2013-11-14T14:16:35-06:00 2012-12-31 ERNST & YOUNG US LLP 111 MONUMENT CIRCLE 2600 INDIANAPOLIS IN 46204 990 2012-01-01 221487173 ENGLEWOOD HOSPITAL AND MEDICAL CENTER % ANTHONY T ORLANDO ENGL 2018943275 350 ENGLE STREET Suite ENGLEWOOD NJ 07631 WARREN GELLER 2013-11-14 3176817000 2012 2016-02-24 21:20:13Z WARREN GELLER 350 ENGLE STREET ENGLEWOOD NJ 07631 390916793 false X englewoodhospital.com X 1888 NJ HEALTHCARE SERVICES (AN ACUTE CARE HOSPITAL). 26 21 2742 745 0 6182175 6149788 342118744 375065275 8901238 499022 7810772 9200008 365012929 390914093 16550 7800 0 0 164565417 164406792 0 0 0 184329098 220789502 348911065 385204094 16101864 5709999 351965887 346212199 272137799 256145448 79828088 90066751 X PROVIDE COMPREHENSIVE, STATE-OF-THE-ART PATIENT SERVICES; EMPHASIZE CARING AND OTHER HUMAN VALUES IN THE TREATMENT OF PATIENTS AND IN RELATIONS AMONG EMPLOYEES, MEDICAL STAFF AND THE COMMUNITY; BE A CENTER OF EDUCATION AND RESEARCH AS DEMONSTRATED BY ITS AFFILIATION WITH THE MOUNT SINAI SCHOOL OF MEDICINE; PROVIDE EMPLOYEES AND MEDICAL STAFF WITH MAXIMUM OPPORTUNITIES TO ACHIEVE THEIR PERSONAL AND PROFESSIONAL GOALS. false false 321556011 7800 380295857 ABOUT ENGLEWOOD HOSPITAL AND MEDICAL CENTER A BRIEF HISTORY ENGLEWOOD HOSPITAL WAS INCORPORATED IN 1888 AS A NON-PROFIT, NON-SECTARIAN VOLUNTARY HEALTH CARE FACILITY DEVOTED TO "THE CARE, MAINTENANCE AND CURE OF THE SICK, INJURED AND THE INFIRMED." THE FIRST BUILDING WAS DEDICATED ON JUNE 14, 1890, AND HOUSED TWELVE BEDS. ENGLEWOOD HOSPITAL ADMITTED ITS FIRST PATIENT ON JUNE 25, 1890. OVER THE YEARS, POPULATION GROWTH IN THE NORTHERN VALLEY RESULTED IN SEVERE OVER-CROWDING, WHICH INDUCED A MAJOR NEW BUILDING PROGRAM IN 1923. IN 1925, THE HOSPITAL MOVED INTO WHAT IS NOW THE EAST WING. ENGLEWOOD HOSPITAL HAD GROWN TO A 200-BED HOSPITAL WITH LABORATORY, X-RAY FACILITIES, AN OPERATING SUITE, PEDIATRIC, MATERNITY AND OUTPATIENT DEPARTMENTS, INCLUDING A PUBLIC HEALTH NURSING SERVICE, AND A MEDICAL STAFF OF 30 DOCTORS INCLUDING SPECIALISTS IN EYE, EAR, NOSE AND THROAT, PEDIATRICS, SURGERY, RADIOLOGY AND LABORATORY. THROUGHOUT THE 1940S, THE HOSPITAL CONTINUED TO INTRODUCE NEW SERVICES NEEDED BY THE COMMUNITY OR AVAILABLE BECAUSE OF TECHNOLOGY. IT FORMALIZED THE RADIOLOGY DEPARTMENT, EQUIPPED WITH CURRENT TECHNOLOGY AND STARTED ITS "PLASMA BANK", BERGEN COUNTY'S FIRST BLOOD BANK FOR WHOLE BLOOD. IT ALSO ESTABLISHED GYNECOLOGICAL, BRONCHOSCOPY, GASTROSCOPY AND CARDIAC CLINICS. THE SPECIALIZATION TREND IN THE 1960S BRED A HOST OF NEW SERVICES, REFLECTING TECHNOLOGY ADVANCES IN EQUIPMENT AND PROCEDURES. AS THE MEDICAL AND CARING REPUTATION OF THE HOSPITAL GREW, SO DID ITS ROLE AS A TEACHING FACILITY; ITS NURSING SCHOOL WAS WELL ESTABLISHED, AND THE HOSPITAL NOW HAD INTERNSHIPS FOR DOCTORS AND DENTISTS, AND FOR CHAPLAINS. NEW PATIENT CARE PROGRAMS REFLECTED THE NEEDS OF THE 1970S: A NEUROSCIENCE CENTER, A DIABETES PROGRAM, A VASCULAR SURGERY PROGRAM AND A CHILD HEALTH CLINIC. A NEW CARDIOLOGY LABORATORY PROVIDED STRESS TESTING, ECHOCARDIOGRAPHY AND OTHER SOPHISTICATED SCREENINGS FOR CORONARY PATIENTS. A CRISIS INTERVENTION CENTER, A NEW BIRTHING CENTER AND A NETWORK OF SERVICES SUPPORTED THE NEW EMPHASIS ON "FAMILY". THE 1980S ALSO BROUGHT A NEW VOCABULARY OF SERVICES AND EQUIPMENT TO THE HOSPITAL. CAT SCAN, MRI, GENETIC COUNSELING, IMAGING, CATHETERIZATION, GERIATRICS, MAMMOGRAPHY, LAPAROSCOPY AND AMBULATORY SURGERY. THE DECADE ALSO INTRODUCED A NEW ARRAY OF ALTERNATIVE DELIVERY SYSTEMS THAT WOULD REQUIRE HOSPITALS ACROSS THE NATION TO CONTEND WITH DECREASING OCCUPANCY RATES AND RISING COSTS, AND WITH NEW DEFINITIONS OF QUALITY AND COMPETITIVENESS. AT THE CLOSE OF ITS FIRST CENTURY OF SERVICE, ENGLEWOOD HOSPITAL HAD GROWN TO 547 BEDS-THE LARGEST VOLUNTARY ACUTE CARE HOSPITAL IN BERGEN COUNTY AND THE THIRD LARGEST IN NEW JERSEY. ENGLEWOOD HOSPITAL WAS FULLY ACCREDITED AND ABOUT TO BECOME A MAJOR TEACHING HOSPITAL. IN 2012, A NURSING STAFF OF APPROXIMATELY 650 AND MEDICAL STAFF OF MORE THAN 600 PROFESSIONALS SERVED MORE THAN 17,000 ADMITTED PATIENTS AND OVER 47,000 EMERGENCY CASES. THERE WERE 12,000 OPERATIONS AND SOME 2,300 BABIES BORN. THE HOSPITAL'S WORKFORCE OF ALMOST 2,000 MADE IT THE LARGEST EMPLOYER IN THE AREA. SUCH MASSIVE GROWTH SPURRED OTHER CHANGES, TOO. A GROWING EMPHASIS ON QUALITY, PATIENT WELFARE AND COMFORT LED TO THE DEVELOPMENT OF A PATIENT ADVOCACY PROGRAM-A MODEL FOR THE BERGEN COUNTY AREA. THE MEDICAL CENTER ALSO ESTABLISHED A DISCHARGE-PLANNING PROGRAM TO HELP EASE THE TRANSITION FROM HOSPITAL TO HOME. IN 1990, ENGLEWOOD HOSPITAL CELEBRATED ITS 100TH ANNIVERSARY. MEDICAL CENTER-BASED EFFORTS HELPED ENHANCE QUALITY AND MEASURE PERFORMANCE AS COMPARED TO OTHER ORGANIZATIONS. THE MEDICAL CENTER ALSO WORKED WITH OTHER STAKEHOLDERS ACROSS THE COUNTRY, SHARING INFORMATION AND IDEAS, AND PARTICIPATING IN IMPORTANT INITIATIVES SUCH AS TRANSFORMING CARE AT THE BEDSIDE AND 5 MILLION LIVES CAMPAIGN. CORPORATE STRUCTURE ENGLEWOOD HEALTHCARE FOUNDATION D/B/A/ ENGLEWOOD HEALTHCARE SYSTEM (THE "SYSTEM" OR "PARENT") IS A NEW JERSEY NONPROFIT CORPORATION, WHICH WAS ORGANIZED AS A 501(C)(3) TAX EXEMPT HOLDING CORPORATION. IT IS OPERATED EXCLUSIVELY FOR THE BENEFIT OF THE MEDICAL CENTER AND THE OTHER SUBSIDIARIES OF THE PARENT. THE PARENT COORDINATES PLANNING, HOSPITAL OPERATIONS, REAL ESTATE ACTIVITY, AND SERVICES THAT SUPPORT FOR PROFIT VENTURES INCLUDING FUND RAISING PROVIDED BY THE SYSTEM AND ITS AFFILIATES. THE PARENT SERVES AS THE SOLE MEMBER OF THE MEDICAL CENTER, ENGLEWOOD HEALTHCARE PROPERTIES, INC., ("PROPERTIES"), ENGLEWOOD HOSPITAL AND MEDICAL CENTER FOUNDATION, INC. (THE "FOUNDATION") AND ENGLEWOOD HEALTHCARE ENTERPRISES, INC. ("ENTERPRISES"); REFERRED TO COLLECTIVELY AS AFFILIATES ("AFFILIATES"), ENGLEWOOD MEDICAL ASSOCIATES, INC., IS A WHOLLY OWNED, 501(C)(3) NOT FOR PROFIT SUBSIDIARY OF THE MEDICAL CENTER. FOLLOWING IS A BRIEF DESCRIPTION OF EACH OF THE AFFILIATES OF THE PARENT OTHER THAN THE MEDICAL CENTER: ENGLEWOOD HOSPITAL AND MEDICAL CENTER FOUNDATION ENGLEWOOD HOSPITAL AND MEDICAL CENTER FOUNDATION, A NOT FOR PROFIT 501(C)(3) ORGANIZATION FOUNDED IN 1995, PERFORMS FUND RAISING AND DEVELOPMENT ON BEHALF OF THE SYSTEM AND ITS AFFILIATES. ENGLEWOOD HEALTHCARE PROPERTIES, INC. ENGLEWOOD HEALTHCARE PROPERTIES, INC, A NOT FOR PROFIT 501(C)(3) COMPANY, WAS FORMED FOR THE PURPOSE OF ACQUIRING REAL ESTATE TO BE USED BY THE MEDICAL CENTER AND AFFILIATES OF THE SYSTEM. IT OWNS PROPERTIES IN BERGEN AND HUDSON COUNTIES. ENGLEWOOD HEALTHCARE ENTERPRISES, INC. ENGLEWOOD HEALTHCARE ENTERPRISES, INC. IS A FOR PROFIT CORPORATION THAT PROVIDES HEALTHCARE RELATED SERVICES WITHIN THE MEDICAL CENTER'S SERVICE AREA. IT CURRENTLY MAINTAINS A MANAGEMENT SERVICE ORGANIZATION FOR THE PRACTICES OF ENGLEWOOD MEDICAL ASSOCIATES. ENGLEWOOD MEDICAL ASSOCIATES, INC. ENGLEWOOD MEDICAL ASSOCIATES, INC. ("EMA"), IS A 501(C)(3) NOT FOR PROFIT CORPORATION EMPLOYING FULL-TIME FACULTY PHYSICIANS. IT IS A WHOLLY OWNED SUBSIDIARY OF THE MEDICAL CENTER. MEDICAL ASSOCIATES OF ENGLEWOOD, PC MEDICAL ASSOCIATES OF ENGLEWOOD, PC ("MAE"), IS A 501(C)(3) NOT FOR PROFIT CORPORATION THAT EMPLOYS FULL-TIME FACULTY PHYSICIANS AND ACQUIRES PHYSICIAN PRACTICES IN THE PRIMARY AND SECONDARY MARKETS OF ENGLEWOOD HOSPITAL AND MEDICAL CENTER. PHYSICIAN PARTNERS OF ENGLEWOOD, PC PHYSICIAN PARTNERS OF ENGLEWOOD, PC IS A 501(C)(3) NOT FOR PROFIT CORPORATION THAT EMPLOYS FULL-TIME FACULTY PHYSICIANS. EMERGENCY PHYSICIANS OF ENGLEWOOD, PC EMERGENCY PHYSICIANS OF ENGLEWOOD, PC IS A 501(C)(3) NOT FOR PRFIT CORPORATION THAT EMPLOYS FULL-TIME EMERGENCY MEDICINE PHYSICIANS. GOVERNANCE THE AFFAIRS OF THE MEDICAL CENTER ARE GOVERNED BY A 26 MEMBER BOARD OF TRUSTEES. THE PRESIDENT OF THE MEDICAL CENTER AND THE PRESIDENT, VICE PRESIDENT AND IMMEDIATE PAST PRESIDENT OF THE MEDICAL STAFF SERVE EX OFFICIO WITH VOTING PRIVILEGES. THE BOARD OF TRUSTEES GENERALLY MEETS MONTHLY. COMMITTEES OF THE BOARD OF TRUSTEES COMMITTEES OF THE BOARD INCLUDE FACILITIES PLANNING, FINANCE, PERSONNEL, PROFESSIONAL AFFAIRS, AND STRATEGIC PLANNING. THE AUDIT AND COMPLIANCE, COMPENSATION, EXECUTIVE, INVESTMENT, GOVERNMENT AFFAIRS AND NOMINATING AND GOVERNANCE, ARE COMMITTEES OF THE SYSTEM. ENGLEWOOD HOSPITAL AND MEDICAL CENTER TODAY ENGLEWOOD HOSPITAL AND MEDICAL CENTER, A NON PROFIT ORGANIZATION, HAS CONTINUALLY RESPONDED TO THE NEEDS OF THE COMMUNITIES IT SERVES SINCE 1888. IT PROVIDES QUALITY HEALTHCARE TO AREA RESIDENTS AND FREQUENTLY TO PEOPLE FROM ACROSS THE NATION, ESPECIALLY THROUGH OUR BLOODLESS MEDICINE PROGRAM. ENGLEWOOD RECOGNIZES THE CONSTANT CHALLENGES OF DELIVERING QUALITY HEALTHCARE AND HAS DEVELOPED A CULTURE WHEREIN WE TREAT THE PATIENT, NOT JUST THE PATIENT'S ILLNESS. ENGLEWOOD HOSPITAL AND MEDICAL CENTER STRIVES TO BE THE REGIONAL LEADER IN PROVIDING STATE OF THE ART COMPASSIONATE CARE, IN A HUMANISTIC ENVIRONMENT. VISION STATEMENT ENGLEWOOD HOSPITAL AND MEDICAL CENTER WILL BE THE REGIONAL LEADER IN PROVIDING STATE-OF-THE-ART COMPASSIONATE CARE IN A HUMANISTIC ENVIRONMENT. THE MISSION OF ENGLEWOOD HOSPITAL AND MEDICAL CENTER IS TO: PROVIDE COMPREHENSIVE, STATE-OF-THE-ART PATIENT SERVICES. EMPHASIZE CARING AND OTHER HUMAN VALUES IN THE TREATMENT OF PATIENTS AND IN RELATIONS AMONG EMPLOYEES, MEDICAL STAFF AND COMMUNITY. -BE A CENTER OF EDUCATION AND RESEARCH, AS DEMONSTRATED BY ITS AFFILIATION WITH THE NEW YORK'S MOUNT SINAI SCHOOL OF MEDICINE. -PROVIDE EMPLOYEES AND MEDICAL STAFF WITH MAXIMUM OPPORTUNITIES TO ACHIEVE THEIR PERSONAL AND PROFESSIONAL GOALS. THE MEDICAL CENTER OPERATES AS A NON PROFIT ORGANIZATION, AND AS SUCH ANSWERS NOT TO SHAREHOLDERS, BUT TO THE COMMUNITIES IT SERVES. EXCESS OF REVENUE OVER EXPENSE IS RE-INVESTED IN THE ORGANIZATION, PRINCIPALLY THROUGH CAPITAL INVESTMENT, BUT ALSO TO MEET FUTURE PROGRAMMATIC NEEDS. ENGLEWOOD IS COMMITTED TO MEETING THE EXPECTATION OF ITS PATIENTS BY PROVIDING QUALITY HEALTHCARE, AND THEREFORE MUST MAKE THESE INVESTMENTS TO SECURE ITS FUTURE OF SERVICE DELIVERY TO THE COMMUNITY. THE MEDICAL CENTER IS COMMITTED TO TREAT ALL PATIENTS REGARDLESS OF THEIR FINANCIAL ABILITY AND HAS IN PLACE A FORMAL CHARITY CARE POLICY; AS PER THIS POLICY THE MEDICAL 321556011 true true false true false false false false false false true false false true true false false true false false false false false false false false true true false true true false false false false false true true true false false false false false true true true true false true 222 0 true 2742 true false false false false false false false false false false X 26 21 true false false false true true true true true false false true true true true true true true true false NJ X ANTHONY T ORLANDO 2018943280 350 ENGLE STREET ENGLEWOOD NJ 076311898 X DOUGLAS A DUCHAK 55.0 8.0 X X 778906 169557 50560 JAY C NADEL 5.0 3.0 X X THOMAS C SENTER ESQ 14.0 2.0 X X ROBERT F MANGANO 2.0 2.0 X X YALE BLOCK 2.0 1.0 X MICHAEL B BRENNER 1.0 2.0 X EUGENE R DIAZ 1.0 1.0 X ANDREW F DURKIN 1.0 2.0 X HUGH E EVANS MD 1.0 X GAYLE GERSTEIN 1.0 X RONALD GOLD 1.0 X EDDIE R HADDEN ESQ 1.0 1.0 X MARGARET R KAPLEN 1.0 X SAM S KIM 1.0 1.0 X X RICHARD J KURTZ 1.0 4.0 X MARK METZGER 1.0 X DANIEL RUBIN 1.0 X MIGUEL A SANCHEZ MD 2.0 1.0 X STEVEN SIESSER 1.0 1.0 X ARYEH SHANDER MD 1.0 X 50000 DAVID A SHANKS 1.0 1.0 X IN JIN CHOI 1.0 X BARRY SUSSMAN MD 2.0 1.0 X THOMAS J VOLPE 1.0 1.0 X BARBARA DILL MD 1.0 X JONATHAN ABAD 3.0 X PAUL T FADER 1.0 X WARREN GELLER 55.0 X 481711 0 41712 ANTHONY T ORLANDO 55.0 4.0 X 376938 77280 33067 MADELYN PEARSON RN 55.0 X 273998 0 30305 PATRICIA G WILSON 55.0 X 285254 0 30442 MICHAEL PIETROWICZ 55.0 2.0 X 322991 0 33584 RONALD FUSCHILLO 55.0 X 293301 0 2474 THOMAS GRECO 55.0 X 241967 0 15104 LORI FURNARI 55.0 X 229812 0 1975 3334878 246837 239223 285 false true false ENGLEWOOD CARDIAC SURGERY ASSOCIATE 350 ENGLE STREET ENGLEWOOD NJ 07631 PHYSICIAN SERVICES 2800000 NORTHERN VALLEY ANESTHESIOLOGY PA 375 ENGLE STREET ENGLEWOOD NJ 07631 PHYSICIAN SERVICES 2542897 ADVANCED MEDICAL IMAGING OF NORTH J 452 OLD HOOK ROAD SUITE 301 EMERSON NJ 07630 MANAGEMENT SERVICES 960000 ENGLEWOOD RADIOLOGY GROUP 350 ENGLE STREET ENGLEWOOD NJ 07631 PHYSICIAN SERVICES 751600 ENT AND ALLERGY ASSOCIATES LLP 560 WHITE PLAINS ROAD TARRYTOWN NY 10591 PHYSICIAN SERVICES 742052 24 2675613 3435174 39001 6149788 NET PATIENT SERVICE REVENUE 622110 374902025 374902025 AFFILIATED ORGANIZATION RENT 531190 163250 163250 375065275 416785 0 416785 0 0 1029346 0 1029346 0 1029346 1029346 58650 26287 0 2700 58650 23587 82237 82237 0 0 0 CAFETERIA SALES 722210 2170797 2170797 GAIN ON DEBT MODIFICATION 900099 2865864 2865864 VOLUME PURCHASING DISCOUNTS 900099 664560 664560 2469441 1700158 769283 8170662 390914093 380295857 0 4468448 X 0 7800 7800 0 0 2131813 50000 2081813 0 99919 67172 32747 129946082 109196729 20749353 6959857 5851208 1108649 14975581 12590093 2385488 10293540 8653863 1639677 647350 647350 1523396 196313 1327083 166239 166239 19443 19443 0 0 58711371 52632086 6079285 2360851 1685737 675114 4644777 3344022 1300755 5964998 414292 5550706 0 7911550 4522935 3388615 373132 270296 102836 0 182112 171590 10522 3591391 3591391 0 19864355 10197376 9666979 6391919 4930942 1460977 MEDICAL SUPPLIES 51341747 51341747 DRUGS AND PHARMACEUTICALS 21146051 21123420 22631 OUTSIDE/CONTRACTED SERVICES 22769966 18802931 3967035 PROVISION FOR BAD DEBT 11000000 11000000 2178854 266718 1912136 385204094 321556011 63648083 0 1517243 16413307 36404148 17105090 0 0 44387773 39914897 0 0 0 0 3523018 3466102 8880402 8525088 4563262 5189343 479736537 285375496 185948921 194361041 9016064 9788372 0 0 4526500 4842328 0 0 53198556 46606631 351965887 346212199 61286231 57381680 0 0 839772 288594 78043733 0 0 0 0 0 31355222 105335430 0 0 100612841 93139744 272137799 256145448 X 60681940 68918035 16022290 18024858 3123858 3123858 79828088 90066751 351965887 346212199 X 5709999 -53614 4582278 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 19443 19443 19443 19443 385184966 385184966 385204409 385204409 1000000 1000000 250000 250000 1000000 1000000 1000000 1000000 4000000 6000000 21985 26220 17753 19443 85401 250000 250000 250000 250000 1000000 1500000 0 0 0 180588 180588 115871843 46627010 69244833 1614079 1572633 41446 357887533 237175853 120711680 4182494 4182494 194361041 ASSETS WHOSE USE IS LIMITED 6892516 INT IN NET ASSETS OF EHMC FDN 21148716 DUE FROM AFFILIATED COMPANIES 5208681 UNPAID MALPRACTICE CLAIMS 5938211 DEFERRED DEBT ISSUANCE COSTS 2881869 MED RESIDENT FICA REFUNDS DUE 1030053 UNPAID WORKERS' COMP CLAIMS 1171085 MDCAID ELEC HLTH REIMB DUE 504290 REBATES & OTHER VENDOR CREDIT 349477 OTHER RECEIVABLES 1481733 46606631 0 ACCRUED PENSION LIABILITY 46877419 ESTIMATED AMOUNTS DUE TO PAYORS 33002607 UNPAID MALPRACTICE CLAIMS 5938211 RETIREE HEALTH BENEFITS LIABILITY 2430982 IBNR - MALPRACTICE CLAIMS 1984121 UNPAID WORKERS' COMPENSATION CLAIMS 1171085 MED. 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350 ENGLE STREET ENGLEWOOD NJ 07631

ENGLEWOODHOSPITAL.COM X X X X X ENGLEWOOD HOSPITAL AND MEDICAL CENTER 1 true true 201. true 201. true X X X X X X X true true X X X X X true false X X X true X false false PART I, LINE 3C IF A PATIENT IS NOT ELIGIBLE FOR CHARITY CARE UNDER THE STATE OF NEW JERSEY CHARITY CARE GUIDELINES, AND HAS NO OTHER INSURANCE COVERAGE, THEY ARE CLASSIFIED AS A "SELF-PAY" PATIENT. SUCH PATIENTS' BILLS WILL BE DISCOUNTED TO BE EQUAL TO 115% OF THE MEDICARE RATE UNDER THE MEDICAL CENTER'S SUPPLEMENTAL CHARITY CARE PROGRAM. PART I, LINE 6A AS PART OF ITS ANNUAL FILING OF FORM 990, THE MEDICAL CENTER PREPARES A STATEMENT THAT PROVIDES A HISTORY OF THE MEDICAL CENTER, ITS CORPORATE STRUCTURE LISTING ITS AFFILIATED ORGANIZATIONS AND COMPANIES, A DESCRIPTION OF ITS GOVERNANCE AND STANDING COMMITTEES, ITS VISION STATEMENT, AND A DESCRIPTION OF ITS SERVICES PROVIDED TO THE COMMUNITY IN THE PRECEDING YEAR. THIS REPORT IS AVAILABLE TO ANYONE THAT REQUESTS A COPY OF THE MEDICAL CENTER'S FORM 990 AND IS LIKEWISE AVAILABLE TO INTERNET USERS THAT VISIT THE GUIDESTAR WEB SITE. PART I, LINE 7 (COLUMN F) THE MEDICAL CENTER'S COST TO CHARGE RATIO REFLECTS TOTAL OPERATING COSTS, EXCLUDING BAD DEBT AND OTHER OPERATING REVENUE, TO GROSS CHARGES. PART I, LINE 7 THE MEDICAL CENTER UTILIZED WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS TO DERIVE ITS COST-TO-CHARGE RATIO. THE ORGANIZATION DOES NOT UTILIZE A COST ACCOUNTING SYSTEM, NOR WAS A COST-TO-CHARGE RATIO UTILIZED TO DERIVE ANY OF THE AMOUNTS USED IN WORKSHEET 2. PART III, LINES 2 AND 3 PART III, LINE 2 THE AMOUNT OF ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN MEDICARE AND MEDICAID HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. ADDITIONS TO THE PROVISION FOR DOUBTFUL ACCOUNTS RESULT FROM THE PROVISION FOR BAD DEBTS; DEDUCTIONS FROM THE ALLOWANCE FOR DOUBTFUL ACCOUNTS RESULT FROM ACCOUNTS WRITTEN OFF AS UNCOLLECTIBLE. PART III, LINE 3 THE ESTIMATED BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER CHARITY CARE IS APPROXIMATELY 10% OF THE TOTAL BAD DEBT EXPENSE (AT COST), WHICH IS CONSISTENT WITH THE MEDICAL CENTER'S EXPERIENCE OF PATIENT ACCOUNT WRITE-OFFS. PART III, LINE 4 THE TEXT OF THE MEDICAL CENTER'S AUDIT REPORT FOOTNOTE IN REGARDS TO BAD DEBTS IS AS FOLLOWS: PATIENT ACCOUNTS RECEIVABLE RESULT FROM HEALTH CARE SERVICES PROVIDED BY THE MEDICAL CENTER. THE AMOUNT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN MEDICARE AND MEDICAID HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. ADDITIONS TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS RESULT FROM THE PROVISION FOR BAD DEBTS. ACCOUNTS WRITTEN OFF AS UNCOLLECTIBLE ARE DEDUCTED FROM THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FURTHER, THE CURRENT NEW JERSEY DEPARTMENT OF HEALTH AND SENIOR SERVICES CHARITY CARE GUIDELINES REQUIRE THE PARTICIPATION AND COOPERATION OF THE PATIENT IN ORDER TO BE IDENTIFIED AS A CHARITY CARE ACCOUNT. MANAGEMENT BELIEVES THAT THE PRESENT CHARITY CARE GUIDELINES UNDERSTATE THE MEDICAL CENTER'S CHARITY CARE AMOUNTS AND OVERSTATE THE LEVEL OF BAD DEBTS REPORTED BECAUSE OF THE DIFFICULTIES INVOLVED WITH OBTAINING PATIENT COOPERATION. DISCOUNTS ARE AVAILABLE TO ALL UNINSURED PATIENTS UNDER THE MEDICAL CENTER'S UNINSURED FINANCIAL ASSISTANCE PROGRAM. DISCOUNTS TO THOSE PATIENTS WHO DID NOT QUALIFY UNDER THE CHARITY CARE GUIDELINES ARE NOT INCLUDED IN THE CHARITY CARE AMOUNTS. THE MEDICAL CENTER RECEIVES PARTIAL REIMBURSEMENT FOR THE CHARITY CARE IT PROVIDES PART III, LINE 18 THE MEDICARE SHORTFALL REFLECTS THE "NET" PROVISION OF FULL SERVICES TO A CERTAIN POPULATION, AGE 65 AND OVER, THAT IS SUBSIDIZED BY THE MEDICAL CENTER. THE MEDICAL CENTER'S COST TO CHARGE RATIO REFLECTS TOTAL OPERATING COSTS, EXCLUDING BAD DEBT AND OTHER OPERATING REVENUE, TO GROSS CHARGES. PART V, LINE 9 IT IS THE POLICY OF ENGLEWOOD HOSPITAL AND MEDICAL CENTER TO BILL AND COLLECT ACCOUNTS RECEIVABLE IN ACCORDANCE WITH ALL FEDERAL AND STATE BILLING AND COLLECTION REGULATIONS. ENGLEWOOD HOSPITAL PROVIDES A FULL RANGE OF MEDICAL SERVICES TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. ALL PATIENTS OR RESPONSIBLE PARTIES ARE INTERVIEWED AT THE TIME OF REGISTRATION, REGARDLESS OF WHAT AREA OF THE MEDICAL CENTER THEY ARE IN. IF THE MEDICAL CONDITION OF THE PATIENT DOES NOT PERMIT AN INTERVIEW, INFORMATION WILL BE TAKEN FROM A FAMILY MEMBER OR AS SOON AS MEDICALLY POSSIBLE, FROM THE PATIENT. ALL PATIENT OR RESPONSIBLE PARTY DEMOGRAPHIC DATA IS COLLECTED AND DOCUMENTED. IDENTIFICATION, SUCH AS A DRIVER'S LICENSE OR A SOCIAL SECURITY CARD WILL BE REQUESTED AND COPIED IF AVAILABLE. IF IDENTIFICATION IS UNAVAILABLE, THE REGISTRATION FORM IS DOCUMENTED ACCORDINGLY. INSURANCE INFORMATION IS REQUESTED AND DOCUMENTED, AND IF AVAILABLE, INSURANCE IDENTIFICATION CARDS ARE COPIED. ALL PATIENTS OR RESPONSIBLE PARTIES ARE GIVEN A NEW JERSEY HOSPITAL CARE PAYMENT ASSISTANCE FACT SHEET. IF HEALTH INSURANCE INFORMATION IS NOT GIVEN AT THE TIME OF REGISTRATION, OR HEALTH INSURANCE INFORMATION IS GIVEN THAT WILL NOT PROVIDE PAYMENT IN FULL, THE MEDICAL CENTER WILL REFER PATIENTS TO PUBLIC ASSISTANCE PROGRAMS IF APPROPRIATE. REFERRAL WILL BE BASED ON INCOME AND ASSETS INFORMATION GIVEN. IF THE PATIENT APPEARS TO BE ELIGIBLE BASED ON THE INFORMATION GIVEN, THE MEDICAL CENTER WILL PROVIDE THAT PATIENT WITH WRITTEN INFORMATION REGARDING THE NAME, ADDRESS AND TELEPHONE NUMBER OF THE APPROPRIATE PUBLIC ASSISTANCE PROGRAM. PATIENTS ARE REFERRED TO PUBLIC ASSISTANCE PROGRAMS BASED ON INCOME THAT MEETS THE POVERTY INCOME GUIDELINES. ALL INCOME AND ASSETS INFORMATION IS DOCUMENTED AND KEPT WITH THE PATIENT'S BILLING FILE. PATIENTS WHO ARE FOUND TO BE ELIGIBLE FOR MEDICAID AND HAVE OUTSTANDING BILLS FROM THE THREE MONTHS PRIOR TO THE APPLICATION FOR MEDICAID, ARE GIVEN A RETROACTIVE MEDICAID APPLICATION FORM (FD74) TO COMPLETE AND MAIL. IF THE PATIENT DOES NOT APPEAR TO BE ELIGIBLE FOR A PUBLIC ASSISTANCE PROGRAM BASED ON INCOME AND ASSETS INFORMATION PROVIDED OR IF THE PUBLIC ASSISTANCE PROGRAM PROVIDES THE PATIENT WITH A WRITTEN DENIAL, THE PATIENT WILL BE SCREENED FOR CHARITY CARE. PERSONS WHO ARE NOT NEW JERSEY RESIDENTS MAY NOT BE SCREENED FOR CHARITY CARE UNLESS THE CARE IS RELATED TO AN EMERGENCY RESULTING IN AN INPATIENT ADMISSION. SIGNS PROVIDED BY THE NEW JERSEY DEPARTMENT OF HEALTH INDICATING THE AVAILABILITY OF CHARITY CARE IN ENGLISH, SPANISH, AND KOREAN ARE POSTED IN THE MEDICAL CENTER DEPARTMENTS: ADMITTING, EMERGENCY ROOM, OUTPATIENT REGISTRATION, CLINIC, AND ALL PATIENT ACCOUNTING DEPARTMENTS. THE PATIENT OR RESPONSIBLE PARTY WILL BE ASKED TO PROVIDE PROPER IDENTIFICATION, PLACE OF EMPLOYMENT, INCOME, REAL PROPERTY, DURABLE PERSONAL PROPERTY, LIQUID ASSETS, AND BANK ACCOUNTS. A PERSON'S INCOME FOR PURPOSES OF DETERMINING ELIGIBILITY FOR CHARITY CARE ASSISTANCE SHALL BE THE LESSER OF THE ACTUAL GROSS INCOME FOR TWELVE MONTHS PRECEDING THE SERVICES OR FOUR TIMES THE ACTUAL GROSS INCOME FOR THE THREE MONTHS PRECEDING THE SERVICES OR ONE MONTH'S GROSS INCOME MULTIPLIED BY TWELVE. INCOME INCLUDES A SPOUSE'S INCOME FOR AN ADULT AND PARENTAL INCOME FOR A MINOR CHILD. A PERSON'S LIQUID ASSETS MAY NOT EXCEED $7,500 AND A PERSON'S FAMILY ASSETS MAY NOT EXCEED $15,000 TO BE ELIGIBLE FOR CHARITY CARE. ASSETS INCLUDE SPOUSAL ASSETS FOR ADULT PATIENTS AND PARENTAL ASSETS FOR A MINOR CHILD. A COPY OF ALL INCOME AND ASSET INFORMATION IS MAINTAINED WITH THE PATIENT'S BILLING FILE. BASED ON THE INCOME AND ASSET INFORMATION PROVIDED, THE MEDICAL CENTER WILL DETERMINE ELIGIBILITY FOR CHARITY CARE USING THE ELIGIBILITY CRITERIA CHART PROVIDED BY THE NEW JERSEY DEPARTMENT OF HEALTH AND SENIOR SERVICES. THE PATIENT OR RESPONSIBLE PARTY WILL BE ASKED TO COMPLETE A CHARITY CARE APPLICATION. ENGLEWOOD HOSPITAL AND MEDICAL CENTER WILL ACCEPT CHARITY CARE APPLICATIONS BEYOND ONE YEAR FROM DATES OF SERVICE. THE MEDICAL CENTER WILL USE THE ELIGIBILITY CRITERIA IN EFFECT FOR THE DATES OF SERVICE FOR ALL DETERMINATIONS. AN ELIGIBILITY DETERMINATION FOR CHARITY CARE WILL BE MADE WITHIN TEN WORKING DAYS FOLLOWING THE DATE OF REQUEST. IF THE REQUEST DOES NOT INCLUDE SUFFICIENT DOCUMENTATION TO MAKE A DETERMINATION, THE REQUEST WILL BE DENIED. IF DENIAL OF ELIGIBILITY IS DUE TO LACK OF DOCUMENTATION, THE PATIENT SHALL BE PERMITTED TO PROVIDE THE ADDITIONAL DOCUMENTATION. THE MEDICAL CENTER SHALL PROMPTLY PROVIDE THE PATIENT WITH A WRITTEN COPY OF THE DETERMINATION. A COPY OF THE CHARITY CARE APPLICATION AND THE DETERMINATION IS KEPT WITH THE PATIENT'S BILLING FILE. IF THE AMOUNT A PATIENT IS DETERMINED TO BE RESPONSIBLE FOR EXCEEDS 30% OF THEIR INDIVIDUAL OR FAMILY INCOME, THIS EXCESS WILL BE ELIGIBLE FOR CHARITY CARE. ANY DETERMINATION THAT GRANTS CHARITY CARE WILL BE IN EFFECT FOR ONE YEAR FROM THE DATE OF SERVICE. ALL CHARITY CARE ALLOWANCES ON BALANCES AFTER MEDICARE PAYMENTS ENTERED INTO THE MEDICAL CENTER'S COMPUTERIZED BILLING SYSTEM WITH A SEPARATE "MEDICARE CHARITY CARE" TRANSACTION CODE. ANY PATIENT NOT ELIGIBLE FOR CHARITY CARE UNDER THE STATE OF NEW JERSEY CHARITY CARE GUIDELINES, AND HAVE NO OTHER INSURANCE COVERAGE, ARE CLASSIFIED AS A "SELF-PAY" PATIENT. SUCH PATIENTS' BILLS WILL BE DISCOUNTED TO BE EQUAL TO 115% OF THE MEDICARE RATE UNDER THE MEDICAL CENTER'S SUPPLEMENTAL CHARITY CARE PROGRAM. ANY PATIENT WHO IS NOT FOUND TO BE ELIGIBLE FOR CHARITY CARE WILL BE GIVEN THE OPPORTUNITY TO MAKE PAYMENT ARRANGEMENTS. THE MEDICAL CENTER WILL MAKE EVERY ATTEMPT TO MAKE ARRANGEMENTS WITH THE PATIENT OR RESPONSIBLE PARTY FOR PAYING THE BALANCE DUE WITHIN ONE YEAR. THE MEDICAL CENTER WILL ACCEPT CIRCUMSTANCES WHERE IT MAY TAKE A PATIENT OR RESPONSIBLE PARTY LONGER THAN ONE YEAR TO PAY THE DEBT. DEPOSITS ARE REQUESTED FROM PATIENTS OR RESPONSIBLE PARTIES AT THE TIME OF REGISTRATION WHEN THE PATIENT IS NOT COVERED BY INSURANCE OR THE SERVICE IS A NON-COVERED SERVICE (I.E. COSMETIC SURGERY). ONCE ALL INSURANCE BILLING AND FOLLOW-UP HAS BEEN EXHAUSTED AND THE PATIENT IS NOT ELIGIBLE FOR ANY TYPE OF PUBLIC OR CHARITY CARE, THE COLLECTION CYCLE BEGINS. THREE BILLING STATEMENTS ARE SENT AT THREE WEEK INTERVALS, FOLLOWED BY THREE COLLECTION LETTERS SENT AT TWO WEEK INTERVALS. IF A PAYMENT OR OTHER PERTINENT INFORMATION IS RECEIVED DURING THE COLLECTION CYCLE, THE CYCLE WILL STOP AND RESTART WHEN APPROPRIATE WITH THE THREE BILLING STATEMENTS PREVIOUSLY NOTED. MAIL RETURNS ARE DOCUMENTED IN THE PATIENT'S ACCOUNTS. AFTER THE COLLECTION CYCLE IS COMPLETED AND NO PAYMENT OR RESPONSE FROM THE PATIENT IS RECEIVED, THE ACCOUNT IS TURNED OVER TO AN OUTSIDE AGENCY AT THE END OF THE MONTH FOLLOWING THE COMPLETION OF THE COLLECTION CYCLE. ALL ACCOUNTS ARE REVIEWED AND SIGNED BY THE CREDIT SUPERVISOR PRIOR TO REFERRAL TO AN OUTSIDE COLLECTION AGENCY. PART V, LINE 18 SEE PARAGRAPH ABOVE EXPLAINING PART V, LINE 9. NEEDS ASSESSMENT THE ORGANIZATION UTILIZES AN INDEPENDENT MARKET RESEARCH COMPANY TO SOLICIT SURVEYS AND COMMENTS FROM ALL PATIENTS OF THE MEDICAL CENTER REGARDING THEIR PATIENT CARE. THE THIRD PARTY ANALYZES AND PROVIDES REPORTS ON THE ORGANIZATION'S PERFORMANCE IN A VARIETY OF AREAS AND PROCEDURES. FURTHER, THE MEDICAL CENTER MONITORS ITS PERFORMANCE ON THE INTERNET WEB SITE REFERRED TO AS HEALTH GRADES, WHICH OFFERS COMPARATIVE DATA TO OTHER HOSPITALS. THE CENTERS FOR MEDICARE AND MEDICAID SERVICES RELEASE "REPORT CARDS" TO THE PUBLIC REGARDING THE MEDICAL CENTER'S PERFORMANCE. THE ORGANIZATION ALSO ACQUIRES DEMOGRAPHIC DATA FOR ITS SURROUNDING COMMUNITIES AND MAKES DETERMINATIONS IF THE NEEDS OF ANY OF THE GROUPS WITHIN THE COMMUNITY ARE BEING SERVED. ALL OF THESE TOOLS ARE UTILIZED BY THE MEDICAL CENTER TO DETERMINE IF THE COMMUNITY IS BEING FULLY SERVED. PATIENT EDUCATION ENGLEWOOD HOSPITAL AND MEDICAL CENTER PROVIDES A FULL RANGE OF MEDICAL SERVICES TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. ALL PATIENTS OR RESPONSIBLE PARTIES ARE INTERVIEWED AT THE TIME OF REGISTRATION, REGARDLESS OF WHAT AREA OF THE MEDICAL CENTER THEY ARE IN. IF THE MEDICAL CONDITION OF THE PATIENT DOES NOT PERMIT AN INTERVIEW, INFORMATION WILL BE TAKEN FROM A FAMILY MEMBER OR AS SOON AS MEDICALLY POSSIBLE, FROM THE PATIENT. ALL PATIENT OR RESPONSIBLE PARTY DEMOGRAPHIC DATA IS COLLECTED AND DOCUMENTED. IDENTIFICATION, SUCH AS A DRIVER'S LICENSE OR A SOCIAL SECURITY CARD WILL BE REQUESTED AND COPIED IF AVAILABLE. IF IDENTIFICATION IS UNAVAILABLE, THE REGISTRATION FORM IS DOCUMENTED ACCORDINGLY. INSURANCE INFORMATION IS REQUESTED AND DOCUMENTED, AND IF AVAILABLE, INSURANCE IDENTIFICATION CARDS ARE COPIED. ALL PATIENTS OR RESPONSIBLE PARTIES ARE GIVEN A NEW JERSEY HOSPITAL CARE PAYMENT ASSISTANCE FACT SHEET. IF HEALTH INSURANCE INFORMATION IS NOT GIVEN AT THE TIME OF REGISTRATION, OR HEALTH INSURANCE INFORMATION IS GIVEN THAT WILL NOT PROVIDE PAYMENT IN FULL, THE MEDICAL CENTER WILL REFER PATIENTS TO PUBLIC ASSISTANCE PROGRAMS IF APPROPRIATE. REFERRAL WILL BE BASED ON INCOME AND ASSETS INFORMATION GIVEN. IF THE PATIENT APPEARS TO BE ELIGIBLE BASED ON THE INFORMATION GIVEN, THE MEDICAL CENTER WILL PROVIDE THAT PATIENT WITH WRITTEN INFORMATION REGARDING THE NAME, ADDRESS AND TELEPHONE NUMBER OF THE APPROPRIATE PUBLIC ASSISTANCE PROGRAM. PATIENTS ARE REFERRED TO PUBLIC ASSISTANCE PROGRAMS BASED ON INCOME THAT MEETS THE POVERTY INCOME GUIDELINES. ALL INCOME AND ASSETS INFORMATION IS DOCUMENTED AND KEPT WITH THE PATIENT'S BILLING FILE. PATIENTS WHO ARE FOUND TO BE ELIGIBLE FOR MEDICAID AND HAVE OUTSTANDING BILLS FROM THE THREE MONTHS PRIOR TO THE APPLICATION FOR MEDICAID, ARE GIVEN A RETROACTIVE MEDICAID APPLICATION FORM (FD74) TO COMPLETE AND MAIL. IF THE PATIENT DOES NOT APPEAR TO BE ELIGIBLE FOR A PUBLIC ASSISTANCE PROGRAM BASED ON INCOME AND ASSETS INFORMATION PROVIDED OR IF THE PUBLIC ASSISTANCE PROGRAM PROVIDES THE PATIENT WITH A WRITTEN DENIAL, THE PATIENT WILL BE SCREENED FOR CHARITY CARE. PERSONS WHO ARE NOT NEW JERSEY RESIDENTS MAY NOT BE SCREENED FOR CHARITY CARE UNLESS THE CARE IS RELATED TO AN EMERGENCY RESULTING IN AN INPATIENT ADMISSION. SIGNS PROVIDED BY THE DEPARTMENT OF HEALTH INDICATING THE AVAILABILITY OF CHARITY CARE IN ENGLISH, SPANISH, AND KOREAN ARE POSTED IN THE FOLLOWING MEDICAL CENTER DEPARTMENTS: ADMITTING, EMERGENCY ROOM, OUTPATIENT REGISTRATION, CLINIC, AND ALL PATIENT ACCOUNTING DEPARTMENTS. ANY PATIENT NOT ELIGIBLE FOR CHARITY CARE UNDER THE STATE OF NEW JERSEY CHARITY CARE GUIDELINES, AND WHO HAS NO OTHER INSURANCE COVERAGE ARE CLASSIFIED AS A "SELF-PAY" PATIENT. SUCH PATIENTS' BILLS WILL BE DISCOUNTED TO BE EQUAL TO 115% OF THE MEDICARE RATE UNDER THE MEDICAL CENTER'S SUPPLEMENTAL CHARITY CARE PROGRAM. COMMUNITY INFORMATION THE MEDICAL CENTER IS LOCATED IN BERGEN COUNTY, NEW JERSEY AND SERVES SEVERAL SURROUNDING COMMUNITIES, INCLUDING A FEW THAT ARE IN NEW YORK STATE AND FOR THE MOST PART IS A SUBURBAN SETTING. COMMUNITY BUILDING ACTIVITIES THE MEDICAL CENTER'S COMMUNITY BUILDING EFFORTS WERE REPORTED IN PART I, LINE 7E. THE MEDICAL CENTER PROVIDES NUMEROUS EDUCATIONAL PROGRAMS FOR THE COMMUNITY WHICH INCLUDES, BUT IS NOT LIMITED TO: ACCELERATED CHILDBIRTH CLASSES, BREASTFEEDING CLASSES, CHILDBIRTH REFRESHER CLASSES, HEALTH FAIRS AT VARIOUS COMMUNITY EVENTS, AND SIBLING PREPARATION CLASSES. THE MEDICAL CENTER PROVIDES NUMEROUS HEALTH SCREENINGS FOR THE COMMUNITY WHICH INCLUDES, BUT IS NOT LIMITED TO: BLOOD DRIVE, HOSPITAL SCREENINGS, SKIN CANCER SCREENING, PROSTATE CANCER SCREENING, AND VEIN SCREENING. ENGLEWOOD HOSPITAL PROVIDES PROGRAMS THAT PROMOTE GOOD HEALTH WHICH INCLUDES, BUT IS NOT LIMITED TO: FLU/COVER YOUR MOUTH EDUCATIONAL HANDOUTS AND POSTERS, HAND HYGIENE PUBLIC SERVICE ANNOUNCEMENT AND POSTERS, PILATES WHICH PROMOTES IMPROVED HEALTH, POSTNATAL YOGA, PRENATAL YOGA, AND WEIGHT WATCHERS AT WORK (FOR EMPLOYEES). THE MEDICAL CENTER REACHES OUT TO NOTIFY THE COMMUNITY ABOUT THE SERVICES IT OFFERS VIA A COMMUNITY NEWSLETTER PUBLISHED QUARTERLY, PUBLIC NOTICE ADVERTISING IN COMMUNITY AND REGIONAL NEWSPAPERS. OTHER INFORMATION THE MEDICAL CENTER FURTHERS ITS EXEMPT PURPOSE IN THE FOLLOWING MANNERS: A) 85% OF THE MEMBERSHIP OF THE BOARD OF TRUSTEES ARE INDEPENDENT INDIVIDUALS MEANING THAT THEY ARE NOT DIRECTLY AFFILIATED WITH THE ORGANIZATION, MOST OF WHOM RESIDE IN THE MEDICAL CENTER'S SERVICE AREA, B) THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS SERVICE AREA, C) EXCESSES OF REVENUE OVER EXPENSES IS REINVESTED IN THE ORGANIZATION, PRINCIPALLY THROUGH CAPITAL INVESTMENT, AND ALSO TO MEET FUTURE PROGRAMMATIC NEEDS, WHICH MEETS THE ORGANIZATION'S COMMITMENT TO MEET THE EXPECTATIONS OF ITS PATIENTS BY PROVIDING QUALITY HEALTH CARE AND THEREFORE, MAKES THESE INVESTMENTS TO SECURE ITS FUTURE OF SERVICE DELIVERY TO THE COMMUNITY. AFFILIATED HEALTH CARE SYSTEM FOLLOWING IS A BRIEF DESCRIPTION OF EACH OF THE AFFILIATES OF THE MEDICAL CENTER: A) ENGLEWOOD HOSPITAL AND MEDICAL CENTER FOUNDATION, A NOT FOR PROFIT 501(C)(3) ORGANIZATION FOUNDED IN 1995, PERFORMS FUND RAISING AND DEVELOPMENT ON BEHALF OF THE SYSTEM AND ITS AFFILIATES; B) ENGLEWOOD HEALTHCARE PROPERTIES, INC, A NOT FOR PROFIT 501(C)(2) COMPANY, WAS FORMED FOR THE PURPOSE OF ACQUIRING REAL ESTATE TO BE USED BY THE MEDICAL CENTER AND AFFILIATES OF THE SYSTEM. IT OWNS PROPERTIES IN BERGEN AND HUDSON COUNTIES IN NEW JERSEY; C) ENGLEWOOD HEALTHCARE ENTERPRISES, INC. IS A FOR PROFIT CORPORATION THAT PROVIDES HEALTHCARE RELATED SERVICES WITHIN THE MEDICAL CENTER'S SERVICE AREA. IT CURRENTLY MAINTAINS A MANAGEMENT SERVICE ORGANIZATION FOR THE PRACTICES OF ENGLEWOOD MEDICAL ASSOCIATES; D) ENGLEWOOD MEDICAL ASSOCIATES, INC. IS A 501(C)(3) NOT FOR PROFIT CORPORATION EMPLOYING FULL-TIME FACULTY PHYSICIANS. IT IS A WHOLLY OWNED SUBSIDIARY OF THE MEDICAL CENTER; E) MEDICAL ASSOCIATES OF ENGLEWOOD, PC IS A 501(C)(3) CORORATION THAT EMPLOYS FULL-TIME FACULTY PHYSICIANS AND ACQUIRES PHYSICIAN PRACTICES IN THE PRIMARY AND SECONDARY MARKETS OF ENGLEWOOD HOSPITAL AND MEDICAL CENTER; F) ENGLEWOOD HEALTHCARE SYSTEM IS A 501(C)(3) NOT FOR PROFIT CORPORATION THAT IS THE PARENT OF ALL OF THE AFFILIATED ORGANIZATIONS AND CORPORATION; G) PHYSICIAN PARTNERS OF ENGLEWOOD, PC IS A 501(C)(3) CORPORATION THAT EMPLOYS FULL-TIME FACULTY PHYSICIANS; AND H) EMERGENCY PHYSICIANS OF ENGLEWOOD, PC IS A 501(C)(3) CORPORATION THAT EMPLOYS FULL-TIME FACULTY EMERGENCY MEDICINE PHYSICIANS. true EDUCATIONAL SCHOLARSHIPS 7 7800 CASH Description of Organization's Procedures for Monitoring the Use of Grants FORM 990, SCHEDULE I SCHOLARSHIPS ARE AWARDED BASED ON ACADEMIC PERFORMANCE AND THE TYPE OF HEALTHCARE RELATED CURRICULUM BEING STUDIED. X X X X false true false false false false false false false DOUGLAS A DUCHAK 511410 169557 179328 0 88168 0 30634 0 19926 0 829466 169557 0 0 WARREN GELLER 375643 0 66865 0 39203 0 24441 0 17271 0 523423 0 0 0 ANTHONY T ORLANDO 304121 77280 50866 0 21951 0 28000 0 5067 0 410005 77280 0 0 MADELYN PEARSON RN 241565 0 29232 0 3201 0 23506 0 6799 0 304303 0 0 0 MICHAEL PIETROWICZ 279557 0 35334 0 8100 0 24118 0 9466 0 356575 0 0 0 RONALD FUSCHILLO 253532 0 39066 0 703 0 0 0 2474 0 295775 0 0 0 PATRICIA G WILSON 238679 0 40345 0 6230 0 24173 0 6269 0 315696 0 0 0 THOMAS GRECO 171763 0 18568 0 51636 0 13043 0 2061 0 257071 0 47759 0 LORI FURNARI 219365 0 10000 0 447 0 0 0 1975 0 231787 0 0 0 Supplemental Compensation Information SCHEDULE J, PART I, LINE 4B LINE 4B: CONTRIBUTIONS TO NONQUALIFIED PLAN (457F): PATRICIA WILSON $1,568 The purpose of the Medical Centers and affiliated companies 457(f) plan is to offer eligible executive employees deferred compensation benefits taxable under Section 457(f) of the Internal Revenue Code to supplement such employees retirement benefits under the employers Section 403(b) retirement plan and the employers Section 457(b) eligible deferred compensation plan; it is an unfunded deferred compensation plan. Eligibility is limited to employees holding certain titles and determined eligible by the Medical Centers Compensation Committee. ENGLEWOOD PATHOLOGISTS PA SEE SCHEDULE L, PART V 592827 SEE SCHEDULE L, PART V false NORTHERN VALLEY ANESTHESIOLOGY SEE SCHEDULE L, PART V 2542897 SEE SCHEDULE L, PART V false PATRICIA DURKIN SEE SCHEDULE L, PART V 67172 SEE SCHEDULE L, PART V false NOAH SHANDER SEE SCHEDULE L, PART V 27028 SEE SCHEDULE L, PART V false HI TOUCH BUSINESS SERVICES SEE SCHEDULE L, PART V 622679 SEE SCHEDULE L, PART V false BUSINESS TRANSACTIONS WITH INTERESTED PERSONS SCHEDULE L, PART IV (1) NAME: ENGLEWOOD PATHOLOGISTS, PA RELATIONSHIP: MIGUEL SANCHEZ, MD, TRUSTEE IS A PRINCIPAL OF ENGLEWOOD PATHOLOGISTS, PA. AMOUNT: $592,827 DESCRIPTION: COMPENSATION PAID TO UNRELATED ENTITY WAS FOR PHYSICIAN SERVICES PROVIDED IN THE HOSPITAL'S LABORATORY. (2) NAME: NORTHERN VALLEY ANESTHESIOLOGY RELATIONSHIP: ARYEH SHANDER, MD, TRUSTEE IS A PRINCIPAL OF NORTHERN VALLEY ANESTHESIOLOGY. AMOUNT: $2,542,897 DESCRIPTION: COMPENSATION PAID TO UNRELATED ENTITY WAS FOR PHYSICIAN SERVICES. (3) NAME: PATRICIA DURKIN RELATIONSHIP: PATRICIA DURKIN IS THE SISTER-IN-LAW OF ANDREW F. DURKIN, TRUSTEE. SHE IS EMPLOYED AS A MAMMOGRAPHY TECHNOLOGIST BY ENGLEWOOD HOSPITAL AND MEDICAL CENTER. AMOUNT: $67,172 DESCRIPTION: EMPLOYMENT (4) NAME: NOAH SHANDER RELATIONSHIP: NOAH SHANDER IS THE SON OF ARYEH SHANDER, MD, TRUSTEE. HE IS EMPLOYED AS A PURCHASING ASSISTANT BY ENGLEWOOD HOSPITAL AND MEDICAL CENTER. AMOUNT: $27,028 DESCRIPTION: EMPLOYMENT (5) NAME: HI TOUCH BUSINESS SERVICES RELATIONSHIP: JAY NADEL, TRUSTEE IS A DIRECTOR OF HITOUCH BUSINESS SERVICES. AMOUNT: $622,679 DESCRIPTION: PAYMENTS TO THE UNRELATED ENTITY WERE FOR OFFICE SUPPLIES. INVESTMENT INCOME FORM 990, PART I, LINE 10 IN 2011, THE MEDICAL CENTER SOLD ITS HOME HEALTH AND HOSPICE AGENCY. IN THIS TRANSACTION, THE MEDICAL CENTER RECOGNIZED A GAIN OF $9.0 MILLION. DESCRIPTION OF RELATIONSHIPS FORM 990, PART VI, LINE 2 BOARD MEMBERS, MR. JAY NADEL AND MR. RICHARD KURTZ HAVE A BUSINESS RELATIONSHIP. DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PART VI, LINE 6 ENGLEWOOD HEALTHCARE SYSTEM IS THE SOLE MEMBER OF ENGLEWOOD HOSPITAL AND MEDICAL CENTER. DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS FORM 990, PART VI, LINE 7A ENGLEWOOD HEALTHCARE SYSTEM, SOLE MEMBER, HAS THE RIGHTS AND POWERS TO: A) VOTE IN THE ELECTION OF TRUSTEES AND TO CAST ONE VOTE FOR EACH TRUSTEE ELECTED; B) ONE VOTE ON ALL OTHER MATTERS TO BE VOTED ON. DESCR CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTS FORM 990, PART VI, LINE 7B ENGLEWOOD HEALTHCARE SYSTEM, SOLE MEMBER, HAS THE RIGHTS AND POWERS TO APPROVE: A) AMENDMENT TO THE ARTICLES OF INCORPORATION OR BYLAWS, B) SALE, LEASE OR EXCHANGE OF SUBSTANTIALLY ALL OF THE PROPERTY OR ASSETS, C) MERGER OR CONSOLIDATION WITH ANY OTHER CORPORATION, D) DISSOLUTION, E) APPROVAL OF THE ANNUAL BUDGET, E) ANY SUBSTANTIAL TRANSFER OF FUNDS BY GRANT, GIFT OR LOAN, F) ANY OTHER MATTER THAT BY LAW REQUIRES THE APPROVAL OF THE MEMBER. DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 FORM 990, PART VI, LINE 11B AT THE OCTOBER MEETING OF ENGLEWOOD HEALTHCARE SYSTEM, THE PARENT COMPANY OF ENGLEWOOD HOSPITAL AND MEDICAL CENTER, FORM 990 WAS REVIEWED WITH ALL MEMBERS; PRESENTATION WAS MADE BY SENIOR MANAGEMENT AS WELL AS BY THE ORGANIZATION'S EXTERNAL AUDIT FIRM/PREPARER OF FORM 990. QUESTIONS AND ANSWERS ENSUED. DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST FORM 990, PART VI, LINE 12C ENGLEWOOD HOSPITAL AND MEDICAL CENTER HAS CONFLICT OF INTEREST POLICIES THAT APPLY TO OFFICERS, DIRECTORS AND TRUSTEES. ENGLEWOOD HOSPITAL AND MEDICAL CENTER'S NOMINATING AND GOVERNANCE COMMITTEE OF ITS BOARD OF TRUSTEES REVIEWS CONFLICT OF INTEREST STATEMENTS. IF ANY MATTER IS BROUGHT TO THE BOARD IN SUCH A WAY AS TO GIVE RISE TO A CONFLICT OF INTEREST, THE AFFECTED TRUSTEE SHALL MAKE KNOWN THE POTENTIAL CONFLICT, WHETHER DISCLOSED BY THE TRUSTEE'S WRITTEN STATEMENT OR NOT, AND AFTER ANSWERING ANY QUESTIONS THAT MIGHT BE ASKED, SHALL WITHDRAW FROM THE MEETING FOR SO LONG AS THE MATTER SHALL CONTINUE UNDER DISCUSSION, AND SHALL BE ALLOWED NO VOTE ON THE MATTER. OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN FORM 990, PART VI, LINES 15A AND 15B ENGLEWOOD HOSPITAL AND MEDICAL CENTER HAS A STANDING EXECUTIVE COMPENSATION COMMITTEE THAT MEETS THREE TO FIVE TIMES PER YEAR TO REVIEW MANAGEMENT'S PERFORMANCE AND APPROVE THEIR COMPENSATION LEVELS. REVIEW CRITERIA INCLUDES, BUT IS NOT LIMITED TO, OPERATING RESULTS, PERSONAL AND INSTITUTIONAL OBJECTIVES, ETC. THE COMMITTEE ALSO ENGAGES AN INDEPENDENT FIRM TO ASSESS COMPETITIVE COMPENSATION WITHIN THE LOCAL AREA COMMENSURATE WITH EXPERIENCE AND RESPONSIBILITY. FINALLY, DATA IS GATHERED FROM SEVERAL SOURCES REFLECTING LOCAL MARKET RATES AND COMPENSATION LEVELS FOR SIMILAR POSITIONS. AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC FORM 990, PART VI, LINE 19 ENGLEWOOD HOSPITAL AND MEDICAL CENTER COMPLIES WITH ALL GOVERNMENT REQUIREMENTS RELATING TO THE DISCLOSURE OF THESE ITEMS. FINANCIAL INFORMATION IS AVAILABLE PUBLICLY VIA THE REQUIRED SUBMISSION OF DATA TO THE INTERNAL REVENUE SERVICE AND THE NEW JERSEY STATE ATTORNEY GENERAL'S OFFICE. REQUESTS FROM THE PUBLIC FOR ADDITIONAL INFORMATION ARE HANDLED ON A CASE-BY-CASE BASIS. OTHER CHANGES IN NET ASSETS OR FUND BALANCES FORM 990, PART XI, LINE 9 CHANGE IN PENSION LIABILITY $2,579,728 CHANGE IN INTEREST OF EHMCF 2,002,568 OTHER CHANGES ( 18) --------- TOTAL $4,582,278 OTHER FEES FOR SERVICE FORM 990, PART IX, LINE 11G Physician fees, community based $ 31,792,058 Physician fees, hospital based 17,381,989 Physician fees, administrative 1,537,710 Nurse practitioner fees 1,796,442 State of NJ adjusted admission fee 1,764,420 Consulting fees 2,550,339 Transcription fees 514,218 All other fees 1,374,195 ---------- TOTAL OTHER FEES FOR SERVICES $58,711,371 ENGLEWOOD HOSPITAL & MEDICAL CTR FDTN 350 ENGLE STREET ENGLEWOOD NJ 07631 223367281 FUNDRAISING NJ 501(C)(3) 7 EHS true ENGLEWOOD HEALTHCARE PROPERTIES INC 350 ENGLE STREET ENGLEWOOD NJ 07631 222943092 PROPERTY ACQ. NJ 501(C)(2) EHS true ENGLEWOOD MEDICAL ASSOCIATES INC 350 ENGLE STREET ENGLEWOOD NJ 07631 223446625 PHYSICIAN SVC NJ 501(C)(3) 11, TYPE I EHMC true ENGLEWOOD HEALTHCARE SYSTEM 350 ENGLE STREET ENGLEWOOD NJ 07631 222749097 HLTH ACTIVITY NJ 501(C)(3) 11, TYPE II NA false MEDICAL ASSOCIATES OF ENGLEWOOD PC 350 ENGLE STREET ENGLEWOOD NJ 07631 452548322 PHYSICIAN SVC NJ 501(C)(3) 11, TYPE I EHMC true PHYSICIAN PARTNERS OF ENGLEWOOD PC 350 ENGLE STREET ENGLEWOOD NJ 07631 455597971 PHYSICIAN SVC NJ 501(C)(3) 11, TYPE I EHMC true EMERGENCY PHYSICIANS OF ENGLEWOOD PC 350 ENGLE STREET ENGLEWOOD NJ 07631 454604076 PHYSICIAN SVC NJ 501(C)(3) 11, TYPE I EHMC true ENGLEWOOD HEALTHCARE ENTERPRISES INC 350 ENGLE STREET ENGLEWOOD NJ 07631 222872393 MEDICAL SERVICES NJ NA C CORP true false false true false false false false false false true false false false false true true true true false ENGLEWOOD HOSP & MED CTR FOUNDATION O 763576 FMV ENGLEWOOD HOSP & MED CTR FOUNDATION Q 1706708 CASH ENGLEWOOD HOSP & MED CTR FOUNDATION C 2675613 CASH ENGLEWOOD HEALTHCARE ENTERPRISES J 100000 FMV ENGLEWOOD HEALTHCARE ENTERPRISES Q 234629 CASH ENGLEWOOD MEDICAL ASSOCIATES Q 1917868 CASH ENGLEWOOD MEDICAL ASSOCIATES R 6457542 CASH ENGLEWOOD HEALTHCARE PROPERTIES J 157331 FMV MEDICAL ASSOCIATES OF ENGLEWOOD PC P 323074 FMV MEDICAL ASSOCIATES OF ENGLEWOOD PC Q 185754 FMV MEDICAL ASSOCIATES OF ENGLEWOOD PC R 14740536 CASH