4A (Expenses $ 4974179000 including grants of $ 21438500) (Revenue $ 5251278000)
PATIENT CARE: MEMORIAL SLOAN-KETTERING CANCER CENTER EXPERTS HAVE ESTABLISHED STANDARDS OF CARE AND TREATMENT PROTOCOLS FOR EACH TYPE AND STAGE OF CANCER. OUR PHYSICIANS HAVE AN EXTRAORDINARY DEPTH AND BREADTH OF EXPERIENCE IN DIAGNOSING AND TREATING ALL FORMS OF THE DISEASE, FROM THE MOST COMMON TO THE VERY RARE. EACH YEAR, THEY TREAT MORE THAN 400 DIFFERENT SUBTYPES OF CANCER. THIS LEVEL OF SPECIALIZATION CAN HAVE AN OFTEN-DRAMATIC EFFECT ON A PATIENT'S CHANCES FOR A CURE OR CONTROL OF THEIR CANCER. WHILE WE ARE KNOWN FOR OUR ADVANCED, INNOVATIVE THERAPIES, OUR PHYSICIANS ARE EQUALLY WELL REGARDED FOR THEIR COMPASSION AND CONCERN. OUR DISEASE MANAGEMENT PROGRAM FEATURES 16 MULTIDISCIPLINARY CANCER TEAMS. PATIENTS ARE TREATED BY AS MANY DIFFERENT SPECIALISTS AS ARE NEEDED FOR THEIR PARTICULAR TYPE OF DISEASE, INCLUDING SURGEONS, MEDICAL ONCOLOGISTS, RADIATION ONCOLOGISTS, RADIOLOGISTS, PATHOLOGISTS, PSYCHIATRISTS, AND NURSES. OUR PATHOLOGISTS HAVE UNSURPASSED EXPERTISE IN USING ADVANCED METHODS TO ACCURATELY DIAGNOSE CANCER. BECAUSE OF THEIR SOLE FOCUS ON CANCER, OUR SURGEONS USE SURGICAL TECHNIQUES THAT PRESERVE FORM AND FUNCTION. OUR RADIATION ONCOLOGISTS ARE DEVELOPING AND PUTTING INTO CLINICAL PRACTICE LEADING-EDGE TECHNOLOGIES AND TECHNIQUES IN RADIATION THERAPY. IN ADDITION, THE CENTER OFFERS A FULL RANGE OF PROGRAMS TO HELP PATIENTS AND FAMILIES THROUGHOUT ALL PHASES OF TREATMENT, INCLUDING SUPPORT GROUPS, GENETIC COUNSELING, HELP MANAGING CANCER PAIN AND SYMPTOMS, REHABILITATION, INTEGRATIVE MEDICINE SERVICES, AND ASSISTANCE IN NAVIGATING LIFE AFTER TREATMENT. Throughout the COVID-19 pandemic, MSKCC has worked to protect and assist the public. In the Spring of 2020, Memorial Hospital accepted transfers of COVID-positive cancer patients from other New York hospitals to free up space at those hospitals and provide specialized care to such patients. Similarly, MSKCC has undertaken COVID-19 vaccination efforts not just for its patients and employees, but also for community health care partners and the public. Specifically, MSKCC opened pop up clinics at locations in Harlem and Brooklyn, as well as working with New York City to open a public vaccination site at the Abyssinian Baptist Church in Harlem, which administered approximately 12,000 doses over the course of almost four months.

4B (Expenses $ 821244000 including grants of $ 0) (Revenue $ 170746000)
RESEARCH: MEMORIAL SLOAN-KETTERING CANCER CENTER MAINTAINS ONE OF THE WORLD'S MOST DYNAMIC PROGRAMS OF CANCER RESEARCH. THE EXTRAORDINARY PATIENT CARE WE PROVIDE BENEFITS FROM OUR INNOVATIVE PROGRAMS IN BASIC, TRANSLATIONAL, AND CLINICAL RESEARCH. RESEARCH AT SLOAN-KETTERING INSTITUTE IS DEDICATED TO UNDERSTANDING THE BIOLOGY OF CANCER THROUGH PROGRAMS IN CELL BIOLOGY, GENETICS, BIOCHEMISTRY, MOLECULAR BIOLOGY, STRUCTURAL BIOLOGY, COMPUTATIONAL BIOLOGY, IMMUNOLOGY, AND THERAPEUTICS. INVESTIGATORS AT SLOAN-KETTERING INSTITUTE COLLABORATE WITH MEMORIAL HOSPITAL PHYSICIAN-SCIENTISTS, A PARTNERSHIP THAT HELPS SPEED IMPORTANT RESEARCH FINDINGS FROM THE LABORATORY TO THE BEDSIDE, IN A PROCESS KNOWN AS TRANSLATIONAL RESEARCH. MEMORIAL SLOAN-KETTERING CANCER CENTER ALSO ACTIVELY INITIATES AND PARTICIPATES IN CLINICAL TRIALS TO IDENTIFY MORE EFFECTIVE CANCER THERAPIES, AND OUR PHYSICIANS ARE CURRENTLY LEADING 1,159 CLINICAL TRIALS FOR PEDIATRIC AND ADULT CANCERS. THE HUMAN ONCOLOGY AND PATHOGENESIS PROGRAM (HOPP) IS A FURTHER EFFORT TO INCREASE INSTITUTIONAL RESEARCH STRENGTH IN AREAS IMPORTANT IN CONTEMPORARY TRANSLATIONAL RESEARCH. HOPP IS DESIGNED TO MELD EVEN MORE THOROUGHLY THE CULTURES OF BASIC BIOLOGIC SCIENCE AND CLINICAL ONCOLOGY, AUGMENTING THE WORK CONDUCTED IN THE LABORATORIES OF MEMORIAL SLOAN-KETTERING CANCER CENTER'S PHYSICIAN-SCIENTISTS.

4C (Expenses $ 213880308 including grants of $ 0) (Revenue $ 0)
EDUCATION: EDUCATION IS A VITAL PART OF MEMORIAL SLOAN-KETTERING CANCER CENTER'S MISSION. OUR TRAINING PROGRAMS PREPARE PHYSICIANS AND SCIENTISTS FOR CAREERS IN THE BIOMEDICAL SCIENCES. OUR COLLABORATIONS WITH THE ROCKEFELLER UNIVERSITY, CORNELL UNIVERSITY, AND WEILL MEDICAL COLLEGE OF CORNELL UNIVERSITY OFFER PHD PROGRAMS IN CHEMICAL BIOLOGY, COMPUTATIONAL BIOLOGY AND MEDICINE, AND THE MEDICAL SCIENCES. THE CENTER ALSO PARTNERS WITH WEILL MEDICAL COLLEGE AND THE ROCKEFELLER UNIVERSITY TO OFFER A MD/PHD DEGREE FOR ASPIRING PHYSICIAN-SCIENTISTS. THE CENTER HAS A PHD PROGRAM IN CANCER BIOLOGY THROUGH ITS LOUIS V. GERSTNER, JR. GRADUATE SCHOOL OF BIOMEDICAL SCIENCES. THIS NOVEL PROGRAM HAS BEEN ENROLLING STUDENTS SINCE 2006 AND TRAINS BASIC LABORATORY SCIENTISTS TO WORK IN RESEARCH AREAS DIRECTLY RELEVANT TO CANCER AND OTHER HUMAN DISEASES. WE ALSO OFFER POSTGRADUATE CLINICAL FELLOWSHIPS TO TRAIN PHYSICIANS WHO SEEK SPECIAL EXPERTISE IN A PARTICULAR TYPE OF CANCER AND POSTGRADUATE RESEARCH FELLOWSHIPS THAT PROVIDE PHYSICIANS AND SCIENTISTS WITH ADVANCED LABORATORY RESEARCH TRAINING. WITH FACULTY APPOINTMENTS AT THE WEILL MEDICAL COLLEGE OF CORNELL UNIVERSITY, OUR CLINICAL STAFF ALSO TRAIN RESIDENTS AND MEDICAL STUDENTS.

PART V FACILITY INFORMATION
LINE 3E WE PRIORITIZED THE IDENTIFIED COMMUNITY HEALTH NEEDS BASED ON CERTAIN CRITERION AS OUTLINED IN THE CHNA AND LINKED THEM TO APPROPRIATE PROGRAMS AND ACTIVITIES AS DESCRIBED IN THE IMPLEMENTATION STRATEGIES POSTED TO OUR WEBSITE AT WWW.MSKCC.ORG/COMMUNITYSERVICEPLANS. LINE 3J MSK CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT DURING THE SECOND QUARTER OF 2019 TO DETERMINE THE CRITICAL CANCER-RELATED HEALTH NEEDS FACING RESIDENTS IN OUR 23-COUNTY CATCHMENT AREA IN NEW YORK, NEW JERSEY, AND CONNECTICUT. WE ANALYZED CANCER STATISTICS ON INCIDENCE, PREVALENCE, AND MORTALITY. WE ALSO REVIEWED KEY HEALTH TRENDS AMONG CANCER PATIENTS, MULTICULTURAL POPULATIONS, AND THE PUBLIC. LINE 5 TO ENGAGE THE BROAD COMMUNITY IN OUR HEALTH NEEDS ASSESSMENT, MSK HELD A SERIES OF COMMUNITY FORUMS IN MANHATTAN (HARLEM), BROOKLYN, LONG ISLAND, WESTCHESTER AND NEW JERSEY AS WELL AS AN ADDITIONAL WEBINAR PLACING SPECIAL FOCUS ON THE HEALTH NEEDS OF THE HISPANIC COMMUNITY. THE FORUMS WERE CONDUCTED TO CONNECT WITH REPRESENTATIVES FROM COMMUNITY-BASED ORGANIZATIONS. THESE PRIVATE, NON-PROFIT, PUBLIC, AND GOVERNMENT AGENCIES WORK TO MEET COMMUNITY NEEDS WITH SERVICES AND RESOURCES THROUGHOUT NEW YORK CITY AND ITS SURROUNDING COMMUNITIES. REPRESENTATIVES FROM 38 COMMUNITY-BASED ORGANIZATIONS AND PARTNERS WHO SERVE A DIVERSE RANGE OF CLIENTS PARTICIPATED IN THESE FORUMS. SERVICES PROVIDED BY THE ORGANIZATIONS INCLUDE CANCER CARE SUPPORT, FOOD, MEDICAL, PSYCHOSOCIAL, IMMIGRATION ASSISTANCE, AND PRIMARY CARE SERVICES. COMMUNITY ORGANIZATIONS THAT PROVIDED INPUT ON MSK'S HEALTH NEEDS ASSESSMENT INCLUDE: AMERICAN CANCER SOCIETY, HUDSON VALLEY CHAPTER AMERICAN CANCER SOCIETY, LONG ISLAND CHAPTER AMERICAN CANCER SOCIETY, NEW JERSEY CHAPTER BERNARD'S TOWNSHIP HEALTH DEPARTMENT BROTHER TO BROTHER PROSTATE EDUCATION AND SUPPORT GROUP CANCER AND CAREERS CANCER SUPPORT TEAM COLETTE COYNE MELANOMA AWARENESS CAMPAIGN CUSTOM COLLABORATIVE EAST HARLEM COMMUNITY ALLIANCE FEEDING WESTCHESTER GOTHAM HEALTH HACKENSACK MERIDIAN HEALTH HARLEM CHILDREN'S ZONE HOFSTRA UNIVERSITY HUDSON VALLEY CASE MANAGEMENT SOCIETY JOHN J. BURN COMMUNITY CENTER LATINA SHARE LAURA FEINBLUM NUTRITION LEUKEMIA & LYMPHOMA SOCIETY, LONG ISLAND CHAPTER LEUKEMIA & LYMPHOMA SOCIETY, NEW JERSEY CHAPTER MARY'S PLACE BY THE SEA METROPOLITAN HOSPITAL MONMOUTH COUNTY HEALTH DEPARTMENT MOUNT VERNON CHAMBER OF COMMERCE NOSTRAND GARDENS CIVIC ASSOCIATION OCEAN COUNTY HEALTH ALLIANCE OPEN DOOR FAMILY MEDICAL CENTERS PLANNED PARENTHOOD PULSE RAICES SENIOR CENTER SHARE SISTERS UNITED IN HEALTH SPIRIT OF HOPE THE MEXICAN CONSULATE THE OFFICE OF BROOKLYN BOROUGH PRESIDENT - THEN ERIC ADAMS UNION COMMUNITY COUNCIL UNIONDALE CHAMBER OF COMMERCE LINE 7D SUMMARY FINDINGS OF MSK'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WERE SENT TO COMMUNITY-BASED ORGANIZATIONS WITH WHOM WE WORK AND INVITED THEIR FEEDBACK. WE ALSO INCORPORATED THE CHNA INTO OUR ANNUAL COMMUNITY SERVICE PLAN (CSP) TO ADDRESS THE IDENTIFIED HEALTH NEEDS. THE CSP WAS DISTRIBUTED TO LOCAL ELECTED OFFICIALS AND OTHER COMMUNITY ORGANIZATIONS. THE CHNA WAS ALSO PUBLISHED ON OUR WEBSITE FOR PUBLIC INFORMATION AND INPUT AT WWW.MSKCC.ORG/COMMUNITYSERVICEPLANS. WE PUBLISHED THE CHNA IN 2019 WHEN THE ASSESSMENT WAS COMPLETED. WHILE THE NEXT CHNA CYCLE IS IN 2022, MSK WILL BE MAKING ANNUAL UPDATES TO ITS COMMUNITY SERVICE PLAN WHENEVER REQUIRED BY THE NEW YORK DEPARTMENT OF HEALTH. LINE 11 THE CHNA FOUND THAT MSK IS CURRENTLY ADDRESSING MANY AREAS OF NEED INCLUDING PREVENTION AND SCREENING EDUCATION, NUTRITION EDUCATION, TOBACCO CESSATION, FOOD INSECURITY, SCREENING GUIDELINES IN SPANISH, LANGUAGE ASSISTANCE FOR LIMITED ENGLISH PROFICIENCY PATIENTS, COLLABORATIVES INITIATIVES, TARGETED OUTREACH, AND SPANISH PROMOTIONS IN RELEVANT MEDIA. THROUGHOUT THE COVID-19 PANDEMIC, MSK HAS WORKED TO PROTECT AND ASSIST THE PUBLIC. MSK HAS UNDERTAKEN COVID-19 TESTING AND VACCINATION EFFORTS FOR ITS PATIENTS AND EMPLOYEES. TO MINISTER TO THE HEALTH CARE NEEDS OF THE BROADER COMMUNITY, THE INSTITUTION PARTNERED WITH OTHER GOVERNMENTAL AND COMMUNITY ORGANIZATIONS. SPECIFICALLY, MSK OPENED POP UP CLINICS AT LOCATIONS IN HARLEM AND BROOKLYN, AS WELL AS WORKING WITH NEW YORK CITY TO OPEN A PUBLIC VACCINATION SITE AT THE ABYSSINIAN BAPTIST CHURCH IN HARLEM. DURING THE PERIOD APRIL AND JULY, WE ADMINISTERED APPROXIMATELY 12,000 DOSES OF THE VACCINE TO THE HARLEM COMMUNITY. AN ADDITIONAL 440 DOSES WERE ALSO ADMINISTERED TO THE NASSAU COMMUNITY THROUGHOUT MARCH AND APRIL 2021 AT OUR FACILITY IN NASSAU COUNTY. THE ORGANIZATION HAS A WIDE RANGE OF PROGRAMS AND ACTIVITIES; AND CONTINUES TO DEVELOP NECESSARY PROGRAMS TO ADDRESS THE SIGNIFICANT NEEDS IDENTIFIED IN THE RECENTLY CONDUCTED CHNA. MSK'S RALPH LAUREN CENTER PROVIDES FREE AND DISCOUNTED CANCER CARE PREVENTION AND SCREENING, AS WELL AS HEALTH RELATED AND NUTRITIONAL EDUCATION AT NO COST TO THE COMMUNITY. MSK'S IMMIGRANT HEALTH AND CANCER DISPARITIES SERVICE (IHCD), ALSO ADDRESSES PREVENTION/SCREENING, NUTRITION EDUCATION AND REFERRALS TO IMMIGRANTS THROUGH THE ARAB HEALTH INITIATIVE, VENTANILLAS DE SALUD (HEALTH WINDOWS WITH MEXICAN CONSULATE), AND THE TAXI NETWORK. MSK'S IHCD ALSO RUNS THE FOOD TO OVERCOME DISPARITIES PROGRAM (F.O.O.D.), WHICH TACKLES FOOD INSECURITY AMONG UNDERSERVED CANCER PATIENTS BY PROVIDING NUTRITION EDUCATION AND FREE NUTRITIOUS FOODS THROUGH FOOD PANTRIES. F.O.O.D. PARTNERS WITH COMMUNITY-BASED ORGANIZATIONS, HOSPITALS AND OTHER AGENCIES TO CONDUCT RESEARCH ON THE IMPACT OF THE PROGRAM TO DECREASE FOOD INSECURITY AND INCREASE CANCER TREATMENT ADHERENCE AND PATIENT OUTCOMES. TO BENEFIT THE TOBACCO CESSATION, MSK'S TOBACCO TREATMENT PROGRAM (TTP) REDUCES TOBACCO-RELATED CANCER BURDENS AND ADDRESSES DISPARITIES THROUGH CLINICAL CARE, EDUCATION, TRAINING, COMMUNITY OUTREACH AND RIGOROUS INNOVATIVE TOBACCO USE PREVENTION AND TREATMENT RESEARCH. TTP PARTNERS WITH NYC DEPARTMENT OF HEALTH IN THE CITYWIDE TOBACCO CESSATION PARTNERSHIP. MSK'S MULTICULTURAL OUTREACH INITIATIVE AND HISPANIC COMMUNICATIONS INITIATIVE BOTH ADDRESS THE NEEDS EXPRESSED FOR TARGETED OUTREACH, COLLABORATIVE INITIATIVES WITH COMMUNITY-BASED ORGANIZATIONS, AND SPANISH ADVERTISING PROMOTION IN RELEVANT MEDIA. TO ADDRESS LANGUAGE ASSISTANCE FOR LIMITED ENGLISH PROFICIENCY PATIENTS, MSK HAS DEVOTED THREE PROGRAMS INCLUDING MSK'S LANGUAGE ASSISTANCE PROGRAM (WHICH PROVIDES TRAINING TO HEALTHCARE STAFF IN MEDICAL INTERPRETING AND CULTURAL/LINGUISTIC RESPONSIVENESS), THE LANGUAGE ASSISTANCE PROGRAM WHICH ENSURES ALL MSK'S PATIENTS AND FAMILIES ARE ABLE TO CONNECT TO HIGH QUALITY CARE THROUGH MEDICAL INTERPRETING AND TRANSLATION SERVICES, AND THE PATIENT & CAREGIVER ENGAGEMENT EDUCATIONAL MATERIALS WHICH TRANSLATES ALL EDUCATIONAL RESOURCES BY MSK TO ARABIC, CHINESE, FRENCH, HEBREW, ITALIAN, KOREAN, POLISH, RUSSIAN, AND SPANISH. TO ADDRESS PROVIDING SCREENING GUIDELINES IN SPANISH, MSK'S MARKETING & COMMUNICATIONS DEPARTMENT IS EXPANDING THE INSTITUTION'S EDUCATIONAL RESOURCES TO PROVIDE THE SPANISH-SPEAKING GENERAL PUBLIC WITH EASILY UNDERSTANDABLE RESOURCES AND RECOMMENDATIONS FOR PREVENTING CURRENT LEADING CANCERS AND FEATURE A GUIDE TO UNDERSTANDING CANCER SCREENINGS. MSK IDENTIFIED NEEDS THAT ARE BEYOND MSK'S SCOPE OF SERVICES INCLUDE HPV VACCINATION AND ADDRESSING THE LACK OF KNOWLEDGE ABOUT ACCESSING GENERAL SERVICES, IMMIGRATION CONCERNS AND HOW TO ACCESS THESE SERVICES. MSK PROVIDES REFERRALS TO EXTERNAL ORGANIZATIONS THAT RESPOND TO THESE NEEDS. ADDITIONAL INFORMATION ON IDENTIFIED NEEDS AND WHAT NEEDS ARE NOT BEING ADDRESSED TOGETHER WITH THE REASON WHY SUCH NEEDS ARE NOT BEING ADDRESSED CAN ALSO BE FOUND IN THE HOSPITAL'S MOST RECENT COMPREHENSIVE THREE-YEAR CSP AND CHNA REPORT POSTED AT WWW.MSKCC.ORG/COMMUNITYSERVICEPLANS. LINE 13B WE USE A 500% OF THE FEDERAL POVERTY LEVEL (FPL) AS AN ANNUAL INCOME GUIDELINE. HOWEVER, WE MAY QUALIFY PATIENTS FOR OUR FAP EVEN IF THEIR INCOME EXCEEDS THE 500%. THAT'S BECAUSE WE ALLOW A DEDUCTION FOR MONTHLY ROUTINE HOUSEHOLD BILLS BASED ON FAMILY SIZE. PATIENTS WITH A ZERO OR NEGATIVE BALANCE ARE THEREFORE ELIGIBLE FOR THE PROGRAM UNLESS THEY HAVE LARGE ASSETS NOT LINKED TO THEIR RETIREMENT OR EDUCATION. LINE 13G NEW PATIENTS WHO RESIDE IN NEW YORK OR NEW JERSEY MAY QUALIFY FOR FINANCIAL ASSISTANCE. EXISTING PATIENTS MAY QUALIFY FOR AID REGARDLESS OF WHERE THEY LIVE IN THE UNITED STATES. LINE 15E MSK IS COMMITTED TO PROVIDING FINANCIAL ASSISTANCE TO PATIENTS WITH THE GREATEST MEDICAL AND FINANCIAL NEEDS, INCLUDING UNINSURED AND UNDERINSURED PATIENTS WHO CANNOT AFFORD TO PAY FOR MEDICAL CARE OR WHO CANNOT ACCESS HEALTH INSURANCE. EACH APPLICATION FOR AID IS HANDLED CONFIDENTIALLY, IN COOPERATION WITH THE APPLICANT, AND IS DETERMINED BASED ON HOUSEHOLD INCOME AND FAMILY SIZE. HOSPITAL AND PHYSICIAN FEES ARE REDUCED OR TOTALLY FORGIVEN FOR QUALIFYING PATIENTS. TO HELP A BROAD RANGE OF PATIENTS, OUR INCOME ELIGIBILITY GUIDELINE FOR FREE CARE IS 500 PERCENT ABOVE THE FEDERAL POVERTY LEVEL, WELL ABOVE THE REQ

SCHEDULE H, PART VI
"PART 1, LINE 3A A PATIENT WITH INCOME LESS THAN OR EQUAL TO 500% OF THE FEDERAL POVERTY GUIDELINES IS ELIGIBLE FOR THE INSTITUTION'S FINANCIAL ASSISTANCE PROGRAM (FAP). THE INSTITUTION MAY REDUCE THE FEES INCURRED BY THE PATIENT OR ACCEPT AS FULL PAYMENT AMOUNTS PAID BY THE INSURANCE CARRIER ON THE PATIENT'S BEHALF. IN ADDITION, A PATIENT MAY ALSO QUALIFY FOR ASSISTANCE EVEN IF HIS/HER INCOME IS GREATER THAN THE THRESHOLD LIMIT. THE INSTITUTION ADJUSTS PATIENTS' INCOME FOR ROUTINE MONTHLY EXPENSES, INCLUDING TAXES, TO DETERMINE ""DISPOSABLE INCOME"". MSK ALSO DEDUCTS A SPECIFIC AMOUNT (DEBT BURDEN) AS A MONTHLY CLOTHES AND FOOD ALLOWANCE BASED ON A PATIENT'S FAMILY SIZE IN EVALUATING THE TYPE AND AMOUNT OF ASSISTANCE NEEDED. THE TABLE BELOW ILLUSTRATES THE INCOME GUIDELINE USED IN EVALUATING THE PATIENT'S FINANCIAL STATUS. FAMILY SIZE ALLOWED INCOME RESOURCE LEVELS 1 $ 64,400 $ 37,875 2 $ 87,100 $ 55,500 3 $109,800 $ 62,535 4 $132,500 $ 70,688 5 $155,200 $ 78,848 6 $177,900 $ 87,000 PART 1, LINE 3C THE MAXIMUM AMOUNT CHARGED TO PATIENTS DEEMED ELIGIBLE UNDER THE FAP FOR ""EMERGENCY OR OTHER MEDICALLY NECESSARY CARE"" IS THE AMOUNT THE INSTITUTION INITIALLY CONCLUDED A PATIENT CAN AFFORD TO PAY WHEN FINALIZING THE FAP APPLICATION. THIS AMOUNT IS DERIVED BY CALCULATING A PATIENT'S HOUSEHOLD ""NET MONTHLY INCOMEDEDUCTING THE TOTAL AMOUNT OF ROUTINE MONTHLY BILLS. THE AMOUNT REMAINING IS WHAT WE CONSIDER THE PATIENT CAN PAY EACH MONTH. IF THE PATIENT'S HOUSEHOLD MONTHLY ROUTINE BILLS ARE MORE THAN OR EQUAL TO ""NET MONTHLY INCOME"", THE INSTITUTION ACCEPTS WHATEVER THE PATIENT'S INSURANCE PAYS AS PAYMENT IN FULL, (THE PATIENT WOULD NOT HAVE TO PAY ANYTHING OUT-OF-POCKET); UNLESS THE PATIENT HAS ASSETS SUCH AS A SECOND HOME, STOCKS, CERTIFICATE OF DEPOSITS, LARGE SAVINGS OR ANY OTHER ASSETS EXCLUDING RETIREMENT AND EDUCATION ACCOUNTS. PATIENTS WITH LARGE AMOUNTS OF ASSETS WHOSE ROUTINE MONTHLY BILLS ARE GREATER THAN THEIR ""NET MONTHLY INCOME"" MAY BE ELIGIBLE FOR REDUCED TIME AND PAYMENT ARRANGEMENT AND WOULD MAKE MONTHLY PAYMENTS (12 TO 18 MONTHS) TO PAY OFF THE AMOUNT THE INSTITUTION DETERMINED THEY CAN AFFORD TO PAY. ONCE THE FAP APPLICATION IS FINALIZED AND A PATIENT IS DEEMED ELIGIBLE TO PAY NOTHING OR A REDUCED TIME PAYMENT, THIS AGREEMENT IS EFFECTIVE FOR ONE YEAR AND INCLUDES THE PATIENT'S OUTSTANDING BALANCES. ALL PATIENTS ARE ADVISED OF MSK'S FAP, BUT AGAIN THE DETERMINATION IS ONLY DOCUMENTED IF THE PATIENT APPLIES FOR THE ASSISTANCE."

PART III, LINE 2
"THE AMOUNT ON LINE 2 OF PART III IS THE ACTUAL 2021 BAD DEBT WRITE-OFF WHICH IS DERIVED BY TAKING THE GROSS CHARGES ASSOCIATED WITH THE PROVISIONS FOR BAD DEBTS AND MULTIPLYING BY A RATIO OF HISTORICAL EXPENSES TO CHARGES AS DERIVED FROM THE HOSPITAL'S NEW YORK STATE INSTITUTIONAL COST REPORT. A SEPARATE RATIO IS CALCULATED FOR EACH TYPE OF PATIENT CARE ACTIVITY: INPATIENT, OUTPATIENT, AND PHYSICIAN. PART III, LINE 3 PATIENTS CAN PURSUE FINANCIAL ASSISTANCE THROUGH MSK'S FINANCIAL ASSISTANCE PROGRAM. IF A PATIENT IS FOUND TO HAVE THE APPROPRIATE RESOURCES TO PAY FOR HEALTH SERVICES AND DOES NOT OR CHOOSES NOT TO PARTICIPATE IN AVAILABLE HEALTH BENEFIT PROGRAMS, THE INSTITUTION WILL BEGIN COLLECTION PROCEEDINGS IN ACCORDANCE WITH THE INSTITUTION'S POLICY. ONCE DEEMED UNCOLLECTABLE, THE CHARGES ARE CLASSIFIED AS BAD DEBTS AND ARE CHARGED OFF AS SUCH. THE AMOUNT ON LINE 3, OF PART III, REFLECTS THE COST OF THESE ACCOUNTS AS CALCULATED BASED ON THE COST-TO-CHARGE RATIO METHODOLOGY DESCRIBED EARLIER. IN DETERMINING THE AMOUNT THAT REASONABLY COULD BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE INSTITUTION'S POLICY, THE INSTITUTION REVIEWED THE CASES THAT WERE CLOSED WITH AN ""INCOMPLETE"" STATUS IN THE FINANCIAL ASSISTANCE PROGRAM DURING 2017 THROUGH 2021. THE INSTITUTION THEN COMPARED THESE CASES AGAINST THE BAD DEBT WRITE-OFFS FROM 2021. PART III, LINE 4 THE INSTITUTION FOLLOWS GENERALLY ACCEPTED ACCOUNTING PRINCIPLES IN REPORTING ON BAD DEBT EXPENSES. THEREFORE, A DETAILED DESCRIPTION OF THE BAD DEBT POLICY IS NOT REQUIRED IN THE FOOTNOTES TO THE AUDITED FINANCIAL STATEMENTS. PART III, LINE 8 THE MEDICARE LOSS REFLECTS LOSSES FROM BOTH HOSPITAL AND PHYSICIANS' ACTIVITY. PHYSICIAN REVENUE IS SHOWN AS OTHER REVENUE ON THE MEDICARE COST REPORT. COSTS DISALLOWED BY THE MEDICARE PROGRAM, BUT WHICH AR INCURRED IN PROVIDING CARE TO MEDICARE BENEFICIARIES HAVE BEEN INCLUDED. PART III, LINE 9B THE INSTITUTION DOES NOT PURSUE COLLECTIONS FROM PATIENTS APPLYING FOR FINANCIAL ASSISTANCE. IF, HOWEVER, COLLECTIONS WERE INITIATED, THE EFFORT IS IMMEDIATELY SUSPENDED WHEN THE PATIENT APPLIES FOR FINANCIAL ASSISTANCE. IF THE PATIENT QUALIFIES FOR THE FAP WITH ZERO FEE PAYMENT, THE INSTITUTION ACCEPTS AS FULL SETTLEMENT ANY AMOUNT PAID BY THE INSURANCE CARRIER ON THE PATIENT'S BEHALF. ADDITIONALLY, IF A PATIENT QUALIFIES FOR A TIME PAYMENT PLAN (TPP), ALL OTHER CHARGES APART FROM THE AGREED TPP AMOUNT IS WRITTEN OFF AS FINANCIAL ASSISTANCE. FOR EXAMPLE, IF THE AGREEMENT CALLS FOR THE PATIENT TO MAKE AN ANNUAL PAYMENT OF $1,200 ($100 MONTHLY), THEN ALL OTHER CHARGES ACCRUING TO THE PATIENT ARE CANCELED AND WRITTEN OFF AS FINANCIAL ASSISTANCE. ANNUALLY, THE PATIENT'S CASE IS RE-EVALUATED AND ADJUSTMENTS MADE BASED ON CHANGING CIRCUMSTANCES."

PART VI, LINE 2
THE CHNA IS THE MEANS BY WHICH THE INSTITUTION ASSESSES THE HEALTH NEEDS OF THE COMMUNITY SEE PART V, SECTION B. PART VI, LINE 3 SINCE 1987, MSK HAS HAD A FINANCIAL ASSISTANCE PROGRAM IN PLACE TO ASSIST UNDERINSURED AND UNINSURED PATIENTS WHO ARE EXPERIENCING DIFFICULTIES MEETING THEIR FINANCIAL RESPONSIBILITIES TO MEMORIAL HOSPITAL AND ITS PHYSICIANS. FINANCIAL COUNSELORS WORK WITH PATIENTS AND INSURANCE COMPANIES INCLUDING MEDICARE AND MEDICAID TO HELP THE PATIENTS TO ACCESS SERVICES. THOSE WHO DO NOT QUALIFY FOR PUBLICLY AVAILABLE HEALTH INSURANCE, OR WHO ARE UNABLE TO PAY THEIR PORTION OF FEES ABOVE INSURANCE REIMBURSEMENT, MAY OBTAIN HELP THROUGH THE INSTITUTION'S FAP IF THEY ARE ELIGIBLE. THE PREMISE OF THE PROGRAM IS THAT ALL PATIENTS ARE EXPECTED TO CONTRIBUTE TO THEIR CARE BASED ON THEIR FINANCIAL ABILITY. THE FAP EMPLOYS SEVERAL STRATEGIES TO INCREASE PATIENTS' AWARENESS OF THE PROGRAM. DURING THE REGISTRATION PROCESS, FINANCIAL INTERVIEWERS EDUCATE PATIENTS ON THE VARIOUS PROGRAMS AVAILABLE TO THEM, INCLUDING GOVERNMENTAL PROGRAMS AND THE FINANCIAL ASSISTANCE PROGRAMS. MSK PERSONNEL SENDS THE FAP BROCHURE WITH THE INITIAL HOSPITAL BILL TO EVERY NEW PATIENT TO MAKE THEM AWARE OF THE CHARITY CARE/FINANCIAL ASSISTANCE PROGRAM. THE FAP IS ALSO MENTIONED IN EVERY STATEMENT AND LETTER THAT SENT TO A PATIENT. MOREOVER, THE FAP IS AGAIN MENTIONED IN EVERY COLLECTION LETTER SENT TO PATIENTS BY THE COLLECTION AGENCIES. EVEN AFTER A PATIENT'S ACCOUNT IS SENT TO COLLECTIONS, HE/SHE CAN STILL APPLY FOR FINANCIAL ASSISTANCE. IT IS NEVER TOO LATE TO APPLY FOR FINANCIAL ASSISTANCE AND RETROACTIVE FAP COVERAGE WOULD BE GIVEN IF A PATIENT IS DETERMINED ELIGIBLE FOR ASSISTANCE. INFORMATION ABOUT THE FINANCIAL ASSISTANCE PROGRAM IS ALSO AVAILABLE ON THE INSTITUTION'S WEBSITE AT WWW.MSKCC.ORG/FINANCIAL-ASSISTANCE OR BY CALLING OUR DEDICATED FINANCIAL ASSISTANCE LINE AT (212) 639-3810. PART VI, LINE 4 MSK'S INPATIENT HOSPITAL IS IN MID-MANHATTAN WITH ADDITIONAL OUTPATIENT TREATMENT CENTERS IN BROOKLYN, LONG ISLAND, WESTCHESTER COUNTY, AND NEW JERSEY. OUR PRIMARY CATCHMENT AREA ENCOMPASSES 23 COUNTIES ACROSS THE FIVE BOROUGHS OF NEW YORK CITY, LONG ISLAND, SOUTHERN NEW YORK STATE, NEW JERSEY, AND SOUTHWESTERN CONNECTICUT. A TOTAL OF 201,586 PATIENTS WERE SEEN AT MSK'S FACILITIES IN 2021, INCLUDING 184,175 (91.4 PERCENT) PATIENTS FROM THE TRI-STATE AREA (NY, NJ, CT); 16,994 (8.4 PERCENT) PATIENTS FROM OTHER PARTS OF THE UNITED STATES; AND 417 (0.2 PERCENT) PATIENTS FROM OTHER COUNTRIES. THESE PATIENTS ACCOUNTED FOR 24,142 ADMISSIONS TO OUR HOSPITAL WITH 171,355 RELATED PATIENT DAYS AND 904,743 OUTPATIENT VISITS AT OUR COMBINED FACILITIES IN NEW YORK CITY AND THE REGION. PART VI, LINE 5 MSK'S MISSION IS TO LEAD IN THE PREVENTION, DIAGNOSIS, TREATMENT, AND CURE OF CANCER THROUGH PROGRAMS OF EXCELLENCE IN COST-EFFECTIVE RESEARCH, EDUCATION, OUTREACH AND PATIENT CARE. OUR CLINICAL RESEARCHERS HAVE DEVELOPED NUMEROUS CHEMOTHERAPY AND RADIATION THERAPY REGIMENS, SURGICAL METHODS, AND DIAGNOSTIC TECHNIQUES THAT ARE NOW CONSIDERED THE STANDARD OF CARE FOR PATIENTS AROUND THE WORLD. WE FOCUS ON MULTIDISCIPLINARY CARE, WHERE EXPERTS FROM MANY FIELDS OF MEDICINE COME TOGETHER TO DEVELOP THE BEST TREATMENTS FOR INDIVIDUAL PATIENTS AND FOR THE TREATMENT OF PATIENTS WITH ALL TYPES OF CANCER. THIS HAS ALLOWED US TO BE AT THE FOREFRONT OF DEVELOPING TREATMENTS THAT ARE MORE EFFECTIVE AT TREATING CANCER, WHILE AT THE SAME TIME SPARING MANY PATIENTS FROM THE MOST SERIOUS SIDE EFFECTS OF TREATMENT. OUR BASIC AND TRANSLATIONAL RESEARCHERS HAVE MADE MANY SIGNIFICANT CONTRIBUTIONS TO THE SCIENTIFIC COMMUNITY'S UNDERSTANDING OF CANCER BIOLOGY AND CANCER GENETICS AS WELL AS TO RELATED FIELDS CELL BIOLOGY, MOLECULAR BIOLOGY, STRUCTURAL BIOLOGY, DEVELOPMENTAL BIOLOGY, MOLECULAR PHARMACOLOGY AND CHEMISTRY, IMMUNOLOGY, COMPUTATIONAL BIOLOGY, AND DRUG DEVELOPMENT. GENES FIRST IDENTIFIED IN OUR LABORATORIES ARE NOW THE FOCUS OF INTENSE RESEARCH IN OTHER LABORATORIES AROUND THE WORLD. DRUGS, MONOCLONAL ANTIBODIES, AND OTHER AGENTS FIRST DEVELOPED IN OUR LABORATORIES HAVE GONE ON TO GAIN REGULATORY APPROVAL FOR TREATING PATIENTS WORLDWIDE. RECENT EXPANSION OF OUR LABORATORY SPACE HAS ALLOWED US TO GROW OUR RESEARCH EFFORTS SO THAT GOING FORWARD WE CAN CONTINUE TO MAKE DISCOVERIES THAT WILL CHANGE THE WAY THE WORLD UNDERSTANDS CANCER AND AID IN THE DEVELOPMENT OF BETTER TREATMENTS FOR CANCER PATIENTS EVERYWHERE. IN 2021, MEMORIAL SLOAN KETTERING SPENT $662.3M IN SUPPORT OF ITS RESEARCH MISSION, OF WHICH $241.0M WAS SPONSORED BY GOVERNMENTAL AND OTHER NON-PROFIT ORGANIZATIONS, $142.4M FROM PHILANTHROPY, AND $278.9M FROM THE INSTITUTION'S FUNDS. EDUCATION AND TRAINING ARE KEY COMPONENTS OF MEMORIAL SLOAN KETTERING'S MISSION AND IMPORTANT EXAMPLES OF HOW THE INSTITUTION MAKES CONTRIBUTIONS TO THE CARE AND TREATMENT OF CANCER PATIENTS FAR BEYOND ITS OWN WALLS THROUGH WORKFORCE DEVELOPMENT. OUR TRAINING, GRADUATE, AND CONTINUING EDUCATION PROGRAMS PREPARE PHYSICIANS, SCIENTISTS, NURSES, AND TECHNICIANS TO BE LEADERS IN THEIR CHOSEN FIELDS. THESE HEALTHCARE PROVIDERS CAN THEN TAKE THE EXPERTISE GAINED FROM WORKING WITH OUR SPECIALISTS TO OTHER HEALTHCARE INSTITUTIONS AROUND THE COUNTRY AND THROUGHOUT THE WORLD. MSK ALSO TRAINS GRADUATE STUDENTS AND POSTDOCTORAL RESEARCHERS WORKING IN MANY AREAS OF BASIC SCIENCE AND TRANSLATIONAL RESEARCH. WHEN THESE YOUNG SCIENTISTS COMPLETE THEIR TRAINING, THEY BRING THE SKILLS OBTAINED IN OUR LABORATORIES INTO THE ACADEMIC COMMUNITY AT LARGE AS WELL AS THE PRIVATE SECTOR. MSK SPONSORS SEVERAL PROGRAMS THAT GIVE MEDICAL STUDENTS, UNDERGRADUATES, AND HIGH SCHOOL STUDENTS THE OPPORTUNITY TO WORK AT THE INSTITUTION DOING CLINICAL AND LABORATORY RESEARCH. THROUGH THESE PROGRAMS, MEMORIAL SLOAN KETTERING STRIVES TO INCREASE THE PIPELINE OF SCIENTISTS AND PHYSICIANS WORKING IN ONCOLOGY. IN 2021, THE ORGANIZATION ESTABLISHED THE OFFICE OF HEALTH EQUITY (OHE) TO ADDRESS CANCER DISPARITIES THAT EXIST DUE TO RACIAL, ETHNIC, CULTURAL, OR SOCIOECONOMIC BARRIERS. THROUGH A PATIENT CENTRIC FOCUS, THE OHE IS RESPONSIBLE FOR LEADING PATIENT CARE AND RESEARCH ACTIVITIES INCLUDING THE CANCER HEALTH EQUITY RESEARCH PROGRAM (CHERP) AND CANCER EQUITY PROGRAMS. INTEGRAL TO OHE'S ROLE IS THE DEVELOPMENT OF HEALTH EQUITY RESEARCH AND EDUCATION AND TRAINING. AS SUCH THE OHE HAS IMPLEMENTED RECRUITING AND TRAINING INITIATIVES ACROSS THE INSTITUTION. THE OBJECTIVE OF THESE TRAINING PROGRAMS IS TO ENHANCE THE DIVERSITY OF FUTURE CANCER RESEARCH WORKFORCE BY PROVIDING MINORITY STUDENTS WITH EXPOSURE TO CUTTING-EDGE CANCER RESEARCH WITH RENOWNED MENTORS. THE RESEARCH PROGRAM IS FOCUSED ON HAVING DIVERSE POPULATIONS MORE EQUALLY REPRESENTED IN CANCER CLINICAL RESEARCH AND DEVELOPING A BETTER UNDERSTANDING OF THE DIFFERENCES IN CANCER INCIDENCE AND CANCER OUTCOMES EXPERIENCED BY GROUPS TRADITIONALLY UNDERREPRESENTED IN CLINICAL RESEARCH. THE OHE RESEARCH PROGRAM IS ALSO FOCUSED ON INCREASING ENROLLMENT OF UNDERREPRESENTED GROUPS ONTO CLINICAL TRIALS AT MSK. THE OHE PROVIDES FUNDING FOR THESE PROGRAMS ALLOWING MINORITY GROUPS WHO ARE UNDERREPRESENTED IN MEDICINE OPPORTUNITIES TO PARTICIPATE IN THE NATIONAL CANCER INSTITUTE'S MEDICAL STUDENTS SUMMER FELLOWSHIP PROGRAM. THE OHE ALSO COORDINATES A SIX-WEEK SUMMER EXPOSURE PROGRAM TO EXPOSE MINORITY HIGH SCHOOL STUDENTS TO CAREERS IN MEDICINE AND RESEARCH. MEMORIAL SLOAN KETTERING UTILIZED $213.9M OF THE INSTITUTION'S RESOURCES DURING 2021 TO SUPPORT ITS EDUCATION AND TRAINING MISSION, WHICH WE CONSIDER VITAL, GIVEN OUR LEADERSHIP ROLE IN CANCER CARE TREATMENT AND RESEARCH. $58.0M OF THE AMOUNT WAS SPONSORED BY GOVERNMENTAL AND OTHER REVENUE SOURCES AND $155.9M FROM THE INSTITUTION'S GENERAL FUND. THE INSTITUTION HAS A BOARD FOR EACH OF THE SEVEN ENTITIES. AS OUTLINED IN SCHEDULE O, THERE IS A TOTAL OF 114 BOARD MEMBERS. MANY ARE MEMBERS OF MORE THAN ONE ENTITY'S BOARD AND THEREFORE ARE COUNTED MORE THAN ONCE. THE GOVERNING BODY IS COMPRISED OF INDEPENDENT BOARD MEMBERS FROM THROUGHOUT THE UNITED STATES. MSK DOES NOT EXTEND MEDICAL STAFF PRIVILEGES TO COMMUNITY-BASED PHYSICIANS. ALL PHYSICIANS ARE ON STAFF AND ARE EMPLOYEES OF MSK, WITH LIMITED EXCEPTIONS. IN ITS PURSUIT TO FURTHER IMPROVE PATIENT CARE, MEDICAL EDUCATION, AND RESEARCH, THE INSTITUTION REINVESTS ANY SURPLUS FUNDS IN THE INSTITUTION'S POOL OF RESERVES. THESE RESERVES GENERATE INCOME TO SUPPORT FUTURE OPERATIONS AND RESTRICTED FUND SPENDING. BY PROVIDING FUNDING FOR OPERATIONS AND CAPITAL PROJECTS, IMPROVEMENTS TO PATIENT CARE, MEDICAL EDUCATION, AND RESEARCH ARE MADE POSSIBLE. COVID-19 ON MARCH 11, 2020, THE WORLD HEALTH ORGANIZATION DESIGNATED THE COVID-19 OUTBREAK AS A GLOBAL PANDEMIC. FEDERAL, STATE AND LOCAL GOVERNMENT POLICIES RESULTED IN A SUBSTANTIAL PORTION OF THE POPULATION REMAINING AT HOME AND FORCED THE CLOSURE OF CERTAIN BUSINESSES. THESE ACTIONS PRESENTED UNPRECEDENTED CHALLENGES TO ALL, INCLUDING THE MEDICAL COMMUNITY AS THEY GRAPPLED TO CONTAIN THE DE

PART I, LINE 7G
MEMORIAL SLOAN KETTERING HAS CONSISTENTLY SET THE STANDARD OF CARE FOR PEOPLE WITH CANCER BY EMPHASIZING EARLY DETECTION, PRECISE DIAGNOSIS, AND INDIVIDUALLY TAILORED TREATMENT. THE HOSPITAL SUBSIDIZES CANCER SCREENING, TREATMENT, AND SUPPORT SERVICES TO FULFILL ITS MISSION AND TO HELP REDUCE CANCER HEALTH DISPARITIES AMONG MINORITY AND MEDICALLY UNDERSERVED POPULATIONS. THE RALPH LAUREN CENTER AT MEMORIAL SLOAN KETTERING CANCER CENTER WAS ESTABLISHED IN 2003 WITH GENEROUS FUNDING FROM THE RALPH LAUREN CORPORATE FOUNDATION AND THE LAUREN FAMILY TO ADDRESS SIGNIFICANT HEALTH DISPARITIES FOUND IN LOW-INCOME AND HISTORICALLY UNDERSERVED COMMUNITIES IN NEW YORK CITY. LOCATED IN HARLEM AND ASSISTING PEOPLE FROM ALL FIVE BOROUGHS, THE RALPH LAUREN CENTER (RLC) IS A MODEL FOR BROADENING ACCESS TO HIGH-STANDARD CANCER PREVENTION, DIAGNOSTICS, AND TREATMENT SERVICES. IN 2019, THE RLC WAS INCORPORATED WITHIN MSK, CREATING IMPORTANT OPPORTUNITIES TO EXPAND AND INCREASE SUSTAINABLE BENEFITS TO UNDERSERVED NEW YORKERS AFFECTED BY CANCER. MSK ALSO MERGED ITS BREAST EXAMINATION CENTER OF HARLEM INTO THE RLC THAT YEAR, STREAMLINING EFFORTS IN ONE CONVENIENT LOCATION. MSK RALPH LAUREN CENTER PROVIDES CANCER PREVENTION, SCREENING, DIAGNOSIS, TREATMENT, AND SOCIAL SERVICES, AS WELL AS FINANCIAL COUNSELING AND A FOOD PANTRY SUPPLEMENTED WITH NUTRITIONAL COUNSELING. RLC'S SCOPE OF SERVICES INCLUDE BREAST CANCER EVALUATION, DIAGNOSTIC AND TREATMENT SERVICES, INCLUDING CHEMOTHERAPY, FOR MOST CANCERS AND BLOOD DISEASES, AND SCREENING SERVICES FOR BREAST, CERVICAL, COLON, PROSTATE AND LUNG CANCER AND SMOKING CESSATION PROGRAM. RLC IS STAFFED BY MEDICAL ONCOLOGISTS, A BREAST SURGEON, APP'S, REGISTERED NURSES, PATIENT CARE TECHNICIANS, A DIETICIAN/NUTRITIONIST, RADIOLOGY TECHNOLOGISTS, AND LAB TECHNICIANS. REFERRALS TO CLINICIANS, PROGRAMS, AND FACILITIES WITHIN MEMORIAL HOSPITAL ARE COORDINATED FOR PATIENTS REQUIRING SUCH SERVICES. TO-DATE RLC HAS MANAGED MORE THAN 180,000 PATIENT VISITS SINCE ITS FOUNDING. APPROXIMATELY 15,500 VISITS WERE MADE BETWEEN APRIL 1, 2019 AND DECEMBER 31, 2021 WHEN RLC TRANSITIONED TO MSK. MORE THAN 2,000 FINANCIAL ASSESSMENTS WERE ALSO RECORDED, DURING THE PERIOD APRIL 1, 2019 AND DECEMBER 31, 2021. MEMORIAL SLOAN KETTERING'S PSYCHIATRY & BEHAVIORAL SERVICES DEPARTMENT IS COMMITTED TO THE URGENT AS WELL AS ROUTINE CARE OF PATIENTS WITH CANCER. OUR PSYCHIATRISTS AND PSYCHOLOGISTS HAVE EXPERTISE IN ASSISTING PATIENTS WITH THE SPECTRUM OF PSYCHIATRIC AND BEHAVIORAL ISSUES THAT CAN ARISE DURING DIAGNOSIS AND TREATMENT. THE DEPARTMENT ALSO WORKS TO DEEPEN ITS UNDERSTANDING AND EXPAND TREATMENT OPTIONS FOR ONCOLOGY PATIENTS AROUND THE GLOBE THROUGH CLINICAL TRIALS, RESEARCH, AND OTHER MEANS. TO ACCOMPLISH THESE GOALS, THE DIVISION OFFERS INPATIENT AND OUTPATIENT PSYCHOLOGICAL AND SOCIAL SUPPORT SERVICES TO PATIENTS, THEIR FAMILIES, AND CAREGIVERS. FUNDING FOR THE MEDICAID OUTPATIENT VISITS AND INPATIENT ENCOUNTERS ARE SUBSIDIZED BY MSK, AS ARE UNREIMBURSED TIME AND EFFORT BY NURSES TO STAFF A SMOKING CESSATION CLINIC. PHILANTHROPIC FUNDS ARE USED TO SUPPORT A SIGNIFICANT NUMBER OF THE DEPARTMENT'S OVERALL CLINICAL AND TRAINING ACTIVITIES. SERVICES PROVIDED INCLUDE CONSULTATIONS AND EVALUATION, PSYCHOTHERAPY, MEDICATION MANAGEMENT AND PHARMACOTHERAPY, SUPPORTIVE COUNSELING, SMOKING CESSATION, HYPNOTHERAPY, VARIOUS DIAGNOSTIC TESTS, AND OTHERS. DURING 2021, THE DEPARTMENT EXPERIENCED 32,600 INPATIENT AND OUTPATIENT ENCOUNTERS WITH 1,739 PATIENTS TREATED THROUGH THE SMOKING CESSATION PROGRAM. APPROXIMATELY $4.49M WAS EXPENDED BY THE DEPARTMENT TO SUPPORT ITS COMMUNITY BENEFIT-RELATED PROGRAMS, OF WHICH $1.78M OR 40%, WERE INCURRED FOR SUBSIDIZED CLINICAL CARE. AT MSK WE BELIEVE IN CARING FOR THE WHOLE PERSON NOT JUST THE DISEASE OR SYMPTOM. INTEGRATIVE MEDICINE WEAVES NATURAL TREATMENTS SUCH AS ACUPUNCTURE, MASSAGE, AND YOGA INTO OUR OVERALL CARE PLAN. ALL OF OUR HOLISTIC HEALTH SERVICES AND PROGRAMS ARE BASED ON THE LATEST SCIENTIFIC EVIDENCE. THE INTEGRATIVE MEDICINE SERVICE PROVIDES FREE CLINICAL CARE FOR INPATIENTS. DURING 2021, WE SERVICED 7,903 PATIENT VISITS. THESE CLINICAL SERVICES INCLUDED MUSIC THERAPY, TOUCH THERAPY, ACUPUNCTURE, YOGA AND YOGIC BREATHING, MEDITATION AND GUIDED IMAGERY, KARATE AND DANCE THERAPY. WE ALSO PROVIDED EXTENSIVE EDUCATION FOR PATIENTS AND CAREGIVERS DURING BEDSIDE AND GROUP VISITS. IN ADDITION, WE OFFER OUTPATIENT ACUPUNCTURE CONSULTATIONS TO ANYONE IN THE COMMUNITY AT NO COST TO THEM. THESE CONSULTATIONS ADVISED CLIENTS ON HOW ACUPUNCTURE BENEFIT THEIR CONDITION BASED ON THEIR SPECIFIC THERAPEUTIC NEEDS. THERE WERE 91 ACUPUNCTURE CONSULTATIONS PROVIDED IN 2021. THE DEPARTMENT INCURRED $1.53M IN PERSONNEL COST TO DELIVER COMMUNITY BENEFIT-RELATED PROGRAMS. $0.60M OR 39% WERE SPENT ON SUBSIDIZED CLINICAL CARE.

PART I, LINE 7, COL (F)
THE BAD DEBT EXPENSE WAS NOT INCLUDED ON LINE 25 IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP). PART I, LINE 7 FINANCIAL ASSISTANCE REPRESENTS THE COST OF SERVICES PROVIDED TO PATIENTS WHO CANNOT AFFORD HEALTH CARE SERVICES DUE TO INADEQUATE RESOURCES AND/OR ARE UNINSURED OR UNDERINSURED. A PATIENT IS CLASSIFIED AS A FINANCIAL ASSISTANCE PATIENT IN ACCORDANCE WITH THE INSTITUTION'S ESTABLISHED POLICIES AND WHERE INSUFFICIENT PAYMENT FOR SUCH SERVICES IS ANTICIPATED. THE INSTITUTION CONSIDERS PATIENTS FOR FINANCIAL ASSISTANCE IF HOUSEHOLD INCOME IS LESS THAN 500% OF THE FEDERAL POVERTY GUIDELINES, AND AS DESCRIBED IN OTHER SECTIONS OF THIS DOCUMENT. SERVICES PROVIDED AS FINANCIAL ASSISTANCE ARE NOT REPORTED AS REVENUE. THE COSTS REPORTED IN THE TABLE ON LINE 7, WERE BASED ON VARIOUS SOURCES. FINANCIAL ASSISTANCE AND THE UNREIMBURSED MEDICAID COST WERE BASED ON A COST-TO-CHARGE RATIO CALCULATION. THE TOTAL CHARGES ASSOCIATED WITH THESE PROGRAMS ARE MULTIPLIED BY A RATIO OF HISTORICAL EXPENSES TO CHARGES AS DERIVED FROM THE HOSPITAL'S NEW YORK STATE INSTITUTIONAL COST REPORT. THE COSTS ASSOCIATED WITH A PORTION OF THE HEALTH PROFESSIONAL EDUCATION COMMUNITY BENEFIT ARE OBTAINED FROM THE STEP-DOWN OF COSTS PREPARED AS PART OF THE NEW YORK STATE INSTITUTIONAL COST REPORT. TO ARRIVE AT THE AMOUNTS REPORTED IN THE TABLE ON LINE 7, ADDITIONAL STEPS AS OUTLINED BELOW WERE TAKEN. UNPAID COST OF GOVERNMENT-SPONSORED HEALTH CARE REPRESENTS THE ESTIMATED DIFFERENCE BETWEEN THE PAYMENTS MADE UNDER THE MEDICARE AND MEDICAID PROGRAMS AND THE INSTITUTION'S COST OF PROVIDING THESE SERVICES AS CALCULATED ABOVE. THE INSTITUTION SUBTRACTS ALL REVENUES RECEIVED FROM THE MEDICARE AND MEDICAID PROGRAMS TO DETERMINE THE COMMUNITY BENEFIT PROVIDED. RESEARCH COMMUNITY BENEFIT COSTS REPRESENT ALL COSTS FOR BASIC TRANSLATIONAL AND CLINICAL RESEARCH, SUPPORTED BY INSTITUTIONAL FUNDS, GOVERNMENTAL, AND OTHER NON-PROFIT ORGANIZATIONS. THE INSTITUTION IS A PREEMINENT PROVIDER OF HEALTH TRAINING TO HEALTH PROFESSIONALS WHO DESIRE TRAINING IN THE SKILLS NECESSARY TO TREAT CANCER PATIENTS. THE INSTITUTION TRAINS PHYSICIANS, SCIENTISTS, MEDICAL STUDENTS, RADIOLOGY STUDENTS, NURSING STUDENTS, SOCIAL WORK STUDENTS AND INDIVIDUALS LOOKING TO CREATE A CAREER IN THE FIELD OF CANCER BIOLOGY. THE AMOUNTS REPORTED AS HEALTH TRAINING REPRESENT INSTITUTIONAL FUNDS, AS WELL AS COSTS IN EXCESS OF AMOUNTS REIMBURSED BY THIRD-PARTY PAYERS SUCH AS TRAINING GRANT REVENUES AND DIRECT MEDICAL EDUCATION PAYMENTS FROM THE MEDICARE PROGRAM. AS INDICATED EARLIER, MSK'S PSYCHIATRY & BEHAVIORAL SERVICES DEPARTMENT OFFERS INPATIENT AND OUTPATIENT PSYCHOLOGICAL SERVICES AND OTHER QUALIFYING SUBSIDIZED COMMUNITY BENEFIT PROGRAMS TO PATIENTS. SUBSIDIZED CANCER SCREENINGS ARE ALSO OFFERED THROUGH OTHER COMMUNITY PROGRAMS PROVIDED BY THE INSTITUTION. THE COST ASSOCIATED WITH THESE PATIENTS' CARE ARE REPORTED IN THE TABLE ON LINE 7, BASED ON PATIENT CARE COST TO CHARGE RATIO, WHERE APPLICABLE. ALL SALARY EXPENSES RELATED TO OTHER SUBSIDIZED PATIENT CARE BY ATTENDING PHYSICIANS, CLINICAL AND RESEARCH FELLOWS AND NURSE PRACTITIONERS ARE ALSO REPORTED IN THE TABLE ON LINE 7G. PART II MSK ENGAGES IN AND SUPPORTS COALITION-BUILDING ACTIVITIES THAT PROMOTE THE HEALTH OF THE COMMUNITIES THE INSTITUTION SERVES. STAFF MEMBERS ARE ENCOURAGED TO SHARE THEIR CLINICAL EXPERTISE AND EXPERIENCE WITH PARTNERING HEALTHCARE FACILITIES AND COMMUNITY ORGANIZATIONS. STAFF MEMBERS SERVE AND PARTICIPATE IN NUMEROUS COMMUNITY GROUPS INCLUDING THE AMERICAN CANCER SOCIETY, THE GREATER NEW YORK HOSPITAL ASSOCIATION, AND MANY HEALTH IMPROVEMENT ADVOCACY GROUPS FOR VARIOUS TYPES OF CANCER. ALTHOUGH THE SIGNIFICANT COST OF STAFF TIME DEVOTED TO THESE ACTIVITIES IS NOT QUANTIFIED BY THE CENTER, THE INSTITUTION CONSIDERS THESE EFFORTS TO COLLABORATE AND BUILD COMMUNITY RESOURCES TO BE OF SIZEABLE COMMUNITY BENEFIT.