2020-11-16T10:58:38-06:00 2019-12-31 271728945 PKF O'CONNOR DAVIES LLP 300 TICE BOULEVARD SUITE 315 WOODCLIFF LAKE NJ 07677 990 2019-01-01 465285330 VALLEY PHYSICIANS SERVICES PC VALL 2012916000 15 ESSEX ROAD NO 506 PARAMUS NJ 07652 DAVID STRASSBERG MD PRESIDENT 2012916000 2020-11-16 1 EDWARD G O'CONNOR P00434443 2017129800 2020-11-10 2019 2022-09-23 18:48:47Z DAVID STRASSBERG MD 15 ESSEX ROAD NO 506 PARAMUS NJ 07652 162443746 0 X WWW.VALLEYHEALTH.COM X 2014 NJ VALLEY PHYSICIANS SERVICES, P.C. WAS FORMED TO PROVIDE MEDICAL CARE AND TO CARRY OUT THE PURPOSES OF THE VALLEY HEALTH SYSTEM, INC. 17 13 416 32 0 0 0 318156 149157797 162125590 0 0 0 0 149157797 162443746 0 25867861 0 0 111468504 114742256 0 0 0 37689293 22609366 149157797 163219483 0 -775737 14158195 20787942 19928708 27334192 -5770513 -6546250 TO ENGAGE IN THE RENDERING OF PROFESSIONAL SERVICES OF AND RELATED TO THE PRACTICE OF MEDICINE PURSUANT TO " THE PROFESSIONAL SERVICES CORPORATION ACT, AND TO SUPPORT AND CARRY OUT THE CHARITABLE PURPOSE OF VALLEY HEALTH SYSTEM, INC. 0 0 154546861 25867861 162443746 VALLEY PHYSICIAN SERVICES, P.C. RENDERED MEDICAL CARE TO A TOTAL OF 208,710 PATIENTS. MEDICAL CARE PROVIDED WERE IN THE FIELDS OF FAMILY MEDICINE, INTERNAL MEDICINE, CARDIOLOGY, OB/GYN, URGENT CARE AND ENDOCRINOLOGY. VALLEY PHYSICIAN SERVICES, P.C. ALSO PROVIDES STRATEGIC PROGRAMS TO VALLEY HOSPITAL, INC. 154546861 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 4 0 416 1 0 0 0 0 0 0 0 0 0 0 0 0 X 17 13 0 0 1 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 X MARIETTA STONE 2012916391 15 ESSEX ROAD PARAMUS NJ 07652 JOHN GONCALVES MD DIRECTOR CARDIAC SURGERY 40.00 X 2086864 0 32145 ALEX ZAPOLANSKI MD PHYSICIAN 40.00 X 1778994 0 33280 AUDREY MEYERS PRESIDENT & CEO 0.50 40.00 X X 0 1710491 43337 THOMAS AHLBORN MD CHAIR, SURGICAL SERVICES 40.00 X 1266827 0 32385 MICHAEL RAHMIN MD PHYSICIAN 40.00 X 989666 0 42479 GAIL MATTHEWS MD TREAS. THRU 6/30/19 & PHYSICIAN 40.00 0.50 X X 870941 0 20060 ROBERT KORST MD CHIEF OF ONCOLOGY SURGERY 40.00 X 844298 0 46859 MARC MELAMED MD SECY. THRU 5/21/19 & PHYSICIAN 40.00 0.50 X X 561230 0 25057 DAVID STRASSBERG MD PRES. THRU 6/30/19 & PHYSICIAN 40.00 0.50 X X 512917 0 20745 VINCENT FORLENZA CHAIRMAN 0.50 0.50 X X 0 0 0 FRANK SHEEHY VICE CHAIRMAN 0.50 0.50 X X 0 0 0 ANN LIMBERG SECRETARY 0.50 0.50 X X 0 0 0 JOSEPH MARION TREASURER 0.50 0.50 X X 0 0 0 JUDY BASELICE TRUSTEE 0.50 0.50 X 0 0 0 MICHELLE HASSON TRUSTEE 0.50 0.50 X 0 0 0 KEVIN LOBO TRUSTEE 0.50 0.50 X 0 0 0 BRUCE MACTAS TRUSTEE 0.50 0.50 X 0 0 0 BARNETT RUKIN TRUSTEE, THRU 12/18/19 0.50 0.50 X 0 0 0 DUANE SACHS TRUSTEE 0.50 0.50 X 0 0 0 DENIS SALAMONE TRUSTEE 0.50 0.50 X 0 0 0 SCOTT SCHROEDER TRUSTEE 0.50 0.50 X 0 0 0 EDWARD SELF MD TRUSTEE 0.50 0.50 X 0 0 0 STEVEN SILVERSTEIN TRUSTEE 0.50 0.50 X 0 0 0 JEFFREY TUCKER TRUSTEE 0.50 0.50 X 0 0 0 PATRICIA VERDUIN TRUSTEE 0.50 0.50 X 0 0 0 WAYNE WALD ESQ TRUSTEE 0.50 0.50 X 0 0 0 8911737 1710491 296347 304 0 1 0 SELTZER MD LAWRENCE 215 HARRISON AVE WESTFIELD NJ 07090 MEDICAL CONSULTANT 495044 PROGRESSIVE RADIOLOGY LLC 86 CLINTON AVE MONTCLAIR NJ 07042 MEDICAL CONSULTING 473000 2 318156 318156 NET PATIENT SERVICE REVENUE 624100 141032049 141032049 MEDICAL FEE REVENUE 624100 21093541 21093541 162125590 162443746 162125590 0 0 25867861 25867861 2010949 1946689 64260 104034345 100725232 3309113 2527715 2441899 85816 1861547 1790450 71097 4307700 4181414 126286 1870521 1870521 12597 12597 15890503 11265610 4624893 13004 13004 414268 33965 380303 33377 32473 904 4369 3297 1072 2886559 2886559 CONTINUING EDUCATION 926214 917336 8878 RECRUITMENT 489132 489132 BAD DEBT 62624 62624 MISCELLANEOUS 6198 6198 163219483 154546861 8672622 0 1323172 5372072 12806840 15415870 28183 14158195 20787942 19928708 27334192 19928708 27334192 X 0 0 0 0 -5770513 -6546250 -5770513 -6546250 14158195 20787942 -775737 0 X X 0 1 X 1 0 X 318156 318156 133265190 149157797 162125590 444548577 133265190 149157797 162443746 444866733 0 0 0 444866733 98304 98304 133363494 149157797 162443746 444965037 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 X 170314829 7871083 7871083 162443746 0 162443746 249080129 85860646 85860646 163219483 0 163219483 PART X, LINE 2: THE COMPANY RECOGNIZES THE BENEFIT FROM INCOME TAX POSITIONS TAKEN IN ITS INCOME TAX RETURNS ONLY WHEN THOSE POSITIONS ARE BELIEVED TO BE MORE LIKELY THAN NOT TO BE SUSTAINED UPON REVIEW BY THE TAX AUTHORITIES. VMG PROVIDES VALUATION ALLOWANCES FOR NET DEFERRED TAX ASSETS WHEN THE REALIZATION OF THE DEFERRED TAX ASSET IS UNCERTAIN. MANAGEMENT HAS DETERMINED THAT VMG HAD NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION OR DISCLOSURE. THE ENTITIES INCLUDED IN VMG ARE NO LONGER SUBJECT TO EXAMINATIONS BY THE APPLICABLE TAXING JURISDICTIONS FOR PERIODS PRIOR TO THE 2016 TAX YEAR. PART XI, LINE 2D - OTHER ADJUSTMENTS: REVENUE ATTRIBUTABLE TO CONSOLIDATED ENTITIES 7,871,083. PART XII, LINE 2D - OTHER ADJUSTMENTS: EXPENSES ATTRIBUTABLE TO CONSOLIDATED ENTITIES 85,860,646. 0 THE VALLEY HOSPITAL INC 223 NORTH VAN DIEN AVENUE RIDGEWOOD NJ 07450 221487307 501(C)(3) 15207883 STRATEGIC FUNDING VALLEY PHYSICIAN SERVICES INC 223 NORTH VAN DIEN AVENUE RIDGEWOOD NJ 07450 320041186 501(C)(3) 10504078 STRATEGIC FUNDING VALLEY MEDICAL SERVICES PC 15 ESSEX ROAD PARAMUS NJ 07652 465297054 501(C)(3) 122143 STRATEGIC FUNDING VALLEY PHYSICIAN SERVICES NY PC 15 ESSEX ROAD PARAMUS NJ 07652 453125678 501(C)(3) 33757 STRATEGIC FUNDING 4 X X X X 0 0 0 0 0 0 0 1 0 JOHN GONCALVES MD DIRECTOR CARDIAC SURGERY 1434948 0 650000 0 1916 0 9625 0 22520 0 2119009 0 0 0 ALEX ZAPOLANSKI MD PHYSICIAN 1398630 0 365886 0 14478 0 9625 0 23655 0 1812274 0 0 0 AUDREY MEYERS PRESIDENT & CEO 0 1066752 0 551670 0 92069 0 20825 0 22512 0 1753828 0 0 THOMAS AHLBORN MD CHAIR, SURGICAL SERVICES 999848 0 252501 0 14478 0 9625 0 22760 0 1299212 0 0 0 MICHAEL RAHMIN MD PHYSICIAN 932457 0 50000 0 7209 0 9800 0 32679 0 1032145 0 0 0 GAIL MATTHEWS MD TREAS. THRU 6/30/19 & PHYSICIAN 672016 0 191401 0 7524 0 9800 0 10260 0 891001 0 0 0 ROBERT KORST MD CHIEF OF ONCOLOGY SURGERY 688895 0 150501 0 4902 0 15400 0 31459 0 891157 0 0 0 MARC MELAMED MD SECY. THRU 5/21/19 & PHYSICIAN 446207 0 105000 0 10023 0 9800 0 15257 0 586287 0 0 0 DAVID STRASSBERG MD PRES. THRU 6/30/19 & PHYSICIAN 403432 0 98255 0 11230 0 9800 0 10945 0 533662 0 0 0 PART I, LINE 3 VALLEY MEDICAL GROUP HAS DEVELOPED A COMPENSATION PLAN WHICH GOVERNS THE COMPENSATION FOR ALL PHYSICIANS AND ADVANCED PRACTICE PROVIDERS. THE PLAN WAS DEVELOPED IN CONJUNCTION WITH A CONSULTING FIRM, REVIEWED BY OUR PHYSICIAN LEADERSHIP COUNCIL AND APPROVED BY THE BOARD OF TRUSTEES AND THE VALLEY HEALTH SYSTEM PHYSICIAN COMPENSATION COMMITTEE. ON AN ANNUAL BASIS THE PLAN WILL BE REVIEWED AND UPDATED AS NEEDED. ONCE DRAFTED THE PLAN WILL FOLLOW THE SAME PROCESS AS OUTLINED ABOVE. PART I, LINE 7 PHYSICIANS MAY BE ELIGIBLE FOR CERTAIN CLINICAL BONUSES OR OTHER INCENTIVES THAT MAY BE ESTABLISHED ACCORDING TO COMPETITIVE MARKET PRACTICES DESIGNED TO ENCOURAGE PRODUCTIVITY AND OTHER PERFORMANCE OBJECTIVES. ANY AND ALL BONUSES WILL BE SUBJECT TO CAPS AND MAY BE AWARDED ON THE BASIS OF EITHER STATED PRODUCTIVITY METRICS OR STATED QUALITY METRICS (BASED ON PATIENT EVALUATIONS) OR SOME COMBINATION OF BOTH. FORM 990, PART VI, SECTION A, LINE 4 ON 5/21/19 VALLEY PHYSICIAN SERVICES, P.C. (PART OF THE VALLEY MEDICAL GROUP) UPDATED AND ADOPTED NEW BYLAWS AND LEGAL DOCUMENTS TO IMPLEMENT FORMALLY THE BOARD'S INTEGRATION INTO A PARALLEL BOARD OF THE VALLEY HEALTH SYSTEM'S ("VHS") BOARD. THIS CHANGE TOOK EFFECT JULY 1, 2019. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION IS A PROFESSIONAL CORPORATION HAVING STOCKHOLDERS. FORM 990, PART VI, SECTION A, LINE 7A THE TRUSTEES OF THE CORPORATION SHALL ELECT, APPOINT, REPLACE OR REMOVE TRUSTEES; PROVIDED, HOWEVER, THAT BEFORE TAKING ANY SUCH ACTION, THE TRUSTEES SHALL GIVE THE VALLEY PHYSICIAN SERVICES, INC. BOARD OF TRUSTEES ("VPS BOARD") AT LEAST THIRTY (30) DAYS WRITTEN ADVANCE NOTICE OF ITS INTENDED ACTIONS; WILL NOT VOTE UNTIL WRITTEN APPROVAL OF SUCH ACTION IS RECEIVED FROM THE VPS BOARD; AND WILL VOTE IN THE MANNER SPECIFIED IN THE WRITTEN NOTICE PROVIDED TO THE VPS BOARD. FORM 990, PART VI, SECTION A, LINE 7B (A) IN THE EVENT THE BOARD INTENDS TO VOTE ON ONE OF THE FOLLOWING ACTIONS, THE BOARD WILL GIVE THE VPS BOARD THIRTY (30) DAYS' WRITTEN ADVANCE NOTICE OF THE FOLLOWING INTENDED ACTIONS, WILL NOT VOTE UNTIL THE BOARD RECEIVES WRITTEN APPROVAL FROM THE VPS BOARD, AND WILL VOTE IN THE MANNER SPECIFIED IN THE WRITTEN NOTICE. THE ACTIONS SUBJECT TO THIS PROCEDURE ARE: (I) STRATEGIC ACTIONS, WHICH SHALL INCLUDE, BUT NOT BE LIMITED TO, NEW STRATEGIC PLANS, MODIFICATIONS OF EXISTING STRATEGIC PLANS OR MISSION STATEMENTS; (II) MAJOR CORPORATE DECISIONS, WHICH MAY POTENTIALLY IMPACT THE PHILOSOPHY OF THE VALLEY SYSTEM, WHICH SHALL INCLUDE, BUT NOT BE LIMITED TO, JOINT VENTURES, CORPORATE ACQUISITIONS, PROGRAMMATIC AFFILICATIONS, MERGERS OR CONSOLIDATIONS, CONVERSION OF THE TAX-EXEMPT STATUS, SALE OR TRANSFER OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION, OR THE DISSOLUTION OF THE CORPORATION; (III) ANY SINGLE EXPENDITURE GREATER THAN FIVE PERCENT (5%) OF THE ANNUAL OPERATING BUDGET OF THE CORPORATION AND AMENDMENTS THERETO; (IV) THE ELECTION, APPOINTMENT, REPLACEMENT OR REMOVAL OF TRUSTEES OF THE CORPORATION WITH OR WITHOUT CAUSE; (V) THE SELECTION OF AUDITORS; (VI) THE APPOINTMENT AND REMOVAL OF THE PRESIDENT OF THE CORPORATION (OR THE APPROVAL OF ANY RECCOMENDATION OF THE VPS BOARD FOR REMOVAL); (VII) THE ADOPTION, AMENDMENT, REVISION OR DELETION OF THE CORPORATION'S BYLAWS AND THE CREATION OR APPROVAL OF ANY AMENDMENTS, ALTERATIONS OR REVISIONS TO THE CORPORATION'S CERTIFICATE OF INCORPORATION; (VIII) THE ADOPTION OF THE CORPORATION'S ANNUAL CAPITAL AND OPERATING BUDGETS; (IX) MAJOR CORPORATE DECISIONS REGARDING THE INCURRENCE OF DEBT IN EXCESS OF FIVE PERCENT (5%) OF THE OPERATING BUDGET OF THE CORPORATION (INCLUDING CAPITAL AND OPERATING LEASES), AND THE TRANSFER OR LOAN OF CASH OR THE CONVEYANCE, LEASE OR OTHER DISPOSITION OF OTHER ASSETS TO AN AFFILIATE OR SUBSIDIARY WITHOUT RECEIVING EQUIVALENT VALUE IN RETURN. (X) THE APPROVAL OF THE PURCHASE OR SALE OF ANY REAL PROPERTY BY THE CORPORATION AND THE APPROVAL OF THE CREATION OF A MORTGAGE, LIEN, OR ANY OTHER SECURITY INTERESTS IN THE CORPORATION'S REAL OR PERSONAL PROPERTY; (XI) DETERMINATIONS OF HOW ANY AND ALL EXCESS CASH GENERATED BY THE CORPORATION WILL BE SPENT; (XII) THE CESSATION OR ANY CHANGE IN THE CORPORATION'S PROVISION OF SERVICES TO MEDICARE AND MEDICAID RECIPIENTS AND ITS PROVISION OF CHARITY CARE SERVICES IN ACCORDANCE WITH CHARITY CARE SERVICES IN ACCORDANCE WITH CHARITY CARE POLICIES ESTABLISHED BY THE VALLEY HOSPITAL. FORM 990, PART VI, SECTION B, LINE 11B VPS P.C. HAS ITS FORM 990 PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND HAS ESTABLISHED THE FOLLOWING REVIEW PROCESS TO ENSURE THAT THE INFORMATION REPORTED IS COMPLETE AND ACCURATE. WHEN THE FROM 990 IS PREPARED, IT IS SUBMITTED TO THE DIRECTOR OF FINANCE AND FINANCE COMMITTEE FOR REVIEW. ANY COMMENTS ARE SUMMARIZED AND PROVIDED TO THE DIRECTOR OF FINANCE. EACH ISSUE IS DOCUMENTED AND ADDRESSED UNTIL THE RETURN IS FINALIZED AND APPROVED BY THE FINANCE COMMITTEE FOR FILING WITH THE INTERNAL REVENUE SERVICE. BEFORE FILING, THE FORM 990 IS MADE AVAILABLE FOR THE BOARD'S REVIEW, BY HARD COPY AND OR ELECTRONIC COPY. FORM 990, PART VI, SECTION B, LINE 12C VALLEY PHYSICIANS SERVICES, P.C. ADOPTS THE VALLEY HEALTH SYSTEM CONFLICTS OF INTEREST POLICY (THE "CONFLICTS OF INTEREST POLICY") AS THE SAME MAY BE AMENDED OR SUPPLEMENTED BY THE VALLEY HEALTH SYSTEM BOARD FROM TIME TO TIME. THE PRESIDENT OF VPS SHALL PROVIDE TO EACH TRUSTEE AND OFFICER ANNUALLY A COPY OF THE CONFLICTS OF INTEREST POLICY AND SHALL ADVISE EACH TRUSTEE AND OFFICER OF THE DUTY TO COMPLY WITH THE PROVISIONS SET THEREIN. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMPENSATION COMMITTEE OF VALLEY HOSPITAL WILL BE RESPONSIBLE FOR APPROVING THE COMPENSATION OF THE PRESIDENT AND OTHER KEY EXECUTIVES OF VPS, P.C. THE COMPENSATION FOR OTHER PHYSICIANS WILL BE APPROVED BY THE PHYSICIAN COMPENSATION COMMITTEE OF VALLEY HEALTH SYSTEM. TOTAL COMPENSATION WILL BE SET BASED ON INFORMATION REGARDING COMPENSATION PAID BY SIMILARITY SITUATED ORGANIZATIONS FOR SIMILAR SERVICES, CURRENT COMPENSATION SURVEYS COMPLETED BY INDEPENDENT FIRMS, OR ACTUAL WRITTEN OFFERS FROM SIMILARLY SITUATED ORGANIZATIONS. FORM 990, PART VI, SECTION C, LINE 19 VPS P.C MAKES ITS FORM 990, FINANCIAL STATEMENTS, FORM 1023, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS AVAILABLE UPON WRITTEN REQUEST AT 223 NORTH VAN DIEN AVE, RIDGEWOOD, NJ 07450 OR BY CALLING THE ORGANIZATION DIRECTLY AT 201-447-8000. FORM 990, PART XI, LINE 2C THE AUDIT COMMITTEE IS RESPONSIBLE FOR SELECTING AN INDEPENDENT ACCOUNTANT AND FOR OVERSIGHT OF THE AUDIT. VALLEY HEALTH SYSTEM INC 223 NORTH VAN DIEN AVE RIDGEWOOD NJ 07450 222922016 PROVIDE MANAGEMENT AND PLANNING SERVICES FOR ITS MEMBERS NJ 501(C)(3) LINE 3 N/A 0 THE VALLEY HOSPITAL INC 223 NORTH VAN DIEN AVE RIDGEWOOD NJ 07450 221487307 PROVIDE HEALTHCARE PROGRAMS AND SERVICES TO ALL NJ 501(C)(3) LINE 3 VALLEY HEALTH SYSTEM INC 0 VALLEY PHYSICIAN SERVICES INC 223 NORTH VAN DIEN AVE RIDGEWOOD NJ 07450 320041186 PROVIDES MANAGEMENT AND VARIED CONSULTING SERVICES NJ 501(C)(3) LINE 10 THE VALLEY HOSPITAL INC 0 VALLEY HOME CARE INC 15 ESSEX ROAD PARAMUS NJ 07652 223208480 PROVIDE HOME CARE AND HOSPICE SERVICES TO RESIDENTS OF NORTHERN NJ NJ 501(C)(3) LINE 10 VALLEY HEALTH SYSTEM INC 0 THE VALLEY HOSPITAL FOUNDATION INC 223 NORTH VAN DIEN AVE RIDGEWOOD NJ 07450 222324554 SOLICITS, RECEIVES AND APPLIES CONTRIBUTIONS FOR THE BENEFIT OF THE HOSPITAL NJ 501(C)(3) LINE 7 VALLEY HEALTH SYSTEM INC 0 VALLEY MEDICAL SERVICES PC 15 ESSEX ROAD PARAMUS NJ 07652 465297054 PROVIDE PRIMARY AND SPECIALTY MEDICAL CARE NJ 501(C)(3) LINE 10 VALLEY PHYSICIAN SERVICES INC 0 VALLEY PHYSICIAN SERVICE NY PC 15 ESSEX ROAD PARAMUS NJ 07450 453125678 OPERATES URGENT/PRIMARY CARE CLINICS NY 501(C)(3) LINE 10 VALLEY PHYSICIAN SERVICES INC 0 VHS INSURANCE COMPANY LTD 010 MAIN STREET CAYMAN ISLANDS CJ 980408200 PROVIDES PROFESSIONAL, MEDICAL, AND COMMERCIAL GENERAL LIABILITY INSURANCE CJ VALLEY HEALTH SYSTEM INC C 0 VALLEY HEALTH MEDICAL GROUP INC 15 ESSEX ROAD PARAMUS NJ 07652 223475235 OPERATES URGENT/PRIMARY CARE CLINICS NJ VALLEY HEALTH SYSTEM INC C 0 VALLEY HEALTH MEDICAL GROUP NJPC 15 ESSEX ROAD PARAMUS NJ 07652 223475166 OPERATES URGENT/PRIMARY CARE CLINICS NJ N/A C 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 1 1