| Form 990, Part III, Lines 2 & 3: |
In response to the COVID-19 pandemic, the Medical Center undertook significant program service initiatives in our effort to combat the deadly Coronavirus that was sweeping the nation and causing great suffering in its wake. COVID-19 in the Bronx and Montefiore's response: The Bronx was the epicenter of the first wave of COVID-1. In the early phase of the pandemic, Montefiore increased surge bed capacity, constructed and staffed new testing sites at nearby public locations, deployed associates to assume re-purposed roles in the hospitals or testing sites, and greatly expanding telehealth services. Montefiore has continued to implement these efforts with the resurgence of COVID-19 in recent months. In addition, we are now actively engaged in local vaccination efforts and following New York State guidelines for the continued rollout of this initiative. Montefiore increased its bed capacity by 100% to treat COVID-19 patients, initially without federal or state funding. As part of its rapid response, Montefiore spent upwards of $350 million to procure personal protective equipment (PPE) and established seven COVID-19 testing sites throughout the Bronx and Westchester. Montefiore's ongoing investments include funding a robust telehealth program, establishing a COVID vaccine trials unit, and creating a research and care clinic, offering treatment for COVID patients with long-term chronic symptoms and related health issues. The first Covid-19 case was admitted to Montefiore on March 10, 2020. The peak COVID-19 patients admitted was 1,162 and occurred on April 10, 2020. During the first wave of COVID-19, Montefiore had to suspend elective surgeries. From late April 2020 until early June 2020, elective surgeries were not conducted. Clinically, we had to transform the way that we operated practically overnight. We repurposed every space possible to double the number of beds and tripe the number of critical care beds. Our clinical staff had to be flexible, for example, anesthesiologists worked as respiratory technicians, directors worked overnight shifts, nurse practitioners worked as ICU nurses. The pace was relentless, around the clock. We are an essential provider, and, thus, we had to remain in full operation. We built new facilities almost overnight. We went to nearly 100 percent telemedicine for our outpatient visits, created new platforms and patient resources, and greatly expanded our health information technology capabilities. Telehealth: MMC initiated a rollout of telehealth in its hospitals and ambulatory sites in response to the COVID-19 pandemic, which was quickly and comprehensively integrated into our service provision. MMC's telehealth program is designed to meet the needs of our patients who are largely from high-risk and low-income communities; many of our patients have multiple chronic conditions. Beginning in mid-March 2020, several MMC ambulatory spaces were converted to inpatient settings and additional ICU beds were opened to meet the surge of incoming high-acuity patients. MMC is currently utilizing telehealth capabilities to triage patients with COVID-19 symptoms; safely conduct video and voice visits with patients in our ambulatory sites and hospitals; and expand ICU communication with physicians who are serving patients with and without COVID-19 in other parts of the medical center and Montefiore Health System. Telehealth made it possible for medical staff in MMC's three hospitals to communicate safely with our ICU Command Center, which is staffed by board-certified Critical Care and Pulmonary Physicians at all times, effectively enabling all beds involved in the treatment of COVID-19 to be ICU beds. We exponentially increased our ICU capacity. Prior to the pandemic, MMC operated 106 ICU beds; at the peak, we are operated 287 ICU beds. The technology ensured remote monitoring of vital signs, ultrasounds, and electrocardiograms for all patients throughout the system, and for consults with other physicians in the role of hospitalists. Access to our ambulatory sites was minimized to only essential, critical in-person services. Recognizing that patients need to communicate with their physicians and other medical providers about chronic conditions, as well as evolving conditions and their concerns about potential COVID-19-related symptoms, our ambulatory services immediately converted to telehealth. In addition, the telehealth capabilities in our Psychiatry Department have been beneficial in providing consultations for our physicians and associates who need assistance in coping with the immense suffering and volume of death they have been facing on a daily basis, and their concerns about exposure for themselves and their families. Office of Government and Community Relations (OCGR): The outbreak of COVID-19 exposed the vulnerabilities already affecting our local communities. In order to best respond to the impact brought upon the COVID-19 public health emergency, our OGCR team identified the greatest challenges facing the communities we serve. As a result, OGCR coordinated distribution events providing: Fresh produce; PPE and hand sanitizers; Clothing and other essential items such as toothpaste and soap; free Flu shot drives; Back to School Events; and COVID-19 Education on Research, Prevention & Vaccination. Research: Montefiore undertook a number of research efforts focused on COVID-19. - COVID-19 Vaccine - Montefiore and Einstein opened a COVID-19 vaccine trials unit, enrolling people in clinical trials that tested the efficacy of vaccines against the novel coronavirus. - Common Blood Test Identifies Benefits and Risks of Steroid Treatment in COVID-19 Patients - A new study led by Albert Einstein College of Medicine and Montefiore Health System confirmed the findings of the large scale British trial of steroid use for COVID-19 patients and advanced the research by answering several key questions: Which patients are most likely to benefit from steroid therapy? Could some of them be harmed? Can other formulations of steroids substitute for the agent studied in the British trial? - Largest Study of Cancer Patients with COVID-19 - Provides Guidance on How to Protect This Vulnerable Population and concluded that people with cancer who develop Covid-19 are more likely to die from the disease than those without cancer, according to the physician-researchers. Community Health Education: Due to social distancing requirements, starting in September 2020, the Montefiore community education team transitioned from offering in-person workshops to live virtual events in partnership with community-based organizations, including faith based groups, senior centers, and local schools. Topics covered included Covid-19 testing, the benefits of both Covid-19 and flu vaccines, as well as staying heathy during Covid (i.e. healthy weight, managing diabetes). Twenty-seven virtual events were conducted reaching 324 community members. Coordinating with public health agencies to combat COVID 19 in the community: OCPH coordinated granting access and training for 65 Montefiore associates to be able to connect patients/families to the NYC Get Food program. The program allowed for patients with mobility issues to receive 3 days of food delivery at least once per month. Montefiore also embarked on the BRAID project. Bridging Research, Accurate Information and Dialogue (BRAID) is an evidence-based community engagement model developed by a team of Einstein and Montefiore clinicians and researchers in 2020 to increase and improve the delivery of timely and trusted health messaging to the community. The BRAID model aims to build trust between community experts and local healthcare providers, researchers, and health systems by providing safe spaces for bilateral community dialogues that evoke what matters most to the community. The process of BRAIDing represents an active supportive network coming together. The BRAID model brings community members, clinicians, and scientists together for facilitated discussions about timely health issues like cancer screening and COVID-19 vaccination. Through causal dialogues called "conversation circles," relationships are developed and commonalities between participants identified. Clinicians and scientists answer community questions and address misinformation by sharing emerging evidence and local data. Once trust is established, participants collaborate to co-design health messages that would be acceptable to their community. Community members are then tasked with sharing those messages downstream to their social networks (BRAIDing), and with recruiting other trusted messengers, as local health influencers (BRAIDers), to further support the dissemination of accurate information. |
| Form 990, Part VI, Section A, Line 6: |
Montefiore Health System, Inc. is the sole member of Montefiore Medical Center. Form 990, Part VI, Section A, Line 7A: The board of trustees of Montefiore Health System, Inc., the sole member of Montefiore Medical Center, has the authority to appoint 49% of the Board of trustees of Montefiore Medical Center. The other 51% of the Board is elected by the Board of Trustees of the Medical Center from a slate of candidates approved by the sole member. |
| Form 990, Part VI, Section A, Line 7B: |
The board of trustees of Montefiore Health System, Inc., the sole member of Montefiore Medical Center, has the authority to approve the operating and capital budgets of Montefiore Medical Center. |
| Form 990, Part VI, Section B, Line 11B: |
THE FORM 990 WAS PREPARED BY THE MONTEFIORE'S FINANCE DEPARTMENT WITH THE assistance OF VARIOUS DEPARTMENTS THROUGHOUT THE MEDICAL CENTER. THE FORM 990 WAS REVIEWED AND APPROVED BY THE VICE PRESIDENT-FINANCE AND THE MEDICAL CENTER'S SENIOR LEADERSHIP TEAM INCLUDING THE CHIEF FINANCIAL OFFICER. IN ADDITION, AN INDEPENDENT ACCOUNTING FIRM WAS ENGAGED TO REVIEW THE FORM 990. UPON COMPLETION OF THE VARIOUS REVIEWS, THE FORM 990 WAS PRESENTED TO THE FINANCE COMMITTEE OF THE BOARD OF TRUSTEES FOR REVIEW AND APPROVAL. ONCE APPROVED BY THE FINANCE COMMITTEE OF THE BOARD OF TRUSTEES, THE FORM 990 WAS PROVIDED TO ALL MEMBERS OF MONTEFIORE MEDICAL CENTER'S GOVERNING BODY before filing. |
| Form 990, Part VI, Section B, Line 12C: |
The organization regularly and consistently monitors and enforces compliance with the disclosure policy by means of a survey developed by counsel and approved by the Legal and Compliance Committees of the BOARD of Trustees. The survey is sent to all trustees, officers and key employees for completion. All survey responses are reviewed by the Compliance Officer. Any potential conflicts identified in the responses are discussed with senior management and/or the Legal and Compliance committees of the Board of Trustees. Potential actions to be taken in response to a conflict is one or more of the following: 1)disclosure of conflict; 2)individual recusal from decisions for transactions where that individual may have a conflict; 3)request the individual to alleviate the conflict; OR 4)removal of the individual from the board of trustees. |
| Form 990, Part VI, Section B, Line 15A & Line 15B: |
All officers and Key Employees are employed and paid by either Montefiore Medicine Academic Health System, Inc. or Montefiore Health System, Inc., the parent company of Montefiore Health System, Inc. and Montefiore Medical Center, respectively. Montefiore is committed to ensuring that its executive compensation program adheres to the highest standards of regulatory compliance and best corporate governance. The Montefiore Board of Trustees has charged the Compensation Committee of the Board (which is comprised of independent Board members with no conflicts of interest in regards to executive compensation) with making all decisions related to compensation for officers and certain key employees. All decisions made by the Compensation Committee are appropriately and timely documented in meeting minutes. The compensation committee's review process follows the intermediate Sanctions guidelines for qualifying for the rebuttable presumption of reasonableness. The Committee retains an independent compensation consultant to assist it with this process. Compensation levels are established considering data for comparable organizations, an assessment of management performance (including the services provided to the community), and other business judgment factors, consistent with Montefiore's executive compensation philosophy. The Committee's decisions are made in the best interest of Montefiore, and are intended to ensure the recruitment and retention of key executive talent, consistent with the market practices of other not-for-profit healthcare organizations of comparable scope, mission and complexity. On an annual basis, the Committee provides the full Board of Trustees with a description of the Committee's review and approval process and its decisions. |
| Form 990, Part VI, Section C, Line 19: |
THE CONFLICT OF INTEREST POLICY, GOVERNING DOCUMENTS and montefiore Medical Center's audited consolidated financial statements ARE MADE AVAILABLE UPON REQUEST. |
| Form 990, Part IX, line 11e |
Even though the organization engaged a professional fundraiser as an event planner for it's remote gala benefit, there is no expense on line 11e of Part IX for Professional Fundraising services. The expense for this service is included in line 8b of Part VIII, Statement of Revenue, as a direct expense of a fundraising activity. |
| Form 990, Part XI, Line 9: |
The Other reduction in net assets of $69,697,147 were due to equity transfers to affiliates ($80,964,135) offset partially by a $11,266,988 decrease in defined pension and other postretirement plan liabilities to be recognized in future periods. |
Attach to Form 990 or 990-EZ.