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. See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
GREATER NEW YORK HOSPITAL FOUNDATION INC
Employer identification number
13-2954140
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.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
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.)
10
11
e
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).
f
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
..................................................
g
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
No
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)
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(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?
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2011
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.") ....
1,577,054
1,000,001
1,106,459
823,436
673,634
5,180,584
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..
1,577,054
1,000,001
1,106,459
823,436
673,634
5,180,584
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)..
6,707
6
Public Support. Subtract line 5 from line 4.
5,173,877
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..
1,577,054
1,000,001
1,106,459
823,436
673,634
5,180,584
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
0
0
259
0
17
276
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).
5,180,860
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
1,302,372
13
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..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
99.865 %
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
99.995 %
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
......................
b
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
.....................
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
..................................................
b
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
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
Schedule A (Form 990 or 990-EZ) 2011
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.).
14
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.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2011 (line 8 column (f) divided by line 13 column (f))
.........
15
16
Public support percentage from 2010 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2011 (line 10c column (f) divided by line 13 column (f))
......
17
18
Investment income percentage from 2010 Schedule A, Part III, line 17
.............
18
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
..........
b
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
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2011
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 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.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
GREATER NEW YORK HOSPITAL FOUNDATION INC
Employer identification number
13-2954140
Identifier
Return Reference
Explanation
FORM 990, PART III, LINE 1
THE GREATER NEW YORK HOSPITAL FOUNDATION IS THE NOT-FOR-PROFIT 501(C)(3) AFFILIATE OF THE GREATER NEW YORK HOSPITAL ASSOCIATION (GNYHA), AN ORGANIZATION EXEMPT FROM INCOME TAX UNDER IRC SECTION 501(C)(6). THE FOUNDATION WAS CREATED TO ASSIST SUCH ENTITIES IN THEIR DELIVERY OF SERVICES TO THE COMMUNITY, INCLUDING PATIENTS AND THE PUBLIC AT LARGE, ALL BY SUCH MEANS AS SHALL FROM TIME TO TIME BE FOUND APPROPRIATE AND AS ARE LAWFUL FOR A NOT-FOR-PROFIT CORPORATION, INCLUDING, WITHOUT LIMITATION, THE DEVELOPMENT OF EDUCATIONAL PROGRAMS, THE UNDERTAKING OF QUANTITATIVE ANALYSES AND OTHER STUDIES, THE GRANTING OF FINANCIAL AID AND THE CREATION OF FUNDS TO PROVIDE RECOGNITION AND/OR FINANCIAL SUPPORT TO INDIVIDUALS WHO DELIVER CARE AND/OR THEIR FAMILIES FOR EXTRAORDINARY SERVICES RENDERED.
FORM 990, PART III, LINE 4D-OTHER PROGRAM SERVICES
PLANNING FOR INNOVATION COLLOQUIUM: EXPENDITURES FOR THIS PROJECT ARE TO ASSIST IN CONVENING A ONE-DAY INVITATIONAL COLLOQUIUM TO BRING TOGETHER PRACTITIONERS, ANALYSTS, AND RESEARCHERS WORKING IN MEDICAL CARE AND OTHER SERVICES FOR THE ELDERLY TO IDENTIFY, DISCUSS, AND EVALUATE PROMISING NEW APPROACHES TO ORGANIZING AND DELIVERING HEALTHCARE TO OLDER PEOPLE, ESPECIALLY, THE MOST FRAIL AND THOSE WITH SERIOUS CHRONIC ILLNESS. $44,561 ACCESS AND COST ISSUES ASSOCIATED WITH THE DELIVERY OF MENTAL HEALTH SERVICES (MENTAL HEALTH): THIS PROJECT WILL DEVELOP TOOLS THAT HOSPITALS CAN USE TO PROMOTE BETTER ACCESS TO MENTAL HEALTH SERVICES AND QUANTIFY CERTAIN INCREMENTAL COSTS ASSOCIATED WITH ADMINISTRATIVE ISSUES WITHIN THE MENTAL HEALTH CARE DELIVERY SYSTEM. $51,777 MEDICAL MALPRACTICE EDUCATIONAL CONFERENCE: EXPENDITURES FOR THIS PROJECT ARE TO CONVENE AN EDUCATIONAL CONFERENCE TO HAVE STAKEHOLDERS PROVIDE AN OVERVIEW OF A UNIQUE MEDICAL MALPRACTICE SETTLEMENT MODEL CURRENTLY IN USE BY THE NEW YORK CITY HEALTH AND HOSPITALS CORPORATION, SO THAT THE ASSOCIATION, OTHER INTERESTED NEW YORK HOSPITALS, POLICYMAKERS, AND OTHERS COULD LEARN ABOUT THE SYSTEM AND DETERMINE WHETHER THIS MODEL FOR EARLY RESOLUTION OF MEDICAL MALPRACTICE CASES IS "EXPORTABLE." $26,390 BIOTERRORISM AND EMERGENCY PREPAREDNESS (BIOTERRORISM): EXPENDITURES FOR THIS PROJECT ARE BEING USED TO CONDUCT A NEEDS ASSESSMENT AND DEVELOP TRAINING STRATEGIES IN THE AREA OF BIOTERRORISM IN HOSPITALS AND LONG-TERM CARE FACILITIES. $45,046 PALLIATIVE CARE LEADERSHIP NETWORK (PALLIATIVE CARE): EXPENDITURES FOR THIS PROJECT ARE TO BRING TOGETHER THOSE HOSPITALS ACTIVELY ENGAGED IN PALLIATIVE CARE WITH THOSE WITH LESS PALLIATIVE CARE EXPERIENCE, PROVIDING A FORUM TO SHARE AND DEVELOP BEST PRACTICES. $13,313 NY COMMUNITY HEALTH WORKFORCE ADVANCEMENT (WORKFORCE ADVANCEMENT): THIS INITIATIVE WILL SUPPORT HOSPITAL AND LONG TERM CARE FACILITIES IN IDENTIFYING AND IMPLEMENTING WORKFORCE STRATEGIES AS THEY ADAPT TO DELIVERY SYSTEM CHANGES CONTAINED WITHIN BOTH STATE AND FEDERAL HEALTH REFORM. $34,431 HITE: THIS PROJECT MAINTAINS AND DEVELOPS AN ONLINE SEARCHABLE RESOURCE FOR VARIOUS SERVICE PROVIDERS FOR FAST AND ACCURATE LINKAGES FOR UNINSURED AND LOW-INCOME INDIVIDUALS AND FAMILIES IN NEW YORK CITY'S MOST DISADVANTAGES NEIGHBORHOODS. THE RESOURCES INCLUDE, AMONG OTHERS, HEALTH AND SOCIAL SERVICES, FINANCIAL ASSISTANCE AGENCIES, IMMIGRANT SUPPORT, TRANSPORTATION, SUBSTANCE ABUSE AND YOUTH AND FAMILY SERVICES. $161,692 IMPROVING CARE CONTINUITY IN HOSPITAL-SPONSORED TEACHING CLINICS (CLINIC CARE MANAGEMENT): THE OBJECTIVE OF THIS PROGRAM IS IMPROVE PATIENT CARE MANAGEMENT IN HOSPITAL-SPONSORED TEACHING CLININC BY PROVIDING RESIDENCY PROGRAMS AND THEIR CLINICS SITES WITH TOOLS TO PROMOTE BETTER CONTINUITY OF CARE FOR PATIENTS. $19,466 LEWIS AND JACK RUDIN NEW YORK PRIZE FOR MEDICINE AND HEALTH (RUDIN PRIZE): EXPENDITURES FOR THIS PRIZE RECOGNIZES A MEMBER OF THE HEALTHCARE COMMUNITY WHO HAS CONTRIBUTED TO THE HEALTH OF THE NEW YORK CITY COMMUNITY. $50,000 NYS PARTNERSHIP FOR PATIENTS: THE GOAL OF THIS PROJECT IS TO WORK WITH HOSPITALS TO ADDRESS CMS' GOALS TO REDUCE HOSPITAL-ACQUIRED CONDITIONS BY 40% AND PREVENTABLE READMISSIONS BY 20%. $69,139 IPRO: FOUNDATION SUBCONTRACTED WITH IPRO TO REDUCE THE INCIDENCE OF METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS (MRSA) INFECTIONS (THE "PROJECT"). THE PROJECT BUILT ON A SUCCESSFUL COACHING MODEL THAT INCLUDED DEVELOPMENT AND DISSEMINATION OF A "BUNDLE" OF BEST-PRACTICES; ASSISTANCE ON THE COACH TRAINING AS PART OF TEAM STEPS TRAINING; AND ADMINISTRATIVE SUPPORT IN THE MANAGEMENT OF THE PROJECT. $7,536
FORM 990, PART VI, SECTION A, QUESTIONS 7
QUESTION 7A THE SOLE MEMBER OF THE ORGANIZATION IS THE GREATER NEW YORK HOSPITAL ASSOCIATION ("GNYHA"), AN ORGANIZATION EXEMPT FROM INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(C)(6). GNYHA HAS THE RIGHT TO VOTE ON ALL MATTERS ON WHICH MEMBERS VOTE INCLUDING THE ELECTION OF THE MEMBERS OF THE BOARD OF DIRECTORS. QUESTION 7B THE MEMBER MUST APPROVE THE ELECTION OF THE BOARD OF DIRECTORS AND ANY OTHER ACTION REQUIRING MEMBERS' APPROVAL AS A MATTER OF LAW.
FORM 990, PART VI, SECTION B
QUESTION 11 THE ORGANIZATION'S FORM 990 RETURN WAS PREPARED BY THE ORGANIZATION'S FINANCE DEPARTMENT AND AN INDEPENDENT ACCOUNTING FIRM. THE ORGANIZATION'S AUDIT AND COMPLIANCE COMMITTEE, WHICH COMPRISES 4 MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS, REVIEWED THE DRAFT RETURN INFORMATION AT A COMMITTEE MEETING. THE FINAL FORM 990 WAS PROVIDED TO ALL MEMBERS OF THE GOVERNING BODY BY ELECTRONIC MEANS PRIOR TO THE RETURN BEING FILED WITH THE IRS. QUESTION 12C THE ORGANIZATION ADMINISTERS AN ANNUAL CONFLICT OF INTEREST DISCLOSURE STATEMENT TO EXECUTIVE EMPLOYEES, OFFICERS AND DIRECTORS OF THE ORGANIZATION. THE AUDIT & COMPLIANCE COMMITTEE IS RESPONSIBLE FOR REVIEWING AND MONITORING ANY POTENTIAL CONFLICTS. ADDITIONALLY THE AUDIT & COMPLIANCE COMMITTEE MEETS REGULARLY TO REVIEW ONGOING ADMINISTRATION AND IMPLEMENTATION OF THE CONFLICT OF INTEREST POLICY. QUESTION 14 THE BOARD OF DIRECTORS ADOPTED A WRITTEN DOCUMENT RECORD RETENTION AND DESTRUCTION POLICY IN 2009. QUESTION 15 THE COMPENSATION COMMITTEE OF THE ORGANIZATION (COMPOSED OF INDEPENDENT PERSONS) REVIEWS AND APPROVES THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT AND OTHER TOP MANAGEMENT. ADDITIONALLY, THE ORGANIZATION ENGAGES AN OUTSIDE CONSULTANT TO PROVIDE COMPARABLE DATA AND OTHER INFORMATION TO THE COMPENSATION COMMITTEE IN CONNECTION WITH THE DETERMINATION OF AND ADJUSTMENT TO COMPENSATION OF SUCH PERSONNEL. THE DECISION PROCESS OF THE COMMITTED IS DOCUMENTED. ALL OFFICERS' COMPENSATION AND BENEFITS ARE PAID BY A RELATED ORGANIZATION, GNYHA MANAGEMENT CORPORATION.
FORM 990, PART VI, SECTION C
QUESTION 19 ALL GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, THE RECORD RETENTION AND DESTRUCTION POLICY, AND FINANCIAL STATEMENTS ARE STORED IN THE FOUNDATION'S MAIN OFFICE. THE FOUNDATION WILL PROVIDE COPIES UPON REQUEST IN A TIMELY MANNER.
FORM 990, PART XII, LINE 2B AND 2C
THE FOUNDATION ISSUED STAND ALONE FINANCIAL STATEMENTS, AND IS ALSO PART OF CONSOLIDATED AUDITED FINANCIAL STATEMENTS. THE ORGANIZATION HAS AN AUDIT COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT, REVIEW OR COMPILATION OF ITS FINANCIAL STATEMENTS, AND SELECTION OF AN INDEPENDENT ACCOUNTANT.