TY 2021 Form 990

(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)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) Louis A Shapiro...................................................................... President & Chief Exec Officer	45.23 ................. 14.77	X	X				5,180,829	1,295,208	86,359
(2) Bryan T Kelly...................................................................... Member/Surgeon-in-Chief	76.08 ................. 1.27	X	X				5,913,023	0	79,359
(3) Stacey L Malakoff...................................................................... Exec VP & Chief Fin Officer	48.23 ................. 11.77		X				2,767,416	488,369	73,823
(4) Answorth A Allen...................................................................... Attending Physician	49.38 ................. 0.62				X		2,856,349	28,852	71,997
(5) Danyal Nawabi...................................................................... Assistant Attending Physician	50.0 ................. 0.0				X		2,753,451	0	63,847
(6) William M Ricci...................................................................... Chief of the Trauma Service	50.0 ................. 0.0				X		2,594,441	0	61,722
(7) Ernest Sink...................................................................... Attending Physician	50.0 ................. 0.0				X		2,286,607	0	66,773
(8) Anil Ranawat...................................................................... Associate Attending Physician	56.27 ................. 0.0				X		1,891,782	0	69,937
(9) Lisa A Goldstein...................................................................... Former Executive VP & COO	12.0 ................. 0.0					X	1,871,496	0	0
(10) Douglas Padgett...................................................................... Member/Assoc Surgeon-in-Chief	59.23 ................. 0.77	X					1,548,179	0	75,581
(11) Hollis Potter...................................................................... Radiologist-in-Chief	60.0 ................. 0.0			X			1,408,617	0	79,359
(12) Duretti Fufa...................................................................... Member/Assoc Attending Physici	49.6 ................. 0.4	X					1,027,549	0	48,665
(13) Justin Oppenheimer...................................................................... ENTERP Chief Operating Officer	60.0 ................. 0.0			X			977,101	0	54,882
(14) Irene Koch...................................................................... Exec VP & Chief Legal Officer	48.42 ................. 11.58		X				759,530	134,034	59,882
(15) Lionel Ivashkiv...................................................................... Member/Chief Scientific Offic.	60.0 ................. 0.0	X					818,610	0	62,392
(16) S Louis Bridges Jr...................................................................... Member/Physician-in-Chief	59.23 ................. 0.77	X					717,107	0	29,099
(17) Ralph Bianco...................................................................... Former Sr. VP, Operations	12.0 ................. 0.0					X	722,236	0	0

(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)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) Jennifer O'Neill - To 921........................................................................ Sr. VP, Patient Care SRV & CNO	60.0 .......................0.0			X		687,893	22,438
(19) Andy Miller - Join BOT 2021........................................................................ Member/Assoc Attending Physici	49.6 .......................0.4	X				493,246	31,989
(20) Karen Onel - Left BOT 2021........................................................................ Member/Attending Physician	49.6 .......................0.4	X				372,464	69,633
(21) Ricky Guillot - From 921........................................................................ VP, Interim CNO	60.0 .......................0.0			X		384,839	42,865
(22) Todd J Albert........................................................................ Former Surgeon-in-Chief	11.29 .......................0.77				X	134,380	58,052
(23) James M Benson........................................................................ Member	0.23 .......................0.04	X				0	0
(24) Daniel C Benton........................................................................ Member	1.38 .......................0.24	X				0	0
(25) Herbert Black........................................................................ Member	0.23 .......................0.04	X				0	0
(26) Michael C Brooks........................................................................ Member	0.89 .......................0.15	X				0	0
(27) Kathryn Chenault........................................................................ Member	1.61 .......................0.29	X				0	0
(28) Charles Coleman III........................................................................ Member	0.75 .......................0.13	X				0	0
(29) Leslie Cornfeld........................................................................ Member	0.62 .......................0.11	X				0	0
(30) Cynthia Foster Curry........................................................................ Member	2.48 .......................0.44	X				0	0
(31) Barrie M Damson........................................................................ Member	0.58 .......................0.11	X				0	0
(32) Anthony de Nicola........................................................................ Member-Join BOT 2021	2.01 .......................0.36	X				0	0
(33) James G Dinan........................................................................ Member	2.65 .......................0.47	X				0	0
(34) Anne Ehrenkranz........................................................................ Member	2.48 .......................0.44	X				0	0
(35) Michael Esposito........................................................................ Vice Chair	4.9 .......................0.87	X	X			0	0
(36) Marina Kellen French........................................................................ Member	1.54 .......................0.27	X				0	0
(37) Giammaria Giuliani........................................................................ Member	0.23 .......................0.04	X				0	0
(38) Robert Goldstein........................................................................ Member-Join BOT 2021	0.23 .......................0.04	X				0	0
(39) Russell Hutchinson........................................................................ Member-Join BOT 2021	0.23 .......................0.04	X				0	0
(40) Craig Ivey........................................................................ Vice Chair	4.71 .......................0.83	X	X			0	0
(41) Warren B Kanders........................................................................ Member	0.23 .......................0.04	X				0	0
(42) Scott Kapnick........................................................................ Member	1.29 .......................0.23	X				0	0
(43) Monica Keany........................................................................ Member	2.65 .......................0.47	X				0	0
(44) Thomas J Kelly........................................................................ Member	1.68 .......................0.3	X				0	0
(45) Sacha Lainovic........................................................................ Member	2.06 .......................0.36	X				0	0
(46) Laurie Hodges Lapeyre........................................................................ Member	4.43 .......................0.78	X				0	0
(47) Pablo Legorreta........................................................................ Member	0.53 .......................0.09	X				0	0
(48) Lara R Lerner........................................................................ Member	0.39 .......................0.07	X				0	0
(49) Kathy Leventhal........................................................................ Member	1.6 .......................0.28	X				0	0
(50) Thomas H Lister........................................................................ Co-Chair	14.52 .......................2.98	X	X			0	0
(51) Alan S MacDonald........................................................................ Member	0.53 .......................0.09	X				0	0
(52) David H McCormick........................................................................ Member-Left BOT 2021	1.38 .......................0.24	X				0	0
(53) Celene Menschel........................................................................ Member	2.01 .......................0.36	X				0	0
(54) Mary Kathryn Navab........................................................................ Member	0.23 .......................0.04	X				0	0
(55) Terence M O'Toole........................................................................ Member	4.18 .......................0.74	X				0	0
(56) Gordon Pattee........................................................................ Member	0.46 .......................0.08	X				0	0
(57) Matthew H Peltz........................................................................ Member	0.38 .......................0.08	X				0	0
(58) Steven Rattner........................................................................ Member	1.42 .......................0.25	X				0	0
(59) Scott Rechler........................................................................ Member	0.23 .......................0.04	X				0	0
(60) Jonathan Sobel........................................................................ Member	2.6 .......................0.46	X				0	0
(61) Deirdre Stanley........................................................................ Member	2.44 .......................0.43	X				0	0
(62) Robert K Steel........................................................................ Co-Chair	14.87 .......................2.63	X	X			0	0
(63) Jonathan Tisch........................................................................ Member-Join BOT 2021	0.23 .......................0.04	X				0	0
(64) Frances Townsend........................................................................ Member-Join BOT 2021	0.23 .......................0.04	X				0	0
(65) Sanford I Weill........................................................................ Member	0.23 .......................0.04	X				0	0
(66) Kendrick R Wilson III........................................................................ Chair Emeritus	2.94 .......................0.6	X	X			0	0
(67) Ellen M Wright........................................................................ Member	2.52 .......................0.45	X				0	0

(A) Name and business address	(B) Description of services	(C) Compensation
TISHMAN CONSTRUCTION CORP, 100 PARK AVE 5TH FL NEW YORK,NY10017	CONSTRUCTION	17,181,057
MINDSTREAM MEDIA, PO BOX 409 MEMPHIS,TN38101	MARKETING	5,732,510
PM CONSTRUCTION, 80 VERDI ST FARMINGDALE,NY11735	CONSTRUCTION	3,816,857
PROSKAUER ROSE LLP, ELEVEN TIMES SQUARE NEW YORK,NY10036	LEGAL SERVICES	3,602,364
EPIC SYSTEMS CORP, PO BOX 88314 MILWAUKEE,WI53288	EHR SYSTEM SERVICES	3,304,034
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 227

- TIN:

SCHEDULE A
(Form 990)

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

2021

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.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990) 2021

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)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..	49,923,152	92,212,279	73,781,160	207,845,766	157,963,139	581,725,496
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	49,923,152	92,212,279	73,781,160	207,845,766	157,963,139	581,725,496
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) ..						35,527,540
6	Public support. Subtract line 5 from line 4.						546,197,956

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
7	Amounts from line 4..	49,923,152	92,212,279	73,781,160	207,845,766	157,963,139	581,725,496
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...	7,872,710	12,344,419	13,708,669	15,097,618	13,820,536	62,843,952
9	Net income from unrelated business activities, whether or not the business is regularly carried on..		525,180	571,972	1,001,451	1,519,480	3,618,083
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..	435,475	0	0	0	0	435,475
11	Total support. Add lines 7 through 10						648,623,006

Gross receipts from related activities, etc. (see instructions) ..................

5,921,077,456

First 5 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

Public support percentage for 2021 (line 6, column (f) divided by line 11, column (f)) .........

84.209 %

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

81.234 %

16a

33 1/3% support test—2021. If the organization did not check the box on line 13, and line 14 is 33 1/3 % or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2020. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2021. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2020. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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) 2021

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)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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 on 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.)..

First 5 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

Public support percentage for 2021 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2020 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2021 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2020 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2021. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2020. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990) 2021

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

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.

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).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

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.

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.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

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.

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.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c 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).

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?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

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.

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) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

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.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on 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.

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

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) 2021

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, 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.

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.

Section C. Type II Supporting Organizations

Yes

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).

Section D. All Type III Supporting Organizations

Yes

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?

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).

By reason of the relationship described in line 2 above, 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.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

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.

Did the activities described on line 2a, above 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.

Parent of Supported Organizations. Answer lines 3a and 3b below.

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?If "Yes" or "No", provide details in Part VI.

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.

Schedule A (Form 990) 2021

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	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 0.015 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 0.035	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

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2021

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	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2021 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2021	(iii) Distributable Amount for 2021
1 Distributable amount for 2021 from Section C, line 6
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2021:
a From 2016.......
b From 2017.......
c From 2018.......
d From 2019.......
e From 2020.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2021 distributable amount
i Carryover from 2016 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2021 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2021 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2021, 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 2021. 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 2022. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2017.....
b Excess from 2018.....
c Excess from 2019.....
d Excess from 2020.....
e Excess from 2021.....

Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021

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) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

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

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... 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) (2021)

Schedule B (Form 990) (2021) Page 2

Name of organization NEW YORK SOCIETY FOR THE RELIEF OF THE RUPTURED AND CRIPPLED MAINTAINING THE

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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2021)

Schedule B (Form 990) (2021)

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) (2021)

Schedule B (Form 990) (2021)

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.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose 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

(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

(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

(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) (2021)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

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

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

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.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

Political campaign activity expenditures. See instructions .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

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

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

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.

Cat. No. 50084S

Schedule C (Form 990) 2021

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 Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

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) ........................	0
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................	0
d	Other exempt purpose expenditures ...............................................................................	1,351,652,928
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................	1,351,652,928
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? ...................................................................................................................		Yes No

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) 2018	(b) 2019	(c) 2020	(d) 2021	(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	48,000	0	0	0	48,000

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	0

Schedule C (Form 990) 2021

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

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:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Total. Add lines 1c through 1i ....................................................................................................

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

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

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

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."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

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? ......................................................................................................................

Taxable amount of lobbying and political expenditures. See Instructions .........................................

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) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

2021

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 ........

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? ............

Yes No

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? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

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)? .............................

Yes No

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.

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.

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

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:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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) 2021

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?...

Yes No

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.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

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 ....	468,683,477	406,573,849	361,278,693	336,457,233	317,061,760
b	Contributions ...	154,111,634	86,343,747	78,944,694	98,195,455	55,313,894
c	Net investment earnings, gains, and losses	26,040,976	48,326,882	33,455,325	-6,198,738	28,886,639
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	63,241,039	72,561,001	67,104,863	67,175,257	64,805,060
f	Administrative expenses ....
g	End of year balance ......	585,595,048	468,683,477	406,573,849	361,278,693	336,457,233

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

1.000 %

Permanent endowment SchDMd Bullet

32.000 %

Term endowment SchDMd Bullet

67.000 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

Yes

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

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 .....	98,934,959		98,934,959
b	Buildings ....	794,009,983	435,233,144	358,776,839
c	Leasehold improvements
d	Equipment ....	697,506,606	506,146,198	191,360,408
e	Other .....	83,730,055		83,730,055
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				732,802,261

Schedule D (Form 990) 2021

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	421,694,000	F
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	421,694,000

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

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				349,405,534
(2)INSURANCE CLAIMS RECEIVABLE				99,152,768
(3)INT IN HSS FUND, INC.-FASB 136				94,969,410
(4)DUE FROM AFFILIATES -MRKT SEC.				26,921,911
(5)457B DEFERRED COMP PLAN ASSETS				22,739,915
(6)DUE FROM AFFILIATES - NET				25,878,882
(7)INT - HSS FLORIDA PHYSICIA LLC				5,348,605
(8)INT - HSS ASC OF MANHATTAN LLC				1,848,934
(9)INVESTMENT IN PALM BEACH ASC				461,130
(10)TI RECEIVABLE WESTCHESTER - LT				1,406,250
(11)INVESTMENT IN SUTTON HOUSE				820,000
(12)INVESTMENT IN HS2				117,318
(13)INVESTMENT IN PREMIER DEROYAL				102,564
(14)INVESTMENT IN LIMA WARRANTS				1,000
(15)INT - HSS WESTSIDE ASC LLC				-423,438
(16)GPA HOLDING, LLC				1,000
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				628,751,783

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.)	806,466,635
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) 2021

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) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

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

2021

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.

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? . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.

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		117,466,416
	Central America and the Caribbean	0	0	Medical Insurance Premiums		14,821,281
	Central America and the Caribbean	0	1	Program Services	PT. LIAISON/BUS DEV	102,000
	Central America and the Caribbean	0	1	Program Services	PT. LIAISON/BUS DEV	30,000
	South America	0	1	Program Services	PT. LIAISON/BUS DEV	36,000
	South America	0	1	Program Services	PT. LIAISON/BUS DEV	30,000
	Europe (Including Iceland and Greenland)	0	0	Investments		1,394,763










3a	Sub-total ....	0	4			133,880,460
b	Total from continuation sheets to Part I ...
c	Totals (add lines 3a and 3b)	0	4			133,880,460

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2021

Schedule F (Form 990) 2021

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 .......
3	Enter total number of other organizations or entities .......................

Schedule F (Form 990) 2021

Schedule F (Form 990) 2021Page 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) 2021

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2021

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) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

2021

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

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

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.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

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.

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:

Yes

100% 150% 200% Other %

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: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other 700 %

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.

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"? . . . . . . . . . . . . .

Yes

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

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

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? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(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) . . .	15,604,838	797,115	14,807,723	1.070 %
b	Medicaid (from Worksheet 3, column a) . . . . .	45,497,946	15,519,100	29,978,846	2.160 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	442,224	211,254	230,970	0.020 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	61,545,008	16,527,469	45,017,539	3.250 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	14,331,078	2,963,989	11,367,089	0.820 %
f	Health professions education (from Worksheet 5) . . .	62,332,027	8,262,810	54,069,217	3.900 %
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .	58,445,074	30,365,195	28,079,879	2.030 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .
j	Total. Other Benefits . .	135,108,179	41,591,994	93,516,185	6.750 %
k	Total. Add lines 7d and 7j .	196,653,187	58,119,463	138,533,724	10.000 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2021

Schedule H (Form 990) 2021

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

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

3,655,973

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. ......

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

Enter total revenue received from Medicare (including DSH and IME).....

164,243,728

Enter Medicare allowable costs of care relating to payments on line 5.....

243,634,388

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-79,390,660

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

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 .........................

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	51.61 %		48.39 %
2HSS WEST SIDE ASC	HEALTH CARE	67 %		33 %
3HS2 LLC	SURGEON TALENT MANAGEMENT CO	10.42 %	79.1 %	81.67 %
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2021

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)
1	HOSPITAL FOR SPECIAL SURGERY 535 EAST 70TH STREET NEW YORK,NY10021 www.hss.edu 7002012H	X	X	X	X

Schedule H (Form 990) 2021

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):

Yes

Community Health Needs Assessment

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?........................

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...............

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......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 19

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 .................

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..................................

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. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): http://www.hss.edu/community.asp

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

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. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): http://www.hss.edu/community.asp

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

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

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

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) 2021

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

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 500.%
and FPG family income limit for eligibility for discounted care of 700.%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

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):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

See Section C

The FAP application form was widely available on a website (list url):

See Section C

A plain language summary of the FAP was widely available on a website (list url):
See Section C

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2021

Page 6

Part VFacility Information (continued)

Billing and Collections

	HOSPITAL FOR SPECIAL SURGERY
Name of hospital facility or letter of facility reporting group

Yes

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?..................................

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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?..................

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2021

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

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.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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? ...............................

If "Yes," explain in Section C.

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? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2021

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 Comment
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 improve 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 designed 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
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) 2021

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?21
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 WEST SIDE ASC LLC 600-610 WEST 58TH STREET NEW YORK,NY10019	AMBULATORY SURGERY CENTER
4	HSS WESTCHESTER OUTPATIENT CENTER 1133 WESTCHESTER AVENUE WHITE PLAINS,NY10604	OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING, PHYSICAL THERAPY & AFFL PHYS OFFICES
5	HSS STAMFORD OUTPATIENT CENTER 1 BLACHLEY ROAD STAMFORD,CT06902	OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING, SPECIAL PROCEDURES,& AFFL PHYS OFFICES
6	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
7	HSS EAST RIVER PROFESSIONAL BUILDING 523 EAST 72ND STREET NEW YORK,NY10021	OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING & AFFILIATED PHYSICIAN OFFICES
8	HSS PARAMUS OUTPATIENT CENTER 140 EAST RIDGEWOOD AVENUE PARAMUS,NJ07652	OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING, PHYSICAL THERAPY & AFFL PHYS OFFICES
9	HSS LONG ISLAND OUTPATIENT CENTER 333 EARLE OVINGTON BLVD UNIONDALE,NY11553	OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING, SPECIAL PROCEDURES & AFFL PHYS OFFICES
10	HSS SPORTS PERFORMANCE CENTER 525 EAST 71ST BELAIRE BUILDING NEW YORK,NY10021	OUTPATIENT CENTER WITH PHYSICAL THERAPY
11	HSS BROOKLYN OUTPATIENT CENTER 148-168 39TH STREET BROOKLYN,NY11232	OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING, PHYSICAL THERAPY, & AFFL PHYS OFFICES
12	HSS AMBULATORY CARE CLINIC 475 EAST 72ND STREET NEW YORK,NY10021	OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING, PHYSICAL THERAPY AND CLINIC
13	HSS RIVER TERRACE 519 EAST 72ND STREET NEW YORK,NY10021	OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING AND AFFILIATED PHYSICIAN OFFICES
14	HSS HUDSON YARDS 560 W 33RD ST NEW YORK,NY10001	OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING, PHYSICAL THERAPY, & AFFL PHYS OFFICES
15	HSS SPINE THERAPY CENTER 405 EAST 75TH STREET NEW YORK,NY10021	OUTPATIENT CENTER WITH PHYSICAL THERAPY
16	HSS Midtown 770 Lexington Ave NEW YORK,NY10065	OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING, PHYSICAL THERAPY, & AFFL PHYS OFFICES
17	HSS FLORIDA 300 PALM BEACH LAKES BLVD WEST PALM BEACH,FL33401	OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING, PHYSICAL THERAPY, & AFFL PHYS OFFICES
18	HSS ORTHO INJURY CARE 1233 SECOND AVENUE NEW YORK,NY10065	OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING AND AFFILIATED PHYSICIAN OFFICES
19	HSS INTEGRATIVE CARE CENTER 635 MADISON AVENUE NEW YORK,NY10022	OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING AND AFFILIATED PHYSICIAN OFFICES
20	HSS DANA CENTER 510 EAST 73RD STREET NEW YORK,NY10021	OUTPATIENT CENTER WITH MOTION ANALYSIS
21	HSS QUEENS OUTPATIENT CENTER 176-60 UNION TURNPIKE FRESH MEADOWS,NY11366	OUTPATIENT CENTER WITH DIAGNOSTIC IMAGING AND AFFILIATED PHYSICIAN OFFICES

Schedule H (Form 990) 2021

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	2021 BAD DEBT EXPENSE PRESENTED ON THE 2021 AUDITED FINANCIAL STATEMENTS WAS $8,247,175. IN ADDITION, TOTAL OPERATING EXPENSE WAS ADJUSTED ACCORDINGLY TO REFLECT THE .35% ($3,773,398) HEALTH FACILITY TAX ASSESSMENT AND 1% ($5,074,681) 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 2021 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 2021 MEDICARE COST REPORT AND HSS' 2021 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 2021 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 2021 MEDICARE COST REPORT WAS UTILIZED.
PART III, LINES 2, 3, 4	A COST TO CHARGE RATIO OF 44.33% AS CALCULATED PER THE APPLICABLE FORM 990 INSTRUCTIONS WAS APPLIED TO THE BAD DEBT EXPENSE (AT CHARGES) OF $8,247,175 TO CALCULATE THE BAD DEBT EXPENSE OF $3,655,973 AT COST. IN 2021, 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 2021 AND 2020 FOR ALL PATIENT SERVICES AGGREGATED APPROXIMATELY $20.4 MILLION AND $17.9 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 52% OF THE HOSPITAL'S INPATIENT POPULATION IS REPRESENTED BY MEDICARE and Medicare Managed Care. THE MEDICARE SHORTFALL OF $79,390,660 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 RANSFERRED 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 A 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 2021, THE HOSPITAL CONDUCTED NO EXTRAORDINARY COLLECTION ACTIONS.
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 PROGPOSTED 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 Northern NEW YORK, Northern and Central 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 (HSS) 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, HSS provides educational opportunities to the community through health fairs and public events, as well as public schools, health clinics, and senior centers. In 2021, 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, social support and disease self-management. Each year the hospital sponsors 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, Aging With Dignity Initiative, Sneaker (super nutrition for all kids to eat right), HSS Sports Safety Program, 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), and the Voices Medicaid Education Program. In response to the global pandemic, HSS transitioned its educational programming from in-person to virtual in 2020, which continued in 2021. Depending on the audience, there were various formats used including zoom and conference call, ensuring our education, support and coaching programs were able to reach our diverse community. This transition expanded our regional services to a national and global audience of patients and the public. Many HSS programs featured HSS medical/clinical staff in helping patients and the public navigate this very challenging time. HSS places a high value on the impact that our community benefit programs have on the community. In 2021, we reached more than 5.2 million people with our live and on-demand programs, through more than 800 programs, and distributed health education materials to nearly 1.6 million people (which includes over 1.5 million web page views). Program evaluation surveys given to program participants assessing self-management metrics indicated that 91% of respondents gained knowledge from attending programs, 90% learned how to manage their condition, 96% were satisfied with the program and 95% would recommend the program to others. Qualitative assessments indicated that due to participating in our programs, participants felt a sense of connection with others, learned something new, felt less isolated and learned the most current, up-to-date information. As part of its commitment to the community, in 2021 HSS continued to provide our community with valuable information on developed the Feel Better From Home platform, designed to make HSS expertise, insights and care available to anyone who needed it, wherever they needed it. The content addresses lifestyle changes brought on by the pandemic and contained content that helped people to stay active and healthy. In addition, the Social Work Programs and Community Education & Outreach worked with rheumatology clinicians and other HSS faculty to provide their expertise for a better understanding of musculoskeletal disease as well as COVID-19, and to communicate the best medical guidance to minimize risk of exposure, medication considerations, mask wearing, social distancing, etc. Additionally, social workers and the Aging with Dignity Program continue to offer patients support around feelings of anxiety, depression, isolation, the loss of loss of loved ones and fear of contracting COVID-19 as they coped with a chronic illness. A committee of the Board of Trustees focusing on the hospital's community benefit activities 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. HSS continues to have wide representation of our Community Service Plan (CSP) initiatives through ongoing programs specifically tailored for diverse communities offered in English, Spanish & Chinese. This included addressing the management of musculoskeletal issues and pain in older adults, lupus and mental health, lifestyle medicine and conducting key informant interviews to understand cultural themes regarding healthcare to enhance our interventions with our diverse communities. The RA Latinx Support & Education Program launched its first bilingual event focusing on inflammatory arthritis community members. The Pain and Stress Management Program continues to provide support to our diverse, vulnerable patient population. In addition, HSS has created webinars, blogs and educational videos for wide ranging community benefit topics. HSS continues to present at national conferences to bring awareness to the larger professional and public communities about musculoskeletal health and self-management of disease. The HSS Community Education & Outreach staff was invited to deliver one oral presentation and a study group at the 2021 American College of Rheumatology (ACR) Annual Meeting (virtual meeting). The oral presentation focused on improving health outcomes and social connectedness through virtual exercise programs in community members with musculoskeletal conditions, while the study group focused on developing virtual self-management musculoskeletal health education programs for patients and the community. In addition, four staff members delivered a symposium consisting of four abstracts focused on fostering social, emotional and physical connectivity in older adults during the pandemic and beyond at the 2021 American Public Health Association (APHA) Annual Meeting (virtual meeting). The Social Work Programs Department was invited to the annual meeting of the American College of Rheumatology and contributed both poster and podium presentations including a new study group on promoting an interdisciplinary approach to supporting patients with inflammatory arthritis at work, based on an IRB study. Other presentations included the psychosocial impact of the COVID-19 pandemic on the rheumatology patient experience and the evaluation of a national longstanding telephone peer counseling service for people with systemic lupus erythematosus and their loved ones. Additionally, our department presented on an important and new topic to the conference titled: "Implicit Bias: All of Us". This session raised awareness on the concept of implicit bias and how to engage in specific, effective behaviors for managing bias. The goal was to educate rheumatology physicians and other interdisciplinary professionals to recognize and manage unconscious bias, to promote more equitable decisions, more productive teams, and a more inclusive organizational culture. 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. For the past seven years in a row the hospital has been designated as a leader in LGBTQ health by the Human Rights Campaign's Healthcare Equity Index devoted to promoting equitable and inclusive care for LGBTQ patients and their families. HSS is committed to equity and inclusion for all and as such created the Diversity, Equity and Inclusion Council which is working to further enhance diversity initiatives; develop mentorship and leadership efforts and policies, procedures and processes that cultivate a sense of inclusion for everyone at HSS; and utilize metrics and goals to hold the institution accountable to new programmatic initiatives. Consistent with these initiatives, the position of Assistant Vice President 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. Our Senior Outcomes Manager continues to play 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 to ensure we provide the highest quality of care for all of our patients and community members. Additionally, in 2021, the Diversity, Equity and Inclusion Council laid the foundation for establishing Employee Resource Groups (ERGS), voluntary, employee-led groups that promote inclusion and enrich the employee
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) 2021

Additional Data

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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

2021

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

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? ........................

Yes No

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) RESEARCH FOUNDATION OF CUNY 65-30 KISSENA BLVD FLUSHING,NY11367	13-1988190	501 (C) (3)	40,000				GENERAL SUPPORT
(2) URBAN DOVE 21-21 41st Ave Ste 2D LIC,NY11101	13-3997718	501 (C) (3)	15,000				GENERAL SUPPORT
(3) FRIENDS OF KAREN INC 118 TITICUS ROAD NORTH SALEM,NY11560	14-1612290	501 (C) (3)	25,000				GENERAL SUPPORT
(4) 92Y NURSERY SCHOOL 1395 LEXINGTON AVE NEW YORK,NY10128	13-1624229	501 (C) (3)	100,000				GENERAL SUPPORT
(5) BROOKLYN BASEBALL CO LLC 1904 Surf Avenue Brooklyn,NY11224	11-3509354		30,000				GENERAL SUPPORT
(6) DOMINICAN SISTER OF SPARKILL 175 Route 340 Sparkill,NY10976	14-1340103	501 (C) (3)	25,000				GENERAL SUPPORT
(7) USA FOOTBALL INC 45 N Pennsylvania St Ste 700 Indianapolis,IN46204	11-3667205	501 (C) (3)	25,000				GENERAL SUPPORT
(8) MATCH POINT INC 30 NW 1st Avenue Delray Beach,FL33444	65-0228852		24,000				GENERAL SUPPORT
(9) GREENWICH POLO CLUB INC 80 Field Point Road Greenwich,CT06830	06-1103871		15,000				GENERAL SUPPORT
(10) BROOKLYN NETS LLC 168 39th Street 7th Fl Brooklyn,NY11232	22-2219916		10,000				GENERAL SUPPORT
(11) FLORIDA HS ATHLETIC ASSOCIATION 1801 NW 80th BLVD Gainesville,FL32606	59-0657413	501 (C) (3)	10,000				GENERAL SUPPORT
(12) WORLD TEAM TENNIS LLC PO Box 7295 Rancho Santa Fe,CA92067	26-3671017		10,000				GENERAL SUPPORT
(13) HW SPRING TRAINING COMPLEX LLC 5444 Haverhill Road West Palm Beach,FL33407	47-3871764		9,000				GENERAL SUPPORT
(14) MIDDLESEX COUNTY COLLEGE FOUNDATION 2600 Woodbridge Ave Edison,NJ08818	22-6079662	501 (C) (3)	7,000				GENERAL SUPPORT
(15) AMHE Foundation 8142 Driggs Hill West Palm Beach,FL33411	52-1112733	501 (C) (3)		175,000	BOOK VALUE	MEDICAL SUPP & EQUIP	EARTHQUAKE IN HAITI

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2021

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) 2021

Additional Data

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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

2021

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

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.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

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 .....

Yes

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? ....

Yes

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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

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:

Receive a severance payment or change-of-control payment? .............

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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.

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:

The organization? ....................

Yes

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

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:

The organization? ..................

Yes

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

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 ............

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 ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2021

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, 1099-MISC compensation, and/or 1099-NEC			(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
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1Karen Onel - Left BOT 2021 Member/Attending Physician	(i) (ii)	270,500 ------------- 0	0 ------------- 0	101,964 ------------- 0	26,100 ------------- 0	43,533 ------------- 0	442,097 ------------- 0	0 ------------- 0
2Douglas Padgett Member/Assoc Surgeon-in-Chief	(i) (ii)	979,235 ------------- 0	130,000 ------------- 0	438,944 ------------- 0	26,100 ------------- 0	49,481 ------------- 0	1,623,760 ------------- 0	0 ------------- 0
3Lionel Ivashkiv Member/Chief Scientific Offic.	(i) (ii)	718,962 ------------- 0	60,000 ------------- 0	39,648 ------------- 0	26,100 ------------- 0	36,292 ------------- 0	881,002 ------------- 0	0 ------------- 0
4Todd J Albert Former Surgeon-in-Chief	(i) (ii)	114,049 ------------- 0	0 ------------- 0	20,331 ------------- 0	11,625 ------------- 0	46,427 ------------- 0	192,432 ------------- 0	0 ------------- 0
5S Louis Bridges Jr Member/Physician-in-Chief	(i) (ii)	608,736 ------------- 0	76,849 ------------- 0	31,522 ------------- 0	21,750 ------------- 0	7,349 ------------- 0	746,206 ------------- 0	0 ------------- 0
6Bryan T Kelly Member/Surgeon-in-Chief	(i) (ii)	2,560,048 ------------- 0	400,000 ------------- 0	2,952,975 ------------- 0	26,100 ------------- 0	53,259 ------------- 0	5,992,382 ------------- 0	0 ------------- 0
7Duretti Fufa Member/Assoc Attending Physici	(i) (ii)	523,493 ------------- 0	0 ------------- 0	504,056 ------------- 0	26,100 ------------- 0	22,565 ------------- 0	1,076,214 ------------- 0	0 ------------- 0
8Andy Miller - Join BOT 2021 Member/Assoc Attending Physici	(i) (ii)	428,051 ------------- 0	0 ------------- 0	65,195 ------------- 0	26,100 ------------- 0	5,889 ------------- 0	525,235 ------------- 0	0 ------------- 0
9Louis A Shapiro President & Chief Exec Officer	(i) (ii)	1,409,058 ------------- 352,265	3,725,757 ------------- 931,439	46,014 ------------- 11,504	20,880 ------------- 5,220	48,207 ------------- 12,052	5,249,916 ------------- 1,312,480	0 ------------- 0
10Lisa A Goldstein Former Executive VP & COO	(i) (ii)	84,007 ------------- 0	410,008 ------------- 0	1,377,481 ------------- 0	0 ------------- 0	0 ------------- 0	1,871,496 ------------- 0	0 ------------- 0
11Stacey L Malakoff Exec VP & Chief Fin Officer	(i) (ii)	1,165,852 ------------- 205,739	1,509,858 ------------- 266,446	91,706 ------------- 16,184	22,185 ------------- 3,915	40,565 ------------- 7,158	2,830,166 ------------- 499,442	0 ------------- 0
12Irene Koch Exec VP & Chief Legal Officer	(i) (ii)	515,825 ------------- 91,028	216,361 ------------- 38,181	27,344 ------------- 4,825	18,488 ------------- 3,263	32,411 ------------- 5,720	810,429 ------------- 143,017	0 ------------- 0
13Ralph Bianco Former Sr. VP, Operations	(i) (ii)	58,512 ------------- 0	124,332 ------------- 0	539,392 ------------- 0	0 ------------- 0	0 ------------- 0	722,236 ------------- 0	0 ------------- 0
14Jennifer O'Neill - To 921 Sr. VP, Patient Care SRV & CNO	(i) (ii)	485,555 ------------- 0	178,200 ------------- 0	24,138 ------------- 0	21,750 ------------- 0	688 ------------- 0	710,331 ------------- 0	0 ------------- 0
15Hollis Potter Radiologist-in-Chief	(i) (ii)	1,154,548 ------------- 0	168,750 ------------- 0	85,319 ------------- 0	26,100 ------------- 0	53,259 ------------- 0	1,487,976 ------------- 0	0 ------------- 0
16Justin Oppenheimer ENTERP Chief Operating Officer	(i) (ii)	755,678 ------------- 0	218,893 ------------- 0	2,530 ------------- 0	21,750 ------------- 0	33,132 ------------- 0	1,031,983 ------------- 0	0 ------------- 0
17Ricky Guillot - From 921 VP, Interim CNO	(i) (ii)	328,430 ------------- 0	29,789 ------------- 0	26,620 ------------- 0	21,750 ------------- 0	21,115 ------------- 0	427,704 ------------- 0	0 ------------- 0
18Answorth A Allen Attending Physician	(i) (ii)	509,748 ------------- 5,149	0 ------------- 0	2,346,601 ------------- 23,703	25,839 ------------- 261	45,438 ------------- 459	2,927,626 ------------- 29,572	0 ------------- 0
19William M Ricci Chief of the Trauma Service	(i) (ii)	994,063 ------------- 0	0 ------------- 0	1,600,378 ------------- 0	21,750 ------------- 0	39,972 ------------- 0	2,656,163 ------------- 0	0 ------------- 0
20Danyal Nawabi Assistant Attending Physician	(i) (ii)	397,436 ------------- 0	0 ------------- 0	2,356,015 ------------- 0	21,750 ------------- 0	42,097 ------------- 0	2,817,298 ------------- 0	0 ------------- 0
21Ernest Sink Attending Physician	(i) (ii)	394,388 ------------- 0	0 ------------- 0	1,892,219 ------------- 0	21,750 ------------- 0	45,023 ------------- 0	2,353,380 ------------- 0	0 ------------- 0
22Anil Ranawat Associate Attending Physician	(i) (ii)	667,993 ------------- 0	0 ------------- 0	1,223,789 ------------- 0	26,100 ------------- 0	43,837 ------------- 0	1,961,719 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2021

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. Due to the COVID-19 pandemic, for Q1-Q3 2021, first class travel for the CEO and Surgeon-in-Chief was permitted by the Co-Chairs of the Board of Trustees, regardless of flight time. 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 2021, FIRST CLASS TRAVEL WAS REIMBURSED TO THE CEO AND SURGEON-IN-CHIEF. Housing Allowance - Housing allowance was paid to the Executive Vice President & Chief Financial Officer and Chief of the Trauma Service and was treated as taxable compensation. Schedule J, Part I, Line 4A Lisa Goldstein, former Executive Vice President & Chief Operating Officer, and Ralph Bianco, former Senior Vice President of Operations, received severance pay of $1,142,949 and $461,001, which are included in Schedule J, Part II, Column (B)(III). Severance will be paid for 18 months for Lisa Goldstein and 12 months for Ralph Bianco starting January 1, 2021. THE FORMER EVP & COO AND FORMER SVP OF OPERATIONS ALSO RECEIVED FORM 1099-NEC PAYMENTS FOR CONSULTING SERVICES OF $234,000 AND $78,000, WHICH ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III). TIME DEVOTED TO THESE SERVICES DID NOT EXCEED 12 HOURS PER WEEK, AND WERE FOR A 6 MONTH TERM STARTING JANUARY 1, 2021.
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 2021, 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. Amounts reported for Louis Shapiro and Stacey Malakoff On Schedule J, Part II, Column (B)(II) include special Performance-Dependent Retention Awards (PDRAs) that were dependent on the achievement of long-term strategic goals. Such awards were approved by the Board Compensation Committee based on long-term performance outcomes.

Schedule J (Form 990) 2021

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

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

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
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	Dormitory Authority of the State of New York	14-6000293		06-15-2016	19,992,620	Tax Exempt Equipment Leasing		X		X		X
B	Dormitory Authority of the State of New York	14-6000293		07-14-2017	14,979,666	Tax Exempt Equipment Leasing		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	18,560,620		11,095,666
2 Amount of bonds legally defeased ..............	0		0
3 Total proceeds of issue ..................	19,992,620		14,979,666
4 Gross proceeds in reserve funds .............	0		0
5 Capitalized interest from proceeds .............	0		0
6 Proceeds in refunding escrows ...............	0		0
7 Issuance costs from proceeds ...............	145,620		76,089
8 Credit enhancement from proceeds .............	0		0
9 Working capital expenditures from proceeds .............	0		0
10 Capital expenditures from proceeds .............	19,847,000		14,903,577
11 Other spent proceeds .............	0		0
12 Other unspent proceeds .............	0		0
13 Year of substantial completion .............	2016		2017
	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 2020, a current refunding issue)? ........		X		X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X
16 Has the final allocation of proceeds been made? ..........	X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............	X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	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 ....	0.300 %		0.300 %
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 .........
6 Total of lines 4 and 5 .............	0.300 %		0.300 %
7 Does the bond issue meet the private security or payment test? ...		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............		X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X
b Exception to rebate? ........		X		X
c No rebate due? .........	X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X		X

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X
b Name of provider ..........	0		0
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X
b Name of provider ..........	0		0
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X

Part Ⅵ

Supplemental Information. 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) 2021

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Schedule L
(Form 990)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

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	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

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?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

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) 2021

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?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) DePuy Synthes	SEE PART V	13,793,633	SEE PART V		No
(2) Don Joy Orthopedics	SEE PART V	2,280,308	SEE PART V		No
(3) Smith Nephew	SEE PART V	18,081,907	SEE PART V		No
(4) Zimmer Biomet	SEE PART V	14,574,038	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: $13,793,633 DESCRIPTION OF TRANSACTION: In 2021, HSS paid $13,793,633 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: $2,280,308 DESCRIPTION OF TRANSACTION: In 2021, HSS paid $2,280,308 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) - 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. HSS has had a long-standing business relationship with Smith & Nephew that preceded Dr. Kelly joining the HSS Board of Trustees. With the exception of products used in the procedures he personally performs, Dr. Kelly does not play a role in the consideration or acquisition of Smith & Nephew's products. AMOUNT OF TRANSACTION: $18,081,907 DESCRIPTION OF TRANSACTION: In 2021, HSS paid $18,081,907 to Smith & Nephew for medical devices.
SCHEDULE L, PART IV, (4) - 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: $14,574,038 DESCRIPTION OF TRANSACTION: In 2021, HSS paid $14,574,038 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) 2021

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SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete 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 image

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

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	25	1,385,870	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 ( )
26 Other ( )
27 Other ( )
28 Other ( )

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

Yes

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

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

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) (2021)

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) (2021)

Additional Data

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SCHEDULE O
(Form 990)

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

2021

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 2021 to remove term limitations for Trustees and to form a new subcommittee of the board entitled the "Committee on Trustees". The amendment is consistent with the organizational and operational tests of Section 501(c)(3) as well as the furtherance of the organization's charitable mission.
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 the management and reviewed 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, 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 AND COMMITMENT POLICY ALSO REQUIRES THAT ANY COVERED PERSON INCLUDING MEMBERS OF THE HSS MEDICAL STAFF MUST PROVIDE PRIOR NOTICE TO COMPLIANCE BEFORE BEGINNING ANY ACTIVITY OR SIGNIFICANTLY MODIFYING THE TERMS OF ANY EXISTING OUTSIDE PROFESSIONAL ACTIVITY, WHERE THE COVERED PERSON HAS A FINANCIAL INTEREST VALUED IN EXCESS OF $5,000 OR EQUITY INTERESTS OF INDETERMINATE VALUE. DISCLOSURES MAY BE MADE THROUGH HSS' ONLINE REPORTING PLATFORM, MYDISCLOSURES OR DIRECTLY TO COMPLIANCE. THE REPORTED INTERESTS ARE 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, AS REQUESTED, 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 COMMITTEE THAT MEETS AT LEAST THREE TIMES A YEAR, OR AS NECESSARY AND IS CHARGED WITH ADJUDICATING COMPLEX CONFLICTS OF INTEREST AND COMMITMENT, DEVELOPING AND ADOPTING REASONABLE AND APPROPRIATE CONFLICT MANAGEMENT PLANS AND SERVING AS A POLICY ADVISORY TO THE HSS BOARD OF TRUSTEES AND HSS EXECUTIVE LEADERSHIP.
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 2021), 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. $13,088,023, AND INCREASE IN DEFINED PENSION AND POST RETIREMENT PLAN LIABILITIES $44,907,567.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

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?
(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	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) 2021

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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) HSS ASC OF MANHATTAN LLC 1233 2ND AVE NEW YORK,NY10065 47-1353602	HEALTH CARE	NY	HSS	Related	6,312,045	16,576,485		No	0	Yes		51.610 %
(2) HSS WEST SIDE ASC LLC 600 WEST 58TH STREET NEW YORK,NY10019 81-4351390	HEALTH CARE	NY	HSS	related	4,108,731	20,061,620		No	0	Yes		67.000 %
(3) HSS-FL PHYSICIANS LLC 535 EAST 70TH STREET NEW YORK,NY10021 82-4502169	HEALTH CARE	FL	HSS	Related	-3,551,710	11,101,028		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?
(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	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) 2021

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

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 .....................

Yes

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

Yes

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

Yes

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	4,703,642	ALLOC COST
(2) HSS FUND INC	J	1,442,221	ALLOC COST
(3) HSS FUND INC	M	8,211,087	ALLOC COST
(4) HSS FUND INC	Q	10,811,166	ALLOC COST
(5) HSS FUND INC	S	5,500,000	ALLOC COST
(6) HSS PROPERTIES CORPORATION	A	607,951	ALLOC COST
(7) HSS PROPERTIES CORPORATION	D	15,044,789	ALLOC COST
(8) HSS PROPERTIES CORPORATION	K	59,621,063	ALLOC COST
(9) HSS PROPERTIES CORPORATION	L	3,675,665	ALLOC COST
(10) HSS PROPERTIES CORPORATION	Q	49,801,727	ALLOC COST
(11) HSS HORIZONS INC	D	282,325	ALLOC COST
(12) MEDICAL INDEMNITY ASSURANCE COMPANY LTD	P	14,821,281	ALLOC COST
(13) MEDICAL INDEMNITY ASSURANCE COMPANY LTD	Q	12,742,757	ALLOC COST
(14) HSS ASC OF MANHATTAN LLC	L	2,947,772	ALLOC COST
(15) HSS ASC OF MANHATTAN LLC	Q	9,121,868	ALLOC COST
(16) HSS WEST SIDE ASC LLC	A	154,300	ALLOC COST
(17) HSS WEST SIDE ASC LLC	J	1,501,412	ALLOC COST
(18) HSS WEST SIDE ASC LLC	L	2,018,053	ALLOC COST
(19) HSS WEST SIDE ASC LLC	Q	4,344,932	ALLOC COST
(20) HSS-FLORIDA PHYSICIANS LLC	L	833,270	ALLOC COST
(21) HSS-FLORIDA PHYSICIANS LLC	Q	1,174,377	ALLOC COST

Schedule R (Form 990) 2021

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)	(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
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2021

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 organizations.

Schedule R (Form 990) 2021

Additional Data

Software ID:
Software Version:

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
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	51
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	44
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	6,760
6	Total number of volunteers (estimate if necessary) .............	6	182
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	1,519,480
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	207,845,766	157,963,139
9	Program service revenue (Part VIII, line 2g) .........	1,002,410,494	1,178,109,875
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	32,871,782	20,846,574
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	86,965,684	100,744,527
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,330,093,726	1,457,664,115
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	172,000	554,500
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)	744,329,960	778,408,038
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	540,044,373	573,090,390
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,284,546,333	1,352,052,928
19	Revenue less expenses. Subtract line 18 from line 12.......	45,547,393	105,611,187
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	3,032,332,032	3,004,163,711
21	Total liabilities (Part X, line 26).............	1,746,789,350	1,492,999,852
22	Net assets or fund balances. Subtract line 21 from line 20.....	1,285,542,682	1,511,163,859

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 1,000,473,293 including grants of $ 554,500 ) (Revenue $ 1,229,880,570 )
	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 STAFFED BEDS AS OF DECEMBER 31, 2021 AND DECEMBER 31, 2020; AND 39 OPERATING ROOMS AS OF DECEMBER 31, 2021 AND DECEMBER 31, 2020. WE PERFORMED 27,595 SURGERIES, A INCREASE OF 4,201 OVER THE PRIOR YEAR, WHILE NON-SURGICAL OUTPATIENT VISITS NUMBERED 547,472, 113,323 MORE THAN 2020. HOSPITAL FOR SPECIAL SURGERY PROVIDED INPATIENT CARE TO 12,534 PATIENTS, 2 LESS THAN 2020. OF THOSE IN 2021, 12,284 WERE SURGICAL. TOTAL AMBULATORY SURGICAL CASES NUMBERED 15,313, A INCREASE OF 4,023 FROM 2020. 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 $ 48,206,199 including grants of $ 0 ) (Revenue $ 39,468,940 )
	RESEARCH: THE RESEARCH DIVISION OF HOSPITAL FOR SPECIAL SURGERY CONTINUED ITS ACTIVITIES IN 2021 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. HSS Research Institute (HSSRI) composed of basic and translational scientists has created programmatic areas that has allowed us to make major contributions to musculoskeletal health. The programmatic areas in the HSSRI address orthopedic and rheumatic conditions and include (1) Bone Health and Osseointegration (2) Inflammation and Arthritis (3) Autoimmune Rheumatic Diseases and (4) Joint Preservation. These programs are supported by an enabling infrastructure including a Genomics Center, Precision Medicine Laboratory, and Experimental Pathology. HSSRI has active collaborations with the Biomechanics Department, many clinical Departments including Orthopedic Services, Rheumatology/Medicine, and Imaging(Radiology), and is expanding collaborations with Physiatry, Anesthesia and Neurology. Combining HSSRI expertise with the volume, breadth, and depth of patients seen at HSS to develop unparalleled clinical research and populations health outcomes programs, has further the national and international visibility of our institution. 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. IN 2021, THE RESEARCH INSTITUTE WAS FUNDED BY AN OPERATING BUDGET OF $48 MILLION, SUPPORTED IN PART BY APPROXIMATELY $39 MILLION IN EXTRAMURAL FUNDS, INCLUDING $10 MILLION FROM FEDERAL GRANTS. THIS RESEARCH RESULTED IN over 1,300 PUBLICATIONS AMONG 215 researchers IN 2021. HIGHLIGHTS FOR 2021 INCLUDE: continued advancement of HSS's research mission by: 1) supporting and retaining our most productive faculty, 2) mentoring the next generation of scientists, 3) expanding our collaborative efforts with clinicians and recruitment of full time clinical research scientists, 4) supporting the infrastructure necessary to advance our research and ensure compliance, AND 5) SCIENTIFIC HIGHLIGHTS INCLUDE, COVID related research and laboratory studies in areas such as bone and implant integration, spine disc development, periprosthetic joint infection, tendon and ligament repair, biologics and autoimmune diseases (i.e. Rheumatoid Arthritis, Systemic Sclerosis, Lupus), REGENERATIVE MEDICINE, and SINGLE CELL SEQUENCING. REGENERATIVE MEDICINE, and SINGLE CELL SEQUENCING.

4c	(Code: ) (Expenses $ 52,589,442 including grants of $ 0 ) (Revenue $ 8,407,751 )
	EDUCATION INSTITUTE: HSS EDUCATION INSTITUTE "EI" 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 2021 WE STRENGTHENED STRATEGIC PARTNERSHIPS WITH OUR 23 EDUCATION AND ACADEMIC AFFAIRS ADVISORY COMMITTEES AND COUNCILS, AS WELL AS FURTHERING EXTERNAL COMMUNITY RELATIONS GLOBALLY, ENGAGING 32 PARTNER COUNTRIES. THE INSTITUTE TRAINED 47 RESIDENTS, 71 FELLOWS, AND 106 MEDICAL STUDENTS AND TRAINEES WHO SPEND PART OF THE YEAR AT HSS. FOR OTHER TRAINEES, THERE WERE 291 IN-ROTATORS AND 216 CONSULTS. IN ADDITION, HSS' RESIDENCY PROGRAM HAS BEEN TOP RANKED FOR SIX YEARS BY PHYSICIAN NETWORK DOXIMITY IN BOTH REPUTATION AND RESEARCH OUTPUT. IN 2021, WE ENGAGED 6.6 million people THROUGH CUTTING EDGE Live and Digital 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 COMMUNITY EDUCATION & OUTREACH PROGRAMS. EI ALSO HOSTED 45 ACADEMIC VISITORS AND CREDENTIALED NEARLY 1,450 PHYSICIANS AND HEALTH CARE PROVIDERS. WE CONTINUE TO SET THE HIGHEST STANDARD WITH OUR ACCME ACCREDITED AND NON-ACCREDITED PROFESSIONAL EDUCATION PROGRAMS. IN 2021, THE EDUCATION INSTITUTE THROUGH ITS CONTINUING EDUCATION and Global Academic Partnerships DEPARTMENTs, including HSS E-ACADEMY DELIVERED MORE THAN 1,800 EDUCATIONAL ACTIVITIES INCLUDING ONSITE COURSES, GRAND ROUNDS, INTERNET LIVE COURSES, INTERNET ENDURING MATERIAL AND JOURNAL-BASED CONTINUING MEDICAL EDUCATION ACTIVITIES RESULTING IN OVER 274,000 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 expenses1,101,268,934

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	38,167,145	1,946,463	1,208,654

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	4,703,642
e	Government grants (contributions)		1e	13,503,581

f	All other contributions, gifts, grants, and similar amounts not included above		1f	139,755,916

g	Noncash contributions included in lines 1a - 1f:$		1g	1,385,870

h Total. Add lines 1a-1f.......		157,963,139

		Business Code
2a	NET INPATIENT REVENUE	622110	493,488,222	493,488,222
b	NET OUTPATIENT REVENUE	622110	530,758,301	530,758,301
c	PROFESSIONAL FEES	622110	153,863,352	153,863,352
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		1,178,109,875

3 Investment income (including dividends, interest, and othersimilar amounts) ......			11,791,155		-61,844	11,852,999
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			78,500			78,500
		(ii) Personal	(i) Real
6a	Gross rents		1,889,037	6a
b	Less: rental expenses		2,451,720	6b
c	Rental income or (loss)	0	-562,683	6c
d	Net rental income or (loss).......			-562,683			-562,683
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		92,135,734	7a
b	Less: cost or other basis and sales expenses		83,080,315	7b
c	Gain or (loss)		9,055,419	7c
d	Net gain or (loss).........			9,055,419			9,055,419
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..			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..			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..			0
Business Code			Miscellaneous Revenue
11a	RECOVERIES-EXPENSES		622110	27,860,342	27,860,342
b	RECOVERIES-MD RELATED EXP		622110	34,861,001	34,861,001
c	MISCELLANEOUS		622110	38,507,367	36,926,043	1,581,324
d	All other revenue ....
e	Total. Add lines 11a–11d ......			101,228,710
12	Total revenue. See instructions.....			1,457,664,115	1,277,757,261	1,519,480	20,424,235

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	554,500	554,500
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 ...........	23,835,401	14,944,890	8,890,511
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	2,786,164	914,668	1,871,496
7	Other salaries and wages........	610,481,164	527,866,860	82,614,304
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	35,898,262	31,310,606	4,587,656
9	Other employee benefits .......	68,723,435	58,796,761	9,926,674
10	Payroll taxes ...........	36,683,612	31,384,892	5,298,720
11	Fees for services (non-employees):
a	Management ......	13,389,922	3,354,281	10,035,641
b	Legal .........	12,666,995		12,666,995
c	Accounting ...........	516,789		516,789
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	400,000		400,000
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	23,259,813	20,573,005	2,686,808
12	Advertising and promotion ....	18,861,599		18,861,599
13	Office expenses .......	21,187,980	16,721,472	4,466,508
14	Information technology ......	34,022,334		34,022,334
15	Royalties ..	0
16	Occupancy ...........	69,617,433	56,589,075	13,028,358
17	Travel ............	1,884,539	1,703,502	181,037
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	0
20	Interest ...........	16,108,066	12,118,279	3,989,787
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	86,290,668	64,771,520	21,519,148
23	Insurance ...	27,283,113	19,296,655	7,986,458
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	181,367,538	181,367,538
b	RESEARCH (NET OF RECOVERIES)	21,918,145	21,918,145
c	SPF SUPPLIES	14,177,951	14,177,951
d	BAD DEBT	7,973,238	7,973,238
e	All other expenses	22,164,267	14,931,096	7,233,171
25	Total functional expenses. Add lines 1 through 24e	1,352,052,928	1,101,268,934	250,783,994	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 if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			443,386,847	1	253,302,041
2	Savings and temporary cash investments .........			0	2	0
3	Pledges and grants receivable, net ......			53,261,765	3	81,854,091
4	Accounts receivable, net .............			191,156,986	4	208,596,143
5	Loans and other receivables from 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 ...........			15,032,620	7	15,044,789
8	Inventories for sale or use ............			16,314,726	8	17,929,181
9	Prepaid expenses and deferred charges ......			12,631,869	9	8,596,772
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,674,181,603
b	Less: accumulated depreciation	10b	941,379,342	668,753,410	10c	732,802,261
11	Investments—publicly traded securities .			574,321,298	11	635,145,450
12	Investments—other securities. See Part IV, line 11 .....			394,452,637	12	421,694,000
13	Investments—program-related. See Part IV, line 11 ..			0	13	0
14	Intangible assets ...............			503,100	14	447,200
15	Other assets. See Part IV, line 11 ...........			662,516,774	15	628,751,783
16	Total assets. Add lines 1 through 15 (must equal line 33)...			3,032,332,032	16	3,004,163,711

17	Accounts payable and accrued expenses .....	144,339,647	17	145,126,340
18	Grants payable ...	1,191,937	18	1,191,937
19	Deferred revenue .........	946,667	19	0
20	Tax-exempt bond liabilities .........	18,936,171	20	5,315,846
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 ..	537,425,458	23	534,899,094
24	Unsecured notes and loans payable to unrelated third parties ..	100,000,000	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	943,949,470	25	806,466,635
26	Total liabilities. Add lines 17 through 25..	1,746,789,350	26	1,492,999,852

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	820,577,865	27	929,287,471
28	Net assets with donor restrictions ...........	464,964,817	28	581,876,388
	Organizations that do not follow FASB ASC 958, check here 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 ...........	1,285,542,682	32	1,511,163,859
33	Total liabilities and net assets/fund balances ........	3,032,332,032	33	3,004,163,711

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). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
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). . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
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). . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
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) .	Yes	No
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). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
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).. . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No