2017-11-13T08:15:40-06:00 2016-12-31 WithumSmithBrown PC 200 Jefferson Park Suite 400 Whippany NJ 079811070 990 2016-01-01 221487173 ENGLEWOOD HOSPITAL AND MEDICAL CENTER % ANTHONY T ORLANDO ENGL 2018943275 350 ENGLE STREET ENGLEWOOD NJ 07631 WARREN GELLER PRESIDENT/CEO 2018943280 2017-11-08 true Scott J Mariani P00642486 9738989494 198.46.120.251 22006220173175000001 2017-11-13 P 582F47EFACDD6166E52205D1FBFEA2601660FA18 B8BA16CFEDA17302B35ECB0C007529BABF51136A 2016 2017-02-10 21:41:12Z WARREN GELLER 350 ENGLE STREET ENGLEWOOD NJ 07631 567690152 false X WWW.ENGLEWOODHEALTH.ORG X 1888 NJ TO PROVIDE COMPREHENSIVE, STATE-OF-THE- ART PATIENT SERVICES, EMPHASIZE CARING AND OTHER HUMAN VALUES IN THE TREATMENT OF PATIENTS AND IN RELATIONS WITH THEIR FAMILIES. 28 23 3112 770 0 3277063 5269220 494636698 558203224 61377 269464 7155728 3869088 505130866 567610996 22500 8250 0 0 176264883 187552562 0 0 0 315294724 358105975 491582107 545666787 13548759 21944209 489280714 554470152 331422127 353212926 157858587 201257226 X To provide comprehensive, state-of-the-art patient services; emphasize caring and other human values in the treatment of patients and in relations with their families, and among employees, medical staff, and community; be a center of education and research; and provide employees and medical staff with maximum opportunities to achieve their personal and professional goals. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT. false false 451707400 8250 558203224 EXPENSES INCURRED IN PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY MEDICALLY NECESSARY SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT (STATEMENT OF PROGRAM SERVICES) WHICH INCLUDES DETAILED INFORMATION REGARDING THE VARIOUS SERVICES PROVIDED BY THIS ORGANIZATION. 451707400 true true false true false false false false false false true false true false true true false true false false false false false false false false true true true false true false false false false false false true false false false false false true true true true false false true 263 0 true 3112 true false false false false false false false false false false X 28 23 true false false false true true true true true false false true true true true true true true true true true NJ X ANTHONY T ORLANDO 2018943280 350 ENGLE STREET ENGLEWOOD NJ 07631 X THOMAS C SENTER ESQ CHAIRMAN - TRUSTEE 14.0 2.0 X X 0 0 0 STEVEN E SIESSER ESQ VICE CHAIRMAN - TRUSTEE 1.0 1.0 X X 0 0 0 WARREN GELLER SECRETARY - TRUSTEE; PRES/CEO 55.0 8.0 X X 983309 195000 187502 JONATHAN ABAD TREASURER - TRUSTEE 2.0 1.0 X X 0 0 0 YALE BLOCK TRUSTEE 2.0 1.0 X 0 0 0 IN JIN CHOI TRUSTEE 1.0 1.0 X 0 0 0 IRA COHEN TRUSTEE (EFFECTIVE 10/01/16) 1.0 0.0 X 0 0 0 ANDREW F DURKIN TRUSTEE 1.0 1.0 X 0 0 0 CHRIST ECONOMOUS TRUSTEE (EFFECTIVE 10/01/16) 1.0 0.0 X 0 0 0 GAYLE GERSTEIN TRUSTEE 1.0 0.0 X 0 0 0 RONALD GOLD TRUSTEE 1.0 1.0 X 0 0 0 DAVID GRAF TRUSTEE 1.0 0.0 X 0 0 0 EDDIE R HADDEN ESQ TRUSTEE 4.0 1.0 X 0 0 0 THOMAS M JACKSON ESQ TRUSTEE 1.0 0.0 X 0 0 0 MARGARET R KAPLEN TRUSTEE 1.0 0.0 X 0 0 0 SUN CHONG KIM TRUSTEE 1.0 1.0 X 0 0 0 RICHARD J KURTZ TRUSTEE 1.0 4.0 X 0 0 0 GERALD LEE MD TRUSTEE 1.0 1.0 X 0 0 0 RICHARD LERNER TRUSTEE 1.0 1.0 X 0 0 0 GREGG LOBEL MD TRUSTEE - MED STAFF PRESIDENT 1.0 0.0 X 0 0 0 ROBERT F MANGANO TRUSTEE 2.0 2.0 X 0 0 0 JEFFREY MATICAN MD TRUSTEE 1.0 55.0 X 25004 432966 25676 JAY C NADEL TRUSTEE 5.0 3.0 X 0 0 0 LEON REDENSKY TRUSTEE 1.0 0.0 X 0 0 0 STEVEN RUDNITSKY TRUSTEE 1.0 0.0 X 0 0 0 MARK SAPIENZA MD TRUSTEE (EFFECTIVE 01/01/16) 3.0 0.0 X 0 0 0 MARK SHAPIRO MD TRUSTEE 1.0 1.0 X 0 250000 0 THOMAS J VOLPE TRUSTEE 1.0 1.0 X 0 0 0 ANTHONY T ORLANDO SVP FINANCE/CFO 55.0 4.0 X 591345 20102 51737 MARY ANN DONOHUE-RYAN PHD RN VP, PCS & CNO (EFF 01/19/16) 55.0 0.0 X 272509 0 22739 HELENE WOLK SVP OPERATIONS 55.0 0.0 X 405042 0 19153 MICHAEL PIETROWICZ SVP PLANNING & DEVLOPMENT 55.0 2.0 X 406385 0 53063 PATRICIA G WILSON SVP HUMAN RESOURCES 55.0 0.0 X 380432 0 52134 KATHLEEN KAMINSKY RN SVP CHIEF POP HEALTH OFFICER 55.0 0.0 X 343097 0 54056 ALICIA PARK VP COMMUNICATIONS 55.0 0.0 X 264984 0 7634 DIMITRI CRUZ DIRECTOR INFO TECHNOLOGY/CIO 55.0 0.0 X 264554 0 22210 3936661 898068 495904 405 false true false CROTHALL HEALTHCARE GROUP 1500 LIBERTY RIDGE DRIVE SUITE 210 WAYNE PA 19087 ENVIRONMENTAL SVCS 5003355 ENGLEWOOD CARDIAC SURGERY ASSOCIATE 350 ENGLE STREET ENGLEWOOD NJ 07631 PHYSICIAN SERVICES 3335000 ABSOLUTE MEDIA INC 1150 SUMMER STREET STAMFORD CT 06905 ADVERTISING 1735535 US SECURITY ASSOCIATES PO BOX 931703 ATLANTA GA 31193 SECURITY 1684346 TRIAGE CONSULTING GROUP 221 MAIN STREET SUITE 1100 SAN FRANCISCO CA 94105 CONSULTING 1459463 102 X 3971916 1297304 5269220 NET PATIENT SERVICE REVENUE 622110 552788328 552788328 OTHER HEALTHCARE RELATED REVENUE 622110 4054412 4054412 INCOME FROM JOINT VENTURE - VNA OF ENG. 621610 1159826 1159826 RENTAL INCOME FROM AFFILIATES 531190 200658 200658 558203224 269364 269364 0 0 1063611 1063611 0 1063611 1063611 79256 79156 100 100 100 0 0 0 0 0 0 0 0 0 CAFETERIA/VENDING SALES 722210 2473236 2473236 PARKING 812930 323743 323743 TELEPHONE/TELEVISION 900099 8498 8498 2805477 567610996 558203224 4138552 X 8250 8250 0 0 0 2558339 25004 2533335 0 0 147150144 123092508 24057636 9885164 8270714 1614450 15873819 13281299 2592520 12085096 10111352 1973744 826075 826075 1041827 99068 942759 265816 265816 65757 65757 0 0 136741036 125905913 10835123 0 4434565 2760864 1673701 1694904 493242 1201662 11572762 549836 11022926 0 9338651 5333833 4004818 438952 307346 131606 0 288841 259092 29749 7155636 7155636 0 31033078 14377286 16655792 3889065 3201246 687819 MEDICAL SUPPLIES 73408739 73408739 0 0 PHARMACEUTICALS/DRUGS 39360322 39307617 52705 0 CONTRACTED SERVICES 29443431 21767012 7676419 0 OTHER EXPENSES 7106518 1165468 5941050 0 545666787 451707400 93959387 0 X 9244336 9521759 35019736 36725442 0 0 49624560 56039138 0 0 0 0 2371043 2371043 10043234 11857041 6245338 6174848 655822609 365916457 277428049 289906152 0 0 0 0 75920789 127537293 0 0 23383629 14337436 489280714 554470152 62139940 71170700 0 0 241192 202477 0 0 0 0 0 0 181215248 207260036 0 0 87825747 74579713 331422127 353212926 X 115979928 148160204 38754801 49973164 3123858 3123858 157858587 201257226 489280714 554470152 X 21944209 -23821 21478251 X X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 65757 65757 65757 65757 545601034 545601034 545666791 545666791 1000000 1000000 250000 250000 1000000 1000000 1000000 1000000 4000000 6000000 16953 18152 55718 65757 156580 250000 250000 250000 250000 1000000 1500000 0 0 0 0 0 SCHEDULE C, PART II-A, LINE 2C THE ORGANIZATION IS AN AFFILIATE WITHIN ENGLEWOOD HEALTHCARE SYSTEM, INC. AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). ENGLEWOOD HOSPITAL AND MEDICAL CENTER ENGAGES IN LOBBYING EFFORTS ON A FEDERAL AND STATE LEVEL. DURING 2016, THE ORGANIZATION PAID AN OUTSIDE FIRM $36,000 FOR LOBBYING ACTIVITIES PERFORMED ON BEHALF OF THE ORGANIZATION. IN ADDITION, THE ORGANIZATION IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION ("AHA") AND THE NEW JERSEY HOSPITAL ASSOCIATION ("NJHA") WHICH BOTH ENGAGE IN LOBBYING EFFORTS ON BEHALF OF THEIR MEMBER HOSPITALS. A PORTION OF THE DUES PAID TO THESE ORGANIZATIONS HAS BEEN ALLOCATED TO LOBBYING ACTIVITIES PERFORMED ON BEHALF OF THE ORGANIZATION. THIS ALLOCATION AMOUNTED TO $29,757 DURING 2016. THIS ORGANIZATION IS ALSO A MEMEBER OF FAIR SHARE HOSPITALS COLLABORATIVE, INC. TO WHICH IT PAID DUES IN THE AMOUNT OF $15,000 IN 2016. ONE OF THE FUNCTIONS OF FAIR SHARE HOSPITALS COLLABORATIVE, INC. IS TO ENGAGE IN LOBBYING ACTIVITIES PERFORMED ON BEHALF OF ITS MEMBER HOSPITALS. 180588 180588 193486262 58936383 134549879 445224055 305370970 139853085 16931704 1609104 15322600 289906152 CASH & CASH EQUIVALENTS 15217174 F INCOME SECURITIES 13091000 F MORTGAGE RESERVE FUND 12151174 F LEASE AGREEMENTS 27940285 F INVESTMENTS IN JOINT VENTURES 6040638 F EHMC FOUNDATION 53097022 F 127537293 0 DUE TO AFFILIATES 447915 DUE TO THIRD PARTY PAYORS 29903031 ACCRUED PENSION LIABILITY 32089424 ESTIMATED MALPRACTICE CLAIMS 3868602 OTHER LIABILITIES 8270741 74579713 X SCHEDULE D, PART X, LINE 2 THE ORGANIZATION IS AN AFFILIATE WITHIN ENGLEWOOD HEALTHCARE SYSTEM, INC. AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF ENGLEWOOD HOSPITAL AND MEDICAL CENTER AND SUBSIDIARIES FOR THE YEARS ENDED DECEMBER 31, 2016 AND DECEMBER 31, 2015; RESPECTIVELY. THE FOLLOWING FOOTNOTE IS INCLUDED IN THE ORGANIZATION'S 2016 AUDITED CONSOLIDATED FINANCIAL STATEMENTS THAT REPORTS THE ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 (ASC 740): The Medical Center accounts for uncertainty in income taxes using a recognition threshold of more-likely-than-not to be sustained upon examination by the appropriate taxing authority. Measurement of the tax uncertainty occurs if the recognition threshold is met. Management determined there were no tax uncertainties that met the recognition threshold in 2016 and 2015. true true X true X true X 900. true true true false false 18941320 488874 18452446 0.03380 43439355 26695833 16743522 0.03070 62380675 27184707 35195968 0.06450 1528242 1528242 0.00280 12996583 1600232 11396351 0.02090 95907000 54018000 41889000 0.07680 460688 148850 311838 0.00060 331961 331961 0.00060 111224474 55767082 55457392 0.10170 173605149 82951789 90653360 0.16620 true 15000999 4110274 137734255 205886589 -68152334 X true true 1 1 ENGLEWOOD HOSPITAL AND MEDICAL CENTER 350 ENGLE STREET ENGLEWOOD NJ 07631 WWW.ENGLEWOODHEALTH.ORG 10202 X X X X X ENGLEWOOD HOSPITAL AND MEDICAL CENTER 1 false false true X X X X X X X X X 16 true true true true X WWW.ENGLEWOODHEALTH.ORG X www.healthybergen.org X true 17 true WWW.ENGLEWOODHEALTH.ORG false true X 200. 9999999900. X X X X X true true X X X true X WWW.ENGLEWOODHEALTH.ORG X WWW.ENGLEWOODHEALTH.ORG X WWW.ENGLEWOODHEALTH.ORG X X X X X X true X false X X X true X false false SCHEDULE H, PART V, SECTION B, QUESTION 5 While conducting its most recent community health needs assessment ("CHNA") Englewood Hospital and Medical Center ("EHMC") took into account input from persons who represent the broad interest of the community served by the hospital facility. The organizations CHNA incorporates data from both quantitative and qualitative sources. Quantitative data input includes primary research (the PRC Community Health Survey) and secondary research (vital statistics and other existing health-related data); these quantitative components allow for comparison to benchmark data at the county, state and national levels. Qualitative data input includes primary research gathered through an Online Key Informant Survey of various community stakeholders. Online Key Informant Survey --------------------------- In an effort to solicit input from key informants, those individuals who have a broad interest in the health of the community, the organization utilized an Online Key Informant Survey as part of its CHNA 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. Through this process, input was gathered from several individuals whose organizations work with low-income, minority populations, or other medically underserved populations. Minority/medically underserved populations represented include: African-Americans, Asians, children, day laborers, the disabled, elderly population, foster children, those with high deductibles, Hispanics, the homeless, immigrants, Koreans, residents with low education level, low income residents, Medicare/Medicaid recipients, the mentally ill, MICA clients, Native Americans, non-English speaking persons, obese individuals, students attending schools in low income areas, teenage mothers, undocumented individuals, unemployed residents, the uninsured/underinsured, veterans. In the online survey, key informants were asked to rate the degree to which various health issues are a problem in their own community. Follow-up questions asked them to describe why they identify problem areas as such, and how these might be better addressed. Results of their ratings, as well as their verbatim comments, are included in EHMCs CHNA. 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; and - Teaneck Health Department/Social Services. SCHEDULE H, PART V, SECTION B, QUESTIONS 6A & 6B EHMC's CHNA was completed in collaboration with the Community Health Improvement Partnership ("CHIP") of Bergen County. The EHMC CHNA is part of a broader regional assessment made possible through the generous support of Christian Health Care Center (Ramapo Ridge Psychiatric Hospital), Hackensack University Medical Center, HackensackUMC at Pascack Valley, Holy Name Medical Center and The Valley Hospital. Representatives from each of these hospitals, along with representatives of the Bergen County Department of Health Services ("BCDHS") and the CHIP of Bergen County. The organizations worked collaboratively to guide assessments of health needs for Bergen County and for the specific communities served by each hospital. Additionally, EHMCs CHNA was conducted by Professional Research Consultants, Inc. ("PRC"). PRC is a nationally-recognized healthcare consulting firm with extensive experience conducting CHNAs such as this in hundreds of communities across the United States since 1994. SCHEDULE H, PART V, SECTION B, QUESTIONS 7A & 7B THE ORGANIZATION IS AN AFFILIATE WITHIN ENGLEWOOD HEALTHCARE SYSTEM, INC. AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN PART V, SECTION B, QUESTION 7A, IS THE HOME PAGE FOR THE SYSTEM. THE CHNA CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: www.englewoodhealth.org/about#community-health-needs-assessment Additionally, the Community Health Improvement Partnership of Bergen Countys CHNA, which includes this organization, is made widely available at the following URL: www.healthybergen.org SCHEDULE H, PART V, SECTION B, QUESTION 10A DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN PART V, SECTION B, QUESTION 10A, IS THE HOME PAGE FOR THE SYSTEM. THE ORGANIZATION'S IMPLEMENTATION STRATEGY IS MADE WIDELY AVAILABLE AND CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: www.englewoodhealth.org/about#community-health-needs-assessment SCHEDULE H, PART V, SECTION B, QUESTION 11 The EHMC CHNA identified twenty-seven (27) 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. On August 4, 2016 EHMC, along with the Bergen County Department of Health Services and the other hospitals sponsoring the broader Bergen County assessment project, convened a group of community stakeholders (representing a cross-section of community-based agencies and organizations) to evaluate, discuss and prioritize health issues for Bergen County, based on findings of the countywide CHNA. The results of this prioritization will inform the selection of priorities for each of the hospitals in its respective service area. PRC began the meeting with a presentation of key findings from the CHNA, highlighting the significant health issues identified from the research. Following the data review, PRC answered any questions and facilitated a group dialogue, allowing participants to advocate for any of the health issues discussed. Finally, participants were provided an overview of the prioritization exercise that followed. In order to assign priority to the identified health needs (Areas of Opportunity), a wireless audience response system was used in which each participant was able to register his/her ratings using a small remote keypad. Individuals' ratings for each criteria were averaged for each tested health issue, and then these composite criteria scores were averaged to produce an overall score. This process yielded the following prioritized list of community health needs: 1. Substance Abuse 2. Mental Health 3. Diabetes 4. Nutrition, Physical Activity, & Weight 5. Access to Healthcare Services 6. Heart Disease & Stroke 7. Dementias, Including Alzheimers Disease 8. Immunization & Infectious Diseases 9. Cancer EHMC is committed to achieving the "triple aim": improved health through better quality of care at lower costs. To address the needs of its community, EHMC allocated significant resources to ensure achievement of the CHNA implementation strategy goals. Additionally, EHMC has developed a Population Health Department which includes both clinical and support services. EHMC is dedicated to being a beacon of health for its community. EHMC has prioritized the significant needs identified into the following Goals: Goal 1: Increase Access to Health Care Through Population Health Management ---------------------------------------------------------------- 1) Expand primary and preventative care to meet the community needs; 2) Enhance access and convenience to meet consumer expectations; 3) Ensure adequate network of providers to meet needs of community; 4) Develop a system-wide care management program; 5) Develop population-specific programs to ensure access to care; and 6) Partner with local communities and community based agencies to provide resources and expertise in achieving healthy populations. Goal 2: Promote Behavioral Health --------------------------------- 1) Continue to offer behavioral health education and screenings to the community; 2) Integrate behavioral health into the primary care setting; 3) Increase population-specific programs and services; and 4) Collaborate with other providers on cross continuum initiatives. Goal 3: Improve Health Status Through Chronic Disease and Care Management Across the Continuum ------------------------------------------------------------------------- **Cardiovascular/Heart Disease and Stroke** 1) Continue outreach to the community with a focus on prevention and early diagnosis; 2) Ensure adequate network; and 3) Ensure access to providers. ** Cancer ** 1) Continue outreach to the community with a focus on prevention and early diagnosis; and 2) Continue to be a Commission on Cancer accredited hospital. ** Diabetes ** 1) Continue outreach to the community with a focus on prevention and early diagnosis. ** Nutrition, Physical Activity and Weight ** 1) Develop population-specific programs. Goal 4: Increase Access to Immunizations and Reduce Infectious Diseases ----------------------------------------------------------------------- 1) Increase preventative measures in primary care setting. SCHEDULE H, PART V, SECTION B, QUESTION 13A DUE TO CHARACTER LIMITATIONS, THE PERCENTAGE REFLECTED IN SCHEDULE H, PART V, SECTION B, QUESTION 13, FOR THE ORGANIZATION'S FEDERAL POVERTY GUIDELINES ("FPG") FAMILY INCOME LIMIT TO DETERMINE ELIGIBILITY FOR DISCOUNTED CARE IS 900%. HOWEVER, THIS ORGANIZATION OFFERS DISCOUNTED CARE TO ALL UNINSURED PATIENTS FOR EMERGENCY AND MEDICALLY NECESSARY CARE REGARDLESS OF INCOME. SCHEDULE H, PART V, SECTION B, QUESTION 16 DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN PART V, SECTION B, QUESTION 16, IS THE HOME PAGE FOR THE SYSTEM. THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, APPLICATION AND PLAIN LANGUAGE SUMMARY ARE MADE WIDELY AVAILABLE ON THE ORGANIZATION'S WEBSITE. THESE DOCUMENTS CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: www.englewoodhealth.org/for-patients-visitors/billing-insurance SCHEDULE H, PART I, LINE 3B DUE TO CHARACTER LIMITATIONS, THE PERCENTAGE REFLECTED IN SCHEDULE H, PART I, LINE 3B, FOR THE ORGANIZATION'S FEDERAL POVERTY GUIDELINES ("FPG") FAMILY INCOME LIMIT TO DETERMINE ELIGIBILITY FOR DISCOUNTED CARE IS 900%. HOWEVER, THIS ORGANIZATION OFFERS DISCOUNTED CARE TO ALL UNINSURED PATIENTS FOR EMERGENCY AND MEDICALLY NECESSARY CARE REGARDLESS OF INCOME. SCHEDULE H, PART I, LINE 3C In addition to the Federal Poverty Guidelines, EHMC uses other factors in determining eligibility criteria for free and discounted care. Other factors to determine eligibility include: - Asset level; - Medical Indigency; - Insurance status; - Underinsurance status; and - Residency. Additional information with respect to EHMCs eligibility criteria for financial assistance is outlined below. New Jersey Hospital Care Payment Assistance Program ("Charity Care") ==================================================================== Charity Care is a New Jersey program in which free or discounted care is available to patients who receive inpatient and outpatient services at acute care hospitals throughout the State of New Jersey. Hospital assistance and reduced charge care are only available for necessary emergency or other medically necessary care. Patients may be eligible for Charity Care if they are New Jersey residents who: 1) Have no health coverage or have coverage that pays only part of the hospital bill (uninsured or underinsured); 2) Are ineligible for any private or governmental sponsored coverage (such as Medicaid); and 3) Meet the following income and asset eligibility criteria described below. Income Eligibility Criteria --------------------------- Patients with family gross income less than or equal to 200% of the Federal Poverty Guidelines are eligible for 100% Charity Care coverage. Patients with family gross income greater than 200% but less than or equal to 300% of the Federal Poverty Guidelines are eligible for discounted care. Asset Criteria -------------- Charity Care includes asset eligibility thresholds which states that individual assets cannot exceed $7,500 and family assets cannot exceed $15,000 as of the date of service. Residency Criteria ------------------ Charity Care may be available to non-New Jersey residents, requiring immediate medical attention for an emergency medical condition. ADDITIONALLY, PLEASE NOTE THAT THIS ORGANIZATION OFFERS DISCOUNTED CARE TO ALL UNINSURED PATIENTS FOR EMERGENCY AND MEDICALLY NECESSARY CARE REGARDLESS OF INCOME. SCHEDULE H, PART I; QUESTION 6A Not applicable. SCHEDULE H, PART I; QUESTION 7 The organization's cost to charge ratio reflects total operating costs, excluding bad debt and other operating revenue, to gross charges. EHMC utilized Worksheet 2 of the Schedule H instructions to derive its cost-to-charge ratio. SCHEDULE H, PART II Not applicable. SCHEDULE H, PART III, QUESTIONS 2 & 3 Bad debt expense was calculated using the providers' bad debt expense from its financial statement, which is based upon management's assessment of historical and expected net collections, business and economic conditions, trends in medicare and medicaid health coverage and other collection indicators. Additions to the provision for doubtful accounts result from the provision for bad debts; deductions from the allowance for doubtful accounts result from accounts written off as uncollectible. The estimated bad debt expense attributable to patients eligible under the organizations financial assistance policy, reflected on Schedule H, Part III, Line 3, is approximately 27.40% of the total bad debt expense. This percentage represents the portion of self-pay individuals included within the bad debt expense amount. Had these individuals completed the requirements necessary to apply for financial assistance, they would have likely been eligible. The organization's allowance for doubtful accounts (bad debt expense) methodology and financial assistance policies are consistently applied. SCHEDULE H, PART III, QUESTION 4 EHMC and its Subsidiaries prepare and issue Audited Consolidated Financial Statements. The text below was obtained from the Englewood Hospital and Medical Center and Subsidiaries Audited Consolidated Financial Statements footnotes: Patient Accounts Receivable/Allowance for Doubtful Accounts ----------------------------------------------------------- Patient accounts receivable result from health care services provided by the Medical Center, EMA, MD Partners, PPE and EPE. The amount of the allowance for doubtful accounts is based upon managements assessment of historical and expected net collections, business and economic conditions, trends in Medicare and Medicaid health care coverage and other collection indicators. Additions to the allowance for doubtful accounts result from the provision for doubtful collections. Accounts written off as uncollectible are deducted from the allowance for doubtful accounts. Net Patient Service Revenue --------------------------- The Medical Center has agreements with third-party payors that provide for payments to the Medical Center at amounts different from its established rates. Payment arrangements include prospectively determined rates per discharge, reimbursed costs, discounts from charges and per diem payments. Net patient service revenue is reported at estimated net realizable amounts due from patients, third-party payors and others for services rendered and includes estimated retroactive revenue adjustments due to ongoing and future audits, reviews and investigations. Retroactive adjustments are considered in the recognition of revenue on an estimated basis in the period that related services are rendered and adjusted in future periods as adjustments become known or as years are no longer subject to such audits, reviews and investigations. Charity Care and Community Benefit ---------------------------------- In accordance with its mission and philosophy, the Medical Center commits substantial resources to sponsor a broad range of services to both the indigent as well as the broader community. Community benefits provided to the indigent include the cost of providing services to persons who cannot afford health care due to inadequate resources and/or who are uninsured or underinsured. This type of community benefit includes the costs of: traditional charity care; unpaid costs of care provided to beneficiaries of Medicare and Medicaid and other indigent public programs. Charity care is provided by the Medical Center to patients who meet certain criteria defined by the New Jersey Department of Health ("DOH") without charge or at amounts less than established rates. The Medical Center reduces net revenues in accordance with these criteria. The Medical Center's records identify and monitor the level of charity care it provides. Community benefits provided to the broader community include the costs of providing services to other populations who may not qualify as indigent but may need special services and support. This type of community benefit includes the costs of: services such as health promotion and education, health screenings, all of which are not billed or can be operated only on a deficit basis; unpaid portions of training health professionals such as medical residents, students in allied health professions; and the unpaid portions of testing medical equipment and controlled studies of therapeutic protocols. The costs of charity care and other community benefit activities are derived from both estimated and actual data. The estimated cost of charity care includes the direct and indirect cost of providing such services and is estimated utilizing the Medical Center's ratio of cost to gross charges, which is then multiplied by the gross uncompensated charges associated with providing care to charity patients. The Medical Center receives payments from the New Jersey Health Care Subsidy Funds for charity care and such amounts totaled approximately $489,000 and $1.1 million for the years ended December 31, 2016 and 2015, respectively. This amount is subject to change from year to year based on available State amounts and allocation methodologies. Charity care subsidies and distributions subsequent to June 30, 2017 are presently unknown. Other Third-Party Payors ------------------------ The Medical Center also has entered into payment agreements with certain commercial insurance carriers and health maintenance organizations. The basis for payment to the Medical Center under these agreements includes prospectively determined rates per discharge or days of hospitalization and discounts from established charges. Some of these agreements have retrospective audit clauses, allowing the payor to review and adjust claims subsequent to initial payment. The Medical Center recognizes patient service revenue associated with services provided to patients who have third-party payor coverage on the basis of these established rates for the services rendered. For uninsured patients that do not qualify for charity care, the Medical Center recognizes revenues on the basis of its standard rates, discounted in accordance with the Medical Centers policy. On the basis of historical experience, a significant portion of the Medical Centers uninsured patients will be unable or unwilling to pay for the services provided. Thus, the Medical Center records a significant provision of bad debts related to uninsured patients in the period the services are provided. For the years ended December 31, 2016 and 2015, net patient service revenue was increased by approximately $10,906,000 and $5,894,000, respectively, for favorable adjustments and settlements related to prior years. SCHEDULE H, PART III, SECTION B; QUESTION 8 Medicare costs were derived from the 2016 Medicare cost report. The organization feels that Medicare underpayments (shortfall), bad debt and associated costs are community benefit and are includable on the Form 990, Schedule H, Part I. As outlined more fully below, the organization believes that these services and related costs promote the health of the community as a whole and are rendered in conjunction with the organization's charitable tax-exempt purposes and mission in providing medically necessary healthcare services to all individuals in a non-discriminatory manner without regard to race, color, creed, sex, national origin or ability to pay and consistent with the community benefit standard promulgated by the IRS. The community benefit standard is the current standard for a hospital for recognition as a tax-exempt and charitable organization under internal revenue code ("IRC") 501(c)(3). The organization is recognized as a tax-exempt entity and charitable organization under 501(c)(3) of the IRC. Although there is no definition in the tax code for the term "charitable" a regulation promulgated by the department of the treasury provides some guidance and states that "the term charitable is used in section 501(c)(3) in its generally accepted legal sense,provides examples of charitable purposes, including the relief of the poor or unprivileged; the promotion of social welfare; and the advancement of education, religion, and science. Note it does not explicitly address the activities of hospitals. In the absence of explicit statutory or regulatory requirements applying the term "charitable" to hospitals, it has been left to the IRS to determine the criteria hospitals must meet to qualify as IRC 501(c)(3) charitable organizations. The original standard was known as the charity care standard. This standard was replaced by the IRS with the community benefit standard which is the current standard. Charity care standard In 1956, the IRS issued revenue ruling 56-185, which addressed the requirements hospitals needed to meet in order to qualify for IRC 501(c)(3) status. One of these requirements is known as the "charity care standard." under the standard, a hospital must provide, to the extent of its financial ability, free or reduced-cost care to patients who cannot pay for such services. A hospital that expected full payment did not, according to the ruling, provide charity care based on the fact that some patients ultimately failed to pay. The ruling emphasized that a low level of charity care did not necessarily mean that a hospital had failed to meet the requirement since that level could reflect its financial ability to provide such care. The ruling also noted that publicly supported community hospitals would normally qualify as charitable organizations because they serve the entire community and a low level of charity care would not affect a hospital's exempt status if it was due to the surrounding community's lack of charitable demands. Community benefit standard In 1969, the IRS issued revenue ruling 69-545, which "removed" from revenue ruling 56-185 "the requirements relating to caring for patients without charge or at rates below cost." under the standard developed in revenue ruling 69-545, which is known as the "community benefit standard," hospitals are judged on whether they promote the health of a broad class of individuals in the community. The ruling involved a hospital that only admitted individuals who could pay for the services (by themselves, private insurance, or public programs such as Medicare), but operated a full-time emergency room that was open to everyone. The IRS ruled that the hospital qualified as a charitable organization because it promoted the health of people in its community. The IRS reasoned that because the promotion of health was a charitable purpose according to the general law of charity, it fell within the "generally accepted legal sense" of the term "charitable," as required by the department of treasury reg. 1.501(c)(3)-1(d)(2). The IRS ruling stated that the promotion of health, like the relief of poverty and the advancement of education and religion, is one of the purposes in the general law of charity that is deemed beneficial to the community as a whole even though the class of beneficiaries eligible to receive a direct benefit from its activities does not include all members of the community, such as indigent members of the community, provided that the class is not so small that its relief is not of benefit to the community. The IRS concluded that the hospital was "promoting the health of a class of persons that is broad enough to benefit the community" because its emergency room was open to all and it provided care to everyone who could pay, whether directly or through third-party reimbursement. Other characteristics of the hospital that the IRS highlighted included the following: its surplus funds were used to improve patient care, expand hospital facilities, and advance medical training, education and research; it was controlled by a board of trustees that consisted of independent civic leaders; and hospital medical staff privileges were available to all qualified physicians. The American Hospital Association ("AHA") feels that Medicare underpayments (shortfall) and bad debt are community benefit and thus includable on the Form 990, Schedule H, Part I. This organization agrees with the AHA's position. As outlined in the AHA's letter to the IRS dated August 21, 2007 with respect to the first published draft of the new Form 990 and Schedule H, the AHA felt that the IRS should incorporate the full value of the community benefit that hospitals provide by counting Medicare underpayments (shortfall) as quantifiable community benefit for the following reasons: - providing care for the elderly and serving Medicare patients is an essential part of the community benefit standard - Medicare, like Medicaid, does not pay the full cost of care. From the latest data provided by the AHA, as of 2012, Medicare reimburses hospitals only 86 cents for every dollar they spend to take care of Medicare patients. The Medicare payment advisory commission ("Medpac"), in its march 2013 report to congress, states that beneficiaries will grow notably faster in the next 10 years than in the past decade as the baby-boom generation ages into the program. In addition, the population aging into the Medicare program will present a new set of challenges since rising obesity levels put this population at a greater risk than previous generations for chronic disease. - Many Medicare beneficiaries, like their Medicaid counterparts, are poor. More than 42 percent of Medicare spending is for beneficiaries whose income is below 200 percent of the federal poverty level. Many of those Medicare beneficiaries are also eligible for Medicaid -- so called eligible." There is every compelling public policy reason to treat Medicare and Medicaid underpayments similarly for purposes of a hospital's community benefit and include these costs on Form 990, Schedule H, Part I. Medicare underpayment must be shouldered by the hospital in order to continue treating the community's elderly and poor. These underpayments represent a real cost of serving the community and should count as a quantifiable community benefit. Both the AHA and this organization also feel that patient bad debt is a community benefit and thus includable on the Form 990, Schedule H, Part I. Like Medicare underpayment (shortfalls), there also are compelling reasons that patient bad debt should be counted as quantifiable community benefit as follows: - A significant majority of bad debt is attributable to low-income patients, who, for many reasons, decline to complete the forms required to establish eligibility for hospitals' charity care or those who do not pay all, or a portion of the already discounted billed amounts under our financial assistance policy. A 2006 congressional budget office ("CBO") report, nonprofit hospitals and the provision of community benefits, cited two studies indicating that "the great majority of bad debt was attributable to patients with incomes below 200% of the federal poverty line." - the report also noted that a substantial portion of bad debt is pending charity care. Unlike bad debt in other industries, hospital bad debt is complicated by the fact that hospitals follow their mission to the community and treat every patient that comes through their emergency department, regardless of ability to pay. Patients who have outstanding bills are not turned away, unlike other industries. Bad debt is further complicated by the auditing industry's standards on reporting charity care. Many patients cannot or do not provide the necessary, extensive documentation required to be deemed charity care by auditors. As a result, roughly 40% of bad debt is pending charity care. The CBO concluded that its findings "support the validity of the use of u SCHEDULE H, PART III, SECTION B; QUESTION 9B It is the policy of Englewood Hospital and Medical Center to treat all patients, regardless of their ability to pay for all emergency and medically necessary healthcare services and to bill and collect accounts receivable in accordance with all federal and state billing and collection regulations. Additionally, in accordance with Internal Revenue Code Section 501(r)(6), the organizations billing and collection policy does contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance as further outlined below. The organizations billing and collection policy which is made widely available on its website (www.englewoodhealth.org/for-patients-visitors/billing-insurance). Included below are the procedures outlined within that policy: 1) The bills for all insured patients will be sent directly from EHMC to the patients insurance company. If the insurance company denies the claim for reasons such as: benefits exhausted, experimental, medical necessity, pre-existing condition, non-covered charges, etc. the patient will be billed at the uninsured rate of percentage of gross charges as outlined in the Financial Assistance Policy. 2) If a patients insurance pays the claim and there is a deductible, co-pay, or co-insurance amount due from the patient, EHMC will bill the patient the amount indicated as patient responsibility by the insurance company. 3) Bills for uninsured patients are reduced to a percentage of gross charges as described in the Financial Assistance Policy. 4) Patients will receive billing statements and collection letters from EHMC on all balances that are deemed patient responsibility. The billing statements and collection letters include information about financial assistance availability. 5) Employees from the Financial Counseling Department will attempt to contact the patient by telephone on unpaid balances of $5,000 or greater that are deemed patient responsibility. They will explain the availability of financial assistance when speaking with the patient. All calls are documented within the financial system. 6) In addition to financial assistance, payment plans will be offered to patients. Patients can make monthly payments on outstanding balances. Payment plans will be approved for a period of one year. Payment plans beyond one year must be approved by the Financial Counseling Manager. 7) All unpaid balances that are due from patients will be referred to outside collection agencies after collection attempts by EHMC have failed. The collection agencies will attempt to obtain payment from the patient. If full payment is not received, the collection agencies will notify the patient by mail that they may proceed with extraordinary collection actions ("ECAs") as defined in Internal Revenue Code Section 501(r) which can include filing of judgments that include wage garnishments, seizing bank accounts, and placing liens on property owned in the State of New Jersey. The collection agencies must notify the patient in writing at least 30 days before initiating ECAs. The collection agencies will refrain from engaging in ECAs until at least 120 days after the date of the first post-discharge billing statement sent by EHMC. 8) All referrals to outside collection agencies are approved by the Financial Counseling Manager. 9) Refer to the Financial Assistance Policy for EHMC Financial Assistance guidelines. 10) Refer to New Jersey Hospital Care Payment Assistance Program/Charity Care Policy for procedures on applying for assistance through the New Jersey Hospital Care Payment Assistance Program/Charity Care at EHMC. In addition, Englewood Hospital and Medical Center does not engage in any actions that discourage individuals from seeking emergency medical care, such as by demanding the emergency department patients pay before receiving treatment for emergency medical conditions or by permitting debt collection activities in the emergency department or other areas where such activities could interfere with the provision of emergency care on a non-discriminatory basis. SCHEDULE H, PART VI; QUESTION 2 In addition to the CHNA process outlined in Schedule H, Part V, Section B, Questions 1-12 and the narrative response to Schedule H, Part V, Section B, Question 5 included in Schedule H, Part V, Section C, the organizations CHNA assessed the healthcare needs of the community it serves by incorporating data from secondary sources (vital statistics and other existing health-related data). A variety of existing secondary data was obtained from the following sources to complement the research used for the organizations CHNA: - Center for Applied Research and Environmental Systems; - Centers for Disease Control & Prevention, Office of Infectious Disease, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention; - Centers for Disease Control & Prevention, Office of Public Health Science Services, Center for Surveillance, Epidemiology and Laboratory Services, Division of Health Informatics and Surveillance; - Centers for Disease Control & Prevention, Office of Public Health Science Services, National Center for Health Statistics; - Community Commons; - ESRI ArcGIS Map Gallery; - National Cancer Institute, State Cancer Profiles; - OpenStreetMap; - Truven Health Analytics and Dignity Health; - US Census Bureau, American Community Survey; - US Census Bureau, County Business Patterns; - US Census Bureau, Decennial Census; - US Department of Agriculture, Economic Research Service; - US Department of Health & Human Services; - US Department of Health & Human Services, Health Resources and Services Administration; - US Department of Justice, Federal Bureau of Investigation; and - US Department of Labor, Bureau of Labor Statistics. Englewood Hospital and Medical Center also utilizes an independent market research company to solicit surveys and comments from all patients of the medical center regarding their patient care. The independent market research company analyzes and provides reports on the organization's performance in a variety of areas and procedures. Additionally, this organization monitors its performance on the internet web site referred to as healthgrades, which offers comparative data to other hospitals. The Centers for Medicare and Medicaid Services release "report cards" to the public regarding the Medical Center's performance. Englewood Hospital and Medical Center acquires demographic data for its surrounding communities and makes determinations as to whether the needs of any of the groups within the community are being served. All of these tools are utilized by the medical center to determine if the community is being fully served. SCHEDULE H, PART VI; QUESTION 3 Englewood Hospital and Medical Center informs and educates patients who may be billed for patient care about eligibility for financial assistance by widely publicizing the availability of financial assistance. In accordance with Internal Revenue Code Section 501(r)(4) the availability of financial assistance is widely publicized in the following ways: In an effort to ensure the community served by the organization is aware of the availability of financial assistance, informative signs and posters are posted in the following hospital locations: Emergency Room, Admitting Department, Outpatient Registration Department and the Financial Counseling Department. These signs and posters advise patients of the availability of financial assistance and provide additional information on how to apply for financial assistance. The organizations Financial Assistance Policy, Application and Plain Language Summary are available and may be obtained on the organizations website at the following URL: www.englewoodhealth.org/for-patients-visitors/billing-insurance. These documents are available upon request, free of charge in the patient registration areas and the Financial Counseling Department located at 350 Engle Street Englewood, NJ 07631. Paper copies may be requested by contacting (201)894-3031. Representatives are available Monday through Friday 9am to 5pm. Additionally, the organization has an employee of the Bergen County Board of Social Services on-site at the Medical Center at least three days per week to assist patients with Medicaid applications, if eligible. In accordance with Internal Revenue Code Section 501(r), these documents are also translated and available in the following Limited English Proficiency ("LEP") languages: Spanish, Korean, Chinese, Russian, Japanese, Italian, Tagalog, Arabic, Gujarati, Greek, Portuguese, Portuguese Creole, Serbio-Croatian and Armenian. it is important to note that any and all patients not eligible for charity care under the state of new jersey charity care guidelines, and who have no other insurance coverage are classified as a "self-pay" patient. such patients' bills are automatically discounted per our financial assistance policy (which approximates 115% of medicare rates). SCHEDULE H, PART VI; QUESTION 4 Englewood Hospital and Medical Center is located in Bergen County, New Jersey. Its primary service consists of various zip-codes within Bergen and Hudson County, New Jersey. SCHEDULE H, PART VI; QUESTION 5 Englewood Hospital and Medical Center ("EHMC") was founded in 1890. EHMC is a leading provider of high-quality, comprehensive, and humanistic care serving northern New Jersey and beyond. EHMC is a provider of general acute healthcare services in Bergen County, New Jersey. EHMC is recognized by the IRS as an Internal Revenue Code 501(c)(3) tax-exempt organization. Pursuant to its charitable purposes, EHMC provides healthcare services to all individuals in a non-discriminatory manner regardless of race, color, creed, sex, national origin or ability to pay. Moreover, EHMC operates consistently with the following criteria outlined in IRS revenue ruling 69-545: 1. Provides healthcare services to all individuals regardless of ability to pay, including Charity Care, Self-Pay, Medicare and Medicaid patients; 2. Operates an emergency department for all persons; which are open 24 hours a day, 7 days a week, 365 days per year; 3. Maintains an open medical staff, with privileges available to all qualified physicians; 4. Control of EHMC rests with its board of trustees which is comprised of independent civic leaders and other prominent members of the community; and 5. Surplus funds are used to improve the quality of patient care, expand and renovate facilities and advance medical care, programs and activities. Surplus fundS are reinvested in the organization, principally through capital investment, and also to meet future programmatic needs, which meets the organization's commitment to meet the expectations of its patients by providing quality healthcare and therefore, makes these investments to secure its future of service delivery to the community. The operations of EHMC as shown through the factors outlined above and other information contained herein, clearly demonstrate that the use and control of EHMC is for the benefit of the public and that no part of the income or net earnings of the organization inures to the benefit of any private individual nor is any private interest being served other than incidentally. Additionally, various community building activities undertaken by this organization improve the Medical and socio-economic well-being of the communities it serves. This is accomplished through numerous activities which are not a part of Part I, Charity Care and Other Community Benefits, and are not included elsewhere on Schedule H. These activities include programs that address the root causes of health problems such as education, poverty, unemployment, access to care, health advocacy and economic development. The organization provides numerous educational programs for the community which includes, but is not limited to: - Accelerated childbirth classes; - Breastfeeding classes; - Childbirth refresher classes; - Health fairs at various community events; and - Sibling preparation classes. Englewood Hospital and Medical Center also provides numerous health screenings for the community which includes, but is not limited to: - Blood drives; - Hospital screenings; - Skin cancer screenings; - Prostate cancer screenings; and - Vein screening. In addition, the organization provides various programs that promote good health these include, but are not limited to: - Flu/cover your mouth educational handouts and posters; - Hand hygiene public service announcements and posters; - Pilates (which promotes improved health); - Postnatal yoga; - Prenatal yoga; and - Weight Watchers at work (for employees). Englewood Hospital and Medical Center reaches out to notify the community about its various programs and services via a community newsletter published quarterly. Additionally, the organization advertises in community and regional newspapers. For additional information, please refer to Form 990, Schedule O, which contains the organization's Community Benefit Statement. SCHEDULE H, PART VI; QUESTION 6 Outlined below is a summary of the entities which comprises Englewood Healthcare System and its Affiliates: Not-For-Profit Englewood Healthcare System Entities =================================================== Englewood Healthcare System --------------------------- Englewood Healthcare System ("EHS") is the tax-exempt parent of Englewood Healthcare System and Affiliates ("System"). This integrated healthcare delivery system consists of a group of affiliated healthcare organizations. The sole member or stockholder of each entity is either EHS or another system affiliate controlled by EHS. The organization was founded in 1986 and is recognized by the Internal Revenue Service as tax-exempt pursuant to Internal Revenue Code 501(c)(3). Additionally, the organization is a supporting organization pursuant to Internal Revenue Code 509(a)(3). The organizations purpose is to coordinate and support the planning and other activities related to the promotion of health of people in Englewood Hospital and Medical Centers service area of Bergen County. Englewood Hospital and Medical Center, Inc. ------------------------------------------- Englewood Hospital and Medical Center, Inc. ("EHMC") was founded in 1888 and is currently a 531-licensed bed, major teaching, acute care hospital located in Englewood, New Jersey. The organizations mission is to provide comprehensive, state-of-the-art patient services; emphasize caring and other human values in the treatment of patients and in relations with their families, and among employees, medical staff, and community; be a center of education and research; and provide employees and medical staff with maximum opportunities to achieve their personal and professional goals. EHMC is recognized by the Internal Revenue Service as an Internal Revenue Code 501(c)(3) tax-exempt organization. Pursuant to its charitable purposes, EHMC provides medically necessary healthcare services to all individuals in a non-discriminatory manner regardless of race, color, creed, sex, national origin or ability to pay. Moreover, EHMC operates consistently with the criteria outlined in IRS revenue ruling 69-545. Englewood Hospital and Medical Center Foundation, Inc. ------------------------------------------------------ Englewood Hospital and Medical Center Foundation, Inc. is not-for-profit organization founded in 1995. The organization is recognized by the Internal Revenue Service as tax-exempt pursuant to Internal Revenue Code 501(c)(3) and as a non-private foundation pursuant to Internal Revenue Code 509(a)(1). Through fundraising and development activities the organization supports the charitable purposes, programs and services of EHMC; A related Internal Revenue Code 501(c)(3) tax-exempt hospital organization, that provides medically necessary healthcare services to all individuals in a non-discriminatory manner regardless of race, color, creed, sex, national origin or ability to pay. Medical Associates of Englewood, P.C. ------------------------------------- Medical Associates of Englewood, P.C. d/b/a MD Partners of Englewood Hospital & Medical Center is a not-for-profit organization founded in 2011. The organization is recognized by the Internal Revenue Service as tax-exempt pursuant to Internal Revenue Code 501(c)(3) and is a supporting organization pursuant to Internal Revenue Code 509(a)(3). The organization is structured as a professional corporation pursuant to the provisions of the professional services corporation act of New Jersey. The organization's purpose is to provide physician services to further the charitable and healthcare purposes of the Englewood Healthcare System and its affiliates. By practicing medicine, engaging in medical education and working to improve the welfare of individuals in New Jersey, the organization comprises a component of the clinical service physician practice plans of Englewood Hospital and Medical Center and is an integral part of the System. Emergency Physicians of Englewood, P.C. --------------------------------------- Emergency Physicians of Englewood, P.C. is a not-for-profit organization founded in 2012. The organization is recognized by the Internal Revenue Service as tax-exempt pursuant to Internal Revenue Code 501(c)(3) and is a supporting organization pursuant to Internal Revenue Code 509(a)(3). The organization is structured as a professional corporation pursuant to the provisions of the professional services corporation act of New Jersey. The organization's purpose is to provide emergency room services at Englewood Hospital and Medical Center; a related Internal Revenue Code 501(c)(3) tax-exempt hospital organization, that provides medically necessary healthcare services to all individuals in a non-discriminatory manner regardless of race, color, creed, sex, national origin or ability to pay. Physician Partners of Englewood, P.C. ------------------------------------- Physician Partners of Englewood, P.C. is a not-for-profit organization founded in 2012. The organization is recognized by the Internal Revenue Service as tax-exempt pursuant to Internal Revenue Code 501(c)(3) and is a supporting organization pursuant to Internal Revenue Code 509(a)(3). The organization is structured as a professional corporation pursuant to the provisions of the professional services corporation act of New Jersey. The organization's purpose is to provide physician services for patients of Englewood Hospital and Medical Center; a related Internal Revenue Code 501(c)(3) tax-exempt hospital organization, that provides medically necessary healthcare services to all individuals in a non-discriminatory manner regardless of race, color, creed, sex, national origin or ability to pay. Englewood Medical Associates, Inc. --------------------------------- Englewood Medical Associates, Inc. is a not-for-profit organization founded in 1996. The organization is recognized by the Internal Revenue Service as tax-exempt pursuant to Internal Revenue Code 501(c)(3) and is a supporting organization pursuant to Internal Revenue Code 509(a)(3). The organization was formed to acquire physician medical practices and employ full-time faculty physicians in support of Englewood Hospital and Medical Center; a related Internal Revenue Code 501(c)(3) tax-exempt hospital organization, that provides medically necessary healthcare services to all individuals in a non-discriminatory manner regardless of race, color, creed, sex, national origin or ability to pay. The organization is currently inactive. Englewood Healthcare Properties, Inc. ------------------------------------- Englewood Healthcare Properties, Inc. is a not-for-profit organization founded in 1989. The organization is an organization recognized by the Internal Revenue Service as tax-exempt pursuant to Internal Revenue Code 501(c)(2). The organization's purpose is to manage real property in support of Englewood Hospital and Medical Centers primary tax-exempt purpose of providing quality healthcare services in Bergen County, New Jersey. EHMC Health Alliance ACO, LLC ----------------------------- EHMC Health Alliance ACO, LLC is a limited liability company formed in the State of new jersey whose sole member is Englewood Hospital and Medical Center. This organization is an accountable care organization formed with the purpose of promoting the provision of better care for individuals, improved health for populations and lower per capita growth in expenditures of Horizon beneficiaries. For-Profit Englewood Healthcare System Entities =============================================== Englewood Healthcare Enterprises, Inc. -------------------------------------- Englewood Healthcare Enterprises, Inc. is a wholly-owned for-profit subsidiary of Englewood Healthcare System. The organization was formed in 1988 for the purpose of providing healthcare services within the Systems primary service area. This organization provides clinical and administrative staff support the professional corporations within the Englewood Hospital and Medical Center Physician Integration Program. SCHEDULE H, PART VI; QUESTION 7 Not applicable this organization is located in the State of New Jersey. No community benefit report is required to be filed by this state. true SCHEDULE I, PART I; QUESTION 2 GRANTS ARE MONITORED BY THE ORGANIZATION'S FINANCE PERSONNEL THROUGH THE UTILIZATION OF COST CENTERS AND OTHER INFORMATION; INCLUDING WRITTEN DOCUMENTATION AND RECEIPTS. SCHEDULE I, PART II PLEASE NOTE THAT ALL GIFTS, GRANTS AND CONTRIBUTIONS TO OTHER ORGANIZATIONS WERE LESS THAN OR EQUAL TO $5,000 EACH. THEREFORE, THERE ARE NO ORGANIZATIONS LISTED IN SCHEDULE I, PART II. THE TOTAL AMOUNTS PAID FOR CONTRIBUTIONS AND EVENT SPONSORSHIPS CAN BE FOUND ON CORE FORM, PART IX, LINE 1. X X X X false true false false false false false true false WARREN GELLER SECRETARY - TRUSTEE; PRES/CEO 594159 195000 279500 0 109650 0 154417 0 33085 0 1170811 195000 0 0 JEFFREY MATICAN MD TRUSTEE 0 337428 0 83288 25004 12250 0 5300 0 20376 25004 458642 0 0 MARK SHAPIRO MD TRUSTEE 0 250000 0 0 0 0 0 0 0 0 0 250000 0 0 ANTHONY T ORLANDO SVP FINANCE/CFO 443484 20102 107186 0 40675 0 27275 0 24462 0 643082 20102 0 0 MARY ANN DONOHUE-RYAN PHD RN VP, PCS & CNO (EFF 01/19/16) 267280 0 0 0 5229 0 0 0 22739 0 295248 0 0 0 HELENE WOLK SVP OPERATIONS 315729 0 83628 0 5685 0 5300 0 13853 0 424195 0 0 0 MICHAEL PIETROWICZ SVP PLANNING & DEVLOPMENT 312986 0 74502 0 18897 0 24760 0 28303 0 459448 0 0 0 PATRICIA G WILSON SVP HUMAN RESOURCES 290813 0 71836 0 17783 0 26008 0 26126 0 432566 0 0 0 KATHLEEN KAMINSKY RN SVP CHIEF POP HEALTH OFFICER 282813 0 42463 0 17821 0 26242 0 27814 0 397153 0 0 0 ALICIA PARK VP COMMUNICATIONS 228695 0 34442 0 1847 0 4634 0 3000 0 272618 0 0 0 DIMITRI CRUZ DIRECTOR INFO TECHNOLOGY/CIO 234874 0 26000 0 3680 0 3280 0 18930 0 286764 0 0 0 SCHEDULE J, PART I; QUESTION 4B THE DEFERRED COMPENSATION AMOUNTS REFLECTED IN SCHEDULE J, PART II, COLUMN C FOR THE FOLLOWING INDIVIDUALS INCLUDES UNVESTED BENEFITS IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) WHICH ARE SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THESE INDIVIDUALS MAY NEVER ACTUALLY RECEIVE THE UNVESTED BENEFIT AMOUNTS. THE AMOUNTS OUTLINED HEREIN WERE NOT INCLUDED IN THE INDIVIDUALS 2016 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: WARREN GELLER, $128,790 AND PATRICIA WILSON, $58. SCHEDULE J, PART I; QUESTION 7 CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A BONUS DURING CALENDAR YEAR 2016 WHICH AMOUNTS WERE INCLUDED IN SCHEDULE J, PART II, COLUMN B(II) HEREIN AND IN EACH INDIVIDUAL'S 2016 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT. PATRICIA DURKIN FAMILY MEMBER OF TRUSTEE 79321 EMPLOYEE false DANIELLE VOLPE FAMILY MEMBER OF TRUSTEE 15622 EMPLOYEE false FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICAN FEES - COMMUNITY TOTAL FEES:95743488 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN FEES - HOSPITAL TOTAL FEES:26435812 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN FEES - ADMIN. TOTAL FEES:2295449 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:3429619 FORM 990 PART IX LINE 11G DESCRIPTION:NJ ADJUSTED ADMISSION FEE TOTAL FEES:2333442 FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING FEES TOTAL FEES:3006116 FORM 990 PART IX LINE 11G DESCRIPTION:TRANSCRIPTION FEES TOTAL FEES:671381 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER FEES TOTAL FEES:2825729 ENGLEWOOD HEALTH ALLIANCE ACO LLC 350 ENGLE STREET ENGLEWOOD NJ 07631 465759919 HEALTHCARE NJ 0 447915 EHMC ENGLEWOOD HOSPITAL & MEDICAL CENTER FDN 350 ENGLE STREET ENGLEWOOD NJ 07631 223367281 FUNDRAISING NJ 501(C)(3) 509(A)(1) EHS false ENGLEWOOD HEALTHCARE SYSTEM INC 350 ENGLE STREET ENGLEWOOD NJ 07631 222749097 HEALTHCARE NJ 501(C)(3) 509(A)(3) NA false ENGLEWOOD HEALTHCARE PROPERTIES INC 350 ENGLE STREET ENGLEWOOD NJ 07631 222943092 PROPERTY ACQ NJ 501(C)(2) EHS false ENGLEWOOD MEDICAL ASSOCIATES INC 350 ENGLE STREET ENGLEWOOD NJ 07631 223446625 HEALTHCARE NJ 501(C)(3) 509(A)(3) EHMC true MEDICAL ASSOCIATES OF ENGLEWOOD PC 350 ENGLE STREET ENGLEWOOD NJ 07631 452548322 HEALTHCARE NJ 501(C)(3) 509(A)(3) EHMC true EMERGENCY PHYSICIANS OF ENGLEWOOD PC 350 ENGLE STREET ENGLEWOOD NJ 07631 454604076 HEALTHCARE NJ 501(C)(3) 509(A)(3) EHMC true PHYSICIAN PARTNERS OF ENGLEWOOD PC 350 ENGLE STREET ENGLEWOOD NJ 07631 455597971 HEALTHCARE NJ 501(C)(3) 509(A)(3) EHMC true ENGLEWOOD HEALTHCARE ENTERPRISES INC 350 ENGLE STREET ENGLEWOOD NJ 07631 222872393 HEALTHCARE SVCS. NJ NA C CORP. false false false true true true false false false false true false false false true true true true true false MEDICAL ASSOCIATES OF ENGLEWOOD PC E 1549122 COST MEDICAL ASSOCIATES OF ENGLEWOOD PC J 54600 COST SCHEDULE R, PART V THE ORGANIZATION IS AN AFFILIATE WITHIN ENGLEWOOD HEALTHCARE SYSTEM, INC. AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). ENGLEWOOD HEALTHCARE SYSTEM, INC. IS THE TAX-EXEMPT PARENT ENTITY OF THE SYSTEM. THIS ORGANIZATION ROUTINELY PAYS EXPENSES FOR VARIOUS RELATED AFFILIATES IN THE ORDINARY COURSE OF BUSINESS. THESE RELATED PARTY TRANSACTIONS ARE RECORDED ON THE REVENUE/EXPENSE AND BALANCE SHEET STATEMENTS OF THIS ORGANIZATION AND ITS AFFILIATES. THESE ENTITIES WORK TOGETHER TO DELIVER HIGH QUALITY HEALTHCARE AND WELLNESS SERVICES TO THE COMMUNITIES IN WHICH THEY ARE SITUATED.