INTERFAITH MEDICAL CENTER INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
INTERFAITH MEDICAL CENTER INC (EIN 11-2626155)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-15
IRS object ID
201303199349310270
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-11-15T16:24:03-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Charles A Barragato & Co LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1950 Third Avenue - 20th FLAddressLine1
CityNew YorkCity
StateNYState
ZIP Code10022ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN112626155EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Interfaith Medical Center IncBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% ROBERT MARIANIInCareOfName
Name ControlINTENameControl
Phone7186134000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11545 Atlantic AvenueAddressLine1
Address Line2SuiteAddressLine2
CityBrooklynCity
StateNYState
ZIP Code11213ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameROBERT MARIANIName
TitleVP & CFOTitle
Phone7186134003Phone
Date Signed2013-11-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameAngelo Pirozzi CPAName
Phone2123714446Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonPatrick SullivanNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11545 ATLANTIC AVENUEAddressLine1
CityBROOKLYNCity
StateNYState
ZIP Code11213ZIPCode
FieldValueIRS element (for citing)
Gross Receipts183189420GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.INTERFAITHMEDICAL.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1984YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionINTERFAITH MEDICAL CENTER'S MISSION IS TO PROVIDE EXCEPTIONAL PATIENT SERVICE THROUGH PREVENTION, EDUCATION AND TREATMENT IN A SAFE ENVIRONMENT.ActivityOrMissionDescription
Nbr Voting Members Governing Body6NbrVotingMembersGoverningBody
Nbr Independent Voting Members5NbrIndependentVotingMembers
Total Nbr Employees1877TotalNbrEmployees
Total Nbr Volunteers75TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year4263606ContributionsGrantsPriorYear
Contributions Grants Current Year3299515ContributionsGrantsCurrentYear
Program Service Revenue Prior Year194531403ProgramServiceRevenuePriorYear
Program Service Revenue CY172969100ProgramServiceRevenueCY
Investment Income Prior Year2293632InvestmentIncomePriorYear
Investment Income Current Year3204628InvestmentIncomeCurrentYear
Other Revenue Prior Year5433988OtherRevenuePriorYear
Other Revenue Current Year3716177OtherRevenueCurrentYear
Total Revenue Prior Year206522629TotalRevenuePriorYear
Total Revenue Current Year183189420TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year135527758SalariesEtcPriorYear
Salaries Etc Current Year137587196SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year82712698OtherExpensePriorYear
Other Expenses Current Year68632707OtherExpensesCurrentYear
Total Expenses Prior Year218240456TotalExpensesPriorYear
Total Expenses Current Year206219903TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-11717827RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-23030483RevenuesLessExpensesCY
Total Assets BOY166739861TotalAssetsBOY
Total Assets EOY157084047TotalAssetsEOY
Total Liabilities BOY349099154TotalLiabilitiesBOY
Total Liabilities EOY361608066TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-182359293NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-204524019NetAssetsOrFundBalancesEOY
Mission DescriptionINTERFAITH MEDICAL CENTER'S MISSION IS TO PROVIDE EXCEPTIONAL PATIENT SERVICE THROUGH PREVENTION, EDUCATION AND TREATMENT IN A SAFE ENVIRONMENT.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense189080550Expense
Revenue175944471Revenue
DescriptionINTERFAITH MEDICAL CENTER ("IMC") PROVIDES A WIDE RANGE OF COMPREHENSIVE INPATIENT AND OUTPATIENT MEDICAL, SURGICAL, GYNECOLOGICAL, PSYCHIATRIC AND PEDIATRIC CARE SERVICES THROUGHOUT THE CENTRAL BROOKLYN, NEW YORK AREA. IMC ALSO PROVIDES TERTIARY HEALTHCARE SERVICES, INCLUDING RENAL DIALYSIS, MEDICAL ONCOLOGY SERVICES, NUCLEAR MEDICINE AND RADIATION ONCOLOGY. AMBULATORY, PODIATRIC AND DENTAL SERVICES ARE ALSO AVAILABLE. On December 2, 2012, IMC filed a voluntary petition seeking protection under Chapter 11 of the U.S. Bankruptcy Code and commencing a case in the United States Bankruptcy Court for the Eastern District of New York. Eastern District of New York (the Bankruptcy Court). Eastern District of New York (the Bankruptcy Court). Eastern District of New York (the Bankruptcy Court).Description
Total Program Service Expense189080550TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109687NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees1877NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members6NbrVotingGoverningBodyMembers
Number Independent Voting Members5NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonROBERT MARIANINamePerson
Telephone Number7186134003TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11545 ATLANTIC AVENUEAddressLine1
CityBROOKLYNCity
StateNYState
ZIP Code11213ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (16 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationOther CompensationOtherCompensationAverage Hours Per Week RelatedAverageHoursPerWeekRelatedReportable Comp From Related OrgsReportableCompFromRelatedOrgsKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Nathan M Barotz Esq
Chairman5.0XX00
Canon Diane M Porter
Vice Chair/Dir. Comm. Affairs35.0XX7200005.00
Charles Grannum DMD
Secretary5.0XX
Brenda A Bennett MD
Board Member5.0X
James Philips
Board Member5.0X
Albert Wiltshire
Treasurer5.0XX
Luis Hernandez
President & CEO40.0X
Patrick Sullivan
VP & Chief Operating Officer40.0X
Robert Mariani
VP & CFO40.0X
Pradeep Chandra
Chief Medical Officer40.04448150X
Patricia Cathill
Chief Nursing Officer40.02065000X
Samuel Agyare
Doctor40.03268880X
Valcy Etienne
Doctor40.03278140X
Theophilus Okeke
Doctor40.02934210X
Lodze Steckman
Doctor40.03836840X
Amal Saha
Doctor40.02705820X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2325704TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K216NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
KURRON SHARES OF AMERICA
700 HICKSVILLE ROADBETHPAGENY11714MANAGEMENT SERVICE2909813
SODEXHO INC AFFILIATES
PO BOX 360170PITTSBURGHPA152516170DIET & HOUSEKEEPING2375458
ADVANCED MEDICAL STAFFING CORP
331 RUTLEDGE STREET SUITE 204BROOKLYNNY11211NURSING & CLINICAL2030422
SECURITAS SECURITY SERVICES USA IN
PO BOX 403412ATLANTAGA303843412SECURITY SERVICES1488194
Willkie Farr and Gallagher LLP
787 Seventh AvenueNEW YORKNY10019legal services844444
FieldValueIRS element (for citing)
Number Of Contractors GT100 K36NumberOfContractorsGT100K
Government Grants3125039GovernmentGrants
All Other Contributions174476AllOtherContributions
Total Contributions3299515TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICE REVENUE621990180731649180731649
PROVISION FOR BAD DEBTS-SEE SCHEDULE O621990-7762549-7762549
FieldValueIRS element (for citing)
Total Program Service Revenue172969100TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column3204628TotalRevenueColumn
Exclusion$3,204,628ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real447014Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real447014Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column447014TotalRevenueColumn
Exclusion$447,014ExclusionAmount

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
MEDICAL RESIDENT/STUDENT TRAINING90009929484862948486
MISCELLANEOUS REVENUE90009932067726885$293,792
FieldValueIRS element (for citing)
Total Other Revenue3269163TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column183189420TotalRevenueColumn
Related Or Exempt Function Income175944471RelatedOrExemptFunctionIncome
Exclusion$3,945,434ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total723315Total
Management And General723315ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total102166876Total
Program Services95173427ProgramServices
Management And General6993449ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total9770616Total
Program Services9037820ProgramServices
Management And General732796ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total17588981Total
Program Services16269807ProgramServices
Management And General1319174ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total7337408Total
Program Services6787102ProgramServices
Management And General550306ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total2901215Total
Management And General2901215ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total3052467Total
Program Services2823532ProgramServices
Management And General228935ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total269774Total
Management And General269774ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total14168398Total
Program Services13105768ProgramServices
Management And General1062630ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total5405519Total
Program Services5000105ProgramServices
Management And General405414ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total4864559Total
Program Services4499717ProgramServices
Management And General364842ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total62235Total
Program Services57567ProgramServices
Management And General4668ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total2209Total
Program Services2043ProgramServices
Management And General166ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total6931210Total
Program Services6411369ProgramServices
Management And General519841ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total12960328Total
Program Services12960328ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total3136018Total
Program Services2900817ProgramServices
Management And General235201ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SUPPLIES1003478010034780
PATIENT FOOD SERVICES21806202180620
COLLECTION FEES14703511470351
REORGANIZATION ITEMS798000798000

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total395024Total
Program Services365397ProgramServices
Management And General29627ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total206219903Total
Program Services189080550ProgramServices
Management And General17139353ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY0BOY
EOY9907EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY9914451BOY
EOY13504574EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY1686946BOY
EOY1927346EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY18411552BOY
EOY17520951EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY580066BOY
EOY606751EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY262431BOY
EOY359358EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis165286023LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec91037536LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY86564470BOY
EOY74248487EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY23022902BOY
EOY18185000EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY5106853BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY21190190BOY
EOY30721673EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY166739861BOY
EOY157084047EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY83976034BOY
EOY15337304EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY118880000BOY
EOY117784158EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY37985855BOY
EOY8330206EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY108257265BOY
EOY220156398EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY349099154BOY
EOY361608066EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-183628656BOY
EOY-205759793EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY160515BOY
EOY126926EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1108848BOY
EOY1108848EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-182359293BOY
EOY-204524019EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY166739861BOY
EOY157084047EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-23030483ReconcilationRevenueExpenses
Reconciliation Unrealized Invest-243ReconciliationUnrealizedInvest
Reconcilation Other Changes866000ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorstrueDirectContactLegislators
Direct Contact Legislators$98,211DirectContactLegislatorsAmount
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$11,857OtherActivitiesAmount
Total Lobbying Expenditures IIB110068TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

Form990 Schedule C Part IV Form990ScheduleCPartIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DIRECT CONTACT DESCRIPTIONPART II-B, LINE 1GTHE 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 INTERFAITH MEDICAL CENTER PAID $98,211 IN CONNECTION WITH THESE SERVICES.
OTHER ACTIVITIES DESCRIPTIONPART II-B, LINE 1IINTERFAITH MEDICAL CENTER PAYS DUES TO THE GREATER NEW YORK HOSPITAL ASSOCIATION (GNYHA). IN ACCORDANCE WITH SECTION 6033 (E) OF THE INTERNAL REVENUE CODE, AND AS REPORTED BY GNYHA, A PORTION OF THESE DUES ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES. THE LOBBYING ACTIVITIES APPLICABLE TO 2012 GNYHA ANNUAL DUES WAS $10,866. IN CONNECTION WITH COLLECTIVE BARGAINING NEGOTIATIONS BETWEEN INTERFAITH MEDICAL CENTER AND 1199/CEIU, CERTAIN EMPLOYER CONTRIBUTION AMOUNTS THAT GO TO THE LABOR MANAGEMENT INITIATIVE (FORMERLY CALLED THE PLANNING AND PLACEMENT FUND) AND THE JOB SECURITY FUND ARE ALLOCATED TO HEALTHCARE EDUCATION PROJECT(HEP) FOR ITS PROGRAMS, SERVICES, AND ACTIVITIES. A PORTION OF SUCH FUNDS THAT HEP RECEIVES IS USED FOR LOBBYING PURPOSES IN CONNECTION WITH NEW YORK STATE AND FEDERAL POLICY ISSUES. INTERFAITH MEDICAL CENTER'S PRO-RATED SHARE OF HEP LOBBYING EXPENSES FOR 2012 IS $991

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance1269363BeginningOfYearBalance
Contributions1010Contributions
Grants Or Scholarships3119746GrantsOrScholarships
Other Expenditures3154345OtherExpenditures
End Of Year Balance-5003718EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance3545715BeginningOfYearBalance
Contributions36761Contributions
Other Expenditures13389OtherExpenditures
Administrative Expenses2299724AdministrativeExpenses
End Of Year Balance1269363EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance3552000BeginningOfYearBalance
Contributions12261Contributions
Other Expenditures18546OtherExpenditures
End Of Year Balance3545715EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance3563083BeginningOfYearBalance
Contributions9145213Contributions
Other Expenditures9156296OtherExpenditures
End Of Year Balance3552000EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance3699848BeginningOfYearBalance
Contributions4591000Contributions
Other Expenditures4727765OtherExpenditures
End Of Year Balance3563083EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance0.90000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.10000TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1305623OtherCostOrOtherBasis
Book Value1305623BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis27662538OtherCostOrOtherBasis
Depreciation7482803Depreciation
Book Value20179735BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis26074784OtherCostOrOtherBasis
Depreciation9155967Depreciation
Book Value16918817BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis108239185OtherCostOrOtherBasis
Depreciation74085125Depreciation
Book Value34154060BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2003893OtherCostOrOtherBasis
Depreciation313641Depreciation
Book Value1690252BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings74248487TotalOfBookValueLandBuildings

Other Assets OtherAssets (7 entries)

DescriptionDescriptionBook ValueBookValue
DEFERRED FINANCING COSTS1723677
OTHER LONG TERM ASSET1904936
DUE FROM 3RD PARTY PAYORS12711107
OTHER RECEIVABLES749731
INVESTMENT IN HEALTHFIRST6568998
HEALTHFIRST RETAINED PAYMENTS5367448
SECURITY DEPOSITS1695776
FieldValueIRS element (for citing)
Total Book Value Other Assets30721673TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescriptionAmountAmount
DUE TO THIRD PARTY PAYORS$39,067,347
SELF-INSURED PROFESSIONAL LIAB$6,063,707
DUE TO IM FOUNDATION$4,300,073
ACCRUED BOND INTEREST PAYABLE$5,388,271
LIABILITIES SUBJECT TO COMPROMISE$164,849,000
ACCRUED RETIREMENT BENEFITS$488,000
FieldValueIRS element (for citing)
Total Of Amounts220156398TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt183223776TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-243NetUnrealizedGainsInvestments
Other Revenues3154345OtherRevenues
Revenue Not Rptd F9903154102RevenueNotRptdF990
Revenue Subtotal180069674RevenueSubtotal
Other Revenues Not Included3119746OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt3119746RevenueNotRptdOnFinStmt
Total Revenue Per Form990183189420TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt206219903TotExpensesEtcAuditedFinclStmt
Expenses Subtotal206219903ExpensesSubtotal
Total Expenses Per Form990206219903TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
INTENDED USES OF ENDOWMENT FUNDPART V, LINE 4INTERFAITH MEDICAL CENTER'S ENDOWMENT FUNDS ARE FOR SPECIFIC PURPOSES DEFINED UNDER INTERNAL DESIGNATION OR TERMS OF AGREEMENT.
Other Revenue included in A/F/S but not on Form 990Part XI, line 2dNet Assets Released From Restrictions. . . . . . . . $ 3,154,345.
Other Revenue included on Form 990 but not in A/F/SPart XI, line 4bTemporarily restricted grants. . . . $ 3,119,746

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense6447774TotalCommunityBenefitExpense
Direct Offsetting Revenue12522870DirectOffsettingRevenue
Net Community Benefit Expense-6075096NetCommunityBenefitExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense96528572TotalCommunityBenefitExpense
Direct Offsetting Revenue83655364DirectOffsettingRevenue
Net Community Benefit Expense12873208NetCommunityBenefitExpense
Percent Of Total Expense0.06240PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense102976346TotalCommunityBenefitExpense
Direct Offsetting Revenue96178234DirectOffsettingRevenue
Net Community Benefit Expense6798112NetCommunityBenefitExpense
Percent Of Total Expense0.06240PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense4249896TotalCommunityBenefitExpense
Net Community Benefit Expense4249896NetCommunityBenefitExpense
Percent Of Total Expense0.02060PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense16488496TotalCommunityBenefitExpense
Direct Offsetting Revenue7991322DirectOffsettingRevenue
Net Community Benefit Expense8497174NetCommunityBenefitExpense
Percent Of Total Expense0.04120PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense20738392TotalCommunityBenefitExpense
Direct Offsetting Revenue7991322DirectOffsettingRevenue
Net Community Benefit Expense12747070NetCommunityBenefitExpense
Percent Of Total Expense0.06180PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense123714738TotalCommunityBenefitExpense
Direct Offsetting Revenue104169556DirectOffsettingRevenue
Net Community Benefit Expense19545182NetCommunityBenefitExpense
Percent Of Total Expense0.12420PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$7,762,549BadDebtExpenseAmount
Amount Reimbursed By Medicare32871732AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare22676119CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall10195613MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CarefalseProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Interfaith Medical Center IncBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line11545 Atlantic AvenueAddressLine1
CityBrooklynCity
StateNYState
ZIP Code11213ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Teaching HospitalXTeachingHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Interfaith Medical Center IncBusinessNameLine1
FieldValueIRS element (for citing)
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent100FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent300.FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities11NumberOfOtherFacilities

Other Facilities OtherFacilities (11 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
BISHOP ORRIS G WALKER JR HEALTH CENTER
528 PROSPECT PLACEBROOKLYNNY11238CLINIC
PRIMARY CARE DESIG AIDS TREATMENT CENTER
880 BERGEN STREETBROOKLYNNY11238AIDS TREATMENT CENTER
DENTAL CENTER
1536 BEDFORD AVENUEBROOKLYNNY11216DENTAL CLINIC
ALTERNATIVE HOUSINGAPT PROGRAM
1366 EAST NEW YORK AVENUEBROOKLYNNY11233BEHAVIORAL HEALTH CLINIC
METHADONE MAINTENANCE TREATMENT PROGRAM
882 BERGEN STREETBROOKLYNNY11238DETOX AND CONSULTATION
BEHAVIORAL HEALTH PROGRAM - ADULT CLINIC
1038 BROADWAYBROOKLYNNY11221BEHAVIORAL HEALTH CLINIC
CONTINUING DAY TREATMENT PROGRAM
1275 BEDFORD AVENUEBROOKLYNNY11216DETOX AND CONSULTATION
KINGSBORO MEN'S SHELTER
681 CLARKSON AVENUEBROOKLYNNY11213SHELTER
LOLA CUFFEE FAMILY HEALTH CENTER
485 THROOP AVENUEBROOKLYNNY11221CLINIC
BEHAVIORAL HEALTH PROGRAM - ADULT CLINIC
1475 FULTON STREETBROOKLYNNY11216BEHAVIORAL HEALTH CLINIC
LEARNING CENTER FOR MENTAL HEALTH
960 PROSPECT PLACEBROOKLYNNY11213BEHAVIORAL HEALTH CLINIC

Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
EXPLANATION OF COSTING METHODOLOGYPART I, LINE 7INTERFAITH MEDICAL CENTER USES PATIENT COST TO CHARGES RATIO FROM THE NEW YORK STATE DEPARTMENT OF HEALTH INSTITUTIONAL COST REPORT.
METHODOLOGY USED TO ESTIMATE AMOUNT OF BAD DEBT EXPENSEPART III, LINE 2THE AMOUNT REPORTED ON LINE 2 IS EQUAL TO THE PROVISION FOR BAD DEBTS PER THE AUDITED FINANCIAL STATEMENTS ("AFS"). THE EXPLANATION OF THE METHODOLOGY USED TO ESTIMATE THIS AMOUNT CAN BE FOUND IN FOOTNOTE 2 ON PAGES 18, 19 AND 22 OF THE ATTACHED AFS.
BAD DEBT EXPENSE AUDITED FINANCIAL STATEMENT FOOTNOTEPART III, LINE 4THE TEXT OF THE FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE CAN BE FOUND ON PAGES 18, 19 AND 22 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.
EXPLANATION OF SHORTFALL AS COMMUNITY BENEFITPART III, LINE 8MEDICARE'S COST FINDING IS THE DETERMINATION OF THE ALLOCATION OF DIRECT COSTS AND PRORATION OF INDIRECT COSTS. THE COST REPORT ALLOWS FOR THE ALLOCATION OF GENERAL SERVICE COST CENTERS, INPATIENT ROUTINE SERVICE COST CENTERS, ANCILLARY SERVICE COST CENTERS, OUTPATIENT SERVICE COST CENTERS, OTHER REIMBURSABLE COST CENTERS, SEPCIAL PURPOSE COST CENTERS AND NONREIMBURSABLE COST CENTERS. MOST COST CENTERS ARE ALLOCATED ON DIFFERENT STATISTICAL BASES. AFTER THE ALLOCATION OF THESE COSTS, MEDICARE ALLOWABLE COST IS DERIVED. THE HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE. MEDICARE IS OUR SECONDARY PAYOR AND HOSPITALS MUST ACCEPT THESE PATIENTS REGARDLESS OF WHETHER THEY MAKE A SURPLUS OR DEFICIT FROM PROVIDING SUCH SERVICES. MEDICARE SERVICES PROMOTE ACCESS TO HEALTH CARE SERVICES.
PROVISIONS ON COLLECTION PRACTICES FOR QUALIFIED PATIENTSPART III, LINE 9BINTERFAITH MEDICAL CENTER ADOPTS A WRITTEN COLLECTION POLICY TO FOLLOW UP ON SELF PAY ACCOUNTS CONSISTENTLY TO ENSURE MAXIMIZATION OF CASH FLOW AND FOR TIMELY IDENTIFICATION OF BAD DEBT ACCOUNTS. SELF-PAY PATIENTS WILL BE MAILED AN ITEMIZED COPY OF THEIR HOSPITAL BILL, ALONG WITH FINANCIAL ASSISTANCE INFORMATION. PAYMENT IS EXPECTED WITHIN 30 DAYS OF BILLING. IF THE BALANCE CAN NOT BE PAID WITHIN 30 DAYS, THE PATIENT IS ASKED TO CALL THE ACCOUNT REPRESENTATIVE. AFTER ALL OTHER METHODS OF PAYMENT HAVE BEEN EXHAUSTED, A CONTRACT PAYMENT AGREEMENT MAY BE ACCEPTED. A SERIES OF BILLING STATEMENTS ARE MAILED TO THE GUARANTOR WITH EACH MESSAGE PROGRESSIVELY STRONGER. TELEPHONE COLLECTION ACTIVITY OCCURS FOR INPATIENT SELF-PAY ACCOUNTS THAT ARE GREATER THAN $1,000. ONCE THE BILLING STATEMENTS AND FINAL LETTER HAVE BEEN SENT, THE ACCOUNT WILL CYCLE FOR A PRE-COLLECTION LETTER. AFTER 120 DAYS, ANY SELF-PAY ACCOUNTS DETERMINED TO BE UNCOLLECTIBLE WILL BE WRITTEN OFF TO BAD DEBT AND IMMEDIATELY PLACED WITH A COLLECTION AGENCY.
MAXIMUM AMOUNTS THAT CAN BE CHARGEDPART V, SECTION B, LINE 20DThe hospital facility used the Medicaid rates when calculating the maximum amounts that can be charged & no less than $150.00.
NEEDS ASSESSMENTPART VI, LINE 2INTERFAITH MEDICAL CENTER RELIES ON DATA PROVIDED BY THE NEW YORK CITY DEPARTMENT OF HEALTH AND MENTAL HYGIENE COMMUNITY HEALTH PROFILES, AND THE NEW YORK STATE DEPARTMENT OF HEALTH. IT HAS BEEN FEDERALLY DESIGNATED AS LOCATED WITHIN A HEALTH PROFESSIONAL SHORTAGE AREA AND MEDICALLY UNDERSERVED AREA. THE HOSPITAL ALSO PARTICIPATES IN HEALTH PLANNING AND EVALUATION COALITIONS IN BROOKLYN, I.E. BHIX - BROOKLYN HEALTH INFORMATION EXCHANGE AND SIMILAR PLANNING GROUPS.
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEPART VI, LINE 3PATIENT EDUCATION OF ELIGIBILITY OF ASSISTANCE: INTERFAITH MEDICAL CENTER HAS DEVELOPED A FINANCIAL ASSISTANCE POLICY THAT PROVIDES MEDICAL/FINANCIAL ASSISTANCE TO ALL. THE POLICY IS UPDATED ANNUALLY ESPECIALLY THE PORTIONS REGARDING CURRENT FEDERAL POVERTY LEVELS AND THAT INFORMATION IS DISTRIBUTED TO ALL THE REGISTRATION AREAS. A COPY OF THE FINANCIAL ASSISTANCE APPLICATION IS INCLUDED IN THE PATIENT'S REGISTRATION PACKAGE AND EACH UNINSURED PERSON IS ADVISED OF THE PROCESS FOR BECOMING ENROLLED AND IF ELIGIBLE ASSISTANCE IS PROVIDED WITH MEDICAID ENROLLING AT THE FACILITY INFORMATION REGARDING THE FINANCIAL ASSISTANCE POLICY IS POSTED IN THE ADMITTING DEPARTMENT AND AT ALL OUTPATIENT REGISTRATION LOCATIONS. TRANSLATION SERVICES ARE AVAILABLE FOR THOSE FOR WHOM ENGLISH IS NOT THEIR FIRST LANGUAGE.
COMMUNITY INFORMATIONPART VI, LINE 4INTERFAITH MEDICAL CENTER IS LOCATED IN CENTRAL BROOKLYN, NEW YORK. WE PROVIDE SERVICE TO PEOPLE THROUGHOUT KINGS COUNTY AND EVEN INTO THE SURROUNDING BOROUGHS OF NEW YORK CITY HOWEVER OUR PRIMARY SERVICE AREA COVERS ZIP CODES: 11212, 11213, 11221, 11233, 11238 AND THE SECONDARY SERVICE ZIP CODES ARE: 11203, 11206, 11207,11208, 11217, 11221, 11225, AND 11226. OUR SERVICE AREA HAS A POPULATION OF NEARLY 900,000 WITH APPROXIMATELY IN THE PRIMARY 5 ZIP CODES. THE ETHNIC COMPOSITION IS 80% AFRICAN-AMERICAN OR CARIBBEAN AMERICAN, 11% HISPANIC, 5% WHITE AND 4% OTHER. NEARLY 1 IN 3 OR 31% LIVE BELOW THE POVERTY LEVEL.
COMMUNITY BUILDING ACTIVITIESPART VI, LINE 5INTERFAITH MEDICAL CENTER STRIVES TO BE A GOOD NEIGHBOR AND TO MAINTAIN OPEN COMMUNICATIONS WITH ITS COMMUNITY AND BEYOND. THE HOSPITAL READILY MAKES ITS CONFERENCE ROOM AND CAFETERIA AVAILABLE TO NEIGHBORHOOD GROUPS FOR MEETINGS, RECEPTIONS AND COMMUNITY FORUM. IN ADDITION TO MAKING SPACE AVAILABLE, THE MEDICAL STAFF GRACIOUSLY OFFERS FREE CLINICS AND SCREENINGS THROUGHOUT THE YEAR AT CHURCHES, SENIOR CENTERS, DAY CARE CENTER, HIGH SCHOOLS AND COLLEGE MENTORING SESSIONS AND ANY NUMBER OF STREET FAIRS. THE HOSPITAL ALSO WELCOMES THE INPUT OF THE COMMUNITY THROUGH AN ADVISORY BOARD FOR SEVERAL OF ITS PROGRAMS AND A MONTHLY OPEN DISCUSSION FORUM WITH MEMBERS OF THE BOARD OF TRUSTEES. IN ADDITION TO THE HEAL PROGRAMS OF UTMOST IMPORTANCE TO WOMEN, THE WOMEN'S HEALTH PROGRAM OFFERS WORKSHOPS IN BUDGETING, STRESS REDUCTION, HEALTHY LIVING/COOKING, AND PROVIDES FACILITIES FOR JOB SEARCHES AND HELP WITH AT RISK YOUTH.
STATE FILING OF COMMUNITY BENEFIT REPORT990 SCHEDULE H, PART VINY,

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgBonus Filing OrgBonusFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgComp Report Prior990 Filing OrgCompReportPrior990FilingOrg
Pradeep Chandra
Chief Medical Officer44481500004448150
Patricia Cathill
Chief Nursing Officer20650000002065000
Samuel Agyare
Doctor32688800003268880
Valcy Etienne
Doctor32781400003278140
Theophilus Okeke
Doctor29342100002934210
Lodze Steckman
Doctor38368400003836840
Amal Saha
Doctor27058200002705820

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierADDITIONAL INFORMATIONIdentifier
Return ReferencePART IIIReturnReference
ExplanationTHE FOLLOWING CURRENT EXECUTIVES WERE EMPLOYED BY A MANGEMENT COMPANY, KURRON SHARES OF AMERICA, INC. DURING 2012 - LUIS HERNANDEZ, PATRICK SULLIVAN, AND ROBERT MARIANI. INTERFAITH MEDICAL CENTER PAID THE MANAGEMENT COMPANY $2,909,813 FOR THE EXECUTIVES' SERVICES DURING THE YEAR.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1Dormitory Authority of the State of New YorkBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN146000293IssuerEIN
CUSIP Number64983MVK1CUSIPNumber
Date Issued2007-03-28DateIssued
Issue Price132587135IssuePrice
Description Of PurposeSEE PART VIDescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer
Pool FinancingfalsePoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Amount Retired0AmountRetired
Amount Bond Defeased0AmountBondDefeased
Total Proceeds132587135TotalProceeds
Amount In Reserve Fund10565216AmountInReserveFund
Capitalized Interest0CapitalizedInterest
Refunding Escrow0RefundingEscrow
Issuance Costs From Proceeds1723677IssuanceCostsFromProceeds
Credit Enhancement0CreditEnhancement
Working Capital Expenditures0WorkingCapitalExpenditures
Capital Expenditures0CapitalExpenditures
Other Spent Proceeds0OtherSpentProceeds
Amount Unspent0AmountUnspent
Current RefundingfalseCurrentRefunding
Advance RefundingtrueAdvanceRefunding
Final Allocation MadefalseFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Prcntge Prvt Business Use By Others0PrcntgePrvtBusinessUseByOthers

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T FiledfalseForm8038TFiled
Rebate Not Due YetfalseRebateNotDueYet
Exception To RebatefalseExceptionToRebate
No Rebate DuefalseNoRebateDue
Variable Rate IssuefalseVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1
FieldValueIRS element (for citing)
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC

Name Of GIC Provider NameOfGICProvider

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1
FieldValueIRS element (for citing)
Gross Proceeds InvestedfalseGrossProceedsInvested
Written Proc To Monitor ReqsfalseWrittenProcToMonitorReqs

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Proc To Undertk Corrective ActionfalseProcToUndertkCorrectiveAction

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
IdentifierSCHEDULE K, PART I, COLUMN FIdentifier
Return Reference0ReturnReference
ExplanationTHE PROJECT CONSISTS OF (I) THE REFUNDING OF THE OUTSTANDING BONDS DESIGNATED DORMITORY AUTHORITY OF THE STATE OF NEW YORK SECURED HOSPITAL REVENUE BONDS, SERIES 1998D, THE PROCEEDS OF WHICH WERE LOANED TO THE INSTITUTION AND INCLUDING EACH "PROJECT" FINANCED AND REFINANCED WITH THE PROCEEDS OF SUCH BONDS, (II) THE FUNDING OF THE CAPITAL RESERVE FUND REQUIREMENT AND (III) PAYING THE COSTS OF ISSUANCE OF THE BONDS. THE ORIGINAL ISSUE DATE FOR THE SERIES 1998D BONDS WAS FEBRUARY 26, 1998.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF DELEGATED DUTIES TO MANAGEMENT COMPANYFORM 990, PART VI, LINE 3INTERFAITH MEDICAL CENTER ENGAGES THE SERVICES OF KURRON SHARES OF AMERICA, INC. ("KURRON"), AN UNRELATED COMPANY, TO PROVIDE MANAGEMENT SERVICES. RENUMERATION PAID TO KURRON DURING 2012 IS REPORTED IN THE FORM 990, PART VII, SECTION B - INDEPENDENT CONTRACTORS. THE APPLICABLE NAMES AND TITLES OF KURRON PERSONNEL ARE DISCLOSED ON PART VII - SECTION A - OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES.
FORM 990 REVIEW PROCESSFORM 990, PART VI, LINE 11BTHE INTERFAITH MEDICAL CENTER BOARD IS NOTIFIED WHEN THE FORM 990 IS AVAILABLE AND THEY HAVE THE OPPORTUNITY TO REVIEW THE FORM. THE CHIEF FINANCIAL OFFICER REVIEWS THE FORM 990 BEFORE IT IS FILED WITH THE IRS.
EXPLANATION OF MONITORING AND ENFORCEMENT OF CONFLICTSFORM 990, PART VI, LINE 12CANNUAL QUESTIONNAIRE IS SENT TO ALL DIRECTORS AND MANAGEMENT PERSONNEL. QUESTIONNAIRES ARE REVIEWED BY THE EXECUTIVE STAFF. ANY DISCREPANCIES ARE SENT TO THE BOARD.
COMPENSATION REVIEW & APPROVAL PROCESS FOR CEO, EXEC. DIRECTOR OR TOP MGMTFORM 990, PART VI, LINE 15ATHE TOP MANAGEMENT OFFICIAL IS PAID BY KURRON SHARES OF AMERICA, INC. ("KURRON"), AN UNRELATED COMPANY. INTERFAITH MEDICAL CENTER ENGAGES THE SERVICES OF KURRON TO PROVIDE MANAGEMENT SERVICES. RENUMERATION PAID TO KURRON DURING 2012 IS REPORTED IN THE FORM 990, PART VII, SECTION B - INDEPENDENT CONTRACTORS.
COMPENSATION REVIEW & APPROVAL PROCESS FOR OTHER OFFICERS OR KEY EMPLOYEESFORM 990, PART VI, LINE 15BWhen determining if compensation was fair value for the services, Interfaith Medical Center compared current compensation to compensation that had been paid previously to an employee for similar services.
OTHER ORGANIZATION DOCUMENTS PUBLICLY AVAILABLEFORM 990, PART VI, LINE 19UPON REQUEST, THE ORGANIZATION WILL MAKE AVAILABLE ONLY THOSE DOCUMENTS REQUIRED TO BE DISCLOSED UNDER THE PUBLIC INSPECTION LAWS.
COMPENSATION EXPLANATIONFORM 990, PART VIILUIS HERNANDEZ, PATRICK SULLIVAN, AND ROBERT MARIANI: INTERFAITH MEDICAL CENTER ENGAGED THE SERVICES OF KURRON SHARES OF AMERICA, INC.("KURRON"), AN UNRELATED COMPANY, TO PROVIDE DAY-TO-DAY AND CONSULTING SERVICES. REMUNERATION PAID TO KURRON DURING 2012 IS REPORTED IN PART VII, SECTION B INDEPENDENT CONTRACTORS.
PRESENTATION OF PROVISION FOR BAD DEBTSFORM 990, PART VIII, LINE 2AIn July 2011, the FASB issued Accounting Standards Update No. (ASU) 2011-07, Presentation and Disclosure of Patient Service Revenue, Provision for Bad Debts, and the Allowance for Doubtful Accounts for Certain Health Care Entities. The provisions of ASU 2011-07 require certain health care entities that recognize significant amounts of patient service revenue at the time the services are rendered without assessing the patients ability to pay to present the provision for bad debts related to patient service revenue as a deduction from patient service revenue in the statement of operations rather than as an operating expense. Additional disclosures relating to sources of patient service revenue and the allowance for uncollectible accounts are also required. This new guidance is effective for fiscal years and interim periods within those fiscal years beginning after December 15, 2011, with early adoption permitted. The Medical Center adopted the provisions of ASU 2011-07 in 2012. years and interim periods within those fiscal years beginning after December 15, 2011, with early adoption permitted. The Medical Center adopted the provisions of ASU 2011-07 in 2012.
OTHER CHANGES IN NET ASSETS OR FUND BALANCESFORM 990, PART XI, LINE 9CHANGE IN ADDITIONAL MINIMUM PENSION LIABILITY . . . $ 866,000.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1I M FOUNDATION INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11545 ATLANTIC AVENUEAddressLine1
CityBROOKLYNCity
StateNYState
ZIP Code11213ZIPCode
FieldValueIRS element (for citing)
EIN113144364EIN
Primary ActivitiesFUNDRAISINGPrimaryActivities
Legal Domicile StateNYLegalDomicileState
Exempt Code Section501(c)(3)ExemptCodeSection
Public Charity Status11 TYPE IPublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1IMCBusinessNameLine1
FieldValueIRS element (for citing)
Controlled OrgtrueControlledOrg

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityControlled OrgControlledOrg
Interfaith Emergency Medicine PC
1545 Atlantic AvenueBrooklynNY11213452480633Physician BilNYIMCC Corptrue
Interfaith Professional Physician Svc PC
1545 Atlantic AvenueBrooklynNY11213451861648Physician BilNYIMCC Corptrue
Interfaith Psychiatry Services PC
1545 Atlantic AvenueBrooklynNY11213274297404Physician BilNYIMCC Corptrue
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgtrueLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1I M FOUNDATION INCBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeETransactionType
Amount Involved9805073AmountInvolved
Method Of Amt DeterminationCOSTMethodOfAmtDetermination

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.