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

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2012
Open to Public Inspection
A For the 2012 calendar year, or tax year beginning 01-01-2012 , 2012, and ending 12-31-2012
BCheck if applicable:
CName of organization
MERIDIAN HEALTH SYSTEM INC
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
1350 CAMPUS PARKWAY
Suite
Room/suite
City or town, state or country, and ZIP + 4
NEPTUNE, NJ07753
D Employer identification number

22-3474145
E Telephone number

G Gross receipts $ 1,404,735
F Name and address of principal officer:
JOHN K LLOYD FACHE
1350 CAMPUS PARKWAY
NEPTUNE,NJ07753
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.meridianhealth.com
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1997
M State of legal domicile: NJ
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: THE ORGANIZATION IS THE PARENT ENTITY OF THE MERIDIAN HEALTH SYSTEM, A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THE ORGANIZATION COORDINATES AND SUPPORTS THE CHARITABLE ACTIVITIES OF THE SYSTEM.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 19
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 11
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ...... 5 0
6 Total number of volunteers (estimate if necessary) ............. 6 0
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 -19,301
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 0 0
9 Program service revenue (Part VIII, line 2g) ......... 51,393 8,629
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 9,399 1,281,698
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 0 0
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 60,792 1,290,327
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 0
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 0 0
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 3,328,489 1,166,366
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 3,328,489 1,166,366
19 Revenue less expenses. Subtract line 18 from line 12....... -3,267,697 123,961
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 57,864,861 57,163,843
21 Total liabilities (Part X, line 26)............. 1,367,239 1,892,260
22 Net assets or fund balances. Subtract line 21 from line 20..... 56,497,622 55,271,583
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2012)
Form 990 (2012)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III ...............
1
Briefly describe the organization’s mission: THE ORGANIZATION IS THE PARENT ENTITY OF THE MERIDIAN HEALTH SYSTEM, A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. IN ITS ROLE, THE ORGANIZATION COORDINATES AND SUPPORTS THE CHARITABLE ACTIVITIES OF THE SYSTEM.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If “Yes,” describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 1,166,366 including grants of $ 0 ) (Revenue $ 8,629 )
THE ORGANIZATION IS THE PARENT ENTITY OF THE MERIDIAN HEALTH SYSTEM, A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. IN ITS ROLE, THE ORGANIZATION COORDINATES AND SUPPORTS THE CHARITABLE ACTIVITIES OF THE SYSTEM. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet1,166,366
Form 990 (2012)
Form 990 (2012)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? ...
2
 
No
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If “Yes,” complete Schedule C, Part II........
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C,
Part III
............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment
...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,” complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If “Yes,” complete Schedule D, Part VI.Click to see attachment
...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIIIClick to see attachment.......
11c
Yes
 
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part XClick to see attachment.........................
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If “Yes,” complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the United States? If “Yes,” complete Schedule F, Parts II and IV
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the United States? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I (see instructions)....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If “Yes,” complete Schedule H....
20a
 
No
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
 
 
Form 990 (2012)
Form 990 (2012)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II...
21
 
No
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?
......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I........ Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................... Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highest compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II
.......................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV .......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV
..................... Click to see attachment
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If “Yes,” complete Schedule L, Part IV... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I
...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2012)
Form 990 (2012)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V ...............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
59
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
0
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
 
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletBD
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes,” to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?............
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?..........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?.......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note.
See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2012)
Form 990 (2012)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI ...............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
19
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
11
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
 
No
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
 
No
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
NJ
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBulletJOHN GANTNER1350 CAMPUS PARKWAYNEPTUNENJ07753 (732) 751-7500
Form 990 (2012)
Form 990 (2012)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII ...............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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

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

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

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) Peter H Wegener Esq........................................................................
Chairperson - Trustee
5.0
.......................  
X   X       0 0 0
(2) Gordon N Litwin Esq........................................................................
Vice Chairperson - Trustee
5.0
.......................  
X   X       0 0 0
(3) Richard A Amdur Esq........................................................................
Secretary - Trustee
5.0
.......................  
X   X       0 0 0
(4) John Garbarino........................................................................
Treasurer - Trustee
5.0
.......................  
X   X       0 0 0
(5) Peter Amenta MD........................................................................
Trustee; Ex-Officio
3.0
.......................  
X           0 0 0
(6) Raymond M Masterson MD........................................................................
Trustee; Ex-Officio
3.0
.......................  
X           0 0 0
(7) Ivan Brown........................................................................
Trustee
3.0
.......................  
X           0 0 0
(8) Norman V Buttaci........................................................................
Trustee; Ex-Officio
3.0
.......................  
X           0 0 0
(9) John Ford........................................................................
Trustee
3.0
.......................  
X           0 0 0
(10) Paul G Gaffney II........................................................................
Trustee
3.0
.......................  
X           0 0 0
(11) Kenneth W Hitchner III........................................................................
Trustee
3.0
.......................  
X           0 0 0
(12) Luke Kealy Esq........................................................................
Trustee
3.0
.......................  
X           0 0 0
(13) Joseph P Lattanzi MD........................................................................
Trustee; Ex-Officio
3.0
.......................  
X           0 49,407 0
(14) Peter S Goldman........................................................................
Trustee
3.0
.......................  
X           0 0 0
(15) John K Lloyd FACHE........................................................................
Trustee; Ex-Officio-Pres/CEO
60.0
.......................  
X   X       0 1,649,901 615,065
(16) Frank Sharp MD........................................................................
Trustee; Ex-Officio
3.0
.......................  
X           0 0 0
(17) Roger Thompson MD........................................................................
Trustee; Ex-Officio
3.0
.......................  
X           0 33,240 0
Form 990 (2012)
Form 990 (2012)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) John Weiland........................................................................
Trustee
3.0
.......................  
X           0 0 0
(19) K George Younan MD........................................................................
Trustee; Ex-Officio
3.0
.......................  
X           0 21,590 0
(20) John Gantner........................................................................
Executive VP/CFO
60.0
.......................  
    X       0 910,126 310,248
(21) Marc H Lory........................................................................
EVP - HOSPITALS OPERATIONS
60.0
.......................  
    X       0 744,497 120,152
(22) SALVATORE INCIARDI........................................................................
ASSISTANT SECRETARY
60.0
.......................  
    X       0 639,766 88,172
















1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 0 4,048,527 1,133,637
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet0
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
AMDUR MAGGS SHORE, PO BOX 190OAKHURSTNJ07755 LEGAL 308,251
Ronan Tuzzio Giannone, One Hovchild Plaza 4000 Rt 66TINTON FALLSNJ07753 LEGAL 233,244
OrlovskyMoodySchaaffConlonGabry, 187 Hwy 36WEST LONG BRANCHNJ07764 LEGAL 253,660
Martin J McGreevy LLC, PO Box 850OAKHURSTNJ07755 LEGAL 131,950
ALLSCRIPTS HEALTHCARE LLC, 8529 SIX FORKS RDRALEIGHNJ27615 ELEC HEALTH RECORDS 133,981
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 MediumBullet11
Form 990 (2012)
Form 990 (2012)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response to any question in this Part VIII ..............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above
1f
 
g Noncash contributions included in lines
1a-1f:$
 
h Total. Add lines 1a-1f.......MediumBullet 0
 Program Service Revenue Business Code
2a PATRONAGE REBATE 900099 8,629 8,629    
b
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 8,629
 Other Revenue 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 1,281,698     1,281,698
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties...........MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents 114,408  
b Less: rental expenses 114,408  
c Rental income or (loss) 0 0
d Net rental income or (loss).......MediumBullet 0      
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory    
b Less: cost or other basis and sales expenses    
c Gain or (loss)    
d Net gain or (loss)..........MediumBullet 0      
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..MediumBullet 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...MediumBullet 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..MediumBullet 0      
Miscellaneous Revenue Business Code
11a            
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 0
12 Total revenue. See Instructions......MediumBullet 1,290,327 8,629   1,281,698
Form 990 (2012)
Form 990 (2012)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response to any question in this Part IX ...............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the United States. See Part IV, line 21 0  
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 0  
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 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 0      
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 0      
9 Other employee benefits ....... 0      
10 Payroll taxes ........... 0      
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 0      
c Accounting ........... 0      
d Lobbying ........... 0      
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 0      
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 0      
12 Advertising and promotion .... 0      
13 Office expenses ....... 0      
14 Information technology ...... 0      
15 Royalties .. 0      
16 Occupancy ........... 0      
17 Travel ............ 0      
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 0      
20 Interest ........... 0      
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 99,521 99,521    
23 Insurance .............. 0      
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a EHR:MHA 1,062,000 1,062,000 0 0
b PURCHASED SERVICES 4,345 4,345    
c LICENSES, DUES & FEES 500 500    
d
e All other expenses        
25 Total functional expenses. Add lines 1 through 24e 1,166,366 1,166,366 0 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 MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2012)
Form 990 (2012)
Page 11
Part X Balance Sheet Check if Schedule O contains a response to any question in this Part X ...............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash—non-interest-bearing ............. 150 1 0
2 Savings and temporary cash investments ......... 4,103,154 2 135,459
3 Pledges and grants receivable, net ........... 0 3 0
4 Accounts receivable, net ............. 0 4 0
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
0 6 0
7 Notes and loans receivable, net ............. 10,410 7 10,410
8 Inventories for sale or use .............. 0 8 0
9 Prepaid expenses and deferred charges .......... 0 9 0
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 838,450
b Less: accumulated depreciation ..... 10b 569,617 287,125 10c 268,833
11 Investments—publicly traded securities .......... 126 11 0
12 Investments—other securities. See Part IV, line 11 ..... 337,936 12 233,052
13 Investments—program-related. See Part IV, line 11 ..... 54,279,599 13 57,657,398
14 Intangible assets ............... 199,041 14 99,519
15 Other assets. See Part IV, line 11 ........... -1,352,680 15 -1,240,828
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 57,864,861 16 57,163,843
Liabilities 17 Accounts payable and accrued expenses ......... 721,341 17 1,247,260
18 Grants payable ................. 0 18 0
19 Deferred revenue ................ 0 19 0
20 Tax-exempt bond liabilities ............. 0 20 0
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
22 Loans and other 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 .. 645,000 23 645,000
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.................... 898 25 0
26 Total liabilities. Add lines 17 through 25......... 1,367,239 26 1,892,260
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 56,296,283 27 55,070,244
28 Temporarily restricted net assets ........... 201,339 28 201,339
29 Permanently restricted net assets ........... 0 29 0
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ........   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 56,497,622 33 55,271,583
34 Total liabilities and net assets/fund balances ........ 57,864,861 34 57,163,843
Form 990 (2012)
Form 990 (2012)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI ...............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
1,290,327
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
1,166,366
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
123,961
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
56,497,622
5
Net unrealized gains (losses) on investments ...............
5
 
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-1,350,000
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
55,271,583
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII ..............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If “Yes,” to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits
3b
 
 
Form 990 (2012)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID:  
Software Version:  
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
MERIDIAN HEALTH SYSTEM INC
 
Employer identification number

22-3474145
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the supported organization? ................
11g(i)
 
No
(ii) A family member of a person described in (i) above? ......................
11g(ii)
 
No
(iii) A 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
No
h
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) (iv) Is the organization in col. (i) listed in your governing document? (v) Did you notify the organization in col. (i) of your support? (vi) Is the organization in col. (i) organized in the U.S.? (vii) Amount of monetary support
Yes No Yes No Yes No
(A) MERIDIAN HOSPITALS CORPORATION
 
223471515 03 Yes   Yes   Yes   0
(B) BAYSHORE COMMUNITY HOSPITAL
 
210744668 03 Yes   Yes   Yes   0
(C) MERIDIAN NURSING & REHABILITATION INC
 
521772578 09 Yes   Yes   Yes   0
(D) BAYSHORE HEALTH CARE CENTER
 
222715789 09 Yes   Yes   Yes   0
(E) MERIDIAN PRACTICE INSTITUTE INC
 
061755235 09 Yes   Yes   Yes   0
(F) MERIDIAN HOME CARE SERVICES INC
 
222731440 09 Yes   Yes   Yes   0
(G) JERSEY SHORE UNIVERSITY MEDICAL CENTER FOUNDATION INC
 
222342452 07 Yes   Yes   Yes   0
(H) OCEAN MEDICAL CENTER FOUNDATION INC
 
222361311 07 Yes   Yes   Yes   0
(I) RIVERVIEW MEDICAL CENTER FOUNDATION INC
 
222333524 07 Yes   Yes   Yes   0
(J) MERIDIAN HEALTH FOUNDATION INC
 
300107825 07 Yes   Yes   Yes   0
(K) SOUTHERN OCEAN MEDICAL CENTER FOUNDATION INC
 
222666099 07 Yes   Yes   Yes   0
(L) BAYSHORE COMMUNITY HOSPITAL FOUNDATION INC
 
222367109 07 Yes   Yes   Yes   0
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 3
Part III
Support Schedule for Organizations Described in Section 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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 4
Part IV
Supplemental Information. Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2012

Additional Data


Software ID:  
Software Version:  
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
MERIDIAN HEALTH SYSTEM INC
 
Employer identification number

22-3474145
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) .....    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds 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? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a 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.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (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 XIII, the text of the footnote to its financial statements that describes these items.
b
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 $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance ....     0    
b Contributions ........ 201,339 201,339 201,339    
c Net investment earnings, gains, and losses          
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........
         
f Administrative expenses ....          
g End of year balance ...... 201,339 201,339 201,339    
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet100.000 %
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII 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 (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   85,700 85,700
b Buildings ................   752,750 588,918 163,832
c Leasehold improvements ............        
d Equipment ................        
e Other .................        
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 249,532
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)
(b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1) INVESTMENT IN AFFILIATES 57,657,398 F








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet 57,657,398
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.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes 0








Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 0
2. Fin 48 (ASC 740) Footnote. In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII .....................................................
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 4
Part XI 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 XIII.) ............ 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 XIII.) ........... 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 XII 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 XIII.) ............ 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 XIII.) ............ 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 XIII
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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
ENDOWMENT FUNDS SCHEDULE D, PART V ENDOWMENT FUNDS ARE TO BE USED CONSISTENT WITH INTENT AND IN FURTHERANCE OF THE ORGANIZATION'S CHARITABLE TAX-EXEMPT PURPOSES.
TEXT OF FIN 48 AUDITED FINANCIAL STATEMENT FOOTNOTE SCHEDULE D, PART X THE ORGANIZATION IS THE TAX-EXEMPT PARENT ORGANIZATION OF THE MERIDIAN HEALTH SYSTEM ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THE SYSTEM ISSUES CONSOLIDATED AUDITED FINANCIAL STATEMENTS PREPARED BY PRICEWATERHOUSE COOPERS, L.L.P., AN INDEPENDENT CPA FIRM, WHICH INCLUDE ALL RELATED ENTITIES. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ALSO CONTAIN CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. THE FIN 48 DISCLOSURE BELOW IS FROM THE SYSTEM'S INCOME TAX FOOTNOTE INCLUDED IN THE SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES FOOTNOTE OF ITS 2012 CONSOLIDATED AUDITED FINANCIAL STATEMENTS. ALL OF THE NOT-FOR-PROFIT ENTITIES INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS ARE CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE ("CODE") AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE EXCEPT FOR COMPASS WHICH QUALIFIES AS A TAXABLE NOT-FOR-PROFIT. THESE ENTITIES ARE ALSO EXEMPT FROM STATE INCOME TAXES. PER THE REQUIREMENT TO ASSESS FOR TAX UNCERTAINTY MANAGEMENT HAS DETERMINED THAT IT DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS REQUIRED TO BE ACCRUED OR REPORTED.
Schedule D (Form 990) 2012

Additional Data


Software ID:  
Software Version:  




Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
MERIDIAN HEALTH SYSTEM INC
 
Employer identification number

22-3474145
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all officers,
directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? .......
2
 
 
3
Indicate which, if any, of the following the filing organization used 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.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2012

Schedule J (Form 990) 2012
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 (E) amounts for that individual.
(A) Name and Title (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
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1)John K Lloyd FACHETrustee; Ex-Officio-Pres/CEO (i)
(ii)
0
980,006
0
600,000
0
69,895
0
586,974
0
28,091
0
2,264,966
0
0
(2)John GantnerExecutive VP/CFO (i)
(ii)
0
611,039
0
250,000
0
49,087
0
298,193
0
12,055
0
1,220,374
0
0
(3)Marc H LoryEVP - HOSPITALS OPERATIONS (i)
(ii)
0
505,400
0
90,000
0
149,097
0
91,785
0
28,367
0
864,649
0
107,165
(4)SALVATORE INCIARDIASSISTANT SECRETARY (i)
(ii)
0
313,142
0
160,000
0
166,624
0
70,271
0
17,901
0
727,938
0
140,539
Schedule J (Form 990) 2012

Schedule J (Form 990) 2012
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Identifier Return Reference Explanation
COMPENSATION INFORMATION SCHEDULE J, PART I; QUESTION 4B THE AMOUNT REFLECTED IN SCHEDULE J, PART II, COLUMN B(III) FOR THE FOLLOWING INDIVIDUALS INCLUDES PARTICIPATION IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP"). THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2012 FORM W-2, BOX 1, AS TAXABLE WAGES: SALVATORE INCIARDI, $140,539 AND MARC H. LORY, $107,165. THE DEFERRED COMPENSATION AMOUNT REFLECTED IN SCHEDULE J, PART II, COLUMN (C) FOR THE FOLLOWING INDIVIDUAL INCLUDES UNVESTED BENEFITS IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN WHICH ARE SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THE INDIVIDUAL MAY NEVER ACTUALLY RECEIVE THE UNVESTED BENEFIT AMOUNT. ACCORDINGLY, THE AMOUNT OUTLINED HEREIN WAS NOT INCLUDED IN THE INDIVIDUAL'S 2012 FORM W-2, AS TAXABLE WAGES: JOHN GANTNER, $204,093. THE DEFERRED COMPENSATION AMOUNTS REFLECTED IN SCHEDULE J, PART II, COLUMN (C) FOR THE FOLLOWING INDIVIDUALS INCLUDE INTEREST CREDITS IN A SUPPLEMENTAL EXECUTIVE RETIREMENT 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 2012 FORM W-2, AS TAXABLE WAGES: JOHN LLOYD, $531,056; MARC LORY, $60,073; JOHN GANTNER, $65,393; AND SALVATORE INCIARDI $35,076.
COMPENSATION INFORMATION SCHEDULE J, PART I; QUESTION 7 CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A BONUS DURING CALENDAR YEAR 2012 WHICH AMOUNTS WERE INCLUDED IN COLUMN B(II) HEREIN AND IN EACH INDIVIDUAL'S 2012 FORM W-2, BOXES 1 AND 5, AS TAXABLE WAGES. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT.
COMPENSATION INFORMATION SCHEDULE J, PART II, COLUMN F THE AMOUNTS REPORTED IN SCHEDULE J, PART II, COLUMN (F) FOR THE FOLLOWING INDIVIDUALS REPRESENT UNVESTED BENEFITS IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN THAT BECAME TAXABLE IN 2012 BECAUSE THEY WERE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE, AND WERE REPORTED AS RETIREMENT AND OTHER DEFERRED COMPENSATION ON PRIOR FORMS 990 OF THE ORGANIZATION. THESE AMOUNTS WERE TREATED AS TAXABLE INCOME AND REPORTED ON EACH INDIVIDUAL'S 2012 FORM W-2, BOX 1, AS TAXABLE WAGES: SALVATORE INCIARDI, $140,539 AND MARC H. LORY, $107,165.
Schedule J (Form 990) 2012

Additional Data


Software ID:  
Software Version:  
Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
MERIDIAN HEALTH SYSTEM INC
 
Employer identification number

22-3474145
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501(c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No





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

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
Total ......Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2012
Schedule L (Form 990 or 990-EZ) 2012
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) AMDUR MAGGS SHORE TRUSTEE/OFFICER - AMDUR 327,239 LEGAL - SEE PART V   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
BUSINESS TRANSACTIONS WITH INT. PERSONS SCHEDULE L, PART IV Richard A. Amdur, Esq is a partner WITH Amdur, Maggs & Shore. Meridian Health System, Inc. utilized the services of Amdur, Maggs & Shore during 2012. Total fees paid to Amdur, Maggs & Shore were $327,239. Services were rendered at fair market value rates pursuant to arm's length negotiations comparable to other firms providing similar services to Meridian Health System, Inc.
Schedule L (Form 990 or 990-EZ) 2012

Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
MERIDIAN HEALTH SYSTEM INC
 
Employer identification number

22-3474145
Identifier Return Reference Explanation
COMMUNITY BENEFIT STATEMENT CORE FORM, PART III, STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS Meridian has been viewed as a leader in developing the full continuum of care, providing integrated services to ensure our patients receive coordinated and seamless care from diagnosis to treatment and rehabilitation. The following updates show how we are shaping the future of health care and speak to our philosophy that its not the ability to do a single thing well, but the unique ability to do everything better. Meridian Cancer Care - Getting You Back to the Life You Love ------------------------------------------------------------ Under the leadership of Mark Krasna, M.D., corporate medical director for Meridian Cancer Care, Meridian is continuing to improve cancer care delivery. Meridian Cancer Care is part of Robert Wood Johnson University Medical School and a system partner with the Cancer Institute of New Jersey, the only National Cancer Institute designated Cancer Center in the state of New Jersey. The renewed focus on a multi-disciplinary, patient-oriented approach provides opportunities for both state-of-the-art care and research trials. Meridian has instituted nine disease site-specific multi- disciplinary conferences, which allow physicians to prospectively discuss cases and reach a consensus regarding what is ultimately the best treatment plan for each patient. Ten new disease site-specific cancer nurse navigators help simplify the complex world of cancer care by coordinating doctor visits and providing education and access to important resources at all Meridian hospitals. Meridian CardioVascular Network Regions Most Complete, Most Coordinated Care -------------------------------------------------------------- Jersey Shore University Medical Center became one of the first programs in the state to offer Transcatheter Aortic Valve Replacement (TAVR), a new minimally invasive procedure to treat critical aortic stenosis, recently approved by the FDA. The partnership between cardiothoracic surgeons and cardiologists establishes the core of the TAVR Heart Team. In addition, the Congenital Heart Disease Program continued to make strides in treating Atrial Septal Defect (ASD), a common and potentially fatal congenital heart abnormality with potentially serious consequences. ASD patients can now be treated with the Amplatzer Septal Occluder an FDA approved device providing a less invasive alternative to cardiac surgery. In 2012, Meridian Health launched the Heart and Sole Cup, a series of 5K run/walks at Ocean Medical Center, Bayshore Community Hospital and Jersey Shore University Medical Center. In its first year, nearly 1,000 runners participated in the series. Jersey Shore University Medical Center, Ocean Medical Center, and Riverview Medical Center have received System Heart Failure Accreditation by the Society of Cardiovascular Patient Care (SCPC). The Heart Failure accreditation recognizes expertise in providing quality care to patients who are treated for heart failure. Only 72 centers nationally and internationally have received this accreditation, and the three Meridian hospitals are the only certified programs in New Jersey. Meridian Neuroscience A Moment Changes Everything --------------------------------------------------- Meridian Neuroscience specialists have continued to develop programs to diagnose and treat a range of conditions from stroke to brain tumors and spine injuries to sleep disorders. Over the past two years, Bayshore Community Hospital has seen significant growth in their stroke services and as a designated Primary Stroke Center, Bayshore is preparing for Joint Commission Certification in Stroke to join Riverview Medical Center, Ocean Medical Center, and Jersey Shore University Medical Center with this added distinction. In addition, we continued to expand our clinical trials with the DIAS-4 Study, where we offered our patients the latest clot-busting drug to treating acute and ischemic stroke. As the spokesperson for Meridian Neuroscience, NFL Hall of Famer Harry Carson is leading the way in educating our community about prevention and wellness. At Neptune High School, Harry teamed up with Meridian experts for an evening of lifesaving information on risk factors, prevention, and detection of stroke. At Colts Neck High School, Harry stressed the importance of concussion awareness, especially in children and adolescents. Meridian Pediatric Network Care in Your Community Connected to More Than 100 Specialists --------------------------------------------------------------------- Meridian Pediatric Network continues to address the needs of our youngest patients with the completion of pediatric care centers located at each of our hospitals. With this, families will have access to more than 100 pediatric specialists and the most coordinated care throughout the region. With the increased occurrence of concussions among children, Meridian Pediatric Network and our expert team of pediatric sports medicine physicians have developed a comprehensive concussion program, which utilizes the latest in baseline testing and detection to properly treat our youngest patients. In the summer of 2012, Jersey Shore University Medical Center hosted a pep rally where hundreds of children, parents, team members, and soccer supporters gathered to cheer on U.S. Womens Soccer Team Captain, role model, hometown hero, and spokesperson for K. Hovnanian Childrens Hospital Christie Rampone before she left for the 2012 Summer Olympics in London. After leading the team to a gold medal victory, an even bigger celebration was held once she returned home. Doctor Bernard celebrates his milestone 5th birthday with the rest of the Pawsitive Action Team, which is now closing in on its 10,000th member! For the past five years, he and his pals Hopscotch and Picatso have had a positive influence on teaching our regions children about staying healthy, eating right and being safe. Jersey Shore University Medical Center -------------------------------------- First Hospital in New Jersey to Receive Advanced Certification in Palliative Care ----------------------------------------------------------------- Jersey Shore is the first hospital in the state to receive the Advanced Certification in Palliative Care from The Joint Commission a true testament to the quality and compassion that distinguishes Meridian Health and Jersey Shores Palliative Care Program. Palliative care is specialized medical care that provides patients at any age or stage of illness with relief from the symptoms, pain and stress that accompany serious illnesses. The Joint Commissions Advanced Certification for Palliative Care recognizes hospital inpatient programs that demonstrate exceptional patient and family-centered care and optimize the quality of life for patients with serious illness. Training Future Physicians -------------------------- The academic programs at Jersey Shore University Medical Center continue to excel. Through our affiliation with Rutgers Medical School, Jersey Shore expanded the teaching program of students in their third and fourth year of medical school to provide experiences in all required rotations, and also placed first year medical students with select primary care physicians to learn the art and science of family medicine. The residency training programs in OB/GYN, pediatrics, and internal medicine emphasize evidenced-based medicine, and graduates continue their training at some of the nations most prestigious hospitals. Students also take advantage of practice opportunities within Meridian Healths OB/GYN and internal medicine departments, and a residency program in podiatry will commence in 2013. Finally, Meridian continues to expand the Continuing Medical Education program, offering more than 700 hours of education in 2012, an increase of more than 60 percent since 2008!
COMMUNITY BENEFIT STATEMENT (CONTINUED) CORE FORM, PART III, STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS Innovative Research for a Healthier Future ------------------------------------------ Meridian Health, through its Office of Clinical Research and undergraduate, graduate, and continuing medical education programs, is dedicated to advancing medical knowledge, training physicians of tomorrow, and educating physicians in practice with the latest medical information. Meridians system-wide research program provides the community with the latest clinical trials in many specialty areas. 2012 witnessed the launch of a landmark study in the management of hypertension, SYMPLICITY HTN-3, as well as continuation of a ground-breaking study on genetic mutations and new treatments for thyroid cancer. The thyroid cancer research has led to a new test to predict the development of this form of cancer in high risk patients and reduce unnecessary surgery. It has been cited in the New England Journal of Medicine and holds great promise for families with a history of thyroid cancer. K. Hovnanian Childrens Hospital -------------------------------- Baby-Friendly has Arrived! -------------------------- The birth of a new baby brings joy to every family, and right from the beginning, every mother wants to make healthy choices for her newborn. As a Baby-Friendly designated hospital, Jersey Shore University Medical Center is one of only 150 American hospitals recognized by the World Health Organization and the United Nations Childrens Fund as providing the best quality care and support for breastfeeding mothers and their babies. As a Baby-Friendly Hospital, Jersey Shore provides the resources, confidence and skills that can help a mother embrace breastfeeding a powerful and preventive practice with many health benefits. A New Home for Pediatric Same Day Surgery ----------------------------------------- Thanks to advances in medical technology and surgical expertise, pediatric surgical procedures are most often performed on an outpatient basis, allowing children to return home the same day. Pediatric Same Day Services provides children with dedicated, comprehensive care for todays most common procedures, including procedural sedation, CAT scan and MRI, blood tests, special testing and surgical services all performed in a family-centered and child friendly environment. And weve recently relocated and expanded our space and services to provide a more convenient and comfortable area for pediatric patients and their families. Expert Concussion Care ---------------------- By utilizing the latest in baseline testing and detection, our expert team of pediatric specialists have developed several programs to screen, detect and treat children who have suffered concussions, sports injuries, accidents and falls. Located in the new Pediatric Specialty Care Center on K. Hovnanian Childrens Hospitals campus, the outpatient offices deliver the most advanced care in a convenient, state-of-the-art setting. Treating High Risk Children for Heart Disease --------------------------------------------- We support families to make healthy lifestyle changes for themselves to reduce a childs risk for the early onset of heart disease. Our new pediatric lipid program evaluates and treats children and adolescents who have high levels of lipids in their blood, as elevated lipids, particularly cholesterol, put young people at risk for heart disease later in life. Children and their families work with a pediatric cardiologist and pediatric nurse specialist trained in lipid disorders to review family health history, assess a childs risk, and develop a plan of care thats right for every child. Its the Tops...Nationally Recognized Pediatric Surgery, Close to Home ---------------------------------------------------------------------- K. Hovnanian Childrens Hospital participates in the American College of Surgeons with the National Surgical Quality Improvement Pediatric Program, which allows hospitals to collect highly reliable clinical data and compare their surgical outcomes with those from other childrens hospitals in the program. K. Hovnanian Childrens Hospital is the only childrens hospital in New Jersey and one of 47 hospitals in the nation to work closely with this elite group of childrens hospitals dedicated to advancing pediatric surgery. Ocean Medical Center -------------------- A Personal Touch and Care Coordination Improving Access to Primary Care -------------------------------------------------------------------- With the landscape of health care dramatically changing, building a strong, well aligned primary care physician base is critical to meet the needs of the community in the years to come. Ocean Medical Center has been steadfast in its recruitment strategies for primary care physicians. In fact, Oceans team was excited to welcome 19 primary care physicians to the medical staff over the past year and a half. Many of these physicians are joining or establishing offices in key areas of growth, such as Toms River and Jackson. Growing Emergency Services in More Than One Way There has been a great deal of activity pertaining to emergency services at both Ocean Care Center and Ocean Medical Center. Located in Point Pleasant, Ocean Care Center has broken away from being a best kept secret and saw exceptional growth in volume and awareness in 2012. Wait times are now posted online and comprehensive marketing efforts resulted in strong growth, serving 14 percent more visits over the prior year. On the main hospital campus, a physical transformation is underway to improve emergency services. A groundbreaking ceremony kicked off an $82 million Master Facility Plan, which will include the new Hirair and Anna Hovnanian Emergency Care Center. Perhaps just as impressive as the physical grandeur of the project is the success of fundraising efforts to support it. Over $7 million has been raised to date, and several record breaking gifts from community members, physicians, and team members have energized a new era of giving at Ocean Medical Center. Ocean is on the Move and Getting Noticed ---------------------------------------- Increasing public awareness of Oceans capabilities and clinical strengths was a priority in 2012. An awareness campaign hit the public, as well as a campaign focused on Total Joint Replacement, which resulted in improvements in consumer perception. Beyond the local market, Ocean received national recognition as a best hospital in US News & World Report and was placed in the top five percent nationally for clinical performance. A Healing Touch for the Most Complex Wounds ------------------------------------------- Recognizing a tremendous need in the greater Ocean County market, the Center for Wound Healing was opened in June 2012. A unique team of doctors, nurses and therapists create an interdisciplinary approach to healing chronic wounds. For the most complex cases, the Center has two hyperbaric oxygen chambers that provide a concentrated level of oxygen to promote healing. Record Volumes and Expanded Services Pick up the Pace for Cardiovascular Services ------------------------------------------------------------------------ Ensuring that comprehensive cardiac services are available locally and close to home for residents is a priority at Ocean Medical Center. In 2012, Oceans cardiac catheterization laboratory experienced a 21% increase in primary angioplasty cases, hitting a record number of 100 lifesaving emergency procedures. Ocean also started a pacemaker program, which completed 31 pacemaker cases in the first three months, exceeding the number of cases anticipated for year one. Cardiac capabilities for inpatients expanded, as 40 additional medical/surgical beds were outfitted with telemetry monitoring, bringing the number to 116 hospital wide. This makes it possible to reduce patient holding in the Emergency Department, and better accommodate post-operative patients on a surgical unit. Other cardiac highlights include Chest Pain and Heart Failure Accreditations from the Society of Cardiovascular Patient Care.
COMMUNITY BENEFIT STATEMENT (CONTINUED) CORE FORM, PART III, STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS Riverview Medical Center ------------------------ Surgical Expansion has Been Life Changing for the Riverview Community ----------------------------------------------------------------------- In 2011, Riverview Medical Center announced the creation of a 22,000 square foot center for surgical excellence and launched a Capital Campaign, Life. Changing. In 2012, and early 2013, Riverview celebrated the completion of the final phases of this project. 2012 introduced the opening of the Joan and Robert Rechnitz Conference and Education Center, along with the new Surgical Day Stay Unit, including an oversized surgical waiting area, 23 new private healing bays, and a new private consultation room for physicians and patients. Riverview also opened its new Brainsuite iCT, a digitally integrated operating room solution that combines image guided surgery technology, multi-slice intra-operative computed tomography, and comprehensive operating room data management. It is the first in the greater New York City area and one of only 10 sites throughout the country. The final phase of the project was the opening of the newly renovated Post-Anesthesia Care Area, affording Riverview an increased opportunity to provide patients and families with a personalized health care experience in a more comfortable and healing environment. An Experience That is Outstanding --------------------------------- Riverview Medical Center was once again 'Distinguished' by J.D. Power and Associates for Outpatient Services. The J.D. Power and Associates 'An Outstanding Patient Experience' recognition is one of the most prestigious health care distinctions in the nation. Unlike many other industry awards, the research behind the nationally-recognized honor is grounded in candid interviews with over 300 patients who have experienced Riverview first hand. Less than one percent of hospitals across the country receive this distinction. Riverviews wide array of outpatient programs provides quality care and service in a timely manner. These include same-day surgery, imaging, cancer care, rehabilitation, womens diagnostics, pain management, cardiac care, Crohns and colitis care, and emergency care. Recognized by the Best for Delivering the Best ---------------------------------------------- Riverview Medical Center has a history of being recognized on clinical excellence measures. Riverview was once again awarded The Joint Commissions Gold Seal of Approval(tm) for accreditation by demonstrating compliance with The Joint Commissions national standards for health care quality and safety in hospitals. In addition, the Jane H. and John Marshall Booker Cancer Center at Riverview was recognized as one of the nations best by the Commission on Cancer and was awarded the 'Outstanding Achievement Award,' designed to recognize cancer programs that strive for excellence in providing quality care to cancer patients. In 2012, the Womens Center at Riverview was designated a Breast Imaging Center of Excellence by the American College of Radiology. In addition, Riverview received the 2012 Target: Stroke Honor Roll Award for its commitment to and success in improving care for stroke patients, one of only 135 hospitals in the United States to receive this award. Finally, Riverviews Cardiac Rehabilitation program and its Chest Pain Center were accredited for 2012 by the American Association of Cardiovascular and Pulmonary Rehabilitation. Southern Ocean Medical Center ----------------------------- A New Experience for Kids at the Pediatric Care Center at Southern Ocean Medical Center ------------------------------------------------------------------------ The new Martin Truex Jr. Pediatric Care Center at Southern Ocean Medical Center was separated from the adult Emergency Department in order to create a calmer, more inviting environment for children. The Center features an observation area staffed by a dedicated team of board certified pediatricians, as well as dedicated pediatric emergency care beds with in-room accommodations for parents. This Center has been designed as a kid and family-friendly center specializing in emergency care in a cheerful environment to truly meet the needs of children. Southern Ocean Celebrates Anniversary Milestone at Forty Fest ------------------------------------------------------------- Picture perfect fall weather, a bit of history, music, games and seasonal dcor comprised the festive backdrop for a fun-filled Forty Fest celebration at Southern Ocean in September of 2012. The extended hospital family, including team members, physicians, donors, auxilians, volunteers and Foundation board members and Community Advisory Committee members, gathered with their families to celebrate Southern Oceans 40th anniversary. Southern Ocean Grows Services to Meet the Health Needs of a Growing Community ------------------------------------------------------------------- Southern Ocean Medical Center continues to expand its services to better serve the community. The orthopedic program has grown with the addition of several new orthopedic surgeons who provide unique expertise in subspecialties such as shoulder surgery and foot and ankle surgery. The program has been expanded with the addition of a new urologist and urodynamic diagnostic and rehabilitative services. Neuroscience services have also grown with a new concussion program and spine program. Southern Oceans maternity program has expanded and now offers an all-female practice as an option for women. Finally, the general surgery program continues to grow with the addition of new surgeons specializing in minimally invasive surgery. This progress ensures the highest level of care for our friends and neighbors right in their own community. Bayshore Community Hospital --------------------------- Funding a Vision ---------------- Several members of the community have shown their support of Bayshore Community Hospital through generous donations. The first donation was a $5 million charitable contribution from Janice Mitchell Vassar, whose sole desire, in her words, is to 'make my hospital the best hospital it can be.' Given in honor of the memory of her brother, Ashby John Mitchell, Mrs. Vassars gift will propel Bayshores vision to significantly grow cardiovascular services, as well as enhance access to services for the vision impaired throughout the communities Meridian Health serves. The second gift came by way of Evaristo (Evey) and Tammi Stanziale of Holmdel, NJ. The Stanziale family felt strongly about supporting Bayshores vision after having several positive experiences with Bayshore and Meridian Health over the past two decades. In addition to the generous financial support from Evey and Tammi, Evey decided that a monetary donation was simply not enough and joined as a Trustee of Bayshore Community Hospital Foundation. Taking Care of Our Littlest Patients ------------------------------------ Bayshore Community Hospital celebrated the opening of its new Pediatric Care Center, an affiliate of K. Hovnanian Childrens Hospital at Jersey Shore University Medical Center. The Center opened its doors to better serve the needs of the children in the Northern Monmouth community, providing a completely new experience and enhanced level of care for pediatric patients and families. The Pediatric Care Center was immediately embraced by the community, indicated by a substantial increase in patient satisfaction scores, as well as double digit growth in volume. It features an observation area staffed by a dedicated team of board certified pediatricians who are on call around the clock and an emergency care section staffed by certified emergency physicians. The child-friendly approach and design is bright and cheerful, and offers in-room accommodations for parents. Its Time to Stop Counting Sheep -------------------------------- Bayshore Community Hospital recently celebrated the opening of a new Center for Sleep Medicine, a service of Meridian Neuroscience. Bayshore has been helping patients find more restful sleep since 2000, when a Center opened within the hospital. Now, the newly opened Center for Sleep Medicine is located in a renovated home just a few doors down from the hospital, so patients can feel as though they are 'at home.' Carol Ash, D.O., corporate medical director for Sleep Medicine across Meridian Health and board certified in Sleep Medicine and Adrian Pristas, M.D., medical director, also board certified in Sleep Medicine, are working together to expand Sleep Medicine and the services offered for patients. In addition, the pair have developed a comprehensive approach to identifying, diagnosing, and treating sleep disorder patients.
COMMUNITY BENEFIT STATEMENT (CONTINUED) CORE FORM, PART III, STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS This is Only the Beginning -------------------------- When Bayshore merged with Meridian Health in 2010, the strategic priority was to improve the product before taking the message to market. Since then, there has been significant and palpable changes at Bayshore. The leadership team and team members at Bayshore have done a significant amount of work to move the brand forward and to create a better experience for customers and guests, and it shows! This new integrated ad campaign highlighted some of the operational, clinical, and service changes that have been made at Bayshore, serving as a reintroduction of the brand to the community. While the changes made at Bayshore have been significant, This is Only the Beginning. Partner Companies ----------------- Meridians continuum of care extends far beyond the reach of our six award winning hospitals and allows us to effectively integrate care across different geographic sites, while delivering multiple clinical services, including our physician primary care network, Alert Ambulance, Meridian At Home, Meridian Nursing and Rehabilitation, Shore Rehabilitation Institute, Meridian Occupational Health, and more. Our partner companies continue to be a distinguishing feature of Meridian Health. Theres No Place Like Home Meridian At Home --------------------------------------------- Meridian At Home continues to be the leader in home care services in Monmouth and Ocean counties, providing service to over 27,000 patients in 2012. Meridian At Home provides a complete continuum of services including: visiting home nurses and rehabilitation services, hospice care, certified private and personal care aides, infusion therapy, oxygen delivery, medical equipment and supplies, and medication management technologies. JFK At Home, Meridian At Homes partnership with JFK Health System, continues to grow in its service of Middlesex, Union, and Somerset counties. Rehab Meets Virtual Reality --------------------------- In 2012, Shore Rehabilitation Institute opened a new Neuro-Rehabilitation Technology Center. The Center is comprised of the most innovative and advanced equipment used for neuro rehabilitative services including Reo(tm) Therapys Reo Go(tm) and Bionic Leg. Meridians Nursing and Rehabilitation Facilities Are Seeing Stars ----------------------------------------------------------------- When it comes to finding the best nursing facility for a loved one, our community members can rest assured that we are among the best in the nation. Our Meridian Nursing and Rehabilitation facilities in Brick, Holmdel, Ocean Grove, and Shrewsbury; and Meridian Subacute Rehabilitation at Wall received the highest possible overall rating of five stars in U.S. News & World Reports fifth annual Best Nursing Homes. The Best Nursing Homes 2013 ratings highlight the top nursing homes in each city and state, out of nearly 16,000 facilities nationwide. Fewer than one out of every five nursing homes received an overall rating of five stars, which makes this recognition even more impressive and a testament to our high quality care. Enhancing Our Services and Programs, Thanks to Generous Contributions from the Community --------------------------------------------------------------------- 2012 was a historic year for Meridian Health Affiliated Foundations in many ways. We are proud to report that our foundations received approximately $27 million in contributions and grants in 2012 to invest in the lifesaving work at all five campuses. Thanks to our generous family of donors, we have been able to provide new programs to our communities, construct and expand our facilities, and introduce cutting edge technologies across Meridian Health, including the projects listed below: - Programmatic and structural needs for K. Hovnanian Childrens Hospital and the Oncology and Cardiology departments at Jersey Shore University Medical Center - Emergency Department expansion projects at Ocean Medical Center and Southern Ocean Medical Center - Planned construction of two new leading-edge heart and vascular labs and the establishment of the Mitchell-Vassar Lobby at Bayshore Community Hospital - Completion of two new surgical suites, renovation of Surgical Day Stay and Post Anesthesia Care Unit, and creation of state of the art Rechnitz Conference and Education Center at Riverview Medical Center - Community Outreach programming throughout Meridian Health ---------------------------------------------------------------------- MERIDIAN'S 2012 COMMUNITY BENEFIT REPORT CAN BE FOUND ONLINE AT WWW.MERIDIANHEALTH.COM OR ON REQUEST THROUGH ANY ONE OF OUR FACILITIES. ----------------------------------------------------------------------
DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION B; QUESTION 11B THE ORGANIZATION, MERIDIAN HEALTH, IS THE PARENT OF A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THIS FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF THE GOVERNING BODY OF THIS ORGANIZATION. THE PROCESS FOR REVIEWING THE FORM 990 IS AS FOLLOWS: MERIDIAN HEALTH RETAINED A FIRM OF INDEPENDENT CERTIFIED PUBLIC ACCOUNTANTS WITH EXPERIENCE AND EXPERTISE IN HEALTHCARE AND NOT FOR PROFIT TAX RETURN PREPARATION ("CPA FIRM") TO REVIEW AND FILE THE FORM 990. Meridian PREPARED A DRAFT OF THE FORM 990, WHICH WAS THEN REVIEWED BY OTHER APPROPRIATE INTERNAL STAFF FOR ACCURACY, GENERAL COUNSEL AND OUTSIDE TAX COUNSEL. THE DRAFT WAS THEN REVIEWED BY THE CPA FIRM AND PRESENTED TO THE GOVERNING BODY'S COMPLIANCE AND AUDIT COMMITTEE FOR REVIEW AND RECOMMENDATION TO THE GOVERNING BODY. AFTER THE COMPLIANCE AND AUDIT COMMITTEE MEETING, ANY SUGGESTED REVISIONS TO THE FORM 990 WERE MADE, AND THE REVISED FORM 990, IN Final FORM, WAS PROVIDED TO EACH voting MEMBER OF THE ORGANIZATION'S GOVERNING BODY FOR REVIEW AT A MEETING PRIOR TO FILING OF THE FORM 990.
DISCLOSURE INFORMATION CORE FORM 990; PART VI, SECTION B; QUESTION 12 THE ORGANIZATION, MERIDIAN HEALTH, IS THE PARENT OF A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). MERIDIAN HEALTH HAS ADOPTED A CONFLICT OF INTEREST POLICY. THE ORGANIZATION REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. ANNUALLY ALL MEMBERS OF THE BOARD OF TRUSTEES, OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION ARE REQUIRED TO REVIEW THE EXISTING CONFLICT OF INTEREST POLICY AND COMPLETE A QUESTIONNAIRE WITH RESPECT TO ANY APPLICABLE TRANSACTIONS AND RELATIONSHIPS. THE COMPLETED QUESTIONNAIRES ARE RETURNED TO THE SYSTEM'S SENIOR VICE PRESIDENT AND GENERAL COUNSEL FOR REVIEW. THE SENIOR VICE PRESENT AND GENERAL COUNSEL THEN PREPARES A SUMMARY OF THE COMPLETED QUESTIONNAIRES, AND PRESENTS THE SUMMARY TO THE SYSTEM'S EXECUTIVE COMMITTEE FOR ITS REVIEW, DISCUSSION AND ACTION (IF NEEDED). DURING THE YEAR, THE SENIOR VICE PRESIDENT AND GENERAL COUNSEL ALSO MONITORS ON-GOING TRANSACTIONS IN LIGHT OF THE SUMMARY TO ENSURE THAT ANY POTENTIAL CONFLICTS OF INTEREST ARE APPROPRIATELY HANDLED IN COMPLIANCE WITH THE POLICY.
DISCLOSURE INFORMATION CORE FORM 990; PART VI, SECTION B; QUESTION 15 THIS ORGANIZATION IS THE PARENT OF A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE EXECUTIVE COMPENSATION COMMITTEE ("COMMITTEE") OF THIS ORGANIZATION IS RESPONSIBLE FOR REVIEWING THE EXECUTIVE COMPENSATION OF THE PRESIDENT AND KEY EMPLOYEES (SENIOR MANAGEMENT) OF THIS ORGANIZATION. THE COMMITTEE HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY, APPROVED BY THE EXECUTIVE COMMITTEE AND GOVERNING BODY, WHICH IT FOLLOWS WHEN IT REVIEWS AND APPROVES COMPENSATION AND BENEFITS. THE EXECUTIVE COMPENSATION PHILOSOPHY RECOGNIZES THE SIZE AND COMPLEXITY OF THE HEALTHCARE SYSTEM AND THE CRITICAL NEED TO HAVE AND RETAIN EXECUTIVES THAT CONSISTENTLY DEMONSTRATE SUPERIOR LEVELS OF PERFORMANCE SO THAT THE HEALTH SYSTEM CAN FULFILL ITS CHARITABLE MISSION. THE COMMITTEE REVIEWS THE "TOTAL COMPENSATION" OF THE INDIVIDUALS, INCLUDING BOTH CURRENT AND DEFERRED COMPENSATION AND ALL EMPLOYEE BENEFITS, BOTH QUALIFIED AND NON-QUALIFIED ON AT LEAST AN ANNUAL BASIS TO ENSURE THAT THE "TOTAL COMPENSATION" OF THE PRESIDENT AND EACH SENIOR MANAGEMENT KEY EMPLOYEE IS REASONABLE. TO ASSIST WITH THE REVIEW, THE COMMITTEE ENGAGES THE SERVICES OF A NATIONALLY RECOGNIZED INDEPENDENT CONSULTING FIRM SPECIALIZING IN EXECUTIVE COMPENSATION FOR NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS, AND RECEIVES REGIONAL MARKET DATA FOR COMPARABLE ORGANIZATIONS, A REPORT SUMMARIZING SUCH DATA, AND AN OPINION LETTER RELATING TO THE REASONABLENESS OF EACH EXECUTIVE'S TOTAL COMPENSATION AND BENEFITS. ADDITIONALLY, A SENIOR MEMBER OF THE CONSULTING FIRM ATTENDS THE COMMITTEE'S MEETINGS TO PROVIDE INFORMATION AND TO RESPOND TO QUESTIONS BY THE MEMBERS OF THE COMMITTEE. THE INDEPENDENT COMMITTEE UTILIZES THE OUTSIDE MARKET DATA COMPARABILITY AND BASED UPON THE ORGANIZATION'S PERFORMANCE, BUSINESS JUDGMENT CONSIDERATIONS, AND THE INDIVIDUAL'S PERFORMANCE ESTABLISHES COMPENSATION FOR EACH INDIVIDUAL. THE COMPREHENSIVE REVIEW PROCESS UTILIZED BY THE COMMITTEE QUALIFIES FOR THE REBUTTABLE PRESUMPTION UNDER SECTION 4958 OF THE INTERNAL REVENUE CODE OF 1986: 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 WITHIN THE MEANING OF THE REGULATIONS UNDER SECTION 4958; 2. THE AUTHORIZED BODY OBTAINS AND RELIES UPON "APPROPRIATE DATA AS TO COMPARABILITY" PRIOR TO MAKING ITS DETERMINATION, WHICH COMPARABILITY DATA IS PROVIDED AND ANALYZED BY SULLIVAN COTTER AND ASSOCIATES, INC., A WELL-REGARDED EXPERT IN THE AREA OF NOT-FOR-PROFIT HEALTHCARE COMPENSATION; AND 3. THE AUTHORIZED BODY ADEQUATELY DOCUMENTS THE BASIS FOR ITS DETERMINATION CONCURRENTLY WITH MAKING THAT DETERMINATION, AGAIN AS REQUIRED IN THE REGULATIONS. AS APPROPRIATE, THE AUTHORIZED BODY SUPPLEMENTS THE COMPARABILITY DATA WITH OTHER OBJECTIVE FACTORS DESIGNED TO ENSURE THE REASONABLENESS OF THE COMPENSATION PAID, INCLUDING AN ANALYSIS OF INDIVIDUAL GOALS AND OBJECTIVES, ORGANIZATIONAL PERFORMANCE, PERSONNEL REVIEWS, EVALUATIONS, SELF-EVALUATIONS, AND WRITTEN OFFERS FROM COMPETING ORGANIZATIONS. THE APPROVED COMPENSATION ARRANGEMENTS BY THE EXECUTIVE COMMITTEE ARE REPORTED IN EXECUTIVE SESSION TO THE GOVERNING BOARD BY THE SENIOR MEMBER OF THE CONSULTING FIRM.
DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION C; QUESTION 19 THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE STATE OF NEW JERSEY DEPARTMENT OF THE TREASURY. IN ADDITION, THE ORGANIZATION MAKES AVAILABLE TO THE PUBLIC VIA ITS WEBSITE, WWW.MERIDIANHEALTH.COM, ITS CODE OF CONDUCT AND CONFLICT OF INTEREST POLICY.
COMPENSATION INFORMATION CORE FORM, PART VII AND SCHEDULE J PART VII AND SCHEDULE J REFLECT CERTAIN INDIVIDUALS, JOHN K. LLOYD, John Gantner, Marc Lory AND SALVATORE INCIARDI, WHO ARE PART OF THE SENIOR MANAGEMENT TEAM AT MERIDIAN HEALTH SYSTEM; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THESE INDIVIDUALS WORK FULL-TIME FOR MERIDIAN HEALTH SYSTEM AND RECEIVE COMPENSATION AND BENEFITS FROM MERIDIAN HOSPITALS CORPORATION, A TAX-EXEMPT HOSPITAL WITHIN THE SYSTEM. THEIR REMUNERATION WAS FOR SERVICES RENDERED AS FULL TIME EMPLOYEES OF THE HEALTHCARE SYSTEM AND FOR SERVICES RENDERED TO THE ENTIRE MERIDIAN HEALTH SYSTEM, NOT SOLELY FOR THIS ORGANIZATION AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OF THE BOARD OR OFFICER OF THIS ORGANIZATION. PLEASE NOTE THAT THIS FORM 990 REFLECTS THE FINANCIAL ACTIVITY AND OTHER INFORMATION OF THE PARENT ORGANIZATION ONLY.
RELATED HOURS DISCLOSURE CORE FORM, PART VII, SECTION A, COLUMN B Meridian Health System, Inc. is the parent of MERIDIAN HEALTH; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM INCLUDES BOTH FOR-PROFIT AND NOT-FOR-PROFIT ORGANIZATIONS. CERTAIN BOARD OF TRUSTEE MEMBERS and/or OFFICERS LISTED ON CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 MAY HOLD SIMILAR POSITIONS WITH more than one ORGANIZATION WITHIN THE SYSTEM. THE HOURS SHOWN ON THIS FORM 990 REPRESENT THE ESTIMATED HOURS DEVOTED PER WEEK FOR THIS ORGANIZATION. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF TRUSTEES OF RELATED ORGANIZATIONS IN THE SYSTEM, THEIR RESPECTIVE HOURS PER WEEK PER ORGANIZATION ARE APPROXIMATELY three to five HOURs. THE HOURS REFLECTED ON PART VII OF THIS FORM 990 FOR PAID OFFICERS REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF MERIDIAN HEALTH; NOT SOLELY THe ORGANIZATION included in this return.
OTHER CHANGES IN NET ASSETS CORE FORM, PART XI; QUESTION 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCE INCLUDE: - NET TRANSFERS TO MERIDIAN HEALTH AFFILIATES; $1,350,000
AUDITED FINANCIAL STATEMENTS CORE FORM, PART XII; QUESTION 2 PRICEWATERHOUSE COOPERS, L.L.P., AN INDEPENDENT CERTIFIED PUBLIC ACCOUNTING FIRM, AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF MERIDIAN HEALTH SYSTEM, INC. AND ALL ENTITIES WITHIN THE SYSTEM FOR THE YEARS ENDED DECEMBER 31, 2012 AND DECEMBER 31, 2011; RESPECTIVELY. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAINED CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. PRICEWATERHOUSE COOPERS, L.L.P. ISSUED AN UNQUALIFIED OPINION WITH RESPECT TO THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS. THE MERIDIAN HEALTH SYSTEM, INC. COMPLIANCE AND AUDIT COMMITTEE HAS ASSUMED RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE CONSOLIDATED FINANCIAL STATEMENTS, WHICH INCLUDES THIS ORGANIZATION, AND THE SELECTION OF AN INDEPENDENT AUDITOR.
DISCLOSURE INFORMATION CORE FORM, PART IV, QUESTION 5 PLEASE NOTE THAT THE ORGANIZATION IS AN INTERNAL REVENUE CODE SECTION 501(C)(3) ORGANIZATION AND QUESTION 5 IS NOT APPLICABLE.
DISCLOSURE INFORMATION SECTION 1.351-3(A) STATEMENT PURSUANT TO REGULATION SECTION 1.351-3(A) BY MERIDIAN HEALTH SYSTEM, INC. (EIN: 22-3474145), A SIGNIFICANT TRANSFEROR This statement is pursuant to Regulation Section 1.351-3(a) by the following entity, a significant transferor: Meridian Health System, Inc. ("MHSI") 22-3474145 1350 Campus Parkway, Neptune, NJ 07753 MHSI (EIN: 22-3474145), a U.S. tax-exempt corporation and a significant transferor, made constructive transfers of cash on the following dates to Coastal Meridian Insurance Limited (EIN: 98-0166769), its wholly-owned subsidiary formed in Bermuda (the "Transferee"): 1/27/2012: $1,130,000 2/24/2012: $13,151,650 12/27/2012: $825,000 The good faith estimate of the aggregate fair market value of the assets transferred by MHSI (as determined immediately before the exchanges) was $15,106,650. The good faith estimate of the aggregate tax basis of the assets transferred by MHSI (as determined immediately before the exchanges) was $15,106,650. No private letter rulings were issued by the Internal Revenue Service in connection with the Section 351 exchanges.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2012

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
MERIDIAN HEALTH SYSTEM INC
 
Employer identification number

22-3474145
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" to Form 990, Part IV, line 33.)
(a)
Name, address, and EIN (if applicable) 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) MERIDIAN ACCOUNTABLE CARE ORGANIZATION
1350 CAMPUS PARKWAY
NEPTUNE,NJ07753
45-5440670
HEALTH SVCS NJ 0 100,000 MH SYSTEM
 
(2) COASTAL DATA SOLUTIONS
1350 CAMPUS PKWY
NEPTUNE,NJ07753
45-2441857
HEALTH IT NJ 0 571,119 MH SYSTEM
 








Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" to 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 entity?
Yes No
(1) MERIDIAN HOSPITALS CORPORATION

1350 CAMPUS PARKWAY

NEPTUNE,NJ07753
22-3471515
HEALTH SVCS. NJ 501(C)(3) 509(a)(1) MH SYSTEM
 
Yes
 
(2) MERIDIAN HOME CARE SERVICES INC

103 EAST FRONT STREET

RED BANK,NJ07701
22-2731440
HEALTH SVCS. NJ 501(C)(3) 509(A)(2) MH SYSTEM
 
Yes
 
(3) JERSEY SHORE UNIVERSITY MEDICAL CNTR FDN

1350 CAMPUS PARKWAY

NEPTUNE,NJ07753
22-2342452
FUNDRAISING NJ 501(C)(3) 509(A)(1) MH SYSTEM
 
Yes
 
(4) RIVERVIEW MEDICAL CENTER FDN INC

1350 CAMPUS PARKWAY

NEPTUNE,NJ07753
22-2333524
FUNDRAISING NJ 501(C)(3) 509(A)(1) MH SYSTEM
 
Yes
 
(5) OCEAN MEDICAL CENTER FOUNDATION INC

1350 CAMPUS PARKWAY

NEPTUNE,NJ07753
22-2361311
FUNDRAISING NJ 501(C)(3) 509(A)(1) MH SYSTEM
 
Yes
 
(6) MERIDIAN NURSING & REHABILITATION INC

3349 HIGHWAY 138 BUILDING C SUITE

WALL,NJ07719
52-1772578
NURSING LTC NJ 501(C)(3) 509(A)(2) MH SYSTEM
 
Yes
 
(7) MERIDIAN HEALTH FOUNDATION INC

1350 CAMPUS PARKWAY

NEPTUNE,NJ07753
30-0107825
FUNDRAISING NJ 501(C)(3) 509(A)(1) MH SYSTEM
 
Yes
 
(8) MERIDIAN PRACTICE INSTITUTE INC

1200 JUMPING BROOK RD BLDG 5

NEPTUNE,NJ07753
06-1755235
HEALTH SVCS. NJ 501(C)(3) 509(A)(2) MH SYSTEM
 
Yes
 
(9) MERIDIAN HEALTH REALTY CORPORATION

1350 CAMPUS PARKWAY

NEPTUNE,NJ07753
22-3200147
TITLE HLDING NJ 501(C)(3) 509(A)(3) MH SYSTEM
 
Yes
 
(10) HEALTH INNOVATIONS UNLIMITED INC

1350 CAMPUS PARKWAY

NEPTUNE,NJ07753
22-2581430
HEALTH SVCS. NJ 501(C)(3) 509(A)(2) HOMECARE
 
 
No
(11) MERIDIAN SURGICAL ASSOCIATES PC

1945 STATE ROUTE 33

NEPTUNE,NJ07753
06-1755228
HEALTH SVCS. NJ 501(C)(3) 509(A)(2) MH SYSTEM
 
Yes
 
(12) MERIDIAN PEDIATRIC ASSOCIATES PC

1945 STATE ROUTE 33

NEPTUNE,NJ07753
06-1755230
HEALTH SVCS. NJ 501(C)(3) 509(A)(2) MH SYSTEM
 
Yes
 
(13) MERIDIAN MEDICAL ASSOCIATES PC

1945 STATE ROUTE 33

NEPTUNE,NJ07753
06-1755233
HEALTH SVCS. NJ 501(C)(3) 509(A)(2) MH SYSTEM
 
Yes
 
(14) NORTHERN OCEAN CTY MEDICAL ASSOC PC

1945 STATE ROUTE 33

NEPTUNE,NJ07753
14-1981653
HEALTH SVCS. NJ 501(C)(3) 509(A)(2) MH SYSTEM
 
Yes
 
(15) NORTHERN MONMOUTH CTY MED ASSOC PC

1945 STATE ROUTE 33

NEPTUNE,NJ07753
14-1981647
HEALTH SVCS. NJ 501(C)(3) 509(A)(2) MH SYSTEM
 
Yes
 
(16) MERIDIAN TRAUMA ASSOCIATES PC

1945 STATE ROUTE 33

NEPTUNE,NJ07753
14-1981651
HEALTH SVCS. NJ 501(C)(3) 509(A)(2) MH SYSTEM
 
Yes
 
(17) MERIDIAN OBST & GYN ASSOCIATES PC

1945 STATE ROUTE 33

NEPTUNE,NJ07753
06-1755239
HEALTH SVCS. NJ 501(C)(3) 509(A)(2) MH SYSTEM
 
Yes
 
(18) MERIDIAN PEDIATRIC SURGICAL ASSOC PC

1200 JUMPING BROOK ROAD BLDG 5 S

NEPTUNE,NJ07753
77-0720131
HEALTH SVCS. NJ 501(C)(3) 509(A)(2) MH SYSTEM
 
Yes
 
(19) SHORE REHABILITATION INSTITUTE INC

425 JACK MARTIN BLVD

BRICK,NJ08724
22-3274755
HEALTH SVCS. NJ 501(C)(3) 509(A)(2) MHC
 
 
No
(20) SOUTHERN OCEAN MEDICAL CENTER FOUNDATION

1140 ROUTE 72 WEST

MANAHAWKIN,NJ08050
22-2666099
FUNDRAISING NJ 501(C)(3) 509(A)(1) MH SYSTEM
 
Yes
 
(21) BAYSHORE COMMUNITY HOSPITAL

727 NO BEERS ST

HOLMDEL,NJ07733
21-0744668
HEALTH SVCS. NJ 501(C)(3) 509(a)(1) MHC
 
 
No
(22) BAYSHORE COMMUNITY HOSPITAL FOUNDATION

727 NO BEERS ST

HOLMDEL,NJ07733
22-2367109
FUNDRAISING NJ 501(C)(3) 509(A)(1) MH SYSTEM
 
Yes
 
(23) BAYSHORE HEALTH CARE CENTER INC

715 NO BEERS ST

HOLMDEL,NJ07733
22-2715789
HEALTH SVCS. NJ 501(C)(3) 509(A)(2) MNR
 
 
No
(24) SOCH PROPERTIES INC

1140 ROUTE 72 WEST

MANAHAWKIN,NJ08050
22-3846197
TITLE HLDG. NJ 501(C)(3) 509(A)(3) MH REALTY
 
 
No
(25) SOMC MEDICAL GROUP PC

1140 RT 72 WEST

MANAHAWKIN,NJ08050
27-1412183
HEALTH SVCS. NJ 501(C)(3) 509(A)(2) MH SYSTEM
 
Yes
 
(26) MERIDIAN OCCUPATIONAL HEALTH PC

1350 CAMPUS PARKWAY

NEPTUNE,NJ07753
27-2377326
HEALTH SVCS. NJ 501(C)(3) 509(A)(2) MH SYSTEM
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



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

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




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



(k)
Percentage
ownership


Yes No Yes No
(1) COASTAL CO-OP OF NJ

1350 CAMPUS PARKWAY
NEPTUNE,NJ07753
22-3603146
PURCHASING NJ NA
 
N/A                












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" to 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
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) ASSISTED LIVING AT COLTS NECK INC

3349 HIGHWAY 138 BLDG C SUITE A
WALL,NJ07719
22-2567119
HEALTHCARE SVCS NJ N/A
C CORP.         No
(2) MERIDIAN HEALTH MANAGEMENT INC

1350 CAMPUS PARKWAY
NEPTUNE,NJ07753
22-2519699
HEALTHCARE SVCS NJ MH SYSTEM
 
C CORP. 31,060,000 36,580,000 100.000 % Yes  
(3) MERIDIAN HEALTHWARES BRICK

1350 CAMPUS PARKWAY
NEPTUNE,NJ07753
22-3571926
HEALTHCARE SVCS NJ N/A
C CORP.         No
(4) MERIDIAN HEALTHWARES WEST LONG BRANCH

1350 CAMPUS PARKWAY
NEPTUNE,NJ07753
22-3571931
HEALTHCARE SVCS NJ MH SYSTEM
 
C CORP.     100.000 % Yes  
(5) COASTAL MEDICAL INSURANCE LTD

44 CHURCH STREET 3RD FLOOR
HAMILTON,BERMUDAHA 12
BD
98-0166769
FINANCIAL VEHICLE BD MH SYSTEM
 
FOREIGN CORP. 773,000 58,016,000 100.000 % Yes  
(6) COMPASS HEALTHCARE INC

1140 ROUTE 72 WEST
MANAHAWKIN,NJ08050
22-3357958
HEALTHCARE SVCS NJ MH SYSTEM
 
C CORP.   836,000 100.000 % Yes  
(7) BAYSHORE HEALTHCARE MANAGEMENT CORP

727 NO BEERS ST
HOLMDEL,NJ07733
22-2550716
HEALTHCARE SVCS NJ MH SYSTEM
 
C CORP. 2,086,000 8,904,000 100.000 % Yes  
(8) HCMC INC

PO BOX 176
HOLMDEL,NJ07733
22-2620595
HEALTHCARE SVCS NJ N/A
C CORP.         No
(9) BAYSHORE CENTER FOR REHAB & PHYS THERAPY

1 BETHANY ROAD SUITE 43
HAZLET,NJ07730
22-3116637
INACTIVE NJ N/A
C CORP.         No
Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34, 35b, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) MERIDIAN HEALTH REALTY CORPORATION

R 1,582,000 COST
(2) MERIDIAN HEALTH MANAGEMENT INC

S 1,332,000 COST
(3) MERIDIAN HOSPITALS CORPORATION

S 2,400,000 COST
(4) HCMC INC

R 3,500,000 COST


Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under section 512-514)

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


Yes No Yes No Yes No






























Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
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: