2015-11-16T10:20:43-06:00 2014-12-31 WithumSmithBrown PC 465 South St Ste 200 Morristown NJ 079606497 990 2014-01-01 221487322 HOLY NAME MEDICAL CENTER % RYAN KENNEDY CPA HOLY 2018337016 718 TEANECK ROAD TEANECK NJ 07666 RYAN KENNEDY CPA CFO 9738989494 2015-11-09 true Scott J Mariani P00642486 9738989494 2014 2016-02-25 16:41:14Z MICHAEL MARON 718 TEANECK ROAD TEANECK NJ 07666 329673414 false X WWW.HOLYNAME.ORG X 1958 NJ TO PROVIDE QUALITY MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN THE COMMUNITY REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. 21 19 2362 720 0 1138611 574625 300095758 314241680 8591050 2144762 3313150 3486361 313138569 320447428 182588 101542 0 0 154034098 161039825 0 0 0 130967577 137571186 285184263 298712553 27954306 21734875 324392964 333952585 181313932 183402268 143079032 150550317 X HOLY NAME MEDICAL CENTER IS A COMMUNITY OF CAREGIVERS COMMITTED TO A MINISTRY OF HEALING, EMBRACING THE TRADITION OF CATHOLIC PRINCIPLES, THE PURSUIT OF PROFESSIONAL EXCELLENCE, AND CONSCIENTIOUS STEWARDSHIP. THE MEDICAL CENTER HELPS THE COMMUNITY ACHIEVE THE HIGHEST ATTAINABLE LEVEL OF HEALTH THROUGH EDUCATION, PREVENTION AND TREATMENT. false false 137864433 0 139669103 EXPENSES INCURRED IN PROVIDING MEDICALLY NECESSARY INPATIENT SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. PLEASE REFER TO THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT INCLUDED IN SCHEDULE O. 117443710 0 146514299 EXPENSES INCURRED IN PROVIDING MEDICALLY NECESSARY OUTPATIENT SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. PLEASE REFER TO THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT INCLUDED IN SCHEDULE O. 13441766 0 22644265 EXPENSES INCURRED IN PROVIDING MEDICALLY NECESSARY EMERGENCY DEPARTMENT SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. PLEASE REFER TO THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT INCLUDED IN SCHEDULE O. 101542 101542 5414013 268851451 true true false true false false false false false true true false true true true false false true false false true false false false false false true true true true true true false true false false false false false false false false false false false false true true true true false false true 145 0 true 2362 true false false false false false false false false false false X 21 19 false false false false true true true true true false false true true true true true true true true true true X RYAN KENNEDY CPA 2018337016 718 TEANECK ROAD TEANECK NJ 07666 X ROBERT BRITZ CHAIRMAN - TRUSTEE 1.0 0.0 X X 0 0 0 JOHN GERAGHTY VICE-CHAIRMAN - TRUSTEE 1.0 0.0 X X 0 0 0 SISTER BARBARA MORAN CJSP SECRETARY - TRUSTEE 1.0 0.0 X X 0 0 0 EDWIN H RUZINSKY CPA TREASURER - TRUSTEE 1.0 0.0 X X 0 0 0 ARNOLD BALSAM TRUSTEE 1.0 0.0 X 0 0 0 DAVID BUTLER MD TRUSTEE 1.0 0.0 X 0 0 0 FRANK BRUNETTI ESQ TRUSTEE 1.0 0.0 X 0 0 0 TED A CARNEVALE CPA TRUSTEE 1.0 0.0 X 0 0 0 DALE A CREAMER TRUSTEE 1.0 0.0 X 0 0 0 JOSEPH FRASCINO MD TRUSTEE 1.0 0.0 X 0 0 0 SISTER ANNE HAYES CSJP TRUSTEE 1.0 0.0 X 0 0 0 DAVID E LANDERS MD TRUSTEE 1.0 0.0 X 0 0 0 SALVATORE LARAIA MD TRUSTEE 1.0 0.0 X 0 0 0 DANIEL LEBER TRUSTEE 1.0 0.0 X 0 0 0 MICHAEL MARON TRUSTEE- PRESIDENT/CEO 55.0 0.0 X X 1680872 0 496915 SISTER ANTOINETTE MOORE CSJP TRUSTEE 1.0 0.0 X 0 0 0 JOSEPH PARISI JR TRUSTEE 1.0 0.0 X 0 0 0 SISTER ANN RUTAN CJSP TRUSTEE 1.0 0.0 X 0 0 0 SISTER ANN TAYLOR CJSP TRUSTEE 1.0 0.0 X 0 0 0 LEON TEMIZ TRUSTEE 1.0 0.0 X 0 0 0 RONALD WHITE MD TRUST-PRESIDENT, MEDICAL STAFF 55.0 0.0 X X 0 0 0 JOSEPH M LEMAIRE TERM 627 TRUSTEE - ASST SEC/ASST TREAS 55.0 0.0 X X 722025 0 24927 RYAN KENNEDY CPA VP; CHIEF FINANCIAL OFFICER 55.0 0.0 X 382331 0 21295 ADAM JARRETT MD CHIEF MEDICAL OFFICER 55.0 0.0 X 700302 0 142171 SHERYL SLONIM SENIOR VP; PATIENT CARE SVCS 55.0 0.0 X 580539 0 207325 MICHAEL SKVARENINAEFF 62214 CHIEF INFORMATIONAL OFFICER 55.0 0.0 X 279803 0 26213 JOHN GRANGEIA TERM 12714 VP; PROFESSIONAL SERVICES 55.0 0.0 X 272829 0 11692 STEVEN MOSSER VP; FACILITIES 55.0 0.0 X 269031 0 31591 CYNTHIA KAUFHOLD VP; REVENUE CYCLE MANAGEMENT 55.0 0.0 X 235271 0 36841 MARYANN KICENUIK EFF 71414 VP; LEGAL SERVICES 55.0 0.0 X 225237 0 13787 RICHARD VAN EERDE EFF 62214 VP; FINANCE 55.0 0.0 X 191013 0 16166 APRIL RODGERS VP; HUMAN RESOURCES 55.0 0.0 X 168220 0 26003 SHARAD WAGLE MD MEDICAL DIRECTOR 55.0 0.0 X 357505 0 24831 RAVIT BARKAMA EXEC DIR CLINICAL RESEARCH 55.0 0.0 X 348217 0 34691 KYUNG-HEE CHOI VP; KOREAN MEDICAL PROGRAM 55.0 0.0 X 241200 0 8693 ALLAN J CAGGIANO PHYSICIST 55.0 0.0 X 228969 0 31048 DEBORAH ZAYAS VP; NURSING SERVICES 55.0 0.0 X 225844 0 15477 7109208 0 1169666 239 false true false ALOYSIUS BUTLER CLARK PO BOX 672 WILMINGTON DE 198990672 ADVERTISING 2951466 CLAUDIO BOZZO SON INC 503 FARLEY ROAD WHITEHOUSE STATION NJ 08889 CONSTRUCTION 2836791 MAYO COLLABORATIVE SERVICES INC PO BOX 9146 MINNEAPOLIS MN 554809146 LABORATORY 1265979 GE MEDICAL SYSTEMS INFORMATION TECH 15724 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 MAINTENANCE/SERVICE 1215864 TRIMEDX INC PO BOX 636129 CINCINNATI OH 452636129 MAINTENANCE/SERVICE 917173 96 X 122978 451647 574625 NET PATIENT SERVICE REVENUE 541900 308849124 308849124 OTHER HEALTHCARE RELATED REVENUE 541900 3192446 3192446 SCHOOL OF NURSING 900099 2200110 2200110 314241680 574445 574445 828410 828410 0 1062878 798688 264190 0 264190 264190 9158105 11100 8423280 4018 734825 7082 741907 741907 0 0 0 CAFETERIA 900099 1924742 1924742 DAY CARE 624410 952894 952894 TELEVISION & TELEPHONE 517000 344535 344535 3222171 320447428 314241680 5631123 31317 31317 70225 70225 0 0 6798399 6118559 679840 0 127711600 114940440 12771160 2499564 2249608 249956 9606403 8645762 960641 14423859 12981473 1442386 25000 22500 2500 821512 739361 82151 239412 215471 23941 88441 79597 8844 0 197623 177861 19762 3434590 3091131 343459 5038981 4535083 503898 18640432 16776389 1864043 33187 29868 3319 0 4486131 4037518 448613 444882 400394 44488 0 249646 224681 24965 5373579 4836221 537358 0 16705973 15035376 1670597 1911557 1720401 191156 MEDICAL SUPPLIES 49657066 44691359 4965707 0 PURCHASED SERVICES 9639588 8675629 963959 REPAIRS 7742366 6968129 774237 PHYSICIAN FEES 7518434 6766591 751843 5322786 4790507 532279 298712553 268851451 29861102 0 297269 536118 30365167 26181496 0 0 31182657 33942669 0 0 0 0 0 0 4819713 5746602 3850373 3429980 373569247 236080411 136198277 137488836 0 0 0 0 87076130 92086480 0 0 30603378 34540404 324392964 333952585 39925933 42745685 0 0 311804 252356 113663777 110626868 0 0 0 0 3173593 6919129 0 0 24238825 22858230 181313932 183402268 X 132139565 137222578 9929467 13317739 1010000 10000 143079032 150550317 324392964 333952585 X 21734875 974503 -15238093 X X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false false true 60000 false true 28441 88441 false SCHEDULE C, PART II-B; LINES 1G AND 1I DURING 2014, HOLY NAME MEDICAL CENTER PAID AN OUTSIDE INDEPENDENT LOBBYING FIRM $60,000 FOR LOBBYING ON A FEDERAL AND STATE LEVEL RELATED TO MEDICARE, MEDICAID AND OTHER HEALTHCARE LEGISLATIVE MATTERS. THE ORGANIZATION HAS ALLOCATED TOWARD LOBBYING ACTIVITY A PERCENTAGE OF TOTAL 2014 COMPENSATION PAID TO THE VICE PRESIDENT OF PLANNING AND GOVERNMENT AFFAIRS TO REPRESENT TIME SPENT ADDRESSING FEDERAL AND STATE HEALTHCARE MATTERS. THIS ALLOCATION AMOUNTED TO $13,110. THE ORGANIZATION IS A MEMBER OF THE NEW JERSEY HOSPITAL ASSOCIATION WHICH ENGAGES IN LOBBYING EFFORTS ON BEHALF OF ITS MEMBER HOSPITALS. A PORTION OF THE DUES PAID TO THIS ORGANIZATION HAS BEEN ALLOCATED TO LOBBYING ACTIVITIES PERFORMED ON BEHALF OF THE ORGANIZATION. THIS ALLOCATION AMOUNTED TO $15,331. 10939467 4169163 89883 1870774 13327739 9434352 2874632 233966 1603483 10939467 7897777 3782260 193148 2438833 9434352 8479363 442431 -46614 977403 7897777 12058693 501730 193750 4274810 8479363 0.00075 0.99925 false false 3471294 3471294 192027964 99043830 92984134 173545216 134792373 38752843 4524773 2244208 2280565 137488836 GOVERNMENT SECURITIES 49104627 F MORGAN STANLEY SWEEP ACCOUNT 6162528 F TD WEALTH MGMT US GOVT 1093829 F NORTH JERSEY COMMUNITY BANK 0 F DEPOSIT 894762 F GEM REALTY SECURITIES, LTD 1997845 F MS CAPITAL PARTNERS V 1481451 F CARLSON CAPITAL DOUBLE BLACK F CERBERUS INTERNATIONAL, LTD 417310 F YORK CREDIT OPPORTUNITIES FUND F BREVAN HOWARD FUND LTD CLASS B F INTEREST IN FOUNDATION 3770456 F CASH & CASH EQUIVALENTS 17157130 F QUALCARE ALLIANCE NETWORKS INC 441806 F ACCRUED INTEREST 280370 F CERTIFICATES OF DEPOSIT 2117371 F EQUITY SECURITIES 7083813 F TACONIC OPPORTUNITIES UNIT TR. F MS OPPORTUNISTIC MORTGAGE INC. 83182 F 92086480 DUE FROM AFFILIATES 19373324 DEFERRED FINANCING COSTS 1487961 OTHER RECEIVABLES 8494552 OTHER ASSETS 5184567 34540404 0 DUE TO THIRD-PARTY PAYORS 392113 OTHER LIABILITIES 5175838 ASSET RETIREMENT OBLIGATION 103538 DUE TO AFFILLIATES 17186741 22858230 X SCHEDULE D, PART V; QUESTION 4 ENDOWMENT FUNDS ARE TO BE USED CONSISTENT WITH INTENT AND IN FURTHERANCE OF THE ORGANIZATION'S CHARITABLE TAX-EXEMPT PURPOSES. 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X X X X X true true X X X X true X X X X X true X false X X X X true X false false Schedule h, part v; section b, question 3j Detailed data tables (vs. Simple descriptions) are included in the chna to enhance understanding. Schedule h, part v, section b, question 5 Over 80 interviews were conducted including primary care providers; behavioral health providers; elder services provider; social services; hospital clinical providers and administrative staff; public health officials; public housing staff; advocacy organizations; faith-based organizations and public officials. Schedule h, part v, section b, questions 6a & 6b Hackensack university medical center, englewood hospital and medical center, the valley hospital and christian health care center collaborated on a county-wide chna. Holy name created an accompanying chna addressing its specific service areas. The community health improvement partnership ("chip") of bergen county was also a partnering organization in the creation of the chna. Schedule h, part v, section b, question 7d The chna was also discussed at the annual open public meeting of the bergen county community health improvement plan, and made available at the medical center's annual open public meeting. Schedule h, part v, section b, question 11 Both the bergen county chna and the medical center's chna identified five significant areas of need: obesity, chronic disease, elder health, access to care, and mental health and substance abuse. The last area, mental health and substance abuse, is not a specialty of the medical center; although a 23-bed acute care psychiatric unit is available, ambulatory services are not. Consequently, efforts to address excessive drinking, drug use and gambling issues are led by other community organizations and supported by the medical center through education, participation in county task forces, coordination efforts, screening, referral and other support. Obesity, deemed an "umbrella" condition that increases the risk of numerous diseases, is being addressed via community education, lectures, programs, classes and screening. Hnmc also participates with the county "chip" in its behavior change and self-management programs. Chronic disease encompasses a wide range of conditions, e.g., cardiac disease, cancer, chronic respiratory conditions and diabetes. Efforts have focused on prevention, education and chronic disease self-management. Diabetes, which may be categorized under both obesity and chronic disease, was the focus of a coordinated regional shared screening and referral event in conjunction with other county hospitals. Fully redesigned end-of-life offerings address the issues contributing to health quality and longevity that invariably accompany later stage chronic diseases. Various care screenings and referrals, programs, education, support and other types of intervention have been strengthened to address this too-often overlooked, yet crucial aspect. Bergen county is the third oldest county in new jersey and has the greatest absolute number of elderly. Education, screenings, follow-up, coordination with community groups, senior centers, re-education and expansion of home care staff have been employed. This category overlaps with chronic disease initiatives and, again, we note the use of end-of-life offerings to foster wellness and quality of life. Although present in bergen county, access to care is more pronounced in hudson county. Socioeconomic factors such as language barriers and lack of transportation greatly increase the risk of lack of both preventive care and care for existing conditions, resulting in overuse of ERs and less optimal outcomes. An expanded system of free transportation has been implemented for persons unable to obtain transportation; and a network of bilingual physician practices that will accept low-pay, Medicaid and free care has been increased in the target area. A multi-specialty volunteer physician practice in bergen county that provides free care to persons in financial need is also supported by the medical center via free clinical services and financial support. Perhaps the greatest access issue is lack of insurance, which has been addressed via the medical center's large-scale ACA enrollment activities targeting both spanish-speaking and asian language-speaking persons. Schedule h, part v,section b,qs 13b,13h,15e,16i,18d,19d,20e,21c,21d,23&24 Not applicable. Schedule h, part v, section b, question 22d The facility uses 33% of gross charges to approximate the average charged managed care rate as the maximum amount that can be charged to fap-eligible individuals for emergency or other medically necessary care. 4 ORADELL REHAB 514 KINDERKAMACK ROAD ORADELL NJ 07649 OUTPATIENT CENTER VILLA MARIE CLAIRE 12 WEST SADDLE RIVER ROAD SADDLE RIVER NJ 07458 HOSPICE HNH FITNESS LLC 514 KINDERKAMACK ROAD ORADELL NJ 07649 MEDICALLY BASED FITNESS CENTER UNION CITY LAB 408 37TH STREET UNION CITY NJ 07087 OFF-SITE LAB SCHEDULE H, PART I; LINE 3C Income-based criteria used to determine eligibility are in accordance with the nj administrative code 10:52 sub-chapters 11, 12 and 13. Federal poverty guidelines are included in the criteria for determining eligibility for charity and discounted care. SCHEDULE H, PART I; LINE 6A Not applicable. SCHEDULE H, PART I, QUESTION 7 The organization's cost accounting system was utilized. SCHEDULE H, PART II Activities classified as community building include use of hnmc's facility and/or employees to support efforts that: promote the positive growth of the community; assist diverse groups in coming together for the community's short and long term benefit; and seek to protect the community from anything that could significantly affect the health and well-being of the community. Hnmc also assists other non-profits and provides various forms of non-monetary aid. In addition, employees are permitted to assist valid non-profit organizations during paid work time. Among the organizations so aided are nursing homes, boy scouts, houses of worship, community service groups, battered women's shelters, rotary clubs, police groups, environmental groups, schools, and nursing homes. Hnmc also allows the public to use various meeting rooms (in non-clinical areas) and its conference center for events. Career days are held for local high schools, fostering entrance of interested and applicable students into the health professions. Although hnmc's parking fees are minimal, free parking is extended to persons in need. Hnmc was one of nine hospitals in new jersey designated by the new jersey department of health ("njdoh") as a regional medical coordination center ("mcc"). The only facility in bergen county to be so designated, hnmc's on-campus mcc was able to be activated in the event of public health emergencies and/or a terrorist attack causing mass casualty incidents, infectious or communicable disease, or other types of public health disruption. The mcc also monitored, on a daily basis, situational awareness of local activity. In 2014, the njdoh lost much of its federal funding for the statewide program, cutting in half the number of mcc's it could support. Hnmc chose not to apply to renew its designation but has maintained most of its capabilities on its own. Given hnmc's proximity to new york city (i.e., five miles north of the george washington bridge), emergency preparedness is deemed necessary to ensure the health and well-being of the community, regardless of the mcc designation. Central to this commitment is a hnmc-funded vice president whose job function includes substantial involvement in preparedness both on-campus and in the community. Hnmc has long been recognized by state and federal sectors for its expertise in emergency preparedness and response. A frequent participant in local and new york city disaster drills, hnmc has participated in several large scale disaster drills, as well as drills conducted by the centers for disease control involving local, county, state, and federal agencies' emergency response to threats of public health significance. Hnmc maintains its designation by the federal division of global migration and quarantine to deal with possible communicable diseases and acts of bioterrorism occurring on public health conveyances. Hnmc is also active in the northern new jersey urban area security initiative. Members of holy name ems serve on the statewide nj ems task force. The medical center maintains a special operations team comprised of paramedics and emergency medical technicians who are ready to respond 24 hours a day, 7 days a week to assist local communities with emergencies. During 2014, hnmc prepared and taught courses in responding to an active shooter situation. Devised in conjunction with the police department of teaneck, nj, hnmc's video training was used during over 2,000 hours of training. SCHEDULE H, PART III, SECTION A; LINE 4 Bad debt expense was calculated using the providers' bad debt expense from its financial statements, net of accounts written off at charges. Hnmc and its affiliates prepare and issue audited consolidated financial statements. The attached texts were obtained from the footnotes to the audited financial statements of hnmc and subsidiaries. Patient accounts receivable and net patient service revenue Patient accounts receivable and net patient service revenue from third-party programs for which the company receives payment under various reimbursement formulae or negotiated rates are stated at the estimated net amounts realizable and receivable from such payers, which are generally less than the company's established billing rates. The amount of the allowance for doubtful accounts is based upon management's assessment of historical and expected net collections, business and economic conditions, trends in health care coverage and other collection indicators. Additions to the allowance for doubtful accounts result from the provision for bad debts. Accounts written off as uncollectible are deducted from the allowance for doubtful accounts. Net patient service revenue is reported at the estimated net realizable amounts from patients, third-party payers, and others for services rendered and includes retroactive revenue adjustments due to ongoing and future audits, reviews, and investigations. Charity care For patients that do not receive free care and who are deemed eligible for charity care, care given but not paid for is classified as charity care. Management believes that, because of the difficulties involved with obtaining patient cooperation, the present charity care guidelines understate the medical center's charity care amounts and overstate the level of bad debts reported. The cost of charity care is estimated by utilizing a cost accounting system, and includes the direct and indirect cost of providing charity care services. SCHEDULE H, PART III, SECTION B; LINE 8 Medicare costs were derived from the hospital's cost accounting system. Medicare underpayments and bad debt are considered to be community benefit and associated costs are includable on the form 990, schedule h, part i. The organization feels that medicare underpayments (shortfall) and bad debt are community benefit and associated costs are includable on the form 990, schedule h, part i. As outlined more fully below the organization believes that these services and related costs promote the health of the community as a whole and are rendered in conjunction with the organization's charitable tax-exempt purposes and mission in providing medically necessary health care services to all individuals in a non-discriminatory manner without regard to race, color, creed, sex, national origin, religion or ability to pay and consistent with the community benefit standard promulgated by the irs. The community benefit standard is the current standard for a hospital for recognition as a tax-exempt and charitable organization under internal revenue code ("irc") 501(c)(3). The medical center is recognized as a tax-exempt entity and charitable organization under 501(c)(3) of the irc. Although there is no definition in the tax code for the term "charitable," a regulation promulgated by the department of the treasury provides some guidance and states that "[t]he term charitable is used in section 501(c)(3) in its generally accepted legal sense," and provides examples of charitable purposes, including: the relief of the poor or unprivileged; the promotion of social welfare; and the advancement of education, religion, and science. Note it does not explicitly address the activities of hospitals. In the absence of explicit statutory or regulatory requirements applying the term "charitable" to hospitals, it has been left to the irs to determine the criteria hospitals must meet to qualify as irc 501(c)(3) charitable organizations. The original standard was known as the charity care standard. This standard was replaced by the irs with the community benefit standard which is the current standard. Charity care standard In 1956, the irs issued revenue ruling 56-185, which addressed the requirements hospitals needed to meet in order to qualify for irc 501(c)(3) status. One of these requirements is known as the "charity care standard." under the standard, a hospital had to provide, to the extent of its financial ability, free or reduced-cost care to patients unable to pay for it. A hospital that expected full payment did not, according to the ruling, provide charity care based on the fact that some patients ultimately failed to pay. The ruling emphasized that a low level of charity care did not necessarily mean that a hospital had failed to meet the requirement since that level could reflect its financial ability to provide such care. The ruling also noted that publicly supported community hospitals would normally qualify as charitable organizations because they serve the entire community, and a low level of charity care would not affect a hospital's exempt status if it was due to the surrounding community's lack of charitable demands. Community benefit standard In 1969, the irs issued revenue ruling 69-545, which "remove[d]" from revenue ruling 56-185 "the requirements relating to caring for patients without charge or at rates below cost." under the standard developed in revenue ruling 69-545, which is known as the "community benefit standard," hospitals are judged on whether they promote the health of a broad class of individuals in the community. The ruling involved a hospital that only admitted individuals who could pay for the services (by themselves, private insurance, or public programs such as medicare), but operated a full-time emergency room that was open to everyone. The irs ruled that the hospital qualified as a charitable organization because it promoted the health of people in its community. The irs reasoned that because the promotion of health was a charitable purpose according to the general law of charity, it fell within the "generally accepted legal sense" of the term "charitable," as required by treasury reg. 1.501(c)(3)-1(d)(2). The irs ruling stated that the promotion of health, like the relief of poverty and the advancement of education and religion, is one of the purposes in the general law of charity that is deemed beneficial to the community as a whole even though the class of beneficiaries eligible to receive a direct benefit from its activities does not include all members of the community, such as indigent members of the community, provided that the class is not so small that its relief is not of benefit to the community. The irs concluded that the hospital was "promoting the health of a class of persons that is broad enough to benefit the community" because its emergency room was open to all and it provided care to everyone who could pay, whether directly or through third-party reimbursement. Other characteristics of the hospital that the irs highlighted included the following: its surplus funds were used to improve patient care, expand hospital facilities, and advance medical training, education, and research; it was controlled by a board of trustees that consisted of independent civic leaders; and hospital medical staff privileges were available to all qualified physicians. Medicare underpayments and bad debt are community benefit and associated costs are includable on the form 990, schedule h, part i. The american hospital association ("aha") holds the position that medicare underpayments (or, "shortfalls") and bad debt are community benefit and thus includable on the form 990, schedule h, part i. The medical center agrees with the aha's position. As outlined in the aha letter to the irs dated august 21, 2007 with respect to the first published draft of the new form 990 and schedule h, the aha stated that the irs should incorporate the full value of the community benefit provided by hospitals by counting medicare underpayments (shortfall) as quantifiable community benefit for the following reasons: - the provision of care for the elderly and serving medicare patients is an essential part of the community benefit standard. - medicare, like medicaid, does not fund the full cost of care. Medicare's reimbursement to hospitals equates to only 92 cents for every dollar spent by the hospitals on care of medicare patients. The medicare payment advisory commission ("medpac") in its march 2007 report to congress cautioned that underpayment will worsen. - many medicare beneficiaries, like their medicaid counterparts, are poor. More than 46 percent of medicare spending is for beneficiaries whose income is below 200 percent of the federal poverty level. Many of those medicare beneficiaries are also eligible for medicaid, the so called "dual eligibles." There is a very compelling public policy reason to treat medicare and medicaid underpayments similarly for purposes of a hospital's community benefit and include these costs on form 990, schedule h, part i. Medicare underpayment must be shouldered by the hospital in order to continue treating the community's elderly and poor. These underpayments represent a real cost of serving the community and should count as a quantifiable community benefit. Both the aha and the medical center also regard patient bad debt as a community benefit and thus includable on the form 990, schedule h, part i. Similar to medicare underpayment (shortfalls), there also are compelling reasons that patient bad debt should be counted as quantifiable community benefit as noted below: - a significant majority of bad debt is attributable to low-income patients, who, for many reasons, decline to complete the forms required to establish eligibility for hospitals' charity care or financial assistance programs. A 2006 congressional budget office ("cbo") report, non-profit hospitals and the provision of community benefits, cited two studies indicating that "the great majority of bad debt was attributable to patients with incomes below 200% of the federal poverty line." - the report also noted that a substantial portion of bad debt is actually pending charity care. Unlike bad debt in other industries, hospital bad debt is complicated by the fact that hospitals follow their mission to the community and treat every patient that comes through their emergency departments, regardless of ability to pay. Patients who have outstanding bills are not turned away, in sharp contrast to other industries. Bad debt is further complicated by the auditing industry's standards on reporting charity care. Many patients cannot or do not provide the necessary, extensive documentation required to be deemed charity care by auditors. As a result, roughly 40% of bad debt is pending charity care. - the cbo concluded that its findings "support the validity of the use of uncompensated care (bad debt and charity care) as a measure of community benefits," assum SCHEDULE H, PART III, SECTION B; LINE 9B Accounts considered to be charity care are not included in the bad debt expense but, rather, accounted for as an allowance. It is the policy of hnmc and subsidiaries' business office to treat all patients equally regardless of insurance and their ability to pay. For accounts determined to be "self-pay" and/or accounts with balance after primary insurance payments, the collection policy requires the sending of three statements, a minimum of one pre-collection letter, and telephone contact for any account over $5,000, or at the discretion of the account representative and/or supervisor. The medical center also has a charity care access policy to assure patients are provided with charity care assistance as determined by state and federal regulations. It is the policy to inform all patients deemed self-pay of the appropriate assistance programs available. Patients applying for charity care assistance are financially screened by a resource advisor to determine eligibility according to state and federal guidelines and are informed of documentation required to complete a charity care application. Patients not eligible for charity care receive financial counseling for all other options. Qualified patients are referred to all appropriate agencies or programs to meet other financial needs. At the time of the patient visit, and as part of the registration process at the medical center, the following options are made available to patients: - financial counseling for possible eligibility for medical assistance, including medicaid and ssi; - financial counseling for possible eligibility for the new jersey hospital care payment assistance program; and - financial arrangements including: 1. Cash/checks/credit card (american express, discover, visa, mastercard), 2. Flexible payment plans. In addition to the above options, the medical center has established a self-pay assistance program for its uninsured patients that do not qualify for either medicaid or the new jersey hospital care payment assistance program. Patients whose income falls between 300% and 500% of the federal poverty guideline are eligible for rates that are reflective of medicare reimbursement, as referred by the state of new jersey. For patients whose income is above 500% of the federal poverty guidelines, the medical center utilizes a compassionate care fee schedule. SCHEDULE H, PART VI; QUESTION 2 Hnmc utilizes a variety of means by which it identifies and analyzes patient care needs. Among them are: patient satisfaction data; analysis of demographics; analysis of utilization and market trends; review of externally published data and information; acuity levels (daily planning of staffing); and individual projects/evaluation/reviews. Hnmc also commissions external specialists to conduct surveys and focus groups of individuals, households, physicians, and others. Hnmc also is a member of the bergen county community health improvement program ("chip"), whose mission is to evaluate and address the health needs of the county. The chip produces an extensive, very useful, database demonstrating the needs of the county's residents. Hnmc is a founding member of the northern new jersey maternal-child health consortium (now the partnership for maternal and child health of northern new jersey), whose mission is to educate and promote appropriate healthcare to woman and infants in the area. Again, a complete needs assessment is performed every three years and is provided to members for their use. In addition, us census bureau data is utilized, as is purchased market data, and databases of all acute and same-day care throughout both new jersey and new york, the source of which is billing data provided to the respective state departments of health. Such databases provide perhaps the greatest wealth of clinical, demographic, financial and other information, and are extremely valuable in understanding and addressing the needs of the communities served by hnmc. Data from the county and state health departments, and from the new jersey hospital association, are also used. In accordance with provisions of the affordable care act, enacted march 23, 2010, the medical center began a comprehensive community health needs assessment ("chna") in late 2011 in cooperation with the bergen county "chip" and four other hospitals whose service areas also include municipalities in bergen county. This chna was completed in 2013. The medical center also created a hnmc-specific chna that addresses its service areas in northern hudson county, incorporates the bergen county chna, and provides an implementation plan for all areas. The two documents provide a wealth of information with respect to the needs of the community served and are posted on the medical center's website. SCHEDULE H, PART VI; QUESTION 3 Prior to or during an admission, all patients without insurance are screened for possible assistance from other sources (e.g., medicaid, veteran administration, s.s.i., or municipal welfare). If the patient is found to be ineligible for any or all of the aforementioned, the patient will be screened for charity care. The education of patients at hnmc is provided in-person by knowledgeable medical center personnel at the time of the initial screening, and accompanied by a packet of information that includes all contact information as well. Arrangements for follow up are typically made immediately. If the patient qualifies for charity care, the patient is not billed for services. The medical center's billing and collection policy includes specific language stating that charity care patients are not billed. Through its compassionate care program, hnmc further assists uninsured patients who do not qualify for charity care and who are ineligible for medicare, medicaid or other federal and state insurance programs. The purpose of the program is to decrease the financial burden of patients in the community served by hnmc. If the patient meets certain eligibility requirements for financial assistance as described below, further discounts will be applied to the patient's bill. - self-pay patients are eligible for the compassionate care fee schedule regardless of income. - patients whose income levels fall within the published hhs poverty guidelines and do not qualify for benefits under the federal undocumented alien program, nj state medicaid program, or charity care program, will be considered for additional discounts. These discounts will be provided to patients who meet the required guidelines. - patients who qualify for the n.j. Medical care assistance program and whose income falls within 200%-300% of the federal poverty limits will be eligible for discounts ranging from 20%-100% off of gross billed charges. Patients who qualify for this program, but who have a balance after the discount, will be responsible for between 20%-80% of the n.j. Medicaid rate. - patients who do not qualify for the n.j. Medical care assistance program and whose income fall within 300%-500% of the federal poverty limits will be eligible for a discount based upon medicare rates. - patients whose income is above 500% of the federal poverty limits will be eligible for hnmc compassionate care fee schedule as stated above. SCHEDULE H, PART VI; QUESTION 4 Located in teaneck, in the southern portion of bergen county and approximately five miles to the northwest of new york city, hnmc's primary service area ("psa") comprises 15 municipalities in bergen county and 3 municipalities in hudson county, new jersey. Hnmc's secondary service area ("ssa") includes 17 municipalities in bergen county and 2 municipalities in hudson county. Together, the psa and ssa account for approximately 80 percent of the medical center's admission volume. As the sole catholic hospital in an area that is estimated at more than 50% roman catholic, hnmc also draws from towns well beyond both the psa and ssa. The majority of psa towns have an average population of 27,500, and are located in the southern half of bergen county. Overall, the service area is 44% hispanic, although the proportions differ markedly between bergen and hudson: 76% of the residents of bergen psa towns are not hispanic; while the four hudson county towns together count 76% of their residents as hispanic. The racial mix of the psa is approximately 60% white, 22% asian, 10% black, and 8% other, including multi-racial persons. Certain towns in the region are heavily korean; korean/asian presence is much less pronounced in the four hudson county towns. The broad age make-up of the primary service area includes 23% aged up to 19; 50% aged 20-54; and 27% aged 55 and older. The last category is projected to see the most significant growth during the next fifteen years. With the exception of two hudson county towns, all ssa zip codes are located throughout bergen county. The towns in this service area are much smaller than those of the psa, averaging only 14,000 residents each. In stark contrast to the largely hispanic hudson county psa towns, the two hudson ssa towns are only 20% hispanic. The overall racial mix of the service area is 76% white, 13% asian, 4% black, and 7% other, including multi-racial persons. The overall korean presence is significant, but only half that seen in the primary service area. The area's age mix is similar to the psa, with 23% aged up to 19; 51% aged 20-54; and 26% aged 55 and older. The medical center's service area is primarily suburban, with many residents working outside bergen county in places such as new york city. However, there are large employers in the service area, e.g., other hospitals, a large sports chain, a large communications firm, a large pharmaceutical firm, and a large commercial laboratory. Residents of hnmc's service area are also served by another community hospital and a tertiary care facility with trauma services. Hnmc's psa covers a majority of the towns serviced by the other community hospital, whereas the tertiary care facility's primary service area also includes many towns to the west that are not part of hnmc's service area. Given the number of service area residents who work in nearby new york city, it is not surprising that a small portion of these residents also receive their healthcare in manhattan. While the service area is predominantly non-hispanic caucasian, both hispanics (of any race) and asian populations (principally korean) are the fastest growing groups. In response, the medical center has programs addressing these groups' needs, and physicians and nurses fluent in the applicable languages. In 2008, approximately 75 korean physicians joined the medical staff, adding to the need for staff and services to meet this growing segment of the community. In 2014, the medical center expanded its korean medical program to include a focus on chinese and filipino residents as well, renaming the service "asian health services." SCHEDULE H, PART VI; QUESTION 5 Hnmc promotes the health of its communities in a variety of ways. The majority of the board of trustees live in bergen county, new jersey, where hnmc is located, with most living in the municipalities of the medical center's defined service area. The trustees' understanding of the service area is thus enhanced, as is their understanding of the need to reinvest funds in improvements in patient care, medical education and research. As part of its charitable purpose, hnmc provides a wide array of services to the community, targeted toward improving the health of the community. The majority of such services are free. A small sampling of such activities is provided below. - frequent health fairs throughout the region are given. At these fairs risk assessments, screenings and literature are provided (many in spanish and korean, as well as english). - immunizations are provided. - free and/or very low fee transportation (e.g., for cancer treatment, dialysis) is available. - community health nurses and mobile learning are also provided. - staff from various departments throughout the medical center visit local schools to provide health classes. - screenings, e.g., blood pressure, cancer, stroke, diabetes, prostate cancer, breast cancer, osteoporosis, peripheral artery disease, skin cancer, colon cancer, and other clinical screening and education are provided, often as part of community programs specific to the particular disease group. - senior centers are supported with free exercise classes, lectures and screenings. - support groups are provided, such as cancer, perinatal bereavement, adult bereavement, new mothers, diabetes, smoking, and cardiac disease. - hnmc's als bike team, als and bls vehicles and/or special operations vehicles are present at events occurring in municipalities in hnmc's service area without charge. - courses (provided either free or for a low fee) are provided throughout the year. Examples include: cpr certification, defensive driving, general and specialty (e.g., osteoporosis) exercise, breastfeeding preparation, stress management, diabetes self-management, baby care basics, weight management, and parenting. - classes to promote better health are abundant: yoga, weight reduction, osteoporosis, proper hand-washing, tai chi, cooking for cardiac patients. - lectures, often involving hnmc's medical staff as presenters, are provided, the majority of which are free. Men's health, women's health, a mid-life and menopause lecture series, sleep disorders, allergies, depression, asthma, uterine fibroids, copd, stroke, hypertension, mental wellness, cardiac issues, alzheimer's, joint replacement, sleep apnea, cancers, children's health, disaster preparedness, and general health and well-being are among the topics presented. - hnmc's fully updated and redesigned website (www.holyname.org) provides a wealth of free consumer health information. The site includes an on-line medical library housing information on diseases and conditions, surgeries and procedures, vitamins and supplements, nutrition, wellness, and a drug reference. On-line risk assessments and quizzes are also available, as is the ability to set up a personal health page. Information is also presented in spanish, and a korean language version is also available (www.kholyname.org). A new interactive body guide ("symptom checker") to research health information about the symptoms the user is experiencing. - hnmc's "ask-my-nurse" program, which provides 24/7 phone access to registered nurses, is provided free of charge. - blood drives are hosted regularly at hnmc. Many health services are subsidized by hnmc, such as its clinics, hospice and hemodialysis programs. Each year the medical center contributes to airfare, supplies and other support for hnmc nurses and doctors to travel to third world countries (e.g., haiti) to provide medical care, including surgery, to persons who otherwise would never receive adequate treatment due to poverty and lack of access. Hnmc supports the bergen volunteer medical initiative ("bvmi"), which provides free care to persons in need and other similar programs. Hnmc also participates in the women, infants and children ("wic") and health start programs, providing nutritional and social services, ancillary services and other programs to participants. Inexpensive medically supervised day care for ill children is available on campus to working parents in the community affording them the ability to work even when a child is sick. Senior or disabled persons requiring medical day care are transported free of charge to hnmc's adult day care program, reducing the burden on family caretakers. Hnmc's emergency department ("ed") is open 24 hours a day, every day of the year. Although the ed generally is able to cover its costs, it provides a significant amount of uncompensated care and is a well-used resource for many without insurance who rely on it for care. Other services, such as clinics, do not cover their costs, and hnmc absorbs the additional expense. Language interpretation is available for approximately 220 languages at the medical center through use of a commercial service that provides a live translator 24/7 free of charge to the patient and family. Hnmc has an open medical staff with privileges available to all qualified physicians in the area. Hnmc has intentionally sought out physicians fluent in spanish and who care for hispanic populations, and provides free transportation for such populations (as well as others) unable to access care on their own. Hnmc has also added many korean physicians to its medical staff and provides a korean clinic weekly, with korean speaking physicians and nurses, as the asian community is one of the fastest growing sectors in the county. Recent additions of staff to support the expanded Chinese and Filipino populations address needs specific to these groups. Care is provided in a culturally sensitive manner. The institute for clinical research at hnmc provides exceptional investigators, facilities, and services for sponsoring agencies that seek to advance patient care through superior clinical research. The institute is dedicated to conducting expeditious, high-quality clinical trials to test new medications, devices, diagnostic modalities and treatment protocols. As a dynamic healthcare institution that has received many honors of distinction for its clinical excellence and compassionate patient care, hnmc is well-suited to participate in the quest for scientific breakthroughs. Hnmc's state-of-the-art facilities match the highest standards for carrying out today's most promising clinical research. The institute provides sponsors with research support throughout all the stages of their clinical trials. Since its inception, hnmc has been actively involved in health professions education, training, educating and mentoring healthcare professionals. The holy name school of nursing was founded in 1925, with a dedication to fostering the well-being and dignity of all individuals, sick or well. The registered nurse ("rn") program is a highly competitive registered nurse diploma program, and is accredited with the new jersey board of nursing and the national league for nursing accrediting commission. In 1972 the school expanded to include a practical nurse ("lpn") program as well, which is a 12-month practical nurse diploma program also accredited with the new jersey board of nursing. Both programs continue to supply the region with highly skilled nurses of many ethnicities and age groups. In addition to its own nursing school, hnmc provides, free of charge, both a training ground and mentoring for students from various health academic programs of several colleges and universities. A variety of "externships" are also offered without charge. Career days are also held on campus, and the medical center participates in health career days throughout various schools and communities. Hnmc has a number of academic relationships through which it serves as an educational environment for students. Affiliation agreements are maintained with several colleges and universities for nursing students, and for radiology, nuclear medicine, ultrasound, respiratory, and surgical technicians. Trainees from a university who are predominantly doctor of pharmacy students complete rotations in acute critical care, infectious disease, oncology, nephrology, and administration. Community health students rotate through the medical center as well. Physical and/or occupational therapy students from with ten colleges in new jersey and other states complete clinical rotations at the medical center; hnmc employees serve as supervisors and clinical instructors for these students. Undergraduate, nurse practitioner and nursing doctoral students from yet another university complete rotations with oversight from hnmc's department of nursing education. Each year, hnmc accepts a small number of residents in health policy, health finance, and health mana SCHEDULE H, PART VI; QUESTION 6 The medical center is the sole member of seven entities: (i) holy name health care foundation, inc., a non-profit corporation which seeks voluntary donations to support the health care services provided by the medical center; (ii) holy name real estate corp., a non-profit corporation which manages, and in some cases possesses title to and engages in leasing arrangements with respect to, real estate holdings of the medical center and its related entities; (iii) health partner services, inc., a for-profit corporation engaged in providing management services for health care providers; (iv) holy name ems, inc., a non-profit corporation which owns and operates the medical center's basic life support ("bls") and advanced life support ("als") vehicles and services; (v) ms comprehensive care center, a non-profit ambulatory care program for ms patients; (vi) hnmc hospital/physician aco, l.l.c., a non-profit limited liability company formed as an accountable care organization; and (vii) hnh fitness, l.l.c., a for-profit limited liability company that operates a medically based fitness and wellness center, located in the borough of oradell, bergen county, new jersey. Included in the facility is a satellite non-profit physical therapy practice that is operated by the medical center. The medical center is also a 40% owner of holy name renal care, l.l.c., a for-profit limited liability company that operates an ambulatory renal dialysis service on the medical center's campus. SCHEDULE H, PART VI; QUESTION 7 Not applicable. The entity and related provider organizations are located in new jersey. New jersey does not require hospitals to annually submit a community benefit report. true SISTERS OF ST JOSEPH OF PEACE 399 HUDSON TERRACE ENGLEWOOD CLIFFS NJ 07632 223412084 501(C)(3) 10000 PROGRAM SUPPORT EDUCATIONAL SCHOLARSHIPS 54 70225 SCHEDULE I, PART I; QUESTION 2 GRANTS ARE MONITORED BY THE ORGANIZATION'S FINANCE PERSONNEL THROUGH THE UTILIZATION OF COST CENTERS AND OTHER INFORMATION; INCLUDING WRITTEN DOCUMENTATION AND RECEIPTS. X X X X X false true false false false false false true false MICHAEL MARON TRUSTEE- PRESIDENT/CEO 1096750 0 550000 0 34122 0 475124 0 21791 0 2177787 0 0 0 JOSEPH M LEMAIRE TERM 627 TRUSTEE - ASST SEC/ASST TREAS 442600 0 250000 0 29425 0 10400 0 14527 0 746952 0 0 0 RYAN KENNEDY CPA VP; CHIEF FINANCIAL OFFICER 280999 0 100000 0 1332 0 10400 0 10895 0 403626 0 0 0 ADAM JARRETT MD CHIEF MEDICAL OFFICER 421750 0 250000 0 28552 0 120380 0 21791 0 842473 0 0 0 SHERYL SLONIM SENIOR VP; PATIENT CARE SVCS 372868 0 175000 0 32671 0 192460 0 14865 0 787864 0 0 0 MICHAEL SKVARENINAEFF 62214 CHIEF INFORMATIONAL OFFICER 212017 0 50000 0 17786 0 4422 0 21791 0 306016 0 0 0 JOHN GRANGEIA TERM 12714 VP; PROFESSIONAL SERVICES 255824 0 10000 0 7005 0 8492 0 3200 0 284521 0 0 0 STEVEN MOSSER VP; FACILITIES 241750 0 25000 0 2281 0 9800 0 21791 0 300622 0 0 0 CYNTHIA KAUFHOLD VP; REVENUE CYCLE MANAGEMENT 223500 0 10000 0 1771 0 9300 0 27541 0 272112 0 0 0 MARYANN KICENUIK EFF 71414 VP; LEGAL SERVICES 218008 0 0 0 7229 0 8758 0 5029 0 239024 0 0 0 RICHARD VAN EERDE EFF 62214 VP; FINANCE 190022 0 0 0 991 0 7689 0 8477 0 207179 0 0 0 APRIL RODGERS VP; HUMAN RESOURCES 167109 0 0 0 1111 0 4212 0 21791 0 194223 0 0 0 SHARAD WAGLE MD MEDICAL DIRECTOR 353192 0 0 0 4313 0 10400 0 14431 0 382336 0 0 0 RAVIT BARKAMA EXEC DIR CLINICAL RESEARCH 266516 0 80000 0 1701 0 10400 0 24291 0 382908 0 0 0 KYUNG-HEE CHOI VP; KOREAN MEDICAL PROGRAM 217316 0 20000 0 3884 0 8693 0 0 0 249893 0 0 0 ALLAN J CAGGIANO PHYSICIST 228167 0 300 0 502 0 9257 0 21791 0 260017 0 0 0 DEBORAH ZAYAS VP; NURSING SERVICES 203986 0 20000 0 1858 0 8200 0 7277 0 241321 0 0 0 SCHEDULE J, PART I; QUESTION 4B THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THE FOLLOWING INDIVIDUALS INCLUDES UNVESTED BENEFITS IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) WHICH ARE SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THE INDIVIDUALS MAY NEVER ACTUALLY RECEIVE THIS UNVESTED BENEFIT AMOUNT. THE AMOUNTS OUTLINED HEREIN WERE NOT INCLUDED IN EACH INDIVIDUAL'S 2014 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: MICHAEL MARON, $464,724; ADAM JARRETT, M.D., $109,980 AND SHERYL SLONIM, $182,060. SCHEDULE J, PART I; QUESTION 7 AND CORE FORM, PART VII CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A BONUS DURING CALENDAR YEAR 2014 WHICH AMOUNTS WERE INCLUDED IN COLUMN B(II) HEREIN AND IN EACH INDIVIDUAL'S 2014 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT. A NJ HEALTH CARE FACILITIES FINANCING AUTHORITY 221987084 64579FHK2 2006-06-15 60816719 CONSTRUCTION/RENOVATION/EQUIP false false false B NJ HEALTH CARE FACILITIES FINANCING AUTHORITY 221987084 64579FH89 2010-09-02 55971065 BOND REFUNDING/CAPITAL EXPENDITURE false false false C NJ HEALTH CARE FACILITIES FINANCING AUTHORITY 221987084 64579FJT1 2006-11-22 7000000 HNH FITNESS ACQUISITION false false false A 10025558 0 64937963 5744107 0 0 1014001 0 0 42313332 15831828 32376 2009 true false false true B 47290816 0 55971117 0 0 0 1242174 0 0 7560834 47290816 0 2010 true false true true C 0 0 7039950 0 416077 0 103703 43900 0 6476266 5 0 2006 false false true true A false true true true true true 0.00600 0.00600 false false false true B false true true true true true 0.00600 0.00600 false false false true C false false false false false false 0.00600 0.00600 false false false true A false false false true false false 0 false 0 false true B false true false false false false 0 false 0 false true C false false false true true false 0 false 0 false true A true B true C true SCHEDULE K, PART IV; LINE 2C THE REBATE COMPUTATIONS WERE PERFORMED ON JULY 6, 2011 FOR BOND A AND ON DECEMBER 1, 2011 FOR BOND C. CORE FORM, PART III Holy name medical center ("hnmc") is a private, 361-bed new jersey-licensed general acute care medical center. The medical center is a non-profit corporation under the laws of the state of new jersey, and is exempt from federal income taxes under section 501(a) of the internal revenue code by virtue of being an organization described in section 501(c)(3) of the code. Pursuant to its charitable purposes, hnmc provides medically necessary healthcare services to all individuals in a non-discriminatory manner regardless of race, color, creed, sex, national origin or ability to pay. Moreover, hnmc operates consistently with the following criteria outlined in irs revenue ruling 69-545: 1. Hnmc provides medically necessary healthcare services to all individuals regardless of ability to pay, including charity care, self-pay, medicare and medicaid patients; 2. Hnmc operates an active emergency department for all persons, which is open 24 hours a day, 7 days a week, 365 days per year; 3. Hnmc maintains a medical staff, with privileges available to all qualified physicians; 4. Control of hnmc rests with its board of trustees and the sisters of st. Joseph of peace. Both boards are comprised of independent civic leaders and other prominent members of the community; and 5. Surplus funds are used to improve the quality of patient care, expand and renovate facilities and advance medical care, programs and activities. The operations of hnmc, as shown through the factors outlined above and other information contained herein, clearly demonstrate that hnmc provides substantial community benefit and that the use and control of hnmc is for the benefit of the public and that no part of the income or net earnings of the organization inures to the benefit of any private individual, nor is any private interest being served other than incidentally. The sisters of st. Joseph of peace health care system corporation (the "holding company") is a non-profit corporation under the laws of the state of new jersey, and is exempt from federal income taxes under section 501(a) of the internal revenue code by virtue of being an organization described in section 501(c)(3) of the code. The holding company is the sole member of the medical center. This tax-exempt integrated healthcare delivery system consists of a group of affiliated healthcare organizations. The sole member of each entity is either the holding company or hnmc. Mission ======= We are a community of caregivers committed to a ministry of healing, embracing the tradition of catholic principles, the pursuit of professional excellence, and conscientious stewardship. We help our community achieve the highest attainable level of health through education, prevention and treatment. History ======= The medical center was founded by the congregation of the sisters of st. Joseph of peace (the "sisters") in 1925, and in 1958 was incorporated as an independent new jersey non-profit corporation, sponsored by the sisters. It was the dedication of two teaneck surgeons and the leadership of a sister that made hnmc a reality in 1925. Recognizing the need to serve the sick and indigent of the community, drs. Frank mccormack and george pitkin appealed to mother general agatha brown of the sisters for help in finding a suitable medical center site and providing administrative and nursing staff. The sisters purchased the estate of the late william walter phelps and erected the medical center there, staffing it with sisters. At its opening in 1925, hnmc boasted 115 beds. Five years later, a 90-bed clinic building was built to meet the needs of area residents who had been impoverished by the great depression. Teaneck was little more than a rural village then; in all of bergen county there were some 250,000 inhabitants. With the completion of the george washington bridge in 1931, a surge of development followed world war ii, and the area soon became a thriving residential and business community. Hnmc thrived as well. In 1955 a second addition was completed: the four-story, 110-bed marian building, with two more stories added to the facility within the next ten years. During the 1960's, the west wing of the marian building was enlarged by three more units. Faced again with the threat of overcrowding in the 1980's, the medical center complex was once more enlarged with construction of the breslin/kennedy building. In 1993 the "new addition" was constructed, principally to accommodate the increasing ambulatory and same-day-stay patients, and a new physical medicine building was added. A four-level regional cancer center was completed in the late 1990's. More recent additions include a new 41-bay emergency department, a health and fitness center, and a residential hospice, villa marie claire. The medical center has grown in size, reputation and capability with each addition. As hnmc celebrates almost 90 years, it continues to take steps to become a national model by implementing new, advanced technologies and medical/surgical techniques, as well as best practices in processes such as simulation learning, medication administration, healthcare information systems, disaster preparedness, and building construction and design. Improvements such as these allow hnmc to provide every patient with a superior experience characterized by safe, high quality care. Leading-edge care ================= Hnmc is a comprehensive, 361-bed acute care facility providing leading-edge medical practice and technology administered in an environment rooted in a tradition of compassion and respect for every patient. Hnmc offers high quality healthcare across a continuum that encompasses education, prevention, early intervention, comprehensive treatment options, rehabilitation, and wellness maintenance-from pre-conception through end-of-life. With almost 900 physicians representing dozens of medical and surgical specialties, hnmc provides an exceptional healthcare experience for its patients. A few of the "centers of excellence" at hnmc include: - regional cancer center (including a new gynecological specialty) - interventional institute (offering innovative, non-surgical treatment options) - cardiovascular services - george p. Pitkin m.d. emergency care center - women's and children's health services - hospice and palliative care services, both home-based and residential (villa marie claire, hnmc's comprehensive hospice facility in saddle river, nj) - bone and joint center - breast center - institute for simulation learning Other outstanding services include, but are not limited to: - specialty surgery services with expertise in minimally invasive techniques, including robotics - advanced radiological imaging - rehabilitation medicine, and sports medicine, encompassing hnh fitness, hnmc's medically-based fitness center in oradell, nj - bariatric medicine - center for sleep medicine - maternal-fetal medicine for high-risk and complicated pregnancies - renal dialysis - culturally- and linguistically-sensitive health programs, such as the asian health services, addressing korean, chinese and filipino needs, and hispanic outreach program, "familia y salud." - institute for clinical research - multiple sclerosis center - the holy name school of nursing CORE FORM, PART III Promotion of community health ============================= Hnmc promotes the health of its communities in a variety of ways. The majority of the board of trustees live in bergen county, new jersey, where hnmc is located, with most living in the municipalities of the medical center's defined service area. The trustees' understanding of the service area is thus enhanced, as is their understanding of the need to reinvest funds in improvements in patient care, medical education and research. As part of its charitable purpose, hnmc provides a wide array of services to the community, targeted toward improving the health of the community. The majority of such services are free. A small sampling of such activities is provided below. - frequent health fairs throughout the region are given. At these fairs risk assessments, screenings and literature are provided (many in spanish and korean, as well as english). - immunizations are provided. - free and/or very low fee transportation (e.g., for cancer treatment, dialysis) is available. - community health nurses and mobile learning are also provided. - staff from various departments throughout the medical center visit local schools to provide health classes. - screenings, e.g., blood pressure, cancer, stroke, diabetes, prostate cancer, breast cancer, osteoporosis, peripheral artery disease, skin cancer, colon cancer, and other clinical screening and education are provided, often as part of community programs specific to the particular disease group. - senior centers are supported with free exercise classes, lectures and screenings. - support groups are provided, such as cancer, perinatal bereavement, adult bereavement, new mothers, diabetes, smoking, and cardiac disease. - hnmc's als bike team, als vehicles and/or special operations vehicles are present at events occurring in municipalities in hnmc's service area without charge. - courses (provided either free or for a low fee) are provided throughout the year. Examples include: cpr certification, defensive driving, general and specialty (e.g., osteoporosis) exercise, breastfeeding preparation, stress management, diabetes self-management, baby care basics, weight management, and parenting. - classes to promote better health are abundant: yoga, weight reduction, osteoporosis, proper hand-washing, tai chi, cooking for cardiac patients. - lectures, often involving hnmc's medical staff as presenters, are provided, the majority of which are free. Men's health, women's health, a mid-life and menopause lecture series, sleep disorders, allergies, depression, asthma, uterine fibroids, copd, stroke, hypertension, mental wellness, cardiac issues, alzheimer's, joint replacement, sleep apnea, cancers, children's health, disaster preparedness, and general health and well-being are among the topics presented. - hnmc's fully updated and redesigned website (www.holyname.org) provides a wealth of free consumer health information. The site includes an on-line medical library housing information on diseases and conditions, surgeries and procedures, vitamins and supplements, nutrition, wellness, and a drug reference. On-line risk assessments and quizzes are also available, as is the ability to set up a personal health page. a korean language version is also available (www.kholyname.org). A new interactive body guide ("symptom checker") to research health information about the symptoms the user is experiencing. - hnmc's "ask-my-nurse" program, which provides 24/7 phone access to registered nurses, is provided free of charge. - blood drives are hosted regularly at hnmc. Many health services are subsidized by hnmc, such as its clinics, hospice and hemodialysis programs. Each year the medical center contributes to airfare, supplies and other support for hnmc nurses and doctors to travel to third world countries (e.g., haiti) to provide medical care, including surgery, to persons who otherwise would never receive adequate treatment due to poverty and lack of access. Hnmc supports the bergen volunteer medical initiative ("bvmi"), which provides free care to persons in need and other similar programs. Hnmc also participates in the women, infants and children ("wic") and health start programs, providing nutritional and social services, ancillary services and other programs to participants. Inexpensive medically supervised day care for ill children is available on campus to working parents in the community affording them the ability to work even when a child is sick. Senior or disabled persons requiring medical day care are transported free of charge to hnmc's adult day care program, reducing the burden on family caretakers. Hnmc's emergency department ("ed") is open 24 hours a day, every day of the year. Although the ed generally is able to cover its costs, it provides a significant amount of uncompensated care and is a well-used resource for many without insurance who rely on it for care. Other services, such as clinics, do not cover their costs, and hnmc absorbs the additional expense. Language interpretation is available for approximately 220 languages at the medical center through use of a commercial service that provides a live translator 24/7, free of charge to the patient and family. Hnmc has an open medical staff with privileges available to all qualified physicians in the area. Hnmc has intentionally sought out physicians fluent in spanish and who care for hispanic populations, and provides free transportation for such populations (as well as others) unable to access care on their own. Hnmc has also added many korean physicians to its medical staff and provides a korean clinic weekly, with korean speaking physicians (and nurses), as the asian community is one of the fastest growing sectors in the county. Recent additions of staff to support the expanded Chinese and Filipino populations address needs specific to these groups. Care is provided in a culturally sensitive manner. The institute for clinical research at hnmc provides exceptional investigators, facilities, and services for sponsoring agencies that seek to advance patient care through superior clinical research. The institute is dedicated to conducting expeditious, high-quality clinical trials to test new medications, devices, diagnostic modalities and treatment protocols. As a dynamic health care institution that has received many honors of distinction for its clinical excellence and compassionate patient care, hnmc is well-suited to participate in the quest for scientific breakthroughs. Hnmc's state-of-the-art facilities match the highest standards for carrying out today's most promising clinical research. The institute provides sponsors with research support throughout all the stages of their clinical trials. Since its inception, hnmc has been actively involved in health professions education, training, educating and mentoring healthcare professionals. The holy name school of nursing was founded in 1925, with a dedication to fostering the well-being and dignity of all individuals, sick or well. The registered nurse ("rn") program is a highly competitive registered nurse diploma program, and is accredited with the new jersey board of nursing and the national league for nursing accrediting commission. In 1972 the school expanded to include a practical nurse ("lpn") program as well, which is a 12-month practical nurse diploma program also accredited with the new jersey board of nursing. Both programs continue to supply the region with highly skilled nurses of many ethnicities and age groups. Hnmc also supports its community through the use of the medical center's facility and/or employees to support efforts that: promote the positive growth of the community; assist diverse groups in coming together for the community's short and long term benefit; and seek to protect the community from anything that could significantly affect the health and well-being of the community. Hnmc also assists other non-profits and provides various forms of non-monetary aid as well. In addition, employees are permitted to assist valid non-profit organizations during paid work time. Among the organizations so aided are nursing homes, boy scouts, houses of worship, community service groups, battered women's shelters, rotary clubs, police groups, environmental groups, schools, and nursing homes. Hnmc also allows the public to use various meeting rooms (in non-clinical areas) and its conference center for events. Career days are held for local high schools, fostering entrance of interested and applicable students into the health professions. Although hnmc's parking fees are minimal, free parking is extended to persons in need. Since 2012, the medical center has provided assistance to a hospital in the earthquake-ravaged country of haiti through cash support, provision of equipment and personnel working to rebuild the hospital's operations, and through training health providers working at the hospital. CORE FORM, PART III Affiliations and academic relationships ======================================= The hnmc community enjoys academic relationships that provide an educational environment for students from a variety of healthcare professions: - in july 2010, hnmc began accepting third and fourth year students from the touro college of osteopathic medicine (new york, ny), to complete clinical rotations in fulfillment of their curriculum. - affiliation agreements are maintained with bergen community college (paramus, nj) for nursing students, and for radiology, ultrasound, respiratory, and surgical technicians. Trainees from rutgers university (new brunswick, nj) are predominantly doctor of pharmacy students who are completing rotations in acute critical care, infectious disease, oncology, nephrology, and administration. The trainees are supervised by a clinical care coordinator from the university. One community health student rotates through hnmc as well. - the medical center maintains a collaborative agreement with st. Peter's college (jersey city, nj) to provide the option for holy name school of nursing students to take additional college credits to earn an associates of applied science ("aas") degree in health sciences. The aas complements the diploma awarded from the holy name school of nursing. Employees of hnmc are also able to continue their studies by pursuing bachelor's (bsn), master's, and advanced practice nursing degrees at st. Peter's college. In this process, student employees work with various administrative leaders within hnmc to complete clinical rotations. - undergraduate, nurse practitioner and nursing doctoral students from farleigh dickinson university ("fdu") complete rotations with oversight from hnmc's department of nursing education. In addition, the medical center hosts, at no charge, classes provided by fdu for adult learners. - Hnmc has a number of other academic relationships through which it serves as an educational environment for students. Affiliation agreements are maintained with several colleges and universities for nursing students, and for radiology, nuclear medicine, ultrasound, respiratory, and surgical technicians. Trainees from a university who are predominantly doctor of pharmacy students complete rotations in acute critical care, infectious disease, oncology, nephrology, and administration. Community health students rotate through the medical center as well. Physical and/or occupational therapy students from with ten colleges in new jersey and other states complete clinical rotations at the medical center; hnmc employees serve as supervisors and clinical instructors for these students. Undergraduate, nurse practitioner and nursing doctoral students from yet another university complete rotations with oversight from hnmc's department of nursing education. In all cases, instruction and oversite are provided by hnmc staff. - each year, hnmc accepts students from the columbia university mailman school of public health program in health policy and management as summer interns. Interns work on specific projects under the direction of members of senior management. - every year students from a preparatory school complete internships at the medical center in various departments. Typically, such students are disadvantaged from a socioeconomic standpoint and benefit from the coaching received from members of the senior administrative staff. The students spend one full day each week at holy name over the course of a semester. Emergency preparedness ====================== Hnmc was one of nine hospitals in new jersey designated by the new jersey department of health ("njdoh") as a regional medical coordination center ("mcc"). The only facility in bergen county to be so designated, hnmc's on-campus mcc's purpose was able to be activated in the event of public health emergencies and/or a terrorist attack causing mass casualty incidents, infectious or communicable disease, or other types of public health disruption. The mcc also monitored, on a daily basis, situational awareness of local activity. In 2014, the njdoh last much of its federal funding for the statewide program, cutting in half the number of mcc's it could support. Hnmc chose not to apply to renew its designation but has maintained most of its capabilities on its own. Given hnmc's proximity to new york city (i.e., five miles north of the george washington bridge), emergency preparedness is deemed necessary to ensure the health and well-being of the community, regardless of the mcc designation. Central to this commitment is a hnmc-funded vice president whose job function includes substantial involvement in preparedness both on-campus and in the community. Hnmc has long been recognized by state and federal sectors for its expertise in emergency preparedness and response. A frequent participant in local and new york city disaster drills, hnmc has participated in several large scale disaster drills, as well as drills conducted by the centers for disease control involving local, county, state, and federal agencies' emergency response to threats of public health significance. Hnmc maintains its designation by the federal division of global migration and quarantine to deal with possible communicable diseases and acts of bioterrorism occurring on public health conveyances. Hnmc is also active in the northern new jersey urban area security initiative. Members of holy name ems serve on the statewide nj ems task force. The medical center maintains a special operations team comprised of paramedics and emergency medical technicians who are ready to respond 24 hours a day, 7 days a week to assist local communities with emergencies. Recognition ============ Hnmc is recognized for its clinical skill, quality outcomes and high rate of patient satisfaction by multiple national accreditation agencies and benchmarking organizations. Hnmc holds magnet status for outstanding nursing care from the american nurses credentialing center ("ancc"). The magnet recognition program was developed by the ancc to recognize healthcare organizations that provide nursing excellence, and to provide a vehicle for disseminating successful nursing practices and strategies. Only six percent (6%) of hospitals nationwide are magnet recognized hospitals. Hnmc also received the beacon award for critical care excellence for its telemetry and intensive care units. This award from the american association of critical-care nurses recognizes nursing excellence in professional practice, patient care and outcomes. Us news & world report cited hnmc as one of the best hospitals in new jersey and the new york metro area, 2013-2014. Holy name received "high-performing" status in nine specialties: diabetes and endocrinology, gastroenterology, geriatrics, gynecology, nephrology, neurology and neurosurgery, orthopedics, pulmonology and urology. The medical center carries an "a" rating from the leapfrog group for safety, and is also a community 5-star top provider, awarded by cleverly and associates. It was also ranked fourth in the state for safety by consumer reports. holy name is recognized by the american heart association/american stroke association as a gold-plus primary stroke center as part of the "get with the guidelines" program. Hnmc has been praised repeatedly as an exemplary workplace by modern healthcare's 100 best places to work in healthcare program, in which the medical center ranked in the top ten; and by njbiz (the leading weekly business publication in new jersey), which cites hnmc as a top business (all industries) in its 50 best places to work in new jersey program, a designation earned by hnmc for 10 years in a row. CORE FORM, PART III; LINE 4D EXPENSES INCURRED IN PROVIDING MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. PLEASE REFER TO THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT INCLUDED IN SCHEDULE O. CORE FORM, PART VI, SECTION B; QUESTION 11B THE ORGANIZATION'S FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY (ITS BOARD OF TRUSTEES) PRIOR TO THE FILING OF THE FEDERAL FORM 990 WITH THE INTERNAL REVENUE SERVICE ("IRS"). IN ADDITION THE ORGANIZATION'S AUDIT COMMITTEE ASSUMED THE RESPONSIBILITY TO OVERSEE AND COORDINATE THE FEDERAL FORM 990. AS PART OF THE ORGANIZATION'S FEDERAL FORM 990 TAX RETURN PREPARATION PROCESS THE ORGANIZATION HIRED A PROFESSIONAL CPA FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION TO PREPARE THE FEDERAL FORM 990. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE ORGANIZATION'S FINANCE PERSONNEL INCLUDING THE CHIEF FINANCIAL OFFICER, DIRECTOR OF ACCOUNTING AND VARIOUS OTHER INDIVIDUALS TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE ORGANIZATION'S INTERNAL WORKING GROUP, INCLUDING THOSE INDIVIDUALS OUTLINED ABOVE FOR THEIR REVIEW. THE ORGANIZATION'S INTERNAL WORKING GROUP REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE ORGANIZATION'S INTERNAL WORKING GROUP FOR FINAL REVIEW AND APPROVAL. A MEETING WAS ALSO HELD TO REVIEW THE FINAL DRAFT OF THE FEDERAL FORM 990 WITH THE ORGANIZATION'S AUDIT COMMITTEE FOR REVIEW AND APPROVAL. FOLLOWING THIS REVIEW THE FINAL FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY PRIOR TO THE FILING OF THE TAX RETURN WITH THE IRS. CORE FORM, PART VI, SECTION B; QUESTION 12 THE ORGANIZATION REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. ANNUALLY ALL MEMBERS OF THE BOARD OF TRUSTEES, OFFICERS AND SENIOR MANAGEMENT PERSONNEL ARE REQUIRED TO REVIEW THE EXISTING CONFLICT OF INTEREST POLICY AND COMPLETE A QUESTIONNAIRE. THE COMPLETED QUESTIONNAIRES ARE RETURNED TO THE ORGANIZATION AND THE ORGANIZATION'S CHIEF COMPLIANCE OFFICER FOR REVIEW. THEREAFTER THE ORGANIZATION'S CHIEF COMPLIANCE OFFICER PREPARES A SUMMARY OF THE COMPLETED QUESTIONNAIRES WHICH CONTAINS INFORMATION DISCLOSED ON AN INDIVIDUAL BY INDIVIDUAL BASIS. THEREAFTER, THE ORGANIZATION'S CHIEF COMPLIANCE OFFICER PRESENTS THIS SUMMARY TO THE ORGANIZATION'S GOVERNANCE COMMITTEE FOR ITS REVIEW AND DISCUSSION. CORE FORM, PART VI, SECTION B; QUESTION 15 THE ORGANIZATION'S BOARD OF TRUSTEES HAS AN EXECUTIVE COMPENSATION COMMITTEE ("COMMITTEE"). THE COMMITTEE HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY WHICH IT FOLLOWS WHEN IT REVIEWS AND APPROVES OF THE COMPENSATION AND BENEFITS OF THE ORGANIZATION'S SENIOR MANAGEMENT, INCLUDING THE PRESIDENT/CHIEF EXECUTIVE OFFICER, EXECUTIVE VICE PRESIDENT/CHIEF FINANCIAL OFFICER AND VICE PRESIDENT OF PATIENT CARE SERVICES. THE COMMITTEE REVIEWS THE "TOTAL COMPENSATION" OF THE INDIVIDUALS WHICH IS INTENDED TO INCLUDE BOTH CURRENT AND DEFERRED COMPENSATION AND ALL EMPLOYEE BENEFITS, BOTH QUALIFIED AND NON-QUALIFIED. THE COMMITTEE'S REVIEW IS DONE ON AT LEAST AN ANNUAL BASIS AND ENSURES THAT THE "TOTAL COMPENSATION" OF SENIOR MANAGEMENT OF THE ORGANIZATION IS REASONABLE. THE ACTIONS TAKEN BY THE COMMITTEE ENABLE THE ORGANIZATION TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 4958 WITH RESPECT TO THE TOTAL COMPENSATION OF CERTAIN MEMBERS OF THE SENIOR MANAGEMENT TEAM, INCLUDING THE PRESIDENT/CHIEF EXECUTIVE OFFICER, EXECUTIVE VICE PRESIDENT/CHIEF FINANCIAL OFFICER AND VICE PRESIDENT OF PATIENT CARE SERVICES. THE THREE FACTORS WHICH MUST BE SATISFIED IN ORDER TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS ARE THE FOLLOWING: 1. THE COMPENSATION ARRANGEMENT IS APPROVED IN ADVANCE BY AN "AUTHORIZED BODY" OF THE APPLICABLE TAX-EXEMPT ORGANIZATION WHICH IS COMPOSED ENTIRELY OF INDIVIDUALS WHO DO NOT HAVE A "CONFLICT OF INTEREST" WITH RESPECT TO THE COMPENSATION ARRANGEMENT; 2. THE AUTHORIZED BODY OBTAINED AND RELIED UPON "APPROPRIATE DATA AS TO COMPARABILITY" PRIOR TO MAKING ITS DETERMINATION; AND 3. THE AUTHORIZED BODY "ADEQUATELY DOCUMENTED THE BASIS FOR ITS DETERMINATION" CONCURRENTLY WITH MAKING THAT DETERMINATION. THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES EACH OF WHO ARE INDEPENDENT AND ARE FREE FROM ANY CONFLICTS OF INTEREST. THE COMMITTEE RELIED UPON APPROPRIATE COMPARABLE DATA; SPECIFICALLY THE COMMITTEE OBTAINED A WRITTEN COMPENSATION STUDY FROM AN INDEPENDENT FIRM WHICH SPECIALIZES IN THE REVIEWING OF HOSPITAL AND HEALTHCARE SYSTEM EXECUTIVE COMPENSATION AND BENEFITS THROUGHOUT THE UNITED STATES. THIS STUDY USED COMPARABLE GEOGRAPHIC AND DEMOGRAPHIC MARKET DATA INCLUDING BUT NOT LIMITED TO SIMILAR SIZED HOSPITALS, # OF LICENSED BEDS AND NET PATIENT SERVICE REVENUE. THE COMMITTEE ADEQUATELY DOCUMENTED ITS BASIS FOR ITS DETERMINATION THROUGH THE TIMELY PREPARATION OF WRITTEN MINUTES OF THE COMPENSATION COMMITTEE MEETINGS DURING WHICH THE EXECUTIVE COMPENSATION AND BENEFITS WAS REVIEWED AND SUBSEQUENTLY APPROVED. THE ACTIONS OUTLINED ABOVE WITH RESPECT TO THE COMMITTEE AND THE ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS ONLY APPLIES TO CERTAIN SENIOR MANAGEMENT PERSONNEL, INCLUDING BUT NOT LIMITED TO THE PRESIDENT/CHIEF EXECUTIVE OFFICER, EXECUTIVE VICE PRESIDENT/CHIEF FINANCIAL OFFICER AND VICE PRESIDENT OF PATIENT CARE SERVICES. THE COMPENSATION AND BENEFITS OF CERTAIN OTHER INDIVIDUALS CONTAINED IN THIS FORM 990 ARE REVIEWED ANNUALLY BY THE PRESIDENT/CHIEF EXECUTIVE OFFICER WITH ASSISTANCE FROM ORGANIZATION'S HUMAN RESOURCES DEPARTMENT IN CONJUNCTION WITH THE INDIVIDUAL'S JOB PERFORMANCE DURING THE YEAR AND IS BASED UPON OTHER OBJECTIVE FACTORS DESIGNED TO ENSURE THAT REASONABLE AND FAIR MARKET VALUE COMPENSATION IS PAID BY THE ORGANIZATION. OTHER OBJECTIVE FACTORS INCLUDE MARKET SURVEY DATA FOR COMPARABLE POSITIONS, INDIVIDUAL GOALS AND OBJECTIVES, PERSONNEL REVIEWS, EVALUATIONS, SELF-EVALUATIONS AND PERFORMANCE FEEDBACK MEETINGS. CORE FORM, PART VI, SECTION C; QUESTION 19 THE ORGANIZATION HAS ISSUED TAX-EXEMPT BONDS TO FINANCE VARIOUS CAPITAL IMPROVEMENT PROJECTS, RENOVATIONS AND EQUIPMENT. IN CONJUNCTION WITH THE ISSUANCE OF THESE TAX-EXEMPT BONDS, THE ORGANIZATION'S FINANCIAL STATEMENTS WERE INCLUDED WITH THE TAX-EXEMPT BOND PROSPECTUS WHICH WAS MADE AVAILABLE TO THE GENERAL PUBLIC FOR REVIEW. THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE STATE OF NEW JERSEY DEPARTMENT OF THE TREASURY. CORE FORM, PART VII AND SCHEDULE J PART VII AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM THE ORGANIZATION. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OF THE ORGANIZATION; NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THE ORGANIZATION'S BOARD OF TRUSTEES. CORE FORM, PART VII AND SCHEDULE J THIS ORGANIZATION TRANSFERRED THE PAYROLL OF CERTAIN INDIVIDUALS TO HOLY NAME HEALTH CARE FOUNDATION, INC., A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION, DURING 2014. CELESTE ORANCHAK, VICE PRESIDENT OF DEVELOPMENT, WAS ONE OF THESE INDIVIDUALS AS HER DUTIES ARE IN SUPPORT OF THE FOUNDATION. THEREFORE, SHE IS NO LONGER REPORTED ON THIS ORGANIZATION'S CORE FORM, PART VII OR SCHEDULE J. HER COMPENSATION AND BENEFITS CAN BE FOUND ON THE FORM 990 OF HOLY NAME HEALTH CARE FOUNDATION, INC. IN ADDITION, THE ORGANIZATION RE-EVALUATED THE LISTING OF KEY EMPLOYEES AND DETERMINED THAT CERTAIN INDIVIDUALS, ALTHOUGH MEETING THE INCOME TEST, DO NOT MEET THE RESPONSIBILITY TEST AND SHOULD, THEREFORE, NOT BE REPORTED AS KEY EMPLOYEES ON PART VII OF THIS FORM 990. THESE EMPLOYEES ARE STILL EMPLOYED BY THE MEDICAL CENTER SO THEY ARE NOT DISCLOSED AS FORMER KEY EMPLOYEES. CORE FORM, PART VII, SECTION A, COLUMN B CERTAIN BOARD OF TRUSTEE MEMBERS, OFFICERS AND/OR DIRECTORS LISTED ON CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 MAY HOLD SIMILAR POSITIONS WITH BOTH THIS ORGANIZATION AND OTHER RELATED AFFILIATES. THE HOURS SHOWN ON THIS FORM 990 FOR BOARD MEMBERS WHO RECEIVE NO COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, REPRESENTS THE ESTIMATED HOURS DEVOTED PER WEEK FOR THIS ORGANIZATION. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF TRUSTEES OF OTHER RELATED ORGANIZATIONS, THEIR RESPECTIVE HOURS PER WEEK PER ORGANIZATION ARE APPROXIMATELY ONE HOUR. THE HOURS REFLECTED ON PART VII OF THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, PAID OFFICERS AND KEY EMPLOYEES, REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF ALL RELATED ORGANIZATIONS AND THIS ORGANIZATION, IN TOTAL. CORE FORM, PART XI; QUESTION 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES INCLUDE: - CHANGE IN NET INTEREST OF HOLY NAME HEALTH CARE FOUNDATION, INC. - ($2,049,791) - NET ASSETS RELEASED FROM RESTRICTION FOR CAPITAL PURPOSES - $18,889 - TRANSFERS TO AFFILIATES - ($14,926,816) - TRANSFER FROM HOLY NAME HEALTH CARE FOUNDATION, INC.; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION - $58,455 - CHANGE IN BENEFICIAL INTEREST IN HOLY NAME HEALTH CARE FOUNDATION, INC. - $2,326,593 - NET CHANGE IN TEMPORARILY RESTRICTED INVESTMENT GAIN - $84,867 - NET ASSETS RELEASED FROM RESTRICTION FOR OPERATIONS; TEMPORARILY RESTRICTED - ($230,481) - NET ASSETS RELEASED FROM RESTRICTION FOR CAPITAL PURPOSES; TEMPORARILY RESTRICTED - ($18,889) - NET ASSETS TRANSFER; TEMPORARILY RESTRICTED - $1,000,000 - NET ASSETS TRANSFER; PERMANENTLY RESTRICTED - ($1,000,000) - ADJUSTMENT TO REFLECT BEGINNING BALANCES WITH RESPECT TO INCLUSION OF HNMC HOSPITAL/PHYSICIAN ACO, L.L.C., A SINGLE MEMBER LIMITED LIABILITY COMPANY WHOLLY OWNED BY THIS ORGANIZATION - ($500,920) CORE FORM, PART XII; QUESTION 2 AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF HOLY NAME MEDICAL CENTER, INC. AND AFFILIATES, FOR THE YEARS ENDED DECEMBER 31, 2014 AND DECEMBER 31, 2013; RESPECTIVELY. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAINS CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. THE INDEPENDENT CPA FIRM ISSUED AN UNQUALIFIED OPINION WITH RESPECT TO THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS. HOLY NAME MEDICAL CENTER'S AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR THE AUDITED FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT AUDITOR. 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THESE RELATED PARTY TRANSACTIONS ARE RECORDED ON THE REVENUE/EXPENSE AND BALANCE SHEET STATEMENTS OF THIS ORGANIZATION AND ITS AFFILIATES. THESE ENTITIES WORK TOGETHER TO DELIVER HIGH QUALITY HEALTHCARE AND WELLNESS SERVICES TO THE COMMUNITIES IN WHICH THEY ARE SITUATED.