Form990
Click to see attachment
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)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2012
Open to Public Inspection
A For the 2012 calendar year, or tax year beginning 01-01-2012 , 2012, and ending 12-31-2012
BCheck if applicable:
CName of organization
THE MOUNT SINAI HOSPITAL
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
ONE GUSTAVE L LEVY PLACE
Suite
Room/suite
City or town, state or country, and ZIP + 4
NEW YORK, NY100296574
D Employer identification number

13-1624096
E Telephone number

G Gross receipts $ 1,849,227,785
F Name and address of principal officer:
DONALD SCANLON
633 THIRD AVE 10TH FL
NEW YORK,NY10017
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
http://www.mountsinai.org
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1852
M State of legal domicile: NY
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: SEE attachment 1
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 40
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 32
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ...... 5 12,669
6 Total number of volunteers (estimate if necessary) ............. 6 1,085
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 1,027,481
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 32,506,751 33,969,200
9 Program service revenue (Part VIII, line 2g) ......... 1,646,614,636 1,740,077,307
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 13,529,797 24,372,986
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 25,838,621 50,234,742
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 1,718,489,805 1,848,654,235
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 27,230,030 30,035,966
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) 828,576,524 873,835,795
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet3,692,420    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 754,610,537 813,432,638
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 1,610,417,091 1,717,304,399
19 Revenue less expenses. Subtract line 18 from line 12....... 108,072,714 131,349,836
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 2,240,196,653 2,402,315,481
21 Total liabilities (Part X, line 26)............. 1,313,753,523 1,309,023,629
22 Net assets or fund balances. Subtract line 21 from line 20..... 926,443,130 1,093,291,852
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
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2012)
Form 990 (2012)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III ...............
1
Briefly describe the organization’s mission: MOUNT SINAI IS COMMITTED TOWARDS THE ADVANCEMENT OF THE ART AND SCIENCE OF MEDICINE THROUGH CLINICAL EXCELLENCE. THE CENTRAL MISSION CONSISTS OF HIGH-QUALITY PATIENT CARE AND TEACHING CONDUCTED IN AN ATMOSPHERE OF SOCIAL CONCERN AND SCHOLARLY INQUIRY INTO NATURE, CAUSATION, PREVENTION AND TREATMENT OF HUMAN DISEASE.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If “Yes,” describe these changes on Schedule O.
4
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 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 $ 1,537,254,698 including grants of $ 30,035,966 ) (Revenue $ 1,773,887,617 )
The Mount Sinai Hospital provides quality medical healthcare regardless of race, creed, sex, national origin, handicap, age, or ability to pay. Although reimbursement for services rendered is critical to the operation and stability of the Mount Sinai Hospital, it is recognized that not all individuals possess the ability to purchase essential medical services and healthcare education. As a matter of policy, the Hospital provides significant amounts of partially or totally uncompensated patient care. For accounting purposes, such uncompensated care is treated either as charity care or bad debt expense. The Hospital's charity care policy ensures the provision of quality health care to the community served while carefully considering the ability of the patient to pay. The policy has sliding fee schedules for inpatient, ambulatory and emergency services provided to the uninsured and under-insured patients who qualify. Patients are eligible for the charity care fee schedule if they meet certain income tests. Furthermore, as part of its charity care and financial aid policy, the Hospital obtains and uses additional financial information for uninsured or under-insured patients who have not supplied the requisite information to qualify for charity care. The additional information obtained is used by the Hospital to determine whether to qualify patients for charity care and/or financial aid in accordance with the Hospital's policies. For accounting and disclosure purposes, charity care is considered to be the difference between the Hospital's customary charges and the sliding charity care fee schedule rates. Since payment of this difference is not sought, charity care allowances are not reported as revenue. The Hospital's estimated costs for charity care were $38.8 million for 2012 and $31.8 million for 2011. The cost of charity includes the direct and indirect cost of providing charity care services. The cost is estimated by utilizing a ratio of cost to gross charges applied to the gross uncompensated charges associated with providing charity care. Funds received from the New York State Indigent Care Pool to offset charity services provided totaled approximately $17.5 million and $14.9 million for the years ended December 31, 2012 and 2011, respectively. The charity care component of the indigent care pool payments is estimated utilizing a ratio of charity care charges to total charity care and bad debt charges applied to the indigent care pool reimbursement and excludes amounts designated for teaching programs. Additionally, patients who do not qualify for sliding scale fees and all uninsured inpatients who do not qualify for Medicaid assistance are billed at the Hospital's rates. Uncollected balances for these patients are categorized as bad debts. Total uncompensated care as a result of bad debts for all patient services approximated $23.7 million in 2012 and $10.8 million in 2011. The Mount Sinai Hospital is the primary healthcare provider for the East Harlem Area of New York City. East Harlem is one of the poorest communities in the New York City region, and has been designated as a medically underserved area. A wide variety of programs and services are currently provided for the community which includes: -Primary care -AIDS -Cardiovascular health -Cancer treatment -Maternal and infant health -Geriatrics -Ambulatory sensitive conditions (Astma and Diabetes) -Adolescent health -Youth education -Volunteer services
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $ 0 including grants of $ 0 ) (Revenue $ 0 )
4e Total program service expensesMediumBullet1,537,254,698
Form 990 (2012)
Form 990 (2012)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
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 IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If “Yes,” complete Schedule C, Part IIClick to see attachment........
4
Yes
 
5
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 IIIClick to see attachment............................
5
 
No
6
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 IClick to see attachment........................
6
 
No
7
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 IIClick to see attachment...
7
 
No
8
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....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; 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 IVClick to see attachment..............
9
 
No
10
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 VClick to see attachment......
10
Yes
 
11
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.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If “Yes,” complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
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 VIIClick to see attachment.......
11b
Yes
 
c
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 VIIIClick to see attachment.......
11c
 
No
d
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 IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
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 XClick to see attachment.........................
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If “Yes,” complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
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 and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
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, Parts I and IV......... Click to see attachment
14b
Yes
 
15
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 United States? If “Yes,” complete Schedule F, Parts II and IVClick to see attachment
15
 
No
16
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 United States? If “Yes,” complete Schedule F, Parts III and IV... Click to see attachment
16
 
No
17
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 (see instructions).... Click to see attachment
17
 
No
18
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............ Click to see attachment
18
Yes
 
19
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................... Click to see attachment
19
 
No
20a
Did the organization operate one or more hospital facilities? If “Yes,” complete Schedule H.... Click to see attachment
20a
Yes
 
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see list of attachments
20b
Yes
 
Form 990 (2012)
Form 990 (2012)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
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... Click to see attachment
21
Yes
 
22
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........ Click to see attachment
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, line 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
23
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 lines 24b through 24d and complete Schedule K. If “No,” go to line 25................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
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
 
No
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
No
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........ Click to see attachment
25a
 
No
b
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................... Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highest compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II.......................... Click to see attachment
26
 
No
27
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......... Click to see attachment
27
 
No
28
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
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV .......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV..................... Click to see attachment
28b
Yes
 
c
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 direct or indirect owner? If “Yes,” complete Schedule L, Part IV... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M..Click to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............. Click to see attachment
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II......................
32
 
No
33
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
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
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
 
36
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
36
 
No
37
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 VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2012)
Form 990 (2012)
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
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
4,551
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
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 ..................
2a
12,669
b
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)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
4a
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, securities account, or other financial account)?..........................
4a
 
No
b
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.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes,” to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
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 as charitable contributions?...
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
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?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
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?............
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?..........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?.......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
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
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2012)
Form 990 (2012)
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
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
40
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
32
2
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? .................
2
Yes
 
3
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? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
 
No
7a
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? ....................
7a
 
No
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
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.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
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
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
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
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
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?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
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
 
No
b
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
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
NY
18
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.
19
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.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBulletMICHAEL PASTIER633 THIRD AVENUE 10FLNew YorkNY10017 (212) 731-3149
Form 990 (2012)
Form 990 (2012)
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. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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

RoundBullet 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.

RoundBullet 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 organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(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
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) peter w may........................................................................
chairman of board of trustees
 4.0
.......................5.0 		X   X            
(2) frederick a klingenstein........................................................................
honorary chairman/trustee
 4.0
.......................5.0 		X   X            
(3) donald j gogel........................................................................
senior vice chairman/trustee
 4.0
.......................5.0 		X   X            
(4) michael minikes........................................................................
senior vice chairman/trustee
 4.0
.......................6.0 		X   X            
(5) robert e rubin........................................................................
senior vice chairman/trustee
 4.0
.......................5.0 		X   X            
(6) james s tisch........................................................................
senior vice chairman/trustee
 4.0
.......................5.0 		X   X            
(7) joel s ehrenkranz........................................................................
vice chairman/trustee
 4.0
.......................5.0 		X   X            
(8) ellen katz........................................................................
vice chair/secretary/trustee
 4.0
.......................5.0 		X   X            
(9) henry r kravis........................................................................
vice chairman/trustee
 4.0
.......................5.0 		X   X            
(10) john a levin........................................................................
vice chairman/trustee
 4.0
.......................5.0 		X   X            
(11) eric mindich........................................................................
vice chairman/trustee
 4.0
.......................5.0 		X   X            
(12) andrew m saul........................................................................
vice chairman/trustee
 4.0
.......................5.0 		X   X            
(13) thomas w strauss........................................................................
vice chairman/trustee
 4.0
.......................5.0 		X   X            
(14) clifford h goldsmith........................................................................
treasurer/trustee
 4.0
.......................4.0 		X   X            
(15) leon d black........................................................................
trustee
 2.0
.......................0.0 		X                
(16) henry calderon........................................................................
trustee
 2.0
.......................0.0 		X                
(17) peter a cohen........................................................................
trustee
 2.0
.......................0.0 		X                
Form 990 (2012)
Form 990 (2012)
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 (list any hours for related organizations below dotted line) 		(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
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) edgar m cullman jr........................................................................
trustee
 2.0
.......................0.0 		X                
(19) susan r cullman........................................................................
trustee
 2.0
.......................0.0 		X                
(20) blaine v fogg........................................................................
trustee
 2.0
.......................4.0 		X                
(21) david s gottesman........................................................................
trustee
 2.0
.......................0.0 		X                
(22) judah gribetz........................................................................
trustee
 2.0
.......................1.0 		X                
(23) andrew d heineman........................................................................
trustee
 2.0
.......................3.0 		X                
(24) john b hess........................................................................
trustee
 2.0
.......................0.0 		X                
(25) carl c icahn........................................................................
trustee
 2.0
.......................2.0 		X                
(26) lewis p jones........................................................................
trustee
 2.0
.......................2.0 		X                
(27) jo carole lauder........................................................................
trustee
 2.0
.......................0.0 		X                
(28) patricia s levinson........................................................................
trustee
 2.0
.......................2.0 		X                
(29) tony martell........................................................................
trustee
 2.0
.......................0.0 		X                
(30) bernard w nussbaum........................................................................
trustee
 2.0
.......................3.0 		X                
(31) judith o rubin........................................................................
trustee
 2.0
.......................3.0 		X                
(32) eric m ruttenberg........................................................................
trustee
 2.0
.......................3.0 		X                
(33) stephen l schwartz........................................................................
trustee
 2.0
.......................2.0 		X                
(34) john s winkleman........................................................................
trustee
 2.0
.......................3.0 		X                
(35) dr jephtha tausig-edwards........................................................................
trustee (ex-officio)
 2.0
.......................2.0 		X                
(36) Richard Ravitch........................................................................
VICE CHAIRMAN/Trustee
 4.0
.......................5.0 		X   X            
(37) DR GILA LEITER........................................................................
TRUSTEE (EX-OFFICIO)
 2.0
.......................0.0 		X                
(38) DR DAVID L REICH........................................................................
TRUSTEE (EX-OFFICIO)
 2.0
.......................0.0 		X                
(39) Kenneth L Davis MD........................................................................
CHIEF EXECUTIVE OFFICER
 26.5
.......................28.5 		    X       1,599,911 1,599,911 57,450
(40) Wayne Keathley........................................................................
President/COO
 53.0
.......................2.0 		    X       1,343,848 0 50,120
(41) Michael Macdonald ESQ........................................................................
Executive VP/General counsel
 27.0
.......................28.0 		    X       480,777 480,777 61,658
(42) donald t scanlon........................................................................
Executive VP, BUS & FINANCE
 26.0
.......................29.0 		    X       786,032 786,032 52,084
(43) jeffrey silberstein........................................................................
exec vp/chief admin officer
 27.0
.......................28.0 		    X       514,147 514,147 41,572
(44) connie c klepper........................................................................
Sr VP, Bus Dev & Managed Care
 27.0
.......................28.0 		    X       352,556 352,556 40,926
(45) mark kostegan fahp........................................................................
Sr VP, Development
 15.9
.......................39.1 		    X       248,202 579,138 43,526
(46) jane maksoud........................................................................
Sr VP, HR & Labor Relations
 25.3
.......................29.7 		    X       345,245 389,319 57,157
(47) michael mccarry........................................................................
Sr VP, Periop. Services
 55.0
.......................0.0 		    X       413,333 0 33,645
(48) ira s nash md........................................................................
senior vp/cmo (resigned)
 49.0
.......................6.0 		    X       228,585 0 30,092
(49) michael pastier........................................................................
Sr VP, Finance/CFO
 48.0
.......................7.0 		    X       710,347 0 65,411
(50) carol porter........................................................................
senior vp/chief nurse officer
 55.0
.......................0.0 		    X       457,030 0 37,902
(51) caryn schwab........................................................................
Sr VP/Exec Dir, MSHQ
 55.0
.......................0.0 		    X       491,806 0 50,123
(52) margaret pastuszko........................................................................
SENIOR vp, STRATEGIC planning
 27.0
.......................28.0 		    X       332,349 332,349 49,668
(53) m v benthuysen resign........................................................................
sr vp, card. inst. & hosp. op.
 28.0
.......................27.0 		    X       228,946 0 22,823
(54) jane whitney........................................................................
vp/chief compliance officer
 28.1
.......................26.9 		    X       182,770 168,710 39,807
(55) daryl Wilkerson 1........................................................................
vp, support srvs (resigned)
 44.5
.......................10.5 		    X       103,284 25,821 18,486
(56) elana abraham 2........................................................................
corporate treasurer
 40.5
.......................14.5 		    X       242,660 0 49,393
(57) JAMES W CRYSTAL........................................................................
VICE CHAIRMAN/TRUSTEE
 4.0
.......................5.0 		    X            
(58) GLENN DUBIN........................................................................
VICE CHAIRMAN/TRUSTEE
 4.0
.......................5.0 		    X            
(59) ERIN S DUPREE MD........................................................................
VP, PAT SAFETY CHIEF MED OFF.
 52.2
.......................2.8 		    X       501,418 26,390 39,692
(60) PATRICIA LAMB........................................................................
VP, HOSPITAL OPERATIONS
 49.5
.......................5.5 		    X       133,404 14,822 9,449
(61) ALFRED R STERN........................................................................
HONORARY CHAIRMAN/TRUSTEE
 4.0
.......................5.0 		    X            
(62) frank cino MS CPA........................................................................
vp, chief audit exec
 33.5
.......................2.5 		      X     277,238 169,920 46,018
(63) KUMAR CHATANI........................................................................
SENIOR VP, IT, & CIO
 47.0
.......................8.0 		      X     756,312 113,012 24,547
(64) David nierman md........................................................................
VP, Med Affairs/CMO, MSHQ
 55.0
.......................0.0 		        X   462,740 0 55,464
(65) ajoy sinha md........................................................................
chief, dept of orth sur & pres
 55.0
.......................0.0 		        X   610,224 0 31,476
(66) ROBERT CHASSIN........................................................................
SR DIRECTOR - BUS DEV NET OPS
 55.0
.......................0.0 		        X   398,204 0 34,694
(67) CAROLYN ALBANESE........................................................................
VP, PATIENT FINANCIAL SERVICES
 55.0
.......................0.0 		        X   373,688 0 33,992
(68) CLAUDIA COLGAN RN........................................................................
VP, QUALITY INITIATIVES
 55.0
.......................0.0 		        X   352,282 26,516 22,407
(69) Burton Drayer 134........................................................................
former officer
 5.0
.......................50.0 		          X 0 1,338,924 37,957
(70) deborah Marin md 3........................................................................
former officer
 38.5
.......................16.5 		          X 287,023 123,009 36,814
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 13,214,361 7,041,353 1,174,353
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet2,121
Yes
No
3
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 ..............
3
Yes
 
4
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...........................
4
Yes
 
5
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 ........
5
 
No
Section B. Independent Contractors
1
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
ERNST YOUNG LLP, 5 TIMES SQUARENEW YORKNY10036 ACCOUNTING 1,052,985
PROSKAUER ROSE LLP, 11 TIMES SQUARENEW YORKNY100368299 LEGAL 1,031,195
EDWARD WILDMAN PALMER, PO BOX 416395NEW YORKNY10003 LEGAL 1,028,370
NADASKAY KOPELSON ARCHITECTS, 95 WASHINGTON STREETMORRISTOWNNJ07960 ARCHITECTURE 764,765
AKIN GUMP STRAUSS HAUER FELD, 399 PARK AVENUENEW YORKNY10022 LEGAL 463,388
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet45
Form 990 (2012)
Form 990 (2012)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response to any question in this Part VIII ..............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c 2,845,372
d Related organizations...1d 3,587,005
e Government grants (contributions)1e 2,794,452
f All other contributions, gifts, grants, and
similar amounts not included above1f 		24,742,371
g Noncash contributions included in lines
1a-1f:$ 		693,830
h Total. Add lines 1a-1f.......MediumBullet 33,969,200
Program Service Revenue Business Code
2a NET PATIENT SERVICE REVENUE 621110 1,738,334,036 1,738,334,036    
b LABORATORY SERVICES REVENUE 621500 1,743,271   1,743,271  
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 1,740,077,307
Other Revenue 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 8,972,986   303,705 8,669,281
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties...........MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents    
b Less: rental expenses    
c Rental income or (loss) 0 0
d Net rental income or (loss).......MediumBullet 0      
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 15,400,000  
b Less: cost or other basis and sales expenses    
c Gain or (loss) 15,400,000  
d Net gain or (loss)..........MediumBullet 15,400,000     15,400,000
8a Gross income from fundraising events (not including
$ 2,845,372
of contributions reported on line 1c). See Part IV, line 18 ..
a 291,520
b Less: direct expenses ...b 573,550
c Net income or (loss) from fundraising events..MediumBullet -282,030   -282,030
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...MediumBullet 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..MediumBullet 0      
Miscellaneous Revenue Business Code
11a CAFETERIA 722320 8,535,650     8,535,650
b MEANINGFUL USE 900099 6,539,015 6,539,015    
c FICA RESIDENT REFUND 900099 21,915,698 21,915,698    
d All other revenue .... 13,526,409 5,355,597 -1,019,495 9,190,307
e Total. Add lines 11a–11d ...... MediumBullet 50,516,772
12 Total revenue. See Instructions......MediumBullet 1,848,654,235 1,772,144,346 1,027,481 41,513,208
Form 990 (2012)
Form 990 (2012)
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).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 30,035,966 30,035,966
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 .... 11,392,897   10,839,436 553,461
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 659,179,717 579,821,917 78,044,935 1,312,865
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 48,063,263 41,885,743 6,075,272 102,248
9 Other employee benefits ....... 100,018,833 86,883,000 12,892,443 243,390
10 Payroll taxes ........... 55,181,085 47,764,550 7,270,074 146,461
11 Fees for services (non-employees):        
a Management ...... 20,383,319 17,689,707 2,693,612  
b Legal ......... 1,955,890   1,690,422 265,468
c Accounting ........... 698,760   698,760  
d Lobbying ........... 376,590 376,590    
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 978,017 978,017    
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 168,392,496 146,147,847 22,244,649  
12 Advertising and promotion .... 4,195,192 3,470,198 528,187 196,807
13 Office expenses ....... 12,898,005 11,041,984 1,669,719 186,302
14 Information technology ...... 12,639,808 10,947,173 1,666,230 26,405
15 Royalties .. 0      
16 Occupancy ........... 55,240,819 47,536,393 7,235,347 469,079
17 Travel ............ 1,034,283 868,550 132,199 33,534
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 485,593 421,447 64,146  
20 Interest ........... 15,986,987 15,986,987    
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 92,980,922 76,858,030 16,122,892  
23 Insurance .............. 34,187,977 29,671,745 4,516,232  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a BAD DEBTS 22,163,986 22,163,986    
b DIETARY 11,268,208 9,643,938 1,467,870 156,400
c STAFF SUPPORT 3,821,773 3,316,917 504,856  
d MEDICAL SUPPLIES 353,744,013 353,744,013    
e All other expenses        
25 Total functional expenses. Add lines 1 through 24e 1,717,304,399 1,537,254,698 176,357,281 3,692,420
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 MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2012)
Form 990 (2012)
Page 11
Part X Balance Sheet Check if Schedule O contains a response to any question in this Part X ...............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing ............. 844,569 1 375,619
2 Savings and temporary cash investments ......... 235,145,997 2 354,100,780
3 Pledges and grants receivable, net ........... 20,767,203 3 18,861,365
4 Accounts receivable, net ............. 200,800,109 4 215,644,611
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
0 6 0
7 Notes and loans receivable, net ............. 2,319,246 7 0
8 Inventories for sale or use .............. 20,911,343 8 25,801,859
9 Prepaid expenses and deferred charges .......... 2,616,055 9 2,005,601
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 1,442,865,843
b Less: accumulated depreciation ..... 10b 889,650,206 477,442,112 10c 553,215,637
11 Investments—publicly traded securities .......... 749,184,088 11 347,466,495
12 Investments—other securities. See Part IV, line 11 ..... 63,097,000 12 461,409,000
13 Investments—program-related. See Part IV, line 11 ..... 62,500,371 13 71,763,672
14 Intangible assets ............... 0 14 0
15 Other assets. See Part IV, line 11 ........... 404,568,560 15 351,670,842
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 2,240,196,653 16 2,402,315,481
Liabilities 17 Accounts payable and accrued expenses ......... 212,814,957 17 225,888,281
18 Grants payable ................. 0 18 0
19 Deferred revenue ................ 27,517,346 19 30,144,633
20 Tax-exempt bond liabilities ............. 425,144,138 20 406,207,675
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
22 Loans and other 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 .. 22,312,500 23 19,762,500
24 Unsecured notes and loans payable to unrelated third parties .... 0 24 6,314,165
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.................... 625,964,582 25 620,706,375
26 Total liabilities. Add lines 17 through 25......... 1,313,753,523 26 1,309,023,629
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 763,859,330 27 932,896,973
28 Temporarily restricted net assets ........... 86,709,913 28 84,126,615
29 Permanently restricted net assets ........... 75,873,887 29 76,268,264
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet 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 ........... 926,443,130 33 1,093,291,852
34 Total liabilities and net assets/fund balances ........ 2,240,196,653 34 2,402,315,481
Form 990 (2012)
Form 990 (2012)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI ...............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
1,848,654,235
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
1,717,304,399
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
131,349,836
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
926,443,130
5
Net unrealized gains (losses) on investments ...............
5
27,248,610
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
8,250,276
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
1,093,291,852
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII ..............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If “Yes,” to line 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?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
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?
3a
Yes
 
b
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
3b
Yes
 
Form 990 (2012)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID:  
Software Version:  
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.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
THE MOUNT SINAI HOSPITAL
 
Employer identification number

13-1624096
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
f
g
(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 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 monetary support
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..            
11 Total support (Add lines 7 through 10).            
12
12
 
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........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
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 ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 3
Part III
Support Schedule for Organizations Described in Section 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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (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
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 4
Part IV
Supplemental Information. Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2012

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2012
Name of the organization
THE MOUNT SINAI HOSPITAL
 
Employer identification number

13-1624096
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




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
Special Rules
......................... 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) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
Page 2
Name of organization
THE MOUNT SINAI HOSPITAL
  		Employer identification number

13-1624096
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


(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
Page 3
Name of organization
THE MOUNT SINAI HOSPITAL
  		Employer identification number

13-1624096
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) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
Page 4
Name of organization
THE MOUNT SINAI HOSPITAL
  		Employer identification number

13-1624096
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 (c) Use 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 (c) Use 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 (c) Use 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 (c) Use 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) (2012)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public
Inspection
If the organization answered “Yes” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35c (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
THE MOUNT SINAI HOSPITAL
 
Employer identification number

13-1624096
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ...................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2012

Schedule C (Form 990 or 990-EZ) 2012
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(b) Affiliated group
totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in) 		(a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) Total
             
2a Lobbying nontaxable amount          
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		         
             
c Total lobbying expenditures          
             
d Grassroots nontaxable amount          
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		          
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2012


Schedule C (Form 990 or 990-EZ) 2012
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each “Yes” response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
Yes
 
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
Yes
 
376,590
j
Total. Add lines 1c through 1i ...............................
376,590
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
No
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered “No” OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ............................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.
Identifier Return Reference Explanation
Part II-B, Line I Other Activities The Mount Sinai Hospital pays dues to various organizations that lobby federal and state legislators on behalf of health care facilities, including the Mount Sinai Hospital. The portion of these dues by entity are summarized below: American Health Association $123,014 1199 sieu $5,934 Greater New York Hospital Association $10,000 Health Association of NYS (HANYS) $220,548 MOUNT SINAI HOSPITAL EXECUTIVES $17,094
Schedule C (Form 990 or 990EZ) 2012

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet 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
2012
Open to Public Inspection
Name of the organization
THE MOUNT SINAI HOSPITAL
 
Employer identification number

13-1624096
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 ........    
5
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? ............
6
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? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
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.
Held at the End of the 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  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, 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.
1a
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 XIII, the text of the footnote to its financial statements that describes these items.
b
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 $  
2
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:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
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?........
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.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance .... 162,583,800 177,522,231 161,021,859 149,259,087 150,601,021
b Contributions ........ 29,683,697 28,545,569 40,480,116 42,703,335 32,755,660
c Net investment earnings, gains, and losses     0 0 0
d Grants or scholarships .....     0 0 0
e Other expenditures for facilities
and programs ........ 		31,872,618 43,484,000 23,979,744 30,940,563 34,097,594
f Administrative expenses ....     0 0 0
g End of year balance ...... 160,394,879 162,583,800 177,522,231 161,021,859 149,259,087
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet52.000 %
b
Permanent endowment SchDMd Bullet48.000 %
c
Temporarily restricted endowment SchDMd Bullet0 %
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII 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 (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   39,305,828 39,305,828
b Buildings ................   304,445,539 203,125,461 101,320,078
c Leasehold improvements ............        
d Equipment ................   1,062,474,300 686,524,745 375,949,555
e Other .................   36,640,176   36,640,176
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 553,215,637
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 3
Part VII
Investments—Other 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    
(3)Other
(A) HEDGE FUNDS 		370,853,000 F

(B) PRIVATE INVESTMENTS 		90,556,000 F







Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 461,409,000
Part VIII
Investments—Program 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.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) DUE TO/FROM RELATED ORGS 86,838,702
(2) DEFERRED FINANCING FEES 8,583,142
(3) 457B PLAN 4,935,506
(4) ROTATING RESIDENTS 2,294,541
(5) TENANT SECURITY DEPOSITS 344,201
(6) DEPOSITS HELD BY THIRD PARTIES 2,765,873
(7) THIRD PARTIES REC POOL RELATED 13,367,960
(8) OTHER RECEIVABLES 2,922,181
(9) FICA RECEIVABLE 3,629,266
(10) PROF BILLING RECEIVABLE 3,160,270
(11) PROF LIAB INS REC 222,829,200
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 351,670,842
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes 0
POST RETIREMENT BENEFITS 20,023,681
THIRD PARTY LIABILITIES 328,079,766
RENT SECURITY DEPOSIT 344,201
AR CREDIT BALANCES 11,166,074
MALPRACTICE INSURANCE 22,490,858
PLANNED GIFT LIABILITY 779,563
RECRUITMENT LIABILITY 10,000,000
MULTISPECIALITY LIABILITY 57,526
457B PLAN LIABILITY 4,935,506
PROFESSIONAL LIABILITIES 222,829,200
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 620,706,375
2. Fin 48 (ASC 740) Footnote. In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII .....................................................
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1 1,796,463,000
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 XIII.) ............ 2d 41,050,250
e Add lines 2a through 2d ..................... 2e 41,050,250
3 Subtract line 2e from line 1..................... 3 1,755,412,750
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 978,017
b Other (Describe in Part XIII.) ........... 4b 92,263,468
c Add lines 4a and 4b....................... 4c 93,241,485
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 1,848,654,235
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ........... 1 1,717,361,000
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 XIII.) ............ 2d 30,733,966
e Add lines 2a through 2d...................... 2e 30,733,966
3 Subtract line 2e from line 1..................... 3 1,686,627,034
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 978,017
b Other (Describe in Part XIII.) ............ 4b 29,699,348
c Add lines 4a and 4b....................... 4c 30,677,365
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 1,717,304,399
Part XIII
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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
Part V, Line 4 Intended Uses of Organization's Endowment Funds MOUNT SINAI HOSPITAL'S ENDOWMENT FUNDS ARE RESTRICTED TO INVESTMENT IN PERPETUITY WITH THE INCOME EXPENDABLE TO SUPPORT PROGRAM ACTIVITIES AS STIPULATED BY DONORS. THE HOSPITAL FOLLOWS THE REQUIREMENTS OF THE UNIFORM MANAGEMENT OF INSTITUTIONAL FUNDS ACT ("UMIFA") AS THEY ARE RELATED TO ITS ENDOWMENT CONTRIBUTIONS. THE HOSPITAL HAS ADOPTED INVESTMENT AND SPENDING POLICIES FOR ENDOWMENT ASSETS THAT ATTEMPTS TO PROVIDE A PREDICTABLE STREAM OF FUNDING TO PROGRAMS SUPPORTED BY ITS ENDOWMENT. UNDER THIS POLICY, AS APPROVED BY THE BOARD OF TRUSTEES, THE ENDOWMENT ASSETS ARE INVESTED IN A MANNER TO PROVIDE THAT SUFFICIENT ASSETS ARE AVAILABLE AS A SOURCE OF LIQUIDITY FOR THE INTENDED USE OF THE FUNDS, ACHIEVE THE OPTIMAL RETURN POSSIBLE WITH THE SPECIFIC PARAMETERS, PRUDENTLY INVEST ASSETS IN A HIGH-QUALITY DIVERSIFIED MANNER AND ADHERE TO ESTABLISHED GUIDELINES.
Part XII, Line #2d Reconciliation of Revenue per AFS Assets Released from Restrictions $23,858,287 Diagnostic & Treatment Center $17,191,963 TOTAL $41,050,250
Part XII, Line #4B Reconciliation of Revenue per AFS All other Contributions $29,683,697 third parties reimbursement settlement $41,623,186 medical residents fica refund $21,915,698 DISTRIBUTION FROM MSMC RESIDENTIAL REALTY $60,374 8 East 102nd Street Manager LLC ($1,019,495) rounding $8 TOTAL $92,263,468
Part XIII, Line #2d Reconciliation of Expenses Per AFS Diagnostic & Treatment Center $30,733,966 TOTAL $30,733,966
Part XIII, Line #4B Reconciliation of Expenese per AFS transfer to affiiates $16,096,089 Contribution to Mt. Sinai DTC $13,542,003 GRANT TO ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI $60,374 Rounding $882 TOTAL $29,699,348
Schedule D (Form 990) 2012

Additional Data


Software ID:  
Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990. Right pointing arrow large image See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
THE MOUNT SINAI HOSPITAL
 
Employer identification number

13-1624096
Part I
General Information on Activities Outside the United States. Complete if the organization answered “Yes” to Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of the grants or
assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used to award
the grants or assistance? ...................................
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of grant funds outside
the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in region (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region		 (f) Total expenditures
for and investments
in region
Central America and the Caribbean     Program Services insurance 41,908,632
Central America and the Caribbean     Investments investments 238,508,000
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total .....     280,416,632
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b)     280,416,632
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2012
Schedule F (Form 990) 2012
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered “Yes” to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (c) Region (d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount of
of non-cash
assistance 		(h) Description
of non-cash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter ....MediumBullet
 
3
Enter total number of other organizations or entities .......................MediumBullet
 
Schedule F (Form 990) 2012
Schedule F (Form 990) 2012Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
non-cash
assistance 		(g) Description
of non-cash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2012
Schedule F (Form 990) 2012
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If “Yes,”the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926)......................................
2 Did the organization have an interest in a foreign trust during the tax year? If “Yes,” the organizationmay be required to file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A).......................................
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471)..............................
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If "Yes," the organization may be required to file Form 8621, Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621)
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865)....................................
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see Instructions for Form 5713)................................................
Schedule F (Form 990) 2012
Schedule F (Form 990) 2012
Page 5
Part V
Supplemental Information
Complete this part to provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).
Identifier ReturnReference Explanation
Part I, Line 2   The primary coverage of professional and general liability incidents has been provided through participation in a pooled program with certain other health care facilities (principally hospitals) affiliated with the Federation of Jewish Philanthropies of New York. This occurrence basis insurance coverage participation is with captive insurance companies and commercial insurance companies. The Captive Insurance companies have two offices in the Caribbean, specifically Bermuda and Barbados. The companies were incorporated in Bermuda and Barbados in 1982 and 1986 respectively and are licensed under the Insurance Act of both countries. Since the Hospital is a shareholder of the captive insurance companies, the Hospital follows the equity method of accounting for its interest in the insurance companies associated with its medical malpractice insurance program. Additionally, Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations, has been filed with the Hospital's 990T.
parts I & IV   PLEASE NOTE THAT THE INVESTMENT ACTIVITIES LISTED IN PART I ARE ALLOCATED TO AGREE TO THE AUDITED FINANCIAL STATEMENT REPORTING AS POOLED INVESTMENTS WHILE PART IV REPORTS ON FOREIGN FILINGS FILED BY THE RESPECTIVE ORGANIZATION.
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
Schedule F (Form 990) 2012
Additional Data


Software ID:  
Software Version:  



SCHEDULE G (Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. Form 990-EZ filers are not required to complete this part. right arrowAttach to Form 990 or Form 990-EZ. right arrowSee separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
THE MOUNT SINAI HOSPITAL
 
Employer identification number

13-1624096
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.
(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
             
             
             
             
             
             
             
             
             
             
Total .................right arrow      
3
List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.
For Paperwork Reduction Act Notice, see the Instructions for Form 990or 990-EZ.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2012
Schedule G (Form 990 or 990-EZ) 2012
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.
(a) Event #1

WINE DINNER
(event type) 		(b) Event #2

BREAKFAST
(event type) 		(c) Other events

2
(total number) 		(d) Total events
(add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 1,878,200 676,000 582,692 3,136,892
2 Less: Contributions . . 1,841,700 501,000 502,672 2,845,372
3 Gross income (line 1
minus line 2) . . . 		36,500 175,000 80,020 291,520
VerticalDirectExpenses 4 Cash prizes . . .        
5 Noncash prizes . .        
6 Rent/facility costs . . 30,000   2,075 32,075
7 Food and beverages . 115,876 30,200 104,497 250,573
8 Entertainment . . . 9,000 10,300 1,960 21,260
9 Other direct expenses . 200,551 24,500 44,591 269,642
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 573,550
11 Net income summary. Combine line 3, column (d), and line 10. .......... right arrow -282,030
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (add col.(a) through col.(c))
1 Gross revenue . . . .        
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .        
4 Rent/facility costs . . .        
5 Other direct expenses . .        
6 Volunteer labor . . .
 
 
 
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow  
8 Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow  
9
Enter the state(s) in which the organization operates gaming activities:
a
Is the organization licensed to operate gaming activities in each of these states? ............
b
If "No," explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," explain:
 
Schedule G (Form 990 or 990-EZ) 2012
Schedule G (Form 990 or 990-EZ) 2012
Page 3
11
Does the organization operate gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ..........................
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
 
b
An outside facility ........................
13b
 
14
Enter the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address of the third party:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Supplemental Information. Complete this part to provide the explanations required by Part I, line 2b, columns (iii) and (v), and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions).
Identifier Return Reference Explanation
Schedule G (Form 990 or 990-EZ) 2012
Additional Data


Software ID:  
Software Version:  
SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet 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
2012
Open to Public Inspection
Name of the organization
THE MOUNT SINAI HOSPITAL
 
Employer identification number

13-1624096
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
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.
3
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.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: .........
3b
Yes
 
%
c
If the organization used factors other than FPG in determining 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, as a factor in determining eligibility for free or discounted care.
4
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"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
Yes
 
c
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? ..............
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (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) .. 		    40,467,898 12,039,937 28,427,961 1.660 %
b Medicaid (from Worksheet 3,
column a) .... 		    399,461,393 344,835,779 54,625,614 3.180 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		           
d Total Financial Assistance
and Means-Tested
Government Programs . 		    439,929,291 356,875,716 83,053,575 4.840 %
Other Benefits
     16,613,217   16,613,217 0.970 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		    176,199,520 71,543,209 104,656,311 6.100 %
g Subsidized health services
(from Worksheet 6) .. 		    29,179,096 15,637,093 13,542,003 0.790 %
h Research (from Worksheet 7)            
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		    292,439   292,439 0.020 %
j Total. Other Benefits ..     222,284,272 87,180,302 135,103,970 7.880 %
k Total. Add lines 7d and 7j .     662,213,563 444,056,018 218,157,545 12.720 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
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.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support     212,212   212,212 0.010 %
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building            
7 Community health improvement advocacy     216,101   216,101 0.010 %
8 Workforce development            
9 Other            
10 Total     428,313   428,313 0.020 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
22,163,986
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
416,172,520
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
406,739,659
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
9,432,861
8
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:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
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.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—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) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?2
Name, address, and primary website address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 MOUNT SINAI HOSPITAL
ONE GUSTAVE L LEVY PLACE
NEW YORK,NY10029 		X X   X     X X    
2 MOUNT SINAI HOSPITAL OF QUEENS
25-10 30TH AVENUE
LONG ISLAND CITY,NY11102 		X X         X X    
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
MOUNT SINAI HOSPITAL
Name of hospital facility or facility reporting group  
For single facility filers only: line Number of Hospital Facility (from Schedule H, Part V, Section A) 1
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1    
If “Yes,” indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20  
3 In conducting its most recent CHNA, did the hospital facility take into account input from representatives of the community served by the hospital facility, including those with special knowledge of or expertise in public health? 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 CHNA 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 CHNA report widely available to the public? ............. 5    
If “Yes,” indicate how the CHNA report was made widely available (check all that apply):
a
b
c
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7    
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a    
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 100%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 300.%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 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?....... 15 Yes  
16 Check all of the following 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
b
c
d
e
17 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?.......... 17   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 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?.......... 19 Yes  
If “No,” indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 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
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individuals 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? ............................ 21   No
If “Yes,” explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individuals an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
MOUNT SINAI HOSPITAL OF QUEENS
Name of hospital facility or facility reporting group  
For single facility filers only: line Number of Hospital Facility (from Schedule H, Part V, Section A) 2
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1    
If “Yes,” indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20  
3 In conducting its most recent CHNA, did the hospital facility take into account input from representatives of the community served by the hospital facility, including those with special knowledge of or expertise in public health? 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 CHNA 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 CHNA report widely available to the public? ............. 5    
If “Yes,” indicate how the CHNA report was made widely available (check all that apply):
a
b
c
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7    
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a    
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 100%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 300.%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 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?....... 15 Yes  
16 Check all of the following 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
b
c
d
e
17 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?.......... 17   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 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?.......... 19 Yes  
If “No,” indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 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
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individuals 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? ............................ 21   No
If “Yes,” explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individuals an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
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?18
Name and address Type of Facility (describe)
1 CENTER FOR ADVANCE MEDICINE
5 E 102ND STREET
NEW YORK,NY10029 		CLINIC
2 MOUNT SINAI ADOLESCENT HEALTH CENTER
320 E 94TH STREET
NEW YORK,NY10029 		CLINIC
3 MOUNT SINAI HOSPITAL KIDNEY CENTER
309 E 94TH STREET
NEW YORK,NY10128 		DIALYSIS CENTER
4 PSYCHIATRIC OUTPATIENT CLINIC
1160 FIFTH AVENUE
NEW YORK,NY10029 		CLINIC
5 JOSEPH H HAZAN AMB CARDIAC CENTER
5 E 98 STREET
NEW YORK,NY10029 		CLINIC
6 MT SINAI SPORTS THERAPY
625 MADISON AVENUE
NEW YORK,NY10022 		PHYSICAL THERAPY CLINIC
7 BAYARD RUSTIN EDUCATIONAL COMPLEX
W 18TH STREET
NEW YORK,NY10011 		PART TIME CLINIC
8 PS 108
1615 MADISON AVENUE
NEW YORK,NY10029 		PART TIME CLINIC
9 JHS 117 ALTERNATIVE EDUCATIONAL COMPLEX
240 E 109TH STREET
NEW YORK,NY10029 		PART TIME CLINIC
10 PS 38
232 E 103RD STREET
NEW YORK,NY10029 		PART TIME CLINIC
11 JULIAN RICHMAN HIGH SCHOOL
317 E 67TH STREET
NEW YORK,NY10021 		PART TIME CLINIC
12 PS 83 MENDOZA SCHOOL
219 E 109TH STREET
NEW YORK,NY10029 		PART TIME CLINIC
13 MANHATTAN CENTER FOR MATH & SCIENCES
FDR DRIVE 116TH STREET
NEW YORK,NY10029 		PART TIME CLINIC
14 PRIMARY CARE CENTER
31-06 21ST STREET
ASTORIA,NY11102 		CLINIC
15 MOUNT SINAI AMBULATORY CARE
1200 FIFTH AVENUE
NEW YORK,NY10029 		CLINIC
16 MOUNT SINAI COMPREHENSIVE HEALTH PGRM DT
26 WEST SEVENTH AVENUE
NEW YORK,NY10011 		CLINIC
17 MT SINAI PSYCHIATRIC CONTIN DAY TREAT
53-55 E 96TH STREET ABC 1ST FL
NEW YORK,NY10029 		CLINIC
18 MOUNT SINAI QUEENS PHYSICIAN ASSOCIATES
27-15 30TH AVENUE
LONG ISLAND CITY,NY11102 		CLINIC
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
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; Part V, Section A; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
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.
8 Facility reporting group(s). If applicable, for each hospital facility in a facility reporting group provide the descriptions required for Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
Identifier ReturnReference Explanation
SCHEDULE H SUPPLEMENTAL INFORMATION   Part I, Line 7 The Mount Sinai Hospital used the ratio of cost-to-charges methodology for costing purposes. The cost-to-charge ratio was derived utilizing Worksheet 2, Ratio of Patient Care Costs-to-Charges. PART I, LINE 7F BAD DEBT EXPENSES OF $22,163,986 FOR 2012 WERE INCLUDED IN TOTAL EXPENSES IN PART IX, LINE 25 AND EXCLUDED IN WORKSHEET 8, LINE 14 OF SCHEDULE H FOR PURPOSE OF COMPARISON YEAR OVER YEAR. Part I, Line 7G The Hospital reported its support for the Mount Sinai Diagnostic and Treatment Center (MSDTC) under Part I, Line 7g Subsidized Health Services. MSDTC is a separately licensed entity that operates a variety of diagnostic and treatment clinics in the Hospital's East Harlem service area. The Hospital provides sufficient funding for MSDTC so that it can meet its annual operating requirements. In 2012, the Hospital funded the MSDTC's operating loss of $13.5 million.
Part II Community Building Expense   The Mount Sinai Hospital expended funds on advocacy and community support during 2012. These activities represented efforts by the Hospital to improve the health of the community by advocating for enhanced services and public policies that would expand access to important medical and social services for its surrounding community. Additionally, the Hospital invested in emergency preparedness so as to ensure the provision of necessary medical services in the event of any situation that required emergency medical services for the members of the community. Part III Line 2 In evaluating the collectability of accounts receivable, the Hospital analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for bad debts. Additionally, patients who do not qualify for sliding scale fees and all uninsured inpatients who do not qualify for Medicaid assistance are billed at the Hospital's rates. Uncollected balances for these patients are categorized as bad debts. Part III, Line 4 The Mount Sinai Hospital reported bad debt as an expense in Part IX. However, in its audited financial statements, the Hospital reports bad debts as a reduction to revenue in accordance with Accounting Standards Update No. 2011-07, Presentation and Disclosure of Patient Service Revenue, Provision for Bad Debts, and the Allowance for Doubtful Accounts for Certain Health Care Entities. The Hospital's Accounts Receivable and Net Patient Service Revenue footnote includes the following disclosures in relation to bad debts: "Deductibles and copayments under third-party payment programs within the third-party payor amount above are the patient's responsibility and the Hospital considers these amounts in its determination of the provision for bad debts based on collection experience." "In evaluating the collectability of accounts receivable, the Hospital analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for bad debts." "Patients who do not qualify for sliding scale fees and all uninsured inpatients who do not qualify for Medicaid assistance are billed at the Hospital's rates. Uncollected balances for these patients are categorized as bad debts." Part III, Line 8 Schedule H, Part III, Section B. Medicare Line 6 (Medicare Allowable Cost) were obtained from the Medicare cost report. The cost report utilizes a step-down methodology to allocate an institution's allowable costs by service and program. In addition, the Hospital included the Medicare share of the loss for Health Professions Education (Schedule H, Part I, Line 7f), which amounted to $23.4 million in order to provide a more accurate reflection of the Hospital's Medicare financial results. Part III, Line 9 The Hospital's collection practices do not apply to charity care balances. Once an account or a portion thereof is deemed to be charity care, it is written off as such. As a result, there is no further collection effort on the account balance. Part V, Section A. Hospital Facilities Mount Sinai Hospital and Mount Sinai Hospital of Queens both operate under the same Certificate Number 7002024H issued by the State of New York's Department of Health. We thereby consider them to be one hospital facility subject to Section 501(r) including its Community Health Needs Assessment requirement. Part V, Line 18E The Hospital would follow up with phone calls and emails as part of the outreach effort to determine the patients eligibility under the facilitys FAP. Part V, Line 20D In compliance with New York State Law, Mount Sinai uses the set contract rates of it highest volume commercial payer.
2. Needs Assessment   A continuous community needs assessment process occurs in Manhattan and Western Queens through active membership/participation of administrative leaders, staff and faculty in over 20 community committees, coalitions and board; and through service and educational partnerships with community health, social service, civic organization and schools. The Department of Community and Government Affairs acts as a liaison for the Medical Center to health, social service and civic organizations, schools, coalition and community leaders in East and Central Harlem, the Upper West Side and in boroughs outside of Manhattan and Western Queens. Community and Government Affairs work closely with the Mount Sinai School of Medicine, Mount Sinai's Center for Multicultural and Community Affairs and the Department of Community and Preventive Medicine to assist other Medical Center departments that seek to implement community programs and research projects. The Mount Sinai Medical Center actively seeks the views of community residents, hospital consumers, health care providers, religious groups, community boards, elected officials, supports groups, and community health and human service professionals in identifying the need for services and public health priorities. The Mount Sinai Medical Center's public participation includes the following: * Mount Sinai's Board of Trustees has established a Community Affairs committee whose members include senior management, health providers, and Trustees. A Trustee serves as a Community Advisory Board member to ensure board to board communications. The Board of Trustees meets quarterly to evaluate services and community needs. * Mount Sinai's Community Advisory Board (CAB) members represent diverse socioeconomic and ethnic constituencies and representatives from the Medical Center leadership and departments. The CAB's goal is to ensure that the medical center is responsive to health care needs of consumers, with particular emphasis on the needs of East Harlem. The CAB meets monthly to evaluate services and community needs. * The Tisch Cancer Institute has established a CAB to work in partnership with East and Central Harlem community residents and organizations to reduce the excess burden of cancer among its majority African-American and Hispanic residents to find ways to overcome cancer disparities. The CAB meets monthly to discuss community resources, strengths and interventions to improve the quality of cancer prevention, treatment and care. * Mount Sinai has established and hosts a monthly Community Roundtable to keep its pulse on the needs of East Harlem and Central Harlem communities. Approximately 80 community leaders, educators, elected officials, and CAB members are in attendance at the monthly meetings. * The Mount Sinai Medical Center representatives participate actively in monthly/quarterly meetings with the following organizations in its continuing efforts to discuss health care needs of the community. * Abyssinian Development Corporation. * Boriken Neighborhood Health Center. * Bronx Aids Services. * Children's Aids Society. * Community Board No.11 - Manhattan, Health & Human Services Committee. * East Harlem Chamber of Commerce. * East Harlem HIV Care Network. * East Harlem Partnership for Cancer. * Greater Harlem Chamber of Commerce. * Little Sisters of the Assumption Family Health Services. * New York Academy of Medicine. * New York City Housing Authority - Carver Houses Tenants Association & Johnson Tenants Association. * Jewish Home and Hospital * Settlement Health Association. * Union Settlement Association. * Yorkville Common Pantry The Mount Sinai Hospital of Queens' public participation includes the following: * Mount Sinai Hospital of Queens recently formed a CAB and serves the needs of a culturally diverse population with representatives from social and human service organizations, civic associations, public housing authority, and health care providers. The CAB meets quarterly to evaluate services and community needs. * Mount Sinai Hospital of Queens conducts an annual Community Roundtable to inform and update participants on new programs and projects and facility improvements at the Hospital. The focus is also on engaging participants in a discussion of ways in which the Hospital can improve and better serve the needs of the community. * The annual Pastoral Care Forum for clergy and other religious leaders in the community featured an educational session as well as an information-sharing component of services available in the community. * Mount Sinai representatives participate actively in monthly/quarterly meetings with the following organizations in its continuing efforts to discuss health care needs of the community. * American Cancer Society. * Astoria Civic Association. * Catholic Charities of Brooklyn and Queens. * Community Boards No.1 & 2 - Queens. * Gateway to Health Sciences Secondary School. * Greek Orthodox Archdiocesan of America Hellenic Cultural Center. * HANAC. * Jacob Riis Neighborhood Settlement House. * Queens Chamber of Commerce. * New York City Housing Authority - Ravenswood Tenants Association. * SHAREing and CAREing. * United Community Civic Association. * Visiting Nurse of New York. The Mount Sinai Medical Center discusses and analyzes the following demographic and socio-economic data with community partners as part of the community needs assessment process. 1. Utilization - Identify which services/programs have met or exceeded projected utilization 2. Patient satisfaction surveys - Analyze the hospitals' patient surveys to determine areas of needs identified by patients and their families 3. Local demand for services - Identify the services/programs with waiting lists, which demonstrate that the local demand for services exceeds capacity 4. Community need data - Determine the health of the community by examining the health statistics on the NYCDOHMH and NYSDOH websites; and determine the areas in which the target goals of Take Care New York are not met. Additionally, in assessing the communities' needs in conjunction with community partners, consumers, community boards, community leaders, and community health and human service professionals, the following questions are considered: 1. Is the cause of the illness, disease or health behavior preventable? 2. Does the hospital have existing resources, capacity, and processes to conduct outreach, provide screenings and treatment, measure, and evaluate set goals? 3. Was the health focus also identified by, discussed with, and determined as a priority in the health of the community by community partners, consumers, community health and human service professionals, NYCDOHMH, and the hospital's Community Advisory Board? Based on the information gathering process described above, the Hospital develops a community service plan that focuses on the health priorities for the surrounding community.
3. Patient education and eligibility for assistance   All patients that do not have insurance are notified that financial assistance may be available for them. Prominently placed signs notify patients of the financial assistance policy and flyers summarizing the process are available in registration areas. The Hospital provides assistance with enrollment in Federal and State insurance programs including Medicare, Medicaid, Child Health Plus and Family Health Plus. If patients do not qualify for these programs they may qualify for financial assistance through the Hospital's Charity Care and Self Pay Discount Policy. Patient bills also provide information as to where a patient or the person responsible for the Hospital bill can call to receive financial assistance if they are not able to pay the Hospital's bill. Patients are provided with assistance through the Hospital's Financial Counseling Department (Mount Sinai patients only) or through its Resource Entitlement and Advocacy Program (REAP) Office. The REAP Office assists both Hospital patients and community members to obtain financial assistance for their medical expenses.
4. Community Information   The Mount Sinai Medical Center serves patients in all five boroughs of New York City, Long Island, Westchester and Rockland counties, New Jersey and Connecticut. Mount Sinai is a regional and national referral center. The hospital defines New York County as the area used for community/local health planning for the purposes of the Community Service Plan. Census data were used to determine the service area of The Mount Sinai Medical Center. The total population of New York County in 2010 was 1,585,873 (increase of 3.2 percent from the 2000 Census). Approximately 52% of the New York County population in 2010 was of a minority population (18.5% African-American, 11.8% Asian and 21.7% "other" minority group members including individuals of 2+ races). There were 405,983 (25.6%) Hispanics, who can be of any race. New York County has eight federally-designated medically underserved areas. There are 20 hospitals, including specialty hospitals, serving this area. The U.S. Census identified that 282,285 members (17.8%) of the population were living at or below the Federal Poverty Level in 2010. It has been documented that individuals of minority and/or low-income status experience difficulties in accessing healthcare in some places. Mount Sinai serves residents of its service area without regard to any personal characteristics, including race/ethnicity or payer source. It is important to note the large minority population that Mount Sinai serves as most minority groups have been documented to suffer from cardiovascular disease at rates in excess of those of the White population. The Mount Sinai Medical Center has a strong history of serving traditionally underserved individuals throughout its service area, including Harlem and East Harlem communities surrounding the hospital. Mount Sinai provides the following health services to its community: * 67% of clinic visits are minority patients. * 53% of inpatient discharges are minority patients. * 85% of Emergency Department visits are minority patients. * More than 30% of inpatients reside in upper Manhattan. * Nearly 50% of outpatients reside in upper Manhattan. * More than 50% of Emergency Department patients reside in upper Manhattan. Reflective of the Hospitals location in the East Harlem neighborhood of New York County, approximately 45.5% and 53.5% of the hospital's inpatient discharges and outpatient visits, respectively, were from Medicaid patients. In many of the hospital's programs, over 60% of the patients have historically belonged to a minority group. The total number and percentage of individuals in the 45 and older age group in New York County is projected to grow dramatically from 2000 to 2015. The total number of individuals in this group is projected to increase from 534,263 individuals in 2000 to 694,295 individuals in 2015, representing a growth of 30.0% over this time period. This age group is projected to grow at a rate over seven times that of New York County from 2000 to 2015, and is at greater risk for cardiac problems than the general population. There were 217,265 individuals older than age 65 (comprising 13.7% of the population) residing within the service area in 2010. This population is projected to continue to grow to 242,281 individuals (comprising 15.1% of the population) by 2015, per the New York Statistical Information System from Cornell University. This age group is at greater risk for cancer than the general population. According to data from the New York State Department of Health (NYSDOH), infectious diseases, such as HIV, are more prevalent in the hospital's service area of New York County than in New York City and New York State overall. The HIV case rate from 2005 to 2007 in New York County was 72.9 individuals per 100,000, which was significantly higher than that of New York City (46.0 persons per 100,000) and the State (24.3 persons per 100,000). The Mount Sinai Hospital of Queens defines its primary service area as the following zip codes that comprise Northwestern Queens: 11101, 11102, 11103, 11104, 11105 and 11106 known as Long Island City/Astoria. The secondary service area consists of zip codes that comprise Western Queens: 11368, 11369, 11370, 11372, 11373, 11377 and 11378. Those zip codes define the areas used for community/local health planning for the purposes of the Community Service Plan. The population of the primary service area of Northwestern Queens in 2008 was 231,440 while the population of the secondary service area of Western Queens was 464,497 for a total of 695,937 residents. Over half (51%) of the population (representing more than 100 cultural and ethnic groups) is foreign-born compared to only 36% for New York City as a whole. In Northwestern Queens, roughly one in five persons lives in poverty; one in five adults smoke and is less likely to quit than smokers in New York City overall; women are less likely to get a regular Pap test for cervical cancer than women in New York City as a whole; and the service area has the second highest proportion of uninsured adults among all New York City neighborhoods, with foreign-born residents more likely to be without health insurance than those born in the United States. The heart disease hospitalization rate in the primary service area has increased by more than 10% in the past 10 years. The poverty and language barriers in Western Queens inhibit access to inpatient care. Per the New York City Department of City Planning, Mount Sinai Hospital of Queens is located in Queens Community Board No.1 - Queens. In 2007, 24.2% of the residents lived below the poverty level. This percentage is much greater than the percentage of residents below the poverty level (12.2%) for the entire county. Overall, greater than 50% of the residents in Community Board No.1 - Queens do not speak English "very well", according to the US Census Bureau. Staff members at Mount Sinai Hospital of Queens speak approximately 50 languages, a statistic that is growing each year. This is reflective of the cultural diversity of the service area, which includes residents comprising greater than 100 cultural and ethnic groups.
5. Promotion of Community Health   As mentioned in the description of the Needs Assessment in Part VI.2, the Hospital has formed a Community Board to ensure that the Medical Center is able to work closely with the surrounding community to identify and respond to the healthcare needs of the community. The Mount Sinai Medical Center Community Advisory Board was formed as a committee of the Board of Trustees to review and comment on the Medical Center's service, educational and research programs. The Board's goal is to ensure that the medical center is responsive to the health care needs of consumers, with particular emphasis on the needs of East Harlem. The Community Advisory Board is a forum for articulating patient care and community health concerns and for evaluating the effectiveness of services on the community's health status, patients' rights, and the quality of services provided to consumers. Community Advisory Board members represent diverse socioeconomic and ethnic constituencies and representatives of Medical Center leadership and departments. A majority are consumers. A Trustee serves as a Community Advisory Board member to ensure board-to-board communications. Based on the needs assessment and feedback the Hospital receives from groups like the Community Advisory Board, the Mount Sinai Hospital conducts a number of services and activities that are designed to promote and improve the health of individuals residing in the surrounding community. These services and activities help to inform people of healthy living habits and provide access to valuable health care services, including diagnostic screening services for at risk people. A brief description of each of these services and activities is provided below. * HouseCall is a newsletter developed and designed to introduce the Harlem community to the doctors, nurses, social workers, and other health professionals who serve the community. The publication includes extensive outpatient service information * Prescriptions for Healthy Living is a campaign launched in 2007 in which banners that stress the importance of taking control of health care and adopting a healthy lifestyle are placed throughout the community. * Good Health Is Precious brings health education and screening to community organizations, responding to a need for early detection. Mini health talks about asthma, cancer, cardiovascular health, chronic kidney disease, diabetes, mental health, nutrition and fitness, orthopedic care, palliative care, and women's health are available in English and Spanish. * The Greenmarket is a partnership between the Medical Center and the Council on the Environment of New York City that sells fresh fruit and vegetables in East Harlem each week. It also offers free medical screenings as well as demonstrations of healthy cooking. * Free Community Health Screenings. In the past year Mount Sinai faculty and staff sponsored and/or participated in thirty-six community health fairs and health screening programs, street festivals, children's festivals, health expos and information fairs, reaching over 25,000 people. Screening have been conducted to test blood pressure, glucose, cholesterol, vision, bone density, body mass index, kidney disease, and Hepatitis C at health fairs year-round. There are nearly 7,000 screenings annually. * Support Groups are offered to patients and their families so that they can share their stories with others who have had similar experiences. * Workshops and seminars are important components of Mount Sinai's commitment to the community. Topics covered have included areas such as Power of Attorney, Living Wills and Advanced Directives: What You Need to Know, Men's Health Seminars, Women's Cardiovascular Health * Exercise and Education classes are offered weekly or bi-monthly. * Resource Entitlement Advocacy Program (REAP ) serves uninsured and underinsured community members and hospital patients who need assistance with entitlement issues. REAP enables them to get health insurance and gain access to health care. In addition, it helps them obtain income, home care, and nutrition support by working with community agencies. REAP also provides technical assistance regarding changes to entitlement programs such as welfare, Medicaid, Medicare, Family Health Plus, child health insurance, and other programs. * East Harlem Free Clinic, created and operated by the students of the Mount Sinai School of Medicine, provides free medical care to East Harlem residents. * The Medical Center provides HEART (Heart Failure Education and Rehabilitation Training), a congestive heart failure nurse-management program to improve patient self management and physician-initiated services for patients with heart failure in East and Central Harlem. Additionally, Mount Sinai offers a wide variety of community outreach programs that provide screening, educational and patient care. These programs are funded through operating revenues of the Hospital. Some of the programs provided by the Medical Center include: * The Jack Martin Fund Clinic is a New York State Department of Health Designated AIDS Center that provides primary and specialty care, urgent care, social services, and counseling to those who are infected; and preventive services to those at risk. * Mount Sinai Adolescent Health Center was the first primary care facility in New York City specifically designed to meet the health care needs of adolescents. Today, it is the largest, most comprehensive adolescent center in the United States, with a mission to help adolescents grow up happy, healthy, and well educated by preventing disease and promoting health. The Adolescent Health Center offers comprehensive medical, nutritional, exercise, and mental health services to teenagers concerned with eating disorders, becoming overweight or obese, and high cholesterol. * The Mount Sinai Diabetes Center provides inpatient and outpatient treatment and education to adults with type I or type II diabetes. The Diabetes Center works closely with Mount Sinai Internal Medicine Associates, whose patient population includes many patients from East and Central Harlem. The Diabetes Center sponsors community diabetes screenings in English and Spanish. * The Mount Sinai Emergency Department provides state-of-the-art emergency care for the residents of East Harlem and Northern Manhattan 24 hours/day 7 days/week and is a receiving hospital for the 911 ambulance system. It is organized into five treatment areas: Emergency Psychiatric Care, Adult Urgent Care, Chest Pain Unit, Adult Emergency Services, and Pediatric Emergency Services. On-site bilingual staff and social work services are available around the clock. Many initiatives have been introduced in response to community needs and concerns. * Martha Stewart Center for Living at Mount Sinai was established in 2007 as a state-of-the-art medical practice for the outpatient care of seniors, and will surely become a benchmark in geriatric patient care. The Center provides care for patients and training for physicians, and coordinates healthy-aging research and practices. * The Dubin Breast Center opened at the The Tisch Cancer Institute, providing patients with a multidisciplinary, comprehensive approach to breast cancer screening, treatment and survivorship in a serene setting. Dubin Breast Center offers state-of-the-art diagnostics, including 3-D mammography, and minimally invasive diagnostic procedures. Our highly skilled physicians are some of the most sought-after breast cancer experts in the country. Patients at the Dubin Breast Center have access to the latest approaches and techniques, such as seed localization. A team of breast cancer experts are specialized in the diagnosis and treatment of breast cancer patients and offer the most advanced services in breast cancer prevention, diagnosis, and treatment. * The Breast Health Resource Program (BHRP) is dedicated to meeting the emotional and practical needs of women and men with breast cancer. The program offers information, guidance, and critical support to patients from diagnosis through survivorship. Our clinical social workers offer highly individualized counseling to help manage the complex demands of a breast cancer diagnosis. The Breast Health Resource Program offers counseling, seminars, support groups, and a library of information about the latest breast cancer treatments * The Visiting Doctors Program at Mount Sinai provides hands-on, high quality medical care and social support to men and women with complex and serious illnesses who have difficulty leaving their homes. The program aims to help patients maximize their health and independence. The homebound population has traditionally been underserved by the medical community, but the Visiting Doctors Program works to fill that gap by providing ongoing primary medical care. Today, Visiting Doctors serves over 1,000 patients throughout Manhattan and is a national model for the care of this most vulnerable group. * The Mount Sina
6. Part of an Affiliated Health Care System   NOT APPLICABLE
7. Community Benefit Report   Mount Sinai files a community service plan in New York State.
Schedule H (Form 990) 2012
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
THE MOUNT SINAI HOSPITAL
 
Employer identification number
13-1624096
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) MOUNT SINAI DIAG & TREATMENT CENTER
ONE GUSTAVE L LEVY PL
New York,NY10029 		45-0537391 501(C)(3) 13,542,003   cost   fund operating loss
(2) ICHAN SCHOOL OF MEDICINE AT MOUNT SINAI
ONE GUSTAVE L LEVY PL
NEW YORK,NY10029 		13-6171197 501(C)(3) 60,374   cost   FUND PHYSICIAN PRACTICE
(3) ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
ONE GUSTAVE L LEVY PL
NEW YORK,NY10029 		13-6171197 501(c)(3) 16,096,089   COST   FUND PHYSICIAN PRACTICE
(4) INSTITUTE FOR FAMILY HEALTH
ONE GUSTAVE L LEVY PL
NEW YORK,NY10029 		13-3273402 501(C)(3) 337,500   COST   COMMUNITY BENEFIT
















2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
3
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2012

Schedule I (Form 990) 2012
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance












Part IV
Supplemental Information.
Complete this part to provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Identifier Return Reference Explanation
Part II, Line 1   The grant is to fund the net deficit of its related organization's and no monitoRing is required since the entity is a related tax exempt organization. Part II, Line 2 The grant is to fund various strategic programs to promote common mission of the Hospital and ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI. PART II, LINE 3 The grant is to fund the operating loss of various off-site physician practices owned by the ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI. PART II, LINE 2 THE GRANT IS TO BENEFIT THE COMMUNITY AND IS FUNDED TO A EXEMPT ORGANIZATION WITHIN THE COMMUNITY. THE ENTITY IS REQUIRED TO SUBMIT BUDGET AND RECONCILIATIONS.
Schedule I (Form 990) 2012


Additional Data


Software ID:  
Software Version:  


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
2012
Open to Public Inspection
Name of the organization
THE MOUNT SINAI HOSPITAL
 
Employer identification number

13-1624096
Part I
Questions Regarding Compensation
Yes
No
1a
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.
b
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 of the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
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? .......
2
 
 
3
Indicate which, if any, of the following the filing organization used 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.
4
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:
a
Receive a severance payment or change-of-control payment? ................
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
 
No
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
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.
5
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:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
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:
a
The organization? ...........................
6a
Yes
 
b
Any related organization? .........................
6b
Yes
 
If "Yes," to line 6a or 6b, describe in Part III.
7
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 ............
7
 
No
8
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 .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2012

Schedule J (Form 990) 2012
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 (E) amounts for that individual.
(A) Name and Title (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
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1)Kenneth L Davis MDCHIEF EXECUTIVE OFFICER (i)
(ii)		 735,500
735,500 		750,000
750,000 		114,411
114,411 		12,500
12,500 		16,225
16,225 		1,628,636
1,628,636 		0
0
(2)Wayne KeathleyPresident/COO (i)
(ii)		 806,000
0 		400,000
0 		137,848
0 		25,000
0 		25,120
0 		1,393,968
0 		0
0
(3)Burton Drayer 134former officer (i)
(ii)		 0
212,097 		0
250,000 		0
876,827 		0
21,210 		0
16,747 		0
1,376,881 		0
0
(4)Michael Macdonald ESQExecutive VP/General counsel (i)
(ii)		 290,500
290,500 		71,309
71,309 		118,968
118,968 		10,000
10,000 		20,829
20,829 		511,606
511,606 		0
 
(5)deborah Marin md 3former officer (i)
(ii)		 227,500
97,500 		0
0 		59,523
25,509 		17,500
7,500 		8,270
3,544 		312,793
134,053 		0
0
(6)donald t scanlonExecutive VP, BUS & FINANCE (i)
(ii)		 396,000
396,000 		325,000
325,000 		65,032
65,032 		12,500
12,500 		13,542
13,542 		812,074
812,074 		0
0
(7)jeffrey silbersteinexec vp/chief admin officer (i)
(ii)		 342,000
342,000 		128,369
128,369 		43,778
43,778 		12,500
12,500 		8,286
8,286 		534,933
534,933 		0
0
(8)connie c klepperSr VP, Bus Dev & Managed Care (i)
(ii)		 213,000
213,000 		121,367
121,367 		18,189
18,189 		10,000
10,000 		10,463
10,463 		373,019
373,019 		0
0
(9)mark kostegan fahpSr VP, Development (i)
(ii)		 150,000
350,000 		63,006
147,013 		35,196
82,125 		7,500
17,500 		5,558
12,968 		261,260
609,606 		0
0
(10)jane maksoudSr VP, HR & Labor Relations (i)
(ii)		 238,760
269,240 		75,200
84,800 		31,285
35,279 		11,750
13,250 		15,114
17,043 		372,109
419,612 		0
0
(11)michael mccarrySr VP, Periop. Services (i)
(ii)		 290,000
0 		117,500
0 		5,833
0 		20,000
0 		13,645
0 		446,978
0 		0
0
(12)ira s nash mdsenior vp/cmo (resigned) (i)
(ii)		 169,743
0 		0
0 		58,842
0 		18,618
0 		11,474
0 		258,677
0 		0
0
(13)michael pastierSr VP, Finance/CFO (i)
(ii)		 508,000
0 		145,698
0 		56,649
0 		25,000
0 		40,411
0 		775,758
0 		0
0
(14)carol portersenior vp/chief nurse officer (i)
(ii)		 335,000
0 		78,000
0 		44,030
0 		25,000
0 		12,902
0 		494,932
0 		0
0
(15)caryn schwabSr VP/Exec Dir, MSHQ (i)
(ii)		 406,000
0 		36,018
0 		49,788
0 		20,000
0 		30,123
0 		541,929
0 		0
0
(16)margaret pastuszkoSENIOR vp, STRATEGIC planning (i)
(ii)		 216,875
216,875 		115,000
115,000 		474
474 		10,000
10,000 		14,834
14,834 		357,183
357,183 		0
0
(17)m v benthuysen resignsr vp, card. inst. & hosp. op. (i)
(ii)		 187,500
0 		0
0 		41,446
0 		16,300
0 		6,523
0 		251,769
0 		0
0
(18)jane whitneyvp/chief compliance officer (i)
(ii)		 160,680
148,320 		19,549
18,045 		2,541
2,345 		10,400
9,600 		10,300
9,507 		203,470
187,817 		0
0
(19)elana abraham 2corporate treasurer (i)
(ii)		 233,248
0 		7,500
0 		1,912
0 		19,934
0 		29,459
0 		292,053
0 		0
0
(20)David nierman mdVP, Med Affairs/CMO, MSHQ (i)
(ii)		 400,000
0 		25,727
0 		37,013
0 		25,000
0 		30,464
0 		518,204
0 		0
0
(21)ajoy sinha mdchief, dept of orth sur & pres (i)
(ii)		 190,000
0 		0
0 		420,224
0 		15,200
0 		16,276
0 		641,700
0 		0
0
(22)frank cino MS CPAvp, chief audit exec (i)
(ii)		 201,810
123,690 		60,140
36,860 		15,288
9,370 		12,400
7,600 		16,131
9,887 		305,769
187,407 		0
0
(23)KUMAR CHATANISENIOR VP, IT, & CIO (i)
(ii)		 391,500
58,500 		235,263
35,154 		129,549
19,358 		6,525
975 		14,831
2,216 		777,668
116,203 		0
0
(24)ROBERT CHASSINSR DIRECTOR - BUS DEV NET OPS (i)
(ii)		 300,000
0 		86,000
0 		12,204
0 		20,000
0 		14,694
0 		432,898
0 		0
0
(25)ERIN S DUPREE MDVP, PAT SAFETY CHIEF MED OFF. (i)
(ii)		 241,157
12,693 		129,527
6,817 		130,734
6,880 		23,750
1,250 		13,957
735 		539,125
28,375 		0
0
(26)PATRICIA LAMBVP, HOSPITAL OPERATIONS (i)
(ii)		 87,473
9,719 		22,500
2,500 		23,431
2,603 		0
0 		8,504
945 		141,908
15,767 		0
0
(27)CAROLYN ALBANESEVP, PATIENT FINANCIAL SERVICES (i)
(ii)		 305,010
0 		48,071
0 		20,607
0 		20,000
0 		13,992
0 		407,680
0 		0
0
(28)CLAUDIA COLGAN RNVP, QUALITY INITIATIVES (i)
(ii)		 279,930
21,070 		55,800
4,200 		16,552
1,246 		18,600
1,400 		2,238
169 		373,120
28,085 		0
0
Schedule J (Form 990) 2012

Schedule J (Form 990) 2012
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Identifier Return Reference Explanation
Supplemental Information Form 990, Part VII, Section A & Schedule J compensation footnotes Officers of the Board of Trustees hours reflect service to either/or, or all, the Mount Sinai Hospital, ICHAN SCHOOL OF MEDICINE AT MOUNT SINAI, The Mount Sinai Medical Center, Inc. and all related entities. (1) Employee has an outstanding loan reflected in Schedule L, Part II of THE ICHAN SCHOOL OF MEDICINE AT MOUNT SINAI Form 990. (2) A portion of this compensation and benefits is attributable to her services provided to ICHAN SCHOOL OF MEDICINE AT MOUNT SINAI. (3) Compensation is attributed to current services as a Non-Officer. (4) A portion of this compensation and benefits is attributable to his services provided to The Mount Sinai Hospital. Schedule J, Part I, Lines 6A & 6B The Hospital answered yes to questions 6A and 6B in Schedule J as the institution utilizes an incentive based bonus program for certain employees, including several of those employees listed in Schedule J. Net earnings is one of several metrics utilized by the institution in the annual bonus calculation. Other metrics utilized in the incentive compensation model include the organization's performance on the JCAHO Hospital Core Measures, patient satisfaction scores, and other organizational goals such as length of stay initiatives. Individuals that have responsibilities in related organizations to the Hospital may have incentives based on the performance of these organizations as well as that of the Hospital.
Schedule J (Form 990) 2012

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
THE MOUNT SINAI HOSPITAL
 
Employer identification number
13-1624096
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer 		(i) Pool
financing
Yes No Yes No Yes No
A DORMITORY AUTHORITY OF THE STATE OF NEW YORK
  		14-6000293 649905Q58 06-10-2010 348,374,400 REFINANCE OUTSTANDING DEBT 5/18/00   X   X   X
B DORMITORY AUTHORITY OF THE STATE OF NEW YORK
  		14-6000293 649906MB7 10-27-2011 60,064,208 CONSTRuct OF ALLOCABLE SHARE RESCH   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 0 0    
2 Amount of bonds legally defeased . . . . . . . . . . . 0 0    
3 Total proceeds of issue . . . . . . . . . . . . . . 348,437,476 66,127,651    
4 Gross proceeds in reserve funds . . . . . . . . . . . . 32,949,850 4,248,750    
5 Capitalized interest from proceeds . . . . . . . . . . . 0 2,936,559    
6 Proceeds in refunding escrows . . . . . . . . . . . . 0 0    
7 Issuance costs from proceeds . . . . . . . . . . . . 950,618 1,074,778    
8 Credit enhancement from proceeds . . . . . . . . . . . 0 0    
9 Working capital expenditures from proceeds . . . . . . . . . 0 0    
10 Capital expenditures from proceeds . . . . . . . . . . . 0 42,853,353    
11 Other spent proceeds . . . . . . . . . . . . . . 347,454,121 1,233,211    
12 Other unspent proceeds . . . . . . . . . . . . . . 0 13,781,000    
13 Year of substantial completion . . . . . . . . . . . . 2013 2013
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . . X     X        
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X   X        
16 Has the final allocation of proceeds been made? . . . . . . . . X     X        
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X          
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X        
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   X   X        
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2012
Schedule K (Form 990) 2012
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . . X   X          
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . . . . . . . . . . . . . X   X          
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .   X   X        
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? .                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0% 0%   %   %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet   %   %   %   %
6 Total of lines 4 and 5 . . . . . . . . . . . . . . .   %   %   %   %
7 Does the bond issue meet the private security or payment test? . . . . .   X   X        
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X        
b If “Yes” to line 8a, enter the percentage of bond-financed property sold or disposed of.   %   %   %   %
c If “Yes” to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .   X   X        
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2?
  X   X        
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T? . . . . .   X   X        
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . . X   X          
b Exception to rebate? . . . . . . . .                
c No rebate due? . . . . . . . . . .
               
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .   X   X        
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X        
b Name of provider . . . . . . . . . 0
  		0
  		 
  		 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . . . .                
e Was a hedge terminated? . . . . . . .                
Schedule K (Form 990) 2012
Schedule K (Form 990) 2012
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .   X   X        
b Name of provider . . . . . . . . . 0
  		0
  		 
  		 
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .                
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X        
7 Has the organization established written procedures to monitor the requirements of section 148? . . .   X   X        
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
1 Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?   X   X        
Part VI
Supplemental Information. Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
SCHEDULE K SUPPLEMENTAL INFORMATION 0 PART III, LINE 3A THE ORGANIZATION HAS ONE MANAGEMENT AGREEMENT WHICH COMPLIES WITH REVENUE PROCEDURE 97-13. PART II, LINE 3 ISSUE A TOTAL PROCEEDS PER TAX CERTIFICATE $348,374,400 PLUS INVESTMENT EARNINGS $63,076 = $348,437,476. PART II, LINE 3 ISSUE B TOTAL PROCEEDS PER TAX CERTIFICATE $66,064,208 PLUS INVESTMENT EARNINGS $66,443 = $66,127,651. PART III, LINE 9 THE ORGANIZATION IS CONSIDERING DEVISING PROCEDURES TO ENSURE THAT IF ANY BONDS BECOME NONQUALIFIED, THEY WILL BE REMEDIATED IN ACCORDANCE WITH REGULATIONS SECTIONS 1.141-12 AND 1.145-2. PART IV, LINE 7 THE BOND ISSUER (INDICATED IN PART I, COLUMN A) DIRECTS AND MONITORS INVESTMENTS AND TAKES SOLE RESPONSIBILITY FOR COMPLIANCE WITH THE REQUIREMENTS OF SECTION 148. THE ORGANIZATION DOES NOT DIRECT THE INVESTMENT OF BOND PROCEEDS. PART V THE ORGANIZATION IS AWARE THAT A VOLUNTARY CLOSING AGREEMENT PROGRAM IS AVAILABLE IF A VIOLATION OF THE FEDERAL TAX REQUIREMENTS, SHOULD THEY OCCUR, CANNOT BE CORRECTED THROUGH SELF-REMEDIATION UNDER APPLICABLE REGULATIONS. The organization IS CONSIDERING DEVISING procedures to ensure that in the event federal tax violations occur that cannot be corrected through self-remediation, such violations will qualify for resolution through the voluntary closing agreement program.
Schedule K (Form 990) 2012

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
THE MOUNT SINAI HOSPITAL
 
Employer identification number

13-1624096
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501(c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No





2
Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
Total ......Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2012
Schedule L (Form 990 or 990-EZ) 2012
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) Hess Corporation John Hess, Trustee 20,525,024 See part v   No
(2) XO Communications Carl Icahn, Trustee 865,613 See part v   No
(3) dr Carolyn sicher SUSAN CULLMAN, trustee 28,928 See part v   No
(4) Dr Elissa Gretz Friedman Robert Friedman, trustee 15,058 See part v   No
(5) Dr Irwin Gribetz Judah Gribetz, trustee 72,720 See part v   No
(6) kimberly harrison clifford goldsmith, trust 106,119 See part v   No
(7) us foods GOGEL & KRAVIS, TRUSTEES 826,420 See part v   No
(8) OCH ZIFF CAPITAL MANAGEMENT DAVID WINDREICH, TRUSTEE 3,392,610 See part v   No
(9) KAREN KOSTEGAN MARK KOSTEGAN, OFFICER 41,519 See part v   No
(10) ETHYLIM WANE JABS DOUGLAS JABS, OFFICER 190,464 See part v   No
(11) BRIAN SCANLON DONALD SCANLON, OFFICER 53,981 See part v   No
(12) GARY B DAVIS DR. KENNETH DAVIS,OFFICER 147,725 SEE PART V   No
(13) AVENUE CAPITAL GARDNER & LARSY, TRUSTEES 230,295 SEE PART V   No
(14) RELATED MANAGEMENT COMPANY LP JEFF BLAU, TRUSTEE 2,029,382 SEE PART V   No
(15) MARGARET RUTTENBERG ERIC RUTTENBERG, TRUSTEE 23,733 SEE PART V   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
Schedule L, Part IV, Column D Business Transactions involving interested parties NAME OF INTERESTED PERSON: US FOODS: MOUNT SINAI PURCHASES A PORTION OF ITS FOOD FROM US FOODS. ALL SUCH PURCHASES ARE MADE UNDER A GROUP PURCHASING ORGANIZATION (GPO) ARRANGEMENT THAT HAS BEEN NEGOTIATED WITH US FOODS. THESE GPO PRICES ARE AVAILABLE TO MOUNT SINAI AND ALL OTHER MEMBERS OF THE LOCAL HEALTHCARE ASSOCIATION. MR. GOGEL AND MR. KRAVIS ARE CEOS OF FIRMS THAT ARE INDIRECTLY A GREATER-THAN-35% OWNER OF US FOODS. NEITHER MR. GOGEL NOR MR. KRAVIS WERE INVOLVED IN DECISIONS RELATED TO THE ORGANIZATION'S PURCHASES FROM U.S. FOODS. NAME OF INTERESTED PERSON: HESS CORPORATION: FOLLOWING AN OBJECTIVE, COMPETITIVE MULTI-PARTY BIDDING PROCESS (IN WHICH MR. HESS WAS UNINVOLVED), THE ORGANIZATION PURCHASED NATURAL GAS AND FUEL OIL FROM HESS CORPORATION. MR. HESS IS CHIEF EXECUTIVE OFFICER OF, AND HAS A FINANCIAL INTEREST IN, HESS CORPORATION AND REMAINS UNINVOLVED IN THE ORGANIZATION'S DECISIONS RELATED TO HESS CORPORATION. NAME OF INTERESTED PERSON: XO COMMUNICATIONS: FOLLOWING AN EXTENSIVE RFP AND A MULTI-PARTY COMPETITIVE BIDDING PROCESS, AS WELL AS A REVIEW BY A SPECIAL BOARD COMMITTEE (WHICH DID NOT INCLUDE MR. ICAHN) OF THE ENGAGEMENT PROCESS, THE ORGANIZATION PURCHASED COMMUNICATIONS SERVICES FROM XO COMMUNICATIONS. MR. ICAHN IS A GREATER-THAN-35% OWNER OF XO COMMUNICATIONS. MR. ICAHN REMAINS UNINVOLVED IN THE ORGANIZATION'S DECISIONS RELATED TO XO COMMUNICATIONS. NAME OF INTERESTED PERSON: OCH ZIFF CAPITAL MANAGEMENT: MR. WINDREICH IS A DIRECTOR OF OCH ZIFF CAPITAL MANAGEMENT ("OCH ZIFF"), WHICH MANAGES INVESTMENT CAPITAL FOR THE ORGANIZATION. MR. WINDREICH HAS NO INVOLVEMENT IN THE ORGANIZATION'S INVESTMENT DECISIONS OR ITS INVOLVEMENT WITH OCH ZIFF. THE FEES CHARGED BY OCH ZIFF TO THE ORGANIZATION ARE IN LINE WITH INDUSTRY STANDARDS AND ARE THE SAME AS THE FEES CHARGED TO OTHER INVESTORS IN THE SAME FUND. NAME OF INTERESTED PERSON: AVENUE CAPITAL: TRUSTEES SONIA GARDNER AND MARC LASRY ARE 100% OWNERS OF AVENUE CAPITAL WHICH MANAGED INVESTMENT CAPITAL FOR THE ORGANIZATION DURING CALENDAR YEAR 2012. THE FEES CHARGED BY AVENUE CAPITAL TO THE ORGANIZATION ARE IN LINE WITH INDUSTRY STANDARDS AND ARE THE SAME AS THE FEES CHARGED TO OTHER INVESTORS IN THE SAME FUND. NEITHER MS. GARDNER NOR MR. LASRY WERE INVOLVED IN THE ORGANIZATION'S DECISIONS RELATED TO AVENUE CAPITAL. NAME OF INTERESTED PERSON: RELATED MANAGEMENT COMPANY, L.P.: FOLLOWING AN EXTENSIVE RFP AND A MULTI-PARTY COMPETITIVE BIDDING PROCESS, AS WELL AS A REVIEW BY A SPECIAL BOARD COMMITTEE (WHICH DID NOT INCLUDE MR. BLAU) OF THE ENGAGEMENT PROCESS, THE ORGANIZATION PURCHASED CONSULTING AND MANAGEMENT SERVICES FROM RELATED MANAGEMENT COMPANY, L.P. ("RMC"). MR. BLAU IS A DIRECTOR OF RMC. MR. BLAU REMAINS UNINVOLVED IN THE ORGANIZATION'S DECISIONS REGARDING RELATED MANAGEMENT COMPANY, L.P. NAME OF INTERESTED PERSON: CAROLYN SICHER: TRUSTEE SUSAN CULLMAN'S DAUGHTER IS EMPLOYED BY THE ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI. MS. CULLMAN HAS NO INVOLVEMENT IN DECISIONS RELATED TO HER EMPLOYMENT. NAME OF INTERESTED PERSON: ELISSA GRETZ FRIEDMAN: TRUSTEE ROBERT FRIEDMAN'S WIFE IS EMPLOYED BY THE ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI. MR. FRIEDMAN HAS NO INVOLVEMENT IN DECISIONS RELATED TO HIS WIFE'S EMPLOYMENT. NAME OF INTERESTED PERSON: KIMBERLY HARRISON: TRUSTEE CLIFFORD GOLDSMITH'S GRANDDAUGHTER IS EMPLOYED BY THE ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI. MR. GOLDSMITH HAS NO INVOLVEMENT IN DECISIONS RELATED TO HIS GRANDDAUGHTER'S EMPLOYMENT. NAME OF INTERESTED PERSON: IRWIN GRIBETZ: TRUSTEE JUDAH GRIBETZ'S BROTHER IS EMPLOYED BY THE ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI. MR. GRIBETZ HAS NO INVOLVEMENT IN DECISIONS RELATED TO HIS BROTHER'S EMPLOYMENT. NAME OF INTERESTED PERSON: KAREN KOSTEGAN: OFFICER MARK KOSTEGAN'S SPOUSE IS AN EMPLOYEE OF THE ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI. MR. KOSTEGAN HAS NO INVOLVEMENT IN DECISIONS RELATED TO HIS WIFE'S EMPLOYMENT. NAME OF INTERESTED PERSON: ETHYLIN WANE JABS: KEY EMPLOYEE DOUGLAS JABS' SPOUSE IS AN EMPLOYEE OF THE ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI. MR. JABS HAS NO INVOLVEMENT IN DECISIONS RELATED TO HIS WIFE'S EMPLOYMENT. NAME OF INTERESTED PERSON: BRIAN SCANLON: OFFICER DONALD SCANLON'S SON IS AN EMPLOYEE OF THE MOUNT SINAI HOSPITAL. MR. SCANLON HAS NO INVOLVEMENT IN DECISIONS RELATED TO HIS SON'S EMPLOYMENT. NAME OF INTERESTED PERSON: GARY B. DAVIS: OFFICER DR. KENNETH DAVIS'S BROTHER IS AN EMPLOYEE OF THE HOSPITAL. DR. DAVIS HAS NO INVOLVEMENT IN DECISIONS RELATED TO HIS BROTHER'S EMPLOYMENT. NAME OF INTERESTED PERSON: MARGARET RUTTENBERG: TRUSTEE ERIC RUTTENBERG'S SISTER-IN-LAW IS AN EMPLOYEE OF THE ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI. MR. RUTTENBERG HAS NO INVOLVEMENT IN DECISIONS RELATED TO HIS SISTER-IN-LAW'S EMPLOYMENT. *ALL REPORTED AMOUNTS REFLECT AGGREGATE 2012 SPENDING FOR THE MOUNT SINAI HOSPITAL, ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI, THE MOUNT SINAI MEDICAL CENTER, INC., AND ALL RELATED ENTITIES AND ORGANIZATIONS.
Schedule L (Form 990 or 990-EZ) 2012

Additional Data


Software ID:  
Software Version:  




SCHEDULE M
(Form 990)

Department of the Treasury
Internal Revenue Service
Noncash Contributions
Right pointing arrow large imageComplete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
THE MOUNT SINAI HOSPITAL
 
Employer identification number

13-1624096
Part I
Types of Property
(a)
Check if applicable 		(b)
Number of contributions or items contributed 		(c)
Noncash contribution amounts reported on
Form 990, Part VIII, line 1g 		(d)
Method of determining
noncash contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods ....... 		X 5,105 resale value
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded . X 30 327,625 FMV
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests .... 		       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures ..... 		       
14 Qualified conservation
contribution—Other ... 		       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( 496 BOTTLE WINE ) X 65 361,100 auction
26 Other Right pointing arrow large image( )
27 Other Right pointing arrow large image( )
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...
29
 
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1-28 that it
must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ..........................
32a
 
No
b
If "Yes," describe in Part II.
33
If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) (2012)
Schedule M (Form 990) (2012)
Page 2
Part II
Supplemental Information. Complete this part to provide the information required by Part I, lines 30b,
32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.
Identifier Return Reference Explanation
Part I, Line 9 Securities - Publicly traded 64 SHARES OF SPRD GOLD STOCKS VALUED AT $10,040.96 RECEIVED ON 1/9/12. 900 SHARES OF METHANEX CORPORATION STOCKS VALUED AT $25,974 RECEIVED ON 2/3/12. 325 SHARES OF VANGUARD MID-CAP STOCKS VALUED AT $25,096.50 RECEIVED ON 7/2/12. 330 SHARES OF VANGUARD SMALL CAP STOCKS VALUED AT $25,169.10 RECEIVED ON 7/2/12. 16 SHARES OF APPLE STOCKS VALUED AT $9,639.04 RECEIVED ON 7/11/12. 86 SHARES OF AMERICAN TOWER STOCKS VALUED AT $5,995.92 RECEIVED ON 7/11/12. 54 SHARES OF CROWN CASTLE STOCKS VALUED AT $3,187.62 RECEIVED ON 7/11/12. 15 SHARES OF EQUINIX STOCKS VALUED AT $2,499.45 RECEIVED ON 7/11/12. 5 SHARES OF MASTERCARD STOCKS VALUED AT $2,082.90 RECEIVED ON 7/11/12. 77 SHARES OF ORACLE STOCKS VALUED AT $2,242.24 RECEIVED ON 7/11/12. 50 SHARES OF AMERICAN TOWER CORPORATION STOCKS VALUED AT $3,476.50 RECEIVED ON 8/28/12. 75 SHARES OF BROOKFIELD INFRASTRUCTURE STOCKS VALUED AT $2,662.50 RECEIVED ON 8/28/12. 323 SHARES OF ENBRIDGE ENERGY STOCKS VALUED AT $9,974.24 RECEIVED ON 8/28/12. 125 SHARES OF GOLUB CAPITAL BDC STOCKS VALUED AT $1,933.75 RECEIVED ON 8/28/12. 75 SHARES OF ITC HOLDINGS STOCKS VALUED AT $5,432.25 RECEIVED ON 8/28/12. 115 SHARES OF KINDER MORGAN MANAGEMENT STOCKS VALUED AT $8,470.90 RECEIVED ON 8/28/12. 75 SHARES OF NEW MOUNTAIN FINANCE STOCKS VALUED AT $1,105.50 RECEIVED ON 8/28/12. 75 SHARES OF NEXTERA ENERGY STOCKS VALUED AT $5,122.50 RECEIVED ON 8/28/12. 885 SHARES OF PHILLIP MORRIS STOCKS VALUED AT $80,101.35 RECEIVED ON 8/28/12. 50 SHARES OF SEASPAN CORPORATION PREFERRED STOCKS VALUED AT $1,389.50 RECEIVED ON 8/28/12. 50 SHARES OF TARGA RESCOURCE CORPORATION STOCKS VALUED AT $2,266 RECEIVED ON 8/28/12. 250 SHARES OF TEEKAY OFFSHORE STOCKS VALUED AT $7,150 RECEIVED ON 8/28/12. 20 SHARES OF VORNADO REALTY TRUST STOCKS VALUED AT 1,633.40 RECEIVED ON 8/28/12. 37 SHARES OF SUNCOR ENERGY STOCKS VALUED AT $1,241.35 RECEIVED ON 9/20/12. 70 SHARES OF EXELON CORPORATION STOCKS VALUED AT $2,523.50 RECEIVED ON 10/9/12. 345 SHARES OF SUNTRUST STOCKS VALUED AT $9,977.40 RECEIVED ON 10/16/12. 1,000 SHARES OF GRIFFIN LAND & NURSERIES STOCKS VALUED AT $28,750 RECEIVED ON 11/6/12. 1,290 SHARES OF GRIFFIN LAND & NURSERIES STOCKS VALUED AT $37,087.50 RECEIVED ON 11/6/12. 17 SHARES OF COPART STOCKS VALUED AT $515.50 RECEIVED ON 12/20/12. 57 SHARES OF EXXON MOBIL STOCKS VALUED AT $4,883.76 RECEIVED ON 12/28/12.
Schedule M (Form 990) (2012)
Additional Data


Software ID:  
Software Version:  
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
2012
Open to Public
Inspection
Name of the organization
THE MOUNT SINAI HOSPITAL
 
Employer identification number

13-1624096
Identifier Return Reference Explanation
PART I, LINE 5 NUMBER OF EMPLOYEES All employees of The Hospital and ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI, including those who provide services at Elmhurst Hospital Center and Queens Hospital Center, utilize a common paymaster under the Hospital's tax identification number. The total number of employees reported under the Hospital tax identification number is 21,829. The number of direct Hospital employees is 12,669.
PART VI, LINE 2 FAMILY/BUSINESS RELATIONSHIPS TRUSTEES LEON BLACK AND JOSHUA HARRIS ARE MANAGING PARTNERS OF THE SAME FIRM. TRUSTEES JAMES CRYSTAL AND JEAN CRYSTAL ARE MARRIED TO EACH OTHER. TRUSTEES CARL ICAHN AND GAIL GOLDEN-ICAHN ARE MARRIED TO EACH OTHER AND MRS. GOLDEN-ICAHN IS AN EMPLOYEE OF AN ORGANIZATION OF WHICH MR. ICAHN IS A DIRECTOR. TRUSTEES EDGAR CULLMAN, JR. AND SUSAN CULLMAN ARE SIBLINGS. TRUSTEE BONNIE DAVIS, M.D. IS MARRIED TO KENNETH DAVIS, M.D., WHO IS PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE MOUNT SINAI MEDICAL CENTER. TRUSTEES SONIA GARDNER AND MARC LASRY ARE SIBLINGS AND ARE ALSO CO-OWNERS OF THE SAME FIRM. TRUSTEES MICHAEL GROSS AND VICKI GROSS ARE MARRIED TO EACH OTHER. TRUSTEE MARC LIPSCHULTZ IS A MEMBER OF A FIRM OF WHICH TRUSTEE HENRY KRAVIS IS CO-CEO. TRUSTEES JUDITH RUBIN AND HON. ROBERT RUBIN ARE MARRIED TO EACH OTHER. TRUSTEES PETER COHEN AND TOM STRAUSS ARE OFFICERS OF THE SAME FIRM. TRUSTEES DONALD GOGEL AND HENRY KRAVIS ARE CEO'S OF FIRMS THAT ARE EACH INDIRECTLY A GREATER-THAN 35% OWNER OF US FOODS. Part VI, Section B, Line 11B Form 990 Provided to governing body The Finance Department gathered the relevant information and prepared the tax returns * Our outside auditors, Ernst & Young, participated in the preparation of, and reviewed, all tax returns. * A questionnaire was circulated to all trustees (i.e., directors), officers and key employees in order to elicit the information required to be reported on the tax returns. * The Trustee Conflicts of Interest Review Committee reviewed the responses provided by trustees and certain officers in the questionnaires and assessed additional pertinent facts gathered by the institution in order to evaluate the applicability of IRS reporting requirements. The Review Committee then determined the appropriate trustee (and certain officer) disclosures that should be made on Form 990 based on the recommendations of the Finance Department, the General Counsel's office and the Compliance Department. These recommendations were reviewed and approved by E&Y. The same process was conducted by the Finance Department, the General Counsel's office, the Compliance Department and E&Y with respect to the questionnaires submitted by other officers and key employees. * The Audit and Compliance Committee of the Board of Trustees conducted a review of the entire tax return, with the participation of E&Y, the Finance Department, and the General Counsel's office. The Audit Committee approved the tax returns as presented. * The Audit Committee's report of its review of the tax returns and its recommendation to file the returns were presented to, and accepted by, the Executive Committee of the Board of Trustees (the "Executive Committee"). * In addition to authorizing the filing of the tax returns, the Executive Committee directed that the returns, which will be filed on or before November 15, 2011, be provided to all trustees via the trustees' confidential website, and those returns were so provided before being filed.
Part VI, Section B, Line 12C Monitoring & enforcing compliance with the policy Compliance with the Organization's Business Conflicts of Interest Policy (the "Policy") is required of trustees, employees, medical staff and non-employee members of institutional committees and includes an ongoing duty to disclose potential conflicts. Compliance with the Policy is monitored and enforced regularly and consistently. All disclosures with the potential for conflict are reviewed by an appropriate committee where they are carefully evaluated. When appropriate, a plan, which may involve measures including, but not limited to, recusal from participating in affected transactions, is developed to manage the potential conflict.
Part VI, Section B, LineS 15A & 15 B Process for determination of compensation The Compensation, Employee Benefits and Employee Relations Committee of the Boards of Trustees (the "Compensation Committee") determines the compensation for the CEO and reviews and modifies or approves the CEO's recommendations for compensation for other officers and key employees, including physician leaders, who are or may be "disqualified persons" as that term is defined in IRC Section 4958. The Compensation Committees' operating procedures are designed to ensure that the compensation of all such officers and key employees is reasonable (i.e. the value of services is the amount that would ordinarily be paid for like services by like enterprises under like circumstances), and to follow the specific steps outlined in the IRC regulations for establishing the rebuttable presumption of reasonableness that a transaction is not an excess benefit transaction. The Compensation Committee consists exclusively of independent trustees without any conflict of interest (as defined in the applicable IRC regulations) with regard to the compensation arrangements being reviewed or approved. The absence of any conflict of interest with respect to items on that meeting's agenda is confirmed at the beginning of each meeting of the Compensation Committee. The Compensation Committee selects and engages an independent, qualified compensation consultant which performs such valuations on a regular basis to provide appropriate comparability data. Comparability data includes, but is not limited to, compensation levels paid by similarly situated organizations, both taxable and tax-exempt, for functionally comparable positions; the availability of similar services in Mount Sinai's geographic area; current compensation surveys compiled by independent firms; customized surveys in specific circumstances, and actual written offers from similar institutions competing for the services of the disqualified person. The sources of the comparability data used by the compensation consultant are provided to the Compensation Committee. The Compensation Committee receives and reviews the comparability data and any analysis provided by the consultant, as well as information provided by management or, in the case of the CEO, by the Chairman of the Board of Trustees, including information about the CEO's performance. For the CEO, the Committee then determines an appropriate level of total compensation in relation to the comparability data. For the other executives and key employees, the Committee also reviews the position description, the credentials of the incumbent or the candidate for the position, an incumbent's performance appraisal, and the CEO's (or Chairman of the Board's, with respect to the CEO) recommendation, in relation to the comparability data, and decides whether to approve the recommended compensation or to modify it. The Compensation Committee discusses and votes on the compensation arrangements for the CEO, CFO and other senior executive staff members in executive session. The Compensation Committee contemporaneously documents in written minutes the terms of the transaction that was approved and the date it was approved; the members of the Compensation Committee who were present during debate on the transaction that was approved and those who voted on it; the comparability data and information from management obtained and relied on, and how the comparability data was obtained; and the Compensation Committee's basis for the decisions, if the approved compensation is outside the range of comparability data. These minutes are prepared before the later of the next meeting of the Compensation Committee or 60 days after the final actions of the Compensation Committee are taken with respect to the compensation decisions made. The minutes are reviewed and approved by the Compensation Committee within a reasonable time thereafter.
Part VI, Section C, Line 19 Governing documents, conflict of interest policy available to the public The organization makes its Business Conflicts of Interest Policy available on its website (www.mountsinai.org) and makes its governing documents and financial statements available upon request.
Part VII, Line 2 Employees who received more than $100,000 in compensation Direct Hospital employees who receive more than $100,000 total 2,121. This excludes employees of the other entities for which the Hospital operates as the paymaster as described in the Schedule O explanation for IRS Form 990, Core Form Part I, Line 5. PART XI, LINE 9 RECONCILIATION OF NET ASSETS NET CHANGE IN CAPTIVE INSURANCE PROGRAM: $8,470,179 CHANGE IN POST RETIREMENT LIABILITY: ($1,239,812) 8 EAST 102ND STREET MANAGER LLC: $1,019,495 ROUNDING: $414 TOTAL: $8,250,276
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2012

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
THE MOUNT SINAI HOSPITAL
 
Employer identification number

13-1624096
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" to Form 990, Part IV, line 33.)
(a)
Name, address, and EIN (if applicable) 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
(1) mount sinai proton holding company llc
one gustave l levy place
new york,NY10029
27-4281194 		investment NY   793,126 MSH
 










Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" to 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 entity?
Yes No
(1) ICHAN SCHOOL OF MEDICINE AT MOUNT SINAI

one Gustave L Levy Place

new york,NY10029
13-6171197 		school NY 501(c)(3) 2 na
 
 
No
(2) Mount Sinai Medical Center

one Gustave L Levy Place

new york,NY10029
13-6271888 		support NY 501(c)(3) 11 type II na
 
 
No
(3) MSMC Realty Corp

one Gustave L Levy Place

new york,NY10029
13-3852596 		real estate NY 501(c)(3) 11 type I see part vii
 
Yes
 
(4) MITRAL FOUNDATION

555 5th avenue

new york,NY10029
80-0468600 		RESEARCH NY 501(c)(3) 11 type I ismms
 
Yes
 
(5) msmc residential realty llc

1425 madison avenue

new york,NY10029
20-0244426 		real estate NY 501(c)(3) 11 type i see part vii
 
Yes
 
(6) mount sinai diagnostic & treatment ctr

one gustave l levy place

new york,NY10029
45-0537391 		diag clinic NY 501(c)(3) 3 msh
 
Yes
 
(7) msmc residential realty manager inc

1425 madison avenue

New York,NY10029
20-1289396 		Real Est Mgmt NY 501(c)(3) 11 type I see part vii
 
Yes
 
(8) THE CHILDREN'S CENTER FOUNDATION

one gustave l levy place

new york,NY10029
20-1289396 		Support NY 501(c)(3) 11 type I ISMMS
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to 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



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" to 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) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No












Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34, 35b, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
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 or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
Yes
 
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
Yes
 
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
 
No
2
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-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) Mount Sinai Diagnostic & Treatment Center

 b 13,542,003 cost
(2) ICHAN SCHOOL OF MEDICINE AT MOUNT SINAI

 b 60,374 cost
(3) ICHAN SCHOOL OF MEDICINE AT MOUNT SINAI

 b 16,096,089 cost
(4) MSMC REALTY CORP

 C 3,526,631 cost
(5) MSMC RESIDENTIAL REALTY CORP

 C 60,374 COST
(6) ICHAN SCHOOL OF MEDICINE AT MOUNT SINAI

 e 4,748,162 COST
(7) mount sinai diagnostic & treament center

 I 2,891,179 cost
(8) ICHAN SCHOOL OF MEDICINE AT MOUNT SINAI

 k 8,051,106 cost
(9) MSMC REALTY CORP

 K 4,794,720 cost
(10) ICHAN SCHOOL OF MEDICINE AT MOUNT SINAI

 M 12,248,249 cost
(11) ICHAN SCHOOL OF MEDICINE AT MOUNT SINAI

 n 21,684,809 cost
(12) ICHAN SCHOOL OF MEDICINE AT MOUNT SINAI

 P 163,036,250 cost
(13) msmc residential realty corp

 P 4,626,489 cost
(14) ICHAN SCHOOL OF MEDICINE AT MOUNT SINAI

 Q 896,106,814 cost
(15) mount sinai diagnostic & treament center

 Q 26,287,917 cost
(16) MSMC REALTY CORP

 R 505,000 cost
(17) ICHAN SCHOOL OF MEDICINE AT MOUNT SINAI

 H 49,175,533 cost
Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to 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) 		(d)
Predominant income (related, unrelated, excluded from tax under section 512-514)

(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 V—UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Part II, Line 3, column F direct controlling entity THE ICHAN SCHOOL OF MEDICINE AT MOUNT SINAI, THE MOUNT SINAI HOSPITAL, AND THE MOUNT SINAI MEDICAL CENTER ARE ALL MEMBERS OF THIS ENTITY. PART II, LINE 5, COLUMN F DIRECT CONTROLLING ENTITY THE ICHAN SCHOOL OF MEDCINE AT MOUNT SINAI, THE MOUNT SINAI HOSPITAL, THE MSMC REALTY CORPORATION, AND THE MSMC RESIDENTIAL REALTY MANAGERS LLC ARE ALL MEMBERS OF THIS ENTITY. PART II, LINE 7, COLUMN F DIRECT CONTROLLING ENTITY THE ICHAN SCHOOL OF MEDICINE AT MOUNT SINAI, THE MOUNT SINAI HOSPITAL, AND THE MSMC REALTY CORPORATION ARE ALL MEMBERS OF THIS ENTITY.

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