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
2011
Open to Public Inspection
A For the calendar year, or tax year beginning 01-01-2011 and ending 12-31-2011
BCheck if applicable:
CName of organization
BAYSHORE COMMUNITY HOSPITAL
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
727 NORTH BEERS STREET
 
Room/suite
City or town, state or country, and ZIP + 4
HOLMDEL, NJ07733
D Employer identification number

21-0744668
E Telephone number

G Gross receipts $ 117,572,916
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.BCHS.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: 1962
M State of legal domicile: NJ
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: THIS ORGANIZATION IS COMMITTED TO IMPROVING THE HEALTH AND WELL-BEING OF THE RESIDENTS OF NEW JERSEY BY PROVIDING QUALITY, PATIENT-CENTERED HEALTH CARE SERVICES.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a)..... 3 22
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 11
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ... 5 1,241
6 Total number of volunteers (estimate if necessary) .... 6 195
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 111,766 180,870
9 Program service revenue (Part VIII, line 2g) ......... 97,341,071 115,267,864
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 1,533,156 1,204,437
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 475,512 533,807
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 99,461,505 117,186,978
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) 53,456,855 56,033,734
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–24f).... 50,652,731 57,839,313
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 104,109,586 113,873,047
19 Revenue less expenses. Subtract line 18 from line 12....... -4,648,081 3,313,931
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 123,139,885 125,634,634
21 Total liabilities (Part X, line 26)............. 70,927,617 73,477,797
22 Net assets or fund balances. Subtract line 21 from line 20..... 52,212,268 52,156,837
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 Right pointing arrowhead image

Firm's EIN Right pointing arrowhead image
Firm's address Right pointing arrowhead image



Phone no.
May the IRS discuss this return with the preparer shown above? See instructions .........bullet
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2011)
Form 990 (2011)
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: THIS ORGANIZATION IS COMMITTED TO IMPROVING THE HEALTH AND WELL-BEING OF THE RESIDENTS OF NEW JERSEY BY PROVIDING QUALITY, PATIENT-CENTERED HEALTH CARE SERVICES. THE ORGANIZATION 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. PLEASE REFER THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT INCLUDED IN SCHEDULE O.
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 and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
EXPENSES INCURRED IN PROVIDING MEDICALLY NECESSARY OUTPATIENT SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
EXPENSES INCURRED IN PROVIDING MEDICALLY NECESSARY INPATIENT SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT.
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
EXPENSES INCURRED IN PROVIDING MEDICALLY NECESSARY EMERGENCY DEPARTMENT SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT.
4d Other program services (Describe in Schedule O.)
(Expenses $ 96,848,776 including grants of $ 0 ) (Revenue $ 115,267,864 )
4e Total program service expensesMediumBullet$ 96,848,776
Form 990 (2011)
Form 990 (2011)
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? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part IIClick to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts 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; 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, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
Yes
 
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
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, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statement to this return? Note. All Form 990 filers that operated one or more hospitals must attach audited financial statements. Click to see attachment
20b
Yes
 
Form 990 (2011)
Form 990 (2011)
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, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
No
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II......................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or 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 owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
 
No
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
 
No
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 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2011)
Form 990 (2011)
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
184
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
1,241
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2011)
Form 990 (2011)
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
If the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
1a
22
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
Yes
 
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
Yes
 
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
Yes
 
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
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ..........
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
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 the 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: MediumBullet
JOHN GANTNER
1350 CAMPUS PARKWAY
NEPTUNE,NJ07753
(732) 751-7500
Form 990 (2011)
Form 990 (2011)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII .........
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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

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

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

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (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 REINHART ESQ
CHAIRMAN - TRUSTEE
 1.0 X   X       0 0 0
(2) THOMAS J KONONOWITZ
VICE CHAIRMAN - TRUSTEE
 1.0 X   X       0 0 0
(3) MEREDYTH ARMITAGE
SECRETARY - TRUSTEE
 1.0 X   X       0 0 0
(4) RICHARD AMDUR ESQ
TRUSTEE
 1.0 X           0 0 0
(5) GREGG AZCUY
TRUSTEE
 1.0 X           0 0 0
(6) SERENA DIMASO ESQ
TRUSTEE
 1.0 X           0 0 0
(7) PETER S FALVO JR ESQ
TRUSTEE
 1.0 X           0 0 0
(8) JOHN J FLYNN
TRUSTEE
 1.0 X           0 0 0
(9) JEFFREY HAGER DO
TRUSTEE
 1.0 X           0 17,067 0
(10) WILLIAM LAWLESS PHD
TRUSTEE
 1.0 X           0 0 0
(11) MARC H LORY
TRUSTEE - PRESIDENT MHC
 60.0 X   X       0 983,974 57,082
(12) JOSEPH H MANCINI
TRUSTEE
 1.0 X           0 0 0
(13) JOHN ROSE MD
TRUSTEE
 1.0 X           0 10,300 0
(14) ANTHONY T SCARDELLA MD
TRUSTEE
 1.0 X           0 0 0
(15) ALFRED SCHIAVETTI
TRUSTEE
 1.0 X           0 0 0
(16) NORMAN V BUTTACI
TRUSTEE; EX-OFFICIO
 1.0 X           0 0 0
(17) STEVEN KOERNER DO
TRUSTEE; EX-OFFICIO
 1.0 X           0 12,300 0
Form 990 (2011)
Form 990 (2011)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (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 K LLOYD FACHE
TRUSTEE; EX-OFFICIO
 60.0 X           0 2,173,864 50,142
(19) FRANK SHARP MD
TRUSTEE; EX-OFFICIO
 1.0 X           0 36,500 0
(20) ROGER THOMPSON MD
TRUSTEE; EX-OFFICIO
 1.0 X           0 37,000 0
(21) K GEORGE YOUNAN MD
TRUSTEE; EX-OFFICIO
 1.0 X           0 20,000 0
(22) LEONARD J ZAWODNIAK MD
TRUSTEE; EX-OFFICIO
 1.0 X           0 0 0
(23) JOHN GANTNER
EXECUTIVE VP/CFO MHS
 60.0     X       0 1,172,862 239,047
(24) MICHAEL SCHWARTZ
VP, ACTING PRESIDENT/CEO
 0.0     X       0 0 0
(25) KARL MEINERT
SVP CORPORATE SVCS (1/1-3/11)
 55.0       X     341,189 0 7,284
(26) L SCOTT LARSEN MD
VP MEDICAL STAFF
 50.0       X     291,351 0 17,843
(27) ADRIAN M PRISTAS MD
MEDICAL DIRECTOR
 50.0         X   177,632 0 9,126
(28) JANET T SCHEURMAN
HR DIRECTOR
 50.0         X   118,642 0 4,149
(29) DONNA M ANGELUCCI
NURSING STAFF DEVELOPMENT MNGR
 50.0         X   119,516 0 6,492
(30) GLORIA BORJA
REGISTERED NURSE
 50.0         X   125,244 0 12,175
(31) ANNE BROWN
PHARMACY MANAGER
 50.0         X   121,646 0 8,926
(32) RAIMONDA A CLARK
FORMER PRESIDENT/CEO
 0.0           X 753,005 0 0
(33) MICHAEL KEEN
FORMER VICE PRESIDENT
 0.0           X 358,489 0 0
(34) EMRO KRASOVEC
FORMER VP HUMAN RESOURCES
 0.0           X 222,110 0 165
(35) WENDY BROWN
FORMER VP NURSING
 0.0           X 200,180 0 248
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 2,829,004 4,463,867 412,679
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet28
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
Yes
 
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
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet0
Form 990 (2011)
Form 990 (2011)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e 180,870
f All other contributions, gifts, grants, and
similar amounts not included above1f 		 
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 180,870
Program Service Revenue Business Code
2a NET PATIENT SERVICE REVENUE 541,900 113,677,633 113,677,633    
b OTHER HEALTHCARE RELATED REVENUE 541,900 1,590,231 1,590,231    
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 115,267,864
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 1,565,438     1,565,438
4 Income from investment of tax-exempt bond proceeds..MediumBullet 2,872     2,872
5 Royalties............MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents 41,943  
b Less: rental expenses    
c Rental income or (loss) 41,943  
d Net rental income or (loss).......MediumBullet 41,943     41,943
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory   22,065
b Less: cost or other basis and sales expenses   385,938
c Gain or (loss)   -363,873
d Net gain or (loss)..........MediumBullet -363,873     -363,873
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 CAFETERIA 722,210 416,978     416,978
b TELEVISION 517,000 53,675     53,675
c TELEPHONE 517,000 11,501     11,501
d All other revenue .... 9,710     9,710
e Total. Add lines 11a–11d ......MediumBullet 491,864
12 Total revenue. See Instructions....MediumBullet 117,186,978 115,267,864   1,738,244
Form 990 (2011)
Form 990 (2011)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
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 .... 837,140 711,569 125,571 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 43,900,917 37,422,565 6,478,352  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 33,814 27,639 6,175  
9 Other employee benefits ....... 8,006,090 6,544,625 1,461,465  
10 Payroll taxes ........... 3,255,773 2,661,183 594,590  
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 148,299 120,398 27,901  
c Accounting ........... 165,750 135,480 30,270  
d Lobbying ........... 0      
e Professional fundraising. See Part IV, line 17.. 0  
f Investment management fees ...... 0      
g Other .......... 7,776,278 6,390,724 1,385,554  
12 Advertising and promotion .... 128,074 731 127,343  
13 Office expenses ....... 21,226,636 18,181,151 3,045,485  
14 Information technology ...... 18,342   18,342  
15 Royalties .. 266,464 151,867 114,597  
16 Occupancy ........... 2,564,757 374,587 2,190,170  
17 Travel ............ 2,522 124 2,398  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 70,170 32,148 38,022  
20 Interest ........... 2,098,090 1,714,923 383,167  
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 6,171,399 5,406,495 764,904  
23 Insurance .............. 608,155 497,090 111,065  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24f. If line 24f amount exceeds 10% of line 25, column (A) amount, list line 24f expenses on Schedule O.)
a PROVISION FOR BAD DEBT 12,110,411 12,110,411 0 0
b PHYSICIAN FEES 3,294,966 3,294,966 0 0
c OTHER EXPENSES 1,189,000 1,070,100 118,900 0
d
e
f All other expenses        
25 Total functional expenses. Add lines 1 through 24f 113,873,047 96,848,776 17,024,271 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 (2011)
Form 990 (2011)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 3,400 1 3,250
2 Savings and temporary cash investments ....... 2,711,488 2 11,740,402
3 Pledges and grants receivable, net ......... 0 3 0
4 Accounts receivable, net ......... 10,375,950 4 8,501,871
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L .......... 0 5 0
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L .......... 0 6 0
7 Notes and loans receivable, net ............. 8,923,731 7 8,346,462
8 Inventories for sale or use .............. 2,008,508 8 2,749,142
9 Prepaid expenses and deferred charges ............ 3,727,487 9 707,332
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 98,686,993
b Less: accumulated depreciation. ..... 10b 54,346,944 47,259,349 10c 44,340,049
11 Investments—publicly traded securities .......... 0 11 0
12 Investments—other securities. See Part IV, line 11 ...... 44,402,256 12 44,091,851
13 Investments—program-related. See Part IV, line 11 .. 0 13 0
14 Intangible assets ......... 1,723,000 14 1,723,000
15 Other assets. See Part IV, line 11 ........... 2,004,716 15 3,431,275
16 Total assets. Add lines 1 through 15 (must equal line 34)... 123,139,885 16 125,634,634
Liabilities 17 Accounts payable and accrued expenses . 13,295,231 17 11,315,934
18 Grants payable .......... 0 18 0
19 Deferred revenue .......... 0 19 0
20 Tax-exempt bond liabilities .......... 42,354,974 20 40,468,298
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.......... 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 0 23 0
24 Unsecured notes and loans payable to unrelated third parties .... 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D..... 15,277,412 25 21,693,565
26 Total liabilities. Add lines 17 through 25..... 70,927,617 26 73,477,797
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 51,935,268 27 51,939,837
28 Temporarily restricted net assets ..... 277,000 28 217,000
29 Permanently restricted net assets ..... 0 29 0
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 52,212,268 33 52,156,837
34 Total liabilities and net assets/fund balances ..... 123,139,885 34 125,634,634
Form 990 (2011)
Form 990 (2011)
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
117,186,978
2
Total expenses (must equal Part IX, column (A), line 25) ....
2
113,873,047
3
Revenue less expenses. Subtract line 2 from line 1 ...
3
3,313,931
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
52,212,268
5
Other changes in net assets or fund balances (explain in Schedule O) ...
5
-3,369,362
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) ....
6
52,156,837
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII .........
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?....
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant? If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O. ...........................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
Yes
 
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
Yes
 
Form 990 (2011)
Additional Data


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

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

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
BAYSHORE COMMUNITY HOSPITAL
 
Employer identification number

21-0744668
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
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) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2011

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2011
Name of organization
BAYSHORE COMMUNITY HOSPITAL
 
Employer identification number

21-0744668
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on Part I, line 2, of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 2
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
BAYSHORE COMMUNITY HOSPITAL
  		Employer identification number

21-0744668
Part I
Contributors (see Instructions). Use duplicate copies of Part I if additional space is needed.
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 3
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
BAYSHORE COMMUNITY HOSPITAL
  		Employer identification number

21-0744668
Part II
Noncash Property (see Instructions). Use duplicate copies of Part II if additional space is needed.
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 4
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
BAYSHORE COMMUNITY HOSPITAL
  		Employer identification number

21-0744668
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
Use duplicate copies of Part III if additional space is needed
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Additional Data


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

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

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.
SchCMd Bullet Attach to Form 990 or Form 990-EZ. SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
If the organization answered “Yes” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, line 35c (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
BAYSHORE COMMUNITY HOSPITAL
 
Employer identification number

21-0744668
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

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

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

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










For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2011

Schedule C (Form 990 or 990-EZ) 2011
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check expenses, and share of excess lobbying expenditures).
B Check
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(b) Affiliated group
totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in) 		(a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) Total
             
2a Lobbying non-taxable amount          
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		         
             
c Total lobbying expenditures          
             
d Grassroots nontaxable amount          
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		          
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2011


Schedule C (Form 990 or 990-EZ) 2011
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each “Yes” response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
Yes
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
Yes
 
 
i
Other activities? ..........................
 
No
 
j
Total. Add lines 1c through 1i ...............................
 
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2 are answered “No” OR (b) Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, Part II-A; line 5; and Part ll-B, line 1.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
LOBBYING ACTIVITIES SCHEDULE C, PART II-B; LINE 1H BAYSHORE COMMUNITY HOSPITAL IS A MEMBER OF MERIDIAN HEALTH; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM WHICH INCLUDES MERIDIAN HOSPITALS CORPORATION ("MHC"). THE ORGANIZATION IS A MEMBER OF THE NEW JERSEY HOSPITAL ASSOCIATION ("NJHA") AND THE AMERICAN HOSPITAL ASSOCIATION ("AHA"), WHICH BOTH ENGAGE IN LOBBYING EFFORTS ON BEHALF OF THEIR MEMBER HOSPITALS. A PORTION OF THE DUES PAID TO THESE ORGANIZATIONS HAS BEEN ALLOCATED TO LOBBYING ACTIVITES PERFORMED ON BEHALF OF THE ORGANIZATION. THIS ALLOCATION AMOUNTED TO $11,615 IN 2011. PLEASE NOTE THAT THE DUES PAID TO BOTH NJHA AND AHA FOR THIS ORGANIZATION WERE PAID BY MHC. THIS ORGANIZATION REIMBURSES MHC FOR THESE DUES. ACCORDINGLY, THIS ALLOCATION OF DUES TOWARD LOBBYING ACTIVITIES PERFORMED ARE INCLUDED ON THE FORM 990, SCHEDULE C, PART II-A OF MERIDIAN HEALTH SYSTEM, INC. - SUBORDINATES (FEIN: 01-0649794).
Schedule C (Form 990 or 990EZ) 2011

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
2011
Open to Public Inspection
Name of the organization
BAYSHORE COMMUNITY HOSPITAL
 
Employer identification number

21-0744668
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 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
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 Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance .... 277,000 302,949 345,245 699,498
b Contributions ........   153,000   192,768
c Net investment earnings, gains, and losses ...   -35,949 42,704 -90,262
d Grants or scholarships .....        
e Other expenditures for facilities
and programs ........ 		60,000 143,000 85,000 456,759
f Administrative expenses ....        
g End of year balance ...... 217,000 277,000 302,949 345,245
2
Provide the estimated percentage of the year end balance (line 1g) 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 XIV the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   3,063,591 3,063,591
b Buildings ................   51,969,800 23,642,563 28,327,237
c Leasehold improvements ............   1,314,023 1,072,703 241,320
d Equipment ................   41,566,779 29,631,678 11,935,101
e Other .................   772,800 0 772,800
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 44,340,049
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
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    
(3)Other
(A) CASH & CASH EQUIVALENTS 		5,665,512 F

(B) MUTUAL FUNDS - FIXED INCOME 		12,220,000 F

(C) MUTUAL FUNDS - EQUITY 		17,354,000 F

(D) CORPORATE EQUITY SECURITIES 		8,621,000 F

(E) RESTRICTED CASH 		30,000 F

(F) ORGANIZATION 		201,339 F



Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 44,091,851
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








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








Total. (Column (b) 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
PARTY PAYORS 4,407,786
ACCRUED PENSION LIABILITY 6,955,390
ESTIMATED INSURANCE LIABILITIES 5,778,727
OTHER LIABILITIES 2,039,556
DUE TO AFFILIATES; NET 2,512,106




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 21,693,565
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1 117,186,978
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 113,873,047
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 3,313,931
4 Net unrealized gains (losses) on investments .......................... 4 -1,569,915
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV.) ................................. 8 -1,800,000
9 Total adjustments (net). Add lines 4 through 8 ......................... 9 -3,369,915
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 -55,984
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1 115,617,063
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a -1,569,915
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV.) ............ 2d  
e Add lines 2a through 2d ..................... 2e -1,569,915
3 Subtract line 2e from line 1..................... 3 117,186,978
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV.) ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total Revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 117,186,978
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1 113,873,047
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV.) ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3 113,873,047
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV.) ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 113,873,047
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
ENDOWMENT FUNDS SCHEDULE D, PART V RESTRICTED FUNDS ARE USED TO SUPPORT THE CHARITABLE ACTIVITIES AND PROGRAMS OF THE ORGANIZATION AND ITS AFFILIATES.
TEXT OF FIN 48 AUDITED FINANCIAL STATEMENT FOOTNOTE SCHEDULE D, PART X THE ORGANIZATION IS AN AFFILIATE WITHIN MERIDIAN HEALTH SYSTEM; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THE SYSTEM ISSUES CONSOLIDATED FINANCIAL STATEMENTS AUDITED BY PRICEWATERHOUSE COOPERS, L.L.C. 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 2011 CONSOLIDATED AUDITED FINANCIAL STATEMENTS. THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE ("CODE") AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME. THE HOSPITAL IS 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. THE ORGANIZATION IS ALSO INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF MERIDIAN HOSPITALS CORPORATION AND SUBSIDIARY AUDITED BY PRICEWATERHOUSE COOPERS, L.L.C. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ALSO CONTAIN CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. THE FIN 48 DISCLOSURE BELOW IS FROM MERIDIAN HOSPITALS CORPORATION'S INCOME TAX FOOTNOTE INCLUDED IN THE SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES FOOTNOTE OF ITS 2011 CONSOLIDATED AUDITED FINANCIAL STATEMENTS. THE CORPORATION IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE ("CODE") AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME. THE CORPORATION IS 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. THE ORGANIZATION IS ALSO INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF MERIDIAN HEALTH SYSTEM, INC. AND AFFILIATES AUDITED BY PRICEWATERHOUSE COOPERS, L.L.P. 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 2011 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.
OTHER CHANGES IN NET ASSETS SCHEDULE D, PART XI, LINE 8 OTHER CHANGES IN NET ASSETS INCLUDE: - OTHER CHANGES IN BENEFITS AND PLAN ASSETS - ($1,740,000) - DECREASES IN INTEREST IN AFFILIATED FUNDRAISING ORGANIZATIONS - ($60,000)
Schedule D (Form 990) 2011

Additional Data


Software ID:  
Software Version:  




SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
BAYSHORE COMMUNITY HOSPITAL
 
Employer identification number

21-0744668
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a....
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG to determine eligibility for providing discounted care? If "Yes," indicate which of the
following was the family income limit for eligibility for discounted care: ............
3b
Yes
 
c
If the organization did not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount?......
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care?...............
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year?...........
6a
 
No
b
If "Yes," did the organization make it available to the public? ...............
6b
 
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance
and Means-Tested Government Programs		 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) .. 		    4,875,475 333,688 4,541,787 4.460 %
b Medicaid (from Worksheet 3, column a) .....     4,939,610 3,194,256 1,745,354 1.720 %
c Costs of other means-tested government programs (from Worksheet 3, column b) .            
dTotal Financial Assistance and
Means-Tested Government Programs ..... 		    9,815,085 3,527,944 6,287,141 6.180 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		    200,791   200,791 0.200 %
f Health professions education
(from Worksheet 5) .. 		           
g Subsidized health services
(from Worksheet 6) .. 		           
h Research (from Worksheet 7)            
i Cash and in-kind contributions for community benefit (from Worksheet 8) ....            
jTotal Other Benefits ...     200,791   200,791 0.200 %
kTotal. Add lines 7d and 7j. ..     10,015,876 3,527,944 6,487,932 6.380 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total            
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense........
2
12,110,411
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy .....
3
 
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
43,187,835
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
51,631,249
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
-8,443,414
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures
(see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership% 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest)
How many hospital facilities did the organization operate during the tax year?1
Name and address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 BAYSHORE COMMUNITY HOSPITAL
727 NORTH BEERS STREET
HOLMDEL,NJ07733 		X X         X    
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
BAYSHORE COMMUNITY HOSPITAL
Name of Hospital Facility:  
Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2011)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet the community health needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Participation in the development of a community-wide community benefit plan
d Participation in the execution of a community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the Needs Assessment
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs. .... 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8 Yes  
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 9 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.%
If "No," explain in Part VI the criteria the hospital facility used.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care?................. 10 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 500.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Explained the basis for calculating amounts charged to patients?................. 11 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12 Yes  
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 14 Yes  
15 Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
16 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 16   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
17 Indicate which efforts the hospital facility made before initiating any of the actions checked in line 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy
e Other (describe in Part VI)
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18 Yes  
If “No,” indicate why:
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility’s policy was not in writing
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Individuals Eligible for Financial Assistance
19 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
b The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
c The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20   No
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?............................... 21   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?4
Name and address Type of Facility (describe)
1 HOLMDEL SLEEP CENTER
668 NORTH BEERS STREET
HOLMDEL,NJ07733 		SLEEP CENTER
2 BAYSHORE FITNESS & WELLNESS HAZLET
1420 HIGHWAY 36 AIRPORT PLAZA
HAZLET,NJ07730 		REHAB FACILITY
3 BAYSHORE FITNESS & WELLNESS OLD BRIDGE
RT 9 ERNST ROAD
OLD BRIDGE,NJ08857 		REHAB FACILITY UNTIL MARCH 2011
4 FREEHOLD SLEEP CENTER
55 SCHANCK ROAD SUITE 7B
FREEHOLD,NJ07728 		SLEEP CENTER UNTIL MARCH 2011
5
6
7
8
9
10
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 9, 10, 11h, 13g, 15e, 16e, 17e, 18d, 19d, 20, and 21.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
FINANCIAL ASSISTANCE ELIGIBILITY SCHEDULE H, PART I, LINE 3C NOT APPLICABLE - THE ORGANIZATION USES FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR FREE AND DISCOUNTED CARE.
COMMUNITY BENEFIT REPORT SCHEDULE H, PART I, LINE 6A NOT APPLICABLE
FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST SCHEDULE H, PART I, LINE 7 THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $12,110,411.
COMMUNITY BUILDING ACTIVITIES SCHEDULE H, PART II AT BAYSHORE COMMUNITY HOSPITAL, WE RECOGNIZE THAT THE CARE WE PROVIDE THROUGH OUR HOSPITAL REACHES FAR BEYOND THE BOUNDARIES OF OUR FACILITY. OUR MISSION TO IMPROVE THE HEALTH STATUS OF THE COMMUNITIES WE SERVE IS AT THE HEART OF OUR CHARITABLE ROOTS. IN THIS NEW ERA OF HEALTH CARE REFORM, COMMUNITY BASED PREVENTION AND WELLNESS ACTIVITIES WILL PLAY A CRITICAL ROLE IN KEEPING OUR LOCAL COMMUNITIES HEALTHY AND KEEPING HEALTH CARE COSTS DOWN. BAYSHORE REMAINS COMMITTED TO STRENGTHENING ITS MISSION AND IN 2011 DEVOTED MORE THAN $200,000 IN COMMUNITY BENEFITS. THE SUCCESS AND EFFECTIVENESS OF BAYSHORE'S COMMUNITY BENEFIT PROGRAMS ARE A DIRECT RESULT OF THE EFFORTS OF ITS COMMITTED STAFF OF PHYSICIANS, NURSES, HEALTHCARE SPECIALISTS AND COMMUNITY EDUCATORS ALONG WITH DEDICATED COMMUNITY MEMBERS WHO HELP IDENTIFY, DEVELOP AND IMPLEMENT INITIATIVES THAT POSITIVELY IMPACT THE HEALTH OF THE COMMUNITY.
BAD DEBT EXPENSE SCHEDULE H, PART III, LINE 4 BAD DEBT EXPENSE WAS CALCULATED USING THE PROVIDERS' BAD DEBT EXPENSE FROM FINANCIAL STATEMENT, NET OF ACCOUNTS WRITTEN OFF AT CHARGES. THE ORGANIZATION AND ITS AFFILIATES PREPARE AND ISSUE AUDITED CONSOLIDATED FINANCIAL STATEMENTS. THE SYSTEM'S ALLOWANCE FOR DOUBTFUL ACCOUNTS (BAD DEBT EXPENSE) METHODOLOGY AND CHARITY CARE POLICIES ARE CONSISTENTLY APPLIED ACROSS ALL HOSPITAL AFFILIATES. THE ATTACHED TEXT WAS OBTAINED FROM THE FOOTNOTES TO THE AUDITED FINANCIAL STATEMENTS OF THE ORGANIZATION. PATIENT ACCOUNTS RECEIVABLE THE PROCESS FOR ESTIMATING THE ULTIMATE COLLECTION OF RECEIVABLES INVOLVES SIGNIFICANT ASSUMPTIONS AND JUDGMENTS. THE HOSPITAL HAS IMPLEMENTED A MONTHLY STANDARDIZED APPROACH TO ESTIMATE AND REVIEW THE COLLECTABILITY OF RECEIVABLES BASED ON THE PAYOR CLASSIFICATION AND THE PERIOD FROM WHICH THE RECEIVABLES HAVE BEEN OUTSTANDING. ACCOUNT BALANCES ARE WRITTEN OFF AGAINST THE ALLOWANCE WHEN MANAGEMENT FEELS IT IS PROBABLE THE RECEIVABLE WILL NOT BE RECOVERED. HISTORICAL COLLECTION AND PAYOR REIMBURSEMENT EXPERIENCE IS AN INTEGRAL PART OF THE ESTIMATION PROCESS RELATED TO RESERVES FOR DOUBTFUL ACCOUNTS. IN ADDITION, THE HOSPITAL ASSESSES THE CURRENT STATE OF ITS BILLING FUNCTIONS IN ORDER TO IDENTIFY ANY KNOWN COLLECTION OR REIMBURSEMENT ISSUES AND ASSESS THE IMPACT, IF ANY, ON RESERVE ESTIMATES. THE HOSPITAL BELIEVES THAT THE COLLECTABILITY OF ITS RECEIVABLES IS DIRECTLY LINKED TO THE QUALITY OF ITS BILLING PROCESSES, MOST NOTABLY THOSE RELATED TO OBTAINING THE CORRECT INFORMATION IN ORDER TO BILL EFFECTIVELY FOR THE SERVICES IT PROVIDES. REVISIONS IN RESERVE FOR DOUBTFUL ACCOUNTS ESTIMATES ARE RECORDED AS AN ADJUSTMENT TO BAD DEBT EXPENSE. CHARITY CARE The Hospital provides care to patients who meet certain criteria defined by the New Jersey Department of Health and Senior Services without charge or at amounts less than its established rates. The Hospital maintains records to identify and monitor the level of charity care it provides. These records include the amount of charges foregone for services and supplies furnished. The Hospital receives partial reimbursement for the uncompensated care it provides (Note 4). Of the Hospitals $114 million of total expenses reported for December 31, 2011, an estimated cost of $4,513,000 is attributable to providing services to charity patients. The estimated costs of providing charity services are based on a calculation which applies a ratio of cost to charges to the gross uncompensated charges associated with providing care to charity patients. The ratio of cost to charges is calculated based on the Hospitals total expenses, excluding bad debt expense, divided by gross patient service revenue.
MEDICARE SHORTFALL SCHEDULE H, PART III, LINE 8 MEDICARE COSTS WERE DERIVED FROM THE 2011 MEDICARE COST REPORT. MEDICARE UNDERPAYMENTS AND BAD DEBT ARE COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THE ORGANIZATION FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT ARE COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THE AMERICAN HOSPITAL ASSOCIATION ("AHA") FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT ARE COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THIS ORGANIZATION AGREES WITH THE AHA POSITION. AS OUTLINED IN THE AHA LETTER TO THE IRS DATED AUGUST 21, 2007 WITH RESPECT TO THE FIRST PUBLISHED DRAFT OF THE NEW FORM 990 AND SCHEDULE H, THE AHA FELT THAT THE IRS SHOULD INCORPORATE THE FULL VALUE OF THE COMMUNITY BENEFIT THAT HOSPITALS PROVIDE BY COUNTING MEDICARE UNDERPAYMENTS (SHORTFALL) AS QUANTIFIABLE COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: - PROVIDING CARE FOR THE ELDERLY AND SERVING MEDICARE PATIENTS IS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD. - MEDICARE, LIKE MEDICAID, DOES NOT PAY THE FULL COST OF CARE. RECENTLY, MEDICARE REIMBURSES HOSPITALS ONLY 92 CENTS FOR EVERY DOLLAR THEY SPEND TO TAKE CARE OF MEDICARE PATIENTS. THE MEDICARE PAYMENT ADVISORY COMMISSION ("MEDPAC") IN ITS MARCH 2007 REPORT TO CONGRESS CAUTIONED THAT UNDERPAYMENT WILL GET EVEN WORSE, WITH MARGINS REACHING A 10-YEAR LOW AT NEGATIVE 5.4 PERCENT. - MANY MEDICARE BENEFICIARIES, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR. MORE THAN 46 PERCENT OF MEDICARE SPENDING IS FOR BENEFICIARIES WHOSE INCOME IS BELOW 200 PERCENT OF THE FEDERAL POVERTY LEVEL. MANY OF THOSE MEDICARE BENEFICIARIES ARE ALSO ELIGIBLE FOR MEDICAID -- SO CALLED "DUAL ELIGIBLES." THERE IS EVERY COMPELLING PUBLIC POLICY REASON TO TREAT MEDICARE AND MEDICAID UNDERPAYMENTS SIMILARLY FOR PURPOSES OF A HOSPITAL'S COMMUNITY BENEFIT AND INCLUDE THESE COSTS ON FORM 990, SCHEDULE H, PART I. MEDICARE UNDERPAYMENT MUST BE SHOULDERED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE COMMUNITY'S ELDERLY AND POOR. THESE UNDERPAYMENTS REPRESENT A REAL COST OF SERVING THE COMMUNITY AND SHOULD COUNT AS A QUANTIFIABLE COMMUNITY BENEFIT. BOTH THE AHA AND THIS ORGANIZATION ALSO FEEL THAT PATIENT BAD DEBT IS A COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. LIKE MEDICARE UNDERPAYMENT (SHORTFALLS), THERE ALSO ARE COMPELLING REASONS THAT PATIENT BAD DEBT SHOULD BE COUNTED AS QUANTIFIABLE COMMUNITY BENEFIT AS FOLLOWS: - A SIGNIFICANT MAJORITY OF BAD DEBT IS ATTRIBUTABLE TO LOW-INCOME PATIENTS, WHO, FOR MANY REASONS, DECLINE TO COMPLETE THE FORMS REQUIRED TO ESTABLISH ELIGIBILITY FOR HOSPITALS' CHARITY CARE OR FINANCIAL ASSISTANCE PROGRAMS. A 2006 CONGRESSIONAL BUDGET OFFICE ("CBO") REPORT, NONPROFIT HOSPITALS AND THE PROVISION OF COMMUNITY BENEFITS, CITED TWO STUDIES INDICATING THAT "THE GREAT MAJORITY OF BAD DEBT WAS ATTRIBUTABLE TO PATIENTS WITH INCOMES BELOW 200% OF THE FEDERAL POVERTY LINE." - THE REPORT ALSO NOTED THAT A SUBSTANTIAL PORTION OF BAD DEBT IS PENDING CHARITY CARE. UNLIKE BAD DEBT IN OTHER INDUSTRIES, HOSPITAL BAD DEBT IS COMPLICATED BY THE FACT THAT HOSPITALS FOLLOW THEIR MISSION TO THE COMMUNITY AND TREAT EVERY PATIENT THAT COMES THROUGH THEIR EMERGENCY DEPARTMENT, REGARDLESS OF ABILITY TO PAY. PATIENTS WHO HAVE OUTSTANDING BILLS ARE NOT TURNED AWAY, UNLIKE OTHER INDUSTRIES. BAD DEBT IS FURTHER COMPLICATED BY THE AUDITING INDUSTRY'S STANDARDS ON REPORTING CHARITY CARE. MANY PATIENTS CANNOT OR DO NOT PROVIDE THE NECESSARY, EXTENSIVE DOCUMENTATION REQUIRED TO BE DEEMED CHARITY CARE BY AUDITORS. AS A RESULT, ROUGHLY 40% OF BAD DEBT IS PENDING CHARITY CARE. - THE CBO CONCLUDED THAT ITS FINDINGS "SUPPORT THE VALIDITY OF THE USE OF UNCOMPENSATED CARE [BAD DEBT AND CHARITY CARE] AS A MEASURE OF COMMUNITY BENEFITS" ASSUMING THE FINDINGS ARE GENERALIZABLE NATIONWIDE; THE EXPERIENCE OF HOSPITALS AROUND THE NATION REINFORCES THAT THEY ARE GENERALIZABLE. AS OUTLINED BY THE AHA, DESPITE THE HOSPITALS' BEST EFFORTS AND DUE DILIGENCE, PATIENT BAD DEBT IS A PART OF THE HOSPITAL'S MISSION AND CHARITABLE PURPOSES. BAD DEBT REPRESENTS PART OF THE BURDEN HOSPITALS SHOULDER IN SERVING ALL PATIENTS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. IN ADDITION, THE HOSPITAL INVESTS SIGNIFICANT RESOURCES IN SYSTEMS AND STAFF TRAINING TO ASSIST PATIENTS THAT ARE IN NEED OF FINANCIAL ASSISTANCE.
DEBT COLLECTION POLICY SCHEDULE H, PART III, LINE 9B ACCOUNTS CONSIDERED TO BE CHARITY CARE ARE NOT INCLUDED IN THE BAD DEBT EXPENSE, BUT RATHER, ACCOUNTED FOR AS AN ALLOWANCE. BAYSHORE COMMUNITY HOSPITAL BUSINESS OFFICE FUNCTIONS WERE CONSOLIDATED WITH MERIDIAN HOSPITALS CORPORATION IN 2011 MERIDIAN HANDLES ALL COLLECTION OF DEBT IN THE SAME FASHION REGARDLESS OF TYPE OF PAYER. MERIDIAN UTILIZES THE FAIR ISAAC BAD DEBT MANAGEMENT SYSTEM FOR ITS COLLECTION PRACTICES. MERIDIAN ALSO ROUTINELY REFERS UNPAID PATIENT ACCOUNTS TO VARIOUS COLLECTION AGENCIES WHEN THE ACCOUNTS REACH THE END OF THE DUNNING CYCLE. BELOW IS THE PROCESS FOR THE COLLECTION OF BAD DEBT: - ACCOUNTS UNDER $7,500 THAT REACH THE END OF THE DUNNING CYCLE AUTOMATICALLY TRANSFER TO THE FAIR ISAAC BAD DEBT MANAGEMENT SYSTEM. - ACCOUNTS OVER $25,000 ARE APPROVED BY THE VICE PRESIDENT OF PATIENT FINANCIAL SERVICES. - PAYMENTS AND FILES ARE RECONCILED THROUGH THE FAIR ISAAC BAD DEBT MANAGEMENT SYSTEM REPORT (RMSSMS REC TOTALS) WHICH IS SENT TO MERIDIAN'S FINANCE DEPARTMENT. - AUTOMATIC TRANSFER TO A SECONDARY COLLECTION AGENCY OCCURS 180 DAYS AFTER PRIMARY PLACEMENT. - AUTOMATIC TRANSFER TO A TERTIARY ATTORNEY OCCURS 180 DAYS AFTER SECONDARY ASSIGNMENT.
FACILITY POLICIES AND PRACTICES SCHEDULE H, PART V; SECTION B Financial Assistance Policy, Question 11h This organization exists to benefit our communities by promoting good health, healing, caring and comforting. The Hospital is proud of its not-for-profit public mission to provide quality care to all in need 24 hours a day, 365 days a year. The Hospital seeks ways of fulfilling our moral, ethical, and legal obligations to ensure that everyone gets the care they need regardless of ability to pay. To successfully provide this assistance, we ask that patients actively cooperate with us. The Hospital assists patients in obtaining financial assistance from public programs and other sources whenever appropriate. To remain viable as it fulfills its mission, the Hospital must meet its fiduciary responsibility to appropriately bill and collect for medical services provided to patients. The purpose of the Hospital's Financial Assistance Policy is to provide general guidelines to assure reasonable collection of accounts from all available sources and to recognize as soon as possible when an individual requires assistance and/or that an account may qualify for free care, uncompensated care or as bad debt. It is also intended to ensure that the Hospital complies with applicable state and federal requirements as well as those set forth in the Fair Debt Collections Practices Act. The Hospital must charge for services rendered. The exact charges will depend on the extent of the services rendered by the patients' physicians and clinical team. Some examples of this include but are not limited to: Blood work, Diagnostic Testing, MRI, CT Scan, Endoscopy, Biopsies, Pathology, and Surgery. We understand and appreciate how overwhelming it can be to deal with health issues and billing issues at the same time, particularly confusing medical bills and insurance details. We strive to make this process as easy as possible for our patients by inviting patients to call our Patient Accounts Department directly at 732-776-4380 if they have questions or if they need assistance, either while still as a patient or after they have returned home. A complete bill will be mailed to the patient. However, private room costs and insurance deductibles are due at the time of admission, and can be paid at the Admitting Department which is open 24 hours a day. If the patient does not have coverage with an insurance provider, we will contact them to determine eligibility for financial assistance and to make payment arrangements. Separate Billing Under federal law, certain services cannot be included in a hospital bill. Therefore, the patient will receive separate physician bills for each service rendered by the following: Anesthesiology Cardiology EEG EKG Emergency Physicians House Staff Psychiatry Nuclear Medicine Pathology Pulmonary Function Department Radiology (films and interpretations) Surgical Assistants Speech Therapy These physician fees are for professional services rendered and/or interpretation of studies performed, and any questions regarding them should be addressed directly to those physician offices. In addition, if a house staff physician treats a patient for a situation that arises when their own physician is not available, they will be billed directly by that physician. The charges will not appear on the hospital bill. Patients should submit any such bills to their insurance provider or make arrangements for payment directly with the physician. Surgical Patients In major surgical cases, it is mandatory to have a second qualified surgeon or surgeons available to assist the attending surgeon. Its purpose is to ensure the quality and safety of complex procedures. Traditionally, the cost of an assisting surgeon or surgeons was included in your hospital bill. Today, however, the Federal Tax Equity and Responsibility Act (TEFRA) does not allow such an inclusion, so the patient will receive a separate bill from the assisting surgeon or surgeons and are expected to pay for the services rendered by them. Insurance companies are familiar with this practice and should include the assisting surgeon or surgeons for payment, if it is an included benefit. These bills should be forwarded to the patient's insurance provider. Insurance Limitations Under Medicare, Medicaid, and other third-party regulations, only certain levels of care may be covered by the Hospitals. Insurance benefits may be discontinued if a patient's physician or Health Care Quality Strategies, Inc. (HQSI), decides that further care is not medically necessary. The patient may be held personally responsible for any non-covered services. It is the patient's responsibility to provide us with accurate information about their insurance (Medicaid, Medicare, Managed Medicaid) so that the insurance can be billed correctly. If patients don't have insurance or their insurance doesn't cover all of the costs, there are federal and state sources of financial assistance that may be available to them. Eligibility requirements and the application process may be different depending upon the program. Financial Assistance Representatives are available to discuss what the best plan is for the patient. When patients meet with our Financial Assistance Representatives, he/she will provide a detailed list of what they will need. We specialize in the five major programs that are available to help New Jersey residents. Eligibility for these programs is dependent on the New Jersey State income and assets. Income thresholds are based on the Federal Poverty Guidelines (FPG) issued each year in the Federal Register by the Department of Health and Human Services (HHS). The 2011 income and asset levels can be found at http://www.state.nj.us/health/cc/documents/ccfactsh.pdf MEDICAID The Hospital has contracted with a nationwide vendor, Century Business Services (CBIZ), to assist our patients who meet the eligibility criteria with the application process. There are many types of Medicaid available through the NJ Department of Health. CBIZ works with our patients to determine the program best suited for their circumstances. SSI - MEDICAID This is a program that supplements Medicaid benefits with a monthly income stipend that can help with basic needs such as food, clothing, or housing. The Hospitals have contracted with Chamberlin Edmonds and Century Business Solutions (CBIZ) to be onsite to assist inpatients and certain outpatients who meet the eligibility criteria with the application process. FAMILY CARE This program is designed to provide coverage for children. The Hospitals' Financial Assistance Team will assist you in completing the application. The application is then forwarded to the County Board of Social Services or the State vendor in Trenton for processing. The patient will hear directly from the processing agency regarding the status of their application. PRESUMPTIVE ELIGIBILITY - MEDICAID This program provides temporary coverage for persons who meet some basic eligibility criteria so that their health care costs can be covered while the formal Medicaid or Family Care application is processed. It provides 45 days of coverage from the initial date of the application. It is the patient's responsibility to complete the charity care documents and submit them to the Financial Assistance Office. Patients are to notify the registration team member when they have been approved for any service such as Charity Care or Medicaid. Patients who are not covered by insurance and do not qualify for Financial Assistance will be asked to pay an upfront reduced rate for any ancillary services that are needed. These fees are available upon request. Patients paying at the time of their visit will be charged a flat rate. This rate equals less than 50% of our actual charges. Any patients that qualify for Financial Assistance will have applicable fees refunded. CHARITY CARE Unlike Medicaid and Family Care, which provides ongoing coverage for health care services, including physician services and drugs, Charity Care is designed to provide assistance to cover the costs of hospital services only. In order to apply for Charity Care a patient must have a scheduled appointment in the hospital within 30 days or have received a hospital bill within the last 12 months. Patients should know that their immigration status doesn't matter when they apply for Charity Care - it will not affect eligibility. If no other options are available to the patient, the Hospitals' Financial Assistance Team will assist in completing a Charity Care application. Charity Care discounts are in compliance with regulations established in NJAC 8:31.B-4.38. Uninsured billing limits are in accordance with P.L.2008 c.60. Discounted rates are available for patients without insurance depending on financial need. Patients are asked to provide proof of income, family size, and asset information in order to be considered for discounted rates. Patients requesting financial assistance are referred to Entitlement for consideration. 1. Charity Care - Pati
NEEDS ASSESSMENT SCHEDULE H, PART VI; QUESTION 2 BUILDING HEALTHY COMMUNITIES OUTREACH HAS BEEN DEFINED AS AN ATTEMPT TO PROVIDE SERVICES BEYOND CONVENTIONAL LIMITS, OFTEN TO PARTICULAR SEGMENTS OF A COMMUNITY. AT BAYSHORE COMMUNITY HOSPITAL, NOTHING WE DO IS CONVENTIONAL, AS WE CONTINUOUSLY STRIVE TO PROVIDE OUTSTANDING CARE, SERVICE, AND SUPPORT TO OUR COMMUNITY MEMBERS. AS YOU WILL SEE, BAYSHORE IS EXTREMELY DEDICATED TO IMPROVING THE HEALTH STATUS OF THE COMMUNITIES WE SERVE. AS THE LEADING PROVIDER OF HEALTH CARE SERVICES IN OUR AREA, OUR COMMUNITY IMPACT EXTENDS FAR BEYOND NUMBERS ON A PAPER. WE WALK THE TALK AND LIVE AND BREATHE OUR BRAND PROMISE OF PROVIDING THE BEST HEALTH CARE EXPERIENCE, WHETHER WITHIN THE WALLS OF OUR FACILITIES OR OUT IN OUR SURROUNDING COMMUNITIES. AT BAYSHORE COMMUNITY HOSPITAL, OUR MISSION TO IMPROVE THE HEALTH STATUS OF THE COMMUNITIES WE SERVE IS AT THE HEART OF OUR CHARITABLE ROOTS. BAYSHORE REMAINS COMMITTED TO STRENGTHENING ITS MISSION AND IN 2011, DEVOTED APPROXIMATELY $6.5 MILLION IN COMMUNITY BENEFITS. CARING FOR ALL MEMBERS OF THE COMMUNITY AS A NOT-FOR-PROFIT HEALTH CARE PROVIDER, MERIDIAN HEALTH IS THE REGIONAL LEADER IN PROVIDING INNOVATIVE AND ACCESSIBLE HEALTH CARE PROGRAMS AND SERVICES TO INDIVIDUALS, FAMILIES AND COMMUNITIES THROUGHOUT MONMOUTH AND OCEAN COUNTIES. EVERYONE DESERVES ACCESS TO QUALITY CARE REGARDLESS OF THEIR ABILITY TO PAY. IN 2011, BAYSHORE COMMUNITY HOSPITAL PROVIDED APPROXIMATELY 14.7 MILLION DOLLARS IN CHARITY CARE AND OTHER UNCOMPENSATED CARE, SERVING AS A HEALTH CARE SAFETY NET FOR OUR COMMUNITY'S MOST VULNERABLE POPULATIONS. ASSESSING AND ADDRESSING COMMUNITY HEALTH NEEDS COMMUNITY-BASED PREVENTION AND WELLNESS ACTIVITIES PLAY A CRITICAL ROLE IN KEEPING OUR LOCAL COMMUNITIES HEALTHY AND KEEPING HEALTH CARE COSTS DOWN. THAT'S WHY MERIDIAN EMBARKED ON A STRATEGIC PROCESS OF REASSESSING THE AREA'S HEALTHCARE NEEDS. WORKING WITH A NATIONALLY RENOWNED RESEARCH FIRM, MERIDIAN SURVEYED OVER 1,000 HOUSEHOLDS VIA TELEPHONE IN MONMOUTH AND OCEAN COUNTIES TO GATHER LOCAL RESIDENTS' VIEWS OF THEIR COMMUNITY'S MOST CRITICAL HEALTH NEEDS. IN ADDITION, MERIDIAN INVITED COMMUNITY MEMBERS, COUNTY AND LOCAL HEALTH DEPARTMENT OFFICERS, AND OTHER COMMUNITY LEADERS TO PARTICIPATE IN FOCUS GROUPS TO GATHER INPUT FROM PARTICIPANTS REGARDING THEIR OPINIONS AND PERCEPTIONS OF THE HEALTH OF THE RESIDENTS OF THE AREA. BAYSHORE COMMUNITY HOSPITAL WAS REPRESENTED AND INCLUDED IN THIS NEEDS ASSESSMENT PROCESS. FINDINGS OF THE ASSESSMENT ARE REVIEWED TOGETHER WITH MERIDIAN'S COMMUNITY ADVISORY COMMITTEES, LOCAL HEALTH DEPARTMENT OFFICIALS, PHYSICIANS, AND OTHER COMMUNITY LEADERS, WITH THE GOAL OF SELECTING AND PRIORITIZING THE TOP HEALTH CONCERNS FOR OUR COMMUNITY. THIS COLLABORATIVE EFFORT, WILL SERVE AS A TOOL TO REACHING THREE BASIC GOALS: TO IMPROVE RESIDENTS' HEALTH STATUS, AND ELEVATE THEIR OVERALL QUALITY OF LIFE, TO REDUCE THE HEALTH DISPARITIES AMONG RESIDENTS AND TO INCREASE ACCESSIBILITY TO PREVENTIVE SERVICES FOR ALL RESIDENTS. DELIVERING ON COMMUNITY COMMITMENT COMMUNITY MEMBERS BOTH YOUNG AND OLD TOOK ADVANTAGE OF FREE HEALTH AND WELLNESS SCREENINGS, EDUCATION PROGRAMS, SUPPORT GROUPS AND OTHER HEALTH PROMOTION ACTIVITIES OFFERED THROUGHOUT BAYSHORE COMMUNITY HOSPITAL'S MARKET AREA. THESE SCREENINGS ARE CONDUCTED IN A VARIETY OF COMMUNITY LOCATIONS INCLUDING, HOUSES OF WORSHIP, SCHOOLS, ACTIVE ADULT COMMUNITIES, SENIOR HOUSING, LOW INCOME HOUSING DEVELOPMENTS, AS WELL AS WITHIN THE HOSPITAL FACILITY. 2011 ACCOMPLISHMENTS AT BAYSHORE COMMUNITY HOSPITAL INCLUDE: - SERVING SEVERAL THOUSAND PEOPLE THROUGH OUR COMMUNITY HEALTH EDUCATION PROGRAMS - PROVIDING FREE HEALTH SCREENINGS - EDUCATING CHILDREN ON HOW TO EAT RIGHT, STAY FIT AND BE SAFE MERIDIAN'S LATEST ADDITION TO ITS COMMUNITY OUTREACH PROGRAM IS ANGIOSCREEN. A REVOLUTIONARY, NEW VASCULAR SCREENING DESIGNED TO PROVIDE PARTICIPANTS WITH INFORMATION ABOUT THEIR CIRCULATION AND RISK FOR CARDIOVASCULAR DISEASE AND STROKE. DATA FROM THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT SHOWED THAT THE PREVALENCE OF STROKE HAS DOUBLED IN OUR AREA IN THE PAST 5 YEARS. THIS WAS THE DRIVING FORCE BEHIND DEVELOPING THIS INNOVATIVE SCREENING FOR OUR COMMUNITY AND OFFERING IT IN THE BAYSHORE MARKET AREA. A SPIRIT OF COLLABORATION COLLABORATION IS WORKING TOGETHER TO ACHIEVE A GOAL. TO THAT END, MERIDIAN CONVENES SEVERAL COMMUNITY ADVISORY COMMITTEES WHOSE MISSION IT IS TO ASSIST US IN IDENTIFYING AND ADDRESSING LOCAL HEALTH CARE NEEDS. COMMITTEE MEMBERS REPRESENT A CROSS-SECTION OF THE COMMUNITY IN TERMS OF AGE, GENDER, RELIGION, ETHNICITY, INTERESTS AND PROFESSIONAL STATUS. OUR PARTNERS IN HEALTH AND UNIDOS COMMITTEES ARE COMPRISED OF AFRICAN AMERICAN AND HISPANIC CIVIC AND COMMUNITY LEADERS RESPECTIVELY AND ARE FOCUSED ON ADDRESSING HEALTH ISSUES AND DISPARITIES AFFECTING COMMUNITIES OF COLOR. CURRENTLY, MORE THAN 150 PEOPLE FROM THE SURROUNDING AREA SERVE AS MEMBERS OF MERIDIAN'S COMMUNITY ADVISORY COMMITTEES. MERIDIAN MAINTAINS LEADERSHIP ROLES IN BOTH THE MONMOUTH COUNTY HEALTH IMPROVEMENT COALITION AND THE OCEAN COUNTY HEALTH ADVISORY GROUP. BOTH COALITIONS REPRESENT COLLABORATION BETWEEN COUNTY AND LOCAL HEALTH DEPARTMENTS AS WELL AS A VARIETY OF SOCIAL SERVICE, HEALTH CARE, HIGHER EDUCATION AND OTHER INTERESTED ORGANIZATIONS THAT WORK TOGETHER TO IMPROVE THE HEALTH STATUS OF OUR COMMUNITY. STAYING CONNECTED MERIDIAN REGULARLY PUBLISHES TWO FREE CONSUMER MAGAZINES - HEALTHVIEWS - AND KIDVIEWS - TO EDUCATE AND INFORM RESIDENTS OF MONMOUTH AND OCEAN COUNTIES ON TIMELY AND RELEVANT HEALTH TOPICS. BOTH PUBLICATIONS FEATURE REAL-LIFE PATIENT STORIES THAT DETAIL HOW INDIVIDUALS RECEIVE THEIR DIAGNOSIS AND MAKE IMPORTANT TREATMENT DECISIONS IN CONJUNCTION WITH THEIR PHYSICIANS. THE MAGAZINES CONTAINS MERIDIAN'S CALENDAR OF EVENTS WHERE RESIDENTS CAN FIND FREE COMMUNITY EDUCATION AND SCREENING PROGRAMS AS WELL AS A VARIETY OF HEALTH AND WELLNESS TIPS. MERIDIAN ALSO PUBLISHES SEVERAL MONTHLY E-NEWSLETTERS - HEALTH-E HEART, MERIDIAN WOMEN'S HEART CONNECTION AND HEALTH-E CHILD - THESE ARE DISTRIBUTED FREE TO RESIDENTS WHO REQUEST THE PUBLICATION AND PROVIDE THEIR EMAIL ADDRESS. ALL PUBLICATIONS PROVIDE TIPS FOR MAINTAINING A HEALTHIER LIFESTYLE, PLUS INFORMATION ON THE LATEST PROCEDURES, SCREENINGS AND CLASSES OFFERED AT MERIDIAN. MERIDIAN'S MULTIPLE WEBSITES OFFER AN EXTENSIVE, FREE HEALTH LIBRARY (IN ENGLISH AND SPANISH) AND ATTRACT OVER 1.5 MILLION PEOPLE EACH YEAR. ONLINE VISITORS CAN TAKE A HEALTH ASSESSMENT QUIZ, LEARN ABOUT DIAGNOSTIC AND SURGICAL PROCEDURES, FIND A DOCTOR, AND REGISTER FOR A FREE CLASS OR HEALTH SCREENING AND MORE. IN ADDITION, MERIDIAN PROVIDES FREE 24/7 CALL CENTER SERVICES TO THE COMMUNITY TO LOCATE PHYSICIANS, HEALTHCARE SERVICES AND SUPPORT GROUPS, AS WELL AS TO REGISTER FOR HEALTH EDUCATION AND SCREENING PROGRAMS. IN 2011, THE CALL CENTER HANDLED MORE THAN 37,000 CALLS. THE SUCCESS AND EFFECTIVENESS OF BAYSHORE'S COMMUNITY BENEFIT PROGRAMS IS DERIVED FROM A COMMITTED STAFF OF PHYSICIANS, NURSES, HEALTH CARE SPECIALISTS AND COMMUNITY EDUCATORS ALONG WITH DEDICATED COMMUNITY MEMBERS WHO HELP BAYSHORE IDENTIFY, STRATEGIZE AND IMPLEMENT INITIATIVES THAT POSITIVELY IMPACT THE HEALTH OF THE COMMUNITY.
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SCHEDULE H, PART VI; QUESTION 3 BAYSHORE HAS NOTICES POSTED IN ALL REGISTRATION AREAS, IN BOTH ENGLISH AND SPANISH, INFORMING PATIENTS TO INQUIRE ABOUT FINANCIAL ASSISTANCE. DURING THE INTERVIEW PROCESS, PATIENTS ARE VERBALLY GIVEN THE OPPORTUNITY TO INQUIRE ABOUT FINANCIAL ASSISTANCE. ALL STATEMENTS MAILED TO THE PATIENTS INCLUDE A FORM TO COMPLETE AND A PHONE NUMBER TO CALL, IF THEY WISH TO APPLY FOR FINANCIAL ASSISTANCE. IF PATIENTS CALL THE BUSINESS OFFICE, THEY ARE TOLD THEY MAY APPLY FOR FNANCIAL ASSISTANCE.
COMMUNITY INFORMATION SCHEDULE H, PART VI; QUESTION 4 BAYSHORE OPERATES IN MONMOUTH COUNTY, NEW JERSEY. The following information is based on recent CENSUS ESTIMATES: MONMOUTH COUNTY =============== POPULATION, 2010 630,380 UNDER 5 YEARS OF AGE, 2010 5.5% UNDER 18 YEARS OF AGE, 2010 23.8% 65 YEARS OLD AND OVER, 2010 13.8% PERSONS BELOW POVERTY LEVEL, 2006-2010 6.3% MEDIAN HOUSEHOLD INCOME, 2006-2010 $ 82,265 RACIAL COMPOSITION, 2010: WHITE 76.7% AFRICAN AMERICAN 7.4% ASIAN 5.0% HISPANIC OR LATINO ORIGIN 9.7% OTHER 1.2%
PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI; QUESTION 5 THIS ORGANIZATION OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545: 1. THE ORGANIZATION PROVICES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF-PAY, MEDICARE AND MEDICAID PATIENTS; 2. THE ORGANIZATION OPERATES AN ACTIVE EMERGENCY ROOM FOR ALL PERSONS; WHICH IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR; 3. THE ORGANIZATION MAINTAINS AN OPEN MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; 4. CONTROL OF THE ORGANIZATION RESTS WITH ITS BOARD OF TRUSTEES; WHICH IS COMPRISED OF INDEPENDENT CIVIC LEADERS AND OTHER PROMINENT MEMBERS OF THE COMMUNITY; AND 5. SURPLUS FUNDS ARE USED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND RENOVATE FACILITIES AND ADVANCE MEDICAL CARE; PROGRAMS AND ACTIVITIES.
AFFILIATED HEALTHCARE SYSTEM SCHEDULE H, PART VI; QUESTION 6 MERIDIAN HEALTH SYSTEM, INC. ---------------------------- MERIDIAN HEALTH SYSTEM, INC. ("MERIDIAN") IS THE TAX-EXEMPT PARENT OF THE MERIDIAN HEALTH SYSTEM, INC. AND AFFILIATES SYSTEM ("SYSTEM"). THIS INTEGRATED HEALTHCARE DELIVERY SYSTEM CONSISTS OF A GROUP OF AFFILIATED HEALTHCARE ORGANIZATIONS. THE SOLE MEMBER OR STOCKHOLDER OF EACH ENTITY IS EITHER MERIDIAN OR ANOTHER SYSTEM AFFILIATE CONTROLLED BY MERIDIAN. THE SYSTEM IS AN INTEGRATED NETWORK OF HEALTHCARE PROVIDERS THROUGHOUT MONMOUTH AND OCEAN COUNTIES AND SURROUNDING AREAS. MERIDIAN IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A SUPPORTING ORGANIZATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). AS THE PARENT ORGANIZATION OF A LARGE TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM IN NEW JERSEY, MERIDIAN STRIVES TO CONTINUALLY DEVELOP AND OPERATE A MULTI-HOSPITAL HEALTHCARE SYSTEM WHICH PROVIDES SUBSTANTIAL COMMUNITY BENEFIT THROUGH THE PROVISION OF A COMPREHENSIVE SPECTRUM OF HEALTHCARE SERVICES TO THE RESIDENTS OF MONMOUTH AND OCEAN COUNTIES AND SURROUNDING COMMUNITIES. MERIDIAN ENSURES THAT ITS SYSTEM 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. NO INDIVIDUALS ARE DENIED NECESSARY MEDICAL CARE, TREATMENT OR SERVICES. THE SYSTEM'S ACTIVE HOSPITALS INCLUDE: JERSEY SHORE UNIVERSITY MEDICAL CENTER, RIVERVIEW MEDICAL CENTER, OCEAN MEDICAL CENTER, SOUTHERN OCEAN MEDICAL CENTER, BAYSHORE COMMUNITY HOSPITAL AND K. HOVNANIAN CHILDREN'S HOSPITAL. EACH OF THESE HOSPITALS OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. MERIDIAN HOSPITALS CORPORATION ------------------------------ MERIDIAN HOSPITALS CORPORATION ("HOSPITALS") IS A NOT FOR-PROFIT CORPORATION THAT OPERATES AN ACUTE CARE HOSPITAL SYSTEM, WHICH PROVIDES PRIMARY AND TERTIARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. HOSPITALS ALSO PROVIDES PROGRAMS FOR MEDICAL TRAINING, RESEARCH, EDUCATION AND CONDUCTS ACTIVITIES ESTABLISHED TO IMPROVE THE HEALTH OF ITS COMMUNITIES. HOSPITALS INCLUDES JERSEY SHORE UNIVERSITY MEDICAL CENTER, RIVERVIEW MEDICAL CENTER, OCEAN MEDICAL CENTER, SOUTHERN OCEAN MEDICAL CENTER, K. HOVNANIAN CHILDREN'S HOSPITAL AND BAYSHORE COMMUNITY HOSPITAL, A WHOLLY OWNED SUBSIDIARY OF HOSPITALS AND NOT INCLUDED IN THIS CONSOLIDATED GROUP FORM 990. JERSEY SHORE UNIVERSITY MEDICAL CENTER -------------------------------------- JERSEY SHORE UNIVERSITY MEDICAL CENTER ("JSUMC") IS A 661-BED NON-PROFIT ACUTE CARE MEDICAL CENTER LOCATED IN NEPTUNE, MONMOUTH COUNTY, NEW JERSEY. JSUMC OPERATES AS AN EXEMPT HOSPITAL UNDER MERIDIAN HOSPITALS CORPORATION'S 501(C)(3) DETERMINATION. PURSUANT TO ITS CHARITABLE PURPOSES, JSUMC 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. MOREOVER, JSUMC OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. RIVERVIEW MEDICAL CENTER ------------------------ RIVERVIEW MEDICAL CENTER ("RMC") IS A 492-BED NON-PROFIT ACUTE CARE MEDICAL CENTER LOCATED IN RED BANK, MONMOUTH COUNTY, NEW JERSEY. RMC OPERATES AS AN EXEMPT HOSPITAL UNDER MERIDIAN HOSPITALS CORPORATION'S 501(C)(3) DETERMINATION. PURSUANT TO ITS CHARITABLE PURPOSES, RMC 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. MOREOVER, RMC OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. OCEAN MEDICAL CENTER -------------------- OCEAN MEDICAL CENTER ("OMC") IS A 303-BED NON-PROFIT ACUTE CARE MEDICAL CENTER LOCATED IN BRICK, OCEAN COUNTY, NEW JERSEY. OMC OPERATES AS AN EXEMPT HOSPITAL UNDER MERIDIAN HOSPITALS CORPORATION'S 501(C)(3) DETERMINATION. PURSUANT TO ITS CHARITABLE PURPOSES, OMC 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. MOREOVER, OMC OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. SOUTHERN OCEAN MEDICAL CENTER ----------------------------- SOUTHERN OCEAN MEDICAL CENTER ("SOMC") IS A 186-BED NON-PROFIT ACUTE CARE MEDICAL CENTER LOCATED IN MANAHAWKIN, OCEAN COUNTY, NEW JERSEY. SOMC OPERATES AS AN EXEMPT HOSPITAL UNDER MERIDIAN HOSPITALS CORPORATION'S 501(C)(3) DETERMINATION. PURSUANT TO ITS CHARITABLE PURPOSES, SOMC 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. MOREOVER, SOMC OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. BAYSHORE COMMUNITY HOSPITAL --------------------------- BAYSHORE COMMUNITY HOSPITAL ("BCH") IS A 238-BED NON-PROFIT ACUTE CARE MEDICAL CENTER LOCATED IN HOLMDEL, MONMOUTH COUNTY, NEW JERSEY. BCH IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, BCH 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. MOREOVER, BCH OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. K. HOVNANIAN CHILDREN'S HOSPITAL -------------------------------- K. HOVNANIAN CHILDREN'S HOSPITAL ("HOVNANIAN") IS A NON-PROFIT ACUTE CARE CHILDREN'S HOSPITAL LOCATED IN NEPTUNE, MONMOUTH COUNTY, NEW JERSEY. HOVNANIAN OPERATES AS AN EXEMPT HOSPITAL UNDER MERIDIAN HOSPITALS CORPORATION'S 501(C)(3) DETERMINATION. PURSUANT TO ITS CHARITABLE PURPOSES, HOVNANIAN PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL CHILDREN IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. MOREOVER, HOVNANIAN OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. SHORE REHABILITATION INSTITUTE, INC. ------------------------------------ SHORE REHABILITATION INSTITUTE, INC. ("SRI") IS A 40-BED NON-PROFIT ACUTE REHABILITATION CENTER LOCATED IN BRICK, OCEAN COUNTY, NEW JERSEY. SRI IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, SRI PROVIDES MEDICALLY NECESSARY REHABILITATIVE CARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. MOREOVER, SRI OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. MERIDIAN HOME CARE SERVICES, INC. --------------------------------- MERIDIAN HOME CARE SERVICES, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). THE ORGANIZATION COORDINATES AND OPERATES HOME HEALTHCARE, HOME INFUSION AND HOSPICE SERVICES AND PROVIDES DURABLE MEDICAL EQUIPMENT TO ALL FAMILIES IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. THE ORGANIZATION ALSO SUPPORTS MERIDIAN HEALTH SYSTEM BY PROVIDING TEMPORARY STAFFING SERVICES TO VARIOUS MERIDIAN HEALTH SYSTEM AFFILIATES. HEALTH INNOVATIONS UNLIMITED, INC. ---------------------------------- HEALTH INNOVATIONS UNLIMITED, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2) WHOSE SOLE MEMBER IS MERIDIAN HOME CARE SERVICES, INC. THE ORGANIZATION PROVIDES THE DURABLE MEDICAL EQUIPMENT AND TEMPORARY STAFFING SERVICES TO VARIOUS MERIDIAN HEALTH SYSTEM AFFILIATES ON BEHALF OF ITS SOLE MEMBER, MERIDIAN HOME CARE SERVICES, INC. JERSEY SHORE UNIVERSITY MEDICAL CENTER FOUNDATION, INC. ------------------------------------------------------- JERSEY SHORE UNIVERSITY MEDICAL CENTER FOUNDATION, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(1). THROUGH FUNDRAISING ACTIVITIES THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF JERSEY SHORE UNIVERSITY MEDICAL CENTER; A DIVISION OF A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. OCEAN MEDICAL CENTE
STATE FILING OF COMMUNITY BENEFIT REPORT SCHEDULE H, PART VI; QUESTION 7 NOT APPLICABLE. THE ENTITY AND RELATED PROVIDER ORGANIZATIONS ARE LOCATED IN NEW JERSEY. NO COMMUNITY BENEFIT REPORT IS FILED WITH THE STATE OF NEW JERSEY. MERIDIAN HOSPITALS CORPORATION, AN ORGANIZATION INCLUDED IN THIS GROUP FORM 990, PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT WHICH IT MAKES AVAILABLE TO THE PUBLIC ON ITS WEBSITE: WWW.MERIDIANHEALTH.COM.
Schedule H (Form 990) 2011
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
2011
Open to Public Inspection
Name of the organization
BAYSHORE COMMUNITY HOSPITAL
 
Employer identification number

21-0744668
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 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 organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
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
Yes
 
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 Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2011

Schedule J (Form 990) 2011
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and column (E) for that individual.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) MARC H LORY (i)
(ii)		 0
504,014 		0
170,000 		0
309,960 		0
30,288 		0
26,794 		0
1,041,056 		0
268,707
(2) JOHN K LLOYD FACHE (i)
(ii)		 0
927,782 		0
558,000 		0
688,082 		0
23,275 		0
26,867 		0
2,224,006 		0
200,000
(3) JOHN GANTNER (i)
(ii)		 0
586,091 		0
245,000 		0
341,771 		0
216,359 		0
22,688 		0
1,411,909 		0
100,000
(4) KARL MEINERT (i)
(ii)		 41,788
0 		0
0 		299,401
0 		789
0 		6,495
0 		348,473
0 		0
0
(5) L SCOTT LARSEN MD (i)
(ii)		 194,008
0 		92,593
0 		4,750
0 		896
0 		16,947
0 		309,194
0 		0
0
(6) ADRIAN M PRISTAS MD (i)
(ii)		 177,554
0 		0
0 		78
0 		0
0 		9,126
0 		186,758
0 		0
0
(7) RAIMONDA A CLARK (i)
(ii)		 0
0 		0
0 		753,005
0 		0
0 		0
0 		753,005
0 		0
0
(8) MICHAEL KEEN (i)
(ii)		 0
0 		0
0 		358,489
0 		0
0 		0
0 		358,489
0 		0
0
(9) EMRO KRASOVEC (i)
(ii)		 2,887
0 		0
0 		219,223
0 		62
0 		103
0 		222,275
0 		0
0
(10) WENDY BROWN (i)
(ii)		 3,010
0 		16,173
0 		180,997
0 		64
0 		184
0 		200,428
0 		0
0






Schedule J (Form 990) 2011

Schedule J (Form 990) 2011
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
COMPENSATION INFORMATION CORE FORM PART VII AND SCHEDULE J, PART I; QUESTION 4A THE FOLLOWING INDIVIDUALS RECEIVED A SEVERANCE PAYMENT DURING 2011. THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2011 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: RAIMONDA A. CLARK, $750,298; MICHAEL KEEN, $358,489; KARL MEINERT, $272,739; EMRO KRASOVEC, $197,679; WENDY BROWN, $162,904; DONNA M. ANGELUCCI, $52,303 AND JANET SCHEURMAN, $66,407.
COMPENSATION INFORMATION SCHEDULE J, PART I; QUESTION 4B THE AMOUNT REFLECTED IN COLUMN B(III) FOR THE FOLLOWING INDIVIDUAL INCLUDES PARTICIPATION IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP"). THE AMOUNT OUTLINED HEREIN WAS INCLUDED IN THE INDIVIDUAL'S 2011 FORM W-2, BOX 1, AS TAXABLE WAGES: MARC H. LORY, $268,707. THE AMOUNT REFLECTED IN SCHEDULE J, PART II, COLUMN B(III) FOR THE FOLLOWING INDIVIDUALS INCLUDES VESTED BENEFITS IN A RETENTION AGREEMENT WHICH ARE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2011 FORM W-2, BOXES 1 AND 5 AS TAXABLE WAGES: JOHN GANTNER, $300,000 AND JOHN K. LLOYD, FACHE, $600,000. THE DEFERRED COMPENSATION AMOUNTS 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 THIS UNVESTED BENEFIT AMOUNT. THE AMOUNT OUTLINED HEREIN WAS NOT INCLUDED IN THE INDIVIDUAL'S 2011 FORM W-2, AS TAXABLE WAGES: JOHN GANTNER, $191,906.
COMPENSATION INFORMATION SCHEDULE J, PART I; QUESTION 7 CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A BONUS DURING CALENDAR YEAR 2011 WHICH AMOUNTS WERE INCLUDED IN COLUMN B(II) HEREIN AND IN EACH INDIVIDUAL'S 2011 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT.
COMPENSATION INFORMATION SCHEDULE J, PART II, COLUMN F THE AMOUNT REPORTED IN SCHEDULE J, PART II, COLUMN (F) FOR THE FOLLOWING INDIVIDUAL REPRESENTS UNVESTED BENEFITS IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN THAT BECAME TAXABLE IN 2011 BECAUSE THEY WERE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE, AND WERE REPORTED AS AN ACCRUED BENEFIT ON PRIOR FORMS 990 OF THE ORGANIZATION. THIS AMOUNT WAS TREATED AS TAXABLE INCOME AND REPORTED ON THE INDIVIDUAL'S 2011 FORM W-2, BOX 1, AS TAXABLE WAGES: MARC H. LORY, $268,707. THE AMOUNTS REPORTED IN SCHEDULE J, PART II, COLUMN (F) FOR THE FOLLOWING INDIVIDUALS REPRESENT UNVESTED BENEFITS IN A RETENTION AGREEEMENT THAT BECAME TAXABLE IN 2011 BECAUSE THEY WERE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE, AND WERE REPORTED AS AN ACCRUED BENEFIT ON PRIOR FORMS 990 OF THE ORGANIZATION. THESE AMOUNTS WERE TREATED AS TAXABLE INCOME AND REPORTED ON EACH INDIVIDUAL'S 2011 FORM W-2, BOXES 1 AND 5, AS TAXABLE WAGES: JOHN K. LLOYD, FACHE, $200,000 AND JOHN GANTNER, $100,000.
COMPENSATION INFORMATION CORE FORM, PART VII AND SCHEDULE J MICHAEL SCHWARTZ DID NOT RECEIVE ANY COMPENSATION DIRECTLY FROM THE ORGANIZATION OR A RELATED ORGANIZATION DURING 2011 FOR HIS SERVICES AS ACTING PRESIDENT/CEO. AS REFLECTED IN OUR RESPONSE TO CORE FORM, PART VI, QUESTION #3, BAYSHORE COMMUNITY HOSPTIAL ("BCH") RETAINED THE SERVICES OF AN OUTSIDE, INDEPENDENT MANAGEMENT COMPANY TO MANAGE THE DAY-TO-DAY ACTIVITIES AND OPERATIONS OF THE ORGANIZATION UNTIL ALL THESE FUNCTIONS WERE TRANSITIONED TO MERIDIAN HEALTH SYSTEM, INC. PERSONNEL IN AUGUST OF 2011. MICHAEL SCHWARTZ IS THE REPRESENTATIVE OF THIS OUTSIDE MANAGEMENT COMPANY THAT PERFORMED THE DUTIES WITH RESPECT TO THE MANAGEMENT OF THE DAY-TO-DAY OPERATIONS AND ACTIVITIES OF THE ORGANIZATION. MERIDIAN HOSPITALS CORPORATION ("MHC"), BCH'S SOLE MEMBER AFTER THE STATUTORY MERGER OF BAYSHORE COMMUNITY HEALTH SERVICES, INC. AND AFFILIATES INTO MERIDIAN HEALTH SYSTEM, INC., COMPENSATED THE OUTSIDE MANAGEMENT COMPANY DIRECTLY AND BCH REIMBURSED MHC FOR THESE EXPENSES.
Schedule J (Form 990) 2011

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
BAYSHORE COMMUNITY HOSPITAL
 
Employer identification number
21-0744668
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A NJ HEALTH CARE FACILITIES FINANCING AUTHORITY
  		22-1987084 64579FCY7 06-24-2004 8,000,000 MEDICAL OFFICE, EQUIPMENT AND RENO   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . 4,520,000      
2 Amount of bonds legally defeased . . . . . . . . . . 0      
3 Total proceeds of issue . . . . . . . . . . . . . 8,000,000      
4 Gross proceeds in reserve funds . . . . . . . . 0      
5 Capitalized interest from proceeds . . . . . . . . . . 0      
6 Proceeds in refunding escrows . . . . . . . . . . . 0      
7 Issuance costs from proceeds . . . . . . . . . . . 130,451      
8 Credit enhancement from proceeds . . . . . . . . . . 0      
9 Working capital expenditures from proceeds . . . . . . . 0      
10 Capital expenditures from proceeds . . . . . . . . . . 7,869,549      
11 Other spent proceeds . . . . . . . . . . . 0      
12 Other unspent proceeds . . . . . . . . . . . 0      
13 Year of substantial completion . . . . . . . . . . . 2006
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . .   X            
15 Were the bonds issued as part of an advance refunding issue? . . . .   X            
16 Has the final allocation of proceeds been made? . . . . . . X              
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . X              
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X            
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   X            
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2011
Schedule K (Form 990) 2011
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . .   X            
b If ‘Yes’ to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . .                
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . .   X            
d If ‘Yes’ to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? .                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0%   %   %   %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0.00000%   %   %   %
6 Total of lines 4 and 5 . . .. . . . . . . . . 0%   %   %   %
7 Does the bond issue meet the private security or payment test? . . . X              
8 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2?
X              
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X            
2 Is the bond issue a variable rate issue? X              
3a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X            
b Name of provider . . . . . . . . 0
  		 
  		 
  		 
 
c Term of hedge . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was a hedge terminated? . . . . .                
4a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . .   X            
b Name of provider . . . . . . 0
  		 
  		 
  		 
 
c Term of GIC . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . .                
5 Were any gross proceeds invested beyond an available temporary period? . . . . . .   X            
6 Did the bond issue qualify for an exception to rebate? .   X            
7 Has the organization established written procedures to monitor the requirements of section 148? . . .   X            
Schedule K (Form 990) 2011

Schedule K (Form 990) 2011
Page 3
Part V
Procedures To Undertake Corrective Action
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? . . . . . . . . . . . . . .
Part VI
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
Schedule K (Form 990) 2011

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
BAYSHORE COMMUNITY HOSPITAL
 
Employer identification number

21-0744668
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





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

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2011
Schedule L (Form 990 or 990-EZ) 2011
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) EMERGENCY MEDICAL ASSOCIATES INC OFFICER - LARSEN 343,994 HOUSE PHYSICIAN SERVICES   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 L. SCOTT LARSEN, M.D. is the Vice President of the Medical Staff. The hospital pays Emergency Medical Associates, Inc. ("EMA") for services. Total fees paid to EMA in 2011 were $343,994. Services were rendered at fair market value rates pursuant to arm's length negotiations. PLEASE NOTE THAT THE TOTAL FEES PAID ARE COMPARABLE TO OTHER FIRMS PROVIDING SIMILAR TYPE SERVICES TO AFFILIATES WITHIN THE MERIDIAN HEALTH SYSTEM.
Schedule L (Form 990 or 990-EZ) 2011

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
2011
Open to Public
Inspection
Name of the organization
BAYSHORE COMMUNITY HOSPITAL
 
Employer identification number

21-0744668
Identifier Return Reference Explanation
COMMUNITY BENEFIT STATEMENT CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS BACKGROUND ========== BAYSHORE COMMUNITY HOSPITAL ("BAYSHORE") IS A GENERAL MEDICAL AND SURGICAL HOSPITAL. BAYSHORE IS RECOGNIZED BY THE IRS AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, BAYSHORE PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. MOREOVER, BAYSHORE OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. OUR HISTORY ----------- IN 1963, COMMUNITY MEMBERS IDENTIFIED THE NEED FOR AN ACUTE CARE HOSPITAL IN THE BAYSHORE AREA. IN 1964, 17 ACRES OF OPEN LAND ON NORTH BEERS STREET IN HOLMDEL WAS ACQUIRED AND GROUND WAS OFFICIALLY BROKEN ON APRIL 29, 1970. BAYSHORE COMMUNITY HOSPITAL OPENED ON TIME AND UNDER BUDGET IN 1972 WITH 158 ACUTE CARE BEDS. THE EARLY MEDICAL STAFF, NURSES, TECHNICIANS AND SUPPORT STAFF DESERVE THE CREDIT FOR IMPROVING THE HEALTH AND WELL-BEING OF OUR COMMUNITY. AS THE SURROUNDING COMMUNITIES GREW, SO DID THE NEED FOR MORE MEDICAL SERVICES. THE HOSPITAL IMPLEMENTED MAJOR CONSTRUCTION PROGRAMS FROM 1977 TO 1984, STARTING WITH A 10,000-SQUARE-FOOT EMERGENCY ROOM AND GENERAL OFFICE EXPANSION; THE ADDITION OF A 10-BED SURGICAL-RESPIRATORY INTENSIVE CARE UNIT; THE CONSTRUCTION OF THE HOSPITAL'S NORTH WING, ADDING 50 MEDICAL-SURGICAL BEDS, ALONG WITH RENOVATION OF ALL SUPPORT SERVICES; ALL INCREASED THE HOSPITAL'S BED COMPLEMENT TO 218. PLEASANT VALLEY ADULT DAY CARE, AN INDEPENDENT AFFILIATE OF BCHS, OPENED IN 1985, PROVIDING RESPITE FROM ONE TO FIVE DAYS PER WEEK FOR FAMILIES CARING FOR THE ELDERLY. LOCATED ON THE BAYSHORE HOSPITAL CAMPUS, THE BAYSHORE HEALTH CARE CENTER OPENED IN 1988 WITH 120 SKILLED CARE BEDS. SOON AFTER, A SECOND FLOOR WAS ADDED WITH AN ADDITIONAL 60 RESIDENTIAL BEDS. AN 11-BED LONG-TERM CARE VENTILATOR UNIT WAS ADDED IN 1996. A SUBACUTE CARE UNIT ALSO PROVIDED A CONTINUUM OF CARE FOR PATIENTS BEING DISCHARGED FROM THE HOSPITAL FOLLOWING AN ACUTE ILLNESS WHO REQUIRE INTENSIVE REHABILITATIVE SERVICES TO ENABLE THEM TO RETURN HOME. IN 1992, BAYSHORE COMMUNITY HOSPITAL ADDED SEVEN INTENSIVE CARE BEDS, FURTHER INCREASING ITS LICENSED BED COMPLEMENT TO 225. INTERNAL RENOVATIONS RESULTED IN THE RELOCATION AND UPGRADE OF A 20-YEAR-OLD INTENSIVE CARE UNIT, CREATING A NEW, 16-BED FACILITY AND A RENOVATED AND EXPANDED OPERATING ROOM SUITE. A STATE-OF-THE-ART CARDIAC CATHETERIZATION AND DIGITAL ANGIOGRAPHY SUITE OPENED IN 1997, COMPLEMENTING THE ALREADY EXPANSIVE TECHNOLOGICAL SERVICES OF THE HOSPITAL IN THE FIELD OF CARDIOLOGY AND INTERVENTIONAL RADIOLOGY. IN JULY 1999, THE WILLOWS AT HOLMDEL, AN ELEGANT 74-UNIT ASSISTED LIVING RESIDENCE OPENED ON THE BAYSHORE CAMPUS. THE WILLOWS ALSO OFFERS THE TERRACE, PRIVATE SUITES IN A SAFE AND SECURE ENVIRONMENT FOR ALZHEIMER'S RESIDENTS. THE JOHN BOYD AND KATHRYN ROBERTA MITCHELL PAVILION FOR EMERGENCY AND AMBULATORY CARE SERVICES OPENED IN 2000. THE NEW PAVILION HOUSES AN EXPANDED STATE-OF-THE-ART EMERGENCY DEPARTMENT AND INCREASED OUTPATIENT SERVICES FOR THE COMMUNITY. A FAST TRACK UNIT EXPANSION WAS ADDED IN 2003 FOR PATIENTS IN NEED OF TREATMENT FOR MINOR ILLNESS OR INJURY. BAYSHORE CONTINUED TO ADDRESS THE NEEDS OF THE COMMUNITY WHILE EXPANDING SERVICES THROUGHOUT THE AREA WITH TWO UNIQUE CENTERS: THE BAYSHORE FITNESS AND WELLNESS CENTER AT HAZLET, ONE OF THE FIRST FACILITIES IN THE NATION TO INTEGRATE FITNESS AND WELLNESS INTO ONE MODEL FOCUSED ON PROMOTING A HEALTHY LIFESTYLE, AND THE SLEEPCARE CENTERS OF BAYSHORE (2000) AND FREEHOLD (2001), WHICH DIAGNOSE AND TREAT SLEEP DISORDERS. ON MAY 1, 2002, BAYSHORE COMMUNITY HOSPITAL CELEBRATED ITS 30TH ANNIVERSARY. IN JUNE 2003, THE $15 MILLION GANZ AMBULATORY IMAGING PAVILION OPENED, PROVIDING THE COMMUNITY WITH STATE-OF-THE-ART DIAGNOSTICS FOR OUTPATIENT SERVICES THAT INCLUDE THE PICTURE ARCHIVING COMMUNICATION (PACS) AND PET SCANS. THE FACILITY ALSO HOUSES THE BREAST CARE CENTER AT BAYSHORE OFFERING DIGITAL MAMMOGRAPHY (2009), BREAST MRI, BONE DENSITOMETRY. ACCREDITED BY THE COMMISSION ON CANCER AND THE AMERICAN COLLEGE OF SURGEONS, ONCOLOGY SERVICES WERE IMPLEMENTED AT BAYSHORE IN 2005 THAT ALLOWED INDIVIDUALS WITH CANCER TO RECEIVE CHEMOTHERAPY AND OTHER TREATMENT SERVICES IN AN OUTPATIENT SETTING. A NEW INFUSION SUITE WAS ALSO ADDED. BAYSHORE WAS PROUD TO ANNOUNCE THE RENOVATION OF ITS OPERATING ROOMS TO A DIGITAL SYSTEM IN 2006, WHICH AIMED TO HELP ENHANCE PATIENT CARE BY PROVIDING SURGEONS WITH OPTIMUM CONTROL OF THE EQUIPMENT AND OVERALL ENVIRONMENT WITH THE TOUCH OF A SCREEN. IN 2007, BAYSHORE WELCOMED CENTRAL JERSEY BARIATRICS, A TEAM OF BOARD CERTIFIED, NEW YORK FELLOWSHIP TRAINED SURGEONS AS WELL AS A BARIATRIC PROGRAM DESIGNED TO OFFER OPTIONS TO PEOPLE WHO ARE 100 POUNDS OR MORE OVERWEIGHT. BAYSHORE COMMUNITY HOSPITAL ANNOUNCED THAT IT IS THE FIRST HOSPITAL IN THE NATION TO ADOPT SPOKEN TRANSLATION'S PRODUCT CONVERSER FOR HEALTHCARE, WHICH IS AN ENGLISH-TO-SPANISH TRANSLATION SOFTWARE. IN 2009, THE HOSPITAL RECEIVED A GOLD SEAL ACCREDITATION FROM THE JOINT COMMISSION. BAYSHORE WAS DESIGNATED AS A PRIMARY STROKE CENTER BY THE NEW JERSEY DEPARTMENT OF HEALTH AND SENIOR SERVICES. IN SEPTEMBER 2010, BAYSHORE COMMUNITY HOSPITAL JOINED THE MERIDIAN HEALTH FAMILY! IN SEPTEMBER 2010, BAYSHORE BECAME THE SIXTH HOSPITAL IN MERIDIAN'S MONMOUTH AND OCEAN COUNTY SYSTEM. WITH A STRONG FOCUS ON CUSTOMER SERVICE, ALIGNMENT WITH MERIDIAN HEALTH CLINICAL BEST PRACTICES, A NEW LEADERSHIP TEAM, AND COUNTLESS NEW PHYSICIANS, BAYSHORE HAS BEGUN TO DEVELOP AN EXCITING PLAN TO CREATE A DESTINATION HOSPITAL THAT WILL BECOME THE PRIDE OF THE COMMUNITY. A NUMBER OF EXCITING INITIATIVES HAVE BEEN IMPLEMENTED SINCE BAYSHORE JOINED THE MERIDIAN HEALTH FAMILY: - SINCE SEPTEMBER OF 2010, 100+ NEW PHYSICIANS HAVE JOINED THE MEDICAL STAFF - MORE THAN IN THE PAST FIVE YEARS COMBINED! - CARDIOVASCULAR SERVICES CONTINUE TO BE CENTRAL TO BAYSHORE'S FUTURE. WITHIN THE PAST YEAR, THE HEART OF BAYSHORE HAS EXPANDED WITH A NEW DESIGNATION GRANTED TO THE CARDIAC CATHETERIZATION LAB, EXPANDED SERVICES, LAB UPGRADES, AND PLANS FOR EXPANSION. - NEW SERVICES HAVE BEEN INTRODUCED, INCLUDING A NEW CENTER FOR BARIATRICS, DEVELOPED UNDER THE LEADERSHIP OF NATIONALLY-RECOGNIZED BARIATRIC SURGEON, KARL STROM, M.D. - SEVERAL INITIATIVES TO PROMOTE NURSING EXCELLENCE HAVE BEEN INTRODUCED TO ENCOURAGE PROFESSIONAL GROWTH, ADDITIONAL TRAINING, AND ACCESS TO THE LATEST CLINICAL STANDARDS AT MERIDIAN HEALTH. THE NEW HEART OF BAYSHORE IN 2011, BAYSHORE ANNOUNCED THE CARDIAC CATHETERIZATION LABORATORY WAS GRANTED FULL-SERVICE ADULT DIAGNOSTIC CAPABILITIES FOR ALL CARDIAC CATHETERIZATION PATIENTS BY THE NEW JERSEY DEPARTMENT OF HEALTH. THIS DESIGNATION ALLOWS BAYSHORE TO COMPLETE DIAGNOSTIC PROCEDURES ON HIGH-RISK PATIENTS, AS WELL AS THE ABILITY TO CONTINUE PERFORMING THESE PROCEDURES ON LOW-RISK PATIENTS, WITHOUT THE NEED OF TRANSFERS TO OUTSIDE FACILITIES. IN ADDITION, THE LAB HAS ALSO BEEN UPGRADED WITH TWO INTRA AORTIC BALLOON PUMPS, A MECHANICAL DEVICE THAT INCREASES CORONARY BLOOD FLOW AND OXYGEN DELIVERY TO THE HEART. A COMPREHENSIVE CENTER FOR BARIATRICS BAYSHORE IS SUCCESSFULLY HELPING PATIENTS DEAL WITH THIS MAJOR PUBLIC HEALTH PROBLEM AND ANNOUNCED A NEWLY DEVELOPED CENTER FOR BARIATRICS. THE NEW CENTER TAKES A COMPREHENSIVE APPROACH ON BARIATRIC TREATMENT INCLUDING: COUNSELING, NUTRITION, EXERCISE AND MEDICAL/SURGICAL TREATMENT. THE CENTER FEATURES THE LAP-BAND SYSTEM, THE ONLY U.S. FDA APPROVED, ADJUSTABLE AND COMPLETELY REVERSIBLE PROCEDURE, WHICH REQUIRES LESS THAN A 24-HOUR HOSPITAL STAY, HAS NO STOMACH STAPLING OR REROUTING, AND IS 10 TIMES SAFER THAN GASTRIC BYPASS. KID FRIENDLY! BAYSHORE COMMUNITY HOSPITAL RECENTLY OPENED A NEW PEDIATRIC CARE CENTER, AN AFFILIATE OF K. HOVNANIAN CHILDREN'S HOSPITAL AT JERSEY SHORE UNIVERSITY MEDICAL CENTER. WITH THE OPENING OF THE PEDIATRIC CARE CENTER AT BAYSHORE, FAMILIES IN THE SURROUNDING COMMUNITIES WILL EXPERIENCE THE DIFFERENCE IN HOW BAYSHORE APPROACHES EMERGENCY CARE FOR CHILDREN. THE NEEDS OF CHILDREN AND THEIR FAMILIES IN AN EMERGENCY ARE UNIQUE, CLINICALLY AND EMOTIONALLY. PROVIDING A SPECIAL PLACE, DESIGNED JUST FOR CHILDREN, CAN HELP MAKE A DIFFICULT TIME A LITTLE EASIER. OUR MISSION ----------- MERIDIAN HEALTH IS COMMITTED TO IMPROVING THE HEALTH AND WELL-BEING OF THE RESIDENTS OF NEW JERSEY BY PROVIDING QUALITY, PATIENT-CENTERED HEALTH CARE SERVICES DELIVERED IN HOSPITAL, COMMUNITY AND IN-HOME SETTINGS, AND TO ADVANCING MEDICINE THROUGH CLINICAL EDUCATION AND RESEARCH. WE FOSTER A CULTURE OF EXCELLENCE WITHIN A COLLABORATIVE ENVIRONMENT. WE ACTIVELY SEEK INNOVATIVE SOLUTIONS, TECHNOLOGIES AND PARTNERSHIPS TO SUPPORT SUSTAINABLE FINANCIAL GROWTH AND TO ENSURE COMMUNITIES WE SERVE HAVE ACCESS TO A COMPREHENSIVE CONTINUUM OF INTEGRATED SERVICES THAT MEET THEIR PRESENT AND FUTURE HEALTH CARE NEEDS.
COMMUNITY BENEFIT STATEMENT CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS AWARDS AND RECOGNITION ---------------------- BAYSHORE WAS RECOGNIZED AS A "TOP PERFORMER ON KEY QUALITY MEASURES" BY THE JOINT COMMISSION BASED ON DATA REPORTED ABOUT EVIDENCE-BASED CLINICAL PROCESSES SHOWN TO IMPROVE CARE FOR CERTAIN CONDITIONS, INCLUDING HEART ATTACK, HEART FAILURE, PNEUMONIA, SURGICAL CARE, AND CHILDREN'S ASTHMA. BAYSHORE IS ONE OF ONLY 405 U.S. HOSPITALS AND CRITICAL ACCESS HOSPITALS EARNING THE DISTINCTION OF TOP PERFORMER ON KEY QUALITY MEASURES FOR ATTAINING AND SUSTAINING EXCELLENCE IN ACCOUNTABILITY MEASURE PERFORMANCE. WITH OUR MERIDIAN PARTNER HOSPITALS, BAYSHORE COMMUNITY HOSPITAL RECEIVED THE FOLLOWING AWARDS: - FORTUNE'S "100 BEST COMPANIES TO WORK FOR" IN 2010 & 2011 - TOP 100 INTEGRATED HEALTH NETWORKS BY MODERN HEALTHCARE MAGAZINE - "BEST PLACES TO WORK IN NEW JERSEY" FOR SEVEN CONSECUTIVE YEARS BY NJBIZ - NEW JERSEY'S OUTSTANDING EMPLOYER OF THE YEAR IN 2003 AND 2009 - ONE OF THE TOP 100 MOST WIRED HEALTH SYSTEMS IN THE UNITED STATES FOR 10 CONSECUTIVE YEARS - JOHN M. EISENBERG AWARD FOR PATIENT SAFETY, ONE OF THE HIGHEST RECOGNITIONS IN THE NATION FOR HOSPITAL QUALITY. CENTERS OF EXCELLENCE ====================== BALANCE AND MOTION CENTER ------------------------- THIS SPECIALIZED TEAM OF MEDICAL PRACTITIONERS WILL PERFORM DIAGNOSTIC TESTS ON ALL ASPECTS OF A PARTICIPANT'S BALANCE SYSTEM TO IDENTIFY THE CAUSE OF DIZZINESS OR EQUILIBRIUM RELATED DIFFICULTIES, AND DESIGN AN INDIVIDUALIZED TREATMENT PLAN TO RESTORE MOBILITY AND FUNCTION. BALANCE TRAINING PROGRAM & VESTIBULAR REHABILITATION THROUGH THIS CUSTOMIZED PROGRAM AT BAYSHORE, PATIENTS WILL PARTAKE IN VARIOUS TYPES OF PHYSICAL REHABILITATION THERAPY, WITH THE GOAL OF PREVENTING UNINTENTIONAL FALLS IN THE FUTURE THAT COULD LEAD TO LIFE-ALTERING HEALTH COMPLICATIONS. THIS TRAINING METHODOLOGY FOCUSES ON EXERCISES DESIGNED TO HEIGHTEN EACH PATIENT'S KINESTHETIC BODY AWARENESS, IMPROVE COORDINATION, AND INCREASE STRENGTH AND ENDURANCE. TECHNIQUES INCLUDE: - FLEXIBILITY TRAINING - TRUNK AND LOWER EXTREMITY STRENGTHENING - GAZE STABILIZATION TRAINING - STANDING, DYNAMIC, AND AMBULATION BALANCE TRAINING - MOVEMENT SAFETY TIPS - VISUAL, VESTIBULAR, AND MUSCULOSKELETAL INTEGRATION TRAINING BREAST CARE CENTER ------------------ FULL SERVICE BREAST CARE RIGHT HERE AT BAYSHORE OFFERING ADVANCED TECHNOLOGIES FOR BREAST HEALTH SCREENINGS, DIAGNOSIS AND TREATMENT, THE BREAST CARE CENTER AT BAYSHORE PROVIDES EXPERT, YET PERSONALIZED, SERVICE CONVENIENTLY LOCATED FOR EASY ACCESS BY AREA RESIDENTS, BOTH WOMEN AND MEN. STAFF EXPERTISE THE BREAST CARE TEAM - LED BY FELLOWSHIP TRAINED, BOARD CERTIFIED RADIOLOGISTS - IS AMONG THE FINEST IN THE CENTRAL NEW JERSEY VICINITY, WITH PHYSICIANS HAILING FROM TOP-RATED MEDICAL PROGRAMS AT INSTITUTIONS THAT INCLUDE HARVARD, CORNELL, COLUMBIA PRESBYTERIAN, NEW YORK UNIVERSITY AND MONTEFIORE/ALBERT EINSTEIN MEDICAL CENTER. BAYSHORE'S MAMMOGRAPHY COORDINATOR RECENTLY RECEIVED THE DESIGNATION OF CERTIFIED BREAST PATIENT NAVIGATOR BY THE NATIONAL CONSORTIUM OF BREAST CENTERS, INC. THROUGH THIS CERTIFICATION, PATIENTS WHO TURN TO BAYSHORE FOR THEIR DIAGNOSTIC BREAST IMAGING NEEDS WILL HAVE ACCESS TO A KNOWLEDGEABLE AND CARING PROFESSIONAL WHO CAN ASSIST IN ENSURING TIMELY EXAM RESULTS AND SCHEDULING OF FOLLOW-UP CARE. ACCREDITED BY THE AMERICAN COLLEGE OF RADIOLOGY, THE BREAST CARE CENTER PROVIDES CARING, INDIVIDUALIZED ATTENTION WITH A STAFF OF REGISTERED MAMMOGRAPHY TECHNOLOGISTS. RANGE OF SERVICES EMPLOYING THE LATEST TECHNOLOGIES IN BREAST CARE HEALTH, THE BREAST CARE CENTER FURNISHES THE FOLLOWING DIAGNOSTIC SERVICES: - DIGITAL MAMMOGRAPHY - ULTRASOUND - BREAST MRI - STEREOTACTIC BIOPSY - BONE DENSITOMETRY CANCER CARE ----------- COMPREHENSIVE CARE PROVIDING A CONTINUUM OF CANCER CARE, FROM DIAGNOSIS THROUGH TREATMENT, IS A TOP PRIORITY FOR THE MEDICAL PRACTITIONERS AT BAYSHORE, WITH THESE SERVICES BEING OFFERED: - HIGH-TECHNOLOGY DIAGNOSTIC TESTING, INCLUDING PET/CT SCAN, DIGITAL MAMMOGRAPHY, MRI, BREAST MRI - BIOPSY PROCEDURES INCLUDING STEREOTACTIC BREAST BIOPSY - TEAM-BASED CASE MANAGEMENT - CANCER SURGERY - OUTPATIENT AND INPATIENT CHEMOTHERAPY - IMMUNOTHERAPY - BRACHYTHERAPY - NUTRITIONAL AND GENETIC COUNSELING - CANCER REHABILITATION SERVICES - AT-HOME ASSISTANCE THROUGH MERIDIAN-AT-HOME SERVICES OUTPATIENT INFUSION SERVICES A BREADTH OF TREATMENT PROCEDURES ARE AVAILABLE TO PATIENTS REQUIRING FREQUENT INFUSIONS OF MEDICATIONS, ALL PROVIDED IN THE SOOTHING, NATURAL LIGHT-FILLED COMFORT OF THE INFUSION SUITE: - CHEMOTHERAPY - BLOOD AND PLATELET TRANSFUSIONS - INTRAVENOUS ANTIBIOTICS - TREATMENTS FOR ANEMIA AND LOW CALCIUM - ANTI-INFLAMMATORY MEDICATIONS - THERAPEUTIC PHLEBOTOMY - MEDICATIONS FOR VARIOUS BLOOD DISORDERS AS A MEMBER OF THE MERIDIAN HEALTH FAMILY, PATIENTS HAVE ACCESS TO THE MERIDIAN CANCER CARE PATIENT NAVIGATOR SERVICE WHERE THEY WILL FIND COMFORT, COMPASSION, AND A WEALTH OF KNOWLEDGE IN THEIR DEDICATED NURSE NAVIGATOR SHOULD A CANCER DIAGNOSIS BE MADE. CARDIAC SERVICES ---------------- CARDIAC DIAGNOSTICS THE FIRST STEP IN CARDIAC TREATMENT IS TO PROPERLY EVALUATE AND IDENTIFY CARDIOVASCULAR DISEASE THROUGH THE USE OF NONINVASIVE DIAGNOSTIC IMAGING SERVICES. BAYSHORE OFFERS THE FOLLOWING MEDICAL TESTS: - CARDIAC EVENT MONITORING - NUCLEAR STRESS TEST ELECTROCARDIOGRAM (EKG) - ECHOCARDIOGRAM STRESS ECHOCARDIOGRAM - EXERCISE STRESS TEST - TRANS-ESOPHAGEAL ECHOCARDIOGRAM (TEE) - MULTIPLE GATED ACQUISITION (MUGA) SCANS - HOLTER MONITORING (AMBULATORY ECG MONITORING) CENTER FOR BARIATRICS --------------------- TO HELP OUR PATIENTS SUCCEED, WE HAVE BUILT A PROGRAM THAT ENSURES ACTIVE PARTICIPATION OF OUR PATIENTS IN THEIR WEIGHT-LOSS JOURNEY, WHICH INCLUDES MEDICAL, NUTRITIONAL, EMOTIONAL, AND EXERCISE COUNSELING. AFTER SURGERY, WE CONTINUE TO BE COMMITTED TO OUR PATIENTS TO ENSURE POSITIVE RESULTS BY HELPING THEM MAINTAIN HEALTHY HABITS. OUR COMPREHENSIVE APPROACH TO CARE IS ONLY ONE REASON THAT SETS US APART. IN ORDER TO PROVIDE YOU WITH THE BEST POSSIBLE CARE, WE OFFER ACCESS TO A PANEL OF DEDICATED SPECIALISTS. OUR BARIATRIC SURGERY TEAM INCLUDES CARDIOLOGISTS, GASTROENTEROLOGISTS, PULMONOLOGISTS, ENDOCRINOLOGISTS, SURGEONS, DIETITIANS, EXERCISE AND BEHAVIORAL HEALTH EXPERTS, ALL WORKING TOGETHER TO DEVELOP A PERSONALIZED CARE PLAN FOR YOU. THIS CARE PLAN INCLUDES EXTENSIVE EDUCATION AND EVALUATION BEFORE SURGERY, AND THE LIFETIME FOLLOW-UP CARE AND SUPPORT CRUCIAL TO KEEPING THE WEIGHT OFF AND STAYING HEALTHY. CENTER FOR WOUND HEALING ------------------------ LAUDING A WOUND HEALING RATE CONSISTENTLY OVER 95%, THE EXPERT MEDICAL PRACTITIONERS AT THE CENTER FOR WOUND HEALING AT BAYSHORE, AN OUTPATIENT WOUND CARE MANAGEMENT PROGRAM, PROVIDE TREATMENT AND CARE THAT NOT ONLY HEALS WOUNDS - IT HEALS LIVES. DEALING WITH A WOUND CAN BE PERSONALLY FRUSTRATING, IN ADDITION TO BEING RESTRICTIVE TO THE PERFORMANCE OF DAILY ACTIVITIES, AND CAN POSSIBLY LEAD TO MORE SERIOUS, LIFE-CHANGING HEALTH CONDITIONS. USING THE MOST UP-TO-DATE APPROACHES IN THE SCIENCE OF WOUND CARE, THESE HEALTH CARE PROFESSIONALS - COMPRISED OF BOARD-CERTIFIED SURGEONS, PODIATRISTS AND REGISTERED NURSES - EMPLOY AN INTERDISCIPLINARY CASE MANAGEMENT APPROACH, WITH THE GOAL OF RETURNING PATIENTS TO AN IMPROVED QUALITY OF LIFE. DIABETES MANAGEMENT ------------------- THIS COMPREHENSIVE PROGRAM TEACHES PATIENTS HOW TO CONTROL, AND HEALTHFULLY LIVE WITH, EITHER TYPE 1 OR TYPE 2 DIABETES. THE BAYSHORE DIABETES SELF-MANAGEMENT EDUCATION PROGRAM HAS BEEN RECOGNIZED BY THE AMERICAN DIABETES ASSOCIATION FOR QUALITY SELF-MANAGEMENT EDUCATION. MONITORING FOR PREVENTION OF COMPLICATIONS PROGRAM PARTICIPANTS LEARN HOW TO BECOME EXPERT IN THE THREE BASIC SKILLS FOR PROPER DIABETES CONTROL: - DETECTION - PREVENTION - TREATMENT DIAGNOSTIC IMAGING ------------------ THE MEDICAL PRACTITIONERS IN DIAGNOSTIC IMAGING PROVIDE 24-HOUR REPORT TURNAROUND FROM THE TIME A PROCEDURE IS PERFORMED UNTIL THE REPORT IS DELIVERED TO THE PATIENT'S PHYSICIAN. TEST SERVICES INCLUDE: - PET/CT SCAN - MRI - CT SCAN - MR ANGIOGRAPHY (MRA) AND CT ANGIOGRAPHY (CTA) - ULTRASOUND/SONOGRAPHY - BREAST IMAGING: DIGITAL MAMMOGRAPHY, ULTRASOUND AND MRI - INTERVENTIONAL RADIOLOGY - GENERAL RADIOLOGY EMERGENCY MEDICINE ------------------ THE EMERGENCY DEPARTMENT AT BAYSHORE OFFERS THE EXPERTISE OF A HIGHLY TRAINED STAFF OF MEDICAL PROFESSIONALS, ALL READY TO RESPOND TO THE IMMEDIATE HEALTH CARE CRISES OF AREA RESIDENTS.
COMMUNITY BENEFIT STATEMENT CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS EXPERT EMERGENCY MEDICINE TEAM CRITICAL MEMBERS OF THE MEDICAL TEAM INCLUDE BOARD-CERTIFIED EMERGENCY MEDICINE PHYSICIANS, ALONG WITH EXPERIENCED MID-LEVEL PROVIDERS - PHYSICIAN ASSISTANTS AND NURSE PRACTITIONERS - WITH CLINICAL SPECIALTY TRAINING IN EMERGENCY MEDICINE. PROVIDING CRUCIAL HANDS-ON HEALTH CARE ARE ACCOMPLISHED REGISTERED NURSES WITH TRAUMA NURSING CORE COURSE TRAINING, IN ADDITION TO CERTIFICATIONS IN BASIC LIFE SUPPORT, ADVANCED CARDIAC LIFE SUPPORT AND PEDIATRIC ADVANCED LIFE SUPPORT. PATIENT CARE ASSOCIATES ARE ON STAFF TO PERFORM A VARIETY OF DIAGNOSTIC AND MONITORING SERVICES, WHILE PATIENT ADVOCATES ARE AVAILABLE 12 HOURS PER DAY AS A RESOURCE FOR PATIENTS AND THEIR FAMILIES. MULTI-NEED FACILITIES HOUSING 13 ACUTE-CARE BEDS, IN ADDITION TO TEN FAST TRACK BEDS, THE EMERGENCY DEPARTMENT PROMPTLY EVALUATES A PATIENT'S CONDITION VIA A SKILLED TRIAGE NURSE, WHO DETERMINES THE IMMEDIACY OF TREATMENT NEEDED. A NEGATIVE PRESSURE ROOM IS AVAILABLE TO ACCOMMODATE PATIENTS WITH INFECTIOUS DISEASE, IN ADDITION TO A SPECIALLY OUTFITTED ROOM TO HANDLE EYE AND EAR AILMENTS. A LOCKED ROOM IS ON-HAND, SHOULD A PATIENT REQUIRE CRISIS INTERVENTION AND SECURE SUPERVISION. FAST TRACK WITH ITS FAST TRACK PROGRAM, THE EMERGENCY DEPARTMENT IS ABLE TO QUICKLY TREAT NON-LIFE THREATENING CONDITIONS, UTILIZING THE SKILLED SERVICES OF PHYSICIAN ASSISTANTS AND NURSE PRACTITIONERS. THESE MEDICAL PROFESSIONALS CAN OFTEN OVERSEE BASIC DIAGNOSTIC TESTS AND PROCEDURES, SUCH AS X-RAYS, SPLINTING AND SUTURING, UNDER THE DIRECTION OF A STAFF PHYSICIAN, ALLOWING FOR IMPROVED PATIENT FLOW AND REDUCED TREATMENT TURNAROUND TIME. PRIMARY STROKE CENTER BAYSHORE HOSPITAL IS A DESIGNATED PRIMARY STROKE CENTER, INDICATING THAT ITS SPECIALLY TRAINED STROKE TEAM IS PREPARED WITH THE SKILLS AND EQUIPMENT NECESSARY TO EXPEDITIOUSLY ASSESS STROKE SYMPTOMS AND DETERMINE THE PROPER IMMEDIATE TREATMENT. CONSISTING OF A PHYSICIAN, REGISTERED NURSE, RESPIRATORY THERAPIST AND EMERGENCY DEPARTMENT STAFF, THE STROKE TEAM'S QUICK RESPONSE CAN DRAMATICALLY IMPACT A PATIENT'S SUCCESSFUL RECOVERY FROM A STROKE. ENDOSCOPY SERVICES ------------------ WITH A MULTI-DISCIPLINARY TEAM THAT INCLUDES PHYSICIANS SPECIALIZING IN GASTROENTEROLOGY, PROCTOLOGY, PULMONOLOGY, BARIATRICS AND ANESTHESIOLOGY, THE ENDOSCOPY DEPARTMENT IS ROUNDED OUT WITH A TEAM OF HIGHLY TRAINED REGISTERED NURSES AND CERTIFIED TECHNICIANS. RESPONSIBLE FOR ALL ITS OWN PRE- AND POST-PROCEDURE CARE, THE ENDOSCOPY DEPARTMENT IS A CONVENIENT ONE-STOP LOCATION FOR SAME-DAY PROCEDURES, RECEIVING REPEATEDLY RECOGNIZED FOR ITS HIGH LEVEL OF PATIENT SATISFACTION. HOUSING THREE PROCEDURE ROOMS - ONE IS A SPECIAL NEGATIVE PRESSURE BRONCHIAL ROOM -THE ENDOSCOPY DEPARTMENT PROVIDES CARE FOR OUTPATIENTS, IN-HOUSE PATIENTS AND EMERGENCY ROOM ADMITTANCES, HANDLING A VARIETY OF MEDICAL PROCEDURES THAT INCLUDE: - ANORECTAL TESTS - BRONCHOSCOPY - COLONOSCOPY - SMALL BOWEL ENTEROSCOPY - SMALL BOWEL CAPSULE ENDOSCOPY - ESOPHAGEAL GASTRO DUODENOSCOPY (EGD) - PERCUTANEOUS ENDOSCOPIC GASTROSTOMY (PEG) - ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP) MINOR SURGERY ------------- THE MINOR SURGERY STAFF PROVIDES COMPREHENSIVE PRE- AND POST-OPERATIVE CARE, INCLUDING A THOROUGH PRE-OP PHONE INTERVIEW AND CONTINUOUS MONITORING BY A REGISTERED NURSE THROUGHOUT THE PROCEDURE. POST-OPERATIVE CARE IS REVIEWED WITH EACH PATIENT UPON DISCHARGE, COMPLETING THE CYCLE OF FINE MEDICAL SERVICE FROM THE BAYSHORE MINOR SURGERY TEAM. RANGE OF SERVICES - EYE LASER TREATMENTS FOR GLAUCOMA AND SECONDARY CATARACTS. - EXCISION AND LASER REMOVAL OF SKIN ABNORMALITIES - ARTHROPLASTY OF TOES - SKIN GRAFTS - EPIDURAL STEROID INJECTIONS - LUMBAR AND CERVICAL FACET INJECTIONS - RADIOFREQUENCY PROCEDURES ORTHOPEDIC SERVICES ------------------- COMPREHENSIVE ORTHOPEDIC SERVICES SIMPLE TO COMPLEX, THE BAYSHORE ORTHOPEDIC STAFF HAS THE SKILLED EXPERTISE TO ACCURATELY ASSESS INJURIES AND DISORDERS OF THE SKELETAL SYSTEM, INCLUDING DEGENERATIVE DISEASES, ORTHOPEDIC TRAUMA, SPINE DISORDERS, SPORTS INJURIES AND CONGENITAL CONDITIONS. AN ASSORTMENT OF THE CORRECTIVE PROCEDURES INCLUDES: - TOTAL HIP REPLACEMENT - JOINT AND LIGAMENT REPAIR - FULL AND PARTIAL KNEE REPLACEMENT - SHOULDER RECONSTRUCTION - BACK AND SPINAL SURGERY - HAND SURGERY - SCOLIOSIS TREATMENT AND SURGERY - ELBOW SURGERY - BONE AND TENDON GRAFTS - BUNIONECTOMY - SPINAL DECOMPRESSION - SPINAL FUSION - CERVICAL AND LUMBAR EPIDURALS - NERVE BLOCKS - ARTHROPLASTY JOINT REPLACEMENT OF FINGER AND TOE - ARTHROSCOPIC SURGERIES OF THE KNEE, ANKLE, SHOULDER, WRIST BLOOD MANAGEMENT PROGRAM ------------------------ BAYSHORE HAS THE DISTINCTION OF OFFERING A BLOOD MANAGEMENT SYSTEM, OFTEN REFERRED TO AS A "CELL SAVER" PROGRAM, TO PATIENTS UNDERGOING MORE EXTENSIVE ORTHOPEDIC SURGERIES. DURING THE OPERATION, A PATIENT'S LOST BLOOD IS RECOVERED, THEN RECYCLED AND REINFUSED INTO THE PATIENT DURING THE PERIOPERATIVE PROCESS. THIS TECHNIQUE IS AN APPEALING ALTERNATIVE FOR PATIENTS WITH OBJECTIONS TO BLOOD TRANSFUSIONS. EXCEPTIONAL INTRAOPERATIVE MONITORING ------------------------------------- USING CUTTING-EDGE TECHNOLOGY, BAYSHORE'S ORTHOPEDIC SPINE SURGERY TEAM IS ABLE TO PRECISELY TRACK CHANGES IN THE BRAIN, SPINAL CORD, AND PERIPHERAL NERVE FUNCTION DURING MAJOR SPINE SURGERIES. THROUGH THE USE OF A NEUROPHYSIOLOGICAL MONITORING SYSTEM, MANAGED BY SPECIALLY TRAINED TECHNICIANS, SURGEONS CAN ENSURE THAT DELICATE NERVES ARE NOT DAMAGED DURING EXTENSIVE SURGICAL PROCEDURES, ALL TO OBTAIN THE OPTIMUM OUTCOME FOR PATIENTS. REHABILITATION SERVICES ----------------------- TYPES OF THERAPY AVAILABLE: - PHYSICAL THERAPY - VESTIBULAR REHABILITATION - OCCUPATIONAL THERAPY - SPEECH THERAPY - AUDIOLOGY TESTING - NEURODIAGNOSTIC TESTING - AQUATIC THERAPY - CONTINENCE TRAINING RESPIRATORY CARE ---------------- RANGE OF SERVICES THE SKILLFUL RESPIRATORY CARE PRACTITIONERS PERFORM A VARIETY OF THERAPIES AND DIAGNOSTIC TESTS TO AID PHYSICIANS IN DETERMINING PROPER TREATMENT FOR CONDITIONS OF THE CARDIO-RESPIRATORY SYSTEM. THE FOLLOWING SERVICES ARE OFFERED, ALL UNDER THE DIRECTION OF A PHYSICIAN: - ADMINISTERING MEDICAL GASES (AIR AND OXYGEN), HUMIDIFICATION, AND AEROSOLS - BREATHING EXERCISES TO IMPROVE LUNG FUNCTION - BRONCHIAL HYGIENE TECHNIQUES (POSTURAL DRAINAGE, PERCUSSION, AND VIBRATION) - ARTERIAL BLOOD GAS SAMPLING AND ANALYSIS TO DETERMINE LEVELS OF OXYGEN, CARBON DIOXIDE AND ACIDITY (PH) IN BLOOD FROM AN ARTERY - PULMONARY FUNCTION TEST TO MEASURE OVERALL LUNG FUNCTION - AIRWAY MANAGEMENT (INSERTION AND MAINTENANCE OF ARTIFICIAL AIRWAYS) - MECHANICAL VENTILATORY SUPPORT - PERFORMANCE OF CARDIO-PULMONARY RESUSCITATION (CPR) - BILEVEL AND CONTINUOUS POSITIVE AIRWAY PRESSURE (BIPAP AND CPAP) THERAPY ALL LICENSED BY THE STATE OF NEW JERSEY TO PRACTICE RESPIRATORY THERAPY, THE STAFF ARE PART OF BAYSHORE'S EMERGENCY RESPONSE TEAMS - CODE BLUE, STROKE ACTIVATION AND RAPID RESPONSE - PROVIDING URGENT MEDICAL CARE TO PATIENTS. SLEEP CARE CENTER ----------------- SLEEP TESTING THERE ARE SEVERAL TYPES OF EVALUATIONS THAT CAN BE PERFORMED AT THE SLEEP CARE CENTER AT BAYSHORE, WHICH HOUSES TWO PRIVATE BEDROOMS FURNISHED WITH QUEEN-SIZE BEDS AND TELEVISIONS FOR PATIENTS' COMFORT. TESTS ARE GENERALLY PERFORMED AT NIGHT, ALTHOUGH DAYTIME TESTING IS AVAILABLE FOR PATIENTS WHO WORK NIGHT SHIFTS. - POLYSOMNOGRAM (PSG) - CPAP/BIPAP TITRATION STUDY - MULTIPLE SLEEP LATENCY TEST (MSLT) - MAINTENANCE OF WAKEFULNESS TEST (MWT) COMMUNITY BENEFIT AND OPERATIONS ================================ COMMUNITY OUTREACH ------------------ BAYSHORE OFFERS MANY COMMUNITY OUTREACH PROGRAMS INCLUDING, BUT NOT LIMITED TO, THE FOLLOWING: ADULT HEALTH AND WELLNESS INITIATIVES: - FREE HEALTH EDUCATION LECTURES AND SEMINARS ON A VARIETY OF TOPICS - CHRONIC DISEASE SELF MANAGEMENT PROGRAM - FREE AND LOW COST HEALTH SCREENINGS - SUPPORT GROUPS - ACTIVE ADULT HEALTH & WELLNESS OUTREACH - BOOKER HEALTH SCIENCES LIBRARY - CALL CENTER SERVICES (PHYSICIAN REFERRAL, CLASS REGISTRATION) - HEALTH EDUCATION - HEALTH SCREENINGS - SUPPORT GROUPS CHILDREN'S HEALTH INITIATIVES: - DOCTOR BERNARD AND THE PAWSITIVE ACTION TEAM EDUCATES CHILDREN ON NUTRITION, FITNESS, STAYING SAFE AND GOOD CITIZENSHIP. - ASTHMA EDUCATION AND SCREENING - SAFESITTER BABYSITING TRAINING BAYSHORE'S COMMUNITY OUTREACH PROGRAMS ARE HELD AT BAYSHORE COMMUNITY HOSPITAL, MERIDIAN FITNESS AND WELLNESS CENTER AT HAZLET AS WELL AS AT VARIOUS COMMUNITY BASED LOCATIONS. MANY OF BAYSHORE'S COMMUNITY OUTREACH PROGRAMS ARE AVAILABLE IN ENGLISH AS WELL AS SPANISH.
COMMUNITY BENEFIT STATEMENT CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS OTHER COMMUNITY BENEFIT INFORMATION =================================== CARING FOR ALL MEMBERS OF THE COMMUNITY --------------------------------------- PEOPLE WITHOUT HEALTH INSURANCE COVERAGE ARE MORE LIKELY TO FOREGO PREVENTIVE CARE AND SEEK TREATMENT ONLY WHEN THEIR ILLNESSES REQUIRE VISITS TO HOSPITAL EMERGENCY ROOMS. BY THAT TIME, THEIR ILLNESSES TYPICALLY ARE MORE ADVANCED AND MORE COSTLY TO TREAT. BAYSHORE'S OUTREACH EFFORTS AND PROGRAMS HAVE ENCOURAGED MANY TO WALK THROUGH ITS DOORS WHO MIGHT OTHERWISE HAVE GONE WITHOUT NECESSARY HEALTH CARE. IN 2011, BAYSHORE PROVIDED $4.5 MILLION IN CHARITY CARE TO PATIENTS FOR WHICH WE RECEIVED NO PAYMENT. IN ADDITION, MEDICARE AND MEDICAID OFTEN DO NOT COVER ALL THE COSTS ASSOCIATED WITH PROVIDING QUALITY PATIENT CARE. IN 2011, BAYSHORE SPENT MORE THAN $4.9 MILLION IN DIRECT PATIENT CARE THAT WAS NOT REIMBURSED BY ANY OF THE FEDERAL OR STATE HEALTH PROGRAMS. SUPPORTING LOCAL ORGANIZATIONS ------------------------------ OVER THE YEARS, BAYSHORE HAS BEEN ABLE TO OFFER SUPPORT THROUGH CHARITABLE DONATIONS TO A HOST OF WORTHY, LOCAL NOT-FOR-PROFIT ORGANIZATIONS. BAYSHORE ALSO ENCOURAGES OUR LEADERS, PHYSICIANS, AND TEAM MEMBERS TO SERVE ON A VARIETY OF BOARDS AND COMMUNITY GROUPS DEDICATED TO IMPROVING THE QUALITY OF LIFE IN OUR NEIGHBORHOODS. AS A SOCIALLY CONSCIOUS MEMBER OF THE COMMUNITY, BAYSHORE FOCUSES ITS CHARITABLE GIVING ON THE AREAS THAT SUPPORT OR ARE ALIGNED WITH BAYSHORE'S CHARITABLE MISSION. THESE INCLUDE; GROUPS THAT PROMOTE AWARENESS OF HEALTH-RELATED ISSUES; COMMUNITY ASSOCIATIONS THAT HELP THOSE IN NEED OBTAIN BASIC NECESSITIES LIKE FOOD, CLOTHING AND SHELTER; ORGANIZATIONS THAT ENCOURAGE YOUNG PEOPLE TO ACHIEVE THEIR POTENTIAL, USE THEIR IMAGINATION, AND KEEP THEM SAFE FROM HARM; SOCIAL SERVICES THAT PROVIDE RELIEF AND COUNSELING TO THOSE SUFFERING FROM ABUSE; AND EVENTS THAT PROMOTE HEALTHY ACTIVITY AND SOCIALIZATION SUCH AS COMMUNITY FESTIVALS AND WALKS. MERIDIAN REGULARLY PUBLISHES TWO FREE CONSUMER MAGAZINES - HEALTHVIEWS - AND KIDVIEWS - TO EDUCATE AND INFORM RESIDENTS OF MONMOUTH AND OCEAN COUNTIES ON TIMELY AND RELEVANT HEALTH TOPICS. BOTH PUBLICATIONS FEATURE REAL-LIFE PATIENT STORIES THAT DETAIL HOW INDIVIDUALS RECEIVE THEIR DIAGNOSIS AND MAKE IMPORTANT TREATMENT DECISIONS IN CONJUNCTION WITH THEIR PHYSICIANS. THE MAGAZINES CONTAINS MERIDIAN'S CALENDAR OF EVENTS WHERE RESIDENTS CAN FIND FREE COMMUNITY EDUCATION AND SCREENING PROGRAMS AS WELL AS A VARIETY OF HEALTH AND WELLNESS TIPS. BAYSHORE'S LATEST ADDITION TO ITS COMMUNITY OUTREACH PROGRAM IS ANGIOSCREEN. A REVOLUTIONARY, NEW VASCULAR SCREENING DESIGNED TO PROVIDE PARTICIPANTS WITH INFORMATION ABOUT THEIR CIRCULATION AND RISK FOR CARDIOVASCULAR DISEASE AND STROKE. DATA FROM THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT SHOWED THAT THE PREVALENCE OF STROKE HAS DOUBLED IN OUR AREA IN THE PAST 5 YEARS. THIS WAS THE DRIVING FORCE BEHIND DEVELOPING THIS INNOVATIVE SCREENING FOR OUR COMMUNITY. BAYSHORE ALSO COORDINATES A SPEAKER'S BUREAU WHERE PHYSICIANS, NURSES OR OTHER HEALTH CARE PROFESSIONALS BRING PREVENTION AND WELLNESS EDUCATION TO LOCAL BUSINESSES, SCHOOLS AND UNIVERSITIES, COMMUNITY GROUPS, FAITH BASED ORGANIZATIONS AND UNDERSERVED COMMUNITIES UPON REQUEST. IN ADDITION, THE HOSPITAL HAS ESTABLISHED AND COORDINATED A PROGRAM THAT PROVIDES A REFERRAL SYSTEM AND ASSISTANCE TO SENIOR CITIZENS IN COMPLETING FORMS FOR INSURANCE SUBMISSION AND MEDICARE AND MEDICAID APPLICATIONS AS WELL AS OTHER HEALTH-RELATED PAPER WORK THEY MAY HAVE. A SENIOR DINING PROGRAM PROVIDES NUTRITIONALLY BALANCED MEALS TO LOCAL SENIORS AT REDUCED RATES.
OTHER PROGRAM SERVICES CORE FORM, PART III; LINE 4D EXPENSES INCURRED IN PROVIDING VARIOUS OTHER MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. PLEASE REFER TO THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT INCLUDED IN SCHEDULE O.
DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION A; QUESTION 3 PLEASE NOTE THAT BAYSHORE COMMUNITY HOSPITAL RETAINED THE SERVICES OF AN OUTSIDE, INDEPENDENT MANAGEMENT COMPANY TO MANAGE THE DAY-TO-DAY ACTIVITIES AND OPERATIONS OF THE ORGANIZATION UNTIL ALL THESE FUNCTIONS WERE TRANSITIONED TO MERIDIAN HEALTH SYSTEM, INC. PERSONNEL IN AUGUST OF 2011.
DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7 MERIDIAN HOSPITALS CORPORATION ("MHC") IS THE SOLE MEMBER OF THIS ORGANIZATION. MERIDIAN HEALTH SYSTEM, INC. ("MHS") IS THE SOLE MEMBER OF MHC. MHS HAS THE ULTIMATE AUTHORITY AND RIGHT TO ELECT THE MEMBERS OF THIS ORGANIZATION'S BOARD OF TRUSTEES AND HAS CERTAIN RESERVED POWERS AS DEFINED IN THIS ORGANIZATION'S BYLAWS.
DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION B; QUESTION 11B THIS ORGANIZATION IS AN AFFILIATE WITHIN MERIDIAN HEALTH ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. MERIDIAN HEALTH SYSTEM, INC. IS THE PARENT ORGANIZATION OF THE SYSTEM. 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 PREPARE AND FILE THE FORM 990. THE CPA FIRM PREPARED A DRAFT OF THE FORM 990 BASED ON INFORMATION PROVIDED BY THE ORGANIZATION, WHICH WAS THEN REVIEWED BY THE ORGANIZATION'S FINANCE PERSONNEL, OTHER APPROPRIATE INTERNAL STAFF FOR ACCURACY, GENERAL COUNSEL AND OUTSIDE TAX COUNSEL. THE DRAFT WAS THEN REVISED BY THE CPA FIRM BASED ON THIS REVIEW AND PRESENTED TO THE GOVERNING BODY'S AUDIT COMMITTEE FOR REVIEW AND RECOMMENDATION TO THE GOVERNING BODY. AFTER THE AUDIT COMMITTEE MEETING, ANY SUGGESTED REVISIONS TO THE FORM 990 WERE MADE, AND THE REVISED FORM 990 WAS PROVIDED TO EACH MEMBER OF THE ORGANIZATION'S GOVERNING BODY FOR REVIEW AT A MEETING PRIOR TO FILING OF THE FORM 990.
DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION B; QUESTION 12 THIS ORGANIZATION IS AN AFFILIATE WITHIN MERIDIAN HEALTH ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. MERIDIAN HEALTH SYSTEM, INC. IS THE PARENT ORGANIZATION OF THE SYSTEM. MERIDIAN HEALTH SYSTEM HAS ADOPTED A SYSTEM WIDE CONFLICT OF INTEREST POLICY WHICH IS APPLICABLE TO ALL OF ITS AFFILIATED ORGANIZATIONS. THE ORGANIZATIONS REGULARLY MONITOR AND ENFORCE COMPLIANCE WITH THE SYSTEM'S CONFLICT OF INTEREST POLICY. ANNUALLY ALL MEMBERS OF THE BOARD OF TRUSTEES, OFFICERS AND KEY EMPLOYEES OF EACH 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 PRESIDENT 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, PART VI, SECTION B; QUESTION 15 THIS ORGANIZATION IS AN AFFILIATE WITHIN MERIDIAN HEALTH; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). MERIDIAN HEALTH SYSTEM, INC. IS THE PARENT ORGANIZATION OF THE SYSTEM. THE EXECUTIVE COMPENSATION COMMITTEE ("COMMITTEE") OF THE PARENT ORGANIZATION IS RESPONSIBLE FOR REVIEWING THE EXECUTIVE COMPENSATION OF THE PRESIDENT AND KEY EMPLOYEES (SENIOR MANAGEMENT) OF THE PARENT AND ALL OF THE SUBSIDIARY ORGANIZATIONS. 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 HAS ISSUED TAX-EXEMPT BONDS TO FINANCE VARIOUS CAPITAL IMPROVEMENT PROJECTS, RENOVATIONS AND EQUIPMENT. IN CONJUNCTION WITH THE ISSUANCE OF THESE TAX-EXEMPT BONDS, THE ORGANIZATION'S FINANCIAL STATEMENTS WERE INCLUDED WITH THE TAX-EXEMPT BOND PROSPECTUS WHICH WAS MADE AVAILABLE TO THE GENERAL PUBLIC FOR REVIEW. THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE STATE OF NEW JERSEY DEPARTMENT OF THE TREASURY.
RELATED HOURS DISCLOSURE CORE FORM, PART VII, SECTION A, COLUMN B THE ORGANIZATION IS PART 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, OFFICERS AND/OR Key Employees 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 PER WEEK. THE HOURS REFLECTED ON PART VII OF THIS FORM 990 FOR PAID OFFICERS AND KEY EMPLOYEES REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF MERIDIAN HEALTH; NOT SOLELY THIS ORGANIZATION.
COMPENSATION INFORMATION DISCLOSURE CORE FORM, PART VII AND SCHEDULE J PART VII AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM THIS ORGANIZATION OR A RELATED ORGANIZATION. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OR INDEPENDENT CONTRACTORS OF THE ORGANIZATION OR THE RELATED ORGANIZATION AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THIS ORGANIZATION'S BOARD OF TRUSTEES.
OTHER CHANGES IN NET ASSETS CORE FORM, PART XI; LINE 5 OTHER CHANGES IN NET ASSETS OR FUND BALANCES INCLUDE: - NET CHANGE IN UNREALIZED GAINS AND LOSSES AND EQUITY IN EARNINGS OF OTHER INVESTMENTS - ($1,569,915) - DECREASES IN INTEREST IN AFFILIATED FUNDRAISING ORGANIZATIONS - ($60,000) - OTHER CHANGES IN PENSION BENEFITS AND PLAN ASSETS - ($1,740,000)
AUDITED FINANCIAL STATEMENTS CORE FORM, PART XII; QUESTION 2 AN INDEPENDENT CPA FIRM AUDITED THE FINANCIAL STATEMENTS OF THE ORGANIZATION FOR THE YEAR ENDED DECEMBER 31, 2011, AND ISSUED A CERTIFIED AUDITED FINANCIAL STATEMENT. AN UNQUALIFIED OPINION WAS ISSUED BY THE INDEPENDENT CPA FIRM. THIS ORGANIZATION WAS ALSO INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF MERIDIAN HOSPITALS CORPORATION AND SUBSIDIARY. PRICEWATERHOUSE COOPERS, L.L.P., AN INDEPENDENT BIG FOUR CPA FIRM, AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF MERIDIAN HOSPITALS CORPORATION AND SUBSIDIARY FOR THE YEARS ENDED DECEMBER 31, 2011 AND 2010. PRICEWATERHOUSE COOPERS, L.L.P. ISSUED AN UNQUALIFIED OPINION WITH RESPECT TO THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS EACH YEAR. THIS ORGANIZATION WAS ALSO INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF MERIDIAN HEALTH SYSTEM, INC. AND AFFILIATES. PRICEWATERHOUSE COOPERS, L.L.P. AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF MERIDIAN HEALTH SYSTEM, INC. AND AFFILIATES FOR THE YEARS ENDED DECEMBER 31, 2011 AND DECEMBER 31, 2010; RESPECTIVELY, INCLUDING THOSE ENTITIES INCLUDED IN THIS FORM 990. PRICEWATERHOUSE COOPERS, L.L.P. ISSUED AN UNQUALIFIED OPINION WITH RESPECT TO THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS.
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 NUMBER 5 IS NOT APPLICABLE.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2011

Additional Data


Software ID:  
Software Version:  
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
2011
Open to Public Inspection
Name of the organization
BAYSHORE COMMUNITY HOSPITAL
 
Employer identification number

21-0744668
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income
(e)
End-of-year assets


 		(f)
Direct controlling
entity

















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


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

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

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) MERIDIAN HOSPITALS CORPORATION

1350 CAMPUS PARKWAY

NEPTUNE,NJ07753
22-3471515 		HEALTH SVCS. NJ 501(C)(3) 509(A)(1) MH SYSTEM
 
 
No
(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
 
 
No
(3) JERSEY SHORE UNIVERSITY MEDICAL CNTR FDN

1350 CAMPUS PARKWAY

NEPTUNE,NJ07753
22-2342452 		FUNDRAISING NJ 501(C)(3) 509(A)(1) MH SYSTEM
 
 
No
(4) RIVERVIEW MEDICAL CENTER FDN INC

1350 CAMPUS PARKWAY

NEPTUNE,NJ07753
22-2333524 		FUNDRAISING NJ 501(C)(3) 509(A)(1) MH SYSTEM
 
 
No
(5) OCEAN MEDICAL CENTER FOUNDATION INC

1350 CAMPUS PARKWAY

NEPTUNE,NJ07753
22-2361311 		FUNDRAISING NJ 501(C)(3) 509(A)(1) MH SYSTEM
 
 
No
(6) MERIDIAN NURSING & REHABILITATION INC

3349 HIGHWAY 138 BUILDING C

WALL,NJ07719
52-1772578 		NURSING LTC NJ 501(C)(3) 509(A)(2) MH SYSTEM
 
 
No
(7) MERIDIAN HEALTH FOUNDATION INC

1350 CAMPUS PARKWAY

NEPTUNE,NJ07753
30-0107825 		FUNDRAISING NJ 501(C)(3) 509(A)(1) MH SYSTEM
 
 
No
(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
 
 
No
(9) MERIDIAN HEALTH REALTY CORPORATION

1350 CAMPUS PARKWAY

NEPTUNE,NJ07753
22-3200147 		TITLE HLDING NJ 501(C)(3) 509(A)(3) MH SYSTEM
 
 
No
(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
 
 
No
(12) MERIDIAN PEDIATRIC ASSOCIATES PC

1945 STATE ROUTE 33

NEPTUNE,NJ07753
06-1755230 		HEALTH SVCS. NJ 501(C)(3) 509(A)(2) MH SYSTEM
 
 
No
(13) MERIDIAN MEDICAL ASSOCIATES PC

1945 STATE ROUTE 33

NEPTUNE,NJ07753
06-1755233 		HEALTH SVCS. NJ 501(C)(3) 509(A)(2) MH SYSTEM
 
 
No
(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
 
 
No
(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
 
 
No
(16) MERIDIAN TRAUMA ASSOCIATES PC

1945 STATE ROUTE 33

NEPTUNE,NJ07753
14-1981651 		HEALTH SVCS. NJ 501(C)(3) 509(A)(2) MH SYSTEM
 
 
No
(17) MERIDIAN OBST & GYN ASSOCIATES PC

1945 STATE ROUTE 33

NEPTUNE,NJ07753
06-1455239 		HEALTH SVCS. NJ 501(C)(3) 509(A)(2) MH SYSTEM
 
 
No
(18) MERIDIAN PEDIATRIC SURGICAL ASSOC PC

1200 JUMPING BROOK RD BLDG 5

NEPTUNE,NJ07753
77-0720131 		HEALTH SVCS. NJ 501(C)(3) 509(A)(2) MH SYSTEM
 
 
No
(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 		HEALTH SVCS. NJ 501(C)(3) 509(A)(1) MH SYSTEM
 
 
No
(21) BAYSHORE COMMUNITY HOSPITAL FOUNDATION

727 NO BEERS ST

HOLMDEL,NJ07733
22-2367109 		HEALTH SVCS. NJ 501(C)(3) 509(A)(1) MH SYSTEM
 
 
No
(22) BAYSHORE HEALTH CARE CENTER INC

715 NO BEERS ST

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

1140 ROUTE 72 WEST

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

1140 RT 72 WEST

MANAHAWKIN,NJ08050
27-1412183 		HEALTH SVCS. NJ 501(C)(3) 509(A)(2) MH SYSTEM
 
 
No
(25) MERIDIAN OCCUPATIONAL HEALTH PC

1350 CAMPUS PARKWAY

NEPTUNE,NJ07753
27-2377326 		HEALTH SVCS. NJ 501(C)(3) 509(A)(2) MH SYSTEM
 
 
No
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(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  
        No        












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



 		(b)
Primary activity



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


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

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership
(1) ASSISTED LIVING AT COLTS NECK INC
3349 HIGHWAY 138 BLDG C SUITE A
WALL,NJ07719
22-2567119 		HEALTHCARE SVCS. NJ  
C CORP.      
(2) MERIDIAN HEALTH MANAGEMENT INC
1350 CAMPUS PARKWAY
NEPTUNE,NJ07753
22-2519699 		HEALTHCARE SVCS. NJ  
C CORP.      
(3) MERIDIAN HEALTHWARES BRICK
1350 CAMPUS PARKWAY
NEPTUNE,NJ07753
22-3571926 		HEALTHCARE SVCS. NJ  
C CORP.      
(4) MERIDIAN HEALTHWARES WEST LONG BRANCH
1350 CAMPUS PARKWAY
NEPTUNE,NJ07753
22-3571931 		HEALTHCARE SVCS. NJ  
C CORP.      
(5) COASTAL MEDICAL INSURANCE LTD
44 CHURCH STREET 3RD FLOOR
HAMILTON   HA 12
BD
98-0166769 		FINANCIAL VEHICLE BD  
FOREIGN CORP.      
(6) COMPASS HEALTHCARE INC
1140 ROUTE 72 WEST
MANAHAWKIN,NJ08050
22-3357958 		HEALTHCARE SVCS. NJ  
C CORP.      
(7) BAYSHORE HEALTHCARE MANAGEMENT CORP
727 NO BEERS ST
HOLMDEL,NJ07733
22-2550716 		HEALTHCARE SVCS. NJ  
C CORP.      
(8) HCMC INC
PO BOX 176
HOLMDEL,NJ07733
22-2620595 		HEALTHCARE SVCS. NJ  
C CORP.      
(9) BAYSHORE CENTER FOR REHAB & PHYS THERAPY
1 BETHANY ROAD SUITE 43
HAZLET,NJ07730
22-3116637 		INACTIVE NJ  
C CORP.      
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
Yes
 
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
Yes
 
f Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1)
(2)
(3)
(4)
(5)
(6)
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income(related, unrelated, excluded from tax under sections 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) 2011
Schedule R (Form 990) 2011
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


Software ID:  
Software Version: