2018-02-27T13:45:39-06:00 2016-12-31 271728945 PKF O'Connor Davies LLP 300 Tice Boulevard Suite 315 Woodcliff Lake NJ 07677 990 2016-01-01 221487307 THE VALLEY HOSPITAL Inc VALL 2014478000 223 NORTH VAN DIEN AVENUE RIDGEWOOD NJ 07450 RICHARD KEENAN SENIOR VP FINANCE & CFO 2014478000 2018-02-27 1 Edward G O'Connor P00434443 2017129800 2018-02-26 65.51.112.58 2018-02-27 13:45:36 ES 262423201731903d2e85 2017-11-15 P 8F3E04F861F0216E32497907D09A877E57DED22A A3EB9A663B166A7F172762214481AEBFA8C1AD13 2016 2021-01-29 14:40:06Z X RICHARD KEENAN 223 NORTH VAN DIEN AVENUE RIDGEWOOD NJ 07450 789999250 0 X WWW.VALLEYHEALTH.COM X 1925 NJ THE VALLEY HOSPITAL SERVES THE COMMUNITY BY HEALING AND CARING FOR PATIENTS, COMFORTING THEIR FAMILIES AND TEACHING GOOD HEALTH. 19 18 4174 1510 1807293 -329092 12960710 9076860 646126327 678539611 5561027 16074529 7776719 8393233 672424783 712084233 0 0 0 0 306449663 306104254 0 0 0 350176736 368701073 656626399 674805327 15798384 37278906 975221417 1021454906 200649384 198441909 774572033 823012997 X THE VALLEY HOSPITAL SERVES THE COMMUNITY BY HEALING AND CARING FOR PATIENTS, COMFORTING THEIR FAMILIES AND TEACHING GOOD HEALTH. THE VALLEY HOSPITAL IS DISTINGUISHED BY A COMMITMENT TO EXCELLENCE IN CLINICAL CARE, INNOVATION IN PROGRAMS AND TECHNOLOGY, AND PROVIDING A COMPASSIONATE AND RESPECTFUL ENVIRONMENT. 0 0 370217555 428992335 Inpatient Services:It is the mission of The Valley Hospital to serve the community by healing and caring for patients, comforting their families and teaching good health. Valley has three buildings on its main campus. The valley Hospital serves more than 440,000 people in 32 towns in Bergen County and adjoining communities. (See continuation on schedule o).In 2016, Approximately 46,717 individuals were admitted to Valley. Our core inpatient services include:- The Valley Heart and Vascular Institute, which provides a continuum of prevention and wellness services, diagnostic and treatment services, research, and education for all types of cardiac and vascular disease.- a Cardiac Surgery Intensive Care Unit.- four Critical Care Units.- a Cardiac Catheterization Laboratory.- an inpatient Oncology unit.- The Neuroscience Center of Excellence, which includes The Stroke Center, as well as programs and services for a wide range of neurological disorders.- medical and surgical floors.- a Geriatric Services Unit.- The Institute for Robotic and Minimally Invasive Surgery.- The Total Joint Replacement Center.- The Center for Metabolic and Weight Loss Surgery.- The Center for Childbirth, which welcomed more than 3,366 newborns in 2016, and includes a Level III Neonatal Intensive Care Unit nursery.- a Pediatric Intensive Care Unit.- The Population Health DepartmentThe Population Health Department was established in January 2016. This step was taken by a multidisciplinary team of professionals dedicated to improving healthcare outcomes, lowering the number of readmissions and improving quality and outcomes as patients move through the continuum of care. The initial focus of the team is on the most vulnerable patients and is expanding to include all high-risk patients. The assortment of patients in 2016 had chronic disease such as coronary artery disease, hypertension, heart failure and diabetes. The team works together to manage high-risk patient populations - identifying and studying care gaps, assessing the root cause for these disparities and intervening to fill that void. In 2016, the team had 2,930 patient alerts. Their readmission rate was about 7.41%.Valley has earned an impressive 14 Gold Seals of Approval for healthcare quality from The Joint Commission placing Valley among the top tier of hospitals in the country for this Joint Commission recognition. 116732959 161869537 Outpatient Services: Through satellite facilities located throughout its service area, The Valley Hospital provides the communities it serves with a comprehensive array of outpatient services. Those services include:-The Blumenthal Cancer Center, offering comprehensive outpatient cancer services, including chemotherapy infusion radiation therapy treatments and Gama Knife treatments-a full-service laboratory.(See continuation on schedule o).-a Diagnostic Imaging Center.-The Fertility Center.-The Center for Maternal-Fetal Medicine.-a Pain Management Center.-The Breast Center.-The Urologic Oncology Center.-Integrative Healing Services, which provides complementary medicine, educational programs and support groups.-The Lung Cancer Center.-Rehabilitation Medicine.-The Kireker Center for Child Development.-The George R. Jaqua Same Day Services Center.-The Center for Sleep Medicine.-The Pediatric Sleep Disorders and Apnea Center.-The Spine Center.-The Center for Women's Heart Health.-The Men's Heart Center.Valley's Outpatient Transitional Care is a multidisciplinary program whose goal is to keep heart failure patients functioning in their homes and community and to prevent hospital readmissions. 210 patients (2,658 patient visits) were treated in 2016 and the 30-day readmission rate is 7.04 percent, which is below the national average. The Mobile Integrated Healthcare Program saw 280 CHF patients in 2016. These interventions involved clarifying medications and doses, making appointments and assisting patients with questions. Almost 6,000 people attended free support groups offered by Valley in 2016. An additional 2,393 people attended mental health education programs through our free community speaker's bureau. Valley's Department of Emergency Services donated 1,800 tourniquets to numerous police departments throughout Bergen and Passaic Counties. Additionally, they donated $55,000 of in-kind contributions to local towns to cover special events, pronouncements and EMT educational sessions. In 2016, Valley Health System volunteers completed 211,108 hours, representing the equivalent of 101 full time employees. The estimated dollar value of volunteer time is $4,973,704. Approximately 1,600 active volunteers included 720 adult volunteers, 207 college volunteers, 389 junior volunteers, 66 contingent volunteers, 77 Valley Home Care volunteers, 133 Board/committee volunteers and 26 pet therapy dogs. Bedside Harp volunteers enchanted over 18,000 patients, families, guests and staff. Consumer Health Ambassadors rounded with 3,800 patients and families leading to 400 direct requests for information from our Medical Library Services. We now have 110 Patient/Family Advisors (PFAs) who sit on councils, committees and work on special projects. As a group, PFAs donated over 5,000 hours of services.Valley Medical Group's 353 providers represent 57 medical specialties in 77 different locations. Their 1,008 employees served 266,615 patients in 2016.Valley Home Care had 221,310 patient visits in 2016 including 2,177 Maternal/Child Health Nursing visits and 69,061 Rehabilitation visits. Valley Hospice had 16,496 visits. 86 people attended bereavement programs and 1,066 participated in support groups offered by Valley Home Care. 25036147 42536931 Emergency Services:The Valley Hospital offers the communities it serves a full-service Emergency Department providing emergency services and minor treatment services. All physicians on the active staff are board certified in emergency medicine, and many nurses are certified in emergency nursing. Services include a minor treatment area and a pediatric emergency room that features a child-friendly layout and design. The Department also has a dedicated Computed Tomography Scanner. (See continuation on schedule o).Valley's Emergency Department also features the services of several Mobile Intensive Care Units, which answer thousands of calls each year. Mobile Intensive Care Units, staffed by qualified Valley paramedics, are specially equipped vehicles that bring the highly sophisticated techniques of intravenous therapy, airway management, cardiac monitoring and defibrillation directly to people in need of emergency care.In 2016, The Valley Hospital recorded 73,133 Emergency Department visits. 511986661 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 351 0 4174 1 1 1 1 CJ 0 0 0 0 0 0 0 0 X 19 18 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 NJ X RICHARD D KEENAN 2014478000 223 NORTH VAN DIEN AVENUE RIDGEWOOD NJ 07450 auDREY MEYERS pRESIDENT/ceo, vhs 38.00 2.00 X X 1527405 0 46326 josePH MARION chAIRMAN 2.50 0.50 X X 0 0 0 frANK SHEEHY chairman 3.00 0.50 X X 0 0 0 john W ALBOHM ESQ vice chairman 3.00 0.50 X X 0 0 0 edWARD B SELF MD treasurer 3.00 X X 0 0 0 ann m limberg secretary 3.00 X X 0 0 0 joan brunelle truSTEE 3.00 X 0 0 0 Michelle Hasson truSTEE 3.00 X 0 0 0 BRUCE J MACTAS TRUSTEE 3.00 X 0 0 0 geORGE BECKER md truSTEE 3.00 X 0 0 0 miCHAEL RAHMIN MD truSTEE 3.00 0.50 X 0 0 0 Judy Baselice TruSTEE 3.00 X 0 0 0 Rakesh Sharma MD FCCP truSTEE 3.00 X 0 0 0 stEVEN SILVERSTEIN truSTEE 2.50 1.00 X 0 0 0 DUANE SACHS TRUSTEE 3.00 X 0 0 0 Debra Taylor trusTEE 3.00 X 0 0 0 Jeffrey S Tucker truSTEE 2.50 1.00 X 0 0 0 Patricia Verduin truSTEE 3.00 X 0 0 0 Denis Salamone truSTEE 3.00 X 0 0 0 RICHARD KEENAN SR VP, FINANCE/CFO 39.50 0.50 X 1190707 0 48536 marIA MEDIAGO vp, facilities management 40.00 X 541242 0 44685 gaIL CALLANDRILLO vp, planning/ gov't relati 40.00 X 636617 0 52616 anASTASIOS KOZAITIS preSIDENT, FOUNDATION 40.00 X 370041 0 35521 megAN FRASER vp, cOMMUNICATIONS/MARKETI 40.00 X 378932 0 52645 william klutkowski vp, finance 40.00 X 391707 0 54344 julia karcher vp, aDMINISTRATION 40.00 X 373563 0 25146 peter w DIESTEL sr VP, ADMINISTRATION/COO 40.00 X 838398 0 53576 ROBIN G HOLLANDER SR VP, LEGAL SERVICES/GENE 40.00 X 708054 0 53347 ann maRIE LEICHMAN VP/CNO Patient Care Servic 40.00 X 528473 0 51241 ERIC CAREY vp/CIO, INFORMATION SYSTEM 40.00 X 493693 0 48988 Joseph yallowitz VP & Chief Medical officer 40.00 X 583812 0 45954 jose a balderrama vp, human resources 40.00 X 422231 0 35101 karteek bhavsar VP, ADMINISTRATION 40.00 X 327059 0 25204 robert w brenner senior vp/chief physician 40.00 X 938725 0 10741 leonard guglielmo asst vp, facilities 40.00 X 283608 0 35663 ki-chuen chak chief physicist 40.00 X 261843 0 44003 Julie W Lo Chief physicist 40.00 X 260382 0 48778 John mcconnell Physician Director 40.00 X 280947 0 34041 ephraim casper chief medical officer 40.00 X 277316 0 11851 11614755 0 858307 660 0 1 0 TORCON INC 8 NEWMAN SPRINGS ROAD RED BANK NJ 07701 General Contractor 11671810 navin haffty & associates llc 200 cordwainer drive suite 100 norwell MA 02061 information systems consulting 5133507 Bergen Anesthesia group pc 500 west main street suite 16 wyckoff NJ 07481 anesthesia 4042500 mechanical associates of new jersey inc 24 forest avenue hawthorne NJ 07507 mechanical contractor 2505533 hdr architecture 8404 indian hills drive omaha NE 68114 architectural 2503363 123 9042569 34291 9076860 INSURERS AND PATIENTS 621990 481763124 481763124 MEDICARE/MEDICAID PAYMENTS 621990 196776487 196776487 678539611 6674275 6674275 1495030 3380349 -1885319 -1885319 -1885319 83934922 74534668 9400254 9400254 9400254 other 621990 3830552 3830552 VALLEY HEALTH PHARMACY 621990 2013000 205707 1807293 FOOD SERVICES 621990 1992000 1992000 2443000 2443000 10278552 712084233 696411124 1807293 4788956 10934630 9124187 1810443 236488424 197333599 39154825 21074225 17584333 3489892 19614244 16366126 3248118 17992731 15013135 2979596 2746410 2746410 181370 181370 45559341 29581552 15977789 5979688 3792 5975896 9331629 2284530 7047099 11751192 3391255 8359937 556807 434960 121847 5250371 4322530 927841 43402009 43402009 SUPPLIES 136254945 74204975 62049970 DRUGS 58916385 58916385 Equipment rentals 22642641 13895008 8747633 provision for bad debt 21504793 21504793 4623492 4623492 674805327 511986661 162818666 0 11478653 16753947 74349394 70504904 17880898 17312444 871854973 602058585 268069324 269796388 448124720 477681099 9991653 10059343 145326775 159346781 975221417 1021454906 84487914 87535348 116161470 110906561 200649384 198441909 X 768137385 816596141 2005321 1987529 4429327 4429327 774572033 823012997 975221417 1021454906 X 37278906 4951337 6210721 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 64098360 64098360 391621306 281428361 110192945 16009042 12534593 3474449 387620058 307051046 80569012 12506207 1044585 11461622 269796388 ASSETS HELD BY RELATED ORGANIZATION 35963513 deferred financing costs and OTHER ASSETS 120394863 pension benefit 2988405 159346781 Amount due to third party payers and other liabilities 80682561 ESTIMATED PROFESSIONAL MEDICAL LIABILITY 30224000 110906561 695530777 4951337 4951337 690579440 21504793 21504793 712084233 653300534 0 653300534 21504793 21504793 674805327 Part XI, Line 4b - Other Adjustments: provision for bad debts offset against revenue 21,504,793. Part XII, Line 4b - Other Adjustments: bad debt provision offset against revenue 21,504,793. cayman islands 0 0 investment;ListTotal 0 120000 0 0 0 0 0 0 120000 0 120000 0 0 1 0 1 0 1 1 1 X 1 X 500.000000000000 1 1 0 1 1 8341331 68106 8273225 0.01230 18278107 10763642 7514465 0.01110 26619438 10831748 15787690 0.02340 2482857 266255 2216602 0.00330 3022926 532685 2490241 0.00370 2618007 807678 1810329 0.00270 2657202 2657202 0.00390 696381 696381 0.00100 11477373 1606618 9870755 0.01460 38096811 12438366 25658445 0.03800 407155 100903 306252 0.00050 45210 45210 0.00010 191216 191216 0.00030 643581 100903 542678 0.00090 0 7203400 3097462 208686000 277173606 -68487606 X 1 1 1 1 THE VALLEY HOSPITAL 223 NORTH VAN DIEN AVENUE RIDGEWOOD NJ 07450 X X X THE VALLEY HOSPITAL 1 0 0 1 X X X X X X X X X 16 1 1 0 1 X www.valleyhealth.com 1 14 1 www.valleyhealth.com 0 1 X 200.000000000000 500.000000000000 X 1 1 X X X 1 X www.valleyhealth.com X www.valleyhealth.com X www.valleyhealth.com X X X X X 1 X 1 X X X 1 X 0 0 THE VALLEY HOSPITAL Part V, Section B, Line 5: To solicit input from key informants, those individuals who have a broad interest in the health of the community, an Online Key Informant Survey was also implemented as part of this process. A list of recommended participants was provided by the Community Health Improvement Partnership of Bergen County; this list included names and contact information for physicians, public health representatives, other health professionals, social service providers, and a variety of other community leaders. 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 contacted by email, introducing the purpose of the survey and providing a link to take the survey online; reminder emails were sent as needed to increase participation. In all, 75 community stakeholders in Bergen County took part in the Online Key Informant Survey.Final participation included representatives of the organizations outlined below. Bergen County Cancer Education and Early Detection Bergen County Department of Health Services Bergen County Department of Human Services Bergen County School Nurses Association Bergen County Special Services Bergen County United Way Bergen County Youth Services Commission Bergen Regional Medical Center Bergen Volunteer Center Bergenfield/Hackensack Health Departments Brightview Senior Living CancerCare Care Plus Medical Services Center for Dentistry at HUMC Children's Aid and Family Services Christian Health Care Center Edgewater Office of Public Health/Health Department Englewood Health Department Fair Lawn Senior Center Friends to Friends Community Church Geriatric Services, Inc. Gold's Gym Hackensack University Medical Center HARP of Hackensack University Medical Center Healthy Families North Jersey High Focus Centers Holy Name Medical Center Jewish Family Service of Bergen and North Hudson Metropolitan AME Zion Church Narcotics Anonymous North Hudson Community Action Corp Health Center Northern Valley ADC Paramus Board of Health and Human Services Partnership for Maternal and Child Health of North NJ Pascack Valley Meals on Wheels Senior Source Teaneck Health Department/Social Services Teaneck Police Department THE VALLEY HOSPITAL Part V, Section B, Line 6a: The hospital's CHNA was completed with the following other hospital facilities: Christian Health Care Center (ramapo ridge psychiatric hospital), Englewood Hospital and Medical Center, Hackensack University Medical Center, HacksensackUMC at pascack valley and Holy Name Medical Center. THE VALLEY HOSPITAL Part V, Section B, Line 11: The Valley Hospital CHNA identified eighteen (18) Areas of Opportunity. These areas were determined after consideration of various criteria, including: standing in comparison with benchmark data (particularly national data); the preponderance of significant findings within topic areas; the magnitude of the issue in terms of the number of persons affected; and the potential health impact of a given issue. We will be addressing 16 of the 18 areas by: Improve health status through chronic disease and care management. Continue to offer Community Care Clinic Expand reach to underserved and special populations Expand primary and preventative care, and enhance access and convenience ofprovider services. Continue to offer programs, services and support groups to promote positivemental health and prevent substance abuse Increase access to immunizations and reduce infectious diseaseThe two areas not covered are Children's Dental care and Children's Physical activity.They will not be addressed because:Children's dental care- Hospital does not have the expertise to effectively address Children's dental care. Issue is not a priority for community members and therefore approach is unlikely to succeed. Need is not as pressing as other problems. Children's physical activity initiatives are included in our efforts to improve health status however we chose to address activity initiatives for all age levels, not specifically children only. Part I, Line 6a: The hospital prepares an annual community benefit report which is mailed to our service area. Community benefit statistics are also reported at our Annual Meeting, which is open to the public. Part I, Line 7: The cost to charge ratio used to calculate the amounts in the table was derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges. Part I, Line 7g: There are no subsidized health services which are attributable to a physician clinic. Costs included represent medication and transportation for indigent patients. Part II, Community Building Activities: see statement of program service accomplishments Part III, Line 2: This is the total bad debt expense for the hospital discounted by the ratio of patient care cost to charges. Part III, Line 3: this is the total bad debt expense for patients eligible for financial assistance discount by the ratio of patient care cost to charges. Part III, Line 4: THE AMOUNT OF THE PROVISION FOR BAD DEBT IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. THE METHODOLOGY USED IS THE COST TO CHARGE RATIO, APPLIED ON A BASIS CONSISTENT WITH MEDICARE COST REPORTING PRINCIPLES. Part III, Line 8: In addition to Charity care, bad debt, and the treatment of financially needy patients under the Medicaid program, the Hospital provides services to elderly and disabled patients covered under the Medicare program regardless of income. The unpaid costs attributed to providing care under this program, and thus considered a community benefit, were estimated at $68.5 million. Part III, Line 9b: When a patient may qualify for charity care or financial assistance, our system is set up to stop sending statements to prevent them from going to a collection agency. We also have the ability to manually put an account on hold to avoid collection activity as well. Part VI, Line 2: Hospital staff reviews all the discharge data from the state DOHSS to determine what the major health issues are in the community. We look at disease specific incidence rates in our community and develop forecasts for what health issues are projected to plague the population in the future. We review census data to monitor demographic shifts and we conduct qualitative research (focus groups) to assess community feedback to new programs and services. We develop our core services around the major health issues in the community - thus, they are mostly in the area of heart and vascular disease, oncology (medical and surgical), neurology (stroke) and women's and children's services (OB, NICU, PICU, MFM and IVF). Part VI, Line 3: Signs are posted at every registration area. Information regarding financial screening is posted on the hospital's website for charity care as well as the uninsured discount policy. Patients can print applications and requirements from the website. The hospital's statements contain information alerting patients of financial assistance. The hospital's handbooks explain financial options which include information of state assistance, discount policy and any other type of financial arrangement. Part VI, Line 4: The primary and secondary service area of The Valley Hospital is composed of 32 towns in northwest Bergen and Passaic counties. These communities account for 70% of all our discharges. The population is 440,000 people. Part VI, Line 5: Renewal, which is being evaluated, is all about meeting the health care needs of our community. The oldest building on the campus, Phillips, was constructed in 1960. It houses over 250 beds, most of which are in small, outdated, semi-private rooms. The physical structure can no longer accommodate the equipment and technology needed to deliver care, thus our plans to renew our campus are based in our mission to provide the best quality care to the residents of our community. When we built the Luckow Pavilion in Paramus, we did research that indicated the best way to deliver care to cancer patients was to locate all services into one building. This not only provides a service to the patient, it is good medicine as the medical oncologists, surgical oncologists and radiation oncologists can consult each other to ensure that the patient is receiving the most appropriate treatment. We built the Ambulatory Surgery Center to adapt to the changing practice of performing surgery on a same day basis. X X X X 0 1 0 0 0 0 0 1 0 auDREY MEYERS pRESIDENT/ceo, vhs 991656 0 458156 0 77593 0 25135 0 21191 0 1573731 0 0 0 RICHARD KEENAN SR VP, FINANCE/CFO 675186 0 287812 0 227709 0 25115 0 23421 0 1239243 0 0 0 marIA MEDIAGO vp, facilities management 291395 0 82940 0 166907 0 24375 0 20310 0 585927 0 0 0 gaIL CALLANDRILLO vp, planning/ gov't relati 309993 0 86645 0 239979 0 25175 0 27441 0 689233 0 0 0 anASTASIOS KOZAITIS preSIDENT, FOUNDATION 230003 0 85928 0 54110 0 15144 0 20377 0 405562 0 0 0 megAN FRASER vp, cOMMUNICATIONS/MARKETI 253253 0 71599 0 54080 0 24693 0 27952 0 431577 0 0 0 william klutkowski vp, finance 254899 0 80225 0 56583 0 24949 0 29395 0 446051 0 0 0 julia karcher vp, aDMINISTRATION 257231 0 74715 0 41617 0 18146 0 7000 0 398709 0 0 0 peter w DIESTEL sr VP, ADMINISTRATION/COO 556886 0 211475 0 70037 0 25175 0 28401 0 891974 0 0 0 ROBIN G HOLLANDER SR VP, LEGAL SERVICES/GENE 485418 0 198965 0 23671 0 22525 0 30822 0 761401 0 0 0 ann maRIE LEICHMAN VP/CNO Patient Care Servic 332907 0 89595 0 105971 0 25175 0 26066 0 579714 0 0 0 ERIC CAREY vp/CIO, INFORMATION SYSTEM 327831 0 105935 0 59927 0 22525 0 26463 0 542681 0 0 0 Joseph yallowitz VP & Chief Medical officer 401567 0 111920 0 70325 0 16687 0 29267 0 629766 0 0 0 jose a balderrama vp, human resources 294122 0 82302 0 45807 0 17225 0 17876 0 457332 0 0 0 karteek bhavsar VP, ADMINISTRATION 227835 0 66770 0 32454 0 17654 0 7550 0 352263 0 0 0 robert w brenner senior vp/chief physician 696284 0 106675 0 135766 0 0 0 10741 0 949466 0 0 0 leonard guglielmo asst vp, facilities 233675 0 39865 0 10068 0 25175 0 10488 0 319271 0 0 0 ki-chuen chak chief physicist 254858 0 550 0 6435 0 24627 0 19376 0 305846 0 0 0 Julie W Lo Chief physicist 259280 0 550 0 552 0 17055 0 31723 0 309160 0 0 0 John mcconnell Physician Director 252414 0 22220 0 6313 0 25175 0 8866 0 314988 0 0 0 ephraim casper chief medical officer 270517 0 0 0 6799 0 0 0 11851 0 289167 0 0 0 Part I, Line 4b -The following persons received payment from a SERP plan during 2016: Peter Diestel received $42,400, Gail Callandrillo received $113,228, Maria Mediago received $66,348, Ann Marie Leichman received $24,143. These amounts are taxable and is reported on part II column B(iii). -Peter Schwartz received payment of $81,458 from an executive benefit plan plan during 2016. These amounts are taxable and reported on part II column B(iii). Part I, Line 7 Bonus is based on management performance and is determined by the board of trustees. The following individuals received the following bonus, which was taxable and included in each of his/her W-2: Audrey Meyers - $458,156 Richard Keenan - $287,812 Megan Fraser - $71,599 Maria Mediago - $82,940 Gail Callandrillo - $86,645 Anastasios Kozaitis - $85,928 William Klutkowski - $80,225 Julia Karcher - $74,715 Peter Diestel - $211,475 Robin Hollander - $198,965 Ann Marie Leichman - $89,595 Eric Carey - $105,935 Robert W Brenner - $106,675 Karteek Bhavsar - $66,770 Jose Balderrama - $82,302 Joseph Yallowitz - $111,920 Bonus is determined by a management scorecard & leadership competencies with established payout targets as approvided by CEO. The following individuals received the following bonus, which was taxable and included in each of his/her W-2: Leonard Guglielmo - $39,865 John McConnell - $22,220 Bonus is determined by the organization meeting established patient satisfaction scores. The following individuals received the following bonus, which was taxable and included in each of his/her W-2: Ki-Chuen Chak - $550 Julie Lo - $550 Form 990, Part VI, Section B, line 11b When the Form 990 has been prepared, reviewed by management and is ready to be filed with the internal revenue service, a paper copy or e-file copy is submitted to members of the board audit committee for review and comments. Each issue is documented and addressed until the return is finalized and approved for filing. Form 990, Part VI, Section B, line 12c The Valley Hospital, Inc. has a conflict of interest policy that applies to all of the members of management and board members. Annually, the board mandates that all members of management and board members sign a conflict of interest policy and disclose any potential or actual conflicts that may exist. If a conflict of interest exists, the hospital will notify management and or board members and investigate the potential conflict. The interested person must leave the board or committee meeting while a discussion regarding the potential conflict of interest is discussed upon. The remaining board or committee members will decide if a conflict of interest exists. If it is determined that a conflict exists the member of management or the board will be notified immediately and will not be allowed to vote or be part of any decisions about such matters. This process is recorded in the minutes of the board meetings. Form 990, Part VI, Section B, line 15 The hospital has established a policy for compensation of its officers, top management and key employees. The policy mandates that compensation for its officers, top management and key employees, be periodically reviewed by the executive compensation committee of the board of trustees free of any members with conflicts of interest related thereto. The committee determines that the executives are being paid an appropriate level of compensation by using comparative data for similarly qualified persons in functionally comparable positions at similarly situated organizations. Compensation decision on the amount of compensation paid and term is adequately documented in a contemporaneously written format. this process was last undertaken in 2016. Form 990, Part VI, Section C, line 19 The hospital makes its Form 990 available for public inspection as required under section 6104 of the internal revenue code by posting of the return on guidestar.org and similar types of websites. In addition Form 990 as well as the financial statements and conflict of interest policy and other relevent documents are available upon request at 223 North Van Dien Avenue, Ridgewood, NJ 07450. Form 990, Part XI, line 9: CHANGE IN ACCRUED PENSION LIABILITY TO BE RECOGNIZED IN FUTURE PERIODS 6,305,524. CHANGE IN ASSETS HELD BY VALLEY HOSPITAL FOUNDATION -94,803. Form 990, Part XII, Line 2c: the process for selecting an independent accountant and establishing a committee that assumes responsibility for oversight of the audit has not changed from prior years. Form 990 - Amended Return Explanation Taxpayer is hereby ameding form 990, schedule H part i line 7, part ii, and part iii to report numerical information inadvertently omitted from the originally filed form 990, schedule h. 555 maple acquisition LLC 223 NORTH VAN DIEN AVENUE ridgewood NJ 07450 453070365 real estate HOLDINGS DE 8110000 The Valley Hospital Inc 599 PARAMUS ACQUISITION LLC 223 NORTH VAN DIEN AVENUE Ridgewood NJ 07450 460985392 real estate HOLDINGS DE 12041484 The Valley Hospital Inc 620 WINTERS AVENUE LLC 223 NORTH VAN DIEN AVENUE Ridgewood NJ 07450 real estate HOLDINGS DE The Valley Hospital Inc 1200 east ridgewood llc 223 NORTH VAN DIEN AVENUE ridgewood NJ 07450 464115513 real estate HOLDINGS DE 4031256 24933541 the Valley Hospital Inc VALLEY HEALTH SYSTEM INC 223 NORTH VAN DIEN AVENUE RIDGEWOOD NJ 07450 222922016 PROVIDES MANAGEMENT & PLANNING SERVICES FOR ITS MEMBERS NJ 501(C)(3) line 3 N/A 0 VALLEY MEDICAL SERVICES INC 223 NORTH VAN DIEN AVENUE RIDGEWOOD NJ 07450 223260998 PROVIDES CERTAIN MEDICAL CARE TO PATIENTS INCL.PEDIATRIC & NEONATAL SERVICES NJ 501(C)(3) Line 10 The Valley Hospital Inc 1 VALLEY PHYSICIAN SERVICES INC 15 ESSEX ROAD PARAMUS NJ 07652 320041186 PROVIDES MEDICAL CARE TO CARRYOUT THE PURPOSE OF THE VALLEY HEALTH SYSTEM NJ 501(C)(3) Line 10 THe Valley Hospital Inc 1 VALLEY HOME CARE INC 15 ESSEX ROAD PARAMUS NJ 07652 223208480 PROVIDES REHABILITATION VISITS AND HOME HEALTH AIDS VISITS TO PATIENTS NJ 501(C)(3) Line 10 valley health system inc 0 The VALLEY HOSPITAL FOUNDATION Inc 223 NORTH VAN DIEN AVENUE RIDGEWOOD NJ 07450 222324554 SOLICIT,RECEIVE AND APPLY CONTRIBUTIONS FOR THE BENEFIT OF THE HOSPITAL NJ 501(C)(3) line 7 VALLEY HEalth system inc 0 VALLEY HEALTH MEDICAL GROUP INC 15 ESSEX ROAD PARAMUS NJ 07652 223475233 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 valley physician service ny pc 15 ESSEX ROAD pARAMUS NJ 07652 453125678 oPERATES URGENT/PRIMARY CARE CLINICS NY N/A C 0 VHS INSURANCE COMPANY LTD 010 MAIN STREET cayman islands CJ 980408200 PROVIDES PROFESSIONAL, MEDICAL AND COMMERCIAL GENERAL LIABILITY INSURANCE CJ the valley hospital inc C 70559437 1.00000 1 0 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 1 1 0 Valley Medical Services Inc Q 80000 Cost Valley Physician Services inc Q 57800000 Cost VHS INSURANCE COMPANY LTD R 9236000 Cost