2018-11-14T10:02:52-06:00 2017-12-31 346565596 Ernst & Young US LLP 100 North Tryon Street - Suite 3800 Charlotte NC 28202 990 2017-01-01 223392808 Foundation for Morristown Medical Center FOUN 9735932400 475 South Street Morristown NJ 07960 Kevin Lenahan SVP-CFO & Admin Officer 9735932400 2018-11-14 1 Christopher B Boggs P00032493 7043726300 165.225.39.54 2018-11-14 10:02:42 ES P 14408212A635E8F42A904D17529EDD5146E6480F 1E2706C375E039EB00F36CED9FDCA9AB677DCF8F 2017 2019-02-21 02:37:17Z Kevin Lenahan 475 South Street Morristown NJ 07960 56434446 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. 37 28 0 264 0 -850 13857625 24359955 0 0 3947989 8090895 -7107 3193 17798507 32454043 7387105 7822231 0 0 3190422 3206054 296338 375200 4222166 354378 966575 11228243 12370060 6570264 20083983 133425507 154257717 4483900 4536358 128941607 149721359 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 7822231 7822231 This return consists of a standalone foundation which is a not-for-profit fundraising organization which solicits funds in its general appeal for the benefit and support of Atlantic Health System, Inc. and AHS Hospital Corporation (the Corporation), all subsidiaries thereof, with the principal beneficiary of the Corporation to be Morristown Medical Center. 7822231 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 0 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 X 37 28 0 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 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 Carol S Jones MSN RN Trustee 2.00 55.00 X 0 379320 39782 Cathy Herbst Trustee 2.00 X 0 0 0 Christopher Zipp DO Trustee 2.00 X 0 482475 30549 Damion A Martins MD Trustee 2.00 55.00 X 0 729525 32427 Daniel Pyo MD FACS FCCWS Trustee 2.00 X 0 0 0 Eric L Lazar MD Trustee 2.00 55.00 X 0 632303 35127 Finn Wentworth Trustee, Chairman 2.00 X 0 0 0 Fran Davino Trustee 2.00 X 0 0 0 Gil Santaliz Trustee 2.00 X 0 0 0 Guy Taylor MD 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 Leslie Quick Trustee-Vice Chairman 2.00 X 0 0 0 Linda Gillam MD Trustee 55.00 X 0 702268 17430 M Veronica Daly MD Trustee 2.00 55.00 X 0 427972 16082 Marianne Ehinger Trustee 2.00 X 0 0 0 Mark Clouse Trustee 2.00 X 0 0 0 Mark D Widmann MD Trustee 2.00 55.00 X 0 874954 24227 Mary Anne Wood Trustee 2.00 X 0 0 0 Mary Courtemanche Trustee 2.00 X 0 0 0 Patricia O'Keefe Trustee 2.00 55.00 X 0 851972 149946 Paul L Sturman Trustee 2.00 X 0 0 0 Peter J Cocoziello Trustee 2.00 X 0 0 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 Shari Bunks Geller Trustee 2.00 X 0 0 0 Steven Maser Trustee 2.00 X 0 567499 14046 Veronica M Goldberg Trustee 2.00 X 0 0 0 William Conger 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 Cynthia W O'Donnell Director of Gift Planning 55.00 X 0 188118 29025 James F Quinn Chief Development Officer 55.00 X 0 1232143 51327 Kevin Lenahan SVP-CFO and Admin Officer 2.00 55.00 X 0 1203458 239390 Bonnie Gannon Director - Relations 55.00 X 0 151064 22771 Christine Hajsok Director of Finance 55.00 X 0 174860 32496 Geraldine Kling Major Gift Fundraisers 55.00 X 0 139124 0 Regina Diverio Director - Communications 55.00 X 0 150690 7636 Susan Johns Major Gift Fundraisers 55.00 X 0 133192 19872 0 9020937 762133 0 0 1 0 0 85464 24274491 45697 24359955 3741083 3741083 28288909 23939097 4349812 4349812 4349812 17080 85464 39102 -22022 -22022 27419 2204 25215 25215 32454043 0 0 8094088 7241783 7241783 580448 580448 2574530 2574530 631524 631524 248 248 23840 23840 375200 375200 2521 2521 553989 553989 86527 86527 179059 179059 50670 50670 29074 29074 40251 40251 Freight 396 396 12370060 7822231 325663 4222166 7821356 14337327 64571200 70934563 48025569 60403288 9809630 5303864 3197752 3278675 133425507 154257717 1959452 2133460 2524448 2402898 4483900 4536358 X 30647337 36772840 61978213 74375069 36316057 38573450 128941607 149721359 133425507 154257717 X 20083983 9158374 -8462605 X 0 1 X 1 0 X 15053302 23933319 16576243 13850518 16834955 86248337 15053302 23933319 16576243 13850518 16834955 86248337 8862004 77386333 2663112 2541677 3917716 3238025 3741083 16101613 102349950 0.75610 0.79960 X 98294270 23068070 8012241 16426062 112948519 96153493 12371179 4163138 14393540 98294270 96541283 15868737 -907015 15349512 96153493 86141983 22846715 2130928 14578343 96541283 74295119 12998553 6690255 7841944 86141983 0.34000 0.66000 0 0 0 Annuities Payable 2402898 2402898 32454043 0 32454043 0 32454043 12370060 0 12370060 0 12370060 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 X X X X 1 The Angeletti Group 17 Village Rd New Vernon NJ 07976 Consulting/FR 0 14220544 69000 14151544 Phonathon 455 NW 35th St Ste 104 Boca Raton FL 33431 Mail/Phone 0 423025 306200 116825 14643569 375200 14268369 NJ NY PA FL DE Kids 4 Kids Race 32423 32423 3087 1016 189 535 3937 Craniofacial Gala 31625 23550 8075 2035 13986 5484 3 38496 29491 9005 293 70 6089 1420 961 102544 85464 17080 5415 15072 6278 1955 10382 39102 -22022 27419 1646 558 0 27419 1646 558 2204 25215 NJ 1 0 0 0 0.50000 0.50000 Christine Hajsok 475 South Street Morristown NJ 07960 0 Christine Hajsok 174860 The Director of Finance manages & oversees all fundraising activities for this entity. X 1 0 1 Morristown Medical Center 100 Madison Avenue Morristown NJ 07960 521958352 501(c)(3) 7241783 Program Services. 1 Project Independence 91 531448 Women's Association Scholarship Fund 19 49000 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 two months 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 $6,000 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 by granting scholarships to high school graduates, and qualified hospital employees pursuing careers 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 only 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. 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 2017 calendar year, WAMMC awarded a total of $49,000 in Scholarships to 19 scholars. Award amounts varied. Over half of the 19 scholarships went to those pursuing their BSN, with the balance of the awards granted to those pursuing post-graduate and doctorate work. WAMMC is very proud that it is able to extend support to so many professionals and "patient care heros". 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 Carol S Jones MSN RN Trustee 0 330920 0 47900 0 500 0 29700 0 10082 0 419102 0 0 Christopher Zipp DO Trustee 0 407675 0 74300 0 500 0 16200 0 14349 0 513024 0 0 Damion A Martins MD Trustee 0 615125 0 113900 0 500 0 16200 0 16227 0 761952 0 0 Eric L Lazar MD Trustee 0 522079 0 0 0 110224 0 18900 0 16227 0 667430 0 0 Linda Gillam MD Trustee 0 596768 0 105000 0 500 0 9450 0 7980 0 719698 0 0 M Veronica Daly MD Trustee 0 363072 0 64400 0 500 0 8100 0 7982 0 444054 0 0 Mark D Widmann MD Trustee 0 874579 0 0 0 375 0 8000 0 16227 0 899181 0 0 Patricia O'Keefe Trustee 0 540104 0 254400 0 57468 0 137998 0 11948 0 1001918 0 0 Steven Maser Trustee 0 494999 0 0 0 72500 0 2700 0 11346 0 581545 0 0 Cynthia W O'Donnell Director of Gift Planning 0 170609 0 6600 0 10909 0 17077 0 11948 0 217143 0 0 James F Quinn Chief Development Officer 0 304557 0 54600 0 872986 0 35100 0 16227 0 1283470 0 0 Kevin Lenahan SVP-CFO and Admin Officer 0 821671 0 346600 0 35187 0 223163 0 16227 0 1442848 0 0 Bonnie Gannon Director - Relations 0 141642 0 5500 0 3922 0 10823 0 11948 0 173835 0 0 Christine Hajsok Director of Finance 0 167860 0 6500 0 500 0 16269 0 16227 0 207356 0 0 Regina Diverio Director - Communications 0 143007 0 5500 0 2183 0 0 0 7636 0 158326 0 0 Susan Johns Major Gift Fundraisers 0 128092 0 4600 0 500 0 11892 0 7980 0 153064 0 0 X 16883 Sale of comp property X 5 192 Sale of comp property X Toys 142 24832 Sale of comp propert X Gift Cards 7 2470 Cash value of cards X Electronics 7 1045 Sale of comp propert X Entertainment 2 275 Cash value of gift 0 1 0 Part I, Column (b): Schedule M, column (b) represents the number of contributions. 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 In conjunction with Atlantic Health System Inc., the Foundation for Morristown Medical Center (Foundation) requires disclosure of potential conflicts. This policy governs all personnel at the Foundation, 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. 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 confliction. 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 (Mercer) is completed every year. The most recent survey was conducted in 2017. Officers reviewed include President and CEO AHS; SVP Chief Financial & Administrative Officer; SVP, Care Innovation & Technology; SVP, Chief Nursing & Patient Experience Officer; SVP, Chief Human Resource Officer; SVP, Integrated Care Delivery & CEO Hospital Division; SVP, System & Network Planning & Business Development; SVP, Physician Enterprise & President, AMG; SVP Quality & Chief Medical & Academic Officer, AHS; VP Government & Public Affairs; VP AHS & President OMC; VP AHS & President MMC; VP AHS & President CMC; VP AHS & President NMC; VP, President ACO; VP, Clinical Intelligence; VP Legal Affairs & General Counsel; VP, Marketing & Communications; VP, Compliance & Audit; VP Ambulatory Services; VP, Finance; VP, Revenue Cycle; VP, Strategic Development & Network Affairs; VP, Chief Information Officer; VP, Insurance Networks. On behalf of Atlantic Health System, Inc., Mercer conducts an annual total compensation survey based on appropriate comparability data for like positions in like organizations. Line 15B: 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 -8,920,544. Beneficial Interest in Charitable Remainder Unitrust 457,939. 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 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 AHS Hospital Corp B 27256318 Actual amount of transaction. AHS Hospital Corp Q 20973901 Actual amount of transaction. AHS Hospital Corp B 8920544 Actual amount of transaction. AHS Hospital Corp P 368986 Actual amount of transaction. AHS Hospital Corp B 385189 Actual amount of transaction.