2012-12-19T08:49:42-06:00 2011-12-31 WithumSmithBrown PC 465 South St Ste 200 Morristown NJ 079606497 990 2011-01-01 226067549 HOMECARE & HOSPICECARE OF SOUTH JERSEY INC % JOHN A DIANGELO HOME 8566418610 333 IRVING AVENUE BRIDGETON NJ 08302 john diangelo 2012-12-12 true 9738989494 2011 2016-02-24 21:20:13Z CHESTER B KALETKOWSKI 333 IRVING AVENUE BRIDGETON NJ 08302 12753874 false X WWW.SJHEALTHCARE.NET X 1965 NJ THE ORGANIZATION'S MISSION IS TO PROVIDE MEDICALLY NECESSARY HOSPICE SERVICES, HOME HEALTHCARE AND ADULT MEDICAL CARE SERVICES TO ELDERLY AND HANDICAPPED RESIDENTS OF SOUTHERN NEW JERSEY. 14 8 0 0 0 0 669141 446166 12892383 11294214 72282 11917 0 1835 13633806 11754132 0 0 0 0 7392416 0 0 0 0 5209269 11236959 12601685 11236959 1032121 517173 7887538 6158565 3988905 1442250 3898633 4716315 X THE ORGANIZATION'S PRIMARY EXEMPT PURPOSE IS TO PROVIDE MEDICALLY NECESSARY HOSPICE SERVICES, HOME HEALTHCARE SERVICES AND ADULT MEDICAL DAY CARE SERVICES TO ELDERLY AND HANDICAPPED RESIDENTS OF SOUTHERN NEW JERSEY WHO ARE ALONE OR HOMEBOUND IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. true true 5190894 0 5943332 EXPENSES INCURRED IN PROVIDING MEDICALLY NECESSARY HOSPICE CARE TO THE RESIDENTS OF SALEM AND CUMBERLAND COUNTIES IN NEW JERSEY IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. THE ORGANIZATION PROVIDED 32,756 HOSPICE CARE PATIENT DAYS IN 2011. 3410422 0 3678074 EXPENSES INCURRED IN FUNCTIONING AS A CERTIFIED HOME HEALTH AGENCY AS A DIRECT PROVIDER OF SKILLED NURSING, THERAPY SERVICES AND HOME HEALTH AIDES FOR RESIDENTS OF SALEM AND CUMBERLAND COUNTIES IN NEW JERSEY (EXCLUDING THE CITY OF VINELAND, NJ) IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. THE ORGANIZATION TREATED 21,631 HOME HEALTH PATIENTS IN 2011. 1498378 0 1017390 EXPENSES INCURRED IN PROVIDING MEDICALLY NECESSARY INPATIENT HOSPICE CARE SERVICES TO ELDERLY OR HANDICAPPED ADULTS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. THE ORGANIZATION TREATED 2,349 INPATIENT HOSPICE PATIENTS DURING 2011. 13572 0 655418 10113266 true true false false true false false false false false true false false false false false false true false false false false false false true false false false false true false false false false false false false false false false false false false true true true false false true 19 0 true 0 false false false false false false false false false false X 14 8 false false false false true true true true true false false true true true true true true true true false NJ X JOHN A DIANGELO 8566418610 333 IRVING AVENUE BRIDGETON NJ 08302 X ANN M BUDDE 1.0 X X 0 0 0 DAVID ROBBINS JR 1.0 X X 0 0 0 MICHAEL M ROSSI III 1.0 X X 0 0 0 HUGH MCCAFFREY 1.0 X X 0 0 0 BRUNO A BASILE 1.0 X 0 0 0 JOHN B CATALANO MD 1.0 X 0 1500 0 BEVERLY L DAIRSOW 1.0 X 0 0 0 ALBERT A FRALINGER JR 1.0 X 0 0 0 EILEEN A HALLISSEY 1.0 X 0 0 0 NAUVEED IQBAL MD 2.0 X 0 13262 0 CHESTER B KALETKOWSKI 55.0 X X 0 606251 299485 MAURICE SHEETZ MD 10.0 X 0 57996 0 JACK M SHIELDS MD 2.0 X 0 12000 0 TACIE TRULL 1.0 X 0 0 0 JOHN A DIANGELO 55.0 X 0 409653 104869 ROBERT M DANGEL ESQ 55.0 X 0 307308 107930 WAYNE PENDLETON 55.0 X 0 152024 11468 0 1559994 523752 0 false true false FRANK GIANNANTONIO ASSOCIATES INC 44 STELTON ROAD SUITE 315 PISCATAWAY NJ 08854 CONSULTING 164387 1 24716 421450 446166 NET PATIENT SERVICE REVENUE 541900 11274210 11274210 OTHER HEALTHCARE RELATED REVENUE 541900 20004 20004 11294214 111572 111572 0 0 16203 872000 987858 16203 -115858 -99655 -99655 11844 24716 11844 0 1875 40 1835 1835 0 0 11754132 11294214 13752 0 0 0 0 0 0 0 0 0 0 24281 21853 2428 0 0 0 0 5196 4677 519 147990 133191 14799 4550 4095 455 525524 472972 52552 95462 85916 9546 0 1091540 982386 109154 260606 234545 26061 0 7098 6388 710 6323 5691 632 0 132633 119370 13263 7090 6381 709 ALLOCATION OF PERSONNEL COSTS 6745855 6071270 674585 0 AGENCY PERSONNEL 550730 495657 55073 0 OUTSIDE SERVICES 445742 401168 44574 0 MEDICAL SUPPLIES 440267 396241 44026 0 746072 671465 74607 11236959 10113266 1123693 0 837 837 2279511 1582906 0 0 1567937 1512546 0 0 0 0 2502819 2387278 0 0 24919 22034 607057 234257 437680 372800 0 0 0 0 0 0 1007760 132500 66075 147664 7887538 6158565 2080653 1232953 0 0 130011 209297 0 0 0 0 0 0 1778241 0 0 0 0 0 3988905 1442250 X 3898633 4716315 0 0 0 0 3898633 4716315 7887538 6158565 X 517173 300509 X X false true true X true true X 705580 767707 610960 669141 448001 3201389 705580 767707 610960 669141 448001 3201389 3201389 476640 79203 67924 77665 111572 813004 4014393 56007020 0.79748 0.74836 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 361296 132765 228531 245761 101492 144269 372800 LOBSTER BAKE 36560 24716 11844 132 9472 2240 0 36560 24716 11844 132 9472 2240 11844 X X X X X false true false false false false false true false CHESTER B KALETKOWSKI 0 475571 0 104929 0 25751 0 270279 0 29206 0 905736 0 0 JOHN A DIANGELO 0 311274 0 60502 0 37877 0 84901 0 19968 0 514522 0 0 ROBERT M DANGEL ESQ 0 253727 0 22399 0 31182 0 85835 0 22095 0 415238 0 0 WAYNE PENDLETON 0 101612 0 17308 0 33104 0 2072 0 9396 0 163492 0 0 COMPENSATION INFORMATION SCHEDULE J, PART I; QUESTION 4B THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THE FOLLOWING INDIVIDUALS INCLUDES UNVESTED BENEFITS IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) WHICH ARE SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THE INDIVIDUALS MAY NEVER ACTUALLY RECEIVE THIS UNVESTED BENEFIT AMOUNT. THE AMOUNTS OUTLINED HEREIN WERE NOT INCLUDED IN EACH INDIVIDUAL'S 2011 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: CHESTER B. KALETKOWSKI, $233,645; JOHN A. DIANGELO, $62,244 AND ROBERT M. D'ANGEL, ESQ., $48,051. COMPENSATION INFORMATION SCHEDULE J, PART I; QUESTION 7 CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A BONUS DURING CALENDAR YEAR 2011 WHICH AMOUNTS WERE INCLUDED IN COLUMN B(II) HEREIN AND IN EACH INDIVIDUAL'S 2011 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT. COMPENSATION INFORMATION SCHEDULE J, PART II; COLUMN B(III) CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J OF THIS FEDERAL FORM 990 RECEIVED COMPENSATION WITH RESPECT TO PAID TIME OFF, WHICH WAS INCLUDED IN SCHEDULE J, PART II, COLUMN B(III) HEREIN AND IN EACH INDIVIDUAL'S 2011 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS CORE FORM, PART III; LINE 2 IN 2011 HOMECARE & HOSPICECARE OF SOUTH JERSEY, INC. ASSUMED THE OPERATIONS OF THE HOMECARE PROGRAM FOR THE CITY OF VINELAND, NEW JERSEY. STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS CORE FORM, PART III; LINE 3 IN 2011 HOMECARE & HOSPICECARE OF SOUTH JERSEY, INC. CEASED THE OPERATIONS AND ACTIVITIES OF AND SOLD ITS DAYCARE PROGRAMS IN SALEM AND FAIRTON, NEW JERSEY. STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS CORE FORM, PART III; LINE 4D EXPENSES INCURRED IN PROVIDING VARIOUS OTHER MEDICALLY NECESSARY HOSPICE SERVICES, HOME HEALTHCARE AND ADULT MEDICAL CARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION A; QUESTION 1 AND SCHEDULE L; PART IV THE ORGANIZATION IS A TAX-EXEMPT AFFILIATE IN SOUTH JERSEY HEALTHCARE; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). FOR THE PERIOD JANUARY 1, 2011 THROUGH DECEMBER 31, 2011 AND DURING THE ORDINARY COURSE OF BUSINESS, THE ORGANIZATION MAY ENGAGE IN ONE OR MORE TRANSACTIONS WITH COMPANIES THAT (1) ARE OWNED BY AN INDIVIDUAL WHO IS A MEMBER OF THE BOARD OF TRUSTEES OF THIS ORGANIZATION OR A RELATED NOT-FOR-PROFIT ORGANIZATION, (2) ARE OWNED BY A FAMILY MEMBER OF AN INDIVIDUAL WHO IS A MEMBER OF THE BOARD OF TRUSTEES OF THIS ORGANIZATION OR A RELATED NOT-FOR-PROFIT ORGANIZATION, OR (3) WHEREIN A BOARD MEMBER OF THIS ORGANIZATION OR A FAMILY MEMBER OF A BOARD MEMBER OF THIS ORGANIZATION IS EITHER AN OFFICER, DIRECTOR, TRUSTEE OR KEY EMPLOYEE OF A COMPANY WITH WHICH THIS ORGANIZATION OR A RELATED NOT-FOR-PROFIT ORGANIZATION TRANSACTS BUSINESS. IN THESE SITUATIONS, ANY GOODS PURCHASED OR SERVICES PERFORMED ARE DONE AT FAIR MARKET VALUE RATES PURSUANT TO ARM'S LENGTH NEGOTIATIONS. ANY SUCH TRANSACTIONS ARE DISCLOSED TO, REVIEWED AND APPROVED BY THE FULL BOARD OF TRUSTEES. THE ORGANIZATION MAINTAINS A WRITTEN CONFLICT OF INTEREST POLICY AND QUESTIONNAIRE AND USES REASONABLE EFFORTS TO OBTAIN THIS INFORMATION FROM THE MEMBERS OF ITS BOARD OF TRUSTEES. THE ORGANIZATION FOLLOWS A FORMALIZED BID PROCESS WHEREIN ALL TRANSACTIONS OF THIS NATURE ARE SENT OUT TO BID. IF IT IS DETERMINED THAT THE ORGANIZATION WILL ENTER INTO A TRANSACTION IDENTIFIED ABOVE, IT IS SENT TO THE FULL BOARD OF TRUSTEES FOR REVIEW AND APPROVAL. THE INTERESTED PERSON IN THESE CASES RECUSES THEMSELVES FROM THE VOTING PROCESS. THIS RECUSAL PROCESS IS OUTLINED IN THE ORGANIZATION'S WRITTEN CONFLICT OF INTEREST POLICY WHICH ALL BOARD MEMBERS AND SENIOR MANAGEMENT REVIEW ANNUALLY. DURING 2011 THE ORGANIZATION OR A RELATED NOT-FOR-PROFIT ORGANIZATION ENGAGED IN THE FOLLOWING: PAYMENT BY SOUTH JERSEY HOSPITAL, INC. IN THE AMOUNT OF $10,185 TO FRALINGER ENGINEERING FOR ENGINEERING SERVICES. MR. FRALINGER IS A BOARD MEMBER OF HOMECARE AND HOSPICECARE OF SOUTH JERSEY, INC. PAYMENT BY SOUTH JERSEY HOSPITAL, INC. IN THE AMOUNT OF $8,701 TO IQBAL & KHAN SURGICAL ASSOCIATES, INC. FOR MEDICAL SERVICES. DR. IQBAL IS A BOARD MEMBER OF HOMECARE AND HOSPICECARE OF SOUTH JERSEY, INC. LENDING OF MONEY PURSUANT TO A PRACTICE SUPPORT AGREEMENT IN PREVIOUS YEARS BY SOUTH JERSEY HOSPITAL, INC. TO IQBAL & KHAN SURGICAL ASSOCIATES, P.A. IN THE TOTAL ORIGINAL AMOUNT OF $250,000 FOR START-UP CAPITAL REQUIREMENTS FOR THE MEDICAL PRACTICE IN RESPONSE TO AN IDENTIFIED HEALTHCARE COMMUNITY NEED AND MEDICAL SERVICES SHORTAGE. THE TOTAL AMOUNT DUE FROM THE PRACTICE AT DECEMBER 31, 2011 IS $166,667. DR. IQBAL IS A BOARD MEMBER OF HOMECARE AND HOSPICECARE OF SOUTH JERSEY, INC. PLEASE NOTE THAT THIS TRANSACTION IS ALSO DISCLOSED ON SCHEDULE L OF THE SOUTH JERSEY HOSPITAL, INC. FORM 990. BRUNO A. BASILE HAS A DAUGHTER THAT IS EMPLOYED BY SOUTH JERSEY HOSPITAL, INC. AS A PHARMACIST FOR WHICH SHE RECEIVED FORM W-2, BOX 5 MEDICARE WAGES IN THE AMOUNT OF $66,362 DURING 2011. MR. BASILE IS A BOARD MEMBER OF HOMECARE AND HOSPICECARE OF SOUTH JERSEY, INC. PLEASE NOTE THAT THIS TRANSACTION IS ALSO DISCLOSED ON SCHEDULE L OF THE SOUTH JERSEY HOSPITAL, INC. FORM 990. PAYMENT BY SOUTH JERSEY HOSPITAL, INC. IN THE AMOUNT OF $20,036 TO PERFORMANCE MARKETING FOR MARKETING SERVICES DURING 2011. MICHAEL M. ROSSI, III'S SPOUSE IS AN EMPLOYEE OF PERFORMANCE MARKETING. MR. ROSSI IS A BOARD MEMBER OF HOMECARE AND HOSPICECARE OF SOUTH JERSEY, INC. PAYMENT BY SOUTH JERSEY HEALTH SYSTEM FOUNDATION, INC. IN THE AMOUNT OF $117,124 TO PERFORMANCE MARKETING FOR MARKETING SERVICES DURING 2011. MICHAEL M. ROSSI, III'S SPOUSE IS AN EMPLOYEE OF PERFORMANCE MARKETING. MR. ROSSI IS A BOARD MEMBER OF HOMECARE AND HOSPICECARE OF SOUTH JERSEY, INC. PAYMENT BY SOUTH JERSEY HOSPITAL IN THE AMOUNT OF $45,863 TO DAVID SHIELDS, M.D. FOR PHYSICIAN SERVICES. JACK M. SHIELDS, M.D. IS THE BROTHER OF DAVID SHIELDS, M.D. AND A BOARD MEMBER OF HOMECARE AND HOSPICECARE OF SOUTH JERSEY, INC. PLEASE NOTE THAT THIS TRANSACTION IS ALSO DISCLOSED ON SCHEDULE L OF THE SOUTH JERSEY HOSPITAL, INC. FORM 990. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7 SOUTH JERSEY HEALTH SYSTEM, INC. ("SYSTEM") IS THE SOLE MEMBER OF THIS ORGANIZATION. SYSTEM HAS THE RIGHT TO ELECT THE MEMBERS OF THIS ORGANIZATION'S BOARD OF TRUSTEES AND HAS CERTAIN RESERVED POWERS AS DEFINED IN THIS ORGANIZATION'S BYLAWS. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION B; QUESTION 11B THE ORGANIZATION IS AN AFFILIATE IN SOUTH JERSEY HEALTHCARE; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. SOUTH JERSEY HEALTH SYSTEM, INC. IS THE TAX-EXEMPT PARENT ENTITY OF THE SYSTEM. THIS ORGANIZATION'S FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF IT'S GOVERNING BODY, ITS BOARD OF TRUSTEES, PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE ("IRS"). IN ADDITION, EACH MEMBER OF THE SOUTH JERSEY HEALTH SYSTEM, INC. COMPENSATION COMMITTEE REVIEWED THIS ORGANIZATION'S FORM 990 PRIOR TO PROVIDING IT TO EACH VOTING MEMBER OF THIS ORGANIZATION'S BOARD OF TRUSTEES AND FILING WITH THE IRS. THE SOUTH JERSEY HEALTH SYSTEM, INC. COMPENSATION COMMITTEE HAS ASSUMED THE RESPONSIBILITY TO OVERSEE AND COORDINATE THE FEDERAL FORM 990 PREPARATION, REVIEW AND FILING PROCESS FOR ALL TAX-EXEMPT AFFILIATES OF THE SYSTEM. AS PART OF THE ORGANIZATION'S FEDERAL FORM 990 TAX RETURN PREPARATION PROCESS THE ORGANIZATION HIRED A PROFESSIONAL CPA FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION TO PREPARE THE FEDERAL FORM 990. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE ORGANIZATION'S FINANCE PERSONNEL AND SYSTEM INDIVIDUALS INCLUDING IN HOUSE COUNSEL, VICE-PRESIDENT OF FINANCE, DIRECTOR OF INTERNAL AUDIT AND VARIOUS OTHER INDIVIDUALS TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE ORGANIZATION'S FINANCE PERSONNEL AND OTHER INDIVIDUALS FOR THEIR REVIEW. THE ORGANIZATION'S FINANCE PERSONNEL AND OTHER INDIVIDUALS REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE ORGANIZATION'S FINANCE PERSONNEL AND VARIOUS OTHER INDIVIDUALS FOR FINAL REVIEW AND APPROVAL PRIOR TO PRESENTATION OF THE FEDERAL FORM 990 TO THE MEMBERS OF THE SOUTH JERSEY HEALTH SYSTEM, INC. COMPENSATION COMMITTEE AND THEREAFTER TO EACH VOTING MEMBER OF ITS BOARD OF TRUSTEES. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION B; QUESTION 12 THE ORGANIZATION IS AN AFFILIATE OF SOUTH JERSEY HEALTHCARE ("SYSTEM"). THE ORGANIZATION AND THE SYSTEM REGULARLY MONITOR AND ENFORCE COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. ANNUALLY ALL MEMBERS OF THE BOARD OF TRUSTEES, OFFICERS AND SENIOR MANAGEMENT PERSONNEL ARE REQUIRED TO REVIEW THE EXISTING CONFLICT OF INTEREST POLICY AND COMPLETE A QUESTIONNAIRE. THE COMPLETED QUESTIONNAIRES ARE RETURNED TO THE ORGANIZATION AND THE GENERAL COUNSEL FOR LEGAL AFFAIRS FOR REVIEW. THEREAFTER THE GENERAL COUNSEL PREPARES A SUMMARY OF THE COMPLETED QUESTIONNAIRES WHICH CONTAINS INFORMATION DISCLOSED ON AN INDIVIDUAL BY INDIVIDUAL BASIS WHICH HE THEN PRESENTS TO THE ORGANIZATION'S GOVERNANCE COMMITTEE FOR ITS REVIEW AND DISCUSSION. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION B; QUESTION 15 THE ORGANIZATION IS AN AFFILIATE IN A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THIS FILING ORGANIZATION ITSELF HAS NO PAID SENIOR MANAGEMENT PERSONNEL RECEIVING COMPENSATION DIRECTLY FROM THIS ORGANIZATION. RATHER, KEY SENIOR MANAGEMENT PERSONNEL, INCLUDING THE PRESIDENT/CHIEF EXECUTIVE OFFICER IS EMPLOYED BY THE TAX-EXEMPT HOSPITAL WITHIN THE HEALTHCARE SYSTEM. HOWEVER, THE COMPENSATION AND BENEFITS OF THIS INDIVIDUAL IS SHOWN ON THIS TAX RETURN BECAUSE HE IS ALSO A BOARD MEMBER OF THIS ORGANIZATION. ACCORDINGLY, THE HOSPITAL'S BOARD OF TRUSTEES HAS AN EXECUTIVE COMPENSATION COMMITTEE ("COMMITTEE"). THE COMMITTEE HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY WHICH IT FOLLOWS WHEN IT REVIEWS AND APPROVES OF THE COMPENSATION AND BENEFITS OF THE HOSPITAL'S SENIOR MANAGEMENT, INCLUDING THE PRESIDENT/CHIEF EXECUTIVE OFFICER. THE COMMITTEE REVIEWS THE "TOTAL COMPENSATION" OF THE INDIVIDUALS WHICH IS INTENDED TO INCLUDE BOTH CURRENT AND DEFERRED COMPENSATION AND ALL EMPLOYEE BENEFITS, BOTH QUALIFIED AND NON-QUALIFIED. THE COMMITTEE'S REVIEW IS DONE ON AT LEAST AN ANNUAL BASIS AND ENSURES THAT THE "TOTAL COMPENSATION" OF SENIOR MANAGEMENT IS REASONABLE. THE ACTIONS TAKEN BY THE COMMITTEE ENABLE THE HOSPITAL TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 4958 WITH RESPECT TO THE TOTAL COMPENSATION OF CERTAIN MEMBERS OF THE SENIOR MANAGEMENT TEAM, INCLUDING THE PRESIDENT/CHIEF EXECUTIVE OFFICER. THE THREE FACTORS WHICH MUST BE SATISFIED IN ORDER TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS ARE THE FOLLOWING: 1. THE COMPENSATION ARRANGEMENT IS APPROVED IN ADVANCE BY AN "AUTHORIZED BODY" OF THE APPLICABLE TAX-EXEMPT ORGANIZATION WHICH IS COMPOSED ENTIRELY OF INDIVIDUALS WHO DO NOT HAVE A "CONFLICT OF INTEREST" WITH RESPECT TO THE COMPENSATION ARRANGEMENT; 2. THE AUTHORIZED BODY OBTAINED AND RELIED UPON "APPROPRIATE DATA AS TO COMPARABILITY" PRIOR TO MAKING ITS DETERMINATION; AND 3. THE AUTHORIZED BODY "ADEQUATELY DOCUMENTED THE BASIS FOR ITS DETERMINATION" CONCURRENTLY WITH MAKING THAT DETERMINATION. THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES EACH OF WHO ARE INDEPENDENT AND ARE FREE FROM ANY CONFLICTS OF INTEREST. THE COMMITTEE RELIED UPON APPROPRIATE COMPARABLE DATA; SPECIFICALLY THE COMMITTEE OBTAINED A WRITTEN COMPENSATION STUDY FROM AN INDEPENDENT FIRM WHICH SPECIALIZES IN THE REVIEWING OF HOSPITAL AND HEALTHCARE SYSTEM EXECUTIVE COMPENSATION AND BENEFITS THROUGHOUT THE UNITED STATES. THIS STUDY USED COMPARABLE GEOGRAPHIC AND DEMOGRAPHIC MARKET DATA INCLUDING BUT NOT LIMITED TO SIMILAR SIZED HOSPITALS, # OF LICENSED BEDS AND NET PATIENT SERVICE REVENUE. THE COMMITTEE ADEQUATELY DOCUMENTED ITS BASIS FOR ITS DETERMINATION THROUGH THE TIMELY PREPARATION OF WRITTEN MINUTES OF THE COMPENSATION COMMITTEE MEETINGS DURING WHICH THE EXECUTIVE COMPENSATION AND BENEFITS WAS REVIEWED AND SUBSEQUENTLY APPROVED. THE ACTIONS OUTLINED ABOVE WITH RESPECT TO THE COMMITTEE AND THE ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS ONLY APPLIES TO CERTAIN SENIOR MANAGEMENT PERSONNEL, INCLUDING BUT NOT LIMITED TO THE PRESIDENT/CHIEF EXECUTIVE OFFICER. THE COMPENSATION AND BENEFITS OF THE OTHER INDIVIDUALS CONTAINED IN THIS FORM 990 IS REVIEWED ANNUALLY BY THE PRESIDENT/CHIEF EXECUTIVE OFFICER WITH ASSISTANCE FROM THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER AND THE HUMAN RESOURCES DEPARTMENT IN CONJUNCTION WITH THE INDIVIDUAL'S JOB PERFORMANCE DURING THE YEAR AND IS BASED UPON OTHER OBJECTIVE FACTORS DESIGNED TO ENSURE THAT REASONABLE AND FAIR MARKET VALUE COMPENSATION IS PAID BY THE ORGANIZATION. OTHER OBJECTIVE FACTORS INCLUDE MARKET SURVEY DATA FOR COMPARABLE POSITIONS, INDIVIDUAL GOALS AND OBJECTIVES, PERSONNEL REVIEWS, EVALUATIONS, SELF-EVALUATIONS AND PERFORMANCE FEEDBACK MEETINGS. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION C; QUESTION 19 THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE STATE OF NEW JERSEY DEPARTMENT OF THE TREASURY. COMPENSATION INFORMATION CORE FORM, PART VII AND SCHEDULE J PART VII AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM A RELATED ORGANIZATION. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OR INDEPENDENT CONTRACTORS OF THE RELATED ORGANIZATION AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THIS ORGANIZATION'S BOARD OF TRUSTEES. RELATED HOURS DISCLOSURE CORE FORM, PART VII, SECTION A, COLUMN B THIS ORGANIZATION IS PART OF SOUTH JERSEY HEALTHCARE; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM INCLUDES BOTH FOR-PROFIT AND NOT FOR-PROFIT ORGANIZATIONS. CERTAIN BOARD OF TRUSTEE MEMBERS, OFFICERS AND/OR DIRECTORS LISTED ON CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 MAY HOLD SIMILAR POSITIONS WITH BOTH THIS ORGANIZATION AND OTHER AFFILIATES WITHIN THE SYSTEM. THE HOURS SHOWN ON THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE NO COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, REPRESENTS THE ESTIMATED HOURS DEVOTED PER WEEK FOR THIS ORGANIZATION. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF TRUSTEES OF OTHER RELATED ORGANIZATIONS IN THE SYSTEM, THEIR RESPECTIVE HOURS PER WEEK PER ORGANIZATION ARE APPROXIMATELY ONE HOUR. THE HOURS REFLECTED ON PART VII OF THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, PAID OFFICERS AND KEY EMPLOYEES, REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF SOUTH JERSEY HEALTH SYSTEM, INC.; NOT SOLELY THIS ORGANIZATION. OTHER CHANGES IN NET ASSETS CORE FORM, PART XI; QUESTION 5 OTHER CHANGES IN NET ASSETS OR FUND BALANCE INCLUDE: - CHANGE IN NET UNREALIZED GAINS AND LOSSES ON INVESTMENTS - $17,573; AND - NET TRANFERS FROM AFFILIATES - $282,936. AUDITED FINANCIAL STATEMENTS CORE FORM, PART XII; QUESTION 2 THE ORGANIZATION IS AN AFFILIATE WITHIN SOUTH JERSEY HEALTHCARE; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM'S PARENT ENTITY IS SOUTH JERSEY HEALTH SYSTEM, INC. AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF SOUTH JERSEY HEALTH SYSTEM, INC. AND ALL ENTITIES WITHIN THE SYSTEM FOR THE YEARS ENDED DECEMBER 31, 2011 AND DECEMBER 31, 2010; RESPECTIVELY. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAINED CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. THE INDEPENDENT CPA FIRM ISSUED AN UNQUALIFIED OPINION WITH RESPECT TO THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS. THE SOUTH JERSEY HEALTH SYSTEM, INC. AUDIT COMMITTEE HAS ASSUMED RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE CONSOLIDATED FINANCIAL STATEMENTS, WHICH INCLUDES THIS ORGANIZATION, AND THE SELECTION OF AN INDEPENDENT AUDITOR. SOUTH JERSEY HEALTH SYSTEM INC 333 IRVING AVENUE BRIDGETON NJ 08302 222508425 HEALTH SVCS. NJ 501(C)(3) 509(a)(3) N/A false SOUTH JERSEY HEALTH SYSTEM FDN INC 333 IRVING AVENUE BRIDGETON NJ 08302 223746758 SUPPORT SJHS. NJ 501(C)(3) 509(a)(3) SJH false SOUTH JERSEY HOSPITAL INC 333 IRVING AVENUE BRIDGETON NJ 08302 210634484 HEALTH SVCS. NJ 501(C)(3) HOSPITAL SJHS false SOUTH JERSEY HEALTHCARE LIFE INC 2950 COLLEGE DRIVE SUITE 1E VINELAND NJ 08360 264827936 HEALTH SVCS. NJ 501(C)(3) 509(A)(2) SJHS false BPOC LP 333 IRVING AVENUE BRIDGETON NJ 08302 222956029 REAL ESTATE NJ 0 OAK & MAIN SURGICTR 907 NORTH MAIN ROAD VINELAND NJ 08360 223532371 HEALTHCARE SVCS. NJ HELP SERVICES OF SOUTH JERSEY INC PO BOX 126 SALEM NJ 08079 222823028 HEALTHCARE SVCS. NJ H&H CARE SVCS C CORP. JERSEY HEALTH MANAGEMENT INC 333 IRVING AVENUE BRIDGETON NJ 08302 222502241 HEALTHCARE SVcs. NJ N/A C CORP. PHYSICIANS OF SOUTHERN NEW JERSEY PC 2950 COLLEGE DRIVE SUITE 1E VINELAND NJ 08360 205745047 HEALTHCARE SVcs. 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