Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
Graphic Arrow Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
Graphic Arrow Attach to Form 990.
Graphic Arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
NEW YORK SOCIETY FOR THE RELIEF OF THE
RUPTURED AND CRIPPLED MAINTAINING THE
Employer identification number

13-1624135
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
 
No
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
Yes
 
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ..................
6a
Yes
 
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2020
Page 2

Schedule J (Form 990) 2020
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits
(E) Total of columns
(B)(i)-(D)
(F) Compensation in column (B) reported as deferred on prior Form 990
(i) Base
compensation
(ii) Bonus & incentive
compensation
(iii) Other reportable compensation
1Mary K Crow - To 92020
Member/Physician-in-Chief
(i)

(ii)
637,857
-------------
0
298,599
-------------
0
8,397
-------------
500
25,650
-------------
0
17,339
-------------
0
987,842
-------------
500
0
-------------
0
2Lionel Ivashkiv
Member/Chief Scientific Offic.
(i)

(ii)
757,849
-------------
0
80,667
-------------
0
20,360
-------------
0
25,650
-------------
0
37,004
-------------
0
921,530
-------------
0
0
-------------
0
3Todd J Albert
Former Surgeon-in-Chief
(i)

(ii)
139,309
-------------
0
75,000
-------------
0
814
-------------
500
12,072
-------------
0
46,877
-------------
0
274,072
-------------
500
0
-------------
0
4Bryan T Kelly
Member/Surgeon-in-Chief
(i)

(ii)
2,642,025
-------------
0
250,500
-------------
0
2,963,647
-------------
0
25,650
-------------
0
53,555
-------------
0
5,935,377
-------------
0
0
-------------
0
5Karen Onel
Member/Attending Physician
(i)

(ii)
281,117
-------------
0
0
-------------
0
73,144
-------------
0
25,650
-------------
0
43,933
-------------
0
423,844
-------------
0
0
-------------
0
6Douglas Padgett
Member/Assoc Surgeon-in-Chief
(i)

(ii)
1,018,278
-------------
0
97,500
-------------
0
407,106
-------------
0
25,650
-------------
0
49,928
-------------
0
1,598,462
-------------
0
0
-------------
0
7Duretti Fufa - Join BOT 2020
Member/Attending Physician
(i)

(ii)
598,268
-------------
0
0
-------------
0
523,109
-------------
0
25,650
-------------
0
24,134
-------------
0
1,171,161
-------------
0
0
-------------
0
8S Louis BridgesJr -From 920
Member/Physician-in-Chief
(i)

(ii)
199,173
-------------
0
7,617
-------------
0
14,060
-------------
0
15,144
-------------
0
4,283
-------------
0
240,277
-------------
0
0
-------------
0
9Edwin Su - Left BOT 2020
Member/Attending Physician
(i)

(ii)
74,939
-------------
0
0
-------------
0
31,169
-------------
0
8,879
-------------
0
48,960
-------------
0
163,947
-------------
0
0
-------------
0
10Louis A Shapiro
President & Chief Exec Officer
(i)

(ii)
1,479,698
-------------
369,925
1,750,966
-------------
437,742
30,898
-------------
7,724
20,520
-------------
5,130
48,446
-------------
12,112
3,330,528
-------------
832,633
0
-------------
0
11Stacey L Malakoff
Exec VP & Chief Fin Officer
(i)

(ii)
1,213,992
-------------
214,234
798,767
-------------
140,959
32,376
-------------
5,713
21,803
-------------
3,848
41,848
-------------
7,385
2,108,786
-------------
372,139
0
-------------
0
12Lisa A Goldstein
Executive VP & COO
(i)

(ii)
978,097
-------------
146,152
614,451
-------------
91,814
30,487
-------------
4,555
22,316
-------------
3,335
35,261
-------------
5,269
1,680,612
-------------
251,125
0
-------------
0
13Irene Koch
Exec VP & Chief Legal Officer
(i)

(ii)
528,400
-------------
93,247
280,904
-------------
49,571
7,442
-------------
1,313
18,169
-------------
3,206
32,665
-------------
5,765
867,580
-------------
153,102
0
-------------
0
14Hollis Potter
Radiologist-in-Chief
(i)

(ii)
1,199,717
-------------
0
337,500
-------------
0
55,477
-------------
0
25,650
-------------
0
53,555
-------------
0
1,671,899
-------------
0
0
-------------
0
15Stephanie J Goldberg
Fmr Sr. VP, Pat Care SRV & CNO
(i)

(ii)
0
-------------
0
93,407
-------------
0
473,756
-------------
0
0
-------------
0
2,295
-------------
0
569,458
-------------
0
0
-------------
0
16Ralph Bianco
Sr. Vice President, Operations
(i)

(ii)
423,163
-------------
47,018
138,300
-------------
15,367
5,976
-------------
664
23,085
-------------
2,565
41,488
-------------
4,610
632,012
-------------
70,224
0
-------------
0
17Jennifer O'Neill
Sr. VP, Patient Care SRV & CNO
(i)

(ii)
512,904
-------------
0
140,085
-------------
0
5,386
-------------
0
21,375
-------------
0
1,144
-------------
0
680,894
-------------
0
0
-------------
0
18Sheeraz Qureshi
Associate Attending Physician
(i)

(ii)
185,731
-------------
0
0
-------------
0
2,481,507
-------------
0
21,375
-------------
0
30,995
-------------
0
2,719,608
-------------
0
0
-------------
0
19Answorth A Allen
Attending Physician
(i)

(ii)
491,649
-------------
5,630
0
-------------
0
2,642,848
-------------
30,263
25,360
-------------
290
46,471
-------------
532
3,206,328
-------------
36,715
0
-------------
0
20William M Ricci
Chief of the Trauma Service
(i)

(ii)
1,032,487
-------------
0
0
-------------
0
1,701,562
-------------
0
21,375
-------------
0
40,270
-------------
0
2,795,694
-------------
0
0
-------------
0
21Ernest Sink
Associate Attending Physician
(i)

(ii)
416,414
-------------
0
0
-------------
0
1,885,138
-------------
0
21,375
-------------
0
44,484
-------------
0
2,367,411
-------------
0
0
-------------
0
22Danyal Nawabi
Assistant Attending Physician
(i)

(ii)
432,894
-------------
0
0
-------------
0
1,869,574
-------------
0
21,375
-------------
0
42,733
-------------
0
2,366,576
-------------
0
0
-------------
0
Schedule J (Form 990) 2020
Page 3

Schedule J (Form 990) 2020
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
Schedule J, Part I, Line 1A/B First Class Travel - THE HSS TRAVEL POLICY STATES FOR BUSINESS CLASS TRAVEL PRIOR APPROVAL FROM THE CEO IS REQUIRED AND USUALLY ONLY APPROVED IF THE LENGTH OF THE FLIGHT IS GREATER THAN 5 HOURS. UPGRADE TO FIRST CLASS OCCURS ONLY IF BUSINESS CLASS DOES NOT EXIST. THE CEO, SURGEON-IN-CHIEF AND EXECUTIVE VICE PRESIDENTS HAVE APPROVAL FROM THE COMPENSATION COMMITTEE OF THE BOARD TO FLY BUSINESS CLASS IF THE FLIGHT IS GREATER THAN 5 HOURS, OR FIRST CLASS IF THE FLIGHT IS GREATER THAN 10 HOURS, OR BUSINESS CLASS IS NOT AVAILABLE. THE CEO REVIEWS THE EXECUTIVE VICE PRESIDENTS EXPENSES, AND THE AUDIT AND CORPORATE COMPLIANCE COMMITTEE OF THE BOARD OF TRUSTEES REVIEWS THE CEO'S AND SURGEON-IN-CHIEF'S EXPENSES ON A QUARTERLY BASIS. BUSINESS CLASS OR FIRST CLASS TRAVEL ARE NOT TREATED AS TAXABLE COMPENSATION. IN 2020, FIRST CLASS TRAVEL WAS REIMBURSED TO THE CEO AND SURGEON-IN-CHIEF. Housing Allowance - Housing allowance was paid to the Chief of the Trauma Service, as per his contract, and was treated as taxable compensation. Schedule J, Part I, Line 4A STEPHANIE GOLDBERG, FORMER SENIOR VICE PRESIDENT & CHIEF NURSING OFFICER, RECEIVED SEVERANCE PAY OF $473,756 WHICH IS INCLUDED IN SCHEDULE J, PART II, COLUMN (III). Severance payments began June 2019 and ended December 2020.
Schedule J, Part I, Line 5A Certain employed physicians listed on Part VII, Section A, Line 1A receive compensation in part, based on professional service revenue generated from services they personally performed in their individual practices. In 2020, no physician was paid compensation contingent upon the organization's overall revenue or net earnings.
Schedule J, Part I, Line 6A Performance based incentive awards are paid to officers and key employees based on a number of important quality, satisfaction, efficiency, and financial measures, of which achieving budget is a factor.
Schedule J, Part II THE FORMER SURGEON-IN-CHIEF, THE PHYSICIAN-IN-CHIEF AND ONE OTHER ATTENDING PHYSICIAN RECEIVED $500 FROM MIAC, A RELATED ORGANIZATION, TO ATTEND MIAC'S BOARD OF DIRECTORS MEETING.
Schedule J (Form 990) 2020

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