2015-11-13T09:43:37-06:00 2014-12-31 346565596 Ernst & Young US LLP 111 Monument Circle Suite 4000 Indianapolis IN 46204 990 2014-01-01 223392808 Foundation for Morristown Medical Center FOUN 9735932400 475 South Street Morristown NJ 07960 Kevin Lenahan VP of Finance-CFO 9735932400 2015-11-13 0 P00032493 3176817000 2014 2016-04-25 22:37:26Z Kevin Lenahan 475 South Street Morristown NJ 07960 43988541 0 X www.f4mmc.org X 501c3 1995 NJ The Foundation for Morristown Medical Center is a not-for-profit fundraising organization which solicits funds in its general appeal to support both Morristown Medical Center , which is a division of AHS Hospital Corporation, and the community as the Foundation's Board may deem appropriate. 37 25 0 219 5853 3485 15054855 23947581 0 0 5905125 6828185 -1553 -14262 20958427 30761504 5043030 7495485 0 0 2309469 1918028 238765 238332 2266507 290693 260257 7881957 9912102 13076470 20849402 118850144 131435202 3149375 4013254 115700769 127421948 X To inspire community philanthropy to advance exceptional health care for patients at Morristown Medical Center. The objective is to use philanthropy to preserve and expand the Medical Center's programs and services in patient care, clinical research, medical and public health education, and preventive medicine. 0 0 7495485 6505860 This return consists of a standalone Foundation which is a not-for-profit fundraising organization which solicits funds in its general appeal to support both Morristown Medical Center and the Community as deemed appropriate. 7495485 1 1 0 0 0 0 0 0 0 1 0 1 0 0 1 0 1 1 0 0 0 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 1 1 1 0 0 0 0 1 1 0 0 0 1 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 X 37 25 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NJ NY PA FL DE X X Ken Butkowski 9734512005 100 Madison Avenue - Box 920 Morristown NJ 07960 Christopher J Baldwin Trustee 2.00 X 0 0 0 William D Bruen Jr Trustee 2.00 X 0 0 0 William Conger Trustee 2.00 X 0 0 0 Edward B Deutsch Trustee 2.00 X 0 0 0 Shari Bunks Geller Trustee 2.00 X 0 0 0 John A Gerson Trustee 2.00 X 0 0 0 Richard Goryeb Trustee 2.00 X 0 0 0 Joseph Graff Trustee 2.00 X 0 0 0 William Greenblatt Trustee 2.00 X 0 0 0 William Ju MD Trustee 2.00 X 0 0 0 Anthony A Lombardo Trustee 2.00 X 0 0 0 Derek T Malmberg Trustee 2.00 X 0 0 0 Damion A Martins MD Trustee 2.00 37.50 X 0 748859 135210 Gaines Mimms MD trustee 2.00 X 0 0 0 Steven A Maser MD Trustee 2.00 X 0 0 0 Trish O'Keefe Trustee 2.00 37.50 X 0 405615 108142 Daniel Pyo MD Trustee 2.00 X 0 1107 0 Leslie C Quick III Trustee 2.00 X 0 0 0 Marc Robinson Trustee 2.00 X 0 0 0 Gil Santaliz Trustee 2.00 X 0 0 0 David Shulkin MD Trustee 2.00 37.50 X 0 1302441 74352 J Peter Simon Trustee 2.00 X 0 0 0 Mark J Simon Trustee 2.00 X 0 0 0 Paul Sturman Trustee 2.00 X 0 0 0 Guy Taylor MD Trustee 2.00 X 0 0 0 Karen Walsh Trustee 2.00 X 0 0 0 Susan Walter Trustee 2.00 X 0 0 0 Finn Wentworth Trustee 2.00 X 0 0 0 Mark D Widmann MD Trustee 2.00 37.50 X 0 807857 20286 Richard Diegnan Trustee 2.00 X 0 0 0 Linda D Gillam MD Trustee 2.00 37.50 X 0 540706 57003 Veronica M Goldberg Trustee 2.00 X 0 0 0 Catherine Herbst Trustee 2.00 X 0 0 0 Ernest Larini Trustee 2.00 X 0 0 0 Eric L Lazar MD Trustee 2.00 37.50 X 0 551442 42944 Dannette Merchant Trustee 2.00 X 0 0 0 Francine C Shaw Trustee 2.00 X 0 0 0 James F Quinn Chief Developoment Officer 37.50 X 0 420119 100710 Cynthia W O'Donnell Director of Gift Planning 37.50 X 0 162557 35699 Kevin Lenahan VP Finance-CFO 2.00 37.50 X 0 1007280 86444 Hyona Revere Director of Major Gifts 37.50 X 0 161142 38071 Christine Hajsok Director of Finance 37.50 X 0 154699 41531 Regina Diverio Director - Communications 37.50 X 0 133537 22179 Bonnie Gannon Director - Relations 37.50 X 0 124007 33359 Susan Johns Major Gifts 37.50 X 0 118624 24224 0 6639992 820154 0 0 1 0 0 103810 23843771 77683 23947581 2541677 5853 2535824 17478569 13192061 4286508 4286508 4286508 11647 103810 34530 -22883 -22883 9067 446 8621 8621 30761504 0 5853 6808070 6890585 6890585 604900 604900 1600897 1600897 317131 317131 13744 13744 238332 238332 57530 57530 52617 52617 88651 88651 23576 23576 19655 19655 4484 4484 9912102 7495485 150110 2266507 12750632 15605470 50971863 55897703 41723462 45564327 10700736 11512260 2703451 2855442 118850144 131435202 1577190 1900489 1572185 2112765 3149375 4013254 X 29558786 30880665 53515660 61869038 32626323 34672245 115700769 127421948 118850144 131435202 X 20849402 -1117498 -8010725 X 0 1 X 1 0 X 11881492 14766658 20441711 15053302 23933319 86076482 11881492 14766658 20441711 15053302 23933319 86076482 2322075 83754407 2797866 1511954 2140604 2663112 2541677 11655213 97731695 0.85700 0.82120 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 86141983 22846715 2130928 14578343 96541283 74295119 12998553 5394199 6545888 86141983 60179353 18844913 4371231 9100378 74295119 60633886 12989768 148154 13592455 60179353 57108691 9557598 4280237 10312640 60633886 0.64000 0.36000 0 0 0 11512260 C 11512260 Annuities Payable 2112765 2112765 30761504 0 30761504 0 30761504 9912102 0 9912102 0 9912102 Part V, Line 4: The Foundation for Morristown Medical Center(the "Foundation")is a not-for-profit fundraising organization which solicits funds in its general appeal to support both Morristown Medical Center, which is a divison of AHS Hospital Corporation, and the community as the Foundation's Board may deem appropriate. The by-laws of the Foundation were amended on September 27, 2007, to provide that funds received by the Foundation after the date of the amendment may be used for the benefit of the Overlook Division of AHS Hospital Corporation upon approval of the Executive Committee of the Board of the Foundation. X X X X X X 1 Jay Angeletti Group 17 Village Road New Vernon NJ 07976 Consulting and Fundraising 0 13575993 16500 13559493 Harris Connect 1511 Route 22 Suite C-25 Brewster NY 10509 Direct Mail/Internet/Phone 0 386621 209473 177148 CCG Marketing Solutions PO Box 36061 Newark NJ 07188 Mail 0 8195 12359 -4164 13970809 238332 13732477 NJ NY PA FL DE Caniofacial Gala 38685 32378 6307 0 3865 12132 4255 Kids 4 Kids Race 25995 25995 0 1695 775 2702 3 50777 45437 5340 0 234 5015 1325 2532 115457 103810 11647 5794 17922 1325 9489 34530 -22883 NJ 1 0 0 0 0 0 1 Morristown Medical Center 100 Madison Avenue Morristown NJ 07960 521958352 501(c)(3) 6890585 Program Services. 1 Project Independence 93 587900 Nursing School Tuition Grants 7 17000 Part I, Line 2: The organization uses due diligence in the process for reviewing and selecting grant recipients and is comfortable that the grants are used for their intended purpose. The grants issued were made to related organizations to further their exempt purpose. Schedule I, Part III, Line 1 Project Independence is a grant funding project to help Morristown Medical Center patients over a temporary financial hardship. It is overseen by a volunteer committee made up of care providers from different areas of the Medical Center. They meet every two months to review detailed applications. An application can only be submitted by a case worker who would be aware of the financial position of the patient and is working with them to secure other types of help including prescription assistance, food stamps, Social Security disability, etc. Most of the recommenders are social workers or patient liaisons. Grants up to $7,500 are made payable directly to the individual. Schedule I, Part III, Line 2 WAMMC has a long history of supporting quality nursing at Morristown Medical Center. Early on, the Association helped staff the hospital with nurses, and assisted with their housing and uniforms. In 1957, this interest evolved into a formal Scholarship Program, funded entirely by private donations. At that time, one scholarship of $500 would pay tuition costs for the entire three-year program. As tuition costs rose and recipient financial needs increased, generous donations made annually by WAMMC members, continued to underwrite the program. However, the early 1990s brought an economic downturn, which slowed the brisk pace of donations to the Scholarship Program, and necessitated a new approach to ensure the program's future. Since its inception, the Scholarship Program has supported the professional staff at Morristown Medical Center by granting scholarships to high school graduates, and qualified hospital employees pursuing careers in the health care field. A Scholarship Trust Fund was established in 1995, with all scholarship contributions directly benefiting the fund. Presently, the Scholarship Committee spends only the interest generated annually by the fund. In this way, the invested principal remains intact, securing both the fund's future and the Scholarship Program's mission. WAMMC largely attributes the steady growth of this program to the hard work of successful fundraising and the generous donations of WAMMC members. In 2014, $20k was awarded to 8 scholars with award amounts varying between $12 and $4k. In 2015, WAMMC is planning to award $25k. The number of awards and their amounts will vary and will be decided by the Scholarship Committee during their review of the completed applications. Scholarship candidates typically possess high-ranking employee evaluations and are often described as, "Among the best in the department." The candidates are often leaders in their field as members of honorary societies, as hospital committee chairs, or as participants in department studies. It is not unusual for our scholars to be as actively engaged in their local community, as they are in the workplace 0 0 0 0 0 0 0 0 0 Damion A Martins MD Trustee 0 489630 0 195013 0 64216 0 110100 0 25110 0 884069 0 97600 Trish O'Keefe Trustee 0 321347 0 63200 0 21068 0 89000 0 19142 0 513757 0 63200 David Shulkin MD Trustee 0 647508 0 262700 0 392233 0 50992 0 23360 0 1376793 0 0 Mark D Widmann MD Trustee 0 807857 0 0 0 0 0 0 0 20286 0 828143 0 0 Linda D Gillam MD Trustee 0 501606 0 39100 0 0 0 43800 0 13203 0 597709 0 0 Eric L Lazar MD Trustee 0 490760 0 2000 0 58682 0 18200 0 24744 0 594386 0 0 James F Quinn Chief Developoment Officer 0 276226 0 51000 0 92893 0 77600 0 23110 0 520829 0 51000 Cynthia W O'Donnell Director of Gift Planning 0 156657 0 5900 0 0 0 17557 0 18142 0 198256 0 5900 Kevin Lenahan VP Finance-CFO 0 697604 0 268300 0 41376 0 61334 0 25110 0 1093724 0 0 Hyona Revere Director of Major Gifts 0 155642 0 5500 0 0 0 15564 0 22507 0 199213 0 5500 Christine Hajsok Director of Finance 0 148999 0 5700 0 0 0 16921 0 24610 0 196230 0 5700 Regina Diverio Director - Communications 0 128337 0 5200 0 0 0 13101 0 9078 0 155716 0 5200 Bonnie Gannon Director - Relations 0 118907 0 5100 0 0 0 13325 0 20034 0 157366 0 5100 Part I, Line 6 An annual incentive plan exists for the Foundation's Director. The incentive plan distributes bonuses to the Director based on performance results on various performance measurements. The performance measurements include: - Total Philanthropy - Cost per dollar raised - Budget - Soliciatations of $100K or more - General Gifts - Renewal - Mail & Phone - Special Gifts - Acquisition and Renewal - Major Gifts - Donor Renewal - Cost - Operating Gain/(Loss) - Cost - Expense per Adjusted Admission/CMIA System - Service - Patient Satisfaction Overall - Growth - IP Admissisions - Growth - OP Visits - People - Employee Engagement Index - Quality & Safety - Nosocomial Infection Maker - Quality & Safety - Mortality - Individual Goals The above performance measures have the following three specific performance goals in order to determine any incentive award: Threshold Target Maximum These above amounts were paid by a related organization. Deloitte Refer to below. 737105 Performance. Derek Malmberg (Board Member-Trustee) is a Partner at Deloitte. AHS Hospital Corp (A related organization) paid Deloitte $737,105 during 2014 for applicable services. Transaction is considered to be negotiated at arms-length. 0 MidAtlantic Neonatiology Associates Refer to below. 308497 Performance. Gaines Mimms, MD (Board Member-Trustee) is a Neonatologist at MidAtlantic Neonatiology Assoc, AHS Hospital Corp (A related organization) paid MidAtlantic Neonatiology $308,497 during 2014 for applicable services. Transaction is considered to be negotiated at arms-length. 0 Mcelroy Deutsch Mulvaney and Carpenter Refer to below. 47853 Performance. Edward B Deutsch (Board Member-Trustee) is a partner at McElroy, Deutsch, Mulvaney and Carpenter. AHS Hospital Corp (A related organization) paid McElroy, Deutsch, Mulvaney and Carpenter $47,853 during 2014 for applicable services. Transaction is considered to be negotiated at arms-length. 0 Anesthesia Associates of Morristown Refer to below. 72004 Performance. Dannette Merchant (Board Member-Trustee) husband (Sameer) is an Anesthesiologist at Anesthesia Associates of Morristown. AHS Hospital Corp (A related organization) paid Anestehsi Associates of Morristown $72,004 during 2014 for applicable services. Transaction is considered to be negotiated at arms-length. 0 Anesthesia Associates of Morristown Refer to below. 72004 Performance. Guy Taylor (Board Member-Trustee) is an Anesthesiologist at Anesthesia Associates of Morristown. AHS Hospital Corp (A related organization) paid Anestehsia Associates of Morristown $72,004 during 2014 for applicable services. Transaction is considered to be negotiated at arms-length. 0 PWC Refer to below. 617341 Performance. Marc Robinson (Board Member-Trustee) is a Partner at PWC. AHS Hospital Corp (A related organization) paid PWC $617,341 during 2014 for applicable services. Transaction is considered to be negotiated at arms-length. 0 X 1536 Sale of comp property X 17279 Sale of comp property X 7 2129 Sale of comp property X Toys 139 34838 Sale of comp propert X Entertainment 14 13675 Cash value of gift X Electronics 15 5366 Sale of comp propert X Gift Cards 5 2860 Cash value of cards 0 1 0 Form 990, Part VI, Section A, line 6 As per the by-laws, each of the entities has one "member", that being Atlantic Health System, Inc. There are no other members or classes of membership whatsoever as indicated in the by-laws. Form 990, Part VI, Section A, line 6 Atlantic Health System, Inc. is the sole member of this organization. Atlantic Health System, Inc. has the right to elect the members of this organization's board of trustees and has certain reserved powers as dined in the organiztion's bylaws. Form 990, Part VI, Section A, line 7a Atlantic Health System, Inc. is the only "member" which wholly owns the Foundation for Morristown Medical Center. As a result, Atlantic Health System, Inc. may elect the members of the governing bodies for each of the entities. Form 990, Part VI, Section A, line 7b Atlantic Health System, Inc. is the only "member" which wholly owns the Foundation for Morristown Medical Center. As a result, Atlantic Health System, Inc. approves the decisions of the governing bodies. Form 990, Part VI, Section B, line 11 The final draft of the IRS 990 was distributed to the "Accounting Sub-Committee" for their review. The "Accounting Sub-Committee" then presents it to the Financial Oversight Committee who will then present it to the Board of Directors. Form 990, Part VI, Section B, line 12c In conjunction wtih Atlantic Health System (Parent), the Foundation for Morristown Medical Center requires disclosure of potential conflicts. This policy governs all personnel at the Foundation, including Board Members. Additionally, the Board Committee members must fill out annual disclosures with specific questions regarding potential conflicts. For potential conflicts involving employees, conflicts involving business relationships require prior disclosure and approval by the Compliance Officer (General Counsel). Conflicts involving Board members require approval from the Compliance Officer and the head of the Audit Committee, who may refer those conflicts to the Compliance Committee of the Board. Restrictions are fact-dependent, but may include recusal from deliberations regarding subject matter affected by the conflict. Form 990, Part VI, Section B, line 15 In conjunction with Atlantic Health System (Parent): Line 15A: - A review of officer compensation by an independent 3rd party (Integrated Healthcare Strategies) is completed every year. The most recent survey was conducted in 2014. Officers include President and CEO AH, VP HR & CAO, VP Finance & CFO, VP Legal Affairs, VP Quality & Chief Medical Officer, AHS; VP Government Affairs; VP, Behavioral & Integrative Medicine & CIO, VP Finance & Treasurer, VP AHS & President OH, VP AH & President MMC, and VP AHS & President NMC; VP, System Development & Chief Strategy Officer. In 12/15/2013, VP AHS & President CCM. - On behalf of Atlantic Health, Integrated Healthcare Strategies conducts an annual total compensation survey based on appropriate comparability data for like positions in like organizations. - The results of the survey are presented to the Executive Compensation Committee of the board which documents the findings and recommendations in committee minutes. Line 15b: - Compensation for key physicians is determined by soliciting salary data from 3 to 4 published sources. These salary recommendations are then reviewed with the MD Contract Committee and approved by the Physician Compensation Committee of the board. Form 990, Part VI, Section C, line 18 Currently the Foundation for Morristown Medical Center retains copies of the filed IRS 990 for the last three years and IRS Form 1023 with the most senior management's assistant. Public disclosure of these IRS 990's can be made at any time at each of the organization's sites. In addition, the 990 is posted on the website "www.foundationcenter.org" and "guidestar.org". Form 990, Part VI, Section C, line 19 The organization does not currently make it's financial statements open to public disclosure but the statement of financial position is available by accessing the Form 990 from the website. The governing documents and conflict of interest polices are not currently made available to the public. Form 990, Part XI, line 9: Distributions to Morristown Division-Capital -8,072,483. Beneficial Interest in Charitable Remainder Unitrust 61,758. AHS Hospital Corp 475 South Street Morristown NJ 07960 521958352 Healthcare NJ 501(c)(3) Line 3 Atlantic Health System Inc 1 Atlantic Ambulance Corporation 475 South Street Morristown NJ 07960 223820288 Healthcare Transportation NJ 501(c)(3) Line 9 Atlantic Health System Inc 1 Atlantic Health System Inc 475 South Street Morristown NJ 07960 223380375 Human Health through AHS Hospital Corp. NJ 501(c)(3) Line 11a, I N/A 0 Newton Medical Center Foundation 175 High Street Newton NJ 07860 222618102 Administers donations, grants and bequests and performs fundraising NJ 501(c)(3) Line 7 Atlantic Health System Inc 1 Prime Care Inc 175 High Street Newton NJ 07860 222759566 Provides home health and other healthcare services NJ 501(c)(3) Line 9 Atlantic Health System Inc 1 North Jersey Health Care Properties Inc 175 High Street Newton NJ 07860 223519709 Owns commercial buildings and conducts leasing activities NJ 501(c)(2) Atlantic Health System Inc 1 PRACTICE ASSOCIATES MEDICAL GROUP 475 South Street Morristown NJ 07960 202088165 PHYSICIAN SERVICES NJ 501(c)(3) Line 11a, I Atlantic Health System Inc 1 Chilton Memorial Corporation 97 West Parkway Pompton Plains NJ 07444 222719339 support Chartiable Exempt Programs and Services of Medical Center NJ 501(c)(3) Line 7 Atlantic Health System Inc 1 Chilton Medical Center Auxiliary Inc 97 West Parkway Pompton Plains NJ 07444 222883605 Support Chartiable Exempt Programs and Services of Medical Center NJ 501(c)(3) Line 11a, I Atlantic Health System Inc 1 Chilton Medical Center FoundationInc 97 West Parkway Pompton Plains NJ 07444 223084817 Support Chartiable Exempt ProgramS and ServiceS of Medical Center NJ 501(c)(3) Line 7 Atlantic Health System Inc 1 Chilton Realty Holding Inc 97 West Parkway Pompton Plains NJ 07444 223067739 Real Estate and Leasing Activities for the Benefit of Exempt Organization NJ 501(c)(2) Atlantic Health System Inc 1 Morris Photopheresis 100 Madison Avenue Morristown NJ 07960 223314012 Healthcare Research NJ 0 0 Affiliated Collection Services LLC 17 Prospect Street Morristown NJ 07960 270555659 Collection Services NJ 0 0 Morristown Medical Investors 200 American Road Morris Plains NJ 07950 650840535 Real Estate NJ 0 0 Primary Care Partners LLC 475 South Street Morristown NJ 07960 274980253 Physician Services NJ 0 0 Atlantic Health Management Corp and Subsidiaries 200 American Road Morris Plains NJ 07950 223538027 Health NJ N/A C 0 AHS Insurance Company LTD 200 American Road Morris Plains NJ 07950 223380375 Insurance NJ Atlantic Health System Inc C 0 Nutley Medical Care PA 100 Madison Avenue Morristown NJ 07960 223645010 Healthcare NJ Atlantic Health System Inc C 0 Non-Invasive Diagnstics PA 100 Madison Avenue Morristown NJ 07960 202027439 Healthcare NJ Atlantic Health System Inc C 0 Specialty Care of Practice Associates PA 100 Madison Avenue Morristown NJ 07960 030376428 Healthcare NJ Atlantic Health System Inc C 0 Maternal Fetal Medicine of PRactice Associates PA 100 Madison Avenue Morritown NJ 07960 030376421 Healthcare NJ Atlantic Health System Inc C 0 Madison Pediatrics PA 100 Madison Avenue Morristown NJ 07960 223645007 Healthcare NJ Atlantic Health System Inc C 0 AHS ACO LLC 475 South Street Morristown NJ 07960 273800813 Physician Practice NJ AHS Investment Corp C 0 The Northwest New Jersey MedicalSurgicalAlliance PC 175 High Street Newton NJ 07860 450577942 Healthcare Services NJ AHS Investment Corp C 0 The Northwest New Jersey Urgent Care Alliance PC 175 High Street Newton NJ 07860 830492357 Healthcare Services NJ Atlantic Health System Inc C 0 Chilton Community Care Inc and Subs 97 West Parkway Pompton Plains NJ 07444 222869148 Healthcare NJ Atlantic Health System Inc C 0 Chilton Medical Group PC 97 West Parkway Pompton Plains NJ 07444 383769436 Healthcare NJ C 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 AHS Hospital Corp P 22944726 Actual amount of transaction. AHS Hospital Corp B 16994960 Actual amount of transaction. AHS Hospital Corp B 8072483 Actual amount of transaction.