2024-11-15T00:58:57-06:00 2023-12-31 861065772 DELOITTE TAX LLP 7900 TYSONS ONE PLACE SUITE 800 MCLEAN VA 22102 990 2023-01-01 590624424 MOUNT SINAI MEDICAL CENTER OF FLORIDA INC MOUN 3056742032 4300 ALTON ROAD MIAMI BEACH FL 33140 ALEXANDER MENDEZ EXECUTIVE VP/CFO 3056742032 2024-11-14 1 0 RACHEL KAUFMAN P01485017 7032511000 2023 2024-10-15 13:58:12Z GINO SANTORIO 4300 ALTON ROAD MIAMI BEACH FL 33140 1252783437 0 X WWW.MSMC.COM X 1946 FL TO PROVIDE HIGH QUALITY HEALTH CARE TO OUR DIVERSE COMMUNITY ENHANCED THROUGH TEACHING, RESEARCH, CHARITY CARE AND FINANCIAL RESPONSIBILITY. 24 20 4210 0 102314 0 10031860 18824462 933864156 1000046186 3071245 11290016 21598767 31126792 968566028 1061287456 150000 150000 0 0 450375302 477688808 0 0 0 482128120 494573809 932653422 972412617 35912606 88874839 944774202 1123672620 626418321 728204530 318355881 395468090 X TO PROVIDE HIGH QUALITY HEALTH CARE TO OUR DIVERSE COMMUNITY ENHANCED THROUGH TEACHING, RESEARCH, CHARITY CARE AND FINANCIAL RESPONSIBILITY. 0 0 621516195 150000 856810063 SAFETY NET HOSPITAL OPERATIONSIN 2023, MOUNT SINAI SERVED 25,632 INPATIENT ADMISSIONS, 275,365 OUTPATIENT ADMISSIONS, 55,135 EMERGENCY CARE VISITS IN ITS PRIMARY SERVICE AREA, 19,429 IN ITS SENIOR HEALTH TARGET AREA OF AVENTURA AND 35,868 IN ITS HIALEAH FREE STANDING EMERGENCY DEPARTMENT. MOUNT SINAI PERFORMED 14,802 SURGERIES MEETING SURGICAL CARE STANDARDS AND WELCOMED 2,208 INFANTS WITH HEALTHY BIRTH WEIGHTS. 55918274 0 46055617 TEACHING & RESEARCHIN 2023, MOUNT SINAI RETAINED ITS OWN TEACHING FACULTY AND 15 ACCREDITED GRADUATE MEDICAL EDUCATION PROGRAMS, TEACHING 212 RESIDENTS AND FELLOWS. MOUNT SINAI PROVIDED A TEACHING CLINICAL ENVIRONMENT FOR PHYSICIANS TO BECOME BOARD CERTIFIED. ADDITIONALLY, TO MEET THE DEMANDS OF THE WORKFORCE, MOUNT SINAI TAUGHT 285 NURSING STUDENTS, 437 MEDICAL STUDENTS AND 156 ALLIED HEALTH STUDENTS FOR HEALTH CARE CAREERS. TO SUPPLEMENT THE ACADEMIC ENVIRONMENT IN 2023, MOUNT SINAI HAD 162 RESEARCH STUDIES APPROVED BY A NATIONAL REVIEW BOARD OR BY A MOUNT SINAI INSTITUTION PEER REVIEW BOARD. MOUNT SINAI HAD 115 CANCER STUDIES, 16 MEMORY DISORDER, 11 CARDIAC, AND 20 OTHER STUDIES. 160824006 0 97180506 PHYSICIAN NETWORK AND ACCESS TO CAREACCORDING TO THE 2017 UPDATE TO THE AAMC-COMMISSIONED STUDY OF PHYSICIAN SUPPLY AND DEMAND, PHYSICIAN DEMAND IS PROJECTED TO CONTINUE GROWING FASTER THAN THE SUPPLY. (THE COMPLEXITIES OF PHYSICIAN SUPPLY AND DEMAND: PROJECTIONS FROM 2015 TO 2030, IHS MARKET, FEBRUARY 17, 2017) THE STATE OF FLORIDA AGENCY FOR HEALTHCARE, AND THE STATEWIDE MEDICAID RESIDENCY PROGRAM SUPPORTED THE TEACHING OF SPECIALTY CLINICAL PROVIDERS. MOUNT SINAI PROVIDED BOTH ACCESS TO CARE AND SUPPORT FOR THE TEACHING OF 437 MEDICAL STUDENTS AND 212 RESIDENTS AND FELLOWS. MOUNT SINAI SERVICES 13 LOCATIONS IN TWO COUNTIES BY PROVIDING 297,037 PRIMARY OR SPECIALTY CARE VISITS. MOUNT SINAI HAS WIDENED ACCESS TO SPECIALTY CARE IN FLORIDA AND THE STATE MEDICAID PROGRAM. 838258475 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 1 0 0 0 0 0 1 1 1 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 0 1 667 0 1 4210 1 1 1 1 CJ 0 0 0 0 0 0 0 0 1 0 X 24 20 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 0 FL X LOURDES DIAZ 3056742032 4300 ALTON ROAD MIAMI BEACH FL 33140 STEVE XYDAS EMPLOYED MD CHIEF, CARDIOTHORACIC SURGERY 60.00 0.00 X 2477047 0 89575 GINO SANTORIO PRESIDENT/CEO 60.50 1.00 X X 1860277 0 74144 SAMUEL GOLDSMIT EMPLOYED MD STAFF PHYSICIAN, NEUROSURGERY 60.00 0.00 X 1869747 0 59492 STEVEN HOCHWALD MD STAFF PHYSICIAN, SURGICAL ONCOLOGY 60.00 0.00 X 1542096 0 99042 ALEXANDER MENDEZ EXECUTIVE VP/CFO 60.00 1.00 X 1366300 0 100266 ROY WILLIAMS EMPLOYED MD CHIEF, THORACIC SURGERY 60.00 0.00 X 1192793 0 97151 FERNANDO SAFDIE EMPLOYED MD ASSOC. DIR., THORACIC SURGERY 60.00 0.00 X 1192009 0 69855 STEVEN SONENREICH FORMER PRESIDENT/CEO 0.00 0.00 X 1084684 0 0 ANGEL PALLIN EXECUTIVE VP/COO 57.00 3.00 X 627165 0 103116 ARNOLD JAFFEE SENIOR VP/GEN COUNSEL 60.00 2.00 X 617375 0 100336 THOMAS GILLETTE SENIOR VP/CIO 60.00 0.00 X 604677 0 99234 ROBERT GOLDSZER SENIOR VP/CMO 57.00 3.00 X 604768 0 87676 WAYNE CHUTKAN SENIOR VP OF FINANCE 60.00 0.00 X 551137 0 103116 WENDY STUART SENIOR VP/CNO 60.00 0.00 X 501741 0 59779 BENJAMIN DAVIS SENIOR VP FACILITIES/RESOURCE MGMT 60.00 0.00 X 507884 0 40288 ALON WEIZER SVP/CHIEF MEDICAL OFFICER 60.00 0.00 X 438387 0 49958 ROBERT POPPITI MD PRES MED STAFF/TRUSTEE 2.00 0.00 X 25000 0 0 PAUL BLOCH TRUSTEE 2.00 0.00 X 0 0 0 NORMAN BRAMAN TRUSTEE 2.00 0.00 X 0 0 0 WAYNE CHAPLIN TRUSTEE 2.00 0.50 X 0 0 0 DAPHNA CRAMER SECRETARY 2.00 0.00 X 0 0 0 EDWARD DAUER MD TRUSTEE 2.00 0.00 X 0 0 0 DAVID DEUTCH TRUSTEE 2.00 0.50 X 0 0 0 MARC FARBSTEIN TRUSTEE 2.00 0.00 X 0 0 0 DR ANTONIO FERNANDEZ TRUSTEE 2.00 0.00 X 0 0 0 EUGENE FRENKEL TRUSTEE 2.00 0.00 X 0 0 0 PHILLIP FROST MD TRUSTEE 2.00 0.00 X 0 0 0 JACK GLOTTMANN TRUSTEE 2.00 0.00 X 0 0 0 MARK HALPERN TRUSTEE 2.00 0.00 X 0 0 0 MARK HILDEBRANDT TRUSTEE 2.00 0.50 X 0 0 0 EDIE LAQUER TRUSTEE 2.00 0.00 X 0 0 0 HOWARD LORBER TRUSTEE 2.00 0.00 X 0 0 0 LAURANS MENDELSON TRUSTEE 2.00 0.50 X 0 0 0 SERGIO ROK TRUSTEE 2.00 0.00 X 0 0 0 BRENT SAUNDERS TRUSTEE 2.00 0.00 X 0 0 0 BARRY SIADAT TRUSTEE 2.00 0.00 X 0 0 0 PAUL SINGERMAN VICE CHAIR 2.00 0.00 X 0 0 0 BARRY SKOLNICK CHAIR 2.00 0.50 X 0 0 0 JAMES TATE TRUSTEE 2.00 0.00 X 0 0 0 17063087 0 1233028 798 1 1 0 KVC CONSTRUCTORS INC 9499 NE 2ND AVENUE 205 MIAMI SHORES FL 33138 GENERAL CONTRACTOR 12864043 HYPE IV THERAPY LLC 1500 NE MIAMI PLACE MIAMI FL 33132 NURSING LABOR 9526307 RENOVO SOLUTIONS LLC 4 EXECUTIVE CIRCLE 185 IRVINE CA 92616 HEALTHCARE TECHNOLOGY MGMT SOLUTIONS 7102799 CORESLAB STRUCTURES INC 10501 NW 121 WAY MEDLEY FL 33178 CONCRETE CONTRACTOR 6464966 CANNON DESIGN DEPT CHICAGO 19824 PALATINE IL 600559824 ARCHITECTS 4847265 147 X 16545137 2273905 5420 18824462 PATIENT SERVICE REVENU 621300 755001274 755001274 MEDICARE/MEDICAID REV. 621300 185371353 185371353 GRANT REVENUE 900099 42704849 42704849 OTHER PATIENT REVENUE 621300 16968710 16968710 1000046186 10741445 10741445 3357991 11880 4813168 0 -1455177 11880 -1443297 11880 -1455177 186755117 476267 186250043 432770 505074 43497 548571 548571 EMERGENCY DEPARTMENT 621400 7196067 7196067 PHARMACY 621990 6513831 6513831 CAFETERIA 722514 2784074 2784074 16076117 90434 15985683 32570089 1061287456 1000046186 102314 42314494 150000 150000 11485368 9762563 1722805 405064640 339048139 66016501 35998162 30144146 5854016 25140638 21052271 4088367 558195 90774 467421 4665827 4665827 531100 531100 469311 469311 10163223 10163223 4282200 4282200 19444506 16582411 2862095 15171216 12704075 2467141 1016339 851062 165277 1197522 1002781 194741 13077681 10950990 2126691 42687464 35745634 6941830 38280587 32055403 6225184 MEDICAL SUPPLIES 184814715 184193268 621447 PROVISION FOR BAD DEBT 90118197 75463188 14655009 SERVICE CONTRACTS/MAINT 34098413 28553334 5545079 CONSULTANT FEES 9515451 7968050 1547401 24481862 21777163 2704699 972412617 838258475 134154142 0 242076433 356525469 4322228 8902043 105506685 139905935 12333558 13142660 9797828 10256634 900789300 501320130 388812503 399469170 153830776 113313691 236152 5449877 27858039 76707141 944774202 1123672620 82951352 108064469 390152012 410954182 153314957 209185879 626418321 728204530 X 318355881 395468090 0 0 318355881 395468090 944774202 1123672620 X 88874839 4429825 -16192455 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 454362 0 0 1 14949 469311 0 PART II-B, LINE 1: MOUNT SINAI ENGAGES LOBBYIST TO WORK ON ITS BEHALF TO ENSURE CONTINUED STATE FUNDING TO SUPPORT PATIENT CARE PROGRAMS. A PERCENTAGE OF ANNUAL MEMBERSHIP DUES PAID TO SEVERAL HOSPITAL ORGANIZATIONS ($14,949) IS ATTRIBUTABLE TO LOBBYING EXPENSES AS WELL. 140668000 76722000 704000 15386000 5663000 197045000 120740000 30216000 476000 9022000 1742000 140668000 111845000 19552000 445000 10503000 599000 120740000 107821000 13410000 425000 9162000 649000 111845000 94395000 19487000 356000 5472000 945000 107821000 0.00000 0.03600 0.96400 0 1 1 40436107 40436107 622877295 324395858 298481437 234884664 176924272 57960392 2591234 2591234 399469170 INVESTMENTS IN AFFILIATES 3390868 DEPOSITS 480689 CONSTRUCTION IN PROGRESS 72835584 76707141 INDIGENT CARE ASSESSMENT 10740488 OTHER CURRENT LIABILITIES 27032432 SELF-INSURED CLAIMS RESERVE 87516940 DUE TO THIRD PARTIES 23794953 OTHER LONG-TERM LIABILITIES 6271248 RIGHT-OF-USE FINANCE LIABILITY - SHORT-TERM 9468903 RIGHT-OF-USE OPERATING LIABILITY - SHORT-TERM 2343097 RIGHT-OF-USE FINANCE LIABILITY - LONG-TERM 38052206 RIGHT-OF-USE OPERATING LIABILITY - LONG-TERM 3966404 EPIC LIABILITIES -792 209185879 X 1015164190 4429825 -34602979 -30173154 1045337344 15950112 15950112 1061287456 901795263 19053533 19053533 882741730 89670887 89670887 972412617 PART V, LINE 4: THE FOUNDATION'S ENDOWMENT CONSISTS OF APPROXIMATELY 51 INDIVIDUAL FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. THE ENDOWMENT CONSISTS OF DONOR-RESTRICTED FUNDS THAT HAVE BEEN LIMITED BY DONORS TO A SPECIFIC TIME PERIOD OR PURPOSE. AS REQUIRED BY GAAP, NET ASSETS ASSOCIATED WITH ENDOWMENT FUNDS ARE CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OR ABSENCE OF DONOR-IMPOSED RESTRICTIONS. THE ENDOWMENT NET ASSET COMPOSITION BY FUND TYPE AS OF DECEMBER 31, 2023, IS COMPOSED OF THE FOLLOWING: TEMPORARILY RESTRICTED PERMANENTLY RESTRICTED ALZHEIMER'S PROGRAM 3,365,000 0 MSMC 50 YEARS 68,793,000 0 (PATIENT TOWER) HEMATOLOGY & ONCOLOGY 2,307,000 0 RAD CENTER FOR CANCER GENETICS 10,134,000 0 LABOR & DELIVERY 10,845,000 0 SURGICAL ONCOLOGY 2,221,000 0 BEHAVIORAL HEALTH 5,016,000 0 CANCER CENTER FACILITY 59,613,000 0 WITKOFF CENTER 10,016,000 0 AMBULATORY 8,003,000 0 OTHER PROGRAMS 9,641,000 7,091,000 _____________ _____________ TOTAL FUNDS 189,954,000 7,091,000 PART X, LINE 2: THE FOOTNOTE TO THE AUDITED FINANCIAL STATEMENTS FOR MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC. AND SUBSIDIARIES REGARDING ASC 740 READS AS FOLLOWS: THE MEDICAL CENTER IS A NOT-FOR-PROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE IRC. THE IRC PROVIDES FOR TAXATION OF UNRELATED BUSINESS INCOME UNDER CERTAIN CIRCUMSTANCES. MANAGEMENT HAS CONCLUDED THAT THE MEDICAL CENTER HAS NO MATERIAL UNRELATED BUSINESS INCOME. THE MEDICAL CENTER FOLLOWS THE PROVISIONS OF ASC 740-15-2, INCOME TAXES, AND HAS DETERMINED THAT AS OF DECEMBER 31, 2023 AND 2022, THE MEDICAL CENTER HAD NO MATERIAL UNRECOGNIZED TAX BENEFITS. THE MEDICAL CENTER DOES NOT EXPECT THAT UNRECOGNIZED TAX BENEFITS WILL MATERIALLY INCREASE WITHIN THE NEXT 12 MONTHS. IN THE EVENT THE MEDICAL CENTER WERE TO RECOGNIZE INTEREST AND PENALTIES RELATED TO UNCERTAIN TAX POSITIONS, IT WOULD BE RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS AS INCOME TAX EXPENSE. TAX YEARS FROM 2018 THROUGH 2023 ARE SUBJECT TO EXAMINATION BY THE FEDERAL AND STATE TAXING AUTHORITIES. THERE ARE NO INCOME TAX EXAMINATIONS CURRENTLY IN PROCESS. PART XI, LINE 2D - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT -89,670,887. INCOME FROM MT SINAI MEDICAL OFFICE BLDG II, INC 158,523. INCOME FROM MSMC FOUNDATION 54,474,776. INCOME FROM MSMC ELDERCARE 434,609. PART XI, LINE 4B - OTHER ADJUSTMENTS: NET ASSETS RELEASED FROM RESTRICTION 20,763,280. RENTAL EXPENSES -4,813,168. PART XII, LINE 2D - OTHER ADJUSTMENTS: AMOUNTS REPORTED SEPARATELY 14,240,365. RENTAL EXPENSES 4,813,168. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT 89,670,887. CENTRAL AMERICA & THE CARIBBEAN 0 0 PROGRAM SERVICES INSURANCE PREMIUM 119686 0 0 0 0 0 0 119686 0 119686 1 0 1 0 0 0 PART IV, LINE 3 MOUNT SINAI MEDICAL CENTER OF FLORDA, INC.'S INTEREST IN A FOREIGN CORPORATION IS A WHOLLY OWNED INTEREST IN MOUNT SINAI MEDICAL CENTER OF FLORIDA GUARANTEE CORPORATION, A CORPORATION INCORPORATED IN THE CAYMAN ISLANDS. 1 1 X 1 X 1 X 1 1 1 0 1 1 34425291 1866825 32558466 0.03690 18132372 8725097 9407275 0.01070 60597297 45312222 15285075 0.01730 113154960 55904144 57250816 0.06490 1892990 1892990 0.00210 45943052 11990348 33952704 0.03850 116149323 70193937 45955386 0.05210 8265707 7030879 1234828 0.00140 150000 150000 0.00020 172401072 89215164 83185908 0.09430 285556032 145119308 140436724 0.15920 469311 0 469311 0.00050 7790779 0 7790779 0.00880 8260090 8260090 0.00930 0 20668623 331590294 449527183 -117936889 X 1 0 1 1 MOUNT SINAI MEDICAL CENTER OF FL INC 4300 ALTON ROAD MIAMI BEACH FL 33140 X X X X X MOUNT SINAI MEDICAL CENTER OF FL INC 1 0 0 1 X X X X X X X X X 23 1 1 0 1 X SEE PART V, SECTION C X X 1 23 1 SEE PART V, SECTION C 0 1 X 200.000000000000 200.000000000000 X X X X X 1 1 X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X 1 X 0 X 1 X 0 0 MOUNT SINAI MEDICAL CENTER OF FL, INC. PART V, SECTION B, LINE 5: MOUNT SINAI MEDICAL CENTER COMPLETED ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") IN TAX YEAR 2023 IN COORDINATION WITH THE MIAMI-DADE COMMUNITY HEALTH COLLABORATIVE.ABOUT THE MIAMI-DADE COMMUNITY HEALTH COLLABORATIVEFOUR ORGANIZATIONS CAME TOGETHER TO CREATE A COMPREHENSIVE CHNA FOR MIAMI-DADE COUNTY: JACKSON HEALTH SYSTEM, MOUNT SINAI MEDICAL CENTER, NICKLAUS CHILDREN'S HOSPITAL, AND UNIVERSITY OF MIAMI HEALTH SYSTEM. THE COLLECTIVE IMPACT THIS GROUP CAN MAKE IS MUCH GREATER THAN EACH ONE ACTING SEPARATELY. BELOW IS INFORMATION ON EACH COLLABORATIVE HOSPITAL.THE CHNA USES SYSTEMATIC, COMPREHENSIVE DATA COLLECTION AND ANALYSIS TO DEFINE PRIORITIES FOR HEALTH IMPROVEMENT, CREATES A COLLABORATIVE COMMUNITY ENVIRONMENT TO ENGAGE STAKEHOLDERS, AND FOSTERS AN OPEN AND TRANSPARENT PROCESS TO LISTEN AND UNDERSTAND THE HEALTH NEEDS OF MIAMI-DADE COUNTY, FLORIDA.COLLABORATORSTHIS IS A MULTI-FACILITY CHNA FOR MIAMI-DADE COUNTY CONDUCTED BY THE MIAMI-DADE HEALTH COLLABORATIVE COMPRISED OF:- JACKSON HEALTH SYSTEM - JACKSON MEMORIAL HOSPITAL - JACKSON NORTH MEDICAL CENTER - JACKSON SOUTH MEDICAL CENTER - JACKSON WEST MEDICAL CENTER- MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC.- VARIETY CHILDREN'S HOSPITAL D/B/A NICKLAUS CHILDREN'S HOSPITAL- UNIVERSITY OF MIAMI HOSPITALS AND CLINICSTHE MIAMI-DADE COMMUNITY HEALTH COLLABORATIVE, AS THE SPONSORS OF THE ASSESSMENT, ENGAGED SYNTELLIS, NATIONAL LEADERS IN COMMUNITY HEALTH NEEDS ASSESSMENTS, TO ASSIST IN THE PROJECT. SYNTELLIS PROVIDED THE ANALYSIS OF SECONDARY COMMUNITY HEALTH DATA, THE PRIMARY SURVEY DATA, FACILITATED THE FOCUS GROUPS, AS WELL AS THE COMMUNITY HEALTH SUMMIT. WILKINS RESEARCH SERVICES CONDUCTED THE COMMUNITY SURVEYS.METHODS AND DATESIN FEBRUARY 2023, THE MIAMI-DADE COMMUNITY HEALTH COLLABORATIVE BEGAN A CHNA FOR MIAMI-DADE COUNTY AND SOUGHT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY USING SEVERAL METHODS:- INFORMATION GATHERING, USING SECONDARY PUBLIC HEALTH SOURCES, OCCURRED IN APRIL 2023- COMMUNITY MEMBERS PARTICIPATED IN FOCUS GROUPS FOR THEIR PERSPECTIVES ON COMMUNITY HEALTH NEEDS AND ISSUES ON MAY 9, 2023- COMMUNITY PROVIDER SURVEYS WERE CONDUCTED FROM MAY 15, 2023 THROUGH JULY 10, 2023- HEALTH SYSTEM EMPLOYEE SURVEYS WERE CONDUCTED FROM MAY 15, 2023 THROUGH JULY 10, 2023- A COMMUNITY SURVEY WAS CONDUCTED VIA ONLINE, CELL PHONE, AND LANDLINES FROM MAY 25 THROUGH JUNE 13, 2023- A COMMUNITY HEALTH SUMMIT WAS HELD ON JULY 13, 2023, TO CREATE A COMMON DATABASE OF UNDERSTANDING OF HEALTH NEEDS, PRIORITIZE THE MOST SIGNIFICANT HEALTH NEEDS, AND BRAINSTORM WAYS TO IMPROVE THE COMMUNITY'S HEALTH. THE AUDIENCE CONSISTED OF REPRESENTATIVES FROM THE HEALTH DEPARTMENT, HEALTHCARE PROVIDERS, GOVERNMENT REPRESENTATIVES, SCHOOLS, NOT-FOR-PROFIT ORGANIZATIONS, EMPLOYERS, AND OTHER COMMUNITY MEMBERS.PARTICIPATION BY THOSE REPRESENTING THE BROAD INTERESTS OF THE COMMUNITYONE HUNDRED AND TWENTY INDIVIDUALS FROM 62 COMMUNITY ORGANIZATIONS PARTICIPATED IN THE FOCUS GROUPS AND THE CHNA SUMMIT. THE FOCUS GROUPS WERE AIMED AT IDENTIFYING AND DEFINING SIGNIFICANT HEALTH NEEDS, ISSUES, AND CONCERNS OF MIAMI-DADE COUNTY. ADDITIONALLY, A COMMUNITY HEALTH SUMMIT WAS HELD TO ESTABLISH A COMMON UNDERSTANDING OF THE COMMUNITY'S HEALTH STATUS AND PRIORITIZE THE HEALTH NEEDS OF THE COMMUNITY. THE FOUR-MONTH PROCESS CENTERED ON GATHERING AND ANALYZING DATA, AS WELL AS COMPILING INPUT FROM PERSONS WHO REPRESENTED THE BROAD INTERESTS OF THE COMMUNITY, TO PROVIDE DIRECTION FOR THE COMMUNITY AND HOSPITAL TO CREATE A PLAN TO IMPROVE THE HEALTH OF THE COMMUNITIES. A DETAILED LIST OF PARTICIPANTS FOLLOWS:- AMERICAN HEART ASSOCIATION- CAMILLUS HEALTH CONCERN AND CAMILLUS HOUSE- CHILDREN'S BEREAVEMENT CENTER/LIFT FROM LOSS- CHILDREN'S HOME SOCIETY- CITY YEAR MIAMI- CLT BUSINESS SOLUTIONS- COMMON THREADS- CORAL GABLES FIRE DEPARTMENT- DADE COUNTY STREET RESPONSE- FLORIDA DEPARTMENT OF HEALTH IN MIAMI-DADE COUNTY- DOCTORS WITHIN BORDERS FREE URGENT CARE AND CLINIC- DREAM IN GREEN- EARLY STEPS- EPILEPSY ALLIANCE FLORIDA- FEEDING SOUTH FLORIDA- FLORIDA DEPARTMENT OF HEALTH IN MIAMI-DADE COUNTY- FLORIDA INTERNATIONAL UNIVERSITY- GIRL SCOUTS OF TROPICAL FLORIDA- HEALTH COUNCIL OF SOUTH FLORIDA- HEALTH FOUNDATION OF SOUTH FLORIDA- HEALTHY START COALITION OF MIAMI-DADE- HOPE FOR MIAMI- ICU BABY- JACKSON HEALTH SYSTEM- LION ORDER GOLD LLC- LEUKEMIA AND LYMPHOMA SOCIETY- METRO MOMMY AGENCY- MIAMI BEACH COMMUNITY HEALTH CENTER, INC.- MIAMI DADE COUNTY CAHSD HEAD START- MIAMI-DADE COUNTY COMMUNITY ACTION AGENCY- MIND OVER MATTER ALLIED HEALTH, LLC- NAACP SOUTH DADE AND SICKLE CELL FOUNDATION- NAMI MIAMI- NOVA SOUTHEASTERN UNIVERSITY- OFFICE OF MAYOR LEVINE CAVA- OPEN DOOR HEALTH CENTER- OVERTOWN YOUTH CENTER- PROSPERITY SOCIAL AND COMMUNITY DEVELOPMENT GROUP- ROXCY BOLTON RAPE TREATMENT CENTER- SHARE OUR STRENGTH- SOUTH FL CANCER COLLABORATIVE- SSJ HEALTH FOUNDATION- ST. JOHN BOSCO CLINIC, INC.- THE CHILDREN'S TRUST- TRANSSOCIAL, INC.- UNIVERSITY OF MIAMI SYLVESTER COMPREHENSIVE CANCER CENTER- UNITE US- UNITED HOME CARE- UNITED WAY MIAMI- UNIVERSITY OF MIAMI- UNIVERSITY OF MIAMI MILLER SCHOOL OF MEDICINE- VIP 305 MIAMI- WESTCHESTER LIBRARY HEALTH & WELLNESS INFORMATION CENTER- YWCAINPUT OF THE MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONSINPUT OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS WAS RECEIVED THROUGH THE FOCUS GROUPS AND THE COMMUNITY SURVEYS. AGENCIES REPRESENTING THESE POPULATION GROUPS WERE INTENTIONALLY INVITED TO THE FOCUS GROUPS AND THE COMMUNITY HEALTH SUMMIT.INPUT OF THOSE WITH EXPERTISE IN PUBLIC HEALTHTHE FLORIDA DEPARTMENT OF HEALTH IN MIAMI-DADE COUNTY PARTICIPATED IN THE FOCUS GROUPS, HEALTH SUMMIT, AND SELECTION OF THE MOST SIGNIFICANT HEALTH PRIORITIES.PROCESS AND METHODS USEDCOMMUNITY SELECTED FOR ASSESSMENTMIAMI-DADE COUNTY WAS THE PRIMARY FOCUS OF THE CHNA DUE TO THE SERVICE AREA OF THE MIAMI-DADE COMMUNITY HEALTH COLLABORATIVE HOSPITALS. THE COMMUNITY INCLUDES MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS WHO LIVE IN THE GEOGRAPHIC AREAS FROM WHICH THE MIAMI-DADE COMMUNITY HEALTH COLLABORATIVE HOSPITALS DRAWS THEIR PATIENTS.DATA AND OTHER INFORMATION USED IN THE ASSESSMENTPRIMARY METHODS INCLUDED:- FOCUS GROUPS WITH COMMUNITY MEMBERS AND COMMUNITY-BASED ORGANIZATIONS FOR THEIR PERSPECTIVES ON COMMUNITY HEALTH- ONLINE SURVEY OF COMMUNITY PROVIDERS (PHYSICIANS AND ADVANCE PRACTICE PROVIDERS)- ONLINE SURVEY OF HOSPITAL EMPLOYEES- RANDOMLY SELECTED COMMUNITY SURVEY VIA ONLINE, LANDLINE, AND CELL PHONES- SURVEYS AND FOCUS GROUPS WERE CONDUCTED IN BOTH ENGLISH AND SPANISH- COMMUNITY HEALTH SUMMIT FOR PRIORITIZATION AND BRAINSTORMINGSECONDARY METHODS INCLUDED:- PUBLIC HEALTH DATA DEATH STATISTICS, COUNTY HEALTH RANKINGS- DEMOGRAPHICS AND SOCIOECONOMICS POPULATION, POVERTY, UNINSURED, UNEMPLOYMENT- PSYCHOGRAPHICS BEHAVIOR MEASURED BY SPENDING AND MEDIA PREFERENCES MOUNT SINAI MEDICAL CENTER OF FL, INC. PART V, SECTION B, LINE 6A: MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC. CONDUCTED ITS CHNA AS PART OF A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT FOR MIAMI-DADE COUNTY. THE CHNA WAS CONDUCTED THE FOLLOWING OTHER HOSPITAL FACILITIES:- JACKSON HEALTH SYSTEM- NICKLAUS CHILDREN'S HOSPITAL- UNIVERSITY OF MIAMI HEALTH SYSTEM MOUNT SINAI MEDICAL CENTER OF FL, INC. PART V, SECTION B, LINE 7D: THE CHNA REPORT IS AVAILABLE VIA E-MAIL. MOUNT SINAI MEDICAL CENTER OF FL, INC. PART V, SECTION B, LINE 11: IN 2023, MOUNT SINAI CONTINUES TO FOCUS ON ITS MISSION:"TO PROVIDE HIGH QUALITY HEALTH CARE TO OUR DIVERSE COMMUNITY ENHANCED THROUGH TEACHING, RESEARCH, CHARITY CARE AND FINANCIAL RESPONSIBILITY."BASED ON THE RESULTS OF THE CHNA, MOUNT SINAI MEDICAL CENTER HAS SELECTED THREE OF THE IDENTIFIED SIGNIFICANT HEALTH NEEDS TO ADDRESS. 1. ACCESS TO HEALTHCARE/TRANSPORTATION2. BEHAVIORAL/MENTAL HEALTH3. CHRONIC DISEASES1. ACCESS TO CARETRANSPORTATION:MOUNT SINAI ASSISTS IN COORDINATING TRANSPORTATION THROUGH INSURANCE PROVIDERS, LOCAL CHAPTERS OF THE AMERICAN CANCER SOCIETY OR LOCAL TRANSIT SERVICES. MOUNT SINAI PROVIDES BUS PASSES AS NEEDED FOR THE HOMELESS AND OTHER POPULATIONS WITHOUT MEANS.FINANCIAL BARRIERS:MOUNT SINAI ASSISTS PATIENTS WITH NO INSURANCE COVERAGE IN APPLYING FOR MEDICAID OR MOUNT SINAI'S FINANCIAL ASSISTANCE PROGRAM. PARTNERS AND COMMUNITY RESOURCES:THE CHIEF MEDICAL OFFICER WAS DESIGNATED TO CREATE AND LEAD A HEALTHCARE DISPARITIES COUNCIL. THE GOAL OF THIS COUNCIL IS TO CONDUCT A HEALTH EQUITY GAP ANALYSIS AND ADDRESS POTENTIAL SOLUTIONS FOR PRIORITY POPULATIONS. CARE MANAGEMENT, IN COLLABORATION WITH NURSING AND INFORMATION TECHNOLOGY (IT) DEPARTMENT, WILL WORK TO IMPLEMENT A PROCESS FOR DOCUMENTATION AND PROVISION OF COMMUNITY RESOURCES FOR PATIENTS IDENTIFIED TO HAVE SOCIAL DETERMINANTS OF HEALTH (SDOH) IN EPIC. MOUNT SINAI CURRENTLY UTILIZES FINDHELP IN EPIC FOR CASE MANAGERS TO EASILY LOOK UP RESOURCES. ADDITIONAL RELATIONSHIPS ARE BEING EXPLORED TO FURTHER ENHANCE THIS TECHNOLOGY.NETWORK:MOUNT SINAI ELDERCARE RECENTLY OPENED IN HIALEAH. ELDERCARE IS A FEDERAL AND STATE SPONSORED PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE). THE SERVICE OFFERS COMPREHENSIVE MEDICAL, SOCIAL AND RECREATIONAL SERVICES TO ADULTS OVER THE AGE OF 55 WHO ARE LIVING WITH CHRONIC ILLNESS OR DISABILITY AND NEED COORDINATED MEDICAL CARE TO CONTINUE LIVING AS INDEPENDENTLY AS POSSIBLE AT HOME OR IN THE COMMUNITY. MOUNT SINAI ELDERCARE'S GOAL IS TO GROW THE NUMBER OF PARTICIPANTS AND KEEP THEM AS ACTIVE AND INDEPENDENT AS POSSIBLE LIVING THEIR BEST LIVES AT HOME. THE IRMA AND NORMAN BRAMAN COMPREHENSIVE CANCER CENTER IS UNDER CONSTRUCTION WITH AN ANTICIPATED COMPLETION IN 2025. MOUNT SINAI WILL JOIN COLUMBIA UNIVERSITY TO CREATE GREATER ACCESS TO CLINICAL EXPERTISE AND CLINICAL TRIALS.MOUNT SINAI CONTINUES TO WIDEN ACCESS TO PRIMARY AND SPECIALTY CARE WITH EXPANSION OF SATELLITE CENTERS AND FREESTANDING EMERGENCY CENTERS. A THIRD FREESTANDING EMERGENCY CENTER IN WESTCHESTER IS SCHEDULED TO OPEN IN FALL OF 2025.EDUCATION:MOUNT SINAI OFFERS FREE HEALTH LECTURES, THROUGHOUT MIAMI-DADE AND MONROE COUNTIES (LIVE AND VIRTUAL), ON TOPICS SUCH AS CARDIOVASCULAR HEALTH, UROLOGY, NUTRITION AND EXERCISE AND CANCER DEVELOPMENTS 2. BEHAVIORAL/MENTAL HEALTHTHE MOUNT SINAI'S BEHAVIORAL HEALTH TEAM WORKS CLOSELY WITH MULTIPLE MIAMI-DADE ORGANIZATIONS AND COMMUNITY-BASED OUTPATIENT HEALTH FACILITIES (MIAMI-DADE COUNTY HOMELESS TRUST, THRIVING MIND SOUTH FLORIDA, MIAMI-DADE BEHAVIORAL HEALTH ALLIANCE, FIRST RESPONDER EDUCATION AND CIT SUPPORT) TO REACH UNDERSERVED AND HOMELESS POPULATIONS. THESE IMPORTANT RELATIONSHIPS ARE PART OF MOUNT SINAI'S COMMITMENT TO SERVING PATIENTS WHO MAY OTHERWISE HAVE NO ACCESS TO MENTAL HEALTH CARE. THE MEDICAL CENTER IS A BAKER ACT RECEIVING FACILITY, AND THOSE NEEDING BEHAVIORAL HEALTH SERVICES CAN SEEK TREATMENT AT OUR EMERGENCY CENTERS IN MIAMI BEACH, AVENTURA, HIALEAH AND WESTCHESTER (COMING SOON). MOUNT SINAI OFFERS INPATIENT AND OUTPATIENT PSYCHIATRIC CARE ON ITS MAIN CAMPUS. OUTPATIENT PARTIAL HOSPITALIZATION AND INTENSIVE OUTPATIENT PROGRAMS ARE OFFERED FOR PATIENTS NEEDING MORE INTENSIVE OUTPATIENT THERAPY, NOT REQUIRING AN OVERNIGHT STAY. MOUNT SINAI IS ONE OF EIGHT PSYCHIATRY RESIDENCY PROGRAMS IN FLORIDA. THE PROGRAM IS ACGME (ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION) ACCREDITED AS A FOUR-YEAR PROGRAM WITH THREE SLOTS PER PGY (POST-GRADUATE YEAR).3. CHRONIC DISEASESCANCERCANCER REMAINS A LEADING CAUSE OF DEATH. MOUNT SINAI'S COMPREHENSIVE CANCER CENTER, AFFILIATED WITH COLUMBIA UNIVERSITY, IS A NATIONALLY RECOGNIZED, AWARD-WINNING CANCER TREATMENT PROGRAM THAT EMBRACES A COLLABORATIVE, MULTIDISCIPLINARY APPROACH TO DIAGNOSE AND TREAT NEARLY EVERY TYPE OF CANCER IN ADULTS. THE ONLY IVY LEAGUE-AFFILIATED CANCER PROGRAM IN SOUTH FLORIDA, OUR TEAM INCLUDES EXPERTS IN MEDICAL ONCOLOGY, RADIATION THERAPY, AND SURGERY. FOCUSED ON THE NEEDS OF EACH INDIVIDUAL PATIENT, OUR CARING TEAM DEVELOPS A COMPREHENSIVE TREATMENT PLAN FOR EACH PATIENT THAT ADDRESSES ALL ASPECTS OF THEIR CARE AND RECOVERY. MEDICAL GENETICS OVERVIEWCLINICAL GENETICS IS A MEDICAL SPECIALTY THAT FOCUSES ON IDENTIFYING WHETHER AN INDIVIDUAL PERSON'S GENES ARE CAUSING DISEASE OR INFLUENCING HEALTH CONDITIONS FOR EXAMPLE, CERTAIN CANCERS AND CARDIAC CONDITIONS. AT MOUNT SINAI MEDICAL CENTER, OUR GENETICS DEPARTMENT FOCUSES ON HELPING PATIENTS IDENTIFY THEIR RISK FOR CERTAIN GENETICALLY DETERMINED OR INHERITED MEDICAL CONDITIONS. THE TEAM HELPS PATIENTS, AFTER THEY HAVE BEEN DIAGNOSED WITH A GENETIC CONDITION, TO BETTER MONITOR OR MANAGE THEIR HEALTH CIRCUMSTANCES.NOTE:DUE TO RESOURCE LIMITATIONS AND LACK OF EXPERTISE, MOUNT SINAI MEDICAL CENTER DOES NOT INTEND TO ADDRESS ALL OF THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. PART V, SECTION B, LINE 7A, CHNA WEBSITE: HTTPS://WWW.MSMC.COM/WP-CONTENT/UPLOADS/2023/12/MIAMI-DADE-COMMUNITY-HEALTH-COLLABORATIVE-COMMUNITY-REPORT-2023-REV-2.PDF PART V, SECTION B, LINE 10A, IMPLEMENTATION STRATEGY WEBSITE: HTTPS://WWW.MSMC.COM/WP-CONTENT/UPLOADS/2024/07/MSMC-COMMUNITY-HEALTH-IMPROVEMENT-PLAN.PDF PART V, LINE 16A, FAP WEBSITE: WWW.MSMC.COM/PATIENT-INFO/FINANCIAL-ASSISTANCE-INFORMATION PART V, LINE 16B, FAP APPLICATION: WWW.MSMC.COM/PATIENT-INFO/FINANCIAL-ASSISTANCE-INFORMATION PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE: WWW.MSMC.COM/PATIENT-INFO/FINANCIAL-ASSISTANCE-INFORMATION PART I, LINE 7: A RATIO OF PATIENT CARE COST TO PATIENT CARE CHARGES WAS APPLIED TO GROSS WRITE-OFFS TO ARRIVE AT AN ESTIMATED PROGRAM COST. ANY APPLICABLE PROGRAM REVENUES RECEIVED WERE OFFSET AGAINST GROSS COST TO ARRIVE AT THE NET COST OR SHORTFALL OF THE PROGRAM. PART I, LINE 7G: MOUNT SINAI'S TEACHING PHYSICIAN NETWORK IS A NOT FOR PROFIT CLINICAL PHYSICIAN AND PROVIDER NETWORK THAT OPERATES AT A LOSS. THE NETWORK PROVIDES A WIDE RANGE OF MEDICAID ELIGIBLE TREATMENT FOR UNDERSERVED PATIENTS. IT ALSO TRAINS PROVIDERS IN ADVANCED SPECIALTIES THAT ARE DOCUMENTED BY THE STATE OF THE FLORIDA TO BE IN SUPPLY-DEMAND DEFICIT. THE GOAL IS TO ALLEVIATE THE HEALTHCARE CRISIS FOR ALL RESIDENTS BUT ESPECIALLY FOR THE UNINSURED, UNDERINSURED AND MEDICAID PATIENTS. BECAUSE OF THE LACK OF CAPACITY, THE STATE OF FLORIDA HAS SHARED THE RESPONSIBILITY OF REMEDYING THE PHYSICIAN SHORTAGE WITH TEACHING HOSPITALS IN FLORIDA. MOUNT SINAI IS ONE OF TWO MIAMI-DADE COUNTY HOSPITALS THAT IS AN AHCA MEDICAID ESSENTIAL PROVIDER FOR ADULT CARE BECAUSE OF ITS ROLE IN TEACHING AND TRAINING FLORIDA'S HEALTHCARE WORKFORCE UNDER THE STATEWIDE MEDICAID RESIDENCY PROGRAM (SMRP).THE COMMUNITY BENEFIT METHOD FOR SUBSIDIZED HEALTH SERVICES IS TAKEN FROM THE PROFIT AND LOSS DETAIL FOR THE MOUNT SINAI TEACHING PHYSICIAN NETWORK. THE EXPENSES REPRESENT DIRECT CLINICAL EXPENSES WHICH GENERATE PRIMARY CARE AND SPECIALTY CARE PATIENT REVENUE IN MIAMI-DADE COUNTY AND MONROE COUNTY. THESE COSTS INCLUDE, BUT ARE NOT LIMITED TO PATIENT CARE SERVICES, UTILITIES, DEPARTMENTAL SUPPLIES AND OTHER EXPENSES ASSOCIATED WITH A MEDICAL OFFICE. THE METHODOLOGY USED IS A MORE ACCURATE COST ACCOUNTING THAN THE COST TO CHARGE RATIO BASED PRIMARILY ON INPATIENT AND OUTPATIENT HOSPITAL CARE. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 90,118,198. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING ACTIVITIES:1. WORKFORCE DEVELOPMENT PROJECTS TO RECRUIT HEALTHCARE WORKERS, INCLUDING PHYSICIANS, NURSES AND ALLIED HEALTH PROFESSIONALS PART III, LINE 2: A RATIO OF PATIENT CARE COST TO PATIENT CARE CHARGES WAS APPLIED TO BAD DEBT GROSS WRITE-OFFS TO ARRIVE AT AN ESTIMATED BAD DEBT EXPENSE AT COST. PART III, LINE 4: THE FOOTNOTE TO THE AUDITED FINANCIAL STATEMENTS FOR MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC. AND SUBSIDIARIES REGARDING BAD DEBT EXPENSE READS AS FOLLOWS:THE MEDICAL CENTER RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARD RATES FOR SERVICES PROVIDED (OR ON THE BASIS OF DISCOUNTED RATES, IF NEGOTIATED OR PROVIDED BY POLICY). CONSISTENT WITH ITS MISSION, THE MEDICAL CENTER PROVIDES CARE TO ITS PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. HISTORICALLY, A SIGNIFICANT PORTION OF THE MEDICAL CENTER'S UNINSURED PATIENTS WILL BE UNABLE TO PAY FOR THE SERVICES PROVIDED. AS SUCH, THE MEDICAL CENTER RECORDS A SIGNIFICANT REDUCTION TO PATIENT SERVICE REVENUE FOR PRICE CONCESSIONS TO UNINSURED PATIENTS AND PATIENTS WITH OTHER INSURED BALANCES, SUCH AS COPAYS AND DEDUCTIBLES, IN THE PERIOD THE SERVICES ARE PROVIDED.THE MEDICAL CENTER ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH DEDUCTIBLES AND COINSURANCE AND FROM THOSE WHO ARE UNINSURED BASED ON HISTORICAL EXPERIENCE AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS. THE IMPLICIT PRICE CONCESSIONS INCLUDED IN ESTIMATING THE TRANSACTION PRICE REPRESENT THE DIFFERENCE BETWEEN THE AMOUNTS BILLED TO THE PATIENT AND THE AMOUNTS THE MEDICAL CENTER EXPECTS TO COLLECT. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. PART III, LINE 8: A RATIO OF PATIENT CARE COST TO PATIENT CARE CHARGES WAS APPLIED TO MEDICARE REVENUES AND ALLOWABLE COSTS TO ARRIVE AT AN ESTIMATED MEDICARE EXPENSE AT COST. THE HOSPITAL DOES NOT TREAT ANY MEDICARE SHORTFALL AMOUNTS AS COMMUNITY BENEFIT. PART III, LINE 9B: PATIENTS ARE FIRST SCREENED TO SEE IF THEY ARE ELIGIBLE FOR MEDICAID OR CHARITY WHEN THEY COME IN THROUGH THE ER. THE HOSPITAL DETERMINES WHICH PATIENTS QUALIFY FOR CHARITY BASED ON A VERIFIABLE PROCESS REQUIRED BY THE AGENCY HEALTH CARE ADMINISTRATION USING THE FOLLOWING CRITERIA:- PATIENT IS ELIGIBLE IF THE PATIENT'S FAMILY AGGREGATE INCOME DURING THE 12 MONTHS PRECEDING THE DETERMINATION DATE IS AT OR BELOW 200% OF THE THEN CURRENT FEDERAL POVERTY GUIDELINES.- IF PATIENT IS ELIGIBLE FOR CHARITY THE AMOUNT OF ELIGIBLE CHARGES ARE REDUCED ON A SLIDING SCALE BASED ON WHERE THEY FALL IN RELATION TO THE FEDERAL POVERTY GUIDELINES.-MEDICAID PATIENTS WITH BENEFITS EXHAUSTED MAY APPLY FOR CHARITY.- PATIENTS WITH DOCUMENTATION THAT A THIRD PARTY BENEFIT HAS BEEN DENIED OR EXHAUSTED MAY APPLY FOR CHARITY.ALL OPPORTUNITIES FOR PAYMENT OF HOSPITAL DEBT WILL BE INVESTIGATED PRIOR TO APPROVAL INCLUDING A COMPLETE REVIEW OF THE FINANCIAL INFORMATION PROVIDED IN THE UNCOMPENSATED CARE APPLICATION.THE BUSINESS OFFICE'S ROLE IN CHARITY CARE DEALS WITH THE FINAL REVIEW AND APPROVAL OF ELIGIBLE PATIENTS. BUSINESS OFFICE IS RESPONSIBLE FOR ADJUSTING ACCOUNT CHARGES/BALANCES AFTER REVIEWING SEARCH AMERICA'S RESULTS, AND/OR ANY RED FLAGS ON THE ACCOUNT THAT WOULD SUGGEST THE POSSIBILITY OF ALTERNATE METHODS OF PAYMENT. THESE PRACTICES SET FORTH IN THE POLICY WOULD ONLY APPLY TO PATIENTS WHO MAY QUALIFY FOR CHARITY CARE. PART VI, LINE 2: NEEDS ASSESSMENT:COMMUNITY HEALTH NEEDS WERE IDENTIFIED THROUGH A RECOGNIZED HEALTH PLANNING ASSESSMENT PROCESS. THE ASSESSMENT INCLUDED, BUT WAS NOT LIMITED TO, AN ANALYSIS OF DEMOGRAPHIC, ENVIRONMENTAL, STATISTICAL AND BEHAVIORAL PUBLIC HEALTH DATA, ORGANIZING PUBLIC DISCUSSIONS ON HEALTH TOPICS, AND CONDUCTING A SURVEY OF CURRENT HEALTH TOPICS TO EXPLORE THE HEALTH NEEDS OF THE PRIMARY, NEIGHBORING AND COUNTYWIDE SERVICE AREAS OF MOUNT SINAI MEDICAL CENTER. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:MOUNT SINAI'S COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIES INCREASING ACCESS TO CARE AND REMOVING CULTURAL BARRIERS TO CARE AS IMPORTANT GOALS. THE FINANCIAL ASSISTANCE POLICY / APPLICATION PROCESS IS ONE WAY THAT MOUNT SINAI HAS ADDRESSED THIS NEED. MOUNT SINAI HAS PIONEERED AN EFFICIENT AND CULTURALLY SENSITIVE FINANCIAL ASSISTANCE POLICY / APPLICATION PROCESS THAT ADDRESSES THE KEY OBSTACLES OF FINANCIAL ANXIETY AND LACK OF FAMILIARITY OF THE AMERICAN HEALTHCARE SYSTEM.MOUNT SINAI'S FINANCIAL ASSISTANCE POLICY, APPLICATION, AND PLAIN-LANGUAGE SUMMARY ARE AVAILABLE ON MOUNT SINAI'S WEBSITE AT HTTPS://WWW.MSMC.COM/PATIENT-INFO/FINANCIAL-ASSISTANCE-INFORMATION AS WELL AS IN PERSON AT THE MOUNT SINAI BUSINESS OFFICE, IN THE REGISTRATION AND ADMITTING DEPARTMENTS, UPON REQUEST IN ANY OTHER DEPARTMENT OR IN ANY OTHER PUBLIC SPACE. MOUNT SINAI'S FINANCIAL ASSISTANCE POLICY, APPLICATION AND PLAIN-LANGUAGE SUMMARY ARE AVAILABLE FREE OF CHARGE IN ENGLISH, SPANISH, AND RUSSIAN, THE PRIMARY LANGUAGES SPOKEN BY THE LOCAL POPULATIONS AND, UPON REQUEST, CAN BE TRANSLATED INTO OTHER LANGUAGES SUCH AS FRENCH, GERMAN, YIDDISH, CREOLE AND ITALIAN, AS NEEDED.THIS APPLICATION PROCESS IS UNIQUE IN THAT IT DOES NOT REQUIRE AN UPFRONT PAPER DOCUMENT SUBMISSION, ALTHOUGH A WRITTEN APPLICATION IS MADE AVAILABLE ON OUR WEBSITE. A PROSPECTIVE APPLICANT SCHEDULES AN IN PERSON COUNSELING SESSION USING THE CONTACT INFORMATION AVAILABLE IN PLAIN LANGUAGE AT HTTPS://WWW.MSMC.COM/PATIENT-INFO/FINANCIAL-ASSISTANCE-INFORMATION. WHILE SCHEDULING THE MEETING, THE APPLICANT RECEIVES INFORMATION ALSO POSTED ONLINE ABOUT HELPFUL FINANCIAL DOCUMENTATION TO SHOW FINANCIAL STATUS THAT WILL BE REVIEWED AND INPUT INTO A MOUNT SINAI MEDICAL CENTER FINANCIAL ASSISTANCE FORM BY A MOUNT SINAI FINANCIAL ASSISTANT TOGETHER WITH THE APPLICANT AT THE FINANCIAL COUNSELING SESSION. FOR PATIENTS WITHOUT HEALTH INSURANCE, MOUNT SINAI WILL DETERMINE ELIGIBILITY USING PUBLIC INFORMATION ABOUT THE PATIENT'S AVAILABLE ASSETS, AND ALL OTHER FINANCIAL RESOURCES THAT THE PATIENT SUPPLIES AS WELL AS A REVIEW OF THE PATIENT'S ACCOUNT HISTORY. MOUNT SINAI WILL FIRST SCREEN FOR APPLICANT ELIGIBILITY FOR MEANS TESTED PROGRAMS AND LOCALLY AVAILABLE GRANTS. IF INELIGIBLE FOR THESE PROGRAMS, MOUNT SINAI PROVIDES AN AUTOMATIC REDUCTION TO GROSS CHARGES BASED UPON THE "LOOK BACK" METHOD. ALL PROSPECTIVE AND RETROSPECTIVE MEDICALLY NECESSARY PATIENT CARE WILL BE CONSIDERED, THOUGH CHARITY CARE IS FIRST FOCUSED ON PATIENTS WHOSE INCOME FOR THE 12 MONTHS PRECEDING THE DETERMINATION IS LESS THAN OR EQUAL TO 200 PERCENT OF THE FEDERAL POVERTY LEVEL FOR THE PATIENT'S FAMILY SIZE, UNLESS THE AMOUNT OF HOSPITAL CHARGES FROM THE PATIENT WILL OR DO EXCEED 25 PERCENT OF THE ANNUAL FAMILY INCOME. INDIVIDUALS MAY OBTAIN FREE, WRITTEN INFORMATION ON THE DETERMINATION OF AMOUNT OF FINANCIAL ASSISTANCE BY CONTACTING THE BUSINESS OFFICE AT (305) 674-2130, MONDAY-FRIDAY 9:00AM-4:00PM. MOUNT SINAI PROVIDES A RIGHT TO APPEAL AND RECEIVE ASSISTANCE IN ALL PARTS OF THE APPLICATION. THE PATIENT MUST WRITE A LETTER WHICH CAN BE POST MAILED OR EMAILED TO THE BUSINESS OFFICE DIRECTOR TO EXPLAIN WHY THE DECISION MADE BY MOUNT SINAI MEDICAL CENTER WAS INAPPROPRIATE. THE APPEAL LETTER WILL BE REVIEWED BY MOUNT SINAI MEDICAL CENTER AND A FINAL DECISION WILL BE SENT TO THE PATIENT WITHIN 30 DAYS OF THE RECEIPT OF THE REQUEST FOR APPEAL. PART VI, LINE 4: COMMUNITY INFORMATION:MOUNT SINAI IS THE ONLY ACUTE CARE HOSPITAL AND EMERGENCY CARE PROVIDER ON THE NORTHEASTERN BARRIER ISLANDS OF MIAMI-DADE COUNTY. MOUNT SINAI PRIMARILY SERVICES A DENSELY POPULATED DIVERSE URBAN AREA ENCOMPASSING THE BARRIER ISLAND CITIES OF MIAMI BEACH, SURFSIDE, NORTH BAY VILLAGE, BAL HARBOUR, AND BAY HARBOR ISLANDS. THE NEIGHBORING MAINLAND OR SECONDARY SERVICE AREA INCLUDES SECTIONS OF THE CITIES OF MIAMI, NORTH MIAMI, AND NORTH MIAMI BEACH. MOUNT SINAI'S HEALTH NEEDS TARGET AREAS INCLUDE SECTIONS OF THE UPPER BARRIER ISLAND CITY OF SUNNY ISLES BEACH AND THE MAINLAND CITIES OF AVENTURA, HIALEAH, AND CORAL GABLES. THERE ARE THREE DESIGNATED MEDICALLY UNDERSERVED AREAS IN THE PRIMARY SERVICE AREA REPRESENTED BY MUAS FEDERAL ID# 5031, 511 AND 7474. PART VI, LINE 5: AS SOUTH FLORIDA'S LARGEST INDEPENDENT TEACHING HOSPITAL, MOUNT SINAI'S NOT-FOR-PROFIT MISSION IS TO PROVIDE HIGH QUALITY HEALTH CARE TO OUR DIVERSE COMMUNITY ENHANCED THROUGH TEACHING, RESEARCH, CHARITY CARE, AND FINANCIAL RESPONSIBILITY. WE MAINTAIN OUR NOT FOR PROFIT MISSION USING A TWO-TIER STRATEGY, FOCUSING, FIRST, ON SAFETY NET SERVICES AND, SECOND, ON ADDRESSING HEALTH RISKS RELATED TO HEART DISEASE, CANCER, NEUROLOGICAL, PULMONARY AND OTHER DISEASES THAT POSE SERIOUS COMMUNITY HEALTH RISKS.THIS NOT FOR PROFIT COMMUNITY DRIVEN MISSION IS DETAILED FURTHER IN SCHEDULE O. WE HAVE BRIEFLY DISCUSSED IT BELOW.TIER ONE - PROVIDE A WIDE RANGE OF SAFETY NET SERVICES- TRAINING TO ADDRESS FLORIDA'S PHYSICIAN AND HEALTHCARE WORKER SHORTAGE - CHARITY CARE FOR THE UNINSURED AND UNDERINSURED- DISASTER FIRST RESPONSE HEALTH SERVICES AND REGIONAL LEADERSHIP- EMERGENCY MEDICAL SERVICES- ADULT PSYCHIATRIC AND BEHAVIORAL CARE- INTENSIVE GERIATRIC / SENIOR CARE- MATERNITY SERVICES AND NEONATAL EMERGENT CARE- HEALTH AND DISEASE PREVENTION EDUCATION- INTERVENTIONAL AND COMMUNITY HEALTH SCREENINGSTIER TWO - MISSION DRIVEN COMMUNITY HEALTH PRIORITIESMOUNT SINAI FOCUSES RESOURCES ON PROVIDING ACCESS TO CARE WHILE TREATING AND PREVENTING THE LEADING DISEASE RELATED CONDITIONS FOR ALL INCOMES IN THE COMMUNITY BY SUBSIDIZING A NONPROFIT TEACHING AND COMMUNITY PHYSICIAN NETWORK.TIER ONE - PROVIDE A WIDE RANGE OF SAFETY NET SERVICESTO ADDRESS FLORIDA'S PHYSICIAN AND HEALTHCARE WORKER SHORTAGE, MOUNT SINAI RETAINED ITS OWN TEACHING FACULTY AND 13 ACGME ACCREDITED, 1 EUSAC ACCREDITED, 1 CPME ACCREDITED AND 4 NON-ACCREDITED GRADUATE MEDICAL EDUCATION PROGRAMS, TEACHING 215 RESIDENTS OR FELLOWS. MOUNT SINAI ALSO PROVIDED A TEACHING CLINICAL ENVIRONMENT FOR BOTH ITS ACUTE CARE AND SPECIALTY CARE PHYSICIAN TEACHING NETWORK FOR PHYSICIANS TO BECOME BOARD CERTIFIED AND TO EDUCATE THE OTHER CRUCIAL COMPONENTS OF THE HEALTHCARE WORKFORCE NOT WITHIN A TRADITIONAL CMS RESIDENCY PROGRAM. IN 2023, MOUNT SINAI TAUGHT NURSING STUDENTS, MEDICAL STUDENTS, AND ALLIED HEALTH STUDENTS FOR HEALTH CARE CAREERS. IN 2023, MOUNT SINAI SERVED 25,632 INPATIENT ADMISSIONS AND 275,365 OUTPATIENT ADMISSIONS. TO ADDRESS CHARITY CARE FOR THE UNINSURED AND UNDERINSURED, MOUNT SINAI PROVIDED $177,466,069 IN CHARITY AND UNCOMPENSATED CARE IN 2023. ADDITIONALLY, IN ITS PRIMARY SERVICE AREA, MOUNT SINAI IS THE ONLY PROVIDER OF MEDICAID HOSPITAL SERVICES.TO PROVIDE DISASTER FIRST RESPONSE HEALTH SERVICES AND REGIONAL LEADERSHIP, IN CONJUNCTION WITH THE CITY OF MIAMI BEACH AND THE STATE OF FLORIDA, MOUNT SINAI HAS COMPLETED A $275 MILLION REGIONAL EMERGENCY SERVICES AND TOWER PROJECT. THIS PROJECT WILL PROVIDE A JOINT EMERGENCY OPERATIONS CENTER FOR THE CITY STAFF, POLICE, FIRE, AND MEDICAL STAFF DURING DECLARED COMMUNITY CRISIS. IT WILL RELOCATE OPERATING ROOMS ABOVE THE FLOOD PLAIN IN A SPECIAL HAZARD FLOOD ZONE, PROVIDE EMERGENCY CARE SERVICES FOR THE STATE'S SECOND LARGEST TOURISM AREA IN HIGH VELOCITY HURRICANE ZONE, PROVIDE A MEDICAL MANAGEMENT DISASTER SHELTER FOR OXYGEN AND ELECTRIC DEPENDENT RESIDENTS INCLUDING THOSE IN INTENSIVE CARE THAT CANNOT EVACUATE, ENSURE THAT ALL PATIENT CARE FOR REGIONAL FACILITY MEETS A MODERN LEVEL OF CARE, PROVIDE SAFE HELIPAD SERVICE AND BOAT ACCESS TO THE ISLAND WHEN BRIDGES ARE LOCKED DOWN AND SERVE AS A NATIONAL STOCKPILE DROP LOCATION FOR COUNTER TERRORISM MEASURES.TO ADDRESS THE NEED FOR EMERGENCY MEDICAL SERVICES AS THE SOLE HOSPITAL ON THE BARRIER ISLANDS OF MIAMI-DADE COUNTY, IN 2023, MOUNT SINAI PROVIDED EMERGENCY SERVICES FOR 55,135 VISITS IN THE PRIMARY SERVICE AREA OF MIAMI BEACH AND FOR AN ADDITIONAL 19,429 IN ITS SENIOR AND GERIATRIC TARGET AREA OF AVENTURA AND 35,868 VISITS IN HIALEAH.TO ADDRESS INTENSIVE GERIATRIC/SENIOR CARE, MOUNT SINAI MAINTAINS THE WEIN CENTER FOR ALZHEIMER'S CARE, THE STATE OF FLORIDA'S LEADING MEMORY DISORDER CLINIC. IT ALSO SERVES AS THE MIAMI-DADE COUNTY COORDINATOR FOR THE STATE-AUTHORIZED CAREGIVER SUPPORT AND SILVER ALERT PROGRAMS, AND PROVIDES INBOUND SENIOR VISITS THROUGH ITS STATE-AUTHORIZED GERIATRIC HOUSE CALL PROGRAM.TO ADDRESS MATERNITY SERVICES AND NEONATAL EMERGENT CARE, MOUNT SINAI PARTNERS WITH THE MIAMI BEACH COMMUNITY HEALTH CENTER TO PROVIDE PREVENTATIVE AND ACUTE OB/GYN CARE FOR ALL INCOMES, RACES, AND ETHNICITIES REGARDLESS OF NATIONAL ORIGIN OR DOCUMENTATION. IN 2023, MOUNT SINAI WELCOMED 2,208 INFANTS TO THE COMMUNITY.TO ADDRESS HEALTH EDUCATION AND COMMUNITY HEALTH SCREENINGS AND EDUCATION, MOUNT SINAI PROVIDES COMMUNITY HEALTH LECTURES AND MEDICAL SCREENINGS. 0 MIAMI BEACH COMMUNITY HEALTH CENTER 11645 BISCAYNE BLVD SUITE 207 MIAMI FL 33181 591829984 501(C)(3) 150000 0 ASSIST THE CITY WITH PROVIDING PRIMARY CARE 1 0 PART I, LINE 2: MOUNT SINAI OVERSEES THE SCHEDULING AND CLINICAL OPPORTUNITIES PROVIDED TO RESIDENTS WHILE SERVING THE PATIENTS AT THE COMMUNITY HEALTH CENTER. X 1 1 X X X X X 0 0 0 0 0 0 0 0 0 STEVE XYDAS EMPLOYED MD CHIEF, CARDIOTHORACIC SURGERY 1947333 0 500000 0 29714 0 49350 0 40225 0 2566622 0 0 0 GINO SANTORIO PRESIDENT/CEO 1498386 0 350000 0 11891 0 29850 0 44294 0 1934421 0 0 0 SAMUEL GOLDSMIT EMPLOYED MD STAFF PHYSICIAN, NEUROSURGERY 1063273 0 800000 0 6474 0 52350 0 7142 0 1929239 0 0 0 STEVEN HOCHWALD MD STAFF PHYSICIAN, SURGICAL ONCOLOGY 1286942 0 250000 0 5154 0 58927 0 40115 0 1641138 0 0 0 ALEXANDER MENDEZ EXECUTIVE VP/CFO 700354 0 300000 0 365946 0 59850 0 40416 0 1466566 0 0 0 ROY WILLIAMS EMPLOYED MD CHIEF, THORACIC SURGERY 979754 0 198828 0 14211 0 54536 0 42615 0 1289944 0 0 0 FERNANDO SAFDIE EMPLOYED MD ASSOC. DIR., THORACIC SURGERY 839429 0 350000 0 2580 0 29850 0 40005 0 1261864 0 0 0 STEVEN SONENREICH FORMER PRESIDENT/CEO 900000 0 0 0 184684 0 0 0 0 0 1084684 0 0 0 ANGEL PALLIN EXECUTIVE VP/COO 399355 0 137165 0 90645 0 59850 0 43266 0 730281 0 0 0 ARNOLD JAFFEE SENIOR VP/GEN COUNSEL 377422 0 92371 0 147582 0 59850 0 40486 0 717711 0 0 0 THOMAS GILLETTE SENIOR VP/CIO 418479 0 94436 0 91762 0 59850 0 39384 0 703911 0 0 0 ROBERT GOLDSZER SENIOR VP/CMO 441836 0 101810 0 61122 0 59850 0 27826 0 692444 0 0 0 WAYNE CHUTKAN SENIOR VP OF FINANCE 377789 0 87207 0 86141 0 59850 0 43266 0 654253 0 0 0 WENDY STUART SENIOR VP/CNO 323143 0 107100 0 71498 0 37350 0 22429 0 561520 0 0 0 BENJAMIN DAVIS SENIOR VP FACILITIES/RESOURCE MGMT 359539 0 76004 0 72341 0 32650 0 7638 0 548172 0 0 0 ALON WEIZER SVP/CHIEF MEDICAL OFFICER 361899 0 75000 0 1488 0 37350 0 12608 0 488345 0 0 0 PART I, LINE 1A GROSS-UP PAYMENTS FOR LIFE AND DISABILITY INSURANCE POLICIES WERE PROVIDED TO ONE OFFICER, ONE FORMER OFFICER, AND ELEVEN KEY EMPLOYEES. SUCH AMOUNTS WERE TREATED AS TAXABLE COMPENSATION AND INCLUDED IN THE W-2 WAGES FOR SUCH EMPLOYEES. PART I, LINE 1B THE DECISION-MAKING PROCESS FOR THE GROSS-UP PAYMENTS MADE PURSUANT TO THE LIFE INSURANCE AND DISABILITY POLICIES FOLLOWED THE SAME COMPENSATION PROCESS OUTLINED IN THE DISCLOSURE FOR FORM 990, PART VI, LINE 15, INCLUDING APPROVAL BY THE COMPENSATION COMMITTEE AND REVIEW BY AN INDEPENDENT CONSULTANT. APPROVAL FOR THE GROSS-UP PAYMENTS IS ALSO OUTLINED IN THE PLAN DOCUMENTS. A CITY OF MIAMI BEACH HEALTH FACILITIES AUTHORITY 650372870 593211EZ4 2014-09-04 181289212 CURRENT REFUND BOND ISSUED 4/28/04 & CAPITAL IMPROVEMENTS 0 0 0 B CITY OF MIAMI BEACH HEALTH FACILITIES AUTHORITY 650372870 000000000 2021-02-25 31775000 CURRENT REFUND BONDS ISSUED 9/4/2014 0 0 0 C CITY OF MIAMI BEACH HEALTH FACILITIES AUTHORITY 650372870 593211FQ3 2021-09-21 162464714 CONSTRUCT OUTPATIENT ONCOLOGY CENTER 0 0 0 D CITY OF MIAMI BEACH HEALTH FACILITIES AUTHORITY 650372870 000000000 2022-11-15 63980000 CURRENT REFUND BONDS ISSUED 2/25/2021 0 0 0 A 42715000 181914236 872760 2358111 110221427 69334698 2019 1 0 1 1 B 31775000 322970 31452030 1 0 1 1 C 164583772 721 11464846 1768629 40464349 110885948 0 0 0 1 D 8770000 63980000 63980000 0 1 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 1 1 B 0 1 0 0 1 0 0 0 1 C 0 1 0 0 0 0 0 0 1 D 0 1 0 0 1 0 0 0 1 A 1 B 1 C 1 D 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CITY OF MIAMI BEACH HEALTH FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 09/14/2019 SCHEDULE K, PART II, LINE 4, COLUMNS A AND B: THE AMOUNT SHOWN HERE CONSISTS SOLELY OF DEBT SERVICE FUND DEPOSITS. PART IV, LINE 6, COLUMN A: SUCH AMOUNTS WERE APPROPRIATELY YIELD RESTRICTED. SCHEDULE K, PART II, LINE 3, COLUMNS A AND C: DIFFERENCES BETWEEN THE AMOUNT SHOWN HERE AND THE ISSUE PRICE REPORTED IN PART I, COLUMN (E) ARE DUE TO ACCUMULATED INTEREST EARNINGS. SCHEDULE K, PART II, LINES 14 AND 15, COLUMN D: THE FORM 8038 FILED FOR THIS ISSUE ERRONEOUSLY REPORTED IT AS HAVING REFUNDED TAX-EXEMPT BONDS, BUT THE REFUNDED DEBT WAS TAXABLE. DR PAUL CHAPLIN MSMC EMPLOYEE & BROTHER OF WAYNE CHAPLIN, MSMC BOARD MEMBER 69232 WAYNE CHAPLIN'S BROTHER, DR. PAUL CHAPLIN, WAS AN EMPLOYEE OF THE HOSPITAL AND IN 2023 HE EARNED WAGES IN THE AMOUNT OF $69,232. 0 COMPREHENSIVE PRIMARY CARE MSMC VOTING MEMBER & MEMBER OF COMPREHENSIVE PRIMARY CARE. 190133 DR. ANTONIO FERNANDEZ, A VOTING MEMBER OF THE HOSPITAL, IS A 70% OWNER OF THE COMPREHENSIVE PRIMARY CARE, WHICH RENTS SPACE FROM THE HOSPITAL. TOTAL RENT PAID IN 2023 WAS $190,133. 0 FORM 990, PART VI, SECTION A, LINE 2 TRUSTEES MARK H. HILDEBRANDT AND LAURANS A. MENDELSON HAVE A BUSINESS RELATIONSHIP. TRUSTEES SERGIO ROK AND JAMES TATE HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11B THE PROCESS FOR REVIEW OF THE FORM 990 BY MEMBERS OF THE GOVERNING BODY AND MANAGEMENT IS AS FOLLOWS: THE MEMBERS OF THE GOVERNING BODY AND MANAGEMENT WILL MEET AND REVIEW IN DETAIL THE COMPLETED FORM 990. A FINAL DRAFT OF FORM 990 IS PROVIDED TO ALL VOTING MEMBERS OF THE ORGANIZATION BEFORE THE FINAL FORM IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY: MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC. AND SUBSIDIARIES (THE "MEDICAL CENTER") FORMALLY IMPLEMENTED A WRITTEN CONFLICT OF INTEREST POLICY (THE "POLICY") IN MARCH 2006 TO PROTECT THE MEDICAL CENTER AND ENSURE THAT THE DELIBERATIONS AND DECISIONS MADE ON BEHALF OF THE MEDICAL CENTER ARE MADE IN THE BEST INTEREST OF THE MEDICAL CENTER. THE TERM "CONFLICT OF INTEREST" AS DEFINED BY THIS POLICY REFERS TO SITUATIONS IN WHICH FINANCIAL OR OTHER PERSONAL CONSIDERATIONS MAY COMPROMISE, OR HAVE THE APPEARANCE OF COMPROMISING, THE JUDGMENT OF SOMEONE CHARGED WITH THE RESPONSIBILITY TO ACT ON BEHALF OF THE MEDICAL CENTER. THIS POLICY IS REVIEWED PERIODICALLY BUT NOT LESS THAN ONCE A YEAR BY THE AUDIT COMMITTEE OF THE BOARD OF TRUSTEES TO BETTER MEET ITS OBJECTIVES. IT IS INTENDED TO SUPPLEMENT BUT NOT REPLACE ANY APPLICABLE LAWS GOVERNING CONFLICTS OF INTEREST IN NONPROFIT AND CHARITABLE ORGANIZATIONS. PERSONS COVERED UNDER THIS POLICY INCLUDE: (1) ANY CURRENT OR FORMER TRUSTEE, OFFICER, OR MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS FOR THE MEDICAL CENTER; (2) MEMBERS OF MANAGEMENT AND ANY EMPLOYEE OF THE MEDICAL CENTER WHO: A) RECEIVES COMPENSATION FROM THE MEDICAL CENTER IN EXCESS OF $150,000 ANNUALLY, WHETHER AS A FULL- OR PART-TIME EMPLOYEE, INDEPENDENT CONTRACTOR, OR OTHERWISE, AND, B) HAS RESPONSIBILITIES, POWER OF INFLUENCE OVER AN ACTIVITY OF THE MEDICAL CENTER SIMILAR TO THAT OF AN OFFICER OR TRUSTEE AND WHICH REPRESENTS MORE THAN 10% OF THE ACTIVITIES, ASSETS, INCOME OR EXPENSES OF THE MEDICAL CENTER, AND C) IS ONE OF THE TWENTY EMPLOYEES WITH THE HIGHEST COMPENSATION FROM THE MEDICAL CENTER. (3) ANY PERSON(S) WHO SERVE AS A MEMBER OF THE MEDICAL CENTER'S MEDICAL STAFF AS A CHAIRPERSON OF A DEPARTMENT, CHIEF OF A CLINICAL SERVICE, OR MEMBER OF THE MEDICAL EXECUTIVE COMMITTEE. MONITORING AND COMPLIANCE: AN IMPORTANT STEP IN MONITORING AND ENFORCING COMPLIANCE WITH A CONFLICT OF INTEREST POLICY INCLUDES MANAGEMENT'S EDUCATION EFFORTS TO MAKE INTERESTED PERSONS AWARE OF THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. TO THAT END, MANAGEMENT HAS INCLUDED IN ITS CODE OF CONDUCT (THE "CODE") A SECTION ON CONFLICTS OF INTEREST WHICH HAS TO BE SIGNED AND RETURNED BY EVERY INTERESTED PERSON TO ACKNOWLEDGE AND ATTEST THAT THEY READ THE CODE INCLUDING THE CONFLICT OF INTEREST SECTION. ANNUALLY, INTERESTED PERSONS ALSO RECEIVE A REFRESHER TRAINING SESSION ON ETHICS AND CONFLICTS OF INTEREST. IN ADDITION, THE AUDIT COMMITTEE OF THE BOARD OF TRUSTEES HAS CREATED A SUBCOMMITTEE ON CONFLICTS OF INTEREST ("CONFLICTS COMMITTEE") TO ADMINISTER AND MONITOR COMPLIANCE WITH THIS POLICY. THE CONFLICTS COMMITTEE REQUIRES A STATEMENT FROM EACH INTERESTED PERSON NOT LESS FREQUENTLY THAN ONCE A YEAR SETTING FORTH ALL BUSINESS AND OTHER AFFILIATIONS THAT RELATE IN ANY WAY TO THE BUSINESS AND OTHER ACTIVITIES OF THE MEDICAL CENTER. INTERNAL AUDIT COMPILES AND SUMMARIZES ALL THE DISCLOSURES RECEIVED FROM INTERESTED PERSONS TO FACILITATE THEIR REVIEW BY THE CONFLICTS COMMITTEE. THE CONFLICTS COMMITTEE INDIVIDUALLY DISCUSSES EACH DISCLOSURE TO EVALUATE WHETHER A CONFLICT OF INTEREST EXISTS AND DETERMINES THE APPROPRIATE COURSE OF ACTION TO TAKE. NEITHER THE BOARD NOR ANY COMMITTEE OF THE BOARD SHALL VOTE UPON ANY PROPOSED TRANSACTION OR ARRANGEMENT IN CONNECTION WITH A POTENTIAL CONFLICT OF INTEREST UNTIL SUCH TIME AS THE CONFLICTS COMMITTEE HAS DETERMINED WHETHER A CONFLICT OF INTEREST EXISTS. WHERE THE CONFLICTS COMMITTEE HAS CONCLUDED THAT A CONFLICT OF INTEREST EXISTS, THE CHAIRMAN OF THE CONFLICTS COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO A PROPOSED TRANSACTION, CONTRACT, OR ARRANGEMENT. IF THE CONFLICTS COMMITTEE DETERMINES THAT THE MEDICAL CENTER CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THEN THE MEDICAL CENTER SHALL NOT ENTER INTO THE TRANSACTION THAT INVOLVES THE CONFLICT OF INTEREST. IF A TRANSACTION OR ARRANGEMENT MORE ADVANTAGEOUS IS NOT REASONABLY ATTAINABLE UNDER THE CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THEN THE BOARD OR COMMITTEE, AS APPLICABLE, SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED TRUSTEES WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE MEDICAL CENTER'S BEST INTEREST AND WHETHER IT IS FAIR AND REASONABLE TO THE MEDICAL CENTER, AND SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH SUCH DETERMINATION. FAILURE BY AN INTERESTED PERSON TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST UNDER THE CONFLICT OF INTEREST POLICY IS CONSIDERED A SERIOUS MATTER AND MAY CONSTITUTE "CAUSE" FOR REMOVAL OR TERMINATION OF A TRUSTEE, OFFICER, OR THE TERMINATION OF ANY CONTRACTUAL OR EMPLOYMENT RELATIONSHIP THE MEDICAL CENTER MAY HAVE WITH AN INTERESTED PERSON OR OTHER PARTY. FORM 990, PART VI, SECTION B, LINE 15 ON AN ANNUAL BASIS, THE MOUNT SINAI MEDICAL CENTER COMPENSATION COMMITTEE CONTRACTS WITH AN INDEPENDENT CONSULTANT TO PREPARE AN OPINION REGARDING THE REASONABLENESS AND COMPARABILITY OF THE TOTAL COMPENSATION PROVIDED TO ITS SENIOR OFFICERS AND KEY EMPLOYEES. THE COMPENSATION COMMITTEE INFORMS THE INDEPENDENT CONSULTANT THAT THE INDEPENDENT CONSULTANT'S OPINION WILL BE PART OF THE COMMITTEE'S PROCEDURE FOR ESTABLISHING THE REBUTTABLE PRESUMPTION OF REASONABLENESS DESCRIBED IN THE INCOME TAX REGULATIONS. THE INDEPENDENT CONSULTANT'S DETERMINATION OF REASONABLENESS IS MADE AFTER A THOROUGH REVIEW OF ALL THE ELEMENTS OF THE TOTAL COMPENSATION COMPRISED OF: CASH COMPENSATION, HEALTH AND WELFARE BENEFITS, RETIREMENT BENEFITS, EXECUTIVE BENEFITS AND PERQUISITES, AND OTHER ELEMENTS OF COMPENSATION INCLUDING SEVERANCE ARRANGEMENTS. THE OPINION EXPRESSED BY THE INDEPENDENT CONSULTANT IS THEN PRESENTED TO THE MSMC COMPENSATION COMMITTEE IN A REPORT FORM FOR THEIR REVIEW. THE OPINION REPORT IS REFERRED TO BY THE COMPENSATION COMMITTEE WHEN DETERMINING AND APPROVING THE ANNUAL COMPENSATION FOR ITS SENIOR OFFICERS AND KEY EMPLOYEES. THE EXECUTIVE BOARD OF TRUSTEES OF MSMC HAS AUTHORIZED ITS COMPENSATION COMMITTEE TO SET ANNUAL COMPENSATION FOR MSMC'S SENIOR OFFICERS AND KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS THAT ARE REQUIRED TO BE OPEN FOR PUBLIC INSPECTION ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART VIII, LINE 12: THE PRESENTATION OF REVENUE FROM MOUNT SINAI MEDICAL CENTER, INC.'S ("MSMC") INVESTMENT IN MIAMI JEWISH HOME HEALTH AGENCY, LLC HAS BEEN UPDATED ON MSMC'S 2023 FORM 990 TO REFLECT REVENUE BASED ON MSMC'S BOOKS AND RECORDS RATHER THAN INCOME REPORTED TO MSMC ON SCHEDULE K-1. FORM 990, PART XI, LINE 9: AMOUNT REPORTED SEPARATELY 1,750,112. NET ASSETS TRANSFERRED FROM MSMC FDN -20,763,280. INCOME FROM MOB 158,523. INCOME FROM ELDERCARE -2,046,490. NET ASSETS RELEASED FROM RESTRICTION 4,708,680. 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