SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
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OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
KINGS PHYSICIAN SERVICES PC
 
Employer identification number

46-2333282
Return Reference Explanation
Form 990, Part III, Line 2 New program services SERVICES THAT ARE NO LONGER PROVIDED BY PARK SLOPE MEDICAL SERVICES, PC, BROOKLYN RADIOLOGY, PC AND PARK SLOPE PATHOLOGY, PC. ARE NOW AVAILABLE TO THE COMMUNITY THROUGH KINGS PHYSICIANS SERVICES PC., A RELATED ORGANIZATION
Form 990, Part VI, Line 15 PROCESS FOR DETERMINING COMPENSATION THE INDIVIDUAL IDENTIFIED HEREIN AS THE PRESIDENT OF THE CORPORATION IS EMPLOYED AND COMPENSATED BY A RELATED ORGANIZATION, NEWYORK-PRESBYTERIAN/BROOKLYN METHODIST HOSPITAL (THE "HOSPITAL"). THE INDIVIDUAL PERFORMS SERVICES FOR THE CORPORATION BY ARRANGEMENT BETWEEN THE HOSPITAL AND SUCH ORGANIZATION(S). AS SET FORTH IN SCHEDULE R, THE CORPORATION AND THE HOSPITAL ARE RELATED ORGANIZATIONS. THE ORGANIZATION'S PRESIDENT HAS NO INFLUENCE OVER THE COMPENSATION PROCESS PERFORMED BY THE RELATED ORGANIZATION.
Form 990, Part VI, Line 6 Classes of members or stockholders THE ORGANIZATION HAS A SHAREHOLDER WHO ALSO SERVES AS THE CHIEF MEDICAL OFFICER, AN EMPLOYEE OF THE NEWYORK-PRESBYTERIAN/BROOKLYN METHODIST. DR. SILBER IS THE SOLE SHAREHOLDER OF KINGS PHYSICIAN SERVICES, P.C.. THE P.C. IS ORGANIZED AND OPERATED EXCLUSIVELY FOR THE SOLE PURPOSE OF SUPPORTING AND FURTHERING THE CHARITABLE PURPOSES OF NEWYORK-PRESBYTERIAN/BROOKLYN METHODIST.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body NO ACTION MAY BE TAKEN BY A SHAREHOLDER, OFFICER, OR DIRECTOR, WITHOUT THE CONSENT OF NEWYORK-PRESBYTERIAN/BROOKLYN METHODIST.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders NO ACTION MAY BE TAKEN BY A SHAREHOLDER, OFFICER, OR DIRECTOR, WITHOUT THE CONSENT OF NEWYORK-PRESBYTERIAN/BROOKLYN METHODIST.
Form 990, Part VI, Line 11b Review of form 990 by governing body MEMBERS OF THE NEWYORK-PRESBYTERIAN HOSPITAL (NYPH) FINANCE DEPARTMENT (FINANCE) COORDINATED AND COMPLETED ALL OF THE INFORMATION REQUIRED FOR FORM 990, ACCESSING VARIOUS RESOURCES INCLUDING, LEGAL, HUMAN RESOURCES, CORPORATE COMPLIANCE, DEVELOPMENT, AND OTHER DEPARTMENTS AS NEEDED. THE FOLLOWING IS THE PROCESS FOR REVIEW: SENIOR FINANCE EXECUTIVES REVIEW THE RETURN IN CONJUNCTION WITH ERNST & YOUNG U.S. LLP, PAID PREPARER, PRIOR TO SUBMISSION TO THE CHAIR OF THE AUDIT AND CORPORATE COMPLIANCE COMMITTEE OF THE NYPH BOARD (NYPH AUDIT COMMITTEE) OR HIS/HER DESIGNEE.PURSUANT TO THE CORPORATION'S BYLAWS, IT IS THE NYPH AUDIT COMMITTEE THAT REVIEWS THE CORPORATION'S FORM 990. THE CHAIR OF THE NYPH AUDIT COMMITTEE OR HIS/HER DESIGNEE CONDUCTS A DETAILED REVIEW AND MEETS WITH FINANCE TO ADDRESS ANY QUESTIONS. A COPY OF THE 990 IS SENT TO THE OTHER COMMITTEE MEMBERS FOR REVIEW, AND A REPORT IS GIVEN ON THE 990 BY MANAGEMENT AT THE COMMITTEE'S MEETING IMMEDIATELY PRECEDING THE FILING. A COPY OF THE FORM 990 IS MADE AVAILABLE TO MEMBERS OF THE GOVERNING BODY PRIOR TO ITS FILING. THE CORPORATION FILES THE 990 UPON FINAL REVIEW.
Form 990, Part VI, Line 12c Conflict of interest policy KINGS PHYSICIAN SERVICES, P.C. ADHERES TO A CONFLICT OF INTEREST (COI) POLICY THAT WAS APPROVED BY THE AUDIT AND CORPORATE COMPLIANCE COMMITTEE OF THE BOARD OF TRUSTEES. THE POLICY STATES IN PART: "EACH BOARD MEMBER, OFFICER OR KEY PERSON OF A NEW YORK-PRESBYTERIAN ORGANIZATION SHALL COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE PRIOR TO BECOMING A BOARD MEMBER, OFFICER OR KEY PERSON OF THE NEW YORK-PRESBYTERIAN ORGANIZATION AND ANNUALLY THEREAFTER." THE POLICY ALSO STATES THAT "EACH BOARD MEMBER, OFFICER, OR KEY PERSON SHALL PROMPTLY ADVISE THE CHIEF EXECUTIVE OFFICER OF THE NEWYORK-PRESBYTERIAN ORGANIZATION, OR HIS OR HER DESIGNEE, OF ANY CHANGES TO THE INFORMATION PROVIDED IN THAT INDIVIDUAL'S LAST COMPLETED CONFLICT OF INTEREST QUESTIONNAIRE." THE CHIEF EXECUTIVE OFFICER OF NEW YORK-PRESBYTERIAN HOSPITAL, OR HIS OR HER DESIGNEE, SHALL REVIEW ALL COMPLETED QUESTIONNAIRES AND ALL SUBSEQUENT ADVICE OF CHANGES AND SHALL TAKE SUCH ACTION AS IS DEEMED APPROPRIATE TO ELIMINATE POTENTIALS FOR CONFLICTS OF INTEREST, INCLUDING SUCH STEPS AS REASSIGNMENT OF RESPONSIBILITIES OR ESTABLISHMENT OF PROTECTIVE ARRANGEMENTS. ALL DISCLOSURES OF INTERESTS IN COMPLETED QUESTIONNAIRES OR SUBSEQUENT ADVICE, UNLESS CLEARLY IRRELEVANT OR IMMATERIAL, SHALL BE COMPILED AND REPORTED BY MANAGEMENT TO THE AUDIT AND CORPORATE COMPLIANCE COMMITTEE OF THE BOARD OF NEW YORK- PRESBYTERIAN HOSPITAL, TOGETHER, IN EACH CASE, WITH RESPONSE OR RECOMMENDATION OF MANAGEMENT. THE AUDIT AND CORPORATE COMPLIANCE COMMITTEE SHALL DETERMINE WHETHER THE REPORTED RESOLUTION OF ISSUES RAISED BY THE DISCLOSURES IS SATISFACTORY AND, IF NOT, SHALL REQUIRE SUCH FURTHER ACTION AS IT DEEMS APPROPRIATE.
Form 990, Part VI, Line 19 Required documents available to the public EXTERNAL REQUESTS FOR OUR GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE REVIEWED FOR VALIDITY. THESE REQUESTS ARE THEN GRANTED IF DEEMED APPROPRIATE.
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue OTHER - Total Revenue: 586395, Related or Exempt Function Revenue: 447080, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 139315; - Total Revenue: , Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part IX, Line 11g Other Fees BILLING/COLLECTION FEES - Total Expense: 10420211, Program Service Expense: , Management and General Expenses: 10420211, Fundraising Expenses: ; LEASED PHYSICIANS - Total Expense: 32675577, Program Service Expense: 32675577, Management and General Expenses: , Fundraising Expenses: ; LEASE PHYSICIAN FEE - Total Expense: 4917808, Program Service Expense: 2360548, Management and General Expenses: 2557260, Fundraising Expenses: ; PROFESSIONAL FEES MEDICAL - Total Expense: 3253432, Program Service Expense: 3243907, Management and General Expenses: 9525, Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances ELIMINATION OF PARENT PAYABLE - XXX-XX-XXXX;
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021


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