2021-11-12T07:08:50-06:00 2020-12-31 WithumSmithBrown PC 200 Jefferson Park Suite 400 Whippany NJ 079811070 990 2020-01-01 221487322 HOLY NAME MEDICAL CENTER % RYAN KENNEDY CPA HOLY 2018337016 718 TEANECK ROAD TEANECK NJ 07666 RYAN KENNEDY EVP/CFO 2018337016 2021-11-03 true RYAN KENNEDY 000000000 Scott J Mariani P00642486 9738989494 2021-11-03 2 2020 2022-09-23 18:48:47Z MICHAEL MARON 718 TEANECK ROAD TEANECK NJ 07666 488287805 false 0928 X WWW.HOLYNAME.ORG X 1958 NJ TO PROVIDE MEDICALLY NECESSARY HEALTHCARE SVCS TO INDIVIDUALS IN THE COMMUNITY REGARDLESS OF RACE, COLOR, CREED, SEX, GENDER IDENTITY, NAT'L ORIGIN, AGE, DISABILITY OR ABILITY TO PAY. 19 15 3345 435 716496 684544 5712580 87928733 448759353 393676205 4630263 -709201 3809307 2300845 462911503 483196582 681770 442181 0 0 198950667 198501387 0 0 0 244052173 246203463 443684610 445147031 19226893 38049551 414463274 538902803 182803449 264212487 231659825 274690316 X HOLY NAME MEDICAL CENTER IS A COMMUNITY OF CAREGIVERS COMMITTED TO A MINISTRY OF HEALING, EMBRACING THE TRADITION OF CATHOLIC PRINCIPLES, THE PURSUIT OF PROFESSIONAL EXCELLENCE AND CONSCIENTIOUS STEWARDSHIP. WE HELP OUR COMMUNITY ACHIEVE THE HIGHEST ATTAINABLE LEVEL OF HEALTH THROUGH PREVENTION, EDUCATION, AND TREATMENT. false false 191793378 0 220604149 EXPENSES INCURRED IN PROVIDING MEDICALLY NECESSARY OUTPATIENT SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. PLEASE REFER TO THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT INCLUDED IN SCHEDULE O. 174847734 0 143735940 EXPENSES INCURRED IN PROVIDING MEDICALLY NECESSARY INPATIENT SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. PLEASE REFER TO THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT INCLUDED IN SCHEDULE O. 15854999 0 21005963 EXPENSES INCURRED IN PROVIDING MEDICALLY NECESSARY EMERGENCY DEPARTMENT SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. 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DURING 2020, THE ORGANIZATION PAID AN INDEPENDENT FIRM FOR LOBBYING AND OTHER CONSULTING SERVICES. A PORTION OF THE AMOUNTS PAID TO THIS ORGANIZATION HAS BEEN ALLOCATED TO LOBBYING ACTIVITIES PERFORMED ON BEHALF OF THE ORGANIZATION. DURING 2020, THIS ALLOCATION AMOUNTED TO $64,500. IN ADDITION, HOLY NAME MEDICAL CENTER IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION ("AHA"), THE NEW JERSEY HOSPITAL ASSOCIATION ("NJHA") AND THE NEW JERSEY BUSINESS & INDUSTRY ASSOCIATION ("NJBIA") WHICH ALL ENGAGE IN LOBBYING EFFORTS ON BEHALF OF THEIR MEMBER HOSPITALS. A PORTION OF THE DUES PAID TO THESE ORGANIZATIONS HAS BEEN ALLOCATED TO LOBBYING ACTIVITIES PERFORMED ON BEHALF OF THE ORGANIZATION. THIS ALLOCATION AMOUNTED TO $21,602 DURING 2020. 17265260 1746802 1090762 1232212 18870612 17139015 2303074 1351808 3528637 17265260 17974962 3243196 -367084 3712059 17139015 13370743 7522236 616667 3534684 17974962 17784371 2830030 161879 7405537 13370743 1.00000 false false 7313472 7313472 224457753 141794378 82663375 3244188 2970389 273799 204841489 160579620 44261869 16164092 16164092 150676607 CASH & CASH EQUIV; LIM USE 3616513 F MUTUAL FUNDS-FIX INC; LIM USE 979363 F MUTUAL FUNDS - EQUITY; LIM USE 5657053 F EQUITIES; LIMITED USE 433837 F CORPORATE BONDS; LIMITED USE 1280726 F U.S. GOVT OBLIGATIONS; LIM USE -186900 F CERT OF DEPOSIT; LIMITED USE 1790932 F ALT INVESTMENTS; LIMITED USE 9949 F ACCRUED INTEREST; LIMITED USE 228 F CASH & CASH EQUIVALENTS 1316458 F MUTUAL FUNDS - FIXED INCOME 92699448 F MUTUAL FUNDS - EQUITY 36434295 F EQUITIES 2067304 F CORPORATE BONDS 11217608 F U.S. GOVERNMENT OBLIGATIONS 11062180 F CERTIFICATES OF DEPOSIT 289690 F ALTERNATIVE INVESTMENTS 695073 F ACCRUED INTEREST 117204 F ASSETS HELD BY RELATED ORG. 3705223 F 173186184 DUE FROM AFFILIATES 38490182 OTHER RECEIVABLES 17864023 OTHER ASSETS 14652565 RIGHT OF USE ASSETS 12310836 83317606 0 DUE TO THIRD-PARTY PAYORS 27733211 OPERATING LEASE LIABILITIES 12253783 CMS ADVANCE LIABILITY 48823000 OTHER LIABILITIES 7570810 96380804 SCHEDULE D, PART V; QUESTION 4 ENDOWMENT FUNDS ARE TO BE USED CONSISTENT WITH INTENT AND IN FURTHERANCE OF THE ORGANIZATION'S CHARITABLE TAX-EXEMPT PURPOSES. THE MEDICAL CENTER HAS ADOPTED INVESTMENT AND SPENDING POLICIES FOR ENDOWMENT ASSETS THAT ATTEMPT TO PROVIDE A PREDICTABLE STREAM OF FUNDING TO THE ENDOWMENT FUNDS. true true X true X true X 500. true true false false 3753719 375355 3378364 0.00760 59423559 37971244 21452315 0.04820 63177278 38346599 24830679 0.05580 1872081 1872081 0.00420 313981 313981 0.00070 50750724 20282444 30468280 0.06840 1114219 1114219 0.00250 392397 392397 0.00090 54443402 20282444 34160958 0.07670 117620680 58629043 58991637 0.13250 56298 56298 0.00010 56298 56298 0.00010 true 12503224 3003832 127323407 170177406 -42853999 X true true BERGEN RENAL CARE CENTER LLC HEALTHCARE SERVICES 0.06 0.35 BERGEN RENAL HOME PD CENTER LLC HEALTHCARE SERVICES 0.06 0.35 1 1 HOLY NAME MEDICAL CENTER 718 TEANECK ROAD TEANECK NJ 07666 WWW.HOLYNAME.ORG 10205 X X X 1 HOLY NAME MEDICAL CENTER 1 false false true X X X X X X X X X 19 true true true true X WWW.HOLYNAME.ORG X WWW.HEALTHYBERGEN.ORG X X true 19 true WWW.HOLYNAME.ORG false true X 200. 500. X X X X X true true X X X true X WWW.HOLYNAME.ORG X WWW.HOLYNAME.ORG X WWW.HOLYNAME.ORG X X X X X X true X false X X X true X false false SCHEDULE H, PART V, SECTION B, QUESTION 5 WHILE CONDUCTING ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") HOLY NAME MEDICAL CENTER ("HNMC") TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTEREST OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY. THE ORGANIZATION'S CHNA INCORPORATES DATA FROM BOTH QUANTITATIVE AND QUALITATIVE SOURCES. QUANTITATIVE DATA INPUT INCLUDES PRIMARY RESEARCH (THE COMMUNITY HEALTH SURVEY) AND SECONDARY RESEARCH (VITAL STATISTICS AND OTHER EXISTING HEALTH-RELATED DATA). THESE QUANTITATIVE COMPONENTS ALLOW FOR COMPARISON TO BENCHMARK DATA AT THE COUNTY, STATE AND NATIONAL LEVELS. QUALITATIVE DATA INPUT INCLUDES PRIMARY RESEARCH GATHERED THROUGH AN ONLINE KEY INFORMANT SURVEY OF VARIOUS COMMUNITY STAKEHOLDERS. KEY INFORMANT SURVEY -------------------- IN AN EFFORT TO SOLICIT INPUT FROM KEY INFORMANTS, THOSE INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY, THE ORGANIZATION UTILIZED A KEY INFORMANT SURVEY AS PART OF ITS CHNA PROCESS. A LIST OF RECOMMENDED PARTICIPANTS WAS PROVIDED BY THE PARTICIPATING HOSPITALS AND THE COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP ("CHIP") OF BERGEN COUNTY. THIS LIST INCLUDED NAMES AND CONTACT INFORMATION FOR PROVIDERS AND REPRESENTATIVES OF BEHAVIORAL HEALTH, CHILDREN AND FAMILIES, COMMUNITY CENTERS AND RECREATION, BERGEN COUNTY, VARIOUS MUNICIPALITIES, CULTURAL ADVOCATES AND ORGANIZATIONS FOOD RESOURCES, CLINICAL AND OTHER HEALTH SPECIALTIES, HOUSING AND HOMELESSNESS, LAW ENFORCEMENT, FIRE, EMS, OLDER ADULTS/HEALTHY AGING, PHILANTHROPY, RELIGIOUS OR FAITH-BASED ORGANIZATIONS, SERVICES FOR LOW-RESOURCE INDIVIDUALS AND FAMILIES AND A VARIETY OF OTHER COMMUNITY LEADERS. ADMINISTRATIVE AND CLINICAL LEADERSHIP FROM THE PARTICIPATING HOSPITALS WERE ALSO INCLUDED. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. KEY INFORMANTS WERE INTERVIEWED BY PHONE USING A STRUCTURED INTERVIEW GUIDE DEVELOPED BY JOHN SNOW, INC. ("JSI") AND THE CHNA STEERING COMMITTEE. IN ALL, APPROXIMATELY 80 COMMUNITY STAKEHOLDERS IN BERGEN COUNTY TOOK PART IN THE KEY INFORMANT SURVEY. IN THE PHONE SURVEY, KEY INFORMANTS WERE ASKED TO RATE THE DEGREE TO WHICH VARIOUS HEALTH ISSUES ARE A PROBLEM IN THEIR OWN COMMUNITY. FOLLOW-UP QUESTIONS ASKED THEM TO DESCRIBE WHY THEY IDENTIFY PROBLEM AREAS AS SUCH, AND HOW THESE MIGHT BE BETTER ADDRESSED. RESULTS OF THIS SURVEY ARE INCLUDED IN THE CHNA. PARTICIPATION INCLUDED REPRESENTATIVES OF THE ORGANIZATIONS LISTED BELOW: - OFFICE OF ALCOHOL AND DRUG DEPENDENCY, BERGEN COUNTY DEPT OF HEALTH SERVICES; - COMPREHENSIVE BEHAVIORAL HEALTH CARE; - DIVISION OF MENTAL HEALTH SERVICES, BERGEN COUNTY DEPT OF HEALTH SERVICES; - PARTNERSHIP FOR MATERNAL AND CHILD HEALTH; - PASCACK VALLEY HIGH SCHOOL; - CHILDREN'S AID AND FAMILY SERVICES; - DWIGHT MORROW ZONE, BERGEN FAMILY CENTER; - HACKENSACK SCHOOL DISTRICT; - COMMUNITY CENTERS AND RECREATION; - WESTWOOD RECREATION DEPARTMENT; - WYCKOFF BOARD OF HEALTH; - BERGEN COUNTY DIVISION OF COMMUNITY DEVELOPMENT; - TOWNSHIP OF TEANECK; - DIVISION OF DISABILITY SERVICES, BERGEN COUNTY DEPT OF HEALTH SERVICES; - PUBLIC HEALTH NURSE, CITY OF GARFIELD; - BERGEN COUNTY DEPARTMENT OF HEALTH SERVICES; - HEALTH AND HUMAN SERVICES COMMITTEE, BERGEN COUNTY LINKS; - HEALTH INSURANCE AGENT/INTERPRETER; - HEALTH AND WELLNESS COORDINATOR, GARDEN STATE EQUALITY; - MEALS ON WHEELS NORTH JERSEY; - REGISTERED DIETICIAN, SHOP RITE OF HILLSDALE; - REGISTERED DIETICIAN, SHOPRITE OF NORTHVALE; - VAN DYK HEALTH CARE; - BERGEN COUNTY CANCER EDUCATION AND EARLY DETECTION, BERGEN CO. DEPT. OF HEALTH SERVICES; - JEWISH HOME FAMILY; - AMERICAN CANCER SOCIETY; - BERGEN VOLUNTEER MEDICAL INITIATIVE; - CANCERCARE; - NORTH HUDSON COMMUNITY ACTION; - LEADERSHIP, BERGEN COUNTY HOSPITALS; - PHYSICIANS, BERGEN COUNTY HOSPITALS; - TRUSTEES, BERGEN COUNTY HOSPITALS; - ASIAN HEALTH SERVICES, HOLY NAME MEDICAL CENTER; - SENIOR HOUSING SERVICES; - BERGEN COUNTY HOUSING AUTHORITY; - RIDGECREST APARTMENTS; - WESTWOOD POLICE DEPARTMENT; - WESTWOOD FOR ALL AGES; - MIDLAND PARK SENIOR CENTER AND AGE-FRIENDLY RIDGEWOOD; - BERGEN COUNTY DIVISION OF SENIOR SERVICES; - AGE FRIENDLY ENGLEWOOD; - BERGEN COUNTY DIVISION OF SENIOR SERVICES; - THE RUSSELL BERRIE FOUNDATION; - RELIGIOUS OR FAITH-BASED INDIVIDUALS/REPRESENTATIVES; - FAMILY PROMISE OF RIDGEWOOD; - NORTH HUDSON COMMUNITY ACTION CORPORATION; AND - SOCIAL SERVICE ASSOCIATION OF RIDGEWOOD AND VICINITY. SCHEDULE H, PART V, SECTION B, QUESTIONS 7A & 7B THE ORGANIZATION IS AN AFFILIATE WITHIN HOLY NAME MEDICAL CENTER, INC. AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN SCHEDULE H, PART V, SECTION B, QUESTION 7A, IS THE HOME PAGE FOR THE SYSTEM. THE CHNA CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: WWW.HOLYNAME.ORG/INCLUDES/FILES/HNMC-CHNA-2019.PDF ADDITIONALLY, THE COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP OF BERGEN COUNTY'S CHNA, WHICH INCLUDES THIS ORGANIZATION, IS MADE WIDELY AVAILABLE AT THE FOLLOWING URL: WWW.HEALTHYBERGEN.ORG SCHEDULE H, PART V, SECTION B, QUESTION 7D IN ADDITION TO POSTING THE COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") ON THE MEDICAL CENTER'S WEBSITE AND MAKING A PAPER COPY AVAILABLE WITHIN THE HOSPITAL FACILITY, THE CHNA WAS DISCUSSED AT THE ANNUAL OPEN PUBLIC MEETING OF THE BERGEN COUNTY COMMUNITY HEALTH IMPROVEMENT PLAN AND WAS MADE AVAILABLE AT THE MEDICAL CENTER'S ANNUAL OPEN PUBLIC MEETING. SCHEDULE H, PART V, SECTION B, QUESTION 10A THE ORGANIZATION IS AN AFFILIATE WITHIN HOLY NAME MEDICAL CENTER, INC. AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN SCHEDULE H, PART V, SECTION B, QUESTION 10A, IS THE HOME PAGE FOR THE SYSTEM. THE MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: WWW.HOLYNAME.ORG/INCLUDES/FILES/2019-IMPLEMENTATION-STRATEGY.PDF SCHEDULE H, PART V, SECTION B, QUESTION 11 PRIORITY AREAS -------------- HOLY NAME'S CHNA PROVIDED MANY OPPORTUNITIES TO VET QUANTITATIVE AND QUALITATIVE FINDINGS. BASED ON THESE FINDINGS, HOLY NAME'S SERVICE LINES AND AREAS OF EXPERTISE, LEADERSHIP AND STAFF FROM HOLY NAME MEDICAL CENTER IDENTIFIED THREE COMMUNITY HEALTH PRIORITY AREAS, WHICH TOGETHER EMBODY THE LEADING HEALTH ISSUES AND BARRIERS TO CARE FOR RESIDENTS OF THE HOSPITAL'S SERVICE AREA: (1) CHRONIC/COMPLEX CONDITIONS AND RISK FACTORS; (2) SOCIAL DETERMINANTS OF HEALTH AND ACCESS TO CARE; AND (3) MENTAL HEALTH AND SUBSTANCE USE DISORDERS. PRIORITY POPULATIONS -------------------- BASED ON THE CHNA'S QUANTITATIVE AND QUALITATIVE FINDINGS, THERE WAS AGREEMENT THAT THE IMPLEMENTATION STRATEGY SHOULD PRIORITIZE CERTAIN DEMOGRAPHIC AND SOCIOECONOMIC SEGMENTS OF THE POPULATION THAT HAVE COMPLEX NEEDS OR FACE ESPECIALLY SIGNIFICANT BARRIERS TO CARE. FIVE PRIORITY POPULATIONS WERE IDENTIFIED: - INDIVIDUALS WITH CHRONIC/COMPLEX CONDITIONS; - OLDER ADULTS; - RACIALLY, ETHNICALLY & CULTURALLY DIVERSE POPULATIONS; - INDIVIDUALS WITH LIMITED RESOURCES; AND - YOUTH AND ADOLESCENTS. PRIORITY AREA #1: CHRONIC / COMPLEX CONDITIONS AND RISK FACTORS --------------------------------------------------------------- GOALS INCLUDE: (1) ENHANCE ACCESS TO HEALTH EDUCATION, SCREENING AND REFERRAL/TREATMENT SERVICES (2) SUPPORT INDIVIDUALS WITH CHRONIC/COMPLEX CONDITIONS AND THEIR CAREGIVERS (3) ENHANCE UNDERSTANDING OF END-OF-LIFE NEEDS AND CARE OBJECTIVES ADDRESSING THESE GOALS INCLUDE: - SCREEN FOR CHRONIC/COMPLEX CONDITIONS AND RISK FACTORS AND REFER TO APPROPRIATE SERVICES; - INCREASE THE NUMBER OF INDIVIDUALS WHO RECEIVE EDUCATION REGARDING CHRONIC/COMPLEX CONDITIONS AND RISK FACTORS; - INCREASE SKILLS, CONFIDENCE, AND ABILITIES OF PARENTS AND CAREGIVERS; - INCREASE THE NUMBER OF INDIVIDUALS FROM PRIORITY POPULATIONS ENGAGED IN CARE; - IMPROVE COORDINATION OF CARE FOR ADULTS WITH CHRONIC/COMPLEX CONDITIONS; - PROMOTE CHRONIC DISEASE MANAGEMENT AND BEHAVIORAL CHANGE; - INCREASE HEALTHY EATING AND PHYSICAL ACTIVITY; - INCREASE ACCESS TO END-OF-LIFE AND PALLIATIVE CARE PROGRAMS; - DECREASE SOCIAL ISOLATION AMONG OLDER ADULTS; - INCREASE THE NUMBER OF ADULTS WITH ADVANCE HEALTHCARE DIRECTIVES; AND - PROVIDE SUPPORT FOR THE HEALTH CARE OF IMPOVERISHED PERSONS IN MILOT, HAITI. PRIORITY AREA #2: SOCIAL DETERMINANTS OF HEALTH AND ACCESS TO CARE ------------------------------------------------------------------ GOALS INCLUDE: (1) ADDRESS THE SOCIAL DETERMINANTS OF HEALTH AND ACCESS TO CARE ISSUES THAT INHIBIT THE ABILITY OF INDIVIDUALS TO LEAD HAPPY, HEALTHY, AND PRODUCTIVE LIVES (2) REDUCE HEALTH DISPARITIES OBJECTIVES ADDRESSING THESE GOALS INCLUDE: - SUPPORT PROGRAMS AND POLICIES THAT ADDRESS THE SOCIAL DETERMINANTS OF HEALTH; - ADDRESS COMMON BARRIERS TO ACCESSING HEALTH CARE; - PROMOTE CARE COORDINATION AND ENGAGEMENT IN PRIMARY CARE; - PROMOTE CULTURAL COMPETENCY, HEALTH LITERACY, AND LINGUISTICALLY; APPROPRIATE CARE TO REDUCE HEALTH DISPARITIES AND TO INCREASE ACCESS TO SERVICES; - REDUCE INAPPROPRIATE USE OF THE EMERGENCY ROOM AND HOSPITAL READMISSIONS; AND - REDUCE TRANSPORTATION BARRIERS. PRIORITY AREA #3: MENTAL HEALTH AND SUBSTANCE ABUSE DISORDERS ------------------------------------------------------------- GOAL: (1) SUPPORT AND/OR IMPLEMENT STRATEGIES THAT PROMOTE MENTAL, EMOTIONAL, AND SOCIAL WELL-BEING OBJECTIVES ADDRESSING THIS GOAL INCLUDE: - ENHANCE IDENTIFICATION OF INDIVIDUALS WITH UNDIAGNOSED MENTAL AND BEHAVIORAL HEALTH CONDITIONS; - SUPPORT EFFORTS THAT AIM TO REDUCE THE STIGMA ASSOCIATED WITH MENTAL/BEHAVIORAL HEALTH AND SUBSTANCE USE DISORDER; - SUPPORT INITIATIVES THAT PROMOTE HEALTHY MENTAL, EMOTIONAL, AND SOCIAL BEHAVIORS; - EXPAND ACCESS TO BEHAVIORAL HEALTH SCREENING, TREATMENT, AND SUPPORTIVE SERVICES; - COLLABORATE WITH CLINICAL AND COMMUNITY-BASED PARTNERS TO ADDRESS MENTAL/BEHAVIORAL HEALTH AND SUBSTANCE USE DISORDER; AND - REDUCE USE OF OPIOIDS, ESPECIALLY OPIOID PRESCRIPTIONS ISSUED BY HNMC AND ITS AFFILIATES. NEEDS THAT WILL NOT BE ADDRESSED -------------------------------- THERE ARE ALSO COMMUNITY HEALTH NEEDS THAT WERE IDENTIFIED THROUGH HOLY NAME'S CHNA THAT WERE NOT PRIORITIZED FOR INCLUSION IN THE IMPLEMENTATION STRATEGY. REASONS FOR THIS INCLUDE: - FEASIBILITY OF HOLY NAME HAVING AN IMPACT ON THIS ISSUE IN THE SHORT OR LONG-TERM - SPECIFIC CAPABILITY OF THE ORGANIZATION - THE ISSUE IS ALREADY ADDRESSED BY COMMUNITY PARTNERS IN A WAY THAT DOES NOT WARRANT ADDITIONAL SUPPORT POVERTY/EMPLOYMENT, HOUSING STABILITY, AND CERTAIN LEVELS OF BEHAVIORAL AND SUBSTANCE ABUSE NEEDS WERE IDENTIFIED AS COMMUNITY NEEDS, BUT WERE DEEMED TO BE OUTSIDE OF HOLY NAME MEDICAL CENTER'S PRIMARY SPHERE OF INFLUENCE. HOLY NAME REMAINS OPEN AND WILLING TO WORK WITH HOSPITALS AND OTHER PUBLIC AND PRIVATE PARTNERS TO ADDRESS THESE ISSUES SHOULD AN OPPORTUNITY ARISE. HOLY NAME MEDICAL CENTER WILL STRIVE TO PROMOTE ITS MISSION: "WE ARE A COMMUNITY OF CAREGIVERS COMMITTED TO A MINISTRY OF HEALING, EMBRACING THE TRADITION OF CATHOLIC PRINCIPLES, THE PURSUIT OF PROFESSIONAL EXCELLENCE, AND CONSCIENTIOUS STEWARDSHIP. WE HELP OUR COMMUNITY ACHIEVE THE HIGHEST ATTAINABLE LEVEL OF HEALTH THROUGH EDUCATION, PREVENTION AND TREATMENT." IN CONCERT WITH THIS MISSION, THE MEDICAL CENTER IS COMMITTED TO THE STRATEGIES OUTLINED BELOW AND INCLUDED WITHIN THE ORGANIZATION'S IMPLEMENTATION STRATEGY ACTION PLAN. SCHEDULE H, PART V, SECTION B, QUESTION 16 THE ORGANIZATION IS AN AFFILIATE WITHIN HOLY NAME MEDICAL CENTER, INC. AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN SCHEDULE H, PART V, SECTION B, QUESTION 16, IS THE HOME PAGE FOR THE SYSTEM. THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION AND PLAIN LANGUAGE SUMMARY ARE MADE WIDELY AVAILABLE ON THE ORGANIZATION'S WEBSITE. THESE DOCUMENTS CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: WWW.HOLYNAME.ORG/FINANCIAL/FINANCIAL-ASSISTANCE-POLICY.ASPX 9 ENGLEWOOD PULMONARY 200 GRAND AVENUE ENGLEWOOD NJ 07631 OUTPATIENT SERVICES - PULMONARY VILLA MARIA CLAIRE 12 WEST SADDLE RIVER ROAD SADDLE RIVER NJ 07458 HOSPICE FACILITY HNMC RADIOLOGY & ADULT CLINIC 222 CEDAR LANE TEANECK NJ 07666 OUTPATIENT SERVICES - RADIOLOGY & CLINIC ORADELL REHAB 514 KINDERKAMACK ROAD ORADELL NJ 07649 OUTPATIENT SERVICES - REHABILITATION HN INSTITUTE FOR WOUND HEALING 699 TEANECK ROAD TEANECK NJ 07666 OUTPATIENT SERVICES - WOUNDCARE HNH FITNESS LLC 514 KINDERKAMACK ROAD ORADELL NJ 07649 MEDICALLY BASED FITNESS CENTER UNION CITY LAB 408 37TH STREET 2ND FLOOR UNION CITY NJ 07087 LABORATORY HACKENSACK CARDIOLOGY 493 ESSEX STREET HACKENSACK NJ 07601 OUTPATIENT SERVICES - CARDIOLOGY UNION CITY CARDIOLOGY 529 39TH STREET UNION CITY NJ 07087 OUTPATIENT SERVICES - CARDIOLOGY SCHEDULE H, PART I; LINE 3C IN ADDITION TO THE FEDERAL POVERTY GUIDELINES, HOLY NAME MEDICAL CENTER USES OTHER FACTORS IN DETERMINING ELIGIBILITY CRITERIA FOR FREE AND DISCOUNTED CARE. OTHER FACTORS TO DETERMINE ELIGIBILITY INCLUDE: - ASSET LEVEL; - MEDICAL INDIGENCY; - INSURANCE STATUS; - UNDERINSURANCE STATUS; AND - RESIDENCY. ADDITIONAL INFORMATION WITH RESPECT TO HNMC'S ELIGIBILITY CRITERIA FOR FINANCIAL ASSISTANCE IS OUTLINED BELOW. NEW JERSEY CHARITY CARE ----------------------- NJ CHARITY CARE IS FREE OR REDUCED CHARGE CARE WHICH IS PROVIDED TO PATIENTS WHO RECEIVE INPATIENT AND OUTPATIENT SERVICES AT ACUTE CARE HOSPITALS THROUGHOUT THE STATE OF NEW JERSEY. CHARITY CARE IS AVAILABLE ONLY FOR EMERGENT OR MEDICALLY NECESSARY HOSPITAL CARE. SOME SERVICES SUCH AS PHYSICIAN FEES, ANESTHESIOLOGY FEES, RADIOLOGY INTERPRETATION, AND OUTPATIENT PRESCRIPTIONS ARE SEPARATE FROM HOSPITAL CHARGES AND MAY NOT BE ELIGIBLE FOR REDUCTION. IN ACCORDANCE WITH CHARITY CARE GUIDELINES, PAYMENT ASSISTANCE IS AVAILABLE TO NEW JERSEY RESIDENT PATIENTS WHOSE HOUSEHOLD GROSS INCOME IS AT OR BELOW 300% OF THE FEDERAL POVERTY GUIDELINES AND WHO: 1. HAVE NO HEALTH COVERAGE OR HAVE COVERAGE THAT PAYS ONLY PART OF THE BILL; 2. ARE INELIGIBLE FOR ANY PRIVATE OR GOVERNMENTAL SPONSORED COVERAGE (SUCH AS MEDICAID): AND 3. MEET THE INCOME AND ASSETS CRITERIA DESCRIBED BELOW. CHARITY CARE IS AVAILABLE TO THOSE THAT DO NOT QUALIFY FOR STATE OR FEDERAL PROGRAMS. INCOME CRITERIA - PATIENTS WITH FAMILY GROSS INCOME LESS THAN OR EQUAL TO 200% OF THE FEDERAL POVERTY GUIDELINES ("FPG") ARE ELIGIBLE FOR 100% CHARITY CARE COVERAGE. PATIENTS WITH FAMILY GROSS INCOME GREATER THAN 200% BUT LESS THAN OR EQUAL TO 300% OF FPG ARE ELIGIBLE FOR DISCOUNTED CARE UNDER THE CHARITY CARE PROGRAM. FREE OR DISCOUNTED CHARGES ARE DETERMINED BY THE FOLLOWING FEE SCHEDULE: INCOME AS A PERCENTAGE OF HHS POVERTY INCOME GUIDELINES: LESS THAN OR EQUAL TO 200% -- 0% OF MEDICAID RATE GREATER THAN 200% BUT LESS THAN OR EQUAL TO 225% -- 20% OF MEDICAID RATE GREATER THAN 225% BUT LESS THAN OR EQUAL TO 250% -- 40% OF MEDICAID RATE GREATER THAN 250% BUT LESS THAN OR EQUAL TO 275% -- 60% OF MEDICAID RATE GREATER THAN 275% BUT LESS THAN OR EQUAL TO 300% -- 80% OF MEDICAID RATE GREATER THAN 300% -- UNINSURED DISCOUNT RATE AVAILABLE ASSETS CRITERIA - INDIVIDUAL ASSETS CANNOT EXCEED $7,500 AND FAMILY ASSETS CANNOT EXCEED $15,000. SHOULD AN APPLICANT'S ASSETS EXCEED THESE LIMITS, HE/SHE MAY "SPEND DOWN" THE ASSETS TO THE ELIGIBLE LIMITS THROUGH PAYMENT OF THE EXCESS TOWARD THE HOSPITAL BILL AND OTHER APPROVED OUT-OF-POCKET MEDICAL EXPENSES. CHARITY CARE MAY BE AVAILABLE TO NON-NEW JERSEY RESIDENTS, SUBJECT TO SPECIFIC PROVISIONS (SUCH AS EMERGENCY MEDICAL CONDITIONS). NEW JERSEY UNINSURED DISCOUNT CARE RATE --------------------------------------- UNINSURED NEW JERSEY STATE RESIDENT PATIENTS WHO DO NOT QUALIFY FOR CHARITY CARE AND WHOSE INCOME FALLS LESS THAN OR EQUAL TO 500% OF THE FEDERAL POVERTY GUIDELINES WILL BE ELIGIBLE FOR A DISCOUNT BASED UPON MEDICARE RATES AS PER THE NJ STATE STATUTE P.L. 2008, CHAPTER 60, APPROVED ON AUGUST 8, 2008, ASSEMBLY, NO. 2609, AS ENACTED BY THE SENATE AND GENERAL ASSEMBLY OF THE STATE OF NEW JERSEY. COMPASSIONATE CARE DISCOUNT POLICY ---------------------------------- PATIENTS WHO DO NOT QUALIFY FOR ANY HEALTHCARE RELATED GOVERNMENTAL SPONSORED COVERAGE OR PROGRAMS UNDER HNMC'S FAP AND DO NOT HAVE PRIMARY INSURANCE COVERAGE WILL BE ELIGIBLE FOR OUR COMPASSIONATE CARE DISCOUNT POLICY. THIS DISCOUNT IS APPLIED AT THE TIME OF BILLING. THE COMPASSIONATE CARE DISCOUNT IS ONLY FOR UNINSURED PATIENTS AND IS NOT DEPENDENT ON INCOME OR ASSET CRITERIA, AND NO APPLICATION IS REQUIRED. IT IS FOR ALL SELF-PAY PATIENTS THAT DO NOT QUALIFY OR DO NOT CHOOSE TO APPLY FOR ANY HOSPITAL PAYMENT ASSISTANCE PROGRAMS. DISCOUNTS APPLIED ARE FOR OUTPATIENT DIAGNOSTIC TESTING SUCH AS RADIOLOGY OR LABORATORY SERVICES, AND A FLAT FEE RATE IS APPLIED TO LEVELS OF CARE SUCH AS AN INPATIENT (I.E. MEDICAL, SURGICAL, OR ICU) OR SAME DAY SURGERY. THE COMPASSIONATE CARE DISCOUNT DOES NOT APPLY TO BALANCES AFTER INSURANCE PAYMENTS, COSMETIC SURGERY, AND OTHER SPECIAL PROGRAMS. THIS DISCOUNT WILL BE APPLIED AT THE TIME OF BILLING. AMOUNT GENERALLY BILLED ("AGB") ------------------------------- PER INTERNAL REVENUE CODE 501(R)(5) CHARGES FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE FOR FAP-ELIGIBLE INDIVIDUALS UNDER HNMC'S FAP WILL BE LIMITED TO BUT NOT BILLED MORE THAN THE AMOUNTS GENERALLY BILLED TO INDIVIDUALS WHO HAVE INSURANCE COVERING SUCH CARE. SCHEDULE H, PART I, QUESTION 6A NOT APPLICABLE. SCHEDULE H, PART I, QUESTION 7 THE ORGANIZATION'S COST ACCOUNTING SYSTEM WAS UTILIZED. SCHEDULE H, PART II ACTIVITIES CLASSIFIED AS COMMUNITY BUILDING INCLUDE USE OF HOLY NAME MEDICAL CENTER'S FACILITY AND/OR EMPLOYEES TO SUPPORT EFFORTS THAT: - PROMOTE THE POSITIVE GROWTH OF THE COMMUNITY; - ASSIST DIVERSE GROUPS IN COMING TOGETHER FOR THE COMMUNITY'S SHORT AND LONG TERM BENEFIT; AND - SEEK TO PROTECT THE COMMUNITY FROM ANYTHING THAT COULD SIGNIFICANTLY AFFECT THE HEALTH AND WELL-BEING OF THE COMMUNITY. HNMC ALSO ASSISTS OTHER NON-PROFITS AND PROVIDES VARIOUS FORMS OF NON-MONETARY AID. IN ADDITION, EMPLOYEES ARE PERMITTED TO ASSIST VALID NON-PROFIT ORGANIZATIONS DURING PAID WORK TIME. AMONG THE ORGANIZATIONS AIDED ARE: NURSING HOMES, BOY SCOUTS, HOUSES OF WORSHIP, COMMUNITY SERVICE GROUPS, ROTARY CLUBS, POLICE GROUPS, ENVIRONMENTAL GROUPS AND SCHOOLS. HNMC ALSO ALLOWS THE PUBLIC TO USE VARIOUS MEETING ROOMS (IN NON-CLINICAL AREAS) AND ITS CONFERENCE CENTER FOR EVENTS. CAREER DAYS ARE HELD FOR LOCAL HIGH SCHOOLS, FOSTERING ENTRANCE OF INTERESTED AND APPLICABLE STUDENTS INTO THE HEALTH PROFESSIONS. HNMC WAS ONE OF NINE HOSPITALS IN NEW JERSEY DESIGNATED BY THE NEW JERSEY DEPARTMENT OF HEALTH ("NJDOH") AS A REGIONAL MEDICAL COORDINATION CENTER ("MCC"). THE ONLY FACILITY IN BERGEN COUNTY TO BE SO DESIGNATED, HNMC'S ON-CAMPUS MCC WAS ABLE TO BE ACTIVATED IN THE EVENT OF PUBLIC HEALTH EMERGENCIES AND/OR A TERRORIST ATTACK CAUSING MASS CASUALTY INCIDENTS, INFECTIOUS OR COMMUNICABLE DISEASE OR OTHER TYPES OF PUBLIC HEALTH DISRUPTION. THE MCC ALSO MONITORED, ON A DAILY BASIS, SITUATIONAL AWARENESS OF LOCAL ACTIVITY. IN 2014, THE NJDOH LOST MUCH OF ITS FEDERAL FUNDING FOR THE STATEWIDE PROGRAM, CUTTING IN HALF THE NUMBER OF MCC'S IT COULD SUPPORT. HNMC CHOSE NOT TO APPLY TO RENEW ITS DESIGNATION BUT HAS MAINTAINED MOST OF ITS CAPABILITIES ON ITS OWN. GIVEN HNMC'S PROXIMITY TO NEW YORK CITY (I.E., FIVE MILES NORTH OF THE GEORGE WASHINGTON BRIDGE) EMERGENCY PREPAREDNESS IS DEEMED NECESSARY TO ENSURE THE HEALTH AND WELL-BEING OF THE COMMUNITY, REGARDLESS OF THE MCC DESIGNATION. SCHEDULE H, PART III, SECTION A, QUESTIONS 2, 3 & 4 BAD DEBT EXPENSE WAS CALCULATED USING THE PROVIDERS' BAD DEBT EXPENSE FROM ITS FINANCIAL STATEMENTS, NET OF ACCOUNTS WRITTEN OFF AT CHARGES. HNMC AND ITS AFFILIATES PREPARE AND ISSUE AUDITED CONSOLIDATED FINANCIAL STATEMENTS. THE BELOW WAS OBTAINED FROM THE FOOTNOTES TO THE AUDITED FINANCIAL STATEMENTS OF HNMC AND SUBSIDIARIES. PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT SERVICE REVENUE ----------------------------------------------------------- NET PATIENT SERVICE REVENUE IS REPORTED AT THE AMOUNT THAT REFLECTS THE CONSIDERATION FOR WHICH THE MEDICAL CENTER EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDING PATIENT CARE. THE MEDICAL CENTER USES A PORTFOLIO APPROACH AS A PRACTICAL EXPEDIENT 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 AND OUTPATIENT REVENUE. BASED ON HISTORICAL COLLECTION TRENDS AND OTHER ANALYSES, THE MEDICAL CENTER BELIEVES THAT REVENUE RECOGNIZED BY UTILIZING THE PORTFOLIO APPROACH APPROXIMATES THE REVENUE THAT WOULD HAVE BEEN RECOGNIZED IF AN INDIVIDUAL CONTRACT APPROACH WERE USED. THE MEDICAL CENTER'S INITIAL ESTIMATE OF THE TRANSACTION PRICE FOR THE SERVICES PROVIDED TO PATIENTS SUBJECT TO REVENUE RECOGNITION 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 THE MEDICAL CENTER'S STANDARD CHARGES. THE MEDICAL CENTER 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 PAYMENT PROGRAMS BELOW). THE ESTIMATES FOR CONTRACTUAL ALLOWANCES AND DISCOUNTS ARE BASED ON CONTRACTUAL AGREEMENTS, THE MEDICAL CENTER'S DISCOUNT POLICIES AND HISTORICAL EXPERIENCE. FOR UNINSURED AND UNDER-INSURED PATIENTS WHO DO NOT QUALIFY FOR CHARITY CARE, THE MEDICAL CENTER 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 THE MEDICAL CENTER'S HISTORICAL COLLECTION EXPERIENCE FOR APPLICABLE PATIENT PORTFOLIOS. GENERALLY, THE MEDICAL CENTER 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 THE MEDICAL CENTER. NET PATIENT SERVICE REVENUE FOR PERFORMANCE OBLIGATIONS SATISFIED OVER TIME IS RECOGNIZED BASED ON ACTUAL CHARGES INCURRED IN RELATION TO TOTAL CHARGES. THE MEDICAL CENTER 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 THE MEDICAL CENTER'S OUTPATIENT SETTINGS. THE MEDICAL CENTER MEASURES THE PERFORMANCE OBLIGATION FROM ADMISSION INTO THE MEDICAL CENTER 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. AS SUBSTANTIALLY ALL OF ITS PERFORMANCE OBLIGATIONS RELATE TO CONTRACTS WITH A DURATION OF LESS THAN ONE YEAR, THE MEDICAL CENTER HAS ELECTED TO NOT DISCLOSE THE AGGREGATE AMOUNT OF THE TRANSACTION PRICE ALLOCATED TO PERFORMANCE OBLIGATIONS THAT ARE UNSATISFIED OR PARTIALLY UNSATISFIED AT THE END OF THE REPORTING PERIOD. THE UNSATISFIED OR PARTIALLY UNSATISFIED PERFORMANCE OBLIGATIONS REFERRED TO ABOVE ARE PRIMARILY RELATED 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 THE MEDICAL CENTER'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 YEAR ENDED DECEMBER 31, 2020, CHANGES IN THE MEDICAL CENTER'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 AND THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AS OF AN FOR THE YEARS ENDED DECEMBER 31, 2020 AND 2019 WERE NOT SIGNIFICANT. THE MEDICAL CENTER 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. SCHEDULE H, PART III, SECTION B, QUESTION 8 MEDICARE COSTS WERE DERIVED FROM THE 2020 MEDICARE COST REPORT. THE ORGANIZATION FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL), BAD DEBT AND ASSOCIATED COSTS ARE COMMUNITY BENEFIT AND ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. AS OUTLINED MORE FULLY BELOW, THE ORGANIZATION BELIEVES THAT THESE SERVICES AND RELATED COSTS PROMOTE THE HEALTH OF THE COMMUNITY AS A WHOLE AND ARE RENDERED IN CONJUNCTION WITH THE ORGANIZATION'S CHARITABLE TAX-EXEMPT PURPOSES AND MISSION IN PROVIDING MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER WITHOUT REGARD TO RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY AND CONSISTENT WITH THE COMMUNITY BENEFIT STANDARD PROMULGATED BY THE IRS. THE COMMUNITY BENEFIT STANDARD IS THE CURRENT STANDARD FOR A HOSPITAL FOR RECOGNITION AS A TAX-EXEMPT AND CHARITABLE ORGANIZATION UNDER INTERNAL REVENUE CODE ("IRC") 501(C)(3). THE ORGANIZATION IS RECOGNIZED AS A TAX-EXEMPT ENTITY AND CHARITABLE ORGANIZATION UNDER 501(C)(3) OF THE IRC. ALTHOUGH THERE IS NO DEFINITION IN THE TAX CODE FOR THE TERM "CHARITABLE" A REGULATION PROMULGATED BY THE DEPARTMENT OF THE TREASURY PROVIDES SOME GUIDANCE AND STATES THAT "THE TERM CHARITABLE IS USED IN SECTION 501(C)(3) IN ITS GENERALLY ACCEPTED LEGAL SENSE,PROVIDES EXAMPLES OF CHARITABLE PURPOSES, INCLUDING THE RELIEF OF THE POOR OR UNPRIVILEGED; THE PROMOTION OF SOCIAL WELFARE; AND THE ADVANCEMENT OF EDUCATION, RELIGION, AND SCIENCE. NOTE IT DOES NOT EXPLICITLY ADDRESS THE ACTIVITIES OF HOSPITALS. IN THE ABSENCE OF EXPLICIT STATUTORY OR REGULATORY REQUIREMENTS APPLYING THE TERM "CHARITABLE" TO HOSPITALS, IT HAS BEEN LEFT TO THE IRS TO DETERMINE THE CRITERIA HOSPITALS MUST MEET TO QUALIFY AS IRC 501(C)(3) CHARITABLE ORGANIZATIONS. THE ORIGINAL STANDARD WAS KNOWN AS THE CHARITY CARE STANDARD. THIS STANDARD WAS REPLACED BY THE IRS WITH THE COMMUNITY BENEFIT STANDARD WHICH IS THE CURRENT STANDARD. CHARITY CARE STANDARD IN 1956, THE IRS ISSUED REVENUE RULING 56-185, WHICH ADDRESSED THE REQUIREMENTS HOSPITALS NEEDED TO MEET IN ORDER TO QUALIFY FOR IRC 501(C)(3) STATUS. ONE OF THESE REQUIREMENTS IS KNOWN AS THE "CHARITY CARE STANDARD." UNDER THE STANDARD, A HOSPITAL MUST PROVIDE, TO THE EXTENT OF ITS FINANCIAL ABILITY, FREE OR REDUCED-COST CARE TO PATIENTS WHO CANNOT PAY FOR SUCH SERVICES. A HOSPITAL THAT EXPECTED FULL PAYMENT DID NOT, ACCORDING TO THE RULING, PROVIDE CHARITY CARE BASED ON THE FACT THAT SOME PATIENTS ULTIMATELY FAILED TO PAY. THE RULING EMPHASIZED THAT A LOW LEVEL OF CHARITY CARE DID NOT NECESSARILY MEAN THAT A HOSPITAL HAD FAILED TO MEET THE REQUIREMENT SINCE THAT LEVEL COULD REFLECT ITS FINANCIAL ABILITY TO PROVIDE SUCH CARE. THE RULING ALSO NOTED THAT PUBLICLY SUPPORTED COMMUNITY HOSPITALS WOULD NORMALLY QUALIFY AS CHARITABLE ORGANIZATIONS BECAUSE THEY SERVE THE ENTIRE COMMUNITY AND A LOW LEVEL OF CHARITY CARE WOULD NOT AFFECT A HOSPITAL'S EXEMPT STATUS IF IT WAS DUE TO THE SURROUNDING COMMUNITY'S LACK OF CHARITABLE DEMANDS. COMMUNITY BENEFIT STANDARD IN 1969, THE IRS ISSUED REVENUE RULING 69-545, WHICH "REMOVED" FROM REVENUE RULING 56-185 "THE REQUIREMENTS RELATING TO CARING FOR PATIENTS WITHOUT CHARGE OR AT RATES BELOW COST." UNDER THE STANDARD DEVELOPED IN REVENUE RULING 69-545, WHICH IS KNOWN AS THE "COMMUNITY BENEFIT STANDARD," HOSPITALS ARE JUDGED ON WHETHER THEY PROMOTE THE HEALTH OF A BROAD CLASS OF INDIVIDUALS IN THE COMMUNITY. THE RULING INVOLVED A HOSPITAL THAT ONLY ADMITTED INDIVIDUALS WHO COULD PAY FOR THE SERVICES (BY THEMSELVES, PRIVATE INSURANCE, OR PUBLIC PROGRAMS SUCH AS MEDICARE), BUT OPERATED A FULL-TIME EMERGENCY ROOM THAT WAS OPEN TO EVERYONE. THE IRS RULED THAT THE HOSPITAL QUALIFIED AS A CHARITABLE ORGANIZATION BECAUSE IT PROMOTED THE HEALTH OF PEOPLE IN ITS COMMUNITY. THE IRS REASONED THAT BECAUSE THE PROMOTION OF HEALTH WAS A CHARITABLE PURPOSE ACCORDING TO THE GENERAL LAW OF CHARITY, IT FELL WITHIN THE "GENERALLY ACCEPTED LEGAL SENSE" OF THE TERM "CHARITABLE," AS REQUIRED BY THE DEPARTMENT OF TREASURY REG. 1.501(C)(3)-1(D)(2). THE IRS RULING STATED THAT THE PROMOTION OF HEALTH, LIKE THE RELIEF OF POVERTY AND THE ADVANCEMENT OF EDUCATION AND RELIGION, IS ONE OF THE PURPOSES IN THE GENERAL LAW OF CHARITY THAT IS DEEMED BENEFICIAL TO THE COMMUNITY AS A WHOLE EVEN THOUGH THE CLASS OF BENEFICIARIES ELIGIBLE TO RECEIVE A DIRECT BENEFIT FROM ITS ACTIVITIES DOES NOT INCLUDE ALL MEMBERS OF THE COMMUNITY, SUCH AS INDIGENT MEMBERS OF THE COMMUNITY, PROVIDED THAT THE CLASS IS NOT SO SMALL THAT ITS RELIEF IS NOT OF BENEFIT TO THE COMMUNITY. THE IRS CONCLUDED THAT THE HOSPITAL WAS "PROMOTING THE HEALTH OF A CLASS OF PERSONS THAT IS BROAD ENOUGH TO BENEFIT THE COMMUNITY" BECAUSE ITS EMERGENCY ROOM WAS OPEN TO ALL AND IT PROVIDED CARE TO EVERYONE WHO COULD PAY, WHETHER DIRECTLY OR THROUGH THIRD-PARTY REIMBURSEMENT. OTHER CHARACTERISTICS OF THE HOSPITAL THAT THE IRS HIGHLIGHTED INCLUDED THE FOLLOWING: ITS SURPLUS FUNDS WERE USED TO IMPROVE PATIENT CARE, EXPAND HOSPITAL FACILITIES, AND ADVANCE MEDICAL TRAINING, EDUCATION AND RESEARCH; IT WAS CONTROLLED BY A BOARD OF TRUSTEES THAT CONSISTED OF INDEPENDENT CIVIC LEADERS; AND HOSPITAL MEDICAL STAFF PRIVILEGES WERE AVAILABLE TO ALL QUALIFIED PHYSICIANS. THE AMERICAN HOSPITAL ASSOCIATION ("AHA") FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT ARE COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THIS ORGANIZATION AGREES WITH THE AHA'S POSITION. AS OUTLINED IN THE AHA'S LETTER TO THE IRS DATED AUGUST 21, 2007 WITH RESPECT TO THE FIRST PUBLISHED DRAFT OF THE NEW FORM 990 AND SCHEDULE H, THE AHA FELT THAT THE IRS SHOULD INCORPORATE THE FULL VALUE OF THE COMMUNITY BENEFIT THAT HOSPITALS PROVIDE BY COUNTING MEDICARE UNDERPAYMENTS (SHORTFALL) AS QUANTIFIABLE COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: - PROVIDING CARE FOR THE ELDERLY AND SERVING MEDICARE PATIENTS IS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD - MEDICARE, LIKE MEDICAID, DOES NOT PAY THE FULL COST OF CARE. FROM THE LATEST DATA PROVIDED BY THE AHA, MEDICARE REIMBURSES HOSPITALS ONLY 87 CENTS FOR EVERY DOLLAR THEY SPEND TO TAKE CARE OF MEDICARE PATIENTS. - MANY MEDICARE BENEFICIARIES, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR. MORE THAN 42 PERCENT OF MEDICARE SPENDING IS FOR BENEFICIARIES WHOSE INCOME IS BELOW 200 PERCENT OF THE FEDERAL POVERTY LEVEL. MANY OF THOSE MEDICARE BENEFICIARIES ARE ALSO ELIGIBLE FOR MEDICAID -- SO CALLED ELIGIBLE." THERE IS EVERY COMPELLING PUBLIC POLICY REASON TO TREAT MEDICARE AND MEDICAID UNDERPAYMENTS SIMILARLY FOR PURPOSES OF A HOSPITAL'S COMMUNITY BENEFIT AND INCLUDE THESE COSTS ON FORM 990, SCHEDULE H, PART I. MEDICARE UNDERPAYMENT MUST BE SHOULDERED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE COMMUNITY'S ELDERLY AND POOR. THESE UNDERPAYMENTS REPRESENT A REAL COST OF SERVING THE COMMUNITY AND SHOULD COUNT AS A QUANTIFIABLE COMMUNITY BENEFIT. BOTH THE AHA AND THIS ORGANIZATION ALSO FEEL THAT PATIENT BAD DEBT IS A COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. LIKE MEDICARE UNDERPAYMENT (SHORTFALLS), THERE ALSO ARE COMPELLING REASONS THAT PATIENT BAD DEBT SHOULD BE COUNTED AS QUANTIFIABLE COMMUNITY BENEFIT AS FOLLOWS: - A SIGNIFICANT MAJORITY OF BAD DEBT IS ATTRIBUTABLE TO LOW-INCOME PATIENTS, WHO, FOR MANY REASONS, DECLINE TO COMPLETE THE FORMS REQUIRED TO ESTABLISH ELIGIBILITY FOR HOSPITALS' CHARITY CARE OR THOSE WHO DO NOT PAY ALL, OR A PORTION OF THE ALREADY DISCOUNTED BILLED AMOUNTS UNDER OUR FINANCIAL ASSISTANCE POLICY. A 2006 CONGRESSIONAL BUDGET OFFICE ("CBO") REPORT, NONPROFIT HOSPITALS AND THE PROVISION OF COMMUNITY BENEFITS, CITED TWO STUDIES INDICATING THAT "THE GREAT MAJORITY OF BAD DEBT WAS ATTRIBUTABLE TO PATIENTS WITH INCOMES BELOW 200% OF THE FEDERAL POVERTY LINE." - THE REPORT ALSO NOTED THAT A SUBSTANTIAL PORTION OF BAD DEBT IS PENDING CHARITY CARE. UNLIKE BAD DEBT IN OTHER INDUSTRIES, HOSPITAL BAD DEBT IS COMPLICATED BY THE FACT THAT HOSPITALS FOLLOW THEIR MISSION TO THE COMMUNITY AND TREAT EVERY PATIENT THAT COMES THROUGH THEIR EMERGENCY DEPARTMENT, REGARDLESS OF ABILITY TO PAY. PATIENTS WHO HAVE OUTSTANDING BILLS ARE NOT TURNED AWAY, UNLIKE OTHER INDUSTRIES. BAD DEBT IS FURTHER COMPLICATED BY THE AUDITING INDUSTRY'S STANDARDS ON REPORTING CHARITY CARE. MANY PATIENTS CANNOT OR DO NOT PROVIDE THE NECESSARY, EXTENSIVE DOCUMENTATION REQUIRED TO BE DEEMED CHARITY CARE BY AUDITORS. AS A RESULT, ROUGHLY 40% OF BAD DEBT IS PENDING CHARITY CARE. THE CBO CONCLUDED THAT ITS FINDINGS "SUPPORT THE VALIDITY OF THE USE OF UNCOMPENSATED CARE [BAD DEBT AND CHARITY CARE] AS A MEASURE OF COMMUNITY BENEFIT" ASSUMING THE FINDINGS ARE GENERALIZABLE NATIONWIDE; THE EXPERIENCE OF HOSPITALS AROUND THE NATION REINFORCES THAT THEY ARE GENERALIZABLE. AS OUTLINED BY THE AHA, DESPITE THE HOSPITAL'S BEST EFFORTS AND DUE DILIGENCE, PATIENT BAD DEBT IS A PART OF THE HOSPITAL'S MISSION AND CHARITABLE PURPOSES. BAD DEBT REPRESENTS PART OF THE BURDEN HOSPITALS SHOULDER IN SERVING ALL PATIENTS RE SCHEDULE H, PART III, SECTION B, QUESTION 9B ACCOUNTS CONSIDERED TO BE CHARITY CARE ARE NOT INCLUDED IN THE BAD DEBT EXPENSE BUT, RATHER, ACCOUNTED FOR AS AN ALLOWANCE. IT IS THE POLICY OF HOLY NAME MEDICAL CENTER AND ITS SUBSIDIARIES TO TREAT ALL PATIENTS EQUALLY REGARDLESS OF INSURANCE AND THEIR ABILITY TO PAY. ADDITIONALLY, HNMC IS COMMITTED TO BILL PATIENTS AND INSURANCE CARRIERS IN A MANNER THAT IS UNDERSTANDABLE, PROFESSIONAL, COMPASSIONATE AND IN COMPLIANCE WITH ALL STATE, LOCAL AND FEDERAL RULES INCLUDING INTERNAL REVENUE CODE SECTION 501(R). IT IS THE INTENTION THAT THE BILLING AND COLLECTION POLICY BE CONSISTENT WITH HNMC'S FINANCIAL ASSISTANCE POLICY ("FAP") AND ANY INCONSISTENCIES SHALL BE GUIDED BY THE FAP AND APPLIED IN A MANNER THAT BENEFITS THE PATIENT. HNMC WILL FOLLOW THE FOLLOWING PROCEDURES WHEN PURSUING BILLING AND COLLECTION ACTIONS: (1) PATIENTS SHALL BE REGISTERED IN THE HOSPITAL'S INFORMATION SYSTEM IN A MANNER THAT ENSURES THE CAPTURE OF THE INFORMATION NECESSARY TO EFFECTIVELY PROVIDE MEDICALLY NECESSARY CARE AND TO PROFESSIONALLY BILL FOR SERVICES RENDERED; (2) AFTER SERVICES ARE RENDERED THE PATIENTS OR GUARANTOR'S INSURANCE (IF ANY) SHALL BE BILLED. IF THE PATIENT HAS NO INSURANCE AND WAS REGISTERED SELF-PAY THE BILL FOR SERVICES WILL BE ADJUSTED IN ACCORDANCE WITH THE HOSPITAL'S FAP; (3) THE HOSPITAL WILL MAKE REASONABLE EFFORTS TO COLLECT FROM AN INSURANCE CARRIER PRIOR TO BILLING THE PATIENT FOR SERVICES RENDERED. IF AFTER REASONABLE EFFORTS ARE MADE TO COLLECT FROM THE INSURANCE CARRIER THE HOSPITAL SHALL SEEK ASSISTANCE FROM THE PATIENT TO CONTACT THE INSURANCE CARRIER AND RESOLVE THE OUTSTANDING CLAIM. IF THESE EFFORTS ARE NOT SUCCESSFUL THEN THE ACCOUNT MAY BE CHANGED TO A SELF-PAY ACCOUNT; (4) AFTER THE ACCOUNT, OR ANY PORTION OF SUCH ACCOUNT, IS DEEMED SELF-PAY THE HOSPITAL, OR IT'S DESIGNATED AGENT, WILL BILL THE PATIENT OR GUARANTOR FOR THE REMAINING BALANCE ON THE ACCOUNT; (5) ACCOUNTS THAT ARE DEEMED SELF-PAY WILL RECEIVE UP TO FOUR STATEMENTS AND/OR NOTICES ASKING THAT THE ACCOUNT BALANCE BE PAID; (6) AFTER EXHAUSTING REASONABLE EFFORTS OVER A PERIOD OF UP TO 120 DAYS TO COLLECT A SELF-PAY BALANCE, THE HOSPITAL MAY REFER THE ACCOUNT TO A COLLECTION AGENCY. SUCH REFERRAL SHALL NOT BE DEEMED TO BE AN EXTRAORDINARY COLLECTION ACTION ("ECA"); (7) AN ACCOUNT WITH A COLLECTION AGENCY SHALL GENERALLY BE PURSUED UP TO 180 DAYS UNLESS, AFTER CONSULTING WITH THE HOSPITAL, IT IS DETERMINED TO MAINTAIN AN ACCOUNT BEYOND THAT TIMEFRAME. IF IT IS DETERMINED BY THE HOSPITAL'S PATIENT FINANCIAL SERVICES DEPARTMENT THAT THE ACCOUNT REQUIRES AN ECA, AND SUCH ACCOUNT MEETS THE REQUIREMENTS OF INTERNAL REVENUE CODE SECTION 501(R), INCLUDING BUT NOT LIMITED TO WAITING A MINIMUM OF 120 DAYS AFTER THE FIRST POST DISCHARGE BILL TO COMMENCE ECA ACTIVITIES, THE AGENCY SHALL NOTIFY THE PATIENT IN WRITING A MINIMUM OF 30 DAYS PRIOR TO COMMENCING ECA. SUCH NOTIFICATION SHALL INCLUDE A COPY OF THE HOSPITALS PLAIN LANGUAGE SUMMARY OF THE FAP ALONG WITH A STATEMENT AS TO WHICH ECA'S THE AGENCY MAY BE TAKING. IF WITHIN THE 30 DAY NOTICE PERIOD THE PATIENT REQUESTS FINANCIAL ASSISTANCE, AND THE ACCOUNT IS NOT OLDER THAN 240 DAYS FROM THE FIRST POST DISCHARGE BILL, THEN THE PATIENT SHALL BE GIVEN TIME TO APPLY FOR FINANCIAL ASSISTANCE BEFORE ANY ECAS MAY BE INITIATED. IN THE EVENT THAT AN ECA HAS BEEN INITIATED AND THE ACCOUNT IS NOT OLDER THAN 240 DAYS FROM THE FIRST POST DISCHARGE BILLING DATE AND THE PATIENT REQUESTS FINANCIAL ASSISTANCE THEN THE ECA WILL BE SUSPENDED TO ALLOW FOR THE PATIENT TO APPLY FOR FINANCIAL ASSISTANCE. THE FIRST POST DISCHARGE BILL SHALL BE THE FIRST BILL A PATIENT RECEIVES FOR SERVICES REGARDLESS IF SERVICES ARE ONGOING. ECA'S THAT THE HOSPITAL OR ITS AGENTS MAY TAKE UPON THE EXPIRATION OF THE NOTIFICATION PERIOD INCLUDE: - REPORTING ADVERSE INFORMATION TO A CREDIT REPORTING AGENCY; - PLACING A LIEN ON PROPERTY; AND - GARNISHING WAGES. SCHEDULE H, PART VI, QUESTION 2 IN ACCORDANCE WITH PROVISIONS OF THE AFFORDABLE CARE ACT, ENACTED MARCH 23, 2010, HNMC BEGAN A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA"). THE ORGANIZATION'S 1ST CHNA WAS COMPLETED IN 2013, ITS 2ND IN 2016, AND ITS MOST RECENT IN 2019. A COMPLETE NEEDS ASSESSMENT IS PERFORMED EVERY THREE YEARS AND IS MADE WIDELY AVAILABLE ON THE ORGANIZATION'S WEBSITE. IN ADDITION TO THE CHNA PROCESS DESCRIBED ABOVE AND IN SCHEDULE H, SECTION B, QUESTIONS 1-12 AND SECTION C, HNMC UTILIZES A VARIETY OF MEANS BY WHICH IT IDENTIFIES AND ANALYZES PATIENT CARE NEEDS. AMONG THEM ARE: - PATIENT SATISFACTION DATA; - ANALYSIS OF DEMOGRAPHICS; - ANALYSIS OF UTILIZATION AND MARKET TRENDS; - REVIEW OF EXTERNALLY PUBLISHED DATA AND INFORMATION; - ACUITY LEVELS (DAILY PLANNING OF STAFFING); AND - INDIVIDUAL PROJECTS/EVALUATION/REVIEWS. HNMC ALSO COMMISSIONS EXTERNAL SPECIALISTS TO CONDUCT SURVEYS AND FOCUS GROUPS OF INDIVIDUALS, HOUSEHOLDS, PHYSICIANS AND OTHERS. ADDITIONALLY, HNMC IS A MEMBER OF THE BERGEN COUNTY COMMUNITY HEALTH IMPROVEMENT PROGRAM ("CHIP"), WHOSE MISSION IS TO EVALUATE AND ADDRESS THE HEALTH NEEDS OF THE COUNTY. THE CHIP PRODUCES AN EXTENSIVE, VERY USEFUL, DATABASE DEMONSTRATING THE NEEDS OF THE COUNTY'S RESIDENTS. HNMC IS A FOUNDING MEMBER OF THE NORTHERN NEW JERSEY MATERNAL-CHILD HEALTH CONSORTIUM (NOW THE PARTNERSHIP FOR MATERNAL AND CHILD HEALTH OF NORTHERN NEW JERSEY), WHOSE MISSION IS TO EDUCATE AND PROMOTE APPROPRIATE HEALTHCARE TO WOMAN AND INFANTS IN THE AREA. IN ADDITION, US CENSUS BUREAU DATA IS UTILIZED, AS IS PURCHASED MARKET DATA AND DATABASES OF ALL ACUTE AND SAME-DAY CARE THROUGHOUT BOTH NEW JERSEY AND NEW YORK, THE SOURCE OF WHICH IS BILLING DATA PROVIDED TO THE RESPECTIVE STATE DEPARTMENTS OF HEALTH. SUCH DATABASES PROVIDE PERHAPS THE GREATEST WEALTH OF CLINICAL, DEMOGRAPHIC, FINANCIAL AND OTHER INFORMATION, AND ARE EXTREMELY VALUABLE IN UNDERSTANDING AND ADDRESSING THE NEEDS OF THE COMMUNITIES SERVED BY HNMC. DATA FROM THE COUNTY AND STATE HEALTH DEPARTMENTS, AND FROM THE NEW JERSEY HOSPITAL ASSOCIATION, ARE ALSO USED. IN ADDITION, THE MEDICAL CENTER PARTICIPATES IN VARIOUS POPULATION HEALTH MODELS, AND HAS DONE SO SINCE 2013. AMONG THESE ARE THREE BUNDLED PAYMENT PROGRAMS AND A MEDICARE SHARED SAVINGS PROGRAM, AN ACO. IN ADDITION, THE HOSPITAL IS IN FIVE OTHER ACOS. THESE PROGRAMS PROIVDE CLAIMS DATA, WHICH ARE ANALYZED, PROVIDING VALUABLE INSIGHTS INTO CARE NEEDS AND INTO WAYS TO FACILITATE BETTER HEALTH AND HEALTH CARE WHILE REDUCING COSTS. SCHEDULE H, PART VI, QUESTION 3 IN ACCORDANCE WITH INTERNAL REVENUE CODE SECTION 501(R)(4) HOLY NAME MEDICAL CENTER INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE BY WIDELY PUBLICIZING THE AVAILABILITY OF FINANCIAL ASSISTANCE. THE AVAILABILITY OF FINANCIAL ASSISTANCE IS WIDELY PUBLICIZED IN THE FOLLOWING WAYS: 1) TO ENSURE THE COMMUNITY SERVED BY HNMC IS AWARE OF THE AVAILABILITY OF FINANCIAL ASSISTANCE, INFORMATIVE SIGNS AND POSTERS ARE POSTED IN ENGLISH, SPANISH AND KOREAN. THESE SIGNS AND POSTERS ADVISE PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE AND HOW TO APPLY IN PUBLIC ACCESS AREAS (EMERGENCY ROOM AND PATIENT ACCESS). 2) THE COMPLETE FINANCIAL ASSISTANCE POLICY ("FAP"), PLAIN LANGUAGE SUMMARY ("PLS") AND FINANCIAL ASSISTANCE APPLICATION FORM AS WELL AS THE CHARITY CARE APPLICATION IS AVAILABLE ON HNMC'S WEBSITE AT: WWW.HOLYNAME.ORG/FINANCIAL. 3) THE FAP, APPLICATION AND PLS ARE ALSO AVAILABLE UPON REQUEST A FREE COPY IS AVAILABLE BY MAIL OR IN HARD COPY FORM AT HNMC'S FINANCIAL COUNSELING OFFICE AND PATIENT ACCESS DEPARTMENT ON THE MAIN FLOOR. THE ORGANIZATION'S FINANCIAL COUNSELING OFFICE IS OPEN MONDAY THROUGH FRIDAY BETWEEN 8:30AM TO 2:30PM. AN APPOINTMENT MAY BE SCHEDULED BY CALLING (201) 833-3157. 4) DURING THE INTAKE REGISTRATION PROCESS, THE PLS IS PROVIDED TO ALL PATIENTS. 5) HNMC HAS TRANSLATED ITS FAP, FINANCIAL ASSISTANCE APPLICATION FORM, AND THE PLS IN OTHER LANGUAGES WHERE THE PRIMARY LANGUAGE OF THE RESIDENTS OF THE COMMUNITY SERVED BY HNMC REPRESENTS 5% OR 1,000; WHICHEVER IS LESS; OF THE POPULATION OF INDIVIDUALS LIKELY TO BE AFFECTED OR ENCOUNTERED BY HNMC. TRANSLATED VERSIONS ARE ALSO AVAILABLE UPON REQUEST AND ARE POSTED ON HNMC'S WEBSITE. IN CIRCUMSTANCES WHERE A SIGNIFICANT NUMBER OF PATIENTS ARE NOT PROFICIENT IN READING AND WRITING ENGLISH, OR WHOSE PRIMARY LANGUAGE IS OTHER THAN WHAT HNMC HAS ALREADY TRANSLATED, MAY REQUEST ASSISTANCE IN ORDER TO COMPLETE REQUIRED FORMS. SCHEDULE H, PART VI, QUESTION 4 LOCATED IN TEANECK, IN THE SOUTHERN PORTION OF BERGEN COUNTY AND APPROXIMATELY FIVE MILES TO THE NORTHWEST OF NEW YORK CITY, HNMC'S PRIMARY SERVICE AREA ("PSA") COMPRISES 15 MUNICIPALITIES IN BERGEN COUNTY AND 3 MUNICIPALITIES IN HUDSON COUNTY, NEW JERSEY. HNMC'S SECONDARY SERVICE AREA ("SSA") INCLUDES 17 MUNICIPALITIES IN BERGEN COUNTY AND 2 MUNICIPALITIES IN HUDSON COUNTY. TOGETHER, THE PSA AND SSA ACCOUNT FOR APPROXIMATELY 80 PERCENT OF THE MEDICAL CENTER'S ADMISSION VOLUME. AS THE SOLE CATHOLIC HOSPITAL IN AN AREA THAT IS ESTIMATED AT MORE THAN 50% ROMAN CATHOLIC, HNMC ALSO DRAWS FROM TOWNS WELL BEYOND BOTH THE PSA AND SSA. THE MAJORITY OF PSA TOWNS HAVE AN AVERAGE POPULATION OF 27,500, AND ARE LOCATED IN THE SOUTHERN HALF OF BERGEN COUNTY. OVERALL, THE SERVICE AREA IS 44% HISPANIC, ALTHOUGH THE PROPORTIONS DIFFER MARKEDLY BETWEEN BERGEN AND HUDSON: 76% OF THE RESIDENTS OF BERGEN PSA TOWNS ARE NOT HISPANIC; WHILE THE FOUR HUDSON COUNTY TOWNS TOGETHER COUNT 76% OF THEIR RESIDENTS AS HISPANIC. THE RACIAL MIX OF THE PSA IS APPROXIMATELY 60% WHITE, 22% ASIAN, 10% BLACK, AND 8% OTHER, INCLUDING MULTI-RACIAL PERSONS. CERTAIN TOWNS IN THE REGION ARE HEAVILY KOREAN; KOREAN/ASIAN PRESENCE IS MUCH LESS PRONOUNCED IN THE FOUR HUDSON COUNTY TOWNS. THE BROAD AGE MAKE-UP OF THE PRIMARY SERVICE AREA INCLUDES 23% AGED UP TO 19; 50% AGED 20-54; AND 27% AGED 55 AND OLDER. THE LAST CATEGORY IS PROJECTED TO SEE THE MOST SIGNIFICANT GROWTH DURING THE NEXT FIFTEEN YEARS. WITH THE EXCEPTION OF TWO HUDSON COUNTY TOWNS, ALL SSA ZIP CODES ARE LOCATED THROUGHOUT BERGEN COUNTY. THE TOWNS IN THIS SERVICE AREA ARE MUCH SMALLER THAN THOSE OF THE PSA, AVERAGING ONLY 14,000 RESIDENTS EACH. IN STARK CONTRAST TO THE LARGELY HISPANIC HUDSON COUNTY PSA TOWNS, THE TWO HUDSON SSA TOWNS ARE ONLY 20% HISPANIC. THE OVERALL RACIAL MIX OF THE SERVICE AREA IS 76% WHITE, 13% ASIAN, 4% BLACK, AND 7% OTHER, INCLUDING MULTI-RACIAL PERSONS. THE OVERALL KOREAN PRESENCE IS SIGNIFICANT, BUT ONLY HALF THAT SEEN IN THE PRIMARY SERVICE AREA. THE AREA'S AGE MIX IS SIMILAR TO THE PSA, WITH 23% AGED UP TO 19; 51% AGED 20-54; AND 26% AGED 55 AND OLDER. THE MEDICAL CENTER'S SERVICE AREA IS PRIMARILY SUBURBAN, WITH MANY RESIDENTS WORKING OUTSIDE BERGEN COUNTY IN PLACES SUCH AS NEW YORK CITY. HOWEVER, THERE ARE LARGE EMPLOYERS IN THE SERVICE AREA, E.G., OTHER HOSPITALS, A LARGE SPORTS CHAIN, A LARGE COMMUNICATIONS FIRM, A LARGE PHARMACEUTICAL FIRM, A UNIVERSITY, AND A LARGE COMMERCIAL LABORATORY. RESIDENTS OF HNMC'S SERVICE AREA ARE ALSO SERVED BY TWO COMMUNITY HOSPITALS AND A TERTIARY CARE FACILITY WITH TRAUMA SERVICES. GIVEN THE NUMBER OF SERVICE AREA RESIDENTS WHO WORK IN NEARBY NEW YORK CITY, IT IS NOT SURPRISING THAT A SMALL PORTION OF THESE RESIDENTS ALSO RECEIVE THEIR HEALTHCARE IN MANHATTAN. HNMC'S PSA AND SSA COVER A MAJORITY OF THE TOWNS SERVICED BY THE OTHER COMMUNITY HOSPITALS, WHEREAS THE TERTIARY CARE FACILITY'S PRIMARY SERVICE AREA ALSO INCLUDES MANY TOWNS TO THE WEST THAT ARE NOT PART OF HNMC'S SERVICE AREA. NEW JERSEY IS EXPERIENCING SIGNIFICANT CONSOLIDATION OF FORMERLY INDEPENDENT HOSPITALS INTO ANY OF THREE LARGE SYSTEMS. TWO OF THE THREE HOSPITALS WITHIN HNMC'S SERVICE AREA ARE PART OF NEW JERSEY'S LARGEST SYSTEM; THE THIRD IS AWAITING APPROVAL TO JOIN THEM. WHILE THE SERVICE AREA IS PREDOMINANTLY NON-HISPANIC CAUCASIAN, BOTH HISPANICS (OF ANY RACE) AND ASIAN POPULATIONS (PRINCIPALLY KOREAN) ARE THE FASTEST GROWING GROUPS. IN RESPONSE, THE MEDICAL CENTER HAS PROGRAMS ADDRESSING THESE GROUPS' NEEDS, AND PHYSICIANS AND NURSES FLUENT IN THE APPLICABLE LANGUAGES. IN 2008, APPROXIMATELY 75 KOREAN PHYSICIANS JOINED THE MEDICAL STAFF, ADDING TO THE NEED FOR STAFF AND SERVICES TO MEET THIS GROWING SEGMENT OF THE COMMUNITY. IN 2014, THE MEDICAL CENTER EXPANDED ITS KOREAN MEDICAL PROGRAM TO INCLUDE A FOCUS ON CHINESE AND FILIPINO RESIDENTS AS WELL, RENAMING THE SERVICE "ASIAN HEALTH SERVICES,THEREAFTER BOTH JAPANESE AND ASIAN INDIAN PROGRAMS WERE INCORPORATED AS WELL. SCHEDULE H, PART VI, QUESTION 5 HNMC PROMOTES THE HEALTH OF ITS COMMUNITIES IN A VARIETY OF WAYS. PLEASE REFER TO "PROMOTION OF COMMUNITY HEALTH" WITHIN THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT INCLUDED IN SCHEDULE O FOR ADDITIONAL INFORMATION. SCHEDULE H, PART VI; QUESTION 6 OUTLINED BELOW IS A SUMMARY OF THE ENTITIES WHICH COMPRISE HOLY NAME MEDICAL CENTER, INC. AND SUBSIDIARIES. NOT-FOR-PROFIT SYSTEM AFFILIATED ENTITIES ========================================= PEACE MINISTRIES, INC. ---------------------- PEACE MINISTRIES, INC. IS THE TAX-EXEMPT PARENT OF THE SYSTEM. THIS INTEGRATED HEALTHCARE DELIVERY SYSTEM CONSISTS OF A GROUP OF AFFILIATED HEALTHCARE ORGANIZATIONS. THE SOLE MEMBER OR STOCKHOLDER OF EACH ENTITY IS EITHER PEACE MINISTRIES, INC. OR HOLY NAME MEDICAL CENTER, INC. THE SYSTEM IS AN INTEGRATED NETWORK OF HEALTHCARE PROVIDERS IN THE STATE OF NEW JERSEY. THE PRIMARY ACTIVITY OF THE ORGANIZATION IS TO GOVERN, SUPPORT AND ADVOCATE FOR THE PUBLIC CHARITABLE MINISTRIES OF THE EASTERN REGION OF THE CONGREGATION OF THE SISTERS OF ST. JOSEPH OF PEACE. PEACE MINISTRIES, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(1). HOLY NAME MEDICAL CENTER ------------------------ HOLY NAME MEDICAL CENTER IS A COMPREHENSIVE, 361-BED ACUTE CARE FACILITY PROVIDING TECHNOLOGICALLY ADVANCED AND LEADING EDGE CARE ACROSS A CONTINUUM THAT ENCOMPASSES EDUCATION, PREVENTION, DIAGNOSIS, TREATMENT, REHABILITATION AND WELLNESS MAINTENANCE. OVER 1,000 PHYSICIANS, REPRESENTING DOZENS OF MEDICAL SPECIALTIES, PROVIDE PERSONAL ATTENTION IN A CULTURALLY SENSITIVE ENVIRONMENT, CREATING AN EXCEPTIONAL HEALTH CARE EXPERIENCE FOR EVERY PATIENT. HNMC IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, HNMC PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. MOREOVER, HNMC OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. 1. HNMC PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF-PAY, MEDICARE AND MEDICAID PATIENTS; 2. HNMC OPERATES AN ACTIVE EMERGENCY DEPARTMENT FOR ALL PERSONS; WHICH IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR; 3. HNMC MAINTAINS AN OPEN MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; 4. CONTROL OF HNMC RESTS WITH ITS BOARD OF TRUSTEES AND, TO THE EXTENT SET FORTH IN ITS BYLAWS, PEACE MINISTRIES, INC. HNMC'S BOARD IS COMPRISED OF INDEPENDENT CIVIC LEADERS AND OTHER PROMINENT MEMBERS OF THE COMMUNITY; AND 5. SURPLUS FUNDS ARE USED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND RENOVATE FACILITIES AND ADVANCE MEDICAL CARE; PROGRAMS AND ACTIVITIES. HOLY NAME HEALTH CARE FOUNDATION, INC. -------------------------------------- HOLY NAME HEALTH CARE FOUNDATION, INC. IS A NON-PROFIT CORPORATION THAT WAS ESTABLISHED TO RAISE FUNDS FOR THE MEDICAL CENTER AND ITS AFFILIATED ORGANIZATIONS. HOLY NAME HEALTH CARE FOUNDATION, INC. IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). HOLY NAME REAL ESTATE CORPORATION --------------------------------- HOLY NAME REAL ESTATE CORPORATION IS A NON-PROFIT CORPORATION WHICH WAS ORGANIZED TO OWN, LEASE AND OPERATE PROPERTY FOR THE BENEFIT OF THE MEDICAL CENTER AND ITS AFFILIATED ORGANIZATIONS. HOLY NAME REAL ESTATE CORPORATION IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). HOLY NAME EMS, INC. ------------------ HOLY NAME EMS, INC. IS A NON-PROFIT CORPORATION WHICH OWNS AND OPERATES THE MEDICAL CENTER'S BASIC LIFE SUPPORT ("BLS") AND ADVANCED LIFE SUPPORT ("ALS") MEDICAL INTENSIVE CARE VEHICLES AND SERVICES; HOLY NAME EMS, INC. IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). MS COMPREHENSIVE CARE CENTER ---------------------------- MS COMPREHENSIVE CARE CENTER IS A NON-PROFIT CORPORATION WHICH OFFERS COMPREHENSIVE MEDICAL, NURSING, BILLING, REHABILITATIVE, PSYCHOLOGICAL AND EDUCATIONAL CARE TO PATIENTS WITH MULTIPLE SCLEROSIS. MS COMPREHENSIVE CARE CENTER IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). THE CRUDEM FOUNDATION, INC. --------------------------- THE CRUDEM FOUNDATION, INC. IS A NON-PROFIT CORPORATION WHICH WAS ESTABLISHED TO RAISE FUNDS FOR THE HOSPITAL SACRE COEUR IN MILOT HAITI. THE CRUDEM FOUNDATION, INC. IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(1). HOLY NAME HEALTH PHYSICIANS, P.C. --------------------------------- HOLY NAME HEALTH PHYSICIANS, P.C. IS A NON-PROFIT PROFESSIONAL CORPORATION WHICH ENGAGES IN PROFESSIONAL MEDICAL HEALTHCARE SERVICES WHICH ARE HIGH QUALITY AND COST EFFECTIVE FOR THE BENEFIT OF THE COMMUNITY AND IN SUPPORT OF THE CHARITABLE PURPOSES OF HOLY NAME MEDICAL CENTER AND ITS AFFILIATES. HOLY NAME HEALTH PHYSICIANS, P.C. IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). HNH FITNESS, LLC ---------------- HNH FITNESS, LLC IS A SINGLE MEMBER LIMITED LIABILITY COMPANY WHOSE SOLE MEMBER IS HOLY NAME MEDICAL CENTER. THE ORGANIZATION OPERATES A MEDICALLY BASED FITNESS AND WELLNESS CENTER AND PHYSICAL THERAPY PRACTICE. HOLY NAME MEDICAL CENTER ACO, LLC --------------------------------- HOLY NAME MEDICAL CENTER ACO, LLC IS A SINGLE MEMBER LIMITED LIABILITY COMPANY WHOSE SOLE MEMBER IS HOLY NAME MEDICAL CENTER. THE ORGANIZATION OPERATES AS ACCOUNTABLE CARE ORGANIZATION. HARMONY HEALTH ALLIANCE, LLC ---------------------------- HARMONY HEALTH ALLIANCE, LLC IS A SINGLE MEMBER LIMITED LIABILITY COMPANY WHOSE SOLE MEMBER IS HOLY NAME MEDICAL CENTER. THE ORGANIZATION IS A CLINICALLY INTEGRATED NETWORK OF HEALTHCARE PROVIDERS WITH THE GOAL OF PROVIDING IMPROVED PATIENT CARE QUALITY, EXPERIENCE, EFFICIENCY AND ENGAGEMENT. FOR-PROFIT SYSTEM AFFILIATED ENTITIES ===================================== HEALTH PARTNER SERVICES, INC. ----------------------------- HEALTH PARTNER SERVICES, INC. IS A FOR-PROFIT CORPORATION ENGAGED IN PROVIDING MANAGEMENT SERVICES FOR HEALTHCARE PROVIDERS. PAIX TECHNOLOGIES, INC. ----------------------- PAIX TECHNOLOGIES, INC. IS A FOR-PROFIT CORPORATION ENGAGED IN SELLING A SOFTWARE LICENSE FOR DEVELOPED APPLICATIONS. HOLY NAME PHYSICIAN NETWORK --------------------------- THE HOLY NAME PHYSICIAN NETWORK WAS FORMED ACCORDING TO EACH GROUP'S SPECIALIZED PRACTICE. THE FOR-PROFIT ORGANIZATIONS WITHIN THE HOLY NAME PHYSICIAN NETWORK ARE OUTLINED BELOW: - PEACE HEALTH PARTNERS, P.C.; - HOUSE PHYSICIAN PARTNERS, P.C.; - HEMATOLOGY ONCOLOGY PARTNERS, P.C.; - RIVERSIDE FAMILY PRACTICE, P.C.; - RADIATION ONCOLOGY PARTNERS, P.C.; - EXCELCARE MEDICAL ASSOCIATES, P.A.; - BREAST IMAGING PARTNERS, P.C.; - HOLY NAME CARDIOLOGY ASSOCIATES, P.C.; - BREAST CARE PARTNERS, P.C.; - HOLY NAME PULMONARY ASSOCIATES, P.C.; - WOMEN'S CLINIC PARTNERS, P.C.; - MULKAY CARDIOLOGY CONSULTANTS AT HOLY NAME MEDICAL CENTER; - HOLY NAME PRIMARY CARE & SPECIALTY ASSOCIATES, P.C.; - PRIMARY CARE OF ORADELL; - HOLY NAME MEDICAL ASSOCIATES, P.C.; - NORTH JERSEY MEDICAL ASSOCIATES, P.C.; - NORTH JERSEY MEDICAL PARTNERS, P.C.; - HOLY NAME PHYSICIAN PARTNERS, P.C.; AND - HOLY NAME ANESTHESIA PARTNERS, P.C. THESE ORGANIZATIONS ENGAGE IN PROFESSIONAL MEDICAL HEALTHCARE SERVICES WHICH ARE HIGH QUALITY AND COST EFFECTIVE FOR THE BENEFIT OF THE COMMUNITY AND IN SUPPORT OF THE CHARITABLE PURPOSES OF HOLY NAME MEDICAL CENTER AND ITS AFFILIATES. SCHEDULE H, PART VI; QUESTION 7 NOT APPLICABLE. THE ENTITY AND RELATED PROVIDER ORGANIZATIONS ARE LOCATED IN NEW JERSEY. NEW JERSEY DOES NOT REQUIRE HOSPITALS TO ANNUALLY SUBMIT A COMMUNITY BENEFIT REPORT. true BERGEN CATHOLIC HIGH SCHOOL 1040 ORADELL AVENUE ORADELL NJ 07649 221599180 RELIGIOUS ORG 22207 PROGRAM SUPPORT CAUCUS EDUCATIONAL CORP 75 MIDLAND AVE MONTCLAIR NJ 07042 223240680 501(C)(3) 125000 PROGRAM SUPPORT HOLY NAME HEALTH CARE FOUNDATION INC 718 TEANECK ROAD TEANECK NJ 07666 222737143 501(C)(3) 15000 PROGRAM SUPPORT SAVE LATIN AMERICA 138 39TH STREET UNION CITY NJ 07087 222942402 501(C)(3) 26000 PROGRAM SUPPORT SINAI SPECIAL NEEDS INSTITUTE 1485 TEANECK RD STE 304 TEANECK NJ 07666 134198529 501(C)(3) 125000 PROGRAM SUPPORT TEMPLE EMANUEL OF THE PASCACK VALLEY 87 OVERLOOK DRIVE WOODCLIFF LAKE NJ 07677 226013926 RELIGIOUS ORG 10000 PROGRAM SUPPORT 6 0 NURSING SCHOLARSHIPS 106 107971 SCHEDULE I, PART I; QUESTION 2 GRANTS ARE MONITORED BY THE ORGANIZATION'S FINANCE PERSONNEL THROUGH THE UTILIZATION OF COST CENTERS AND OTHER INFORMATION; INCLUDING WRITTEN DOCUMENTATION AND RECEIPTS. SCHEDULE I, PART II PLEASE NOTE THAT CERTAIN GIFTS, GRANTS AND CONTRIBUTIONS PROVIDED TO OTHER ORGANIZATIONS WERE LESS THAN OR EQUAL TO $5,000 EACH. THEREFORE, IN ACCORDANCE WITH FORM 990 RULES AND REGULATIONS THOSE CONTRIBUTIONS WOULD NOT BE INCLUDED WITHIN IN SCHEDULE I, PART II. THE TOTAL AMOUNTS PAID FOR CONTRIBUTIONS AND EVENT SPONSORSHIPS CAN BE FOUND WITHIN CORE FORM, PART IX, LINE 1. X X X X X true true false false false false false true false MICHAEL MARON TRUSTEE - PRESIDENT & CEO 1278714 0 700000 0 41379 0 11400 0 18279 0 2049772 0 0 0 ADAM JARRETT MD FACHE EVP, CHIEF MEDICAL OFFICER 543363 0 300000 0 41103 0 154621 0 31961 0 1071048 0 0 0 SHERYL SLONIM DNP RN-BC EVP, PCS & CNO(RETIRED 1/8/20) 18237 0 100000 0 885585 0 672 0 1354 0 1005848 0 660189 0 MARYANN KICENUIK ESQ VP, GENERAL COUNSEL 609687 0 75000 0 44290 0 86400 0 18279 0 833656 0 0 0 RYAN KENNEDY CPA EVP/CFO, ASSIST. SEC/TREAS 478325 0 200000 0 22169 0 82385 0 31961 0 814840 0 0 0 SAIKRISHNAN KANDAMANGALAM EVP, CHIEF INFORMATION OFFICER 404382 0 100000 0 7424 0 11400 0 29261 0 552467 0 0 0 KRISTEN L SILBERSTEIN VP, PAYOR RELATIONS 360879 0 80000 0 3514 0 61400 0 31261 0 537054 0 0 0 STEVEN L MOSSER EVP, OPERATIONS 345629 0 75000 0 5844 0 11400 0 31961 0 469834 0 0 0 RON WHITE MD DIRECTOR, MEDICAL AFFAIRS 418280 0 10000 0 2926 0 11400 0 17343 0 459949 0 0 0 SEAN O'ROURKE VP, HEALTH PARTNERS SERVICES 342497 0 25000 0 6760 0 11400 0 31861 0 417518 0 0 0 RAVIT BARKAMA MD AVP, CLINICAL DEVELOPMENT 327688 0 25000 0 1680 0 11400 0 29101 0 394869 0 0 0 MICHELE ACITO DNP RN NE-BC EVP, CNO (EFF 06/28/20) 334439 0 25000 0 3752 0 11400 0 18146 0 392737 0 0 0 PHYLLIS MARINO MD MEDICAL DIRECTOR 274925 0 0 0 74702 0 9936 0 14217 0 373780 0 0 0 MICHAEL SKVARENINA FORMER KEY EMPLOYEE 278682 0 0 0 16288 0 5706 0 31961 0 332637 0 0 0 DAVID BUTLER MD TRUSTEE 0 213048 0 0 0 1391 0 4356 0 19579 0 238374 0 0 SCHEDULE J, PART I; QUESTION 4A THE FOLLOWING INDIVIDUAL INCLUDED IN SCHEDULE J, PART II RECEIVED A SEVERANCE PAYMENT DURING CALENDAR YEAR 2020 WHICH WAS INCLUDED IN HER 2020 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: PHYLLIS MARINO, M.D., $71,308. SCHEDULE J, PART I; QUESTION 4B THE AMOUNT REFLECTED IN SCHEDULE J, PART II, COLUMN B(III) FOR THE FOLLOWING INDIVIDUAL INCLUDES A CURRENT YEAR VESTING IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) AS THIS AMOUNT WAS NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THE AMOUNT OUTLINED HEREIN WAS INCLUDED IN HER 2020 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: SHERYL SLONIM, DNP, RN-BC, $827,313. THE DEFERRED COMPENSATION AMOUNTS REFLECTED IN SCHEDULE J, PART II, COLUMN C FOR THE FOLLOWING INDIVIDUALS INCLUDE UNVESTED BENEFITS IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) WHICH ARE SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THE INDIVIDUALS MAY NEVER ACTUALLY RECEIVE THIS UNVESTED BENEFIT AMOUNT. THE AMOUNTS OUTLINED HEREIN WERE NOT INCLUDED IN EACH INDIVIDUAL'S 2020 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: ADAM JARRETT, M.D., FACHE, $143,221; MARYANN KICENUIK, ESQ., $75,000; RYAN KENNEDY, CPA, $70,985 AND KRISTEN SILBERSTEIN, $50,000. SCHEDULE J, PART I; QUESTION 7 CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A BONUS DURING CALENDAR YEAR 2020 WHICH WAS INCLUDED IN SCHEDULE J, PART II, COLUMN B(II) HEREIN AND IN EACH INDIVIDUAL'S 2020 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT. SCHEDULE J, PART II, COLUMN F THE AMOUNTS REPORTED IN SCHEDULE J, PART II, COLUMN (F) INCLUDE VESTED BENEFITS IN A DEFERRED COMPENSATION PLAN AS THESE AMOUNTS WERE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. THESE AMOUNTS WERE REPORTED AS DEFERRED COMPENSATION ON PRIOR YEARS' FORMS 990 AND ARE NOW BEING REPORTED AGAIN ON THIS YEAR'S FORM 990. THESE HAVE BEEN TREATED AS TAXABLE INCOME AND REPORTED ON EACH INDIVIDUAL'S FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. A NJ HEALTH CARE FACILITIES FINANCING AUTHORITY 221987084 2016-07-12 54425000 SEE SUPPLEMENTAL INFO false false false B NJ HEALTH CARE FACILITIES FINANCING AUTHORITY 221987084 2020-04-02 19100000 SEE SUPPLEMENTAL INFO false false false A 7250000 0 54425000 0 0 0 597834 0 0 0 53827166 0 2016 false false true true B 0 0 19100000 0 0 0 233746 0 0 0 18866254 0 2020 true false true true A false true true true true true 0.00600 0.00000 0.00600 false false false true B false true true true true true 0.00600 0.00000 0.00600 false false false true A false true false false false false 0 false 0 false true B false true false false false false 0 false 0 false true A true B true SCHEDULE K SCHEDULE K, PART I, LINE A, COLUMN F PER THE ORGANIZATION'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS, THE PROCEEDS OF THE NEW JERSEY HEALTHCARE FACILITIES AUTHORITY SERIES 2016A & 2016B BOND FINANCING WERE USED TO FUND AND PAY IN FULL THE 2006 DEBT SERVICE RESERVE FUND, 2006 DEBT SERVICE PRINCIPAL FUND AND THE 2006 DEBT SERVICE INTEREST FUND FOR THE SERIES 2006 BONDS. SCHEDULE K, PART I, LINE B, COLUMN F PER THE ORGANIZATION'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS, THE PROCEEDS OF THE NEW JERSEY HEALTHCARE FACILITIES AUTHORITY SERIES 2020 BOND FINANCING WERE USED TO REFUND THE SERIES 2010 BONDS. MICHAEL MARON TRUSTEE/OFFICER SuppRetCASD X 27080087 27080087 false true true 27080087 PATRICK MARON FAMILY MEMBER OF OFFICER/TRUSTEE 125359 EMPLOYEE false BARBARA CARNEVALE FAMILY MEMBER OF TRUSTEE 74766 EMPLOYEE false SCHEDULE L, PART II, SUPPLEMENTAL RETIREMENT BENEFIT - CASD MICHAEL A. MARON, THE ORGANIZATION'S CEO, AGREED TO RELINQUISH BENEFITS TO WHICH HE WAS OTHERWISE ENTITLED IN EXCHANGE FOR A SPLIT DOLLAR LIFE INSURANCE RETENTION AND LOAN PLAN (THE PLAN). THIS EXCHANGE WAS DONE AT NO ADDED COST TO THE ORGANIZATION. THE ORGANIZATION WILL BE FULLY REPAID ITS LOANS, PLUS INTEREST, BY THE CEO OR HIS ESTATE. TO ENSURE REPAYMENT, THE LOAN IS SECURED BY COLLATERAL ASSIGNMENTS ON TWO LIFE INSURANCE POLICIES' CASH VALUE AND DEATH PROCEEDS. THE PLAN IS STRUCTURED TO PROVIDE THE ORGANIZATION WITH A SIGNIFICANT RETENTION INCENTIVE. THE ORGANIZATION'S ADVISORS HAVE OPINED THAT THIS NEW PROGRAM SATISFIES ALL APPLICABLE LAWS, COMPENSATION REASONABLESNESS AND BEST PRACTICE STANDARDS. CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS HOLY NAME MEDICAL CENTER ("HNMC") IS A PRIVATE, 361-BED NEW JERSEY-LICENSED GENERAL ACUTE CARE MEDICAL CENTER. THE MEDICAL CENTER IS A NON-PROFIT CORPORATION UNDER THE LAWS OF THE STATE OF NEW JERSEY, AND IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE BY VIRTUE OF BEING AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE CODE. PURSUANT TO ITS CHARITABLE PURPOSES, HNMC PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, GENDER IDENTITY, NATIONAL ORIGIN, AGE, DISABILITY OR ABILITY TO PAY. MOREOVER, HNMC OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN INTERNAL REVENUE SERVICE ("IRS") REVENUE RULING 69-545: 1. HNMC PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF-PAY, MEDICARE AND MEDICAID PATIENTS; 2. HNMC OPERATES AN ACTIVE EMERGENCY DEPARTMENT FOR ALL PERSONS, WHICH IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR; 3. HNMC MAINTAINS A MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; 4. CONTROL OF HNMC RESTS WITH ITS BOARD OF TRUSTEES AND, TO THE EXTENT SET FORTH IN ITS BYLAWS, PEACE MINISTRIES, INC. HNMC'S BOARD IS COMPRISED OF INDEPENDENT CIVIC LEADERS AND OTHER PROMINENT MEMBERS OF THE COMMUNITY; AND 5. SURPLUS FUNDS ARE USED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND RENOVATE FACILITIES AND ADVANCE MEDICAL CARE, PROGRAMS AND ACTIVITIES. THE OPERATIONS OF HNMC, AS SHOWN THROUGH THE FACTORS OUTLINED ABOVE AND OTHER INFORMATION CONTAINED HEREIN, CLEARLY DEMONSTRATE THAT HNMC PROVIDES SUBSTANTIAL COMMUNITY BENEFIT, THAT THE USE AND CONTROL OF HNMC IS FOR THE BENEFIT OF THE PUBLIC AND THAT NO PART OF THE INCOME OR NET EARNINGS OF THE ORGANIZATION INURES TO THE BENEFIT OF ANY PRIVATE INDIVIDUAL, NOR IS ANY PRIVATE INTEREST BEING SERVED OTHER THAN INCIDENTALLY. PEACE MINISTRIES, INC ("PMI") IS A NON-PROFIT CORPORATION UNDER THE LAWS OF THE STATE OF NEW JERSEY AND IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE BY VIRTUE OF BEING AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE CODE. PMI IS THE SOLE MEMBER OF THE MEDICAL CENTER. THIS TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM CONSISTS OF A GROUP OF AFFILIATED HEALTHCARE ORGANIZATIONS. THE SOLE MEMBER OF EACH ENTITY IS EITHER PMI OR HNMC. MISSION ======= WE ARE A COMMUNITY OF CAREGIVERS COMMITTED TO A MINISTRY OF HEALING, EMBRACING THE TRADITION OF CATHOLIC PRINCIPLES, THE PURSUIT OF PROFESSIONAL EXCELLENCE, AND CONSCIENTIOUS STEWARDSHIP. WE HELP OUR COMMUNITY ACHIEVE THE HIGHEST ATTAINABLE LEVEL OF HEALTH THROUGH EDUCATION, PREVENTION AND TREATMENT. HISTORY ======= THE MEDICAL CENTER WAS FOUNDED BY THE CONGREGATION OF THE SISTERS OF ST. JOSEPH OF PEACE (THE "SISTERS") IN 1925, AND IN 1958 WAS INCORPORATED AS AN INDEPENDENT NEW JERSEY NON-PROFIT CORPORATION, SPONSORED BY THE SISTERS. IT WAS THE DEDICATION OF TWO TEANECK SURGEONS AND THE LEADERSHIP OF A SISTER THAT MADE HNMC A REALITY IN 1925. RECOGNIZING THE NEED TO SERVE THE SICK AND INDIGENT OF THE COMMUNITY, DR. FRANK MCCORMACK AND DR. GEORGE PITKIN APPEALED TO MOTHER GENERAL AGATHA BROWN OF THE SISTERS FOR HELP IN FINDING A SUITABLE MEDICAL CENTER SITE AND PROVIDING ADMINISTRATIVE AND NURSING STAFF. THE SISTERS PURCHASED THE ESTATE OF THE LATE WILLIAM WALTER PHELPS AND ERECTED THE MEDICAL CENTER THERE, STAFFING IT WITH SISTERS. AT ITS OPENING IN 1925, HNMC HAD 115 BEDS. FIVE YEARS LATER, A 90-BED CLINIC BUILDING WAS BUILT TO MEET THE NEEDS OF AREA RESIDENTS WHO HAD BEEN IMPOVERISHED BY THE GREAT DEPRESSION. TEANECK WAS LITTLE MORE THAN A RURAL VILLAGE THEN; IN ALL OF BERGEN COUNTY THERE WERE SOME 250,000 INHABITANTS. WITH THE COMPLETION OF THE GEORGE WASHINGTON BRIDGE IN 1931, A SURGE OF DEVELOPMENT FOLLOWED WORLD WAR II AND THE AREA SOON BECAME A THRIVING RESIDENTIAL AND BUSINESS COMMUNITY. HNMC THRIVED AS WELL. IN 1955 A SECOND ADDITION WAS COMPLETED: THE FOUR-STORY, 110-BED MARIAN BUILDING, WITH TWO MORE STORIES ADDED TO THE FACILITY WITHIN THE NEXT TEN YEARS. DURING THE 1960'S, THE WEST WING OF THE MARIAN BUILDING WAS ENLARGED BY THREE MORE UNITS. FACED AGAIN WITH THE THREAT OF OVERCROWDING IN THE 1980'S, THE MEDICAL CENTER COMPLEX WAS ONCE MORE ENLARGED WITH CONSTRUCTION OF THE BRESLIN/KENNEDY BUILDING. IN 1993 THE "NEW ADDITION" WAS CONSTRUCTED, PRINCIPALLY TO ACCOMMODATE THE INCREASING AMBULATORY AND SAME-DAY-STAY PATIENTS, AND A NEW PHYSICAL MEDICINE BUILDING WAS ADDED. A FOUR-LEVEL REGIONAL CANCER CENTER WAS COMPLETED IN THE LATE 1990'S. MORE RECENT ADDITIONS INCLUDE A NEW 41-BAY EMERGENCY DEPARTMENT, A HEALTH AND FITNESS CENTER, AND A RESIDENTIAL HOSPICE, VILLA MARIE CLAIRE. THE MEDICAL CENTER HAS GROWN IN SIZE, REPUTATION AND CAPABILITY WITH EACH ADDITION. AS HNMC CELEBRATES OVER 95 YEARS, IT CONTINUES TO TAKE STEPS TO BECOME A NATIONAL MODEL BY IMPLEMENTING NEW, ADVANCED TECHNOLOGIES AND MEDICAL/SURGICAL TECHNIQUES, AS WELL AS BEST PRACTICES IN PROCESSES SUCH AS SIMULATION LEARNING, HEALTHCARE INFORMATION SYSTEMS, END-OF-LIFE CARE, DISASTER PREPAREDNESS, AND BUILDING CONSTRUCTION AND DESIGN. IMPROVEMENTS SUCH AS THESE ALLOW HNMC TO PROVIDE EVERY PATIENT WITH A SUPERIOR EXPERIENCE CHARACTERIZED BY SAFE, HIGH QUALITY CARE. LEADING-EDGE CARE ================= HNMC IS A COMPREHENSIVE, 361-BED ACUTE CARE FACILITY PROVIDING LEADING-EDGE MEDICAL PRACTICE AND TECHNOLOGY ADMINISTERED IN AN ENVIRONMENT ROOTED IN A TRADITION OF COMPASSION AND RESPECT FOR EVERY PATIENT. HNMC OFFERS HIGH QUALITY HEALTHCARE ACROSS A CONTINUUM THAT ENCOMPASSES EDUCATION, PREVENTION, EARLY INTERVENTION, COMPREHENSIVE TREATMENT OPTIONS, REHABILITATION, AND WELLNESS MAINTENANCE-FROM PRE-CONCEPTION THROUGH END-OF-LIFE. WITH MORE THAN 900 PHYSICIANS REPRESENTING DOZENS OF MEDICAL AND SURGICAL SPECIALTIES, HNMC PROVIDES AN EXCEPTIONAL HEALTHCARE EXPERIENCE FOR ITS PATIENTS. A FEW OF THE "CENTERS OF EXCELLENCE" AT HNMC INCLUDE: - THE PATRICIA LYNCH CANCER CENTER AT HOLY NAME (INCLUDING A NEW INFUSION CENTER AND GYNECOLOGICAL SPECIALTY); - INTERVENTIONAL INSTITUTE (OFFERING INNOVATIVE, NON-SURGICAL TREATMENT OPTIONS); - CARDIOVASCULAR SERVICES; - GEORGE P. PITKIN M.D. EMERGENCY CARE CENTER; - WOMEN'S AND CHILDREN'S HEALTH SERVICES; - HOSPICE AND PALLIATIVE CARE SERVICES, BOTH HOME-BASED AND RESIDENTIAL, INCLUDING VILLA MARIE CLAIRE, HNMC'S COMPREHENSIVE HOSPICE FACILITY IN SADDLE RIVER, NJ; - BREAST CENTER; AND - INSTITUTE FOR SIMULATION LEARNING. OTHER OUTSTANDING SERVICES INCLUDE, BUT ARE NOT LIMITED TO: - SPECIALTY SURGERY SERVICES WITH EXPERTISE IN MINIMALLY INVASIVE TECHNIQUES, INCLUDING ROBOTICS; - ADVANCED RADIOLOGICAL IMAGING; - REHABILITATION MEDICINE, AND SPORTS MEDICINE, ENCOMPASSING HNH FITNESS, HNMC'S MEDICALLY-BASED FITNESS CENTER IN ORADELL, NJ; - BARIATRIC MEDICINE; - CENTER FOR SLEEP MEDICINE; - MATERNAL-FETAL MEDICINE FOR HIGH-RISK AND COMPLICATED PREGNANCIES; - RENAL DIALYSIS; - THE NEW INSTITUTE FOR WOUND HEALING; - CULTURALLY AND LINGUISTICALLY-SENSITIVE HEALTH PROGRAMS, SUCH AS ASIAN HEALTH SERVICES, WHICH ADDRESSES KOREAN, CHINESE, JAPANESE, FILIPINO, AND ASIAN INDIAN NEEDS, AND THE HISPANIC OUTREACH PROGRAM, FAMILIA Y SALUD; - INSTITUTE FOR CLINICAL RESEARCH; - MULTIPLE SCLEROSIS CENTER; AND - THE SISTER CLAIRE TYNAN SCHOOL OF NURSING. CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS PROMOTION OF COMMUNITY HEALTH ============================= HNMC PROMOTES THE HEALTH OF ITS COMMUNITIES IN A VARIETY OF WAYS. THE MAJORITY OF THE BOARD OF TRUSTEES LIVE IN BERGEN COUNTY, NEW JERSEY, WHERE HNMC IS LOCATED, WITH MOST LIVING IN THE MUNICIPALITIES OF THE MEDICAL CENTER'S DEFINED SERVICE AREA. THE TRUSTEES' UNDERSTANDING OF THE SERVICE AREA IS THUS ENHANCED, AS IS THEIR UNDERSTANDING OF THE NEED TO REINVEST FUNDS IN IMPROVEMENTS IN PATIENT CARE, MEDICAL EDUCATION AND RESEARCH. AS PART OF ITS CHARITABLE PURPOSE, HNMC PROVIDES A WIDE ARRAY OF SERVICES TO THE COMMUNITY, TARGETED TOWARD IMPROVING THE HEALTH OF THE COMMUNITY. THE MAJORITY OF SUCH SERVICES ARE FREE. A SMALL SAMPLING OF SUCH ACTIVITIES IS PROVIDED BELOW. - FREQUENT HEALTH FAIRS THROUGHOUT THE REGION ARE GIVEN. AT THESE FAIRS RISK ASSESSMENTS, SCREENINGS AND LITERATURE ARE PROVIDED (MANY IN SPANISH AND KOREAN, AS WELL AS ENGLISH); - IMMUNIZATIONS ARE PROVIDED; - ENROLLMENT ASSISTANCE FOR PERSONS WHO WISH TO OBTAIN HEALTH INSURANCE (ANY TYPE) BUT WHO HAVE HAD DIFFICULTY DUE TO LANGUAGE OR OTHER BARRIERS. - NEED-BASED FREE AND/OR VERY LOW FEE TRANSPORTATION (E.G., FOR CANCER TREATMENT, DIALYSIS) IS AVAILABLE; - COMMUNITY HEALTH NURSES AND MOBILE LEARNING ARE ALSO PROVIDED; - STAFF FROM VARIOUS DEPARTMENTS THROUGHOUT THE MEDICAL CENTER VISIT LOCAL SCHOOLS TO PROVIDE HEALTH CLASSES; - SCREENINGS, E.G., BLOOD PRESSURE, CANCER, STROKE, DIABETES, PROSTATE CANCER, BREAST CANCER, OSTEOPOROSIS, PERIPHERAL ARTERY DISEASE, SKIN CANCER, COLON CANCER, AND OTHER CLINICAL SCREENING AND EDUCATION ARE PROVIDED, TYPICALLY AS PART OF COMMUNITY PROGRAMS SPECIFIC TO THE PARTICULAR DISEASE GROUP; - SENIOR CENTERS ARE SUPPORTED WITH FREE EXERCISE CLASSES, LECTURES AND SCREENINGS; - SUPPORT GROUPS ARE PROVIDED, SUCH AS CANCER, PERINATAL BEREAVEMENT, ADULT BEREAVEMENT, NEW MOTHERS, DIABETES, SMOKING, AND CARDIAC DISEASE; - HNMC'S ALS BIKE TEAM, ALS VEHICLES AND/OR SPECIAL OPERATIONS VEHICLES ARE PRESENT AT EVENTS OCCURRING IN MUNICIPALITIES IN HNMC'S SERVICE AREA WITHOUT CHARGE; - COURSES (PROVIDED EITHER FREE OR FOR A LOW FEE) ARE PROVIDED THROUGHOUT THE YEAR. EXAMPLES INCLUDE: CPR CERTIFICATION, DEFENSIVE DRIVING, GENERAL AND SPECIALTY (E.G., OSTEOPOROSIS) EXERCISE, BREASTFEEDING PREPARATION, STRESS MANAGEMENT, DIABETES SELF-MANAGEMENT, BABY CARE BASICS, WEIGHT MANAGEMENT, AND PARENTING; - CLASSES TO PROMOTE BETTER HEALTH ARE ABUNDANT: YOGA, WEIGHT REDUCTION, PILATES, STRENGTH AND BALANCE; OSTEOPOROSIS, PROPER HAND-WASHING, QI GONG AND TAI CHI, COOKING FOR CARDIAC PATIENTS; - LECTURES, OFTEN INVOLVING HNMC'S MEDICAL STAFF AS PRESENTERS, ARE PROVIDED, THE MAJORITY OF WHICH ARE FREE. MEN'S HEALTH, WOMEN'S HEALTH, A MID-LIFE AND MENOPAUSE LECTURE SERIES, SLEEP DISORDERS, ALLERGIES, DEPRESSION, ASTHMA, UTERINE FIBROIDS, COPD, STROKE, HYPERTENSION, MENTAL WELLNESS, CARDIAC ISSUES, ALZHEIMER'S, JOINT REPLACEMENT, SLEEP APNEA, CANCERS, CHILDREN'S HEALTH, DISASTER PREPAREDNESS, AND GENERAL HEALTH AND WELL-BEING ARE AMONG THE TOPICS PRESENTED; - HNMC'S WEBSITE (WWW.HOLYNAME.ORG) PROVIDES A WEALTH OF FREE CONSUMER HEALTH INFORMATION. THE SITE INCLUDES AN ON-LINE MEDICAL LIBRARY HOUSING INFORMATION ON DISEASES AND CONDITIONS, SURGERIES AND PROCEDURES, VITAMINS AND SUPPLEMENTS, NUTRITION, WELLNESS, AND A DRUG REFERENCE. ON-LINE RISK ASSESSMENTS AND QUIZZES ARE ALSO AVAILABLE, AS IS THE ABILITY TO SET UP A PERSONAL HEALTH PAGE. A KOREAN LANGUAGE VERSION IS ALSO AVAILABLE (WWW.KHOLYNAME.ORG). AN INTERACTIVE BODY GUIDE ("SYMPTOM CHECKER") ALLOWS THE USER TO RESEARCH HEALTH INFORMATION ABOUT THE SYMPTOMS THE USER IS EXPERIENCING; - BLOOD DRIVES ARE HOSTED REGULARLY AT HNMC. EACH YEAR THE MEDICAL CENTER CONTRIBUTES TO AIRFARE, SUPPLIES AND OTHER SUPPORT FOR HNMC NURSES AND DOCTORS TO TRAVEL TO THIRD WORLD COUNTRIES (E.G., HAITI) TO PROVIDE MEDICAL CARE, INCLUDING SURGERY, TO PERSONS WHO OTHERWISE WOULD NEVER RECEIVE ADEQUATE TREATMENT DUE TO POVERTY AND LACK OF ACCESS. HNMC SUPPORTS THE BERGEN VOLUNTEER MEDICAL INITIATIVE ("BVMI"), WHICH PROVIDES FREE CARE TO PERSONS IN NEED AND OTHER SIMILAR PROGRAMS. HOLY NAME ALSO PARTICIPATES IN THE WOMEN, INFANTS AND CHILDREN ("WIC") AND HEALTH START PROGRAMS, PROVIDING NUTRITIONAL AND SOCIAL SERVICES, ANCILLARY SERVICES AND OTHER PROGRAMS TO PARTICIPANTS. INEXPENSIVE MEDICALLY SUPERVISED DAY CARE FOR ILL CHILDREN IS AVAILABLE ON CAMPUS TO WORKING PARENTS IN THE COMMUNITY AFFORDING THEM THE ABILITY TO WORK EVEN WHEN A CHILD IS SICK. SENIOR OR DISABLED PERSONS REQUIRING MEDICAL DAY CARE ARE TRANSPORTED FREE OF CHARGE TO HNMC'S ADULT DAY CARE PROGRAM, REDUCING THE BURDEN ON FAMILY CARETAKERS. HNMC'S EMERGENCY DEPARTMENT ("ED") IS OPEN 24 HOURS A DAY, EVERY DAY OF THE YEAR. ALTHOUGH THE ED GENERALLY IS ABLE TO COVER ITS COSTS, IT PROVIDES A SIGNIFICANT AMOUNT OF UNCOMPENSATED CARE AND IS A WELL-USED RESOURCE FOR MANY WITHOUT INSURANCE WHO RELY ON IT FOR CARE. OTHER SERVICES, SUCH AS CLINICS, DO NOT COVER THEIR COSTS, AND HNMC ABSORBS THE ADDITIONAL EXPENSE. LANGUAGE INTERPRETATION IS AVAILABLE FOR APPROXIMATELY 220 LANGUAGES AT THE MEDICAL CENTER THROUGH USE OF A COMMERCIAL SERVICE THAT PROVIDES A LIVE TRANSLATOR 24/7, FREE OF CHARGE TO THE PATIENT AND FAMILY. HNMC HOSTS A PROGRAM ("PROJECT SEARCH") IN WHICH PERSONS AGED 18-22 WITH DISABILITIES WHO MIGHT OTHERWISE BE UNABLE TO OBTAIN EMPLOYMENT ARE TAUGHT MARKETABLE SKILLS VIA MENTORED ROTATIONS IN MANY OF THE MEDICAL CENTER'S DEPARTMENTS. A TEACHER IS PROVIDED BY BERGEN COUNTY. OTHERWISE, HNMC PROVIDES A DEDICATED CLASSROOM AND STAFF FROM SEPTEMBER THROUGH JUNE, OFFERING THREE ELEVEN-WEEK SUPERVISED ROTATIONS FOR EACH STUDENT. THIS VERY SUCCESSFUL PROGRAM HAS PROVIDED THESE STUDENTS WITH THE ABILITY TO SEEK JOBS, AND THE MEDICAL CENTER HAS ALSO HIRED SOME OF THE STUDENTS UPON COMPLETION. THE MEDICAL CENTER ABSORBS ALL COSTS WITHOUT REIMBURSEMENT. HNMC HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA. HNMC HAS INTENTIONALLY SOUGHT OUT PHYSICIANS FLUENT IN SPANISH AND WHO CARE FOR HISPANIC POPULATIONS, AND PROVIDES FREE TRANSPORTATION FOR SUCH POPULATIONS (AS WELL AS OTHERS) UNABLE TO ACCESS CARE ON THEIR OWN. HNMC HAS ALSO ADDED MANY KOREAN PHYSICIANS TO ITS MEDICAL STAFF AND PROVIDES A KOREAN CLINIC WEEKLY, WITH KOREAN SPEAKING PHYSICIANS (AND NURSES), AS THE ASIAN COMMUNITY IS ONE OF THE FASTEST GROWING SECTORS IN THE COUNTY. RECENT ADDITIONS OF STAFF TO SUPPORT THE EXPANDED CHINESE, JAPANESE, FILIPINO AND ASIAN INDIAN POPULATIONS ADDRESS NEEDS SPECIFIC TO THESE GROUPS. CARE IS PROVIDED IN A CULTURALLY SENSITIVE MANNER. THE INSTITUTE FOR CLINICAL RESEARCH AT HNMC PROVIDES EXCEPTIONAL INVESTIGATORS, FACILITIES, AND SERVICES FOR SPONSORING AGENCIES THAT SEEK TO ADVANCE PATIENT CARE THROUGH SUPERIOR CLINICAL RESEARCH. THE INSTITUTE IS DEDICATED TO CONDUCTING EXPEDITIOUS, HIGH-QUALITY CLINICAL TRIALS TO TEST NEW MEDICATIONS, DEVICES, DIAGNOSTIC MODALITIES AND TREATMENT PROTOCOLS. AS A DYNAMIC HEALTH CARE INSTITUTION THAT HAS RECEIVED MANY HONORS OF DISTINCTION FOR ITS CLINICAL EXCELLENCE AND COMPASSIONATE PATIENT CARE, HNMC IS WELL-SUITED TO PARTICIPATE IN THE QUEST FOR SCIENTIFIC BREAKTHROUGHS. HNMC'S STATE-OF-THE-ART FACILITIES MATCH THE HIGHEST STANDARDS FOR CARRYING OUT TODAY'S MOST PROMISING CLINICAL RESEARCH. THE INSTITUTE PROVIDES SPONSORS WITH RESEARCH SUPPORT THROUGHOUT ALL THE STAGES OF THEIR CLINICAL TRIALS. SINCE ITS INCEPTION, HNMC HAS BEEN ACTIVELY INVOLVED IN HEALTH PROFESSIONS EDUCATION, TRAINING, EDUCATING AND MENTORING HEALTHCARE PROFESSIONALS. THE HOLY NAME SCHOOL OF NURSING WAS FOUNDED IN 1925, WITH A DEDICATION TO FOSTERING THE WELL-BEING AND DIGNITY OF ALL INDIVIDUALS, SICK OR WELL. THE REGISTERED NURSE ("RN") PROGRAM IS A HIGHLY COMPETITIVE REGISTERED NURSE DIPLOMA PROGRAM, AND IS ACCREDITED WITH THE NEW JERSEY BOARD OF NURSING AND THE NATIONAL LEAGUE FOR NURSING ACCREDITING COMMISSION. IN 1972 THE SCHOOL EXPANDED TO INCLUDE A PRACTICAL NURSE ("LPN") PROGRAM AS WELL, WHICH IS A 12-MONTH PRACTICAL NURSE DIPLOMA PROGRAM ALSO ACCREDITED WITH THE NEW JERSEY BOARD OF NURSING. BOTH PROGRAMS CONTINUE TO SUPPLY THE REGION WITH HIGHLY SKILLED NURSES OF MANY ETHNICITIES AND AGE GROUPS. THE REGISTERED NURSE PROGRAM HAS A COLLABORATIVE AGREEMENT WITH SAINT PETER'S UNIVERSITY TO PROVIDE STUDENTS IN THE PROGRAM THE OPTION OF TAKING COLLEGE CREDITS, IN ADDITION TO THE BASIC CURRICULUM, TO EARN AN ASSOCIATE OF APPLIED SCIENCE (AAS) DEGREE IN HEALTH SCIENCES FROM SAINT PETER'S UNIVERSITY. HNMC ALSO SUPPORTS ITS COMMUNITY THROUGH THE USE OF THE MEDICAL CENTER'S FACILITY AND/OR EMPLOYEES TO SUPPORT EFFORTS THAT: PROMOTE THE POSITIVE GROWTH OF THE COMMUNITY; ASSIST DIVERSE GROUPS IN COMING TOGETHER FOR THE COMMUNITY'S SHORT AND LONG TERM BENEFIT; AND SEEK TO PROTECT THE COMMUNITY FROM ANYTHING THAT COULD SIGNIFICANTLY AFFECT THE HEALTH AND WELL-BEING OF THE COMMUNITY. CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS HNMC ALSO ASSISTS OTHER NON-PROFITS AND PROVIDES VARIOUS FORMS OF NON-MONETARY AID AS WELL. IN ADDITION, EMPLOYEES ARE PERMITTED TO ASSIST VALID NON-PROFIT ORGANIZATIONS DURING PAID WORK TIME. AMONG THE ORGANIZATIONS SO AIDED ARE NURSING HOMES, BOY SCOUTS, HOUSES OF WORSHIP, COMMUNITY SERVICE GROUPS, BATTERED WOMEN'S SHELTERS, ROTARY CLUBS, POLICE GROUPS, ENVIRONMENTAL GROUPS, SCHOOLS, AND NURSING HOMES. HNMC ALSO ALLOWS THE PUBLIC TO USE VARIOUS MEETING ROOMS (IN NON-CLINICAL AREAS) AND ITS CONFERENCE CENTER FOR EVENTS. CAREER DAYS ARE HELD FOR LOCAL HIGH SCHOOLS, FOSTERING ENTRANCE OF INTERESTED AND APPLICABLE STUDENTS INTO THE HEALTH PROFESSIONS. ALTHOUGH HNMC'S PARKING FEES ARE MINIMAL, FREE PARKING IS EXTENDED TO PERSONS IN NEED. SINCE 2012, THE MEDICAL CENTER HAS PROVIDED ASSISTANCE TO A HOSPITAL IN THE EARTHQUAKE-RAVAGED COUNTRY OF HAITI THROUGH CASH SUPPORT, PROVISION OF EQUIPMENT AND PERSONNEL WORKING TO REBUILD THE HOSPITAL'S OPERATIONS, AND THROUGH TRAINING HEALTH PROVIDERS WORKING AT THE HOSPITAL. AFFILIATIONS AND ACADEMIC RELATIONSHIPS ======================================= THE HNMC COMMUNITY ENJOYS ACADEMIC RELATIONSHIPS THAT PROVIDE AN EDUCATIONAL ENVIRONMENT FOR STUDENTS FROM A VARIETY OF HEALTHCARE PROFESSIONS: - AFFILIATION AGREEMENTS ARE MAINTAINED WITH BERGEN COMMUNITY COLLEGE (PARAMUS, NJ) FOR NURSING STUDENTS, AND FOR RADIOLOGY, ULTRASOUND, RESPIRATORY, AND SURGICAL TECHNICIANS. TRAINEES FROM RUTGERS UNIVERSITY (NEW BRUNSWICK, NJ) ARE PREDOMINANTLY DOCTOR OF PHARMACY STUDENTS WHO ARE COMPLETING ROTATIONS IN ACUTE CRITICAL CARE, INFECTIOUS DISEASE, ONCOLOGY, NEPHROLOGY, AND ADMINISTRATION. THE TRAINEES ARE SUPERVISED BY A CLINICAL CARE COORDINATOR FROM THE UNIVERSITY. STUDENTS FROM OTHER PROGRAMS MAY BE ACCEPTED AS WELL. ONE COMMUNITY HEALTH STUDENT ROTATES THROUGH HNMC AS WELL. - THE MEDICAL CENTER MAINTAINS A COLLABORATIVE AGREEMENT WITH ST. PETER'S UNIVERSITY (JERSEY CITY, NJ) TO PROVIDE THE OPTION FOR HOLY NAME SCHOOL OF NURSING STUDENTS TO TAKE ADDITIONAL COLLEGE CREDITS TO EARN AN ASSOCIATES OF APPLIED SCIENCE ("AAS") DEGREE IN HEALTH SCIENCES. THE AAS COMPLEMENTS THE DIPLOMA AWARDED FROM THE HOLY NAME SCHOOL OF NURSING. EMPLOYEES OF HNMC ARE ALSO ABLE TO CONTINUE THEIR STUDIES BY PURSUING BACHELOR'S (BSN), MASTER'S, AND ADVANCED PRACTICE NURSING DEGREES AT ST. PETER'S UNIVERSITY. IN THIS PROCESS, STUDENT EMPLOYEES WORK WITH VARIOUS ADMINISTRATIVE LEADERS WITHIN HNMC TO COMPLETE CLINICAL ROTATIONS. - UNDERGRADUATE, NURSE PRACTITIONER AND NURSING DOCTORAL STUDENTS FROM FAIRLEIGH DICKINSON UNIVERSITY ("FDU") COMPLETE ROTATIONS WITH OVERSIGHT FROM HNMC'S DEPARTMENT OF NURSING EDUCATION. IN ADDITION, THE MEDICAL CENTER HOSTS, AT NO CHARGE, CLASSES PROVIDED BY FDU FOR BOTH NURSES AND ADULT LEARNERS. - HNMC HAS A NUMBER OF OTHER ACADEMIC RELATIONSHIPS THROUGH WHICH IT SERVES AS AN EDUCATIONAL ENVIRONMENT FOR STUDENTS. AFFILIATION AGREEMENTS ARE MAINTAINED WITH SEVERAL COLLEGES AND UNIVERSITIES FOR NURSING STUDENTS, AND FOR RADIOLOGY, NUCLEAR MEDICINE, ULTRASOUND, RESPIRATORY, AND SURGICAL TECHNICIANS. TRAINEES FROM A UNIVERSITY WHO ARE PREDOMINANTLY DOCTOR OF PHARMACY STUDENTS COMPLETE ROTATIONS IN ACUTE CRITICAL CARE, INFECTIOUS DISEASE, ONCOLOGY, NEPHROLOGY, AND ADMINISTRATION. COMMUNITY HEALTH STUDENTS ROTATE THROUGH THE MEDICAL CENTER AS WELL. PHYSICAL AND/OR OCCUPATIONAL THERAPY STUDENTS FROM WITH TEN COLLEGES IN NEW JERSEY AND OTHER STATES COMPLETE CLINICAL ROTATIONS AT THE MEDICAL CENTER; HNMC EMPLOYEES SERVE AS SUPERVISORS AND CLINICAL INSTRUCTORS FOR THESE STUDENTS. UNDERGRADUATE, NURSE PRACTITIONER AND NURSING DOCTORAL STUDENTS FROM YET ANOTHER UNIVERSITY COMPLETE ROTATIONS WITH OVERSIGHT FROM HNMC'S DEPARTMENT OF NURSING EDUCATION. IN ALL CASES, INSTRUCTION AND OVERSITE ARE PROVIDED BY HNMC STAFF. - DURING CERTAIN YEARS STUDENTS FROM A PREPARATORY SCHOOL COMPLETE INTERNSHIPS AT THE MEDICAL CENTER IN VARIOUS DEPARTMENTS. TYPICALLY, SUCH STUDENTS ARE CONSIDERED DISADVANTAGED FROM A SOCIOECONOMIC STANDPOINT AND BENEFIT FROM THE COACHING RECEIVED FROM MEMBERS OF THE SENIOR ADMINISTRATIVE STAFF. THE STUDENTS SPEND ONE FULL DAY EACH WEEK AT HOLY NAME OVER THE COURSE OF A SEMESTER. EMERGENCY PREPAREDNESS ====================== HNMC WAS ONE OF NINE HOSPITALS IN NEW JERSEY DESIGNATED BY THE NEW JERSEY DEPARTMENT OF HEALTH ("NJDOH") AS A REGIONAL MEDICAL COORDINATION CENTER ("MCC"). THE ONLY FACILITY IN BERGEN COUNTY TO BE SO DESIGNATED, HNMC'S ON-CAMPUS MCC'S PURPOSE WAS ABLE TO BE ACTIVATED IN THE EVENT OF PUBLIC HEALTH EMERGENCIES AND/OR A TERRORIST ATTACK CAUSING MASS CASUALTY INCIDENTS, INFECTIOUS OR COMMUNICABLE DISEASE, OR OTHER TYPES OF PUBLIC HEALTH DISRUPTION. THE MCC ALSO MONITORED, ON A DAILY BASIS, SITUATIONAL AWARENESS OF LOCAL ACTIVITY. IN 2014, THE NJDOH LOST MUCH OF ITS FEDERAL FUNDING FOR THE STATEWIDE PROGRAM, CUTTING IN HALF THE NUMBER OF MCC'S IT COULD SUPPORT. HNMC CHOSE NOT TO APPLY TO RENEW ITS DESIGNATION BUT HAS MAINTAINED MOST OF ITS CAPABILITIES ON ITS OWN. GIVEN HNMC'S PROXIMITY TO NEW YORK CITY (I.E., FIVE MILES NORTH OF THE GEORGE WASHINGTON BRIDGE), EMERGENCY PREPAREDNESS IS DEEMED NECESSARY TO ENSURE THE HEALTH AND WELL-BEING OF THE COMMUNITY, REGARDLESS OF THE MCC DESIGNATION. HNMC HAS LONG BEEN RECOGNIZED BY STATE AND FEDERAL SECTORS FOR ITS EXPERTISE IN EMERGENCY PREPAREDNESS AND RESPONSE. HNMC HAS PARTICIPATED IN SEVERAL LARGE SCALE DISASTER DRILLS, AS WELL AS DRILLS CONDUCTED BY THE CENTERS FOR DISEASE CONTROL INVOLVING LOCAL, COUNTY, STATE, AND FEDERAL AGENCIES' EMERGENCY RESPONSE TO THREATS OF PUBLIC HEALTH SIGNIFICANCE. HNMC MAINTAINS ITS DESIGNATION BY THE FEDERAL DIVISION OF GLOBAL MIGRATION AND QUARANTINE TO DEAL WITH POSSIBLE COMMUNICABLE DISEASES AND ACTS OF BIOTERRORISM OCCURRING ON PUBLIC HEALTH CONVEYANCES. HNMC IS ALSO ACTIVE IN THE NORTHERN NEW JERSEY URBAN AREA SECURITY INITIATIVE. MEMBERS OF HOLY NAME EMS SERVE ON THE STATEWIDE NJ EMS TASK FORCE. THE MEDICAL CENTER MAINTAINS A SPECIAL OPERATIONS TEAM COMPRISED OF PARAMEDICS AND EMERGENCY MEDICAL TECHNICIANS WHO ARE READY TO RESPOND 24 HOURS A DAY, 7 DAYS A WEEK TO ASSIST LOCAL COMMUNITIES WITH EMERGENCIES. CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS CORONAVIRUS PANDEMIC ==================== Following the admission of our first COVID-19 positive patient on March 4, 2020, Holy Name Medical Center quickly became the epicenter of NJ's outbreak and one of the first and hardest hit hospitals in the country. With the COVID inpatient census doubling every four days to a peak of 251 inpatients, and thousands of virus-positive patients being monitored in their homes with telemedicine, Holy Name was "ground zero" of the pandemic. Holy Name's massive crisis response and management effort to confront unprecedented challenges resulted in a remarkable safety record to treat patients and to protect staff and patients. Less than 10 percent of all employees who were tested for COVID tested positive, and following the building of five new ICUs, not one employee tested positive. We retrofitted the medical center to build new ICUs to handle patient surge and to isolate COVID-positive patients. Over four weeks in March-April, our facilities team, with input from nursing and other clinicians, built five ICUs containing 75 beds. IVs, pumps, ventilators, monitors, and medication computers were placed outside rooms through punch-through ports, which safeguarded precious PPE and reduced the number of times clinical staff had to go inside. Overhead mirrors enabled caregivers outside to see patients' faces, while intercoms facilitated conversations. Additionally, we built 250 unique negative-pressure isopods from off-the-shelf materials readily available at building supply centers to surround COVID-positive patients for treatment and transportation and to protect staff. Also, 276 negative-pressure areas were constructed. As the pandemic continued, we developed new treatment protocols and participated in clinical trials as a result of Holy Name's high profile, which normally would have been reserved for large academic institutions, for remdesivir, blood plasma, Regeneron antibody cocktails, and Pluristem with placental stem cells, which Holy Name was the first in the country to use. In the beginning of June 2020 as we embarked upon a "new normal" on our road to recovery, we conducted a deep, rigorous cleaning of our 450,000 square feet of clinical and non-clinical space using manual disinfection, electrostatic sanitizing mist, and UV-C light. Our routine steps include rigorous cleaning and sterilizing in patient care locations; adopting new screening protocols and protection procedures for patients and staff; and separating non-COVID treatment areas from COVID treatment areas. We have carefully reopened to the public in phases, expanding services as public health guidelines permit. We are now scheduling elective surgeries and procedures; resuming many elective tests, such as mammograms and colonoscopies; and offering select in-person rehabilitation therapy services. To safeguard our patients and staff, we have instituted procedures for pre-registering, pre-admission COVID-19 testing, and entering all our facilities. Our website, www.holyname.org, contains crucial facts and information on COVID-19 to educate and inform the community. Additionally, we have a COVID-19 Toolkit on our website which provides information on COVID-19 vaccinations, testing, and treatments. Patients are able to schedule appointments for testing and vaccinations online as well as perform self-assessments to diagnose their symptoms. RECOGNITION =========== HNMC IS RECOGNIZED FOR ITS CLINICAL SKILL, QUALITY OUTCOMES AND HIGH RATE OF PATIENT SATISFACTION BY MULTIPLE NATIONAL ACCREDITATION AGENCIES AND BENCHMARKING ORGANIZATIONS. HNMC HOLDS MAGNET STATUS FOR OUTSTANDING NURSING CARE FROM THE AMERICAN NURSES CREDENTIALING CENTER ("ANCC"). THE MAGNET RECOGNITION PROGRAM WAS DEVELOPED BY THE ANCC TO RECOGNIZE HEALTHCARE ORGANIZATIONS THAT PROVIDE NURSING EXCELLENCE, AND TO PROVIDE A VEHICLE FOR DISSEMINATING SUCCESSFUL NURSING PRACTICES AND STRATEGIES. ONLY EIGHT PERCENT (8%) OF HOSPITALS NATIONWIDE ARE MAGNET RECOGNIZED HOSPITALS. ACCREDITED BY THE JOINT COMMISSION ("TJC") HNMC HAS ALSO RECEIVED TJC'S GOLD SEAL OF APPROVAL FOR HEALTHCARE QUALITY AND SAFETY FOR EACH OF HIP REPLACEMENT AND KNEE REPLACEMENT. HNMC IS ALSO CERTIFIED BY TJC AS A PRIMARY STROKE CENTER. HOLY NAME IS RECOGNIZED BY THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION AS A GOLD-PLUS, HONOR ROLL ELITE, PRIMARY STROKE CENTER AS PART OF THE "GET WITH THE GUIDELINES" PROGRAM, AND IS A BARIATRIC SURGERY CENTER OF EXCELLENCE, DESIGNATED AND ACCREDITED BY THE AMERICAN SOCIETY FOR METABOLIC AND BARIATRIC SURGERY ("MBSQIP"). HNMC IS DESIGNATED AS A CENTER OF EXCELLENCE BY AAGL (AMERICAN ASSOCIATION OF GYNECOLOGIC LAPAROSCOPISTS) FOR ITS MINIMALLY INVASIVE GYNECOLOGY SERVICE; BY SRC (SURGICAL REVIEW CORPORATION) FOR ITS ROBOTIC SURGERY PROGRAM; AND BY THE AMERICAN COLLEGE OF RADIOLOGY FOR BREAST IMAGING. HNMC HOLDS THE WOMEN'S CHOICE AWARDS FOR EACH OF "AMERICA'S BEST HOSPITALS FOR CANCER CARE,"AMERICAN'S BEST HOSPITALS FOR BARIATRIC SURGERY." HNMC HAS BEEN PRAISED REPEATEDLY AS AN EXEMPLARY WORKPLACE BY NJBIZ (THE LEADING WEEKLY BUSINESS PUBLICATION IN NEW JERSEY), WHICH CITES HNMC AS A TOP BUSINESS (ALL INDUSTRIES) IN ITS 50 BEST PLACES TO WORK IN NEW JERSEY PROGRAM, A DESIGNATION EARNED BY HNMC, AND BY NO OTHER HOSPITAL, FOR 14 YEARS IN A ROW. CORE FORM, PART III; LINE 4D EXPENSES INCURRED IN PROVIDING MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, GENDER IDENTITY, NATIONAL ORIGIN, AGE, DISABILITY OR ABILITY TO PAY. PLEASE REFER TO THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT INCLUDED IN SCHEDULE O. CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7 PEACE MINISTRIES, INC. IS THE SOLE MEMBER OF THIS ORGANIZATION. PEACE MINISTRIES, INC. HAS THE RIGHT TO ELECT THE MEMBERS OF THIS ORGANIZATION'S BOARD OF TRUSTEES AND HAS CERTAIN RESERVED POWERS AS DEFINED IN THIS ORGANIZATION'S BYLAWS. CORE FORM, PART VI, SECTION B; QUESTION 11B THE ORGANIZATION IS AN AFFILIATE WITHIN HOLY NAME MEDICAL CENTER, INC. AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THIS ORGANIZATION'S FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY, ITS BOARD OF TRUSTEES, PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE ("IRS"). IN ADDITION, THE ORGANIZATION'S AUDIT COMMITTEE HAS ASSUMED THE RESPONSIBILITY TO OVERSEE AND COORDINATE THE FEDERAL FORM 990 PREPARATION, REVIEW AND FILING PROCESS FOR ALL TAX-EXEMPT AFFILIATES WITHIN THE SYSTEM. AS PART OF THE ORGANIZATION'S FEDERAL FORM 990 TAX RETURN PREPARATION PROCESS THE SYSTEM HIRED A PROFESSIONAL CERTIFIED PUBLIC ACCOUNTING ("CPA") FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION TO PREPARE THE FEDERAL FORM 990. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE SYSTEM'S FINANCE PERSONNEL AND VARIOUS OTHER INDIVIDUALS INCLUDING, BUT NOT LIMITED TO, THE EXECUTIVE VICE PRESIDENT/CHIEF FINANCIAL OFFICER, ASSISTANT VICE PRESIDENT OF FINANCE AND EXECUTIVE DIRECTOR OF FINANCE ("INTERNAL WORKING GROUP") TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE INTERNAL WORKING GROUP, INCLUDING THOSE INDIVIDUALS OUTLINED ABOVE FOR THEIR REVIEW. THE INTERNAL WORKING GROUP REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE INTERNAL WORKING GROUP FOR FINAL REVIEW AND APPROVAL. FOLLOWING THIS REVIEW, THE FORM 990 WAS THEN PROVIDED TO THE ORGANIZATION'S AUDIT COMMITTEE AND SUBSEQUENTLY TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY PRIOR TO FILING WITH THE IRS. CORE FORM, PART VI, SECTION B; QUESTION 12 THE ORGANIZATION IS AN AFFILIATE WITHIN HOLY NAME MEDICAL CENTER, INC. AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE ORGANIZATION AND SYSTEM REGULARLY MONITOR AND ENFORCE COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. ANNUALLY ALL MEMBERS OF THE BOARD OF TRUSTEES, OFFICERS AND SENIOR MANAGEMENT PERSONNEL ARE REQUIRED TO REVIEW THE EXISTING CONFLICT OF INTEREST POLICY AND COMPLETE A QUESTIONNAIRE. THE COMPLETED QUESTIONNAIRES ARE RETURNED TO THE ORGANIZATION'S CHIEF COMPLIANCE OFFICER FOR REVIEW. THEREAFTER, THE CHIEF COMPLIANCE OFFICER PREPARES A SUMMARY OF THE COMPLETED QUESTIONNAIRES WHICH CONTAINS INFORMATION DISCLOSED ON AN INDIVIDUAL BY INDIVIDUAL BASIS WHICH IS THEN PRESENTED TO THE ORGANIZATION'S GOVERNANCE COMMITTEE FOR ITS REVIEW AND DISCUSSION. CORE FORM, PART VI, SECTION B; QUESTION 15 THE ORGANIZATION IS AN AFFILIATE WITHIN HOLY NAME MEDICAL CENTER, INC. AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE ORGANIZATION'S BOARD OF TRUSTEES HAS AN EXECUTIVE COMPENSATION COMMITTEE ("COMMITTEE"). THE COMMITTEE HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY WHICH IT FOLLOWS WHEN IT REVIEWS AND APPROVES THE COMPENSATION AND BENEFITS OF ALL HOLY NAME MEDICAL CENTER VICE PRESIDENTS AND ABOVE ("SENIOR MANAGEMENT PERSONNEL"). THIS INCLUDES BUT IS NOT LIMITED TO, THE OFFICERS AND KEY EMPLOYEES INCLUDED IN CORE FORM, PART VII OF THIS FEDERAL FORM 990. THE COMMITTEE REVIEWS THE "TOTAL COMPENSATION" OF THESE INDIVIDUALS WHICH IS INTENDED TO INCLUDE BOTH CURRENT AND DEFERRED COMPENSATION AND ALL EMPLOYEE BENEFITS, BOTH QUALIFIED AND NON-QUALIFIED. THE COMMITTEE'S REVIEW IS DONE ON AT LEAST AN ANNUAL BASIS AND ENSURES THAT THE "TOTAL COMPENSATION" OF SENIOR MANAGEMENT OF THE ORGANIZATION IS REASONABLE. THE ACTIONS TAKEN BY THE COMMITTEE ENABLE THE ORGANIZATION TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 4958 WITH RESPECT TO THE TOTAL COMPENSATION OF CERTAIN MEMBERS OF THE SENIOR MANAGEMENT TEAM. THE THREE FACTORS WHICH MUST BE SATISFIED IN ORDER TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS ARE THE FOLLOWING: 1. THE COMPENSATION ARRANGEMENT IS APPROVED IN ADVANCE BY AN "AUTHORIZED BODY" OF THE APPLICABLE TAX-EXEMPT ORGANIZATION WHICH IS COMPOSED ENTIRELY OF INDIVIDUALS WHO DO NOT HAVE A "CONFLICT OF INTEREST" WITH RESPECT TO THE COMPENSATION ARRANGEMENT; 2. THE AUTHORIZED BODY OBTAINED AND RELIED UPON "APPROPRIATE DATA AS TO COMPARABILITY" PRIOR TO MAKING ITS DETERMINATION; AND 3. THE AUTHORIZED BODY "ADEQUATELY DOCUMENTED THE BASIS FOR ITS DETERMINATION" CONCURRENTLY WITH MAKING THAT DETERMINATION. THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES EACH OF WHO ARE INDEPENDENT AND ARE FREE FROM ANY CONFLICTS OF INTEREST. THE COMMITTEE RELIED UPON APPROPRIATE COMPARABLE DATA; SPECIFICALLY THE COMMITTEE OBTAINED A WRITTEN COMPENSATION STUDY FROM AN INDEPENDENT FIRM WHICH SPECIALIZES IN THE REVIEWING OF HOSPITAL AND HEALTHCARE SYSTEM EXECUTIVE COMPENSATION AND BENEFITS THROUGHOUT THE UNITED STATES. THIS STUDY USED COMPARABLE GEOGRAPHIC AND DEMOGRAPHIC MARKET DATA INCLUDING BUT NOT LIMITED TO SIMILAR SIZED HOSPITALS, # OF LICENSED BEDS AND NET PATIENT SERVICE REVENUE. THE COMMITTEE ADEQUATELY DOCUMENTED ITS BASIS FOR ITS DETERMINATION THROUGH THE TIMELY PREPARATION OF WRITTEN MINUTES OF THE COMPENSATION COMMITTEE MEETINGS DURING WHICH THE EXECUTIVE COMPENSATION AND BENEFITS WAS REVIEWED AND SUBSEQUENTLY APPROVED. THE ACTIONS OUTLINED ABOVE WITH RESPECT TO THE COMMITTEE AND THE ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS ONLY APPLIES TO SENIOR MANAGEMENT PERSONNEL. THE COMPENSATION AND BENEFITS OF CERTAIN OTHER INDIVIDUALS WITHIN THE ORGANIZATION ARE REVIEWED ANNUALLY BY THE PRESIDENT/CHIEF EXECUTIVE OFFICER WITH ASSISTANCE FROM THE ORGANIZATION'S HUMAN RESOURCES DEPARTMENT IN CONJUNCTION WITH THE INDIVIDUAL'S JOB PERFORMANCE DURING THE YEAR AND IS BASED UPON OTHER OBJECTIVE FACTORS DESIGNED TO ENSURE THAT REASONABLE AND FAIR MARKET VALUE COMPENSATION IS PAID BY THE ORGANIZATION. OTHER OBJECTIVE FACTORS INCLUDE MARKET SURVEY DATA FOR COMPARABLE POSITIONS, INDIVIDUAL GOALS AND OBJECTIVES, PERSONNEL REVIEWS, EVALUATIONS, SELF-EVALUATIONS AND PERFORMANCE FEEDBACK MEETINGS. CORE FORM, PART VI, SECTION C; QUESTION 19 THE ORGANIZATION HAS ISSUED TAX-EXEMPT BONDS TO FINANCE VARIOUS CAPITAL IMPROVEMENT PROJECTS, RENOVATIONS AND EQUIPMENT. IN CONJUNCTION WITH THE ISSUANCE OF THESE TAX-EXEMPT BONDS, THE ORGANIZATION'S FINANCIAL STATEMENTS WERE INCLUDED WITH THE TAX-EXEMPT BOND PROSPECTUS WHICH WAS MADE AVAILABLE TO THE GENERAL PUBLIC FOR REVIEW. THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE STATE OF NEW JERSEY DEPARTMENT OF THE TREASURY. CORE FORM, PART VII AND SCHEDULE J CORE FORM, PART VII AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM THIS ORGANIZATION OR A RELATED ORGANIZATION. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OF THIS ORGANIZATION OR A RELATED ORGANIZATION AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THE ORGANIZATION'S BOARD OF TRUSTEES. CORE FORM, PART VII AND SCHEDULE J MICHAEL SKVARENINA, A FORMER KEY EMPLOYEE OF THE ORGANIZATION, IS STILL EMPLOYED WITHIN THE SYSTEM AS THE VICE PRESIDENT OF INFORMATION TECHNOLOGY. CORE FORM, PART VII AND SCHEDULE J MICHAEL MARON IS AN OFFICER OF THIS ORGANIZATION AND INVOLVED IN THE LEADERSHIP AND MANAGEMENT OF THIS ORGANIZATION. MR. MARON IS EMPLOYED BY THIS ORGANIZATION AND RECEIVES A FORM W-2. ACCORDINGLY, HIS COMMON LAW EMPLOYER/EMPLOYEE RELATIONSHIP IS WITH HOLY NAME MEDICAL CENTER (EIN: 22-1487322). HOLY NAME MEDICAL CENTER FILED A 2020 FORM 4720 WHICH INCLUDED A REMITTANCE OF EXCISE TAX RELATED TO MR. MARON'S COMPENSATION IN EXCESS OF $1M. CORE FORM, PART VII, SECTION A, COLUMN B THE ORGANIZATION IS AN AFFILIATE WITHIN HOLY NAME MEDICAL CENTER, INC. AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). CERTAIN BOARD OF TRUSTEE MEMBERS AND OFFICERS INCLUDED ON CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 MAY HOLD SIMILAR POSITIONS WITH BOTH THIS ORGANIZATION AND OTHER AFFILIATES WITHIN THE SYSTEM. THE HOURS SHOWN ON THIS FORM 990 FOR BOARD MEMBERS WHO RECEIVE NO COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, REPRESENTS THE ESTIMATED HOURS DEVOTED PER WEEK FOR THIS ORGANIZATION. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF TRUSTEES OF OTHER RELATED ORGANIZATIONS IN THE SYSTEM, THEIR RESPECTIVE HOURS PER WEEK PER ORGANIZATION ARE APPROXIMATELY THE SAME AS REFLECTED ON CORE FORM, PART VII OF THIS FORM 990. THE HOURS REFLECTED ON CORE FORM, PART VII OF THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, PAID OFFICERS AND KEY EMPLOYEES, REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF THE SYSTEM; NOT SOLELY THIS ORGANIZATION. CORE FORM, PART XI; QUESTION 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES INCLUDE: - CHANGE IN NET INTEREST OF HOLY NAME HEALTH CARE FOUNDATION, INC.; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION - ($829,592); AND - CHANGE IN BENEFICIAL INTEREST IN HOLY NAME HEALTH CARE FOUNDATION, INC.; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION - $1,403,311. CORE FORM, PART XII; QUESTION 2 THE ORGANIZATION IS AN AFFILIATE WITHIN HOLY NAME MEDICAL CENTER, INC. AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF HOLY NAME MEDICAL CENTER, INC. AND SUBSIDIARIES, FOR THE YEARS ENDED DECEMBER 31, 2020 AND DECEMBER 31, 2019; RESPECTIVELY. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAIN CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. THE INDEPENDENT CPA FIRM ISSUED AN UNMODIFIED OPINION WITH RESPECT TO THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS EACH YEAR. THE ORGANIZATION'S AUDIT COMMITTEE HAS ASSUMED RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE CONSOLIDATED FINANCIAL STATEMENTS, WHICH INCLUDES THIS ORGANIZATION AND THE SELECTION OF AN INDEPENDENT AUDITOR. CORE FORM, PART XII; QUESTION 3A THE ORGANIZATION IS AN AFFILIATE WITHIN HOLY NAME MEDICAL CENTER, INC. AND SUBSIDIARIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM ENGAGED AN INDEPENDENT CPA FIRM TO PREPARE AND ISSUE AN AUDIT UNDER THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133. 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