4A (Expenses $ 67363932 including grants of $ 0) (Revenue $ 57938299)
ON JULY 1, 2013, NEW YORK DOWNTOWN HOSPITAL CEASED OPERATING AS A SEPaRATE LICENSED FACILITY. PROGRAM SERVICES 4A - 4C BELOW DISCUSS THE OPERATIONS FROM JANUARY 1 THRU JUNE 30, 2013. HOSPITAL SERVICES FOR PATIENTS WHO ARE ADMITTED INTO THE HOSPITAL. THE SERVICES THAT WE PROVIDE ARE FOR MEDICINE, SURGERY, ORTHOPEDICS, OB/GYN AND NURSERY DELIVERIES. INPATIENT SERVICE STATISTICS: TOTAL DISCHARGES 5,541; TOTAL PATIENT DAYS 23,179; AVERAGE LENGTH OF STAY 4.2 DAYS.

4B (Expenses $ 21272820 including grants of $ 0) (Revenue $ 18296305)
HOSPITAL SERVICES FOR PATIENTS THAT COME THROUGH THE EMERGENCY ROOM, FOR PATIENTS THAT HAVE AMBULATORY SURGERY (SAME DAY SURGERY),PATIENTS THAT ARE SEEN IN THE CLINIC, RENAL DIALYSIS AND REFERRED AMBULATORY SERVICES. OUTPATIENT SERVICE STATISTICS: TOTAL VISITS-CLINIC 5,439; AMBULATORY SURGERY 3,099; EMERGENCY ROOM 20,154.

4C (Expenses $ 0 including grants of $ 0) (Revenue $ 12354582)
HEALTHFIRST IS A MEDICAID MANAGED CARE INSURANCE PLAN IN WHICH NEW YORK DOWNTOWN HOSPITAL IS A PARTICIPANT. THE DISTRIBUTION REPRESENTS EXCESS MEDICAL REVENUE.

the New York Downtown hospital merged with the New York Presbyterian Hospital. All required information for schedule h part V for the reporting period (January 1, 2013 - June 30, 2013) will be disclosed on the New York and Presbyterian hospital form 990 for the period (January 1, 2013 - December 31, 2013). ON JULY 1, 2013, NEW YORK DOWNTOWN HOSPITAL CEASED OPERATING AS A SEPaRATE LICENSED FACILITY. THE INFORMATION DISCLOSED for part v, section b, Financial assistance policy (#9 - 14); Billing and collections (#15 - 18); Policy relating to emergency medical care (#19); and FAP - eligible individuals (#20 - 22) apply to the period JANUARY 1, 2013 - JUNE 30, 2013. Part V, Section B, Question 14g The measures by which the Hospital publicizes the policy to the community served by the Hospital include: Distribution of a Summary of the policy (which describes income levels used to determine eligibility, the primary service area of the Hospital, and the means of applying for assistance) to patients, posting of signs alerting patients to the availability of financial assistance, inclusion of a notice on patient bills that charity care/financial assistance is available to eligible patients, and the distribution of applications for charity care/financial aid to interested patients. care/financial assistance is available to eligible patients, and the distribution of applications for charity care/financial aid to interested patients.

SCHEDULE H
"ON JULY 1, 2013, NEW YORK DOWNTOWN HOSPITAL CEASED OPERATING AS A SEPaRATE LICENSED FACILITY. Part I (#1 - 6b) and Part III (#1 - 9b) required descriptions; needs assessment; patient education of eligibility; community information; and promotion of community health disclosed apply to the period JANUARY 1, 2013 - JUNE 30, 2013. PART I, LINE 3C N/A PART I, LINE 6A N/A Part I, Line 7 the New York Downtown hospital merged with the New York Presbyterian Hospital. All required information for schedule h part I, Line 7 for the reporting period (January 1, 2013 - June 30, 2013)will be disclosed on the New York and Presbyterian hospital form 990 for the period (January 1, 2013 - December 31, 2013). PART III, LINE 2 FOR PATIENTS WHO WERE DETERMINED BY THE HOSPITAL TO HAVE THE ABILITY TO PAY BUT DID NOT, THE UNCOLLECTED AMOUNTS ARE BAD DEBT EXPENSE. ESTIMATED COST IS BASED ON THE TOTAL BAD DEBT AT THE RATIO OF PATIENT CARE COST TO CHARGES. PART III, LINE 3 Amounts represent unpaid self pay balances at the net realizable amounts that are not anticipated to be collected. PART III, LINE 4 AUDITED FINANCIAL STATEMENTS PAGE 14 - 15 PART III, LINE 8 The required method of reporting in schedule h obfuscates the full losses associated with delivery of services to medicare beneficiaries. As reported in part III, section b, line 7, medicare is calculated to result in a $3.1 million surplus; this results because medicare losses of $2.6 million would be reflected in Part I, lines 7f and 7g where losses identified with professional education and subsidized health services are calculated per the methodology mandated for completion of schedule h. furthermore, medicare managed care losses of $1.8 million are excluded altogether from all schedule H disclosures. Medicare Surplus Per Schedule H $3,052,338 Medicare Gme Net Costs ($1,213,927) Medicare net costs of Subsidized Health services ($1,389,905) Medicare Managed Care Net Costs ($1,839,093) Total Net Associated with Medicare Program ($1,390,587) ""net"" is defined as revenue net of costs PART III, LINE 9B NEW YORK DOWNTOWN HOSPITAL WILL NOT FORWARD ANY CLAIMS TO A COLLECTION AGENCY IF THE PATIENT COMPLETED THE FINANCIAL AID APPLICATION AND IS WAITING FOR A DETERMINATION. NYDH PROHIBITS THE FORCED SALE OR FORECLOSURE OF A PRIMARY RESIDENCE BUT PLACEMENT OF LIEN IS ALLOWED. NYDH WILL NOTIFY THE PATIENT OR RESPONSIBLE PARTY AT LEAST 30 DAYS BEFORE THE ACCOUNT IS BEING FORWARDED TO A COLLECTION AGENCY. NYDH WILL PROVIDE WRITTEN CONSENT TO A COLLECTION AGENCY BEFORE IT BEGINS LEGAL ACTION ON THE PATIENT, OR RESPONSIBLE PARTY. NYDH REQUIRES ALL ITS COLLECTION AGENCIES TO FOLLOW THE HOSPITAL'S FINANCIAL AID POLICIES AND PROCEDURES, INCLUDING HOW TO APPLY FOR FINANCIAL AID. NYDH WILL NOT COLLECT ANY MONIES FROM PATIENTS ELIGIBLE FOR MEDICAID AT THE TIME OF SERVICES. NEEDS ASSESSMENT: NEW YORK DOWNTOWN HOSPITAL MEETS QUARTERLY WITH ITS COMMUNITY ADVISORY BOARD (CAB) TO ENCOURAGE CONSTRUCTIVE DIALOGUE WITH OTHER COMMUNITY ORGANIZATIONS. THE CAB IS COMPOSED OF HOSPITAL EXECUTIVES, REPRESENTATIVES FROM STATE AND LOCAL GOVERNMENT, HEALTH DEPARTMENT REPRESENTATIVES, COMMUNITY ORGANIZATIONS, AND LOCAL BUSINESSES. THROUGH THESE MEETINGS, THE HEALTH CARE NEEDS OF THE COMMUNITY ARE REGULARLY ASSESSED, AND FEEDBACK ON THE HOSPITAL'S PERFORMANCE IS OBTAINED AND SUBSEQUENTLY INTEGRATED INTO ITS STRATEGIC PLAN. THE HOSPITAL ALSO ENGAGES IN REGULAR AND EXTENSIVE CONVERSATIONS WITH THE ALLIANCE FOR DOWNTOWN NEW YORK, MANHATTAN COMMUNITY BOARDS ONE AND THREE, AND RESIDENT ADVISORY COUNCILS FROM LOCAL NATURALLY OCCURRING RETIREMENT COMMUNITIES (NORC) AND NEIGHBORHOOD SENIOR HOUSING DEVELOPMENTS. THE HOSPITAL ALSO MAINTAINS EXTENSIVE COLLABORATION AND ON-GOING DIALOGUE WITH LOCAL NURSING HOMES AND HOME CARE SERVICES TO ASSESS COMMUNITY HEALTHCARE NEEDS. THE HOSPITAL ANALYZES HEALTH CARE DATA FROM THE NEW YORK CITY DEPARTMENT OF HEALTH AND MENTAL HYGIENE (DOHMH) AND THE DEPARTMENT FOR THE AGING; DEMOGRAPHIC DATA FROM LOCAL, STATE AND FEDERAL AGENCIES; HOSPITAL-GENERATED STATISTICAL REPORTS; REPORTS GENERATED BY INTERNAL COMMITTEES, TASK FORCES AND THE HOSPITAL'S ANNUAL PLANNING PROCESS; AND POLICY REPORTS FROM THE NEW YORK CITY HEALTH CARE ADVISORY PANEL. IN COLLABORATION WITH THE VISITING NURSE SERVICE (VNSNY), THE CHARLES B. WANG COMMUNITY HEALTH CENTER, BETANCES HEALTH CENTER, THE CHINESE AMERICAN PLANNING COUNCIL, GRAND STREET SETTLEMENT, HAMILTON MADISON HOUSE, THE BROOKLYN CHINESE-AMERICAN ASSOCIATION, THE CHINESE CONSOLIDATED BENEVOLENT ASSOCIATION AND THE AMERICAN CANCER SOCIETY, THE HOSPITAL HAS IDENTIFIED THE PROVISION OF COMPREHENSIVE CANCER CARE AS A NEIGHBORHOOD HEALTH PRIORITY. THE HOSPITAL ALSO PARTICIPATES IN THE COLON HEALTH TASK FORCE. OTHER PARTICIPANTS INCLUDE: VNSNY; THE DOHMH; THE UNITED HOSPITAL FUND (UHF); MANNING PHARMACY AND SURGICAL, INC.; THE AMERICAN CANCER SOCIETY - ASIAN UNIT; AND THE CHARLES B. WANG COMMUNITY HEALTH CENTER. DATA GATHERED BY THE DOHMH AND THE UHF PROMPTED THE HOSPITAL TO ESTABLISH A PATIENT NAVIGATOR PROGRAM WITH THE ULTIMATE GOAL OF INCREASING THE CHINESE COMMUNITY COLONOSCOPY SCREENING RATE. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: IN COMPLIANCE WITH SECTION 2807-K(9-A) OF THE NEW YORK STATE PUBLIC HEALTH LAW, THE HOSPITAL EXTENDS DISCOUNT POLICIES AND INSTALLMENT PAYMENT PLANS TO NEW YORK STATE RESIDENTS WHO HAVE HEALTH INSURANCE, BUT MAY BE UNABLE TO FULLY PAY CO-PAY AND DEDUCTIBLE AMOUNTS. THE HOSPITAL ALSO MAKES DISCOUNTS AVAILABLE TO PATIENTS WITH INCOMES ABOVE 300% OF THE FEDERAL POVERTY LEVEL. THE LEVEL OF DISCOUNT FROM THE HOSPITAL'S REGULAR CHARGES DEPENDS ON A PATIENT'S INCOME - THE MORE A PATIENT'S INCOME FALLS BELOW 300% OF THE FEDERAL POVERTY LEVEL THE HIGHER THE DISCOUNT THE HOSPITAL PROVIDES. PATIENTS WITH INCOMES AT OR BELOW 100% OF THE FEDERAL POVERTY LEVEL CAN BE CHARGED NO MORE THAN THE FOLLOWING: INPATIENT HOSPITAL SERVICES: $150; AMBULATORY SURGERY: $150 PER PROCEDURE; MRI TESTING: $150 PER SESSION; ADULT EMERGENCY ROOM AND OUTPATIENT CLINIC VISITS: $15 PER VISIT; PRENATAL AND CHILDREN'S EMERGENCY ROOM AND CLINIC VISITS: NO CHARGE. THIS LAW COVERS ALL THE MEDICAL SERVICES OFFERED BY THE HOSPITAL, INCLUDING: INPATIENT SERVICES; EMERGENCY ROOM VISITS; AND OTHER OUTPATIENT VISITS, SUCH AS TO CLINICS OPERATED BY THE HOSPITAL. THE HOSPITAL HAS STAFF ON-SITE (BOTH IN THE CREDIT OFFICE AND THE OUTPATIENT DEPARTMENT) TO HELP ELIGIBLE PATIENTS ENROLL INTO STRAIGHT MEDICAID, PCAP OR FAMILY HEALTH PLUS/CHILD HEALTH PLUS. THE CHARITY CARE PROGRAM OFFERS CHARITY CARE TO ELIGIBLE PATIENTS. THIS INCLUDES ACCESS TO EMERGENCY SERVICES FOR RESIDENTS OF NEW YORK STATE, AS WELL AS TO EMERGENCY AND NON-EMERGENCY SERVICES FOR RESIDENTS OF NEW YORK CITY. THIS SERVICE IS PROVIDED THROUGH THE HOSPITAL'S MEDICAID - CHARITY CARE OFFICE. THE HOSPITAL'S PROVISION OF THESE SERVICES was PUBLICIZED THROUGH THE HOSPITAL'S INTERNET (WWW.DOWNTOWNHOSPITAL.ORG) SITE. VARIOUS EDUCATIONAL EFFORTS CONDUCTED BY THE HOSPITAL, PARTICULARLY WITHIN THE LARGE IMMIGRANT COMMUNITIES CONTAINED WITHIN OUR CATCHMENT AREA, ARE INCREASING AWARENESS OF BILLING PROCESSES AND THE AVAILABILITY OF CHARITY CARE AND GOVERNMENT ASSISTANCE PROGRAMS FOR THOSE UNABLE TO PAY FOR SERVICES. THE HOSPITAL ALSO MAKES BROCHURES AND FLYERS AVAILABLE, WHICH REVIEW THESE SERVICES. COMMUNITY INFORMATION: DOWNTOWN HOSPITAL IS THE PRIMARY HOSPITAL SERVING THE LOWER MANHATTAN COMMUNITIES OF THE FINANCIAL DISTRICT; CHINATOWN; BATTERY PARK CITY; LITTLE ITALY; TRIBECA; CITY HALL; POLICE PLAZA; THE FEDERAL, STATE AND CITY COURTHOUSE COMPLEX; AND THE RAPIDLY EXPANDING RESIDENTIAL COMMUNITY OF LOWER MANHATTAN. NEW YORK DOWNTOWN HOSPITAL DEFINES ITS PRIMARY SERVICE AREA AS THE AREA SOUTH OF 14TH STREET. THIS AREA, AS WELL AS THOSE IMMEDIATELY ADJACENT, DELIVERS A HIGH NUMBER OF PATIENTS TO THE HOSPITAL. THE HOSPITAL ALSO CONTINUES TO SERVE A SIGNIFICANT NUMBER OF PATIENTS FROM BROOKLYN AND QUEENS. THE SOUTH STREET SEAPORT, THE WORLD TRADE CENTER SITE AND THE STATUE OF LIBERTY ATTRACT 5 MILLION TOURISTS ANNUALLY TO THE HOSPITAL'S SERVICE AREA, SWELLING THE DOWNTOWN POPULATION BY AN AVERAGE OF ALMOST 14,000 PEOPLE A DAY. IN ADDITION, AN INCREASING NUMBER OF PATIENTS FROM SOHO, GREENWICH VILLAGE AND THE LOWER WEST SIDE ARE RELYING ON THE HOSPITAL FOR EMERGENCY, OBSTETRICAL AND SURGICAL SERVICES FOLLOWING THE CLOSING OF ST. VINCENT'S HOSPITAL. PROMOTION OF COMMUNITY HEALTH: NEARLY ALL OF THE FOLLOWING COMMUNITY OUTREACH PROGRAMS ARE PROVIDED FREE OF CHARGE AS PART OF THE HOSPITAL'S COMMITMENT TO THE PUBLIC GOOD: CORPORATE HEALTH PROGRAMS: DOWNTOWN'S FINANCIAL COMMUNITY DEPENDS DAILY ON THE HOSPITAL FOR EMERGENCY CARE, PREVENTIVE MEDICINE, AND CONVENIENT OUTPATIENT CARE. THE HOSPITAL CUSTOMIZES WORKSITE HEALTH PROMOTION PROGRAMS, SCREENINGS, AND LECTURES FOR EMPLOYEES OF DOWNTOWN COMPANIES.WORKING CLOSELY WITH ITS PARTNERS IN THE CORPORATE COMMUNITY; THE HOSPITAL HAS OPENED SEVERAL ON-SITE MEDICAL UNITS IN VARIOUS BUSINESS OFFICES, INCLUDING C"