Attach to Form 990 or Form 990-EZ.
See separate instructions.| (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? |
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|---|---|---|---|---|---|---|---|---|---|
| Yes | No | Yes | No | Yes | No | ||||
| Total | |||||||||
| 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. | ||||||
| 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). | ||||||






| 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.) | ||||||
| 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.). | ||||||




| Facts And Circumstances Test |
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| Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
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| COMMUNITY BENEFIT STATEMENT | CORE FORM, PART III, STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS | BACKGROUND ========== KIMBALL MEDICAL CENTER ("KMC") IS A GENERAL MEDICAL AND SURGICAL HOSPITAL. KMC IS RECOGNIZED BY THE IRS AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, KMC PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. MOREOVER, KMC OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545: 1. KMC PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUAL'S REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF-PAY, MEDICARE AND MEDICAID PATIENTS; 2. KMC OPERATES AN ACTIVE EMERGENCY ROOM FOR ALL PERSONS; WHICH IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR; 3. KMC MAINTAINS AN OPEN MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; AND 4. CONTROL OF KMC RESTS WITH ITS BOARD OF TRUSTEES AND THE BOARD OF TRUSTEES OF SAINT BARNABAS CORPORATION. BOTH BOARDS ARE COMPRISED OF INDEPENDENT CIVIC LEADERS AND OTHER PROMINENT MEMBERS OF THE COMMUNITY. 5. SURPLUS FUNDS ARE USED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND RENOVATE FACILITIES AND ADVANCE MEDICAL CARE; PROGRAMS AND ACTIVITIES. THE OPERATIONS OF KMC, AS SHOWN THROUGH THE FACTORS OUTLINED ABOVE AND OTHER INFORMATION CONTAINED HEREIN, CLEARLY DEMONSTRATE THE HOSPITAL PROVIDES SUBSTANTIAL COMMUNITY BENEFIT AND THAT THE USE AND CONTROL OF KMC IS FOR THE BENEFIT OF THE PUBLIC AND THAT NO PART OF THE INCOME OR NET EARNINGS OF THE ORGANIZATION INURES TO THE BENEFIT OF ANY PRIVATE INDIVIDUAL NOR IS ANY PRIVATE INTEREST BEING SERVED OTHER THAN INCIDENTALLY. KMC'S SOLE CORPORATE MEMBER IS SAINT BARNABAS CORPORATION ("SBC"). SBC IS THE TAX-EXEMPT PARENT OF THE SAINT BARNABAS HEALTH CARE SYSTEM ("SYSTEM"). THIS TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM CONSISTS OF A GROUP OF AFFILIATED HEALTHCARE ORGANIZATIONS. THE SOLE MEMBER OR STOCKHOLDER OF EACH ENTITY IS EITHER SBC OR ANOTHER SYSTEM AFFILIATE CONTROLLED BY SBC. SYSTEM IS AN INTEGRATED NETWORK OF HEALTHCARE PROVIDERS THROUGHOUT THE STATE OF NEW JERSEY THAT PROVIDES SUBSTANTIAL COMMUNITY BENEFIT. SYSTEM IS CURRENTLY ONE OF THE LARGEST MULTI-HOSPITAL SYSTEMS IN NEW JERSEY. SYSTEM CONSISTS OF FREE-STANDING HOSPITALS, A FREE-STANDING PSYCHIATRIC HOSPITAL, MEDICARE-CERTIFIED HOME HEALTHCARE AND HOSPICE PROGRAMS, MULTI-SPECIALTY AMBULATORY CARE FACILITIES, OUTPATIENT BEHAVIORAL HEALTH CENTERS, AND OTHER ENTITIES. SYSTEM PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY. MOREOVER, SYSTEM PROVIDES HEALTHCARE SERVICES TO PATIENTS WHO MEET CERTAIN CRITERIA DEFINED BY THE NEW JERSEY DEPARTMENT OF HEALTH AND SENIOR SERVICES WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. SBC MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE AMOUNT OF CHARITY CARE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FOREGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY. PATIENT STATISTICAL INFORMATION/ACCOMPLISHMENTS/MILESTONES ========================================================== KMC IS A 330-BED FULLY ACCREDITED NON-PROFIT ACUTE CARE HOSPITAL DEDICATED TO PROVIDING THE FINEST MEDICAL AND HEALTHCARE SERVICES TO THE RESIDENTS OF OCEAN COUNTY AND THE SURROUNDING AREAS. KMC IS LOCATED IN LAKEWOOD, OCEAN COUNTY, NEW JERSEY. KMC SERVES A DIVERSE URBAN POPULATION INCLUDING A PROPORTIONATELY HIGHER MIX OF ELDERLY AND UNINSURED/UNDERINSURED COMMUNITIES. DURING 2010, KMC SERVICED APPROXIMATELY 13,600 INPATIENTS AND NEARLY 50,000 EMERGENCY VISITS. THE EMERGENCY ROOM IS OPEN TO ALL INDIVIDUALS 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS A YEAR. A RULL RANGE OF ULTRA-MODERN DIAGNOSTIC AND TREATMENT SERVICES ARE AVAILABLE AT KMC IN ALL MAJOR SPECIALTIES: MEDICAL-SURGICAL PROGRAMS INCLUDING LASER AND ARTHROSCOPIC SURGERY, EMERGENCY AND TRAUMA CARE, MATERNITY AND PEDIATRICS, CANCER AND DIABETES CARE, LEVEL II SPECIAL CARE NURSERY, INPATIENT DIALYSIS, REHABILITATION PROGRAMS AND OCCUPATIONAL THERAPY. CENTERS OF EXCELLENCE ===================== - RECIPIENT OF THE MAGNET AWARD FOR NURSING EXCELLENCE -THREE TEAMS OF EMPLOYEES WERE SELECTED IN 2010 TO PRESENT THEIR CLINICAL RESEARCH PROJECTS AT THE 21ST ANNUAL NATIONAL FORUM ON QUALITY IMPROVEMENT IN HEALTHCARE, HOSTED BY THE INSTITUTE FOR HEALTHCARE IMPROVEMENT KMC'S RECOGNIZED MEDICAL SERVICES CENTERS OF EXCELLENCE INCLUDE BUT ARE NOT LIMITED TO THE FOLLOWING: THE MOTHER-INFANT PAVILION -------------------------- COMMITTED TO THE HIGHEST LEVEL OF MEDICAL CARE FOR OBSTETRICAL SERVICES, THE MOTHER-INFANT PAVILION HELPS TO DELIVER OVER 1,350 OF OUR LITTLEST PATIENTS EACH YEAR. KMC PROVIDES A COMFORTABLE AND SUPPORTIVE SETTING FOR LABOR AND DELIVERY AND A PRIVATE UNIT FOR POST PARTUM CARE. OUR FACILITIES ALSO INCLUDE A FULLY-EQUIPPED OPERATING SUITE FOR CESAREAN BIRTHS, 24-HOUR ANESTHESIOLOGY AND IN-HOUSE NEONATOLOGY. KMC'S MOTHER-INFANT PAVILION HAS THE LOWEST CESAREAN-SECTION BIRTH RATE IN THE STATE OF NEW JERSEY AND ONE OF THE LOWEST IN THE NATION. KIMBALL'S LOW CESAREAN SECTION RATES ARE ATTRIBUTABLE TO THE TEAM APPROACH TAKEN TO PREGNANCY - MIDWIVES, DOCTORS, NURSES AND PRENATAL SPECIALISTS ALL WORK TOGETHER TO PRESERVE THE OPPORTUNITY FOR A NATURAL BIRTH FOR AS LONG AS POSSIBLE. THE EMERGENCY DEPARTMENT AT KIMBALL MEDICAL ------------------------------------------- THE EMERGENCY DEPARTMENT TREATS APPROXIMATLY 50,000 PATIENTS ANNUALLY, UTILIZING THE MOST MODERN TECHNOLOGY COUPLED WITH A TOTAL FOCUS ON PATIENT AND FAMILY SATISFACTION. THE EMERGENCY DEPARTMENT HAS REVOLUTIONIZED HOW PATIENTS ARE TREATED IN MODERN HEALTHCARE SETTINGS BY EXPEDITING THE PROCESS WHICH PATIENTS MUST UNDERGO PRIOR TO RECEIVING MEDICAL TREATMENT. THE MAIN EMERGENCY DEPARTMENT INCLUDES 31 TREATMENT BAYS, ALL EQUIPPED WITH THE LATEST IN CARDIAC MONITORING EQUIPMENT, INCLUDING SPECIALIZED ROOMS FOR TRAUMA, ORTHOPEDICS, EAR/NOSE/THROAT, OBSTETRICS/ GYNECOLOGY, PEDIATRICS, SUTURING AND PSYCHIATRIC EMERGENCIES. THE STAFF IS FOCUSED ON RESPECTING THE INDIVIDUAL NEEDS OF ALL ADULT AND PEDIATRIC PATIENTS. KMC IS A STATE-DESIGNTED PRIMARY STROKE CENTER AND JCAHO CERTIFIED CHEST PAIN CENTER AND HAS OCEAN COUNTY'S ONLY PSYCHIATRIC EMERGENCY SCREENING PROGRAM. EVERY ASPECT OF THE EMERGENCY DEPARTMENT HAS BEEN DESIGNED TO PROVIDE THE ULTIMATE IN EFFICIENCY AND COMFORT FOR PATIENTS AND THEIR FAMILIES, WHILE OFFERING THE HIGHEST QUALITY MEDICAL CARE. THIS HAS LED TO NUMEROUS RECOGNITIONS AND AWARDS FOR PATIENT SATISFACTION AND QUALITY MEDICAL CARE. THE CENTER FOR HEALTHY LIVING ----------------------------- THE CENTER FOR HEALTHY LIVING OFFERS AN ARRAY OF PROGRAMS DESIGNED TO KEEP THE COMMUNITY HEALTHY THROUGH EDUCATION AND SCREENINGS. AMONG ITS AWARD WINNING PROGRAMS ARE THE CAREGIVERS EDUCATION & SUPPORT BY A LICENSED CLINICAL SOCIAL WORKER TO PROVIDE COUNSELING AND SUPPORT GROUPS. THE CENTER ALSO OFFERS DIABETES EDUCATION AND SUPPORT WHICH IS DESIGNED FOR NEWLY DIAGNOSED DIABETES AND PROVIDES EDUCATION THROUGH A SERIES OF FOUR CLASSES. THE CENTER IS ALSO HOME TO THE ARTHRITIS EDUCATION CENTER WHERE PEOPLE SUFFERING FROM ANY OF THE DEBILITATING FORMS OF ARTHRITIS CAN SEEK EDUCATION ABOUT DIAGNOSIS, TREATMENTS, NEW MEDICATIONS AND PHYSICAL THERAPY AND ALSO PARTICIPATE IN SPECIALLY DESIGNED CLASSES SUCH AS T'AI CHI, YOGA AND THE ARTHRITIS FOUNDATIONS EXERCISE PROGRAM. PARTICIPANTS IN ALL OF THE PROGRAMS AT THE CENTER FOR HEALTHY LIVING WILL EXPERIENCE ENHANCED PHYSICAL, EMOTIONAL AND SPIRITUAL HEALING THROUGH INDIVIDUAL AND GROUP PROGRAMS IN AN ENVIRONMENT WHERE THEY CAN JOIN WITH OTHERS TO LEARN AND SHARE EXPERIENCES, STRENGTH AND HOPE. MEDICAL SERVICES ================= KMC HAD OVER 450 PHYSICIANS ON ITS MEDICAL STAFF DURING 2010, COMPRISED OF THE FOLLOWING SPECIALTIES: - ALLERGY/IMMUNOLOGY - ANESTHESIOLOGY - CARDIOLOGY - CRITICAL CARE MEDICINE - DENTISTRY - DERMATOLOGY - EMERGENCY MED - ENDOCRINOLOGY - FAMILY PRACTICE - GASTROENTEROLOGY - GERIATRICS - GYNECOLOGY - HAND SURGERY - HEMATOLOGY/ONCOLOGY - INTERNAL MED - INFECTIOUS DISEASE - NEONATOLOGY - NEPHROLOGY - NEUROLOGY - NEUROSURGERY - OBSTETRICS - OTOLARYNGOLOGY - OPHTHALMOLOGY - ORAL SURGERY - ORTHOPEDIC SURGERY - PAIN MANAGEMENT - PATHOLOGY - PEDIATRIC CARDIOLOGY - PEDIATRICS - PERI-NATAL MEDICINE - PHYSICAL MEDICINE & REHABILIATION - PLASTIC SURGERY - PODIATRY - PSYCHIATRY - PULMONARY MEDICINE - RADIOLOGY - RADIATION ONCOLOGY - REPRODUCTIVE ENDOCRINOLOGY - RHEUMATOLOGY - SURGERY - SURGERY-BREAST - SURGERY-COLON - SURGERY-ONCOLOGY - SURGERY-THORACIC - SURGERY-VASCULAR - UROLOGY |
| COMMUNITY BENEFIT STATEMENT CONTINUED | CORE FORM, PART III, STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS | COMMUNITY PROGRAMS ================== MEDICAL SCREENINGS ------------------ KMC PROVIDES NUMEROUS MEDICAL SCREENING PROGRAMS TO THE COMMUNITY IN FURTHERANCE OF ITS TAX-EXEMPT PURPOSES INCLUDING, BUT NOT LIMITED TO, THE FOLLOWING: - SKIN CANCER SCREENINGS - BLOOD PRESSURE SCREENINGS - GLUCOSE SCREENINGS - SKIN CANCER SCREENINGS COMMUNITY EDUCATION ------------------- KMC OFFERS A FULL ARRAY OF WELLNESS PROGRAMS, INCLUDING NUMEROUS LECTURES, SEMINARS AND OTHER EDUCATIONAL PROGRAMS TO THE COMMUNITY IN FURTHERANCE OF ITS TAX-EXEMPT PURPOSES INCLUDING, BUT NOT LIMITED TO, THE FOLLOWING: 1. SELF DEFENSE FOR OLDER ADULTS 2. EXERCISE 3. TOBACCO DEPENDENCE TREATMENT PROGRAM 4. VARIOUS SEMINARS 5. WOMEN'S HEALTH - KEEPING YOUR HEART HEALTHY - ADVANCEMENTS IN OBSTETRICS & GYNECOLOGY - THE IMPORTANCE OF MAMMOGRAPHY - INNOVATIONS IN BREAST SURGERY 7. OTHER SUPPORT GROUPS - CAREGIVER'S - DIABETES - BEREAVEMENT - GRANDPARENTS - SMOKING CESSATION 8. CHILDBIRTH PREPARATION AND PARENTING CLASSES - BREASTFEEDING EDUCATION - GRANDPARENTING - INFANT AND CHILD CPR - LAMAZE REFRESHER SERIES - PRENATAL AND POSTPARTUM EXERCISE - PARENTING INSIGHTS - PREPARED CHILDBIRTH SERIES - PREPARED CHILDBIRTH / LAMAZE SERIES - SIBLING CLASS - WOMEN'S RESOURCE LIBRARY 9. CPR AND FIRST AID INSTRUCTION - BASIC LIFE SUPPORT - ADVANCED CARDIAC LIFE SUPPORT - PEDIATRIC ADVANCED CARDIAC LIFE SUPPORT - NEONATAL RESUSCITATION - AUTOMATED EXTERNAL DEFIBRILLATOR (AED) TRAINING - FIRST AID - HEART SAVER - INSTRUCTOR DEVELOPMENT 10. INSTRUCTIONAL CLASSES AND PROGRAMS - CPR - FIRST AID - MOMS IN MOTHERS: PRENATAL AND POSTPARTUM EXERCISE - DEFENSIVE DRIVING - LOOK GOOD, FEEL BETTER - YOGA - TAI CHI APPROXIMATELY 2,500 INDIVIDUALS PARTICIPATED IN MEDICAL SCREENINGS AND EDUCATIONAL PROGRAMS AT KMC IN 2010. |
| OTHER PROGRAM SERVICES | CORE FORM, PART III; LINE 4D | EXPENSES INCURRED IN PROVIDING VARIOUS OTHER MEDICALLY NECESSARY HEALTHCARE 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 THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT INCLUDED IN SCHEDULE O. |
| GOVERNANCE, MANAGEMENT, AND DISCLOSURE | CORE FORM, PART VI, SECTION A; QUESTION 2 | DEANNA SPERLING, CARYL L. SINGER AND GERALDINE SMITH, M.D. - BUSINESS RELATIONSHIP |
| DISCLOSURE INFORMATION | CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7 | SAINT BARNABAS CORPORATION ("SBC") IS THE SOLE MEMBER OF THIS ORGANIZATION. SBC 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 11A | THE ORGANIZATION IS AN AFFILIATE IN THE SAINT BARNABAS HEALTH CARE SYSTEM ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. SAINT BARNABAS CORPORATION IS THE PARENT ENTITY OF THE SYSTEM. THE ORGANIZATION'S FEDERAL FORM 990 WAS MADE AVAILABLE TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY (ITS BOARD OF TRUSTEES) PRIOR TO THE FILING OF THE FEDERAL FORM 990 WITH THE IRS. IN ADDITION THE SAINT BARNABAS CORPORATION AUDIT COMMITTEE ASSUMED THE RESPONSIBILITY TO OVERSEE AND COORDINATE THE FEDERAL FORM 990 PREPARATION AND FILING PROCESS FOR ALL TAX-EXEMPT AFFILIATES OF THE SYSTEM BUT DID NOT PERFORM AN ACTUAL REVIEW OF EACH AFFILIATE FEDERAL FORM 990 WITH THE EXCEPTION OF SAINT BARNABAS CORPORATION. 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 IN HOUSE COUNSEL, EXECUTIVE VICE-PRESIDENT AND CHIEF FINANCIAL OFFICER, VICE PRESIDENT, 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 INTERNAL WORKING GROUP, INCLUDING THOSE INDIVIDUALS OUTLINED ABOVE FOR THEIR REVIEW. THE ORGANIZATION'S INTERNAL WORKING GROUP 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 INTERNAL WORKING GROUP FOR FINAL REVIEW AND APPROVAL. A MEETING WAS ALSO HELD TO REVIEW THE FINAL DRAFT OF THE FEDERAL FORM 990 WITH THE CHAIRPERSON OF THE ORGANIZATION'S FINANCE COMMITTEE AND OTHER INDIVIDUALS FOR REVIEW AND APPROVAL. FOLLOWING THIS REVIEW THE FINAL FEDERAL FORM 990 WAS MADE AVAILABLE TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY PRIOR TO THE FILING OF THE TAX RETURN WITH THE IRS. |
| DISCLOSURE INFORMATION | CORE FORM, PART VI, SECTION B; QUESTION 12 | THE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY. THE ORGANIZATION REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. THIS CONFLICT OF INTEREST POLICY REQUIRES THAT A CONFLICT OF INTEREST FORM CONSISTENT WITH BEST GOVERNANCE PRACTICES AND INTERNAL REVENUE SERVICE GUIDELINES BE CIRCULATED TO OFFICERS, TRUSTEES AND KEY EMPLOYEES ANNUALLY. IN A SITUATION IN WHICH A TRUSTEE DISCLOSES AN INTEREST THAT COULD GIVE RISE TO A CONFLICT, THE TRUSTEE'S POTENTIAL CONFLICT IS REFERRED TO THE CORPORATE NOMINATING AND GOVERNANCE COMMITTEE WHICH EVALUATES THE CONFLICT AND ITS POTENTIAL IMPACT ON THE TRUSTEE'S PARTICIPATION ON THE BOARD OR ON CERTAIN ISSUES WHICH MAY COME BEFORE THE BOARD. AS APPROPRIATE THE COMMITTEE WILL TAKE ACTION TO ADDRESS THE CONFLICT. |
| DISCLOSURE INFORMATION | CORE FORM, PART VI, SECTION B; QUESTION 15 | THE ORGANIZATION IS AN AFFILIATE OF THE SAINT BARNABAS HEALTH CARE SYSTEM, WHOSE PARENT ORGANIZATION IS SAINT BARNABAS CORPORATION ("SBC"). SBC'S BOARD OF TRUSTEES MAINTAINS 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 SBC'S SENIOR MANAGEMENT, INCLUDING THE CHIEF EXECUTIVE OFFICER, PRESIDENT/CHIEF OPERATING OFFICER AND EXECUTIVE VP OPERATIONS. THE COMPENSATION COMMITTEE ALSO REVIEWS THE COMPENSATION AND BENEFITS OF OTHER KEY OFFICERS AND KEY EMPLOYEES OF THE SAINT BARNABAS HEALTH CARE SYSTEM; INCLUDING, WITHOUT LIMITATION, THE EXECUTIVE DIRECTORS OF THE SAINT BARNABAS HEALTH CARE SYSTEM'S HOSPITALS AND MEDICAL CENTERS. THE COMPENSATION COMMITTEE, WHICH IS REQUIRED BY SBC'S BYLAWS TO BE COMPRISED SOLELY OF INDEPENDENT TRUSTEES, SEEKS GUIDANCE AND SUBSTANTIATION FROM A NATIONALLY RECOGNIZED COMPENSATION CONSULTANT. 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 OF THE ORGANIZATION IS REASONABLE. THE ACTIONS TAKEN BY THE COMMITTEE ENABLE THE ORGANIZATION 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 CHIEF EXECUTIVE OFFICER, PRESIDENT/CHIEF OPERATING OFFICER AND EXECUTIVE VP OPERATIONS. 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 SIMILARLY SIZED HEALTHCARE SYSTEMS AND 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 APPLIES TO CERTAIN SENIOR MANAGEMENT PERSONNEL, INCLUDING, BUT NOT LIMITED TO, THE CHIEF EXECUTIVE OFFICER, PRESIDENT/CHIEF OPERATING OFFICER, EXECUTIVE VP OPERATIONS AND THE EXECUTIVE DIRECTORS OF THE SAINT BARNABAS HEALTH CARE SYSTEM HOSPITALS AND MEDICAL CENTERS. THE COMPENSATION AND BENEFITS OF CERTAIN OTHER INDIVIDUALS CONTAINED IN THIS FORM 990 ARE REVIEWED ANNUALLY BY THE SAINT BARNABAS HEALTH CARE SYSTEM'S CHIEF EXECUTIVE OFFICER WITH ASSISTANCE FROM THE ORGANIZATION'S 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 HAS ISSUED TAX-EXEMPT BONDS TO FINANCE VARIOUS CAPITAL IMPROVEMENT PROJECTS, RENOVATIONS AND EQUIPMENT. IN CONJUNCTION WITH THE ISSUANCE OF THESE TAX-EXEMPT BONDS, THE ORGANIZATION'S FINANCIAL STATEMENTS WERE INCLUDED WITH THE TAX-EXEMPT BOND PROSPECTUS WHICH WAS MADE AVAILABLE TO THE GENERAL PUBLIC FOR REVIEW. THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE STATE OF NEW JERSEY SECRETARY OF STATE. |
| COMPENSATION INFORMATION DISCLOSURE | CORE FORM, PART VII AND SCHEDULE J | PART VII AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM THIS ORGANIZATION OR A RELATED ORGANIZATION. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OF THE ORGANIZATION OR A RELATED ORGANIZATION AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THIS ORGANIZATION'S BOARD OF TRUSTEES. MR. HICKS ALSO SERVES AS EXECUTIVE DIRECTOR OF SAINT BARNABAS BEHAVIORAL HEALTH CENTER; A RELATED TAX-EXEMPT AFFILIATE WITHIN THE SAINT BARNABAS HEALTH CARE SYSTEM. MR. TOFANI ALSO SERVES AS CHIEF FINANCIAL OFFICER OF ANOTHER TAX-EXEMPT ACUTE CARE HOSPITAL WHICH IS ALSO AN AFFILIATE WITHIN THE SAINT BARNABAS HEALTH CARE SYSTEM. BETWEEN THESE TWO HOSPITALS MR. TOFANI WORKS APPROXIMATELY 55 HOURS PER WEEK. |
| OTHER CHANGES IN NET ASSETS | CORE FORM, PART XI; QUESTION 5 | OTHER CHANGES IN NET ASSETS OR FUND BALANCE INCLUDE: - PENSION CHANGES OTHER THAN NET PERIODIC BENEFIT COST - ($706,257) - NET CHANGE IN UNREALIZED GAINS AND LOSSES ON INVESTMENTS - $944,646 - OTHER INCREASES IN NET ASSETS, NET - $2,446,721 - NET ASSETS RELEASED FROM RESTRICTION FOR PURCHASES OF PROPERTY AND EQUIPMENT - ($39,000) |
| AUDITED FINANCIAL STATEMENTS | CORE FORM, PART XII; QUESTION 2 | THE ORGANIZATION IS AN AFFILIATE WITHIN THE SAINT BARNABAS HEALTH CARE SYSTEM ("SYSTEM"), A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THE SYSTEM'S PARENT ENTITY IS SAINT BARNABAS CORPORATION. AN INDEPENDENT BIG FOUR CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF SAINT BARNABAS CORPORATION AND ALL ENTITIES WITHIN THE SYSTEM FOR THE YEARS ENDED DECEMBER 31, 2010 AND DECEMBER 31, 2009; 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 SAINT BARNABAS CORPORATION 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. |
| FINANCIAL STATEMENTS AND REPORTING | CORE FORM, PART XII; QUESTION 3 | THIS ORGANIZATION IS AN AFFILIATE IN THE SAINT BARNABAS HEALTH CARE SYSTEM ("SYSTEM"). THE SYSTEM ENGAGED A BIG FOUR INDEPENDENT ACCOUNTING FIRM TO PREPARE AND ISSUE A SYSTEM WIDE CONSOLIDATED A-133 AUDIT. THIS ORGANIZATION WAS INCLUDED IN THE SYSTEM WIDE A-133 AUDIT. |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:RAYMOND SHEA TITLE:CHAIRMAN - TRUSTEE HOURS:6 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:DAVID SICKEL TITLE:VICE CHAIRMAN - TRUSTEE HOURS:9 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:FRED VAN LOOY TITLE:TREASURER - TRUSTEE HOURS: |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:WILLIAM SMITHERS TITLE:SECRETARY - TRUSTEE HOURS:3 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:MOSHE BACHARACH MD TITLE:TRUSTEE HOURS: |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:FRANK COCCO MD TITLE:TRUSTEE HOURS: |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:RONALD J DEL MAURO TITLE:TRUSTEE HOURS:59 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:HOWARD KAPLAN TITLE:TRUSTEE HOURS: |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:THOMAS F KELAHER ESQ TITLE:TRUSTEE HOURS:30 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JERRY KOKES TITLE:TRUSTEE HOURS: |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:RABBI AARON KOTLER TITLE:TRUSTEE HOURS: |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:REV MONSIGNOR C H LADZINSKI TITLE:TRUSTEE HOURS: |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:STEPHEN LANE III TITLE:TRUSTEE HOURS: |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:GERALD J PICERNO TITLE:TRUSTEE HOURS:52 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:WILLIAM M SCHULMAN MD TITLE:TRUSTEE HOURS:3 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:LAWRENCE SILVERS MD TITLE:TRUSTEE HOURS: |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:NILES SPIER DDS TITLE:TRUSTEE HOURS: |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:GEORGE HICKS TITLE:EXECUTIVE DIRECTOR HOURS:30 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:GERALD L TOFANI CPA TITLE:CFO, VP HOURS:30 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:DEANNA SPERLING TITLE:VICE PRESIDENT HOURS: |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:CARYL L SINGER TITLE:VICE PRESIDENT HOURS:52 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:MICHELE H SCHWEERS TITLE:VICE PRESIDENT HOURS: |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JAMES L PEQUEEN JR TITLE:VICE PRESIDENT HOURS: |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:ANTHONY LOMBARDINO MD TITLE:VP MEDICAL AFFAIRS HOURS: |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:ERIC G LEHNES MD TITLE:MEDICAL STAFF PRESIDENT HOURS:3 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:BRUCE FEINBERG MD TITLE:MEDICAL DIRECTOR HOURS: |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:STEVEN A CULBERT MD TITLE:PHYSICIAN HOURS: |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:VINCENT L MOSS MD TITLE:PHYSICIAN HOURS: |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:ANDREW HARRISON MD TITLE:PHYSICIAN HOURS: |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:THOMAS KEDERSHA MD TITLE:PHYSICIAN HOURS: |
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