TY 2012 Form 990

Part X Balance Sheet Check if Schedule O contains a response to any question in this Part X ...............
	1	Cashnon-interest-bearing .............	0	1	0
2	Savings and temporary cash investments .........	0	2	0
3	Pledges and grants receivable, net ...........	0	3	0
4	Accounts receivable, net .............	0	4	0
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
		0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
		0	6	0
7	Notes and loans receivable, net .............	0	7	0
8	Inventories for sale or use ..............	0	8	0
9	Prepaid expenses and deferred charges ..........	0	9	0
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a
b	Less: accumulated depreciation .....	10b		0	10c
11	Investments—publicly traded securities ..........	0	11	0
12	Investments—other securities. See Part IV, line 11 .....	0	12	0
13	Investments—program-related. See Part IV, line 11 .....	2,124,583	13	1,517,948
14	Intangible assets ...............	0	14	0
15	Other assets. See Part IV, line 11 ...........	0	15	0
16	Total assets. Add lines 1 through 15 (must equal line 34)......	2,124,583	16	1,517,948
	17	Accounts payable and accrued expenses .........	0	17	0
18	Grants payable .................	0	18	0
19	Deferred revenue ................	0	19	0
20	Tax-exempt bond liabilities .............	0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D..	0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	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....................	0	25	0
26	Total liabilities. Add lines 17 through 25.........	0	26	0
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	2,124,583	27	1,517,948
28	Temporarily restricted net assets ...........	0	28	0
29	Permanently restricted net assets ...........	0	29	0
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	2,124,583	33	1,517,948
34	Total liabilities and net assets/fund balances ........	2,124,583	34	1,517,948

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.

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

See separate instructions.

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization

PRINCETON HEALTHCARE SYSTEM HOLDING INC

Employer identification number

22-3493256

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

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

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

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

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

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

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

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

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

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

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

receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of

its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses

acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

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

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Non-functionally integrated

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

and (iii) below, the governing body of the supported organization? ................

11g(i)

(ii) A family member of a person described in (i) above? ......................

11g(ii)

(iii) A 35% controlled entity of a person described in (i) or (ii) above? ................

11g(iii)

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

(i) Name of supported organization	(ii) EIN	(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))	(iv) Is the organization in col. (i) listed in your governing document?		(v) Did you notify the organization in col. (i) of your support?		(vi) Is the organization in col. (i) organized in the U.S.?		(vii) Amount of monetary support
(i) Name of supported organization	(ii) EIN		Yes	No	Yes	No	Yes	No	(vii) Amount of monetary support
(A) PRINCETON HEALTHCARE SYSTEM A NEW JERSEY NONPROFIT CORP	210635009	03	Yes		Yes		Yes		0

Total									0

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2012

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
11	Total support (Add lines 7 through 10).

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

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2012 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2011 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2012. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2011. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2012. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2011. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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

Schedule A (Form 990 or 990-EZ) 2012

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2008	(b) 2009	(c) 2010	(d) 2011	(e) 2012	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2012 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2011 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2012 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2011 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2012. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ........ right arrow

33 1/3% support tests—2011. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

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

Schedule A (Form 990 or 990-EZ) 2012

Page 4

Part IV

Supplemental Information. Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2012

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

PRINCETON HEALTHCARE SYSTEM HOLDING INC

Employer identification number

22-3493256

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate contributions to (during year) ...
3	Aggregate grants from (during year) .....
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ....................	2d

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

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

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

Yes No

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

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

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

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

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

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

Assets included in Form 990, Part X ............................... SchDMd Bullet

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

Cat. No. 52283D

Schedule D (Form 990) 2012

Page 2

Part III

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

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

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

Yes No

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


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

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

Yes No

If “Yes,” explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	b (c)Two years back	(d)Three years back	(e)Four years back
1a	Beginning of year balance ....
b	Contributions ........
c	Net investment earnings, gains, and losses
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

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

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

Yes

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

3a(i)

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

3a(ii)

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

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

Part VI

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

Description of property		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................
b	Buildings ................
c	Leasehold improvements ............
d	Equipment ................
e	Other .................
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......

Schedule D (Form 990) 2012

Page 3

Part VII

InvestmentsOther Securities. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)		(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. See Form 990, Part X, line 13.

(a) Description of investment type	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) INVESTMENTS IN JOINT VENTURES	1,517,948	F








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)	1,517,948

Part IX

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

(a) Description				(b) Book value









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

Part X

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

1.(a) Description of liability		(b) Book value
Federal income taxes		0









Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		0
2. Fin 48 (ASC 740) Footnote. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII .....................................................

Schedule D (Form 990) 2012

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b.......................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d......................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.......................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Identifier	Return Reference	Explanation
TEXT OF FIN 48 AUDITED FINANCIAL STATEMENT FOOTNOTE	SCHEDULE D, PART X	THE ORGANIZATION IS THE TAX-EXEMPT PARENT OF PRINCETON HEALTHCARE SYSTEM, A NEW JERSEY NONPROFIT CORPORATION AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF PRINCETON HEALTHCARE SYSTEM HOLDING, INC. FOR THE YEARS ENDED DECEMBER 31, 2012 AND DECEMBER 31, 2011; RESPECTIVELY. THE FOLLOWING, WITH RESPECT TO A FIN 48 DISCLOSURE, IS INCLUDED IN THE TEXT OF THE INCOME TAX FOOTNOTE IN THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED DECEMBER 31, 2012: PER THE REQUIReMENT TO ASSESS FOR TAX UNCERTAINTY, MANAGEMENT HAS DETERMINED THAT IT DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS REQUIRED TO BE ACCRUED OR REPORTED.

Schedule D (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

PRINCETON HEALTHCARE SYSTEM HOLDING INC

Employer identification number

22-3493256

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

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

Travel for companions Payments for business use of personal residence

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

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

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

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all officers,
directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? .......

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

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

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

Yes

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

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

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

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

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

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

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

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

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

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

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

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

Cat. No. 50053T

Schedule J (Form 990) 2012

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported as deferred in prior Form 990
(1)MARGARET LANCEFIELD MD PHDVICE CHAIR - TRUSTEE	(i) (ii)	0 251,825	0 0	0 3,109	0 15,297	0 23,999	0 294,230	0 0
(2)BARRY S RABNERTRUSTEE - PRESIDENT/CEO	(i) (ii)	0 554,530	0 691,686	0 8,997	0 82,773	0 19,799	0 1,357,785	0 0
(3)BRUCE L TRAUB FHFMA CPAASSt TREAS-SVP/CFO (1/1-9/4)	(i) (ii)	0 340,080	0 73,307	0 3,099	0 12,797	0 26,931	0 456,214	0 0
(4)YALE H BOHN ESQASST SEC - VP/GENERAL COUNSEL	(i) (ii)	0 316,846	0 130	0 6,492	0 12,797	0 35,746	0 372,011	0 0

Schedule J (Form 990) 2012

Page 3

Part III

Supplemental Information

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

Identifier	Return Reference	Explanation
COMPENSATION INFORMATION	SCHEDULE J, PART I; QUESTION 4B	THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THE FOLLOWING INDIVIDUAL INCLUDES UNVESTED BENEFITS IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN WHICH ARE SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THE INDIVIDUAL MAY NEVER ACTUALLY RECEIVE THE UNVESTED BENEFIT AMOUNT. THE AMOUNT OUTLINED HEREIN WAS NOT INCLUDED IN THE INDIVIDUAL'S 2012 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: BARRY S. RABNER, $69,976.
COMPENSATION INFORMATION	SCHEDULE J, PART I; QUESTION 7	CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A BONUS DURING CALENDAR YEAR 2012 WHICH AMOUNTS WERE INCLUDED IN COLUMN B(II) HEREIN AND IN EACH INDIVIDUAL'S 2012 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT.

Schedule J (Form 990) 2012

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2012

Open to Public
Inspection

Name of the organization

PRINCETON HEALTHCARE SYSTEM HOLDING INC

Employer identification number

22-3493256

Identifier	Return Reference	Explanation
COMMUNITY BENEFIT STATEMENT	CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS	PRINCETON HEALTHCARE SYSTEM HOLDING, INC. IS A NOT FOR PROFIT HOLDING COMPANY BASED IN PRINCETON, NEW JERSEY. PRINCETON HEALTHCARE SYSTEM HOLDING, INC. IS THE SOLE CORPORATE MEMBER OF A NUMBER OF NOT FOR-PROFIT ENTITIES AND THE SOLE SHAREHOLDER OF VARIOUS OTHER FOR-PROFIT ENTITIES. THE IRS HAS RECOGNIZED PRINCETON HEALTHCARE SYSTEM HOLDING, INC. AS A TAX-EXEMPT ORGANIZATION UNDER INTERNAL REVENUE CODE ("IRC") SECTION 501(C)(3). AS THE PARENT ORGANIZATION OF A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM, PRINCETON HEALTHCARE SYSTEM HOLDING, INC. STRIVES TO CONTINUALLY DEVELOP AND OPERATE AN INTEGRATED HEALTHCARE DELIVERY SYSTEM WHICH PROVIDES A COMPREHENSIVE SPECTRUM OF HEALTHCARE SERVICES TO THE RESIDENTS OF CENTRAL NEW JERSEY AND THE SURROUNDING COMMUNITY. PRINCETON HEALTHCARE SYSTEM HOLDING, INC. ENSURES THAT ITS SYSTEM PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. PRINCETON HEALTHCARE SYSTEM HOLDING, INC. IS THE SOLE CORPORATE MEMBER OF PRINCETON HEALTHCARE SYSTEM, A NEW JERSEY NONPROFIT CORPORATION ("PHCS"); AN ENTITY PROVIDING COMPREHENSIVE INPATIENT, OUTPATIENT AND EMERGENCY SERVICES. Princeton HealthCare System, A NEW JERSEY NON PROFIT CORPORATION ("PHCS") is composed of three divisions: University Medical Center of Princeton at Plainsboro (UMCPP), Princeton House Behavioral Health and Princeton HomeCare Services. PHCS is recognized by the Internal Revenue Service (IRS) as an Internal Revenue Code Section 501(c)(3) tax-exempt organization. In accordance with its charitable mission, PHCS provides healthcare services to all individuals in a non-discriminatory manner regardless of race, color, creed, sex, national origin or ability to pay. Moreover, PHCS operates consistently with the following criteria outlined in IRS Revenue Ruling 69-545: 1) PHCS provides medically necessary healthcare services to all individuals regardless of ability to pay, including charity care, self- pay, Medicare and Medicaid patients; 2) PHCS operates for all persons an active emergency department; which is open 24 hours a day, 7 days a week, 365 days per year; 3) PHCS maintains an open medical staff, with privileges available to all qualified physicians; 4) Control of PHCS rests with its Board of Trustees which is composed of independent civic leaders, members of the community and medical staff representation; and 5) Surplus funds are used to improve the quality of patient care, expand and renovate facilities, and advance medical care, programs and activities. The operations of PHCS, as shown through the factors outlined above and other information contained herein, clearly demonstrate that the use and control of PHCS is for the benefit of the public and that no part of the income or net earnings of the organization inures to the benefit of any private individual nor is any private interest being served other than incidentally. BACKGROUND ========== PHCS is a leading provider of healthcare services. A respected nonprofit, community teaching system, we offer compassionate care supported by advanced technologies and an outstanding medical staff. Ninety-four percent of our 1,066 of the medical staff members have achieved board certification, the hallmark of professional excellence, the balance are board eligible. Through our affiliations with academic institutions, we are setting new standards in diagnostic and treatment protocols and achieving successful clinical outcomes for our patients. Princeton HealthCare System is Redefining Care through our commitment to delivering an exceptional level of healthcare. Our mission statement is as follows: The Mission of phcs is to be the focal point of a comprehensive community health system that responds to the healthcare needs of our service area residents. Pchs will provide inpatient and outpatient care, community health education, medical education, and should promote medical and scientific research when appropriate. It is integral to the Mission of Phcs to continually improve quality of service to our patients and community and to provide appropriate healthcare to all. PHCS is composed of the following: University Medical Center of Princeton at Plainsboro ("UMCPP") is a teaching hospital that provides comprehensive patient care and support services relating to patient care to all individuals in a non-discriminatory manner regardless of ability to pay. It is an acute care facility with 319 beds comprised of 288 acute care beds, 17 physical rehabilitation beds and 14 neonatal bassinets. In 2012 patient days totaled 61,997. Outpatient patient visits/encounters totaled 684,076. UMCPP launched an intensivists program in 2005 to ensure that physicians with advanced critical care training coordinate the care of the most critically ill patients. The 2005 year also saw the addition of two pediatric outpatient specialties (pediatric nephrology and pediatric cardiology) and UMCPP's bariatric surgery program earned a designation as a center of excellence. In 2009, umcpp kicked off an exciting partnership with the Children's Hospital of Philadelphia bringing world-class pediatric healthcare to our community. UMCPP further developed its diabetes management services providing approximately 3,440 occasions of service in 2012. umcpp Diabetes Management services also reach out into the community. a certified diabetes nurse clinician provides a monthly support group meeting at both our Princeton and Monroe locations. In 2012, 147 residents from the community participated in our diabetes support groups. UMCPP also provides cardiac and pulmonary rehabilitation which includes exercise sessions, maintenance and re-assessments. During 2012, approximately 8,830 cardiac and pulmonary rehabilitation sessions were provided. UMCPP is proud to be among a select number of hospitals nationwide with a 24-bed Acute Care of the Elderly (ACE) unit. In fact, we were one of the first hospitals in New Jersey to offer this nursing unit specifically designed to meet the complex needs of the older adult population. Major Achievements ------------------ - UMCPP named to 100 Great Hospitals, a list published annually by Becker's Hospital Review, a comprehensive ranking that also includes on the 2013 list: the Johns Hopkins Hospital; Mayo Clinic; Cleveland Clinic; Massachusetts General Hospital. - Top Hospital for Patient Safety and Quality of Care in 2008, 2009 and 2010 by The Leapfrog Group, one of fewer than 40 hospitals in the nation and the only one in New Jersey - to receive this designation for three consecutive years. The Leapfrog Group is a partnership of major employers and other large healthcare purchasers in the United States, an independent national nonprofit working to improve the safety, quality and affordability of healthcare. - An "A" in patient safety from The Leapfrog Group, a national nonprofit working to improve the safety, quality and affordability of healthcare. The top grade was awarded as part of The Leapfrog Group's Hospital Safety Score, which is calculated twice yearly based on data related to preventable medical errors, injuries, accidents and infections. UMCPP has earned straight A's since the grades were first published in June 2012. - Magnet status, the highest institutional recognition available for nursing excellence, one of 395 Magnet-recognized organizations, representing fewer than five percent of the hospitals nationwide. The American Nurses Credentialing Center (ANCC), a subsidiary of the American Nurses Association, developed the Magnet Recognition Program to acknowledge superior patient care, nursing excellence and innovations in professional nursing practice. - Press Ganey patient experience surveys ranked UMCPP in the 98th percentile, compared to the New Jersey Peer Group, for overall inpatient services during the fourth quarter of 2012. Also during this same time frame, in the HCAHPS-Hospital Consumer Assessment of Healthcare Providers and Systems-survey, UMCPP ranked in the 92nd percentile among New Jersey hospitals in response to the question: "How would you rate this hospital?" Nearly 75 percent of the patients surveyed rated the hospital 9 or 10 on a scale from 1 to 10. - Center of Excellence for Bariatric Surgery by the American Society for Metabolic & Bariatric Surgery. The designation is based on the Bariatric Surgery program's equipment, staffing, training, safety and patient outcomes. - Clinical Research Affiliate of The Cancer Institute of New Jersey, an accredited oncology-teaching program of the American College of Surgeons' Commission on Cancer (CoC) and recipient of the CoC's Outstanding Achievement Award.
COMMUNITY BENEFIT STATEMENT CONT'D	CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS	- National accreditation recognizing the excellence of its full spectrum of breast care, from preventive services such as mammography to the most advanced cancer treatments. The National Accreditation Program for Breast Centers (NAPBC), a program administered by the American College of Surgeons, awarded the three-year full accreditation to the breast care services provided at UMCPP and the UMCPP Breast Health Center in East Windsor. - Princeton HealthCare System (PHCS) named one of the nation's Top Performers on Key Quality Measures by The Joint Commission, the leading accrediting agency of healthcare organizations in America. PHCS was recognized by The Joint Commission for exemplary performance in using evidence-based clinical processes that are shown to improve care. PHCS was recognized for its achievement in the following areas: heart attack, heart failure, pneumonia, and surgical care. - NICHE (Nurses Improving Care for Health System Elders), a national initiative based at the Hartford Institute for Geriatric Nursing at New York University. The program aims to facilitate the infusion of evidence-based geriatric best practices throughout institutions to improve nursing care for older adult patients. - UMCPP's Breast Health Center designated Breast Imaging Center of Excellence by American College of Radiology. Princeton HomeCare Services is a home care and visiting nurse service providing healthcare services to all individuals in a non-discriminatory manner regardless of ability to pay. In 2012 there were 46,300 visits recorded. This growing service is vital in the capacity to provide care at the patient's home rather than requiring a stay in the hospital. Princeton HomeCare Services also operates a Palliative Care Program and a Hospice Program. The Palliative Care Program focuses on comfort and support providing 22,821 Hospice visits in 2012. The Hospice Program offers Grief Support groups in the day and evening, to accommodate the needs of the community. In 2005, the Hospice Program began offering volunteer training in Monroe for individuals who wish to visit and offer support to patients and families. To help children mourn the loss of a loved one, a Child Bereavement Program educates parents and healthcare providers as to the effects of death on children. In 2007 the Hospice Program opened a new Library for bereaved children and teens. Princeton House Behavioral Health (PHBH) offers treatment for acute psychiatric illnesses, substance use problems, and co-occurring disorders at the inpatient, partial hospital, and intensive outpatient levels of care to all patients in a non-discriminatory manner regardless of ability to pay. As an advanced behavioral health service provider in the State of New Jersey, PHBH maintains a main campus in Princeton and outpatient sites throughout Central and Southern New Jersey in Princeton, North Brunswick, Hamilton and Cherry Hill. PHBH's inpatient facility on the main campus in Princeton now has 110 beds that produced 33,059 patient days in 2012. Outpatient visits and treatments across multiple sites amounted to 75,323. PHCS MEDICAL SERVICES AND HEALTHCARE PROGRAMS ============================================== The medical services and healthcare programs conducted by PHCS include, but are not limited to, the following: 1. Behavioral Health Services Princeton House Behavioral Health offers a wide and growing range of behavioral health programs to meet the needs of the communities that it serves. Specialized programs for children, adolescents, adults, women, and older adults are available across the continuum of care, with a few examples that follow. In April 2005, PHBH opened, the "Short Term Care Facility", (STCF), designed to stabilize patients who meet the commitment criteria in the State of New Jersey and help them transition to a less restrictive level of care as quickly as possible. Designated by the New Jersey Department of Health, this STCF unit has 21 beds and its multidisciplinary treatment approach includes the participation of community mental health representatives from various agencies. In 2009, a children's outpatient psychiatric program opened in Hamilton, in addition to the already established children's programs at the North Brunswick and Cherry Hill sites. These partial hospital and intensive outpatient programs provide treatment for children ages 5-12 that cannot function in the classroom due to severe psychiatric and behavioral problems. Across all of its many programs, Princeton House promotes evidence-based practices, continuous improvement of quality, ongoing professional and community education, and innovative approaches to behavioral healthcare. In addition to clinical programs for patients, PHBH hosts professional education programs and is actively involved in the community. For example, PHBH's Department of Training and Research maintains an American Psychological Association (APA)-accredited Pre-Doctoral Psychology Internship Program, which attracts highly qualified candidates from around the country. PHBH community-based activities include free continuing education events to area behavioral health professionals, as well as frequent participation in relevant community events such as the Recovery Rally, the Trenton Drug Free Festival, the Mercer Traumatic Loss Coalition's 5K Run, the National Alliance for Mental Illness's annual "NAMI Walk", and the National Council of Alcohol and Drug Dependence's Tree of Hope Ceremony. 2. Breast Health Center The Breast Health Center is a state of the art breast imaging facility located in East Windsor, the first facility in Mercer County to be designated as a Breast Imaging Center of Excellence by the American College of Radiology. UMCPP Breast Health Center is one of only about five percent of breast imaging facilities nationwide to have been designated a Breast Imaging Center of Excellence by the American College of Radiology signifying that UMCPP meets the highest standards of the radiology profession. The Center was designed to provide a relaxing environment for patients undergoing breast imaging and diagnostics. The goal of the Breast Health Center is to promote recommended screening guidelines, provide education and support to women in an effort to diagnose cancer in early, treatable stages when positive outcomes are most achievable. In addition to mammography, breast ultrasound, stereotactic biopsy and ultrasound biopsy, the Center has certified Breast Health Navigators to assist patients throughout their treatment for breast cancer. Breast Surgeons and Medical Oncologists also see patients at the Breast Health Center. The National Accreditation Program for Breast Centers (NAPBC), a program administered by the American College of Surgeons, awarded the three-year full accreditation to the breast care services provided at UMCPP and the UMCPP Breast Health Center in East Windsor. Educational programs are presented at the Center by Community Education and Outreach with topics relevant to women. Educational outreach promoting breast health is performed with collaborating organizations such as the Breast Cancer Resource Center of the Princeton YWCA, The Christina Walsh Breast Cancer Foundation and Heart to Heart. A grant from Susan G. Komen for the Cure provided 119 mammograms for underserved women. The Breast Health Center staff participates in the Komen Race for the Cure each year. In 2012, the Breast Health Center participated in 22 educational and outreach programs which included 197 attendees. It also launched a Breast Cancer Support Group in collaboration with CancerCare of New Jersey. 3. Eating Disorders The Eating Disorders Program at University Medical Center of Princeton at Plainsboro is committed to providing exceptional medical, psychotherapeutic and nutritional care as well as highly personal caring for each and every patient in our program. Our multidisciplinary treatment team provides effective and compassionate treatment for adults, adolescents and children who are suffering from anorexia, bulimia and other eating disorders. Our goal is to help patients recover physically and emotionally in a warm, caring environment that offers acceptance, safety and support. Because of our location in a full-service medical center, we emphasize thorough and efficient treatment of any medical complications while simultaneously addressing the psychological issues underlying eating disorders.
COMMUNITY BENEFIT STATEMENT CONT'D	CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS	4. Emergency Department The Center for Emergency Care at UMCPP provides state-of-the-art emergency medicine, treating patients with all medical problems that cannot wait to be seen by their regular doctor, as well as severe and life-threatening illnesses and injuries. The Center is open 24 hours a day, 365 days a year, and is staffed around-the-clock by physicians who are board certified in emergency medicine and registered nurses who are trained in trauma, emergency care and disaster preparedness. Staffed by physicians who are board certified in emergency medicine and nurses who are trained in trauma, emergency care and disaster preparedness, the Emergency Department realized 42,260 visits in 2012. The focus is on prompt, effective treatment with a bedside registration process and a Fast Track Suite that provides treatment for a less serious injury or illness within an hour. A hospitalist from the world renowned Children's Hospital of Philadelphia (CHOP) is on-site 24/7 to consult on emergency cases involving infants, children and adolescents to ensure the highest-level of, and most age-appropriate, care. A hospitalist is a physician who specializes in caring for patients in the hospital setting only. In 2009, the LIFENET Cardiac Care System was fully implemented enabling EMTs to transmit patients EKGs from the field to the Emergency Department, allowing ED staff more time to prepare for patients requiring emergency care. In addition, the Center for Emergency Care at UMCPP is a state-designated Primary Stroke Center, based on UMCPP's advanced capabilities and protocols for the rapid and effective treatment of stroke patients. Our specially-trained, acute stroke teams are available 24 hours, seven days a week and are ready to see patients within 15 minutes. UMCPP has around-the-clock neuro-imaging capabilities via its state-of-the-art computerized tomography (CT) scanner, and neurosurgical services. 5. Epilepsy Program The University Medical Center of Princeton at Plainsboro's Epilepsy Program provides comprehensive and compassionate outpatient and inpatient services for adults and children over the age of 6 who have seizure disorders. Our program is committed to providing skilled and compassionate care that focuses on achieving successful outcomes, continuity of care and quality of life. Epilepsy is a chronic neurological condition that produces sudden disturbances in the normal electrical function of the brain. This causes seizures that affect an individual's awareness, movement, sensations or behavior. More than 3.0 million Americans have been diagnosed with epilepsy, and 200,000 new cases occur each year. The disorder can occur at any age but is especially common in children and older adults. The Epilepsy Program at University Medical Center of Princeton at Plainsboro is led by a fellowship-trained neurologist with highly specialized training in epilepsy. Each of our board certified physicians emphasizes a team approach to care. They work closely with a patient's personal physician as well as PHCS' skilled nursing and certified technical staff. 6. Inpatient Hospice Program Inpatient hospice care is available at University Medical Center of Princeton at Plainsboro when uncontrolled pain or intractable symptoms make remaining at home extraordinarily difficult. The Inpatient Hospice Program is a unique partnership between University Medical Center of Princeton at Plainsboro, Princeton HomeCare Services and members of the community committed to providing highly skilled and compassionate inpatient care for hospice patients. 7. Intensivists Program Patients have access to highly specialized care if and when it is needed most through the Intensivists Program, now available at The University Medical Center of Princeton at Plainsboro. Intensivists are physicians with advanced critical care board certification who specialize in treating the most seriously ill or injured patients. Studies have shown that patients whose care is managed by a specially trained intensivist in the ICU recover more quickly and achieve better clinical outcomes overall. UMCPP's Intensivists Program is provided in collaboration with the rutgers new jersey medical school, one of the country's leading medical schools. The University Medical Center of Princeton at Plainsboro is an acute care teaching hospital and University Hospital Affiliate of the medical school. 8. Maternity Program The Center for Maternal and Newborn Care at University Medical Center of Princeton at Plainsboro is committed to promoting a unique, family-centered birth experience, healthy pregnancies and safe deliveries. University Medical Center of Princeton at Plainsboro OB patients receive nationally recognized maternity care provided by an exceptional team of physicians and maternal and family health experts. Staff and physicians help patients and their families feel confident and comfortable through pregnancy, labor and delivery as well as prepared to care for their new baby when they go home. The University Medical Center of Princeton at Plainsboro is proud to be a national leader in maternity care. Our partnership with the Maternal Fetal Department at Penn Medicine, a team of nationally recognized experts in high-risk obstetrics, fetal evaluation and ante-partum testing, allows us to offer a broad range of services on site at our new Plainsboro facility. Through this partnership, Penn Maternal Fetal Medicine at UMCPP offers advanced care which provides round-the-clock access to board certified obstetricians, peri-natologists (maternal fetal medicine specialists for complex pregnancies), anesthesiologists, neonatologists and pediatricians. The program also includes daily access to lactation instruction and access to outpatient lactation services through the Community Education and Outreach Program once they are discharged. We provide screening for post partum depression and Community Education provides post partum adjustment support groups. UMCPP has a very busy maternity clinic for patients that are uninsured or uninsured. To support this service, UMCPP provides and pays for 24/7 physician obstetrical care. 9. Orthopedics Program A leading provider of orthopedic care, The University Medical Center of Princeton at Plainsboro helps patients return to active, comfortable living. HealthGrades, the nation's leading healthcare quality company, has named University Medical Center of Princeton at Plainsboro the top-rated provider of overall orthopedic care and joint replacement surgery in the Trenton area. Because of the exceptional quality of our care, University Medical Center of Princeton at Plainsboro has also been ranked among the top five hospitals in New Jersey for overall orthopedics and joint replacement surgery. the umcpp Orthopedic Program offers skilled and comprehensive care. - Board certified physicians with fellowship training in key sub-specialties including spine, hand, shoulder, hip and knee surgeries - Innovators in minimally invasive techniques that promote faster recovery and greater comfort - Pioneers in the use of highly durable advanced materials, resulting in greater function and convenience for patients 10. Bristol-Myers Squibb Community Health Center ("BMSCHC") The BMSCHC is dedicated to providing excellent primary and specialty care for adults and children who meet New Jersey State financial guidelines: - Care provided by board certified physicians, highly trained residents (from the Rutgers New Jersey Medical School working under the guidance of members of our medical staff who also serve on the faculty of the medical school), nutritionists, social workers, RN's, CMA's, and health educators. - Will provide more than 24,194 total patient visits to in 2012, representing approximately a 24 percent increase in visit volume vs. five years ago. - Obstetrics and Gynecology Program that includes extensive counseling, ongoing case management, and provision of services to a uniquely underserved population. The volume of obstetric cases continues to experience steady growth since inception. In 2012 we began to accept direct referrals for Medicaid patients into our Gynecologic service. We experienced a 26 percent volume increase in these types of visits as compared to 2009 volumes. It is important to note that few, if any, private physicians in our community accept Medicaid and very few participate in managed medicaid programs.
COMMUNITY BENEFIT STATEMENT CONT'D	CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS	- Our Pediatric PROGRAM serves more than 1,250 children and its visit volume has grown more than 29 percent in the past five years. The program includes provision of a very high volume of pediatric immunizations & EPSDT services, as well as case management and referral for subspecialty care. The Pediatric PROGRAM also coordinates an asthma education/monitoring effort, that includes provision of nebulizers for home administration of respiratory medications, coordination with parents & schools regarding asthma care, and more focused re-education and case coordination for infants/children with respiratory problems. - General Surgery visit volume AT bmschc has grown 66 percent in the past five years, and more than 290 percent in the past 10 years. - Outpatient care includes not only treatment of chronic and acute illnesses/health conditions, but also preventive care and screening services, referral to a wide variety of UMCPP specialty programs, and extensive case management for at-risk populations. bmschc staff participates in a variety of grant-related and community-health focused activities, including the annual Latino Health Fair, breast health outreach/education/mammography screening, and diabetic eye screening efforts. In addition, the bmschc coordinates an ongoing Diabetes Management Initiative for adult patients that include close monitoring of key clinical indicators, individualized follow-up, specialized education/nutrition services, and provision of glucose testing materials. - In addition to the clinical care services provided, the bmschc provides and/or facilitates additional associated support services for bmschc Patients. These include referral/linkages to other community services and resources such as the WIC maternal-child nutrition program, Domestic Violence services and provision of scheduling & translation services for a bi-weekly onsite Medicaid worker. - bmschc staff assists patients in applying for indigent drug programs provided by pharmaceutical companies, and for PAAD/Medicare Part D prescription coverage. UMCPP also provides a variety of medications to bmschc patients who have no prescription coverage through its Pharmacy Department, totaling 2317 prescriptions filled for bmschc patients in 2012. bmschc staff also assists patients & families with submission of/follow-up per their Medicaid and FamilyCare applications, and staff is designated Presumptive Eligibility screeners for facilitated patient access to governmental coverage for obstetric and Pediatric services. - A high volume of interpretive/translation services are also provided for Limited English Proficient patients & families, both within the bmschc and for service provision elsewhere within UMCPP. A full-time Volunteer Translation Coordinator provides interpretive services and translation of written materials, as well as coordination of recruitment/screening/supervision of a cadre of community volunteers who interpret for patient clinical encounters. In addition, a number of bmschc staff are fully bilingual/bicultural and provide a very high volume of interpretive services for patient care and services. 11. Pain Management Program The University Medical Center of Princeton at Plainsboro's Pain Management Program has been providing innovative care to our community since 1995. the mission is to support effective pain control for patients suffering from chronic or acute pain by formulating a comprehensive plan of care. The physicians and staff of the Pain Management Program are committed to offering outstanding clinical care and exceptional personal caring to each and every patient in our program. These services are offered as part of Princeton HealthCare System's full continuum of care. 12. Pediatric HealthCare Center The Pediatric HealthCare Center at University Medical Center of Princeton at Plainsboro offers specialized pediatric care on an inpatient basis to families of the greater Princeton area. Care is provided through Children's Hospital of Philadelphia and the board certified physicians in its Departments of Pediatrics and Neonatology. We provide 24/7 inpatient coverage in the Emergency Department and inpatient well baby care, pediatrics and for low birth weight babies treated in our intermediate level 2 Neonatal intensive care unit ("nicu"). 13. Radiation Oncology The Edward & Marie Matthews Center for Cancer Care at University Medical Center of Princeton at Plainsboro (UMCPP) unites the Cancer Program's cutting-edge services in one specially designed space, allowing our multidisciplinary team to give patients high quality clinical care and compassionate support in a modern, yet warm, setting. By providing a complete continuum of care, the Center gives patients full access to the specialized clinical services, rehabilitative care, and support they need during treatment and recovery from cancer. As the very latest generation of linear accelerator the TrueBeamTM delivers radiation treatments with unparalleled precision and speed, reducing daily treatment times, improving targeting accuracy, and allowing for great versatility in treatment design. Radiation treatment uses an invisible and painless high-energy beam to arrest growth of cancer cells. Radiation may be administered either through a powerful linear accelerator or through the placement of radiation beads. The linear accelerator is capable of generating seven separate beams of high-energy x-rays or electrons, and it is supported by a sophisticated treatment planning computer. A board certified physicist uses this computer to perform the thousands of complex calculations required to tailor each radiation treatment to individual patient needs. Quality radiation treatment depends not only on the sophistication of the equipment, but also on the skill and compassion of the team of professionals providing care: physician, physicist, nurse and technologist. University Medical Center's Radiation Oncology team provides a diverse background of skills and experience to assist the cancer patient during the course of treatment. 14. Sleep Center Sleep disorders are a common condition affecting about one out of every six people in the United States. A sleep disorder can adversely affect health, work performance, school and relationships, so it is important to seek professional help. With prompt diagnosis and effective treatment, patients can sleep, feel and live better. Committed to the study, diagnosis and treatment of sleep-related problems, the University Medical Center of Princeton at Plainsboro Sleep Center offers adults and children expert care from a compassionate team of professionals. Our multidisciplinary treatment team includes: - Board certified physicians - Insomnia specialists - Technologists registered in clinical polysomnography 15. Surgery General and highly specialized surgical procedures are provided by a team of outstanding board certified surgeons and anesthesiologists. Surgeries are performed in our state-of-the-art operating facility, which now includes breakthrough robotic technology such as the da Vinci Surgical System to advance patient's access to high quality care. PHCS surgeons are skilled in innovative minimally invasive surgical techniques that ease and speed recovery while minimizing scarring. Services include: - Abdominal procedures - Bariatric surgery for morbid obesity - Gynecological surgery - Hernia repair - Neurosurgery - Ophthalmologic surgical procedures - Oral surgery - Orthopedic surgery - Otolaryngologic surgical procedures - Pediatric surgery and pediatric urology - Plastic surgery - Thoracic surgery (surgery of the lungs and esophagus) - Thyroid, parathyroid and breast surgeries - Urology - surgeries of the male/female genital and urinary tracts - Vascular surgery
COMMUNITY BENEFIT STATEMENT CONT'D	CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS	COMMUNITY ACTIVITIES AND PROGRAMS ================================= The Community Education & Outreach Program delivers low-cost and free lectures, health screenings, and special events for a service area comprising parts of Mercer, Middlesex, and Somerset Counties. They offer a dynamic curriculum of innovative health and lifestyle-related programming, screenings and support at little or no cost to the communities we serve. Princeton HealthCare System is dedicated to promoting healthy living at every stage of life and to enhancing quality of life by addressing the unique needs of women, men, seniors, children, adolescents and diverse populations. Special outreach efforts have been directed to the Latino, Indian-American, African-American, Chinese and Korean-American communities. The System is also involved with partnerships with the Princeton, Hopewell Valley, West Windsor, Plainsboro and Montgomery Regional School Districts for childhood and adolescent health issues including underage drinking, smoking and eating disorders. Other program venues include area senior centers, public libraries, community centers, YMCA's and YWCA's. In 2012, Community Education & Outreach provided 1154 programs to 43,500 participants. Total monies spent less payments received on Community Education for 2012 was $690,000. Provider Taxes All New Jersey acute care hospitals are required to pay a percentage of their total operating revenue to the Department of Health for deposit into the Health Care Subsidy Fund. We also pay the State of New Jersey an adjusted admission fee. In 2012 PHCS paid a total of $1,611,216 to the State of New Jersey for these assessments. Assistance Provided to Patients without Insurance PHCS provides emergent care irrespective of a patient's ability to pay. Often a patient requires follow-up care after hospitalization and encounter disposition/access problems because of no insurance coverage. PHCS often pays for these needed services. In 2012 PHCS paid other healthcare providers $5,000 for such services until alternative coverage could be obtained or care was not longer indicated. Medical Education Princeton HealthCare System has a long standing relationship with the Rutgers New Jersey Medical School to provide training for medical residents and students. PHCS trained the equivalent of 37 full time medical and surgical residents. The direct costs associated with these programs in 2012 approximated $5.9 million dollars, which was partially offset by Medicare and Medicaid funds of $4.9 million dollars, resulting in a shortfall of $1 million dollars. This shortfall excludes allocated overhead costs of $1.9 million. Also, PHCS is actively involved in the training of approximately 50 medical students a year for which it receives no reimbursement. PHCS is also committed to support the education and training of nursing students. PHCS has long standing affiliation agreements with The College of New Jersey, Rutgers University, Mercer County Community College, and St. Francis School of Nursing to provide training experiences for their nursing students. In 2012, there were 159 students with a total of 848 clinical rotations throughout PHCS. Charity Care PHCS provides care to patients who meet certain criteria defined by the New Jersey Department of Health without charge or at amounts less than its established rates. Because PHCS does not pursue collection of amounts determined to qualify as charity care, they are not reported as revenue. PHCS's records identify and monitor the level of charity care it provides and the amount of charges foregone for services and supplies furnished. Charges foregone for charity care during 2012 were approximately $55,532,000. This amount is higher than the amount reported in the audited financial statements because many patients subsequently qualified for charity care. The full costs (less some minor payments) associated to provide charity care approximated $12,900,000. DHSS charity care guidelines require participation and specific documentation of the patient in order to be identified as a charity care account. Management believes that the present charity care guidelines understate PHCS's charity care amounts and overstate the level of bad debts reported, because of the difficulties involved with obtaining patient participation and specific documentation. The New Jersey Health Care Subsidy Fund ("HCSF") was established for various purposes including the distribution of charity care payments to hospitals statewide. In 2012, PHCS received subsidy amounts of $1,416,000 which are included in net patient service revenue. Additionally, the State of New Jersey has established a Mental Health Subsidy Fund to pay for specific behavioral health services. In 2012 and 2011, PHCS received $1,257,000 for this program. Since the State created a Mental Health Subsidy Fund in recognition of the need to support Short Term Care Facility (STCF) and Child Community Inpatient Services (CCIS) beds. This fund is not specifically targeted to underfunding related to Charity Care and Medicaid patients but for all patients in need of these services. Approximately 54 percent of Princeton House's STCF days are Charity Care or Medicaid. The charity care provided above is only that reported to DHSS. PHCS does not submit claims to DHSS for qualified patients (financially indigent meeting poverty guidelines) relating to uncovered services such as behavioral health services. In 2012 PHCS provided inpatient behavioral health services to 55 patients that were hospitalized a total of 648 days and $306,055 of direct costs to uninsured patients that would normally meet DHSS financial criteria. Governmental Shortfalls PHCS participates with all governmental programs including but not limited to Medicare, Medicaid, Champus, etc. In 2012 PHCS received approximately $88.7 million dollars from the Medicare program. The costs associated with these revenues in accordance with Medicare rules and reported on the Medicare cost report was $115.2 million, resulting in a shortfall of $26.4 million or 23 percent. In 2012, PHCS received approximately $9.3 million dollars from the Medicaid and Medicaid managed care programs. The costs associated with these revenues in accordance with Medicare rules were $16.7 million, resulting in a shortfall of $7.4 million or 44 percent.
DISCLOSURE INFORMATION	CORE FORM, PART VI, SECTION B; QUESTION 11b	THE ORGANIZATION IS THE TAX-EXEMPT PARENT ENTITY OF PRINCETON HEALTHCARE SYSTEM, A NEW JERSEY NONPROFIT CORPORATION ("phcs") AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THE ORGANIZATION'S FEDERAL FORM 990 WAS provided TO EACH VOTING MEMBER OF ITS GOVERNING BODY (ITS BOARD OF TRUSTEES) PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE ("IRS"). IN ADDITION, PHCS' AUDIT COMMITTEE ASSUMED THE RESPONSIBILITY TO OVERSEE AND COORDINATE THE FEDERAL FORM 990 PREPARATION, REVIEW AND FILING PROCESS FOR ALL TAX-EXEMPT AFFILIATES OF THE SYSTEM. AS PART OF THE FEDERAL FORM 990 TAX RETURN PREPARATION PROCESS THE ORGANIZATION HIRED A PROFESSIONAL CPA FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION TO PREPARE THE FEDERAL FORM 990. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE ORGANIZATION'S FINANCE PERSONNEL AND SYSTEM INDIVIDUALS INCLUDING THE CHIEF FINANCIAL OFFICER, CHIEF COMPLIANCE OFFICER, CONTROLLER AND VARIOUS OTHER INDIVIDUALS TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE ORGANIZATION'S INTERNAL WORKING GROUP, INCLUDING THOSE INDIVIDUALS OUTLINED ABOVE FOR THEIR REVIEW. THE ORGANIZATION'S INTERNAL WORKING GROUP REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE ORGANIZATION'S INTERNAL WORKING GROUP FOR FINAL REVIEW AND APPROVAL. A MEETING WAS ALSO HELD TO REVIEW THE FINAL DRAFT OF THE FEDERAL FORM 990 WITH THE PHCS' AUDIT COMMITTEE FOR REVIEW AND APPROVAL. FOLLOWING THIS REVIEW THE FINAL FEDERAL FORM 990 WAS provided TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY PRIOR TO FILING WITH THE IRS.
DISCLOSURE INFORMATION	CORE FORM, PART VI, SECTION B; QUESTION 12	THE ORGANIZATION IS THE TAX-EXEMPT PARENT ENTITY OF PRINCETON HEALTHCARE SYSTEM, A NEW JERSEY NONPROFIT CORPORATION ("phcs") AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. PHCS AND its AFFILIATES, INCLUDING THIS ORGANIZATION, REGULARLY MONITOR AND ENFORCE COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. ANNUALLY ALL MEMBERS OF THE BOARD OF TRUSTEES, OFFICERS AND SENIOR MANAGEMENT PERSONNEL ARE REQUIRED TO REVIEW THE EXISTING CONFLICT OF INTEREST POLICY AND COMPLETE A QUESTIONNAIRE. THE COMPLETED QUESTIONNAIRES FROM THE ORGANIZATION'S BOARD OF TRUSTEES ARE RETURNED TO PHCS' VICE PRESIDENT AND GENERAL COUNSEL FOR REVIEW. THE COMPLETED QUESTIONNAIRES FOR PHCS' OFFICERS AND SENIOR MANAGEMENT ARE RETURNED TO PHCS' CHIEF COMPLIANCE OFFICER FOR REVIEW. THEREAFTER, PHCS' VICE PRESIDENT AND GENERAL COUNSEL AND THE CHIEF COMPLIANCE OFFICER BRING TO THE ATTENTION OF PHCS' GOVERNANCE COMMITTEE ANY DISCLOSED CONFLICTS OF INTEREST FOR ITS REVIEW AND DISCUSSION.
DISCLOSURE INFORMATION	CORE FORM, PART VI, SECTION B; QUESTION 15	THE ORGANIZATION IS THE TAX-EXEMPT PARENT ENTITY OF PRINCETON HEALTHCARE SYSTEM, A NEW JERSEY NONPROFIT CORPORATION ("phcs") AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THIS FILING ORGANIZATION ITSELF HAS NO PAID SENIOR MANAGEMENT PERSONNEL RECEIVING COMPENSATION DIRECTLY FROM THIS ORGANIZATION. RATHER, KEY SENIOR MANAGEMENT PERSONNEL, INCLUDING but not limited to THE PRESIDENT/CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER, ARE EMPLOYED BY PHCS, THE TAX-EXEMPT HOSPITAL WITHIN THE HEALTHCARE SYSTEM. HOWEVER, THE COMPENSATION AND BENEFITS OF THESE INDIVIDUALS ARE SHOWN ON THIS TAX RETURN BECAUSE THEY ARE ALSO EITHER OFFICERS OR BOARD MEMBERS OF THIS ORGANIZATION. ACCORDINGLY, PHCS' BOARD OF TRUSTEES HAS AN EXECUTIVE COMPENSATION COMMITTEE ("COMMITTEE"). THE COMMITTEE HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY WHICH IT FOLLOWS WHEN IT REVIEWS AND APPROVES OF THE COMPENSATION AND BENEFITS OF PHCS' SENIOR MANAGEMENT, INCLUDING but not limited to THE PRESIDENT/CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER. THE COMMITTEE REVIEWS THE "TOTAL COMPENSATION" OF THE INDIVIDUALS WHICH IS INTENDED TO INCLUDE BOTH CURRENT AND DEFERRED COMPENSATION AND ALL EMPLOYEE BENEFITS, BOTH QUALIFIED AND NON-QUALIFIED. THE COMMITTEE'S REVIEW IS DONE ON AT LEAST AN ANNUAL BASIS AND ENSURES THAT THE "TOTAL COMPENSATION" OF SENIOR MANAGEMENT IS REASONABLE. THE ACTIONS TAKEN BY THE COMMITTEE ENABLE PHCS TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 4958 WITH RESPECT TO THE TOTAL COMPENSATION OF CERTAIN MEMBERS OF THE SENIOR MANAGEMENT TEAM, INCLUDING but not limited to THE PRESIDENT/CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER. THE THREE FACTORS WHICH MUST BE SATISFIED IN ORDER TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS ARE THE FOLLOWING: 1. THE COMPENSATION ARRANGEMENT IS APPROVED IN ADVANCE BY AN "AUTHORIZED BODY" OF THE APPLICABLE TAX-EXEMPT ORGANIZATION WHICH IS COMPOSED ENTIRELY OF INDIVIDUALS WHO DO NOT HAVE A "CONFLICT OF INTEREST" WITH RESPECT TO THE COMPENSATION ARRANGEMENT; 2. THE AUTHORIZED BODY OBTAINED AND RELIED UPON "APPROPRIATE DATA AS TO COMPARABILITY" PRIOR TO MAKING ITS DETERMINATION; AND 3. THE AUTHORIZED BODY "ADEQUATELY DOCUMENTED THE BASIS FOR ITS DETERMINATION" CONCURRENTLY WITH MAKING THAT DETERMINATION. THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES EACH OF WHOm ARE INDEPENDENT AND ARE FREE FROM ANY CONFLICTS OF INTEREST. THE COMMITTEE RELIED UPON APPROPRIATE COMPARABLE DATA; SPECIFICALLY THE COMMITTEE OBTAINED A WRITTEN COMPENSATION STUDY FROM AN INDEPENDENT FIRM WHICH SPECIALIZES IN REVIEWING OF HOSPITAL AND HEALTHCARE SYSTEM EXECUTIVE COMPENSATION AND BENEFITS THROUGHOUT THE UNITED STATES. THIS STUDY USED COMPARABLE GEOGRAPHIC AND DEMOGRAPHIC MARKET DATA INCLUDING BUT NOT LIMITED TO SIMILAR SIZED HOSPITALS, NUMBER OF LICENSED BEDS AND NET PATIENT SERVICE REVENUE. THE COMMITTEE ADEQUATELY DOCUMENTED ITS BASIS FOR ITS DETERMINATION THROUGH THE TIMELY PREPARATION OF WRITTEN MINUTES OF THE COMPENSATION COMMITTEE MEETINGS DURING WHICH THE EXECUTIVE COMPENSATION AND BENEFITS WAS REVIEWED AND SUBSEQUENTLY APPROVED. THE ACTIONS OUTLINED ABOVE WITH RESPECT TO THE COMMITTEE AND THE ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS ONLY APPLIES TO CERTAIN SENIOR MANAGEMENT PERSONNEL, INCLUDING BUT NOT LIMITED TO THE PRESIDENT/CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER. THE COMPENSATION AND BENEFITS OF CERTAIN OTHER INDIVIDUALS CONTAINED IN THIS FORM 990 ARE REVIEWED ANNUALLY BY THE PRESIDENT/CHIEF EXECUTIVE OFFICER WITH ASSISTANCE FROM PHCS' HUMAN RESOURCES DEPARTMENT IN CONJUNCTION WITH THE INDIVIDUAL'S JOB PERFORMANCE DURING THE YEAR AND IS BASED UPON OTHER OBJECTIVE FACTORS DESIGNED TO ENSURE THAT REASONABLE AND FAIR MARKET VALUE COMPENSATION IS PAID BY PHCS. OTHER OBJECTIVE FACTORS INCLUDE MARKET SURVEY DATA FOR COMPARABLE POSITIONS, INDIVIDUAL GOALS AND OBJECTIVES, PERSONNEL REVIEWS, EVALUATIONS, SELF-EVALUATIONS AND PERFORMANCE FEEDBACK MEETINGS.
DISCLOSURE INFORMATION	CORE FORM, PART VI, SECTION C; QUESTION 19	THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE STATE OF NEW JERSEY DEPARTMENT OF TREASURY.
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 RELATED ORGANIZATIONS. PLEASE NOTE THAT THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OF THE RELATED ORGANIZATIONS AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THIS ORGANIZATION'S BOARD OF TRUSTEES.
RELATED HOURS DISCLOSURE	CORE FORM, PART VII, SECTION A, COLUMN B	THE ORGANIZATION IS THE TAX-EXEMPT PARENT ENTITY OF PRINCETON HEALTHCARE SYSTEM, A NEW JERSEY NONPROFIT CORPORATION ("phcs") AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THE SYSTEM INCLUDES BOTH FOR-PROFIT AND NOT FOR-PROFIT ORGANIZATIONS. CERTAIN BOARD OF DIRECTOR MEMBERS, OFFICERS AND/OR TRUSTEES LISTED ON CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 MAY HOLD SIMILAR POSITIONS WITH BOTH THIS ORGANIZATION AND OTHER AFFILIATES WITHIN THE SYSTEM. THE HOURS SHOWN ON THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE NO COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, 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 OTHER RELATED ORGANIZATIONS IN THE SYSTEM, THEIR RESPECTIVE HOURS PER WEEK PER ORGANIZATION ARE APPROXIMATELY ONE HOUR. THE HOURS REFLECTED ON PART VII OF THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, PAID OFFICERS AND KEY EMPLOYEES, REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF THE SYSTEM; NOT SOLELY THIS ORGANIZATION.
AUDITED FINANCIAL STATEMENTS	CORE FORM, PART XI; QUESTION 2	THE ORGANIZATION IS THE TAX-EXEMPT PARENT ENTITY OF PRINCETON HEALTHCARE SYSTEM, A NEW JERSEY NONPROFIT CORPORATION ("phcs") AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. AN INDEPENDENT CPA FIRM, AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF PRINCETON HEALTHCARE SYSTEM HOLDING, INC. FOR THE YEARS ENDED DECEMBER 31, 2012 AND DECEMBER 31, 2011; RESPECTIVELY. THE AUDITED FINANICAL STATEMENTS INCLUDE CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. THE INDEPENDENT CPA FIRM ISSUED AN UNQUALIFIED OPINION WITH RESPECT TO THE AUDITED FINANCIAL STATEMENTS EACH YEAR. PHCS' AUDIT COMMITTEE HAS ASSUMED RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE CONSOLIDATED FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT AUDITOR.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2012

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2012

Open to Public Inspection

Name of the organization

PRINCETON HEALTHCARE SYSTEM HOLDING INC

Employer identification number

22-3493256

Part I

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

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) PRINCETON HEALTHCARE SYSTEM ONE PLAINSBORO ROAD PLAINSBORO,NJ08536 21-0635009	HEALTH SVCS.	NJ	501(C)(3)	HOSPITAL	PHCS HOLDING	Yes
(2) PRINCETON HEALTHCARE SYSTEM FDN INC ONE PLAINSBORO ROAD PLAINSBORO,NJ08536 22-2225911	SUPPORT PHCS	NJ	501(C)(3)	509(A)(1)	PHCS HOLDING	Yes
(3) PRINCETON MEDICAL PROPERTIES INC ONE PLAINSBORO ROAD PLAINSBORO,NJ08536 22-0022702	REAL ESTATE	NJ	501(C)(2)	N/A	PHCS HOLDING	Yes
(4) PRINCETON CAREGIVERS INC ONE PLAINSBORO ROAD PLAINSBORO,NJ08536 22-2842773	HOMECARE SVCS	NJ	501(C)(3)	HOSPITAL	PHCS HOLDING	Yes
(5) PRINCETON HEALTHCARE AFFILIATED PHYS PC ONE PLAINSBORO ROAD PLAINSBORO,NJ08536 26-4203938	HLTHCARE SRCS	NJ	501(C)(3)	PENDING	PHCS		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2012

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(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		Yes	No
(1) PRINCETON HEALTH INC ONE PLAINSBORO ROAD PLAINSBORO,NJ08536 22-3450093	MEDICAL	NJ	PHCS HOLDING	C CORP.	975,225	3,521,521	100.000 %	Yes
(2) PRINCETON HEALTHCARE MGMT SVCS INC 4 PRINCESS ROAD LAWRENCEVILLE,NJ08648 22-3377256	MEDICAL BILLING	NJ	NA	C CORP.					No
(3) PRINCETON HEALTHCARE MEDICAL EQUIP CO ONE PLAINSBORO ROAD PLAINSBORO,NJ08536 22-3467900	INACTIVE	NJ	NA	C CORP.					No
(4) PHI PHARMACY INC ONE PLAINSBORO ROAD PLAINSBORO,NJ08536 22-3467899	INACTIVE	NJ	PHCS HOLDING	C CORP.	0	0	100.000 %	Yes

Schedule R (Form 990) 2012

Page 3

Part V

Transactions With Related Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34, 35b, or 36.)

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest (ii) annuities (iii) royalties or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

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

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

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

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

f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

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

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

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

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

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

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

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

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

Yes

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

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

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

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

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of other organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2012

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to Form 990, Part IV, line 37.)

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

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

Schedule R (Form 990) 2012

Page 5

Part VII

Supplemental Information

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

Identifier	Return Reference	Explanation
TRANSACTIONS WITH RELATED ORGANIZATIONS	SCHEDULE R, PART V	THE ORGANIZATION IS THE TAX-EXEMPT PARENT ENTITY OF PRINCETON HEALTHCARE SYSTEM, A NEW JERSEY NONPROFIT CORPORATION ("phcs") AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. phcs ROUTINELY PAYS EXPENSES FOR VARIOUS AFFILIATES WITHIN THE SYSTEM IN THE ORDINARY COURSE OF BUSINESS. THESE RELATED PARTY TRANSACTIONS ARE RECORDED ON THE REVENUE/EXPENSE AND BALANCE SHEET STATEMENTS OF THIS ORGANIZATION AND ITS AFFILIATES. THESE ENTITIES WORK TOGETHER TO DELIVER HIGH QUALITY HEALTHCARE AND WELLNESS SERVICES TO THE COMMUNITIES IN WHICH THEY ARE SITUATED.

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: THE ORGANIZATION ACTS AS THE PARENT HOLDING COMPANY OF A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	7
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	3
5	Total number of individuals employed in calendar year 2011 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	0
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	0	0
9	Program service revenue (Part VIII, line 2g) .........	0	0
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	420,405	-606,635
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	0	0
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	420,405	-606,635
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	0	0
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	0	0
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	0	0
19	Revenue less expenses. Subtract line 18 from line 12.......	420,405	-606,635
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	2,124,583	1,517,948
21	Total liabilities (Part X, line 26).............	0	0
22	Net assets or fund balances. Subtract line 21 from line 20.....	2,124,583	1,517,948

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 0 including grants of $ 0 ) (Revenue $ 0 )
	THE ORGANIZATION ACTS AS THE PARENT HOLDING COMPANY OF A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM WHICH INCLUDES PRINCETON HEALTHCARE SYSTEM, A NEW JERSEY NONPROFIT CORPORATION. PRINCETON HEALTHCARE 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. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses0

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)		(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(1) DONALD J HOFMANN........................................................................ CHAIRMAN - TRUSTEE	1.0 .......................	X	X	0	0	0
(2) MARGARET LANCEFIELD MD PHD........................................................................ VICE CHAIR - TRUSTEE	55.0 .......................	X	X	0	254,934	39,296
(3) HONORABLE DEBORAH T PORITZ........................................................................ VICE CHAIR - TRUSTEE	1.0 .......................	X	X	0	0	0
(4) DAVID F ERTEL........................................................................ VICE CHAIR/TREAS. - TRUSTEE	1.0 .......................	X	X	0	0	0
(5) JOANN HEFFERNAN HEISEN........................................................................ SECRETARY - TRUSTEE	1.0 .......................	X	X	0	0	0
(6) Gerard Compito MD........................................................................ TRUSTEE	1.0 .......................	X		0	0	0
(7) BARRY S RABNER........................................................................ TRUSTEE - PRESIDENT/CEO	55.0 .......................	X	X	0	1,255,213	102,572
(8) BRUCE L TRAUB FHFMA CPA........................................................................ ASSt TREAS-SVP/CFO (1/1-9/4)	55.0 .......................		X	0	416,486	39,728
(9) YALE H BOHN ESQ........................................................................ ASST SEC - VP/GENERAL COUNSEL	55.0 .......................		X	0	323,468	48,543

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	0	2,250,101	230,139

(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 0

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

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.......			0
			Business Code
2a
b
c
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			0
3	Investment income (including dividends, interest, and other similar amounts).......			-606,635			-606,635
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties...........			0
		(i) Real	(ii) Personal
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)	0	0
d	Net rental income or (loss).......			0
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory
b	Less: cost or other basis and sales expenses
c	Gain or (loss)
d	Net gain or (loss)..........			0
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ..
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...			0
10a	Gross sales of inventory, less returns and allowances .
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..			0
Miscellaneous Revenue			Business Code
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			0
12	Total revenue. See Instructions......			-606,635		0	-606,635

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.		(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to governments and organizations in the United States. See Part IV, line 21	0
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages	0	0	0	0
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	0
9	Other employee benefits .......	0
10	Payroll taxes ...........	0
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	0
c	Accounting ...........	0
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........	0
12	Advertising and promotion ....	0
13	Office expenses .......	0
14	Information technology ......	0
15	Royalties ..	0
16	Occupancy ...........	0
17	Travel ............	0
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	0
20	Interest ...........	0
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	0
23	Insurance ..............	0
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a
b
c
d
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	0	0	0	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).


			(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing .............		0	1	0
2	Savings and temporary cash investments .........		0	2	0
3	Pledges and grants receivable, net ...........		0	3	0
4	Accounts receivable, net .............		0	4	0
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
			0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
			0	6	0
7	Notes and loans receivable, net .............		0	7	0
8	Inventories for sale or use ..............		0	8	0
9	Prepaid expenses and deferred charges ..........		0	9	0
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a
b	Less: accumulated depreciation .....	10b	0	10c
11	Investments—publicly traded securities ..........		0	11	0
12	Investments—other securities. See Part IV, line 11 .....		0	12	0
13	Investments—program-related. See Part IV, line 11 .....		2,124,583	13	1,517,948
14	Intangible assets ...............		0	14	0
15	Other assets. See Part IV, line 11 ...........		0	15	0
16	Total assets. Add lines 1 through 15 (must equal line 34)......		2,124,583	16	1,517,948
17	Accounts payable and accrued expenses .........		0	17	0
18	Grants payable .................		0	18	0
19	Deferred revenue ................		0	19	0
20	Tax-exempt bond liabilities .............		0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..		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....................		0	25	0
26	Total liabilities. Add lines 17 through 25.........		0	26	0
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............		2,124,583	27	1,517,948
28	Temporarily restricted net assets ...........		0	28	0
29	Permanently restricted net assets ...........		0	29	0
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........			30
31	Paid-in or capital surplus, or land, building or equipment fund .....			31
32	Retained earnings, endowment, accumulated income, or other funds			32
33	Total net assets or fund balances ...........		2,124,583	33	1,517,948
34	Total liabilities and net assets/fund balances ........		2,124,583	34	1,517,948