2011-11-15T06:44:27-06:00 2010-12-31 PARENTEBEARD LLC 46 PUBLIC SQUARE SUITE 400 WILKESBARRE PA 18701 990 2010-01-01 221500572 NEWTON MEMORIAL HOSPITAL NEWT 9735798301 175 HIGH STREET NEWTON NJ 07860 SEAN O'ROURKE 9735798301 2011-11-16 1 JULIUS GREEN CPA 5708200100 2010 2016-03-07 17:11:31Z THOMAS J SENKER 175 HIGH STREET NEWTON NJ 07860 131583183 0 X WWW.NMHNJ.ORG X 1932 NJ THE HOSPITAL'S VISION - BE RECOGNIZED AS A PREMIER PROVIDER OF HEALTHCARE SERVICES BY 2012 19 14 1347 200 0 0 4699258 3809482 131690219 125488572 1064910 1553878 511979 -88180 137966366 130763752 1541505 6003930 0 0 72966419 70477406 0 0 0 59726046 55424270 134233970 131905606 3732396 -1141854 129059855 130302920 47903200 48519935 81156655 81782985 TO PROVIDE EXCEPTIONAL CARE AND SERVICE AS WELL AS DEMONSTRATING THE FOLLOWING VALUES: PASSION - FOR EVERYTHING WE DO, COMPASSION - FOR YOU AND YOUR FAMILY, RESPECT - FOR EACH OTHER, INTEGRITY - ALWAYS, AND QUALITY - WITHOUT COMPROMISE. 0 0 100586394 6003930 125488572 TO PROVIDE HEALTHCARE SERVICES TO NEWTON AND THE SURROUNDING AREA. THE THREE LARGEST PROGRAM SERVICES ARE NET PATIENT SERVICE REVENUE OF $124,159,627; OTHER PROGRAM REVENUE OF $764,764 AND PSYCH REVENUE OF $333,300. THE COMMUNITY BENEFIT CONTRIBUTION OF NEWTON MEMORIAL HOSPITAL INCLUDES PROGRAMS AND ACTIVITIES THAT IMPROVE ACCESS TO, AND PROVISION OF, HEALTH CARE SERVICES AND PROGRAMS AND TO IMPROVE HEALTH IN OUR COMMUNITIES.SEE SCHEDULE H FOR ADDITIONAL INFORMATION REGARDING THE HOSPITAL'S COMMUNITY BENEFIT CONTRIBUTIONS. 100586394 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 1 0 1 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 1 0 1 107 0 1 1347 1 0 0 0 0 0 0 0 0 0 0 X 19 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NJ X DAVID S RIKKOLA CFO 9735798301 175 HIGH STREET NEWTON NJ 07860 X MARK AVONDOGLIO 4.20 X 0 0 0 GLENN A CLARK 4.20 X 0 0 0 RICHARD I CLARK 4.20 X 0 0 0 CRAIG U DANA 4.20 X 0 0 0 PHILLIP D DEACON 4.20 X 0 0 0 DR NICK P DIBITETTO 4.20 X 0 0 0 BRIAN FITZPATRICK 4.20 X 0 0 0 WILLIAM I HOUGHTON III 4.20 X 0 0 0 CONSTANCE C MIERENDORF PHD 4.20 X 0 0 0 GEORGE W MORVILLE JR 4.20 X 0 0 0 PAUL J OWENS MD 4.20 X 0 0 0 JEFFREY J QUINN 4.20 X 0 0 0 ROBERT E MCCRACKEN 4.20 X X 0 0 0 TAMMIE HORSFIELD 4.20 X X 0 0 0 JAMES S HUBLEY 4.20 X X 0 0 0 CHRISTOPHER LYNCH 4.20 X X 0 0 0 E JANE BROWN 4.20 X X 0 0 0 CLAUDETTE DELONG 4.20 X X 0 0 0 THOMAS J SENKER 37.50 X X 501017 0 37387 SEAN O'ROURKE 37.50 X 293818 0 38387 DAVID RIKKOLA 37.50 X 268649 0 39286 DAVID LAZARUS 37.50 X 292289 0 38630 EVA GOLDENBERG 37.50 X 231971 0 23491 MARY ELLEN RAUNER 37.50 X 209839 0 33645 MEGAN SANDOW 37.50 X 178201 0 34931 JOHN O'BRIEN MD 37.50 X 380252 0 32956 BRIAN NEWMAN MD 37.50 X 364249 0 33026 MARIE ANN MARGIOTTI MD 37.50 X 307269 0 34959 SANDRA SQUIRES MD 37.50 X 278488 0 40020 SHASHIDAR REDDY MD 37.50 X 277753 0 24267 3583795 0 410985 82 0 1 0 CERNER CORPORATION 2800 ROCKCREEK PKWY KANSAS CITY MO 64117 SOFTWARE SUPPORT & CONSULTING 1446530 ONYX MD PO BOX 4715 GREENSBORO NC 27404 PHYSICIAN STAFFING SERVICES 1213467 METZ & ASSOC TWO WOODLAND DRIVE DALLAS PA 18612 FOOD SERVICES 858538 AMERICAN RED CROSS PO BOX 33093 NEWARK NJ 07188 LAB SERVICES 719040 REED SMITH LLP 136 MAIN STREET PRINCETON NJ 08543 LEGAL SERVICES 708176 38 509776 3089957 209749 3809482 NET PATIENT SVC REV 621990 124159627 124159627 OTHER PATIENT SERVICES 621990 888408 888408 PSYCHIATRIC REV 621300 333300 333300 EDUCATION PROGRAMS 611600 106372 106372 LAB SERVICES 621500 865 865 125488572 845862 845862 122 122 358062 703817 -345755 -345755 -345755 707894 707894 707894 707894 137083 115614 21469 21469 PURCHASE REBATES/DISC 900099 190779 190779 PHARMACY-EMPLOYEES 446110 21999 21999 CAFETERIA & VENDING 722210 12606 12606 10722 10722 236106 130763752 125488572 0 1465698 6000000 6000000 3930 3930 2221542 1110771 1110771 186388 186388 54723151 45938335 8784816 1084977 899820 185157 6962969 5771515 1191454 5298379 4397655 900724 1013135 1013135 170000 170000 48350 48350 7171974 4045940 3126034 606181 606181 20589718 17515895 3073823 5145882 5145882 2604008 2099805 504203 263108 117777 145331 1193563 930979 262584 7038898 5452174 1586724 1448699 1129985 318714 BAD DEBT EXPENSE 6193804 4831167 1362637 BILLING/COLLECTION EXP 790060 790060 HCCR FUND 508206 508206 MISCELLANEOUS FEES 318425 318425 CLEANING/GROUNDS MAINT 197767 154258 43509 122492 122492 131905606 100586394 31319212 0 30361 82202 16723876 15396108 12574359 12714916 1794293 1506008 1707858 1747714 112361799 62739991 51878064 49621808 33295832 35945591 4940314 5593814 6114898 7694759 129059855 130302920 16411363 17650885 23905155 22452235 1469998 336669 6116684 8080146 47903200 48519935 X 72140193 71603247 5618730 6475186 3397732 3704552 81156655 81782985 129059855 130302920 X -1141854 1768184 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 48350 48350 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: CORNERSTONE GOVERNMENT AFFAIRS IS A WASHINGTON D.C.-BASED LOBBYING FIRM WHICH ASSISTS NEWTON MEMORIAL HOSPITAL WITH IDENTIFYING, CRAFTING AND PITCHING FEDERAL APPROPRIATIONS REQUESTS TO MEMBERS OF THE HOUSE OF REPRESENTATIVES AND THE U.S. SENATE. THEY COORDINATE IN-PERSON INTERVIEWS BETWEEN THE HOSPITAL'S GOVERNMENT AFFAIRS TEAMS AND ELECTED OFFICIALS TO ENSURE THE HOSPITAL'S REQUESTS ARE HEARD, AND THEN FOLLOWS THE REQUESTS AS THEY GO BEFORE THE HOUSE APPROPRIATIONS COMMITTEE. CORNERSTONE ALSO MONITORS LEGISLATIVE ACTIVITY AND PROVIDES REGULARLY UPDATES ON HOW THE INNER WORKINGS OF GOVERNMENT IMPACT NEWTON MEMORIAL. 357034 14000 22149 393183 312268 5000 39766 357034 314468 60000 -62200 312268 0.00000 1.00000 0.00000 0 1 1 714499 714499 57782983 24461663 33321320 101776 101776 0 50748408 36554882 14193526 3014133 1621670 1392463 49621808 DUE FROM AFFILIATES 313042 DEPOSITS 15024 MISCELLANEOUS RECEIVABLES 7366693 7694759 DUE TO AFFILIATES 15897 AMOUNTS DUE TO THIRD-PARTY PAYERS 7509590 ACCRUED INTEREST PAYABLE 554659 8080146 130763752 131905606 -1141854 1114684 653500 1768184 626330 133351367 1114684 653500 1768184 131583183 -819431 -819431 130763752 132725037 819431 819431 131905606 0 131905606 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE ENDOWMENT FUNDS ARE HELD BY NEWTON MEMORIAL HOSPITAL FOUNDATION FOR THE BENEFIT OF NEWTON MEMORIAL HOSPITAL. $250,000 OF THE BALANCE IN THE ENDOWMENT FUND IS DESIGNATED TO NEWTON HOSPITAL CARDIAC CATH. THE REMAINING BALANCE IN THE ENDOWMENT FUND IS NOT DESIGNATED. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE HOSPITAL IS ALSO EXEMPT FROM STATE AND LOCAL TAXES. WHEN APPLICABLE, A PROVISION FOR FEDERAL INCOME TAXES IS REFLECTED IN THE FINANCIAL STATEMENTS AND IS INCLUDED IN SUPPLIES AND OTHER EXPENSES ON THE CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS. A PROVISION FOR FEDERAL INCOME TAXES WAS NOT APPLICABLE FOR 2010 OR 2009. PART XI, LINE 8 - OTHER ADJUSTMENTS: NET CHANGE IN BENEFICIAL INTEREST IN NEWTON MEMORIAL HOSPITAL FOUNDATION 346,680. CHANGE IN VALUE OF PERPETUAL TRUSTS 306,820. PART XII, LINE 2D - OTHER ADJUSTMENTS: NET CHANGE IN BENEFICIAL INTEREST IN NEWTON MEMORIAL HOSPITAL FOUNDATION 346,680. CHANGE IN VALUE OF PERPETUAL TRUSTS 306,820. PART XII, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -703,817. GIFT SHOP EXPENSES -115,614. PART XIII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 703,817. GIFT SHOP EXPENSES 115,614. 1 1 1 X 1 X 1 1 1 0 1 1 6134133 6134133 0.04880 1092461 1092461 0.00870 7226594 7226594 0.05750 140480 19540 120940 0.00100 1338428 420638 917790 0.00730 1478908 440178 1038730 0.00830 8705502 440178 8265324 0.06580 1 1124795 576670 37959590 45143190 -7183600 X 1 1 1 1 NEWTON MEMORIAL HOSPITAL

175 HIGH STREET NEWTON NJ 07860

X X X NA 1 0 0 0 0 0 0 0 0 0 0 0 PART I, LINE 7: THE COSTING METHODOLOGY USED WAS BASED ON THE 2010 MEDICARE COST REPORT SCHEDULE S-10. PART I, LINE 7G: THE ORGANIZATION INCLUDED $813,533 OF COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC IN SUBSIDIZED HEALTH SERVICES. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 6193804. PART I, LINE 6B AN ANNUAL REPORT IS PUBLISHED AND A PUBLIC MEETING WITH THE COMMUNITY IS HELD AND WHAT WE PROVIDE FOR THE COMMUNITY IS DISCUSSED OPENLY AT THIS MEETING. IN ADDITION TO THE VOLUNTEER BOARD OF DIRECTORS THERE IS A COMMUNITY ADVISORY COMMITTEE WITH REPRESENTATIVES OF VARIOUS COMMUNITY MEMBERS WHO MEET TWICE A YEAR, RECEIVE UPDATES ON THE HOSPITAL, AND GIVE THE HOSPITAL FEEDBACK. PART I, LINE 7 QUANTIFIABLE COMMUNITY BENEFIT:THE FINANCIAL INFORMATION IN THIS REPORT WAS PREPARED IN ACCORDANCE WITH THE CATHOLIC HEALTH ASSOCIATION'S (CHA) COMMUNITY BENEFIT REPORTING GUIDELINES. THESE GUIDELINES RECOMMEND THE FOLLOWING:1) REPORT CHARITY CARE AT COST, NOT CHARGES.2) DO NOT INCLUDE BAD DEBT, CONTRACTUAL ALLOWANCES, AND QUICK PAY DISCOUNTS AS PART OF CHARITY CARE EXPENSE.3) DO NOT COUNT MEDICARE SHORTFALL AS A COMMUNITY BENEFIT.4) REPORT THE NET EXPENSE FOR COMMUNITY BENEFIT SERVICES, I.E., THE TOTAL COMMUNITY BENEFIT EXPENSE MINUS ANY ASSOCIATED REVENUE FROM PATIENTS, PAYERS, AND OTHER EXTERNAL SOURCES.THE GOAL OF THE REPORTING GUIDELINES IS TO PRODUCE COMMUNITY BENEFIT FINANCIAL REPORTS THAT REFLECT TRUE COSTS AND THAT DESCRIBE COMMUNITY BENEFIT ACTIVITIES THAT INCREASE ACCESS TO HEALTH CARE AND IMPROVE COMMUNITY HEALTH. PART II: HOSPITAL STAFF PARTICIPATE IN THE UNITED WAY DAY OF CARING AND IN COLLECTING AND DONATING BACKPACKS TO UNITED WAY. THIS IS CONSIDERED A WORKING DAY FOR THOSE WHO PARTICIPATE. THE STAFF ALSO ARE ACTIVE ON THE BOARD OF UNITED WAY AND ON COMMITTEES FOR UNITED WAY.THE HOSPITAL'S PRESIDENT & CEO PARTICIPATES IN THE SUSSEX COUNTY ECONOMIC DEVELOPMENT PARTNERSHIP OF SUSSEX COUNTY CHAMBER OF COMMERCE TO IMPROVE ECONOMIC QUALITY OF LIFE FOR SUSSEX COUNTY. THE PRESIDENT & CEO IS ALSO A MEMBER OF THE YMCA PIONEERING HEALTHY COMMUNITIES INITIATIVE AND SPENT TIME IN WASHINGTON, DC FOR TRAINING IN DECEMBER 2008. MEMBERS OF THE EDUCATION, OUTREACH, COMMUNITY BENEFITS DEPARTMENTS, AND BEHAVIORAL HEALTH AREAS PARTICIPATE ACTIVELY IN COALITION BUILDING WITH THE SUSSEX COUNTY COMMUNITY HEALTH PARTNERSHIP, COALITION FOR HEALTHY & SAFE FAMILIES, SUSSEX COUNTY HUMAN SERVICES ADVISORY COUNCIL, SUSSEX COUNTY CHAMBER OF COMMERCE WELLNESS COMMITTEE, SUSSEX COUNTY KEEP KIDS SAFE COUNCIL, SUSSEX COUNTY PROVIDER AND SENIOR PROVIDER GROUPS, SUSSEX COUNTY CHAMBER OF COMMERCE (SCCC), SCCC ECONOMIC DEVELOPMENT PARTNERSHIP, SCCC WELLNESS COMMITTEE; GINNIE'S HOUSE BOARD OF DIRECTORS, GINNIE'S HOUSE CHILD ADVOCACY CENTER, GINNIE'S HOUSE PROGRAM COMMITTEE, SUSSEX COUNTY MULTIDISCIPLINARY TREATMENT TEAM (MDT); CHAIR OF SUSSEX COUNTY SEXUAL ASSAULT RESOURCE TEAM; CO-CHAIR SUSSEX COUNTY DOMESTIC PREPAREDNESS TASK FORCE; NORTHWEST REGIONAL PARTNERSHIP & FIRST RECEIVER EDUCATION TEAM FOR AWARENESS & OPERATIONS; PIONEERING HEALTHIER COMMUNITIES, ACTIVATE AMERICA PROGRAM COMMITTEE, SUSSEX COUNTY SCHOOLS TASK FORCE FOR PIONEERING HEALTHIER COMMUNITIES; AMERICAN HEART ASSOCIATION REGIONAL FACULTY (BLS, ACLS, PALS); NEWTON ROTARY CLUB, BOARD OF DIRECTORS SUSSEX COUNTY COMMUNITY COLLEGE; GARDEN STATE ASSOCIATION OF DIABETES EDUCATORS; SUSSEX COUNTY CANCER COALITION; PIKE COUNTY CHILD DEATH REVIEW TEAM; & PIKE COUNTY INTERAGENCY COUNCIL.ONE FULL TIME HOSPITAL EMPLOYEE WHO HAS PARTICIPATED IN A COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT WITHIN THE COUNTY AND STATE IN ADDITION TO CO-CHAIRING THE SUSSEX COUNTY DOMESTIC PREPAREDNESS TASK FORCE MANAGES THE COMMUNITY BENEFITS COORDINATION AND OPERATION. PART III, LINE 4: FINANCIAL STATEMENT FOOTNOTE REGARDING ACCOUNTS RECEIVABLE AND ALLOWANCE FOR DOUBTFUL ACCOUNTS:PATIENT ACCOUNTS RECEIVABLE RESULTING FROM THE HEALTH CARE SERVICES PROVIDED BY THE HOSPITAL ARE STATED AT THE ESTIMATED NET AMOUNTS RECEIVABLE FROM PAYORS. ADDITIONS TO ALLOWANCE FOR DOUBTFUL ACCOUNTS RESULT FROM THE PROVISION FOR BAD DEBTS. ACCOUNTS WRITTEN OFF AS UNCOLLECTIBLE ARE DEDUCTED FROM THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE AMOUNTS OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH COVERAGE AND OTHER COLLECTION INDICATORS.THE COSTING METHODOLOGY USED IN DETERMINING BAD DEBT EXPENSE AT COST AND THE ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS BAD DEBT EXPENSES TIMES COST TO CHARGE RATIO.IN DETERMINING BAD DEBT EXPENSE, PATIENT LIABILITIES ARE NET OF THIRD PARTY PAYMENTS AND PATIENT DISCOUNTS.THE METHOD THE ORGANIZATION USES TO DETERMINE THE AMOUNT THAT REASONABLY COULD BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY IS THAT UNINSURED DISCOUNTED SELF PAY PATIENTS THAT ARE CLASSIFIED AS BAD DEBT TIMES COST TO CHARGE RATIO.NEW JERSEY HOSPITALS PROVIDE CARE TO ALL PATIENTS WHO NEED IT, REGARDLESS OF THEIR ABILITY TO PAY. THAT IS PART OF THE HOSPITAL'S CARING MISSION, AND IT IS ALSO A MANDATE WRITTEN IN STATE LAW. NEW JERSEY DOES NOT HAVE A PUBLIC HOSPITAL SYSTEM. PART III, LINE 8: THE COSTING METHODOLOGY/SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE ALLOWABLE COSTS IS THE COST TO CHARGE RATIO PER THE 2010 MEDICARE COST REPORT SCHEDULE S-10.NEW JERSEY HOSPITALS PROVIDE CARE TO ALL PATIENTS WHO NEED IT, REGARDLESS OF THEIR ABILITY TO PAY. THAT IS PART OF THE HOSPITAL'S CARING MISSION, AND IT IS ALSO A MANDATE WRITTEN IN STATE LAW. NEW JERSEY DOES NOT HAVE A PUBLIC HOSPITAL SYSTEM. PART III, LINE 9B: ALL PATIENTS ARE PROVIDED WITH FREE AND BELOW COST CARE GUIDELINES VIA NOTICES AND SIGNS AT TIME OF SERVICE. UNINSURED INPATIENTS ARE QUALIFIED FOR CHARITY OR MEDICAID. OUTPATIENTS ARE SCREENED FOR ELECTIVE SERVICES. HOSPITAL PRE-COLLECTION AND COLLECTION AGENCIES ALSO PROVIDE INFORMATION TO PATIENTS ABOUT QUALIFICATION FOR UNCOMPENSATED CARE. PART VI, LINE 2: THE LAST COMMUNITY ASSESSMENT WAS COMPLETED THROUGH THE SUSSEX COUNTY HUMAN SERVICES ADVISORY COUNCIL IN 2008. THIS WAS AN UPDATE OF THE 2003 ASSESSMENT WHICH THE HOSPITAL PARTNERED WITH AND CHAMPIONED FOR THE SUSSEX COUNTY DIVISION OF HEALTH & HUMAN SERVICES. THE DATA WAS BASED ON HOUSEHOLD SURVEYS AND UTILIZED VALIDATED QUESTIONS AS WELL AS TARGETED FOCUS GROUPS.NEWTON MEMORIAL HOSPITAL IS ALSO A PART OF THE COMMUNITY HEALTH PARTNERSHIP THAT RELEASED THE SUSSEX COUNTY HEALTH IMPROVEMENT PLAN IN JULY OF 2008. THE DATA WAS BASED ON SURVEYS COMPLETED IN 2005 AND UTILIZED VALIDATED QUESTIONS AS WELL AS TARGETED FOCUS GROUPS.NEWTON MEMORIAL HOSPITAL HAS BEEN VERY ACTIVE IN COMMUNITY ASSESSMENTS AND PARTICIPATES ACTIVELY IN THE SUSSEX COUNTY PIONEERING HEALTHIER COMMUNITIES WHICH IS A COALITION OF LEADERS TO ASSIST IN MAKING NECESSARY POLICY CHANGES TO PROMOTE HEALTHIER LIVING AND A HEALTHIER COMMUNITY WITHIN THE COUNTY. THE PRESIDENT & CEO AS WELL AS THE DIRECTOR OF EDUCATION, OUTREACH & COMMUNITY BENEFITS OF THE HOSPITAL PARTICIPATE ACTIVELY ON THE OVERSIGHT COMMITTEE AS WELL AS SUBCOMMITTEES OF THIS COALITION.NEWTON MEMORIAL HOSPITAL PROVIDES PROGRAMMING AND SERVICES BASED ON THESE ACTIVE/CURRENT COMMUNITY ASSESSMENTS TO RESIDENTS. NEWTON MEMORIAL HOSPITAL WORKS WITHIN COALITIONS AS WELL AS WITH PARTNERS TO MEET ASSESSED COMMUNITY NEEDS. THIS IS A MAJOR STRATEGIC INITIATIVE ADDRESSING IDENTIFIED NEEDS AND PROBLEMS. PART VI, LINE 3: NEWTON MEMORIAL HOSPITAL PROVIDES FINANCIAL COUNSELING INFORMATION IN ENGLISH AND SPANISH TO THOSE IN NEED.NEWTON MEMORIAL HOSPITAL'S POLICY FOR THE PURPOSE OF PROVIDING INPATIENT AND/OR OUTPATIENT SERVICES TO THE MEDICALLY INDIGENT RESIDENTS OF NEW JERSEY STATES: "THE HOSPITAL'S FINANCIAL COUNSELOR WILL INTERVIEW ALL APPLICANTS TO DETERMINE ELIGIBILITY. INITIAL APPROVAL FOR REDUCED RATES WILL BE MADE BY THE DIRECTOR OF PATIENT ACCOUNTS. AN ELIGIBILITY DETERMINATION ON ANY APPLICATION WILL BE MADE WITHIN TEN (10) WORKING DAYS FOLLOWING THE APPLICANT'S COMPLETION AND SUBMISSIONS OF ALL REQUIRED INFORMATION." ELIGIBILITY REQUIREMENT: ALL APPLICANTS WILL BE SCREENED BY THE HOSPITAL'S FINANCIAL COUNSELOR TO ASSURE ELIGIBILITY IN THE FOLLOWING CATEGORIES PRIOR TO FORWARDING THE APPLICATION TO THE DIRECTOR OF PATIENT ACCOUNTS FOR INITIAL APPROVAL. 1. RESIDENCY: BELOW COST OR FREE CARE WILL BE AVAILABLE TO ALL ELIGIBLE NEW JERSEY RESIDENTS. 2. AGE: THE APPLICANT MUST HAVE REACHED THE AGE OF MAJORITY OR BE EMANCIPATED. UNDERAGE APPLICANTS REQUIRING SERVICES UNDER THIS POLICY MUST HAVE THEIR PARENT, GUARDIAN, OR RESPONSIBLE PARTY COMPLETE ALL APPLICATION FORMS. 3. THIRD PARTY ASSISTANCE: AN ELIGIBILITY ASSESSMENT WILL BE CONDUCTED BY THE FINANCIAL COUNSELOR UTILIZING CURRENT PUBLIC ASSISTANCE STANDARDS AS PUBLISHED BY THE NEW JERSEY DEPARTMENT OF INSTITUTIONS AND AGENCIES, DIVISION OF PUBLIC WELFARE. THE HOSPITAL'S FINANCIAL COUNSELOR WILL REFER APPLICANTS DEEMED ELIGIBLE FOR THIRD PARTY ASSISTANCE TO ONE OR MORE OF THE FOLLOWING APPROPRIATE PROGRAMS: A. PUBLIC ASSISTANCE MEDICAID B. SSI MEDICAID C. MEDICARE D. SOCIAL SECURITY DISABILITY E. NEW JERSEY STATE DISABILITY UNEMPLOYMENT F. DIRECT ENROLLMENT IN BLUE CROSS AND BLUE SHIELD G. OTHER MEDICAL INSURANCE (SCHOOL PROGRAMS, ETC.) FAILURE OF THE PATIENT TO APPLY FOR ELIGIBLE PUBLIC ASSISTANCE PROGRAMS WILL TERMINATE HIS/HER ELIGIBILITY FROM THE HOSPITAL'S INDIGENCE PROGRAM.ALL OBSTETRICAL APPLICANTS ELIGIBLE FOR MEDICAID ASSISTANCE WILL BE REFERRED TO THE FINANCIAL COUNSELOR. 4. INCOME TEST: THE PERSON'S INCOME FOR ELIGIBILITY DETERMINATIONS WILL BE THE LESSER OF THE ACTUAL GROSS INCOME OF THE APPLICANT OR FAMILY FOR THE TWELVE (12) MONTHS PRECEDING THE SERVICES OR FOUR TIMES THE ACTUAL GROSS INCOME OF THE APPLICANT OR FAMILY OF THE THREE (3) MONTHS PRECEDING THE SERVICES. APPLICANTS ARE REQUIRED TO PRODUCE VERIFICATION OF INCOME AS A CONDITION OF ELIGIBILITY, E.G., TAX RETURNS, PAY STUBS, BANK STATEMENTS, ETC. 5. ASSET TEST: THE APPLICANT CAN BE DEEMED INELIGIBLE IF HE/SHE POSSESSES EITHER REAL OR PERSONAL PROPERTY WHICH WOULD ENABLE HIM/HER TO MEET HIS/HER MEDICAL FINANCIAL REQUIREMENTS. ASSETS WILL BE CONSIDERED IN THE ELIGIBILITY REQUIREMENTS FOR ALL CASES. ASSETS ARE DEFINED AS CASH, SAVINGS AND CHECKING ACCOUNTS, CERTIFICATES OF DEPOSIT, TREASURY NOTES, STOCKS AND BONDS, OTHER NEGOTIABLE PAPER, AND REAL ESTATE OTHER THAN THE APPLICANT'S PRIMARY RESIDENCE. INDIVIDUAL ASSETS MAY NOT EXCEED $7,500.00; FAMILY ASSETS MAY NOT EXCEED $15,000.00. HOSPITAL FEE SCHEDULE: FREE CARE OR BELOW COST CARE WILL BE DETERMINED BY USE OF THE NEW JERSEY STATE DEPARTMENT OF HEALTH FEE SCHEDULE.PERIODIC REVIEW: APPROVED APPLICANTS ARE ELIGIBLE FOR BELOW COST OR FREE CARE FOR A MAXIMUM PERIOD OF ONE (1) YEAR FROM THE APPLICATION DATE AFTER WHICH DATE THEIR ELIGIBILITY WILL AGAIN BE VERIFIED. PART VI, LINE 4: NEWTON MEMORIAL HOSPITAL IS LOCATED IN SUSSEX COUNTY IN THE SKYLANDS REGION OF THE STATE AND APPROXIMATELY 60 MILES FROM MANHATTAN. NEWTON IS THE COUNTY SEAT AND PARTICIPATES IN THE NORTHWEST REGIONAL PARTNERSHIP FOR EMERGENCY PREPAREDNESS. IN ADDITION, NEWTON MEMORIAL HOSPITAL PROVIDES SERVICES TO RESIDENTS IN SUSSEX COUNTY, PART OF WARREN COUNTY, AND PIKE COUNTY, PENNSYLVANIA.FROM THE 2008 COMMUNITY ASSESSMENT, THERE ARE APPROXIMATELY 151,442 RESIDENTS. THE MINORITY POPULATION IS 9% AND THERE HAS BEEN APPROXIMATELY A 6% INCREASE IN POPULATION IN THE LAST 6 YEARS. THERE HAS BEEN AN INCREASE IN THE NUMBER OF HISPANIC POPULATION SEEN WITHIN THE HOSPITAL. PATIENTS IN THE WOMEN'S HEALTH CENTER AND ADULT MEDICAL CLINIC COME FROM TWO SOURCES OF THIS HISPANIC COMMUNITY--EL REFUGIO BASED IN NEWTON AND BLESSED KATERI MINISTRY BASED IN SPARTA.THE MEDIAN AGE FOR THE COUNTY IS 39 AND 60% OF RESIDENTS ATTENDED COLLEGE. THE MEDIAN INCOME IN 2008 IS $74,420. THE UNEMPLOYMENT RATE IS 3.9%, HIGHEST AMONG 16-19 YEAR OLDS AND THERE ARE 6,628 RESIDENTS LIVING IN POVERTY.THERE ARE 14,245 HOUSEHOLDS WITH AN INDIVIDUAL 65 AND OVER IN RESIDENCE. AT THE SAME TIME THE NUMBER OF BIRTHS DECREASED BY 10% FROM 1,778 TO 1,601.SUSSEX COUNTY RANKS FIRST IN THE PERCENTAGE OF WOMEN RECEIVING PRENATAL CARE DURING THE FIRST TRIMESTER (90%). IN FACT NEWTON MEMORIAL HOSPITAL PROVIDED PRENATAL CARE TO 99% OF THE PATIENTS IN THE WOMEN'S HEALTH CENTER.THE LEADING CAUSES OF DEATH ARE HEART DISEASE AND CANCER; THERE ARE 134 CASES OF HIV. THERE WAS A 33% INCREASE IN EMERGENCY SCREENING SERVICES AND A 7% DECREASE IN OUTPATIENT MENTAL HEALTH SERVICES.FOR THE SAME PERIOD, THERE WAS A 183% INCREASE IN INJECTION DRUG USERS, 14.6% OF THE ADULT POPULATION REQUIRED ALCOHOL/DRUG TREATMENT AND 37% HAD NO INSURANCE.THERE ARE 2,410 STUDENTS WHO RECEIVE FREE OR REDUCED COST LUNCHES. SCHOOL BASED INCIDENCES OF VIOLENCE/VANDALISM INCREASED 5%. INCIDENTS OF SUBSTANCE ABUSE INCREASED 23%. OVERALL ADMISSIONS TO THE JUVENILE DETENTION CENTER ARE DOWN 15%. HOWEVER, FEMALE ADMISSIONS ARE UP 116%.REPORTS OF CHILD ABUSE AND NEGLECT HAVE INCREASED 30%. SUSSEX COUNTY IS ONE OF 5 COUNTIES STATEWIDE THAT HAS INCREASED EVERY YEAR. OUT OF HOME PLACEMENTS ARE DOWN FOR THE SAME PERIOD OF TIME. THE NUMBER OF FAMILY CRISIS INTERVENTION UNIT CASES IS DOWN 35% EXCEPT FOR CASES INVOLVING A "SERIOUS THREAT TO THE SAFETY OF THE JUVENILE" WHICH ARE UP BY 12%.THE NUMBER OF DOMESTIC VIOLENCE OFFENSES IS DOWN 24%. THE OVERALL CRIME RATE IN SUSSEX COUNTY INCREASED BY 27% - LARGELY NON-VIOLENT CRIMES INCLUDING LARCENY, THEFT AND BURGLARY.NEWTON MEMORIAL IS THE LARGEST HOSPITAL IN SUSSEX COUNTY AND SAINT CLARE'S, SUSSEX IS A SMALLER HOSPITAL WITHIN THE COUNTY WHICH SEES PATIENTS. PART VI, LINE 6: NEWTON MEMORIAL HOSPITAL:1. OPERATES AN EMERGENCY ROOM THAT IS OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY; 2. HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA; 3. HAS A GOVERNING BODY IN WHICH INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY COMPRISE A MAJORITY;4. WORKS WITH OTHER AFFILIATED OR CLINICALLY AFFILIATED STAFF AND THEIR FACILITIES TO PROVIDE MEDICAL OR SCIENTIFIC RESEARCH PROGRAMS;5. ENGAGES IN THE TRAINING AND EDUCATION OF HEALTH CARE PROFESSIONALS FROM PASSAIC COMMUNITY COLLEGE IN NURSING, SUSSEX COUNTY COMMUNITY COLLEGE FOR ALLIED HEALTH FIELDS MEDICAL ASSISTANT STUDENTS, SURGICAL TECHNICIAN STUDENTS, RESPIRATORY THERAPY STUDENTS AS WELL AS WILLIAM PATERSON UNIVERSITY NURSING STUDENTS, DOVER BUSINESS COLLEGE FOR PRACTICAL NURSE STUDENTS, CENTRAL STERILE PROCESSING STUDENTS. IN ADDITION, INTERNS IN SOCIAL WORK, HEALTH EDUCATION, PHARMACY, EXERCISE PHYSIOLOGY, BEHAVIORAL HEALTH, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, HOSPITAL ADMINISTRATION, EMERGENCY MEDICAL TECHNICIAN CLINICAL TIME IN THE EMERGENCY DEPARTMENT AND OTHER PROGRAMS HAVE BEEN PROVIDED AT NEWTON MEMORIAL HOSPITAL; 6. PARTICIPATES IN MEDICAID, MEDICARE, CHAMPUS, TRICARE, AND/OR OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS;7. THE BOARD OF DIRECTORS IS MADE UP OF PEOPLE WHO RESIDE WITHIN THE COMMUNITY WE SERVE AND VOLUNTEER THEIR TIME BECAUSE OF THEIR CONCERN FOR THE HOSPITAL AND THE COMMUNITY IT SERVES. PART VI, LINE 7: NORTH JERSEY HEALTH CARE CORPORATION ("NJHCC") AND SUBSIDIARIES (COLLECTIVELY THE "CORPORATION") WERE INCORPORATED IN THE STATE OF NEW JERSEY AND, AS APPLICABLE, WERE ORGANIZED TO PROVIDE HOSPITAL, HOME HEALTH CARE AND OTHER COMMUNITY HEALTH CARE SERVICES TO PATIENTS FROM THE SUSSEX COUNTY, NEW JERSEY AND SURROUNDING COMMUNITIES OR TO PROVIDE FINANCIAL SUPPORT TO THE CORPORATION THROUGH LEASING ACTIVITIES RELATED TO INVESTMENT AND OWNERSHIP OF OFFICE BUILDINGS OR FUND-RAISING ACTIVITIES.NJHCC HAS THE FOLLOWING WHOLLY OWNED OR CONTROLLED SUBSIDIARIES:NEWTON MEMORIAL HOSPITAL ("HOSPITAL")PRIME CARE, INC. ("PRIME CARE")NORTH JERSEY HEALTH VENTURES, INC. ("VENTURES")NORTH JERSEY HEALTH CARE PROPERTIES, INC. ("PROPERTIES")NEWTON MEMORIAL HOSPITAL FOUNDATION, INC. ("FOUNDATION")NJHCC IS A NOT-FOR-PROFIT ORGANIZATION AND WAS ESTABLISHED TO OVERSEE THE POLICIES AND ACTIVITIES OF ITS SUBSIDIARIES. ITS SUBSIDIARIES PROVIDE A FULL RANGE OF HEALTH CARE AND OTHER SERVICES AS BRIEFLY DESCRIBED BELOW.THE HOSPITAL IS A NOT-FOR-PROFIT ORGANIZATION. THE HOSPITAL IS LOCATED IN NEWTON, NEW JERSEY AND PROVIDES REGIONAL HEALTH CARE SERVICES INCLUDING A BROAD RANGE OF ADULT, PEDIATRIC, REHABILITATION, PSYCHIATRIC, OBSTETRICAL/GYNECOLOGICAL, ONCOLOGY AND INTENSIVE CARE SERVICES TO PATIENTS FROM AND SURROUNDING THE SUSSEX COUNTY COMMUNITY. THE HOSPITAL ALSO PROVIDES NUMEROUS OUTPATIENT AMBULATORY SERVICES AND EMERGENCY CARE. IN ADDITION, THE HOSPITAL PROVIDES FAMILY COUNSELING, PERSONAL CARE, HOMELESS AND RESIDENTIAL PROGRAMS.PRIME CARE IS A NOT-FOR-PROFIT ORGANIZATION WHICH OPERATES A MEDICARE CERTIFIED HOME HEALTH AGENCY AND PROVIDES VARIOUS WELLNESS, HEALTH EDUCATION AND OTHER HEALTH PROMOTION SERVICES.VENTURES WAS INCORPORATED ON JANUARY 30, 1986 AND CARRIES ON FOR-PROFIT ACTIVITIES. CURRENTLY, VENTURES HOLDS INVESTMENTS IN CERTAIN HEALTH CARE RELATED JOINT VENTURES.PROPERTIES IS A NOT-FOR-PROFIT ORGANIZATION WHICH WAS FORMED TO OWN COMMERCIAL BUILDINGS AND CONDUCT LEASING ACTIVITIES. THE ORGANIZATION OWNS AND CONDUCTS LEASING OPERATIONS OF COMMERCIAL BUILDINGS IN SPARTA AND NEWTON, NEW JERSEY AND IN MILFORD, PENNSYLVANIA AND A CONDOMINIUM IN NEWTON, NEW JERSEY.FOUNDATION IS A NOT-FOR-PROFIT FUND-RAISING ORGANIZATION THAT SOLICITS FUNDS IN ITS GENERAL APPEAL TO SUPPORT THE HOSPITAL AND AFFILIATED ORGANIZATIONS AND THE HEALTH CARE NEEDS OF THE COMMUNITY, AS THE FOUNDATION'S BOARD MAY DEEM APPROPRIATE. REPORTS FILED WITH STATES PART VI, LINE 7 NJ ADDITIONAL COMMUNITY BENEFIT INFORMATION THE HOSPITAL'S VISION IS TO BE RECOGNIZED AS A PREMIERE COMMUNITY PROVIDER OF HEALTHCARE SERVICES. THE HOSPITAL IS A NOT-FOR-PROFIT COMMUNITY HOSPITAL DESIGNED TO SERVE THE NEEDS OF THE COMMUNITY. THE HOSPITAL IS THE PRIMARY HEALTH CARE FACILITY IN THE COUNTY AND DELIVERED CARE TO OVER 10,000 INPATIENTS IN 2010. NEWTON MEMORIAL HOSPITAL'S MISSION IS "WE PROVIDE EXCEPTIONAL CARE AND SERVICE."NEWTON MEMORIAL HOSPITAL IS A SHORT TERM, ACUTE CARE 148-BED HOSPITAL WITH BEHAVIORAL HEALTH BEDS LOCATED IN NORTHWESTERN NEW JERSEY. DURING 2010, NEWTON MEMORIAL MAINTAINED A CLINICAL AFFILIATION WITH ATLANTIC HEALTH SYSTEM FOR TERTIARY CARE AND AS THE COMPREHENSIVE STROKE CENTER FOR OUR DESIGNATION AS A PRIMARY STROKE CENTER, AS WELL AS FOR REFERRAL OF PATIENTS IN NEED OF SERVICES WE DO NOT OFFER. NEWTON MEMORIAL HOSPITAL PHYSICIANS REPRESENT MORE THAN 40 SPECIALTIES AND SUBSPECIALTIES.NEWTON MEMORIAL HOSPITAL PROVIDES:1. SERVICES BASED ON ASSESSED COMMUNITY NEEDS ASSESSMENTS CONDUCTED IN 2003, 2005 AND 2008 IDENTIFIED THE MAJOR TRENDS, NEEDS, AND PROBLEMS IN THE COMMUNITY AS CARDIOVASCULAR DISEASE, BEHAVIORAL HEALTH NEEDS, CANCER PREVENTION AND SCREENING (ESPECIALLY IN THE AREA OF BREAST, LUNG, COLON, PROSTATE, AND SKIN CANCER); AS WELL AS CHRONIC DISEASES ASSOCIATED WITH POOR DIET AND INACTIVITY, E.G., OBESITY, DIABETES, CARDIAC, STROKE, CANCER. 2. SERVICES TO RESIDENTS ARE PROVIDED WORKING THROUGH COALITIONS AND WITH PARTNERS TO MEET ASSESSED COMMUNITY NEEDS. THIS HAS BEEN A PART OF THE MAJOR STRATEGIC PLAN TO ADDRESS IDENTIFIED NEEDS AND PROBLEMS INCLUDING THOSE OF A HISPANIC POPULATION AT EL REFUGIO WITHIN NEWTON AND BLESSED KATERI HISPANIC PROGRAM IN SPARTA. THE MEMBERS OF THESE PROGRAMS ARE SERVICED THROUGH THE HOSPITAL'S WOMEN'S HEALTH CENTER AND ADULT MEDICAL CLINIC.3. COMMUNITY ORGANIZATIONS COLLABORATING WITH THE HOSPITAL TO IMPROVE COMMUNITY HEALTH, EXPAND ACCESS TO HEALTH CARE, OR IN OTHER WAYS BENEFIT THE COMMUNITY INCLUDE SUSSEX COUNTY CHAMBER OF COMMERCE (SCCC), SCCC ECONOMIC DEVELOPMENT PARTNERSHIP, SCCC WELLNESS COMMITTEE; GINNIE'S HOUSE BOARD OF DIRECTORS, GINNIE'S HOUSE PROGRAM COMMITTEE, SUSSEX COUNTY MULTIDISCIPLINARY TREATMENT TEAM (MDT); CHAIR OF SUSSEX COUNTY SEXUAL ASSAULT RESOURCE TEAM; SUSSEX COUNTY DOMESTIC PREPAREDNESS TASK FORCE; SUSSEX COUNTY COMMUNITY HEALTH PARTNERSHIP; NORTHWEST REGIONAL PARTNERSHIP ADVISORY COMMITTEE & FIRST RECEIVER EDUCATION TEAM FOR AWARENESS & OPERATIONS; PIONEERING HEALTHIER COMMUNITIES, ACTIVATE AMERICA PROGRAM COMMITTEE, PIONEERING HEALTHIER COMMUNITIES SUSSEX COUNTY SCHOOLS TASK FORCE; AMERICAN HEART ASSOCIATION REGIONAL FACULTY (BLS, ACLS, PALS); NEWTON ROTARY CLUB, BOARD OF DIRECTORS SUSSEX COUNTY COMMUNITY COLLEGE; GARDEN STATE ASSOCIATION OF DIABETES EDUCATORS; SUSSEX COUNTY CANCER COALITION; SUSSEX COUNTY COALITION FOR HEALTHY & SAFE FAMILIES; SUSSEX COUNTY SENIOR PROVIDER GROUP; PIKE COUNTY INTERAGENCY COUNCIL, SUSSEX COUNTY HUMAN SERVICES ADVISORY COUNCIL; UNITED WAY KEEP KIDS SAFE COUNCIL.4. THERE IS ONE PERSON DEDICATED TO QUALIFYING AND QUANTIFYING THE COMMUNITY BENEFIT THAT NEWTON MEMORIAL HOSPITAL PROVIDES AND MANY STAFF WITHIN THE FACILITY CONTRIBUTED TO THE OVERALL EFFORT OF PROVIDING NEEDED SERVICE TO THE COMMUNITY.ACCESS TO PRENATAL CARE SERVICES SUPPLIED BY NEWTON MEMORIAL HOSPITAL ACCOUNTED FOR THE HOSPITAL'S WOMEN'S HEALTH CENTER SEEING 493 NEW PATIENTS AND PROVIDING 2,573 VISITS AND 128 OF THE DELIVERIES. PRENATAL SERVICES WERE DELIVERED TO 99% OF THE NEWTON MEMORIAL HOSPITAL DELIVERIES IN 2010. WOMEN'S HEALTH CENTER PROVIDES OBSTETRIC AND GYNECOLOGICAL CARE TO WOMEN WHO ARE IN FINANCIAL NEED. THERE IS A FINANCIAL SCREENING PROCESS TO DETERMINE ELIGIBILITY. PREGNANT WOMEN CONTACT THE CENTER TO MAKE AN APPOINTMENT BETWEEN THE EIGHTH AND TENTH WEEK OF PREGNANCY. CARE IS PROVIDED BY CERTIFIED NURSE MIDWIVES WORKING WITH A TEAM OF HEALTH CARE PROFESSIONALS. EVERY PATIENT ALSO RECEIVES NUTRITION COUNSELING AND SOCIAL SERVICE FOLLOW-UP. ACCESS TO BEHAVIORAL HEALTH CARE RESULTED IN 13,234 VISITS FOR 2010. THE EMERGENCY SERVICES DEPARTMENT OF THE HOSPITAL'S CENTER FOR MENTAL HEALTH OFFERS 24 HOUR HELP FOR ANYONE EXPERIENCING AN ACUTE BEHAVIORAL HEALTH EMERGENCY OR CRISIS. EMERGENCY SERVICES PROVIDES IMMEDIATE CARE FOR PATIENTS OF ALL AGES, INCLUDING SPECIALIZED CARE FOR CHILDREN, ADOLESCENTS AND SENIOR CITIZENS. IN ADDITION, CRITICAL INCIDENT STRESS DEBRIEFING IS PROVIDED IN AN EMERGENCY TO SCHOOLS, COMMUNITIES, AMBULANCE SQUADS, AND OTHERS WHO NEED THESE SERVICES WHEN A TRAGEDY OR OTHER STRESSFUL EVENT OCCURS.ACCESS TO MEDICAL CARE IN THE HOSPITAL'S ADULT MEDICAL CLINIC ACCOUNTED FOR 253 NEW PATIENTS AND 1,495 VISITS IN 2010. THIS PROGRAM PROVIDES CARE TO THOSE WHO QUALIFY TO RECEIVE INDIGENT CARE.OVER 6,600 PEOPLE IN SUSSEX, MORRIS, WARREN, AND PIKE COUNTIES WERE SEEN BY THE DEPARTMENT OF EDUCATION, OUTREACH, COMMUNITY BENEFITS IN 2010. HEALTH EDUCATION PROGRAMMING ACCOUNTED FOR 2,343 PEOPLE SEEN IN ADDITIONAL PROGRAMMING IN 2010, I.E. STROKE OR OTHER HEALTH SCREENINGS AND STROKE EDUCATION PROGRAMS. ASSESSED COMMUNITY NEEDS HAVE BEEN TARGETED RELATED TO OBESITY WITH CARDIAC KIDS PROGRAMMING, IN ADDITION TO WORKING WITH THE SCHOOLS RELATED TO TARGETED NUTRITION AND EXERCISE ISSUES. OBESITY INITIATIVES INCLUDED: CARDIAC KIDS SCREENED 30 CHILDREN IN 2010 YEAR WITH 19 STUDENTS IDENTIFIED AS HAVING ABNORMAL VALUES OF CHOLESTEROL AND/OR GLUCOSE. THE GOAL OF THE PROGRAM IS TO IDENTIFY CHILDREN AT RISK SO THEY CAN GET FOLLOW-UP EARLY. IN MILFORD, PENNSYLVANIA FOR THE PIKE COUNTY HEALTH FUND, THREE FREE SCREENINGS PER MONTH ACCOUNTED FOR 144 PARTICIPANTS IN 21 HEALTH SCREENING PROGRAMS/EVENTS IN 2010 WITH NO ABNORMAL VALUES IDENTIFIED.THE FORENSIC NURSE - SEXUAL ASSAULT PROGRAM SAW 11 ADULT CASES, PROVIDED 2 CHILD EXAMS, 11 CONSULTS AND EDUCATED 60 PROFESSIONALS IN 2010. FLU AND PNEUMONIA IMMUNIZATIONS WERE PROVIDED TO 176 COMMUNITY MEMBERS IN 2010.EMERGENCY PREPAREDNESS - COORDINATION AND PREPARATION HAS ALSO BEEN TARGETED SO THE HOSPITAL IS PREPARED FOR ANY ALL HAZARDS EVENT WHICH MIGHT OCCUR. THE HOSPITAL'S DIRECTOR OF EDUCATION, OUTREACH & COMMUNITY BENEFITS CO-CHAIRS THE SUSSEX COUNTY DOMESTIC PREPAREDNESS TASK FORCE AND WORKS CLOSELY WITH COUNTY AND NORTHWEST REGIONAL PARTNERS TO BE PREPARED AS WELL FOR ANY EMERGENCY THAT MAY ARISE IN THE COUNTY AND REGION. THE DIRECTOR ALSO SITS ON THE MEDICAL COORDINATION CENTER (MCC) ADVISORY COMMITTEE FOR THE NORTHWEST REGION MCC. THE HOSPITAL HAS PARTICIPATED IN EXERCISES WITH THE COUNTY AND REGION TO IMPROVE PLANS AND RESPONSE. THE HOSPITAL ALSO CONDUCTS EXERCISES REGULARLY TO KEEP STAFF IN A STATE OF READINESS. HEARTSAFE COMMUNITY INITIATIVES INCLUDE: PROVIDING A COMMUNITY IN WHICH EARLY CPR IS INITIATED BY A BYSTANDER AND EARLY BYSTANDER DEFIBRILLATION IS AVAILABLE WITH THE USE OF AN AUTOMATED EXTERNAL DEFIBRILLATOR (AED). THE BASIC LIFE SUPPORT PROGRAM ACCOUNTED FOR TRAINING 1,828 PARTICIPANTS IN COURSES IN 2010. THE AED PROGRAM DEPLOYED 28 UNITS TO THE COMMUNITY; TRAINED 702 PARTICIPANTS HAD 50 USES OF THE AED AND SAVED FIVE LIVES OVER 70 YEARS OF AGE FOR 2010. THE MEDICAL DIRECTOR OF THE EMERGENCY DEPARTMENT AND THE MILFORD HEALTH & WELLNESS CENTER PROVIDE MEDICAL OVERSIGHT OF THE PROGRAM. THE PROGRAM FOR AED'S IS UNDERWRITTEN BY THE NEWTON MEMORIAL HOSPITAL FOUNDATION.AN AMERICAN DIABETES ASSOCIATION RECOGNIZED DIABETES SELF-MANAGEMENT EDUCATION PROGRAM ACCOUNTED FOR 129 INPATIENTS AND 403 OUTPATIENTS, WHICH INCLUDED INITIATION OF INSULIN PUMP THERAPY AND CONTINUOUS BLOOD GLUCOSE MONITORING, 113 OUTPATIENT FOLLOW-UPS, 75 PARTICIPANTS IN BUILDING BLOCKS. THE DAYTIME SUPPORT GROUP SAW 124 PARTICIPANTS. IN ADDITION, 66 PARTICIPANTS WERE SEEN IN PROGRAMS RELATED TO DIABETES IN 2010. OUTCOMES CONTINUE TO BE ABOVE THE NATIONAL AVERAGE. QUALITY INITIATIVES FOR DIABETES EDUCATION CONTINUE TO BE ABOVE THE NATIONAL AVERAGE AND DEMONSTRATED: NATIONALLY, 10% OF PEOPLE WITH DIABETES KNOW THEIR BLOOD GLUCOSE AND 99% OF DIABETIC PATIENTS AT NEWTON MEMORIAL HOSPITAL KNOW THEIR BLOOD GLUCOSE WITH 63% PATIENTS KNOWING THEIR HGB A1C FOR 2010. THERE WAS AN IMPROVEMENT IN HGB A1C FOR 72% OF THE PATIENTS SEEN BY THE PROGRAM.A GOAL BENCHMARK FOR WEIGHT OF BABY OF A GESTATIONAL MOTHER IS TO HAVE THE BABY WEIGH LESS THAN 9 POUNDS. AVERAGE WEIGHT OF NEWTON MEMORIAL HOSPITAL BABIES OF MOTHERS WITH GESTATIONAL DIABETES IN 2010 WAS 6 POUNDS 7 OUNCES.NUTRITIONAL COUNSELING IS PROVIDED TO ASSIST PEOPLE WITH EATING ISSUES AND DISORDERS. IN 2010 NUTRITIONAL COUNSELING WAS PROVIDED TO 445 OUTPATIENTS. IN ADDITION, 158 PEOPLE ATTENDED COMMUNITY PROGRAMMING RELATED TO NUTRITION. NUTRITION SERVICES ARE PROVIDED FOR THE YMCA ACTIVATE AMERICA PROGRAM COMMITTEE EXERCISE PROGRAM WHICH IS BASED ON THE DIABETES PREVENTION PROGRAM GUIDELINES FOR PEOPLE WITH OBESITY OR TYPE 2 DIABETES. THE DIRECTOR OF EDUCATION, OUTREACH & COMMUNITY BENEFITS WRITES A MONTHLY HEALTH PROMOTION, HEALTH PREVENTION ARTICLE FOR A SCHOOL PAPER THINK WHICH HAS A CIRCULATION OF 44,000 SUSSEX COUNTY STUDENTS AND THEIR PARENTS AS WELL AS A HEALTH PROMOTION/PREVENTION ARTICLE FOR LITTLE THINKERS TARGETING PRESCHOOLERS AND THEIR PARENTS. THE PAPERS ARE WRITTEN FOR AGE APPROPRIATE AUDIENCES AND THEIR PARENTS. THE GOAL OF THIS PROGRAM IS TO PROVIDE CURRENT HEALTH PREVENTION AND HEALTH PROMOTION EDUCATION TO THE READERSHIP.FOR FURTHER INFORMATION PLEASE VISIT WWW.NMHNJ.ORG TO VIEW SPECIFIC INFORMATION AVAILABLE TO THE COMMUNITY WHICH INCLUDES FINANCIAL ASSISTANCE INFORMATION AND COMMUNITY RESOURCES FOR THE PUBLIC. 1 NORTH JERSEY HEALTH CARE CORPORATION 175 HIGH STREET NEWTON NJ 07860 222618100 501(C)(3) 6000000 FUND CHARITABLE OPERATIONS 1 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE NEWTON MEMORIAL HOSPITAL SUNSHINE FUND HAS BEEN ESTABLISHED TO PROVIDE FINANCIAL ASSISTANCE TO EMPLOYEES OF THE HOSPITAL AND PRIME CARE WHO, AT ANY GIVEN TIME, ARE FACING A SIGNIFICANT PERSONAL OR FAMILY HARDSHIP. THE NEWTON MEMORIAL HOSPITAL SUNSHINE FUND COMMITTEE (THE "COMMITTEE") IS AN ALL VOLUNTEER COMMITTEE REPRESENTED BY EMPLOYEES OF NEWTON MEMORIAL HOSPITAL. THIS COMMITTEE IS CHARGED WITH THE RESPONSIBILITY OF MANAGING AND ADMINISTERING THE FUND. THE COMMITTEE WILL REVIEW AND RESPOND TO ALL APPLICATIONS FOR ASSISTANCE WITHIN TWO WEEKS OF THE RECEIPT OF THE APPLICATION. TO MAINTIAN CONFIDENTIALITY IN THE APPLICATION REVIEW PROCESS, ALL APPLICANTS WILL BE ASSIGNED A RANDOM NUMBER FOR IDENTIFICATION PURPOSES UPON SUBMISSION. IN ORDER TO PROTECT THE APPLICANT'S CONFIDENTIALITY AND PRIVACY, THE COMMITTEE WILL REVIEW AND MAKE DECISIONS ABOUT THE APPLICATION WITH IDENTIFYING DATA REMOVED. THIS PROCESS IS INTENDED TO ALLEVIATE ANY CONCERNS REGARDING PARTIALITY, BIAS, OR PERCEIVED CONFLICT OF INTEREST BETWEEN APPLICANT AND COMMITTEE MEMBERS. ALL COMMITTEE MEMBERS SIGN A CONFIDENTIALITY STATEMENT. ALL APPLICATIONS AND INFORMATION SUBMITTED TO THE COMMITTEE WILL REMAIN STRICTLY CONFIDENTIAL. IN 2010, THE AMOUNT OF ASSISTANCE PROVIDED WAS LESS THAN $5,000 AND IS THEREFORE NOT REPORTED IN SCHEDULE I, PART III. X 0 0 X X X X X 0 1 0 1 0 0 0 0 0 THOMAS J SENKER 342900 0 89910 0 68207 0 7350 0 30037 0 538404 0 0 0 SEAN O'ROURKE 248460 0 40627 0 4731 0 7350 0 31037 0 332205 0 0 0 DAVID RIKKOLA 226600 0 37818 0 4231 0 7350 0 31936 0 307935 0 0 0 DAVID LAZARUS 257500 0 29981 0 4808 0 7350 0 31280 0 330919 0 0 0 EVA GOLDENBERG 195077 0 31590 0 5304 0 6945 0 16546 0 255462 0 0 0 MARY ELLEN RAUNER 180250 0 26224 0 3365 0 6295 0 27350 0 243484 0 0 0 MEGAN SANDOW 155540 0 22661 0 0 0 5346 0 29585 0 213132 0 0 0 JOHN O'BRIEN MD 370000 0 0 0 10252 0 5648 0 27308 0 413208 0 0 0 BRIAN NEWMAN MD 335000 0 0 0 29249 0 5674 0 27352 0 397275 0 0 0 MARIE ANN MARGIOTTI MD 300000 0 0 0 7269 0 7350 0 27609 0 342228 0 0 0 SANDRA SQUIRES MD 265452 0 0 0 13036 0 7350 0 32670 0 318508 0 0 0 SHASHIDAR REDDY MD 226346 0 21281 0 30126 0 7350 0 16917 0 302020 0 0 0 PART I, LINE 1A CONTRACTUALLY OBLIGATED COMPENSATION RELATED TO RETIREMENT WAS GROSSED UP TO MINIMIZE TAXABLE IMPACT TO MR. THOMAS SENKER. PART I, LINE 4B PRESIDENT & CEO THOMAS J. SENKER PARTICIPATED IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN AND WAS PAID $48,428.14 IN 2010. PART I, LINE 5 NEWTON MEMORIAL HOSPITAL ACCRUED POTENTIAL BONUS PAYMENTS BASED ON NET REVENUE AND PERFORMANCE TARGETS AS DESCRIBED IN A FORMAL WRITTEN BONUS PROGRAM APPROVED BY THE BOARD. DR NICK P DIBITETTO HOSPITAL BOARD MEMBER/PARTNER IN SUSSEX COUNTY MEDICAL ASSOCIATION 160394 SUSSEX COUNTY MEDICAL ASSOCIATION RECEIVED PAYMENTS FOR INDIGENT CARE AS WELL AS ADVANCES FOR PHYSICIAN LOANS FROM THE HOSPITAL. 0 PAUL J OWENS MD HOSPITAL BOARD MEMBER/PARTNER IN CARDIOLOGY ASSOCIATION OF SUSSEX COUNTY 179078 CARDIOLOGY ASSOCIATION OF SUSSEX COUNTY RECEIVED PAYMENTS FOR ECG READINGS AS WELL AS ADVANCES FOR PHYSICIAN LOANS FROM THE HOSPITAL. 0 BRIAN FITZPATRICK WIFE (KATHLEEN FITZPATRICK) WORKS AT NEWTON MEMORIAL HOSPITAL 89736 COMPENSATION 0 GEORGE MORVILLE JR SON-IN-LAW (JOHN BRAND) WORKS AT NEWTON MEMORIAL HOSPITAL 96652 COMPENSATION 0 FORM 990, PART VI, SECTION B, LINE 11 THE 2010 FORM 990 FILINGS FOR NORTH JERSEY HEALTH CARE CORPORATION ("NJHCC") AND ALL SUBSIDIARIES, INCLUDING THE HOSPITAL, WERE PREPARED BY THE FINANCE DEPARTMENT WITH THE ASSISTANCE OF NJHCC TAX ADVISORS. THE COMPLETED FILINGS WERE REVIEWED BY NJHCC'S CHIEF OPERATING OFFICER AND CHIEF FINANCIAL OFFICER. UPON FINALIZATION OF THE FORM 990, COPIES WERE MADE AVAILABLE TO BOARD MEMBERS. FORM 990 IS FILED WITH THE IRS AFTER THIS REVIEW PROCESS. FORM 990, PART VI, SECTION B, LINE 12C EACH "INTERESTED PERSON" OF THE HOSPITAL SHALL ANNUALLY SIGN THE NEW JERSEY HEALTH CARE CORPORATION ("NJHCC") CONFLICT OF INTEREST DISCLOSURE STATEMENT (FORM #1885C) WHICH AFFIRMS THAT SUCH PERSON: A. HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY OR THE NJHCC BY-LAWS, B. HAS READ AND UNDERSTANDS THE POLICY, C. HAS AGREED TO COMPLY WITH THE POLICY, AND D. UNDERSTANDS THAT NJHCC IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES UNDER IRC SECTION 501(C)(3) OR 501(C)(4) OF THE INTERNAL REVENUE CODE. ON THE CONFLICT OF INTEREST DISCLOSURE STATEMENT, ALL "INTERESTED PERSONS" MUST DETAIL ALL EXISTING OR POTENTIAL CONFLICTS OF INTEREST AND FILE THE FORM WITH THE CHIEF COMPLIANCE OFFICER ANNUALLY. INTERIM DISCLOSURES SHALL ALSO BE REQUIRED AS CONFLICTS DEVELOP SUBSEQUENT TO THE ANNUAL DISCLOSURES. TO ENSURE THAT NJHCC OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES AND THAT IT DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX, PERIODIC REVIEW SHALL BE CONDUCTED BY THE CHIEF COMPLIANCE OFFICER. THE PERIODIC REVIEWS SHALL, AT A MINIMUM, INCLUDE THE FOLLOWING SUBJECTS: A. WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE AND ARE THE RESULTS OF APPROPRIATE NEGOTIATIONS. B. WHETHER PHYSICIAN RECRUITMENT PRACTICES AND OTHER PROVIDER SERVICES RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT. C. WHETHER PARTNERSHIP AND JOINT VENTURE ARRANGEMENTS CONFORM TO WRITTEN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE PAYMENTS FOR GOODS AND SERVICES, FURTHER NJHCC'S CHARITABLE PURPOSES, AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT. D. WHETHER AGREEMENTS TO PROVIDE HEALTH CARE AND AGREEMENTS WITH OTHER HEALTH CARE PROVIDERS, EMPLOYEES AND THIRD PARTY PAYORS FURTHER NJHCC'S CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION REVIEWED AND DETERMINED THE TOTAL CASH COMPENSATION (CONSISTS OF BASE SALARY AND INCENTIVE AWARDS) OF THE PRESIDENT & CEO AND ALL EXECUTIVES (NAMELY, THE SVP-OPERATIONS/COO, VP-MEDICAL AFFAIRS/CMO, VP-FINANCE/CFO, VP-HR/CHIEF HR OFFICER AND CHIEF LEGAL OFFICER, VP-PATIENT CARE SERVICES/CNO, VP-FOUNDATION/CHIEF DEVELOPMENT OFFICER AND VP-MARKETING/BUSINESS DEVELOPMENT). THE ORGANIZATION ENGAGED INDEPENDENT CONSULTING FIRM, SULLIVAN COTTER AND ASSOCIATES, INC. TO PROVIDE GUIDANCE, ANALYSIS, RECOMMENDATIONS AND A REASONABLENESS OPINION. THIS PROCESS WAS LAST UNDERTAKEN IN 2008 FOR ALL OF THE AFOREMENTIONED EMPLOYEES. THE PROCESS INCLUDED SULLIVAN COTTER'S EVALUATION OF TOTAL CASH COMPENSATION FOR THESE EMPLOYEES BY USING COMPREHENSIVE COMPETITIVE MARKET DATA TO BENCHMARK SUCH COMPENSATION AGAINST OTHER HOSPITALS WITH SIMILAR NET REVENUE, COMPLEXITY, SCOPE, NON-PROFIT STATUS AND SIMILAR POSITIONS. MARKET DATA USED INCLUDES BOTH REGIONAL AND NATIONAL DATA. SULLIVAN COTTER DOCUMENTS ITS FINDINGS AND DELIVERS A WRITTEN REPORT AND OPINION TO THE ORGANIZATION. SULLIVAN COTTER'S FINDINGS AND RECOMMENDATIONS ARE REVIEWED BY THE EXECUTIVE COMPENSATION SUBCOMMITTEE OF THE GOVERNANCE COMMITTEE OF THE BOARD OF DIRECTORS OF THE ORGANIZATION WHOSE REVIEW VIA ANALYSIS AND DELIBERATION IS DOCUMENTED IN THE MINUTE(S) OF ITS MEETINGS REGARDING SAME. UPON RECOMMENDATION OF THE EXECUTIVE COMPENSATION SUBCOMMITTEE OF THE GOVERNANCE COMMITTEE, THE FINDINGS AND RECOMMENDATIONS ARE ULTIMATELY REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS OF THE ORGANIZATION. THE BOARD'S FINDINGS AND DETERMINATIONS ARE DOCUMENTED IN THE MINUTES OF ITS MEETING(S) REGARDING SAME. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. AVERAGE HOURS PER WEEK FORM 990, PART VII AVERAGE HOURS PER WEEK LISTED IN PART VII ARE FOR THIS LEGAL ENTITY ONLY. BOARD MEMBERS AND OFFICERS ALSO DEVOTE TIME TO THE RELATED ORGANIZATIONS LISTED ON SCHEDULE R. TOTAL AVERAGE HOURS PER WEEK FOR ALL RELATED ORGANIZATIONS ARE AS FOLLOWS: BOARD MEMBERS - 5.8 HOURS PER WEEK PRESIDENT & CEO THOMAS J. SENKER - 42.5 HOURS PER WEEK COO SEAN O'ROURKE - 42.5 HOURS PER WEEK CFO DAVID RIKKOLA - 42.5 HOURS PER WEEK CHIEF DEVELOPMENT OFFICER MEGAN SANDOW - 38.5 HOURS PER WEEK CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 1,114,684. NET CHANGE IN BENEFICIAL INTEREST IN NEWTON MEMORIAL HOSPITAL FOUNDATION 346,680. CHANGE IN VALUE OF PERPETUAL TRUSTS 306,820. TOTAL TO FORM 990, PART XI, LINE 5: 1,768,184. NEWTON MEMORIAL HOSPITAL FOUNDATION INC 175 HIGH STREET NEWTON NJ 07860 222618102 ADMINISTERS DONATIONS, GRANTS & BEQUESTS AND PERFORMS FUNDRAISING NJ 501(C)(3) LINE 7 NORTH JERSEY HEALTH CARE CORPORATION 0 NORTH JERSEY HEALTH CARE CORPORATION 175 HIGH STREET NEWTON NJ 07860 222618100 OVERSEES POLICIES AND ACTIVITIES OF SUBSIDIARIES NJ 501(C)(3) LINE 11A, I N/A 0 NORTH JERSEY HEALTH CARE PROPERTIES INC 175 HIGH STREET NEWTON NJ 07860 223519709 OWNS COMMERCIAL BUILDINGS AND CONDUCTS LEASING ACTIVITIES NJ 501(C)(2) NORTH JERSEY HEALTH CARE CORPORATION 0 PRIME CARE INC 175 HIGH STREET NEWTON NJ 07860 222759566 PROVIDES HOME AND HEALTH CARE SERVICES NJ 501(C)(3) LINE 9 NORTH JERSEY HEALTH CARE CORPORATION 0 NORTH JERSEY HEALTH VENTURES INC 175 HIGH STREET NEWTON NJ 07860 222705732 INVESTMENTS IN HEALTH CARE RELATED JOINT VENTURES NJ N/A C 0 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 NORTH JERSEY HEALTH CARE PROPERTIES INC J 905603 COST