TY 2011 Form 990

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) DAVID KOSTINAS CHAIRMAN - TRUSTEE	1.0	X	X	0	0
(2) ROBIN A WALTON 1ST VICE CHAIR - TRUSTEE	1.0	X	X	0	0
(3) SUEANNE D KORN 2ND VICE CHAIR - TRUSTEE	1.0	X	X	0	0
(4) STEVEN M ROSENBERG ESQ SECRETARY - TRUSTEE	1.0	X	X	0	0
(5) MARGARET M PEGO TREASURER - TRUSTEE	1.0	X	X	0	0
(6) KISHAN AGARWAL MD TRUSTEE	1.0	X		0	0
(7) BONNIE BALOGA ALTIERI PHD TRUSTEE	1.0	X		0	0
(8) FRANK CASTELLO MD TRUSTEE - MEDICAL DIRECTOR	1.0	X		0	0
(9) SCOTT CHESNEY TRUSTEE	1.0	X		0	0
(10) MARTIN DIAMOND MD TRUSTEE - DIRECTOR O/P SRVCS	55.0	X		264,128	25,824
(11) SAVERIO GARRUTO CPA TRUSTEE	1.0	X		0	0
(12) ALEXANDER R GIAQUINTO PHD TRUSTEE	1.0	X		0	0
(13) ELIZABETH HANCE TRUSTEE	1.0	X		0	0
(14) HEATHER HOWARD TRUSTEE	1.0	X		0	0
(15) NANCY JACKSON TRUSTEE	1.0	X		0	0
(16) AMY B MANSUE TRUSTEE - PRESIDENT/CEO	55.0	X	X	589,991	132,333
(17) NANCI D MORRIS TRUSTEE	1.0	X		0	0

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(18) GLENN MORTIMER TRUSTEE	1.0	X			0	0
(19) BARBARA ROTHMAN TRUSTEE	1.0	X			0	0
(20) PHILIP SALERNO TRUSTEE - PRES/CDO FOUNDATION	55.0	X	X		348,863	35,812
(21) VINCENT SERPICO TRUSTEE	1.0	X			0	0
(22) VICTORIA WICKS TRUSTEE	1.0	X			0	0
(23) PATRICIA WHITLEY WILLIAMS MD TRUSTEE	1.0	X			0	0
(24) MARILYN ZOCCA TRUSTEE	1.0	X			0	0
(25) WARREN E MOORE EVP/COO	55.0		X		395,162	85,479
(26) JOSEPH J DOBOSH JR VP/CFO	55.0		X		369,069	90,493
(27) KAREN M DEWITT EDD VP PATIENT CARE	55.0		X		284,917	57,719
(28) MICHAEL R DRIBBON PHD VP REHAB SERVICES & PROG. DEV.	55.0		X		281,604	55,031
(29) WILLIAM DWYER VP HUMAN RESOURCES	55.0		X		261,676	52,076
(30) UDAY MEHTA MD ASSOCIATE MEDICAL DIRECTOR	55.0			X	275,403	29,862
(31) KRISHAN YALAMANCHI MD DIRECTOR; BRAIN INJURY	55.0			X	221,506	34,320
(32) YVETTE JANVIER MD DIRECTOR; MEDICAL SERVICES	55.0			X	208,292	10,139
(33) MICHELE FANTASIA MD PHYSIATRIST	55.0			X	202,945	24,895
(34) THOMAS A RUGINO MD PHYSIATRIST	55.0			X	194,850	29,406

(A) Name and business address	(B) Description of services	(C) Compensation
MICHAEL REISZ AND COMPANY INC 588 NEW BRUNSWICK AVENUE FORDS,NJ08863	CONSTRUCTION	628,582
QUALCARE INC 30 KNIGHTSBRIDGE ROAD PISCATAWAY,NJ08854	CLAIMS ADMIN	544,590
SCHOLES ELECTRIC COMMUNICATION 1021 CENTENNIAL AVENUE PISCATAWAY,NJ08854	IT	375,458
MICROSOFT 1950 NORTH STEMMONS FWY SUITE 5010 DALLAS,TX75207	IT	245,823
MEDIX STAFFING SOLUTION DEPT 16548 PALATINE,IL60055	STAFFING	222,346
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 47

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 United States. See Part IV, line 21	0
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	3,330,177	0	3,330,177	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	58,057,431	46,769,943	11,287,488	0
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	1,149,167	943,250	205,917
9	Other employee benefits .......	7,891,679	6,263,147	1,628,532
10	Payroll taxes ...........	4,942,522	3,805,742	1,136,780
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	146,643		146,643
c	Accounting ...........	155,000		155,000
d	Lobbying ...........	95,879		95,879
e	Professional fundraising. See Part IV, line 17..	0
f	Investment management fees ......	0
g	Other ..........	4,988,483	1,998,340	2,990,143
12	Advertising and promotion ....	166,365	152,170	14,195
13	Office expenses .......	5,814,961	3,762,404	2,052,557
14	Information technology ......	0
15	Royalties ..	0
16	Occupancy ...........	5,170,142	255,115	4,915,027
17	Travel ............	478,375	397,811	80,564
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	110,745	63,107	47,638
20	Interest ...........	2,175,642		2,175,642
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	7,776,501		7,776,501
23	Insurance ..............	768,419		768,419
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24f. If line 24f amount exceeds 10% of line 25, column (A) amount, list line 24f expenses on Schedule O.)
a	PROVISION FOR BAD DEBTS, NET	2,245,184	2,245,184	0	0
b	SOFTWARE MAINTENANCE	845,688	0	845,688	0
c	LICENSES, DUES AND FEES	427,466	131,705	295,761	0
d	CONTRACTED SERVICES	377,413	179,313	198,100	0
e
f	All other expenses	852,329	605,658	246,671
25	Total functional expenses. Add lines 1 through 24f	107,966,211	67,572,889	40,393,322	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet
	1	Cashnon-interest-bearing ..........	640,410	1	363,808
2	Savings and temporary cash investments .......	10,205,929	2	16,384,635
3	Pledges and grants receivable, net .........	2,101,537	3	4,405,084
4	Accounts receivable, net .........	18,241,123	4	16,506,178
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........	0	5	0
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 ..........	0	6	0
7	Notes and loans receivable, net .............	5,529,198	7	4,369,110
8	Inventories for sale or use ..............	418,240	8	450,296
9	Prepaid expenses and deferred charges ............	3,587,821	9	643,132
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	146,006,136
b	Less: accumulated depreciation. .....	10b	61,981,465	85,771,975	10c	84,024,671
11	Investments—publicly traded securities ..........	0	11	0
12	Investments—other securities. See Part IV, line 11 ......	0	12	0
13	Investments—program-related. See Part IV, line 11 ..	25,432,033	13	24,198,893
14	Intangible assets .........	1,131,724	14	1,083,027
15	Other assets. See Part IV, line 11 ...........	5,943,645	15	9,366,420
16	Total assets. Add lines 1 through 15 (must equal line 34)...	159,003,635	16	161,795,254
	17	Accounts payable and accrued expenses .	16,857,309	17	18,092,822
18	Grants payable ..........	0	18	0
19	Deferred revenue ..........	0	19	0
20	Tax-exempt bond liabilities ..........	48,347,432	20	46,833,778
21	Escrow or custodial account liability. Complete Part IV of Schedule D..	0	21	0
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	4,911,949	23	4,028,274
24	Unsecured notes and loans payable to unrelated third parties ....	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.....	6,566,226	25	7,055,461
26	Total liabilities. Add lines 17 through 25.....	76,682,916	26	76,010,335
		Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....	62,560,251	27	67,435,285
28	Temporarily restricted net assets .....	13,357,366	28	11,925,914
29	Permanently restricted net assets .....	6,403,102	29	6,423,720
	Organizations that do not follow SFAS 117, check here 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 .....	82,320,719	33	85,784,919
34	Total liabilities and net assets/fund balances .....	159,003,635	34	161,795,254

- TIN:

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.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2011

Open to Public
Inspection

Name of the organization

CHILDREN'S SPECIALIZED HOSPITAL

Employer identification number

22-1487148

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.)

A church, convention of churches, or association of churches. section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in

section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

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.)

An organization organized and operated exclusively to test for public safety. Seesection 509(a)(4).

An 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). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Other

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).

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 ..................................................

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

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)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(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?
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of support?


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2011

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) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(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) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(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).

Gross receipts from related activities, etc. (See instructions.) ..................

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.......................................... right arrow

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f)) .........

Public Support Percentage for 2009 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2011. 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 ...................... right arrow

33 1/3% support test—2010. 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 ..................... right arrow

17a

10%-facts-and-circumstances test—2011. 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 .................................................. right arrow

10%-facts-and-circumstances test—2010. 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 .............................................. right arrow

Private Foundation If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions ................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2011

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) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(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) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(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.).

Section C. Computation of Public Support Percentage

Public Support Percentage for 2011 (line 8 column (f) divided by line 13 column (f)) .........

Public support percentage from 2010 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2011 (line 10c column (f) divided by line 13 column (f)) ......

Investment income percentage from 2010 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2011. 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 .......... right arrow

33 1/3% support tests—2010. 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 .... right arrow

Private Foundation If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2011

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) 2011

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

OMB No. 1545-0047

2011

Name of organization

CHILDREN'S SPECIALIZED HOSPITAL

Employer identification number

22-1487148

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not total to more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year. ......................... Arrow Bullet

Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on Part I, line 2, of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 2

Name of organization CHILDREN'S SPECIALIZED HOSPITAL
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Part I	Contributors (see Instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTED RESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 3

Name of organization CHILDREN'S SPECIALIZED HOSPITAL
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Part II	Noncash Property (see Instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions).	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 4

Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Name of organization
CHILDREN'S SPECIALIZED HOSPITAL

Employer identification number

22-1487148

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

$
Use duplicate copies of Part III if additional space is needed

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Additional Data

Software ID:
Software Version:

- TIN:

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

2011

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, line 35c (Proxy Tax), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

CHILDREN'S SPECIALIZED HOSPITAL

Employer identification number

22-1487148

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c) except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ................................... SchCMd Bullet

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

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

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) 2011

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 if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(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? ......................................	Yes No

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) 2008	(b) 2009	(c) 2010	(d) 2011	(e) Total

2a	Lobbying non-taxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2011

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)).

For each “Yes” response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

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:

Volunteers? .........................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Yes

90,000

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Other activities? ..........................

Yes

5,879

Total. Add lines 1c through 1i ...............................

95,879

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

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

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2 are answered “No” OR (b) Part III-A, line 3 is answered “Yes”.

Dues, assessments and similar amounts from members .....................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ...........................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

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? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

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, Part II-A; line 5; and Part ll-B, line 1.
Also, complete this part for any additional information.

Identifier	Return Reference	Explanation
LOBBYING ACTIVITY EXPLANATION	SCHEDULE C, PART II-B; LINES 1G AND 1I	CHILDREN'S SPECIALIZED HOSPITAL IS A MEMBER OF THE ROBERT WOOD JOHNSON HEALTH CARE CORPORATION HEALTH SYSTEM ("SYSTEM"). CHILDREN'S SPECIALIZED HOSPITAL PAID ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL, A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION, $90,000 FOR ITS PORTION OF THE LOBBYING EXPENSES INCURRED BY THE SYSTEM. ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL PAID AN OUTSIDE INDEPENDENT LOBBYING FIRM TO PROVIDE LOBBYING EFFORTS ON BEHALF OF ALL AFFILIATES WITHIN THE SYSTEM. IN ADDITION, THE ORGANIZATION IS A MEMBER OF THE NEW JERSEY HOSPITAL ASSOCIATION, THE AMERICAN HOSPITAL ASSOCIATION, NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS AND THE NEW JERSEY STATE CHAMBER OF COMMERCE WHICH ALL ENGAGE IN LOBBYING EFFORTS ON BEHALF OF THEIR MEMBER HOSPITALS. A PORTION OF THE DUES PAID TO THESE ORGANIZATIONS HAS BEEN ALLOCATED TO LOBBYING ACTIVITES PERFORMED ON BEHALF OF THE ORGANIZATION. THIS ALLOCATION AMOUNTED TO $5,879 IN 2011.

Schedule C (Form 990 or 990EZ) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

CHILDREN'S SPECIALIZED HOSPITAL

Employer identification number

22-1487148

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 .......

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? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can 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? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax 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, and not on a historic structure listed in the National Register ....................	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

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)? ....................................

Yes No

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.

If the organization elected, as permitted under SFAS 116 (ASC 958), 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.

If the organization elected, as permitted under SFAS 116 (ASC 958), 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

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 (ASC 958), relating to these items:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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) 2011

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.

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?........

Yes No

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.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIV and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

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
1a	Beginning of year balance ....	8,364,523	9,145,933	7,904,460	9,312,477
b	Contributions ........	20,618	90,772	173,425	174,322
c	Net investment earnings, gains, and losses ...	215,644	873,763	1,559,846	-1,562,339
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........	490,603	1,745,945	491,798	20,000
f	Administrative expenses ....
g	End of year balance ......	8,110,182	8,364,523	9,145,933	7,904,460

Provide the estimated percentage of the year end balance (line 1g) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

79.200 %

Temporarily restricted endowment SchDMd Bullet

20.800 %

The percentages in lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIV the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment. See Form 990, Part X, line 10.

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	156,400		156,400
b	Buildings ................	70,610,388	22,580,382	48,030,006
c	Leasehold improvements ............
d	Equipment ................	71,561,657	38,111,425	33,450,232
e	Other .................	3,677,691	1,289,658	2,388,033
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				84,024,671

Schedule D (Form 990) 2011

Page 3

Part VII

InvestmentsOther 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) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram 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
(1) LIMITED USE	3,295,285	F
(2) LIMITED USE	524,791	F
(3) LIMITED USE	839,591	F
(4) FOUNDATION, INC.	15,349,634	F
(5) EQUIVALENTS; LIMITED USE	584,942	F
(6) EQUIVALENTS; LIMITED USE	3,562,106	F
(7) LIMITED USE	42,544	F


Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)	24,198,893

Part IX

Other Assets. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) OTHER ASSETS				5,502,454
(2) NB BUILDING CONSTRUCTION COSTS				2,936,055
(3) THIRD-PARTY PAYORS				927,911






Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				9,366,420

Part X

Other Liabilities. See Form 990, Part X, line 25.

1.(a) Description of Liability		(b) Book value
Federal Income Taxes		0
OTHER LIABILITIES		2,009,000
CURRENT		1,630,158
NON-CURRENT		3,416,303






Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		7,055,461
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) 2011

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	110,272,272
2	Total expenses (Form 990, Part IX, column (A), line 25) .....................	2	107,966,211
3	Excess or (deficit) for the year. Subtract line 2 from line 1 .............	3	2,306,061
4	Net unrealized gains (losses) on investments ..........................	4	-223,394
5	Donated services and use of facilities .............................	5
6	Investment expenses ...................................	6
7	Prior period adjustments ..................................	7
8	Other (Describe in Part XIV.) .................................	8	1,381,533
9	Total adjustments (net). Add lines 4 through 8 .........................	9	1,158,139
10	Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 .........	10	3,464,200

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	110,048,878
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a	-223,394
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	-223,394
3	Subtract line 2e from line 1.....................			3	110,272,272
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
c	Add lines 4a and 4b.......................			4c
5	Total Revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	110,272,272

Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1	Total expenses and losses per audited financial statements .............		1	107,966,211
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
3	Subtract line 2e from line 1.....................		3	107,966,211
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
c	Add lines 4a and 4b.......................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5	107,966,211

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
ENDOWMENT FUNDS	SCHEDULE D, PART V; QUESTION 4	ENDOWMENT FUNDS ARE TO BE USED CONSISTENT WITH INTENT AND IN FURTHERANCE OF THE ORGANIZATION'S CHARITABLE TAX-EXEMPT PURPOSES.
TEXT OF FIN 48 AUDITED FINANCIAL STATEMENT FOOTNOTE	SCHEDULE D, PART X	THE ORGANIZATION ENGAGED AN INDEPENDENT CPA FIRM TO ISSUE AUDITED FINANCIAL STATEMENTS. OUTLINED BELOW IS THE TEXT OF THE FIN 48 DISCLOSURE FOOTNOTE FROM THE ORGANIZATION'S 2011 AUDITED FINANCIAL STATEMENTS: THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND IS EXEMPT FORM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTIONS 501(A) OF THE CODE. THE HOSPITAL IS ALSO EXEMPT FROM STATE INCOME TAXES. THE HOSPITAL RECOGNIZES INCOME TAX POSITIONS WHEN IT IS MORE-LIKELY-THAN-NOT THAT THE POSITION WILL BE SUSTAINABLE BASED ON THE MERITS OF THE POSITION. MANAGEMENT HAS CONCLUDED THAT THERE ARE NO MATERIAL TAX LIABILITIES THAT NEED TO BE RECORDED.
RECON. OF CHANGE IN NET ASSETS FROM 990 TO AUDITED FINANCIAL STATEMENTS	SCHEDULE D, PART XI; LINE 8	OTHER CHANGES IN FUND BALANCE INCLUDE: - CHANGE IN INTEREST IN RESTRICTED NET ASSETS OF FOUNDATION - $3,055,192 - NET ASSETS RELEASED FROM RESTRICTIONS FOR CAPITAL PURPOSES - ($1,673,659)

Schedule D (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16. Right pointing arrow large image

Attach to Form 990. Right pointing arrow large image

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization
CHILDREN'S SPECIALIZED HOSPITAL

Employer identification number

22-1487148

Part I

General Information on Activities Outside the United States. Complete if the organization answered
“Yes” to Form 990, Part IV, line 14b.

For grantmakers. Does the organization maintain records to substantiate the amount of its grants

and other assistance, the grantees' eligibility for the grants or assistance, and the selection criteria used

to award the grants or assistance? ..............................

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other
assistance outside the United States.

Activites per Region. (Use Part V if additional space is needed.)

(a) Region		(b) Number of offices in the region	(c) Number of employees or agents in region or independent contractors	(d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region)	(e) If activity listed in (d) is a program service, describe specific type of service(s) in region	(f) Total expenditures for region/investments in region
	Central America and the Caribbean	1	1	Program Services	FINANCIAL VEHICLE	442,844
















3a	Sub-total .....	1	1			442,844
b	Total from continuation sheets to Part I ...
c	Totals (add lines 3a and 3b)	1	1			442,844

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2011

Schedule F (Form 990) 2011

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990,

Part IV, line 15, for any recipient who received more than $5,000. Check this box if no one recipient received more than $5,000 ........ MediumBullet

Use Part V if additional space is needed.

1 (a) Name of organization		(b) IRS code section and EIN (if applicable)	(c) Region	(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement	(g) Amount of of non-cash assistance	(h) Description of non-cash assistance	(i) Method of valuation (book, FMV, appraisal, other)

Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter ..... MediumBullet

Enter total number of other organizations or entities ........................ MediumBullet

Schedule F (Form 990) 2011

Schedule F (Form 990) 2011Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.

Use Part V if additional space is needed.

(a) Type of grant or assistance		(b) Region	(c) Number of recipients	(d) Amount of cash grant	(e) Manner of cash disbursement	(f) Amount of non-cash assistance	(g) Description of non-cash assistance	(h) Method of valuation (book, FMV, appraisal, other)

Schedule F (Form 990) 2011

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2011

Page 5

Part V

Supplemental Information
Complete this part to provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).

Identifier	ReturnReference	Explanation

Schedule F (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

2011

Open to Public Inspection

Name of the organization

CHILDREN'S SPECIALIZED HOSPITAL

Employer identification number

22-1487148

Part I

Charity Care and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a....

Yes

If "Yes," was it a written policy? .......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other 300 %

Did the organization use FPG to determine eligibility for providing discounted care? If "Yes," indicate which of the

following was the family income limit for eligibility for discounted care: ............

Yes

200% 250% 300% 350% 400% Other

If the organization did 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 used an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount?......

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care?...............

Did the organization prepare a community benefit report during the tax year?...........

Yes

If "Yes," did the organization make it available to the public? ...............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

	(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 Financial Assistance at cost (from Worksheet 1) ..		738	600,990	0	600,990	0.570 %
b Medicaid (from Worksheet 3, column a) .....
c Costs of other means-tested government programs (from Worksheet 3, column b) .
dTotal Financial Assistance and Means-Tested Government Programs .....		738	600,990	0	600,990	0.570 %
Other Benefits e Community health improvement services and community benefit operations (from (Worksheet 4) ....	63	58,808	998,011	0	998,011	0.940 %
f Health professions education (from Worksheet 5) ..	17	8,649	372,445	0	372,445	0.350 %
g Subsidized health services (from Worksheet 6) ..
h Research (from Worksheet 7)
i Cash and in-kind contributions for community benefit (from Worksheet 8) ....	2	6,325	1,118,257	0	1,118,257	1.060 %
jTotal Other Benefits ...	82	73,782	2,488,713	0	2,488,713	2.350 %
kTotal. Add lines 7d and 7j. ..	82	74,520	3,089,703	0	3,089,703	2.920 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2011

Schedule H (Form 990) 2011

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(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	1	275	1,704	0	1,704	0 %
4	Environmental improvements
5	Leadership development and training for community members	1	2,241	331,386	0	331,386	0.310 %
6	Coalition building
7	Community health improvement advocacy	1	255	47,274	0	47,274	0.040 %
8	Workforce development
9	Other
10	Total	3	2,771	380,364	0	380,364	0.350 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense........

2,245,184

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy .....

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

Enter total revenue received from Medicare (including DSH and IME).....

Enter Medicare allowable costs of care relating to payments on line 5.....

Subtract line 6 from line 5. This is the surplus or (shortfall)........

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

Part IV

Management Companies and Joint Ventures

(see instructions)

(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) 2011

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest) How many hospital facilities did the organization operate during the tax year?1 Name and address		Other (Describe)
1	PSE&G CHILDREN'S SPECIALIZED HOSPITAL 200 SOMERSET STREET NEW BRUNSWICK,NJ08901	X	X

Schedule H (Form 990) 2011

Page

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)

PSE&G CHILDREN'S SPECIALIZED HOSPITAL

Name of Hospital Facility:

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 2011)
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 the community health 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 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	Participation in the development of a community-wide community benefit plan
	d	Participation in the execution of a 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 Needs Assessment
	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 and 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	Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?		8	Yes
9	Used federal poverty guidelines (FPG) to determine eligibility for providing free care?...........		9	Yes
	If "Yes," indicate the FPG family income limit for eligibility for free care: 300.% If "No," explain in Part VI the criteria the hospital facility used.

Schedule H (Form 990) 2011

Page

Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care?.................		10	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 400.% If "No," explain in Part VI the criteria the hospital facility used.
11	Explained the basis for calculating amounts charged to patients?.................		11	Yes
	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	Yes
13	Included measures to publicize the policy within the community served by the hospital facility?.......		13	Yes
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
	a	The policy was posted 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 (FAP) that explained actions the hospital facility may take upon non-payment?.......		14	Yes
15	Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other similar actions (describe in Part VI)
16	Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?..........		16		No
	If “Yes,” check all actions in which the hospital facility or a third party engaged:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other similar actions (describe in Part VI)
17	Indicate which efforts the hospital facility made before initiating any of the actions checked in line 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 patients were eligible for financial assistance under the hospital facility’s financial assistance policy
	e	Other (describe in Part VI)

Schedule H (Form 990) 2011

Page

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 why:
	a	The hospital facility did not provide care for any emergency medical conditions
	b	The hospital facility’s policy was not in writing
	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)
Individuals Eligible for Financial Assistance
19	Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
	a	The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
	b	The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
	c	The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
	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 FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?...............................		21
	If “Yes,” explain in Part VI.

Schedule H (Form 990) 2011

Page

Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?9
Name and address		Type of Facility (describe)
1	CSH LONG TERM CARE AT MOUNTAINSIDE 150 NEW PROVIDENCE ROAD MOUNTAINSIDE,NJ07092	LONG-TERM CARE AND OUTPATIENT CENTER
2	CSH LONG TERM CARE AT TOMS RIVER 94 STEVENS ROAD TOMS RIVER,NJ08755	LONG-TERM CARE AND OUTPATIENT CENTER
3	CSH OUTPATIENT CENTER AT HAMILTON 3575 QUAKERBRIDGE ROAD HAMILTON,NJ08619	OUTPATIENT CENTER
4	CSH OUTPATIENT CENTER AT LAKEHURST ROAD 368 LAKEHURST ROAD TOMS RIVER,NJ08755	OUTPATIENT CENTER
5	CSH MED DAY CARE CTR & EARLY INT 316 WEST WESTFIELD AVENUE ROSELLE PARK,NJ07204	OUTPATIENT CENTER
6	CSH EARLY INTERVENTION TOMS RIVER 316 WASHINGTON STREET TOMS RIVER,NJ08755	EARLY INTERVENTION
7	CSH OUTPATIENT CENTER AT FANWOOD 313 SOUTH AVENUE FANWOOD,NJ07023	OUTPATIENT CENTER
8	CSH OUTPATIENT CENTER AT CLIFTON 1135 BROAD STREET CLIFTON,NJ07013	OUTPATIENT CENTER
9	CSH OUTPATIENT CENTER AT BAYONNE 818 BROADWAY AVENUE BAYONNE,NJ07002	OUTPATIENT CENTER
10

Schedule H (Form 990) 2011

Page

Part VI

Supplemental Information

Complete this part to provide the following information.

1	Required descriptions. Provide the descriptions 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, 3, 4, 5c, 6i, 7, 9, 10, 11h, 13g, 15e, 16e, 17e, 18d, 19d, 20, and 21.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any 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
ELIGIBILITY FOR DISCOUNTED CARE	PART I, LINE 3C	THE INCOME BASED CRITERIA USED TO DETERMINE ELIGIBILITY IS PER NEW JERSEY ADMINISTRATIVE CODE 10:52 SUB CHAPTERS 11, 12 AND 13, AND BASED UPON THE 2011 FEDERAL POVERTY GUIDELINES ("FPG")(DEPARTMENT OF HEALTH AND SENIOR SERVICES) ADJUSTED TO 300% OF THE INCOME POVERTY GUIDELINE. FPG ARE INCLUDED IN THE CRITERIA FOR DETERMINING ELIGIBILITY FOR CHARITY AND DISCOUNTED CARE.
COMMUNITY BENEFIT REPORT	SCHEDULE H, PART I; QUESTION 6A	NOT APPLICABLE.
SUBSIDIZED HEALTH SERVICES	SCHEDULE H, PART I; QUESTION 7G	NO COSTS RELATING TO SUBSIDIZED HEALTHCARE SERVICES ARE ATTRIBUTABLE TO ANY PHYSICIAN CLINICS.
PERCENT OF TOTAL EXPENSE	SCHEDULE H, PART I; QUESTION 7 COLUMN (F)	THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $2,245,184.
CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFIT COST	SCHEDULE H, PART I, QUESTION 7	WORKSHEET 2 WAS USED FOR THE COST TO CHARGE RATIO.
BAD DEBT EXPENSE	SCHEDULE H, PART III, SECTION A; QUESTION 4	BAD DEBT EXPENSE WAS CALCULATED USING THE PROVIDERS' BAD DEBT EXPENSE FROM FINANCIAL STATEMENT, NET OF ACCOUNTS WRITTEN OFF AT CHARGES. THE ORGANIZATION ISSUED AUDITED FINANCIAL STATEMENTS. THE ORGANIZATION'S ALLOWANCE FOR DOUBTFUL ACCOUNTS (BAD DEBT EXPENSE) METHODOLOGY AND CHARITY CARE POLICIES ARE CONSISTENTLY APPLIED. BELOW DESCRIBES IT IN MORE DETAIL: PATIENT ACCOUNTS RECEIVABLE PATIENT ACCOUNTS RECEIVABLE ARE RECORDED AT THE REIMBURSED OR CONTRACTED AMOUNT AND DO NOT BEAR INTEREST. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS THE HOSPITAL'S BEST ESTIMATE OF THE AMOUNT OF PROBABLE CREDIT LOSSES IN THE HOSPITAL'S EXISTING PATIENT ACCOUNTS RECEIVABLE. THE HOSPITAL DETERMINES THE ALLOWANCE BASED ON HISTORICAL WRITE-OFF EXPERIENCE. THE HOSPITAL REVIEWS ITS ALLOWANCE FOR DOUBTFUL ACCOUNTS PERIODICALLY. PAST-DUE BALANCES ARE REVIEWED INDIVIDUALLY FOR COLLECTABILITY. ACCOUNT BALANCES ARE CHARGED OFF AGAINST THE ALLOWANCE AFTER ALL MEANS OF COLLECTION HAVE BEEN EXHAUSTED AND THE POTENTIAL FOR RECOVERY IS CONSIDERED REMOTE. CHARITY CARE THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES AND MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE; THEREFORE, THESE AMOUNTS ARE NOT REPORTED AS NET PATIENT SERVICE REVENUE. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FORGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY. THE HOSPITAL DOES NOT RECEIVE ANY DISTRIBUTION OF STATE OR FEDERAL SUBSIDIES FOR CHARITY CARE SERVICES RENDERED. AN OVERALL COST TO CHARGE RATIO WAS APPLIED TO ARRIVE AT THE COST OF CHARITY CARE. AS A RESULT, THE COST OF PROVIDING CHARITY CARE WAS $600,990 AND $674,266 FOR THE YEARS ENDED DECEMBER 31, 2011 AND 2010, RESPECTIVELY.
COMMUNITY BENEFIT	SCHEDULE H, PART III, SECTION B; QUESTION 8	BAD DEBT IS COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THE ORGANIZATION FEELS THAT BAD DEBT SHOULD BE A COMMUNITY BENEFIT AND ASSOCIATED COSTS SHOULD BE INCLUDED ON THE FORM 990, SCHEDULE H, PART I. AS OUTLINED MORE FULLY BELOW THE ORGANIZATION BELIEVES THAT THESE SERVICES AND RELATED COSTS PROMOTE THE HEALTH OF THE COMMUNITY AS A WHOLE AND ARE RENDERED IN CONJUNCTION WITH THE ORGANIZATION'S CHARITABLE TAX-EXEMPT PURPOSES AND MISSION IN PROVIDING MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUAL'S IN A NON-DISCRIMINATORY MANNER WITHOUT REGARD TO RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY AND CONSISTENT WITH THE COMMUNITY BENEFIT STANDARD PROMULGATED BY THE IRS. THE COMMUNITY BENEFIT STANDARD IS THE CURRENT STANDARD FOR A HOSPITAL FOR RECOGNITION AS A TAX-EXEMPT AND CHARITABLE ORGANIZATION UNDER INTERNAL REVENUE CODE ("IRC") 501(C)(3). THE ORGANIZATION IS RECOGNIZED AS A TAX-EXEMPT ENTITY AND CHARITABLE ORGANIZATION UNDER 501(C)(3) OF THE IRC. ALTHOUGH THERE IS NO DEFINITION IN THE TAX CODE FOR THE TERM "CHARITABLE" A REGULATION PROMULGATED BY THE DEPARTMENT OF THE TREASURY PROVIDES SOME GUIDANCE AND STATES THAT "[T]HE TERM CHARITABLE IS USED IN SECTION 501(C)(3) IN ITS GENERALLY ACCEPTED LEGAL SENSE," AND PROVIDES EXAMPLES OF CHARITABLE PURPOSES, INCLUDING THE RELIEF OF THE POOR OR UNPRIVILEGED; THE PROMOTION OF SOCIAL WELFARE; AND THE ADVANCEMENT OF EDUCATION, RELIGION, AND SCIENCE. NOTE IT DOES NOT EXPLICITLY ADDRESS THE ACTIVITIES OF HOSPITALS. IN THE ABSENCE OF EXPLICIT STATUTORY OR REGULATORY REQUIREMENTS APPLYING THE TERM "CHARITABLE" TO HOSPITALS, IT HAS BEEN LEFT TO THE IRS TO DETERMINE THE CRITERIA HOSPITALS MUST MEET TO QUALIFY AS IRC 501(C)(3) CHARITABLE ORGANIZATIONS. THE ORIGINAL STANDARD WAS KNOWN AS THE CHARITY CARE STANDARD. THIS STANDARD WAS REPLACED BY THE IRS WITH THE COMMUNITY BENEFIT STANDARD WHICH IS THE CURRENT STANDARD. CHARITY CARE STANDARD IN 1956, THE IRS ISSUED REVENUE RULING 56-185, WHICH ADDRESSED THE REQUIREMENTS HOSPITALS NEEDED TO MEET IN ORDER TO QUALIFY FOR IRC 501(C)(3) STATUS. ONE OF THESE REQUIREMENTS IS KNOWN AS THE "CHARITY CARE STANDARD." UNDER THE STANDARD, A HOSPITAL HAD TO PROVIDE, TO THE EXTENT OF ITS FINANCIAL ABILITY, FREE OR REDUCED-COST CARE TO PATIENTS UNABLE TO PAY FOR IT. A HOSPITAL THAT EXPECTED FULL PAYMENT DID NOT, ACCORDING TO THE RULING, PROVIDE CHARITY CARE BASED ON THE FACT THAT SOME PATIENTS ULTIMATELY FAILED TO PAY. THE RULING EMPHASIZED THAT A LOW LEVEL OF CHARITY CARE DID NOT NECESSARILY MEAN THAT A HOSPITAL HAD FAILED TO MEET THE REQUIREMENT SINCE THAT LEVEL COULD REFLECT ITS FINANCIAL ABILITY TO PROVIDE SUCH CARE. THE RULING ALSO NOTED THAT PUBLICLY SUPPORTED COMMUNITY HOSPITALS WOULD NORMALLY QUALIFY AS CHARITABLE ORGANIZATIONS BECAUSE THEY SERVE THE ENTIRE COMMUNITY AND A LOW LEVEL OF CHARITY CARE WOULD NOT AFFECT A HOSPITAL'S EXEMPT STATUS IF IT WAS DUE TO THE SURROUNDING COMMUNITY'S LACK OF CHARITABLE DEMANDS. COMMUNITY BENEFIT STANDARD IN 1969, THE IRS ISSUED REVENUE RULING 69-545, WHICH "REMOVE[D]" FROM REVENUE RULING 56-185 "THE REQUIREMENTS RELATING TO CARING FOR PATIENTS WITHOUT CHARGE OR AT RATES BELOW COST." UNDER THE STANDARD DEVELOPED IN REVENUE RULING 69-545, WHICH IS KNOWN AS THE "COMMUNITY BENEFIT STANDARD," HOSPITALS ARE JUDGED ON WHETHER THEY PROMOTE THE HEALTH OF A BROAD CLASS OF INDIVIDUALS IN THE COMMUNITY. THE RULING INVOLVED A HOSPITAL THAT ONLY ADMITTED INDIVIDUALS WHO COULD PAY FOR THE SERVICES (BY THEMSELVES, PRIVATE INSURANCE, OR PUBLIC PROGRAMS SUCH AS MEDICARE), BUT OPERATED A FULL-TIME EMERGENCY ROOM THAT WAS OPEN TO EVERYONE. THE IRS RULED THAT THE HOSPITAL QUALIFIED AS A CHARITABLE ORGANIZATION BECAUSE IT PROMOTED THE HEALTH OF PEOPLE IN ITS COMMUNITY. THE IRS REASONED THAT BECAUSE THE PROMOTION OF HEALTH WAS A CHARITABLE PURPOSE ACCORDING TO THE GENERAL LAW OF CHARITY, IT FELL WITHIN THE "GENERALLY ACCEPTED LEGAL SENSE" OF THE TERM "CHARITABLE," AS REQUIRED BY TREAS. REG. 1.501(C)(3)-1(D)(2). THE IRS RULING STATED THAT THE PROMOTION OF HEALTH, LIKE THE RELIEF OF POVERTY AND THE ADVANCEMENT OF EDUCATION AND RELIGION, IS ONE OF THE PURPOSES IN THE GENERAL LAW OF CHARITY THAT IS DEEMED BENEFICIAL TO THE COMMUNITY AS A WHOLE EVEN THOUGH THE CLASS OF BENEFICIARIES ELIGIBLE TO RECEIVE A DIRECT BENEFIT FROM ITS ACTIVITIES DOES NOT INCLUDE ALL MEMBERS OF THE COMMUNITY, SUCH AS INDIGENT MEMBERS OF THE COMMUNITY, PROVIDED THAT THE CLASS IS NOT SO SMALL THAT ITS RELIEF IS NOT OF BENEFIT TO THE COMMUNITY. THE IRS CONCLUDED THAT THE HOSPITAL WAS "PROMOTING THE HEALTH OF A CLASS OF PERSONS THAT IS BROAD ENOUGH TO BENEFIT THE COMMUNITY" BECAUSE ITS EMERGENCY ROOM WAS OPEN TO ALL AND IT PROVIDED CARE TO EVERYONE WHO COULD PAY, WHETHER DIRECTLY OR THROUGH THIRD-PARTY REIMBURSEMENT. OTHER CHARACTERISTICS OF THE HOSPITAL THAT THE IRS HIGHLIGHTED INCLUDED THE FOLLOWING: ITS SURPLUS FUNDS WERE USED TO IMPROVE PATIENT CARE, EXPAND HOSPITAL FACILITIES, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH; IT WAS CONTROLLED BY A BOARD OF TRUSTEES THAT CONSISTED OF INDEPENDENT CIVIC LEADERS; AND HOSPITAL MEDICAL STAFF PRIVILEGES WERE AVAILABLE TO ALL QUALIFIED PHYSICIANS. BAD DEBT IS COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THE AMERICAN HOSPITAL ASSOCIATION ("AHA") FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT ARE COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THIS ORGANIZATION AGREES WITH THE AHA POSITION THAT BAD DEBT SHOULD BE COMMUNITY BENEFIT. AS OUTLINED IN THE AHA LETTER TO THE IRS DATED AUGUST 21, 2007 WITH RESPECT TO THE FIRST PUBLISHED DRAFT OF THE NEW FORM 990 AND SCHEDULE H, THE AHA FELT THAT THE IRS SHOULD INCORPORATE THE FULL VALUE OF THE COMMUNITY BENEFIT THAT HOSPITALS PROVIDE BY COUNTING BAD DEBT AS QUANTIFIABLE COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: - A SIGNIFICANT MAJORITY OF BAD DEBT IS ATTRIBUTABLE TO LOW-INCOME PATIENTS, WHO, FOR MANY REASONS, DECLINE TO COMPLETE THE FORMS REQUIRED TO ESTABLISH ELIGIBILITY FOR HOSPITALS' CHARITY CARE OR FINANCIAL ASSISTANCE PROGRAMS. A 2006 CONGRESSIONAL BUDGET OFFICE ("CBO") REPORT, NONPROFIT HOSPITALS AND THE PROVISION OF COMMUNITY BENEFITS, CITED TWO STUDIES INDICATING THAT "THE GREAT MAJORITY OF BAD DEBT WAS ATTRIBUTABLE TO PATIENTS WITH INCOMES BELOW 200% OF THE FEDERAL POVERTY LINE." - THE REPORT ALSO NOTED THAT A SUBSTANTIAL PORTION OF BAD DEBT IS PENDING CHARITY CARE. UNLIKE BAD DEBT IN OTHER INDUSTRIES, HOSPITAL BAD DEBT IS COMPLICATED BY THE FACT THAT HOSPITALS FOLLOW THEIR MISSION TO THE COMMUNITY AND TREAT EVERY PATIENT THAT COMES THROUGH THEIR EMERGENCY DEPARTMENT, REGARDLESS OF ABILITY TO PAY. PATIENTS WHO HAVE OUTSTANDING BILLS ARE NOT TURNED AWAY, UNLIKE OTHER INDUSTRIES. BAD DEBT IS FURTHER COMPLICATED BY THE AUDITING INDUSTRY'S STANDARDS ON REPORTING CHARITY CARE. MANY PATIENTS CANNOT OR DO NOT PROVIDE THE NECESSARY, EXTENSIVE DOCUMENTATION REQUIRED TO BE DEEMED CHARITY CARE BY AUDITORS. AS A RESULT, ROUGHLY 40% OF BAD DEBT IS PENDING CHARITY CARE. - THE CBO CONCLUDED THAT ITS FINDINGS "SUPPORT THE VALIDITY OF THE USE OF UNCOMPENSATED CARE [BAD DEBT AND CHARITY CARE] AS A MEASURE OF COMMUNITY BENEFITS" ASSUMING THE FINDINGS ARE GENERALIZABLE NATIONWIDE; THE EXPERIENCE OF HOSPITALS AROUND THE NATION REINFORCES THAT THEY ARE GENERALIZABLE. AS OUTLINED BY THE AHA, DESPITE THE HOSPITALS' BEST EFFORTS AND DUE DILIGENCE, PATIENT BAD DEBT IS A PART OF THE HOSPITAL'S MISSION AND CHARITABLE PURPOSES. BAD DEBT REPRESENTS PART OF THE BURDEN HOSPITALS SHOULDER IN SERVING ALL PATIENTS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. IN ADDITION, THE HOSPITAL INVESTS SIGNIFICANT RESOURCES IN SYSTEMS AND STAFF TRAINING TO ASSIST PATIENTS THAT ARE IN NEED OF FINANCIAL ASSISTANCE.
COLLECTION POLICY	SCHEDULE H, PART III, SECTION B; QUESTION 9B	ACCOUNTS CONSIDERED TO BE CHARITY CARE ARE NOT INCLUDED IN THE BAD DEBT EXPENSE, BUT RATHER, ACCOUNTED FOR AS AN ALLOWANCE AGAINST REVENUE. IT IS THE POLICY OF CHILDREN'S SPECIALIZED HOSPITAL TO TREAT ALL PATIENTS EQUALLY REGARDLESS OF INSURANCE AND THEIR ABILITY TO PAY. FOR ACCOUNTS DETERMINED TO BE "SELF-PAY" AND/OR ACCOUNTS WITH BALANCE AFTER PRIMARY INSURANCE PAYMENTS, THE COLLECTION POLICY REQUIRES: SENDING THREE STATEMENTS, A MINIMUM OF ONE PRE-COLLECTION LETTER, TELEPHONE CONTACT FOR ANY ACCOUNT OVER THE POLICY LIMIT OR AT THE DISCRETION OF THE ACCOUNT REPRESENTATIVE AND/OR SUPERVISOR. THE FACILITY ALSO HAS A CHARITY CARE POLICY TO ASSURE PATIENTS ARE PROVIDED WITH CHARITY CARE ASSISTANCE DETERMINED BY STATE AND FEDERAL REGULATIONS. IT IS THE POLICY TO INFORM ALL PATIENTS DEEMED SELF-PAY OF THE APPROPRIATE ASSISTANCE PROGRAMS AVAILABLE. PATIENTS APPLYING FOR CHARITY CARE ASSISTANCE WILL BE FINANCIALLY SCREENED BY A RESOURCE ADVISOR TO DETERMINE ELIGIBILITY ACCORDING TO STATE AND FEDERAL GUIDELINES AND WILL BE INFORMED OF DOCUMENTATION NEEDED TO COMPLETE A CHARITY CARE APPLICATION. PATIENTS NOT ELIGIBLE FOR CHARITY CARE WILL BE FINANCIALLY COUNSELED FOR ALL OTHER OPTIONS. QUALIFIED PATIENTS WILL BE REFERRED TO ALL APPROPRIATE AGENCIES OR PROGRAMS TO MEET OTHER FINANCIAL NEEDS. AT THE TIME OF THE PATIENT VISIT AND PART OF THE REGISTRATION PROCESS AT THE FACILITY, THE FOLLOWING OPTIONS ARE MADE AVAILABLE TO PATIENTS: - FINANCIAL COUNSELING FOR POSSIBLE ELIGIBILITY FOR MEDICAL ASSISTANCE INCLUDING MEDICAID AND SSI; - FINANCIAL COUNSELING FOR POSSIBLE ELIGIBILITY FOR CHILDREN'S SPECIALIZED HOSPITAL CARE PAYMENT ASSISTANCE PROGRAM; AND, - FINANCIAL ARRANGEMENTS INCLUDING: 1. CASH/CREDIT CARD (AMERICAN EXPRESS, DISCOVER, VISA, MASTERCARD), OR 2. FLEXIBLE PAYMENT PLANS. IN ADDITION TO THE ABOVE OPTIONS, THE FACILITY HAS ESTABLISHED A SELF-PAY ASSISTANCE PROGRAM FOR OUR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR MEDICAID OR HOSPITAL'S ASSISTANCE PROGRAM. THE SELF-PAY ASSISTANCE PROGRAM RATES ARE REFLECTIVE OF MEDICAID REIMBURSEMENT.
FACILITY INFORMATION	SCHEDULE H, PART V, SECTION B, QUESTIONS 1J, 3, 4, 5C, 6I & 7	NOT APPLICABLE.
FACILITY INFORMATION	SCHEDULE H, PART V, SECTION B,QUESTIONS 9,10,11H,13G,15E,16E,17E,18D,20&21	NOT APPLICABLE.
FACILITY INFORMATION	SCHEDULE H, PART V, SECTION B, QUESTION 19D	THE ORGANIZATION CURRENTLY UTILIZES AMOUNTS TYPICALLY CHARGED IN THESE INSTANCES.
NEEDS ASSESSMENT	SCHEDULE H, PART VI; QUESTION 2	THIS ORGANIZATION CONDUCTS A REVIEW OF KEY FACTOR INFORMATION ANNUALLY WHICH INCLUDES: A REVIEW OF HEALTHCARE UTILIZATION OF ITS SERVICE AREA POPULATION BY SERVICES (UROLOGY, CARDIOLOGY, OBSTETRICS, ETC.) FOR DETERMINING INCREASED OR DECREASED HEALTH NEEDS; HEALTHCARE SERVICE ESTIMATES AND FORECASTS (BOTH INPATIENT AND OUTPATIENT); ASSESSMENTS OF LOCAL DEMOGRAPHIC AND SOCIOECONOMIC INFORMATION; AND, A REVIEW OF HEALTH STATUS/NEEDS ASSESSMENTS AND STUDIES CONDUCTED BY EXTERNAL PARTIES (HEALTH RESEARCH AND EDUCATION TRUST OF NEW JERSEY, KID'S COUNT, ETC.). THIS ORGANIZATION CONDUCTS AN EXTENSIVE SERVICE AREA POPULATION PHYSICIAN NEED STUDY (BY PRIMARY AND SPECIALTY) EVERY THREE TO FIVE YEARS. SPECIFIC SPECIALTY NEEDS ARE CONDUCTED FOR IDENTIFIED GAPS IN SERVICE. THESE REVIEWS INFORM MEDICAL STAFF DEVELOPMENT AT THE MEDICAL CENTER TO ASSURE RESPONSIVENESS TO IDENTIFIED COMMUNITY NEEDS. IN ADDITION, THIS ORGANIZATION WORKS WITH LOCAL PROVIDERS TO PLAN AND DISCUSS HEALTH NEEDS OF THE POPULATION.
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	SCHEDULE H, PART VI; QUESTION 3	CHARITY CARE SIGNS ARE POSTED THROUGHOUT THE FACILITY, MAINLY IN PATIENT REGISTRATION AREAS. SIGNS ARE POSTED IN BOTH ENGLISH AND SPANISH. ALL PATIENTS DEEMED SELF PAY ARE SCREENED FOR FINANCIAL ASSISTANCE BY A RESOURCE ADVISOR ACCORDING TO THE FEDERAL POVERTY GUIDELINES AND REFERRED TO APPROPRIATE AGENCIES OR PROGRAMS.
COMMUNITY INFORMATION	SCHEDULE H, PART VI; QUESTION 4	THIS ORGANIZATION IS IN A DIVERSE SUBURBAN LOCATION SERVING DIVERSE COMMUNITIES RANGING FROM INNER CITY COMMUNITIES TO MORE AFFLUENT SUBURBAN AREAS THROUGHOUT THE STATE OF NEW JERSEY. CHILDREN'S HAS NINE LOCATIONS THROUGHOUT THE STATE AND IS COMMITTED TO SERVICE ALL OF ITS COMMUNITIES AND SERVES BOTH INNER CITY AND SUBURBAN AREAS. ABOUT 60% OF ITS INPATIENTS ARE OF MINORITY RACE/ETHNICITY. IN ADDITION, APPROXIMATELY 8% OF ITS PATIENTS ARE OF UNDERINSURED AND UNINSURED PAYER CATEGORIES.
PROMOTION OF COMMUNITY HEALTH	SCHEDULE H, PART VI; QUESTION 5	COMMUNITY BUILDING ACTIVITIES UNDERTAKEN BY CHILDREN'S SPECIALIZED HOSPITAL IMPROVES THE MEDICAL AND SOCIOECONOMIC WELL-BEING OF THE COMMUNITIES IN OUR CARE. THIS IS ACCOMPLISHED THROUGH SERVICE ON STATE AND REGIONAL ADVOCACY COMMITTEES AND BOARDS, VOLUNTEERISM WITH LOCAL COMMUNITY-BASED NON-PROFIT ADVOCACY GROUPS, AND PARTICIPATION IN CONFERENCES AND OTHER EDUCATIONAL ACTIVITIES TO PROMOTE UNDERSTANDING OF THE ROOT CAUSES OF HEALTH CONCERNS. THIS ORGANIZATION PROVIDES EDUCATIONAL MATERIALS, CONDUCTS COMMUNITY HEALTH FAIRS AND HOLDS HEALTH EDUCATION SEMINARS AND OUTREACH SESSIONS FOR ITS PATIENTS AND FOR COMMUNITY PROVIDERS. PRESENTATIONS ARE PROVIDED BY PHYSICIANS, NURSES AND OTHER HEALTH CARE PROFESSIONALS. CHILDREN'S SPECIALIZED HOSPITAL PLANS TO HOLD AN ANNUAL BOARD MEETING OPEN TO THE PUBLIC. THE MAJORITY OF THE BOARD OF TRUSTEES ARE INDIVIDUALS WITH LOCAL BUSINESSES OR WHOM RESIDE IN THE COMMUNITY. HOSPITAL STAFF MEMBERS SERVE ON THE BOARDS OF MANY LOCAL NOT-FOR-PROFIT ORGANIZATIONS AND PROVIDE OTHER FORMS OF SUPPORT (FUNDRAISING, ACTIVITY PARTICIPATION). ALL QUALIFIED PHYSICIANS ARE EXTENDED PRIVILEGES BY THE MEDICAL STAFF OFFICE CREDENTIALING COMMITTEE. UNDER THE DIRECTIVE OF THE ORGANIZATION'S CORPORATE FINANCE OFFICE, SURPLUS FUNDS ARE UTILIZED FOR CAPITAL PROJECTS TO IMPROVE SERVICES OR PURCHASE EQUIPMENT WHICH IN TURN, BENEFIT THE COMMUNITY. PLEASE ALSO REFER TO FORM 990, SCHEDULE O, WHICH CONTAINS THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT AND SUMMARY OF ALL ENTITIES WHICH COMPRISE CHILDREN'S SPECIALIZED HOSPITAL.
AFFILIATED HEALTHCARE SYSTEM	SCHEDULE H, PART VI; QUESTION 6	OUTLINED BELOW IS A SUMMARY OF THE ENTITIES WHICH COMPRISE THE ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL NETWORK AND AFFILIATES. NOT FOR PROFIT ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL NETWORK ENTITIES RWJ HEALTH CARE CORPORATION RWJ HEALTH CARE CORPORATION ("RWJHCC") IS THE TAX-EXEMPT PARENT OF THE ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL NETWORK ("NETWORK"). THIS INTEGRATED HEALTH CARE DELIVERY SYSTEM CONSISTS OF A GROUP OF AFFILIATED HEALTH CARE ORGANIZATIONS. THE SOLE MEMBER OR STOCKHOLDER OF EACH ENTITY IS EITHER RWJHCC OR ANOTHER NETWORK AFFILIATE CONTROLLED BY RWJCC. NETWORK IS AN INTEGRATED NETWORK OF HEALTHCARE PROVIDERS THROUGHOUT THE STATE OF NEW JERSEY. RWJ HEALTH CARE CORPORATION IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A SUPPORTING ORGANIZATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). RWJ HEALTH CARE CORPORATION STRIVES TO CONTINUALLY DEVELOP AND OPERATE A MULTI-HOSPITAL HEALTH CARE SYSTEM WHICH PROVIDES SUBSTANTIAL COMMUNITY BENEFIT THROUGH THE PROVISION OF A COMPREHENSIVE SPECTRUM OF HEALTH CARE SERVICES TO THE RESIDENTS OF NEW JERSEY AND SURROUNDING COMMUNITIES. RWJ HEALTH CARE CORPORATION ENSURES THAT ITS SYSTEM PROVIDES MEDICALLY NECESSARY HEALTH CARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGINS OR ABILITY TO PAY. NO INDIVIDUALS ARE DENIED NECESSARY MEDICAL CARE, TREATMENT OR SERVICES. ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL NETWORK ACTIVE HOSPITALS INCLUDE: CHILDREN'S SPECIALIZED HOSPITAL, ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL, ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT HAMILTON AND ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT RAHWAY. EACH OF THESE HOSPITALS OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545: 1. EACH PROVIDE MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF- PAY, MEDICARE AND MEDICAID PATIENTS; 2. EACH OPERATE AN ACTIVE EMERGENCY ROOM FOR ALL PERSONS; WHICH IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR 3. EACH MAINTAIN AN OPEN MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; AND 4. CONTROL OF EACH RESTS WITH ITS BOARD OF TRUSTEES AND THE BOARD OF TRUSTEES OF RWJ HEALTH CARE CORPORATION. BOTH BOARDS ARE COMPRISED OF INDEPENDENT CIVIC LEADERS AND OTHER PROMINENT MEMBERS OF THE COMMUNITY. 5. SURPLUS FUNDS ARE USED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND RENOVATE FACILITIES AND ADVANCE MEDICAL CARE; PROGRAMS AND ACTIVITIES. CHILDREN'S SPECIALIZED HOSPITAL CHILDREN'S SPECIALIZED HOSPITAL ("CSH") IS A 158 BED LICENSED COMPREHENSIVE PEDIATRIC REHABILITATION HOSPITAL AND PEDIATRIC LONG-TERM CARE FACILITY WITH LOCATIONS IN NEW BRUNSWICK, MOUNTAINSIDE AND TOMS RIVER NEW JERSEY. CSH IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, CSH PROVIDES MEDICALLY NECESSARY HEALTH CARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. MOREOVER, CSH OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545 ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL ("RWJUH") IS A 610-BED NON-PROFIT ACADEMIC MEDICAL CENTER LOCATED IN NEW BRUNSWICK, MIDDLESEX COUNTY, NEW JERSEY. RWJUH IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, RWJUH PROVIDES MEDICALLY NECESSARY HEALTH CARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. MOREOVER, RWJUH OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545 ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT HAMILTON ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT HAMILTON ("RWJUHH") IS A 280-BED NON-PROFIT ACUTE CARE MEDICAL CENTER LOCATED IN HAMILTON, MERCER COUNTY, NEW JERSEY. RWJUHH IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, RWJUHH PROVIDES MEDICALLY NECESSARY HEALTH CARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. MOREOVER, RWJUHH OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545 ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT RAHWAY ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT RAHWAY ("RWJUHR") IS A 265-BED NON-PROFIT ACUTE CARE MEDICAL CENTER LOCATED IN RAHWAY, UNION COUNTY, NEW JERSEY. RWJUHR IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, RWJUHR PROVIDES MEDICALLY NECESSARY HEALTH CARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. MOREOVER, RWJUHR OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545 AUXILIARY OF ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AUXILIARY OF ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). THE ORGANIZATION IS A SUPPORTING ORGANIZATION OF ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. CHILDREN'S SPECIALIZED HOSPITAL FOUNDATION CHILDREN'S SPECIALIZED HOSPITAL FOUNDATION IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(1). THROUGH FUNDRAISING ACTIVITIES THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF CHILDREN'S SPECIALIZED HOSPITAL; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. FRIENDS OF CHILDREN'S SPECIALIZED HOSPITAL FORMERLY THE AUXILIARY OF CHILDREN'S SPECIALIZED HOSPITAL THE FRIENDS OF CHILDREN'S SPECIALIZED HOSPITAL IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). THE ORGANIZATION IS A SUPPORTING ORGANIZATION OF CHILDREN'S SPECIALIZED HOSPITAL; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. LAKEVIEW CHILD CARE CENTER, INC. LAKEVIEW CHILD CARE CENTER, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). THE ORGANIZATION PROVIDES HIGH-QUALITY CARE OPERATING UNDER THE MONTESSORI METHOD AND PHILOSOPHY FOR THE EMPLOYEES OF ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT HAMILTON AND TO THE GENERAL PUBLIC. IN ADDITION, THE CENTER HAS A DROP OFF PROGRAM AND BABY-SITTING PROGRAM USED BY PARENTS WHO MUST GO TO THE HOSPITAL FOR OUTPATIENT PROCEDURES. ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT HAMILTON FOUNDATION, INC. ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT HAMILTON FOUNDATION, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(1). THROUGH FUNDRAISING ACTIVITIES THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT HAMILTON; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY.
AFFILIATED HEALTHCARE SYSTEM CONTINUED	SCHEDULE H, PART VI; QUESTION 6	ROBERT WOOD JOHNSON HEALTH CARE CORPORATION AT HAMILTON ROBERT WOOD JOHNSON HEALTH CARE CORPORATION AT HAMILTON IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THE ORGANIZATION IS THE PARENT ORGANIZATION OF A TAX-EXEMPT NOT FOR-PROFIT INTEGRATED HEALTHCARE DELIVERY SYSTEM IN NEW JERSEY WHICH INCLUDES ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT HAMILTON; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT RAHWAY AUXILIARY ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT RAHWAY AUXILIARY IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THE ORGANIZATION IS A SUPPORTING ORGANIZATION OF ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT RAHWAY; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT RAHWAY FOUNDATION, INC. ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT RAHWAY FOUNDATION, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THROUGH FUNDRAISING ACTIVITIES THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT RAHWAY; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. NEW BRUNSWICK AFFILIATED HOSPITALS, INC. NEW BRUNSWICK AFFILIATED HOSPITAL, INC.. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL, INC.; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY ROBERT WOOD JOHNSON PROPERTY HOLDING CORPORATION ROBERT WOOD JOHNSON PROPERTY HOLDING CORPORATION IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THE ORGANIZATION IS A SUPPORTING ORGANIZATION OF ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY, AND IS PRIMARILY RESPONSIBLE FOR THE MANAGEMENT AND OPERATION OF RENTAL SPACE FOR VARIOUS AFFILIATES OF THE ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL NETWORK. ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL FOUNDATION, INC. ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL FOUNDATION, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THROUGH FUNDRAISING ACTIVITIES THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. FOR PROFIT ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL NETWORK ENTITIES HAMILTON O/B GYN, P.A. A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT HAMILTON. THE ORGANIZATION IS LOCATED IN HAMILTON, MERCER COUNTY, NEW JERSEY. THE ORGANIZATION PROVIDES MEDICAL SERVICES TO INDIVIDUALS. RWJ DIABETES & ENDOCRINOLOGY A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT HAMILTON. THE ORGANIZATION IS LOCATED IN HAMILTON, MERCER COUNTY, NEW JERSEY. THE ORGANIZATION PROVIDES MEDICAL SERVICES TO INDIVIDUALS. RWJ MEDICAL ASSOCIATES AT HAMILTON A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT HAMILTON. THE ORGANIZATION IS LOCATED IN HAMILTON, MERCER COUNTY, NEW JERSEY. THE ORGANIZATION PROVIDES MEDICAL SERVICES TO INDIVIDUALS. RWJ MEDICAL ASSOCIATES A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL. THE ORGANIZATION IS LOCATED IN NEW BRUNSWICK, MIDDLESEX COUNTY, NEW JERSEY. THE ORGANIZATION PROVIDES MEDICAL SERVICES TO INDIVIDUALS. RWJ MEDICAL SERVICES ORGANIZATION AT HAMILTON A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS ROBERT WOOD JOHNSON HEALTH CARE CORPORATION AT HAMILTON. THE ORGANIZATION IS LOCATED IN HAMILTON, MERCER COUNTY, NEW JERSEY. THIS ENTITY DERIVES INCOME FROM THE RECEIPT OF RENTAL INCOME. RWJ HEALTH NETWORK, INC. A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS ROBERT WOOD JOHNSON HEALTH CARE CORPORATION. THE ORGANIZATION IS LOCATED IN NEW BRUNSWICK, MIDDLESEX COUNTY, NEW JERSEY. THIS ENTITY DERIVES INCOME FROM THE OPERATION OF A HEALTH CARE SYSTEM. RWJ KIDNEY TRANSPLANT ASSOCIATION A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL. THE ORGANIZATION IS LOCATED IN NEW BRUNSWICK, MIDDLESEX COUNTY, NEW JERSEY. THIS ENTITY PROVIDES MEDICAL SERVICES TO INDIVIDUALS. RWJ MUTI-SPECIALTY, P.A. A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL. THE ORGANIZATION IS LOCATED IN NEW BRUNSWICK, MIDDLESEX COUNTY, NEW JERSEY. THIS ENTITY PROVIDES MEDICAL SERVICES TO INDIVIDUALS. RWJ PHYSICIAN ENTERPRISE, P.A. A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL. THE ORGANIZATION IS LOCATED IN NEW BRUNSWICK, MIDDLESEX COUNTY, NEW JERSEY. THIS ENTITY PROVIDES MEDICAL SERVICES TO INDIVIDUALS. RWJ SURGERY CENTER, INC. A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS ROBERT WOOD JOHNSON HEALTH CARE CORPORATION. THE ORGANIZATION IS LOCATED IN NEW BRUNSWICK, MIDDLESEX COUNTY, NEW JERSEY. THIS ENTITY PROVIDES SURGERY SERVICES TO INDIVIDUALS. SYSTEM AND AFFILIATE MEMBERS, LTD. A CONTROLLED FOREIGN CORPORATION BY ROBERT WOOD JOHNSON HEALTH CARE CORPORATION. THE ORGANIZATION WAS FORMED AND OPERATES SOLELY IN BERMUDA. VISION HEALTHCARE, INC. A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT RAHWAY. THE ORGANIZATION IS LOCATED IN RAHWAY, UNION COUNTY, NEW JERSEY. THIS ENTITY PROVIDES INVESTMENT SERVICES TO ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT RAHWAY.
STATE FILING OF COMMUNITY BENEFIT REPORT	SCHEDULE H, PART III, SECTION B; QUESTION 7	NOT APPLICABLE. THE ENTITY AND RELATED PROVIDER ORGANIZATIONS ARE LOCATED IN NEW JERSEY. THE STATE OF NEW JERSEY DOES NOT REQUIRE HOSPITALS TO ANNUALLY FILE A COMMUNITY BENEFIT REPORT WITH THE STATE OF NEW JERSEY.

Schedule H (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

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

2011

Open to Public Inspection

Name of the organization

CHILDREN'S SPECIALIZED HOSPITAL

Employer identification number

22-1487148

Part I

Questions Regarding Compensation

Yes

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.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all the expenses described above? If "No," complete Part III to explain....

Yes

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? ....

Yes

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. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

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:

Receive a severance payment or change-of-control payment? ...............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? ........

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.

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:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

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:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

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 ............

Yes

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 Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 50053T

Schedule J (Form 990) 2011

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and column (E) for that individual.

(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 as deferred in prior Form 990
(A) Name		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(1) MARTIN DIAMOND MD	(i) (ii)	254,540 0	0 0	9,588 0	9,800 0	16,024 0	289,952 0	0 0
(2) AMY B MANSUE	(i) (ii)	395,669 0	160,333 0	33,989 0	122,291 0	10,042 0	722,324 0	25,299 0
(3) PHILIP SALERNO	(i) (ii)	291,161 0	43,800 0	13,902 0	9,800 0	26,012 0	384,675 0	0 0
(4) WARREN E MOORE	(i) (ii)	313,250 0	46,997 0	34,915 0	65,335 0	20,144 0	480,641 0	25,838 0
(5) JOSEPH J DOBOSH JR	(i) (ii)	285,170 0	47,924 0	35,975 0	73,264 0	17,229 0	459,562 0	25,946 0
(6) KAREN M DEWITT EDD	(i) (ii)	227,460 0	31,442 0	26,015 0	51,052 0	6,667 0	342,636 0	18,653 0
(7) MICHAEL R DRIBBON PHD	(i) (ii)	225,811 0	38,538 0	17,255 0	51,323 0	3,708 0	336,635 0	7,785 0
(8) WILLIAM DWYER	(i) (ii)	210,920 0	27,543 0	23,213 0	45,423 0	6,653 0	313,752 0	14,981 0
(9) UDAY MEHTA MD	(i) (ii)	261,237 0	0 0	14,166 0	9,800 0	20,062 0	305,265 0	0 0
(10) KRISHAN YALAMANCHI MD	(i) (ii)	218,696 0	0 0	2,810 0	8,572 0	25,748 0	255,826 0	0 0
(11) YVETTE JANVIER MD	(i) (ii)	205,600 0	0 0	2,692 0	8,229 0	1,910 0	218,431 0	0 0
(12) MICHELE FANTASIA MD	(i) (ii)	200,642 0	0 0	2,303 0	7,843 0	17,052 0	227,840 0	0 0
(13) THOMAS A RUGINO MD	(i) (ii)	192,242 0	0 0	2,608 0	5,989 0	23,417 0	224,256 0	0 0

Schedule J (Form 990) 2011

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.

Identifier	Return Reference	Explanation
COMPENSATION INFORMATION	SCHEDULE J, PART I; QUESTION 1A	THE ORGANIZATION PAID FOR HEALTH CLUB DUES FOR CERTAIN EMPLOYEES. THE HEALTH CLUB DUES ARE TREATED AS TAXABLE WAGES AND ARE INCLUDED ON EACH INDIVIDUAL'S RESPECTIVE 2011 FORM W-2, BOX 5 AS TAXABLE MEDICARE WAGES: AMY B. MANSUE, $500; WARREN E. MOORE, $500; JOSEPH J. DOBOSH, JR.; $500; KAREN M. DEWITT, ED. D., $256 AND MICHAEL R. DRIBBON, PH.D., $1,000.
COMPENSATION INFORMATION	SCHEDULE J, PART I; QUESTION 4B	THE AMOUNT REFLECTED IN COLUMN B(III) FOR THE FOLLOWING INDIVIDUALS INCLUDES CURRENT YEAR VESTING IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) AS THE AMOUNTS WERE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THESE AMOUNTS WERE REPORTED AS EMPLOYEE BENEFIT PLAN CONTRIBUTIONS ON PRIOR YEARS FORMS 990. THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2011 FORM W-2, BOX 5 AS TAXABLE MEDICARE WAGES: AMY B. MANSUE, $25,299; WARREN E. MOORE, $25,838; JOSEPH J. DOBOSH, JR., $25,946; KAREN M. DEWITT, ED.D., $18,653; MICHAEL R. DRIBBON, PH.D., $7,785 AND WILLIAM DWYER, $14,981. THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THE FOLLOWING INDIVIDUALS INCLUDES UNVESTED BENEFITS IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) WHICH ARE SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THE INDIVIDUALS MAY NEVER ACTUALLY RECEIVE THIS UNVESTED BENEFIT AMOUNT. THE AMOUNTS OUTLINED HEREIN WERE NOT INCLUDED IN EACH INDIVIDUAL'S 2011 FORM W-2, AS TAXABLE WAGES: AMY B. MANSUE, $114,941; WARREN E. MOORE, $55,535; JOSEPH J. DOBOSH, JR., $63,464; KAREN M. DEWITT, ED.D., $41,252; MICHAEL R. DRIBBON, PH.D., $41,523 AND WILLIAM DWYER, $35,740.
COMPENSATION INFORMATION	SCHEDULE J, PART I; QUESTION 7	CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A BONUS DURING CALENDAR YEAR 2011 WHICH AMOUNTS WERE INCLUDED IN COLUMN B(II) HEREIN AND IN EACH INDIVIDUAL'S 2011 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT.
COMPENSATION INFORMATION	SCHEDULE J, PART II, COLUMN F	THE AMOUNT REPORTED IN SCHEDULE J, PART II, COLUMN F REPRESENTS AMOUNTS THAT WERE RECEIVED IN 2011 AND REPORTED ON PRIOR FORMS 990 AS NOT CURRENTLY TAXABLE DEFERRED COMPENSATION BECAUSE THE AMOUNTS WERE SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THESE AMOUNTS WERE TREATED AS TAXABLE INCOME AND REPORTED ON EACH INDIVIDUAL'S 2011 FORM W-2, BOX 5 AS TAXABLE MEDICARE WAGES AS FOLLOWS: AMY B. MANSUE, $25,299; WARREN E. MOORE, $25,838; JOSEPH J. DOBOSH, JR., $25,946; KAREN M. DEWITT, ED.D., $18,653; MICHAEL R. DRIBBON, PH.D., $7,785 AND WILLIAM DWYER, $14,981.

Schedule J (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990. SchKMediumBullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public
Inspection

Name of the organization
CHILDREN'S SPECIALIZED HOSPITAL

Employer identification number
22-1487148

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
(a) Issuer Name		(b) Issuer EIN	(c) CUSIP #	(d) Date Issued	(e) Issue Price	(f) Description of Purpose	Yes	No	Yes	No	Yes	No
A	NJ HEALTH CARE FACILITIES FINANCING AUTHORITY	22-1487148	64579FGL1	11-01-2005	56,895,000	CONSTRUCTION		X	X			X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . .	10,625,000
2 Amount of bonds legally defeased . . . . . . . . . .	0
3 Total proceeds of issue . . . . . . . . . . . . .	56,895,000
4 Gross proceeds in reserve funds . . . . . . . .	2,474,925
5 Capitalized interest from proceeds . . . . . . . . . .	743,756
6 Proceeds in refunding escrows . . . . . . . . . . .	0
7 Issuance costs from proceeds . . . . . . . . . . .	1,169,455
8 Credit enhancement from proceeds . . . . . . . . . .	0
9 Working capital expenditures from proceeds . . . . . . .	0
10 Capital expenditures from proceeds . . . . . . . . . .	56,895,000
11 Other spent proceeds . . . . . . . . . . .	0
12 Other unspent proceeds . . . . . . . . . . .	0
13 Year of substantial completion . . . . . . . . . . .	2007
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . .		X
15 Were the bonds issued as part of an advance refunding issue? . . . .		X
16 Has the final allocation of proceeds been made? . . . . . .	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . .	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
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .		X

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2011

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 of bond-financed property? . . . . . . . . .		X
b If ‘Yes’ to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . .
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . .		X
d If ‘Yes’ to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any 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 . .	0.00000%		%		%		%
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 . . . . . . .	0.00000%		%		%		%
6 Total of lines 4 and 5 . . .. . . . . . . . .	0.00000%		%		%		%
7 Does the bond issue meet the private security or payment test? . . .	X
8 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2?	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
2 Is the bond issue a variable rate issue?	X
3a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X
b Name of provider . . . . . . . .	0
c Term of hedge . . . . . . . .
d Was the hedge superintegrated? . . . .
e Was a hedge terminated? . . . . .
4a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . .		X
b Name of provider . . . . . .	0
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
6 Did the bond issue qualify for an exception to rebate? .		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .		X

Schedule K (Form 990) 2011

Page 3

Part V

Procedures To Undertake Corrective Action

Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? . . . . . . . . . . . . . . YesNo

Part VI

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule K (see instructions).

Identifier	Return Reference	Explanation
SCHEDULE K, PART I	TAX-EXEMPT BOND ISSUES	THE TAX-EXEMPT BOND ISSUANCE INCLUDED IN SCHEDULE K, PART I INCLUDES CUSIP NUMBERS IN ADDITION TO THE ONE DISCLOSED IN SCHEDULE K, PART I, COLUMN (C). THESE ARE THE FOLLOWING: 64579FGM9; 64579FGN7; 64579FGP2; 64579FGQ0; 64579FGR8; 64579FGS6; 64579FGT4; 64579FGU1 & 64579FGV9

Schedule K (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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. MediumBullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

CHILDREN'S SPECIALIZED HOSPITAL

Employer identification number

22-1487148

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?
1(a) Name of disqualified person	(b) Description of transaction	Yes	No

Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image

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?
(a) Name of interested person and purpose	To	From	(c)Original principal amount	(d)Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

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) 2011

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?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) UMDNJ	FRANK CASTELLO,MD-TRUSTEE	373,445	REIMB. OF COMP & BENEFITS		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
BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS	SCHEDULE L; PART IV	THE ORGANIZATION PAID UMDNJ $373,445 WHICH REPRESENTED REIMBURSEMENT ATTRIBUTABLE TO DR. CASTELLO'S EMPLOYEE COMPENSATION, BENEFITS AND MALPRACTICE INSURANCE RECEIVED BY DR. CASTELLO AS A UMDNJ EMPLOYEE.

Schedule L (Form 990 or 990-EZ) 2011

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.
MediumBullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2011

Open to Public
Inspection

Name of the organization

CHILDREN'S SPECIALIZED HOSPITAL

Employer identification number

22-1487148

Identifier	Return Reference	Explanation
COMMUNITY BENEFIT STATEMENT	CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS	BACKGROUND ========== CHILDREN'S SPECIALIZED HOSPITAL ("CSH"), AN AFFILIATE MEMBER OF THE ROBERT WOOD JOHNSON HEALTH SYSTEM, IS A NOT FOR-PROFIT LICENSED COMPREHENSIVE PEDIATRIC REHABILITATION HOSPITAL AND PEDIATRIC LONG-TERM CARE FACILITIES. CSH ALSO OPERATES A LICENSED PEDIATRIC MEDICAL DAY CARE, AND A PEDIATRIC PRACTICE FOR CHILDREN WITH DISABILITIES. CSH HAS BEEN PROVIDING SERVICES TO THE CHILDREN OF NEW JERSEY AND SURROUNDING STATES FOR 122 YEARS. OUR TALENTED AND CARING STAFF PROVIDE A WIDE ARRAY OF MEDICAL, DEVELOPMENTAL, EDUCATIONAL AND REHABILITATIVE SERVICES FOR INFANTS, CHILDREN, ADOLESCENTS, AND YOUNG ADULTS. CSH'S HEALTHCARE PROFESSIONALS ARE COMMITTED TO PROVIDING EXPERT AND COMPASSIONATE CARE TO CHILDREN WITH CHRONIC ILLNESSES AND DISABILITIES. EVALUATION AND TREATMENT IS AVAILABLE FOR A VARIETY OF REHABILITATION NEEDS, INCLUDING, BUT NOT LIMITED TO, BRAIN INJURIES, SPINAL CORD DYSFUNCTION, RESPIRATORY ISSUES, AUTISM, ORTHOPEDIC PROBLEMS, SPORTS INJURIES, LEARNING DISABILITIES, LANGUAGE OR HEARING PROBLEMS, DEVELOPMENTAL DELAYS, AND BEHAVIOR OR ATTENTION PROBLEMS AT HOME OR IN SCHOOL. COMPREHENSIVE, COORDINATED CARE IS PROVIDED FOR CHILDREN WITH CHRONIC ILLNESSES AND DISABILITIES WHO MAY HAVE MULTIPLE AND COMPLEX THERAPY NEEDS. CHARITABLE PURPOSES, CHARITY CARE AND COMMUNITY ACTIVITIES ========================================================== CSH PROVIDES HEALTHCARE SERVICES TO ALL CHILDREN IN THE TRI-STATE AREA WHO CAN BENEFIT FROM REHABILITATIVE CARE AND WHO ARE LEGAL RESIDENTS OF NEW JERSEY IN A NON-DISCRIMINATORY MANNER REGARDLESS OF ABILITY TO PAY. CSH PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN IT'S ESTABLISHED RATES AND MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. CSH DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE; THEREFORE, THESE AMOUNTS ARE NOT REPORTED AS NET PATIENT SERVICE REVENUE. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FORGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY. CSH DOES NOT RECEIVE ANY DISTRIBUTION OF FEDERAL OR STATE SUBSIDIES FOR CHARITY CARE SERVICES RENDERED. ACCREDITATIONS ============== CSH IS ACCREDITED BY THE JOINT COMMISSION OF ACCREDITATION OF HEALTHCARE ORGANIZATIONS. MISSION STATEMENT ================= THE MISSION OF CHILDREN'S SPECIALIZED HOSPITAL IS TO BE THE PREEMINENT PROVIDER OF SPECIALIZED HEALTHCARE SERVICES FOR INFANTS, CHILDREN AND YOUNG ADULTS. CHILDREN'S SPECIALIZED HOSPITAL CORPORATE VALUES ================================================ THE VALUES OF CSH ARE COMPASSION, INTEGRITY, EXCELLENCE, FUN, INNOVATION, AND TEAMWORK. COMPASSION: WE WILL PROVIDE A LOVING, CARING ENVIRONMENT FOR THE CHILDREN, FAMILIES, AND EACH OTHER. INTEGRITY: WE ARE COMMITTED TO ORGANIZATIONAL AND FINANCIAL ACCOUNTABILITY, TRANSPARENCY, RESPECT FOR ALL AND ETHICAL PRACTICES. EXCELLENCE: WE WILL BE THE BEST AT OUR JOBS AND PROVIDE THE HIGHEST QUALITY CARE TO OUR CHILDREN, CONSTANTLY STRIVING TO IMPROVE AND BE THE BEST. FUN: WE WILL PROVIDE A CHILD-FRIENDLY ENVIRONMENT. IF WE HAVE FUN DOING OUR JOBS, IT WILL REFLECT IN HOW WE DEAL WITH THE CHILDREN AND EACH OTHER. INNOVATION: WE WILL BE CREATIVE IN PROVIDING CARE AND PROBLEM SOLVING. TEAMWORK: CSH IS A TEAM WHERE EVERY PERSON IS NEEDED TO PROVIDE THE QUALITY CARE FOR WHICH WE ARE KNOWN. WE MUST WORK TOGETHER TO BE SUCCESSFUL. PATIENT-AND-FAMILY-CENTERED CARE AND CHILDREN'S SPECIALIZED HOSPITAL ==================================================================== PATIENT-AND-FAMILY CENTERED CARE IS AN APPROACH TO HEALTHCARE THAT SHAPES HEALTHCARE POLICIES, PROGRAMS, FACILITY DESIGN, AND DAY TO DAY INTERACTIONS AMONG PATIENTS FAMILIES, PHYSICIANS AND OTHER HEALTHCARE PROFESSIONALS. HEALTHCARE PROFESSIONALS, WHO PRACTICE PATIENT-AND-FAMILY CENTERED CARE, RECOGNIZE THE VITAL ROLE THAT FAMILIES PLAY IN ENSURING THE HEALTH AND WELL-BEING OF CHILDREN AND FAMILY MEMBERS OF ALL AGES. THESE PRACTITIONERS ACKNOWLEDGE THAT EMOTIONAL, SOCIAL AND DEVELOPMENTAL SUPPORTS ARE INTEGRAL COMPONENTS OF HEALTHCARE. THEY RESPECT EACH CHILD AND FAMILY'S INNATE STRENGTHS AND VIEW THE HEALTHCARE EXPERIENCE AS AN OPPORTUNITY TO BUILD ON THESE STRENGTHS AND SUPPORT FAMILIES IN THEIR CARE-GIVING AND DECISION-MAKING ROLES. A PATIENT-AND-FAMILY CENTERED APPROACH LEADS TO BETTER HEALTH OUTCOMES AND WISER ALLOCATIONS OF RESOURCES, AS WELL AS GREATER PATIENT AND FAMILY SATISFACTION. PATIENT-AND-FAMILY CENTERED CARE IN PEDIATRICS IS BASED ON THE UNDERSTANDING THAT THE FAMILY IS THE CHILD'S PRIMARY SOURCE OF STRENGTH AND SUPPORT AND THAT THE CHILD'S AND FAMILY'S PERSPECTIVES AND INFORMATION ARE IMPORTANT IN CLINICAL DECISION MAKING. PATIENT-AND-FAMILY CENTERED PRACTITIONERS ARE KEENLY AWARE THAT HEALTHCARE EXPERIENCES CAN ENHANCE PARENTS' CONFIDENCE IN THEIR ROLES AND, OVER TIME INCREASE THE COMPETENCE OF CHILDREN AND YOUNG ADULTS TO TAKE RESPONSIBILITY FOR THEIR OWN HEALTHCARE, PARTICULARLY IN ANTICIPATION OF THE TRANSITION TO ADULT SERVICE SYSTEMS. PATIENT-AND-FAMILY-CENTERED CARE IS GROUNDED IN COLLABORATION AMONG PATIENTS, FAMILIES, AND ALL HOSPITAL PERSONNEL FOR THE PLANNING, DELIVERY, AND EVALUATION OF THE DELIVERY OF HEALTHCARE TO THE CHILDREN WE SERVE, AS WELL AS IN THE EDUCATION OF HEALTHCARE WORKERS. CONTINUING OUR GOAL TO BE RECOGNIZED AS A CENTER OF EXCELLENCE IN PEDIATRIC CARE, CSH IS COMMITTED TO THE INTEGRATION OF PATIENT-AND-FAMILY-CENTERED PRINCIPLES INTO OUR HEALTHCARE POLICIES AND PRACTICES ACROSS THE CONTINUUM OF CARE PROVIDED BY OUR INSTITUTION. IN PLACING THE NEEDS OF THE CHILD AND FAMILY AT THE CENTER OF ALL ACTIVITIES WE WILL FULFILL OUR MISSION AND EMBODY THE VALUES OF PATIENT-AND-FAMILY-CENTERED CARE AND CHILDREN'S SPECIALIZED HOSPITAL BY: RESPECTING EACH CHILD AND HIS OR HER FAMILY AS PARTNERS IN CARE; HONORING DIVERSITY AND ITS EFFECT ON THE FAMILY'S EXPERIENCE AND THE PERCEPTION OF CARE THROUGH RECOGNIZING THAT EACH FAMILY IS UNIQUE IN THEIR STRUCTURE, VALUES, CULTURE, ETHNICITY, ORIENTATION, SPIRITUAL BELIEFS, SOCIAL-ECONOMICS, EDUCATIONAL, AND GEOGRAPHIC DIVERSITY; BUILDING ON THE STRENGTHS OF EACH CHILD AND FAMILY, EVEN IN DIFFICULT AND CHALLENGING SITUATIONS, BY ACKNOWLEDGING EACH FAMILY'S PRIORITIES AND LEVEL OF EXPERTISE; RECOGNIZING AND RESPECTING DIFFERENT METHODS OF COPING; IMPLEMENTING COMPREHENSIVE SERVICES THAT PROVIDE DEVELOPMENTAL, EDUCATIONAL, EMOTIONAL, ENVIRONMENTAL, AND FINANCIAL SUPPORTS; SUPPORTING AND FACILITATING CHOICE FOR THE CHILD AND FAMILY ABOUT APPROACHES TO CARE AND SUPPORT; ENSURING FLEXIBILITY IN ORGANIZATIONAL POLICIES, PROCEDURES AND PROVIDER PRACTICES TO REFLECT DIVERSITY AND MEET THE NEEDS, BELIEFS, PERSONALITIES, LIFE EXPERIENCES, SPIRITUAL AND CULTURAL VALUES OF EACH CHILD AND FAMILY; PROVIDING FORMAL AND INFORMAL SUPPORT FOR EACH CHILD AND FAMILY - COLLABORATING WITH FAMILIES AT ALL LEVELS OF HEALTHCARE, IN THE CARE OF THE INDIVIDUAL CHILD AND IN PROFESSIONAL EDUCATION, POLICY MAKING AND PROGRAM DEVELOPMENT, THROUGH THE EXCHANGE OF HONEST AND UNBIASED INFORMATION ON AN ONGOING BASIS AND IN WAYS THAT ARE USEFUL AND AFFIRMING; EMPOWERING CHILDREN AND FAMILIES TO DISCOVER THEIR OWN STRENGTHS, BUILD CONFIDENCE AND MAKE CHOICES AND DECISIONS ABOUT THEIR HEALTH THROUGH THE CREATION OF TRUE PARTNERSHIPS WITH HEALTHCARE PROFESSIONALS, AND; WORKING WITH LOCAL COMMUNITIES, SCHOOLS AND HEALTH OFFICIALS TO ENSURE THAT COMMUNITY SERVICES AND SUPPORT SYSTEMS FOR CHILDREN AND THEIR FAMILIES ARE FLEXIBLE, ACCESSIBLE AND COMPREHENSIVE. CSH MAINTAINS INPATIENT PROGRAMS FOR BRAIN INJURY, SPINAL CORD DYSFUNCTION, INFANT-TODDLERS WITH PREMATURITY AND BIRTH RELATED DISORDERS, CHRONIC ILLNESS, AND GENERAL REHABILITATION. OUTPATIENT PROGRAMS EXIST AT VARYING LEVELS OF DEVELOPMENT INCLUDING THE AUTISM PROGRAM AND THE COMPREHENSIVE FEEDING PROGRAM. SERVICES INCLUDE PHYSICIAN SUB-SPECIALTY CARE, PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY, AS WELL AS PSYCHOLOGY. THESE ARE JUST A FEW OF OUR MANY PROGRAMS AND SPECIALTY SERVICE AREAS THAT COMBINE CUTTING-EDGE TECHNOLOGY WITH CLINICAL EXPERTISE AND COMPASSIONATE CARE IN A PATIENT-AND-FAMILY-CENTERED ENVIRONMENT AT FACILITIES IN NEW BRUNSWICK, MOUNTAINSIDE, TOMS RIVER, FANWOOD, HAMILTON, BAYONNE, CLIFTON AND ROSELLE PARK. ADDITIONALLY, CSH'S STAFF PROVIDES EXPERTISE AT VARIOUS SCHOOLS, CENTERS, AND PROGRAMS FOR CHILDREN WITH SPECIAL NEEDS THROUGHOUT NEW JERSEY.
COMMUNITY BENEFIT STATEMENT; CONT'D	CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS	BRAIN INJURY ------------ HELPING A CHILD RECOVER FROM A BRAIN INJURY PRESENTS COMPLEX CHALLENGES. WHILE THE CHILD NEEDS HELP IN RECOVERING FROM HIS INJURIES, HE ALSO IS STILL DEVELOPING PHYSICALLY, EMOTIONALLY, AND INTELLECTUALLY. THE BRAIN INJURY PROGRAM AT CSH MEETS THESE CHALLENGES AND THE UNIQUE NEEDS OF CHILDREN BY PROVIDING INNOVATIVE, EXPERT AND LOVING CARE FOR THE PATIENT WITH A BRAIN INJURY ON HIS OR HER ROAD TO INDEPENDENCE. THE BRAIN INJURY PROGRAM, WHICH WAS ESTABLISHED IN 1981, IS DESIGNED TO MEET THE NEEDS OF BRAIN-INJURED, AGE APPROPRIATE PATIENTS AT ALL LEVELS OF COGNITIVE AWARENESS. THE REHABILITATION PROCESS IS THE FOUNDATION FOR LONG TERM RECOVERY. CHILDREN ARE BEST TREATED BY PEDIATRIC SPECIALISTS IN AN ENVIRONMENT ESPECIALLY GEARED TO THEIR NEEDS. CSH PROVIDES SPECIALIZED CARE FOR EACH CHILD'S UNIQUE NEEDS DURING THEIR RECOVERY IN A COMPREHENSIVE MEDICAL AND REHABILITATION SETTING. A FULL CONTINUUM OF CARE FROM COMA TO RE-ENTRY TO THE COMMUNITY IS PROVIDED FOR EACH CHILD. THE BRAIN INJURY PROGRAM IS GEARED TOWARD MAXIMAL PROGRESS THROUGH REHABILITATION WHILE EMPHASIZING THE ACHIEVEMENT OF NORMAL PEDIATRIC DEVELOPMENTAL MILESTONES. CSH'S PROFESSIONAL STAFF, WHO ARE EXPERIENCED WITH BRAIN INJURIES AND THE DEVELOPMENTAL NEEDS OF CHILDREN, INCORPORATE EACH CHILD AND FAMILY WITHIN THE REHABILITATION TEAM TO ENCOURAGE OPTIMAL PROGRESS. EACH CHILD'S INDIVIDUALIZED PROGRAM FOCUSES ON THEIR MEDICAL, PHYSICAL, COGNITIVE, AND PSYCHOSOCIAL NEEDS. IN ADDITION TO INDIVIDUAL THERAPY, GROUP THERAPY PROVIDES COMPREHENSIVE STRUCTURED STIMULATION SESSIONS FOR PATIENTS IN ORDER TO ENHANCE AND ACCELERATE AROUSAL, ALERTNESS, ORIENTATION, AND SOCIALIZATION. THE BRAIN INJURY PROGRAM ADDRESSES: - MEDICAL MANAGEMENT - SPECIALIZED NURSING CARE - PHYSICAL THERAPY - OCCUPATIONAL THERAPY - SPEECH THERAPY - AUDITORY EVALUATION - COGNITIVE STATUS - NUTRITIONAL STATUS - FAMILY SUPPORT - CASE MANAGEMENT - PSYCHOLOGICAL STATUS - CORTICAL FUNCTIONING - RE-ENTRY TO HOME, SCHOOL, AND COMMUNITY ONE OUTPATIENT COMPONENT OF THE BRAIN INJURY PROGRAM IS THE NEURO-REHABILITATION PROGRAM. THE NEURO-REHABILITATION GROUP PROGRAM IS AN INTENSIVE TREATMENT PROGRAM FOR CHILDREN AND ADOLESCENTS WHO HAVE SUSTAINED A TRAUMATIC BRAIN INJURY, OR WHO ARE EXPERIENCING COGNITIVE DYSFUNCTION AS A RESULT OF NEUROLOGICAL OR OTHER CHRONIC ILLNESS. THIS FAMILY-CENTERED PROGRAM PROVIDES THERAPEUTIC INTERVENTIONS DESIGNED TO HELP CHILDREN AND ADOLESCENTS REGAIN COGNITIVE SKILLS AND LEARN COMPENSATORY STRATEGIES THAT ARE NEEDED FOR SCHOOL AND SOCIAL FUNCTIONING. THE PROGRAM ALSO ADDRESSES MOTOR IMPAIRMENTS THAT MAY ACCOMPANY ACQUIRED BRAIN INJURY OR ILLNESS. THE GROUP PROGRAM IS DELIVERED PRIMARILY IN SMALL GROUP SETTINGS. INDIVIDUAL PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPIES MAY ALSO BE PROVIDED AS INDICATED. INVOLVEMENT IN THE GROUP PROGRAM PREPARES THE YOUNGSTER FOR RETURN TO A LARGER GROUP SETTING, USUALLY SCHOOL, AND PROVIDES HIM OR HER WITH IMPROVED SKILLS FOR PEER INTERACTION AND SOCIALIZATION. CHILDREN MAY ALSO BE SEEN THROUGH THE NEURO-REHABILITATION INDIVIDUAL PROGRAM. CHILDREN IN THE INDIVIDUAL PROGRAM ARE PRESENTLY INVOLVED IN SCHOOL AND COMMUNITY ACTIVITIES BUT REQUIRE ADDITIONAL INTERVENTION TO BETTER REGAIN OR DEVELOP COMPENSATORY SKILLS TO IMPROVE OR MAINTAIN AGE APPROPRIATE WAYS OF THINKING AND BEHAVING. SPINAL CORD PROGRAM ------------------- THE SPINAL CORD PROGRAM PROVIDES INTENSIVE AND COMPREHENSIVE REHABILITATION SERVICES FOR CHILDREN AND ADOLESCENTS WITH ACQUIRED AND CONGENITAL SPINAL CORD PROBLEMS. THE PROGRAM TREATS PATIENTS WITH ALL LEVELS OF PEDIATRIC SPINAL CORD DYSFUNCTION, FROM THE CHILD DEPENDENT ON A VENTILATOR TO THE INDIVIDUAL WITH THE LOWEST LEVEL OF SPINAL CORD INJURY. PATIENTS ARE PROVIDED WITH AN AGGRESSIVE REHABILITATION TREATMENT PROGRAM COUPLED WITH COMPREHENSIVE MEDICAL AND NURSING CARE. THE PROGRAM'S TEAM APPROACH RESULTS IN A COORDINATED TREATMENT PLAN DESIGNED TO MEET THE COMPLEX NEEDS OF EACH PATIENT AND HIS OR HER FAMILY. WHILE AN EMPHASIS IS PLACED ON ACHIEVING NORMAL DEVELOPMENTAL MILESTONES, THE TREATMENT PLAN TAKES INTO ACCOUNT THE PATIENT'S LEVEL OF INJURY, AGE, AND DEVELOPMENTAL ABILITIES IN CREATING REALISTIC EXPECTATIONS FOR PERFORMING ACTIVITIES. THE TEAM IS ADEPT AT DEVELOPING TREATMENT PLANS TO ACCOMMODATE PATIENTS WITH HIGH SPINAL CORD INJURIES (TETRAPLEGIA; QUADRAPLEGIA) WHO REQUIRE A TREMENDOUS AMOUNT OF SUPPORT, SPECIAL EQUIPMENT, AND VENTILATOR ASSISTANCE, AS WELL AS THOSE PATIENTS WITH LOW LEVEL SPINAL CORD INJURIES (PARAPLEGIA) WHO CAN GAIN VIRTUAL INDEPENDENCE. INTENSIVE MEDICAL NEEDS CAN BE SAFELY ACCOMMODATED AT CSH BY VIRTUE OF THE EXTENSIVE MEDICAL COVERAGE PROVIDED TO THE PATIENTS. PATIENTS WITH TRACHEOSTOMIES, SPECIAL FEEDING NEEDS, AND INTRAVENOUS AND CENTRAL LINES, FOR EXAMPLE, CAN BE MANAGED WHILE RECEIVING THE NECESSARY REHABILITATION THERAPY. FAMILIES AND PATIENTS ARE INTEGRALLY INVOLVED IN THE COMPREHENSIVE TREATMENT PLANNING. FAMILIES AND PATIENTS ALSO RECEIVE INSTRUCTION FROM THE STAFF IN OVERALL CARE AND THE USE OF SPECIAL EQUIPMENT. THE TEAM THOROUGHLY EDUCATES THE PATIENT AND HIS OR HER FAMILY REGARDING THE PHYSICAL CONSEQUENCES OF A SPINAL CORD INJURY AND THE REQUIRED CARE AND TREATMENT. SOME OF THE DIAGNOSTIC AND SPECIAL SERVICES AVAILABLE TO PATIENTS IN THE SPINAL CORD PROGRAM INCLUDE: - ELECTRODIAGNOSTIC TESTING - VENTILATOR ASSISTANCE PROGRAM - REFERRALS FOR EVALUATIONS FOR DIAPHRAGMATIC PACING - A FULL RANGE OF DIAGNOSTIC UROLOGIC TESTING - REFERRAL FOR BACLOFEN PUMP PLACEMENT - ORTHOTICS AND PROSTHETICS - REHABILITATION TECHNOLOGY SERVICES INCLUDING: - SEATING AND POSITIONING - MOBILITY AND ENVIRONMENTAL ACCESS - AUGMENTATIVE AND ALTERNATIVE COMMUNICATION - COMPUTER ACCESS GENERAL REHABILITATION PROGRAM ------------------------------ THE GENERAL REHABILITATION PROGRAM AT CHILDREN'S SPECIALIZED HOSPITAL OFFERS HABILITATIVE AND REHABILITATIVE SERVICES TO PATIENTS AGED 0-21 WITH, BUT NOT LIMITED TO, NEUROLOGIC, ORTHOPEDIC, DEVELOPMENTAL, CARDIOPULMONARY DISORDERS AND/OR OTHER ACQUIRED INJURIES AND ILLNESSES, THROUGH AN INTERDISCIPLINARY TEAM APPROACH. THE PROGRAM PROVIDES ASSESSMENT, TREATMENT, AND/OR SUPPORT TO THE PATIENT AND FAMILY FROM THE ACUTE INPATIENT PHASE OF REHABILITATION THROUGH THE COMMUNITY, VOCATIONAL, AND EDUCATIONAL RE-ENTRY PHASE. IN ORDER TO OFFER A CONTINUUM OF COMPREHENSIVE TRANSDISCIPLINARY SERVICE TO THESE CHILDREN AND THEIR FAMILIES, IN A COMPASSIONATE, PROFESSIONAL AND HOLISTIC FASHION, SERVICES ARE PROVIDED THROUGH BOTH INPATIENT AND OUTPATIENT PHASES OF REHABILITATIVE CARE. PATIENTS ADMITTED TO THE PROGRAM INCLUDE CHILDREN THROUGH YOUNG ADULTS 0-21 YEARS OF AGE. THEY ARE REQUIRED TO MEET THE FOLLOWING CRITERIA REGARDING THEIR MEDICAL STABILITY: INITIAL DIAGNOSTIC AND SURGICAL PROCEDURES MUST BE COMPLETED; MEDICATION REGIMEN, FLUID AND ELECTROLYTE BALANCE, AND LIFE SUPPORT SERVICES MUST BE STABILIZED. THE PATIENTS SERVED MAY HAVE IMPAIRMENTS IN AREAS INCLUDING THOSE OF, COGNITION, MOBILITY, SELF-CARE, COMMUNICATION, SOCIAL EMOTIONAL FUNCTIONING, SENSORY PROCESSING, ACADEMIC FUNCTIONING, AND FEEDING. THE PROGRAM ADDRESSES THE BEHAVIORAL, FUNCTIONAL, PHYSICAL, COGNITIVE, PSYCHOSOCIAL, VOCATIONAL, EDUCATIONAL, LEISURE, AND RECREATIONAL NEEDS OF EACH PATIENT. EVERY EFFORT IS MADE TO ACCOMMODATE THE PATIENT AND FAMILIES UNIQUE CULTURAL AND SPIRITUAL NEEDS. THE GOAL OF THE PROGRAM IS TO REDUCE THE BARRIERS, WHICH LIMIT A CHILD'S ABILITY TO PARTICIPATE IN DEVELOPMENTALLY APPROPRIATE ACTIVITIES OF HIS OR HER LIFE. TO FACILITATE A SMOOTH TRANSITION AND OPTIMIZE THE PATIENT'S ABILITY TO FULLY INTEGRATE INTO THE COMMUNITY, OUTREACH, AND EDUCATION ARE PROVIDED TO THE INTENDED DISCHARGE ENVIRONMENT (E.G. SCHOOL, HOME, COMMUNITY ORGANIZATIONS). IN ADDITION, PATIENTS ARE PROVIDED DEVELOPMENTALLY APPROPRIATE LIFE SKILLS TRAINING THROUGH GROUP AND INDIVIDUAL THERAPY AS WELL AS COMMUNITY OUT-TRIPS. SOME CHILDREN AND ADOLESCENTS SEEN THROUGH THESE PROGRAMS REQUIRE INTENSIVE MEDICAL, NURSING, AND RESPIRATORY THERAPY SUPPORT FOR RESPIRATORY PROBLEMS. THESE CHILDREN MAY HAVE CONGENITAL OR ACQUIRED RESPIRATORY PROBLEMS INCLUDING BRONCHOPULMONARY DYSPLASIA, CONGENITAL MUSCULAR PROBLEMS, AND CONGENITAL AND ACQUIRED AIRWAY AND RESPIRATORY ABNORMALITIES. INFANT/TODDLER PROGRAM ---------------------- THE INFANT TODDLER PROGRAM PROVIDES INTENSIVE AND COMPREHENSIVE REHABILITATION SERVICES FOR INFANTS AND YOUNG CHILDREN WITH MEDICAL DIFFICULTIES RELATED TO PREMATURITY AND A RANGE OF DISORDERS PRESENTING AT BIRTH. THE PROGRAM TREATS CHILDREN WHO REQUIRE ALL LEVELS OF NEONATAL CARE.
COMMUNITY BENEFIT STATEMENT; CONT'D	CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS	PATIENTS ARE TREATED WITH A COMPREHENSIVE, THERAPEUTIC PROGRAM, COUPLED WITH EXCELLENT MEDICAL AND NURSING CARE. BECAUSE OF THIS TEAM APPROACH, A COORDINATED TREATMENT PLAN CAN BE DESIGNED TO MEET THE COMPLEX NEEDS OF EACH PATIENT AND HIS OR HER FAMILY. WHILE EMPHASIZING AGE-APPROPRIATE SKILLS, THE TEAM CUSTOMIZES GOALS BASED ON EACH INFANT'S OR TODDLER'S MEDICAL STABILITY, AGE, AND DEVELOPMENTAL LEVEL TO MAXIMIZE HIS OR HER UNIQUE POTENTIAL. THE MULTISPECIALTY STAFF IS HIGHLY TRAINED IN WORKING WITH THESE CHILDREN WHO REQUIRE SPECIAL EQUIPMENT AND VENTILATOR ASSISTANCE. THE TEAM USES SPECIAL TECHNIQUES TO ENCOURAGE THE CHILD'S INTERACTION WITH THE ENVIRONMENT DURING THERAPY SESSIONS. WE ARE ABLE TO OFFER THIS SPECIALIZED TREATMENT BECAUSE OUR STAFF IS COMMITTED TO PURSUING ON-GOING EDUCATION AND TRAINING IN STATE-OF-THE-ART TECHNIQUES THAT ARE NECESSARY TO TREAT THIS SPECIAL POPULATION. THOSE INFANT AND TODDLER PATIENTS WHO NEED SPECIAL MEDICAL CARE CAN BE SAFELY ACCOMMODATED WITH CHILDREN'S SPECIALIZED HOSPITAL'S EXTENSIVE MEDICAL COVERAGE. THESE PATIENTS MAY BE TRACHEOSTOMY DEPENDENT, OXYGEN DEPENDENT, OR VENTILATOR DEPENDENT, REQUIRING CLOSE MONITORING AND FREQUENT CHANGES IN MANAGEMENT. THESE PATIENTS, AS WELL AS THOSE INFANTS AND TODDLERS WITH SPECIAL FEEDING NEEDS, INTRAVENOUS AND CENTRAL LINES, CAN BE MANAGED WHILE RECEIVING REHABILITATION THERAPY. FAMILY INVOLVEMENT IS VITAL TO A CHILD'S OVERALL DEVELOPMENT. WE STRONGLY ENCOURAGE FAMILY PARTICIPATION IN TREATMENT SESSIONS. OUR TEAM INSTRUCTS FAMILIES IN CARING FOR THEIR CHILDREN AND USING SPECIAL EQUIPMENT. FAMILIES LEARN ABOUT THERAPEUTIC INTERVENTIONS THAT PROMOTE GROWTH AND DEVELOPMENT. INFANT TODDLER MEDICAL SPECIALTIES: A NEONATOLOGIST/PEDIATRICIAN, A PHYSICIAN WHO SPECIALIZES IN NEONATAL CARE AND PEDIATRICS, HEADS THE INFANT TODDLER PROGRAM TEAM. OTHER MULTIDISCIPLINARY PEDIATRIC PROFESSIONALS PROVIDE MEDICAL SUPPORT, REHABILITATION SERVICES, AND ADDRESS DEVELOPMENTAL NEEDS WHILE AIMING TOWARD MAXIMIZING RESPIRATORY INDEPENDENCE. WHILE UPON ADMISSION MANY OF THE CHILDREN REQUIRE INTENSIVE RESPIRATORY CARE, THE GOAL FOR EACH IS TO BE TRANSITIONED BACK TO HIS OR HER HOME AND COMMUNITY. OTHER MEDICAL SPECIALISTS FOR THE INFANT TODDLER PROGRAM ARE ALSO AVAILABLE FOR CONSULTATION: EAR, NOSE, AND THROAT NEUROLOGY OPHTHALMOLOGY ORTHOPEDICS PHYSIATRY RADIOLOGY UROLOGY THE AUTISM PROGRAM ------------------ THE AUTISM PROGRAM AT CHILDREN'S SPECIALIZED HOSPITAL WORKS WITH CHILDREN THROUGH 21 YEARS OF AGE, WHO HAVE AN AUTISM SPECTRUM DISORDER. THE PROGRAM IS DEDICATED TO IMPROVING THE LIVES OF CHILDREN, ADOLESCENTS AND FAMILIES WITH AUTISM SPECTRUM DISORDERS BY PROVIDING COMPREHENSIVE EVALUATIONS, TREATMENT, COMMUNITY EDUCATION AND RESEARCH. WE ARE ONE OF THE FEW PROGRAMS IN NEW JERSEY TO PROVIDE COORDINATED, MULTIDISCIPLINARY CARE FOR CHILDREN, ADOLESCENTS AND FAMILIES AFFECTED BY AN AUTISM SPECTRUM DISORDER. WE OFFER WORKSHOPS IN ENGLISH AND SPANISH FOR FAMILIES NEWLY DIAGNOSED WITH AUTISM AS WELL AS A COMPREHENSIVE SYMPOSIUM WHERE FAMILIES HAVE THE OPPORTUNITY TO MEET WITH THE EXPERTS AND INTERACT WITH OTHER FAMILIES. AS PART OF OUR OUTREACH PROGRAMS WE PROVIDE AUTISM SCREENING/DIAGNOSIS TO SIX UNDERSERVED AREAS IN NEW JERSEY AS WELL AS EDUCATIONAL PROGRAMS FOR SCHOOLS AND COMMUNITY ORGANIZATIONS AND GROUPS. COMPREHENSIVE FEEDING PROGRAM ----------------------------- THE COMPREHENSIVE FEEDING PROGRAM IS AN OUTPATIENT PROGRAM THAT SERVES INFANTS, TODDLERS, AND YOUNG CHILDREN WHO ARE UNABLE OR REFUSE TO MAINTAIN AN ADEQUATE ORAL INTAKE OF FOOD. PROBLEMS MAY BE MEDICAL/PHYSIOLOGICAL, DEVELOPMENTAL, BEHAVIORAL, PSYCHOSOCIAL, AND INDIVIDUAL OR FAMILY RELATED. THIS TEAM UTILIZES A MULTIDISCIPLINARY APPROACH TO HAVE CHILDREN EAT PROPER FOODS AND IMPROVE NUTRITIONAL STANDING. BASED ON A PREDICTED INCIDENCE OF 25% OF INFANTS AND YOUNG CHILDREN WITH FEEDING PROBLEMS, THERE ARE THOUSANDS OF CHILDREN WHO CAN BENEFIT FROM THIS SERVICE. EACH CHILD IS PROVIDED WITH A COMPREHENSIVE EVALUATION THAT COVERS MEDICAL, PHYSIOLOGICAL, DEVELOPMENTAL, BEHAVIORAL, AND PSYCHOSOCIAL ISSUES. THE TEAM COMBINES THE EXPERTISE OF A MULTIDISCIPLINARY TEAM OF PROFESSIONALS WHOSE PRIMARY GOAL IS TO ESTABLISH FEEDING PATTERNS THAT CAN BE MAINTAINED IN THE CHILD'S NATURAL ENVIRONMENT. THE TEAM INCLUDES THE FOLLOWING: - SPEECH PATHOLOGIST - CHILD PSYCHOLOGIST - PEDIATRIC DIETITIAN - DEVELOPMENTAL PEDIATRICIAN - OCCUPATIONAL THERAPIST - PHYSICAL THERAPIST - PATIENT CARE COORDINATOR THE PROGRAM AND ITS TEAM MEMBERS EMPOWER PARENTS AND CAREGIVERS BY PROVIDING KNOWLEDGE AND TECHNIQUES, WHICH WILL ALLOW THEM TO ENGAGE THEIR CHILD IN POSITIVE THERAPEUTIC FEEDING EXPERIENCES AND INTERACTIONS. THE PROGRAM ALSO PROVIDES SUPPORT AND KNOWLEDGE TO OTHER PROFESSIONALS IN THE COMMUNITY, SUCH AS CHILDCARE PROVIDERS, WHO PARTICIPATE IN THE CHILD'S FEEDING EXPERIENCES. ADHD ---- CHILDREN'S SPECIALIZED HOSPITAL ALSO PROVIDES COMPREHENSIVE SERVICES FOR CHILDREN WITH ATTENTION-DEFICIT HYPERACTIVITY DISORDERS (AD/HD). CSH IS A SERVICE PROVIDER DEDICATED TO IMPROVING THE LIVES OF CHILDREN AND ADOLESCENTS WITH ATTENTION-DEFICIT HYPERACTIVITY DISORDER AND ASSOCIATED DISABILITIES. PROGRAMS AND SERVICES INFORMATION ================================= INPATIENT PROGRAMS ------------------ INPATIENT SERVICES ARE LICENSED FOR 90 PEDIATRIC REHABILITATION BEDS, 60 BEDS IN OPERATION AND 68 PEDIATRIC LONG-TERM CARE BEDS. INPATIENT REHABILITATION CARE PROVIDED INCLUDES MEDICAL AND NURSING CARE, COMPREHENSIVE THERAPY SERVICES, PSYCHOLOGICAL AND NEUROPSYCHOLOGICAL SERVICES, ACADEMICS, SOCIAL SERVICES, AND NUTRITIONAL SERVICES. INCLUDED IN THE THERAPY SERVICES ARE PHYSICAL THERAPY, HYDROTHERAPY, REHABILITATION TECHNOLOGY, AUGMENTATIVE COMMUNICATION, OCCUPATIONAL THERAPY, ACTIVITIES OF DAILY LIVING, SPEECH AND HEARING, RESPIRATORY THERAPY, RECREATIONAL THERAPY AND CHILD LIFE. THESE CSH SERVICES ARE PROVIDED TO ALLOW THE CHILDREN TO ATTAIN THEIR GREATEST POTENTIAL - MEDICALLY, SOCIALLY, ACADEMICALLY, AND EMOTIONALLY. THEIR FAMILIES ARE PROVIDED WITH SUPPORT AND EDUCATIONAL SERVICES TO ENSURE THEIR CHILD CAN RETURN TO THEIR HOME AND COMMUNITY. OUR LONG TERM CARE CENTERS, LOCATED IN MOUNTAINSIDE AND TOMS RIVER, NJ ARE SKILLED NURSING FACILITIES PROVIDING 24 HOUR NURSING CARE TO THE MEDICALLY INVOLVED PATIENT. WE HAVE 42 BEDS IN MOUNTAINSIDE AND 26 IN TOMS RIVER AND HAVE 8 WAIVER BEDS IN MOUNTAINSIDE IF THE NEED ARISES. OUR LONG TERM CARE PATIENTS RECEIVE RESPIRATORY AND NUTRITIONAL SERVICES, PHYSICAL, SPEECH AND OCCUPATIONAL THERAPY, AS WELL AS RECREATIONAL AND CHILD LIFE SERVICES. SOME OF THE PATIENTS ATTEND AN ON-SITE SCHOOL WHILE OTHERS ARE TRANSPORTED TO COMMUNITY SCHOOLS. OUTPATIENT PROGRAMS AND SERVICES -------------------------------- CSH PROVIDES A NUMBER OF OUTPATIENT SERVICES RELATED TO PEDIATRIC REHABILITATION AND EDUCATION. OUTPATIENT PROGRAMS OFFERED BY CSH INCLUDE SERVICES IN ASSESSMENT AND THERAPY FROM PEDIATRIC MEDICAL SPECIALISTS AND SUB-SPECIALISTS, AS WELL AS VARIOUS THERAPY DEPARTMENTS. IN ADDITION, THE FOLLOWING SPECIALTY PROGRAMS AND CLINICS ARE OFFERED: ORTHOPEDICS, NEUROLOGY, PHYSIATRY, PSYCIATRY AND DEVELOPMENTAL PEDIATRICS. IN ADDITION WE PROVIDE A PEDIATRIC PRACTICE FOR SPECIAL NEEDS CHILDREN. THE MEDICAL DAYCARE AND THE EARLY INTERVENTION PROGRAMS ARE DESIGNED TO MEET THE EDUCATIONAL, THERAPEUTIC, SOCIAL, AND EMOTIONAL NEEDS OF CHILDREN FROM BIRTH TO AGE FIVE WITH PHYSICAL HANDICAPS OR DEVELOPMENTAL DELAYS. THE EIP PROGRAM IS FUNDED BY GRANTS OR A FEE SCHEDULE FROM THE STATE OF NEW JERSEY AND THE FEDERAL GOVERNMENT. VARIOUS COMMUNITY EVENTS AND OUTPATIENT PROGRAMS AND SERVICES ARE OFFERED BY CSH. LISTED BELOW IS A BRIEF LIST OF EVENTS AND PROGRAMS: CHILDREN'S REGIONAL SWIM MEET FOR ATHLETES WITH A PHYSICAL DISABILITY GUPPIES I AND II(AQUATICS) SHARKS I AND II (AQUATICS) INTERACTIVE ORAL SENSORY - MOTOR THERAPY IN AUTISM PEDIATRIC TRAUMATIC BRAIN INJURY - THE JOURNEY CHILDREN'S INVITATIONAL TRACK AND FIELD MEET FOR ATHLETES WITH A PHYSICAL DISABILITY CAMP OPEN ARMS DAY CAMP PALS PARADISE OVERNIGHT CAMP CAMP CHATTERBOX NEURO-REHABILITATION PROGRAM PEDIATRIC PRACTICE SPINAL CORD FROM A T0 Z CHRONIC ILLNESS PROGRAM AUTISM SYMPOSIUM - HEAR FROM THE EXPERTS PARENT RESOURCE CENTER TOYS-TO-GO PROGRAM "LIGHTNING WHEELS" WHEELCHAIR & AMBULATORY SPORTS TEAM FOR THOSE WITH PHYSICAL DISABILITIES AGES 5 - 22 YEARS "FRIDAY NIGHT FEVER - MOUNTAINSIDE AND TOMS RIVER - SOCIAL GROUP FOR TEENS"
COMMUNITY BENEFIT STATEMENT; CONT'D	CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS	PROFESSIONAL TRAINING --------------------- CSH IS COMMITTED TO PROVIDING AN EDUCATIONAL SETTING WHICH WILL LEAD TO CONTINUOUS ADVANCEMENT IN PROFESSIONAL KNOWLEDGE AND SKILLS FOR THOSE INTERESTED IN PEDIATRIC REHABILITATION. CSH PROVIDES CLINICAL TRAINING AND EXPERIENCE IN THE FIELD OF PEDIATRIC REHABILITATION AND CARE OF THE DISABLED CHILD FOR RESIDENT PHYSICIANS IN THE AREAS OF PEDIATRICS AND PHYSIATRY THROUGH SCHOOLS, WHICH AFFILIATE WITH THE HOSPITAL. IN ADDITION, THE HOSPITAL TRAINS FELLOWS, NURSES, AND THERAPISTS ENROLLED IN SCHOOLS AND COLLEGES THAT ARE ALSO AFFILIATED WITH THE HOSPITAL. TO ADVANCE THE STATE OF PEDIATRIC REHABILITATION, CHILDREN'S SPECIALIZED ALSO CONDUCTS AND SUBSIDIZES PROGRAMS AND SEMINARS TO EDUCATE INTERESTED HEALTHCARE PROFESSIONALS. ACCESSIBILITY PLAN ================== EACH YEAR CHILDREN'S SPECIALIZED HOSPITAL LOOKS AT HOW TO IMPROVE ACCESS TO CARE AND THE COMMUNITY FOR OUR PATIENTS AND FAMILIES. WE REVIEW ANY BARRIERS THAT MAY EXIST AND HOW TO BEST REMOVE THEM. OUR APPROACH AND OUTCOMES ARE OUTLINED BELOW: REVIEW PLAN FOR PROMOTING ACCESSIBILITY TO ORGANIZATION-WIDE SERVICES FOR PERSONS SERVED, PERSONNEL & OTHER STAKEHOLDERS. IDENTIFY & REMOVE POTENTIAL BARRIERS TO OUR PROGRAMS & SERVICES FOR PERSONS SERVED, PERSONNEL & OTHER STAKEHOLDERS. IDENTIFY & REMOVE EXISTING BARRIERS AND MAKE PROGRAMS AND SERVICES ACCESSIBLE FOR PERSONS SERVED, PERSONNEL & OTHER STAKEHOLDERS AS SOLICITED & IDENTIFIED THROUGH AN ANNUAL ACCESSIBILITY SURVEY, AND MONTHLY ENVIRONMENT OF CARE ROUNDS. INITIATE AND IMPLEMENT NECESSARY STEPS TO DECREASE OR REMOVE IDENTIFIED BARRIER(S) FOR PERSONS SERVED, PERSONNEL & OTHER STAKEHOLDERS WITH A SPECIFIED TIMELINE. THE OPENING OF TWO NEW SITES IN BAYONNE AND CLIFTON WHERE WE PROVIDE PHYSICAL, OCCUPATIONAL AND SPEECH THERAPIES HAVE MADE OUR RENOWNED CARE MORE CONVENIENT AND ACCESSIBLE TO NEW JERSEY'S CHILDREN. INTEGRATION: ADVOCACY & EDUCATION TO ELIMINATE & REDUCE BARRIERS IN THE COMMUNITIES OF PERSONS SERVED. PROVIDE A REVIEW MECHANISM FOR "REASONABLE ACCOMMODATION" REQUESTS MADE BY PERSONS SERVED AND/OR PERSONNEL. ON AN ANNUAL BASIS, HOSPITAL LEADERSHIP REVIEWS THE PLAN FOR PROMOTING ACCESSIBILITY TO ORGANIZATION-WIDE SERVICES FOR PERSONS SERVED AND POTENTIAL PERSONS SERVED, AS WELL AS THE FINDINGS FROM THE ANNUAL ACCESSIBILITY SURVEY THAT IS CONDUCTED BY A REHABILITATION PROFESSIONAL & A PERSON SERVED. THIS REVIEW TAKES PLACE AT THE HOSPITAL'S ENVIRONMENT OF CARE, OPERATIONS & PI STEERING COMMITTEE(S). COMMUNICATION AND FOLLOW THROUGH IS DONE WITHIN THE EXISTING HOSPITAL-WIDE PERFORMANCE IMPROVEMENT STRUCTURE. BARRIERS ADDRESSED: ------------------- ACCESSIBILITY BARRIERS N=7 ARCHITECTURE 4 ENVIRONMENTAL 3 ATTITUDINAL 0 FINANCIAL 0 EMPLOYMENT 0 COMMUNICATION 0 TRANSPORTATION 0 OTHER 0 ARCHITECTURAL/ENVIRONMENTAL: ---------------------------- ENSURE THAT ALL HOSPITAL ENVIRONMENTS (INTERNAL & EXTERNAL)/NEWLY DESIGNED CONSTRUCTION AREAS ADHERE TO ADA STANDARDS. MEASURE: SERVICE ACCESS FOR PERSONS SERVED, PERSONNEL & OTHER STAKEHOLDERS DATA SOURCE: CONSTRUCTION DOCUMENTS, ENVIRONMENT OF CARE ROUNDS LOG 2011 FINDINGS: 100% OF ALL CONSTRUCTION MEETS ADA STANDARDS. SOME INITIAL BARRIERS WERE IDENTIFIED AT THE TIME OF THE SURVEY (I.E.1. REPAIR OF AN UNEVEN SURFACE IN A SIDEWALK LEADING TO A PARKING LOT; 2. AN NFPA DESIGNATED EXIT HALLWAY WITH PATIENT EQUIPMENT IN AREAS NOT DESIGNATED FOR THEM. THESE ISSUES WERE ADDRESSED BY THE 4TH QUARTER 2011. CONSISTENT MONTHLY MONITORING CONTINUES TO ENSURE COMPLIANCE. ATTITUDINAL: ------------ PROVIDE COMMUNITY STAFF EDUCATION PROGRAMS THAT AIM TO HEIGHTEN THE AWARENESS OF CAREGIVERS AND COMMUNITY MEMBERS TO THE SPECIAL NEEDS OF PERSONS SERVED. MEASURE: PROVISION OF COMMUNITY/STAFF EDUCATION TO HEIGHTEN AWARENESS OF SPECIAL NEEDS OF PERSONS SERVED. DATA SOURCE: EDUCATION DEPT. LISTING & ADVOCACY ACTIVITIES (SEE LAST SECTION) IN 2011 WE CONTINUED TO OFFER PROGRAMS TO THE COMMUNITY IN THE AREAS OF TRAUMATIC BRAIN INJURY, AUTISM SPECTRUM DISORDERS, SPINAL CORD INJURY, AND CHRONIC ILLNESS IN CHILDREN. THESE PROGRAMS ARE DAYLONG PROGRAMS AND ARE OPEN TO PARENTS AS WELL AS PROFESSIONALS WHO RECEIVE CEU'S. FINANCIAL: ---------- PROVIDE PERSONS SERVED WITH REFERRAL TO SOCIAL, LEGAL OR ECONOMIC ADVOCACY RESOURCES. CONTINUE TO OFFER "HOSPITAL ASSISTANCE PROGRAM" (CHARITY CARE PROGRAM REFERRED TO EARLIER IN THE DOCUMENT) IN ADDITION TO CUSTOMIZED PAYMENT PLANS. MEASURE: IMPROVE FINANCIAL REIMBURSEMENT FOR SERVICES DELIVERED TO PERSONS SERVED, PERSONNEL & OTHER STAKEHOLDERS DATA SOURCE: ADVOCACY ACTIVITIES (SEE LAST SECTION) & PATIENT ACCESS SERVICE DEPT. MATERIALS & POLICIES 2011 FINDINGS: SEVERAL ADVOCACY ACTIVITIES HAVE FOCUSED ON IMPROVING REIMBURSEMENT FOR PERSONS SERVED, AS WELL AS MODIFICATIONS TO "HOSPITAL ASSISTANCE PROGRAMS". IN 2011 PROVIDED $601,000 OF CHARITY CARE CHARGES TO PATIENTS WHO NEEDED CARE. IN 2011 WE PROVIDED MEDICAL EDUCATION TO PHYSICAL MEDICINE AND REHABILITATION RESIDENTS FROM UMDNJ AND WITH EXPENSES VERSUS TOTAL RECEIPTS FOR CHGME WE REALIZED A SHORTFALL OF $439,832 IN 2011 CSH PROVIDED $31,800 IN HOUSING TO STUDENTS IN THE DISCIPLINES OF PHYSICAL, OCCUPATIONAL AND SPEECH THERAPIES DURING THEIR CLINICAL TRAINING WHICH RANGED FROM 2 - 16 WEEKS. WE ARE IN THE FINAL YEAR OF A $150,000 GRANT FROM AUTISM SPEAKS WHICH WAS FOR A THREE YEAR RESEARCH PROJECT. THE NAME OF THE PROJECT IS "SENSORY BASED STRATEGIES FOR IMPROVING ADAPTIVE BEHAVIORS IN CHILDREN WITH AUTISM". POSITIVE GAIN FROM OPERATIONS, POSITIVE BOTTOM LINE, RAISE 100% FUNDS FOR NEW OUTPATIENT SITE. SIGNIFICANTLY IMPROVED FINANCIAL VIABILITY OF REHABILITATION TECHNOLOGY (OVER 90%). IMPLEMENTED MEDITECH WHICH WILL IMPROVE CONSISTENCY AND TIMELINESS OF DOCUMENTATION, LEADING TO CORRECT REIMBURSEMENT. CODING ISSUES FOR THE NPSY EVALUATIONS WERE RESOLVED. NPSY CPT CODES WERE RECONFIGURED ACCORDING TO CMS RECOMMENDATIONS. EVALUATIONS FOR 2008 UP UNTIL THE RECODING TOOK PLACE IN 6/09 WERE RE BILLED. THE MEDITECH SYSTEM HAS IMPROVED CONSISTENCY AND TIMELINESS OF ALL DOCUMENTATION IN THE MEDICAL RECORD. DEVELOPED THE TOOL TO TRACK BILLABLE TIME AND CENSUS FOR ALL SERVICES. THROUGH OUR FOUNDATION RECEIVED $380K FROM KOHL'S TO BE USED TO RUN PROGRAMS FOR THE COMMUNITY THROUGH KOHL'S CARES PROGRAMS SUCH AS AQUATICS, FRIDAY NIGHT FEVER, AUTISM COMMUNITY OUTREACH ($90K OF TOTAL) COMMUNITY CARNIVALS, INCLUDING EDUCATIONAL PIECES, AND CHILDREN'S LIGHTNING WHEELS, HOSPITAL'S SPORTS TEAM FOR AGES 5 - 22. SECURED FUNDING TO COVER COSTS OF FUNCTIONAL BEHAVIOR ASSESSMENT/CONSULTATION SERVICE. BEGAN (WITH MEDICAL) YEAR 2 OF $1 MILLION CLINICAL EXPANSION GRANT FROM THE GOVERNOR'S COUNCIL ON MEDICAL RESEARCH AND TREATMENT OF AUTISM. NEUROPSYCHOLOGY AND NEUROREHABILITATION EXCEEDED GROUP ANNUAL CENSUS BUDGETED PROJECTIONS. ACHIEVED A FAVORABLE EXPENSE VARIANCE FOR ALL DEPARTMENTS/PROGRAMS COMBINED. ELIMINATED ON-LINE ENROLLMENT PROCESS FOR THE AUTISM PROGRAM WHICH RESULTED IN $22,000 IN COST SAVINGS. INSTITUTED ON-LINE REGISTRATION PROCESS WHERE FAMILIES CAN SCHEDULE AN APPOINTMENT ON LINE. UPGRADED MEDITECH APPLICATION TO VERSION 5.65 TO SUPPORT THE REQUIREMENTS OF THE AMERICAN RECOVERY & REINVESTMENT ACT AND TO MEET THE REGULATIONS OF THE ELECTRONIC HEALTH RECORD(EHR). ACCOUNTS RECEIVABLE BALANCES HAVE BEEN REDUCED SINCE THE IMPLEMENTATION OF MEDITECH. TOTAL DAYS IN ACCOUNTS RECEIVABLE REDUCED BY APPROXIMATELY 7 DAYS YEAR END 2010. OVER ONE YEAR RECEIVABLE DOLLARS DECREASED APPROXIMATELY $4M SINCE THE END OF 2010. CHILDREN'S SPECIALIZED HOSPITAL IS THE FIRST HOSPITAL IN NEW JERSEY TESTED FOR MEDICAID INCENTIVE FUNDING FOR THE USE OF A CERTIFIED ELECTRONIC HEALTH RECORD. INSTALLED AN AUTOMATED INSURANCE VERIFICATION SYSTEM WORKING IN CONJUNCTION WITH THE MEDITECH SOFTWARE FOR IMPROVED REGISTRATION PROCESS. MAJOR BUILD OF VARIOUS FILES THAT WORK IN CONJUNCTION WITH THE CLINICAL MODULES FOR PROPER BILLING AND CODING AND IMPROVED PROCESSES FOR NOTIFICATION TO THERAPIST UPON ARRIVAL OF THE PATIENT VIA A SMART BOARD. ALL CHILDREN'S FACILITIES WERE UPGRADED TO ENABLE WIRELESS COMMUNICATIONS FOR CLINICIANS' USE OF MINI LAPTOPS TO DOCUMENT AND CHARGE DURING SESSIONS. MANAGED THE HOSPITAL'S CASH FLOW TO INTERNALLY MAINTAIN A FUND CONSISTING OF ONE YEAR PRINCIPAL AND INTEREST PAYMENTS ON THE BOND PAYMENTS APPROXIMATING $3.6 MILLION WHILE HAVING NO DRAW DOWNS ON THE HOSPITAL'S LINE OF CREDIT WITH TD BANK. CASH COLLECTIONS INCREASED BY 6% OVER 2010 WITH 3 MONTHS EXCEEDING EXPECTATION. MET ALL ANNUAL AND QUARTERLY REPORTING REQUIREMENTS RELATED TO OUR BOND ISSUE AND WAS IN FULL COMPLIANCE WITH THE REQUIRED FINANCIAL COVENANTS IN EACH QUARTER.
COMMUNITY BENEFIT STATEMENT; CONT'D	CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS	RE-NEGOTIATED SEVEN (7) MANAGED CARE CONTRACTS DURING THE YEAR RESULTING IN INCREASED REIMBURSEMENT. RECEIVED NOTIFICATION RE-AFFIRMING OUR BOND RATING WITH BOTH MOODY'S AND FITCH RATINGS IN THE 4TH QUARTER OF 2011. CONDUCTED ORGANIZATIONAL-WIDE EDUCATION PROGRAMS FOR IMPROVING CHART DOCUMENTATION, SELECTING PROPER CODING FOR BILLING AND COMPLIANCE OF ALL HIPAA REGULATIONS. COMPLETED THE 2011 OPERATING AND CAPITAL BUDGET PROMPTLY FOR BOARD APPROVAL IN DECEMBER. DEVELOPED IN-HOUSE "FLEX POOL" TO STAFF TEMPORARY VACANCIES WHICH RESULTED IN $10,059 IN COST SAVINGS. THE CASE MANAGEMENT AND SERVICE COORDINATION DEPARTMENT INCREASED REFERRALS OVER 2010 BY 16% AND 12% RESPECTFULLY. COMMUNICATION: -------------- PROMOTE FULL PROGRAM AND SERVICE ACCESS FOR PERSONS SERVED BY RESPECTING ETHNO-CULTURAL DIVERSITY. ENSURE THAT LANGUAGE & CULTURAL DIFFERENCES ARE NOT BARRIERS TO ACCESSING & PARTICIPATING IN HOSPITAL PROGRAMS (I.E. TRANSLATION SERVICES ARE AVAILABLE & OTHER COMMUNICATION RESOURCES). MEASURE: COMMUNICATION SERVICE ACCESS FOR PERSONS SERVED DATA SOURCE: CONTRACTS FOR VERBAL AND WRITTEN TRANSLATION TO PROMOTE COMMUNICATION & ADMINISTRATIVE POLICY ON MEETING COMMUNICATION NEEDS. TRANSPORTATION: --------------- PROVIDE TRANSPORTATION SERVICES AS NEEDED THROUGH THE PATIENT CARE COORDINATION DEPARTMENT. MEASURE: MAKE AVAILABLE TRANSPORTATION ACCESS FOR PERSONS SERVED DATA SOURCE: PATIENT CARE COORDINATION DEPT. LISTING 2011 FINDINGS: NO BARRIERS IDENTIFIED. ADMISSION TO HOSPITAL PROGRAM: ------------------------------ GRANT ADMISSION TO PROGRAM SERVICES & ACTIVITIES TO THOSE WITH AN IDENTIFIED NEED THAT IS VALIDATED BY MEETING PRE-ESTABLISHED ADMISSION CRITERIA/SCREENING. MEASURE: PATIENT REFERRALS THAT MEET PRE-ESTABLISHED ADMISSION CRITERIA/SCREENING ARE OFFERED RELEVANT SERVICES/ADMISSION DATA SOURCE: PRE-ADMISSION DEPT. LOG. 2011 FINDINGS: 100% OF ALL ADMISSIONS MEETING CRITERIA/SCREENING ARE OFFERED ADMISSION. IF PATIENT NOT OFFERED ADMISSION, APPROPRIATE REFERRALS MADE. EMPLOYMENT: ----------- RECRUIT QUALIFIED EMPLOYEES WITH "REASONABLE ACCOMMODATIONS" FOR PERSONS WITH ACTIVITY LIMITATIONS IN ORDER TO PROMOTE EQUAL EMPLOYMENT/PARTICIPATION OPPORTUNITIES THROUGHOUT ALL ORGANIZATIONAL LEVELS. MEASURE: ADHERENCE TO STATE/FEDERAL REGULATIONS RE: EMPLOYMENT WITHOUT REGARD TO ACTIVITY LIMITATIONS, RACE, COLOR, NATIONAL ORIGIN OR AGE & PARTICIPATE IN COMMUNITY EFFORTS TO PROMOTE OPPORTUNITIES FOR PERSONS WITH ACTIVITY LIMITATIONS DATA SOURCE: HUMAN RESOURCE DEPT. FILES. 2011 FINDINGS: 100% OF ALL JOB APPLICANTS FOLLOWED "STANDARD" PROCEDURES FOR EMPLOYMENT APPLICATION PROCESS AND ONGOING EMPLOYMENT. OTHER: ------ REMAIN ACTIVELY INVOLVED IN COMMITTEES AT THE LOCAL, STATE & NATIONAL LEVEL WHERE POLICIES, REGULATIONS AND PROGRAM PLANNING IMPACT PEDIATRIC SERVICES & THEIR ACCESSIBILITY & DELIVERY. MEASURE: CONTINUED CHILDREN'S PRESENCE AT LOCAL, STATE, FEDERAL LEVEL PROGRAM PLANNING RE: SERVICE DELIVERY FOR PERSONS SERVED, ACTING AS AN ADVOCATE FOR PERSONS SERVED. MEMBERS OF FAMILY AND PATIENT CENTERED CARE ALONG WITH PRESIDENT & CEO TRAVELED TO WASHINGTON, DC TO MEET WITH LEGISLATURES WITH REGARD TO INSURANCE COVERAGE FOR INDIVIDUALS WITH DISABILITIES. DATA SOURCE: ADVOCACY ACTIVITIES. 2011 FINDINGS: SEVERAL ADVOCACY ACTIVITIES FOR PERSONS SERVED. LEADERSHIP - NEW YORK MAGAZINE - TOP CHILDREN'S HOSPITAL RANKING. - HOSPITAL STAFF, SENIOR LEADERSHIP BOARD REPRESENTATION ON THE ALLIANCE FOR THE BETTERMENT OF CITIZENS WITH DISABILITIES (ABCD). INVOLVED WITH ADVOCATING FOR EARLY INTERVENTION THROUGH THIS ORGANIZATION. - LEADERSHIP SERVES ON THE MAYOR'S ADVISORY COUNCIL ON BEHALF OF CHILDREN AND YOUNG ADULTS WITH DEVELOPMENTAL DISABILITIES IN THE TOWNSHIP OF DOVER. - CEO APPOINTED NJHA BOARD OF DIRECTORS - CEO SERVES ON NACH BOARD OF DIRECTORS AND PUBLIC POLICY COUNCIL - CEO SERVES ON NJ STATE CHAMBER OF COMMERCE BOARD OF DIRECTORS - PARTICIPANT IN THE HEALTH CARE TASK FORCE THAT IS DEVELOPING A PLAN TO ADDRESS CRITICAL HEALTH CARE ISSUES IN THE STATE INCLUDING COST OF HEALTH INSURANCE, EXPANSION OF MEDICAID, AND THE NEED FOR WORKFORCE TO BE TRAINED TO BE ABLE TO MEET OUR NEEDS. - NJ LIFE - DOCTORS WHO MAKE A DIFFERENCE - NJBIZ - HEALTHCARE HEROES - DOCTOR OF THE YEAR - CEO CHAIR FOR THE NJ CHAMBER A WORKGROUP ON EMPLOYMENT OF PEOPLE WITH DISABILITIES. - CEO, CDO AND VP-HUMAN RESOURCES ARE GRADUATES OF LEADERSHIP NJ - COO IS A MEMBER OF THE STATE INTERAGENCY COORDINATING COUNCIL WHICH OVERSEES THE DELIVERY OF EARLY INTERVENTION SERVICES THROUGHOUT THE STATE. MEMBERS ARE APPOINTED BY THE GOVERNOR. - MEDICAL DIRECTOR IS MEMBER OF THE DEPARTMENT OF HEALTH CARDIAC TASK FORCE - VP BUSINESS & PROGRAM DEVELOPMENT SERVES AS CHAIR FOR THE INTERNATIONAL PEDIATRIC REHABILITATION COLLABORATIVE (IPRC), AN INTERNATIONAL CONSORTIUM OF FORTY ORGANIZATIONS WITH A MISSION TO PROMOTE QUALITY PEDIATRIC REHABILITATION CARE - NJ LIFE - BEST DOCTOR - PEDIATRIC DEVELOPMENTAL & BEHAVIOR PROBLEMS - TOP DOCTOR - NJ - CASTLE CONNELLY - NJ LIFE BEST DOCTOR - GENERAL NEUROLOGY - NJ LIFE - BEST DOCTOR - PEDIATRIC PHYSICAL MEDICINE & REHABILITATION - MODERN HEALTHCARE - LARGEST SKILLED NURSING COMPANY - RESIDENCY, INTERN, STUDENT, AND FELLOW PROGRAMS FOR ADMINISTRATION, MEDICINE, NURSING, PHARMACY, THERAPIES. - PARTNERSHIP WITH THE EDUCATION SUPERVISOR FROM THE COMMISSION OF SPECIAL EDUCATION TO COORDINATE EDUCATIONAL AND CLINICAL REHABILITATION SERVICES TO ENSURE POSITIVE TRANSITIONS TO SCHOOL AND COMMUNITY. - PRESIDENTIAL APPOINTEE ON THE INTERAGENCY AUTISM COORDINATING COUNCIL THAT SETS THE NATIONAL STRATEGIC PLAN FOR THE CONDUCT OF & SUPPORT FOR AUTISM RESEARCH. - APPOINTED TO THE TRAUMATIC BRAIN INJURY TASK FORCE - DONATE EQUIPMENT TO THE UNITED SPINAL ORGANIZATION THAT HELPS DISTRIBUTE ADAPTIVE EQUIPMENT TO THE NEEDY AND THIRD WORLD COUNTRIES. - MEMBER, NEW JERSEY HOSPITAL ASSOCIATION (NJHA). - NJHA REHABILITATION ADVISORY COMMITTEE - CLINICAL ADVISORY BOARD FOR SUNRISE MEDICAL - ADVOCATE FOR CHANGE IN HOUSING WITH AREA REALTORS AS WELL AS SECTION 8 HOUSING FOR OTHER FAMILIES. - CLINICAL CONSORTIUM FOR REHABILITATION TECHNOLOGY WITH AREA HOSPITALS, CLINICS AND DEVELOPMENTAL CENTERS. - OPENED NEUROREHABILITATION PROGRAM IN NEW BRUNSWICK. - PAST PRESIDENT OF THE NJ CHAPTER OF THE AMERICAN ACADEMY OF PEDIATRICS. - BOARD MEMBER, NEW JERSEY'S PEDIATRIC COUNCIL ON RESEARCH AND EDUCATION (PCORE) AND NEW JERSEY AAP CHAPTER. - NATIONAL INSTITUTE ON DISABILITY AND REHABILITATION RESEARCH (NIDRR) GRANT WITH NEW JERSEY INSTITUTE OF TECHNOLOGY. - MEDICAID PHYSICIAN GROUP MEETINGS TO ENSURE UNDERSTANDING OF REHABILITATION TECHNOLOGY SERVICES AND EQUIPMENT. - NASW-NJ CONFERENCE COMMITTEE. - TOP DOCS NAMED BY NEW JERSEY MONTHLY. - UNION COUNTY CIACC - ADVISORY BOARD FOR OCEAN INC. - HEAD START - OCEAN COUNTY YMCA - CEO, FAMILY AND PATIENT REPRESENTATIVES PRESENTED ON CAPITOL HILL WITH NACHRI. - TARGETED EARLY INTERVENTION PROGRAM EVALUATION TEAM FOR MERCER COUNTY, NJ. - REPRESENTATION ON THE DIVISION OF DEVELOPMENTAL DISABILITIES COMMITTEE THAT MAKE RECOMMENDATIONS TO THE STATE OF NJ AND FEDERAL GOVERNMENT WITH REGARD TO THE IDEA AND HOW LAWS IMPACT CHILDREN WE SERVE. - SERVE ON THE ADVOCACY AND PUBLIC AFFAIRS COMMITTEE TO THE BRAIN INJURY ASSOCIATION OF NEW JERSEY (BIANJ). - NJ SPECIAL EDUCATION & BRAIN INJURY TASK FORCE - MEMBER OF THE GOVERNOR'S COMMISSION ON RECREATIONAL OPPORTUNITIES FOR INDIVIDUALS WITH DISABILITIES. - MEMBERS OF THE CHILD AND ADOLESCENT TASK FORCE OF THE BIANJ. - CHILDREN'S MENTAL HEALTH EVIDENCE BASED PRACTICE COMMITTEE SPONSORED BY FACT - PSYCHOLOGY STAFF ARE MEMBERS OF VARIOUS GROUPS INCLUDING ASPERGER SYNDROME EDUCATION NETWORK (ASPEN) AND CENTER FOR OUTREACH AND SERVICES FOR THE AUTISM COMMUNITY (COSAC). - COMMUNITY AGENCY REPRESENTATIVE TO SCOTCH PLAINS-FANWOOD SCHOOLS AS PART OF THEIR SELF-MONITORING FOR NJ DEPT OF EDUCATION. - SERVICE ON MERCER COUNTY PROFESSIONAL ADVISORY COMMITTEE. - PRESIDENT NEW JERSEY NEUROPSYCHOLOGICAL SOCIETY. - TREASURER OF THE NEW JERSEY NEUROPSYCHOLOGICAL SOCIETY. - BOARD MEMBER OF THE NEW JERSEY NEUROPSYCHOLOGICAL SOCIETY. - NATIONAL TASK FORCE MEMBER FOR FAMILY-CENTERED CARE SURVEY INITIATIVE. - PARTNER WITH COSAC TO PROVIDE EDUCATION AND SUPPORT SERVICES TO FAMILIES OF CHILDREN WITH AUTISM. - SOMERSET & HUNTERDON PSYCHOLOGICAL ASSOCIATION - EXECUTIVE BOARD - CHAIR LEADERSHIP NEW JERSEY - CHAIR WATERWORKS CONSERVANCY - BOARD OF ETHICS - LIFE TIME SUPPORT DIVISION OF ARC - GUARDIANSHIP & ADVOCACY FOR YOUNG ADULTS & ADULTS WITH DISABILITIES - MEMBER OF THE GRANTS REVIEW COMMITTEE FOR NIDRR. - "BRIDGES" PROGRAM TO HELP CHILDREN TRANSITION BACK TO SCHOOL. - FAMILY FACULTY A PART OF ORGANIZATION WIDE WORK GROUPS AND COMMITTEES, AS WELL AS SUPPORTS FOR FAMILIES ON INPATIENT UNITS. - LIGHTNING WHEELS - INTERNATIONAL REPRESENTATION FOR OUR WHEELCHAIR & AMBULATORY SPORTS TEAM.
COMMUNITY BENEFIT STATEMENT; CONT'D	CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS	- MEET DIRECTOR FOR INVITATIONAL TRACK & FIELD MEET FOR ATHLETES AGES 5 - 22 WITH A PHYSICAL DISABILITY CHAIR - UNION COUNTY HEALTHCARE EMERGENCY MANAGEMENT COMMITTEE - MEMBER NJHA EMERGENCY MANAGEMENT CONSTITUENCY GROUP - MEMBER MIDDLESEX COUNTY OEM, PUBLIC HEALTH & HOSPITALS COMMITTEE. - MEET DIRECTOR FOR TRI-STATE SWIM MEET FOR ATHLETES AGES 5 TO ADULT WITH A PHYSICAL DISABILITY - MEMBER NJ CENTRAL EAST NORTH ASPR GRANT COMMITTEE - MEMBER NJHA ADVISORY COMMITTEE FOR "WEATHERING THE STORM" - EXPANDED OUTREACH TO THE SPANISH SPEAKING COMMUNITY THROUGH EDUCATION ON SPANISH LANGUAGE TELEVISION, RADIO STATIONS AND NEWSPAPERS. - EFFECT OF YOGA FOR CHILDREN WITH AUTISM SPECTRUM DISORDERS - - PROFESSOR - UNION COUNTY COLLEGE PTA PROGRAM. - MEMBER COUNCIL OF HOSPITAL PT DIRECTORS. - MEMBER - APTANJ PRACTICE COMMITTEE. - STAFF ARE MEMBERS OF APTA,AOTA,ASHA AND APA. - SAFE KIDS MIDDLESEX COUNTY MEMBER. - SECRETARY APTA SECTION ON PEDIATRICS HOSPITAL BASED SPECIAL INTEREST GROUP. - NATIONAL INSTITUTE OF HEALTH RESEARCH PROGRAM EXAMINING REGRESSION IN AUTISM. - MEDICATION TRIALS RESEARCH - AUTISM. - REPRESENTATION ON THE BOARD OF COSAC. - BEST PRACTICES TASKFORCE - AUTISM, AMERICAN SPEECH AND HEARING ASSOCIATION (ASHA). - FACILITATED CLOSURE OF THE NJ RECYCLING PROGRAM FOR ADAPTIVE EQUIPMENT PROGRAM. - MEMBER, EDUCATION AND TRAINING COMMITTEE - GOVERNOR'S CONFERENCE ON RECREATION FOR INDIVIDUALS WITH DISABILITIES. - MEMBER, NJ NEUROPSYCHOLOGY BOARD OF TRUSTEES. - SECRETARY, EXECUTIVE COMMITTEE OF BRAIN INJURY INTERDISCIPLINARY SPECIAL INTEREST GROUP (BI-ISIG) OF THE AMERICAN CONGRESS OF REHABILITATION MEDICINE (ACRM). - MEMBER NATIONAL PEDIATRIC REHAB DIRECTORS FORUM - NJ STATE REP APTA REGION IV SECTION ON PEDIATRICS. - MEMBER NATIONAL PEDIATRIC REHAB DIRECTORS FORUM - NJ CHAPTER HFMA - DIRECTOR - NJ CHAPTER HFMA ANNUAL INSTITUTE COMMITTEE CO-CHAIR - AMERICAN BOARD OF PHYSICAL THERAPY SPECIALTIES (ABPTS) MEMBER SPECIALIZATION ACADEMY OF CONTENT EXPERTS (SACE) WRITER FOR PEDIATRIC SPECIALTY AREA. - NJ BRAIN INJURY ASSOCIATION - CHILD & ADOLESCENT COMMITTEE - CHILD PASSENGER SAFETY COALITION - MEMBER - ANTI-BULLYING TASK FORCE, MCKINLEY SCHOOL, WESTFIELD, NJ - WESTFIELD PUBLIC SCHOOLS SPECIAL EDUCATION COMMITTEE - MIDDLESEX COUNTY SAFE KIDS BOARD - NJHFMA BOARD - NJHFMA ADVISORY COUNCIL - NATIONAL HFMA NAC COMMITTEE - CHAIR, IMPLEMENTATION OF THE FEDERAL HEALTH INFORMATION TECHNOLOGY (HIT) COMMITTEE - CHAMBER OF COMMERCE EXECUTIVE COMMITTEE - MEDICAL ADVISOR, STAY FOCUSED INC., A PROGRAM DEVOTED TO HELPING SPECIAL NEEDS KIDS BECOME CERTIFIED IN SCUBA DIVING - MEDICAL ADVISOR, PEAK POTENTIAL INC., AN ADAPTIVE ROCK CLIMBING PROGRAM FOR SPECIAL NEEDS CHILDREN AND ADOLESCENTS - APPOINTED TO THE NEW JERSEY STATE COMMITTEE ON PEDIATRIC EMERGENCY SERVICES - RECEIVED $1 MILLION GOVERNOR'S COUNCIL ON AUTISM GRANT - CHAIR OF THE STATE PERFORMANCE PLAN COMMITTEE FOR THE STATE INTERAGENCY COORDINATING COUNCIL - MEMBER OF THE MAYOR'S ADVISORY COUNCIL ON DEVELOPMENTAL DISABILITIES, TOMS RIVER - CHAIR OF SAFE KIDS COMMUNITY PROGRAM COMMITTEE - PEDIATRIC LIAISON SERVICE TO PROVIDE TRAINING TO COMMUNITY PEDIATRICIANS REGARDING DEVELOPMENTAL SURVEILLANCE/SCREENING IN THE MEDICAL HOME - APPOINTED BY THE SECRETARY OF HEALTH AND HUMAN SERVICES TO INTERAGENCY AUTISM COORDINATING COUNCIL (IACC) - MEMBER, NJ GOVERNOR'S COUNCIL ON MEDICAL RESEARCH AND TREATMENT OF AUTISM - AUTISM FAMILY SERVICES OF NJ AWARD FOR EXCELLENCE AND DEDICATION TO FAMILIES OF KIDS WITH AUTISM - MEMBER, BOARD OF DIRECTORS NEW JERSEY SPEECH AND HEARING ASSOCIATION (NJSHA) - NJSHA BOARD LIAISON TO THE AAC COMMITTEE - NJSHA CLINICAL FORUM CHAIR - REPRESENTATION ON THE LEADERSHIP OF THE DIVISION OF DEVELOPMENTAL DISABILITIES - SPECIAL RECOGNITION FROM NACHRI FOR FEDERAL ADVOCACY FOR CHILDREN - MEMBER, MERCER COUNTY PROFESSIONAL ADVISORY COMMITTEE - MEMBER, BOARD OF TRUSTEES FOR NATIONAL ASSOCIATION FOR THE MENTALLY ILL (NAMI)-NJ - PROFESSORS/LECTURERS AT VARIOUS LOCAL UNIVERSITIES. - PRESIDENT OF THE NJ CHAPTER OF THE AMERICAN ACADEMY OF PEDIATRICS - RECEIVED GRANT FROM KOHL'S KIDS ABILITIES PROGRAM TO RAISE AUTISM AWARENESS COMMUNITY INTEGRATION INTERNATIONALLY - SPONSORED THREE DISABILITY AWARENESS CARNIVALS AT DIFFERENT LOCATIONS THROUGHOUT NJ, ATTENDED BY OVER 1,500 FAMILIES - MEMBER, PHILANTHROPY LEADERSHIP COUNCIL - ASSOCIATION OF FUNDRAISING PROFESSIONALS - APPOINTED TO THE NEW JERSEY GOVERNOR'S COUNCIL FOR MEDICAL RESEARCH AND TREATMENT OF AUTISM. - RECEIVED THE NJ COMMUNITY SERVICE AWARD PRESENTED BY AUTISM FAMILY SERVICES. - LONG TERM CARE RECOGNIZED IN "US NEWS & WORLD REPORT" ARTICLE, "AMERICA'S BEST NURSING HOMES" - MEMBER, U.S. SECRETARY OF HEALTH AND HUMAN SERVICES INTERAGENCY AUTISM COORDINATING COUNCIL - ACHIEVED AMERICAN COLLEGE OF GRADUATE MEDICAL EDUCATION ACCREDITATION FOR OUR DEVELOPMENTAL-BEHAVIOR PEDIATRICS FELLOWSHIP (FIRST AND ONLY ONE IN NEW JERSEY) - MULTIPLE PRESENTATIONS AT NATIONAL MEETINGS - MEMBER OF THE UNITED STATES INTERAGENCY AUTISM COORDINATING COUNCIL - MEMBER OF EDUCATIONAL ACCREDITATION SURVEY TEAM, MEDICAL SOCIETY OF NEW JERSEY - MEMBER OF NEW JERSEY GOVERNOR'S COUNCIL ON TRAUMATIC BRAIN INJURY - MEMBER OF THE ADVISORY COUNCIL, ELIZABETH BOGGS CENTER, NEW BRUNSWICK - PRESIDENT, NEW JERSEY ASSOCIATION OF NEURODEVELOPMENTAL PEDIATRICIANS - VICE CHAIR FOR NEW JERSEY'S CATASTROPHIC RELIEF FUND FOR CHILDREN - COMPLETED TENURE AS PRESIDENT OF THE NEW JERSEY CHAPTER OF THE AMERICAN ACADEMY OF PEDIATRICS AND SERVES ON THE EXECUTIVE BOARD AS IMMEDIATE PAST PRESIDENT - ESTABLISHED RESEARCH COLLABORATIONS WITH VARIOUS UNIVERSITIES NATIONALLY - TREASURER, TRI-STATE WHEELCHAIR AND AMBULATORY ATHLETICS - BOARD MEMBER OF STAY-FOCUSED, A PROGRAM DEVOTED TO HELPING SPECIAL NEEDS KIDS BECOME CERTIFIED IN SCUBA DIVING - MEMBER SAFE KIDS UNION COUNTY - SECRETARY - TOMS RIVER SUNRISE ROTARY - DEVCO BOARD MEMBER - CAUCUS CEC OF NJ - NJ COUNCIL OF TEACHING HOSPITALS
STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENT	CORE FORM, PART III; QUESTION 4D	EXPENSES INCURRED IN PROVIDING VARIOUS OTHER MEDICALLY NECESSARY PEDIATRIC HEALTHCARE SERVICES TO ALL CHILDREN IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. PLEASE REFER TO THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT INCLUDED IN SCHEDULE O.
DISCLOSURE INFORMATION	CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7	ROBERT WOOD JOHNSON HEALTHCARE CORPORATION IS THE SOLE MEMBER OF THIS ORGANIZATION. ROBERT WOOD JOHNSON HEALTHCARE CORPORATION HAS THE RIGHT TO ELECT THE MEMBERS OF THIS ORGANIZATION'S BOARD OF TRUSTEES AND HAS CERTAIN RESERVED POWERS AS DEFINED IN THIS ORGANIZATION'S BYLAWS.
DISCLOSURE INFORMATION	CORE FORM, PART VI, SECTION B; QUESTION 11b	THE ORGANIZATION'S FEDERAL FORM 990 WAS provided TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE ("IRS") AND AFTER REVIEW BY THE ORGANIZATION'S AUDIT AND COMPLIANCE COMMITTEE. THE CHILDREN'S SPECIALIZED HOSPITAL BOARD OF TRUSTEES HAS DELEGATED TO THE AUDIT AND COMPLIANCE COMMITTEE THE RESPONSIBILITY TO OVERSEE, REVIEW AND APPROVE OF THE FEDERAL FORM 990, INCLUDING THE PREPARATION, REVIEW AND FILING PROCESS. AS PART OF THE TAX RETURN PREPARATION PROCESS THE ORGANIZATION HIRED A PROFESSIONAL CPA FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION TO PREPARE THE FEDERAL FORM 990. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE ORGANIZATION'S FINANCE PERSONNEL AND VARIOUS OTHER INDIVIDUALS OF THE ORGANIZATION TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE ORGANIZATION'S FINANCE PERSONNEL AND OTHER INDIVIDUALS FOR THEIR REVIEW. THE ORGANIZATION'S FINANCE PERSONNEL AND OTHER INDIVIDUALS REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE ORGANIZATION'S FINANCE PERSONNEL AND VARIOUS OTHER INDIVIDUALS FOR FINAL REVIEW AND APPROVAL PRIOR TO PRESENTATION OF THE FEDERAL FORM 990 TO THE MEMBERS OF THE CHILDREN'S SPECIALIZED HOSPITAL AUDIT AND COMPLIANCE COMMITTEE.
DISCLOSURE INFORMATION	CORE FORM, PART VI, SECTION B; QUESTION 12	THE ORGANIZATION REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. ANNUALLY ALL MEMBERS OF THE BOARD OF TRUSTEES, OFFICERS AND SENIOR MANAGEMENT PERSONNEL ARE REQUIRED TO REVIEW THE EXISTING CONFLICT OF INTEREST POLICY AND COMPLETE A QUESTIONNAIRE. THE COMPLETED QUESTIONNAIRES ARE RETURNED TO THE ORGANIZATION'S CHIEF COMPLIANCE OFFICER FOR REVIEW. THEREAFTER THE CHIEF COMPLIANCE OFFICER PREPARES A SUMMARY OF THE COMPLETED QUESTIONNAIRES WHICH CONTAINS INFORMATION DISCLOSED ON AN INDIVIDUAL BY INDIVIDUAL BASIS. THE CHIEF COMPLIANCE OFFICER THEN PRESENTS THIS SUMMARY TO THE ORGANIZATION'S AUDIT AND COMPLIANCE COMMITTEE FOR THEIR REVIEW AND DISCUSSION.
DISCLOSURE INFORMATION	CORE FORM, PART VI, SECTION B; QUESTION 15	THE ORGANIZATION'S BOARD OF TRUSTEES HAS AN EXECUTIVE COMPENSATION COMMITTEE ("COMMITTEE"). THE COMMITTEE HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY WHICH IT FOLLOWS WHEN IT REVIEWS AND APPROVES OF THE COMPENSATION AND BENEFITS OF THE ORGANIZATION'S SENIOR MANAGEMENT, INCLUDING THE PRESIDENT/CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER. THE COMMITTEE REVIEWS THE "TOTAL COMPENSATION" OF THE INDIVIDUALS WHICH IS INTENDED TO INCLUDE BOTH CURRENT AND DEFERRED COMPENSATION AND ALL EMPLOYEE BENEFITS, BOTH QUALIFIED AND NON-QUALIFIED. THE COMMITTEE'S REVIEW IS DONE ON AT LEAST AN ANNUAL BASIS AND ENSURES THAT THE "TOTAL COMPENSATION" OF SENIOR MANAGEMENT OF THE ORGANIZATION IS REASONABLE. THE ACTIONS TAKEN BY THE COMMITTEE ENABLE THE ORGANIZATION TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 4958 WITH RESPECT TO THE TOTAL COMPENSATION OF CERTAIN MEMBERS OF THE SENIOR MANAGEMENT TEAM, INCLUDING THE PRESIDENT/CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER. THE THREE FACTORS WHICH MUST BE SATISFIED IN ORDER TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS ARE THE FOLLOWING: 1. THE COMPENSATION ARRANGEMENT IS APPROVED IN ADVANCE BY AN "AUTHORIZED BODY" OF THE APPLICABLE TAX-EXEMPT ORGANIZATION WHICH IS COMPOSED ENTIRELY OF INDIVIDUALS WHO DO NOT HAVE A "CONFLICT OF INTEREST" WITH RESPECT TO THE COMPENSATION ARRANGEMENT; 2. THE AUTHORIZED BODY OBTAINED AND RELIED UPON "APPROPRIATE DATA AS TO COMPARABILITY" PRIOR TO MAKING ITS DETERMINATION; AND 3. THE AUTHORIZED BODY "ADEQUATELY DOCUMENTED THE BASIS FOR ITS DETERMINATION" CONCURRENTLY WITH MAKING THAT DETERMINATION. THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES EACH OF WHO ARE INDEPENDENT AND ARE FREE FROM ANY CONFLICTS OF INTEREST. THE COMMITTEE RELIED UPON APPROPRIATE COMPARABLE DATA; SPECIFICALLY THE COMMITTEE OBTAINED A WRITTEN COMPENSATION STUDY FROM AN INDEPENDENT FIRM WHICH SPECIALIZES IN THE REVIEWING OF HOSPITAL AND HEALTHCARE SYSTEM EXECUTIVE COMPENSATION AND BENEFITS THROUGHOUT THE UNITED STATES. THIS STUDY USED COMPARABLE GEOGRAPHIC AND DEMOGRAPHIC MARKET DATA INCLUDING BUT NOT LIMITED TO SIMILAR SIZED HOSPITALS, # OF LICENSED BEDS AND NET PATIENT SERVICE REVENUE. THE COMMITTEE ADEQUATELY DOCUMENTED ITS BASIS FOR ITS DETERMINATION THROUGH THE TIMELY PREPARATION OF WRITTEN MINUTES OF THE COMPENSATION COMMITTEE MEETINGS DURING WHICH THE EXECUTIVE COMPENSATION AND BENEFITS WAS REVIEWED AND SUBSEQUENTLY APPROVED. THE ACTIONS OUTLINED ABOVE WITH RESPECT TO THE COMMITTEE AND THE ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS ONLY APPLIES TO CERTAIN SENIOR MANAGEMENT PERSONNEL, INCLUDING BUT NOT LIMITED TO THE PRESIDENT/CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER. THE COMPENSATION AND BENEFITS OF THE OTHER INDIVIDUALS CONTAINED IN THIS FORM 990 IS REVIEWED ANNUALLY BY THE PRESIDENT/CHIEF EXECUTIVE OFFICER WITH ASSISTANCE FROM ORGANIZATION'S HUMAN RESOURCES DEPARTMENT IN CONJUNCTION WITH THE INDIVIDUAL'S JOB PERFORMANCE DURING THE YEAR AND IS BASED UPON OTHER OBJECTIVE FACTORS DESIGNED TO ENSURE THAT REASONABLE AND FAIR MARKET VALUE COMPENSATION IS PAID BY THE ORGANIZATION. OTHER OBJECTIVE FACTORS INCLUDE MARKET SURVEY DATA FOR COMPARABLE POSITIONS, INDIVIDUAL GOALS AND OBJECTIVES, PERSONNEL REVIEWS, EVALUATIONS, SELF-EVALUATIONS AND PERFORMANCE FEEDBACK MEETINGS.
DISCLOSURE INFORMATION	CORE FORM, PART VI, SECTION C; QUESTION 19	THE ORGANIZATION HAS ISSUED TAX-EXEMPT BONDS TO FINANCE VARIOUS CAPITAL IMPROVEMENT PROJECTS, RENOVATIONS AND EQUIPMENT. IN CONJUNCTION WITH THE ISSUANCE OF THESE TAX-EXEMPT BONDS, THE ORGANIZATION'S FINANCIAL STATEMENTS WERE INCLUDED WITH THE TAX-EXEMPT BOND PROSPECTUS WHICH WAS MADE AVAILABLE TO THE GENERAL PUBLIC FOR REVIEW. IN ADDITION, THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE state OF NEW JERSEY department of the treasury.
COMPENSATION INFORMATION	CORE FORM, PART VII AND SCHEDULE J	PHILIP SALERNO IS A MEMBER OF THIS ORGANIZATION'S BOARD OF TRUSTEES BUT WORKS ON A FULL-TIME BASIS 55 HOURS PER WEEK AS THE PRESIDENT AND CHIEF DEVELOPMENT OFFICER OF CHILDREN'S SPECIALIZED HOSPITAL FOUNDATION; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION.
RELATED HOURS DISCLOSURE	CORE FORM, PART VII, SECTION A, COLUMN B	THIS ORGANIZATION IS PART OF the robert wood johnson health network; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY network ("network"). THE network INCLUDES BOTH FOR-PROFIT AND NOT FOR-PROFIT ORGANIZATIONS. CERTAIN BOARD OF TRUSTEE MEMBERS, OFFICERS AND/OR DIRECTORS LISTED ON CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 MAY HOLD SIMILAR POSITIONS WITH BOTH THIS ORGANIZATION AND OTHER AFFILIATES WITHIN THE SYSTEM. THE HOURS SHOWN ON THIS FORM, 990 FOR BOARD MEMBERS WHO RECEIVE NO COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, REPRESENTS THE ESTIMATED HOURS DEVOTED PER WEEK FOR THIS ORGANIZATION. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF TRUSTEES OF OTHER RELATED ORGANIZATIONS IN THE SYSTEM, THEIR RESPECTIVE HOURS PER WEEK PER ORGANIZATION ARE APPROXIMATELY ONE HOUR. THE HOURS REFLECTED ON PART VII OF THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, PAID OFFICERS AND KEY EMPLOYEES, REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF ROBERT WOOD JOHNSON HEALTH NETWORK; NOT SOLELY THIS ORGANIZATION.
OTHER CHANGES IN NET ASSETS	CORE FORM, PART XI; QUESTION 5	OTHER CHANGES IN NET ASSETS OR FUND BALANCE INCLUDE: - NET CHANGE IN UNREALIZED losses ON INVESTMENTS OTHER THAN TRADING SECURITIES - ($223,394); - CHANGE IN INTEREST IN RESTRICTED NET ASSETS OF FOUNDATION - $3,055,192; and - NET ASSETS RELEASED FROM TEMPORARY RESTRICTIONS FOR CAPITAL PURPOSES - ($1,673,659).
AUDITED FINANCIAL STATEMENTS	CORE FORM, PART XII; QUESTION 2	An INDEPENDENT CPA FIRM AUDITED THE FINANCIAL STATEMENTS OF THE TAXPAYER FOR THE YEARS ENDED DECEMBER 31, 2011 AND DECEMBER 31, 2010; RESPECTIVELY, AND ISSUED A CERTIFIED AUDITED FINANCIAL STATEMENT. AN UNQUALIFIED OPINION WAS ISSUED BY THE INDEPENDENT CPA FIRM EACH YEAR. THE TAXPAYER'S AUDIT AND COMPLIANCE COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT AUDITOR.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

CHILDREN'S SPECIALIZED HOSPITAL

Employer identification number

22-1487148

Part I

Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)

(a) Name, address, and EIN of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling 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
(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	Yes	No
(1) CHILDRENS SPECIALIZED HOSPITAL FDN 150 NEW PROVIDENCE ROAD MOUNTAINSIDE,NJ07092 13-6844298	FUNDRAISING	NJ	501(C)(3)	509(A)(1)	RWJHCC		No
(2) LAKEVIEW CHILD CARE CENTER INC ONE HAMILTON HEALTH PLACE HAMILTON,NJ08690 22-2627639	CHILD CARE	NJ	501(C)(3)	509(A)(2)	RWJHCCH		No
(3) RWJ UNIV HOSPITAL AT HAMILTON ONE HAMILTON HEALTH PLACE HAMILTON,NJ08690 21-0634572	HLTHCARE SVC	NJ	501(C)(3)	HOSPITAL	RWJHCCH		No
(4) RWJ UNIV HOSP AT HAMILTON FDN INC ONE HAMILTON HEALTH PLACE HAMILTON,NJ08690 22-2552329	FUNDRAISING	NJ	501(C)(3)	509(A)(1)	RWJHCCH		No
(5) RWJ HEALTH CARE CORPORATION AT HAMILTON ONE HAMILTON HEALTH PLACE HAMILTON,NJ08690 22-2566863	HOLDING CO.	NJ	501(C)(3)	509(A)(3)	RWJHCC		No
(6) RWJ UNIV HOSP RAHWAY AUXILIARY 865 STONE STREET RAHWAY,NJ07065 22-0012205	SUPPORTING	NJ	501(C)(3)	509(A)(3)	RWJUHR		No
(7) RWJ UNIV HOSP RAHWAY FOUNDATION 865 STONE STREET RAHWAY,NJ07065 22-2405094	FUNDRAISING	NJ	501(C)(3)	509(A)(3)	RWJUHR		No
(8) RWJ UNIVERSITY HOSPITAL RAHWAY 865 STONE STREET RAHWAY,NJ07065 22-1487305	HLTHCARE SVC	NJ	501(C)(3)	HOSPITAL	RWJHCC		No
(9) NEW BRUNSWICK AFFILIATED HOSPITALS INC 120 ALBANY STREET SUITE 750 NEW BRUNSWICK,NJ08901 22-1946837	HLTHCARE SVC	NJ	501(C)(3)	509(A)(3)	RWJHCC		No
(10) RWJ PROPERTY HOLDING CORPORATION 120 ALBANY STREET SUITE 750 NEW BRUNSWICK,NJ08901 22-2474955	PROPERTY	NJ	501(C)(3)	509(A)(3)	RWJHCC		No
(11) RWJ HEALTH CARE CORPORATION 120 ALBANY STREET SUITE 750 NEW BRUNSWICK,NJ08901 22-2568905	HOLDING CO.	NJ	501(C)(3)	509(A)(3)	NA		No
(12) RWJ UNIV HOSPITAL FOUNDATION INC 120 ALBANY STREET SUITE 750 NEW BRUNSWICK,NJ08901 22-2378007	FUNDRAISING	NJ	501(C)(3)	509(A)(3)	RWJHCC		No
(13) RWJ UNIVERSITY HOSPITAL ONE ROBERT WOOD JOHNSON PLACE NEW BRUNSWICK,NJ08903 22-1487243	HLTHCARE SVC	NJ	501(C)(3)	HOSPITAL	RWJHCC		No
(14) AUXILIARY OF RWJ UNIVERSITY HOSPITAL 120 ALBANY STREET SUITE 750 NEW BRUNSWICK,NJ08901 22-6014339	SUPPORTING	NJ	501(C)(3)	509(A)(2)	RWJUH		No

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2011

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	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	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)
(1) HAMILTON OB GYN PA ONE HAMILTON HEALTH PLACE HAMILTON,NJ08690 20-0218248	HEALTHCARE SVCS.	NJ	NA	C CORP.
(2) RWJ DIABETES & ENDOCRINOLOGY ONE HAMILTON HEALTH PLACE HAMILTON,NJ08690 26-1447574	HEALTHCARE SVCS.	NJ	NA	C CORP.
(3) RWJ MED ASSOC AT HAMILTON ONE HAMILTON HEALTH PLACE HAMILTON,NJ08690 22-3454267	PROF. SVCS.	NJ	NA	C CORP.
(4) RWJ MED SVCS ORG AT HAMILTON ONE HAMILTON HEALTH PLACE HAMILTON,NJ08690 22-3454270	RENTAL REAL EST.	NJ	NA	C CORP.
(5) VISION HEALTHCARE INC 865 STONE STREET RAHWAY,NJ07065 20-4285005	INVESTMENT	NJ	NA	C CORP.
(6) RWJ HEALTH NETWORK INC 120 ALBANY STREET SUITE 750 NEW BRUNSWICK,NJ08901 22-3420314	HEALTHCARE SVCS.	NJ	NA	C CORP.
(7) RWJ KIDNEY TRANSPLANT ASSOC 120 ALBANY STREET SUITE 750 NEW BRUNSWICK,NJ08901 03-0382501	HEALTHCARE SVCS.	NJ	NA	C CORP.
(8) RWJ MULTI-SPECIALTY PA 120 ALBANY STREET SUITE 750 NEW BRUNSWICK,NJ08901 03-0382492	HEALTHCARE SVCS.	NJ	NA	C CORP.
(9) RWJ MEDICAL ASSOCIATES PA 120 ALBANY STREET SUITE 750 NEW BRUNSWICK,NJ08901 22-3586872	HEALTHCARE SVCS.	NJ	NA	C CORP.
(10) RWJ SURGERY CENTER INC 120 ALBANY STREET SUITE 750 NEW BRUNSWICK,NJ08901 22-3698431	HEALTHCARE SVCS.	NJ	NA	C CORP.
(11) RWJ PHYSICIAN ENTERPRISE PA 120 ALBANY STREET TOWER 2 FLOOR 3 NEW BRUNSWICK,NJ08901 45-3967414	HEALTHCARE SVCS.	NJ	NA	C CORP.
(12) SYSTEM AND AFFILIATE MEMBERS CRAIG APPIN HOUSE 8 WESLEY STREET HAMILTON,BDHM JX BD 98-0656382	FINANCIAL VEHICLE	BD	NA	FOREIGN CORP.

Schedule R (Form 990) 2011

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

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 . . . . . . . . . . . . . . . . . . . . . . .

b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

f Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

j Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

k Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .

l Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .

m Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .

n Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

o Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

p Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

q Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

r Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

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)
(2)
(3)
(4)
(5)
(6)

Schedule R (Form 990) 2011

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)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2011

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

Software ID:
Software Version:

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	7,385,914	7,757,709
9	Program service revenue (Part VIII, line 2g) .........	98,463,142	101,614,857
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	178,696	445,780
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	487,339	453,926
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	106,515,091	110,272,272
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
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)	71,691,175	75,370,976
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f)....	34,440,852	32,595,235
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	106,132,027	107,966,211
19	Revenue less expenses. Subtract line 18 from line 12.......	383,064	2,306,061
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	159,003,635	161,795,254
21	Total liabilities (Part X, line 26).............	76,682,916	76,010,335
22	Net assets or fund balances. Subtract line 21 from line 20.....	82,320,719	85,784,919

Sign Here

	Signature of officer	Date

	Type or print name and title.


4a	(Code: ) (Expenses $ 36,875,036 including grants of $ 0 ) (Revenue $ 36,964,300 )
	EXPENSES INCURRED IN PROVIDING INPATIENT REHABILITATION SERVICES TO ALL CHILDREN IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. THE ORGANIZATION INCURRED 18,176 PATIENT DAYS FROM THE PROVISION OF INPATIENT REHABILITATION SERVICES IN 2011. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT.

4b	(Code: ) (Expenses $ 19,577,484 including grants of $ 0 ) (Revenue $ 20,393,211 )
	EXPENSES INCURRED IN PROVIDING LONG-TERM CARE SERVICES TO ALL CHILDREN IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. THE ORGANIZATION INCURRED 25,088 PATIENT DAYS FROM THE PROVISION OF LONG-TERM CARE SERVICES IN 2011. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT.

4c	(Code: ) (Expenses $ 8,574,816 including grants of $ 0 ) (Revenue $ 6,110,924 )
	EXPENSES INCURRED IN PROVIDING AMBULATORY CARE CENTER PROGRAM SERVICES TO ALL CHILDREN IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 2,545,553 including grants of $ 0 ) (Revenue $ 38,146,422 )
4e	Total program service expenses$ 67,572,889

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	3,898,406	0	663,389

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d		4,436,053
e	Government grants (contributions)1e		3,224,184

f	All other contributions, gifts, grants, and similar amounts not included above1f		97,472
g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			7,757,709
			Business Code
2a	NET PATIENT SERVICE REVENUE		541,900	99,899,107	99,899,107
b	OTHER HEALTHCARE RELATED REVENUE		541,900	1,715,750	1,715,750
c
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			101,614,857
3	Investment income (including dividends, interest
	and other similar amounts).....			249,745		0	249,745
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties............			0
		(i) Real	(ii) Personal
6a	Gross rents	29,531
b	Less: rental expenses
c	Rental income or (loss)	29,531
d	Net rental income or (loss).......			29,531			29,531
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	91,066	130,519
b	Less: cost or other basis and sales expenses	0	25,550
c	Gain or (loss)	91,066	104,969
d	Net gain or (loss)..........			196,035			196,035
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..			0
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...			0
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..			0
Miscellaneous Revenue			Business Code
11a	CAFETERIA & DIETARY REVENUE		722,210	424,395			424,395
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			424,395
12	Total revenue. See Instructions....			110,272,272	101,614,857	0	899,706

1	Briefly describe the organization’s mission or most significant activities: TO BE THE PREEMINENT PROVIDER OF SPECIALIZED HEALTHCARE SERVICES FOR INFANTS, CHILDREN AND YOUNG ADULTS.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a).....	3	24
4	Number of independent voting members of the governing body (Part VI, line 1b) ....	4	20
5	Total number of individuals employed in calendar year 2011 (Part V, line 2a) ...	5	1,323
6	Total number of volunteers (estimate if necessary) ....	6	537
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ..	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 ..	7b	0


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing ..........			640,410	1	363,808
2	Savings and temporary cash investments .......			10,205,929	2	16,384,635
3	Pledges and grants receivable, net .........			2,101,537	3	4,405,084
4	Accounts receivable, net .........			18,241,123	4	16,506,178
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........			0	5	0
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 ..........			0	6	0
7	Notes and loans receivable, net .............			5,529,198	7	4,369,110
8	Inventories for sale or use ..............			418,240	8	450,296
9	Prepaid expenses and deferred charges ............			3,587,821	9	643,132
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	146,006,136
b	Less: accumulated depreciation. .....	10b	61,981,465	85,771,975	10c	84,024,671
11	Investments—publicly traded securities ..........			0	11	0
12	Investments—other securities. See Part IV, line 11 ......			0	12	0
13	Investments—program-related. See Part IV, line 11 ..			25,432,033	13	24,198,893
14	Intangible assets .........			1,131,724	14	1,083,027
15	Other assets. See Part IV, line 11 ...........			5,943,645	15	9,366,420
16	Total assets. Add lines 1 through 15 (must equal line 34)...			159,003,635	16	161,795,254
17	Accounts payable and accrued expenses .			16,857,309	17	18,092,822
18	Grants payable ..........			0	18	0
19	Deferred revenue ..........			0	19	0
20	Tax-exempt bond liabilities ..........			48,347,432	20	46,833,778
21	Escrow or custodial account liability. Complete Part IV of Schedule D..			0	21	0
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........			0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..			4,911,949	23	4,028,274
24	Unsecured notes and loans payable to unrelated third parties ....			0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.....			6,566,226	25	7,055,461
26	Total liabilities. Add lines 17 through 25.....			76,682,916	26	76,010,335
	Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....			62,560,251	27	67,435,285
28	Temporarily restricted net assets .....			13,357,366	28	11,925,914
29	Permanently restricted net assets .....			6,403,102	29	6,423,720
	Organizations that do not follow SFAS 117, check here 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 .....			82,320,719	33	85,784,919
34	Total liabilities and net assets/fund balances .....			159,003,635	34	161,795,254

1	Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926 (see instructions for Form 926).................	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If " Yes," the organization may be required to file Form 3520 and/or Form 3520-A. (see instructions for Forms 3520 and 3520-A)..........	Yes	No
3	Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with respect to Certain Foreign Corporations. (see instructions for Form 5471)..............................	Yes	No
4	Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If "Yes," the organization may be required to file Form 8621, Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see instructions for Form 8621)	Yes	No
5	Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with respect to Certain Foreign Partnerships. (see instructions for Form 8865)....................................	Yes	No
6	Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see instructions for Form 5713)................................................	Yes	No