2021-11-11T13:30:33-06:00 2020-12-31 271728945 PKF O'CONNOR DAVIES LLP 300 TICE BOULEVARD SUITE 315 WOODCLIFF LAKE NJ 07677 990 2020-01-01 465285330 VALLEY PHYSICIANS SERVICES PC VALL 2012916000 15 ESSEX ROAD NO 506 PARAMUS NJ 07652 DAVID STRASSBERG MD PRESIDENT 2012916000 2021-11-11 1 DAVID STRASSBERG MD 999009999 EDWARD G O'CONNOR P00434443 2017129800 2021-11-11 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z DAVID STRASSBERG MD 15 ESSEX ROAD NO 506 PARAMUS NJ 07652 156131506 0 X WWW.VALLEYHEALTH.COM X 2014 NJ VALLEY PHYSICIANS SERVICES, P.C. WAS FORMED TO PROVIDE MEDICAL CARE AND TO CARRY OUT THE PURPOSES OF THE VALLEY HEALTH SYSTEM, INC. 2 0 407 7 0 0 318156 3860788 162125590 152265272 0 0 0 5446 162443746 156131506 25867861 24386912 0 0 114742256 112202183 0 0 0 22609366 21787502 163219483 158376597 -775737 -2245091 20787942 24664339 27334192 33756929 -6546250 -9092590 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 154041481 24386912 152265272 VALLEY PHYSICIAN SERVICES, P.C. RENDERED MEDICAL CARE TO A TOTAL OF 454,319 PATIENTS. MEDICAL CARE PROVIDED WAS IN THE FIELDS OF FAMILY MEDICINE, INTERNAL MEDICINE, CARDIOLOGY, OB/GYN, URGENT CARE AND ENDOCRINOLOGY. VALLEY PHYSICIAN SERVICES, P.C. ALSO PROVIDE STRATEGIC PROGRAMS TO VALLEY HOSPITAL, INC. 154041481 1 1 0 0 0 0 0 0 0 0 0 0 0 1 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 18 0 407 1 0 0 0 0 0 0 0 0 0 0 0 0 X 2 0 0 1 0 0 1 1 1 1 1 0 0 1 1 0 0 1 1 1 1 0 X MARIETTA STONE 2012916391 15 ESSEX ROAD PARAMUS NJ 07652 GAIL MATTHEWS TREASURER 39.40 0.60 X X 827026 0 20942 DAVID STRASSBERG MD PRESIDENT 39.40 0.60 X X 549203 0 21267 AUDREY MEYERS PRESIDENT & CEO, VHS 1.00 39.00 X 0 1842384 45085 WILLIAM KLUTKOWSKI VP & CFO EFF. 3/2020 2.00 38.00 X 0 664987 51335 ROBERT W BRENNER PRESIDENT, CLINICAL INTEGRATION 2.00 38.00 X 0 1339685 24791 RICHARD KEENAN SENIOR VP, FINANCE/CFO THRU 8/2020 2.00 38.00 X 0 1159434 37643 ALEX ZAPOLANSKI MD PHYSICIAN 40.00 X 1489899 0 35783 ROBERT KORST MD CHIEF OF ONCOLOGY SURGERY 40.00 X 1276207 0 49285 THOMAS AHLBORN MD CHAIR, SURGICAL SERVICES 40.00 X 1247449 0 34193 MICHAEL RAHMIN MD PHYSICIAN 40.00 X 1131623 0 47815 ALI NASSERI MEDICAL DIRECTOR, TVH FERTILITY CENTER 40.00 X 937580 0 42640 7458987 5006490 410779 324 0 1 0 VALLEY PHYSICIAN SERVICES NY PC 15 ESSEX ROAD PARAMUS NJ 07652 MANAGEMENT SERVICES 1515862 VALLEY PHYSICIAN SERVICES INC 223 NORTH VAN DIEN AVE RIDGEWOOD NJ 07450 MANAGEMENT SERVICES 1311526 PROGRESSIVE RADIOLOGY LLC 86 CLINTON AVE MONTCLAIR NJ 07042 MEDICAL CONSULTING 418250 LAWRENCE SELTZER MD 215 HARRISON AVE WESTFIELD NJ 07090 MEDICAL CONSULTING 356056 RAKESH SHARMA MD 1124 E RIDGEWOOD AVE STE 103 RIDGEWOOD NJ 07450 MEDICAL CONSULTING 251380 9 877632 2983156 3860788 NET PATIENT SERVICE REVENUE 624100 128620014 128620014 MEDICAL FEE REVENUE 624100 23645258 23645258 152265272 OTHER REVENUE 900099 4010 4010 BAD DEBT RECOVERY 900099 1436 1436 5446 156131506 152265272 0 5446 24386912 24386912 1418438 1415734 2704 101670787 101478977 191810 2419129 2405989 13140 2470545 2470545 4223284 4162446 60838 2827388 2827388 14596390 10547245 4049145 239 239 443087 426423 16664 1002 1002 24340 24108 232 890 307 583 3132925 3132925 CONTINUING EDUCATION 654296 654296 BAD DEBT 76289 76289 RECRUITMENT 30656 30656 158376597 154041481 4335116 0 5372072 2339354 15415870 14083107 0 8241878 20787942 24664339 27334192 22685499 0 11071430 27334192 33756929 X 0 0 0 0 -6546250 -9092590 -6546250 -9092590 20787942 24664339 X -2245091 -301251 X X 0 1 X 1 0 X 0 0 0 318156 3860788 4178944 0 133265190 149157797 162125590 152265272 596813849 133265190 149157797 162443746 156126060 600992793 0 0 0 600992793 98304 1436 99740 133363494 149157797 162443746 156127496 601092533 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 DUE FROM VALLEY HOSPITAL 8241878 8241878 ADVANCE PAYMENT FROM MEDICARE 8241878 ESTIMATED 3RD PARTY PAYOR SETTLEMENTS 2829552 11071430 X 243103229 87925644 87925644 155177585 953921 953921 156131506 326223347 168800671 168800671 157422676 953921 953921 158376597 PART X, LINE 2: VMG RECOGNIZES THE BENEFIT FROM INCOME TAX POSITIONS TAKEN IN ITS INCOME TAX RETURNS ONLY WHEN THOSE POSITIONS ARE BELIEVED TO BE MORE LIKELY THAN NOT TO BE SUSTAINED UPON REVIEW BY THE TAX AUTHORITIES. VMG PROVIDES VALUATION ALLOWANCES FOR NET DEFERRED TAX ASSETS WHEN THE REALIZATION OF THE DEFERRED TAX ASSET IS UNCERTAIN. MANAGEMENT HAS DETERMINED THAT VMG HAD NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION OR DISCLOSURE. THE ENTITIES INCLUDED IN VMG ARE NO LONGER SUBJECT TO EXAMINATIONS BY THE APPLICABLE TAXING JURISDICTIONS FOR PERIODS PRIOR TO THE 2017 TAX YEAR. PART XI, LINE 2D - OTHER ADJUSTMENTS: REVENUE ATTRIBUTABLE TO CONSOLIDATED ENTITIES 87,925,644. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE NETTED AGAINST REVENUE 76,289. CONTRIBUTIONS NETTED AGAINST EXPENSES 877,632. PART XII, LINE 2D - OTHER ADJUSTMENTS: EXPENSES ATTRIBUTABLE TO CONSOLIDATED ENTITIES 168,800,671. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE NETTED AGAINST REVENUE 76,289. CONTRIBUTIONS NETTED AGAINST EXPENSES 877,632. 0 THE VALLEY HOSPITAL INC 223 NORTH VAN DIEN AVENUE RIDGEWOOD NJ 07450 221487307 501(C)(3) 14736696 STRATEGIC FUNDING VALLEY PHYSICIAN SERVICES INC 223 NORTH VAN DIEN AVENUE RIDGEWOOD NJ 07450 320041186 501(C)(3) 9648216 STRATEGIC FUNDING 2 X X X X 0 0 0 0 0 0 0 1 0 AUDREY MEYERS PRESIDENT & CEO, VHS 0 1166636 0 592200 0 83548 0 21375 0 23710 0 1887469 0 0 ALEX ZAPOLANSKI MD PHYSICIAN 905079 0 550285 0 34535 0 9975 0 25808 0 1525682 0 0 0 ROBERT W BRENNER PRESIDENT, CLINICAL INTEGRATION 0 790426 0 327596 0 221663 0 12825 0 11966 0 1364476 0 0 ROBERT KORST MD CHIEF OF ONCOLOGY SURGERY 696023 0 575094 0 5090 0 15675 0 33610 0 1325492 0 0 0 THOMAS AHLBORN MD CHAIR, SURGICAL SERVICES 1018823 0 193846 0 34780 0 9975 0 24218 0 1281642 0 0 0 RICHARD KEENAN SENIOR VP, FINANCE/CFO THRU 8/2020 0 633136 0 342696 0 183602 0 21375 0 16268 0 1197077 0 0 MICHAEL RAHMIN MD PHYSICIAN 966554 0 138498 0 26571 0 9975 0 37840 0 1179438 0 0 0 ALI NASSERI MEDICAL DIRECTOR, TVH FERTILITY CENT 718502 0 194487 0 24591 0 9975 0 32665 0 980220 0 0 0 GAIL MATTHEWS TREASURER 665106 0 127385 0 34535 0 9975 0 10967 0 847968 0 0 0 WILLIAM KLUTKOWSKI VP & CFO EFF. 3/2020 0 445152 0 121535 0 98300 0 18525 0 32810 0 716322 0 0 DAVID STRASSBERG MD PRESIDENT 424660 0 110923 0 13620 0 9975 0 11292 0 570470 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 7 THE FOLLOWING EMPLOYEES OF THE ORGANIZATION RECEIVED A BOARD-APPROVED DISCRETIONARY BONUS, AWARDED BASED ON PERFORMANCE, AS REPORTED FOR THEM IN PART II, COLUMN B(II): 1. ALEX ZAPOLANSKI, M.D., $550,285 2. ROBERT KORST, M.D., $575,094 3. THOMAS AHLBORN, M.D., $193,846 4. MICHAEL RAHMIN, M.D., $138,498 5. ALI NASSERI, $194,487 6. GAIL MATTHEWS, $127,385 7. DAVID STRASSBERG, $110,923 FORM 990, PART VI, SECTION A, LINE 3 VALLEY PHYSICIAN SERVICES, P.C. PAID VALLEY PHYSICIAN SERVICES, NY, P.C. $1,515,862 AND VALLEY PHYSICIAN SERVICES, INC. $1,311,526 MANAGEMENT FEES. SERVICES RENDERED INCLUDED HUMAN RESOURCE MANAGEMENT, MARKETING AND OTHER ADMINISTRATIVE SERVICES. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION IS A PROFESSIONAL CORPORATION HAVING SHAREHOLDERS. FORM 990, PART VI, SECTION A, LINE 7A THE TRUSTEES OF THE CORPORATION SHALL ELECT, APPOINT, REPLACE OR REMOVE TRUSTEES; PROVIDED, HOWEVER, THAT BEFORE TAKING ANY SUCH ACTION, THE TRUSTEES SHALL GIVE THE VALLEY PHYSICIAN SERVICES, INC. BOARD OF TRUSTEES ("VPS BOARD") AT LEAST THIRTY (30) DAYS WRITTEN ADVANCE NOTICE OF ITS INTENDED ACTIONS; WILL NOT VOTE UNTIL WRITTEN APPROVAL OF SUCH ACTION IS RECEIVED FROM THE VPS BOARD; AND WILL VOTE IN THE MANNER SPECIFIED IN THE WRITTEN NOTICE PROVIDED TO THE VPS BOARD. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING DECISIONS OF THE ORGANIZATION ARE RESERVED TO THE BOARD OF VALLEY PHYSICIAN SERVICES: STRATEGIC ACTIONS, WHICH SHALL INCLUDE, BUT NOT BE LIMITED TO, NEW STRATEGIC PLANS, MODIFICATIONS OF EXISTING STRATEGIC PLANS OR MISSION STATEMENTS; MAJOR CORPORATE DECISIONS, WHICH MAY POTENTIALLY IMPACT THE PHILOSOPHY OF THE VALLEY SYSTEM, WHICH SHALL INCLUDE, BUT NOT BE LIMITED TO, JOINT VENTURES, CORPORATE ACQUISITIONS, PROGRAMMATIC AFFILICATIONS, MERGERS OR CONSOLIDATIONS, CONVERSION OF THE TAX-EXEMPT STATUS, SALE OR TRANSFER OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION, OR THE DISSOLUTION OF THE CORPORATION; ANY SINGLE EXPENDITURE GREATER THAN FIVE PERCENT (5%) OF THE ANNUAL OPERATING BUDGET OF THE CORPORATION AND AMENDMENTS THERETO; THE ELECTION, APPOINTMENT, REPLACEMENT OR REMOVAL OF TRUSTEES OF THE CORPORATION WITH OR WITHOUT CAUSE; THE SELECTION OF AUDITORS; THE APPOINTMENT AND REMOVAL OF THE PRESIDENT OF THE CORPORATION (OR THE APPROVAL OF ANY RECCOMENDATION OF THE VPS BOARD FOR REMOVAL); THE ADOPTION, AMENDMENT, REVISION OR DELETION OF THE CORPORATION'S BYLAWS AND THE CREATION OR APPROVAL OF ANY AMENDMENTS, ALTERATIONS OR REVISIONS TO THE CORPORATION'S CERTIFICATE OF INCORPORATION; THE ADOPTION OF THE CORPORATION'S ANNUAL CAPITAL AND OPERATING BUDGETS; MAJOR CORPORATE DECISIONS REGARDING THE INCURRENCE OF DEBT IN EXCESS OF FIVE PERCENT (5%) OF THE OPERATING BUDGET OF THE CORPORATION (INCLUDING CAPITAL AND OPERATING LEASES), AND THE TRANSFER OR LOAN OF CASH OR THE CONVEYANCE, LEASE OR OTHER DISPOSITION OF OTHER ASSETS TO AN AFFILIATE OR SUBSIDIARY WITHOUT RECEIVING EQUIVALENT VALUE IN RETURN. THE APPROVAL OF THE PURCHASE OR SALE OF ANY REAL PROPERTY BY THE CORPORATION AND THE APPROVAL OF THE CREATION OF A MORTGAGE, LIEN, OR ANY OTHER SECURITY INTERESTS IN THE CORPORATION'S REAL OR PERSONAL PROPERTY; DETERMINATIONS OF HOW ANY AND ALL EXCESS CASH GENERATED BY THE CORPORATION WILL BE SPENT; THE CESSATION OR ANY CHANGE IN THE CORPORATION'S PROVISION OF SERVICES TO MEDICARE AND MEDICAID RECIPIENTS AND ITS PROVISION OF CHARITY CARE SERVICES IN ACCORDANCE WITH CHARITY CARE SERVICES IN ACCORDANCE WITH CHARITY CARE POLICIES ESTABLISHED BY THE VALLEY HOSPITAL. FORM 990, PART VI, SECTION B, LINE 11B VALLEY PHYSICIAN SERVICES, P.C. HAS ITS FORM 990 PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND HAS ESTABLISHED THE FOLLOWING REVIEW PROCESS TO ENSURE THAT THE INFORMATION REPORTED IS COMPLETE AND ACCURATE. WHEN THE FORM 990 IS PREPARED, IT IS SUBMITTED TO MANAGEMENT AND THE AUDIT COMMITTEE OF VALLEY HEALTHY SYSTEM FOR REVIEW. ANY COMMENTS ARE SUMMARIZED AND PROVIDED TO THE DIRECTOR OF FINANCE VALLEY PHYSICIAN SERVICES. EACH ISSUE IS DOCUMENTED AND ADDRESSED UNTIL THE RETURN IS FINALIZED AND APPROVED BY THE AUDIT COMMITTEE FOR FILING WITH THE INTERNAL REVENUE SERVICE. BEFORE FILING, THE FORM 990 IS MADE AVAILABLE FOR THE BOARD'S REVIEW, BY HARD COPY AND OR ELECTRONIC COPY. 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 SIMILARITY SITUATED ORGANIZATIONS FOR SIMILAR SERVICES, CURRENT COMPENSATION SURVEYS COMPLETED BY INDEPENDENT FIRMS, OR ACTUAL WRITTEN OFFERS FROM SIMILARLY SITUATED ORGANIZATIONS. HE COMPENSATION IS CONTEMPORANEOUSLY DOCUMENTED AND THE PROCESS WAS LAST UNDERTAKEN IN 2020. FORM 990, PART VI, SECTION C, LINE 19 VPS P.C MAKES ITS FORM 990, FINANCIAL STATEMENTS, FORM 1023, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS AVAILABLE UPON WRITTEN REQUEST AT 223 NORTH VAN DIEN AVE, RIDGEWOOD, NJ 07450 OR BY CALLING THE ORGANIZATION DIRECTLY AT 201-447-8000. FORM 990, PART XI, LINE 9: NET LIABILITY TRANSFER FROM VALLEY MEDICAL SERVICES, P.C. EIN: 46-5297054 -301,251. FORM 990, PART XI, LINE 2C THE FINANCE COMMITTEE IS RESPONSIBLE FOR SELECTING AN INDEPENDENT ACCOUNTANT AND FOR OVERSIGNT OF THE AUDIT. THIS 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 0 1 1 1 1 1 1 1