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 Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
A For the 2019 calendar year, or tax year beginning 01-01-2019 , and ending 12-31-2019
BCheck if applicable:
CName of organization
NEW YORK SOCIETY FOR THE RELIEF OF THE
RUPTURED AND CRIPPLED MAINTAINING THE
% MARC GOULD
Doing business as
HOSPITAL FOR SPECIAL SURGERY
 
Number and street (or P.O. box if mail is not delivered to street address)
535 EAST 70TH ST STREET
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
NEW YORK, NY10021
D Employer identification number

13-1624135
E Telephone number

G Gross receipts $ 1,525,920,579
F Name and address of principal officer:
LOUIS SHAPIRO
535 EAST 70TH STREET
NEW YORK,NY10021
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.hss.edu
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: 1863
M State of legal domicile: NY
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: PROVIDE THE HIGHEST QUALITY PATIENT CARE, IMPROVE MOBILITY, & ENHANCE THE QUALITY OF LIFE FOR ALL, & ADVANCE THE SCIENCE OF ORTHOPEDIC SURG, RHEUMATOLOGY, & THEIR RELATED DISCIPLINES.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 50
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 43
5 Total number of individuals employed in calendar year 2019 (Part V, line 2a) ...... 5 6,551
6 Total number of volunteers (estimate if necessary) ............. 6 364
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 571,972
b Net unrelated business taxable income from Form 990-T, line 39 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 92,212,279 73,781,160
9 Program service revenue (Part VIII, line 2g) ......... 1,129,760,171 1,219,837,053
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 20,257,134 25,240,641
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 46,570,624 56,186,134
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 1,288,800,208 1,375,044,988
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 351,519 327,200
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) 687,017,383 726,093,792
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).... 500,365,368 550,707,483
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 1,187,734,270 1,277,128,475
19 Revenue less expenses. Subtract line 18 from line 12....... 101,065,938 97,916,513
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 1,738,788,770 2,315,097,883
21 Total liabilities (Part X, line 26)............. 661,497,421 1,133,964,344
22 Net assets or fund balances. Subtract line 21 from line 20..... 1,077,291,349 1,181,133,539
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 (2019)
Form 990 (2019)
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: THE MISSION OF HOSPITAL FOR SPECIAL SURGERY IS TO PROVIDE THE HIGHEST QUALITY PATIENT CARE, IMPROVE MOBILITY, AND ENHANCE THE QUALITY OF LIFE FOR ALL AND TO ADVANCE THE SCIENCE OF ORTHOPEDIC SURGERY, RHEUMATOLOGY, AND THEIR RELATED DISCIPLINES THROUGH RESEARCH AND EDUCATION. WE DO THIS REGARDLESS OF RACE, COLOR, CREED, SEXUAL ORIENTATION, OR ETHNIC ORIGIN.
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 $ 949,085,530 including grants of $ 327,200 ) (Revenue $ 1,226,519,487 )
PATIENT CARE: HOSPITAL FOR SPECIAL SURGERY IS COMMITTED TO PROVIDING WORLD-CLASS CARE TO ITS PATIENTS AND HELPING THEM TO REGAIN THEIR MOBILITY, WHILE ALSO ADVANCING RESEARCH INITIATIVES TO EXPLORE AND IMPROVE TREATMENTS FOR ORTHOPEDIC AND RHEUMATOLOGIC CONDITIONS. HOSPITAL FOR SPECIAL SURGERY OPERATED 205 AND 210 STAFFED BEDS AS OF DECEMBER 31, 2019 AND DECEMBER 31, 2018; AND 39 OPERATING ROOMS AS OF DECEMBER 31, 2019 AND DECEMBER 31, 2018. WE PERFORMED 29,645 SURGERIES, AN INCREASE OF 191 OVER THE PRIOR YEAR, WHILE NON-SURGICAL OUTPATIENT VISITS NUMBERED 484,949, 14,342 MORE THAN 2018. HOSPITAL FOR SPECIAL SURGERY PROVIDED INPATIENT CARE TO 15,906 PATIENTS, 134 MORE THAN 2018. OF THOSE IN 2019, 15,660 WERE SURGICAL. TOTAL AMBULATORY SURGICAL CASES NUMBERED 13,985, AN INCREASE OF 4 FROM 2018. THE HOSPITAL HAS A DIVERSE PATIENT POPULATION SERVING THOSE WITH PUBLIC INSURANCE (MEDICARE AND MEDICAID), PRIVATE INSURANCE (VARIOUS PAYORS) AND THE UNINSURED. THE HOSPITAL MAINTAINS A FINANCIAL ASSISTANCE PROGRAM TO ASSIST THOSE THAT CANNOT PAY FOR ITS SERVICES AND PROVIDES NUMEROUS OTHER COMMUNITY BENEFIT PROGRAMS. HOSPITAL FOR SPECIAL SURGERY IS ALSO RECOGNIZED AS A MAGNET HOSPITAL FOR EXCELLENCE IN NURSING CARE. THE HOSPITAL IS RECOGNIZED FOR ITS EXCELLENCE IN PATIENT CARE AND IS CONSISTENTLY RANKED BY U.S. NEWS AND WORLD REPORT IN ITS SPECIALTIES.
4b (Code:   ) (Expenses $ 48,659,042 including grants of $ 0 ) (Revenue $ 40,613,137 )
RESEARCH: THE RESEARCH DIVISION OF HOSPITAL FOR SPECIAL SURGERY CONTINUED ITS ACTIVITIES IN 2019 TOWARD ENHANCING AND EXPANDING OUR RESEARCH IN MUSCULOSKELETAL DISEASES. RESEARCH AT HOSPITAL FOR SPECIAL SURGERY WORKS TO ADVANCE THE UNDERSTANDING AND TREATMENT OF MUSCULOSKELETAL DISORDERS THROUGH BASIC, TRANSLATIONAL AND CLINICAL RESEARCH AND EDUCATION. THE GOALS ARE TO IDENTIFY GENETIC, ENVIRONMENTAL, CELLULAR, STRUCTURAL AND MOLECULAR MECHANISMS UNDERLYING DISORDERS IMPORTANT IN ORTHOPEDICS, RHEUMATOLOGY AND RELATED DISCIPLINES AND TO DISCOVER EFFECTIVE APPROACHES FOR DIAGNOSIS PREVENTION, AND TREATMENT OF THESE DISORDERS. THE RESEARCH INSTITUTE HAS CREATED PROGRAMMATIC AREAS POISED TO MAKE MAJOR CONTRIBUTIONS TO MUSCULOSKELETAL AND RHEUMATOLOGY HEATH CARE: (1) AUTOIMMUNITY AND RHEUMATIC DISEASES (2) ARTHRITS AND INFLAMMATION (3) SOFT TISSUE REPAIR (4) BONE HEALTH AND SPINE RESTORATION (5) GENOMICS (6) PRECISION MEDICINE AND (7) BIOMECHANICS. AS A RESULT OF STRONG INTRA - AND INTER - PROGRAMMATIC INTERACTIONS, AND THE USE OF SHARED CORE RESOURCES, OUR PORTFOLIO OF INNOVATIVE DISCOVERY AND DEVELOPMENT HAS EXPANDED EXPONENTIALLY. TO PROVIDE THE FINAL COMPONENT NEEDED TO ACHIEVE BENCH-TO BEDSIDE RESEARCH, THE RESEARCH INSTITUTE, IN COLLABORATION WITH CLINICIAN RESEARCHERS HAS CREATED A DISTINGUISHED CLINICAL RESEARCH PROGRAM. THE RESEARCH INSTITUTE IS FUNDED BY AN OPERATING BUDGET OF $48.6 MILLION, SUPPORTED IN PART BY APPROXIMATELY $40.6 MILLION IN EXTRAMURAL FUNDS, INCLUDING $13.7 MILLION FROM FEDERAL GRANTS. THIS RESEARCH RESULTED IN APPROXIMATELY 1,000 PUBLICATIONS FROM 100 BASIC SCIENTISTS AND CLINICAL RESEARCHERS IN 2019. HIGHLIGHTS FOR 2019 INCLUDE: ADVANCING HSS' RESEARCH STRATEGIC PLAN WITH INVESTMENTS IN: 1)SUPPORTING FACULTY WHO REMAIN EXPOSED TO FUNDING UNCERTAINTIES; 2)MENTORING THE NEXT GENERATION OF SCIENTISTS, 3)CONTINUED INITIATIVES TO RETAIN OUR MOST PRODUCTIVE FACULTY, 4)CONTINUED INVESTMENT AND EXPANSION OF THE PRECISION MEDICINE, AND 5) SCIENTIFIC HIGHLIGHTS INCLUDE, AMONG OTHERS: REGENERATIVE MEDICINE; SINGLE CELL SEQUENCING: NEW DISEASE-RELATED CELL TYPES IN RA AND SLE AND HOW THEY RESPOND TO THERAPY; MICROBIOME (GUT BACTERIA) AFFECTS PERIPROSTHETIC JOINT INFECTIONS: NEW THERAPIES; GENOME EDITING (CRISPR): "GENE SWITCHES" THAT CONTROL AUTOIMMUNITY, AND; ENDOTHELIAL CELLS ALTER IMMUNE RESPONSE AND IMPROVE TENDON HEALING.
4c (Code:   ) (Expenses $ 49,037,669 including grants of $ 0 ) (Revenue $ 7,545,973 )
EDUCATION INSTITUTE: HSS EDUCATION INSTITUTE CONTINUED TO MAKE STRIDES TOWARDS THE MISSION TO BE "THE MOST TRUSTED EDUCATOR" IN THE FIELD OF MUSCULOSKELETAL HEALTH FOR PATIENTS, PHYSICIANS, ALLIED HEALTH PROFESSIONALS AND THE GENERAL PUBLIC. IN 2019 WE STRENGTHENED STRATEGIC PARTNERSHIPS WITH OUR 26 EDUCATION AND ACADEMIC AFFAIRS ADVISORY COMMITTEES AND INSTITUTIONAL PARTNERS, AS WELL AS FURTHERING EXTERNAL COMMUNITY RELATIONS GLOBALLY. THE INSTITUTE TRAINED 45 RESIDENTS, 73 FELLOWS, AND 105 MEDICAL STUDENTS AND TRAINEES WHO SPEND PART OF THE YEAR AT HSS. IN ADDITION, HSS' RESIDENCY PROGRAM HAS BEEN TOP RANKED FOR THE FIVE YEARS BY PHYSICIAN NETWORK DOXIMITY IN BOTH REPUTATION AND RESEARCH OUTPUT. IN 2019, WE ENGAGED NEARLY 165,000 PARTICIPANTS THROUGH CUTTING EDGE EDUCATION PROGRAMS, INCLUDING OUR HSS e-ACADEMY (THE HOSPITAL'S ONLINE LEARNING PLATFORM FOR PROFESSIONALS), ACGME PROGRAMS, CME ACCREDITED ACTIVITIES, BIOSKILLS EDUCATION LABORATORY SESSIONS, GLOBAL PARTNERSHIP INITIATIVES, KIM BARRETT MEMORIAL MEDICAL LIBRARY USERS, AND PUBLIC AND PATIENT EDUCATION PROGRAMS. EI ALSO HOSTED 424 ACADEMIC VISTORS AND CREDENTIALED NEARLY 1,000 PHYSICIANS AND HEALTH CARE PROVIDERS. WE CONTINUE TO SET THE HIGHEST STANDARD WITH OUR ACCME ACCREDITED AND NON-ACCREDITED PROFESSIONAL EDUCATION PROGRAMS. IN 2019, THE EDUCATION INSTITUTE THROUGH ITS POFESSIONAL EDUCATION DEPARTMENT AND HSS E-ACADEMY DELIVERED MORE THAN 250 EDUCATIONAL ACTIVITIES INCLUDING ONSITE COURSES, GRAND ROUNDS, INTERNET LIVE COURSES, INTERNET ENDURING MATERIAL AND JOURNAL-BASED CONTINUING MEDICAL EDUCATION ACTIVITIES RESULTING IN OVER 19,000 LEARNER INTERACTIONS WITH A DIVERSITY OF HEALTHCARE PROFESSIONALS AND TEAMS.
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet1,046,782,241
Form 990 (2019)
Form 990 (2019)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment.........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D,
Part IIIClick to see attachment..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D,
Part VI. Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII
Click to see attachment......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
Yes
 
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....Click to see attachment
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I(see instructions) ....
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
 
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.....Click to see attachment
21
Yes
 
Form 990 (2019)
Form 990 (2019)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
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........Click to see attachment
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............Click to see list of attachments
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 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 .... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part IIClick to see attachment...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part IIIClick to see attachment.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................Click to see attachment
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....Click to see attachment
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in lines 28a or 28b? If "Yes," complete Schedule L, Part IV..................... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..Click to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................Click to see attachment
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
33
 
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
 
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
673
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
 
Form 990 (2019)
Form 990 (2019)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
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
6,551
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletEI , VI , CJ
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
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
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
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see instructions and file Form 4720, Schedule N.
15
Yes
 
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
Form 990 (2019)
Form 990 (2019)
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
50
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
43
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
 
No
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
Yes
 
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
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
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
Yes
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
AK , CO , FL , GA , HI , IL , KS , KY , MD , MA , MI , MN , MS , NH , NJ , NM , NY , NC , ND , OK , OR , PA , SC , TN , UT , WA , WI
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A 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:
MediumBulletMARC GOULD535 EAST 70TH STREET   NEW YORK,NY10021 (212) 606-1323
Form 990 (2019)
Form 990 (2019)
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.

See instructions for the order in which to list the persons above.
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) Sheeraz Qureshi......................................................................
Associate Attending Physician
50.0
.................
0.0
        X   6,122,573 0 57,008
(2) Bryan Kelly - FROM 07......................................................................
Member/Surgeon-in-Chief
74.82
.................
0.77
X   X       5,267,261 500 77,214
(3) Louis A Shapiro......................................................................
President & Chief Exec Officer
45.23
.................
14.77
X   X       2,944,114 736,029 84,220
(4) Answorth Allen......................................................................
Attending Physician
50.0
.................
0.0
        X   3,583,093 0 69,284
(5) Frank Schwab......................................................................
Attending Physician
50.0
.................
0.0
        X   3,506,409 0 63,964
(6) William Ricci......................................................................
Chief of the Trauma Service
50.0
.................
0.0
        X   2,617,495 0 59,841
(7) Ernest Sink......................................................................
Associate Attending Physician
50.0
.................
0.0
        X   2,401,456 0 63,964
(8) Stacey Malakoff......................................................................
Exec VP & Chief Fin Officer
48.23
.................
11.77
    X       1,831,029 323,124 72,317
(9) Hollis Potter......................................................................
Radiologist-in-Chief
60.0
.................
0.0
      X     1,708,816 0 77,037
(10) Lisa Goldstein......................................................................
Executive VP & COO
50.7
.................
9.3
    X       1,488,053 222,354 63,394
(11) Douglas Padgett-Join B......................................................................
Member/Assoc Surgeon-in-Chief
57.16
.................
0.0
X           1,476,985 0 73,472
(12) Todd Albert - Left 07......................................................................
Member/Surgeon-in-Chief
44.44
.................
1.27
X   X       1,075,565 0 66,093
(13) Mary Crow......................................................................
Member/Physician-in-Chief
59.23
.................
0.77
X           952,748 1,000 41,872
(14) Joel Press - Left BOT......................................................................
Member/Physiatrist-in-Chief
49.6
.................
0.4
X           888,448 0 71,559
(15) Irene Koch......................................................................
Exec VP & Chief Legal Officer
48.42
.................
11.58
    X       738,210 130,273 56,971
(16) Lionel Ivashkiv......................................................................
Member/Chief Scientific Offic.
60.0
.................
0.0
X           797,681 0 61,511
(17) Stephanie Goldberg -Le......................................................................
Sr. VP, Patient Care SRV & CNO
60.0
.................
0.0
      X     707,269 0 30,343
Form 990 (2019)
Form 990 (2019)
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) Ralph Bianco........................................................................
Sr. Vice President, Operation
54.0
.......................6.0
      X     527,291 58,587 68,717
(19) Karen Onel- Join BOT 2........................................................................
Member/Attending Physician
49.6
.......................0.4
X           368,872 0 62,346
(20) Jennifer O'Neill - Fro........................................................................
Sr. VP, Patient Care SRV & CNO
60.0
.......................0.0
      X     357,599 0 23,166
(21) Michael Parks - Left B........................................................................
Member/Attending Physician
9.13
.......................0.77
X           122,412 1,000 28,851
(22) Edwin Su........................................................................
Member/Attending Physician
14.81
.......................0.4
X           77,747 0 54,767
(23) Thomas Sculco - Left B........................................................................
Member/Attending Physician
26.81
.......................0.4
X           62,802 0 50,044
(24) James M Benson........................................................................
Member
0.37
.......................0.06
X           0 0 0
(25) Daniel C Benton........................................................................
Member
1.61
.......................0.28
X           0 0 0
(26) Herbert Black........................................................................
Member
0.37
.......................0.06
X           0 0 0
(27) Michael Brooks........................................................................
Member
1.15
.......................0.21
X           0 0 0
(28) Kathryn Chenault........................................................................
Member
0.54
.......................0.09
X           0 0 0
(29) Charles Coleman III........................................................................
Member
0.96
.......................0.17
X           0 0 0
(30) Leslie Cornfeld........................................................................
Member
0.83
.......................0.15
X           0 0 0
(31) Cynthia Foster Curry........................................................................
Member
3.7
.......................0.66
X           0 0 0
(32) Barrie M Damson........................................................................
Member
0.84
.......................0.17
X           0 0 0
(33) James G Dinan........................................................................
Member
2.97
.......................0.53
X           0 0 0
(34) Anne Ehrenkranz........................................................................
Member
2.7
.......................0.48
X           0 0 0
(35) Michael Esposito........................................................................
Vice-Chair
5.21
.......................0.92
X   X       0 0 0
(36) Marina Kellen French........................................................................
Member
0.54
.......................0.09
X           0 0 0
(37) Giammaria Giuliani........................................................................
Member
0.37
.......................0.06
X           0 0 0
(38) Craig Ivey........................................................................
Vice-Chair - CHG FROM MBR 4/19
4.99
.......................0.88
X   X       0 0 0
(39) Winfield P Jones........................................................................
Chair Emeritus-CHG FR MBR 4/19
1.73
.......................0.3
X   X       0 0 0
(40) Warren Kanders........................................................................
Member
0.37
.......................0.06
X           0 0 0
(41) Scott Kapnick........................................................................
Member
2.26
.......................0.4
X           0 0 0
(42) Monica Keany........................................................................
Member
1.0
.......................0.18
X           0 0 0
(43) Thomas J Kelly........................................................................
Member
2.17
.......................0.39
X           0 0 0
(44) Sacha Lainovic........................................................................
Member
0.74
.......................0.13
X           0 0 0
(45) Laurie Hodges Lapeyre........................................................................
Member
4.67
.......................0.83
X           0 0 0
(46) Pablo Legorreta........................................................................
Member
0.74
.......................0.13
X           0 0 0
(47) Lara Lerner........................................................................
Member
0.54
.......................0.09
X           0 0 0
(48) Kathy Leventhal........................................................................
Member
1.82
.......................0.33
X           0 0 0
(49) Marylin B Levitt........................................................................
Member
0.66
.......................0.12
X           0 0 0
(50) Thomas H Lister........................................................................
Co-Chair
14.52
.......................2.98
X   X       0 0 0
(51) Alan S MacDonald........................................................................
Member
1.63
.......................0.29
X           0 0 0
(52) David McCormick........................................................................
Member
1.61
.......................0.28
X           0 0 0
(53) Celene Menschel -Join........................................................................
Member
0.29
.......................0.06
X           0 0 0
(54) Mary Kathryn Navab........................................................................
Member
1.27
.......................0.22
X           0 0 0
(55) Terence M O'Toole........................................................................
Member
4.5
.......................0.8
X           0 0 0
(56) Gordon Pattee........................................................................
Member
0.66
.......................0.12
X           0 0 0
(57) Matthew Peltz - Join B........................................................................
Member
0.07
.......................0.02
X           0 0 0
(58) Steven Rattner........................................................................
Member
1.57
.......................0.27
X           0 0 0
(59) Susan W Rose........................................................................
Member
0.66
.......................0.12
X           0 0 0
(60) Jonathan Sobel........................................................................
Member
3.93
.......................0.69
X           0 0 0
(61) Deirdre Stanley........................................................................
Vice-Chair - CHG FROM MBR 4/19
3.65
.......................0.64
X   X       0 0 0
(62) Robert K Steel........................................................................
Co-Chair
14.87
.......................2.63
X   X       0 0 0
(63) Patricia Warner........................................................................
Member
2.5
.......................0.45
X           0 0 0
(64) Sanford I Weill........................................................................
Member
0.37
.......................0.06
X           0 0 0
(65) Kendrick R Wilson III........................................................................
Chair Emeritus
4.3
.......................0.88
X   X       0 0 0
(66) Ellen M Wright........................................................................
Member
2.7
.......................0.48
X           0 0 0
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 39,623,928 1,472,867 1,377,955
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 MediumBullet1,863
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
 
No
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
MCKINSEY CO,
PO BOX 7247-7255
PHILADELPHIA,PA191707255
CONSULTING 7,335,000
EWING COLE,
FEDERAL RESERVE BANK BLDG 100 N 6TH
PHILADELPHIA,PA191061590
Construction 6,000,392
CONSTRUCTION CONTRACTORS OF NY COR,
208 RUSSELL PLACE
HACKENSACK,NJ07601
CONSTRUCTION 4,874,708
PM CONSTRUCTION,
80 VERDI ST
FARMINGDALE,NY11735
CONSTRUCTION 4,520,614
Proskauer Rose LLP,
ELEVEN TIMES SQUARE
NEW YORK,NY10036
LEGAL SERVICES 4,447,671
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet239
Form 990 (2019)
Form 990 (2019)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 7,750,316
e Government grants (contributions)1e 5,261,321
f All other contributions, gifts, grants, and similar amounts not included above1f 60,769,523
g Noncash contributions included in lines 1a - 1f:$ 1g 874,947
h Total. Add lines 1a-1f.......MediumBullet 73,781,160
 Program Service RevenueAmt Business Code
2a NET INPATIENT REVENUE 622110 665,767,088 665,767,088    
b NET OUTPATIENT REVENUE 622110 381,803,817 381,803,817    
c PROFESSIONAL FEES 622110 172,266,148 172,266,148    
d
e
f All other program service revenue.        
g Total. Add lines 2a–2f .....MediumBullet 1,219,837,053
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 12,936,051   -214,618 13,150,669
4 Income from investment of tax-exempt bond proceedsMediumBullet 0      
5 Royalties...........MediumBullet 558,000     558,000
(ii) Personal (i) Real
6a Gross rents     6a
b Less: rental expenses     6b
c Rental income or (loss) 0 0 6c
d Net rental income or (loss).......MediumBullet 0      
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory   163,180,181 7a
b Less: cost or other basis and sales expenses   150,875,591 7b
c Gain or (loss)   12,304,590 7c
d Net gain or (loss).........MediumBullet 12,304,590     12,304,590
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a 0
b Less: direct expenses ... 8b 0
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a 0
b Less: direct expenses ... 9b 0
c Net income or (loss) from gaming activities..MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances ..
10a 0
b Less: cost of goods sold .. 10b 0
c Net income or (loss) from sales of inventory..MediumBullet 0      
Business Code Miscellaneous Revenue
11a RECOVERIES-EXPENSES 622110 26,478,094 26,478,094    
b RECOVERIES-MD RELATED EXP 622110 11,537,396 11,537,396    
c MISCELLANEOUS 622110 17,612,644 16,826,054 786,590  
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 55,628,134
12 Total revenue. See instructions.....MediumBullet 1,375,044,988 1,274,678,597 571,972 26,013,259
Form 990 (2019)
Form 990 (2019)
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 .... 327,200 327,200
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ........... 0  
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. 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 ........... 22,405,446 15,171,616 7,233,830  
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........ 577,646,127 503,062,702 74,583,425  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 26,656,200 23,372,725 3,283,475  
9 Other employee benefits ....... 65,546,693 56,689,647 8,857,046  
10 Payroll taxes ........... 33,839,326 29,266,762 4,572,564  
11 Fees for services (non-employees):        
a Management ...... 12,947,975 3,325,237 9,622,738  
b Legal ......... 8,358,926   8,358,926  
c Accounting ........... 376,380   376,380  
d Lobbying ........... 48,000   48,000  
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 300,000   300,000  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 23,711,714 20,626,934 3,084,780  
12 Advertising and promotion .... 20,149,663   20,149,663  
13 Office expenses ....... 29,260,993 21,310,815 7,950,178  
14 Information technology ...... 31,564,139   31,564,139  
15 Royalties .. 0      
16 Occupancy ........... 64,462,205 51,369,907 13,092,298  
17 Travel ............ 3,470,546 2,800,760 669,786  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials . 0      
19 Conferences, conventions, and meetings .... 0      
20 Interest ........... 9,115,262 7,058,551 2,056,711  
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization .. 79,348,994 59,990,416 19,358,578  
23 Insurance ... 28,514,036 23,051,356 5,462,680  
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 SUPPLIES & IMPLANT 176,467,282 176,467,282    
b RESEARCH (NET OF RECOVERIES) 22,227,997 22,227,997    
c SPF SUPPLIES 13,900,128 13,900,128    
d BAD DEBT 9,637,110 9,637,110    
e All other expenses 16,846,133 7,125,096 9,721,037  
25 Total functional expenses. Add lines 1 through 24e 1,277,128,475 1,046,782,241 230,346,234 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 (2019)
Form 990 (2019)
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 ........ 108,166,575 1 114,042,058
2 Savings and temporary cash investments ......... 0 2 0
3 Pledges and grants receivable, net ...... 49,331,152 3 46,748,868
4 Accounts receivable, net ............. 147,756,404 4 173,772,528
5 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
0 6 0
7 Notes and loans receivable, net ........... 15,008,282 7 15,020,451
8 Inventories for sale or use ............ 10,911,847 8 11,620,266
9 Prepaid expenses and deferred charges ...... 7,729,251 9 8,449,697
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 1,388,630,881
b Less: accumulated depreciation 10b 784,211,679 592,639,013 10c 604,419,202
11 Investments—publicly traded securities . 393,382,815 11 430,744,323
12 Investments—other securities. See Part IV, line 11 ..... 228,081,719 12 292,884,183
13 Investments—program-related. See Part IV, line 11 .. 0 13 0
14 Intangible assets ............... 0 14 559,000
15 Other assets. See Part IV, line 11 ........... 185,781,712 15 616,837,307
16 Total assets. Add lines 1 through 15 (must equal line 33)... 1,738,788,770 16 2,315,097,883
Liabilities 17 Accounts payable and accrued expenses ..... 124,893,442 17 128,619,607
18 Grants payable ... 0 18 898,393
19 Deferred revenue ......... 0 19 0
20 Tax-exempt bond liabilities ......... 66,712,524 20 40,270,588
21 Escrow or custodial account liability. Complete Part IV of Schedule D 0 21 0
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 195,824,043 23 193,150,164
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 274,067,412 25 771,025,592
26 Total liabilities. Add lines 17 through 25.. 661,497,421 26 1,133,964,344
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 719,731,316 27 778,278,350
28 Net assets with donor restrictions ........... 357,560,033 28 402,855,189
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 1,077,291,349 32 1,181,133,539
33 Total liabilities and net assets/fund balances ........ 1,738,788,770 33 2,315,097,883
Form 990 (2019)
Form 990 (2019)
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
1,375,044,988
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
1,277,128,475
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
97,916,513
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
1,077,291,349
5
Net unrealized gains (losses) on investments ...............
5
60,544,602
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
-54,618,925
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
1,181,133,539
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
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2019)
Form 990 (2019)
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 Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
NEW YORK SOCIETY FOR THE RELIEF OF THE
RUPTURED AND CRIPPLED MAINTAINING THE
Employer identification number

13-1624135
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 12, check only one box.)
1
2
3
4
5
6
7
8
9
10
11
12
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- 10 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) 2019

Schedule A (Form 990 or 990-EZ) 2019
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 failed 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) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. 68,047,821 57,154,844 49,923,152 92,212,279 73,781,160 341,119,256
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....           0
3 The value of services or facilities furnished by a governmental unit to the organization without charge..           0
4 Total. Add lines 1 through 3 68,047,821 57,154,844 49,923,152 92,212,279 73,781,160 341,119,256
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).. 11,470,916
6 Public support. Subtract line 5 from line 4. 329,648,340
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (f) Total
7 Amounts from line 4.. 68,047,821 57,154,844 49,923,152 92,212,279 73,781,160 341,119,256
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... 7,254,332 10,912,208 7,872,710 12,344,419 13,708,669 52,092,338
9 Net income from unrelated business activities, whether or not the business is regularly carried on..       525,180 571,972 1,097,152
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. 450,141 470,424 435,475 0 0 1,356,040
11 Total support. Add lines 7 through 10 395,664,786
12
12
5,535,420,087
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
83.315 %
15
15
78.550 %
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) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (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) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (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) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d 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 12a or 12b 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) 2019

Schedule A (Form 990 or 990-EZ) 2019
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) 2019

Schedule A (Form 990 or 990-EZ) 2019
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) 2019

Schedule A (Form 990 or 990-EZ) 2019
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 2019 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-2019
(iii)
Distributable
Amount for 2019
1 Distributable amount for 2019 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI).
See instructions.
 
3 Excess distributions carryover, if any, to 2019:
a From 2014.......  
b From 2015.......  
c From 2016.......  
d From 2017.......  
e From 2018.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2019 distributable amount  
i Carryover from 2014 not applied (see
instructions)
 
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2019 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2019 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2019, if any. Subtract lines 3g and 4a from line 2.
If the amount is greater than zero, explain in Part VI.
See instructions.
 
6 Remaining underdistributions for 2019. Subtract
lines 3h and 4b from line 1. If the amount is greater
than zero, explain in Part VI. See instructions.
 
7 Excess distributions carryover to 2020. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a Excess from 2015.....  
b Excess from 2016.....  
c Excess from 2017.....  
d Excess from 2018.....  
e Excess from 2019.....  
Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019
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, Part II The Schedule A, Part II support schedule has been completed to demonstrate that HSS meets the 170(b)(1)(A)(vi) public support test as required to use the Schedule B, Special Rule. HSS is not classified as a 170(b)(1)(A)(vi) entity, as it meets its public charity status requirement as a Hospital under section 170(b)(1)(A)(iii).
Schedule A (Form 990 or 990-EZ) 2019


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Name of the organization
NEW YORK SOCIETY FOR THE RELIEF OF THE
RUPTURED AND CRIPPLED MAINTAINING THE
Employer identification number

13-1624135
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2
Name of organization
NEW YORK SOCIETY FOR THE RELIEF OF THE
RUPTURED AND CRIPPLED MAINTAINING THE
Employer identification number
13-1624135
Part I
Contributors
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
RESTRICTED
 
 
 
 
  ,    

$ RESTRICTED


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

$  


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

$  


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

$  


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

$  


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

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Page 3
Name of organization
NEW YORK SOCIETY FOR THE RELIEF OF THE
RUPTURED AND CRIPPLED MAINTAINING THE
Employer identification number

13-1624135
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Page 4
Name of organization
NEW YORK SOCIETY FOR THE RELIEF OF THE
RUPTURED AND CRIPPLED MAINTAINING THE
Employer identification number

13-1624135
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Additional Data


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

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

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet Complete if the organization is described below. SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
NEW YORK SOCIETY FOR THE RELIEF OF THE
RUPTURED AND CRIPPLED MAINTAINING THE
Employer identification number

13-1624135
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

2
Political campaign activity expenditures (see instructions) ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities (see instructions) ..................................................................
 

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

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

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2019

Schedule C (Form 990 or 990-EZ) 2019
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(b) Affiliated group totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................    
b Total lobbying expenditures to influence a legislative body (direct lobbying) ........................ 48,000  
c Total lobbying expenditures (add lines 1a and 1b) ............................................................ 48,000  
d Other exempt purpose expenditures ............................................................................... 1,277,080,475  
e Total exempt purpose expenditures (add lines 1c and 1d) .................................................. 1,277,128,475  
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
1,000,000  
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) ................................................. 250,000  
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ...................................................................................................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in)
(a) 2016 (b) 2017 (c) 2018 (d) 2019 (e) Total
2a Lobbying nontaxable amount 1,000,000 1,000,000 1,000,000 1,000,000 4,000,000
b Lobbying ceiling amount
(150% of line 2a, column(e))
6,000,000
c Total lobbying expenditures 44,000 52,000 48,000 48,000 192,000
d Grassroots nontaxable amount 250,000 250,000 250,000 250,000 1,000,000
e Grassroots ceiling amount
(150% of line 2d, column (e))
1,500,000
f Grassroots lobbying expenditures 0 0 0   0
Schedule C (Form 990 or 990-EZ) 2019


Schedule C (Form 990 or 990-EZ) 2019
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
Yes|No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
 
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
 
 
c
Media advertisements? ...................................................................................................
 
 
 
d
Mailings to members, legislators, or the public? .............................................................................
 
 
 
e
Publications, or published or broadcast statements? ...........................................................
 
 
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
 
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
 
 
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
 
 
i
Other activities? ...................................................................................................................
 
 
 
j
Total. Add lines 1c through 1i ....................................................................................................
 
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
 
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) .........................................
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
Schedule C (Form 990 or 990EZ) 2019


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.
SchDMd Bullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
NEW YORK SOCIETY FOR THE RELIEF OF THE
RUPTURED AND CRIPPLED MAINTAINING THE
Employer identification number

13-1624135
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 7/25/06, 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 FASB 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 FASB 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 FASB 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) 2019

Schedule D (Form 990) 2019
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 .... 361,278,693 336,457,233 317,061,760 302,864,378 281,958,095
b Contributions ... 78,944,694 98,195,455 55,313,894 62,588,933 66,490,623
c Net investment earnings, gains, and losses 33,455,325 -6,198,738 28,886,639 10,841,617 5,933,317
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ...
67,104,863 67,175,257 64,805,060 59,233,168 51,517,657
f Administrative expenses ....          
g End of year balance ...... 406,573,849 361,278,693 336,457,233 317,061,760 302,864,378
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet1.000 %
b
Permanent endowment SchDMd Bullet41.000 %
c
Term endowment SchDMd Bullet58.000 %
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)
Yes
 
(ii) Related organizations .................
3a(ii)
 
No
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 .....   223,403 223,403
b Buildings ....   731,874,673 384,316,205 347,558,468
c Leasehold improvements        
d Equipment ....   606,432,784 399,895,474 206,537,310
e Other .....   50,100,021   50,100,021
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 604,419,202
Schedule D (Form 990) 2019

Schedule D (Form 990) 2019
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) ALTERNATIVE INVESTMENTS
292,884,183 F
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 292,884,183
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
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
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)LEASE ASSETS 403,791,242
(2)INSURANCE CLAIMS RECEIVABLE 82,169,768
(3)INT IN HSS FUND, INC.-FASB 136 72,069,994
(4)DUE FROM AFFILIATES -MRKT SEC. 22,329,025
(5)457B DEFERRED COMP PLAN ASSETS 15,524,243
(6)DUE FROM AFFILIATES - NET 13,839,027
(7)INT - HSS FLORIDA PHYSICIA LLC 4,674,175
(8)INT - HSS ASC OF MANHATTAN LLC 2,135,741
(9)INVESTMENT IN PALM BEACH ASC 1,637,322
(10)TI RECEIVABLE WESTCHESTER - LT 1,406,250
(11)INVESTMENT IN SUTTON HOUSE 820,000
(12)INVESTMENT IN HS2 96,294
(13)GPA HOLDINGS, LLC 42,211
(14)INVESTMENT IN LIMA WARRANTS 1,000
(15)INT - HSS WESTSIDE ASC LLC -3,698,985
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 616,837,307
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
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 771,025,592
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) 2019

Schedule D (Form 990) 2019
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  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1.................. 3  
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  
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  
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  
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  
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, PART V, LINE 4 - ENDOWMENT FUNDS THE HOSPITAL'S ENDOWMENTS INCLUDE RESTRICTED (RESEARCH OR SPECIFIC PURPOSE) AND UNRESTRICTED ENDOWMENTS AND ARE USED FOR RESEARCH, EDUCATION, PATIENT NEEDS, OR RELATED ADMINISTRATIVE ACTIVITIES IN ACCORDANCE WITH APPLICABLE DONOR RESTRICTIONS.
Schedule D (Form 990) 2019


Additional Data


Software ID:  
Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990.Right pointing arrow large image Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
NEW YORK SOCIETY FOR THE RELIEF OF THE
RUPTURED AND CRIPPLED MAINTAINING THE
Employer identification number

13-1624135
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of its grants and
other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in the region (d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in the region
(f) Total expenditures
for and investments
in the region
Central America and the Caribbean 0 0 Investments   107,983,340
Central America and the Caribbean 0 0 MEDICAL INSURANCE PREMIUMS   17,873,152
Central America and the Caribbean 0 1 Program Services PT.LIAISON/BUS DEV 99,000
Central America and the Caribbean 0 1 Program Services PT.LIAISON/BUS DEV 15,000
South America 0 1 Program Services PT.LIAISON/BUS DEV 15,000
South America 0 1 Program Services PT.LIAISON/BUS DEV 7,500
Europe (Including Iceland and Greenland) 0 0 Program Services PT.LIAISON/BUS DEV 6,000
           
           
           
           
           
           
           
           
           
           
3a Sub-total .... 0 4 125,998,992
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b) 0 4 125,998,992
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2019
Schedule F (Form 990) 2019
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)
(c) Region (d) Purpose of
grant
(e) Amount of
cash grant
(f) Manner of
cash
disbursement
(g) Amount
of noncash
assistance
(h) Description
of noncash
assistance
(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......MediumBullet
 
3 Enter total number of other organizations or entities .......................MediumBullet
 
Schedule F (Form 990) 2019
Schedule F (Form 990) 2019Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant
(e) Manner of cash
disbursement
(f) Amount of
noncash
assistance
(g) Description
of noncash
assistance
(h) Method of
valuation
(book, FMV,
appraisal, other)
APS ACTION YOUNG SCHOLAR AWARD Europe (Including Iceland and Greenland)            
APS ACTION YOUNG SCHOLAR AWARD East Asia and the Pacific            
APS ACTION YOUNG SCHOLAR AWARD North America            
APS ACTION YOUNG SCHOLAR AWARD South Asia            
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2019
Schedule F (Form 990) 2019
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .
Schedule F (Form 990) 2019
Schedule F (Form 990) 2019
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.
ReturnReference Explanation
Schedule F, Part I, Line 3 - Health Education The Hospital reimburses its executives, physicians and scientists for attending conferences, some of which may be outside of the United States.
Schedule F, Part I, Line 3, Column F The accrual method of accounting is used to report expenditures reported on column F.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2019
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 Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
NEW YORK SOCIETY FOR THE RELIEF OF THE
RUPTURED AND CRIPPLED MAINTAINING THE
Employer identification number

13-1624135
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the 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
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . .
    15,628,781 1,790,666 13,838,115 1.060 %
b Medicaid (from Worksheet 3, column a) . . . . .     41,843,056 16,837,805 25,005,251 1.920 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     1,217,839 537,031 680,808 0.050 %
d Total Financial Assistance and Means-Tested Government Programs . . . . .     58,689,676 19,165,502 39,524,174 3.030 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     11,652,714 2,372,935 9,279,779 0.710 %
f Health professions education (from Worksheet 5) . . .     57,632,557 7,370,228 50,262,329 3.860 %
g Subsidized health services (from Worksheet 6) . . . .            
h Research (from Worksheet 7) .     59,050,247 31,829,539 27,220,708 2.090 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .            
j Total. Other Benefits . .     128,335,518 41,572,702 86,762,816 6.660 %
k Total. Add lines 7d and 7j .     187,025,194 60,738,204 126,286,990 9.690 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
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            
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 Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
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
4,386,480
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
165,841,119
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
234,936,447
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-69,095,328
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 %
1HSS ASC OF MANHATTAN
 
HEALTH CARE 54.68 %   45.32 %
2HSS WEST SIDE ASC
 
HEALTH CARE 67 %   33 %
3HS2 LLC
 
SURGEON TALENT MANAGEMENT CO 10.09 % 8.86 % 81.05 %
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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?1Name, 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 HOSPITAL FOR SPECIAL SURGERY
535 EAST 70TH STREET
NEW YORK,NY10021
www.hss.edu
7002012H
X X   X   X        
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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)
HOSPITAL FOR SPECIAL SURGERY
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):
1
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 19
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 19
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): http://www.hss.edu/community.asp
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
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) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
HOSPITAL FOR SPECIAL SURGERY
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 Was widely publicized 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
See Section C
b
See Section C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
HOSPITAL FOR SPECIAL SURGERY
Name of hospital facility or letter of facility reporting group  
Yes No
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 nonpayment?.................................. 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
f
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
e
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
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
HOSPITAL FOR SPECIAL SURGERY
Name of hospital facility or letter of facility reporting group  
Yes No
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) 2019
Schedule H (Form 990) 2019
Page 8
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, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 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 A 60-question survey was developed through a collective effort by a four-member HSS CHNA steering committee, community partners, internal stakeholders and the public. The CHNA steering committee identified validated research questions to be addressed, drafted the individual survey questions, and identified community partners and internal stakeholders to review and provide input to survey development. Collaboration with these groups was crucial to the success of this survey, with valuable feedback provided on survey construction and length. In an effort to reach a culturally diverse community, the survey was translated into Spanish, Chinese and Russian using a culturally sensitive back translation approach. Below outlines the list of community partners involved in survey construction: . Arthritis Foundation - New York Chapter . Clinical & Translational Science Center (CTSC) - Weill Cornell Medicine . New York Presbyterian Hospital . Medicare Rights Center . NYC DOHMH - Office of Policy, Planning and Strategic Data Use . New York City Department of Aging . S.L.E. Lupus Foundation . Self - Help Innovative Senior Center . Isabella Geriatric . Touro College Graduate School of Social Work . Visiting Nurses Services . Charles B. Wang Community Health Center . Spondylitis Association of America . Stamford YMCA . Charter School of Excellence . NY Sports Connection The CHNA was piloted for one month (October 15 - November 16, 2018) among 70 community members to obtain meaningful feedback about the survey and ensure cultural relevancy and health literacy. Survey Administration: The survey was administered via six methods: mail, online, email, social media, QR codes, and in-person. Mailed surveys were sent to existing lists maintained by the HSS Public & Patient Education and the Social Work Department reaching 15,126 community residents. In an effort to reach the medically underserved population, two strategies were employed: 1) An oversampling approach was used in selecting zip codes identified as Medically Underserved Areas (MUA) derived from the U.S. Department of Health and Human Services (https://data.hrsa.gov/tools/shortage-area/mua-find). Household mailing lists were purchased and distributed to a randomly selected sample of 7,500 households of individuals aged 18 years and older in the MUA zip codes within HSS' primary and secondary service areas. 2) The use of Survey Gizmo Panel services to administer the CHNA survey online reaching 591 low income and diverse community residents. Electronic surveys were sent via e-mail to HSS patients and existing email lists maintained by the Public and Patient Education and the Social Work Departments. Surveys were also posted on the HSS website, and social media outlets such as Facebook and Twitter. Lastly, post cards with QR-codes, and in-person surveys were distributed or displayed with instructions in some waiting areas within the hospital, and Ambulatory Care Centers (ACC), while others were administered in existing educational lectures/workshops within the community, and hospital-based programs. HSS facilitated systematic feedback from its varied constituents (i.e. internal stakeholders, community partners including the local public health department, and the public) based on the CHNA results to guide the selection of the health needs and services to address in its community programming. Our approach in identifying, prioritizing and selecting significant health needs is described below. a) Internal Stakeholders - Recognizing that the development of community health programming requires a concerted effort by all members of the organization, we involved various representatives from HSS departments (i.e. Education Institute, Nursing, Social Work, Nutrition, Rehabilitation, Ambulatory Care Centers, Service Excellence and Language Services, Regional Markets, Patient Experience, Medical Staff and Attendings, Development, Public Relations and Marketing, Digital Communications and Quality). The knowledge and experience of staff that have a vested interest in serving the community was essential in identifying and addressing the community's health needs. An internal stakeholder meeting was held on August 13, 2019 with 20 staff in attendance to discuss identified health priorities and explore areas for implementing initiatives, using CHNA results and stakeholders' awareness of community needs to guide the discussion. Discussions were focused on increasing awareness of educational resources and programs available to the community as well as healthcare providers through increased marketing efforts, and implementing digital programs (i.e. exercises, lectures and workshops) to increase program reach. b) Community partners - Feedback from community partners was critical to driving the assessment and selection of public health priorities for the Hospital. Using results of the CHNA survey as the basis for discussion, HSS and its partners exchanged valuable information regarding community needs, explored areas for future collaboration, and solidified a mutual commitment to advancing public health. Furthermore, community partner knowledge of their respective communities helped to identify gaps in community programming - or more specifically, areas where HSS could use its areas of expertise to make a lasting public health impact. The New York City DOHMH was actively involved in our CHNA process by providing input in the development of the survey and identifying significant health needs based on the CHNA results. A NYC DOHMH staff participated in our community partners meeting. See details about the meeting below: A community partners meeting was held on June 19, 2019 with 23 individuals from five community partner organizations in attendance. During the meeting, we shared the CHNA results, elicited feedback and ranked health issues according to the communities they serve. CHNA results were received positively and there was extensive discussion about how results accurately depicted the various communities served and how these results could be used to impact the community at large. Specifically, there were discussions about access to educational programs and ways in which HSS could extend the reach of its programs. c) General public including medically underserved and low-income population - To further HSS' commitment to developing programs that improve the health of our culturally diverse communities, obtaining feedback from the public and medically underserved, low-income, and minority populations was instrumental in driving the Hospital's selection of significant health needs to improve the health of communities where dramatic health disparities exist. Our approach in soliciting input from the public was through community forums. Seven community forums were held to allow community members an opportunity to identify and prioritize health needs that provided HSS with the appropriate direction in selecting its public health priorities. Our marketing strategy for the community forums included distribution of flyers at public and patient education programs and awareness on social media i.e. Facebook. Furthermore, in order to reach low-income population, HSS partnered with Community-Based Organizations (CBOs) serving medically underserved communities to advertise community forums. Specific dates, locations, and attendance for the community forums were as follows: . June 12, 2019 at Stamford Senior Center, Stamford, CT (40 people present) . June 13, 2019 at Building One Community Center, Stamford, CT (15 people present) . June 13, 2019 at HSS Campus, NYC (14 people present) . June 14, 2019 a Webinar (2 people present) . June 17, 2019 at Chinatown Community Center, Visiting Nurse Service of New York, NY (53 people present) . June 20, 2019 at Selfhelp Innovative Senior Center, Flushing, NY (22 people present) . June 26, 2019 at Leonard Covello Senior Center, Carter Burden Network, Manhattan, NY (21 people present) A total of 167 community members participated in the community forums. At each community forum, participants were asked to rank the top 10 health indicators from a list of 25 identified in the CHNA according to order of importance (where 1 ranks the highest). Ranking results were calculated using a simple point system in which each ranking is assigned a point value from 1-10, with the indicator ranked 1 receiving 10 points and the indicator ranked 10 receiving 1 point. The indicators that received the most collective points were identified as the top priorities for the participants at each respective event. d) Additional Input - HSS also solicited additional input from the Greater New York Hospital Association (GNYHA), a trade association to inform the CHNA process. Additional in-person meetings and conference calls were held with GNYHA on 01/12/2018, 05/11/2018, 10/19/18, 12/14/2018, 03/13/2019 and 05/29/2019 to discuss the NYS DOH CSP requirements and federal requirements for the CHNA. e) Public Comments f
PART V, LINE 7D THE HOSPITAL SUMMARIZED THE RESULTS OF ITS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN ITS COMMUNITY BENEFIT REPORT. THE COMMUNITY BENEFIT REPORT AND CHNA ARE POSTED ON THE HOSPITALS WEBSITE, AT HTTP://WWW.HSS.EDU/COMMUNITY.ASP, AND BOOKLETS ARE ALSO DISTRIBUTED WITHIN THE HOSPITAL. THE COMMUNITY BENEFIT REPORT IS ALSO E-MAIL BLASTED TO OUR COMMUNITY PARTNERS, SELECTED DONORS AND PUBLIC OFFICIALS.
PART V, LINE 11 A detailed description of how HSS' programs will address health needs, anticipated impact of implementation strategy, and planned collaboration with organizations is provided below. HSS is addressing all significant health needs identified in the most recently conducted CHNA. 1. Asian Community Bone Health Initiative: This initiative is comprised of culturally relevant educational and exercise programs (i.e. yoga and low impact chair exercises) designed to improve Asian seniors' management of their chronic musculoskeletal conditions (such as osteoarthritis and osteoporosis) and its symptoms (e.g. falls, stiffness, fatigue, muscle bone and joint pain) while also increasing access to care in this medically underserved community. The anticipated program impact includes improved musculoskeletal health by decreasing musculoskeletal pain, stiffness, fatigue and falls, and increasing frequency of physical activity and self-efficacy. This program is a community-based initiative and will partner with senior and community centers serving Asian older adults such as Selfhelp Innovative Senior Center and Chinatown Community Center, Visiting Nurse Service of New York in addressing the health need. 2. Charla de Lupus/Lupus Chat: This is a social work led program that engages and trains peer volunteers to become empowering role models by providing culturally relevant strategies to help increase understanding of this complex illness and its treatment, improve medical adherence, and enhance coping and healthy behaviors. Comprehensive bilingual(English/Spanish) services include: the Charla Line, a toll-free national support and education helpline; weekly Onsite Peer Support Outreach at four hospital-based clinics, monthly Charla Teen and Parent Lupus Chat Groups; numerous communities, professional education and government collaborations. Anticipated program impact includes increased knowledge and self-management skills of lupus and its symptoms. The Charla de Lupus/Lupus Chat will partner with community-based organizations throughout NYC such as Planned Parenthood of NYC and Community Healthcare Partners in addressing the health need. 3. LANtern Lupus Asian Network: HSS LANtern is a national model for support and education of Asian Americans with lupus and their families. LANtern is the only hospital-based support and education program designed specifically for Asians/Asian Americans with lupus. Through its bilingual (Chinese) SupportLine, publications, community and professional programs, and capacity building, the program seeks to enhance awareness, understanding, coping and knowledge for Asian Americans with lupus and their loved ones. Anticipated program impact includes increased knowledge about high quality preventive care for the Asian community and improved clinical management of lupus and its symptoms. LANtern will partner with community-based, hospital-based and professional organizations such as Charles B. Wang Community Health Center, NY Presbyterian's Lower Manhattan Hospital's Community Partnership for Health (CCPH), Association of Chinese American Physicians (CAMS), the Lupus Research Alliance in addressing the health need. 4. Musculoskeletal Health Wellness Initiative (MHI): This initiative is comprised of hospital and community-based educational and exercise programs to raise awareness, educate and reduce the impact of musculoskeletal conditions in the community. The educational component of MHI offers lectures, workshops and webinars about musculoskeletal health-specific topics such as osteoarthritis, osteoporosis, and rheumatoid arthritis and some of the symptoms associated with these conditions (falls, fatigue, stiffness, and muscle, bone and joint pain), in addition to maintaining a healthy lifestyle. The exercise component of the initiative is comprised of weekly exercise classes such as Yoga, Pilates, Tai Chi, Dance, and Yogalates specifically designed for individuals that are suffering from or at risk of musculoskeletal and rheumatologic conditions. The anticipated program impact includes improved musculoskeletal health by decreasing musculoskeletal pain, stiffness, fatigue and falls, and increasing frequency of physical activity and self-efficacy. MHI will partner with Arthritis Foundation, and local community centers in NYC and Stamford in addressing the health need. 5. Nursing Community Education Outreach Program (NCEOP): This program targets underserved older adults living in the community. The program's overall goal is to deliver evidence-based educational content germane to issues appropriate for older adults. The quality educational sessions use teaching strategies and educational principles deigned to improve knowledge, skills and confidence to manage and prevent chronic diseases. Educational lectures are mainly delivered by HSS nursing staff, and topics are selected based upon needs assessment results and participant feedback, such as management of chronic conditions (i.e. osteoarthritis, osteoporosis and rheumatoid arthritis, obesity, etc.), falls prevention, vaccines, nutrition and medication safety. Anticipated program impact includes increased knowledge and self-management skills of chronic conditions. NCEOP will partner with CBOs such as the Carter Burden Network and Community Access, NYC Department of Education, and NY Presbyterian Clinical Translational Science Center in addressing the health need. 6. Pain and Stress Management (PSM) Program: This program is comprised of educational, and mindfulness based coping techniques to raise awareness, educate and improve the ability to cope with pain and stress. This program offers mind/body workshops, exercises such as Yoga, and expert-guided meditation to help reduce physical and mental stressors. All the educational programs are taught by experienced physicians, nurses, physical and occupational therapists, while Yoga workshops are led by certified yoga instructors. Anticipated program impact includes increased knowledge and self-management skills of coping with pain and stress. The PSM program will partner with subject matter experts such clinicians, social workers, certified yoga therapists in addressing the health need. 7. Rheumatoid Arthritis (RA) Support and Education Programs: This initiative addresses the psychoeducational needs of community members and their families living with long-standing rheumatoid arthritis, and for people newly diagnosed. These monthly programs feature a lecture on an RA-specific topic its management, presented by healthcare professionals, and are followed by a support group, co-facilitated by a social worker and a rheumatology nurse. Anticipated program impact includes enhancing self-management skills and self-efficacy around managing RA and its symptoms. The RA support and education programs will partner with Arthritis Foundation, Spondylitis Association of America, and Creaky Joints in addressing the health need. 8. SNEAKER Super Nutrition Education for All Kids to Eat Right: This is a 7-week interactive nutrition and physical activity education program designed to provide children and families with essential knowledge about healthy eating and physical activity. The SNEAKER curriculum focuses on portion control, whole grains and fiber, fruits and vegetables, beverages, physical activity, protein and dairy, and fast food and snacks. The program provides interactive lessons that help to teach students the importance of eating a healthy, well-balanced diet and being physically active, encourage children to make healthier food choices, and educate students about how to be more physically active. Understanding the importance and influential role parents and caregivers have on a child's diet, SNEAKER contains a parent/caregiver component wherein weekly newsletters are sent home to educate the parent/caregiver about the lessons their child learned in school so they can help foster healthy changes for the child and the entire family. The program is implemented in public schools and after-school programs largely located in medically underserved areas throughout NYC. Residents in these areas are predominantly Hispanic/Latino, African American and Asian. Anticipated program impact includes improving the nutrition knowledge of children and families as well as their food choices and level of physical activity. SNEAKER will partner with NYC Department of Education and public schools in addressing the health need. 9. VOICES 60+ Senior Advocacy Program: VOICES 60+ is designed to enhance the medical care experience of low income, ethnically diverse (primarily Hispanic) HSS patients 60 and older in these areas. The program helps patients to navigate and access support, education and communication resources needed to manage their rheumatologic or musculoskeletal conditions and its symptoms to improve their quality of life. In addition, the program provides services focused on identifying and addressing communication barriers between older adult pati
PART V, LINE 13C,G PER HOSPITAL POLICY, ASSETS FOR THOSE INDIVIDUALS WITH INCOME ABOVE 300% OF THE POVERTY GUIDELINES MAY BE CONSIDERED IN THE CALCULATION UTILIZED IN DETERMINING DISCOUNTS TO PATIENTS. HOWEVER, IN PRACTICE, ASSETS ARE NOT CONSIDERED IN ANY DETERMINATION. AVAILABLE NET ASSETS WILL NOT BE CONSIDERED FOR ANY INDIVIDUAL WHOSE INCOME LEVEL IS AT 300% OR LESS OF THE FPL. RESIDENTS OF THE UNITED STATES WHOSE GROSS ANNUAL INCOME DOES NOT EXCEED SEVEN TIMES THE MOST CURRENT U.S. HEALTH AND HUMAN SERVICES (HHS) POVERTY GUIDELINES FOR THEIR FAMILY SIZE (TOTAL EXEMPTIONS CLAIMED ON THEIR FEDERAL TAX RETURN) ARE ELIGIBLE TO BE CONSIDERED FOR A PERCENTAGE DISCOUNT OF THEIR HOSPITAL BILL AS OUTLINED IN THIS POLICY, INCLUDING, WHERE APPLICABLE, A DISCOUNT OFF OF THEIR CO-PAYMENTS OR DEDUCTIBLES. NON-RESIDENTS OF THE UNITED STATES MAY BE CONSIDERED FOR A CHARITABLE DISCOUNT. THE POLICY INCLUDES A "SPECIAL ACCESS PROGRAM". INDIVIDUALS WHO DON'T EXCEED 700% OF THE FPL, BUT FAIL THE COVERAGE CRITERIA STATED BELOW, MAY STILL BE ELIGIBLE FOR FINANCIAL ASSISTANCE THROUGH THE SPECIAL ACCESS PROGRAM, BUT ONLY THOSE INDIVIDUALS WHO ARE NOT ANTICIPATED TO REQUIRE SERVICES OUTSIDE OF HSS. THE SPECIAL ACCESS PROGRAM MAKES FINANCIAL ASSISTANCE AVAILABLE TO THE FOLLOWING GROUPS, PROVIDED THE APPLICABLE INDIVIDUALS SATISFY THE FINANCIAL CRITERIA (INCOME AT OR BELOW 700% FPL): U.S. RESIDENTS WHO HAVE MEDICAL INSURANCE THAT DOES NOT PAY FOR SERVICES AT HSS (AND NO OUT-OF-NETWORK COVERAGE IS AVAILABLE), BUT THE SERVICE THE INDIVIDUAL NEEDS IS OF A TYPE THAT IS NOT REASONABLY AVAILABLE (AND COVERED UNDER THE INDIVIDUAL'S PLAN) NEARER TO THE PATIENT'S RESIDENCE THAN HSS. GENERALLY THIS RULE IS INTENDED TO APPLY TO HIGHLY SPECIALIZED CARE THAT IS NOT AVAILABLE AT MOST HOSPITALS, BUT IS AVAILABLE AT HSS. U.S. RESIDENTS WHO HAVE MEDICAL INSURANCE THAT DOES NOT PAY FOR SERVICES AT HSS (AND NO OUT-OF-NETWORK COVERAGE IS AVAILABLE) BUT DO NOT QUALIFY UNDER THE PRECEDING PARAGRAPH (2)(D)(1), AND NON-U.S. RESIDENTS WITH NO APPLICABLE COVERAGE, IN EACH CASE WHO ARE REFERRED TO HSS BY PHYSICIANS WHO ARE PARTICIPANTS IN THE HSS PHYSICIAN HOSPITAL ORGANIZATION (PHO), PROVIDED THAT SUCH REFERRAL IS APPROVED BY HSS.
PART V, LINE 16A-C THE FINANCIAL ASSISTANCE POLICY, APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY IS AVAILABLE ON THE HOSPITALS WEBSITE AT: www.hss.edu/financial-assistance.asp PART V, LINE 16J INFORMATION ABOUT THE AVAILABILITY OF THE FINANCIAL ASSISTANCE PROGRAM IS POSTED IN SIGNAGE IN ALL AREAS OF THE HOSPITAL AND ANCILLARY SERVICE LOCATIONS WHERE A PATIENT IS REGISTERED FOR SERVICES. IN ADDITION, THE FINANCIAL ASSISTANCE POLICY AND SUMMARY OF THE HOSPITAL'S POLICY IS POSTED ON THE HOSPITAL'S WEBSITE. ANY HOSPITAL BILL RECEIVED BY THE PATIENT FOR SERVICE CONTAINS INFORMATION ON THE AVAILABILITY OF THE FINANCIAL ASSISTANCE PROGRAM. ADDITIONALLY, ANY BILL SENT TO A PATIENT BY THE HOSPITAL OR THE HOSPITAL'S COLLECTION SERVICE CONTAINS INFORMATION ON THE AVAILABILITY OF THE FINANCIAL ASSISTANCE PROGRAM. ALL REGISTRATION, CUSTOMER SERVICE, AND PATIENT ACCOUNTING STAFF ARE TRAINED ON THE AVAILABILITY OF THE PROGRAM AND INSTRUCTED ON HOW AND WHEN TO COMMUNICATE THIS INFORMATION.
PART V, LINE 21D THE HOSPITAL FOR SPECIAL SURGERY IS A SPECIALTY ORTHOPEDIC HOSPITAL AND DOES NOT OPERATE AN EMERGENCY ROOM. THE HOSPITAL IS AFFILIATED WITH THE NEW YORK PRESBYTERIAN HEALTH SYSTEM, WHICH OPERATES A FULL-SERVICE HOSPITAL MAINTAINING AN EMERGENCY ROOM LOCATED ADJACENT TO THE HOSPITAL FOR SPECIAL SURGERY.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 9
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?18
Name and address Type of Facility (describe)
1 HSS ASC OF MANHATTAN
1233 SECOND AVENUE
NEW YORK,NY10065
AMBULATORY SURGERY CENTER
2 HSS PHYSIATRY & PAIN MANAGEMENT
429 EAST 75TH STREET
NEW YORK,NY10021
OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING, SPECIAL PROCEDURES & AFFL PHYS OFFICES
3 HSS EAST RIVER PROFESSIONAL BUILDING
523 EAST 72ND STREET
NEW YORK,NY10021
OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING & AFFILIATED PHYSICIAN OFFICES
4 HSS STAMFORD OUTPATIENT CENTER
1 BLACHLEY ROAD
STAMFORD,CT06902
OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING, SPECIAL PROCEDURES,& AFFL PHYS OFFICES
5 HSS WESTCHESTER OUTPATIENT CENTER
1133 WESTCHESTER AVENUE
WHITE PLAINS,NY10604
OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING, PHYSICAL THERAPY & AFFL PHYS OFFICES
6 HSS SPORTS PERFORMANCE CENTER
525 EAST 71ST BELAIRE BUILDING
NEW YORK,NY10021
OUTPATIENT CENTER WITH PHYSICAL THERAPY
7 HSS LONG ISLAND OUTPATIENT CENTER
333 EARLE OVINGTON BLVD
UNIONDALE,NY11553
OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING, SPECIAL PROCEDURES & AFFL PHYS OFFICES
8 HSS PARAMUS OUTPATIENT CENTER
140 EAST RIDGEWOOD AVENUE
PARAMUS,NJ07652
OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING, PHYSICAL THERAPY & AFFL PHYS OFFICES
9 HSS WEST SIDE OUTPATIENT CENTER
600-610 WEST 58TH STREET
NEW YORK,NY10019
OUTPATIENT CENTER WITH DIAGN IMAGING, PHYS THERAPY, SPECIAL PROCEDURES & AFFL PHYS OFFICES
10 HSS WEST SIDE ASC LLC
600-610 WEST 58TH STREET
NEW YORK,NY10019
AMBULATORY SURGERY CENTER
11 HSS AMBULARY CARE CLINIC
475 EAST 72ND STREET
NEW YORK,NY10021
OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING, PHYSICAL THERAPY AND CLINIC
12 HSS INTEGRATIVE CARE CENTER
635 MADISON AVENUE
NEW YORK,NY10022
OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING AND AFFILIATED PHYSICIAN OFFICES
13 HSS RIVER TERRACE
519 EAST 72ND STREET
NEW YORK,NY10021
OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING AND AFFILIATED PHYSICIAN OFFICES
14 HSS SPINE THERAPY CENTER
405 EAST 75TH STREET
NEW YORK,NY10021
OUTPATIENT CENTER WITH PHYSICAL THERAPY
15 HSS ORTHO INJURY CARE
1233 SECOND AVENUE
NEW YORK,NY10065
OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING AND AFFILIATED PHYSICIAN SERVICES
16 HSS DANA CENTER
510 EAST 73RD STREET
NEW YORK,NY10021
OUTPATIENT CENTER WITH MOTION ANALYSIS
17 HSS QUEENS OUTPATIENT CENTER
176-60 UNION TURNPIKE
FRESH MEADOWS,NY11366
OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING AND AFFILIATED PHYSICIAN OFFICES
18 HSS BROOKLYN OUTPATIENT CENTER
148-168 39TH STREET
BROOKLYN,NY11232
OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING, PHYSICAL THERAPY, & AFFL PHYS OFFICES
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 10
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 7, COLUMN F 2019 BAD DEBT EXPENSE PRESENTED ON THE 2019 AUDITED FINANCIAL STATEMENTS WAS $9,730,434. IN ADDITION, TOTAL OPERATING EXPENSE WAS ADJUSTED ACCORDINGLY TO REFLECT THE HOSPITAL'S PROPORTIONATE SHARE OF EXPENDITURES IN JOINT VENTURES HSS ASC OF MANHATTAN ($11,243,378) AND HSS WEST SIDE ASC ($5,204,520), THE .35% ($3,800,642) HEALTH FACILITY TAX ASSESSMENT AND 1% ($6,402,591) STATEWIDE ASSESSMENT IMPOSED BY NEW YORK STATE. AS SUCH, THESE FEES WERE ADJUSTED ACCORDINGLY IN LINE 7 AS WELL AS THE TOTAL OPERATING EXPENSE. PART I, LINE 7 THE HOSPITAL USED THE FOLLOWING METHODOLOGIES TO CALCULATE THE AMOUNTS REPORTED FOR EACH LINE ON SCHEDULE H, LINE 7: (1)LINE 7A "FINANCIAL ASSISTANCE AT COST" - UTILIZED GROSS CHARGES WRITTEN OFF REFLECTED IN THE 2019 MEDICARE COST REPORT AND REDUCED TO COST BY APPLYING THE RATIO OF PATIENT CARE COST-TO-CHARGES. THE PATIENT COST TO CHARGE RATIO IS CALCULATED IN WORKSHEET 2 WITH INFORMATION FROM THE 2019 MEDICARE COST REPORT AND HSS 2019 GENERAL LEDGER TRIAL BALANCE. THIS COST WAS OFFSET BY THE NEW YORK STATE UNCOMPENSATED CARE POOL REVENUE. (2)LINE 7B "UNREIMBURSED MEDICAID" - UTILIZED THE DECISION SUPPORT ACCOUNTING SYSTEM TO IDENTIFY TOTAL COST (DIRECT AND INDIRECT) IN PROVIDING PATIENT SERVICE TO MEDICAID AND MEDICAID MANAGED CARE PATIENTS. IN ADDITION, ASSESSMENTS TO NYS FOR INDIGENT CARE POOLS ARE INCLUDED. (3)LINE 7E "COMMUNITY HEALTH IMPROVEMENT SERVICES" - THE HOSPITAL APPLIED ACTUAL EXPENSES TO DERIVE DIRECT COST AND UTILIZE THE COST REPORT TO DERIVE INDIRECT EXPENSES, APPLICABLE TO SUCH PROGRAMS. (4)LINE 7F "HEALTH PROFESSION EDUCATION" - THE MEDICAL EDUCATION COST WAS OBTAINED FROM THE 2019 MEDICARE COST REPORT FOR DIRECT AND INDIRECT EXPENSE. THE COST WAS OFFSET BY MEDICARE AND MEDICAID REVENUE RELATED TO DIRECT GME AS WELL AS OTHER DIRECT OFFSETTING REVENUE RELATED TO "HEALTH PROFESSION EDUCATION". (5)LINE 7H "RESEARCH" - THE 2019 MEDICARE COST REPORT WAS UTILIZED.
PART III, LINES 2, 3, 4 A COST TO CHARGE RATIO OF 45.08% AS CALCULATED PER THE APPLICABLE FORM 990 INSTRUCTIONS WAS APPLIED TO THE BAD DEBT EXPENSE (AT CHARGES) OF $9,730,434 TO CALCULATE THE BAD DEBT EXPENSE OF $4,386,480 AT COST. IN 2019, THE HOSPITAL SCREENED BOTH INPATIENT AND OUTPATIENT ACCOUNTS PRIOR TO BEING CLASSIFIED AS BAD DEBT FOR "PRESUMPTIVE ELIGIBILITY" UTILIZING A COMMERCIALLY AVAILABLE INCOME PREDICTOR SOFTWARE. THE UNCOMPENSATED CARE TEXT OF THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENT STATES, "AS A MATTER OF POLICY, THE HOSPITAL PROVIDES SIGNIFICANT AMOUNTS OF PARTIALLY OR TOTALLY UNCOMPENSATED PATIENT CARE. FOR ACCOUNTING PURPOSES, SUCH UNCOMPENSATED CARE IS TREATED EITHER AS CHARITY CARE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY OR AS BAD DEBT EXPENSE. THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY ENSURES THE PROVISION OF QUALITY HEALTH CARE TO THE COMMUNITY SERVED WHILE CAREFULLY CONSIDERING AND TAKING INTO ACCOUNT THE ABILITY OF THE PATIENT TO PAY. THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM'S ELIGIBILITY THRESHOLD IS 700% OF THE FEDERAL POVERTY GUIDELINES, WHICH IS IN EXCESS OF THE NEW YORK STATE MINIMUM REQUIREMENTS OF 300%. THE HOSPITAL HAS DEFINED CHARITY CARE FOR ACCOUNTING AND DISCLOSURE PURPOSES AS THE DIFFERENCE BETWEEN ITS CUSTOMARY CHARGES AND THE DISCOUNTED RATES GIVEN TO PATIENTS IN NEED OF FINANCIAL ASSISTANCE. AS THE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY IS NOT PURSUED, SUCH AMOUNTS ARE NOT REPORTED AS REVENUE. PATIENTS WHO DO NOT QUALIFY FOR DISCOUNTED FEES ARE BILLED AT THE HOSPITAL'S ESTABLISHED CHARGES. UNCOLLECTED BALANCES FOR THESE PATIENTS ARE CATEGORIZED AS BAD DEBTS. TOTAL UNCOMPENSATED CARE IN 2019 AND 2018 FOR ALL PATIENT SERVICES AGGREGATED APPROXIMATELY $22.3 MILLION AND $22.4 MILLION RESPECTIVELY. IN ADDITION, THE HOSPITAL OPERATES ITS CLINICS AT A LOSS, TO HELP MEET THE NEEDS OF LOW INCOME AND UNINSURED INDIVIDUALS, AND ALSO OPERATES NUMEROUS OUTREACH AND EDUCATION PROGRAMS WHICH BENEFIT THE COMMUNITIES IT SERVES."
PART III, LINE 8 OVER 43% OF THE HOSPITAL'S INPATIENT POPULATION IS REPRESENTED BY MEDICARE and Medicare Managed Care. THE MEDICARE SHORTFALL OF $69,095,328 AS REPORTED IN PART III, LINE 7 WAS CALCULATED USING MEDICARE COST REPORTING PRINCIPLES AND A COST TO CHARGE RATIO METHODOLOGY. THE MEDICARE SHORTFALL SHOULD BE CONSIDERED AS A COMMUNITY BENEFIT BECAUSE THE HOSPITAL IS PROVIDING CARE TO THESE PATIENTS WITH FULL KNOWLEDGE THAT THE MEDICARE REIMBURSEMENT WILL NOT COVER THE COST OF PROVIDING CARE TO THESE RESIDENTS OF OUR COMMUNITY.
PART III, LINE 9B SELF PAY BALANCES, INCLUDING RESIDUAL BALANCES DUE AFTER PAYMENT FROM AN INSURANCE CARRIER, AS WELL AS BALANCES DUE AFTER FINANCIAL ASSISTANCE DISCOUNTS HAVE BEEN APPLIED, ARE HANDLED ACCORDING TO THE FOLLOWING POLICY: ALL PATIENTS ARE BILLED USING STANDARD CYCLES INCLUDING THE ISSUANCE OF A DETAILED BILL, COLLECTION LETTERS AND/OR TELEPHONE CALLS, AND THEN TRANSFERRED TO A "PRE-COLLECTION STATUS." THESE COLLECTION EFFORTS ARE DOCUMENTED ELECTRONICALLY IN THE PATIENT'S FILE. DURING THE PRE-COLLECTION PHASE, ADDITIONAL TELEPHONE CALLS AND/OR LETTERS ARE MADE TO ATTEMPT TO COLLECT PAYMENT IN FULL. IF UNSUCCESSFUL, THE ACCOUNT IS TRANSFERRED TO A PROFESSIONAL COLLECTION AGENCY, NO LESS THAN 120 DAYS AFTER THE ORIGINAL SELF PAY BILLING DATE. THESE REASONABLE COLLECTION EFFORTS INCLUDE ALL PATIENT ACCOUNTS, FOR BOTH MEDICARE AND NON-MEDICARE PATIENTS. MEDICARE AND NON-MEDICARE ACCOUNTS ARE RECORDED SEPARATELY. ANY PATIENTS EXPRESSING INTEREST IN APPLYING FOR FINANCIAL ASSISTANCE WILL HAVE THEIR BILLS HELD PENDING ELIGIBILITY DETERMINATION. IF PATIENT IS ELIGIBLE, THE ACCOUNT WILL BE REDUCED BASED ON THE APPROPRIATE SLIDING SCALE DISCOUNT AND THE RESULTING BALANCE WILL BE RE-BILLED ACCORDINGLY. PAYMENTS RECEIVED BY THE COLLECTION AGENCY REDUCE THE AMOUNT RECORDED AS BAD DEBT. IT IS THE HOSPITAL'S PRACTICE NOT TO FILE SUIT, ATTACH ASSETS, OR PURSUE LIENS FOR ALL PATIENTS INCLUSIVE OF FAP ELIGIBLE PATIENTS. IN CERTAIN INSTANCES, IN COORDINATION WITH THE HOSPITAL'S INTERNAL LEGAL COUNSEL, THE HOSPITAL MAY TAKE SUCH MEASURES IF DEEMED WARRANTED. PAYMENT ARRANGEMENTS: IF PATIENTS ARE UNABLE TO PAY THE ENTIRE BALANCE IN FULL, PAYMENT ARRANGEMENTS OF MONTHLY PAYMENT WILL BE OFFERED. UNDER SUCH ARRANGEMENTS, ACCOUNTS ARE TYPICALLY PAID IN FULL WITHIN SIX TO TWELVE MONTHS UNLESS OTHERWISE EXTENDED AS PART OF THE FINANCIAL ASSISTANCE PROGRAM. A CONFIRMATION LETTER WILL BE SENT WITHIN 5 DAYS, EXPLAINING THE TERMS OF THE AGREEMENT. IF MONTHLY PAYMENT IS MISSED, THE ACCOUNT WILL PROGRESS TO THE NEXT STAGE IN THE CYCLE. UNDER CERTAIN CIRCUMSTANCES, HSS MAY PROVIDE FINANCIAL ASSISTANCE PRIOR TO, OR WITHOUT, ANY APPLICATION BEING MADE FOR SUCH ASSISTANCE. AT HSS, THIS WILL BE PERFORMED THROUGH A SCREENING PROCESS. UNPAID ACCOUNTS WILL BE SCREENED USING COMMERCIALLY AVAILABLE INCOME PREDICTOR SOFTWARE TO DETERMINE WHETHER INDIVIDUALS MAY QUALIFY FOR FINANCIAL ASSISTANCE BASED ON VARIABLES SUCH AS ADDRESS, AGE AND GENDER (PRESUMPTIVE ELIGIBILITY). HSS WILL ALSO CONDUCT PRESUMPTIVE ELIGIBILITY SCREENINGS ON ACCOUNTS PRIOR TO REFERRAL FOR ANY EXTRAORDINARY COLLECTION ACTIONS (ECA) AS DEFINED BELOW IN "COLLECTION ACTIVITIES". PRESUMPTIVE ELIGIBILITY DETERMINATIONS WILL APPLY ONLY TO THE UNPAID BALANCE(S) THAT TRIGGERED THE SCREENING PROCESS. IF THE INDIVIDUAL QUALIFIES UNDER THE PRESUMPTIVE METHODOLOGY WITH RESPECT TO THE UNPAID BALANCE(S), THEN HSS WILL GRANT THE MAXIMUM LEVEL OF ASSISTANCE OTHERWISE PERMITTED WITH RESPECT TO THE UNPAID AMOUNT. INDIVIDUALS WHO ARE GRANTED FINANCIAL ASSISTANCE UNDER PRESUMPTIVE ELIGIBILITY WILL BE PROVIDED NOTICE OF THEIR ABILITY TO APPLY FOR ADDITIONAL ASSISTANCE UNDER THE POLICY. IF PRESUMPTIVE ELIGIBILITY IS AWARDED BASED ON A SCREENING OF UNPAID BALANCES OVER 240 DAYS, INDIVIDUALS MAY, WITHIN THIRTY (30) DAYS FROM THE DATE OF THE GRANTING OF PRESUMPTIVE ELIGIBILITY, APPLY FOR ADDITIONAL FINANCIAL ASSISTANCE FOR THE SERVICES TO WHICH THE PRESUMPTIVE ELIGIBILITY DETERMINATION HAS BEEN APPLIED. IN 2019, THE HOSPITAL CONDUCTED NO EXTRAORDINARY COLLECTION ACTION'S.
PART VI, LINE 2 - NEEDS ASSESSMENT HOSPITAL FOR SPECIAL SURGERY'S NEEDS ASSESSMENT PROCESS INCORPORATES RELEVANT NATIONAL, STATE, AND CITY HEALTH DATA, GOALS, AND PRIORITIES. THE HOSPITAL UTILIZES HEALTHY PEOPLE 2025, WHICH SETS BROAD-BASED GOALS AND OBJECTIVES TO EXPAND AMERICANS' ACCESS TO CARE, AND TO ELIMINATE HEALTH DISPARITIES BY AGE, GENDER, RACE, OR DISABILITIES, AND PAYS SPECIAL ATTENTION TO INFORMATION REGARDING THE DIVERSE NEEDS OF ALL NEW YORKERS. THE HOSPITAL ROUTINELY CONDUCTS NEEDS ASSESSMENTS AMONG KEY GROUPS IN ITS COMMUNITY, ON WHICH TO BASE MULTI-YEAR PROGRAMS. OTHER NEEDS ASSESSMENT DATA IS GATHERED THROUGH A RIGOROUS EVALUATION PROCESS OF PUBLIC PROGRAMS. IN 2019, HSS CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO PROVIDE INSIGHT INTO OUR COMMUNITY'S: (1) HEALTH STATUS AND QUALITY OF LIFE; (2) HEALTH BEHAVIOR AND LIFESTYLE; (3) USE OF AND ACCESS TO CARE; AND (4) SOCIO-DEMOGRAPHIC CHARACTERISTICS. IN ADDITION, SEVEN COMMUNITY FORUMS REACHING 179 COMMUNITY MEMBERS WERE HELD TO ALLOW COMMUNITY MEMBERS AN OPPORTUNITY TO PRIORITIZE HEALTH NEEDS THAT PROVIDED HSS WITH THE APPROPRIATE DIRECTION IN SELECTING ITS PUBLIC HEALTH PRIORITIES. COMMUNITY MEMBERS WERE ASKED TO RANK THE HEALTH NEEDS MOST IMPORTANT TO THEM AND GIVE THEIR PERSPECTIVE ON COMMUNITY HEALTH ISSUES IN AN OPEN DISCUSSION. ALL HOSPITAL PUBLIC AND PATIENT EDUCATION PROGRAMS, AND DIAGNOSIS-BASED SUPPORT AND EDUCATION GROUPS INCLUDE PARTICIPANT QUESTIONNAIRES, AND THE FEEDBACK FROM THESE ARE COLLECTED, EVALUATED, AND USED IN FORMULATING NEW OR REFINING EXISTING OFFERINGS FOR THE PUBLIC. FURTHER, THE HOSPITAL'S PATIENT EXPERIENCE COUNCIL REVIEWS PRESS GANEY PATIENT COMMENTS AND QUARTERLY REPORTS, AND ALONG WITH DEPARTMENTAL MANAGERS AND MULTIDISCIPLINARY TEAMS DEVELOPS IMPROVEMENTS IN SERVICES BASED ON THIS FEEDBACK OF PATIENTS' NEEDS. FINALLY, TO ENSURE THE RANGE OF NEEDS IS INTERPRETED AT THE HIGHEST LEVEL OF MANAGEMENT, THE QUALITY BETTER COMMITTEE OF THE HOSPITAL'S BOARD OF TRUSTEES RECEIVES AND REVIEWS ONGOING REPORTS THAT INCLUDE RESULTS OF PATIENTS' SATISFACTION TRENDS AND A SUMMARY OF THE HOSPITAL-WIDE QUALITY ASSESSMENT AND PERFORMANCE IMPROVEMENT PROGRAM.
PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE INFORMATION ABOUT THE AVAILABILITY OF THE FINANCIAL ASSISTANCE PROGRAM IS POSTED IN SIGNAGE IN ALL AREAS OF THE HOSPITAL AND ANCILLARY SERVICE LOCATIONS WHERE A PATIENT IS REGISTERED FOR SERVICES. ANY HOSPITAL BILL RECEIVED BY THE PATIENT FOR SERVICE CONTAINS INFORMATION ON THE AVAILABILITY OF THE FINANCIAL ASSISTANCE PROGRAM. ADDITIONALLY, ANY BILL SENT TO A PATIENT BY THE HOSPITAL OR THE HOSPITAL'S COLLECTION SERVICE CONTAINS INFORMATION ON THE AVAILABILITY OF THE FINANCIAL ASSISTANCE PROGRAM. ALL REGISTRATION, CUSTOMER SERVICE, AND PATIENT ACCOUNTING STAFF ARE TRAINED ON THE AVAILABILITY OF THE PROGRAM AND INSTRUCTED ON HOW AND WHEN TO COMMUNICATE THIS INFORMATION. THE FINANCIAL ASSISTANCE ASSOCIATES EDUCATE, SCREEN, AND MAKE THE ELIGIBILITY DETERMINATION FOR THE HSS FINANCIAL ASSISTANCE PROGRAM. THE ASSOCIATES ARE ALSO AVAILABLE TO ASSIST THE PATIENT IN FILLING OUT ALL FINANCIAL ASSISTANCE RELATED FORMS.
PART VI, LINE 4 - COMMUNITY INFORMATION THE HOSPITAL FOR SPECIAL SURGERY'S COMMUNITY IS DEFINED BY THE FIVE BOROUGHS. THE SUBURBAN COUNTIES IN NEW YORK, NEW JERSEY, CONNECTICUT AND LONG ISLAND COMPRISE OUR SECONDARY SERVICE AREA. HSS PATIENTS COME FROM MANY COMMUNITIES LOCALLY, REGIONALLY, NATIONALLY, AS WELL AS INTERNATIONALLY.
PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH HOSPITAL FOR SPECIAL SURGERY'S COMMUNITY AND PROFESSIONAL OUTREACH BRINGS INFORMATION TO THE COMMUNITY THROUGH COLLABORATION WITH EDUCATIONAL, MULTI-SERVICE SOCIAL SERVICE AGENCIES, FAITH-BASED ORGANIZATIONS, SUPPORT AND EDUCATION GROUPS AND PROGRAMS, COMMUNITY-BASED ORGANIZATIONS, AND ACADEMIC INSTITUTIONS. IN ADDITION, IT PROVIDES EDUCATIONAL OPPORTUNITIES TO THE COMMUNITY THROUGH HEALTH FAIRS, AND PUBLIC EVENTS, AS WELL AS PUBLIC SCHOOLS, HEALTH CLINICS, SENIOR CENTERS, AND COMMUNITY HOSPITAL FORUMS. WE REACH OUT TO UNDERSERVED AND ETHNICALLY DIVERSE POPULATIONS AND SEEK TO SERVE AND COLLABORATE WITH THE ABOVE-MENTIONED ORGANIZATIONS TO ENGAGE COMMUNITIES AROUND MAJOR HEALTH ISSUES. IN 2019, THE HOSPITAL SPONSORED VARIOUS COMMUNITY EDUCATION, SUPPORT AND OUTREACH PROGRAMS INCLUDING EDUCATIONAL WORKSHOPS ON MUSCULOSKELETAL HEALTH AND WELLNESS, LEON ROOT, MD PEDIATRIC OUTREACH PROGRAM, HSS ASIAN COMMUNITY BONE HEALTH INITIATIVE, GREENBERG ACADEMY FOR SUCCESSFUL AGING, SNEAKER (SUPER NUTRITION FOR ALL KIDS TO EAT RIGHT), HSS SPORTS SAFETY PROGRAM, WORKSHOPS ON MUSCULOSKELETAL HEALTH AND WELLNESS AT THE STAMFORD OUTPATIENT CENTER, PAIN & STRESS MANAGEMENT PROGRAM, LUPUSLINE, LANTERN (LUPUS ASIAN NETWORK) THE SLE WORKSHOP, EARLY RHEUMATOID ARTHRITIS (RA) AND LIVING WITH RA SUPPORT AND EDUCATION GROUPS, VOICES 60+ SENIOR ADVOCACY PROGRAM, THE MYOSITIS SUPPORT AND EDUCATION GROUP, CHARLA DE LUPUS (LUPUS CHAT), VOICES MEDICAID MANAGED CARE EDUCATION PROGRAM AND THE NURSING OUTREACH EDUCATION INITIATIVE. A COMMITTEE OF THE BOARD FOCUSING ON THE HOSPITAL'S COMMUNITY BENEFIT ACTIVITIES AND COMMUNITY SERVICES CONTINUES TO PROVIDE OVERSIGHT ON HSS COMMUNITY EDUCATION, OUTREACH AND SUPPORT PROGRAMS. IN ADDITION, THE HOSPITAL CONTINUES TO IMPLEMENT COMMUNITY PROGRAMMING BASED ON THE RESULTS OF THE 2019 HSS CHNA. THE HSS PUBLIC & PATIENT EDUCATION DEPARTMENT STAFF DELIVERED TWO ORAL PRESENTATIONS AT THE 2019 AMERICAN COLLEGE OF RHEUMATOLOGY (ACR) ANNUAL MEETING IN ATLANTA, GEORGIA. BOTH PRESENTATIONS FOCUSED ON ENGAGING PATIENTS IN NEEDS ASSESSMENT AND BEST PRACTICES IN DEVELOPING SELF-MANAGEMENT EDUCATION PROGRAMS FOR PATIENTS. IN ADDITION, SEVERAL MEMBERS OF THE PUBLIC & PATIENT EDUCATION STAFF PRESENTED A SYMPOSIUM AND AN ORAL PRESENTATION AT THE 2019 AMERICAN PUBLIC HEALTH ASSOCIATION (APHA) ANNUAL MEETING. THE SYMPOSIUM FOCUSED ON HSS PUBLIC HEALTH INTERVENTIONS TARGETING THE UNMET NEEDS OF AN AGING POPULATION WHILE THE ORAL PRESENTATION SHOWCASED THE RESULTS OF AN ONLINE NATIONAL SURVEY ASSESSING PARENTS' NEEDS AND PERCEPTION IN ENROLLING THEIR CHILDREN IN ORGANIZED SPORTS. THE SOCIAL WORK PROGRAMS' DEPARTMENT WAS INVITED TO THE ANNUAL MEETING OF THE AMERICAN COLLEGE OF RHEUMATOLOGY FOR A FOURTH TIME TO PRESENT A STUDY GROUP ON DEVELOPING SUPPORT AND EDUCATION PROGRAMS FOR PEOPLE WITH RHEUMATIC ILLNESS, AND TO PRESENT THE RESULTS OF THEIR NATIONAL NEEDS ASSESSMENT FOCUSED ON LUPUS AND MEN. STRATEGIES TO ENSURE CULTURAL RELEVANCE FOR HISTORICALLY UNDERSERVED COMMUNITIES WAS AN INTEGRAL PART OF THESE PRESENTATIONS IN ADDITION TO PROVIDING CLINICIANS TOOLS TO ENGAGE THEIR PATIENTS AS PARTNERS IN CARE. THIS IS A PART OF OUR ONGOING EFFORT TO IDENTIFY THE NEEDS OF DIVERSE COMMUNITIES AND TO DISSEMINATE SUCCESSFUL EVIDENCE BASED COMMUNITY INTERVENTIONS AS PART OF HSS' COMMUNITY SERVICE PLAN. WE CONTINUE TO HAVE WIDE REPRESENTATION OF OUR CSP INITIATIVES THROUGH MULTIPLE PRESENTATIONS SPECIFICALLY IN DIVERSE COMMUNITIES, FOR PATIENTS AND PROVIDERS, ON HEALTH LITERACY FOR BILINGUAL (SPANISH) OLDER ADULTS AND PROFESSIONAL PROVIDERS, UNDERSTANDING AND COPING WITH RHEUMATOID ARTHRITIS, LUPUS AND MENTAL HEALTH: MOVING BEYOND STIGMA AND EDUCATIONAL PROGRAMS TARGETED TO THE ASIAN AMERICAN COMMUNITY HOSTED IN MANHATTAN'S CHINATOWN TO ENHANCE LUPUS CARE, COPING AND TO BUILD COMMUNITY CAPACITY WITH PATIENTS AND PROVIDERS. IN ADDITION, THE HOSPITAL HAS CREATED WEBINARS, BLOGS AND EDUCATIONAL VIDEOS FOR WIDE RANGING COMMUNITY BENEFIT TOPICS. THE HOSPITAL ALSO PARTICIPATED IN AND CO-SPONSORED NUMEROUS COMMUNITY-BASED EVENTS WITH VARIOUS ORGANIZATIONS. FOR THE PAST FIVE YEARS IN A ROW THE HOSPITAL HAS BEEN DESIGNATED AS A LEADER IN LGBTQ HEALTH BY THE HUMAN RIGHTS CAMPAIGN AND THIS YEAR PARTICIPATED IN NYC WORLD PRIDE MARCH TO DEMONSTRATE OUR COMMITMENT TO SERVING THE LGBTQ+ COMMUNITY IN AN INCLUSIVE AND SENSITIVE WAY. OTHER COMMUNITY PARTNERS WE WORKED WITH INCLUDE THE ARTHRITIS FOUNDATION'S NORTH EAST REGION AND THE NEW YORK CHAPTER, LINCOLN CENTER EDUCATION, THE ALLIANCE FOR LUPUS RESEARCH'S NYC LUPUS WALK, THE ASIAN HEALTH AND SOCIAL SERVICE COUNCIL, THE ANKYLOSING SPONDYLITIS ASSOCIATION, AND THE EAST SIDE COUNCIL ON AGING. IN 2019, WE COLLABORATED WITH OVER FORTY COMMUNITY ORGANIZATIONS TO MEET EDUCATIONAL NEEDS FOR UNDERSERVED COMMUNITIES IN AREAS SUCH AS MUSCULOSKELETAL HEALTH, NUTRITION AND PHYSICAL ACTIVITY, HEALTH LITERACY, AND DISEASE SELF-MANAGEMENT. THE HOSPITAL HAD OVER 62,000 CONTACTS WITH PATIENTS/PROGRAM PARTICIPANTS THROUGH NEARLY 1,000 PROGRAMS AND DISTRIBUTED HEALTH EDUCATION MATERIALS TO NEARLY 1 MILLION INDIVIDUALS (WHICH INCLUDES OVER 974,000 WEB PAGE VIEWS). THE HOSPITAL IS ALSO PART OF A NATIONAL CLINICAL RESEARCH TRANSLATIONAL CONSORTIUM WHOSE GOAL IS TO ASSESS AND IMPLEMENT THE NEEDS OF UNDERSERVED POPULATIONS IN ORDER TO DEVELOP HEALTH PROGRAMS TO DIVERSE CULTURAL COMMUNITIES IN THE NEW YORK CITY FIVE BOROUGHS. WE ARE ALSO MEMBERS OF NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES' NATIONAL MULTICULTURAL OUTREACH INITIATIVE TO REDUCE HEALTH DISPARITIES, THROUGH RELEVANT PUBLIC HEALTH EDUCATIONAL INITIATIVES. THE POSITION OF DIRECTOR FOR COMMUNITY ENGAGEMENT, DIVERSITY AND RESEARCH, FURTHER ENHANCES RESOURCES AND THE HOSPITALS COMMITMENT TO ADDRESSING HEALTH DISPARITIES AND HEALTH EQUITY, WHILE ENGAGING THE COMMUNITY AND GROUNDING INTERVENTIONS IN EVIDENCE BASED RESEARCH AND PRACTICE. IN 2018 WE HIRED A NEW OUTCOMES MANAGER WHO PLAYS AN INTEGRAL ROLE IN THE ASSESSMENT, COLLABORATION, AND EVALUATION OF OUTCOMES REGARDING THE COLLECTION OF RACE ETHNICITY AND LANGUAGE, SEXUAL ORIENTATION AND GENDER IDENTITY DATA COLLECTION. IN COLLABORATION WITH THE DIRECTOR FOR COMMUNITY ENGAGEMENT, DIVERSITY AND RESEARCH, THEY PROVIDED OVER 750 EMPLOYEES WITH TRAININGS FOCUSED ON ENHANCING THEIR AWARENESS AND SKILLS IN WORKING WITH LGBTQ+ PATIENTS AND COMMUNITIES. THE TRAININGS ALSO INCLUDED A FOCUS ON DIGNITY AND RESPECT FOR ALL DIVERSE POPULATIONS. AS THE NATION'S LEADING HOSPITAL FOR ORTHOPEDICS AND MUSCULOSKELETAL CARE, THE HSS COMMUNITY IS NATIONAL IN THAT HSS PLAYS A LEADING ROLE IN PROVIDING RESEARCH AND EDUCATION IN THE TREATMENT OF ORTHOPEDIC AND MUSCULOSKELETAL ILLNESS AND CONDITIONS.
PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM THE HOSPITAL HAS A MEDICAL AND CLINICAL AFFILIATION WITH NEW YORK PRESBYTERIAN HOSPITAL (NYPH) WHERE THE HOSPITAL FUNCTIONS AS THE PRINCIPAL ORTHOPEDIC AND RHEUMATOLOGY FACILITY FOR NYPH AT ITS EAST 68-EAST 70 STREET FACILITY (EAST CAMPUS). THE HOSPITAL ALSO HAS A COLLABORATION AGREEMENT WITH THE STAMFORD HOSPITAL (SH), AN ACUTE CARE HOSPITAL IN STAMFORD, CONNECTICUT, AND STAMFORD HEALTH, INC. (SHI), THE SOLE MEMBER OF SH. UNDER THE COLLABORATION AGREEMENT, THE HOSPITAL WILL MANAGE THE SH DEPARTMENT OF ORTHOPEDIC SURGERY, INCLUDING CERTAIN DISCRETE ORTHOPEDIC SPACE AND ACTIVITIES WITHIN THE MAIN BUILDING OF SH.
Schedule H (Form 990) 2019
Additional Data


Software ID:  
Software Version:  

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
NEW YORK SOCIETY FOR THE RELIEF OF THE
RUPTURED AND CRIPPLED MAINTAINING THE
Employer identification number
13-1624135
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC section
(if applicable)
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
noncash assistance
(h) Purpose of grant
or assistance
(1) Arthritis Foundation New York
122 E 42nd St18th FL
NEW YORK,NY10168
58-1341679 501 (C) (3) 165,000       GENERAL SUPPORT
(2) Dominican Friars Healthcare Ministry of NY
411 E 68th St
NEW YORK,NY10065
13-1873291 501 (C) (3) 25,000       GENERAL SUPPORT
(3) GREENWICH INTERNATIONAL FILM
0 Horseneck Lane
Greenwich,CT06830
46-3500058 501 (C) (3) 25,000       GENERAL SUPPORT
(4) GREENWICH TOWN PARTY INC
PO BOX 59
Old Greenwich,CT06870
45-3555667 501 (C) (3) 24,000       GENERAL SUPPORT
(5) URBAN DOVE
21-21 41st Ave Ste 2D
LIC,NY11101
13-3997718 501 (C) (3) 15,000       GENERAL SUPPORT
(6) VIE FOR THE KIDS INC
58 Drumlin Road
West Simsbury,CT06092
82-4935374 501 (C) (3) 15,000       GENERAL SUPPORT
(7) HEALTHCARE LEADERS OF NY
28-24 Steinway Street
Astoria,NY11103
20-0866992 501 (C) (6) 10,000       GENERAL SUPPORT
(8) IONA COLLEGE
715 North Avenue
New Rochelle,NY10801
13-3508093 501 (C) (3) 10,000       GENERAL SUPPORT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
7
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
1
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2019

Schedule I (Form 990) 2019
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients
(c) Amount of
cash grant
(d) Amount of
noncash assistance
(e) Method of valuation (book,
FMV, appraisal, other)
(f) Description of noncash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
SCHEDULE I, PART I, LINE 2 THE HOSPITAL FOR SPECIAL SURGERY RAISED FUNDS TO SUPPORT THE CHARITABLE, EDUCATIONAL, AND SCIENTIFIC PURPOSE OF ITS TAX EXEMPTION. THE CONTRIBUTIONS GIVEN TO THE OUTSIDE ORGANIZATIONS ARE FOR GENERAL PURPOSES.
Schedule I (Form 990) 2019



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 Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
NEW YORK SOCIETY FOR THE RELIEF OF THE
RUPTURED AND CRIPPLED MAINTAINING THE
Employer identification number

13-1624135
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 on 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
Yes
 
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 on Line 1a? ..
2
Yes
 
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
 
No
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 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
Yes
 
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
Yes
 
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 nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
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) 2019

Schedule J (Form 990) 2019
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
1Todd Albert - Left 0719
Member/Surgeon-in-Chief
(i)

(ii)
697,575
-------------
0
369,375
-------------
0
8,615
-------------
0
21,000
-------------
0
45,093
-------------
0
1,141,658
-------------
0
0
-------------
0
2Mary Crow
Member/Physician-in-Chief
(i)

(ii)
650,331
-------------
0
293,147
-------------
0
9,270
-------------
1,000
25,200
-------------
0
16,672
-------------
0
994,620
-------------
1,000
0
-------------
0
3Lionel Ivashkiv
Member/Chief Scientific Offic.
(i)

(ii)
686,743
-------------
0
96,000
-------------
0
14,938
-------------
0
25,200
-------------
0
36,311
-------------
0
859,192
-------------
0
0
-------------
0
4Bryan Kelly - FROM 0719
Member/Surgeon-in-Chief
(i)

(ii)
1,504,109
-------------
0
58,500
-------------
0
3,704,652
-------------
500
25,200
-------------
0
52,014
-------------
0
5,344,475
-------------
500
0
-------------
0
5Karen Onel- Join BOT 2019
Member/Attending Physician
(i)

(ii)
270,843
-------------
0
0
-------------
0
98,029
-------------
0
21,000
-------------
0
41,346
-------------
0
431,218
-------------
0
0
-------------
0
6Douglas Padgett-Join BOT 2019
Member/Assoc Surgeon-in-Chief
(i)

(ii)
900,468
-------------
0
0
-------------
0
576,517
-------------
0
25,200
-------------
0
48,272
-------------
0
1,550,457
-------------
0
0
-------------
0
7Michael Parks - Left BOT 2019
Member/Attending Physician
(i)

(ii)
121,811
-------------
0
0
-------------
0
601
-------------
1,000
12,102
-------------
0
16,749
-------------
0
151,263
-------------
1,000
0
-------------
0
8Joel Press - Left BOT 2019
Member/Physiatrist-in-Chief
(i)

(ii)
732,872
-------------
0
95,000
-------------
0
60,576
-------------
0
21,000
-------------
0
50,559
-------------
0
960,007
-------------
0
0
-------------
0
9Louis A Shapiro
President & Chief Exec Officer
(i)

(ii)
1,305,041
-------------
326,260
1,608,750
-------------
402,188
30,323
-------------
7,581
20,160
-------------
5,040
47,216
-------------
11,804
3,011,490
-------------
752,873
0
-------------
0
10Stacey Malakoff
Exec VP & Chief Fin Officer
(i)

(ii)
1,062,175
-------------
187,443
737,123
-------------
130,081
31,731
-------------
5,600
21,420
-------------
3,780
40,050
-------------
7,067
1,892,499
-------------
333,971
0
-------------
0
11Lisa Goldstein
Executive VP & COO
(i)

(ii)
885,276
-------------
132,283
573,375
-------------
85,677
29,402
-------------
4,394
21,924
-------------
3,276
33,229
-------------
4,965
1,543,206
-------------
230,595
0
-------------
0
12Irene Koch
Exec VP & Chief Legal Officer
(i)

(ii)
470,773
-------------
83,078
261,467
-------------
46,141
5,970
-------------
1,054
17,850
-------------
3,150
30,575
-------------
5,396
786,635
-------------
138,819
0
-------------
0
13Hollis Potter
Radiologist-in-Chief
(i)

(ii)
981,032
-------------
0
692,500
-------------
0
35,284
-------------
0
25,200
-------------
0
51,837
-------------
0
1,785,853
-------------
0
0
-------------
0
14Stephanie Goldberg -Left 0319
Sr. VP, Patient Care SRV & CNO
(i)

(ii)
245,672
-------------
0
199,010
-------------
0
262,587
-------------
0
20,304
-------------
0
10,039
-------------
0
737,612
-------------
0
0
-------------
0
15Ralph Bianco
Sr. Vice President, Operation
(i)

(ii)
387,868
-------------
43,096
134,068
-------------
14,896
5,355
-------------
595
22,680
-------------
2,520
39,165
-------------
4,352
589,136
-------------
65,459
0
-------------
0
16Jennifer O'Neill - From 0319
Sr. VP, Patient Care SRV & CNO
(i)

(ii)
352,992
-------------
0
0
-------------
0
4,607
-------------
0
21,000
-------------
0
2,166
-------------
0
380,765
-------------
0
0
-------------
0
17Sheeraz Qureshi
Associate Attending Physician
(i)

(ii)
393,274
-------------
0
0
-------------
0
5,729,299
-------------
0
21,000
-------------
0
36,008
-------------
0
6,179,581
-------------
0
0
-------------
0
18Answorth Allen
Attending Physician
(i)

(ii)
524,043
-------------
0
0
-------------
0
3,059,050
-------------
0
25,200
-------------
0
44,084
-------------
0
3,652,377
-------------
0
0
-------------
0
19Frank Schwab
Attending Physician
(i)

(ii)
643,493
-------------
0
0
-------------
0
2,862,916
-------------
0
21,000
-------------
0
42,964
-------------
0
3,570,373
-------------
0
0
-------------
0
20William Ricci
Chief of the Trauma Service
(i)

(ii)
994,441
-------------
0
0
-------------
0
1,623,054
-------------
0
21,000
-------------
0
38,841
-------------
0
2,677,336
-------------
0
0
-------------
0
21Ernest Sink
Associate Attending Physician
(i)

(ii)
318,493
-------------
0
0
-------------
0
2,082,963
-------------
0
21,000
-------------
0
42,964
-------------
0
2,465,420
-------------
0
0
-------------
0
Schedule J (Form 990) 2019

Schedule J (Form 990) 2019
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
Schedule J, Part I, Line 1A/B First Class Travel - THE HSS TRAVEL POLICY STATES FOR BUSINESS CLASS TRAVEL PRIOR APPROVAL FROM THE CEO IS REQUIRED AND USUALLY ONLY APPROVED IF THE LENGTH OF THE FLIGHT IS GREATER THAN 5 HOURS. UPGRADE TO FIRST CLASS OCCURS ONLY IF BUSINESS CLASS DOES NOT EXIST. THE CEO, SURGEON-IN-CHIEF AND EXECUTIVE VICE PRESIDENTS HAVE APPROVAL FROM THE COMPENSATION COMMITTEE OF THE BOARD TO FLY BUSINESS CLASS IF THE FLIGHT IS GREATER THAN 5 HOURS, OR FIRST CLASS IF THE FLIGHT IS GREATER THAN 10 HOURS, OR BUSINESS CLASS IS NOT AVAILABLE. THE CEO REVIEWS THE EXECUTIVE VICE PRESIDENTS EXPENSES, AND THE AUDIT AND CORPORATE COMPLIANCE COMMITTEE OF THE BOARD OF TRUSTEES REVIEWS THE CEO'S AND SURGEON-IN-CHIEF'S EXPENSES ON A QUARTERLY BASIS. BUSINESS CLASS OR FIRST CLASS TRAVEL ARE NOT TREATED AS TAXABLE COMPENSATION. IN 2019, FIRST CLASS TRAVEL WAS REIMBURSED TO THE CEO AND PRECEDING SURGEON-IN-CHIEF. Housing Allowance - Housing allowance was paid to the Physiatrist-in-Chief and Chief of the Trauma Service, as per their contracts, and was treated as taxable compensation. Schedule J, Part I, Line 4A STEPHANIE GOLDBERG, FORMER SENIOR VICE PRESIDENT & CHIEF NURSING OFFICER, RECEIVED SEVERANCE PAY OF $259,438 WHICH IS INCLUDED IN SCHEDULE J, PART II, COLUMN (III).
Schedule J, Part I, Line 5A Certain employed physicians listed on Part VII, Section A, Line 1A receive compensation in part, based on professional service revenue generated from services they personally performed in their individual practices. In 2019, no physician was paid compensation contingent upon the organization's overall revenue or net earnings.
Schedule J, Part I, Line 6A Performance based incentive awards are paid to officers and key employees based on a number of important quality, satisfaction, efficiency, and financial measures, of which achieving budget is a factor.
Schedule J, Part II THE CURRENT SURGEON-IN-CHIEF RECEIVED PAYMENT OF $500 AND THE PHYSICIAN-IN-CHIEF AND TWO OTHER ATTENDING PHYSICIANS RECEIVED $1,000 FROM MIAC, A RELATED ORGANIZATION, TO ATTEND MIAC'S BOARD OF DIRECTORS MEETING.
Schedule J (Form 990) 2019

Additional Data


Software ID:  
Software Version:  

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part , line 24a. Provide descriptions,
explanations, and any additional information in Part .
SchKMediumBullet Attach to Form 990.

SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
NEW YORK SOCIETY FOR THE RELIEF OF THE
RUPTURED AND CRIPPLED MAINTAINING THE
Employer identification number
13-1624135
Part
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A Dormitory Authority of the State of New York
 
14-6000293   05-22-2014 27,992,584 Tax Exempt Equipment Leasing   X   X   X
B Dormitory Authority of the State of New York
 
14-6000293   08-26-2014 62,400,000 Tax Exempt Equipment Leasing   X   X   X
C Dormitory Authority of the State of New York
 
14-6000293   06-24-2015 17,974,978 Tax Exempt Equipment Leasing   X   X   X
D Dormitory Authority of the State of New York
 
14-6000293   06-15-2016 19,992,620 TAX EXEMPT EQUIPMENT LEASING   X   X   X
Dormitory Authority of the State of New York
 
14-6000293   07-14-2017 14,979,666 TAX EXEMPT EQUIPMENT LEASING   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 26,382,584 45,251,000 13,590,978  
2 Amount of bonds legally defeased .............. 0 0 0  
3 Total proceeds of issue .................. 27,992,584 62,400,000 17,974,978  
4 Gross proceeds in reserve funds ............. 0 0 0  
5 Capitalized interest from proceeds ............. 0 1,632,000 0  
6 Proceeds in refunding escrows ............... 0 0 0  
7 Issuance costs from proceeds ............... 152,584 160,000 129,987  
8 Credit enhancement from proceeds ............. 0 0 0  
9 Working capital expenditures from proceeds ............. 0 0 0  
10 Capital expenditures from proceeds ............. 27,840,000 60,608,000 17,845,000  
11 Other spent proceeds ............. 0 0 0  
12 Other unspent proceeds ............. 0 0 0  
13 Year of substantial completion ............. 2015 2016 2016
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2018, a current refunding issue)? ........
  X   X   X    
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2018, an advance refunding issue)? ........
  X   X   X    
16 Has the final allocation of proceeds been made? .......... X   X   X      
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X      
Part
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X    
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............   X   X   X    
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2019

Schedule K (Form 990) 2019
Page 2
Part
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............   X   X   X    
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?                
c Are there any research agreements that may result in private business use of bond-financed property? ............. X   X   X      
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X      
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 0.280 % 0.280 % 0.280 %  
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet 0 % 0 % 0 %  
6 Total of lines 4 and 5 ............. 0.280 % 0.280 % 0.280 %  
7 Does the bond issue meet the private security or payment test? ...   X   X   X    
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X    
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. .. 0 % 0 % 0 %  
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............   X   X   X    
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
X   X   X      
Part
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X    
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X   X   X    
b Exception to rebate? ........   X   X   X    
c No rebate due? ......... X   X   X      
If "Yes" to line 2c, provide in Part the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? .....   X   X   X    
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X    
b Name of provider .......... 0
 
0
 
0
 
 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
Schedule K (Form 990) 2019

Schedule K (Form 990) 2019
Page 3
Part
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X   X   X    
b Name of provider .......... 0
 
0
 
0
 
 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X   X   X    
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X      
Part
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X      
Part
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
Part VI, Line 2C For Tax Exempt Equipment Leasing Issues, the financing does not generate an investment income, therefore no calculation was performed and no rebate is due.
Schedule K (Form 990) 2019

Additional Data


Software ID:  
Software Version:  


Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part , line 24a. Provide descriptions,
explanations, and any additional information in Part .
SchKMediumBullet Attach to Form 990.

SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
NEW YORK SOCIETY FOR THE RELIEF OF THE
RUPTURED AND CRIPPLED MAINTAINING THE
Employer identification number
13-1624135
Part
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A Dormitory Authority of the State of New York
 
14-6000293   05-22-2014 27,992,584 Tax Exempt Equipment Leasing   X   X   X
B Dormitory Authority of the State of New York
 
14-6000293   08-26-2014 62,400,000 Tax Exempt Equipment Leasing   X   X   X
C Dormitory Authority of the State of New York
 
14-6000293   06-24-2015 17,974,978 Tax Exempt Equipment Leasing   X   X   X
D Dormitory Authority of the State of New York
 
14-6000293   06-15-2016 19,992,620 TAX EXEMPT EQUIPMENT LEASING   X   X   X
Dormitory Authority of the State of New York
 
14-6000293   07-14-2017 14,979,666 TAX EXEMPT EQUIPMENT LEASING   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 26,382,584 45,251,000 13,590,978  
2 Amount of bonds legally defeased .............. 0 0 0  
3 Total proceeds of issue .................. 27,992,584 62,400,000 17,974,978  
4 Gross proceeds in reserve funds ............. 0 0 0  
5 Capitalized interest from proceeds ............. 0 1,632,000 0  
6 Proceeds in refunding escrows ............... 0 0 0  
7 Issuance costs from proceeds ............... 152,584 160,000 129,987  
8 Credit enhancement from proceeds ............. 0 0 0  
9 Working capital expenditures from proceeds ............. 0 0 0  
10 Capital expenditures from proceeds ............. 27,840,000 60,608,000 17,845,000  
11 Other spent proceeds ............. 0 0 0  
12 Other unspent proceeds ............. 0 0 0  
13 Year of substantial completion ............. 2015 2016 2016
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2018, a current refunding issue)? ........
  X   X   X    
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2018, an advance refunding issue)? ........
  X   X   X    
16 Has the final allocation of proceeds been made? .......... X   X   X      
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X      
Part
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X    
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............   X   X   X    
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2019

Schedule K (Form 990) 2019
Page 2
Part
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............   X   X   X    
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?                
c Are there any research agreements that may result in private business use of bond-financed property? ............. X   X   X      
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X      
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 0.280 % 0.280 % 0.280 %  
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet 0 % 0 % 0 %  
6 Total of lines 4 and 5 ............. 0.280 % 0.280 % 0.280 %  
7 Does the bond issue meet the private security or payment test? ...   X   X   X    
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X    
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. .. 0 % 0 % 0 %  
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............   X   X   X    
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
X   X   X      
Part
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X    
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X   X   X    
b Exception to rebate? ........   X   X   X    
c No rebate due? ......... X   X   X      
If "Yes" to line 2c, provide in Part the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? .....   X   X   X    
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X    
b Name of provider .......... 0
 
0
 
0
 
 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
Schedule K (Form 990) 2019

Schedule K (Form 990) 2019
Page 3
Part
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X   X   X    
b Name of provider .......... 0
 
0
 
0
 
 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X   X   X    
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X      
Part
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X      
Part
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
Part VI, Line 2C For Tax Exempt Equipment Leasing Issues, the financing does not generate an investment income, therefore no calculation was performed and no rebate is due.
Schedule K (Form 990) 2019

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
NEW YORK SOCIETY FOR THE RELIEF OF THE
RUPTURED AND CRIPPLED MAINTAINING THE
Employer identification number

13-1624135
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e) Original principal amount (f) Balance due (g) In default? (h) Approved by board or committee? (i) Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2019
Schedule L (Form 990 or 990-EZ) 2019
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) DePuy Synthes SEE PART V 16,547,167 SEE PART V   No
(2) Don Joy Orthopedics SEE PART V 1,856,790 SEE PART V   No
(3) Exactech Inc SEE PART V 3,034,995 SEE PART V   No
(4) Smith Nephew SEE PART V 18,743,845 SEE PART V   No
(5) Zimmer Biomet SEE PART V 15,682,655 SEE PART V   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
SCHEDULE L, PART IV, (1) - DePuy Synthes In July, 2014, Dr. Todd Albert joined HSS Medical Staff as Surgeon-In-Chief and became an ex-officio member of HSS' Board of Trustees. Dr. Albert served as Surgeon-In-Chief until July 2019. Dr. Albert is a designer of, and receives royalties for, Expedium spine system, and Swift and Eagle anterior cervical fixation systems, products manufactured and sold by DePuy Synthes. Per HSS policy, Dr. Albert is not allowed to receive royalty payments for these patented products when used on patients at HSS. HSS has had a long-standing business relationship with DePuy Synthes that preceded Dr. Albert becoming Surgeon-In-Chief in July, 2014. With the exception of products used in the procedures he personally performs (and for which he does not receive royalties), Dr. Albert plays no role in the consideration or acquisition of DePuy Synthes products. AMOUNT OF TRANSACTION: $16,547,167 DESCRIPTION OF TRANSACTION: In 2019, HSS paid $16,547,167 to DePuy Synthes for medical devices. This amount represents all purchases, a part of which relates to the Expedium spine system and Eagle anterior cervical fixation systems.
SCHEDULE L, PART IV, (2) - Don Joy Orthopedics In July, 2019, Dr. Douglas Padgett, Associate Surgeon-in-Chief and a member of the Medical Staff, was elected as an ex-officio member of HSS Board of Trustees. Dr. Padgett is a designer of and receives royalties for, the design of a total hip replacement system, a product manufactured and sold by Don Joy Orthopedics. Per HSS policy, Dr. Padgett is not allowed to receive royalty payments for these patented products when used on patients at HSS. HSS has had a long-standing business relationship with Don Joy Orthopedics that preceded Dr. Padgett joining HSS' Board of Trustees in July 2019. With the exception of products used in the procedures he personally performs (and for which he does not receive royalties), Dr. Padgett plays no role in the consideration or acquisition of Don Joy Orthopedics products. AMOUNT OF TRANSACTION: $1,856,790 DESCRIPTION OF TRANSACTION: In 2019, HSS paid $1,856,790 to Don Joy Orthopedics for medical devices. This amount represents all purchases, a part of which relates to the total hip replacement system.
SCHEDULE L, PART IV, (3) - Exactech, Inc In 2014, Dr. Thomas Sculco was elected to the HSS' Board of Trustees after stepping down as Surgeon-In-Chief, and remained a BOT member thru November 2019. Dr. Sculco is a designer of, and receives royalties for, the design of a posterior stabilized knee prosthesis, a product manufactured and sold by Exactech. Per HSS policy, Dr. Sculco is not allowed to receive royalty payments for this patented product when used on patients at HSS. HSS had a business relationship with Exactech in the years prior to Dr. Sculco's term as Surgeon-In-Chief (May, 2003 through June, 2014). With the exception of products used in the procedures he personally performs, Dr. Sculco played no role, in those years or since, in the consideration or acquisition of Exactech's products. AMOUNT OF TRANSACTION: $3,034,995 DESCRIPTION OF TRANSACTION: In 2019, HSS paid $3,034,995 to Exactech for surgical instruments. This amount represents all purchases, a part of which relates to the posterior stabilized knee prosthesis.
SCHEDULE L, PART IV, (4) - Smith & Nephew In July, 2019, Dr. Bryan T. Kelly, Surgeon-In-Chief, was elected to the HSS Board of Trustees. Dr. Kelly is a consultant for Smith & Nephew. In 2018, Dr. Edwin Su, a member of the Medical Staff was elected to the HSS Board of Trustees. Dr. Su receives research support and is a consultant for Smith & Nephew. HSS has had a long-standing business relationship with Smith & Nephew that preceded Dr. Kelly and Dr. Su joining the HSS Board of Trustees. With the exception of products used in the procedures they personally perform Dr. Kelly nor Dr. Su play no role in the consideration or acquisition of Smith & Nephew's products. AMOUNT OF TRANSACTION: $18,743,845 DESCRIPTION OF TRANSACTION: In 2019, HSS paid $18,743,845 to Smith & Nephew for medical devices.
SCHEDULE L, PART IV, (5) - Zimmer Biomet In July, 2014, Dr. Todd Albert joined HSS Medical Staff as Surgeon-In-Chief and became an ex-officio member of HSS' Board of Trustees. Dr. Albert served as Surgeon-In-Chief until July 2019. Dr. Albert is an inventor and a design team member for Solitaire Cervical Cage. Dr. Albert is a patent holder, and receives royalties for, Lineum Cervical System and Polaris Spinal System, products manufactured and sold by Zimmer Biomet. Per HSS policy, Dr. Albert is not allowed to receive royalty payments for these patented products when used on patients at HSS. HSS has had a long-standing business relationship with Zimmer Biomet that preceded the date Dr. Albert became Surgeon-In-Chief and ex-officio member of HSS' Board of Trustees. With the exception of products used in the procedures he personally performs (and for which he does not receive royalties), Dr. Albert plays no role in the consideration or acquisition of Zimmer Biomet products. AMOUNT OF TRANSACTION: $15,682,655 DESCRIPTION OF TRANSACTION: In 2019, HSS paid $15,682,655 to Zimmer Biomet for medical instruments and surgical products. This amount represents all purchases, only a small part of which relates to the Solitaire Cervical Cage, Lineum Cervical System and Polaris Spinal System.
Schedule L (Form 990 or 990-EZ) 2019


Additional Data


Software ID:  
Software Version:  




SCHEDULE M
(Form 990)


Department of the Treasury
Internal Revenue Service
Noncash Contributions
Right pointing arrow large imageComplete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
Right pointing arrow large imageGo to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
NEW YORK SOCIETY FOR THE RELIEF OF THE
RUPTURED AND CRIPPLED MAINTAINING THE
Employer identification number

13-1624135
Part I
Types of Property
(a)
Check if applicable
(b)
Number of contributions or items contributed
(c)
Noncash contribution amounts reported on
Form 990, Part VIII, line 1g
(d)
Method of determining
noncash contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods .......
     
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded . X 20 874,947 FMV
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests ....
       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures .....
       
14 Qualified conservation
contribution—Other ...
       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( )
26 Other Right pointing arrow large image ( )
27 Other Right pointing arrow large image ( )
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement
29
 
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ..........................
32a
 
No
b
If "Yes," describe in Part II.
33
If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) (2019)
Schedule M (Form 990) (2019)
Page 2
Part IISupplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.
Return Reference Explanation
Schedule M, Part I, Column (B) The organization is reporting the number of contributions in Part I, column (b).
Schedule M (Form 990) (2019)

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 Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
NEW YORK SOCIETY FOR THE RELIEF OF THE
RUPTURED AND CRIPPLED MAINTAINING THE
Employer identification number

13-1624135
Return Reference Explanation
FORM 990, PART VI - LINE 4 "SIGNIFICANT CHANGES TO GOVERNING DOCUMENTS" The organization amended its bylaws in 2019. All amendments, which are described below, are consistent with the organizational and operational tests of Section 501(c)(3) as well as the furtherance of the organization's charitable mission. (A) Changes related to Board Composition - Delete references to GFT Trustee to members of Board of Trustees and Executive Subcommittee - Delete Immediate Past Director of Orthopedic Trauma Service as non-voting member of Board and replace with Immediate Past Surgeon-In-Chief (i.e., newest SIC Emeritus). - Removes language related to term limits that is no longer applicable. - Removes "Subcommittee of the Finance Committee" to reflect the current standing of Audit & Corporate Compliance Committee as a full Committee of the Board. - Addition of one Ex-Officio, non-voting member of the Board of Trustees to provide additional medical staff representation of Education & Academic Affairs. This individual must be a member of the medical staff, appointed by the Surgeon-in-Chief to represent Academics. This individual may, but is not required to, be the individual serving as Vice Chair, Education and Academic Affairs. (B) Changes related to restructuring Governance Functions - Replacement of "Governance Committee" with "Executive Committee", in reference to the committee that will consider nominations to the Reserved Board Position. - Replacement of "Governance Committee" with "Executive Committee", in reference to the committee that may nominate individuals for election to the Board of Trustees. - Replacement of "Governance Committee" with "Chair of the Board", in reference to the recommendation for members of Executive Committee. - Adds language requiring the Executive Committee to present Board of Trustees nominations to the Members for election and to present nominations for officers and committees to the Board of Trustees, provided that the Chair of the Board present the nomination for Executive Committee and no officeholder shall be entitled to vote as a member of Executive Committee on his or her own re-nomination as an officer. - Removes the requirement for Governance Committee. - Adds language requiring the Chair of the Board to present the nomination for Executive Committee and Executive Committee to present the nomination for all other committees to the Board of Trustees. - Removes language regarding no officeholder shall be entitled to vote as a member of Executive Committee on his or her own re-nomination as an officer.
FORM 990, PART VI, SECTION A - LINE 6 & 7A - "MEMBERSHIP" THE HOSPITAL FOR SPECIAL SURGERY IS A MEMBERSHIP CORPORATION. THERE ARE FIVE MEMBERS OF THE CORPORATION. THREE OF THE FIVE HOSPITAL'S MEMBERS COME FROM THE HOSPITAL'S BOARD OF TRUSTEES (WITH ONE OF THREE ALSO DESIGNATED BY THE HOSPITAL TO SERVE ON THE BOARD OF AN AFFILIATE OF NEW YORK-PRESBYTERIAN HOSPITAL), A FOURTH MEMBER SERVES ON THE BOARD OF THE AFFILIATE OF THE NEW YORK-PRESBYTERIAN HOSPITAL, AND THE FIFTH MEMBER SERVES ON THE BOARD OF TRUSTEES OF WEILL CORNELL MEDICAL COLLEGE. THE FIVE HOSPITAL MEMBERS ELECT THE BOARD OF TRUSTEES OF THE HOSPITAL, UPON THE RECOMMENDATION OF CANDIDATES EITHER BY A MEMBER OR BY THE HOSPITAL BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION B - LINE 11B, "REVIEW PROCESS" THE FORM 990 IS PREPARED BY AN OUTSIDE INDEPENDENT ACCOUNTING FIRM. PRIOR TO SUBMITTING THE FORM 990 TO THE INTERNAL REVENUE SERVICE (IRS), THERE IS AN ESTABLISHED PROCESS FOR REVIEW OF THE DOCUMENT IN ITS ENTIRETY BY THE GOVERNING BODY WHOSE EVALUATIONS ARE MADE IN THE BEST INTEREST OF HSS. THE FORM 990 IS FIRST REVIEWED WITH THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. THE REVIEWED FORM 990 IS THEN SUBMITTED TO THE FULL BOARD OF TRUSTEES. THE TRUSTEES ARE PROVIDED A COPY OF THE FORM 990 PRIOR TO SUBMISSION OF THE FORM. IN ADDITION, SIGNIFICANT AREAS OF FORM 990 ARE DISCUSSED AT A BOARD OF TRUSTEES MEETING.
FORM 990, PART VI, SECTION B - LINE 12C, "CONFLICT OF INTEREST POLICY" ON AN ANNUAL BASIS, FINANCIAL INTEREST DISCLOSURE STATEMENTS ARE SENT TO ALL BOARD MEMBERS, OFFICERS, MEDICAL STAFF, MANAGEMENT, FELLOWS, RESIDENTS, RESEARCH PROFESSIONAL STAFF, IRB MEMBERS, AND OTHER DESIGNATED GROUPS. OUR CONFLICT OF INTEREST POLICY ALSO REQUIRES THAT ANY CHANGES BE COMMUNICATED TO THE OFFICE OF CORPORATE COMPLIANCE WITHIN 30 DAYS. THE INFORMATION RECEIVED IS ENTERED INTO A DATABASE AND REVIEWED FOR POTENTIAL CONFLICT OF INTEREST. THE DATABASE INFORMATION IS ALSO REVIEWED BY THE EXECUTIVE VICE PRESIDENT FOR LEGAL AFFAIRS, THE CHIEF EXECUTIVE OFFICER, AND THE AUDIT AND CORPORATE COMPLIANCE COMMITTEE OF THE BOARD OF TRUSTEES. SUMMARY INFORMATION IS PROVIDED TO SERVICE CHIEFS SO THAT THEY ARE AWARE OF THE FINANCIAL INTERESTS OF THE MEDICAL STAFF WITHIN THEIR SPECIALTY. IN ADDITION TO SENDING DISCLOSURE STATEMENTS DIRECTLY TO THE GROUP NOTED ABOVE, INDUSTRY WEBSITES ARE MONITORED FOR DISCLOSURES RELATED TO EMPLOYEES OF HSS. THIS INFORMATION IS ENTERED INTO THE DATABASE, AS WELL. HSS HAS A CONFLICT OF INTEREST TASK FORCE THAT MEETS THREE TIMES A YEAR, OR AS NECESSARY, TO REVIEW AND UPDATE THE CONFLICT OF INTEREST POLICIES AND PROCEDURES. HSS' POLICY ON CONFLICT OF INTEREST IN DAY-TO-DAY OPERATIONS STATES THAT IF HSS IS CONTEMPLATING A TRANSACTION WHICH MIGHT POSSIBLY BENEFIT (OR APPEAR TO BENEFIT) A COVERED PERSON OR ANY MEMBER OF HIS/HER IMMEDIATE FAMILY, THEN THE POTENTIAL BENEFIT OR CONFLICT MUST BE DISCLOSED TO, AND APPROVED BY, A DISINTERESTED OFFICER OF HSS BEFORE THE TRANSACTION MAY PROCEED. ACCORDINGLY, A COVERED PERSON MAY NOT PLACE BUSINESS WITH ANY THIRD PARTY (E.G., A VENDOR, COMPETITOR, OR OTHER ORGANIZATION) IN WHICH THAT PERSON OR ANY MEMBER OF HIS/HER IMMEDIATE FAMILY HAS AN INTEREST, UNLESS THAT INTEREST IS DISCLOSED TO, AND THE TRANSACTION IS APPROVED BY, THE VICE PRESIDENT FOR CORPORATE COMPLIANCE AND INTERNAL AUDIT ("CORPORATE COMPLIANCE OFFICER").
FORM 990, PART VI, SECT B - LINE 15A & 15B, "PROCESS FOR DETERMINING COMP" THE HOSPITAL FOR SPECIAL SURGERY(HSS) IS COMMITTED TO ENSURING THAT ITS EXECUTIVE COMPENSATION PROGRAM ADHERES TO THE HIGHEST STANDARDS OF REGULATORY COMPLIANCE AND BEST CORPORATE GOVERNANCE. THE HSS BOARD HAS CHARGED THE COMPENSATION COMMITTEE (WHICH IS COMPOSED OF INDEPENDENT BOARD MEMBERS WITH NO CONFLICTS OF INTEREST IN REGARD TO EXECUTIVE COMPENSATION) WITH MAKING ALL DECISIONS RELATED TO COMPENSATION FOR OFFICERS AND KEY EMPLOYEES. THE COMMITTEE RETAINS AN INDEPENDENT COMPENSATION CONSULTANT TO ASSIST IT IN THIS PROCESS. COMPENSATION LEVELS ARE ESTABLISHED CONSIDERING DATA FOR FUNCTIONALLY COMPARABLE ROLES IN COMPARABLE ORGANIZATIONS, AN ASSESSMENT OF PERFORMANCE, AND OTHER BUSINESS JUDGMENT FACTORS, CONSISTENT WITH HSS EXECUTIVE COMPENSATION PHILOSOPHY. THE COMMITTEE'S DECISIONS ARE MADE IN THE BEST INTERESTS OF HSS, AND ARE INTENDED TO ENSURE THE RECRUITMENT AND RETENTION OF KEY EXECUTIVE TALENT, CONSISTENT WITH THE MARKET PRACTICES OF OTHER NOT-FOR-PROFIT HEALTH CARE ORGANIZATIONS OF COMPARABLE MISSION AND COMPLEXITY, CONSIDERING BOTH LOCAL AND NATIONAL MARKET CHALLENGES IN SUCH REGARD. ON AN ANNUAL BASIS (INCLUDING 2019), THE COMMITTEE PROVIDES THE FULL BOARD WITH AN OVERVIEW OF ITS DETERMINATIONS AND PROCESS. HSS ESTABLISHED THIS PROCESS IN AN EFFORT TO COMPLY WITH THE INTERMEDIATE SANCTIONS GUIDELINES FOR QUALIFYING FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS, AS WELL AS BEST CORPORATE GOVERNANCE PRACTICES IN ENSURING THE TRANSPARENCY OF THE EXECUTIVE COMPENSATION DECISION-MAKING PROCESS WITH THE BOARD.
FORM 990, PART VI, SECTION B - LINE 19, "DISCLOSURE GOVERNING DOCUMENTS" HOSPITAL FOR SPECIAL SURGERY MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST FROM THE OFFICE OF LEGAL AFFAIRS.
FORM 990, PART XI, LINE 9- "OTHER CHANGES IN NET ASSETS OR FUND BALANCES" INCLUDES INCREASE IN INTEREST OF HSS FUND, INC. $11,465,813, AND DECREASE IN DEFINED PENSION AND POST RETIREMENT PLAN LIABILITIES $66,084,738.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2019


Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
NEW YORK SOCIETY FOR THE RELIEF OF THE
RUPTURED AND CRIPPLED MAINTAINING THE
Employer identification number

13-1624135
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)HOSPITAL FOR SPECIAL SURGERY FUND INC
535 EAST 70TH STREET

NEW YORK,NY10021
13-6714749
FUNDRAISING NY 501 (C)(3) 7 NA
 
Yes
 
(2)HSS PROPERTIES CORPORATION
535 EAST 70TH STREET

NEW YORK,NY10021
13-3246249
REAL ESTATE NY 501 (C)(3) 12 TYPE II HSS FUND INC
 
Yes
 
(3)HSS HORIZONS INC
535 EAST 70TH STREET

NEW YORK,NY10021
13-4152131
RESEARCH SUPP NY 501 (C)(3) 12 TYPE I HSS FUND INC
 
Yes
 
(4)NEW YORK-PRESBYTERIAN FOUNDATION INC
525 EAST 68TH STREET BOX 156

NEW YORK,NY10065
13-4153668
HLTH CARE ORG NY 501 (C)(3) 12 TYPE I NA
 
 
No
(5)TJA ORTHOPEDIC SURGERY PC
535 EAST 70TH STREET

NEW YORK,NY10021
81-5178969
HEALTH CARE NY 501 (C)(3) 10 HSS
 
Yes
 




For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
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) HSS ASC OF MANHATTAN LLC

1233 2ND AVE
NEW YORK,NY10065
47-1353602
HEALTH CARE NY HSS
 
RELATED 4,514,870 15,850,069   No 0 Yes   54.677 %
(2) HSS WEST SIDE ASC LLC

600 WEST 58TH STREET
NEW YORK,NY10019
81-4351390
HEALTH CARE NY HSS
 
RELATED -11,099,549 24,070,493   No 0 Yes   67.000 %
(3) HSS-FL PHYSICIANS LLC

535 EAST 70TH STREET
NEW YORK,NY10021
82-4502169
HEALTH CARE FL HSS
 
RELATED -322,543 5,972,048   No 0 Yes   51.000 %








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) MEDICAL INDEMNITY ASSURANCE COMPANY LTD

535 EAST 70TH STREET
NEW YORK,NY10021
98-1050215
SELF-INDEMNITY CJ NA
 
C       Yes  
(2) HSS VENTURES

535 EAST 70TH STREET
NEW YORK,NY10021
06-1624300
HEALTH CARE NY NA
 
C       Yes  
(3) CHARITABLE TRUST

 
 
INVESTMENT/CHARIT OH NA
 
T         No








Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
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
Yes
 
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
Yes
 
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
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
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
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) HSS FUND INC

C 7,750,316 FMV
(2) HSS FUND INC

J 1,440,975 FMV
(3) HSS FUND INC

M 8,009,892 FMV
(4) HSS FUND INC

Q 3,384,252 FMV
(5) HSS PROPERTIES CORPORATION

A 607,951 FMV
(6) HSS PROPERTIES CORPORATION

D 15,020,450 FMV
(7) HSS PROPERTIES CORPORATION

K 56,587,146 FMV
(8) HSS PROPERTIES CORPORATION

L 3,594,609 FMV
(9) HSS PROPERTIES CORPORATION

Q 42,751,790 FMV
(10) HSS HORIZONS INC

D 427,063 FMV
(11) MEDICAL INDEMNITY ASSURANCE COMPANY LTD

P 17,873,152 FMV
(12) MEDICAL INDEMNITY ASSURANCE COMPANY LTD

Q 10,878,356 FMV
(13) HSS ASC OF MANHATTAN LLC

A 12,641 FMV
(14) HSS ASC OF MANHATTAN LLC

D 1,940,000 FMV
(15) HSS ASC OF MANHATTAN LLC

L 2,399,329 FMV
(16) HSS ASC OF MANHATTAN LLC

Q 8,155,010 FMV
(17) HSS ASC OF MANHATTAN LLC

S 1,940,000 FMV
(18) HSS WEST SIDE ASC LLC

A 50,249 FMV
(19) HSS WEST SIDE ASC LLC

D 4,212,000 FMV
(20) HSS WEST SIDE ASC LLC

J 1,501,412 FMV
(21) HSS WEST SIDE ASC LLC

L 933,173 FMV
(22) HSS WEST SIDE ASC LLC

Q 10,458,856 FMV
(23) HSS WEST SIDE ASC LLC

R 4,212,000 FMV
(24) HSS-FLORIDA PHYSICIANS LLC

L 558,646 FMV
(25) HSS-FLORIDA PHYSICIANS LLC

Q 3,659,477 FMV
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
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) 2019
Schedule R (Form 990) 2019
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. (see instructions).
Return Reference Explanation
SCHEDULE R, PART V, LINE 1o The amounts for sharing of paid employees with related organization(s) are included in line m, performance of services or membership or fundraising solicitations by related organization.
Schedule R (Form 990) 2019

Additional Data


Software ID:  
Software Version: