Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
ALBERT EINSTEIN HEALTHCARE NETWORK
Employer identification number
23-2290323
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization?
................
11g(i)
No
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
No
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
No
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of support?
Yes
No
Yes
No
Yes
No
(1)
ALBERT EINSTEIN MEDICAL CENTER
231396794
03
Yes
Yes
Yes
10,109,784
(2)
BELMONT CENTER FOR COMPREHENSIVE TREATMENT
231352200
03
Yes
Yes
Yes
0
(3)
EINSTEIN PRACTICE PLAN
232664784
0
Yes
Yes
Yes
0
(4)
EINSTEIN COMMUNITY HEALTH ASSOCIATES
232760086
0
Yes
Yes
Yes
1,437,443
(5)
GHMC MANAGEMENT INC
232225809
03
Yes
Yes
Yes
0
(6)
EINSTEIN MEDICAL CENTER MONTGOMERY
204193243
03
Yes
Yes
Yes
2,094,833
(7)
FRIENDS OF MOSS REHAB
222483287
0
Yes
Yes
Yes
0
(8)
MONTGOMERY HOSPITAL
231352193
03
Yes
Yes
Yes
1,467,228
(9)
MONTGOMERY HEALTH FOUNDATION
222456265
0
Yes
Yes
Yes
0
(10)
FORNANCE PHYSICIAN SERVICES INC
232275991
0
Yes
Yes
Yes
0
(11)
MONTGOMERY HOSPITAL WORKERS COMPENSATION
232351775
0
Yes
Yes
Yes
0
(12)
BROADLINE RISK RETENTION GROUP
272583356
0
Yes
Yes
Yes
0
Total
15,109,288
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
4
Total. Add lines 1 through 3..
5
The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included
on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6
Public Support. Subtract line 5 from line 4.
Section B. Total Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
7
Amounts from line 4..
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11
Total support (Add lines 7 through 10).
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2010.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2009.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2009.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2
Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
6
Total. Add lines 1 through 5.
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c
Add lines 7a and 7b..
8
Public Support (Subtract line 7c from line 6.)
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
9
Amounts from line 6...
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13
Total support (Add lines 9, 10c, 11 and 12.).
14
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f))
.........
15
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2010.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2009.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information.
Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2010
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
ALBERT EINSTEIN HEALTHCARE NETWORK
Employer identification number
23-2290323
Identifier
Return Reference
Explanation
FORM 990, PART III, LINE 1 - ORGANIZATIONS'S MISSION
THE CORPORATION HAS, AS ITS PRINCIPAL PURPOSE, THE PROVISION OF COMPASSIONATE, HIGH QUALITY HEALTH CARE IN ORDER TO ELEVATE THE HEALTH STATUS OF THE PATIENTS IT SERVES IN SOUTHEASTERN PENNSYLVANIA,SOUTHERN NEW JERSEY AND DELAWARE. THE CORPORATION SERVES THESE INDIVIDUALS AND OTHERS WITH HEALTH CARE PROGRAMS AND SERVICES RANGING FROM COMMUNITY HEALTH EDUCATION AND PREVENTIVE MEDICINE TO COMPLEX AND SPECIALIZED CARE REQUIRING ADVANCED TECHNOLOGY AND HIGHLY EXPERT STAFF. THE CORPORATION ENTHUSIASTICALLY EMBRACES ITS SPECIAL RESPONSIBILITY TO THE MOST VULNERABLE RESIDENTS IN ITS PRIMARY SERVICE AREA AND TO THE MEMBERS OF THE JEWISH COMMUNITY. THE CORPORATION REFLECTS THE VALUES OF THE JEWISH COMMUNITY BY CARING FOR ANY PERSON REGARDLESS OF RACE, RELIGION, NATIONAL ORIGIN, OR THE ABILITY TO PAY. THE CORPORATION'S EDUCATIONAL COMMITMENT INCLUDES PROVIDING HEALTH EDUCATION TO THE COMMUNITY, AND TRAINING AND EDUCATING MEDICAL SCHOOL STUDENTS, GRADUATE AND PRACTICING PHYSICIANS, AND OTHER HEALTH CARE PROFESSIONALS. THE CORPORATION ALSO SUPPORTS CLINICAL RESEARCH FOR THE PURPOSE OF ENHANCING THE QUALITY OF PATIENT CARE AND ADVANCING THE SCIENCE OF MEDICINE.
FORM 990, PART VI, SECTION A, GOVERNING BODY and MANAGEMENT, LINE 2
Trustee John Korman is the nephew of Trustee Leonard Korman at Albert Einstein Healthcare Network. FORM 990, PART VI, SECTION B POLICIES, LINE 11a The form 990 is prepared jointly between AEHN's Accounting Department and AEHN's independent accounting firm's Tax Department and is reviewed internally by AEHN Executive management. The form 990 is then provided to the audit committee of the governing body for review and approval before filing. FORM 990, PART VI, SECTION B POLICIES, LINE 12C In accordance with organization policy, each member of the Board of Trustees, all key employees and officers are required annually to complete a comprehensive conflict of interest disclosure for review by the governance committee of the board of trustees and are required to update such disclosures if there are any changes. Any actual or potential conflicts of interest are discussed and resolved in accordance with specific guidelines and reported to the board of Trustees. FORM 990, PART VI, SECTION B POLICIES, LINE 15a and 15b The board of trustees has delegated the responsibility for compensation review to the compensation committee of the board of trustees. Independent members of the compensation committee review and approve the compensation for the CEO and all other officers and key employees of Albert Einstein Healthcare Network. The compensation committee requires that one or more independent compensation experts review the compensation of all such persons to determine that such compensation is appropriate and resonable and such independent expert uses applicable comparability data. The committee reviews the reports of the independent experts in detail and documents the data reviewed, the deliberation and discussion contemporaneously. FORM 990, PART VI, SECTION C DISCLOSURE, LINE 19 The organization makes its governing documents, conflict of interest policy, and financial statements available upon request. Form 990, Part VII, Section A, Column B The officers devote their time to all of the organizations within Albert Einstein healthcare network. As such, the total hours worked by the officers, across all of the organizations, cumulatively represent their full-time employment status. Form 990, Part X, Line 20 The Series '09 Bonds are owned by Albert Einstein Healthcare Network (EIN 23-2290323): the debt is recorded on the books of the following affiliated companies: - Albert Einstein Medical Center (EIN 23-1396794)@ 97.272% - Belmont (EIN 23-1352200) @ 2.728% FORM 990, PART XI, RECONCILIATION OF NET ASSETS, LINE 5 Change in Unrealized gains on investments 1,625,515 Change in Equity in Subsidiary Companies 3,730 ----------- 1,629,245
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.