FURP.ORG / PUBLIC DATA EXPLORER

HACKENSACK MERIDIAN HEALTH INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
HACKENSACK MERIDIAN HEALTH INC (EIN 22-1714106)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-15
IRS object ID
201233209349305433
Schema version
2011v1.3
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-11-15T13:39:04-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1EISNERAMPER LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12015 LINCOLN HIGHWAY PO BOX 988AddressLine1
CityEDISONCity
StateNJState
ZIP Code08818ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN221714106EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CARRIER CLINIC INCBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% C RICHARD SARLEInCareOfName
Name ControlCARRNameControl
Phone9082811000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 147AddressLine1
CityBELLE MEADCity
StateNJState
ZIP Code085020147ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameC RICHARD SARLEName
TitlePRESIDENT & CEOTitle
Date Signed2012-11-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameRICHARD SACKIN CPAName
Phone7322871000Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonC RICHARD SARLENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO BOX 147AddressLine1
CityBELLE MEADCity
StateNJState
ZIP Code08502ZIPCode
FieldValueIRS element (for citing)
Gross Receipts82261185GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.CARRIERCLINIC.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1910YearFormation
State Legal DomicileNJStateLegalDomicile
Activity Or Mission DescriptionCARRIER CLINIC'S PRIMARY ACTIVITIES ARE INPATIENT PSYCHIATRIC AND ADDICTION, ADOLESCENT RESIDENTIAL AND SPECIAL EDUCATION FOR ADOLESCENTS.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees903TotalNbrEmployees
Total Gross UBI6620TotalGrossUBI
Net Unrelated Business Txbl Income2674NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year96716ContributionsGrantsPriorYear
Contributions Grants Current Year133977ContributionsGrantsCurrentYear
Program Service Revenue Prior Year56276879ProgramServiceRevenuePriorYear
Program Service Revenue CY56394493ProgramServiceRevenueCY
Investment Income Prior Year1818106InvestmentIncomePriorYear
Investment Income Current Year2380652InvestmentIncomeCurrentYear
Other Revenue Prior Year90950OtherRevenuePriorYear
Other Revenue Current Year415606OtherRevenueCurrentYear
Total Revenue Prior Year58282651TotalRevenuePriorYear
Total Revenue Current Year59324728TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year1000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY1250GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year40762924SalariesEtcPriorYear
Salaries Etc Current Year41339134SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year133525TotalFundrsngExpCurrentYear
Other Expense Prior Year14615397OtherExpensePriorYear
Other Expenses Current Year14797344OtherExpensesCurrentYear
Total Expenses Prior Year55379321TotalExpensesPriorYear
Total Expenses Current Year56137728TotalExpensesCurrentYear
Revenues Less Expenses Prior Year2903330RevenuesLessExpensesPriorYear
Revenues Less Expenses CY3187000RevenuesLessExpensesCY
Total Assets BOY53520532TotalAssetsBOY
Total Assets EOY51742137TotalAssetsEOY
Total Liabilities BOY25894491TotalLiabilitiesBOY
Total Liabilities EOY21997772TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY27626041NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY29744365NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionREFER TO SCHEDULE O FOR MISSION STATEMENT.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense31277772Expense
Grants1250Grants
Revenue34223636Revenue
DescriptionPSYCHIATRIC HOSPITAL WHICH CARED FOR 3,366 INPATIENTS AND HAD A TOTAL OF 39,797 PATIENT DAYS.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense5980429Expense
Revenue6173966Revenue
DescriptionEAST MOUNTAIN SCHOOL WHICH PROVIDED QUALITY SPECIAL EDUCATION AND THERAPEUTIC SERVICES FOR 102 ADOLESCENTS AFFECTED BY BEHAVIORAL AND PSYCHIATRIC DISORDERS BASED ON 2011 AVERAGE DAILY ENROLLMENT.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense4970307Expense
Revenue5035943Revenue
DescriptionBLAKE RECOVERY CENTER WHICH CARED FOR 1,510 INPATIENTS AND HAD A TOTAL OF 9,499 PATIENT DAYS.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp9509030TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev9899887TotalOfOtherProgramServiceRev
Total Program Service Expense51737538TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiestrueFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109624NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees903NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionstrueQuidProQuoContributions
Quid Pro Quo DisclosuretrueQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledNJStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonC RICHARD SARLENamePerson
Telephone Number9082811000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1252 ROUTE 601AddressLine1
CityBELLE MEADCity
StateNJState
ZIP Code085020147ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (23 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
C RICHARD SARLE
PRESIDENT & CEO40.0XX1038412020309
ALLAN CLELLAND
TRUSTEEX
THOMAS G AMATO
CHAIRMANX
CAROL HOLZER
TRUSTEEX
JEAN M KRAUSS
TRUSTEEX
GORDON PINGICER
TRUSTEEX
BRUCE HERDMAN PHD
TRUSTEEX
SUSAN Q SWAIN DNP
TRUSTEEX
ANN DAMSGAARD
TRUSTEEX
JOHN KOLLIGAN JR PHD
VICE CHAIRMANX
ASMA NISAR MD
MEDICAL STAFF PRESIDENT40.0X25722334098
MARIE HASSON MD
MEDICAL DIRECTOR40.0XX127424582
THOMAS R WILSON
TRUSTEEX
RANDOLPH JACOBSON
VP & CFO40.0X223997033787
DAVID GREENSPAN MD
MEDICAL DIRECTOR40.0X159227014584
MARY PAWLIKOWSKI
VICE PRESIDENT40.0X21665623787
PATRICIA TOOLE
VP/COMPLIANCE OFFICER40.0X19460410779
CAROL KOSZTYO
VICE PRESIDENT40.0X19511433757
UMESH MEHTA MD
PSYCHIATRIST40.040851442072X
LINDA LANG MD
PSYCHIATRIST40.017499620684X
CLAIRE MARSH MD
PSYCHIATRIST40.022414634818X
WOJCIECH SZULACZKOWSKI MD
PSYCHIATRIST40.024043538924X
ANTHONY MARINO MD
PSYCHIATRIST40.019412323778X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3654871TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation331959TotalOtherCompensation
Number Individuals GT100 K35NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
SODEXO INC AFFILIATES
PO BOX 905374CHARLOTTENC282905374DIETARY & HOUSEKEEP1821328
NASS TECH MECHANICAL LLC
1204 LOWER FERRY ROADEWINGNJ08618HVAC SERVICES164922
GAMIL MAKAR LLC
20 RENSHAW DRIVEMONTVILLENJ07045INTERNAL MEDICINE155000
KPMG LLP
150 JOHN F KENNEDY PARKWAYSHORT HILLSNJ07078AUDITING SERVICES136425
DRINKER BIDDLE REATH LLP
500 CAMPUS DRIVEFLORHAM PARKNJ07932LEGAL SERVICES130286
FieldValueIRS element (for citing)
Number Of Contractors GT100 K6NumberOfContractorsGT100K
All Other Contributions133977AllOtherContributions
Total Contributions133977TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
NET PATIENT SERVICES6241004915946649159466
EDUCATIONAL PROGRAMS61171061739666173966
SERVICES & MANAGEMENT5610001061061824387$236,674
FieldValueIRS element (for citing)
Total Program Service Revenue56394493TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column883454TotalRevenueColumn
Unrelated Business Revenue3493UnrelatedBusinessRevenue
Exclusion$879,961ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities24094195Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities22596997Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities1497198Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1497198TotalRevenueColumn
Unrelated Business Revenue3127UnrelatedBusinessRevenue
Exclusion$1,494,071ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events128565GrossIncomeFundraisingEvents
Fundraising Direct Expenses33661FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column94904TotalRevenueColumn
Exclusion$94,904ExclusionAmount

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Sales Of Inventory222746GrossSalesOfInventory
Cost Of Goods Sold305799CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-83053TotalRevenueColumn
Related Or Exempt Function Income-83053RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
INSURANCE SETTLEMENT900099192096$192,096
VENDING/PHONE/PHARMACY90009932556$32,556
GAIN ON ASSET REPLACEMENT900099165144$165,144

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column13959TotalRevenueColumn
Exclusion$13,959ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue403755TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column59324728TotalRevenueColumn
Related Or Exempt Function Income56074766RelatedOrExemptFunctionIncome
Unrelated Business Revenue6620UnrelatedBusinessRevenue
Exclusion$3,109,365ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total1250Total
Program Services1250ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2116394Total
Program Services171829ProgramServices
Management And General1944565ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total31624318Total
Program Services27509027ProgramServices
Management And General4014690ManagementAndGeneral
Fundraising100601Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2754300Total
Program Services2259625ProgramServices
Management And General486463ManagementAndGeneral
Fundraising8212Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1984927Total
Program Services1628432ProgramServices
Management And General350576ManagementAndGeneral
Fundraising5919Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2859195Total
Program Services2345681ProgramServices
Management And General504989ManagementAndGeneral
Fundraising8525Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total555976Total
Management And General555976ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total215362Total
Program Services367ProgramServices
Management And General214995ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total205588Total
Program Services45452ProgramServices
Management And General160136ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total47806Total
Management And General47806ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1207345Total
Program Services830156ProgramServices
Management And General377189ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total841686Total
Management And General841686ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total907493Total
Program Services493293ProgramServices
Management And General411877ManagementAndGeneral
Fundraising2323Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total204278Total
Program Services23655ProgramServices
Management And General180623ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1299898Total
Management And General1299898ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total90651Total
Program Services78538ProgramServices
Management And General12113ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total90760Total
Program Services35457ProgramServices
Management And General50567ManagementAndGeneral
Fundraising4736Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total338163Total
Management And General338163ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1174414Total
Program Services49567ProgramServices
Management And General1124847ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total978633Total
Management And General978633ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
DIETARY/ENVIRONMENTAL SVCS2131783576652073789329
PATIENT-RELATED15394391539439
BAD DEBTS15381141221252316862
MAINTENANCE/EMPLOYEE/MISC14299553426291086802524

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total56137728Total
Program Services51737538ProgramServices
Management And General4266665ManagementAndGeneral
Fundraising133525Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY3178862BOY
EOY2341989EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1812732BOY
EOY1000482EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY5044820BOY
EOY5036842EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY298127BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY103019BOY
EOY134328EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1084786BOY
EOY1145969EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis41584969LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec30307863LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY10859317BOY
EOY11277106EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY22293310BOY
EOY21797920EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY1064390BOY
EOY1030498EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY7781169BOY
EOY7977003EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY53520532BOY
EOY51742137EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY8659088BOY
EOY8731651EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY7140218BOY
EOY6447044EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY10095185BOY
EOY6819077EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY25894491BOY
EOY21997772EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY27448068BOY
EOY29481946EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY177973BOY
EOY262419EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY27626041BOY
EOY29744365EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY53520532BOY
EOY51742137EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses3187000ReconcilationRevenueExpenses
Reconcilation Other Changes-1068676ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorstrueDirectContactLegislators
Direct Contact Legislators$3,973DirectContactLegislatorsAmount
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB3973TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPART II-B, LINE 1 (I), OTHER LOBBYING ACTIVITIES:Identifier
ExplanationThis expense represents a portion of Carrier Clinic's membership dues paid to the American Hospital Association (AHA) and NJ Hospital Association (NJHA) that both associations identified to pertain to their lobbying activities on behalf of their members. OTHER DUES ARE PAID TO THE NEW JERSEY ALLIANCE FOR CHILDREN, NATIONAL ASSOCIATION OF PSYCHIATRIC HEALTH SYSTEM (NAPHS) AND NEW JERSEY ASSOCIATION OF MENTAL HEALTH AND ADDICTION AGENCIES (NJAMHAA). LOBBYING ACTIVITIES ARE PERFORMED BY THESE ASSOCIATIONS ON BEHALF OF THEIR MEMBERS. THE SPECIFIC LOBBYING ALLOCATION IS NOT AVAILABLE.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis278290OtherCostOrOtherBasis
Book Value278290BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis23477401OtherCostOrOtherBasis
Depreciation15747682Depreciation
Book Value7729719BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis9873467OtherCostOrOtherBasis
Depreciation9269360Depreciation
Book Value604107BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis7955811OtherCostOrOtherBasis
Depreciation5290821Depreciation
Book Value2664990BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings11277106TotalOfBookValueLandBuildings

Other Assets OtherAssets (5 entries)

DescriptionDescriptionBook ValueBookValue
OTHER RECEIVABLES1645717
OTHER ASSETS47870
CHARITABLE REMAINDER TRUST560914
FUNDED DEFERRED COMPENSATION249732
LAND5472770
FieldValueIRS element (for citing)
Total Book Value Other Assets7977003TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
DEFERRED COMPENSATION$953,547
DUE TO THIRD-PARTY PAYORS$1,400,374
ACCRUED PENSION AND BENEFITS$4,451,324
OTHER LIABILITIES$13,832
FieldValueIRS element (for citing)
Total Of Amounts6819077TotalOfAmounts
Total Revenue59324728TotalRevenue
Total Expenses56137728TotalExpenses
Excess Or Deficit For Year3187000ExcessOrDeficitForYear
Net Unrealized GL On Investments-2860333NetUnrealizedGLOnInvestments
Other$1,791,659OtherAmount
Total Adjustments-1068674TotalAdjustments
Excess Or Deficit Per FS2118326ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt57032723TotRevenueEtcAuditedFinclStmt
Other Revenues305799OtherRevenues
Revenue Not Rptd F990305799RevenueNotRptdF990
Revenue Subtotal56726924RevenueSubtotal
Other Revenues Not Included2597804OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt2597804RevenueNotRptdOnFinStmt
Total Revenue Per Form99059324728TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt56405724TotExpensesEtcAuditedFinclStmt
Other Expenses Included305799OtherExpensesIncluded
Expenses Not Rptd F990305799ExpensesNotRptdF990
Expenses Subtotal56099925ExpensesSubtotal
Other Expenses Not Included37803OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt37803ExpensesNotRptdOnFinStmt
Total Expenses Per Form99056137728TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)

IdentifierIdentifierExplanationExplanation
PART X, LINE 2THE CLINIC IS AN ORGANIZATION DESCRIBED IN SECTION 501(c)(3) OF THE INTERNAL REVENUE CODE AND, THEREFORE, IS EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTIONS 501(a) OF THE CODE. THE HOSPITAL IS ALSO EXEMPT FROM STATE INCOME TAXES. THE HOSPITAL RECOGNIZES INCOME TAX POSITIONS WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINABLE BASED ON THE MERITS OF THE POSITION. MANAGEMENT HAS CONCLUDED THAT THERE ARE NO MATERIAL TAX LIABILITIES THAT NEED TO BE RECORDED.
PART XI, LINE 8 - OTHER ADJUSTMENTS:MINIMUM PENSION LIABILITY 1,753,358 CHANGE IN DERIVATIVE INSTRUMENT 51,363 CHANGE IN TRUST (13,062) TOTAL PART XI, LINE 8 1,791,659
PART XII, LINE 2D - OTHER ADJUSTMENTS:COST OF GOODS SOLD 305,799 TOTAL PART XII, LINE 2D 305,799
PART XII, LINE 4B - OTHER ADJUSTMENTS:EMS FOOD RECOVERY REPORTED AS REVENUE 37,802 ACTUAL DONATIONS VS. INCOME STATEMENT 84,446 INVESTMENT INCOME 2,380,652 CONTRIBUTIONS RECEIVED 94,904 TOTAL PART XII, LINE 4B 2,597,804
PART XIII, LINE 2D - OTHER ADJUSTMENTS:COST OF GOODS SOLD 305,799 TOTAL PART XIII, LINE 2D 305,799
PART XIII, LINE 4B - OTHER ADJUSTMENTS:EMS FOOD RECOVERY REPORTED AS REVENUE 37,802 ROUNDING 1 TOTAL PART XIII, LINE 4B 37,803

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GALANameOfEvent1
Gross Receipts Event186700GrossReceiptsEvent1
Gross Revenue Event186700GrossRevenueEvent1
Rent Facility Costs Event116610RentFacilityCostsEvent1
Other Direct Expenses Event13940OtherDirectExpensesEvent1
Name Of Event2GOLF OUTINGNameOfEvent2
Gross Receipts Event225340GrossReceiptsEvent2
Gross Revenue Event225340GrossRevenueEvent2
Rent Facility Costs Event29071RentFacilityCostsEvent2
Other Direct Expenses Event2303OtherDirectExpensesEvent2
Total Number Of Other Events1TotalNumberOfOtherEvents
Gross Receipts Other Events16525GrossReceiptsOtherEvents
Gross Revenue Other Events16525GrossRevenueOtherEvents
Other Direct Expenses Other Events3737OtherDirectExpensesOtherEvents
Gross Receipts Total128565GrossReceiptsTotal
Gross Revenue Total Events128565GrossRevenueTotalEvents
Rent Facility Costs Total Events25681RentFacilityCostsTotalEvents
Other Direct Expenses Total Events7980OtherDirectExpensesTotalEvents
Direct Expense Summary Events33661DirectExpenseSummaryEvents
Net Income Summary94904NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage100DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReportfalseAnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense301663TotalCommunityBenefitExpense
Net Community Benefit Expense301663NetCommunityBenefitExpense
Percent Of Total Expense0.00550PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense2707461TotalCommunityBenefitExpense
Direct Offsetting Revenue2268979DirectOffsettingRevenue
Net Community Benefit Expense438482NetCommunityBenefitExpense
Percent Of Total Expense0.00800PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense3009124TotalCommunityBenefitExpense
Direct Offsetting Revenue2268979DirectOffsettingRevenue
Net Community Benefit Expense740145NetCommunityBenefitExpense
Percent Of Total Expense0.01350PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense6125TotalCommunityBenefitExpense
Direct Offsetting Revenue500DirectOffsettingRevenue
Net Community Benefit Expense5625NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense7747TotalCommunityBenefitExpense
Net Community Benefit Expense7747NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1180401TotalCommunityBenefitExpense
Direct Offsetting Revenue862367DirectOffsettingRevenue
Net Community Benefit Expense318034NetCommunityBenefitExpense
Percent Of Total Expense0.00580PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense19883TotalCommunityBenefitExpense
Net Community Benefit Expense19883NetCommunityBenefitExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense1214156TotalCommunityBenefitExpense
Direct Offsetting Revenue862867DirectOffsettingRevenue
Net Community Benefit Expense351289NetCommunityBenefitExpense
Percent Of Total Expense0.00640PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense4223280TotalCommunityBenefitExpense
Direct Offsetting Revenue3131846DirectOffsettingRevenue
Net Community Benefit Expense1091434NetCommunityBenefitExpense
Percent Of Total Expense0.01990PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense17925TotalCommunityBuildingExpense
Net Community Building Expense17925NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense17925TotalCommunityBuildingExpense
Net Community Building Expense17925NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$648,209BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare10733958AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare9355356CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall1378602MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CarefalseProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1CARRIER CLINIC INCBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1PO BOX 147AddressLine1
CityBELLE MEADCity
StateNJState
ZIP Code08502ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1CARRIER CLINIC INCBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent100FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent100FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiestrueCollectionActivities
Other ActionsXOtherActions
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Medicare RateXMedicareRate
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargestrueGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities5NumberOfOtherFacilities

Other Facilities OtherFacilities (5 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
EAST MOUNTAIN YOUTH LODGE
PO BOX 147BELLE MEADNJ08502RESIDENTIAL TREATMENT FACILITY
EAST MOUNTAIN SCHOOL
PO BOX 147BELLE MEADNJ08502PRIVATE SCHOOL FOR THE HANDICAPPED
BLAKE RECOVERY CENTER
PO BOX 147BELLE MEADNJ08502RESIDENTIAL SUBSTANCE ABUSE FACILITY
SWAN LODGE
PO BOX 147BELLE MEADNJ08502INTENSIVE RESIDENTIAL TREATMENT FACILITY
SUNFLOWER LODGE
PO BOX 147BELLE MEADNJ08502PSYCHIATRIC COMMUNITY HOME FOR CHILDREN

Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Part I, Line 7FBAD DEBT EXPENSE FOR 2011 IS $1,538,114 AND IS EXCLUDED FROM TOTAL EXPENSES FOR CALCULATING THE PERCENTAGE OF TOTAL EXPENSE.
PART I, LINE 7 & PART III, LINE 8THE COST-TO-CHARGE RATIO USED FOR PART I, LINE 7 IS BASED ON WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES.
PART III, LINE 4PATIENT ACCOUNTS RECEIVABLE ARE RECORDED AT THE REIMBURSABLE OR CONTRACTED AMOUNT AND DO NOT BEAR INTEREST. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS THE CLINIC'S BEST ESTIMATE OF THE AMOUNT OF PROBABLE CREDIT LOSSES IN THE CLINIC'S EXISTING PATIENT ACCOUNTS RECEIVABLE. THE CLINIC DETERMINES THE ALLOWANCE BASED ON HISTORICAL WRITE-OFF EXPERIENCE. THE CLINIC REVIEWS ITS ALLOWANCE FOR DOUBTFUL ACCOUNTS PERIODICALLY. PAST DUE BALANCES ARE REVIEWED INDIVIDUALLY FOR COLLECTIBILITY. ACCOUNT BALANCES ARE CHARGED OFF AGAINST THE ALLOWANCE AFTER ALL MEANS OF COLLECTION HAVE BEEN EXHAUSTED AND THE POTENTIAL FOR RECOVERY IS CONSIDERED REMOTE.
PART V, LINE 13GA PROVISION ABOUT THE FINANCIAL ASSISTANCE POLICY IS INCLUDED IN THE PATIENT HANDBOOK WHICH IS PROVIDED TO THE PATIENT AT THE TIME OF ADMISSION.
PART V, LINE 19DPATIENTS WHO ARE RESIDENTS OF NEW JERSEY AND DO NOT HAVE INSURANCE ARE billed pursuant to New Jersey State billing regulations. ALL PATIENTS REGARDLESS OF RESIDENCY ARE ABLE TO APPLY FOR FINANCIAL ASSISTANCE.
PART V, LINE 21PATIENTS WHO ARE NOT RESIDENTS OF NEW JERSEY AND WHO DO NOT HAVE INSURANCE ARE BILLED FOR GROSS CHARGES, BUT CAN APPLY FOR FINANCIAL ASSISTANCE.
PART VI, SUPPLEMENTAL INFORMATION 2AS PART OF CARRIER CLINIC'S STRATEGIC PLANNING PROCESS, CARRIER GATHERS AND INCORPORATES NATIONAL, STATE AND CLINICAL INDUSTRY DATA IN THE DEVELOPMENT OF CLINICAL SERVICES AND EDUCATIONAL FORUMS. CARRIER CLINIC IS A PARTICIPATORY MEMBER OF THE NEW JERSEY HOSPITAL ASSOCIATION, NEW JERSEY ASSOCIATION OF MENTAL HEALTH AND ADDICTION, NATIONAL ASSOCIATION OF PSYCHIATRIC HEALTH SYSTEMS, AND THE AMERICAN HOSPITAL ASSOCIATION. EACH OF THESE ORGANIZATIONS ALSO PROVIDES BEHAVIORAL HEALTH AND ADDICTION INFORMATION RELEVANT TO OUR COMMUNITY'S BEHAVIORAL HEALTH AND ADDICTION NEEDS. ADDITIONALLY, CARRIER STAFF ATTENDS AN AVERAGE OF 25 COMMUNITY MEETINGS A MONTH THROUGHOUT THE STATE OF NEW JERSEY. DOING SO ENABLES US TO BE EDUCATED ON EACH COUNTY'S MENTAL HEALTH AND ADDICTION NEEDS AND SPECIFIC ISSUES OF IMPORTANCE. READING INDUSTRY JOURNALS, NEWSLETTERS AND COMMUNITY NEWSPAPERS ALSO ALLOWS US TO HELP TAILOR FREE EDUCATIONAL EVENTS TO OUR SURROUNDING COMMUNITY. CARRIER CLINIC RECEIVES MANY TELEPHONE CALLS ON A REGULAR BASIS, IN EXCESS OF 77,000 PER YEAR, REQUIRING REFERRALS TO AND INFORMATION REGARDING COMMUNITY RESOURCES, OTHER TREATMENT CENTERS OUTSIDE THE AREA, SUPPORT GROUPS, SELF-HELP GROUPS, ETC. INFORMATION IS PROVIDED WITHOUT CHARGE. CARRIER ALSO MAINTAINS ITS WEBSITE, WHICH IN ADDITION TO PROVIDING INFORMATION ABOUT CARRIER'S PROGRAMS AND SERVICES, PROVIDES THE ABILITY TO REQUEST INFORMATION VIA E-MAIL AND LINKS TO OTHER MENTAL HEALTH RESOURCES. IT IS THROUGH THIS CONTACT WITH OUR COMMUNITY THAT WE ARE ABLE TO UNDERSTAND WHAT SERVICES ARE NEEDED THROUGHOUT OUR GEOGRAPHIC AREA.NEEDS ASSESSMENT
PART VI, SUPPLEMENTAL INFORMATION 3PATIENTS OF CARRIER CLINIC ARE GIVEN A PATIENT HANDBOOK WHICH INCLUDES INFORMATION FOR PATIENTS REGARDING THEIR FINANCIAL RESPONSIBILITY. A CARRIER CLINIC FINANCIAL COUNSELOR MEETS WITH THE PATIENT, IF THEY ARE MENTALLY CAPABLE, AND/OR A DESIGNATED FAMILY MEMBER OR GUARDIAN INDIVIDUALLY AND ADIVISES THEM THAT THEY CAN APPLY FOR CHARITY CARE FOR THEIR SELF PAY BALANCES IF THEY HAVE LIMITED INCOME. THE FINANCIAL COUNSELOR PROVIDES CHARITY CARE APPLICATIONS TO THE PATIENT ACCORDINGLY.PATIENT EDUCATION
PART VI, SUPPLEMENTAL INFORMATION 4CARRIER CLINIC SERVES THE ENTIRE STATE OF NEW JERSEY; HOWEVER THE MAIN PATIENT POPULATION IS FROM SUBURBAN AREAS. THE MAIN SOURCE OF ADMISSIONS IN 2011 WAS FROM MIDDLESEX, SOMERSET, OCEAN, MERCER AND MONMOUTH COUNTIES, ALL LOCATED IN NEW JERSEY. OF THESE FIVE COUNTIES, AN AVERAGE OF 7.28% OF THE POPULATION FALLS BELOW POVERTY LEVEL, BASED ON 2006-2010 CENSUS STATISTICS.COMMUNITY INFORMATION
PART VI, SUPPLEMENTAL INFORMATION 5CARRIER CLINIC STAFF ATTENDS AN AVERAGE OF 25 COMMUNITY MEETINGS A MONTH THROUGHOUT THE STATE OF NEW JERSEY. DOING SO ENABLES CARRIER CLINIC TO BE EDUCATED ON EACH COUNTY'S MENTAL HEALTH AND ADDICTION NEEDS AND SPECIFIC ISSUES THAT ARE IMPORTANT TO THE COMMUNITY.COMMUNITY BUILDING ACTIVITIES
PART V, LINE 16EIF AFTER FOUR BILLING STATEMENTS AND PHONE CALLS TO PATIENTS, THE PATIENT HAS NOT MADE A PAYMENT, THEN THE ACCOUNT IS DEEMED TO BE UNCOLLECTIBLE. IT IS THEN TURNED OVER TO AN OUTSIDE COLLECTION AGENCY.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgs
C RICHARD SARLE
41525106231612030910587210
RANDOLPH JACOBSON
2239970337872577840
DAVID GREENSPAN MD
1592270145841738110
MARY PAWLIKOWSKI
21665623787240443
PATRICIA TOOLE
19460410779205383
CAROL KOSZTYO
1755141960033757228871
UMESH MEHTA MD
40851442072450586
LINDA LANG MD
17499620684195680
CLAIRE MARSH MD
22414634818258964
ASMA NISAR MD
25722334098291321
WOJCIECH SZULACZKOWSKI MD
24043538924279359
ANTHONY MARINO MD
19412323778217901

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierExplanationExplanation
PART I, LINE 3THE BOARD OF TRUSTEE EXECUTIVE COMMITTEE SERVES AS THE COMPENSATION COMMITTEE FOR CARRIER CLINIC, INC.
PART IIC. RICHARD SARLE'S OTHER REPORTABLE COMPENSATION OF $623,161 REPRESENTS VESTED ADDITIONAL COMPENSATION IN ACCORDANCE WITH HIS CONTRACTUAL AGREEMENT. CAROL KOSZTYO'S OTHER REPORTABLE COMPENSATION OF $19,600 REPRESENTS PENSION CONTRIBUTION THAT FAILED DISCRIMINATION TESTING.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (13 entries)

IdentifierIdentifierExplanationExplanation
PART III, LINE 1, MISSIONPROVIDING CARING SOLUTIONS SINCE 1910, CARRIER CLINIC'S MISSION IS TO PROVIDE THE BEST CARE AND TREATMENT TO THESE PERSONS WHO COME TO US STRUGGLING WITH EMOTIONAL AND BEHAVIORAL DISTRESS AND ADDICTIVE AND PSYCHIATRIC DISORDERS. AS ONE OF NEW JERSEY'S LARGEST, NOT-FOR-PROFIT BEHAVIORAL HEALTHCARE ORGANIZATIONS, WE REMAIN DEDICATED TO HEALING, SUPPORTING AND TEACHING ADOLESCENTS, ADULTS AND THEIR FAMILIES IN A SAFE, COMPASSIONATE AND RESPECTFUL ENVIRONMENT. WITHIN OUR CONTINUUM OF CARE, HOPE IS RESTORED AND RECOVERY BEGINS.
PART III, LINE 4D, OTHER PROGRAMSRESIDENTIAL PROGRAMS INCLUDE RESIDENTIAL TREATMENT CENTER, INTENSIVE RESIDENTIAL TREATMENT SERVICES AND PSYCHIATRIC COMMUNITY HOME FOR CHILDREN FOR EMOTIONALLY DISTURBED ADOLESCENTS WHICH CARED FOR 103 RESIDENTS AND HAD A TOTAL OF 26,303 PATIENT DAYS.
PART VI, SECTION B, LINE 11A&BTHE BOARD OF TRUSTEES HAS DELEGATED THE REVIEW OF THE FORM 990 TO THE BOARD OF TRUSTEES FINANCE COMMITTEE. THE FINANCE COMMITTEE WILL REVIEW THE DOCUMENT IN ADVANCE OF THE FILING WITH THE IRS. THE FINANCE COMMITTEE WILL ACKNOWLEDGE AND REPORT ON THE STATUS OF ITS REVIEW PROCESS TO THE FULL BOARD IN ADVANCE OF THE FILING DEADLINE. THE BOARD OF TRUSTEES IS PROVIDED A COPY OF THE REVIEWED AND APPROVED 990 PRIOR TO FILING.
PART VI, SECTIONS B, LINE 12CEACH TRUSTEE, OFFICER AND MEDICAL STAFF MEMBER ANNUALLY SIGNS A STATEMENT WHICH AFFIRMS THAT SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY AND UNDERSTANDS CARRIER CLINIC IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES.
PART VI, SECTION B, LINE 15BCARRIER CLINIC UTILIZES THE NEW JERSEY HOSPITAL ASSOCIATION, SULLIVAN AND COTTER, MODERN HEALTHCARE PUBLICATIONS AND OTHER VARIOUS SALARY SURVEYS FOR MARKET COMPARISONS. THE INFORMATION IS THEN PROVIDED TO THE BOARD OF TRUSTEES AND IS REVIEWED BY THE BOARD'S EXECUTIVE COMMITTEE TO ENSURE THE SALARIES ARE WITHIN APPROPRIATE MARKET AND NONPROFIT EXECUTIVE COMPENSATION BASES. THIS COMMITTEE SERVES AS THE COMPENSATION COMMITTEE AND REVIEWS THE REASONABLENESS OF THE SALARY STRUCTURE FOR EXECUTIVES AND KEY TOP INDIVIDUALS WITHIN THE ORGANIZATION. THIS COMMITTEE IS ONLY COMPRISED OF COMMUNITY TRUSTEES AND REVIEWS AND ESTABLISHES THESE SALARIES ANNUALLY IN ACCORDANCE WITH THE REBUTTABLE PRESUMPTION OF REASONABLENESS.
PART VI, SECTION C, LINE 19CARRIER CLINIC PROVIDES DOCUMENTS TO THE PUBLIC UPON REQUEST. THE IRS FORM 990 IS ALSO ACCESSIBLE FROM GUIDESTAR ON THE INTERNET.
PART VII, SECTION ADRS. NISAR, MEHTA AND SZULACZKOWSKI RECEIVE COMPENSATION FOR ELECTRO-CONVULSIVE THERAPY (ECT) SERVICES IN ADDITION TO THEIR BASE SALARY.
PART IX, LINE 24E, ALL OTHER EXPENSESOVERHEAD ALLOCATION REPRESENTS FACILITY SUPPORT AND CORPORATE COSTS ALLOCATED TO CARRIER'S VARIOUS PROGRAMS USING ACCEPTED MEDICARE COST REPORT ALLOCATION PRINCIPLES.
PART XI, LINE 5CHANGES IN NET ASSETS: NET UNREALIZED LOSS ON INVESTMENTS (2,860,333) MINIMUM PENSION LIABILITY 1,753,358 CHANGE IN DERIVATIVE INSTRUMENT 51,363 CHANGE IN TRUST (13,062) ROUNDING (2) TOTAL (1,068,676)
PART XII, LINE 2CTHE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.
PART IV, QUESTION 26 & PART X, LINE 5THE LOAN TO C. RICHARD SARLE FOR TAXES PAID ON HIS BEHALF FOR DEFERRED COMPENSATION WAS SETTLED IN 2011 PURSUANT TO THE WRITTEN AGREEMENT.
PART VI, QUESTION 1ATHE EXECUTIVE COMMITTEE OF THE BOARD EXERCISES ALL POWERS AND AUTHORITY OF THE BOARD IN THE MANAGEMENT OF AFFAIRS OF CARRIER CLINIC DURING INTERVALS BETWEEN BOARD MEETINGS.
PART VII, SECTION AIN 2011, THERE WAS A TRANSITION OF MEDICAL DIRECTOR. DR. DAVID GREENSPAN RESIGNED IN MAY 2011 AND DR. MARIE HASSON BECAME THE NEW MEDICAL DIRECTOR IN JULY 2011.