2017-11-15T11:28:38-06:00 2016-12-31 WithumSmithBrown PC 200 Jefferson Park Suite 400 Whippany NJ 079811070 990 2016-01-01 222456079 MONMOUTH MEDICAL CENTER FOUNDATION INC % CATHERINE DOWDY CPA MONM 9733224032 300 SECOND AVENUE LONG BRANCH NJ 07740 LAURA SCHILARE CORPORATE CONTROLLER 7329238929 2017-11-07 true Scott J Mariani P00642486 9738989494 148.77.36.74 22006220173195000101 2017-11-15 P EFB3F90CD62757DA7B098748B029987CE34337C5 50FA3CAACB9DCF9CC55FFB50DF358FCE3B7A875F 2016 2017-02-10 21:41:12Z BARRY H OSTROWSKY 95 OLD SHORT HILLS ROAD WEST ORANGE NJ 07052 9090824 false X WWW.RWJBH.ORG X 1982 NJ TO SUPPORT THE CHARITABLE TAX-EXEMPT PURPOSES, PROGRAMS AND SERVICES OF MONMOUTH MEDICAL CENTER; A RELATED IRC SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. 37 32 0 260 0 2758642 3230240 1344290 1547593 1032982 3334808 165661 73328 5301575 8185969 1742807 4128297 0 0 0 0 12500 50000 1173186 1709253 2630059 3464560 6808356 1837015 1377613 31455999 29717308 412999 255308 31043000 29462000 X TO SUPPORT THE CHARITABLE TAX-EXEMPT PURPOSES, PROGRAMS AND SERVICES OF MONMOUTH MEDICAL CENTER; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION, WHICH 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. false false 4128297 4128297 1547593 EXPENSES INCURRED IN SUPPORT OF THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF MONMOUTH MEDICAL CENTER; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION WHICH PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. 4128297 true true false false false false false false false true true false true false true true false true false false false false false true true true false true true true false false false false false false false false true false false false false true false false false true 134 1 true 0 false false false false false true true false false false false X 37 32 true false false false true true true true true false false true true true true true true true true false NJ X CATHERINE DOWDY CPA 7329238929 2 CRESCENT PLACE OCEANPORT NJ 07757 X ANN UNTERBERG CHAIR - TRUSTEE 1.0 0.0 X X 0 0 0 TERRY INGRAM VICE CHAIR - TRUSTEE 1.0 0.0 X X 0 0 0 ROBERT PATTON VICE CHAIR - TRUSTEE 1.0 0.0 X X 0 0 0 VICTOR ALMEIDA DO TRUSTEE 1.0 0.0 X 0 0 0 RICHARD S BERGER TRUSTEE 1.0 0.0 X 0 0 0 ANA BLANK TRUSTEE 1.0 0.0 X 0 0 0 ROBERT L BOYLE TRUSTEE 1.0 0.0 X 0 0 0 ROBERT BUTTERS TRUSTEE 1.0 0.0 X 0 0 0 SCOTT CARMILANI TRUSTEE 1.0 0.0 X 0 0 0 JUDITH W DAWKINS TRUSTEE 1.0 0.0 X 0 0 0 CAROLYN DEFORTE-WASSERFALL TRUSTEE 1.0 0.0 X 0 0 0 CAROLYN DESENA TRUSTEE 1.0 0.0 X 0 0 0 WARREN DIAMOND TRUSTEE 1.0 0.0 X 0 0 0 MARGARET C FISHER MD TRUSTEE; EX-OFFICIO 55.0 0.0 X 0 264312 29109 DOUGLAS H FORSYTH TRUSTEE 1.0 0.0 X 0 0 0 GREGORY GRECO MD TRUSTEE 25.0 0.0 X 0 88659 5313 KEVIN KELLY TRUSTEE 1.0 0.0 X 0 0 0 TARA FORMICA KELLY TRUSTEE; EX-OFFICIO - VP DEV 50.0 0.0 X X 0 258235 34350 BONNIE KLEIN TRUSTEE 1.0 0.0 X 0 0 0 CLAIRE M KNOPF TRUSTEE 1.0 0.0 X 0 0 0 MARSHALL KNOPF TRUSTEE 1.0 0.0 X 0 0 0 GEORGE R LAUFENBERG TRUSTEE 1.0 0.0 X 0 0 0 TY J OLSON MD TRUSTEE 1.0 0.0 X 0 0 0 MICHAEL O'NEILL TRUSTEE 1.0 0.0 X 0 0 0 LUANNE M PETERPAUL ESQ TRUSTEE 1.0 0.0 X 0 0 0 RONALD J RAC ESQ TRUSTEE 1.0 0.0 X 0 0 0 CARL REISS TRUSTEE 1.0 0.0 X 0 0 0 RONALD RICCIO TRUSTEE 1.0 0.0 X 0 0 0 GERI ROPER TRUSTEE 1.0 0.0 X 0 0 0 RICHARD B RUCHMAN MD TRUSTEE 50.0 0.0 X 0 120000 0 SIRAN HOVANIAN SAHAKIAN TRUSTEE 1.0 0.0 X 0 0 0 PATRICK P SCIRE TRUSTEE 1.0 0.0 X 0 0 0 ROBERT H SICKLES TRUSTEE 1.0 0.0 X 0 0 0 CAROL STILLWELL TRUSTEE 1.0 0.0 X 0 0 0 FRANK J VOZOS MD FACS TRUSTEE 55.0 0.0 X 0 994876 231273 DANIEL WHALEN TRUSTEE 1.0 0.0 X 0 0 0 LOUIS J ZINTERHOFER MD TRUSTEE 1.0 0.0 X 0 0 0 LAURA L SCHILARE CORPORATE CONTROLLER 50.0 0.0 X 0 144613 25903 0 1870695 325948 0 false true false 0 X 605199 6800 2618241 32860 3230240 OTHER PROGRAM RELATED REVENUE 900099 1547593 1547593 1547593 3334808 3334808 0 0 0 0 0 0 860491 605199 860491 109270 40918 68352 68352 8422 3446 4976 4976 0 8185969 1547593 3408136 3822121 3822121 306176 306176 0 0 0 0 0 0 0 0 0 11643 11643 19101 19101 0 50000 50000 0 398 398 0 2264 2264 74874 54284 20590 0 0 0 253 253 0 7000 7000 0 0 11774 11774 0 ALLOCATION OF PERSONNEL COST 998964 0 328927 670037 BAD DEBT EXPENSE 925536 0 925536 0 VARIOUS FUNDRAISING EXPENSES 248575 0 0 248575 DUES AND SUBSCRIPTIONS 953 0 953 0 328724 147004 181720 6808356 4128297 1506873 1173186 X 300 300 8099811 6302318 3738034 3432164 0 0 0 0 0 0 0 0 0 0 1407 0 299829 134331 142104 165498 0 0 0 0 18738100 19073388 0 0 736243 743640 31455999 29717308 42960 45527 0 0 30195 0 0 0 0 0 0 0 0 0 0 0 339844 209781 412999 255308 X 7438000 5914000 18189000 18132000 5416000 5416000 31043000 29462000 31455999 29717308 1377613 -2958613 X X false true X true false X 2893485 5054745 3144891 2758642 3230240 17082003 0 0 2893485 5054745 3144891 2758642 3230240 17082003 7204 17074799 464775 788601 336633 1032982 3334808 5957799 0 0 23039802 13143528 0.74110 0.83642 X UNUSUAL GRANTS The organization received CONTRIBUTIONS: (1) in the amount of $2,506,300 from an individual in 2012; (2) in the amount of $1,501,175 from an individual in 2013; (3) in the amount of $1,025,000 from a private foundation in 2013 (4) IN THE AMOUNT OF $1,500,000 FROM A PUBLIC CHARITY IN 2013; and (5) in the amount of $1,000,000 from a private foundation in 2016 These contributions are being classified as unusual grants and excluded from both the numerator and denominator in the public support percentage calculation. The contributions are unusual in nature because, according to Form 990, Schedule A instructions and in accordance with Treasury Regulations 1.509(a)-3(c)(4): - They were attracted because of the publicly supported nature of the organization, - They were unusual and unexpected because of the amounts (no other individuals or foundations contributed any amount similar to these amounts in the five year period), and - They are large enough that they would significantly decrease the organization's public support percentage. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5416000 5416000 5416000 5416000 5416000 5416000 5416000 5416000 5416000 5416000 1.00000 false false 299829 134331 165498 165498 MUTUAL FUNDS - U.S. EQUITIES 1969000 F MUTUAL FUNDS - INT'L EQUITIES 0 F MUTUAL FUNDS - FIXED INCOME 53698 F PRIVATE EQUITY FUNDS 434079 F CASH EQUIVALENTS 30474 F CORPORATE BONDS 6852003 F ASSET BACKED SECURITIES 589799 F COMMERCIAL MORTGAGE-BACKED 392214 F EQUITY SECURITIES - DOMESTIC 5551700 F FIXED INCOME CORPORATE BONDS 1537870 F FIXED INCOME MUNICIPAL BONDS 477307 F FIXED INCOME MUTUAL FUNDS INTL 5145 F GOV'T MORTG-BACKED SECURITIES 1180099 F 19073388 0 DUE TO AFFILIATES 41311 OTHER LIABILITIES 168470 209781 X SCHEDULE D, PART V, QUESTION 4 RESTRICTED FUNDS ARE USED TO SUPPORT THE CHARITABLE ACTIVITIES AND PROGRAMS OF THE ORGANIZATION AND ITS AFFILIATES. THE FOUNDATIONS' ENDOWMENTS CONSIST OF THE BOARD-DESIGNATED AND DONOR-RESTRICTED ENDOWMENT FUNDS. THE ENDOWMENT INVESTMENTS PROVIDE FUNDING FROM INVESTMENT EARNINGS, WHICH IS EXPENDABLE TO SUPPORT EQUIPMENT PURCHASES, EDUCATION, COMMUNITY, AND OTHER VARIOUS PROGRAMS. SCHEDULE D, PART X THE ORGANIZATION IS AN AFFILIATE WITHIN RWJBARNABAS HEALTH ("RWJBH"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. RWJBH ISSUES AUDITED CONSOLIDATED FINANCIAL STATEMENTS WHICH INCLUDE ALL RELATED ENTITIES; INCLUDING THIS ORGANIZATION. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAIN CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS FOR THE RWJBH HOSPITALS AND CERTAIN OTHER RWJBH AFFILIATES. THE FOOTNOTE BELOW IS FROM RWJBH'S 2016 AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND REPORTS RWJBH'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 (ASC 740): THE CORPORATION DOES NOT HAVE ANY SIGNIFICANT UNCERTAIN TAX POSITIONS AS OF AND FOR THE NINE MONTHS ENDED DECEMBER 31, 2016. IN ADDITION, THE BARNABAS HEALTH FOUNDATIONS ISSUE AUDITED COMBINED FINANCIAL STATEMENTS WHICH INCLUDE ALL BARNABAS HEALTH RELATED FOUNDATIONS; INCLUDING THIS ORGANIZATION. THE AUDITED COMBINED FINANCIAL STATEMENTS ALSO CONTAIN CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. THE FOOTNOTE BELOW IS FROM BARNABAS HEALTH FOUNDATIONS' 2016 AUDITED COMBINED FINANCIAL STATEMENTS AND REPORTS BARNABAS HEALTH FOUNDATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 (ASC 740): THE FOUNDATIONS RECOGNIZE THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. NO PROVISION FOR INCOME TAXES WAS REQUIRED FOR 2016 AND 2015. true COMMUNITY COUNSELLING SERVICE CO FUNDRAISING CONSULTING false 0 50000 0 0 50000 0 GOLF OUTING 218745 46533 172212 45813 126399 CRYSTAL BALL 286315 18477 267838 80380 187458 8 960630 540189 420441 67170 353271 1465690 605199 860491 193363 667128 860491 109270 2550 38368 false 109270 2550 38368 40918 68352 NJ true false false false 0.90000 0.10000 evelyn nits 300 SECOND AVENUE LONG BRANCH NJ 07740 false evelyn nits AND OTHER MMCF PERSONNE 0 MANAGE DAY TO DAY ACTIVITIES OF RAFFLES X false true MONMOUTH MEDICAL CENTER 300 SECOND AVENUE LONG BRANCH NJ 07740 223452412 501(C)(3) 3822121 PROGRAM SUPPORT 1 0 EMPLOYEE ASSISTANCE 36 27492 COMMUNITY ASSISTANCE 24 278684 SCHEDULE I, PART I, QUESTION 2 GRANTS ARE MONITORED BY THE ORGANIZATION'S FINANCE PERSONNEL and human RESOURCES department personnel THROUGH THE UTILIZATION OF COST CENTERS AND OTHER INFORMATION; INCLUDING WRITTEN DOCUMENTATION AND RECEIPTS. X X X X X false true false false false false false true false MARGARET C FISHER MD TRUSTEE; EX-OFFICIO 0 257454 0 0 0 6858 0 20142 0 8967 0 293421 0 0 TARA FORMICA KELLY TRUSTEE; EX-OFFICIO - VP DEV 0 204875 0 52199 0 1161 0 7749 0 26601 0 292585 0 0 FRANK J VOZOS MD FACS TRUSTEE 0 570968 0 377768 0 46140 0 212245 0 19028 0 1226149 0 0 LAURA L SCHILARE CORPORATE CONTROLLER 0 137462 0 5000 0 2151 0 8105 0 17798 0 170516 0 0 SCHEDULE J, PART I; QUESTION 4B THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THE FOLLOWING INDIVIDUAL INCLUDES UNVESTED BENEFITS IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) WHICH IS SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, HE MAY NEVER ACTUALLY RECEIVE THIS UNVESTED BENEFIT AMOUNT. THE AMOUNT OUTLINED HEREIN WAS NOT INCLUDED IN HIS 2016 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: FRANK J. VOZOS, M.D., FACS, $189,270. 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 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. X 5 32860 FAIR MARKET VALUE false true true SCHEDULE M, PART I; QUESTION 32A THE ORGANIZATION HIRES INDEPENDENT THIRD-PARTIES TO SELL NON-CASH CONTRIBUTIONS IT RECEIVES; IF THE ORGANIZATION DECIDES NOT TO RETAIN THE ITEM(S). THE ORGANIZATION PAYS FAIR MARKET VALUE RATES AND COMMISSIONS IN THESE INSTANCES. FOR ANY GIFTS OF STOCK THE ORGANIZATION'S POLICY IS TO SELL IT IMMEDIATELY FOLLOWING RECEIPT. CORE FORM, PART VI, SECTION A; QUESTIONS 2 CLAIRE M. KNOPF AND MARSHALL KNOPF - FAMILY RELATIONSHIP. CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7 BARNABAS HEALTH, INC. ("BH") IS THE SOLE MEMBER OF THIS ORGANIZATION. RWJ BARNABAS HEALTH, INC. ("RWJ BH") IS THE SOLE MEMBER OF BH. RWJ BH HAS THE ULTIMATE AUTHORITY AND RIGHT TO ELECT THE MEMBERS OF THIS ORGANIZATION'S BOARD OF TRUSTEES AND HAS CERTAIN RESERVED POWERS AS DEFINED IN THIS ORGANIZATION'S BYLAWS. CORE FORM, PART VI, SECTION B; QUESTION 11B THE ORGANIZATION IS AN AFFILIATE WITHIN RWJBARNABAS HEALTH; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). RWJ BARNABAS HEALTH, INC. IS THE TAX-EXEMPT PARENT ENTITY OF THE SYSTEM. THIS ORGANIZATION'S FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF ITS GOVERNING BODY (ITS BOARD OF TRUSTEES) PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE ("IRS"). THE RWJ BARNABAS HEALTH, INC. AUDIT COMMITTEE ASSUMED THE RESPONSIBILITY TO OVERSEE AND COORDINATE THE FEDERAL FORM 990 PREPARATION, REVIEW AND FILING PROCESS FOR ALL TAX-EXEMPT AFFILIATES WITHIN THE SYSTEM. AS PART OF THE ORGANIZATION'S FEDERAL FORM 990 TAX RETURN PREPARATION PROCESS, THE SYSTEM HIRED A PROFESSIONAL CERTIFIED PUBLIC ACCOUNTING ("CPA") FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION TO PREPARE THE FEDERAL FORM 990. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE ORGANIZATION'S FINANCE PERSONNEL AND SYSTEM INDIVIDUALS INCLUDING SENIOR VICE PRESIDENT/GENERAL COUNSEL, CHIEF FINANCIAL OFFICER, SENIOR VICE PRESIDENT OF SYSTEM INTERNAL AUDIT AND VARIOUS OTHER INDIVIDUALS ("INTERNAL WORKING GROUP") TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE ORGANIZATION'S INTERNAL WORKING GROUP FOR REVIEW. THE ORGANIZATION'S INTERNAL WORKING GROUP REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE ORGANIZATION'S INTERNAL WORKING GROUP FOR FINAL REVIEW AND APPROVAL. THIS FORM 990 WAS ALSO REVIEWED AT A SPECIAL MEETING WHICH INCLUDED THE ORGANIZATION'S CHIEF FINANCIAL OFFICER, A BOARD MEMBER OF THE ORGANIZATION AND THE OUTSIDE PROFESSIONAL CPA FIRM WHICH WAS RETAINED TO PREPARE THE FEDERAL FORM 990. FOLLOWING THIS REVIEW, THE FINAL FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY PRIOR TO FILING WITH THE IRS. CORE FORM, PART VI, SECTION B; QUESTION 12 THE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY WITH WHICH IT REGULARLY MONITORS AND ENFORCES COMPLIANCE. THIS CONFLICT OF INTEREST POLICY REQUIRES THAT A CONFLICT OF INTEREST FORM CONSISTENT WITH BEST GOVERNANCE PRACTICES AND INTERNAL REVENUE SERVICE GUIDELINES BE CIRCULATED TO OFFICERS, TRUSTEES AND KEY EMPLOYEES ANNUALLY. IN A SITUATION IN WHICH A TRUSTEE DISCLOSES AN INTEREST THAT COULD GIVE RISE TO A CONFLICT, THE TRUSTEE'S POTENTIAL CONFLICT IS REFERRED TO THE SYSTEM'S CORPORATE NOMINATING AND GOVERNANCE COMMITTEE WHICH EVALUATES THE CONFLICT AND ITS POTENTIAL IMPACT ON THE TRUSTEE'S PARTICIPATION ON THE BOARD OR ON CERTAIN ISSUES WHICH MAY COME BEFORE THE BOARD. AS APPROPRIATE THE COMMITTEE WILL TAKE ACTION TO ADDRESS THE CONFLICT. CORE FORM, PART VI, SECTION B; QUESTION 15 THE ORGANIZATION IS AN AFFILIATE WITHIN RWJBARNABAS HEALTH; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM WHICH INCLUDES BARNABAS HEALTH, INC. ("BH"); A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. BH'S BOARD OF TRUSTEES MAINTAINS AN EXECUTIVE COMPENSATION COMMITTEE ("COMMITTEE"). THE COMMITTEE HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY WHICH IT FOLLOWS WHEN IT REVIEWS AND APPROVES OF THE COMPENSATION AND BENEFITS OF BH'S SENIOR MANAGEMENT. THE COMMITTEE ALSO REVIEWS THE COMPENSATION AND BENEFITS OF OTHER OFFICERS AND KEY EMPLOYEES OF BARNABAS HEALTH; INCLUDING, WITHOUT LIMITATION, THE CHIEF EXECUTIVE OFFICERS OF RWJBARNABAS HEALTH HOSPITALS AND MEDICAL CENTERS. THE COMMITTEE, WHICH IS REQUIRED BY THE CORPORATION'S BYLAWS TO BE COMPRISED SOLELY OF INDEPENDENT TRUSTEES, SEEKS GUIDANCE AND SUBSTANTIATION FROM A NATIONALLY RECOGNIZED COMPENSATION CONSULTANT. THE COMMITTEE REVIEWS THE "TOTAL COMPENSATION" OF THE INDIVIDUALS WHICH IS INTENDED TO INCLUDE BOTH CURRENT AND DEFERRED COMPENSATION AND ALL EMPLOYEE BENEFITS, BOTH QUALIFIED AND NON-QUALIFIED. THE COMMITTEE'S REVIEW IS DONE ON AT LEAST AN ANNUAL BASIS AND ENSURES THAT THE "TOTAL COMPENSATION" OF SENIOR MANAGEMENT OF THE ORGANIZATION IS REASONABLE. THE ACTIONS TAKEN BY THE COMMITTEE ENABLE THE ORGANIZATION TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 4958 WITH RESPECT TO THE TOTAL COMPENSATION OF CERTAIN MEMBERS OF THE SENIOR MANAGEMENT TEAM. THE THREE FACTORS WHICH MUST BE SATISFIED IN ORDER TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS ARE THE FOLLOWING: 1. THE COMPENSATION ARRANGEMENT IS APPROVED IN ADVANCE BY AN "AUTHORIZED BODY" OF THE APPLICABLE TAX-EXEMPT ORGANIZATION WHICH IS COMPOSED ENTIRELY OF INDIVIDUALS WHO DO NOT HAVE A "CONFLICT OF INTEREST" WITH RESPECT TO THE COMPENSATION ARRANGEMENT; 2. THE AUTHORIZED BODY OBTAINED AND RELIED UPON "APPROPRIATE DATA AS TO COMPARABILITY" PRIOR TO MAKING ITS DETERMINATION; AND 3. THE AUTHORIZED BODY "ADEQUATELY DOCUMENTED THE BASIS FOR ITS DETERMINATION" CONCURRENTLY WITH MAKING THAT DETERMINATION. THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES EACH OF WHO ARE INDEPENDENT AND ARE FREE FROM ANY CONFLICTS OF INTEREST. THE COMMITTEE RELIED UPON APPROPRIATE COMPARABLE DATA; SPECIFICALLY THE COMMITTEE OBTAINED A WRITTEN COMPENSATION STUDY FROM AN INDEPENDENT FIRM WHICH SPECIALIZES IN THE REVIEW OF HOSPITAL AND HEALTHCARE SYSTEM EXECUTIVE COMPENSATION AND BENEFITS THROUGHOUT THE UNITED STATES. THIS STUDY USED COMPARABLE GEOGRAPHIC AND DEMOGRAPHIC MARKET DATA INCLUDING, BUT NOT LIMITED TO, SIMILARLY SIZED HEALTHCARE SYSTEMS AND HOSPITALS, # OF LICENSED BEDS AND NET PATIENT SERVICE REVENUE. THE COMMITTEE ADEQUATELY DOCUMENTED THE BASIS FOR ITS DETERMINATION THROUGH THE TIMELY PREPARATION OF WRITTEN MINUTES OF THE COMPENSATION COMMITTEE MEETINGS DURING WHICH THE EXECUTIVE COMPENSATION AND BENEFITS WAS REVIEWED AND SUBSEQUENTLY APPROVED. THE ACTIONS OUTLINED ABOVE WITH RESPECT TO THE COMMITTEE AND THE ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS APPLIES TO CERTAIN BH SENIOR MANAGEMENT PERSONNEL. THE COMPENSATION AND BENEFITS OF CERTAIN OTHER INDIVIDUALS CONTAINED IN THIS FORM 990, WHERE APPLICABLE, ARE REVIEWED ANNUALLY BY THE BARNABAS HEALTH PRESIDENT/CHIEF EXECUTIVE OFFICER WITH ASSISTANCE FROM THE ORGANIZATION'S HUMAN RESOURCES DEPARTMENT IN CONJUNCTION WITH THE INDIVIDUAL'S JOB PERFORMANCE DURING THE YEAR AND IS BASED UPON OTHER OBJECTIVE FACTORS DESIGNED TO ENSURE THAT REASONABLE AND FAIR MARKET VALUE COMPENSATION IS PAID BY THE ORGANIZATION. OTHER OBJECTIVE FACTORS INCLUDE MARKET SURVEY DATA FOR COMPARABLE POSITIONS, INDIVIDUAL GOALS AND OBJECTIVES, PERSONNEL REVIEWS, EVALUATIONS, SELF-EVALUATIONS AND PERFORMANCE FEEDBACK MEETINGS. CORE FORM, PART VI, SECTION C; QUESTION 19 THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE STATE OF NEW JERSEY DEPARTMENT OF THE TREASURY. CORE FORM, PART VII AND SCHEDULE J PART VII AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM A RELATED ORGANIZATION. PLEASE NOTE THAT THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OF THE RELATED ORGANIZATION AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THIS ORGANIZATION'S BOARD OF TRUSTEES. CORE FORM, PART VII, SECTION A, COLUMN B THIS ORGANIZATION IS AN AFFILIATE WITHIN RWJBARNABAS HEALTH; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM INCLUDES BOTH FOR-PROFIT AND NOT FOR-PROFIT ORGANIZATIONS. CERTAIN BOARD OF TRUSTEE MEMBERS, OFFICERS, DIRECTORS AND KEY EMPLOYEES LISTED ON CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 MAY HOLD SIMILAR POSITIONS WITH BOTH THIS ORGANIZATION AND OTHER AFFILIATES WITHIN THE SYSTEM. THE HOURS SHOWN ON THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE NO COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, REPRESENT THE ESTIMATED HOURS DEVOTED PER WEEK FOR THIS ORGANIZATION. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF TRUSTEES OF OTHER RELATED ORGANIZATIONS IN THE SYSTEM, THEIR RESPECTIVE HOURS PER WEEK PER ORGANIZATION ARE APPROXIMATELY THE SAME AS REFLECTED IN CORE FORM, PART VII OF THIS FORM 990. THE HOURS REFLECTED ON PART VII OF THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, PAID OFFICERS AND KEY EMPLOYEES, REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF RWJBARNABAS HEALTH; NOT SOLELY THIS ORGANIZATION. CORE FORM, PART XII; QUESTION 2 THE ORGANIZATION IS AN AFFILIATE WITHIN RWJBARNABAS HEALTH, A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM'S TAX-EXEMPT PARENT ENTITY IS RWJ BARNABAS HEALTH, INC. AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF RWJ BARNABAS HEALTH, INC. AND ALL AFFILIATES WITHIN THE SYSTEM FOR THE YEAR ENDED DECEMBER 31, 2016. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAIN CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS FOR THE RWJBARNABAS HEALTH HOSPITALS AND CERTAIN OTHER RWJBARNABAS HEALTH AFFILIATES. THE INDEPENDENT CPA FIRM ISSUED AN UNQUALIFIED OPINION WITH RESPECT TO THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS. THE RWJ BARNABAS HEALTH, INC. AUDIT COMMITTEE HAS ASSUMED RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE CONSOLIDATED FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT AUDITOR. IN ADDITION, THE BARNABAS HEALTH FOUNDATIONS ISSUED AUDITED COMBINED FINANCIAL STATEMENTS FOR THE YEAR ENDED DECEMBER 31, 2016, WHICH INCLUDE ALL BARNABAS HEALTH RELATED FOUNDATION ENTITIES; INCLUDING THIS ORGANIZATION. THE AUDITED COMBINED FINANCIAL STATEMENTS ALSO CONTAIN CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. THE INDEPENDENT CPA FIRM ISSUED AN UNQUALIFIED OPINION WITH RESPECT TO THE COMBINED FINANCIAL STATEMENTS. BARNABAS BAYONNE DEV URBAN RENEWAL CORP 95 OLD SHORT HILLS ROAD WEST ORANGE NJ 07052 352219655 STAFFING SVCS NJ 501(C)(3) 509(a)(3) SBRDC false BARNABAS HEALTH MEDICAL GROUP PC 95 OLD SHORT HILLS ROAD WEST ORANGE NJ 07052 223316007 HEALTH SVCS. NJ 501(C)(3) 509(a)(2) BH false Barnabas Health Physician Associates PC 95 OLD SHORT HILLS ROAD WEST ORANGE NJ 07052 473922235 INACTIVE NJ 501(C)(3) 509(a)(2) BH false BARNABAS HEALTH INC 95 OLD SHORT HILLS ROAD WEST ORANGE NJ 07052 222405279 HEALTH SVCS. NJ 501(C)(3) 509(A)(3) RWJBH false CENTER STATE HEALTH GROUP INC 2 CRESCENT PLACE OCEANPORT NJ 07757 222939956 HEALTH SVCS. NJ 501(C)(3) 509(A)(3) BH false CENTRAL JERSEY BEHAVIORAL HEALTH ASSOC 1691 ROUTE 9 TOMS RIVER NJ 08754 223343959 HEALTH SVCS. NJ 501(C)(3) 509(a)(3) SBBH false CHILDRENS SPECIALIZED HOSPITAL 150 NEW PROVIDENCE ROAD MOUNTAINSIDE NJ 07092 221487148 PED. CARE NJ 501(C)(3) HOSPITAL RWJHCC false CHILDRENS SPECIALIZED HOSPITAL FDN 150 NEW PROVIDENCE ROAD MOUNTAINSIDE NJ 07092 136844298 FUNDRAISING NJ 501(C)(3) 509(A)(1) CSH false CLARA MAASS FOUNDATION ONE CLARA MAASS DRIVE BELLEVILLE NJ 07109 222132516 FUNDRAISING NJ 501(C)(3) 509(a)(1) BH false CLARA MAASS MEDICAL CENTER ONE CLARA MAASS DRIVE BELLEVILLE NJ 07109 221500556 HEALTH SVCS. NJ 501(C)(3) HOSPITAL BH false COMMUNITY MEDICAL CENTER 99 HIGHWAY 37 WEST TOMS RIVER NJ 08755 223452306 HEALTH SVCS. NJ 501(C)(3) HOSPITAL BH false COMMUNITY MEDICAL CENTER FOUNDATION 99 HIGHWAY 37 WEST TOMS RIVER NJ 08755 222597592 FUNDRAISING NJ 501(C)(3) 509(a)(1) BH false GREENVILLE HOSPITAL 44 BRIGHT STREET JERSEY CITY NJ 07302 220963805 INACTIVE NJ 501(c)(3) HOSPITAL LHCS false IRVINGTON HOSPITAL FOUNDATION 95 OLD SHORT HILLS ROAD WEST ORANGE NJ 07052 237025428 INACTIVE NJ 501(C)(3) 509(a)(3) BH false JERSEY CITY MEDICAL CENTER 44 BRIGHT STREET JERSEY CITY NJ 07302 222783298 HEALTH SVCS. NJ 501(C)(3) HOSPITAL BH false LAKEVIEW CHILD CARE CENTER INC ONE HAMILTON HEALTH PLACE HAMILTON NJ 08690 222627639 CHILD CARE NJ 501(C)(3) 509(A)(2) RWJHCCH false LAKEVIEW CHILD CENTER FOUNDATION INC ONE HAMILTON HEALTH PLACE HAMILTON NJ 08690 462038300 FUNDRASING NJ 501(1)(3) 509(A)(3) LCCC false LIBERTY BEHAVIORAL HEALTH ASSOCIATES 44 BRIGHT STREET JERSEY CITY NJ 07302 223506358 HEALTH SVCS. NJ 501(C)(3) 509(A)(3) JCMC false LIBERTY HEALTHCARE SYSTEM FOUNDATION 44 BRIGHT STREET JERSEY CITY NJ 07302 223113911 FUNDRAISING NJ 501(C)(3) 509(A)(2) LHCS false LIBERTY HEALTHCARE SYSTEM INC 44 BRIGHT STREET JERSEY CITY NJ 07302 223113960 HEALTH SVCS. NJ 501(C)(3) 509(A)(2) BH false LIBERTY RIVERSIDE HEALTHCARE 44 BRIGHT STREET JERSEY CITY NJ 07302 223284894 INACTIVE NJ 501(C)(3) HOSPITAL LHCS false LIBERTY SURGICAL ASSOCIATES 44 BRIGHT STREET JERSEY CITY NJ 07302 223386850 HEALTH SVCS. NJ 501(C)(3) 509(A)(3) JCMC false MEGA CARE INC 2 CRESCENT PLACE OCEANPORT NJ 07757 222578561 HEALTH SVCS. NJ 501(C)(3) 509(a)(3) CSHG false MONMOUTH MED CNTR - SOUTHERN CAMPUS 600 RIVER AVE ANNEX BLDG E LAKEWOOD NJ 08701 222630076 FUNDRAISING NJ 501(C)(3) 509(a)(1) BH false MONMOUTH MEDICAL CENTER 300 SECOND AVENUE LONG BRANCH NJ 07740 223452412 HEALTH SVCS. NJ 501(C)(3) HOSPITAL BH false MONMOUTH MEDICAL CENTER - FACULTY PRACT 100 STATE HIGHWAY 36 WEST LONG BRANCH NJ 07764 223357053 HEALTH SVCS. NJ 501(C)(3) 509(a)(3) MMC false NEW BRUNSWICK AFFILIATED HOSPITALS INC ONE ROBERT WOOD JOHNSON PLACE NEW BRUNSWICK NJ 08901 221946837 HLTHCARE SVCS NJ 501(C)(3) 509(A)(3) RWJHCC false NEW MARGARET HAGUE CTR WOMENS JCM OBGYN 44 BRIGHT STREET JERSEY CITY NJ 07302 223363012 HEALTH SVCS. NJ 501(C)(3) 509(A)(3) JCMC false NEWARK BETH ISRAEL MEDICAL CENTER 201 LYONS AVENUE NEWARK NJ 07112 223452311 HEALTH SVCS. NJ 501(C)(3) HOSPITAL BH false ROBERT WOOD JOHNSON VISITING NURSES INC 972 SHOPPES BOULEVARD NORTH BRUNSWICK NJ 08902 263659270 HLTHCARE SVCS NJ 501(C)(3) 509(A)(2) NA false RWJ BARNABAS HEALTH INC 95 OLD SHORT HILLS ROAD WEST ORANGE NJ 07052 810682747 INACTIVE NJ 501(C)(3) 509(A)(3) NA false RWJ HEALTH CARE CORPORATION ONE ROBERT WOOD JOHNSON PLACE NEW BRUNSWICK NJ 08901 222568905 HOLDING CO. NJ 501(C)(3) 509(A)(3) RWJBH false RWJ HEALTH CARE CORPORATION AT HAMILTON ONE HAMILTON HEALTH PLACE HAMILTON NJ 08690 222566863 HOLDING CO. NJ 501(C)(3) 509(A)(3) RWJHCC false RWJ PROPERTY HOLDING CORPORATION ONE ROBERT WOOD JOHNSON PLACE NEW BRUNSWICK NJ 08901 222474955 PROPERTY NJ 501(C)(3) 509(A)(3) RWJHCC false RWJ UNIVERSITY HOSPITAL ONE ROBERT WOOD JOHNSON PLACE NEW BRUNSWICK NJ 08903 221487243 HLTHCARE SVCS NJ 501(C)(3) HOSPITAL RWJHCC false RWJ UNIV HOSP AT HAMILTON FDN INC ONE HAMILTON HEALTH PLACE HAMILTON NJ 08690 222552329 FUNDRAISING NJ 501(C)(3) 509(A)(1) RWJHCCH false RWJ UNIV HOSP RAHWAY FOUNDATION 865 STONE STREET RAHWAY NJ 07065 222405094 FUNDRAISING NJ 501(C)(3) 509(A)(1) RWJUHR false RWJ UNIV HOSPITAL AT HAMILTON ONE HAMILTON HEALTH PLACE HAMILTON NJ 08690 210634572 HLTHCARE SVCS NJ 501(C)(3) HOSPITAL RWJHCCH false RWJ UNIV HOSPITAL FOUNDATION INC 10 PLUM STREET NO 910 NEW BRUNSWICK NJ 08901 222378007 FUNDRAISING NJ 501(C)(3) 509(A)(1) RWJHCC false RWJ UNIVERSITY HOSPITAL RAHWAY 865 STONE STREET RAHWAY NJ 07065 221487305 HLTHCARE SVCS NJ 501(C)(3) HOSPITAL RWJHCC false SAINT BARNABAS BEHAVIORAL HEALTH CENTER 1691 ROUTE 9 TOMS RIVER NJ 08754 222977312 HEALTH SVCS. NJ 501(C)(3) HOSPITAL CSHG false SAINT BARNABAS HEALTH CARE SYSTEM FDN 95 OLD SHORT HILLS ROAD WEST ORANGE NJ 07052 223769036 FUNDRAISING NJ 501(C)(3) 509(a)(1) BH false SAINT BARNABAS HOSPICE AND PALLIATIVE 95 OLD SHORT HILLS ROAD WEST ORANGE NJ 07052 222354659 HEALTH SVCS. NJ 501(C)(3) 509(a)(1) BH false SAINT BARNABAS MEDICAL CENTER 94 OLD SHORT HILLS ROAD LIVINGSTON NJ 07039 221494440 HEALTH SVCS. NJ 501(C)(3) HOSPITAL BH false SAINT BARNABAS OUTPATIENT CENTERS 200 SOUTH ORANGE AVENUE LIVINGSTON NJ 07039 222458479 HEALTH SVCS. NJ 501(C)(3) 509(A)(2) BH false SAINT BARNABAS REALTY DEVELOPMENT CORP 94 OLD SHORT HILLS ROAD LIVINGSTON NJ 07039 222940008 TITLE HLDNG. NJ 501(C)(3) 509(a)(3) BH false SANDY HOOK FRNDS OF ST BARNABAS BURN FDN 94 OLD SHORT HILLS ROAD LIVINGSTON NJ 07039 223236202 FUNDRAISING NJ 501(C)(3) 509(A)(3) BH false SOMERSET COMMUNITY CARE CORP 110 REHILL AVENUE SOMERVILLE NJ 08876 223295495 INACTIVE NJ 501(C)(3) 509(A)(2) RWJUH false SOMERSET HEALTH CARE AFFILIATES INC 110 REHILL AVENUE SOMERVILLE NJ 08876 222665685 INACTIVE NJ 501(C)(3) 509(A)(2) RWJUH false THE NEWARK BETH ISRAEL MEDICAL CNTR FDN 201 LYONS AVENUE NEWARK NJ 07112 222587176 FUNDRAISING NJ 501(C)(3) 509(a)(1) BH false UNITED RESCUE AT JERSEY CITY INC 95 OLD SHORT HILLS ROAD WEST ORANGE NJ 07052 222458481 INACTIVE NJ 501(C)(3) 509(a)(2) JCMC false VNA HEALTH GROUP OF NEW JERSEY LLC 176 RIVERSIDE AVENUE RED BANK NJ 07701 474841103 HEALTH SVCS. NJ 501(C)(3) 509(a)(2) mega care false CENTRAL JERSEY ACO LLC 95 OLD SHORT HILLS ROAD WEST ORANGE NJ 07052 455460713 HEALTHCARE SVCS. NJ NA INNOVATIVE PURCHASING CONCEPTS 95 OLD SHORT HILLS ROAD WEST ORANGE NJ 07052 223786557 PURCHASING NJ NA JERSEY ASC VENTURES LLC 1A BURTON HILLS BLVD NASHVILLE TN 37215 473368037 MEDICAL TN NA KIM-MED ASSOCIATES 300 SECOND AVENUE LONG BRANCH NJ 07740 222775619 INACTIVE NJ NA LIBERTY HEALTHCARE MANAGEMENT 44 BRIGHT STREET JERSEY CITY NJ 07302 223597891 MANAGEMENT NJ NA LIBERTYUSP SURGERY CENTERS LLC 15305 DALLAS PKWY SUITE 1600 LB 28 ADDISON TX 75001 264756962 HEALTHCARE SVCS. TX NA NEW JERSEY IMAGING NTWKLLC 95 OLD SHORT HILLS ROAD WEST ORANGE NJ 07052 460623701 HEALTHCARE SVCS. NJ NA RWJ-REGENT II LLC ONE ROBERT WOOD JOHNSON PLACE NEW BRUNSWICK NJ 08903 800878969 HEALTHCARE SVCS. NJ NA RWJ-REGENT LLC 10 PLUM STREET 4TH FLOOR NEW BRUNSWICK NJ 08901 453853994 HEALTHCARE SVCS. NJ NA SHREWSBURY DIAGNOSTIC IMAGING LLC 1131 BROAD STREET SUITE 110 SHREWSBURY NJ 07702 203833246 HEALTHCARE SVCS. NJ NA HAMILTON ENDO & SURG LLC 1235 WHITEHORSE-MERCERVILLE RD STE HAMILTON NJ 08619 223837967 HEALTHCARE SVCS. NJ NA false true false true true false false false false false false false false true true true false true true SCHEDULE R, PART V THE ORGANIZATION IS A MEMBER OF RWJBARNABAS HEALTH; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. AFFILIATES WITHIN THE SYSTEM, BARNABAS HEALTH, INC. AND SBC MANAGEMENT CORPORATION, BOTH RELATED ORGANIZATIONS, ROUTINELY PAY EXPENSES FOR VARIOUS AFFILIATES WITHIN RWJBARNABAS HEALTH IN THE ORDINARY COURSE OF BUSINESS, INCLUDING THIS ORGANIZATION. 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. ADDITIONAL TIME IS NEEDED TO GATHER THE INFORMATION NECESSARY TO FILE A COMPLETE AND ACCURATE TAX RETURN.