2017-11-07T08:18:18-06:00 2016-12-31 390859910 Baker Tilly Virchow Krause LLP 1650 Market Street Suite 4500 Philadelphia PA 191037341 990 2016-01-01 221773439 Kennedy University Hospital Inc KENN 8566615185 500 Marlboro Avenue Cherry Hill NJ 08002 JOSEPH DEVINE Chief Executive Officer 8566615185 2017-10-25 1 Julius C Green CPA P00350393 2159720701 96.89.178.154 2017-10-25 14:20:21 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 9D0D8DD59390B7764A3ECE0F40BBFE3618018605 2016 2021-01-29 14:40:06Z JOSEPH DEVINE 1099 WHITEHORSE RD VOORHEES NJ 08043 581738975 0 X www.kennedyhealth.org X 1965 NJ Kennedy University Hospital is an Academic Medical Center providing the finest healthcare services. 21 18 4899 325 0 0 2373640 4538448 554345378 572522839 4005499 3577627 1937083 631109 562661600 581270023 10544506 11548674 0 0 254261169 260559402 0 0 73261 264419028 281044742 529224703 553152818 33436897 28117205 543001699 613286832 212164612 254516746 330837087 358770086 Kennedy University Hospital is an Academic Medical Center that provides the finest healthcare services with excellent outcomes to people living in our community. 0 0 480437636 11548674 572782360 Established in 1965, Kennedy University Hospital provides outstanding medical services to residents in our communities in inpatient and outpatient facilities. Kennedy has three acute care hospitals located in southern New Jersey. Kennedy offers a wide variety of programs and services at our Outpatient Facilities including a Cancer Center, Dialysis Centers, Outpatient Radiology, Family Health Centers, Center for Wound Care, Home Health, Women's and Children's and Behavioral Health.In 2016, Kennedy provided unreimbursed community benefit costs of approximately $33.4 million as noted on Schedule H. See complete discussion of community programs and activities on Schedule H. 480437636 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 381 0 1 4899 1 0 0 0 0 0 0 0 0 0 0 X 21 18 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NJ X J David Hyers 8566615186 500 Marlboro Avenue Cherry Hill NJ 08002 John F Durante Chairman 1.00 2.00 X X 0 0 0 John P Silvestri VICE CHAIR 1.00 4.00 X X 0 0 0 Justice John E Wallace Jr Secretary 1.00 X X 0 0 0 Joseph W Devine President & CEO 35.00 5.00 X X 1104166 0 99332 Melanie Angelo DO Trustee 1.00 X 0 0 0 William Barker Trustee 1.00 X 0 0 0 Robert I Barsky DO Trustee 1.00 X 0 0 0 Anthony Brown DO Trustee 1.00 X 0 0 0 Ronald L Caputo Trustee 1.00 2.00 X 0 0 0 Daniel J Dalton Trustee 1.00 3.00 X 0 0 0 Robert DiStanislao Trustee 1.00 X 0 0 0 Michele A Fletcher CPA Trustee 1.00 2.00 X 0 0 0 Thomas J Gallia EdD Trustee 1.00 1.00 X 0 0 0 Wanda P Hardy EMBA Trustee 1.00 1.00 X 0 0 0 John Lucas emeritus Trustee 1.00 X 0 0 0 Joseph Maressa JR ESQ Trustee 1.00 2.00 X 0 0 0 Bruce J Paparone Trustee 1.00 X 0 0 0 Daniel J Ragone Trustee 1.00 3.00 X 0 0 0 Albert E Smith CPA Trustee 1.00 3.00 X 0 0 0 Ali A Houshmand PhD ex-Officio 1.00 X 0 0 0 Thomas A Cavalieri DO Ex-Officio 1.00 X 0 0 0 RHONDA COSTELLO TREASURER (UNTIL 10/16) 1.00 X X 0 0 0 STANLEY JC GIBERSON SR TRUSTEE (UNTIL 4/16) 1.00 X 0 0 0 Edward Sullivan Esq SVP/General Counsel 38.00 2.00 X 538945 0 67895 Carman Ciervo SVP, Clinical Services 38.00 2.00 X 977525 0 87112 THOMAS BALCAVAGE svp TECHNOLOGY & PROGRAM Services 40.00 X 396257 0 70728 Glenn Zirbser SVP, CHIEF FINANCIAL OFFICER 40.00 X 462871 0 41324 HELENE BURNS CHIEF NURSING EXEC/VP CLIN 40.00 X 313727 0 49774 JILL C OSTREM SVP OPERATIONS 40.00 X 286109 0 28544 David Goldstein DO Physician 40.00 X 581905 0 48997 Fritz Bech MD Physician 40.00 X 624023 0 51708 ANTHONY WEHBE DO MBA FACOI CHIEF POPULATION HEALTH EXECUTIVE 40.00 X 450851 0 43676 ROBERT Principato DO PHYsician 40.00 X 569884 0 57152 TIMOTHY DOMBOWSKI PHYSICIAN 40.00 X 351672 0 17977 Richard Koss FORMER SVP/Amb & Product 0.00 X 199437 0 159 6857372 0 664378 238 1 1 0 THE NORWOOD COMPANY 375 TECHNOLOGY DRIVE MALVERN GA 19355 CONSTRUCTION 40782932 ARAMARK REFRESH 1351 METROPOLITAN AVE WEST DEPTFORD NJ 08066 FOOD SERVICE 5256351 RANCOCAS ANESTHESIOLOGY PA 15000 Midlantic Drive Suite 102 Mt Laurel NJ 08048 Anesthesiologists 4249867 MED METRIX LLC 9 Entin Road Parsippany NJ 07504 Billing Services 2148894 GARDEN STATE INFECT DISEASE 709 Haddonfield Berlin Road Voorhees NJ 080433714 Infectious Disease Services 1746446 68 327991 4198902 11555 4538448 Net Patient Service Revenue 621400 572522839 572522839 572522839 3576877 3576877 728473 468952 259521 259521 259521 750 0 750 750 750 Interest on insurance payments 900099 351569 351569 Vending Machines 722210 16716 16716 MISCELLANEOUS 900099 1979 1979 1324 1324 371588 581270023 572782360 0 3949215 X 11548674 11548674 214841324 186969534 27803792 67998 10429318 9205951 1223367 18682548 16569460 2113088 16606212 14376646 2224303 5263 537400 219633 317767 130593 130593 701802 701802 84620439 72692285 11928154 2452128 65921 2386207 5106574 2066924 3039650 11583140 11583140 8075419 7876128 199291 730160 569376 160784 2774196 2635486 138710 25197989 17134633 8063356 5735705 5735705 Medical Supplies 85451360 85451360 Bad Debt Expense 29977299 29977299 Maintenance & Repairs 6011896 5898423 113473 FOOD 3571455 3571455 8387187 7872743 514444 553152818 480437636 72641921 73261 303123 303073 54655768 58377672 445963 630198 60485857 63438654 8798116 10001899 3482467 5610607 666920872 394419239 225427121 272501633 172925702 181894572 765000 618788 200825 413735 15511757 19496001 543001699 613286832 93255049 86900446 1566265 616709 67040369 64846327 7720195 53445544 42582734 48707720 212164612 254516746 X 330590298 358442026 246789 328060 330837087 358770086 543001699 613286832 X 28117205 5716151 -5900357 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4379016 4379016 246716020 110817820 135898200 3811865 3750897 60968 366583027 278908061 87674966 45430944 942461 44488483 272501633 Capitalized Leases 9400485 Long-term Pension Liability 39307235 48707720 X 550791223 5716151 -36579458 -30863307 581654530 -384507 -384507 581270023 522858224 384507 384507 522473717 30679101 30679101 553152818 Part X, Line 2: The Hospital 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. Part XI, Line 2d - Other Adjustments: Pension Adjustment -5,754,145. Bad Debt Expense -29,977,299. Investment Fees -701,802. CHANGE IN VALUE OF CHERRY HILL ASC INVESTMENT -146,212. Part XI, Line 4b - Other Adjustments: RENTAL EXPENSES -468,952. TRANSFER FROM AFFILIATE (NETTED ON F/S) 84,445. Part XII, Line 2d - Other Adjustments: RENTAL EXPENSES 468,952. TRANSFER FROM AFFILIATE (NETTED ON F/S) -84,445. Part XII, Line 4b - Other Adjustments: Bad Debt Expense 29,977,299. Investment Fees 701,802. 1 1 X 1 X 1 X 500.000000000000 1 1 0 1 1 10928968 9174400 1754568 0.00340 108914195 84462192 24452003 0.04670 119843163 93636592 26206571 0.05010 101521 1001 100520 0.00020 18115771 11903704 6212067 0.01190 2657409 2092470 564939 0.00110 370793 370793 0.00070 21245494 13997175 7248319 0.01390 141088657 107633767 33454890 0.06400 1 5213965 1824888 136767978 148340921 -11572943 X 1 1 3 1 Kennedy University Hospital (Cherry Hill) 2201 Chapel Avenue-West Cherry Hill NJ 08002 10401 X X X X A 2 Kennedy University Hospital (Stratford) 18 East Laurel Road Stratford NJ 08084 10403 X X X X A 3 Kennedy University Hospital (Washington Township) 435 Hurffville-Crosskeys Road Turnersville NJ 08012 10802 X X X X A Facility Reporting Group - A 0 0 1 X X X X X X X 16 1 1 1 1 X www.kennedyhealth.org/about/community-health-needs-assessment 1 16 1 www.kennedyhealth.org/about/community-health-needs-assessment 0 1 X 200.000000000000 500.000000000000 X X X X X 1 1 X X X X 1 X www.kennedyhealth.org/patients/preparing-your-visit/finance-insurance X www.kennedyhealth.org/patients/preparing-your-visit/finance-insurance X www.kennedyhealth.org/patients/preparing-your-visit/finance-insurance X X X X 1 X 0 X X 1 X 0 0 Part V, Section B Facility Reporting Group A Facility Reporting Group A consists of: - Facility 1: Kennedy University Hospital (Cherry Hill), - Facility 2: Kennedy University Hospital (Stratford), - Facility 3: Kennedy University Hospital (Washington Townsh Facility Reporting Group - A Part V, Section B, line 5: Community engagement was an integral component of the 2016 SJHP CHNA. Partner Forums with key community leaders and focus groups with health consumers solicited wide participation from public health experts and representatives of medically underserved, low income, and minority populations. Additionally, representatives from each of the four study counties served on the CHNA committee to provide insight in data collection and planning.As part of the 2016 CHNA, five partner forums were conducted within the southern New Jersey counties, one each within Burlington, Gloucester, and Ocean Counties and two within Camden County. Camden partner forums were conducted in Camden City and in the southern portion of the county in recognition of the unique socioeconomic and health disparities within the city. The objective of the forums was to solicit feedback from representatives of key stakeholder groups about priority health needs, including identifying underserved populations, existing resources to address the priority needs, and barriers to accessing services. The forum also served to facilitate collaboration to address community health needs. An overview of the 2016 CHNA research findings was presented to the partners. Participants were then asked to respond to a list of identified health needs as determined by the research and offer feedback on prioritizing issues.Facilitated meetings were held with residents across the four study counties. A total of 72 adults attended five sessions held in September 2016 in Burlington, Camden, Gloucester, and Ocean Counties and Camden City. Participants were recruited by South Jersey Health Partnership member organizations and were prescreened to have a chronic condition diagnosis. Facility Reporting Group - A Part V, Section B, line 6a: The 2016 CHNA was conducted by the South Jersey Health Partnership (SJHP), within four Southern New Jersey Counties: Burlington, Camden, Gloucester, and Ocean. Through a coordinated approach, the Partnership worked with county health departments and local community partners to gather feedback and conduct regional research and planning efforts to ensure community health improvement initiatives were aligned. The 2016 SJHP CHNA included the following member hospitals: Cooper University Hospital, Deborah Heart and Lung Center, Kennedy University Hospitals (Cherry Hill, Stratford, Washington Township), Lourdes Medical Center of Burlington County; Our Lady of Lourdes Medical Center, Virtua Marlton, Virtua Memorial, & Virtua Voorhees. Facility Reporting Group - A Part V, Section B, line 6b: Burlington, Camden, Gloucester, and Ocean County Health Departments Facility Reporting Group - A Part V, Section B, line 11: As part of the 2016 CHNA, five partner forums were conducted with local health and human service providers and other community-based organizations to review research results from the CHNA and provide feedback on community health priorities. A voting system based on the criteria of scope, severity, and ability to impact was used to help participants prioritize local health needs. Priority lists from each forum were compared to develop a prioritized list of health needs across the region as follows:1. Substance abuse2. Chronic disease prevention and management3. Mental health4. Cancer5. Maternal and child healthThe SJHP hospital representatives held a facilitated meeting to discuss priority setting and goals. The SJHP CHNA Steering Committee considered data from the CHNA research in conjunction with input from community partners and public health representatives to adopt the following regional priority health needs (listed in alphabetical order).- Behavioral Health and Chronic Disease Comorbidities- Linkages to Care- Substance AbuseThe SJHP developed common goals to address each priority area and ensure community health improvement initiatives are aligned across the region. Kennedy Health's Community Health Implementation Plan, for the period 2016 to 2019, will specifically guide community benefit and population health improvement activities for Kennedy University Hospital-Cherry Hill, Kennedy University Hospital-Stratford, and Kennedy University Hospital-Washington Township. The plan builds upon previous health improvement activities, while recognizing new health needs and a changing health care delivery environment, to address the most pressing health needs.Priority Area: Behavioral Health/Chronic Disease ComorbiditiesGoal: Increase identification and treatment of behavioral health among individuals with chronic disease.Objectives:- Increase screening for behavioral health among patients with chronic conditions.- Increase the proportion of adults with mental health disorders who are properly diagnosed and receive treatment.- Improve disease management for behavioral health and chronic conditions.Strategies:- Continue to be a partner in the South Jersey Behavioral Health Innovation Collaborative to evaluate and recommend improvements to the behavioral health system- Continue to offer community seminars about risk factors related to mental health and substance abuse, targeting individuals with chronic disease- Engage Kennedy Health's behavioral health navigator to improve access to behavioral health treatment services among patients with chronic disease- Enhance partnerships with community agencies to support behavioral health treatment services among residents- Implement the use of early identification behavioral health screening tools among chronic disease patients in the hospital and the community- Provide chronic disease-specific community-based screenings, targeting underserved and at-risk populations- Provide education about healthy lifestyles and chronic disease management techniques- Provide support groups for specific health conditions and target populationsPriority Area: Linkages to Care Goal: Increase the proportion of persons who have a specific source of ongoing care and are able to obtain services when they need them.Objectives:- Improve navigation of health care services to link individuals to appropriate care.- Reduce the proportion of persons who are unable to obtain or delay receiving necessary medical care, dental care, or prescription medicines.- Reduce usage of the Emergency Department as primary medical home.- Reduce transportation barriers for residents to receive care.- Increase the number of people who have health insurance.Strategies:- Collaborate with community agencies and health centers to improve access points and referrals for primary and dental care- Conduct health care education seminars to improve resident understanding of navigating the health system, available sources of care, and appropriate care usage- Conduct insurance education seminars to increase the proportion of residents who understand their health care options and are insured- Continue partnership with CompleteCare, a Federally Qualified Health Center to coordinate care for underserved and/or uninsured residents- Explore the potential to expand transportation options for individuals in need of medical services through collaboration with community partners and current transportation providers- Provide New Jersey FamilyCare insurance enrollment and information assistance at hospital locations and in the communityPriority Area: Substance AbuseGoal: Develop partnerships to enhance education and treatment for substance abuse.Objectives:- Increase community awareness of signs and symptoms related to substance abuse.- Increase the number of individuals that are screened for substance abuse.- Increase the number of individuals who receive treatment for substance abuse.Strategies:- Continue to be a partner in the South Jersey Behavioral Health Innovation Collaborative to evaluate and recommend improvements to the behavioral health system- Engage Kennedy Health's behavioral health navigator to improve access to substance abuse treatment services among patients- Enhance partnerships with community agencies to support substance abuse treatment services and referrals among residents- Implement the use of early identification substance abuse screening tools among primary care and emergency department patients and the community- Promote community drug take back programs and drop boxes- Provide community education and outreach regarding substance abuse risk factors and signs and symptoms- Provide educational training and materials to dispensers and prescribers on appropriate opiate prescribing guidelines 13 1 - Kennedy Home Health Care Center 1099 White Horse Road Voorhees NJ 08043 Home Health 2 - Kennedy Diagnostic & Treatment Center 900 MEDICAL CENTER DRIVE STE 100 SEWELL NJ 08080 RADIATION ONCOLOGY CENTER 3 - KENNedy Diagnostic & Treatment Center 900 MEDICAL CENTER DRIVE SEWELL NJ 08080 MEDICAL IMAGING CENTER 4 - KENNEDY FAMILY HEALTH CTR - WASHINGTON 445 HURFFVILLE CROSSKEYS ROAD TURNERSVILLE NJ 08012 FAMILY HEALTH CENTER 5 - KENNEDY FAMILY HEALTH CTR - SOMERDALE 1 SOMERDALE SQUARE WHITE HORSE SOMERDALE NJ 08083 FAMILY HEALTH CENTER 6 - KENNEDY DIALYSIS CENTER - VOORHEES 201 LAUREL OAK ROAD VOorhees NJ 08043 DIALYSIS CENTER 7 - KENNEDY DIALYSIS CENTER - WASHINGTON 300 MEDICAL CENTER DRIVE SEWELL NJ 08080 DIALYSIS CENTER 8 - KENNEDY BEHAVIORAL HEALTH 454 HURFFVILLE CROSSKEYS ROAD TURNERSVILLE NJ 08012 BEHAVIORAL HEALTH SERVICES 9 - THE CENTER FOR WOUND HEALING 543 EGG HARBOR ROAD TURNERSVILLE NJ 08012 WOUND CARE CENTER 10 - KENNEDY SLEEP CENTER - WASHINGTON TWP 400 MEDICAL CENTER DRIVE SEWELL NJ 08080 SLEEP STUDY CENTER 11 - KENNEDY SLEEP CENTER - STRATFORD 19 EAST LAUREL ROAD STRATFORD NJ 08084 SLEEP STUDY CENTER 12 - KENNEDY SURGICAL CENTER 540 EGG HARBOR ROAD SEWELL NJ 08080 SURGICAL CENTER 13 - KENNEDY PHYSICAL THERAPY AT WT 405 HURFFVILLE CROSSKEYS ROAD SEWELL NJ 08080 OUTPATIENT PHYSICAL THERAPY Part I, Ln 7 Col(f): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $29,977,299. Part III, Line 2: THE TOTAL CHARGES FOR EACH PATIENT WRITTEN OFF TO BAD DEBT IN 2016 WERE SUMMED. THE 2016 COST TO CHARGE RATIO FROM THE MEDICARE COST REPORT WAS APPLIED TO ESTIMATE THE COST OF THE BAD DEBT ACCOUNTS. Part III, Line 3: THE ESTIMATED PERCENTAGE OF BAD DEBTS THAT WOULD QUALIFY AS CHARITY CARE IF DOCUMENTATION WERE PROVIDED IS 35%. THIS ESTIMATE WAS DETERMINED THROUGH DISCUSSIONS WITH HEALTH ACCESS PERSONNEL WHO PROCESS BOTH THE CHARITY CARE APPLICATIONS AND BAD DEBT DETERMINATIONS. MANY PATIENTS REFUSE TO COMPLETE THE CHARITY CARE APPLICATION FOR REASONS OF PRIDE, PRIVACY, MOTIVATION AND COMPREHENSION. THE CHARITY CARE DOCUMENTATION REQUIREMENTS ARE SPECIFICALLY PRESCRIBED IN NEW JERSEY AND MUST BE FOLLOWED BY ALL HOSPITALS. THE BAD DEBT PROCESS FOR MANY PATIENTS WITHOUT HEALTH INSURANCE OR ASSETS, PROVIDES A MEANS TO ACCESS NEEDED HEALTH CARE SERVICES WITH NO OUT-OF-POCKET PAYMENTS SIMILAR IN MANY WAYS TO THE CHARITY CARE PROCESS. THIS IS CLEARLY A COMMUNITY BENEFIT FOR PATIENTS WHO WOULD HAVE QUALIFIED FOR CHARITY CARE SINCE THEY HAVE NO OR INADEQUATE HEALTH INSURANCE AND THEY HAVE FEW ASSETS YET REQUIRE HOSPITAL CARE. Part III, Line 4: Accounts receivable, patients are reported at net realizable value. Accounts are written off when they are determined to be uncollectible based upon management's assessment of individual accounts. The allowance for doubtful collections is estimated based upon a periodic review of the accounts receivable aging, payor classifications, and application of historical write-off percentages. For receivables associated with services provided to patients who have third-party coverage, the Hospital analyzes contractual amounts due and provides an allowance for doubtful collections and a provision for doubtful collections, if necessary. For receivables associated with self-pay patients, the Hospital records a significant provision for doubtful collections in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the billed rates and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful collections.The Hospital's allowance for doubtful collections for self-pay patients was approximately 87% and 88% of self-pay accounts receivable at December 31, 2016 and December 31, 2015, respectively. The Hospital's self-pay account write-offs (net of recoveries) increased to $29,239,000 in 2016 from $27,665,000 in 2015. The increase is a result of the shift from charity care to more insurance plans with high deductibles. The Hospital has not changed its financial assistance policy in 2016 or 2015. Part III, Line 8: The Estimated Medicare Shortfall was calculated using the cost to charge ratio and IRS Worksheets. Any Medicare shortfall should be considered a community benefit due to the health care access provided to our senior citizens with Medicare coverage. All of our hospitals provide access to Medicare patients regardless of financial gains or losses. If this were not the case, access to care could be limited as it is for certain private physician offices. Part III, Line 9b: The collection policy for all patients who may qualify for financial assistance is based on the State of New Jersey regulations and is consistent with IRS guidelines under 501r. Part VI, Line 2: The health system purchases proprietary databases including physician supply and demand studies and utilizes publicly available health, non health (demographic) and New Jersey state statistics such as disease specific incidence and prevalence rates to identify gaps in services. The system works closely with the Southern New Jersey Prenatal cooperative to identify and improve maternal, infant, and pediatric health care in the region.See also Schedule H Part V for discussion of community health needs assessment undertaken in 2016. Part VI, Line 3: All uninsured patients are presented with information regarding Charity Care when they present for services. Also, the parents of uninsured children are provided the opportunity to complete a New Jersey Family Care application at the time the services are provided. The hospital's registration department identifies all patients that are uninsured and refers them either to a hospital financial counselor or an external company hired by the hospital ( Adreima ) to inform them of eligibility for Medicaid programs and the New Jersey Charity Care program. Adreima representatives have Spanish speaking personnel and also provides applications for assistance in Spanish and Russian and a foreign language line is also provided for assistance to patients who do not speak English to assist them in determining their eligibility for financial assistance. Patients can set up an appointment or walk in to speak with a financial counselor. Patients that may qualify for charity are given an application that includes a list of the documents necessary to complete the application process. The financial counselor reviews the information with the patient. Applications are available in English, Spanish and Russian. Financial counselors will also call the language line as appropriate. Accounts over 30 days are referred to Adreima.Signage regarding NJHAP and NJ Family Care are positioned at both the registration area for elective services as well as in each of the Emergency Departments. Information is also provided on our website. Part VI, Line 4: Kennedy University Hospital services patients from the following seven counties in Southern New Jersey: Atlantic, Burlington, Cape May, Cumberland, Gloucester, and Salem. The systems' primary service area includes Camden and Gloucester counties. Camden County is a densely populated, ethnically diverse, primarily urban county. According to 2016 demographic data provided by the Nielsen Company, 63.2% of the population was White, 19.6% black or african american, 5.8% Asian, and 11.4% other. Part VI, Line 5: KUH is continuously investing in our programs and services to provide the finest healthcare to the individuals and families who make up our communities. As part of our commitment to enhance the health status of everyone in our communities, KUH offers several free outreach programs and support services including HIV counseling and treatment. KUH provides care to all patients who present for services regardless of their ability to pay and where reimbursement is less than cost.Board members are all members of the community that live and work in the community. They have joined the board as a way to further serve their commitment to the community. The hospital surplus funds are maintained in investments for future capital projects that benefit the hospital and community. Part VI, Line 6: Kennedy Health System, Inc. is a not-for-profit corporation which is responsible for the overall policy, management and financial support of all entities.STAT Medical Transport, Inc. is a not-for-profit ambulance company which owns and operates ambulances that service the Hospital and the community.Kennedy Property Corporation is a not-for-profit property and development company. This corporation owns and operates buildings within the service area of the Hospital.Kennedy Health Facilities, Inc. is a not-for-profit nursing home company and currently has 190 beds consisting of 130 long-term care beds and 60 sub-acute beds.Kennedy Management Group, Inc. is a for-profit corporation that invests in for-profit businesses to further its mission. Professional Medical Management, Inc. is a for-profit collection service company which has been operational since September of 1984. Kennedy Imaging, P.C. is a professional corporation providing professional imaging services to the System.Kennedy Medical Group, Inc.is a network of primary care physicians and specialists with offices located throughout the South Jersey region.The Kennedy Health Alliance (KHA) is a network of health care providers that offers patients high-quality, efficient medical care close to home. We act as a "gateway" for our patients, connecting them with medical expertise, primary and specialty care services, hospitals and various outpatient programs, as needed. Our team of medical professionals uses a coordinated approach to care that focuses on each patient's individual needs. Several of KHA's primary care practices have received National Committee for Quality Assurance (NCQA) Patient-Centered Medical Home (PCMH) Level 3 recognition. Kennedy Health Alliance also treats all patients in the community regardless of their ability to pay for their services. Part VI, Line 7, Reports Filed With States NJ 1 Kennedy Health System inc 500 marlboro avenue cherry hill NJ 08002 222442036 501 (c)(3) 2557918 related party assistance Kennedy Property Corporation 500 marlboro avenue cherry hill NJ 08002 222442034 501 (c)(3) 406920 related party assistance Kennedy health foundation 500 marlboro avenue cherry hill NJ 08002 800550282 501 (c)(3) 570308 related party assistance KENNEDY MEDICAL GROUP PRACTICE PC 500 marlboro avenue cherry hill NJ 08002 461420853 501 (c)(3) 8013528 related party assistance 4 0 Part I, Line 2: FUNDS WERE TRANSFERRED TO RELATED ORGANIZATIONS FOR FINANCIAL SUPPORT - USE OF FUNDS IS MONITORED THROUGH COMMON MANAGEMENT WITH RELATED ORGANIZATION. X X X X X 1 1 0 0 0 0 0 1 0 Joseph W Devine President & CEO 709830 0 366387 0 27949 0 74977 0 24355 0 1203498 0 0 0 Edward Sullivan Esq SVP/General Counsel 397052 0 113300 0 28593 0 45530 0 22365 0 606840 0 0 0 Carman Ciervo SVP, Clinical Services 636960 0 317971 0 22594 0 59716 0 27396 0 1064637 0 0 0 THOMAS BALCAVAGE svp TECHNOLOGY & PROGRAM Services 314798 0 66959 0 14500 0 51400 0 19328 0 466985 0 0 0 Glenn Zirbser SVP, CHIEF FINANCIAL OFFICER 348120 0 100000 0 14751 0 21509 0 19815 0 504195 0 0 0 HELENE BURNS CHIEF NURSING EXEC/VP CLIN 257170 0 50102 0 6455 0 22704 0 27070 0 363501 0 0 0 JILL C OSTREM SVP OPERATIONS 219499 0 50000 0 16610 0 13558 0 14986 0 314653 0 0 0 David Goldstein DO Physician 566730 0 0 0 15175 0 26780 0 22217 0 630902 0 0 0 Fritz Bech MD Physician 563731 0 50008 0 10284 0 21480 0 30228 0 675731 0 0 0 ANTHONY WEHBE DO MBA FACOI CHIEF POPULATION HEALTH EXECUTIVE 330685 0 108943 0 11223 0 25025 0 18651 0 494527 0 0 0 ROBERT Principato DO PHYsician 554634 0 0 0 15250 0 26780 0 30372 0 627036 0 0 0 TIMOTHY DOMBOWSKI PHYSICIAN 304500 0 38879 0 8293 0 16180 0 1797 0 369649 0 0 0 Richard Koss FORMER SVP/Amb & Product 43926 0 0 0 155511 0 0 0 159 0 199596 0 0 0 Part I, Lines 4a-b RICHARD KOSS RECEIVED A SEVERANCE PAYMENT OF $154,976. THE FOLLOWING PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: JOSEPH DEVINE - DEFERRED $42,897 CARMAN CIERVO - DEFERRED $38,236 EDWARD SULLIVAN - DEFERRED $24,050 THOMAS BALCAVAGE - DEFERRED $36,551 GLENN ZIRBSER - DEFERRED $21,509 JILL OSTREM - DEFERRED $13,558 Part I, Line 7 Certain Officers, Key employees and Highly Compensated employees were eligible to participate in an incentive compensation plan. The Compensation Committee determines if the eligible participants have achieved the predetermined targets of budgeted financial performance and patient quality indicators. A NEW JERSEY HEALTH CARE FACILITIES AUTHORITY 222845542 64579FZ63 2012-07-30 69906263 REFUND 1997 AND 2001 BONDS; FUND CAPITAL PROJECTS; PAY ISSUANCE COSTS 0 0 0 A 4619042 69906263 664835 19985805 49255623 2015 1 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 SOMERDALE EQUITIES ENTITY MORE THAN 35% OWNED BY JOHN SILVESTRI, BOARD TRUSTEE 206330 RENTAL OF REAL ESTATE PROPERTY. John Silvestri and/or members of his immediate family directly or indirectly lease office space to entities within Kennedy Health pursuant to written agreements. Such individual leases have been reviewed and approved by independent Members of the Board of Trustees, verifying such leases are within Fair Market Value. 0 MARY DISTANISLAO SISTER OF ROBERT DISTANISLAO, BOARD TRUSTEE 88447 EMPLOYEE 0 SCHEDULE L BOARD TRUSTEE, ROBERT CAPUTO IS EMPLOYED BY WILMINGTON TRUST. WILMINGTON TRUST PROVIDES PENSION PLAN SERVICES TO KENNEDY HEALTH SYSTEM AND IS A CORPORATE AFFILIATE OF M&T BANK, A LENDER AND INSURANCE BROKER FOR KENNEDY HEALTH SYSTEM. MR. CAPUTO IS NOT AN OWNER OR OFFICER OF WILMINGTON TRUST AND THEREFORE TRANSACTIONS WITH WILMINGTON TRUST ARE NOT REQUIRED TO BE REPORTED ON PART IV OF SCHEDULE L. Form 990, Part VI, Section A, line 7a THE TRUSTEES OF THE BOARD ARE ELECTED BY A MAJORITY VOTE OF THE BOARD OF DIRECTORS OF KENNEDY HEALTH SYSTEM. Form 990, Part VI, Section A, line 7b THE BOARD OF DIRECTORS OF KENNEDY HEALTH SYSTEM MAY AMEND OR REPEAL THE ORGANIZATION'S BYLAWS AND ADOPT NEW BYLAWS. Form 990, Part VI, Section B, line 11b A copy of the Form 990 and all related schedules have been presented to the Audit and Compliance Committee for review. A copy was also provided to the Board of Trustees and Senior Management for review prior to filing with the Internal Revenue Service. Form 990, Part VI, Section B, line 12c The Internal Audit department distributes Conflict of Interest disclosure statements annually to Management. These statements are reviewed and submitted to the Audit and Compliance Committee. The Board of Trustees and Corporate Officers are required to submit annual Conflict of Interest statements to Legal Counsel. Trustees are required to abstain from debate or vote on any issues where a conflict arises. Form 990, Part VI, Section B, line 15 The process for determining the compensation of the CEO and other Senior Management is completed ANNUALLY by the organizations' Compensation Committee, WHICH IS ESTABLISHED BY THE BOARD OF TRUSTEES OF THE HOSPITAL. The Compensation Committee reviews all salary benefit packages. The committee compiles various sources of market data to substantiate the compensation AND USES THE SERVICES OF INDEPENDENT EXPERTS, SULLIVAN COTTER AND MERCER TO VALIDATE THE REASONABLENESS OF COMPENSATION. THE SALARY RECOMMENDATIONS OF THE COMPENSATION COMMITTEE ARE REVIEWED AND APPROVED BY THE FULL BOARD. ANY INTERESTED PARTIES ARE EXCUSED FROM PARTICIPATION DURING DEBATE AND APPROVAL OF THE ACTUAL COMPENSATION. The review and approval process is CONTEMPORANEOUSLY documented VIA MINUTES OF THE MEETINGS. Form 990, Part VI, Section C, line 19 Kennedy University Hospital makes its Audited Financial Statements, governing documents and conflict of interest policy available to the public through EMMA, Electronic Municipal Market Access. This website provides a means by which the public can access official statements and disclosures. All documents are also available upon request. Form 990, Part IX, line 11g Physician Fees: Program service expenses 35,778,710. Management and general expenses 0. Fundraising expenses 0. Total expenses 35,778,710. CONSULTING Fees: Program service expenses 0. Management and general expenses 3,478,933. Fundraising expenses 0. Total expenses 3,478,933. COLLECTION FEES: Program service expenses 0. Management and general expenses 2,069,177. Fundraising expenses 0. Total expenses 2,069,177. AGENCY FEES: Program service expenses 7,091,200. Management and general expenses 0. Fundraising expenses 0. Total expenses 7,091,200. purchased SERVICES: Program service expenses 29,822,375. Management and general expenses 6,380,044. Fundraising expenses 0. Total expenses 36,202,419. Form 990, Part XI, line 9: Pension Adjustment -5,754,145. CHANGE IN VALUE OF CHERRY HILL ASC INVESTMENT -146,212. Kennedy Health System Inc 500 Marlboro Avenue Cherry Hill NJ 08002 222442036 Fundraising NJ 501(c)(3) Line 7 N/A 0 STAT Medical Transport Inc 500 Marlboro Avenue Cherry Hill NJ 08002 222443981 Medical Transport NJ 501(c)(3) Line 12a, I Kennedy Health System Inc 0 Kennedy Health Facilities Inc 500 Marlboro Avenue Cherry Hill NJ 08002 222442032 Nursing Home NJ 501(c)(3) Line 12a, I Kennedy Health System Inc 0 Kennedy Property Corporation 500 Marlboro Avenue cherry Hill NJ 08002 222442034 Property Management NJ 501(c)(3) Line 12a, I Kennedy Health System Inc 0 KENNEDY MEDICAL GROUP PRACTICE PC 500 Marlboro Avenue CHERRY HILL NJ 08002 461420853 MEDICAL SERVICES NJ 501(c)(3) Line 10 KENnedy Health System Inc 0 KENNEDY HEALTHCARE FOUNDATION 500 Marlboro Avenue CHerry Hill NJ 08002 800550282 FUNDRAISING NJ 501(c)(3) Line 7 KENNedy Health System Inc 0 GARDEN STATE RADIOLOGY LLC 500 MARLBORO AVE CHERRY HILL NJ 08002 471323463 RADIOLOGY SERVICES NJ N/A KENNEDY CHERRY HILL SURGICAL CENTER LLC 11221 ROE AVE SUITE 320 LEAWOOD KS 66211 472462625 surgical center NJ KENNEDY UNIVERSITY HOSPITAL INC related 618786 0 1 0.51000 Professional Medical Management Inc 500 Marlboro Avenue Cherry Hill NJ 08002 222559690 Collections NJ N/A C 0 Kennedy Management Group Inc 500 Marlboro Avenue Cherry Hill NJ 08002 223347294 Management Services NJ N/A C 0 KENNEDY ACCESS INCORPORATED 500 Marlboro Avenue Cherry Hill NJ 08002 472661672 Physician Practice NJ N/A C 0 0 1 1 0 0 0 0 0 0 0 1 1 1 0 1 0 1 1 1