2024-07-10T14:16:35-05:00 2023-08-31 990 2022-09-01 364841069 NYU LANGONE IPA INC NYUL 2122633092 550 FIRST AVENUE HCC15 NEW YORK NY 10016 JOSEPH J LHOTA TREASURER 2122633474 2024-07-03 JOSEPH LHOTA 999009999 0 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z JOSEPH J LHOTA 550 FIRST AVENUE HCC15 NEW YORK NY 10016 0 0 X N/A X 2016 NY THE ORGANIZATION WILL CONTRACT WITH PHYSICIANS AND OTHER PROVIDERS WHO SERVE THE MEDICAID POPULATION IN ORDER TO FACILITATE THE DELIVERY OF HIGH QUALITY MEDICAL CARE TO THOSE INDIVIDUALS. 5 1 0 0 0 0 0 0 840 0 0 0 0 0 840 0 0 0 0 0 790317 740615 0 0 0 0 458 790317 741073 -789477 -741073 2877685 2136612 60 60 2877625 2136552 X THE BOARD ADOPTED MISISON STATEMENT IS: TO OPERATE A MEDICAID-FOCUSED INDEPENDENT PRACTICE ASSOCIATION ("IPA") FOR THE BENEFIT OF THE INDIGENT MEDICAID POPULATION BY CONTRACTING WITH MANAGED CARE ORGANIZATIONS ("MCOS") THAT SERVE SUCH MEDICAID POPULATIONS, THEREBY MAKING AVAILABLE TO SUCH POPULATION A CADRE OF MEDICAID-ACCEPTING PHYSICIANS, ACROSS MULTIPLE SPECIALTIES, AND TO ENHANCE THE DELIVERY OF HIGH QUALITY CARE TO MEDICAID PATIENTS THROUGH THE DEVELOPMENT OF PROGRAMS AND PROCEDURES TO ENCOURAGE PATIENT SAFETY AND QUALITY IMPROVEMENT INITIATIVES. 0 0 726252 0 0 OPERATE A MEDICAID-FOCUSED IPA FOR THE BENEFIT OF THE INDIGENT MEDICAID POPULATION BY CONTRACTING WITH MCOS THAT SERVE SUCH MEDICAID POPULATIONS, THEREBY MAKING AVAILABLE TO SUCH POPULATION A CADRE OF MEDICAID-ACCEPTING PHYSICIANS, ACROSS MULTIPLE SPECIALTIES, AND TO ENHANCE THE DELIVERY OF HIGH QUALITY CARE TO MEDICAID PATIENTS THROUGH THE DEVELOPMENT OF PROGRAMS AND PROCEDURES TO ENCOURAGE PATIENT SAFETY AND QUALITY IMPROVEMENT INITIATIVES. 726252 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 X 5 1 0 0 0 0 1 1 1 1 1 0 0 1 0 0 0 0 0 0 NY X JOSEPH J LHOTA TREASURER 2122633474 550 FIRST AVENUE NEW YORK NY 10016 ANDREW W BROTMAN MD EVP CLINICAL AFFAIRS 1.00 60.00 X X 0 11290840 2200455 KARIM HABIBI VICE PRESIDENT 1.00 60.00 X X 0 1747273 71803 LARRY MCREYNOLDS DIRECTOR 1.00 0.00 X 0 0 0 ANNETTE JOHNSON JD SECRETARY 1.00 60.00 X 0 6378219 69836 DANIEL J WIDAWSKY EVP FINANCE & CCFO 1.00 60.00 X 0 9131252 2857745 0 28547584 5199839 0 0 1 0 0 0 0 0 0 558112 546950 11162 182503 178853 3650 458 449 9 741073 726252 14821 0 1040993 1040993 1836692 1095619 2877685 2136612 60 60 60 60 X 2877625 2136552 2877625 2136552 2877685 2136612 -741073 0 X 0 1 X 1 0 X X 1 NYU LANGONE HOSPITALS 133971298 3 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 DUE FROM RELATED ORGANIZATIONS 1095619 1095619 X PART X, LINE 2: FASB ACCOUNTING STANDARDS CODIFICATION ("ASC") 740, INCOME TAXES, CLARIFIES THE ACCOUNTING FOR UNCERTAINTY OF INCOME TAX POSITIONS. THIS GUIDANCE DEFINES THE THRESHOLD FOR RECOGNIZING TAX RETURN POSITIONS IN THE FINANCIAL STATEMENTS AS "MORE LIKELY THAN NOT" THAT THE POSITION IS SUSTAINABLE, BASED ON ITS TECHNICAL MERITS. THE GUIDANCE ALSO PROVIDES DIRECTON ON THE MEASUREMENT, CLASSIFICATION AND DISCLOSURE OF TAX RETURN POSITIONS IN THE COMBINED FINANCIAL STATEMENTS. UNCERTAIN INCOME TAX POSITIONS DID NOT HAVE A SIGNIFICANT IMPACT ON NYU LANGONE HEALTH'S COMBINED FINANCIAL STATEMENTS DURING THE YEARS ENDED AUGUST 31, 2023 AND 2022. 0 1 0 0 0 0 0 0 0 ANDREW W BROTMAN MD EVP CLINICAL AFFAIRS 0 1885833 0 4500000 0 4905007 0 2194191 0 6264 0 13491295 0 1573430 DANIEL J WIDAWSKY EVP FINANCE & CCFO 0 2198075 0 4688000 0 2245177 0 2809343 0 48402 0 11988997 0 2199268 ANNETTE JOHNSON JD SECRETARY 0 1193688 0 3250000 0 1934531 0 30500 0 39336 0 6448055 0 560920 KARIM HABIBI VICE PRESIDENT 0 1235089 0 500000 0 12184 0 30500 0 41303 0 1819076 0 0 PART I, LINE 4B THE FOLLOWING OFFICERS PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN ("SERP") DURING CALENDAR YEAR 2022. THE AMOUNTS LISTED BELOW REPRESENT THE EMPLOYER CONTRIBUTIONS TO THESE PLANS FOR CALENDAR YEAR 2022. THESE AMOUNTS ARE REPORTED AS SHARED COSTS BETWEEN NYU LANGONE HOSPITALS AND NYU GROSSMAN SCHOOL OF MEDICINE. ANDREW W. BROTMAN, MD - $2,163,691 AND DANIEL J. WIDAWSKY - $2,778,843. THE SERP CONTRIBUTIONS WERE MADE PURSUANT TO NEGOTIATED AGREEMENTS WITH THE OFFICERS. FORM 990, SCHEDULE J, PART II, COL. (F) THE FOLLOWING INDIVIDUALS' OTHER REPORTABLE COMPENSATION (COL. (B)(III))INCLUDES A TAXABLE SERP DURING CALENDAR YEAR 2022. THIS AMOUNT INCLUDES SERP CONTRIBUTIONS REPORTED ON A PRIOR FORM 990 AS DEFERRED COMPENSATION. THIS AMOUNT IS REPORTED AS A SHARED COST BETWEEN NYULH AND SOM. ANDREW W. BROTMAN, MD - $1,573,430; ANNETTE JOHNON, JD - $560,920; AND DANIEL J. WIDAWSKY - $2,199,268. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION IS NYU LANGONE HEALTH SYSTEM, INC. FORM 990, PART VI, SECTION A, LINE 7A WITH RESPECT TO THE ELECTION OF THE BOARD OF TRUSTEES OF NYU LANGONE IPA, NYU LANGONE HEALTH SYSTEM, AS THE SOLE MEMBER HAS THE POWER AND AUTHORITY TO: (A) ELECT THE CORPORATION'S BOARD; (B) REMOVAL OF THE CORPORATION'S BOARD; AND (C) FILLING ANY VACANCIES IN THE CORPORATION'S BOARD. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING POWERS AND AUTHORITY ARE RESERVED EXCLUSIVELY TO THE MEMBER: (A) ELECTION OF THE CORPORATION'S BOARD; (B) REMOVAL OF THE CORPORATION'S BOARD; (C) FILLING ANY VACANCIES IN THE CORPORATION'S BOARD; (D) AMENDING OR REPEALING THESE BY-LAWS OR ADOPTING NEW BY-LAWS; (E) APPROVING THE CORPORATION'S MERGER OR CONSOLIDATION WITH ANOTHER ENTITY; (F) APPROVING THE SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, OF THE ASSETS OF THE CORPORATION; (G) REVIEWING THE VISION, MISSION AND STRATEGIC AND FINANCIAL PLANS OF THE CORPORATION; (H) REVIEWING THE CORPORATION'S ANNUAL OPERATING AND CAPITAL BUDGETS, PROVIDED THAT FINAL APPROVAL OF THE BUDGETS SHALL REMAIN WITH THE CORPORATION; (I) APPROVING ANY TRANSACTION HAVING A VALUE OF $5,000,000 OR MORE; AND (J) APPROVING THE CREATION, ACQUISITION AND/OR DISSOLUTION OF AN ENTITY IN WHICH THE CORPORATION IS PROPOSED TO BE, OR IS, THE CONTROLLING MEMBER. FORM 990, PART VI, SECTION B, LINE 11B DESCRIPTION OF THE PROCESS USED BY MANAGEMENT AND/OR GOVERNING BODY TO REVIEW THE FORM 990: 1. NYU LANGONE HEALTH'S ("NYULH") FINANCE DEPARTMENT DRAFTS THE FORM 990 AND THE ACCOMPANYING SCHEDULE BASED ON THE FISCAL YEAR'S FINANCIAL ACTIVITY. 2. THE DRAFT IS REVIEWED BY THE SENIOR VICE PRESIDENT OF FINANCE AND CHIEF FINANCIAL OFFICER FOR COMPLETENESS AND ACCURACY. 3. THE REVIEWED DRAFT IS PRESENTED TO THE NYULH BOARD OF TRUSTEES' AUDIT COMMITTEE AS WELL AS CERTAIN OTHER OFFICERS FOR REVIEW. 4. ONCE APPROVED BY THE AUDIT COMMITTEE, THE FORM 990 IS MADE AVAILABLE TO THE FULL BOARD AND THEN IT IS FORWARDED TO THE IRS. FORM 990, PART VI, LINES 12 A-B: NYU LANGONE IPA HAS FORMALLY ADOPTED THE CONFLICTS OF INTEREST POLICY OF ITS SOLE MEMBER, NYULH. THIS POLICY IS MONITORED ON AN ANNUAL BASIS AND REQUIRES OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES TO DISCLOSE ANY CONFLICTS OF INTEREST. THESE DISCLOSURES ARE REVIEWED BY NYULH ANNUALLY. FORM 990, PART VI, LINES 13-14: NYU LANGONE IPA HAS FORMALLY ADOPTED THE WHISTLEBLOWER AND DOCUMENT RETENTION AND DESTRUCTION POLICIES OF ITS SOLE MEMBER, NYULH. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE NYU LANGONE HEALTH SYSTEM OFFICE OF GENERAL COUNSEL MAINTAINS COPIES OF THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES. A COPY OF THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES MAY BE OBTAININED BY CONTACTING: NYU LANGONE HEALTH SYSTEM OFFICE OF THE GENERAL COUNSEL 550 FIRST AVENUE NEW YORK, NEW YORK 10016 TELEPHONE NUMBER: (212) 263-7300 NEW YORK UNIVERSITY 726 BROADWAY NEW YORK NY 10003 135562308 UNIVERSITY NY 501(C)(3) LINE 2 N/A 0 NYU LANGONE HEALTH SYSTEM 550 FIRST AVENUE MSB 153 NEW YORK NY 10016 472613531 SUPPORTING ORG. NY 501(C)(3) LINE 12B, II NEW YORK UNIVERSITY 1 34TH STREET CANCER CENTER INC C/O NYULH 550 FIRST AVENUE NEW YORK NY 10016 300262470 CANCER CARE NY 501(C)(3) LINE 12C, III-FI NYU LANGONE HEALTH SYSTEM 1 SIR HAROLD ACTON TRUST 105 EAST 17TH STREET 2ND FL NEW YORK NY 10003 137050560 SUPPORT OF NYU'S CAMPUS IN FLORENCE, ITALY NY 501(C)(3) LINE 12C, III-FI NEW YORK UNIVERSITY 1 HORTENSE ACTON TRUST PO BOX 1802 PROVIDENCE RI 02901 367110976 SUPPORT OF NYU'S CAMPUS IN FLORENCE, ITALY IL 501(C)(3) PF NEW YORK UNIVERSITY 1 KJC (REY JUAN CARLOS I DE ESPANA DE LA UNIVERSIDAD DE NUEVA YORK) CALLE SEGRE 8 MADRID SP 28002 SUPPORT NYU'S PROGRAM IN SPAIN SP NEW YORK UNIVERSITY 1 NATIONAL CENTER ON PHILANTHROPY AND THE LAW 139 MACDOUGAL STREET 1ST FL NEW YORK NY 10012 133954405 STUDY, RESEARCH, EDUCATION ON PHILANTHROPY & THE LAW NY 501(C)(3) LINE 12A, I NEW YORK UNIVERSITY SCHOOL OF LAW FOUNDATION 1 NYU IN ABU DHABI CORP 105 EAST 17TH STREET 2ND FL NEW YORK NY 10003 262652713 SUPPORT NYU'S CAMPUS IN ABU DHABI NY 501(C)(3) LINE 12A, I NEW YORK UNIVERSITY 1 NYU IMAGING INC 545 FIRST AVENUE NEW YORK NY 10016 134000622 SUPPORT NYU SCHOOL OF MEDICINE NY 501(C)(3) LINE 12A, I NEW YORK UNIVERSITY 1 NEW YORK UNVERSITY SCHOOL OF LAW FOUNDATION 110 WEST 3RD ST 2ND FL NEW YORK NY 10012 136161036 SUPPORT NYU'S SCHOOL OF LAW NY 501(C)(3) LINE 10 NEW YORK UNIVERSITY 1 WASHINGTON SQUARE LEGAL SERVICES INC 110 WEST 3RD ST 2ND FL NEW YORK NY 10012 237392120 CERTAIN PUBLIC INTEREST ACTIVITIES OF NYU'S SCHOOL OF LAW NY 501(C)(3) LINE 12A, I NEW YORK UNIVERSITY 1 NYU IN LONDON 6 BEDFORD SQUARE LONDON UK WC1B 3RA 981074101 SUPPORT NYU'S PROGRAM IN LONDON UK NEW YORK UNIVERSITY 1 NYU HONG KONG FOUNDATION LTD RM 804 THE TESBURY CENTRE 28 QUEE WAN CHAI HK SUPPORT NYU'S PROGRAM IN HONG KONG HK NEW YORK UNIVERSITY 1 NYU IN TEL-AVIV LTD TUVAL 13 RAMAT GAN IS 52522 981058326 SUPPORT NYU'S PROGRAM IN TEL-AVIV IS NEW YORK UNIVERSITY 1 NEW YORK UNIVERSITY IN FRANCE 56 RUE DE PASSY PARIS FR 75016 981058568 SUPPORT NYU'S PROGRAM IN FRANCE FR NEW YORK UNIVERSITY 1 NEW YORK UNIVERSITY IN AFGHANISTAN 150 MASJID E HAJI ABDURRAHIM ST CHA KABUL AF SUPPORT NYU'S ACTIVITIES IN AFGHANISTAN AF NEW YORK UNIVERSITY 1 NYU LANGONE HOSPITALS 550 FIRST AVENUE NEW YORK NY 10016 133971298 HOSPITAL NY 501(C)(3) LINE 3 NYU LANGONE HEALTH SYSTEM 1 NYU LANGONE MSO INC 550 FIRST AVENUE NEW YORK NY 10016 824528600 CONTRACT FOR DELIVERY/PROVISION OF HEALTH SERVICES NY 501(C)(3) LINE 12A, I NEW YORK UNIVERSITY 1 LONG ISLAND COMMUNITY HOSPITAL AT NYU LANGONE HEALTH 101 HOSPITAL ROAD PATCHOGUE NY 11772 111704595 HOSPITAL NY 501(C)(3) LINE 3 NYU LANGONE HEALTH SYSTEM 1 BROOKHAVEN HEALTH CARE SERVICES CORPORATION 101 HOSPITAL ROAD PATCHOGUE NY 11772 112950196 SUPPORT LONG ISLAND COMMUNITY HOSPITAL NY 501(C)(3) LINE 7 NYU LANGONE HEALTH SYSTEM 1 NYU LANGONE DIAGNOSTICS LLC 550 FIRST AVENUE NEW YORK NY 10016 301001205 OUTREACH TESTING NY N/A 0 0 CCC 550 INSURANCE SCC 550 FIRST AVENUE NEW YORK NY 10016 SELF-INSURANCE BB N/A C 1 LA PIETRA SRL VIA BOLOGNESE 120 FIRENZE IT 50139 HOLDS PROPERTY COMPRISING NYU'S FLORENCE CAMPUS IT N/A C 1 NIU DA ED INFOR CONSULTING CO LTD 1555 CENTURY AVENUE ROOM 1063 PUDONG NEW AREA SHANGHAI CH 200062 SUPPORT NYU'S PROGRAM IN CHINA CH N/A C 1 NYU PLUS PARIS 57 BD SAINT GERMAIN PARIS FR 75005 CONTINUING AND EXECUTIVE EDUCATION FR N/A C 0 SHORE HILL HOUSING ASSOCIATES GP INC 550 FIRST AVENUE HCC 15 NEW YORK NY 10016 262243695 HOUSING NY N/A C 1 BROOKHAVEN PHYSICIAN SERVICES PC 100 HOSPITAL ROAD PATCHOGUE NY 11772 260628913 HEALTHCARE NY N/A C 0 BROOKHAVEN SURGICAL SERVICES PC 100 HOSPITAL ROAD PATCHOGUE NY 11772 260885844 HEALTHCARE NY N/A C 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 0