HACKETTSTOWN COMMUNITY HOSPITAL: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
HACKETTSTOWN COMMUNITY HOSPITAL (EIN 22-6106281)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-11-15
IRS object ID
201633209349301778
Schema version
2015v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2016-11-15T08:24:48-06:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN366055558PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1GRANT THORNTON LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1201 S COLLEGE STREETAddressLine1Txt
CityCHARLOTTECityNm
State AbbreviationNCStateAbbreviationCd
ZIP28244ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN226106281EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HACKETTSTOWN COMMUNITY HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlHACKBusinessNameControlTxt
Phone9088525100PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1651 WILLOW GROVE STREETAddressLine1Txt
CityHACKETTSTOWNCityNm
State AbbreviationNJStateAbbreviationCd
ZIP07840ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJAMES G LEEPersonNm
Person TitleEXE. VICE PRESIDENT AND CFOPersonTitleTxt
Phone3013153025PhoneNum
Signature2016-11-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMICHELE MELCHIORPreparerPersonNm
PTINP00488037PTIN
Phone7046323500PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1HACKETTSTOWN REGIONAL MEDICAL CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerJAMES G LEEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1651 WILLOW GROVE STREETAddressLine1Txt
CityHACKETTSTOWNCityNm
State AbbreviationNJStateAbbreviationCd
ZIP07840ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$132,987,607GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Group Exemption1071GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.HRMCNJ.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1955FormationYr
Legal Domicile StateNJLegalDomicileStateCd
Activity Or Mission"WE DEMONSTRATE GOD'S CARE BY IMPROVING THE HEALTH OF PEOPLE AND COMMUNITIES THROUGH A (SEE SCH O) MINISTRY OF PHYSICAL, MENTAL AND SPIRITUAL HEALING." HRMC'S VISION IS TO BE "A LEADING RESOURCE FOR INNOVATIVE PATIENT-CENTERED HEALTHCARE." HRMC'S VALUES ARE "RESPECT, INTEGRITY, SERVICE, EXCELLENCE AND STEWARDSHIP (RISES)."ActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee1007TotalEmployeeCnt
Total Volunteers104TotalVolunteersCnt
Total Gross UBI$147,432TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$5,747NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,465,824PYContributionsGrantsAmt
CY Contributions Grants$389,932CYContributionsGrantsAmt
PY Program Service Revenue$83,627,687PYProgramServiceRevenueAmt
CY Program Service Revenue$86,393,023CYProgramServiceRevenueAmt
PY Investment Income$901,263PYInvestmentIncomeAmt
CY Investment Income$170,389CYInvestmentIncomeAmt
PY Other Revenue-$77,124PYOtherRevenueAmt
CY Other Revenue-$140,763CYOtherRevenueAmt
PY Total Revenue$85,917,650PYTotalRevenueAmt
CY Total Revenue$86,812,581CYTotalRevenueAmt
PY Grants And Similar Paid$53,535PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$423,650CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$43,929,777PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$45,201,383CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$45,912CYTotalFundraisingExpenseAmt
PY Other Expenses$41,164,273PYOtherExpensesAmt
CY Other Expenses$42,892,947CYOtherExpensesAmt
PY Total Expenses$85,147,585PYTotalExpensesAmt
CY Total Expenses$88,517,980CYTotalExpensesAmt
PY Revenues Less Expenses$770,065PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,705,399CYRevenuesLessExpensesAmt
Total Assets BOY$101,209,448TotalAssetsBOYAmt
Total Assets EOY$93,379,582TotalAssetsEOYAmt
Total Liabilities BOY$43,450,774TotalLiabilitiesBOYAmt
Total Liabilities EOY$39,085,532TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$57,758,674NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$54,294,050NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
Mission"WE DEMONSTRATE GOD'S CARE BY IMPROVING THE HEALTH OF PEOPLE AND COMMUNITIES THROUGH A MINISTRY OF PHYSICAL, MENTAL AND SPIRITUAL HEALING." HRMC'S VISION IS TO BE "A LEADING RESOURCE FOR INNOVATIVE PATIENT-CENTERED HEALTHCARE." HRMC'S VALUES ARE "RESPECT, INTEGRITY, SERVICE, EXCELLENCE AND STEWARDSHIP (RISES)."MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$72,453,217ExpenseAmt
Grant$423,650GrantAmt
Revenue$86,895,586RevenueAmt
DescHACKETTSTOWN REGIONAL MEDICAL CENTER, A NOT-FOR-PROFIT INTEGRATED HEALTH SERVICES ACUTE CARE HOSPITAL, SEEKS TO CONTRIBUTE VALUE TO THE COMMUNITY BY PROMOTING HEALTH AND WELLNESS. HRMC OFFERS ACUTE CARE INPATIENT SERVICES, PHYSICIAN-STAFFED 24-HOUR EMERGENCY SERVICES, A DIAGNOSTIC IMAGING CENTER AS WELL AS LABORATORY, PATHOLOGY, SURGICAL AND OUTPATIENT SERVICES AVAILABLE ON-AND-OFF-CAMPUS, THROUGH AFFILIATIONS AND LINKAGE AGREEMENTS. HRMC ALSO OFFERS WELLNESS PROGRAMS, INCLUDING EDUCATIONAL CLASSES AND SCREENINGS DESIGNED TO ENCOURAGE COMMUNITY MEMBERS TO ADOPT A HEALTHIER LIFESTYLE, AVOID ILLNESS AND LIVE LIFE TO ITS FULLEST.2015 YEAR IN REVIEWCHARITY CARE PROVIDED TO THE COMMUNITY $864,854UNREIMBURSED COSTS OF MEDICAID PROGRAM $528,065COMMUNITY HEALTH SERVICES $885,079HEALTH PROFESSIONS EDUCATION $244,942COMMUNITY HEALTH RESEARCH $36,979FINANCIAL AND IN-KIND CONTRIBUTIONS $37,008COMMUNITY BENEFITS OPERATIONS $30,618TOTAL $2,627,545*2015 TOTAL SERVICES PROVIDEDCOMMUNITY BENEFIT PROGRAMS INCLUDE: SCREENINGS, CLASSES, PROGRAMS, SUPPORT GROUPS, VACCINATIONS AND HEALTH PROFESSIONS EDUCATION.A TOTAL OF 14,189 PEOPLE WERE SERVED THROUGH COMMUNITY BENEFIT PROGRAMS IN 2015.*NOTE: IN 2015, HRMC PROVIDED AN ADDITIONAL $20 MILLION IN UNCOMPENSATED CARE ATTRIBUTABLE TO MEDICARE SHORTFALLS AND BAD DEBT. COMMUNITY BENEFIT ACTIVITIES INCLUDE INDIRECT COSTS FOR 2015.Desc
Total Program Service Expenses$72,453,217TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document139IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee1007EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint VentureYes (1)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (1)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldNJStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ROBERT PETERSONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone9088506931PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1651 WILLOW GROVE STREETAddressLine1Txt
CityHACKETTSTOWNCityNm
State AbbreviationNJStateAbbreviationCd
ZIP07840ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
JOSE CORTES
TRUSTEE2.00Yes (X)$0$0$0
GLENN K TIPPY CPCU CLU
TRUSTEE2.00Yes (X)$0$0$0
CLAY HINRICHS MD
TRUSTEE2.00Yes (X)$0$0$0
BOGDEN BIENKO
TRUSTEE2.00Yes (X)$0$0$0
ERIC CROSS
TRUSTEE2.00Yes (X)$0$0$0
MICHAEL HALPIN
TRUSTEE2.00Yes (X)$0$0$0
MICHAEL LAVERY
TRUSTEE2.00Yes (X)$0$0$0
BARBARA-JAYNE LEWTHWAITE PHD
TRUSTEE2.00Yes (X)$0$0$0
TIMOTHY C MCDONOUGH
TRUSTEE2.00Yes (X)$0$0$0
RAY NISIVOCCIA CPA
TRUSTEE2.00Yes (X)$0$0$0
JAMES J TRAVIS
TRUSTEE2.00Yes (X)$0$0$0
NORMAN WORTH
TRUSTEE2.00Yes (X)$0$0$0
JAMES G LEE
CHAIRMAN; EVP & CFO, AHC5.00Yes (X)$0$662,822$135,96157.00Yes (X)
TERRY FORDE
PRESIDENT & CEO, AHC3.00Yes (X)$0$1,225,363$219,13859.00Yes (X)
JASON C COE
SECRETARY; PRESIDENT, HRMC45.00Yes (X)$0$393,566$82,99815.00Yes (X)
ROBERT C PETERSON
CHIEF FINANCIAL OFFICER50.00$273,061$0$60,89910.00Yes (X)
KENNETH JANOWSKI
CHIEF MEDICAL OFFICER40.00$297,229$0$66,83910.00Yes (X)
STELLA VISAGGIO
CHIEF OPERATING OFFICER40.00$283,376$0$68,18810.00Yes (X)
MARY ANN ANDERSON
CHIEF NURSING OFFICER40.00$289,772$0$26,64710.00Yes (X)
JUDITH H WIEGAND
EXE DIR, BUS DEVELOPMENT40.00$219,090$0$25,61710.00Yes (X)
CHRISTOPHER R MAZZIE
DIRECTOR OF BUSINESS OPERATIONS40.00$156,968$0$12,76410.00Yes (X)
TRACY HEIMBACH
ADMINISTRATIVE DIRECTOR40.00$136,220$0$26,85510.00Yes (X)
MICHAEL SCHIAVONE
OB/GYN PHYSICIAN40.00$213,019$0$8,63710.00Yes (X)
JEANNE JEPSON
DIRECTOR, HUMAN RESOURCES40.00$140,404$0$18,18810.00Yes (X)
ANTONELLA AUCIELLO
STAFF PHYSICIAN40.00$157,300$0$3,31110.00Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,166,439TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,281,751TotReportableCompRltdOrgAmt
Total Other Compensation$756,042TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K35IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
SODEXO INC
PO BOX 536922ATLANTAGA303536922FOOD MGMT SERVICES$724,972
DRINKER BIDDLE & REATH LLP
ONE LOGAN SQUARE SUITE 2000PHILADELPHIAPA191036996LEGAL SERVICES$692,008
ZENITH PHYSICIANS LLC
PO BOX 447HACKETTSTOWNNJ07840HOSPITALIST GROUP$603,538
HACKETTSTOWN PEDIATRIC HOSPITALIST LLC
290 UNION BLVDTOTOWANJ07512PEDIATRIC HOSPITALIST$575,000
MEDASSETS INC
PO BOX 405652ATLANTAGA303845652REVENUE CYCLE SERVICE$539,681
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K31CntrctRcvdGreaterThan100KCnt
Related Organizations$259,565RelatedOrganizationsAmt
All Other Contributions$130,367AllOtherContributionsAmt
Total Contributions$389,932TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE REVENU900099$83,057,064$83,057,064
ANCILLIARY SERVICE REV900099$3,335,959$3,335,959
FieldValueIRS element (for citing)
Total Program Service Revenue$86,393,023TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$673,967TotalRevenueColumnAmt
Exclusion$673,967ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$682,772RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$1,491,450RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$808,678RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$808,678TotalRevenueColumnAmt
Exclusion-$808,678ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$44,162,154SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$44,665,732SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$503,578SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$503,578TotalRevenueColumnAmt
Exclusion-$503,578ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$14,028FundraisingGrossIncomeAmt
Fundraising Direct Expenses$635FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$13,393TotalRevenueColumnAmt
Exclusion$13,393ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$21,737GrossSalesOfInventoryAmt
Cost Of Goods Sold$17,209CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,528TotalRevenueColumnAmt
Exclusion$4,528ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
CAFETERIA INCOME900099$499,620$499,620
MAINTENANCE INCOME900099$147,432$147,432
PHARMACY INCOME900099$2,942$2,942
FieldValueIRS element (for citing)
Other Revenue Total$649,994OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$86,812,581TotalRevenueColumnAmt
Related Or Exempt Func Income$86,393,023RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$147,432UnrelatedBusinessRevenueAmt
Exclusion-$117,806ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$420,650TotalAmt
Program Services$420,650ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$3,000TotalAmt
Program Services$3,000ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,610,718TotalAmt
Management And General$1,610,718ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$34,788,114TotalAmt
Program Services$29,828,319ProgramServicesAmt
Management And General$4,959,795ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$673,107TotalAmt
Program Services$577,141ProgramServicesAmt
Management And General$95,966ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$5,307,283TotalAmt
Program Services$4,550,615ProgramServicesAmt
Management And General$756,668ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,822,161TotalAmt
Program Services$2,419,801ProgramServicesAmt
Management And General$402,360ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$124,566TotalAmt
Management And General$124,566ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$73,243TotalAmt
Management And General$73,243ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$8,062,120TotalAmt
Program Services$6,495,528ProgramServicesAmt
Management And General$1,566,430ManagementAndGeneralAmt
Fundraising$162FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$275,654TotalAmt
Management And General$275,654ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$8,429,445TotalAmt
Program Services$6,873,516ProgramServicesAmt
Management And General$1,534,429ManagementAndGeneralAmt
Fundraising$21,500FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$5,083,842TotalAmt
Program Services$3,863,720ProgramServicesAmt
Management And General$1,220,122ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$3,642,712TotalAmt
Program Services$2,978,590ProgramServicesAmt
Management And General$642,307ManagementAndGeneralAmt
Fundraising$21,815FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$20,372TotalAmt
Program Services$14,551ProgramServicesAmt
Management And General$5,821ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$53,568TotalAmt
Program Services$41,860ProgramServicesAmt
Management And General$9,273ManagementAndGeneralAmt
Fundraising$2,435FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,314,226TotalAmt
Program Services$1,314,226ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,830,555TotalAmt
Program Services$4,807,361ProgramServicesAmt
Management And General$23,194ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$446,293TotalAmt
Management And General$446,293ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$8,247,126$8,247,126
COST ALLOC. FROM PARENT$2,230,604$2,230,604
RECRUITMENT$58,621$17,213$41,408

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$88,517,980TotalAmt
Program Services$72,453,217ProgramServicesAmt
Management And General$16,018,851ManagementAndGeneralAmt
Fundraising$45,912FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,280BOYAmt
EOY$1,280EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$42,026,808BOYAmt
EOY$32,450,134EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$93,748BOYAmt
EOY$58,929EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$8,028,398BOYAmt
EOY$11,034,639EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$686,475BOYAmt
EOY$614,900EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,771,971BOYAmt
EOY$1,861,623EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$740,557BOYAmt
EOY$852,261EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$128,682,603LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$90,135,073LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$40,636,324BOYAmt
EOY$38,547,530EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$2,788,505BOYAmt
EOY$2,777,924EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$1,342,168BOYAmt
EOY$1,563,794EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$867,660BOYAmt
EOY$867,660EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$2,225,554BOYAmt
EOY$2,748,908EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$101,209,448BOYAmt
EOY$93,379,582EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$7,186,977BOYAmt
EOY$5,162,854EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$48,196BOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$36,215,601BOYAmt
EOY$33,922,678EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$43,450,774BOYAmt
EOY$39,085,532EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$56,390,933BOYAmt
EOY$52,843,737EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,367,741BOYAmt
EOY$1,450,313EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$57,758,674BOYAmt
EOY$54,294,050EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$101,209,448BOYAmt
EOY$93,379,582EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$1,705,399ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$232,025NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$1,527,200OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,145,121OtherCostOrOtherBasisAmt
Book Value$1,145,121BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$52,192,078OtherCostOrOtherBasisAmt
Depreciation$32,425,780DepreciationAmt
Book Value$19,766,298BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,541,385OtherCostOrOtherBasisAmt
Depreciation$4,899,134DepreciationAmt
Book Value$3,642,251BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$62,536,137OtherCostOrOtherBasisAmt
Depreciation$51,112,453DepreciationAmt
Book Value$11,423,684BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,267,882OtherCostOrOtherBasisAmt
Depreciation$1,697,706DepreciationAmt
Book Value$2,570,176BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$38,547,530TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
CONSTRUCTION PAYABLE$50,410
MOBII OCCUPANCY GUARANTEE LIAB$867,660
OTHER LONG TERM LIABILITY$33,870
DUE TO PARENT ORGANIZATION$32,229,053
THIRD PARTY PAYABLES$741,685
FieldValueIRS element (for citing)
Total Liability$33,922,678TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationFIN 48 NOTES: THE CORPORATION 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 2015 OR 2014. THE CORPORATION'S POLICY IS TO RECOGNIZE INTEREST RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE AND PENALTIES IN OPERATING EXPENSES. THE CORPORATION'S FEDERAL EXEMPT ORGANIZATION RETURNS OF INCOME TAX AND ITS BUSINESS INCOME TAX RETURNS FOR THE YEARS ENDED PRIOR TO DECEMBER 31, 2012 NO LONGER REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$990,108TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$125,254DirectOffsettingRevenueAmt
Net Community Benefit Expns$864,854NetCommunityBenefitExpnsAmt
Total Expense0.00980TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,172,076TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$644,011DirectOffsettingRevenueAmt
Net Community Benefit Expns$528,065NetCommunityBenefitExpnsAmt
Total Expense0.00600TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,162,184TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$769,265DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,392,919NetCommunityBenefitExpnsAmt
Total Expense0.01580TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$954,295TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$69,216DirectOffsettingRevenueAmt
Net Community Benefit Expns$885,079NetCommunityBenefitExpnsAmt
Total Expense0.01000TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$244,942TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$244,942NetCommunityBenefitExpnsAmt
Total Expense0.00280TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$36,979TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$36,979NetCommunityBenefitExpnsAmt
Total Expense0.00040TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$37,008TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$37,008NetCommunityBenefitExpnsAmt
Total Expense0.00040TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,273,224TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$69,216DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,204,008NetCommunityBenefitExpnsAmt
Total Expense0.01360TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,435,408TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$838,481DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,596,927NetCommunityBenefitExpnsAmt
Total Expense0.02940TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,265TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,265NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$27,353TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$27,353NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$30,618TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$30,618NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$3,622,660BadDebtExpenseAmt
Reimbursed By Medicare$26,496,010ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$43,035,530CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$16,539,520MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (8 entries)

Primary ActivitiesPrimaryActivitiesTxtOrg Profit Or OwnershipOrgProfitOrOwnershipPctPhysicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct
1 HACKETTSTOWN DIAGNOSTIC ASSOCIATES LLC
IMAGING CENTER0.500000.50000
2 DYNAMIC IMAGING ASSOCIATES LLC
EQUIPMENT HOLDING COMPANY0.500000.50000
3 RADIOLOGY ASSOCIATES OF HACKETTSTOWN LLC
IMAGING CENTER0.333000.66700
4 HACKETTSTOWN REGIONAL MRILLC
EQUIPMENT HOLDING COMPANY0.333000.66700
5 MRI ASSOCIATES OF HACKETTSTOWN LLC
IMAGING CENTER0.500000.50000
6 GCM LLC
EQUIPMENT HOLDING COMPANY0.500000.50000
7 TRI MED ASSOCIATES
REAL ESTATE ENTITY0.333000.66700
8 GORDON HACKETTSTOWN MAB ASSOCIATES
MEDICAL OFFICE BUILDING VENTURE0.200000.22500
FieldValueIRS element (for citing)
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HACKETTSTOWN COMMUNITY HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1651 WILLOW GROVE STREETAddressLine1Txt
CityHACKETTSTOWNCityNm
State AbbreviationNJStateAbbreviationCd
ZIP07840ZIPCd
FieldValueIRS element (for citing)
Website AddressHTTP://WWW.HRMCNJ.ORG/WebsiteAddressTxt
State License12101StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1HACKETTSTOWN COMMUNITY HOPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLHTTP://WWW.HRMCNJ.ORGOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt16ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLHTTP://WWW.HRMCNJ.ORGStrategyWebsiteURLTxt
Strategy Attached0StrategyAttachedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLHTTP://WWW.HRMCNJ.ORG/FINANCIAL-ASSISTANCE.ASPFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSAME AS LINE 16AFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSAME AS LINE 16AFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
FAP Notice DisplayedYes (X)FAPNoticeDisplayedInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Medicare RatesYes (X)MedicareRatesInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
HACKETTSTOWN COMMUNITY HOPITALPART V, SECTION B, LINE 5: HACKETTSTOWN COMMUNITY HOSPITAL UNDERTOOK A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT WHICH CONCLUDED IN 2015. THE PURPOSE OF THE STUDY WAS TO GATHER CURRENT STATISTICS AND QUALITATIVE FEEDBACK ON THE KEY HEALTH ISSUES FACING OUR SERVICE MARKET RESIDENTS. SECONDARY DATA WAS RESEARCHED AND UPDATED. FIFTY FIVE COMMUNITY STAKEHOLDERS COMPLETED A "KEY INFORMANT SURVEY TOOL". AFTER COMPLETION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, APPROXIMATELY 23 LEADERS FROM HACKETTSTOWN COMMUNITY HOSPITAL, COMMUNITY AGENCIES AND AREA HEALTHCARE AND SOCIAL SERVICES ORGANIZATIONS MET TO REVIEW AND PRIORITIZE THE FINDINGS AND TO DEVELOP AN IMPLEMENTATION PLAN. THE FOLLOWING KEY STAKEHOLDERS PARTICIPATED IN THE PROCESS:ADMINISTRATIVE DIRECTOR, HRMC;BACH'S MEDICAL SUPPLIES;BENTLEY COMMONS AT PARAGON VILLAGE;CENTENARY COLLEGE;CHELSEA AT BROOKFIELD;CHIEF NURSING OFFICER, HRMC;CHURCH OF THE ASSUMPTION;COMMUNITY PREVENTION RESOURCES;COORDINATOR, HEALTHLINK, HRMC;EMS, HRMC;EXECUTIVE DIRECTOR, HRMC;FAMILY GUIDANCE OF WARREN COUNTY;HACKETTSTOWN BUSINESS IMPROVEMENT;HACKETTSTOWN POLICE DEPARTMENT;HACKETTSTOWN ROTARY CLUB;HEALTH EDUCATOR, HRMC;HEALTHSTART PRENATAL CLINIC, HRMC;HEALTH VILLAGE;HOME INSTEAD;HOUSE OF THE GOOD SHEPHERD;KAREN ANN QUINLAN HOSPICE;KIWANIS CLUB OF HACKETTSTOWN;LONG VALLEY FIRST AID SQUAD;MANAGER, CENTER FOR HEALTHIER LIVING, HRMC;MANAGER, COUNSELING AND ADDICTION CENTER, HRMC;MANAGER, EDUCATION, HRMC;MANAGER, EMERGENCY DEPARTMENT, HRMC;MANAGER, MARKETING AND PUBLIC RELATIONS, HRMC;MT. OLIVE HEALTH DEPARTMENT;NORTH WARREN REGIONAL SCHOOL DISTRICT;PHYSICIAN, EMERGENCY DEPARTMENT, HRMC;PLANNED PARENTHOOD;PRESIDENT, HACKETTSTOWN REGIONAL MEDICAL CENTER;PROJECT SELF-SUFFICIENCY;UNITED WAY OF NORTHERN NJ;WARREN COUNTY AGENCY ON AGING AND DISABILITY;WARREN COUNTY DEPARTMENT OF HUMAN SERVICES;WARREN COUNTY HEALTH DEPARTMENT;WARREN COUNTY MENTAL HEALTH BOARD;WARREN COUNTY OFFICE OF EMERGENCY MANAGEMENT;WARREN COUNTY SURROGATE;WARREN COUNTY TEMPORARY ASSISTANCE;WARREN COUNTY TRANSPORTATION COORDINATOR;WASHINGTON TOWNSHIP HEALTH DEPARTMENT;ZUFALL, FEDERALLY QUALIFIED HEALTH CENTER.
HACKETTSTOWN COMMUNITY HOPITALPART V, SECTION B, LINE 11: THE FOLLOWING WERE IDENTIFIED AS THE KEY COMMUNITY PRIORITIES: ACCESS TO CARE,CHRONIC DISEASE MANAGEMENT, COORDINATION OF CARE, AND MENTAL HEALTH.THE PLAN TO ADDRESS THESE ISSUES ARE AS FOLLOWS. ACCESS TO CARE:GOAL - INCREASE ACCESS TO AFFORDABLE QUALITY HEALTH CARE FOR HACKETTSTOWN MEDICAL CENTER'S SERVICE AREA RESIDENTS. OBJECTIVE - IDENTIFY A COMPREHENSIVE LIST OF AVAILABLE COMMUNITY RESOURCES FOR THE LOW INCOME AND UNINSURED POPULATION IN HACKETTSTOWN MEDICAL CENTER'S SERVICE AREA BY MARCH 2017. ACTIONS - > IDENTIFY COMMUNITY PARTNERS TO OBTAIN AND EVALUATE AVAILABLE RESOURCES AND RESOURCE GUIDES. > WORK WITH COMMUNITY PARTNERS TO CONSOLIDATE RESOURCE INFORMATION ON AREA HEALTH CLINICS AND LOCAL RESOURCES. > POST INFORMATION ON THE HOSPITAL'S WEBSITE AND DISTRIBUTE THROUGH: HACKETTSTOWN MEDICAL CENTER'S FINANCIAL COUNSELORS, EMERGENCY DEPARTMENT, WARREN COUNTY HEALTH DEPARTMENT, MT. OLIVE HEALTH DEPARTMENT AND OTHER IDENTIFIED AGENCIES.PLAN TO EVALUATE - HACKETTSTOWN MEDICAL CENTER WILL EVALUATE THE DISTRIBUTION OF THE RESOURCE GUIDE BY CONTACTING THE LOCAL AGENCIES TO EVALUATE THE NUMBER THAT WERE PROVIDED TO COMMUNITY RESIDENTS. POTENTIAL PARTNERS - HACKETTSTOWN MEDICAL CENTER, ZUFALL HEALTH CENTER, WARREN COUNTY HEALTH DEPARTMENT, MT. OLIVE HEALTH DEPARTMENT, WARREN COUNTY DIVISION OF HUMAN SERVICES, UNITED WAY.MENTAL HEALTH/SUBSTANCE ABUSE: GOAL - INCREASE ACCESS TO EXISTING MENTAL HEALTH SERVICES AND INCREASE AWARENESS OF MENTAL HEALTH ISSUES FOR HACKETTSTOWN MEDICAL CENTER'S SERVICE AREA. OBJECTIVE - IDENTIFY A COMPREHENSIVE LIST OF AVAILABLE RESOURCES FOR THOSE IN NEED OF MENTAL HEALTH AND ADDICTION SERVICES IN HACKETTSTOWN MEDICAL CENTER'S SERVICE AREA BY MARCH 2017. ACTIONS - > IDENTIFY AND CONTACT COMMUNITY PARTNERS TO PARTICIPATE IN A MENTAL HEALTH STRATEGY WORKGROUP. > IDENTIFY LOCAL COMMUNITY PARTNERS TO OBTAIN AND EVALUATE AVAILABLE RESOURCES AND RESOURCE GUIDES. > WORK WITH LOCAL COMMUNITY PARTNERS TO CONSOLIDATE RESOURCE INFORMATION. > POST INFORMATION ON THE HOSPITAL'S WEBSITE AND DISTRIBUTE THROUGH: HACKETTSTOWN MEDICAL CENTER'S COUNSELING AND ADDICTION CENTER, SCHOOLS, CHURCHES, EMERGENCY DEPARTMENT, FIRST AID SQUADS, WARREN COUNTY HEALTH DEPARTMENT, MT. OLIVE HEALTH DEPARTMENT, ZUFALL HEALTH CENTER. PLAN TO EVALUATE - HACKETTSTOWN MEDICAL CENTER WILL EVALUATE THE DISTRIBUTION OF THE RESOURCE GUIDE BY CONTACTING LOCAL AGENCIES TO EVALUATE THE NUMBER THAT WERE DISTRIBUTED. POTENTIAL PARTNERS - HACKETTSTOWN MEDICAL CENTER'S COUNSELING AND ADDICTION CENTER, EMERGENCY DEPARTMENT, FIRST AID SQUADS, WARREN COUNTY HEALTH DEPARTMENT, MT. OLIVE HEALTH DEPARTMENT, ZUFALL HEALTH CENTER WARREN COUNTY DIVISION OF HUMAN SERVICES, FAMILY GUIDANCE, LOCAL SCHOOLS AND CHURCHES. OBJECTIVE - DECREASE MENTAL HEALTH STIGMA BY INCREASING AWARENESS AND IDENTIFICATION OF MENTAL HEALTH /SUBSTANCE ABUSE DISORDERS. ACTIONS - > EXPLORE EVIDENCED BASED TRAINING OPPORTUNITIES TO INCREASE AWARENESS OF MENTAL HEALTH ISSUES. > IDENTIFY TARGET GROUPS TO RECEIVE TRAINING SUCH AS STUDENT ASSISTANCE COUNSELORS, CLERGY, AND LOCAL FIRST AID SQUADS. > ENGAGE GROUPS TO BE TRAINED AND COLLECT DATA ON THE NEEDS OF THE GROUP. HOLD TRAINING FOR 25 PARTICIPANTS IN YEAR ONE. PLAN TO EVALUATE - EVALUATE THE SUCCESS OF THE PROGRAM BY FEEDBACK FROM PARTICIPANTS. POTENTIAL PARTNERS - MENTAL HEALTH WORKGROUP, HACKETTSTOWN MEDICAL CENTER'S COUNSELING AND ADDICTION CENTER, CENTER FOR HEALTHIER LIVING, FAMILY GUIDANCE, NAMI. CHRONIC DISEASE MANAGEMENT/COORDINATION OF CARE: GOAL - REDUCE RISK FACTORS FOR CHRONIC DISEASE AND IMPROVE MANAGEMENT OF DISEASE CONDITIONS THROUGH PROMOTION AND EDUCATION OF HEALTHY LIFESTYLES. OBJECTIVE - INCREASE THE NUMBER OF PARTICIPANTS ATTENDING CHRONIC DISEASE EDUCATION PROGRAMS AND SUPPORT GROUPS. ACTIONS - > PROVIDE AT LEAST 4 EDUCATIONAL OPPORTUNITIES FOR THOSE DIAGNOSED WITH CHRONIC DISEASES SUCH AS DIABETES, CARDIOVASCULAR DISEASE AND PULMONARY DISEASE. > WORK WITH LOCAL COMMUNITY RESOURCES AND PHYSICIANS TO REFER PATIENTS TO SUPPORT GROUPS. > INCREASE ATTENDANCE AT THE HEALTHY HEARTS, BETTER BREATHER'S CLUB AND DIABETES SUPPORT GROUPS. PLAN TO EVALUATE - > DOCUMENT THE NUMBER OF EDUCATIONAL PROGRAMS. > EVALUATE THE NUMBER OF PEOPLE ATTENDING THE PROGRAMS VERSUS ATTENDANCE IN THE PAST. > EVALUATE THE NUMBER OF PEOPLE REFERRED TO SUPPORT GROUPS THROUGH COMMUNITY AGENCIES AND PHYSICIANS BY SURVEY. POTENTIAL PARTNERS - HACKETTSTOWN MEDICAL CENTER, LOCAL HEALTH DEPARTMENTS, ZUFALL HEALTH CLINIC, LOCAL PRIMARY CARE PHYSICIAN'S. OBJECTIVE - PARTNER WITH COMMUNITY AGENCIES TO PROVIDE 3 HEALTH SCREENINGS AND 3 EDUCATION EVENTS TO THE LOW INCOME AND UNINSURED POPULATION.ACTIONS - > IDENTIFY LOCAL AGENCIES TO COORDINATE HEALTH EDUCATION PROGRAMS AND SCREENINGS. > PROVIDE AT LEAST 3 SCREENINGS AND 3 COMMUNITY EDUCATION PROGRAMS TO IDENTIFY THOSE AT RISK FOR CHRONIC DISEASES. > TARGET PROGRAMS AND SCREENINGS TO THE LOW INCOME AND UNINSURED POPULATION. PLAN TO EVALUATE - DOCUMENT THE COMPLETION OF 3 COMMUNITY EDUCATION AND SCREENING PROGRAMS. > EVALUATE THE NUMBER OF PEOPLE WHO ATTENDED THE PROGRAM. > EVALUATE THE NUMBER OF PEOPLE REFERRED FROM THE SCREENING PROGRAM. POTENTIAL PARTNERS - HACKETTSTOWN MEDICAL CENTER, ZUFALL HEALTH CLINIC, WARREN COUNTY HEALTH DEPARTMENT, MT. OLIVE HEALTH DEPARTMENT, WARREN COUNTY DIVISION OF HUMAN SERVICES, LOCAL CHURCHES.RATIONALE FOR COMMUNITY HEALTH NEEDS NOT ADDRESSED: HACKETTSTOWN MEDICAL CENTER PLANS TO ADDRESS ALL OF THE HEALTH PRIORITIES AS IDENTIFIED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT AND PRIORITIZATION SESSION. COORDINATION OF CARE WILL FOCUS ON CHRONIC DISEASE MANAGEMENT.

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:HACKETTSTOWN COMMUNITY HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA DEFINED BY THE NEW JERSEY DEPARTMENT OF HEALTH AND SENIOR SERVICES WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. PATIENTS BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG) ARE ELIGIBLE FOR FREE CARE. PATIENTS BETWEEN 200% AND 300% OF THE FPG ARE ELIGIBLE FOR DISCOUNTED CARE.PART I, LINE 6A:ALTHOUGH NOT REQUIRED BY THE STATE OF NEW JERSEY, HACKETTSTOWN COMMUNITY HOSPITAL PREPARED A 2015 COMMUNITY BENEFIT REPORT AND MADE IT READILY AVAILABLE TO THE COMMUNITY ON OUR WEBSITE.
PART I, LINE 7:IN ORDER TO DETERMINE THE EXPENSE FOR CHARITY CARE AND OTHER COMMUNITY BENEFITS AT COST, HACKETTSTOWN COMMUNITY HOSPITAL UTILIZED COST TO CHARGE RATIOS TO DETERMINE THE COST OF THESE PROGRAMS.
PART I, LN 7 COL(F):NO BAD DEBT IS INCLUDED IN THE FUNCTIONAL EXPENSES IN PART IX OF THE FORM 990 AND THEREFORE NO ADJUSTMENT WAS NECESSARY TO COMPUTE THE PERCENTAGES IN THE CHART FOR LINE 7.
PART II, COMMUNITY BUILDING ACTIVITIES:COMMUNITY BUILDING:THE HACKETTSTOWN COMMUNITY HOSPITAL ADMINISTRATIVE TEAM ACTIVELY PARTICIPATES AS MEMBERS OF THE HACKETTSTOWN ROTARY AND IN THEIR EFFORTS TO IMPROVE THE HEALTH AND SAFETY OF THE HACKETTSTOWN COMMUNITY.HACKETTSTOWN COMMUNITY HOSPITAL WORKS JOINTLY WITH STATE AND COUNTY AGENCIES TO COORDINATE DISASTER PREPAREDNESS POLICIES AND PROCEDURES IN THE EVENT OF A LARGE STAGE DISASTER AFFECTING HACKETTSTOWN AND THE SURROUNDING COMMUNITIES.HACKETTSTOWN COMMUNITY HOSPITAL HAS ALSO PARTNERED WITH MANY PROGRAMS TO PROVIDE INTERNSHIPS TO STUDENTS WHO ARE PURSUING CAREERS IN A VARIETY OF HEALTH PROFESSIONS INCLUDING BUT NOT LIMITED TO: NURSING, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, DIAGNOSTIC IMAGING, BEHAVIORAL HEALTH AND ADDICTION COUNSELING AND PHARMACY RESIDENTS.THE CENTER FOR HEALTHIER LIVING PLAYS AN ACTIVE ROLE IN THE WARREN SUSSEX CHRONIC DISEASE COALITION WHICH IS DEDICATED TO THE IMPLEMENTATION OF EVIDENCE/PRACTICE BASED POLICY, AND ENVIRONMENTAL AND SYSTEM CHANGE INTERVENTIONS FOR CHRONIC DISEASE PREVENTION AND CONTROL WITH A FOCUS ON CANCER. THE COALITION IS COMMITTED TO MAINTAINING A DIVERSE PARTNERSHIP OF COMMUNITY MEMBERS AND AGENCIES.
PART III, LINE 4:PATIENT ACCOUNTS RECEIVABLE 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. IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, THE CORPORATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL COLLECTIONS AND PROVISION FOR DOUBTFUL COLLECTIONS. FOR PATIENT ACCOUNTS RECEIVABLE ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE CORPORATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL COLLECTIONS AND PROVISION FOR DOUBTFUL COLLECTIONS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE CORPORATION RECORDS A PROVISION FOR DOUBTFUL COLLECTIONS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE 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.
PART III, LINE 8:MEDICARE IN ORDER TO DETERMINE THE COST OF PROVIDING MEDICARE SERVICES, HACKETTSTOWN COMMUNITY HOSPITAL UTILIZED COST TO CHARGE RATIOS AS DETERMINED BY THE HOSPITAL'S MEDICARE COST REPORT. THE TOTAL COST WAS COMPARED TO PAYMENTS RECEIVED FROM THE MEDICARE PROGRAM. THE SHORTFALL CALCULATED REPRESENTS UNREIMBURSED COSTS UNDER THE MEDICARE PROGRAM THAT THE HOSPITAL ABSORBS ON BEHALF OF THE PATIENTS THAT IT SERVES.THE SHORTFALL ON PART III, LINE 7 IS CONSIDERED TO BE A COMMUNITY BENEFIT.
PART III, LINE 9B:COLLECTION PRACTICESINDIVIDUALS THAT QUALIFY FOR 100% CHARITY CARE UNDER THE NEW JERSEY DEPARTMENT OF HEALTH AND SENIOR SERVICES GUIDELINES ARE NOT BILLED FOR ANY AMOUNTS. INDIVIDUALS THAT QUALIFY FOR PARTIAL CHARITY CARE UNDER THESE GUIDELINES ARE BILLED AT A REDUCED RATE. FINANCIAL COUNSELORS ARE AVAILABLE TO ALL PATIENTS TO DETERMINE WHETHER ANY PROGRAMS (E.G. CHARITY CARE, MEDICAID) ARE AVAILABLE TO ASSIST PATIENTS.FINANCIAL ASSISTANCE PROCESS AND COLLECTION PROTOCOL ARE WELL DEFINED WITH MANAGERS AVAILABLE TO GUIDE AND HANDLE EXCEPTION SITUATIONS. OUTSOURCED AGENCIES AND COLLECTIONS FIRMS ARE EXPECTED TO ADHERE TO HACKETTSTOWN COMMUNITY HOSPITAL'S POLICY. BAD DEBT, CHARITY AND ADMINISTRATIVE WRITE OFF ARE CLEARLY DEFINED WITH PRE-DETERMINED AUTHORIZATION LEVELS DEPENDING ON THE MAGNITUDE GRANTED.
PART VI, LINE 2:NEEDS ASSESSMENT:HACKETTSTOWN COMMUNITY HOSPITAL COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT IN 2015 UTILIZING THE SERVICES OF HOLLERAN CONSULTING. A WIDE VARIETY OF COMMUNITY PARTNERS PARTICIPATED IN THE PROCESS TO IDENTIFY AND PRIORITIZE THE HEALTH NEEDS OF THE COMMUNITY. UPON COMPLETION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, AND IMPLEMENTATION PLAN WAS DEVELOPED AND APPROVED IN 2016. ALTHOUGH THE STATE OF NEW JERSEY DOES NOT REQUIRE THAT A COMMUNITY BENEFIT REPORT BE FILED, HACKETTSTOWN COMMUNITY HOSPITAL (HCH) PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT WHICH IS POSTED ON ITS WEBSITE AND MAILED TO THE COMMUNITY UPON REQUEST. A MEETING IS HELD EACH YEAR TO INFORM THE COMMUNITY.
PART VI, LINE 3:PATIENT EDUCATION:ALL PATIENTS OF THE HOSPITAL THAT DO NOT HAVE INSURANCE ARE PROVIDED WITH INFORMATION REGARDING FINANCIAL ASSISTANCE. THE INFORMATION PROVIDES INFORMATION REGARDING THE REQUIREMENTS FOR QUALIFYING FOR CHARITY CARE AND OTHER ASSISTANCE PROGRAMS. IN ADDITION, THE HOSPITAL HAS A FULL TIME FINANCIAL COUNSELING OFFICE WITH DEDICATED FINANCIAL COUNSELORS THAT PROVIDE SCREENINGS AND INFORMATION TO ALL PATIENTS REQUESTING ASSISTANCE.
PART VI, LINE 4:COMMUNITY INFORMATION:HACKETTSTOWN COMMUNITY HOSPITAL'S PRIMARY SERVICE AREA IS MADE UP OF 12 ZIP CODES THAT STRADDLE THE WESTERN PORTION OF MORRIS COUNTY AND THE CENTRAL AND EASTERN SIDE OF WARREN COUNTY, WITH ONE ADDITIONAL ZIP CODE LOCATED IN NEIGHBORING SUSSEX COUNTY TO THE NORTH. HRMC'S PSA COMPRISES A POPULATION BASE OF APPROXIMATELY 100,000.HACKETTSTOWN COMMUNITY HOSPITAL'S SECONDARY SERVICE AREA IS MADE UP OF SEVEN ZIP CODES THAT INCLUDE THE SOUTHERN TIP OF SUSSEX COUNTY AND PORTIONS OF THE SOUTH CENTRAL AND NORTHERN SECTIONS OF WARREN COUNTY. HRMC'S SSA COMPRISES A POPULATION BASE OF ALMOST 35,000.
PART VI, LINE 5:COMMUNITY HEALTH PROMOTION:HACKETTSTOWN COMMUNITY HOSPITAL, DBA HACKETTSTOWN REGIONAL MEDICAL CENTER, OPENED IN 1973 AND IS A FULLY LICENSED 111 BED ACUTE CARE HOSPITAL THAT PROVIDES ACUTE CARE, EMERGENCY, DIAGNOSTIC, SURGICAL AND OUTPATIENT SERVICES TO RESIDENTS OF WARREN, MORRIS, SUSSEX AND HUNTERDON COUNTIES. HACKETTSTOWN COMMUNITY HOSPITAL IS A FAITH BASED, NOT FOR PROFIT ORGANIZATION GOVERNED BY A BOARD OF DIRECTORS COMPRISED OF HACKETTSTOWN COMMUNITY RESIDENTS COMMITTED TO OUR MISSION OF IMPROVING THE HEALTH OF PEOPLE AND COMMUNITIES THROUGH A MINISTRY OF PHYSICAL, MENTAL AND SPIRITUAL HEALING. MEMBERS OF THE HACKETTSTOWN COMMUNITY HOSPITAL ADMINISTRATION AND LEADERSHIP TEAM ARE ALSO ACTIVE IN THE COMMUNITY SERVING ON VARIOUS BOARDS, COALITIONS AND COMMITTEES TO HELP ADDRESS HEALTH ISSUES IN THE COMMUNITY.IN KEEPING WITH OUR MISSION, HACKETTSTOWN REGIONAL MEDICAL CENTER CONTINUES TO PROMOTE GOOD HEALTH THROUGH THE PROGRAMS OFFERED BY THE CENTER FOR HEALTHIER LIVING. A TOTAL OF 7891 COMMUNITY RESIDENTS WERE SERVED THROUGH THE VARIOUS PROGRAMS OFFERED BY THE CENTER IN 2015.AT HACKETTSTOWN REGIONAL MEDICAL CENTER WE BELIEVE THAT EDUCATION IS THE FIRST AND OFTEN THE MOST IMPORTANT STEP IN ACHIEVING GOOD HEALTH. HACKETTSTOWN REGIONAL MEDICAL CENTER PROMOTES A LIFESTYLE CHANGE THAT EMPHASIZES REGULAR EXERCISE, GOOD NUTRITION, EARLY DETECTION OF ILLNESS AND THE KNOWLEDGE TO MAKE INFORMED HEALTH RELATED DECISIONS.IN ORDER TO HELP AREA RESIDENTS ACHIEVE OPTIMAL HEATH, HACKETTSTOWN REGIONAL MEDICAL CENTER, THROUGH THE CENTER FOR HEALTHIER LIVING, OFFERED A NUMBER OF HEALTH PROMOTION AND EDUCATION CLASSES AND HEALTH SCREENINGS IN 2015 INCLUDING:> A VARIETY OF HEALTH SCREENINGS INCLUDING CANCER SCREENINGS WERE OFFERED AT THE CENTER FOR HEALTHIER LIVING, COMMUNITY HEALTH FAIRS, AND SCHOOL HEALTH FAIRS AND AREA BUSINESSES.> HEALTH EDUCATION PROGRAMS WERE HELD AT THE CENTER FOR HEALTHIER LIVING, SEVERAL SENIOR GROUP MEETINGS, SENIOR HOUSING AND AREA BUSINESS. SENIOR EXERCISE PROGRAMS LIKE TAI CHI AND ARTHRITIS EXERCISE KEEP SENIORS ACTIVE AND FLEXIBLE. "BACK IN TIME" HISTORY SERIES PROVIDES SENIORS THE OPPORTUNITY TO ENGAGE IN LIFELONG LEARNING, USE CRITICAL THINKING SKILLS AND TO SOCIALIZE.> SUPPORT GROUPS HELPED ADDRESS THE NEEDS OF THOSE WITH CHRONIC ILLNESS INCLUDING PULMONARY DISEASE, CARDIAC ILLNESSES AND DIABETES AND BREAST CANCER.> DIABETES PREVENTION EFFORTS INCLUDED PRE-DIABETES WORKSHOPS. > INFLUENZA VACCINES WERE GIVEN AT NO CHARGE TO THE HOMELESS AND MEDICALLY UNDERSERVED THROUGH A FOOD PANTRY AND PROJECT HOMELESS CONNECT. > PRENATAL EDUCATION CLASSES WERE OFFERED AT NO COST TO UNDERINSURED WOMEN AND FAMILIES INCLUDING CHILDBIRTH EDUCATION, BREAST FEEDING CLASSES, SIBLING CLASSES AND BABY CARE CLASSES> HACKETTSTOWN COMMUNITY HOSPITAL OFFERS A VARIETY OF CPR AND FIRST AID CLASSES TO OUR COMMUNITY. CLASSES ARE OFFERED FREE OR FOR A NOMINAL FEE TO LOCAL POLICE, FIREFIGHTERS AND EMS. A LARGE NUMBER OF COMMUNITY RESIDENTS WERE INSTRUCTED IN "HANDS-ONLY" CPR AT A NUMBER OF HEALTH FAIRS.HACKETTSTOWN REGIONAL MEDICAL CENTER IS COMMITTED TO ENSURING THAT THE COMMUNITIES IT SERVES THRIVE IN A CULTURE OF WELLNESS AND HAVE ACCESS TO AND THE BENEFITS OF HIGH QUALITY, EQUITABLE HEALTHCARE THAT PROMOTES PHYSICAL, MENTAL AND SPIRITUAL WELLBEING.
PART VI, LINE 6:AFFILIATED HEALTH CARE:HACKETTSTOWN COMMUNITY HOSPITAL IS A MEMBER OF THE ADVENTIST HEALTHCARE SYSTEM BASED IN GAITHERSBURG, MARYLAND. ADVENTIST HEALTHCARE PROVIDES MANAGERIAL AND SHARED SERVICES TO HACKETTSTOWN COMMUNITY HOSPITAL IN SUPPORT OF ITS MISSION TO SERVE HACKETTSTOWN AND THE OTHER COMMUNITIES IN ITS PRIMARY AND SECONDARY SERVICE AREAS.
PART VI, LINE 7, REPORTS FILED WITH STATESNJ

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
HACKETTSTOWN COMMUNITY HOSPITAL FOUNDATION
651 WILLOW GROVE STREETHACKETTSTOWNNJ07840222333410501(C)(3)$15,350GENERAL SUPPORT FROM HOSPITAL AUXILIARY.
HACKETTSTOWN BUSINESS IMPROVEMENT DISTRICT
219 MAIN STHACKETTSTOWNNJ07840202535990501(C)(3)$5,300EVENT SPONSORSHIPS: SPRING FESTIVAL AND HOMETOWN HOLIDAY
HACKETTSTOWN COMMUNITY HOSPITAL FOUNDATION
651 WILLOW GROVE STREETHACKETTSTOWNNJ07840222333410501(C)(3)$400,000GENERAL SUPPORT
FieldValueIRS element (for citing)
Total501c3 Org2Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationIN SUPPORT OF ITS MISSION AND VISION TO BE A LEADING RESOURCE FOR INNOVATIVE PATIENT -CENTERED HEALTHCARE, THE HOSPITAL AND ITS AUXILIARY WILL PROVIDE GRANTS AND ASSISTANCE TO AFFILIATED ENTITIES SUCH AS ITS FOUNDATION AND OTHER NON-PROFIT ORGANIZATIONS IN THE COMMUNITY. PRIOR TO PROVIDING THIS ASSISTANCE, HOSPITAL ADMINISTRATION REVIEWS AND APPROVES REQUESTS FOR NEEDS THAT FULFILL OUR MISSION AND SUPPORT THE COMMUNITY.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
JAMES G LEE
CHAIRMAN; EVP & CFO, AHC$0$498,437$0$159,345$0$5,040$0$110,360$0$25,601$0$798,783$0$0
TERRY FORDE
PRESIDENT & CEO, AHC$0$864,928$0$328,406$0$32,029$0$191,122$0$28,016$0$1,444,501$0$0
JASON C COE
SECRETARY; PRESIDENT, HRMC$0$290,030$0$94,356$0$9,180$0$51,577$0$31,421$0$476,564$0$0
ROBERT C PETERSON
CHIEF FINANCIAL OFFICER$211,924$0$55,504$0$5,633$0$28,584$0$32,315$0$333,960$0$0$0
KENNETH JANOWSKI
CHIEF MEDICAL OFFICER$232,990$0$60,994$0$3,245$0$35,722$0$31,117$0$364,068$0$0$0
STELLA VISAGGIO
CHIEF OPERATING OFFICER$220,920$0$59,079$0$3,377$0$32,524$0$35,664$0$351,564$0$0$0
MARY ANN ANDERSON
CHIEF NURSING OFFICER$207,542$0$53,445$0$28,785$0$10,082$0$16,565$0$316,419$0$0$0
JUDITH H WIEGAND
EXE DIR, BUS DEVELOPMENT$116,226$0$49,390$0$53,474$0$6,053$0$19,564$0$244,707$0$0$0
CHRISTOPHER R MAZZIE
DIRECTOR OF BUSINESS OPERATIONS$156,867$0$0$0$101$0$4,694$0$8,070$0$169,732$0$0$0
TRACY HEIMBACH
ADMINISTRATIVE DIRECTOR$115,508$0$20,593$0$119$0$2,997$0$23,858$0$163,075$0$0$0
MICHAEL SCHIAVONE
OB/GYN PHYSICIAN$210,485$0$0$0$2,534$0$569$0$8,068$0$221,656$0$0$0
JEANNE JEPSON
DIRECTOR, HUMAN RESOURCES$118,851$0$21,306$0$247$0$3,557$0$14,631$0$158,592$0$0$0
ANTONELLA AUCIELLO
STAFF PHYSICIAN$156,850$0$0$0$450$0$3,022$0$289$0$160,611$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3COMPENSATION DEFINED. THE COMPENSATION REPORTED FOR THE EMPLOYEES SET FORTH ON SCHEDULE J IS COMPRISED OF THE FOLLOWING: BASE COMPENSATION INCLUDES NONDISCRETIONARY PAYMENTS, AGREED UPON IN ADVANCE, CONTINGENT ONLY UPON THE PAYEES PERFORMANCE OF AGREED UPON SERVICES (SUCH AS SALARY OR FEES). INCENTIVE COMPENSATION INCLUDES PAYMENTS BASED ON SATISFACTION OF PRE-DETERMINED PERFORMANCE TARGETS SUCH AS QUALITY/PATIENT SAFETY GOALS, EMPLOYEE AND CUSTOMER ENGAGEMENT GOALS, ORGANIZATIONAL GROWTH, AND FINANCIAL PERFORMANCE, AMONG OTHER THINGS. A NEW EXECUTIVE RETENTION 457F PLAN, EFFECTIVE JANUARY 1, 2015, REPLACED THE ADVENTIST HEALTHCARE CAPITAL ACCUMULATION ACCOUNT PLAN. PRE-TAX CONTRIBUTIONS ACCUMULATED ANNUALLY ARE DISTRIBUTED ON JANUARY 1ST OF THE 2ND YEAR, IF STILL EMPLOYED. THERE IS A 2 YEAR DEFERRAL PERIOD BEFORE PAYMENTS ARE RELEASED. THE FIRST PAYMENT FOR THE NEW EXECUTIVE RETENTION PLAN, RELATED TO CONTRIBUTIONS ACCUMULATED IN 2015, WILL BE DISTRIBUTED ON JANUARY 1, 2017 AND CONTRIBUTIONS ACCUMULATED IN 2016 WILL BE DISTRIBUTED ON JANUARY 1, 2018. IN ADDITION, OTHER REPORTABLE COMPENSATION INCLUDES LONG-TERM DISABILITY COVERAGE, CELL PHONE ALLOWANCES, CASH-OUT OF UNUSED PAID TIME OFF (PTO) HOURS (ONLY FOR EMPLOYEES THAT LEAVE OUR ORGANIZATION), IMPUTED VALUE OF LIFE INSURANCE BENEFITS, TAXABLE PAYABLE PAY, AND SEVERANCE, AS APPLICABLE. NON-TAXABLE BENEFITS INCLUDES PRE-TAX PAYROLL DEDUCTIONS (SUCH AS FLEXIBLE MEDICAL SPENDING, DEPENDENT CARE, AND EMPLOYEE HEALTH BENEFIT PREMIUM), AND THE EMPLOYER PORTION OF CERTAIN EMPLOYEE BENEFITS SUCH AS HEALTH INSURANCE, DENTAL INSURANCE, VISION INSURANCE, LIFE INSURANCE, BASE CONTRIBUTIONS TO RETIREMENT PLANS, MATCHING OF EMPLOYEE RETIREMENT CONTRIBUTIONS, ETC. PAY PRACTICE: ADVENTIST HEALTHCARE UTILIZES A SINGLE EMPLOYER ID FOR ALL OF ITS AFFILIATED ENTITIES FOR EMPLOYMENT PURPOSES. AS SUCH, ACTUAL COMPENSATION AND BENEFITS ARE CHARGED TO THE RESPECTIVE ENTITIES AND THE RESULTING COMPENSATION AND BENEFITS ARE REPORTED ON EACH AFFILIATE'S IRS FORM 990 AS IF PAID DIRECTLY BY SUCH AFFILIATE. HACKETTSTOWN FOLLOWS ADVENTIST HEALTHCARE'S PAY PRACTICE. MR. COE'S COMPENSATION AND BENEFITS ARE PAID BY ADVENTIST HEALTHCARE AND NOT CHARGED BACK TO HACKETTSTOWN COMMUNITY HOSPITAL. AS APPLICABLE, THE SAME AND NON-ADDITIVE COMPENSATION AND EMPLOYMENT BENEFIT PLAN CONTRIBUTION AMOUNTS WERE ALSO DISCLOSED IN THE ADVENTIST HEALTHCARE INC.'S RELATED ENTITIES RETURNS. INDEPENDENT GUIDELINES - WHEN SETTING COMPENSATION FOR THE "OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, AND THE HIGHEST COMPENSATED EMPLOYEES," ADVENTIST HEALTHCARE FULLY COMPLIES WITH THE PROCEDURAL SAFE GUARDS EMBODIED IN IRS REGULATIONS. COMPENSATION FOR ADVENTIST HEALTHCARE AND HACKETTSTOWN COMMUNITY HOSPITAL "OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, AND THE HIGHEST COMPENSATED EMPLOYEES" IS ENTIRELY SET BY A COMMITTEE OF ADVENTIST HEALTHCARE'S BOARD OF TRUSTEES. IN SETTING COMPENSATION, THE GOVERNING BOARD COMMITTEE RELIES UPON MARKET COMPARABILITY DATA PROVIDED BY AN INDEPENDENT OUTSIDE COMPENSATION CONSULTANT WHO PROVIDES A SUMMARY OF HEALTH CARE SALARIES AND BENEFITS FOR COMPARABLE SIZED ORGANIZATIONS BOTH NATIONALLY AND IN THE NEW JERSEY-NEW YORK REGION. TO FURTHER ENSURE REASONABLENESS, BOTH COMPENSATION AND BENEFITS ARE TARGETED AT THE 50TH PERCENTILE (OR MEDIAN) OF THE MARKET. PAY PHILOSOPHY - FOR ALL HACKETTSTOWN COMMUNITY HOSPITAL EMPLOYEES INCLUDING THOSE LISTED ON SCHEDULE J, THE GOAL OF ADVENTIST HEALTHCARE IS TO OFFER COMPETITIVE SALARIES IN ORDER TO ATTRACT, HIRE AND RETAIN QUALIFIED AND TALENTED INDIVIDUALS. MAINTAINING A QUALITY, STABLE WORKFORCE HAS A POSITIVE IMPACT ON THE WORKPLACE AND ON THE CARE PROVIDED TO OUR PATIENTS/RESIDENTS AND THEIR FAMILIES. IN GENERAL, NON-EXECUTIVE EMPLOYEES ARE COMPENSATED UTILIZING THE FULL WAGE SCALE FOR THEIR RESPECTIVE POSITIONS, COMPARED TO THE MARKET. HOWEVER, EXECUTIVES ARE GENERALLY LIMITED TO THE MEDIAN OF THE MARKET FOR THEIR RESPECTIVE POSITIONS.
PART I, LINES 4A-BA NEW EXECUTIVE RETENTION 457F PLAN, EFFECTIVE JANUARY 1, 2015, REPLACED THE ADVENTIST HEALTHCARE CAPITAL ACCUMULATION ACCOUNT PLAN. PRE-TAX CONTRIBUTIONS ACCUMULATED ANNUALLY ARE DISTRIBUTED ON JANUARY 1ST OF THE 2ND YEAR, IF STILL EMPLOYED. THERE IS A 2 YEAR DEFERRAL PERIOD BEFORE PAYMENTS ARE RELEASED. THE FIRST PAYMENT FOR THE NEW EXECUTIVE RETENTION PLAN, RELATED TO CONTRIBUTIONS ACCUMULATED IN 2015, WILL BE DISTRIBUTED ON JANUARY 1, 2017 AND CONTRIBUTIONS ACCUMULATED IN 2016 WILL BE DISTRIBUTED ON JANUARY 1, 2018. THE FOLLOWING EMPLOYEE LISTED BELOW FELL OUTSIDE THE AGE BRACKET TO BE INCLUDED IN THE 457F PLAN, AND THEY RECEIVED A LUMP-SUM CASH BONUS PAYMENT: MARY ANN ANDERSON: $24,844 ALSO, IN 2015, SEVERANCE PAYMENTS WERE MADE TO: JUDITH H WIEGAND: $50,976

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6BY LAWS, ARTICLE II: THERE SHALL BE A SINGLE CLASS OF CONSTITUENT MEMBERS OF THE HOSPITAL CORPORATION (INDIVIDUAL - MEMBER, COLLECTIVELY - MEMBERSHIP), WHICH SHALL CONSIST OF THE DULY ELECTED MEMBERS OF THE BOARD OF DIRECTORS OF ADVENTIST HEALTHCARE, INC., A NONPROFIT CORPORATION EXISTING UNDER AND OPERATING BY VIRTUE OF THE LAWS OF THE STATE OF MARYLAND.
FORM 990, PART VI, SECTION A, LINE 7ABY LAWS, ARTICLES II AND III (VARIOUS PARTS) TRUSTEES OF THIS ORG ARE ELECTED BY THE MEMBER (I.E. ADVENTIST HEALTHCARE, INC.).
FORM 990, PART VI, SECTION A, LINE 7BBY LAWS, ARTICLE II- RESERVED AUTHORITY AND RESPONSIBILITY: NOTWITHSTANDING ANY PROVISION OF THE CERTIFICATE OF INCORPORATION OR THESE BYLAWS TO THE CONTRARY, THE FOLLOWING ACTIONS ARE RESERVED TO THE MEMBERSHIP: 1. THE PURCHASE, SALE OR DISPOSITION OF REAL PROPERTY OF THE HOSPITAL CORPORATION; 2. THE ADOPTION, ALTERING, AMENDING OR REPLACING OF THE CERTIFICATE OF INCORPORATION OR THE BYLAWS OF THE HOSPITAL CORPORATION; 3. THE LIQUIDATION, DISSOLUTION, WINDING UP OR ABANDONMENT OF THE HOSPITAL CORPORATION; AND 4. THE RETENTION AND EXERCISE OR DELEGATION OF VOTING RIGHTS ASSOCIATED WITH THE OWNERSHIP OF ANY SHARES OF STOCK OR INTEREST OWNED OR HELD BY THE HOSPITAL CORPORATION OR ANY ENTITY SUBSIDIARY TO OR CONTROLLED BY THE HOSPITAL CORPORATION ("SUBSIDIARY ORGANIZATION") IN CONNECTION WITH THE FOLLOWING ACTIONS: (A) THE AMENDMENT OF THE ORGANIZATIONAL DOCUMENTS OF A SUBSIDIARY ORGANIZATION; (B) THE CONSOLIDATION OF A SUBSIDIARY ORGANIZATION WITH ONE OR MORE ENTITIES TO FORM A NEW CONSOLIDATED CORPORATION; (C) THE MERGER OF A SUBSIDIARY ORGANIZATION INTO ANOTHER ENTITY OR THE MERGER OF ONE OR MORE OTHER ENTITIES INTO A SUBSIDIARY ORGANIZATION; (D) THE SALE, LEASE, EXCHANGE OR OTHER TRANSFER OF ALL, OR SUBSTANTIALLY ALL, OF THE PROPERTY AND ASSETS OF A SUBSIDIARY ORGANIZATION, INCLUDING ITS GOODWILL AND FRANCHISES; (E) THE PARTICIPATION BY A SUBSIDIARY ORGANIZATION IN A SHARE EXCHANGE AS THE ENTITY THE STOCK/INTEREST OF WHICH IS TO BE ACQUIRED; (F) THE VOLUNTARY OR INVOLUNTARY LIQUIDATION, DISSOLUTION OR WINDING-UP OF A SUBSIDIARY ORGANIZATION. 5. APPOINTMENT OF MEMBERS OF THE BOARD OF THE HOSPITAL CORPORATION FROM NOMINEES SUBMITTED BY THE BOARD OF THE HOSPITAL CORPORATION; 6. REMOVAL OF MEMBERS OF THE BOARD OF THE HOSPITAL CORPORATION. 7. AUTHORIZE AND APPROVE THE ISSUANCE OF DEBT AND THE USE OF PROCEEDS OF SUCH DEBT FOR AND ON BEHALF OF THE HOSPITAL CORPORATION; 8. DEVELOP CAPITAL INVESTMENT, CAPITAL ALLOCATION AND BORROWING POLICIES FOR THE HOSPITAL CORPORATION; 9. CEASE PROVIDING HEALTH CARE SERVICES NECESSARY FOR OPERATION AS A LICENSED GENERAL ACUTE CARE FACILITY AT ANY SITE; 10. CHANGE THE STATED PURPOSES, MISSION OR PHILOSOPHY OF THE HOSPITAL CORPORATION, OR ANY CONTROLLED ENTITY AS FOUND IN THE ARTICLES OF INCORPORATION, BYLAWS, OR OTHER GOVERNING DOCUMENTS OF THE HOSPITAL CORPORATION; 11. ADOPTING THE HOSPITAL CORPORATION'S ANNUAL AND LONG-TERM CAPITAL AND OPERATION BUDGETS; 12. MAKING ANY MAJOR CHANGES IN ANY OF THE HOSPITAL CORPORATION'S INSURANCE PROGRAM; AND 13. RECOMMENDING ANY UNBUDGETED CAPITAL EXPENDITURE OF THE HOSPITAL CORPORATION'S CAPITAL BUDGET IN EXCESS OF $500,000.
FORM 990, PART VI, SECTION B, LINE 11PRIOR TO FILING THE FORM 990, THE FORM WAS PREPARED BY THE INTERNAL FINANCE TEAM OF THE HEALTH SYSTEM WITH INPUT FROM MANY HOSPITAL DEPARTMENTS. IT WAS REVIEWED IN DETAIL BY THE HRMC CONTROLLER AND CFO. THE FORM WAS DISCUSSED AND REVIEWED IN DETAIL WITH THE ORGANIZATION'S OUTSIDE TAX ADVISORS. THE CFO THEN CONDUCTED A HIGHER LEVEL REVIEW OF THE FORM WITH THE HRMC PRESIDENT. THE 990 WAS THEN MADE AVAILABLE TO THE ORGANIZATION'S BOARD OF DIRECTORS BEFORE FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CPURSUANT TO THE ORGANIZATIONS CONFLICT OF INTEREST POLICY, EACH BOARD MEMBER, OFFICER, DIRECTOR AND ANY EMPLOYEE IN A POSITION THAT REQUIRES COORDINATION AND/OR NEGOTIATION WITH CONTRACTORS OR SUPPLIERS, IS REQUIRED ON AN ANNUAL BASIS TO DISCLOSE ANY BUSINESS OR FINANCIAL RELATIONSHIP OUTSIDE OF THE ORGANIZATION. COMPLIANCE WITH POLICY IS MONITORED AND ENFORCED BY THE HUMAN RESOURCES DEPARTMENT, INTEGRITY DEPARTMENT AND THE LEGAL DEPARTMENT IN THE EVENT THERE IS A CONFLICT OF INTEREST, BOARD MEMBERS WILL RECUSE THEMSELVES FROM VOTING.
FORM 990, PART VI, SECTION B, LINE 15THE ORGANIZATION FOLLOWS THE COMPENSATION GUIDELINES OF ITS SOLE MEMBER, ADVENTIST HEALTHCARE, INC. A TAX-EXEMPT AFFILIATE. INDEPENDENT GUIDELINES - WHEN SETTING COMPENSATION FOR THE CEO/PRESIDENT, ADVENTIST HEALTHCARE FULLY COMPLIES WITH THE PROCEDURAL SAFEGUARDS EMBEDDED IN THE IRS REGULATIONS. COMPENSATION FOR ADVENTIST HEALTHCARE'S CEO/PRESIDENT IS ENTIRELY SET BY A COMMITTEE OF ADVENTIST HEALTHCARE INC.'S BOARD OF TRUSTEES. IN SETTING COMPENSATION, THE GOVERNING BOARD COMMITTEE RELIES UPON MARKET COMPARABILITY DATA PROVIDED BY AN INDEPENDENT OUTSIDE COMPENSATION CONSULTANT WHO PROVIDES A SUMMARY OF HEALTHCARE SALARIES AND BENEFITS FOR COMPARABLE SIZED ORGANIZATIONS BOTH NATIONALLY AND THE BALTIMORE-WASHINGTON REGION. TO FURTHER ENSURE REASONABLENESS, BOTH COMPENSATION AND BENEFITS ARE TARGETED AT THE 50TH PERCENTILE OF THE MARKET.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9:NET ORGANIZATION TRANSFERS -1,527,200.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (15 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
ADVENTIST HEALTHCARE INC
820 W DIAMOND AVE SUITE 600GAITHERSBURGMD208781419521532556HEALTHCARE SERVICESMD501(C)(3)LINE 3MID-ATLANTIC ADVENTIST HEALTHCARE CORPORATION0
ADVENTIST HEALTHCARE URGENT CARE CENTERS INC
820 W DIAMOND AVE SUITE 600GAITHERSBURGMD208781419461577511CLINIC - EMERGENCY CAREMD501(C)(3)LINE 9ADVENTIST HEALTHCARE INC0
ADVENTIST HOME HEALTH SERVICES INC
820 W DIAMOND AVE SUITE 600GAITHERSBURGMD208781419520986808HOME CARE SERVICESMD501(C)(3)LINE 9ADVENTIST HEALTHCARE INC0
ADVENTIST PHYSICIAN SERVICES INC
820 W DIAMOND AVE SUITE 600GAITHERSBURGMD208781419204600646PHYSICIAN SERVICESMD501(C)(3)LINE 9ADVENTIST HEALTHCARE INC0
ADVENTIST REHABILITATION HOSPITAL OF MARYLAND INC
820 W DIAMOND AVE SUITE 600GAITHERSBURGMD208781419201486678REHABILITATION HOSPITALMD501(C)(3)LINE 3ADVENTIST HEALTHCARE INC0
ADVENTIST REHABILITATION INC
820 W DIAMOND AVE SUITE 600GAITHERSBURGMD208781419300780513REHABILITATION SERVICESMD501(C)(3)LINE 9ADVENTIST REHABILITATION HOSPITAL OF MARYLAND INC0
HACKETTSTOWN REGIONAL MEDICAL CENTER EMERGENCY SERVICES INC
651 WILLOW GROVE STREETHACKETTSTOWNNJ07840270820164AMBULANCE SERVICENJ501(C)(3)LINE 11A, IHACKETTSTOWN COMMUNITY HOSPITAL INCYes (1)
HACKETTSTOWN COMMUNITY HOSPITAL FOUNDATION INC
651 WILLOW GROVE STREETHACKETTSTOWNNJ07840222333410FUNDRAISINGNJ501(C)(3)LINE 11A, IHACKETTSTOWN COMMUNITY HOSPITAL INCYes (1)
MEDICAL CENTER PARTNERS INC
651 WILLOW GROVE STREETHACKETTSTOWNNJ07840454789273PHYSICIAN SERVICESNJ501(C)(3)LINE 11A, IHACKETTSTOWN COMMUNITY HOSPITAL INCYes (1)
MID-ATLANTIC ADVENTIST HEALTHCARE CORPORATION
820 W DIAMOND AVE SUITE 600GAITHERSBURGMD208781419521884153HOLDING COMPANYMD501(C)(3)LINE 90N/A
ADVENTIST BEHAVIORAL HEALTH FOUNDATION INC
820 W DIAMOND AVE SUITE 600GAITHERSBURGMD208781419205479860FUNDRAISINGMD501(C)(3)LINE 11A, IADVENTIST HEALTHCARE INC0
REGINALD S LOURIE CENTER FOR INFANTS AND YOUNG CHILDREN
820 W DIAMOND AVE SUITE 600GAITHERSBURGMD208781419521255870BEHAVIORAL CAREMD501(C)(3)LINE 9ADVENTIST HEALTHCARE INC0
SHADY GROVE ADVENTIST HOSPITAL FOUNDATION INC
820 W DIAMOND AVE SUITE 600GAITHERSBURGMD208781419521216429FUNDRAISINGMD501(C)(3)LINE 11A, I0N/A
WASHINGTON ADVENTIST HOSPITAL FOUNDATION INC
820 W DIAMOND AVE SUITE 600GAITHERSBURGMD208781419521692158FUNDRAISINGMD501(C)(3)LINE 11A, IADVENTIST HEALTHCARE INC0
WASHINGTON ADVENTIST FITNESS CENTER
820 W DIAMOND AVE SUITE 600GAITHERSBURGMD208781419274758462WELLNESSMD501(C)(3)LINE 9ADVENTIST HEALTHCARE INC0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
PREMIER MEDICAL NETWORK INC
820 W DIAMOND AVE SUITE 600GAITHERSBURGMD208781419521952469JOINT PHYSICIAN CONTMDADVENTIST HEALTHCARE INCC0
CLARKSBURG COMMUNITY HOSPITAL INC
820 W DIAMOND AVE SUITE 600GAITHERSBURGMD208781419272330124HOLDS PROPERTY FOR FUTURE NON-PROFIT HOSPITALMDADVENTIST HEALTHCARE INCC0
WASHINGTON ADVENTIST HOSPITAL INC
820 W DIAMOND AVE SUITE 600GAITHERSBURGMD208781419272330170HOLDS PROPERTY FOR FUTURE NON-PROFIT HOSPITALMDADVENTIST HEALTHCARE INCC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (8 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
HACKETTSTOWN COMMUNITY HOSPITAL FOUNDATION
B$400,000COST
HACKETTSTOWN COMMUNITY HOSPITAL FOUNDATION
B$15,350COST
HACKETTSTOWN COMMUNITY HOSPITAL FOUNDATION
C$259,565COST
HRMC EMERGENCY MEDICAL SERVICES
L$58,348COST
MEDICAL CENTER PARTNERS INC
L$35,824COST
ADVENTIST HEALTHCARE INC
M$2,324,773COST
ADVENTIST HEALTHCARE INC
P$5,083,842COST
ADVENTIST HEALTHCARE INC
Q$1,527,200COST

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