Mount Sinai Beth Israel 2019 Audited Financial Statements

CONSOLIDATED FINANCIAL STATEMENTS
Beth Israel Medical Center and Affiliates

Years Ended December 31, 2019 and 2018
With Report of Independent Auditors
Ernst & Young LLP

Consolidated Financial Statements
Years Ended December 31, 2019 and 2018
Contents
Report of Independent Auditors.......................................................................................................1
Consolidated Financial Statements
Consolidated Statements of Financial Position................................................................................3

Consolidated Statements of Operations ...........................................................................................4
Consolidated Statements of Changes in Net Assets ........................................................................5
Consolidated Statements of Cash Flows ..........................................................................................6
Notes to Consolidated Financial Statements....................................................................................7
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Report of Independent Auditors
The Board of Trustees

Mount Sinai Health System, Inc.
We have audited the accompanying consolidated financial statements of Beth Israel Medical
Center and Affiliates, which comprise the consolidated statements of financial position as of
December 31, 2019 and 2018, and the related consolidated statements of operations, changes in
net assets, and cash flows for the years then ended, and the related notes to the consolidated
financial statements.
Management’s Responsibility for the Financial Statements
Management is responsible for the preparation and fair presentation of these financial statements
in conformity with U.S. generally accepted accounting principles; this includes the design,
implementation, and maintenance of internal control relevant to the preparation and fair
presentation of financial statements that are free of material misstatement, whether due to fraud or
error.
Auditor’s Responsibility
Our responsibility is to express an opinion on these financial statements based on our audits.
We conducted our audits in accordance with auditing standards generally accepted in the
United States. Those standards require that we plan and perform the audit to obtain reasonable
assurance about whether the financial statements are free of material misstatement.
An audit involves performing procedures to obtain audit evidence about the amounts and
disclosures in the financial statements. The procedures selected depend on the auditor’s judgment,
including the assessment of the risks of material misstatement of the financial statements, whether
due to fraud or error. In making those risk assessments, the auditor considers internal control
relevant to the entity’s preparation and fair presentation of the financial statements in order to
design audit procedures that are appropriate in the circumstances, but not for the purpose of
expressing an opinion on the effectiveness of the entity’s internal control. Accordingly, we express
no such opinion. An audit also includes evaluating the appropriateness of accounting policies used
and the reasonableness of significant accounting estimates made by management, as well as
evaluating the overall presentation of the financial statements.
We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis
for our audit opinion.
1
A member firm of Ernst & Young Global Limited
Opinion
In our opinion, the financial statements referred to above present fairly, in all material respects,
the consolidated financial position of Beth Israel Medical Center and Affiliates at December 31,
2019 and 2018, and the consolidated results of their operations, changes in their net assets, and
their cash flows for the years then ended in conformity with U.S. generally accepted accounting
principles.
Adoption of ASU No. 2016-02, Leases
As discussed in Note 1 to the consolidated financial statements, Beth Israel Medical Center and
Affiliates changed their method of accounting for leases as a result of the adoption of the
amendments to the FASB Accounting Standards Codification resulting from Accounting
Standards Update No. 2016-02, Leases, effective January 1, 2019. Our opinion is not modified
with respect to this matter.
March 31, 2020
2
A member firm of Ernst & Young Global Limited
Consolidated Statements of Financial Position
December 31
2019 2018
(In Thousands)
Assets
Current assets:
Cash and cash equivalents $ 184,833 $ 64,977
Short-term investments 25,206 24,074
Total cash and cash equivalents and short-term investments 210,039 89,051
Patient accounts receivable, net 68,196 72,134

Professional liabilities insurance recoveries receivable, current portion 29,231 41,513
Inventories 8,259 12,564
Other current assets 14,517 11,009
Total current assets 330,242 226,271
Pooled investments 24,665 22,163

Other investments 54,802 194,693
Assets limited as to use 318 25,475
Beneficial interest in self-insurance trust 28,465 11,123
Other assets 33,032 15,746
Right-of-use assets 179,304 –
Professional liabilities insurance recoveries receivable, less current portion 133,165 189,113
Property, plant, and equipment, net 569,729 351,471
Total assets $ 1,353,722 $ 1,036,055
Liabilities and net assets

Current liabilities:
Accounts payable and accrued expenses $ 83,283 $ 89,646
Accrued salaries and related liabilities 47,769 44,563
Accrued construction and capital asset liabilities 6,569 5,535
Due to related organizations, current portion 51,807 17,316
Professional liabilities, current portion 29,231 41,513
Finance lease obligations, current portion 753 717
Operating lease liabilities, current portion 29,631 –
Other current liabilities 25,176 54,482
Total current liabilities 274,219 253,772
Due to related organizations, less current portion 161,776 130,776

Estimated self-insurance liability 28,465 11,123
Professional liabilities, less current portion 133,165 189,113
Finance lease obligations, less current portion 189,293 2,250
Operating lease liabilities, less current portion 151,838 –
Other liabilities 176,991 169,783
Total liabilities 1,115,747 756,817
Commitments and contingencies
Net assets:
Net assets without donor restrictions 205,215 245,263
Net assets with donor restrictions 32,760 33,975
Total net assets 237,975 279,238
Total liabilities and net assets $ 1,353,722 $ 1,036,055
See accompanying notes.
3
Consolidated Statements of Operations
Year Ended December 31

2019 2018
(In Thousands)
Operating revenue
Net patient service revenue $ 820,105 $ 831,088
Investment income and net realized gains and losses on sales of
securities 5,402 3,666
Other revenue 75,046 68,145
Net assets released from restrictions 1,473 1,969
Total operating revenue before other items 902,026 904,868
Operating expenses
Salaries and wages 379,751 383,133
Employee benefits 133,807 141,039
Supplies and other 431,293 418,114
Depreciation and amortization 71,123 63,860
Interest and amortization 7,979 3,309
Total operating expenses before other items 1,023,953 1,009,455
Deficiency of operating revenue over operating expenses before

other items (121,927) (104,587)
Other items
Net change in unrealized gains and losses on investments
and change in value of alternative investments 3,407 (2,091)
Net change in participation in captive insurance program 66,852 56,864
Gain on sale of captive insurance company 11,620 –
Gain on sale of building – 1,254
Gain on sale of clinical outreach laboratory business – 2,823
Deficiency of revenue over expenses (40,048) (45,737)
Other changes in net assets without donor restrictions

Transfer from The Mount Sinai Hospital – 4,723
Total other changes in net assets without donor restrictions – 4,723
Net decrease in assets without donor restrictions $ (40,048) $ (41,014)
4
Consolidated Statements of Changes in Net Assets
Net Assets with Donor Restrictions

Net Assets Total Net
Without Purpose and Assets With
Donor Time Permanent Donor Total Net
Restrictions Restrictions Endowment Restrictions Assets
Net assets at January 1, 2018 $ 286,277 $ 12,364 $ 24,215 $ 36,579 $ 322,856

Net decrease in net assets (41,014) – – – (41,014)
Donor restricted contributions, net – 422 91 513 513
Uncollectible pledges – (1,148) – (1,148) (1,148)
Net assets released from restrictions – (1,969) – (1,969) (1,969)
Total change in net assets (41,014) (2,695) 91 (2,604) (43,618)
Net assets at December 31, 2018 245,263 9,669 24,306 33,975 279,238
Net decrease in net assets (40,048) – – – (40,048)
Donor restricted contributions, net – 258 – 258 258
Net asset reclassifications – 12,372 (12,372) – –
Net assets released from restrictions – (1,473) – (1,473) (1,473)
Total change in net assets (40,048) 11,157 (12,372) (1,215) (41,263)
Net assets at December 31, 2019 $ 205,215 $ 20,826 $ 11,934 $ 32,760 $ 237,975
5
Consolidated Statements of Cash Flows
Year Ended December 31
2019 2018
(In Thousands)
Operating activities
Change in net assets $ (41,263) $ (43,618)
Adjustments to reconcile change in net assets to net cash (used in) provided by
operating activities:
Depreciation and amortization 71,123 63,860
Transfer from The Mount Sinai Hospital – (4,723)
Net donor restricted contributions (258) (513)
Uncollectible pledges – 1,148
Net realized and change in net unrealized gains and losses on investments and
change in value of alternative investments (3,407) (763)
Net change in participation in captive insurance program (66,852) (56,864)
Gain on sale of building – (1,254)
Gain on sale of captive insurance company (11,620) –
Gain on sale of clinical outreach laboratory business – (2,823)
(Decrease) increase in cash resulting from a change in:
Patient accounts receivable, net (3,938) 4,072
Accounts payable and accrued expenses (6,363) (10,204)
Other current liabilities (29,306) (30,779)
Change in right-of-use-assets 12,258 –
Net effect of increases and decreases in other operating assets
and liabilities (105,286) 86,930
Net cash (used in) provided by operating activities (184,912) 4,469
Investing activities
Acquisitions of property, plant, and equipment, net (106,966) (72,131)
Proceeds from sale of building and clinical outreach laboratory business – 5,847
Decrease in assets limited as to use, net 25,157 1,917
Funding of self-insurance trust (9,744) (3,000)
Proceeds from sale of captive insurance company 168,405
Decrease (increase) in investments, net 138,759 (3,354)
Net cash provided by (used in) investing activities 215,611 (70,721)
Financing activities
Principal payments of finance lease obligations (716) (683)
Transfer from The Mount Sinai Hospital – 4,723
Proceeds from related parties, net 65,491 27,194
Net donor restricted contributions 258 (635)
Net cash provided by financing activities 65,033 30,599
Net increase (decrease) in cash and cash equivalents and restricted cash 95,732 (35,653)
Cash, cash equivalents and restricted cash at beginning of year 90,614 126,267
Cash and cash equivalents and restricted cash at end of year $ 186,346 $ 90,614
Reconciliation of cash, cash equivalents and restricted cash at end of year to the
consolidated statements of financial position
Cash and cash equivalents 184,833 64,977
Assets limited as to use: cash and cash equivalents 318 25,475
Short term and other investments: cash and cash equivalents 1,195 162
Total cash, cash equivalents and restricted cash $ 186,346 $ 90,614
Supplemental disclosure of cash flow information
Non-cash investing and financings transactions
Assets acquired under finance lease obligations $ 182,415 $ –
6
Notes to Consolidated Financial Statements
December 31, 2019
1. Organization and Summary of Significant Accounting Policies
Organization
Beth Israel Medical Center, d/b/a Mount Sinai Beth Israel and Mount Sinai Brooklyn (collectively,
BIMC) is a not-for-profit health care provider with various facilities located in New York City.
BIMC is a tertiary care teaching hospital with two campuses located in Manhattan and Brooklyn.
In addition, BIMC includes several ambulatory care locations throughout the metropolitan area.
BIMC is the sole member of or controls the following entities: Mount Sinai Ambulatory Ventures,
Inc.; BICCC West, LLC; East 17th Street Properties, Inc.; B.I.M.C. Holding Corporation; and
Beth Israel Medical Center Foundation, Inc. Additionally, BIMC owns or controls various other
entities whose operations were effectively dormant for the years ended December 31, 2019 and
2018.
Prior to September 30, 2013, Continuum Health Partners, Inc. (CHP) was the sole corporate
member of BIMC, The St. Luke’s-Roosevelt Hospital Center (SLR), and The New York Eye and
Ear Infirmary (NYEEI).
On September 30, 2013, BIMC, SLR, and NYEEI (together, the CHP Entities) consummated a
transaction pursuant to which the CHP Entities and The Mount Sinai Hospital (MSH), the Icahn
School of Medicine at Mount Sinai (ISMMS), and The Mount Sinai Medical Center, Inc. (MSMC)
came together to create the Mount Sinai Health System (MSHS), an integrated health care system
and academic medical center (the Transaction). Pursuant to the Transaction, two new not-for-profit
entities were formed: Mount Sinai Health System, Inc. (MSHS) and Mount Sinai Hospitals Group,
Inc. (MSHG). MSHG was formed to be the sole member of MSH, BIMC, SLR and NYEE. MSHS
was formed to be the sole member of MSHG, ISMMS and MSMC.
In February 2018, MSHG and South Nassau Communities Hospital (SNCH) executed a definitive
agreement pursuant to which MSHG would become the sole corporate member of SNCH and its
“active parent” under New York Law. The transaction became effective in October 2018. Pursuant
to the agreement, MSHG agreed to contribute $120.0 million over a five-year period to be used in
support of certain capital projects. For each of the years ended December 31, 2019 and 2018, the
MSH contributed $20.0 million to SNCH, respectively. Effective September 2019, SNCH is doing
business as (d/b/a) Mount Sinai South Nassau (MSSN).
7
Notes to Consolidated Financial Statements (continued)
1. Organization and Summary of Significant Accounting Policies (continued)
Liquidity and Operating Results
As of December 31, 2019, BIMC has consolidated cash and cash equivalents, short-term
investments, assets limited as to use, pooled investments and other investments (exclusive of
BIMC’s $52.2 million interest in the insurance program described in Note 6) of approximately
$237.6 million and net assets without donor restrictions of approximately $205.2 million. The
deficiency of operating revenue over operating expenses before other items for the year ended
December 31, 2019, was approximately $121.9 million and net cash used in operations for the year
ended December 31, 2019, was approximately $184.9 million. BIMC experienced significant
operating losses due to reduced patient volume in 2018 and 2019 attributable to several factors
generally impacting the health care industry and the continuation of the transformation of BIMC
whereby several departments are moving to other hospitals within MSHS.
Management continues to focus on programs to improve operating results in 2020, including the
continued transformation of BIMC. MSHS management continues to implement a financial
stabilization plan aimed at reducing costs, monetizing certain assets, and evaluating opportunities
for synergies within MSHS, including among clinical programs. It is management’s expectation
that the successful culmination of certain of the above-mentioned initiatives will result in improved
liquidity and operating results. However, there is no certainty that such improvements will be
realized.
Management believes that BIMC’s cash and investments, along with initiatives designed to
stabilize financial results, the continued monetization of certain assets, will allow BIMC to
continue its operations and satisfy its liabilities in the normal course of business through at least
one year beyond the date of issuance of the accompanying consolidated financial statements.
Financial assets available for general expenditure within one year at December 31 consist of the
following:
2019 2018
(in thousands)

Patient accounts receivable, net 68,196 72,134
$ 278,235 $ 161,185
8
BIMC has certain short-term investments with no liquidity restrictions that are available for
general expenditure within one year in the normal course of operations. Accordingly, these assets
have been included in the qualitative information above. BIMC has pooled investments and other
assets limited as to use for donor-restricted purposes and for funded depreciation. These assets,
which are more fully described in Note 3 are not available for general expenditure within the next
year and are not reflected in the amounts above.
Principles of Consolidation
The accompanying consolidated financial statements have been prepared on the accrual basis of
accounting and include the accounts of BIMC and its owned or controlled affiliates. All significant
intercompany accounts and transactions have been eliminated in consolidation.
Transactions among BIMC and related organizations relate principally to the sharing of certain
services, facilities, equipment, and personnel and are accounted for on the basis of allocated cost,
as agreed among the parties. Amounts due to MSH under the intercompany loan bear interest. The
remainder of amounts due from or to related organizations do not bear interest. The nature of
BIMC’s transactions with various related organizations is described more fully in Note 10.
Cash and Cash Equivalents
BIMC considers highly liquid financial instruments purchased with a maturity of three months or
less to be cash equivalents. Substantially all of BIMC’s cash and cash equivalents are deposited
with two financial institutions at December 31, 2019 and 2018. Included in cash and cash
equivalents are amounts in excess of Federal depository insurance limits. Management does not
believe the credit risk related to those deposits to be significant. BIMC does not hold any money
market funds with significant liquidity restrictions that would be required to be excluded from cash
equivalents.
Amounts within restricted cash include cash held within investments and assets limited as to use
and represent funds set aside within the investment portfolio based on management’s policy or
contractual arrangements.
9
Patient Accounts Receivable
Patient accounts receivable and net patient service revenue result from the health care services
provided by BIMC and is reported at the amount that reflects the consideration to which BIMC
expects to be entitled in exchange for providing patient care. These amounts are due from patients,
third-party payors (including health insurers and government programs), and others and includes
variable consideration in determination of transaction price.
Investments
A substantial portion of BIMC’s investments are pooled for management purposes with those held
by related entities. MSMC has custody of investments held in the investment pool and records all
of the pooled investments in its financial statements, with a corresponding liability due to each of
the participants in the investment pool for their respective share of the pooled investments; the
pool participants report their respective share of the investment pool as “pooled investments.”
Pooled investments represent assets with donor restrictions that are perpetual in nature and
represent BIMC’s endowment assets. Investment earnings on the pooled investments are recorded
by the pool participants, based on their pro rata share of the pool’s investment returns.
Investments, both pooled and non-pooled, consist of cash and cash equivalents, U.S. government
and corporate bonds, money market funds, equity securities, and interests in alternative
investments. Debt securities and equity securities with readily determinable values are carried at
fair value based on independent published sources (quoted market prices).
Alternative investments (nontraditional, not readily marketable securities), held in the investment
pool, may consist of equity, debt, and derivatives both within and outside the U.S. in multi-strategy
hedge funds, event-driven strategies, global investment mandates, distressed securities, and private
funds. Alternative investment interests generally are structured such that the investment pool holds
a limited partnership interest or an interest in an investment management company. The investment
pool’s ownership structure does not provide for control over the related investees and the
investment pool’s financial risk is limited to the carrying amount reported for each investee, in
addition to any unfunded capital commitment. Future funding commitments by members of the
investment pool for alternative investments aggregated approximately $194.0 million at
December 31, 2019.
10
Individual investment holdings within the alternative investments include nonmarketable and
market-traded debt and equity securities and interests in other alternative investments. BIMC may
be exposed indirectly to securities lending, short sales of securities and trading in futures and
forward contracts, options, and other derivative products. Alternative investments often have
liquidity restrictions under which the pooled investment capital may be divested only at specified
times. Liquidity restrictions may apply to all or portions of a particular invested amount.
Alternative investments in the pool are stated at fair value based upon net asset values as a practical
expedient. Financial information used to evaluate alternative investments is provided by the
respective investment manager or general partner and includes fair value valuations (quoted
market prices and values determined through other means) of underlying securities and other
financial instruments held by the investee, and estimates that require varying degrees of judgment.
The financial statements of the investee companies are audited annually by independent auditors,
although the timing for reporting the results of such audits may not coincide with BIMC’s annual
financial statement reporting.
There is uncertainty in determining values of alternative investments arising from factors such as
lack of active markets (primary and secondary), lack of transparency into underlying holdings, and
time lags associated with reporting by the investee companies. As a result, the estimated fair values
might differ from the values that would have been used had a ready market for the alternative
investment interests existed and there is at least a reasonable possibility that estimates will change.
Investment Income
Investment income from the investment pool is allocated to investment pool participants using the
market-value unit method. The annual spending rate for pooled funds is approved by the Board of
Trustees annually (see Note 3). Realized gains and losses from the sale of securities are computed
using the average cost method.
In the absence of donor restrictions, investment income, realized gains and losses, the change in
net unrealized gains and losses on investments and change in value of alternative investments, is
reflected in the accompanying consolidated statements of operations within the deficiency of
revenue over expenses.
11
Inventories
BIMC values its inventories, principally drugs and medical supplies, at the lower of cost or net
realizable value.
Assets Limited as to Use
Assets limited as to use primarily includes funds held for specific purposes, primarily related to
the funded depreciation account held in accordance with New York State regulations (see Note 3).
Other Assets
BIMC has invested in various health care entities, certain of which are accounted for using the
equity method. These amounts are classified as other assets in the accompanying consolidated
statements of financial position. In addition, included in other current assets are receivables related
to third-party rate accounts of approximately $3.9 million and $2.3 million at December 31, 2019
and 2018, respectively.
Property, Plant, and Equipment
Property, plant, and equipment is carried at cost and those assets acquired by gifts and bequests
are carried at appraised or fair value established at the date of contribution. Depreciation expense
is computed utilizing the straight-line method over the estimated useful lives of the assets which
range from 3 to 40 years. In accordance with BIMC’s policy, one-half year’s depreciation is
recorded in the year of asset acquisition, and in the final year of the asset’s useful life. When assets
are retired or otherwise disposed of, the cost and the related depreciation are reversed from the
accounts, and any gain or loss is reflected in the deficiency of revenue over expenses. Repairs and
maintenance expenditures are expensed as incurred.
Equipment under finance lease obligations is recorded at the present value of the minimum lease
payments at the inception of the leases and is amortized on the straight-line method over the shorter
of the lease term or the estimated useful life of the equipment. Such amortization is included in
depreciation and amortization expense in the accompanying consolidated statements of operations.
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Impairment of Long-Lived Assets
Long-lived assets are reviewed for impairment whenever events or changes in circumstances
indicate that the carrying amount of an asset may not be recoverable. If such assets are deemed to
be impaired, the impairment to be recognized is measured by the amount by which the carrying
amount of the assets exceeds the fair value. Assets to be disposed of are reported at the lower of
the carrying amount or fair value less costs to sell.
Conditional Asset Retirement Obligations
Asset retirement obligations, reported in other liabilities, are legal obligations associated with the
retirement of long-lived assets. These liabilities are initially recorded at fair value and the related
asset retirement costs are capitalized by increasing the carrying amount of the related assets by the
same amount as the liability. Asset retirement costs are subsequently depreciated over the useful
lives of the related assets. Subsequent to initial recognition, BIMC records changes in the liability
resulting from the passage of time and revisions to either the timing or the amount of the original
estimate of undiscounted cash flows. BIMC reduces its liabilities when the related obligations are
settled. As of December 31, 2019 and 2018, approximately $9.2 million and $8.8 million,
respectively, of conditional asset retirement obligations are included within other liabilities in the
accompanying consolidated statements of financial position.
Other Liabilities
Other liabilities in the accompanying consolidated statements of financial position consist

primarily of the long-term portion of estimated payables to third-party payors, deferred revenue
and liabilities related to the insurance program (refer to Note 6).
Net Assets Without Donor Restrictions
Net assets that are not subject to donor-imposed restrictions may be expended for any purpose in
performing the primary objectives of the organization. These net assets may be used at the
discretion of BIMC’s management and the Board of Trustees.
13
Net Assets With Donor Restrictions
Net assets with donor restrictions are those whose use by BIMC has been limited by donors to a
specific time period or purpose. Some donor restrictions are temporary in nature; those restrictions
will be met by actions of BIMC or by the passage of time. Other donor restrictions are perpetual
in nature, whereby the donor has stipulated the funds be maintained in perpetuity.
Donor restricted contributions are reported as increases in net assets with donor restrictions. When
a restriction expires, net assets are reclassified from net assets with donor restrictions to net assets
without donor restrictions in the consolidated statements of operations and changes in net assets.
Contributions
Contributions, including unconditional promises to give cash and other assets (pledges), are
reported at fair value on the date received. The gifts are reported as net assets with donor
restrictions if they are received with donor stipulations that limit the use of the donated assets.
When a donor restriction expires, that is, when a stipulated time restriction ends or purpose
restriction is accomplished, net assets with donor restrictions are reclassified to net assets without
donor restrictions and reported as net assets released from restrictions. Donor-restricted
contributions whose restrictions are met within the same year as received are reflected in net assets
with donor restrictions and net assets released from restrictions in the accompanying consolidated
Performance Indicator
The consolidated statements of operations include the deficiency of revenue over expenses as the
performance indicator. Changes in net assets without donor restrictions, which are excluded from
the deficiency of revenue over expenses, include the transfer from MSH (for the year ended
December 31, 2018).
BIMC differentiates its operating activities through the use of the deficiency of operating revenue
over operating expenses before other items as an intermediate measure of operations. For the
purposes of display, items which management does not consider components of BIMC’s central
operating activities are excluded from this measure and reported as other items in the
accompanying consolidated statements of operations.
14
Use of Estimates
The preparation of the consolidated financial statements in conformity with U.S. generally
accepted accounting principles requires management to make estimates and assumptions that
affect the reported amounts of assets and liabilities and disclosures of contingent assets and
liabilities at the date of the consolidated financial statements and the reported amounts of revenue
and expenses during the reporting period. The most significant estimates relate to patient accounts
receivable, amounts due from and to third party payors, the net carrying value of BIMC’s interest
in the captive insurance program, and estimated professional liabilities and related insurance
recoveries receivable. Actual results may differ from those estimates.
Tax Status
BIMC and its consolidated affiliate organizations are tax-exempt organizations under Section
501(c)(3) of the Internal Revenue Code. They are also exempt from New York State and
New York City income taxes. Accordingly, no provision for income taxes related to these entities
has been made. BIMC files unrelated business tax returns annually and submits taxes as
determined. Such amounts are not significant to the consolidated financial statements.
The Taxpayer Certainty and Disaster Tax Relief Act of 2019, signed into law on December 20,
2019, retroactively repealed IRC Section 512(a)(7) which subjected amounts paid or incurred by
an exempt organization to provide certain transportation fringe benefits to its employees to taxation
as unrelated business taxable income. The impact of the Taxpayer Certainty and Disaster Tax
Relief Act of 2019 was not significant to the accompanying consolidated financial statements.
Sale of Captive Insurance Company
On November 27, 2018, the Hospital, BIMC, Montefiore Health System, and Maimonides
Medical Center, collectively the owners of Hospitals Insurance Company (HIC) and FOJP Service
Corporation (FOJP), announced their agreement to sell HIC and FOJP to The Doctors Company
for $718.9 million, after closing adjustments. The transaction closed on July 31, 2019, and the
hospitals shared in the proceeds ratably according to their ownership. BIMC received
approximately $168.4 million in 2019 and recorded a gain on the sale of approximately
$11.6 million (see Note 6).
15
Recently Adopted Accounting Pronouncements
In January 1, 2019, BIMC adopted ASU 2016-01, Recognition and Measurement of Financial
Assets and Financial Liabilities (ASU 2016-01). ASU 2016-01 requires business-oriented health
care not-for-profit entities to measure equity investments that do not result in consolidation and
are not accounted for under the equity method at fair value and recognize any changes in fair value
in the performance indicator unless the investments qualify for a new practicability exception.
BIMC adopted ASU 2016-01 effective January 1, 2019. The adoption of ASU 2016-01 did not
have a material impact on the consolidated financial statements.
In February 2016, the Financial Accounting Standards Board (FASB) issued Accounting
Standards Update No. (ASU) 2016-02, Leases, which requires the rights and obligations arising
from the lease contracts, including existing and new arrangements, to be recognized as assets and
liabilities on the statements of financial position, including both finance leases (formerly referred
to as capital leases) and operating leases. ASU 2016-02 requires expanded disclosure related to
lease agreements to help the financial statement users better understand the amount, timing, and
uncertainty of cash flows arising from leases. The recognition, measurement and presentation of
expenses and cash flows arising from a lease primarily depends on its classification as a finance
or operating lease.
BIMC adopted ASU 2016-02 effective January 1, 2019, following the modified retrospective
method of application. As such, the 2018 consolidated financial statement amounts and disclosures
have not been adjusted to reflect the provisions of the new standard. There was no cumulative-
effect impact to the 2018 consolidated net assets as a result of the adoption. BIMC has made the
transition-specific election to apply the package of practical expedients which allows for the
carryforward of historical assessments of (1) whether contracts are or contain leases, (2) lease
classification and (3) initial direct costs. Additionally, for operating leases entered into prior to
January 1, 2019, BIMC has elected to utilize the operating leases’ initial lease term to determine
the discount rate used to initially measure the liability. Certain other accounting policy elections
and quantitative and qualitative information pertaining to BIMC’s adoption of ASU 2016-02 are
described in Note 5.
In August 2016, the FASB issued ASU 2016-15, Statement of Cash Flows – Classification of
Certain Cash Receipts and Cash Payments, which addresses the following eight specific cash flow
issues in order to limit diversity in practice: debt prepayment or debt extinguishment costs;
settlement of zero-coupon debt instruments or other debt instruments with coupon interest rates
16
that are insignificant in relation to the effective interest rate of the borrowing; contingent
consideration payments made after a business combination; proceeds from the settlement of
insurance claims; proceeds from the settlement of corporate-owned life insurance policies,
including bank-owned life insurance policies; distributions received from equity method investees;
beneficial interests in securitization transactions; and separately identifiable cash flows and
application of the predominance principle. The adoption of ASU 2016-15 did not have a material
impact on BIMC’s consolidated financial statements.
In November 2016, the FASB issued ASU 2016-18, Statement of Cash Flows – Restricted Cash,
which requires that the statement of cash flows explain the change during the period in the total of
cash, cash equivalents, and amounts generally described as restricted cash or restricted cash
equivalents. BIMC adopted ASU 2016-18 effective December 31, 2019. Therefore, amounts
generally described as restricted cash and restricted cash equivalents should be included with cash
and cash equivalents when reconciling the beginning-of-period and end-of-period total amounts
shown on the statement of cash flows. BIMC has adopted ASU 2016-18 using a retrospective
transition method.
In June 2018, the FASB issued ASU 2018-08, Not-for-Profit Entities (Topic 958); Clarifying the
Scope and the Accounting Guidance for Contributions Received and Contributions Made. ASU
2018-08 clarifies existing guidance in order to address diversity in practice in classifying grants
(including governmental grants) and contracts received by not-for-profit entities, and requires
entities to evaluate whether the resource provider receives commensurate value. In addition, the
standard clarifies the guidance on how entities determine when a contribution is conditional,
including whether the agreement includes a barrier (or barriers) that must be overcome for the
recipient to be entitled to the transferred assets (or a right of release of the promisor’s obligation
to transfer the assets). BIMC adopted ASU 2018-08 effective January 1, 2019. The standard was
applied on a modified prospective basis to agreements that were not completed as of the effective
date and to agreements entered into after the effective date. BIMC adopted ASU 2018-08 effective
January 1, 2019. The adoption of ASU 2018-08 in relation to other revenue activity did not have
a material impact to BIMC’s consolidated financial statements.
In August 2018, the FASB issued ASU 2018-15, Intangibles—Goodwill and Other—Internal-Use
Software (Subtopic 350-40): Customer’s Accounting for Implementation Costs Incurred in a
Cloud Computing Arrangement That Is a Service Contract, which aligns the requirements for
capitalizing implementation costs incurred in a hosting arrangement that is a service contract with
the requirements for capitalizing implementation costs incurred to develop or obtain internal-use
17
software (and hosting arrangements that include an internal use software license). The accounting
for the service element of a hosting arrangement that is a service contract is not affected by the
standard. ASU 2018-15 requires an entity (customer) in a hosting arrangement that is a service
contract to follow the guidance in Subtopic 350-40 to determine which implementation costs to
capitalize as an asset related to the service contract and which costs to expense. ASU 2018-15 also
requires the entity (customer) to expense the capitalized implementation costs of a hosting
arrangement that is a service contract over the term of the hosting arrangement, amongst other
provisions. The amendments in ASU 2018-15 are effective for annual reporting periods beginning
after December 15, 2020, and interim periods thereafter. Early adoption is permitted. The
amendments should be applied either retrospectively or prospectively to all implementation costs
incurred after the date of adoption. BIMC early adopted ASU 2018-15 effective January 1, 2019.
The adoption of ASU 2018-15 did not have a material impact on the financial statements.
Other Recent Accounting Pronouncements
In June 2016, the FASB issued ASU 2016-13, Financial Instruments – Credit Losses (Topic 326):
Measurement of Credit Losses on Financial Instruments. The new credit losses standard changes
the impairment model for most financial assets and certain other instruments. For trade and other
receivables, contract assets recognized as a result of applying ASU 2014-09, Revenue from
Contracts with Customers (Topic 606), loans and certain other instruments, entities will be
required to use a new forward looking “expected loss” model that generally will result in earlier
recognition of credit losses than under today’s incurred loss model. The ASU is effective for annual
periods beginning after December 31, 2021. BIMC has not completed the process of evaluating
the impact of ASU 2016-13 on its consolidated financial statements.
In May 2019, the FASB issued ASU 2019-06, Intangibles – Goodwill and Other (Topic 350),
Business Combinations (Topic 805), and Not-for-Profit Entities (Topic 958), Extending the Private
Company Accounting Alternatives on Goodwill and Certain Identifiable Intangible Assets to Not-
for-Profit Entities. Under ASU 2019-06, entities that elect the goodwill accounting alternative will
amortize goodwill and perform a one-step impairment test, at either the entity level or the reporting
unit level, only when an impairment indicator exists. Entities that elect the intangible asset
accounting alternative may recognize fewer intangible assets in an acquisition, and they would be
required to elect the goodwill accounting alternative. Entities that elect to adopt the alternatives do
not have to demonstrate preferability and will follow the alternatives’ transition guidance. Entities
that elect this accounting alternative will amortize goodwill on a straight-line basis over 10 years
or over a shorter period if they are able to demonstrate that another useful life is more appropriate.
BIMC has not completed the process of evaluating the impact of ASU 2019-06 on its consolidated
18
The FASB has amended certain guidance related to various disclosures in ASU 2018-13, Technical
Corrections and Improvements to Financial Instruments—Overall (Subtopic 825-10)—
Recognition and Measurement of Financial Assets and Financial Liabilities, and ASU 2018-14,
Compensation—Retirement Benefits—Defined Benefit Plans—General (Subtopic 715-20)—
Disclosure Framework—Changes to the Disclosure Requirements for Defined Benefit Plans.
Among various provisions, ASU 2018-09 may result in additional assets included in an entity’s
fair value disclosure table if, among other criteria, net asset value has public visibility. ASU 2018-
13 includes several disclosure changes involving transfers between the fair value levels and other
updates related to fair value Level 3 investments. ASU 2018-13 also requires entities that use the
practical expedient to measure the fair value of certain investments at their net asset values to
disclose (1) the timing of liquidation of an investee’s assets and (2) the date when redemption
restrictions will lapse, but only if the investee has communicated this information to the entity or
announced it publicly. The guidance in ASU 2018-14 requires all sponsors of defined benefit plans
to provide certain new disclosures: the weighted-average interest crediting rate for cash balance
plans and other plans with promised interest crediting rates and an explanation of the reasons for
significant gains and losses related to changes in the benefit obligation for the period. Among other
changes, ASU 2018-14 eliminates the required disclosure for all sponsors of defined benefit plans
to disclose the amounts in accumulated other comprehensive income expected to be recognized as
components of net periodic benefit cost over the next fiscal year. The updates noted above have
effective dates as follows with early adoption permitted: ASU 2018-13: fiscal years beginning
after December 15, 2019; and ASU 2018-14: fiscal years ending after December 15, 2021. BIMC
has not completed the process of evaluating the impact of ASU 2018-13 and ASU 2018-14 on its
consolidated financial statements.
Reclassifications
Certain reclassifications have been made to the 2018 consolidated financial statements and
disclosures to conform to the 2019 presentation. These reclassifications have no impact on the net
assets previously reported.
2. Accounts Receivable for Services to Patients and Net Patient Service Revenue
Net patient service revenue is reported at the amount that reflects the consideration for which
BIMC expects to be entitled in exchange for providing patient care.
19
(continued)
BIMC uses a portfolio approach to account for categories of patient contracts as collective groups
rather than recognizing revenue on an individual contract basis. The portfolio consists of major
payor classes for inpatient revenue and outpatient revenue. Based on historical collection trends
and other analyses, BIMC believes that revenue recognized by utilizing the portfolio approach
approximates the revenue that would have been recognized if an individual contract approach were
used.
BIMC’s initial estimate of the transaction price for services provided to patients is determined by
reducing the total standard charges related to the patient services provided by various elements of
variable consideration, including contractual adjustments, discounts, implicit price concessions,
and other reductions to BIMC’s standard charges. BIMC determines the transaction price
associated with services provided to patients who have third-party payor coverage on the basis of
contractual or formula-driven rates for the services rendered (see description of third-party payor
payment programs below). The estimates for contractual allowances and discounts are based on
contractual agreements, BIMC’s discount policies and historical experience. For uninsured and
under-insured patients who do not qualify for charity care, BIMC determines the transaction price
associated with services rendered on the basis of charges reduced by implicit price concessions.
Implicit price concessions included in the estimate of the transaction price are based on BIMC’s
historical collection experience for applicable patient portfolios.
Generally, BIMC bills patients and third-party payors after the services are performed and the
patient is discharged. Net patient service revenue is recognized as performance obligations are
satisfied. Performance obligations are determined based on the nature of the services provided by
BIMC. Net patient service revenue for performance obligations satisfied over time is recognized
based on actual charges incurred in relation to total charges. BIMC believes that this method
provides a reasonable depiction of the transfer of services over the term of the performance
obligation based on the services needed to satisfy the obligation. Generally, performance
obligations satisfied over time relate to patients receiving inpatient acute care services or patients
receiving services in BIMC’s outpatient settings. BIMC measures the performance obligation from
admission into BIMC or the commencement of an outpatient service to the point when it is no
longer required to provide services to that patient, which is generally at the time of discharge or
the completion of the outpatient visit.
20
(continued)
Substantially all of its performance obligations relate to contracts with a duration of less than one
year. Unsatisfied or partially unsatisfied performance obligations primarily relate to inpatient acute
care services at the end of the reporting period for patients who remain admitted at that time (in-
house patients). The performance obligations for in-house patients are generally completed when
the patients are discharged, which for the majority of BIMC’s in-house patients occurs within days
or weeks after the end of the reporting period.
Subsequent changes to the estimate of the transaction price (determined on a portfolio basis when
applicable) are generally recorded as adjustments to patient service revenue in the period of the
change. For the years ended December 31, 2019 and 2018, changes in BIMC’s estimates of
implicit price concessions, discounts, contractual adjustments or other reductions to expected
payments for performance obligations satisfied in prior years were not significant. Portfolio
collection estimates are updated based on collection trends. Subsequent changes that are
determined to be the result of an adverse change in the patient’s ability to pay (determined on a
portfolio basis when applicable) are recorded as bad debt expense. Bad debt expense for the years
ended December 31, 2019 and 2018 was not significant.
BIMC has determined that the nature, amount, timing and uncertainty of revenue and cash flows
are affected by the following factors: payors, lines of business and timing of when revenue is
recognized. Tables providing details of these factors are presented below.
Net patient service revenue disaggregated by payor comprises the following for the years ended
December 31:
2019 2018
(In Thousands)
Medicare $ 190,921 $ 203,705

Medicare managed care 127,235 129,899
Medicaid, including Medicaid pending 121,028 121,192
Medicaid managed care 117,755 147,559
Blue Cross 94,440 94,635
Managed care 128,734 109,268
Commercial and other 27,401 19,722
Self-pay 12,591 5,108
$ 820,105 $ 831,088
21
(continued)
Deductibles, copayments and coinsurance under third-party payment programs which are the
patient’s responsibility are included within the respective primary payor category above.
Net patient service revenue disaggregated by lines of service comprises of the following for the
years ended December 31:
2019 2018
(In Thousands)
Inpatient services $ 390,738 $ 438,131

Outpatient services 429,367 392,957
$ 820,105 $ 831,088
Patient accounts receivable, net is comprised of the following:
December 31
2019 2018
Patient receivables $ 63,926 $ 67,307

Contract assets 4,270 4,827
$ 68,196 $ 72,134
Contract assets are related to in-house patients who were provided services during the reporting
period but were not discharged as of the reporting date and for which BIMC does not have the
right to bill.
Third-Party Payment Programs
BIMC has agreements with third-party payors that provide for payment for services rendered at
amounts different from its established rates. A summary of the payment arrangements with major
third-party payors follows:
Medicare: Hospitals are paid for most Medicare patient services under national prospective
payment systems and other methodologies of the Medicare program for certain other services.
Federal regulations provide for adjustments to current and prior years’ payment rates, based
on industry-wide and Hospital-specific data.
22
(continued)
Non-Medicare: In New York State, hospitals and all non-Medicare payors (including Medicare
and Medicaid managed care plans), except Medicaid, workers’ compensation and no-fault
insurance programs, negotiate hospitals’ payment rates. Outpatient services also are paid based
on a statewide prospective system. Medicaid rate methodologies are subject to approval at the
Federal level by the Centers for Medicare and Medicaid Services (CMS), which may routinely
request information about such methodologies prior to approval. Revenue related to specific
rate components that have not been approved by CMS is not recognized until BIMC is
reasonably assured that such amounts are realizable. Adjustments to the current and prior
years’ payment rates for those payors will continue to be made in future years.
Other Third-Party Payors: BIMC also has entered into payment agreements with certain
commercial insurance carriers and health maintenance organizations. The basis for payment to
BIMC under these agreements includes prospectively determined rates per discharge or days
of hospitalization and discounts from established charges.
Medicare cost reports, which serve as the basis for final settlement with the Medicare program,
have been audited by the Medicare fiscal intermediary and settled through 2011, except for the
years 2001 and 2004 which final settlements have not been issued due to pending litigation,
although revisions to final settlements or other retroactive changes could be made. Other years and
various issues remain open for audit and settlement, as are numerous issues related to the New
York State Medicaid program for prior years. As a result, there is at least a reasonable possibility
that recorded estimates will change by a material amount when open years are settled, audits are
completed and additional information is obtained.
Settlements with third-party payors (see description of third-party payor payment programs above)
for cost report filings and retroactive adjustments due to ongoing and future audits, reviews or
investigations are considered variable consideration and are included in the determination of the
estimated transaction price for providing patient care. These settlements are estimated based on
the terms of the payment agreement with the payor, correspondence from the payor and BIMC’s
historical settlement activity (for example, cost report final settlements or repayments related to
recovery audits), including an assessment to ensure that it is probable that a significant reversal in
the amount of cumulative revenue recognized will not occur when the uncertainty associated with
the retroactive adjustment is subsequently resolved. Such estimates are determined through either
a probability-weighted estimate or an estimate of the most likely amount, depending on the
circumstances related to a given estimated settlement item. Estimated settlements are adjusted in
future periods as adjustments become known (that is, new information becomes available), or as
years are settled or are no longer subject to such audits, reviews, and investigations.
23
(continued)
Laws and regulations concerning government programs, including Medicare and Medicaid, are
complex and subject to varying interpretation. As a result of investigations by governmental
agencies, various health care organizations have received requests for information and notices
regarding alleged noncompliance with those laws and regulations, which, in some instances, have
resulted in organizations entering into significant settlement agreements. Compliance with such
laws and regulations may also be subject to future government review and interpretation as well
as significant regulatory action, including fines, penalties, and potential exclusion from the related
programs. There can be no assurance that regulatory authorities will not challenge BIMC’s
compliance with these laws and regulations, and it is not possible to determine the impact (if any)
such claims or penalties would have upon BIMC. BIMC is not aware of any allegations of non-
compliance that could have a material adverse effect on the accompanying consolidated financial
statements and believes that it is in compliance with all applicable laws and regulations. In
addition, certain contracts BIMC has with commercial payors also provide for retroactive audit
and review of claims.
There are various proposals at the federal and state levels that could, among other things,
significantly change payment rates or modify payment methods. The ultimate outcome of these
proposals and other market changes, including the potential effects of or revisions to health care
reform that has been or will be enacted by the federal and state governments, cannot be determined
presently. Future changes in the Medicare and Medicaid programs and any reduction of funding
could have an adverse impact on BIMC. Additionally, certain payors’ payment rates for various
years have been appealed by BIMC. If the appeals are successful, additional income applicable to
those years could be realized.
BIMC grants credit without collateral to its patients, most of whom are insured under third-party
payor agreements. Significant concentrations of patient accounts receivable, net at December 31,
2019 and 2018, are as follows:
2019 2018
Medicare 39% 38%
Medicaid 23 25
Blue cross 10 12
Managed 27 24
Self-pay 1 1
100% 100%
24
(continued)
Uncompensated Care and Community Benefit Expense
For patients who are deemed eligible for charity care and patients who apply and qualify for
financial aid under BIMC’s financial aid policy, care given but not paid for is classified as charity
care. For the years ended December 31, 2019 and 2018, the estimated cost of charity care was
approximately $15.4 million and $12.4 million, respectively. The estimated cost of charity care
includes the direct and indirect cost of providing charity care services and is estimated by utilizing
a ratio of cost to gross charges applied to the gross uncompensated charges associated with
providing charity care.
Vital Access Provider Safety Net Program and Medicaid Enhanced Rates
In September 2015, MSHG entered into an agreement with the New York State Department of
Health (NYSDOH) to participate in the Vital Access Provider/Safety Net Program (VAP). MSHG
was awarded approximately $81.4 million in VAP funding over three years. In accordance with
the governing agreement, MSHG submitted quarterly reports to the NYSDOH, detailing how the
VAP funds were being expended, in line with approved objectives, budgets, timelines and
benchmarks. In addition, MSHG has committed to complete a full asset merger of MSH, BIMC,
SLR and NYEEI. The full asset merger is expected to be completed no later than January 1,
2021. MSHG continues to have discussions with the NYSDOH regarding the provisions of the
proposed full asset merger.
The NYSDOH had also agreed to provide certain MSHG member hospitals with a temporary
Medicaid rate enhancement for three years. The enhanced Medicaid rates were paid to the MSHG
member hospitals directly by the Medicaid program or Medicaid managed care payors as patient
services were rendered. The MSHG member hospitals recognized revenue from the VAP payments
on a quarterly basis as reporting requirements were completed and approved expenditures are
incurred. BIMC recognized approximately $0.4 million and $1.6 million in VAP funding revenue
in 2019 and 2018, respectively. MSH recognized VAP revenue of approximately $4.0 million in
2019 ($25.0 million in 2018). All amounts related to VAP funding for the MSHG member
hospitals were received by BIMC. There were no such transfers made for the year ended December
31, 2019. In accordance with VAP stipulations, MSHG spent all remaining VAP funds during the
first quarter of 2019.
25
(continued)
The Medicaid rate enhancement ended on March 31, 2018, and as such, no revenue was recognized
in 2019. In 2018, MSH and BIMC recognized approximately $4.7 million and $1.4 million,
respectively, of revenue associated with the Medicaid rate enhancements. In 2018, MSH
transferred the full amount of $4.7 million, to BIMC (see Note 10). In the event that conditions of
the governing agreement are not met, funding associated with the VAP program and the enhanced
Medicaid rates will be refundable to the NYSDOH. Management believes the possibility that the
condition will not be met is remote.
3. Investments and Assets Limited as to Use
Investments and assets limited as to use are maintained as follows at December 31:
2019 2018
(In Thousands)
Pooled investments $ 24,665 $ 22,163
Non-pooled investments:
Assets limited as to use 318 25,475
Other investments 54,802 194,693
80,326 244,242
$ 104,991 $ 266,405
26
3. Investments and Assets Limited as to Use (continued)
The following table summarizes the composition of the total investment pool at December 31,
2019 and 2018; BIMC’s interests in the pooled investment components is proportionate based on
the ratio of its pooled investment balance to the total of the pool. BIMC owns 1.24% and 1.28%
of the investment pool at December 31, 2019 and 2018, respectively.
December 31
2019 2018
(In Thousands)

Fixed income:
Mutual funds 24,153 4,241
Equities:
U.S. equities 198,906 129,962
Global equities 59,771 47,802
Non-U.S. equities 168,754 133,291
Alternative investments:
Hedge funds:
Long-only equity(a) 315,111 213,772
Hedged equity(b) 339,801 324,608
Long/short credit(c) 58,749 64,407
Open mandate(d) 296,325 283,157
Macro(e) 105,610 122,529
Private investments:
Equity(f) 105,763 75,482
Credit/distressed(g) 62,827 65,216
Real assets(h) 233,203 224,672
$ 1,994,138 $ 1,733,009
(a)
Investments, consisting of publicly traded equity holdings with long positions.
(b)
Investments, consisting primarily of publicly traded equity holdings with both long and
short positions.
(c)
Investments, consisting primarily of publicly traded credit holdings with both long and
short positions.
27

(d)
Investments with a balanced mix of asset exposures and strategies. Underlying
exposures primarily include publicly traded equity and credit positions in fundamental
value, relative value, and various arbitrage strategies. Investments may reflect a tilt
towards equity or credit with hedging and hold large cash positions if value
opportunities are not found.
(e)
Investments focused on global macro dislocations rather than micro driven
opportunities. Holdings are both long and short in equity, fixed income, currency, and
futures markets.
(f)
Investments targeting buyout, growth equity, and venture opportunities that require
time to reach realization.
(g)
Investments in structured credit, claims, or distressed positions of either a minority or
controlling interest that require time to reach realization.
(h)
Real estate, natural resources, and asset backed royalty investments that require time to
reach realization.
The total return on the pooled investments comprises the following for the years ended
December 31:
2019 2018
(In Thousands)
Interest and dividend income $ 8,586 $ 6,615

Net realized gains and losses on sales of securities 94,267 80,920
Change in net unrealized gains and losses and
change in value of alternative investments 195,198 (124,976)
Fees and other expenses (6,488) (7,136)
$ 291,563 $ (44,577)
BIMC was allocated a total investment return from the pool based on agreements among the pool
participants and donor stipulations a gain of approximately $3.7 million for the year ended
December 31, 2019, and a loss of approximately $545,000 for the year ended December 31, 2018.
28
The composition of non-pooled marketable securities and long-term investments measured at fair
value on a recurring basis at December 31 is set forth in the following table:
2019 2018
(In Thousands)
Cash and cash equivalents $ 1,195 $ 162

U.S. government and fixed income 26,587 26,420
Interests in the captive insurance program (see Note 6) 52,226 192,185
Total short-term and other investments 80,008 218,767
Other investments $ 54,802 $ 194,693
Assets Limited as to Use
Assets limited as to use, consisting of cash and cash equivalents, and their specific designations
are set forth in the following table at December 31:
2019 2018
(In Thousands)
Funded depreciation $ 318 $ 25,475

$ 318 $ 25,475
In 2013, BIMC established this account in order to comply with New York State regulations which
require hospitals to fund a depreciation account in order to realize Medicaid rate reimbursement
for depreciation expense incurred (to the extent that the total of capital purchases and certain
qualifying debt repayments made during the fiscal year are less than BIMC’s depreciation
expense). The decrease in amount funded in 2019 is a direct result of the increase in capital
purchases during the year.
29
Investment income and gains on long-term investments, marketable securities, assets limited as to
use, pooled investments, and cash and cash equivalents consist of the following for the years ended
December 31:
2019 2018
(In Thousands)
Interest and dividend income $ 3,985 $ 2,338

Net realized gains and losses on sales of securities 1,417 1,328
Change in net unrealized gains and losses on investments
and change in value of alternative investments 3,407 (2,091)
$ 8,809 $ 1,575
4. Property, Plant, and Equipment
A summary of property, plant, and equipment is as follows at December 31:
2019 2018
(In Thousands)
Land and land improvements $ 12,360 $ 12,360

Buildings and building improvements 846,698 605,589
Equipment 1,225,391 1,186,910
2,084,449 1,804,859
Less: accumulated depreciation and amortization (1,550,846) (1,479,723)
533,603 325,136
Construction in progress 36,126 26,335
$ 569,729 $ 351,471
Depreciation and amortization expense was approximately $71.1 million and $63.9 million for the
years ended December 31, 2019 and 2018, respectively.
At December 31, 2019 and 2018, assets recorded in connection with finance leases aggregate
approximately $213.9 million and $31.5 million, respectively, with accumulated amortization
aggregating $34.7 million and $28.9 million, respectively.
30
4. Property, Plant, and Equipment (continued)
During 2019 and 2018, BIMC capitalized approximately $1.1 million and $847,000, respectively,
of interest expense related to various construction projects.
In January 2019, BIMC entered into a thirty-year finance lease with Rivington Street Investors
LLC to lease the entire building known as 45 Rivington Street, New York, New York. At lease
inception, BIMC recorded a right-of-use asset – finance lease, included within buildings and
building improvements and finance lease obligation (noncurrent) of approximately $182.4 million.
The arrangement contains a tenant incentive of approximately $45.7 million which has reduced
the related balance sheet accounts at lease inception.
5. Leases
As described in Note 1, BIMC adopted ASU 2016-02 effective January 1, 2019. BIMC leases
certain property and equipment under finance and operating leases, the classification of which is
based on the underlying terms of the agreement and certain criteria, such as lease term relative to
useful life and total lease payments compared to fair value, among others. Finance leases result in
an accounting treatment similar to an acquisition of the asset.
For leases with initial terms greater than one year (or initially, greater than one year remaining
under the lease at the date of adoption of ASU 2016-02), BIMC records the related right-of-use
assets and liabilities at the present value of the lease payments to be paid over the life of the related
lease. BIMC’s leases may include variable lease payments and renewal options. Variable lease
payments are excluded from the amounts used to determine the right-of-use assets and liabilities
unless the variable lease payments depend on an index or rate or are in substance fixed payments.
Lease payments related to periods subject to renewal options are also excluded from the amounts
used to determine the right-of-use assets and liabilities unless BIMC is reasonably certain to
exercise the option to extend the lease. The present value of lease payments is calculated by
utilizing the discount rate stated in the lease, when readily determinable. For leases for which this
rate is not readily available, BIMC has elected to use a risk-free discount rate determined using a
period comparable with that of the lease term. BIMC has made an accounting policy election not
to separate lease components from non-lease components in contracts when determining its lease
payments, as permitted by ASU 2016-02. As such, BIMC accounts for the applicable non-lease
components together with the related lease components when determining the right-of-use assets
and liabilities.
BIMC has made an accounting policy election not to record leases with an initial term of less than
one year as right-of-use assets and liabilities.
31
5. Leases (continued)
The following schedule summarizes information related to the lease assets and liabilities as of and
for the year ended December 31, 2019 (in thousands):
Right-of-use assets
Right-of-use assets – finance leases $ 179,202
Right-of-use assets – operating leases 179,304
Total right-of-use assets $ 358,506
Right-of-use liabilities
Right-of-use liabilities – finance leases $ 190,046
Right-of-use liabilities –operating leases 181,469
Total right-of-use liabilities $ 371,515
Other information
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from finance leases 5,507
Operating cash flows from operating leases 181,469
Financing cash flows from finance leases 5,784
Weighted-average remaining lease term – finance leases 30.83
Weighted-average remaining lease term – operating leases 8.90
Weighted-average discount rate – finance leases 3.09%
Weighted-average discount rate – operating leases 2.77%
For finance leases, right-of-use assets are recorded in property, buildings and equipment and lease
liabilities are recorded in finance lease liabilities, current and non-current in the accompanying
consolidated statements of financial position. For operating leases, right-of-use assets are recorded
in right-of-use assets and lease liabilities are recorded in operating lease liabilities, current and
non-current, in the accompanying consolidated statement of financial position.
32
5. Leases (continued)
The following table reconciles the undiscounted lease payments to the lease liabilities recorded on
the accompanying consolidated statement of financial position at December 31, 2019
(in thousands):
Finance Operating
Leases Leases
(in Thousands)
2020 $ 1,692 $ 29,631

2021 6,943 27,802
2022 11,256 22,983
2023 10,115 20,993
2024 10,317 19,367
Thereafter 306,173 84,322
Total lease payments 346,496 205,098
Less: imputed interest 156,450 23,629
Total lease obligations 190,046 181,469
Less: current portion 753 29,631
Long–term portion $ 189,293 $ 151,838
Total rental expense for the years ended December 31, 2019 and 2018 aggregated approximately
$33.7 million and $29.0 million, respectively. Sublease income and contingent rentals were not
significant. BIMC leases certain properties owned by related entities.
6. Professional Liabilities Insurance Program
Primary coverage of professional and general liability incidents has been provided through
participation in a pooled program with certain other health care facilities (principally hospitals)
affiliated with the Federation of Jewish Philanthropies of New York (FOJP). This occurrence-basis
insurance coverage participation is with captive insurance companies and commercial insurance
companies.
33
6. Professional Liabilities Insurance Program (continued)
As described in Note 1, BIMC, MSH, Montefiore Health System and Maimonides Medical Center,
collectively the owners of HIC and FOJP, announced their agreement to sell HIC and FOJP to The
Doctors Company for approximately $718.9 million, after closing adjustments. The transaction
closed on July 31, 2019, and the hospitals shared in the proceeds ratably according to their
ownership. HIC has provided the hospitals and related physicians with medical malpractice
insurance for 40 years. Healthcare Risk Advisors (HRA) (formerly FOJP), continues to provide
the same services to the Hospital and the member hospitals as prior to the transaction.
As of December 31, 2019, BIMC retained ownership interests of 25% in two captive insurance
companies affiliated with the FOJP Program. BIMC follows the equity method of accounting for
its investment in the captive insurance companies and has recognized its allocated share of a
portion of the program’s accumulated surplus.
The aggregate net carrying value of BIMC’s interests in the insurance program is approximately
$52.2 million and $192.2 million at December 31, 2019 and 2018, respectively, which is included
in other investments in the accompanying consolidated statements of financial position. During
the years ended, December 31, 2019 and 2018, BIMC received cash distributions of approximately
$37.2 million and $49.0 million, respectively.
During the years ended December 31, 2019 and 2018, BIMC recorded approximately
$66.9 million and $56.9 million, respectively, of net change in participation in captive insurance
program in the accompanying consolidated statements of operations. Approximately $37.2 million
and $29.7 million of the 2019 amount related to retroactive premium adjustments and net change
in equity investments in the captive insurance companies, respectively. Approximately
$31.2 million and $25.7 million of the 2018 amount related to retroactive premium adjustments
and net change in equity investments in the captive insurance companies, respectively.
The estimate of professional liabilities and the estimate for incidents that have been incurred but
not reported is included in professional liabilities in the accompanying consolidated statements of
financial position of approximately $162.4 million ($230.6 million at December 31, 2018). BIMC
has recorded related insurance recoveries receivable of approximately $162.4 million at
December 31, 2019 ($230.6 million at December 31, 2018), in consideration of the expected
insurance recoveries. The current portion of professional liabilities and the related insurance
recoveries receivable represents an estimate of expected settlements and insurance recoveries over
the next 12 months.
34
6. Professional Liabilities Insurance Program (continued)
BIMC, as part owner of its malpractice captive, guarantees a certain level of investment return of
the captive insurance companies and may be required to fund shortfalls resulting from differences
between guaranteed and actual returns. BIMC was not required to fund any differences in 2019 or
2018.
BIMC’s estimates of professional liabilities are based upon complex actuarial calculations, which
utilize factors such as historical claims experience for BIMC and related industry factors, trending
models, estimates for the payment patterns of future claims, and present value discount factors. As
a result, there is at least a reasonable possibility that recorded estimates will change by a material
amount in the near term. Revisions to estimated amounts resulting from actual experience differing
from projected expectations are recorded in the period the information becomes known or when
changes are anticipated.
At December 31, 2019, BIMC has recorded a liability of approximately $29.2 million in deferred
premium payments related to its malpractice coverage ($25.7 million at December 31, 2018). Such
amounts are included as components of other current liabilities and other liabilities in the
accompanying consolidated statements of financial position based on scheduled payment terms.
Effective January 1, 2019, the Mount Sinai Health System Self-Insurance Trust (the Self-Insurance
Trust) was established to provide coverage in excess of FOJP Program limits. Currently, MSH,
BIMC, SLR, and NYEEI participate in the Self-Insurance Trust, which is irrevocable. As of
December 31, 2019 and 2018, the Self-Insurance Trust held investments of approximately
$7.9 million on behalf of BIMC and a receivable from BIMC of approximately $20.6 million
($3.0 million and a receivable from BIMC of approximately $8.1 million as of December 31,
2018), both of which are included in beneficial interest in self-insurance trust in the accompanying
2019 consolidated statement of financial position, and consolidated statement of operations,
respectively. In addition, as of December 31, 2019 and 2018, the Self-Insurance Trust had
actuarially determined liabilities of approximately $28.5 million and $11.1 million respectively,
discounted at 3.5% (for each of the years ended December 31, 2019 and 2018), which is included
as estimated self-insurance liability in the accompanying consolidated statements of financial
position.
7. Pension and Similar Plans
BIMC provides pension and similar benefits to substantially all employees through tax sheltered
annuity plans for nonunion employees and several defined benefit multi-employer plans for union
employees. Contributions to these plans are generally based on gross salaries. It is BIMC’s policy
to fund accrued costs under these plans on a current basis.
35
7. Pension and Similar Plans (continued)
Contributions to tax sheltered annuity plans approximated $7.0 million and $7.2 million for the
years ended December 31, 2019 and 2018, respectively. The total expense relating to union defined
multi-employer pension plans amounted to approximately $34.4 million and $28.3 million for the
years ended December 31, 2019 and 2018, respectively. Approximately 72% of BIMC’s
employees are union members.
BIMC contributions to its multi-employer pension funds for the years ended December 31, 2019
and 2018, are as follows:
2019 2018
(In Thousands)
Pension fund
1199 SEIU Health Care Employees Pension Fund(a) $ 34,407 $ 28,163
1199 SEIU Health Care Employees Health & Welfare
Fund(b) 51,677 60,779
Other pension funds(c) 35 112
$ 86,119 $ 89,054
(a)
Represents greater than 5% of total plan contributions, based on available Form 5500.
(b)
This benefit fund provides medical benefits (health, dental, prescription, vision) for
active employees and retirees. Eligibility for benefit coverage level and type is dependent
upon their status as an active employee or retiree.
(c)
Consists of three pension funds in which BIMC’s contributions are individually and in
the aggregate insignificant.
36
7. Pension and Similar Plans (continued)
The following table includes additional disclosure information related to the 1199 SEIU Health
Care Employees Pension Fund.
Pension Protection Expiration Date of

EIN/Pension Plan Act Zone Status(a) FIP/RP(b) Surcharge Collective Bargaining
Number 2019 2018 Status Pending Imposed Agreement
Green as of Green as of
13-3604862/001 1/01/2019 1/01/2018 No No 09/30/2021
(a)
A zone status rating of green indicates the plan is at least 80% funded.
(b)
Funding improvement plan or rehabilitation plan.
At the date BIMC’s consolidated financial statements were issued, Form 5500 was not available
for the 1199 SEIU Health Care Employees Pension Fund for the year ended in 2019.
8. Net Assets With Donor Restrictions
Net assets with donor restrictions include endowment assets that have been restricted by donors to
be maintained in perpetuity and invested by BIMC. BIMC follows the requirements of the
New York Prudent Management of Institutional Funds Act (NYPMIFA) as they relate to its
endowment assets.
BIMC has interpreted NYPMIFA as requiring the preservation of the fair value of the original gift
as of the gift date of the donor-restricted endowment fund, absent explicit donor stipulations to the
contrary. As a result of this interpretation, BIMC classifies as within net assets with donor
restrictions the original value of the gifts donated to the permanent endowment and the original
value of subsequent gifts to the permanent endowment. Accumulations to the permanent
endowment are used in accordance with the direction of the applicable donor gift. The remaining
portion of the donor-restricted endowment fund that is also classified in net assets with donor
restrictions until the amounts are appropriated for expenditure in accordance with a manner
consistent with the standard of prudence prescribed by NYPMIFA. In accordance with NYPMIFA,
BIMC considers the following factors in making a determination to appropriate or accumulate
donor-restricted endowment funds: (1) the duration and preservation of the fund; (2) the purposes
of BIMC and the donor-restricted endowment fund; (3) general economic conditions; (4) the
37
8. Net Assets With Donor Restrictions (continued)
possible effect of inflation and deflation; (5) where appropriate and circumstances would
otherwise warrant, alternatives to expenditure of the endowment fund, giving due to consideration
to the effect that such alternatives may have on the institution; (6) the expected total return from
income and the appreciation of investments; (7) other resources of BIMC; and (8) the investment
and spending policies of BIMC. BIMC’s policies provide the guidelines for setting the annual
spending rate (4.5%) and the treatment of any investment returns in excess of the annual spending
rate. The endowment spend rate is calculated on the average three-year rolling market value of
each endowed fund. Any excess investment returns beyond the spending rate, to the extent
available are added to the endowed fund and classified as net assets with donor restrictions, unless
also appropriated for expenditure. BIMC expends the income distributed from certain restricted
assets on an annual basis in support of health care services (distributions totaled approximately
$1.3 million and $1.1 million for the years ended December 31, 2019 and 2018, respectively).
BIMC has adopted investment and spending policies for endowment assets that attempt to provide
a predictable stream of funding to programs supported by its endowment. Endowment assets are
invested in a manner to provide that sufficient assets are available as a source of liquidity for the
intended use of the funds, achieve the optimal return possible within the specified risk parameters,
prudently invest assets in a high-quality diversified manner, and adhere to the established
guidelines.
To satisfy its long-term rate-of-return objectives, BIMC relies on a total return strategy in which
investment returns are achieved through both capital appreciation (realized and unrealized) and
current yield (interest and dividends). BIMC targets a diversified asset allocation that places a
greater emphasis on equity-based investments to achieve its long-term return objectives within
prudent risk constraints.
38
Net assets with donor restrictions are available to support program activities as stipulated by
donors. Certain net assets with donor restrictions are restricted to investment in perpetuity with the
income expendable to support program activities as stipulated by donors. Net assets with donor
restrictions that are temporary in nature are restricted as follows at December 31:
2019 2018
(In Thousands)
Health education $ 5,452 $ 2,374

Program improvement 6,289 5,356
Medical research 7,751 598
Capital 1,334 1,341
$ 20,826 $ 9,669
Net assets with donor restrictions that are perpetual in nature are restricted as follows at
December 31:
2019 2018
(In Thousands)
Investments to be held in perpetuity, the income from
which is restricted as to use $ 21,662 $ 22,480
Investments to be held in perpetuity, the income from
which is unrestricted as to use 1,826 1,826
$ 23,488 $ 24,306
Investments to be held in perpetuity are included in pooled investments and other investments in
the accompanying consolidated statements of financial position.
39
During 2019 and 2018, certain net assets with donor restrictions were released from restrictions as
follows:
2019 2018
(In Thousands)
Health education $ 831 $ 678

Capital 70 720
Program improvement 181 399
Medical research 391 172
$ 1,473 $ 1,969
9. Functional Expenses
BIMC provides general health care services to residents within its geographic location. Expenses
related to providing these services for the years ended December 31, 2019 and 2018, are as follows:
December 31, 2019 December 31, 2018

Program Program
Health Support Health Support
Care and and Care and and
Related General Related General
Services Services Total Services Services Total
(In Thousands)
Salaries and wages $ 321,255 $ 58,496 $ 379,751 $ 323,628 $ 59,505 $ 383,133

Employee Benefits 116,412 17,395 133,807 122,489 18,550 141,039
Supplies and other 421,236 10,057 431,293 409,421 8,693 418,114
Depreciation and amortization 71,123 – 71,123 63,830 30 63,860
Interest and amortization 7,590 389 7,979 2,813 496 3,309
$ 937,616 $ 86,337 $ 1,023,953 $ 922,181 $ 87,274 $ 1,009,455
The financial statements report certain expense categories that are attributable to more than one
healthcare service or support function. Therefore, these expenses require an allocation on a
reasonable basis that is consistently applied. Costs not directly attributable to a function are
allocated to a function based on units of service basis or are otherwise allocated based on revenue.
40
10. Related Organizations
BIMC conducts various transactions with other related organizations of MSHS. The following
table summarizes amounts due (to) from related organizations at December 31:
2019 2018
(In Thousands)
The St. Luke’s-Roosevelt Hospital Center(a) $ 24,294 $ 25,536

The St. Luke’s-Roosevelt Hospital Center Loan(a) 262 448
The New York Eye and Ear Infirmary(b) 955 672
The Mount Sinai Hospital(c) (103,971) (59,143)
The Mount Sinai Hospital Loan(c) (105,776) (105,776)
Icahn School of Medicine at Mount Sinai(d) (29,347) (9,829)
(213,583) (148,092)
Less: current portion (51,807) (17,316)
$ (161,776) $ (130,776)
(a)
Net transactions charged (at cost) between SLR and BIMC for payroll and benefits charges and various other shared
services totaled approximately $24.3 million and $49.3 million during the years ended December 31, 2019 and 2018,
respectively.
In April 2011, SLR entered into a $1.6 million loan agreement with BIMC to finance capital improvements. The loan
has a ten-year term and bears interest at 5.0% per annum. Principal and interest payments are due monthly. At
December 31, 2019 and 2018, the balance remaining on the loan amounted to approximately $262,000 and $448,000,
respectively.
(b)
Amounts due from BIMC relate to the cost of residents provided by NYEE to BIMC and amounts due to NYEE for
faculty practice plan revenue billed by BIMC on behalf of NYEE.
(c)
Transactions charged (at cost) by MSH to BIMC, totaled approximately $44.8 million and $48.1 million during the
years ended December 31, 2019 and 2018, respectively. Included in the charges are certain employee health plan
claims and premiums, which are paid by MSH and, subsequently, charged to BIMC.
In December 2017, MSH issued $382.0 million of taxable bonds for general taxable purposes. Subsequently, MSH
issued a long-term intercompany loan to BIMC for approximately $105.8 million, of which the proceeds were used
to pay-off all of the outstanding debt of BIMC, which MSH had previously guaranteed. The intercompany loan incurs
interest at the MSH Borrowing Rate and matures in December 2040. BIMC will pay interest only for the first thirteen
years of the loan, after which principal will be amortized over eighteen years.
(d)
Effective January 1, 2016, all physicians affiliated with BIMC’s faculty practice had migrated to ISMMS. As a result,
BIMC purchases professional services from ISMMS for the clinical care of its patients, teaching and supervision of
its residents, the performance of certain administrative functions, and various strategic initiatives. Net transactions
charged (at cost) by ISMMS to BIMC totaled approximately $28.0 million and $34,1 million during the years ended
December 31, 2019 and 2018, respectively.
41
11. Commitments and Contingencies
Litigation
BIMC is a defendant in various legal actions arising out of the normal course of its operations. The
ultimate outcome of these cases cannot be predicted at this time. Management does not believe
that the ultimate outcome of these matters will have a material adverse effect on BIMC’s
consolidated financial position.
Professional liability claims have been asserted against BIMC by various claimants. The claims
are in various stages of processing and some may ultimately be brought to trial. There are known
incidents occurring through December 31, 2019, that may result in the assertion of additional
claims and other claims may be asserted arising from services provided to patients in the past. It
is the opinion of BIMC management, based on prior experience, that adequate insurance is
maintained to provide for all significant professional liability losses.
Collective Bargaining Agreements
Approximately 72% of BIMC’s employees are union employees who are covered under the terms
of various collective bargaining agreements. The 1199 contract will expire on September 30, 2021.
Other
BIMC is self-insured, based on individual employees’ elections, for medical, dental, and
pharmaceutical benefits. BIMC also is self-insured for unemployment benefits. Liabilities have
been accrued at December 31, 2019 and 2018, based on expected future payments pertaining to
such years (included in accrued salaries and related liabilities in the accompanying consolidated
statements of financial position).
42
12. Fair Values of Financial Instruments
For assets and liabilities requiring fair value measurement, BIMC measures fair value based on
the price that would be received to sell an asset or paid to transfer a liability in an orderly
transaction between market participants at the measurement date. BIMC follows a fair value
hierarchy based upon the transparency of inputs to the valuation of an asset or liability as of the
measurement date. The three levels are defined as follows:
Level 1 – Quoted prices (unadjusted) in active markets that are accessible at the measurement
date for identical assets or liabilities. The fair value hierarchy gives the highest priority to
Level 1 inputs.
Level 2 – Observable inputs that are based on inputs not quoted in active markets, but
corroborated by market data.
Level 3 – Unobservable inputs are used when little or no market data is available. The fair
value hierarchy gives the lowest priority to Level 3 inputs.
A financial instrument’s categorization within the valuation hierarchy is based upon the lowest
level of input that is significant to the fair value measurement. In determining fair value, BIMC
uses valuation techniques that maximize the use of observable inputs and minimize the use of
unobservable inputs to the extent possible, as well as considers non-performance risk in its
assessment of fair value. Investments valued based upon net asset value (NAV) are not subject to
the valuation hierarchy.
Financial assets carried at fair value by BIMC as of December 31, 2019, are classified in the tables
below in one of the three categories described above:
2019
Level 1 Level 2 Level 3 Total
(In Thousands)
Cash and cash equivalents $ 186,346 $ – $ – $ 186,346
U.S. government obligations 26,587 – – 26,587
$ 212,933 $ – $ – 212,933
Investments measured at NAV as
a practical expedient:
Pooled investments 24,665
$ 237,598
43
12. Fair Values of Financial Instruments (continued)
Financial assets carried at fair value by BIMC as of December 31, 2018, are classified in the tables
below in one of the three categories described above:
2018
Level 1 Level 2 Level 3 Total
(In Thousands)
Cash and cash equivalents $ 90,614 $ – $ – $ 90,614
U.S. government obligations 26,420 – – 26,420
$ 117,034 $ – $ – 117,034
Investments measured at NAV as
a practical expedient:
Pooled investments 22,163
$ 139,197
The tables above exclude BIMC’s interests in the captive insurance program and investments held
with the Self-Insurance Trust described in Notes 1 and 6.
The following is a summary of total investments (by major category) in the investment pool with
restrictions to redeem the investments at the measurement date, any unfunded capital
commitments, and investment strategies of the investees as of December 31, 2019:
Description of Carrying Unfunded Redemption Notice Funds

Investment Value Commitments Frequency Period Availability
(In Thousands)
Hedge funds:
Long-only equity $ 315,111 $ – Monthly/5 years 30 to 90 days 3 to 30 days
Hedged equity 339,801 – Monthly/rolling 3 years 30 to 90 days 30 to 45 days
Long/short credit 58,749 – Quarterly 90 days 30 days
Open mandate 296,325 – Quarterly/rolling 2 years 60 to 90 days 30 days
Macro 105,610 – Quarterly/Semi-annually 45 to 90 days 30 days
Private investments:
Equity 105,763 114,409 N/A N/A N/A
Credit/distressed 62,827 28,124 Monthly 30 days and N/A 180 days and N/A
Real assets 233,203 51,514 N/A N/A N/A
$ 1,517,389 $ 194,047
44
13. Other Revenue
Other revenue includes operating revenues that are not directly related to BIMC’s patient services.
Major items included in other revenue are revenues derived from HMO incentives of $14.6 million
in 2019 and $16.9 million in 2018, pharmacy 340B program revenue of $25.7 million in 2019 and
$16.0 million in 2018, rental income of $4.6 million in 2019 and $5.8 million in 2018, joint
ventures of $3.0 million in 2019 and $3.8 million in 2018 and grants and contracts revenue of
$5.3 million in 2019 and $6.8 million in 2018.
14. Subsequent Events
For purposes of the accompanying consolidated financial statements, BIMC has considered for
accounting and disclosure events that occurred through March 31, 2020, the date the consolidated
financial statements were issued. There were no subsequent events transactions that either resulted
in recognition in the accompanying consolidated financial statements or required additional
disclosure.
Due to the global viral outbreak caused by Coronavirus Disease 2019 (COVID-19) in 2020, there
have been resulting effects which could negatively impact BIMC’s financial condition. The
ultimate impact of these matters to BIMC and its financial condition is presently unknown. The
accompanying consolidated financial statements do not reflect the effects of these subsequent
events.
45
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CONSOLIDATED FINANCIAL STATEMENTS

Beth Israel Medical Center and Affiliates

Ernst & Young LLP

Consolidated Financial Statements

Years Ended December 31, 2019 and 2018

Report of Independent Auditors.......................................................................................................1

Consolidated Financial Statements

Consolidated Statements of Financial Position................................................................................3

Report of Independent Auditors

The Board of Trustees

Management’s Responsibility for the Financial Statements

Adoption of ASU No. 2016-02, Leases

March 31, 2020

Consolidated Statements of Financial Position

Patient accounts receivable, net 68,196 72,134

Pooled investments 24,665 22,163

Liabilities and net assets

Due to related organizations, less current portion 161,776 130,776

Commitments and contingencies

See accompanying notes.

Consolidated Statements of Operations

Year Ended December 31

Deficiency of operating revenue over operating expenses before

Other changes in net assets without donor restrictions

See accompanying notes.

Consolidated Statements of Changes in Net Assets

Net Assets with Donor Restrictions

Net assets at January 1, 2018 $ 286,277 $ 12,364 $ 24,215 $ 36,579 $ 322,856

See accompanying notes.

See accompanying notes.

Notes to Consolidated Financial Statements

December 31, 2019

1. Organization and Summary of Significant Accounting Policies

Notes to Consolidated Financial Statements (continued)

1. Organization and Summary of Significant Accounting Policies (continued)

Liquidity and Operating Results

Cash and cash equivalents $ 184,833 $ 64,977

Notes to Consolidated Financial Statements (continued)

1. Organization and Summary of Significant Accounting Policies (continued)

Cash and Cash Equivalents

Notes to Consolidated Financial Statements (continued)

1. Organization and Summary of Significant Accounting Policies (continued)

Patient Accounts Receivable

Notes to Consolidated Financial Statements (continued)

1. Organization and Summary of Significant Accounting Policies (continued)

Notes to Consolidated Financial Statements (continued)

1. Organization and Summary of Significant Accounting Policies (continued)

Assets Limited as to Use

Property, Plant, and Equipment

Notes to Consolidated Financial Statements (continued)

1. Organization and Summary of Significant Accounting Policies (continued)

Impairment of Long-Lived Assets

Conditional Asset Retirement Obligations

Other liabilities in the accompanying consolidated statements of financial position consist

Net Assets Without Donor Restrictions

Notes to Consolidated Financial Statements (continued)

1. Organization and Summary of Significant Accounting Policies (continued)

Net Assets With Donor Restrictions

Notes to Consolidated Financial Statements (continued)

1. Organization and Summary of Significant Accounting Policies (continued)