TY 2011 Form 990

- TIN:

Form990

Department of the Treasury
Internal Revenue Service

Return of Organization Exempt From Income Tax

Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

The organization may have to use a copy of this return to satisfy state reporting requirements.

OMB No. 1545-0047

2011

Open to Public Inspection

A For the calendar year, or tax year beginning 01-01-2011 and ending 12-31-2011

BCheck if applicable: Address change Name change Initial return Terminated Amended return Application pending

CName of organization
The New York Gracie Square Hospital Inc

Doing Business As

Number and street (or P.O. box if mail is not delivered to street address)
420 East 76 Street

Room/suite

City or town, state or country, and ZIP + 4
New York, NY10021

D Employer identification number

13-3746997

E Telephone number

G Gross receipts $ 44,996,847

F Name and address of principal officer:
FRANK BRUNO
420 EAST 76 STREET
NEW YORK,NY10021

Tax-exempt status: 501(c)(3) 501(c) ( ) LeftBullet

(insert no.) 4947(a)(1) or 527

Website:

www.nygsh.org

H(a)

Is this a group return for
affiliates? Yes No

H(b)

Are all affiliates included?

Yes No

If "No," attach a list. (see instructions)

H(c)

Group exemption number MediumBullet

K Form of organization: Corporation Trust Association Other MediumBullet

L Year of formation: 1958

M State of legal domicile: NY

Part I

Summary

1	Briefly describe the organization’s mission or most significant activities: 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.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a).....	3	10
4	Number of independent voting members of the governing body (Part VI, line 1b) ....	4	6
5	Total number of individuals employed in calendar year 2011 (Part V, line 2a) ...	5	340
6	Total number of volunteers (estimate if necessary) ....	6	0
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ..	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 ..	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	57,225	53,445
9	Program service revenue (Part VIII, line 2g) .........	44,084,457	44,752,889
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	17,713	16,794
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	127,477	173,719
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	44,286,872	44,996,847
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	24,299,643	24,560,854
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 9,780
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f)....	15,885,113	16,601,121
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	40,184,756	41,161,975
19	Revenue less expenses. Subtract line 18 from line 12.......	4,102,116	3,834,872
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	21,150,486	24,261,278
21	Total liabilities (Part X, line 26).............	18,716,662	17,992,582
22	Net assets or fund balances. Subtract line 21 from line 20.....	2,433,824	6,268,696

Part II

Signature Block

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.

Sign Here

	Signature of officer	Date

	Type or print name and title.

Paid preparer use only

Print/type preparer's name

Preparer's signature

Date

Check if
self-employed

PTIN

Firm's name Right pointing arrowhead image

Firm's EIN Right pointing arrowhead image

Firm's address Right pointing arrowhead image

Phone no.

May the IRS discuss this return with the preparer shown above? See instructions ......... bullet

YesNo

For Paperwork Reduction Act Notice, see the separate instructions.

Cat. No. 11282Y

Form 990 (2011)

Page 2

Part III

Statement of Program Service Accomplishments

Check if Schedule O contains a response to any question in this Part III .........

Briefly describe the organization’s mission: 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.

Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .................... Yes No

If “Yes,” describe these new services on Schedule O.

Did the organization cease conducting, or make significant changes in how it conducts, any program services? .......................... Yes No

If “Yes,” describe these changes on Schedule O.

Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.


4a	(Code: ) (Expenses $ 36,712,922 including grants of $ 0 ) (Revenue $ 44,926,608 )
	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

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses$ 36,712,922

Form 990 (2011)

Page 3

Part IV

Checklist of Required Schedules

Yes

Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule A Click to see attachment

.....................

Yes

Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment

........

Yes

Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I..........

Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part II.........................

Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................

Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete Schedule D, Part I Click to see attachment

....................

Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part II Click to see attachment

...

Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment

....................

Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IV Click to see attachment

...................

Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part V Click to see attachment

If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:

Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI. Click to see attachment

11a

Yes

Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII. Click to see attachment

11b

Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII. Click to see attachment

11c

Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX. Click to see attachment

11d

Yes

Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X. Click to see attachment

11e

Yes

Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X. Click to see attachment

11f

12a

Did the organization obtain separate, independent audited financial statements for the tax year?
If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment

12a

Yes

Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment

12b

Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E

14a

Did the organization maintain an office, employees, or agents outside of the United States?....

14a

Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Part I.........

14b

Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..

Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..

Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I

Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........

Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................

20a

Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment

20a

Yes

If “Yes” to line 20a, did the organization attach a copy of its audited financial statement to this return? Note. All Form 990 filers that operated one or more hospitals must attach audited financial statements. Click to see list of attachments

20b

Yes

Form 990 (2011)

Page 4

Part IV

Checklist of Required Schedules (continued)

Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II..

Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III.....

Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment

Yes

24a

Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................

24a

Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...

24b

Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................

24c

Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...

24d

25a

Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I......

25a

Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................

25b

Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II.........................

Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III.........

Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):

A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV .........................

28a

A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV...................

28b

An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV..

28c

Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M

Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............

Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................

Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................

Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment

Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment

Yes

35a

Did the organization have a controlled entity within the meaning of section 512(b)(13)?

35a

Yes

If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment

35b

Yes

Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment

Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VI Click to see attachment

Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............

Yes

Form 990 (2011)

Page 5

Part V

Statements Regarding Other IRS Filings and Tax Compliance

Check if Schedule O contains a response to any question in this Part V .........

Yes

Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......

Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.

Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................

Yes

Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................

340

If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)

Yes

Did the organization have unrelated business gross income of $1,000 or more during the year?.............................

If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....

At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................

If "Yes," enter the name of the foreign country: MediumBullet

See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.

Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..

Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?

If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........

Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........

If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................

Organizations that may receive deductible contributions under section 170(c).

Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................

If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....

Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................

If “Yes,” indicate the number of Forms 8282 filed during the year ....

Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................

Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..

If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................

If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............

Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................

Sponsoring organizations maintaining donor advised funds.

Did the organization make any taxable distributions under section 4966?.........

Did the organization make a distribution to a donor, donor advisor, or related person?......

Section 501(c)(7) organizations. Enter:

Initiation fees and capital contributions included on Part VIII, line 12 ...

10a

Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities

10b

Section 501(c)(12) organizations. Enter:

Gross income from members or shareholders .........

11a

Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them) ........

11b

12a

Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?

12a

If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.

12b

Section 501(c)(29) qualified nonprofit health insurance issuers.

Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.

13a

Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.

13b

Enter the aggregate amount of reserves on hand.

13c

14a

Did the organization receive any payments for indoor tanning services during the tax year?.....

14a

If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..

14b

Form 990 (2011)

Page 6

Part VI

Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.

Check if Schedule O contains a response to any question in this Part VI .........

Section A. Governing Body and Management

Yes

Enter the number of voting members of the governing body at the end of the tax year
If the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.

Enter the number of voting members included in line 1a, above, who are independent .................

Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................

Yes

Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .

Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?

Did the organization become aware during the year of a significant diversion of the organization’s assets? .

Did the organization have members or stockholders? ................

Yes

Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? .................

Yes

Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ............

Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:

The governing body? .........................

Yes

Each committee with authority to act on behalf of the governing body? ..........

Yes

Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....

Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)

Yes

10a

Did the organization have local chapters, branches, or affiliates? ............

10a

If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes? ....

10b

11a

Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?

11a

Yes

Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....

12a

Did the organization have a written conflict of interest policy? If “No,” go to line 13.......

12a

Yes

Were officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ........................

12b

Yes

Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done ....................

12c

Yes

Did the organization have a written whistleblower policy? ...............

Yes

Did the organization have a written document retention and destruction policy? .........

Yes

Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?

The organization’s CEO, Executive Director, or top management official ...........

15a

Yes

Other officers or key employees of the organization ................

15b

Yes

If "Yes," to line 15a or 15b, describe the process in Schedule O (see instructions).

16a

Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................

16a

If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............

16b

Section C. Disclosure

List the States with which a copy of this Form 990 is required to be filed MediumBullet

Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.

Own website Another's website Upon request

Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.

State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet

DAVID WIECKS CFO
420 EAST 76 STREET
new york,NY10021
(212) 434-5457

Form 990 (2011)

Page 7

Part VII

Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors

Check if Schedule O contains a response to any question in this Part VII .........

Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees

1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet

List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

List all of the organization’s current key employees, if any. See instructions for definition of "key employee."

List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.

Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)				(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(1) Mr Frank Bruno President & CEO	60.0	X	X			479,700	0	36,439
(2) Mr Edward Ward Franklin Board Member	2.0	X				0	0	0
(3) Mr Laurence Berger Board Member	1.0	X				0	396,712	42,068
(4) E William Davis Jr MD Board Member	1.0	X				0	9,735	13,931
(5) Mrs Vincent De Roulet Board Member	1.0	X				0	0	0
(6) Mr Mark Larmore asst treasurer	2.0	X	X			0	1,380,177	150,762
(7) Mr Adam Owett Sr Board Member	1.0	X				0	0	0
(8) Mrs Cynthia Zirinsky chairperson of the board	2.0	X	X			0	0	0
(9) Mr Joseph Peyronnin board member	1.0	X				0	0	0
(10) Mr phillip j wilner board member	1.0	X				0	0	0
(11) Mr David Wiecks Chief Financial Officer	60.0		X			180,373	0	28,268
(12) Kathleen M Burke ESQ Secretary	1.0		X			0	344,549	45,021
(13) Ms Phyllis R Lantos Treasurer	1.0		X			0	2,164,676	93,843
(14) Ms Hilde Lutz director of nursing	60.0			X		182,817	0	29,171
(15) Dr Roger Wolfsohn MD Medical director	40.0			X		293,803	0	58,547
(16) Mr Chiang Kuo asst administrator	60.0			X		150,207	0	22,079
(17) dr juan baturone MD psychiatrist	53.0				X	238,422	0	36,370

Form 990 (2011)

Page 8

Part VII

Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)			(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) Dr Igor Kirzhner MD psychatrist	28.0	X		207,692	0	10,385
(19) Purisima Tadeo Registered Nurse	52.0	X		179,771	0	160
(20) Gemma Balquin Registered Nurse	56.0	X		170,210	0	22,652
(21) Yan Chun Mui registered nurse	52.0	X		168,212	0	22,652
(22) Dr Herbert Pardes Board Member	0.0		X	0	4,053,956	54,780

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	2,251,207	8,349,805	667,128

Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet

Yes

Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............

Yes

For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................

Yes

Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....

Section B. Independent Contractors

Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.

(A) Name and business address	(B) Description of services	(C) Compensation
Garfunkel Wild and Travis PC 175 Great Neck Road GREAT NECK,NY11021	Legal Services	326,169
Vince Popesco MD 84-34 74th Avenue GLENDALE,NY11385	medical services	326,575
Igor Kirzhner MD 2512 East 64th Street BROOKLYN,NY11234	medical services	187,590


2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 3

Form 990 (2011)

Page 9

Part VIII

Statement of Revenue

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d
e	Government grants (contributions)1e

f	All other contributions, gifts, grants, and similar amounts not included above1f		53,445
g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			53,445
			Business Code
2a	MEDICARE		622,210	29,168,338	29,168,338
b	MEDICAID		622,210	4,047,581	4,047,581
c	HMO/COMMERCIAL		622,210	10,974,987	10,974,987
d	SELF PAY		622,210	561,983	561,983
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			44,752,889
3	Investment income (including dividends, interest
	and other similar amounts).....			16,794			16,794
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties............			0
		(i) Real	(ii) Personal
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)
d	Net rental income or (loss).......
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory
b	Less: cost or other basis and sales expenses
c	Gain or (loss)
d	Net gain or (loss)..........			0
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...			0
10a	Gross sales of inventory, less returns and allowances .
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..			0
Miscellaneous Revenue			Business Code
11a	OFFICE RENTAL		622,210	144,287	144,287
b	OTHER MISCELLANEOUS		622,210	23,662	23,662
c	ABSTRACTS AND SUBPONAS		622,210	5,770	5,770
d	All other revenue ....
e	Total. Add lines 11a–11d ......			173,719
12	Total revenue. See Instructions....			44,996,847	44,926,608		16,794

Form 990 (2011)

Page 10

Part IX

Statement of Functional Expenses

Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Check if Schedule O contains a response to any question in this Part IX. .........

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.		(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to governments and organizations in the United States. See Part IV, line 21	0
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	1,461,404	736,625	724,779
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	17,554,568	16,065,327	1,489,241
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	971,300	918,919	52,381
9	Other employee benefits .......	3,186,947	2,938,266	248,681
10	Payroll taxes ...........	1,386,635	1,269,000	117,635
11	Fees for services (non-employees):
a	Management ......	680,596	667,549	13,047
b	Legal .........	605,387		605,387
c	Accounting ...........	193,012		193,012
d	Lobbying ...........	0
e	Professional fundraising. See Part IV, line 17..	0
f	Investment management fees ......	0
g	Other ..........	5,114,259	4,673,501	440,758
12	Advertising and promotion ....	54,550	54,550
13	Office expenses .......	1,020,934	985,089	35,845
14	Information technology ......	329,181	48,891	280,290
15	Royalties ..	0
16	Occupancy ...........	1,150,216	1,095,006	55,210
17	Travel ............	0
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	3,642	2,139	1,503
20	Interest ...........	719,216	719,216
21	Payments to affiliates .......	44,592		44,592
22	Depreciation, depletion, and amortization .....	821,114	781,701	39,413
23	Insurance ..............	1,201,189	1,197,143	4,046
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24f. If line 24f amount exceeds 10% of line 25, column (A) amount, list line 24f expenses on Schedule O.)
a	BAD DEBT	2,880,000	2,880,000
b	MEDICAL EXPENSES	1,103,502	1,103,502
c	ALL OTHER EXPENSES	679,731	576,498	93,453	9,780
d
e
f	All other expenses
25	Total functional expenses. Add lines 1 through 24f	41,161,975	36,712,922	4,439,273	9,780
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Form 990 (2011)

Page 11


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing ..........			0	1	0
2	Savings and temporary cash investments .......			7,266,707	2	9,891,729
3	Pledges and grants receivable, net .........			0	3	0
4	Accounts receivable, net .........			4,441,685	4	4,735,824
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........			0	5	0
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........			0	6	0
7	Notes and loans receivable, net .............			0	7	0
8	Inventories for sale or use ..............			38,457	8	59,350
9	Prepaid expenses and deferred charges ............			421,913	9	309,840
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	16,904,548
b	Less: accumulated depreciation. .....	10b	9,311,679	6,908,321	10c	7,592,869
11	Investments—publicly traded securities ..........			0	11	0
12	Investments—other securities. See Part IV, line 11 ......			0	12	0
13	Investments—program-related. See Part IV, line 11 ..			0	13	0
14	Intangible assets .........			0	14	0
15	Other assets. See Part IV, line 11 ...........			2,073,403	15	1,671,666
16	Total assets. Add lines 1 through 15 (must equal line 34)...			21,150,486	16	24,261,278
17	Accounts payable and accrued expenses .			3,884,934	17	3,987,727
18	Grants payable ..........			0	18	0
19	Deferred revenue ..........			0	19	0
20	Tax-exempt bond liabilities ..........			0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D..			0	21	0
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........			0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..			13,125,000	23	12,375,000
24	Unsecured notes and loans payable to unrelated third parties ....			0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.....			1,706,728	25	1,629,855
26	Total liabilities. Add lines 17 through 25.....			18,716,662	26	17,992,582
	Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....			2,433,824	27	6,268,696
28	Temporarily restricted net assets .....			0	28	0
29	Permanently restricted net assets .....			0	29	0
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances .....			2,433,824	33	6,268,696
34	Total liabilities and net assets/fund balances .....			21,150,486	34	24,261,278

Form 990 (2011)

Page 12

Part XI

Reconcilliation of Net Assets

Check if Schedule O contains a response to any question in this Part XI .........

Total revenue (must equal Part VIII, column (A), line 12) ...

44,996,847

Total expenses (must equal Part IX, column (A), line 25) ....

41,161,975

Revenue less expenses. Subtract line 2 from line 1 ...

3,834,872

Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..

2,433,824

Other changes in net assets or fund balances (explain in Schedule O) ...

Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) ....

6,268,696

Part XII

Financial Statements and Reporting

Check if Schedule O contains a response to any question in this Part XII .........

Yes

Accounting method used to prepare the Form 990: Cash Accrual Other
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.

Were the organization’s financial statements compiled or reviewed by an independent accountant?....

Were the organization’s financial statements audited by an independent accountant?........

Yes

If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant? If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O. ...........................

Yes

If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:

Separate basis Consolidated basis Both consolidated and separated basis

As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................

If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..

Form 990 (2011)

Additional Data

Software ID:
Software Version:

Form 990, Special Condition Description:

Special Condition Description

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2011

Open to Public
Inspection

Name of the organization

The New York Gracie Square Hospital Inc

Employer identification number

13-3746997

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches. section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in

section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of

its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses

acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. Seesection 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Other

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

and (iii) below, the governing body of the the supported organization? ................

11g(i)

(ii) a family member of a person described in (i) above? ......................

11g(ii)

(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................

11g(iii)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization in col. (i) listed in your governing document?		(v) Did you notify the organization in col. (i) of your support?		(vi) Is the organization in col. (i) organized in the U.S.?		(vii) Amount of support?
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of support?


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2011

Page 2

Part II

Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3..
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public Support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year(or fiscal year beginning in)		(a) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11	Total support (Add lines 7 through 10).

Gross receipts from related activities, etc. (See instructions.) ..................

First Five Years If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.......................................... right arrow

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f)) .........

Public Support Percentage for 2009 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2011. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ...................... right arrow

33 1/3% support test—2010. If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2011. If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization .................................................. right arrow

10%-facts-and-circumstances test—2010. If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly
supported organization .............................................. right arrow

Private Foundation If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions ................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2011

Page 3

Part III

Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public Support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13	Total support (Add lines 9, 10c, 11 and 12.).

Section C. Computation of Public Support Percentage

Public Support Percentage for 2011 (line 8 column (f) divided by line 13 column (f)) .........

Public support percentage from 2010 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2011 (line 10c column (f) divided by line 13 column (f)) ......

Investment income percentage from 2010 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2011. If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .......... right arrow

33 1/3% support tests—2010. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private Foundation If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2011

Page 4

Part IV

Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2011

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

OMB No. 1545-0047

2011

Name of organization

The New York Gracie Square Hospital Inc

Employer identification number

13-3746997

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not total to more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year. ......................... Arrow Bullet

Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on Part I, line 2, of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 2

Name of organization The New York Gracie Square Hospital Inc
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Part I	Contributors (see Instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTED RESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 3

Name of organization The New York Gracie Square Hospital Inc
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Part II	Noncash Property (see Instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 4

Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Name of organization
The New York Gracie Square Hospital Inc

Employer identification number

13-3746997

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

$
Use duplicate copies of Part III if additional space is needed

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

The New York Gracie Square Hospital Inc

Employer identification number

13-3746997

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .......
2	Aggregate contributions to (during year) ...
3	Aggregate grants from (during year) ...
4	Aggregate value at end of year .......

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ....................	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................

Yes No

In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:

(i)

Revenues included in Form 990, Part VIII, line 1 ........................ SchDMd Bullet

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958), relating to these items:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 52283D

Schedule D (Form 990) 2011

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIV and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

If “Yes,” explain the arrangement in Part XIV.

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current Year	(b)Prior Year	(c)Two Years Back	(d)Three Years Back	(e)Four Years Back
1a	Beginning of year balance ....
b	Contributions ........
c	Net investment earnings, gains, and losses ...
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the year end balance (line 1g) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages in lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIV the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment. See Form 990, Part X, line 10.

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................
b	Buildings ................
c	Leasehold improvements ............	9,576,585	4,664,652	4,911,933
d	Equipment ................	6,949,407	4,647,027	2,302,380
e	Other .................	378,556		378,556
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				7,592,869

Schedule D (Form 990) 2011

Page 3

Part VII

InvestmentsOther Securities. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)		(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. See Form 990, Part X, line 13.

(a) Description of investment type		(b) Book value	(c) Method of valuation: Cost or end-of-year market value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) DEPOSITS				21,120
(2) SELF INSURED TRUST FUND				1,529,000
(3) DUE FROM THIRD PARTY PAYORS				121,546






Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				1,671,666

Part X

Other Liabilities. See Form 990, Part X, line 25.

1.(a) Description of Liability		(b) Book value
Federal Income Taxes		0
SELF INSURED PROF LIABILITIES		1,486,000
DUE TO RELATED ORGANIZATIONS		143,855







Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		1,629,855
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).

Schedule D (Form 990) 2011

Page 4

Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1	Total revenue (Form 990, Part VIII, column (A), line 12) ....................	1	44,996,847
2	Total expenses (Form 990, Part IX, column (A), line 25) .....................	2	41,161,975
3	Excess or (deficit) for the year. Subtract line 2 from line 1 .............	3	3,834,872
4	Net unrealized gains (losses) on investments ..........................	4
5	Donated services and use of facilities .............................	5
6	Investment expenses ...................................	6
7	Prior period adjustments ..................................	7
8	Other (Describe in Part XIV.) .................................	8
9	Total adjustments (net). Add lines 4 through 8 .........................	9
10	Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 .........	10	3,834,872

Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1	Total revenue, gains, and other support per audited financial statements .......		1	44,996,847
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIV.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1.....................		3	44,996,847
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIV.) ...........	4b
c	Add lines 4a and 4b.......................		4c
5	Total Revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5	44,996,847

Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1	Total expenses and losses per audited financial statements .............		1	41,161,975
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIV.) ............	2d
e	Add lines 2a through 2d......................		2e
3	Subtract line 2e from line 1.....................		3	41,161,975
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIV.) ............	4b
c	Add lines 4a and 4b.......................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5	41,161,975

Part XIV

Supplemental Information

Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.

Identifier	Return Reference	Explanation

Schedule D (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

The New York Gracie Square Hospital Inc

Employer identification number

13-3746997

Part I

Charity Care and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a....

Yes

If "Yes," was it a written policy? .......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

100% 150% 200% Other

Did the organization use FPG to determine eligibility for providing discounted care? If "Yes," indicate which of the

following was the family income limit for eligibility for discounted care: ............

200% 250% 300% 350% 400% Other

If the organization did not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount?......

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care?...............

Did the organization prepare a community benefit report during the tax year?...........

If "Yes," did the organization make it available to the public? ...............

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a Financial Assistance at cost (from Worksheet 1) ..	1,773,131	0	1,773,131	4.630 %
b Medicaid (from Worksheet 3, column a) .....	4,437,300	4,058,743	378,558	0.990 %
c Costs of other means-tested government programs (from Worksheet 3, column b) .	3,390,153	3,022,499	367,654	0.960 %
dTotal Financial Assistance and Means-Tested Government Programs .....	9,600,584	7,081,242	2,519,343	6.580 %
Other Benefits e Community health improvement services and community benefit operations (from (Worksheet 4) ....
f Health professions education (from Worksheet 5) ..
g Subsidized health services (from Worksheet 6) ..
h Research (from Worksheet 7)
i Cash and in-kind contributions for community benefit (from Worksheet 8) ....
jTotal Other Benefits ...
kTotal. Add lines 7d and 7j. ..	9,600,584	7,081,242	2,519,343	6.580 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2011

Schedule H (Form 990) 2011

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing	72,796	0	72,796	0.190 %
2	Economic development
3	Community support	12,801	0	12,801	0.030 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other	28,991	0	28,991	0.080 %
10	Total	114,588	0	114,588	0.300 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense........

1,423,740

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy .....

Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

29,281,797

Enter Medicare allowable costs of care relating to payments on line 5.....

20,827,783

Subtract line 6 from line 5. This is the surplus or (shortfall)........

8,454,014

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

Yes

Part IV

Management Companies and Joint Ventures

(see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership%	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2011

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest) How many hospital facilities did the organization operate during the tax year?1 Name and address		Other (Describe)
1	The New York Gracie Square Hospital Inc 420 East 76th STreet new york,NY10021	X	psychiatric hospital

Schedule H (Form 990) 2011

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)

The New York Gracie Square Hospital Inc

Name of Hospital Facility:

Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

				Yes	No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2011)
1	During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. .....................		1
	If “Yes,” indicate what the Needs Assessment describes (check all that apply):
	a	A definition of the community served by the hospital facility
	b	Demographics of the community
	c	Existing health care facilities and resources within the community that are available to respond to the health needs of the community
	d	How data was obtained
	e	The health needs of the community
	f	Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
	g	The process for identifying and prioritizing community health needs and services to meet the community health needs
	h	The process for consulting with persons representing the community’s interests
	i	Information gaps that limit the hospital facility’s ability to assess the community’s health needs
	j	Other (describe in Part VI)
2	Indicate the tax year the hospital facility last conducted a Needs Assessment: 20
3	In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted.		3
4	Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................		4
5	Did the hospital facility make its Needs Assessment widely available to the public? ...........		5
	If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
	a	Hospital facility’s website
	b	Available upon request from the hospital facility
	c	Other (describe in Part VI)
6	If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
	a	Adoption of an implementation strategy to address the health needs of the hospital facility’s community
	b	Execution of the implementation strategy
	c	Participation in the development of a community-wide community benefit plan
	d	Participation in the execution of a community-wide community benefit plan
	e	Inclusion of a community benefit section in operational plans
	f	Adoption of a budget for provision of services that address the needs identified in the Needs Assessment
	g	Prioritization of health needs in the community
	h	Prioritization of services that the hospital facility will undertake to meet health needs in its community
	i	Other (describe in Part VI)
7	Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs. ....		7
Financial Assistance Policy
	Did the hospital facility have in place during the tax year a written financial assistance policy that:
8	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?		8	Yes
9	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........		9		No
	If "Yes," indicate the FPG family income limit for eligibility for free care: % If "No," explain in Part VI the criteria the hospital facility used.

Schedule H (Form 990) 2011

Page

Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care?.................		10		No
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: % If "No," explain in Part VI the criteria the hospital facility used.
11	Explained the basis for calculating amounts charged to patients?.................		11	Yes
	If “Yes,” indicate the factors used in determining such amounts (check all that apply):
	a	Income level
	b	Asset level
	c	Medical indigency
	d	Insurance status
	e	Uninsured discount
	f	Medicaid/Medicare
	g	State regulation
	h	Other (describe in Part VI)
12	Explained the method for applying for financial assistance?...................		12	Yes
13	Included measures to publicize the policy within the community served by the hospital facility?.......		13	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
	a	The policy was posted on the hospital facility’s web site
	b	The policy was attached to all billing invoices
	c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
	d	The policy was posted in the hospital facility’s admissions offices
	e	The policy was provided, in writing, to patients upon admission to the hospital facility
	f	The policy was available upon request
	g	Other (describe in Part VI)
Billing and Collections
14	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?.......		14	Yes
15	Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other similar actions (describe in Part VI)
16	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?..........		16		No
	If “Yes,” check all actions in which the hospital facility or a third party engaged:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other similar actions (describe in Part VI)
17	Indicate which efforts the hospital facility made before initiating any of the actions checked in line 16 (check all that apply):
	a	Notified patients of the financial assistance policy upon admission
	b	Notified patients of the financial assistance policy prior to discharge
	c	Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
	d	Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy
	e	Other (describe in Part VI)

Schedule H (Form 990) 2011

Page

Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
				Yes	No
18	Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........		18		No
	If “No,” indicate why:
	a	The hospital facility did not provide care for any emergency medical conditions
	b	The hospital facility’s policy was not in writing
	c	The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
	d	Other (describe in Part VI)
Individuals Eligible for Financial Assistance
19	Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
	a	The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
	b	The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
	c	The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
	d	Other (describe in Part VI)
20	Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?.........		20		No
	If “Yes,” explain in Part VI.
21	Did the hospital facility charge any of its FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?...............................		21		No
	If “Yes,” explain in Part VI.

Schedule H (Form 990) 2011

Page

Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?
Name and address		Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2011

Page

Part VI

Supplemental Information

Complete this part to provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 9, 10, 11h, 13g, 15e, 16e, 17e, 18d, 19d, 20, and 21.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any needs assessments reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Identifier	ReturnReference	Explanation
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.

Schedule H (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

The New York Gracie Square Hospital Inc

Employer identification number

13-3746997

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all the expenses described above? If "No," complete Part III to explain....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....

Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ...............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........

Participate in, or receive payment from, an equity-based compensation arrangement? ........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.

For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 50053T

Schedule J (Form 990) 2011

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and column (E) for that individual.

(A) Name		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(A) Name		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(1) Mr Frank Bruno	(i) (ii)	375,156 0	77,000 0	27,544 0	24,500 0	11,939 0	516,139 0	0 0
(2) Mr David Wiecks	(i) (ii)	157,573 0	6,000 0	16,800 0	12,776 0	15,492 0	208,641 0	0 0
(3) Mr Laurence Berger	(i) (ii)	0 300,047	0 62,292	0 34,373	0 17,150	0 24,918	0 438,780	0 0
(4) Mr Mark Larmore	(i) (ii)	0 666,221	0 549,468	0 164,488	0 113,178	0 37,584	0 1,530,939	0 14,649
(5) Kathleen M Burke ESQ	(i) (ii)	0 284,455	0 54,174	0 5,920	0 24,500	0 20,521	0 389,570	0 0
(6) Ms Phyllis R Lantos	(i) (ii)	0 835,847	0 828,613	0 500,216	0 59,494	0 34,349	0 2,258,519	0 169,720
(7) Ms Hilde Lutz	(i) (ii)	174,345 0	6,000 0	2,472 0	18,169 0	11,002 0	211,988 0	0 0
(8) Dr Roger Wolfsohn MD	(i) (ii)	244,114 0	27,000 0	22,689 0	19,600 0	38,947 0	352,350 0	0 0
(9) dr juan baturone MD	(i) (ii)	214,607 0	0 0	23,815 0	16,833 0	19,537 0	274,792 0	0 0
(10) Dr Igor Kirzhner MD	(i) (ii)	207,692 0	0 0	0 0	10,385 0	0 0	218,077 0	0 0
(11) Mr Chiang Kuo	(i) (ii)	149,517 0	0 0	690 0	10,500 0	11,579 0	172,286 0	0 0
(12) Purisima Tadeo	(i) (ii)	179,771 0	0 0	0 0	0 0	160 0	179,931 0	0 0
(13) Gemma Balquin	(i) (ii)	170,010 0	0 0	200 0	8,216 0	14,436 0	192,862 0	0 0
(14) Yan Chun Mui	(i) (ii)	151,512 0	0 0	16,700 0	8,216 0	14,436 0	190,864 0	0 0
(15) Dr Herbert Pardes	(i) (ii)	0 1,712,792	0 1,841,009	0 500,155	0 24,500	0 30,280	0 4,108,736	0 0

Schedule J (Form 990) 2011

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.

Identifier	Return Reference	Explanation
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.

Schedule J (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2011

Open to Public
Inspection

Name of the organization

The New York Gracie Square Hospital Inc

Employer identification number

13-3746997

Identifier	Return Reference	Explanation
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.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

The New York Gracie Square Hospital Inc

Employer identification number

13-3746997

Part I

Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)

(a) Name, address, and EIN of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled organization
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) New-York Presbyterian Foundation Inc 525 East 68th STreet Box 156 new york,NY10065 13-4153668	support org	NY	501(c)(3)	11 type 1	na		No
(2) The New York and Presbyterian Hospital 525 East 68th STreet Box 156 New York,NY10065 13-3957095	healthcare	NY	501(c)(3)	3	NYP FDN	Yes
(3) New York Presby Healthcare System Inc 525 East 68th STreet Box 156 New York,NY10065 13-3792361	sponsor	NY	501(c)(3)	11 type III	NYP FND	Yes
(4) Royal Charter Properties Inc 525 East 68th STreet Box 156 New York,NY10065 13-3158502	real estate	NY	501(c)(3)	11 type ii	NYP FDN	Yes
(5) Royal Charter Properties East Inc 525 E 68th St Box 156 New York,NY10065 13-3158496	real estate	NY	501(c)(3)	11 type ii	NYP FDN	Yes
(6) Royal Charter Properties WestchesterInc 525 E 68th St Box 156 New York,NY10065 13-3160354	real estate	NY	501(c)(3)	11 type ii	NYP FDN	Yes
(7) Presbyterian Health Resources Inc 525 E 68th St Box 156 New York,NY10065 13-3145970	INACTIVE	NY	501(c)(3)	11 type I	NYP FDN	Yes
(8) Hospital for Special Surgery 535 E 70th Street New York,NY10021 13-1624135	healthcare	NY	501(c)(3)	3	NYP FDN	Yes
(9) New York Hospital Medical Ctr of Queens 56-45 Main Street flushing,NY11355 11-1839362	healthcare	NY	501(c)(3)	3	NYP SYS INC	Yes
(10) The New York Methodist Hospital 506 sixth Street BROOKLYN,NY11215 11-1631796	healthcare	NY	501(c)(3)	3	NYP SYS INC	Yes
(11) The Brooklyn Hospital Center 121 Dekalb Ave Brooklyn,NY11201 11-1630755	healthcare	NY	501(c)(3)	3	NYP SYS INC	Yes
(12) The NY community Hospital of Brooklyn 525 E 68th St Box 156 New York,NY10065 11-1986351	healthcare	NY	501(c)(3)	3	NYP SYS INC	Yes
(13) New York Westchester Square Medical Ctr 2475 St Raymond Ave Bronx,NY10461 31-1730177	healthcare	NY	501(c)(3)	3	NYP SYS INC	Yes
(14) The Rogosin Institute 505 E 70th Street New York,NY10021 13-3184198	dialysis/med	NY	501(c)(3)	4	NYP SYS INC	Yes
(15) Nyack Hospital 160 North Midland Avenue Nyack,NY10960 13-1740119	healthcare	NY	501(c)(3)	3	NYP SYS INC	Yes
(16) The Silvercrest Ctr for Nursing & REhab 144-45 87th AVenue Jamaica,NY11435 11-2925535	nursing facil	NY	501(c)(3)	3	NYP SYS INC	Yes
(17) Network Recovery Services Inc 525 East 68th STreet Box 156 New York,NY10065 11-3160901	collection	NY	501(c)(3)	11 type iii	NYP SYS INC	Yes
(18) NY - Presbyterian Community Health Plan 525 East 68th STreet Box 156 New York,NY10065 13-3849659	inactive	NY	501(c)(4)	n/a	NYP SYS INC	Yes
(19) Preferred Health Network Inc 525 East 68th STreet Box 156 New York,NY10065 11-2964432	inactive	NY	501(c)(3)	11 type i	NYP SYS INC	Yes
(20) New York Presbyterian Fund Inc 525 East 68th STreet Box 156 New York,NY10065 13-3160356	fundraising	NY	501(c)(3)	7	NYP FDN	Yes
(21) Hospital for Special Surgery Fund Inc 535 East 70th Street New York,NY10021 13-6714749	support	NY	501(c)(3)	7	hos spec Sur	Yes
(22) CRT Surgical Associates PC 56-45 Main Street Flushing,NY11355 11-2226870	healthcare	NY	501(c)(3)	11 type i	nyhq	Yes
(23) BMA Medical Foundation Inc 56-45 Main Street Flushing,NY11355 11-2848858	edu/research	NY	501(c)(3)	4	nyhq	Yes
(24) Brooklyn Dental Services PC 506 Sixth Street Brooklyn,NY11215 43-2015903	dental	NY	501(c)(3)	11 type i	methodist	Yes
(25) Brooklyn Foot & Ankle PC 506 Sixth Street Brooklyn,NY11215 11-3341502	healthcare	NY	501(c)(3)	11 type i	methodist	Yes
(26) Brooklyn Radiology Services 506 Sixth Street Brooklyn,NY11215 11-3423162	radiology	NY	501(c)(3)	11	methodist	Yes
(27) Park Slope Emergency Physician Svc PC 506 Sixth Street Brooklyn,NY11215 06-1160280	healthcare	NY	501(c)(3)	11 type I	methodist	Yes
(28) Park Slope Hematology & Oncology PC 506 Sixth Street Brooklyn,NY11215 11-3564621	hemo/oncology	NY	501(c)(3)	11	methodist	Yes
(29) Park Slope Medical Health Provider PC 506 Sixth Street Brooklyn,NY11215 42-1591811	inactive	NY	501(c)(3)	11	methodist	Yes
(30) Park Slope Medical Services PC 506 Sixth Street Brooklyn,NY11215 11-2843882	healthcare	NY	501(c)(3)	11 type I	methodist	Yes
(31) Park Slope Medicine PC 506 Sixth Street Brooklyn,NY11215 11-3362663	healthcare	NY	501(c)(3)	11 type I	methodist	Yes
(32) Park Slope Obstetrics & Gynecology PC 506 Sixth Street Brooklyn,NY11215 11-3124294	healthcare	NY	501(c)(3)	11 type I	methodist	Yes
(33) Park Slope Pathology Services PC 506 Sixth Street Brooklyn,NY11215 11-2843879	healthcare	NY	501(c)(3)	11 type i	methodist	Yes
(34) Park Slope Pediatric Medicine PC 506 Sixth Street Brooklyn,NY11215 11-3303499	healthcare	NY	501(c)(3)	11 type I	methodist	Yes
(35) Park Slope Physician Services PC 506 Sixth Street Brooklyn,NY11215 11-3231685	healthcare	NY	501(c)(3)	11 type I	methodist	Yes
(36) South Brooklyn Health Center Inc 120 Richards St Brooklyn,NY11231 11-2339341	healthcare	NY	501(c)(3)	7	methodist	Yes
(37) Ashland Place Houses Inc 121 Dekalb Ave Brooklyn,NY11201 11-2390927	real estate	NY	501(c)(3)		TBHC	Yes
(38) Caledonian Health Center 121 Dekalb Ave Brooklyn,NY11201 54-2117028	clinics	NY	501(c)(3)	9	TBHC	Yes
(39) Ashland Place Holding Corp 121 Dekalb Ave Brooklyn,NY11201 11-3304353	title holding	NY	501(c)(2)	n/a	tbhc	Yes
(40) Brooklyn Hospital Self Insurance Trust 121 Dekalb Ave Brooklyn,NY11201 11-2501235	self ins trus	NY	501(c)(3)	11 type i	tbhc	Yes
(41) Brooklyn Hospital Foundation Inc 121 Dekalb Ave Brooklyn,NY11201 11-2936410	support	NY	501(c)(3)	11 type i	tbhc	Yes
(42) Silvercrest SR Housing Development Fund 144-45 87th Ave Briarwood,NY11435 26-2894911	housing	NY	501(c)(3)	9	silvercrest	Yes
(43) Nyack Hospital Foundation Inc 160 North Midland Ave Nyack,NY10960 13-3245804	support	NY	501(c)(3)	7	Nyack Hosp	Yes
(44) Nephrology Foundation of Brooklyn 1845 McDonald Avenue Brooklyn,NY11223 11-2508594	Dialysis	NY	501(c)(3)	9	Rogosin	Yes

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2011

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) NYP SYS SELECT HLTH 525 East 68th Street New York,NY10065 13-4197527	Medicaid HMO	NY	NYPH	0	0		No	0		No	0 %
(2) Rogosin-Auburndale LLC 39-20 Utopia Parkway Flushing,NY11358	Consulting	NY	Rogosin	0	0		No	0		No	0 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)
(1) NYP Services Inc 525 E 68th St Box 156 New York,NY10065 06-1830524	inactive	NY	NYP FDN	c corp
(2) New York Presbyterian Global Inc 525 E 68th St Box 156 New York,NY10065 80-0336716	inactive	NY	NYP FDN	c corp
(3) Network Insurance Company LTD PO Box HM 1760 Hamilton HM HX BD	reinsurance	BD	NYP SYS INC	c corp
(4) NYH-SHP IPA Inc 525 East 68th Street box 156 New York,NY10065 13-3919980	inactive	NY	NYP SYS INC	c corp
(5) Harkness Hall Club Inc 525 East 68th St Box 156 New York,NY10065 13-3170488	liquor licens	NY	NYPH	c corp
(6) Columbia Presbyterian Health System Inc 525 East 68th St Box 156 New York,NY10065 13-3053885	real estate	NY	Fund Inc	c corp
(7) NY Presbyterian Global Services Inc 525 East 68th St Box 156 New York,NY10065 13-3845935	inactive	NY	Fund Inc	c corp
(8) Brooklyn Hospital ECG Medical Services 121 Dekalb Ave Brooklyn,NY11201 11-2833052	medical servi	NY	tbhc	c corp
(9) Brooklyn Hospital Nuclear Medicine PC 121 Dekalb Ave Brooklyn,NY11201 11-2833589	medical servi	NY	tbhc	c corp
(10) TBHC Medical Services PC 121 Dekalb Ave Brooklyn,NY11201 11-2833590	medical servi	NY	TBHC	c corp
(11) Brooklyn Hospital Radiology PC 121 Dekalb Ave Brooklyn,NY11201 11-2833588	medical servi	NY	tbhc	c corp
(12) TBHC Emergency Medicine PC 121 Dekalb Ave Brooklyn,NY11201 11-2833587	medical servi	NY	tbhc	c corp
(13) TBHC Anesthesiology Services PC 121 Dekalb Ave Brooklyn,NY11201 11-2833049	medical servi	NY	tbhc	c corp
(14) TBHC Pediatrics PC 121 Dekalb Ave Brooklyn,NY11201 27-0174684	medical servi	NY	TBHC	c corp
(15) TBHC Medical Testing Services PC 121 Dekalb Ave Brooklyn,NY11201 27-0174413	Medical Servi	NY	tbhc	c corp
(16) TBHC Physician Services PC 121 Dekalb Ave Brooklyn,NY11201 27-0174589	medical servi	NY	tbhc	c corp
(17) TBHC Radiation Oncology PC 121 Dekalb Ave Brooklyn,NY11201 27-0174805	medical servi	NY	tbhc	c corp
(18) NH Management Inc 160 North Midland Ave Nyack,NY10960 13-4026486	medical servi	NY	Nyack Hospital	c corp
(19) Highland Medical PC 160 North Midland Ave Nyack,NY10960 13-4034481	medical servi	NY	nyack hospital	c corp
(20) Main Street Medical PC 56-45 Main Street Flushing,NY11358 06-1205476	medical servi	NY	NYHQ	c corp
(21) NYHQ OBgyn pc 56-45 main street flushing,NY11358 11-3395424	medical servi	NY	NYHQ	c corp
(22) BMA pc 56-45 main street flushing,NY11358 11-2747259	medical servi	NY	nyhq	c corp
(23) MSO of Kings County LLC 506 Sixth St Brooklyn,NY11215 27-2387333	Medical Services	NY	Methodist Hosp	C Corp
(24) New York Queens Medicine and Surgery PC 56-45 Main St Flushing,NY11358 27-4719998	Medical Services	NY	NY Hosp Queens	C Corp
(25) Brooklyn Hospital Women's HMC PC 121 Dekalb Ave Brooklyn,NY11201 27-5459970	Medical Services	NY	TBHC	C Corp

Schedule R (Form 990) 2011

Page 3

Part V

Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)

Note. Complete line 1 if any entity is listed in Parts II, III or IV.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

f Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

j Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

k Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .

l Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .

m Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .

n Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

o Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

p Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

q Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

r Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of other organization	(b) Transaction type(a-r)	(c) Amount involved	(d) Method of determining amount involved
(1) THE NEW YORK AND PRESBYTERIAN HOSPITAL	O	2,790,220	FMV
(2) ROYAL CHARTER PROPERTIES INC (GUARANTEE ONLY)	E	12,375,000	FMV
(3)
(4)
(5)
(6)

Schedule R (Form 990) 2011

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2011

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Part VII

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule R (see instructions).

Identifier	Return Reference	Explanation

Additional Data

Software ID:
Software Version: