2016-11-15T15:23:32-06:00 2015-12-31 221478099 COHNREZNICK LLP 1301 Avenue of the Americas New York NY 10019 990 2015-01-01 111631746 BROOKDALE HOSPITAL MEDICAL CENTER BROO 7182405000 ONE BROOKDALE PLAZA BROOKLYN NY 11236 james porter cfo 7182405000 2016-11-15 1 THOMAS LANNING P00851654 2122970400 2015 2017-02-10 21:41:12Z james porter ONE BROOKDALE PLAZA BROOKLYN NY 11236 483682720 0 X www.BROOKDALEHOSPITAL.ORG X 1914 NY THE BROOKDALE HOSPITAL MEDICAL CENTER OPERATES A 530 BED HOSPITAL IN BROOKLYN, NEW YORK. 12 10 3597 623 0 0 158811730 94942920 395712041 375267819 3439113 1027223 30361660 12444758 588324544 483682720 0 0 0 0 318743812 330210866 0 0 51375 197327562 177515207 516071374 507726073 72253170 -24043353 198574585 187953438 455080751 444749424 -256506166 -256795986 THE BROOKDALE HOSPITAL MEDICAL CENTER WAS CREATED FOR THE PURPOSE OF OPERATING A 530 BED HOSPITAL IN BROOKLYN, NEW YORK. 0 0 437769854 386104991 THE BROOKDALE HOSPITAL MEDICAL CENTER WAS CREATED FOR THE PURPOSE OF OPERATING A 530 BED HOSPITAL IN BROOKLYN, NEW YORK. IN 2015, BROOKDALE HOSPITAL MEDICAL CENTER LOGGED 14,948 ADMISSIONS, 15,008 PATIENT DISCHARGES, AND 100,176 OUTPATIENT EMERGENCY ROOM VISITS WHICH RESULTED IN 1,205 ADMISSIONS AND 229,161 OTHER OUTPATIENT SERVICE VISITS. 437769854 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 1 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 1 637 0 1 3597 1 0 0 0 0 0 0 0 0 0 0 X 12 10 1 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X james porter 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 ESTEVaN GARCIA MD Ex-Officio Trustee 40.00 X X 567259 0 28141 IRINA BENFIELD 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 Ex-Officio Trustee 40.00 X 392418 0 28141 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 STEPHEN PLOTNICK Trustee 1.00 5.40 X 0 0 0 MARK E TONEY PRESIDENT AND CEO 40.00 44.40 X 0 0 0 Paul Goldberg CFO 40.00 44.40 X 419022 0 5660 reginald bullock assistant secretary 40.00 44.40 X 340587 0 30641 Cyrus McCalla Director, OBS/GYN 40.00 X 590443 0 28296 David Rose Chairperson, MD 40.00 X 545549 0 21938 Lucio Flores MD Chief of Vascular Surgery 40.00 X 854715 0 29221 Michele Follen Chairperson, OBS/GYN 40.00 X 653700 0 660 Saul Arber MD Chairperson, Radiation Oncology 40.00 X 542517 0 29281 4906210 0 201979 752 0 1 0 Velocity 1901 Roxborough Road Charlotte NC 28211 IT Hosting, Service & Support Staffing 8269865 ToneyKorf Partners 1595-14 NORTH CENTRAL AVENUE VALLEY STREAM NY 11580 Restructuring Services 5137163 Oxford Global Resources 100 Cummings Center Beverly MA 01915 IT Staffing 3694318 Xtend Healthcare 500 W Main St Hendersonville TN 37075 Patient Revenue Consulting Services 3239095 Pricewaterhouse Coopers 300 Madison Ave NEW YORK NY 10017 Pateint Revenue & Consulting Services 2577817 44 9179481 84090212 1673227 94942920 net Patient Revene 621400 295247976 295247976 Patient Services provi 621400 33028424 33028424 Other Patient Revenue 621400 32140641 32140641 pharmacy 621400 12659049 12659049 Teaching 621400 1337350 1337350 854379 854379 375267819 1024909 1024909 819910 0 819910 819910 819910 2314 0 2314 2314 2314 medmal IBNR ADJ 900099 3572420 3572420 Settlement Fees 900099 1683134 1683134 Rebates and refunds 621110 973225 973225 5396069 4606079 789990 11624848 483682720 386104991 0 2634809 1811869 1684955 126825 89 251049565 233463997 17572559 13009 15144432 14084322 1060110 44476334 41362991 3113343 17728666 16487658 1241008 7338452 7338452 3019197 2401610 617587 507479 507479 29506534 24165934 5317828 22772 177590 169723 7867 18499922 14709856 3782719 7347 9748783 7754636 1994147 7977301 6345517 1631784 849914 676061 173853 70419 55913 14378 128 2301755 1830923 470832 12185375 9692815 2492560 1398365 1112325 286040 Medical Supplies 45615382 45615382 bad debt expense 22847140 2005328 20841812 equipment rental and ma 9111961 8135992 975806 163 Food 3850109 3850109 2509529 2163807 345722 507726073 437769854 69904844 51375 9956204 13296650 37167781 34716259 5161036 5096705 11535944 9646058 359620097 292172260 69490989 67447837 143554 77296 65119077 57672633 198574585 187953438 104610276 72618666 91303264 131086762 259167211 241043996 455080751 444749424 X -256506166 -256795986 -256506166 -256795986 198574585 187953438 X -24043353 23753533 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 174079 174079 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 $21,663 GREATER NEW YORK HOSPITAL ASSOCIATION 7,918 CONTINUING CARE LEADERSHIP COALITION 1,998 TOTAL COST $31,579 THE ORGANIZATION ALSO PROVIDED PAYMENT TO THE FOLLOWING TO LOBBY ON THEIR BEHALF: STATE & BROADWAY, INC. $32,500 BROWN & WEINRAUB PLLC $110,000 1068657 1068657 88210815 70773755 17437060 88284178 79740952 8543226 182056447 141657553 40398894 67447837 Due from third party payors 11663788 insurance recoveries 17184528 assets whose use is limited 28399794 due from affiliates 238133 security deposits 186390 57672633 malpractice insurance payable 139084671 due to third payors 18352221 workers compensation payable 22843403 accrued pension payable 59669351 executive post retirement benefits 1094350 241043996 X 468926825 -11183475 -11183475 480110300 3572420 3572420 483682720 502148450 -3572295 -3572295 505720745 2005328 2005328 507726073 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: Bad Debt expenses -2,005,328. related organization activity -9,178,147. Part XI, Line 4b - Other Adjustments: medmal IBNR ADJ 3,572,420. Part XII, Line 2d - Other Adjustments: related organization activity 125. medmal IBNR ADJ -3,572,420. Part XII, Line 4b - Other Adjustments: Bad Debt 2,005,328. Central America and the Caribbean 0 0 program service expenses 21463627 0 0 0 0 0 0 21463627 0 21463627 0 0 1 0 0 0 1 1 1 X 1 X 1 1 1 0 1 1 19063633 13023760 6039873 0.01190 211293747 125583935 85709812 0.16950 1807577 808355 999222 0.00200 232164957 139416050 92748907 0.18340 5901480 3655958 2245522 0.00440 52309592 18800597 33508995 0.06630 45983018 27939617 18043401 0.03570 1108655 1108655 105302745 51504827 53797918 0.10640 337467702 190920877 146546825 0.28980 1 2005328 1184174 39491290 29359802 10131488 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: Brookdale conducted a comprehensive Community Health Needs Assessment (CHNA) in 2013. The CHNA planning process was an opportunity to seek the involvement of a diverse group of community and healthcare stakeholders. A Brookdale Hospital Working Group (the "Working Group"), comprised of a cross-section of staff from Brookdale Hospital, led the CHNA design and implementation effort. 2013 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 engaged in the following activities from February to December 2013: - Agreed on the scope of the CHNA report, and developed a strategy to ensure that Brookdale met all of the IRS reporting criteria. - 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 qualitative data from community residents. A representative sample of the service area participated in both surveys i.e. male and female adults, senior citizens, immigrants, and non-immigrants. The first survey, a multiple choice format, focused on community needs, and was designed to gauge residents' perception of personal and community health. This survey captured the perspective of 563 residents from Brookdale's primary service area. The second survey was interactive, and designed to obtain residents' visions for healthcare in the community. A total of 70 residents participated in the second survey. - 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. - Secured the qualitative and quantitative data needed to develop the 2013 CHNA. As part of the 2013 CHNA development process, 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. From 2013 to 2014, Brookdale collaborated with the larger Brooklyn healthcare community and the NYS DOH to discuss healthcare issues faced by healthcare providers, and to explore solutions that would improve the healthcare system in the borough of Brooklyn. Discussions were facilitated by B-HIP. Almost all healthcare providers in the borough reported significant challenges in the delivery of healthcare, including fiscal struggles that threatened their sustainability. In 2014, NYS provided funds through the "Delivery System Incentive Payment Program (DSRIP) to revamp the healthcare system. DSRIP funding enabled Brooklyn hospitals to conduct a comprehensive healthcare needs assessment for the entire borough. While Brookdale did not receive any funds through DSRIP, the needs assessment conducted is serving as important planning tool for Brookdale, as Brookdale redesigns its healthcare model to improve healthcare delivery in East Brooklyn. 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 2013 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 Obesity is one of two disease priorities for Brookdale, selected as part of the 3-year (2013-2015) New York State Department of Health-mandated Community Service Plan (CSP). Brookdale is implementing a multi-prong approach to reducing obesity in its patient population. A core program, "Live Light, Live Right," which is funded by the Robin Hood Foundation, reaches kids and families, providing clinical treatment of obesity, as well as promotion of physical activities for community residents. - HIV/AIDS HIV/AIDS was Brookdale's second disease priority for the 3-year period 2013-2016, to comply with the New York State-Department of Health CSP. Brookdale continues to work with community partners and across Brookdale departments to diagnose and treat patients with HIV/AIDS. - 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. Brookdale launched the "Brookdale Breast Center" in 2015 to address the incidence of breast cancer in patients. 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. 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 needs that are disproportionately prevalent in its service areas (obesity, diabetes, HIV/AIDS, etc.) .(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. 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 11B continued: a. Prevention models - Prevention models including 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.b. Specialty care - While specialty care capacity is not adequate to meet the healthcare demand in its primary service area, 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 specialists, 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 - to facilitate care Brookdale offers a variety of language assistance services to non-English and Limited English Proficient (LEP) patients and their families. 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 $ 2,005,328. Part III, Line 4: 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. During 2015, the Patcom system (the patient accounting system that was replaced in 2013) balance of $12.7 million was written off due to the age of the accounts, and another $7.2 million was transferred from bad debt to charity care causing a significant reduction in allowance for doubtful accounts. Additionally, due to a change in charity care policy, new reserves are set at a much lower level and the reserves were decreased by an additional $6.8 million. Part III, Line 8: THE METHOD USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS OF CARE RELATING TO PAYMENTS ON LINE 5 WAS THE 2015 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 by Brookdale in 2013 was comprehensive, and provided important input directly from Brookdale's service areas. Brookdale recognizes that, as a nonprofit hospital wth limited resources, it is imperative that we track 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, with the most recent being a 2014 comprehensive healthcare assessment of the entire borough of Brooklyn funded by New York State DSRIP funding. Further, staff participation in population health dialogues (both general and disease-specific) at local and national forums, and other community events held by local churches and local community-based organizations, provide an understanding of the critical needs of the communities served by Brookdale. Part VI, Line 3: Per FAP policy. Part VI, Line 4: account the geographic area and demographic constituents it serves. Brookdale is 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 that it serves. 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 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 2015, 73% 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 2015, 18% of all discharges came from these zip codes. Together, the two service areas account for 91% of our discharges. Brookdale's primary and secondary service areas have a population of approximately 370,000 and 662,000, respectively, a total of just over one million residents. The majority of residents from both service areas are Black/African American (approximately 71%). Both service areas have a large concentration of immigrants and a myriad of ethnicities - 37% 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 32.5, with 31% under 19 years old. The median age in our secondary service area is slightly higher at approximately 35.1, with 27% under 19 years old. Socio-economic Status of Brookdale Service Areas Brookdale serves a patient population in East Brooklyn that is predominantly low-income, with at least 50% receiving government income support (Temporary Assistance for Needy Families, Supplemental Security Income, and Medicaid). Most patients come from neighborhoods with a large concentration of poverty. 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. 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%. The health insurance coverage for Brookdale's patient population is approximately: 53% Medicaid; 29% Medicare, 18% 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 2015 NYC DOH community health profile report, the two top causes of death in Brownsville were heart disease and cancer, both rates of death significantly higher that the NYC rates. The heart disease rate was 272.9 per 100,000 deaths, 35% higher than the NYC rate of 202.6, and the cancer rate was 205.8 per 100,000 deaths, 31% higher than the NYC rate of 156.7 deaths per 100,000. 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. 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 Urgicare Center, to provide patients with better access to healthcare. Brookdale's combination of clinics, including six primary care sites that are 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. Brookdale's Community Advisory Board is charged with ensuring that the voice of the community is represented in Brookdale's decision making process. Brookdale's External Affairs Department staff work with community leaders, CBOs and elected officials to access the community and ensure that all major stakeholders remain engaged and contribute to Brookdale's role as a leading healthcare provider in East Brooklyn. The External Affairs staff work with departments across Brookdale to coordinate health education fairs, wellness events, youth initiatives, and a host of activities that are designed to disseminate health information, inform the community about treatment and care options, and overall, improve health and empower the communities served. Part VI, Line 6: PLEASE REFER TO SCHEDULE R FOR THE ORGANIZATIONS AFFILIATED WITH THE HEALTHCARE SYSTEM. Part VI, Line 7, Reports Filed With States NY X X 0 0 0 0 0 0 0 0 0 ESTEVaN GARCIA MD Ex-Officio Trustee 567259 0 0 0 0 0 0 0 28141 0 595400 0 0 0 LEWIS MARSHALL MD Ex-Officio Trustee 390096 0 0 0 2322 0 0 0 28141 0 420559 0 0 0 Paul Goldberg CFO 419022 0 0 0 0 0 0 0 5660 0 424682 0 0 0 reginald bullock assistant secretary 339759 0 0 0 828 0 0 0 30641 0 371228 0 0 0 Cyrus McCalla Director, OBS/GYN 590354 0 0 0 89 0 0 0 28296 0 618739 0 0 0 David Rose Chairperson, MD 542501 0 0 0 3048 0 0 0 21938 0 567487 0 0 0 Lucio Flores MD Chief of Vascular Surgery 852243 0 0 0 2472 0 0 0 29221 0 883936 0 0 0 Michele Follen Chairperson, OBS/GYN 650136 0 0 0 3564 0 0 0 660 0 654360 0 0 0 Saul Arber MD Chairperson, Radiation Oncology 542517 0 0 0 0 0 0 0 29281 0 571798 0 0 0 Form 990, Part VI, Section A, line 2 ALEX ROVT, CHAIRMAN AND TRUSTTE, IRINA BENFIELD, 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 restructuring services. IN 2015, GRANT THORNTON'S SERVICES INCLUDED THE CHIEF FINANCIAL OFFICER AS WELL AS MULTIPLE OTHER POSTIONS IN FINANCE AND OPERATIONS UNTIL MARCH 2015. GRANT THORNTON ALSO PERFORMED HUMAN RESOURCE ADVISORY SERVICES IN 2015. GRANT THORNTON'S ENGAGEMENTS HAVE CONCLUDED. ANY AMOUNTS PAID IN CONNECTION WITH THE ABOVE SERVICES WERE PAID DIRECTLY TO GRANT THORNTON. IN DECEMBER 2012, THE HOSPITAL RETAINED TONEYKORF PARTNERS, LLC. FOR THE SERVICES OF SENIOR POSITIONS, INCLUDING CHIEF EXECUTIVE OFFICER, CHIEF RESTRUCTURING OFFICER, AND CHIEF OPERATING OFFICER. IN 2015, TONEYKORF PARTNERS' SERVICES INCLUDED THE SERVICES OF CHIEF EXECUTIVE OFFICER AND SVP OF RESTRUCTURING, AS WELL AS OTHER SENIOR POSTIONS IN FINANCE AND OPERATIONS. ANY AMOUNTS PAID IN CONNECTION WITH THE ABOVE SERVICES WERE PAID DIRECTLY TO TONEYKORF PARTNERS, LLC. THE FOLLOWING WERE PAID FOR SERVICES RENDERED DURING THE YEAR TONEYKORF PARTNERS, LLC $5,137,163 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 made available to the board prior to it being filed WITH THE IRS. Form 990, Part VI, Section B, line 12c DISCLOSURE IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY BY EMPLOYEES and board members 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 2015. 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 -3,572,026. transfer from affiliate 27,325,559. Form 990, Part XII, Line 2c: The process has not changed from the prior year. 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