2015-11-16T15:36:15-06:00 2014-12-31 271728945 O'CONNOR DAVIES LLP 15 ESSEX RD PARAMUS NJ 076521412 990 2014-01-01 320041186 VALLEY PHYSICIAN SERVICES INC VALL 2014478000 223 NORTH VAN DIEN AVE RIDGEWOOD NJ 07450 MARC GOLDSTEIN PRESIDENT 2014478000 2015-11-16 1 EDWARD G O'CONNOR P00434443 2017129800 2015-11-16 2014 2016-03-07 17:11:31Z MARC GOLDSTEIN 15 ESSEX ROAD PARAMUS NJ 07652 59731680 0 X WWW.VALLEYHEALTH.COM X 2002 NJ VALLEY PHYSICIAN SERVICES, INC. WAS FORMED TO PROVIDE MEDICAL CARE AND TO CARRY OUT THE PURPOSES OF THE VALLEY HEALTH SYSTEM, INC. 10 6 703 6 0 0 0 0 43646815 50490181 0 0 5535103 9241499 49181918 59731680 0 0 0 0 59839341 83626193 0 0 0 23841047 24607583 83680388 108233776 -34498470 -48502096 21108375 22816359 12591937 14871922 8516438 7944437 TO PROVIDE MEDICAL CARE TO PATIENTS AND TO FACILITATE THE MEDICAL NEEDS OF THE PATIENTS OF THE VALLEY HEALTH SYSTEM, INC. 0 0 96531398 50490181 VALLEY PHYSICIAN SERVICES PROVIDES MEDICAL PATIENT CARE, GENERAL/OTHER AND PEDIATRIC PULMONARY CARE. THE TOTAL NUMBER OF PATIENTS SEEN IN 2014 WAS 157,139. 96531398 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 94 0 703 1 0 0 0 0 0 0 0 0 0 0 X 10 6 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 NJ X X MARIETTA STONE 2012916391 15 ESSEX ROAD PARAMUS NJ 07652 ROBERT E FINK CHAIRMAN 0.50 0.50 X X 0 0 0 JEFFREY S TUCKER VICE CHAIRMAN 0.50 0.50 X X 0 0 0 TOM POLEN SECRETARY/TREASURER 0.50 0.50 X X 0 0 0 WARREN F COOKE ESQ TRUSTEE 0.50 0.50 X 0 0 0 JOHN KANDRAVY ESQ TRUSTEE 0.50 1.00 X 0 0 0 SUNEET MITTAL MD TRUSTEE 0.50 39.50 X 0 705987 38186 THOMAS RAKOWSKI MD TRUSTEE 39.50 0.50 X 832753 0 34002 MARIA SCIBETTA MD TRUSTEE 39.50 0.50 X 179304 0 6045 STEVEN SILVERSTEIN TRUSTEE 0.50 0.50 X 0 0 0 AUDREY MEYERS TRUSTEE 0.50 39.50 X 0 1231416 981323 GAIL MATTHEWS MD VICE CHAIRMAN RESIGNED NOV. 2014 39.50 0.50 X 583306 0 17334 MARC R GOLDSTEIN PRESIDENT 39.50 0.50 X 498847 0 28053 JEAN FLANAGAN EXECUTIVE DIRECTOR 39.50 0.50 X 164953 0 38265 MARYANN KEPPLE CFO 39.50 0.50 X 53067 0 0 LAURIE C DEBENEDETTO ASSISTANT SECRETARY 0.50 39.50 X 0 87022 14885 ROBERT KORST MEDICAL DIRECTOR 40.00 X 1091228 0 44393 ALI NASSERI PHYSICIAN 40.00 X 993667 0 36432 DENNIS REISON PHYSICIAN 40.00 X 831137 0 36340 GERALD SOTSKY PHYSICIAN 40.00 X 861428 0 37114 ALEX ZAPOLANSKI PHYSICIAN 40.00 X 1382868 0 25923 7472558 2024425 1338295 10 0 1 0 ATHENA HEALTH INC 311 ARSENAL ST WATERTOWN MA 02472 MEDICAL BILLING 2617675 VISBEEN CONSTRUCTION CO 555 GOFFLE ROAD RIDGEWOOD NJ 07450 CONSTRUCTION FEE 1511805 PHYSICIAN SALES & SERVICE INC 208 PASSAIC AVE STE 2 FAIRFIELD NJ 07004 DISTRIBUTOR OF MEDICAL PRODUCTS, BILING 1072678 SOUTHWIND PO BOX 79461 BALTIMORE MD 21279 GLOBAL RESEARCH, TECHNOLOGY & CONSULTING 801093 EXPRESS SCRIPTS INC 14000 RIVERPORT DR MARYLAND HEIGHTS MO 606731216 BENEFIT MANAGEMENT 698277 5 PATIENT SERVICE REVENUE 624100 50490181 50490181 50490181 OTHER INCOME FROM THE VALLY HOSPI 624100 8329498 8329498 OTHER INCOME 624100 912001 912001 9241499 59731680 50490181 0 9241499 2435926 1652743 783183 70740287 65318080 5422207 1280573 1190309 90264 5599220 5156635 442585 3570187 3269688 300499 205417 205417 79600 79600 6374109 6033856 340253 181731 181731 1019891 466582 553309 476940 76772 400168 5942685 5942685 116370 116370 60975 60975 3439445 2389971 1049474 1390681 1390681 SUPPLIES 2338926 2338926 BAD DEBT EXPENSE 739225 739225 TEMPORARY HELP 639941 639941 OUTSIDE SERVICE & CONTR 334674 334674 1266973 565245 701728 108233776 96531398 11702378 0 2948758 2085868 4051631 6050039 9292 219828 15120833 4634293 7799404 10486540 1399837 443852 2929273 3276504 1970180 253728 21108375 22816359 8857475 13892944 3734462 978978 12591937 14871922 X 8516438 7944437 8516438 7944437 21108375 22816359 X -48502096 47930095 X X 0 1 X 1 0 X 3057299 8452622 16612425 43646815 50490181 122259342 3057299 8452622 16612425 43646815 50490181 122259342 0 0 0 122259342 63052 5535103 9241499 14839654 3057299 8452622 16675477 49181918 59731680 137098996 0.89180 0.00000 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME FROM VMG - 2012 AMOUNT: $ 63,052. 2013 AMOUNT: $ 1,260,000. OTHER INCOME FROM THE VALLEY HOSPITAL - 2013 AMOUNT: $ 4,275,103. 2014 AMOUNT: $ 8,329,498. OTHER INCOME - 2014 AMOUNT: $ 912,001. 7773438 2649143 5124295 4951883 1985150 2966733 2395512 2395512 10486540 DUE TO AFFILIATES 5899 ESTIMATED THIRD-PARTY PAYER SETTLEMENT 973079 978978 X 77996912 18265232 18265232 59731680 0 59731680 128897418 20663642 20663642 108233776 0 108233776 PART X, LINE 2: VPS IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. VPS RECOGNIZES THE EFFECT OF TAX POSITIONS ONLY WHEN THEY ARE MORE LIKELY THAN NOT TO BE SUSTAINED. MANAGEMENT HAS DETERMINED THAT VPS HAD NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION OR DISCLOSURE. VPS IS NO LONGER SUBJECT TO EXAMINATIONS BY THE APPLICABLE TAXING JURISDICTIONS FOR PERIODS PRIOR TO THE 2011 TAX YEAR. PART XI, LINE 2D - OTHER ADJUSTMENTS: REVENUE ATTRIBUTABLE TO OTHER ENTITIES 18,265,232. PART XII, LINE 2D - OTHER ADJUSTMENTS: EXPENSES ATTRIBUTABLE TO OTHER ENTITIES 20,663,642. X X 0 1 0 0 0 0 0 1 0 SUNEET MITTAL MD TRUSTEE 0 545581 0 158860 0 1546 0 9100 0 29086 0 744173 0 0 THOMAS RAKOWSKI MD TRUSTEE 750229 0 75000 0 7524 0 7949 0 26053 0 866755 0 0 0 MARIA SCIBETTA MD TRUSTEE 155059 0 6315 0 17930 0 6045 0 0 0 185349 0 0 0 AUDREY MEYERS TRUSTEE 0 941869 0 0 0 289547 0 960538 0 20785 0 2212739 0 215436 GAIL MATTHEWS MD VICE CHAIRMAN RESIGNED NOV. 2014 534237 0 44167 0 4902 0 8427 0 8907 0 600640 0 0 0 MARC R GOLDSTEIN PRESIDENT 404695 0 88689 0 5463 0 8656 0 19397 0 526900 0 0 0 JEAN FLANAGAN EXECUTIVE DIRECTOR 150271 0 13957 0 725 0 12536 0 25729 0 203218 0 0 0 ROBERT KORST MEDICAL DIRECTOR 992268 0 96338 0 2622 0 17779 0 26614 0 1135621 0 0 0 ALI NASSERI PHYSICIAN 865189 0 125856 0 2622 0 7747 0 28685 0 1030099 0 0 0 DENNIS REISON PHYSICIAN 741113 0 82500 0 7524 0 7915 0 28425 0 867477 0 0 0 GERALD SOTSKY PHYSICIAN 740126 0 116400 0 4902 0 7929 0 29185 0 898542 0 0 0 ALEX ZAPOLANSKI PHYSICIAN 1355416 0 20507 0 6945 0 6475 0 19448 0 1408791 0 0 0 PART I, LINE 4B THE FOLLOWING PERSON RECEIVED PAYMENT FROM SERP PLAN DURING 2014: AUDREY MEYERS RECEIVED $215,436. THIS AMOUNT IS TAXABLE AND REPORTED ON PART II COLUMN F. -THE FOLLOWING PERSON CONTRIBUTED IN 457(F) PLAN DURING 2014: AUDREY MEYERS CONTRIBUTED $937,838. THESE CONTRIBUTIONS ARE INCLUDED IN PART II COLUMN C IN ADDITION TO 401(K)/457(B) CONTRIBUTIONS. PART I, LINE 7 BONUS IS BASED ON PERFORMANCE AND IS DETERMINED BY THE BOARD OF TRUSTEES OR PHYSICIAN CONTRACTS. BONUS IS TAXABLE AND INCLUDED EACH OF THE RECIPIENT'S FORM W-2. BONUS CAN ALSO BE DEFERRED TO 457(F) PLAN AND 401(K) PLAN AND THUS IS NOT TAXABLE IN THE CURRENT YEAR. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION IS A MEMBERSHIP CORPORATION. THE SOLE MEMBER OF THE ORGANIZATION SHALL BE THE PARENT, THE VALLEY HOSPITAL,INC. FORM 990, PART VI, SECTION A, LINE 7A THE PARENT BOARD SHALL HAVE THE RIGHT TO APPROVE THE SLATE OF NOMINEES FOR TRUSTEES AND/OR TO DETERMINE AND SUBMIT A SUBSTITUTE SLATE OF NOMINEES PURSUANT TO THE PROVISIONS OF SECTION 3.3 OF THE BY-LAWS. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING GOVERNANCE DECISIONS ARE RESERVED AND/OR SUBJECT TO APPROVAL OF THE PARENT BOARD: 1) STRATEGIC ACTIONS 2) MAJOR CORPORATE DECISIONS 3) ANY SINGLE EXPENDITURE GREATER THAN FIVE PERCENT OF THE ANNUAL OPERATING BUDGET 4) SELECTION OF AUDITORS 5) APPOINTMENT AND REMOVAL OF THE CHIEF PHYSICIAN EXECUTIVE/CMO AND THE PRESIDENT OF THE GROUP 6) MAJOR CORPORATE DECISIONS REGARDING THE INCURRENCE OF DEBT IN EXCESS OF FIVE PERCENT OF THE OPERATING BUDGET FORM 990, PART VI, SECTION B, LINE 11 VPS HAS ITS FORM 990 PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND HAS ESTABLISHED THE FOLLOWING REVIEW PROCESS TO ENSURE THAT THE INFORMATION REPORTED IS COMPLETE AND ACCURATE. WHEN THE FROM 990 IS PREPARED, IT'S SUBMITTED TO MANAGEMENT FOR REVIEW. ANY COMMENTS ARE SUMMARIZED AND PROVIDED TO THE INDIVIDUAL IN CHARGE. EACH ISSUE IS DOCUMENTED AND ADDRESSED UNTIL THE RETURN IS FINALIZED AND APPROVED FOR FILING WITH THE INTERNAL REVENUE SERVICE. THE FORM 990 IS MADE AVAILABLE FOR THE BOARD'S REVIEW, BY HARD COPY AND OR ELECTRONIC COPY, AFTER IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C VALLEY PHYSICIAN SERVICES, INC. HAS A CONFLICT OF INTEREST POLICY THAT APPLIES TO ALL OF THE MEMBERS OF MANAGEMENT AND BOARD MEMBERS. ANNUALLY, THE BOARD MANDATES THAT ALL MEMBERS OF MANAGEMENT AND THE GOVERNING BODY SIGN A CONFLICT OF INTEREST POLICY AND DISCLOSE ANY POTENTIAL OR ACTUAL CONFLICTS OF INTEREST THAT MAY EXIST ANNUALLY. IF A CONFLICT OF INTEREST EXISTS THE ORGANIZATION WILL NOTIFY MEMBERS OF MANAGEMENT OR THE GOVERNING BODY AND INVESTIGATE THE CONFLICT. IF IT IS DETERMINED THAT AN ACTUAL CONFLICT OF INTEREST EXISTS, THE MEMBER OF MANAGEMENT OR THE GOVERNING BODY WILL BE NOTIFIED IMMEDIATELY AND WILL NOT BE ALLOWED TO VOTE OR BE PART OF ANY DECISIONS ABOUT SUCH TRANSACTIONS. THIS PROCESS IS DOCUMENTED IN THE MINUTES OF THE BOARD MEETINGS. FORM 990, PART VI, SECTION B, LINE 15 VPS HAS ESTABLISHED A POLICY FOR COMPENSATION OF ITS OFFICERS, TOP MANAGEMENT AND KEY EMPLOYEES. THE POLICY MANDATES THAT COMPENSATION FOR ITS OFFICERS, TOP MANAGEMENT AND KEY EMPLOYEES, BE PERIODICALLY REVIEWED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES FREE OF ANY MEMBERS WITH CONFLICTS OF INTEREST RELATED THERETO. THE COMMITTEE DETERMINES THAT THE EXECUTIVES ARE BEING PAID AN APPROPRIATE LEVEL OF COMPENSATION BY USING COMPARATIVE DATA FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. COMPENSATION DECISION ON THE AMOUNT OF COMPENSATION PAID AND TERM IS ADEQUATELY DOCUMENTED IN A CONTEMPORANEOUSLY WRITTEN FORMAT. THIS PROCESS WAS LAST UNDERTAKEN IN 2014. FORM 990, PART VI, SECTION C, LINE 19 VPS MAKES ITS FORM 990 AVAILABLE FOR PUBLIC INSPECTION AS REQUIRED UNDER SECTION 6104 OF THE INTERNAL REVENUE CODE BY POSTING IT ON GUIDESTAR.COM AND OTHER SIMILAR TYPES OF WEBSITES. IN ADDITION TO FORM 990 THE FINANCIAL STATEMENTS, FORM 1023 AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON WRITTEN REQUEST AT 223 NORTH VAN DIEN AVE, RIDGEWOOD, NJ 07450. FORM 990, PART XI, LINE 9: TRANSFER FROM AFFILIATES 48,851,553. EQUITY LOSS ON INVESTMENT -955,985. CHANGE IN PRIOR YEAR ALLOWANCE AND REIMBURSEMENT ESTIMATES 34,527. FORM 990, PART XI, LINE 2C THE PROCESS FOR SELECTING AN INDEPENDENT ACCOUNTANT AND ESTABLISHING A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT HAS NOT CHANGED FROM PRIOR YEARS. THE VALLEY HOSPITAL INC 223 NORTH VAN DIEN AVE RIDGEWOOD NJ 07450 221487307 PROVIDE HEALTHCARE PROGRAMS AND SERVICES TO ALL NJ 501(C)(3) LINE 3 VALLEY HEALTH SYSTEM INC 0 VALLEY HEALTH SYSTEM INC 223 NORTH VAN DIEN AVE RIDGEWOOD NJ 07450 222922016 PROVIDE MANAGEMENT AND PLANNING SERVICES TO ITS MEMBERS NJ 501(C)(3) LINE 7 N/A 0 VALLEY MEDICAL SERVICES 223 NORTH VAN DIEN AVE RIDGEWOOD NJ 07450 223260998 PROVIDE THE VALLEY HOSPITAL WITH EMPLOYED PHYSICIANS AND MEDICAL SERVICES NJ 501(C)(3) LINE 9 THE VALLEY HOSPITAL INC 0 VALLEY HOME CARE INC 15 ESSEX ROAD PARAMUS NJ 07652 223208480 PROVIDE HOME CARE AND HOSPICE SERVICES TO RESIDENTS OF NORTHERN NJ NJ 501(C)(3) LINE 9 VALLEY HEALTH SYSTEM INC 0 THE VALLEY HOSPITAL FOUNDATION INC 223 NORTH VAN DIEN AVE RIDGEWOOD NJ 07450 222324554 SOLICIT, RECEIVE AND APPLY CONTRIBUTIONS FOR THE BENEFIT OF THE HOSPITAL NJ 501(C)(3) LINE 7 VALLEY HEALTH SYSTEM INC 0 VALLEY HEALTH MEDICAL GROUP NJPC 15 ESSEX ROAD PARAMUS NJ 07652 223475166 OPERATES URGENT/PRIMARY CARE CLINICS NJ N/A C 0 VALLEY HEALTH MEDICAL GROUP 15 ESSEX ROAD PARAMUS NJ 07652 223475233 OPERATES URGENT/PRIMARY CARE CLINICS NJ VALLEY HEALTH SYSTEM INC C 0 VALLEY PHYSICIAN SERVICE NY PC 15 ESSEX ROAD PARAMUS NJ 07652 453125678 OPERATES URGENT/PRIMARY CARE CLINICS NY VALLEY HEALTH SYSTEM INC C 0 VHS INSURANCE COMPANY LTD 010 MAIN STREET CAYMAN ISLANDS CJ 980408200 PROVIDES PROFESSIONAL, MEDICAL AND COMMERCIAL GENERAL LIABILITY INSURANCE CJ THE VALLEY HOSPITAL INC C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1