2013-11-14T16:26:06-06:00 2012-12-31 WithumSmithBrown PC 465 South St Ste 200 Morristown NJ 079606497 990 2012-01-01 222783298 JERSEY CITY MEDICAL CENTER % PAUL GOLDBERG JERS 2015215920 350 Montgomery Street Suite JERSEY CITY NJ 07302 PAUL GOLDBERG 9738989494 2013-11-13 true Scott Mariani 9738989494 2012 2016-02-24 21:20:13Z JOSEPH F SCOTT FACHE 350 Montgomery Street JERSEY CITY NJ 07302 326034315 false X WWW.LIBERTYHEALTH.ORG X 1987 NJ the organization's mission is to offer healthcare services with compassion and dignity. 9 7 2541 200 0 0 16101893 19558615 292321298 304206823 116258 239684 1875256 1944784 310414705 325949906 0 0 0 0 148613755 153842812 0 0 0 168835722 157891608 317449477 311734420 -7034772 14215486 242391015 424794890 262163306 415398415 -19772291 9396475 X THE ORGANIZATION'S MISSION IS TO OFFER HEALTHCARE SERVICES WITH COMPASSION AND DIGNITY. LIBERTY HEALTH PROVIDES PATIENTS, THEIR FAMILIES AND ALL IN NEED, EXCELLENCE IN HOSPITAL AND HEALTHCARE SERVICES AND PROGRAMS TO ENHANCE COMMUNITY HEALTH. TO ACHIEVE THIS MISSION, LIBERTY HEALTH IN COLLABORATION WITH ITS PHYSICIANS, NURSES AND STAFF, WILL: - PROVIDE A FULL RANGE OF CLINICAL SERVICES FOR ALL, REGARDLESS OF RACE, COLOR, CREED, SEX, GENDER, RELIGION, ABILITY TO PAY INCLUDING REGIONAL SPECIALTY AND SUBSPECIALTY CARE. - ESTABLISH APPROPRIATE ACADEMIC AND CLINICAL AFFILIATIONS. - DEVELOP EDUCATIONAL PROGRAMS FOR MEDICAL STUDENTS, PHYSICIANS IN RESIDENCY TRAINING, NURSES, EMT'S-PARAMEDICS AND OTHER HEALTHCARE PROFESSIONALS. - BUILD INNOVATIVE RELATIONSHIP WITH OTHER HOSPITALS AND SYSTEMS. LIBERTY HEALTH WILL BE GUIDED BY BOARD OF TRUSTEES, REPRESENTING A DIVERSITY OF COMMUNITY AND BUSINESS LEADERS, PUBLIC OFFICIALS, AND HEALTHCARE AND OTHER PROFESSIONALS. THROUGH DIFFERENTIATION, COORDINAT false false 32655543 0 37264151 EXPENSES INCURRED (THE ABOVE AMOUNT REFLECTS DIRECT EXPENSES ONLY; IT DOES NOT INCLUDE INDIRECT EXPENSES) IN PROVIDING MEDICALLY NECESSARY CARDIAC SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. THE ORGANIZATION PROVIDED CARDIAC SERVICES TO 2,890 PATIENTS FOR A TOTAL OF 9,936 PATIENT DAYS. PLEASE REFER TO THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT INCLUDED IN SCHEDULE O. 32624841 0 34468729 EXPENSES INCURRED (THE ABOVE AMOUNT REFLECTS DIRECT EXPENSES ONLY; IT DOES NOT INCLUDE INDIRECT EXPENSES) IN PROVIDING MEDICALLY NECESSARY PSYCHIATRIC SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. THE ORGANIZATION PROVIDED PSYCHIATRIC SERVICES TO 18,704 PATIENTS FOR A TOTAL OF 14,625 PATIENT DAYS. PLEASE REFER TO THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT INCLUDED IN SCHEDULE O. 20627663 0 16626420 EXPENSES INCURRED (THE ABOVE AMOUNT REFLECTS DIRECT EXPENSES ONLY; IT DOES NOT INCLUDE INDIRECT EXPENSES) IN PROVIDING MEDICALLY NECESSARY OBSTETRICS SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. THE ORGANIZATION PROVIDED OBSTETRICS SERVICES TO 9,170 PATIENTS FOR A TOTAL OF 7,188 PATIENT DAYS. PLEASE REFER TO THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT INCLUDED IN SCHEDULE O. 177550555 0 215847523 263458602 true true false true false false false false false false true false true false true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true false false false true 245 0 true 2541 true false false false false false false false false false false false false false X 9 7 false false false false true true true true true false false true true true true true true true true false NJ X PAUL GOLDBERG 2015215920 350 MONTGOMERY STREET JERSEY CITY NJ 07302 X HARRY MELENDEZ 1.0 X X 0 0 0 MARVIN GLAZERMAN 1.0 X X 0 0 0 ABEGAIL DOUGLAS JOHNSON EDD 1.0 X 0 0 0 EDGAR MARTINEZ 1.0 X 0 0 0 W NEVINS MCCANN ESQ 1.0 X 0 0 0 JOSEPH A PANEPINTO JR 1.0 X 0 0 0 IGNATIUS SCALIA DMD 55.0 X X 131014 0 17356 JOSEPH F SCOTT FACHE 55.0 X X 0 992691 147904 KABILI TAYARI 1.0 X 0 0 0 KENNETH GARAY MD 55.0 X 0 556897 160844 PAUL GOLDBERG 55.0 X 0 491722 220957 PAUL R MURPHY ESQ 55.0 X 0 312167 122051 RITA V SMITH 55.0 X 308814 0 135610 BRENDA HALL 55.0 X 0 218670 103440 DOUGLAS RATNER MD 55.0 X 337446 0 25422 HENRY C IRVING MD 55.0 X 264188 0 4189 MARY CATAUDELLA 55.0 X 0 253870 67298 KIRAT Y KHARODE 55.0 X 207153 0 9981 BARRY A MALTZMAN MD 55.0 X 162086 0 17337 ANDREW T SUKALA 55.0 X 0 153701 18353 PAUL M ROTUNDA MD 55.0 X 124901 0 11152 RITU CHANDAK MD 55.0 X 300176 0 24684 SUSAN M WALSH MD 55.0 X 0 249772 19001 ROBERT VALENTINE 55.0 X 0 225837 4553 WILLIAM J COOK 55.0 X 156766 0 2139 MICHAEL PEKAREK 55.0 X 0 182221 18962 ZIAD HANHAN MD 55.0 X 449860 0 25392 SRINIVAS GONGIGREDDY MD 55.0 X 301183 0 24301 NIRMALA RAJAKUMAR MD 55.0 X 253428 0 12023 ADRIANA GRIGORIU MD 55.0 X 233838 0 24884 ANTHONY LAMONACA MD 55.0 X 226129 0 24216 3456982 3637548 1242049 247 false true false SHERIDAN ANESTHESIA SERVICES OF NJ 1613 NORTH HARRISON PARKWAY SUITE SUNRISE FL 33323 MEDICAL 4664678 UNIVERSITY RADIOLOGY PC 579 CRANBURY ROAD EAST BRUNSWICK NJ 08816 MEDICAL 1965459 EMERGENCY MEDICAL ASSOCIATES OF NJ 3 CENTURY DRIVE PARSIPPANY NJ 33323 MEDICAL 1828000 FTI HEALTHCARE LLC PO BOX 418005 BOSTON MA 022418005 CONSULTING 1549587 SERVPRO 8372 N US HWY 45 EFFINGHAM IL 62401 BUILDING 1000000 50 X 96642 19461973 19558615 NET PATIENT SERVICE REVENUE 541900 294282634 294282634 OTHER HEALTHCARE RELATED REVENUE 541900 9924189 9924189 304206823 239684 239684 0 0 84409 84409 0 0 0 0 0 0 0 PARKING REVENUE 812930 1000938 1000938 GIFT SHOP REVENUE 722210 422047 422047 CAFETERIA REVENUE 453220 484506 484506 37293 37293 1944784 325949906 304206823 2184468 0 0 0 0 2240414 2016374 224040 0 121862897 120473045 1389852 2784028 2759407 24621 17214605 17013074 201531 9740868 9615889 124979 51495683 6661805 44833878 63017 62209 808 0 0 0 0 8144657 8136602 8055 103614 102764 850 16753142 16349577 403565 0 0 5324305 5272323 51982 567894 536130 31764 0 0 10135627 9572815 562812 0 9209475 9091314 118161 5620882 5548764 72118 MEDICAL SUPPLIES 31309226 31091768 217458 0 PHYSICIAN & RESIDENT FEES 16513909 16511909 2000 CONTRACTED SERVICES 1245424 1240256 5168 LINEN 1235168 1235168 169585 167409 2176 311734420 263458602 48275818 0 X 17523933 35036296 0 0 924613 1864036 19235472 26825912 0 0 0 0 30451679 31502781 1154012 1479890 927752 693337 247477701 96304558 158443131 151173143 0 0 0 0 5784158 165002048 0 0 7946265 11217447 242391015 424794890 28910440 31494353 0 0 4964344 4957371 0 0 0 0 0 0 155144841 299452057 0 0 73143681 79494634 262163306 415398415 X -19772291 9396475 0 0 0 0 -19772291 9396475 242391015 424794890 X 14215486 3889903 11063377 X X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 137455 137455 false false LOBBYING ACTIVITIES SCHEDULE C, PART II-B; LINE 1H THE ORGANIZATION IS AN AFFILIATE IN THE LIBERTY HEALTHCARE SYSTEM, INC. ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. LIBERTY HEALTHCARE SYSTEM, INC. ("LHCS") IS THE PARENT ENTITY OF THE SYSTEM. LHCS PAYS DUES TO THE NEW JERSEY HOSPITAL ASSOCIATION AND VARIOUS OTHER ORGANIZATIONS ON BEHALF OF JERSEY CITY MEDICAL CENTER. A PORTION OF THE DUES PAID TO THIS ORGANIZATION HAS BEEN ALLOCATED TO LOBBYING ACTIVITES PERFORMED ON BEHALF OF THE ORGANIZATION. THIS ALLOCATION AMOUNTED TO $17,455. IN ADDITION, LHCS PAID AN OUTSIDE INDEPENDENT FIRM $120,000 TO PERFORM LOBBYING EFFORTS ON A FEDERAL AND STATE LEVEL ON BEHALF OF ALL AFFILIATES WITHIN THE SYSTEM. 10887143 10887143 181352040 53962941 127389099 5413559 1373629 4039930 48868833 40792953 8075880 938558 157467 781091 151173143 USE 2454083 F LIMITED USE 1467449 F USE 3517158 F USE 157563358 F 165002048 0 ACCRUED PENSION COST 26628062 ESTIMATED MEDICAL MALPRACTICE 6926000 OTHER LIABILITIES 22718410 SETTLEMENTS 21474602 ADVANCES FROM GOVERNMENT AGENC 0 ACCRUED RESTRUCTURING COSTS 1747560 79494634 X TEXT OF FIN 48 AUDITED FINANCIAL STATEMENT FOOTNOTE SCHEDULE D, PART X THE ORGANIZATION IS AN AFFILIATE IN A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). LIBERTY HEALTHCARE SYSTEM, INC. IS THE TAX-EXEMPT PARENT OF THE SYSTEM. AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF JERSEY CITY MEDICAL CENTER AND SUBSIDIARIES FOR THE YEARS ENDED DECEMBER 31, 2012 AND DECEMBER 31, 2011; RESPECTIVELY. THE FOLLOWING IS THE TEXT OF THE FOOTNOTE INCLUDED IN THE JERSEY CITY MEDICAL CENTER AND SUBSIDIARIES YEAR ENDED DECEMBER 31, 2012 CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT REPORTS THE ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX PROVISIONS UNDER FIN 48: THE MEDICAL CENTER ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. MANAGEMENT DETERMINED THAT THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNIZED THRESHOLD IN 2012 AND 2011. true true X true X true X true true true false true true 56815601 51205440 5610161 0.01800 97210652 81377282 15833370 0.05090 154026253 132582722 21443531 0.06890 674008 674008 0.00220 8632655 3148590 5484065 0.01760 2433269 1482347 950922 0.00310 17945 17945 0.00010 11757877 4630937 7126940 0.02300 165784130 137213659 28570471 0.09190 true 15124521 61386479 56153844 5232635 X true true 1 1 JERSEY CITY MEDICAL CENTER

355 GRAND STREET JERSEY CITY NJ 07302

WWW.LIBERTYHEALTH.ORG X X X X X JERSEY CITY MEDICAL CENTER 1 true true 200. true 300. true X X X X X X X true true X X X X X X true false X X X X true X false false 5 JERSEY CITY MEDICAL CENTER

953-961 GARFIELD AVENUE JERSEY CITY NJ 07302

OUTPATIENT CLINICS JERSEY CITY MEDICAL CENTER

9 NUNDA AVENUE JERSEY CITY NJ 07302

RESIDENTIAL PSYCHIATRIC SERVICES JCMC AMBULATORY CARE FACILITY

415 SUMMIT AVENUE JERSEY CITY NJ 07306

AMBULATORY CARE JCMC AMBULATORY CARE FACILITY

377 JERSEY AVENUE JERSEY CITY NJ 07302

AMBULATORY CARE JCMC AMBULATORY CARE FACILITY

395 GRAND STREET JERSEY CITY NJ 07302

AMBULATORY CARE FINANCIAL ASSISTANCE ELIGIBILITY SCHEDULE H, PART I, LINE 3C 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 2012 POVERTY GUIDELINES (DEPARTMENT OF HEALTH AND SENIOR SERVICES). FEDERAL POVERTY GUIDELINES ARE INCLUDED IN THE CRITERIA FOR DETERMINING ELIGIBILITY FOR CHARITY AND DISCOUNTED CARE. COMMUNITY BENEFIT REPORT SCHEDULE H, PART I, LINE 6A THE MEDICAL CENTER HAS PREPARED AN ANNUAL REPORT FOR 2012 REPORTING ON ITS ACCOMPLISHMENTS AND SERVICES PROVIDED. THE REPORT IS AVAILABLE TO THE PUBLIC. SUBSIDIZED HEALTH SERVICES SCHEDULE H, PART I, QUESTION 7G NO COSTS RELATED TO SUBSIDIZED HEALTHCARE SERVICES ARE ATTRIBUTABLE TO ANY PHYSICIAN CLINICS. CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFIT COST SCHEDULE H, PART I, QUESTION 7 THE ORGANIZATION'S COST ACCOUNTING SYSTEM WAS UTILIZED. COMMUNITY BUILDING ACTIVITIES SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES UNDERTAKEN BY JERSEY CITY MEDICAL CENTER ("JCMC") IMPROVE THE MEDICAL AND SOCIOECONOMIC WELL-BEING OF THE COMMUNITIES IN OUR CARE. THIS IS ACCOMPLISHED THROUGH SERVICE ON STATE AND REGIONAL ADVOCACY COMMITTEES AND BOARDS, VOLUNTEERISM WITH LOCAL COMMUNITY-BASED NON-PROFIT ADVOCACY GROUPS, AND PARTICIPATION IN CONFERENCES AND OTHER EDUCATIONAL ACTIVITIES TO PROMOTE UNDERSTANDING OF THE ROOT CAUSES OF HEALTH CONCERNS. JCMC PROVIDES EDUCATIONAL MATERIALS, CONDUCTS COMMUNITY HEALTH FAIRS AND HOLDS HEALTH EDUCATION SEMINARS AND OUTREACH SESSIONS FOR ITS PATIENTS AND FOR COMMUNITY PROVIDERS. PRESENTATIONS ARE PROVIDED BY PHYSICIANS, NURSES AND OTHER HEALTH CARE PROFESSIONALS. WE ALSO PROVIDE TO SCHOOLS, SENIOR CENTERS AND OTHER COMMUNITY ORGANIZATIONS PROGRAMS ABOUT SAFETY AND TRAUMA PREVENTION INCLUDING PROPER USE OF CAR SEATS, BICYCLE SAFETY, AND FALL PREVENTION FOR SENIORS. SEVERAL TIMES A YEAR WORKING WITH LOCAL POLICE DEPARTMENTS WE PROVIDE THIS FREE EDUCATIONAL SERVICE AT LOCAL SHOPPING CENTERS, LIBRARIES AND POLICE DEPARTMENT HEADQUARTERS. THE HOSPITAL HOLDS AN ANNUAL COMMUNITY MEETING AS REQUIRED BY THE NJ DEPARTMENT OF HEALTH WHERE THE COMMUNITY CAN ASK QUESTIONS AND GIVE COMMENTS TO THE HOSPITAL LEADERSHIP AND BOARD OF TRUSTEES. PLEASE REFER TO THE FORM 990, SCHEDULE O, WHICH CONTAINS THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT. BAD DEBT EXPENSE SCHEDULE H, PART III, LINE 4 BAD DEBT EXPENSE WAS DERIVED FROM THE PROVIDERS' BAD DEBT EXPENSE AS REPORTED ON ITS AUDITED FINANCIAL STATEMENT, NET OF ACCOUNTS WRITTEN OFF AT CHARGES. THE ORGANIZATION AND ITS AFFILIATES 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 ORGANIZATION. ACCOUNTS RECEIVABLE, PATIENTS ACCOUNTS RECEIVABLE, PATIENTS ARE REPORTED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THEY ARE DETERMINED TO BE UNCOLLECTIBLE BASED UPON MANAGEMENT'S ASSESSMENT OF INDIVIDUAL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, THE MEDICAL CENTER ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL COLLECTIONS AND PROVISION FOR DOUBTFUL COLLECTIONS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, WHICH INCLUDES PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL, THE MEDICAL CENTER ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL COLLECTIONS AND A PROVISION FOR DOUBTFUL COLLECTIONS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, THE MEDICAL CENTER RECORDS A SIGNIFICANT PROVISION FOR DOUBTFUL COLLECTIONS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE BILLED RATES AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL COLLECTIONS. THE MEDICAL CENTER HAD NOT CHANGED THEIR FINANCIAL ASSISTANCE POLICY IN 2012. THE MEDICAL CENTER DOES NOT MAINTAIN A MATERIAL ALLOWANCE FOR DOUBTFUL COLLECTIONS FROM THIRD-PARTY PAYORS, NOR DID IT HAVE SIGNIFICANT WRITE-OFFS FROM THIRD-PARTY PAYORS. CHARITY CARE THE MEDICAL CENTER PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE THE MEDICAL CENTER DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUES. MEDICARE SHORTFALL SCHEDULE H, PART III, LINE 8 MEDICARE COSTS WERE DERIVED FROM THE 2012 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 FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT ARE COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. AS OUTLINED MORE FULLY BELOW THE ORGANIZATION BELIEVES THAT THESE SERVICES AND RELATED COSTS PROMOTE THE HEALTH OF THE COMMUNITY AS A WHOLE AND ARE RENDERED IN CONJUNCTION WITH THE ORGANIZATION'S CHARITABLE TAX-EXEMPT PURPOSES AND MISSION IN PROVIDING MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUAL'S 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. MEDICARE UNDERPAYMENTS AND BAD DEBT ARE COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THE AMERICAN HOSPITAL ASSOCIATION ("AHA") FEELS 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; DEBT COLLECTION POLICY SCHEDULE H, PART III, LINE 9B ACCOUNTS CONSIDERED TO BE CHARITY CARE ARE NOT INCLUDED IN THE BAD DEBT EXPENSE, BUT RATHER, ACCOUNTED FOR AS AN ALLOWANCE. IT IS THE POLICY OF THE LIBERTY HEALTHCARE SYSTEM BUSINESS OFFICE AND ITS HOSPITAL AFFILIATES TO TREAT ALL PATIENTS EQUALLY REGARDLESS OF INSURANCE AND THEIR ABILITY TO PAY. FOR ALL ACCOUNTS DETERMINED TO BE "SELF-PAY" AND/OR ACCOUNTS WITH BALANCE AFTER PRIMARY INSURANCE PAYMENTS, THE COLLECTION POLICY REQUIRES: SENDING A MINIMUM OF THREE STATEMENTS WHICH INCLUDES A PRE-COLLECTION LETTER. WE HAVE CHARITY CARE AND HILL BURTON ACCESS POLICIES TO ASSURE PATIENTS ARE PROVIDED WITH CHARITY CARE ASSISTANCE DETERMINED BY STATE AND FEDERAL REGULATIONS. IT IS OUR 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. AT THE TIME OF THE PATIENT'S VISIT AND AS PART OF THE REGISTRATION PROCESS, THE FOLLOWING OPTIONS ARE MADE AVAILABLE TO PATIENTS: - FINANCIAL COUNSELING FOR POSSIBLE ELIGIBILITY FOR MEDICAL ASSISTANCE, INCLUDING MEDICAID AND SSI. - FINANCIAL COUNSELING TO EVALUATE ELIGIBILITY FOR A REDUCED PAYMENT RATE WHEN COVERAGE IS NOT AVAILABLE UNDER CHARITY CARE, MEDICAID, OR NEW JERSEY'S HOPSITAL CARE PAYMENT ASSISTANCE PROGRAMS (LIBERTY'S COMPASSIONATE CARE PROGRAM). - OTHER FINANCIAL ARRANGEMENTS WE OFFER INCLUDING: 1. CASH/CREDIT CARD (AMERICAN EXPRESS, DISCOVER, VISA, MASTERCARD), 2. FLEXIBLE PAYMENT PLANS. FACILITY POLICIES AND PRACTICES SCHEDULE H, PART V;SECTION B,QUESTIONS 10,11,12H,14G,16E,17E,18E,19D,21&22 NOT APPLICABLE. FACILITY POLICIES AND PRACTICES SCHEDULE H, PART V; SECTION B, QUESTION 20d THE ORGANIZATION DETERMINED THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE USING A RATE LOWER THAN ITS LOWEST COMMERCIAL RATE. NEEDS ASSESSMENT SCHEDULE H, PART VI; QUESTION 2 LIBERTY ENGAGES A PLANNING CONSULTANT TO ASSIST US IN MONITORING UTILIZATION IN OUR SERVICE AREA SO WE CAN IDENTIFY TRENDS IN COMMUNITY HEALTH NEEDS. THE DATA WE GATHER IS SHARED WITH OUR PHYSICIAN LEADERSHIP AND OTHER COMMUNITY LEADERS TO CORROBORATE THE DATA WE GATHER AND TO RECEIVE FEEDBACK ON OTHER HEALTH ISSUES OF CONCERN. THESE ACTIVITIES CONTRIBUTE TO THE DEVELOPMENT OF A STRATEGIC PLAN FOR THE MEDICAL CENTER THAT WE FOLLOW TO EXPAND EXISTING SERVICES OR DEVELOP NEW SERVICES FOR OUR COMMUNITY. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SCHEDULE H, PART VI; QUESTION 3 CHARITY CARE SIGNS ARE POSTED THROUGHOUT THE FACILITY, MAINLY IN PATIENT REGISTRATION AREAS. SIGNS ARE POSTED IN BOTH ENGLISH AND SPANISH. ALL PATIENTS DEEMED SELF-PAY ARE SCREENED FOR FINANCIAL ASSISTANCE BY A RESOURCE ADVISOR ACCORDING TO THE FEDERAL POVERTY GUIDELINES AND REFERRED TO APPROPRIATE AGENCIES OR PROGRAMS. COMMUNITY INFORMATION SCHEDULE H, PART VI; QUESTION 4 JCMC IS LOCATED IN JERSEY CITY, NEW JERSEY AND SERVES THE GREATER HUDSON COUNTY COMMUNITY HUDSON COUNTY IS A DIVERSE SUBURBAN COMMUNITY AND ONE OF THE MOST POPULOUS COMMUNITIES IN NEW JERSEY. 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 GOVERNORS; 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. AFFILIATED HEALTHCARE SYSTEM SCHEDULE H, PART VI; QUESTION 6 NOT FOR-PROFIT AFFILIATES: LIBERTY HEALTHCARE SYSTEM, INC. LIBERTY HEALTHCARE SYSTEM, INC. IS THE TAX-EXEMPT PARENT OF THE LIBERTY HEALTH CARE SYSTEM ("LHCS"). THIS INTEGRATED HEALTHCARE DELIVERY SYSTEM CONSISTS OF A GROUP OF AFFILIATED HEALTHCARE ORGANIZATIONS. LIBERTY HEALTHCARE SYSTEM, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A SUPPORTING ORGANIZATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). LIBERTY BEHAVIORAL HEALTH ASSOCIATES LIBERTY BEHAVIORAL HEALTH ASSOCIATES 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)(3). THE ORGANIZATION WAS ESTABLISHED TO PROVIDE MEDICALLY NECESSARY PROFESSIONAL HEALTH SERVICES TO THE MEDICALLY UNDERSERVED COMMUNITIES OF HUDSON COUNTY, NEW JERSEY. PATIENTS ARE SEEN REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY FOR THE PROFESSIONAL SERVICES RENDERED. LIBERTY CHILD HEALTH SERVICES LIBERTY CHILD HEALTH SERVICES 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)(3). THE ORGANIZATION WAS ESTABLISHED TO PROVIDE MEDICALLY NECESSARY HEALTH SERVICES TO THE MEDICALLY UNDERSERVED COMMUNITIES OF HUDSON COUNTY, NEW JERSEY, IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. THE ORGANIZATION CEASED OPERATIONS DURING 2009 AND IS IN THE PROCESS OF FINALIZING ALL OUTSTANDING TRANSACTIONS. LIBERTY HEALTHCARE SYSTEM FOUNDATION LIBERTY HEALTHCARE 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)(2). THE ORGANIZATION SOLICITS AND MAINTAINS GIFTS, GRANTS AND OTHER CONTRIBUTIONS FOR THE PROMOTION OF HEALTH AND OVERALL WELLNESS IN THE HUDSON COUNTY, NEW JERSEY COMMUNITY SERVED BY THE LIBERTY HEALTHCARE SYSTEM. LIBERTY SURGICAL ASSOCIATES LIBERTY SURGICAL ASSOCIATES 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)(3). THE ORGANIZATION PROVIDES MEDICALLY NECESSARY PROFESSIONAL HEALTH SERVICES TO THE MEDICALLY UNDERSERVED COMMUNITIES OF HUDSON COUNTY, NEW JERSEY SERVED BY ITS NOT FOR-PROFIT AFFILIATE, JERSEY CITY MEDICAL CENTER. PATIENTS ARE SEEN REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY FOR THE PROFESSIONAL SERVICES RENDERED. NEW MARGARET HAGUE CENTER WOMENS JERSEY MEDICAL CENTER OB/GYN NEW MARGARET HAGUE CENTER WOMEN'S JERSEY MEDICAL CENTER OB/GYN 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)(3). THE ORGANIZATION PROVIDES MEDICALLY NECESSARY PROFESSIONAL OBSTETRICAL AND GYNECOLOGICAL HEALTH SERVICES TO THE MEDICALLY UNDERSERVED COMMUNITIES OF HUDSON COUNTY, NEW JERSEY. PATIENTS ARE SEEN REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY FOR THE PROFESSIONAL SERVICES RENDERED. FOR-PROFIT AFFILIATES: LIBERTY HEALTHCARE MANAGEMENT, LLC A LIMITED LIABILITY COMPANY TAXED AS A PARTNERSHIP LOCATED IN SECAUCUS, HUDSON COUNTY, NEW JERSEY WHICH PROVIDES MANAGEMENT SERVICES. LIBERTY HEALTHCARE SYSTEM, INC. AND LIBERTY HEALTHCARE CAPITAL, INC. ARE THE PARTNERS IN THIS PARTNERSHIP WITH 99% AND 1% OWNERSHIP INTERESTS, RESPECTIVELY. LIBERTY HEALTHCARE CAPITAL A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS LHCS. THE ORGANIZATION IS LOCATED IN SECAUCUS, HUDSON COUNTY, NEW JERSEY. THIS ENTITY PROVIDES LEASING AND FINANCING SUPPORT TO LIBERTY HEALTHCARE SYSTEM. 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 STATEMENT WITH THE STATE OF NEW JERSEY. FACILITY REPORTING GROUP(S) SCHEDULE H, PART VI; QUESTION 8 NOT APPLICABLE. X X X X X false true false false false false false true false JOSEPH F SCOTT FACHE 0 724222 0 75000 0 193469 0 122225 0 25679 0 1140595 0 172278 KENNETH GARAY MD 0 551801 0 0 0 5096 0 139339 0 21505 0 717741 0 0 PAUL GOLDBERG 0 460299 0 25000 0 6423 0 208325 0 12632 0 712679 0 0 PAUL R MURPHY ESQ 0 307852 0 0 0 4315 0 118437 0 3614 0 434218 0 0 RITA V SMITH 294806 0 0 0 14008 0 113805 0 21805 0 444424 0 0 0 BRENDA HALL 0 215740 0 0 0 2930 0 85136 0 18304 0 322110 0 0 DOUGLAS RATNER MD 332535 0 0 0 4911 0 1225 0 24197 0 362868 0 0 0 HENRY C IRVING MD 258914 0 0 0 5274 0 1225 0 2964 0 268377 0 0 0 MARY CATAUDELLA 0 252595 0 0 0 1275 0 49878 0 17420 0 321168 0 0 KIRAT Y KHARODE 206817 0 0 0 336 0 444 0 9537 0 217134 0 0 0 BARRY A MALTZMAN MD 159830 0 0 0 2256 0 811 0 16526 0 179423 0 0 0 ANDREW T SUKALA 0 150001 0 0 0 3700 0 758 0 17595 0 172054 0 0 RITU CHANDAK MD 299622 0 0 0 554 0 1225 0 23459 0 324860 0 0 0 SUSAN M WALSH MD 0 247708 0 0 0 2064 0 1225 0 17776 0 268773 0 0 ROBERT VALENTINE 0 215823 0 9000 0 1014 0 1126 0 3427 0 230390 0 0 WILLIAM J COOK 155476 0 0 0 1290 0 780 0 1359 0 158905 0 0 0 MICHAEL PEKAREK 0 173283 0 4500 0 4438 0 906 0 18056 0 201183 0 0 ZIAD HANHAN MD 389893 0 59085 0 882 0 1225 0 24167 0 475252 0 0 0 SRINIVAS GONGIGREDDY MD 281183 0 20000 0 0 0 1225 0 23076 0 325484 0 0 NIRMALA RAJAKUMAR MD 250814 0 0 0 2614 0 1225 0 10798 0 265451 0 0 0 ADRIANA GRIGORIU MD 231746 0 0 0 2092 0 1183 0 23701 0 258722 0 0 0 ANTHONY LAMONACA MD 225135 0 0 0 994 0 1140 0 23076 0 250345 0 0 0 COMPENSATION INFORMATION SCHEDULE J, PART I; QUESTION 4B THE AMOUNT REFLECTED IN COLUMN B(III) FOR JOSEPH F SCOTT, FACHE $193,469; INCLUDES CURRENT YEAR VESTING AND DISTRIBUTIONS IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) IN THE AMOUNT OF $172,278 AS THE AMOUNT WAS NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. CERTAIN OF THIS AMOUNT WAS REPORTED AS EMPLOYEE BENEFIT PLAN CONTRIBUTIONS OF THE ORGANIZATION'S PRIOR YEARS' FORM 990. THE AMOUNT WAS INCLUDED IN HIS 2012 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. THE DEFERRED COMPENSATION AMOUNTS IN COLUMN C FOR THE FOLLOWING INDIVIDUALS INCLUDE 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 AMOUNT OUTLINED HEREIN WAS NOT INCLUDED IN THE INDIVIDUALS' 2012 FORM W-2, AS TAXABLE WAGES: JOSEPH F. SCOTT, FACHE, $121,000; KENNETH GARAY, MD, $139,339; PAUL GOLDBERG, $208,325; PAUL R. MURPHY, ESQ, $117,212; RITA V. SMITH, $112,580; BRENDA HALL, $84,049; MARY CATAUDELLA, $48,653. ALL OF THESE INDIVIDUALS (WITH THE EXCEPTION OF MR. SCOTT) WERE CREDITED WITH PRIOR YEARS OF SERVICE BEFORE THE IMPLEMENTATION OF THE DEFERRED COMPENSATION PLAN. MS. CATAUDELLA'S ACCRUAL REFLECTS THREE YEARS OF CREDITED SERVICE. DR. GARAY, MR. GOLDBERG, MR. MURPHY, MS. SMITH, AND MS. HALL WERE CREDITED WITH FOUR YEARS OF SERVICE. COMPENSATION INFORMATION SCHEDULE J, PART I; QUESTION 7 CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A BONUS DURING CALENDAR YEAR 2012 WHICH AMOUNTS WERE INCLUDED IN COLUMN B(II) HEREIN AND IN EACH INDIVIDUAL'S 2012 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT. COMPENSATION INFORMATION SCHEDULE J, PART II, COLUMN F THE AMOUNT REPORTED IN SCHEDULE J, PART II, COLUMN F FOR THE FOLLOWING INDIVIDUAL INCLUDES VESTED BENEFITS IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) BECAUSE THE AMOUNT WAS NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THIS AMOUNT WAS REPORTED ON PRIOR YEAR FORMS 990, SCHEDULE J, PART II, COLUMN C, RETIREMENT AND OTHER DEFERRED COMPENSATION FOR MR. SCOTT. THIS AMOUNT WAS TREATED AS TAXABLE INCOME AND REPORTED ON THE INDIVIDUAL'S 2011 FORM W-2, BOX 5 AS TAXABLE MEDICARE WAGES: JOSEPH F. SCOTT, FACHE, $172,278. COMMUNITY BENEFIT STATEMENT CORE FORM, PART III LIBERTY HEALTHCARE SYSTEM, INC. ("LIBERTY") IS A NOT FOR-PROFIT HOLDING COMPANY BASED IN HUDSON COUNTY, NEW JERSEY. LIBERTY IS THE SOLE CORPORATE MEMBER OF A NUMBER OF NOT FOR-PROFIT ENTITIES AND THE SOLE SHAREHOLDER OF VARIOUS OTHER FOR-PROFIT ENTITIES. THE INTERNAL REVENUE SERVICE ("IRS") HAS RECOGNIZED LIBERTY AS A TAX-EXEMPT ORGANIZATION UNDER INTERNAL REVENUE CODE ("IRC") SECTION 501(C)(3). LIBERTY'S MISSION IS ENHANCING LIFE. THESE TWO WORDS ARE OUR COMMITMENT TO PROVIDE PATIENTS, THEIR FAMILIES AND ALL IN NEED, EXCELLENCE IN HOSPITAL AND HEALTHCARE SERVICES AND PROGRAMS TO ENHANCE COMMUNITY HEALTH. TO ACHIEVE THIS MISSION, LIBERTY, IN COLLABORATION WITH ITS PHYSICIANS, NURSES AND STAFF, WILL: - PROVIDE A FULL RANGE OF CLINICAL SERVICES FOR ALL, REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY INCLUDING REGIONAL SPECIALTY AND SUBSPECIALTY CARE. - ESTABLISH APPROPRIATE ACADEMIC AND CLINICAL AFFILIATIONS. - DEVELOP EDUCATIONAL PROGRAMS FOR MEDICAL STUDENTS, PHYSICIANS IN RESIDENCY TRAINING, NURSES, EMT'S-PARAMEDICS AND OTHER HEALTHCARE PROFESSIONALS. - BUILD INNOVATIVE RELATIONSHIPS WITH OTHER HOSPITALS, FQHC'S AND OTHER PROVIDERS. - LIBERTY WILL BE GUIDED BY VOLUNTEER BOARDS OF TRUSTEES, REPRESENTING A DIVERSITY OF COMMUNITY AND BUSINESS LEADERS, PUBLIC OFFICIALS, AND HEALTHCARE AND OTHER PROFESSIONALS. LIBERTY PROVIDES THE REGION WITH A WIDE RANGE OF HEALTH SERVICES, FROM HIGH TECHNOLOGY INFANT AND ADULT CARE AND THE HIGHEST LEVEL OF TRAUMA CARE. LIBERTY HEALTHCARE SYSTEM AFFILIATES INCLUDE THE JERSEY CITY MEDICAL CENTER: THE JERSEY CITY MEDICAL CENTER ("JCMC") IS A REGIONAL REFERRAL TEACHING HOSPITAL AND A MAJOR TEACHING AFFILIATE OF THE MOUNT SINAI SCHOOL OF MEDICINE. THE HOSPITAL ALSO OPERATES THE CRISTIE KERR WOMEN'S HEALTH CARE. THE INTERNAL REVENUE SERVICE ("IRS") HAS RECOGNIZED LIBERTY AND JERSEY CITY MEDICAL CENTER AS TAX-EXEMPT ORGANIZATIONS UNDER IRC SECTION 501(C)(3). PURSUANT TO ITS CHARITABLE PURPOSES, JCMC 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, JCMC OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545: 1. MEDICALLY NECESSARY HEALTHCARE SERVICES ARE PROVIDED TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF PAY, MEDICARE, AND MEDICAID PATIENTS; 2. EMERGENCY ROOMS ARE OPEN 24 HOURS A DAY SEVEN DAYS A WEEK, 365 DAYS A YEAR; 3. OPEN MEDICAL STAFFS ARE MAINTAINED, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; 4. CONTROL OF JCMC RESTS WITH ITS BOARD OF TRUSTEES AND THE BOARD OF TRUSTEES OF LIBERTY HEALTH. THE BOARD 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. JCMC TREATS ALL ADULTS AND CHILDREN REGARDLESS OF AGE AND OF THEIR ABILITY TO PAY FOR SERVICES RENDERED. LIBERTY IS ONE OF THE LARGEST PROVIDERS OF CHARITY CARE SERVICES IN THE STATE OF NEW JERSEY. JCMC IS AN AFFILIATE OF LIBERTY. LIBERTY IS A NOT FOR-PROFIT HOLDING COMPANY BASED IN HUDSON COUNTY, NEW JERSEY. THE IRS HAS RECOGNIZED LIBERTY AS A TAX-EXEMPT ORGANIZATION UNDER IRC SECTION 501(C)(3). LIBERTY'S MISSION IS ENHANCING LIFE. LIBERTY PROVIDES PATIENTS, THEIR FAMILIES, AND ALL IN NEED EXCELLENCE IN HOSPITAL AND HEALTHCARE SERVICES THAT ENHANCE COMMUNITY HEALTH. TO ACHIEVE THIS MISSION, LIBERTY COLLABORATES WITH ITS PHYSICIANS, NURSES AND STAFF TO: - PROVIDE A FULL RANGE OF CLINICAL SERVICES FOR ALL REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION, OR ABILITY TO PAY. OUR CLINICAL SERVICES INCLUDE REGIONAL SPECIALTY AND SUBSPECIALTY CARE. - ESTABLISH APPROPRIATE ACADEMIC AND CLINICAL AFFILIATIONS. - DEVELOP EDUCATIONAL PROGRAMS FOR MEDICAL STUDENTS, PHYSICIANS IN RESIDENCY TRAINING, NURSES, EMT'S-PARAMEDICS AND OTHER HEALTHCARE PROFESSIONALS. - BUILD INNOVATIVE RELATIONSHIPS WITH OTHER HOSPITALS AND SYSTEMS. - LIBERTY IS GUIDED BY BOARDS OF TRUSTEES, REPRESENTING A DIVERSITY OF COMMUNITY AND BUSINESS LEADERS, PUBLIC OFFICIALS, AND HEALTHCARE AND OTHER PROFESSIONALS. JERSEY CITY MEDICAL CENTER - CARE CENTERS ========================================== THE CRISTIE KERR WOMEN'S HEALTH CENTER -------------------------------------- OUR NEW CRISTIE KERR WOMEN'S HEALTH CENTER OPENED IN 2010 OFFERING IMAGING AND OTHER DIAGNOSTIC SERVICES TO WOMEN IN OUR COMMUNITY. THE CENTER OFFERS BREAST CANCER SCREENING PROGRAMS INCLUDING MAMMOGRAMS AND EDUCATION TO WOMEN IN THE COMMUNITY REGARDLESS OF ABILITY TO PAY. THE CENTER IS THE FIRST FULL-SERVICE FACILITY IN HUDSON COUNTY TO PROVIDE DETECTION, HEALING, SUPPORT, AND RECOVERY SERVICES. THE EPILEPSY CENTER AT JERSEY CITY MEDICAL CENTER ------------------------------------------------- THE EPILEPSY CENTER AT JERSEY CITY MEDICAL CENTER OPENED IN 2010 AND PROVIDES DIAGNOSTIC, EVALUATION, AND TREATMENT PLANS ON AN INPATIENT AND OUTPATIENT BASIS. FANNIE E. RIPPEL FOUNDATION HEART INSTITUTE (THE "INSTITUTE") ------------------------------------------------------------- THE INSTITUTE FEATURES STATE-OF-THE-ART DIAGNOSTIC TECHNOLOGY TO PROVIDE EXEMPLARY OUTPATIENT CARDIAC CARE. THE INSTITUTE PROVIDES TWO HIGH-RISK CARDIAC CATHETERIZATION LABORATORIES, A SINGLE PLANE AND A THREE-DIMENSIONAL BI-PLANE ALONG WITH OTHER CRITICALLY IMPORTANT DIAGNOSTIC TECHNOLOGY. THE MEDICAL CENTER IS THE REGION'S "HIGH-RISK" DESTINATION FOR PATIENTS. IN 2011 WE ADDED ELECTROPHYSIOLOGY PROCEDURES IN THE CATH LAB. JCMC IS HUDSON COUNTY'S ONLY FULL-SERVICE HEART HOSPITAL. CARDIAC SERVICES PROVIDED INCLUDE: - ANGIOPLASTY - DIAGNOSTIC CARDIAC CATHETERIZATION - INTRAVASCULAR ULTRASOUND - PACEMAKER & IMPLANTABLE CARDIOVERTER DEFIBRILLATOR THERAPY - MINIMALLY INVASIVE VEIN HARVESTING AND CARDIAC ARTERY BYPASS GRAFT - THORACIC AND ABDOMINAL AORTIC ANEURYSM REPAIR - MITRAL AND AORTIC VALVE REPAIR AND REPLACEMENT - PERIPHERAL VASCULAR PROCEDURES, INCLUDING ENDO VASCULAR PROCEDURES COMMUNITY BENEFIT STATEMENT CONTINUED CORE FORM, PART III PORT AUTHORITY HEROES OF SEPTEMBER 11 TRAUMA CENTER --------------------------------------------------- THIS REGIONAL TRAUMA CENTER IS THE STATE-DESIGNATED LEVEL II TRAUMA CENTER FOR HUDSON COUNTY. IN ADDITION TO SERVING THE GROWING COMMUNITIES OF JERSEY CITY, THE SERVICE COVERS HUDSON COUNTY NEW JERSEY WATERWAYS, NEW JERSEY TURNPIKE, THE HOLLAND AND LINCOLN TUNNELS, AND LIBERTY STATE PARK. THE TRAUMA CENTER PROVIDES 24 HOUR TRAUMA SURGERIES FOR ADULTS AND CHILDREN. THE CENTER HAS BEEN ACTIVE IN ALL REGIONAL DISASTERS INCLUDING THE 1993 AND 2001 WORLD TRADE CENTER BOMBINGS; SEVERAL TRAIN DERAILMENTS, AND VARIOUS HAZMAT INCIDENTS. OUTPATIENT SERVICES ------------------- JCMC OPERATES AN AMBULATORY CARE CENTER ADJACENT TO THE HOSPITAL AS WELL AS TWO SATELLITE CLINICS TO ENSURE ACCESS TO THOSE MOST IN NEED. OUR OUTPATIENT SERVICE OFFERINGS INCLUDE OBSTETRICS AND GYNECOLOGY, OPHTHALMOLOGY, DENTAL, PHYSICAL AND SPEECH THERAPY, AND AUDIOLOGY. WE PROVIDE NEEDED OUTPATIENT SERVICES TO SPECIAL NEEDS POPULATIONS IN OUR COMMUNITY, INCLUDING THE HOMELESS AND ADULTS AND CHILDREN NEEDING BEHAVIORAL HEALTH SERVICES, HIV/AIDS PATIENTS, AND THOSE IN NEED OF DIALYSIS. JCMC IS THE REGIONAL PSYCHIATRIC REFERRAL CENTER PROVIDING CRISIS INTERVENTION AND EVALUATION, VOLUNTARY AND INVOLUNTARY IN-PATIENT SERVICES, COMMUNITY PSYCHIATRIC OUTREACH SERVICES AND A FULL SPECTRUM OF OUTPATIENT PSYCHIATRIC AND ADDICTION SERVICES. VOLUNTEER SERVICES ------------------ JCMC HAS AN ACTIVE AND DIVERSE VOLUNTEER PROGRAM PROVIDING COMPANIONSHIP AND SUPPORT TO PATIENTS OF ALL AGES HOSPITALIZED ON OUR NURSING FLOORS, THE EMERGENCY DEPARTMENT, AND OTHER PATIENT AREAS. THE JCMC VOLUNTEERS ADVOCATE FOR PATIENT FAMILIES AND PROVIDE THEM WITH INFORMATION AND SUPPORT. THEY ALSO PROVIDE CLERICAL AND OTHER SUPPORT TO OUR STAFF. OVERALL, JCMC ADMITTED OVER 17,400 PATIENTS PROVIDING APPROXIMATELY 83,000 DAYS OF INPATIENT CARE. THE EMERGENCY DEPARTMENT DELIVERED EMERGENCY MEDICAL CARE TO OVER 87,800 INDIVIDUALS AND OUR OUTPATIENT PROGRAMS SERVICED OVER 169,000 VISITS. COMMUNITY --------- JCMC IS ACTIVELY ENGAGED IN COMMUNITY EDUCATION INCLUDING OUTREACH TO SCHOOLS, CHURCHES AND COMMUNITY GROUPS ADDRESSING TARGETED, APPROPRIATE EDUCATION NEEDS. HEALTH FAIRS ARE HELD ANNUALLY IN CONJUNCTION WITH BUSINESSES AND COMMUNITY GROUPS TO PROVIDE A WIDE RANGE OF SCREENING AND EDUCATION. A DINNER WITH THE DOCTOR PROGRAM WAS IMPLEMENTED IN 2009 AND OVER THE PAST FOUR YEARS PHYSICIANS ADDRESS THE COMMUNITY ON VARIOUS HEALTH ISSUES AND THE PREVENTION OF DISEASE. WE ALSO PROVIDE RECURRING SAFETY PROGRAMS IN OUR COMMUNITY SCHOOLS TO EDUCATE CHILDREN ON WELLNESS, TRAUMA PREVENTION AND BICYCLE SAFETY. WE ALSO VISIT SENIOR CENTERS TO EDUCATE SENIORS ON FALL PREVENTION, AND OUR EMS SERVICE PROVIDES MEDICAL CARE AT COMMUNITY EVENTS DURING THE YEAR. AWARDS AND DESIGNATIONS ======================= JCMC HAS BEEN RECOGNIZED FOR EXCELLENCE IN PROVIDING CARE AND SUPPORTING THE HEALTH AND WELLNESS OF OUR COMMUNITY. THE FOLLOWING IS A LISTING OF AWARDS AND DESIGNATIONS RECENTLY AFFORDED THE JERSEY CITY MEDICAL CENTER IN RECOGNITION OF ITS SERVICE: - DNV FULLY ACCREDITED HOSPITAL - 3 CONSECUTIVE "A" RATINGS IN HOSPITAL SAFETY FROM THE INDEPENDENT LEAPFROG GROUP - US NEWS & WORLD REPORT- BEST REGIONAL HOSPITAL LISTING (HIGH PERFORMANCE IN NEPHROLOGY 2012-2013) - MAGNET RECOGNITION FOR EXCELLENCE IN PATIENT CARE BY THE AMERICAN NURSES CREDENTIALING CENTER - RECOGNIZED BY THE AMERICAN COLLEGE OF SURGEONS FOR "EXCELLENCE IN TRAUMA" 2013 - STATE DESIGNATED REGIONAL TRAUMA CENTER - FIRST EMS SERVICE IN US TO EARN TRIPLE ACCREDITATION IN DISPATCH, EDUCATION AND EMERGENCY MEDICAL SERVICE - CEO CANCER ROUNDTABLE - GOLD STANDARD - GOLD PLUS ACHIEVEMENT AWARD IN STROKE QUALITY CARE FROM THE AMERICAN HEART AND STROKE ASSOCIATION 2012 & 2013 - STATE DESIGNATED REGIONAL HEART CENTER - 100 BEST PLACES TO WORK IN HEALTHCARE, RANKED NATIONALLY BY MODERN HEALTHCARE MAGAZINE 2011 - 100 BEST PLACES TO WORK IN THE HEALTHCARE FIELD BY BECKER'S HOSPITAL REVIEW 2012-2013 - CASTLE CONNOLLY "TOP HOSPITAL IN NJ" UNDER 350 BEDS (2010 AND 2011 - 2 CONSECUTIVE YEARS) - CHF BRONZE AWARD FROM AMERICAN HEART AND STROKE ASSOCIATION - AMERICAN HEART ASSOCIATION NAMED JCMC A "GOLD FIT-FRIENDLY" COMPANY IN 2013 - STATE DESIGNATED REGIONAL NEONATAL INTENSIVE CARE CENTER FOR DIAGNOSIS AND TREATMENT OF MOST CRITICALLY ILL NEWBORNS - CRISTIE KERR WOMEN'S HEALTH CENTER IS LOCATED IN OUR MEDICAL OFFICE BUILDING ON OUR CAMPUS - PRIMARY STROKE CENTER APPROVED BY THE NJ DEPARTMENT OF HEALTH AND HUMAN SERVICES STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS 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 IV, SECTION A; QUESTIONS 6 & 7 LIBERTY HEALTHCARE SYSTEM, INC. ("LHCS") IS THE SOLE MEMBER OF THIS ORGANIZATION. LHCS HAS THE RIGHT TO ELECT THE MEMBERS OF THIS ORGANIZATION'S BOARD OF TRUSTEES AND HAS CERTAIN RESERVED POWERS AS DEFINED IN THIS ORGANIZATION'S BYLAWS. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION b; QUESTION 11B THE ORGANIZATION IS AN AFFILIATE WITHIN LIBERTY HEALTHCARE SYSTEM, INC. AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. LIBERTY HEALTHCARE SYSTEM, INC. ("SYSTEM") IS THE PARENT OF THE SYSTEM. THE ORGANIZATION'S FEDERAL FORM 990 WAS MADE AVAILABLE TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY, ITS BOARD OF TRUSTEES, PRIOR TO THE FILING OF THE FEDERAL FORM 990 WITH THE IRS. AS PART OF THE ORGANIZATION'S FEDERAL FORM 990 TAX RETURN PREPARATION PROCESS THE ORGANIZATION HIRED A PROFESSIONAL CPA FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION TO PREPARE THE FEDERAL FORM 990. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE ORGANIZATION'S FINANCE PERSONNEL AND SYSTEM INDIVIDUALS INCLUDING IN HOUSE COUNSEL, VICE-PRESIDENT OF FINANCE, DIRECTOR OF INTERNAL AUDIT AND VARIOUS OTHER INDIVIDUALS TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE ORGANIZATION'S INTERNAL WORKING GROUP, INCLUDING THOSE INDIVIDUALS OUTLINED ABOVE FOR THEIR REVIEW. THE ORGANIZATION'S INTERNAL WORKING GROUP REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE ORGANIZATION'S INTERNAL WORKING GROUP FOR FINAL REVIEW AND APPROVAL. A JOINT MEETING WAS THEN HELD WITH THE SYSTEM'S AUDIT, COMPLIANCE AND RISK MANAGEMENT COMMITTEE AND THE SYSTEM'S COMPENSATION AND PERFORMANCE COMMITTEE TO REVIEW THE FINAL DRAFT OF THIS ORGANIZATION'S FEDERAL FORM 990. FOLLOWING THIS REVIEW THE FINAL FEDERAL FORM 990 WAS MADE AVAILABLE TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY, ITS BOARD OF TRUSTEES, PRIOR TO THE FILING WITH THE IRS. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION B; QUESTION 12 THE ORGANIZATION IS AN AFFILIATE IN THE LIBERTY HEALTHCARE SYSTEM, INC. ("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'S VP RISK MANAGEMENT/CORPORATE COMPLIANCE FOR REVIEW. THEREAFTER THE VP RISK MANAGEMENT/CORPORATE COMPLIANCE PREPARES A SUMMARY OF THE COMPLETED QUESTIONNAIRES WHICH CONTAINS INFORMATION DISCLOSED ON AN INDIVIDUAL BY INDIVIDUAL BASIS. THEREAFTER, THE VP RISK MANAGEMENT/CORPORATE COMPLIANCE OF THE ORGANIZATION PRESENTS ANY CONFLICT CONCERNS TO THE ORGANIZATION'S AUDIT, COMPLIANCE AND RISK MANAGEMENT COMMITTEE FOR ITS REVIEW AND DISCUSSION. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION B; QUESTION 15 The organization is AN AFFILIATE IN the LIBERTY HEALTHCARE SYSTEM AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE parent entity of THE SYSTEM IS Liberty HealthCare System, Inc. ("LHS"). LHS' Board of Trustees maintains a Compensation and Performance Committee (the "Committee") consisting entirely of independent trustees. The Committee has a written executive compensation philosophy which it follows when it reviews the compensation and benefits of senior management and key employees. The Committee approves the compensation of the Chief Executive Officer. The Chief Executive Officer, in consultation with the Committee, approves the compensation of the Senior Vice-President and General Counsel, and the Chief Financial Officer. The Committee relies upon comparison data provided by a nationally recognized independent benefits consulting firm to determine fair market value. The Committee also reviews the compensation of other senior management and key employees as recommended by the Chief Executive Officer in consultation with the human resources department on the basis of comparison data provided by independent sources to determine fair market value. In performing these reviews, the Committee takes into account the total compensation payable to each individual, including both current and deferred compensation and all employee benefits, both qualified and non-qualified. The Committee's review is done annually. THE ACTIONS TAKEN BY THE COMMITTEE ENABLE THE ORGANIZATION TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 4958 WITH RESPECT TO THE TOTAL COMPENSATION OF CERTAIN MEMBERS OF THE SENIOR MANAGEMENT TEAM, INCLUDING THE PRESIDENT/CHIEF EXECUTIVE OFFICER, SENIOR VICE PRESIDENT/GENERAL COUNSEL AND CHIEF FINANCIAL OFFICER. 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 ACTIONS OUTLINED ABOVE WITH RESPECT TO THE COMMITTEE AND THE ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS APPLIES TO CERTAIN LHS SENIOR MANAGEMENT PERSONNEL, INCLUDING, BUT NOT LIMITED TO, THE PRESIDENT/CHIEF EXECUTIVE OFFICER. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION C; QUESTION 19 THE ORGANIZATION HAS ISSUED TAX-EXEMPT BONDS TO FINANCE VARIOUS CAPITAL IMPROVEMENT PROJECTS, RENOVATIONS AND EQUIPMENT. IN CONJUNCTION WITH THE ISSUANCE OF THESE TAX-EXEMPT BONDS, THE ORGANIZATION'S FINANCIAL STATEMENTS WERE INCLUDED WITH THE TAX-EXEMPT BOND PROSPECTUS WHICH WAS MADE AVAILABLE TO THE GENERAL PUBLIC FOR REVIEW. THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE STATE OF NEW JERSEY SECRETARY OF STATE. COMPENSATION DISCLOSURE INFORMATION CORE FORM, PART VII AND SCHEDULE J Part VII and Schedule J reflect a board member and officer receiving compensation from THIS ORGANIZATION OR a related organization. Please note that this remuneration was for services rendered as full-time employees of THIS ORGANIZATION OR A related organization and not for services rendered as A voting member or officer of this organization's board of trustees. RELATED HOURS DISCLOSURE CORE FORM, PART VII, SECTION A, COLUMN B THIS ORGANIZATION IS PART OF LIBERTY HEALTHCARE SYSTEM; 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 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 PER WEEK. THE HOURS REFLECTED ON PART VII OF THIS FORM 990 FOR PAID OFFICERS AND KEY EMPLOYEES REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF LIBERTY HEALTHCARE SYSTEM; NOT SOLELY THIS ORGANIZATION. OTHER CHANGES IN NET ASSETS CORE FORM, PART XI; QUESTION 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCE INCLUDE: - GAIN ON DEBT REFINANCING - $12,705,830 - NET ASSETS RELEASED FROM RESTRICTION FOR PROPERTY & EQUIPMENT - $457,104 - PENSION LIABILITY ADJUSTMENT - ($1,722,460) - POSTRETIREMENT LIABILITY ADJUSTMENT - ($1,172,580) - TRANSFER FROM/(TO) AFFILIATES - $795,483 AUDITED FINANCIAL STATEMENTS CORE FORM, PART XII; QUESTION 2B THE ORGANIZATION IS AN AFFILIATE WITHIN THE LIBERTY HEALTHCARE SYSTEM, INC. ("SYSTEM"), A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THE SYSTEM'S PARENT ENTITY IS LIBERTY HEALTHCARE SYSTEM, INC. AN INDEPENDENT CPA FIRM AUDITS THE CONSOLIDATED FINANCIAL STATEMENTS OF THE SYSTEM AND ALL ENTITIES WITHIN THE SYSTEM ANNUALLY. IN ADDITION, AN INDEPENDENT CPA FIRM AUDITS THE FINANCIAL STATEMENTS OF JERSEY CITY MEDICAL CENTER AND ITS AFFILIATES ANNUALLY. THE LIBERTY HEALTHCARE SYSTEM, INC. AUDIT, COMPLIANCE AND RISK MANAGEMENT COMMITTEE HAS ASSUMED RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF BOTH THE CONSOLIDATED FINANCIAL STATEMENTS REFERENCED ABOVE AND THE SELECTION OF AN INDEPENDENT AUDITOR. LIBERTY BEHAVIORAL HEALTH ASSOCIATES 350 MONTGOMERY STREET JERSEY CITY NJ 07302 223506358 HEALTH SVCS. NJ 501(c)(3) 509(a)(3) JCMC true LIBERTY CHILD HEALTH SERVICES 350 MONTGOMERY STREET JERSEY CITY NJ 07302 223386849 HEALTH SVCS. NJ 501(c)(3) 509(a)(3) JCMC true LIBERTY HEALTHCARE SYSTEM FOUNDATION 350 MONTGOMERY STREET JERSEY CITY NJ 07302 223113911 FUNDRAISING NJ 501(c)(3) 509(a)(2) LHCS false LIBERTY HEALTHCARE SYSTEM INC 350 MONTGOMERY STREET JERSEY CITY NJ 07302 223113960 HEALTH SVCS. NJ 501(c)(3) 509(a)(3) NA false LIBERTY HOME CARE 350 MONTGOMERY STREET JERSEY CITY NJ 07302 223327677 HEALTH SVCS. NJ 501(c)(3) 509(a)(2) LHCS false LIBERTY REHAB CTR FACULTY PRACTICE PLAN 350 MONTGOMERY STREET JERSEY CITY NJ 07302 223605610 HEALTH SVCS. NJ 501(c)(3) 509(a)(3) JCMC true LIBERTY SURGICAL ASSOCIATES 350 MONTGOMERY STREET JERSEY CITY NJ 07302 223386850 HEALTH SVCS. NJ 501(c)(3) 509(a)(3) JCMC true MEADOWLANDS HOSPITAL MEDICAL CENTER 350 MONTGOMERY STREET JERSEY CITY NJ 07302 223284894 HEALTH SVCS. NJ 501(c)(3) HOSPITAL LHCS false NEW MARGARET HAGUE CTR WOMENS JCM OBGYN 350 MONTGOMERY STREET JERSEY CITY NJ 07302 223363012 HEALTH SVCS. NJ 501(c)(3) 509(A)(3) JCMC true JERSEY CITY FAMILY HEALTH CENTER 350 MONTGOMERY STREET JERSEY CITY NJ 07302 223579538 HEALTH SVCS. NJ 501(c)(3) HOSPITAL LHCS false GREENVILLE HOSPITAL 350 MONTGOMERY STREET JERSEY CITY NJ 07302 220963805 HEALTH SVCS. NJ 501(c)(3) HOSPITAL LHCS false LIBERTY HEALTHCARE MANAGEMENT 350 Montgomery Street JERSEY CITY NJ 07302 223597891 MANAGEMENT NJ NA LIBERTYUSP SURGERY CENTERS LLC 15305 DALLAS PKWY SUITE 1600 LB 28 ADDISON TX 75001 264756962 HEALTHCARE SVCS. NJ NA 0 LIBERTY HEALTHCARE CAPITAL 350 Montgomery Street JERSEY CITY NJ 07302 223444345 LEASE/FINANCE NJ NA C CORP false false false true true false false false false false false false false false false false false false false true TRANSACTIONS WITH RELATED ORGANIZATIONS SCHEDULE R, PART V JERSEY CITY MEDICAL CENTER RECEIVES SERVICES FROM VARIOUS AFFILIATES WITHIN THE LIBERTY HEALTHCARE SYSTEM IN THE ORDINARY COURSE OF BUSINESS AND PROVIDES FUNDS AS NEEDED TO SUPPORT THOSE SERVICES. THESE RELATED PARTY TRANSACTIONS ARE RECORDED ON THE REVENUE/EXPENSE AND BALANCE SHEET STATEMENTS OF THIS ORGANIZATION AND ITS AFFILIATES. THESE ENTITIES WORK TOGETHER TO DELIVER HIGH QUALITY. HEALTHCARE AND WELLNESS SERVICES TO THE COMMUNITIES IN WHICH THEY ARE SITUATED.