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 | ||||
| (A)
JERSEY CITY MEDICAL CENTER |
222783298 | 03 | Yes | Yes | Yes | 0 | |||
| (B)
JERSEY CITY FAMILY HEALTH CENTER |
223579538 | 03 | Yes | Yes | Yes | 0 | |||
| (C)
LIBERTY RIVERSIDE HEALTHCARE INC (DBA) MHMC |
223284894 | 03 | Yes | Yes | Yes | 0 | |||
| (D)
GREENVILLE HOSPITAL |
220963805 | 03 | Yes | Yes | Yes | 0 | |||
| (E)
LIBERTY HOME CARE |
223327677 | 04 | Yes | Yes | Yes | 0 | |||
| Total | 0 | ||||||||
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 |
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Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
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| CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS | LIBERTY HEALTHCARE SYSTEM, INC. ("LIBERTY") IS A NOT FOR-PROFIT HOLDING COMPANY BASED IN HUDSON COUNTY, NEW JERSEY. LIBERTY IS THE SOLE CORPORATE MEMBER OF A NUMBER OF NOT FOR-PROFIT ENTITIES AND THE SOLE SHAREHOLDER OF VARIOUS OTHER FOR-PROFIT ENTITIES. THE INTERNAL REVENUE SERVICE ("IRS") HAS RECOGNIZED LIBERTY AS A TAX-EXEMPT ORGANIZATION UNDER INTERNAL REVENUE CODE ("IRC") SECTION 501(C)(3). LIBERTY'S MISSION IS ENHANCING LIFE. THESE TWO WORDS ARE OUR COMMITMENT TO PROVIDE PATIENTS, THEIR FAMILIES AND ALL IN NEED, EXCELLENCE IN HOSPITAL AND HEALTHCARE SERVICES AND PROGRAMS TO ENHANCE COMMUNITY HEALTH. TO ACHIEVE THIS MISSION, LIBERTY, IN COLLABORATION WITH ITS PHYSICIANS, NURSES AND STAFF, WILL: - PROVIDE A FULL RANGE OF CLINICAL SERVICES FOR ALL, REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY INCLUDING REGIONAL SPECIALTY AND SUBSPECIALTY CARE. - ESTABLISH APPROPRIATE ACADEMIC AND CLINICAL AFFILIATIONS. - DEVELOP EDUCATIONAL PROGRAMS FOR MEDICAL STUDENTS, PHYSICIANS IN RESIDENCY TRAINING, NURSES, EMT'S-PARAMEDICS AND OTHER HEALTHCARE PROFESSIONALS. - BUILD INNOVATIVE RELATIONSHIPS WITH OTHER HOSPITALS, FQHC'S AND OTHER PROVIDERS. - LIBERTY WILL BE GUIDED BY VOLUNTEER BOARDS OF TRUSTEES, REPRESENTING A DIVERSITY OF COMMUNITY AND BUSINESS LEADERS, PUBLIC OFFICIALS, AND HEALTHCARE AND OTHER PROFESSIONALS. LIBERTY PROVIDES THE REGION WITH A WIDE RANGE OF HEALTH SERVICES, FROM HIGH TECHNOLOGY INFANT AND ADULT CARE TO THE HIGHEST LEVEL OF TRAUMA CARE. LIBERTY AFFILIATES INCLUDE JERSEY CITY MEDICAL CENTER: JERSEY CITY MEDICAL CENTER ("JCMC") IS A REGIONAL REFERRAL TEACHING HOSPITAL AND A MAJOR TEACHING AFFILIATE OF THE MOUNT SINAI SCHOOL OF MEDICINE. JCMC ALSO OPERATES THE CRISTIE KERR WOMEN'S HEALTH CENTER. THE INTERNAL REVENUE SERVICE ("IRS") HAS RECOGNIZED LIBERTY AND JERSEY CITY MEDICAL CENTER AS TAX-EXEMPT ORGANIZATIONS UNDER IRC SECTION 501(C) (3). PURSUANT TO ITS CHARITABLE PURPOSES, JCMC 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, JCMC OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN REVENUE RULING 69-545: 1. MEDICALLY NECESSARY HEALTHCARE SERVICES ARE PROVIDED TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF PAY, MEDICARE, AND MEDICAID PATIENTS; 2. EMERGENCY ROOMS ARE OPEN 24 HOURS A DAY, SEVEN DAYS A WEEK, 365 DAYS A YEAR; 3. OPEN MEDICAL STAFFS ARE MAINTAINED, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; 4. CONTROL OF JCMC RESTS WITH ITS BOARD OF TRUSTEES AND THE BOARD OF TRUSTEES OF LIBERTY HEALTH. THE BOARD IS COMPRISED OF INDEPENDENT CIVIC LEADERS AND OTHER PROMINENT MEMBERS OF THE COMMUNITY; AND 5. SURPLUS FUNDS ARE USED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND RENOVATE FACILITIES AND ADVANCE MEDICAL CARE, PROGRAMS AND ACTIVITIES. JCMC TREATS ALL ADULTS AND CHILDREN REGARDLESS OF AGE OR THEIR ABILITY TO PAY FOR SERVICES RENDERED. LIBERTY IS ONE OF THE LARGEST PROVIDERS OF CHARITY CARE SERVICES IN THE STATE OF NEW JERSEY. IN 2013 JCMC ADMITTED OVER 16,900 PATIENTS PROVIDING APPROXIMATELY 82,000 DAYS OF INPATIENT CARE. THE EMERGENCY DEPARTMENT DELIVERED EMERGENCY MEDICAL CARE TO OVER 84,000 INDIVIDUALS AND OUR OUTPATIENT PROGRAMS SERVICED OVER 142,000 VISITS. JCMC IS AN AFFILIATE OF LIBERTY. LIBERTY IS A NOT FOR-PROFIT HOLDING COMPANY BASED IN HUDSON COUNTY, NEW JERSEY. THE IRS HAS RECOGNIZED LIBERTY AS A TAX-EXEMPT ORGANIZATION UNDER IRC SECTION 501(C) (3). LIBERTY'S MISSION IS ENHANCING LIFE. LIBERTY PROVIDES PATIENTS, THEIR FAMILIES, AND ALL IN NEED WITH EXCELLENT HOSPITAL AND HEALTHCARE SERVICES THAT ENHANCE COMMUNITY HEALTH. TO ACHIEVE THIS MISSION, LIBERTY COLLABORATES WITH ITS PHYSICIANS, NURSES AND STAFF TO: - PROVIDE A FULL RANGE OF CLINICAL SERVICES FOR ALL REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION, OR ABILITY TO PAY. OUR CLINICAL SERVICES INCLUDE REGIONAL SPECIALTY AND SUBSPECIALTY CARE. - ESTABLISH APPROPRIATE ACADEMIC AND CLINICAL AFFILIATIONS. - DEVELOP EDUCATIONAL PROGRAMS FOR MEDICAL STUDENTS, PHYSICIANS IN RESIDENCY TRAINING, NURSES, EMT'S-PARAMEDICS AND OTHER HEALTHCARE PROFESSIONALS. - BUILD INNOVATIVE RELATIONSHIPS WITH OTHER HOSPITALS AND SYSTEMS. - LIBERTY IS GUIDED BY BOARDS OF TRUSTEES, REPRESENTING A DIVERSITY OF COMMUNITY AND BUSINESS LEADERS, PUBLIC OFFICIALS, HEALTHCARE PROFESSIONALS, AND OTHER PROFESSIONALS. JERSEY CITY MEDICAL CENTER - CARE CENTERS ========================================== THE CRISTIE KERR WOMEN'S HEALTH CENTER -------------------------------------- THE CRISTIE KERR WOMEN'S HEALTH CENTER OPENED IN 2010 OFFERING IMAGING AND OTHER DIAGNOSTIC SERVICES TO WOMEN IN OUR COMMUNITY. THE CENTER OFFERS BREAST CANCER SCREENING PROGRAMS INCLUDING MAMMOGRAMS AND EDUCATION TO WOMEN IN THE COMMUNITY REGARDLESS OF ABILITY TO PAY. THE CENTER IS THE FIRST FULL-SERVICE FACILITY IN HUDSON COUNTY TO PROVIDE DETECTION, HEALING, SUPPORT, AND RECOVERY SERVICES. THE EPILEPSY CENTER AT JERSEY CITY MEDICAL CENTER ------------------------------------------------- THE EPILEPSY CENTER AT JERSEY CITY MEDICAL CENTER OPENED IN 2010 AND PROVIDES DIAGNOSTIC, EVALUATION, AND TREATMENT PLANS ON AN INPATIENT AND OUTPATIENT BASIS. FANNIE E. RIPPEL FOUNDATION HEART INSTITUTE (THE "INSTITUTE") ------------------------------------------------------------- THE INSTITUTE FEATURES STATE-OF-THE-ART DIAGNOSTIC TECHNOLOGY TO PROVIDE EXEMPLARY OUTPATIENT CARDIAC CARE. THE INSTITUTE PROVIDES TWO HIGH-RISK CARDIAC CATHETERIZATION LABORATORIES, A SINGLE PLANE AND A THREE-DIMENSIONAL BI-PLANE ALONG WITH OTHER CRITICALLY IMPORTANT DIAGNOSTIC TECHNOLOGY. THE MEDICAL CENTER IS THE REGION'S "HIGH-RISK" DESTINATION FOR PATIENTS. IN 2011 WE ADDED ELECTROPHYSIOLOGY PROCEDURES IN THE CARDIAC CATHETERIZATION LABORATORY. CARDIAC CATHETERIZATION ----------------------- JCMC IS HUDSON COUNTY'S ONLY FULL-SERVICE HEART HOSPITAL. CARDIAC SERVICES PROVIDED INCLUDE: - ANGIOPLASTY - DIAGNOSTIC CARDIAC CATHETERIZATION - INTRAVASCULAR ULTRASOUND - PACEMAKER & IMPLANTABLE CARDIOVERTER DEFIBRILLATOR THERAPY - MINIMALLY INVASIVE VEIN HARVESTING AND CARDIAC ARTERY BYPASS GRAFT - THORACIC AND ABDOMINAL AORTIC ANEURYSM REPAIR - MITRAL AND AORTIC VALVE REPAIR AND REPLACEMENT - PERIPHERAL VASCULAR PROCEDURES, INCLUDING ENDO VASCULAR PROCEDURES - CARDIAC ABLATION |
| CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS | Port Authority Heroes of September 11 Trauma Center --------------------------------------------------- This regional trauma center is the state-designated level II Trauma center for Hudson County. In addition to serving the growing communities of Jersey City, the service covers Hudson County New Jersey waterways, New Jersey Turnpike, the Holland and Lincoln Tunnels, and Liberty State Park. The trauma center provides 24 hour trauma surgery for adults and children. The center has been active in all regional disasters including the 1993 and 2001 world trade center bombings; the "Miracle on the Hudson" plane landing; several train derailments, and various hazmat incidents. Outpatient Services ------------------- JCMC operates an ambulatory care center adjacent to the hospital as well as two satellite clinics to ensure access for those most in need. Our outpatient service offerings include obstetrics and gynecology, ophthalmology, dental, physical and speech therapy, and audiology. We provide needed outpatient services to special needs populations in our community, including the homeless and adults and children requiring behavioral health services, HIV/AIDS patients, and those in need of dialysis. JCMC is the regional psychiatric referral center providing crisis intervention and evaluation, voluntary and involuntary in-patient services, community psychiatric outreach services, and a full spectrum of outpatient psychiatric and addiction services. Volunteer Services ------------------ JCMC has an active and diverse volunteer program providing companionship and support to patients of all ages hospitalized on our nursing floors, the emergency department, and other patient areas. JCMC volunteers advocate for patient families and provide them with information and support. They also provide clerical and other support to our staff. Community --------- JCMC is actively engaged in community education including outreach to schools, churches, and community groups to address targeted, appropriate education needs. Health fairs are held annually in conjunction with businesses and community groups to provide a wide range of screening and education. A Dinner with the Doctor program was implemented in 2009 and over the past five years physicians have addressed the community on various health issues and the prevention of disease. We also provide recurring safety programs in our community schools to educate children on wellness, trauma prevention, car seat inspections, and bicycle safety. We also visit senior centers to educate seniors on fall prevention, and our EMS service provides medical care at community events during the year. We supported a Turkey Drop program in Jersey City to provide Thanksgiving meals for those in need in our community. Population Health ================= Jersey City Medical Center has created the Wealth From Health Program ("WFH") to assist patients who suffer from chronic disease to be able to better self-manage through the support of physicians and support staff working in this program, as well as provide access to the Medical Center or FQHC's in the community. The Wealth from Health navigator team has become an integral part of the JCMC community activity calendar. Specifically, there are biweekly or monthly health screenings at churches and joint events with the Jersey City Department of Health. In addition, the team participates with ShopRite to schedule nutritional oriented visits for members of the Wealth From Health program. In 2013, the Wealth From Health team also met with school nurses at an area high school to implement a blood pressure screening event for staff and adolescents. For JCMC staff, WFH navigators have implemented in-house weight loss teams. WFH has also provided free of charge environmental home reviews for asthma triggers. As JCMC employees, members of the WFH program have also participated as volunteers for community half marathons, assembled teams for walk-a-thons for breast cancer, heart disease, epilepsy, and infant health. Awards and Designations ======================= JCMC has been recognized for its excellence in providing care and support for the health and wellness of our community. The following is a listing of awards and designations recently received by the Jersey City Medical Center in recognition of its service to the community: - DNV fully accredited hospital - Five consecutive "A" ratings in hospital safety from the independent LeapFrog Group - US News & World Report - Best Regional Hospital listing (high performance in nephrology 2012-2013) - Magnet designation for excellence in patient care by the American Nurses Credentialing Center - Recognized by the American College of Surgeons for "Excellence in Trauma" 2013 - State designated regional trauma center - First Emergency Medical Service ("EMS") in the US to earn triple accreditation in dispatch, education and emergency medical service - CEO Cancer Roundtable - Gold Standard - Gold Plus Achievement Award in stroke quality care from the American Heart and Stroke Association, 2012 & 2013 - State designated regional heart center - 100 Best Places to Work in Healthcare, ranked nationally by Modern Healthcare Magazine 2011 - 100 Best Places to Work in the Healthcare Field by Becker's Hospital Review, 2012-2013 - Castle Connolly "Top Hospital in NJ" under 350 beds, 2010 and 2011 - CHF Bronze Award from American Heart and Stroke Association - American Heart Association named JCMC a "Gold Fit-Friendly" company in 2013 - State designated regional neonatal intensive care ("NICU") center for diagnosis and treatment of most critically ill newborns - Cristie Kerr Women's Health Center is located in our medical office building on the JCMC campus - Primary stroke center approved by the NJ Department of Health and Human Services ON MAY 16, 2013, LIBERTY HEALTHCARE SYSTEM, INC., JERSEY CITY MEDICAL CENTER AND BARNABAS HEALTH, INC. SIGNED A DEFINITIVE AGREEMENT WHEREBY JERSEY CITY MEDICAL CENTER WILL BECOME A MEMBER OF BARNABAS HEALTH, INC. AS A WHOLLY OWNED SUBSIDIARY OF BARNABAS HEALTH, INC. (BUT NOT A MEMBER OF BARNABAS HEALTH, INC.'S OBLIGATED AND COMBINED GROUP WITH RESPECT TO BARNABAS HEALTH, INC.'S BOND AND BANK OBLIGATIONS). NO MEMBER OF BARNABAS HEALTH, INC. WILL BECOME LIABLE FOR THE CURRENT LIBERTY HEALTHCARE SYSTEM, INC. OR JERSEY CITY MEDICAL CENTER BOND OR MORTGAGE FINANCINGS. THE CONSUMMATION OF THE TRANSACTION CONTEMPLATED BY THE DEFINITIVE AGREEMENT REQUIRES PRIOR APPROVALS FROM OR NOTIFICATIONS TO STATE AND FEDERAL REGULATORY AUTHORITIES AND CERTAIN JERSEY CITY MEDICAL CENTER STAKEHOLDERS, AMONG OTHERS. IT IS ANTICIPATED THAT THIS TRANSACTION WILL BE COMPLETED IN THE SECOND QUARTER OF 2014. |
| CORE FORM, PART VI, SECTION B; QUESTION 11b | THE ORGANIZATION IS THE PARENT ENTITY OF THE LIBERTY HEALTHCARE SYSTEM, INC. ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THE ORGANIZATION'S FEDERAL FORM 990 WAS MADE AVAILABLE TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY (ITS BOARD OF TRUSTEES) PRIOR TO THE FILING OF THE FEDERAL FORM 990 WITH THE IRS. 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, VICE-PRESIDENT OF FINANCE, DIRECTOR OF 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 THEN HELD WITH THE EXECUTIVE/FINANCE COMMITTEE TO REVIEW THE FINAL DRAFT OF THE FEDERAL FORM 990. AT THIS MEETING A FORM 990 PRESENTATION WAS MADE BY THE TAXPAYER'S CPA FIRM. FOLLOWING THIS REVIEW THE FINAL FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY, ITS BOARD OF TRUSTEES, PRIOR TO THE FILING OF THE TAX RETURN WITH THE IRS. |
| CORE FORM, PART VI, SECTION B; QUESTION 12 | THE ORGANIZATION IS THE PARENT ENTITY OF THE LIBERTY HEALTHCARE SYSTEM, INC. ("SYSTEM"). THE ORGANIZATION AND THE SYSTEM REGULARLY MONITOR AND ENFORCE COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. ANNUALLY ALL MEMBERS OF THE BOARD OF TRUSTEES, OFFICERS AND SENIOR MANAGEMENT PERSONNEL ARE REQUIRED TO REVIEW THE EXISTING CONFLICT OF INTEREST POLICY AND COMPLETE A QUESTIONNAIRE. THE COMPLETED QUESTIONNAIRES ARE RETURNED TO THE ORGANIZATION'S VP RISK MANAGEMENT/CORPORATE COMPLIANCE FOR REVIEW. THEREAFTER THE VP RISK MANAGEMENT/CORPORATE COMPLIANCE PREPARES A SUMMARY OF THE COMPLETED QUESTIONNAIRES WHICH CONTAINS INFORMATION DISCLOSED ON AN INDIVIDUAL BY INDIVIDUAL BASIS. THEREAFTER, THE VP RISK MANAGEMENT/CORPORATE COMPLIANCE OF THE ORGANIZATION PRESENTS ANY CONFLICT CONCERNS TO THE ORGANIZATION'S AUDIT, COMPLIANCE AND RISK MANAGEMENT COMMITTEE FOR ITS REVIEW AND DISCUSSION. |
| CORE FORM, PART VI, SECTION B; QUESTION 15 | The organization is the parent entity of Liberty HealthCare System, Inc. ("System"). The Organization's Board of Trustees maintains a Compensation and Performance Committee (the "Committee") consisting entirely of independent trustees. The Committee has a written executive compensation philosophy which it follows when it reviews the compensation and benefits of senior management and key employees. The Committee approves the compensation of the Chief Executive Officer. The Chief Executive Officer, in consultation with the Committee, approves the compensation of the Senior Vice-President and General Counsel, and the Chief Financial Officer. The Committee relies upon comparison data provided by a nationally recognized independent benefits consulting firm to determine fair market value. The Committee also reviews the compensation of other senior management and key employees as recommended by the Chief Executive Officer in consultation with the human resources department on the basis of comparison data provided by independent sources to determine fair market value. In performing these reviews, the Committee takes into account the total compensation payable to each individual, including both current and deferred compensation and all employee benefits, both qualified and non-qualified. The Committee's review is done annually. 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, SENIOR VICE PRESIDENT/GENERAL COUNSEL 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 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 ACTIONS OUTLINED ABOVE WITH RESPECT TO THE COMMITTEE AND THE ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS APPLIES TO CERTAIN system SENIOR MANAGEMENT PERSONNEL, INCLUDING, BUT NOT LIMITED TO, THE PRESIDENT/CHIEF EXECUTIVE OFFICER. |
| CORE FORM, PART VI, SECTION B; QUESTION 16B | The organization adoptED a written joint venture policy in 2009. Prior to AND AFTER THE ADOPTION OF THIS POLICY the organization always utilized due diligence and certain procedures to ensure participation in a joint venture with a taxable entity does not jeopardize tax exempt status or impair any of its assets. These safeguards include but are not limited to assistance and advice from external legal counsel and professional tax advisors with expertise in healthcare and not-for-profit taxation. |
| 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. |
| CORE FORM, PART VII AND SCHEDULE J | Part VII and Schedule J reflect board members and officers receiving compensation from a related organizations. Please note that this remuneration was for services rendered as full-time employees of THE related organizations and not for services rendered as a board member or officer of this organization's board of trustees. |
| CORE FORM, PART VII AND SCHEDULE J | SUSAN M. WALSH, M.D., VICE PRESIDENT, ACCOUNTABLE CARE ORGANIZATION, IS STILL EMPLOYED WITHIN LIBERTY HEALTHCARE SYSTEM, INC. HOWEVER, HER ROLE IS LIMITED TO JERSEY CITY MEDICAL CENTER; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. THEREFORE, SHE IS NO LONGER BEING REPORTED ON THIS FORM 990 AND HER COMPENSATION AND BENEFITS CAN BE FOUND ON THE JERSEY CITY MEDICAL CENTER 2013 FORM 990. |
| CORE FORM, PART VII, SECTION A, COLUMN B | THIS ORGANIZATION IS PART OF LIBERTY HEALTHCARE SYSTEM; 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 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 PER WEEK. THE HOURS REFLECTED ON PART VII OF THIS FORM 990 FOR PAID OFFICERS AND KEY EMPLOYEES REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF LIBERTY HEALTHCARE SYSTEM; NOT SOLELY THIS ORGANIZATION. |
| CORE FORM, PART XI; QUESTION 9 | OTHER CHANGES IN NET ASSETS OR FUND BALANCE INCLUDE: - TRANSFER TO RELATED ORGANIZATION - ($4,700,000) - DISCONTINUED OPERATIONS - ($436,386) |
| CORE FORM, PART XII; QUESTION 2C | THE TAXPAYER IS THE PARENT ENTITY IN A TAX-EXEMPT, INTEGRATED HEALTHCARE DELIVERY SYSTEM. AN INDEPENDENT CPA FIRM AUDITS THE CONSOLIDATED FINANCIAL STATEMENTS OF THE TAXPAYER AND ALL AFFILIATES ANNUALLY. THE AUDIT, COMPLIANCE AND RISK MANAGEMENT COMMITTEE OF THE SYSTEM ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE TAXPAYER'S FINANCIAL STATEMENTS AND THE SELECTION OF ITS INDEPENDENT AUDITOR. |
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