2023-11-12T22:11:57-06:00 2022-12-31 873231666 PKF O'CONNOR DAVIES ADVISORY LLC 300 TICE BOULEVARD SUITE 315 WOODCLIFF LAKE NJ 07677 990 2022-01-01 465285330 VALLEY PHYSICIANS SERVICES PC VALL 2012916000 15 ESSEX ROAD 506 PARAMUS NJ 07652 WILLIAM KLUTKOWSKI SENIOR VP AND CFO 2012916000 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 ROBERT W BRENNER 15 ESSEX ROAD 506 PARAMUS NJ 07652 200994425 0 X WWW.VALLEYHEALTH.COM/VALLEY-MEDICAL-GROUP X 2014 NJ TO PROVIDE MEDICAL CARE AND TO CARRY OUT THE PURPOSES OF THE VALLEY HEALTH SYSTEM, INC. 19 18 475 18 0 0 4322503 0 180847334 200994425 0 0 417 0 185170254 200994425 44133513 47852914 0 0 118786849 129124826 0 0 0 25341874 27158033 188262236 204135773 -3091982 -3141348 21972839 26604976 34157411 41930896 -12184572 -15325920 TO ENGAGE IN THE RENDERING OF PROFESSIONAL SERVICES OF AND RELATED TO THE PRACTICE OF MEDICINE PURSUANT TO "THE PROFESSIONAL SERVICES CORPORATION ACT, AND TO SUPPORT AND CARRY OUT THE CHARITABLE PURPOSE OF VALLEY HEALTH SYSTEM, INC. 0 0 192352936 47852914 200994425 THE ORGANIZATION PROVIDED MEDICAL CARE TO A TOTAL OF 538,031 PATIENTS IN 2022 IN THE FIELDS OF INTERNAL MEDICINE, FAMILY MEDICINE, AND CARDIOLOGY. THE ORGANIZATION ALSO PROVIDED STRATEGIC FUNDING TO VALLEY HOSPITAL, INC. 192352936 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 14 0 475 1 0 0 0 0 0 0 0 0 0 0 0 0 X 19 18 0 1 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X MARIETTA STONE 2012916391 15 ESSEX ROAD PARAMUS NJ 07652 AUDREY MEYERS PRESIDENT & CEO, VHS 0.50 39.50 X X 0 3974039 49572 VINCENT FORLENZA CHAIR 0.10 0.40 X X 0 0 0 KEVIN LOBO VICE CHAIR 0.10 0.40 X X 0 0 0 FRANK J SHEEHY VICE CHAIR 0.10 0.40 X X 0 0 0 ANN LIMBERG VICE CHAIR & SECRETARY 0.10 0.40 X X 0 0 0 JOSEPH MARION TREASURER 0.10 0.40 X X 0 0 0 JUDY BASELICE TRUSTEE 0.10 0.40 X 0 0 0 JAMES BUSH TRUSTEE 0.10 0.40 X 0 0 0 MICHELLE HASSON TRUSTEE 0.10 0.40 X 0 0 0 M SHAWN KENNEDY TRUSTEE 0.10 0.40 X 0 0 0 BRUCE MACTAS TRUSTEE 0.10 0.40 X 0 0 0 DUANE SACHS TRUSTEE 0.10 0.40 X 0 0 0 DENIS SALAMONE TRUSTEE 0.10 0.40 X 0 0 0 SCOTT SCHROEDER TRUSTEE 0.10 0.40 X 0 0 0 EDWARD B SELF MD TRUSTEE 0.10 0.40 X 0 0 0 STEVEN SILVERSTEIN TRUSTEE 0.10 0.40 X 0 0 0 JEFFREY TUCKER TRUSTEE 0.10 0.40 X 0 0 0 PATRICIA VERDUIN TRUSTEE 0.10 0.40 X 0 0 0 WAYNE WALD ESQ TRUSTEE 0.10 0.40 X 0 0 0 ROBERT W BRENNER PRESIDENT CLINICAL INTEGRATION/ PHYSICIAN ENT. 2.00 38.00 X 0 1461032 28405 WILLIAM KLUTKOWSKI SR. VP, FINANCE & CFO 2.00 38.00 X 0 1016955 57305 DAVID STRASSBERG CHAIR, PRIMARY CARE SERVICES 0.10 39.90 X 478540 0 33620 GERALD SOTSKY CHAIR, CARDIOLOGY SERVICES 2.00 38.00 X 795102 0 40265 JUAN GRAU DIRECTOR, CARDIOTHORACIC SURGERY 40.00 0.00 X 1643753 0 37242 ALEX ZAPOLANSKI PHYSICIAN 40.00 0.00 X 1310266 0 38657 THOMAS AHLBORN MD CHAIR, SURGICAL SERVICES 40.00 0.00 X 1265394 0 37992 MICHAEL RAHMIN MD PHYSICIAN 40.00 0.00 X 1225822 0 35702 ROBERT KORST MD CHIEF OF ONCOLOGY SURG SERVICE 40.00 0.00 X 1001459 0 50967 7720336 6452026 409727 351 0 1 0 PROGRESSIVE RADIOLOGY LLC 86 CLINTON AVE MONTCLAIR NJ 07042 MEDICAL SERVICES 577000 LAWRENCE SELTZER MD 215 HARRISON AVE WESTFIELD NJ 07090 MEDICAL SERVICES 456356 MALWINDER SINGH MD 402 JAY COURT FRANKLIN LAKES NJ 07417 MEDICAL SERVICES 416780 RAKESH SHARMA MD 1124 E RIDGEWOOD AVENUE SUITE 103 RIDGEWOOD NJ 07450 MEDICAL SERVICES 403200 ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI 1 GUSTAVE L LEVY PLACE NEW YORK NY 10029 MEDICAL SERVICES 312560 6 PATIENT SERVICE REVENUE 624100 170160398 170160398 MEDICAL SVCS. TO HOSPITAL 624100 30834027 30834027 200994425 200994425 200994425 0 0 47852914 47852914 1347527 385363 962164 114915858 114224696 691162 2800808 2675263 125545 5035399 5015967 19432 5025234 5022763 2471 9381550 9381550 47015 47015 12602119 12602119 11516 11516 565557 39294 526263 7335 7335 35212 34072 1140 3680670 3672429 8241 CONTINUING EDUCATION 744000 744000 BAD DEBT EXPENSE 59420 59420 SUBSCRIPTIONS 16353 16353 RECRUITMENT 4184 3272 912 3102 2513 589 204135773 192352936 11782837 0 4684423 2610314 17246916 23852329 41500 142333 21972839 26604976 23673765 33722121 10483646 8208775 34157411 41930896 X -12184572 -15325920 -12184572 -15325920 21972839 26604976 -3141348 0 X X 0 1 X 1 0 X 0 318156 3860788 4322503 0 8501447 149157797 162125590 152265272 180847334 200994425 845390418 149157797 162443746 156126060 185169837 200994425 853891865 0 0 0 853891865 1436 417 1853 149157797 162443746 156127496 185170254 200994425 853893718 1.00000 0.00000 X 0 ESTIMATED 3RD PARTY PAYOR SETTLEMENTS 8208775 8208775 X 281598039 104150405 104150405 177447634 23546791 23546791 200994425 284739390 104150408 104150408 180588982 23546791 23546791 204135773 PART X, LINE 2: VMG RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT TO BE SUSTAINED. MANAGEMENT HAS DETERMINED THAT VMG HAD NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION OR DISCLOSURE. VMG IS NO LONGER SUBJECT TO EXAMINATIONS BY THE APPLICABLE TAXING JURISDICTIONS FOR PERIODS PRIOR TO 2019. PART XI, LINE 2D - OTHER ADJUSTMENTS: REVENUE OF RELATED ENTITIES INCLUDED IN COMBINED FINANCIAL STATEMENTS 104,150,405. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT NET WITH PATIENT SERVICE REVENUE IN FINANCIAL STATEMENTS 59,420. STRATEGIC FUNDING 23,487,371. PART XII, LINE 2D - OTHER ADJUSTMENTS: EXPENSES OF RELATED ENTITIES INCLUDED IN COMBINED FINANCIAL STATEMENTS 104,150,408. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT NET WITH PATIENT SERVICE REVENUE IN FINANCIAL STATEMENTS 59,420. STRATEGIC FUNDING 23,487,371. 1 THE VALLEY HOSPITAL INC 223 NORTH VAN DIEN AVENUE RIDGEWOOD NJ 07450 221487307 501(C)(3) 47852914 0 STRATEGIC FUNDING 1 PART I, LINE 2: THE ORGANIZATION PROVIDED STRATEGIC FUNDING TO ITS RELATED ENTITY, THE VALLEY HOSPITAL, INC. THE ORGANIZATION MONITORS THE USE OF THE FUNDS THROUGH COMMON MANAGEMENT. 0 1 0 0 0 0 0 1 0 AUDREY MEYERS PRESIDENT & CEO, VHS 0 1249299 0 984960 0 1739780 0 22875 0 26697 0 4023611 0 1583249 JUAN GRAU DIRECTOR, CARDIOTHORACIC SURGERY 1519351 0 100000 0 24402 0 7875 0 29367 0 1680995 0 0 0 ROBERT W BRENNER PRESIDENT CLINICAL INTEGRATION/ PHYSICIAN ENT. 0 816543 0 357704 0 286785 0 13725 0 14680 0 1489437 0 0 ALEX ZAPOLANSKI PHYSICIAN 886819 0 380463 0 42984 0 9450 0 29207 0 1348923 0 0 0 THOMAS AHLBORN MD CHAIR, SURGICAL SERVICES 978416 0 252000 0 34978 0 10675 0 27317 0 1303386 0 0 0 MICHAEL RAHMIN MD PHYSICIAN 950970 0 249200 0 25652 0 10675 0 25027 0 1261524 0 0 0 WILLIAM KLUTKOWSKI SR. VP, FINANCE & CFO 0 627904 0 192180 0 196871 0 21138 0 36167 0 1074260 0 0 ROBERT KORST MD CHIEF OF ONCOLOGY SURG SERVICE 836557 0 160000 0 4902 0 15551 0 35416 0 1052426 0 0 0 GERALD SOTSKY CHAIR, CARDIOLOGY SERVICES 585325 0 181753 0 28024 0 9858 0 30407 0 835367 0 0 0 DAVID STRASSBERG CHAIR, PRIMARY CARE SERVICES 429075 0 38625 0 10840 0 10675 0 22945 0 512160 0 0 0 PART I, LINE 3 VALLEY HEALTH SYSTEM HAS DEVELOPED A COMPENSATION PLAN, WHICH GOVERNS THE COMPENSATION FOR ALL EXECUTIVES, INCLUDING THE CEO AND VICE PRESIDENTS OF THE ORGANIZATION. THE PLAN WAS DEVELOPED IN CONJUNCTION WITH A CONSULTING FIRM, REVIEWED BY THE PHYSICIAN LEADERSHIP COUNCIL AND APPROVED BY THE BOARD OF TRUSTEES AND THE VALLEY HEALTH SYSTEM PHYSICIAN COMPENSATION COMMITTEE. ON AN ANNUAL BASIS, THE PLAN IS REVIEWED AND UPDATED AS NEEDED. PART I, LINE 4B AUDREY MEYERS AND WILLIAM KLUTKOWSKI PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN. AUDREY MEYERS RECEIVED A PAYMENT IN THE AMOUNT OF $1,583,249 FROM THIS PLAN AS REPORTED IN PART II, COLUMN BIII AND COLUMN F. AUDREY MEYERS PARTICIPATED IN A CAP-EX (SPLIT-DOLLAR LIFE INSURANCE PLAN). SHE DID NOT RECEIVE A PAYMENT DURING 2022. PART I, LINE 7 EMPLOYEES OF THE ORGANIZATION RECEIVED A BOARD-APPROVED DISCRETIONARY BONUS, AWARDED BASED ON PERFORMANCE, AS REPORTED FOR THEM IN PART II, COLUMN B(II). FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION RECEIVED MANAGEMENT SERVICES FROM TWO RELATED ORGANIZATIONS, VALLEY PHYSICIAN SERVICES NY, P.C. AND VALLEY PHYSICIAN SERVICES, INC. SERVICES PROVIDED INCLUDED HUMAN RESOURCE MANAGEMENT, MARKETING AND OTHER ADMINISTRATIVE SERVICES. THE ORGANIZATION INCURRED EXPENSES OF $6,108,543 AND $3,273,006 RESPECTIVELY FOR SERVICES FROM THESE RELATED ORGANIZATIONS. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION IS A PROFESSIONAL CORPORATION WITH SHAREHOLDERS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM. IT IS REVIEWED BY MANAGEMENT AND THE AUDIT COMMITTEE OF VALLEY HEALTH SYSTEM. A COMPLETE COPY OF THE FORM 990 IS MADE AVAILABLE TO ALL MEMBERS OF THE ORGANIZATION'S GOVERNING BODY PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE VALLEY HEALTH SYSTEM HAS A CONFLICT OF INTEREST POLICY WHICH COVERS ALL CONTROLLED ORGANIZATIONS WITHIN THE HEALTH SYSTEM, INCLUDING THIS ORGANIZATION. THE POLICY REQUIRES ALL TRUSTEES, OFFICERS, AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS, TO ANNUALLY SIGN A CONFLICT OF INTEREST STATEMENT, DISCLOSING ANY POTENTIAL CONFLICTS WHICH MAY EXIST. SUCH PERSONS ARE ALSO REQUIRED TO DISCLOSE ANY POTENTIAL CONFLICTS AS THEY ARISE. CONFLICTS ARE DETERMINED BY THE BOARD OF TRUSTEES OR DELEGATED COMMITTEE CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. PERSONS WITH CONFLICTS OF INTEREST MUST NOT PARTICIPATE IN THE DISCUSSION OR VOTE ON THE RELATED MATTER. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMPENSATION COMMITTEE OF VALLEY HOSPITAL WILL BE RESPONSIBLE FOR APPROVING THE COMPENSATION OF THE PRESIDENT AND OTHER KEY EXECUTIVES OF VPS, P.C. THE COMPENSATION FOR OTHER PHYSICIANS WILL BE APPROVED BY THE PHYSICIAN COMPENSATION COMMITTEE OF VALLEY HEALTH SYSTEM. TOTAL COMPENSATION WILL BE SET BASED ON INFORMATION REGARDING COMPENSATION PAID BY SIMILARLY SITUATED ORGANIZATIONS FOR SIMILAR SERVICES, CURRENT COMPENSATION SURVEYS COMPLETED BY INDEPENDENT FIRMS, OR ACTUAL WRITTEN OFFERS FROM SIMILARLY SITUATED ORGANIZATIONS. THE COMPENSATION IS CONTEMPORANEOUSLY DOCUMENTED AND THE PROCESS WAS LAST UNDERTAKEN IN 2022. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, AND GOVERNING DOCUMENTS AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS A COMMITTEE RESPONSIBLE FOR THE OVERSIGHT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. THE VALLEY HOSPITAL FOUNDATION INC 223 NORTH VAN DIEN AVE RIDGEWOOD NJ 07450 222324554 SOLICITS AND RECEIVES CONTRIBUTIONS FOR THE BENEFIT OF HEALTH SYSTEM NJ 501(C)(3) LINE 7 VALLEY HEALTH SYSTEM INC 0 THE VALLEY HOSPITAL INC 223 NORTH VAN DIEN AVE RIDGEWOOD NJ 07450 221487307 PROVIDE HEALTHCARE PROGRAMS AND SERVICES TO ALL NJ 501(C)(3) LINE 3 VALLEY HEALTH SYSTEM INC 0 VALLEY HEALTH SYSTEM INC 223 NORTH VAN DIEN AVE RIDGEWOOD NJ 07450 222922016 PROVIDE MANAGEMENT AND PLANNING SERVICES FOR ITS MEMBERS NJ 501(C)(3) LINE 3 N/A 0 VALLEY HOME CARE INC 15 ESSEX ROAD PARAMUS NJ 07652 223208480 PROVIDE HOME CARE AND HOSPICE SERVICES TO RESIDENTS OF NORTHERN NJ NJ 501(C)(3) LINE 10 VALLEY HEALTH SYSTEM INC 0 VALLEY MEDICAL SERVICES PC 15 ESSEX ROAD PARAMUS NJ 07652 465297054 PROVIDE PRIMARY AND SPECIALTY MEDICAL CARE NJ 501(C)(3) LINE 10 VALLEY PHYSICIAN SERVICES INC 0 VALLEY PHYSICIAN SERVICE NY PC 15 ESSEX ROAD PARAMUS NJ 07450 453125678 OPERATES URGENT/PRIMARY CARE CLINICS NY 501(C)(3) LINE 10 VALLEY PHYSICIAN SERVICES INC 0 VALLEY PHYSICIAN SERVICES INC 223 NORTH VAN DIEN AVE RIDGEWOOD NJ 07450 320041186 PROVIDES MANAGEMENT AND VARIED CONSULTING SERVICES NJ 501(C)(3) LINE 10 THE VALLEY HOSPITAL 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 1 1 1 1 1 1 1