Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year
(or fiscal year beginning in)
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(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. | ||||||
Calendar year
(or fiscal year beginning in)
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(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 | ||||||
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.) | ||||||
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.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 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): |
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| 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 | ||||
| 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. |
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| 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) |
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| 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. |
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|
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. |
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|
7 Excess distributions carryover to 2023. Add lines 3j and 4c. |
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| 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..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1A | EXPLANATION OF DELEGATED BOARD AUTHORITY TO COMMITTEE THE EXECUTIVE COMMITTEE CONSISTS OF THE BOARD CHAIR, VICE CHAIR(S), SECRETARY, TREASURER AND PRESIDENT, AND MAY HAVE ADDITIONAL MEMBERS AS DETERMINED BY THE BOARD CHAIR. THE EXECUTIVE COMMITTEE HAS THE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE SINAI HEALTH SYSTEM DURING THE PERIOD BETWEEN MEETINGS OF THE BOARD, SUBJECT TO ANY PRIOR LIMITATION IMPOSED BY THE BOARD OR BY LAW. WHEN ACTION IS TAKEN BY THE EXECUTIVE COMMITTEE, IT WILL BE REPORTED TO THE BOARD AT THE NEXT MEETING OF THE BOARD. |
| FORM 990, PART VI, SECTION A, LINE 6 | EXPLANATION OF CLASSES OF MEMBERS OR SHAREHOLDERS SINAI HEALTH SYSTEM (FEIN 36-3166895) IS SOLE MEMBER OF SCHWAB REHABILITATION HOSPITAL. |
| FORM 990, PART VI, SECTION A, LINE 7A | HOW MEMBERS OR SHAREHOLDERS ELECT GOVERNING BODY DIRECTORS ARE ELECTED BY THE SOLE CORPORATE MEMBER, SINAI HEALTH SYSTEM, FOR A TERM OF 3 YEARS FROM AMONG THOSE PERSONS NOMINATED BY THE SINAI HEALTH SYSTEM GOVERNANCE COMMITTEE. THE GOVERNANCE COMMITTEE SHALL BE RESPONSIBLE FOR SELECTING AND REVIEWING PROSPECTIVE CANDIDATES FOR ELECTION TO THE BOARD OF DIRECTORS, COMMUNICATING EXPECTATIONS OF INDIVIDUAL BOARD MEMBERS, AND RECRUITING PROSPECTIVE BOARD MEMBERS WITH A FOCUS ON DIVERSITY AND EXPERTISE. ALL PROSPECTIVE DIRECTORS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST FORM AS PART OF THE APPLICATION PROCESS, AND ANNUALLY THEREAFTER |
| FORM 990, PART VI, SECTION A, LINE 7B | DECISIONS OF GOVERNING BODY APPROVAL BY MEMBERS OR SHAREHOLDERS THE SOLE CORPORATE MEMBER, WORKING CLOSELY WITH THE CORPORATION'S BOARD OF DIRECTORS, HAS CERTAIN RESERVED POWERS OVER SIGNIFICANT CORPORATE ACTIONS, INCLUDING MATTERS SUCH AS APPOINTMENT OF CORPORATE OFFICERS, AMENDMENT OF GOVERNING DOCUMENTS, APPROVAL OF A MERGER, CONSOLIDATION OR DISSOLUTION, APPROVAL OF BUDGETS AND STRATEGIC PLANS, APPROVAL OF INDEPENDENT CERTIFIED PUBLIC ACCOUNTANTS FOR THE ORGANIZATION, AND APPROVAL OF NON-BUDGETED LONG-TERM DEBT. THE SOLE CORPORATE MEMBER ALSO ENSURES THAT THE CORPORATION IS IN COMPLIANCE WITH ITS STATED CORPORATE AND CHARITABLE PURPOSE AND MISSION. |
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 REVIEW PROCESS THE FORM 990 INFORMATION WAS INITIALLY PROVIDED BY THE FINANCE STAFF WITH MULTI-DISCIPLINARY INPUT FROM PUBLIC AFFAIRS, CORPORATE COMPLIANCE AND OTHER APPROPRIATE STAFF OF THE ORGANIZATION. THE FORM 990 WAS THEN PREPARED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM AND REVIEWED BY SENIOR FINANCE STAFF AND OTHER MEMBERS OF SENIOR LEADERSHIP. PRIOR TO THE FILING, THE FORM 990 WAS MADE AVAILABLE TO THE FULL BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 12C | PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST THE CONFLICT OF INTEREST DISCLOSURE FORM IS COMPLETED AND SIGNED ANNUALLY BY ALL BOARD MEMBERS AND OTHER EMPLOYEES WHO ARE IN A POSITION TO INFLUENCE PURCHASING DECISIONS, AFFILIATIONS OR REFERRALS, HIRING DECISIONS OR CONTRACTS. CONFLICTS DISCLOSED ON THE CONFLICT OF INTEREST DISCLOSURE FORM ARE TAKEN INTO CONSIDERATION WHEN MAKING BOARD COMMITTEE ASSIGNMENTS. IN ADDITION, INDIVIDUALS WHO HAVE A CONFLICT OF INTEREST MUST ABSTAIN FROM PARTICIPATING IN DECISIONS AFFECTING THE INTERESTED PARTIES AND MAKE IT CLEAR WHY THEY ARE ABSTAINING. IF THE POTENTIAL FOR CONFLICT OF INTEREST EXISTS, EMPLOYEES AND PHYSICIANS ARE REQUIRED TO DISCUSS THE SITUATION WITH MANAGEMENT. THE SINAI HEALTH SYSTEM CHIEF EXECUTIVE OFFICER AND CHAIR OF THE AUDIT AND COMPLIANCE COMMITTEE DISCUSS ANY POTENTIAL CONFLICTS WITH THE CHAIRMAN OF THE BOARD OF DIRECTORS. BOARD MEMBERS OF THE SINAI HEALTH SYSTEM OR ANY OF ITS ENTITIES ARE REQUIRED TO REPORT POTENTIAL CONFLICTS TO THE CHIEF COMPLIANCE OFFICER WHO WILL REVIEW POTENTIAL CONFLICTS WITH THE SINAI HEALTH SYSTEM CHIEF EXECUTIVE OFFICER AND CHAIRMAN OF THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION REVIEW & APPROVAL PROCESS - OFFICERS & KEY EMPLOYEES SINAI HEALTH SYSTEM HAS A HUMAN RESOURCES COMMITTEE THAT APPROVES ALL EXECUTIVE COMPENSATION ARRANGEMENTS, INCLUDING INCENTIVE COMPENSATION. SINAI HEALTH SYSTEM'S HUMAN RESOURCES COMMITTEE SUPPORTS THE ORGANIZATIONAL PERFORMANCE OF SINAI HEALTH SYSTEM AND ITS RELATED ENTITIES THROUGH THE ALIGNMENT OF EXECUTIVE COMPENSATION WITH SYSTEM STRATEGIES AND PROGRAMS, AND ENSURES COMPLIANCE WITH APPLICABLE LAW. THE VOTING MEMBERS OF THE COMMITTEE ARE INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. THE COMMITTEE MEETS TWICE ANNUALLY OR MORE FREQUENTLY AS CIRCUMSTANCES REQUIRE. THE COMMITTEE ESTABLISHES DETAILED GOALS ANNUALLY FOR THE PRESIDENT AND CEO AND OTHER EXECUTIVES, AND REVIEWS PERFORMANCE AGAINST THESE GOALS ON AN ANNUAL BASIS. THE COMMITTEE ANNUALLY ENGAGES AN OUTSIDE, INDEPENDENT COMPENSATION CONSULTANT TO BENCHMARK THE SALARIES AND BENEFITS OF THE ORGANIZATION'S ASSISTANT VICE PRESIDENTS AND ABOVE, AS WELL AS A FEW DIRECTORS. COMPENSATION IS BASED ON DETAILED WRITTEN PERFORMANCE APPRAISALS AND EXTERNAL MARKET DATA. IN AN EXECUTIVE SESSION, THE COMMITTEE REVIEWS THE PERFORMANCE OF THE PRESIDENT AND CEO, EACH ELEMENT OF COMPENSATION, DATA OF COMPENSATION PROGRAMS IN EFFECT FOR CEOS OF COMPARABLE ORGANIZATIONS, AND CONDUCTS AN ANNUAL REVIEW OF CEO PERFORMANCE AGAINST ESTABLISHED GOALS. THE COMMITTEE MAINTAINS WRITTEN MINUTES WHICH ARE MAINTAINED IN EXECUTIVE ADMINISTRATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | OTHER DOCUMENTS PUBLICLY AVAILABLE GOVERNING DOCUMENTS, CONFLICT OF INTEREST AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 3,437,008. MANAGEMENT AND GENERAL EXPENSES 3,670,484. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,107,492. |
| FORM 990, PART XI, LINE 9: | OTHER CHANGES IN NET ASSETS W/O DONOR RESTRICTION 67,210. |
| Software ID: | |
| Software Version: |