Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (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 listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... | 62,228,514 | 73,401,408 | 71,529,428 | 85,320,101 | 82,104,450 | 374,583,901 |
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | 0 | |||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | 0 | |||||
| 4 | Total. Add lines 1 through 3 | 62,228,514 | 73,401,408 | 71,529,428 | 85,320,101 | 82,104,450 | 374,583,901 |
| 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).. | 0 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 374,583,901 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 62,228,514 | 73,401,408 | 71,529,428 | 85,320,101 | 82,104,450 | 374,583,901 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 14,095,215 | 20,119,152 | 21,976,403 | 22,369,547 | 25,296,485 | 103,856,802 |
| 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 VI.).. | 31,129,512 | 6,588,942 | 18,030,378 | 9,367,064 | 12,589,698 | 77,705,594 |
| 11 | Total support Add lines 7 through 10. | 551,021,773 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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 VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e | Discount claimed for blockage or other factors (explain in detail in Part VI): | |||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| 7 | Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions) | |||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2014 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2014 |
(iii) Distributable Amount for 2014 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2014 from Section C, line 6 |
||||
|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2014: | ||||
| a From 2009.......X | ||||
| b From 2010.......X | ||||
| c From 2011.......X | ||||
| d From 2012.......X | ||||
| e From 2013....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2014 distributable amount | ||||
|
i
Carryover from 2009 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2014 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2014 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
||||
|
6
Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2015. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a From 2010.......X | ||||
| b From 2011.......X | ||||
| c From 2012.......X | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| Form 990, Schedule A, Part II | The Schedule A, Part II support schedule has been completed to |
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| Form 990, Part VI, Section A, Line 2: | David C. Gottlieb (trustee) is related to Jay B. Langner (trustee) - Family relationship. Peter J. Neufeld (trustee) is related to Robert A. Bernhard (trustee) - Family relationship. Form 990, Part VI, Section A, Line 6: Montefiore Health System, Inc. is the sole member of Montefiore Medical Center. |
| Form 990, Part VI, Section A, Line 7A: | The board of trustees of the Montefiore Health System, Inc., the sole member of Montefiore Medical Center, has the authority to appoint the board of trustees of Montefiore Medical Center. |
| Form 990, Part VI, Section A, Line 7B: | The board of trustees of the Montefiore Health System, Inc., the sole member of Montefiore Medical Center, has the authority to approve the operating and capital budgets of Montefiore Medical Center. |
| Form 990, Part VI, Section B, Line 11B: | THE FORM 990 WAS PREPARED BY THE MEDICAL CENTER'S FINANCE DEPARTMENT WITH THE ASSISTANCE OF VARIOUS DEPARTMENTS THROUGHOUT THE MEDICAL CENTER. THE FORM 990 WAS REVIEWED AND APPROVED BY THE VICE PRESIDENT-FINANCE, ACCOUNTING AND FINANCIAL REPORTING AND THE MEDICAL CENTER'S SENIOR LEADERSHIP TEAM INCLUDING THE CHIEF FINANCIAL OFFICER. IN ADDITION, AN INDEPENDENT ACCOUNTING FIRM WAS ENGAGED TO REVIEW THE FORM 990. UPON COMPLETION OF THE VARIOUS REVIEWS, THE FORM 990 WAS PRESENTED TO THE FINANCE COMMITTEE OF THE BOARD OF TRUSTEES FOR REVIEW AND APPROVAL. ONCE APPROVED BY THE FINANCE COMMITTEE OF THE BOARD OF TRUSTEES, THE FORM 990 WAS PROVIDED TO ALL MEMBERS OF MONTEFIORE MEDICAL CENTER'S GOVERNING BODY. |
| Form 990, Part VI, Section B, Line 12C: | The organization regularly and consistently monitors and enforces compliance with the disclosure policy by means of a survey developed by counsel and approved by the Legal and Compliance Committees of the Board of Trustees. The survey is sent to all trustees, officers and key employees for completion. All survey responses are reviewed by the Compliance Officer. Any potential conflicts identified in the responses are discussed with senior management and/or the Legal and Compliance Committees of the Board of Trustees. Potential actions to be taken in response to a conflict is one or more of the following: 1)disclosure of conflict; 2)individual recusal from decisions for transactions where that individual may have a conflict; 3)request the individual to alleviate the conflict; OR 4)removal of the individual from the board of trustees. |
| Form 990, Part VI, Section B, Line 15A & Line 15B: | As of 1/1/2014, all officers and Key Employees are employed and paid by Montifore Health Sytem, Inc., the parent of Montefiore Medical Center. Montefiore is committed to ensuring that its executive compensation program adheres to the highest standards of regulatory compliance and best corporate governance. The Montefiore Board of Trustees has charged the Compensation Committee of the Board (which is comprised of independent Board members with no conflicts of interest in regards to executive compensation) with making all decisions related to compensation for officers and key employees. All decisions made by the Compensation Committee are appropriately and timely documented in meeting minutes. The compensation committee's review process follows the Intermediate Sanctions guidelines for qualifying for the rebuttable presumption of reasonableness. The Committee retains an independent compensation consultant to assist it with this process. Compensation levels are established considering data for comparable organizations, an assessment of management performance (including the services provided to the community), and other business judgment factors, consistent with Montefiore's executive compensation philosophy. The Committee's decisions are made in the best interest of Montefiore, and are intended to ensure the recruitment and retention of key executive talent, consistent with the market practices of other not-for-profit healthcare organizations of comparable scope, mission and complexity. On an annual basis, the Committee provides the full Board of Trustees with a description of the committee's review and approval process and its decisions. |
| Form 990, Part VI, Section B, LINE 16B: | Montefiore Medical Center is the sole member of Montefiore Proton Acquisition, LLC ("MPA"), which was formed for the purpose of enabling Montefiore Medical Center to join with other New York tax-exempt not-for-profit hospitals in the creation of a facility that will provide proton beam therapy, which is a targeted form of treatment for certain types of cancer, to the patient population in the New York City metropolitan area. In 2014, MPA made a capital contribution to New York Proton Management, LLC ("NYPM"), the entity that is responsible for managing the construction process and the future operations of the to-be-built proton beam treatment center (the "Proton Center"). In addition to MPA, the members of NYPM consist of three other limited liability companies, the sole members of which are two not-for-profit 501(c)(3) hospitals and a for-profit taxable health care services management company. While Montefiore Medical Center did not have a formal written policy pertaining to joint ventures with taxable entities in 2014, there were safeguards in place to ensure that its participation in this joint venture is consistent with Montefiore Medical Center's tax-exempt charitable healthcare mission, including, but not limited to: (1) An evaluation of the importance of Montefiore Medical Center's clinical access to the Proton Center for the benefit of its patients; (2) A cap on each member's investment obligation for this project was set at a pre-determined limit; (3) The engagement of legal counsel experienced in tax-exempt organization matters to advise on this transaction and the implications for Montefiore Medical Center's 501(c) (3) status; (4) The Operating Agreement of NYPM expressly requiring that the Proton Center at all times be operated and managed in a manner that furthers the charitable healthcare purposes, mission, vision and values of the affiliated tax-exempt hospitals, including establishing and maintaining reasonable financial assistance policies and procedures and providing reasonable levels of charity care, and requiring the prioritization of such charitable objectives over the financial profit objectives of any member. Montefiore Medical Center is in the process of developing a comprehensive formal written policy relating to joint ventures with taxable entities and anticipates that this joint venture policy will be adopted in 2015. |
| Form 990, Part VI, Section C, Line 19: | THE CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. |
| Form 990, Part XI, Line 9: | The Other change in net assets reduction of $31,755,000 was due to an increase of $39,799,000 in defined pension and other postretirement plan liabilities to be recognized in future periods, partially offset, by a $7,600,000 intercompany note reserve reduction and $444,000 accumulated deficit transfer of a Information Technology Company to the parent, Montefiore Health System, Inc. |
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