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

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2011
Open to Public Inspection
A For the calendar year, or tax year beginning 01-01-2011 and ending 12-31-2011
BCheck if applicable:
CName of organization
MONMOUTH MEDICAL CENTER
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
300 SECOND AVENUE
 
Room/suite
City or town, state or country, and ZIP + 4
LONG BRANCH, NJ07740
D Employer identification number

22-3452412
E Telephone number

G Gross receipts $ 333,556,071
F Name and address of principal officer:
BARRY H OSTROWSKY
95 OLD SHORT HILLS ROAD
WEST ORANGE,NJ07052
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.BARNABASHEALTH.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1996
M State of legal domicile: NJ
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: THE ORGANIZATION PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION, OR ABILITY TO PAY.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a)..... 3 35
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 29
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ... 5 2,358
6 Total number of volunteers (estimate if necessary) .... 6 360
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 3,736,567 5,735,051
9 Program service revenue (Part VIII, line 2g) ......... 294,650,419 323,724,088
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 2,385,251 2,506,831
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 1,903,108 1,590,101
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 302,675,345 333,556,071
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 168,999 267,495
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) 116,950,396 122,637,486
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 157,193,705 172,860,929
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 274,313,100 295,765,910
19 Revenue less expenses. Subtract line 18 from line 12....... 28,362,245 37,790,161
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 280,319,355 324,260,831
21 Total liabilities (Part X, line 26)............. 244,011,543 259,559,030
22 Net assets or fund balances. Subtract line 21 from line 20..... 36,307,812 64,701,801
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid preparer use only
Print/type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name Right pointing arrowhead image

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



Phone no.
May the IRS discuss this return with the preparer shown above? See instructions .........bullet
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2011)
Form 990 (2011)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III .........
1
Briefly describe the organization’s mission: THE ORGANIZATION PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION, OR ABILITY TO PAY. PLEASE REFER TO SCHEDULE O FOR ORGANIZATION'S COMMUNITY BENEFIT STATEMENT.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 73,425,272 including grants of $ 0 ) (Revenue $ 66,329,332 )
EXPENSES INCURRED IN PROVIDING MEDICALLY NECESSARY GENERAL MEDICAL SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. DURING 2011 THE ORGANIZATION TREATED 7,327 PATIENTS FOR A TOTAL OF 35,232 PATIENT DAYS. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT.
4b (Code:   ) (Expenses $ 25,867,107 including grants of $ 0 ) (Revenue $ 30,282,372 )
EXPENSES INCURRED IN PROVIDING MEDICALLY NECESSARY OBSTETRIC SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. DURING 2011 THE ORGANIZATION TREATED 4,475 PATIENTS FOR A TOTAL OF 12,608 PATIENT DAYS. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT.
4c (Code:   ) (Expenses $ 23,205,474 including grants of $ 0 ) (Revenue $ 18,280,995 )
EXPENSES INCURRED IN PROVIDING MEDICALLY NECESSARY ORTHOPEDIC SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. DURING 2011 THE ORGANIZATION TREATED 886 PATIENTS FOR A TOTAL OF 2,767 PATIENT DAYS. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT.
4d Other program services (Describe in Schedule O.)
(Expenses $ 143,719,170 including grants of $ 267,495 ) (Revenue $ 208,831,389 )
4e Total program service expensesMediumBullet$ 266,217,023
Form 990 (2011)
Form 990 (2011)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part IIClick to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete Schedule D, Part IClick to see attachment....................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
 
No
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
Yes
 
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statement to this return? Note. All Form 990 filers that operated one or more hospitals must attach audited financial statements. Click to see attachment
20b
Yes
 
Form 990 (2011)
Form 990 (2011)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II......................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2011)
Form 990 (2011)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V .........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
1,260
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
2,358
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
No
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2011)
Form 990 (2011)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI .........
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
If the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
1a
35
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
29
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? .................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ............
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ..........
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes? ....
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Did the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Were officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done ....................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes," to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
NJ
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
THOMAS G SCOTT CPA
2 CRESCENT PLACE
OCEANPORT,NJ07757
(732) 923-8072
Form 990 (2011)
Form 990 (2011)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII .........
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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

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

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

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) ANTHONY P TERRACCIANO
CHAIRMAN - TRUSTEE
 1.0 X   X       0 0 0
(2) RONALD J RICCIO ESQ
VICE CHAIRMAN - TRUSTEE
 1.0 X   X       0 0 0
(3) ANN UNTERBERG
VICE CHAIR - TRUSTEE
 1.0 X   X       0 0 0
(4) JAMES G AARON ESQ
TRUSTEE
 1.0 X           0 0 0
(5) MICHAEL ARVANITIS MD
TRUSTEE
 15.0 X           0 65,046 0
(6) JOHN BROCKRIEDE
TRUSTEE
 1.0 X           0 0 0
(7) PETER L CARTON ESQ
TRUSTEE
 1.0 X           0 0 0
(8) GEORGE CONWAY
TRUSTEE
 1.0 X           0 0 0
(9) STEVEN J CORODEMUS ESQ
TRUSTEE
 1.0 X           0 0 0
(10) ALAN E DAVIS ESQ
TRUSTEE
 1.0 X           0 0 0
(11) GEORGE C DAVIS MD
TRUSTEE - MED STAFF PRESIDENT
 15.0 X   X       0 65,625 0
(12) JUDI W DAWKINS
TRUSTEE
 1.0 X           0 0 0
(13) ANNE EVANS ESTABROOK
TRUSTEE
 1.0 X           0 0 0
(14) VICTOR FERLISE ESQ
TRUSTEE
 1.0 X           0 0 0
(15) MARGARET FISHER MD
TRUSTEE
 50.0 X           0 251,159 26,191
(16) GREGORY M FROMKIN
TRUSTEE
 1.0 X           0 0 0
(17) ROBERT M GERARD
TRUSTEE
 1.0 X           0 0 0
Form 990 (2011)
Form 990 (2011)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) ARTHUR M GREENBAUM ESQ
TRUSTEE
 1.0 X           0 0 0
(19) ROBERT HARRISON
TRUSTEE
 1.0 X           0 0 0
(20) JOHN W HEAVEY
TRUSTEE
 1.0 X           0 0 0
(21) ROBERT P HERRMANN
TRUSTEE
 1.0 X           0 0 0
(22) TODD E KATZ
TRUSTEE
 1.0 X           0 0 0
(23) HEYWOOD W KNOPF
TRUSTEE
 1.0 X           0 0 0
(24) BRUCE KRAMER
TRUSTEE
 1.0 X           0 0 0
(25) CHRISTOPHER LABRECQUE
TRUSTEE
 1.0 X           0 0 0
(26) GEORGE LAUFENBERG
TRUSTEE
 1.0 X           0 0 0
(27) GERALD C MARRONE
TRUSTEE
 1.0 X           0 0 0
(28) DANIEL O MINERVA
TRUSTEE
 1.0 X           0 0 0
(29) MARY ANN NAGY
TRUSTEE
 1.0 X           0 0 0
(30) HARRY J ROCKAFELLER
TRUSTEE
 1.0 X           0 0 0
(31) LOUIS A RODRIGUEZ PE
TRUSTEE
 1.0 X           0 0 0
(32) KAREN M SICILIANO
TRUSTEE
 1.0 X           0 0 0
(33) JOSEPH A TORCIVIA
TRUSTEE
 1.0 X           0 0 0
(34) WEBSTER TRAMMELL JR
TRUSTEE
 1.0 X           0 0 0
(35) JAMES S VACCARO
TRUSTEE
 1.0 X           0 0 0
(36) FRANK J VOZOS MD FACS
EXECUTIVE DIRECTOR
 55.0     X       822,521 0 34,151
(37) GERALD L TOFANI CPA
VICE PRESIDENT, FINANCE/CFO
 55.0     X       469,539 0 110,733
(38) WILLIAM S ARNOLD
VICE PRESIDENT
 50.0     X       365,972 0 15,458
(39) THOMAS HELEOTIS
VICE PRESIDENT
 50.0     X       339,794 0 40,028
(40) DIANN JOHNSTON
VICE PRESIDENT
 50.0     X       248,407 0 10,935
(41) GLENN OPPITO
VICE PRESIDENT
 50.0     X       235,455 0 28,030
(42) PATRICIA A KEATING
VICE PRESIDENT
 50.0     X       146,023 0 17,412
(43) KATHRYN A KELLY
VP ADMINISTRATION
 50.0     X       137,830 0 43,900
(44) TARA KELLY
VP DEVELOPMENT (EFF 6/1/2011)
 50.0     X       118,849 0 5,926
(45) PAUL C GARRIN
VICE PRESIDENT(TERM 1/31/2011)
 50.0     X       36,424 0 14,381
(46) ERIC N BURKETT MD
VPMA
 50.0     X       315,188 54,819 27,663
(47) THOMAS PICCOLI
PHYSICIST
 50.0         X   200,870 0 35,888
(48) JOSEPH JAEGER
ASSOCIATE VP, ACADEMIC AFFAIRS
 50.0         X   193,949 0 35,485
(49) PATRICIA A MCNAMEE
ASSISTANT VICE PRESIDENT
 50.0         X   186,127 0 26,508
(50) JAMES ALEXANDER
ASSISTANT VICE PRESIDENT
 50.0         X   185,519 0 17,731
(51) GREGORY A ALBAN
DIRECTOR
 50.0         X   174,807 0 33,972
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 4,177,274 436,649 524,392
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet94
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
SBC MANAGEMENT CORPORATION
95 OLD SHORT HILLS ROAD
WEST ORANGE,NJ07052 		MANAGEMENT 23,453,082
NEW JERSEY LABORIST GROUP LLC
911 SOUTH MAIN STREET
BELMAR,NJ07719 		MEDICAL 1,277,500
HCSC COOPERATIVE INC
PO BOX 25092
LEHIGH VALLEY,PA18002 		LAUNDRY 1,160,612
HEALTHSOUTH
2 CENTRE PLAZA
TINTON FALLS,NJ07724 		MEDICAL 1,010,475
SAINT PETERS UNIVERSITY HOSPITAL
254 EASTON AVENUE
NEW BRUNSWICK,NJ08901 		MEDICAL 949,040
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet63
Form 990 (2011)
Form 990 (2011)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 469,044
e Government grants (contributions)1e 5,261,457
f All other contributions, gifts, grants, and
similar amounts not included above1f 		4,550
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 5,735,051
Program Service Revenue Business Code
2a NET PATIENT SERVICE REVENUE 541,900 318,309,280 318,309,280    
b OTHER HEALTHCARE RELATED REVENUE 541,900 5,414,808 5,414,808    
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 323,724,088
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 2,506,831     2,506,831
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties............MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents 306,866  
b Less: rental expenses    
c Rental income or (loss) 306,866  
d Net rental income or (loss).......MediumBullet 306,866     306,866
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory    
b Less: cost or other basis and sales expenses    
c Gain or (loss)    
d Net gain or (loss)..........MediumBullet 0      
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a CAFETERIA 722,210 771,548     771,548
b PARKING GARAGE 812,930 401,367     401,367
c TELEVISION 517,000 74,265     74,265
d All other revenue .... 36,055     36,055
e Total. Add lines 11a–11d ......MediumBullet 1,283,235
12 Total revenue. See Instructions....MediumBullet 333,556,071 323,724,088 0 4,096,932
Form 990 (2011)
Form 990 (2011)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Check if Schedule O contains a response to any question in this Part IX. .........
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the United States. See Part IV, line 21 267,495 267,495
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 0  
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 3,584,618 3,226,157 358,461 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 95,750,260 86,175,231 9,575,029  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 5,461,731 4,915,558 546,173  
9 Other employee benefits ....... 9,667,214 8,700,492 966,722  
10 Payroll taxes ........... 8,173,663 7,356,297 817,366  
11 Fees for services (non-employees):        
a Management ...... 18,884,527 16,996,074 1,888,453  
b Legal ......... 732,226 659,003 73,223  
c Accounting ........... 230,717 207,645 23,072  
d Lobbying ........... 24,130 21,717 2,413  
e Professional fundraising. See Part IV, line 17.. 0  
f Investment management fees ...... 0      
g Other .......... 2,649,904 2,384,914 264,990  
12 Advertising and promotion .... 2,681,829 2,413,646 268,183  
13 Office expenses ....... 11,261,489 10,135,340 1,126,149  
14 Information technology ...... 3,842,640 3,458,376 384,264  
15 Royalties .. 0      
16 Occupancy ........... 202,298 182,068 20,230  
17 Travel ............ 222,574 200,317 22,257  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 0      
20 Interest ........... 7,085,994 6,377,395 708,599  
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 12,117,810 10,906,029 1,211,781  
23 Insurance .............. 6,404,809 5,764,328 640,481  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24f. If line 24f amount exceeds 10% of line 25, column (A) amount, list line 24f expenses on Schedule O.)
a MEDICAL SUPPLIES 45,670,116 41,103,104 4,567,012 0
b PHYSICIAN FEES AND SALARIES 21,837,938 19,654,144 2,183,794 0
c PURCHASED SERVICES 10,975,287 9,877,758 1,097,529 0
d PROVISION FOR BAD DEBT 8,532,963 7,679,667 853,296 0
e
f All other expenses 19,503,678 17,554,268 1,949,410  
25 Total functional expenses. Add lines 1 through 24f 295,765,910 266,217,023 29,548,887 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2011)
Form 990 (2011)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 9,100 1 9,300
2 Savings and temporary cash investments ....... 48,818,905 2 0
3 Pledges and grants receivable, net ......... 1,819,790 3 1,549,694
4 Accounts receivable, net ......... 30,059,710 4 34,536,736
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L .......... 0 5 0
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L .......... 0 6 0
7 Notes and loans receivable, net ............. 83,713,150 7 169,765,527
8 Inventories for sale or use .............. 3,319,495 8 3,776,437
9 Prepaid expenses and deferred charges ............ 7,919,152 9 7,221,590
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 262,042,927
b Less: accumulated depreciation. ..... 10b 182,288,055 77,839,128 10c 79,754,872
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 .. 20,641,792 13 21,045,641
14 Intangible assets ......... 0 14 0
15 Other assets. See Part IV, line 11 ........... 6,179,133 15 6,601,034
16 Total assets. Add lines 1 through 15 (must equal line 34)... 280,319,355 16 324,260,831
Liabilities 17 Accounts payable and accrued expenses . 34,140,535 17 31,726,247
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 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 .. 165,180 23 1,722,025
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..... 209,705,828 25 226,110,758
26 Total liabilities. Add lines 17 through 25..... 244,011,543 26 259,559,030
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 36,307,812 27 64,701,801
28 Temporarily restricted net assets ..... 0 28 0
29 Permanently restricted net assets ..... 0 29 0
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 36,307,812 33 64,701,801
34 Total liabilities and net assets/fund balances ..... 280,319,355 34 324,260,831
Form 990 (2011)
Form 990 (2011)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI .........
1
Total revenue (must equal Part VIII, column (A), line 12) ...
1
333,556,071
2
Total expenses (must equal Part IX, column (A), line 25) ....
2
295,765,910
3
Revenue less expenses. Subtract line 2 from line 1 ...
3
37,790,161
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
36,307,812
5
Other changes in net assets or fund balances (explain in Schedule O) ...
5
-9,396,172
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) ....
6
64,701,801
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII .........
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?....
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant? If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O. ...........................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
Yes
 
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
Yes
 
Form 990 (2011)
Additional Data


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

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

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

22-3452412
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2011

Additional Data


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

22-3452412
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




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

Page 2
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
MONMOUTH MEDICAL CENTER
  		Employer identification number

22-3452412
Part I
Contributors (see Instructions). Use duplicate copies of Part I if additional space is needed.
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




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

     
 
   

$  




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

     
 
   

$  




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

     
 
   

$  




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

     
 
   

$  




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

     
 
   

$  




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

Page 3
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
MONMOUTH MEDICAL CENTER
  		Employer identification number

22-3452412
Part II
Noncash Property (see Instructions). Use duplicate copies of Part II if additional space is needed.
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 4
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
MONMOUTH MEDICAL CENTER
  		Employer identification number

22-3452412
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
Use duplicate copies of Part III if additional space is needed
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Additional Data


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

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

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

22-3452412
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

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

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

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

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










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

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

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


Schedule C (Form 990 or 990-EZ) 2011
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each “Yes” response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
Yes
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
Yes
 
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
Yes
 
24,130
i
Other activities? ..........................
 
No
 
j
Total. Add lines 1c through 1i ...............................
24,130
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2 are answered “No” OR (b) Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, Part II-A; line 5; and Part ll-B, line 1.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
LOBBYING ACTIVITIES SCHEDULE C, PART II-B; LINE 1H SAINT BARNABAS CORPORATION, THE PARENT ENTITY OF BARNABAS HEALTH, WHICH INCLUDES MONMOUTH MEDICAL CENTER, ENGAGES IN LOBBYING EFFORTS ON A FEDERAL AND STATE LEVEL ON BEHALF OF ALL AFFILIATES WITHIN THE SYSTEM. IN ADDITION, THE ORGANIZATION IS A MEMBER OF THE NEW JERSEY HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION WHICH BOTH ENGAGE IN LOBBYING EFFORTS ON BEHALF OF THEIR MEMBER HOSPITALS. A PORTION OF THE DUES PAID TO THESE ORGANIZATIONS HAS BEEN ALLOCATED TO LOBBYING ACTIVITES PERFORMED ON BEHALF OF THE ORGANIZATION. THIS ALLOCATION AMOUNTED TO $24,130.
Schedule C (Form 990 or 990EZ) 2011

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
MONMOUTH MEDICAL CENTER
 
Employer identification number

22-3452412
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958), relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance ....        
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 ......        
2
Provide the estimated percentage of the year end balance (line 1g) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   1,156,755 1,156,755
b Buildings ................ 0 147,303,031 96,502,416 50,800,615
c Leasehold improvements ............ 0      
d Equipment ................ 0 108,599,667 83,672,856 24,926,811
e Other ................. 0 4,983,474 2,112,783 2,870,691
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 79,754,872
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1) LIMITED USE 1,175,366 F
(2) CONSTRUCTION FUND; LIMITED USE 0 F
(3) SUBSIDIARIES 4,620,275 F
(4) INVESTMENT IN FOUNDATION 15,250,000 F





Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet 21,045,641
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Book value
Federal Income Taxes 0
DUE TO AFFILIATES; CURRENT 58,289,915
DUE TO AFFILIATES; NON-CURRENT 111,430,436
PENSION EXPENSE PAYABLE 30,801,946
OTHER LIABILITIES 11,627,329
NON-CURRENT 13,526,766
CURRENT 434,366



Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 226,110,758
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1  
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2  
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3  
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV.) ................................. 8  
9 Total adjustments (net). Add lines 4 through 8 ......................... 9  
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10  
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV.) ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total Revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV.) ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV.) ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
TEXT OF FIN 48 AUDITED FINANCIAL STATEMENT FOOTNOTE SCHEDULE D, PART X THE ORGANIZATION IS AN AFFILIATE of BARNABAS HEALTH ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THE SYSTEM ISSUES CONSOLIDATED AUDITED FINANCIAL STATEMENTS WHICH INCLUDE ALL RELATED ENTITIES; INCLUDING THIS ORGANIZATION. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ALSO CONTAINS CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. THE FIN 48 FOOTNOTE BELOW IS FROM THE SYSTEM'S 2007 CONSOLIDATED AUDITED FINANCIAL STATEMENTS. IN JULY 2006, FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) INTERPRETATION NO. 48 (FIN 48), ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, AN INTERPRETATION OF FASB STATEMENT NO. 109, ACCOUNTING FOR INCOME TAXES, WAS ISSUED. FIN 48 CREATES A SINGLE MODEL TO ADDRESS UNCERTAINTY IN TAX POSITIONS AND CLARIFIES THE ACCOUNTING FOR INCOME TAXES BY PRESCRIBING THE MINIMUM RECOGNITION THRESHOLD A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. UNDER THE REQUIREMENTS OF FIN 48, TAX-EXEMPT ORGANIZATIONS COULD BE REQUIRED TO RECORD AN OBLIGATION AS THE RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN ON VARIOUS TAX EXPOSURE ITEMS. PRIOR TO FIN 48, THE DETERMINATION OF WHEN TO RECORD A LIABILITY FOR A TAX EXPOSURE WAS BASED ON WHETHER A LIABILITY WAS CONSIDERED PROBABLE AND REASONABLY ESTIMABLE IN ACCORDANCE WITH FASB STATEMENT NO. 5, ACCOUNTING FOR CONTINGENCIES. ON JANUARY 1, 2007, THE CORPORATION ADOPTED FIN 48. THE IMPACT OF THE ADOPTION OF FIN 48 ON THE CORPORATION'S CONSOLIDATED FINANCIAL STATEMENTS IS NOT SIGNIFICANT.
Schedule D (Form 990) 2011

Additional Data


Software ID:  
Software Version:  




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

22-3452412
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a....
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG to determine eligibility for providing discounted care? If "Yes," indicate which of the
following was the family income limit for eligibility for discounted care: ............
3b
Yes
 
c
If the organization did not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

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

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount?......
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care?...............
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year?...........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ...............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance
and Means-Tested Government Programs		 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) .. 		    21,607,285 10,033,765 11,573,520 4.030 %
b Medicaid (from Worksheet 3, column a) .....     48,593,004 45,462,773 3,130,231 1.090 %
c Costs of other means-tested government programs (from Worksheet 3, column b) .     1,839,490 0 1,839,490 0.640 %
dTotal Financial Assistance and
Means-Tested Government Programs ..... 		    72,039,779 55,496,538 16,543,241 5.760 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		32 69,843 276,765 2,595 274,170 0.100 %
f Health professions education
(from Worksheet 5) .. 		    13,908,054 4,983,590 8,924,464 3.110 %
g Subsidized health services
(from Worksheet 6) .. 		5 3,391 7,230,889 6,555,143 675,746 0.240 %
h Research (from Worksheet 7)     0 0 0 0 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) ....     976,724 0 976,724 0.340 %
jTotal Other Benefits ... 37 73,234 22,392,432 11,541,328 10,851,104 3.790 %
kTotal. Add lines 7d and 7j. .. 37 73,234 94,432,211 67,037,866 27,394,345 9.550 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total            
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense........
2
8,532,963
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy .....
3
429,321
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
65,842,607
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
66,789,505
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
-946,898
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures
(see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership% 		(e) Physicians'
profit % or stock
ownership %
1SHREWSBURY DIAG IMAG
  		OUTPATIENT RADIOLOGY SERVICES 51.000 % 49.000 % 0 %
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest)
How many hospital facilities did the organization operate during the tax year?1
Name and address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 MONMOUTH MEDICAL CENTER
300 SECOND AVENUE
LONG BRANCH,NJ07740 		X X X X     X    
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

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

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

Yes No
10 Used FPG to determine eligibility for providing discounted care?................. 10 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 300.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Explained the basis for calculating amounts charged to patients?................. 11 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12 Yes  
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 14 Yes  
15 Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
16 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 16 Yes  
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
17 Indicate which efforts the hospital facility made before initiating any of the actions checked in line 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy
e Other (describe in Part VI)
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

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

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?3
Name and address Type of Facility (describe)
1 MONMOUTH MEDICAL CENTER
310 ROUTE 34
COLTS NECK,NJ07722 		LAB SERVICES AND MAMMOGRAPHY SCREENING
2 MONMOUTH MEDICAL CENTER
1910 HIGHWAY 35
OAKHURST,NJ07755 		LAB SERVICES AND RADIOLOGY SERVICES
3 MONMOUTH MEDICAL CENTER
59 KENT ROAD
HOWELL,NJ07731 		MAMMOGRAPHY SCREENING
4
5
6
7
8
9
10
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 9, 10, 11h, 13g, 15e, 16e, 17e, 18d, 19d, 20, and 21.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
ELIGIBILITY FOR DISCOUNTED CARE PART I, LINE 3C THE INCOME BASED CRITERIA USED TO DETERMINE ELIGIBILITY IS PER NEW JERSEY ADMINISTRATIVE CODE 10:52 SUB CHAPTERS 11, 12 AND 13, AND BASED UPON THE 2011 POVERTY GUIDELINES (DEPARTMENT OF HEALTH AND SENIOR SERVICES). FPG ARE INCLUDED IN THE CRITERIA FOR DETERMINING ELIGIBILITY FOR CHARITY AND DISCOUNTED CARE.
COMMUNITY BENEFIT REPORT SCHEDULE H, PART I; QUESTION 6A NOT APPLICABLE.
SUBSIDIZED HEALTH SERVICES SCHEDULE H, PART I; QUESTION 7G NO COSTS RELATING TO SUBSIDIZED HEALTHCARE SERVICES ARE ATTRIBUTABLE TO ANY PHYSICIAN CLINICS.
PERCENT OF TOTAL EXPENSE SCHEDULE H, PART I; QUESTION 7 COLUMN (F) THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $8,532,963.
CHARITY CARE AND CERTIAN OTHER COMMUNITY BENEFIT COST SCHEDULE H, PART I, QUESTION 7 WORKSHEET 2 WAS USED FOR THE COST TO CHARGE RATIO.
COMMUNITY BUILDING ACTIVITIES SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES UNDERTAKEN BY THE FACILITY IMPROVE THE MEDICAL AND SOCIOECONOMIC WELL-BEING OF THE COMMUNITIES IN OUR CARE. THIS IS ACCOMPLISHED THROUGH A WIDE ARRAY OF ACTIVITIES AND SERVICES, INCLUDING, BUT NOT LIMITED, TO: - SERVICE ON STATE AND REGIONAL ADVOCACY COMMITTEES AND BOARDS, - VOLUNTEERISM WITH LOCAL COMMUNITY-BASED NON-PROFIT ADVOCACY GROUPS, - PARTICIPATION IN CONFERENCES AND OTHER EDUCATIONAL ACTIVITIES TO PROMOTE UNDERSTANDING OF THE CAUSES AND TREATMENT OF HEALTH CONCERNS, - THE PROVISION OF EDUCATIONAL MATERIALS AND SPONSORING HEALTH EDUCATION SEMINARS AND OUTREACH SESSIONS FOR ITS PATIENTS AND FOR COMMUNITY PROVIDERS [PRESENTATIONS ARE OFTEN PROVIDED BY PHYSICIANS, NURSES AND OTHER HEALTHCARE PROFESSIONALS], - PARTICIPATION IN COMMUNITY HEALTH FAIRS, - SERVING ON THE BOARDS OF MANY LOCAL NOT FOR-PROFIT ORGANIZATIONS AND PROVIDE OTHER FORMS OF SUPPORT (FUNDRAISING, ACTIVITY PARTICIPATION), AND - PROFESSIONAL EDUCATION PLEASE ALSO REFER TO FORM 990, SCHEDULE O, WHICH CONTAINS THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT AND SUMMARY OF ALL ENTITIES WHICH COMPRISE BARNABAS HEALTH.
BAD DEBT EXPENSE AND HFMA STATEMENT #15 SCHEDULE H, PART III, SECTION A; QUESTION 1 HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15 ("STATEMENT 15") PROVIDES GUIDELINES FOR DISTINGUISHING CHARITY CARE FROM BAD DEBT EXPENSE. STATEMENT 15 REQUIRES THAT CHARITY CARE IS NOT RECOGNIZED AS RECEIVABLE OR REVENUE IN THE FINANCIAL STATEMENTS. STATEMENT 15 FURTHER EXPLAINS THAT SELF-PAY PATIENTS THAT DO HAVE A REASONABLE LIKELIHOOD OF PAYMENT SHOULD BE REPORTED AS CHARITY CARE AND NOT BAD DEBT EXPENSE. THE HOSPITAL GENERALLY FOLLOWS THE GUIDELINES OUTLINED IN STATEMENT 15. IN ADDITION, THE HOSPITAL FOLLOWS THE STATE OF NEW JERSEY GUIDELINES IN DETERMINING CHARITY CARE ELIGIBILITY. IN CERTAIN INSTANCES, IT IS UNLIKELY THAT UNINSURED PATIENTS WILL PAY FOR THE SERVICES RENDERED, BUT THEY DO NOT QUALIFY FOR THE STATE'S CHARITY CARE PROGRAM BECAUSE OF LACK OF PATIENT COOPERATION OR OTHER REASONS. THE HOSPITAL PURSUES COLLECTION OF THESE AMOUNTS AND UNPAID BALANCES ARE REPORTED AS BAD DEBT EXPENSE. UNDER STATEMENT 15, THESE AMOUNTS WOULD BE RECORDED AS CHARITY CARE RATHER THAN BAD DEBT EXPENSE AND THIS IS THE RATIONALE FOR OUR RESPONSE: "NO".
BAD DEBT EXPENSE SCHEDULE H, PART III, SECTION A; QUESTION 4 BAD DEBT EXPENSE WAS CALCULATED USING THE PROVIDERS' BAD DEBT EXPENSE FROM FINANCIAL STATEMENT, NET OF ACCOUNTS WRITTEN OFF AT CHARGES. BARNABAS HEALTH AND ITS AFFILIATES, INCLUDING ITS HOSPITALS AND SUBSIDIARIES, PREPARE AND ISSUE AUDITED CONSOLIDATED FINANCIAL STATEMENTS. BH'S ALLOWANCE FOR DOUBTFUL ACCOUNTS (BAD DEBT EXPENSE) METHODOLOGY AND CHARITY CARE POLICIES ARE CONSISTENTLY APPLIED ACROSS ALL HOSPITAL AFFILIATES. THE ATTACHED TEXT WAS OBTAINED FROM THE FOOTNOTES TO THE AUDITED FINANCIAL STATEMENTS OF THE SAINT BARNABAS CORPORATION. PATIENT ACCOUNTS RECEIVABLE THE CORPORATION HAS AGREEMENTS WITH THIRD-PARTY PAYORS THAT PROVIDE FOR PAYMENT AT AMOUNTS DIFFERENT FROM ITS ESTABLISHED RATES. PAYMENT ARRANGEMENTS INCLUDE PROSPECTIVELY DETERMINED RATES PER DISCHARGE, REIMBURSED COSTS, DISCOUNTED CHARGES, AND PER DIEM PAYMENTS. MANAGEMENT REGULARLY REVIEWS ACCOUNTS AND CONTRACTS AND PROVIDES APPROPRIATE CONTRACTUAL ALLOWANCES AND DISCOUNTS THAT ARE NETTED AGAINST PATIENT ACCOUNTS RECEIVABLE IN THE CONSOLIDATED BALANCE SHEETS. PATIENT ACCOUNTS RECEIVABLE ARE FURTHER REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE CORPORATION ANALYZES ITS PAST COLLECTION HISTORY AND IDENTIFIES TRENDS BY EACH OF ITS MAJOR PAYOR SOURCES OF PATIENT SERVICE REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THE MAJOR PAYOR SOURCES OF PATIENT SERVICE REVENUE IN EVALUATING THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE CORPORATION ANALYZES CONTRACTUAL AMOUNTS DUE FROM PATIENTS WHO HAVE THIRD-PARTY COVERAGE AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS. FOR PATIENT ACCOUNTS RECEIVABLE ASSOCIATED WITH SELF-PAY PATIENTS, WHICH INCLUDES THOSE PATIENTS WITHOUT INSURANCE COVERAGE AND PATIENTS WITH DEDUCTIBLES AND COPAYMENT BALANCES FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR A PORTION OF THE BILL, THE CORPORATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS FOR PATIENTS THAT ARE UNABLE OR UNWILLING TO PAY FOR THE PORTION OF THE BILL REPRESENTING THEIR FINANCIAL RESPONSIBILITY. ACCOUNT BALANCES ARE CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AFTER ALL MEANS OF COLLECTION HAS BEEN EXHAUSTED. CHARITY CARE THE CORPORATION PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES (SEE NOTE 3). SINCE THE CORPORATION DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, SUCH AMOUNTS ARE NOT REPORTED AS PATIENT SERVICE REVENUE. CHARITY CARE AND COMMUNITY BENEFIT IN ACCORDANCE WITH ITS MISSION AND PHILOSOPHY, BARNABAS HEALTH'S HOSPITALS COMMIT SUBSTANTIAL RESOURCES TO BOTH THE INDIGENT POPULATION AND THE BROADER COMMUNITY. THE CORPORATION'S CHARITY CARE POLICY IS TO PROVIDE CARE WITHOUT REGARD TO THE PATIENT'S ABILITY TO PAY FOR SERVICES RENDERED. TO THE EXTENT THAT PATIENTS DO NOT HAVE THE ABILITY TO PAY, SERVICES RENDERED TO THOSE PATIENTS ARE REPORTED AS CHARITY CARE. THE CORPORATION'S HOSPITALS AND AFFILIATES ALSO PROVIDE OTHER BENEFITS THROUGH A BROAD RANGE OF COMMUNITY SERVICE PROGRAMS AND CHARITABLE ACTIVITIES. THE AMOUNT OF CHARITY CARE, COMMUNITY SERVICE PROGRAMS, AND CHARITABLE ACTIVITIES, AT COST, PROVIDED TO THE INDIGENT POPULATION AND BROADER COMMUNITY FOR THE YEARS ENDED DECEMBER 31 IS AS FOLLOWS: 2011 2010 -------- ------- (IN THOUSANDS) COST OF CHARITY CARE AND COMMUNITY BENEFIT PROGRAMS: - NET COST OF CHARITY CARE PROVIDED $91,800 $89,396 - UNPAID COST OF PUBLIC PROGRAMS, MEDICAID AND OTHER MEANS TESTED PROGRAMS $51,390 $37,804 OTHER PROGRAMS: - CASH AND IN-KIND DONATIONS $ 2,296 $ 1,860 - EDUCATION AND RESEARCH $40,017 $42,666 - SUBSIDIZED DEPARTMENTS $ 2,710 $ 5,601 - OTHER COMMUNITY BENEFIT $ 1,968 $ 2,092 THE CORPORATION'S HOSPITALS UTILIZE A COST TO CHARGE RATIO METHODOLOGY TO CONVERT CHARITY CARE TO COST. THE COST TO CHARGE RATIO IS CALCULATED UTILIZING THE CORPORATION'S COST ACCOUNTING SYSTEM. THE STATE OF NEW JERSEY'S REGULATIONS PROVIDE FOR THE DISTRIBUTION OF FUNDS FROM A CHARITY CARE FUND, WHICH IS INTENDED TO PARTIALLY OFFSET THE COST OF SERVICES PROVIDED TO THE UNINSURED, AS WELL AS A HOSPITAL RELIEF FUND, WHICH IS INTENDED TO PRIMARILY OFFSET THE COST OF SERVICES PROVIDED FOR CERTAIN DIAGNOSIS, INCLUDING MENTAL HEALTH, SUBSTANCE ABUSE, MATERNITY AND COMPLEX NEONATAL CASES, TUBERCULOSIS, AND AIDS. THESE FUNDS ARE DISTRIBUTED TO THE CORPORATION'S HOSPITALS BASED ON THEIR LEVEL OF CHARITY CARE AND UNITS OF SERVICE IN RELATION TO ALL OTHER NEW JERSEY HOSPITALS. FOR THE YEARS ENDED DECEMBER 31, 2011 AND 2010, BARNABAS HEALTH'S HOSPITALS RECEIVED DISTRIBUTIONS FROM BOTH FUNDS TOTALING $90,476 AND $85,238, RESPECTIVELY. THE RATIONALE FOR INCLUDING A PORTION OF BAD DEBT AMOUNTS AS COMMUNITY BENEFIT IS DISCUSSED IN RESPONSE TO PART III, LINE 8 BELOW.
COMMUNITY BENEFIT SCHEDULE H, PART III, SECTION B; QUESTION 8 MEDICARE COSTS WERE DERIVED FROM THE 2011 MEDICARE COST REPORT. MEDICARE UNDERPAYMENTS AND BAD DEBT ARE COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THE ORGANIZATION FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT ARE COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. AS OUTLINED MORE FULLY BELOW THE ORGANIZATION BELIEVES THAT THESE SERVICES AND RELATED COSTS PROMOTE THE HEALTH OF THE COMMUNITY AS A WHOLE AND ARE RENDERED IN CONJUNCTION WITH THE ORGANIZATION'S CHARITABLE TAX-EXEMPT PURPOSES AND MISSION IN PROVIDING MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUAL'S IN A NON-DISCRIMINATORY MANNER WITHOUT REGARD TO RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY AND CONSISTENT WITH THE COMMUNITY BENEFIT STANDARD PROMULGATED BY THE IRS. THE COMMUNITY BENEFIT STANDARD IS THE CURRENT STANDARD FOR A HOSPITAL FOR RECOGNITION AS A TAX-EXEMPT AND CHARITABLE ORGANIZATION UNDER INTERNAL REVENUE CODE ("IRC") 501(C)(3). THE ORGANIZATION IS RECOGNIZED AS A TAX-EXEMPT ENTITY AND CHARITABLE ORGANIZATION UNDER 501(C)(3) OF THE IRC. ALTHOUGH THERE IS NO DEFINITION IN THE TAX CODE FOR THE TERM "CHARITABLE" A REGULATION PROMULGATED BY THE DEPARTMENT OF THE TREASURY PROVIDES SOME GUIDANCE AND STATES THAT "[T]HE TERM CHARITABLE IS USED IN 501(C)(3) IN ITS GENERALLY ACCEPTED LEGAL SENSE," AND PROVIDES EXAMPLES OF CHARITABLE PURPOSES, INCLUDING THE RELIEF OF THE POOR OR UNPRIVILEGED; THE PROMOTION OF SOCIAL WELFARE; AND THE ADVANCEMENT OF EDUCATION, RELIGION, AND SCIENCE. NOTE IT DOES NOT EXPLICITLY ADDRESS THE ACTIVITIES OF HOSPITALS. IN THE ABSENCE OF EXPLICIT STATUTORY OR REGULATORY REQUIREMENTS APPLYING THE TERM "CHARITABLE" TO HOSPITALS, IT HAS BEEN LEFT TO THE IRS TO DETERMINE THE CRITERIA HOSPITALS MUST MEET TO QUALIFY AS IRC 501(C)(3) CHARITABLE ORGANIZATIONS. THE ORIGINAL STANDARD WAS KNOWN AS THE CHARITY CARE STANDARD. THIS STANDARD WAS REPLACED BY THE IRS WITH THE COMMUNITY BENEFIT STANDARD WHICH IS THE CURRENT STANDARD. CHARITY CARE STANDARD IN 1956, THE IRS ISSUED REVENUE RULING 56-185, WHICH ADDRESSED THE REQUIREMENTS HOSPITALS NEEDED TO MEET IN ORDER TO QUALIFY FOR IRC 501(C)(3) STATUS. ONE OF THESE REQUIREMENTS IS KNOWN AS THE "CHARITY CARE STANDARD." UNDER THE STANDARD, A HOSPITAL HAD TO PROVIDE, TO THE EXTENT OF ITS FINANCIAL ABILITY, FREE OR REDUCED-COST CARE TO PATIENTS UNABLE TO PAY FOR IT. A HOSPITAL THAT EXPECTED FULL PAYMENT DID NOT, ACCORDING TO THE RULING, PROVIDE CHARITY CARE BASED ON THE FACT THAT SOME PATIENTS ULTIMATELY FAILED TO PAY. THE RULING EMPHASIZED THAT A LOW LEVEL OF CHARITY CARE DID NOT NECESSARILY MEAN THAT A HOSPITAL HAD FAILED TO MEET THE REQUIREMENT SINCE THAT LEVEL COULD REFLECT ITS FINANCIAL ABILITY TO PROVIDE SUCH CARE. THE RULING ALSO NOTED THAT PUBLICLY SUPPORTED COMMUNITY HOSPITALS WOULD NORMALLY QUALIFY AS CHARITABLE ORGANIZATIONS BECAUSE THEY SERVE THE ENTIRE COMMUNITY, AND A LOW LEVEL OF CHARITY CARE WOULD NOT AFFECT A HOSPITAL'S EXEMPT STATUS IF IT WAS DUE TO THE SURROUNDING COMMUNITY'S LACK OF CHARITABLE DEMANDS. COMMUNITY BENEFIT STANDARD IN 1969, THE IRS ISSUED REVENUE RULING 69-545, WHICH "REMOVE[D]" FROM REVENUE RULING 56-185 "THE REQUIREMENTS RELATING TO CARING FOR PATIENTS WITHOUT CHARGE OR AT RATES BELOW COST." UNDER THE STANDARD DEVELOPED IN REVENUE RULING 69-545, WHICH IS KNOWN AS THE "COMMUNITY BENEFIT STANDARD," HOSPITALS ARE JUDGED ON WHETHER THEY PROMOTE THE HEALTH OF A BROAD CLASS OF INDIVIDUALS IN THE COMMUNITY. THE RULING INVOLVED A HOSPITAL THAT ONLY ADMITTED INDIVIDUALS WHO COULD PAY FOR THE SERVICES (BY THEMSELVES, PRIVATE INSURANCE, OR PUBLIC PROGRAMS SUCH AS MEDICARE), BUT OPERATED A FULL-TIME EMERGENCY ROOM THAT WAS OPEN TO EVERYONE. THE IRS RULED THAT THE HOSPITAL QUALIFIED AS A CHARITABLE ORGANIZATION BECAUSE IT PROMOTED THE HEALTH OF PEOPLE IN ITS COMMUNITY. THE IRS REASONED THAT BECAUSE THE PROMOTION OF HEALTH WAS A CHARITABLE PURPOSE ACCORDING TO THE GENERAL LAW OF CHARITY, IT FELL WITHIN THE "GENERALLY ACCEPTED LEGAL SENSE" OF THE TERM "CHARITABLE," AS REQUIRED BY TREAS. REG. 1.501(C)(3)-1(D)(2). THE IRS RULING STATED THAT THE PROMOTION OF HEALTH, LIKE THE RELIEF OF POVERTY AND THE ADVANCEMENT OF EDUCATION AND RELIGION, IS ONE OF THE PURPOSES IN THE GENERAL LAW OF CHARITY THAT IS DEEMED BENEFICIAL TO THE COMMUNITY AS A WHOLE EVEN THOUGH THE CLASS OF BENEFICIARIES ELIGIBLE TO RECEIVE A DIRECT BENEFIT FROM ITS ACTIVITIES DOES NOT INCLUDE ALL MEMBERS OF THE COMMUNITY, SUCH AS INDIGENT MEMBERS OF THE COMMUNITY, PROVIDED THAT THE CLASS IS NOT SO SMALL THAT ITS RELIEF IS NOT OF BENEFIT TO THE COMMUNITY. THE IRS CONCLUDED THAT THE HOSPITAL WAS "PROMOTING THE HEALTH OF A CLASS OF PERSONS THAT IS BROAD ENOUGH TO BENEFIT THE COMMUNITY" BECAUSE ITS EMERGENCY ROOM WAS OPEN TO ALL AND IT PROVIDED CARE TO EVERYONE WHO COULD PAY, WHETHER DIRECTLY OR THROUGH THIRD-PARTY REIMBURSEMENT. OTHER CHARACTERISTICS OF THE HOSPITAL THAT THE IRS HIGHLIGHTED INCLUDED THE FOLLOWING: ITS SURPLUS FUNDS WERE USED TO IMPROVE PATIENT CARE, EXPAND HOSPITAL FACILITIES, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH; IT WAS CONTROLLED BY A BOARD OF TRUSTEES THAT CONSISTED OF INDEPENDENT CIVIC LEADERS; AND HOSPITAL MEDICAL STAFF PRIVILEGES WERE AVAILABLE TO ALL QUALIFIED PHYSICIANS. MEDICARE UNDERPAYMENTS AND BAD DEBT ARE COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THE AMERICAN HOSPITAL ASSOCIATION ("AHA") FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT ARE COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THIS ORGANIZATION AGREES WITH THE AHA POSITION. AS OUTLINED IN THE AHA LETTER TO THE IRS DATED AUGUST 21, 2007 WITH RESPECT TO THE FIRST PUBLISHED DRAFT OF THE NEW FORM 990 AND SCHEDULE H, THE AHA FELT THAT THE IRS SHOULD INCORPORATE THE FULL VALUE OF THE COMMUNITY BENEFIT THAT HOSPITALS PROVIDE BY COUNTING MEDICARE UNDERPAYMENTS (SHORTFALL) AS QUANTIFIABLE COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: - PROVIDING CARE FOR THE ELDERLY AND SERVING MEDICARE PATIENTS IS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD. - MEDICARE, LIKE MEDICAID, DOES NOT PAY THE FULL COST OF CARE. RECENTLY, MEDICARE REIMBURSES HOSPITALS ONLY 92 CENTS FOR EVERY DOLLAR THEY SPEND TO TAKE CARE OF MEDICARE PATIENTS. THE MEDICARE PAYMENT ADVISORY COMMISSION ("MEDPAC") IN ITS MARCH 2007 REPORT TO CONGRESS CAUTIONED THAT UNDERPAYMENT WILL GET EVEN WORSE, WITH MARGINS REACHING A 10-YEAR LOW AT NEGATIVE 5.4 PERCENT. - MANY MEDICARE BENEFICIARIES, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR. MORE THAN 46 PERCENT OF MEDICARE SPENDING IS FOR BENEFICIARIES WHOSE INCOME IS BELOW 200 PERCENT OF THE FEDERAL POVERTY LEVEL. MANY OF THOSE MEDICARE BENEFICIARIES ARE ALSO ELIGIBLE FOR MEDICAID -- SO CALLED "DUAL ELIGIBLES." THERE IS EVERY COMPELLING PUBLIC POLICY REASON TO TREAT MEDICARE AND MEDICAID UNDERPAYMENTS SIMILARLY FOR PURPOSES OF A HOSPITAL'S COMMUNITY BENEFIT AND INCLUDE THESE COSTS ON FORM 990, SCHEDULE H, PART I. MEDICARE UNDERPAYMENT MUST BE SHOULDERED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE COMMUNITY'S ELDERLY AND POOR. THESE UNDERPAYMENTS REPRESENT A REAL COST OF SERVING THE COMMUNITY AND SHOULD COUNT AS A QUANTIFIABLE COMMUNITY BENEFIT. BOTH THE AHA AND THIS ORGANIZATION ALSO FEEL THAT PATIENT BAD DEBT IS A COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. LIKE MEDICARE UNDERPAYMENT (SHORTFALLS), THERE ALSO ARE COMPELLING REASONS THAT PATIENT BAD DEBT SHOULD BE COUNTED AS QUANTIFIABLE COMMUNITY BENEFIT AS FOLLOWS: - A SIGNIFICANT MAJORITY OF BAD DEBT IS ATTRIBUTABLE TO LOW-INCOME PATIENTS, WHO, FOR MANY REASONS, DECLINE TO COMPLETE THE FORMS REQUIRED TO ESTABLISH ELIGIBILITY FOR HOSPITALS' CHARITY CARE OR FINANCIAL ASSISTANCE PROGRAMS. A 2006 CONGRESSIONAL BUDGET OFFICE ("CBO") REPORT, NONPROFIT HOSPITALS AND THE PROVISION OF COMMUNITY BENEFITS, CITED TWO STUDIES INDICATING THAT "THE GREAT MAJORITY OF BAD DEBT WAS ATTRIBUTABLE TO PATIENTS WITH INCOMES BELOW 200% OF THE FEDERAL POVERTY LINE." - THE REPORT ALSO NOTED THAT A SUBSTANTIAL PORTION OF BAD DEBT IS PENDING CHARITY CARE. UNLIKE BAD DEBT IN OTHER INDUSTRIES, HOSPITAL BAD DEBT IS COMPLICATED BY THE FACT THAT HOSPITALS FOLLOW THEIR MISSION TO THE COMMUNITY AND TREAT EVERY PATIENT THAT COMES THROUGH THEIR EMERGENCY DEPARTMENT, REGARDLESS OF ABILITY TO PAY. PATIENTS WHO HAVE OUTSTANDING BILLS ARE NOT TURNED AWAY, UNLIKE OTHER INDUSTRIES. BAD DEBT IS FURTHER COMPLICATED BY THE AUDITING INDUSTRY'S STANDARDS ON REPORTING CHARITY CARE. MANY PATIENTS CANNOT OR DO NOT PROVIDE THE NECESSARY, EXTENSIVE DOCUMENTATION REQUIRED TO BE DEEMED CHARITY CARE BY AUDITORS. AS A RESULT, ROUGHLY 40% OF BAD DEBT IS PENDING CHARITY CARE. - THE CBO CONCLUDED THAT ITS FINDINGS "SUPPORT THE VALIDITY OF THE USE OF UNCOMPENSATED CARE [BAD DEBT AND CHARITY CARE] AS A MEASURE OF COMMUNITY BENEFITS" ASSUMING THE FINDINGS ARE GENERALIZABLE NATIONWIDE; THE EXPE
COLLECTION POLICY SCHEDULE H, PART III, SECTION B; QUESTION 9B ACCOUNTS CONSIDERED TO BE CHARITY CARE ARE NOT INCLUDED IN THE BAD DEBT EXPENSE, BUT RATHER, ACCOUNTED FOR AS AN ALLOWANCE. IT IS THE POLICY OF BARNABAS HEALTH ("BH") BUSINESS OFFICE, AND ALL ITS HOSPITAL AFFILIATES, TO TREAT ALL PATIENTS EQUALLY REGARDLESS OF INSURANCE AND THEIR ABILITY TO PAY. FOR ACCOUNTS DETERMINED TO BE "SELF-PAY" AND/OR ACCOUNTS WITH BALANCE AFTER PRIMARY INSURANCE PAYMENTS, THE COLLECTION POLICY REQUIRES: SENDING THREE STATEMENTS, A MINIMUM OF ONE PRE-COLLECTION LETTER/TELEPHONE CONTACT FOR ANY ACCOUNT OVER $5,000.00 OR AT THE DISCRETION OF THE ACCOUNT REPRESENTATIVE AND/OR SUPERVISOR. THE FACILITY ALSO HAS A CHARITY CARE ACCESS POLICY TO ASSURE PATIENTS ARE PROVIDED WITH CHARITY CARE ASSISTANCE DETERMINED BY STATE AND FEDERAL REGULATIONS. IT IS THE POLICY TO INFORM ALL PATIENTS DEEMED SELF-PAY OF THE APPROPRIATE ASSISTANCE PROGRAMS AVAILABLE. PATIENTS APPLYING FOR CHARITY CARE ASSISTANCE WILL BE FINANCIALLY SCREENED BY A RESOURCE ADVISOR TO DETERMINE ELIGIBILITY ACCORDING TO STATE AND FEDERAL GUIDELINES AND WILL BE INFORMED OF DOCUMENTATION NEED TO COMPLETE A CHARITY CARE APPLICATION. PATIENTS NOT ELIGIBLE FOR CHARITY CARE WILL BE FINANCIALLY COUNSELED FOR ALL OTHER OPTIONS. QUALIFIED PATIENTS WILL BE REFERRED TO ALL APPROPRIATE AGENCIES OR PROGRAMS TO MEET OTHER FINANCIAL NEEDS. AT THE TIME OF THE PATIENT VISIT AND PART OF THE REGISTRATION PROCESS AT THE FACILITY, THE FOLLOWING OPTIONS ARE MADE AVAILABLE TO PATIENTS: - FINANCIAL COUNSELING FOR POSSIBLE ELIGIBILITY FOR MEDICAL ASSISTANCE INCLUDING MEDICAID AND SSI; - FINANCIAL COUNSELING FOR POSSIBLE ELIGIBILITY FOR THE NEW JERSEY HOSPITAL CARE PAYMENT ASSISTANCE PROGRAM; AND, - FINANCIAL ARRANGEMENTS INCLUDING: 1. CASH/CREDIT CARD (AMERICAN EXPRESS, DISCOVER, VISA, MASTERCARD), 2. LOW INTEREST LOAN PROGRAM, OR 3. FLEXIBLE PAYMENT PLANS. IN ADDITION TO THE ABOVE OPTIONS, THE FACILITY HAS ESTABLISHED A SELF-PAY ASSISTANCE PROGRAM FOR OUR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR MEDICAID OR THE NEW JERSEY HOSPITAL CARE PAYMENT ASSISTANCE PROGRAM. THE SELF-PAY ASSISTANCE PROGRAM RATES ARE REFLECTIVE OF MEDICARE REIMBURSEMENT, AS REFERRED BY THE STATE OF NEW JERSEY.
FACILITY INFORMATION SCHEDULE H, PART V, SECTION B, QUESTIONS 1J, 3, 4, 5C, 6I & 7 NOT APPLICABLE.
FACILITY INFORMATION SCHEDULE H, PART V, SECTION B,QUESTIONS 9,10,11H,13G,15E,16E,17E,18D,20&21 NOT APPLICABLE.
FACILITY INFORMATION SCHEDULE H, PART V, SECTION B, QUESTION 19D THE FACILITY USES 115% OF THE MEDICARE RATE AS THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE.
NEEDS ASSESSMENT SCHEDULE H, PART VI; QUESTION 2 MMC CONDUCTS A REVIEW OF KEY FACTOR INFORMATION ANNUALLY WHICH INCLUDES: A REVIEW OF HEALTHCARE UTILIZATION OF ITS SERVICE AREA POPULATION BY SERVICES (UROLOGY, CARDIOLOGY, OBSTETRICS, ETC.) FOR DETERMINING INCREASED OR DECREASED HEALTH NEEDS; HEALTHCARE SERVICE ESTIMATES AND FORECASTS (BOTH INPATIENT AND OUTPATIENT); ASSESSMENTS OF LOCAL DEMOGRAPHIC AND SOCIOECONOMIC INFORMATION; AND, A REVIEW OF HEALTH STATUS/NEEDS ASSESSMENTS INCLUDING STUDIES CONDUCTED BY EXTERNAL PARTIES (HEALTH RESEARCH AND EDUCATION TRUST OF NEW JERSEY, KID'S COUNT, ETC.). IN ADDITION, MMC WORKS WITH LOCAL COMMUNITY LEADERS AND PROVIDERS TO PLAN AND DISCUSS HEALTH NEEDS OF THE POPULATION. MMC CONDUCTS AN EXTENSIVE SERVICE AREA POPULATION PHYSICIAN NEED STUDY (BY PRIMARY AND SPECIALTY) EVERY THREE TO FIVE YEARS. SPECIFIC SPECIALTY NEEDS ARE CONDUCTED FOR IDENTIFIED GAPS IN SERVICE. THESE REVIEWS INFORM MEDICAL STAFF DEVELOPMENT AT THE MEDICAL CENTER TO ASSURE RESPONSIVENESS TO IDENTIFIED COMMUNITY NEEDS.
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SCHEDULE H, PART VI; QUESTION 3 CHARITY CARE SIGNAGE IS POSTED IN ALL PATIENT REGISTRATION AREAS IN ENGLISH AND SPANISH. CHARITY CARE NOTICE OF FINANCIAL ASSISTANCE IS PROVIDED TO PATIENTS WITH THEIR GENERAL CONSENT. PATIENTS ARE REFERRED TO A FINANCIAL COUNSELOR IF THEY REQUIRE ASSISTANCE. LETTERS ARE MAILED TO SELF-PAY PATIENTS ADVISING THEM OF FINANCIAL ASSISTANCE PROGRAMS.
COMMUNITY INFORMATION SCHEDULE H, PART VI; QUESTION 4 MMC IS LOCATED IN LONG BRANCH, MONMOUTH COUNTY. LONG BRANCH IS THE COUNTY'S LARGEST CITY. MONMOUTH COUNTY, THE NORTHERNMOST COUNTY ON THE JERSEY SHORE, IS IN CLOSE PROXIMITY TO NEW YORK CITY AND HAS THE FIFTH LARGEST TOTAL POPULATION IN THE STATE. MONMOUTH COUNTY IS HOME TO IMMIGRANT POPULATIONS OF ITALIAN, GERMAN AND POLISH, WITH A LARGE IRISH-AMERICAN POPULATION AND A RAPIDLY GROWING ASIAN PRESENCE. THE LONG BRANCH LOCATION OF MMC HAS BEEN DESIGNATED AS A MUA/MUP (MEDICALLY UNDERSERVED AREA/POPULATION) BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) OF THE DEPARTMENT OF HEALTH AND HUMAN SERVICES. BETWEEN THE RESIDENTS AND THE SUMMERTIME SHORE VISITORS, MMC SERVES A DIVERSE PATIENT POPULATION WITH OVER 23% OF ITS PATIENTS MINORITY/RACE ETHNICITY GROUPS AND ABOUT 30% OF PATIENTS IN UNDERINSURED AND UNINSURED PAYER GROUPS. MEDICARE REPRESENTS THE PAYOR CLASSIFICATION OF AN ADDITIONAL 30% OF PATIENTS SERVED.
PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI; QUESTION 5 COMMUNITY BUILDING ACTIVITIES UNDERTAKEN BY MMC IMPROVE THE MEDICAL AND SOCIOECONOMIC WELL-BEING OF THE COMMUNITIES IN OUR CARE. THIS IS ACCOMPLISHED THROUGH SERVICE ON STATE AND REGIONAL ADVOCACY COMMITTEES AND BOARDS, VOLUNTEERISM WITH LOCAL COMMUNITY-BASED NON-PROFIT ADVOCACY GROUPS, AND PARTICIPATION IN CONFERENCES AND OTHER EDUCATIONAL ACTIVITIES TO PROMOTE UNDERSTANDING OF THE ROOT CAUSES OF HEALTH CONCERNS. MMC PROVIDES EDUCATIONAL MATERIALS, CONDUCTS COMMUNITY HEALTH FAIRS AND HOLDS HEALTH EDUCATION SEMINARS AND OUTREACH SESSIONS FOR ITS PATIENTS AND FOR COMMUNITY PROVIDERS. PRESENTATIONS ARE PROVIDED BY PHYSICIANS, NURSES AND OTHER HEALTHCARE PROFESSIONALS. THE MAJORITY OF THE BOARD OF TRUSTEES MEMBERS ARE INDIVIDUALS WITH LOCAL BUSINESSES OR WHOM RESIDE IN THE COMMUNITY. HOSPITAL STAFF MEMBERS SERVE ON THE BOARDS OF MANY LOCAL NOT FOR-PROFIT ORGANIZATIONS AND PROVIDE OTHER FORMS OF SUPPORT (FUNDRAISING, ACTIVITY PARTICIPATION). ALL QUALIFIED PHYSICIANS ARE EXTENDED PRIVILEGES. UNDER THE DIRECTIVE OF THE SYSTEM'S CORPORATE FINANCE OFFICE, SURPLUS FUNDS ARE UTILIZED FOR CAPITAL PROJECTS TO IMPROVE SERVICES OR PURCHASE EQUIPMENT WHICH IN TURN, BENEFIT THE COMMUNITY. PLEASE ALSO REFER TO FORM 990, SCHEDULE O, WHICH CONTAINS THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT AND SUMMARY OF ALL ENTITIES WHICH COMPRISE BARNABAS HEALTH.
AFFILIATED HEALTHCARE SYSTEM SCHEDULE H, PART VI; QUESTION 6 MMC IS AN AFFILIATE OF BARNABAS HEALTH ("BH"). ALL AFFILIATES ARE COMMITTED TO ENHANCING THE OVERALL HEALTH STATUS OF THE COMMUNITY BY PROVIDING THE HIGHEST QUALITY HEALTHCARE AND RELATED SERVICES. BH STRIVES TO EXCEED THE PATIENTS' EXPECTATIONS BY EMPHASIZING COMMITMENT, COMPETENCE, COLLABORATION, COMMUNICATION, AND COMPASSION. BH SETS OVERALL POLICY REGARDING BILLING AND COLLECTIONS AND THE FACILITY RESPONSES PROVIDED FOR PART I, PART II, AND PART III ARE REFLECTED OF THAT POLICY. MMC'S SOLE CORPORATE MEMBER IS SAINT BARNABAS CORPORATION ("SBC",)A TAX-EXEMPT NEW JERSEY NON-PROFIT PARENT CORPORATION DOING BUSINESS AS BARNABAS HEALTH ("BH"). BH IS A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM CONSISTING OF A GROUP OF AFFILIATED HEALTHCARE ORGANIZATIONS. THE INTEGRATED SYSTEM OF HEALTHCARE PROVIDERS THROUGHOUT THE STATE OF NEW JERSEY PROVIDES SUBSTANTIAL COMMUNITY BENEFIT. THE SOLE MEMBER OR STOCKHOLDER OF EACH ENTITY IS EITHER SBC OR ANOTHER BH AFFILIATE CONTROLLED OR OWNED BY SBC. SAINT BARNABAS CORPORATION IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A SUPPORTING ORGANIZATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). AS THE PARENT ORGANIZATION OF THE LARGEST TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM IN NEW JERSEY, SAINT BARNABAS CORPORATION STRIVES TO CONTINUALLY DEVELOP AND OPERATE A MULTI-HOSPITAL HEALTH SYSTEM WHICH PROVIDES SUBSTANTIAL COMMUNITY BENEFIT THROUGH THE PROVISION OF A COMPREHENSIVE SPECTRUM OF HEALTHCARE AND PREVENTION SERVICES TO THE RESIDENTS OF NEW JERSEY AND SURROUNDING COMMUNITIES. SAINT BARNABAS CORPORATION ENSURES THAT ITS SYSTEM PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGINS OR ABILITY TO PAY. OUTLINED BELOW IS A SUMMARY OF THE ENTITIES WHICH COMPRISE BARNABAS HEALTH. ACTIVE HOSPITALS INCLUDE CLARA MAASS MEDICAL CENTER, COMMUNITY MEDICAL CENTER, KIMBALL MEDICAL CENTER, MONMOUTH MEDICAL CENTER, NEWARK BETH ISRAEL MEDICAL CENTER, SAINT BARNABAS BEHAVIORAL HEALTH CENTER, INC., AND SAINT BARNABAS MEDICAL CENTER. EACH OF THESE HOSPITALS OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545: 1. EACH PROVIDE MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF-PAY, MEDICARE AND MEDICAID PATIENTS; 2. EACH ACUTE CARE HOSPITAL OPERATES AN ACTIVE EMERGENCY ROOM FOR ALL PERSONS, WHICH IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR; 3. EACH MAINTAINS AN OPEN MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; 4. CONTROL OF EACH RESTS WITH ITS BOARD OF TRUSTEES AND THE BOARD OF TRUSTEES OF SAINT BARNABAS CORPORATION (BOTH BOARDS ARE COMPRISED OF INDEPENDENT CIVIC LEADERS AND OTHER PROMINENT MEMBERS OF THE COMMUNITY); AND 5. SURPLUS FUNDS ARE USED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND RENOVATE FACILITIES AND ADVANCE MEDICAL CARE, PROGRAMS AND ACTIVITIES. THE BARNABAS HEALTH ENTITIES ARE AS FOLLOWS: CLARA MAASS MEDICAL CENTER ("CMMC") IS A 469-BED NON-PROFIT ACUTE CARE MEDICAL CENTER LOCATED IN BELLEVILLE, ESSEX COUNTY, NEW JERSEY. CMMC IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, CMMC PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NONDISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. MOREOVER, CMMC OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. COMMUNITY MEDICAL CENTER, INC. ("CMC") IS A 592-BED NON-PROFIT HOSPITAL LOCATED IN TOMS RIVER, OCEAN COUNTY, NEW JERSEY. CMC IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, CMC PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. MOREOVER, CMC OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. KIMBALL MEDICAL CENTER, INC. ("KMC") IS A 330-BED NON-PROFIT MEDICAL CENTER LOCATED IN LAKEWOOD, OCEAN COUNTY, NEW JERSEY. KMC IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, KMC PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. MOREOVER, KMC OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. MONMOUTH MEDICAL CENTER ("MMC") IS A 513-BED NON-PROFIT COMMUNITY TEACHING HOSPITAL LOCATED IN LONG BRANCH, MONMOUTH COUNTY, NEW JERSEY. MMC IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, MMC PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. MOREOVER, MMC OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. NEWARK BETH ISRAEL MEDICAL CENTER ("NBIMC") IS A 665-BED NON-PROFIT, FULLY ACCREDITED REGIONAL CARE TEACHING HOSPITAL LOCATED IN NEWARK, ESSEX COUNTY, NEW JERSEY. NBIMC IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, NBIMC PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NONDISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. MOREOVER, NBIMC OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. SAINT BARNABAS BEHAVIORAL HEALTH CENTER, INC., D/B/A BARNABAS HEALTH BEHAVIORAL HEALTH CENTER, IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3). THE ORGANIZATION PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NONDISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. SAINT BARNABAS BEHAVIORAL HEALTH CENTER (WITH KIMBALL BEHAVIORAL HEALTH SERVICES) CONSTITUTES A FREESTANDING 100-BED ACUTE CARE PSYCHIATRIC FACILITY IN OCEAN COUNTY, NEW JERSEY. THE ORGANIZATION PROVIDES INPATIENT, PARTIAL HOSPITALIZATION, AND INTENSIVE OUTPATIENT PROGRAMS FOR ADULTS DIAGNOSED WITH PSYCHIATRIC AND DUAL DISORDERS. BARNABAS HEALTH BEHAVIORAL HEALTH CENTER IS ACCREDITED BY THE JOINT COMMISSION ON ACCREDITATION FOR HEALTHCARE ORGANIZATIONS. SAINT BARNABAS MEDICAL CENTER ("SBMC") IS NEW JERSEY'S OLDEST NON-PROFIT, NON-SECTARIAN ACUTE CARE HOSPITAL, LOCATED IN LIVINGSTON, ESSEX COUNTY, NEW JERSEY. WITH 645 LICENSED BEDS, SBMC IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, SBMC PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. MOREOVER, SBMC OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. CENTER STATE HEALTH GROUP, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THE ORGANIZATION IS A SUPPORTING ORGANIZATION OF SAINT BARNABAS CORPORATION AND THE BARNABAS HEALTH SYSTEM HOSPITALS AND MEDICAL CENTERS. IT ACTS AS THE CENTRALIZED BUSINESS OFFICE FOR BARNABAS HEALTH AND ASSISTS THEM WITH BILLING AND COLLECTING OF REVENUE FOR MEDICAL SERVICES PROVIDED BY THESE ORGANIZATIONS. CENTER STATE PROPERTIES, INC. IS AN INACTIVE ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(2).
AFFILIATED HEALTHCARE SYSTEM CONTINUED SCHEDULE H, PART VI; QUESTION 6 CENTRAL JERSEY BEHAVIORAL HEALTH ASSOCIATES, INC., IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THE ORGANIZATION PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NONDISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY AND SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF SAINT BARNABAS BEHAVIORAL HEALTH CENTER, INC., A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT ALSO 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. CLARA MAASS FOUNDATION, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(1). THROUGH FUNDRAISING ACTIVITIES, THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF CLARA MAASS MEDICAL CENTER, A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NONDISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. CLARA MAASS HEALTH SYSTEM, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF CLARA MAASS MEDICAL CENTER, A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. CLARA MAASS PROPERTIES, INC. IS AN INACTIVE ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(2). COMMUNITY MEDICAL CENTER FOUNDATION, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(1). THROUGH FUNDRAISING ACTIVITIES THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF COMMUNITY MEDICAL CENTER, A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NONDISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. HARVEY E. NUSSBAUM, MD RESEARCH INSTITUTE OF SAINT BARNABAS IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION. THE ORGANIZATION ACTS AS A MEDICAL RESEARCH ORGANIZATION OPERATED IN CONJUNCTION WITH SAINT BARNABAS MEDICAL CENTER, A HOSPITAL DESCRIBED IN INTERNAL REVENUE CODE 170 (B)(L)(A)(III) AND RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. THE ORGANIZATION CONDUCTS RESEARCH IN FURTHERANCE OF SAINT BARNABAS MEDICAL CENTER'S MEDICAL EDUCATION AND TEACHING PROGRAM AND CHARITABLE PURPOSES, PROGRAMS AND SERVICES. PERIODICALLY, THE ORGANIZATION WILL ASSIST AND/OR SUPPORT FINANCIALLY SAINT BARNABAS MEDICAL CENTER IN MEDICAL RESEARCH AND DEVELOPMENT ACTIVITIES. KIMBALL MEDICAL CENTER FOUNDATION, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(1). THROUGH FUNDRAISING ACTIVITIES, THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF KIMBALL MEDICAL CENTER, A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. MEDICAL CENTER STAFFING SERVICES, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF CENTER STATE HEALTH GROUP, INC., A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX- EXEMPT ORGANIZATION, AND SUPPORTS THE BARNABAS HEALTH SYSTEM BY PROVIDING TEMPORARY STAFFING SERVICES TO VARIOUS AFFILIATES. MEGA CARE, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THE ORGANIZATION IS LOCATED IN UNION, UNION COUNTY, NEW JERSEY. THE ORGANIZATION WAS THE PARENT ORGANIZATION FOR FORMER RELATED NURSING HOME FACILITIES WHICH WERE SOLD. THE NURSING HOMES PROVIDED MEDICALLY NECESSARY NURSING HOME CARE AND HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. THESE ENTITIES WERE (1) GREENBROOK MANOR, IN GREENBROOK, NEW JERSEY, (2) LLANFAIR HOUSE, IN WAYNE, NEW JERSEY, (3) CORNELL HALL, IN UNION, NEW JERSEY, AND (4) ASHBROOK, IN SCOTCH PLAINS, NEW JERSEY. MONMOUTH MEDICAL CENTER FACULTY PRACTICE PLAN, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF MONMOUTH MEDICAL CENTER, A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. THE ORGANIZATION PROVIDES CLINICAL SERVICES, EDUCATION AND TRAINING IN CONJUNCTION WITH MONMOUTH MEDICAL CENTER'S MEDICAL RESIDENCY TEACHING PROGRAM. MONMOUTH MEDICAL CENTER FOUNDATION, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(1). THROUGH FUNDRAISING ACTIVITIES THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF MONMOUTH MEDICAL CENTER, A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY.
AFFILIATED HEALTHCARE SYSTEM CONTINUED SCHEDULE H, PART VI; QUESTION 6 MONMOUTH MEDICAL GROUP, P.C. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). THE ORGANIZATION SUPPORTS MONMOUTH MEDICAL CENTER, A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. BY PRACTICING MEDICINE, ENGAGING IN MEDICAL EDUCATION AND WORKING TO IMPROVE THE WELFARE OF INDIVIDUALS IN NEW JERSEY, THE ORGANIZATION COMPRISES A COMPONENT OF THE CLINICAL SERVICE PHYSICIAN PRACTICE PLANS OF MONMOUTH MEDICAL CENTER AND IS AN INTEGRAL PART OF MONMOUTH MEDICAL CENTER. SAINT BARNABAS DEVELOPMENT FOUNDATION, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). THROUGH FUNDRAISING ACTIVITIES, THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF SAINT BARNABAS MEDICAL CENTER, A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. SAINT BARNABAS HEALTH CARE SYSTEM FOUNDATION, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(1). THROUGH FUNDRAISING ACTIVITIES THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF BARNABAS HEALTH. SAINT BARNABAS HOSPICE AND PALLIATIVE CARE CENTER, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(1). THE ORGANIZATION PROVIDES CARE AND SUPPORT FOR TERMINALLY ILL PATIENTS AND THEIR FAMILIES IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. FOR MORE THAN 25 YEARS THE CARING, COMPASSIONATE PROFESSIONALS OF THE NATIONALLY RENOWNED SAINT BARNABAS HOSPICE AND PALLIATIVE CARE CENTER, INC. HAVE PROVIDED EXCEPTIONAL PHYSICAL, EMOTIONAL AND SPIRITUAL SUPPORT TO PATIENTS AND THEIR FAMILIES DURING LIFE'S FINAL STAGES WHETHER AT HOME, IN THE HOSPITAL, OR IN A LONG-TERM CARE OR ASSISTED LIVING FACILITY. OUR DEDICATED, HIGHLY SKILLED TEAM STRIVES TO IMPROVE QUALITY OF LIFE WHILE PROVIDING COMFORT, PRESERVING DIGNITY, AND HONORING THE UNIQUE WISHES OF EACH PATIENT AND FAMILY. SAINT BARNABAS OUTPATIENT CENTERS, CORP. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). SAINT BARNABAS OUTPATIENT CENTERS IS ONE OF THE NATION'S MOST SOPHISTICATED AMBULATORY HEALTHCARE FACILITIES--PROVIDING THE HIGHEST QUALITY MEDICAL CARE IN AN ENVIRONMENT DESIGNED TO SET A NEW STANDARD FOR PATIENT SATISFACTION. THE ORGANIZATION PROVIDES VARIOUS TYPES OF MEDICALLY NECESSARY OUTPATIENT MEDICAL AND SURGICAL SPECIALTY SERVICES, INCLUDING AMBULATORY SURGERY AND WOMEN'S GYNECOLOGICAL SURGERY, RENAL DIALYSIS SERVICES, IMAGING SERVICES, DIABETES SERVICES AND ENDOCRINOLOGY SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. SAINT BARNABAS PALLIATIVE CARE PHYSICIANS, P.A. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). THE ORGANIZATION WAS FORMED TO SUPPORT SAINT BARNABAS HOSPICE AND PALLIATIVE CARE CENTER, INC. ("HOSPICE"), A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION THAT PROVIDES CARE AND SUPPORT FOR TERMINALLY ILL PATIENTS AND THEIR FAMILIES IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY, BY ENGAGING IN PATIENT CARE EDUCATION, RESEARCH AT HOSPICE, PROVIDING ADMINISTRATIVE SERVICES FOR HOSPICE, PROVIDING CLINICAL SERVICES FOR THE PATIENTS OF HOSPICE AND WORKING TO IMPROVE THE WELFARE OF INDIVIDUALS IN NEW JERSEY THE ORGANIZATION CONSTITUTES A MAJORITY OF THE ADMINISTRATIVE AND CLINICAL SERVICES PHYSICIAN PRACTICE PLANS OF HOSPICE AND IS AN INTEGRAL PART OF HOSPICE'S MEMBERSHIP WITHIN THE BARNABAS HEALTH SYSTEM. SAINT BARNABAS PHYSICIAN ASSOCIATES, P.A. IS A NOT FOR PROFIT ORGANIZATION WHICH HAS FILED AN APPLICATION FOR TAX-EXEMPTION WITH THE INTERNAL REVENUE SERVICE FOR CLASSIFICATION AS A TAX-EXEMPT ENTITY PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). THE ORGANIZATION SUPPORTS SAINT BARNABAS MEDICAL CENTER, A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. BY PRACTICING MEDICINE, ENGAGING IN MEDICAL EDUCATION AND WORKING TO IMPROVE THE WELFARE OF INDIVIDUALS IN NEW JERSEY, THE ORGANIZATION COMPRISES A COMPONENT OF THE CLINICAL SERVICE PHYSICIAN PRACTICE PLANS OF SAINT BARNABAS MEDICAL CENTER AND IS AN INTEGRAL PART OF SAINT BARNABAS MEDICAL CENTER. SAINT BARNABAS REALTY DEVELOPMENT CORPORATION IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THE ORGANIZATION IS A SUPPORTING ORGANIZATION OF SAINT BARNABAS MEDICAL CENTER, A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY, AND IS PRIMARILY RESPONSIBLE FOR THE MANAGEMENT AND OPERATION OF RENTAL SPACE FOR VARIOUS AFFILIATES OF THE BARNABAS HEALTH SYSTEM. SANDY HOOK FRIENDS OF SAINT BARNABAS BURN FOUNDATION IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF THE SAINT BARNABAS BURN UNIT AT SAINT BARNABAS MEDICAL CENTER; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. SBHCS RESEARCH INSTITUTE, INC. IS AN INACTIVE ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C )(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THE NEWARK BETH ISRAEL MEDICAL CENTER FOUNDATION, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(1). THROUGH FUNDRAISING ACTIVITIES THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF NEWARK BETH ISRAEL MEDICAL CENTER, A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. THE SYSTEM ALSO CONSISTS OF VARIOUS ENTITIES THAT ARE RECOGNIZED AS INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATIONS BUT ARE CURRENTLY INACTIVE. THESE ENTITIES INCLUDE THE FOLLOWING: - COUNTRY MANOR AT DOVER - EMTAC, INC. - IRVINGTON GENERAL HOSPITAL, INC. - IRVINGTON HOSPITAL FOUNDATION, INC. - KENSINGTON MANOR CARE CENTER - MMC AMBULATORY SURGERY CENTER, INC. - NBI HEALTH PARTNERS, P.A. - SAINT BARNABAS ASSISTED LIVING AT LAKEWOOD - UNION HOSPITAL
AFFILIATED HEALTHCARE SYSTEM CONTINUED SCHEDULE H, PART VI; QUESTION 6 FOR PROFIT BARNABAS HEALTH ENTITIES INCLUDE THE FOLLOWING: ACC PHARMACY, INC. IS A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS LIVINGSTON SERVICES CORPORATION ("LSC"). THIS ENTITY OPERATES A PHARMACY AT THE SAINT BARNABAS AMBULATORY CARE CENTER, IN LIVINGSTON, ESSEX COUNTY, NEW JERSEY AND VARIOUS OTHER LOCATIONS. THIS ENTITY WAS SOLD AT THE END OF 2011. CENTER STATE COLLECTION SERVICES, INC. IS A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS CENTER STATE HEALTH SERVICES CORPOARTION. THE ENTITY PROVIDES COLLECTION SERVICES FOR BOTH BARNABAS HEALTH ENTITIES AND NON-BARNABAS HEALTH ENTITIES. CENTER STATE HEALTH SERVICES CORPORATION A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS LSC HOLDING COMPANY, INC. THE ORGANIZATION IS LOCATED IN TOMS RIVER, OCEAN COUNTY, NEW JERSEY. THE ORGANIZATION DERIVES RENTAL INCOME AND RECEIVES FORMS K-1 INCOME FROM MEDICAL SERVICES RELATED INVESTMENT PARTNERSHIPS. CENTER STATE MANAGEMENT CORPORATION IS A FOR-PROFIT ENTITY, WHOSE SOLE SHAREHOLDER IS CSHS THE ORGANIZATION IS LOCATED IN TOMS RIVER, OCEAN COUNTY, NEW JERSEY. THIS ENTITY PROVIDES ADVERTISING SERVICES FOR BOTH BH ENTITIES AND NON-SBHCS ENTITIES AND PROVIDES MANAGEMENT SERVICES TO PHYSICIAN GROUPS. COMMERCIAL PROFESSIONAL INSURANCE COMPANY, LTD, A CONTROLLED FOREIGN CORPORATION OF SAINT BARNABAS MEDICAL CENTER. THE ORGANIZATION WAS FORMED AND OPERATES SOLELY IN BERMUDA. COMMUNITY KARE, INC. IS A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS CENTER STATE HEALTH SERVICES CORP. THE ORGANIZATION IS LOCATED IN LAKEWOOD, OCEAN COUNTY, NEW JERSEY. THE ORGANIZATION IS A HOME HEALTH AGENCY THAT PROVIDES NURSES AND NURSES AIDES TO THE HOMES OF INDIVIDUALS THAT REQUIRE ASSISTANCE. HEALTH CARE FACILITIES MANAGEMENT, INC. IS A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS SBC MANAGEMENT CORPORATION (THE SOLE STOCKHOLDER OF WHICH IS SBC). THE ORGANIZATION IS LOCATED IN SOUTH PLAINFIELD, MIDDLESEX COUNTY, NEW JERSEY THE ORGANIZATION PROVIDES ENGINEERING, PLANT OPERATIONS AND MATERIALS MANAGEMENT SERVICES PRIMARILY TO BH ENTITIES. INNOVATIVE PURCHASING CONCEPTS, L.L.C. IS A LIMITED LIABILITY COMPANY TAXED AS A PARTNERSHIP OWNED BY THE BARNABAS HEALTH SYSTEM HOSPITALS THIS ORGANIZATION ENGAGES IN GROUP PURCHASING ACTIVITY. KIMBALL HEALTH CARE AFFILIATES, INC. IS A FOR PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS CENTER STATE HEALTH SERVICES CORP. THIS ENTITY IS A PARTNER IN KIM-MED ASSOCIATES AND RECEIVES A FORM K-1 ANNUALLY FROM THE PARTNERSHIP. KIM-MED ASSOCIATES IS A PARTNERSHIP WHICH OWNS A MEDICAL OFFICE BUILDING IN LAKEWOOD, OCEAN COUNTY, NEW JERSEY. KMC AND KIMBALL HEALTH CARE AFFILIATES, INC. ARE THE PARTNERS IN THIS PARTNERSHIP. LIVINGSTON INFUSION CARE, INC. IS A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS LSC THE ORGANIZATION IS LOCATED IN SOUTH PLAINFIELD, MIDDLESEX COUNTY, NEW JERSEY. THE ORGANIZATION PROVIDES HOME INFUSION AND DIALYSIS SERVICES TO INDIVIDUALS. LIVINGSTON SERVICES CORPORATION IS A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS LSC HOLDING COMPANY, INC. THE ORGANIZATION IS LOCATED IN SOUTH PLAINFIELD, MIDDLESEX COUNTY, NEW JERSEY. THE ORGANIZATION PROVIDES TECHNOLOGY SERVICES TO BH ENTITIES AND UNRELATED ENTITIES. IT OPERATES A "LIFELINE BEEPER" PROGRAM FOR ELDERLY INDIVIDUALS, OPERATES A PHYSICAL THERAPY PROGRAM AND CONDUCTS MEDICALLY RELATED LECTURES. LSC HOLDING COMPANY, INC. IS A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS LSC. THIS ENTITY IS THE SOLE OWNER OF ALL THE OUTSTANDING COMMON STOCK OF LIVINGSTON SERVICES CORPORATION, CENTER STATE HEALTH SERVICES, CORP. AND SBC MANAGEMENT CORPORATION. LSC PHARMACY SERVICES, INC. IS A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS SBC. THE ORGANIZATION IS LOCATED IN WEST ORANGE, ESSEX COUNTY, NEW JERSEY. THE ORGANIZATION OPERATES A PHARMACY FOR BH ENTITIES. MAJOR SECURITY SERVICES, INC. IS A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS LSC. THE ORGANIZATION IS LOCATED IN SOUTH PLAINFIELD, MIDDLESEX COUNTY, NEW JERSEY. THE ORGANIZATION PROVIDES SECURITY SERVICES PRIMARILY TO BH ENTITIES AND OTHERS. THE ORGANIZATION CONDUCTS BACKGROUND CHECKS AND OTHER INVESTIGATORY SERVICES. MEDICAL CENTER HEALTH CARE SERVICES, INC. IS A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS LSC. THE ORGANIZATION IS LOCATED IN SOUTH PLAINFIELD, MIDDLESEX COUNTY, NEW JERSEY. THE ORGANIZATION OPERATES AN AGENCY FOR TEMPORARY STAFFING SERVICES, SUCH AS NURSES AND ADMINISTRATION PRIMARILY TO BH ENTITIES AND OTHERS. NEW JERSEY HEALTH CARE SYSTEM, INC. IS AN INACTIVE FOR-PROFIT CORPORATION. PREMIUM HEALTH SYSTEMS, INC. IS A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS SBC. THE ORGANIZATION IS LOCATED IN BELLEVILLE, ESSEX COUNTY, NEW JERSEY. THIS ENTITY DERIVES INCOME FROM THE OPERATION OF A MRI MACHINE AND THE RECEIPT OF RENTAL INCOME. PROFESSIONAL QUALITY LIABILITY INSURANCE COMPANY, A RISK RETENTION GROUP, IS A VERMONT BASED INSURANCE COMPANY. SBC MANAGEMENT CORPORATION IS A FOR-PROFIT ENTITY, WHOSE SOLE SHAREHOLDER IS LSC HOLDING COMPANY, INC. THE ORGANIZATION IS LOCATED IN WEST ORANGE, ESSEX COUNTY, NEW JERSEY. THIS ENTITY PROVIDES MANAGERIAL ADMINISTRATION AND SUPPORT TO BH.
STATE FILING OF COMMUNITY BENEFIT REPORT SCHEDULE H, PART III, SECTION B; QUESTION 7 NOT APPLICABLE. THE ENTITY AND RELATED PROVIDER ORGANIZATIONS ARE LOCATED IN NEW JERSEY. NO COMMUNITY BENEFIT REPORT IS FILED WITH THE STATE OF NEW JERSEY.
Schedule H (Form 990) 2011
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
MONMOUTH MEDICAL CENTER
 
Employer identification number
22-3452412
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) AMERICAN CANCER SOCIETY1035 HOOPER AVE
TOMS RIVER,NJ08753 		16-0743902 501(C)(3) 6,925       SPONSORSHIP
(2) AMERICAN RED CROSS1540 WEST PARK AVE
TINTON FALLS,NJ07724 		21-0634958 501(C)(3) 7,500       SPONSORSHIP
(3) DEAL GOLF & COUNTRY CLUB1 GOLF LANE
DEAL,NJ07723 		21-0436970 501(C)(3) 25,299       SPONSORSHIP
(4) GREATER LONG BRANCH CHANBER OF COMMERCEPO BOX 628
LONG BRANCH,NJ07740 		21-0502065 501(C)(3) 9,200       SPONSORSHIP
(5) JEWISH FEDERATION OF GREATER MONMOUTH CTY100 US HWY 9 STE 7
MANALAPAN,NJ07726 		22-2041946 501(C)(3) 11,000       SPONSORSHIP
(6) MONMOUTH MEDICAL CENTER FOUNDATION300 SECOND AVENUE
LONG BRANCH,NJ07740 		21-0634584 501(C)(3) 5,775       SPONSORSHIP
(7) MONMOUTH UNIVERSITY400 CEDAR AVENUE
WEST LONG BRACH,NJ07764 		21-0634584 501(C)(3) 11,200       LEASE AGREEMENT
(8) RONALD MCDONALD HOUSE OF LONG BRANCH NJ131 BATH AVENUE
LONG BRANCH,NJ07740 		22-2715544 501(C)(3) 16,250       SPONSORSHIP
(9) INSTITUTE FOR NURING INC1479 PENNINGTON ROAD
TRENTON,NJ08618 		22-2259791 501(C)(3) 7,500       SPONSORSHIP
(10) THE JERSEY SHORE PARTNERSHIP FOUNDATION331 NEWMAN SPRINGS RD
RED BANK,NJ07701 		16-1759519 501(C)(3) 11,500       SPONSORSHIP
(11) SUSAN G KOMEN BREAST CANCER FOUNDATION785 SPRINGFIELD AVENUE
SUMMIT,NJ07901 		22-3528454 501(C)(3) 15,000       SPONSORSHIP


2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
11
3
Enter total number of other organizations listed in the line 1 table ......................... . Bullet Image
 
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2011

Schedule I (Form 990) 2011
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance













Part IV
Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.
Identifier Return Reference Explanation
GRANT FUND MONITORING SCHEDULE D, PART I; QUESTION 2 GRANTS ARE MONITORED BY THE ORGANIZATION'S FINANCE PERSONNEL THROUGH THE UTILIZATION OF COST CENTERS AND OTHER INFORMATION; INCLUDING WRITTEN DOCUMENTATION AND RECEIPTS.
Schedule I (Form 990) 2011


Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
MONMOUTH MEDICAL CENTER
 
Employer identification number

22-3452412
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
 
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2011

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

Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and column (E) for that individual.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) MARGARET FISHER MD (i)
(ii)		 0
247,595 		0
0 		0
3,564 		0
19,004 		0
7,187 		0
277,350 		0
0
(2) FRANK J VOZOS MD FACS (i)
(ii)		 430,320
0 		110,000
0 		282,201
0 		20,417
0 		13,734
0 		856,672
0 		144
0
(3) GERALD L TOFANI CPA (i)
(ii)		 302,462
0 		35,525
0 		131,552
0 		89,845
0 		20,888
0 		580,272
0 		0
0
(4) WILLIAM S ARNOLD (i)
(ii)		 271,922
0 		28,539
0 		65,511
0 		14,369
0 		1,089
0 		381,430
0 		0
0
(5) THOMAS HELEOTIS (i)
(ii)		 307,970
0 		27,864
0 		3,960
0 		14,875
0 		25,153
0 		379,822
0 		0
0
(6) DIANN JOHNSTON (i)
(ii)		 226,462
0 		20,565
0 		1,380
0 		9,520
0 		1,415
0 		259,342
0 		0
0
(7) GLENN OPPITO (i)
(ii)		 186,855
0 		19,477
0 		29,123
0 		9,294
0 		18,736
0 		263,485
0 		 
0
(8) PATRICIA A KEATING (i)
(ii)		 127,724
0 		12,432
0 		5,867
0 		9,973
0 		7,439
0 		163,435
0 		0
0
(9) KATHRYN A KELLY (i)
(ii)		 128,975
0 		8,221
0 		634
0 		31,186
0 		12,714
0 		181,730
0 		0
0
(10) ERIC N BURKETT MD (i)
(ii)		 280,018
0 		25,524
0 		9,646
54,819 		15,054
0 		12,609
0 		342,851
54,819 		0
0
(11) THOMAS PICCOLI (i)
(ii)		 172,000
0 		11,628
0 		17,242
0 		14,817
0 		21,071
0 		236,758
0 		0
0
(12) JOSEPH JAEGER (i)
(ii)		 181,727
0 		11,322
0 		900
0 		10,510
0 		24,975
0 		229,434
0 		0
0
(13) PATRICIA A MCNAMEE (i)
(ii)		 176,357
0 		9,104
0 		666
0 		8,449
0 		18,059
0 		212,635
0 		0
0
(14) JAMES ALEXANDER (i)
(ii)		 174,568
0 		10,710
0 		241
0 		11,850
0 		5,881
0 		203,250
0 		0
0
(15) GREGORY A ALBAN (i)
(ii)		 164,356
0 		10,125
0 		326
0 		14,451
0 		19,521
0 		208,779
0 		0
0

Schedule J (Form 990) 2011

Schedule J (Form 990) 2011
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
COMPENSATION INFORMATION SCHEDULE J, PART I; QUESTION 4B THE AMOUNT REFLECTED IN COLUMN B(III) FOR THE FOLLOWING INDIVIDUAL INCLUDES PARTICIPATION IN A BARNABAS HEALTH INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN). THE AMOUNT OUTLINED HEREIN WAS INCLUDED IN THE INDIVIDUAL'S 2011 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: FRANK J. VOZOS, M.D., FACS, $144, AS THE AMOUNT WAS NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THE FOLLOWING INDIVIDUAL INCLUDES UNVESTED BENEFITS IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) WHICH IS SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THE INDIVIDUAL MAY NEVER ACTUALLY RECEIVE THIS UNVESTED BENEFIT AMOUNT. THE AMOUNT OUTLINED HEREIN WAS NOT INCLUDED IN THE INDIVIDUAL'S 2011 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: GERALD L. TOFANI, CPA, $71,955.
COMPENSATION INFORMATION CORE FORM, PART VII AND SCHEDULE J, PART I; QUESTION 7 CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A BONUS DURING CALENDAR YEAR 2011 WHICH AMOUNTS WERE INCLUDED IN COLUMN B(II) HEREIN AND IN EACH INDIVIDUAL'S 2011 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT.
COMPENSATION INFORMATION SCHEDULE J, PART II, COLUMN F THE AMOUNT REPORTED IN SCHEDULE J, PART II, COLUMN F FOR THE FOLLOWING INDIVIDUAL INCLUDES VESTED BENEFITS IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) BECAUSE THE AMOUNT WAS NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THIS AMOUNT WAS TREATED AS TAXABLE INCOME AND REPORTED ON THE INDIVIDUAL'S 2011 FORM W-2, BOX 5 AS TAXABLE MEDICARE WAGES: FRANK J. VOZOS, M.D., FACS, $144.
Schedule J (Form 990) 2011

Additional Data


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

22-3452412
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





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

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2011
Schedule L (Form 990 or 990-EZ) 2011
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) FROMKIN BROTHERS INC COMPANY - TRUSTEE 297,317 CONTRACTING SERVICES   No
(2) Siciliano Landscaping Company COMPANY - TRUSTEE 132,525 LANDSCAPING SERVICES   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS SCHEDULE L, PART IV Gregory M. Fromkin is a Trustee for the organization. Monmouth Medical Center and its affiliates utilized the services of his company, Fromkin Brothers, Inc., during 2011. Total fees paid BY THIS ORGANIZATION AND ITS AFFILIATES to Fromkin Brothers, Inc. were $308,125. Services were rendered at fair market value rates pursuant to arm's length negotiations. Karen M. SiCIliano is a Trustee for the organization. Monmouth Medical Center and its affiliates utilized the services of her company, Siciliano Landscaping Company, during 2011. Total fees paid BY THIS ORGANIZATION AND ITS AFFILIATES to Siciliano Landscaping Company were $132,525. Services were rendered at fair market value rates pursuant to arm's length negotiations.
Schedule L (Form 990 or 990-EZ) 2011

Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990 or 990-EZ)

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

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
MONMOUTH MEDICAL CENTER
 
Employer identification number

22-3452412
Identifier Return Reference Explanation
COMMUNITY BENEFIT STATEMENT CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS BACKGROUND ========== MONMOUTH MEDICAL CENTER ("MMC") IS A GENERAL MEDICAL AND SURGICAL HOSPITAL. MMC IS RECOGNIZED BY THE IRS AS AN INTERNAL REVENUE CODE SECTION 501(C) (3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, MMC PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. MOREOVER, MMC OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545: 1. MMC PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUAL'S REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF-PAY, MEDICARE AND MEDICAID PATIENTS; 2. MMC OPERATES AN ACTIVE EMERGENCY ROOM FOR ALL PERSONS WHICH IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR; 3. MMC MAINTAINS AN OPEN MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; 4. CONTROL OF MMC RESTS WITH ITS BOARD OF TRUSTEES AND THE BOARD OF TRUSTEES OF SAINT BARNABAS CORPORATION. BOTH BOARDS ARE COMPRISED OF INDEPENDENT CIVIC LEADERS AND OTHER PROMINENT MEMBERS OF THE COMMUNITY; AND 5. SURPLUS FUNDS ARE USED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND RENOVATE FACILITIES AND ADVANCE MEDICAL CARE, PROGRAMS AND ACTIVITIES. THE OPERATIONS OF MMC, AS SHOWN THROUGH THE FACTORS OUTLINED ABOVE AND OTHER INFORMATION CONTAINED HEREIN, CLEARLY DEMONSTRATE THE HOSPITAL PROVIDES SUBSTANTIAL COMMUNITY BENEFIT AND THAT THE USE AND CONTROL OF MMC 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. MMC'S SOLE CORPORATE MEMBER IS SAINT BARNABAS CORPORATION ("SBC"), A TAX-EXEMPT NEW JERSEY NON-PROFIT PARENT CORPORATION DOING BUSINESS AS BARNABAS HEALTH ("BH"). BARNABAS HEALTH IS A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM CONSISTING OF A GROUP OF AFFILIATED HEALTHCARE ORGANIZATIONS. THE INTEGRATED NETWORK OF HEALTHCARE PROVIDERS THROUGHOUT THE STATE OF NEW JERSEY PROVIDES SUBSTANTIAL COMMUNITY BENEFIT. THE SOLE MEMBER OR STOCKHOLDER OF EACH ENTITY IS EITHER SBC OR ANOTHER BH AFFILIATE CONTROLLED OR OWNED BY SBC. BH IS THE LARGEST MULTI-HOSPITAL SYSTEM IN NEW JERSEY PROVIDING SUBSTANTIAL COMMUNITY BENEFIT. BH CONSISTS OF FREE-STANDING ACUTE CARE HOSPITALS, A FREE-STANDING PSYCHIATRIC HOSPITAL, MEDICARE-CERTIFIED HOME HEALTHCARE AND HOSPICE PROGRAMS, MULTI-SPECIALTY AMBULATORY CARE FACILITIES, OUTPATIENT BEHAVIORAL HEALTH CENTERS, AND OTHER ENTITIES. BH PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY. MOREOVER, BH PROVIDES HEALTHCARE SERVICES TO PATIENTS WHO MEET CERTAIN CRITERIA DEFINED BY THE NEW JERSEY DEPARTMENT OF HEALTH AND SENIOR SERVICES WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. SBC MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE AMOUNT OF CHARITY CARE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FOREGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY. PATIENT STATISTICAL INFORMATION ================================ FOR MORE THAN 100 YEARS, MMC HAS BEEN THE LEADER IN CENTRAL NEW JERSEY IN PROVIDING THE BEST IN HEALTHCARE AND THE LATEST IN MEDICAL TECHNOLOGY TO THE NEARLY 1 MILLION RESIDENTS THAT COMPRISE ITS PRIMARY SERVICE AREA OF MONMOUTH COUNTY, AND PORTIONS OF OCEAN AND MIDDLESEX COUNTIES. MMC IS ONE OF NEW JERSEY'S LARGEST COMMUNITY TEACHING HOSPITALS, WHERE PHYSICIANS WORK AS A TEAM DEDICATED TO ACADEMIC EXCELLENCE, CLINICAL COMPETENCE, AND COMPREHENSIVE AND COMPASSIONATE PATIENT CARE. MMC IS A 513-BED NON-PROFIT, REGIONAL TERTIARY CARE TEACHING HOSPITAL LOCATED IN LONG BRANCH, MONMOUTH COUNTY, NEW JERSEY. THE INSTITUTION PROVIDES A FULL SPECTRUM OF SERVICES, RANGING FROM HIGH-RISK NEONATOLOGY TO GERIATRIC CARE. ADMISSIONS TOTAL OVER 22,000 ANNUALLY, WITH OVER 4,000 BIRTHS, AND APPROXIMATELY 50,000 EMERGENCY VISITS A YEAR. MMC SERVES A DIVERSE COMMUNITY WITH OVER 25% OF ITS PATIENTS COMPRISED OF MINORITY GROUPS AND 31% OF PATIENTS IN UNDERINSURED AND UNINSURED PAYER GROUPS. IT HAS A JCAHO CERTIFIED CHEST PAIN CENTER AND IS STATE DESIGNATED AS A PRIMARY STROKE CENTER. ANNUAL OUTPATIENT VISITS ARE MORE THAN 187,000. MISSION STATEMENT ================== MONMOUTH MEDICAL CENTER'S VISION, AS A PART OF BARNABAS HEALTH, IS A LEADER IN DESIGNING UNPARALLELED NEW WAYS FOR DELIVERING HEALTHCARE. THE MEDICAL CENTER PROVIDES QUALITY-DRIVEN, SAFE, EFFICIENT, COST-EFFECTIVE AND RESPONSIVE HEALTHCARE SERVICES THAT MEET THE NEEDS AND EXCEED THE EXPECTATIONS OF OUR COMMUNITY. OUR MISSION: - TO MEET THE HEALTHCARE NEEDS OF OUR COMMUNITY BY PROVIDING COST-EFFECTIVE QUALITY CARE. - TO EDUCATE PRESENT AND FUTURE GENERATIONS OF HEALTHCARE PROVIDERS. - TO PROVIDE A CONTINUUM OF REGIONAL TERTIARY CARE. ACCOMPLISHMENTS/MILESTONES/RECOGNITIONS/AWARDS =============================================== - RATED IN THE TOP FIVE PERCENT OF THE NATION FOR BOTH EMERGENCY MEDICINE AND MATERNITY CARE BY HEALTHGRADES FOR THREE YEARS IN A ROW - 2010 THROUGH 2012. - IN 2011, THE JACQUELINE M. WILENTZ COMPREHENSIVE BREAST CENTER AT MONMOUTH MEDICAL CENTER ACHIEVED STATUS AS A CERTIFIED QUALITY BREAST CENTER OF EXCELLENCE - THE HIGHEST CERTIFICATION LEVEL OFFERED BY THE NATIONAL QUALITY MEASURES FOR BREAST CENTERS (NQMBC). - THE WILENTZ CENTER IS THE FIRST IN THE REGION AND THE 18TH IN THE NATION TO BE DESIGNATED AS A CERTIFIED QUALITY BREAST CENTER OF EXCELLENCE, THE HIGHEST RECOGNITION ATTAINABLE FROM THE NATIONAL QUALITY MEASURES FOR BREAST CENTERS. - MONMOUTH WAS THE FIRST HOSPITAL IN NEW JERSEY TO IMPLEMENT BREAST SPECIFIC GAMMA IMAGING (BSGI) - THE NEWEST TECHNIQUE TO IDENTIFY CANCEROUS LESIONS IN THE BREAST - AND AUTOMATED WHOLE BREAST ULTRASOUND - TECHNOLOGY THAT COMBINES THE KNOWN BENEFIT OF ULTRASOUND FOR BREAST CANCER DIAGNOSIS WITH AN AUTOMATED IMAGING SYSTEM. - MONMOUTH HOLDS THE GOLD SEAL OF ACCREDITATION FROM THE AMERICAN COLLEGE OF RADIOLOGY FOR ITS ADVANCED IMAGING SYSTEMS, AND WAS THE FIRST IN NEW JERSEY AND THE 20TH IN THE NATION TO ACHIEVE THIS STATUS FOR MAGNETIC RESONANCE IMAGING (MRI) FOR THE BREAST. - TOMOTHERAPY INC. NAMED MONMOUTH THEIR OFFICIAL GLOBAL TRAINING SITE TO PROVIDE TRAINING TO VISITORS FROM AROUND THE WORLD. - MONMOUTH WAS THE FIRST HOSPITAL IN THE REGION TO OPEN A GAMMA KNIFE CENTER, OFFERING PATIENTS WITH BRAIN DISORDERS A PROVEN ALTERNATIVE TO INVASIVE SURGERY. - MONMOUTH MEDICAL CENTER WAS CHOSEN BY THE INSTITUTE FOR HEALTHCARE IMPROVEMENT AS ONE OF ONLY 14 HOSPITALS IN THE NATION AND THE ONLY HOSPITAL IN NEW JERSEY TO PARTICIPATE IN A KEY NATIONAL INITIATIVE TO IMPROVE CARE FOR HEART FAILURE PATIENTS. - THE CHILDREN'S HOSPITAL AT MONMOUTH MEDICAL CENTER WAS THE FIRST HOSPITAL IN NEW JERSEY TO OPEN A LEVEL III NEONATAL INTENSIVE CARE UNIT. IT HAS ONE OF THE HIGHEST SURVIVAL RATES AMONG NEONATAL INTENSIVE CARE UNITS IN THE COUNTY AND RANKS IN THE TOP ONE-THIRD FOR SURVIVAL AMONG SUCH UNITS THAT PARTICIPATED IN VERMONT/OXFORD NETWORK'S INTERNATIONAL DATABASE FOR BENCHMARKING. - THE CHILDREN'S HOSPITAL AT MONMOUTH MEDICAL CENTER PERFORMS THE SECOND-HIGHEST NUMBER OF PEDIATRIC SURGERIES IN THE STATE - NEARLY 2,000 INPATIENT AND SAME-DAY PROCEDURES EACH YEAR. - THE CHILDREN'S HOSPITAL AT MONMOUTH MEDICAL CENTER DELIVERS MORE THAN 4,000 BABIES EACH YEAR - MORE THAN ANY OTHER HOSPITAL IN MONMOUTH AND OCEAN COUNTIES. - THE CHILDREN'S CRISIS INTERVENTION SERVICE IS THE ONLY STATE-DESIGNATED PROGRAM IN MONMOUTH AND OCEAN COUNTIES THAT PROVIDES INPATIENT TREATMENT FOR CHILDREN AND ADOLESCENTS WITH ACUTE EMOTIONAL, BEHAVIORAL OR PSYCHOLOGICAL PROBLEMS. - MONMOUTH HAS ONE OF ONLY THREE CYSTIC FIBROSIS CENTERS IN THE STATE AND HAS EARNED A PRESTIGIOUS DISTINCTION AS A COMPREHENSIVE CF CENTER. IT IS THE OLDEST AND LARGEST OF THE CENTERS IN NEW JERSEY. - MONMOUTH MEDICAL CENTER HAS RECEIVED FULL ACCREDITATION AS A CYCLE III ACCREDITED CHEST PAIN CENTER FROM THE SOCIETY OF CHEST PAIN CENTERS (SCPC). CYCLE III IS THE HIGHEST LEVEL OF ACCREDITATION. - MONMOUTH MEDICAL CENTER RECEIVED THE CULTURAL DIVERSITY PARTNERSHIP AWARD FROM THE LAKEWOOD SHOPPER AND THE OCEAN COUNTY SHERIFF'S DEPARTMENT. - MONMOUTH MEDICAL CENTER RECEIVED CT ACCREDITATION FROM THE AMERICAN COLLEGE OF RADIOLOGY (ACR) WITH ZERO DEFICIENCIES. MONMOUTH MEDICAL CENTER, A BARNABAS HEALTH FACILITY, HAS BEEN GRANTED ULTRASOUND ACCREDITATION BY THE AMERICAN COLLEGE OF RADIOLOGY (ACR) ULTRASOUND COMMITTEE. - MONMOUTH MEDICAL CENTER WAS VOTED BEST OF THE BEST HOSPITAL IN THE 2011 ASBURY PARK PRESS READERS' CHOICE AWARDS. - U.S. NEWS & WORLD REPORT RECOGNIZED MONMOUTH AS A REGIONAL LEADER IN CANCER, GERIATRICS, GYNECOLOGY, NEUROLOGY AND NEUROSURGERY.
COMMUNITY BENEFIT STATEMENT CONTINUED CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS - MONMOUTH MEDICAL CENTER HAS THE LOWEST SURGICAL MORTALITY RATE IN NEW JERSEY AND THE LOWEST PNEUMONIA MORTALITY RATE IN THE STATE. - MONMOUTH IS DREXEL UNIVERSITY'S LARGEST MAJOR ACADEMIC MEDICAL AFFILIATE IN NEW JERSEY AND IS THE ONLY AREA ACADEMIC MEDICAL CENTER TO ACHIEVE REGIONAL MEDICAL CAMPUS STATUS. - MMC IS RECOGNIZED AS A DISTINGUISHED ACADEMIC MEDICAL CENTER AMONG AN ELITE GROUP OF THE NATION'S NINE LEADING TEACHING HOSPITALS, BY PRESS GANEY. - MMC IS A DESIGNATED PRIMARY STROKE CENTER AND ACCREDITED CHEST PAIN CENTER. - MONMOUTH MEDICAL CENTER, A BARNABAS HEALTH FACILITY, HAS BEEN GRANTED ULTRASOUND ACCREDITATION BY THE AMERICAN COLLEGE OF RADIOLOGY (ACR) ULTRASOUND COMMITTEE. - THE NEW GEM UNIT OPENED IN NOVEMBER AND FEATURES SIX PRIVATE ENCLOSED ROOMS IN A SEPARATE AREA OF THE HOSPITAL'S EMERGENCY DEPARTMENT SPECIALLY DESIGNED TO MEET THE COMPLEX NEEDS OF THE FRAIL ELDERLY AND THEIR CARETAKERS. - THE PRESTIGIOUS AMERICAN DIABETES ASSOCIATION EDUCATION RECOGNITION CERTIFICATE FOR A QUALITY DIABETES SELF-MANAGEMENT EDUCATION PROGRAM WAS RECENTLY AWARDED TO THE PEDIATRIC ENDOCRINOLOGY PROGRAM OF THE CHILDREN'S HOSPITAL AT MONMOUTH MEDICAL CENTER AS WELL AS THE CENTER FOR DIABETES EDUCATION AT MONMOUTH MEDICAL CENTER - AN HONOR ORIGINALLY BESTOWED ON THE MEDICAL CENTER IN 2007. WITH THIS RECOGNITION, THE CENTER WAS RE-CERTIFIED BY THE ADA AS OFFERING HIGH QUALITY DIABETES SELF-MANAGEMENT EDUCATION THAT IS AN ESSENTIAL COMPONENT OF EFFECTIVE DIABETES TREATMENT. CENTERS OF EXCELLENCE ===================== MMC'S RECOGNIZED MEDICAL SERVICES CENTERS OF EXCELLENCE INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING: 1. THE CHILDREN'S HOSPITAL AT MONMOUTH MEDICAL CENTER. THE CHILDREN'S HOSPITAL IS A MEMBER OF THE NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS AND RELATED INSTITUTIONS (NACHRI) AND OFFERS MORE THAN 140 PEDIATRIC SPECIALISTS WHO CONCENTRATE IN 26 SPECIALTIES. THE ORGANIZATION PROVIDES SPECIALIZED PEDIATRIC CARE, OFFERING A 29-BASSINET REGIONAL NEWBORN CENTER, A 15-BED LEVEL III NEONATAL INTENSIVE CARE UNIT, THE REGION'S ONLY PROGRAM IN CHILDREN'S CRISIS INTERVENTION SERVICES AND SUBSPECIALTY PEDIATRIC CARE IN AREAS SUCH AS CARDIOLOGY, GASTROENTEROLOGY, SURGERY AND ORTHOPEDICS. 2. PSYCHIATRIC CENTERS/PROGRAM MMC HAS THE LARGEST PSYCHIATRIC PROGRAM IN MONMOUTH COUNTY, WITH A TOTAL OF 63 BEDS IN VOLUNTARY AND INVOLUNTARY ADULT INPATIENT UNITS AND 19 BEDS IN ITS INPATIENT CHILDREN'S CRISIS INTERVENTION SERVICE, WHERE CHILDREN AND ADOLESCENTS WITH ACUTE EMOTIONAL, BEHAVIORAL OR PSYCHIATRIC PROBLEMS ARE TREATED. IN ADDITION, ITS NEWLY RENOVATED PSYCHIATRIC EMERGENCY SCREENING SERVICE IS THE DESIGNATED SUCH SERVICE FOR MONMOUTH COUNTY. 3. THE JACQUELINE M. WILENTZ COMPREHENSIVE BREAST CENTER COMMITTED TO MEETING THE BREAST HEALTHCARE NEEDS OF ALL WOMEN, THE BREAST CENTER IS THE REGION'S ONLY FACILITY TO OFFER A MULTIDISCIPLINARY TEAM DEDICATED TO THE BREAST HEALTH NEEDS OF ALL WOMEN. MMC PROVIDES A COMFORTABLE AND SUPPORTIVE SETTING IN WHICH ALL OUTPATIENT BREAST HEALTHCARE SERVICES ARE FOUND IN ONE CONVENIENT LOCATION. MMC TAKES A COORDINATED APPROACH TO BREAST CARE -- BOTH WELL CARE AND CANCER CARE. MMC IS HERE FOR WOMEN WHO SEEK ANNUAL BREAST EVALUATION AND FOR THOSE WOMEN DIAGNOSED WITH BREAST CANCER OR BENIGN BREAST DISEASE. AND IT'S MORE THAN CARE, IT'S CARING. SEVERAL OF MMC'S SERVICES ARE SPECIFICALLY FOR WOMEN DIAGNOSED WITH BREAST CANCER, INCLUDING: AN OUTPATIENT CHEMOTHERAPY SUITE, PSYCHOSOCIAL COUNSELING AND REHABILITATION SERVICES, BREAST CANCER SUPPORT GROUPS AND BREAST CONSERVATION SURGERY. THESE QUALIFIED EXPERTS REPRESENT MANY MEDICAL DISCIPLINES, WORKING TOGETHER TO PROVIDE WOMEN WITH DIAGNOSTIC, TREATMENT, SURGICAL, PSYCHOSOCIAL SUPPORT, AND EDUCATION AND REHABILITATION SERVICES. MMC'S STATE-OF-THE-ART FACILITY OFFERS THE LATEST IN MEDICAL EQUIPMENT, TECHNOLOGY AND SERVICES, INCLUDING: - ANNUAL PHYSICAL BREAST EXAMINATIONS, MAMMOGRAPHY AND DIAGNOSTIC SERVICE, HEADED BY A DEDICATED BREAST RADIOLOGIST WHO OVERSEES A STAFF OF HIGHLY TRAINED TECHNOLOGISTS. - CONSULTATIONS AND SECOND OPINIONS (SURGERY, MEDICAL ONCOLOGY, PATHOLOGY, MAMMOGRAPHY, PLASTIC SURGERY AND RADIATION THERAPY), BREAST CANCER HIGH RISK PROGRAM, STEREOTACTIC BIOPSY SYSTEM, TOMOSYNTHESIS, BREAST-SPECIFIC GAMMA IMAGING, CLINICAL RESEARCH AND A BREAST INFORMATION CENTER. 4. THE CRANMER AMBULATORY SURGERY CENTER THE CENTER PROVIDES A FULL SPECTRUM OF SAME-DAY SURGICAL SERVICES USING THE MOST MODERN TECHNOLOGY AVAILABLE. THE FACILITY INCLUDES FOUR FULL-SERVICE OPERATING ROOMS, THREE MINOR PROCEDURE ROOMS AND A THREE-TIERED GRADUATED RECOVERY AREA, RESPECTING THE INDIVIDUAL NEEDS OF ADULT AND PEDIATRIC PATIENTS. THE ONE-STORY, 19,000-SQUARE-FOOT BUILDING IS EQUIPPED TO PERFORM ALL TYPES OF SAME-DAY SURGICAL PROCEDURES, INCLUDING ARTHROSCOPIC, LAPAROSCOPIC AND LASER TECHNIQUES. EVERY ASPECT OF THE CENTER HAS BEEN DESIGNED TO PROVIDE THE ULTIMATE IN EFFICIENCY AND COMFORT FOR PATIENTS AND THEIR FAMILIES, WHILE OFFERING THE HIGHEST QUALITY MEDICAL CARE. 5. THE VALERIE FUND CHILDREN'S CENTER FOR CANCER AND BLOOD DISORDERS THE CENTER PROVIDES COMPREHENSIVE MEDICAL SERVICES FOR CHILDREN WITH CANCER AND BLOOD DISORDERS SUCH AS SICKLE CELL ANEMIA, THALASSEMIA AND THROMBOCYTOPENIA. CHILDREN AND YOUNG ADULTS (BIRTH TO 21 YEARS OF AGE) WITH LEUKEMIA AND OTHER CANCERS ARE TREATED ACCORDING TO THE MOST ADVANCED THERAPEUTIC PROTOCOLS. THE CENTER IS A DESIGNATED AS A "COMPREHENSIVE TREATMENT CENTER FOR SICKLE CELL ANEMIA" BY THE STATE OF NEW JERSEY. MEDICAL AND EMOTIONAL SUPPORT FOR PATIENTS AND THEIR FAMILIES IS PROVIDED THROUGH AN INTERDISCIPLINARY TEAM. MMC IS ONE OF FIVE HOSPITALS IN NEW JERSEY THAT ARE PART OF THE VALERIE FUND, ONE OF THE LARGEST AND MOST ADVANCED PEDIATRIC ONCOLOGY/HEMATOLOGY NETWORKS IN THE COUNTRY. 6. THE GOLDSMITH WELLNESS CENTER PROVIDING INTEGRATIVE TREATMENTS FOR INDIVIDUALS LIVING WITH CANCER, THE GOAL OF WELLNESS CENTER IS TO ENABLE CANCER PATIENTS, AND THEIR LOVED ONES, TO LIVE THEIR LIVES "WELL" AND JOYFULLY WHILE FACING THE FEAR AND PAIN ASSOCIATED WITH CANCER. AS A SUPPLEMENT TO THEIR CURRENT MEDICAL CARE, PARTICIPANTS AT THE WELLNESS CENTER WILL EXPERIENCE ENHANCED PHYSICAL, EMOTIONAL AND SPIRITUAL HEALING THROUGH INDIVIDUAL AND GROUP PROGRAMS IN AN ENVIRONMENT WHERE THEY CAN JOIN WITH OTHERS TO LEARN AND SHARE EXPERIENCES, STRENGTH AND HOPE. MEDICAL AND COMMUNITY SERVICES ============================== MONMOUTH MEDICAL CENTER'S SERVICES INCLUDE AN ARRAY OF ADDITIONAL MEDICAL SERVICES AND PROGRAMS THAT ADDRESS THE HEALTHCARE NEEDS OF ITS COMMUNITIES, FROM DIAGNOSTIC, TO PREVENTION AND TREATMENT. ADDITIONAL MEDICAL SERVICES --------------------------- MMC OFFERS MANY SPECIALIZED PROGRAMS INCLUDING ROBOTIC SURGERY, MINIMALLY INVASIVE SURGERY, REGIONAL PERINATAL CENTER, SLEEP CENTER, HYPERBARIC TREATMENT, AND INTEGRATIVE MEDICINE. MMC PROVIDES COMPREHENSIVE BEHAVIORAL HEALTH SERVICES INCLUDING PSYCHIATRIC EMERGENCY SERVICES, MOBILE OUTREACH, CHILDREN'S CRISIS INTERVENTION AND INTENSIVE OUTPATIENT SERVICES CONSISTENT WITH REVENUE RULING 69-545 ALL QUALIFIED PHYSICIANS ARE ELIGIBLE FOR MEDICAL STAFF PRIVILEGES AT MMC. MMC HAS OVER 800 PHYSICIANS ON ITS MEDICAL STAFF AND OTHER HEALTH PROFESSIONALS, COMPRISED OF THE FOLLOWING SPECIALTIES: - ANATOMIC & CLINICAL, PATH - ALLERGY MEDICINE - ALLERGY PEDIATRIC - ADULT PSYCHIATRY - ANESTHESIOLOGY - COLON & RECTAL SURGERY - CRITICAL CARE, ANESTHESIA - CHILD DEVELOPMENT, PEDIATRIC - CHILD PSYCHIATRY - CARDIOLOGY, MED - CARDIOLOGY, PEDIATRIC - CRITICAL CARE, PEDIATRIC - CERTIFIED NURSE MIDWIFE - NURSE ANESTHETIST - DERMATOLOGY, MED - DIAGNOSTIC RADIOLOGY - ENDODONTICS - EMERGENCY MEDICINE - ENDOCRINOLOGY, MED - ENDOCRINOLOGY, PEDIATRIC - FAMILY PRACTICE - GENERAL DENT, INPATIENT DENTAL - GENERAL DENT, OUTPATIENT DENTAL - GENERAL PEDIATRICS - GENERAL SURGERY - GASTROENTEROLOGY, MED - GASTROENTEROLOGY, PEDIATRIC - GERIATRICS - GYNECOLOGIC ONCOLOGY - HAND SURGERY - HEMATOLOGY, MED - HEMATOLOGY / ONCOLOGY, MED - HEMATOLOGY / ONCOLOGY, PEDIATRIC - INTENSIVE CARE, PEDIATRIC - INTERNAL MED - INFECTIOUS DISEASE, MED - INFECTIOUS DISEASE, PEDIATRIC - MATERNAL-FETAL MEDICINE - MEDICAL GENETICS, PEDIATRIC - NUCLEAR MEDICINE, RAD - PSYCHIATRY & NEUROLOGY - NEONATOLOGY - NEPHROLOGY - NEPHROLOGY, PED - NEUROLOGY - NEUROLOGY, PEDIATRIC - NEUROSURGERY - NURSE PRACTITIONER - ORAL SURGERY, INPATIENT DENTAL - ORAL SURGERY, OUTPATIENT - OB/GYN - ONCOLOGY, MED - OPHTHALMOLOGY - ORTHOPEDIC SURGERY - ORTHODONTICS, OUTPATIENT DENT - OTOLARYNGOLOGY - PHYSICIAN ASSISTANT - PEDIATRIC, INPATIENT DENTAL - PEDIATRIC SURGERY - PERIODONTICS, OUTPATIENT DENTAL - PHYSICAL MED & REHAB - PLASTIC & RECON SURGERY - PAIN MEDICINE - PODIATRIC MEDICINE - PROSTHODONTICS / OUTPATIENT DENTAL - PULMONARY MED - PULMONARY PEDIATRIC - PSYCHOLOGY - RADIATION ONCOLOGY - RADIOLOGY - VASCULAR / INTERVENTIONAL RADIOLOGY - REPRODUCTIVE ENDOCRINOLOGY - RHEUMATOLOGY MED - THORACIC SURGERY - UROLOGY - VASCULAR SURGERY
COMMUNITY BENEFIT STATEMENT CONTINUED CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS COMMUNITY SERVICE CENTERS ------------------------- MMC IS COMMITTED TO KEEPING ITS COMMUNITY HEALTHY, AND OFFERS AN EXTENSIVE ARRAY OF COMMUNITY OUTREACH PROGRAMS AND SERVICES FOR THE BENEFIT OF THE COMMUNITY RESIDENTS AND EMPLOYEES. MMC OPERATES THE FOLLOWING DEPARTMENT DESIGNED TO PROMOTE HEALTH AND HEALTH AWARENESS FOR THE COMMUNITY. - DEPARTMENT OF COMMUNITY HEALTH WELLNESS HAS A PHILOSOPHY AND WAY OF LIFE THAT ALLOWS INDIVIDUALS TO REACH THEIR FULL POTENTIAL FOR OPTIMAL WELL-BEING. RECOGNIZING THAT INDIVIDUALS HAVE BECOME INCREASINGLY HEALTH CONSCIOUS AND ARE SEEKING NEW WAYS TO IMPROVE THEIR HEALTH AND PREVENT ILLNESS, MONMOUTH MEDICAL CENTER'S DEPARTMENT OF COMMUNITY HEALTH EDUCATION HAS DEVELOPED MULTIPLE PROGRAMS TO ASSIST THE COMMUNITY IN FULFILLING THEIR HEALTH GOALS. SCREENING PROGRAMS ------------------ MMC PROVIDES NUMEROUS MEDICAL SCREENING PROGRAMS TO THE COMMUNITY IN FURTHERANCE OF ITS TAX-EXEMPT PURPOSES. APPROXIMATELY 76,388 INDIVIDUALS PARTICIPATED IN MEDICAL SCREENINGS AND EDUCATIONAL PROGRAMS AT MMC IN 2011. THESE INCLUDE, BUT NOT LIMITED TO, THE FOLLOWING: 1. HIV TESTING 2. CHOLESTEROL TESTING 3. BLOOD PRESSURE 4. BODY COMPOSITION ANALYSIS 5. DEPRESSION SCREENING 6. ORAL CANCER 7. DERMAVIEW SKIN SCANS 8. FOOT SCREENINGS 9. DRIVER RISK AWARENESS 10. SKIN CANCER 11. GLUCOSE SCREEN 12. PROSTATE CANCER SCREENING 13. VISION SCREENINGS COMMUNITY EDUCATION -------------------- THE HOSPITAL'S ONGOING EFFORTS TO EDUCATE THE COMMUNITY WITH RESPECT TO GENERAL HEALTH AWARENESS, ISSUES AND PUBLIC SAFETY, HEALTHCARE ACTIVITIES, SCREENINGS, EDUCATION AND PROGRAMS IS ADVANCED THROUGH PUBLICATIONS, NEWS BULLETINS, NEWSLETTERS, WEB POSTINGS AND OTHER PUBLICATIONS PRODUCED BY THE HOSPITAL. IN ADDITION, PATIENTS PART OF AT RISK POPULATIONS ARE ASSESSED FOR INFLUENZA AND PNEUMONIA VACCINATIONS AND PROVIDED THE VACCINES UPON THEIR APPROVAL. ALL PATIENTS ARE ASKED REGARDING LIVING WILLS AND ADVANCED DIRECTIVES. MMC PROVIDES NUMEROUS LECTURES, SEMINARS AND OTHER EDUCATIONAL PROGRAMS TO THE COMMUNITY IN FURTHERANCE OF ITS TAX-EXEMPT PURPOSES INCLUDING, BUT NOT LIMITED TO, THE FOLLOWING: 1. CPR AND FIRST AID INSTRUCTION NEONATAL RESUSCITATION 2. WELLNESS PROGRAMS SMOKING CESSATION STRESS MANAGEMENT BACK INJURY PREVENTION PREPARATION FOR CHILDBIRTH BABYSITTING FATAL VISION VIOLENCE PREVENTION LEAD POISONING PREVENTION SEAT BELT SAFETY KIDS HOME ALONE STRANGER SAFETY TOBACCO TIPS FOR TEENS SAFE SITTER TEDDY BEAR AND DOLL CLINIC IDENT-A-KID 3. CHILDBIRTH PREPARATION AND PARENTING PROGRAMS MOTHER TO MOTHER SUPPORT GROUP PREPARATION FOR CHILDBIRTH CESAREAN BIRTH EDUCATION MAKE ROOM FOR BABY BABY CARE BASICS BABY FAIR BREASTFEEDING TODAY MARVELOUS MULTIPLES PRENATAL RHYTHMIC EXERCISE PROGRAM BECOMING A BIG BROTHER OR A BIG SISTER GRANDPARENTS PROGRAM ADOPTIVE PARENTING INFANT MASSAGE POSTPARTUM RHYTHMIC EXERCISE PROGRAM FAMILY CENTER TOURS 4. OTHER SUPPORT GROUPS ADULT PULMONARY ALZHEIMER/CAREGIVER BARIATRIC SUPPORT BEREAVEMENT BREAST CANCER CAREGIVERS EDUCATION FOR BRAIN TUMOR PATIENTS CAREGIVERS CHRONIC FATIGUE SYNDROME/EPSTEIN-BARR IRRITABLE BOWEL SYNDROME CELIAC DISEASE VIRUS/FIBROMYALGIA CARDIAC SUPPORT DIABETES SUPPORT/DIABETES INSULIN PUMP NEWLY DIAGNOSED/COPING WITH BREAST CANCER CLEFT PALATE SUPPORT POSITIVE AND BEAUTIFUL (HIV SUPPORT) CHILDREN/ADOLESCENTS EXPERIENCING LOSS KIDS NEED SUPPORT, TOO OVARIAN CANCER SUPPORT SUPPORT FOR PEOPLE WITH ORAL, HEAD, AND NECK CANCER "LOOK GOOD, FEEL BETTER" WHEN BREAST CANCER RETURNS EASY BREATHERS - ADULT PULMONARY SHORE AREA STROKE SURVIVORS FAMILY SUPPORT US TOO - PROSTATE CANCER INFANT LOSS (SHARE) STOP SMOKING 5. SPEAKERS BUREAU ADVANCE DISEASE MANAGEMENT AGING EYE PROBLEMS AGING IMPLICATIONS ALZHEIMER'S DISEASE ARTHRITIS TREATMENT OPTIONS BREAST CANCER AWARENESS BREAST CANCER UPDATE CALORIC NEEDS FOR WEIGHT LOSS CARE FOR CAREGIVERS COLORECTAL CANCER AWARENESS DEMENTIA DENTAL HYGIENE DIABETES MANAGEMENT UPDATE ELDERLY CAREGIVING ISSUES EXERCISE FOR HEALTH FETAL GROWTH AND DEVELOPMENTAL/RELAXATION GERIATRIC SERVICES GOOD NIGHT'S SLEEP GUIDED IMAGERY HEALTHY DIET HOLIDAY STRESS BUSTERS INCONTINENCE LAUGHTER CLUB LIFETIME & ESTATE PLANNING MEDICATION INDUCED DIABETES MEMORY IMPROVEMENT TIPS NUTRITION TO PREVENT OSTEOPOROSIS OSTEOARTHRITIS SAFE SITTER SENSITIVITY TO AGING ISSUES SLEEP DISORDERS STRESS MANAGEMENT STROKE AWARENESS THYROID DISORDERS WARNING SIGNS OF HEART ATTACK WOMEN'S HEART HEALTH 6. SPECIAL PROGRAMS ACT IN TIME TO HEART ATTACK SIGNS AGING AND SLEEP BODY IMAGE BRAIN TUMOR SURVIVORSHIP BREAST CANCER SURVIVORSHIP CELIAC DISEASE CLEFT PALATE EXERCISE FOR BACK PAIN GLAUCOMA AWARENESS INDIGESTION KEEPING YOUR MIND SHARP LAP BAND PROGRAM LIVING WELL WITH DIABETES LIVING WITH DEPRESSION MANAGING MULTIPLE MEDICATIONS OSTEOPOROSIS PREVENTION PRE-DIABETES SAFE SITTER SHINGLES VACCINE UPDATE STRESS FREE WORKSHOP STROKE PREVENTION THYROID DISORDERS TOTAL JOINT REPLACEMENT 7. HEALTH FAIRS/COMMUNITY EVENTS AHA HEART WALK BIKE RODEO/WHEELED SPORTS SAFETY EVENT CAR SEAT CHECKS CARDIOPULMONARY HEALTH FAIR COMMUNITY HEALTH FAIR COMMUNITY YMCA HEALTHY KIDS DAY CYSTIC FIBROSIS WALK FOOD ALLERGY WALK MONMOUTH COUNTY EMPLOYEES WELLNESS DAY MONMOUTH UNIVERSITY RN STUDENTS HEALTH FAIR OCEANFEST SAFE KIDS WEEK CHILD SAFETY EVENT
STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS CORE FORM, PART III; LINE 4D EXPENSES INCURRED IN PROVIDING VARIOUS OTHER MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. PLEASE REFER TO THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT INCLUDED IN SCHEDULE O.
DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7 SAINT BARNABAS CORPORATION ("SBC") IS THE SOLE MEMBER OF THIS ORGANIZATION. SBC HAS THE RIGHT TO ELECT THE MEMBERS OF THIS ORGANIZATION'S BOARD OF TRUSTEES AND HAS CERTAIN RESERVED POWERS AS DEFINED IN THIS ORGANIZATION'S BYLAWS.
DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION B; QUESTION 11B THE ORGANIZATION IS AN AFFILIATE OF BARNABAS HEALTH ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. SAINT BARNABAS CORPORATION IS THE PARENT ENTITY OF THE SYSTEM. THE ORGANIZATION'S FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY (ITS BOARD OF TRUSTEES) PRIOR TO THE FILING WITH THE IRS. IN ADDITION THE SAINT BARNABAS CORPORATION AUDIT COMMITTEE ASSUMED THE RESPONSIBILITY TO OVERSEE AND COORDINATE THE FEDERAL FORM 990 PREPARATION AND FILING PROCESS FOR ALL TAX-EXEMPT AFFILIATES OF THE SYSTEM BUT DID NOT PERFORM AN ACTUAL REVIEW OF EACH AFFILIATE FEDERAL FORM 990 WITH THE EXCEPTION OF SAINT BARNABAS CORPORATION. AS PART OF THE ORGANIZATION'S FEDERAL FORM 990 TAX RETURN PREPARATION PROCESS THE ORGANIZATION HIRED A PROFESSIONAL CPA FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION TO PREPARE THE FEDERAL FORM 990. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE ORGANIZATION'S FINANCE PERSONNEL AND SYSTEM INDIVIDUALS INCLUDING IN HOUSE COUNSEL, EXECUTIVE VICE-PRESIDENT AND CHIEF FINANCIAL OFFICER, VICE PRESIDENT, INTERNAL AUDIT 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 CHAIRPERSON OF THE ORGANIZATION'S FINANCE COMMITTEE AND OTHER INDIVIDUALS 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 THE FILING WITH THE IRS.
DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION B; QUESTION 12 THE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY. THE ORGANIZATION REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. THIS CONFLICT OF INTEREST POLICY REQUIRES THAT A CONFLICT OF INTEREST FORM CONSISTENT WITH BEST GOVERNANCE PRACTICES AND INTERNAL REVENUE SERVICE GUIDELINES BE CIRCULATED TO OFFICERS, TRUSTEES AND KEY EMPLOYEES ANNUALLY. IN A SITUATION IN WHICH A TRUSTEE DISCLOSES AN INTEREST THAT COULD GIVE RISE TO A CONFLICT, THE TRUSTEE'S POTENTIAL CONFLICT IS REFERRED TO THE CORPORATE NOMINATING AND GOVERNANCE COMMITTEE WHICH EVALUATES THE CONFLICT AND ITS POTENTIAL IMPACT ON THE TRUSTEE'S PARTICIPATION ON THE BOARD OR ON CERTAIN ISSUES WHICH MAY COME BEFORE THE BOARD. AS APPROPRIATE THE COMMITTEE WILL TAKE ACTION TO ADDRESS THE CONFLICT.
DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION B; QUESTION 15 THE ORGANIZATION IS AN AFFILIATE OF BARNABAS HEALTH; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. SAINT BARNABAS CORPORATION ("SBC") IS THE PARENT ENTITY OF BARNABAS HEALTH. SBC'S BOARD OF TRUSTEES MAINTAINS 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 SBC'S SENIOR MANAGEMENT, INCLUDING THE RETIRED CHIEF EXECUTIVE OFFICER, PRESIDENT/CHIEF EXECUTIVE OFFICER, BOTH THE RETIRED AND CURRENT EXECUTIVE VP OPERATIONS AND EXECUTIVE VP/CFO. THE COMPENSATION COMMITTEE ALSO REVIEWS THE COMPENSATION AND BENEFITS OF OTHER KEY OFFICERS AND KEY EMPLOYEES OF BARNABAS HEALTH; INCLUDING, WITHOUT LIMITATION, THE EXECUTIVE DIRECTORS OF BARNABAS HEALTH HOSPITALS AND MEDICAL CENTERS. THE COMPENSATION COMMITTEE, WHICH IS REQUIRED BY THE CORPORATION'S BYLAWS TO BE COMPRISED SOLELY OF INDEPENDENT TRUSTEES, SEEKS GUIDANCE AND SUBSTANTIATION FROM A NATIONALLY RECOGNIZED COMPENSATION CONSULTANT. THE COMMITTEE REVIEWS THE "TOTAL COMPENSATION" OF THE INDIVIDUALS WHICH IS INTENDED TO INCLUDE BOTH CURRENT AND DEFERRED COMPENSATION AND ALL EMPLOYEE BENEFITS, BOTH QUALIFIED AND NON-QUALIFIED. THE COMMITTEE'S REVIEW IS DONE ON AT LEAST AN ANNUAL BASIS AND ENSURES THAT THE "TOTAL COMPENSATION" OF SENIOR MANAGEMENT OF THE ORGANIZATION IS REASONABLE. THE ACTIONS TAKEN BY THE COMMITTEE ENABLE THE ORGANIZATION TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 4958 WITH RESPECT TO THE TOTAL COMPENSATION OF CERTAIN MEMBERS OF THE SENIOR MANAGEMENT TEAM, INCLUDING THE RETIRED CHIEF EXECUTIVE OFFICER, PRESIDENT/CHIEF EXECUTIVE OFFICER, BOTH THE RETIRED AND CURRENT EXECUTIVE VP OPERATIONS AND EXECUTIVE VP/CFO. THE THREE FACTORS WHICH MUST BE SATISFIED IN ORDER TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS ARE THE FOLLOWING: 1. THE COMPENSATION ARRANGEMENT IS APPROVED IN ADVANCE BY AN "AUTHORIZED BODY" OF THE APPLICABLE TAX-EXEMPT ORGANIZATION WHICH IS COMPOSED ENTIRELY OF INDIVIDUALS WHO DO NOT HAVE A "CONFLICT OF INTEREST" WITH RESPECT TO THE COMPENSATION ARRANGEMENT; 2. THE AUTHORIZED BODY OBTAINED AND RELIED UPON "APPROPRIATE DATA AS TO COMPARABILITY" PRIOR TO MAKING ITS DETERMINATION; AND 3. THE AUTHORIZED BODY "ADEQUATELY DOCUMENTED THE BASIS FOR ITS DETERMINATION" CONCURRENTLY WITH MAKING THAT DETERMINATION. THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES EACH OF WHO ARE INDEPENDENT AND ARE FREE FROM ANY CONFLICTS OF INTEREST. THE COMMITTEE RELIED UPON APPROPRIATE COMPARABLE DATA; SPECIFICALLY THE COMMITTEE OBTAINED A WRITTEN COMPENSATION STUDY FROM AN INDEPENDENT FIRM WHICH SPECIALIZES IN THE REVIEWING OF HOSPITAL AND HEALTHCARE SYSTEM EXECUTIVE COMPENSATION AND BENEFITS THROUGHOUT THE UNITED STATES. THIS STUDY USED COMPARABLE GEOGRAPHIC AND DEMOGRAPHIC MARKET DATA INCLUDING BUT NOT LIMITED TO SIMILARLY SIZED HEALTHCARE SYSTEMS AND HOSPITALS, # OF LICENSED BEDS AND NET PATIENT SERVICE REVENUE. THE COMMITTEE ADEQUATELY DOCUMENTED ITS BASIS FOR ITS DETERMINATION THROUGH THE TIMELY PREPARATION OF WRITTEN MINUTES OF THE COMPENSATION COMMITTEE MEETINGS DURING WHICH THE EXECUTIVE COMPENSATION AND BENEFITS WAS REVIEWED AND SUBSEQUENTLY APPROVED. THE ACTIONS OUTLINED ABOVE WITH RESPECT TO THE COMMITTEE AND THE ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS APPLIES TO CERTAIN SBC SENIOR MANAGEMENT PERSONNEL, INCLUDING, BUT NOT LIMITED TO, THE RETIRED CHIEF EXECUTIVE OFFICER, PRESIDENT/CHIEF EXECUTIVE OFFICER, BOTH THE RETIRED AND CURRENT EXECUTIVE VP OPERATIONS, EXECUTIVE VP/CFO AND THE EXECUTIVE DIRECTORS OF THE BARNABAS HEALTH HOSPITALS AND MEDICAL CENTERS. THE COMPENSATION AND BENEFITS OF CERTAIN OTHER INDIVIDUALS CONTAINED IN THIS FORM 990, WHERE APPLICABLE, ARE REVIEWED ANNUALLY BY THE BARNABAS HEALTH PRESIDENT/CHIEF EXECUTIVE OFFICER WITH ASSISTANCE FROM THE ORGANIZATION'S HUMAN RESOURCES DEPARTMENT IN CONJUNCTION WITH THE INDIVIDUAL'S JOB PERFORMANCE DURING THE YEAR AND IS BASED UPON OTHER OBJECTIVE FACTORS DESIGNED TO ENSURE THAT REASONABLE AND FAIR MARKET VALUE COMPENSATION IS PAID BY THE ORGANIZATION. OTHER OBJECTIVE FACTORS INCLUDE MARKET SURVEY DATA FOR COMPARABLE POSITIONS, INDIVIDUAL GOALS AND OBJECTIVES, PERSONNEL REVIEWS, EVALUATIONS, SELF-EVALUATIONS AND PERFORMANCE FEEDBACK MEETINGS.
DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION C; QUESTION 19 THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE STATE OF NEW JERSEY DEPARTMENT OF THE TREASURY.
COMPENSATION INFORMATION DISCLOSURE CORE FORM, PART VII AND SCHEDULE J PART VII AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM THIS ORGANIZATION OR A RELATED ORGANIZATION. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OF THE ORGANIZATION OR A RELATED ORGANIZATION 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 THIS ORGANIZATION IS PART OF BARNABAS HEALTH; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM INCLUDES BOTH FOR-PROFIT AND NOT FOR-PROFIT ORGANIZATIONS. CERTAIN BOARD OF TRUSTEE MEMBERS, OFFICERS AND/OR DIRECTORS LISTED ON CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 MAY HOLD SIMILAR POSITIONS WITH BOTH THIS ORGANIZATION AND OTHER AFFILIATES WITHIN THE SYSTEM. THE HOURS SHOWN ON THIS FORM, 990 FOR BOARD MEMBERS WHO RECEIVE NO COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, REPRESENTS THE ESTIMATED HOURS DEVOTED PER WEEK FOR THIS ORGANIZATION. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF TRUSTEES OF OTHER RELATED ORGANIZATIONS IN THE SYSTEM, THEIR RESPECTIVE HOURS PER WEEK PER ORGANIZATION ARE APPROXIMATELY ONE HOUR. THE HOURS REFLECTED ON PART VII OF THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, PAID OFFICERS AND KEY EMPLOYEES, REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF BARNABAS HEALTH; NOT SOLELY THIS ORGANIZATION.
OTHER CHANGES IN NET ASSETS CORE FORM, PART XI; QUESTION 5 OTHER CHANGES IN NET ASSETS OR FUND BALANCE INCLUDE: - PENSION CHANGEs OTHER THAN NET PERIODIC BENEFIT COST - ($8,489,125) - NET ASSETS RELEASED FROM RESTRICTION FOR PURCHASE OF PROPERTY AND EQUIPMENT - $1,872,340 - EQUITY TRANSFER TO AFFILIATES - ($2,551,387) - CHANGE IN NET INTEREST OF MONMOUTH MEDICAL CENTER FOUNDATION; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX EXEMPT ORGANIZATION - ($228,000).
AUDITED FINANCIAL STATEMENTS CORE FORM, PART XII; QUESTION 2 THE ORGANIZATION IS AN AFFILIATE OF BARNABAS HEALTH ("SYSTEM"), A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THE SYSTEM'S PARENT ENTITY IS SAINT BARNABAS CORPORATION. AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF SAINT BARNABAS CORPORATION AND ALL ENTITIES WITHIN THE SYSTEM FOR THE YEARS ENDED DECEMBER 31, 2011 AND DECEMBER 31, 2010; RESPECTIVELY. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAINED CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. THE INDEPENDENT CPA FIRM ISSUED AN UNQUALIFIED OPINION WITH RESPECT TO THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS. THE SAINT BARNABAS CORPORATION AUDIT COMMITTEE HAS ASSUMED RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE CONSOLIDATED FINANCIAL STATEMENTS, WHICH INCLUDES THIS ORGANIZATION, AND THE SELECTION OF AN INDEPENDENT AUDITOR.
FINANCIAL STATEMENTS AND REPORTING CORE FORM, PART XII; QUESTION 3 THIS ORGANIZATION IS AN AFFILIATE IN BARNABAS HEALTH ("SYSTEM"). THE SYSTEM ENGAGED An INDEPENDENT ACCOUNTING FIRM TO PREPARE AND ISSUE A SYSTEM WIDE CONSOLIDATED A-133 AUDIT. THIS ORGANIZATION WAS INCLUDED IN THE SYSTEM WIDE A-133 AUDIT.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2011

Additional Data


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

OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
MONMOUTH MEDICAL CENTER
 
Employer identification number

22-3452412
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

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


 		(f)
Direct controlling
entity

















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


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

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

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) CENTER STATE HEALTH GROUP INC

2 CRESCENT PLACE

OCEANPORT,NJ07757
22-2939956 		HEALTH SVCS. NJ 501(C)(3) 509(a)(3) SBC
 
 
No
(2) CENTER STATE PROPERTIES CORPORATION

99 HIGHWAY 37 WEST

TOMS RIVER,NJ08755
52-1571939 		TITLE HLDNG. NJ 501(C)(2) N/A CSHG
 
 
No
(3) CENTRAL JERSEY BEHAVIORAL HEALTH ASSOC

1691 ROUTE 9

TOMS RIVER,NJ08754
22-3343959 		HEALTH SVCS. NJ 501(C)(3) 509(a)(3) SBBH
 
 
No
(4) CLARA MAASS FOUNDATION

ONE CLARA MAASS DRIVE

BELLEVILLE,NJ07109
22-2132516 		FUNDRAISING NJ 501(C)(3) 509(a)(1) SBC
 
 
No
(5) CLARA MAASS HEALTH SYSTEM INC

ONE CLARA MAASS DRIVE

BELLEVILLE,NJ07109
22-2802778 		HEALTH SVCS. NJ 501(C)(3) 509(a)(3) SBC
 
 
No
(6) CLARA MAASS MEDICAL CENTER

ONE CLARA MAASS DRIVE

BELLEVILLE,NJ07109
22-1500556 		HEALTH SVCS. NJ 501(C)(3) HOSPITAL SBC
 
 
No
(7) CLARA MAASS PROPERTIES INC

ONE CLARA MAASS DRIVE

BELLEVILLE,NJ07109
52-1855420 		INACTIVE NJ 501(C)(2) N/A SBC
 
 
No
(8) COMMUNITY MEDICAL CENTER

99 HIGHWAY 37 WEST

TOMS RIVER,NJ08755
22-3452306 		HEALTH SVCS. NJ 501(C)(3) HOSPITAL SBC
 
 
No
(9) COMMUNITY MEDICAL CENTER FOUNDATION

99 HIGHWAY 37 WEST

TOMS RIVER,NJ08755
22-2597592 		FUNDRAISING NJ 501(C)(3) 509(a)(1) SBC
 
 
No
(10) COUNTRY MANOR AT DOVER

16 WHITESVILLE ROAD

TOMS RIVER,NJ08753
22-2462909 		INACTIVE NJ 501(C)(3) 509(A)(2) CSHG
 
 
No
(11) EMTAC INC

2 CRESCENT PLACE

OCEANPORT,NJ07757
22-2549945 		INACTIVE NJ 501(C)(3) 509(a)(2) SBC
 
 
No
(12) IRVINGTON GENERAL HOSPITAL

832 CHANCELLOR AVENUE

IRVINGTON,NJ07111
22-3452411 		INACTIVE NJ 501(C)(3) HOSPITAL SBC
 
 
No
(13) IRVINGTON HOSPITAL FOUNDATION

95 OLD SHORT HILLS ROAD

WEST ORANGE,NJ07052
23-7025428 		INACTIVE NJ 501(C)(3) 509(a)(3) SBC
 
 
No
(14) KENSINGTON MANOR CARE CENTER

16 WHITESVILLE ROAD

TOMS RIVER,NJ08753
52-1571883 		INACTIVE NJ 501(C)(3) 509(a)(2) CSHG
 
 
No
(15) KIMBALL MEDICAL CENTER

600 RIVER AVENUE

LAKEWOOD,NJ08701
22-3452413 		HEALTH SVCS. NJ 501(C)(3) HOSPITAL SBC
 
 
No
(16) KIMBALL MEDICAL CENTER FOUNDATION

600 RIVER AVE ANNEX BLDG E

LAKEWOOD,NJ08701
22-2630076 		FUNDRAISING NJ 501(c)(3) 509(a)(1) SBC
 
 
No
(17) MEDICAL CENTER STAFFING SERVICES INC

1 CRAGWOOD ROAD SUITE 3D

SOUTH PLAINFIELD,NJ07080
35-2219655 		STAFFING SVCS NJ 501(C)(3) 509(a)(3) CSHG
 
 
No
(18) MEGA CARE INC

1020 GALLOPING HILL ROAD

UNION,NJ07083
22-2578561 		HEALTH SVCS. NJ 501(C)(3) 509(a)(3) CSHG
 
 
No
(19) MMC AMBULATORY SURGERY CENTER INC

95 OLD SHORT HILLS ROAD

WEST ORANGE,NJ07052
75-3166377 		INACTIVE NJ 501(C)(3) N/A MMC
 
Yes
 
(20) MONMOUTH MEDICAL CENTER - FACULTY PRACT

100 STATE HIGHWAY 36

WEST LONG BRANCH,NJ07764
22-3357053 		HEALTH SVCS. NJ 501(C)(3) 509(a)(3) MMC
 
Yes
 
(21) MONMOUTH MEDICAL CENTER FOUNDATION

300 SECOND AVENUE

LONG BRANCH,NJ07740
22-2456079 		FUNDRAISING NJ 501(C)(3) 509(a)(1) SBC
 
 
No
(22) MONMOUTH MEDICAL GROUP PC

300 SECOND AVENUE

LONG BRANCH,NJ07740
22-3316007 		HEALTH SVCS. NJ 501(C)(3) 509(a)(2) MMC
 
Yes
 
(23) NBI HEALTH PARTNERS PA

201 LYONS AVENUE

NEWARK,NJ07112
27-1694034 		INACTIVE NJ 501(C)(3) N/A NBI
 
 
No
(24) NEWARK BETH ISRAEL MEDICAL CENTER

201 LYONS AVENUE

NEWARK,NJ07112
22-3452311 		HEALTH SVCS. NJ 501(C)(3) HOSPITAL SBC
 
 
No
(25) SAINT BARNABAS ASSIST LIVING AT LAKEWOOD

77 WILLIAMS STREET

LAKEWOOD,NJ08701
22-3451655 		INACTIVE NJ 501(C)(3) 509(a)(2) CSHG
 
 
No
(26) SAINT BARNABAS BEHAVIORAL HEALTH CENTER

1691 ROUTE 9

TOMS RIVER,NJ08754
22-2977312 		HEALTH SVCS. NJ 501(C)(3) HOSPITAL CSHG
 
 
No
(27) SAINT BARNABAS CORPORATION

95 OLD SHORT HILLS ROAD

WEST ORANGE,NJ07052
22-2405279 		HEALTH SVCS. NJ 501(C)(3) 509(a)(3) NA
 
 
No
(28) SAINT BARNABAS DEVELOPMENT FOUNDATION

95 OLD SHORT HILLS ROAD

WEST ORANGE,NJ07052
22-2378422 		FUNDRAISING NJ 501(C)(3) 509(a)(2) SBHCSRI
 
 
No
(29) SAINT BARNABAS HEALTH CARE SYSTEM FDN

95 OLD SHORT HILLS ROAD

WEST ORANGE,NJ07052
22-3769036 		FUNDRAISING NJ 501(C)(3) 509(a)(1) SBC
 
 
No
(30) SAINT BARNABAS HOSPICE AND PALLIATIVE

95 OLD SHORT HILLS ROAD

WEST ORANGE,NJ07052
22-2354659 		HEALTH SVCS. NJ 501(C)(3) 509(a)(1) SBC
 
 
No
(31) SAINT BARNABAS MEDICAL CENTER

94 OLD SHORT HILLS ROAD

LIVINGSTON,NJ07039
22-1494440 		HEALTH SVCS. NJ 501(C)(3) HOSPITAL SBC
 
 
No
(32) HARVEY E NUSSBAUM MD RESEARCH INST OF SB

94 OLD SHORT HILLS ROAD

LIVINGSTON,NJ07039
22-7146916 		RESEARCH NJ 501(C)(3) 170, BOX 4 SBHCSRI
 
 
No
(33) SAINT BARNABAS OUTPATIENT CENTERS

200 SOUTH ORANGE AVENUE

LIVINGSTON,NJ07039
22-2458479 		HEALTH SVCS. NJ 501(C)(3) 509(A)(2) SBC
 
 
No
(34) SAINT BARNABAS PALLIATIVE CARE PHYS PA

95 OLD SHORT HILLS ROAD

WEST ORANGE,NJ07052
26-2532578 		HEALTH SVCS. NJ 501(C)(3) 509(A)(2) HOSPICE
 
 
No
(35) SAINT BARNABAS PHYSICIAN ASSOCIATES PA

94 OLD SHORT HILLS ROAD

LIVINGSTON,NJ07039
27-1259104 		HEALTH SVCS. NJ 501(C)(3) 509(A)(2) SBMC
 
 
No
(36) SAINT BARNABAS REALTY DEVELOPMENT CORP

94 OLD SHORT HILLS ROAD

LIVINGSTON,NJ07039
22-2940008 		TITLE HLDNG. NJ 501(C)(3) 509(a)(3) SBHCSRI
 
 
No
(37) SBHCS RESEARCH INSTITUTE INC

94 OLD SHORT HILLS ROAD

LIVINGSTON,NJ07039
22-2458481 		HEALTH SVCS. NJ 501(C)(3) 509(a)(3) SBC
 
 
No
(38) THE NEWARK BETH ISRAEL MEDICAL CNTR FDN

201 LYONS AVENUE

NEWARK,NJ07112
22-2587176 		FUNDRAISING NJ 501(C)(3) 509(a)(1) SBC
 
 
No
(39) UNION HOSPITAL

1000 GALLOPING HILL ROAD

UNION,NJ07083
22-1413947 		INACTIVE NJ 501(C)(3) HOSPITAL SBC
 
 
No
(40) SANDY HOOK FRNDS OF ST BARNABAS BURN FDN

94 OLD SHORT HILLS ROAD

LIVINGSTON,NJ07039
22-3236202 		FUNDRAISING NJ 501(C)(3) 509(A)(3) SBC
 
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



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

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




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



 		(k)
Percentage
ownership
Yes No Yes No
(1) INNOVATIVE PURCHASING CONCEPTS

95 OLD SHORT HILLS ROAD
WEST ORANGE,NJ07052
22-3786557 		PURCHASING NJ SBC
  		        No 0   No 10.000 %
(2) KIM-MED ASSOCIATES

300 SECOND AVENUE
LONG BRANCH,NJ07740
22-2775619 		REAL ESTATE NJ KHCA
  		        No 0   No 0 %
(3) SHREWSBRY DIAG IMAG

1131 BROAD ST BLDG B STE 110
SHREWSBURY,NJ07702
20-3833246 		RADIOLOGY SVC NJ MMC
  		        No 0   No 51.000 %








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



 		(b)
Primary activity



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


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

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership
(1) LSC HOLDING COMPANY INC
1 CRAGWOOD ROAD SUITE 3D
SOUTH PLAINFIELD,NJ07080
22-3569598 		HOLDING CO. NJ NA
  		C CORP.      
(2) LIVINGSTON SERVICES CORP
1 CRAGWOOD ROAD SUITE 3D
SOUTH PLAINFIELD,NJ07080
22-2465402 		HEALTHCARE SVCS. NJ NA
  		C CORP.      
(3) ACC PHARMACY INC
1 CRAGWOOD ROAD SUITE 3D
SOUTH PLAINFIELD,NJ07080
22-3555334 		PHARMACY SVCS. NJ NA
  		C CORP.      
(4) LIVINGSTON INFUSION CARE INC
1 CRAGWOOD ROAD SUITE 3D
SOUTH PLAINFIELD,NJ07080
22-3190756 		HEALTHCARE SVCS. NJ NA
  		C CORP.      
(5) MAJOR SECURITY SERVICES INC
1 CRAGWOOD ROAD SUITE 3D
SOUTH PLAINFIELD,NJ07080
22-3040539 		SECURITY SVCS. NJ NA
  		C CORP.      
(6) MEDICAL CTR HEALTH CARE SVCS
1 CRAGWOOD ROAD SUITE 3D
SOUTH PLAINFIELD,NJ07080
22-3011742 		HEALTHCARE SVCS. NJ NA
  		C CORP.      
(7) CENTER STATE HEALTH SVCS
1 CRAGWOOD ROAD SUITE 3D
SOUTH PLAINFIELD,NJ07080
22-2592293 		HEALTHCARE SVCS. NJ NA
  		C CORP.      
(8) CENTER STATE MANAGEMENT CORP
300 SECOND AVENUE
LONG BRANCH,NJ07740
22-2506125 		MGMT SVCS. NJ NA
  		C CORP.      
(9) CENTER STATE COLLECTION SVCS
2 CRESCENT PLACE
OCEANPORT,NJ07757
22-2629075 		COLLECTION SVCS. NJ NA
  		C CORP.      
(10) COMMUNITY KARE INC
1 CRAGWOOD ROAD SUITE 3D
SOUTH PLAINFIELD,NJ07080
22-2993840 		HEALTHCARE SVCS. NJ NA
  		C CORP.      
(11) KIMBALL HLTH CARE AFFILIATES
300 SECOND AVENUE
LONG BRANCH,NJ07740
22-2701213 		INVESTMENT NJ NA
  		C CORP.      
(12) HEALTH CARE FACILITIES MGT
1 CRAGWOOD ROAD SUITE 3D
SOUTH PLAINFIELD,NJ07080
22-3532988 		MAINT. SVCS. NJ NA
  		C CORP.      
(13) PREMIUM HEALTH SYSTEMS INC
ONE FRANKLIN AVENUE
BELLEVILLE,NJ07109
22-2779395 		HEALTHCARE SVCS. NJ NA
  		C CORP.      
(14) SBC MANAGEMENT CORPORATION
95 OLD SHORT HILLS ROAD
WEST ORANGE,NJ07052
22-3414332 		MGMT SVCS. NJ NA
  		C CORP.      
(15) PROFESSIONAL QUALITY LIAB
100 BANK STREET
BURLINGTON,VT05401
20-5163819 		INSURANCE SVCS. NJ NA
  		C CORP.      
(16) NJ HEALTH CARE SYSTEM INC
94 OLD SHORT HILLS ROAD
LIVINGSTON,NJ07039
22-3536986 		INACTIVE NJ NA
  		C CORP.      
(17) CPIC
44 CHURCH STREET
HAMILTON,BERMUDAHM11
BD
FINANCIAL VEHICLE BD NA
  		FOREIGN CORP.      
(18) LSC PHARMACY SERVICES INC
95 old short hills road
west orange,NJ07052
45-2552776 		pharmacy svcs. NJ na
  		c corp.      
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1)
(2)
(3)
(4)
(5)
(6)
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(e)
Are all
partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


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