Form990
Click to see attachment
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private
foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
A For the 2015 calendar year, or tax year beginning 01-01-2015 , and ending 12-31-2015
BCheck if applicable:
CName of organization
The New York Gracie Square Hospital Inc
 
% DAVID WIECKS CFO
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
420 East 76 Street
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
New York, NY10021
D Employer identification number

13-3746997
E Telephone number

G Gross receipts $ 19,150,284
F Name and address of principal officer:
DAVID WYMAN
420 EAST 76 STREET
NEW YORK,NY10021
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.nygsh.org
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1958
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 10
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 5
5 Total number of individuals employed in calendar year 2015 (Part V, line 2a) ...... 5 325
6 Total number of volunteers (estimate if necessary) ............. 6 0
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b  
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 59,930 4,188
9 Program service revenue (Part VIII, line 2g) ......... 39,248,922 15,516,814
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 111,483 22,426
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 286,747 222,360
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 39,707,082 15,765,788
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 0
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 25,352,166 21,699,162
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 12,397,592 9,226,626
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 37,749,758 30,925,788
19 Revenue less expenses. Subtract line 18 from line 12....... 1,957,324 -15,160,000
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 29,389,693 16,816,914
21 Total liabilities (Part X, line 26)............. 13,828,126 15,566,027
22 Net assets or fund balances. Subtract line 21 from line 20..... 15,561,567 1,250,887
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 (2015)
Form 990 (2015)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: TO PROVIDE HIGH QUALITY MENTAL HEALTH AND CHEMICAL DEPENDENCY TREATMENT IN A CARING AND COMPASSIONATE MANNER TO PATIENTS RESIDING IN THE GREATER NEW YORK CITY METROPOLITAN AREA. TO EDUCATE THE COMMUNITY THAT WE SERVE ABOUT THE DIAGNOSIS, TREATMENT AND PREVENTION OF MENTAL ILLNESS AND CHEMICAL DEPENDENCY. TO PROVIDE CULTURALLY SENSITIVE AND LINGUISTICALLY APPROPRIATE MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES TO THE NEW YORK CITY ASIAN POPULATION.
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 $ 26,315,236 including grants of $ 0 ) (Revenue $ 15,535,977 )
AS DESCRIBED IN THE NEEDS ASSESSMENT ABOVE DURING 2015 THE HOSPITAL EMBARKED UPON A REVITALIZATION PROGRAM TO IMPROVE THE QUALITY OF PATIENT CARE AND THE WAY WE PROVIDE IT; WITH THE GOAL OF PROVIDING THE HIGHEST QUALITY, STATE OF THE ART MENTAL HEALTH AND CHEMICAL DEPENDENCY TREATMENT IN A WARM AND HEALING ENVIRONMENT. THIS PROGRAM INCLUDED IMPROVING STAFFING RATIONS, QUALITY AND SAFETY MONITORING, PLANT RENOVATIONS, ITS INFRASTRUCTURE AND THE IMPLEMENTATION OF AN ELECTRONIC HEALTH RECORD. THE FOLLOWING DESCRIBES SOME THE CHANGES TO OUR MISSION, CULTURE AND VALUES, PROGRAMS AND HEALTHCARE TEAM THAT BEGAN IN 2015 AND WILL CONTINUE TO BE IMPLEMENTED OVER THE COMING YEARS. GRACIE SQUARE HOSPITAL HAS PROVIDED ADVANCED, PATIENT-CENTERED INPATIENT BEHAVIORAL HEALTH SERVICES SINCE 1959. WE ARE COMMITTED TO PROVIDING PATIENTS WITH COMPASSIONATE AND COMPREHENSIVE CARE IN A WARM AND WELCOMING ENVIRONMENT IN ORDER TO FACILITATE THEIR RECOVERY AND RETURN TO THEIR FAMILIES AND COMMUNITIES. GRACIE SQUARE HOSPITAL, A PSYCHIATRIC INPATIENT FACILITY LOCATED ON A QUIET SIDE STREET ON THE UPPER EAST SIDE OF MANHATTAN, IS NOW EXPERIENCING A PERIOD OF EXTRAORDINARY TRANSFORMATION AND REVITALIZATION. THROUGH OUR AFFILIATION WITH NEWYORK-PRESBYTERIAN, ONE OF THE NATIONS PREMIER ACADEMIC HEALTHCARE DELIVERY SYSTEMS, GRACIE SQUARE HOSPITAL IS UNDERGOING RENOVATIONS, GROWING ITS STAFF, AND ENHANCING SERVICES AND PROGRAMS. UNDER NEW LEADERSHIP, THE HOSPITAL IS FOCUSED ON PROVIDING THE HIGHEST QUALITY OF CARE, EVIDENCE-BASED TREATMENTS, EDUCATION, AND TRAINING. GRACIE SQUARE HOSPITALS HIGHLY SPECIALIZED CLINICAL SERVICES ARE COMPRISED OF SPECIAL UNITS DEDICATED TO: - CRISIS STABILIZATION PROGRAM - MOOD DISORDERS PROGRAM - PSYCHOTIC DISORDERS PROGRAM - DUAL FOCUS PROGRAM - OLDER ADULT PROGRAM - EARLY RECOVERY PROGRAM - ASIAN PSYCHIATRY PROGRAM GRACIE SQUARE HOSPITAL OFFERS A MULTIDISCIPLINARY APPROACH TO CARE FOR PATIENTS WITH PSYCHIATRIC DISORDERS WHO CAN BENEFIT FROM INPATIENT HOSPITALIZATION. OUR DIAGNOSTIC AND TREATMENT PROGRAMS ARE PROVIDED BY SKILLED BEHAVIORAL HEALTHCARE AND MANAGEMENT TEAMS FOR A WIDE RANGE OF PSYCHIATRIC ILLNESSES AND DISORDERS. OUR DEDICATED TEAMS INCLUDE LICENSED AND CERTIFIED STAFF MEMBERS WHO CREATE A NURTURING, THERAPEUTIC ENVIRONMENT WHERE PATIENTS ARE ENCOURAGED TO ASK QUESTIONS AND GAIN A BETTER UNDERSTANDING ABOUT THEIR ILLNESSES AND TREATMENT. OUR GOAL IS TO HELP PATIENTS RETURN TO THEIR COMMUNITIES TO LIVE HEALTHY, PRODUCTIVE LIVES. OUR MISSION OUR MISSION IS TO PROVIDE THE HIGHEST-QUALITY, STATE-OF-THE-ART MENTAL HEALTH AND CHEMICAL DEPENDENCY TREATMENT IN A WARM, HEALING ENVIRONMENT. OUR CARING, COMPASSIONATE TEAM PREPARES OUR PATIENTS TO RETURN TO THEIR FAMILIES AND COMMUNITIES AND ENGAGE IN PRODUCTIVE AND FULFILLING LIVES. WE SERVE THE DIVERSE RESIDENTS OF THE GREATER NEW YORK METROPOLITAN AREA THROUGH TREATMENT, EDUCATION AND HEALTH PROMOTION. OUR CULTURE AND VALUES AT GRACIE SQUARE HOSPITAL, ALL MEMBERS OF OUR TEAM ARE GUIDED BY THESE CORE VALUES: - RESPECT TREATING EVERY PERSON IN OUR CARE WITH DIGNITY AND RESPECT - COMPASSION AND EMPATHY LISTENING, UNDERSTANDING, AND RESPONDING TO OUR PATIENTS NEEDS AND CONCERNS AND DEDICATING OURSELVES TO ALLEVIATING THEIR DISTRESS - QUALITY AND EXCELLENCE CONTINUOUSLY ADVANCING THE QUALITY OF OUR CARE TO ACHIEVE THE HIGHEST STANDARD OF EXCELLENCE - INTEGRITY MAINTAINING THE HIGHEST ETHICAL AND MORAL STANDARDS THROUGHOUT EVERY FACET OF OUR ORGANIZATION - TEAMWORK WORKING COLLABORATIVELY WITHIN OUR INTERDISCIPLINARY TEAM, PARTNERING WITH THE INDIVIDUALS UNDER OUR CARE, AND INVOLVING THEIR FAMILIES AND SUPPORT SYSTEMS PROGRAMS ACUTE CRISIS STABILIZATION SERVICE: THE CRISIS STABILIZATION PROGRAM AT GRACIE SQUARE HOSPITAL PROVIDES SHORT TERM HOSPITALIZATION FOR ADULTS WITH ACUTE PRESENTATIONS OR EXACERBATIONS OF PSYCHIATRIC SYNDROMES. THE SERVICE OFFERS DIAGNOSTIC ASSESSMENT AND TREATMENT FOR THE FULL RANGE OF MENTAL HEALTH CONDITIONS INCLUDING MOOD AND ANXIETY DISORDERS, POST-TRAUMATIC STRESS DISORDERS AND OTHERS. INDIVIDUALS REQUIRING A SAFE AND SUPPORTIVE ENVIRONMENT FOR ASSESSMENT AND SYMPTOM RELIEF ARE UNDER THE CARE OF A MULTIDISCIPLINARY TEAM. PROMPT AND THOROUGH PSYCHIATRIC AND MEDICAL EVALUATIONS HELP TO FOCUS THE GOALS OF TREATMENT. STAFF MEMBERS COLLABORATE TO PROVIDE COMPREHENSIVE CARE IN AN ACUTE TREATMENT SETTING FOR RAPID SYMPTOM RELIEF. INDIVIDUAL THERAPY IS AVAILABLE TO HELP PATIENTS IDENTIFY LIFE STRESSORS. OUR GROUP AND THERAPEUTIC ACTIVITY PROGRAM IS SUITABLE FOR A DIVERSE PATIENT POPULATION. SUCCESSFUL RETURN TO THE FAMILY AND COMMUNITY, AS WELL AS PRIOR WORK, EDUCATIONAL AND LEISURE ACTIVITIES, IS THE GOAL OF THE PROGRAM. THEREFORE, DISCHARGE PLANNING BEGINS SOON AFTER A PATIENT IS ADMITTED TO TAILOR APPROPRIATE AFTERCARE AND TO HELP PATIENTS ACCESS THE MOST APPROPRIATE SERVICES TO CONTINUE TREATMENT AS NEEDED. MOOD DISORDERS PROGRAM: GRACIE SQUARE HOSPITAL OFFERS A SPECIALIZED UNIT FOCUSING ON THE TREATMENT OF ADULTS WITH AFFECTIVE DISORDERS. INDIVIDUALS SUFFERING FROM DEPRESSION AND BIPOLAR DISORDERS AND OTHER CONDITIONS MANIFESTING MOOD SYMPTOMS RECEIVE STATE OF THE ART PSYCHOPHARMACOLOGY AND PSYCHOTHERAPY AFTER A THOROUGH DIAGNOSTIC ASSESSMENT. MULTIDISCIPLINARY TREATMENT PLANNING INCLUDES THE TREATMENT PROVIDERS AND PATIENT FOR FORMULATION OF AN INDIVIDUALIZED PLAN FOR CARE DURING THE ADMISSION. INDIVIDUAL THERAPY, MILIEU TREATMENT, DIVERSE GROUPS AND THERAPEUTIC ACTIVITIES COMPRISE ACTIVE TREATMENT, OFTEN IN ADDITION TO MEDICATION MANAGEMENT. COMBINATIONS OF MEDICATIONS AND SHORT TERM THERAPIES ARE OFTEN THE MOST EFFECTIVE APPROACHES FOR THESE CONDITIONS. PATIENTS WITH TREATMENT RESISTANT SYMPTOMS OR REQUIRING COMPLEX MEDICATION REGIMENS ARE OFTEN BEST MONITORED ON AN INPATIENT SETTING. IN ADDITION AN INPATIENT UNIT WITH A FOCUS ON MOOD DISORDERS CAN ADDRESS SAFETY ISSUES AND MEDICAL MONITORING. DURING THE STAY EXPERIENCED SOCIAL WORKERS DISCUSS APPROPRIATE OUTPATIENT FOLLOW UP AND ACCESS TO COMMUNITY RESOURCES TO PROMOTE RECOVERY. GROUP AND INDIVIDUAL THERAPIES ON THE AFFECTIVE DISORDERS UNIT DRAW UPON PRINCIPLES FROM COGNITIVE BEHAVIORAL AND DIALECTIC BEHAVIORAL TECHNIQUES. OUR MULTIDISCIPLINARY APPROACH IN A HEALING, THERAPEUTIC MILIEU WITH AN ARRAY OF RESOURCES AIMS TO PROMOTE WELLNESS WHILE PROVIDING SKILLS FOR RELAPSE PREVENTION AND RETURN TO OPTIMAL FUNCTIONING. PSYCHOTIC DISORDERS TREATMENT PROGRAM: THE PSYCHOTIC DISORDERS UNIT PROVIDES CARE FOR INDIVIDUALS WITH ACUTE EXACERBATIONS OF SCHIZOPHRENIA AND SCHIZOAFFECTIVE DISORDERS AS WELL AS THOSE WITH BIPOLAR DISORDER WITH PSYCHOTIC FEATURES. A MULTIDISCIPLINARY TREATMENT TEAM SKILLED IN TREATMENT OF THESE CONDITIONS PROVIDES A SETTING TO MANAGE ACUTE SYMPTOMS AS WELL AS DISCUSSION OF STRESSORS LEADING TO EXACERBATIONS. GROUP THERAPIES TARGET SYMPTOM IDENTIFICATION TO HELP PATIENTS LEARN WARNING SIGNS AS WELL AS COPING STRATEGIES TO MANAGE PERSISTENT SYMPTOMS OUTSIDE OF THE HOSPITAL AFTER STABILIZATION. EDUCATION ABOUT PSYCHOTIC DISORDERS PROMOTES BETTER ACCEPTANCE OF THE ILLNESSES AND ENCOURAGES TREATMENT ADHERENCE TO HELP PREVENT FUTURE RELAPSES AND MAXIMIZE FUNCTIONAL RECOVERY. THE TREATMENT MILIEU PROVIDES SUPPORT AND PROMOTES SOCIALIZATION WHILE ACUTE SYMPTOMS ARE ADDRESSED BY EXPERT PSYCHOPHARMACOLOGISTS AND PSYCHOTHERAPISTS. THE PATIENTS MEDICATION HISTORY IS REVIEWED TO PROVIDE A TREATMENT REGIMEN DESIGNED TO HAVE THE LOWEST SIDE EFFECT PROFILE AND LOWEST POSSIBLE RISK OF FUTURE MEDICAL COMPLICATIONS WHILE TREATING SYMPTOMS EFFICIENTLY. THE INDIVIDUALS PHYSICAL HEALTH STATUS IS ASSESSED AND MONITORED DURING THE INPATIENT STABILIZATION. EXPERT CLINICIANS SKILLED IN THE TREATMENT OF PSYCHOTIC DISORDERS PROVIDE INDIVIDUAL AND FAMILY THERAPY ALONG WITH EDUCATION TO PROMOTE THE BEST OUTCOMES. THE UNIT SOCIAL WORKERS DISCUSS COMMUNITY RESOURCES FOR ONGOING STABILIZATION AND COMMUNITY INTEGRATION. DUAL FOCUS UNIT: THE DUAL FOCUS UNIT PROVIDES INPATIENT TREATMENT FOR INDIVIDUALS WITH SIGNIFICANT EMOTIONAL OR PSYCHIATRIC PROBLEMS IN ADDITION TO BEING CHEMICALLY DEPENDENT. GRACIE SQUARE HOSPITAL PROVIDES COMPREHENSIVE TREATMENT ON A SPECIALIZED UNIT WHICH UTILIZES A FLEXIBLE BLEND OF PSYCHIATRIC AND SUBSTANCE ABUSE MODELS IN A SUPPORTIVE THERAPEUTIC MILIEU. OUR STAFF CONSISTS OF HIGHLY TRAINED, DEDICATED AND EXPERIENCED PSYCHIATRISTS, NURSE PRACTITIONERS, NURSES, SOCIAL WORKERS, ACTIVITIES THERAPISTS AND SUBSTANCE USE COUNSELORS AS WELL AS MEDICAL, NEUROLOGICAL AND PSYCHOLOGY CONSULTANTS. CERTAIN CHEMICALLY DEPENDENT INDIVIDUALS DO NOT RESPOND READILY TO STANDARD SUBSTANCE ABUSE TREATMENT. MANY OF THESE PATIENTS ARE IN FACT SUFFERING FROM TWO CONCURRENT ILLNESSES. OFTEN THESE DUALLY DIAGNOSED PATIENTS ARE TREATED EITHER IN MENTAL HEALTH OR ADDICTION SYSTEMS OR SHUTTLED BACK AND FORTH BETWEEN THEM. FREQUENTLY THIS FRAGMENTED APPROACH RESULTS IN TREATMENT FAILURE. THE DUAL FOCUS PROGRAM HAS BEEN SPECIFICALLY DESIGNED TO PROVIDE A UNIQUE INTEGRATED TREATMENT PROGRAM TAILORED TO THE NEEDS OF THIS SPECIAL
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet26,315,236
Form 990 (2015)
Form 990 (2015)
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)? ...
2
 
No
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 I.............
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 II..............
4
 
No
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 III.................
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
 
No
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
 
No
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
Yes
 
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
 
No
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.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
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) ....
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............
18
 
No
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...................
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 (2015)
Form 990 (2015)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....
21
 
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........
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 25a...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
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
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I............
25a
 
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 ...................
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II ................
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.........
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 ........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV.....................
28b
 
No
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...
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .............
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
 
No
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 (2015)
Form 990 (2015)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
14
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
325
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
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
 
 
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 FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
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.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? .........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring 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 (2015)
Form 990 (2015)
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 or note to any line 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
10
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
5
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
Yes
 
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
Yes
 
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
 
No
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, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletDAVID WIECKS CFO420 EAST 76 STREET   new york,NY10021 (212) 988-4400
Form 990 (2015)
Form 990 (2015)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line 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; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) Mr David Wyman......................................................................
PRESIDENT & CEO
 50.0
.................
0.0 		X   X       320,790 0 13,875
(2) DR PHILLIP WILNER......................................................................
CHAIRMAN OF THE BOARD
 2.0
.................
0.0 		X           0 0 0
(3) Mrs Vincent De Roulet......................................................................
Board Member
 1.0
.................
0.0 		X           0 0 0
(4) Mr Adam Owett Sr......................................................................
Board Member
 1.0
.................
0.0 		X           0 0 0
(5) MR JOSEPH PEYRONNIN......................................................................
BOARD MEMBER
 1.0
.................
0.0 		X           0 0 0
(6) DR BRIAN REGAN......................................................................
BOARD MEMBER
 2.0
.................
0.0 		X           0 348,117 57,421
(7) MS KIMLEE ROLDAN-SANCHEZ......................................................................
BOARD MEMBER
 2.0
.................
59.0 		X           0 378,599 46,142
(8) Ms Karen Westervelt......................................................................
Board Member
 2.0
.................
59.0 		X           0 482,367 30,407
(9) Mrs Cynthia Zirinsky......................................................................
board member
 2.0
.................
0.0 		X           0 0 0
(10) MR MARK LARMORE......................................................................
asst. treasurer thru 1/2015
 0.0
.................
0.0 		X   X       0 2,322,075 131,580
(11) MR GARY ZUAR......................................................................
ASST. TREASURER
 2.0
.................
58.0 		X   X       0 1,324,550 50,529
(12) MR COSMO LACOSTA......................................................................
Chairman thru 1/2015
 1.0
.................
0.0 		X           0 0 0
(13) Ms Kathleen Burke......................................................................
Secretary
 1.0
.................
59.0 		    X       0 369,606 58,061
(14) Ms Phyllis R Lantos......................................................................
Treasurer
 1.0
.................
59.0 		    X       0 2,718,588 58,917
(15) Mr David Wiecks......................................................................
CFO
 50.0
.................
0.0 		    X       190,028 0 25,120
(16) MS TOI EATON......................................................................
CHIEF HUMAN RESOURSE OFFICER
 50.0
.................
0.0 		    X       82,596 0 3,888
(17) MS MARGARET MANCUSO......................................................................
CHIEF ADMINISTRATIVE OFFICER
 50.0
.................
0.0 		    X       42,737 0 2,540
Form 990 (2015)
Form 990 (2015)
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; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) MR MICHAEL RADOSTA........................................................................
CHIEF NURSING OFFICER
 50.0
.......................0.0 		    X       110,842 116,282 36,315
(19) MR SHAUN ANDERSON........................................................................
Admitting Director
 40.0
.......................0.0 		      X     184,439 0 22,377
(20) Ms Hilde Lutz........................................................................
Director of nursing
 50.0
.......................0.0 		      X     141,499 0 15,504
(21) Roger Wolfsohn........................................................................
Medical director
 40.0
.......................0.0 		      X     283,748 0 46,376
(22) DR SATYANARAYANA ABKARI........................................................................
PSYCHIATRIST
 42.0
.......................0.0 		        X   172,138 0 10,328
(23) MS LYNN BELLAMY........................................................................
REGISTERED NURSE
 41.0
.......................0.0 		        X   132,057 0 25,662
(24) DR Mensud KURJAKOVIC........................................................................
PSYCHIATRIST
 71.0
.......................0.0 		        X   360,900 0 38,529
(25) MS JOYCE MARTINEZ........................................................................
REGISTERED NURSE
 50.0
.......................0.0 		        X   133,537 0 2,598
(26) DR MARK STRACKS........................................................................
PSYCHIATRIST
 50.0
.......................0.0 		        X   136,954 0 13,302
(27) Mr Frank Bruno........................................................................
Former President & CEO
 0.0
.......................0.0 		          X 295,533 0 9,461






1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 2,587,798 8,060,184 698,932
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet48
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
Garfunkel Wild and Travis PC,
175 Great Neck Road
GREAT NECK,NY11021 		Legal Services 191,834
JORGE PETIT,
500 EAST 77 STREET
NEW YORK,NY10162 		CONSULTING SERVICES 120,000
ERNST YOUNG,
PO BOX 640382
PITTSBURGH,PA15264 		AUDITING SERVICES 225,080
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet3
Form 990 (2015)
Form 990 (2015)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and similar amounts not included above1f 4,188
g Noncash contributions included in lines 1a-1f:$  
h Total.Add lines 1a-1f.......MediumBullet 4,188
Program Service RevenueAmt Business Code
2a MEDICARE 621110 7,311,910 7,311,910    
b MEDICAID 621110 1,443,070 1,443,070    
c HMO/COMMERCIAL 621110 2,201,026 2,201,026    
d SELF PAY 621110 2,826,095 2,826,095    
e HMO OTHER 621110 1,734,713 1,734,713    
f All other program service revenue.        
g Total.Add lines 2a–2f.....MediumBullet 15,516,814
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ..........MediumBullet 83,334     83,334
4 Income from investment of tax-exempt bond proceedsMediumBullet 0      
5 Royalties...........MediumBullet 0      
(ii) Personal (i) Real
6a Gross rents   203,197
b Less: rental expenses    
c Rental income or (loss) 0 203,197
d Net rental income or (loss)......MediumBullet 203,197     203,197
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory   3,323,588
b Less: cost or other basis and sales expenses   3,384,496
c Gain or (loss)   -60,908
d Net gain or (loss).....MediumBullet -60,908     -60,908
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities..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      
Business Code Miscellaneous Revenue
11a OTHER MISCELLANEOUS 900099 19,163 19,163    
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 19,163
12 Total revenue. See Instructions......MediumBullet 15,765,788 15,535,977   225,623
Form 990 (2015)
Form 990 (2015)
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 or note to any line 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 domestic organizations and domestic governments. See Part IV, line 21 0  
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 0  
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 1,828,213 806,148 1,022,065  
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 14,341,900 13,198,185 1,143,715  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 979,901 918,906 60,995  
9 Other employee benefits ....... 3,323,943 3,084,508 239,435  
10 Payroll taxes ........... 1,225,205 1,127,499 97,706  
11 Fees for services (non-employees):        
a Management ...... 709,386 696,459 12,927 0
b Legal ......... 397,847   397,847  
c Accounting ........... 224,217   224,217  
d Lobbying ........... 0      
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 0      
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 1,794,648 1,213,775 580,873  
12 Advertising and promotion .... 18,000 18,000    
13 Office expenses ....... 672,018 643,103 28,915  
14 Information technology ...... 359,556   359,556  
15 Royalties .. 0      
16 Occupancy ........... 1,140,987 1,086,220 54,767  
17 Travel ............ 0      
18 Payments of travel or entertainment expenses for any federal, state, or local public officials . 0      
19 Conferences, conventions, and meetings .... 3,006 2,222 784  
20 Interest ........... 550,433 550,433    
21 Payments to affiliates ....... 40,500   40,500  
22 Depreciation, depletion, and amortization .. 1,346,220 1,281,601 64,619  
23 Insurance ... 1,093,217 1,087,842 5,375  
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 MEDICAL EXPENSES 181,636 181,636    
b ALL OTHER EXPENSES 694,955 418,699 276,256  
c
d
e All other expenses        
25 Total functional expenses. Add lines 1 through 24e 30,925,788 26,315,236 4,610,552 0
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 (2015)
Form 990 (2015)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX ..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 0 1 0
2 Savings and temporary cash investments ......... 10,522,544 2 1,946,750
3 Pledges and grants receivable, net ...... 0 3 0
4 Accounts receivable, net ............. 2,763,624 4 1,697,714
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 .... 0 7 0
8 Inventories for sale or use ........ 66,893 8 51,352
9 Prepaid expenses and deferred charges ...... 281,795 9 314,827
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 21,092,388
b Less: accumulated depreciation 10b 12,490,033 7,940,720 10c 8,602,355
11 Investments—publicly traded securities . 6,276,016 11 2,988,063
12 Investments—other securities. See Part IV, line 11 ..... 0 12 0
13 Investments—program-related. See Part IV, line 11 .. 0 13 0
14 Intangible assets ............... 0 14 0
15 Other assets. See Part IV, line 11 ........... 1,538,101 15 1,215,853
16 Total assets. Add lines 1 through 15 (must equal line 34)... 29,389,693 16 16,816,914
Liabilities 17 Accounts payable and accrued expenses ..... 3,135,415 17 3,943,130
18 Grants payable ... 0 18 0
19 Deferred revenue ......... 0 19 0
20 Tax-exempt bond liabilities ......... 0 20 0
21 Escrow or custodial account liability. Complete Part IV of Schedule D 0 21 0
22 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 .. 10,125,000 23 9,375,000
24 Unsecured notes and loans payable to unrelated third parties .. 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D 567,711 25 2,247,897
26 Total liabilities. Add lines 17 through 25.. 13,828,126 26 15,566,027
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 15,561,567 27 1,250,887
28 Temporarily restricted net assets ........... 0 28 0
29 Permanently restricted net assets 0 29 0
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 ........... 15,561,567 33 1,250,887
34 Total liabilities and net assets/fund balances ........ 29,389,693 34 16,816,914
Form 990 (2015)
Form 990 (2015)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
15,765,788
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
30,925,788
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-15,160,000
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
15,561,567
5
Net unrealized gains (losses) on investments ...............
5
25,320
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
824,000
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
1,250,887
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line 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
 
No
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
 
 
Form 990 (2015)
Form 990 (2015)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
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 Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
The New York Gracie Square Hospital Inc
 
Employer identification number

13-3746997
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4


5
6
7
8
9
10
11
a
b
c
d
e
f
Enter the number of supported organizations ..............  

g
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 (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      

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
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) 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.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (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.  
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 section 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) 2015

Schedule A (Form 990 or 990-EZ) 2015
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) 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.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (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.)..            
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) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
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
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)
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)		  
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.		  
8 Breakdown of line 7:
a
b
c Excess from 2013.......  
d From 2014.......  
e From 2015.......  
Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990 or 990-EZ) 2015


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," on 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.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
The New York Gracie Square Hospital Inc
 
Employer identification number

13-3746997
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year ....    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of 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" on 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, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, 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" on 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)
Revenue included on 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
Revenue included on 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) 2015

Schedule D (Form 990) 2015
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" on 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, for escrow or custodial account liability?
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" on Form 990, Part IV, line 10.
(a)Current year (b)Prior year (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance ....          
b Contributions ...          
c Net investment earnings, gains, and losses          
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ... 		         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages on 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)
 
 
(ii) related organizations .................
3a(ii)
 
 
b
If "Yes" on 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.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11a. 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 ...      
b Buildings        
c Leasehold improvements   13,277,087 7,126,683 6,150,404
d Equipment ...   7,815,301 5,363,350 2,451,951
e Other ...        
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 8,602,355
Schedule D (Form 990) 2015

Schedule D (Form 990) 2015
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11b. 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)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) DEPOSITS 46,319
(2) SELF INSURED TRUST FUND 1,147,987
(3) DUE FROM THIRD PARTIES 21,547
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 1,215,853
Part X
Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes 0
DUE TO RELATED ORGANIZATIONS 467,435
ACCRUED MALPRACTIC LIABILITY 863,462
DUE TO THIRD PARTY PROVIDERS 917,000
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 2,247,897
2. Liability for uncertain tax positions. 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) 2015

Schedule D (Form 990) 2015
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1 15,791,108
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a 25,320
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e 25,320
3 Subtract line 2e from line 1.................. 3 15,765,788
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b.................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 15,765,788
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1 30,925,788
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  
e Add lines 2a through 2d.................... 2e  
3 Subtract line 2e from line 1................... 3 30,925,788
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b..................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 30,925,788

Part XIII
Supplemental Information
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.
Return Reference Explanation
Schedule D (Form 990) 2015


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" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
The New York Gracie Square Hospital Inc
 
Employer identification number

13-3746997
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
 
No
%
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
 
No
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used 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
 
No
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
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
 
No
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
 
 
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) . . . 		    774,135   774,135 2.500 %
b Medicaid (from Worksheet 3, column a) . . . . .     3,646,190 1,436,961 2,209,229 7.140 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     3,938,466 3,648,979 289,487 0.940 %
d Total Financial Assistance and Means-Tested Government Programs . . . . .     8,358,791 5,085,940 3,272,851 10.580 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).            
f Health professions education (from Worksheet 5) . . .            
g Subsidized health services (from Worksheet 6) . . . .            
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .            
j Total. Other Benefits . .            
k Total. Add lines 7d and 7j .     8,358,791 5,085,940 3,272,851 10.580 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
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     340   340  
2 Economic development            
3 Community support     6,838   6,838 0.020 %
4 Environmental improvements            
5 Leadership development and
training for community members		            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total     7,178   7,178 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
1,604,987
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
1,283,990
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
7,311,910
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
9,792,384
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-2,480,474
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) 2015
Schedule H (Form 990) 2015
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?1
Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 THE NEW YORK GRACIE SQUARE HOSPITAL
420 EAST 76TH STREET
NEW YORK,NY10021
www.nygsh.org 		X               PSYCHIATRIC HOSPITAL  
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
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)
THE NEW YORK GRACIE SQUARE HOSPITAL
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		 
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 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 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10   No
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
THE NEW YORK GRACIE SQUARE HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
 
b
 
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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 individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

THE NEW YORK GRACIE SQUARE HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?.................. 21   No
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 During the tax year, did the hospital facility charge any FAP-eligible individual 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? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 7
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
PART V, LINE 5 AS PART OF OUR COMMUNITY BENEFIT STRATEGY, GRACIE SQUARE HOSPITAL CONTINUOUSLY STRIVES TO MAINTAIN AND IMPROVE THE QUALITY OF OUR SERVICES PROVIDED TO OUR PATIENTS THROUGH QUALITY IMPROVEMENT STUDIES AND PATIENT SATISFACTION SURVEYS. WE VIEW THESE TOOLS AS A WAY OF TRULY HEARING OUR PATIENTS VOICES AND THEIR OPINIONS ABOUT OUR SERVICES. THE DATA GATHERED FROM SURVEYS AND MORE IN DEPTH STUDIES IS USED TO IDENTIFY ANY AREAS OF UNMET NEED OR WAYS TO IMPROVE OUR SERVICES. WE OFTEN ALSO DISCOVER OPPORTUNITIES THAT WE CAN IMPROVE THE CULTURAL COMPETENCE OF OUR SERVICES THROUGH THESE METHODS. FURTHER, BY ENSURING THAT EACH OF OUR CONSUMERS HAS THE CHANCE TO SHARE THEIR THOUGHTS AND FEELINGS ABOUT THEIR EXPERIENCE WITH US, WE HELP THEM TO (RE)GAIN A SENSE OF EMPOWERMENT AND COMPETENCY THAT IS OFTEN COMPROMISED BY THE INDIVIDUALS STRUGGLE WITH HIS/HER BEHAVIORAL HEALTH ISSUES. PART V, LINE 11 THE HOSPITAL IS LICENSED BY THE NEW YORK STATE OFFICE OF MENTAL HEALTH AS AN ARTICLE 31 FREE STANDING PSYCHIATRIC HOSPITAL AND AS SUCH IS LIMITED IN REGARDS TO PROVIDING ADDITIONAL MEDICAL SERVICES. OUR MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT INDICATED THE HOSPITAL WAS MEETING THE BEHAVIORAL HEALTH NEEDS OF THE COMMUNITY. THE HOSPITAL HAS CONTINUED TO PROVIDE THESES NEEDED SERVICES IN 2015 AND HAS COMMITTED TO THOROUGHLY REVIEWING HOW THESE SERVICES ARE DELIVERED IN 2016, TO ENSURE THAT WE PROVIDE THE HIGHEST QUALITY TO OUR PATIENTS AND THE COMMUNITY.
PART V, LINE 13 THE HOSPITAL PROVIDES FREE AND DISCOUNTED CARE TO UNINSURED AND UNDER INSURED INDIVIDUALS. FREE AND DISCOUNTED CARE IS APPROVED BASED UPON AN INDIVIDUALS FINANCIAL RESOURCES.
PART V, LINE 14 AMOUNTS GENERALLY BILLED TO PATIENTS ARE CALCULATED BASED UPON THE CARE PROVIDED, MEDICARE AND MEDICAID REGULATIONS, AGREEMENTS WITH PRIVATE INSURERS AND INDIVIDUALS. INCOME LEVEL, ASSET LEVEL AND MEDICAL INDIGENCY ARE ALSO CONSIDERED IN CALCULATING DISCOUNTS FOR QUALIFIED INDIVIDUALS.
PART V, LINE 15 and 16 FINANCIAL ASSISTANCE MAY BE APPLIED FOR BY CONTACTING THE ADMITTING OFFICE. APPLICANTS MAY BE REQUIRED TO COMPLETE A MEDICAID APPLICATION AND TO PROVIDE DOCUMENTATION REQUIRED BY MEDICAID TO PROCESS THE APPLICATION. THE HOSPITAL WILL ASSIST WITH SUBMITTING MEDICAID APPLICATIONS AND WITH MEDICARE ENROLMENT OR PROVIDE INFORMATION FOR INDIVIDUALS TO DO SO ON THEIR OWN.
PART V, LINE 18 AND 19 PRIOR TO MAKING EFFORTS TO DETERMINE IF AN INDIVIDUAL MAY BE COVERED BY THE HOSPITALS FINANCIAL ASSISTANCE POLICY THE HOSPITAL WILL NOT, NOR WILL IT AUTHORIZE A THIRD PARTY TO, COMMENCE EXTRAORDINARY COLLECTION EFFORTS SUCH AS REPORTING TO A CREDIT AGENCY, LAWSUITS OR LIENS ON RESIDENCES. THE HOSPITAL MAY REFER SUCH ACCOUNTS TO A COLLECTIONS AGENCY; HOWEVER SUCH AGENCIES ARE ALSO PROHIBITED FROM ENGAGING IN SUCH EXTRAORDINARY COLLECTION EFFORTS WITHOUT THE APPROVAL OF THE HOSPITAL. DURING 2015 THE HOSPITAL DID NOT INITIATE ANY SUCH EXTRAORDINARY COLLECTION EFFORTS.
PART V, LINE 21D THE HOSPITAL DOES NOT PROVIDE EMERGENCY MEDICAL CARE.
PART V, LINE 22D THE MAXIMUM AMOUNT CHARGED TO INDIVIDUALS UNDER THE FINANCIAL ASSISTANCE POLICY IS SET AT A RATE BELOW THE AVERAGE RATE PAID BY NON MEANS TESTED COMMERCIAL PAYORS. THIS METHOD APPROXIMATES THE AVERAGE OF THE THREE LOWEST NEGOTIATED COMMERCIAL INSURANCE RATES WHEN CALCULATING THE MAXIMUM AMOUNT THAT CAN BE CHARGED.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 8
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?  
Name and address Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 9
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.
Form and Line Reference Explanation
PART I, LINE 3C GRACIE SQUARE HOSPITAL PROVIDES FREE OR DISCOUNTED CARE (FINANCIAL ASSISTANCE) TO THE MEDICALLY INDIGENT AND THOSE WHO LACK THE ABILITY TO PAY FOR SOME OR ALL OR THEIR MEDICAL EXPENSES. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED UPON THE PATIENTS FINANCIAL RESOURCES. PART I, LINE 7 INPATIENT COSTS FOR THE AMOUNTS REPORTED WERE CALCULATED ON A COST PER PATIENT DAY BASIS. PART II SEE PROMOTION OF COMMUNITY HEALTH.
PART III, LINE 2 THE COSTS TO PROVIDE CARE WHICH HAS BECOME UNCOLLECTIBLE OR BAD DEBT, HAS BEEN CALCULATED UTILIZING A COST TO CHARGE RATIO. PAYMENTS, DISCOUNTS AND FINANCIAL ASSISTANCE EXCLUDED FROM AMOUNTS CONSIDERED TO BE BAD DEBT. PART III, LINE 4 RECEIVABLES FOR PATIENT CARE: PATIENT ACCOUNTS RECEIVABLE FOR WHICH THE HOSPITAL RECEIVES PAYMENT UNDER COST-BASED OR PROSPECTIVE PAYMENT REIMBURSEMENT FORMULA OR NEGOTIATED RATES, WHICH COVER THE MAJORITY OF THE PATIENT SERVICES, ARE STATED AT THE ESTIMATED NET AMOUNT RECEIVABLE FROM SUCH PAYORS, WHICH ARE GENERALLY LESS THAN THE ESTABLISHED BILLING RATES OF THE HOSPITAL. THE AMOUNT OF THE ALLOWANCE FOR UNCOLLECTIBLES IS BASED ON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED COLLECTIONS, BUSINESS ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. ADDITIONS TO THE ALLOWANCE FOR UNCOLLECTIBLES RESULT FROM THE PROVISION FOR BAD DEBTS. ACCOUNTS WRITTEN OFF AS UNCOLLECTIBLE ARE DEDUCTED FROM THE ALLOWANCE FOR UNCOLLECTIBLES.
PART III, LINE 8 MEDICARE ALLOWABLE COSTS ARE DETERMINED PURSUANT TO THE LAWS AND REGULATIONS APPLICABLE TO ALLOWABLE COSTS AND MEDICARE'S STEP DOWN METHODOLOGY. THE HOSPITAL BELIEVES THAT ALL OF THE $2,480,474 SHORTFALL SHOULD BE CONSIDERED AS COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. THIS YEAR, MEDICARE ACCOUNTED FOR 47% NET PATIENT SERVICE REVENUE. THE HOSPITAL PROVIDES CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. CARING FOR MEDICARE PATIENTS FULFILLS A COMMUNITY NEED AND RELIEVES A GOVERNMENT BURDEN AS THESE PATIENTS TYPICALLY HAVE LOW AND/OR FIXED INCOMES. MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE COST OF PROVIDING CARE FOR THESE PATIENTS AND THAT SHORTFALL SHOULD BE COUNTED AS COMMUNITY BENEFIT. FOR MANY OF THE MEDICAL SERVICES PROVIDED BY THE HOSPITAL, MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE COST OF PROVIDING CARE TO THE PATIENTS FORCING THE HOSPITAL TO USE OTHER FUNDS TO COVER THE DEFICIT.
PART III, LINE 9B PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE ARE NOT SUBJECT TO COLLECTION PRACTICES.
needs assessment AS PART OF OUR COMMUNITY BENEFIT STRATEGY, GRACIE SQUARE HOSPITAL CONTINUOUSLY STRIVES TO MAINTAIN AND IMPROVE THE QUALITY OF SERVICES PROVIDED TO OUR PATIENTS THROUGH QUALITY IMPROVEMENT STUDIES AND PATIENT SATISFACTION SURVEYS. WE VIEW THESE TOOLS AS A WAY OF TRULY HEARING OUR PATIENTS' VOICES AND THEIR OPINIONS ABOUT OUR SERVICES. THE DATA GATHERED FROM SURVEYS AND MORE IN DEPTH STUDIES IS USED TO IDENTIFY ANY AREAS OF UNMET NEED OR WAYS TO IMPROVE OUR SERVICES. DURING 2015 THE HOSPITAL EMBARKED UPON A REVITALIZATION PROGRAM TO IMPROVE THE QUALITY OF PATIENT CARE AND THE WAY WE PROVIDE SUCH CASE; WITH THE GOAL OF PROVIDING THE HIGHEST QUALITY, STATE OF THE ART MENTAL HEALTH AND CHEMICAL DEPENDENCY TREATMENT IN A WARM AND HEALING ENVIRONMENT. THIS PROGRAM INCLUDED IMPROVING STAFFING RATIONS, QUALITY AND SAFETY MONITORING, PLANT RENOVATIONS, ITS INFRASTRUCTURE AND THE IMPLEMENTATION OF AN ELECTRONIC HEALTH RECORD. SEE ATTACHMENT 2 FOR ADDITIONAL INFORMATION. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE GRACIE SQUARE HOSPITAL EDUCATES PATIENTS ABOUT FINANCIAL ASSISTANCE THAT MAY BE AVAILABLE TO THEM, INCLUDING GOVERNMENT RUN PROGRAMS SUCH AS MEDICARE AND MEDICAID. THE HOSPITAL ALSO ASSISTS PATIENTS IN APPLYING FOR SUCH BENEFITS. COMMUNITY INFORMATION GRACIE SQUARE HOSPITAL PROVIDES CARE PRIMARILY TO PATIENTS RESIDING IN THE GREATER NEW YORK CITY METROPOLITAN AREA. PROMOTION OF COMMUNITY HEALTH GRACIE SQUARE HOSPITAL PROVIDES HOUSING, CLOTHING AND OTHER ASSISTANCE TO HOMELESS PATIENTS UPON DISCHARGE. SUCH ASSISTANCE SIGNIFICANTLY REDUCES THE CHANCES OF RE-HOSPITALIZATION. THE HOSPITAL ALSO PROVIDED FREE MEETING SPACE TO SEVERAL COMMUNITY BASED GROUPS. AFFILIATED HEALTH CARE SYSTEM GRACIE SQUARE HOSPITAL IS A MEMBER OF THE NEW YORK-PRESBYTERIAN HEALTHCARE SYSTEM. THE NEW YORK-PRESBYTERIAN HEALTHCARE SYSTEM IS A FEDERATION OF TOP-QUALITY HOSPITALS, SPECIALTY INSTITUTES, AND CONTINUING CARE CENTERS THROUGHOUT NEW YORK, NEW JERSEY, AND CONNECTICUT. IT WAS FOUNDED TO BRING ABOUT A POSITIVE CHANGE IN THE WAY HEALTHCARE IS DELIVERED TO THE COMMUNITY. THE NEW YORK-PRESBYTERIAN HEALTHCARE SYSTEM IS DEDICATED TO IMPROVING PATIENT CARE, MEDICAL EDUCATION AND RESEARCH THROUGHOUT THIS REGION OF THE UNITED STATES.
Schedule H (Form 990) 2015
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" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
The New York Gracie Square Hospital Inc
 
Employer identification number

13-3746997
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on 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
directors, trustees, officers, including 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 on 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
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on 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," on line 5a or 5b, describe in Part III.
6
For persons listed on 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
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on 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
Yes
 
8
Were any amounts reported on 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" on 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) 2015

Schedule J (Form 990) 2015
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 on 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 in column(B) reported as deferred on prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1Mr David WymanPRESIDENT & CEO (i)

(ii)		 290,126
-------------
0 		10,000
-------------
0 		20,664
-------------
0 		0
-------------
0 		13,875
-------------
0 		334,665
-------------
0 		0
-------------
0
2DR BRIAN REGANBOARD MEMBER (i)

(ii)		 0
-------------
229,669 		0
-------------
92,560 		0
-------------
25,888 		0
-------------
21,939 		0
-------------
35,482 		0
-------------
405,538 		0
-------------
0
3MS KIMLEE ROLDAN-SANCHEZBOARD MEMBER (i)

(ii)		 0
-------------
272,404 		0
-------------
79,101 		0
-------------
27,094 		0
-------------
26,927 		0
-------------
19,215 		0
-------------
424,741 		0
-------------
0
4Ms Karen WesterveltBoard Member (i)

(ii)		 0
-------------
450,121 		0
-------------
0 		0
-------------
32,246 		0
-------------
3,313 		0
-------------
27,094 		0
-------------
512,774 		0
-------------
0
5Ms Kathleen BurkeSecretary (i)

(ii)		 0
-------------
290,106 		0
-------------
74,037 		0
-------------
5,463 		0
-------------
33,124 		0
-------------
24,937 		0
-------------
427,667 		0
-------------
0
6Ms Phyllis R LantosTreasurer (i)

(ii)		 0
-------------
915,971 		0
-------------
849,648 		0
-------------
952,969 		0
-------------
24,335 		0
-------------
34,582 		0
-------------
2,777,505 		0
-------------
322,567
7MR MARK LARMOREasst. treasurer thru 1/2015 (i)

(ii)		 0
-------------
40,031 		0
-------------
0 		0
-------------
2,282,044 		0
-------------
130,760 		0
-------------
820 		0
-------------
2,453,655 		0
-------------
61,201
8Mr David WiecksCFO (i)

(ii)		 167,040
-------------
0 		0
-------------
0 		22,988
-------------
0 		13,566
-------------
0 		11,554
-------------
0 		215,148
-------------
0 		0
-------------
0
9MR GARY ZUARASST. TREASURER (i)

(ii)		 0
-------------
585,287 		0
-------------
376,000 		0
-------------
363,263 		0
-------------
22,628 		0
-------------
27,901 		0
-------------
1,375,079 		0
-------------
103,374
10DR SATYANARAYANA ABKARIPSYCHIATRIST (i)

(ii)		 148,138
-------------
0 		0
-------------
0 		24,000
-------------
0 		10,328
-------------
0 		0
-------------
0 		182,466
-------------
0 		0
-------------
0
11MR SHAUN ANDERSONAdmitting Director (i)

(ii)		 183,839
-------------
0 		0
-------------
0 		600
-------------
0 		11,102
-------------
0 		11,275
-------------
0 		206,816
-------------
0 		0
-------------
0
12MS LYNN BELLAMYREGISTERED NURSE (i)

(ii)		 108,057
-------------
0 		0
-------------
0 		24,000
-------------
0 		9,464
-------------
0 		16,198
-------------
0 		157,719
-------------
0 		0
-------------
0
13Mr Frank BrunoFormer President & CEO (i)

(ii)		 295,533
-------------
0 		0
-------------
0 		0
-------------
0 		7,950
-------------
0 		1,511
-------------
0 		304,994
-------------
0 		0
-------------
0
14DR Mensud KURJAKOVICPSYCHIATRIST (i)

(ii)		 348,920
-------------
0 		0
-------------
0 		11,980
-------------
0 		13,249
-------------
0 		25,280
-------------
0 		399,429
-------------
0 		0
-------------
0
15Ms Hilde LutzDirector of nursing (i)

(ii)		 141,427
-------------
0 		0
-------------
0 		72
-------------
0 		14,157
-------------
0 		1,347
-------------
0 		157,003
-------------
0 		0
-------------
0
16MR MICHAEL RADOSTACHIEF NURSING OFFICER (i)

(ii)		 107,293
-------------
103,284 		0
-------------
12,925 		3,549
-------------
73 		0
-------------
9,032 		9,571
-------------
17,712 		120,413
-------------
143,026 		0
-------------
0
17DR MARK STRACKSPSYCHIATRIST (i)

(ii)		 135,062
-------------
0 		0
-------------
0 		1,892
-------------
0 		0
-------------
0 		13,302
-------------
0 		150,256
-------------
0 		0
-------------
0
18Roger WolfsohnMedical director (i)

(ii)		 248,010
-------------
0 		0
-------------
0 		35,738
-------------
0 		21,200
-------------
0 		25,176
-------------
0 		330,124
-------------
0 		0
-------------
0
Schedule J (Form 990) 2015

Schedule J (Form 990) 2015
Page 3
Part III
Supplemental Information
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.
Return Reference Explanation
New Supplemental Information PART I, LINE 4A: MARK LARMORE RECEIVED 2,220,000 IN SEVERANCE EFFECTIVE 1/2015 The former President and CEO Frank Bruno received 304,994 in severance during 2015. PART I, LINE 4B: participated in supplemental nonqualified retirement plan: mark larmore: 120,029. part III, line 4b: supplemental nonqualified retirement plan as reported on the w-2: mark larmore: 61,201. phyllis lantos: 829,614. Gary zuar: 293,471. Schedule J, Part I, Line 7 All bonuses are granted at the discretion of and approved by the compensation committee of the Board of Trustees; they are based on the achievement of predetermined goals and objectives. Form 990, Part VII, Section A Certain officers and key employees of the New York Presbyterian Hospital that are identified in part VII as officers or trustees of the NEW YORK GRACIE SQUARE HOSPITAL INC. are responsible for executing the mission and management of the New York Presbyterian Hospital (NYP) and its affiliated entities. Compensation for 2015 of these upper level executives includes the payout of an annual incentive plan and a long-term incentive plan. This performance-oriented program conditions payments upon the achievement of multiple individual and group performance measures. Measures to monitor performance include: operational and financial strength, patient quality and safety, patient satisfaction, advancement of patient care, and people development and partnership. Incentive awards may only be granted if the organization achieves a financial surplus. Even if all relevant performance measurements are achieved, the NYP Board of Trustees retains full discretion to make or not make any incentive awards, or to reduce the amount of any incentive award. This initiative is critical to assuring that NYP has the requisite leadership to create and manage a highly motivated and engaged workforce, to drive superior performance throughout the organization and to achieve top tier medical center status. As a separate matter, due to restrictions imposed by the Internal Revenue Code, upper level executives are limited in the amount of benefits received under a tax-qualified retirement plan. Like many employers, NYP supplements these executives' pension benefits through a supplemental ("nonqualified") retirement plan. The supplemental executive retirement plan (SERP) is subject to a multi-year vesting requirement (commencing after five years of participation in the SERP, in prorated amounts through age 65) which places an executive's supplemental retirement benefit at risk of forfeiture if the vesting requirements are not satisfied. Once vested, however, provisions of the Internal Revenue Code require that the vested executive include in current income the value of his or her vested supplemental retirement benefit. Notwithstanding the legal requirement to recognize the vested value of the supplemental retirement benefit as current income, the supplemental retirement benefit will not be distributed to the executive until the executive actually retires from NYP (although, as permitted by the Internal Revenue Code, the supplemental retirement plan will effect a distribution of an amount necessary to satisfy the executive's tax liability resulting from the income recognition upon vesting). As noted, this supplemental retirement benefit will not be distributed to the executive until the executive actually retires from NYP. There are constantly changing legal, tax, accounting, and public disclosure rules for a SERP (supplemental executive retirement plan) in not-for-profit organizations. The executive Compensation Committee continuously monitors these changes and incorporates any changes into the overall SERP plan design. As in past years, the executive Compensation Committee of NYP requires a third party complete a review of the organization's compensation program to ensure its effectiveness in terms of government regulations, market conditions and the need to continually elevate organizational performance. The report also serves to meet the regulatory obligations to ensure that all elements of the executive compensation programs are reasonable. The individuals listed in part VII that are compensated by New York Presbyterian Hospital devote an average of sixty hours per week to perform their responsibilities for the New York Presbyterian Hospital and other related organizations in the aggregate. The individuals listed in part VII that are compensated by the new york gracie square hospital, unless otherwise indicated, devote an average of fifty hours per week to perform their responsibilities for the new york gracie square hospital.
Schedule J (Form 990) 2015
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 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
The New York Gracie Square Hospital Inc
 
Employer identification number

13-3746997
Return Reference Explanation
Family Relationships Form 990, Part VI, LIne 2 BOARD MEMBERS MRS. CYNTHIA ZIRINSKY AND MR. JOSEPH PEYRONNIN HAVE A FAMILY RELATIONSHIP.
Organization's Members FORM 990, PART VI, LINES 6 & 7A THE NEW YORK GRACIE SQUARE HOSPITAL, INC. IS A MEMBERSHIP CORPORATION, WHOSE MEMBERS ARE APPOINTED BY NEW YORK-PRESBYTERIAN HEALTHCARE SYSTEM, INC. ("SYSTEM INC."). SYSTEM INC. IS A TAX-EXEMPT ORGANIZATION WHOSE MEMBERS ARE APPOINTED BY NEW YORK-PRESBYTERIAN FOUNDATION, INC., WHICH IS ALSO A TAX-EXEMPT ORGANIZATION. THE MEMBERS OF THE ORGANIZATION ELECT THE ORGANIZATION'S BOARD OF TRUSTEES.
REVIEW PROCESS FOR THE FORM 990 FORM 990, PART VI, LINE 11B THE HOSPITAL'S CONTROLLER PREPARES AND COMPILES SUPPORTING WORK PAPERS AND RELATED DOCUMENTS REQUIRED TO PREPARE THE FORM 990 AND RELATED SCHEDULES (THE "RETURN") THAN PREPARES A DRAFT OF THE RETURN TO BE REVIEWED BY THE HOSPITAL'S CHIEF FINANCIAL OFFICER ("CFO"). UPON SATISFACTORY REVIEW BY THE CFO THE DRAFT RETURN IS FORWARDED TO ERNST & YOUNG U.S. LLP (EY). EY PERFORMS REVIEW PROCEDURES DESIGNED TO EVALUATE THE CORRECTNESS AND MECHANICAL ACCURACY OF THE RETURN. UPON COMPLETION OF THEIR REVIEW PROCEDURES, EY PREPARES A FINAL DRAFT WHICH IS REVIEWED BY THE HOSPITAL'S CFO AND PRESENTED TO THE AUDIT COMMITTEE FOR APPROVAL. UPON SUCH APPROVAL IT IS PRESENTED TO THE BOARD OF TRUSTEES FOR APPROVAL. A COPY OF THE APPROVED RETURN IS PROVIDED TO ALL MEMBERS OF THE BOARD OF TRUSTEES, PRIOR TO ITS FILING WITH THE IRS.
MONITOR AND ENFORCE COMPLIANCE WITH POLICIES CONFLICT OF INTEREST FORM 990, PART VI, LINE 12C ALL TRUSTEES, OFFICERS AND KEY EMPLOYEES WILL, AT LEAST ANNUALLY, FILE A WRITTEN CONFLICT OF INTEREST DISCLOSURE STATEMENT. EVERY TRUSTEE, OFFICER AND KEY EMPLOYEE HAS AN AFFIRMATIVE OBLIGATION TO UPDATE HIS OR HER ANNUAL WRITTEN CONFLICT OF INTEREST DISCLOSURE STATEMENT WHENEVER THERE ARE NEW OR CHANGED FACTS OR CIRCUMSTANCES THAT CREATE A DISCLOSABLE CONFLICT OF INTEREST. COPIES OF ALL SUCH STATEMENTS ARE PROVIDED TO THE CHAIR OF THE AUDIT AND CORPORATE COMPLIANCE COMMITTEE. ALL COMPLETED CONFLICT OF INTEREST DISCLOSURE STATEMENTS AND ALL OTHER DISCLOSURES OF DISCLOSABLE CONFLICTS OF INTEREST THAT RAISE AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST, OR THAT CREATE THE APPEARANCE OF AND ACTUAL OR POTENTIAL CONFLICT OF INTEREST, WILL BE FORWARDED BY THE CHAIR OF THE AUDIT AND CORPORATE COMPLIANCE COMMITTEE TO THE AUDIT AND COMPLIANCE COMMITTEE FOR ITS CONSIDERATION. THE AUDIT AND CORPORATE COMPLIANCE COMMITTEE OF THE BOARD WILL CONDUCT A FULL REVIEW OF ALL MATTERS THAT RAISE AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST, OR THAT CREATE AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST. IN SO DOING, THE AUDIT AND CORPORATE COMPLIANCE COMMITTEE: THE AUDIT AND CORPORATE COMPLIANCE COMMITTEE OF THE BOARD WILL MAKE A FINAL AND BINDING DETERMINATION AS TO WHETHER A CONFLICT OF INTEREST EXISTS OR MAY EXIST, AND WHAT COURSE THE HOSPITAL WILL TAKE IN CONNECTION WITH THE MATTER (SEE SCHEDULE L BELOW).
COMPENSATION APPROVAL PROCESS FORM 990, PART VI, LINES 15A & 15B THE HOSPITAL'S EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES (THE "COMMITTEE") OVERSEES MATTERS CONCERNING COMPENSATION AND BENEFITS FOR OFFICERS AND OTHER EXECUTIVES. THE MEMBERS OF THE COMMITTEE INCLUDE INDEPENDENT TRUSTEES. PART OF THE COMMITTEES DELIBERATION AND DECISION PROCESS INCLUDES REVIEW OF COMPARABLE AND CONTEMPORANEOUS DATA.
ACCESS TO ORGANIZATIONAL DOCUMENTS Form 990, Part VI, Line 19 INSPECTION OF THE HOSPITAL'S FORM 990, GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS WILL BE ARRANGED UPON REQUEST.
AVERAGE HOURS DEVOTED TO RELATED ORGANIZATIONS THE INDIVIDUALS LISTED IN PART VII THAT ARE COMPENSATED BY THE NEW YORK GRACIE SQUARE HOSPITAL, UNLESS OTHERWISE INDICATED, DEVOTE AN AVERAGE OF FIFTY HOURS PER WEEK TO PERFORM THEIR RESPONSIBILITIES FOR THE NEW YORK GRACIE SQUARE HOSPITAL. CERTAIN OFFICERS AND KEY EMPLOYEES OF THE NEW YORK PRESBYTERIAN HOSPITAL THAT ARE IDENTIFIED IN PART VII AS OFFICERS OR TRUSTEES OF THE NEW YORK GRACIE SQUARE HOSPITAL INC ARE RESPONSIBLE FOR EXECUTING THE MISSION AND MANAGEMENT OF THE NEW YORK PRESBYTERIAN HOSPITAL (NYP) AND ITS AFFILIATED ENTITIES. COMPENSATION FOR 2015 OF THESE UPPER LEVEL EXECUTIVES INCLUDES THE PAYOUT OF AN ANNUAL INCENTIVE PLAN AND A LONG-TERM INCENTIVE PLAN. THIS PERFORMANCE-ORIENTED PROGRAM CONDITIONS PAYMENTS UPON THE ACHIEVEMENT OF MULTIPLE INDIVIDUAL AND GROUP PERFORMANCE MEASURES. MEASURES TO MONITOR PERFORMANCE INCLUDE: OPERATIONAL AND FINANCIAL STRENGTH, PATIENT QUALITY AND SAFETY, PATIENT SATISFACTION, ADVANCEMENT OF PATIENT CARE, AND PEOPLE DEVELOPMENT AND PARTNERSHIP. INCENTIVE AWARDS MAY ONLY BE GRANTED IF THE ORGANIZATION ACHIEVES A FINANCIAL SURPLUS. EVEN IF ALL RELEVANT PERFORMANCE MEASUREMENTS ARE ACHIEVED, THE NYP BOARD OF TRUSTEES RETAINS FULL DISCRETION TO MAKE OR NOT MAKE ANY INCENTIVE AWARDS, OR TO REDUCE THE AMOUNT OF ANY INCENTIVE AWARD. THIS INITIATIVE IS CRITICAL TO ASSURING THAT NYP HAS THE REQUISITE LEADERSHIP TO CREATE AND MANAGE A HIGHLY MOTIVATED AND ENGAGED WORKFORCE, TO DRIVE SUPERIOR PERFORMANCE THROUGHOUT THE ORGANIZATION AND TO ACHIEVE TOP TIER MEDICAL CENTER STATUS. AS A SEPARATE MATTER, DUE TO RESTRICTIONS IMPOSED BY THE INTERNAL REVENUE CODE, UPPER LEVEL EXECUTIVES ARE LIMITED IN THE AMOUNT OF BENEFITS RECEIVED UNDER A TAX-QUALIFIED RETIREMENT PLAN. LIKE MANY EMPLOYERS, NYP SUPPLEMENTS THESE EXECUTIVES' PENSION BENEFITS THROUGH A SUPPLEMENTAL ("NONQUALIFIED") RETIREMENT PLAN. THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IS SUBJECT TO A MULTI-YEAR VESTING REQUIREMENT (COMMENCING AFTER FIVE YEARS OF PARTICIPATION IN THE SERP, IN PRORATED AMOUNTS THROUGH AGE 65) WHICH PLACES AN EXECUTIVE'S SUPPLEMENTAL RETIREMENT BENEFIT AT RISK OF FORFEITURE IF THE VESTING REQUIREMENTS ARE NOT SATISFIED. ONCE VESTED, HOWEVER, PROVISIONS OF THE INTERNAL REVENUE CODE REQUIRE THAT THE VESTED EXECUTIVE INCLUDE IN CURRENT INCOME THE VALUE OF HIS OR HER VESTED SUPPLEMENTAL RETIREMENT BENEFIT. NOTWITHSTANDING THE LEGAL REQUIREMENT TO RECOGNIZE THE VESTED VALUE OF THE SUPPLEMENTAL RETIREMENT BENEFIT AS CURRENT INCOME, THE SUPPLEMENTAL RETIREMENT BENEFIT WILL NOT BE DISTRIBUTED TO THE EXECUTIVE UNTIL THE EXECUTIVE ACTUALLY RETIRES FROM NYP (ALTHOUGH, AS PERMITTED BY THE INTERNAL REVENUE CODE, THE SUPPLEMENTAL RETIREMENT PLAN WILL EFFECT A DISTRIBUTION OF AN AMOUNT NECESSARY TO SATISFY THE EXECUTIVE'S TAX LIABILITY RESULTING FROM THE INCOME RECOGNITION UPON VESTING). AS NOTED, THIS SUPPLEMENTAL RETIREMENT BENEFIT WILL NOT BE DISTRIBUTED TO THE EXECUTIVE UNTIL THE EXECUTIVE ACTUALLY RETIRES FROM NYP. THERE ARE CONSTANTLY CHANGING LEGAL, TAX, ACCOUNTING, AND PUBLIC DISCLOSURE RULES FOR A SERP (SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN) IN NOT-FOR-PROFIT ORGANIZATIONS. THE EXECUTIVE COMPENSATION COMMITTEE CONTINUOUSLY MONITORS THESE CHANGES AND INCORPORATES ANY CHANGES INTO THE OVERALL SERP PLAN DESIGN. AS IN PAST YEARS, THE EXECUTIVE COMPENSATION COMMITTEE OF NYP REQUIRES A THIRD PARTY TO COMPLETE A REVIEW OF THE ORGANIZATION'S COMPENSATION PROGRAM TO ENSURE ITS EFFECTIVENESS IN TERMS OF GOVERNMENT REGULATIONS, MARKET CONDITIONS AND THE NEED TO CONTINUALLY ELEVATE ORGANIZATIONAL PERFORMANCE. THE REPORT ALSO SERVES TO MEET THE REGULATORY OBLIGATIONS TO ENSURE THAT ALL ELEMENTS OF THE EXECUTIVE COMPENSATION PROGRAMS ARE REASONABLE. EACH OF THE OFFICERS AND KEY EMPLOYEES LISTED DEVOTES AN AVERAGE OF SIXTY HOURS PER WEEK TO PERFORM HIS OR HER RESPONSIBILITIES FOR THE REPORTING ENTITY AND OTHER RELATED ORGANIZATIONS IN THE AGGREGATE. SCHEDULE L, CONFLICT OF INTEREST DUE TO SIGNIFICANT BUSINESS DISRUPTIONS STARTING IN LATE 2014 AND CONTINUING INTO 2015, THE HOSPITAL WAS UNABLE TO CONDUCT A FORMAL CONFLICT OF INTEREST SURVEY FOR TRANSACTIONS WITH INTERESTED PERSONS. A SURVEY WAS SUCCESSFULLY DONE IN DECEMBER OF 2014 AND ONE IS PLANNED FOR 2016. MANAGEMENT IS NOT AWARE OF ANY REPORTABLE TRANSACTIONS FOR 2015.
OTHER CHANGES IN NET ASSETS OR FUND BALANCES FORM 990, PART XI, LINE 9 DISTRIBUTION FROM NEW YORK AND PRESBYTERIAN HOSPITAL FOR THE PURCHASE OF FIXED ASSETS.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2015


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SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
The New York Gracie Square Hospital Inc
 
Employer identification number

13-3746997
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (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










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


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1)New-York Presbyterian Foundation Inc
525 East 68th STreet Box 156

new york,NY10065
13-4153668 		support org NY 501 (c)(3) 11 type 1 na
 
 
No
(2)The New York and Presbyterian Hospital
525 East 68th STreet Box 156

New York,NY10065
13-3957095 		healthcare NY 501 (c)(3) 3 NYP FDN
 
Yes
 
(3)New York Presby Healthcare System Inc
525 East 68th STreet Box 156

New York,NY10065
13-3792361 		sponsor NY 501 (c)(3) 11 type III NYP FND
 
Yes
 
(4)Royal Charter Properties Inc
525 East 68th STreet Box 156

New York,NY10065
13-3158502 		real estate NY 501 (c)(3) 11 type ii NYP FDN
 
Yes
 
(5)Royal Charter Properties East Inc
525 E 68th St Box 156

New York,NY10065
13-3158496 		real estate NY 501 (c)(3) 11 type ii NYP FDN
 
Yes
 
(6)Royal Charter Properties WestchesterInc
525 E 68th St Box 156

New York,NY10065
13-3160354 		real estate NY 501 (c)(3) 11 type ii NYP FDN
 
Yes
 
(7)Hospital for Special Surgery
535 E 70th Street

New York,NY10021
13-1624135 		healthcare NY 501 (c)(3) 3 NYP FDN
 
Yes
 
(8)NYPQUEENS
56-45 Main Street

flushing,NY11355
11-1839362 		healthcare NY 501 (c)(3) 3 NYP COMM PGM
 
Yes
 
(9)The New York Methodist Hospital
506 sixth Street

BROOKLYN,NY11215
11-1631796 		healthcare NY 501 (c)(3) 3 NYHB INC
 
Yes
 
(10)The NY community Hospital of Brooklyn
525 E 68th St Box 156

New York,NY10065
11-1986351 		healthcare NY 501 (c)(3) 3 NYHB INC
 
Yes
 
(11)The Rogosin Institute
505 E 70th Street

New York,NY10021
13-3184198 		dialysis/med NY 501 (c)(3) 4 NYP SYS INC
 
Yes
 
(12)The Silvercrest Ctr for Nursing & REhab
144-45 87th AVenue

Jamaica,NY11435
11-2925535 		nursing facil NY 501 (c)(3) 3 NYP SYS INC
 
Yes
 
(13)Network Recovery Services Inc
525 East 68th STreet Box 156

New York,NY10065
11-3160901 		collection NY 501 (c)(3) 11 type iii NYP SYS INC
 
Yes
 
(14)Preferred Health Network Inc
525 East 68th STreet Box 156

New York,NY10065
11-2964432 		inactive NY 501 (c)(3) 11 type i NYP SYS INC
 
Yes
 
(15)New York Presbyterian Fund Inc
525 East 68th STreet Box 156

New York,NY10065
13-3160356 		fundraising NY 501 (c)(3) 7 NYP FDN
 
Yes
 
(16)CRT Surgical Associates PC
56-45 Main Street

Flushing,NY11355
11-2226870 		healthcare NY 501 (c)(3) 11 type i NYPQNS
 
Yes
 
(17)THE FDN OF NEW YORK PRESBYTERIANQUEENS
56-45 Main Street

Flushing,NY11355
11-2848858 		edu/research NY 501 (c)(3) 4 NYPQNS
 
Yes
 
(18)Beekman Staff Residence
525 EAST 68TH STREET

New York,NY11065
13-2773085 		REAL EST HOUS NY 501 (c)(3) 11 type I NYPH
 
Yes
 
(19)The Elizabeth Blackwell Foundation Inc
525 EAST 68TH STREET

New York,NY11065
13-3344692 		HLTH Info Sys NY 501 (c)(3) 11 TYPE 1 NYPH
 
Yes
 
(20)New York Queens Charter Ventures Inc
56-45 Main Street

Flushing,NY11355
45-4795032 		Real Estate NY 501 (c)(3) 11 Type I NYPQNS
 
Yes
 
(21)NYHB INC
506 SIXTH STREET

BROOKLYN,NY11215
46-2486539 		HEALTHCARE NY 501 (c)(3) 11 TYPE II NYP SYS INC
 
Yes
 
(22)NEW YORK QUEENS MEDICINE & SURGERY PC
56-45 Main St

Flushing,NY11358
27-4719998 		HEALTHCARE NY 501 (c)(3) 11 TYPE 1 NYPQNS
 
Yes
 
(23)Silvercrest Sr Housing Development Fund
144-45 87th Avenue

Briarwood,NY11435
26-2894911 		Housing NY 501 (c)(3) 9 Silvercrest
 
Yes
 
(24)NYP COMMUNITY SERVICES INC
525 EAST 68TH STREET BOX 156

NEW YORK,NY10065
46-3951535 		HEALTH CARE NY 501 (c)(3) 11 TYPE 1 NYPH
 
Yes
 
(25)NYP COMMUNITY PROGRAMS INC
525 EAST 68TH STREET BOX 156

NEW YORK,NY10065
47-2126668 		HEALTHCARE NY 501 (c)(3) 11 TYPE II nyph
 
Yes
 
(26)NYP Programs Inc
525 EAST 68TH STREET

new york,NY10065
47-5351503 		HEALTHCARE NY 501 (C)(3) 11 TYPE 1 NYP FDN
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(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
(1) NYP Plan Mgmt LLC

525 East 68th Street
New York,NY10021
13-4197527 		In-active NY NYPH
  		                 












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) NYP Services Inc

525 E 68th St Box 156
New York,NY10065
06-1830524 		inactive NY NYP FDN
  		c corp       Yes  
(2) New York Presbyterian Global Inc

525 E 68th St Box 156
New York,NY10065
80-0336716 		inactive NY NYP FDN
  		c corp       Yes  
(3) Network Insurance Company LTD

PO Box HM 1760
Hamilton   HM HX
BD
reinsurance BD NYP SYS INC
  		c corp       Yes  
(4) Harkness Hall Club Inc

525 East 68th St Box 156
New York,NY10065
13-3170488 		liquor licens NY NYPH
  		c corp       Yes  
(5) Columbia Presbyterian Health System Inc

525 East 68th St Box 156
New York,NY10065
13-3053885 		real estate NY Fund Inc
  		c corp       Yes  
(6) NYP Global Services Inc

525 East 68th St Box 156
New York,NY10065
13-3845935 		inactive NY Fund Inc
  		c corp       Yes  
(7) Main Street Medical PC

56-45 Main Street
Flushing,NY11358
06-1205476 		medical servi NY NYPQNS
  		c corp       Yes  
(8) NYHQ OBgyn pc

56-45 main street
flushing,NY11358
11-3395424 		medical servi NY NYPQNS
  		c corp       Yes  
(9) BMA pc

56-45 main street
flushing,NY11358
11-2747259 		medical servi NY NYPQNS
  		c corp       Yes  
Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on 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
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
 
No
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
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
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
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
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 related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) THE NEW YORK AND PRESBYTERIAN HOSPITAL

 P 824,000 FMV
(2) ROYAL CHARTER PROPERTIES INC (GUARANTEE ONLY)

 E 9,375,000 FMV




Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 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) 2015
Schedule R (Form 990) 2015
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2015

Additional Data


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