2016-11-15T17:35:17-06:00 2015-12-31 271728945 PKF O'CONNOR DAVIES LLP 15 ESSEX RD PARAMUS NJ 076521412 990 2015-01-01 221487307 THE VALLEY HOSPITAL INC VALL 2014478000 223 NORTH VAN DIEN AVENUE RIDGEWOOD NJ 07450 RICHARD KEENAN SENIOR VP & CFO 2014478000 2016-11-15 1 EDWARD G O'CONNOR P00434443 2017129800 2015 2017-02-10 21:41:12Z RICHARD KEENAN 223 NORTH VAN DIEN AVE RIDGEWOOD NJ 07450 766791751 0 X WWW.VALLEYHEALTH.COM X 1925 NJ THE VALLEY HOSPITAL SERVES THE COMMUNITY BY HEALING AND CARING FOR PATIENTS, COMFORTING THEIR FAMILIES AND TEACHING GOOD HEALTH. 19 18 4099 1500 2003633 -146307 3933676 12960710 657857204 646126327 5935349 5561027 9411255 7776719 677137484 672424783 0 0 0 0 304192101 306449663 0 0 0 356975320 350176736 661167421 656626399 15970063 15798384 953139248 975221417 202874186 200649384 750265062 774572033 X THE VALLEY HOSPITAL SERVES THE COMMUNITY BY HEALING AND CARING FOR PATIENTS, COMFORTING THEIR FAMILIES AND TEACHING GOOD HEALTH. THE VALLEY HOSPITAL IS DISTINGUISHED BY A COMMITMENT TO EXCELLENCE IN CLINICAL CARE, INNOVATION IN PROGRAMS AND TECHNOLOGY, AND PROVIDING A COMPASSIONATE AND RESPECTFUL ENVIRONMENT. 0 0 379620816 470709932 INPATIENT SERVICES:IT IS THE MISSION OF THE VALLEY HOSPITAL TO SERVE THE COMMUNITY BY HEALING AND CARING FOR PATIENTS, COMFORTING THEIR FAMILIES AND TEACHING GOOD HEALTH. VALLEY HAS THREE BUILDINGS ON ITS MAIN CAMPUS. THE VALLEY HOSPITAL SERVES MORE THAN 440,000 PEOPLE IN 32 TOWNS IN BERGEN COUNTY AND ADJOINING COMMUNITIES. NJ BIZ RANKS THE VALLEY HOSPITAL AS THE THIRD BUSIEST HOSPITAL IN THE STATE BASED ON TOTAL INPATIENT DISCHARGES. (SEE CONTINUATION ON SCHEDULE O).IN 2015, APPROXIMATELY 46,967 INDIVIDUALS WERE ADMITTED TO VALLEY. OUR CORE INPATIENT SERVICES INCLUDE:- THE VALLEY HEART AND VASCULAR INSTITUTE, WHICH PROVIDES A CONTINUUM OF PREVENTION AND WELLNESS SERVICES, DIAGNOSTIC AND TREATMENT SERVICES, RESEARCH, AND EDUCATION FOR ALL TYPES OF CARDIAC AND VASCULAR DISEASE.- A CARDIAC SURGERY INTENSIVE CARE UNIT.- FOUR CRITICAL CARE UNITS.- A CARDIAC CATHETERIZATION LABORATORY.- AN INPATIENT ONCOLOGY UNIT.- THE NEUROSCIENCE CENTER OF EXCELLENCE, WHICH INCLUDES THE STROKE CENTER, AS WELL AS PROGRAMS AND SERVICES FOR A WIDE RANGE OF NEUROLOGICAL DISORDERS.- MEDICAL AND SURGICAL FLOORS.- A GERIATRIC SERVICES UNIT.- THE INSTITUTE FOR ROBOTIC AND MINIMALLY INVASIVE SURGERY.- THE TOTAL JOINT REPLACEMENT CENTER.- THE CENTER FOR METABOLIC AND WEIGHT LOSS SURGERY.- THE CENTER FOR CHILDBIRTH, WHICH WELCOMED MORE THAN 3,400 NEWBORNS IN 2015, AND INCLUDES A LEVEL III NEONATAL INTENSIVE CARE UNIT NURSERY.- A PEDIATRIC INTENSIVE CARE UNIT.VALLEY HAS BEEN RECOGNIZED FOR 10 CONSECUTIVE YEARS FOR PROVIDING AN OUTSTANDING INPATIENT EXPERIENCE BY J.D. POWER AND ASSOCIATES. THE HOSPITAL'S PATIENT RELATIONS STAFF AND VOLUNTEERS MADE MORE THAN 12,400 PATIENT-RELATED VISITS AND RESPONDED TO MORE THAN 8,316 CALLS; AND PASTORAL CARE STAFF RESPONDED TO OVER 8,400 INQUIRIES AND MADE 85,354 PATIENT AND FAMILY CONTACTS. 94518378 147119190 OUTPATIENT SERVICES: THROUGH SATELLITE FACILITIES LOCATED THROUGHOUT ITS SERVICE AREA, THE VALLEY HOSPITAL PROVIDES THE COMMUNITIES IT SERVES WITH A COMPREHENSIVE ARRAY OF OUTPATIENT SERVICES. THOSE SERVICES INCLUDE:-THE BLUMENTHAL CANCER CENTER, OFFERING COMPREHENSIVE OUTPATIENT CANCER SERVICES, INCLUDING CHEMOTHERAPY INFUSION SERVICES AND MORE THAN 14,201 RADIATION THERAPY TREATMENTS IN 2015, INCLUDING 121 GAMA KNIFE TREATMENTS-A FULL-SERVICE LABORATORY.(SEE CONTINUATION ON SCHEDULE O).-A DIAGNOSTIC IMAGING CENTER.-THE FERTILITY CENTER.-THE CENTER FOR MATERNAL-FETAL MEDICINE.-A PAIN MANAGEMENT CENTER.-THE BREAST CENTER.-THE UROLOGIC ONCOLOGY CENTER.-INTEGRATIVE HEALING SERVICES, WHICH PROVIDES COMPLEMENTARY MEDICINE, EDUCATIONAL PROGRAMS AND SUPPORT GROUPS.-THE LUNG CANCER CENTER.-REHABILITATION MEDICINE.-THE KIREKER CENTER FOR CHILD DEVELOPMENT.-THE GEORGE R. JAQUA SAME DAY SERVICES CENTER.-THE CENTER FOR SLEEP MEDICINE.-THE PEDIATRIC SLEEP DISORDERS AND APNEA CENTER.-THE SPINE CENTER.-THE CENTER FOR WOMEN'S HEART HEALTH.-THE MEN'S HEART CENTER.IN 2015, THE HOSPITAL PROVIDED ALMOST $17 MILLION IN UNCOMPENSATED CARE, ATTRIBUTABLE TO CHARITY CARE, BAD DEBT AND MEDICAID SHORTFALLS. PATIENTS RECEIVING UNCOMPENSATED CARE IN 2015 INCLUDE PATIENTS WHO WERE TREATED AT VALLEY'S COMMUNITY CARE CLINIC. IN 2015, THE CLINIC RECORDED 7,900 VISITS. VALLEY'S COMMUNITY CARE CLINIC OFFERS SERVICES IN 16 SPECIALTIES INCLUDING: ALLERGY, CARDIOLOGY, COUMADIN, DERMATOLOGY, OTOLARYNGOLOGY, GASTROENTEROLOGY, GYNECOLOGY, NEUROLOGY, OBSTETRICS, OPHTHALMOLOGY, ORTHOPEDICS, PEDIATRICS, PODIATRY, PULMONARY, RHEUMATOLOGY, SURGICAL AND UROLOGY. MORE THAN 120 WOMEN WERE CARED FOR BY THE CLINIC'S OBSTETRICS TEAM. CLINIC OBSTETRIC PATIENTS RECEIVE GENETIC TESTING AND COUNSELING, NUTRITION SERVICES AND EDUCATION PROGRAMS ABOUT PREGNANCY, CHILDBIRTH AND CHILD CARE.VALLEY'S WORK WITH UNDERSERVED COMMUNITIES INCLUDED 137 FREE EDUCATION AND SCREENING PROGRAMS FOR OVER 5,000 OLDER ADULTS IN THE COMMUNITY. ALSO IN 2015, 121 HOMEBOUND COMMUNITY MEMBERS RECEIVED $122,393 IN "AT COST" MEALS. ADDITIONALLY, VALLEY'S COMMUNITY HEALTH AND COMMUNITY BENEFIT DEPARTMENT IS WORKING WITH FAITH-BASED ORGANIZATIONS WHO SERVE MEMBERS OF THE AFRICAN AMERICAN COMMUNITY TO ADDRESS HEART DISEASE AND DIABETES HEALTH CONCERNS.VALLEY'S COMMITMENT TO OFFER AND ENHANCE PROGRAMS THAT INCREASE PHYSICAL EXERCISE AND PROMOTE WEIGHT LOSS BY PROVIDING NUTRITIONAL COUNSELING, EDUCATION ON HEALTHY EATING AND PROGRAMS THAT SUPPORT CHANGE FOR HEALTHY EATING WERE EVIDENT IN A NUMBER OF PROGRAMS IN 2015. THE PARAMUS WEIGHT LOSS CHALLENGE PARTNERSHIP HELPED 114 PEOPLE LOSE A TOTAL OF 770 POUNDS. 60 PERCENT OF THE PARTICIPANTS IMPROVED THEIR CHOLESTEROL AND 50 PERCENT IMPROVED THEIR DIABETES RISK BY LOWERING THEIR A1C. AN ADDITIONAL 123 PEOPLE LOST 907 POUNDS IN THE JOINT CHALLENGE WITH RIDGEWOOD AND FAIR LAWN. FITNESS IN THE PARK PROGRAMS OFFERED IN PARTNERSHIP WITH THE COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP OF BERGEN COUNTY AND PROVIDED 34 PARTICIPANTS WITH FREE EXERCISE PROGRAMS. A 12-WEEK WALKING PROGRAM IN PARTNERSHIP WITH THE RIDGEWOOD LIBRARY HELPED PARTICIPANTS WALK OVER 7,000 MILES IN 2015. NUTRITION EDUCATION FOCUSED ON RECOGNIZING HEALTHY SUBSTITUTIONS, IDENTIFYING IMPORTANT ASPECTS OF NUTRITION AND EATING HEALTHY. CLASSES INCLUDE: COOKING FOR 1 OR 2, EAT RIGHT TO STAY HEALTHY, FOOD FOR YOUR MOOD, AND MAKING HEALTHY CHOICES. VALLEY'S DIETITIANS PROVIDED FREE EDUCATION TO AN ADDITIONAL 1,545 PEOPLE.VALLEY PARTICIPATED IN THE DIABETES COLLABORATIVE ALONG WITH OTHER AREA HOSPITALS. 91 INDIVIDUALS WERE SCREENED AT VALLEY FOR DIABETES AND PRE-DIABETES. THIS ACCOUNTED FOR ALMOST 50 PERCENT OF THE PROGRAM'S PARTICIPANTS. 57 PERCENT OF THE INDIVIDUALS SCREENED HAD BLOOD WORK INDICATING DIABETES OR PRE-DIABETES. THOSE INDIVIDUALS WERE INVITED TO ATTEND FREE EDUCATION CLASSES ON DIABETES MANAGEMENT OR VALLEY HOME CARE'S DIABETES SELF-MANAGEMENT PROGRAM. VALLEY'S DEPARTMENT OF COMMUNITY HEALTH AND COMMUNITY BENEFIT EDUCATED AND SCREENED 3,175 PEOPLE WITH 100 FREE HEART HEALTH EDUCATION AND SCREENING PROGRAMS. PROGRAMS INCLUDED: HEART HEALTH JEOPARDY, CHOLESTEROL - THE GOOD, THE BAD AND THE UGLY, YOUR KEY TO HEART HEALTH, HEART HEALTH - WHAT YOUR NUMBERS MEAN, AND UNDERSTANDING YOUR CARDIAC MEDICATIONS. AN ADDITIONAL 4,041 PEOPLE PARTICIPATED IN CARDIAC EDUCATION AND HEALTH FAIRS OFFERED BY OUR CENTER FOR HEART HEALTH AND 782 PEOPLE PARTICIPATED IN THE FREE HEART RISK ASSESSMENTS.ALMOST 900 PEOPLE PARTICIPATED IN 32 PROGRAMS ON CANCER EDUCATION AND SCREENING. HEALTH SCREENINGS FOR PROSTATE, COLORECTAL, LUNG AND SKIN CANCER IDENTIFIED 11 INDIVIDUALS FOR FURTHER TESTING THAT REVEALED CANCER. THE FREE SMOKING CESSATION PROGRAM HELPED 45 OF THE 62 PEOPLE ENROLLED IN 2014 TO QUIT SMOKING. IN 2015, VALLEY'S SPIRIT OF WOMEN PROVIDED EDUCATION AND PROGRAMMING TO OVER 1,300 WOMEN OF ALL AGES. SPIRIT NOW HAS OVER 5,400 MEMBERS AND RECEIVED A NEW NAME - THRIVE. PROGRAMS COVERED ALL ASPECTS OF WOMEN'S HEALTH INCLUDING: MENOPAUSE, MOTHER/DAUGHTER TWEEN AND TEEN PROGRAMS, HEALTHY EATING, GYNECOLOGIC HEALTH AND HEART HEALTH.COMPREHENSIVE PARENT EDUCATION PROGRAMS ARE OFFERED TO EXPECTANT FAMILIES THROUGH THE FAMILY EDUCATION CENTER. CLASSES, ATTENDED BY ALMOST 9,528 PEOPLE, INCLUDE: CHILDBIRTH PREPARATION, MARVELOUS MULTIPLES , NEWBORN CARE, GRANDPARENTS', SIBLING, INFANT AND CHILD SAFETY, INFANT MASSAGE, BREASTFEEDING, BABY SITTERS, PRE/POSTNATAL YOGA AND HEALTHY EATING FOR BABY AND ME. CLINIC PATIENTS ATTEND FREE OF CHARGE. THE CENTER PROVIDED FREE BREASTFEEDING CLASSES TO ALMOST 900 PEOPLE AND BREASTFEEDING SUPPORT TO 1,259 PEOPLENEW PARENT SUPPORT SERVICES INCLUDE BREASTFEEDING SUPPORT GROUPS, POSTPARTUM SUPPORT GROUP, A HELPLINE AND LACTATION CONSULTATIONS. WEEKLY TOURS OF MATERNITY SERVICES AND A SELF-HELP SUPPORT GROUP FOR BEREAVED PARENTS ARE OFFERED AT NO CHARGE. THE KIREKER CENTER FOR CHILD DEVELOPMENT PROVIDES FREE IN-SERVICES AND INFORMATION ABOUT LICENSED CHILD CARE FACILITIES AND COMMUNITY GROUPS. TOPICS INCLUDE INFANT/CHILD GROWTH AND DEVELOPMENT; ATYPICAL DEVELOPMENT; ENHANCING LANGUAGE SKILLS IN THE 0-5 POPULATION; DETERMINING IF A CHILD SHOULD BE ASSESSED FOR A SUSPECTED DEVELOPMENTAL DELAY; AND GENERAL PEDIATRIC HEALTH ISSUES. A PARENT SUPPORT GROUP AND FREE INFORMATION IS PROVIDED ON A RANGE OF CHILD CARE TOPICS, INCLUDING DEVELOPMENTALLY APPROPRIATE TOYS, TRANSITIONS INTO PRE-SCHOOL AND CHOICES IN CHILD CARE. A SCHOOL PSYCHOLOGIST, DEVELOPMENTAL PEDIATRICIAN AND APNEA SPECIALIST SPEAK WITH SCHOOLS AND PHYSICIAN GROUPS ABOUT LEARNING ISSUES AND BEHAVIORAL CONCERNS. VALLEY ALSO MADE CONTACT WITH ALMOST 3,000 PEOPLE WHO ATTENDED SUPPORT GROUPS. THESE GROUPS INCLUDE SUPPORT FOR DIFFERENT TYPES OF CANCERS, HEART DISEASE AND STROKE, DOWN SYNDROME, PARKINSON'S DISEASE, ALZHEIMER'S DISEASE, BEREAVEMENT AND WOMEN'S HEALTH. ADDITIONALLY, VALLEY SUPPORTS OTHER ORGANIZATIONS' EFFORTS FOR SUPPORT GROUPS BY OFFERING IN-KIND DONATIONS OF MEETING SPACE AND ADMINISTRATIVE RESOURCES.VALLEY SERVES AS AN INFORMATION RESOURCE FOR THE COMMUNITY. IN 2015, THE PHYSICIAN AND REFERRAL SERVICE HANDLED 12,455 TOLL-FREE INQUIRIES FOR PROGRAM/SERVICE AND PHYSICIAN INFORMATION. CONSUMER HEALTH AMBASSADORS ROUNDED WITH 1,800 PATIENTS AND FAMILIES LEADING TO 350 DIRECT REQUESTS FOR INFORMATION FROM VALLEY'S MEDICAL LIBRARY. THAT INCLUDES THE 1,000 INQUIRIES FROM COMMUNITY MEMBERS WHO WERE ASSISTED WITH INFORMATION FROM THE LIBRARY. THE VALLEY HOSPITAL WEBSITE PROVIDED FREE HEALTH INFORMATION TO 1,162,031 VISITORS. PRESS RELEASES ON DISEASE INFORMATION AND INFORMATIVE NEWSLETTERS ABOUT HEALTH ARE DISTRIBUTED REGULARLY TO MEMBERS OF THE COMMUNITY THROUGH DIRECT MAIL PIECES AND NEWSPAPER PLACEMENT. ADDITIONALLY, VALLEY STAFF REGULARLY CONTRIBUTE TO WCBS 880 AM'S HEALTH & WELLBEING REPORT.VALLEY SUPPORTS COMMUNITY GROUPS. IN 2015 VALLEY STAFF MEMBERS SERVED AS MEMBERS OF THE ROTARY, THE CHAMBER OF COMMERCE, THE RIDGEWOOD MUNICIPAL ALLIANCE, BERGEN COUNTY COLLABORATIVE, AND THE VILLAGE'S HUMAN RESOURCES COORDINATING COUNCIL. VALLEY PROVIDES FINANCIAL CONTRIBUTIONS TO LOCAL ORGANIZATIONS FOR DIABETES, CANCER, MENTAL HEALTH, DOMESTIC VIOLENCE AND MINORITY NEEDS. VALLEY HOSPITAL SUPPORTS THE COMMUNITY THROUGH EMERGENCY MANAGEMENT AND DISASTER PREPARATION. HOSPITAL REPRESENTATIVES SERVE ON TOWN, COUNTY AND STATE-WIDE EMERGENCY MANAGEMENT COMMITTEES AND EXECUTIVE LEVEL COMMITTEES FOR COUNTER-TERRORISM EFFORTS AND DISASTER PREPAREDNESS. VALLEY PARAMEDICS EDUCATED 443 LOCAL VOLUNTEER EMT'S ON TOPICS SUCH AS OPIATE OVERDOSE/ NARCAN USE, SAFETY AND STROKE LIFE SUPPORT. THE VALLEY HOSPITAL, IN CONJUNCTION WITH THE BERGEN COUNTY EMS TRAINING CENTER, OFFERS ADVANCED STROKE LIFE SUPPORT CLASSES FREE OF CHARGE TO ALL EMERGENCY MEDICAL TECHNICIANS, NURSES, AND PARAMEDICS. THE VALLEY HOSPITAL OPERATES AND MAINTAINS BERGEN COUNTY'S MOBIL 26407392 50871689 EMERGENCY SERVICES:THE VALLEY HOSPITAL OFFERS THE COMMUNITIES IT SERVES A FULL-SERVICE EMERGENCY DEPARTMENT PROVIDING EMERGENCY SERVICES AND MINOR TREATMENT SERVICES. ALL PHYSICIANS ON THE ACTIVE STAFF ARE BOARD CERTIFIED IN EMERGENCY MEDICINE, AND MANY NURSES ARE CERTIFIED IN EMERGENCY NURSING. SERVICES INCLUDE A MINOR TREATMENT AREA AND A PEDIATRIC EMERGENCY ROOM THAT FEATURES A CHILD-FRIENDLY LAYOUT AND DESIGN. THE DEPARTMENT ALSO HAS A DEDICATED COMPUTED TOMOGRAPHY SCANNER. (SEE CONTINUATION ON SCHEDULE O).VALLEY'S EMERGENCY DEPARTMENT ALSO FEATURES THE SERVICES OF SEVERAL MOBILE INTENSIVE CARE UNITS, WHICH ANSWER THOUSANDS OF CALLS EACH YEAR. MOBILE INTENSIVE CARE UNITS, STAFFED BY QUALIFIED VALLEY PARAMEDICS, ARE SPECIALLY EQUIPPED VEHICLES THAT BRING THE HIGHLY SOPHISTICATED TECHNIQUES OF INTRAVENOUS THERAPY, AIRWAY MANAGEMENT, CARDIAC MONITORING AND DEFIBRILLATION DIRECTLY TO PEOPLE IN NEED OF EMERGENCY CARE.IN 2015, THE VALLEY HOSPITAL RECORDED 74,185 EMERGENCY DEPARTMENT VISITS AND 8,853 MOBILE INTENSIVE CARE UNIT AND 7,262 SPECIALTY CARE TRANSPORT UNIT DISPATCHES. 500546586 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 336 0 4099 1 1 1 1 CJ 0 0 0 0 0 0 0 0 X 19 18 0 0 1 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 NJ X X RICHARD D KEENAN 2014478000 223 NORTH VAN DIEN AVENUE RIDGEWOOD NJ 07450 AUDREY MEYERS PRESIDENT 38.00 2.00 X X 1505017 0 45496 JOSEPH MARION CHAIRMAN 2.50 0.50 X X 0 0 0 JOHN W ALBOHM ESQ VICE CHAIRMAN & SECRETARY 3.00 X X 0 0 0 FRANK SHEEHY VICE CHAIRMAN 3.00 X X 0 0 0 JUDY BASELICE TRUSTEE 3.00 X 0 0 0 GEORGE BECKER MD TRUSTEE 3.00 X 0 0 0 JOAN BRUNELLE TRUSTEE 3.00 X 0 0 0 MICHELLE HASSON TRUSTEE 3.00 X 0 0 0 ANN M LIMBERG TRUSTEE 3.00 X 0 0 0 BRUCE J MACTAS TRUSTEE 3.00 X 0 0 0 MICHAEL RAHMIN MD TRUSTEE 3.00 0.50 X 0 0 0 EDWARD B SELF MD TREASURER 3.00 X X 0 0 0 RAKESH SHARMA MD FCCP TRUSTEE 3.00 X 0 0 0 STEVEN SILVERSTEIN TRUSTEE 2.50 1.00 X 0 0 0 JUSTICE GARY STEIN TRUSTEE 3.00 X 0 0 0 DEBRA TAYLOR TRUSTEE 3.00 X 0 0 0 JEFFREY S TUCKER TRUSTEE 2.50 1.00 X 0 0 0 PATRICIA VERDUIN TRUSTEE 3.00 X 0 0 0 DENIS SALAMONE TRUSTEE 3.00 X 0 0 0 RICHARD KEENAN SR VP, FINANCE/CFO 39.50 0.50 X 1175831 0 47126 MARIA MEDIAGO VP, FACILITIES MANAGEMENT 40.00 X 473713 0 42306 GAIL CALLANDRILLO VP, PLANNING/ GOV'T RELATI 40.00 X 518266 0 50899 ANASTASIOS KOZAITIS PRESIDENT, FOUNDATION 40.00 X 406158 0 46923 MEGAN FRASER VP, COMMUNICATIONS/MARKETI 40.00 X 371518 0 47951 WILLIAM KLUTKOWSKI VP, FINANCE 40.00 X 382781 0 49621 JULIA KARCHER VP, ADMINISTRATION 40.00 X 365004 0 28136 PETER W DIESTEL SR VP, ADMINISTRATION/COO 40.00 X 830648 0 49967 ROBIN G HOLLANDER SR VP, LEGAL SERVICES/GENE 40.00 X 672535 0 52548 ANN MARIE LEICHMAN VP/CNO PATIENT CARE SERVIC 40.00 X 506635 0 47185 ERIC CAREY VP/CIO, INFORMATION SYSTEM 40.00 X 458408 0 49444 JOSEPH YALLOWITZ VP & CHIEF MEDICAL OFFICER 40.00 X 384441 0 26662 JOSE A BALDERRAMA VP, HUMAN RESOURCES 40.00 X 350855 0 20479 KARTEEK BHAVSAR VP, ADMINISTRATION 40.00 X 251480 0 25394 ROBERT W BRENNER SENIOR VP/CHIEF PHYSICIAN EXECUTIVE 40.00 X 194020 0 2130 LEONARD GUGLIELMO ASST VP, FACILITIES, CHIEF SUPPLY CHIAN OFFICER 40.00 X 271166 0 35093 KI-CHUEN CHAK CHIEF PHYSICIST 40.00 X 265682 0 43646 CLAIRE GRANDE ASST VP, WOMEN'S/CHILDREN'S SERVICES 40.00 X 258762 0 22334 JULIE W LO CLIN SUPERVISOR PHYSICIST 40.00 X 252511 0 46707 BRAD HASPEL ASST VP,ANCILLARY SERVICES 40.00 X 237743 0 35827 MITCHELL RUBINSTEIN FORMER VP, MEDICAL AFFAIRS 0.00 X 199254 0 2078 PETER SCHWARTZ FORMER KEY EMPLOYEE 0.00 X 132055 0 0 AUTHUR DE SIMONE FORMER KEY EMPLOYEE 0.00 X 104431 0 0 10568914 0 817952 648 1 1 0 TORCON INC 8 NEWMAN SPRINGS ROAD RED BANK NJ 07701 GENERAL CONTRACTOR 13583122 NAVIN HAFFTY & ASSOCIATES LLC 200 CORDWAINER DRIVE SUITE 100 NORWELL MA 02061 INFORMATION SYSTEMS CONSULTING 11384578 BERGEN ANESTHESIA GROUP PC 500 WEST MAIN STREET SUITE 16 WYCKOFF NJ 07481 ANESTHESIA 3916740 MEDICAL INFORMATION TECHNOLOGY INC PO BOX 74569 CHICAGO IL 60696 INFORMATION SYSTEMS 2239246 R4ARCHITECTURE LLC 3477 CORPORATE PARKWAY SUITE 100 CENTER VALLEY PA 18034 ARCHITECTURAL 1412701 119 8234900 558342 4167468 12960710 INSURERS AND PATIENTS 621990 439365902 439365902 MEDICARE/MEDICAID PAYMENTS 621990 206760425 206760425 646126327 6471761 6471761 1533472 3779819 -2246347 -2246347 -2246347 89632575 43840 90587149 0 -954574 43840 -910734 -910734 VALLEY HEALTH PHARMACY 621990 2341280 337647 2003633 FOOD SERVICES 621990 1951750 1951750 PURCHASE DISCOUNTS AND REBATES 621990 1625772 1625772 4104264 4104264 10023066 672424783 650041496 2003633 7418944 9479576 7976485 1503091 234193649 197059681 37133968 24348324 20486668 3861656 20791662 17494091 3297571 17636452 14839311 2797141 2041251 2041251 237412 237412 39127527 24816146 14311381 3911075 11131 3899944 8967497 2116818 6850679 14638483 3104881 11533602 647844 492213 155631 5626964 4871124 755840 38993771 38993771 SUPPLIES 133896849 73949159 59947690 DRUGS 51432184 51432184 0 PROVISION FOR BAD DEBT 24175257 24175257 0 BLOOD 2111356 2111356 0 24369266 16616310 7752956 656626399 500546586 156079813 0 27213699 11478653 53945335 74349394 21533092 17880898 825731833 557662509 243446491 268069324 462785519 448124720 3951903 9991653 140263209 145326775 953139248 975221417 85481019 84487914 117393167 116161470 202874186 200649384 X 743837465 768137385 1998270 2005321 4429327 4429327 750265062 774572033 953139248 975221417 X 15798384 -8157234 16665821 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4429327 4429327 4429327 4429327 4429327 4429327 4429327 4429327 4429327 4429327 1.00000 0 1 1 62277965 62277965 370769134 263799799 106969335 15345022 12129082 3215940 363689351 280339934 83349417 13650361 1393694 12256667 268069324 ASSETS HELD BY RELATED ORGANIZATION 36058316 DEFERRED FINANCING COSTS AND OTHER ASSETS 109268459 145326775 AMOUNT DUE TO THIRD PARTY PAYERS AND OTHER LIABILITIES 77514063 ESTIMATED PROFESSIONAL MEDICAL LIABILITY 30189646 ACCRUED PENSION LIABILITY 8457761 116161470 640092292 -8157234 -8157234 648249526 24175257 24175257 672424783 632451142 0 632451142 24175257 24175257 656626399 PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS OFFSET AGAINST REVENUE 24,175,257. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS OFFSET AGAINST REVENUE 24,175,257. CAYMAN ISLANDS 0 0 INVESTMENT 120000 0 0 0 0 0 0 120000 0 120000 1 0 1 0 1 0 1 1 1 X 1 X 500.000000000000 1 1 0 1 1 7636711 600000 7036711 0.01070 14413689 10178390 4235299 0.00650 22050400 10778390 11272010 0.01720 2241386 348299 1893087 0.00290 2419014 533786 1885228 0.00290 2329610 989635 1339975 0.00200 1189369 1189369 0.00180 399770 399770 0.00060 8579149 1871720 6707429 0.01020 30629549 12650110 17979439 0.02740 308469 98619 209850 0.00030 29900 29900 0.00000 314113 314113 0.00050 652482 98619 553863 0.00080 0 7721198 2316359 203670675 269283570 -65612895 X 1 1 1 1 THE VALLEY HOSPITAL 223 NORTH VAN DIEN AVENUE RIDGEWOOD NJ 07450 X X X THE VALLEY HOSPITAL 1 0 0 1 X X X X X X X X X 13 1 1 0 1 X WWW.VALLEYHEALTH.COM 1 14 1 WWW.VALLEYHEALTH.COM 0 0 1 X 200.000000000000 500.000000000000 X 1 1 X X X 1 X WWW.VALLEYHEALTH.COM X WWW.VALLEYHEALTH.COM X X X 1 X 1 X X 1 X 0 0 THE VALLEY HOSPITAL PART V, SECTION B, LINE 5: THE PARTICIPATING HOSPITALS UTILIZED THE SERVICES OF A NUMBER OF PEOPLE REPRESENTING VARIOUS AREAS OF THE HEALTHCARE COMMUNITY IN BERGEN COUNTY. THE MEMBERS OF THE LEADERSHIP STEERING COMMITTEE AND ADVISORY COMMITTEE ARE LISTED BELOW:LEADERSHIP STEERING COMMITTEE:CATHY PILONE, CHRISTIAN HEALTH CARE CENTERMICHAEL PIETROWICZ, ENGLEWOOD HOSPITAL AND MEDICAL CENTERTOM FLYNN, HACKENSACK UNIVERSITY MEDICAL CENTERCATHERINE YAXLEY, HOLY NAME MEDICAL CENTERCOLETTE CUMMINGS, THE VALLEY HOSPITALMARLA KLEIN, BERGEN COUNTY DEPARTMENT OF HEALTH SERVICESELIZABETH RUBOCK, BERGEN COUNTY DEPARTMENT OF HEALTH SERVICESADVISORY COMMITTEE:NANCY MANGIERI, BERGEN COUNTY DEPT. OF HEALTH SERVICESDOUG STRUYK, CHRISTIAN HEALTH CARE CENTERDAVE VOLPE, BOROUGH OF BERGENFIELDNELSON XAVIER-CRUZ, CITY OF ENGLEWOODJOHN CHRIST, CITY OF HACKENSACKNANCY ELLSON, HOLY NAME MEDICAL CENTERPAUL OSTROW, HOLY NAME MEDICAL CENTERVINNY URGOLA, NORTH HUDSON COMMUNITY ACTION CORPORATIONSARA BERK, THE VALLEY HOSPITALGAIL CALLANDRILLO, THE VALLEY HOSPITAL THE VALLEY HOSPITAL PART V, SECTION B, LINE 6A: THE HOSPITAL'S CHNA WAS COMPLETED WITH THE FOLLOWING OTHER HOSPITAL FACILITIES: CHRISTIAN HEALTH CARE CENTER, ENGLEWOOD HOSPITAL AND MEDICAL CENTER, HACKENSACK UNIVERSITY MEDICAL CENTER AND HOLY NAME MEDICAL CENTER. THE VALLEY HOSPITAL PART V, SECTION B, LINE 11: VALLEY HOSPITAL HAS ADDRESSED ALL OF OUR PRIORITY GOALS AND SECONDARY GOALS: OBESITY, FITNESS AND NUTRITION1. VALLEY HAS SPONSORED TWO LARGE MAYOR WELLNESS WEIGHT LOSS CHALLENGES, COMBINED PARTICIPANTS LOST 1,821 POUNDS AND OF THOSE WHO HAD THEIR TOTAL CHOLESTEROL AND A1C SCREENED AND RESCREENED THE MAJORITY SAW POSITIVE RESULTS.2. WE HAVE ALSO PARTNERED WITH COMMUNITY MEALS ON WHEELS TO PROVIDE MEALS FOR 7 BERGEN COUNTY TOWNS.3. VALLEY PROVIDES LOW COST EXERCISE CLASSES FOR SENIORS AND PARTNERED WITH THE COUNTY HEALTH DEPARTMENT TO OFFER FREE EXERCISE IN THE PARK CLASSES.4. HEALTHY STEPS IS A 12 WEEK WALKING CLUB THAT OFFERS BOTH EXERCISE, HEALTH EDUCATION AND FREE SCREENINGS.5. WE ALSO OFFERED MANY NUTRITION PROGRAMS TO THE COMMUNITY, FOCUSED ON HEALTHY EATING, EATING WITH DIABETES, READING FOOD LABELS ETC. MANY OF THESE WERE PROVIDED TO SCHOOL AGE CHILDREN.6. VALLEYS CENTER FOR FAMILY EDUCATION PROVIDED FREE BREASTFEEDING CLASSES TO APPROXIMATELY 800 PEOPLE.7. SPECIFIC FITNESS AND NUTRITION EDUCATION WAS ALSO PROVIDED TO THE DIABETIC AND PRE-DIABETIC POPULATION.CHRONIC DISEASE1. CARDIOVASCULAR DISEASE - THE CENTER FOR WOMEN'S AND MEN'S HEART HEALTH OFFERED 744 FREE SCREENINGS. A LARGE PERCENTAGE OF THE PARTICIPANTS HAD EITHER A HIGH A1C OR CHOLESTEROL AND/OR OBESE. MANY WERE REFERRED TO A CARDIOLOGIST OR PRIMARY CARE PHYSICIAN. VALLEY PROVIDED PROGRAMS TO TARGET STROKE WHICH INCLUDED THREE STROKE SCREENINGS, 191 PEOPLE WERE SCREENED. VALLEY ALSO PROVIDED EDUCATION TARGETED TO PREVENTION AND TREATMENT OF CARDIOVASCULAR DISEASE.2. ONCOLOGY - IN PARTNERSHIP WITH THE BERGEN COUNTY DEPARTMENT OF HEALTH, THE PROSTATE CENTER SCREENED 20 MEN IDENTIFIED AS PART OF THE CEED PROGRAM. IN ADDITION 137 PEOPLE RECEIVED A FREE SKIN CANCER SCREENING AND 107 PEOPLE RECEIVED COLORECTAL SCREENING KITS. VALLEY HAS ALSO PROVIDED ONCOLOGY EDUCATION PROGRAMS.3. PULMONARY - THE LUNG CANCER CENTER SCREENED APPROXIMATELY 100 AT RISK PATIENTS. ALSO OUR SMOKING CESSATION PROGRAM SERVED 41 PEOPLE.4. VALLEY'S MOBILE INTENSIVE CARE UNIT INITIATED A NEW MOBILE INTEGRATED HEALTHCARE PROGRAM WHICH PROVIDES POST-DISCHARGE HOME CHECK-UPS AND TREATMENT TO VULNERABLE PATIENTS. THEY HAVE ALSO PROVIDED COVERAGE AT VARIOUS COMMUNITY EVENTS SUCH AS CHARITY RUNS, SCHOOL EVENTS, CONCERTS AND PARADES. OLDER ADULTS1. THROUGH PRIME TIME, VALLEY HAS PROVIDED PROGRAMS GEARED TO PROMOTING HEALTH AND WELLNESS TO THE OLDER ADULT POPULATION. PRIME TIME PROVIDED EDUCATION AND SCREENING PROGRAMS GEARED SPECIFICALLY FOR SENIORS. VALLEY ALSO PARTNERED WITH BERGEN COMMUNITY COLLEGE, CHRISTIAN HEALTH CARE CENTER AND VAN DYK HEALTH CARE TO PROVIDED EDUCATION.ACCESS TO CARE 1. VALLEY HAS WORKED CLOSELY WITH TWO CHURCHES THAT SERVE PREDOMINATELY MEMBERS OF THE AFRICAN AMERICAN COMMUNITY. A RELATIONSHIP HAS BEEN ESTABLISHED AND PLANS ARE SET TO PROVIDE A STROKE SCREENING AND HEART HEALTHY LECTURES IN THE COMING YEAR.2. VALLEY HAS ENLISTED THE HELP OF PHARMATEK TO HELP PATIENTS ENROLL IN PRESCRIPTION ASSISTANCE PROGRAMS.3. VALLEY CONTINUES TO PROVIDE DONATIONS TO ORGANIZATIONS THAT SUPPORT HEALTH AND WELLNESS INITIATIVES TO UNDERSERVED POPULATIONS.MENTAL HEALTH 1. VALLEY HAS ENLISTED THE HELP OF RAMAPO RIDGE PSYCHIATRIC HOSPITAL TO ASSIST WITH MEETING SOME OF THE MENTAL HEALTH NEEDS OF OUR COMMUNITY. THEIR STAFF HAS BEEN INSTRUMENTAL IN PROVIDING EDUCATION TO THE COMMUNITY AND SCHOOLS. IN ADDITION, COMMUNITY HEALTH AND INTEGRATIVE MEDICINE STAFF HAS PROVIDED EDUCATION ON STRESS RELIEF. THE VALLEY HOSPITAL PART V, SECTION B, LINE 22D: TO DETERMINE THE MAXIMUM AMOUNTS THAT CAN BE CHARGED, THE HOSPITAL USES THE "LOOK-BACK" METHOD, DESCRIBED IN SECTION 4(B)(2) OF THE IRS TREASURY'S 501(R) FINAL RULE. IN THIS METHOD THE HOSPITAL USES DATA WHICH IS BASED ON ACTUAL PAST CLAIMS PAID BY 1) MEDICARE FEE-FOR-SERVICE AND 2) PRIVATE HEALTH INSURERS (INCLUDING ANY ASSOCIATED PORTIONS OF THESE CLAIMS PAID BY MEDICARE BENEFICIARIES OR INSURED INDIVIDUALS) OVER THE PAST YEAR TO DETERMINE THE PERCENTAGE OF GROSS CHARGES THAT IS GENERALLY ALLOWED BY THESE INSURERS. PART I, LINE 6A: THE HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT WHICH IS MAILED TO OUR SERVICE AREA. COMMUNITY BENEFIT STATISTICS ARE ALSO REPORTED AT OUR ANNUAL MEETING, WHICH IS OPEN TO THE PUBLIC. PART I, LINE 7: THE COST TO CHARGE RATIO USED TO CALCULATE THE AMOUNTS IN THE TABLE WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. PART I, LINE 7G: THERE ARE NO SUBSIDIZED HEALTH SERVICES WHICH ARE ATTRIBUTABLE TO A PHYSICIAN CLINIC. COSTS INCLUDED REPRESENT MEDICATION AND TRANSPORTATION FOR INDIGENT PATIENTS. PART II, COMMUNITY BUILDING ACTIVITIES: SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS PART III, LINE 2: THIS IS THE TOTAL BAD DEBT EXPENSE FOR THE HOSPITAL DISCOUNTED BY THE RATIO OF PATIENT CARE COST TO CHARGES. PART III, LINE 3: THIS IS THE TOTAL BAD DEBT EXPENSE FOR PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE DISCOUNT BY THE RATIO OF PATIENT CARE COST TO CHARGES. PART III, LINE 4: THE AMOUNT OF THE PROVISION FOR BAD DEBT IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. THE METHODOLOGY USED IS THE COST TO CHARGE RATIO, APPLIED ON A BASIS CONSISTENT WITH MEDICARE COST REPORTING PRINCIPLES. PART III, LINE 8: IN ADDITION TO CHARITY CARE, BAD DEBT, AND THE TREATMENT OF FINANCIALLY NEEDY PATIENTS UNDER THE MEDICAID PROGRAM, THE HOSPITAL PROVIDES SERVICES TO ELDERLY AND DISABLED PATIENTS COVERED UNDER THE MEDICARE PROGRAM REGARDLESS OF INCOME. THE UNPAID COSTS ATTRIBUTED TO PROVIDING CARE UNDER THIS PROGRAM, AND THUS CONSIDERED A COMMUNITY BENEFIT, WERE ESTIMATED AT $65.6 MILLION. PART III, LINE 9B: WHEN A PATIENT MAY QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE, OUR SYSTEM IS SET UP TO STOP SENDING STATEMENTS TO PREVENT THEM FROM GOING TO A COLLECTION AGENCY. WE ALSO HAVE THE ABILITY TO MANUALLY PUT AN ACCOUNT ON HOLD TO AVOID COLLECTION ACTIVITY AS WELL. PART VI, LINE 2: HOSPITAL STAFF REVIEWS ALL THE DISCHARGE DATA FROM THE STATE DOHSS TO DETERMINE WHAT THE MAJOR HEALTH ISSUES ARE IN THE COMMUNITY. WE LOOK AT DISEASE SPECIFIC INCIDENCE RATES IN OUR COMMUNITY AND DEVELOP FORECASTS FOR WHAT HEALTH ISSUES ARE PROJECTED TO PLAGUE THE POPULATION IN THE FUTURE. WE REVIEW CENSUS DATA TO MONITOR DEMOGRAPHIC SHIFTS AND WE CONDUCT QUALITATIVE RESEARCH (FOCUS GROUPS) TO ASSESS COMMUNITY FEEDBACK TO NEW PROGRAMS AND SERVICES. WE DEVELOP OUR CORE SERVICES AROUND THE MAJOR HEALTH ISSUES IN THE COMMUNITY - THUS, THEY ARE MOSTLY IN THE AREA OF HEART AND VASCULAR DISEASE, ONCOLOGY (MEDICAL AND SURGICAL), NEUROLOGY (STROKE) AND WOMEN'S AND CHILDREN'S SERVICES (OB, NICU, PICU, MFM AND IVF). PART VI, LINE 3: SIGNS ARE POSTED AT EVERY REGISTRATION AREA. INFORMATION REGARDING FINANCIAL SCREENING IS POSTED ON THE HOSPITAL'S WEBSITE FOR CHARITY CARE AS WELL AS THE UNINSURED DISCOUNT POLICY. PATIENTS CAN PRINT APPLICATIONS AND REQUIREMENTS FROM THE WEBSITE. THE HOSPITAL'S STATEMENTS CONTAIN INFORMATION ALERTING PATIENTS OF FINANCIAL ASSISTANCE. THE HOSPITAL'S HANDBOOKS EXPLAIN FINANCIAL OPTIONS WHICH INCLUDE INFORMATION OF STATE ASSISTANCE, DISCOUNT POLICY AND ANY OTHER TYPE OF FINANCIAL ARRANGEMENT. PART VI, LINE 4: THE PRIMARY AND SECONDARY SERVICE AREA OF THE VALLEY HOSPITAL IS COMPOSED OF 32 TOWNS IN NORTHWEST BERGEN AND PASSAIC COUNTIES. THESE COMMUNITIES ACCOUNT FOR 70% OF ALL OUR DISCHARGES. THE POPULATION IS 440,000 PEOPLE. PART VI, LINE 5: RENEWAL, WHICH IS BEING EVALUATED, IS ALL ABOUT MEETING THE HEALTH CARE NEEDS OF OUR COMMUNITY. THE OLDEST BUILDING ON THE CAMPUS, PHILLIPS, WAS CONSTRUCTED IN 1960. IT HOUSES OVER 250 BEDS, MOST OF WHICH ARE IN SMALL, OUTDATED, SEMI-PRIVATE ROOMS. THE PHYSICAL STRUCTURE CAN NO LONGER ACCOMMODATE THE EQUIPMENT AND TECHNOLOGY NEEDED TO DELIVER CARE, THUS OUR PLANS TO RENEW OUR CAMPUS ARE BASED IN OUR MISSION TO PROVIDE THE BEST QUALITY CARE TO THE RESIDENTS OF OUR COMMUNITY. WHEN WE BUILT THE LUCKOW PAVILION IN PARAMUS, WE DID RESEARCH THAT INDICATED THE BEST WAY TO DELIVER CARE TO CANCER PATIENTS WAS TO LOCATE ALL SERVICES INTO ONE BUILDING. THIS NOT ONLY PROVIDES A SERVICE TO THE PATIENT, IT IS GOOD MEDICINE AS THE MEDICAL ONCOLOGISTS, SURGICAL ONCOLOGISTS AND RADIATION ONCOLOGISTS CAN CONSULT EACH OTHER TO ENSURE THAT THE PATIENT IS RECEIVING THE MOST APPROPRIATE TREATMENT. WE BUILT THE AMBULATORY SURGERY CENTER TO ADAPT TO THE CHANGING PRACTICE OF PERFORMING SURGERY ON A SAME DAY BASIS. X X X X 0 1 0 0 0 0 0 1 0 AUDREY MEYERS PRESIDENT 962606 0 467522 0 74889 0 25175 0 20321 0 1550513 0 0 0 RICHARD KEENAN SR VP, FINANCE/CFO 652068 0 293798 0 229965 0 25175 0 21951 0 1222957 0 0 0 MARIA MEDIAGO VP, FACILITIES MANAGEMENT 282782 0 91391 0 99540 0 21790 0 20516 0 516019 0 0 0 GAIL CALLANDRILLO VP, PLANNING/ GOV'T RELATI 303296 0 91899 0 123071 0 25175 0 25724 0 569165 0 0 0 ANASTASIOS KOZAITIS PRESIDENT, FOUNDATION 273719 0 79888 0 52551 0 18960 0 27963 0 453081 0 0 0 MEGAN FRASER VP, COMMUNICATIONS/MARKETI 244636 0 74186 0 52696 0 21348 0 26603 0 419469 0 0 0 WILLIAM KLUTKOWSKI VP, FINANCE 244956 0 82443 0 55382 0 21479 0 28142 0 432402 0 0 0 JULIA KARCHER VP, ADMINISTRATION 245693 0 78890 0 40421 0 21136 0 7000 0 393140 0 0 0 PETER W DIESTEL SR VP, ADMINISTRATION/COO 538349 0 226045 0 66254 0 22525 0 27442 0 880615 0 38617 0 ROBIN G HOLLANDER SR VP, LEGAL SERVICES/GENE 471661 0 177413 0 23461 0 22525 0 30023 0 725083 0 0 0 ANN MARIE LEICHMAN VP/CNO PATIENT CARE SERVIC 321962 0 105210 0 79463 0 22525 0 24660 0 553820 0 0 0 ERIC CAREY VP/CIO, INFORMATION SYSTEM 314564 0 95634 0 48210 0 22525 0 26919 0 507852 0 0 0 JOSEPH YALLOWITZ VP & CHIEF MEDICAL OFFICER 377578 0 0 0 6863 0 0 0 26662 0 411103 0 0 0 JOSE A BALDERRAMA VP, HUMAN RESOURCES 283263 0 23212 0 44380 0 3515 0 16964 0 371334 0 0 0 KARTEEK BHAVSAR VP, ADMINISTRATION 211273 0 31995 0 8212 0 18744 0 6650 0 276874 0 0 0 ROBERT W BRENNER SENIOR VP/CHIEF PHYSICIAN EXECUTIVE 152869 0 40000 0 1151 0 0 0 2130 0 196150 0 0 0 LEONARD GUGLIELMO ASST VP, FACILITIES, CHIEF SUPPLY CH 224122 0 37435 0 9609 0 25090 0 10003 0 306259 0 0 0 KI-CHUEN CHAK CHIEF PHYSICIST 256570 0 650 0 8462 0 24515 0 19131 0 309328 0 0 0 CLAIRE GRANDE ASST VP, WOMEN'S/CHILDREN'S SERVICES 216988 0 32582 0 9192 0 21261 0 1073 0 281096 0 0 0 JULIE W LO CLIN SUPERVISOR PHYSICIST 251284 0 675 0 552 0 16983 0 29724 0 299218 0 0 0 BRAD HASPEL ASST VP,ANCILLARY SERVICES 204247 0 31869 0 1627 0 18194 0 17633 0 273570 0 0 0 MITCHELL RUBINSTEIN FORMER VP, MEDICAL AFFAIRS 107211 0 91800 0 243 0 1112 0 966 0 201332 0 0 0 PETER SCHWARTZ FORMER KEY EMPLOYEE 0 0 0 0 132055 0 0 0 0 0 132055 0 132055 0 AUTHUR DE SIMONE FORMER KEY EMPLOYEE 0 0 0 0 104431 0 0 0 0 0 104431 0 104431 0 PART I, LINE 4B -THE FOLLOWING PERSONS RECEIVED PAYMENT FROM SERP PLAN DURING 2015: PETER DIESTEL RECEIVED $38,617. THIS AMOUNTS IS TAXABLE AND IS REPORTED ON PART II COLUMN F. -PETER SCHWARTZ RECEIVED PAYMENT OF $132,055 FROM EXECUTIVE BENEFIT PLAN , AND AUTHUR DE SIMONE RECEIVED PAYMENT OF $104,431 FROM EXECUTIVE BENEFIT PLAN DURING 2015. THESE AMOUNTS ARE TAXABLE AND REPORTED ON PART II COLUMN F. -NO ONE CONTRIBUTED IN 457(F) PLAN DURING 2015. PART I, LINE 7 BONUS IS BASED ON MANAGEMENT PERFORMANCE AND IS DETERMINED BY THE BOARD OF TRUSTEES. THE FOLLOWING INDIVIDUALS RECEIVED THE FOLLOWING BONUS, WHICH WAS TAXABLE AND INCLUDED IN EACH OF HIS/HER W-2: AUDREY MEYERS - $467,522 RICHARD KEENAN - $293,798 MEGAN FRASER - $74,186 MARIA MEDIAGO - $91,391 GAIL CALLANDRILLO - $91,899 ANASTASIOS KOZAITIS - $79,888 WILLIAM KLUTKOWSKI - $82,443 JULIA KARCHER - $78,890 PETER DIESTEL - $226,045 ROBIN HOLLANDER - $177,413 ANN MARIE LEICHMAN - $105,210 ERIC CAREY - $95,634 ROBERT W BRENNER - $40,000 KARTEEK BHAVSAR - $31,995 JOSE BALDERRAMA - $23,212 CLAIRE GRANDE - $32,582 MITCHELL RUBINSTEIN - $91,800 BONUS IS DETERMINED BY A MANAGEMENT SCORECARD & LEADERSHIP COMPETENCIES WITH ESTABLISHED PAYOUT TARGETS AS APPROVIDED BY CEO. THE FOLLOWING INDIVIDUALS RECEIVED THE FOLLOWING BONUS, WHICH WAS TAXABLE AND INCLUDED IN EACH OF HIS/HER W-2: LEONARD GUGLIELMO - $37,435 BRAD HASPEL - $31,869 BONUS IS DETERMINED BY THE ORGANIZATION MEETING ESTABLISHED PATIENT SATISFACTION SCORES. THE FOLLOWING INDIVIDUALS RECEIVED THE FOLLOWING BONUS, WHICH WAS TAXABLE AND INCLUDED IN EACH OF HIS/HER W-2: KI-CHUEN CHAK - $650 JULIE W LO - $675 BONUS CAN ALSO BE DEFERRED TO 457F PLAN AND 401K PLAN. FORM 990, PART VI, SECTION A, LINE 4 THE BYLAWS OF THE VALLEY HOSPITAL HAVE BEEN AMENDED AS FOLLOWS: SECTION 3.2: DELETED PROVISION ALLOWING THE SECRETARY/ TREASURER OF THE MEDICAL STAFF TO SERVE AS AN EX OFFICIO MEMBER OF THE BOARD OF TRUSTEES OF THE HOSPITAL. THE BYLAWS WERE AMENDED ON DECEMBER 16,2015. FORM 990, PART VI, SECTION B, LINE 11 WHEN THE FORM 990 HAS BEEN PREPARED, REVIEWED BY MANAGEMENT AND IS READY TO BE FILED WITH THE INTERNAL REVENUE SERVICE, A PAPER COPY OR E-FILE COPY IS SENT TO MEMBERS OF THE BOARD AUDIT COMMITTEE FOR REVIEW AND COMMENTS. ANY COMMENTS AND QUESTIONS CONCERNING THE 990 ARE DISCUSSED WITH MANAGEMENT AND APPROPRIATE ACTIONS ARE TAKEN WHEN NECESSARY. FORM 990, PART VI, SECTION B, LINE 12C THE VALLEY HOSPITAL, INC. HAS A CONFLICT OF INTEREST POLICY THAT APPLIES TO ALL OF THE MEMBERS OF MANAGEMENT AND BOARD MEMBERS. ANNUALLY, THE BOARD MANDATES THAT ALL MEMBERS OF MANAGEMENT AND BOARD MEMBERS SIGN A CONFLICT OF INTEREST POLICY AND DISCLOSE ANY POTENTIAL OR ACTUAL CONFLICTS THAT MAY EXIST. IF A CONFLICT OF INTEREST EXISTS, THE HOSPITAL WILL NOTIFY MANAGEMENT AND OR BOARD MEMBERS AND INVESTIGATE THE POTENTIAL CONFLICT. THE INTERESTED PERSON MUST LEAVE THE BOARD OR COMMITTEE MEETING WHILE A DISCUSSION REGARDING THE POTENTIAL CONFLICT OF INTEREST IS DISCUSSED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS WILL DECIDE IF A CONFLICT OF INTEREST EXISTS. IF IT IS DETERMINED THAT A CONFLICT EXISTS THE MEMBER OF MANAGEMENT OR THE BOARD WILL BE NOTIFIED IMMEDIATELY AND WILL NOT BE ALLOWED TO VOTE OR BE PART OF ANY DECISIONS ABOUT SUCH MATTERS. THIS PROCESS IS RECORDED IN THE MINUTES OF THE BOARD MEETINGS. FORM 990, PART VI, SECTION B, LINE 15 THE HOSPITAL HAS ESTABLISHED A POLICY FOR COMPENSATION OF ITS OFFICERS, TOP MANAGEMENT AND KEY EMPLOYEES. THE POLICY MANDATES THAT COMPENSATION FOR ITS OFFICERS, TOP MANAGEMENT AND KEY EMPLOYEES, BE PERIODICALLY REVIEWED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES FREE OF ANY MEMBERS WITH CONFLICTS OF INTEREST RELATED THERETO. THE COMMITTEE DETERMINES THAT THE EXECUTIVES ARE BEING PAID AN APPROPRIATE LEVEL OF COMPENSATION BY USING COMPARATIVE DATA FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. COMPENSATION DECISION ON THE AMOUNT OF COMPENSATION PAID AND TERM IS ADEQUATELY DOCUMENTED IN A CONTEMPORANEOUSLY WRITTEN FORMAT. THIS PROCESS WAS LAST UNDERTAKEN IN 2015. FORM 990, PART VI, SECTION C, LINE 19 THE HOSPITAL MAKES ITS FORM 990 AVAILABLE FOR PUBLIC INSPECTION AS REQUIRED UNDER SECTION 6104 OF THE INTERNAL REVENUE CODE BY POSTING OF THE RETURN ON GUIDESTAR.ORG AND SIMILAR TYPES OF WEBSITES. IN ADDITION FORM 990 AS WELL AS THE FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY AND OTHER RELEVENT DOCUMENTS ARE AVAILABLE UPON REQUEST AT 223 NORTH VAN DIEN AVENUE, RIDGEWOOD, NJ 07450. FORM 990, PART XI, LINE 9: CHANGE IN ACCRUED PENSION LIABILITY TO BE RECOGNIZED IN FUTURE PERIODS -10,274,337. CHANGE IN ASSETS HELD BY VALLEY HOSPITAL FOUNDATION -289,560. CHANGES TO PRIOR YEAR ALLOWANCES 27,229,718. FORM 990, PART XII, LINE 2C: THE PROCESS FOR SELECTING AN INDEPENDENT ACCOUNTANT AND ESTABLISHING A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT HAS NOT CHANGED FROM PRIOR YEARS. 555 MAPLE ACQUISITION LLC 223 NORTH VAN DIEN AVENUE RIDGEWOOD NJ 07450 453070365 REAL ESTATE HOLDINGS DE 0 8110000 THE VALLEY HOSPITAL INC 599 PARAMUS ACQUISITION LLC 223 NORTH VAN DIEN AVENUE RIDGEWOOD NJ 07450 460985392 REAL ESTATE HOLDINGS DE 0 12180473 THE VALLEY HOSPITAL INC 620 WINTERS AVENUE LLC 223 NORTH VAN DIEN AVENUE RIDGEWOOD NJ 07450 REAL ESTATE HOLDINGS DE 0 0 THE VALLEY HOSPITAL INC 1200 EAST RIDGEWOOD LLC 223 NORTH VAN DIEN AVENUE RIDGEWOOD NJ 07450 464115513 REAL ESTATE HOLDINGS DE 3416789 25870375 THE VALLEY HOSPITAL INC VALLEY HEALTH SYSTEM INC 223 NORTH VAN DIEN AVENUE RIDGEWOOD NJ 07450 222922016 PROVIDES MANAGEMENT & PLANNING SERVICES FOR ITS MEMBERS NJ 501(C)(3) LINE 3 N/A 0 VALLEY MEDICAL SERVICES INC 223 NORTH VAN DIEN AVENUE RIDGEWOOD NJ 07450 223260998 PROVIDES CERTAIN MEDICAL CARE TO PATIENTS INCL.PEDIATRIC & NEONATAL SERVICES NJ 501(C)(3) LINE 9 THE VALLEY HOSPITAL INC 1 VALLEY PHYSICIAN SERVICES INC 15 ESSEX ROAD PARAMUS NJ 07652 320041186 PROVIDES MEDICAL CARE TO CARRYOUT THE PURPOSE OF THE VALLEY HEALTH SYSTEM NJ 501(C)(3) LINE 9 THE VALLEY HOSPITAL INC 1 VALLEY HOME CARE INC 15 ESSEX ROAD PARAMUS NJ 07652 223208480 PROVIDES REHABILITATION VISITS AND HOME HEALTH AIDS VISITS TO PATIENTS NJ 501(C)(3) LINE 9 VALLEY HEALTH SYSTEM INC 0 THE VALLEY HOSPITAL FOUNDATION INC 223 NORTH VAN DIEN AVENUE RIDGEWOOD NJ 07450 222324554 SOLICIT,RECEIVE AND APPLY CONTRIBUTIONS FOR THE BENEFIT OF THE HOSPITAL NJ 501(C)(3) LINE 7 VALLEY HEALTH SYSTEM INC 0 VALLEY HEALTH MEDICAL GROUP INC 15 ESSEX ROAD PARAMUS NJ 07652 223475233 OPERATES URGENT/PRIMARY CARE CLINICS NJ VALLEY HEALTH SYSTEM INC C 0 VALLEY HEALTH MEDICAL GROUP NJPC 15 ESSEX ROAD PARAMUS NJ 07652 223475166 OPERATES URGENT/PRIMARY CARE CLINICS NJ N/A C 0 VALLEY PHYSICIAN SERVICE NY PC 15 ESSEX ROAD PARAMUS NJ 07652 453125678 OPERATES URGENT/PRIMARY CARE CLINICS NY VALLEY HEALTH SYSTEM INC C 0 VHS INSURANCE COMPANY LTD 010 MAIN STREET CAYMAN ISLANDS CJ 980408200 PROVIDES PROFESSIONAL, MEDICAL AND COMMERCIAL GENERAL LIABILITY INSURANCE CJ THE VALLEY HOSPITAL INC C 62377217 1.00000 1 0 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 1 1 0 VALLEY MEDICAL SERVICES INC Q 0 COST VALLEY PHYSICIAN SERVICES INC Q 52750000 COST VHS INSURANCE COMPANY LTD R 8604000 COST