2012-10-24T09:01:23-05:00 2011-12-31 ERNST & YOUNG US LLP 111 MONUMENT CIRCLE SUITE 2600 INDIANAPOLIS IN 46204 990 2011-01-01 133746997 The New York Gracie Square Hospital Inc % DAVID WIECKS CFO NEWY 2124345457 420 East 76 Street New York NY 10021 DAVID WIECKS 2012-10-16 3176817000 2011 2016-02-24 21:20:13Z FRANK BRUNO 420 EAST 76 STREET NEW YORK NY 10021 44996847 false X www.nygsh.org X 1958 NY To provide high quality mental health and chemical dependency treatment in a caring and compassionate manner to patients residing in the Greater New York City Metropolitan area. 10 6 340 0 0 0 57225 53445 44084457 44752889 17713 16794 127477 173719 44286872 44996847 0 0 0 0 24299643 24560854 0 0 9780 15885113 16601121 40184756 41161975 4102116 3834872 21150486 24261278 18716662 17992582 2433824 6268696 X To provide high quality mental health and chemical dependency treatment in a caring and compassionate manner to patients residing in the Greater New York City Metropolitan area. To educate the community that we serve about the diagnosis, treatment and prevention of mental illness and chemical dependency. To provide culturally sensitive and linguistically appropriate mental health and substance abuse services to the New York City Asian population. false false 36712922 0 44926608 THE NEW YORK GRACIE SQUARE HOSPITAL INC. IS A 157 BED NOT FOR PROFIT PSYCHIATRIC HOSPITAL LICENSED BY THE NEW YORK STATE OFFICE OF MENTAL HEALTH. THE HOSPITAL IS ACCREDITED BY THE JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS AND IS A MEMBER OF THE NEW YORK PRESBYTERIAN HEALTHCARE SYSTEM. THE HOSPITAL WAS FORMED IN 1958 AND HAS BEEN SERVING OUR COMMUNITY SINCE THAT TIME. OUR MISSION IS TO PROVIDE HIGH QUALITY MENTAL HEALTH AND CHEMICAL DEPENDENCY TREATMENT IN A CARING AND COMPASSIONATE MANNER TO PATIENTS RESIDING IN THE GREATER NEW YORK CITY METROPOLITAN AREA, TO EDUCATE THE COMMUNITY THAT WE SERVE ABOUT THE DIAGNOSIS, TREATMENT AND PREVENTION OF MENTAL ILLNESS, AND CHEMICAL DEPENDENCY AND TO PROVIDE CULTURALLY SENSITIVE AND LIGUSTICALLY APPROPRIATE MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES TO THE NEW YORK CITY ASIAN POPULATION. THE ASIAN PROGRAM THE ASIAN PROGRAM AT GRACIE SQUARE HOSPITAL IS DESIGNED TO MEET THE SPECIFIC NEED OF THE ASIAN PSYCHIATRIC PATIENT IN AN INPATIENT SETTING. THE PROGRAM PROVIDES CULTURALLY SENSITIVE AND LINGUISTICALLY APPROPRIATE SERVICES TO A DIVERSE ASIAN POPULATION, INCLUDING CHINESE, KOREAN, AND JAPANESE COMMUNITIES. RECOGNIZING THAT CULTURAL FACTORS INFLUENCE THE WAY AN INDIVIDUAL VIEWS THE CAUSE AND TREATMENT OF MENTAL ILLNESS, THE PROGRAM PERMITS PATIENTS AND THEIR FAMILIES TO WORK WITHIN THEIR OWN CULTURAL FRAMEWORK TO MAXIMIZE SUCCESSFUL TREATMENT OUTCOMES AND PREVENT RELAPSES. BY PROVIDING STAFF WHO CAN COMMUNICATE IN A PATIENT'S OWN LANGUAGE, THE PROGRAM TRULY MAKES PATIENTS AND THEIR FAMILY ACTIVE MEMBERS OF THE TREATMENT TEAM. THE ASIAN PROGRAM IS DIRECTED BY BILINGUAL/BICULTURAL PSYCHIATRISTS. WITH THE HELP OF A CULTURALLY BILINGUAL SUPPORT STAFF WHO SPEAK DIFFERENT CHINESE ETHNIC DIALECTS (E.G. MANDARIN, CANTONESE, FUKINESE, AND TAIWANESE ETC.) KOREAN, JAPANESE AND OTHER ASIAN LANGUAGES PATIENTS AND THEIR FAMILIES CAN FULLY UNDERSTAND TREATMENT OPTIONS AND COMPLIANCE STRATEGIES. WHEN PATIENTS ARE READY FOR DISCHARGE, BILINGUAL SOCIAL WORKERS FAMILIAR WITH ALL AVAILABLE MENTAL HEALTH RESOURCES WITHIN THE ASIAN COMMUNITIES WORK WITH PATIENTS AND THEIR FAMILIES TO ORGANIZE REALISTIC, EFFECTIVE AND CULTURALLY APPROPRIATE AFTERCARE PLANS. THE EXPERT MEDICAL, PSYCHIATRIC CLINICAL AND NURSING STAFFS OF THE ASIAN PROGRAM AT GRACIE SQUARE HOSPITAL CONDUCT A THOROUGH EVALUATION OF EACH PATIENT'S PHYSICAL AND PSYCHOLOGICAL CONDITION IMMEDIATELY UPON ADMISSION INTO THE PROGRAM. PAST TREATMENT EXPERIENCES ARE INVESTIGATED AND FAMILY MEMBERS ARE INTERVIEWED. A COMPREHENSIVE INDIVIDUALIZED, MULTI-DISCIPLINARY TREATMENT PLAN IS FORMULATED, BASED ON THE MOST ADVANCED KNOWLEDGE AND TECHNIQUES, BUT SENSITIVE TO THE PATIENTS CULTURAL BELIEFS AND EXPECTATIONS. INTERVENTIONS UTILIZED MAY INCLUDE PSYCHOPHARMACOLOGY, CRISIS INTERVENTION, AND STABILIZATION OF ACUTE MEDICAL CONDITIONS. IN ORDER TO PROVIDE FOR A SMOOTH TRANSITION TO THE NEXT PHASE OF TREATMENT, DISCHARGE PLANNING IS BEGUN AT THE TIME OF ADMISSION. THROUGH OUR DIRECT AND AFFILIATED INVOLVEMENT WITH PARTIAL HOSPITALIZATION PROGRAMS, INTENSIVE OUTPATIENT CLINICS, EXTENDED CARE FACILITIES, AND INDIVIDUAL PROVIDERS, WE ARE ABLE TO EFFECT THE MOST APPROPRIATE AND TIMELY REFERRALS, AS WELL AS PROVIDE COMPREHENSIVE INFORMATION ABOUT SERVICES PROVIDED; *PSYCHIATRIC TREATMENT BY BILINGUAL PSYCHIATRISTS INCLUDING COMPLETE DIAGNOSTIC EVALUATION; *COMPREHENSIVE MEDICAL AND NEUROLOGICAL EXAMINATION; *LABORATORY, RADIOGRAPHIC AND OTHER APPROPRIATE MEDICAL TESTS INCLUDING EKG, EEG, CT SCANS ETC. AS INDICATED; *INDIVIDUAL TREATMENT PLAN; *MULTIDISCIPLINARY TREATMENT PSYCHIATRIC SYMPTOMS, INCLUDING DETOXIFICATION, FROM ADDICTIVE SUBSTANCES; *COORDINATION OF CONCURRENT MEDICAL AND PSYCHIATRIC TREATMENT; *NUTRITIONAL EVALUATION AND DIETARY EDUCATION; *ALL SPECIAL DIETS; *GROUP AND INDIVIDUAL ACTIVITIES GEARED TOWARD MEDICATION COMPLIANCE AND RELAPSE PREVENTION; *COMPREHENSIVE DISCHARGE PLANNING, BY BILINGUAL STAFF, INCLUDING REFERRAL TO CULTURALLY AND LINGUISTICALLY APPROPRIATE OUTPATIENT PROVIDERS; *24 HOUR/SEVEN DAY A WEEK ON SITE COVERAGE BY AN INTERNIST AND A PSYCHIATRIST. PATIENTS ARE ACCEPTED FROM A VARIETY OF SOURCES, INCLUDING REFERRALS DIRECTLY FROM MANAGED CARE PROVIDERS, HEALTH MAINTENANCE ORGANIZATIONS, MEDICAL HOSPITALS, THE COMMUNITY AND PRIVATE DOCTORS. THE GERIATRIC PSYCHIATRIC PROGRAM THE GERIATRIC PSYCHIATRY PROGRAM AT GRACIE SQUARE HOSPITAL IS DESIGNED TO TREAT INDIVIDUALS AGE 65 AND OLDER WHO HAVE A PRIMARY PSYCHIATRIC DISORDER WHICH REQUIRES ACUTE INPATIENT TREATMENT. THE EXPERT MEDICAL, PSYCHIATRIC, CLINICAL AND NURSING STAFF AT GRACIE SQUARE HOSPITAL WILL THOROUGHLY EVALUATE EACH PATIENT'S PHYSICAL AND PSYCHOLOGICAL CONDITION. BASED ON OUR FINDINGS WE WILL WORK TO PROVIDE OUR PATIENTS WITH AN INDIVIDUALIZED AFTERCARE PLAN DESIGNED TO MAINTAIN THE IMPROVEMENTS ACHIEVED HERE. AMONG THE MANY AREAS INCLUDED IN OUR AFTERCARE PLAN ARE PSYCHIATRIC AND NON-PSYCHIATRIC MEDICATION MANAGEMENT, RECOMMENDATIONS FOR PSYCHOTHERAPEUTIC, INTERVENTION, INFORMATION ABOUT AVAILABLE COMMUNITY RESOURCES, AND CONCRETE HELP WITH SECURING PUBLIC BENEFITS AND EXTENDED CARE FACILITY PLACEMENT. SERVICES PROVIDED: *COMPLETE PSYCHIATRIC DIAGNOSTIC EVALUATION; *COMPREHENSIVE MEDICAL AND NEUROLOGICAL EXAMINATION; *LABORATORY, RADIOGRAPHIC AND OTHER APPROPRIATE MEDICAL TESTS INCLUDING EKG, EEG, ETC.; *INDIVIDUALIZED TREATMENT PLAN; *MULTIDISCIPLINARY TREATMENT OF PSYCHIATRIC SYMPTOMS; *COORDINATION OF CONCURRENT MEDICAL AND PSYCHIATRIC TREATMENTS INCLUDING MEDICATION MANAGEMENT REGIMENS; *NUTRITIONAL EVALUATION AND DIETARY EDUCATION; *KOSHER AND ALL SPECIAL DIETS; *GROUP AND INDIVIDUAL ACTIVITIES WHICH MAXIMIZE INDEPENDENT FUNCTIONING AND HELP TO REGAIN LOST SKILLS; *COMPREHENSIVE DISCHARGE PLANNING, INCLUDING PLACEMENT AND COMMUNITY RESOURCE DEVELOPMENT; *24 HOUR. SEVEN DAY A WEEK ON SITE COVERAGE BY AN INTERNIST AND A PSYCHIATRIST. PATIENTS ARE ACCEPTED FROM A VARIETY OF SOURCES, INCLUDING EXTENDED CARE FACILITIES, MEDICAL HOSPITALS, THE COMMUNITY AND PRIVATE DOCTORS. PRIVATE CREDENTIALED PSYCHIATRISTS MAY ADMIT AND TREAT THEIR OWN PATIENTS. THE DUAL FOCUS PROGRAM THE DUAL FOCUS PROGRAM IS AN INPATIENT TREATMENT PROGRAM FOR THOSE WHO HAVE SIGNIFICANT EMOTIONAL OR PSYCHIATRIC PROBLEMS IN ADDITION TO BEING CHEMICALLY DEPENDANT. WE PROVIDE A SINGLE SETTING COMPREHENSIVE TREATMENT EXPERIENCE, UTILIZING A FLEXIBLE BLEND OF THE PSYCHIATRICAND SUBSTANCE ABUSE MODELS IN A WARM AA-ORIENTED THERAPEUTIC MILIEU. OUR STAFF CONSISTS OF HIGHLY TRAINED, DEDICATED AND EXPERIENCED PSYCHIATRISTS, NURSES, SOCIAL WORKERS ACTIVITIES THERAPISTS AND CHEMICAL DEPENDENCY COUNSELORS, AS WELL AS MEDICAL, NEUROLOGICAL AND PSYCHOLOGICAL CONSULTANTS. IT HAS LONG BEEN RECOGNIZED THAT CERTAIN CHEMICALLY DEPENDANT PATIENTS DO NOT RESPOND TO STANDARD SUBSTANCE ABUSE TREATMENT. WE NOW KNOW THAT MANY OF THESE SO-CALLED TREATMENT-RESISTANT PATIENTS ARE, IN FACT, SUFFERING FROM TWO CONCURRENT ILLNESSES. OFTEN THESE DUALLY DIAGNOSED PATIENTS WERE TREATED EITHER FOR MENTAL HEALTH OR ADDICTIONS SYSTEMS, OR WERE SHUTTLED BACK AND FORTH BETWEEN THEM. FREQUENTLY, THIS FRAGMENTED APPROACH RESULTED IN TREATMENT FAILURE. THE DUAL FOCUS PROGRAM AT GRACIE SQUARE HOSPITAL PROVIDES SHORT TERM HOSPITALIZATION TO THE ACUTELY ILL PSYCHIATRIC PATIENT. OPERATING UNDER THE BELIEF THAT NO PATIENT SHOULD SPEND MORE TIME IN A HOSPITAL THAN IS ABSOLUTELY NECESSARY, THE PROGRAM IS CHARACTERIZED BY RAPID IN-DEPTH EVALUATIONS AND IMMEDIATE INITIATION OF TREATMENT. THE PROGRAM SWIFTLY AND EFFECTIVELY STABILIZES ACUTE SYMPTOMS, THEREBY MAKING IT POSSIBLE FOR PATIENTS TO LEAVE THE HOSPITAL AS QUICKLY AS POSSIBLE. PATIENTS CAN THEN CONTINUE TREATMENT IN A LESS RESTRICTIVE SETTING. OUR PROGRAM VIEWS HOSPITALIZATION AS A BRIEF COMPONENT IN THE CONTINUUM OF HEALTH CARE SERVICES AND PROVIDES COST EFFECTIVE ANDCREATIVE SOLUTIONS TO TREAT EPISODES OF SEVERE MENTAL ILLNESS. THE EXPERT MEDICAL, PSYCHIATRIC CLINICAL AND NURSING STAFF AT GRACIE SQUARE HOSPITAL CONDUCTS A THOROUGH EVALUATION OF EACH PATIENT'S PHYSICAL AND PSYCHOLOGICAL CONDITION IMMEDIATELY UPON ADMISSION TO THE PROGRAM. PAST TREATMENT EXPERIENCES ARE INVESTIGATED AND FAMILY MEMBERS ARE INTERVIEWED. A COMPREHENSIVE, INDIVIDUALIZED MULTIDISCIPLINARY TREATMENT PLAN IS FORMULATED, TARGETING THE MOST ACUTELY DEBILITATING BEHAVIORS AND SYMPTOMS. UTILIZING THE MOST ADVANCED KNOWLEDGE AND TECHNIQUES, THE TEAM INITIATES FOCUSED GOAL ORIENTED INTERVENTIONS WHICH MAY INCLUDE PSYCHOPHARMACOLOGY, CRISIS INTERVENTION, AND STABILIZATION OF ACUTE MEDICAL CONDITIONS. IN ORDER TO PREPARE FOR A SMOOTH TRANSITION TO THE NEXT PHASE OF TREATMENT, DISCHARGE PLANNING IS BEGUN AT THE TIME OF ADMISSION. THROUGH OUR AFFILIATED INVOLVEMENT WITH PARTIAL HOSPITALIZATION PROGRAMS,INTENSIVE OUTPATIENT CLINICS AND INDIVIDUAL PROVIDERS, WE ARE ABLE TO EFFECT THE MOST APPROPRIATE AND TIMELY REFERRALS, AS WELL AS PROVIDE COMPREHENSIVE INFORMATION ABOUT AVAILABLE COMMUNITY RESOURCES. SERVICES PROVIDED: *CO 36712922 true true false false false false false false false false true false false true true false true false false false false false false false false false true true false false true false false false false false false false false false false false false false true true true false false true 18 0 true 340 true false false false false false false false false false false X 10 6 true false false false true true false true true false false true true true true true true true true false NY X DAVID WIECKS CFO 2124345457 420 EAST 76 STREET new york NY 10021 X Mr Frank Bruno 60.0 X X 479700 0 36439 Mr Edward Ward Franklin 2.0 X 0 0 0 Mr Laurence Berger 1.0 X 0 396712 42068 E William Davis Jr MD 1.0 X 0 9735 13931 Mrs Vincent De Roulet 1.0 X 0 0 0 Mr Mark Larmore 2.0 X X 0 1380177 150762 Mr Adam Owett Sr 1.0 X 0 0 0 Mrs Cynthia Zirinsky 2.0 X X 0 0 0 Mr Joseph Peyronnin 1.0 X 0 0 0 Mr phillip j wilner 1.0 X 0 0 0 Mr David Wiecks 60.0 X 180373 0 28268 Kathleen M Burke ESQ 1.0 X 0 344549 45021 Ms Phyllis R Lantos 1.0 X 0 2164676 93843 Ms Hilde Lutz 60.0 X 182817 0 29171 Dr Roger Wolfsohn MD 40.0 X 293803 0 58547 Mr Chiang Kuo 60.0 X 150207 0 22079 dr juan baturone MD 53.0 X 238422 0 36370 Dr Igor Kirzhner MD 28.0 X 207692 0 10385 Purisima Tadeo 52.0 X 179771 0 160 Gemma Balquin 56.0 X 170210 0 22652 Yan Chun Mui 52.0 X 168212 0 22652 Dr Herbert Pardes 0.0 X 0 4053956 54780 2251207 8349805 667128 57 true true false Garfunkel Wild and Travis PC 175 Great Neck Road GREAT NECK NY 11021 Legal Services 326169 Vince Popesco MD 84-34 74th Avenue GLENDALE NY 11385 medical services 326575 Igor Kirzhner MD 2512 East 64th Street BROOKLYN NY 11234 medical services 187590 3 53445 53445 MEDICARE 622210 29168338 29168338 MEDICAID 622210 4047581 4047581 HMO/COMMERCIAL 622210 10974987 10974987 SELF PAY 622210 561983 561983 44752889 16794 16794 0 0 0 0 0 0 OFFICE RENTAL 622210 144287 144287 OTHER MISCELLANEOUS 622210 23662 23662 ABSTRACTS AND SUBPONAS 622210 5770 5770 173719 44996847 44926608 16794 0 0 0 0 1461404 736625 724779 0 17554568 16065327 1489241 971300 918919 52381 3186947 2938266 248681 1386635 1269000 117635 680596 667549 13047 605387 605387 193012 193012 0 0 0 5114259 4673501 440758 54550 54550 1020934 985089 35845 329181 48891 280290 0 1150216 1095006 55210 0 0 3642 2139 1503 719216 719216 44592 44592 821114 781701 39413 1201189 1197143 4046 BAD DEBT 2880000 2880000 MEDICAL EXPENSES 1103502 1103502 ALL OTHER EXPENSES 679731 576498 93453 9780 41161975 36712922 4439273 9780 0 0 7266707 9891729 0 0 4441685 4735824 0 0 0 0 0 0 38457 59350 421913 309840 16904548 9311679 6908321 7592869 0 0 0 0 0 0 0 0 2073403 1671666 21150486 24261278 3884934 3987727 0 0 0 0 0 0 0 0 0 0 13125000 12375000 0 0 1706728 1629855 18716662 17992582 X 2433824 6268696 0 0 0 0 2433824 6268696 21150486 24261278 3834872 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 9576585 4664652 4911933 6949407 4647027 2302380 378556 378556 7592869 DEPOSITS 21120 SELF INSURED TRUST FUND 1529000 DUE FROM THIRD PARTY PAYORS 121546 1671666 0 SELF INSURED PROF LIABILITIES 1486000 DUE TO RELATED ORGANIZATIONS 143855 1629855 44996847 41161975 3834872 3834872 44996847 44996847 44996847 41161975 41161975 41161975 true true X false false true true false false 1773131 0 1773131 0.04630 4437300 4058743 378558 0.00990 3390153 3022499 367654 0.00960 9600584 7081242 2519343 0.06580 9600584 7081242 2519343 0.06580 72796 0 72796 0.00190 12801 0 12801 0.00030 28991 0 28991 0.00080 114588 0 114588 0.00300 false 1423740 0 29281797 20827783 8454014 X true true 1 1 The New York Gracie Square Hospital Inc

420 East 76th STreet new york NY 10021

X psychiatric hospital The New York Gracie Square Hospital Inc 1 true false false true X X X X X X X true true X true X false false X X false false Schedule H, Supplemental Information PART I, LINE 3C: Gracie Square Hospital provides free or discounted care (charity care) to the medically indigent; those who lack the ability to pay for some or all or their medical expenses. Eligibility for charity care is based upon the patient's financial resources. PART I, LINE 7, COLUMN F Bad debt in the amount of $2,880,000 has been excluded from the total expenses utilized to compute the percentages that charity care and other community benefits represent as a percentage of adjusted expenses. PART I, LINE 7 Inpatient costs for the amounts reported were calculated on a cost per patient day basis. PART II See promotion of community health. PART III, LINE 4 The costs to provide care which has become uncollectible or bad debt has been calculated utilizing a cost to charge ratio. Payments, discounts and charity care are excluded from amounts considered to be bad debt. Receivables for Patient Care: Patient accounts receivable for which the Hospital receives payment under cost-based or prospective payment reimbursement formulae or negotiated rates, which cover the majority of the patient services, are stated at the estimated net amount receivable from such payors, which are generally less than the established billing rates of the Hospital. The amount of the allowance for uncollectibles is based on management's assessment of historical and expected collections, business economic conditions, trends in health care coverage and other collection indicators. Additions to the allowance for uncollectibles result from the provision for bad debts. Accounts written off as uncollectible are deducted from the allowance for uncollectibles. For the years ended December 31, 2011 and 2010, bad debt expense of approximately $2.9 million and $2.8 million, respectively. PART III, LINE 8 Medicare allowable costs are determined pursuant to the laws and regulations applicable to allowable costs and Medicare's cost step down methodology. PART III, LINE 9B Patients who are known to qualify for charity care are not subject to collection practices. PART V Needs Assessment Gracie Square Hospital continually monitors the health care needs of the community and the services which it can provide. During 2011 the Hospital had 96.8% occupancy rate evidencing a strong need for the Hospital's services within the community. Patient Education of Eligibility for Assistance Gracie Square Hospital educates patients about financial assistance that may be available to them including government run programs such as Medicare and Medicaid. The Hospital also assists patients in applying for such benefits. Community Information Gracie Square Hospital provides care primarily to patients residing in the greater New York City metropolitan area. Promotion of Community Health Gracie Square Hospital's commitment to our community and Hospital's exempt purpose is demonstrated by our goals and objectives. Successful attainment of our 2011 goals and objectives included maintenance and improvement of patient safety and the quality of services rendered to our patients, continued regulatory certification, an increased level of community service and continued capital infrastructure improvements. Gracie Square Hospital provides housing, clothing and other assistance to homeless patients upon discharge. Such assistance significantly reduces the chances of re-hospitalization. The Hospital also provided free mental health screenings, conducted educational presentations and provided free meeting space to several community based groups. Screening for Mental Health (SMH) is dedicated to promoting the improvement of mental health by providing the public with education, screening and treatment resources. SMH pioneered the concept of large-scale mental health screening and educational programs in 1991, with its flagship program, National Depression Screening Day (NDSD). SMH programs, provided both in-person and online, educate, raise awareness, and screen individuals for depression, bipolar disorder, generalized anxiety disorder, posttraumatic stress disorder, eating disorders, alcohol use disorders, and suicide. The Hospital participated in this community-based mental health screening event that was offered across the country as part of Mental Illness Awareness week. The goals of NDSD are to call attention to the prevalence of mental health disorders, as well as the availability of effective treatments for mental health disorders, and to connect those in need to the mental health care system. The program featured the following: an anonymous mental health self-assessment, a variety of education resources, a confidential interview with a mental health professional to discuss the results of the screening, a list of local referral resources. National Nutrition Month is a nutrition education and information campaign created by the American Dietetic Association. The campaign focuses attention on the importance of making informed food choices and developing sound eating and physical activity habits. The Hospital sponsored the event locally on each of the five days it was held. Scheduled community service events included: Nutritional Lectures, Nutritional Counseling, Health Food Sample Distribution and Body Fat Exams. The events were publicized in local community newspapers. The National Eating Disorders Association (NEDA) is a non-profit organization dedicated to supporting individuals and families affected by eating disorders. They campaign for prevention, improved access to quality treatment, and increased research funding to better understand and treat eating disorders. NEDAwareness Week is a collective effort of primary volunteers, including eating disorder professionals, health care providers, students, educators, social workers, and individuals committed to raising awareness of the dangers surrounding eating disorders and the need for early intervention and treatment. The Hospital sponsored the event locally. Our physicians and dieticians provided education and screenings. The majority of members of the Gracie Square Hospital's Board of Trustees reside in the community which the Hospital serves and are neither employees nor contractors of the Hospital, nor are members of their families. Requests for medical staff privileges are open to all qualified physicians within the community. During 2011 the Hospital was able to reduce its long term debt by $750,000 and invested $1,494,000 in capital improvement in order to increase patient safety and satisfaction, improve the Hospital's infrastructure and reduce energy consumption. To further our efforts to increase patient safety and satisfaction the Hospital expended $1,610,000 to provided private duty nurses to patients in need. Affiliated Health Care System Gracie Square Hospital is a member of the New York-Presbyterian Healthcare System. The New York-Presbyterian Healthcare System is a federation of top-quality hospitals, specialty institutes, and continuing care centers throughout New York, New Jersey, and Connecticut. It was founded to bring about a positive change in the way healthcare is delivered to the community. The New York-Presbyterian Healthcare System is dedicated to improving patient care, medical education and research throughout this region of the United States. Part V, Line 9 and 10 The Hospital provides free and discounted care to uninsured and under insured individuals. Free and discounted care is approved based upon an individual's financial resources. Part V, Line 11 Amounts charged to patients are calculated based upon the care provided, Medicare and Medicaid regulations, agreements with private insurers and individuals. Income level, asset level and medical indigency are also considered in calculating discounts for qualified individuals. Part V, Line 12 Financial assistance may be applied for by contacting the admitting office. Part V, Line 15, 16 and 17 Prior to making efforts to determine if an individual may be covered by the Hospital's financial assistance policy the Hospital will not, nor will it authorize a third party to, commence extraordinary collection efforts such as reporting to a credit agency, lawsuits or liens on residences. The Hospital may refer such accounts to a collection agency however such agencies are also prohibited from engaging in such extraordinary collection efforts without the approval of the Hospital. During 2011 the Hospital did not initiate any such extraordinary collection efforts. Part V, Line 19 The Hospital does not provide emergency medical care. The maximum amount charged to individuals under the financial assistance policy was set at a rate below the average rate paid by non-means tested commercial payors. X X X X X false false false false false false false true false Mr Frank Bruno 375156 0 77000 0 27544 0 24500 0 11939 0 516139 0 0 0 Mr David Wiecks 157573 0 6000 0 16800 0 12776 0 15492 0 208641 0 0 0 Mr Laurence Berger 0 300047 0 62292 0 34373 0 17150 0 24918 0 438780 0 0 Mr Mark Larmore 0 666221 0 549468 0 164488 0 113178 0 37584 0 1530939 0 14649 Kathleen M Burke ESQ 0 284455 0 54174 0 5920 0 24500 0 20521 0 389570 0 0 Ms Phyllis R Lantos 0 835847 0 828613 0 500216 0 59494 0 34349 0 2258519 0 169720 Ms Hilde Lutz 174345 0 6000 0 2472 0 18169 0 11002 0 211988 0 0 0 Dr Roger Wolfsohn MD 244114 0 27000 0 22689 0 19600 0 38947 0 352350 0 0 0 dr juan baturone MD 214607 0 0 0 23815 0 16833 0 19537 0 274792 0 0 0 Dr Igor Kirzhner MD 207692 0 0 0 0 0 10385 0 0 0 218077 0 0 0 Mr Chiang Kuo 149517 0 0 0 690 0 10500 0 11579 0 172286 0 0 0 Purisima Tadeo 179771 0 0 0 0 0 0 0 160 0 179931 0 0 0 Gemma Balquin 170010 0 0 0 200 0 8216 0 14436 0 192862 0 0 0 Yan Chun Mui 151512 0 0 0 16700 0 8216 0 14436 0 190864 0 0 0 Dr Herbert Pardes 0 1712792 0 1841009 0 500155 0 24500 0 30280 0 4108736 0 0 Supplemental Information Schedule J, Part I, Line 7 All bonuses are granted at the discretion of and approved by the compensation committee of the Board of Trustees; they are based on the achievement of predetermined goals and objectives. Form 990, Part VII, Section A Certain officers and key employees of the New York and Presbyterian Hospital that are identified in Part VII as officers or Trustees of The New York Gracie Square Hospital, Inc. are responsible for executing the mission and management of The New York and Presbyterian Hospital (NYP) and its affiliated entities. Compensation for 2011 of these upper level executives includes the payout of an annual incentive plan and a long-term incentive plan. This performance-oriented program conditions payments upon the achievement of multiple individual and group performance measures. Measures to monitor performance include: operational and financial strength, patient quality and safety, patient satisfaction, advancement of patient care, and people development and partnership. Incentive awards may only be granted if the organization achieves a financial surplus. Even if all relevant performance measurements are achieved, the NYP Board of Trustees retains full discretion to make or not make any incentive awards, or to reduce the amount of any incentive award. This initiative is critical to assuring that NYP has the requisite leadership to create and manage a highly motivated and engaged workforce, to drive superior performance throughout the organization and to achieve top tier medical center status. As a separate matter, due to restrictions imposed by the Internal Revenue Code, upper level executives are limited in the amount of benefits received under a tax-qualified retirement plan. Like many employers, NYP supplements these executives' pension benefits through a supplemental ("nonqualified") retirement plan. The supplemental executive retirement plan (SERP) is subject to a multi-year vesting requirement which places an executive's supplemental retirement benefit at risk of forfeiture if the vesting requirements are not satisfied. Once vested, however, provisions of the Internal Revenue Code require that the vested executive include in current income the value of his or her vested supplemental retirement benefit. Notwithstanding the legal requirement to recognize the vested value of the supplemental retirement benefit as current income, the supplemental retirement benefit will not be distributed to the executive until the executive actually retires from NYP (although, as permitted by the Internal Revenue Code, the supplemental retirement plan will effect a distribution of an amount necessary to satisfy the executive's tax liability resulting from the income recognition upon vesting). As noted, this supplemental retirement benefit will not be distributed to the executive until the executive actually retires from NYP. There are constantly changing legal, tax, accounting, and public disclosure rules for a SERP (supplemental executive retirement plan) in not-for-profit organizations. The executive Compensation Committee continuously monitors these changes and incorporates any changes into the overall SERP plan design. In 2010, the plan was redesigned in anticipation of changes in deferred compensation rules in the not-for-profit environment and to make the value of the benefit easier to understand for participants. The redesigned plan maintains the target level of SERP benefits and modifies the vesting schedules to commence after five years of participation in the SERP, in prorated amounts through age 65. Consequently, for certain individuals, there is an increase in the amount reflected in the SERP compensation due to the change in the vesting and amortization periods. As noted, this supplemental retirement benefit will not be distributed to the executive until the executive actually retires from NYP. As in past years, the executive Compensation Committee of NYP requires a third party complete a review of the organization's compensation program to ensure its effectiveness in terms of government regulations, market conditions and the need to continually elevate organizational performance. The report also serves to meet the regulatory obligations to ensure that all elements of the executive compensation programs are reasonable. The individuals listed in Part VII that are compensated by New York Presbyterian Hospital devote an average of sixty hours per week to perform their responsibilities for the New York Presbyterian Hospital and other related organizations in the aggregate. FORM 990, PART VII, COLUMN B THE HOURS SHOWN FOR EACH OFFICER AND KEY EMPLOYEE ARE ESTIMATED AVERAGE HOURS PER WEEK DEVOTED TO HIS/HER RESPONSIBILITIES FOR THE HOSPITAL. 13 OF THE 53 HOURS PER WEEK PROVIDED BY DR. BATURONE WERE FOR ON-CALL SERVICES. Family Relationships Form 990, Part VI, Line 2 BOARD MEMBERS MRS. CYNTHIA ZIRINSKY AND MR. JOSEPH PEYRONNIN HAVE A FAMILY RELATIONSHIP. Organization's Members Form 990, Part VI, Lines 6 & 7a The New York Gracie Square Hospital, Inc. is a membership corporation, whose members are appointed by New York-Presbyterian Healthcare System, Inc. ("System Inc."). System Inc. is a tax-exempt organization whose members are appointed by New York-Presbyterian Foundation, Inc., which is also a tax-exempt organization. The members of the organization elect the Organization's board of trustees. REVIEW PROCESS FOR THE FORM 990 Form 990, PArt VI, Line 11b THE HOSPITAL'S CONTROLLER PREPARES AND COMPILES SUPPORTING WORK PAPERS AND RELATED DOCUMENTS REQUIRED TO PREPARE THE FORM 990 AND RELATED SCHEDULES (THE "RETURN") THAN PREPARES A DRAFT OF THE RETURN TO BE REVIEWED BY THE HOSPITAL'S CHIEF FINANCIAL OFFICER ("CFO"). UPON SATISFACTORY REVIEW BY THE CFO THE DRAFT RETURN IS FORWARDED TO ERNST & YOUNG U.S. LLP (E&Y). E&Y PERFORMS REVIEW PROCEDURES DESIGNED TO EVALUATE THE CORRECTNESS AND MECHANICAL ACCURACY OF THE RETURN. UPON COMPLETION OF THEIR REVIEW PROCEDURES, E&Y PREPARES A FINAL DRAFT WHICH IS REVIEWED BY THE HOSPITAL'S CFO and presented to the audit committee for approval. Upon such approval it is PRESENTED TO THE BOARD OF TRUSTEES FOR APPROVAL. A COPY OF THE APPROVED RETURN IS PROVIDED TO ALL MEMBERS OF THE BOARD OF TRUSTEES, PRIOR TO ITS FILING WITH THE IRS. MONITOR AND ENFORCE COMPLIANCE WITH POLICIES CONFLICT OF INTEREST Form 990, Part VI, Line 12c QUESTIONNAIRES ARE OBTAINED FROM OFFICERS, TRUSTEES AND KEY EMPLOYEES UPON APPOINTMENT OR HIRE AND ON AN ANNUAL BASIS THEREAFTER. THE QUESTIONNAIRES ARE ALSO REQUIRED TO BE UPDATED BY THESE INDIVIDUALS AT ANY TIME THAT THERE IS A CHANGE IN THEIR CIRCUMSTANCES THAT WOULD ALTER THEIR PRIOR DISCLOSURES. THE QUESTIONNAIRES ARE REVIEWED BY THE HOSPITAL'S CORPORATE COMPLIANCE OFFICER ("CCO"). ANY POTENTIAL CONFLICTS OF INTEREST ARE REPORTED TO THE HOSPITAL'S CHIEF EXECUTIVE OFFICER ("CEO"). IF A POTENTIAL CONFLICT IS NOT RESOLVED THE HOSPITAL WOULD REFER THE MATTER TO LEGAL COUNSEL AND REPORT IT TO THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF TRUSTEES (THE "COMMITTEE"). THE CEO OR CCO REPORTS ON THE STATUS OF THE HOSPITALS COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY TO THE COMMITTEE ON AN ANNUAL BASIS. COMPENSATION APPROVAL PROCESS Form 990, Part VI, Lines 15a & 15b THE HOSPITAL'S EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES (THE "COMMITTEE") OVERSEES MATTERS CONCERNING COMPENSATION AND BENEFITS FOR OFFICERS AND OTHER EXECUTIVES. THE MEMBERS OF THE COMMITTEE INCLUDE INDEPENDENT TRUSTEES. PART OF THE COMMITTEES DELIBERATION AND DECISION PROCESS INCLUDES REVIEW OF COMPARABLE AND CONTEMPORANEOUS DATA. ACCESS TO ORGANIZATIONAL DOCUMENTS Form 990, Part VI, Line 19 INSPECTION OF THE HOSPITAL'S FORM 990, GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS WILL BE ARRANGED UPON REQUEST. AVERAGE HOURS DEVOTED TO RELATED ORGANIZATIONS Form 990, Part VII, Section A Certain officers and key employees of the New York and Presbyterian Hospital that are identified in Part VII as officers or Trustees of The New York Gracie Square Hospital, Inc. are responsible for executing the mission and management of The New York and Presbyterian Hospital (NYP) and its affiliated entities. Compensation for 2011 of these upper level executives includes the payout of an annual incentive plan and a long-term incentive plan. This performance-oriented program conditions payments upon the achievement of multiple individual and group performance measures. Measures to monitor performance include: operational and financial strength, patient quality and safety, patient satisfaction, advancement of patient care, and people development and partnership. Incentive awards may only be granted if the organization achieves a financial surplus. Even if all relevant performance measurements are achieved, the NYP Board of Trustees retains full discretion to make or not make any incentive awards, or to reduce the amount of any incentive award. This initiative is critical to assuring that NYP has the requisite leadership to create and manage a highly motivated and engaged workforce, to drive superior performance throughout the organization and to achieve top tier medical center status. As a separate matter, due to restrictions imposed by the Internal Revenue Code, upper level executives are limited in the amount of benefits received under a tax-qualified retirement plan. Like many employers, NYP supplements these executives' pension benefits through a supplemental ("nonqualified") retirement plan. The supplemental executive retirement plan (SERP) is subject to a multi-year vesting requirement which places an executive's supplemental retirement benefit at risk of forfeiture if the vesting requirements are not satisfied. Once vested, however, provisions of the Internal Revenue Code require that the vested executive include in current income the value of his or her vested supplemental retirement benefit. Notwithstanding the legal requirement to recognize the vested value of the supplemental retirement benefit as current income, the supplemental retirement benefit will not be distributed to the executive until the executive actually retires from NYP (although, as permitted by the Internal Revenue Code, the supplemental retirement plan will effect a distribution of an amount necessary to satisfy the executive's tax liability resulting from the income recognition upon vesting). As noted, this supplemental retirement benefit will not be distributed to the executive until the executive actually retires from NYP. There are constantly changing legal, tax, accounting, and public disclosure rules for a SERP (supplemental executive retirement plan) in not-for-profit organizations. The executive Compensation Committee continuously monitors these changes and incorporates any changes into the overall SERP plan design. In 2010, the plan was redesigned in anticipation of changes in deferred compensation rules in the not-for-profit environment and to make the value of the benefit easier to understand for participants. The redesigned plan maintains the target level of SERP benefits and modifies the vesting schedules to commence after five years of participation in the SERP, in prorated amounts through age 65. Consequently, for certain individuals, there is an increase in the amount reflected in the SERP compensation due to the change in the vesting and amortization periods. As noted, this supplemental retirement benefit will not be distributed to the executive until the executive actually retires from NYP. As in past years, the executive Compensation Committee of NYP requires a third party complete a review of the organization's compensation program to ensure its effectiveness in terms of government regulations, market conditions and the need to continually elevate organizational performance. The report also serves to meet the regulatory obligations to ensure that all elements of the executive compensation programs are reasonable. The individuals listed in Part VII that are compensated by New York Presbyterian Hospital devote an average of sixty hours per week to perform their responsibilities for the New York Presbyterian Hospital and other related organizations in the aggregate. 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