Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
ST JOSEPH'S HEALTH SYSTEM
Employer identification number
27-1344467
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization?
................
11g(i)
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of support?
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
4
Total. Add lines 1 through 3..
5
The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included
on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6
Public Support. Subtract line 5 from line 4.
Section B. Total Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
7
Amounts from line 4..
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11
Total support (Add lines 7 through 10).
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2010.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2009.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2009.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2
Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
6
Total. Add lines 1 through 5.
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c
Add lines 7a and 7b..
8
Public Support (Subtract line 7c from line 6.)
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
9
Amounts from line 6...
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13
Total support (Add lines 9, 10c, 11 and 12.).
14
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f))
.........
15
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2010.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2009.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information.
Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2010
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
ST JOSEPH'S HEALTH SYSTEM
Employer identification number
27-1344467
Identifier
Return Reference
Explanation
FORM 990, PART I LINE 1
THE MISSION OF ST. JOSEPH'S HEALTH SYSTEM IS TO PROVIDE QUALITY HEALTHCARE WITH A SPECIAL CONCERN FOR THE POOR AND UNDERSERVED.
FORM 990, PART III- LINE 1
IN THE SPIRIT OF TOWARD BOUNDLESS CHARITY, THE MISSION OF ST. JOSEPH'S HEALTH SYSTEM, A HEADING MINISTRY OF THE CATHOLIC CHURCH SPONSORED BY THE SISTERS OF CHARITY OF SAINT ELIZABETH, IS TO PROVIDE QUALITY HEALTHCARE WITH A SPECIAL CONCERN FOR THE POOR AND UNDERSERVED.
FORM 990, PART III- LINE 4A
SJRMC HOSPITAL PROVIDES COMPREHENSIVE ACUTE CARE SERVICES IN PATERSON, NEW JERSEY, SKILLED NURSING SERVICES THROUGH ST. VINCENT'S NURSING HOME (A DIVISION OF SJRMC) IN CEDAR GROVE, , AND AMBULATORY CARE SERVICES AT EIGHT FREE-STANDING AMBULATORY SITES. SJRMC IS A NEW JERSEY DEPARTMENT OF HEALTH AND SENIOR SERVICES DESIGNATED LEVEL II TRAUMA CENTER, A CHILDREN'S HOSPITAL, A REGIONAL CARDIAC SURGERY CENTER, AND A REGIONAL PERINATAL CENTER. WITH APPROXIMATELY 5,214 EMPLOYEES AND PHYSICIANS, THE MEDICAL CENTER IS BOTH THE LARGEST HEALTH CARE PROVIDER AND NON-GOVERNMENT EMPLOYER IN PASSAIC COUNTY. SJRMC OPERATES A 651-LICENSED-BED ACUTE CARE TERTIARY CARE HOSPITAL OF APPROXIMATELY 1.2 MILLION SQUARE FEET, SITUATED ON 25 ACRES. SJRMC IS A NEW JERSEY DEPARTMENT OF HEALTH AND SENIOR SERVICES DESIGNATED LEVEL II TRAUMA CENTER THAT OFFERS A FULL COMPLEMENT OF SPECIALTY AND SUBSPECIALTY SERVICES INCLUDING A: 1 CANCER CENTER, 2 COMMUNITY EDUCATION SERVICES, 3 COMPREHENSIVE NEURO-STROKE CENTER, 4 DIALYSIS CENTER, 5 EMERGENCY SERVICES, 6 LABOR & DELIVERY AND MOTHER/BABY UNITS, 7 REGIONAL PERINATAL CENTER, 8 SAME-DAY SURGERY, 9 SPECIALIZED SURGERY, 10 TELEMEDICINE, 11 THE HEART CENTER AT ST. JOSEPH'S, AND 12 THE ORTHOPEDIC INSTITUTE. SJRMC IS ALSO A STATE DESIGNATED FULL-SERVICE CHILDREN'S HOSPITAL, OPERATED UNDER THE NAME "ST. JOSEPH'S CHILDREN'S HOSPITAL," WHICH PROVIDES TERTIARY CARE FOR CHILDREN FROM BIRTH TO 21 YEARS OF AGE. SJRMC OFFERS SPECIALIZED CHILDREN'S SERVICES SUCH AS A NEONATAL INTENSIVE CARE, PEDIATRIC INTENSIVE CARE, AND A DEDICATED PEDIATRIC EMERGENCY ROOM. ADDITIONALLY, SJRMC PROVIDES A: 1 REGIONAL CRANIOFACIAL CENTER, 2 PEDIATRIC CENTER FOR FEEDING AND SWALLOWING DISORDERS, 3 MEDICAL MISSIONS FOR CHILDREN, 4 GIGGLES THEATER, 5 CHILD DEVELOPMENT CENTER, 6 REGIONAL CYSTIC FIBROSIS CENTER, AND 7 A FULL SPECTRUM OF PEDIATRIC SPECIALTY AND SUBSPECIALTY SJRMC CURRENTLY OPERATES 565 BEDS WITHIN THE FOLLOWING 651-LICENSED BED COMPLEMENT: MEDICAL/SURGICAL - 383 INTENSIVE/CORONARY CARE - 64 OBSTETRICS/GYNECOLOGY - 54 PEDIATRICS - 54 PSYCHIATRY - 46 NEONATAL INTENSIVE CARE - 50 TOTAL (EXCLUDES 30 NEWBORN BASSINETS) - 651 SJRMC ALSO OPERATES EIGHT AMBULATORY FACILITY SITES WITHIN CLOSE PROXIMITY TO THE MAIN SJRMC CAMPUS: 1. FRANK X. GRAVES FAMILY HEALTH CENTER, AN AMBULATORY PRIMARY CARE FACILITY IN DOWNTOWN PATERSON, NJ; 2. COMPREHENSIVE CARE CENTER, AN AMBULATORY PRIMARY CARE FACILITY FOR HIV PATIENTS IN DOWNTOWN PATERSON, NJ; 3. CLIFTON FAMILY PRACTICE, AN AMBULATORY PRIMARY CARE FACILITY IN CLIFTON, NJ; 4. ST. JOSEPH'S PEDIATRIC SUB SPECIALTIES AT ROCHELLE PARK, A PEDIATRIC SUBSPECIALTY FACULTY PRACTICE FACILITY IN ROCHELLE PARK, NJ; 5. ST. JOSEPH'S PEDIATRIC SUB SPECIALTIES AT FAIRFIELD, A PEDIATRIC SUBSPECIALTY FACULTY PRACTICE FACILITY IN FAIRFIELD, NJ; 6. THE MEDICAL CENTER AT WILLOWBROOK ("WILLOWBROOK") IN WAYNE, NJ, A FACULTY PRACTICE FACILITY PROVIDING PEDIATRIC, OBSTETRIC AND MEDICAL SUBSPECIALTY SERVICES AND A 20 STATION DIALYSIS CENTER; 7. OUTPATIENT DIALYSIS CENTER, IN PATERSON, NJ PROVIDING 60 OUTPATIENT DIALYSIS STATIONS; AND 8. ST. JOSEPH'S REGIONAL MEDICAL CENTER AMBULATORY IMAGING CENTER, A FULL SERVICE DIAGNOSTIC AND WOMEN'S IMAGING CENTER IN CLIFTON, NJ. ITS SKILLED NURSING FACILITY, ST. VINCENT'S NURSING HOME, IS LOCATED IN ESSEX COUNTY, APPROXIMATELY FIVE MILES FROM SJRMC. ST. VINCENT'S PROVIDES 24/7 NURSING CARE, MEDICAL, PSYCHO-SOCIAL, NUTRITIONAL, THERAPEUTIC RECREATION, AND SPIRITUAL CARE IN ITS 151-BED SKILLED NURSING CARE FACILITY. CLINICAL SERVICES: AS PART OF ST. JOSEPH'S HEALTHCARE SYSTEM, SJRMC COORDINATES COMPREHENSIVE BASIC AND TERTIARY SERVICES ACROSS CAMPUSES WITH ITS SISTER HOSPITAL ST. JOSEPH'S WAYNE HOSPITAL LOCATED IN WAYNE, NJ THROUGH ITS CLINICAL SERVICE LINE "CENTERS OF EXCELLENCE" MANAGEMENT MATRIX.
FORM 990, PART III- LINE 4B
ST. JOSEPH'S WAYNE HOSPITAL (SJW) IS 229-LICENSED BED ACUTE CARE COMMUNITY HOSPITAL FACILITY LOCATED IN WAYNE, NJ. THE HOSPITAL, A MEMBER OF ST. JOSEPH'S HEALTHCARE SYSTEM, OFFERS INPATIENT AND ACUTE REHABILITATION SERVICES WITH SPECIALIZED SERVICES OFFERED IN ITS FULL SERVICE CARDIAC CATHETERIZATION LAB, DEDICATED COMPREHENSIVE ACUTE CARE REHABILITATION NURSING UNIT AND A GERIATRIC NURSING UNIT. OUTPATIENT SERVICES INCLUDE DIAGNOSTIC RADIOLOGY, PHYSICAL THERAPY SERVICES, SAME-DAY SURGERY, SLEEP CARE CENTER, AND THE JOHN VICTOR MACHUGA DIABETES EDUCATION CENTER. CERTAIN ADDITIONAL SPACE IS CURRENTLY LEASED TO A NON-PROFIT HOSPICE AND A NON-PROFIT LONG TERM ACUTE CARE SERVICES PROVIDER. SJW CURRENTLY OPERATES 146 BEDS WITHIN THE FOLLOWING 229 LICENSED BED COMPLEMENT: MEDICAL/SURGICAL - 193 INTENSIVE/CORONARY CARE 16 COMPREHENSIVE REHABILITATION 20 TOTAL - 229 CLINICAL SERVICES: INTEGRAL TO ITS SERVICE DELIVERY, THE SJW COORDINATES COMPREHENSIVE BASIC AND TERTIARY SERVICES ACROSS CAMPUSES WITH ITS SISTER HOSPITAL, ST. JOSEPH'S REGIONAL MEDICAL CENTER LOCATED IN PATERSON, NJ THROUGH A CLINICAL SERVICE LINE "CENTERS OF EXCELLENCE" MANAGEMENT MATRIX.
FORM 990, PART III- LINE 4C
TO MEET THE FOUNDATION'S MISSION, ST. JOSEPH'S HOSPITAL & MEDICAL CENTER FOUNDATION CONDUCTS A COMPREHENSIVE FUNDRAISING PROGRAM, INCLUDING: (1) ANNUAL GIVING, INCLUDING SPECIAL EVENTS, WHICH RAISES UNRESTRICTED DOLLARS FOR ONGOING SUPPORT OF PRIORITY PROGRAMS AND PROJECTS AT ST. JOSEPH'S; (2) CAPITAL CAMPAIGN FUNDRAISING, TO SUPPORT THE HOSPITAL'S CAPITAL IMPROVEMENT PROJECTS; AND (3) RESTRICTED GIVING, SECURING DONATIONS BOTH LARGE AND SMALL FOR RESTRICTED PURPOSES, WHICH INCLUDES ALL ST. JOSEPH'S CHILDREN'S HOSPITAL FUNDRAISING PROGRAMS AND EVENTS, AS WELL AS IN SUPPORT OF A MYRIAD OF OTHER DESIGNATED PROGRAMS AND PROJECTS AT ST. JOSEPH'S.
FORM 990, PART III LINE 4D
TO SUPPORT THE CHARITABLE PURPOSE OF ST. JOSEPH'S WAYNE HOSPITAL BY PROVIDING FUNDING FOR EQUIPMENT, CAPITAL IMPROVEMENT PROJECTS, COMMUNITY OUTREACH, EDUCATIONAL PROGRAMS AND TO PROVIDE SCHOLARSHIP TO INDIVIDUALS AT ANY STAGE OF THE EDUCATIONAL PROCESS WHO ARE PURSUING A DEGREE IN NURSING.
FORM 990, PART VI, SECTION A, LINE 6
ST. JOSEPH'S HEALTHCARE SYSTEM IS THE SOLE MEMBER OF ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER (D/B/A ST. JOSEPH'S REGIONAL MEDICAL CENTER AND ST. JOSEPH'S WAYNE HOSPITAL), ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER FOUNDATION, INC., ST. JOSEPH'S WAYNE HOSPITAL FOUNDATION, INC., AND 200 HOSPITAL PLAZA CORP. SIX PERSONS, WHO ARE MEMBERS OF THE SPONSOR, THE SISTERS OF CHARITY OF SAINT ELIZABETH, ARE THE MEMBER OF THE ST. JOSEPH'S HEALTHCARE SYSTEM, INC. THE SOLE MEMBER OF HARBOR HOUSE, INC., ST. JOSEPH'S EMERGENCY PHYSICIANS, INC., ST. JOSEPH'S FACULTY PHYSICIANS, INC., ST. JOSEPH'S PHYSICIANS, INC., AND ST. JOSEPH'S SUBSPECIALTY PHYSICIANS, INC. IS ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER (D/B/A ST. JOSEPH'S REGIONAL MEDICAL CENTER AND ST. JOSEPH'S WAYNE HOSPITAL).
FORM 990, PART VI, SECTION A, LINE 7A
ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER SHARES A MIRROR BOARD WITH ITS MEMBER ORGANIZATION, ST. JOSEPH'S HEALTHCARE SYSTEM (THE SYSTEM IS AN OBLIGATED GROUP). UNDER SECTION 2.2 OF THE SYSTEM'S BYLAWS, THE POWER TO ELECT AND REMOVE TRUSTEES FROM THE SYSTEM'S BOARD (AND BY EXTENSION, ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER'S BOARD) IS RESERVED TO THE SYSTEM'S SPONSOR ORGANIZATION - THE SISTERS OF CHARITY OF SAINT ELIZABETH.
FORM 990, PART VI, SECTION A, LINE 7B
CERTAIN RIGHTS AND POWERS ARE RESERVED TO THE MEMBER PURSUANT TO THE BY-LAWS OF THE CORPORATIONS. THESE INCLUDE: APPROVAL OF THE STATEMENT OF THE MISSION OF THE INSTITUTION AND ANY SUBSEQUENT CHANGES; THE RIGHT TO ELECT AND REMOVE TRUSTEES OF THE BOARD OF THE CORPORATION AND ITS SUBSIDIARIES OTHER THAN THOSE PERSONS WHO ARE TRUSTEES BY REASON OF BEING APPOINTED BY THE SPONSOR; APPROVAL OF AMENDMENTS TO ST. JOSEPH'S CERTIFICATE OF INCORPORATION; AND THE RIGHT TO APPROVE SIGNIFICANT CORPORATE TRANSACTIONS (E.G. MERGERS, CONSOLIDATIONS, DISSOLUTION).
FORM 990, PART VI, SECTION B, LINE 11
A COPY OF THE FORM 990 WAS PRESENTED TO THE ST. JOSEPH'S HEALTH SYSTEM FINANCE COMMITTEE OF THE BOARD OF TRUSTEES IN OCTOBER OF 2011 BY THE ORGANIZATION'S TAX RETURN PREPARERS, DELOITTE TAX LLP. COMMENTS AND FEEDBACK WERE SOLICITED PRIOR TO FILING AND A FINAL COPY OF THE 990 WAS PROVIDED TO EACH OF THE BOARD MEMBERS VIA ELECTRONIC MEANS. THE SYSTEM HAS ESTABLISHED AN ELABORATE ON-LINE WORK-ROOM FOR ALL BOARD MATERIALS THAT CAN BE ACCESSED BY THE ENTIRE BOARD FROM ANY INTERNET-ACCESSIBLE LOCATION. THE FORM 990 FOR THE YEAR ENDING DECEMBER 31ST, 2010 IS A DOCUMENT WITHIN THAT DATABASE.
FORM 990, PART VI, SECTION B, LINE 12C
ST. JOSEPH'S HEALTH SYSTEM REQUIRES ALL BOARD OF TRUSTEES MEMBERS, KEY EMPLOYEES AND OFFICERS TO COMPLETE AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE THAT IS DESIGNED TO UNCOVER POTENTIAL BOARD MEMBER CONFLICTS. THE QUESTIONNAIRES ARE COMPILED, MONITORED AND REVIEWED BY ST. JOSEPH'S GENERAL COUNSEL AND POTENTIAL CONFLICTS ARE ADDRESSED AND RESOLVED IMMEDIATELY. IN 2010, GENERAL COUNSEL PROVIDED A MEMORANDUM TO THE AUDIT AND FINANCE COMMITTEE DISCLOSING THAT NO CONFLICTS OF INTEREST WERE UNCOVERED FROM THE 2010 QUESTIONNAIRES.
FORM 990, PART VI, SECTION B, LINE 15
ST. JOSEPH'S HEALTH SYSTEM UNDERTAKES A RIGOROUS PROCESS TO ENSURE THAT THE EXECUTIVE COMPENSATION IT PAYS TO ITS TOP MANAGEMENT OFFICIAL AND ALL OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION IS REASONABLE. IN RELEVANT PART, THE BOARD OF TRUSTEES HAS ESTABLISHED A COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT PERSONS THAT HAVE NO PERSONAL INTEREST IN THE PROPOSED COMPENSATION ARRANGEMENT. THE BOARD OF TRUSTEES USES AN INDEPENDENT COMPENSATION CONSULTANT TO HELP ADVICE ON THE APPROPRIATE COMPENSATION LEVELS FOR THE AFOREMENTIONED INDIVIDUALS. THAT COMPENSATION CONSULTANT WILL USE COMPARABILITY OR BENCHMARKING DATA (BASED ON INDUSTRY SURVEYS) THAT DOCUMENTS THE COMPENSATION OF PERSONS HOLDING SIMILAR POSITIONS IN SIMILAR ORGANIZATIONS. ONCE THE COMPENSATION CONSULTANT HAS MADE ITS RECOMMENDATIONS, THE SYSTEM'S COMPENSATION COMMITTEE MUST APPROVE THE COMPENSATION, WITHOUT INPUT OR VOTING PARTICIPATION BY THE PERSON WHOSE COMPENSATION IS BEING APPROVED OR BY ANY OTHER INDIVIDUAL WITH A CONFLICT OF INTEREST. THE FINAL DETERMINATION IS THEN DOCUMENTED IN COMMITTEE MINUTES. THOSE MINUTES WILL CONTAIN THE TERMS OF THE PROPOSED COMPENSATION, THE DECISIONS OF THOSE INDIVIDUALS WHO VOTED ON THE COMPENSATION, AND THE COMPARABILITY DATA THAT WAS RELIED UPON.
FORM 990, PART VI, SECTION C, LINE 19
THE HEALTH SYSTEM MAKES ITS FORM 990 AND FORM 1023 AVAILABLE TO THE PUBLIC BY RETAINING A COPY OF EACH AT THE ADDRESS LISTED ON PAGE 1 OF THIS RETURN. ANY INDIVIDUAL REQUESTING A COPY OF THESE DOCUMENTS IS PROVIDED THAT COPY ON THE SAME BUSINESS DAY. THE ORGANIZATION'S GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST AND AT MANAGEMENT'S DISCRETION
SCHEDULE J-2
SISTER MARYANNE CAMPEOTTO, AS A MEMBER OF A RELIGIOUS ORDER, IS EXEMPT FROM FEDERAL AND STATE INCOME TAX AND THEREFORE HER W-2, BOX 5, WAGES REPORT $0 IN INCOME. IN THE INTEREST OF FULL DISCLOSURE, AMOUNTS PAID TO THE SISTER ARE REPORTED IN COLUMN (F) OF SCHEDULE J.
CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 5:
NET UNREALIZED LOSSES ON INVESTMENTS: -881,253. PRIOR PERIOD ADJUSTMENTS: -1,584,659. PENSION RELATED ADJUSTMENTS -7,821,000. NET ASSETS RELEASED FROM RESTRICTIONS -1,175,000. TRANSFER TO AFFILIATES -2,600,000. DISTRIBUTIONS TO NONCONTROLLOING INTERESTS IN JV'S -3,598,000. CONTRIBUTIONS FROM NONCONTROLLOING INTERESTS IN JV'S 670,000. TOTAL TO FORM 990, PART XI, LINE 5: -16,989,912.
LIST OF AFFILAITES INCLUDED IN GROUP FILING
FORM 990, PAGE 1, ITEM H:
- ST JOSEPH'S HOSPITAL & MEDICAL CENTER (EIN: 22-1487602) - HARBOR HOUSE, INC (EIN: 22-2354611) - ST JOSEPH'S HOSPITAL & MEDICAL CENTER FOUNDATION (EIN: 22-2448138) - ST JOSEPH'S WAYNE HOSPITAL FOUNDATION (EIN: 22-2627588) - 200 HOSPITAL PLAZA (EIN: 22-3061067) - ST. JOSEPH'S EMERGENCY PHYSICIANS INC (EIN: 27-0806549) - ST. JOSEPH'S FACULTY PHYSICIANS INC (EIN: 27-0806980) - ST. JOSEPH'S PHYSICIANS INC. (EIN: 27-0806417) - ST. JOSEPH'S SUBSPECIALTY PHYSICIANS INC. (EIN: 27-0806125)
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.