Attach to Form 990 or Form 990-EZ.
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 listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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 VI.).. | ||||||
| 11 | Total support Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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 VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e | Discount claimed for blockage or other factors (explain in detail in Part VI): | |||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| 7 | Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions) | |||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2014 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2014 |
(iii) Distributable Amount for 2014 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2014 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2014: | ||||
| a From 2009.......X | ||||
| b From 2010.......X | ||||
| c From 2011.......X | ||||
| d From 2012.......X | ||||
| e From 2013....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2014 distributable amount | ||||
|
i
Carryover from 2009 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2014 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2014 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2015. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a From 2010.......X | ||||
| b From 2011.......X | ||||
| c From 2012.......X | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | 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 ========== Robert Wood Johnson University Hospital Rahway (the "hospital") is a general medical and surgical hospital. The hospital is recognized by the IRS as an Internal Revenue Code 501(c)(3) tax-exempt organization. Pursuant to its charitable purposes, the hospital provides medically necessary healthcare services to all individuals in a non-discriminatory manner regardless of race, color, creed, sex, national origin, sexual orientation or ability to pay. Moreover, the hospital operates consistently with the following criteria outlined in IRS revenue ruling 69-545: 1. The hospital provides medically necessary healthcare services to all individuals regardless of their ability to pay, including charity care, self-pay, Medicare and Medicaid patients; 2. The hospital operates an active emergency department for all persons, open 24 hours a day, seven days a week, 365 days per year; 3. The hospital maintains an open medical staff with privileges available to all qualified physicians; 4. Control of the hospital rests with its board of trustees, comprised of independent civic leaders and other prominent members of the community; and 5. Surplus funds are used to improve the quality of patient care, expand and renovate facilities and advance medical care; programs and activities. The operations of the hospital, as shown through the factors outlined above and other information contained herein, clearly demonstrate that the use and control of the hospital is for the benefit of the public and that no part of the income or net earnings of the organization inures to the benefit of any private individual nor is any private interest being served other than incidentally. Moreover, the hospital provides substantial community benefit as outlined herein. Organization Overview ===================== Founded in 1917, Robert Wood Johnson University Hospital Rahway is an acute-care community hospital providing a healthcare continuum to communities in central and northern New Jersey, primarily from Union and Middlesex counties. The hospital's services include 24-hour emergency care, Mobile Intensive Care Unit, Critical Care, surgery, hematology-oncology, cardiac care, including cardiac catheterization and emergency angioplasty, telemetry, cardiac and pulmonary rehabilitation, stress testing and diagnostics. It is a state-designated primary stroke center. It has the full range of laboratory and radiology diagnostic services, as well as neurology, surgery, and pediatric emergency services. The hospital is home to a rehabilitation unit now run by AlarisHealth, and a long-term, acute-care hospital called, Kindred Hospital New Jersey - Rahway. Outpatient services include wound care with hyperbaric oxygen therapy, balance testing and physical, occupational and speech therapy, as well as physical and aquatic therapy at its two RWJ Rahway Fitness & Wellness Centers, located in Scotch Plains and Carteret. Its cardiac and pulmonary rehabilitation are outpatient. It offers transfusion services. It runs a diabetes management program, as well as a weight management program for adults and children. It runs a lab for sleep studies. The hospital provides community education at the hospital, as well as at its fitness centers in Scotch Plains and Carteret, as well as within the community. Subacute care ------------- The hospital has a specialized subacute care unit called Care Connection Rahway, designed to bridge the gap between the hospital and home for the patient who is over the acute phase of illness, but still needs medical care and rehabilitation. The unit is run by AlarisHealth. The Joint Replacement Center ---------------------------- The center offers total knee replacement, minimally invasive partial knee replacement, and total and partial hip replacement. All surgeons are board certified and have extensive experience in joint replacement and minimally invasive techniques. The experienced staff consists of a joint care coordinator, specialized nursing care, licensed occupational and physical therapists, and case managers to help each patient make the transition from the hospital to a pain free, active life. The Center for Wound Healing and Hyperbaric Medicine ---------------------------------------------------- The center provides patients with treatment for chronic, non-healing wounds associated with inadequate circulation, poorly functioning veins and immobilit. Non-healing wounds occur most frequently in people with diabetes and poor circulation. The hospital has partnered with RestorixHealth to provide hyperbaric medicine. The Sleepcare Center -------------------- The center, in partnership with Persante Inc., performs patient sleep studies, both at home and in the hospital, designed to help physicians diagnose and treat patient sleep problems. The test provides a comprehensive record of patient sleep patterns, leg movements, blood oxygen levels, breathing, heart rhythm, and snoring. Results are evaluated by a sleep specialist, who forwards them to the patient's personal physician, along with a diagnosis and recommendation for treatment. Rehabilitation Services ----------------------- Rehabilitation Services include comprehensive inpatient and outpatient rehabilitation for a variety of impairments. The focus is on restoring and improving function in mobility, self-care, independence and quality of life. Services include physical therapy, occupational therapy, speech/language, audiology, dysphasia and swallowing disorders, as well as urinary incontinence treatment. Pulmonary Rehabilitation helps people with asthma, emphysema and chronic bronchitis regain function. The Nicholas Quadrel Healthy Heart Center provides cardiac rehabilitation and maintenance programs, education and counseling for heart disease patients. The Balance Center ------------------ For patients with balance disorders, vertigo and dizziness, the balance center diagnoses and treats using a specialized team made up of a physician, audiologist and physical therapists. The Center for Healthy Lifestyles --------------------------------- This center features the Diabetes Self-management Program, an American Diabetes Association-recognized program that helps people control their disease by giving them the skills, knowledge and motivation to stay healthy. The center also offers group or customized weight-loss programs, open to all who would like to lose weight. The program is especially beneficial for people who are obese, those with an immediate family member with diabetes, members of high-risk ethnic populations, as well as those with high blood pressure, elevated cholesterol, or impaired glucose tolerance. The center also runs a weight management program for children and adolescents. Medical Clinic -------------- The hospital operates a medical clinic to treat uninsured patients. The clinic is staffed by a hospital-employed nurse, nurse practitioner and volunteer physicians from the hospital's medical staff. Community Education ------------------- Each month, RWJ Rahway provides educational programing free to the community at its two fitness centers in Carteret and Scotch Plains. These programs include talks on various health and wellness topics delivered by RWJ Rahway Medical and Dental Staff, in addition to dietitians, exercise physiologists, nurses and mental health experts affiliated with RWJ Rahway or its affiliated hospitals. RWJ Rahway also provides monthly healthy cooking programs, led by a Registered Dietitian, at its Scotch Plains center. Programs are free, including recipes and samples. Community Education includes monthly support groups for caregivers, breast cancer survivors, fibromyalgia, and diabetes. Adult bereavement support is also offered monthly. RWJ Community Education also provides educational outreach, informed in large part from the hospital's Community Needs Assessment. Community outreach includes participation at health fairs, health screenings around the county. RWJ Rahway presents at AARP organizations, senior housing, private companies, fraternal organizations, schools and after school and libraries. Each month, RWJ Rahway diabetes educators volunteer at a local food pantry to counsel people with diabetes and their families. |
| CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS | New Jersey Charity Care Program ------------------------------- The hospital provides care to patients who meet certain criteria defined by the New Jersey Department of Health without charge or at amounts less than its established rates. Enhanced Charity Care program ----------------------------- This program provides free or reduced fee care to patients whose income exceeds the state's Charity Care program but is less than 500% of the poverty level. The hospital receives no reimbursement on these patients, other than reduced fees paid by the patient. Affiliations ------------ Since 2003, RWJ Rahway has been part of the Robert Wood Johnson Health System. The system is made up of Robert Wood Johnson University Hospital in New Brunswick, an academic medical center, and RWJ Somerset, RWJ Hamilton, Children's Specialized Hospital, and The Bristol-Myers Squibb Children's Hospital. RWJ University Hospital in New Brunswick is the flagship hospital for Rutgers Robert Wood Johnson Medical School. This affiliation has provided RWJ Rahway patients with access to the latest medical innovations and the expertise of outstanding physicians in every specialty. Robert Wood Johnson Health Network, Inc. A New Jersey non-profit corporation, whose sole member is RWJHCC. It provides medical transportation services for the communities served by RWJ hospitals. It also has hospital participants, and participation in this entity is a requirement for membership in the system's captive insurance program. Mission Statement ================= The hospital's mission is to deliver safe, quality, cost-effective healthcare services providing access and value to the community through a unified effort that meets individual needs with dignity and respect. Vision Statement ================ The hospital is a combination of dynamic, strategic partnerships dedicated to the delivery of a safe continuum designed to meet community needs for preventative service, acute care and chronic care. The continuum shall provide accessibility, quality and value to members of its community. Values ====== Access: The hospital assures access to care or appropriate referral for all, regardless of ability to pay. Community: The hospital strives to meet the healthcare needs of the patients, families, businesses, industries and community members who reside or work within its service area. Dignity and Respect: The hospital affirms the unique and intrinsic worth of each individual and treats all those we serve with compassion, kindness, dignity and respect recognizing confidentiality and patient rights in its daily practice. Dynamic Services: The hospital continually strives to identify community need and to implement services which meet the ever-changing environment. Partnerships: The hospital forges strong partnerships with those who share its values and service to its community. Quality: The hospital is committed to excellence, which is characterized by high performance, innovation, stewardship of resources, teamwork and regular evaluation of the outcome of service. Teamwork: The hospital trusts its colleagues and physicians as valuable members of its healthcare team and pledges to treat one another with loyalty, dignity and respect. Value: The hospital believes that value is a balance of access, quality and cost and we strive to meet the patient's perception of value. Safety: The hospital is committed to delivering its services in a safe environment that protects patients, staff and visitors. Medical Services ================ The hospital provides an extensive array of medical services which include, but are not limited to, the following: - cardiac services, including emergency angioplasty - community health education - diagnostic imaging - emergency services - laboratory services - neurological services - oncology services - patient services - emergency psychiatric services - pulmonary services - rehabilitation services - stroke services - surgical services, including same-day surgical services - transportation to therapy and testing - WOUND CENTER Community Benefit ----------------- RWJ Rahway identifies healthcare needs in the community through its outreach, partnerships and the Community Needs Assessment. Through its Community Education Department, the hospital participates in health fairs, clinics, and educational programs, both at the hospital and in the community. The hospital also provides free monthly support groups at the hospital and in the community at its RWJ Rahway Fitness & Wellness Center in Scotch Plains, which also provides meeting space for nonprofit organization meetings. Support groups include: - Diabetes support group - Cardiac support group - Parkinson's support group - Fibromyalgia support - Bereavement group - Spousal Bereavement -Overeaters Anonymous - Stress management - Breast cancer support - Caregiver support - Bariatric support - Smoking cessation |
| CORE FORM, PART III; LINE 4D | EXPENSES INCURRED IN PROVIDING VARIOUS OTHER MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. PLEASE REFER TO THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT INCLUDED IN SCHEDULE O. |
| CORE FORM, PART VI; GOVERNANCE, MANAGEMENT, AND DISCLOSURE; QUESTION 2 | CHRISTINE KLINE AND JOHN A. KLINE, M.D. - FAMILY RELATIONSHIP |
| CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7 | ROBERT WOOD JOHNSON HEALTH CARE CORP. ("RWJHCC") IS THE SOLE MEMBER OF THIS ORGANIZATION. RWJHCC MAINTAINS AUTHORIZATION FOR KEY DECISIONS OF THIS ORGANIZATION INCLUDING, BUT NOT LIMITED TO, APPROVAL OF ANNUAL BUDGETS, ENTERING INTO BORROWING ARRANGEMENTS, STRATEGIC PLANNING AND 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 IS AN AFFILIATE WITHIN THE ROBERT WOOD JOHNSON HEALTH NETWORK ("NETWORK"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THis ORGANIZATION'S FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF ITS GOVERNING BODY (ITS BOARD OF TRUSTEES) PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE ("IRS"). IN ADDITION, THE ORGANIZATION'S LEGAL AND AUDIT COMMITTEE PERFORMS A DETAILED REVIEW OF THE FORM 990 PRIOR TO PROVIDING IT TO THE GOVERNING BODY AS IT HAS ASSUMED THE RESPONSIBILITY TO OVERSEE AND COODINATE THE FEDERAL FORM 990 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 INTERNAL WORKING GROUP 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 INTERNAL WORKING GROUP FOR THEIR REVIEW. THE ORGANIZATION'S FINANCE PERSONNEL AND 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 FINANCE PERSONNEL AND INTERNAL WORKING GROUP FOR FINAL REVIEW AND APPROVAL PRIOR TO REVIEW OF THE FEDERAL FORM 990 BY THE ORGANIZATION'S LEGAL AND AUDIT COMMITTEE and providing it to each voting member of ITS governing body. |
| CORE FORM, PART VI, SECTION B; QUESTION 12 | THE ORGANIZATION IS AN AFFILIATE WITHIN THE ROBERT WOOD JOHNSON HEALTH NETWORK ("NETWORK"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THE ORGANIZATION AND THE NETWORK 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 ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL RAHWAY'S PRESIDENT/CHIEF EXECUTIVE OFFICER FOR REVIEW. THEREAFTER THE PRESIDENT/CHIEF EXECUTIVE OFFICER PREPARES A SUMMARY OF THE COMPLETED QUESTIONNAIRES WHICH CONTAINS INFORMATION DISCLOSED ON AN INDIVIDUAL BY INDIVIDUAL BASIS AND PRESENTS THIS SUMMARY TO THE ORGANIZATION'S GOVERNANCE COMMITTEE FOR ITS REVIEW AND DISCUSSION. |
| CORE FORM, PART VI, SECTION B; QUESTION 15 | THE ORGANIZATION IS AN AFFILIATE WITHIN THE ROBERT WOOD JOHNSON HEALTH NETWORK ("NETWORK"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THIS ORGANIZATION'S BOARD OF TRUSTEES HAS A GOVERNANCE 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 GOVERNANCE COMMITTEE MEETINGS DURING WHICH THE EXECUTIVE COMPENSATION AND BENEFITS WAS REVIEWED AND SUBSEQUENTLY APPROVED. THE ACTIONS OUTLINED ABOVE WITH RESPECT TO THE COMMITTEE AND THE ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS ONLY APPLIES TO CERTAIN SENIOR MANAGEMENT PERSONNEL, INCLUDING BUT NOT LIMITED TO THE PRESIDENT/CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER. THE COMPENSATION AND BENEFITS OF CERTAIN OTHER INDIVIDUALS CONTAINED IN THIS FORM 990 ARE REVIEWED ANNUALLY BY THE PRESIDENT/CHIEF EXECUTIVE OFFICER WITH ASSISTANCE FROM THE ORGANIZATION'S HUMAN RESOURCES DEPARTMENT IN CONJUNCTION WITH THE INDIVIDUAL'S JOB PERFORMANCE DURING THE YEAR AND IS BASED UPON OTHER OBJECTIVE FACTORS DESIGNED TO ENSURE THAT REASONABLE AND FAIR MARKET VALUE COMPENSATION IS PAID BY THE ORGANIZATION. OTHER OBJECTIVE FACTORS INCLUDE MARKET SURVEY DATA FOR COMPARABLE POSITIONS, INDIVIDUAL GOALS AND OBJECTIVES, PERSONNEL REVIEWS, EVALUATIONS, SELF-EVALUATIONS AND PERFORMANCE FEEDBACK MEETINGS. |
| 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 IS MADE AVAILABLE TO THE GENERAL PUBLIC FOR REVIEW. THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE STATE OF NEW JERSEY DEPARTMENT OF THE TREASURY. |
| CORE FORM, PART VII, SECTION A, COLUMN B | THIS ORGANIZATION IS an affiliate within ROBERT WOOD JOHNSON HEALTH NETWORK ("NETWORK"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. 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 NETWORK, THEIR RESPECTIVE HOURS PER WEEK PER ORGANIZATION ARE APPROXIMATELY THE SAME AS REFLECTED IN PART VII OF THIS FORM 990. THE HOURS REFLECTED ON PART VII OF THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, PAID OFFICERS AND KEY EMPLOYEES, REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF THE NETWORK; NOT SOLELY THIS ORGANIZATION. |
| CORE FORM, PART VII AND SCHEDULE J | PART VII AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM THIS ORGANIZATION or a related organization. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OR INDEPENDENT CONTRACTORS OF THIS ORGANIZATION or a related organization AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THIS ORGANIZATION'S BOARD OF TRUSTEES. |
| CORE FORM, PART XI; QUESTION 9 | OTHER CHANGES IN NET ASSETS OR FUND BALANCES INCLUDE: - PENSION LIABILITY ADJUSTMENT - ($15,013,909); - NET ASSETS RELEASED FROM RESTRICTION USED FOR PROPERTY AND EQUIPMENT - $181,783. - NET UNRESTRICTED LOSS IN ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL RAHWAY FOUNDATION & AUXILIARY; BOTH RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATIONS - ($131,640). - NET CHANGE IN TEMPORARILY RESTRICTED NET ASSETS - $188,365. |
| CORE FORM, PART XII; QUESTION 2 | THE ORGANIZATION IS AN AFFILIATE WITHIN ROBERT WOOD JOHNSON HEALTH NETWORK ("NETWORK"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF THE ORGANIZATION AND ITS AFFILIATES FOR THE YEARS ENDED DECEMBER 31, 2014 AND DECEMBER 31, 2013; RESPECTIVELY, AND ISSUED A CONSOLIDATED FINANCIAL STATEMENT WITH CONSOLIDATING SCHEDULES BY ENTITY. AN UNQUALIFIED OPINION WAS ISSUED EACH YEAR BY THE INDEPENDENT CPA FIRM each year. THE ORGANIZATION'S LEGAL AND AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT AUDITOR. |
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