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 (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) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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 VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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 | ||||
| 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 2015 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-2015 |
(iii) Distributable Amount for 2015 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2015 from Section C, line 6 |
||||
|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
||||
| 3 Excess distributions carryover, if any, to 2015: | ||||
| a | ||||
| b | ||||
| c | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2015 distributable amount | ||||
|
i
Carryover from 2010 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2015 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2015 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
||||
|
7 Excess distributions carryover to 2016. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a | ||||
| b | ||||
| c Excess from 2013....... | ||||
| d From 2014....... | ||||
| e From 2015....... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| 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 Supplemental Information | FORM 990, PART I, LINE 1 MAIMONIDES MEDICAL CENTER, A 711 BED VITAL AND THRIVING NON-PROFIT HOSPITAL, IS A VITAL ACCESS PROVIDER OF SAFE, HIGH QUALITY AND COMPASSIONATE PATIENT CARE AND COMMUNITY SERVICES TO PEOPLE OF ALL FAITHS AND BACKGROUNDS FROM THE INCREDIBLY DIVERSE POPULATION OF BROOKLYN. FORM 990, PART I, LINE 6 At Maimonides, we are fortunate to have a large corps of dedicated volunteers who enhance the services provided by our staff. There were 1,852 volunteers in 2015 who served 250,846 hours. All volunteer records are kept in a computer database system. Volunteers at Maimonides sign in and out using a touch screen computer. Accordingly, the number of volunteers and hours served are tracked by the system. The Department of Volunteer Services works very closely with youth agencies and provides a worksite for various youth employment programs. We coordinate internship programs with business schools and colleges (both undergraduate and graduate programs). This has developed successful relationships with community agencies and organizations. Some of the service areas the volunteers work in are labor coach (doula), postpartum support, companions to patients, feeders, hospitality, child life, interpreters, refreshment carts, ladies auxiliary, patient library, chaplaincy, clerical support, patient transport, and other support services. PART III, LINES 4A-4D Maimonides Medical Center, a 711 bed acute care voluntary, not-for profit hospital, offers a wide array of inpatient and outpatient healthcare services. Our commitment has always been to serve the community providing quality healthcare services and healthcare education regardless of race, creed, sex, natural origin, age, handicap or ability to pay. During 2015, the Medical Center provided 43,010 inpatient discharges and 431,883 outpatient visits which included 97,233 emergency room visits. We provided care to persons covered by government programs and the uninsured at payment rates below cost. Our surgeons performed 9,118 inpatient and 13,940 outpatient procedures in a full range of surgical specialties. Our tertiary cardiology and cardiac surgery programs serve all of Brooklyn and are widely recognized in the region for excellence in interventional cardiology. A comprehensive array of cancer services is also provided. Maimonides, a designated regional perinatal center, operates one of the busiest obstetrical services on the East Coast with 8,621 deliveries. A Level 3 Neonatal Intensive Care Unit provides highly specialized care for babies born prematurely or with birth defects. The adult and child psychiatric outpatient programs provide walk-in services for any members of the surrounding communities. Maimonides Medical Center is a 9.39 designated psychiatric receiving hospital. We provide full-time (24 hours/365 days per year) emergency services regardless of ability to pay and operate a 911 paramedic ambulance service under contract with the New York City Fire Department to an 800-block area including all of Boro Park and sections of Flatbush, Bensonhurst and Bay Ridge. The Medical Center supports a program of health promotion and education activities for employees and residents of its surrounding communities, including mammography and colon cancer screenings. The Medical Center is a teaching affiliate of Albert Einstein College of Medicine, New York College of Osteopathic Medicine, NYU School of Medicine and SUNY Downstate Medical Center. Maimonides has fully accredited residency-training programs with over 450 interns and residents. |
| Form 990 Supplemental Information | Section A. Governing Body and Management 2. One of the trustees, Mortimer Klaus is a limited partner in real estate ventures for which another trustee, Peter Rebenwurzel, is a managing member. This business relationship is not related to any of the activities of Maimonides Medical Center (the Medical Center.) 6. The organization has a member, Maimonides Health Resources, Inc. (MHRI) a not-for-profit, corporation which is its sole corporate member. 7a. MHRI elects the trustees. The boards of trustees of Medical Center and MHRI are identical. 7b. The powers of MHRI are described below: MHRI is a New York not-for-profit corporation. It is the sole member of the Medical Center. MHRI has the following powers pursuant to the Medical Centers bylaws: (1) MHRI elects trustees to the governing body of the Medical Center at the annual meeting. (Vacancies between annual meetings are filled by the board of trustees of the Medical Center, not MHRI.) (2) MHRI has the power to amend, modify or repeal the bylaws of the Medical Center. The board of trustees of the Medical Center also has such power. MHRI has the following power under New Yorks not-for-profit corporation law: (1) Authorization of merger or consolidation requires MHRIs consent. (2) Non-judicial dissolution requires MHRIs consent. (3) MHRI has the power to petition the court for judicial dissolution. (4) The sale or other disposition of all or substantially all of the assets of the Medical Center requires MHRIs consent. (5) The two boards are identical. Section B. Policies 11b. A copy of the Form 990 is reviewed by senior executive staff and the outside tax preparer who signs off on the return. The reviewed return and attachments are then presented to the President and Audit and Legal Committee of the Board of Trustees to whom the responsibility for reviewing the Form 990 has been delegated for their comments and questions prior to filing. Upon their final review a complete copy of the Form 990 is provided to the entire Board prior to filing. 12c. It is the responsibility of all trustees, officers, employees and members of the medical staff to familiarize themselves with the conflicts of interest policy and to comply and ensure compliance of family members where applicable. They are required to disclose in detail any activities or interests which may conflict or appear to conflict with the Medical Center's best interest. The following are required to complete a conflict of interest certificate: (1) trustees and officers of the Board, (2) non-trustee officers, chairmen and division chiefs and members of the purchasing department, (3) employees and members of the medical staff, who are in a position to influence vendor selection, to approve a transaction with a third party or approve the expenditure of funds, and (4) such other employees or members of the medical staff as determined from time to time by the President. Employees and members of the medical staff who violate this policy are subject to disciplinary action up to and including termination or removal from the staff. Members of the Board of Trustees and officers are subject to removal by the Board of Trustees. The Audit and Legal Committee of the Board of Trustees advises the President and the Chairman of the Board concerning specific conflicts of interest referred to it by the Executive Vice President for Legal Affairs and General Counsel. The Committee decides particular matters referred to them for review, and assists in the overall administration and monitoring of the implementation of the policy. The Audit and Legal Committee also annually reviews all potential conflicts of interest disclosed by members of the board of trustees and employees who are in a position to influence vendor selection on their conflict of disclosure forms. The Corporate Compliance Department assists in ensuring compliance with completion of the Certificate by all relevant employees. The Executive Vice President for Legal Affairs and General Counsel is responsible for reviewing apparent conflicts of interest and other potentially improper activities as referred by the Corporate Compliance Officer and/or the Audit and Legal Committee. A report of all conflicts of interest is made to the Audit and Legal Committee on an annual basis by the Compliance Officer. A report of all conflicts of interest is made by the Chairman of the Audit and Legal Committee at least annually to the Board of Trustees. 15. The process for determining compensation was last done in 2014 for the CEO, CFO and EVP for Legal Affairs/ General Counsel/ Assistant Secretary and other key employees. The process for determining compensation was last done in August 2015 for the COO. The Committees review and approval process is intended to be in compliance with applicable federal tax and New York State laws and regulations, including, (a) Sections 515(b) and 715 of the New York Not-for-Profit Corporation Law, and (b) the regulations issued under New York State Executive Order 38. In addition, the Committees review and approval process is intended to qualify for the rebuttable presumption of reasonableness under the intermediate sanctions rules of federal tax law. The Committee will use the following process (intended to qualify for the rebuttable presumption of reasonableness under the federal tax law intermediate sanctions rules) to consider and approve compensation arrangements for executives: 1. The Committee, which will consist entirely of independent trustees who do not have a conflict of interest with respect to any compensation arrangement under consideration, will approve in advance the compensation of the executives, without any executive present during the deliberation or vote on his or her compensation. 2. The Committee will obtain and rely upon appropriate data as to comparable compensation arrangements, with appropriate data consisting of information sufficient to determine whether each compensation arrangement in its entirety is reasonable, and including, but 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 the New York metropolitan area, current compensation surveys compiled by independent consulting firms, and actual written offers from similar organizations. 3. The Committee will adequately and contemporaneously document the basis for its approval in meeting minutes. There were no required disclosures under New York State Executive Order 38. Section C. Disclosure 19. The organizations articles of incorporation may be obtained from the NYS Secretary of States office. They are also available together with the by-laws upon special request to the Executive Office of Maimonides Medical Center at 4802 Tenth Ave, Admin Bldg, 2nd floor, Brooklyn, NY 11219. The conflict of interest policy is available on the Medical Centers website maimonidesmed.org in the vendor information section. The audited financial statements are available upon request to the Medical Centers Executive Office and are posted on the NYS Charitable Bureau website, oag.state.ny.us. |
| FORM 990, PART XI, LINE 9 | CHANGE IN EQUITY IN CAPTIVE INSURANCE PROGRAM: ($1,172,071) |
| Software ID: | |
| Software Version: |