2013-01-30T15:46:39-06:00 2011-12-31 WithumSmithBrown PC 465 South St Ste 200 Morristown NJ 079606497 990 2011-01-01 223548695 CAPITAL HEALTH SYSTEM INC % SHANE F FLEMING CPA CAPI 6092785415 750 BRUNSWICK AVENUE TRENTON NJ 08638 SHANE F FLEMING 2013-01-21 true Scott Mariani 9738989494 2011 2016-02-25 16:41:14Z AL MAGHAZEHE PHD FACHE 750 BRUNSWICK AVENUE TRENTON NJ 08638 556665289 false X WWW.CAPITALHEALTH.ORG X 1997 NJ THE ORGANIZATION IS COMMITTED TO PROVIDING COMPREHENSIVE, QUALITY HEALTHCARE SERVICES WHICH IMPROVE AND SUSTAIN THE HEALTH STATUS OF THE RESIDENTS PRIMARILY IN CENTRAL NEW JERSEY AND LOWER BUCKS COUNTY. 22 16 4483 285 757099 -232884 4801891 4266045 493761505 512421370 7529559 27862228 3008976 4738571 509101931 549288214 202000 200535 0 0 264493712 290464889 0 0 0 224308597 254680768 489004309 545346192 20097622 3942022 965266420 1193667615 637480517 891211033 327785903 302456582 X THE ORGANIZATION IS COMMITTED TO PROVIDING COMPREHENSIVE, QUALITY HEALTHCARE SERVICES WHICH IMPROVE AND SUSTAIN THE HEALTH STATUS OF THE RESIDENTS PRIMARILY IN CENTRAL NEW JERSEY AND LOWER BUCKS COUNTY. THE ORGANIZATION ASSURES ACCESSIBLE, COMPASSIONATE HEALTHCARE SERVICES THAT HONOR THE DIGNITY OF EVERY PERSON. THE ORGANIZATION WILL BE A LEADER IN DEFINING THE COMMUNITY'S HEALTHCARE NEEDS, IN PROVIDING APPPROPRIATE SOLUTIONS, AND DEVELOPING A COMPREHENSIVE CONTINUUM OF CARE INCLUDING EDUCATION, PREVENTION, DISEASE MANAGEMENT AND RESTORATIVE PROGRAMS. THE ORGANIZATION PROVIDES 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 SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT. false false 82094790 0 66735978 EXPENSES INCURRED IN PROVIDING MEDICALLY NECESSARY PERIOPERATIVE 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 SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT. 46758606 0 59580575 EXPENSES INCURRED IN PROVIDING MEDICALLY NECESSARY EMERGENCY ROOM AND EMS SERVICES 24/7 365 DAYS A YEAR TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT. 35043058 0 30676374 EXPENSES INCURRED IN PROVIDING MEDICALLY NECESSARY MATERNAL CHILD HEALTH 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 SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT. 326935173 200535 356185542 490831627 true true false true false false false false false true false true false true false false true false true true false false false false false true true true false true false false false false false false true true false false false false false true true true false false true 708 0 true 4483 true true true true CJ false false false true true false false false false X 22 16 false false false false false false false true true false false true true true true true true true true false NJ X SHANE F FLEMING CPA 6092785415 750 BRUNSWICK AVENUE TRENTON NJ 08638 X SAMUEL J PLUMERI JR 1.0 X X 0 0 0 NANCY H BECKER 1.0 X X 0 0 0 GILBERT W LUGOSSY 1.0 X X 0 0 0 MILES W TRUESDELL JR 1.0 X X 0 0 0 CARMEN M GARCIA ESQ 1.0 X X 0 0 0 REVEREND DARRELL L ARMSTRONG 1.0 X 0 0 0 JUDGE GERALD J COUNCIL JSC 1.0 X 0 0 0 LOUIS DAMELIO MD 55.0 X 778936 0 16831 ANTHONY C HOOPER 1.0 X 0 0 0 JOSEPH R JINGOLI 1.0 X 0 0 0 MARTIN P JOHNSON 1.0 X 0 0 0 RAMAN KAPUR 1.0 X 0 0 0 DANIEL J LEE MD 25.0 X 105596 0 0 AL MAGHAZEHE PHD FACHE 55.0 X X 1734066 0 494595 SEAN S MURRAY 1.0 X 0 0 0 CLINTON H OGOLO MD 1.0 X 0 0 0 JOHN F RICCI 1.0 X 0 0 0 MICHAEL L SOMERSTEIN MD 1.0 X 0 0 0 TELECHERY SUDHAKAR MD 1.0 X 0 0 0 JOHN P THURBER 1.0 X 0 0 0 RONALD L WARREN MD 1.0 X 0 0 0 MARK S WHITMAN MD 25.0 X 123907 0 0 RONALD J GUY 55.0 X 1787348 0 36353 SHANE F FLEMING CPA 55.0 X 394768 0 30573 EUGENE W GROCHALA 55.0 X 516775 0 85070 STEPHEN A MILLER JD 55.0 X 309215 0 59613 LARRY DISANTO 55.0 X 1021075 0 351757 JAN GABIN ESQ 55.0 X 569131 0 70246 ROBERT REMSTEIN DO 55.0 X 547547 0 86835 PATRICIA V CAVANAUGH RN MSN 55.0 X 503968 0 16206 NATHAN BOSK FACHE 55.0 X 499331 0 75211 J SCOTT CLEMMENSEN 55.0 X 437373 0 89359 GREGORY N DADAMO 55.0 X 423796 0 67117 MARGARET SULLIVAN 55.0 X 414328 0 83016 DENNIS DOOLEY 55.0 X 397484 0 84967 LINDA DITE 55.0 X 391144 0 52503 EILEEN M HORTON 55.0 X 353193 0 61669 ARLENE WALSH 55.0 X 279841 0 44000 ARLINE M STEPHAN 55.0 X 186650 0 15387 EROL VEZNEDAROGLU MD 55.0 X 1939997 0 9727 KENNETH M LIEBMAN MD 55.0 X 1937401 0 20175 LEE M BUONO MD 55.0 X 970972 0 16395 ARIEL F ABUD MD 55.0 X 892323 0 22730 JOHN D LIPANI MD 55.0 X 868930 0 18144 18385095 0 1908479 462 false true false SKANSKA USA BUILDING INC 516 EAST TOWNSHIP LINE ROAD BLUE BELL PA 19422 CONSTRUCTION 85670624 TARGET BUILDING CONSTRUCTION 1124 CHESTER PIKE CRUM LYNNE PA 19022 CONSTRUCTION 25798516 BARR AND BARR BUILDERS INC 460 WEST 34TH STREET 16TH FLOOR NEW YORK NY 10001 CONSTRUCTION 16095370 TRENTON ANESTHESIOLOGY PO BOX 15321 NEWARK NJ 07192 PHYSICIAN 8433490 SODEXHO MANAGEMENT INC PO BOX 360170 PITTSBURGH PA 152516170 MANAGEMENT 5246484 133 4266045 4266045 NET PATIENT SERVICE REVENUE 541900 499851320 499851320 911 COUNTY SUPPORT & FIRE DISPATCH 541900 35000 35000 SCHOOL OF NURSING 541900 523888 523888 OTHER HEALTHCARE RELATED REVENUE 541900 11451963 11451963 AUXILIARY REVENUE 541900 559199 559199 512421370 31165951 31165951 0 0 2111438 2111438 2111438 2111438 4073352 7377075 -3303723 -3303723 -3303723 0 0 0 CHILD DAY CARE 624410 757099 757099 PATIENT/EMPLOYEE CONVENIENCE 722210 1870034 1870034 2627133 549288214 512421370 757099 31843700 200535 200535 0 0 0 13596781 12237103 1359678 0 0 234415294 210973764 23441530 -140631 -126568 -14063 26111715 23500544 2611171 16481730 14833557 1648173 0 325674 293107 32567 405070 364563 40507 203099 182789 20310 0 924908 832417 92491 55338924 49805032 5533892 4871390 4384251 487139 14974081 13476673 1497408 1911933 1720740 191193 0 2280304 2052274 228030 0 0 563619 507257 56362 10505340 9454806 1050534 0 36272029 32644826 3627203 7511723 6760551 751172 MEDICAL SUPPLIES 54855486 49369937 5485549 0 PROVISION FOR BAD DEBT 31008506 27907655 3100851 0 UTILITIES 7545648 6791083 754565 0 REPAIRS AND MAINTENANCE 4463643 4017279 446364 0 20719391 18647452 2071939 545346192 490831627 54514565 0 0 0 24781552 12291531 0 0 49596322 63426868 0 0 0 0 2709346 2252542 2658890 3505491 5382293 20323451 1215812458 398288937 583521723 817523521 0 0 0 0 267855492 227925600 15991969 17180067 12768833 29238544 965266420 1193667615 66464639 85089815 0 0 0 0 0 0 0 0 0 0 500750016 719686092 0 0 70265862 86435126 637480517 891211033 X 327785903 302456582 0 0 0 0 327785903 302456582 965266420 1193667615 X 3942022 -29271343 X X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 203099 203099 LOBBYING ACTIVITIES SCHEDULE C, PART II-B; LINES 1G AND 1H DURING 2011, THE ORGANIZATION PAID TWO OUTSIDE LOBBYING FIRMS A TOTAL OF $157,755 FOR LOBBYING ON A FEDERAL AND STATE LEVEL RELATED TO MEDICARE, MEDICAID AND OTHER HEALTHCARE LEGISLATIVE MATTERS. IN ADDITION, THE ORGANIZATION IS A MEMBER OF THE NEW JERSEY HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION WHICH BOTH ENGAGE IN LOBBYING EFFORTS ON BEHALF OF THEIR MEMBER HOSPITALS. A PORTION OF THE DUES PAID TO THESE ORGANIZATIONS HAS BEEN ALLOCATED TO LOBBYING ACTIVITES PERFORMED ON BEHALF OF THE ORGANIZATION. THIS ALLOCATION AMOUNTED TO $45,344. 49382285 49382285 489129052 85210774 403918278 609109010 308516984 300592026 68192111 4561179 63630932 817523521 SECURITIES 94016495 F SECURITIES 71562235 F INVESTMENT IN SUBSIDIARIES 22803504 F ACCRUED INTEREST 154893 F CERTIFICATES OF DEPOSIT 1098463 F LIMITED USE 9516681 F SUPPLEMENTAL RETIREMENT PLAN 4435865 F ALTERNATIVE INVESTMENTS 24337464 F GUARANTEES 0 F 227925600 0 NON-CURRENT 1406217 OTHER LIABILITIES 52753889 CONSTRUCTION AND RETAINAGE PAYABLE 32275020 86435126 TEXT OF FIN 48 AUDITED FINANCIAL STATEMENT FOOTNOTE SCHEDULE D, PART X THE ORGANIZATION IS THE PARENT ORGANIZATION OF THE CAPITAL HEALTH SYSTEM ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THE SYSTEM ISSUES CONSOLIDATED AUDITED FINANCIAL STATEMENTS WHICH INCLUDE ALL RELATED ENTITIES; INCLUDING THIS ORGANIZATION. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ALSO CONTAIN CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. THE FIN 48 FOOTNOTE BELOW IS FROM THE SYSTEM'S 2007 CONSOLIDATED AUDITED FINANCIAL STATEMENTS. IN JULY 2006, FASB INTERPRETATION NO. 48 (FIN 48), ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, AN INTERPRETATION OF FASB STATEMENT NO. 109, ACCOUNTING FOR INCOME TAXES, WAS ISSUED. FIN 48 CREATES A SINGLE MODEL TO ADDRESS UNCERTAINTY IN TAX POSITIONS AND CLARIFIES THE ACCOUNTING FOR INCOME TAXES BY PRESCRIBING THE MINIMUM RECOGNITION THRESHOLD A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. UNDER THE REQUIREMENTS OF FIN 48, TAX-EXEMPT ORGANIZATIONS COULD BE REQUIRED TO RECORD AN OBLIGATION AS THE RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN ON VARIOUS TAX EXPOSURE ITEMS. PRIOR TO FIN 48, THE DETERMINATION OF WHEN TO RECORD A LIABILITY FOR A TAX EXPOSURE WAS BASED ON WHETHER A LIABILITY WAS CONSIDERED PROBABLE AND REASONABLY ESTIMABLE IN ACCORDANCE WITH FASB STATEMENT NO. 5, ACCOUNTING FOR CONTINGENCIES. ON JANUARY 1, 2007, THE SYSTEM'S ADOPTED FIN 48. THE IMPACT OF THE ADOPTION OF FIN 48 ON THE SYSTEM'S CONSOLIDATED FINANCIAL STATEMENTS IS NOT SIGNIFICANT. true Central America and the Caribbean 1 1 Program Services FINANCIAL VEHICLE 6616836 1 1 1 1 6616836 6616836 true false true false false false true true X true X 0 true X 0 true true true false false 48608260 28584587 20023673 0.03890 34311820 20478072 13833748 0.02690 82920080 49062659 33857421 0.06580 368 69077 274170 1810 272360 0.00050 9248778 6959342 2289436 0.00450 126855 0 126855 0.00020 153 205914 0 205914 0.00040 521 69077 9855717 6961152 2894565 0.00560 521 69077 92775797 56023811 36751986 0.07140 true 31008506 91287814 114767414 -23479600 X true true 3 1 CAPITAL HEALTH MEDICAL CENTER - HOPEWELL

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X X X X 2 CAPITAL HEALTH REGIONAL MEDICAL CENTER

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X X X X 3 CAPITAL HEALTH AT MERCER

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OUTPATIENT FACILITY MICU

65 PROSPECT STREET TRENTON NJ 08618

MICU CHS REHABILITATION SERVICES

832 BRUNSWICK AVENUE TRENTON NJ 08618

REHABILITATION SERVICES FAMILY HEALTH CENTER

433 BELLEVUE AVENUE TRENTON NJ 08618

FAMILY HEALTH AND ADULT DAY CARE CENTER CHS PARTIAL HOSPITALIZATION SERVICES

832 BRUNSWICK AVENUE TRENTON NJ 08618

MENTAL HEALTH WEST TRENTON MEDICAL ASSOCIATES

1230 PARKWAY AVENUE EWING NJ 08628

GENERAL MEDICINE CORPORATE HEALTH CENTER

832 BRUNSWICK AVENUE TRENTON NJ 08618

HEALTH CENTER BORDENTOWN FAMILY MEDICAL

1 THIRD STREET BORDENTOWN NJ 08505

FAMILY MEDICINE EARLY INTERVENTION

413 HILLCREST AVENUE EWING NJ 08618

EARLY INTERVENTION CAPITAL HEALTH PRIMARY CARE - PENNINGTON

2480 PENNINGTON ROAD PENNINGTON NJ 08534

GENERAL MEDICINE CAPITAL SURGICAL ASSOCIATES

40 FULD STREET TRENTON NJ 08638

GENERAL MEDICINE CAPITAL ENDOCRINOLOGY

1235 WHITEHORSE-MERCERVILLE ROAD HAMILTON NJ 08619

ENDOCRINOLOGY HEARTCARE SPECIALISTS AT CAPITAL HEALTH

625 FARNSWORTH AVENUE BORDENTOWN NJ 08505

CARDIOLOGY CHS SCHOOL OF NURSING

542 BELLEVUE AVENUE TRENTON NJ 08618

NURSING CHS - ONCOLOGY STUDY

416 BELLEVUE AVENUE TRENTON NJ 08618

ONCOLOGY PLASTIC SURGERY ASSOCIATES OF NEW JERSEY

850 BEAR TAVERN ROAD EWING NJ 08628

PLASTIC SURGERY CHS LABORATORY SERVICES

2480 PENNINGTON ROAD PENNINGTON NJ 08534

LABORATORY SERVICES CAPITAL HEALTH CLINICAL CARDIOLOGY

2480 PENNINGTON ROAD PENNINGTON NJ 08534

CARDIOLOGY CAPITAL HLTH PRIMARY CARE - QUAKERBRIDGE

4056 QUAKERBRIDGE ROAD LAWRENCEVILLE NJ 08648

GENERAL MEDICINE OBGYN AT HAMILTON

3444 QUAKERBRIDGE ROAD HAMILTON NJ 08619

OBSTETRICS AND GYNECOLOGY CENTER FOR DIGESTIVE HEALTH

850 BEAR TAVERN ROAD EWING NJ 08628

GASTROENTEROLOGY ELIGIBILITY FOR DISCOUNTED CARE SCHEDULE H, PART I, LINE 3 THE ORGANIZATION UTILIZES NEW JERSEY STATE CHARITY CARE GUIDELINES IN DETERMINING ELIGIBLITY FOR PROVIDING FREE OR DISCOUNTED CARE. CHARGES FOR SELF-PAY PATIENTS ARE REDUCED TO 115% OF THE MEDICARE RATE. PATIENTS WHOSE INCOME AND ASSETS CRITERIA ARE AT OR BELOW TWICE THE CURRENT THRESHOLD FOR ELIGIBILTY FOR NEW JERSEY CHARITY CARE WILL BE PROVIDED WITH A 100% DISCOUNT OFF OF THE ORGANIZATION'S USUAL AND CUSTOMARY CHARGES. THE INCOME BASED CRITERIA USED TO DETERMINE ELIGIBILITY IS PER NEW JERSEY ADMINISTRATIVE CODE 10:52 SUB CHAPTERS 11, 12 AND 13, AND BASED UPON THE 2011 POVERTY GUIDELINES (DEPARTMENT OF HEALTH AND SENIOR SERVICES). FPG ARE INCLUDED IN THE CRITERIA FOR DETERMINING ELIGIBILITY FOR CHARITY AND DISCOUNTED CARE. COMMUNITY BENEFIT REPORT SCHEDULE H, PART I, LINE 6A NOT APPLICABLE. SUBSIDIZED HEALTH SERVICES SCHEDULE H, PART I; QUESTION 7G NO COSTS RELATING TO SUBSIDIZED HEALTHCARE SERVICES ARE ATTRIBUTABLE TO ANY PHYSICIAN CLINICS. PERCENT OF TOTAL EXPENSE SCHEDULE H, PART I; QUESTION 7 COLUMN (F) THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $31,008,506. CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFIT COST SCHEDULE H, PART I, QUESTION 7 WORKSHEET 2 WAS USED FOR THE COST TO CHARGE RATIO. BAD DEBT EXPENSE AND HFMA STATEMENT #15 SCHEDULE H, PART III, SECTION A; QUESTION 1 HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15 ("STATEMENT 15") PROVIDES GUIDELINES FOR DISTINGUISHING CHARITY CARE FROM BAD DEBT EXPENSE. STATEMENT 15 REQUIRES THAT CHARITY CARE IS NOT RECOGNIZED AS RECEIVABLE OR REVENUE IN THE FINANCIAL STATEMENTS. STATEMENT 15 FURTHER EXPLAINS THAT SELF-PAY PATIENTS THAT DO HAVE A REASONABLE LIKELIHOOD OF PAYMENT SHOULD BE REPORTED AS CHARITY CARE AND NOT BAD DEBT EXPENSE. THE HOSPITAL GENERALLY FOLLOWS THE GUIDELINES OUTLINED IN STATEMENT 15. IN ADDITION, THE HOSPITAL FOLLOWS THE STATE OF NEW JERSEY GUIDELINES IN DETERMINING CHARITY CARE ELIGIBILITY. IN CERTAIN INSTANCES, IT IS UNLIKELY THAT UNINSURED PATIENTS WILL PAY FOR THE SERVICES RENDERED, BUT THEY DO NOT QUALIFY FOR THE STATE'S CHARITY CARE PROGRAM BECAUSE OF LACK OF PATIENT COOPERATION OR OTHER REASONS. THE HOSPITAL PURSUES COLLECTION OF THESE AMOUNTS AND UNPAID BALANCES ARE REPORTED AS BAD DEBT EXPENSE. UNDER STATEMENT 15, THESE AMOUNTS WOULD BE RECORDED AS CHARITY CARE RATHER THAN BAD DEBT EXPENSE AND THIS IS THE RATIONALE FOR OUR RESPONSE: "NO". BAD DEBT EXPENSE SCHEDULE H, PART III, SECTION A; QUESTION 4 BAD DEBT EXPENSE WAS CALCULATED USING THE PROVIDERS' BAD DEBT EXPENSE FROM ITS AUDITED FINANCIAL STATEMENTS, MULTIPLIED BY ITS COST TO CHARGE RATIO. THE CAPITAL HEALTH SYSTEM, INC. AND ITS AFFILIATES, INCLUDING ITS HOSPITALS AND SUBSIDIARIES, PREPARE AND ISSUE AUDITED CONSOLIDATED FINANCIAL STATEMENTS. THE SYSTEM'S ALLOWANCE FOR DOUBTFUL ACCOUNTS (BAD DEBT EXPENSE) METHODOLOGY AND CHARITY CARE POLICIES ARE CONSISTENTLY APPLIED ACROSS ALL HOSPITAL AFFILIATES. THE ATTACHED TEXT WAS OBTAINED FROM THE FOOTNOTES TO THE AUDITED FINANCIAL STATEMENTS OF THE CAPITAL HEALTH SYSTEM. CHARITY CARE CAPITAL HEALTH PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA DEFINED BY THE NEW JERSEY DEPARTMENT OF HEALTH AND SENIOR SERVICES ("DOHSS") WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE CAPITAL HEALTH DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE. CAPITAL HEALTH'S RECORDS IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES AND INCLUDE THE AMOUNT OF CHARGES FORGONE FOR SERVICES AND SUPPLIES FURNISHED. DOHSS ALLOWS RETROACTIVE APPLICATION FOR CHARITY CARE UP TO TWO YEARS FROM THE DATE OF SERVICE. THE COSTS OF CHARITY CARE IS DERIVED FROM BOTH ESTIMATED AND ACTUAL DATA. THE ESTIMATED COST OF CHARITY CARE INCLUDES THE DIRECT AND INDIRECT COST OF PROVIDING SUCH SERVICES AND IS ESTIMATED UTILIZING CAPITAL HEALTH'S RATIO OF COST TO GROSS CHARGES, WHICH IS THEN MULTIPLIED BY THE GROSS UNCOMPENSATED CHARGES ASSOCIATED WITH PROVIDING CARE TO CHARITY PATIENTS. CHARITY CARE PROVIDED, AT COST, DURING 2011 AND 2010 TOTALED APPROXIMATELY $ $48,608,000 AND $ $46,714,000, RESPECTIVELY. CAPITAL HEALTH RECEIVES PAYMENTS FROM THE NEW JERSEY HEALTH CARE SUBSIDY FUNDS FOR CHARITY CARE AND SUCH AMOUNTS TOTALED APPROXIMATELY $28,585,000 AND $25,746,000 FOR THE YEARS ENDED DECEMBER 31, 2011 AND 2010, RESPECTIVELY. COMMUNITY BENEFIT SCHEDULE H, PART III, SECTION B; QUESTION 8 MEDICARE COSTS WERE DERIVED FROM THE 2009 MEDICARE COST REPORT. MEDICARE UNDERPAYMENTS AND BAD DEBT ARE COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THE ORGANIZATION BELIEVES 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 HEALTHCARE 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 ORGANIZATION 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 TREAS. 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. THE AMERICAN HOSPITAL ASSOCIATION ("AHA") BELIEVES THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT ARE COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THIS ORGANIZATION AGREES WITH THE AHA 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 FELT THAT THE IRS SHOULD INCORPORATE THE FULL VALUE OF THE COMMUNITY BENEFIT THAT HOSPITALS PROVIDE BY COUNTING MEDICARE UNDERPAYMENTS (SHORTFALL) AS QUANTIFIABLE COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: - PROVIDING CARE FOR THE ELDERLY AND SERVING MEDICARE PATIENTS IS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD. - MEDICARE, LIKE MEDICAID, DOES NOT PAY THE FULL COST OF CARE. RECENTLY, MEDICARE REIMBURSES HOSPITALS ONLY 92 CENTS FOR EVERY DOLLAR THEY SPEND TO TAKE CARE OF MEDICARE PATIENTS. THE MEDICARE PAYMENT ADVISORY COMMISSION ("MEDPAC") IN ITS MARCH 2007 REPORT TO CONGRESS CAUTIONED THAT UNDERPAYMENT WILL GET EVEN WORSE, WITH MARGINS REACHING A 10-YEAR LOW AT NEGATIVE 5.4 PERCENT. - 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 -- SO CALLED "DUAL ELIGIBLES." THERE IS EVERY 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 THIS ORGANIZATION ALSO FEEL THAT PATIENT BAD DEBT IS A COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. LIKE MEDICARE UNDERPAYMENT (SHORTFALLS), THERE ALSO ARE COMPELLING REASONS THAT PATIENT BAD DEBT SHOULD BE COUNTED AS QUANTIFIABLE COMMUNITY BENEFIT AS FOLLOWS: - 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, NONPROFIT 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 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 DEPARTMENT, REGARDLESS OF ABILITY TO PAY. PATIENTS WHO HAVE OUTSTANDING BILLS ARE NOT TURNED AWAY, UNLIKE 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" ASSUMING THE FINDINGS ARE GENERALIZABLE NATIONWIDE; THE EXPERIENCE OF HOSPITALS AROUND THE NATION REINFORCES THAT THEY ARE GENERALIZABLE. AS OUTLINED BY THE AHA, DESPITE THE HOSP COLLECTION POLICY SCHEDULE H, PART III, SECTION B; QUESTION 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 THE CAPITAL HEALTH SYSTEM, AND ALL ITS HOSPITAL AFFILIATES, 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: SENDING THREE STATEMENTS, A MINIMUM OF ONE PRE-COLLECTION LETTER, TELEPHONE CONTACT FOR ANY ACCOUNT OVER $5,000.00 OR AT THE DISCRETION OF THE ACCOUNT REPRESENTATIVE AND/OR SUPERVISOR. THE FACILITY ALSO HAS A CHARITY CARE ACCESS POLICY TO ASSURE PATIENTS ARE PROVIDED WITH CHARITY CARE ASSISTANCE 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 WILL BE FINANCIALLY SCREENED BY A RESOURCE ADVISOR TO DETERMINE ELIGIBILITY ACCORDING TO STATE AND FEDERAL GUIDELINES AND WILL BE INFORMED OF DOCUMENTATION NEEDED TO COMPLETE A CHARITY CARE APPLICATION. PATIENTS NOT ELIGIBLE FOR CHARITY CARE WILL BE FINANCIALLY COUNSELED FOR ALL OTHER OPTIONS. QUALIFIED PATIENTS WILL BE REFERRED TO ALL APPROPRIATE AGENCIES OR PROGRAMS TO MEET OTHER FINANCIAL NEEDS. AT THE TIME OF THE PATIENT VISIT AND PART OF THE REGISTRATION PROCESS AT THE FACILITY, 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/CREDIT CARD (AMERICAN EXPRESS, DISCOVER, VISA, MASTERCARD), 2. LOW INTEREST LOAN PROGRAM, OR 3. FLEXIBLE PAYMENT PLANS. IN ADDITION TO THE ABOVE OPTIONS, THE FACILITY HAS ESTABLISHED A SELF-PAY ASSISTANCE PROGRAM FOR ITS UNINSURED PATIENTS THAT DO NOT QUALIFY FOR MEDICAID OR THE NEW JERSEY HOSPITAL CARE PAYMENT ASSISTANCE PROGRAM. THE SELF-PAY ASSISTANCE PROGRAM RATES ARE REFLECTIVE OF MEDICARE REIMBURSEMENT, AS REFERRED BY THE STATE OF NEW JERSEY. FACILITY INFORMATION SCHEDULE H, PART V, SECTION B, QUESTIONS 1J, 3, 4, 5C, 6I & 7 NOT APPLICABLE. FACILITY INFORMATION SCHEDULE H, PART V, SECTION B, QUESTIONS 9,10,11H,15E,16E,17E,18D,20&21 NOT APPLICABLE. FACILITY INFORMATION SCHEDULE H, PART V, SECTION B, QUESTION 13G BILLING STATEMENTS PROVIDED TO PATIENTS INDICATE THAT THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY IS AVAILABLE UPON REQUEST. FACILITY INFORMATION SCHEDULE H, PART V, SECTION B, QUESTION 19D THE FACILITY USES 115% OF THE MEDICARE RATE AS THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. NEEDS ASSESSMENT SCHEDULE H, PART VI; QUESTION 2 CAPITAL HEALTH ROUTINELY MONITORS DEMAND FOR THE SERVICES IT PROVIDES WHILE SIMULTANEOUSLY UTILIZING A VARIETY OF INFORMATION SOURCES TO DETERMINE UNMET OR UNDERSERVED NEEDS OF THE COMMUNITIES IT SERVES. CAPITAL HEALTH MEETS AT LEAST MONTHLY WITH THE OTHER HEALTHCARE PROVIDERS IN ITS SERVICE AREA AS WELL AS A COMMUNITY HEALTH DEPARTMENT DIRECTOR TO DISCUSS UNMET NEEDS AND COLLABORATIVELY STRATEGIZE THE PRIORITIZATION OF NEEDS AND DEVELOP PROGRAMS TO ADDRESS THEM IN A COORDINATED WAY. WE ALSO ROUTINELY REVIEW AVAILABLE DATA REGARDING INCIDENTS OF HEALTH ISSUES AND PROPOSE PROGRAMS TO ADDRESS THESE ISSUES AND ULTIMATELY IMPLEMENT THOSE WHICH WILL HAVE THE GREATEST IMPACT. ADDITIONALLY, WE RETAIN A FULL TIME COMMUNITY RELATIONS COORDINATOR WHOSE TASK IT IS TO BE OUT IN THE COMMUNITY INTERACTING WITH COMMUNITY LEADERS AND RECEIVING FEEDBACK ON THEIR SATISFACTION WITH OUR SERVICES. WE BELIEVE THIS COMPREHENSIVE APPROACH OF MONITORING AND ANALYZING BOTH OBJECTIVE DATA AND SUBJECTIVE FEEDBACK GIVES US A CURRENT UNDERSTANDING OF HOW WE ARE ADDRESSING COMMUNITY NEEDS AND WHAT WE NEED TO DO TO OPTIMIZE OUR IMPACT UPON THE HEALTHCARE STATUS OF OUR REGION. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SCHEDULE H, PART VI; QUESTION 3 CAPITAL HEALTH SYSTEM, INC. EDUCATES PATIENTS ABOUT ELIGIBILITY FOR ASSISTANCE WITH THEIR BILLS IN NUMEROUS WAYS. INSURANCE INFORMATION IS OBTAINED AT ALL REGISTRATION POINTS AT EACH VISIT. IF A PATIENT IS FOUND NOT TO HAVE INSURANCE, OR IS UNDERINSURED THE FOLLOWING PROCEDURE IS FOLLOWED; 1. WHEN A PATIENT IS FOUND TO BE UNINSURED AND IN NEED OF FINANCIAL ASSISTANCE, A NEW JERSEY CARE PAYMENT FACT SHEET IS REVIEWED WITH THE PATIENT, AND A WRITTEN COPY IS PROVIDED TO THE PATIENT BY THE HEALTH ACCESS STAFF. THE FACT SHEET EXPLAINS WHO IS ELIGIBLE, HOW TO APPLY WITH THE PHONE NUMBER OF EACH CAMPUS CHARITY CARE OFFICE, AND WHAT DOCUMENTS ARE NEEDED TO DETERMINE ELIGIBILITY. 2. WHEN A PATIENT IS ADMITTED TO THE HOSPITAL, A CHARITY CARE WORKER WILL VISIT THE PATIENT'S BEDSIDE TO START THE CHARITY CARE PROCESS. IF A PATIENT IS FINANCIALLY SCREENED AND FOUND TO BE ELIGIBLE FOR MEDICAID, A REFERRAL IS GIVEN TO THE HOSPITAL'S MEDICAID OUTSTATION WORKER. THE OUTSTATION WORKER WILL VISIT THE PATIENT, AND BEGIN THE MEDICAID PROCESS. 3. WHEN A PATIENT IS FOUND TO BE UNDERINSURED, (EXAMPLE IS A PATIENT WHO HAS MEDICARE ONLY) A REFERRAL IS MADE TO THE CHARITY CARE WORKER, AND THE SAME PROCESS IS FOLLOWED ABOVE. 4. THE PATIENT IS MONITORED FOR COMPLIANCE IN COMPLETING THE APPLICATION INCLUDING VISITING THE PATIENT'S HOME IF NECESSARY TO OBTAIN NECESSARY DOCUMENTATION TO COMPLETE THE APPLICATION. 5. ONCE THE PATIENT HAS BEEN APPROVED, THE CHARITY CARE DETERMINATION INFORMATION IS DOCUMENTED IN THE PATIENT'S REGISTRATION RECORD. PATIENT ACCESS MONITORS AND INSTRUCTS THE PATIENT WHEN THEIR CHARITY CARE APPLICATION IS DUE FOR RENEWAL. ASIDE FROM INFORMING PATIENTS DURING THEIR REGISTRATION PROCESS, ALL OF CAPITAL HEALTH'S DUNNING STATEMENTS CONTAIN THE FOLLOWING LANGUAGE: CAPITAL HEALTH SYSTEM OFFERS FINANCIAL ASSISTANCE TO ALL OF ITS PATIENTS WHO ARE UNINSURED OR DO NOT HAVE FULL INSURANCE COVERAGE, AND WHO MEET CERTAIN INCOME AND ASSET CRITERIA. CAPITAL HEALTH SYSTEM PROVIDES THIS ASSISTANCE THROUGH THE MEDICAID PROGRAM WHICH IS SPONSORED BY THE STATE OF NEW JERSEY AND FEDERAL GOVERNMENT AND THROUGH THE STATE OF NEW JERSEY'S HEALTHCARE FOR THE UNINSURED PROGRAM. IN ADDITION, IF A PATIENT DOES NOT QUALIFY FOR EITHER OF THESE PROGRAMS, CAPITAL HEALTH SYSTEM CAN OFFER PROMPT PAYMENT DISCOUNTS AND DISCOUNTS FOR PATIENTS WHO HAVE BILLS THAT ARE A SIGNIFICANT FINANCIAL BURDEN TO THEM. CAPITAL HEALTH SYSTEM, INC. ALSO PROVIDES, IN ENGLISH AND SPANISH, A PHONE NUMBER FOR THOSE PATIENTS WHO CAN NOT AFFORD TO PAY THEIR BILL AND WOULD LIKE TO APPLY FOR FINANCIAL ASSISTANCE. LASTLY, THE HOSPITAL HAS A RECORDED MESSAGE THAT IS PLAYED WHILE A CUSTOMER IS ON HOLD THAT SAYS THE FOLLOWING: CAPITAL HEALTH SYSTEM, INC. OFFERS FINANCIAL ASSISTANCE TO ALL OF ITS PATIENTS WHO ARE UNINSURED OR DO NOT HAVE FULL INSURANCE COVERAGE, AND WHO MEET CERTAIN INCOME AND ASSET CRITERIA. CAPITAL HEALTH SYSTEM, INC. PROVIDES THIS ASSISTANCE THROUGH THE MEDICAID PROGRAM WHICH IS SPONSORED BY THE STATE OF NEW JERSEY AND FEDERAL GOVERNMENT AND THROUGH NEW JERSEY'S HEALTHCARE FOR THE UNINSURED PROGRAM. IN ADDITION, IF A PATIENT DOES NOT QUALIFY FOR ANY OF THESE PROGRAMS, CAPITAL HEALTH SYSTEM CAN OFFER PROMPT PAYMENT DISCOUNTS AND DISCOUNTS FOR PATIENTS WHO HAVE BILLS THAT ARE A SIGNIFICANT BURDEN TO THEM. COMMUNITY INFORMATION SCHEDULE H, PART VI; QUESTION 4 CAPITAL HEALTH SERVES THE COMMUNITIES IN MERCER AND BURLINGTON COUNTIES IN NEW JERSEY AND BUCK COUNTY IN PENNSYLVANIA. THERE ARE APPROXIMATELY 400,000 RESIDENTS WITHIN THE DEFINED PRIMARY AND SECONDARY SERVICE AREA. THE RACIAL MAKEUP OF MERCER COUNTY, WHICH INCLUDES TRENTON, THE STATE CAPITAL, IS 61.4% WHITE, 20.3% BLACK, AND 15.1% HISPANIC OR LATINO. NEARLY 87% OF THE COUNTY'S RESIDENTS WHO ARE 25 YEARS OR OLDER GRADUATED HIGH SCHOOL AND 38% HAVE A BACHELOR'S DEGREE. MEDIAN HOUSEHOLD INCOME IN THE COUNTY WAS $70,570 ACCORDING TO THE US CENSUS. THE RACIAL MAKEUP OF BURLINGTON COUNTY IS 73.8% WHITE, 16.6% BLACK, AND 6.4% HISPANIC OR LATINO. MORE THAN 90.6% OF BURLINGTON COUNTY RESIDENTS WHO ARE 25 YEARS OR OLDER GRADUATED HIGH SCHOOL AND 33% HAVE A BACHELOR'S DEGREE. MEDIAN HOUSEHOLD INCOME IN BURLINGTON COUNTY WAS $74,481, ACCORDING TO THE US CENSUS. THE RACIAL MAKEUP OF BUCKS COUNTY, PENNSYLVANIA IS 89.2% WHITE, 3.6% BLACK AND 4.3% HISPANIC OR LATINO. OF THOSE, 91.3% OF BUCKS COUNTY RESIDENTS WHO ARE 25 YEARS OR OLDER GRADUATED HIGH SCHOOL AND 34.1% HAVE A BACHELOR'S DEGREE. MEDIAN HOUSEHOLD INCOME IN BUCKS COUNTY WAS $75,895 ACCORDING TO THE US CENSUS. PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI; QUESTION 5 THIS ORGANIZATION OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545: 1. THE ORGANIZATION PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF-PAY, MEDICARE AND MEDICAID PATIENTS; 2. THE ORGANIZATION OPERATES AN ACTIVE EMERGENCY ROOM FOR ALL PERSONS; WHICH IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR; 3. THE ORGANIZATION MAINTAINS AN OPEN MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; 4. CONTROL OF THE ORGANIZATION RESTS WITH ITS BOARD OF TRUSTEES; WHICH IS 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. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT FOR ADDITIONAL INFORMATION ON HOW THE ORGANIZATION PROMOTES COMMUNITY HEALTH. AFFILIATED HEALTHCARE SYSTEM SCHEDULE H, PART VI; QUESTION 6 OUTLINED BELOW IS A SUMMARY OF THE ENTITIES WHICH COMPRISE THE CAPITAL HEALTH SYSTEM AND AFFILIATES. NOT FOR PROFIT CAPITAL HEALTH SYSTEM AND AFFILIATES ENTITIES CAPITAL HEALTH SYSTEM, INC. CAPITAL HEALTH SYSTEM, INC. ("CHS") IS THE TAX-EXEMPT PARENT OF CAPITAL HEALTH SYSTEM AND AFFILIATES ("SYSTEM"). THIS INTEGRATED HEALTHCARE DELIVERY SYSTEM CONSISTS OF A GROUP OF AFFILIATED HEALTHCARE ORGANIZATIONS. THE SOLE MEMBER OR STOCKHOLDER OF EACH ENTITY IS EITHER CHS OR ANOTHER SYSTEM AFFILIATE CONTROLLED BY CHS. THE SYSTEM IS AN INTEGRATED NETWORK OF HEALTHCARE PROVIDERS IN THE STATE OF NEW JERSEY. CAPITAL HEALTH SYSTEM IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A HOSPITAL UNDER IRC 170(B)(1)(A)(I). AS THE PARENT ORGANIZATION OF A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM IN MERCER COUNTY NEW JERSEY. CAPITAL HEALTH SYSTEM STRIVES TO CONTINUALLY DEVELOP AND OPERATE A MULTI-HOSPITAL HEALTHCARE SYSTEM WHICH PROVIDES SUBSTANTIAL COMMUNITY BENEFIT THROUGH THE PROVISION OF A COMPREHENSIVE SPECTRUM OF HEALTHCARE SERVICES TO THE RESIDENTS OF NEW JERSEY AND SURROUNDING COMMUNITIES. CAPITAL HEALTH SYSTEM, INC. ENSURES THAT ITS SYSTEM PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGINS OR ABILITY TO PAY. NO INDIVIDUALS ARE DENIED NECESSARY MEDICAL CARE, TREATMENT OR SERVICES. CAPITAL HEALTH SYSTEM, INC.'S ACTIVE HOSPITALS ARE CAPITAL HEALTH MEDICAL CENTER - HOPEWELL; CAPITAL HEALTH REGIONAL MEDICAL CENTER AND CAPITAL HEALTH AT MERCER. THE HOSPITAL OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545: 1. PROVIDE MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF-PAY, MEDICARE AND MEDICAID PATIENTS; 2. OPERATE AN ACTIVE EMERGENCY ROOM FOR ALL PERSONS; WHICH IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR; 3. MAINTAIN AN OPEN MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; AND 4. CONTROL RESTS WITH ITS BOARD OF TRUSTEES. THE BOARD IS COMPRISED OF INDEPENDENT CIVIC LEADERS AND OTHER PROMINENT MEMBERS OF THE COMMUNITY. 5. SURPLUS FUNDS ARE USED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND RENOVATE FACILITIES AND ADVANCE MEDICAL CARE; PROGRAMS AND ACTIVITIES. CAPITAL HEALTH SYSTEM FOUNDATION CAPITAL HEALTH SYSTEM FOUNDATION IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(1). THROUGH FUNDRAISING ACTIVITIES THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF CAPITAL HEALTH SYSTEM, INC.; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES 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. FOR PROFIT CAPITAL HEALTH SYSTEM AND AFFILIATES ENTITIES BELLEVUE AVENUE MANAGEMENT, INC. A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS MERCER HOLDING CORPORATION. THE ORGANIZATION IS LOCATED IN TRENTON, MERCER COUNTY, NEW JERSEY. THE ORGANIZATION PROVIDES MANAGERIAL ADMINISTRATION AND SUPPORT. CAPITAL HEALTH SYSTEM CONDOMINIUM ASSOCIATION, INC. A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS CAPITAL HEALTH SYSTEM, INC. THE ORGANIZATION IS LOCATED IN TRENTON, MERCER COUNTY, NEW JERSEY. THIS ENTITY IS A HOMEOWNERS ASSOCIATION. CAPITAL REGION INSURANCE COMPANY A CONTROLLED FOREIGN CORPORATION OF CAPITAL HEALTH SYSTEM, INC. THE ORGANIZATION WAS FORMED AND OPERATES SOLELY IN CAYMAN ISLANDS. MERCER HOLDING CORPORATION A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS CAPITAL HEALTH SYSTEM, INC. THIS ENTITY IS THE SOLE OWNER OF ALL THE OUTSTANDING COMMON STOCK OF BELLEVUE AVENUE MANAGEMENT, INC. AND IS INVOLVED IN VARIOUS ANCILLARY HEALTHCARE RELATED ACTIVITIES. STROKE AND CEREBROVASCULAR CENTER OF NEW JERSEY, P.C. A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS CAPITAL HEALTH SYSTEM, INC. THE ORGANIZATION IS LOCATED IN TRENTON, MERCER COUNTY, NEW JERSEY. THIS ENTITY PROVIDES MEDICAL SERVICES TO INDIVIDUALS. TRENTON NEUROLOGICAL SURGEONS ASSOCIATES, P.A. A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS CAPITAL HEALTH SYSTEM, INC. THE ORGANIZATION IS LOCATED IN LAWRENCEVILLE, MERCER COUNTY, NEW JERSEY. THIS ENTITY PROVIDES GENERAL MEDICAL SERVICES TO INDIVIDUALS. STATE FILING OF COMMUNITY BENEFIT REPORT SCHEDULE H, PART VI; QUESTION 7 NOT APPLICABLE. THE ENTITY AND RELATED PROVIDER ORGANIZATIONS ARE LOCATED IN NEW JERSEY. THE STATE OF NEW JERSEY DOES NOT REQUIRE HOSPITALS TO ANNUALLY FILE A COMMUNITY BENEFIT REPORT WITH THE STATE OF NEW JERSEY. true CAPITAL HEALTH SYSTEM FOUNDATION 750 BRUNSWICK AVENUE TRENTON NJ 08638 222230681 501(C)(3) 100000 PROGRAM SUPPORT MERCER REGIONAL CHAMBER OF COMMERCE 1A QUAKERBRIDGE PLAZA DRIVE MERCERVILLE NJ 08619 210581086 501(C)(3) 15835 PROGRAM SUPPORT PRINCETON REGIONAL CHAMBER OF COMMERCE 9 VANDEVENTER AVE PRINCETON NJ 08542 210722138 501(C)(3) 8950 PROGRAM SUPPORT ISLES INC 10 WOOD STREET TRENTON NJ 08618 222350832 501(C)(3) 10000 PROGRAM SUPPORT AMERICAN CANCER SOCIETY 3076 PRINCETON PIKE LAWRENCEVILLE NJ 08648 160743902 501(C)(3) 7750 PROGRAM SUPPORT MARCH OF DIMES 5 CEDAR BROOK DR CRANBURY NJ 08512 222383132 501(C)(3) 9500 PROGRAM SUPPORT SUSAN G KOMEN BREAST CANCER FOUNDATION INC 5005 LBJ FREEWAY DALLAS TX 752446125 751835298 501(C)(3) 8500 PROGRAM SUPPORT BOY SCOUTS OF AMERICA 1325 WEST WALNUT HILL LANE IRVING TX 75038 221576300 501(C)(3) 10000 PROGRAM SUPPORT HAMILTON TOWNSHIP 2090 GREENWOOD AVE HAMILTON NJ 086500150 216000691 501(C)(3) 8000 PROGRAM SUPPORT AMERICAN HEART ASSOCIATION 2550 US HGHWY 1 NORTH BRUNSWICK NJ 08902 135613797 501(C)(3) 15500 PROGRAM SUPPORT DEBORAH HOSPITAL FOUNDATION 212 TRENTON ROAD BROWNS MILLS NJ 08015 222049500 501(C)(3) 6500 PROGRAM SUPPORT 11 0 GRANT FUND MONITORING SCHEDULE D, 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 true true X X X X X false true false true false false false true false LOUIS DAMELIO MD 662244 0 2500 0 114192 0 13237 0 3594 0 795767 0 0 0 AL MAGHAZEHE PHD FACHE 826807 0 441827 0 465432 0 477099 0 17496 0 2228661 0 298500 0 RONALD J GUY 518014 0 935566 0 333768 0 17574 0 18779 0 1823701 0 223500 0 SHANE F FLEMING CPA 201239 0 31502 0 162027 0 12922 0 17651 0 425341 0 0 0 EUGENE W GROCHALA 255837 0 94944 0 165994 0 80112 0 4958 0 601845 0 98500 0 STEPHEN A MILLER JD 167940 0 60159 0 81116 0 40114 0 19499 0 368828 0 48500 0 LARRY DISANTO 475451 0 217060 0 328564 0 332261 0 19496 0 1372832 0 223500 0 JAN GABIN ESQ 288230 0 102170 0 178731 0 67781 0 2465 0 639377 0 123500 0 ROBERT REMSTEIN DO 325673 0 114188 0 107686 0 71051 0 15784 0 634382 0 48500 0 PATRICIA V CAVANAUGH RN MSN 213625 0 123944 0 166399 0 13358 0 2848 0 520174 0 98500 0 NATHAN BOSK FACHE 245881 0 90984 0 162466 0 58999 0 16212 0 574542 0 98500 0 J SCOTT CLEMMENSEN 201826 0 78000 0 157547 0 71484 0 17875 0 526732 0 98500 0 GREGORY N DADAMO 211199 0 72117 0 140480 0 66868 0 249 0 490913 0 98500 0 MARGARET SULLIVAN 185810 0 72000 0 156518 0 66792 0 16224 0 497344 0 98500 0 DENNIS DOOLEY 193352 0 68325 0 135807 0 64852 0 20115 0 482451 0 98500 0 LINDA DITE 190812 0 64784 0 135548 0 51251 0 1252 0 443647 0 98500 0 EILEEN M HORTON 161932 0 58620 0 132641 0 43587 0 18082 0 414862 0 98500 0 ARLENE WALSH 157150 0 42556 0 80135 0 25767 0 18233 0 323841 0 0 0 ARLINE M STEPHAN 136922 0 26855 0 22873 0 7264 0 8123 0 202037 0 0 0 EROL VEZNEDAROGLU MD 568885 0 1164719 0 206393 0 8575 0 1152 0 1949724 0 0 0 KENNETH M LIEBMAN MD 565749 0 1165219 0 206433 0 8575 0 11600 0 1957576 0 0 0 LEE M BUONO MD 777698 0 71848 0 121426 0 8575 0 7820 0 987367 0 0 0 ARIEL F ABUD MD 748631 0 0 0 143692 0 8714 0 14016 0 915053 0 0 0 JOHN D LIPANI MD 685867 0 69592 0 113471 0 8690 0 9454 0 887074 0 0 0 COMPENSATION INFORMATION SCHEDULE J, PART I; QUESTION 1A THE ORGANIZATION PAID FOR CERTAIN HEALTH CLUB DUES FOR BOTH EUGENE W. GROCHALA AND GREGORY N. D'ADAMO IN THE AMOUNT OF $50 AND $40; RESPECTIVELY, DURING 2011. THESE AMOUNTS WERE FULLY INCLUDED IN TAXABLE INCOME AND REPORTED ON EACH INDIVIDUALS 2011 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. COMPENSATION INFORMATION SCHEDULE J, PART I; QUESTION 4B THE ORGANIZATION IMPLEMENTED AN AT RISK DEFERRED COMPENSATION PROGRAM WITH RESPECT TO THE CONSTRUCTION AND OPENING OF ITS NEW HOPEWELL HOSPITAL FACILITY. THE PROGRAM PAID THESE INDIVIDUALS BASED UPON SPECIFIC CRITERIA BEING SATISFIED WITH RESPECT TO THE HOPEWELL HOSPITAL FACILITY BEING ON TIME AND UNDER BUDGET ("HOTUB"). ACCORDINGLY, THESE HOTUB AMOUNTS AS OUTLINED BELOW ARE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE DUE TO THE SPECIFIC CRITERIA BEING SATISFIED. THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2011 FORM W-2, BOX 5 AS TAXABLE MEDICARE WAGES: AL MAGHAZEHE, PH.D., FACHE, $298,500; RONALD J. GUY, $223,500; SHANE F. FLEMING, CPA, $123,500; EUGENE W. GROCHALA, $98,500; STEPHEN A. MILLER, J.D., $48,500; LARRY DISANTO, $223,500; JAN GABIN, ESQ., $123,500; ROBERT REMSTEIN, D.O., $48,500; PATRICIA V. CAVANAUGH, RN, MSN, $98,500; NATHAN BOSK, FACHE, $98,500; J. SCOTT CLEMMENSEN, $98,500; GREGORY N. D'ADAMO, $98,500; MARGARET SULLIVAN, $98,500; DENNIS DOOLEY, $98,500; LINDA DITE, $98,500; EILEEN M. HORTON, $98,500 AND ARLENE WALSH, $48,500. 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 THESE INDIVIDUAL'S 2011 FORM W-2, BOX 5 AS TAXABLE MEDICARE WAGES: AL MAGHAZEHE, PH.D., FACHE, $456,551; EUGENE W. GROCHALA, $63,296; STEPHEN A. MILLER, J.D., $32,085; LARRY DISANTO, $312,286; JAN GABIN, ESQ., $54,491; ROBERT REMSTEIN, D.O., $60,900; NATHAN BOSK, FACHE, $48,525; J. SCOTT CLEMMENSEN, $52,000; GREGORY N. D'ADAMO, $48,078; MARGARET SULLIVAN, $48,000; DENNIS DOOLEY, $45,550; LINDA DITE, $34,552; EILEEN M. HORTON, $31,264 AND ARLENE WALSH, $14,785. COMPENSATION INFORMATION SCHEDULE J, PART I; QUESTION 5A CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED INCENTIVE COMPENSATION PAYMENTS DURING CALENDAR YEAR 2011 WHICH INCENTIVE COMPENSATION PAYMENTS WERE INCLUDED IN COLUMN B (II) HEREIN AND IN EACH INDIVIDUAL'S 2011 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. THESE INCENTIVE COMPENSATION PAYMENTS WERE BASED UPON A NUMBER OF FACTORS INCLUDING PRODUCTIVITY, PERFORMANCE AND REVENUES COLLECTED BY THE ORGANIZATION FOR PROFESSIONAL PHYSICIAN SERVICES RENDERED BY THESE INDIVIDUALS. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT. COMPENSATION INFORMATION SCHEDULE J, PART I; QUESTION 7 CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED INCENTIVE AWARDS DURING CALENDAR YEAR 2011 WHICH INCENTIVE AWARDS WERE INCLUDED IN COLUMN B (II) HEREIN AND IN EACH INDIVIDUAL'S 2011 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. THESE INCENTIVE AWARDS WERE GIVEN PURSUANT TO THE ORGANIZATION'S 2011 INCENTIVE COMPENSATION PLAN (ICP), APPROVED BY THE BOARD COMPENSATION COMMITTEE, BASED ON ACHIEVEMENT OF PRE-ESTABLISHED SYSTEM-WIDE AND BUSINESS UNIT PERFORMANCE CRITERIA AND METRICS, AS WELL AS MEETING OR EXCEEDING SPECIFIC PERFORMANCE ON "CIRCUIT BREAKERS". PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT. COMPENSATION INFORMATION SCHEDULE J, PART II; COLUMN F THE AMOUNT REPORTED IN SCHEDULE J, PART II, COLUMN F REPRESENTS AMOUNTS RELATED TO THE ORGANIZATION'S AT RISK DEFERRED COMPENSATION PROGRAM WITH RESPECT TO THE CONSTRUCTION AND OPENING OF ITS NEW HOPEWELL HOSPITAL FACILITY. THE PROGRAM PAID THESE INDIVIDUALS BASED UPON SPECIFIC CRITERIA BEING SATISFIED WITH RESPECT TO THE HOPEWELL HOSPITAL FACILITY BEING ON TIME AND UNDER BUDGET ("HOTUB"). ACCORDINGLY, THESE HOTUB AMOUNTS AS OUTLINED BELOW ARE WERE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE DUE TO THE SPECIFIC CRITERIA BEING SATISFIED AND WERE REPORTED ON PRIOR FORMS 990. THESE AMOUNTS WERE TREATED AS TAXABLE INCOME AND REPORTED ON EACH INDIVIDUAL'S 2011 FORM W-2, BOX 5 MEDICARE WAGES AS FOLLOWS: AL MAGHAZEHE, PH.D., FACHE, $298,500; RONALD J. GUY, $223,500; EUGENE W. GROCHALA, $98,500; STEPHEN A. MILLER, J.D., $48,500; LARRY DISANTO, $223,500; JAN GABIN, ESQ., $123,500; ROBERT REMSTEIN, D.O., $48,500; PATRICIA V. CAVANAUGH, RN, MSN, $98,500; NATHAN BOSK, FACHE, $98,500; J. SCOTT CLEMMENSEN, $98,500; GREGORY N. D'ADAMO, $98,500; MARGARET SULLIVAN, $98,500; DENNIS DOOLEY, $98,500; LINDA DITE, $98,500 AND EILEEN M. HORTON, $98,500. PRINCETON PIKE OFFICE PARK LLC TRUSTEE, JINGOLI 493869 RENT false MOUNTAIN VIEW OFFICE PARK LLC TRUSTEE, JINGOLI 641632 RENT false MERCER MEDICAL ASSOCIATES PA TRUSTEE, SUDHAKAR 261667 MEDICAL SERVICES false WILLIS OF NEW YORK INC TRUSTEE, FAM MEMBER CO. 975389 INSURANCE SERVICES false RONA H REMSTEIN SPOUSE OF OFFICER 129722 EMPLOYEE false BAHRAM MAGHAZEHE BROTHER OF OFFICER 110264 EMPLOYEE false BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS SCHEDULE L, PART IV JOSEPH R. JINGOLI IS A TRUSTEE OF THE ORGANIZATION. THE ORGANIZATION RENTED PROPERTY FROM BOTH OF HIS COMPANIES, PRINCETON PIKE OFFICE PARK, L.L.C. AND MOUNTAIN VIEW OFFICE PARK, L.L.C., DURING 2011. TOTAL RENTAL FEES PAID TO PRINCETON PIKE OFFICE PARK, L.L.C. AND MOUNTAIN VIEW OFFICE PARK, L.L.C. WERE $493,869 AND $641,632; RESPECTIVELY. SERVICES WERE RENDERED AT FAIR MARKET VALUE RATES PURSUANT TO ARM'S LENGTH NEGOTIATIONS. SAMUEL J. PLUMERI, JR. IS A TRUSTEE OF THE ORGANIZATION. THE ORGANIZATION UTILIZED THE SERVICES OF HIS FAMILY MEMBER'S COMPANY, WILLIS OF NEW YORK, INC., DURING 2011. TOTAL FEES PAID TO WILLIS OF NEW YORK, INC. WERE $975,389. SERVICES WERE RENDERED AT FAIR MARKET VALUE RATES PURSUANT TO ARM'S LENGTH NEGOTIATIONS. TELECHERY SUDHAKAR, M.D. IS A TRUSTEE OF THE ORGANIZATION. THE ORGANIZATION UTILIZED THE SERVICES OF HIS COMPANY, MERCER MEDICAL ASSOCIATES, P.A., DURING 2011. TOTAL FEES PAID TO MERCER MEDICAL ASSOCIATES, P.A. WERE $261,667. SERVICES WERE RENDERED AT FAIR MARKET VALUE RATES PURSUANT TO ARM'S LENGTH NEGOTIATIONS. COMMUNITY BENEFIT STATEMENT CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS BACKGROUND ========== CAPITAL HEALTH SYSTEM, INC ("CAPITAL HEALTH") IS A GENERAL MEDICAL AND SURGICAL HOSPITAL. CAPITAL HEALTH IS RECOGNIZED BY THE IRS AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, CAPITAL HEALTH 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, CAPITAL HEALTH OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545: 1) CAPITAL HEALTH PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUAL'S REGARDLESS OF ABILITY TO PAY; 2) CAPITAL HEALTH OPERATES EMERGENCY ROOMS AT BOTH OF ITS HOSPITAL CAMPUSES; REGIONAL AND HOPEWELL; WHICH ARE OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR; 3) CAPITAL HEALTH MAINTAINS AN OPEN MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; 4) CONTROL OF CAPITAL HEALTH RESTS WITH ITS BOARD OF DIRECTORS; WHICH IS 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. WITH OVER A CENTURY OF SERVICE TO MERCER AND BUCKS COUNTIES, BOTH HELENE FULD AND MERCER MEDICAL CENTERS SHARED TRADITIONS OF CARING. WITH THE VISION OF BUILDING ON THAT SERVICE INTO THE MILLENNIUM, THEY CAME TOGETHER IN DECEMBER 1997 TO FORM CAPITAL HEALTH. THE NEW ORGANIZATION IS COMPRISED OF 494 BEDS, EMPLOYS APPROXIMATELY 3,500 INDIVIDUALS, AND GENERATES OVER 499 MILLION DOLLARS IN ANNUAL NET PATIENT SERVICE REVENUE. CAPITAL HEALTH REGIONAL AND HOPEWELL CAMPUSES ARE SEPARATELY LICENSED ACUTE CARE HOSPITALS WITH 271 AND 350 BEDS; RESPECTIVELY. CAPITAL HEALTH ALSO OPERATES A NEW KIND OF HEALTHCARE CENTER THAT PUTS FAMILY PHYSICIANS AND SPECIALISTS, STATE-OF-THE-ART TECHNOLOGIES, AND SAME-DAY SURGICAL SERVICES ALL IN ONE LOCATION. CAPITAL HEALTH IN HAMILTON, LOCATED AT 1445 WHITEHORSE-MERCERVILLE ROAD, AND SPANNING 46,293 SQUARE FEET, CREATES A "MEDICAL MALL" WHERE PATIENTS CAN SEEK A HOST OF SERVICES SUCH AS OUTPATIENT SURGERY, RADIOLOGICAL TESTING AND SPECIALIZED CARE. MOREOVER, IT IS AESTHETICALLY DESIGNED TO MAKE PATIENTS FEEL BETTER EVEN BEFORE SEEING A PHYSICIAN. THE FAMILY HEALTH CENTER AT CAPITAL HEALTH IS LOCATED AT 433 BELLEVUE AVENUE IN TRENTON. THE 14,000 SQUARE FOOT LOCATION HELPS TO REDUCE PATIENT WAIT TIME AND EXPEDITE THE REGISTRATION PROCESS. CAPITAL HEALTH IS GUIDED BY ITS DEDICATION TO THE HEALTHCARE NEEDS OF THE COMMUNITIES THAT IT SERVES. THAT LEVEL OF DETERMINATION AND COMMITMENT IS THE VERY SOUL OF CAPITAL HEALTH. CAPITAL HEALTH PROVIDES HEALTHCARE SERVICES TO ALL PERSONS IN A NON-DISCRIMINATORY MANNER, REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGINS OR ABILITY TO PAY. MOREOVER, CAPITAL HEALTH PROVIDES HEALTHCARE SERVICES TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY, AS DEFINED BY THE NEW JERSEY STATE ATTORNEY GENERAL, WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. CAPITAL HEALTH MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE AMOUNT OF CHARITY CARE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FOREGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY. MISSION STATEMENT ================= CAPITAL HEALTH IS COMMITTED TO PROVIDING COMPREHENSIVE, QUALITY HEALTHCARE SERVICES, WHICH IMPROVE AND SUSTAIN THE HEALTH STATUS OF THE RESIDENTS PRIMARILY IN CENTRAL NEW JERSEY AND LOWER BUCKS COUNTY, PENNSYLVANIA. CAPITAL HEALTH ASSURES ACCESSIBLE, COMPASSIONATE HEALTHCARE SERVICES THAT HONOR THE DIGNITY OF EVERY PERSON. CAPITAL HEALTH WILL BE A LEADER IN DEFINING THE COMMUNITY'S HEALTHCARE NEEDS, IN PROVIDING APPROPRIATE SOLUTIONS, AND DEVELOPING A COMPREHENSIVE CONTINUUM OF CARE INCLUDING EDUCATION, PREVENTION, DISEASE MANAGEMENT AND RESTORATIVE PROGRAMS. AWARDS AND RECOGNITION ====================== CAPITAL HEALTH HAS RECENTLY RECEIVED THE FOLLOWING AWARDS AND RECOGNITIONS: JOINT COMMISSION DISEASE SPECIFIC CERTIFICATION FOR HIV/AIDS JOINT COMMISSION DISEASE SPECIFIC CERTIFICATION FOR STROKE JOINT COMMISSION DISEASE SPECIFIC CERTIFICATION FOR RESPIRATORY DISTRESS IN PRETERM INFANTS MAGNET RE-DESIGNATION --------------------- THE AMERICAN NURSES CREDENTIALING CENTER (ANCC) HAS RECOGNIZED CAPITAL HEALTH'S EXEMPLARY NURSING LEADERSHIP AND QUALITY PATIENT CARE BY AWARDING ITS MAGNET RECOGNITION FOR EXCELLENCE IN NURSING SERVICE. MAGNET STATUS IS THE HIGHEST LEVEL OF RECOGNITION THE ANCC CAN EXTEND TO A HEALTHCARE ORGANIZATION. CAPITAL HEALTH HOSTED TWO ANCC APPRAISERS FOR A SITE VISIT AND THEIR RESULTS FOUND CAPITAL HEALTH TO BE THE DEFINITION OF EXCELLENCE SET FORTH BY THE SCOPE AND STANDARDS FOR NURSE ADMINISTRATORS AND OUTLINED BY THE CONGRESS OF NURSING PRACTICE OF THE AMERICAN NURSES ASSOCIATION (ANA). JOINT COMMISSION'S GOLD SEAL OF APPROVAL ---------------------------------------- THE JOINT COMMISSION IS AN INDEPENDENT, NOT-FOR-PROFIT, NATIONAL BODY THAT OVERSEES THE SAFETY AND QUALITY OF HEALTHCARE AND OTHER SERVICES PROVIDED IN ACCREDITED ORGANIZATIONS. BY AWARDING CAPITAL HEALTH THEIR GOLD SEAL OF APPROVAL, THE JOINT COMMISSION CONFIRMED THAT CAPITAL HEALTH IMPROVED THE ACCURACY OF PATIENT IDENTIFICATION, IMPROVED THE EFFECTIVENESS OF COMMUNICATION AMONG CAREGIVERS, AND IMPROVED THE SAFETY OF USING MEDICATIONS. IN ADDITION, THE JOINT COMMISSION CONFIRMED THAT CAPITAL HEALTH REDUCED THE RISK OF HEALTHCARE-ASSOCIATED INFECTIONS, ACCURATELY AND COMPLETELY RECONCILE MEDICATIONS ACROSS THE CONTINUUM OF CARE, REDUCED THE RISK OF PATIENT HARM RESULTING FROM FALLS, ENCOURAGED PATIENTS' ACTIVE INVOLVEMENT IN THEIR OWN CARE AS A PATIENT SAFETY STRATEGY, AND CAPITAL HEALTH IDENTIFIED SAFETY RISKS INHERENT IN THE PATIENT POPULATION. STATEMENT FOR COMMUNITY HEALTH IMPROVEMENT & BENEFITS ===================================================== TO PROMOTE WELLNESS, PREVENT ILLNESS, AND REMOVE BARRIERS THAT HINDER ACCESS TO HEALTHCARE BY WORKING HAND-IN-HAND WITH THE COMMUNITIES SERVED. PRINCIPLES ---------- - CAPITAL HEALTH BELIEVES THAT COMMUNITY HEALTH IMPROVEMENT IS ESSENTIAL TO THE CAPITAL HEALTH MISSION. - CAPITAL HEALTH BELIEVES COMMUNITY-BASED COALITIONS ARE UNIQUELY QUALIFIED TO ACHIEVE COMMUNITY HEALTH GOALS, AND CAPITAL HEALTH VALUES PARTNERSHIPS WITH THEM. - CAPITAL HEALTH VALUES EVIDENCE-BASED PRACTICES AND SEEKS TO MODEL EXCELLENCE IN COMMUNITY HEALTH PRACTICE BASED ON EVIDENCE. - CAPITAL HEALTH BELIEVES IN APPLYING CONTINUOUS QUALITY IMPROVEMENT TO COMMUNITY HEALTH: MEASURING NEED, MATCHING RESOURCES TO NEED, MEASURING OUTCOMES, AND MAKING ADJUSTMENTS IN PROCESSES. OPERATIONAL VALUES ------------------ - INTEGRITY: ADHERES TO AN APPROPRIATE AND EFFECTIVE SET OF CORE BELIEFS INCLUDING HONESTY AND SERVING THE GREATER GOOD. DOES NOT BLAME OTHERS FOR HIS OR HER OWN MISTAKES OR MISREPRESENT HIM OR HER FOR PERSONAL GAIN OR PROTECTION. PERCEIVED BY OTHERS AS A DIRECT, TRUTHFUL INDIVIDUAL AND IS WIDELY TRUSTED, WITH THE ABILITY TO PRESENT THE TRUTH IN AN APPROPRIATE AND HELPFUL MANNER. - EXCELLENCE: PROVIDES THE MOST EFFICIENT AND EFFECTIVE WORK PROCESSES TO MEET THE NEEDS OF PATIENTS AND OTHER CUSTOMERS, WHICH LEADS TO THE HIGHEST QUALITY SERVICES. MAKES SOUND DECISIONS BASED UPON KNOWLEDGE, JUDGMENT, AND EXPERIENCE, AND IS SOUGHT OUT BY OTHERS FOR ADVICE AND SOLUTIONS TO ISSUES AND PROBLEMS. - COMPASSION: DEMONSTRATES CARING AND CONCERN FOR THE WELFARE OF OTHERS, ASSISTING WHEREVER NECESSARY. USES UNDERSTANDING AND INSIGHT WHEN DEALING WITH PATIENTS OR OTHER CUSTOMERS IN ALL ASPECTS OF CARE OR SERVICE DELIVERY. - TEAMWORK: DISPLAYS A PROFESSIONAL AND COLLABORATIVE SPIRIT IN FULFILLING RESPONSIBILITIES AND ASSISTING OTHERS. HELPS TO CREATE AND MAINTAIN POSITIVE MORALE WITH HIS OR HER TEAM, SHARING IN SUCCESSES, WORKING THROUGH PROBLEMS. FOSTERS OPEN DIALOGUE, AND WORKS TOWARDS CREATING AN ATMOSPHERE WHERE OUTCOMES AND SUCCESS ARE BENEFICIAL TO THE TEAM AND/OR THE ORGANIZATION AT LARGE. VISION ------ CAPITAL HEALTH WILL BE THE PREMIER COMMUNITY-BASED HEALTHCARE PROVIDER IN NEW JERSEY. CAPITAL HEALTH WILL CONSTANTLY STRIVE TO SUSTAIN THE HIGHEST PROFESSIONAL QUALITY STANDARDS, TO EXCEED EXPECTATIONS OF THOSE SERVED AND TO PROMOTE A POSITIVE WORK ENVIRONMENT. CAPITAL HEALTH'S SUCCESS WILL BE BUILT UPON CARING, COMPASSION, CREATIVITY, INTEGRITY, RESPECT, SERVICE, AND TEAMWORK. SERVICE CULTURE INITIATIVE -------------------------- CAPITAL HEALTH IS DEDICATED TO HIGH QUALITY PERFORMANCE AND TO EXCEEDING CUSTOMER EXPECTATIONS WITHIN A SUPPORTIVE AND FRIENDLY ENVIRONMENT. EACH EMPLOYEE HAS A RESPONSIBILITY AND IS ACCOUNTABLE FOR PROVIDING OPTIMUM SATISFACTION TO THE PATIENTS AND THEIR FAMILIES, PHYSICIANS AND COWORKERS. COMMUNITY BENEFIT STATEMENT (CONTINUED) CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS SERVICE CULTURE INITIATIVE VISION STATEMENT ------------------------------------------- - CAPITAL HEALTH COMMITS TO THE NEEDS OF THE COMMUNITY SERVED. THROUGH EXCELLENT SERVICE AND CARE, CAPITAL HEALTH ACHIEVES SUCCESSFUL PATIENT OUTCOMES. - CAPITAL HEALTH ADHERES TO A STANDARD OR POSITIVE BEHAVIOR. THIS MUST INCLUDE POSITIVE FIRST IMPRESSIONS, APPROPRIATE COMMUNICATION, PROFESSIONAL APPEARANCE AND THE REALIZATION THAT THEY ARE DEALING WITH PEOPLE'S LIVES. - CAPITAL HEALTH CREATES AN ENVIRONMENT CONDUCIVE TO POSITIVE RELATIONSHIPS. BY HAVING EFFICIENT AND EFFECTIVE SYSTEMS, CAPITAL HEALTH IMPROVES QUALITY CARE AND SERVICE DELIVERY. - CAPITAL HEALTH ACCEPTS THE CHALLENGE OF SERVICE CULTURE IMPROVEMENT AS A BUSINESS STRATEGY. IT IS NOT ONLY THE NICE THING TO DO, BUT THE RIGHT THING TO DO TO ASSURE THE GROWTH OF CAPITAL HEALTH. - CAPITAL HEALTH RECOGNIZES EXCELLENT SERVICE CULTURE PERFORMANCE. FEATURED SERVICES ================= DIABETES SERVICES ----------------- DIABETES CARE AT CAPITAL HEALTH IS AN OUTPATIENT COMPREHENSIVE REFERRAL BASED DIABETES EDUCATION PROGRAM THAT EMPOWERS PATIENTS TO TAKE CONTROL IN THE SUCCESSFUL MANAGEMENT OF THEIR DISEASE. CAPITAL HEALTH'S EDUCATION MODEL, WHERE THE PATIENT IS THE CENTRAL PLAYER, IS WIDELY RECOGNIZED AS THE BEST MODEL TO USE TO HELP THE PATIENT ACHIEVE OPTIMAL HEALTH RELATED OUTCOMES. CAPITAL HEALTH WORKS CLOSELY WITH PRIMARY CARE PHYSICIANS WHO CONTINUE TO MONITOR EACH INDIVIDUAL'S MEDICAL PROBLEMS. EMERGENCY SERVICES ------------------ THE CAPITAL AREA REGIONAL TRAUMA CENTER, THE LEVEL II TRAUMA CENTER AT CAPITAL HEALTH - REGIONAL MEDICAL CENTER, IS ONE OF ONLY 10 DESIGNATED TRAUMA CENTERS IN NEW JERSEY. CAPITAL HEALTH PROVIDES COMPREHENSIVE CARE FROM THE TIME OF INJURY THROUGH REHABILITATION. THE CAPITAL HEALTH CENTER MEETS HIGH NATIONAL STANDARDS FOR PATIENT CARE AND TEACHING. THE CAPITAL AREA REGIONAL TRAUMA CENTER IS A NEW JERSEY STATE DESIGNATED TRAUMA CENTER. THE DESIGNATION PROCESS INVOLVES DETAILED REGULAR INSPECTIONS BY NATIONAL AND STATE ORGANIZATIONS TO ASSURE HIGH STANDARDS OF CARE. CAPITAL HEALTH IS THE REGIONAL REFERRAL CENTER FOR INJURED PATIENTS IN MERCER COUNTY AND ADJACENT PARTS OF SOMERSET, HUNTERDON, BURLINGTON, AND MIDDLESEX COUNTIES AS WELL AS NEARBY AREAS OF PENNSYLVANIA. DESIGNATED TRAUMA CENTERS CARE FOR SEVERELY INJURED PATIENTS AS WELL AS VICTIMS OF ACCIDENT TYPES KNOWN TO BE ASSOCIATED WITH A HIGH RISK FOR INJURY. TRAUMA PATIENTS INCLUDE PERSONS INVOLVED IN MOTOR VEHICLE CRASHES, FALLS, AND ASSAULTS WITH KNIVES, GUNS, OR BLUNT OBJECTS. TRAUMA CENTERS HAVE THE LATEST TECHNOLOGY AND EXPERIENCED STAFF AVAILABLE TO CARE FOR YOUR FAMILY MEMBER. BESIDES PROVIDING CARE TO THE INJURED, TRAUMA CENTERS ARE ALSO ACTIVE PARTNERS WITH THE COMMUNITY IN INJURY PREVENTION AND PUBLIC EDUCATION. MATERNITY --------- FROM ROUTINE DELIVERIES TO HIGH-RISK NEEDS, CAPITAL HEALTH'S GREAT EXPECTATIONS PROGRAM PROVIDES A FULL RANGE OF PRENATAL, OBSTETRICAL, POSTPARTUM, AND NEONATAL CARE OPTIONS TO MAKE SURE YOUR NEW FAMILY HAS THE GREATEST CHANCE FOR A HEALTHY BEGINNING. THE MATERNITY UNIT ON THE REGIONAL CAMPUS IS MERCER COUNTY'S ONLY REGIONAL PERINATAL CENTER AND THE ONLY LEVEL III NEONATAL INTENSIVE CARE UNIT. CAPITAL HEALTH IS THE ONLY HEALTHCARE PROVIDER IN THE REGION TO HAVE IN-HOUSE COVERAGE BY OBSTETRICIANS, MIDWIVES, NEONATOLOGISTS, AND ANESTHESIOLOGISTS 24 HOURS A DAY, SEVEN DAYS A WEEK. AND, CAPITAL HEALTH WAS CHOSEN AS NEW JERSEY'S FIRST SITE TO HOUSE A NEW PROGRAM CALLED MARCH OF DIMES FAMILY SUPPORT. THE PROGRAM PROVIDES INFORMATION AND EMOTIONAL SUPPORT TO FAMILIES OF CRITICALLY ILL NEWBORNS BEING CARED FOR IN THE NEONATAL INTENSIVE CARE UNIT. ALSO, THE COMPREHENSIVE CHILDBIRTH AND PARENT EDUCATION SERVICES HELPS PREPARE INDIVIDUALS TO BE THE BEST PARENT POSSIBLE BY TEACHING ABOUT THE PROCESS OF BIRTH AND HOW TO CARE FOR YOUR INFANT. INSTITUTE FOR NEUROSCIENCES --------------------------- THE CAPITAL INSTITUTE FOR NEUROSCIENCES, SUPPORTED BY CAPITAL HEALTH'S HOSPITALS IN BOTH TRENTON AND HOPEWELL, AND WITH OUTPATIENT OFFICES IN THE MEDICAL OFFICE BUILDING ATTACHED TO CAPITAL HEALTH MEDICAL CENTER - HOPEWELL, HAS ADVANCED THE LEVEL OF CARE AVAILABLE TO PATIENTS IN THE REGION. PROVIDING COMPREHENSIVE, STATE-OF-THE-ART DIAGNOSTICS AND TREATMENTS FOR A WIDE RANGE OF MEDICAL CONDITIONS INVOLVING THE BRAIN, SPINE AND NERVOUS SYSTEM, THE INSTITUTE'S HIGHLY TRAINED PHYSICIANS INCLUDE BOARD-CERTIFIED AND FELLOWSHIP-TRAINED SPECIALISTS, AND AMONG THEM ARE THREE OF ONLY A VERY SELECT NUMBER OF DUAL-TRAINED NEUROSURGEONS IN THE NATION. AT THE INSTITUTE, PART OF CAPITAL HEALTH, PATIENTS BENEFIT FROM A MULTI-DISCIPLINARY TEAM OF SPECIALISTS WHICH CAN INCLUDE NEUROLOGISTS, NEUROSURGEONS, AND OTHER SPECIALIZED PHYSICIANS, AS WELL AS ANESTHESIOLOGISTS, PHYSICIAN ASSISTANTS, CRITICAL CARE NURSES, NURSE ANESTHETISTS, SPEECH PATHOLOGISTS, TECHNICIANS, PHYSICAL AND OCCUPATIONAL THERAPISTS, SOCIAL WORKERS, AND OTHER CRITICAL TEAM MEMBERS WHO PROVIDE AN OUTSTANDING CONTINUUM OF CARE FROM DIAGNOSIS TO TREATMENT AND RECOVERY AT CAPITAL HEALTH. THE INSTITUTE, LED BY NEUROSURGEON DR. EROL VEZNEDAROGLU, INCLUDES MANY SPECIALIZED CENTERS OF CARE INCLUDING THE STROKE AND CEREBROVASCULAR CENTER OF NJ, KNOWN AS A CENTER OF EXCELLENCE TO REFERRING PHYSICIANS AS WELL AS PATIENTS AND THEIR FAMILIES. AMONG THE CONDITIONS TREATED: - STROKE AND TRANSIENT ISCHEMIC ATTACKS - CAROTID STENOSIS - ANEURYSM - ARTERIOVENOUS MALFORMATIONS (AVMS) - CHIARI MALFORMATIONS - TRAUMATIC BRAIN INJURY - TUMORS OF THE BRAIN AND SPINE - BOTH MALIGNANT AND BENIGN AND INCLUDING SCHWANNOMAS, MENINGIOMAS, NEUROFIBROMAS, PITUITARY, PINEAL, SKULL BASE, GLIOMAS AND OTHERS - SPINAL DISEASES AND INJURIES - SUCH AS HERNIATED DISCS, SPONDYLOLISTHESIS, SPINAL COMPRESSION FRACTURES AND SPINAL VASCULAR MALFORMATIONS - DEGENERATIVE DISEASES AND SPINAL TRAUMA - NEUROLOGIC CONDITIONS INCLUDING DEMENTIA, MUSCLE AND MOVEMENT DISORDERS, NERVE DISORDERS AND HEADACHES - MOVEMENT DISORDERS, PARKINSON'S, ESSENTIAL TREMOR, ATYPICAL PARKINSON'S (MULTISYSTEM ATROHY, PROGRESSIVE SUPRANUCLEAR PALSY, AND CORTICOBASILAR DEGENERATION), DYSTONIA, ATAXIA AND SPASTICITY - PEDIATRIC NEUROLOGY, INCLUDING DEVELOPMENTAL DELAYS, AUTISM, NEUROMETABOLIC AND GENETIC DISORDERS, AND ATTENTION DEFICIT DISORDERS - ACUTE AND CHRONIC PAIN, INCLUDING PAIN FROM SPINAL STENOSIS, NERVE DISORDERS, CANCER, FIBROMYALGIA, SCIATICA, MIGRAINES, TRIGEMINAL MEURALGIA, MYOFACIAL, SHINGLES AND OTHER CONDITIONS - EPILEPSY - MOVEMENT LIMITATIONS DUE TO STROKE, ARTHRITIS, INJURY, AMPUTATION, OR OTHER CONDITIONS CENTER FOR DIGESTIVE HEALTH --------------------------- THE CAPITAL HEALTH CENTER FOR DIGESTIVE HEALTH IS ADVANCING THE LEVEL OF CARE AVAILABLE TO PATIENTS IN THE REGION BY PROVIDING COMPREHENSIVE, STATE-OF-THE-ART DIAGNOSTICS AND TREATMENTS FOR A WIDE RANGE OF MEDICAL CONDITIONS INVOLVING THE ENTIRE DIGESTIVE SYSTEM ALL IN ONE LOCATION. THE CENTER'S HIGHLY TRAINED AND SPECIALIZED PHYSICIANS UTILIZE CUTTING-EDGE TECHNOLOGY TO DELIVER OUTSTANDING CARE. THE CENTER'S MEDICAL DIRECTOR IS A BOARD-CERTIFIED GASTROENTEROLOGIST WITH YEARS OF EXPERIENCE WHO HELPS PATIENTS AND THEIR REFERRING DOCTORS NAVIGATE THE CENTER AND ACCESS THE APPROPRIATE SPECIALIST OR SURGEON FOR THE ADVANCED TESTING OR CARE REQUIRED. THE CENTER'S MEDICAL STAFF INCLUDES THE REGION'S PRE-EMINENT MEDICAL EXPERT IN INTERVENTIONAL GASTROENTEROLOGY AND THERAPEUTIC ENDOSCOPY, WHO HAS UNMATCHED EXPERIENCE USING ADVANCED DIAGNOSTIC TECHNIQUES SUCH AS ENDOSCOPIC ULTRASOUND (EUS) AND NON-SURGICAL TREATMENTS SUCH AS ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP), RADIOFREQUENCY ABLATION (BARRX), ENDOSCOPIC MUCOSAL RESECTION (EMR), AND ENTERAL STENT PLACEMENT. IF SURGERY IS AN OPTION, THE CENTER HAS DIRECT ACCESS TO A ROSTER OF HIGHLY TRAINED LAPAROSCOPIC (MINIMALLY INVASIVE) SURGEONS, INCLUDING THE AREA'S ONLY HEPATOBILIARY SURGEON WHO SPECIALIZES IN ADVANCED LAPAROSCOPIC PROCEDURES OF THE LIVER, PANCREAS, AND BILE DUCTS. COMMUNITY BENEFIT STATEMENT (CONTINUED) CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS CENTER FOR ONCOLOGY ------------------- CAPITAL HEALTH HAS CONSISTENTLY OFFERED PATIENTS A CLOSELY INTEGRATED TEAM OF MEDICAL, SURGICAL, RADIATION, AND ALLIED CANCER SPECIALISTS WHO USE THEIR KNOWLEDGE AND EXPERIENCE TO PROVIDE CUTTING-EDGE CANCER TREATMENT CLOSE TO HOME. WHEN ONE CHOOSES CAPITAL HEALTH FOR CANCER CARE, ONE SELECTS BOARD CERTIFIED PHYSICIANS WHO REMAIN WITH THE PATIENT FROM DIAGNOSIS THROUGH TREATMENT. WORKING TOGETHER, CAPITAL HEALTH OFFERS A COMPASSIONATE APPROACH TO ASSIST PATIENTS WITH EVERY ASPECT OF CANCER CARE, INCLUDING SCREENING, DIAGNOSIS, TREATMENT, RECOVERY, AND SURVIVORSHIP. THE CAPITAL HEALTH CENTER FOR ONCOLOGY IS COMMITTED TO PROVIDING COMPREHENSIVE QUALITY ONCOLOGY HEALTHCARE SERVICES, TO HELP IMPROVE AND SUSTAIN THE HEALTH STATUS OF RESIDENTS LIVING PRIMARILY IN CENTRAL NEW JERSEY AND LOWER BUCKS COUNTY. CAPITAL HEALTH STRIVES TO IMPROVE AND EXTEND THE QUALITY OF LIFE FOR THE PATIENT WITH CANCER. THE RCC WILL BE A LEADER IN DEFINING THE COMMUNITY'S CANCER CARE NEEDS BY PROVIDING APPROPRIATE PLANS THROUGH A COMPREHENSIVE CONTINUUM OF CARE, WHICH INCLUDES EDUCATION, PREVENTION, SCREENING, DIAGNOSIS, TREATMENT, SYMPTOM MANAGEMENT, SUPPORTIVE CARE AND SURVIVORSHIP PROGRAMS. CAPITAL HEALTH'S SUCCESS WILL BE BUILT UPON CARE, COMPASSION, CREATIVITY, INTEGRITY, RESPECT, SERVICE, STATE-OF-THE-ART TECHNOLOGY AND MULTIDISCIPLINARY TEAMWORK. PEDIATRICS ---------- CAPITAL HEALTH MEDICAL CENTER - HOPEWELL IS HOME TO THE ONLY IN-PATIENT PEDIATRIC UNIT IN MERCER COUNTY. CAPITAL HEALTH'S PEDIATRIC EMERGENCY SERVICES ENSURES NO CHILD WILL WAIT FOR EMERGENCY CARE. THE PEDIATRIC HOSPITALIST PROGRAM GIVES PEDIATRIC PATIENTS AND THEIR PHYSICIANS AROUND-THE-CLOCK ACCESS TO IN-HOUSE PEDIATRICIANS. RADIOLOGY SERVICES ------------------ CAPITAL HEALTH HAS AN ARSENAL OF THE MOST STATE-OF-THE-ART TECHNOLOGY TOOLS THAN ANY OTHER HEALTHCARE SYSTEM IN THE REGION. AS THE REGION'S TECHNOLOGY LEADER, CAPITAL HEALTH IS THE FIRST TO OFFER FULL-TIME, ONSITE PET SCAN TECHNOLOGY. THE FULL-SERVICE IMAGING SUITE BOASTS A NEW GENERATION SPIRAL CT ULTRA SCANNER EQUIPPED TO PERFORM COMPUTERIZED TOMOGRAPHY (CAT SCANS) AND A MAGNETIC RESONANCE IMAGING (MRI) MACHINE THAT FEATURES THE SHORTEST HIGH-FIELD MAGNET IN THE INDUSTRY. SLEEP CENTER ------------ CAPITAL HEALTH HAS BEEN PROVIDING COMPREHENSIVE EVALUATION AND TREATMENT FOR SLEEP RELATED PROBLEMS FOR MORE THAN 20 YEARS AND CAPITAL HEALTH WAS THE FIRST IN MERCER COUNTY. AT THE PRESENT TIME, CAPITAL HEALTH IS THE LARGEST FULLY ACCREDITED SLEEP CENTER IN MERCER AND BUCKS COUNTIES. BETWEEN BOTH CAMPUSES, CAPITAL HEALTH OFFERS FOURTEEN PRIVATE ROOMS DEDICATED TO SLEEP TESTING FOR PATIENTS WHO HAVE A WIDE VARIETY OF PROBLEMS RELATED TO SLEEP AND WAKEFULNESS. AS SLEEP CENTERS FULLY ACCREDITED BY THE AMERICAN ACADEMY OF SLEEP MEDICINE, CAPITAL HEALTH ENSURES THAT ALL PATIENTS TREATED AT CAPITAL HEALTH BENEFIT FROM A COMPLETE SLEEP EVALUATION AND INDIVIDUALIZED TREATMENT PLAN. DEFINITION OF COMMUNITY AND POPULATION SERVED --------------------------------------------- CAPITAL HEALTH DEFINES ITS COMMUNITY AS THE CITY OF TRENTON, MERCER COUNTY AND BUCKS COUNTY. TRENTON, N.J. IS LOCATED IN MERCER COUNTY ACROSS THE DELAWARE RIVER FROM BUCKS COUNTY, PA. TRENTON WAS ONCE A CENTER FOR INDUSTRY IN THE LATE 1800'S AND EARLY 1900'S, BUT HAS SEEN DRAMATIC ECONOMIC DEVELOPMENT CHALLENGES FOR MOST OF THE 20TH CENTURY. ACCORDING TO THE 2000 U.S. CENSUS, ITS 1999 MEDIAN HOUSEHOLD INCOME WAS $31,074, BY FAR THE LOWEST IN MERCER COUNTY, WHERE THE OVERALL MEDIAN HOUSEHOLD INCOME WAS $56,612. TRENTON WAS THE ONLY MUNICIPALITY IN THE COUNTY TO EXPERIENCE A DECREASE IN ITS POPULATION BETWEEN 1990 AND 2000 AS ITS NUMBER OF RESIDENTS FELL 3.7 PERCENT TO 85,403. TRENTON ALSO HAS THE HIGHEST NUMBER AND PERCENTAGE OF MINORITIES IN MERCER COUNTY WITH A PREDOMINANTLY AFRICAN-AMERICAN POPULATION OF 44,465 RESIDENTS OR 52.1 PERCENT. HISPANICS OR LATINOS OF ANY RACE CONSTITUTED 18,391 RESIDENTS OR 21.5 PERCENT, WHILE CAUCASIANS WERE NUMBERED AT 27,802 OR 32.6 PERCENT. COMMUNITY BENEFITS PROGRAMS =========================== OUTLINED BELOW ARE A NUMBER OF CAPITAL HEALTH COMMUNITY BENEFIT PROGRAMS. THE INFORMATION IS NOT INTENDED TO BE ALL-INCLUSIVE BUT RATHER PROVIDES ADDITIONAL INFORMATION THAT FURTHER DEMONSTRATES HOW CAPITAL HEALTH BENEFITS THE SURROUNDING COMMUNITY IN FURTHERANCE OF ITS CHARITABLE TAX-EXEMPT PURPOSES. CAPITAL HEALTH CHILDBIRTH AND PARENT EDUCATION PROGRAM ------------------------------------------------------ BENEFIT ACTIVITY: PREPARED CHILDBIRTH CLASSES IN SPANISH LANGUAGE THE CHILDBIRTH AND PARENT EDUCATION PROGRAM PROVIDES, FREE OF CHARGE, A FULL-DAY PREPARED CHILDBIRTH CLASS TO SPANISH-SPEAKING EXPECTANT PARENTS FROM THEIR COMMUNITY. THE CLASS IS HELD EVERY OTHER MONTH AND IS TAUGHT BY A CAPITAL HEALTH CERTIFIED CHILDBIRTH AND PARENT EDUCATOR WHO IS FLUENT IN SPANISH. CULTURALLY APPROPRIATE METHODS AND AUDIO-VISUAL MATERIALS ARE UTILIZED IN THE TEACHING OF THIS CLASS. PARTICIPANTS RECEIVE FREE BREAKFAST AND LUNCH. PARTICIPANTS RECEIVE SPANISH LANGUAGE REFERENCE MATERIALS AND AN EXTENSIVE HANDBOOK. REFERRALS TO THIS CLASS COME FROM THE CAPITAL HEALTH, HEALTH START PRENATAL CLINIC, A COMMUNITY PARTNERSHIP WITH CUNA, AND BY WORD-OF-MOUTH. LACTATION SERVICES ------------------ IN 2000, THE BREASTFEEDING RATE AT CAPITAL HEALTH START CLINIC FOR ANY BREASTFEEDING WAS 40 PERCENT. EXCLUSIVE BREASTFEEDING WAS ONLY 14 PERCENT. THROUGH EDUCATIONAL PROGRAMS AND ONE-TO-ONE SUPPORT WITH INCREASES IN SERVICES, THE CAPITAL HEALTH, HEALTH START CLINIC AS OF 2005 DEMONSTRATED A 69 PERCENT BREASTFEEDING INITIATION RATE AND A 34 PERCENT EXCLUSIVE BREASTFEEDING RATE. SUPPORT PROGRAMS FOR THIS VULNERABLE POPULATION HAVE BEEN INSTRUMENTAL IN THESE DRAMATIC INCREASES. THESE RATES EXCEED THOSE OF OTHER CITIES SUCH AS NEWARK, PHILADELPHIA AND BALTIMORE. TRAUMA EDUCATION ---------------- THE CAPITAL AREA REGIONAL TRAUMA CENTER AT CAPITAL HEALTH OFFERS FREE INJURY PREVENTION PROGRAMS TO MEMBERS OF THE COMMUNITY THAT INCLUDE PEDESTRIAN SAFETY, BICYCLE SAFETY, SEAT BELT SAFETY, PROPER USE OF CHILD SAFETY SEATS, AND HOME SAFETY. CONNECTING WITH THE LATINO COMMUNITY ------------------------------------ ENLACE ("LINK" IN SPANISH) IS A NAME FOR AN INNOVATIVE CAPITAL HEALTH PROGRAM DESIGNED TO CREATE CONTACTS AND CONNECTIONS WITHIN THE LATINO COMMUNITY. THROUGH ENLACE, CAPITAL HEALTH PROVIDES MEDICAL INTERPRETING AND HAS TRANSLATED ALL VITAL MEDICAL DOCUMENTS AND ARE NOW DOING THE SAME WITH PATIENT EDUCATION MATERIALS. ENLACE ALSO HELPS EDUCATE THE LATINO COMMUNITY ABOUT AMERICAN CUSTOMS AND HEALTHCARE PRACTICES AND PROVIDES CAPITAL HEALTH STAFF WITH INFORMATION ABOUT LATINO CULTURES. ANOTHER PROGRAM, CUNA (WHICH IS SPANISH FOR "CRIB"), CONNECTS LATINO WOMEN WITH PRE- AND POST-NATAL CARE, AND HELPS NEW MOTHERS OVERCOME LANGUAGE BARRIERS TO BETTER UNDERSTAND HEALTH ISSUES. CUNA ALSO OFFERS HELP WITH NUTRITION, COPING SKILLS AND EVEN BABYSITTING FOR OLDER CHILDREN. COMMUNITY HEALTH EDUCATION -------------------------- CAPITAL HEALTH'S COMMUNITY HEALTH EDUCATION PROGRAM IS DEDICATED TO IMPROVING THE HEALTH AND WELL-BEING OF THE COMMUNITY, AS WELL AS TO THE PREVENTION AND EARLY DETECTION OF DISEASE AMONG PEOPLE LIVING IN OUR COMMUNITY. THESE GOALS ARE ACCOMPLISHED BY PROVIDING HEALTH EDUCATION AND OTHER RELATED SERVICES TO THE GENERAL PUBLIC, AS WELL AS TO BUSINESS ORGANIZATIONS. THESE SERVICES CONSIST OF THE SPEAKER'S BUREAU, HEALTH FAIRS/HEALTH SCREENINGS, HEALTH EDUCATION LECTURE SERIES AND SUPPORT GROUPS, WALKING CLUBS, HEALTH INFORMATION CENTER, WELLNESS SPA, AND A PARTNERSHIP WITH THE MERCER COUNTY TOBACCO QUIT CENTER. PROGRAMS ARE HELD IN VARIOUS LOCATIONS THROUGHOUT MERCER AND BUCKS COUNTIES, WITH TOPICS INCLUDING DIABETES EDUCATION, PERIPHERAL VASCULAR DISEASE AWARENESS, HEALTHY EATING, CANCER GENETICS, AND WOMEN'S HEALTH ISSUES. THE COMMUNITY HEALTH EDUCATION PROGRAM PROVIDES A SERIES OF DIVERSE HEALTH EDUCATION PROGRAMS, RELATED TO HEALTH MAINTENANCE, DISEASE PREVENTION, EARLY DETECTION, GENERAL WELLNESS AND PERSONAL DEVELOPMENT. A SCHEDULE OF THE PROGRAMS, SCREENINGS AND SUPPORT GROUPS MAY BE VIEWED ONLINE AT: WWW.CAPITALHEALTH.ORG. COMMUNITY BENEFIT STATEMENT (CONTINUED) CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS COMMUNITY SPONSORSHIPS ---------------------- CAPITAL HEALTH IS PROUD TO SPONSOR MANY LOCAL ORGANIZATIONS IN MERCER AND BUCKS COUNTIES THROUGH IN-KIND AND MONETARY DONATIONS. CAPITAL HEALTH SUPPORTS A VARIETY OF CIVIC AND CULTURAL ORGANIZATIONS THAT WORK TO IMPROVE THE WELL BEING OF THE COMMUNITY. CONCLUSION ---------- CAPITAL HEALTH IS A NON-PROFIT ORGANIZATION THAT HAS AN "OPEN DOOR" POLICY. THIS POLICY MEANS THAT CAPITAL HEALTH PROVIDES NECESSARY BASIC HOSPITAL CARE TO EVERYONE, REGARDLESS OF THEIR ABILITY TO PAY FOR THEIR CARE. CAPITAL HEALTH IS COMMITTED TO COMMUNITY OUTREACH AND EDUCATION, OFFERING NUMEROUS HEATH CARE RELATED PROGRAMS AND ACTIVITIES, INCLUDING COMMUNITY HEALTH FAIRS, HEALTH SCREENINGS, HEALTH EDUCATION AND MEDICAL LECTURES AND SEMINARS ANNUALLY. CAPITAL HEALTH IS PROUD OF THEIR MANY PARTNERSHIPS WITH LOCAL ORGANIZATIONS. TO FURTHER SHOW HOW CAPITAL HEALTH IS COMMITTED TO BENEFITING ITS COMMUNITY, CAPITAL HEALTH, IN NOVEMBER 2011, OPENED ITS $530 MILLION 223-BED HOSPITAL IN HOPEWELL TOWNSHIP, NEW JERSEY TO REPLACE ITS EXISTING FACILITY, CAPITAL HEALTH - MERCER, IN TRENTON, NEW JERSEY. IN ADDITION, CAPITAL HEALTH REGIONAL MEDICAL CENTER IN TRENTON IS CREATING TWO NEW MEDICAL-SURGICAL UNITS AND HAS UNDERGONE A COMPLETE RENOVATION, INCLUDING THE ADDITION OF SPACE TO ACCOMMODATE SERVICES TRANSFERRED FROM MERCER, WHEN THE NEW HOSPITAL OPENED. CAPITAL HEALTH OBTAINED A MORTGAGE LOAN THROUGH THE FEDERAL HOUSING ADMINISTRATION WHICH ENABLED IT TO LOWER ITS COST OF CREDIT. THIS WILL ALLOW CAPITAL HEALTH TO USE MORE OF ITS RESOURCES TO SERVE THE MEDICAL NEEDS OF ITS COMMUNITY. OTHER PROGRAM SERVICES CORE FORM, PART III; QUESTION 4D EXPENSES INCURRED IN PROVIDING VARIOUS OTHER 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. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION B; QUESTION 11B THE ORGANIZATION IS THE PARENT ENTITY OF CAPITAL HEALTH SYSTEM AND AFFILIATES ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THE ORGANIZATION'S FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY (ITS BOARD OF TRUSTEES) PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE ("IRS"). IN ADDITION THE CAPITAL HEALTH SYSTEM, INC. COMPENSATION COMMITTEE ALSO PERFORMED A DETAILED REVIEW OF THE FEDERAL FORM 990 PRIOR TO PROVIDING IT TO EACH VOTING MEMBER OF ITS BOARD OF TRUSTEES FOR REVIEW. THE CAPITAL HEALTH SYSTEM, INC. BOARD OF TRUSTEES HAS DELEGATED TO THE COMPENSATION COMMITTEE THE RESPONSIBILITY TO OVERSEE AND COORDINATE THE FEDERAL FORM 990 PREPARATION AND FILING PROCESS FOR THE TAX-EXEMPT AFFILIATES OF THE SYSTEM. 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 GENERAL COUNSEL, VICE PRESIDENT OF FINANCE, CHIEF COMPLIANCE OFFICER AND VARIOUS OTHER INDIVIDUALS OF THE SYSTEM 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, BUT NOT LIMITED TO, THOSE INDIVIDUALS OUTLINED ABOVE FOR THEIR REVIEW. THE ORGANIZATION'S INTERNAL WORKING GROUP AND OTHER INDIVIDUALS 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 AND VARIOUS OTHER INDIVIDUALS FOR FINAL REVIEW AND APPROVAL PRIOR TO PRESENTATION OF THE FEDERAL FORM 990 TO THE MEMBERS OF THE CAPITAL HEALTH SYSTEM, INC. COMPENSATION COMMITTEE. FOLLOWING THE COMPENSATION COMMITTEE'S REVIEW THE FINAL FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY PRIOR TO FILING WITH THE IRS. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION B; QUESTION 12 THE ORGANIZATION IS THE PARENT ENTITY IN THE CAPITAL HEALTH SYSTEM AND AFFILIATES ("SYSTEM"). THE ORGANIZATION AND THE SYSTEM REGULARLY MONITOR AND ENFORCE 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 BOTH THE SYSTEM'S GENERAL COUNSEL AND CHIEF COMPLIANCE OFFICER FOR REVIEW. THEREAFTER THE CHIEF COMPLIANCE OFFICER PREPARES A SUMMARY OF THE COMPLETED QUESTIONNAIRES WHICH CONTAINS INFORMATION DISCLOSED ON AN INDIVIDUAL BY INDIVIDUAL BASIS. THE SYSTEMS CHIEF COMPLIANCE OFFICER THEN PRESENTS THIS SUMMARY TO THE SYSTEM'S FULL BOARD OF TRUSTEES FOR ITS REVIEW AND DISCUSSION. THIS SUMMARY IS UPDATED BY THE CHIEF COMPLIANCE OFFICER ON A QUARTERLY BASIS. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION B; QUESTION 15 THE ORGANIZATION'S BOARD OF TRUSTEES HAS A BOARD 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 ALL OF THE ORGANIZATION'S SENIOR MANAGEMENT AND OTHERS, INCLUDING THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER AND OTHER OFFICERS OF THE ORGANIZATION, PHYSICIANS, AND ANY OTHER DISINTERESTED PERSONS. IT ALSO REVIEWS AND APPROVES EMPLOYMENT AGREEMENTS FOR THE COVERED EMPLOYEES AND DISINTERESTED PERSONS. 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 THE SENIOR MANAGEMENT TEAM. REBUTTAL PRESUMPTION REQUIREMENTS HAVE GUIDED THE ACTIVITIES OF THE COMMITTEE IN ALL OF ITS REVIEWS, DELIBERATIONS AND APPROVAL OF EXECUTIVE COMPENSATION ACTIONS FOR ALL OF THE COVERED EMPLOYEES AND DISINTERESTED PERSONS. 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 DATA FROM COMPARABLE HEALTHCARE AND HOSPITAL PEERS IN NEW JERSEY AS WELL AS NEIGHBORING STATES BASED ON APPROPRIATE REVENUE, SERVICES, AND OVERALL FINANCIAL PERFORMANCE. IN ADDITION, SPECIFIC SALARY SURVEYS COVERING SIMILAR, REPRESENTATIVE HOSPITAL COMPENSATION DATA WAS USED. ALL DATA WAS WEIGHTED IN ARRIVING AT MARKET CONSENSUS FOR COVERED EMPLOYEE POSITIONS, IN ORDER TO ACCURATELY REFLECT THE RELEVANT LABOR MARKET. CONTEMPORANEOUS MINUTES ARE COMPILED AND APPROVED OF ALL COMMITTEE DELIBERATIONS. THESE ARE SUPPORTED BY THE WRITTEN DOCUMENTATION COVERING ALL COMPENSATION STUDIES AND PLAN DOCUMENTS, AS WELL AS DETAILED PERFORMANCE JUSTIFICATION USED AS THE BASIS FOR AWARDING OF ALL INCENTIVE PROGRAMS. REBUTTAL PRESUMPTION ACTIVITIES OF THE COMMITTEE COVER ALL MEMBERS OF SENIOR MANAGEMENT, AS WELL AS THE COMPENSATION AND CONTRACTS COVERING PHYSICIANS AND OTHER DISINTERESTED PERSONS, ALL OF WHICH ARE SUBJECT TO THE REVIEW AND APPROVAL OF THE COMMITTEE. RECOGNIZING THE NEED TO CONSIDER RETIREMENT PLANNING FOR ITS SENIOR MANAGEMENT AS A MEANS TO AID IN THEIR RETENTION, THE COMMITTEE UNDERTOOK AN EXTENSIVE RESEARCH AND ANALYSIS OF ALTERNATIVE PROGRAMS, AND CREATED AND APPROVED A FORM OF LONG-TERM NON-QUALIFIED DEFERRED COMPENSATION (REFERRED TO AS THE "PERFORMANCE-BASED CAPITAL ACCUMULATION PLAN", OR "PBCAP"). THIS PLAN ALSO PROVIDES THE ORGANIZATION WITH AN ADDITIONAL TOOL TO ASSIST IN THE RECRUITING OF SENIOR MANAGEMENT WITHIN THE HIGHLY COMPETITIVE HEALTHCARE LABOR MARKET. THE PLAN PROVIDES SENIOR MANAGEMENT WITH THE OPPORTUNITY TO QUALIFY FOR ANNUAL DEFERRED CONTRIBUTIONS TO BE PAID AT RETIREMENT, BASED ON ACHIEVING SPECIFIED FINANCIAL PERFORMANCE TARGETS AND MEETING ESTABLISHED CIRCUIT BEAKERS. THIS PLAN COMPLIES WITH AND ADHERES TO ALL RELATED REGULATIONS, WITH AN EMPHASIS ON IRC SECTIONS 409A AND 457(F). WITH THE DECISION IN MAY 2004 TO CONSTRUCT A NEW HOSPITAL CAMPUS IN HOPEWELL, NJ, THE COMMITTEE WAS CHALLENGED TO PROVIDE THE MOTIVATION TO MEET THE CONSTRUCTION TIMETABLE AND GUARANTEED MAXIMUM PRICE (GMP). THIS WAS NECESSARY TO ENSURE THAT THE PROJECT, INCLUDING THE RETROFIT OF THE REGIONAL CAMPUS, WAS COMPLETED ON A TIMELY AND ECONOMICAL BASIS. THEY RECOGNIZED THAT TRANSACTIONAL BONUSES, INCLUDED IN MOST STATE CONSTRUCTION CONTRACTS, PROVIDE THE INCENTIVE TOOLS NECESSARY TO KEEP PROJECTS ON TIME AND WITHIN BUDGET. THE RESULTING INCENTIVE PLAN, REFERRED TO AS THE "HOSPITAL ON TIME AND UNDER BUDGET PLAN" OR "HOTUB", CONTAINS THE METHODOLOGY TO REWARD MEMBERS OF SENIOR MANAGEMENT AND OTHER IDENTIFIED KEY MANAGEMENT FOR ACHIEVING THOSE GOALS, WHILE REDUCING AND/OR ELIMINATING AWARDS IF THE PROJECT IS NOT ON SCHEDULE AND/OR OVER BUDGET. SINCE THIS TYPE OF PLAN IS RELATIVELY UNIQUE IN THE NOT-FOR-PROFIT ENVIRONMENT, THE COMPENSATION COMMITTEE SPENT CONSIDERABLE TIME IN ITS DEVELOPMENT AND ENGAGED BOTH AN EXTERNAL COMPENSATION CONSULTANT TO DEVELOP THE PLAN, AS WELL AS A NOT-FOR-PROFIT LEGAL COMPENSATION AUTHORITY TO REVIEW THE PLAN. 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. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION C; QUESTION 19 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. COMPENSATION INFORMATION DISCLOSURE CORE FORM, PART VII AND SCHEDULE J PART VII AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM THIS ORGANIZATION. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OR INDEPENDENT CONTRACTORS OF THE ORGANIZATION AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THIS ORGANIZATION'S BOARD OF TRUSTEES. COMPENSATION AND BENEFITS DISCLOSURE CORE FORM, PART VII AND SCHEDULE J THE ORGANIZATION DOES NOT COMPENSATE ITS BOARD MEMBERS FOR THEIR SERVICES PERFORMED AS A TRUSTEE. ALL TRUSTEES ARE VOLUNTEERS. COMPENSATION AND BENEFITS, WHERE APPLICABLE FOR CERTAIN MEMBERS, IS RELATED TO THE BOARD MEMBER'S SERVICES PERFORMED AS A FULL-TIME EMPLOYEE OR INDEPENDENT CONTRACTOR OF THE ORGANIZATION. RELATED HOURS DISCLOSURE CORE FORM, PART VII, SECTION A, COLUMN B THIS ORGANIZATION IS THE PARENT ENTITY OF CAPITAL HEALTH SYSTEM AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM INCLUDES BOTH FOR-PROFIT AND NOT FOR-PROFIT ORGANIZATIONS. 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 AFFILIATES WITHIN THE SYSTEM. THE HOURS SHOWN ON THIS FORM, 990 FOR BOARD MEMBERS WHO RECEIVE NO COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, REPRESENT 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 IN THE SYSTEM, 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 CAPITAL HEALTH SYSTEM; NOT SOLELY THIS ORGANIZATION. INDEPENDENT CONTRACTORS CORE FORM, PART VII; SECTION B THE AMOUNTS REPORTED FOR SERVICES PROVIDED BY SKANSKA USA BUILDING, INC., BARR & BARR BUILDERS, INC. AND TARGET BUILDING CONSTRUCTION INCLUDE BOTH SERVICES AND CONSTRUCTION GOODS AND SUPPLIES. OTHER CHANGES IN NET ASSETS CORE FORM, PART XI; QUESTION 5 OTHER CHANGES IN NET ASSETS OR FUND BALANCES INCLUDE: - NET CHANGE IN UNREALIZED GAINS AND LOSSES ON INVESTMENTS; ($29,519,343); AND - PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST; $248,000. AUDITED FINANCIAL STATEMENTS CORE FORM, PART XII; QUESTION 2 THE TAXPAYER IS THE PARENT ENTITY IN A TAX-EXEMPT, INTEGRATED HEALTHCARE DELIVERY SYSTEM. AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF THE TAXPAYER AND ALL AFFILIATES FOR THE YEARS ENDED DECEMBER 31, 2011 AND DECEMBER 31, 2010; RESPECTIVELY AND ISSUED A CONSOLIDATED FINANCIAL STATEMENT WITH CONSOLIDATING SCHEDULES BY ENTITY. AN UNQUALIFIED OPINION WAS ISSUED EACH YEAR BY THE INDEPENDENT CPA FIRM. THE TAXPAYER'S AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT AUDITOR. FINANCIAL STATEMENTS AND REPORTING CORE FORM, PART XII; QUESTION 3 THE ORGANIZATION IS THE PARENT ENTITY OF CAPITAL HEALTH SYSTEM AND AFFILIATES ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THE SYSTEM ENGAGED AN INDEPENDENT ACCOUNTING FIRM TO PREPARE AND ISSUE A SYSTEM WIDE CONSOLIDATED A-133 AUDIT. THIS ORGANIZATION WAS INCLUDED IN THE SYSTEM WIDE A-133 AUDIT. CHS DEPARTMENTAL EIN LISTING THE ORGANIZATION'S FEDERAL FORM 990 INCLUDES CERTAIN REVENUE RECEIVED AND EXPENSES INCURRED BY VARIOUS CAPITAL HEALTH SYSTEM, INC. RELATED PROGRAMS, DEPARTMENTS, ACTIVITIES AND CAPITAL HEALTH SYSTEM, INC. EMPLOYEES. REVENUE EARNED FROM THESE PROGRAMS AND ACTIVITES WAS RECEIVED BY CAPITAL HEALTH SYSTEM, INC. UTILIZING DIFFERENT FEDERAL IDENTIFICATION NUMBERS OTHER THAN 22-3548695. BELOW IS A LIST OUTLINING THE VARIOUS CAPITAL HEALTH SYSTEM, INC. PROGRAMS, DIVISIONS, DEPARTMENTS AND PHYSICIAN EMPLOYEES AND THEIR RESPECTIVE FEDERAL IDENTIFICATION NUMBERS: CAPITAL ENDOCRINOLOGY 20-1730017 CAPITAL HEALTH CLINICAL CARDIOLOGY 26-3519972 CAPITAL SURGICAL ASSOCIATES 22-3680051 CHS INSTITUTE FOR NEUROSCIENCES 26-0346624 EWING INTERNAL MED ASSOC 27-0192330 FAMILY HEALTH CENTER 22-3796256 HAMILTON PHYSICIANS GROUP 22-3502175 HPG AT BORDENTOWN FAMILY MEDICAL 22-3502175 HEART CARE SPECIALISTS AT CH 27-0309548 MERCER MATERNAL FETAL SPECIALTY GROUP 20-2886402 MULTISPECIALTY PROVIDER GROUP 22-3628075 STROKE & CEREBROVASCULAR CENTER OF NEW JERSEY 26-3519824 TRENTON NEUROSURGEONS ASSOCIATES 22-2035924 WEST TRENTON MEDICAL ASSOCIATES 20-4643360 PEDIATRIC HOSPITALIST 27-2627834 EMERGENCY PHYSICIANS 27-2232524 REHABILITATION MEDICINE 27-3421189 SPINE CENTER 27-3421008 PLASTIC SURGERY 27-4510784 PRIMARY CARE PENNINGTON 27-3945093 RADIATION ONCOLOGY 27-1366819 OB-GYN PHYSICIANS AT HAMILTON 45-2635859 HOSPITALIST GROUP 45-1501476 ADVANCED SURGICAL ASSOCIATES 27-4742615 CENTER FOR DIGESTIVE HEALTH 45-2073374 COMPREHENSIVE SLEEP ASSOCIATES 45-2074032 CAPITAL WOMEN'S HEALTH CENTER 27-2715382 DOCUMENT CORRECTION THE FOLLOWING INFORMATION IS PROVIDED IN ACCORDANCE WITH SECTION XII OF NOTICE 2010-6: NAME OF THE SERVICE PROVIDERS: NAME ---- AL MAGHAZEHE, PH.D., FACHE LARRY DISANTO J. SCOTT CLEMMENSEN EUGENE W. GROCHALA MARGARET SULLIVAN IDENTIFICATION OF PLAN OR AGREEMENT: CAPITAL HEALTH SYSTEM NON-QUALIFIED 457(F) DEFERRED COMPENSATION PLAN (THE "PLAN"). DOCUMENT FAILURE AND CORRECTION UNDER THE NOTICE: THE DOCUMENT FAILURE IS ELIGIBLE FOR CORRECTION UNDER NOTICE 2010-6 AND WAS CORRECTED PURSUANT TO SECTIONS V.B AND V.C AND THE TRANSITION RELIEF IN SECTION XI.A FOR CORRECTIONS COMPLETED PRIOR TO DECEMBER 31, 2010. THE DEFINITIONS OF CHANGE IN CONTROL AND DISABILITY WERE CORRECTED IN ACCORDANCE WITH SECTION V.B AND V.C RESPECTIVELY OF NOTICE 2010-6. DATE OF CORRECTION: CAPITAL HEALTH SYSTEM HAS TAKEN ALL ACTIONS REQUIRED AND OTHERWISE MET ALL REQUIREMENTS FOR SUCH CORRECTION PRIOR TO DECEMBER 31, 2010, THE LAST DAY OF THE 2010 FISCAL YEAR OF CAPITAL HEALTH SYSTEM. CORRECTION WAS ACCOMPLISHED PURSUANT TO AN AMENDMENT AND RESTATEMENT OF THE PLAN EXECUTED ON DECEMBER 15, 2010, EFFECTIVE AS OF THE DATE OF EXECUTION. DATE OF EVENT CAUSING INCOME INCLUSION: NOT APPLICABLE. NO AMOUNTS ARE REQUIRED TO BE INCLUDED IN INCOME UNDER NOTICE 2010-6 FOR THIS DOCUMENT CORRECTION. AMOUNT INVOLVED IN THE DOCUMENT FAILURE: THE AMOUNT INVOLVED WITH RESPECT TO EACH FAILURE IS $1,987,731.76. AMOUNT REPORTED AS INCLUDIBLE IN INCOME: NOT APPLICABLE. NO AMOUNTS ARE REQUIRED TO BE INCLUDED IN INCOME UNDER NOTICE 2010-6 FOR THIS DOCUMENT CORRECTION IN ACCORDANCE WITH THE TRANSITION RELIEF PROVIDED UNDER SECTION XI.A OF NOTICE 2010-6. CAPITAL HEALTH SYSTEM FOUNDATION 750 BRUNSWICK AVENUE TRENTON NJ 08638 222230681 SUPPORT CHS NJ 501(C)(3) 509(A)(1) CH SYSTEM true BELLEVUE AVENUE MANAGEMENT INC 446 BELLEVUE AVENUE TRENTON NJ 08618 222775694 MANAGEMENT NJ N/A C CORP. CAPITAL REGION INSURANCE COMPANY P O BOX 10073 APO GRAND CAYMAN CJ 980656385 FINANCIAL VEHICLE CJ CH SYSTEM FOREIGN CORP. 6664339 35714254 1.00000 MERCER HOLDING CORPORATION 446 BELLEVUE AVENUE TRENTON NJ 08618 222778535 HOLDING CO. NJ CH SYSTEM C CORP. 4067473 12212636 1.00000 STROKE & CEREBROVASCULAR CENTER OF NJ 750 BRUNSWICK AVENUE TRENTON NJ 08638 274554661 HEALTHCARE SVCS. NJ CH SYSTEM C CORP. 6426773 1840971 1.00000 TRENTON NEUROLOGICAL SURGEONS ASSOCIATES 3100 PRINCETON PIKE LAWRENCEVILLE NJ 08648 222035924 HEALTHCARE SVCS. NJ CH SYSTEM C CORP. 209386 2869 1.00000 false true false true true false false false false false false false false true false false true true CAPITAL HEALTH SYSTEM FOUNDATION N 494239 COST MERCER HOLDING CORPORATION E 456804 COST CAPITAL HEALTH SYSTEM FOUNDATION B 100000 COST