2023-11-12T21:59:09-06:00 2022-12-31 873231666 PKF O'CONNOR DAVIES ADVISORY LLC 300 TICE BOULEVARD SUITE 315 WOODCLIFF LAKE NJ 07677 990 2022-01-01 222324554 THE VALLEY HOSPITAL FOUNDATION INC VALL 2012916300 223 NORTH VAN DIEN AVE RIDGEWOOD NJ 07450 WILLIAM KLUTKOWSKI SENIOR VP AND CFO 2012916300 2023-11-12 1 WILLIAM KLUTKOWSKI 999009999 1 EDWARD G O'CONNOR P00434443 2017129800 2023-11-08 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z DAVID BOHAN 223 NORTH VAN DIEN AVE RIDGEWOOD NJ 07450 16524816 0 X WWW.VALLEYHOSPITALFOUNDATION.ORG X 1980 NJ TO SOLICIT AND RECEIVE PHILANTHROPIC GIFTS, GRANTS, BEQUESTS FROM DONORS FOR THE PURPOSE OF SUPPORTING THE VALLEY HEALTH SYSTEM. 23 21 0 73 0 0 15170653 11084206 0 0 3204702 1032413 0 2321 18375355 12118940 17180197 13186608 0 0 0 0 150207 130889 3015161 2917905 3259807 20248309 16577304 -1872954 -4458364 62503903 53391795 1947855 2031305 60556048 51360490 X THE VALLEY HOSPITAL FOUNDATION IS THE PHILANTHROPIC COMPONENT OF VALLEY HEALTH SYSTEM. IT'S PRIMARY FUNCTION IS TO SECURE CHARITABLE CONTRIBUTIONS FROM INDIVIDUALS, CORPORATIONS, FOUNDATIONS, AND OTHER FUNDING ENTITIES, TO MANAGE THOSE GIFTS, AND TO DISTRIBUTE THEM IN ACCORDANCE WITH ITS CHARTER. CHARITABLE FUNDS RAISED FOR THE HOSPITAL SUPPORT CONSTRUCTION, CAPITAL IMPROVEMENTS, MEDICAL TECHNOLOGY, BIOMEDICAL RESEARCH, EDUCATION, ENDOWMENTS, AND SPECIAL PROJECTS. FUNDS RAISED FOR VALLEY HOME CARE SUPPORT THE PROGRAMS OF THE AGENCY, SUCH AS HOSPICE, JOURNEYS, MATERNAL CHILD HEALTH, AND ENDOWMENTS. FUNDS RAISED FOR VALLEY MEDICAL GROUP SUPPORT PROGRAMS, CAPITAL IMPROVEMENTS, MEDICAL TECHNOLOGY, EDUCATION AND SPECIAL PROJECTS. 0 0 13186608 13186608 THE FOUNDATION HAS EVALUATED THE NEEDS OF VALLEY HEALTH SYSTEM AND SEEKS TO SECURE FUNDING FOR FOUR DIFFERENT CASES: CONSTRUCTION COSTS FOR THE VALLEY HOSPITAL IN PARAMUS, CAPITAL AND TECHNOLOGICAL IMPROVEMENTS, CLINICAL AND TRANSLATIONAL RESEARCH, AND ENDOWMENTS.VALLEY HEALTH SYSTEM IS A REGIONAL HEALTHCARE SYSTEM THAT SERVES RESIDENTS IN NORTHERN NEW JERSEY AND SOUTHERN NEW YORK. IT COMPRISES THE VALLEY HOSPITAL, VALLEY HOME CARE, AND VALLEY MEDICAL GROUP. KEY SERVICES INCLUDE CARDIOLOGY, ONCOLOGY, WOMEN'S AND CHILDREN'S SERVICES, EMERGENCY CARE, ORTHOPEDICS, AND NEUROSCIENCES. VALLEY HEALTH SYSTEM IS ONE OF THE MOST HONORED HEALTHCARE ORGANIZATIONS IN NEW JERSEY. 13186608 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 0 0 0 0 1 1 1 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 16 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 23 21 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 0 0 NJ NY FL X X LISA JOHNSON 2012916300 223 NORTH VAN DIEN AVE RIDGEWOOD NJ 07450 VICTOR WORTMANN CHAIRMAN 0.50 0.00 X X 0 0 0 DANIELLE GAGLIOTI VICE CHAIRMAN, THRU 6/2022 0.50 0.00 X X 0 0 0 ANDREW GATTO VICE CHAIRMAN, EFF. 10/10/22 0.50 0.00 X X 0 0 0 PETER C MARRON VICE CHAIRMAN 0.50 0.00 X X 0 0 0 EDWARD M RUBIN TREASURER 0.50 0.00 X X 0 0 0 NANCY V BUSH SECRETARY 0.50 0.00 X X 0 0 0 JOSHUA L ABRAMS TRUSTEE 0.50 0.00 X 0 0 0 EPHRAIM CASPER MD TRUSTEE 0.50 39.50 X 0 1046121 44617 DANIEL P CUMMINGS TRUSTEE 0.50 0.00 X 0 0 0 DENISE DOWNEY TRUSTEE - EX OFFICIO, THRU 6/2022 0.50 0.00 X 0 0 0 THEODORE L HARRIS TRUSTEE 0.50 0.00 X 0 0 0 LYNN HOLUBA TRUSTEE 0.50 0.00 X 0 0 0 KAREN KEYES TRUSTEE, EFF. 12/2022 0.50 0.00 X 0 0 0 RALPH M MASTRANGELO TRUSTEE 0.50 0.00 X 0 0 0 AUDREY MEYERS TRUSTEE - EX OFFICIO 0.50 39.50 X 0 3974039 49572 SURYA N MOHAPATRA TRUSTEE, EFF. 6/2022 0.50 0.00 X 0 0 0 LYA PFEIFER ESQ TRUSTEE 0.50 0.00 X 0 0 0 YOLLA RAHAL TRUSTEE 0.50 0.00 X 0 0 0 THOMAS J RAKOWSKI MD TRUSTEE 0.50 0.00 X 0 0 0 MARC SABINO TRUSTEE 0.50 0.00 X 0 0 0 THERESA A SALAMENO TRUSTEE - EX OFFICIO, EFF. 6/2022 0.50 0.00 X 0 0 0 JEFFREY SEIDLER TRUSTEE, EFF. 10/2022 0.50 0.00 X 0 0 0 ANN MARIE SNYDER TRUSTEE, EFF. 10/2022 0.50 0.00 X 0 0 0 ROBERT VAN DYK TRUSTEE 0.50 0.00 X 0 0 0 CHRIS WRAGGE TRUSTEE 0.50 0.00 X 0 0 0 WILLIAM KLUTKOWSKI SR. VP, FINANCE & CFO 0.50 39.50 X 0 1016955 57305 DAVID J BOHAN VICE PRESIDENT & CDO 40.00 0.00 X 0 582103 39668 0 6619218 191162 0 0 1 0 FAIRCOM NEW YORK 12 WEST 27TH STREET 13TH FLOOR NEW YORK NY 10001 FUNDRAISING CONSULTING 261522 1 116613 10967593 670631 11084206 888079 888079 4517499 4373165 144334 144334 144334 17724 116613 30836 -13112 -13112 17308 1875 15433 15433 12118940 0 0 1034734 13186608 13186608 2875 2875 16400 16400 130889 130889 13405 13405 98864 98864 134238 101225 33013 151912 151912 3562 3562 1997 1997 REIMBURSED COMPENSATION 2563007 241630 2321377 PROGRAM & SPECIAL EVENT 273547 273547 16577304 13186608 375535 3015161 699047 577026 2479419 1493621 19220052 14312782 40105385 37008366 62503903 53391795 14702 17260 1933153 2014045 1947855 2031305 X 11898337 9762280 48657711 41598210 60556048 51360490 62503903 53391795 X -4458364 -4735347 8347 -10194 X X 0 1 X 1 0 X 10507805 17018671 14154884 14867478 11084206 67633044 10507805 17018671 14154884 14867478 11084206 67633044 1338120 66294924 1689779 1196638 1251245 907185 888079 5932926 6951 31723 2321 40995 73606965 0.90070 0.87420 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 20840125 303256 -2170944 682761 18289676 20740794 1085386 2340095 3326150 20840125 18696561 580178 2048555 584500 20740794 16182482 135316 2952763 574000 18696561 17584512 75231 -917361 559900 16182482 0.18832 0.51810 0.29358 0 0 0 ANNUITIES PAYABLE 847515 DUE TO AFFILIATES 1166530 2014045 X 7391940 -4735347 8347 -4727000 12118940 0 12118940 16587498 10194 10194 16577304 0 16577304 PART V, LINE 4: THE FOUNDATION CURRENTLY MAINTAINS NINE DONOR-RESTRICTED AND TWO BOARD-DESIGNATED ENDOWMENT FUNDS WHOSE PURPOSES ARE TO PROVIDE LONG TERM SUPPORT FOR THE PROGRAMS AND SERVICES OF VALLEY HOSPITAL AND/OR VALLEY HOME CARE. PART X, LINE 2: THE FOUNDATION IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE FOUNDATION RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT TO BE SUSTAINED. MANAGEMENT HAS DETERMINED THAT THE FOUNDATION HAD NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION OR DISCLOSURE. THE FOUNDATION IS NO LONGER SUBJECT TO EXAMINATIONS BY THE APPLICABLE TAXING JURISDICTIONS FOR PERIODS PRIOR TO 2019. PART XII, LINE 2D - OTHER ADJUSTMENTS: WRITE-DOWN OF CONTRIBUTIONS 10,194. X X X X X 1 FAIRCOM 12 W 27TH STREET NEW YORK NY 10001 DIRECT MAIL CONSULTING 0 272038 110399 161639 PENTERA 8650 COMMERCE PARK PLACE SUITE G INDIANAPOLIS IN 46268 NEWSLETTERS, AND OTHER SERVICES 0 0 20490 -20490 272038 130889 141149 NJ NY FL STEP UP FOR VALLEY 98997 98997 7286 CAMP NICU 35340 17616 17724 22212 1338 134337 116613 17724 7286 22212 1338 30836 -13112 17308 460 1065 350 1 1.00000 17308 460 1065 350 1875 15433 NJ 1 0 1 0 0.66670 0.33330 MILDRED CHIRIANI 223 NORTH VAN DIEN AVENUE RIDGEWOOD NJ 07450 0 LISA JOHNSON 0 OVERALL MANAGEMENT AND SUPERVISION OF GAMING ACTIVITIES. X 0 0 SCHEDULE G, PART I, LINE 2B, COLUMN (V) THE ORGANIZATION'S AGREEMENTS WITH PENTERA AND FAIRCOM INCLUDES PAYMENTS FOR SERVICES AND REIMBURSEMENT OF EXPENSES AS APPROVED BY THE FOUNDATION. 1 THE VALLEY HOSPITAL INC 223 NORTH VAN DIEN AVENUE RIDGEWOOD NJ 07450 221487307 501(C)(3) 12503578 0 PROJECT/CAPITAL PROJECTS/DONOR-DESIGNATED SPECIAL PROGRAMS AND SERVICES VALLEY HOME CARE INC 15 ESSEX ROAD PARAMUS NJ 07677 223208480 501(C)(3) 243230 0 DONOR-DESIGNATED SPECIAL PROGRAMS AND SERVICES VALLEY MEDICAL GROUP 223 NORTH VAN DIEN AVENUE RIDGEWOOD NJ 07450 320041186 501(C)(3) 439800 0 DONOR-DESIGNATED SPECIAL PROGRAMS AND SERVICES 3 0 PART I, LINE 2: THE ORGANIZATION PROVIDES GRANTS TO ITS RELATED ORGANIZATIONS WITHIN THE VALLEY HEALTH SYSTEM - THE VALLEY HOSPITAL, VALLEY HOME CARE AND VALLEY MEDICAL GROUP. THE ORGANIZATION MONITORS THE USE OF GRANT FUNDS THROUGH COMMON MANAGEMENT WITH ITS GRANTEE ORGANIZATIONS. 0 1 0 0 0 0 0 0 0 AUDREY MEYERS TRUSTEE - EX OFFICIO 0 1249299 0 984960 0 1739780 0 22875 0 26697 0 4023611 0 1583249 EPHRAIM CASPER MD TRUSTEE 0 850327 0 140450 0 55344 0 15250 0 29367 0 1090738 0 0 WILLIAM KLUTKOWSKI SR. VP, FINANCE & CFO 0 627904 0 192180 0 196871 0 21138 0 36167 0 1074260 0 0 DAVID J BOHAN VICE PRESIDENT & CDO 0 367745 0 118908 0 95450 0 15250 0 24418 0 621771 0 0 PART I, LINE 3 THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL (DAVID BOHAN, VICE PRESIDENT & CDO OF THE VALLEY HEALTH SYSTEM) IS COMPENSATED BY THE VALLEY HEALTH SYSTEM. THE VALLEY HEALTH SYSTEM HAS ESTABLISHED A POLICY FOR COMPENSATION OF OFFICERS, TOP MANAGEMENT AND KEY EMPLOYEES. THE POLICY INCLUDES A PERIODIC REVIEW BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES, FREE OF ANY MEMBERS WITH CONFLICTS OF INTEREST. THE COMMITTEE DETERMINES APPROPRIATE LEVELS OF COMPENSATION USING COMPARATIVE DATA OF SIMILAR ORGANIZATIONS. COMPENSATION DECISIONS ARE ADEQUATELY AND CONTEMPORANEOUSLY DOCUMENTED. THE PROCESS WAS LAST UNDERTAKEN IN 2022. PART I, LINE 4B TRUSTEE, AUDREY MEYERS PARTICIPATED IN A 457(F) NONQUALIFIED DEFERRED COMPENSATION PLAN OF THE VALLEY HEALTH SYSTEM, A RELATED ORGANIZATION. SHE RECEIVED A PAYMENT IN THE AMOUNT OF $1,583,249 IN 2022, AS INCLUDED ON PART II, COLUMN B(III). SHE ALSO PARTICIPATED IN A CAP-EX (SPLIT-DOLLAR LIFE INSURANCE PLAN) OF THE VALLEY HEALTH SYSTEM, INC. SHE DID NOT RECEIVE A PAYMENT IN 2022. X 18 668782 AVG SELLING PRICE X PATIENT GIFTS 34 1849 COST 0 0 1 0 PART I, COLUMN (B): THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTORS IN PART I, COLUMN (B). FORM 990, PART VI, SECTION A, LINE 6 VALLEY HEALTH SYSTEM IS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A VALLEY HEALTH SYSTEM HAS THE RIGHT TO ELECT ALL MEMBERS OF THE ORGANIZATION'S GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B ANY OF THE FOLLOWING ACTIONS REQUIRE THE APPROVAL OF THE SOLE MEMBER: A) ORGANIZING, ACQUIRING OR AUTHORIZING THE ORGANIZATION OF, ANY SUBSIDIARY OR AFFILIATE OF THE FOUNDATION B) MAKING ANY DONATIONS, CONTRIBUTIONS, GRANTS OR LOANS TO ANY PERSON OR ENTITY OTHER THAN THE HOSPITAL OR THE PARENT IN EXCESS OF TWENTY FIVE THOUSAND DOLLARS IN ANY FISCAL YEAR OR TO ALL SUCH PERSONS AND ENTITIES IN THE AGGREGATE, IN EXCESS OF ONE HUNDRED THOUSAND DOLLARS IN ANY FISCAL YEAR C) ADOPTION OF A PLAN OF DISSOLUTION OF THE FOUNDATION D) ANY TRANSACTION, OTHER THAN IN ORDINARY AND REGULAR COURSE OF BUSINESS, PROVIDING FOR THE SALE, TRANSFER, MORTGAGE OR OTHER DISPOSITION OR ENCUMBRANCE OF ANY ASSETS OF THE FOUNDATION HAVING AN AGGREGATE VALUE IN EXCESS OF ONE HUNDRED THOUSAND DOLLARS IN ANY FISCAL YEARS E) ADOPTION OF A PLAN OF MERGER OR CONSOLIDATION OF THE FOUNDATION WITH ANOTHER ORGANIZATION F) SELECTION OF INDEPENDENT AUDITORS G) ANY CHANGE IN THE MANNER AND PROCEDURE FOR NOMINATION AND ELECTIONS OF TRUSTEES OF THE FOUNDATION H) AMENDMENT OF THE CERTIFICATE OF INCORPORATION I) AMENDMENT OF THE BYLAWS OF THE FOUNDATION WITH RESPECT TO ANY OF THE SUBJECT MATTERS OF THE ARTICLE III, SECTION 11. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION HAS ITS FORM 990 PREPARED BY AN OUTSIDE ACCOUNTING FIRM. MANAGEMENT REVIEWS, PROVIDES ANY COMMENTS, AND UPON THEIR APPROVAL, A COPY OF THE FORM 990 IS PROVIDED TO THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE REVIEWS THE FORM 990 ON BEHALF OF THE FOUNDATION BOARD, PROVIDES ANY COMMENTS, AND UPON THE EXECUTIVE COMMITTEE'S APPROVAL, THE RETURN IS FINALIZED AND APPROVED FOR FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION IS INCLUDED IN THE CONFLICT OF INTEREST POLICY OF THE VALLEY HEALTH SYSTEM,INC. ALL OFFICERS AND TRUSTEES ANNUALLY SIGN A CONFLICT OF INTEREST STATEMENT DISCLOSING ANY POTENTIAL OR ACTUAL CONFLICTS THAT MAY EXIST. THE GENERAL COUNSEL OF THE VALLEY HEALTH SYSTEM,INC. REVIEWS THE DISCLOSURES TO DETERMINE WHETHER ANY CONFLICT EXISTS. IF IT IS DETERMINED THAT A CONFLICT EXISTS, THE PERSON WILL BE NOTIFIED, AND IS NOT ALLOWED TO VOTE ON OR BE PART OF ANY DECISIONS ABOUT THE RELATED TRANSACTION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS FORM 990 AVAILABLE FOR PUBLIC INSPECTION AS REQUIRED UNDER SECTION 6104 OF THE INTERNAL REVENUE CODE. THE RETURN IS POSTED ON NEW YORK STATE ATTORNEY GENERAL WEBSITE, GUIDESTAR.ORG AND OTHER SIMILAR TYPES OF WEBSITES. THE FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. FORM 990, PART XI, LINE 9: WRITE-DOWN OF CONTRIBUTIONS -10,194. FORM 990, PART XII, LINE 2C: THE ORGANIZATION'S BOARD ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS. THE ORGANIZATION'S SOLE MEMBER, VALLEY HEALTH SYSTEM, ASSUMES RESPONSIBILITY FOR THE SELECTION OF THE ORGANIZATION'S INDEPENDENT ACCOUNTANT. THE VALLEY HOSPITAL INC 223 N VAN DIEN AVE RIDGEWOOD NJ 07450 221487307 PROVIDES HEALTHCARE PROGRAMS AND SERVICES TO ALL NJ 501(C)(3) 3 VALLEY HEALTH SYSTEM INC 0 VALLEY HOME CARE INC 15 ESSEX ROAD PARAMUS NJ 07652 223208480 PROVIDES HOME CARE AND HOSPICE SERVICES TO RESIDENTS OF NORTHERN NJ NJ 501(C)(3) 10 VALLEY HEALTH SYSTEM INC 0 VALLEY PHYSICIAN SERVICES INC 223 N VAN DIEN AVE RIDGEWOOD NJ 07450 320041186 PROVIDE PRIMARY AND SPECIALITY MEDICAL CARE NJ 501(C)(3) 10 THE VALLEY HOSPITAL INC 0 VALLEY HEALTH SYSTEM INC 223 N VAN DIEN AVE RIDGEWOOD NJ 07450 222922016 PROVIDES MANAGEMENT AND PLANNING SERVICES TO ITS MEMBERS NJ 501(C)(3) 7 N/A 0 VALLEY MEDICAL SERVICES PC 15 ESSEX ROAD PARAMUS NJ 07652 465297054 PROVIDE PRIMARY AND SPECIALITY MEDICAL CARE NJ 501(C)(3) 10 VALLEY PHYSICIANS SERVICES INC 0 VALLEY PHYSICIAN SERVICES PC 15 ESSEX ROAD PARAMUS NJ 07652 465285330 PROVIDE PRIMARY AND SPECIALITY MEDICAL CARE NJ 501(C)(3) 10 VALLEY PHYSICIANS SERVICES INC 0 VALLEY PHYSICIAN SERVICE NY PC 15 ESSEX ROAD PARAMUS NJ 07652 453125678 OPERATES URGENT/PRIMARY CARE CLINICS NY 501(C)(3) 10 VALLEY PHYSICIAN SERVICES INC 0 VHS INSURANCE COMPANY LTD 010 MAIN STREET CAYMAN ISLANDS CJ 980408200 PROVIDES PROFESSIONAL, MEDICAL, AND COMMERCIAL GENERAL LIABILITY INSURANCE CJ VALLEY HEALTH SYSTEM INC C 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 1 0 0 0