2020-11-10T14:38:52-06:00 2019-12-31 346565596 Ernst & Young US LLP 5 Times Square New York NY 10036 990 2019-01-01 223392808 Foundation for Morristown Medical Center FOUN 9735932400 475 South Street Morristown NJ 07960 Kevin Lenahan SVP-CFO & Admin Officer 9735932400 2020-11-10 1 Nicole Sokolowski P01683199 2127733000 165.225.39.10 2020-11-10 15:37:29 ES P C9D3C68DDFFD2C6836FD65C52C23E1338A76E4C7 C9D3C68DDFFD2C6836FD65C52C23E1338A76E4C7 2019 2021-01-29 14:40:06Z Kevin Lenahan 475 South Street Morristown NJ 07960 48309978 0 X www.f4mmc.org X 501c3 1995 NJ Refer to Schedule OThe Foundation for Morristown Medical Center is a not-for-profit fundraising organization which solicits funds in its general appeal to support both Morristown Medical Center, which is a division of AHS Hospital Corporation, and the community as the Foundation's Board may deem appropriate. 35 27 0 203 8148 0 17633000 20116030 0 0 5174406 8530810 -6491 9109 22800915 28655949 9502275 8121050 0 0 3228301 3482772 294863 408446 3182631 1213937 1230035 14239376 13242303 8561539 15413646 144161623 160123203 4303730 4493288 139857893 155629915 X To inspire community philanthropy to advance exceptional health care for patients at Morristown Medical Center. The objective is to use philanthropy to preserve and expand the Medical Center's programs and services in patient care, clinical research, medical and public health education, and preventive medicine. 0 0 8121050 8121050 The Foundation for Morristown Medical Center (FFMMC) is a standalone foundation, which is a not-for-profit fundraising organization that solicits funds in its general appeal for the benefit and support of Atlantic Health System, Inc. and AHS Hospital Corporation (the Corporation), and all subsidiaries thereof. Morristown Medical Center is the principal recipient of the fundraising carried out by FFMMC. 8121050 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 1 0 0 0 0 0 1 1 1 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 1 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 35 27 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NJ NY PA FL X X Ken Butkowski 9734512005 100 Madison Avenue - Box 920 Morristown NJ 07960 Patricia O'Keefe Trustee 2.00 55.00 X 0 1181469 184726 Eric L Lazar MD Trustee 2.00 55.00 X 0 1055469 48210 Eric Whitman MD Trustee 2.00 55.00 X 0 947689 45582 Linda Gillam MD Trustee 2.00 55.00 X 0 699732 20616 Thomas Zaubler MD Trustee 2.00 55.00 X 0 464684 45786 Carol S Jones MSN RN Trustee 2.00 55.00 X 0 424246 50413 Keerti Sharma MD Trustee 2.00 55.00 X 0 316272 26514 Anthony A Lombardo Trustee 2.00 X 0 0 0 Anu Gupta Trustee 2.00 X 0 0 0 Blake Silverman Trustee 2.00 X 0 0 0 Carl J Goldberg Trustee 2.00 X 0 0 0 Catherine Herbst Trustee 2.00 X 0 0 0 David Taylor MD Trustee 2.00 X 0 0 0 Finn Wentworth Trustee, Chairman 2.00 X 0 0 0 Fran Davino Trustee 2.00 X 0 0 0 Glenn Yarnis Trustee 2.00 X 0 0 0 James Slater MD Trustee 2.00 X 0 0 0 Joseph C Graff Trustee-Treasurer 2.00 X 0 0 0 Karen R Walsh Trustee-Secretary 2.00 X 0 0 0 Keith Richardson Trustee 2.00 X 0 0 0 Leslie Quick Trustee-Vice Chairman 2.00 X 0 0 0 Lori Ingber PHD Trustee 2.00 X 0 0 0 Marc Adee Trustee 2.00 X 0 0 0 Marianne Ehinger Trustee 2.00 X 0 0 0 Mary Anne Wood Trustee 2.00 X 0 0 0 Mary Courtemanche Trustee 2.00 X 0 0 0 Peter J Cocoziello Trustee 2.00 X 0 0 0 Renee Frankel Trustee 2.00 5.00 X 0 27020 0 Richard P Diegnan Trustee 2.00 X 0 0 0 Richard P Goryeb Trustee 2.00 X 0 0 0 Robert Tafaro Trustee 2.00 X 0 0 0 Veronica M Goldberg Trustee 2.00 X 0 0 0 W Rodman Ryan Trustee 2.00 X 0 0 0 William D Bruen Jr Trustee 2.00 X 0 0 0 William Marino Trustee 2.00 X 0 0 0 Kevin Lenahan SVP-CFO and Admin Officer 2.00 55.00 X 0 1769410 320249 James F Quinn Chief Development Officer 55.00 X 378871 0 59410 Cynthia W O'Donnell Director of Gift Planning 55.00 X 192389 0 34154 571260 6885991 835660 10 0 1 0 0 63940 720545 19331545 79446 20116030 7713003 8148 7704855 20452609 19634802 817807 817807 817807 1600 63940 16144 -14544 -14544 26736 3083 23653 23653 28655949 0 8148 8531771 7802050 7802050 319000 319000 2831079 955789 1875290 651693 219858 431835 7012 7012 24000 24000 408446 408446 382491 382491 317272 317272 135068 45567 89501 182592 182592 58930 19881 39049 32051 10813 21238 90619 90619 13242303 8121050 1938622 3182631 15455320 17961288 63420677 68677190 58085404 67894935 4429975 3132729 2770247 2457061 144161623 160123203 2025242 2107998 2278488 2385290 4303730 4493288 X 30988938 43005400 108868955 112624515 139857893 155629915 144161623 160123203 X 15413646 14462977 -14104601 X 0 1 X 1 0 X 16576243 13850518 16834955 17626509 20125139 85013364 16576243 13850518 16834955 17626509 20125139 85013364 5389903 79623461 3917716 3238025 3741083 4580004 7704855 23181683 8148 8148 108203195 0.73590 0.74390 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 108868955 18661526 7177359 22083325 112624515 112948519 16130639 -2259437 17950766 108868955 98294270 23068070 8012241 16426062 112948519 96153493 12371179 4163138 14393540 98294270 96541283 15868737 -907015 15349512 96153493 0.00000 0.35000 0.65000 0 0 0 Annuities Payable 2385290 2385290 28655949 0 28655949 0 28655949 13242303 0 13242303 0 13242303 Part V, Line 4: Specific purposes of the Corporation shall be to provide grants and gifts to other 501(c)(3) organizations to pursue their charitable, scientific and educational purposes, which grants and gifts may be restricted to specific purposes or may be for the general operating funds of the done organization in the discretion of the Board of Trustees of the Corporation. In particular, the Corporation shall make grants and gifts for the benefit and support of ATLANTIC HEALTH SYSTEM, INC. and AHS HOSPITAL CORP., all subsidiaries thereof, with the principal beneficiary of the Corporation to be Morristown Medical Center, Morristown, NJ, organizations described in 501(c)(3) of the Code which are exempt from Federal income tax pursuant to 501(a) of the Code, and which qualify pursuant to 170(c) of the Code, and to further the charitable, educational and scientific purposes of ATLANTIC HEALTH SYSTEM, INC. and AHS HOSPITAL CORP. (hereinafter referred to collectively as the "AHS"), including but not limited to the receiving of contributions and the use thereof to or for the benefit of AHS ; carrying on fundraising activities for the benefit of the Supported Organization, and the distribution of net income and any excess contributions to the AHS, and the distribution of net income and any excess contributions to AHS. X X 1 Phonathon 455 NW 35th St Ste 104 Boca Raton FL 33431 Mail/Phone 0 629283 408446 220837 629283 408446 220837 NJ NY PA FL DE Kids 4 Kids Race 25041 25041 3552 41 8211 Juniors Fore Goryeb 31135 29535 1600 1497 1032 1 9364 9364 1646 165 65540 63940 1600 5049 41 1646 9408 16144 -14544 26736 1761 1322 1 1.00000 26736 1761 1322 3083 23653 NJ 1 0 0 0 0.50000 0.50000 Christine Hajsok 475 South Street Morristown NJ 07960 0 Christine Hajsok 188383 The Director of Finance manages & oversees all fundraising activities for this entity. X 1 1 Morristown Medical Center 100 Madison Avenue Morristown NJ 07960 521958352 501(c)(3) 7802050 Program Services. 1 Project Independence 70 275000 Women's Association Scholarship Fund 22 44000 Part I, Line 2: The organization conducts due diligence to review and select grant recipients and is comfortable that the grants are used for their intended purposes. The grants issued were made to related organizations to further their tax-exempt purposes. Part III, Line 1 Project Independence is a grant funding project to help Morristown Medical Center patients with temporary financial hardships. It is overseen by a volunteer committee made up of care providers from different areas of the Medical Center. They meet every month to review detailed applications. An application can only be submitted by a case worker who is aware of the financial position of the patients and is working with the patients to secure other types of help including prescription assistance, food stamps, Social Security disability, etc. Most of the recommenders are social workers or patient liaisons. Grants up to $5,000 are made payable directly to the individual. Part III, Line 2 Women's Association Morristown Medical Center (WAMMC) has a long history of supporting quality nursing at Morristown Medical Center. Early on, the WAMMC helped staff the hospital with nurses, and assisted with their housing and uniforms. In 1957, this interest evolved into a formal Scholarship Program, funded entirely by private donations. At that time, one scholarship of $500 would pay tuition costs for the entire three-year program. As tuition costs rose and recipient financial needs increased, generous donations made annually by WAMMC members, continued to underwrite the program. However, the early 1990s brought an economic downturn, which slowed the brisk pace of donations to the Scholarship Program, and necessitated a new approach to ensure the program's future. Since its inception, the Scholarship Program has supported the professional staff at Morristown Medical Center in the health care field. A Scholarship Trust Fund was established in 1995, with all scholarship contributions directly benefiting the fund. Presently, the Scholarship Committee spends the interest generated annually by the fund. In this way, the invested principal remains intact, securing both the fund's future and the Scholarship Program's mission. The remainder of the funds needed to meet the annual budgeted amount is paid from the WAMMC operating budget. WAMMC largely attributes the steady growth of this program to the hard work of successful fundraising and the generous donations of WAMMC members. For the 2019 calendar year, WAMMC awarded a total of $44,000 in $2,000 scholarships to 22 employees. The scholarships are awarded to employees working in health related fields. The majority are awarded to employees pursing nursing degrees. WAMMC is very proud that it is able to extend support to so many professionals. The candidates are often leaders in their field as members of honorary societies, as hospital committee chairs, or as participants in department studies. It is not unusual for our scholars to be as actively engaged in their local community, as they are in the workplace. The candidates are often leaders in their field as members of honorary societies, as hospital committee chairs, or as participants in department studies. It is not unusual for our scholars to be as actively engaged in their local community, as they are in the workplace. 0 0 0 0 0 0 0 0 0 Patricia O'Keefe Trustee 0 685259 0 332477 0 163733 0 168012 0 16714 0 1366195 0 91470 Eric L Lazar MD Trustee 0 674875 0 0 0 380594 0 25200 0 23010 0 1103679 0 0 Eric Whitman MD Trustee 0 720482 0 128472 0 98735 0 25200 0 20382 0 993271 0 0 Linda Gillam MD Trustee 0 620505 0 75000 0 4227 0 9800 0 10816 0 720348 0 0 Thomas Zaubler MD Trustee 0 382485 0 81399 0 800 0 25200 0 20586 0 510470 0 0 Carol S Jones MSN RN Trustee 0 349446 0 69504 0 5296 0 36400 0 14013 0 474659 0 0 Keerti Sharma MD Trustee 0 249684 0 0 0 66588 0 9800 0 16714 0 342786 0 0 Kevin Lenahan SVP-CFO and Admin Officer 0 1007693 0 722504 0 39213 0 299867 0 20382 0 2089659 0 0 James F Quinn Chief Development Officer 315693 0 48015 0 15163 0 36400 0 23010 0 438281 0 0 0 Cynthia W O'Donnell Director of Gift Planning 180219 0 6324 0 5846 0 17440 0 16714 0 226543 0 0 0 X 34134 Sale of comp property X 7 4665 Sale of comp property X Toys 130 22614 Sale of comp propert X Gift Cards 33 14178 Cash value of cards X Electronics 4 3855 Sale of comp propert 0 1 0 Part I, Column (b): The amounts in Part I, column represent the number of contributions. Form 990, Part VI, Section A, line 2 Carl Goldberg and Finn Wentworth had a family/business relationship during 2019. Leslie Quick and Richard Diegnan had a family/business relation ship during 2019. Form 990, Part VI, Section A, line 6 As per the bylaws, each of the entities has one "member", that being Atlantic Health System, Inc. There are no other members or classes of membership whatsoever as indicated in the bylaws. Atlantic Health System, Inc. is the sole member of this organization. Atlantic Health System, Inc. has the right to elect the members of this organization's board of trustees and has certain reserved powers as outlined in the organiztion's bylaws. Form 990, Part VI, Section A, line 7a Atlantic Health System, Inc. is the only "member" that wholly owns the Foundation for Morristown Medical Center. As a result, Atlantic Health System, Inc. may elect the members of the governing bodies for each of the entities. Form 990, Part VI, Section A, line 7b Atlantic Health System, Inc. is the only "member" that wholly owns the Foundation for Morristown Medical Center. As a result, Atlantic Health System, Inc. approves the decisions of the governing bodies. Form 990, Part VI, Section B, line 11b The final draft of the Form 990 was distributed to the "Accounting Sub-Committee" for their review. The "Accounting Sub-Committee" will then present the Form 990 to the Financial Oversight Committee who will then present the Form 990 to the Board of Directors. Form 990, Part VI, Section B, line 12c We require disclosure of potential conflicts. This policy governs all personnel at Atlantic, including Board Members. Additionally, the Board Committee members must fill out annual disclosures with specific questions regarding potential conflicts. For potential conflicts involving employees, conflicts involving business relationships require prior disclosure and approval by the Compliance Officer (General Counsel). Conflicts involving Board members require approval from the Compliance Officer and the head of the Audit Committee, who may refer those conflicts to the Compliance Committee of the Board. Restrictions are fact-dependent, but may include recusal from deliberations regarding subject matter affected by the conflict. Form 990, Part VI, Section B, line 15 In conjunction with Atlantic Health System: Line 15A: A review of officer compensation by an independent 3rd party (Sullivan Cotter)is completed every year. The most recent survey was conducted in 2019. Officers reviewed include President and Chief Executive Officer ; SVP, Integrated Service Delivery & CEO, Hospital Division SVP, Chief Financial Officer & Chief Administrative Officer SVP, Physician Enterprise SVP, Chief Medical Officer & Chief Academic Officer SVP, Chief Human Resources Officer President, OMC President, MMC President, Western Region President CMC VP, Information Technology VP, Clinical and Business Intelligence SVP, General Counsel VP AHS, President ACO VP, COO Atlantic Medical Group VP, Ambulatory & Post Acute Care VP, Coordinated Care Transitions VP, Insurance Networks VP, Physician Enterprise Strategy VP, Compliance, Privacy & Audit VP, Finance VP, Revenue Cycle VP, Facilities Management and Real Estate VP, Government Affairs VP, Network Planning & Development VP, Integrated Care VP, Marketing & Communications On behalf of Atlantic Health, Sullivan Cotter conducts an annual total compensation survey based on appropriate comparability data for like positions in like organizations. The results of the survey are presented to the Executive Committee of the board which documents the findings and recommendations in committee minutes. Compensation for key physicians is determined by soliciting salary data from published sources. These salary recommendations are then approved by the Executive Committee of the board. Form 990, Part VI, Section C, line 18 Currently the Foundation for Morristown Medical Center retains copies of the filed Form 990 for the last three years and Form 1023 with the most senior management's assistant. Public disclosure of these Form 990 can be made at any time at each of the organization's sites. In addition, the Form 990 is posted on the website "www.foundationcenter.org and "guidestar.org". Form 990, Part VI, Section C, line 19 The organization does not currently make its financial statements open to public disclosure, but the statement of financial position is available by accessing the Form 990 from the website. The governing documents and conflict of interest polices are not currently made available to the public. Form 990, Part XI, line 9: Distributions to Morristown Division-Capital -14,319,623. Beneficial Interest in Charitable Remainder Unitrust 215,022. AHS Hospital Corp 475 South Street Morristown NJ 07960 521958352 Healthcare NJ 501(c)(3) Line 3 Atlantic Health System Inc 1 Atlantic Ambulance Corporation 475 South Street Morristown NJ 07960 223820288 Healthcare Transportation NJ 501(c)(3) Line 10 Atlantic Health System Inc 1 Atlantic Health System Inc 475 South Street Morristown NJ 07960 223380375 Human Health through AHS Hospital Corp. NJ 501(c)(3) Line 12a, I N/A 0 Newton Medical Center Foundation 175 High Street Newton NJ 07860 222618102 Administers donations, grants and bequests and performs fundraising NJ 501(c)(3) Line 7 Atlantic Health System Inc 1 Prime Care Inc 175 High Street Newton NJ 07860 222759566 Provides home health and other healthcare services NJ 501(c)(3) Line 10 Atlantic Health System Inc 1 North Jersey Health Care Properties Inc 175 High Street Newton NJ 07860 223519709 Owns commercial buildings and conducts leasing activities NJ 501(c)(2) Atlantic Health System Inc 1 Practice Associates Medical Group 475 South Street Morristown NJ 07960 202088165 Physician Services NJ 501(c)(3) Line 12a, I Atlantic Health System Inc 1 Chilton Memorial Corporation 97 West Parkway Pompton Plains NJ 07444 222719339 Support Charitable Exempt Programs and Services of Medical Center NJ 501(c)(3) Line 7 Atlantic Health System Inc 1 Chilton Medical Center Auxiliary Inc 97 West Parkway Pompton Plains NJ 07444 222883605 Support Charitable Exempt Programs and Services of Medical Center NJ 501(c)(3) Line 12a, I Atlantic Health System Inc 1 Chilton Medical Center Foundation Inc 97 West Parkway Pompton Plains NJ 07444 223084817 Support Charitable Exempt Programs and Services of Medical Center NJ 501(c)(3) Line 7 Atlantic Health System Inc 1 Chilton Realty Holding Inc 97 West Parkway Pompton Plains NJ 07444 223067739 Real Estate and Leasing Activities for the Benefit of Exempt Organization NJ 501(c)(2) Atlantic Health System Inc 1 Foundation for Hackettstown Medical Center 651 Willow Grove Street Hackettstown NJ 07840 226106281 Fundraising for Hackettstown Medical Center NJ 501(c)(3) Line 12a, I Atlantic Health System Inc 1 Medical Center Partners Inc 651 Willow Grove Street Hackettstown NJ 07840 454789273 Physician Services NJ 501(c)(3) Line 12a, I Atlantic Health System Inc 1 Hackettstown Regional Medical Center Emergency Services Inc 651 Willow Grove Street Hackettstown NJ 07840 270820164 Ambulance Services NJ 501(c)(3) Line 12a, I Atlantic Health System Inc 1 Morris Photopheresis 100 Madison Avenue Morristown NJ 07960 223314012 Healthcare Research NJ 0 0 Affiliated Collection Services LLC 17 Prospect Street Morristown NJ 07960 270555659 Collection Services NJ 0 0 Morristown Medical Investors 200 American Road Morris Plains NJ 07950 650840535 Real Estate NJ 0 0 Primary Care Partners LLC 475 South Street Morristown NJ 07960 274980253 Physician Services NJ 0 0 Atlantic Health Management Corp and Subsidiaries 200 American Road Morris Plains NJ 07950 223538027 Health NJ N/A C 0 AHS Insurance Company LTD 200 American Road Morris Plains NJ 07950 223380375 Insurance NJ N/A C 0 Nutley Medical Care PA 100 Madison Avenue Morristown NJ 07960 223645010 Healthcare NJ N/A C 0 Non-Invasive Diagnostics PA 100 Madison Avenue Morristown NJ 07960 202027439 Healthcare NJ N/A C 0 Specialty Care of Practice Associates PA 100 Madison Avenue Morristown NJ 07960 030376428 Healthcare NJ N/A C 0 Maternal Fetal Medicine of Practice Associates PA 100 Madison Avenue Morristown NJ 07960 030376421 Healthcare NJ N/A C 0 Madison Pediatrics PA 100 Madison Avenue Morristown NJ 07960 223645007 Healthcare NJ N/A C 0 AHS ACO LLC 475 South Street Morristown NJ 07960 273800813 Physician Practice NJ N/A C 0 The Northwest New Jersey MedicalSurgical Alliance PC 175 High Street Newton NJ 07860 450577942 Healthcare Services NJ N/A C 0 The Northwest New Jersey Urgent Care Alliance PC 175 High Street Newton NJ 07860 830492357 Healthcare Services NJ N/A C 0 Chilton Community Care Inc and Subs 97 West Parkway Pompton Plains NJ 07444 222869148 Healthcare NJ N/A C 0 Chilton Medical Group PC 97 West Parkway Pompton Plains NJ 07444 383769436 Healthcare NJ N/A C 0 Robert & Susan Sameth 2011 CHA PO Box 218 Far Hills NJ 07931 900842326 Charitable Remainder Uni-Trust (2) NJ N/A T 1.00000 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 AHS Hospital Corp B 12618642 Actual amount of transaction. AHS Hospital Corp Q 26503596 Actual amount of transaction. AHS Hospital Corp B 316812 Actual amount of transaction. AHS Hospital Corp P 306944 Actual amount of transaction. AHS Hospital Corp B 30148819 Actual amount of transaction.