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) ARNOLD BALSAM CHAIRMAN - TRUSTEE	1.0	X	X	0	0
(2) JOSEPH FRASCINO MD VICE CHAIRMAN - TRUSTEE	1.0	X	X	0	0
(3) SISTER BARBARA MORAN CSJP SECRETARY - TRUSTEE	1.0	X	X	0	0
(4) EDWIN H RUZINSKY CPA TREASURER - TRUSTEE	1.0	X	X	0	0
(5) JOSEPH M LEMAIRE TRUSTEE - ASST SEC/ASST TREAS	55.0	X	X	974,631	283,004
(6) ROBERT BRITZ TRUSTEE	1.0	X		0	0
(7) PATRICIA BURKE MD TRUSTEE	1.0	X		0	0
(8) DAVID BUTLER MD TRUSTEE	1.0	X		0	0
(9) TED A CARNEVALE CPA TRUSTEE	1.0	X		0	0
(10) ARTHUR W CONWAY TRUSTEE	1.0	X		0	0
(11) DALE A CREAMER TRUSTEE	1.0	X		0	0
(12) JOHN M GERAGHTY TRUSTEE	1.0	X		0	0
(13) SISTER ANNE HAYES TRUSTEE	1.0	X		0	0
(14) LAWRENCE LAIKIN TRUSTEE	1.0	X		0	0
(15) DAVID E LANDERS MD TRUSTEE	1.0	X		0	0
(16) SALVATORE LARAIA MD TRUSTEE	1.0	X		0	0
(17) DANIEL LEBER 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)	(F) Estimated amount of other compensation from the organization and related organizations
(18) MICHAEL MARON TRUSTEE - PRESIDENT/CEO	55.0	X	X			1,324,393	438,171
(19) SISTER ANTOINETTE MOORE CSJP TRUSTEE	1.0	X				0	0
(20) JOSEPH PARISI JR TRUSTEE	1.0	X				0	0
(21) SISTER ANN RUTAN CSJP TRUSTEE	1.0	X				0	0
(22) SISTER ANN TAYLOR CSJP TRUSTEE	1.0	X				0	0
(23) LEON TEMIZ TRUSTEE	1.0	X				0	0
(24) SHERYL SLONIM SENIOR VP; PATIENT CARE SVCS	55.0			X		524,377	139,318
(25) ADAM JARRETT MD CHIEF MEDICAL OFFICER	55.0			X		439,639	25,444
(26) WAYNE KINDER VP; FACILITIES (TERM 10/1/11)	55.0			X		376,486	19,288
(27) JOHN GRANGEIA VP; PROFESSIONAL SERVICES	55.0			X		235,303	15,004
(28) JANE FIELDING ELLIS VP; MARKETING & PR	55.0			X		230,183	15,905
(29) CATHERINE YAXLEY SCHMIDT VP; PLANNING & GOVT. AFFAIRS	55.0			X		216,955	32,287
(30) KEVIN MCCARTHY VP; DEVELOPMENT (TERM 11/4/11)	55.0			X		215,498	24,801
(31) EDWARD GERITY VP; OPERATIONS	55.0			X		186,866	6,614
(32) MARCELLO GUARNERI VP; FINANCIAL SERVICES	55.0			X		185,412	31,740
(33) DEBORAH ZAYAS VP; NURSING SERVICES	55.0			X		184,874	15,393
(34) CYNTHIA KAUFHOLD VP; REVENUE CYCLE MANAGEMENT	55.0			X		182,710	29,800
(35) SHARAD WALGE MD MEDICAL DIRECTOR	55.0				X	350,176	23,800
(36) CRAIG HERSH MD AVP; MEDICAL MANAGEMENT	55.0				X	265,395	34,689
(37) HENRY FERNANDEZ COS MD MEDICAL DIRECTOR	55.0				X	231,265	19,350
(38) KYUNG HEE CHOI DIR.; KOREAN MEDICAL PROGRAM	55.0				X	217,242	7,798
(39) ALLAN CAGGIANO PHYSICIST	55.0				X	212,592	29,751

(A) Name and business address	(B) Description of services	(C) Compensation
CLAUDIO BOZZO SON INC 503 FARLEY ROAD WHITEHOUSE STATION,NJ08889	CONSTRUCTION	3,139,628
ALOYSIUS BUTLER CLARK PO BOX 672 WILMINGTON,DE098990672	ADVERTISING	1,466,216
GE HEALTHCARE OEC PO BOX 96483 CHICAGO,IL60693	MAINTENANCE/SERVICE	831,281
GE HEALTHCARE PO BOX 640944 PITTSBURGH,PA152640944	EQUIPMENT SVCS	792,698
SLEEPTECH LLC PO BOX 5833 HICKSVILLE,NY11802	DIAG. SLEEP SVCS	675,360
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 77

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	1,375,118	1,375,118
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	116,818	116,818
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	10,056	10,056
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	6,354,096	5,718,688	635,408	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	114,799,892	103,319,902	11,479,990
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	3,021,136	2,719,023	302,113
9	Other employee benefits .......	12,116,472	10,904,824	1,211,648
10	Payroll taxes ...........	8,890,720	8,001,648	889,072
11	Fees for services (non-employees):
a	Management ......	25,000	22,500	2,500
b	Legal .........	1,152,812	1,031,531	121,281
c	Accounting ...........	209,186	188,267	20,919
d	Lobbying ...........	98,089	88,280	9,809
e	Professional fundraising. See Part IV, line 17..	0
f	Investment management fees ......	0
g	Other ..........	5,723,183	5,150,865	572,318
12	Advertising and promotion ....	3,797,025	3,417,322	379,703
13	Office expenses .......	7,221,066	6,498,959	722,107
14	Information technology ......	0
15	Royalties ..	0
16	Occupancy ...........	1,566,560	1,409,904	156,656
17	Travel ............	302,879	272,591	30,288
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	181,569	163,412	18,157
20	Interest ...........	5,063,600	4,557,240	506,360
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	16,265,916	14,639,324	1,626,592
23	Insurance ..............	1,692,821	1,523,539	169,282
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	MEDICAL SUPPLIES	51,477,386	46,329,647	5,147,739	0
b	BAD DEBT PROVISION	13,380,513	12,042,462	1,338,051	0
c	PURCHASED SERVICES	8,127,701	7,314,931	812,770	0
d	REPAIRS AND MAINTENANCE	7,252,076	6,526,869	725,207	0
e
f	All other expenses	13,378,962	12,051,436	1,327,526
25	Total functional expenses. Add lines 1 through 24f	283,600,652	255,395,156	28,205,496	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 ..........	90	1	90
2	Savings and temporary cash investments .......	24,763,256	2	14,280,535
3	Pledges and grants receivable, net .........	105,553	3	26,258
4	Accounts receivable, net .........	30,350,683	4	32,781,049
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 .............	4,319,434	7	5,865,669
8	Inventories for sale or use ..............	4,103,457	8	4,866,642
9	Prepaid expenses and deferred charges ............	1,922,537	9	1,974,745
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	335,397,489
b	Less: accumulated depreciation. .....	10b	190,857,874	137,797,477	10c	144,539,615
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 ..	75,752,305	13	76,046,796
14	Intangible assets .........	0	14	0
15	Other assets. See Part IV, line 11 ...........	6,878,424	15	9,755,711
16	Total assets. Add lines 1 through 15 (must equal line 34)...	285,993,216	16	290,137,110
	17	Accounts payable and accrued expenses .	31,641,533	17	35,977,842
18	Grants payable ..........	0	18	0
19	Deferred revenue ..........	497,775	19	450,556
20	Tax-exempt bond liabilities ..........	123,066,344	20	120,231,168
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 ..	4,279,240	23	5,054,740
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.....	15,296,756	25	20,875,999
26	Total liabilities. Add lines 17 through 25.....	174,781,648	26	182,590,305
		Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....	102,732,205	27	99,649,028
28	Temporarily restricted net assets .....	7,479,363	28	6,897,777
29	Permanently restricted net assets .....	1,000,000	29	1,000,000
	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 .....	111,211,568	33	107,546,805
34	Total liabilities and net assets/fund balances .....	285,993,216	34	290,137,110

- 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

HOLY NAME MEDICAL CENTER

Employer identification number

22-1487322

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

HOLY NAME MEDICAL CENTER

Employer identification number

22-1487322

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 HOLY NAME MEDICAL CENTER
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 HOLY NAME MEDICAL CENTER
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
HOLY NAME MEDICAL CENTER

Employer identification number

22-1487322

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

HOLY NAME MEDICAL CENTER

Employer identification number

22-1487322

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)? ....

Yes

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

60,000

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

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

Yes

38,089

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

98,089

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 ACTIVITIES	SCHEDULE C, PART II-B; LINES 1G AND 1H	DURING 2011, HOLY NAME MEDICAL CENTER PAID AN OUTSIDE INDEPENDENT LOBBYING FIRM $60,000 FOR LOBBYING ON A FEDERAL AND STATE LEVEL RELATED TO MEDICARE, MEDICAID AND OTHER HEALTHCARE LEGISLATIVE MATTERS. THE ORGANIZATION HAS ALLOCATED TOWARD LOBBYING ACTIVITY A PERCENTAGE OF TOTAL 2011 COMPENSATION PAID TO THE VICE PRESIDENT OF PLANNING AND GOVERNMENT AFFAIRS TO REPRESENT TIME SPENT ADDRESSING FEDERAL AND STATE HEALTHCARE MATTERS. THIS ALLOCATION AMOUNTED TO $12,462. THE ORGANIZATION IS A MEMBER OF THE NEW JERSEY HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION WHICH ENGAGE IN LOBBYING EFFORTS ON BEHALF OF THEIR MEMBER HOSPITALS. A PORTION OF THE DUES PAID TO THESE ORGANIZATIONS HAS BEEN ALLOCATED TO LOBBYING ACTIVITIES PERFORMED ON BEHALF OF THE ORGANIZATION. THIS ALLOCATION AMOUNTED TO $25,627.

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

HOLY NAME MEDICAL CENTER

Employer identification number

22-1487322

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 ....	8,479,363	12,058,693	10,237,251	11,357,203
b	Contributions ........	442,431	501,730	1,220,780
c	Net investment earnings, gains, and losses ...	-46,614	193,750	667,920
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........	977,403	4,274,810	67,258	1,119,952
f	Administrative expenses ....
g	End of year balance ......	7,897,777	8,479,363	12,058,693	10,237,251

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

Board designated or quasi-endowment SchDMd Bullet

87.300 %

Permanent endowment SchDMd Bullet

12.700 %

Temporarily restricted endowment SchDMd Bullet

0 %

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 .................	3,471,294		3,471,294
b	Buildings ................	163,804,939	76,654,292	87,150,647
c	Leasehold improvements ............	0	0	0
d	Equipment ................	146,768,682	112,380,069	34,388,613
e	Other .................	21,352,575	1,823,514	19,529,061
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				144,539,615

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) GOVERNMENT SECURITIES	10,585,679	F
(2) MORGAN STANLEY SWEEP ACCOUNT	1,599,435	F
(3) ISRAEL BONDS	1,250,000	F
(4) TD WEALTH MGMT US GOVT	1,138,009	F
(5) NORTH JERSEY COMMUNITY BANK	2,751,414	F
(6) DEPOSIT	866,864	F
(7) GEM REALTY SECURITIES, LTD	1,056,908	F
(8) MS CAPITAL PARTNERS V	1,161,710	F
(9) CARLSON CAPITAL DOUBLE BLACK	1,008,917	F
(10) CERBERUS INTERNATIONAL, LTD	1,051,972	F
(11) YORK CREDIT OPPORTUNITIES FUND	1,086,713	F
(12) ASPECT US INST LTD DIVERSIFIED	998,977	F
(13) BREVAN HOWARD FUND LTD CLASS B	1,207,016	F
(14) INTEREST IN FOUNDATION	3,776,512	F
(15) CASH & CASH EQUIVALENTS	15,022,889	F
(16) QUALCARE ALLIANCE NETWORKS INC	443,402	F
(17) ACCRUED INTEREST	155,181	F
(18) CERTIFICATES OF DEPOSIT	2,060,580	F
(19) MILLENIUM INTERNATIONAL LTD	1,075,467	F
(20) EQUITY SECURITIES	25,837,765	F
(21) TACONIC OPPORTUNITIES UNIT TR.	911,386	F
(22) MS OPPORTUNISTIC MORTGAGE INC.	1,000,000	F
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)	76,046,796

Part IX

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

(a) Description				(b) Book value









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

Part X

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

1.(a) Description of Liability		(b) Book value
Federal Income Taxes		0
DUE TO THIRD-PARTY PAYORS		17,595,265
OTHER LIABILITIES		2,648,220
ASSET RETIREMENT OBLIGATION		632,514






Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		20,875,999
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
2	Total expenses (Form 990, Part IX, column (A), line 25) .....................	2
3	Excess or (deficit) for the year. Subtract line 2 from line 1 .............	3
4	Net unrealized gains (losses) on investments ..........................	4
5	Donated services and use of facilities .............................	5
6	Investment expenses ...................................	6
7	Prior period adjustments ..................................	7
8	Other (Describe in Part XIV.) .................................	8
9	Total adjustments (net). Add lines 4 through 8 .........................	9
10	Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 .........	10

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
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIV.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1.....................		3
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

Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1	Total expenses and losses per audited financial statements .............		1
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
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

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

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
HOLY NAME MEDICAL CENTER

Employer identification number

22-1487322

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	Investments	INVESTMENTS	192,119
















3a	Sub-total .....	1	1			192,119
b	Total from continuation sheets to Part I ...
c	Totals (add lines 3a and 3b)	1	1			192,119

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.

(c) Region	(d) Purpose of grant	(g) Amount of of non-cash assistance	(h) Description of non-cash assistance	(i) Method of valuation (book, FMV, appraisal, other)
Cent. America/Caribbean	HAITI RELIEF	10,056	MATERIALS	FMV

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

HOLY NAME MEDICAL CENTER

Employer identification number

22-1487322

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

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 500 %

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?......

Yes

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

	(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) ..	9,863,213	1,099,000	8,764,213	3.240 %
b Medicaid (from Worksheet 3, column a) .....	17,518,099	10,530,717	6,987,382	2.590 %
c Costs of other means-tested government programs (from Worksheet 3, column b) .
dTotal Financial Assistance and Means-Tested Government Programs .....	27,381,312	11,629,717	15,751,595	5.830 %
Other Benefits e Community health improvement services and community benefit operations (from (Worksheet 4) ....	1,235,101		1,235,101	0.460 %
f Health professions education (from Worksheet 5) ..	136,317		136,317	0.050 %
g Subsidized health services (from Worksheet 6) ..	19,285,452	13,883,121	5,402,331	2.000 %
h Research (from Worksheet 7)	164,131		164,131	0.060 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) ....	205,116		205,116	0.080 %
jTotal Other Benefits ...	21,026,117	13,883,121	7,142,996	2.650 %
kTotal. Add lines 7d and 7j. ..	48,407,429	25,512,838	22,894,591	8.480 %

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.

		(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing	40		40	0 %
2	Economic development	607		607	0 %
3	Community support	4,333	450	3,883	0 %
4	Environmental improvements
5	Leadership development and training for community members	1,053		1,053	0 %
6	Coalition building	9,436		9,436	0 %
7	Community health improvement advocacy	3,267	50	3,217	0 %
8	Workforce development	46,651		46,651	0.020 %
9	Other
10	Total	65,387	500	64,887	0.020 %

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........

13,380,513

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

831,364

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).....

121,494,136

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

130,962,176

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

-9,468,040

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

Yes

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	HOLY NAME MEDICAL CENTER 718 TEANECK ROAD TEANECK,NJ07666	X	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)

HOLY NAME MEDICAL CENTER

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: 200.% 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: 500.% 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	Yes
	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		No
	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?5
Name and address		Type of Facility (describe)
1	CENTER FOR SLEEP MEDICINE 721 TEANECK ROAD TEANECK,NJ07666	OUTPATIENT CENTER
2	ORADELL REHAB 514 KINDERKAMACK ROAD ORADELL,NJ07649	OUTPATIENT CENTER
3	VILLA MARIE CLAIRE 12 WEST SADDLE RIVER ROAD SADDLE RIVER,NJ07649	HOSPICE
4	HNH FITNESS LLC 514 KINDERKAMACK ROAD ORADELL,NJ07649	MEDICALLY BASED FITNESS CENTER
5	UNION CITY LAB 408 37TH STREET UNION CITY,NJ07087	OFF-SITE LAB
6
7
8
9
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	SCHEDULE H, PART I; LINE 3C	INCOME-BASED CRITERIA USED TO DETERMINE ELIGIBILITY ARE IN ACCORDANCE WITH THE NJ ADMINISTRATIVE CODE 10:52 SUB-CHAPTERS 11, 12 AND 13. FEDERAL POVERTY GUIDELINES ARE INCLUDED IN THE CRITERIA FOR DETERMINING ELIGIBILITY FOR CHARITY AND DISCOUNTED CARE.
COMMUNITY BENEFIT REPORT	SCHEDULE H, PART I; LINE 6A	NOT APPLICABLE.
SUBSIDIZED HEALTH SERVICES	SCHEDULE H, PART I; LINE 7G	NO COSTS RELATING TO SUBSIDIZED HEALTHCARE SERVICES ARE ATTRIBUTABLE TO ANY PHYSICIAN CLINICS.
PERCENT OF TOTAL EXPENSE	SCHEDULE H, PART I; LINE 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 $13,380,513.
CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFIT COST	SCHEDULE H, PART I, QUESTION 7	THE ORGANIZATION'S COST ACCOUNTING SYSTEM WAS UTILIZED.
COMMUNITY BUILDING ACTIVITIES	SCHEDULE H, PART II	ACTIVITIES CLASSIFIED AS COMMUNITY BUILDING INCLUDE USE OF HNMC'S FACILITY AND/OR EMPLOYEES TO SUPPORT EFFORTS THAT: PROMOTE THE POSITIVE GROWTH OF THE COMMUNITY; ASSIST DIVERSE GROUPS IN COMING TOGETHER FOR THE COMMUNITY'S SHORT AND LONG TERM BENEFIT; AND SEEK TO PROTECT THE COMMUNITY FROM ANYTHING THAT COULD SIGNIFICANTLY AFFECT THE HEALTH AND WELL-BEING OF THE COMMUNITY. HNMC ASSISTS OTHER NON-PROFITS AND PROVIDES VARIOUS FORMS OF NON-MONETARY AID AS WELL. IN ADDITION, EMPLOYEES ARE PERMITTED TO ASSIST VALID NON-PROFIT ORGANIZATIONS DURING PAID WORK TIME. AMONG THE ORGANIZATIONS SO AIDED ARE NURSING HOMES, BOY SCOUTS, HOUSES OF WORSHIP, COMMUNITY SERVICE GROUPS, BATTERED WOMEN'S SHELTERS, ROTARY CLUBS, POLICE GROUPS, ENVIRONMENTAL GROUPS, SCHOOLS, AND NURSING HOMES. HNMC ALSO ALLOWS THE PUBLIC TO USE VARIOUS MEETING ROOMS (IN NON-CLINICAL AREAS) AND ITS CONFERENCE CENTER FOR EVENTS. CAREER DAYS ARE HELD FOR LOCAL HIGH SCHOOLS, FOSTERING ENTRANCE OF INTERESTED AND APPLICABLE STUDENTS INTO THE HEALTH PROFESSIONS. ALTHOUGH HNMC'S PARKING FEES ARE MINIMAL, FREE PARKING IS EXTENDED TO PERSONS IN NEED. HNMC IS ONE OF NINE HOSPITALS IN NEW JERSEY DESIGNATED BY THE NEW JERSEY DEPARTMENT OF HEALTH AND SENIOR SERVICES ("NJDHSS") AS A REGIONAL MEDICAL COORDINATION CENTER ("MCC"). THE ONLY FACILITY IN BERGEN COUNTY TO BE SO DESIGNATED, HNMC'S ON-CAMPUS MCC IS ACTIVATED IN THE EVENT OF PUBLIC HEALTH EMERGENCIES AND/OR A TERRORIST ATTACK CAUSING MASS CASUALTY INCIDENTS, INFECTIOUS OR COMMUNICABLE DISEASE, OR OTHER TYPES OF PUBLIC HEALTH DISRUPTION. THE MCC ALSO MONITORS, ON A DAILY BASIS, SITUATIONAL AWARENESS OF LOCAL ACTIVITY. TO DATE, THE MCC HAS BEEN ACTIVATED FOR SEVERAL STATE EMERGENCIES. THE STATE OF NEW JERSEY FUNDS A COORDINATOR FOR THE MCC, BUT ALL OTHER EMERGENCY PREPAREDNESS ACTIVITIES, WHICH ARE DESIGNED TO PROTECT THE PUBLIC AND TO RESPOND IN THE EVENT OF ANY PUBLIC HEALTH EMERGENCY, ARE CARRIED OUT BY HNMC WITHOUT FINANCIAL ASSISTANCE. GIVEN HNMC'S PROXIMITY TO NEW YORK CITY (I.E., FIVE MILES NORTH OF THE GEORGE WASHINGTON BRIDGE), EMERGENCY PREPAREDNESS IS NECESSARY TO ENSURE THE HEALTH AND WELL-BEING OF THE COMMUNITY. HNMC IS RECOGNIZED BY STATE AND FEDERAL SECTORS FOR ITS EXPERTISE IN EMERGENCY PREPAREDNESS AND RESPONSE. LOCALLY, HNMC'S MCC COORDINATOR ALSO SERVES AS THE EMS COORDINATOR OF THE BERGEN COUNTY OFFICE OF EMERGENCY MANAGEMENT AND IS A MEMBER OF THE BERGEN COUNTY TERRORISM TASK FORCE. A FREQUENT PARTICIPANT IN LOCAL AND NEW YORK CITY DISASTER DRILLS, HNMC HAS PARTICIPATED IN SEVERAL LARGE SCALE DISASTER DRILLS, AS WELL AS DRILLS CONDUCTED BY THE CENTERS FOR DISEASE CONTROL INVOLVING LOCAL, COUNTY, STATE, AND FEDERAL AGENCIES' EMERGENCY RESPONSE TO THREATS OF PUBLIC HEALTH SIGNIFICANCE. HNMC MAINTAINS ITS DESIGNATION BY THE FEDERAL DIVISION OF GLOBAL MIGRATION AND QUARANTINE TO DEAL WITH POSSIBLE COMMUNICABLE DISEASES AND ACTS OF BIOTERRORISM OCCURRING ON PUBLIC HEALTH CONVEYANCES. HNMC IS ALSO ACTIVE IN THE NORTHERN NEW JERSEY URBAN AREA SECURITY INITIATIVE. MEMBERS OF HOLY NAME EMS SERVE ON THE STATEWIDE NJ EMS TASK FORCE. THE MEDICAL CENTER MAINTAINS A SPECIAL OPERATIONS TEAM COMPRISED OF PARAMEDICS AND EMERGENCY MEDICAL TECHNICIANS WHO ARE READY TO RESPOND 24 HOURS A DAY, 7 DAYS A WEEK TO ASSIST LOCAL COMMUNITIES WITH EMERGENCIES.
BAD DEBT EXPENSE	SCHEDULE H, PART III, SECTION A; LINE 4	BAD DEBT EXPENSE WAS CALCULATED USING THE PROVIDERS' BAD DEBT EXPENSE FROM ITS FINANCIAL STATEMENTS, NET OF ACCOUNTS WRITTEN OFF AT CHARGES. HNMC AND ITS AFFILIATES PREPARE AND ISSUE AUDITED CONSOLIDATED FINANCIAL STATEMENTS. THE ATTACHED TEXTS WERE OBTAINED FROM THE FOOTNOTES TO THE AUDITED FINANCIAL STATEMENTS OF HNMC AND SUBSIDIARIES. PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT SERVICE REVENUE PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT SERVICE REVENUE FROM THIRD-PARTY PROGRAMS FOR WHICH THE COMPANY RECEIVES PAYMENT UNDER VARIOUS REIMBURSEMENT FORMULAE OR NEGOTIATED RATES ARE STATED AT THE ESTIMATED NET AMOUNTS REALIZABLE AND RECEIVABLE FROM SUCH PAYERS, WHICH ARE GENERALLY LESS THAN THE COMPANY'S ESTABLISHED BILLING RATES. THE AMOUNT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE AND OTHER COLLECTION INDICATORS. ADDITIONS TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS RESULT FROM THE PROVISION FOR BAD DEBTS. ACCOUNTS WRITTEN OFF AS UNCOLLECTIBLE ARE DEDUCTED FROM THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYERS, AND OTHERS FOR SERVICES RENDERED AND INCLUDES RETROACTIVE REVENUE ADJUSTMENTS DUE TO ONGOING AND FUTURE AUDITS, REVIEWS, AND INVESTIGATIONS. CHARITY CARE THE MEDICAL CENTER PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE THE MEDICAL CENTER DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THESE AMOUNTS ARE NOT REPORTED AS REVENUE.
MEDICARE SHORTFALL	SCHEDULE H, PART III, SECTION B; LINE 8	MEDICARE COSTS WERE DERIVED FROM THE 2011 MEDICARE COST REPORT. MEDICARE UNDERPAYMENTS AND BAD DEBT ARE CONSIDERED TO BE COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THE ORGANIZATION FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT ARE COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE 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 INDIVIDUALS 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 MEDICAL CENTER 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 TREASURY 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. MEDICARE UNDERPAYMENTS AND BAD DEBT ARE COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THE AMERICAN HOSPITAL ASSOCIATION ("AHA") HOLDS THE POSITION THAT MEDICARE UNDERPAYMENTS (OR, "SHORTFALLS") AND BAD DEBT ARE COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THE MEDICAL CENTER AGREES WITH THE AHA'S POSITION. 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 STATED THAT THE IRS SHOULD INCORPORATE THE FULL VALUE OF THE COMMUNITY BENEFIT PROVIDED BY HOSPITALS BY COUNTING MEDICARE UNDERPAYMENTS (SHORTFALL) AS QUANTIFIABLE COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: - THE PROVISION OF CARE FOR THE ELDERLY AND SERVING MEDICARE PATIENTS IS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD. - MEDICARE, LIKE MEDICAID, DOES NOT FUND THE FULL COST OF CARE. MEDICARE'S REIMBURSEMENT TO HOSPITALS EQUATES TO ONLY 92 CENTS FOR EVERY DOLLAR SPENT BY THE HOSPITALS ON CARE OF MEDICARE PATIENTS. THE MEDICARE PAYMENT ADVISORY COMMISSION ("MEDPAC") IN ITS MARCH 2007 REPORT TO CONGRESS CAUTIONED THAT UNDERPAYMENT WILL WORSEN. - MANY MEDICARE BENEFICIARIES, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR. MORE THAN 46 PERCENT OF MEDICARE SPENDING IS FOR BENEFICIARIES WHOSE INCOME IS BELOW 200 PERCENT OF THE FEDERAL POVERTY LEVEL. MANY OF THOSE MEDICARE BENEFICIARIES ARE ALSO ELIGIBLE FOR MEDICAID, THE SO CALLED "DUAL ELIGIBLES." THERE IS A VERY COMPELLING PUBLIC POLICY REASON TO TREAT MEDICARE AND MEDICAID UNDERPAYMENTS SIMILARLY FOR PURPOSES OF A HOSPITAL'S COMMUNITY BENEFIT AND INCLUDE THESE COSTS ON FORM 990, SCHEDULE H, PART I. MEDICARE UNDERPAYMENT MUST BE SHOULDERED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE COMMUNITY'S ELDERLY AND POOR. THESE UNDERPAYMENTS REPRESENT A REAL COST OF SERVING THE COMMUNITY AND SHOULD COUNT AS A QUANTIFIABLE COMMUNITY BENEFIT. BOTH THE AHA AND THE MEDICAL CENTER ALSO REGARD PATIENT BAD DEBT AS A COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. SIMILAR TO MEDICARE UNDERPAYMENT (SHORTFALLS), THERE ALSO ARE COMPELLING REASONS THAT PATIENT BAD DEBT SHOULD BE COUNTED AS QUANTIFIABLE COMMUNITY BENEFIT AS NOTED BELOW: - 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, NON-PROFIT 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 ACTUALLY 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 DEPARTMENTS, REGARDLESS OF ABILITY TO PAY. PATIENTS WHO HAVE OUTSTANDING BILLS ARE NOT TURNED AWAY, IN SHARP CONTRAST TO 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 F
DEBT COLLECTION POLICY	SCHEDULE H, PART III, SECTION B; LINE 9B	ACCOUNTS CONSIDERED TO BE CHARITY CARE ARE NOT INCLUDED IN THE BAD DEBT EXPENSE BUT, RATHER, ACCOUNTED FOR AS AN ALLOWANCE. IT IS THE POLICY OF HNMC AND SUBSIDIARIES' BUSINESS OFFICE 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 THE SENDING OF THREE STATEMENTS, A MINIMUM OF ONE PRE-COLLECTION LETTER, AND TELEPHONE CONTACT FOR ANY ACCOUNT OVER $5,000, OR AT THE DISCRETION OF THE ACCOUNT REPRESENTATIVE AND/OR SUPERVISOR. THE MEDICAL CENTER ALSO HAS A CHARITY CARE ACCESS POLICY TO ASSURE PATIENTS ARE PROVIDED WITH CHARITY CARE ASSISTANCE AS 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 ARE FINANCIALLY SCREENED BY A RESOURCE ADVISOR TO DETERMINE ELIGIBILITY ACCORDING TO STATE AND FEDERAL GUIDELINES AND ARE INFORMED OF DOCUMENTATION REQUIRED TO COMPLETE A CHARITY CARE APPLICATION. PATIENTS NOT ELIGIBLE FOR CHARITY CARE RECEIVE FINANCIAL COUNSELING FOR ALL OTHER OPTIONS. QUALIFIED PATIENTS ARE REFERRED TO ALL APPROPRIATE AGENCIES OR PROGRAMS TO MEET OTHER FINANCIAL NEEDS. AT THE TIME OF THE PATIENT VISIT, AND AS PART OF THE REGISTRATION PROCESS AT THE MEDICAL CENTER, 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 THE NEW JERSEY HOSPITAL CARE PAYMENT ASSISTANCE PROGRAM; AND - FINANCIAL ARRANGEMENTS INCLUDING: 1. CASH/CREDIT CARD (AMERICAN EXPRESS, DISCOVER, VISA, MASTERCARD), 2. LOW INTEREST LOAN PROGRAM, OR 3. FLEXIBLE PAYMENT PLANS. IN ADDITION TO THE ABOVE OPTIONS, THE MEDICAL CENTER HAS ESTABLISHED A SELF-PAY ASSISTANCE PROGRAM FOR ITS UNINSURED PATIENTS THAT DO NOT QUALIFY FOR EITHER MEDICAID OR THE NEW JERSEY HOSPITAL CARE PAYMENT ASSISTANCE PROGRAM. THE SELF-PAY ASSISTANCE PROGRAM RATES ARE REFLECTIVE OF MEDICARE REIMBURSEMENT, AS REFERRED BY THE STATE OF NEW JERSEY.
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 FACILITY USES 33% OF GROSS CHARGES TO APPROXIMATE THE AVERAGE CHARGED MANAGED CARE RATE AS THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE.
NEEDS ASSESSMENT	SCHEDULE H, PART VI; QUESTION 2	HNMC IS A PRIVATE, 361-LICENSED-BED, GENERAL ACUTE CARE HOSPITAL LOCATED IN TEANECK, NEW JERSEY. THE MEDICAL CENTER IS A NON-PROFIT CORPORATION UNDER THE LAWS OF THE STATE OF NEW JERSEY, AND IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, AND THE REGULATIONS PROMULGATED THEREUNDER, BY VIRTUE OF BEING AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE CODE. HNMC WAS FOUNDED BY THE CONGREGATION OF THE SISTERS OF ST. JOSEPH OF PEACE (THE "SISTERS") IN 1925, AND IN 1958 WAS INCORPORATED AS AN INDEPENDENT NEW JERSEY NON-PROFIT CORPORATION, SPONSORED BY THE SISTERS. ORIGINALLY KNOWN AS "HOLY NAME HOSPITAL," THE NAME "HOLY NAME MEDICAL CENTER" WAS FORMALLY ADOPTED IN MARCH 2010, WHEN THE BOARD OF TRUSTEES OF HOLY NAME DETERMINED THAT THE TERM "HOSPITAL" WAS NO LONGER REFLECTIVE OF THE SIGNIFICANTLY BROADENED SCOPE OF CLINICAL CAPABILITIES AND SERVICES ACHIEVED SINCE HNMC'S INCEPTION. HNMC'S PRIMARY MISSION AND GOALS WERE DEVELOPED BY THE SISTERS AND ESPOUSE THE FACILITATION OF PHYSICAL, SPIRITUAL AND SOCIAL WELL-BEING REGARDLESS OF RACE, CREED OR ECONOMIC CONDITION. WITH CENTERS OF EXCELLENCE IN CANCER CARE, CARDIOVASCULAR SERVICES, INTERVENTIONAL RADIOLOGY, DIALYSIS TREATMENT, WOMEN'S HEALTHCARE, AND NEUROLOGY SERVICES, PLUS A HOST OF OTHER STATE-OF-THE-ART DIAGNOSTIC, TREATMENT, AND HEALTH MANAGEMENT SERVICES, THE MEDICAL CENTER PROVIDES HIGH QUALITY HEALTHCARE ACROSS A CONTINUUM THAT EXTENDS FROM PREVENTION THROUGH TREATMENT AND ON TOWARD RECOVERY AND WELLNESS. HNMC HAS A CLEAR DEFINITION OF ITSELF AND ITS MISSION: "WE ARE A COMMUNITY OF CAREGIVERS COMMITTED TO A MINISTRY OF HEALING, EMBRACING THE TRADITION OF CATHOLIC PRINCIPLES, THE PURSUIT OF PROFESSIONAL EXCELLENCE, AND CONSCIENTIOUS STEWARDSHIP. WE HELP OUR COMMUNITY ACHIEVE THE HIGHEST ATTAINABLE LEVEL OF HEALTH THROUGH EDUCATION, PREVENTION AND TREATMENT." LOCATED IN CLOSE PROXIMITY TO MAJOR ROAD NETWORKS, INCLUDING INTERSTATES 80 AND 95 AND STATE ROUTES 46, 4 AND 17, HNMC IS ACCESSIBLE FROM COMMUNITIES THROUGHOUT NORTHEASTERN NEW JERSEY. HNMC HAS TRADITIONALLY DELIVERED ACUTE CARE SERVICES TO BERGEN AND HUDSON COUNTY RESIDENTS. APPROXIMATELY EIGHTY PERCENT (80%) OF HNMC'S 2011 INPATIENT ADMISSIONS WERE PATIENTS WHO RESIDE IN BERGEN COUNTY. THE MEDICAL CENTER'S SPECIALTY SERVICES, SUCH AS THOSE FOR MULTIPLE SCLEROSIS AND HEMODIALYSIS, TYPICALLY DRAW PATIENTS FROM A LARGER GEOGRAPHIC REGION. HNMC IS A GENERAL ACUTE CARE COMMUNITY HOSPITAL PROVIDING A BROAD SPECTRUM OF INPATIENT, AMBULATORY CARE, HOME HEALTH, HOSPICE AND COMMUNITY SERVICES. IN ADDITION TO ITS GENERAL MEDICAL, SURGICAL, OBSTETRICAL, GYNECOLOGICAL, PEDIATRIC AND PSYCHIATRIC SERVICES, HNMC OFFERS A WIDE ARRAY OF DIAGNOSTIC AND TREATMENT MODALITIES AND VARIOUS SPECIALTY SERVICES. WHILE HNMC IS LICENSED FOR 361 BEDS AND 36 BASSINETTES, AS FOLLOWS: MEDICAL/SURGICAL, 278 BEDS; INTENSIVE CARE, 19 BEDS; OBSTETRICS, 25 BEDS; PEDIATRICS, 16 BEDS; PSYCHIATRY, 23 BEDS; NORMAL NEWBORNS, 25 BASSINETTES; AND SPECIAL CARE NEWBORNS, 11 BASSINETTES. HNMC OPERATES A LARGE ON-CAMPUS NURSING EDUCATION PROGRAM. THE SCHOOL OF NURSING WAS ESTABLISHED IN 1925 AND HAS EDUCATED AND GRADUATED APPROXIMATELY 3,500 NURSES INTO THE PROFESSION. THE SCHOOL OF NURSING IS A HIGHLY COMPETITIVE REGISTERED NURSE DIPLOMA PROGRAM ACCEPTING ONLY 60 STUDENTS ANNUALLY. THE CONTINUED STRONG ENROLLMENT IS ATTRIBUTABLE IN PART TO THE SCHOOL OF NURSING BEING CONSISTENTLY RANKED AS OR NEAR NUMBER ONE OF 1,565 REGISTERED NURSING PROGRAMS NATIONWIDE IN PASSING THE LICENSURE EXAMINATION. HNMC IS LICENSED BY THE NJDHSS AND IS CERTIFIED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES ("CMS") AS A PARTICIPATING PROVIDER. THE MEDICAL CENTER IS ACCREDITED BY THE JOINT COMMISSION, AND IS ALSO ACCREDITED BY THE JOINT COMMISSION AS A PRIMARY STROKE CARE CENTER. OTHER ACCREDITATIONS INCLUDE AMERICAN HEART ASSOCIATION FOR ITS BASIC LIFE SUPPORT PROGRAM, THE SOCIETY OF CHEST PAIN CENTERS AS A DESIGNATED CHEST PAIN CENTER, AMERICAN COLLEGE OF RADIOLOGY, THE AMERICAN SOCIETY OF THERAPEUTIC RADIATION ONCOLOGY, AMERICAN COLLEGE OF SURGEONS COMMISSION ON CANCER, SOCIETY OF CHEST PAIN CENTERS, MEDICAL SOCIETY OF NEW JERSEY FOR THE MEDICAL EDUCATION PROGRAM, THE AMERICAN STROKE ASSOCIATION, COLLEGE OF AMERICAN PATHOLOGISTS, AMERICAN ASSOCIATION OF CARDIAC AND PULMONARY REHABILITATION, THE NATIONAL LEAGUE FOR NURSING AND THE NJ BOARD OF NURSING FOR HOLY NAME'S SCHOOL OF NURSING, AND THE AMERICAN NURSES CREDENTIALING CENTER ("ANCC") FOR ITS MAGNET DESIGNATION. HNMC IS AN AFFILIATE MEMBER OF THE NEW YORK-PRESBYTERIAN HEALTHCARE SYSTEM. THE SYSTEM CONSISTS OF THIRTY-FOUR MEDICAL INSTITUTIONS, AND PROVIDES HNMC WITH ACCESS TO CERTAIN CLINICAL SPECIALISTS AND CLINICAL TRIALS. HNMC IS ALSO AN AFFILIATE OF THE COLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS. COLUMBIA IS ONE OF TWO ACADEMIC AFFILIATES OF THE NEW YORK-PRESBYTERIAN HEALTHCARE SYSTEM AND PROVIDES A SUBSTANTIAL PORTION OF THE SYSTEM'S ACADEMIC INFRASTRUCTURE. HNMC IS RECOGNIZED FOR ITS CLINICAL SKILL, QUALITY OUTCOMES AND HIGH RATE OF PATIENT SATISFACTION BY MULTIPLE NATIONAL ACCREDITATION AGENCIES AND BENCHMARKING ORGANIZATIONS. THE JOINT COMMISSION CITES HNMC AS A "TOP PERFORMER FOR KEY QUALITY MEASURES," CITING EXCELLENCE IN HEART ATTACK, PNEUMONIA AND SURGICAL CARE. HNMC HOLDS MAGNET STATUS FOR OUTSTANDING NURSING CARE FROM THE AMERICAN NURSES CREDENTIALING CENTER ("ANCC"). THE MAGNET RECOGNITION PROGRAM WAS DEVELOPED BY THE ANCC TO RECOGNIZE HEALTHCARE ORGANIZATIONS THAT PROVIDE NURSING EXCELLENCE, AND TO PROVIDE A VEHICLE FOR DISSEMINATING SUCCESSFUL NURSING PRACTICES AND STRATEGIES. APPROXIMATELY SIX PERCENT (6%) OF HOSPITALS NATIONWIDE ARE MAGNET HOSPITALS. HNMC ALSO RECEIVED THE BEACON AWARD FOR CRITICAL CARE EXCELLENCE FOR ITS TELEMETRY AND INTENSIVE CARE UNITS. THIS AWARD FROM THE AMERICAN ASSOCIATION OF CRITICAL-CARE NURSES RECOGNIZES NURSING EXCELLENCE IN PROFESSIONAL PRACTICE, PATIENT CARE AND OUTCOMES. HNMC HAS BEEN RECOGNIZED BY J.D. POWER AND ASSOCIATES WITH ITS DISTINGUISHED HOSPITAL AWARDS FOR EMERGENCY, INPATIENT AND MATERNITY SERVICE EXCELLENCE; AND HAS RECEIVED THE HEALTHGRADES DISTINGUISHED HOSPITAL AWARD FOR CLINICAL EXCELLENCE, AS WELL AS ITS SPECIALTY EXCELLENCE AWARD FOR STROKE CARE. DATA ADVANTAGE, LLC, WHICH IS A HEALTHCARE INFORMATION COMPANY, HONORED HNMC WITH ITS BEST IN VALUE AWARD FOR QUALITY, AFFORDABILITY, EFFICIENCY, PATIENT SAFETY AND OVERALL EXPERIENCE; AND HNMC RECEIVED DESIGNATION AS A COMMUNITY VALUE FIVE-STAR HOSPITAL BY CLEAVERLY+ASSOCIATES, AN INDEPENDENT ORGANIZATION THAT PERFORMS NATIONWIDE STUDIES TO IDENTIFY THOSE HOSPITALS THAT PROVIDE VALUE TO THE COMMUNITY IN TERMS OF FINANCIAL VIABILITY AND PLANT REINVESTMENT, COST STRUCTURE, CHARGE STRUCTURE AND QUALITY PERFORMANCE. HNMC HAS BEEN PRAISED REPEATEDLY AS AN EXEMPLARY WORKPLACE BY MODERN HEALTHCARE'S 100 BEST PLACES TO WORK IN HEALTHCARE PROGRAM; BY NJBIZ (THE LEADING WEEKLY BUSINESS PUBLICATION IN NEW JERSEY), WHICH CITES HNMC AS A TOP HOSPITAL AND BUSINESS OVERALL IN ITS 50 BEST PLACES TO WORK IN NEW JERSEY PROGRAM; AND BY COMPANIES THAT CARE, WHICH CITED HNMC ON ITS 2010 AND 2011 HONOR ROLL. COMPANIES THAT CARE IS A NON-PROFIT ORGANIZATION DEDICATED TO ENCOURAGING AND CELEBRATING BUSINESSES THAT PRIZE THEIR EMPLOYEES AND ARE COMMITTED TO COMMUNITY SERVICE. HNMC UTILIZES A VARIETY OF MEANS BY WHICH IT IDENTIFIES AND ANALYZES PATIENT CARE NEEDS. AMONG THEM ARE: PATIENT SATISFACTION DATA; ANALYSIS OF DEMOGRAPHICS; ANALYSIS OF UTILIZATION AND MARKET TRENDS; REVIEW OF EXTERNALLY PUBLISHED DATA AND INFORMATION; ACUITY LEVELS (DAILY PLANNING OF STAFFING); AND INDIVIDUAL PROJECTS/EVALUATION/REVIEWS. HNMC ALSO COMMISSIONS EXTERNAL SPECIALISTS TO CONDUCT SURVEYS AND FOCUS GROUPS OF INDIVIDUALS, HOUSEHOLDS, PHYSICIANS, AND OTHERS. HNMC ALSO IS A MEMBER OF THE BERGEN COUNTY COMMUNITY HEALTH IMPROVEMENT PROGRAM ("CHIP"), WHOSE MISSION IS TO EVALUATE AND ADDRESS THE HEALTH NEEDS OF THE COUNTY. THE CHIP PRODUCES AN EXTENSIVE, VERY USEFUL, DATABASE DEMONSTRATING THE NEEDS OF THE COUNTY'S RESIDENTS. HNMC IS A FOUNDING MEMBER OF THE NORTHERN NEW JERSEY MATERNAL-CHILD HEALTH CONSORTIUM, WHOSE MISSION IS TO EVALUATE AND PROVIDE CARE TO WOMAN AND INFANTS IN THE AREA. AGAIN, A COMPLETE NEEDS ASSESSMENT IS PERFORMED EVERY THREE YEARS AND IS PROVIDED TO MEMBERS FOR THEIR USE. IN ADDITION, US CENSUS BUREAU DATA IS UTILIZED, AS IS PURCHASED MARKET DATA, AND DATABASES OF ALL HOSPITALIZATIONS THROUGHOUT BOTH NEW JERSEY AND NEW YORK, THE SOURCE OF WHICH IS BILLING DATA PROVIDED TO THE RESPECTIVE STATE DEPARTMENTS OF HEALTH. SUCH DATABASES PROVIDE PERHAPS THE GREATEST WEALTH OF CLINICAL, DEMOGRAPHIC, FINANCIAL AND OTHER INFORMATION, AND ARE EXTREMELY VALUABLE IN UNDERSTANDING AND ADDRESSING THE NEEDS OF THE COMMUNITIES SERVED BY HNMC. DATA FROM THE COUNTY AND STATE HEALTH DEPARTMENTS, AND FROM THE NEW JERSEY HOSPITAL ASSOCIATION, ARE ALSO USED. IN ACCORDANCE WITH PROVISIONS OF THE AFF
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	SCHEDULE H, PART VI; QUESTION 3	PRIOR TO OR DURING AN ADMISSION, ALL PATIENTS WITHOUT INSURANCE ARE SCREENED FOR POSSIBLE ASSISTANCE FROM OTHER SOURCES (E.G., MEDICAID, VETERAN ADMINISTRATION, S.S.I., OR MUNICIPAL WELFARE). IF THE PATIENT IS FOUND TO BE INELIGIBLE FOR ANY OR ALL OF THE AFOREMENTIONED, THE PATIENT WILL BE SCREENED FOR CHARITY CARE. THE EDUCATION OF PATIENTS AT HNMC IS PROVIDED IN-PERSON BY KNOWLEDGEABLE MEDICAL CENTER PERSONNEL AT THE TIME OF THE INITIAL SCREENING, AND ACCOMPANIED BY A PACKET OF INFORMATION THAT INCLUDES ALL CONTACT INFORMATION AS WELL. ARRANGEMENTS FOR FOLLOW UP ARE TYPICALLY MADE IMMEDIATELY. THIS PROCESS APPLIES TO ALL PATIENTS, WHETHER INPATIENT, OUTPATIENT, OR IN THE EMERGENCY DEPARTMENT. IF THE PATIENT QUALIFIES FOR CHARITY CARE, THE PATIENT IS NOT BILLED FOR SERVICES. THE MEDICAL CENTER'S BILLING AND COLLECTION POLICY INCLUDES SPECIFIC LANGUAGE STATING THAT CHARITY CARE PATIENTS ARE NOT BILLED. THROUGH ITS COMPASSIONATE CARE PROGRAM, HNMC FURTHER ASSISTS UNINSURED PATIENTS WHO DO NOT QUALIFY FOR CHARITY CARE AND WHO ARE INELIGIBLE FOR MEDICARE, MEDICAID OR OTHER FEDERAL AND STATE INSURANCE PROGRAMS. THE PURPOSE OF THE PROGRAM IS TO DECREASE THE FINANCIAL BURDEN OF PATIENTS IN THE COMMUNITY SERVED BY HNMC. IF THE PATIENT MEETS CERTAIN ELIGIBILITY REQUIREMENTS FOR FINANCIAL ASSISTANCE AS DESCRIBED BELOW, FURTHER DISCOUNTS WILL BE APPLIED TO THE PATIENT'S BILL. - SELF-PAY PATIENTS ARE ELIGIBLE FOR THE COMPASSIONATE CARE FEE SCHEDULE REGARDLESS OF INCOME. - PATIENTS WHOSE INCOME LEVELS FALL WITHIN THE PUBLISHED HHS POVERTY GUIDELINES AND DO NOT QUALIFY FOR BENEFITS UNDER THE FEDERAL UNDOCUMENTED ALIEN PROGRAM, NJ STATE MEDICAID PROGRAM, OR CHARITY CARE PROGRAM, WILL BE CONSIDERED FOR ADDITIONAL DISCOUNTS. THESE DISCOUNTS WILL BE PROVIDED TO PATIENTS WHO MEET THE REQUIRED GUIDELINES. - PATIENTS WHO QUALIFY FOR THE N.J. MEDICAL CARE ASSISTANCE PROGRAM AND WHOSE INCOME FALLS WITHIN 200%-300% OF THE FEDERAL POVERTY LIMITS WILL BE ELIGIBLE FOR DISCOUNTS RANGING FROM 20%-100% OFF OF GROSS BILLED CHARGES. PATIENTS WHO QUALIFY FOR THIS PROGRAM, BUT WHO HAVE A BALANCE AFTER THE DISCOUNT, WILL BE RESPONSIBLE FOR BETWEEN 20%-80% OF THE N.J. MEDICAID RATE. - PATIENTS WHO DO NOT QUALIFY FOR THE N.J. MEDICAL CARE ASSISTANCE PROGRAM AND WHOSE INCOME FALL WITHIN 300%-500% OF THE FEDERAL POVERTY LIMITS WILL BE ELIGIBLE FOR A DISCOUNT BASED UPON MEDICARE RATES. - PATIENTS WHOSE INCOME IS ABOVE 500% OF THE FEDERAL POVERTY LIMITS WILL BE ELIGIBLE FOR HNMC COMPASSIONATE CARE FEE SCHEDULE AS STATED ABOVE.
COMMUNITY INFORMATION	SCHEDULE H, PART VI; QUESTION 4	LOCATED IN TEANECK, IN THE SOUTHERN PORTION OF BERGEN COUNTY AND APPROXIMATELY FIVE MILES TO THE NORTHWEST OF NEW YORK CITY, HNMC'S PRIMARY SERVICE AREA ("PSA") COMPRISES 14 MUNICIPALITIES IN BERGEN COUNTY AND FOUR MUNICIPALITIES IN HUDSON COUNTY, NEW JERSEY. HNMC'S SECONDARY SERVICE AREA ("SSA") INCLUDES 17 MUNICIPALITIES IN BERGEN COUNTY AND ONE MUNICIPALITY IN HUDSON COUNTY. HNMC DRAWS 66% OF ITS INPATIENT ADMISSIONS FROM ITS PSA, AND 14% FROM ITS SSA. AS THE SOLE CATHOLIC HOSPITAL IN AN AREA THAT IS ESTIMATED AT MORE THAN 50% ROMAN CATHOLIC, HNMC ALSO DRAWS FROM TOWNS WELL BEYOND BOTH THE PSA AND SSA. THE US CENSUS BUREAU'S 2010 CENSUS COUNT FOR THE PSA WAS 493,599, RISING BY 0.8% TO 497,674 IN 2011 ACCORDING TO THE BUREAU'S ESTIMATES. IN THE SSA, THE 2010 CENSUS COUNT WAS 282,263, RISING BY 0.7% TO 284,163 IN 2011. THE 45-64 AGE GROUP IS EXPECTED TO SHOW THE LARGEST AREA OF GROWTH, FOLLOWED BY THOSE AGED 65 OR MORE. THE PSA HAS A MEDIAN HOUSEHOLD INCOME OF $60,996 AND THE SSA $84,695, PER THE US CENSUS BUREAU (2006-2010 5-YEAR PERIOD). THE UNEMPLOYMENT RATE (NOT SEASONALLY ADJUSTED) STOOD AT 8.9% FOR BERGEN COUNTY, AND 11.4% IN 2010 FOR HUDSON COUNTY, PER THE US BUREAU OF LABOR STATISTICS (JULY, 2012). THE MEDICAL CENTER'S SERVICE AREA IS PRIMARILY SUBURBAN, WITH MANY RESIDENTS WORKING OUTSIDE BERGEN COUNTY IN PLACES SUCH AS NEW YORK CITY. HOWEVER, THERE ARE LARGE EMPLOYERS IN THE SERVICE AREA, E.G., OTHER HOSPITALS, A LARGE SPORTS CHAIN, A LARGE COMMUNICATIONS FIRM, A LARGE PHARMACEUTICAL FIRM, AND A LARGE COMMERCIAL LABORATORY. RESIDENTS OF HNMC'S SERVICE AREA ARE ALSO SERVED BY ANOTHER COMMUNITY HOSPITAL AND A TERTIARY CARE FACILITY WITH TRAUMA SERVICES. HNMC'S PSA COVERS A MAJORITY OF THE TOWNS SERVICED BY THE OTHER COMMUNITY HOSPITAL, WHEREAS THE TERTIARY CARE FACILITY'S PRIMARY SERVICE AREA ALSO INCLUDES MANY TOWNS TO THE WEST THAT ARE NOT PART OF HNMC'S SERVICE AREA. GIVEN THE NUMBER OF SERVICE AREA RESIDENTS WHO WORK IN NEARBY NEW YORK CITY, IT IS NOT SURPRISING THAT A SMALL PORTION OF THESE RESIDENTS ALSO RECEIVE THEIR HEALTHCARE IN MANHATTAN. WHILE THE SERVICE AREA IS PREDOMINANTLY NON-HISPANIC CAUCASIAN, BOTH HISPANICS (OF ANY RACE) AND ASIAN POPULATIONS (PRINCIPALLY KOREAN) ARE THE FASTING GROWING GROUPS. IN RESPONSE, THE MEDICAL CENTER HAS PROGRAMS ADDRESSING THESE GROUPS' NEEDS, AND PHYSICIANS AND NURSES FLUENT IN THE APPLICABLE LANGUAGES. IN 2008, APPROXIMATELY 75 KOREAN PHYSICIANS JOINED THE MEDICAL STAFF, ADDING TO THE NEED FOR STAFF AND SERVICES TO MEET THIS GROWING SEGMENT OF THE COMMUNITY.
PROMOTION OF COMMUNITY HEALTH	SCHEDULE H, PART VI; QUESTION 5	HNMC PROMOTES THE HEALTH OF ITS COMMUNITIES IN A VARIETY OF WAYS. ALL MEMBERS OF THE BOARD OF TRUSTEES LIVE IN BERGEN COUNTY, NEW JERSEY, WHERE HNMC IS LOCATED; AND A MAJORITY LIVE IN THE MUNICIPALITIES OF THE MEDICAL CENTER'S DEFINED SERVICE AREA. THE TRUSTEES' UNDERSTANDING OF THE SERVICE AREA IS THUS ENHANCED, AS IS THEIR UNDERSTANDING OF THE NEED TO REINVEST FUNDS IN IMPROVEMENTS IN PATIENT CARE, MEDICAL EDUCATION AND RESEARCH. AS PART OF ITS CHARITABLE PURPOSE, HNMC PROVIDES A WIDE ARRAY OF SERVICES TO THE COMMUNITY, TARGETED TOWARD IMPROVING THE HEALTH OF THE COMMUNITY. THE MAJORITY OF SUCH SERVICES ARE FREE. A SMALL SAMPLING OF SUCH ACTIVITIES IS PROVIDED BELOW. - FREQUENT HEALTH FAIRS THROUGHOUT THE REGION ARE GIVEN. AT THESE FAIRS RISK ASSESSMENTS, SCREENINGS AND LITERATURE ARE PROVIDED (MANY IN SPANISH AND KOREAN, AS WELL AS ENGLISH). - IMMUNIZATIONS ARE PROVIDED. - FREE AND/OR VERY LOW FEE TRANSPORTATION (E.G., FOR CANCER TREATMENT, DIALYSIS) IS AVAILABLE. - COMMUNITY HEALTH NURSES AND MOBILE LEARNING ARE ALSO PROVIDED. - STAFF FROM VARIOUS DEPARTMENTS THROUGHOUT THE MEDICAL CENTER VISIT LOCAL SCHOOLS TO PROVIDE HEALTH CLASSES. - SCREENINGS, E.G., BLOOD PRESSURE, CANCER, STROKE, DIABETES, PROSTATE CANCER, BREAST CANCER, OSTEOPOROSIS, PERIPHERAL ARTERY DISEASE, SKIN CANCER, COLON CANCER, AND OTHER CLINICAL SCREENING AND EDUCATION ARE PROVIDED, OFTEN AS PART OF COMMUNITY PROGRAMS SPECIFIC TO THE PARTICULAR DISEASE GROUP. - SENIOR CENTERS ARE SUPPORTED WITH FREE EXERCISE CLASSES, LECTURES AND SCREENINGS. - SUPPORT GROUPS ARE PROVIDED, SUCH AS CANCER, PERINATAL BEREAVEMENT, ADULT BEREAVEMENT, NEW MOTHERS, DIABETES, SMOKING, AND CARDIAC DISEASE. - HNMC'S ALS BIKE TEAM, ALS VEHICLES AND/OR SPECIAL OPERATIONS VEHICLES ARE PRESENT AT EVENTS OCCURRING IN MUNICIPALITIES IN HNMC'S SERVICE AREA WITHOUT CHARGE. - COURSES (PROVIDED EITHER FREE OR FOR A LOW FEE) ARE PROVIDED THROUGHOUT THE YEAR. EXAMPLES INCLUDE: CPR CERTIFICATION, DEFENSIVE DRIVING, GENERAL AND SPECIALTY (E.G., OSTEOPOROSIS) EXERCISE, BREASTFEEDING PREPARATION, STRESS MANAGEMENT, DIABETES SELF-MANAGEMENT, BABY CARE BASICS, WEIGHT MANAGEMENT, AND PARENTING. - CLASSES TO PROMOTE BETTER HEALTH ARE ABUNDANT: YOGA, WEIGHT REDUCTION, OSTEOPOROSIS, PROPER HAND-WASHING, TAI CHI, COOKING FOR CARDIAC PATIENTS. - LECTURES, OFTEN INVOLVING HNMC'S MEDICAL STAFF AS PRESENTERS, ARE PROVIDED, THE MAJORITY OF WHICH ARE FREE. MEN'S HEALTH, WOMEN'S HEALTH, A MID-LIFE AND MENOPAUSE LECTURE SERIES, SLEEP DISORDERS, ALLERGIES, DEPRESSION, ASTHMA, UTERINE FIBROIDS, COPD, STROKE, HYPERTENSION, MENTAL WELLNESS, CARDIAC ISSUES, ALZHEIMER'S, JOINT REPLACEMENT, SLEEP APNEA, CANCERS, CHILDREN'S HEALTH, DISASTER PREPAREDNESS, AND GENERAL HEALTH AND WELL-BEING ARE AMONG THE TOPICS PRESENTED. - HNMC'S WEBSITE (WWW.HOLYNAME.ORG) PROVIDES A WEALTH OF FREE CONSUMER HEALTH INFORMATION. THE SITE INCLUDES AN ON-LINE MEDICAL LIBRARY HOUSING INFORMATION ON DISEASES AND CONDITIONS, SURGERIES AND PROCEDURES, VITAMINS AND SUPPLEMENTS, NUTRITION, WELLNESS, AND A DRUG REFERENCE. ON-LINE RISK ASSESSMENTS AND QUIZZES ARE ALSO AVAILABLE, AS IS THE ABILITY TO SET UP A PERSONAL HEALTH PAGE. INFORMATION IS ALSO PRESENTED IN SPANISH. - HNMC'S "ASK-A-NURSE" PROGRAM, WHICH PROVIDES 24/7 PHONE ACCESS TO REGISTERED NURSES, IS PROVIDED FREE OF CHARGE. - BLOOD DRIVES ARE HOSTED REGULARLY AT HNMC. MANY HEALTH SERVICES ARE SUBSIDIZED BY HNMC, SUCH AS ITS CLINICS, HOSPICE AND HEMODIALYSIS PROGRAMS. EACH YEAR THE MEDICAL CENTER CONTRIBUTES TO AIRFARE, SUPPLIES AND OTHER SUPPORT FOR HNMC NURSES AND DOCTORS TO TRAVEL TO THIRD WORLD COUNTRIES (E.G., HAITI) TO PROVIDE MEDICAL CARE, INCLUDING SURGERY, TO PERSONS WHO OTHERWISE WOULD NEVER RECEIVE ADEQUATE TREATMENT DUE TO POVERTY AND LACK OF ACCESS. HNMC OPERATES A FREE CLINIC WHICH PROVIDES SERVICES TO WOMEN AND CHILDREN WHO ARE HOMELESS, HOUSED IN COMMUNITY SHELTERS AS VICTIMS OF DOMESTIC ABUSE, OR HOUSED IN COMMUNITY TRANSITIONAL RESIDENCES. HNMC ALSO PARTICIPATES IN THE WOMEN, INFANTS AND CHILDREN ("WIC") AND HEALTH START PROGRAMS, PROVIDING NUTRITIONAL AND SOCIAL SERVICES, ANCILLARY SERVICES AND OTHER PROGRAMS TO PARTICIPANTS. INEXPENSIVE MEDICALLY SUPERVISED DAY CARE FOR ILL CHILDREN IS AVAILABLE ON CAMPUS TO WORKING PARENTS IN THE COMMUNITY AFFORDING THEM THE ABILITY TO WORK EVEN WHEN A CHILD IS SICK. SENIOR OR DISABLED PERSONS REQUIRING MEDICAL DAY CARE ARE TRANSPORTED FREE OF CHARGE TO HNMC'S ADULT DAY CARE PROGRAM, REDUCING THE BURDEN ON FAMILY CARETAKERS. HNMC'S EMERGENCY DEPARTMENT ("ED") IS OPEN 24 HOURS A DAY, EVERY DAY OF THE YEAR. ALTHOUGH THE ED GENERALLY IS ABLE TO COVER ITS COSTS, IT PROVIDES A SIGNIFICANT AMOUNT OF UNCOMPENSATED CARE AND IS A WELL-USED RESOURCE FOR MANY WITHOUT INSURANCE WHO RELY ON IT FOR CARE. OTHER SERVICES, SUCH AS CLINICS, DO NOT COVER THEIR COSTS, AND HNMC ABSORBS THE ADDITIONAL EXPENSE. LANGUAGE INTERPRETATION IS AVAILABLE FOR APPROXIMATELY 220 LANGUAGES AT THE MEDICAL CENTER THROUGH USE OF A COMMERCIAL SERVICE THAT PROVIDES A LIVE TRANSLATOR 24/7. HNMC HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA. HNMC HAS INTENTIONALLY SOUGHT OUT PHYSICIANS FLUENT IN SPANISH AND WHO CARE FOR HISPANIC POPULATIONS, AND PROVIDES FREE TRANSPORTATION FOR SUCH POPULATIONS (AS WELL AS OTHERS) UNABLE TO ACCESS CARE EASILY ON THEIR OWN. HNMC HAS ALSO ADDED MANY KOREAN PHYSICIANS TO ITS MEDICAL STAFF AND PROVIDES A KOREAN CLINIC WEEKLY, WITH KOREAN SPEAKING PHYSICIANS (AND NURSES), AS THE ASIAN COMMUNITY IS ONE OF THE FASTEST GROWING SECTORS IN THE COUNTY. THE INSTITUTE FOR CLINICAL RESEARCH AT HNMC PROVIDES EXCEPTIONAL INVESTIGATORS, FACILITIES, AND SERVICES FOR SPONSORING AGENCIES THAT SEEK TO ADVANCE PATIENT CARE THROUGH SUPERIOR CLINICAL RESEARCH. THE INSTITUTE IS DEDICATED TO CONDUCTING EXPEDITIOUS, HIGH-QUALITY CLINICAL TRIALS TO TEST NEW MEDICATIONS, DEVICES, DIAGNOSTIC MODALITIES AND TREATMENT PROTOCOLS. AS A DYNAMIC HEALTHCARE INSTITUTION THAT HAS RECEIVED MANY HONORS OF DISTINCTION FOR ITS CLINICAL EXCELLENCE AND COMPASSIONATE PATIENT CARE, HNMC IS WELL-SUITED TO PARTICIPATE IN THE QUEST FOR SCIENTIFIC BREAKTHROUGHS. HNMC'S STATE-OF-THE-ART FACILITIES EXCEED THE HIGHEST STANDARDS FOR CARRYING OUT TODAY'S MOST PROMISING CLINICAL RESEARCH. THE INSTITUTE PROVIDES SPONSORS WITH RESEARCH SUPPORT THROUGHOUT ALL THE STAGES OF THEIR CLINICAL TRIALS. SINCE ITS INCEPTION, HNMC HAS BEEN ACTIVELY INVOLVED IN HEALTH PROFESSIONS EDUCATION, TRAINING, EDUCATING AND MENTORING HEALTHCARE PROFESSIONALS. THE HOLY NAME SCHOOL OF NURSING WAS FOUNDED IN 1925, WITH A DEDICATION TO FOSTERING THE WELL-BEING AND DIGNITY OF ALL INDIVIDUALS, SICK OR WELL. THE REGISTERED NURSE ("RN") PROGRAM IS A HIGHLY COMPETITIVE REGISTERED NURSE DIPLOMA PROGRAM, AND IS ACCREDITED WITH THE NEW JERSEY BOARD OF NURSING AND THE NATIONAL LEAGUE FOR NURSING ACCREDITING COMMISSION. IN 1972 THE SCHOOL EXPANDED TO INCLUDE A PRACTICAL NURSE ("LPN") PROGRAM AS WELL, WHICH IS A 12-MONTH PRACTICAL NURSE DIPLOMA PROGRAM ALSO ACCREDITED WITH THE NEW JERSEY BOARD OF NURSING. BOTH PROGRAMS CONTINUE TO SUPPLY THE REGION WITH HIGHLY SKILLED NURSES OF MANY ETHNICITIES AND AGE GROUPS. IN ADDITION TO ITS OWN NURSING SCHOOL, HNMC PROVIDES, FREE OF CHARGE, BOTH A TRAINING GROUND AND MENTORING FOR STUDENTS FROM VARIOUS HEALTH ACADEMIC PROGRAMS OF SEVERAL COLLEGES AND UNIVERSITIES. A VARIETY OF "EXTERNSHIPS" ARE ALSO OFFERED WITHOUT CHARGE. CAREER DAYS ARE ALSO HELD ON CAMPUS, AND THE MEDICAL CENTER PARTICIPATES IN HEALTH CAREER DAYS THROUGHOUT THE VARIOUS SCHOOLS AND COMMUNITIES. HNMC HAS A NUMBER OF ACADEMIC RELATIONSHIPS THROUGH WHICH IT SERVES AS AN EDUCATIONAL ENVIRONMENT FOR STUDENTS. AFFILIATION AGREEMENTS ARE MAINTAINED WITH SEVERAL COLLEGES AND UNIVERSITIES FOR NURSING STUDENTS, AND FOR RADIOLOGY, NUCLEAR MEDICINE, ULTRASOUND, RESPIRATORY, AND SURGICAL TECHNICIANS. TRAINEES FROM A UNIVERSITY ARE PREDOMINANTLY DOCTOR OF PHARMACY STUDENTS WHO ARE COMPLETING ROTATIONS IN ACUTE CRITICAL CARE, INFECTIOUS DISEASE, ONCOLOGY, NEPHROLOGY, AND ADMINISTRATION. COMMUNITY HEALTH STUDENTS ROTATE THROUGH THE MEDICAL CENTER AS WELL. PHYSICAL AND/OR OCCUPATIONAL THERAPY STUDENTS FROM WITH TEN COLLEGES IN NEW JERSEY AND OTHER STATES COMPLETE CLINICAL ROTATIONS AT THE MEDICAL CENTER; HNMC EMPLOYEES SERVE AS SUPERVISORS AND CLINICAL INSTRUCTORS FOR THESE STUDENTS. UNDERGRADUATE, NURSE PRACTITIONER AND NURSING DOCTORAL STUDENTS FROM YET ANOTHER UNIVERSITY COMPLETE ROTATIONS WITH OVERSIGHT FROM HNMC'S DEPARTMENT OF NURSING EDUCATION. EACH YEAR, HNMC ACCEPTS A SMALL NUMBER OF RESIDENTS IN HEALTH POLICY, HEALTH FINANCE, AND HEALTH MANAGEMENT FROM UNIVERSITIES IN NEW YORK AND MARYLAND. THE STUDENTS COMPLETE THEIR RESIDENCIES UNDER THE DIRECTION OF THE CEO AND MEMBERS OF SENIOR MANAGEMENT.
AFFILIATED HEALTHCARE SYSTEM	SCHEDULE H, PART VI; QUESTION 6	THE MEDICAL CENTER IS THE SOLE MEMBER OF SIX ENTITIES: (I) HOLY NAME HEALTH CARE FOUNDATION, INC., A NON-PROFIT CORPORATION WHICH SEEKS VOLUNTARY DONATIONS TO SUPPORT THE HEALTHCARE SERVICES PROVIDED BY THE MEDICAL CENTER; (II) HOLY NAME REAL ESTATE CORP., A NON-PROFIT CORPORATION WHICH MANAGES, AND IN SOME CASES POSSESSES TITLE TO AND ENGAGES IN LEASING ARRANGEMENTS WITH RESPECT TO, REAL ESTATE HOLDINGS OF THE MEDICAL CENTER AND ITS RELATED ENTITIES; (III) HEALTH PARTNER SERVICES, INC., A FOR-PROFIT CORPORATION ENGAGED IN PROVIDING MANAGEMENT SERVICES FOR HEALTHCARE PROVIDERS; (IV) HOLY NAME EMS, INC., A NON-PROFIT CORPORATION WHICH OWNS AND OPERATES THE MEDICAL CENTER'S BASIC LIFE SUPPORT ("BLS") AND ADVANCED LIFE SUPPORT ("ALS") VEHICLES AND SERVICES; (V) MSCCC, A NON-PROFIT AMBULATORY CARE PROGRAM FOR MS PATIENTS; AND (VI) HNH FITNESS, L.L.C., A FOR-PROFIT LIMITED LIABILITY COMPANY THAT OPERATES A MEDICALLY BASED FITNESS AND WELLNESS CENTER, LOCATED IN THE BOROUGH OF ORADELL, BERGEN COUNTY, NEW JERSEY. INCLUDED IN THE FACILITY IS A SATELLITE NON-PROFIT PHYSICAL THERAPY PRACTICE THAT IS OPERATED BY THE MEDICAL CENTER.
STATE FILING OF COMMUNITY BENEFIT REPORT	SCHEDULE H, PART VI; QUESTION 7	NOT APPLICABLE. THE ENTITY AND RELATED PROVIDER ORGANIZATIONS ARE LOCATED IN NEW JERSEY. NEW JERSEY DOES NOT REQUIRE HOSPITALS TO ANNUALLY SUBMIT A COMMUNITY BENEFIT REPORT.

Schedule H (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990

OMB No. 1545-0047

2011

Open to Public
Inspection

Name of the organization
HOLY NAME MEDICAL CENTER

Employer identification number
22-1487322

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet

(a) Name and address of organization or government	(b) EIN	(c) IRC Code section if applicable	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) MS COMPREHENSIVE CARE CENTER718 TEANECK ROAD TEANECK,NJ07666	22-2402959	501(C)(3)	105,000	PROGRAM SUPPORT

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ......................... . Bullet Image

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

Cat. No. 50055P

Schedule I (Form 990) 2011

Page 2

Part III

Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.

(a)Type of grant or assistance	(b)Number of recipients	(c)Amount of cash grant
(1) EDUCATIONAL SCHOLARSHIPS	25	116,818

Part IV

Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.

Identifier	Return Reference	Explanation
GRANT FUND MONITORING	SCHEDULE I, PART I; QUESTION 2	GRANTS ARE MONITORED BY THE ORGANIZATION'S FINANCE PERSONNEL THROUGH THE UTILIZATION OF COST CENTERS AND OTHER INFORMATION; INCLUDING WRITTEN DOCUMENTATION AND RECEIPTS.

Schedule I (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

HOLY NAME MEDICAL CENTER

Employer identification number

22-1487322

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....

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? ....

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) JOSEPH M LEMAIRE	(i) (ii)	741,765 0	200,000 0	32,866 0	256,868 0	26,136 0	1,257,635 0	0 0
(2) MICHAEL MARON	(i) (ii)	896,765 0	400,000 0	27,628 0	417,035 0	21,136 0	1,762,564 0	0 0
(3) SHERYL SLONIM	(i) (ii)	347,878 0	150,000 0	26,499 0	125,575 0	13,743 0	663,695 0	0 0
(4) ADAM JARRETT MD	(i) (ii)	396,765 0	20,000 0	22,874 0	4,308 0	21,136 0	465,083 0	0 0
(5) WAYNE KINDER	(i) (ii)	265,712 0	100,000 0	10,774 0	7,715 0	11,573 0	395,774 0	0 0
(6) JOHN GRANGEIA	(i) (ii)	206,443 0	25,000 0	3,860 0	5,746 0	9,258 0	250,307 0	0 0
(7) JANE FIELDING ELLIS	(i) (ii)	220,054 0	0 0	10,129 0	8,842 0	7,063 0	246,088 0	0 0
(8) CATHERINE YAXLEY SCHMIDT	(i) (ii)	197,529 0	10,000 0	9,426 0	8,151 0	24,136 0	249,242 0	0 0
(9) KEVIN MCCARTHY	(i) (ii)	209,252 0	0 0	6,246 0	2,154 0	22,647 0	240,299 0	0 0
(10) EDWARD GERITY	(i) (ii)	165,340 0	20,000 0	1,526 0	6,614 0	0 0	193,480 0	0 0
(11) MARCELLO GUARNERI	(i) (ii)	174,108 0	10,000 0	1,304 0	7,240 0	24,500 0	217,152 0	0 0
(12) DEBORAH ZAYAS	(i) (ii)	183,991 0	0 0	883 0	7,400 0	7,993 0	200,267 0	0 0
(13) CYNTHIA KAUFHOLD	(i) (ii)	171,408 0	10,000 0	1,302 0	3,600 0	26,200 0	212,510 0	0 0
(14) SHARAD WALGE MD	(i) (ii)	347,800 0	0 0	2,376 0	9,800 0	14,000 0	373,976 0	0 0
(15) CRAIG HERSH MD	(i) (ii)	263,913 0	0 0	1,482 0	9,553 0	25,136 0	300,084 0	0 0
(16) HENRY FERNANDEZ COS MD	(i) (ii)	229,800 0	0 0	1,465 0	2,350 0	17,000 0	250,615 0	0 0
(17) KYUNG HEE CHOI	(i) (ii)	194,959 0	20,500 0	1,783 0	7,798 0	0 0	225,040 0	0 0
(18) ALLAN CAGGIANO	(i) (ii)	212,144 0	150 0	298 0	8,615 0	21,136 0	242,343 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 4B	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, BOX 5, AS TAXABLE MEDICARE WAGES: JOSEPH M. LEMAIRE, $247,068; MICHAEL MARON, $407,235 AND SHERYL SLONIM, $115,775.
COMPENSATION INFORMATION	SCHEDULE J, PART I; QUESTION 7 AND CORE FORM, PART VII	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.

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
HOLY NAME MEDICAL CENTER

Employer identification number
22-1487322

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	22-1987084	64579FHK2	06-15-2006	60,816,719	CONSTRUCTION/RENOVATION/EQUIP		X		X		X
B	NJ HEALTH CARE FACILITIES FINANCING AUTHORITY	22-1987084	64579FH89	09-02-2010	55,971,065	BOND REFUNDING/CAPITAL EXPENDITURE		X		X		X
C	NJ HEALTH CARE FACILITIES FINANCING AUTHORITY	22-1987084	64579FJT1	11-22-2006	7,000,000	HNH FITNESS ACQUISITION		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . .	0		0		0
2 Amount of bonds legally defeased . . . . . . . . . .	0		0		0
3 Total proceeds of issue . . . . . . . . . . . . .	64,932,674		55,971,117		7,039,950
4 Gross proceeds in reserve funds . . . . . . . .	5,738,069		0		0
5 Capitalized interest from proceeds . . . . . . . . . .	0		0		416,077
6 Proceeds in refunding escrows . . . . . . . . . . .	0		0		0
7 Issuance costs from proceeds . . . . . . . . . . .	1,014,001		1,235,776		103,703
8 Credit enhancement from proceeds . . . . . . . . . .	0		0		43,900
9 Working capital expenditures from proceeds . . . . . . .	0		0		0
10 Capital expenditures from proceeds . . . . . . . . . .	42,313,332		7,560,834		6,476,266
11 Other spent proceeds . . . . . . . . . . .	25,859,652		47,290,816		5
12 Other unspent proceeds . . . . . . . . . . .	33,178		0		0
13 Year of substantial completion . . . . . . . . . . .	2009		2010		2006
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . .	X		X			X
15 Were the bonds issued as part of an advance refunding issue? . . . .		X		X		X
16 Has the final allocation of proceeds been made? . . . . . .		X	X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . .	X		X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .	X		X			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		X			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? . . . . .	X		X			X
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . .	X		X			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? .	X		X
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%		0%		0%		%
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%		0.00000%		0.00000%		%
6 Total of lines 4 and 5 . . .. . . . . . . . .	0%		0%		0%		%
7 Does the bond issue meet the private security or payment test? . . .	X		X		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		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .		X		X		X
2 Is the bond issue a variable rate issue?		X		X	X
3a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X
b Name of provider . . . . . . . .	0		0		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		X		X
b Name of provider . . . . . .	0		0		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		X		X
6 Did the bond issue qualify for an exception to rebate? .		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .		X		X		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 (Form 990) 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

HOLY NAME MEDICAL CENTER

Employer identification number

22-1487322

Identifier	Return Reference	Explanation
COMMUNITY BENEFIT STATEMENT	CORE FORM, PART III	HOLY NAME MEDICAL CENTER ("HNMC") IS A PRIVATE, 361-BED NEW JERSEY-LICENSED GENERAL ACUTE CARE HOSPITAL. THE MEDICAL CENTER IS A NON-PROFIT CORPORATION UNDER THE LAWS OF THE STATE OF NEW JERSEY, AND IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE BY VIRTUE OF BEING AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE CODE. PURSUANT TO ITS CHARITABLE PURPOSES, HNMC PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. MOREOVER, HNMC OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545: 1. HNMC PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF- PAY, MEDICARE AND MEDICAID PATIENTS; 2. HNMC OPERATES AN ACTIVE EMERGENCY ROOM FOR ALL PERSONS, WHICH IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR; 3. HNMC MAINTAINS A MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; 4. CONTROL OF HNMC RESTS WITH ITS BOARD OF TRUSTEES AND THE SISTERS OF ST. JOSEPH OF PEACE. BOTH BOARDS ARE COMPRISED OF INDEPENDENT CIVIC LEADERS AND OTHER PROMINENT MEMBERS OF THE COMMUNITY; AND 5. SURPLUS FUNDS ARE USED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND RENOVATE FACILITIES AND ADVANCE MEDICAL CARE, PROGRAMS AND ACTIVITIES. THE OPERATIONS OF HNMC, AS SHOWN THROUGH THE FACTORS OUTLINED ABOVE AND OTHER INFORMATION CONTAINED HEREIN, CLEARLY DEMONSTRATE THAT HNMC PROVIDES SUBSTANTIAL COMMUNITY BENEFIT AND THAT THE USE AND CONTROL OF HNMC IS FOR THE BENEFIT OF THE PUBLIC AND THAT NO PART OF THE INCOME OR NET EARNINGS OF THE ORGANIZATION INURES TO THE BENEFIT OF ANY PRIVATE INDIVIDUAL, NOR IS ANY PRIVATE INTEREST BEING SERVED OTHER THAN INCIDENTALLY. THE SISTERS OF ST. JOSEPH OF PEACE HEALTH CARE SYSTEM CORPORATION (THE "HOLDING COMPANY") IS A NON-PROFIT CORPORATION UNDER THE LAWS OF THE STATE OF NEW JERSEY, AND IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE BY VIRTUE OF BEING AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE CODE. THE HOLDING COMPANY IS THE SOLE MEMBER OF THE MEDICAL CENTER. THIS TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM CONSISTS OF A GROUP OF AFFILIATED HEALTHCARE ORGANIZATIONS. THE SOLE MEMBER OF EACH ENTITY IS EITHER THE HOLDING COMPANY OR HNMC. MISSION ======= WE ARE A COMMUNITY OF CAREGIVERS COMMITTED TO A MINISTRY OF HEALING, EMBRACING THE TRADITION OF CATHOLIC PRINCIPLES, THE PURSUIT OF PROFESSIONAL EXCELLENCE, AND CONSCIENTIOUS STEWARDSHIP. WE HELP OUR COMMUNITY ACHIEVE THE HIGHEST ATTAINABLE LEVEL OF HEALTH THROUGH EDUCATION, PREVENTION, AND TREATMENT. HISTORY ======= THE MEDICAL CENTER WAS FOUNDED BY THE CONGREGATION OF THE SISTERS OF ST. JOSEPH OF PEACE (THE "SISTERS") IN 1925, AND IN 1958 WAS INCORPORATED AS AN INDEPENDENT NEW JERSEY NON-PROFIT CORPORATION, SPONSORED BY THE SISTERS. IT WAS THE DEDICATION OF TWO TEANECK SURGEONS AND THE LEADERSHIP OF A SISTER THAT MADE HNMC A REALITY IN 1925. RECOGNIZING THE NEED TO SERVE THE SICK AND INDIGENT OF THE COMMUNITY, DRS. FRANK MCCORMACK AND GEORGE PITKIN APPEALED TO MOTHER GENERAL AGATHA BROWN OF THE SISTERS FOR HELP IN FINDING A SUITABLE MEDICAL CENTER SITE AND PROVIDING ADMINISTRATIVE AND NURSING STAFF. THE SISTERS PURCHASED THE ESTATE OF THE LATE WILLIAM WALTER PHELPS AND ERECTED THE MEDICAL CENTER THERE, STAFFING IT WITH SISTERS. AT ITS OPENING IN 1925, HNMC BOASTED 115 BEDS. FIVE YEARS LATER, A 90-BED CLINIC BUILDING WAS BUILT TO MEET THE NEEDS OF AREA RESIDENTS WHO HAD BEEN IMPOVERISHED BY THE GREAT DEPRESSION. TEANECK WAS LITTLE MORE THAN A RURAL VILLAGE THEN; IN ALL OF BERGEN COUNTY THERE WERE SOME 250,000 INHABITANTS. WITH THE COMPLETION OF THE GEORGE WASHINGTON BRIDGE IN 1931, A SURGE OF DEVELOPMENT FOLLOWED WORLD WAR II, AND THE AREA SOON BECAME A THRIVING RESIDENTIAL AND BUSINESS COMMUNITY. HNMC THRIVED AS WELL. IN 1955 A SECOND ADDITION WAS COMPLETED: THE FOUR-STORY, 110-BED MARIAN BUILDING, WITH TWO MORE STORIES ADDED TO THE FACILITY WITHIN THE NEXT TEN YEARS. DURING THE 1960'S, THE WEST WING OF THE MARIAN BUILDING WAS ENLARGED BY THREE MORE UNITS. FACED AGAIN WITH THE THREAT OF OVERCROWDING IN THE 1980'S, THE MEDICAL CENTER COMPLEX WAS ONCE MORE ENLARGED WITH CONSTRUCTION OF THE BRESLIN/KENNEDY BUILDING. IN 1993 THE "NEW ADDITION" WAS CONSTRUCTED, PRINCIPALLY TO ACCOMMODATE THE INCREASING AMBULATORY AND SAME-DAY-STAY PATIENTS, AND A NEW PHYSICAL MEDICINE BUILDING WAS ADDED. A FOUR-LEVEL REGIONAL CANCER CENTER WAS COMPLETED IN THE LATE 1990'S. MORE RECENT ADDITIONS INCLUDE A NEW 41-BAY EMERGENCY DEPARTMENT, A HEALTH AND FITNESS CENTER, AND A RESIDENTIAL HOSPICE, VILLA MARIE CLAIRE. THE MEDICAL CENTER HAS GROWN IN SIZE, REPUTATION AND CAPABILITY WITH EACH ADDITION. AS HNMC CELEBRATES ALMOST 90 YEARS, IT CONTINUES TO TAKE STEPS TO BECOME A NATIONAL MODEL BY IMPLEMENTING NEW, ADVANCED TECHNOLOGIES AND MEDICAL/SURGICAL TECHNIQUES, AS WELL AS BEST PRACTICES IN PROCESSES SUCH AS MEDICATION ADMINISTRATION, HEALTHCARE INFORMATION SYSTEMS, DISASTER PREPAREDNESS, AND BUILDING CONSTRUCTION AND DESIGN. IMPROVEMENTS SUCH AS THESE ALLOW HNMC TO PROVIDE EVERY PATIENT WITH A SUPERIOR EXPERIENCE CHARACTERIZED BY SAFE, HIGH QUALITY CARE. LEADING-EDGE CARE ================= HNMC IS A COMPREHENSIVE, 361-BED ACUTE CARE FACILITY PROVIDING LEADING-EDGE MEDICAL PRACTICE AND TECHNOLOGY ADMINISTERED IN AN ENVIRONMENT ROOTED IN A TRADITION OF COMPASSION AND RESPECT FOR EVERY PATIENT. HNMC OFFERS HIGH QUALITY HEALTHCARE ACROSS A CONTINUUM THAT ENCOMPASSES EDUCATION, PREVENTION, EARLY INTERVENTION, COMPREHENSIVE TREATMENT OPTIONS, REHABILITATION AND WELLNESS MAINTENANCE-FROM PRE-CONCEPTION THROUGH END-OF-LIFE. WITH ALMOST 900 PHYSICIANS REPRESENTING DOZENS OF MEDICAL AND SURGICAL SPECIALTIES, HNMC PROVIDES AN EXCEPTIONAL HEALTHCARE EXPERIENCE FOR ITS PATIENTS. A FEW OF THE "CENTERS OF EXCELLENCE" AT HNMC INCLUDE: - REGIONAL CANCER CENTER - INTERVENTIONAL INSTITUTE (OFFERING INNOVATIVE, NON-SURGICAL TREATMENT OPTIONS) - CARDIOVASCULAR SERVICES - GEORGE P. PITKIN M.D. EMERGENCY CARE CENTER - WOMEN'S AND CHILDREN'S SERVICES - BONE AND JOINT CENTER - LUNG CENTER OTHER OUTSTANDING SERVICES INCLUDE BUT ARE NOT LIMITED TO: - SPECIALTY SURGERY SERVICES WITH EXPERTISE IN MINIMALLY INVASIVE TECHNIQUES, INCLUDING ROBOTICS - ADVANCED RADIOLOGICAL IMAGING - HOSPICE AND PALLIATIVE SERVICES, INCLUDING THE ESTABLISHMENT OF VILLA MARIE CLAIRE, A RESIDENTIAL HOSPICE FACILITY IN SADDLE RIVER, NJ - REHABILITATION MEDICINE, ENCOMPASSING HNHFITNESS, HNMC'S MEDICALLY-BASED FITNESS CENTER IN ORADELL, NJ - BARIATRIC MEDICINE - CENTER FOR SLEEP MEDICINE - MATERNAL-FETAL MEDICINE FOR HIGH-RISK AND COMPLICATED PREGNANCIES - RENAL DIALYSIS - CULTURALLY- AND LINGUISTICALLY-SENSITIVE HEALTH PROGRAMS: KOREAN MEDICAL PROGRAM AND HISPANIC OUTREACH PROGRAM - INSTITUTE FOR CLINICAL RESEARCH
COMMUNITY BENEFIT STATEMENT CONTINUED	CORE FORM, PART III	AFFILIATIONS AND ACADEMIC RELATIONSHIPS ======================================= IN 1997, HNMC BEGAN ITS ASSOCIATION WITH THE NEW YORK-PRESBYTERIAN HEALTH SYSTEM. THIS AFFILIATION RESULTED IN THE EXPANSION OF VITAL HEALTH SERVICES FOR OUR COMMUNITY INCLUDING: AN UPGRADED NEONATAL SPECIAL CARE NURSERY WITH ASSISTANCE FROM NEW YORK/PRESBYTERIAN MEDICAL CENTER; INCREASED ACCESS TO CLINICAL TRIALS; AND EXPANDED EDUCATIONAL OPPORTUNITIES FOR PHYSICIANS. HNMC IS ALSO AN ACADEMIC AFFILIATE OF COLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS. THE HNMC COMMUNITY ALSO ENJOYS OTHER ACADEMIC RELATIONSHIPS, WHICH PROVIDE AN EDUCATIONAL ENVIRONMENT FOR STUDENTS FROM A VARIETY OF HEALTHCARE PROFESSIONS: - IN JULY 2010, HNMC BEGAN ACCEPTING THIRD AND FOURTH YEAR STUDENTS FROM THE TOURO COLLEGE OF OSTEOPATHIC MEDICINE (NEW YORK, NY), TO COMPLETE CLINICAL ROTATIONS IN FULFILLMENT OF THEIR CURRICULUM. - AFFILIATION AGREEMENTS ARE MAINTAINED WITH BERGEN COMMUNITY COLLEGE (PARAMUS, NJ) FOR NURSING STUDENTS, AND FOR RADIOLOGY, ULTRASOUND, RESPIRATORY, AND SURGICAL TECHNICIANS. TRAINEES FROM RUTGERS UNIVERSITY (NEW BRUNSWICK, NJ) ARE PREDOMINANTLY DOCTOR OF PHARMACY STUDENTS WHO ARE COMPLETING ROTATIONS IN ACUTE CRITICAL CARE, INFECTIOUS DISEASE, ONCOLOGY, NEPHROLOGY, AND ADMINISTRATION. THE TRAINEES ARE SUPERVISED BY A CLINICAL CARE COORDINATOR FROM THE UNIVERSITY. ONE COMMUNITY HEALTH STUDENT ROTATES THROUGH HNMC AS WELL. - THE MEDICAL CENTER MAINTAINS A COLLABORATIVE AGREEMENT WITH ST. PETER'S COLLEGE (JERSEY CITY, NJ) TO PROVIDE THE OPTION FOR HOLY NAME SCHOOL OF NURSING STUDENTS TO TAKE ADDITIONAL COLLEGE CREDITS TO EARN AN ASSOCIATES OF APPLIED SCIENCE ("AAS") DEGREE IN HEALTH SCIENCES. THE AAS COMPLEMENTS THE DIPLOMA AWARDED FROM THE HOLY NAME SCHOOL OF NURSING. EMPLOYEES OF HNMC ARE ALSO ABLE TO CONTINUE THEIR STUDIES BY PURSUING BACHELOR'S, MASTER'S, AND ADVANCED PRACTICE NURSING DEGREES AT ST. PETER'S COLLEGE. IN THIS PROCESS, STUDENT EMPLOYEES WORK WITH VARIOUS ADMINISTRATIVE LEADERS WITHIN HNMC TO COMPLETE CLINICAL ROTATIONS. - UNDERGRADUATE, NURSE PRACTITIONER AND NURSING DOCTORAL STUDENTS FROM FARLEIGH DICKINSON UNIVERSITY (TEANECK, NJ) COMPLETE ROTATIONS WITH OVERSIGHT FROM HNMC'S DEPARTMENT OF NURSING EDUCATION. - OTHER NURSING AFFILIATION AGREEMENTS ALSO EXIST BETWEEN HNMC AND SETON HALL UNIVERSITY (SOUTH ORANGE, NJ), WILLIAM PATERSON UNIVERSITY (WAYNE, NJ), FELICIAN COLLEGE (LODI, NJ), AND THE UNIVERSITY OF MEDICINE AND DENTISTRY OF NEW JERSEY ("UMDNJ") (NEWARK, NJ). IN ADDITION, ULTRASOUND AND NUCLEAR MEDICINE STUDENTS FROM UMDNJ MAY COMPLETE SEMESTER-LONG ROTATIONS IN HNMC'S DEPARTMENT OF RADIOLOGY UNDER THE INSTRUCTION OF SENIOR ULTRASOUND AND NUCLEAR MEDICINE STAFF. A SIMILAR AGREEMENT FOR ROTATIONS IN ULTRASOUND AT HNMC IS WITH NEW YORK UNIVERSITY (NEW YORK, NY). SENIOR ULTRASOUND STAFF MEMBERS FROM HNMC PROVIDE CLINICAL INSTRUCTION. - PHYSICAL AND/OR OCCUPATIONAL THERAPY AGREEMENTS TO PERMIT STUDENTS TO COMPLETE CLINICAL ROTATIONS AT THE MEDICAL CENTER ARE WITH NEW YORK MEDICAL COLLEGE (VALHALLA, NY), UNION COUNTY COLLEGE (CRANFORD, NJ), HUNTER COLLEGE (NEW YORK, NY), MERCY COLLEGE (DOBBS FERRY, NY), QUINNIPIAC UNIVERSITY (HAMDEN, CT), THE UNIVERSITY OF SCRANTON (SCRANTON, PA), THE UNIVERSITY OF WISCONSIN (LA CROSSE, WI), MISERICORDIA UNIVERSITY (DALLAS, PA), KEAN UNIVERSITY (UNION, NJ), AND ROCKLAND COMMUNITY COLLEGE (SUFFERN, NY). IN ALL CASES, INSTRUCTION IS PROVIDED BY HNMC STAFF. - EACH YEAR, HNMC ACCEPTS A SMALL NUMBER OF STUDENTS FROM THE COLUMBIA UNIVERSITY MAILMAN SCHOOL OF PUBLIC HEALTH PROGRAM IN HEALTH POLICY AND MANAGEMENT AS SUMMER INTERNS. INTERNS WORK ON SPECIFIC PROJECTS UNDER THE DIRECTION OF A MEMBER OF SENIOR MANAGEMENT. IN 2009, HNMC ACCEPTED ITS FIRST STUDENT FROM THE JOHNS HOPKINS BLOOMBERG SCHOOL OF PUBLIC HEALTH MASTERS PROGRAM IN HEALTH FINANCE AND MANAGEMENT. THE STUDENT COMPLETES AN 11-MONTH, FULL-TIME RESIDENCY UNDER THE DIRECTION OF THE CEO AND MEMBERS OF SENIOR MANAGEMENT. RECOGNITION =========== HNMC IS RECOGNIZED FOR ITS CLINICAL SKILL, QUALITY OUTCOMES AND HIGH RATE OF PATIENT SATISFACTION BY MULTIPLE NATIONAL ACCREDITATION AGENCIES AND BENCHMARKING ORGANIZATIONS. THE JOINT COMMISSION CITES HNMC AS A "TOP PERFORMER FOR KEY QUALITY MEASURES," CITING EXCELLENCE IN HEART ATTACK, PNEUMONIA AND SURGICAL CARE. HNMC HOLDS MAGNET STATUS FOR OUTSTANDING NURSING CARE FROM THE AMERICAN NURSES CREDENTIALING CENTER ("ANCC"). THE MAGNET RECOGNITION PROGRAM WAS DEVELOPED BY THE ANCC TO RECOGNIZE HEALTHCARE ORGANIZATIONS THAT PROVIDE NURSING EXCELLENCE, AND TO PROVIDE A VEHICLE FOR DISSEMINATING SUCCESSFUL NURSING PRACTICES AND STRATEGIES. APPROXIMATELY SIX PERCENT (6%) OF HOSPITALS NATIONWIDE ARE MAGNET HOSPITALS. HNMC ALSO RECEIVED THE BEACON AWARD FOR CRITICAL CARE EXCELLENCE FOR ITS TELEMETRY AND INTENSIVE CARE UNITS. THIS AWARD FROM THE AMERICAN ASSOCIATION OF CRITICAL-CARE NURSES RECOGNIZES NURSING EXCELLENCE IN PROFESSIONAL PRACTICE, PATIENT CARE AND OUTCOMES. HNMC HAS BEEN RECOGNIZED BY J.D. POWER AND ASSOCIATES WITH ITS DISTINGUISHED HOSPITAL AWARDS FOR EMERGENCY, INPATIENT AND MATERNITY SERVICE EXCELLENCE; AND HAS RECEIVED THE HEALTHGRADES DISTINGUISHED HOSPITAL AWARD FOR CLINICAL EXCELLENCE, AS WELL AS ITS SPECIALTY EXCELLENCE AWARD FOR STROKE CARE. DATA ADVANTAGE, LLC, WHICH IS A HEALTHCARE INFORMATION COMPANY, HONORED HNMC WITH ITS BEST IN VALUE AWARD FOR QUALITY, AFFORDABILITY, EFFICIENCY, PATIENT SAFETY AND OVERALL EXPERIENCE; AND HNMC RECEIVED DESIGNATION AS A COMMUNITY VALUE FIVE-STAR HOSPITAL BY CLEAVERLY+ASSOCIATES, AN INDEPENDENT ORGANIZATION THAT PERFORMS NATIONWIDE STUDIES TO IDENTIFY THOSE HOSPITALS THAT PROVIDE VALUE TO THE COMMUNITY IN TERMS OF FINANCIAL VIABILITY AND PLANT REINVESTMENT, COST STRUCTURE, CHARGE STRUCTURE AND QUALITY PERFORMANCE. HNMC HAS BEEN PRAISED REPEATEDLY AS AN EXEMPLARY WORKPLACE BY MODERN HEALTHCARE'S 100 BEST PLACES TO WORK IN HEALTHCARE PROGRAM; BY NJBIZ (THE LEADING WEEKLY BUSINESS PUBLICATION IN NEW JERSEY), WHICH CITES HNMC AS A TOP HOSPITAL AND BUSINESS OVERALL IN ITS 50 BEST PLACES TO WORK IN NEW JERSEY PROGRAM; AND BY COMPANIES THAT CARE, WHICH CITED HNMC ON ITS 2010 AND 2011 HONOR ROLL. COMPANIES THAT CARE IS A NON-PROFIT ORGANIZATION DEDICATED TO ENCOURAGING AND CELEBRATING BUSINESSES THAT PRIZE THEIR EMPLOYEES AND ARE COMMITTED TO COMMUNITY SERVICE.
PROGRAM SERVICE ACCOMPLISHMENTS	CORE FORM, PART III; QUESTION 2	IN LATE 2007, THE SISTERS OF ST. JOSEPH OF PEACE TRANSFERRED TO HOLY NAME MEDICAL CENTER TITLE TO A 26-ACRE ESTATE IN SADDLE RIVER, NEW JERSEY. THE ESTATE, KNOWN AS VILLA MARIE CLAIRE ("VMC"), INCLUDES A MANSION THAT HAS BEEN UNDER RENOVATION TO ACCOMMODATE A 20-BED HOSPICE FACILITY, FILLING A KNOWN NEED IN BERGEN COUNTY. THE HOSPICE WILL BE OPEN TO ALL CLINICALLY ELIGIBLE PERSONS, WHETHER PREVIOUSLY ASSOCIATED WITH HOLY NAME MEDICAL CENTER OR NOT. THE HOSPICE BEGAN CONDUCTING BUSINESS IN JANUARY 2011 AND RESULTS OF OPERATIONS ARE INCLUDED IN THE RESPECTIVE PARTS OF THIS FEDERAL FORM 990.
OTHER PROGRAM SERVICES	CORE FORM, PART III; LINE 4D	EXPENSES INCURRED IN PROVIDING MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. PLEASE REFER TO THE ORGANIZAITON'S COMMUNITY BENEFIT STATEMENT INCLUDED IN SCHEDULE O.
DISCLOSURE INFORMATION	CORE FORM, PART IV, QUESTION 28 AND PART VII	A MEMBER OF THE ORGANIZATION'S BOARD OF TRUSTEES, TED A. CARNEVALE, CPA, IS A PARTNER IN A PUBLIC ACCOUNTING FIRM; GRAMKOW, CARNEVALE, SEIFERT & CO., L.L.C. THIS FIRM PROVIDED ACCOUNTING, TAX AND CONSULTING SERVICES TO A RELATED ORGANIZATION OF HOLY NAME MEDICAL CENTER DURING 2011. THE RELATED ENTITY PAID GRAMKOW, CARNEVALE, SEIFERT & CO., L.L.C. $72,736 FOR THESE SERVICES DURING 2011.
DISCLOSURE INFORMATION	CORE FORM, PART VI, SECTION B; QUESTION 11B	THE ORGANIZATION'S FEDERAL FORM 990 WAS MADE AVAILABLE TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY (ITS BOARD OF TRUSTEES) PRIOR TO THE FILING OF THE FEDERAL FORM 990 WITH THE INTERNAL REVENUE SERVICE ("IRS"). IN ADDITION THE ORGANIZATION'S AUDIT COMMITTEE ASSUMED THE RESPONSIBILITY TO OVERSEE AND COORDINATE THE FEDERAL FORM 990. AS PART OF THE ORGANIZATION'S FEDERAL FORM 990 TAX RETURN PREPARATION PROCESS THE ORGANIZATION HIRED A PROFESSIONAL CPA FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION TO PREPARE THE FEDERAL FORM 990. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE ORGANIZATION'S FINANCE PERSONNEL INCLUDING THE CHIEF FINANCIAL OFFICER, DIRECTOR OF ACCOUNTING AND VARIOUS OTHER INDIVIDUALS TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE ORGANIZATION'S INTERNAL WORKING GROUP, INCLUDING THOSE INDIVIDUALS OUTLINED ABOVE FOR THEIR REVIEW. THE ORGANIZATION'S INTERNAL WORKING GROUP REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE ORGANIZATION'S INTERNAL WORKING GROUP FOR FINAL REVIEW AND APPROVAL. A MEETING WAS ALSO HELD TO REVIEW THE FINAL DRAFT OF THE FEDERAL FORM 990 WITH THE ORGANIZATION'S AUDIT COMMITTEE FOR REVIEW AND APPROVAL. FOLLOWING THIS REVIEW THE FINAL FEDERAL FORM 990 WAS MADE AVAILABLE TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY PRIOR TO THE FILING OF THE TAX RETURN WITH THE IRS.
DISCLOSURE INFORMATION	CORE FORM, PART VI, SECTION B; QUESTION 12	THE ORGANIZATION 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 AND THE ORGANIZATION'S CHIEF COMPLIANCE OFFICER FOR REVIEW. THEREAFTER THE ORGANIZATION'S CHIEF COMPLIANCE OFFICER PREPARES A SUMMARY OF THE COMPLETED QUESTIONNAIRES WHICH CONTAINS INFORMATION DISCLOSED ON AN INDIVIDUAL BY INDIVIDUAL BASIS. THEREAFTER, THE ORGANIZATION'S CHIEF COMPLIANCE OFFICER PRESENTS THIS SUMMARY TO THE ORGANIZATION'S GOVERNANCE COMMITTEE FOR ITS 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, EXECUTIVE VICE PRESIDENT/CHIEF FINANCIAL OFFICER AND VICE PRESIDENT OF PATIENT CARE SERVICES. 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, EXECUTIVE VICE PRESIDENT/CHIEF FINANCIAL OFFICER AND VICE PRESIDENT OF PATIENT CARE SERVICES. 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, EXECUTIVE VICE PRESIDENT/CHIEF FINANCIAL OFFICER AND VICE PRESIDENT OF PATIENT CARE SERVICES. THE COMPENSATION AND BENEFITS OF CERTAIN OTHER INDIVIDUALS CONTAINED IN THIS FORM 990 ARE 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. THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE STATE OF NEW JERSEY SECRETARY OF STATE.
COMPENSATION INFORMATION DISCLOSURE	CORE FORM, PART VII AND SCHEDULE J	PART VII AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM THE ORGANIZATION. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OF THE ORGANIZATION; NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THE ORGANIZATION'S BOARD OF TRUSTEES.
RELATED HOURS DISCLOSURE	CORE FORM, PART VII, SECTION A, COLUMN B	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 RELATED AFFILIATES. 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, 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 ALL RELATED ORGANIZATIONS AND THIS ORGANIZATION, IN TOTAL.
OTHER CHANGES IN NET ASSETS	CORE FORM, PART XI; QUESTION 5	OTHER CHANGES IN NET ASSETS OR FUND BALANCES INCLUDE: - CHANGE IN INTEREST OF HOLY NAME HEALTH CARE FOUNDATION, INC. - ($504,549) - CHANGE IN NET UNREALIZED GAINS AND LOSSES ON INVESTMENTS - ($4,071,070) - DISTRIBUTIONS FROM FOUNDATION TO MEDICAL CENTER - $1,075,515 - NET ASSETS RELEASED FROM RESTRICTION FOR CAPITAL PURPOSES - $60,169 - NET CHANGE IN TEMPORARILY RESTRICTED NET ASSETS (NOT INCLUDING DONATIONS OF $442,431) - ($1,024,017) - TEMPORARILY RESTRICTED DONATIONS - $442,431 - TRANSFERS TO AFFILIATES - ($6,567,315)
AUDITED FINANCIAL STATEMENTS	CORE FORM, PART XII; QUESTION 2	AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF HOLY NAME MEDICAL CENTER, INC. AND AFFILIATES, FOR THE YEARS ENDED DECEMBER 31, 2011 AND DECEMBER 31, 2010; RESPECTIVELY. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAINED CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. THE INDEPENDENT CPA FIRM ISSUED AN UNQUALIFIED OPINION WITH RESPECT TO THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS. HOLY NAME MEDICAL CENTER'S AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR THE AUDITED 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

HOLY NAME MEDICAL CENTER

Employer identification number

22-1487322

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
(1) HNH FITNESS LLC 718 TEANECK ROAD TEANECK,NJ07666 59-3836367	WELLNESS	NJ	1,626,142	7,149,103	HNMC
(2) HNLS LLC 718 TEANECK ROAD TEANECK,NJ07666 45-3636025	INACTIVE	NJ	0	0	HNMC

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) HOLY NAME HEALTH CARE FOUNDATION 718 TEANECK ROAD TEANECK,NJ07666 22-2737143	FUNDRAISING	NJ	501(C)(3)	509(A)(3)	HNMC	Yes
(2) HOLY NAME REAL ESTATE CORP 718 TEANECK ROAD TEANECK,NJ07666 22-3412504	PROPERTY CO	NJ	501(C)(2)	N/A	HNMC	Yes
(3) SISTERS OF ST JOSEPH OF PEACE 718 TEANECK ROAD TEANECK,NJ07666 22-3412084	RELIGIOUS ORD	NJ	501(C)(3)	170B1AI	NA		No
(4) MS COMPREHENSIVE CARE CENTER 718 TEANECK ROAD TEANECK,NJ07666 22-2402959	HEALTHCARE	NJ	501(C)(3)	509(A)(2)	HNMC	Yes
(5) HOLY NAME EMS INC 718 TEANECK ROAD TEANECK,NJ07666 27-0294681	HEALTHCARE	NJ	501(C)(3)	509(A)(3)	HNMC	Yes

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)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership
(1) HEALTH PARTNER SERVICES INC 718 TEANECK ROAD TEANECK,NJ07666 22-3618636	MGMT SERVICES	NJ	HNMC	C CORP.	0	1,250,519	100.000 %
(2) PEACE HEALTH PARTNERS 718 TEANECK ROAD TEANECK,NJ07666 22-3618634	HLTHCARE SVCS	NJ	NA	C CORP.
(3) HOUSE PHYSICIAN PARTNERS 718 TEANECK ROAD TEANECK,NJ07666 22-3808427	HLTHCARE SVCS	NJ	NA	C CORP.
(4) HEMATOLOGYONCOLOGY PHYSICIANS 718 TEANECK ROAD TEANECK,NJ07666 22-3808421	HLTHCARE SVCS	NJ	NA	C CORP.
(5) RIVERSIDE FAMILY CARE 718 TEANECK ROAD TEANECK,NJ07666 20-0446233	HLTHCARE SVCS	NJ	NA	C CORP.
(6) RADIATION ONCOLOGY PARTNERS 718 TEANECK ROAD TEANECK,NJ07666 20-1104758	HLTHCARE SVCS	NJ	NA	C CORP.
(7) EXCELCARE MEDICAL ASSOCIATES 718 TEANECK ROAD TEANECK,NJ07666 20-3130405	HLTHCARE SVCS	NJ	NA	C CORP.
(8) BREAST IMAGING PARTNERS 718 TEANECK ROAD TEANECK,NJ07666 75-3226059	HLTHCARE SVCS	NJ	NA	C CORP.
(9) IMA OF BERGEN COUNTY 718 TEANECK ROAD TEANECK,NJ07666 75-3226063	HLTHCARE SVCS	NJ	NA	C CORP.
(10) BREAST CARE PARTNERS 718 TEANECK ROAD TEANECK,NJ07666 11-3787403	HLTHCARE SVCS	NJ	NA	C CORP.
(11) WOMEN'S HEALTH PARTNERS PC 718 TEANECK ROAD TEANECK,NJ07666 83-0511119	HLTHCARE SVCS	NJ	NA	C CORP.
(12) WOMEN'S CLINIC PARTNERS 718 TEANECK ROAD TEANECK,NJ07666 36-4635222	HLTHCARE SVCS	NJ	NA	C 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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

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

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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

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

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

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) MS COMPREHENSIVE CARE CENTER	D	212,929	COST
(2) MS COMPREHENSIVE CARE CENTER	b	105,000	COST
(3) HOLY NAME REAL ESTATE CORPORATION	E	306,546	COST
(4) HOLY NAME HEALTH CARE FOUNDATION	R	1,075,515	COST
(5) HOLY NAME HEALTH CARE FOUNDATION	D	303,680	COST
(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:

1	Briefly describe the organization’s mission or most significant activities: TO PROVIDE QUALITY MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN THE COMMUNITY REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a).....	3	23
4	Number of independent voting members of the governing body (Part VI, line 1b) ....	4	21
5	Total number of individuals employed in calendar year 2011 (Part V, line 2a) ...	5	2,667
6	Total number of volunteers (estimate if necessary) ....	6	750
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

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	4,404,992	3,702,754
9	Program service revenue (Part VIII, line 2g) .........	263,075,228	280,065,531
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,544,977	3,767,294
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	2,874,434	2,989,146
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	271,899,631	290,524,725
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	110,000	1,501,992
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)	138,976,793	145,182,316
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)....	127,095,099	136,916,344
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	266,181,892	283,600,652
19	Revenue less expenses. Subtract line 18 from line 12.......	5,717,739	6,924,073
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	285,993,216	290,137,110
21	Total liabilities (Part X, line 26).............	174,781,648	182,590,305
22	Net assets or fund balances. Subtract line 21 from line 20.....	111,211,568	107,546,805

Sign Here

	Signature of officer	Date

	Type or print name and title.


4a	(Code: ) (Expenses $ 135,192,718 including grants of $ 0 ) (Revenue $ 124,712,304 )
	EXPENSES INCURRED IN PROVIDING MEDICALLY NECESSARY INPATIENT SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. THE ORGANIZATION PROVIDED INPATIENT SERVICES TO 16,722 PATIENTS FOR A TOTAL OF 76,821 PATIENT DAYS. PLEASE REFER TO THE ORGANIZAITON'S COMMUNITY BENEFIT STATEMENT INCLUDED IN SCHEDULE O.

4b	(Code: ) (Expenses $ 109,467,262 including grants of $ 0 ) (Revenue $ 121,438,874 )
	EXPENSES INCURRED IN PROVIDING MEDICALLY NECESSARY OUTPATIENT SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. THE ORGANIZATION PROVIDED OUTPATIENT SERVICES TO 131,442 PATIENTS. PLEASE REFER TO THE ORGANIZAITON'S COMMUNITY BENEFIT STATEMENT INCLUDED IN SCHEDULE O.

4c	(Code: ) (Expenses $ 10,735,176 including grants of $ 0 ) (Revenue $ 16,247,451 )
	EXPENSES INCURRED IN PROVIDING MEDICALLY NECESSARY EMERGENCY ROOM SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. THE ORGANIZATION PROVIDED EMERGENCY ROOM SERVICES TO 41,903 PATIENTS. PLEASE REFER TO THE ORGANIZAITON'S COMMUNITY BENEFIT STATEMENT INCLUDED IN SCHEDULE O. INCLUDED IN SCHEDULE O.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 0 including grants of $ 1,491,936 ) (Revenue $ 17,666,902 )
4e	Total program service expenses$ 255,395,156

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	6,553,997	0	1,192,157

				(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
e	Government grants (contributions)1e		1,389,735

f	All other contributions, gifts, grants, and similar amounts not included above1f		2,313,019
g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			3,702,754
			Business Code
2a	NET PATIENT SERVICE REVENUE		541,900	275,653,805	275,653,805
b	OTHER HEALTHCARE RELATED REVENUE		541,900	1,232,356	1,232,356
c	SCHOOL OF NURSING		900,099	1,852,546	1,852,546
d	HNH FITNESS, L.L.C.		541,900	1,326,824	1,326,824
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			280,065,531
3	Investment income (including dividends, interest
	and other similar amounts).....			839,166			839,166
4	Income from investment of tax-exempt bond proceeds..			342,507			342,507
5	Royalties............			0
		(i) Real	(ii) Personal
6a	Gross rents	108,362
b	Less: rental expenses	58,515
c	Rental income or (loss)	49,847
d	Net rental income or (loss).......			49,847			49,847
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	14,910,931	596,519
b	Less: cost or other basis and sales expenses	12,710,692	211,137
c	Gain or (loss)	2,200,239	385,382
d	Net gain or (loss)..........			2,585,621			2,585,621
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		722,210	1,627,011			1,627,011
b	DAY CARE		624,410	927,258			927,258
c	TELEVISION & TELEPHONE		517,000	385,030			385,030
d	All other revenue ....
e	Total. Add lines 11a–11d ......			2,939,299
12	Total revenue. See Instructions....			290,524,725	280,065,531		6,756,440


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing ..........			90	1	90
2	Savings and temporary cash investments .......			24,763,256	2	14,280,535
3	Pledges and grants receivable, net .........			105,553	3	26,258
4	Accounts receivable, net .........			30,350,683	4	32,781,049
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 .............			4,319,434	7	5,865,669
8	Inventories for sale or use ..............			4,103,457	8	4,866,642
9	Prepaid expenses and deferred charges ............			1,922,537	9	1,974,745
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	335,397,489
b	Less: accumulated depreciation. .....	10b	190,857,874	137,797,477	10c	144,539,615
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 ..			75,752,305	13	76,046,796
14	Intangible assets .........			0	14	0
15	Other assets. See Part IV, line 11 ...........			6,878,424	15	9,755,711
16	Total assets. Add lines 1 through 15 (must equal line 34)...			285,993,216	16	290,137,110
17	Accounts payable and accrued expenses .			31,641,533	17	35,977,842
18	Grants payable ..........			0	18	0
19	Deferred revenue ..........			497,775	19	450,556
20	Tax-exempt bond liabilities ..........			123,066,344	20	120,231,168
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 ..			4,279,240	23	5,054,740
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.....			15,296,756	25	20,875,999
26	Total liabilities. Add lines 17 through 25.....			174,781,648	26	182,590,305
	Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....			102,732,205	27	99,649,028
28	Temporarily restricted net assets .....			7,479,363	28	6,897,777
29	Permanently restricted net assets .....			1,000,000	29	1,000,000
	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 .....			111,211,568	33	107,546,805
34	Total liabilities and net assets/fund balances .....			285,993,216	34	290,137,110

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