FOUNDATION FOR MORRISTOWN MEDICAL CENTER INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- FOUNDATION FOR MORRISTOWN MEDICAL CENTER INC (EIN 22-3392808)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-12
- IRS object ID
- 201323169349303292
- Schema version
- 2012v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-12T10:58:56-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 346565596 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Ernst & Young US LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 Monument Circle Suite 2600 | AddressLine1 |
| City | Indianapolis | City |
| State | IN | State |
| ZIP Code | 46204 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 223392808 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Foundation for Morristown Medical Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | FOUN | NameControl |
| Phone | 9735932400 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 475 South Street | AddressLine1 |
| City | Morristown | City |
| State | NJ | State |
| ZIP Code | 07960 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Kevin Lenahan | Name |
| Title | VP of Finance-CFO | Title |
| Phone | 9735932400 | Phone |
| Date Signed | 2013-11-12 | DateSigned |
| Authorize Third Party | 0 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| PTIN | P00032493 | PTIN |
| Phone | 3176817000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Kevin Lenahan | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 475 South Street | AddressLine1 |
| City | Morristown | City |
| State | NJ | State |
| ZIP Code | 07960 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 26013947 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.f4mmc.org | WebSite |
| Type Of Organization Other | X | TypeOfOrganizationOther |
| Type Of Org Other Description | 501c3 | TypeOfOrgOtherDescription |
| Year Formation | 1995 | YearFormation |
| State Legal Domicile | NJ | StateLegalDomicile |
| Activity Or Mission Description | The Foundation for Morristown Medical Center is a not-for-profit fundraising organization which solicits funds in its general appeal to support both Morristown Medical Center , which is a division of AHS Hospital Corporation, and the community as the Foundation's Board may deem appropriate. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 33 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 25 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 251 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 14749701 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 20627013 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 0 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1667862 | InvestmentIncomePriorYear |
| Investment Income Current Year | 2309286 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 16958 | OtherRevenuePriorYear |
| Other Revenue Current Year | -185302 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 16434521 | TotalRevenuePriorYear |
| Total Revenue Current Year | 22750997 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 7050902 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 7006466 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 860628 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 1098357 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 234312 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 345860 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 1240975 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 105860 | OtherExpensePriorYear |
| Other Expenses Current Year | 121790 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 8251702 | TotalExpensesPriorYear |
| Total Expenses Current Year | 8572473 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 8182819 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 14178524 | RevenuesLessExpensesCY |
| Total Assets BOY | 83644648 | TotalAssetsBOY |
| Total Assets EOY | 101311235 | TotalAssetsEOY |
| Total Liabilities BOY | 3270812 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 3008014 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 80373836 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 98303221 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | To inspire community philanthropy to advance exceptional health care for patients at Morristown Medical Center. The objective is to use philanthropy to preserve and expand the Medical Center's programs and services in patient care, clinical research, medical and public health education, and preventive medicine. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 7250359 | Expense |
| Grants | 7006466 | Grants |
| Description | This return consists of a standalone Foundation which is a not-for-profit fundraising organization which solicits funds in its general appeal to support both Morristown Medical Center and the Community as deemed appropriate. | Description |
| Total Program Service Expense | 7250359 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 0 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 1 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 1 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 1 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 1 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 1 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 33 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 25 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | NJ | StatesWhereCopyOfReturnIsFiled |
| States Where Copy Of Return Is Filed | NY | StatesWhereCopyOfReturnIsFiled |
| States Where Copy Of Return Is Filed | PA | StatesWhereCopyOfReturnIsFiled |
| States Where Copy Of Return Is Filed | FL | StatesWhereCopyOfReturnIsFiled |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Ken Butkowski | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 9734512005 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 Madison Avenue - Box 920 | AddressLine1 |
| City | Morristown | City |
| State | NJ | State |
| ZIP Code | 07960 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (40 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Average Hours Per Week RelatedAverageHoursPerWeekRelated | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| Christopher J Baldwin | ||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | |||
| William D Bruen Jr | ||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | |||
| Richard Diegnan | ||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | |||
| John A Gerson | ||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | |||
| Abbie Giordano | ||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | |||
| Daniel D Harding | ||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | |||
| Cathy Markey Huff Esq | ||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | |||
| William Ju MD | ||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | |||
| Daniel Lehrhoff | ||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | |||
| Gaines Mimms MD | ||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | |||
| Trish O'Keefe | ||||||||
| Trustee | 2.00 | X | 0 | 361448 | 61135 | 37.50 | ||
| Grant Van Siclen Parr MD | ||||||||
| Trustee | 2.00 | X | 0 | 50000 | 0 | 25.00 | ||
| Leslie C Quick III | ||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | |||
| Marc Robinson | ||||||||
| trustee | 2.00 | X | 0 | 0 | 0 | |||
| Anne S Rooke | ||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | |||
| Roberth A Sameth | ||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | |||
| George Saunders | ||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | |||
| J Peter Simon | ||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | |||
| Mark J Simon | ||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | |||
| David Shulkin MD | ||||||||
| Trustee | 2.00 | X | 0 | 907984 | 330356 | 37.50 | ||
| Karen Walsh | ||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | |||
| Finn Wentworth | ||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | |||
| Beth Wipperman | ||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | |||
| Shari Bunks Geller | ||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | |||
| Harvey Gerhard MD | ||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | |||
| Richard Groyeb | ||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | |||
| William Greenblatt | ||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | |||
| Damion A Martins MD | ||||||||
| Trustee | 2.00 | X | 0 | 518031 | 100406 | 37.50 | ||
| Daniel Pyo MD | ||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | |||
| Walter Rosenfeld MD | ||||||||
| Trustee | 2.00 | X | 0 | 478226 | 32606 | 37.50 | ||
| Gil Santaliz | ||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | |||
| Paul Sturman | ||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | |||
| Susan Walter | ||||||||
| Trustee | 2.00 | X | 0 | 0 | 0 | |||
| James F Quinn | ||||||||
| Chief Development Officer | 37.50 | 0 | 335600 | 39906 | X | |||
| Cynthia W O'Donnell JD | ||||||||
| Director of Gift Planning | 37.50 | 0 | 150234 | 9147 | X | |||
| Hyona Revere | ||||||||
| Director of Major Gifts | 37.50 | 0 | 143042 | 6576 | X | |||
| Christine Hajsok | ||||||||
| Director of Finance | 37.50 | 0 | 145127 | 9006 | X | |||
| Regina Diverio | ||||||||
| Director-Communications | 37.50 | 0 | 123173 | 4908 | X | |||
| Bonnie Gannon | ||||||||
| Director-Relations | 37.50 | 0 | 115599 | 10206 | X | |||
| Susan Johns | ||||||||
| Major Gifts | 37.50 | 0 | 106378 | 2976 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 3434842 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 607228 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Fundraising Events | 548303 | FundraisingEvents |
| All Other Contributions | 20078710 | AllOtherContributions |
| Noncash Contributions | 146582 | NoncashContributions |
| Total Contributions | 20627013 | TotalContributions |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2140604 | TotalRevenueColumn |
| Exclusion | $2,140,604 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 3124998 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 2956316 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 168682 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 168682 | TotalRevenueColumn |
| Exclusion | $168,682 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 104645 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 548303 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 306344 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -201699 | TotalRevenueColumn |
| Exclusion | -$201,699 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Gaming | 16687 | GrossIncomeGaming |
| Gaming Direct Expenses | 290 | GamingDirectExpenses |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 16397 | TotalRevenueColumn |
| Exclusion | $16,397 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 22750997 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $2,123,984 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6295896 | Total |
| Program Services | 6295896 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 710570 | Total |
| Program Services | 710570 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 933940 | Total |
| Program Services | 243893 | ProgramServices |
| Fundraising | 690047 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 164417 | Total |
| Fundraising | 164417 | Fundraising |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7825 | Total |
| Management And General | 7825 | ManagementAndGeneral |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 345860 | Total |
| Fundraising | 345860 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24248 | Total |
| Fundraising | 24248 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16403 | Total |
| Fundraising | 16403 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 48296 | Total |
| Management And General | 48296 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8987 | Total |
| Management And General | 8987 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12380 | Total |
| Management And General | 12380 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3651 | Total |
| Management And General | 3651 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8572473 | Total |
| Program Services | 7250359 | ProgramServices |
| Management And General | 81139 | ManagementAndGeneral |
| Fundraising | 1240975 | Fundraising |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8327975 | BOY |
| EOY | 14329033 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30006728 | BOY |
| EOY | 39959754 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41685739 | BOY |
| EOY | 45111789 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3624206 | BOY |
| EOY | 1910659 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 83644648 | BOY |
| EOY | 101311235 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1621099 | BOY |
| EOY | 1426337 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1649713 | BOY |
| EOY | 1581677 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3270812 | BOY |
| EOY | 3008014 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20194483 | BOY |
| EOY | 24008102 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33345456 | BOY |
| EOY | 46835412 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26833897 | BOY |
| EOY | 27459707 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 80373836 | BOY |
| EOY | 98303221 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 83644648 | BOY |
| EOY | 101311235 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 14178524 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 5849972 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | -2099111 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Both | X | FinancialStatementBoth |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 12423658 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 9056345 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 11881492 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 14766658 | CurrentTaxYearMinus1Year |
| Current Tax Year | 20441711 | CurrentTaxYear |
| Total | 68569864 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 12423658 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 9056345 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 11881492 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 14766658 | CurrentTaxYearMinus1Year |
| Current Tax Year | 20441711 | CurrentTaxYear |
| Total | 68569864 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amounts Subst Contributors Total | 4763806 | AmountsSubstContributorsTotal |
| Public Support Total170 | 63806058 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2015776 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1198917 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2797866 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1511954 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2140604 | CurrentTaxYear |
| Total | 9665117 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 78234981 | TotalSupport |
| Public Support Pertcentage170 | 0.81560 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.75620 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 60179353 | BeginningOfYearBalance |
| Contributions | 18844913 | Contributions |
| Investment Earnings Or Losses | 4371231 | InvestmentEarningsOrLosses |
| Other Expenditures | 9100378 | OtherExpenditures |
| End Of Year Balance | 74295119 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 60633886 | BeginningOfYearBalance |
| Contributions | 12989768 | Contributions |
| Investment Earnings Or Losses | 148154 | InvestmentEarningsOrLosses |
| Other Expenditures | 13592455 | OtherExpenditures |
| End Of Year Balance | 60179353 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 57108691 | BeginningOfYearBalance |
| Contributions | 9557598 | Contributions |
| Investment Earnings Or Losses | 4280237 | InvestmentEarningsOrLosses |
| Other Expenditures | 10312640 | OtherExpenditures |
| End Of Year Balance | 60633886 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 54655373 | BeginningOfYearBalance |
| Contributions | 7307198 | Contributions |
| Investment Earnings Or Losses | 3030613 | InvestmentEarningsOrLosses |
| Other Expenditures | 7884493 | OtherExpenditures |
| End Of Year Balance | 57108691 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 58266400 | BeginningOfYearBalance |
| Contributions | 9952666 | Contributions |
| Investment Earnings Or Losses | -2392838 | InvestmentEarningsOrLosses |
| Other Expenditures | 11170855 | OtherExpenditures |
| End Of Year Balance | 54655373 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 0.40000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.60000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
| Total Of Book Value Land Buildings | 0 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Annuities Payable | Description |
| Amount | $1,581,677 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1581677 | TotalOfAmounts |
| Tot Revenue Etc Audited Fincl Stmt | 22750997 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 22750997 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 22750997 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 8572473 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 8572473 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 8572473 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Description of Intended Use of Endowment Funds: | Identifier |
| Return Reference | Part V, Line 4: | ReturnReference |
| Explanation | The Foundation for Morristown Medical Center (the "Foundation")is a not-for-profit fundraising organization which solicits funds in its general appeal to support both Morristown Medical Center , which is a divison of AHS Hospital Corporation, and the community as the Foundation's Board may deem appropriate. The by-laws of the Foundation were amended on September 27, 2007, to provide that funds received by the Foundation after the date of the amendment may be used for the benefit of the Overlook Division of AHS Hospital Corporation upon approval of the Executive Committee of the Board of the Foundation. | Explanation |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Mail Solicitations | X | MailSolicitations |
| Email Solicitations | X | EmailSolicitations |
| Phone Solicitations | X | PhoneSolicitations |
| In Person Solicitations | X | InPersonSolicitations |
| Solicitation Of Non Govt Grants | X | SolicitationOfNonGovtGrants |
| Special Fundraising Events | X | SpecialFundraisingEvents |
| Agreement Ref Fundraising | 1 | AgreementRefFundraising |
Fundraiser Activity Information FundraiserActivityInformation (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | ActivityActivity | Fundraiser Control Of FundsFundraiserControlOfFunds | Gross ReceiptsGrossReceipts | Amount Retained By ContractorAmountRetainedByContractor | Net To OrganizationNetToOrganization |
|---|---|---|---|---|---|---|---|---|
| Jay Angeletti Group | ||||||||
| 17 Village Road | New Vernon | NJ | 07976 | Consulting and Fundraising | 0 | 7535019 | 67100 | 7467919 |
| Bliss Direct Mail | ||||||||
| 641 15th Ave NE | Saint Joseph | MN | 56374 | Direct Mail | 0 | 187116 | 48052 | 139064 |
| Share Group | ||||||||
| Po Box 55183 | Boston | MA | 02205 | Telemarketing | 0 | 97649 | 39960 | 57689 |
| Convio | ||||||||
| PO Box 671445 | Dallas | TX | 75267 | Internet | 0 | 37601 | 16394 | 21207 |
| Harris Connect | ||||||||
| 1511 Route 22 | Brewster | NY | 10509 | Direct Mail | 0 | 13526 | 174355 | -160829 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Gross Receipts | 7870911 | TotalGrossReceipts |
| Total Retained By Contractors | 345861 | TotalRetainedByContractors |
| Total Net To Organization | 7525050 | TotalNetToOrganization |
| Licensed States | NJ | LicensedStates |
| Licensed States | NY | LicensedStates |
| Licensed States | PA | LicensedStates |
| Licensed States | FL | LicensedStates |
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | Watching Goryeb Grow | NameOfEvent1 |
| Gross Receipts Event1 | 449990 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 374040 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 75950 | GrossRevenueEvent1 |
| Food And Beverage Event1 | 81515 | FoodAndBeverageEvent1 |
| Entertainment Event1 | 23727 | EntertainmentEvent1 |
| Other Direct Expenses Event1 | 150220 | OtherDirectExpensesEvent1 |
| Name Of Event2 | Sam's Comedy | NameOfEvent2 |
| Gross Receipts Event2 | 84000 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 73000 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 11000 | GrossRevenueEvent2 |
| Food And Beverage Event2 | 10290 | FoodAndBeverageEvent2 |
| Entertainment Event2 | 1000 | EntertainmentEvent2 |
| Other Direct Expenses Event2 | 347 | OtherDirectExpensesEvent2 |
| Total Number Of Other Events | 4 | TotalNumberOfOtherEvents |
| Gross Receipts Other Events | 118958 | GrossReceiptsOtherEvents |
| Charitable Contrib Other Events | 101263 | CharitableContribOtherEvents |
| Gross Revenue Other Events | 17695 | GrossRevenueOtherEvents |
| Non Cash Prizes Other Events | 471 | NonCashPrizesOtherEvents |
| Rent Facility Costs Other Events | 4645 | RentFacilityCostsOtherEvents |
| Food And Beverage Other Events | 20693 | FoodAndBeverageOtherEvents |
| Entertainment Other Events | 2500 | EntertainmentOtherEvents |
| Other Direct Expenses Other Events | 10936 | OtherDirectExpensesOtherEvents |
| Gross Receipts Total | 652948 | GrossReceiptsTotal |
| Charitable Contributions Total | 548303 | CharitableContributionsTotal |
| Gross Revenue Total Events | 104645 | GrossRevenueTotalEvents |
| Non Cash Prizes Total Events | 471 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 4645 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 112498 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 27227 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 161503 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 306344 | DirectExpenseSummaryEvents |
| Net Income Summary | -201699 | NetIncomeSummary |
Gaming Information GamingInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Revenue Other Gaming | 16687 | GrossRevenueOtherGaming |
| Other Direct Expenses Other Gaming | 290 | OtherDirectExpensesOtherGaming |
| Volunteer Labor Other Gaming | 1 | VolunteerLaborOtherGaming |
| Gross Revenue Total Gaming | 16687 | GrossRevenueTotalGaming |
| Other Direct Expenses Total Gaming | 290 | OtherDirectExpensesTotalGaming |
| Direct Expense Summary Gaming | 290 | DirectExpenseSummaryGaming |
| Net Gaming Income Summary | 16397 | NetGamingIncomeSummary |
| Field | Value | IRS element (for citing) |
|---|---|---|
| States Where Gaming Conducted | NJ | StatesWhereGamingConducted |
| Licensed | 1 | Licensed |
| License Suspended Etc | 0 | LicenseSuspendedEtc |
| Gaming With Nonmembers | 0 | GamingWithNonmembers |
| Member Of Other Entity | 0 | MemberOfOtherEntity |
| Percentage Of Gaming Own Facility | 0.50000 | PercentageOfGamingOwnFacility |
| Percentage Of Gaming Othr Facility | 0.50000 | PercentageOfGamingOthrFacility |
| Name Of Gaming Rec Keeper Person | Christine Hajsok | NameOfGamingRecKeeperPerson |
Address Of Gaming Rec Keeper US AddressOfGamingRecKeeperUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 475 South Street | AddressLine1 |
| City | Morristown | City |
| State | NJ | State |
| ZIP Code | 07960 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contract With3rd Party For Gam Rev | 0 | ContractWith3rdPartyForGamRev |
| Gaming Manager Name Person | Christine Hajsok | GamingManagerNamePerson |
| Gaming Manager Compensation | 149117 | GamingManagerCompensation |
| Gaming Manager Services Provided | The Director of Finance for the Foundation for Morristown Medical Center. She manages and oversees all fundraising activities for this entity. | GamingManagerServicesProvided |
| Gaming Manager Is Employee | X | GamingManagerIsEmployee |
| Charitable Distrib Required | 1 | CharitableDistribRequired |
| Amount Distributed | 0 | AmountDistributed |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Morristown Medical Center | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 Madison Avenue | AddressLine1 |
| City | Morristown | City |
| State | NJ | State |
| ZIP Code | 07960 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 521958352 | EINOfRecipient |
| IRC Section | 501(c)(3) | IRCSection |
| Amount Of Cash Grant | 6295896 | AmountOfCashGrant |
| Purpose Of Grant | Program Services. | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part III Form990ScheduleIPartIII (2 entries)
| Type Of GrantTypeOfGrant | Number Of RecipientsNumberOfRecipients | Amount Of Cash GrantAmountOfCashGrant |
|---|---|---|
| Project Independence | 108 | 690570 |
| Nursing School Tuition Grants | 8 | 20000 |
Form990 Schedule I Part IV Form990ScheduleIPartIV (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Procedure for Monitoring Grants in the U.S.: | Part I, Line 2: | Schedule I, Part I, Line 2: The organization uses due diligence in the process for reviewing and selecting grant recipients and is comfortable that the grants are used for their intended purpose. The grants issued were made to related organizations to further their exempt purpose. |
| Schedule I, Part III, Line 1 | Project Independence | Project Independence is a grant funding project to help Morristown Medical Center patients over a temporary financial hardship. It is overseen by a volunteer committee made up of care providers from different areas of the Medical Center. They meet every two months to review detailed applications. An application can only be submitted by a case worker who would be aware of the financial position of the patient and is working with them to secure other types of help including prescription assistance, food stamps, Social Security disability, etc. Most of the recommenders are social workers or patient liaisons. Grants up to $8,000 are made payable directly to the individual. It is understood that they will use the funds as laid out in the application. Normally, the case worker will continue to work with the individual and can help the individual use the funds in the most efficient way. |
| Schedule I, Part III, Line 2 | Scholarship Awards | WAMMC Scholarship Award Criteria Award criteria must include but are not limited to: 1. The applicant being a full time, on-site MMC or ARI employee who is providing direct nursing care or involved in other activities that impact patient care. Applicant whose employment status changes during the award year, will not receive funding. 2. Supervisor (the person responsible for your performance review) and colleague recommendation(s) as this information is critical in our decision making process. 3. Hospital, community and professional activities. 4. Request for aid should be for studies not covered by Atlantic Health's tuition reimbursement plan. WAMMC defines the academic year as September through August. 5. Nursing credentials held by applicant. 6. MD and DDS degrees are not supported. WAMMC Scholarship Funds - What can they be used for? 1. WAMMC will award scholarship funds for courses that are specific for healthcare, i.e., English, art, history, math, physical education courses are not supported. MD and DDS degrees are not supported. 2. WAMMC will award scholarship funds for books needed for a specific course, prep or review courses. 3. MD and DDS degrees are not supported. Applicant's Responsibilities: Applications will be available as of July 1 and must be completed and submitted, along with the necessary recommendations, on or before October 1. 1. Applicant must be a current employee of MMC or ARI, and remain a full time employee and work on site at AHS's Morristown Medical Center. 2. The applicant must enroll in a course with a recognized health care program accreditation, review program, or be accepted for a clinical experience at MMC or ARI department to be able to apply for a WAMMC scholarship. 3. It is the responsibility of the applicant to ensure that by October 1 the WAMMC Scholarship Committee has received all information required for their decision. Scholarship Application Process Submitting a completed application does not obligate WAMMC, a volunteer based organization, to award a scholarship. Completed applications are due October 1. No application received after October 1 will be considered. A complete application requires the following items: 1. Completed application. Please do not use abbreviated form or acronyms and remember to include a course description. 2. Completed Reference Form(s). This information is critical in our decision making process. The WAMMC Scholarship Committee will notify the applicant of its decision by November 1. The Scholarship Committee may award the total amount of aid requested or a portion of the aid requested. Requirements for Reference Form Ask your supervisor to complete and forward the WAMMC Reference Form. Additional references may be submitted and is recommended. All references are due October 1. Requirements for Scholarship Payments WAMMC scholarship payments will be made only after the semester, course or clinical experience is successfully completed. To receive scholarship award payment for the approved course, you must: 1. Must still be a full time employee and work on site at AHS Morristown Medical Center. 2. Supply a formal school transcript for the approved course(s) with grade(s). A graded course is only reimbursed if the applicant has received a minimum of 2.0 on a 4.0 scale. 3. For education that does not have a grade, supply a certificate or letter from the provider showing satisfactory completion of classes (e.g. pass/fail). 4. If aid was for a clinical experience, provide a letter from your MMC or ARI Department Supervisor, or MMC or ARI Program Coordinator stating that your work met their expectations. 5. An official itemized tuition bill must accompany the formal school transcript. 6. The above information must be received by the WAMMC Scholarship Committee no later than 90 days after course completion. 7. It is the responsibility of the applicant to ensure that the WAMMC Scholarship Committee has received all the required information for the scholarship payment. Requirements for Book Scholarship Payments To receive scholarship award payment for the approved book(s), you must: 1. Supply a formal school transcript or certificate or letter from the provider of the course showing satisfactory completion of classes. 2. Provide a receipt for the book(s). Receipt must show the school bookstore name, the specific title of the book and the course name. If a book is purchased from another source, the receipt must have the name of the vendor, specific title of the book and information from the school, teacher or vendor, stating the book was required. 3. The above information must be received by the WAMMC Scholarship Committee no later than 90 days after course completion. 4. It is the responsibility of the applicant to ensure that the WAMMC Scholarship Committee has received all the required information for reimbursement. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Trish O'Keefe | ||||||||||||||
| Trustee | 0 | 305296 | 0 | 53200 | 0 | 2952 | 0 | 59200 | 0 | 1935 | 0 | 422583 | 0 | 53200 |
| David Shulkin MD | ||||||||||||||
| Trustee | 0 | 641143 | 0 | 241000 | 0 | 25841 | 0 | 326500 | 0 | 3856 | 0 | 1238340 | 0 | 0 |
| Damion A Martins MD | ||||||||||||||
| Trustee | 0 | 459811 | 0 | 57800 | 0 | 420 | 0 | 95200 | 0 | 5206 | 0 | 618437 | 0 | 0 |
| Walter Rosenfeld MD | ||||||||||||||
| Trustee | 0 | 438794 | 0 | 28800 | 0 | 10632 | 0 | 26400 | 0 | 6206 | 0 | 510832 | 0 | 28800 |
| James F Quinn | ||||||||||||||
| Chief Development Officer | 0 | 220041 | 0 | 28900 | 0 | 86659 | 0 | 35700 | 0 | 4206 | 0 | 375506 | 0 | 28900 |
| Cynthia W O'Donnell JD | ||||||||||||||
| Director of Gift Planning | 0 | 144260 | 0 | 4700 | 0 | 1274 | 0 | 4500 | 0 | 4647 | 0 | 159381 | 0 | 4700 |
| Christine Hajsok | ||||||||||||||
| Director of Finance | 0 | 141712 | 0 | 3000 | 0 | 415 | 0 | 4600 | 0 | 4406 | 0 | 154133 | 0 | 3000 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | Part I, Line 6 | ReturnReference |
| Explanation | An annual incentive plan exists for the Foundation's Director. The incentive plan distributes bonuses to the Director based on performance results on various performance measurements. The performance measurements include: - Total Philanthropy - Cost per dollar raised - Budget - Soliciatations of $100K or more - General Gifts - Renewal - Mail & Phone - Special Gifts - Acquisition and Renewal - Major Gifts - Donor Renewal - Cost - Operating Gain/(Loss) - Cost - Expense per Adjusted Admission/CMIA System - Service - Patient Satisfaction Overall - Growth - IP Admissisions - Growth - OP Visits - People - Employee Engagement Index - Quality & Safety - Nosocomial Infection Maker - Quality & Safety - Mortality - Individual Goals The above performance measures have the following three specific performance goals in order to determine any incentive award: Threshold Target Maximum These above amounts were paid by a related organization. | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| Hess Corp | |||
| Refer to below. | 10278149 | Performance. Christopher J Baldwin (Board Member-Trustee) is an Executive Officer of Hess Corp. AHS Hospital Corp (A related organization) paid Hess Corp. $10,278,149 during 2012 for applicable goods. Transaction is considered to be negotiated at arms-length. | 0 |
| Pfizer | |||
| Refer to below. | 174154 | Performance. Paul Sturman (Board Member-Trustee) is an employee of Pfizer. AHS Hospital Corp (A related organization) paid Pfizer $174,154 during 2012 for applicable goods. Transaction is considered to be negotiated at arms-length. | 0 |
Schedule M IRS990ScheduleM
Works Of Art WorksOfArt
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 226 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 4600 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | Sale of comp property | MethodOfDeterminingRevenues |
Books And Publications BooksAndPublications
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Noncash Contribs Rptd F990 | 1445 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | Sale of comp property | MethodOfDeterminingRevenues |
Clothing And Household Goods ClothingAndHouseholdGoods
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Noncash Contribs Rptd F990 | 18475 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | Sale of comp property | MethodOfDeterminingRevenues |
Food Inventory FoodInventory
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Noncash Contribs Rptd F990 | 2598 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | Sale of comp property | MethodOfDeterminingRevenues |
Drugs And Medical Supplies DrugsAndMedicalSupplies
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Noncash Contribs Rptd F990 | 1115 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | Sale of comp property | MethodOfDeterminingRevenues |
Other Non Cash Contributions Table OtherNonCashContributionsTable (4 entries)
| Non Cash CheckboxNonCashCheckbox | DescriptionDescription | Number Of ContributionsNumberOfContributions | Noncash Contribs Rptd F990NoncashContribsRptdF990 | Method Of Determining RevenuesMethodOfDeterminingRevenues |
|---|---|---|---|---|
| X | Gift Cards | 53 | 32264 | Cash value of cards |
| X | Electronics | 19 | 9990 | Sale of comp property |
| X | Toys | 109 | 35503 | Sale of comp property |
| X | Entertainment | 37 | 40592 | Cash value of gift |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 1 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section A, line 2 | Leslie Quick, III, Christopher Baldwin and Rich Diegnan have a "business relationship". All three are individual trustees within the organization. | |
| Form 990, Part VI, Section A, line 6 | As per the by-laws, each of the entities has one "member", that being Atlantic Health System, Inc. There are no other members or classes of membership whatsoever as indicated in the by-laws. | |
| Form 990, Part VI, Section A, line 7a | Atlantic Health System, Inc. is the only "member" which wholly owns the Foundation for Morristown Medical Center. As a result, Atlantic Health System, Inc. may elect the members of the governing bodies for each of the entities. | |
| Form 990, Part VI, Section A, line 7b | Atlantic Health System, Inc. is the only "member" which wholly owns the Foundation for Morristown Medical Center. As a result, Atlantic Health System, Inc. approves the decisions of the governing bodies. | |
| Form 990, Part VI, Section B, line 11 | The final draft of the IRS 990 was distributed to the "Accounting Sub-Committee" for their review. The "Accounting Sub-Committee" then presents it to the Financial Oversight Committee who will then present it to the Board of Directors. | |
| Form 990, Part VI, Section B, line 12c | In conjunction wtih Atlantic Health System (Parent), the Foundation for Morristown Medical Center requires disclosure of potential conflicts. This policy governs all personnel at the Foundation, including Board Members. Additionally, the Board Committee members must fill out annual disclosures with specific questions regarding potential conflicts. For potential conflicts involving employees, conflicts involving business relationships require prior disclosure and approval by the Compliance Officer (General Counsel). Conflicts involving Board members require approval from the Compliance Officer and the head of the Audit Committee, who may refer those conflicts to the Compliance Committee of the Board. Restrictions are fact-dependent, but may include recusal from deliberations regarding subject matter affected by the conflict. | |
| In conjunction with Atlantic Health System (Parent): Line 15A: - A review of officer compensation by an independent 3rd party (Integrated Healthcare Strategies) is completed every year. The most recent survey was conducted in 2012. Officers include President and CEO AH, VP HR & CAO, VP Finance & CFO, VP Legal Affairs, VP Quality, VP Government Affairs, VP Information Services & CIO, VP Finance & Treasurer, VP AH & President OH and VP AH. - On behalf of Atlantic Health, Integrated Healthcare Strategies conducts an annual total compensation survey based on appropriate comparability data for like positions in like organizations. - The results of the survey are presented to the Executive Compensation Committee of the board which documents the findings and recommendations in committee minutes. Line 15b: - Compensation for key physicians is determined by soliciting salary data from 3 to 4 published sources. These salary recommendations are then reviewed with the MD Contract Committee and approved by the Physician Compensation Committee of the board. | ||
| Form 990, Part VI, Section C, line 18 | Currently the Foundation for Morristown Medical Center retains copies of the filed IRS 990 for the last three years and IRS Form 1023 with the most senior management's assistant. Public disclosure of these IRS 990's can be made at any time at each of the organization's sites. In addition, the 990 is posted on the website "www.foundationcenter.org" and "guidestar.org". | |
| Form 990, Part VI, Section C, line 19 | The organization does not currently make it's financial statements open to public disclosure but the statement of financial position is available by accessing the Form 990 from the website. The governing documents and conflict of interest polices are not currently made available to the public. | |
| Form 990, Part XI, line 9: | Distributions to Morristown Division-Capital -2,099,111. | Changes in Net Assets or Fund Balances: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| AHS Hospital Corp | |||||||||||
| 475 South Street | Morristown | NJ | 07960 | 521958352 | Healthcare | NJ | 501(c)(3) | Line 3 | Atlantic Health System Inc | 1 | |
| Atlantic Ambulance Corporation | |||||||||||
| 475 South Street | Morristown | NJ | 07960 | 223820288 | Healthcare Transportation | NJ | 501(c)(3) | Line 9 | Atlantic Health System Inc | 1 | |
| Atlantic Health System Inc | |||||||||||
| 475 South Street | Morristown | NJ | 07960 | 223380375 | Human Health through AHS Hospital Corp. | NJ | 501(c)(3) | Line 11a, I | 0 | N/A | |
| Newton Medical Center Foundation | |||||||||||
| 175 High Street | Newton | NJ | 07860 | 222618102 | Administers donations, grants and bequets and performs fundraising | NJ | 501(c)(3) | Line 7 | Atlantic Health System Inc | 1 | |
| Prime Care Inc | |||||||||||
| 175 High Street | Newton | NJ | 07860 | 222759566 | Provides home health and other healthcare services | NJ | 501(c)(3) | Line 9 | Atlantic Health System Inc | 1 | |
| North Jersey Health Care Properties Inc | |||||||||||
| 175 High Street | Newton | NJ | 07860 | 223519709 | Owns commercial buildings and conducts leasing activities | NJ | 501(c)(2) | Atlantic Health System Inc | 1 | ||
| PRACTICE ASSOCIATES MEDICAL GROUP | |||||||||||
| 475 South Street | Morristown | NJ | 07960 | 202088165 | PHYSICIAN SERVICES | NJ | 501(c)(3) | Line 11a, I | Atlantic Health System Inc | 1 | |
Form990 Schedule R Part III Form990ScheduleRPartIII (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner |
|---|---|---|---|---|---|---|---|---|
| Morris Photopheresis | ||||||||
| 100 Madison Avenue | Morristown | NJ | 07960 | 223314012 | Healthcare Research | NJ | 0 | 0 |
| Affiliated Collection Services LLC | ||||||||
| 17 Prospect Street | Morristown | NJ | 07960 | 270555659 | Colelction Services | NJ | 0 | 0 |
| Morristown Medical Investors | ||||||||
| 200 American Road | Morris Plains | NJ | 07950 | 650840535 | Real Estate | NJ | 0 | 0 |
| Primary Care Partners LLC | ||||||||
| 475 South Street | Morristown | NJ | 07960 | 274980253 | Physician Services | NJ | 0 | 0 |
Form990 Schedule R Part IV Form990ScheduleRPartIV (11 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|
| Atlantic Health Management Corp and Subsidiaries | ||||||||||
| 200 American Road | Morris Plains | NJ | 07950 | 223538027 | Health | NJ | N/A | C | 0 | |
| AHS Insurance Company LTD | ||||||||||
| 200 American Road | Morris Plains | NJ | 07950 | 223380375 | Insurance | NJ | C | 0 | Atlantic Health System Inc | |
| Nutley Medical Care PA | ||||||||||
| 100 Madison Avenue | Morristown | NJ | 07960 | 223645010 | Healthcare | NJ | C | 0 | Atlantic Health System Inc | |
| Non-Invasice Diagnstics PA | ||||||||||
| 100 Madison Avenue | Morristown | NJ | 07960 | 202027439 | Healthcare | NJ | C | 0 | Atlantic Health System Inc | |
| Speciality Care of Practice Associates PA | ||||||||||
| 100 Madison Avenue | Morristown | NJ | 07960 | 030376428 | Healthcare | NJ | C | 0 | Atlantic Health System Inc | |
| Maternal Fetal Medicine of PRactice Associates PA | ||||||||||
| 100 Madison Avenue | Morritown | NJ | 07960 | 030376421 | Healthcare | NJ | C | 0 | Atlantic Health System Inc | |
| Madison Pediatrics PA | ||||||||||
| 100 Madison Avenue | Morristown | NJ | 07960 | 223645007 | Healthcare | NJ | C | 0 | Atlantic Health System Inc | |
| North Jersey Health Ventures Inc | ||||||||||
| 175 High STreet | Newton | NJ | 07860 | 222705732 | Investments in healthcare related joint ventures | NJ | C | 0 | AHS Investment Corp | |
| AHS ACO LLC | ||||||||||
| 475 South Street | Morristown | NJ | 07960 | 273800813 | Physician Practice | NJ | C | 0 | AHS Investment Corp | |
| The Northwest New Jersey MedicalSurgicalAlliance PC | ||||||||||
| 175 High Street | Newton | NJ | 07860 | 450577942 | Healthcare Services | NJ | C | 0 | AHS Investment Corp | |
| The Northwest New Jersey Urgent Care Alliance PC | ||||||||||
| 175 High Street | Newton | NJ | 07860 | 830492357 | Healthcare Services | NJ | C | 0 | Atlantic Health System Inc | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| AHS Hospital Corp | ||
| Q | 10422491 | Actual amount of transaction. |
| AHS Hospital Corp | ||
| B | 19723836 | Actual amount of transaction. |
| AHS Hospital Corp | ||
| B | 2099111 | Actual amount of transaction. |
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