Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 01-01-2010 and ending 12-31-2010
BCheck if applicable:
CName of organization
Atlantic Health System Inc Group Return
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
475 South Street ACCTG 920
 
Room/suite
City or town, state or country, and ZIP + 4
Morristown, NJ07960
D Employer identification number

65-1301877
E Telephone number

G Gross receipts $ 1,276,425,993
F Name and address of principal officer:
Kevin Lenahan
475 South Street ACCTG 920
Morristown,NJ07960
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.atlantichealth.org
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet9704
K Form of organization:
501c3
L Year of formation: 2006
M State of legal domicile: NJ
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: To provide high quality, safe and affordable patient care with respect and compassion.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 22
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 7
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 11,076
6 Total number of volunteers (estimate if necessary) .... 6 2,807
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 5,291,186
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b -115,237
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 21,084,587 10,959,132
9 Program service revenue (Part VIII, line 2g) ......... 1,175,838,383 1,216,295,832
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 8,650,914 10,948,522
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 30,409,964 28,084,828
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 1,235,983,848 1,266,288,314
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 899,805 697,630
14 Benefits paid to or for members (Part IX, column (A), line 4) .... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 662,549,321 665,252,117
16a Professional fundraising fees (Part IX, column (A), line 11e).... 318,516 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet1,615,917    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 534,867,118 561,746,412
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 1,198,634,760 1,227,696,159
19 Revenue less expenses. Subtract line 18 from line 12...... 37,349,088 38,592,155
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 1,387,955,844 1,437,169,614
21 Total liabilities (Part X, line 26)............ 764,331,190 750,126,202
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 623,624,654 687,043,412
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: (1)Deliver high-quality, safe, affordable patient care with respect and compassion (2)Educate, in an exemplary manner, present and future health care professionals (3)Innovate through leadership (4)Improve the health status of the communities we serve.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 1,056,552,206 including grants of $ 697,630 ) (Revenue $ 1,213,802,031 )
This group return consisits of a not-for-profit entity comprised of two hospitals and a not-for-profit ambulance corporation. The Hospital which consists of AHS Hospital Corp and Practice Associates Medical Group, provides regional health care services including a broad range of adult, pediatric, obstetrical/gynecological, psychiatric, oncology, intensive care, cardiac care and newborn acute care services to patients from the counties of Morris, Sussex, Hunterdon, Union, Warren and Somerset. The Hospital is a regional health trauma center that provides tri-state coverage and provides numerous outpatient services, rehabilitation and skilled care and emergency care. The ambulance company (Atlantic Ambulance Corp) is a not-for-profit oganization established for scientific, educational and charitable purposes to sponsor, promote and assist in the establishment or maintenance of activities relating to the improvement of human health and to maintain and operate a system for providing ambulance services, including mobile intensive care unit services together with related emergency medical services, primarily in New Jersey. Refer to Schedule "O" for the entire 2010 Community Benefit Report which explains the exempt accomplishments and achievements of the organization in detail. In addition, refer to Schedule H for detailed disclosures and financial support for the community benefit provided in 2010.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services. (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 1,056,552,206
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? ........
2
 
No
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part IIClick to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part IClick to see attachment.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
Yes
 
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
Yes
 
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
 
No
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. .....
20b
 
No
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment
22
Yes
 
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................ Click to see list of attachments
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
No
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II........................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III............... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ......................... Click to see attachment
28a
Yes
 
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
Yes
 
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
Yes
 
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
775
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
12
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
11,076
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
22
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
7
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
Yes
 
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
Yes
 
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
NJ
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
Ken Butkowski
475 South Street - Acctg Box 920
Morristown,NJ07962
(973) 451-2005
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) Joseph Trunfio
President and CEO
 37.50 X   X       1,799,475 0 1,523,885
(2) Kevin Shanley
Treasurer
 37.50 X   X       860,547 0 408,077
(3) Stephen Sepaniak
VP Legal Affairs
 37.50 X   X       664,050 0 510,908
(4) Andrew Kovach
VP Human Resources
 37.50 X   X       775,159 0 528,770
(5) Kevin Lenahan
VP-Finance/CFO
 37.50 X   X       510,240 0 154,949
(6) Paul Marmora
Director of Fiscal Serv
 37.50 X   X       311,169 0 55,249
(7) Joseph Ramieri MD
Chairman-OB/GYN Depart
 37.50 X   X       525,914 0 34,893
(8) Sylvanus Zimmerman
Director-Corporate Compliance
 37.50 X   X       247,172 0 37,776
(9) Karen Kessler-Horowitz
Trustee
 2.00 X           0 0 0
(10) Robert Toohey
Trustee
 2.00 X           0 0 0
(11) Alan Weisberg
Trustee
 2.00 X           0 0 0
(12) Dexter Earle
Trustee
 2.00 X           0 0 0
(13) Richard Herbst
Trustee
 2.00 X           0 0 0
(14) Robert J Hugin
Trustee
 2.00 X           0 0 0
(15) Robert Mulcahy III
Trustee
 2.00 X           0 0 0
(16) Grant Van Siclen Parr MD
Trustee
 30.00 X           281,000 0 0
(17) Ron J Ponder
Trustee
 2.00 X           0 0 0
Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) Anne S Rooke RN MSN
Trustee
 2.00 X           0 0 0
(19) Earle F Nielsen MD
Trustee
 2.00 X           0 0 0
(20) Robert Sussman MD
Trustee
 2.00 X           0 0 0
(21) Gita F Rothschild
Trustee
 2.00 X           0 0 0
(22) Edward Zampella MD
Trustee
 2.00 X           0 0 0
(23) Alan Leiber
President - OMC
 37.50     X       564,800 0 192,537
(24) David Shulkin
President-MMC
 37.50     X       592,261 0 862,526
(25) Rolando Rolandelli
Director-Dep of Surgery
 37.50       X     735,499 0 2,447
(26) Donald Casey Jr
Director-Quality Improv
 37.50       X     769,036 0 532,092
(27) Frank Smart
Director-Cardiology Serv
 37.50       X     633,717 0 2,949
(28) Linda Reed
Chief Information Officer
 37.50       X     556,167 0 164,180
(29) Stanley Fiel
Director-Dept of Medicine
 37.50       X     549,977 0 41,847
(30) John Halperin
Director - Neuroscience
 37.50       X     507,679 0 36,593
(31) Walter Rosenfeld
Chairman - Pediatrics
 37.50       X     461,889 0 5,419
(32) Madeline Ferraro
VP - Gov't & Public
 37.50       X     367,981 0 123,074
(33) Eric Whitman
Director - Surgery
 37.50         X   557,235 0 5,949
(34) Louis DiFazio
Director-Surg-Critical Car
 37.50         X   538,492 0 4,249
(35) Louis Schwartz
Director-Radiation Oncolog
 37.50         X   573,410 0 1,628
(36) Brian Siegal
Physician - Trauma
 37.50         X   489,816 0 8,419
(37) William Dowling
Director - Orthopedics
 37.50         X   600,173 0 45,261
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 14,472,858 0 5,283,677
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet883
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
BUBB GROGAN & COCCA
25 Prospect Street
MORRISTOWN,NJ07960 		LEGAL SERVICES 1,260,280
ALLIED SLEEP
PO BOX 715450
COLUMBUS,OH43271 		MEDICAL-PHYSICIAN GROUP 1,225,261
SERVCIES ALL MED TRANSCRIPTION
3 WINONA TRAIL
LAKE HOPATCONG,NJ07849 		TRANSCRIPTION SERVICES 961,341
DAVID HENRY AGENCY
10 PROSPECT STREET
WESTFIELD,NJ07090 		MARKETING AGENCY 915,455
ATLANTIC NEUROSURGICAL SPECIALISTS
310 MADISON AVE - SUITE 200
MORRISTOWN,NJ07960 		MEDICAL-PHYSICIAN GROUP 909,950
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet80
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e 10,959,132
f All other contributions, gifts, grants, and
similar amounts not included above1f 		 
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 10,959,132
Program Service Revenue Business Code
2a PATIENT SERVICE REV 900,099 796,777,025 796,777,025    
b MEDICARE-MEDICAID 900,099 384,325,535 384,325,535    
c PHYSICIAN SERVICES 621,110 30,087,614 30,087,614    
d LAB SPEC PROCESSING 621,500 5,105,658   5,105,658  
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 1,216,295,832
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 9,237,731   7,859 9,229,872
4 Income from investment of tax-exempt bond proceeds..MediumBullet 2,016 2,016    
5 Royalties............MediumBullet        
(i) Real (ii) Personal
6a Gross Rents 2,609,841  
b Less: rental expenses    
c Rental income or (loss) 2,609,841  
d Net rental income or (loss).......MediumBullet 2,609,841 2,609,841    
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 9,080,920 2,757,016
b Less: cost or other basis and sales expenses 8,904,278 1,224,883
c Gain or (loss) 176,642 1,532,133
d Net gain or (loss)..........MediumBullet 1,708,775     1,708,775
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a 12,200
b Less: direct expenses ...b 8,518
c Net income or (loss) from fundraising events..MediumBullet 3,682   3,682
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a Cafeteria 721,000 3,659,906     3,659,906
b Parking 812,930 3,053,530     3,053,530
c Medical Education-Cour 611,430 501,462     501,462
d All other revenue .... 18,256,407   177,669 18,078,738
e Total. Add lines 11a–11d ......MediumBullet 25,471,305
12 Total revenue. See Instructions....MediumBullet 1,266,288,314 1,213,802,031 5,291,186 36,235,965
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21 697,630 697,630
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 16,931,907   16,931,907  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 526,286,960 466,822,304 58,470,058 994,598
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 37,685,294 32,385,355 5,228,400 71,539
9 Other employee benefits ....... 42,820,585 36,798,435 5,940,862 81,288
10 Payroll taxes ........... 41,527,371 35,687,094 5,761,444 78,833
11 Fees for services (non-employees):        
a Management ...... 46,424,418 18,176,229 28,248,189  
b Legal ......... 2,066,964   2,066,964  
c Accounting ........... 618,122   618,122  
d Lobbying ........... 302,957   302,957  
e Professional fundraising. See Part IV, line 17..    
f Investment management fees ......        
g Other .......... 4,654,099 4,226,389 421,937 5,773
12 Advertising and promotion .... 8,123,501 1,415,981 6,704,603 2,917
13 Office expenses ....... 265,503,931 260,958,526 4,471,144 74,261
14 Information technology ......        
15 Royalties ..        
16 Occupancy ........... 37,926,409 32,441,257 5,414,296 70,856
17 Travel ............        
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 4,440,315 3,854,450 578,338 7,527
20 Interest ........... 11,184,519 9,611,564 1,552,175 20,780
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 75,467,746 64,988,451 10,337,844 141,451
23 Insurance .............. 30,515,070 26,223,528 4,234,043 57,499
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a BAD DEBTS 45,420,161 45,420,161    
b REPAIRS AND MAINTENANCE 24,466,413 12,849,838 11,616,575  
c EQUIPMENT AND RENTAL 4,631,787 3,995,014 628,178 8,595
d
e
f All other expenses        
25 Total functional expenses. Add lines 1 through 24f 1,227,696,159 1,056,552,206 169,528,036 1,615,917
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation 		       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing ..........   1  
2 Savings and temporary cash investments ....... 23,373,723 2 58,095,646
3 Pledges and grants receivable, net ......... 10,367,205 3 1,419,289
4 Accounts receivable, net ......... 134,532,912 4 136,443,090
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net ............. 2,492,783 7 13,253,499
8 Inventories for sale or use .............. 6,308,688 8 7,361,941
9 Prepaid expenses and deferred charges ............ 37,424,769 9 42,227,913
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 1,559,824,604
b Less: accumulated depreciation. ..... 10b 825,337,923 728,475,054 10c 734,486,681
11 Investments—publicly traded securities .......... 433,141,807 11 428,206,549
12 Investments—other securities. See Part IV, line 11 ......   12  
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 11,838,903 15 15,675,006
16 Total assets. Add lines 1 through 15 (must equal line 34)... 1,387,955,844 16 1,437,169,614
Liabilities 17 Accounts payable and accrued expenses . 116,533,839 17 136,518,887
18 Grants payable ..........   18  
19 Deferred revenue ..........   19  
20 Tax-exempt bond liabilities .......... 353,884,716 20 347,074,861
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 293,912,635 25 266,532,454
26 Total liabilities. Add lines 17 through 25..... 764,331,190 26 750,126,202
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 549,615,558 27 649,742,567
28 Temporarily restricted net assets ..... 41,381,003 28 30,960,791
29 Permanently restricted net assets ..... 32,628,093 29 6,340,054
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 623,624,654 33 687,043,412
34 Total liabilities and net assets/fund balances ..... 1,387,955,844 34 1,437,169,614
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
1,266,288,314
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
1,227,696,159
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
38,592,155
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
623,624,654
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
24,826,603
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
687,043,412
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O............................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
Yes
 
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
Yes
 
Form 990 (2010)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

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.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
Atlantic Health System Inc Group Return
 
Employer identification number

65-1301877
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
f
g
(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
(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
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
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
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
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, Part IV, Supplemental Information: Atlantic Ambulance is a Box 9 organization. It receives more than 33 1/3% of its support from activities related to it's exempt functions and no more than 33 1/3% of its support from gross investment income and unrelated income from businesses acquired by the organization after June 30, 1975. Practice Associates Medicald Group (PAMG) is a Box 11 organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in Section 509(a)(1) or Section 509(a)(2). PAMG is a type 1 organization and is not controlled directly or indirectly by one or more disqualified persons other than managers and other than one or more publicly supported organizations described in section 509(a)(1) or Section 509(a)(2). PAMG did not receive a written determination letter from the IRS that it is Type I, Type II or Type III supporting organization. Since August 17, 2006, PAMG has not accepted any gift or contribution from (i) a person who directly or indirectly controls, either alone or together with persons described in (ii) and (iii) below, the governing body of the supported organization. (ii)A family member of a person described in (i) above. (iii) 35% controlled entity of a person in (i) or (ii) above. PAMG provided support to AHS Hospital Corp-Morrsitown Division (EIN #52-1958352)during 2010 in the amount of $3,487,976.
 
 
 
Schedule A (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.
SchCMd Bullet Attach to Form 990 or Form 990-EZ. SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
If the organization answered “Yes,” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes,” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes,” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35a (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
Atlantic Health System Inc Group Return
 
Employer identification number

65-1301877
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization's direct and indirect political campaign activities on behalf of or in opposition to candidates for public office in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c) except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt funtion activities ....................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2010

Schedule C (Form 990 or 990-EZ) 2010
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check
B Check
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
Organization's
Totals 		(b) Affiliated Group
Totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in) 		(a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) Total
             
2a Lobbying non-taxable amount          
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		         
             
c Total lobbying expenditures          
             
d Grassroots non-taxable amount          
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		          
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2010


Schedule C (Form 990 or 990-EZ) 2010
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
(a)
Yes
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
Yes
 
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
Yes
 
302,957
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? If "Yes," describe in Part IV ..........................
 
No
 
j
Total. lines 1c through 1i ...................................
302,957
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
Explanation of Other Lobbying Activities: Part II-B, Line 1i: During 2010, the organization compensated four different consultants primarily for their services and time in participating in conference telephone calls, attending meetings and conferences, providing communication emails and correspondence and travel expenses for the following Federal and State legislation and affairs: 1. NJ State Charity Care 2. Budget Clarifications 3. Various Regulatory Affairs 4. Hospital Issues 5. GME/Rebasing 6. Budget Meetings 7. Healthcare Forums 8. Lobbying Day in Washington DC 9. EDA Applications 10.A-1993 Helicopters 11.Energy Projects/Grants 12.Fair Share Alliance 13.NJHCFFA
Schedule C (Form 990 or 990EZ) 2010

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Atlantic Health System Inc Group Return
 
Employer identification number

65-1301877
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance .... 74,009,096 98,969,642 82,078,625
b Contributions ........ 19,410,940 14,967,701 33,746,017
c Investment earnings or losses ... 2,006,728 3,030,613 -2,394,000
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		-58,128,919 -42,958,860 -14,461,000
f Administrative expenses ....      
g End of year balance ...... 37,300,845 74,009,096 98,969,642
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet  
b
Permanent endowment: SchDMd Bullet100.000 %
c
Term endowment: SchDMd Bullet  
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   13,756,053 13,756,053
b Buildings ................   829,031,390 329,867,774 499,163,616
c Leasehold improvements ............   33,730,655 8,905,026 24,825,629
d Equipment ................   683,306,506 486,565,123 196,741,383
e Other .................        
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 734,486,681
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes  
ADVANCES THIRD PARTY PAYORS 36,381,287
INTEREST BARRIER SWAP 230,151,167







Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 266,532,454
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1 1,266,288,314
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 1,227,696,159
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 38,592,155
4 Net unrealized gains (losses) on investments .......................... 4 29,184,051
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8 -4,357,448
9 Total adjustments (net). Add lines 4 - 8 ............................. 9 24,826,603
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 63,418,758
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1 1,202,964,929
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d ..................... 2e 0
3 Subtract line 2e from line 1..................... 3 1,202,964,929
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV): ........... 4b 63,323,384
c Add lines 4a and 4b....................... 4c 63,323,384
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5 1,266,288,313
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1 1,164,372,774
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d...................... 2e 0
3 Subtract line 2e from line 1..................... 3 1,164,372,774
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV): ............ 4b 63,323,384
c Add lines 4a and 4b....................... 4c 63,323,384
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5 1,227,696,158
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
Description of Intended Use of Endowment Funds: Part V, Line 4: Temporarily restricted net assets are available and intended for the following purposes: - Research - Construction of the Heart Hospital and other projects - Purchase of plant and equipment - Scholarships and education - Program Services Permanently restricted net assets are restricted to investments to be held in perpetuity, the income from which is expendable to support health care services. It should be noted that the 2010 Endowment assets from Morristown Memorial Health Foundation (MMHF) were excluded from the above 2010 totals as MMHF filed a separate IRS 990 for 2010.
Part XI, Line 8 - Other Adjustments:   Net Assets released from capital restrictions 5,382,434. Government grants used for capital purchases 244,663. Change in funded status of benefit plans 35,867,321. Increase/Decrease in restricted net assets 2,997,898. Removal of 2010 MMHF Net Assets -48,849,764.
Part XII, Line 4b - Other Adjustments:   Revenue recorded as an offset in the AFS expenses 52,364,252. Grant revenue recorded as an offset to the AFS expenses 10,959,132.
Part XIII, Line 4b - Other Adjustments:   Revenue recorded as an offset in the AFS expenses 52,364,252. Grant revenue recorded as an offset to the AFS expenses 10,959,132.
    On January 1, 2009, Atlantic Ambulance adopted the recogintion and disclosure provisions the accounting related to accounting for uncertainty in income taxes. Accordingly, tax positions are evaluated for recognition using a more-likely-than-not threshold, and those tax positions requiring recognition are measured at the largest amount of tax benefit that is greater than 50% likely of being realized upon ultimate settlement with a taxing authority thas has full knowledge of all relevant information. The Company has evaluated the likelihood of their tax exempt status being challenged as remote and, accordingly has not included any income tax provisions, including interest and penalties, in financial statements related to potential violations of their tax exempt status.
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Atlantic Health System Inc Group Return
 
Employer identification number

65-1301877
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Does the organization have a charity care policy? If "No," skip to question 6a...........
1a
Yes
 
b
If "Yes," is it a written policy? .......................
1b
Yes
 
2
If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.
3
Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.
a
Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low
income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If
"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....
3b
Yes
 
c
If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Does the organization's policy provide free or discounted care to the "medically indigent"? ......
4
Yes
 
5a
Does the organization budget amounts for free or discounted care provided under its charity care policy? ...
5a
Yes
 
b
If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............
5c
 
No
6a
Does the organization prepare an annual community benefit report?.............
6a
Yes
 
6b
If "Yes," does the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Charity Care and Certain Other Community Benefits at Cost
Charity Care and
Means-Tested Government Programs		 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Charity care at cost (from
Worksheets 1 and 2) .. 		  37,465 34,649,726 2,993,896 31,655,830 2.680 %
b Unreimbursed Medicaid (from
Worksheet 3, column a) . 		  42,647 45,191,684 33,573,687 11,617,997 0.980 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....            
dTotal Charity Care and
Means-Tested Government Programs ..... 		  80,112 79,841,410 36,567,583 43,273,827 3.660 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		  1,352,845 2,395,647 818,180 1,577,467 0.130 %
f Health professions education
(from Worksheet 5) .. 		    36,823,272 11,870,578 24,952,694 2.110 %
g Subsidized health services
(from Worksheet 6) .. 		    14,271,560 1,006,235 13,265,325 1.120 %
h Research (from Worksheet 7)            
i Cash and in-kind contributions
to community groups
(from Worksheet 8) .. 		    697,630 0 697,630 0.060 %
jTotal Other Benefits ...   1,352,845 54,188,109 13,694,993 40,493,116 3.420 %
kTotal. Add lines 7d and 7j. ..   1,432,957 134,029,519 50,262,576 83,766,943 7.080 %
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 2
Part II
Community Building Activities Complete this table if the organization conducted any community building activities.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support 3 493 1,432,209 1,414,500 17,709 0 %
4 Environmental improvements            
5 Leadership development and training for community members 2 1,144 1,740 0 1,740 0 %
6 Coalition building 2 307 1,281 0 1,281 0 %
7 Community health improvement advocacy            
8 Workforce development 7 1,258 39,873 165 39,708 0 %
9 Other            
10 Total 14 3,202 1,475,103 1,414,665 60,438  
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense (at cost).....
2
34,680,080
3
Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..
3
13,640,682
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
330,892,068
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
372,062,916
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
-41,170,848
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:
Section C. Collection Practices
9a
Does the organization have a written debt collection policy? ...............
9a
Yes
 
b
If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......
9b
Yes
 
Part IV
Management Companies and Joint Ventures
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership% 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 3
Part VFacility Information
Section A. Hospital Facilities
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many hospital facilities did the organization operate during the tax year?2
Name and address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 Morristown Medical Center
100 Madison Avenue
Morristown,NJ07960 		X X X X X   X    
2 Overlook Medical Center
99 Beauvoir Avenue
Summit,NJ07902 		X X X X X   X    
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:Not Required for 2010
Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet those needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Development of a community benefit plan for the facility
d Participation in community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the CHNA
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs. 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8   No
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9   No
If “Yes,” indicate the FPG family income limit for eligibility for free care:   %
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 5
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care to low income individuals?......... 10   No
If “Yes,” indicate the FPG family income limit for eligibility for discounted care:   %
11 Explained the basis for calculating amounts charged to patients?................. 11   No
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12   No
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13   No
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted at all times on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........ 14   No
15 Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments or arrests
e Other (describe in Part VI)
16 Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?................................... 16   No
If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other (describe in Part VI)
17 Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
e Other (describe in Part VI)
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 6
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18   No
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20   No
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 7
Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many non-hospital facilities did the organization operate during the tax year?12
Name and address Type of Facility (Describe)
1 Atlantic Rehabilitation Institute
95 Mt Kemble Avenue
Morristown,NJ07960 		A comprehensive rehabilitation hospital.
2 Atlantic Rehabilitation Institute
95 Mt Kemble Avenue
Morristown,NJ07960 		A comprehensive rehabilitation hospital.
3 Atlantic Rehabilitation Institute
95 Mt Kemble Avenue
Morristown,NJ07960 		A comprehensive rehabilitation hospital.
4 Atlantic Rehabilitation Institute
95 Mt Kemble Avenue
Morristown,NJ07960 		A comprehensive rehabilitation hospital.
5 Atlantic Rehabilitation Institute
95 Mt Kemble Avenue
Morristown,NJ07960 		A comprehensive rehabilitation hospital.
6 Atlantic Rehabilitation Institute
95 Mt Kemble Avenue
Morristown,NJ07960 		A comprehensive rehabilitation hospital.
7 Atlantic Rehabilitation Institute
95 Mt Kemble Avenue
Morristown,NJ07960 		A comprehensive rehabilitation hospital.
8 Atlantic Rehabilitation Institute
95 Mt Kemble Avenue
Morristown,NJ07960 		A comprehensive rehabilitation hospital.
9 Atlantic Rehabilitation Institute
95 Mt Kemble Avenue
Morristown,NJ07960 		A comprehensive rehabilitation hospital.
10 Atlantic Rehabilitation Institute
95 Mt Kemble Avenue
Morristown,NJ07960 		A comprehensive rehabilitation hospital.
11 Atlantic Rehabilitation Institute
95 Mt Kemble Avenue
Morristown,NJ07960 		A comprehensive rehabilitation hospital.
12 Atlantic Rehabilitation Institute
95 Mt Kemble Avenue
Morristown,NJ07960 		A comprehensive rehabilitation hospital.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 8
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2 Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
    Part I, Line 6a: The 2010 community benefit report will be made available to the public via the Atlantic Health System website (www.atlantichealth.org).
    Part I, Line 7: Charity and unreimbursed Medicaid gross patient charges were decreased to cost by applying the cost to charge ratio which was calculated on Worksheet 2 per the IRS instructions. All other costs for the remaining programs were compiled by the applicable program directors and represent actual expenses that were made.
    Part I, Line 7g: Subsidized Health Services represent clinical patient care services that are provided, despite a negative margin, because they are needed in the community. During 2010 the organization provided 39 such clinical patient care programs. The net community benefit expense represents the total actual expenses offset by any patient and grant revenue.
    Part I, L7 Col(f): The bad debt expense at cost was established by "grossing up" the bad debt expense per the audited financial statements to gross charges and applying the 2010 cost to charge ratio as calculated on worksheet 2.
    Part II: -Clincical Affiliations with Surgical Technical Schools - Clinical Site is provided for students from Surgical Technical Schools.-APTA Clinical Instructor and Credentialing - Education program designed for physical therapists and physical therapy assistants offerred by the American Physical Therapy Association.-High School Student Shadowing - High School students shadow health care workers to stimulate interest in the health care careers.-Writing Grant Proposals-Staff of Health Foundation involved in getting grants to raise as much money as possible for projects to support the community.-Information Technology related equipment donations throughout the community.-Measures to prevent your child from being kidnapped, abducted, etc.-Donation of expired IV medications to Union County College- Donate expired drugs to Union County College to be used as a teaching aid. Drugs are used during simulation in their Sim Lab and to teach general pharmacology to students.-Kidney Korner Support Group - Support group for dialysis and transplant patients and their families.Nephrology Certification Review Class - A certification review class to all nephrology nurses in the community. MMC Dialysis Services provided the meeting space, handouts and volunteers to assist with registration.New Jersey renal Coalition meetings - Meetings to plan educatinoal sessions for patients, physicians, and community members of CKD.Special Health Services Coordination - Collaborate with St. Clare's outpatient pediatric clinic to give oveview of SCHS, EIP and Case Management services to provide the best care to our communities.
    Part III, Line 4: Patient Service Revenue and Related Adjustments:The Hospital records gross patient service revenue on an accrual basis at established rates, with contractual and other allowances added to or deducted from such amounts to determine net patient service revenue. The Hospital maintains policies and records to identify and monitor these contractual allowances and its level of charity care. These records include the amount of deductions from gross revenue due to qualified services provided under the State's charity care guidelines.The process for estimating the ultimate collection of receivables involves significant assumptions and judgments. The Hospital has implemented a monthly standardized approach to estimate and review the collectability of receivables based on the payer classification and the period from which the receivables have been outstanding. Account balances are written off against the allowance when management feels it is probable the receivable will not be recovered. Historical collection and payer reimbursement experience is an integral part of the estimation process related to reserves for doubtful accounts. In addition, the Hospital assesses the current state of its billing functions in order to identify any known collection or reimbursement issues and assess the impact, if any, on reserve estimates. The Hospital believes that the collectability of its receivables is directly linked to the quality of billing processes, most notably those related to obtaining the correct information in order to bill effectively for the services it provides. Revisions in reserve for doubtful accounts estimates are recorded as an adjustment to bad debt expense.The bad debt expense at cost was established by "grossing up" the bad debt expense per the audited financial statements to gross charges and applying the 2010 cost to charge ratio as calculated on worksheet 2.
    Part III, Line 8: 2010 Medicare Allowable Costs as calculated per the 2010 Medicare Cost report exceeds the 2010 Medicare payments received generating a Medicare shortfall to the organization of over $41 million.
    Part III, Line 9b: The organization's collection policy is as follows:Uninsured patients are registered as Self Pay Uninsured. Whether an uninsured patient is pre-registered or registered on the date of service, the account will be referred to Financial Counseling to determine eligibility for any Federal or State program for the uninsured. These programs include Social Security (retired and disability), Supplemental Security Income (SSI) that is accompanied by Medicaid coverage, Medicaid, the Federal 1011 Program for illegal aliens, Catastrophic Children's Relief fund, of the NJ State Charity Care program. All efforts will be made to enroll qualified patients into one of these programs for the uninsured. Patients who do not qualify for any Federal or State program will be granted Self Pay discount according to the current discount policy, or a payment plan to satisfy their obligation. Failure to meet a patient's financial obligation will lead to referral to a Collection Agency 126 days after the letter/statement series is completed.
    Part VI, Line 2: -The Morris Regional Public Health Partnership completed a comprehensive Morris County Health Improvement Plan at the end of 2007. This assessment included results of a household survey on residents' perception of health needs, county statistical health data, and a formalized county health system assessment. This Health Improvement Plan was carefully reviewed by our Community Health Committee and priorities for outreach programs were strategically set and communicated to the Advisory Board of the Hospital. The organization's board of directors has approved as one of our mission "imperatives to improve the health status of the communities we serve."The Overlook Community Health Department has aligned its work to support the organization's mission statement which is to improve the health status of the communities we serve. This is accomplished in two ways. The first is the assessment of community needs through our Regional Health Departments and our Community Health Committee. The second is to highlight and to provide access to Overlook Hospital's Centers of Excellence through educational programs and health screenings.
    Part VI, Line 3: It is the financial assistance policy of the organization to ensure patients receive essential health care services regardless of their ability to pay. Financial assistance is available through a variety of programs to those low-income, uninsured and underinsured patients who do not otherwise have the ability to pay all or part of their hospital bill. Financial assistance and discounts are available only for necessary hospital care. Some services such as physician fees, anesthesiology fees, radiology interpretation, and outpatient prescriptions are separate from hospital charges and may not be eligible for financial assistance through Atlantic Health. Only patients qualifying for Social Security (Aged or Disabled), Supplemental Security Income (SSI which is accompanied by Medicaid, and Medicaid would have non-hospital related charges covered.The organization's policy is as follows:-Information regarding Atlantic Health's Financial Assistance Policy will be provided to the public in consumer-friendly terminology and in a language the patient can understand.-Invoices to patients will include information related to the availability of financial assistance and how the patient can obtain further information and apply for financial assistance.-Information on financial assistance will be posted in appropriate Patient Access sites with instructions on how patients can obtain information on financial assistance and apply for available programs.-Staff interacting with patients will receive training regarding financial assistance programs, how to communicate these programs to patients and how to direct patients to appropriate financial counseling staff.-Staff providing financial counseling will receive training to treat patients seeking financial assistance with courtesy, confidentiality and cultural sensitivity.-Translation services will be made available as needed.To take advantage of any available financial assistance program, the patient must meet with a Financial Counselor at the Hospital. The Financial Counselor will explain the requirements for each program and determine which program, if any, the patient qualifies for. Whether an uninsured patient is pre-registered or registered on the date of service, the account will be referred to Financial Counseling to determine eligibility for any Federal or State program for the uninsured.Available Financial Assistance Programs:A. Federal Programs include:1. Social Security (retired and disability)2. Supplemental Security Income (SSI) accompanied by Medicaid3. Medicaid4. The Federal 1011 Program for undocumented immigrantsB. New Jersey State programs include:1-Charity Care is a State program available to New Jersey residents who:a. Have no health insurance coverage or have coverage that pays only for part of the bill: andb. Are ineligible for any private or governmental sponsored coverage (as listed above under "Federal Programs"); andc. Meet both the income and assets eligibility criteria established by the State.This program covers only acute care hospital charges for medically necessary services that would be covered under the State's Medicaid program if the patient were eligible for Medicaid. All Charity Care applicants must present proof of income and assets. The Financial Counseling office will make a determination of whether the applicant is eligible as soon as possible. If a request for income/asset proof is not provided or inadequate, the application will be denied. The applicant will then be allowed to present additional required information after receiving a denial letter. The applicant has up to twenty three (23) months from the date of service to re-apply for Charity Care with documented income/asset information. Applicants who are ineligible may re-apply at a future date when they present for services and their financial circumstances have changed.2. Catastrophic Children's Relief Fund:The State of New Jersey's Catastrophic Children's Relief Fund assists families of chronically ill children when the family's total medical bills exceed the family's ability to pay based on family income and assets.3. Crime Victims Fund:The State of New Jersey has established a Crime Victims Fund to pay the bills of victims of violent crime.C. Self Pay:1. New Jersey Residents. Uninsured patients who do not qualify for Charity Care or any other type of Federal or State funded financial assistance programs will be charged as follows:a. Inpatients: Patients receiving medically necessary inpatient treatment will be charged the appropriate Medicare DRG rate plus 15% (both Medicare payment and co-payment) for the service rendered.b. Outpatients: Patients receiving outpatient services will be charged a discounted rate of 40% off hospital charges.2. Out of State and Foreign Patients:a. For inpatient services, the rate is based on the Medicare DRG rate plus 25%b. If the inpatient length of stay exceeds the average length of stay for the specifically assigned Medicare DRG rate by two (2) days, the daily rate would be $1,500 per day for each additional day beyond the two (2) day threshold.c. Outpatient services will be charged a rate based on the previous year's Medicare cost to charge ratio.D. Payment PlansAtlantic Health assists patients who request payment plans. The payment plan may not exceed one year and the patient must pay at least $25 per month.E. Discounts and WaiversAfter financial screening, if the patient does not qualify for any financial assistance program and cannot afford to pay the charges, additional discounting or financial arrangements may be made available on a case-by-case basis.
    Part VI, Line 4: The organization's patient service area is comprised of the following six counties in northern and central New Jersey: Hunterdon, Morris, Somerset, Sussex, Union and Warren. The organization's six county service area population grew from 1,648,929 in 2000 to 1,740,546 in 2007, or 5.6% and is projected to increase to 1,796,500 by 2012, a 3.2% increase from 2007. This is slightly less than the State of New Jersey, which grew from 8,414,350 in 2000 to 8,786,952 in 2007, or 4.4% and is projected to increase to 9,006,488 by 2012, or 2.5%. The 2007 service median household income of $87,460 exceeded the State of New Jersey's $70,078 median household income by 24.8% and the service area is projected to have a median household income of $96,634 by 2012, which will exceed the state of New Jersey's projected $76,423 median household income by 26.4%.The six county service area population growth from 2000 to 2007, by age groups, shows the highest growth of 23.5% for ages 45 to 64, a 8.4% increase in ages 65 and over, and a 4.8% increase in age groups 17 and under, while the population decreased by 5.9% for ages 18 to 44. The female population with ages 18 to 44 decreased by 6.9% between 2000 and 2007. The six county service area population, by ages groups, in 2012 is projected as follows: the highest growth of 16.5% for ages 65 and older, an 11.0% increase is projected in ages 45 to 64, a 1.9% decrease is projected for ages 17 and under, and a 4.1% decrease is projected for ages 18 to 44. The female population is projected to decrease by 3.2%.The organization extends credit without collateral to its patients, most of whom are local residents and are insured under third-party payer agreements. The accounts receivable from patients and third-party payers, excluding allowance for doubtful accounts, as of December 31, 2010 are as follows:-Medicare an Medicaid 27%-Commercial and other third party payers 37-Self Pay 25-Blue Cross 11-Total: 100%The organization provides a wide variety of community health activities, including health education, screening and prevention programs, and health fairs. The organization views these community health activities as a critical component in its effort to improve the health of the community at large, particularly those community members who are underserved. In 2010, Atlantic Health System reached more than 1,352,845 commmunity members, a total benefit to the community of $1,577,467.
    Part VI, Line 7: The organization has an affiliation agreement with North Jersey Health Care Corporation, the Parent of Newton Memorial Hospital, and Newton Memorial Hospital dated July 1999, which expires December 31, 2010. It provides the collaborative planning and development of new programs to improve patient care and access in the communities served by each institution.The organization is the primary academic affiliate in NJ of Mount Sinai School of Medicine. The affiliation provides opportunities for student rotations, faculty teaching and appointments, and research and clinical collaborations. The organization also maintains medical affiliations with Columbia University College of Physicians and Surgeons, Kirksville College of Medicine, New York College of Osteopathic Medicine, St. George's University, and UMDNJ-NJMS.
Schedule H (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
Atlantic Health System Inc Group Return
 
Employer identification number
65-1301877
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) Morristown Memorial Health FoundationPO Box 1956
Morristown,NJ118034228 		22-3392808 501(c)(3) 25,000       General Support
(2) Two Kids FoundationPO Box 103
Whippany,NJ07981 		11-3740784 501(c)(3) 15,000       General Support
(3) Mountainside Health Foundation1 Bay Avenue
Montclair,NJ07042 		22-3122804 501(c)(3) 10,000       General Support
(4) Tri-County Scholarship Fund4 Century Drive
Parsippany,NJ07054 		22-2354475 501(c)(3) 5,000       General Support
(5) Alliance For Lupas Research28 W 44th Street
New York,NY10036 		58-2492929 501(c)(3) 25,000       General Support
(6) American Cancer Society7 Ridgedale Avenue Suite 103
Cedar Knolls,NJ07927 		13-1788491 501(c)(3) 40,000       General Support
(7) American Heart Association1 Union Street
Robbinsville,NJ08691 		13-5613797 501(c)(3) 28,000       General Support
(8) American Diabetes Association1160 Route 22 Suite 103
Bridgewater,NJ08807 		13-1623888 501(c)(3) 11,800       General Support
(9) Project Fit AmericaPO Box 308
Boy Hot Sring,CA92240 		36-3730823 501(c)(3) 31,672       General Support
(10) County College of Morris214 Center Grove
Randolph,NJ07869 		23-7200730 501(c)(3) 20,000       General Support
(11) Police Unity Tour Inc49 Woodland Avenue
Morristown,NJ07960 		22-3530541 501(c)(3) 5,900       General Support
(12) Summit Fourth of July Celebration512 Springfield Avenue
Summit,NJ07901 		22-3450164 501(c)(3) 7,000       General Support
(13) Valerie Fund2101 Millburn Avenue
Maplewood,NJ07040 		22-2126867 501(c)(3) 6,025       General Support.
(14) American Cancer Society507 Westminister Avenue
Elizabeth,NJ07208 		13-1788491 501(c)(3) 6,000       General Support
(15) Camp Rivebend116 Hillcrest Road
Warren,NJ07059 		22-2673140 501(c)(3) 6,000       General Support
(16) Chilton Memorial Hospital Foundation97 West Parkway
Pompton Plains,NJ07444 		22-2883605 501(c)(3) 6,700       General Support
(17) Crohns & Coltis Foundation of America45 Wilson Avenue
Manalapan,NJ07726 		13-6193105 501(c)(3) 22,000       General Support
(18) Friends of MathenyPO Box 89
Peapak,NJ07977 		22-2512045 501(c)(3) 10,000       General Support
(19) Gateway Regional Chamber of Commerce135 Jefferson Avenue
Elizabeth,NJ07207 		22-0887600 501(c)(3) 10,500       General Support
(20) Hospital Albert SchweitzerPO Box 81046
Pittsburgh,PA15217 		52-2022113 501(c)(3) 7,500       General Support
(21) Interfaith Food Pantry540A West Hanover Avenue
Morristown,NJ07960 		22-3618468 501(c)(3) 5,250       General Support
(22) Jewish Vocatinoal Service111 Prospect Street
EAst ORange,NJ07017 		22-1487229 501(c)(3) 5,000       General Support
(23) Komen NJ Race for the Cure785 Springfield Avenue
Summit,NJ07901 		22-3528454 501(c)(3) 25,000       General Support
(24) Liberty Science Center222 Jersey City Boulevard
Jersey City,NJ07305 		22-2302253 501(c)(3) 25,000       General Support
(25) Medical Needs FoundationPO Box 303
Mountain Lakes,NJ07076 		22-3599504 501(c)(3) 5,000       General Support
(26) Morris Education FundPO Box 1224
Morristown,NJ07962 		22-3205909 501(c)(3) 10,000       General Support
(27) Morristown Partnership14 Maple Avenue
Morristown,NJ07960 		22-3307187 501(c)(3) 45,000       General Support
(28) Mount Sinai Crystal BallOne Gustave L Levy Place
New York,NY10029 		13-6271888 501(c)(3) 13,000       General Support
(29) National Multiple Sclerosis Society733 Third Avenue
New York,NY10017 		13-5661935 501(c)(3) 5,000       General Support
(30) Newton Memorial Health Foundation175 High Streeet
Newton,NJ07860 		22-2618102 501(c)(3) 11,500       General Support
(31) Operation Bling Foundation6 South Street
New Providence,NJ07974 		26-2119081 501(c)(3) 5,000       General Support
(32) Partners in HeatlhPO Box 845578
Boston,MA02284 		04-3567502 501(c)(3) 7,500       General Support
(33) Rhombus Enterprises11 North John Street
Pearl River,NY10965 		20-8983494 501(c)(3) 8,350       General Support
(34) Rotary club of Madison5 Manker Drive
Florham Park,NJ07932 		22-6101617 501(c)(3) 12,500       General Support
(35) Sisters of CharityPO Box 476
Convent Station,NJ07096 		22-1487373 501(c)(3) 5,000       General Support
(36) Soft Bones1500 Washington Street
Hoboken,NJ07030 		26-4619055 501(c)(3) 5,000       General Support
(37) St Patricks Day Parade of Morris County65 Madison Avenue Suite 400
Morristown,NJ07960 		22-3087890 501(c)(3) 5,000       General Support
(38) Summit PAL512 Springfield Avenue
Summit,NJ07901 		22-3294529 501(c)(3) 5,000       General Support
(39) Union County Performing Arts Center101 Irving Street
Rahway,NJ07065 		22-2278631 501(c)(3) 55,000       General Support
(40) WAMMH-MIMPO Box 1956
Morristown,NJ07962 		22-3392808 501(c)(3) 10,000       General Support
(41) Marriott Hanover (4110 Epilepsy Event-Vascular Institute)1401 Route 10 East
Whippany,NJ07981 		27-0602441 501(c)(3) 12,700       General Support
2
Enter total number of section 501(c)(3) and government organizations ......................... Bullet Image
41
3
Enter total number of other organizations ................................ . Bullet Image
0
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2010

Schedule I (Form 990) 2010
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance
(1) Good Neighbor Fund 18 10,471     Support to approved individuals primarily for rent and medical expenses.
(2) Melissa Riggio Memorial Fund 12 13,000     Support to approved individuals for housing, living and medical expenses.
(3) Wellness Partnership 3 1,155     Medical/Health well being.









Part IV
Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.
Identifier Return Reference Explanation
Other Information: Part IV: The organization uses due diligence is the process for reviewing and slecting grant recipients and is comfortable that the grants are used for their intended purpose. All assistance and grants are reviewed and approved by senior management via the accounts payable cycle.
Schedule I (Form 990) 2010


Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Atlantic Health System Inc Group Return
 
Employer identification number

65-1301877
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
Yes
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
 
No
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
Yes
 
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) Joseph Trunfio (i)
(ii)		 1,159,282
0 		568,800
0 		71,393
0 		1,520,936
0 		2,949
0 		3,323,360
0 		568,800
0
(2) Kevin Shanley (i)
(ii)		 635,506
0 		160,200
0 		64,841
0 		403,284
0 		4,793
0 		1,268,624
0 		160,200
0
(3) Stephen Sepaniak (i)
(ii)		 445,723
0 		180,300
0 		38,027
0 		509,115
0 		1,793
0 		1,174,958
0 		180,300
0
(4) Andrew Kovach (i)
(ii)		 480,144
0 		245,000
0 		50,015
0 		524,995
0 		3,775
0 		1,303,929
0 		245,000
0
(5) Kevin Lenahan (i)
(ii)		 434,371
0 		73,600
0 		2,269
0 		149,000
0 		5,949
0 		665,189
0 		73,600
0
(6) Paul Marmora (i)
(ii)		 266,149
0 		44,600
0 		420
0 		51,300
0 		3,949
0 		366,418
0 		44,600
0
(7) Joseph Ramieri MD (i)
(ii)		 490,249
0 		30,800
0 		4,865
0 		33,100
0 		1,793
0 		560,807
0 		30,800
0
(8) Sylvanus Zimmerman (i)
(ii)		 209,052
0 		37,700
0 		420
0 		37,400
0 		376
0 		284,948
0 		37,700
0
(9) Grant Van Siclen Parr MD (i)
(ii)		 281,000
0 		0
0 		0
0 		0
0 		0
0 		281,000
0 		0
0
(10) Alan Leiber (i)
(ii)		 414,814
0 		127,800
0 		22,186
0 		188,318
0 		4,219
0 		757,337
0 		127,800
0
(11) David Shulkin (i)
(ii)		 521,863
0 		50,000
0 		20,398
0 		859,100
0 		3,426
0 		1,454,787
0 		50,000
0
(12) Rolando Rolandelli (i)
(ii)		 615,822
0 		0
0 		119,677
0 		0
0 		2,447
0 		737,946
0 		0
0
(13) Donald Casey Jr (i)
(ii)		 546,641
0 		190,700
0 		31,695
0 		528,317
0 		3,775
0 		1,301,128
0 		190,700
0
(14) Frank Smart (i)
(ii)		 612,051
0 		20,700
0 		966
0 		0
0 		2,949
0 		636,666
0 		20,700
0
(15) Linda Reed (i)
(ii)		 404,809
0 		132,200
0 		19,158
0 		161,733
0 		2,447
0 		720,347
0 		132,200
0
(16) Stanley Fiel (i)
(ii)		 502,553
0 		35,600
0 		11,824
0 		39,400
0 		2,447
0 		591,824
0 		35,600
0
(17) John Halperin (i)
(ii)		 471,207
0 		33,700
0 		2,772
0 		32,800
0 		3,793
0 		544,272
0 		33,700
0
(18) Walter Rosenfeld (i)
(ii)		 437,657
0 		13,600
0 		10,632
0 		0
0 		5,419
0 		467,308
0 		13,600
0
(19) Madeline Ferraro (i)
(ii)		 262,359
0 		95,800
0 		9,822
0 		120,379
0 		2,695
0 		491,055
0 		95,800
0
(20) Eric Whitman (i)
(ii)		 484,769
0 		0
0 		72,466
0 		0
0 		5,949
0 		563,184
0 		0
0
(21) Louis DiFazio (i)
(ii)		 423,180
0 		0
0 		115,312
0 		0
0 		4,249
0 		542,741
0 		0
0
(22) Louis Schwartz (i)
(ii)		 545,638
0 		25,000
0 		2,772
0 		0
0 		1,628
0 		575,038
0 		25,000
0
(23) Brian Siegal (i)
(ii)		 375,004
0 		0
0 		114,812
0 		0
0 		8,419
0 		498,235
0 		0
0
(24) William Dowling (i)
(ii)		 558,439
0 		36,400
0 		5,334
0 		43,700
0 		1,561
0 		645,434
0 		36,400
0
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
  Part I, Line 1a The organization pays for the auto leases, cell phones, life insurance premiums, long term disability premiums, financial planning services and health club membership fees for certain officers, directors and key employees. Such payments made on behalf of these individuals are grossed up and inputted and included as taxable compensation in their respective W-2's.
  Part I, Line 6 An annual incentive plan exists for the senior management team. The incentive plan distributes bonuses to the senior management team based on performance results on various performance measurements. The performance measurements include: operating gain/loss expense per adjusted admission patient satisfaction scores inpatient and outpatient volumes employee engagement scores quality and safety results. The above performance measures have the following three specific performance goals in order to determine any incentive award: Threshold Target Maximum
Schedule J (Form 990) 2010

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
Atlantic Health System Inc Group Return
 
Employer identification number
65-1301877
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A NJ Healthcare Facilities Series 2008B
  		22-1987084 64579FWP4 05-09-2008 88,555,000 To redeem revenue bonds   X   X   X
B NJ Healthcare Facilities Series 2008C
  		22-1987084 64579FWQ2 05-09-2008 88,555,000 To redeem revenue bonds   X   X   X
C NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVP5 04-24-2008 6,040,000 To redeem revenue bonds   X   X   X
D NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVQ3 04-24-2008 100,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVR1 04-24-2008 6,240,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVS9 04-24-2008 825,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVT7 04-24-2008 5,830,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVU4 04-24-2008 6,980,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVV2 04-24-2008 7,330,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVW0 04-24-2008 7,695,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVX8 04-24-2008 1,200,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVY6 04-24-2008 6,880,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVZ3 04-24-2008 8,470,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWA7 04-24-2008 8,900,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWB5 04-24-2008 9,345,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWC3 04-24-2008 9,810,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWD1 04-24-2008 1,150,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWE9 04-24-2008 9,160,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWF6 04-24-2008 525,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWG4 04-24-2008 10,310,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWH2 04-24-2008 550,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWJ8 04-24-2008 10,840,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWK5 04-24-2008 1,175,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWL3 04-24-2008 57,755,000 To redeem revenue bonds   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired. . . . .        
2 Amount of bonds defeased . . . .        
3 Total proceeds of issue . . . . 88,555,000 88,555,000 6,040,000 100,000
4 Gross proceeds in reserve funds . . 3,730,087 3,730,087 254,415 4,212
5 Capitalized interest from proceeds.        
6 Proceeds in refunding escrow. . . . .        
7 Issuance costs from proceeds . . . 620,375 620,375 42,313 701
8 Credit enhancement from proceeds.        
9 Working capital expenditures from proceeds . .        
10 Capital expenditures from proceeds . .        
11 Other spent proceeds . .        
12 Other unspent proceeds. . . 1,914,628 1,914,628 130,589 2,162
13 Year of substantial completion . . . 2008 2008 2008 2008
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? X   X     X    
15 Were the bonds issued as part of an advance refunding issue?   X   X   X   X
16 Has the final allocation of proceeds been made? . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . X   X   X   X  
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2010
Schedule K (Form 990) 2010
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use?   X   X   X   X
b Are there any research agreements that may result in private business use of bond-financed property? . .   X   X   X   X
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? .                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . . SchKMediumBullet 0.680 % 0.680 % 0.680 % 0.680 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . SchKMediumBullet        
6 Total of lines 4 and 5 . . .. . . . . . 0.680 % 0.680 % 0.680 % 0.680 %
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities? X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X   X   X   X
2 Is the bond issue a variable rate issue? X   X     X   X
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?   X   X   X   X
b Name of provider . NA
  		NA
  		NA
  		 
 
c Term of hedge . .        
d Was the hedge superintegrated? .                
e Was a hedge terminated? .                
4a Were gross proceeds invested in a GIC? .   X   X   X   X
b Name of provider . NA
  		NA
  		NA
  		NA
 
c Term of GIC . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? .                
5 Were any gross proceeds invested beyond an available temporary period? .   X   X   X   X
6 Did the bond issue qualify for an exception to rebate? . . .   X   X   X   X
Schedule K (Form 990) 2010

Schedule K (Form 990) 2010
Page 3
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
Schedule K (Form 990) 2010

Additional Data


Software ID:  
Software Version:  

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
Atlantic Health System Inc Group Return
 
Employer identification number
65-1301877
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A NJ Healthcare Facilities Series 2008B
  		22-1987084 64579FWP4 05-09-2008 88,555,000 To redeem revenue bonds   X   X   X
B NJ Healthcare Facilities Series 2008C
  		22-1987084 64579FWQ2 05-09-2008 88,555,000 To redeem revenue bonds   X   X   X
C NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVP5 04-24-2008 6,040,000 To redeem revenue bonds   X   X   X
D NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVQ3 04-24-2008 100,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVR1 04-24-2008 6,240,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVS9 04-24-2008 825,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVT7 04-24-2008 5,830,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVU4 04-24-2008 6,980,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVV2 04-24-2008 7,330,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVW0 04-24-2008 7,695,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVX8 04-24-2008 1,200,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVY6 04-24-2008 6,880,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVZ3 04-24-2008 8,470,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWA7 04-24-2008 8,900,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWB5 04-24-2008 9,345,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWC3 04-24-2008 9,810,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWD1 04-24-2008 1,150,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWE9 04-24-2008 9,160,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWF6 04-24-2008 525,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWG4 04-24-2008 10,310,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWH2 04-24-2008 550,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWJ8 04-24-2008 10,840,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWK5 04-24-2008 1,175,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWL3 04-24-2008 57,755,000 To redeem revenue bonds   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired. . . . .        
2 Amount of bonds defeased . . . .        
3 Total proceeds of issue . . . . 88,555,000 88,555,000 6,040,000 100,000
4 Gross proceeds in reserve funds . . 3,730,087 3,730,087 254,415 4,212
5 Capitalized interest from proceeds.        
6 Proceeds in refunding escrow. . . . .        
7 Issuance costs from proceeds . . . 620,375 620,375 42,313 701
8 Credit enhancement from proceeds.        
9 Working capital expenditures from proceeds . .        
10 Capital expenditures from proceeds . .        
11 Other spent proceeds . .        
12 Other unspent proceeds. . . 1,914,628 1,914,628 130,589 2,162
13 Year of substantial completion . . . 2008 2008 2008 2008
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? X   X     X    
15 Were the bonds issued as part of an advance refunding issue?   X   X   X   X
16 Has the final allocation of proceeds been made? . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . X   X   X   X  
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2010
Schedule K (Form 990) 2010
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use?   X   X   X   X
b Are there any research agreements that may result in private business use of bond-financed property? . .   X   X   X   X
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? .                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . . SchKMediumBullet 0.680 % 0.680 % 0.680 % 0.680 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . SchKMediumBullet        
6 Total of lines 4 and 5 . . .. . . . . . 0.680 % 0.680 % 0.680 % 0.680 %
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities? X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X   X   X   X
2 Is the bond issue a variable rate issue? X   X     X   X
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?   X   X   X   X
b Name of provider . NA
  		NA
  		NA
  		 
 
c Term of hedge . .        
d Was the hedge superintegrated? .                
e Was a hedge terminated? .                
4a Were gross proceeds invested in a GIC? .   X   X   X   X
b Name of provider . NA
  		NA
  		NA
  		NA
 
c Term of GIC . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? .                
5 Were any gross proceeds invested beyond an available temporary period? .   X   X   X   X
6 Did the bond issue qualify for an exception to rebate? . . .   X   X   X   X
Schedule K (Form 990) 2010

Schedule K (Form 990) 2010
Page 3
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
Schedule K (Form 990) 2010

Additional Data


Software ID:  
Software Version:  

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
Atlantic Health System Inc Group Return
 
Employer identification number
65-1301877
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A NJ Healthcare Facilities Series 2008B
  		22-1987084 64579FWP4 05-09-2008 88,555,000 To redeem revenue bonds   X   X   X
B NJ Healthcare Facilities Series 2008C
  		22-1987084 64579FWQ2 05-09-2008 88,555,000 To redeem revenue bonds   X   X   X
C NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVP5 04-24-2008 6,040,000 To redeem revenue bonds   X   X   X
D NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVQ3 04-24-2008 100,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVR1 04-24-2008 6,240,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVS9 04-24-2008 825,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVT7 04-24-2008 5,830,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVU4 04-24-2008 6,980,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVV2 04-24-2008 7,330,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVW0 04-24-2008 7,695,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVX8 04-24-2008 1,200,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVY6 04-24-2008 6,880,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVZ3 04-24-2008 8,470,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWA7 04-24-2008 8,900,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWB5 04-24-2008 9,345,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWC3 04-24-2008 9,810,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWD1 04-24-2008 1,150,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWE9 04-24-2008 9,160,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWF6 04-24-2008 525,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWG4 04-24-2008 10,310,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWH2 04-24-2008 550,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWJ8 04-24-2008 10,840,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWK5 04-24-2008 1,175,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWL3 04-24-2008 57,755,000 To redeem revenue bonds   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired. . . . .        
2 Amount of bonds defeased . . . .        
3 Total proceeds of issue . . . . 88,555,000 88,555,000 6,040,000 100,000
4 Gross proceeds in reserve funds . . 3,730,087 3,730,087 254,415 4,212
5 Capitalized interest from proceeds.        
6 Proceeds in refunding escrow. . . . .        
7 Issuance costs from proceeds . . . 620,375 620,375 42,313 701
8 Credit enhancement from proceeds.        
9 Working capital expenditures from proceeds . .        
10 Capital expenditures from proceeds . .        
11 Other spent proceeds . .        
12 Other unspent proceeds. . . 1,914,628 1,914,628 130,589 2,162
13 Year of substantial completion . . . 2008 2008 2008 2008
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? X   X     X    
15 Were the bonds issued as part of an advance refunding issue?   X   X   X   X
16 Has the final allocation of proceeds been made? . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . X   X   X   X  
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2010
Schedule K (Form 990) 2010
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use?   X   X   X   X
b Are there any research agreements that may result in private business use of bond-financed property? . .   X   X   X   X
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? .                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . . SchKMediumBullet 0.680 % 0.680 % 0.680 % 0.680 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . SchKMediumBullet        
6 Total of lines 4 and 5 . . .. . . . . . 0.680 % 0.680 % 0.680 % 0.680 %
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities? X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X   X   X   X
2 Is the bond issue a variable rate issue? X   X     X   X
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?   X   X   X   X
b Name of provider . NA
  		NA
  		NA
  		 
 
c Term of hedge . .        
d Was the hedge superintegrated? .                
e Was a hedge terminated? .                
4a Were gross proceeds invested in a GIC? .   X   X   X   X
b Name of provider . NA
  		NA
  		NA
  		NA
 
c Term of GIC . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? .                
5 Were any gross proceeds invested beyond an available temporary period? .   X   X   X   X
6 Did the bond issue qualify for an exception to rebate? . . .   X   X   X   X
Schedule K (Form 990) 2010

Schedule K (Form 990) 2010
Page 3
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
Schedule K (Form 990) 2010

Additional Data


Software ID:  
Software Version:  

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
Atlantic Health System Inc Group Return
 
Employer identification number
65-1301877
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A NJ Healthcare Facilities Series 2008B
  		22-1987084 64579FWP4 05-09-2008 88,555,000 To redeem revenue bonds   X   X   X
B NJ Healthcare Facilities Series 2008C
  		22-1987084 64579FWQ2 05-09-2008 88,555,000 To redeem revenue bonds   X   X   X
C NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVP5 04-24-2008 6,040,000 To redeem revenue bonds   X   X   X
D NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVQ3 04-24-2008 100,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVR1 04-24-2008 6,240,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVS9 04-24-2008 825,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVT7 04-24-2008 5,830,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVU4 04-24-2008 6,980,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVV2 04-24-2008 7,330,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVW0 04-24-2008 7,695,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVX8 04-24-2008 1,200,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVY6 04-24-2008 6,880,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVZ3 04-24-2008 8,470,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWA7 04-24-2008 8,900,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWB5 04-24-2008 9,345,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWC3 04-24-2008 9,810,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWD1 04-24-2008 1,150,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWE9 04-24-2008 9,160,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWF6 04-24-2008 525,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWG4 04-24-2008 10,310,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWH2 04-24-2008 550,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWJ8 04-24-2008 10,840,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWK5 04-24-2008 1,175,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWL3 04-24-2008 57,755,000 To redeem revenue bonds   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired. . . . .        
2 Amount of bonds defeased . . . .        
3 Total proceeds of issue . . . . 88,555,000 88,555,000 6,040,000 100,000
4 Gross proceeds in reserve funds . . 3,730,087 3,730,087 254,415 4,212
5 Capitalized interest from proceeds.        
6 Proceeds in refunding escrow. . . . .        
7 Issuance costs from proceeds . . . 620,375 620,375 42,313 701
8 Credit enhancement from proceeds.        
9 Working capital expenditures from proceeds . .        
10 Capital expenditures from proceeds . .        
11 Other spent proceeds . .        
12 Other unspent proceeds. . . 1,914,628 1,914,628 130,589 2,162
13 Year of substantial completion . . . 2008 2008 2008 2008
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? X   X     X    
15 Were the bonds issued as part of an advance refunding issue?   X   X   X   X
16 Has the final allocation of proceeds been made? . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . X   X   X   X  
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2010
Schedule K (Form 990) 2010
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use?   X   X   X   X
b Are there any research agreements that may result in private business use of bond-financed property? . .   X   X   X   X
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? .                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . . SchKMediumBullet 0.680 % 0.680 % 0.680 % 0.680 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . SchKMediumBullet        
6 Total of lines 4 and 5 . . .. . . . . . 0.680 % 0.680 % 0.680 % 0.680 %
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities? X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X   X   X   X
2 Is the bond issue a variable rate issue? X   X     X   X
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?   X   X   X   X
b Name of provider . NA
  		NA
  		NA
  		 
 
c Term of hedge . .        
d Was the hedge superintegrated? .                
e Was a hedge terminated? .                
4a Were gross proceeds invested in a GIC? .   X   X   X   X
b Name of provider . NA
  		NA
  		NA
  		NA
 
c Term of GIC . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? .                
5 Were any gross proceeds invested beyond an available temporary period? .   X   X   X   X
6 Did the bond issue qualify for an exception to rebate? . . .   X   X   X   X
Schedule K (Form 990) 2010

Schedule K (Form 990) 2010
Page 3
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
Schedule K (Form 990) 2010

Additional Data


Software ID:  
Software Version:  

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
Atlantic Health System Inc Group Return
 
Employer identification number
65-1301877
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A NJ Healthcare Facilities Series 2008B
  		22-1987084 64579FWP4 05-09-2008 88,555,000 To redeem revenue bonds   X   X   X
B NJ Healthcare Facilities Series 2008C
  		22-1987084 64579FWQ2 05-09-2008 88,555,000 To redeem revenue bonds   X   X   X
C NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVP5 04-24-2008 6,040,000 To redeem revenue bonds   X   X   X
D NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVQ3 04-24-2008 100,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVR1 04-24-2008 6,240,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVS9 04-24-2008 825,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVT7 04-24-2008 5,830,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVU4 04-24-2008 6,980,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVV2 04-24-2008 7,330,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVW0 04-24-2008 7,695,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVX8 04-24-2008 1,200,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVY6 04-24-2008 6,880,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVZ3 04-24-2008 8,470,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWA7 04-24-2008 8,900,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWB5 04-24-2008 9,345,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWC3 04-24-2008 9,810,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWD1 04-24-2008 1,150,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWE9 04-24-2008 9,160,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWF6 04-24-2008 525,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWG4 04-24-2008 10,310,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWH2 04-24-2008 550,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWJ8 04-24-2008 10,840,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWK5 04-24-2008 1,175,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWL3 04-24-2008 57,755,000 To redeem revenue bonds   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired. . . . .        
2 Amount of bonds defeased . . . .        
3 Total proceeds of issue . . . . 88,555,000 88,555,000 6,040,000 100,000
4 Gross proceeds in reserve funds . . 3,730,087 3,730,087 254,415 4,212
5 Capitalized interest from proceeds.        
6 Proceeds in refunding escrow. . . . .        
7 Issuance costs from proceeds . . . 620,375 620,375 42,313 701
8 Credit enhancement from proceeds.        
9 Working capital expenditures from proceeds . .        
10 Capital expenditures from proceeds . .        
11 Other spent proceeds . .        
12 Other unspent proceeds. . . 1,914,628 1,914,628 130,589 2,162
13 Year of substantial completion . . . 2008 2008 2008 2008
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? X   X     X    
15 Were the bonds issued as part of an advance refunding issue?   X   X   X   X
16 Has the final allocation of proceeds been made? . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . X   X   X   X  
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2010
Schedule K (Form 990) 2010
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use?   X   X   X   X
b Are there any research agreements that may result in private business use of bond-financed property? . .   X   X   X   X
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? .                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . . SchKMediumBullet 0.680 % 0.680 % 0.680 % 0.680 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . SchKMediumBullet        
6 Total of lines 4 and 5 . . .. . . . . . 0.680 % 0.680 % 0.680 % 0.680 %
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities? X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X   X   X   X
2 Is the bond issue a variable rate issue? X   X     X   X
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?   X   X   X   X
b Name of provider . NA
  		NA
  		NA
  		 
 
c Term of hedge . .        
d Was the hedge superintegrated? .                
e Was a hedge terminated? .                
4a Were gross proceeds invested in a GIC? .   X   X   X   X
b Name of provider . NA
  		NA
  		NA
  		NA
 
c Term of GIC . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? .                
5 Were any gross proceeds invested beyond an available temporary period? .   X   X   X   X
6 Did the bond issue qualify for an exception to rebate? . . .   X   X   X   X
Schedule K (Form 990) 2010

Schedule K (Form 990) 2010
Page 3
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
Schedule K (Form 990) 2010

Additional Data


Software ID:  
Software Version:  

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
Atlantic Health System Inc Group Return
 
Employer identification number
65-1301877
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A NJ Healthcare Facilities Series 2008B
  		22-1987084 64579FWP4 05-09-2008 88,555,000 To redeem revenue bonds   X   X   X
B NJ Healthcare Facilities Series 2008C
  		22-1987084 64579FWQ2 05-09-2008 88,555,000 To redeem revenue bonds   X   X   X
C NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVP5 04-24-2008 6,040,000 To redeem revenue bonds   X   X   X
D NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVQ3 04-24-2008 100,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVR1 04-24-2008 6,240,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVS9 04-24-2008 825,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVT7 04-24-2008 5,830,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVU4 04-24-2008 6,980,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVV2 04-24-2008 7,330,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVW0 04-24-2008 7,695,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVX8 04-24-2008 1,200,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVY6 04-24-2008 6,880,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FVZ3 04-24-2008 8,470,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWA7 04-24-2008 8,900,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWB5 04-24-2008 9,345,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWC3 04-24-2008 9,810,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWD1 04-24-2008 1,150,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWE9 04-24-2008 9,160,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWF6 04-24-2008 525,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWG4 04-24-2008 10,310,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWH2 04-24-2008 550,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWJ8 04-24-2008 10,840,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWK5 04-24-2008 1,175,000 To redeem revenue bonds   X   X   X
NJ Healthcare Facilities Series 2008A
  		22-1987084 64579FWL3 04-24-2008 57,755,000 To redeem revenue bonds   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired. . . . .        
2 Amount of bonds defeased . . . .        
3 Total proceeds of issue . . . . 88,555,000 88,555,000 6,040,000 100,000
4 Gross proceeds in reserve funds . . 3,730,087 3,730,087 254,415 4,212
5 Capitalized interest from proceeds.        
6 Proceeds in refunding escrow. . . . .        
7 Issuance costs from proceeds . . . 620,375 620,375 42,313 701
8 Credit enhancement from proceeds.        
9 Working capital expenditures from proceeds . .        
10 Capital expenditures from proceeds . .        
11 Other spent proceeds . .        
12 Other unspent proceeds. . . 1,914,628 1,914,628 130,589 2,162
13 Year of substantial completion . . . 2008 2008 2008 2008
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? X   X     X    
15 Were the bonds issued as part of an advance refunding issue?   X   X   X   X
16 Has the final allocation of proceeds been made? . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . X   X   X   X  
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2010
Schedule K (Form 990) 2010
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use?   X   X   X   X
b Are there any research agreements that may result in private business use of bond-financed property? . .   X   X   X   X
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? .                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . . SchKMediumBullet 0.680 % 0.680 % 0.680 % 0.680 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . SchKMediumBullet        
6 Total of lines 4 and 5 . . .. . . . . . 0.680 % 0.680 % 0.680 % 0.680 %
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities? X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X   X   X   X
2 Is the bond issue a variable rate issue? X   X     X   X
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?   X   X   X   X
b Name of provider . NA
  		NA
  		NA
  		 
 
c Term of hedge . .        
d Was the hedge superintegrated? .                
e Was a hedge terminated? .                
4a Were gross proceeds invested in a GIC? .   X   X   X   X
b Name of provider . NA
  		NA
  		NA
  		NA
 
c Term of GIC . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? .                
5 Were any gross proceeds invested beyond an available temporary period? .   X   X   X   X
6 Did the bond issue qualify for an exception to rebate? . . .   X   X   X   X
Schedule K (Form 990) 2010

Schedule K (Form 990) 2010
Page 3
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
Schedule K (Form 990) 2010

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Atlantic Health System Inc Group Return
 
Employer identification number

65-1301877
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2010
Schedule L (Form 990 or 990-EZ) 2010
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) Mid-Atlantic Neonatology
  		Refer to below. 843,702 Performance. Lucy L Chen MD (Board Member-Trustee) husband is a member of Mid-Atlantic Neonatology. The organization paid Mid-Atlantic Neonatology $843,702 during 2010. Transaction is considered to be negotiated at arms-length.   No
(2) Rent-A-Crate
  		Refer to below. 200,300 Performance. Andrew Kovach (Trustee and Officer) is a Director of H Brown Investments which is the Parent of Rent-A-Crate. During 2010, Rent-A-Crate received $200,300 in payments from the organization. Transaction is considered to be negotiated at arms-length.   No
(3) Verizon
  		Refer to below. 3,330,592 Performance. Robert Toohey (Board Member-Trustee) is Senior Vice President of Verizon. The organization paid Verizon $3,330,592 during 2010 for networking and phone services. Transaction is considered to be negotiated at arms-length.   No
(4) Cross Country Inc
  		Refer to below. 684,276 Performance. Joseph Trunfio (Trustee and Officer)is a member of the Board of Directors of Cross Country , Inc. The organization paid Cross Country, Inc. $684,276 during 2010. Transaction is considered to be negotiated at arms-length.   No
(5) Atlantic Neurosurgical Specialists
  		Refer to below 909,950 Performance. Ed Zampella (Board Member-Trustee) is a member of Atlantic Neurosurgical Specialists. The organization paid Altantic Neurosurgical Specialists $909,950 during 2010 for services. Transaction is considered to be negotiated at arms-length.   No
(6) Elizabeth Lenahan Refer to below 39,807 Performance. Elizabeth Lenahan is the mother of Kevin Lenahan (Trustee and Officer). The organization compensated Elizabeth Lenahan $39,807 during 2010. Transaction is considered to be negotiated at arms-length.   No
(7) Pediatric Eye Physicians
  		Refer to below. 13,825 Performance. Lucy L Chen MD (Board Member - Trustee)is an equity member/partner of Pediatric Eye Physicians. The organization paid Pediatric Eye Physicians $13,825 during 2010. Transaction is considered to be negotiated at arms-length.   No
(8) Pulmonary and Allergy Association
  		Refer to below. 566,690 Performance. Robert Sussman MD (Board Member - Trustee) is a partner of Pulmonary and Allergy Association. The organization paid Pulmonary and Allergy Association $566,690 during 2010. Transaction is considered to be negotiated at arms-length.   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  




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.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
Atlantic Health System Inc Group Return
 
Employer identification number

65-1301877
Identifier Return Reference Explanation
Form 990, Part VI, Section A, line 2   Leigh Porges, J Peter Simon and Mark J Simon (all board members of Morristown Memorial Health Foundation) have a "family relationship".
Form 990, Part VI, Section A, line 6   As per the by-laws, each of the entities has one "member", that being Atlantic Health System, Inc. There are no other members or classes of membership whatsoever as indicated in the by-laws.
Form 990, Part VI, Section A, line 7a   Atlantic Health System, Inc. is the only "member" which wholly owns each of the entities. As a result, Atlantic Health System, Inc. may elect the members of the governing bodies for each of the entities.
Form 990, Part VI, Section A, line 7b   Atlantic Health System, Inc. is the only "member" which wholly owns each of the entities. As a result, Atlantic Health System, Inc. approves the decisions of the governing bodies.
Form 990, Part VI, Section B, line 11   The 2010 IRS 990 was distributed to Senior Management and the Board of Trustees for their review. Any comments were addressed accordingly.
  Form 990, Part VI, Section B, line 12c We require disclosure of potential conflicts. This policy governs all personnel at Atlantic, including Board Members. Additionally, the Board Committee members must fill out annual disclosures with specific questions regarding potential conflicts. For potential conflicts involving employees, conflicts involving business relationships require prior disclosure and approval by the Compliance Officer (General Counsel). Conflicts involving Board members require approval from the Compliance Officer and the head of the Audit Committee, who may refer those conflicts to the Compliance Committee of the Board. Restrictions are fact-dependent, but may include recusal from deliberations regarding subject matter affected by the conflict.
  Form 990, Part VI, Section B, line 15 - A review of officer compensation by an independent 3rd party (Integrated Healthcare Strategies) is completed every year. The most recent survey was conducted in 2010. Officers include President and CEO AH, VP HR & CAO, VP Finance & CFO, VP Legal Affairs, VP Quality, VP Government Affairs, VP Information Services & CIO, VP Finance & Treasurer, VP AH & President OH and VP AH. - On behalf of Atlantic Health, Integrated Healthcare Strategies conducts an annual total compensation survey based on appropriate comparability data for like positions in like organizations. - The results of the survey are presented to the Executive Compensation Committee of the board which documents the findings and recommendations in committee minutes. - Compensation for key physicians is determined by soliciting salary data from 3 to 4 published sources. These salary recommendations are then reviewed with the MD Contract Committee and approved by the Physician Compensation Committee of the board.
  Form 990, Part VI, Section C, line 18 Currently each site of the organization retains copies of the filed IRS 990 for the last three years and IRS Form 1023 with the most senior management's assistant. Public disclosure of these IRS 990's can be made at any time at each of the organization's sites. In addition, the 990 is posted on the website "www.foundationcenter.org" and "guidestar.org".
  Form 990, Part VI, Section C, line 19 The organization does not currently make it's financial statements open to public disclosure but the statement of financial position is available by accessing the Form 990 from the website. The governing documents and conflict of interest polices are not currently made available to the public.
Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized gains on investments: 29,184,051. Net Assets released from capital restrictions 5,382,434. Government grants used for capital purchases 244,663. Change in funded status of benefit plans 35,867,321. Increase/Decrease in restricted net assets 2,997,898. Removal of 2010 MMHF Net Assets -48,849,764. Total to Form 990, Part XI, Line 5: 24,826,603.
2010 Community Benefit Report - Atlantic Health System   Atlantic Health System is one of New Jersey's largest not-for-profit health systems. Atlantic Health System offers world-class medicine through its two medical centers -- Morristown Medical Center (MMC) and Overlook Medical Center (OMC) and their outstanding physicians, procedures and technologies. Atlantic Health System is committed to improving the health status of the communities it serves, and provides community benefit as part of a measured approach to meeting identified health needs in the community. In 2010, Atlantic Health System contributed $66,622,274 in community benefit to the communities of Northern New Jersey. Community benefit includes charity care, subsidized health services, community health services, and financial contributions to community-based health organizations. An important part of Atlantic Health System's mission is to improve the health status of its communities. In 2010, Atlantic Health System's hospitals engaged in 542,750 patient encounters; 63,026 inpatient encounters and 479,724 outpatient encounters. Atlantic Health System is one of New Jersey's largest private employers with 10,048 employees. In 2010, Atlantic Health System was honored to be among the Fortune 100 Best Companies to Work For - the only hospital system in the New Jersey and New York metro area to earn this prestigious, national recognition. Atlantic Health System is committed to training New Jersey's future health care professionals. Atlantic Health System is the primary academic and clinical affiliate in New Jersey of Mount Sinai School of Medicine and The Mount Sinai Hospital. The affiliation represents dual opportunities for getting involved in the latest clinical trials and advances in research, and for providing even more advanced care for patients. Atlantic Health System offers several allied health certificate programs; over 2,131 emergency medical technicians were trained through the EMT basic course and continuing education units. Atlantic Health System has also partnered with The Cancer Institute of New Jersey and Morristown and Overlook Medical Centers are accredited by the Joint Commission. Renowned for its breadth of expert cardiac services, Morristown Medical Center performs the second largest number of heart surgeries in the New York metropolitan area. Overlook Medical Center, the regional leader in comprehensive stroke care and neuroscience, was the first hospital in the Northeast to offer the CyberKnife treatment, a leading technology for precision radiation in the treatment of prostate cancer, brain tumors, spine, lung, liver and pancreatic cancers. Atlantic Health System physicians are leaders in their specialties, such as pediatrics, orthopedics, cancer care, rehabilitation medicine, women's health, cardiovascular care, sports medicine and neuroscience. Continually searching for the most effective diagnosis and treatment options for each patient, pursuing leading medical technologies and treatments, and continuously offering the best hospital services and care, are the hallmarks of the organization. Some of the awards and recognition for our quality programs and dedication to leading technology include: -Gold Seal of Approval from The Joint Commission for Primary Stroke Centers: Atlantic Health System stroke centers -Magnet Recognition for Excellence in Nursing Service: Morristown Medical Center -Three-Year Approval with Commendation by the American College of Surgeons' Commission on Cancer: Overlook Medical Center and Morristown Medical Center -Gold Seal of Approval from The Joint Commission with Disease-Specific Care Certifications for joint replacement programs in the hip and knee categories: Morristown Medical Center -Chest Pain Center Accreditation from the Society for Chest Pain Centers: Overlook Medical Center -Recipient of the ACTION Registry-GWTG Gold Performance Achievement Award from the American College of Cardiology Foundation and American Heart Association: Gagnon Cardiovascular Institute at Morristown Medical Center and Overlook Medical Center. Atlantic Health System's world-class facilities feature state-of-the-art equipment in a comfortable, family-friendly environment that put patients first. Our nationally recognized physicians, experienced nurses and skilled staff provide outstanding and compassionate care. Atlantic Health System delivers high-quality safe, affordable patient care with respect and compassion and provides considerable benefit to the communities it serves.
    In 2010, Morristown Medical Center contributed a total of $36,254,015 in community benefit to its service area. Community Benefit includes charity care, subsidized health services, community health services, and financial contributions to local charities and organizations. Morristown Medical Center is an acute care hospital with 650 licensed beds. Morristown Medical Center has been serving the Morris County community for more than 100 years, setting high standards for patient care in state-of-the-art facilities with a full range of medical specialties and services. Morristown Medical Center offers advanced technology and support services, and brings specialists, renowned for their work in areas such as cancer, cardiology, emergency medicine, orthopedics, women's health, and pediatrics to New Jersey. Morristown Medical Center's commitment to quality patient care has earned the hospital national recognition. Morristown Medical Center has been designated as a Magnet Hospital for Excellence in Nursing Service by the American Nurses Credentialing Center, the nation's leading nursing credentialing organization. Named a Level I Regional Trauma Center by the American College of Surgeons and a Level II by the state, Morristown Medical Center offers superlative care from our highly trained trauma teams. MMC's cardiac surgery center is the largest in the state and the Gagnon Cardiovascular Institute is one of the top 100 hospitals in the nation for cardiovascular care. Morristown Medical Center delivers the largest number of babies in Northwestern NJ. The Level III Regional Perinatal Center, with a 26-bed Neonatal Intensive Care Unit, provides specialized care to sick and premature infants. Goryeb Children's Hospital has more than 100 pediatric specialists caring for patients in a child-friendly facility. Carol G. Simon Cancer Center treats all types of cancer with the most advanced methods, providing compassionate and individualized service. Morristown Medical Center is also home to the North Jersey Regional Arthritis Center. In addition, the Stroke Center at Morristown Medical Center is the only accredited stroke trauma center in the region. Morristown Medical Center is the official hospital of the New York Jets and offers a comprehensive sports medicine program. Morristown Medical Center is one of only 16 facilities nationwide to receive the prestigious Gold Seal of Approval from The Joint Commission for its hip and knee joint replacement programs. In 2010, Morristown Medical Center provided health care in the form of 37,892 inpatient encounters and 287,703 outpatient encounters. 19,865 of those inpatients and 176,623 of the outpatients were residents of Morris County. Of the patients from Morris County, 3,885 of the inpatients and 45,066 of the outpatients were residents of Morristown. In addition, Atlantic Health System employs 10,048 individuals, 3,828 of whom reside in Morris County. Of those in Morris County, 800 are Morristown residents. Atlantic Health System physicians are leaders in their fields, always searching for the most effective diagnosis and treatment options for each patient. Our facilities feature state-of-the-art equipment, unlimited possibilities for growth and learning, and a comfortable environment. Morristown Medical Center graduated 45 residents in 2010 from various programs. Twenty-one of these graduates chose to pursue fellowship training; eight stayed in the Atlantic Health System catchment area with only one of them practicing in a primary care specialty; four took Chief positions in our residency programs; two stayed on as hospitalists and one joined the surgical attending staff. Morristown Medical Center is accredited by the Joint Commission and is a winner of the National Research Corporation's 2010 Consumer Choice Award and the NJ Biz Best Employer. Community Benefit: $5,982,985 Research: $ 402,351 Training: $1,644,623 Total Subsidized Health Services: $8,029,959 Morristown Medical Center provides community benefit as part of a measured approach to meeting identified health needs in the community. The services highlighted herein support Morristown Medical Center's mission to improve the health status of the communities it serves. The quantifiable services highlighted in this report generate a low or negative margin, even after applying grants and other supplemental revenue. These services and programs would most likely be discontinued if the decision were made purely on a financial basis. Where possible, both direct and indirect costs have been considered. Some community benefit services are not easily counted or are inadequately portrayed quantitatively and are reported via narrative summary. Charity Care Consistent with its mission, the hospital provides charity care for medical services and procedures to patients who are uninsured, under-insured or who lack financial resources to pay. Morristown Medical Center provided charity medical services and procedures to patients in the immediate community at a cost to the hospital in 2010 of $19,185,117. The method for calculating this cost is truly on an incurred cost basis. The amount of subsidy received from the state of New Jersey has been included in the cost. We also remove bad debt to truly reflect the actual cost to Atlantic Health System for the provision of charity care. If we included overhead and bad debt with the provision of charity care net costs, this amount would be $41,257,305. Medicaid Medicaid is a program for certain people and families with low income. In 2010, Morristown Medical Center provided Medicaid services at a cost to the hospital in 2010 of $7,724,421. Subsidized Health Services Subsidized health services are clinical patient care services that are provided, despite a negative margin, because they are needed in the community. Community Health Morristown Medical Center provides a wide variety of services, from delivery of care to education and other local activities. These are designed to encourage better health and benefit the community-at-large, while also reaching the underserved members of the community. Community benefit in this area can include staff time, travel, materials and indirect costs. At Morristown Medical Center, one of the top priorities is to reach out to the community to target specific groups and their health care needs. In 2010, Morristown Medical Center reached more than 692,204 community members though ongoing health education, screening and prevention programs and health fairs, providing a total benefit to the community of $867,583. There were a total of 134 different activities provided to the community. Health programs were held at Morristown Medical Center and at easily accessible locations through the Morristown area including: -Morris Center, Madison, West Morris, Lakeland Hills, and Somerset YMCAs -Seventh Day Adventist Church -Calvary Baptist Church -Morristown Municipal Building -Family Health Center of Morristown -Church of the Redeemer Soup Kitchen -Head Start -Headquarters Plaza complex -Homeless Solutions -Saint Margaret's Church -Neighborhood House -Centro Biblico Church -Hispanic Affairs -Morris Senior Housing Authority -Salvation Army -Family of God Church -Hispanic Evangelic Church -Pentecostal Church -Wind of the Spirit -Interfaith Council for the Homeless Morristown Medical Center's health education programs deliver important information on a wide range of health topics to a variety of groups within the community. At Morristown Medical Center's screenings, participants receive individualized testing from medical professionals who also provide on-site counseling based on test results. These screenings are a secondary prevention activity designed to detect the early onset of illness and disease, and may result in referrals to community services or agencies, or appropriate physicians. Morristown Medical Center also collaborates with New Jersey Blood Services to collect lifesaving blood and platelet donations for area hospitals. Morristown Medical Center offers a number of ongoing support groups. Several information and referral lines operate out of Morristown Medical Center as a service to the community, and provide referrals to community services including parenting assistance, drug and alcohol assistance and counseling services.
    Emergency Preparedness: Medical Coordination Center (MCC): Under the supervision of the New Jersey Department of Health and Senior Services, Morristown Medical Center is one of nine designated medical coordination centers designed to organize hospitals by region to better handle communications and coordination in the event of an epidemic, terrorist attack, or other large-scale emergency. The centers will provide information to each other and maintain the integrity of health care delivery in the event that an emergency situation results in mass casualties. Financial Contributions to Other Community-Based Programs: In total, Morristown Medical Center provided $446,936 in direct financial contributions in 2010 to the organizations listed below and others to support the community, individuals and families in need. -American Heart Association -Two Kids Foundation -Mountainside Health Foundation -Livingston Police Department -Police Unity Tour -Italian American Club -Pediatric Council on Research -American Cancer Society -Komen NJ Race for the Cure -March of Dimes -Community Soup Kitchen of Morristown -Morris County Organization for Hispanic Affairs -Deirdre's House -Morristown Neighborhood House -Project Fit America -Morristown Partnership -American Diabetes Association -American Cancer Society -Jersey Battered Women's Services -Hoop-A-Paluza Foundation -R Baby Foundation -First Night Morris County -Partners in Health -Morris Habitat for Humanity -Crohns & Coltis Foundation of America Morristown Medical Center's administrators, managers, and staff actively contribute their time and leadership to a number of community organizations, including: -120 hours were donated to parent education sessions. -50 hours were donated to leading a pulmonary hypertension support group. Pulmonary hypertension is a rare, terminal lung disease that involves the heart. It is poorly diagnosed until late stages, which makes treatment and maintaining quality of life difficult. In addition to "supporting" fellow PH patients and their families, the purpose of this group is to educate the medical community, including ED and ambulance corps, leading to quicker diagnosis and start of treatment. -30 hours were donated to fundraising for The Community Theatre. -30 hours were donated to the Morristown Soup Kitchen helping to prepare, serve, and clean up meals for those in need. -70 hours were donated to Mansion in May. Mansion in May is a program which showcases mansions and gardens to raise money for the hospital. -220 hours were donated to the Board of Adjustment and school activities. -15 hours were spent knitting and crocheting for St. James Roman Catholic Church to make baby blankets for all infants that are baptized at the sister parish in New Brunswick, NJ, as well as lap blankets for nursing homes. -110 hours were donated volunteering to Harding Township Board of Adjustment as a board member. -200 hours were donated to fundraising for Children's Corner Day Care. -25 hours were donated to serving as a board member of Washington Association. -10 hours were donated to NJ Heroes Program. NJ Heroes program is a program that puts a spot light on the individuals and groups that are giving back in their community. Health Professions Education: Morristown Medical Center provides a clinical setting for medical education for nursing students, residents and other clinical providers. Morristown Medical Center trained 245 residents and fellows in 2010. Atlantic Health System has been accredited to sponsor its own programs since 2005. Atlantic Health System underwent a site visit in April of 2009 and received a five-year accreditation cycle, the longest available to a sponsoring institution. The following residency programs are accredited and sponsored by Morristown Medical Center: -Internal Medicine -Pediatrics -Surgery -Urogynecology with rotations at Overlook Medical Center -Radiology with rotations at Overlook Medical Center -Emergency Medicine -Emergency Medicine/Pediatrics -OB/GYN with rotations at Overlook Medical Center -Transitional Year -Podiatric Surgery with rotations at Overlook Medical Center -Dentistry In addition, an integrated OB/GYN residency program with University Hospital of UMDNJ - New Jersey Medical School and Hackensack University Medical Center exists at Morristown Medical Center. Rotating residents are sent from the following institutions: Lenox Hill Hospital (Morristown Medical Center- Orthopedic Sports Medicine) Monmouth Medical Center (Morristown Medical Center- Orthopedic Trauma) New York Downtown Hospital (Overlook Medical Center- OB/GYN) New York Presbyterian Hospital (Overlook Medical Center- Surgery) UMDNJ-NJMS (Overlook Medical Center-Orthopedic Surgery) UMDNJ-Robert Wood Johnson (Overlook Medical Center- Colorectal Surgery) Warren Hospital (Atlantic Health System - Pediatrics) Westchester Medical Center (Atlantic Health System - Oncology) Morristown Medical Center trained seven fellows; four in Emergency Medicine and Pediatrics, one in Sports Medicine, and two in Urogynecology. Atlantic Health System is the primary academic affiliate in NJ of Mount Sinai School of Medicine. The affiliation provides opportunities for student rotations, faculty teaching and appointments, and research and clinical collaborations. Atlantic Health System also maintains medical school affiliations with Columbia University College of Physicians and Surgeons, Kirksville College of Medicine, New York College of Osteopathic Medicine, St. George's University, and UMDNJ-NJMS. Morristown Medical Center provides third- and fourth-year medical students with clinical educational experiences. At any given time, approximately 56 students are training at Morristown Medical Center and Overlook Medical Center. More than 100 nursing students from various nursing schools are educated every month at Morristown Medical Center. Nurses at Morristown Medical Center help students learn how to deliver comprehensive nursing care in various health care settings. Morristown Medical Center also offers an external program to nursing students who have completed at least two clinical rotations. These students work in all nursing units in the hospital, one-on-one with a preceptor for extra hands-on experience. Additionally, a clinical setting for training lab technicians is available, accepting students from six universities that offer a medical technology curriculum. Affiliated universities are Caldwell College, East Stroudsburg University, Fairleigh Dickinson University, Kean University, Rutgers University at New Brunswick and York College of PA. Summary Morristown Medical Center made significant contributions throughout 2010 to benefit its communities for a total expenditure of $36,254,015. Morristown Medical Center's community benefit includes charity care, subsidized health services, community health services and financial contributions to local charities and organizations.
    Overlook Medical Center In 2010, Overlook Medical Center contributed a total of $30,368,259 in community benefit to the communities it served. Community benefit includes charity care, subsidized health services, community health programs and financial contributions to local charities and organizations. Overlook Medical Center, located in Summit, has been serving New Jersey and the Union County community for more than 100 years. Overlook Medical Center is an acute care hospital with 504 licensed beds and an emergency room. At OMC, a nationally recognized regional medical center, top doctors and award-winning nurses provide the most advanced clinical care and unsurpassed patient safety in a healing, family-centered environment. Overlook Medical Center's specialized facilities and programs include: Atlantic Neuroscience Institute, Carol G. Simon Cancer Center, Goryeb Children's Center, Gagnon Cardiovascular Institute, a maternity center, a center of excellence in bariatric surgery, a pioneering wound healing program with hyperbaric oxygen therapy, a Level III Intensive Perinatal Unit and award-winning emergency medicine services. Overlook Medical Center also offers comprehensive programs in breast health, pulmonary medicine, thyroid cancer, minimally invasive surgery, women's heart health, sleep medicine and adolescent eating disorders - among many others. Atlantic Neuroscience Institute houses the first Comprehensive Stroke Center in New Jersey, offering patients groundbreaking technologies such as the Merci Retrieval System and Penumbra devices. The Brain Tumor Center of NJ is renowned for its patient-centered, multidisciplinary approach, including unique treatments such as CyberKnife radiosurgery and clinical trials for new brain tumor targeted vaccines. Other inpatient and outpatient services include the Pain Management and Concussion centers, and a level 4 Epilepsy Center Carol G. Simon Cancer Center provides expert, comprehensive, compassionate treatment for all types of cancer using the latest medical technology Overlook Medical Center ranks second in the world in the number of CyberKnife treatments provided to prostate cancer patients. Overlook Medical Center's pulmonary center brings state-of-the-art care to lung cancer patients, while our thyroid cancer program provides the broadest treatment available in the region. Overlook Medical Center's quality of care has earned national recognition. The Chest Pain Center, part of Gagnon Cardiovascular Institute, is accredited by the National Society of Chest Pain Centers. Overlook is also home to a Center of Excellence in Bariatric Surgery designated by the American Society of Metabolic and Bariatric Surgery. In 2010, Overlook Medical Center provided health care through 25,134 inpatient encounters and 192,021 outpatient encounters. 15,621 of those inpatients and 118,582 of outpatients were residents of Union County. Of the patients from Union County, 1,281 of the inpatients and 15,495 of the outpatients were residents of Summit. In addition, Atlantic Health System employs 10,048 individuals, 1,842 of whom reside in Union County. Of those in Union County, 283 are Summit residents. Atlantic Health System physicians are leaders in their fields, always searching for the most effective diagnosis and treatment options for each patient. Our facilities feature state-of-the-art equipment, unlimited possibilities for growth and learning and a comfortable environment. Overlook Medical Center graduated 45 residents in 2010 from various programs. Twenty-one of these graduates chose to pursue fellowship training; eight stayed in the Atlantic Health System catchment area with only one of them practicing in a primary care specialty; four took Chief positions in our residencies; two stayed on as hospitalists and one joined the surgical attending staff. Community Benefit The services highlighted herein support Overlook Medical Center's mission to improve the health status of the communities it serves. The quantifiable services highlighted in this report generate a low or negative margin, even after applying grants and other supplemental revenue. These services and programs would most likely be discontinued if the decision was made purely for financial reasons. Where possible, direct and indirect costs have been considered. Some community benefit services are not easily counted or are inadequately portrayed quantitatively and are reported via narrative summary. Charity Care Consistent with its mission, the hospital provides charity care for medical services and procedures to patients who are uninsured, under-insured or who lack financial resources to pay. Overlook Medical Center provided charity medical services and procedures to patients in the immediate community at a cost to the hospital in 2010 of $12,470,713. The method for calculating this cost is truly on an incurred cost basis. The amount of subsidy received from the state of NJ has been included in the cost. We also remove bad debt to truly reflect the actual cost to Atlantic Health System for the provision of charity care. If we included overhead and bad debt with the provision of charity care net costs, this amount would be $30,778,509. Medicaid Medicaid is a program for certain people and families with low income. In 2010, Overlook Medical Center provided Medicaid services at a cost to the hospital in 2010 of $3,893,576. Subsidized Health Services Subsidized health services are clinical patient care services that are provided, despite a negative margin, because they are needed in the community. Community Health: $ 7,282,340 Research: $ 270,973 Training: $ 5,422,890 Total Subsidized Health Services: $12,976,203 Community Health Services: Overlook Medical Center provides an array of services ranging from direct delivery of care to education and local activities. These are designed to encourage better health and benefit the community at large, while also reaching the underserved members of the community. Community benefit in this area includes staff time, travel, materials and indirect costs. Reaching out to the community to target specific groups and address their health care needs is a priority at Overlook Medical Center. In 2010, Overlook Medical Center Community Health Education reached more than 663,843 community members though health education, screening and prevention programs and health fairs, providing a total benefit to the community of $777,072. The summary of such programs are as follows: Total Number of Activities: 66 Total Persons Sevrved: 663,843 Total Community Benefit: $777,072 Community Health Education Health education programs were held at Overlook Medical Center and at multiple convenient, accessible locations, including: -YMCAs (Westfield, Scotch Plains/Fanwood, Summit, Berkeley Heights, Springfield and Union -Banks -Fountain Baptist -First Baptist -Pilgrim Baptist -St. Teresa's -Ministerios Monte Santo -Temple Emanuel -Temple Zion -Temple Israel -Italian American Club -Vauxhall Family Health Center -Recreation Centers -Schools -State Capitol -Senior Centers -Libraries -Board of Health -CVS -Walgreens -City Hall -Girl Scouts -Liberty Drugs -Home Depot -Senior and Low Income Housing -Town Parks -Street Fairs Overlook's health education programs deliver important information on a wide range of health topics to a variety of groups within the community. At Overlook's screenings, participants receive individualized testing from medical professionals who also provide on-site counseling based on test results. The screenings are a secondary prevention activity designed to detect the early onset of illness and disease, and may result in referrals to community services or agencies, and appropriate physicians. Lastly, Overlook has an award-winning follow-up program "Closing the Loop." Overlook offers a number of ongoing support groups to its community. Several information and referral lines operate out of Overlook as a service to the community. Overlook provides referrals to community services for parenting assistance, drug and alcohol assistance, counseling services and other support groups held throughout the community.
    Financial Contributions to Other Community-based Programs: In total, Overlook Medical Center provided more than $ 250,695 in 2010 to the organizations listed below and others to support and enrich community building efforts and to assist individuals and families in need. -American Heart Association -Morris Habitat for Humanity -Chatham Fire Department -Young Survival Coalition -DWC Downtown Westfield 5K -Powell Children's Fund -Morris Education Foundation -Chilton Memorial Hospital Foundation -American Cancer Society -Alliance for Lupus Research -Morris Plains PBA -Morris County Crimestoppers -Interfaith Food Pantry -Summit Policeman's Benevolent Association -National MS Society -Family Promise -Alzheimer's Association NJ Chapter -Huntington Disease Society of America -American Diabetes Association -Komen NJ Race for the Cure -Department of Community Education Overlook Medical Center administrators, managers and staff actively contribute their time and leadership to a number of community organizations, including: -500 hours were donated to the Somerville School Board as Vice President, Chairman of the Technology Committee and Building & Grounds Committee, and Liaison to Somerset Medical Center. -8 hours were donated to conducting training exercises with Summit Fire Department on familiarization of the hospital and to review policies and procedures regarding response to fire alarm activations. -20 hours were donated to The Summit Speech School providing free consultative services in medical related matters. Health Professions Education: Overlook Medical Center provides a clinical setting for medical education, contributing to the growth of nursing students, residents and other clinical providers. Overlook trained 245 residents and fellows in 2010. Atlantic Health System has been accredited to sponsor its own programs since 2005. Atlantic Health System underwent a site visit in April 2009 and received a five-year accreditation cycle, the longest available to a sponsoring institution. The following are the residency programs sponsored by Overlook Medical Center: -Internal Medicine (MD & DO) -Family Medicine (MD & DO) -Sports Medicine (MD & DO) -OB/GYN with rotations at Morristown Medical Center -Pediatrics -Radiology with rotations at Morristown Medical Center -Transitional Year -Podiatric with rotations at Morristown Medical Center -Dentistry Rotating residents are sent from the following institutions: Lenox Hill Hospital (Morristown Medical Center- Orthopedic Sports Medicine) Monmouth Medical Center (Morristown Medical Center- Orthopedic Trauma) New York Downtown Hospital (Overlook Medical Center- OB/GYN) New York Presbyterian Hospital (Overlook Medical Center- Surgery) UMDNJ-NJMS (Overlook Medical Center-Orthopedic Surgery) UMDNJ-Robert Wood Johnson (Overlook Medical Center-Colorectal Surgery) Warren Hospital (Atlantic Health System - Pediatrics) Westchester Medical Center (Atlantic Health System - Oncology) Overlook Medical Center maintains osteopathic programs in Internal Medicine and Family Medicine. Currently four positions each year are available to osteopathic trainees in Internal Medicine, and two positions each year are available for training in Family Medicine. Overlook trained two fellows in Sports Medicine and one fellow in Hematology/Oncology in 2010. Atlantic Health System is the primary academic affiliate in NJ of Mount Sinai School of Medicine. The affiliation provides opportunities for student rotations, faculty teaching and appointments, and research and clinical collaborations. Atlantic Health System also maintains medical school affiliations with Columbia University College of Physicians and Surgeons, Kirksville College of Medicine, New York College of Osteopathic Medicine, St. George's University, and UMDNJ-NJMS. One of the largest nonprofit health care systems in New Jersey, Atlantic Health System is a major research clinical affiliate of The Cancer Institute of New Jersey. Summary Overlook Medical Center made significant contributions throughout 2010 to benefit its communities for a total expenditure of $30,368,259. Overlook's community benefit includes charity care, subsidized health services, community health programs, and financial contributions to local charities and organizations.
    Atlantic Health System Atlantic Health System is one of New Jersey's largest nonprofit health systems, offering world-class medicine through its two medical centers -- Morristown Medical Center and Overlook Medical Center. Several departments within Atlantic Health System operate across both campuses. Public Safety and Security Atlantic Health System's Protection and Security Services is involved in many community planning committees such as: -Morris County Bioterrorism Taskforce -Morris County Mass Immunization and Quarantine Committee -Morristown Local Emergency Planning Committee -UASI Regional Planning Committee -Union County OEM Committee -Summit Local Emergency Planning Committee -Business Executives for National Security (BENS) -Montclair Township Local Emergency Planning Committee -Glen Ridge Local Emergency Committee -Metropolitan Medical Response System (MMRS) -New Jersey Hospital Association Emergency Preparedness Taskforce -New Jersey Hospital Association Equipment Subcommittee -New Jersey Hospital Association Education Subcommittee -NJ State Med Prep Committee. Atlantic Health System's Protection and Security department provides many programs in the community. Some of these activities include: -Bioterrorism training -Compliance, Direction, Takedown (CDT) Personal Protection -Last Resort Tactics (LRT) Personal Protection -Child Protection Classes -Outreach services, including HIV and STD awareness, prevention and support groups. Atlantic Health System's Protection and Security Services staff contribute their time and leadership to a number of community organizations, including: -20 hours with Project ALERT (America's Law Enforcement Retiree Team), a corporation of more than 155 retired federal, state, and local law enforcement professionals who volunteer their time and expertise as unpaid consultants to the national law enforcement community. Project ALERT representatives participate in a variety of assignments, including missing child case evaluations, technical meetings with law enforcement personnel to discuss resources and community awareness initiatives. Project ALERT representatives are trained by the National Center for Missing and Exploited Children (NCMEC). -60 hours spent as a representative of NCMEC, whose mission is to help prevent child abduction and sexual exploitation; help find missing children; and assist victims of child abduction and sexual exploitation, their families and the professionals who serve them. NCMEC serves as a clearinghouse of information about missing and exploited children; operates a cyber tip line for the public to report Internet-related child sexual exploitation; and offers training programs to law enforcement and social service professionals. Atlantic Ambulance Our hospitals' readiness to respond to a disaster or health care emergency is part of a coordinated community-based effort. Our ambulances were dispatched for 911 calls 7,108 times and 4,733 patients were treated. Also, our ambulances provided 27,685 transports and our mobile intensive care units responded to 18,102 calls and treated 13,569 patients. Atlantic Health System trained 273 people for the basic EMT course, 1,858 people were trained in CEU programs, and there were 10,033 CEUs awarded Atlantic Ambulance Helicopter: Atlantic Health System began operating a helicopter service in 2006 enabling the quick transport of patients with medical emergencies so that they can receive the most comprehensive care for their needs. Atlantic Health System is the first hospital system in New Jersey to have its own helicopter; all other hospitals rely on the state police for air transport. The new helicopter, a Eurocopter EC-135 twin turbine engine model designed to reduce noise and created specifically for medical transport, allows Atlantic Health System to provide the quickest transportation to Morristown Medical Center, a regional trauma center, or to the closest appropriate facility. In addition to responding to trauma cases, Atlantic Health System's chopper also provides inter-hospital transport throughout Northern New Jersey, where more than 50 hospitals serve more than 4.5 million people. Patients who require specialized treatment for cardiac care, neuron emergencies, pediatrics, or high-risk labor and delivery often are transferred to Morristown Medical Center from elsewhere in the state. The helicopter can travel as far as Boston or Baltimore to take patients to medical facilities with more specialized services. In 2010, Air one was dispatched 907 times for 911 calls and provided 432 transports. Atlantic Center for Research: Advancing science through research is a key area of focus at Atlantic Health System, where our goal is to offer patients the most effective drugs and procedures available anywhere in the country. Atlantic Health System conducts research in a wide variety of areas to evaluate experimental drugs and drug combinations, medical devices and techniques, and to identify new approaches to prevention, diagnosis and treatment of diseases. Currently, more than 350 clinical research studies are underway, led by dedicated physician investigators in most specialties and supported by the organization's 40 research coordinators. One of the largest nonprofit health care systems in New Jersey, Atlantic Health System is a major research clinical affiliate of The Cancer Institute of New Jersey and the primary academic and clinical affiliate in New Jersey of Mount Sinai School of Medicine and The Mount Sinai Hospital. The Atlantic Center for Research serves as a central point of contact for new and established clinical trial sponsors and investigators who are affiliated with our hospitals, as well as for attending physicians interested in conducting clinical trials and physicians looking to refer patients to research studies. Led by a medical director and an administrative director experienced in clinical research and staffed by trained professionals, Atlantic Center for Research provides grants and contract management, budgeting, biostatistician support and a dedicated Institutional Review Board. Atlantic Center for Research's electronic research portal tracks these processes for each trial, streamlining enrollment, approvals, financial management, compliance and trial monitoring. Our researchers are highly skilled professionals experienced in the conduct of drug and medical device clinical trials. Atlantic Center for Research's in-depth research training and education certification programs ensure that core competencies are maintained for safe and effective research, and our compliance policies and compliance education programs ensure that researchers qualify for the kinds of funding that can help support next-generation breakthroughs. Atlantic Health System's research infrastructure supports a broad range of programs in clinical research, health care effectiveness, outcomes and quality-of-care research, and includes research conducted by some private practice physicians. Our research programs have grown significantly in every discipline, including oncology, pediatrics, surgery, cardiology, neuroscience, internal medicine, nursing, orthopedics, and rehabilitative medicine. As Atlantic Health System's research enterprise grows, its research facilities continue to expand. Atlantic Health System's Gagnon Cardiovascular Institute opened its flagship facility on the Morristown Medical Center campus in January 2009. The 250,000-square-foot facility is slated to be the area's top cardiac center, with state-of-the-art diagnostic equipment and 146 private patient rooms. It houses additional space for clinical research and supports Atlantic Health System-affiliated investigators who participate in dozens of research studies each year in electrophysiology, cardiac surgery, vascular surgery and clinical cardiology. Carol G. Simon Cancer Center has grown from its base at Morristown Medical Center to include a new, expanded center and research office at Overlook Medical Center. A major research clinical affiliate of the Cancer Institute of New Jersey, the Center participates in a multitude of clinical studies on new diagnostic procedures and treatments, and conducts Phase II and III clinical trials through various pharmaceutical companies. Atlantic Neuroscience Institute's premier sub-specialists are advancing clinical neurosciences and leading the adoption of innovative technology through clinical research in such areas as stroke, epilepsy, brain tumors and multiple sclerosis. During the past decade, Atlantic Health System has invested more than $22 million in Atlantic Neuroscience Institute and is committed to nearly $17 million in additional funds to expand its facilities, programs and services. And at Goryeb Children's Hospital and Goryeb Children's Center, physician leaders in more than 15 specialty
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Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

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SCHEDULE R
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OMB No. 1545-0047
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Atlantic Health System Inc Group Return
 
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Part I
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entity

















Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) Atlantic Health System Inc

475 South Street

Morristown,NJ07960
22-3380375 		Human Health through AHS Hospital Corp NJ 501(c)(3) 7 N/A
 
No
(2) Morristown Memorial Health Foundation

475 South Street

Morristown,NJ07960
22-3392808 		Fundraising for Morristown Memorial Hospital. NJ 501(c)(3) 7 N/A
 
No










For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



 		(b)
Primary activity



 		(c)
Legal domicile
(state or
foreign
country)
 		(d)
Direct controlling
entity


 		(e)
Type of entity
(C corp, S corp,
or trust)

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership
(1) Atlantic Health Management Corp and Subsidiaries
200 American Road
Morris Plains,NJ07950
22-3538027 		Healthcare NJ Atlantic Health System Inc
  		C 15,445,414 52,506,779  
(2) AHS Insurance Company Ltd
200 American Road
Morris Plains,Grand Cayman07950
CJ
22-3380375 		Insurance NJ Atlantic Health System Inc
  		C 59,408,623 6,869,832  
(3) Nutley Medical Care PA
100 Madison Ave
Morristown,NJ07960
22-3645010 		Healthcare NJ Atlantic Health System Inc
  		C 520    
(4) Non-Invasive Diagnostics PA
100 Madison Ave
Morristown,NJ07960
20-2027439 		Healthcare NJ Atlantic Health System Inc
  		C 1,040 20  
(5) Speciality Care of Practice Associates PA
100 Madison Ave
Morristown,NJ07960
03-0376428 		Healthcare NJ Atlantic Health System Inc
  		C 3,681,731 30,423,888  
(6) Maternal Fetal Medicine of Practice Associates PA
100 Madison Ave
Morristown,NJ07960
03-0376421 		Healthcare NJ Atlantic Health System Inc
  		C 3,150,650 249,764  
(7) Madison Pediatrics PA
100 Madison Ave
Morris Plains,NJ07960
22-3645007 		Healthcare NJ Atlantic Health System Inc
  		C      
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
Yes
 
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
Yes
 
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) Atlantic Ambulance

 O 17,261,567 Actual amount of transacation.
(2) Atlantic Ambulance

 A 17,000,000 Actual amount of transacation.
(3) Atlantic Health Management Corp

 Q 150,000 Actual amount of transacation.
(4) Atlantic Health System Inc

 R 2,475,361 Actual amount of transacation.
(5) Atlantic Health System Inc

 O 8,529,887 Actual amount of transacation.
(6) AHS Insurance CoLTD

 O 8,529,887 Actual amount of transacation.
(7) Overlook Hospital Foundation

 O 2,128,229 Actual amount of transacation.
(8) Overlook Hospital Foundation

 C 1,000,000 Actual amount of transacation.
(9) AHS Investment Corp

 P 60,932 Actual amount of transacation.
(10) AHS Investment Corp

 P 199,147 Actual amount of transacation.
(11) AHS Investment Corp

 P 1,135,918 Actual amount of transacation.
(12) AHS Investment Corp

 P 2,426,008 Actual amount of transacation.
(13) AHS Investment Corp

 F 86,364 Actual amount of transacation.
(14) Morristown Memorial Health Foundation

 C 19,071,992 Actual amount of transacation.
(15) Morristown Memorial Health Foundation

 O 14,040,023 Actual amount of transacation.
(16) AHS Insurance CoLTD

 Q 3,000,000 Actual amount of transacation.
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Are all
partners
section
501(c)(3)
organizations? 		(e)
Share of
end-of-year
assets 		(f)
Disproprtionate allocations? 		(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(h)
General or
managing
partner?
Yes No Yes No Yes No






























Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


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