2016-11-11T13:27:02-06:00 2015-12-31 346565596 Ernst & Young US LLP 100 North Tryon Street - Suite 3800 Charlotte NC 28202 990 2015-01-01 223392808 Foundation for Morristown Medical Center FOUN 9735932400 475 South Street Morristown NJ 07960 Kevin Lenahan SVP-CFO & Admin Officer 9735932400 2016-11-11 0 P00032493 7043726300 2015 2017-02-10 21:41:12Z Kevin Lenahan 475 South Street Morristown NJ 07960 23030250 0 X www.f4mmc.org X 501c3 1995 NJ The Foundation for Morristown Medical Center is a not-for-profit fundraising organization which solicits funds in its general appeal to support both Morristown Medical Center, which is a division of AHS Hospital Corporation, and the community as the Foundation's Board may deem appropriate. 29 25 0 235 -2359 -2359 23947581 16601986 0 0 6828185 4335317 -14262 -25743 30761504 20911560 7495485 7400140 0 0 1918028 2132721 238332 204493 2457970 260257 294718 9912102 10032072 20849402 10879488 131435202 128114195 4013254 3980082 127421948 124134113 X To inspire community philanthropy to advance exceptional health care for patients at Morristown Medical Center. The objective is to use philanthropy to preserve and expand the Medical Center's programs and services in patient care, clinical research, medical and public health education, and preventive medicine. 0 0 7400140 7400140 This return consists of a standalone Foundation which is a not-for-profit fundraising organization which solicits funds in its general appeal for the benefit and support of Atlantic Health System, Inc. and AHS Hospital Corp, all subsidiaries thereof, with the principal beneficiary of the Corporation to be Morristown Medical Center. 7400140 1 1 0 0 0 0 0 0 0 1 0 1 0 0 1 0 1 1 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 1 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 X 29 25 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NJ NY PA FL X X Ken Butkowski 9734512005 100 Madison Avenue - Box 920 Morristown NJ 07960 Christopher J Baldwin Trustee, Chairman 2.00 X 0 0 0 William D Bruen Jr Trustee 2.00 X 0 0 0 Peter J Cocoziello Trustee 2.00 X 0 0 0 William Conger Trustee 2.00 X 0 0 0 Mary VI Courtemanche Trustee 2.00 X 0 0 0 Richard P Diegnan Trustee 2.00 X 0 0 0 Shari Bunks Geller Trustee 2.00 X 0 0 0 Carl J Goldberg Trustee 2.00 X 0 0 0 Veronica M Goldberg Trustee 2.00 X 0 0 0 Richard P Goryeb Trustee 2.00 X 0 0 0 Joseph C Graff Trustee, Treasurer 2.00 X 0 0 0 Cathy Herbst Trustee 2.00 X 0 0 0 William D Ju MD Trustee 2.00 X 0 0 0 Ernest Larini Trustee 2.00 X 0 0 0 Eric L Lazar MD Trustee 2.00 55.00 X 0 599350 32125 Anthony A Lombardo Trustee 2.00 X 0 0 0 Derek T Malmberg Trustee 2.00 X 0 0 0 Damion A Martins MD Trustee 2.00 55.00 X 0 800007 140925 Trish O'Keefe Trustee 2.00 55.00 X 0 479620 219418 Daniel Pyo MD FACS FCCWS Trustee 2.00 X 0 2900 0 Leslie C Quick III Trustee 2.00 X 0 0 0 Marc E Robinson Trustee 2.00 X 0 0 0 Gil Santaliz Trustee 2.00 X 0 0 0 Blake Silverman Trustee 2.00 X 0 0 0 Paul L Sturman Trustee 2.00 X 0 0 0 Guy Taylor MD Trustee 2.00 X 0 0 0 Karen R Walsh Trustee, Secretary 2.00 X 0 0 0 Finn Wentworth Trustee, Vice Chairman 2.00 X 0 0 0 Mark D Widmann MD Trustee 2.00 X 0 908779 13575 John Gerson Trustee-Term 12/31/15 2.00 X 0 0 0 Steve Maser Trustee-Term 12/31/15 2.00 X 0 0 0 Karen Knops Trustee-Term 12/31/15 2.00 55.00 X 0 225705 10430 Edward Deutsch Trustee-Term 12/31/15 2.00 X 0 0 0 Stanley Fiel Trustee-Term 12/31/15 2.00 55.00 X 0 690591 141016 Francine Shaw Trustee-Term 12/31/15 2.00 X 0 0 0 James F Quinn Chief Development Officer 55.00 X 0 441928 120511 Cynthia W O'Donnell Director of Gift Planning 55.00 X 0 175028 30501 Kevin Lenahan SVP-CFO and Admin Officer 2.00 55.00 X 0 1059098 409450 Hyona Revere Director of Major Gifts 55.00 X 0 173821 30743 Christine Hajsok Director of Finance 55.00 X 0 168383 32338 Regina Diverio Director - Communications 55.00 X 0 143778 21278 Bonnie Gannon Director - Relations 55.00 X 0 133708 26872 Susan Johns Major Gifts 55.00 X 0 128943 23755 0 6131639 1252937 0 0 1 0 0 78427 16523559 73294 16601986 3917716 -2359 3920075 2500000 2082399 417601 417601 417601 10548 78427 36291 -25743 -25743 20911560 0 -2359 4311933 6791237 6791237 608903 608903 1776181 1776181 356540 356540 14350 14350 204493 204493 74926 74926 45830 45830 94558 94558 47995 47995 17059 17059 10032072 7400140 173962 2457970 15605470 10507348 55897703 60502122 45564327 43055961 11512260 11279888 2855442 2768876 131435202 128114195 1900489 1994824 2112765 1985258 4013254 3980082 X 30880665 27980620 61869038 60902073 34672245 35251420 127421948 124134113 131435202 128114195 X 10879488 -5939980 -8227343 X 0 1 X 1 0 X 14766658 20441711 15053302 23933319 16576243 90771233 14766658 20441711 15053302 23933319 16576243 90771233 5779370 84991863 1511954 2140604 2663112 2541677 3917716 12775063 103546296 0.82080 0.85700 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 96541283 15868737 -907015 15349512 96153493 86141983 22846715 2130928 14578343 96541283 74295119 12998553 6690255 7841944 86141983 60179353 18844913 4371231 9100378 74295119 60633886 12989768 148154 13592455 60179353 0.63000 0.37000 0 0 0 11279888 C 11279888 Annuities Payable 1985258 1985258 20911560 0 20911560 0 20911560 10032072 0 10032072 0 10032072 Part V, Line 4: The Foundation for Morristown Medical Center(the "Foundation")is a not-for-profit fundraising organization which solicits funds in its general appeal to support both Morristown Medical Center, which is a divison of AHS Hospital Corporation, and the community as the Foundation's Board may deem appropriate. The by-laws of the Foundation were amended on September 27, 2007, to provide that funds received by the Foundation after the date of the amendment may be used for the benefit of the Overlook Division of AHS Hospital Corporation upon approval of the Executive Committee of the Board of the Foundation. X X X X X X 1 Jay Angeletti Group 17 Village Road New Vernon NJ 07976 Consulting and Fundraising 0 8144027 5000 8139027 Harris Connect 1511 Route 22 Suite C-25 Brewster NY 10509 Direct Mail/Internet/Phone 0 288908 83518 205390 Telecomp 3375 Brighton Henriettta Townline R Rochester NY 14623 Mail/Phone 0 69816 115975 -46159 8502751 204493 8298258 NJ NY PA FL DE Caniofacial Gala 34681 29063 5618 4820 13051 2864 Kids 4 Kids Race 18081 18081 2416 592 192 4221 3 36213 31283 4930 227 6050 16 837 1005 88975 78427 10548 7463 19693 208 837 8090 36291 -25743 NJ 1 0 0 0 0 0 1 Morristown Medical Center 100 Madison Avenue Morristown NJ 07960 521958352 501(c)(3) 6791237 0 Program Services. 1 Project Independence 89 588000 0 Women's Association Scholarship Fund 6 20903 0 Part I, Line 2: The organization uses due diligence in the process for reviewing and selecting grant recipients and is comfortable that the grants are used for their intended purpose. The grants issued were made to related organizations to further their exempt purpose. Schedule I, Part III, Line 1 Project Independence is a grant funding project to help Morristown Medical Center patients over a temporary financial hardship. It is overseen by a volunteer committee made up of care providers from different areas of the Medical Center. They meet every two months to review detailed applications. An application can only be submitted by a case worker who would be aware of the financial position of the patient and is working with them to secure other types of help including prescription assistance, food stamps, Social Security disability, etc. Most of the recommenders are social workers or patient liaisons. Grants up to $7,500 are made payable directly to the individual. Schedule I, Part III, Line 2 WAMMC has a long history of supporting quality nursing at Morristown Medical Center. Early on, the Association helped staff the hospital with nurses, and assisted with their housing and uniforms. In 1957, this interest evolved into a formal Scholarship Program, funded entirely by private donations. At that time, one scholarship of $500 would pay tuition costs for the entire three-year program. As tuition costs rose and recipient financial needs increased, generous donations made annually by WAMMC members, continued to underwrite the program. However, the early 1990s brought an economic downturn, which slowed the brisk pace of donations to the Scholarship Program, and necessitated a new approach to ensure the program's future. Since its inception, the Scholarship Program has supported the professional staff at Morristown Medical Center by granting scholarships to high school graduates, and qualified hospital employees pursuing careers in the health care field. A Scholarship Trust Fund was established in 1995, with all scholarship contributions directly benefiting the fund. Presently, the Scholarship Committee spends only the interest generated annually by the fund. In this way, the invested principal remains intact, securing both the fund's future and the Scholarship Program's mission. WAMMC largely attributes the steady growth of this program to the hard work of successful fundraising and the generous donations of WAMMC members. In 2015, over $20k was awarded to 6 scholars with award varying in amounts. Scholarship candidates typically possess high-ranking employee evaluations and are often described as, "Among the best in the department." The candidates are often leaders in their field as members of honorary societies, as hospital committee chairs, or as participants in department studies. It is not unusual for our scholars to be as actively engaged in their local community, as they are in the workplace. 0 0 0 0 0 0 0 0 0 Eric L Lazar MD Trustee 0 541121 0 0 0 58229 0 18550 0 13575 0 631475 0 0 Damion A Martins MD Trustee 0 594611 0 204976 0 420 0 127350 0 13575 0 940932 0 97100 Trish O'Keefe Trustee 0 368414 0 60400 0 50806 0 207952 0 11466 0 699038 0 60400 Mark D Widmann MD Trustee 0 907813 0 0 0 966 0 0 0 13575 0 922354 0 0 Karen Knops Trustee-Term 12/31/15 0 211136 0 3140 0 11429 0 0 0 10430 0 236135 0 0 Stanley Fiel Trustee-Term 12/31/15 0 584595 0 91700 0 14296 0 129550 0 11466 0 831607 0 91700 James F Quinn Chief Development Officer 0 273892 0 49000 0 119036 0 106936 0 13575 0 562439 0 49000 Cynthia W O'Donnell Director of Gift Planning 0 166728 0 6100 0 2200 0 19035 0 11466 0 205529 0 6100 Kevin Lenahan SVP-CFO and Admin Officer 0 783021 0 247300 0 28777 0 395875 0 13575 0 1468548 0 0 Hyona Revere Director of Major Gifts 0 167615 0 5700 0 506 0 17241 0 13502 0 204564 0 5700 Christine Hajsok Director of Finance 0 162190 0 5700 0 493 0 18763 0 13575 0 200721 0 5700 Regina Diverio Director - Communications 0 138079 0 5100 0 599 0 14114 0 7164 0 165056 0 5100 Bonnie Gannon Director - Relations 0 127766 0 4300 0 1642 0 14540 0 12332 0 160580 0 4300 Susan Johns Major Gifts 0 122079 0 4200 0 2664 0 16151 0 7604 0 152698 0 4200 Part I, Line 6 An annual incentive plan exists for the Foundation's Director. The incentive plan distributes bonuses to the Director based on performance results on various performance measurements. The performance measurements include: - Total Philanthropy - Cost per dollar raised - Budget - Soliciatations of $100K or more - General Gifts - Renewal - Mail & Phone - Special Gifts - Acquisition and Renewal - Major Gifts - Donor Renewal - Cost - Operating Gain/(Loss) - Cost - Expense per Adjusted Admission/CMIA System - Service - Patient Satisfaction Overall - Growth - IP Admissisions - Growth - OP Visits - People - Employee Engagement Index - Quality & Safety - Nosocomial Infection Maker - Quality & Safety - Mortality - Individual Goals The above performance measures have the following three specific performance goals in order to determine any incentive award: Threshold Target Maximum These above amounts were paid by a related organization. X 5312 Sale of comp property X 11001 Sale of comp property X 10 2068 Sale of comp property X Toys 181 43661 Sale of comp propert X Gift Cards 16 4855 Cash value of cards X Entertainment 3 3271 Cash value of gift X Electronics 8 3126 Sale of comp propert 0 1 0 Form 990, Part VI, Section A, line 6 As per the by-laws, each of the entities has one "member", that being Atlantic Health System, Inc. There are no other members or classes of membership whatsoever as indicated in the by-laws. Form 990, Part VI, Section A, line 6 Atlantic Health System, Inc. is the sole member of this organization. Atlantic Health System, Inc. has the right to elect the members of this organization's board of trustees and has certain reserved powers as dined in the organiztion's bylaws. Form 990, Part VI, Section A, line 7a Atlantic Health System, Inc. is the only "member" which wholly owns the Foundation for Morristown Medical Center. As a result, Atlantic Health System, Inc. may elect the members of the governing bodies for each of the entities. Form 990, Part VI, Section A, line 7b Atlantic Health System, Inc. is the only "member" which wholly owns the Foundation for Morristown Medical Center. As a result, Atlantic Health System, Inc. approves the decisions of the governing bodies. Form 990, Part VI, Section B, line 11 The final draft of the IRS 990 was distributed to the "Accounting Sub-Committee" for their review. The "Accounting Sub-Committee" then presents it to the Financial Oversight Committee who will then present it to the Board of Directors. Form 990, Part VI, Section B, line 12c In conjunction wtih Atlantic Health System (Parent), the Foundation for Morristown Medical Center requires disclosure of potential conflicts. This policy governs all personnel at the Foundation, including Board Members. Additionally, the Board Committee members must fill out annual disclosures with specific questions regarding potential conflicts. For potential conflicts involving employees, conflicts involving business relationships require prior disclosure and approval by the Compliance Officer (General Counsel). Conflicts involving Board members require approval from the Compliance Officer and the head of the Audit Committee, who may refer those conflicts to the Compliance Committee of the Board. Restrictions are fact-dependent, but may include recusal from deliberations regarding subject matter affected by the conflict. Form 990, Part VI, Section B, line 15 In conjunction with Atlantic Health System (Parent): Line 15A: A review of officer compensation by an independent 3rd party (Mercer) is completed every year. The most recent survey was conducted in 2015. Officers include President and CEO AHS; SVP Chief Financial & Administrative Officer; VP Legal Affairs & General Counsel; SVP Quality & Chief Medical & Academic Officer, AHS; VP Government Affairs; Chief Information Officer; VP AHS & President OMS; VP AHS & President MMC; VP AHS & President CMC; VP AHS & President NMC; SVP, System & Network Planning & Business Development; SVP, Physician Enterprise & President, AMG; VP, President ACO; VP, Clinical Intelligence; VP, Marketing & Communications; VP, Compliance & Audit. On behalf of Atlantic Health, Mercer conducts an annual total compensation survey based on appropriate comparability data for like positions in like organizations. The results of the survey are presented to the Executive Compensation Committee of the board which documents the findings and recommendations in committee minutes. Line 15B: Compensation for key physicians is determined by soliciting salary data from 3 to 4 published sources. These salary recommendations are then reviewed with the MD Contract Committee and approved by the Physician Compensation Committee of the board. Form 990, Part VI, Section C, line 18 Currently the Foundation for Morristown Medical Center retains copies of the filed IRS 990 for the last three years and IRS Form 1023 with the most senior management's assistant. Public disclosure of these IRS 990's can be made at any time at each of the organization's sites. In addition, the 990 is posted on the website "www.foundationcenter.org and "guidestar.org". Form 990, Part VI, Section C, line 19 The organization does not currently make its financial statements open to public disclosure but the statement of financial position is available by accessing the Form 990 from the website. The governing documents and conflict of interest polices are not currently made available to the public. Form 990, Part XI, line 9: Distributions to Morristown Division-Capital -8,001,372. Beneficial Interest in Charitable Remainder Unitrust -225,971. AHS Hospital Corp 475 South Street Morristown NJ 07960 521958352 Healthcare NJ 501(c)(3) Line 3 Atlantic Health System Inc 1 Atlantic Ambulance Corporation 475 South Street Morristown NJ 07960 223820288 Healthcare Transportation NJ 501(c)(3) Line 9 Atlantic Health System Inc 1 Atlantic Health System Inc 475 South Street Morristown NJ 07960 223380375 Human Health through AHS Hospital Corp. NJ 501(c)(3) Line 11a, I N/A 0 Newton Medical Center Foundation 175 High Street Newton NJ 07860 222618102 Administers donations, grants and bequests and performs fundraising NJ 501(c)(3) Line 7 Atlantic Health System Inc 1 Prime Care Inc 175 High Street Newton NJ 07860 222759566 Provides home health and other healthcare services NJ 501(c)(3) Line 9 Atlantic Health System Inc 1 North Jersey Health Care Properties Inc 175 High Street Newton NJ 07860 223519709 Owns commercial buildings and conducts leasing activities NJ 501(c)(2) Atlantic Health System Inc 1 PRACTICE ASSOCIATES MEDICAL GROUP 475 South Street Morristown NJ 07960 202088165 PHYSICIAN SERVICES NJ 501(c)(3) Line 11a, I Atlantic Health System Inc 1 Chilton Memorial Corporation 97 West Parkway Pompton Plains NJ 07444 222719339 Support Chartiable Exempt Programs and Services of Medical Center NJ 501(c)(3) Line 7 Atlantic Health System Inc 1 Chilton Medical Center Auxiliary Inc 97 West Parkway Pompton Plains NJ 07444 222883605 Support Chartiable Exempt Programs and Services of Medical Center NJ 501(c)(3) Line 11a, I Atlantic Health System Inc 1 Chilton Medical Center FoundationInc 97 West Parkway Pompton Plains NJ 07444 223084817 Support Chartiable Exempt ProgramS and ServiceS of Medical Center NJ 501(c)(3) Line 7 Atlantic Health System Inc 1 Chilton Realty Holding Inc 97 West Parkway Pompton Plains NJ 07444 223067739 Real Estate and Leasing Activities for the Benefit of Exempt Organization NJ 501(c)(2) Atlantic Health System Inc 1 Morris Photopheresis 100 Madison Avenue Morristown NJ 07960 223314012 Healthcare Research NJ 0 0 Affiliated Collection Services LLC 17 Prospect Street Morristown NJ 07960 270555659 Collection Services NJ 0 0 Morristown Medical Investors 200 American Road Morris Plains NJ 07950 650840535 Real Estate NJ 0 0 Primary Care Partners LLC 475 South Street Morristown NJ 07960 274980253 Physician Services NJ 0 0 Atlantic Health Management Corp and Subsidiaries 200 American Road Morris Plains NJ 07950 223538027 Health NJ N/A C 0 AHS Insurance Company LTD 200 American Road Morris Plains NJ 07950 223380375 Insurance NJ N/A C 0 Nutley Medical Care PA 100 Madison Avenue Morristown NJ 07960 223645010 Healthcare NJ N/A C 0 Non-Invasive Diagnstics PA 100 Madison Avenue Morristown NJ 07960 202027439 Healthcare NJ N/A C 0 Specialty Care of Practice Associates PA 100 Madison Avenue Morristown NJ 07960 030376428 Healthcare NJ N/A C 0 Maternal Fetal Medicine of PRactice Associates PA 100 Madison Avenue Morritown NJ 07960 030376421 Healthcare NJ N/A C 0 Madison Pediatrics PA 100 Madison Avenue Morristown NJ 07960 223645007 Healthcare NJ N/A C 0 AHS ACO LLC 475 South Street Morristown NJ 07960 273800813 Physician Practice NJ N/A C 0 The Northwest New Jersey MedicalSurgical Alliance PC 175 High Street Newton NJ 07860 450577942 Healthcare Services NJ N/A C 0 The Northwest New Jersey Urgent Care Alliance PC 175 High Street Newton NJ 07860 830492357 Healthcare Services NJ N/A C 0 Chilton Community Care Inc and Subs 97 West Parkway Pompton Plains NJ 07444 222869148 Healthcare NJ N/A C 0 Chilton Medical Group PC 97 West Parkway Pompton Plains NJ 07444 383769436 Healthcare NJ N/A C 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 AHS Hospital Corp P 21400408 Actual amount of transaction. AHS Hospital Corp Q 17981440 Actual amount of transaction. AHS Hospital Corp B 8001372 Actual amount of transaction. AHS Hospital Corp P 334031 Actual amount of transaction. AHS Hospital Corp Q 457873 Actual amount of transaction.