2013-02-01T13:29:06-06:00 2011-12-31 WithumSmithBrown PC 465 South St Ste 200 Morristown NJ 079606497 990 2011-01-01 222339534 HACKENSACK UNIV MED CTR FOUNDATION INC % ROBERT L GLENNING HACK 5519963365 360 ESSEX STREET HACKENSACK NJ 07601 KERRY KRUCKEL-GIBS 2012-11-13 true 9738989494 2011 2016-02-25 16:41:14Z ROBERT C GARRETT 30 PROSPECT AVENUE HACKENSACK NJ 07601 22923221 false X N/A X 1981 NJ THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF HACKENSACK UNIVERSITY MEDICAL CENTER; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. 78 64 0 100 0 0 17246754 22209628 0 324254 420501 -994825 185004 115056 17852259 21654113 9718494 19806860 0 0 0 0 0 0 2744524 4003824 4946830 13722318 24753690 4129941 -3099577 41682602 37973444 3757076 3437776 37925526 34535668 THE HACKENSACK UNIVERSITY MEDICAL CENTER FOUNDATION RAISES FUNDS THAT SUPPORT THE DIVERSE PROGRAMS AND SERVICES OF HACKENSACK UNIVERSITY MEDICAL CENTER ("HACKENSACKUMC"). HACKENSACKUMC IS A 775-BED, NOT FOR-PROFIT TERTIARY CARE, TEACHING AND RESEARCH HOSPITAL SERVING NORTHERN NEW JERSEY AND THE NEW YORK METRO AREA. AFFILIATED WITH THE UNIVERSITY OF MEDICINE AND DENTISTRY OF NEW JERSEY, NEW JERSEY MEDICAL SCHOOL, HACKENSACKUMC IS THE LARGEST PROVIDER OF INPATIENT AND OUTPATIENT SERVICES IN THE STATE OF NEW JERSEY AND RANKED FOURTH IN THE NATION FOR ADMISSIONS. ANNUALLY, THE FOUNATION RECEIVES MORE THAN 10,000 CHARITABLE GIFTS AND RAISES MORE THAN $17 MILLION TO HELP SUPPORT VITAL PROGRAMS AND SERVICES AT HACKENSACKUMC. THE FOUNDATION ALSO PROVIDES FUNDING OF MORE THAN $100 MILLION FOR SPECIAL AND CAPITAL PROJECTS. WHAT'S MORE THE FOUNDATION'S PLANNED GIVING PROGRAM NOW HAS APPROXIMATELY $38 MILLION IN COMMITMENTS FROM ITS DONORS WHICH PROVIDES STABILITY TO ALL OF THE FOUNDATION'S EFFORT false false 19806860 19806860 324254 EXPENSES INCURRED IN SUPPORTING THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF HACKENSACK UNIVERSITY MEDICAL CENTER; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT MEDICAL CENTER WHICH PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. 19806860 true true false true false false false false true true false true false true true true false false false false false false false true true false true false true false false false false false false false false true false false false false true false false false false true 39 4 true 0 false false false false false true true false false false true false X 78 64 true false false false true true true true true false false true true true true true true true true false NJ X ROBERT L GLENNING 5519963365 30 PROSPECT AVENUE HACKENSACK NJ 07601 X JOSEPH SIMUNOVICH 3.0 X X 0 1666 0 RICHARD DRESSEL 3.0 X X 0 0 0 JAMES R BEATTIE ESQ 3.0 X X 0 0 0 KEVIN ALLIOTTS 3.0 X 0 0 0 JAMES P ANDERSEN 3.0 X 0 0 0 JOHN J APOVIAN MD 3.0 X 0 272264 1774 MICHAEL ARMELLINO 3.0 X 0 0 0 MITCHELL BAKER 3.0 X 0 0 0 BRUCE G BOHUNY 3.0 X 0 0 0 JENNIFER A BORG ESQ 3.0 X 0 0 0 STEPHEN T BOSWELL PHD PE SECB 3.0 X 0 0 0 NICK CANGIALOSI 3.0 X 0 0 0 KEVIN J COLLINS ESQ 3.0 X 0 0 0 J FLETCHER CREAMER 3.0 X 0 0 0 GEORGE T CROONQUIST 3.0 X 0 0 0 G THOMAS CROONQUIST JR 3.0 X 0 0 0 VINCENT CURATOLA 3.0 X 0 0 0 MARK CURCIO 3.0 X 0 0 0 ULISES DIAZ 3.0 X 0 0 0 SIRAN GABRELLIAN 3.0 X 0 0 0 JUSTICE MARIE L GARIBALDI 3.0 X 0 0 0 ROBERT C GARRETT SEE SCH O 60.0 X X 0 1664447 717385 MICHAEL GEARY 3.0 X 0 0 0 KRISTEN GERHARD 3.0 X 0 0 0 PETER C GERHARD 3.0 X 0 0 0 MATTHEW A GOLSON 3.0 X 0 0 0 MICHAEL GROSS MD 3.0 X 0 0 0 PETER A GROSS MD 60.0 X 0 716285 73465 WILLIAM C HANSON 3.0 X 0 0 0 ROBERT S HEKEMIAN JR 3.0 X 0 0 0 FRED C HIRSCH 3.0 X 0 0 0 TIMOTHY HODGES 3.0 X 0 0 0 FRANK C HOLTHAM JR 3.0 X 0 0 0 RICHARD HUBSCHMAN JR ESQ 3.0 X 0 0 0 DANTE A IMPLICITO MD 3.0 X 0 0 0 LAWRENCE R INSERRA JR 3.0 X 0 0 0 JILL JOYCE 3.0 X 0 0 0 MARTIN W KAFAFIAN ESQ 3.0 X 0 0 0 SANDRA KEARY 3.0 X 0 0 0 SANDRA KISSLER 3.0 X 0 0 0 JOHN H KLEIN 3.0 X 0 0 0 PATRICIA K LOW 3.0 X 0 0 0 EDWARD J LUDWIG 3.0 X 0 0 0 GLORIA MARTINI 3.0 X 0 0 0 MICHAEL S MCGEARY 3.0 X 0 0 0 NICHOLAS MINICUCCI JR 3.0 X 0 0 0 JACK K MURRAY 3.0 X 0 0 0 WILLIAM J MURRAY 3.0 X 0 0 0 JAMES NAPOLITANO ESQ 3.0 X 0 0 0 STEVE NICOLETTI 3.0 X 0 0 0 ROBERT E OHARA III 3.0 X 0 0 0 SHARON PARKER 3.0 X 0 0 0 SAMUEL S RAIA 3.0 X 0 0 0 JULIA RECAMAN 3.0 X 0 0 0 JOSEPH P RICCARDO 3.0 X 0 0 0 JOSEPH A RIZZI ESQ 3.0 X 0 0 0 DAVID T ROBERTSON ESQ 3.0 X 0 0 0 ANDREW RUBENSTEIN MD 3.0 X 0 0 0 ANN MARIE SACCARO 3.0 X 0 0 0 DAVID SANZARI 3.0 X 0 0 0 JOSEPH M SANZARI 3.0 X 0 0 0 ANTHONY SCARDINO JR 3.0 X 0 0 0 CAROL D SCHAEFER 3.0 X 0 0 0 JOHN A SCHEPISI ESQ 3.0 X 0 0 0 MARK D SCHLESINGER MD 3.0 X 0 95107 5580 CHARLES H SHOTMEYER 3.0 X 0 0 0 PHIL SIMMS 3.0 X 0 0 0 ROSEMARIE J SORCE 3.0 X 0 0 0 DEBORAH A STONE 3.0 X 0 0 0 ANTHONY C TACCETTA JR 3.0 X 0 0 0 SCOTT TARRIFF 3.0 X 0 0 0 HELENA THEURER 3.0 X 0 0 0 ROBERT L TORRE 60.0 X X 0 677551 106098 SAMUEL P TOSCANO JR 3.0 X 0 0 0 PATRICK TOTH MD 3.0 X 0 0 0 CHRISTOPHER TURNER 3.0 X 0 0 0 PRANACHANDRA VAIDYA MD 3.0 X 0 377824 71501 FRANK J VUONO 3.0 X 0 0 0 JOHN P FERGUSON 0.0 X 0 126721 0 0 3931865 975803 0 true true false GREAT PERFORMANCES 304 HUDSON STREET NEW YORK NY 10013 CATERING 290391 CONEWAGO CONSULTING 20 ROYAL DOMINION COURT BETHESDA MD 20817 CONSULTING 264000 2 1766810 121667 8000 20313151 283949 22209628 FORGIVENESS OF DEBT 900099 324254 324254 324254 -994825 -994825 0 0 0 1188014 1766810 1188014 0 196150 81094 115056 115056 0 0 21654113 324254 -879769 19806860 19806860 0 0 0 0 0 0 0 0 0 0 40269 40269 76146 76146 264000 264000 0 0 38097 38097 0 134123 134123 0 0 178595 89298 89297 0 0 99558 99558 0 0 8612 8612 0 ALLOC. OF PERSONNEL COSTS 2512009 0 1256004 1256005 PROVISION FOR UNCOLL PLEDGES 1259395 0 0 1259395 CONTRACTED SERVICES 229997 0 229997 0 DUES & SUBSCRIPTIONS 31208 0 31208 0 74821 74821 24753690 19806860 2202306 2744524 1518081 1579451 70233 108154 11260212 15601165 0 0 0 0 0 0 19131359 10107286 0 0 48828 98071 228120 196937 34566 31183 0 0 0 0 9600803 10390286 0 0 18520 57848 41682602 37973444 372730 827060 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3384346 2610716 3757076 3437776 X 19113510 18290099 14285260 12009492 4526756 4236077 37925526 34535668 41682602 37973444 X -3099577 -290281 X X false true true X false X 13165079 15899711 11155657 17246754 24384628 81851829 13165079 15899711 11155657 17246754 24384628 81851829 12476647 69375182 803152 419861 58331 420501 370475 2072320 83924149 5633068 0.82664 0.81015 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true 264000 false false 264000 false LOBBYING ACTIVITIES SCHEDULE C, PART II-B; LINES 1G AND 1H DURING 2011, THE ORGANIZATION PAID AN OUTSIDE LOBBYING FIRM $264,000 FOR LOBBYING ON A FEDERAL AND STATE LEVEL RELATED TO MEDICARE, MEDICAID AND OTHER HEALTHCARE LEGISLATIVE MATTERS. 18812016 10868086 171390 13605923 16245569 29623209 6134339 26277 16971809 18812016 30085747 9594307 -86342 9970503 29623209 24096205 13259002 -1862122 5407338 30085747 0.26000 0.74000 false false 228120 196937 31183 31183 U.S. GOVERNMENT SECURITIES 633533 F MARKETABLE EQUITY SECURITIES 2873565 F CASH & CASH EQUIVALENTS 18981 F OTHER INVESTMENTS 17500 F CHARITABLE GIFT ANNUITIES 999261 F OUTSIDE TRUSTS 5297004 F MUTUAL FUNDS 485613 F REAL ASSET FUNDS 64829 F 10390286 0 CHARITABLE GIFT ANNUITIES 1643519 TAX-EXEMPT ORGANIZATION 967197 2610716 21654113 24753690 -3099577 -290281 -290281 -3389858 22632940 -290281 1269108 978827 21654113 21654113 26022798 1269108 1269108 24753690 24753690 ENDOWMENT FUNDS SCHEDULE D, PART V; QUESTION 4 INVESTMENT RETURN OBJECTIVES ============================ THE FOUNDATION HAS ADOPTED INVESTMENT AND SPENDING POLICIES FOR ENDOWMENT ASSETS THAT ATTEMPT TO PROVIDE A PREDICTABLE STREAM OF FUNDING TO PROGRAMS SUPPORTED BY SUCH FUNDS WHILE SEEKING TO MAINTAIN THE PURCHASING POWER OF THE ENDOWMENT ASSETS. UNDER THIS POLICY, THE ENDOWMENT ASSETS ARE INVESTED IN A DIVERSIFIED MANNER THAT IS INTENDED TO PRODUCE RESULTS THAT OVER THE LONG TERM WILL AVERAGE AN ESTIMATED 5% RETURN WHILE ASSUMING A MODERATE LEVEL OF INVESTMENT RISK. ACTUAL RETURNS IN ANY GIVEN YEAR MAY VARY FROM THIS AMOUNT. STRATEGIES EMPLOYED FOR ACHIEVING OBJECTIVES ============================================ TO SATISFY ITS LONG-TERM-RATE-OF-RETURN OBJECTIVES, THE FOUNDATION RELIES ON TOTAL RETURN STRATEGY IN WHICH INVESTMENT RETURNS ARE ACHIEVED THROUGH BOTH CAPITAL APPRECIATION AND CURRENT YIELD. THE ACTUAL AND TARGET INVESTMENT ALLOCATIONS WERE AS FOLLOWS AS OF DECEMBER 31, 2011: ACTUAL % TARGET % SHORT-TERM INVESTMENTS 2 - FIXED INCOME SECURITIES 55 60 MARKETABLE EQUITY SECURITIES 43 40 SPENDING POLICY AND HOW THE INVESTMENT OBJECTIVES RELATE TO SPENDING POLICY ==================================================================== THE FOUNDATION HAS A POLICY OF APPROPRIATING FOR DISTRIBUTION EACH YEAR BETWEEN 4% AND 4.5% OF THE ENDOWMENT FUNDS' TOTAL FAIR VALUE, INCLUDING ACCUMULATED TOTAL INVESTMENT RETURNS. IN ESTABLISHING THIS POLICY, THE FOUNDATION CONSIDERED THE LONG-TERM EXPECTED RETURN ON ITS ENDOWMENT ASSETS WHICH IS EXPECTED TO EXCEED THE ALLOWABLE SPENDING, AND THEREFORE OVER THE LONG TERM, THE FOUNDATION EXPECTS ITS ENDOWMENT FUNDS TO GROW. THIS IS CONSISTENT WITH THE FOUNDATION'S OBJECTIVE TO MAINTAIN THE PURCHASING POWER OF THE ENDOWMENT ASSETS HELD IN PERPETUITY OR FOR A SPECIFIED TERM, AS WELL AS TO PROVIDE ADDITIONAL REAL GROWTH THROUGH NEW GIFTS AND INVESTMENT RETURN. TEXT OF FIN 48 AUDITED FINANCIAL STATEMENT FOOTNOTE SCHEDULE D, PART X AN INDEPENDENT CPA FIRM AUDITED THE FINANCIAL STATEMENTS OF THE ORGANIZATION FOR THE YEARS ENDED DECEMBER 31, 2011 AND DECEMBER 31, 2010; RESPECTIVELY, AND ISSUED A CERTIFIED AUDITED FINANCIAL STATEMENT. THE FIN 48 FOOTNOTE BELOW IS FROM THE ORGANIZATION'S 2011 AUDITED FINANCIAL STATEMENTS: THE FOUNDATION FOLLOWED THE PROVISIONS OF AUTHORITATIVE GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES FOR THE YEARS ENDED DECEMBER 31, 2011 AND 2010. UNDER THIS GUIDANCE, TAX POSITIONS ARE EVALUATED FOR RECOGNITION USING A MORE-LIKELY-THAN-NOT THRESHOLD, AND THOSE TAX POSITIONS REQUIRING RECOGNITION ARE MEASURED AT THE LARGEST AMOUNT OF TAX BENEFIT THAT IS GREATER THAN 50 PERCENT LIKELY OF BEING REALIZED UPON ULTIMATE SETTLEMENT WITH A TAXING AUTHORITY THAT HAS FULL KNOWLEDGE OF ALL RELEVANT INFORMATION. RECONC OF REVENUE PER AUDITED FINANCIAL STATEMENTS WITH REV PER RETURN SCHEDULE D, PART XII, LINE 2D OTHER AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12 BUT NOT ON LINE 1 INCLUDES: - SPECIAL EVENT EXPENSE - $1,188,014 - RAFFLE EXPENSE - $81,094 RECONC OF EXPENSES PER AUDITED FINANCIAL STATEMENTS WITH EXP PER RETURN SCHEDULE D, PART XIII; LINE 2D OTHER AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART IX, LINE 25 INCLUDES: - SPECIAL EVENT EXPENSE - $1,188,014 - RAFFLE EXPENSE - $81,094 ANNUAL GALA 1892052 942954 949098 226940 358391 36130 327637 GOLF OUTING 495419 351330 144089 78018 2433 63638 6 567353 472526 94827 14375 80452 2954824 1766810 1188014 304958 375199 36130 471727 1188014 196150 47569 33525 false 196150 47569 33525 81094 115056 true false false false 1.00000 PAIGE COOPER 360 ESSEX STREET HACKENSACK NJ 07601 false SHARON SCIMECA 19748 COORDINATES AND OVERSEES RAFFLE OPERATIONS X false true HACKENSACK UNIVERSITY MEDICAL CENTER 30 PROSPECT AVENUE HACKENSACK NJ 07601 221487576 501(C)(3) 18749528 PROGRAM SERVICES TOMORROWS CHILDREN'S FUND INC 30 PROSPECT AVENUE HACKENSACK NJ 07601 133155199 501(C)(3) 1057332 PROGRAM SERVICES 2 0 GRANT FUND MONITORING SCHEDULE I, PART I, QUESTION 2 GRANTS ARE MONITORED BY THE ORGANIZATION'S FINANCE PERSONNEL THROUGH THE UTILIZATION OF COST CENTERS AND OTHER INFORMATION; INCLUDING WRITTEN DOCUMENTATION AND RECEIPTS. X X X X false true false false false false false true false JOHN J APOVIAN MD 0 270452 0 0 0 1812 0 0 0 1774 0 274038 0 0 ROBERT C GARRETT SEE SCH O 0 1121245 0 250000 0 293202 0 686391 0 30994 0 2381832 0 0 PETER A GROSS MD 0 580457 0 57156 0 78672 0 42089 0 31376 0 789750 0 0 ROBERT L TORRE 0 418990 0 175890 0 82671 0 96328 0 9770 0 783649 0 0 PRANACHANDRA VAIDYA MD 0 374648 0 0 0 3176 0 44049 0 27452 0 449325 0 0 JOHN P FERGUSON 0 0 0 0 0 126721 0 0 0 0 0 126721 0 0 COMPENSATION INFORMATION SCHEDULE J, PART I; QUESTION 4B THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THE FOLLOWING INDIVIDUALS INCLUDES UNVESTED BENEFITS IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) WHICH ARE SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. ACCORDINGLY, THE INDIVIDUALS MAY NEVER ACTUALLY RECEIVE THE UNVESTED BENEFITS. THE AMOUNTS OUTLINED HEREIN WERE NOT INCLUDED IN THESE INDIVIDUAL'S 2011 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: ROBERT C. GARRETT, $382,141; PETER A. GROSS, m.d., $87,442 AND ROBERT L. TORRE, $63,960. COMPENSATION INFORMATION SCHEDULE J; PART II PAYMENTS TO JOHN FERGUSON RELATE TO HIS SEPARATION FROM the organization AS PRESIDENT AND CEO IN 2009. X 4 48536 FMV X MISCELLANEOUS NONCASH CONTRIBUTIONS 101 235413 FMV false false false GOVERNANCE, MANAGEMENT, AND DISCLOSURE CORE FORM, PART VI, SECTION A; QUESTION 2 JOSEPH M. SANZARI AND DAVID SANZARI - FAMILY RELATIONSHIP. RICHARD DRESSEL AND JOSEPH M. SANZARI - BUSINESS RELATIONSHIP. PETER C. GERHARD AND KRISTEN GERHARD - FAMILY RELATIONSHIP. SAMUEL P. TOSCANO, JR. AND SANDRA KEARY - FAMILY RELATIONSHIP. JOSEPH A. RIZZI, ESQ., JAMES R. BEATTIE, ESQ. AND MARTIN W. KAFAFIAN, ESQ. - BUSINESS RELATIONSHIP. WILLIAM C. HANSON, SAMUEL P. TOSCANO, JR., JOSEPH SIMUNOVICH, MITCHELL BAKER, JENNIFER A. BORG, ESQ. AND STEPHEN T. BOSWELL, PH.D., P.E., SECB - BUSINESS RELATIONSHIP. J. FLETCHER CREAMER AND JOHN J. APOVIAN, M.D. - BUSINESS RELATIONSHIP. JOHN A. SCHEPISI, ESQ. AND J. FLETCHER CREAMER, JOSEPH M. SANZARI AND DAVID SANZARI - BUSINESS RELATIONSHIP. PETER C. GERHARD, GEORGE T. CROONQUIST AND SAMUEL P. TOSCANO, JR. - BUSINESS RELATIONSHIP. JOHN J. APOVIAN, M.D. AND ROBERT S. HEKEMIAN, JR. - BUSINESS RELATIONSHIP. STEPHEN T. BOSWELL, PH.D., P.E., SECB, JAMES R. BEATTIE, ESQ., ROBERT S. HEKEMIAN, JR., DANTE A. IMPLICITO, M.D., JOSEPH M. SANZARI, DAVID SANZARI, SAMUEL P. TOSCANO, JR. AND JOSEPH SIMUNOVICH - BUSINESS RELATIONSHIP. SAMUEL P. TOSCANO, JR., LAWRENCE R. INSERRA, JR., ANTHONY C. TACCETTA, JR., STEPHEN T. BOSWELL, PH.D., P.E., SECB, SCOTT TARRIFF AND JOSEPH P. RICCARDO - BUSINESS RELATIONSHIP. WILLIAM C. HANSON AND GEORGE T. CROONQUIST AND G. THOMAS CROONQUIST, JR. - BUSINESS RELATIONSHIP. WILLIAM C. HANSON, JAMES R. BEATTIE, ESQ., MARTIN W. KAFAFIAN, ESQ. AND JOSEPH A. RIZZI, ESQ. - BUSINESS RELATIONSHIP. GEORGE T. CROONQUIST AND G. THOMAS CROONQUIST, JR. - BUSINESS RELATIONSHIP. NICK CANGIALOSI AND NICHOLAS MINICUCCI, JR. - BUSINESS RELATIONSHIP. GEORGE T. CROONQUIST AND G. THOMAS CROONQUIST, JR. - FAMILY RELATIONSHIP. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION A; QUESTION 1B PLEASE NOTE THAT CERTAIN VOTING MEMBERS OF THE ORGANIZATION'S BOARD OF TRUSTEES ARE NOT INDEPENDENT. THIS IS EITHER DUE TO THE FACT THAT THEY: 1. ARE COMPENSATED AS AN EMPLOYEE OF A RELATED ORGANIZATION, 2. ARE COMPENSATED AS AN INDEPENDENT CONTRACTOR OF A RELATED ORGANIZATION, 3. ARE AN OFFICER OR KEY EMPLOYEE OF A COMPANY WITH WHICH A RELATED ORGANIZATION TRANSACTS BUSINESS, 4. ARE AN OWNER OF A COMPANY WITH WHICH A RELATED ORGANIZATION TRANSACTS BUSINESS, 5. HAVE A FAMILY MEMBER THAT IS COMPENSATED AN EMPLOYEE OF A RELATED ORGANIZATION, OR 6. HAVE A FAMILY MEMBER THAT IS COMPENSATED AS AN INDEPENDENT CONTRACTOR OF A RELATED ORGANIZATION. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7 HACKENSACK UNIVERSITY HEALTH NETWORK, INC. ("HUHN") IS THE SOLE MEMBER OF THIS ORGANIZATION. HUHN 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 OF HACKENSACK UNIVERSITY HEALTH NETWORK, INC. AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM") WHICH INCLUDES HACKENSACK UNIVERSITY MEDICAL CENTER ("HACKENSACKUMC"). THE ORGANIZATION'S FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF ITS GOVERNING BODY, ITS BOARD OF TRUSTEES, PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE ("IRS"). THE ORGANIZATION'S BOARD OF TRUSTEES HAS ASSUMED THE RESPONSIBILITY TO OVERSEE, REVIEW AND APPROVE THE FEDERAL FORM 990, INCLUDING THE PREPARATION, REVIEW AND FILING PROCESS. AS PART OF THE 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 VARIOUS OTHER INDIVIDUALS OF THE ORGANIZATION 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 FINANCE PERSONNEL AND OTHER INDIVIDUALS FOR THEIR REVIEW. THE ORGANIZATION'S FINANCE PERSONNEL AND OTHER INDIVIDUALS REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE ORGANIZATION'S FINANCE PERSONNEL AND VARIOUS OTHER INDIVIDUALS FOR FINAL REVIEW AND APPROVAL PRIOR TO PROVIDING A COPY OF THE FEDERAL FORM 990 TO EACH VOTING MEMBER OF ITS GOVERNING BODY. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION B; QUESTION 12 THE ORGANIZATION IS AN AFFILIATE OF HACKENSACK UNIVERSITY HEALTH NETWORK, INC. AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM") WHICH INCLUDES HACKENSACK UNIVERSITY MEDICAL CENTER ("HACKENSACKUMC"). THE ORGANIZATION REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. ANNUALLY ALL MEMBERS OF THE ORGANIZATION'S 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 HACKENSACKUMC'S CHIEF COMPLIANCE OFFICER FOR REVIEW. THEREAFTER THE CHIEF COMPLIANCE OFFICER PREPARES A SUMMARY OF THE COMPLETED QUESTIONNAIRES WHICH CONTAINS INFORMATION DISCLOSED ON AN INDIVIDUAL BASIS. THE ORGANIZATION'S CHIEF COMPLIANCE OFFICER THEN PRESENTS THIS SUMMARY TO HACKENSACKUMC'S GOVERNANCE COMMITTEE FOR ITS REVIEW AND DISCUSSION. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION B; QUESTION 15 THE ORGANIZATION IS AN AFFILIATE OF HACKENSACK UNIVERSITY HEALTH NETWORK, INC. AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM") WHICH INCLUDES HACKENSACK UNIVERSITY MEDICAL CENTER ("HACKENSACKUMC"). HACKENSACKUMC'S BOARD OF GOVERNORS HAS AN EXECUTIVE COMPENSATION COMMITTEE ("COMMITTEE"). THE COMMITTEE HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY WHICH IT FOLLOWS WHEN IT REVIEWS AND APPROVES OF THE COMPENSATION AND BENEFITS OF THE ORGANIZATION'S SENIOR MANAGEMENT, INCLUDING THE PRESIDENT/CHIEF EXECUTIVE OFFICER. THE COMMITTEE REVIEWS THE "TOTAL COMPENSATION" OF THE INDIVIDUALS WHICH IS INTENDED TO INCLUDE BOTH CURRENT AND DEFERRED COMPENSATION AND ALL EMPLOYEE BENEFITS, BOTH QUALIFIED AND NON-QUALIFIED. THE COMMITTEE CONDUCTS ITS REVIEW AND APPROVAL PROCESS AT LEAST ANNUALLY OVER SEVERAL MEETINGS, AND APPROVES ONLY "TOTAL COMPENSATION" THAT THE COMMITTEE HAS CONCLUDED DOES NOT EXCEED WHAT THE COMMITTEE CONSIDERS TO BE REASONABLE COMPENSATION. THE COMMITTEE STRUCTURES AND CONDUCTS ITS REVIEW AND APPROVAL PROCESS SO AS TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERMEDIATE SANCTIONS RULES OF FEDERAL INCOME TAX LAW. THIS REVIEW AND APPROVAL PROCESS APPLIES TO ALL FORMS OF COMPENSATION AND BENEFITS PROVIDED TO ALL MEMBERS OF THE SENIOR MANAGEMENT TEAM. THE THREE FACTORS WHICH MUST BE SATISFIED IN ORDER TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS ARE THE FOLLOWING: 1. THE COMPENSATION ARRANGEMENT IS APPROVED IN ADVANCE BY AN "AUTHORIZED BODY" OF THE APPLICABLE TAX-EXEMPT ORGANIZATION WHICH IS COMPOSED ENTIRELY OF INDIVIDUALS WHO DO NOT HAVE A "CONFLICT OF INTEREST" WITH RESPECT TO THE COMPENSATION ARRANGEMENT; 2. THE AUTHORIZED BODY OBTAINED AND RELIED UPON "APPROPRIATE DATA AS TO COMPARABILITY" PRIOR TO MAKING ITS DETERMINATION; AND 3. THE AUTHORIZED BODY "ADEQUATELY DOCUMENTED THE BASIS FOR ITS DETERMINATION" CONCURRENTLY WITH MAKING THAT DETERMINATION. THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF GOVERNORS, EACH OF WHOM IS "DISINTERESTED" AS DEFINED BY THE IRS IN ITS REGULATIONS DESCRIBING THIS STANDARD. THE COMMITTEE RELIED UPON APPROPRIATE COMPARABLE DATA; SPECIFICALLY THE COMMITTEE OBTAINED A WRITTEN COMPENSATION STUDY FROM AN INDEPENDENT FIRM WHICH SPECIALIZES IN THE REVIEW OF HOSPITAL AND HEALTHCARE SYSTEM EXECUTIVE COMPENSATION AND BENEFITS THROUGHOUT THE UNITED STATES. THIS DETAILED STUDY USES COMPARABLE GEOGRAPHIC AND DEMOGRAPHIC MARKET DATA FOR TAX-EXEMPT HOSPITALS AND HEALTHCARE SYSTEMS OF A SIMILAR LEVEL OF NET ANNUAL OPERATING REVENUE IN THE SAME GEOGRAPHIC REGION. NO DATA FROM ANY FOR-PROFIT ENTITIES IS USED. THE COMMITTEE ADEQUATELY DOCUMENTED ITS BASIS FOR ITS DETERMINATION THROUGH THE TIMELY PREPARATION OF WRITTEN MINUTES OF THE COMPENSATION COMMITTEE MEETINGS DURING WHICH THE EXECUTIVE COMPENSATION AND BENEFITS WAS REVIEWED AND SUBSEQUENTLY APPROVED. THE REVIEW AND APPROVAL PROCESS USED BY THE COMMITTEE, INCLUDING ALL ACTIONS DESIGNED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS, IS APPLIED TO ALL MEMBERS OF THE SENIOR MANAGEMENT TEAM OF THE ORGANIZATION, WHETHER OR NOT THEY WOULD BE CONSIDERED 'DISQUALIFIED PERSONS' UNDER THE INTERMEDIATE SANCTIONS RULES. IN ADDITION TO RELYING ON MARKET DATA, THE COMMITTEE APPLIES A WIDE RANGE OF BUSINESS JUDGMENT FACTORS INCLUDING, BUT NOT LIMITED TO, INDIVIDUAL PERFORMANCE, INDIVIDUAL EXPERIENCE, RECRUITMENT AND RETENTION FACTORS, AND THE UNIQUE DEMANDS OF PARTICULAR POSITIONS. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION C; QUESTION 19 THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE STATE OF NEW JERSEY DEPARTMENT OF THE TREASURY. THE ORGANIZATION ALSO MAKES AVAILABLE TO THE PUBLIC VIA ITS WEBSITE, WWW.HACKENSACKUMC.ORG, ITS COMPLIANCE PLAN DOCUMENTS, CODE OF CONDUCT AND CONFLICT OF INTEREST POLICY. RELATED HOURS INFORMATION CORE FORM, PART VII, SECTION A This organization is AN AFFILIATE WITHIN HACKENSACK UNIVERSITY HEALTH NETWORK, INC.; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM INCLUDES BOTH FOR-PROFIT AND NOT FOR-PROFIT ORGANIZATIONS. CERTAIN BOARD OF TRUSTEE MEMBERS, OFFICERS AND/OR DIRECTORS LISTED ON CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 MAY HOLD SIMILAR POSITIONS WITH BOTH THIS ORGANIZATION AND OTHER AFFILIATES WITHIN THE SYSTEM. THE HOURS SHOWN ON THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE NO COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, REPRESENT THE ESTIMATED HOURS DEVOTED PER WEEK FOR THIS ORGANIZATION. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF OTHER RELATED ORGANIZATIONS IN THE SYSTEM, THEIR RESPECTIVE HOURS PER WEEK PER ORGANIZATION ARE APPROXIMATELY THE SAME AS THOSE REFLECTED ON PART VII OF THIS FORM 990. 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 THE SYSTEM; NOT SOLELY THIS ORGANIZATION. COMPENSATION INFORMATION DISCLOSURE CORE FORM, PART VII AND SCHEDULE J PART VII AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM A RELATED ORGANIZATION. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OF THE RELATED ORGANIZATION AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THIS ORGANIZATION'S BOARD OF TRUSTEES. OTHER CHANGES IN NET ASSETS CORE FORM, PART XI; QUESTION 5 OTHER CHANGES IN NET ASSETS OR FUND BALANCES INCLUDE: - NET UNREALIZED LOSS ON INVESTMENT SECURITIES - ($290,281) AUDITED FINANCIAL STATEMENTS CORE FORM, PART XII; QUESTION 2 AN INDEPENDENT CPA FIRM AUDITED THE FINANCIAL STATEMENTS OF THE ORGANIZATION FOR THE YEARS ENDED DECEMBER 31, 2011 AND DECEMBER 31, 2010; RESPECTIVELY, AND ISSUED A CERTIFIED AUDITED FINANCIAL STATEMENT. AN UNQUALIFIED OPINION WAS ISSUED BY THE INDEPENDENT CPA FIRM EACH YEAR. THE ORGANIZATION'S BOARD OF TRUSTEES ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE TAXPAYER'S FINANCIAL STATEMENTS AND THE SELECTION OF ITS INDEPENDENT AUDITOR. BERGEN HEALTH MANAGEMENT SYSTEM INC 30 PROSPECT AVENUE HACKENSACK NJ 07601 222989731 DAY CARE NJ 501(C)(3) 509(A)(2) HUHN false BERGEN HOME HEALTH SERVICES INC 30 PROSPECT AVENUE HACKENSACK NJ 07601 223091474 HLTHCARE SVCS NJ 501(C)(3) 509(A)(2) HUHN false HACKENSACK UNIVIERSITY MEDICAL CENTER 30 PROSPECT AVENUE HACKENSACK NJ 07601 221487576 HLTHCARE SVCS NJ 501(C)(3) HOSPITAL HUHN false HACKENSACK SPECIALTY CARE ASSOC PC 30 PROSPECT AVENUE HACKENSACK NJ 07601 201017013 PHYS. SVCS. NJ 501(C)(3) 509(A)(3) HUMC false HACKENSACK UNIVERSITY HEALTH NETWORK 30 PROSPECT AVENUE HACKENSACK NJ 07601 222595857 SUPPORT NJ 501(C)(3) 509(A)(3) NA false NJ TRAUMA AND CRITICAL CARE ASSOCIATES 30 PROSPECT AVENUE HACKENSACK NJ 07601 201123530 PHYS. SVCS. 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