Attach to Form 990 or Form 990-EZ.
See separate instructions.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) | (iv) Is the organization in col. (i) listed in your governing document? | (v) Did you notify the organization in col. (i) of your support? | (vi) Is the organization in col. (i) organized in the U.S.? | (vii) Amount of monetary support | |||
|---|---|---|---|---|---|---|---|---|---|
| Yes | No | Yes | No | Yes | No | ||||
| Total | |||||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2009 | (b) 2010 | (c) 2011 | (d) 2012 | (e) 2013 | (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. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2009 | (b) 2010 | (c) 2011 | (d) 2012 | (e) 2013 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.).. | ||||||
| 11 | Total support (Add lines 7 through 10). | ||||||






Calendar year (or fiscal year beginning in) ![]() |
(a) 2009 | (b) 2010 | (c) 2011 | (d) 2012 | (e) 2013 | (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.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2009 | (b) 2010 | (c) 2011 | (d) 2012 | (e) 2013 | (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.).. | ||||||




| Facts And Circumstances Test |
|---|
| Explanation |
|---|
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS | Background ========== Children's Specialized Hospital ("CSH"), an affiliate member of the Robert Wood Johnson Health System, is a not for-profit licensed comprehensive pediatric rehabilitation hospital which operates two pediatric long-term care facilities. CSH also operates a licensed pediatric medical day care and a pediatric practice for children with disabilities. CSH has been providing services to the children of New Jersey and surrounding states for 123 years. Our talented and caring staff provides a wide array of medical, developmental, educational and rehabilitative services for infants, children, adolescents, and young adults. CSH's healthcare professionals are committed to providing expert and compassionate care to children with chronic illnesses and disabilities. Evaluation and treatment is available for a variety of rehabilitation needs, including, but not limited to, brain injuries, spinal cord dysfunction, respiratory issues, autism, orthopedic problems, sports injuries, learning disabilities, language or hearing problems, developmental delays, and behavior or attention problems at home or in school. Comprehensive, coordinated care is provided for children with chronic illnesses and disabilities who may have multiple and complex therapy needs. Charitable purposes, charity care and community activities ========================================================== CSH provides healthcare services to all children in the tri-state area who can benefit from rehabilitative care in a non-discriminatory manner regardless of ability to pay. CSH provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates, and maintains records to identify and monitor the level of charity care it provides. These records include the amount of charges forgone for services and supplies furnished under its charity care policy. CSH does not pursue collection of amounts determined to qualify as charity care; therefore, these amounts are not reported as net patient service revenue. CSH does not receive any distribution of federal or state subsidies for charity care services rendered. Accreditations ============== CSH is accredited by the Joint Commission of Accreditation of Healthcare Organizations. Mission Statement ================= The mission of Children's Specialized Hospital is to be the preeminent provider of specialized healthcare services for infants, children and young adults. Children's Specialized Hospital Corporate Values ================================================ The values of CSH are compassion, integrity, excellence, fun, innovation, and teamwork. Compassion: We will provide a loving, caring environment for the children, families, and each other. Integrity: We are committed to organizational and financial accountability, transparency, respect for all and ethical practices. Excellence: We will be the best at our jobs and provide the highest quality care to our children, constantly striving to improve and be the best. Fun: We will provide a child-friendly environment. If we have fun doing our jobs, it will reflect in how we deal with the children and each other. Innovation: We will be creative in providing care and problem solving. Teamwork: CSH is a team where every person is needed to provide the quality care for which we are known. We must work together to be successful. Patient-and-Family-Centered Care and Children's Specialized Hospital ================================================================== Patient-and-Family Centered Care is an approach to healthcare that shapes healthcare policies, programs, facility design, and day-to-day interactions among patients' families, physicians and other healthcare professionals. Healthcare professionals who practice Patient-and-Family Centered Care recognize the vital role that families play in ensuring the health and well-being of children and family members of all ages. These practitioners acknowledge that emotional, social and developmental supports are integral components of healthcare. They respect each child and family's innate strengths and view the healthcare experience as an opportunity to build on these strengths, and support families in their care-giving and decision-making roles. A patient-and-family centered approach leads to better health outcomes and wiser allocations of resources, as well as greater patient and family satisfaction. Patient-and-Family Centered Care in pediatrics is based on the understanding that the family is the child's primary source of strength and support, and that the child's and family's perspectives and information are important in clinical decision making. Patient-and-family centered practitioners are keenly aware that healthcare experiences can enhance parents' confidence in their roles and, over time, increase the competence of children and young adults to take responsibility for their own healthcare, particularly in anticipation of the transition to adult service systems. Patient-and-Family-Centered Care is grounded in collaboration among patients, families, and all hospital personnel for the planning, delivery, and evaluation of the delivery of healthcare to the children we serve, as well as in the education of healthcare workers. Continuing our goal to be recognized as a center of excellence in pediatric care, CSH is committed to the integration of Patient-and-Family-Centered Care principles into our healthcare policies and practices across the continuum of care provided by our institution. In placing the needs of the child and family at the center of all activities, we will fulfill our mission and embody the values of Patient-and-Family-Centered Care at CSH by: Respecting each child and his or her family as partners in care; Honoring diversity and its effect on the family's experience and the perception of care through recognizing that each family is unique in their structure, values, culture, ethnicity, orientation, spiritual beliefs, social-economics, educational, and geographic diversity; Building on the strengths of each child and family, even in difficult and challenging situations, by acknowledging each family's priorities and level of expertise; Recognizing and respecting different methods of coping; Implementing comprehensive services that provide developmental, educational, emotional, environmental, and financial supports; Supporting and facilitating choice for the child and family about approaches to care and support; Ensuring flexibility in organizational policies, procedures and provider practices to reflect diversity and meet the needs, beliefs, personalities, life experiences, spiritual and cultural values of each child and family; Providing formal and informal support for each child and family - collaborating with families at all levels of healthcare, in the care of the individual child and in professional education, policy making and program development, through the exchange of honest and unbiased information on an ongoing basis and in ways that are useful and affirming; Empowering children and families to discover their own strengths, build confidence and make choices and decisions about their health through the creation of true partnerships with healthcare professionals, and; Working with local communities, schools and health officials to ensure that community services and support systems for children and their families are flexible, accessible and comprehensive. |
| CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS | CSH maintains inpatient programs for brain injury, spinal cord dysfunction, infants and toddlers with prematurity and birth related disorders, chronic illness, and general rehabilitation. Outpatient programs exist at varying levels of development including the autism program and the comprehensive feeding program. Services include physician sub-specialty care, physical, occupational and speech therapies, as well as psychology. These are just a few of our many programs and specialty service areas that combine cutting-edge technology with clinical expertise and compassionate care in a patient-and-family-centered environment at facilities in New Brunswick, Mountainside, Toms River, Fanwood, Hamilton, Bayonne, Clifton, Roselle Park, Newark and Egg Harbor. Additionally, CSH's staff provides expertise at various schools, centers, and programs for children with special needs throughout New Jersey. Programs and services information ================================= Inpatient Programs ------------------ Inpatient services are licensed for 90 pediatric rehabilitation beds, 60 of which are in operation. Eight additional beds were approved which should be operational in the summer of 2014, and 72 pediatric long-term care beds are licensed. Inpatient rehabilitation care provided includes medical and nursing care, comprehensive therapy services, psychological and neuropsychological services, academics, social services, and nutritional services. Included in the therapy services are physical therapy, hydrotherapy, rehabilitation technology, augmentative communication, occupational therapy, activities of daily living, speech and hearing, respiratory therapy, recreational therapy and child life. These CSH services are provided to help the children attain their greatest potential - medically, socially, academically, and emotionally. Their families are provided with support and educational services to ensure their child can return to their home and community. Our long term care centers, located in Mountainside and Toms River, NJ, are Special Care Nursing Facilities providing 24 hour nursing care to the medically involved patient. We have 46 beds in Mountainside and 26 in Toms River. Our long term care patients receive respiratory and nutritional services, physical, speech and occupational therapies, as well as recreational and child life services. Some of the patients attend an on-site school while others are transported to community schools. Brain Injury ------------ Helping a child recover from a brain injury presents complex challenges. While the child needs help in recovering from his injuries, he also is still developing physically, emotionally, and intellectually. The Brain Injury Program at CSH meets these challenges and the unique needs of children by providing innovative, expert and loving care for the patient with a brain injury on his or her road to independence. The Brain Injury Program, which was established in 1981, is designed to meet the needs of brain-injured, age appropriate patients at all levels of cognitive awareness. The rehabilitation process is the foundation for long term recovery. Children are best treated by pediatric specialists in an environment especially geared to their needs. CSH provides specialized care for each child's unique needs during their recovery in a comprehensive medical and rehabilitation setting. A full continuum of care from coma to re-entry to the community is provided for each child. The Brain Injury Program is geared toward maximal progress through rehabilitation while emphasizing the achievement of normal pediatric developmental milestones. CSH's professional staff, who are experienced with brain injuries and the developmental needs of children, incorporate each child and family within the rehabilitation team to encourage optimal progress. Each child's individualized program focuses on their medical, physical, cognitive, and psychosocial needs. In addition to individual therapy, group therapy provides comprehensive structured stimulation sessions for patients in order to enhance and accelerate arousal, alertness, orientation, and socialization. The brain injury program addresses: - medical management - specialized nursing care - physical therapy - occupational therapy - speech therapy - auditory evaluation - cognitive status - nutritional status - family support - case management - psychological status - cortical functioning - re-entry to home, school, and community Spinal Cord Program ------------------- The Spinal Cord Program provides intensive and comprehensive rehabilitation services for children and adolescents with acquired and congenital spinal cord problems. The program treats patients with all levels of pediatric spinal cord dysfunction, from the child dependent on a ventilator to the individual with the lowest level of spinal cord injury. Patients are provided with an aggressive rehabilitation treatment program coupled with comprehensive medical and nursing care. The program's team approach results in a coordinated treatment plan designed to meet the complex needs of each patient and his or her family. While an emphasis is placed on achieving normal developmental milestones, the treatment plan takes into account the patient's level of injury, age, and developmental abilities in creating realistic expectations for performing activities. The team is adept at developing treatment plans to accommodate patients with high spinal cord injuries (tetraplegia; quadraplegia) who require a tremendous amount of support, special equipment, and ventilator assistance, as well as those patients with low level spinal cord injuries (paraplegia) who can gain virtual independence. Intensive medical needs can be safely accommodated at CSH by virtue of the extensive medical coverage provided to the patients. Patients with tracheostomies, special feeding needs, and intravenous and central lines, for example, can be managed while receiving the necessary rehabilitation therapy. Families and patients are integrally involved in the comprehensive treatment planning. Families and patients also receive instruction from the staff in overall care and the use of special equipment. The team thoroughly educates the patient and his or her family regarding the physical consequences of a spinal cord injury and the required care and treatment. Some of the diagnostic and special services available to patients in the Spinal Cord Program include: - electrodiagnostic testing - ventilator assistance program - referral for evaluation for diaphragmatic pacing - a full range of diagnostic urologic testing - referral for baclofen pump placement - orthotics and prosthetics - rehabilitation technology services including: - seating and positioning - mobility and environmental access - augmentative and alternative communication - computer access General Rehabilitation Program ------------------------------ The General Rehabilitation Program at CSH offers habilitative and rehabilitative services to patients aged 0-21 with, but not limited to, neurologic, orthopedic, developmental, cardiopulmonary disorders and/or other acquired injuries and illnesses, through an interdisciplinary team approach. The program provides assessment, treatment, and/or support to the patient and family from the acute inpatient phase of rehabilitation through the community, vocational, and educational re-entry phase. In order to offer a continuum of comprehensive trans-disciplinary service to these children and their families, in a compassionate, professional and holistic fashion, services are provided through both inpatient and outpatient phases of rehabilitative care. |
| CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS | Patients admitted to the program are required to meet the following criteria regarding their medical stability: initial diagnostic and surgical procedures must be completed; medication regimen, fluid and electrolyte balance, and life support services must be stabilized. The patients served may have impairments in areas including those of cognition, mobility, self-care, communication, social emotional functioning, sensory processing, academic functioning, and feeding. The program addresses the behavioral, functional, physical, cognitive, psychosocial, vocational, educational, leisure, and recreational needs of each patient. Every effort is made to accommodate the patient and family's unique cultural and spiritual needs. The goal of the program is to reduce the barriers which limit a child's ability to participate in developmentally appropriate activities of his or her life. To facilitate a smooth transition and optimize the patient's ability to fully integrate into the community, outreach and education are provided to the intended discharge environment (e.g. school, home, community organizations). In addition, patients are provided developmentally appropriate life skills' training through group and individual therapy as well as community out-trips. Some children and adolescents seen through these programs require intensive medical, nursing, and respiratory therapy support for respiratory problems. These children may have congenital or acquired respiratory problems including bronchopulmonary dysplasia, congenital muscular problems, as well as congenital and acquired airway and respiratory abnormalities. Infant/Toddler program ---------------------- The Infant/Toddler program provides intensive and comprehensive rehabilitation services for infants and young children with medical difficulties related to prematurity and a range of disorders presenting at birth. The program treats children who require all levels of neonatal care. Patients are treated with a comprehensive, therapeutic program, coupled with excellent medical and nursing care. Because of this team approach, a coordinated treatment plan can be designed to meet the complex needs of each patient and his or her family. While emphasizing age-appropriate skills, the team customizes goals based on each infant's or toddler's medical stability, age, and developmental level to maximize his or her unique potential. The multispecialty staff is highly trained in working with these children who require special equipment and ventilator assistance. The team uses special techniques to encourage the child's interaction with the environment during therapy sessions. We are able to offer this specialized treatment because our staff is committed to pursuing on-going education and training in state-of-the-art techniques that are necessary to treat this special population. Those infant and toddler patients who need special medical care can be safely accommodated with CSH's extensive medical coverage. These patients may be tracheostomy dependent, oxygen dependent, or ventilator dependent, requiring close monitoring and frequent changes in management. These patients, as well as those infants and toddlers with special feeding needs, intravenous and central lines, can be managed while receiving rehabilitation therapy. Family involvement is vital to a child's overall development. We strongly encourage family participation in treatment sessions. Our team instructs families in caring for their children and using special equipment. Families learn about therapeutic interventions that promote growth and development. Infant/Toddler medical specialties: A neonatologist/pediatrician, a physician who specializes in neonatal care and pediatrics, heads the Infant/Toddler Program team. Other multidisciplinary pediatric professionals provide medical support, rehabilitation services, and address developmental needs while aiming toward maximizing respiratory independence. While upon admission many of the children require intensive respiratory care, the goal for each is to be transitioned back to his or her home and community. Other medical specialists for the Infant/Toddler program are also available for consultation: - Ear, nose, and throat - Neurology - Ophthalmology - Orthopedics - Physiatry - Radiology - Urology Chronic Pain Management Program ------------------------------- The Chronic Pain Program at Children's Specialized Hospital promotes the wellness of children and adolescents ages 11-21 years old, with chronic pain, by teaching strategies to manage pain and encourage functional activity. The inpatient Chronic Pain Management Program at Children's Specialized Hospital is typically for children and adolescents with chronic pain who continue to have significant pain and difficulties with daily functions despite trials of consistent outpatient therapies. This evidence-based program is typically a four week period, with focus on regaining function and using one's body in normal way. The approach to treatment of chronic pain at Children's Specialized Hospital includes intense physical and occupational therapy and integrated exposure to mental health intervention. Our specialized team focuses on treating Chronic Regional Pain Syndrome (CRPS) and related forms of amplified pain such as: - Fibromyalgia - Amplified Musculoskeletal Pain Syndrome (AMPS) - Reflex Sympathetic Dystrophy (RSD) - Reflex Neuropathic Dystrophy (RND) Chronic Illness Management Program ---------------------------------- The Chronic Illness Management Program at Children's Specialized Hospital is a comprehensive inpatient program for adolescents ages 13-21 who struggle to manage their condition. It provides the teen and family with a structured, comprehensive treatment plan to address medical, nutritional, psychological, and family communication issues. Since parents and caregivers have a crucial role in supporting their child's health, we encourage parent/caregiver participation in medical education, nutritional and psychological counseling sessions to ensure the greatest success. The program is typically a four week program that follows a transdisciplinary model and behavioral approach to care, addressing the physical, emotional, and psycho-social needs of each patient. The goal for each adolescent is always to improve self-management of the disease. The Chronic Illness Management Program is especially for adolescents with conditions such as, but not limited to: - Diabetes - Post-organ transplant - Chronic respiratory disease Outpatient Programs and Services ------------------------------- CSH provides a number of outpatient services related to pediatric rehabilitation and education. Outpatient programs offered by CSH include services in assessment and therapy from pediatric medical specialists and sub-specialists, as well as various therapy departments. In addition, the following specialty programs and clinics are offered: orthopedics, neurology, physiatry, psychiatry and developmental pediatrics. In addition we provide a pediatric practice for special needs children. The Medical Daycare and the Early Intervention ("EIP") Programs are designed to meet the educational, therapeutic, social, and emotional needs of children, from birth to age five, with physical handicaps or developmental delays. The EIP program is funded by a fee schedule from the State of New Jersey and the federal government. Primary Care Practice --------------------- At Primary Care Pediatrics, we are proud to provide outstanding, family-centered care for children with special health care needs and their siblings. At Primary Care Pediatrics, our goal is for every child to reach his or her full potential. We employ a team-based approach to the healthcare. Our staff, nurses, doctors and care coordinators work together to meet the needs of our special patients. We strive to be the medical home, or center, of patient's care. Our care coordinators and medical staff help patients and families navigate through the health care system and educational system. We help patients and families interact with community organizations, insurance companies, specialists, therapists, and pharmacies while advocating for our patients along the way. |
| CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS | Our team at Primary Care Pediatrics consists of doctors, nurses, care coordinators, social workers, patient care techs, office coordinators, an insurance liaison and family faculty. Family faculty members are a patient or her full potential. We emplhildren's Specialized Hospital and helps advocate for our patients' and families. The team is experienced in caring for children with special needs. We take care of children affected by cerebral palsy, Down syndrome, prematurity, autism, technology dependence, uncommon medical conditions and many other special healthcare needs. We respect the great privilege it is to care for our patients and families. Various community events and outpatient programs and services are offered by CSH. Listed below is a brief list of events and programs: - Children's Regional Swim Meet for athletes with a physical disability - Guppies I and II (aquatics) - Sharks I and II (aquatics) - Interactive oral sensory - motor therapy in autism - Pediatric Traumatic Brain Injury - The Journey - Children's Invitational Track and Field Meet for athletes with a physical disability - Constraint reduced intensive therapy program - Day Camp - Pals Paradise - Overnight Camp - Camp Chatterbox - Neuro-rehabilitation Program - Pediatric Practice - Spinal Cord From A to Z - Chronic Illness Program - Autism Symposium - Hear From the Experts - Parent Resource Center - Toys-to-Go Program - "Lightning Wheels" wheelchair & ambulatory sports team for those with physical disabilities ages 5 - 22 years - "Friday Night Fever" - Mountainside and Toms River - social group for teens - Community special needs loaner car seat program - Safekids Union County Coordinator - Safekids Middlesex County - Child passenger safety program for inpatients and long term care The Autism Program ------------------ The Autism Program at CSH works with children up to 21 years of age who have an autism spectrum disorder. The program is dedicated to improving the lives of children, adolescents and families with autism spectrum disorders by providing comprehensive evaluations, treatment, community education and research. We are one of the few programs in New Jersey to provide coordinated, multidisciplinary care for children, adolescents and families affected by an autism spectrum disorder. We offer workshops in English and Spanish for families newly diagnosed with autism, as well as a comprehensive symposium where families have the opportunity to meet with the experts and interact with other families. As part of our outreach programs, we provide autism screening/diagnosis to six underserved areas in New Jersey, as well as, educational programs for schools and community organizations and groups. Comprehensive Feeding Program ----------------------------- The Comprehensive Feeding Program is an outpatient program that serves infants, toddlers, and young children who are unable or refuse to maintain an adequate oral intake of food. Problems may be medical/physiological, developmental, behavioral, psychosocial, and individual or family related. This team utilizes a multi-disciplinary approach to have children eat proper foods and improve nutritional standing. Based on a predicted incidence of 25% of infants and young children with feeding problems, there are thousands of children who can benefit from this service. Each child is provided with a comprehensive evaluation that covers medical, physiological, developmental, behavioral, and psychosocial issues. The team combines the expertise of a multidisciplinary team of professionals whose primary goal is to establish feeding patterns that can be maintained in the child's natural environment. The team includes the following: - Speech Pathologist - Child Psychologist - Pediatric Dietitian - Developmental Pediatrician - Occupational Therapist - Physical Therapist - Patient Care Coordinator The program and its team members empower parents and caregivers by providing knowledge and techniques which will allow them to engage their child in positive therapeutic feeding experiences and interactions. The program also provides support and knowledge to other professionals in the community, such as childcare providers, who participate in the child's feeding experiences. AD/HD ---- CSH is a service provider dedicated to improving the lives of children and adolescents with Attention-Deficit Hyperactivity Disorder (AD/HD) and associated disabilities. At CSH we offer comprehensive services for children with AD/HD, including a full range of evaluation and treatment options best tailored for the individual child and family. Neuro-rehabilitation -------------------- An outpatient component of the Brain Injury Program is the Neuro-Rehabilitation Program. The Neuro-Rehabilitation Group Program is an intensive treatment program for children and adolescents who have sustained a traumatic brain injury, or who are experiencing cognitive dysfunction as a result of neurological or other chronic illness. This family-centered program provides therapeutic interventions designed to help children and adolescents regain cognitive skills and learn compensatory strategies that are needed for school and social functioning. The program also addresses motor impairments that may accompany acquired brain injury or illness. The program is delivered primarily in small group settings. Individual physical, occupational, and speech therapies may also be provided as indicated. Involvement in the group program prepares the youngster for return to a larger group setting, usually school, and provides him or her with improved skills for peer interaction and socialization. Children may also be seen in an individual Neuro-Rehabilitation Program. Children in the individual program are presently involved in school and community activities, but require additional intervention to better regain or develop compensatory skills to improve or maintain age appropriate ways of thinking and behaving. Professional Training and Research ---------------------------------- CSH is committed to providing an educational setting and research initiatives which will lead to continuous advancement in professional knowledge and skills for professionals pursuing careers or expertise in pediatric rehabilitation, as well as advancements in knowledge and best practices for the populations we serve. CSH provides clinical training and experience in the field of pediatric rehabilitation and care of the disabled child for resident physicians in the areas of pediatrics and physiatry through schools, which affiliate with the hospital. In addition, the hospital trains fellows, nurses, and therapists enrolled in schools and colleges that are also affiliated with the hospital. To advance the state of pediatric rehabilitation, Children's Specialized also conducts and subsidizes programs and seminars to educate interested healthcare professionals. Accessibility Plan ================== Each year, CSH looks at how to improve access to care and the community for our patients and families. We review any barriers that may exist and how to best remove them. Our approach and outcomes are outlined below: Review plan for promoting accessibility to organization-wide services for persons served, personnel & other stakeholders. Identify & remove potential barriers to our programs & services for persons served, personnel & other stakeholders. Identify & remove existing barriers and make programs and services accessible for persons served, personnel & other stakeholders as solicited & identified through an annual accessibility survey, and monthly environment of care rounds. Initiate and implement necessary steps to decrease or remove identified barrier(s) for persons served, personnel & other stakeholders with a specified timeline. The opening of additional sites in Newark and Egg Harbor, where we provide physician services, physical, occupational and speech therapies, has made our renowned care more convenient and accessible to New Jersey's children. Integration: advocacy & education to eliminate & reduce barriers in the communities of persons served. Provide a review mechanism for "reasonable accommodation" requests made by persons served and/or personnel. On an annual basis, hospital leadership reviews the plan for promoting accessibility to organization-wide services for persons served and potential persons served, as well as the findings from the annual accessibility survey that is conducted by a rehabilitation professional & a person served. This review takes place at the hospital's Environment of Care, Operations & PI Steering Committee(s). Communication and follow through is done within the existing hospital-wide performance improvement structure. Provide a review mechanism for "reasonable accommodation" requests made by persons served and/or personnel. |
| CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS | In 2013 we provided $1,145,000 of charity care charges to patients. In 2013, we provided medical education to physical medicine and rehabilitation residents from Rutgers University and with expenses versus total receipts for CHGME, we realized a shortfall of approximately $596,000. In 2013, CSH provided approximately $41,000 in housing to students in the disciplines of physical, occupational and speech therapies during their clinical training which ranged from 2 - 16 weeks. We are in the final year of a $150,000 grant from Autism Speaks which was for a three year research project. The name of the project is "Sensory Based Strategies for Improving Adaptive Behaviors in Children with Autism". Positive gain from operations, positive bottom line, raise 100% funds for new outpatient sites. Implemented Meditech which will improve consistency and timeliness of documentation, leading to correct reimbursement. Coding issues for the NPSY evaluations were resolved. NPSY CPT Codes were reconfigured according to CMS recommendations. Evaluations for 2008 up until the recoding took place in 6/09 were rebilled. The Meditech system has improved consistency and timeliness of all documentation in the medical record. Developed the tool to track billable time and census for all services. Through our foundation, CSH received $380k from Kohl's to be used to run programs for the community through Kohl's Cares Programs such as Aquatics, Friday Night Fever, Autism Community Outreach ($90k of total) Community Carnivals, including educational pieces, and Children's Lightning Wheels, the hospital's sports team for ages 5 - 22. Secured funding to cover costs of functional behavior assessment/consultation service, began (with medical) year 2 of a $1 million Clinical Expansion Grant from the Governor's Council on Medical Research and Treatment of Autism. Neuropsychology and neurorehabilitation exceeded group annual census budgeted projections. Achieved a favorable expense variance for all departments/programs combined. Eliminated the on-line enrollment process for the Autism Program which resulted in $22,000 in cost savings. Instituted on-line registration process where families can schedule an appointment on line. Upgraded Meditech application to version 5.65 to support the requirements of the American Recovery & Reinvestment Act and to meet the regulations of the electronic health record (EHR). Accounts receivable balances have been reduced since the implementation of Meditech. Total days in accounts receivable reduced by approximately 7 days by year end 2010. Over-one-year receivable dollars decreased approximately $4,500,000 since the end of 2010. Children's Specialized Hospital is the first hospital in New Jersey tested for Medicaid incentive funding for the use of a certified electronic health record. Installed an automated insurance verification system that works in conjunction with the Meditech software for improved registration process. Major build of various files that work in conjunction with the clinical modules that allow for proper billing and coding, and improved processes for notification to the therapist upon arrival of the patient via a smart board. All Children's facilities were upgraded to enable wireless communications for clinicians' use of mini laptops to document and charge during sessions. Managed the hospital's cash flow to internally maintain a fund consisting of one year of principal and interest payments on the bond payments, approximating $3.6 million, while having no draw downs on the hospital's line of credit with TD Bank. Cash collections increased by 7% over 2012 with 7 months exceeding expectation. Met all annual and quarterly reporting requirements related to our bond issue and was in full compliance with the required financial covenants in each quarter. Received notification re-affirming our bond rating with both Moody's and Fitch ratings in the 4th quarter of 2012. Conducted organizational-wide education programs for improving chart documentation, selecting proper coding for billing and compliance of all HIPAA regulations. Completed the 2014 operating and capital budget promptly for board approval in December. Developed in-house "flex pool" to staff temporary vacancies which resulted in $10,059 in cost savings. Communication: -------------- Promote full program and service access for persons served by respecting ethno-cultural diversity. Ensure that language & cultural differences are not barriers to accessing & participating in hospital programs (i.e. translation services are available & other communication resources). Measure: communication service access for persons served Data source: contracts for verbal and written translation to promote communication & administrative policy on meeting communication needs. Transportation: --------------- Provide transportation services as needed through the Patient Care Coordination Department. Measure: make available transportation access for persons served Data source: Patient Care Coordination Department Listing 2013 findings: no barriers identified. Admission to hospital program: ------------------------------ Grant admission to program services & activities to those with an identified need that is validated by meeting pre-established admission criteria/screening. Measure: patient referrals that meet pre-established admission criteria/screening are offered relevant services/admission Data source: Pre-Admission Department Log. 2013 findings: 100% of all admissions meeting criteria/screening are offered admission. If patient not offered admission, appropriate referrals made. Employment: ----------- Recruit qualified employees with "reasonable accommodations" for persons with activity limitations in order to promote equal employment/participation opportunities throughout all organizational levels. Measure: adherence to state/federal regulations re: employment without regard to activity limitations, race, color, national origin or age & participate in community efforts to promote opportunities for persons with activity limitations Data source: Human Resources Department Files. 2013 findings: 100% of all job applicants followed "standard" procedures for employment application process and ongoing employment. Other: ------ Remain actively involved in committees at the local, state & national level where policies, regulations and program planning impact pediatric services & their accessibility & delivery. Measure: continued Children's presence at local, state, federal level program planning re: service delivery for persons served, acting as an advocate for persons served. Members of Family - and - Patient Centered Care along with the President & CEO traveled to Washington, D.C. to meet with legislatures with regard to insurance coverage for individuals with disabilities. Data source: advocacy activities. 2013 findings: several advocacy activities for persons served. |
| CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS | Leadership ---------- - New York Magazine - top children's hospital ranking. - Hospital staff, senior leadership board representation on The Alliance for the Betterment of Citizens with Disabilities (ABCD). Involved with advocating for Early Intervention through this organization. - leadership serves on the Mayor's Advisory Council on behalf of children and young adults with developmental disabilities in the Township of Dover. - CEO serves on Children's Hospital Association National Board of Directors and serves as Secretary - CEO serves on NJ State Chamber of Commerce Board of Directors and serves as First Vice chair - NJ Life - Doctors Who Make a Difference - NJBIZ - Healthcare Heroes - Doctor of the Year - CEO Chair for the NJ Chamber a workgroup on employment of people with disabilities. - CEO, CDO, VP Human Resources and VP of Outpatient Services are graduates of Leadership NJ - EVP and COO is a member of the State Interagency Coordinating Council which oversees the delivery of early intervention services throughout the state. Members are appointed by the Governor. - VP Business & Program Development serves as Chair for the International Pediatric Rehabilitation Collaborative (IPRC), an international consortium of forty organizations with a mission to promote quality pediatric rehabilitation care - NJ Life - Best Doctor - Pediatric Developmental & Behavior Problems - Top Doctor - NJ - Castle Connelly - NJ Life Best Doctor - General Neurology - NJ Life - Best Doctor - Pediatric Physical Medicine & Rehabilitation - Modern Healthcare - largest skilled nursing company - residency, intern, student, and fellow programs for administration, medicine, nursing, pharmacy, therapies. - partnership with the Education Supervisor from The Commission of Special Education to coordinate educational and clinical rehabilitation services to ensure positive transitions to school and community. - Presidential appointee on the Interagency Autism Coordinating Council that sets the national strategic plan for the conduct of & support for autism research. - appointed to the Traumatic Brain Injury Task Force - donated equipment to the United Spinal Organization that helps distribute adaptive equipment to the needy and third world countries. - member, New Jersey Hospital Association (NJHA). - NJHA Rehabilitation Advisory Committee - Clinical Advisory Board for Sunrise Medical - advocate for change in housing with area realtors as well as section 8 housing for other families. - clinical consortium for rehabilitation technology with area hospitals, clinics and developmental centers. - Past President of the NJ Chapter of the American Academy of Pediatrics. - Board Member, New Jersey's Pediatric Council on Research and Education (PCORE) and New Jersey AAP Chapter. - National Institute on Disability and Rehabilitation Research (NJDRR) Grant with New Jersey Institute of Technology. - Medicaid physician group meetings to ensure understanding of rehabilitation technology services and equipment. - NASW-NJ Conference Committee. - Top Docs named by New Jersey Monthly. - Union County CIACC - Advisory Board for Ocean Inc. - Head Start - Ocean County YMCA - CEO, family and patient representatives presented on Capitol Hill with CHA - targeted Early Intervention Program evaluation team for Mercer County, NJ. - representation on the Division of Developmental Disabilities Committee that make recommendations to the State of NJ and federal government with regard to the idea and how laws impact children we serve. - serve on the Advocacy and Public Affairs Committee to the Brain Injury Association of New Jersey (BIANJ). - NJ Special Education & Brain Injury Task Force - member of the Governor's Commission on Recreational Opportunities for Individuals with Disabilities. - members of the Child and Adolescent Task Force of the BIANJ. - Children's Mental Health Evidence Based Practice Committee sponsored by FACT - psychology staff are members of various groups including Asperger Syndrome Education Network (ASPEN) and Center for Outreach and Services for the Autism Community (COSAC). - community agency representative to Scotch Plains-Fanwood schools as part of their self-monitoring for NJ Dept of Education. - service on Mercer County Professional Advisory Committee. - President New Jersey Neuropsychological Society. - Treasurer of the New Jersey Neuropsychological Society. - Board member of the New Jersey Neuropsychological Society. - National task force member for Family-Centered Care survey initiative. - partnered with COSAC to provide education and support services to families of children with autism. - Somerset & Hunterdon Psychological Association - Executive Board - Chair Waterworks Conservancy - Board of Ethics - Life Time Support Division of ARC - guardianship & advocacy for young adults & adults with disabilities - member of the Grants Review committee for NJDRR. - "Bridges" program to help children transition back to school. - family faculty a part of organization wide work groups and committees, as well as supports for families on inpatient units. - Lightning Wheels - international representation for our wheelchair & ambulatory sports team. - Meet Director for Invitational Track & Field Meet for athletes ages 5 - 22 with a physical disability - Chair - Union County Healthcare Emergency Management Committee - member NJHA Emergency Management Constituency Group - member Middlesex County OEM, Public Health & Hospitals Committee. - Meet Director for Tri-State Swim Meet for athletes ages 5 to adult with a physical disability - member NJ Central East North ASPR Grant Committee - member NJHA Advisory Committee for "weathering the storm" - expanded outreach to the Spanish speaking community through education on Spanish language television, radio stations and newspapers. - effect of yoga for children with Autism Spectrum Disorders - professor - Union County College PTA Program. - member Council of Hospital PT Directors. - member - APTANJ Practice Committee. - staff are members of APTA, AOTA, ASHA and APA. - Safe Kids Middlesex County member. - Secretary APTA section on pediatrics hospital based special interest group. - National Institute of Health Research Program examining regression in autism. - medication trials research - autism. - representation on the Board of COSAC. - Best Practices Taskforce - Autism, American Speech and Hearing Association (ASHA). - facilitated closure of the NJ Recycling Program for adaptive equipment program. - member, Education and Training Committee - Governor's Conference on Recreation for Individuals with Disabilities. - member, NJ Neuropsychology Board of Trustees. - Secretary, Executive Committee of Brain Injury Interdisciplinary Special Interest Group (BI-ISIG) of the American Congress of Rehabilitation Medicine (ACRM). - member National Pediatric Rehab Directors Forum - NJ State Rep APTA Region IV section on pediatrics. - member National Pediatric Rehab Directors Forum - NJ Chapter HFMA - Past Director - American Board of Physical Therapy Specialties (ABPTS) member Specialization Academy of Content Experts (SACE) writer for pediatric specialty area. - NJ Brain Injury Association - Child & Adolescent Committee - Child Passenger Safety Coalition - member - Anti-bullying Task Force, McKinley School, Westfield, NJ - Westfield Public Schools Special Education Committee - Middlesex County Safe Kids Board - NJHFMA Board - NJHFMA Advisory Council - Chair, Implementation of the Federal Health Information Technology (HIT) Committee - Chamber of Commerce Executive Committee - Medical Advisor, Stay-Focused, Inc., a program devoted to helping special needs kids become certified in scuba diving - Medical Advisor, Peak Potential Inc., an adaptive rock climbing program for special needs children and adolescents - appointed to the New Jersey State Committee on Pediatric Emergency services - Chair of the State Performance Plan Committee for the State Interagency Coordinating Council - member of the Mayor's Advisory Council on Developmental Disabilities, Toms River - Chair of Safe Kids Community Program Committee - pediatric liaison service to provide training to community pediatricians regarding developmental surveillance/screening in the medical home - appointed by the Secretary of Health and Human Services to Interagency Autism Coordinating Council (IACC) - member NJ Governor's Council on Medical Research and Treatment of Autism - Autism Family Services of NJ Award for Excellence and Dedication to Families of Kids with Autism - member, Board of Directors New Jersey Speech and Hearing Association (NJSHA) - NJSHA Board Liaison to the AAC Committee - NJSHA Clinical Forum Chair |
| CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS | - representation on the leadership of the Division of Developmental Disabilities - special recognition from NACHRI for federal advocacy for children - member, Mercer County Professional Advisory Committee - member, Board of Trustees for National Association for the Mentally Ill (NAMI)-NJ - professors/lecturers at various local universities. - President of the NJ Chapter of the American Academy of Pediatrics - received grant from Kohl's Kids Abilities Program to raise autism awareness community integration internationally - sponsored three disability awareness carnivals at different locations throughout NJ, attended by over 1,500 families - member, Philanthropy Leadership Council - Association of Fundraising Professionals - appointed to the New Jersey Governor's Council for Medical Research and Treatment of Autism. - received the NJ Community Service Award presented by Autism Family Services. - Long Term Care recognized in "US News & World Report" article, "America's Best Nursing Homes" - member, U.S. Secretary of Health and Human services Interagency Autism Coordinating Council - achieved American College of Graduate Medical Education Accreditation for our Developmental-Behavior Pediatrics Fellowship (first and only one in New Jersey) - multiple presentations at national meetings - member of the United States Interagency Autism Coordinating Council - member of Educational Accreditation Survey Team, Medical Society of New Jersey - member of New Jersey Governor's Council on Traumatic Brain Injury - member of the Advisory Council, Elizabeth Boggs Center, New Brunswick - President, New Jersey Association of Neurodevelopmental Pediatricians - established research collaborations with various universities nationally - Treasurer, Tri-State Wheelchair and Ambulatory Athletics - board member of Stay-Focused, a program devoted to helping special needs kids become certified in scuba diving - member Safe Kids Union County - Secretary - Toms River Sunrise Rotary - DEVCO board member and Executive Committee member - NJ Council of Teaching Hospitals |
| CORE FORM, PART III; QUESTION 4D | EXPENSES INCURRED IN PROVIDING VARIOUS OTHER MEDICALLY NECESSARY PEDIATRIC HEALTHCARE SERVICES TO ALL CHILDREN IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. PLEASE REFER TO THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT INCLUDED IN SCHEDULE O. |
| CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7 | ROBERT WOOD JOHNSON HEALTHCARE CORPORATION IS THE SOLE MEMBER OF THIS ORGANIZATION. ROBERT WOOD JOHNSON HEALTHCARE CORPORATION 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. |
| CORE FORM, PART VI, SECTION B; QUESTION 11b | THE ORGANIZATION'S FEDERAL FORM 990 WAS provided TO EACH VOTING MEMBER OF ITS GOVERNING BODY, ITS BOARD OF TRUSTEES, PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE ("IRS") AND FOLLOWING A REVIEW BY THE ORGANIZATION'S AUDIT AND COMPLIANCE COMMITTEE. THE CHILDREN'S SPECIALIZED HOSPITAL BOARD OF TRUSTEES HAS DELEGATED TO THE AUDIT AND COMPLIANCE COMMITTEE THE RESPONSIBILITY TO OVERSEE, REVIEW AND APPROVE OF THE FEDERAL FORM 990, INCLUDING THE PREPARATION, REVIEW AND FILING PROCESS. AS PART OF THE 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 VARIOUS OTHER INDIVIDUALS OF THE ORGANIZATION 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 FINANCE PERSONNEL AND OTHER INDIVIDUALS FOR THEIR REVIEW. THE ORGANIZATION'S FINANCE PERSONNEL AND OTHER INDIVIDUALS 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 FINANCE PERSONNEL AND VARIOUS OTHER INDIVIDUALS FOR FINAL REVIEW AND APPROVAL PRIOR TO PRESENTATION OF THE FEDERAL FORM 990 TO THE MEMBERS OF THE CHILDREN'S SPECIALIZED HOSPITAL AUDIT AND COMPLIANCE COMMITTEE AND TO THE ORGANIZATION'S BOARD OF TRUSTEES. |
| CORE FORM, PART VI, SECTION B; QUESTION 12 | THE ORGANIZATION REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. ANNUALLY ALL MEMBERS OF THE BOARD OF TRUSTEES, OFFICERS AND SENIOR MANAGEMENT PERSONNEL ARE REQUIRED TO REVIEW THE EXISTING CONFLICT OF INTEREST POLICY AND COMPLETE A QUESTIONNAIRE. THE COMPLETED QUESTIONNAIRES ARE RETURNED TO THE ORGANIZATION'S VICE PRESIDENT OF HUMAN RESOURCES FOR REVIEW. THEREAFTER THE VICE PRESIDENT OF HUMAN RESOURCES PREPARES A SUMMARY OF THE COMPLETED QUESTIONNAIRES WHICH CONTAINS INFORMATION DISCLOSED ON AN INDIVIDUAL BY INDIVIDUAL BASIS. THE VICE PRESIDENT OF HUMAN RESOURCES THEN PRESENTS THIS SUMMARY TO THE ORGANIZATION'S AUDIT AND COMPLIANCE COMMITTEE FOR ITS REVIEW AND DISCUSSION. |
| CORE FORM, PART VI, SECTION B; QUESTION 15 | THE ORGANIZATION'S BOARD OF TRUSTEES HAS AN EXECUTIVE COMPENSATION COMMITTEE ("COMMITTEE"). THE COMMITTEE HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY WHICH IT FOLLOWS WHEN IT REVIEWS AND APPROVES OF THE COMPENSATION AND BENEFITS OF THE ORGANIZATION'S SENIOR MANAGEMENT, INCLUDING THE PRESIDENT/CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER. THE COMMITTEE REVIEWS THE "TOTAL COMPENSATION" OF THE INDIVIDUALS WHICH IS INTENDED TO INCLUDE BOTH CURRENT AND DEFERRED COMPENSATION AND ALL EMPLOYEE BENEFITS, BOTH QUALIFIED AND NON-QUALIFIED. THE COMMITTEE'S REVIEW IS DONE ON AT LEAST AN ANNUAL BASIS AND ENSURES THAT THE "TOTAL COMPENSATION" OF SENIOR MANAGEMENT OF THE ORGANIZATION IS REASONABLE. THE ACTIONS TAKEN BY THE COMMITTEE ENABLE THE ORGANIZATION TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 4958 WITH RESPECT TO THE TOTAL COMPENSATION OF CERTAIN MEMBERS OF THE SENIOR MANAGEMENT TEAM, INCLUDING THE PRESIDENT/CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER. THE THREE FACTORS WHICH MUST BE SATISFIED IN ORDER TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS ARE THE FOLLOWING: 1. THE COMPENSATION ARRANGEMENT IS APPROVED IN ADVANCE BY AN "AUTHORIZED BODY" OF THE APPLICABLE TAX-EXEMPT ORGANIZATION WHICH IS COMPOSED ENTIRELY OF INDIVIDUALS WHO DO NOT HAVE A "CONFLICT OF INTEREST" WITH RESPECT TO THE COMPENSATION ARRANGEMENT; 2. THE AUTHORIZED BODY OBTAINED AND RELIED UPON "APPROPRIATE DATA AS TO COMPARABILITY" PRIOR TO MAKING ITS DETERMINATION; AND 3. THE AUTHORIZED BODY "ADEQUATELY DOCUMENTED THE BASIS FOR ITS DETERMINATION" CONCURRENTLY WITH MAKING THAT DETERMINATION. THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES EACH OF WHO ARE INDEPENDENT AND ARE FREE FROM ANY CONFLICTS OF INTEREST. THE COMMITTEE RELIED UPON APPROPRIATE COMPARABLE DATA; SPECIFICALLY THE COMMITTEE OBTAINED A WRITTEN COMPENSATION STUDY FROM AN INDEPENDENT FIRM WHICH SPECIALIZES IN THE REVIEWING OF HOSPITAL AND HEALTHCARE SYSTEM EXECUTIVE COMPENSATION AND BENEFITS THROUGHOUT THE UNITED STATES. THIS STUDY USED COMPARABLE GEOGRAPHIC AND DEMOGRAPHIC MARKET DATA INCLUDING BUT NOT LIMITED TO SIMILAR SIZED HOSPITALS, # OF LICENSED BEDS AND NET PATIENT SERVICE REVENUE. THE COMMITTEE ADEQUATELY DOCUMENTED ITS BASIS FOR ITS DETERMINATION THROUGH THE TIMELY PREPARATION OF WRITTEN MINUTES OF THE COMPENSATION COMMITTEE MEETINGS DURING WHICH THE EXECUTIVE COMPENSATION AND BENEFITS WAS REVIEWED AND SUBSEQUENTLY APPROVED. THE ACTIONS OUTLINED ABOVE WITH RESPECT TO THE COMMITTEE AND THE ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS ONLY APPLIES TO CERTAIN SENIOR MANAGEMENT PERSONNEL, INCLUDING BUT NOT LIMITED TO THE PRESIDENT/CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER. THE COMPENSATION AND BENEFITS OF THE OTHER INDIVIDUALS CONTAINED IN THIS FORM 990 IS REVIEWED ANNUALLY BY THE PRESIDENT/CHIEF EXECUTIVE OFFICER WITH ASSISTANCE FROM ORGANIZATION'S HUMAN RESOURCES DEPARTMENT IN CONJUNCTION WITH THE INDIVIDUAL'S JOB PERFORMANCE DURING THE YEAR AND IS BASED UPON OTHER OBJECTIVE FACTORS DESIGNED TO ENSURE THAT REASONABLE AND FAIR MARKET VALUE COMPENSATION IS PAID BY THE ORGANIZATION. OTHER OBJECTIVE FACTORS INCLUDE MARKET SURVEY DATA FOR COMPARABLE POSITIONS, INDIVIDUAL GOALS AND OBJECTIVES, PERSONNEL REVIEWS, EVALUATIONS, SELF-EVALUATIONS AND PERFORMANCE FEEDBACK MEETINGS. |
| CORE FORM, PART VI, SECTION C; QUESTION 19 | THE ORGANIZATION HAS ISSUED TAX-EXEMPT BONDS TO FINANCE VARIOUS CAPITAL IMPROVEMENT PROJECTS, RENOVATIONS AND EQUIPMENT. IN CONJUNCTION WITH THE ISSUANCE OF THESE TAX-EXEMPT BONDS, THE ORGANIZATION'S FINANCIAL STATEMENTS WERE INCLUDED WITH THE TAX-EXEMPT BOND PROSPECTUS WHICH WAS MADE AVAILABLE TO THE GENERAL PUBLIC FOR REVIEW. IN ADDITION, 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. |
| CORE FORM, PART VII AND SCHEDULE J | BONNIE ALTIERI, PH.D., WAS A TRUSTEE OF THE ORGANIZATION FROM 1/1/2013 THROUGH 1/31/2013. ON 1/7/2013 SHE BECAME THE VICE PRESIDENT OF PATIENT CARE SERVICES AND THE CHIEF NURSING OFFICER, AND THEREFORE AN OFFICER OF THE ORGANIZATION. SHE IS LISTED AS A TRUSTEE OF THE ORGANIZATION BUT, IN ACCORDANCE WITH INTERNAL REVENUE SERVICE FORM 990 INSTRUCTIONS, IS NOT INCLUDED IN THE NUMBER OF VOTING MEMBERS OF THE GOVERNING BODY SHOWN ON FORM 990, CORE FORM, PART I, QUESTION 3. PHILIP SALERNO IS A MEMBER OF THIS ORGANIZATION'S BOARD OF TRUSTEES BUT WORKS ON A FULL-TIME BASIS 55 HOURS PER WEEK AS THE PRESIDENT AND CHIEF DEVELOPMENT OFFICER OF CHILDREN'S SPECIALIZED HOSPITAL FOUNDATION; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. IN ADDITION, PART VII AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM THIS ORGANIZATION. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OF THIS ORGANIZATION AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THIS ORGANIZATION'S BOARD OF TRUSTEES. EMPLOYEES OF THIS ORGANIZATION AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THIS ORGANIZATION'S BOARD OF TRUSTEES. |
| CORE FORM, PART VII, SECTION A, COLUMN B | THIS ORGANIZATION IS PART OF the robert wood johnson health network; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY network ("network"). THE network 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, REPRESENT THE ESTIMATED HOURS DEVOTED PER WEEK FOR THIS ORGANIZATION. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF TRUSTEES OF OTHER RELATED ORGANIZATIONS IN THE SYSTEM, THEIR RESPECTIVE HOURS PER WEEK PER ORGANIZATION ARE APPROXIMATELY ONE HOUR. THE HOURS REFLECTED ON PART VII OF THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, PAID OFFICERS AND KEY EMPLOYEES, REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF ROBERT WOOD JOHNSON HEALTH NETWORK; NOT SOLELY THIS ORGANIZATION. |
| CORE FORM, PART XI; QUESTION 9 | OTHER CHANGES IN NET ASSETS OR FUND BALANCE INCLUDE: - NET ASSETS RELEASED FROM RESTRICTIONS USED FOR PROPERTY AND EQUIPMENT - $4,172,106; - CHANGE IN INTEREST IN TEMPORARILY RESTRICTED NET ASSETS OF CHILDREN'S SPECIALIZED HOSPITAL FOUNDATION; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION - $3,513,021; - NET ASSETS RELEASED FROM TEMPORARILY RESTRICTIONS - ($6,657,106); AND - CHANGE IN INTEREST IN PERMANENTLY RESTRICTED NET ASSETS OF CHILDREN'S SPECIALIZED HOSPITAL FOUNDATION; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION - $16,248. |
| CORE FORM, PART XII; QUESTION 2 | An INDEPENDENT CPA FIRM AUDITED THE FINANCIAL STATEMENTS OF THE TAXPAYER FOR THE YEARS ENDED DECEMBER 31, 2013 AND DECEMBER 31, 2012; RESPECTIVELY, AND ISSUED A CERTIFIED AUDITED FINANCIAL STATEMENT. AN UNQUALIFIED OPINION WAS ISSUED BY THE INDEPENDENT CPA FIRM EACH YEAR. THE TAXPAYER'S AUDIT AND COMPLIANCE COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT AUDITOR. |
| CORE FORM, PART XII, QUESTION 3A | THIS ORGANIZATION ENGAGED AN INDEPENDENT ACCOUNTING FIRM TO PREPARE AND ISSUE AN A-133 AUDIT. |
| Software ID: | |
| Software Version: |