TY 2022 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) DANIEL J MESSINA PHD MPA...................................................................... TRUSTEE - PRESIDENT & CEO	55.0 ................. 0.0	X	X			1,125,470	221,121
(2) MICHAEL F CABBAD MD...................................................................... OBGYN	55.0 ................. 0.0				X	855,995	65,744
(3) LANCE U JUNG MD...................................................................... SURGEON	55.0 ................. 0.0				X	759,400	59,644
(4) LOREN HARRIS MD...................................................................... CHAIRMAN DEPT OF SURGERY	55.0 ................. 0.0			X		751,910	27,450
(5) FRANCESCO ROTATORI MD...................................................................... CARDIOLOGIST	55.0 ................. 0.0				X	697,299	51,144
(6) ALEXANDER BARKAN MD...................................................................... BARIATRIC SURGEON	55.0 ................. 0.0				X	613,986	65,744
(7) ALEXANDER BEYLINSON DO...................................................................... TRUSTEE - PRES MED STAFF	55.0 ................. 0.0	X				632,508	40,938
(8) VAITHILINGHAM ARULTHASANMD...................................................................... INTERNIST	55.0 ................. 0.0				X	650,218	21,350
(9) PIETRO CARPENITO MD...................................................................... TRUSTEE (TERM 6/30) - EVP, CMO	55.0 ................. 0.0	X	X			562,312	97,824
(10) ROSEMARIE STAZZONE RN MSN NE-BC...................................................................... COO & CNO	55.0 ................. 0.0		X			594,015	60,780
(11) RICHARD SALHANY MBA FACHE...................................................................... CHIEF ADMINISTRATION OFFICER	55.0 ................. 0.0			X		513,122	95,542
(12) DAVID MURRAY MBA FHFMA...................................................................... SVP, CFO	55.0 ................. 0.0		X			498,897	92,831
(13) BRIAN S MOODY ESQ...................................................................... SVP, LEGAL/GEN COUNSEL & CCO	55.0 ................. 0.0			X		402,967	76,587
(14) GAITRE A LORICK...................................................................... VP, CHRO (EFF 03/28/2022)	55.0 ................. 0.0			X		243,009	29,193
(15) SAMALA SWAMY MD...................................................................... TRUSTEE	1.0 ................. 0.0	X				5,192	0
(16) RONALD A PURPORA...................................................................... CHAIR - TRUSTEE	1.0 ................. 0.0	X	X			0	0
(17) TIMOTHY C HARRISON...................................................................... VICE CHAIR - TRUSTEE	1.0 ................. 0.0	X	X			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)
(18) KATHERINE CONNORS PT MPH........................................................................ SECRETARY - TRUSTEE	1.0 .......................0.0	X	X
(19) GINA GUTZEIT........................................................................ TREASURER - TRUSTEE	1.0 .......................0.0	X	X
(20) ALAN S BERNIKOW CPA........................................................................ TRUSTEE	1.0 .......................0.0	X
(21) THOMAS DELMASTRO........................................................................ TRUSTEE	1.0 .......................0.0	X
(22) SARA WARREN GARDNER MPH........................................................................ TRUSTEE	1.0 .......................0.0	X
(23) STEVEN M KLEIN........................................................................ TRUSTEE	1.0 .......................0.0	X
(24) ANITA LAREMONT ESQ........................................................................ TRUSTEE	1.0 .......................0.0	X
(25) ROSEMARIE MALDONADO ESQ........................................................................ TRUSTEE	1.0 .......................0.0	X
(26) DAVID MCGOY........................................................................ TRUSTEE	1.0 .......................0.0	X
(27) COURTNEY MOORE........................................................................ TRUSTEE	1.0 .......................0.0	X
(28) JILL O'DONNELL-TORMEY PHD........................................................................ TRUSTEE	1.0 .......................0.0	X
(29) PANKAJ R PATEL MD........................................................................ TRUSTEE	1.0 .......................0.0	X
(30) KATHRYN K ROONEY ESQ........................................................................ TRUSTEE	1.0 .......................0.0	X
(31) JOHN C SANTORA........................................................................ TRUSTEE	1.0 .......................0.0	X
(32) JOHN VINCENT SCALIA SR........................................................................ TRUSTEE	1.0 .......................0.0	X
(33) MARCELLO SCIARRINO........................................................................ TRUSTEE	1.0 .......................0.0	X
(34) JOHN TAPINIS........................................................................ TRUSTEE	1.0 .......................0.0	X
(35) REV DR TONY BAKER SR........................................................................ TRUSTEE (Termed 06/30/2022)	1.0 .......................0.0	X
(36) JAMES P MOLINARO........................................................................ TRUSTEE (Termed 06/30/2022)	1.0 .......................0.0	X
(37) CATHERINE PAULO ESQ........................................................................ TRUSTEE (Termed 06/30/2022)	1.0 .......................0.0	X
(38) DENNIS QUIRK........................................................................ TRUSTEE (Termed 06/30/2022)	1.0 .......................0.0	X

(A) Name and business address	(B) Description of services	(C) Compensation
SAVISTA, PO Box 676188 DALLAS,TX752676188	Patient Billing Svcs	4,311,823
ARAMARK CORP, 25271 Network Place CHICAGO,IL606731252	Food Services	3,171,773
CADUCEUS HEALTH, 30 Montgomery Street Suite 720 JERSEY CITY,NJ073023841	Patient Billing Svcs	2,014,424
CANNON DESIGN, Department Chicago PALATINE,IL600559824	Architectural dgn.	1,690,236
NKN CONSTRUCTION, 5723 2nd Avenue BROOKLYN,NY11220	Construction	1,557,830
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 135

- 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.
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Attach to Form 990 or Form 990-EZ.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public
Inspection

Name of the organization

RICHMOND MEDICAL CENTER

Employer identification number

74-3177454

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) 2022

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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) ..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

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

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 2022 (line 6, column (f) divided by line 11, column (f)) .........

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

16a

33 1/3% support test—2022. 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—2021. 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—2022. 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—2021. 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) 2022

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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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 2022 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2021 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2022 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2021 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2022. 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—2021. 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) 2022

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) 2022

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) 2022

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) 2022

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 2022 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-2022	(iii) Distributable Amount for 2022
1 Distributable amount for 2022 from Section C, line 6
2 Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2022:
a From 2017.......
b From 2018.......
c From 2019.......
d From 2020.......
e From 2021.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2022 distributable amount
i Carryover from 2017 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2022 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2022 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2022, 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 2022. 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 2023. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2018.....
b Excess from 2019.....
c Excess from 2020.....
d Excess from 2021.....
e Excess from 2022.....

Schedule A (Form 990) (2022)

Schedule A (Form 990) 2022

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990) 2022

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

2022

Name of the organization

RICHMOND MEDICAL CENTER

Employer identification number

74-3177454

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) (2022)

Schedule B (Form 990) (2022) Page 2

Name of organization RICHMOND MEDICAL CENTER

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) (2022)

Schedule B (Form 990) (2022)

Page 3

Name of organization RICHMOND MEDICAL CENTER		Employer identification number 74-3177454

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) (2022)

Schedule B (Form 990) (2022)

Page 4


Name of organization RICHMOND MEDICAL CENTER			Employer identification number 74-3177454
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) (2022)

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

RICHMOND MEDICAL CENTER

Employer identification number

74-3177454

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.)		(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) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	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) .................................................
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

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

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

Yes

287,831

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

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

Yes

96,453

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

384,284

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, PART II-B; LINES 1G & 1I	THE ORGANIZATION ENGAGES IN LOBBYING EFFORTS ON A FEDERAL AND STATE LEVEL. DURING 2022, THE ORGANIZATION PAID OUTSIDE FIRMS $287,831 FOR LOBBYING ACTIVITIES PERFORMED ON BEHALF OF THE ORGANIZATION. IN ADDITION, THE ORGANIZATION IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION ("AHA"), THE HEALTHCARE ASSOCIATION OF NEW YORK STATE ("HANYS") AND THE GREATER NEW YORK HOSPITAL ASSOCIATION ("GNYHA") WHICH ALL ENGAGE IN LOBBYING EFFORTS ON BEHALF OF THEIR MEMBER HOSPITALS. A PORTION OF THE DUES PAID TO THESE ORGANIZATIONS HAS BEEN ALLOCATED TO LOBBYING ACTIVITIES PERFORMED ON BEHALF OF THE ORGANIZATION. THIS ALLOCATION AMOUNTED TO $46,304 DURING 2022. THIS ORGANIZATION ALSO IS INVOLVED IN THE HEALTHCARE EDUCATION INTIATIVE OF 1199/GNYHA TO WHICH IT PAID DUES IN THE AMOUNT OF $50,149 IN 2022. ONE OF THE FUNCTIONS OF THE HEALTHCARE EDUCATION PROJECT IS TO ENGAGE IN LOBBYING ACTIVITIES PERFORMED ON BEHALF OF ITS MEMBER HOSPITALS.

Return Reference

Explanation

SCHEDULE C, PART II-B; LINES 1G & 1I

THE ORGANIZATION ENGAGES IN LOBBYING EFFORTS ON A FEDERAL AND STATE LEVEL. DURING 2022, THE ORGANIZATION PAID OUTSIDE FIRMS $287,831 FOR LOBBYING ACTIVITIES PERFORMED ON BEHALF OF THE ORGANIZATION. IN ADDITION, THE ORGANIZATION IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION ("AHA"), THE HEALTHCARE ASSOCIATION OF NEW YORK STATE ("HANYS") AND THE GREATER NEW YORK HOSPITAL ASSOCIATION ("GNYHA") WHICH ALL ENGAGE IN LOBBYING EFFORTS ON BEHALF OF THEIR MEMBER HOSPITALS. A PORTION OF THE DUES PAID TO THESE ORGANIZATIONS HAS BEEN ALLOCATED TO LOBBYING ACTIVITIES PERFORMED ON BEHALF OF THE ORGANIZATION. THIS ALLOCATION AMOUNTED TO $46,304 DURING 2022. THIS ORGANIZATION ALSO IS INVOLVED IN THE HEALTHCARE EDUCATION INTIATIVE OF 1199/GNYHA TO WHICH IT PAID DUES IN THE AMOUNT OF $50,149 IN 2022. ONE OF THE FUNCTIONS OF THE HEALTHCARE EDUCATION PROJECT IS TO ENGAGE IN LOBBYING ACTIVITIES PERFORMED ON BEHALF OF ITS MEMBER HOSPITALS.

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

RICHMOND MEDICAL CENTER

Employer identification number

74-3177454

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 ....	344,647	344,647	344,647	344,647	344,647
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......	344,647	344,647	344,647	344,647	344,647

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

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

100.000 %

Term endowment SchDMd Bullet

0 %

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)

(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 .....	4,471,164		4,471,164
b	Buildings ....	57,844,431	21,779,351	36,065,080
c	Leasehold improvements	9,456,104	3,469,935	5,986,169
d	Equipment ....	94,064,213	66,222,457	27,841,756
e	Other .....	218,343,656	447,884	217,895,772
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				292,259,941

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

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)DUE FROM AFFILIATES				82,217,375
(2)INSURANCE RECOVERIES REC				36,045,487
(3)RIGHT OF USE ASSETS				13,837,741
(4)EST 3RD PARTY PAYOR SETTLEMENT				1,550,727
(5)OTHER ASSETS				679,749
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				134,331,079

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
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	161,548,114
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
PART V, LINE 4:	THE ENDOWMENT FUND, ALSO KNOWN AS THE BELL SOCIETY ENDOWMENT FUND, IS INTENDED TO BENEFIT THE WORK OF THE MEDICAL CENTER.

Schedule D (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 20a.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

RICHMOND MEDICAL CENTER

Employer identification number

74-3177454

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 %

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? . . . . . .

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) . . .	18,106,972	3,267,255	14,839,717	3.720 %
b	Medicaid (from Worksheet 3, column a) . . . . .	126,107,791	129,706,981	0	0 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	144,214,763	132,974,236	14,839,717	3.720 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	2,884	0	2,884
f	Health professions education (from Worksheet 5) . . .	38,641,240	14,923,801	23,717,439	5.950 %
g	Subsidized health services (from Worksheet 6) . . . .	38,923,480	24,681,073	14,242,407	3.580 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .
j	Total. Other Benefits . .	77,567,604	39,604,874	37,962,730	9.530 %
k	Total. Add lines 7d and 7j .	221,782,367	172,579,110	52,802,447	13.250 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2022

Schedule H (Form 990) 2022

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. ......

4,823,489

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. ......

1,447,047

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).....

66,423,111

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

60,220,593

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

6,202,518

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 %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2022

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	RICHMOND MEDICAL CENTER 355 BARD AVENUE STATEN ISLAND,NY10310 WWW.RUMCSI.ORG 7004010H	X	X	X	X

Schedule H (Form 990) 2022

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)

	RICHMOND MEDICAL CENTER
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 22

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): WWW.RUMCSI.ORG

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 22

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

Yes

If "Yes" (list url): WWW.RUMCSI.ORG

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) 2022

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	RICHMOND MEDICAL CENTER
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 100%
and FPG family income limit for eligibility for discounted care of 400.%

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):

WWW.RUMCSI.ORG

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

WWW.RUMCSI.ORG

A plain language summary of the FAP was widely available on a website (list url):
WWW.RUMCSI.ORG

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) 2022

Page 6

Part VFacility Information (continued)

Billing and Collections

	RICHMOND MEDICAL CENTER
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?..................

Yes

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) 2022

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	RICHMOND MEDICAL CENTER
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) 2022

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, SECTION B, LINE 5	Community engagement was an integral part of the 2022 CHNA. In assessing community health needs, input was solicited and received from persons who represent the broad interests of the community, as well as underserved, low-income, and minority populations. These individuals provided wide perspectives on health trends, expertise about existing community resources available to meet those needs, and insights into service delivery gaps that contribute to health disparities and inequities. RUMC is an active community partner and participating member of cross-agency coalitions serving Staten Island residents, including the following: - Staten Island Behavioral Health Infrastructure Project (BHIP), with the goal to help strengthen mental health and substance use disorder infrastructure across Staten Island systems, reduce unnecessary. hospitalizations, and increase access to quality behavioral health services. - Staten Island Performing Provider System (SI PPS), an integrated network of medical, behavioral, and social service agencies with the goal of improving quality of care, reducing costs, and improving health outcomes for Staten Island's Medicaid and uninsured populations. - Tackling Youth Substance Abuse (TYSA), an initiative aimed at decreasing the use of alcohol and prescription drugs and promoting overall healthy choices among youth. As a partner in BHIP, RUMC has most recently been active in the Staten Island Veteran Suicide Prevention Collaborative (SIVSPC), a community-based collaborative of veteran and civilian organizations. The SIVSPC provides quarterly webinars on topics relating to veteran suicide prevention and partners with the Staten Island Retired Volunteer Program to hold community-based Veterans Taskforce meetings. The collaborative also provides ongoing outreach to Staten Island veterans to assess and respond to their social determinants of health needs. RUMC was a founding member in helping construct and form the SI PPS. RUMC exited the PPS after the initial 5-year project, but remains an active participant, particularly around behavioral health initiatives. Since its formation in 2014, SI PPS has become a national model for how to use data driven strategic business intelligence to create multi-agency collaboration, improve care quality, reduce costs, and achieve population-level outcomes for people with behavioral health conditions. As part of the SI PPS, RUMC has implemented within its system the emergency department (ED) Peer Counselor Warm Handoff Program and E-Recovery Addiction Treatment Platform, among other initiatives. Both programs assist patients with substance use disorder access recovery services and supports in real time and have proven outcomes in reducing relapse and increasing treatment adherence. The RUMC Center for Young Adults is a member of the TYSA coalition to advocate for and respond to youth substance use concerns. In addition to its work with TYSA, the Center for Young Adults has been actively engaged in the community, providing education and facilitating service linkages with other youth-focused organizations. The program supervisor has targeted education to local schools and facilitated service delivery linkages with the Department of Education and a large charter school organization on Staten Island. In addition to partnering with community coalitions, RUMC fostered and deepened relationships with school districts across the borough to provide tobacco prevention education. This service was initiated in response to the 2019 CHNA identified issue of e-cigarette use among youth. In 2019 alone, RUMC provided more than 30 tobacco prevention sessions, reaching over 5,000 students across Staten Island. Other community health promotion partners have included the Jewish Community Center, Staten Island Economic Development Corporation, and Community Health Action of Staten Island. The collective initiatives of community coalitions and partners have and will continue to be integral to the CHNA and CSP. The individuals who comprise these partnerships, as well as other diverse stakeholders across the community, were invited to provide feedback as part of the 2022 CHNA to inform both priority needs and ongoing health improvement efforts. KEY INFORMANT INTERVIEWS ------------------------ A KEY INFORMANT SURVEY WAS CONDUCTED WITH COMMUNITY REPRESENTATIVES WITHIN STATEN ISLAND TO SOLICIT INFORMATION ABOUT HEALTH NEEDS AMONG RESIDENTS. A TOTAL OF 35 INDIVIDUALS RESPONDED TO THE SURVEY, INCLUDING HEALTH AND SOCIAL SERVICE PROVIDERS; COMMUNITY AND PUBLIC HEALTH EXPERTS; CIVIC, RELIGIOUS, AND SOCIAL LEADERS; POLICY MAKERS AND ELECTED OFFICIALS; AND OTHERS REPRESENTING DIVERSE POPULATIONS INCLUDING MINORITY, LOW-INCOME, AND OTHER UNDERSERVED OR VULNERABLE POPULATIONS. A LIST OF THE REPRESENTED COMMUNITY ORGANIZATIONS INCLUDED THE FOLLOWING: - Assemblyman Michael Cusick, 63rd Assembly District, District Office Manager - Brighton Heights Reformed Church, Senior Minister - Cancer Tamer Foundation, CEO - Carmel Richmond Healthcare and Rehabilitation Center, Executive Director - Church of the Ascension, Parish Administrator - Community Agency for Senior Citizens, Inc. (CASC), President and CEO - Community Board 1, Chair of Health Hospitals and Human Service - Community Health Action of Staten Island, Executive Director - Eger Health Care and Rehabilitation Center, President and CEO - JCC of Staten Island, CEO - JCC of Staten Island, Director of Marketing & Communications - Kids Against Cancer, Chairman - Meals on Wheels of Staten Island, President and CEO - Mt. Sinai United Christian Church, Inc., Senior Pastor - Northfield Bank Foundation, Executive Director - NY Senate, Deputy Chief of Staff - Office of Staten Island Borough President, Director, Health and Wellness - Real Estate, Realtor - Richmond Center, Administrator - Richmond County Savings Foundation, Program Officer - Robin Hood, Director of Governance and Board Placement - South Beach Civic Association, President - St Paul's Episcopal Church, Priest - St Teresa Church, Pastor - St. Mary's Episcopal Church, Parish Administrator - Staten Island CB #2, Board Member - Staten Island Chamber of Commerce, President and CEO - Staten Island Economic Development Corporation, Sr. VP - Staten Island Economic Development Corporation, VP of Development - Staten Island Partnership for Community Wellness, Executive Director - Staten Island Performing Provider System, Executive Director - The Staten Island Foundation, Executive Director - United States House of Representatives - NY11, Representative Nicole Malliotakis - Veterans, Advocate - VNA Staten Island, President
SCHEDULE H, PART V, SECTION B, QUESTION 7A	THE ORGANIZATION IS AN AFFILIATE WITHIN RICHMOND MEDICAL CENTER D/B/A RICHMOND UNIVERSITY MEDICAL CENTER ("RICHMOND UNIVERSITY MEDICAL CENTER") AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN SCHEDULE H, PART V, SECTION B, QUESTION 7A, IS THE HOME PAGE FOR THE SYSTEM. THE CHNA CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: HTTPS://WWW.RUMCSI.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/
SCHEDULE H, PART V, SECTION B, QUESTION 10A	THE ORGANIZATION IS AN AFFILIATE WITHIN RICHMOND MEDICAL CENTER D/B/A RICHMOND UNIVERSITY MEDICAL CENTER ("RICHMOND UNIVERSITY MEDICAL CENTER") AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM").DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN SCHEDULE H, PART V, SECTION B, QUESTION 10A, IS THE HOME PAGE FOR THE SYSTEM. THE ORGANIZATION'S IMPLEMENTATION STRATEGY IS INCLUDED WITHIN ITS COMMUNITY HEALTH NEEDS ASSESSMENT. THIS IMPLEMENTATION STRATEGY CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: HTTPS://WWW.RUMCSI. ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/
PART V, SECTION B, LINE 11	To work towards health equity, it is imperative to prioritize resources toward the most pressing and cross-cutting health needs within the community. Priorities were determined by the RUMC CHNA Planning Committee, taking into consideration research findings and community stakeholder feedback. Based on CHNA findings and taking into account the health system's expertise and resources, RUMC will focus efforts on the following New York State Prevention Agenda priorities as part of its 2022-2024 CSP: 1) Prevent Chronic Diseases 2) Promote Well-Being and Prevent Mental and Substance Use Disorders Strategies to address the Prevention Agenda priorities will target communities on the North Shore, where residents continue to experience disparate health outcomes largely due to socioeconomic differences and racial inequities. While Staten Island is one of the wealthiest boroughs in NYC, boasting a higher median household income and the lowest poverty rate, wealth is not equally distributed across communities. North Shore residents are two to three times as likely to live in poverty as other borough residents, a disparity that disproportionately affects Black/African Americans who comprise 25% or more of North Shore residents. Across Staten Island, the median household income for Black/African Americans is nearly half the median household income for Whites, and more than 1 in 4 Black/African Americans live in poverty, a higher proportion than Black/African Americans living citywide or nationally. The RUMC 2022-2024 CSP prioritizes evidence-based strategies to address disparities and promote optimal health improvement outcomes. The following is a list of select strategies implemented by RUMC to address the identified priorities areas, and metrics for tracking progress and improvement. Breast Health Patient Navigation Initiative to address social determinants of health barriers to breast health screening, diagnosis, and treatment - Metrics: Patients who receive appropriate follow-up care regardless of identified care access barriers (e.g., transportation, cost, childcare) Community Tobacco Cessation Program, led by a Certified Tobacco Treatment Specialist - Metrics: Program enrollment, completion, and cessation outcomes Diabetes Self-Management Education and Support, led by an American Diabetes Association Certified Diabetes Care Education Specialist - Metrics: Program enrollment, completion, and health outcomes (e.g., participant glucose levels, medication adherence, decreased healthcare costs) National Diabetes Prevention Program, a CDC recognized program for adults with pre-diabetes - Metrics: Program enrollment, completion, and health outcomes (e.g., participant weight loss, glucose levels) Project LAUNCH (Linking Actions for Unmet Needs in Children's Health), a federal initiative funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) to prepare children for success in school - Metrics: Child development outcomes and academic readiness Opioid Overdose Prevention Program to provide clinical and community based Narcan training and free Narcan and fentanyl test kits - Metrics: Number of people trained in Narcan administration, distribution of Narcan and fentanyl test kits, and incidence of opioid overdose and related death Peer Counselor Warm Handoff Program, connecting patients with substance use disorder seen in the ED with timely and appropriate withdrawal management and other treatment services - Improvement metrics: Number of ED interventions, provision of follow-up services, and incidence of opioid overdose Relay, a NYC Department of Health and Mental Hygiene-led nonfatal overdose response system - Improvement metrics: Number of ED interventions, provision of follow-up services, and incidence of opioid overdose Columbia-Suicide Severity Rating Scale (C-SSRS) depression screening among patients with gambling addiction - Improvement metrics: Identification of coexisting mental health conditions and provision of follow-up services In addition to deploying evidence-based strategies to address disparities and identified priority areas, the 2022-2024 CSP reflects RUMC's ongoing commitment to provide free or low-cost health promotion services. These services include community-based education on diverse health topics and screening and referral services, targeting at-risk or underserved communities.
SCHEDULE H, PART V, SECTION B, QUESTION 16	THE ORGANIZATION IS AN AFFILIATE WITHIN RICHMOND MEDICAL CENTER D/B/A RICHMOND UNIVERSITY MEDICAL CENTER ("RICHMOND UNIVERSITY MEDICAL CENTER") AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN SCHEDULE H, PART V, SECTION B, QUESTION 16, IS THE HOME PAGE FOR THE SYSTEM. THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION AND PLAIN LANGUAGE SUMMARY ARE MADE WIDELY AVAILABLE ON THE ORGANIZATION'S WEBSITE. THESE DOCUMENTS CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: HTTPS://WWW.RUMCSI.ORG/PATIENTS -VISITORS/BILLING-AND INSURANCE/ FINANCIAL-ASSISTANCE-SUMMARY/

Schedule H (Form 990) 2022

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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?24
Name and address		Type of Facility (describe)
1	RUMC CARDIOPULMONARY REHAB 288 KISSEL AVENUE STATEN ISLAND,NY10310	OUTPATIENT SERVICES - CARDIOVASCULAR
2	RUMC CENTER FOR CANCER CARE 1000 SOUTH AVENUE STATEN ISLAND,NY10314	OUTPATIENT SERVICES - ONCOLOGY
3	RUMC COMPREHENSIVE OP REHAB CENTER 288 KISSEL AVENUE STATEN ISLAND,NY10310	OUTPATIENT SERVICES - REHABILITATION
4	RUMC FAMILY HEALTH CENTER 800 CASTLETON AVENUE STATEN ISLAND,NY10310	OUTPATIENT SERVICES - FAMILY MEDICINE
5	SIMHS KINGSLEY 10 KINGSELY PLACE STATEN ISLAND,NY10301	OUTPATIENT SERVICES - BEHAVIORAL HEALTH &
6	SIMHS PS 78 100 TOMPKINS AVENUE STATEN ISLAND,NY10304	OUTPATIENT SERVICES - BEHAVIORAL HEALTH DEVELOPMENTAL
7	SIMHS IS 49 101 WARREN STREET STATEN ISLAND,NY10304	OUTPATIENT SERVICES - BEHAVIORAL HEALTH
8	SIMHS IS 27 11 COVE LAKE PLACE STATEN ISLAND,NY10310	OUTPATIENT SERVICES - BEHAVIORAL HEALTH
9	ANNA ERIKA CLINIC 110 HENDERSON AVENUE STATEN ISLAND,NY10304	OUTPATIENT SERVICES - BEHAVIORAL HEALTH
10	CTR FOR INTEGRATIVE BEHAVIORAL MEDICINE 1130 SOUTH AVENUE STATEN ISLAND,NY10314	INPATIENT/OUTPATIENT SVCS - BEHAVIORAL HEALTH
11	SIMHS DDSO BLD 24 1150 FOREST HILL ROAD STATEN ISLAND,NY10314	OUTPATIENT SERVICES - PT/OT/SP
12	SIMHS PS 57 140 PALMA DRIVE STATEN ISLAND,NY10304	OUTPATIENT SERVICES - BEHAVIORAL HEALTH
13	SIMHS OSGOOD 16 OSGOOD AVENUE STATEN ISLAND,NY10304	OUTPATIENT SERVICES - BEHAVIORAL HEALTH &
14	SIMHS PORT RICHMOND 166 LOCKMAN AVENUE STATEN ISLAND,NY10303	OUTPATIENT SERVICES - BEHAVIORAL HEALTH & DEVELOPMENTAL
15	SIMHS IS 2 333 MIDLAND AVENUE STATEN ISLAND,NY10306	OUTPATIENT SERVICES - BEHAVIORAL HEALTH DEVELOPMENTAL
16	SIMHS DONGAN HILL 44 DONGAN HILLS AVENUE STATEN ISLAND,NY10306	OUTPATIENT SERVICES - BEHAVIORAL HEALTH &
17	SIMHS POPLER 444 ST MARKS PLACE STATEN ISLAND,NY10301	OUTPATIENT SERVICES - BEHAVIORAL HEALTH & DEVELOPMENTAL
18	SIMHS POUCH 657 CASTLETON AVENUE STATEN ISLAND,NY10301	OUTPATIENT SERVICES - BEHAVIORAL HEALTH & SUBSTANCE ABUSE
19	SIMHS DAY TREATMENT SOUTH 6581 HIGHLAND BLVD STATEN ISLAND,NY10309	OUTPATIENT SERVICES - BEHAVIORAL HEALTH DEVELOPMENTAL
20	SIMHS CHAIT 669 CASTLETON AVENUE STATEN ISLAND,NY10301	OUTPATIENT SERVICES - BEHAVIORAL HEALTH &
21	SIMHS WEST BRIGHTON 690 CASTLETON AVENUE STATEN ISLAND,NY10314	OUTPATIENT SERVICES - MENTAL HEALTH SUBSTANCE ABUSE
22	SIMHS PS 44 80 MAPLE PARKWAY STATEN ISLAND,NY10303	OUTPATIENT SERVICES - BEHAVIORAL HEALTH
23	SIMHS DDSO BLD 14E 940 WILLOWBROOK ROAD STATEN ISLAND,NY10314	OUTPATIENT SERVICES - PT/OT/SP
24	SUSAN WAGNER HIGH SCHOOL 1200 MANOR ROAD STATEN ISLAND,NY10314	OUTPATIENT SERVICES - GENERAL MEDICAL

Schedule H (Form 990) 2022

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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
SCHEDULE H, PART I; LINE 3C	IN ADDITION TO THE FEDERAL POVERTY GUIDELINES, THE ORGANIZATION USES OTHER FACTORS IN DETERMINING ELIGIBILITY CRITERIA FOR FREE AND DISCOUNTED CARE. AS OUTLINED IN PART V, SECTION B, QUESTION 13, OTHER FACTORS TO DETERMINE ELIGIBILITY INCLUDE: - ASSET LEVEL; - MEDICAL INDIGENCY; - INSURANCE STATUS; - UNDERINSURANCE STATUS; AND - RESIDENCY.
SCHEDULE H, PART I; QUESTION 6A	THE ORGANIZATION ANNUALLY PUBLISHES A REPORT WHICH HIGHLIGHTS ITS ACHIEVEMENTS AS WELL AS ITS PROGRAMS AND SERVICES THAT PROMOTE THE HEALTH OF THE COMMUNITIES SERVED. THIS REPORT IS MADE WIDELY AVAILABLE AND CAN BE FOUND ON THE ORGANIZATION'S WEBSITE.
SCHEDULE H, PART I; QUESTION 7	THE ORGANIZATION'S COST TO CHARGE RATIO REFLECTS TOTAL OPERATING COSTS, EXCLUDING BAD DEBT AND OTHER OPERATING REVENUE, TO GROSS CHARGES. THE HOSPITAL UTILIZED WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS TO DERIVE ITS COST-TO-CHARGE RATIO.
SCHEDULE H, PART I, QUESTION 7B	EFFECTIVE DECEMBER 1, 2021, NYS IMPLEMENTED ENHANCED PAYMENTS FOR SELECTED SERVICES PROVIDED BY FINANCIALLY DISTRESSED HOSPITALS TO MEDICAID ENROLLEES THROUGH A DIRECT PAYMENT TEMPLATE APPLICATION (DPT). THE ENHANCED PAYMENTS (MEDICAID MANAGED CARE RATE ADD-ON PAYMENTS) FOR SELECT SERVICES ARE CONSTRUCTED TO ALLOW QUALIFYING FINANCIALLY DISTRESSED HOSPITALS TO RECEIVE SUFFICIENT REIMBURSEMENT TO ENABLE THEIR CONTINUED ABILITY TO SERVE MEDICAID AND LOW-INCOME PATIENT POPULATIONS AND TO CONTINUE THEIR PROCESS OF TRANSFORMATION TO MEET MEDICAID MANAGED CARE NEEDS. THE MEDICAL CENTER QUALIFIES FOR THESE PAYMENTS. IN 2022, NYS BEGAN ADVANCING FUNDS TO HOSPITALS IN THE DPT PROGRAM WHILE QUALIFYING CLAIMS WERE REPROCESSED. AS OF DECEMBER 31, 2022, THE MEDICAL CENTER RECEIVED APPROXIMATELY $51.1 MILLION IN ADVANCES. ADVANCES ARE TO BE REPAID AS REPROCESSED CLAIMS ARE PAID TO THE HOSPITALS. THE MEDICAL CENTER REPAID APPROXIMATELY $11.5 MILLION IN ADVANCES THROUGH MARCH 2023. FOR THE YEAR ENDED DECEMBER 31, 2022, DPT-RELATED REVENUE OF APPROXIMATELY $59.3 MILLION, HAS BEEN RECOGNIZED AND INCLUDED IN NET PATIENT SERVICE REVENUE IN THE ORGANIZATION'S CONSOLIDATED STATEMENTS OF OPERATIONS. THE ADDITIONAL FUNDS RECEIVED FROM THE PROGRAM ARE INCLUDED IN SCHEDULE H, PART I, LINE 7B; DIRECT OFFSETTING REVENUE. IF RICHMOND UNIVERSITY MEDICAL CENTER DID NOT RECEIVE THESE ADDITIONAL FUNDS, THE NET COMMUNITY BENEFIT EXPENSE REPORTED ON SCHEDULE H, PART I; LINE 7K WOULD BE $108,503,257 AND THE NET COMMUNITY BENEFIT PERCENTAGE REPORTED ON SCHEDULE H, PART I; LINE K WOULD BE 27.23%.
SCHEDULE H, PART II	NOT APPLICABLE.
SCHEDULE H, PART III; QUESTIONS 2 & 3	BAD DEBT EXPENSE WAS CALCULATED USING THE PROVIDERS' BAD DEBT EXPENSE FROM ITS FINANCIAL STATEMENT, WHICH IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN MEDICARE AND MEDICAID HEALTH COVERAGE AND OTHER COLLECTION INDICATORS. ADDITIONS TO THE PROVISION FOR DOUBTFUL ACCOUNTS RESULT FROM THE PROVISION FOR BAD DEBTS; DEDUCTIONS FROM THE ALLOWANCE FOR DOUBTFUL ACCOUNTS RESULT FROM ACCOUNTS WRITTEN OFF AS UNCOLLECTIBLE. THE COSTING METHODOLOGY USED TO ESTIMATE THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY WAS THE RATIO OF APPROVED CHARITY CARE APPLICATIONS TO TOTAL APPLICATIONS APPLIED TO SELF-PAY BAD DEBTS ASSOCIATED WITH PATIENTS WHO DID NOT ADEQUATELY COMPLETE THE FINANCIAL ASSISTANCE PAPERWORK. WE BELIEVE THAT A PORTION OF OUR BAD DEBT RESULTS FROM SERVICES PROVIDED TO PATIENTS WHO MEET THE FINANCIAL ASSISTANCE GUIDELINES BUT WERE UNWILLING OR UNABLE TO PROVIDE THE APPROPRIATE DOCUMENTATION TO ALLOW THAT CLASSIFICATION. THESE SHOULD BE CONSIDERED COMMUNITY BENEFIT AS WE ARE STILL PROVIDING SERVICES TO THESE PATIENTS REGARDLESS OF THEIR ABILITY TO PAY.
SCHEDULE H, PART III; QUESTION 4	RICHMOND MEDICAL CENTER D/B/A RICHMOND UNIVERSITY MEDICAL CENTER ("RICHMOND UNIVERSITY MEDICAL CENTER") AND AFFILIATES PREPARE AND ISSUE AUDITED CONSOLIDATED FINANCIAL STATEMENTS. THE TEXT BELOW WAS OBTAINED FROM THE RICHMOND UNIVERSITY MEDICAL CENTER AUDITED CONSOLIDATED FINANCIAL STATEMENTS FOOTNOTES: PATIENT ACCOUNTS RECEIVABLE --------------------------- PATIENT ACCOUNTS RECEIVABLE ARE RECORDED AT NET REALIZABLE VALUE AT THE TRANSACTION PRICE BASED ON STANDARD CHARGES FOR SERVICES PROVIDED, REDUCED BY CONTRACTUAL ADJUSTMENTS PROVIDED TO THIRD-PARTY PAYORS, DISCOUNTS PROVIDED TO UNINSURED OR UNDERINSURED PATIENTS IN ACCORDANCE WITH THE MEDICAL CENTER'S POLICIES, AND/OR IMPLICIT PRICE CONCESSIONS PROVIDED TO UNINSURED OR UNDERINSURED PATIENTS, AND DO NOT BEAR INTEREST. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE (DETERMINED ON A PORTFOLIO BASIS WHEN APPLICABLE) ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT REVENUE IN THE PERIOD OF THE CHANGE. ACCOUNTS ARE WRITTEN OFF THROUGH THE PROVISION FOR BAD DEBTS WHEN THE MEDICAL CENTER HAS EXHAUSTED ALL COLLECTION EFFORTS AND DETERMINES ACCOUNTS ARE IMPAIRED BASED ON CHANGES IN PATIENT CREDIT WORTHINESS. NET PATIENT SERVICE REVENUES ---------------------------- NET PATIENT SERVICE REVENUES ARE RECOGNIZED AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE MEDICAL CENTER EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS, THIRD PARTY PAYORS (INCLUDING COMMERCIAL AND GOVERNMENTAL PROGRAMS) AND OTHERS AND INCLUDES VARIABLE CONSIDERATION FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO SETTLEMENT OF AUDITS, REVIEWS AND INVESTIGATIONS. GENERALLY, THE MEDICAL CENTER BILLS THE PATIENTS AND THIRD PARTY PAYORS SEVERAL DAYS AFTER THE SERVICES ARE PERFORMED AND/OR THE PATIENT IS DISCHARGED FROM THE FACILITY. REVENUES ARE RECOGNIZED AS PERFORMANCE OBLIGATIONS ARE SATISFIED. PERFORMANCE OBLIGATIONS ARE DETERMINED BASED ON THE NATURE OF THE SERVICES PROVIDED BY THE MEDICAL CENTER. REVENUES FOR PERFORMANCE OBLIGATIONS SATISFIED OVER TIME ARE RECOGNIZED BASED ON ACTUAL CHARGES INCURRED IN RELATION TO TOTAL EXPECTED (OR ACTUAL) CHARGES. THE MEDICAL CENTER BELIEVES THAT THIS METHOD PROVIDES A FAITHFUL DEPICTION OF THE TRANSFER OF SERVICES OVER THE TERM OF THE PERFORMANCE OBLIGATION BASED ON THE INPUTS NEEDED TO SATISFY THE OBLIGATION. GENERALLY, PERFORMANCE OBLIGATIONS SATISFIED OVER TIME RELATE TO PATIENTS RECEIVING INPATIENT ACUTE CARE SERVICES. THE MEDICAL CENTER MEASURES THE PERFORMANCE OBLIGATION FROM ADMISSION INTO THE HOSPITAL, OR THE COMMENCEMENT OF AN OUTPATIENT SERVICE, TO THE POINT WHEN IT IS NO LONGER REQUIRED TO PROVIDE SERVICES TO THAT PATIENT, WHICH IS GENERALLY AT THE TIME OF DISCHARGE OR COMPLETION OF THE OUTPATIENT SERVICES. REVENUES FOR PERFORMANCE OBLIGATIONS SATISFIED AT A POINT-IN-TIME ARE GENERALLY RECOGNIZED WHEN GOODS OR SERVICES ARE PROVIDED, AND THE MEDICAL CENTER DOES NOT BELIEVE IT IS REQUIRED TO PROVIDE ADDITIONAL SERVICES TO THE PATIENT. ALL OF THE MEDICAL CENTER'S PERFORMANCE OBLIGATIONS RELATE TO CONTRACTS WITH A DURATION OF LESS THAN ONE YEAR, THEREFORE THE MEDICAL CENTER HAS ELECTED TO APPLY THE OPTIONAL EXEMPTIONS PROVIDED IN FASB ASC 606-10-50-14(A) AND AS A RESULT IS NOT REQUIRED TO DISCLOSE THE AGGREGATE AMOUNT OF THE TRANSACTION PRICE ALLOCATED TO PERFORMANCE OBLIGATIONS THAT ARE UNSATISFIED OR PARTIALLY UNSATISFIED AT THE END OF THE REPORTING PERIOD. THE UNSATISFIED OR PARTIALLY UNSATISFIED PERFORMANCE OBLIGATIONS REFERRED TO ABOVE ARE PRIMARILY RELATED TO INPATIENT ACUTE CARE SERVICES AT THE END OF THE REPORTING PERIOD. THE PERFORMANCE OBLIGATIONS FOR THESE CONTRACTS ARE GENERALLY COMPLETED WHEN THE PATIENTS ARE DISCHARGED, WHICH GENERALLY OCCURS WITHIN DAYS OR WEEKS OF THE END OF THE REPORTING PERIOD. THE MEDICAL CENTER DETERMINES THE TRANSACTION PRICE BASED ON STANDARD CHARGES FOR SERVICES PROVIDED, REDUCED BY CONTRACTUAL ADJUSTMENTS PROVIDED TO THIRD PARTY PAYORS, DISCOUNTS PROVIDED TO UNINSURED OR UNDERINSURED PATIENTS IN ACCORDANCE WITH THE MEDICAL CENTER'S POLICIES AND/OR IMPLICIT PRICE CONCESSIONS PROVIDED TO UNINSURED OR UNDERINSURED PATIENTS. THE MEDICAL CENTER DETERMINES ITS ESTIMATES OF CONTRACTUAL ADJUSTMENTS AND DISCOUNTS BASED ON CONTRACTUAL AGREEMENTS, ITS DISCOUNT POLICIES AND HISTORICAL EXPERIENCE. THE MEDICAL CENTER DETERMINES ITS ESTIMATES OF IMPLICIT PRICE CONCESSIONS BASED ON ITS HISTORICAL COLLECTION EXPERIENCE WITH A RESPECTIVE CLASS OF PATIENT. THE MEDICAL CENTER HAS ELECTED THE PRACTICAL EXPEDIENT ALLOWED UNDER FASB ASC 606-10-32-18 AND DOES NOT ADJUST THE PROMISED AMOUNT OF CONSIDERATION FROM PATIENTS AND THIRD PARTY PAYORS FOR THE EFFECTS OF A SIGNIFICANT FINANCING COMPONENT DUE TO THE MEDICAL CENTER'S EXPECTATION THAT THE PERIOD BETWEEN THE TIME THE SERVICE IS PROVIDED TO A PATIENT AND THE TIME THAT THE PATIENT OR A THIRD PARTY PAYOR PAYS FOR THAT SERVICE WILL BE ONE YEAR OR LESS. THE MEDICAL CENTER DOES, IN CERTAIN INSTANCES, ENTER INTO PAYMENT AGREEMENTS WITH PATIENTS THAT ALLOW PAYMENTS IN EXCESS OF ONE YEAR, HOWEVER, IN THESE CASES THE FINANCING COMPONENT IS NOT DEEMED TO BE SIGNIFICANT TO THE CONTRACT. CHARITY CARE ------------ THE MEDICAL CENTER PROVIDES CHARITY CARE TO PATIENTS WHO MEET CERTAIN CRITERIA WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE MEDICAL CENTER PROVIDES FREE CARE OR SLIDING FEE SCALES BASED ON FEDERAL POVERTY INCOME GUIDELINES OR WHEN IT IS DETERMINED THAT THE PATIENTS ARE UNABLE TO FULFILL THEIR OBLIGATIONS TO THE MEDICAL CENTER. BECAUSE THE MEDICAL CENTER DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUES.
SCHEDULE H, PART III, SECTION B; QUESTION 8	MEDICARE COSTS WERE DERIVED FROM THE 2022 MEDICARE COST REPORT. THE ORGANIZATION FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL), BAD DEBT AND ASSOCIATED COSTS ARE COMMUNITY BENEFIT AND ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. AS OUTLINED MORE FULLY BELOW, THE ORGANIZATION BELIEVES THAT THESE SERVICES AND RELATED COSTS PROMOTE THE HEALTH OF THE COMMUNITY AS A WHOLE AND ARE RENDERED IN CONJUNCTION WITH THE ORGANIZATION'S CHARITABLE TAX-EXEMPT PURPOSES AND MISSION IN PROVIDING MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER WITHOUT REGARD TO RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY AND CONSISTENT WITH THE COMMUNITY BENEFIT STANDARD PROMULGATED BY THE IRS. THE COMMUNITY BENEFIT STANDARD IS THE CURRENT STANDARD FOR A HOSPITAL FOR RECOGNITION AS A TAX-EXEMPT AND CHARITABLE ORGANIZATION UNDER INTERNAL REVENUE CODE ("IRC") 501(C)(3). THE ORGANIZATION IS RECOGNIZED AS A TAX-EXEMPT ENTITY AND CHARITABLE ORGANIZATION UNDER 501(C)(3) OF THE IRC. ALTHOUGH THERE IS NO DEFINITION IN THE TAX CODE FOR THE TERM "CHARITABLE" A REGULATION PROMULGATED BY THE DEPARTMENT OF THE TREASURY PROVIDES SOME GUIDANCE AND STATES THAT "THE TERM CHARITABLE IS USED IN SECTION 501(C)(3) IN ITS GENERALLY ACCEPTED LEGAL SENSE,PROVIDES EXAMPLES OF CHARITABLE PURPOSES, INCLUDING THE RELIEF OF THE POOR OR UNPRIVILEGED; THE PROMOTION OF SOCIAL WELFARE; AND THE ADVANCEMENT OF EDUCATION, RELIGION, AND SCIENCE. NOTE IT DOES NOT EXPLICITLY ADDRESS THE ACTIVITIES OF HOSPITALS. IN THE ABSENCE OF EXPLICIT STATUTORY OR REGULATORY REQUIREMENTS APPLYING THE TERM "CHARITABLE" TO HOSPITALS, IT HAS BEEN LEFT TO THE IRS TO DETERMINE THE CRITERIA HOSPITALS MUST MEET TO QUALIFY AS IRC 501(C)(3) CHARITABLE ORGANIZATIONS. THE ORIGINAL STANDARD WAS KNOWN AS THE CHARITY CARE STANDARD. THIS STANDARD WAS REPLACED BY THE IRS WITH THE COMMUNITY BENEFIT STANDARD WHICH IS THE CURRENT STANDARD. CHARITY CARE STANDARD IN 1956, THE IRS ISSUED REVENUE RULING 56-185, WHICH ADDRESSED THE REQUIREMENTS HOSPITALS NEEDED TO MEET IN ORDER TO QUALIFY FOR IRC 501(C)(3) STATUS. ONE OF THESE REQUIREMENTS IS KNOWN AS THE "CHARITY CARE STANDARD." UNDER THE STANDARD, A HOSPITAL MUST PROVIDE, TO THE EXTENT OF ITS FINANCIAL ABILITY, FREE OR REDUCED-COST CARE TO PATIENTS WHO CANNOT PAY FOR SUCH SERVICES. A HOSPITAL THAT EXPECTED FULL PAYMENT DID NOT, ACCORDING TO THE RULING, PROVIDE CHARITY CARE BASED ON THE FACT THAT SOME PATIENTS ULTIMATELY FAILED TO PAY. THE RULING EMPHASIZED THAT A LOW LEVEL OF CHARITY CARE DID NOT NECESSARILY MEAN THAT A HOSPITAL HAD FAILED TO MEET THE REQUIREMENT SINCE THAT LEVEL COULD REFLECT ITS FINANCIAL ABILITY TO PROVIDE SUCH CARE. THE RULING ALSO NOTED THAT PUBLICLY SUPPORTED COMMUNITY HOSPITALS WOULD NORMALLY QUALIFY AS CHARITABLE ORGANIZATIONS BECAUSE THEY SERVE THE ENTIRE COMMUNITY AND A LOW LEVEL OF CHARITY CARE WOULD NOT AFFECT A HOSPITAL'S EXEMPT STATUS IF IT WAS DUE TO THE SURROUNDING COMMUNITY'S LACK OF CHARITABLE DEMANDS. COMMUNITY BENEFIT STANDARD IN 1969, THE IRS ISSUED REVENUE RULING 69-545, WHICH "REMOVED" FROM REVENUE RULING 56-185 "THE REQUIREMENTS RELATING TO CARING FOR PATIENTS WITHOUT CHARGE OR AT RATES BELOW COST." UNDER THE STANDARD DEVELOPED IN REVENUE RULING 69-545, WHICH IS KNOWN AS THE "COMMUNITY BENEFIT STANDARD," HOSPITALS ARE JUDGED ON WHETHER THEY PROMOTE THE HEALTH OF A BROAD CLASS OF INDIVIDUALS IN THE COMMUNITY. THE RULING INVOLVED A HOSPITAL THAT ONLY ADMITTED INDIVIDUALS WHO COULD PAY FOR THE SERVICES (BY THEMSELVES, PRIVATE INSURANCE, OR PUBLIC PROGRAMS SUCH AS MEDICARE), BUT OPERATED A FULL-TIME EMERGENCY ROOM THAT WAS OPEN TO EVERYONE. THE IRS RULED THAT THE HOSPITAL QUALIFIED AS A CHARITABLE ORGANIZATION BECAUSE IT PROMOTED THE HEALTH OF PEOPLE IN ITS COMMUNITY. THE IRS REASONED THAT BECAUSE THE PROMOTION OF HEALTH WAS A CHARITABLE PURPOSE ACCORDING TO THE GENERAL LAW OF CHARITY, IT FELL WITHIN THE "GENERALLY ACCEPTED LEGAL SENSE" OF THE TERM "CHARITABLE," AS REQUIRED BY THE DEPARTMENT OF TREASURY REG. 1.501(C)(3)-1(D)(2). THE IRS RULING STATED THAT THE PROMOTION OF HEALTH, LIKE THE RELIEF OF POVERTY AND THE ADVANCEMENT OF EDUCATION AND RELIGION, IS ONE OF THE PURPOSES IN THE GENERAL LAW OF CHARITY THAT IS DEEMED BENEFICIAL TO THE COMMUNITY AS A WHOLE EVEN THOUGH THE CLASS OF BENEFICIARIES ELIGIBLE TO RECEIVE A DIRECT BENEFIT FROM ITS ACTIVITIES DOES NOT INCLUDE ALL MEMBERS OF THE COMMUNITY, SUCH AS INDIGENT MEMBERS OF THE COMMUNITY, PROVIDED THAT THE CLASS IS NOT SO SMALL THAT ITS RELIEF IS NOT OF BENEFIT TO THE COMMUNITY. THE IRS CONCLUDED THAT THE HOSPITAL WAS "PROMOTING THE HEALTH OF A CLASS OF PERSONS THAT IS BROAD ENOUGH TO BENEFIT THE COMMUNITY" BECAUSE ITS EMERGENCY ROOM WAS OPEN TO ALL AND IT PROVIDED CARE TO EVERYONE WHO COULD PAY, WHETHER DIRECTLY OR THROUGH THIRD-PARTY REIMBURSEMENT. OTHER CHARACTERISTICS OF THE HOSPITAL THAT THE IRS HIGHLIGHTED INCLUDED THE FOLLOWING: ITS SURPLUS FUNDS WERE USED TO IMPROVE PATIENT CARE, EXPAND HOSPITAL FACILITIES, AND ADVANCE MEDICAL TRAINING, EDUCATION AND RESEARCH; IT WAS CONTROLLED BY A BOARD OF TRUSTEES THAT CONSISTED OF INDEPENDENT CIVIC LEADERS; AND HOSPITAL MEDICAL STAFF PRIVILEGES WERE AVAILABLE TO ALL QUALIFIED PHYSICIANS. THE AMERICAN HOSPITAL ASSOCIATION ("AHA") FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT ARE COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THIS ORGANIZATION AGREES WITH THE AHA'S POSITION. AS OUTLINED IN THE AHA'S LETTER TO THE IRS DATED AUGUST 21, 2007 WITH RESPECT TO THE FIRST PUBLISHED DRAFT OF THE NEW FORM 990 AND SCHEDULE H, THE AHA FELT THAT THE IRS SHOULD INCORPORATE THE FULL VALUE OF THE COMMUNITY BENEFIT THAT HOSPITALS PROVIDE BY COUNTING MEDICARE UNDERPAYMENTS (SHORTFALL) AS QUANTIFIABLE COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: - PROVIDING CARE FOR THE ELDERLY AND SERVING MEDICARE PATIENTS IS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD. - MEDICARE, LIKE MEDICAID, DOES NOT PAY THE FULL COST OF CARE. FROM THE LATEST DATA PROVIDED BY THE AHA, MEDICARE REIMBURSES HOSPITALS ONLY 87 CENTS FOR EVERY DOLLAR THEY SPEND TO TAKE CARE OF MEDICARE PATIENTS. - MANY MEDICARE BENEFICIARIES, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR. MORE THAN 42 PERCENT OF MEDICARE SPENDING IS FOR BENEFICIARIES WHOSE INCOME IS BELOW 200 PERCENT OF THE FEDERAL POVERTY LEVEL. MANY OF THOSE MEDICARE BENEFICIARIES ARE ALSO ELIGIBLE FOR MEDICAID -- SO CALLED ELIGIBLE." THERE IS EVERY COMPELLING PUBLIC POLICY REASON TO TREAT MEDICARE AND MEDICAID UNDERPAYMENTS SIMILARLY FOR PURPOSES OF A HOSPITAL'S COMMUNITY BENEFIT AND INCLUDE THESE COSTS ON FORM 990, SCHEDULE H, PART I. MEDICARE UNDERPAYMENT MUST BE SHOULDERED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE COMMUNITY'S ELDERLY AND POOR. THESE UNDERPAYMENTS REPRESENT A REAL COST OF SERVING THE COMMUNITY AND SHOULD COUNT AS A QUANTIFIABLE COMMUNITY BENEFIT. BOTH THE AHA AND THIS ORGANIZATION ALSO FEEL THAT PATIENT BAD DEBT IS A COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. LIKE MEDICARE UNDERPAYMENT (SHORTFALLS), THERE ALSO ARE COMPELLING REASONS THAT PATIENT BAD DEBT SHOULD BE COUNTED AS QUANTIFIABLE COMMUNITY BENEFIT AS FOLLOWS: - A SIGNIFICANT MAJORITY OF BAD DEBT IS ATTRIBUTABLE TO LOW-INCOME PATIENTS, WHO, FOR MANY REASONS, DECLINE TO COMPLETE THE FORMS REQUIRED TO ESTABLISH ELIGIBILITY FOR HOSPITALS' CHARITY CARE OR THOSE WHO DO NOT PAY ALL, OR A PORTION OF THE ALREADY DISCOUNTED BILLED AMOUNTS UNDER OUR FINANCIAL ASSISTANCE POLICY. A 2006 CONGRESSIONAL BUDGET OFFICE ("CBO") REPORT, NONPROFIT HOSPITALS AND THE PROVISION OF COMMUNITY BENEFITS, CITED TWO STUDIES INDICATING THAT "THE GREAT MAJORITY OF BAD DEBT WAS ATTRIBUTABLE TO PATIENTS WITH INCOMES BELOW 200% OF THE FEDERAL POVERTY LINE." - THE REPORT ALSO NOTED THAT A SUBSTANTIAL PORTION OF BAD DEBT IS PENDING CHARITY CARE. UNLIKE BAD DEBT IN OTHER INDUSTRIES, HOSPITAL BAD DEBT IS COMPLICATED BY THE FACT THAT HOSPITALS FOLLOW THEIR MISSION TO THE COMMUNITY AND TREAT EVERY PATIENT THAT COMES THROUGH THEIR EMERGENCY DEPARTMENT, REGARDLESS OF ABILITY TO PAY. PATIENTS WHO HAVE OUTSTANDING BILLS ARE NOT TURNED AWAY, UNLIKE OTHER INDUSTRIES. BAD DEBT IS FURTHER COMPLICATED BY THE AUDITING INDUSTRY'S STANDARDS ON REPORTING CHARITY CARE. MANY PATIENTS CANNOT OR DO NOT PROVIDE THE NECESSARY, EXTENSIVE DOCUMENTATION REQUIRED TO BE DEEMED CHARITY CARE BY AUDITORS. AS A RESULT, ROUGHLY 40% OF BAD DEBT IS PENDING CHARITY CARE. THE CBO CONCLUDED THAT ITS FINDINGS "SUPPORT THE VALIDITY OF THE USE OF UNCOMPENSATED CARE [BAD DEBT AND CHARITY CARE] AS A MEASURE OF COMMUNITY BENEFIT" ASSUMING THE FINDINGS ARE GENERALIZABLE NATIONWIDE; THE EXPERIENCE OF HOSPITALS AROUND THE NATION REINFORCES THAT THEY ARE GENERALIZABLE. AS OUTLINED BY THE AHA, DESPITE THE HOSPITAL'S BEST EFFORTS AND DUE DILIGENCE, PATIENT BAD DEBT IS A PART OF THE HOSPITAL'S MISSION AND CHARITABLE PURPOSES. BAD DEBT REPRESENTS PART OF THE BURDEN HOSPITALS SHOULDER IN SERVING ALL PATIENTS R
SCHEDULE H, PART III, SECTION B; QUESTION 9B	ALL PATIENTS WITH SELF PAY BALANCES RELATED TO SERVICES RENDERED AT RICHMOND UNIVERSITY MEDICAL CENTER ARE GIVEN THE OPPORTUNITY TO ADDRESS THEIR RESPONSIBILITY THROUGH A PAYMENT ARRANGEMENT OR A REDUCED FEE, BASED ON THE CRITERIA OF OUR FINANCIAL ASSISTANCE PROGRAM. A SLIDING FEE SCALE IS UTILIZED AND IS BASED UPON FAMILY INCOME AND NUMBER OF FAMILY MEMBERS. ALL PATIENTS WILL RECEIVE STATEMENTS AND/OR LETTERS AND ARE GIVEN THE OPPORTUNITY TO SATISFY THEIR OBLIGATION TO THE FACILITY PRIOR TO TRANSFER TO A COLLECTION AGENCY AND WRITE-OFF TO A BAD DEBT. PATIENTS WHO CANNOT AFFORD TO PAY ARE OFFERED INSTALLMENT PAYMENTS OR A REDUCTION IN BALANCE THROUGH THE FINANCIAL ASSISTANCE PROGRAM.
SCHEDULE H, PART VI; QUESTION 2	RICHMOND UNIVERSITY MEDICAL CENTER'S (RUMC) BOARD, ADMINISTRATION AND STAFF FUNCTION FROM AN UNDERSTANDING THAT HEALTH IS THE CORNERSTONE OF A PRODUCTIVE AND POSITIVE QUALITY-OF-LIFE FOR EVERY STATEN ISLANDER. AS SUCH, OUR FOCUS IS NOT ONLY ON HEALING THE SICK, BUT ALSO UNDERSTANDING THE ROOT CAUSE OF CONDITIONS AFFECTING STATEN ISLANDERS AND WHAT WE CAN DO TO PREVENT THE DISEASE PROCESSES PREVALENT IN OUR COMMUNITY. RUMC UTILIZES A VARIETY OF SOURCES AND APPROACHES TO IDENTIFY THE HEALTH NEEDS OF THE COMMUNITY WE SERVE. COMMUNITY BENEFIT PLANNING IS FORMULATED AROUND INFORMATION GATHERED FROM CONSOLIDATING DATA FROM NEW YORK STATE AND NEW YORK CITY DEPARTMENTS OF HEALTH AND OBTAINING PERSPECTIVES FROM KEY COMMUNITY ORGANIZATIONS AND STAKEHOLDERS ON THE CRITICAL HEALTHCARE ISSUES FACING STATEN ISLAND. THROUGH DATA OBTAINED FROM THE NEW YORK STATE DEPARTMENT OF HEALTH AND NEW YORK CITY DEPARTMENT OF HEALTH, AS WELL AS COLLABORATIONS WITH HEALTHCARE AND OTHER KEY COMMUNITY STAKEHOLDERS, RUMC COORDINATES A UNIFIED EFFORT TO PROVIDE PROGRAMS THAT IMPACT THE HEALTH AND WELL-BEING OF OUR COMMUNITY. TO ENSURE OUR SERVICES ARE ALIGNED WITH THE HEALTHCARE NEEDS OF OUR COMMUNITY, WE CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) EVERY THREE YEARS. THIS STUDY HELPS US TO DETERMINE AND PORTRAY HEALTH STATUS, GATHER STAKEHOLDER PERSPECTIVES, DEFINE EXISTING COMMUNITY ASSETS, AND ULTIMATELY BETTER SERVE OUR COMMUNITY. RUMC REPRESENTATIVES LEAD THE CHNA AND OVERSAW RESEARCH AND STAKEHOLDER ENGAGEMENT. STEERING COMMITTEE MEMBERS ARE LISTED BELOW, ALONG WITH THE CONSULTANT TEAM MEMBERS. COMMUNITY HEALTH CONSULTANTS ASSISTED IN ALL PHASES OF THE CHNA, INCLUDING PROJECT MANAGEMENT, DATA COLLECTION AND ANALYSIS, AND REPORT WRITING. THE CHNA INCLUDED QUANTITATIVE AND QUALITATIVE RESEARCH METHODS TO DETERMINE HEALTH TRENDS AND DISPARITIES WITHIN STATEN ISLAND. PRIMARY STUDY METHODS WERE USED TO SOLICIT INPUT FROM KEY COMMUNITY STAKEHOLDERS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY. SECONDARY STUDY METHODS WERE USED TO IDENTIFY AND ANALYZE STATISTICAL DEMOGRAPHIC AND HEALTH TRENDS. SPECIFIC CHNA STUDY METHODS INCLUDED: - AN ANALYSIS OF SECONDARY DATA SOURCES, INCLUDING PUBLIC HEALTH, DEMOGRAPHIC, AND SOCIAL MEASURES; AND - A KEY INFORMANT SURVEY WITH 22 COMMUNITY REPRESENTATIVES TO SOLICIT FEEDBACK ON COMMUNITY HEALTH PRIORITIES, UNDERSERVED POPULATIONS, AND PARTNERSHIP OPPORTUNITIES.
SCHEDULE H, PART VI; QUESTION 3	IN FURTHERANCE OF ITS CHARITABLE PURPOSES, RUMC PROVIDES HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY WAY, REGARDLESS OF RACE, COLOR, CREED OR ETHNICITY. RUMC CONTINUES TO PROVIDE REDUCED-FEE OR FREE CARE IN ACCORDANCE WITH PUBLIC LAW 2807(K)(9-A). ALTHOUGH NOT REQUIRED BY THIS LAW, WE DO EXTEND THIS POLICY TO INDIVIDUALS WHO MAY NOT BE QUALIFIED BASED ON THE GUIDELINES OF OUR FINANCIAL ASSISTANCE POLICY BUT DO DEMONSTRATE AN INABILITY TO PAY ALL OF THEIR MEDICAL EXPENSES. AS PART OF BEST-PRACTICE CARE, RUMC IS IN COMMUNICATION WITH LOCAL COMMUNITY-BASED CONSUMER ADVOCATE ORGANIZATIONS TO BE CERTAIN THAT THEY ARE AWARE OF THE PROVISIONS OF OUR FINANCIAL AID POLICY. THE PATIENT ACCESS DEPARTMENT HAS RECEIVED SUMMARY DATA OF THE LAW AND OUR REQUIREMENTS. ASSISTANCE CONTINUES TO BE OFFERED BY OUR FINANCIAL SCREENING STAFF AND MEDICAL APPLICATION OFFICE TO THOSE INDIVIDUALS NOT ELIGIBLE FOR MEDICAID, AS WELL AS FINANCIAL SCREENING STAFF LOCATED IN OUR EMERGENCY DEPARTMENT. RUMC POSTS THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY SUMMARY AND FINANCIAL ASSISTANCE CONTACT INFORMATION IN MANY DIFFERENT LANGUAGES (AS DETERMINED BY RUMC'S ANNUAL LANGUAGE NEEDS ASSESSMENT) IN LOCATIONS SUCH AS THE EMERGENCY DEPARTMENT, INTAKE, REGISTRATION AND ADMISSION AREAS. PATIENTS ARE PROVIDED A SUMMARY OF THE POLICY AND FINANCIAL ASSISTANCE CONTACT INFORMATION AS PART OF THE INTAKE PROCESS AND FINANCIAL SCREENING PROCESS. PATIENT BILLS INCLUDE A STATEMENT ON FINANCIAL ASSISTANCE. EVERY PATIENT SEEN IN THE FINANCIAL OFFICE HAS A DISCUSSION ON THE AVAILABILITY OF GOVERNMENT BENEFITS SUCH AS MEDICAID AND AT THE SAME TIME QUALIFICATIONS ON THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. RUMC HAS AN INTERDISCIPLINARY TEAM THAT INTERACTS WITH FINANCIAL ASSISTANCE COUNSELORS SUCH AS SOCIAL WORKERS AND CASE MANAGERS TO IDENTIFY AND ASSIST ELIGIBLE PATIENTS. STAFF TRAINING ON FINANCIAL ASSISTANCE IS DONE ANNUALLY THROUGH AN IN-SERVICE PROGRAM THAT INCLUDES A REVIEW OF HOW TO QUALIFY PATIENTS FOR MEDICAID AND OTHER GOVERNMENT PROGRAMS. ALL THIRD PARTIES THAT WORK FOR RUMC IN THE COLLECTION OF FEES ARE REQUIRED TO FOLLOW THE HOSPITAL'S POLICIES REGARDING PATIENT NOTIFICATION ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE. RUMC'S FINANCIAL ASSISTANCE POLICY CLEARLY STATES THAT MEDICAL CARE IS PROVIDED TO INDIVIDUALS IN NEED, REGARDLESS OF THEIR ABILITY TO PAY AND MAKES CERTAIN THAT ALL REQUESTS FOR FINANCIAL ASSISTANCE ARE EVALUATED AND PROCESSED FAIRLY AND CONSISTENTLY WITH DIGNITY, COMPASSION AND IN A RESPECTFUL MANNER, CONSISTENT WITH ITS MISSION AND VALUES.
SCHEDULE H, PART VI; QUESTION 4	RUMC SERVES RESIDENTS OF STATEN ISLAND, ONE OF THE FIVE BOROUGHS COMPRISING NYC. STATEN ISLAND IS DIVIDED GEOGRAPHICALLY INTO THREE AREAS: NORTH SHORE, MID-ISLAND, AND SOUTH SHORE. RUMC IS LOCATED WITHIN THE NORTH SHORE AND PRIMARILY SERVES RESIDENTS OF THIS AREA. THE POPULATION OF THE NORTH SHORE IS UNIQUELY DIVERSE. A RECENT REPORT BY THE CITIZEN'S COMMITTEE FOR CHILDREN OF NEW YORK STATED, "THE NORTH SHORE IS ONE OF ONLY 10 COMMUNITY DISTRICTS IN THE CITY WHERE NO RACIAL/ETHNIC GROUP REPRESENTS MORE THAN 40% OF THE POPULATION. HOWEVER, ACROSS THE SEVEN NEIGHBORHOODS THAT MAKE UP THE NORTH SHORE, THE DEMOGRAPHIC CHARACTERISTICS OF THE POPULATION AND OUTCOMES VARY GREATLY. FOR EXAMPLE, CAUCASIAN RESIDENTS MAKE UP MORE THAN 70% OF THE POPULATION IN WESTERLEIGH, WHILE AFRICAN AMERICAN AND LATINO RESIDENTS MAKE UP MORE THAN 70% OF THE POPULATION IN GRYMES HILL-PARK HILL." ECONOMIC INDICATORS FOR THE NORTH SHORE ARE ALSO UNIQUE WITH NOTABLE DIFFERENCES IN INCOME ACROSS NEIGHBORHOODS, AND A HIGH PROPORTION OF RESIDENTS BOTH LIVING IN POVERTY AND AFFLUENCE. THE POPULATION OF STATEN ISLAND IS MORE SIMILAR TO THE NATION THAN THE OTHER NYC BOROUGHS IN TERMS OF RACIAL COMPOSITION, WITH CAUCASIANS REPRESENTING THE MAJORITY, BUT CURRENT POPULATION PROJECTIONS ANTICIPATE INCREASING DIVERSITY IN YEARS TO COME. LATINX RESIDENTS ARE AMONG THE FASTEST GROWING DEMOGRAPHIC IN STATEN ISLAND. RELATED TO AGE, STATEN ISLAND RESIDENTS ARE SLIGHTLY OLDER THAN OTHER NEW YORKERS, AS EVIDENCED BY A MEDIAN AGE OF 39.5 VERSUS 36.8. STRONG FINANCIAL INDICATORS ARE ASSOCIATED WITH A HIGH QUALITY OF LIFE AND SUPPORT POSITIVE HEALTH OUTCOMES. STATEN ISLANDERS ARE GENERALLY MORE FINANCIALLY COMFORTABLE THAN MOST OTHER NEW YORKERS. THIS FINDING IS EVIDENCED BY A HIGH MEDIAN INCOME ($82,540), LOW POVERTY (13%), LOW UNEMPLOYMENT (3.6%), AND HIGH PERCENTAGE OF HOMEOWNERS (64.9%). HOWEVER, WHEN STRATIFIED BY RACE, AFRICAN AMERICANS AND LATINXS ARE MORE LIKELY TO LIVE IN POVERTY THAN OTHER DEMOGRAPHIC GROUPS IN STATEN ISLAND. WHEN REVIEWED AT THE ZIP CODE LEVEL, STATEN ISLAND ZIP CODES THAT ARE MORE RACIALLY DIVERSE AND HAVE A YOUNGER POPULATION TEND TO EXPERIENCE GREATER SOCIOECONOMIC NEED. EDUCATION IS A STRONG INDICATOR OF COMMUNITY ECONOMIC STABILITY, QUALITY OF LIFE, AND HEALTH OUTCOMES. STATEN ISLANDERS ARE MORE LIKELY TO COMPLETE HIGH SCHOOL THAN THEIR PEERS ACROSS NYC AND THE NATION, AND ROUGHLY 1 IN 3 ADULTS HAVE COMPLETED A BACHELOR'S DEGREE OR HIGHER. WHEN STRATIFIED BY RACE, AFRICAN AMERICANS AND LATINXS IN STATEN ISLAND ARE MORE LIKELY TO HAVE COMPLETED A BACHELOR'S DEGREE OR HIGHER THAN THEIR PEERS IN NYC, BUT LESS LIKELY WHEN COMPARED TO OTHER DEMOGRAPHIC GROUPS WITHIN STATEN ISLAND. THE 2018 POPULATION OF STATEN ISLAND IS 485,143; APPROXIMATELY 42% OF RESIDENTS LIVE IN THE NORTH SHORE. THE NORTH SHORE EXPERIENCED THE GREATEST POPULATION GROWTH OF THE THREE STATEN ISLAND REGIONS FROM 2010 TO 2018 (2.7%) AND IS PROJECTED TO EXPERIENCE THE GREATEST GROWTH THROUGH 2023 (2.7%). STATEN ISLAND OVERALL IS PROJECTED TO EXPERIENCE 2.4% POPULATION GROWTH BY 2023 COMPARED TO 3.3% ACROSS NYC. ALTHOUGH STATEN ISLAND IS ONE OF NYC'S FIVE BOROUGHS, ITS RACIAL COMPOSITION MORE CLOSELY MIRRORS THE US. IN STATEN ISLAND, THE MAJORITY OF RESIDENTS ARE CAUCASIAN (70.1%), WITH ROUGHLY 1 IN 5 RESIDENTS LATINX OF ANY RACE. POPULATION PROJECTIONS PREDICT THAT BY 2023, STATEN ISLAND WILL BE MORE DIVERSE THAN TODAY, CONSISTENT WITH TRENDS ANTICIPATED IN THE NATION IN GENERAL. THE POPULATION IN STATEN ISLAND IS SLIGHTLY OLDER THAN NYC AND THE NATION IN GENERAL. NEARLY 1 IN 3 HOUSEHOLDS IN STATEN ISLAND REPORT SPEAKING A LANGUAGE OTHER THAN ENGLISH AT HOME, MORE THAN THE NATION, BUT LOWER THAN NYC OVERALL. AMONG INDIVIDUALS SPEAKING A LANGUAGE OTHER THAN ENGLISH, 40.5% SPEAK AN INDO-EUROPEAN LANGUAGE (E.G. ITALIAN, GERMAN) AND 34.5% SPEAK SPANISH. THIS FINDING IS CONSISTENT WITH THE ETHNIC AND ANCESTRAL MAKEUP OF STATEN ISLAND. RESIDENTS OF STATEN ISLAND HAVE HIGHER INCOMES AND ARE LESS LIKELY TO LIVE IN POVERTY THAN OTHER RESIDENTS OF NYC. WHILE THE MEDIAN INCOME IN STATEN ISLAND IS NOTICEABLY GREATER THAN THE NATION IN GENERAL, THE PROPORTION OF ADULTS AND CHILDREN EXPERIENCING POVERTY IS SIMILAR, SUGGESTING INCOME DISPARITY WITHIN STATEN ISLAND. WHEN STRATIFIED BY RACE, THE PERCENT OF AFRICAN AMERICAN AND LATINX PEOPLE LIVING IN POVERTY IN STATEN ISLAND IS SIMILAR TO NYC OR THE NATION IN GENERAL. CAUCASIAN PEOPLE AND ASIAN PEOPLE IN STATE ISLAND ARE LESS LIKELY TO EXPERIENCE POVERTY THAN THEIR PEERS IN NYC. THIS FINDING SUGGESTS THAT RACE AND ETHNICITY HAS AN EFFECT ON THE ECONOMIC DISPARITY SEEN IN STATEN ISLAND. UNEMPLOYMENT IN STATEN ISLAND IS LOW. RESIDENTS OF ALL RACES AND ETHNICITIES ARE LESS LIKELY TO BE UNEMPLOYED THAN THEIR PEERS IN NYC AND THROUGHOUT THE NATION. WORKERS LIVING IN STATEN ISLAND ARE MORE LIKELY TO HAVE WHITE COLLAR JOBS THAN BLUE COLLAR JOBS, BUT IN PROPORTIONS CONSISTENT WITH NYC AND THE NATION AS A WHOLE. RESIDENTS OF STATEN ISLAND ARE MORE THAN TWICE AS LIKELY AS OTHER NEW YORKERS TO OWN THEIR HOMES. WHILE THE MEDIAN HOME VALUE IN STATEN ISLAND IS NEARLY $100,000 LESS THAN NYC IN GENERAL, IT IS STILL MORE THAN TWO TIMES GREATER THAN THE NATIONAL MEDIAN. THE PROPORTION OF RENTERS AND HOMEOWNERS IN STATEN ISLAND IS SIMILAR TO THE NATION, BUT HOMEOWNERS IN STATEN ISLAND ARE MORE LIKELY TO BE COST BURDENED BY THEIR HOME THAN HOMEOWNERS ACROSS THE NATION. EDUCATION IS A STRONG INDICATOR OF COMMUNITY ECONOMIC STABILITY. STATEN ISLAND RESIDENTS HAVE MORE YEARS OF EDUCATION THAN OTHER NEW YORKERS AND MOST AMERICANS. WHEN VIEWED AS A WHOLE, 1 IN 3 STATEN ISLAND RESIDENTS HAS COMPLETED A BACHELOR'S DEGREE OR HIGHER, WHILE ROUGHLY 1 IN 10 DID NOT COMPLETE HIGH SCHOOL. BOTH OF THESE INDICATORS REPRESENT BETTER OUTCOMES THAN NYC OR THE NATION.
SCHEDULE H, PART VI; QUESTION 5	RICHMOND UNIVERSITY MEDICAL CENTER IS A LICENSED 400-PLUS BED HOSPITAL, ONE OF ONLY TWO PRIVATE HOSPITALS SERVING THE ENTIRE POPULATION OF THE BOROUGH. PURSUANT TO ITS CHARITABLE PURPOSES, RUMC PROVIDES HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. MOREOVER, IT OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545: 1. PROVIDES HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF-PAY, MEDICARE AND MEDICAID PATIENTS; 2. OPERATES AN EMERGENCY DEPARTMENT FOR ALL PERSONS; WHICH IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR; 3. MAINTAINS AN OPEN MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; 4. CONTROL RESTS WITH ITS BOARD OF TRUSTEES WHICH IS COMPRISED OF INDEPENDENT CIVIC LEADERS AND OTHER PROMINENT MEMBERS OF THE COMMUNITY; AND 5. SURPLUS FUNDS ARE USED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND RENOVATE FACILITIES AND ADVANCE MEDICAL CARE, PROGRAMS AND ACTIVITIES. SURPLUS FUNDS ARE REINVESTED IN THE ORGANIZATION, PRINCIPALLY THROUGH CAPITAL INVESTMENT, AND ALSO TO MEET FUTURE PROGRAMMATIC NEEDS, WHICH MEETS THE ORGANIZATION'S COMMITMENT TO MEET THE EXPECTATIONS OF ITS PATIENTS BY PROVIDING QUALITY HEALTHCARE AND THEREFORE, MAKES THESE INVESTMENTS TO SECURE ITS FUTURE OF SERVICE DELIVERY TO THE COMMUNITY. THE OPERATIONS OF THE HOSPITAL AS SHOWN THROUGH THE FACTORS OUTLINED ABOVE AND OTHER INFORMATION CONTAINED HEREIN, CLEARLY DEMONSTRATE THAT THE USE AND CONTROL IS FOR THE BENEFIT OF THE PUBLIC AND THAT NO PART OF THE INCOME OR NET EARNINGS OF THE ORGANIZATION INURES TO THE BENEFIT OF ANY PRIVATE INDIVIDUAL NOR IS ANY PRIVATE INTEREST BEING SERVED OTHER THAN INCIDENTALLY. IN ADDITION, RUMC COMMUNITY OUTREACH INITIATIVES, INCLUDING EDUCATION AND SCREENING, REACH THOUSANDS EACH YEAR. THE HOSPITAL IS THE MAIN SPONSOR AND/OR ACTIVE PARTICIPANT IN SEVERAL ANNUAL HEALTH RELATED EVENTS ON STATEN ISLAND, INCLUDING THE STATEN ISLAND ECONOMIC DEVELOPMENT CORPORATION'S HEALTH AND WELLNESS CONFERENCE HELD EACH FALL. THE CONFERENCE OFFERS THOUSANDS OF RESIDENTS A FORUM TO HAVE ACCESS TO EDUCATIONAL MATERIALS, SPEAK WITH PHYSICIANS AND HEALTHCARE PROFESSIONALS, AND HAVE HEALTH SCREENINGS CONDUCTED ON THE PREMISES. OUR COMMUNITY OUTREACH TEAM, KNOWN AS TRAUMA, ATTENDS OVER 100 COMMUNITY EVENTS EACH YEAR, PROVIDING BROCHURES, EDUCATIONAL MATERIALS, AND HANDS ON TRAINING TO THOUSANDS OF ADULTS AND CHILDREN ANNUALLY. PROGRAMS THEY PROVIDE INCLUDE "STOP THE BLEED", WHICH DISCUSSES HOW TO HANDLE BLEEDING EMERGENCIES, AND HANDS ON CPR WHICH SHOWS PEOPLE THE BASICS OF CARDIOPULMONARY RESUSCITATION. FOR MORE THAN 30 YEARS RUMC'S WIC PROGRAM HAS SUCCESSFULLY SERVED THE POOR WOMEN, INFANTS AND CHILDREN OF STATEN ISLAND. THE MISSION IS TO IMPROVE THE NUTRITION AND HEALTH STATUS OF ELIGIBLE WOMEN, INFANTS AND CHILDREN THROUGH THE PROVISION OF NUTRITIOUS FOODS, NUTRITION EDUCATION, COUNSELING AND LINKING PARTICIPANTS TO HEALTH AND HUMAN SERVICES. WIC SERVICES ASSIST WOMEN AND CHILDREN WHO HAVE LOW INCOME, ARE UNDOCUMENTED CITIZENS, ARE UNINSURED, TEENAGERS, UNWED MOTHERS, VICTIMS OF DOMESTIC VIOLENCE, AND FOSTER CHILDREN. OVER 50% OF THE PEOPLE ACCESSING SERVICES AT THE WIC SITE ARE HISPANIC. RUMC HAS A WELL-ESTABLISHED HISTORY OF WORKING WITH OTHER COMMUNITY MENTAL HEALTH ORGANIZATIONS TO WORK COLLABORATIVELY TO ASSIST THOSE IN THE BOROUGH WITH MENTAL HEALTH ISSUES. AMONG ITS PARTNERS ARE THE STATEN ISLAND MENTAL HEALTH SOCIETY, AND JEWISH BOARD OF FAMILY AND CHILDREN SERVICES. RUMC ALSO MAINTAINS RELATIONSHIPS WITH THE LOCAL COMMUNITY ORGANIZATIONS IN ITS VICINITY AND WITH STATEN ISLAND COMMUNITY BOARD. THE COMMUNITY HEALTH ACTION CENTER, STATEN ISLAND CHAMBER OF COMMERCE, PROJECT HOSPITALITY, AND THE PORT RICHMOND COMMUNITY HEALTH CENTER ARE JUST A FEW OF THE LOCAL ORGANIZATIONS RUMC MAINTAINS PARTNERSHIPS WITH. HOSPITAL ADMINISTRATION AND MEMBERS OF THE BOARD OF TRUSTEES VISIT ALBANY ANNUALLY TO LOBBY FOR HEALTHCARE ISSUES AND TO SPEAK WITH STATE HEALTH OFFICIALS. IN ADDITION TO THE COMMUNITY, RUMC MAINTAINS REGULAR COMMUNICATIONS WITH ALL OF STATEN ISLAND'S ELECTED OFFICIALS INCLUDING THE BOROUGH PRESIDENT. THESE PARTNERS ARE MET WITH ON A REGULAR BASIS ALLOWING ADMINISTRATION TO PROVIDE UPDATES ON SERVICE AND SEEK SUPPORT FROM THEM FOR ISSUES IMPORTANT TO THE HOSPITAL.
SCHEDULE H, PART VI; QUESTION 6	OUTLINED BELOW IS A SUMMARY OF THE ENTITIES WHICH COMPRISES RICHMOND MEDICAL CENTER D/B/A RICHMOND UNIVERSITY MEDICAL CENTER ("RICHMOND UNIVERSITY MEDICAL CENTER") AND ITS AFFILIATES: BRIDGE REGIONAL HEALTH SYSTEM ----------------------------- BRIDGE REGIONAL HEALTH SYSTEM IS THE PARENT ENTITY OF THE SYSTEM. THIS INTEGRATED HEALTHCARE DELIVERY SYSTEM CONSISTS OF A GROUP OF AFFILIATED HEALTHCARE ORGANIZATIONS. THE SOLE MEMBER OF EACH AFFILIATE IS EITHER BRIDGE REGIONAL HEALTH SYSTEM OR RICHMOND UNIVERSITY MEDICAL CENTER. RICHMOND UNIVERSITY MEDICAL CENTER ---------------------------------- RICHMOND UNIVERSITY MEDICAL CENTER ("RUMC") WAS FOUNDED IN 2007 AND IS CURRENTLY A 448-LICENSED BED, MAJOR TEACHING, ACUTE CARE HOSPITAL LOCATED IN STATEN ISLAND, NEW YORK. RUMC IS I A NOT-FOR-PROFIT HEALTH CARE PROVIDER SERVING THE ETHNICALLY DIVERSE COMMUNITY OF STATEN ISLAND AND ITS NEIGHBORS. WE PROVIDE PREMIER QUALITY PATIENT CARE THROUGH A FULL SPECTRUM OF EMERGENT, ACUTE, PRIMARY, BEHAVIORAL HEALTH AND EDUCATIONAL SERVICES. WE DO THIS IN AN ENVIRONMENT THAT PROMOTES THE HIGHEST SATISFACTION AMONG PATIENTS, FAMILIES, PHYSICIANS AND STAFF. ON JANUARY 1, 2019, THE RICHMOND ACQUIRED CERTAIN ASSETS AND ASSUMED CERTAIN LIABILITIES OF STATEN ISLAND MENTAL HEALTH SOCIETY, INC., A NOT-FOR-PROFIT ORGANIZATION THAT PROVIDES COMPREHENSIVE MENTAL HEALTH, EARLY CHILDHOOD AND RELATED SERVICES TO STATEN ISLAND CHILDREN AND THEIR FAMILIES. EFFECTIVE JANUARY 1, 2022, RICHMOND ACQUIRED CERTAIN ASSETS AND ASSUMED CERTAIN LIABILITIES OF VISITING NURSE ASSOCIATION OF STATEN ISLAND, INC. AND SUBSIDIARIES (VNA), A NOT-FOR-PROFIT ORGANIZATION THAT IS A CERTIFIED HOME HEALTH AGENCY. RUMC IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, THE ORGANIZATION PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. MOREOVER, IT OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. AMBOY MEDICAL PRACTICE, P.C. ---------------------------- AMBOY MEDICAL PRACTICE, P.C. IS A NOT-FOR-PROFIT ORGANIZATION FOUNDED IN 2008. THE ORGANIZATION IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND IS A SUPPORTING ORGANIZATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THE ORGANIZATION IS STRUCTURED AS A PROFESSIONAL CORPORATION PURSUANT TO THE PROVISIONS OF THE CORPORATE PRACTICE OF MEDICINE ACT. THE ORGANIZATION'S PURPOSE IS TO PROVIDE PHYSICIAN SERVICES TO FURTHER THE CHARITABLE AND HEALTHCARE PURPOSES OF THE SYSTEM. THE ORGANIZATION'S BOARD-CERTIFIED TEAM OF EXPERIENCED PHYSICIANS AND MEDICAL PROVIDERS ARE COMMITTED TO IMPROVING THE HEALTH OF OUR PATIENTS SUFFERING FROM ILLNESS, ACUTE OR CHRONIC CONDITIONS, OR IN NEED OF ADDITIONAL MEDICAL ASSISTANCE. RICHMOND MEDICAL CENTER FOUNDATION, INC. ---------------------------------------- RICHMOND MEDICAL CENTER FOUNDATION, INC. IS NOT-FOR-PROFIT ORGANIZATION FOUNDED IN 2009. THE ORGANIZATION IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THROUGH FUNDRAISING AND DEVELOPMENT ACTIVITIES THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF RICHMOND UNIVERSITY MEDICAL CENTER; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT HOSPITAL ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. RICHMOND QUALITY, LLC --------------------- RICHMOND QUALITY, LLC IS A LIMITED LIABILITY COMPANY FORMED IN THE STATE OF NEW YORK WHOSE SOLE MEMBER IS RICHMOND UNIVERSITY MEDICAL CENTER. THE MISSION OF THIS ORGANIZATION IS TO ESTABLISH A GROUP OF COORDINATED HEALTHCARE PROVIDERS WHICH AGREE TO BE ACCOUNTABLE FOR THE QUALITY, COST AND OVERALL CARE FOR AN ASSIGNED GROUP OF MEDICARE BENEFICIARIES. VISITING NURSE ASSOCIATION HEALTH CARE SERVICES, INC. ----------------------------------------------------- VISITING NURSE ASSOCIATION HEALTH CARE SERVICES, INC. ("VNA") IS NOT-FOR-PROFIT ORGANIZATION FOUNDED IN 1928. THE ORGANIZATION IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). THE ORGANIZATION IS A CERTIFIED HOME HEALTH AGENCY THAT PROVIDES HOME CARE VISITS TO PATIENTS OVER THE COURSE OF THE YEAR. SERVICES PROVIDED INCLUDE SKILLED NURSING, PHYSICAL, OCCUPATIONAL AND OTHER THERAPIES, HOME HEALTH AIDES AND PERSONAL CARE WORKERS. THE AGENCY IS REIMBURSED FOR THESE SERVICES PRINCIPALLY BY MEDICARE, MEDICAID AND INSURANCE COMPANIES AND/OR INDIVIDUALS. EFFECTIVE JANUARY 1, 2022, RICHMOND UNIVERSITY MEDICAL CENTER BECAME THE SOLE MEMBER OF VNA. VISITING NURSE PLUS, INC. ------------------------- VISITING NURSE PLUS, INC. IS NOT-FOR-PROFIT ORGANIZATION. THE ORGANIZATION IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). THE ORGANIZATION IS CURRENTLY INACTIVE. HEALTH WATCH-LIFELINE, INC. --------------------------- HEALTH WATCH-LIFELINE, INC. IS AN ENTITY WHOSE SOLE SHAREHOLDER IS RICHMOND MEDICAL CENTER. THE ORGANIZATION WAS DISSOLVED IN 2022.
SCHEDULE H, PART VI; QUESTION 7	THIS ORGANIZATION IS LOCATED IN THE STATE OF NEW YORK. NEW YORK REQUIRES HOSPITALS TO REPORT THEIR COSTS OF PROVIDING UNREIMBURSED CARE AND REQUIRES NONPROFIT HOSPITALS TO DEMONSTRATE THEIR COMMITMENT TO MEETING COMMUNITY HEALTH NEEDS. NEW YORK LAW REQUIRES THAT NONPROFIT AND FOR-PROFIT HOSPITALS FILE FINANCIAL REPORTS DETAILING, AMONG OTHER THINGS, THEIR COSTS OF PROVIDING FREE OR REDUCED COST SERVICES. N.Y. PUB. HEALTH LAW 2805-A(2)(A); 2803-L(2)(IV). IN ADDITION, AT LEAST EVERY THREE YEARS THE GOVERNING BODY OF A NONPROFIT HOSPITAL MUST DEMONSTRATE THE HOSPITAL'S COMMITMENT TO MEETING COMMUNITY HEALTH CARE NEEDS, PROVIDING CHARITY CARE, AND IMPROVING UNDERSERVED INDIVIDUALS' ACCESS TO HEALTH CARE SERVICES. THE GOVERNING BODY MUST ALSO MAKE AVAILABLE TO THE PUBLIC A SUMMARY STATEMENT OF THE HOSPITAL'S FINANCIAL RESOURCES AND ALLOCATION TO HOSPITAL PURPOSES, INCLUDING ITS PROVISION OF FREE AND DISCOUNTED CARE. AT LEAST ANNUALLY, THE GOVERNING BODY MUST MAKE AVAILABLE TO THE PUBLIC AN IMPLEMENTATION REPORT AS TO THE HOSPITAL'S EFFORTS TO MEET COMMUNITY HEALTH CARE NEEDS, PROVIDE CHARITY CARE, AND IMPROVE ACCESS TO CARE. AT LEAST EVERY THREE YEARS, A NONPROFIT HOSPITAL MUST FILE WITH THE COMMISSIONER OF HEALTH A REPORT DETAILING CHANGES TO ITS MISSION STATEMENT AND ITS OPERATIONAL AND FINANCIAL COMMITMENT TO MEETING COMMUNITY HEALTH CARE NEEDS, TO ITS PROVISION OF CHARITY CARE, AND TO IMPROVING UNDERSERVED INDIVIDUALS' ACCESS TO CARE. N.Y. PUB. HEALTH LAW 2803-L.

Schedule H (Form 990) 2022

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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

2022

Open to Public Inspection

Name of the organization

RICHMOND MEDICAL CENTER

Employer identification number

74-3177454

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 .....

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? ....

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

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

Yes

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

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

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

Yes

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) 2022

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)
1DANIEL J MESSINA PHD MPA TRUSTEE - PRESIDENT & CEO	(i) (ii)	950,093 ------------- 0	0 ------------- 0	175,377 ------------- 0	191,328 ------------- 0	29,793 ------------- 0	1,346,591 ------------- 0	153,183 ------------- 0
2MICHAEL F CABBAD MD OBGYN	(i) (ii)	738,331 ------------- 0	114,000 ------------- 0	3,664 ------------- 0	27,450 ------------- 0	38,294 ------------- 0	921,739 ------------- 0	0 ------------- 0
3LANCE U JUNG MD SURGEON	(i) (ii)	421,498 ------------- 0	315,498 ------------- 0	22,404 ------------- 0	21,350 ------------- 0	38,294 ------------- 0	819,044 ------------- 0	0 ------------- 0
4LOREN HARRIS MD CHAIRMAN DEPT OF SURGERY	(i) (ii)	750,006 ------------- 0	0 ------------- 0	1,904 ------------- 0	27,450 ------------- 0	0 ------------- 0	779,360 ------------- 0	0 ------------- 0
5FRANCESCO ROTATORI MD CARDIOLOGIST	(i) (ii)	599,163 ------------- 0	97,703 ------------- 0	433 ------------- 0	21,350 ------------- 0	29,794 ------------- 0	748,443 ------------- 0	0 ------------- 0
6ALEXANDER BARKAN MD BARIATRIC SURGEON	(i) (ii)	613,322 ------------- 0	0 ------------- 0	664 ------------- 0	27,450 ------------- 0	38,294 ------------- 0	679,730 ------------- 0	0 ------------- 0
7ALEXANDER BEYLINSON DO TRUSTEE - PRES MED STAFF	(i) (ii)	190,877 ------------- 0	441,199 ------------- 0	432 ------------- 0	13,737 ------------- 0	27,201 ------------- 0	673,446 ------------- 0	0 ------------- 0
8VAITHILINGHAM ARULTHASANMD INTERNIST	(i) (ii)	649,554 ------------- 0	0 ------------- 0	664 ------------- 0	21,350 ------------- 0	0 ------------- 0	671,568 ------------- 0	0 ------------- 0
9PIETRO CARPENITO MD TRUSTEE (TERM 6/30) - EVP, CMO	(i) (ii)	529,503 ------------- 0	0 ------------- 0	32,809 ------------- 0	59,530 ------------- 0	38,294 ------------- 0	660,136 ------------- 0	22,280 ------------- 0
10ROSEMARIE STAZZONE RN MSN NE-B COO & CNO	(i) (ii)	552,548 ------------- 0	0 ------------- 0	41,467 ------------- 0	60,780 ------------- 0	0 ------------- 0	654,795 ------------- 0	26,318 ------------- 0
11RICHARD SALHANY MBA FACHE CHIEF ADMINISTRATION OFFICER	(i) (ii)	506,012 ------------- 0	0 ------------- 0	7,110 ------------- 0	57,248 ------------- 0	38,294 ------------- 0	608,664 ------------- 0	3,683 ------------- 0
12DAVID MURRAY MBA FHFMA SVP, CFO	(i) (ii)	497,703 ------------- 0	0 ------------- 0	1,194 ------------- 0	55,744 ------------- 0	37,087 ------------- 0	591,728 ------------- 0	0 ------------- 0
13BRIAN S MOODY ESQ SVP, LEGAL/GEN COUNSEL & CCO	(i) (ii)	402,303 ------------- 0	0 ------------- 0	664 ------------- 0	45,594 ------------- 0	30,993 ------------- 0	479,554 ------------- 0	0 ------------- 0
14GAITRE A LORICK VP, CHRO (EFF 03/28/2022)	(i) (ii)	242,340 ------------- 0	0 ------------- 0	669 ------------- 0	22,047 ------------- 0	7,146 ------------- 0	272,202 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2022

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; QUESTION 4B	THE AMOUNTS REFLECTED IN SCHEDULE J, PART II, COLUMN B(III) FOR THE FOLLOWING INDIVIDUALS INCLUDE A CURRENT YEAR VESTING IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) AS THESE AMOUNTS WERE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2022 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: DANIEL J. MESSINA, PH.D., MPA, FACHE, $153,183; ROSEMARIE STAZZONE, RN, MSN, $34,873; PIETRO CARPENITO, M.D., $22,280 AND RICHARD SALHANY, MBA, FACHE, $3,683. THE DEFERRED COMPENSATION AMOUNT REFLECTED IN SCHEDULE J, PART II, COLUMN C FOR THE FOLLOWING INDIVIDUALS INCLUDE UNVESTED BENEFITS IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) WHICH IS SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THESE INDIVIDUALS MAY NEVER ACTUALLY RECEIVE THE UNVESTED BENEFIT AMOUNT. THE AMOUNTS OUTLINED HEREIN WERE NOT INCLUDED IN EACH INDIVIDUAL'S 2022 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: DANIEL J. MESSINA, PH.D., MPA, FACHE, $157,778; ROSEMARIE STAZZONE, RN, MSN, $27,230; PIETRO CARPENITO, M.D., $25,980; RICHARD SALHANY, MBA, FACHE, $23,698; DAVID MURRAY, MBA, FHFMA, $22,194 AND BRIAN S. MOODY, ESQ., $12,044.
SCHEDULE J, PART I; QUESTION 7	CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A BONUS DURING CALENDAR YEAR 2022 WHICH WAS INCLUDED IN SCHEDULE J, PART II, COLUMN B(II) HEREIN AND IN EACH INDIVIDUAL'S 2022 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT.
SCHEDULE J, PART II; COLUMN F	THE AMOUNTS REPORTED IN SCHEDULE J, PART II, COLUMN (F) INCLUDE VESTED BENEFITS IN A DEFERRED COMPENSATION PLAN AS THESE AMOUNTS WERE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. THESE AMOUNTS WERE REPORTED AS DEFERRED COMPENSATION ON PRIOR YEARS' FORMS 990 AND ARE NOW BEING REPORTED AGAIN ON THIS YEAR'S FORM 990. THESE HAVE BEEN TREATED AS TAXABLE INCOME AND REPORTED ON EACH INDIVIDUAL'S FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES.

Schedule J (Form 990) 2022

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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
RICHMOND MEDICAL CENTER

Employer identification number
74-3177454

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	BUILD NYC RESOURCE CORPORATION			12-20-2018	132,065,000	SEE PART VI		X		X		X
B	BUILD NYC RESOURCE CORPORATION			06-29-2022	27,020,000	SEE PART VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	0		0
2 Amount of bonds legally defeased ..............	0		0
3 Total proceeds of issue ..................	127,937,562		26,209,400
4 Gross proceeds in reserve funds .............	9,891,055		0
5 Capitalized interest from proceeds .............	15,764,404		287,260
6 Proceeds in refunding escrows ...............	0		0
7 Issuance costs from proceeds ...............	3,191,623		1,337,102
8 Credit enhancement from proceeds .............	0		0
9 Working capital expenditures from proceeds .............	0		0
10 Capital expenditures from proceeds .............	110,434,038		23,182,075
11 Other spent proceeds .............	13,739,204		0
12 Other unspent proceeds .............	0		3,027,325
13 Year of substantial completion .............	2020		2022
	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?
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 %		0 %
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 .........	0 %		0 %
6 Total of lines 4 and 5 .............	0 %		0 %
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. ..			0 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............		X		X
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

SCHEDULE K, PART I, BOX F

THE PROCEEDS OF THE 2018 BONDS WILL BE USED TO (I) REFINANCE THE MEDICAL CENTER'S EXISTING REVOLVING LOAN PAYABLE, TERM LOAN PAYABLE, AND FIRST MORTGAGE LOAN PAYABLE, (II) FINANCE THE COST OF VARIOUS CAPITAL IMPROVEMENTS TO THE MEDICAL CENTER'S CAMPUS, (III) FUND A DEBT SERVICE RESERVE FUND AND A CAPITALIZED INTEREST FUND, AND (IV) PAY CERTAIN COSTS RELATED TO THE ISSUANCE OF THE 2018 BONDS. THE PROCEEDS OF THE 2022 BONDS WILL BE USED TO (I) FINANCE THE COST OF VARIOUS CAPITAL IMPROVEMENTS TO THE MEDICAL CENTER'S CAMPUS, (II) FUND A DEBT SERVICE RESERVE FUND AND (III) PAY CERTAIN COSTS RELATED TO THE ISSUANCE OF THE 2022 BOND.

Schedule K (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

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

RICHMOND MEDICAL CENTER

Employer identification number

74-3177454

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) MARINO POLISENO MD	FAMILY MEMBER OF TRUSTEE	581,990	EMPLOYEE		No
(2) ERIC GUTZEIT	FAMILY MEMBER OF TRUSTEE	42,555	EMPLOYEE		No
(3) CHRISTAL BAKER	FAMILY MEMBER OF TRUSTEE	21,027	EMPLOYEE		No
(4) PETER CARPENITO	FAMILY MEMBER OF TRUSTEE	11,872	EMPLOYEE		No
(5) BRITTANY DELMASTRO	FAMILY MEMBER OF TRUSTEE	61,977	EMPLOYEE		No
(6) RICHARD SALHANY JR	FAMILY MEMBER OF KEY EE	112,523	EMPLOYEE		No
(7) VICTORIA R STAZZONE	FAMILY MEMBER OF OFFICER	87,005	EMPLOYEE		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

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

RICHMOND MEDICAL CENTER

Employer identification number

74-3177454

Return Reference	Explanation
CORE FORM, PART III, STATEMENT OF PROGRAM SERVICES	BACKGROUND ========== RICHMOND MEDICAL CENTER D/B/A RICHMOND UNIVERSITY MEDICAL CENTER ("RUMC"MEDICAL CENTER") IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, RUMC PROVIDES HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. MOREOVER, RUMC OPERATES CONSISTENTLY WITHIN THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545: 1. PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF-PAY, MEDICARE AND MEDICAID PATIENTS; 2. OPERATES AN ACTIVE EMERGENCY DEPARTMENT FOR ALL PERSONS THAT IS OPEN 24 HOURS A DAY, SEVEN DAYS A WEEK, 365 DAYS PER YEAR; 3. MAINTAINS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; 4. CONTROL RESTS WITH ITS BOARD OF TRUSTEES, WHICH IS COMPRISED OF INDEPENDENT CIVIC LEADERS AND OTHER PROMINENT MEMBERS OF THE COMMUNITY; AND 5. SURPLUS FUNDS ARE USED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND RENOVATE FACILITIES AND ADVANCE MEDICAL CARE, PROGRAMS AND ACTIVITIES. THE OPERATIONS OF RUMC, AS SHOWN THROUGH THE FACTORS OUTLINED ABOVE AND OTHER INFORMATION CONTAINED HEREIN, CLEARLY DEMONSTRATE THAT RUMC PROVIDES SUBSTANTIAL COMMUNITY BENEFIT, THAT THE USE AND CONTROL OF RUMC IS FOR THE BENEFIT OF THE PUBLIC AND THAT NO PART OF THE INCOME OR NET EARNINGS OF THE ORGANIZATION INURES TO THE BENEFIT OF ANY PRIVATE INDIVIDUAL, NOR IS ANY PRIVATE INTEREST BEING SERVED OTHER THAN INCIDENTALLY. RUMC IS A 448 LICENSED BED, ACUTE CARE HOSPITAL SERVING NEARLY 500,000 RESIDENTS OF STATEN ISLAND, NEW YORK. THE MAIN CAMPUS IS LOCATED IN THE WEST BRIGHTON SECTION OF STATEN ISLAND. THE ORGANIZATION PROVIDES VARIOUS INPATIENT AND OUTPATIENT SERVICES, INCLUDING: MEDICAL/SURGICAL, PEDIATRICS, OBSTETRICS/GYNECOLOGY, NICU, A DESIGNATED STROKE CENTER, A LEVEL 1 TRAUMA CENTER, BEHAVIORAL HEALTH SERVICES, EMERGENCY SERVICES AND CLINIC SERVICES. THE MEDICAL CENTER ALSO PROVIDES AN ARRAY OF COMMUNITY OUTREACH SERVICES INCLUDING HEALTH EDUCATION, FREE AND LOW-COST SCREENINGS AND IMMUNIZATIONS, A WIC PROGRAM, AND VARIOUS OTHER OUTPATIENT SERVICES. THE MEDICAL CENTER PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA DEFINED BY THE NEW YORK DEPARTMENT OF HEALTH AND SENIOR SERVICES (DHSS) WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. THE CURRENT DHSS CHARITY CARE GUIDELINES REQUIRE PARTICIPATION AND COOPERATION OF THE PATIENT IN ORDER TO BE IDENTIFIED AS A CHARITY CARE ACCOUNT. THE MEDICAL CENTER MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THE COSTS ASSOCIATED WITH THE CHARITY CARE SERVICES PROVIDED ARE ESTIMATED BY APPLYING A COST-TO-CHARGE RATIO TO THE AMOUNT OF GROSS UNCOMPENSATED CHARGES FOR THE PATIENTS RECEIVING CHARITY CARE. THE MEDICAL CENTER ALSO PROVIDES COMMUNITY SERVICES, INCLUDING FREE AND LOW-COST SCREENINGS, SUCH AS BLOOD PRESSURE, CHOLESTEROL AND IMMUNIZATION. FREE IMMUNIZATION IS OFFERED TO SENIOR CITIZENS. THE MEDICAL CENTER HOLDS VARIOUS EDUCATIONAL PROGRAMS CONCERNING SUCH TOPICS AS NUTRITION AND CHILDBIRTH. IN ADDITION, THE MEDICAL CENTER PROVIDES FREE SPACE TO VARIOUS COMMUNITY ORGANIZATIONS FOR THEIR MEETINGS. OUR MISSION ----------- THE MEDICAL CENTER IS A NOT-FOR-PROFIT HEALTH CARE PROVIDER SERVING THE ETHNICALLY DIVERSE COMMUNITY OF STATEN ISLAND AND ITS NEIGHBORS. WE PROVIDE PREMIER QUALITY PATIENT CARE THROUGH A FULL SPECTRUM OF EMERGENT, ACUTE, PRIMARY, BEHAVIORAL HEALTH AND EDUCATIONAL SERVICES. WE DO THIS IN AN ENVIRONMENT THAT PROMOTES THE HIGHEST SATISFACTION AMONG PATIENTS, FAMILIES, PHYSICIANS AND STAFF. VALUES ------ THE VALUES OF THE MEDICAL CENTER ARE SUMMARIZED IN THE ACRONYM "WE CARE" (WELCOMING ENERGIZED COMPASSION ADVOCACY RESPECT EXCELLENCE): - WE ARE WELCOMING AND GRACIOUS TOWARD EACH OTHER, AND TOWARD ALL WHO COME TO RECEIVE OUR SERVICES. - PERSONNEL ARE ENERGIZED FOR QUALITY, CREATIVITY, COMMITMENT AND TEAMWORK. - COMPASSION IS THE WAY WE SHARE DEEP CONCERN AND CARE TOWARD EACH PERSON. - ADVOCACY IS OUR ACTIVITY THAT PROMOTES THE RIGHTS AND RESPONSIBILITIES OF PATIENTS, FAMILIES AND STAFF, IN THE HOSPITAL SETTING AND IN THE COMMUNITY. - WE SHOW RESPECT BY RECOGNIZING THE BASIC DIGNITY OF EVERY PERSON IN ALL OUR INTERACTIONS AND IN THE FORMULATION OF POLICIES AND PROCEDURES. - EXCELLENCE IS OUR WAY OF DEMONSTRATING THAT WE CAN ALWAYS BE MORE AND ALWAYS BE BETTER. VISION ------ - TO ESTABLISH A REGIONAL IDENTITY AS RICHMOND UNIVERSITY MEDICAL CENTER AND A REGIONWIDE REPUTATION FOR EXCELLENCE IN PROVIDING THE HIGHEST STANDARDS OF MEDICAL CARE TO THE COMMUNITY; - TO DEVELOP A CULTURE OF PRIDE IN THE HISTORY OF THE INSTITUTION, THE CURRENT ACTIVITIES AND ITS INITIATIVES FOR FUTURE GROWTH AND EXPANSION; AND - TO BE RECOGNIZED AS THE PROVIDER OF CHOICE. RUMC'S COMMITMENT ----------------- - WE'RE PART OF THE FABRIC OF STATEN ISLAND - PAST, PRESENT AND FUTURE; - WE TREAT PATIENTS AND LOVED ONES LIKE FAMILY - BECAUSE THEY ARE; - WE CARE ABOUT THE HEALTH AND WELLNESS OF STATEN ISLANDERS - BECAUSE OUR LOVED ONES MATTER TO US; - WE'RE INVESTING AND PLANNING AHEAD - TO ANSWER THE FUTURE HEALTH CARE NEEDS OF THE COMMUNITY; AND - WE'RE ACCOUNTABLE TO EVERYONE WE SERVE - STATEN ISLAND PATIENTS, LOVED ONES, PHYSICIANS, NURSES AND STAFF. CLINICAL SERVICES ================= RUMC IS LICENSED FOR 448 BEDS THAT INCLUDE MEDICINE, SURGERY, PEDIATRICS AND NEO-NATAL CARE, GYNECOLOGY, OBSTETRICS AND MATERNITY CARE, INTENSIVE CARE UNITS, PSYCHIATRY, BEHAVIORAL AND SUBSTANCE ABUSE DISORDERS. RUMC PROVIDES CRITICAL ACCESS TO THE COMMUNITY THROUGH ITS EMERGENCY DEPARTMENT, SURGERY, INPATIENT ACUTE CARE, AND MANY OTHER PROGRAMS THAT SUPPORT BOTH HEALTH AND BEHAVIORAL HEALTH CARE ACCESS AND PROMOTE QUALITY OF LIFE. A FULL LIST OF SERVICES OFFERED BY RUMC CAN BE GROUPED INTO THE FOLLOWING: - ANESTHESIA - BARIATRIC/WEIGHT LOSS SURGERY - BEHAVIORAL HEALTH - BREAST AND WOMEN'S HEALTH - CARDIOVASCULAR - CLINICAL RESEARCH - DIABETES - EAR, NOSE AND THROAT - EMERGENCY SERVICES - ENDOCRINOLOGY - GASTROENTEROLOGY/ENDOSCOPY - OBSTETRICS AND GYNECOLOGY - ONCOLOGY (CANCER) - OPHTHALMOLOGY - ORTHOPEDICS - PALLIATIVE CARE - PATHOLOGY LAB SERVICES - PEDIATRICS - POST COVID-19 CARE - RADIOLOGY - REHABILITATION - SLEEP DISORDER - STROKE CARE - SURGERY - TELEHEALTH - UROLOGY - WOMEN, INFANTS, AND CHILDREN (WIC) - WOUND CARE TRAUMA CARE =========== RUMC IS A LEVEL I ADULT AND LEVEL II PEDIATRIC TRAUMA CENTER AND A DESIGNATED STROKE CENTER, RECEIVING TOP NATIONAL RECOGNITION FROM THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION. THE STATE-OF-THE-ART CARDIAC CATHETERIZATION LAB HAS PCI CAPABILITIES FOR ELECTIVE AND EMERGENT PROCEDURES IN ANGIOPLASTY. RUMC MAINTAINS A WOUND CARE/HYPERBARIC CENTER AND A SLEEP DISORDER CENTER ON-SITE AT ITS MAIN CAMPUS. THE HOSPITAL ALSO OFFERS BEHAVIORAL HEALTH SERVICES, ENCOMPASSING BOTH INPATIENT AND OUTPATIENT SERVICES FOR CHILDREN, ADOLESCENTS AND ADULTS, INCLUDING EMERGENT INPATIENT AND MOBILE OUTREACH UNITS. RUMC IS THE ONLY BOROUGH FACILITY THAT OFFERS INPATIENT PSYCHIATRIC SERVICES FOR ADOLESCENTS. LEVEL I ADULT TRAUMA CARE ------------------------- THE TRAUMA CENTER WAS VERIFIED BY THE AMERICAN COLLEGE OF SURGEONS (ACS) AND ADHERES TO RIGOROUS STANDARDS IN ORDER TO PROVIDE THE HIGHEST QUALITY OF CARE. SEVERAL DEFINING ELEMENTS OF THE TRAUMA CENTER INCLUDE: - EQUIPPED FOR ALL STAGES OF CARE, FROM PREVENTION TO EMERGENCY SURGERY TO REHABILITATION - TRAUMA TEAM MEMBERS CONTINUOUSLY RECEIVE EDUCATION ABOUT BEST PRACTICES AND LATEST TECHNOLOGY - QUALITY ASSESSMENT PROGRAM HELPS ENSURE SMOOTH, EFFECTIVE OPERATION - PREPARED TO TREAT A HIGH VOLUME OF TRAUMA PATIENTS 24/7 - REFERS PATIENTS TO OTHER RESOURCES IN THE COMMUNITY FOR FURTHER TREATMENT IN ADDITION, RICHMOND UNIVERSITY MEDICAL CENTER'S TRAUMA CENTER SERVES AS THE ONLY IN-PATIENT PSYCHIATRIC RESOURCE IN THE REGION FOR ADOLESCENTS, PROVIDING SERVICES FOR SUBSTANCE ABUSE, PSYCHOTHERAPY AND PSYCHIATRIC CARE. BEHAVIORAL HEALTH ================= RICHMOND UNIVERSITY MEDICAL CENTER IS STATEN ISLAND'S LEADING PROVIDER OF BEHAVIORAL HEALTH SERVICES FOR CHILDREN, ADOLESCENTS, AND ADULTS. OFFERING BOTH INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH SERVICES, A TEAM OF BOARD-CERTIFIED PHYSICIANS, THERAPISTS, AND HEALTH CARE PROFESSIONALS IS AVAILABLE TO PROVIDE COMPREHENSIVE EVALUATION AND REFERRAL SERVICES, SUBSTANCE TREATMENT, AND OTHER SPECIALIZED PROGRAMS. OUR DEPARTMENT OF PSYCHIATRY AND BEHAVIORAL HEALTH PROVIDES ASSISTANCE THROUGH: - ADULT OUTPATIENT MENTAL HEALTH SERVICES - NEUROMODULATION TREATMENT - ADDICTION TREATMENT PROGRAMS - EMERGENCY SERVICES - INPATIENT PSYCHIATRIC PROGRAMS
CORE FORM, PART III, STATEMENT OF PROGRAM SERVICES	STATEN ISLAND MENTAL HEALTH SOCIETY'S SERVICES AND PROGRAMS ARE FULLY INTEGRATED AS A DIVISION OF RICHMOND UNIVERSITY MEDICAL CENTER. ITS ROBUST PROGRAMS FOR CHILDREN AND FAMILIES ARE NOW PART OF A LARGER BEHAVIORAL HEALTH NETWORK OF ADVANCED, EFFECTIVE SERVICES FOR CHILDREN, ADOLESCENTS, AND ADULTS. THE SOCIETY'S DEDICATED, LICENSED PHYSICIANS, THERAPISTS, COUNSELORS, AND BOARD-CERTIFIED PSYCHIATRISTS ARE NOW PART OF THE MOST EXPERIENCED BEHAVIORAL HEALTH TEAM ON STATEN ISLAND. STATEN ISLAND MENTAL HEALTH SOCIETY PROVIDES ASSISTANCE THROUGH: - OUTPATIENT SERVICES FOR CHILDREN, ADOLESCENTS, AND FAMILIES - DEVELOPMENTAL DISABILITY AND EARLY CHILDHOOD SERVICES - FAMILY SUPPORT AND COMMUNITY SERVICES - PRE-SCHOOL EDUCATION SERVICES, INCLUDING THE COUNTRY'S FIRST HOSPITAL-BASED HEAD START PROGRAM PROJECT LAUNCH -------------- A FULLY INTEGRATED DIVISION OF RICHMOND UNIVERSITY MEDICAL CENTER, STATEN ISLAND MENTAL HEALTH SOCIETY SUPPORTS THE BEHAVIORAL HEALTH NEEDS OF CHILDREN AND FAMILIES THROUGH ROBUST SERVICES, PROGRAMS, AND INITIATIVES, INCLUDING PROJECT LAUNCH (LINKING ACTIONS FOR UNMET NEEDS IN CHILDREN'S HEALTH). LEARN MORE ABOUT HOW OUR COMPASSIONATE TEAM IS SUPPORTING PROJECT LAUNCH AND WHAT THIS INITIATIVE MEANS FOR CHILDREN AND FAMILIES IN NEED. A FEDERAL INITIATIVE CREATED BY THE NATIONAL CENTER FOR HEALTHY SAFE CHILDREN AND FUNDED BY THE SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION (SAMHSA), PROJECT LAUNCH HAS A MISSION "TO PROMOTE THE WELLNESS OF YOUNG CHILDREN AGES BIRTH TO 8 BY ADDRESSING THE PHYSICAL, SOCIAL, EMOTIONAL, COGNITIVE, AND BEHAVIORAL ASPECTS OF THEIR DEVELOPMENT." WITH A GOAL TO PREPARE CHILDREN FOR SUCCESS IN SCHOOL, PROJECT LAUNCH SPECIFICALLY AIMS TO: - ENSURE CHILDREN ARE READY TO LEARN WHEN ENTERING SCHOOL - IMPROVE COORDINATION AND COLLABORATION AMONGST SYSTEMS SERVING CHILDREN - BUILD INFRASTRUCTURE BY INCREASING THE AVAILABILITY OF QUALITY, EVIDENCE-BASED PROGRAMMING - INCREASE CHILDREN'S AND THEIR FAMILIES' ACCESS TO TOP-NOTCH PREVENTION, WELLNESS, AND PHYSICAL AND BEHAVIORAL HEALTH SERVICES RICHMOND UNIVERSITY MEDICAL CENTER IS AMONGST A HANDFUL OF GRANT RECIPIENTS FOR PROJECT LAUNCH, A HIGHLY COMPETITIVE PROGRAM WITH ONLY 12 OTHER GRANTEES AT ANY GIVEN TIME. WHAT WE LEARN THROUGHOUT THE FIVE-YEAR TERM OF THE GRANT WILL HELP COMMUNITIES INFLUENCE STATE, TERRITORIAL, AND TRIBAL-LEVEL SYSTEMS CHANGES AND POLICY IMPROVEMENTS. PROJECT LAUNCH'S SERVICES ARE OPEN TO CHILDREN AGES EIGHT AND YOUNGER, THEIR CAREGIVERS, AND EXPECTING CAREGIVERS LIVING IN THE NORTH SHORE AREA OF STATEN ISLAND. AS A FIVE-YEAR GRANT RECIPIENT OF PROJECT LAUNCH, RICHMOND UNIVERSITY MEDICAL CENTER BEGAN WORK ON THIS IMPORTANT, FEDERALLY FUNDED INITIATIVE IN 2019. WE HAVE ASSIGNED A DEDICATED TEAM TO FULFILL OUR COMMITMENTS AND THE PROJECT'S MISSION. OUR HEADQUARTERS FOR THIS INITIATIVE ARE LOCATED AT 669 CASTLETON AVE, AND WE ARE ANTICIPATING THE ARRIVAL OF A MOBILE UNIT, WHICH WILL ENABLE US TO PROVIDE THE FOLLOWING SERVICES IN THE COMMUNITY AND YOUR HOME: - BEHAVIORAL HEALTH - LIGHT-TOUCH MEDICAL ASSESSMENTS AND EDUCATION - CARE COORDINATION CANCER CARE AT RUMC =================== COLORECTAL CANCER ----------------- ACCORDING TO THE AMERICAN CANCER SOCIETY, EXCEPT FOR SKIN CANCERS, COLORECTAL CANCER IS THE THIRD MOST COMMON CANCER DIAGNOSED IN BOTH MEN AND WOMEN IN THE UNITED STATES. THE AMERICAN CANCER SOCIETY ESTIMATES THE NUMBER OF COLORECTAL CANCER CASES IN THE UNITED STATES FOR 2023 WAS OVER 106,900 NEW CASES OF COLON CANCER AND MORE THAN 46,000 NEW CASES OF RECTAL CANCER. IN THE UNITED STATES, COLORECTAL CANCER IS THE THIRD LEADING CAUSE OF CANCER-RELATED DEATHS IN MEN AND IN WOMEN, AND THE SECOND MOST COMMON CAUSE OF CANCER DEATHS WHEN MEN AND WOMEN ARE COMBINED. IT WAS EXPECTED TO CAUSE ABOUT 52,500 DEATHS DURING 2023. Based on the findings of Richmond University Medical Center's 2022 Community Health Needs Assessment (CHNA), increasing access to high quality chronic disease preventive care and management in both clinical and community settings was identified as a priority. This was determined through research to develop the CHNA, including public health and socioeconomic measures, input received from key informants, and a thorough assessment of existing services, resources, and the hospital's areas of expertise. Increasing screening rates for several chronic diseases, including colorectal cancer, was an agreed to measure to help address this identified priority. The CHNA also revealed that the colorectal cancer death rate for Staten Island is similar to the death rates for New York City and the nation. One of the most common barriers to engaging patients to have colonoscopies conducted is the unpleasantness and misconceptions about the colonoscopy prep procedure. There are currently several screening modalities available for community members to choose from beyond the traditional colonoscopy that may help get patients "through the door." The most common are take home stool tests, such as the Fecal Immunochemical Test (FIT kit). In March, in recognition of National Colon Cancer Awareness month, Richmond University Medical Center distributed free at-home FIT Kits to staff and the public. Over 20 individuals requested one of the free kits. The hospital's oncology department provided free assessments and follow-up to individuals who provided completed kits. In addition to the kits distributed in March, FIT kits were also distributed at no charge during the following events that were open to the public. In total over 80 kits were distributed throughout the year, at: - The New York City Parks and Recreation Department's health fair; - The Staten Island Economic Development Corporation's annual health and wellness fair; and - RUMC's Community Day to celebrate the opening of the hospital's new Emergency Department BREAST CANCER ------------- Breast cancer is the second leading cause of cancer death in women behind lung cancer. According to the American Cancer Society, about one in eight women in the United States will develop invasive breast cancer over the course of her lifetime. In recent years, incidence rates have increased slightly, about 0.5 percent per year. In 2022, an estimated 287,850 new cases of invasive breast cancer were expected to be diagnosed in women in the United States, along with 51,400 new cases of non-invasive (in situ) breast cancer. About 43,250 women were expected to die in 2022 from breast cancer. Based on the findings of Richmond University Medical Center's 2022 Community Health Needs Assessment (CHNA), increasing access to high quality chronic disease preventive care and management in both clinical and community settings was identified as a priority. This was determined through research to develop the CHNA, including public health and socioeconomic measures, input received from key informants, and a thorough assessment of existing services, resources, and the hospital's areas of expertise. Increasing screening rates for several chronic diseases, including breast cancer, was an agreed-to measure to help address this identified priority. The CHNA also showed that among an analysis of the most common cancers (female breast, colorectal, lung and prostate), Staten Island has higher female breast incidence rates than the rest of New York City and the nation, but lower death rates. Throughout 2022, RUMC maintained a steady ad campaign in print, digital, and social media platforms promoting the services available at the hospital's outpatient Breast and Women's Center. Several articles were also written in the Staten Island Advance, the only daily newspaper on Staten Island, focusing on the importance of mammograms, symptoms, and risk factors for breast cancer, and additional related topics. Throughout the year, breast cancer information was made available at several community events. PROSTATE CANCER --------------- According to the American Cancer Society, other than skin cancer, prostate cancer is the most common cancer in American men. The Society estimates that in 2022 nearly 268,500 new cases of prostate cancer will be diagnosed and about 34,500 deaths will occur due to the disease. About one man in eight will be diagnosed with prostate cancer during his lifetime, with prostate cancer being more likely to develop in older men and in African-American men.
CORE FORM, PART III, STATEMENT OF PROGRAM SERVICES	Based on the findings of Richmond University Medical Center's 2022 Community Health Needs Assessment (CHNA), increasing access to high quality chronic disease preventive care and management in both clinical and community settings was identified as a priority. This was determined through research to develop the CHNA, including public health and socioeconomic measures, input received from key informants, and a thorough assessment of existing services and the hospital's areas of expertise. Increasing screening rates for several chronic diseases, including prostate cancer, was an agreed-to measure to help address this identified priority because Staten Island has a higher overall cancer incidence rate compared to the rest of New York City. As our society emerges from the COVID-19 pandemic, physicians and medical professionals are finding that many individuals have not kept up with regular health checkups and/or have not followed up for conditions or symptoms that may indicate prostate cancer. According to the CHNA, Staten Island has a higher cancer incidence rate than the nation, but a slightly lower cancer death rate. Staten Island also has higher prostate cancer incidence rates than the other boroughs of New York City and the nation, but lower death rates. To promote the importance of prostate cancer health and the need for early screening, RUMC provided free prostate cancer screenings at several community events over the course of 2022. Test results were reviewed by RUMC's lab and results provided at no cost. Referrals to RUMC's Urology Services Center were made for any abnormal findings. Free prostate cancer screenings were provided at the following public events: - Through a partnership with the Jewish Community Center of Staten Island - At the New York City Parks and Recreation Department's health fair - At the Staten Island Economic Development Corporation's annual health and wellness fair - At the Police Organization Providing Peer Assistance (POPPA) health and wellness fair - At RUMC's Community Day to celebrate the opening of the hospital's new Emergency Department CAPITAL PROJECTS ================ NOW MORE THAN EVER, WE ARE MAKING CRITICAL INVESTMENTS AND CAPITAL IMPROVEMENTS SO THAT RICHMOND UNIVERSITY MEDICAL CENTER CAN CONTINUE TO ANSWER THE FUTURE HEALTH CARE NEEDS OF THE COMMUNITY. WITH A TOTAL INVESTMENT OF NEARLY $200 MILLION, AND OVER $108 MILLION IN FINANCIAL SUPPORT FROM THE CITY, STATE, AND PRIVATE PHILANTHROPY, RUMC WILL BE REVOLUTIONIZING HEALTHCARE FOR EVERYONE. EMERGENCY DEPARTMENT -------------------- Richmond University Medical Center's new Emergency Department (ED), a multi-story state-of-the-art addition with more than twice the space of its predecessor and a host of patient amenities, is a testament to the hospital's commitment to the community. The ED occupies the ground level of a new pavilion, offering private trauma bays and treatment rooms and comprehensive specialty areas for pediatrics and urgent care. Each exam room and treatment bay has double headwalls, enabling RUMC to double the ED's capacity in the event of a patient surge. It replaces an aging and undersized Emergency Department built in 1978, when Staten Island's population was 25 percent smaller. RUMC is an American College of Surgeons (ACS) and New York State Department of Health designated Level I Adult Trauma and Level II Pediatric Trauma Center. This designation means RUMC has trained medical staff, nurses, equipment, and protocols in place to treat all adult and pediatric patients in need of emergency care. RUMC is also a nationally recognized stoke center, Staten Island's only provider of inpatient behavioral health services for adolescents, and the borough's only New York State Department of Health certified Sexual Assault Forensic Examiner (SAFE) Center of Excellence. RUMC's Emergency Department had been at the epicenter of the COVID-19 pandemic, caring for more than 11,000 COVID-positive patients since the pandemic began in 2020. The patient-friendly ED experience for walk-ins begins on arrival at the main entrance, now easily accessible from Castleton Avenue with an adjacent parking lot nearby. Patients take a seat in the spacious waiting area before moving into triage and to one of three private trauma bays, fully equipped and ready for rapid assessment and treatment. The former ED had only one trauma bay. New ultrasound and airway equipment in the ED facilitates surgical intervention and other lifesaving measures. Along the way, family members remain close to their patient in designated zones with comfortable seating, where they can monitor the situation and stay informed. With the Surgical Department located directly above the ED, critically ill patients will be whisked by elevator to the second-floor surgical suites. The proximity of 10 new operating rooms on the second level will cut down on travel time from the ED in life threatening situations. WINDOW UPGRADE PROJECT ---------------------- STEADFAST IN A STORM - THE FEDERAL EMERGENCY MANAGEMENT AGENCY PROVIDED RUMC WITH FINANCIAL SUPPORT TO UPGRADE OVER 700 WINDOWS THROUGHOUT THE HOSPITAL TO PROTECT THE MEDICAL FACILITY FROM STORMS AND WEATHER-RELATED EMERGENCIES. RUMC IS THE ONLY HOSPITAL ON STATEN ISLAND NOT LOCATED IN A FLOOD ZONE. THE NEW WINDOWS WILL BE HURRICANE-FORCE RESISTANT AND PROTECT AGAINST WATER AND WIND DAMAGE. EXPECTED COMPLETION: MID-2022 NEW MEDICAL INTENSIVE CARE UNIT ------------------------------- ADVANCING CARE FOR OUR MOST CRITICAL PATIENTS - MEDICAL INTENSIVE CARE UNIT (MICU) CAPACITY WILL BE INCREASED FROM TEN TO FOURTEEN PRIVATE PATIENT ROOMS. ADDITIONALLY, FOUR ISOLATION/NEGATIVE PRESSURE ROOMS WILL BE INCLUDED. THERE ALSO WILL BE LARGER FAMILY AREAS IN EACH PATIENT ROOM. TO OPTIMIZE INFECTION CONTROL, ELECTROMAGNETIC GLAZING (SMART GLASS) WILL REPLACE CUBICLE CURTAINS. EXPECTED COMPLETION: SPRING 2022 CO-GEN POWER PLANT ------------------ LEADING THE WAY IN ENERGY EFFICIENCY - THE NEW CO-GENERATION PLANT (CO-GEN) IS BEING CONSTRUCTED IN AN EXISTING BUILDING AT THE REAR OF THE CAMPUS. WHEN COMPLETED, IT WILL MAKE THE HOSPITAL SELF-SUFFICIENT AND ABLE TO CONTINUE OPERATING IN THE EVENT OF AN AREA POWER FAILURE. EXCESS HEAT GENERATED FROM THE ENGINES WILL BE UTILIZED TO CREATE IMPROVED AIR CONDITIONING CAPACITY FOR THE HOSPITAL. EXPECTED COMPLETION: SUMMER 2022 FULLY RENOVATED MOTHER/BABY UNIT -------------------------------- DELIVERING LUXURY, COMFORT, AND PRIVACY LOCATED ON THE FIRST AND SECOND FLOORS OF THE HOSPITAL, THE NEWLY RENOVATED RICHMOND COUNTY SAVINGS FOUNDATION MOTHER/BABY UNIT WILL FEATURE SINGLE-BED PRIVATE ROOMS AS WELL AS REMODELED BATHROOMS, FLOORING, WINDOWS AND LIGHTING. EXPECTED COMPLETION: EARLY 2023 NEW OPERATING ROOMS ------------------- TRANSFORMING FOR THE FUTURE - THE NEW OPERATING ROOMS WILL FEATURE 10 ADVANCED AND FULLY EQUIPPED SURGICAL SUITES. PATIENTS WILL ALSO BE ABLE TO UTILIZE INCREASED PREOPERATIVE AND RECOVERY SPACE. EXPECTED COMPLETION: EARLY 2023 RUMC'S AWARD-WINNING QUALITY CARE ================================= Accreditations -------------- - American Association of Blood Banks (AABB) - American College of Radiology: Breast Ultrasound; Mammography; Positron Emission Tomography (PET); Stereotactic Breast Biopsy; AND Ultrasound Guided Biopsy - American College of Radiation Oncology - American College of Surgeons' Commission on Cancer - College of American Pathologists (CAP) - Intersocietal Accreditation Commission (IAC) - Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program - New York State Dept of Health (NYSDOH) - The Joint Commission (TJC) - ACR Accreditation in every modality - CT, MR, Nuclear Medicine, Ultrasound - National Diabetes Prevention Program Accreditation, NYS PCMH Recognition Certifications -------------- - The Joint Commission - Gold Seal - The Joint Commission Disease-Specific Certification: Advanced Primary Stroke Verifications ------------- - American College of Surgeons: Trauma Services - Level I Adult Trauma/Level II Pediatric Trauma - Trauma Awards ------ - American Heart Mission Lifeline - 2022 Stroke Gold Plus with Target stroke, Honor Roll Elite and Target: Type 2 Diabetes Honor Roll Designations ------------ - NYS Department of Health: Level I Adult Trauma/Level II Pediatric Trauma; Primary Stroke; AND Trauma - WHO & UNICEF Designated "Baby-Friendly Hospital" Recognition ----------- - American Diabetes Association - CDC Recognized National Diabetes Prevention Program - International Board Certified Lactation Consultant - Sexual Assault Forensic Examiner
CORE FORM, PART III, STATEMENT OF PROGRAM SERVICES	Resident Education ------------------ - Accreditation of Advanced GI Minimally Invasive Fellowship - ACGME Accredited Fellowship in Hematology /Oncology - Continued Accreditation in Internal Medicine, Obstetrics and Gynecology, Pediatrics, Psychiatry, and Radiology programs by the ACGME - Fully Accredited Council on Podiatric Medical Education (CPME) Podiatry Program
CORE FORM, PART V; QUESTION 1A & CORE FORM, PART VII, SECTION B	THE ORGANIZATION IS AN AFFILIATE WITHIN RICHMOND MEDICAL CENTER D/B/A RICHMOND UNIVERSITY MEDICAL CENTER ("RICHMOND UNIVERSITY MEDICAL CENTER") AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THIS ORGANIZATION PAYS OUTSTANDING ACCOUNTS PAYABLE INVOICES ON BEHALF OF CERTAIN OTHER AFFILIATES WITHIN THE SYSTEM. IN CONJUNCTION WITH THIS SERVICE, THIS ORGANIZATION ALSO PREPARES AND ISSUES FORMS 1099 TO THE VENDORS RECEIVING PAYMENTS WHERE APPLICABLE AND FILES FORMS 1099 WITH THE INTERNAL REVENUE SERVICE. THIS ORGANIZATION ALLOCATES THESE PAYMENTS TO THE APPROPRIATE AFFILIATE WITHIN THE SYSTEM VIA AN INTERCOMPANY ACCOUNT.
CORE FORM, PART V; QUESTION 15	DANIEL J. MESSINA, PH.D., MPA, FACHE IS INVOLVED IN THE LEADERSHIP AND MANAGEMENT OF THIS ORGANIZATION ON A FULL-TIME BASIS. DR. MESSINA IS EMPLOYED BY AND RECEIVES A FEDERAL FORM W-2 FROM THIS ORGANIZATION. ACCORDINGLY, HIS COMMON LAW EMPLOYER/EMPLOYEE RELATIONSHIP IS WITH RICHMOND MEDICAL CENTER D/B/A RICHMOND UNIVERSITY MEDICAL CENTER (EIN: 74-3177454). RICHMOND UNIVERSITY MEDICAL CENTER FILED A 2022 FORM 4720 WHICH INCLUDED A REMITTANCE OF EXCISE TAX RELATED TO DR. MESSINA'S COMPENSATION IN EXCESS OF $1M.
CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7	BRIDGE REGIONAL HEALTH SYSTEM IS THE SOLE MEMBER OF THIS ORGANIZATION. BRIDGE REGIONAL HEALTH SYSTEM HAS THE RIGHT TO ELECT THE MEMBERS OF THIS ORGANIZATION'S BOARD OF TRUSTEES AND HAS CERTAIN RESERVED POWERS AS DEFINED IN THIS ORGANIZATION'S BYLAWS.
CORE FORM, PART VI, SECTION B; QUESTION 11B	THE ORGANIZATION IS AN AFFILIATE WITHIN RICHMOND MEDICAL CENTER D/B/A RICHMOND UNIVERSITY MEDICAL CENTER ("RICHMOND UNIVERSITY MEDICAL CENTER") AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THIS ORGANIZATION'S BOARD OF TRUSTEES HAS AN AUDIT AND COMPLIANCE COMPENSATION COMMITTEE ("COMMITTEE"). THIS ORGANIZATION'S FEDERAL FORM 990 WAS PROVIDED TO EACH MEMBER OF THE ORGANIZATION'S AUDIT AND COMPLIANCE COMMITTEE FOR REVIEW AND THEREAFTER APPROVAL BY THE MEMBERS AT THE COMMITTEE MEETING. SUBSEQUENTLY, THE ORGANIZATION'S 990 WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S BOARD OF TRUSTEES, PRIOR TO FILING WITH THE IRS. THE ORGANIZATION'S AUDIT AND COMPLIANCE COMMITTEE HAS ASSUMED THE RESPONSIBILITY TO OVERSEE AND COORDINATE THE FEDERAL FORM 990 PREPARATION, REVIEW AND FILING PROCESS FOR THIS ORGANIZATION. AS PART OF THE ORGANIZATION'S FEDERAL FORM 990 TAX RETURN PREPARATION PROCESS THE SYSTEM HIRED A PROFESSIONAL CERTIFIED PUBLIC ACCOUNTING ("CPA") FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION TO PREPARE THE FEDERAL FORM 990. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE ORGANIZATION'S FINANCE PERSONNEL AND SYSTEM INDIVIDUALS INCLUDING SENIOR VICE PRESIDENT/CHIEF FINANCIAL OFFICER, SENIOR VICE PRESIDENT, LEGAL AFFAIRS & RISK MANAGEMENT, GENERAL COUNSEL & CHIEF COMPLIANCE OFFICER, VICE PRESIDENT, FISCAL AFFAIRS & ACCOUNTING, AND VARIOUS OTHER SYSTEM INDIVIDUALS ("INTERNAL WORKING GROUP") TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE ORGANIZATION'S INTERNAL WORKING GROUP FOR REVIEW. THE ORGANIZATION'S INTERNAL WORKING GROUP REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE ORGANIZATION'S INTERNAL WORKING GROUP FOR FINAL REVIEW AND APPROVAL. FOLLOWING THIS REVIEW, THE FORM 990 WAS THEN PRESENTED TO THE ORGANIZATION'S AUDIT AND COMPLIANCE COMMITTEE AND PROVIDED TO THE ORGANIZATION'S GOVERNING BODY PRIOR TO FILING WITH THE IRS.
CORE FORM, PART VI, SECTION B; QUESTION 12	THE ORGANIZATION IS AN AFFILIATE WITHIN RICHMOND MEDICAL CENTER D/B/A RICHMOND UNIVERSITY MEDICAL CENTER ("RICHMOND UNIVERSITY MEDICAL CENTER") AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM HAS A WRITTEN CONFLICT OF INTEREST POLICY WITH WHICH ALL AFFILIATES REGULARLY MONITOR AND ENFORCE COMPLIANCE. THE CONFLICT OF INTEREST POLICY REQUIRES THAT A CONFLICT OF INTEREST DISCLOSURE STATEMENT, CONSISTENT WITH BEST GOVERNANCE PRACTICES AND INTERNAL REVENUE SERVICE GUIDELINES, BE CIRCULATED ANNUALLY TO ALL TRUSTEES/DIRECTORS, OFFICERS, KEY EMPLOYEES, MEDICAL STAFF AND PRACTITIONERS WITH CLINICAL PRIVILEGES. ANNUALLY THESE INDIVIDUALS ARE REQUIRED TO REVIEW THE EXISTING CONFLICT OF INTEREST POLICY AND COMPLETE A QUESTIONNAIRE. THE SYSTEM'S SENIOR VICE PRESIDENT, LEGAL AFFAIRS & RISK MANAGEMENT, GENERAL COUNSEL & CHIEF COMPLIANCE OFFICER IS RESPONSIBLE FOR (1) GATHERING THE CONFLICT OF INTEREST DISCLOSURE STATEMENTS; (2) TRACKING THE SUCCESSFUL COMPLETION OF THE STATEMENTS; (3) TRANSMITTING THE STATEMENTS TO THE BOARD COMMITTEE; AND (4) ASSISTING THE BOARD COMMITTEE IN ORGANIZING THE STATEMENTS FOR THE COMMITTEE'S REVIEW. IN ADDITION, THE SYSTEM'S SENIOR VICE PRESIDENT, LEGAL AFFAIRS & RISK MANAGEMENT, GENERAL COUNSEL & CHIEF COMPLIANCE OFFICER IS RESPONSIBLE FOR REVIEWING AND REVISING THE CONFLICT OF INTEREST POLICY ON AN ANNUAL BASIS OR WHEN A CHANGE IS REQUIRED FOR COMPLIANCE WITH JOINT COMMISSION STANDARDS; ETHICAL DIRECTIVES; FEDERAL, STATE, AND CITY LAWS, RULES AND REGULATIONS; CHANGES IN PRACTICE OR REGULATORY MANDATE; NEW PROGRAMS OR PROCEDURES; NEW EQUIPMENT; OR PERFORMANCE IMPROVEMENT CHANGES. THE COMPLETED QUESTIONNAIRES ARE RETURNED TO THE SYSTEM'S SENIOR VICE PRESIDENT, LEGAL AFFAIRS & RISK MANAGEMENT, GENERAL COUNSEL & CHIEF COMPLIANCE OFFICER FOR REVIEW. THEREAFTER, THE CONFLICT OF INTEREST DISCLOSURES ARE PROVIDED TO THE ORGANIZATION'S AUDIT AND COMPLIANCE COMMITTEE FOR ITS REVIEW AND DISCUSSION. THE AUDIT AND COMPLIANCE COMMITTEE HAS ASSUMED RESPONSIBILITY FOR THE OVERSIGHT OF THE CONFLICT OF INTEREST DISCLOSURE AND REVIEW PROCESS.
CORE FORM, PART VI, SECTION B; QUESTION 15	THE ORGANIZATION IS AN AFFILIATE WITHIN RICHMOND MEDICAL CENTER D/B/A RICHMOND UNIVERSITY MEDICAL CENTER ("RICHMOND UNIVERSITY MEDICAL CENTER") AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE ORGANIZATION'S GOVERNING BODY, ITS BOARD OF TRUSTEES, HAS A COMPENSATION COMMITTEE ("COMMITTEE"). THE COMMITTEE HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY WHICH IT FOLLOWS WHEN IT REVIEWS AND APPROVES THE COMPENSATION AND BENEFITS OF ALL EMPLOYEES SPECIFIED AS HAVING A SUBSTANTIAL INFLUENCE OVER THE ORGANIZATION ("EXECUTIVE LEADERSHIP"). THE COMMITTEE REVIEWS THE "TOTAL COMPENSATION" OF THESE INDIVIDUALS WHICH IS INTENDED TO INCLUDE BOTH CURRENT AND DEFERRED COMPENSATION AND ALL EMPLOYEE BENEFITS, BOTH QUALIFIED AND NON-QUALIFIED. THE COMMITTEE'S REVIEW IS DONE ON AT LEAST AN ANNUAL BASIS AND ENSURES THAT THE "TOTAL COMPENSATION" OF EXECUTIVE LEADERSHIP PERSONNEL IS REASONABLE. THE ACTIONS TAKEN BY THE COMMITTEE ENABLE THE ORGANIZATION TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 4958 WITH RESPECT TO THE TOTAL COMPENSATION OF CERTAIN MEMBERS OF THE EXECUTIVE LEADERSHIP TEAM. THE THREE FACTORS WHICH MUST BE SATISFIED IN ORDER TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS ARE THE FOLLOWING: 1. THE COMPENSATION ARRANGEMENT IS APPROVED IN ADVANCE BY AN "AUTHORIZED BODY" OF THE APPLICABLE TAX-EXEMPT ORGANIZATION WHICH IS COMPOSED ENTIRELY OF INDIVIDUALS WHO DO NOT HAVE A "CONFLICT OF INTEREST" WITH RESPECT TO THE COMPENSATION ARRANGEMENT; 2. THE AUTHORIZED BODY OBTAINED AND RELIED UPON "APPROPRIATE DATA AS TO COMPARABILITY" PRIOR TO MAKING ITS DETERMINATION; AND 3. THE AUTHORIZED BODY "ADEQUATELY DOCUMENTED THE BASIS FOR ITS DETERMINATION" CONCURRENTLY WITH MAKING THAT DETERMINATION. THE COMMITTEE IS COMPRISED OF MEMBERS OF THE ORGANIZATION'S BOARD OF TRUSTEES EACH OF WHOM ARE INDEPENDENT AND ARE FREE FROM ANY CONFLICTS OF INTEREST. THE COMMITTEE RELIED UPON APPROPRIATE COMPARABLE DATA; SPECIFICALLY, THE COMMITTEE OBTAINED A WRITTEN COMPENSATION STUDY FROM AN INDEPENDENT FIRM WHICH SPECIALIZES IN THE REVIEWING OF HOSPITAL AND HEALTHCARE SYSTEM EXECUTIVE COMPENSATION AND BENEFITS THROUGHOUT THE UNITED STATES. THIS STUDY USED COMPARABLE GEOGRAPHIC AND DEMOGRAPHIC MARKET DATA INCLUDING BUT NOT LIMITED TO SIMILAR SIZED HOSPITALS, # OF LICENSED BEDS AND NET PATIENT SERVICE REVENUE. THE COMMITTEE ADEQUATELY DOCUMENTED ITS BASIS FOR ITS DETERMINATION THROUGH THE TIMELY PREPARATION OF WRITTEN MINUTES OF THE COMPENSATION COMMITTEE MEETINGS DURING WHICH THE EXECUTIVE COMPENSATION AND BENEFITS WAS REVIEWED AND SUBSEQUENTLY APPROVED. THE ACTIONS OUTLINED ABOVE WITH RESPECT TO THE COMMITTEE AND THE ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS ONLY APPLIES TO CERTAIN SENIOR MANAGEMENT PERSONNEL. THE COMPENSATION AND BENEFITS OF CERTAIN OTHER INDIVIDUALS CONTAINED IN THIS FORM 990 ARE REVIEWED ANNUALLY BY THE PRESIDENT/CHIEF EXECUTIVE OFFICER WITH ASSISTANCE FROM THE SYSTEM'S HUMAN RESOURCES DEPARTMENT. IN CONJUNCTION WITH THE INDIVIDUAL'S JOB PERFORMANCE DURING THE YEAR, COMPENSATION IS BASED UPON OTHER OBJECTIVE FACTORS DESIGNED TO ENSURE THAT REASONABLE AND FAIR MARKET VALUE COMPENSATION IS PAID BY RICHMOND UNIVERSITY MEDICAL CENTER. OTHER OBJECTIVE FACTORS INCLUDE MARKET SURVEY DATA FOR COMPARABLE POSITIONS, INDIVIDUAL GOALS AND OBJECTIVES, PERSONNEL REVIEWS, EVALUATIONS, SELF-EVALUATIONS, AND PERFORMANCE FEEDBACK MEETINGS.
CORE FORM, PART VI, SECTION C; QUESTION 19	THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE STATE OF NEW YORK. IN ADDITION, THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.
CORE FORM, PART VII AND SCHEDULE J	CORE FORM, PART VII AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM THIS ORGANIZATION. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OF THE ORGANIZATION AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THIS ORGANIZATION'S BOARD OF TRUSTEES.
CORE FORM, PART VII, SECTION A, COLUMN B	THE ORGANIZATION IS AN AFFILIATE WITHIN RICHMOND MEDICAL CENTER D/B/A RICHMOND UNIVERSITY MEDICAL CENTER ("RICHMOND UNIVERSITY MEDICAL CENTER") AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). CERTAIN BOARD OF TRUSTEE MEMBERS AND OFFICERS LISTED ON CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 MAY HOLD SIMILAR POSITIONS WITH BOTH THIS ORGANIZATION AND OTHER AFFILIATES WITHIN THE SYSTEM. THE HOURS SHOWN ON THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE NO COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, REPRESENT THE ESTIMATED HOURS DEVOTED PER WEEK FOR THIS ORGANIZATION. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF TRUSTEES OF OTHER RELATED ORGANIZATIONS IN THE SYSTEM, THEIR RESPECTIVE HOURS PER WEEK PER ORGANIZATION ARE APPROXIMATELY THE SAME AS REFLECTED IN CORE FORM, PART VII OF THIS FORM 990. THE HOURS REFLECTED ON CORE FORM, PART VII OF THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, PAID OFFICERS OR KEY EMPLOYEES, REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF THE SYSTEM; NOT SOLELY THIS ORGANIZATION.
CORE FORM, PART XI; QUESTION 9	OTHER CHANGES IN NET ASSETS OR FUND BALANCE INCLUDE: - NET PERIODIC PENSION COSTS - ($412,576); - RESTRICTED GRANTS & CONTRIBUTIONS - $35,728,549; - PENSION LIABILITY ADJUSTMENT - $23,940,655; - NET ASSETS RELEASED FROM RESTRICTIONS - $26,560; - CHANGE IN BENEFICIAL INTEREST IN RICHMOND MEDICAL CENTER FOUNDATION, INC.; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION - $2,606,712; - NET ASSETS RELEASED FROM DONOR RESTRICTIONS - ($51,560). - INHERENT CONTRIBUTION IN ACQUISITION OF VISITING NURSE ASSOCIATE HEALTH CARE SERVICES, INC. - $3,027,936; AND - CUMULATIVE EFFECT OF ACCOUNTING CHANGE - ($358,983).
CORE FORM, PART XII; QUESTION 2	THE ORGANIZATION IS AN AFFILIATE WITHIN RICHMOND MEDICAL CENTER D/B/A RICHMOND UNIVERSITY MEDICAL CENTER ("RICHMOND UNIVERSITY MEDICAL CENTER") AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF RICHMOND UNIVERSITY MEDICAL CENTER AND AFFILIATES FOR THE YEARS ENDED DECEMBER 31, 2022 AND DECEMBER 31, 2021; RESPECTIVELY. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAIN CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. THE INDEPENDENT CPA FIRM ISSUED AN UNMODIFIED OPINION WITH RESPECT TO THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS EACH YEAR. THE ORGANIZATION'S AUDIT AND COMPLIANCE COMMITTEE HAS ASSUMED RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE CONSOLIDATED FINANCIAL STATEMENTS, WHICH INCLUDES THE SELECTION OF AN INDEPENDENT AUDITOR.
CORE FORM, PART XII; QUESTION 3	THE ORGANIZATION IS AN AFFILIATE WITHIN RICHMOND MEDICAL CENTER D/B/A RICHMOND UNIVERSITY MEDICAL CENTER ("RICHMOND UNIVERSITY MEDICAL CENTER") AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM ENGAGED AN INDEPENDENT ACCOUNTING FIRM TO PREPARE AND ISSUE A SYSTEM WIDE CONSOLIDATED AUDIT AS SET FORTH IN THE UNIFORM GUIDANCE, 2 C.F.R., PART 200, SUBPART F. THE SYSTEM ENGAGED AN INDEPENDENT ACCOUNTING FIRM TO PREPARE AND ISSUE THE UNIFORM GUIDANCE AUDIT.
SCHEDULE R	EFFECTIVE JANUARY 1, 2022, PURSUANT TO THE TERMS OF MERGER AGREEMENT, THIS ORGANIZATION BECAME THE SOLE MEMBER OF VISITING NURSE ASSOCIATION HEALTH CARE SERVICES, INC ("VNAHCS"). VNAHCS'S BYLAWS WERE AMENDED EFFECTIVE JANUARY 1, 2022 TO REFLECT THE CHANGE OF THE ORGANIZATION'S SOLE MEMBER. ACCORDINGLY, VNAHCS AND ALL VNA AFFILIATES HAVE BEEN ADDED TO SCHEDULE R OF THIS ORGANIZATION'S FORM 990.
FORM 990 PART IX LINE 11G	DESCRIPTION:CONTRACTED SERVICES TOTAL FEES:17168559
FORM 990 PART IX LINE 11G	DESCRIPTION:BILLING & COLLECTION TOTAL FEES:6119929
FORM 990 PART IX LINE 11G	DESCRIPTION:FOOD SERVICE FEES TOTAL FEES:3361358
FORM 990 PART IX LINE 11G	DESCRIPTION:PURCHASED SERVICES TOTAL FEES:14778768

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

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

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1	Briefly describe the organization’s mission or most significant activities: TO PROVIDE PREMIER QUALITY PATIENT CARE THROUGH A FULL SPECTRUM OF EMERGENT, ACUTE, PRIMARY, BEHAVIORAL HEALTH AND EDUCATIONAL SERVICES.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	22
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	16
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	2,963
6	Total number of volunteers (estimate if necessary) .............	6	16
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
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) .........	48,512,025	18,761,335
9	Program service revenue (Part VIII, line 2g) .........	327,236,920	399,949,710
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	440,038	408,193
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	475,784	257,045
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	376,664,767	419,376,283
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	256,556,603	275,086,630
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)....	124,695,077	123,325,999
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	381,251,680	398,412,629
19	Revenue less expenses. Subtract line 18 from line 12.......	-4,586,913	20,963,654
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	435,447,032	620,758,922
21	Total liabilities (Part X, line 26).............	350,232,996	450,162,529
22	Net assets or fund balances. Subtract line 21 from line 20.....	85,214,036	170,596,393

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	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 348,106,709 including grants of $ 0 ) (Revenue $ 399,944,826 )
	EXPENSES INCURRED IN PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY MEDICALLY NECESSARY SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT (STATEMENT OF PROGRAM SERVICES) WHICH INCLUDES DETAILED INFORMATION REGARDING THE VARIOUS SERVICES PROVIDED BY THIS ORGANIZATION.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses348,106,709

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	8,906,300	0	1,005,892

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	1,251,308
e	Government grants (contributions)		1e	15,540,322

f	All other contributions, gifts, grants, and similar amounts not included above		1f	1,969,705

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

h Total. Add lines 1a-1f.......		18,761,335

		Business Code
2a	NET PATIENT SERVICE REVENUE	622110	386,364,339	386,364,339
b	OTHER HEALTHCARE RELATED REVENUE	622110	13,585,371	13,585,371
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		399,949,710

3 Investment income (including dividends, interest, and othersimilar amounts) ......			96,474			96,474
4 Income from investment of tax-exempt bond proceeds			224,837			224,837
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents		2,013,701	6a
b	Less: rental expenses		1,842,510	6b
c	Rental income or (loss)	0	171,191	6c
d	Net rental income or (loss).......			171,191			171,191
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	106,500		7a
b	Less: cost or other basis and sales expenses		19,618	7b
c	Gain or (loss)	106,500	-19,618	7c
d	Net gain or (loss).........			86,882			86,882
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	PARKING REVENUE		812930	85,854			85,854
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			85,854
12	Total revenue. See instructions.....			419,376,283	399,949,710		665,238

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	0
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 ...........	6,066,476	5,292,428	774,048
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	0
7	Other salaries and wages........	199,107,982	174,068,371	25,039,611
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	19,562,380	17,066,332	2,496,048
9	Other employee benefits .......	36,484,646	31,829,413	4,655,233
10	Payroll taxes ...........	13,865,146	12,096,032	1,769,114
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	545,153	476,319	68,834
c	Accounting ...........	260,072	227,234	32,838
d	Lobbying ...........	384,284	335,762	48,522
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	41,428,614	36,197,594	5,231,020	0
12	Advertising and promotion ....	687,489	600,683	86,806
13	Office expenses .......	1,509,047	1,318,506	190,541
14	Information technology ......	195,992	171,245	24,747
15	Royalties ..	0
16	Occupancy ...........	2,335,902	2,040,957	294,945
17	Travel ............	157,450	137,569	19,881
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	233,501	204,018	29,483
20	Interest ...........	1,680,469	1,468,283	212,186
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	8,854,603	7,736,569	1,118,034
23	Insurance ...	8,191,678	7,157,349	1,034,329
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	46,094,183	40,274,061	5,820,122
b	REPAIRS & MAINTENANCE	6,787,557	5,930,520	857,037
c	LAUNDRY	862,994	754,027	108,967
d	DUES & SUBSCRIPTIONS	922,417	805,947	116,470
e	All other expenses	2,194,594	1,917,490	277,104
25	Total functional expenses. Add lines 1 through 24e	398,412,629	348,106,709	50,305,920	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 ........			14,246,542	1	36,051,442
2	Savings and temporary cash investments .........			5,480,755	2	15,657,394
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			44,619,441	4	107,630,328
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 ...........			0	7	0
8	Inventories for sale or use ............			6,657,095	8	7,924,735
9	Prepaid expenses and deferred charges ......			1,323,155	9	970,837
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	384,179,568
b	Less: accumulated depreciation	10b	91,919,627	214,999,457	10c	292,259,941
11	Investments—publicly traded securities .			0	11	0
12	Investments—other securities. See Part IV, line 11 .....			0	12	0
13	Investments—program-related. See Part IV, line 11 ..			58,727,972	13	25,933,166
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			89,392,615	15	134,331,079
16	Total assets. Add lines 1 through 15 (must equal line 33)...			435,447,032	16	620,758,922

17	Accounts payable and accrued expenses .....	99,469,994	17	124,291,604
18	Grants payable ...	0	18	0
19	Deferred revenue .........	3,525,566	19	7,539,538
20	Tax-exempt bond liabilities .........	125,254,571	20	150,401,303
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 ..	2,519,274	23	6,381,970
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	119,463,591	25	161,548,114
26	Total liabilities. Add lines 17 through 25..	350,232,996	26	450,162,529

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	41,693,387	27	88,842,114
28	Net assets with donor restrictions ...........	43,520,649	28	81,754,279
	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 ...........	85,214,036	32	170,596,393
33	Total liabilities and net assets/fund balances ........	435,447,032	33	620,758,922

(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)AMBOY MEDICAL PRACTICE PC 355 BARD AVENUE STATEN ISLAND,NY10310 26-3381883	HEALTH SVCS.	NY	501(C)(3)	509(A)(3)	RUMC	Yes
(2)RICHMOND MEDICAL CENTER FOUNDATION INC 355 BARD AVENUE STATEN ISLAND,NY10310 27-1059815	FUNDRAISING	NY	501(C)(3)	509(A)(3)	RUMC	Yes
(3)VISITING NURSE ASSOC HEALTH CARE SVCS 669 CASTLETON AVENUE STATEN ISLAND,NY10301 13-5562377	HEALTH SVCS.	NY	501(C)(3)	509(A)(2)	RUMC	Yes
(4)VISITING NURSE PLUS INC 669 CASTLETON AVENUE STATEN ISLAND,NY10301 13-3712494	INACTIVE	NY	501(C)(3)	509(A)(2)	RUMC	Yes

(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	(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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) AMBOY MEDICAL PRACTICE PC	D	15,911,218	COST
(2) RICHMOND MEDICAL CENTER FOUNDATION INC	C	1,251,308	COST
(3) RICHMOND MEDICAL CENTER FOUNDATION INC	E	384,098	COST
(4) RICHMOND MEDICAL CENTER FOUNDATION INC	O	275,297	COST
(5) VISITING NURSE ASSOC HEALTH CARE SVCS	D	1,350,000	COST

(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