARDS - VICE PRESIDENT FOR EXTERNAL AFFAIRS; DR. CHERYL CRONEY - FORMER DIRECTOR OF THE TREATMENT FOR LIFE CENTER; DR. SARITA DHUPER - DIRECTOR OF PEDIATRIC CARDIOLOGY; STEVE PHILLIPS - FORMER ADMINISTRATIVE COORDINATOR, TREATMENT FOR LIFE CENTER.WORKING GROUP RESPONSIBILITIESTHE WORKING GROUP UNDERTOOK THE FOLLOWING ACTIVITIES: - ENGAGED STAKEHOLDERS IN THE CHNA PLANNING PROCESS.- IDENTIFIED PUBLIC HEALTH OFFICIALS AND COMMUNITY STAKEHOLDERS WHO WOULD SUPPORT BROOKDALE'S WORK.- OBTAINED INPUT FROM BROOKDALE'S HEALTHCARE PROFESSIONALS WHO ARE ON THE FRONTLINE OF HEALTHCARE DELIVERY. - DESIGNED AND CONDUCTED TWO SURVEYS (BOTH IN ENGLISH AND SPANISH), TO OBTAIN THE PERSPECTIVE OF COMMUNITY RESIDENTS. THE FIRST, A MULTIPLE CHOICE FORMAT, GAUGED RESIDENTS' PERCEPTION OF PERSONAL AND COMMUNITY HEALTH. THE SECOND, AN INTERACTIVE SURVEY, WAS DESIGNED TO ELICIT RESIDENTS' VISION FOR HEALTHCARE IN THE COMMUNITY.- COORDINATED AND PARTICIPATED IN NUMEROUS PLANNING AND INFORMATIONAL MEETINGS AND EVENTS WITH A VARIETY OF ORGANIZATIONS, INCLUDING THE GREATER NEW YORK HOSPITAL ASSOCIATION (GNYHA), NYC DEPARTMENT OF HEALTH AND MENTAL HYGIENE (NYC-DOH), AND THE BROOKLYN PERINATAL NETWORK. A LIST OF MEETING ACTIVITIES IS INCLUDED AS AN APPENDIX. THE WORKING GROUP LED THE EFFORT TO SECURE THE QUALITATIVE AND QUANTITATIVE DATA NEEDED TO DEVELOP THE CHNA. BEGINNING IN FEBRUARY 2013, THE WORKING GROUP INITIATED PLANNING ACTIVITIES, AGREED ON THE SCOPE OF THE REPORT AND A STRATEGY TO ENSURE THAT BROOKDALE MET ALL OF THE REPORTING CRITERIA. A COMMUNITY NEEDS SURVEY AND AN INTERACTIVE SURVEY, BOTH DESIGNED BY THE WORKING GROUP, PROVIDED QUALITATIVE DATA. THE COMMUNITY NEEDS SURVEY ENABLED THE CAPTURE OF THE PERSPECTIVE OF 563 RESIDENTS FROM OUR PRIMARY SERVICE AREA, ON VARIOUS HEALTH TOPICS. THE INTERACTIVE SURVEY GAVE THE PERSPECTIVE OF ANOTHER 70 RESIDENTS. A REPRESENTATIVE SAMPLE OF THE SERVICE AREA PARTICIPATED IN BOTH OF SURVEYS I.E. MALE AND FEMALE ADULTS, SENIOR CITIZENS, IMMIGRANTS, AND NON-IMMIGRANTS. BROOKDALE ALSO REVIEWED THE FINDINGS FROM THREE SEPARATE ASSESSMENTS OF THE BROOKLYN HEALTHCARE SYSTEM, CONDUCTED BY THE BROOKLYN HEALTHCARE IMPROVEMENT PROJECT (B-HIP), SENATOR JOHN SAMPSON'S BROOKLYN HEALTHCARE WORKING GROUP (BHWG), AND THE BROOKLYN MRT HEALTH SYSTEMS REDESIGN WORK GROUP (THE "WORK GROUP"). BROOKDALE STAFF PARTICIPATED IN THE FIRST TWO OF THE AFOREMENTIONED EFFORTS. SCHEDULE H, PART V, QUESTION 11B: THE CHNA CONDUCTED IN 2013 CONFIRMED THE OVERWHELMING HEALTHCARE NEEDS OF BROOKDALE'S PRIMARY AND SECONDARY SERVICE AREAS. THE DISEASE BURDEN FOR THE PRIMARY COMMUNITIES OF BROWNSVILLE AND EAST NEW YORK IS AMONG THE HIGHEST IN NYC, WITH CHRONIC DISEASES LIKE OBESITY, HIV/AIDS, AND DIABETES BEING DISPROPORTIONATELY PREVALENT. BROOKDALE IDENTIFIED A MYRIAD OF HEALTHCARE BARRIERS THAT ARE TYPICALLY LINKED TO THE HIGH DISEASE BURDEN, WHICH TOGETHER, RESULT IN MAJOR HEALTH DISPARITIES FOR ITS PATIENT POPULATION. BROOKDALE IS COMMITTED TO MAKING THE CHANGES TO SERVICE DELIVERY, INVESTMENTS IN INFRASTRUCTURE, AND BUILDING THE STRATEGIC COLLABORATIONS WITH COMMUNITY PARTNERS, PUBLIC HEALTH OFFICIALS AND OTHER STAKEHOLDERS, TO REVERSE THE NEGATIVE HEALTHCARE TRENDS, AND ACHIEVE HEALTH EQUITY FOR THE COMMUNITIES SERVED. ALTHOUGH BROOKDALE'S FISCAL STRUGGLES AND THE LACK OF FINANCIAL RESOURCES IN ITS SERVICE AREAS MAKE IT CHALLENGING TO MEET THE HIGH DEMAND FOR HEALTHCARE SERVICES AND TO ADDRESS THE NEEDS IDENTIFIED IN THE 2014 CHNA, BROOKDALE IS COMMITTED TO BEING RESOURCEFUL AND INNOVATIVE. BROOKDALE CONTINUES TO WORK WITH AFFILIATES, AND A BROAD NETWORK OF PUBLIC AND NON-PROFIT PARTNERS, TO BRING A FULL COMPLEMENT OF HEALTHCARE SERVICES TO ITS PATIENT POPULATION. BROOKDALE CURRENTLY HAS MANY SPECIALTY AND SUB-SPECIALTY CLINICS/SERVICES TO ADDRESS A WIDE RANGE OF DISEASES THAT IMPACT ITS PATIENT POPULATION. BROOKDALE'S HEALTHCARE DELIVERY MODEL INCLUDES: INPATIENT CARE, AMBULATORY CARE, LONG-TERM CARE, SENIOR LIVING AND EMERGENCY MEDICINE. CORE ASSETS THAT SUPPORT THE DELIVERY OF CARE INCLUDE: - APPROXIMATELY 50 SURGICAL AND SUBSPECIALTY CARE CLINICS/SERVICES;- 530 CERTIFIED ACUTE-CARE BEDS;- AN EMERGENCY DEPARTMENT, WHICH IS A NYS-DESIGNATED LEVEL-1TRAUMA CENTER, AND ONE OF THE BUSIEST IN THE REGION; - A 448-BED SKILLED-NURSING FACILITY, AND AN 86-UNIT ASSISTED-LIVING AND INDEPENDENT-LIVING FACILITY, WHICH BOTH OPERATE AT A 95% OR HIGHER OCCUPANCY RATE; - SIX PRIMARY CARE FACILITIES;- A COMPREHENSIVE ADULT DAY CARE CENTER;- A LEVEL-3 PERINATAL CENTER;- A MENTAL AND BEHAVIORAL HEALTH CENTER;- AN AMBULATORY SURGERY CENTER;- A 16-CHAIR DENTAL SUITE THAT SUPPORTS DENTAL AND ORAL SERVICES;- AN HIV CENTER; AND- AN URGENT CARE CENTER.PRIORITIZATION OF HEALTHCARE NEEDSBROOKDALE CATEGORIZED THE MAJOR HEALTHCARE NEEDS FOUND IN ITS SERVICE AREAS AS: (I) PREVALENT DISEASES; AND (II) BARRIERS TO HEALTHCARE. (I) PREVALENT DISEASES - FOLLOWING ARE SUMMARIES OF HOW EACH PREVALENT DISEASE IS BEING ADDRESSED: A. OBESITY - BROOKDALE IS IN THE PROCESS OF ROLLING OUT A COMPREHENSIVE THREE-YEAR PLAN (2014-2016) TO ADDRESS OBESITY, AS PART OF NEW YORK STATE-MANDATED COMMUNITY SERVICE PLAN (CSP). B. HIV/AIDS - BROOKDALE IS IN THE PROCESS OF ROLLING OUT A COMPREHENSIVE THREE-YEAR (2014-2016) PLAN TO ADDRESS HIV/AIDS, AS PART OF CSP REFERENCED ABOVE. C. HEART DISEASE AND HYPERTENSION - BROOKDALE HAS A CARDIOLOGY DEPARTMENT THAT IS FOCUSED ON TREATING CARDIAC DISEASE IN ADULTS AND CHILDREN. A HYPERTENSION CLINIC TREATS PATIENTS WHO HAVE BEEN DIAGNOSED WITH HYPERTENSION. IN ADDITION, ALL CLINICIANS IN OUR PRIMARY CARE NETWORK ARE TRAINED TO TREAT PATIENTS WITH HYPERTENSION AT POINT OF SERVICE. SINCE HEART DISEASE AND HYPERTENSION ARE SECONDARY CONDITIONS THAT ARE ASSOCIATED WITH OBESITY, OUR FOCUS ON OBESITY IS LIKELY TO HAVE A POSITIVE IMPACT ON THE RATES OF BOTH DISEASES.D. CANCER - BROOKDALE HAS AN ONCOLOGY DEPARTMENT THAT IS FOCUSED ON TREATING CANCER IN ADULTS AND CHILDREN. THE MOST COMMONLY DIAGNOSED ADULT CANCERS ARE BREAST, LUNG, PROSTATE AND COLON. APPROXIMATELY 3,000 BREAST CANCER SCREENINGS AND 4,000 MAMMOGRAMS ARE PERFORMED EACH YEAR. SOME OF THE MOST COMMONLY DIAGNOSED CANCERS IN CHILDREN ARE LEUKEMIA, LYMPHOMA-HODGKINS AND NON-HODGKINS, AND BRAIN TUMORS. ONLY ABOUT 30% OF PATIENTS DIAGNOSED WITH CANCER AT BROOKDALE STAY FOR TREATMENT. MOST PATIENTS ARE REFERRED TO OR OPT TO SEEK TREATMENT AT OTHER FACILITIES WITH MORE ADVANCED TREATMENT PROTOCOLS. E. ASTHMA - BROOKDALE'S PULMONARY DEPARTMENT TREATS PATIENTS WITH ASTHMA. SINCE ASTHMA IS THE MOST FREQUENTLY OCCURRING EMERGENCY DIAGNOSIS, BROOKDALE'S HAS A DEDICATED SPACE IN THE EMERGENCY DEPARTMENT THAT IS FULLY-EQUIPPED TO TREAT ASTHMA PATIENTS IN A TIMELY MANNER.F. DIABETES - BROOKDALE'S OUTPATIENT CLINICS PROVIDE CARE FOR PATIENTS THAT HAVE BEEN DIAGNOSED WITH DIABETES, SUPPORTED BY A CUTTING-EDGE ELECTRONIC HEALTH RECORDS SYSTEM THAT IS EQUIPPED TO PROMPT PRIMARY CARE DOCTORS TO REFER PATIENTS TO THE CRITICAL CONTINUUM OF SPECIALTY CARE TYPICALLY RECOMMENDED FOR DIABETIC PATIENTS (OPHTHALMOLOGY, PODIATRY, ETC.). SINCE DIABETES IS ONE OF THE SECONDARY CONDITIONS ASSOCIATED WITH OBESITY, THE FOCUS ON OBESITY IS LIKELY TO HAVE A POSITIVE IMPACT ON THE PATIENTS WHO SUFFER WITH THE DISEASE.G. ALCOHOLISM AND DRUG ADDICTION - BROOKDALE DOES NOT HAVE AN OASAS LICENSE TO PROVIDE SERVICES DIRECTLY TO THE ADDICTED POPULATION. INSTEAD, THE HOSPITAL PROVIDES CARE AND TREATMENT FOR ADDICTIONS UNDER ITS ARTICLE 28 LICENSE (INPATIENT) AND ITS NYS OFFICE OF MENTAL HEALTH (OMH)-ISSUED LICENSE FOR OUTPATIENTS WITH MENTAL ILLNESS AND SUBSTANCE PROBLEMS. IN ADDITION, SEVERAL OASAS LICENSED CLINICS IN THE AREA ADD TO THE CARE CONTINUUM. (II) BARRIERS TO HEALTHCARE - THE BARRIERS TO HEALTHCARE IDENTIFIED INCLUDE: POVERTY; A LACK OF PRIMARY CARE FACILITIES; A LACK OF PRIMARY CARE FACILITIES WITH FLEXIBLE SCHEDULES TO ACCOMMODATE WORKING FAMILIES; A LACK OF SPECIALTY CLINICS, ESPECIALLY THOSE THAT TARGET THE PREVALENT DISEASES IDENTIFIED; A LACK OF INTEGRATED TREATMENT MODULES TO IMPROVE OUTCOMES FOR PATIENTS; A LACK OF DISEASE PREVENTION PROGRAMS; AND LINGUISTIC AND CULTURAL ISOLATION. BROOKDALE REMAINS COMMITTED TO ADAPTING ITS SERVICE DELIVERY MODEL AND DEVELOPING THE COMMUNITY COLLABORATIONS THAT WILL HELP ADDRESS SOME OF THESE BARRIERS. TO DATE, SPECIFIC ACTIONS TAKEN INCLUDE: A. FINANCIAL RESOURCES - BROOKDALE SENIOR MANAGEMENT IS WORKING DILIGENTLY WITH COMMUNITY PARTNERS, LOCAL ELECTED OFFICIALS AND NEW YORK STATE TO SECURE THE FINANCIAL RESOURCES NEEDED TO ENSURE THE FISCAL VIABILITY OF THE HOSPITAL. FUNDING WILL SUPPORT THE IMPLEMENTATION OF NECESSARY SYSTEM-WIDE CHANGES THAT WILL ENHANCE AND EXPAND THE SCOPE OF OUR HEALTHCARE SERVICES, TO ENSURE THE CONTINUITY OF HEALTHCARE FOR THE RESIDENTS OF EAST BROOKLYN. B. PRIMARY CARE FOCUS - BROOKDALE HAS A NETWORK OF SIX PRIMARY CARE FACILITIES AND OTHER AMBULATORY CARE SITES THAT ARE STRATEGICALLY LOCATED IN ITS SERVICE AREAS, TO ENSURE THAT PATIENTS FROM ALL SOCIO-ECONOMIC AND ETHNIC BACKGROUNDS HAVE ACCESS TO PRIMARY CARE. TOGETHER, THESE CLINICS RECEIVE APPROXIMATELY 100,000 PATIENT VISITS ANNUALLY. BROOKDALE IS PLANNING EXPANSION AND DEVELOPMENT OF NEW SITES TO ACCOMMODATE DEMAND FOR PRIMARY CARE. C. ACCESS TO CARE - THROUGH BROOKDALE'S WIDE NETWORK OF PRIMARY CARE FACILITIES, THE FOCUS REMAINS ON PRIMARY CARE EXPANSION AND ACCESS. NEW FACILITIES LIKE AN URGENT CARE CENTER (UCC) OPENED IN DECEMBER 2013, ARE INCREASING ACCESS TO CARE FOR BROOKDALE'S PATIENT POPULATION. THE UCC IS DESIGNED TO SERVE AS AN ALTERNATIVE TO THE EMERGENCY ROOM FOR PATIENTS WHO NEED CARE FOR NON-LIFE-THREATENING CONDITIONS, AND IS OPEN TO THE COMMUNITY EVERY DAY FOR LONGER AND MORE FLEXIBLE HOURS THAN MOST PRIMARY CARE SERVICES, TO ACCOMMODATE WORKING FAMILIES. IN ADDITION, BROOKDALE HAS A FOCUS ON CO-LOCATING SPECIALTY CARE AT PRIMARY CARE SITES, TO IMPROVE ACCESS FOR PATIENTS IN NEED OF SPECIALTY CARE SERVICES. D. PREVENTION MODELS - PREVENTION MODELS LIKE LIVE LIGHT LIVE RIGHT, BROOKDALE'S ANTI-OBESITY PROGRAM, WORK WITH COMMUNITY PARTNERS TO HAVE A POSITIVE IMPACT ON PATIENT HEALTH. LLLR HAS SERVED THOUSANDS OF CHILDREN DURING THE PAST 10 YEARS. BROOKDALE SEEKS OUT OPPORTUNITIES TO DEVELOP PREVENTION MODELS IN COLLABORATION WITH COMMUNITY PARTNERS ON AN ONGOING BASIS, AS FUNDING AND RESOURCES PERMIT.E. SPECIALTY CARE - WHILE SPECIALTY CARE CAPACITY IS NOT ADEQUATE TO MEET THE HEALTHCARE DEMAND, BROOKDALE PROVIDES A RANGE OF MEDICAL AND SURGICAL SPECIALTY AND SUBSPECIALTY CARE FOR ITS PATIENT POPULATION. SUBSPECIALTY CLINICS PROVIDE CARE FOR PATIENTS WITH COMPLICATED DISEASES THAT REQUIRE HIGHLY TRAINED SPECIALIST, AND WORK IN CLOSE COLLABORATION WITH PRIMARY CARE PROVIDERS. SUBSPECIALTY AREAS INCLUDE: BARIATRIC SURGERY; OPHTHALMOLOGY; NEUROLOGICAL SURGERY; HAND SURGERY; BREAST SURGERY; ORTHOPEDIC SURGERY; VASCULAR SURGERY; EAR, NOSE AND THROAT SURGERY; UROLOGICAL SURGERY; AND WOMEN'S HEALTH. F. LINGUISTIC ISOLATION - BROOKDALE OFFERS A VARIETY OF LANGUAGE ASSISTANCE SERVICES TO NON-ENGLISH AND LIMITED ENGLISH PROFICIENT (LEP) PATIENTS AND THEIR FAMILIES, TO FACILITATE CARE. SCHEDULE H, PART V, QUESTION 22D: PATIENTS AUTOMATICALLY QUALIFY FOR OUR GLOBAL CHARITABLE DISCOUNT WHICH IS BASED ON MEDICAID'S REIMBURSEMENT RATES FOR SERVICES PROVIDED. PART V, SECTION B, LINE 16 FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY BROOKDALE HOSPITAL MEDICAL CENTER PART V, SECTION B, LINE 16A WEBSITE: WWW.BROOKDALEHOSPITAL.ORG BROOKDALE HOSPITAL MEDICAL CENTER PART V, SECTION B, LINE 16B WEBSITE: WWW.BROOKDALEHOSPITAL.ORG BROOKDALE HOSPITAL MEDICAL CENTER PART V, SECTION B, LINE 16C WEBSITE: WWW.BROOKDALEHOSPITAL.ORG PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 14,814,529. PART III, LINE 2: THE MEDICAL CENTER ANALYZES ITS PAST COLLECTION HISTORY AND IDENTIFIES TRENDS BY EACH OF ITS MAJOR PAYOR SOURCES OF PATIENT SERVICE REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS, IF ANY. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THE MAJOR PAYOR SOURCES OF PATIENT SERVICE REVENUE IN EVALUATING THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE MEDICAL CENTER ANALYZES CONTRACTUAL AMOUNTS DUE FROM PATIENTS WHO HAVE THIRD-PARTY COVERAGE AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF ANY. FOR PATIENT ACCOUNTS RECEIVABLE ASSOCIATED WITH SELF-PAY PATIENTS, WHICH INCLUDES THOSE PATIENTS WITHOUT INSURANCE COVERAGE AND PATIENTS WITH DEDUCTIBLES AND COPAYMENT BALANCES FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR A PORTION OF THE BILL, THE MEDICAL CENTER RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS FOR PATIENTS THAT ARE UNABLE OR UNWILLING TO PAY FOR THE PORTION OF THE BILL REPRESENTING THEIR FINANCIAL RESPONSIBILITY IN ACCORDANCE WITH CHARITY CARE POLICY. ACCOUNT BALANCES ARE CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AFTER ALL MEANS OF COLLECTION HAVE BEEN EXHAUSTED. PART III, LINE 8: THE METHOD USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS OF CARE RELATING TO PAYMENTS ON LINE 5 WAS THE 2014 MEDICARE COST REPORT. PART III, LINE 9B: THERE IS NO ACCELERATOR OR SIMILAR CLAUSES UNDER WHICH A HIGHER RATE OF INTEREST IS TRIGGERED. WHEN A PATIENT FAILS TO MAKE A REGULAR MONTHLY SCHEDULED PAYMENT, THE HOSPITAL INCLUDES A WRITTEN NOTICE ON PATIENTS' BILLS AND STATEMENTS AT LEAST 30 DAYS PRIOR TO REFERRING THE ACCOUNT TO COLLECTION. THE HOSPITAL REQUIRES THAT ANY COLLECTION AGENCIES WITH WHICH THEY CONTRACT FOLLOW THE FINANCIAL ASSISTANCE POLICIES OF THE HOSPITAL. THE HOSPITAL DOES NOT FORCE THE SALE OR FORECLOSURE OF A PATIENT'S PRIMARY RESIDENCE TO COLLECT ON AN OUTSTANDING BILL. COLLECTION IS PROHIBITED AGAINST ANY PATIENT WHO WAS ELIGIBLE FOR MEDICAID AT THE TIME SERVICES WERE RENDERED. FINALLY, THE CONTRACTED COLLECTION AGENCIES MUST OBTAIN THE HOSPITAL'S WRITTEN CONSENT BEFORE COMMENCING ANY LEGAL ACTION. PART VI, LINE 2: THE CHNA CONDUCTED IN 2013 WAS COMPREHENSIVE, AND PROVIDED IMPORTANT INPUT DIRECTLY FROM BROOKDALE'S SERVICE AREAS. BROOKDALE RECOGNIZES THAT, AS A NONPROFIT HOSPITAL THAT IS FINANCIALLY DISTRESSED (BROOKDALE IS CURRENTLY GOING THROUGH A FINANCIAL RESTRUCTURING), IT IS IMPERATIVE THAT WE KEEP ABREAST WITH THE HEALTHCARE NEEDS OF OUR PATIENT POPULATION, TO ALLOCATE RESOURCES STRATEGICALLY. IN ADDITION TO THE CHNA, HEALTHCARE NEEDS ARE TYPICALLY ASSESSED ON A PERIODIC BASIS BY OUR MEDICAL STAFF AND SENIOR LEADERSHIP. WE COLLECT AND ANALYZE PATIENT HEALTHCARE DATA ON AN ONGOING BASIS. OUR ANALYSES ARE SUPPLEMENTED BY THOSE CONDUCTED BY THE NEW YORK CITY DEPARTMENT OF HEALTH, THE NEW YORK STATE DEPARTMENT OF HEALTH, THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, AND OTHER EXTERNAL ORGANIZATIONS. FURTHER, STAFF PARTICIPATION IN POPULATION HEALTH DIALOGUES (BOTH GENERAL AND DISEASE-SPECIFIC) AT LOCAL AND NATION FORUMS, AND OTHER COMMUNITY EVENTS HELD BY LOCAL CHURCHES AND LOCAL COMMUNITY-BASED ORGANIZATIONS, PROVIDES AN UNDERSTANDING OF THE CRITICAL NEEDS OF THE COMMUNITIES SERVED BY BROOKDALE. FOR EXAMPLE, STAFF AT BROOKDALE'S HIV/AIDS TREATMENT FOR LIFE CENTER (TLC) MAINTAIN DIALOGUE WITH OTHER HIV CENTERS AROUND THE BOROUGH OF BROOKLYN AND THE LARGER NEW YORK CITY AREA, TO HELP UNDERSTAND PATIENT NEED, RESOURCE ALLOCATION AND TREATMENT INNOVATIONS. TOGETHER, THESE MULTIPLE SOURCES OF DATA INFORM OUR ASSESSMENT OF HEALTHCARE NEEDS, AND DRIVE OUR DECISIONS ON EVERY ASPECT OF SERVICE DELIVERY. OVERALL, DUE TO THE OVERWHELMING NEED FOR HEALTHCARE AND THE SHORTAGE OF HEALTHCARE IN THE CATCHMENT AREA, BROOKDALE CONTINUES TO OFFER HEALTHCARE SERVICES THAT COVER THE FULL GAMUT OF HEALTHCARE NEEDS I.E. FROM OBSTETRICS TO ELDER CARE, WITH SPECIAL FOCUS ON THE AREAS THAT ARE DISPROPORTIONATELY PREVALENT IN ITS SERVICE AREAS (OBESITY, DIABETES, HIV/AIDS, ETC.). PART VI, LINE 3: PATIENTS ARE INFORMED THROUGH THE HANDOUT OF OUR FINANCIAL ASSISTANCE POLICY BY THE ADMISSIONS OFFICE AND OTHER MEDIA FORMATS. PART VI, LINE 4: AS ONE OF FOUR MAJOR HEALTHCARE PROVIDERS IN A THREE-MILE GEOGRAPHIC AREA, WHICH HAS A POPULATION OF APPROXIMATELY ONE MILLION RESIDENTS, BROOKDALE IS A VITAL RESOURCE AND SAFETY NET TO THE BROOKLYN COMMUNITIES WE SERVE. BROOKDALE'S PATIENT VOLUME IS AMONG THE HIGHEST IN THE BOROUGH, RECEIVING APPROXIMATELY 100,000 EMERGENCY ROOM VISITS AND MORE THAN 275,000 OUTPATIENT VISITS ANNUALLY. BEYOND HEALTHCARE, BROOKDALE SERVES AS A STABILIZING FORCE AND AN ANCHOR INSTITUTION TO THE LOCAL ECONOMY AND AN IMPORTANT ECONOMIC DRIVER; APPROXIMATELY 1,800 RESIDENTS FROM THE SURROUNDING COMMUNITIES ACCOUNT FOR CLOSE TO 50% OF BROOKDALE'S WORKFORCE. DEMOGRAPHIC COMPOSITION OF BROOKDALE SERVICE AREAS:BROOKDALE SERVES RESIDENTS PRIMARILY FROM EAST AND CENTRAL BROOKLYN, WHICH INCLUDE THE NEIGHBORHOODS OF BROWNSVILLE, EAST NEW YORK, CANARSIE, AND FLATLANDS. THESE NEIGHBORHOODS, WHICH ARE INSIDE THE GEOGRAPHIC BOUNDARIES OF NYC COMMUNITY DISTRICTS 5, 16, AND 18, COMPRISE BROOKDALE'S PRIMARY SERVICE AREA. IN 2014, 76% OF ALL HOSPITAL DISCHARGES CAME FROM FOUR ZIP CODES IN THESE NEIGHBORHOODS (11212, 11207, 11208, AND 11236). ANOTHER 10 ZIP CODES, WHICH FALL WITHIN THE AREAS OF EAST AND CENTRAL BROOKLYN (INSIDE THE GEOGRAPHIC BOUNDARIES OF COMMUNITY DISTRICTS 3, 4, 8, 9 AND 17), COMPRISE BROOKDALE'S SECONDARY SERVICE AREA. IN 2014, 15% OF ALL DISCHARGES CAME FROM THESE ZIP CODES. TOGETHER, THE TWO SERVICE AREAS ACCOUNT FOR 90% OF OUR DISCHARGES. BROOKDALE'S PRIMARY AND SECONDARY SERVICE AREAS HAVE A POPULATION OF APPROXIMATELY 400,000 AND 600,000, RESPECTIVELY, A TOTAL OF APPROXIMATELY ONE MILLION RESIDENTS. THE MAJORITY OF RESIDENTS FROM BOTH SERVICE AREAS ARE BLACK/AFRICAN AMERICAN (APPROXIMATELY 70%). BOTH SERVICE AREAS HAVE A LARGE CONCENTRATION OF IMMIGRANTS AND A MYRIAD OF ETHNICITIES - 38% OF RESIDENTS ARE FOREIGN-BORN. A GROWING HISPANIC IMMIGRANT POPULATION ACCOUNTS FOR 18% OF RESIDENTS. THE MEDIAN AGE OF RESIDENTS IN OUR PRIMARY SERVICE AREA IS 32, WITH 31% UNDER 19 YEARS OLD. THE MEDIAN AGE IN OUR SECONDARY SERVICE AREA IS SLIGHTLY HIGHER AT APPROXIMATELY 35, WITH 27% UNDER 19 YEARS OLD. IN SHORT, BROOKDALE SERVES AN INCREDIBLY UNDERSERVED POPULATION. SOCIO-ECONOMIC STATUS OF BROOKDALE SERVICE AREAS:WHILE THE OVERALL UNEMPLOYMENT RATE FOR NYC HAD BEEN ON A DOWNWARD TREND FOR THE PAST TWO YEARS, AVERAGING 5.2% FOR THE MONTH OF SEPTEMBER 2015, THE RATE FOR THE BOROUGH OF BROOKLYN TRAILS BEHIND AT 5.6%, WITH THE RATES FOR THE SPECIFIC NEIGHBORHOODS THAT WE SERVE REMAINING SIGNIFICANTLY HIGHER. THREE OF THE FOUR ZIP CODES (11212, 11207, AND 11208) IN BROOKDALE'S PRIMARY SERVICE AREA HAVE AN AVERAGE MEDIAN HOUSEHOLD INCOME OF $32,000. POCKETS OF POVERTY EXIST IN THESE ZIP CODES - APPROXIMATELY 32% OF RESIDENTS LIVE BELOW THE FEDERAL POVERTY LEVEL, COMPARED TO 22% FOR THE BOROUGH OF BROOKLYN, AND 19% FOR NYC OVERALL. FIVE OF 10 ZIP CODES IN THE SECONDARY SERVICE AREA HAVE AN AVERAGE POVERTY RATE OF 28%. APPROXIMATELY 50% OF RESIDENTS IN BOTH SERVICE AREAS RECEIVE INCOME SUPPORT (TEMPORARY ASSISTANCE FOR NEEDY FAMILIES, SUPPLEMENTAL SECURITY INCOME, AND MEDICAID). IN 2012, 53% OF PATIENTS SERVED BY BROOKDALE HAD HEALTHCARE COVERAGE PROVIDED BY MEDICAID, 29% PROVIDED BY MEDICARE, 18% WERE EITHER SELF-PAY, CHARITABLE CARE OR PRIVATELY INSURED. THE PERCENTAGE OF RESIDENTS WITH NO HEALTH INSURANCE COVERAGE RANGES FROM 10% IN CANARSIE/FLATLANDS, TO 25% IN BUSHWICK. MOST OF THE NEIGHBORHOODS THAT WE SERVE HAVE THE HHS-DESIGNATIONS OF "HEALTH PROFESSIONAL SHORTAGE AREA" (HPSA) AND/OR "MEDICALLY UNDERSERVED AREA" (MUA). SOME OF THE FACTORS THAT RESULT IN POOR HEALTH OUTCOMES FOR THE POPULATION SERVED INCLUDE: A HIGH DISEASE BURDEN, LACK OF ACCESS TO CARE, A SHORTAGE OF PRIMARY CARE DOCTORS, LINGUISTIC AND CULTURAL ISOLATION, AND LOW HEALTH LITERACY. RESIDENTS SUFFER DISPROPORTIONATELY FROM CHRONIC DISEASES LIKE HIV/AIDS, HEART DISEASE, OBESITY, DIABETES, CANCER, AND SICKLE CELL ANEMIA. ACCORDING TO THE LATEST NYC DOH "TAKE CARE NY" HEALTH PROFILE REPORT CONDUCTED FOR CENTRAL BROOKLYN, THE ANNUAL AVERAGE DEATH RATE IN CENTRAL BROOKLYN WAS 20% HIGHER THAN BROOKLYN OVERALL, AND 30% HIGHER THAN NYC, WITH DISEASES OF THE HEART BEING THE LEADING CAUSE OF DEATH. ACCORDING TO SPARCS 2012 DATA, DISEASES OF THE HEART ACCOUNTED FOR 33.4% OF BROOKLYN DEATHS, WITH CANCER BEING THE SECOND, AT 24.7%. THE AREA HAS A HEART HOSPITALIZATION RATE THAT IS 10% HIGHER THAN THE REST OF BROOKLYN AND 20% HIGHER THAN THE REST OF NYC. MATERNAL AND NEWBORN HEALTH INDICATORS ARE ALSO POOR IN BROOKDALE'S TARGET AREA; SEVERAL ZIP CODES HAVE LOW BIRTH WEIGHT, PREMATURE BIRTH, TEEN PREGNANCY, AND INFANT MORTALITY RATES THAT ARE AMONG THE HIGHEST IN BROOKLYN. BROOKDALE'S SERVICE AREAS ARE PLAGUED BY CRIME, ESPECIALLY GUN-VIOLENCE. BROOKDALE'S EMERGENCY ROOM ENCOUNTERS ONE OF THE HIGHEST INCIDENCES OF PUNCTURE WOUNDS IN THE STATE, INCLUDING A GUNSHOT WOUND VICTIM EVERY 36 HOURS. THE NYC POLICE DEPARTMENT DESIGNATED BROOKDALE'S PRIMARY SERVICE AREA AS AN "IMPACT ZONE" IN 2013, DUE TO THE HIGH NUMBER OF GUN MURDERS AND OTHER CRIMES. PART VI, LINE 5: BROOKDALE IS A "SAFETY NET" HOSPITAL, AS DEFINED BY NEW YORK STATE (AT LEAST 30% OF ITS INPATIENT DISCHARGES AND 35% OF ITS OUTPATIENT VISITS ARE MEDICAID-ELIGIBLE INDIVIDUALS, UNINSURED INDIVIDUALS OR MEDICAID DUALLY-ELIGIBLE INDIVIDUALS). BROOKDALE'S CENTRAL GOAL IS TO PROMOTE THE HEALTH OF THE POOR COMMUNITIES THAT IT SERVES, AND AS SUCH, ALL OF ITS RESOURCES, FROM MEDICAL STAFF TO FUNDS GENERATED THROUGH SERVICE OR ANY OTHER SOURCES, ARE LEVERAGED TO IMPROVE THE HEALTH OF ITS CONSTITUENCY. BROOKDALE'S SENIOR LEADERSHIP ALLOCATES RESOURCES TO OPTIMIZE SERVICE TO PATIENTS. FOR EXAMPLE, IN 2013, BROOKDALE SECURED FUNDS FROM NEW YORK STATE TO BUILD AN URGENT CARE CENTER, TO PROVIDE PATIENTS WITH GREATER ACCESS TO HEALTHCARE. BROOKDALE'S COMBINATION OF CLINICS, INCLUDING SIX PRIMARY CARE SITES THAT SPREAD THROUGHOUT ITS SERVICE AREAS, ARE DESIGNED TO FACILITATE EASY ACCESS TO HEALTHCARE AND THE PROMOTION OF COMMUNITY HEALTH. BROOKDALE HAS A ROBUST COMMUNITY OUTREACH AND ENGAGEMENT AGENDA. AN ACTIVE COMMUNITY ADVISORY BOARD IS CHARGED WITH ENSURING THAT THE VOICE OF THE COMMUNITY IS REPRESENTED IN BROOKDALE'S DECISION MAKING PROCESS. THE EXTERNAL AFFAIRS DEPARTMENT WORKS WITH STAFF ACROSS THE ORGANIZATION TO COORDINATE NUMEROUS HEALTH EDUCATION FAIRS, WELLNESS EVENTS AND A HOST OF ACTIVITIES THAT ARE DESIGNED TO IMPROVE COMMUNITY HEALTH. PART VI, LINE 6: THE ORGANIZATIONS IS AFFILIATED WITH THE BROOKDALE HEALTHCARE SYSTEM. PART VI, LINE 7, REPORTS FILED WITH STATES NY X X X 0 0 0 0 0 0 0 0 0 ESTEVEN GARCIA MD TRUSTEE/EX-OFFICIO 542437 0 0 0 720 0 0 0 27894 0 571051 0 0 0 LEWIS MARSHALL MD TRUSTEE/EX-OFFICIO 392582 0 0 0 2322 0 0 0 27894 0 422798 0 0 0 LUCIO FLORES MD CHIEF OF VASCULAR SURGERY 595772 0 0 0 0 0 0 0 26867 0 622639 0 0 0 REGINALD BULLOCK ASSISTANT SECRETARY 243910 0 0 0 0 0 0 0 29367 0 273277 0 0 0 SUNIL ABROL MD CHIEF OF SURGERY 600000 0 0 0 1242 0 0 0 111 0 601353 0 0 0 ERIC MINKIN MD RADIOLOGIST 494956 0 0 0 0 0 0 0 28674 0 523630 0 0 0 FREDERICK GULMI MD UROLOGY CHAIRMAN 495390 0 0 0 2322 0 0 0 25117 0 522829 0 0 0 KECIA GAITHER MD MATERNAL FETAL MEDICINE 598449 0 0 0 0 0 0 0 11742 0 610191 0 0 0 MAYANK SHUKLA MD PEDIATRICIAN 465195 0 0 0 0 0 0 0 19776 0 484971 0 0 0 SAUL ARBER MD DIRECTOR OF RADIATION AND ONCOLOGY 600000 0 0 0 1242 0 0 0 111 0 601353 0 0 0 FORM 990, PART VI, SECTION A, LINE 2 ALEX ROVT, CHAIRMAN AND TRUSTTE, IRINA BENFIELD, TRUSTEE AND SECRETARY, AND STEPHEN PLOTNICK, TRUSTTEE, ALL HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER. FORM 990, PART VI, SECTION A, LINE 3 IN MARCH 2012, GRANT THORNTON WAS ENGAGED BY THE ORGANIZATION TO PROVIDE TEMPORARY STAFFING SERVICES. COMMENCING APRIL 26, 2012 GRANT THORTON'S GRANT THORTON'S TEMPORARY STAFFING SERVICES INCLUDED PROVIDING THE CHIEF EXECUTIVE AND RESTRUCTUTING OFFICER, CHIEF OPERATING OFFICER, CHIEF FINANCIAL OFFICER, AND CHIEF INFORMATION OFFICER POSITIONS. AS WELL AS MULTIPLE OTHER ADMINISTRATIVE POSITIONS IN FINANCE, OPERATIONS, AND IT. DURING 2013, THE POSITION OF CHIEF FINANCIAL OFFICER WAS FULFILLED BY JAMES PORTER OF GRANT THORTON. IN DECEMBER 2012, THE HOSPITAL RETAINED TONEYKORF PARTNERS, LLC. TO PROVIDE INDIVIDUALS TO TEMPORARLY FILL THE POSITIONS OF CHIEF EXECUTIVE OFFICER AND CHIEF OPERATING OFFICER, FULLFILLED BY MARK TONEY AD STEVEN KORF, RESPECTIVELY. THESE POSITIONS ARE ALL INDICATED IN PART VII SECTION A FOR OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES. ANY AMOUNTS PAID IN CONNECTION WITH THE ABOVE SERVICES ARE PAID DIRECTLY TO GRANT THORTON OR TONEYKORF PARTNERS, LLC RESPECTIVELY. THE FOLLOWING WERE PAID FOR SERVICES RENDERED DURING THE YEAR: TONEYKORF PARTNERS, LLC $2,944,152 FORM 990, PART VI, SECTION A, LINE 6 BROOKDALE HEALTH SYSTEM, INC., A NEW YORK NOT-FOR-PROFIT ORGANIZATION, IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A BROOKDALE HEALTH SYSTEM, INC., AS SOLE MEMBER OF THE ORGANIZATION, HAS THE AUTHORITY TO APPOINT AND REMOVE THE TRUSTEES OF THE ORGANIZATION, AND OTHER AUTHORITIES AS DEFINED IN THE BYLAWS OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 AND APPROPRIATE SCHEDULES, AS REQUIRED, IS PREPARED BY OUTSIDE ACCOUNTANTS AND REVIEWED INTERNALLY BY MANAGEMENT AND COUNSEL, AT WHICH TIME IT IS CONSIDERED THE FINAL DRAFT. THE FINAL DRAFT OF THE FORM 990 IS THEN FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C DISCLOSURE IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY BY EMPLOYEES THAT SATISIFY THE CRITERIA TO BE CONSIDERED "INTERESTED PERSONS' IS SUBMITTED UPON HIRING AND ANNUALLY THEREAFTER. THE AUDIT AND COMPLIANCE COMITTEE REVIEWS THE SUBMISSIONS FOR CONFLICTS AND THE DEPARTMENT OF INTERNAL AUDIT MANAGES COMPLIANCE. FORM 990, PART VI, SECTION B, LINE 15 THE HOSPITAL'S BYLAWS PROHIBIT TRUSTEES FROM RECEIVING ANY COMPENSATION FOR SERVICES PERFORMED IN THEIR CAPACITY AS A TRUSTEE. ALSO PURSUANT TO THE HOSPITAL'S BYLAWS A TRUSTEE SERVING IN ANOTHER CAPACITY MAY RECEIVE REASONABLE COMPENSATION, THEREFORE, AS AUTHORIZED BY THE BOARD OF TRUSTEES. IT IS THE HOSPITAL'S PRACTICE TO TARGET TOTAL EXECUTIVE COMPENSATION (BASE SALARY, INCENTIVE COMPENSATION AND BENEFITS) AS THE MEDIAN OF THE RELEVANT MARKETPLACE FOR SIMILARLY SITUATED EXECUTIVES, WITH APPROPRIATE ADJUSTMENTS FOR SPECIAL SKILL, EXPERIENCE, COMPETENCE, AND PERFORMANCE. THE BOARD OF TRUSTEES HAS AN EXECUTIVE COMPENSATION COMMITTEE THAT REVIEWED THE COMPENSATION OF CERTAIN OFFICERS IN 2014. FORM 990, PART VI, SECTION C, LINE 19 THE DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST OF DEFINED BENIFIT PLAN -27,624,617. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. AMENDED RETURN: FORM 990 WAS AMENDED TO REFLECT FINAL UPDATED FINANCIAL AND OTHER INFORMATION: THE FOLLOWING PARTS HAVE BEEN UDPATED TO REFLECT THIS: PART I, III, IV, VI, VII, VIII, IX, X, XI. ALSO, THE FOLLOWING SCHEDULES HAVE BEEN UPDATED: SCHEDULE B, D, H, J, O, R. 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