2019-05-14T14:43:10-05:00 2018-06-30 EISNERAMPER LLP 111 WOOD AVE SO STE 600 ISELIN NJ 088302700 990 2017-07-01 010553478 EAST MOUNTAIN HOSPITAL INC % RANDOLPH JACOBSON EAST PO BOX 1029 BELLE MEAD NJ 085021029 RANDOLPH JACOBSON TREASURER 9082811549 2019-05-15 true MICHAEL SOMER P00184276 7322437000 64.238.150.4 20870020191345000023 2019-05-14 P 9E85DF64EB4151BEC747F142B89E57DC9B53A5F3 B2C2256876CC01DA28761367FC3249761703087E 2017 2019-02-21 02:37:17Z PATRICIA TOOLE PO BOX 1029 BELLE MEAD NJ 085021029 5131476 false X eastmountainhospital.com X 2003 NJ EAST MOUNTAIN HOSPITAL IS AN INPATIENT PSYCHIATRIC HOSPITAL 9 7 78 0 0 0 5000 4946540 5120578 37665 5725 825 173 4985030 5131476 600 0 0 0 2553911 2694470 0 0 0 2399994 2467695 4954505 5162165 30525 -30689 2038807 2016373 687726 697391 1351081 1318982 TOGETHER WE WILL PROVIDE A SAFE, STRUCTURED, THERAPEUTIC COMMUNITY TO TREAT ADULTS WHO HAVE BEHAVIORAL AND SUBSTANCE ABUSE PROBLEMS AND RETURN THEM TO THEIR FAMILIES OR THE NEXT LEVEL OF CARE AS SOON AS POSSIBLE. false false 4461023 0 5120578 PSYCHIATRIC HOSPITAL WHICH CARED FOR 527 INPATIENTS AND HAD A TOTAL OF 5,389 PATIENT DAYS. 4461023 true true false false false false false false false false true false false true true true true false false false false false false false false false true true false false true false false false false false false false false false false false false false false false false false true 6 0 true 78 true false false false false false false false false false false X 9 7 false false false false false false false true true false false true true true true true true true true false X X RANDOLPH JACOBSON 9082811560 252 ROUTE 601 BELLE MEAD NJ 085020147 MICHAEL VOORHEES EXECUTIVE DIRECTOR & TRUSTEE 40.0 0.0 X X 145393 0 12825 DAVID CENTAFONT TRUSTEE 0.0 0.0 X 0 0 0 ENRICO DEGIRONIMO TRUSTEE 0.0 0.0 X 0 0 0 RANDOLPH JACOBSON TREASURER & TRUSTEE 0.0 0.0 X X 0 0 0 PATRICIA TOOLE CHAIRPERSON 0.0 0.0 X 0 0 0 SUSAN BONFIELD TRUSTEE 0.0 0.0 X 0 0 0 CAROL KOSZTYO SECRETARY & TRUSTEE 0.0 0.0 X X 0 0 0 DAVID BUCH MD MEDICAL DIRECTOR & TRUSTEE 40.0 0.0 X X 236126 0 20659 SHAUN SWEENEY TRUSTEE 0.0 0.0 X 0 0 0 DEBORAH CHARETTE DIRECTOR OF NURSING 40.0 0.0 X 114548 0 15778 496067 0 49262 3 false true false CARRIER CLINIC PO BOX 147 BELLE MEAD NJ 08502 ADMIN/CLINICAL 951076 SODEXO INC PO BOX 905374 CHARLOTTE NC 28290 DIETARY/HOUSEKEEPING 162601 2 5000 5000 NET PATIENT REVENUE 624100 5120578 5120578 5120578 5725 5725 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ALL OTHER REVENUE 900099 173 173 173 5131476 5120578 5898 X 0 0 0 0 394575 258063 136512 0 1859248 1809342 49906 41300 37884 3416 211741 197304 14437 187606 172290 15316 86950 77058 9892 47832 47832 39884 39884 0 0 0 951076 663334 287742 988 988 57094 29395 27699 614 614 0 241449 237612 3837 3331 3331 0 7364 7364 0 0 9355 9355 95225 69533 25692 PATIENT RELATED 589990 589990 DIETARY/ENVIRONMENTAL SVS 202858 202858 BAD DEBTS 40981 40981 TEMPORARY EMPLOYEES 49339 49339 43365 15345 28020 5162165 4461023 701142 0 0 0 188510 708388 0 0 386692 465293 0 0 0 0 0 0 0 0 69077 55392 179895 100865 38535 79030 133910 138224 0 0 0 0 0 0 1222083 570046 2038807 2016373 504595 519535 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183131 177856 687726 697391 X 1351081 1318982 0 0 0 0 1351081 1318982 2038807 2016373 -30689 -1410 X false true X true false X 123340 81503 41837 56555 19362 37193 79030 3RD PARTY PAYOR SETTLEMENTS 570046 570046 0 DUE TO CARRIER CLINIC 103247 ACCRUED PENSION 40800 ACCRUED TAIL INSURANCE 33809 177856 X 5089085 -1410 -1410 5090495 40981 40981 5131476 5121184 5121184 40981 40981 5162165 PART X, QUESTION #2 THE HOSPITAL IS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND, THEREFORE, IS EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(A) OF THE CODE. THERE ARE CERTAIN TRANSACTIONS THAT COULD BE DEEMED UNRELATED BUSINESS INCOME AND WOULD RESULT IN A TAX LIABILITY. MANAGEMENT REVIEWS TRANSACTIONS USING A THRESHOLD OF MORE LIKELY THAN NOT TO ESTIMATE POTENTIAL TAX LIABILITIES. IT IS MANAGEMENT'S ESTIMATION THAT THERE ARE NO MATERIAL TAX LIABILITIES THAT NEED TO BE RECORDED. PART XI, LINE 4B PATIENT BAD DEBTS $40,981 REPORTED AS REVENUE REDUCTION ON AUDITED FINANCIAL STATEMENTS. PART XII, LINE 4B PATIENT BAD DEBTS $40,981 REPORTED AS REVENUE REDUCTION ON AUDITED FINANCIAL STATEMENTS. true true true X true X 100 true true true false true true 11117 11117 0.00220 11117 11117 0.00220 11117 11117 0.00220 true 23066 288657 276908 11749 X true false 1 1 EAST MOUNTAIN HOSPITAL INC PO BOX 1029 BELLE MEAD NJ 085021029 www.eastmountainhospital.com 22970 X EAST MOUNTAIN HOSPITAL INC 1 false false true X X X X X X X X X 16 true true false true X www.eastmountainhospital.com X true 16 true www.eastmountainhospital.com false true X 100 100 X true true X X X true X www.eastmoutainhospial.com X www.eastmoutainhospial.com X X X true false true X false false PART V, SECTION B, LINE 5 WHILE CONDUCTING EMH'S MOST RECENT CHNA, A REPRESENTATIVE OF EMH INTERVIEWED MENTAL HEALTH ADMINISTRATORS FROM MIDDLESEX AND SOMERSET COUNTIES TO DISCUSS SERVICE GAPS IN THE COMMUNITY. THESE COUNTIES REPRESENT APPROXIMATELY 28% OF EMH ADMISSIONS. PART V, SECTION B, LINE 6A IN AN EFFORT TO BE COST-EFFECTIVE, EMH CONDUCTED ITS CHNA IN CONJUNCTION WITH CARRIER CLINIC. EMH IS A HOSPITAL-WITHIN-A-HOSPITAL ON THE CARRIER CLINIC CAMPUS AND THEIR COMMUNITIES ARE SIMILAR. EMH ALSO COLLABORATED WITH SOMERSET MEDICAL CENTER FOR SOMERSET COUNTY'S DATA COLLECTION. THE CHNA WAS FIRST CONDUCTED IN 2013 AND THEN AGAIN IN 2016. PART V, SECTION B, LINE 11 IN EMH'S IMPLEMENTATION STRATEGY OF THE CHNA THAT WAS CONDUCTED, APPROVED BY ITS BOARD AND PUBLISHED IN 2016, EMH IDENTIFIED CERTAIN COMMUNITY NEEDS INCLUDING PUBLIC EDUCATION AND ACCESS TO MENTAL HEALTH CARE. EMH ADOPTED A TIMELINE AND STATEGIES TO ADDRESS THESE NEEDS OVER A THREE-YEAR TIME PERIOD. THE GOALS AND OBJECTIVES SET TO BE COMPLETED BY JUNE 30, 2018 HAVE BEEN MET. THE CHNA PROCESS IDENTIFIED OTHER COMMUNITY NEEDS THAT WERE NOT INCLUDED IN THE IMPLEMETATION STRATEGY DUE TO LIMITATIONS IN EXPERTISE AND RESOURCES. THE BOARD APPROVED THE CHNA AND IMPLEMENTATON STRATEGY IN JUNE 2016, WHICH IS IN EFFECT FOR THE PERIOD OF JULY 2016 THROUGH JUNE 2019. PART I, LINE 7, COLUMN F BAD DEBT EXPENSE FOR THE YEAR ENDED JUNE 30, 2018 IS $40,981 AND IS EXCLUDED FROM TOTAL EXPENSES FOR CALCULATING THE PERCENTAGE OF TOTAL EXPENSE. PART I, LINE 7 THE COST-TO-CHARGE RATIO USED FOR PART I, LINE 7 IS BASED ON WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. PART III, LINE 4 REFER TO AUDITED FINANCIAL STATEMENTS, PAGE 7, FOR THE FOOTNOTE REGARDING BAD DEBT EXPENSE. PART VI, SUPPLEMENTAL INFORMATION #2 NEEDS ASSESSMENT: AS PART OF EAST MOUNTAIN HOSPITALS'S (EMH) STRATEGIC PLANNING PROCESS, THE HOSPITAL GATHERS AND INCORPORATES NATIONAL, STATE, AND CLINICAL INDUSTRY DATA IN THE DEVELOPMENT OF CLINICAL SERVICES AND EDUCATIONAL FORUMS. EMH IS A PARTICIPATORY MEMBER OF THE NEW JERSEY ASSOCIATION OF MENTAL HEALTH. THIS ORGANIZATION ALSO PROVIDES BEHAVIORAL HEALTH AND ADDICTION INFORMATION RELEVANT TO THE COMMUNITY'S NEEDS. EMH RECEIVES MANY TELEPHONE CALLS FROM THE GENERAL PUBLIC ON A REGULAR BASIS, REQUIRING REFERRALS TO AND INFORMATION REGARDING COMMUNITY RESOURCES, OTHER TREATMENT CENTERS OUTSIDE THE AREA, SUPPORT GROUPS, SELF-HELP GROUPS, ETC. INFORMATION IS PROVIDED WITHOUT CHARGE. IT IS THROUGH THIS CONTACT WITH THE COMMUNITY THAT ENABLES EMH TO UNDERSTAND WHAT SERVICES ARE NEEDED THROUGHOUT THE GEOGRAPHIC AREA. PART VI, SUPPLEMENTAL INFORMATION #3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: UNDER A SERVICE AGREEMENT WITH CARRIER CLINIC, A PATIENT SERVICE REPRESENTATIVE MEETS WITH EACH EMH PATIENT, IF THEY ARE MENTALLY CAPABLE, AND/OR A DESIGNATED FAMILY MEMBER OR GUARDIAN INDIVIDUALLY AND ADVISES THEM THAT THEY CAN APPLY FOR CHARITY CARE FOR THEIR SELF PAY BALANCES IF THEY HAVE LIMITED INCOME. THE PATIENT SERVICE REPRESENTATIVE PROVIDES CHARITY CARE APPLICATIONS TO THE PATIENT ACCORDINGLY. PART VI, SUPPLEMENTAL INFORMATION #4 COMMUNITY INFORMATION: EMH SERVES THE ENTIRE STATE OF NEW JERSEY; HOWEVER, THE MAIN PATIENT POPULATION IS FROM SUBURBAN AREAS. THE MAIN SOURCE OF ADMISSIONS IN 2017/2018 WAS FROM MIDDLESEX AND SOMERSET COUNTIES, BOTH LOCATED IN NEW JERSEY. OF THESE COUNTIES, AN AVERAGE OF 6.9% OF THE POPULATION FALLS BELOW POVERTY LEVEL. PART VI, SUPPLEMENTAL INFORMATION #5 PROMOTION OF COMMUNITY HEALTH: EMH ALSO PROVIDES EDUCATIONAL MATERIALS REGARDING MENTAL HEALTH TO THE COMMUNITY AT NO COST ON ITS WEBSITE. EDUCATIONAL WHITEPAGES, NATIONAL INSTITUTE OF MENTAL HEALTH FACT SHEETS AND SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION FACT SHEETS ARE AVAILABLE IN BOTH ENGLISH AND SPANISH. EDUCATIONAL MENTAL HEALTH VIDEOS AND RESOURCES BY COUNTY ARE ALSO AVAILABLE ON THE WEBSITE. PART III, SECTION B THE AMOUNTS REPORTED ON LINES 5, 6 AND 7 ARE TAKEN FROM EAST MOUNTAIN HOSPITAL'S FILED 2017/2018 MEDICARE COST REPORT PURSUANT TO THE SCHEDULE H INSTRUCTIONS. THESE AMOUNTS DO NOT INCLUDE INCURRED LOSSES FROM PHYSICIAN SERVICES TOTALING APPROXIMATELY $12,000 AS FOLLOWS: PHYSICIAN COST (SALARIES, FRINGES, MALPRACTICE INSURANCE) $26,000 REIMBURSEMENT RECEIVED FROM MEDICARE $14,000, UNREIMBURSED COST $12,000. THE HOSPITAL BELIEVES THAT IN YEARS OF A MEDICARE SHORTFALL, IT SHOULD BE CONSIDERED AS A COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. THIS YEAR, MEDICARE ACCOUNTED FOR 5% OF HOSPITAL REVENUES. THE HOSPITAL PROVIDES CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. CARING FOR MEDICARE PATIENTS FULFILLS A COMMUNITY NEED AND RELIEVES A GOVERNMENT BURDEN AS THESE PATIENTS TYPICALLY HAVE LOW AND/OR FIXED INCOMES. MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE COST OF PROVIDING CARE FOR THESE PATIENTS . MEDICARE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT BECAUSE OUR MISSION IS TO PROMOTE HEALTH IN THE COMMUNITY AND WE DO NOT LIMIT THE CARE AVAILABLE TO ANY PATIENTS, INCLUDING THOSE COVERED BY MEDICARE. TAX-EXEMPT HOSPITALS ARE EXPECTED TO PARTICIPATE IN THE MEDICARE PROGRAM. PART III, LINE 2 BAD DEBT EXPENSE FOR THE YEAR ENDED JUNE 30, 2018 IS $40,981, WHICH IS BASED ON CHARGES. THE RATIO OF PATIENT CARE COSTS TO CHARGES IS 56.28% WHICH IS APPLIED TO THE BAD DEBT AMOUNT FOR AN ESTIMATED COST OF $23,066. THIS EXPENSE IS REPORTED ON PART III, LINE 2. PART VI, SUPPLEMENTAL INFORMATION #7 STATE FILING OF COMMUNITY BENEFIT REPORT: NOT APPLICABLE X X X false false false false false false false false false MICHAEL VOORHEES EXECUTIVE DIRECTOR & TRUSTEE 126393 19000 5400 7425 158218 DAVID BUCH MD MEDICAL DIRECTOR & TRUSTEE 225426 10700 13800 6859 256785 SCHEDULE J, PART II MICHAEL VOORHEES' OTHER REPORTABLE COMPENSATION OF $19,000 IN COLUMN (iii) REPRESENTS PENSION CONTRIBUTION THAT FAILED DISCRIMINATION TESTING, RETIREMENT OF $5,400 IN COLUMN (c) REPRESENTS EAST MOUNTAIN HOSPITAL'S CONTRIBUTION INTO THE TARGET BENEFIT PLAN, AN ERISA PLAN, AND NONTAXABLE BENEFITS OF $7,425 IN COLUMN (d) REPRESENTS HOSPITALIZATION, MEDICAL, DENTAL AND PRESCRIPTION PLAN COVERAGE AS WELL AS LIFE INSURANCE AND LONG-TERM DISABILITY INSURANCE PAID BY EAST MOUNTAIN HOSPITAL. DR. DAVID BUCH'S OTHER REPORTABLE COMPENSATION OF $10,700 IN COLUMN (iii) REPRESENTS A SIGN-ON BONUS, RETIREMENT OF $13,800 IN COLUMN (c) REPRESENTS EAST MOUNTAIN HOSPITAL'S CONTRIBUTION INTO THE TARGET BENEFIT PLAN, AN ERISA PLAN, AND NONTAXABLE BENEFITS OF $6,859 IN COLUMN (d) REPRESENTS HOSPITALIZATION, MEDICAL, DENTAL AND PRESCRIPTION PLAN COVERAGE AS WELL AS LIFE INSURANCE AND LONG-TERM DISABILITY INSURANCE PAID BY EAST MOUNTAIN HOSPITAL. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PREPARED BY INTERNAL FINANCIAL STAFF, IS REVIEWED BY AN OUTSIDE CPA CONSULTING FIRM AND IS THEN REVIEWED BY THE BOARD OF TRUSTEES IN ADVANCE OF THE FILING WITH THE IRS. THIS REVIEW IS DOCUMENTED IN THE BOARD OF TRUSTEE MINUTES. FORM 990, PART VI, SECTION B, LINE 12C EACH TRUSTEE AND OFFICER ANNUALLY SIGNS A STATEMENT WHICH AFFIRMS THAT SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY AND UNDERSTANDS EAST MOUNTAIN HOSPITAL IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ITS TAX-EXEMPT PURPOSE. FORM 990, PART VI, SECTION B, LINE 15 EAST MOUNTAIN HOSPITAL UTILIZES THE NEW JERSEY HOSPITAL ASSOCIATION, SULLIVAN AND COTTER, HOSPITAL AND HEALTHCARE COMPENSATION SERVICE, MODERN HEATHCARE PUBLICATIONS AND OTHER VARIOUS SALARY SURVEYS FOR MARKET COMPARISONS. THE INFORMATION IS THEN PROVIDED TO THE BOARD OF TRUSTEES TO ENSURE THE SALARIES ARE WITHIN APPROPRIATE MARKET AND NONPROFIT EXECUTIVE COMPENSATION BASES. THE BOARD REVIEWS THE REASONABLENESS OF THE SALARY STRUCTURE FOR OFFICERS WITHIN THE ORGANIZATION AND ALSO REVIEWS AND ESTABLISHES THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR THESE SALARIES ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 EAST MOUNTAIN HOSPITAL PROVIDES DOCUMENTS TO THE PUBLIC UPON REQUEST. THE IRS FORM 990 IS ALSO ACCESSIBLE FROM GUIDESTAR ON THE INTERNET. FORM 990, PART VII, SECTION B, INDEPENDENT CONTRACTORS EAST MOUNTAIN HOSPITAL PURCHASED ADMINISTRATIVE AND CLINICAL SUPPORT SERVICES AT COST FROM CARRIER CLINIC AS PER THE DULY EXECUTED SERVICE AGREEMENT BETWEEN THE TWO ENTITIES. FOR THE FISCAL YEAR ENDED JUNE 30, 2018, THE TOTAL COST OF THESE SERVICES AMOUNTED TO $951,076: $663,334 FOR CLINICAL SERVICES AND $287,742 FOR VARIOUS BUSINESS SUPPORT FUNCTIONS SUCH AS FINANCIAL REPORTING, BILLING, INFORMATION TECHNOLOGY, HUMAN RESOURCES, AND OTHER BUSINESS FUNCTIONS. FORM 990, PART IX, LINE 11G OTHER FEES FOR SERVICE OTHER FEES FOR SERVICE INCLUDE $951,076 FOR ADMINISTRATION AND CLINICAL SUPPORT SERVICES PURCHASED AT COST FROM CARRIER CLINIC. SUBSEQUENT EVENT The State of New Jersey eliminated the Institution of Mental Disease (IMD) exclusion effective October 1, 2018. The IMD exclusion was the reason for the establishment of the Hospital in 2001 for the primary purpose of providing diagnosis, treatment or care to patients with mental diseases between the ages of 21 and 65. The Hospital operated as a hospital within as hospital, limited to 16 beds per regulations within Carrier Clinic, Inc. (the Clinic), a private, behavioral health care system treating patients with psychiatric, emotional, and addictive illnesses as the Clinic was precluded from receiving Medicaid reimbursements for the care of the aforementioned patients. Due to the elimination of the IMD exclusion and upon board approval the Hospital filed a Certification of Need (CN) Application - Expedited Review for the dissolution of East Mountain Hospital with the State of New Jersey on August 1, 2018. The State approved the application on September 28, 2018. The Hospital ceased operations for patient care services and in accordance with the terms of the State approval returned the 16 licensed adult psychiatric beds to the Clinic effective October 1, 2018. The Hospital is currently conducting wind down activities and is expected to file for dissolution by December 31, 2019. As provided by the Hospital's certificate of incorporation and affirmed in the resolution of dissolution approved by the board of trustees on September 26, 2018, upon the dissolution of the hospital or the winding up of its affairs, the remaining assets of the hospital after application to the payment of all its liabilities and obligations, shall be distributed to the clinic. FORM 990 PART IX LINE 11G DESCRIPTION:OTHER TOTAL FEES:951076