Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private
foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
A For the 2014 calendar year, or tax year beginning 01-01-2014 , and ending 12-31-2014
BCheck if applicable:
CName of organization
THE COMMUNITY HOSPITAL GROUP INC
 
Doing business as
JFK MEDICAL CENTER
 
Number and street (or P.O. box if mail is not delivered to street address)
98 JAMES STREET
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
EDISON, NJ08820
D Employer identification number

22-6019101
E Telephone number

G Gross receipts $ 493,865,253
F Name and address of principal officer:
RAYMOND F FREDERICKS
80 JAMES STREET
EDISON,NJ08820
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
jfkhealthsystem.org
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1962
M State of legal domicile: NJ
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: WE ARE COMMITTED TO EXCELLENCE IN PROVIDING QUALITY AND COMPASSIONATE HEALTHCARE SERVICES TO OUR DIVERSE COMMUNITIES.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 23
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 19
5 Total number of individuals employed in calendar year 2014 (Part V, line 2a) ...... 5 4,571
6 Total number of volunteers (estimate if necessary) ............. 6 443
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 537,944
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b -191,097
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 2,711,585 2,858,416
9 Program service revenue (Part VIII, line 2g) ......... 446,722,020 466,781,029
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 1,182,979 1,416,223
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 15,538,964 17,886,818
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 466,155,548 488,942,486
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 0
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 251,851,486 256,548,128
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 201,364,647 208,370,528
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 453,216,133 464,918,656
19 Revenue less expenses. Subtract line 18 from line 12....... 12,939,415 24,023,830
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 268,685,938 266,588,129
21 Total liabilities (Part X, line 26)............. 249,649,207 250,285,285
22 Net assets or fund balances. Subtract line 21 from line 20..... 19,036,731 16,302,844
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet
Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2014)
Form 990 (2014)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: WE ARE COMMITTED TO EXCELLENCE IN PROVIDING QUALITY AND COMPASSIONATE HEALTHCARE SERVICES TO OUR DIVERSE COMMUNITIES.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 60,629,142 including grants of $   ) (Revenue $ 68,601,094 )
JFK JOHNSON REHABILITATION INSTITUTE - During 2014, the JFK Johnson Rehabilitation Institute had 2,005 admissions resulting in 26,544 patient days. Please refer to Schedule O, JFK Medical Center Background and History for more information.
4b (Code:   ) (Expenses $ 118,270,152 including grants of $   ) (Revenue $ 118,195,746 )
INPATIENT SERVICE - During 2014, JFK Medical Center had 17,641 admissions resulting in 85,760 patient days. Please refer to Schedule O, JFK Medical Center Background and History for more information.
4c (Code:   ) (Expenses $ 94,553,186 including grants of $   ) (Revenue $ 110,495,884 )
OPERATING ROOM AND SAME DAY SURGERIES - During 2014, JFK Medical Center performed 5,373 inpatient surgeries, 6,300 same day stay surgical procedures and 3,095 surgical procedures at the Mediplex Surgery Center. Please refer to Schedule O, JFK Medical Center Background and History for more information.
4d Other program services (Describe in Schedule O.)
(Expenses $ 154,227,554 including grants of $   ) (Revenue $ 169,488,305 )
4e Total program service expensesMediumBullet427,680,034
Form 990 (2014)
Form 990 (2014)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part III
Click to see attachment............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment
...
7
Yes
 
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment
...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment.........................
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
Yes
 
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H.... Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II..
21
 
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?
......................
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I....
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I...................
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III.........
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV ..........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV
.....................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV...
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I
...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........ Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
379
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
4,571
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?
.........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note.
See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2014)
Form 990 (2014)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
23
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
19
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
Yes
 
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
 
No
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
NJ
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletRICHARD C SMITH
80 JAMES STREET
EDISON,NJ08820 (732) 321-7747
Form 990 (2014)
Form 990 (2014)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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

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

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

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) PRAFUL RAJA........................................................................
CHAIRMAN
0.0
.......................0.0
X           0 0 0
(2) MICHAEL A KLEIMAN DMD........................................................................
VICE CHAIRMAN
0.0
.......................0.0
X           0 0 0
(3) JAY M JENEY........................................................................
SECRETARY & TREASURER
0.0
.......................0.0
X           0 0 0
(4) DAVID A BELOWICH........................................................................
BOARD MEMBER
0.0
.......................0.0
X           0 0 0
(5) RICHARD BULLOCK MD........................................................................
BOARD MEMBER
0.0
.......................0.0
X           0 0 0
(6) SIMPSON YT CHOI........................................................................
BOARD MEMBER
0.0
.......................0.0
X           0 0 0
(7) KIMBERLY GALEOTA........................................................................
BOARD MEMBER
0.0
.......................0.0
X           0 0 0
(8) DONALD GRIFFIN........................................................................
BOARD MEMBER
0.0
.......................0.0
X           0 0 0
(9) JOHN O GRUN........................................................................
BOARD MEMBER
0.0
.......................0.0
X           0 0 0
(10) DONALD KLINE MD........................................................................
BOARD MEMBER
0.0
.......................0.0
X           0 0 0
(11) JOHN G MCDONOUGH DMD........................................................................
BOARD MEMBER
0.0
.......................0.0
X           0 0 0
(12) VAL MESZAROS........................................................................
BOARD MEMBER
0.0
.......................0.0
X           0 0 0
(13) JULANE MILLER-ARMBISTER........................................................................
BOARD MEMBER
0.0
.......................0.0
X           0 0 0
(14) PARAG P PATEL ESQ........................................................................
BOARD MEMBER
0.0
.......................0.0
X           0 0 0
(15) PETER A POGANY........................................................................
BOARD MEMBER
0.0
.......................0.0
X           0 0 0
(16) ELAINE SANTOWASSO........................................................................
BOARD MEMBER
0.0
.......................0.0
X           0 0 0
(17) LEONARD SENDELSKY........................................................................
BOARD MEMBER
0.0
.......................0.0
X           0 0 0
Form 990 (2014)
Form 990 (2014)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) FRANKLIN SPIRN........................................................................
BOARD MEMBER
0.0
.......................0.0
X           0 0 0
(19) RAYMOND F FREDERICKS........................................................................
CEO/PRESIDENT/EX-OFFICIO
40.0
.......................0.0
X   X       982,944 0 330,667
(20) SCOTT GEBHARD........................................................................
COO/EX-OFFICIO
40.0
.......................0.0
X   X       538,600 0 102,858
(21) BARBARA BRAYNOCK........................................................................
EX-OFFICIO
0.0
.......................0.0
X           0 0 0
(22) ELAINE GRAVES........................................................................
EX-OFFICIO
0.0
.......................0.0
X           0 0 0
(23) JASBIR S SARKARIA MD........................................................................
EX-OFFICIO
0.0
.......................0.0
X           0 0 0
(24) BHUDEV SHARMA........................................................................
EX-OFFICIO
0.0
.......................0.0
X           0 0 0
(25) RICHARD C SMITH........................................................................
SENIOR VP & CFO
40.0
.......................0.0
    X       555,497 0 104,226
(26) AMIE THORNTON........................................................................
VP OPERATIONS
40.0
.......................0.0
      X     365,459 0 41,329
(27) WILLIAM OSER........................................................................
SVP MEDICAL AFFAIR
40.0
.......................0.0
      X     536,862 0 107,966
(28) SHIRLEY HIGGINS BOWERS........................................................................
SVP HUMAN RESOURCES
40.0
.......................0.0
      X     355,410 0 73,533
(29) INDRANIL GANGULY........................................................................
CIO
40.0
.......................0.0
      X     309,347 0 46,681
(30) SARA JEAN CUCCURULLO........................................................................
MED DIRECTOR EXEC.
40.0
.......................0.0
      X     389,598 0 66,229
(31) GUDRUN MOLL........................................................................
CNO
40.0
.......................0.0
      X     278,804 0 11,836
(32) ASIF BASHIR........................................................................
HIGHEST COMPENSATED
40.0
.......................0.0
        X   686,710 0 22,325
(33) STEPHEN BLOOMFIELD MD........................................................................
HIGHEST COMPENSATED
40.0
.......................0.0
        X   673,575 0 21,809
(34) JAWAD F KIRMANI........................................................................
HIGHEST COMPENSATED
40.0
.......................0.0
        X   487,189 0 19,771
(35) MOHAMMAD MOUSSAVI........................................................................
HIGHEST COMPENSATED
40.0
.......................0.0
        X   456,258 0 22,295
(36) THOMAS STEINEKE MD........................................................................
HIGHEST COMPENSATED
40.0
.......................0.0
        X   681,800 0 24,350
(37) JOHN MCGEE........................................................................
FORMER OFFICER
0.0
.......................0.0
          X 387,140 0 0
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 7,685,193 0 995,875
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet396
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
GE HEALTHCARE,
3000 North Grandview Blvd
WAUKESHA,WI53188
EQUIPMENT MAINT 4,499,338
MCKESSON TECHNOLOGIES INC,
5995 Windward PARKWAY
ALPHARETTA,GA30005
SOFTWARE SVCS. 3,545,915
OA PETERSON CONSTRUCTION CO,
78 WILLOW STREET
MONTCLAIR,NJ07042
BLDG. CONSTRUCTION 2,944,804
Adickman Communications LLC,
356 Bloomfield Avenue
MONTCLAIR,NJ07042
MEDIA & ADVERTISTING 2,223,309
DHP Management Services,
170 Southport Drive
MORRISVILLE,NC27560
PROF. SERVICES 1,701,927
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet160
Form 990 (2014)
Form 990 (2014)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 1,792,189
e Government grants (contributions)1e 882,673
f All other contributions, gifts, grants, and
similar amounts not included above
1f
183,554
g Noncash contributions included in lines
1a-1f:$
 
h Total. Add lines 1a-1f.......MediumBullet 2,858,416
 Program Service RevenueAmt Business Code
2a PATIENT SERVICE REVENUE 900099 466,098,121 466,098,121    
b MEDICAL RECORDS 900099 188,899 188,899    
c NEURO DRUG STUDY 900099 439,528 439,528    
d LAMAZE 900099 21,320 21,320    
e CPR COURSE 900099 33,161 33,161    
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 466,781,029
 OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 1,340,095     1,340,095
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties...........MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents 435,974  
b Less: rental expenses    
c Rental income or (loss) 435,974 0
d Net rental income or (loss).......MediumBullet 435,974     435,974
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 4,998,895  
b Less: cost or other basis and sales expenses 4,922,767  
c Gain or (loss) 76,128  
d Net gain or (loss)..........MediumBullet 76,128     76,128
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ..
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a SCHOOL OF NURSING 900099 4,573,309 4,112,346 460,963  
b HURRICANE SANDY REVENUE 900099 2,205,571 2,205,571    
c MEDICAID STIMULUS 900099 1,870,011 1,870,011    
d All other revenue .... 8,801,953 8,724,972 76,981  
e Total. Add lines 11a–11d ...... MediumBullet 17,450,844
12 Total revenue. See Instructions......MediumBullet 488,942,486 483,693,929 537,944 1,852,197
Form 990 (2014)
Form 990 (2014)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ...............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 0  
2 Grants and other assistance to domestic individuals. See Part IV, line 22 .... 0  
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ............ 0  
4 Benefits paid to or for members .... 0  
5 Compensation of current officers, directors, trustees, and key employees .... 5,824,810 5,242,329 582,481  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0      
7 Other salaries and wages .... 215,320,550 193,788,495 21,532,055  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 631,692 568,523 63,169  
9 Other employee benefits ....... 17,521,847 15,769,662 1,752,185  
10 Payroll taxes ........... 17,249,229 15,524,306 1,724,923  
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 1,933,777 1,740,399 193,378  
c Accounting ........... 206,107 185,496 20,611  
d Lobbying ........... 0      
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 0      
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) .... 0      
12 Advertising and promotion .... 1,716,379 1,544,741 171,638  
13 Office expenses ....... 2,977,616 2,679,854 297,762  
14 Information technology ...... 11,012,297 9,911,067 1,101,230  
15 Royalties .. 0      
16 Occupancy ........... 2,748,653 2,473,788 274,865  
17 Travel ............ 0      
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 888,784 799,906 88,878  
20 Interest ........... 6,820,517 6,138,465 682,052  
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 16,292,183 14,662,965 1,629,218  
23 Insurance .............. 8,180,466 7,362,419 818,047  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL SUPPLIES 66,047,629 66,047,629    
b BAD DEBT 17,853,233 17,853,233    
c PURCHASE SERVICES 35,077,099 31,569,389 3,507,710  
d EQUIPMENT RENTAL & MAINT. 9,349,132 8,414,219 934,913  
e All other expenses 27,266,656 25,403,149 1,863,507  
25 Total functional expenses. Add lines 1 through 24e 464,918,656 427,680,034 37,238,622 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2014)
Form 990 (2014)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ............. 37,093,651 1 35,963,369
2 Savings and temporary cash investments ......... 0 2 0
3 Pledges and grants receivable, net ........... 0 3 0
4 Accounts receivable, net ............. 57,396,853 4 56,351,023
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
0 6 0
7 Notes and loans receivable, net ............. 0 7 0
8 Inventories for sale or use .............. 6,379,550 8 6,719,108
9 Prepaid expenses and deferred charges .......... 8,497,485 9 9,383,942
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 419,151,897
b Less: accumulated depreciation ..... 10b 295,950,107 126,867,416 10c 123,201,790
11 Investments—publicly traded securities .......... 16,888,965 11 17,739,081
12 Investments—other securities. See Part IV, line 11 ..... 0 12 0
13 Investments—program-related. See Part IV, line 11 ..... 0 13 0
14 Intangible assets ............... 0 14 0
15 Other assets. See Part IV, line 11 ........... 15,562,018 15 17,229,816
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 268,685,938 16 266,588,129
Liabilities 17 Accounts payable and accrued expenses ......... 68,611,135 17 70,076,646
18 Grants payable ................. 0 18 0
19 Deferred revenue ................ 2,692,527 19 2,959,514
20 Tax-exempt bond liabilities ............. 114,997,176 20 111,308,536
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.......... 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 0 23 0
24 Unsecured notes and loans payable to unrelated third parties .... 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 63,348,369 25 65,940,589
26 Total liabilities. Add lines 17 through 25......... 249,649,207 26 250,285,285
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 12,921,755 27 9,615,913
28 Temporarily restricted net assets ........... 4,897,350 28 5,442,305
29 Permanently restricted net assets ........... 1,217,626 29 1,244,626
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ........   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 19,036,731 33 16,302,844
34 Total liabilities and net assets/fund balances ........ 268,685,938 34 266,588,129
Form 990 (2014)
Form 990 (2014)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
488,942,486
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
464,918,656
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
24,023,830
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
19,036,731
5
Net unrealized gains (losses) on investments ...............
5
456,571
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-27,214,288
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
16,302,844
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? .................
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 13
Form 990, Special Condition Description:
Special Condition Description
Form 990 (2014)
Form 990 (2014)
Page 14
Additional Data


Software ID:  
Software Version:  
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
THE COMMUNITY HOSPITAL GROUP INC
 
Employer identification number

22-6019101
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
a
b
c
d
e
f
Enter the number of supported organizations .............................  
g
Provide the following information about the supported organization(s).
(i)Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total    

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (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.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (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.  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (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.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (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.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations....
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed, (ii) the reasons for each such action, (iii) the authority under the organization's organizing document authorizing such action, and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (a) its supported organizations; (b) individuals that are part of the charitable class benefited by one or more of its supported organizations; or (c) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in IRC 4958(c)(3)(C)), a family member of a substantial contributor, or a 35-percent controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part II of Schedule L (Form 990).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9(a)) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9(a)) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of IRC 4943 because of IRC 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 5
Part IV
Supporting Organizations (continued)

Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (1) a written notice describing the type and amount of support provided during the prior tax year, (2) a copy of the Form 990 that was most recently filed as of the date of notification, and (3) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 6
Part V – Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

1.   Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.
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)
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 7
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
 
2 Underdistributions, if any, for years prior to 2014
(reasonable cause required--see instructions)
 
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)
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)
 
6 Remaining underdistributions for 2014. Subtract
lines 3h and 4b from line 1 (if amount greater than
zero, see instructions)
 
7 Excess distributions carryover to 2015. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a From 2010.......X
b From 2011.......X
c From 2012.......X
d From 2013.......  
e From 2014.......  
Schedule A (Form 990 or 990-EZ) (2014)
Schedule A (Form 990 or 990-EZ) 2014
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990 or 990-EZ) 2014

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Name of the organization
THE COMMUNITY HOSPITAL GROUP INC
 
Employer identification number

22-6019101
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 2
Name of organization
THE COMMUNITY HOSPITAL GROUP INC
 
Employer identification number

22-6019101
Part I
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
RESTRICTED
 
 

   
 
 
  ,    

$RESTRICTED


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 3
Name of organization
THE COMMUNITY HOSPITAL GROUP INC
 
Employer identification number

22-6019101
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 4
Name of organization
THE COMMUNITY HOSPITAL GROUP INC
 
Employer identification number

22-6019101
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10)
that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Additional Data


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

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

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd Bullet Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
If the organization answered "Yes" to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" to Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
THE COMMUNITY HOSPITAL GROUP INC
 
Employer identification number

22-6019101
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

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

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

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

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










For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2014

Schedule C (Form 990 or 990-EZ) 2014
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(b) Affiliated group
totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
   
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in)
(a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e))
 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))
 
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2014


Schedule C (Form 990 or 990-EZ) 2014
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
Yes
 
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
Yes
 
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
Yes
 
177,176
j
Total. Add lines 1c through 1i ...............................
177,176
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ............................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
Part II-B, Line 1(I) OTHER LOBBYING ACTIVITIES RETAINER WITH WASHINGTON STRATEGIC CONSULTING, TRAVEL & CONVENTIONS, MEALS & SPECIAL FUNCTIONS AND PAID STAFF OR MANAGEMENT. Also the hospital is a member of the New Jersey Hospital Association, the American Hospital Association, the AMERICAN MEDICAL REHAB PROVIDERS ASSOCIATION, AND THE FAIR SHARE HOSPITAL COLLABORATIVE. ALL FOUR engage in lobbying efforts on behalf of their member hospitals AND A portion of the dues paid to these organizations has been allocated to lobbying activities performed on behalf of the organization. This allocation amounted to $48,678.
Schedule C (Form 990 or 990EZ) 2014

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
THE COMMUNITY HOSPITAL GROUP INC
 
Employer identification number

22-6019101
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a 1
b Total acreage restricted by conservation easements .................. 2b 3.00
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet1
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenue included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII .......
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance ....          
b Contributions ........          
c Net investment earnings, gains, and losses          
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........
         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   8,677,147 8,677,147
b Buildings ................   193,383,629 110,169,033 83,214,596
c Leasehold improvements ............   858,287 654,927 203,360
d Equipment ................   214,862,628 185,126,147 29,736,481
e Other .................   1,370,206   1,370,206
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 123,201,790
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)
(b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) OTHER ASSETS 3,536,934
(2) BENEFICIAL INT IN NET ASSETS 6,686,931
(3) NOTE REC. HARTWYCK AT OAK TREE 2,789,882
(4) DUE FROM JFK HEALTHSHARE, INC. 88,336
(5) DUE FROM JFK FOUNDATION 934,512
(6) DUE FROM ATLANTIC INSURANCE EX 271,448
(7) DUE FROM RWJ JR LIFESTYLE INST 66,284
(8) DUE FROM MUHLENBERG FOUNDATION 222,176
(9) NOTE REC FROM JFK HEALTHSHARE 51,984
(10) DEFERRED FINANCING COSTS 2,529,305
(11) DUE FROM HARTWYCK WEST NURSING 52,024
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 17,229,816
Part X
Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes 0
OTHER LIABILITIES 6,787,798
AMOUNTS DUE 3RD PARTY PAYORS 22,735,013
ACCRUED PENSION LIABILITY 26,583,337
ACCRUED POST RETIREMENT BENEFIT 105,138
CAPITAL LEASE OBLIGATIONS 3,928,240
CURRENT PORTION OF CAP LEASE OBLIGATION 1,921,245
CURRENT PORTION OF LONG-TERM DEBT 3,688,640
DUE TO JFK MEDICAL ASSOCIATES, P.A. 191,178

Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 65,940,589
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1 467,898,258
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d -18,725,866
e Add lines 2a through 2d ..................... 2e -18,725,866
3 Subtract line 2e from line 1..................... 3 486,624,124
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b 2,318,362
c Add lines 4a and 4b....................... 4c 2,318,362
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 488,942,486
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1 447,065,422
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3 447,065,422
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b 17,853,234
c Add lines 4a and 4b....................... 4c 17,853,234
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 464,918,656
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
PART II, LINE 5 JFK MEDICAL CENTER CREATED THE CONSERVATION EASEMENT. THE LAND WAS NOT CONTRIBUTED TO JFK MEDICAL CENTER.
PART II, QUESTIONS 6 AND 7 THE ONLY STAFF HOURS AND EXPENSES INCURRED FOR THE PROPERTY AND EASEMENT WOULD BE FOR ORDINARY LAND UPKEEP.
PART II, LINE 8 THE EASEMENT IS UNDEVELOPABLE RAW LAND.
PART II, LINE 9 JFK MEDICAL CENTER REPORTS CONSERVATION EASEMENTS WITHIN PROPERTY PLANT AND EQUIPMENT ON THE BALANCE SHEET.
PART X, QUESTION 2 JFK Medical Center accounts for uncertainty in income taxes by prescribing a recognition threshold of more-likely-than-not to be sustained upon examination by the appropriate taxing authority. Measurement of the tax uncertainty occurs if the recognition threshold has been met. There were no tax uncertainties that met the recognition threshold in 2014 or 2013.
PART XI, LINE 2D - OTHER ADJUSTMENTS PROVISION FOR DOUBTFUL COLLECTIONS: -18,725,866
PART XI, LINE 4B - OTHER ADJUSTMENTS INVESTMENT INCOME: 603,961 NET ASSETS RELEASED FROM RESTRICTIONS FOR CAPITAL PURCHASES: 1,714,401 TOTAL PART XI, LINE 4B: 2,318,362
PART XII, LINE 4B - OTHER ADJUSTMENTS PROVISION FOR DOUBTFUL COLLECTIONS: 18,725,866 RECOVERY OF DOUBTFUL COLLECTIONS ON RELATED PARTY RECEIVABLES: -872,633 TOTAL PART XII, LINE 4B: 17,853,234
Schedule D (Form 990) 2014

Additional Data


Software ID:  
Software Version:  




SCHEDULE H (Form 990)
Department of the TreasuryInternal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
THE COMMUNITY HOSPITAL GROUP INC
 
Employer identification number

22-6019101
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: .........
3b
Yes
 
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

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

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
 
No
b
If "Yes," did the organization make it available to the public? ..............
6b
 
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) ..
    18,186,978 5,071,495 13,115,483 2.930 %
b Medicaid (from Worksheet 3,
column a) ....
    43,185,351 34,744,152 8,441,199 1.890 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) .
           
d Total Financial Assistance
and Means-Tested
Government Programs .
    61,372,329 39,815,647 21,556,682 4.820 %
Other Benefits
    674,405   674,405 0.150 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) ..
    13,457,116 10,379,558 3,077,558 0.690 %
g Subsidized health services
(from Worksheet 6) ..
    30,317,699 28,363,716 1,953,983 0.440 %
h Research (from Worksheet 7)     1,869,166   1,869,166 0.420 %
i Cash and in-kind
contributions for community
benefit (from Worksheet 8)
           
j Total. Other Benefits ..     46,318,386 38,743,274 7,575,112 1.700 %
k Total. Add lines 7d and 7j .     107,690,715 78,558,921 29,131,794 6.520 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total            
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
17,853,233
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
12,494,058
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
126,012,177
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
170,161,207
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-44,149,030
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?20
Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 THE COMMUNITY HOSPITAL GROUP INC
65 JAMES STREET
EDISON,NJ08820
JFKHEALTHSYSTEM.ORG
X X   X   X X   ACUTE HOSPITAL 1
2 THE COMMUNITY HOSPITAL GROUP INC
65 JAMES STREET
EDISON,NJ08820
JFKHEALTHSYSTEM.ORG
X X   X   X     REHAB FACILITY 2
3 THE COMMUNITY HOSPITAL GROUP INC
PARK RANDOLPH ROADS
PLAINFIELD,NJ07061
JFKHEALTHSYSTEM.ORG
X           X   Plainfield SED and Imaging 1
4 THE COMMUNITY HOSPITAL GROUP INC
60 James Street
Edison,NJ08820
JFKHEALTHSYSTEM.ORG
X               Image Center/MRI 1
5 THE COMMUNITY HOSPITAL GROUP INC
98 JAMES STREET
EDISON,NJ08820
JFKHEALTHSYSTEM.ORG
X               SURGERY CENTER 1
6 THE COMMUNITY HOSPITAL GROUP INC
60 JAMES STREET
EDISON,NJ08820
JFKHEALTHSYSTEM.ORG
X               IMAGE/WOMEN CENTER 1
7 THE COMMUNITY HOSPITAL GROUP INC
4 Ethel Road Suite 406A
Edison,NJ08817
JFKHEALTHSYSTEM.ORG
X               DIAGNOSTIC CARDIOLOGY CENTER 2
8 THE COMMUNITY HOSPITAL GROUP INC
65 JAMES STREET
EDISON,NJ08820
JFKHEALTHSYSTEM.ORG
X               FAMILY MEDICINE 1
9 THE COMMUNITY HOSPITAL GROUP INC
2048 OAKTREE ROAD
EDISON,NJ08818
JFKHEALTHSYSTEM.ORG
X               COGNITIVE REHAB 2
10 THE COMMUNITY HOSPITAL GROUP INC
2050 OAKTREE ROAD
EDISON,NJ08818
JFKHEALTHSYSTEM.ORG
X               PEDIATRIC REHAB 2
11 THE COMMUNITY HOSPITAL GROUP INC
65 JAMES STREET
EDISON,NJ08820
JFKHEALTHSYSTEM.ORG
X               BEHAV/OCCUPATIONAL HEALTH 1
12 THE COMMUNITY HOSPITAL GROUP INC
308 TALMADGE ROAD
EDISON,NJ08817
JFKHEALTHSYSTEM.ORG
X               P&O LAB 2
13 THE COMMUNITY HOSPITAL GROUP INC
1314 Park Ave Suite 9
Plainfield,NJ07060
JFKHEALTHSYSTEM.ORG
X               Diagnostic Cardiology CENTER 2
14 THE COMMUNITY HOSPITAL GROUP INC
300 OVERLOOK DRIVE
MONROE TOWNSHIP,NJ08831
JFKHEALTHSYSTEM.ORG
X               OUTPATIENT REHAB FACILITY 2
15 THE COMMUNITY HOSPITAL GROUP INC
481 MEMORIAL PARKWAY
METUCHEN,NJ08840
JFKHEALTHSYSTEM.ORG
X               OUTPATIENT REHAB FACILITY 2
16 THE COMMUNITY HOSPITAL GROUP INC
561 Middlesex Ave
Metuchen,NJ08840
JFKHEALTHSYSTEM.ORG
X               Cardiac Lab 2
17 THE COMMUNITY HOSPITAL GROUP INC
2050 OAKTREE ROAD
EDISON,NJ08818
JFKHEALTHSYSTEM.ORG
X               CHILDCARE 2
18 THE COMMUNITY HOSPITAL GROUP INC
225 May Street Suite F
Edison,NJ08837
JFKHEALTHSYSTEMS.ORG
X               Diagnostic Cardiology CENTER 2
19 THE COMMUNITY HOSPITAL GROUP INC
3 PROGRESS STREET
EDISON,NJ08817
JFKHEALTHSYSTEM.ORG
X               ADULT DAY CARE 2
20 THE COMMUNITY HOSPITAL GROUP INC
98 James Street
Edison,NJ08820
JFKHEALTHSYSTEMS.ORG
X               Breast Center 2
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
THE COMMUNITY HOSPITAL GROUP INC
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): JFKMC.ORG
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

THE COMMUNITY HOSPITAL GROUP INC
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

THE COMMUNITY HOSPITAL GROUP INC
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ................................ 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
THE COMMUNITY HOSPITAL GROUP INC
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
2
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): jfkmc.org
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

THE COMMUNITY HOSPITAL GROUP INC
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

THE COMMUNITY HOSPITAL GROUP INC
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?................ 21   No
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ................................ 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?  
Name and address Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
PART I, LN 7 COL(F) The bad debt expense included on form 990, Part IX, Line 25, column (A), but subtracted for purposes of calculating the percentage in this column is $17,853,233
Part I, Line 7 WORKSHEET 2 WAS USED FOR THE COST TO CHARGE RATIO.
PART 1, LINE 3C JFK MEDICAL CENTER USES THE INCOME/ASSET CRITERIA AND SLIDING SCALE PROVIDED BY THE STATE OF NEW JERSEY WHEN SCREENING PATIENTS FOR FINANCIAL ASSISTANCE. ADDITIONALLY, JFK MEDICAL CENTER HAS A COMPASSIONATE CARE POLICY TO APPLY DISCOUNTS (WHEN APPLICABLE) IF A PATIENT DOES NOT QUALIFY OR ONLY QUALIFIES FOR PARTIAL CHARITY CARE.
PART 1, LINE 7G Subsidized health services represent clinical patient care services that are provided, despite operating expenses in excess of revenue, because they are needed in the community. During 2014, the organization provided family practice, dental, adult day care, peds rehabilitation and cognitive rehabilitation services programs. The net community benefit expenses represents the total expenses offset by any patient and grant revenue.
PART III, LINE 4 Accounts receivable, patients are reported at net realizable value. Accounts are written off when they are determined to be uncollectible based upon management's assessment of individual accounts. The allowance for doubtful collections is estimated based upon a periodic review of the accounts receivable aging, payor classifications and application of historical write-off percentages. The costing methodology used is the ratio of the cost to charges as described in Worksheet #2 instructions.
PART III, LINE 8 Medicare costs were derived from the 2012 Medicare cost report. The organization's position is that Medicare underpayments and bad debt are community benefits and associated costs should be includable on Form 990, Schedule H, Part I as outlined more fully below. The organization believes that these services and related costs promote health of the community as a whole and are rendered in conjunction with the organization's charitable tax-exempt purpose and mission in providing medically necessary healthcare services to all individuals in a non-discriminatory manner without regard to race, color, creed, sex, national origin, religion or ability to pay and consistent with the Community Benefit Standard promulgated by the IRS. The Community Benefit Standard is the current standard for a hospital for recognition as a tax-exempt and charitable organization under the Internal Revenue Code (IRC) 501(c)(3). The organization is recognized as a tax-exempt and charitable organization under the Internal Revenue Code (IRC) 501(c)(3). Although there is no definition in the tax code for the term "charitable", a regulation promulgated by the Department of the Treasury provides some guidance and states that the term charitable is used in section 501(c)(3) in its generally accepted legal sense, and provides examples of charitable purposes, including the relief of the poor or underprivileged, the promotion of social welfare, and the advancement of education and science. Note, it does not explicitly address the activities of hospitals in the absence of explicit statutory or regulatory requirements applying the term "charitable" to hospitals, it has been left to the IRS to determine the criteria hospitals must meet to qualify as an IRC 501(c)(3) charitable organization. The original standard was known as the Charity Care Standard. This standard was replaced by the IRS with the Community Benefit Standard which is the current Charity Care Standard. In 1956, the IRS issued revenue ruling 56-185, which addressed the requirements hospitals needed to meet in order to qualify for IRC 501(c)(3) status. One of these requirements is known as the Charity Care Standard. Under the standard, a hospital had to provide, to the extent of its financial ability, free or reduced-cost care to patients unable to pay for it. A hospital that expected full payment did not, according to the ruling, provide charity care. The ruling emphasized that a low level of charity care did not necessarily mean that a hospital had failed to meet the requirement since that level could reflect its financial ability to provide such care. The ruling also noted that a publically supported community hospital would normally qualify as a charitable organization because it serves the entire community, and a low level of charity care would not affect a hospitals exempt status if it was due to the surrounding community lack of charitable demands. In 1969, the IRS issued revenue ruling 69-545 which removed from ruling 56-185 the requirements relating to caring for patients without charge or at rates below costs. Under the standard developed in ruling 69-545, which is know as the "Community Benefit Standard", hospitals are judged on whether they promote health of a broad class of individuals in the community. The ruling involved a hospital that only admitted individuals who could pay for the services (by themselves, private insurance, or public programs such as Medicare), but operated a full-time Emergency Room that was open to everyone. The IRS ruled that the hospital qualified as a charitable organization because it promoted the health of people in its community. The IRS reasoned that because the promotion of health was a charitable purpose according to the general law of charity, it fell within the "generally accepted legal sense" of the term "charitable", as required by Treasury Regulation 1.501 (c)(3)-1(d)(2). The IRS ruling stated that the promotion of health, like the relief of poverty and the advancement of education and religion, is one of the purposes in the general law of charity that is deemed beneficial to the community as a whole, even though the class of beneficiaries eligible to receive a direct benefit from its activities does not include all members of the community, such as indigent members of the community, provided that the class is not so small that its relief is not of benefit to the community. The IRS concluded that the hospital was promoting the health of a class of persons that is broad enough to benefit the community because its Emergency Room was open to all and it provided care to everyone who could pay, whether directly or through third-party reimbursement. Other characteristics of the hospital that the IRS highlighted included the following: o Its surplus funds were used to improve patient care, expand hospital facilities, and advance medical training, education and research. o It was controlled by a Board of Trustees that consisted of independent civic leaders. o Hospital medical staff privileges were available to all qualified physicians. The organization believes that Medicare underpayments and bad debt are community benefits and associated costs should be includable on Form 990, Schedule H, Part I. The American Hospital Association's (AHA) position is that Medicare underpayments and bad debt are community benefits and associated costs should be includable on Form 990, Schedule H, Part I. This organization agrees with the AHA position as outlined in the AHA letter to the IRS dated August 21, 2007. With respect to the first published draft of the new Form 990 and Schedule H, the AHA felt that the IRS should incorporate the full value of the community benefit that hospitals provide by counting Medicare underpayments as quantifiable community benefit for the following reasons; o Providing care for the elderly and serving Medicare patients is an essential part of the Community Benefit Standard. o Medicare, like Medicaid, does not pay the full cost of care. Medicare reimburses the hospital only 89 cents for every dollar they spend to take care of Medicare patients. o Many Medicare beneficiaries, like their Medicaid counterparts, are poor. More than 46 percent of Medicare spending is for beneficiaries whose income is below 200 percent Federal poverty level. Many of those Medicare beneficiaries are also eligible for Medicaid, so called dual eligibles. There is every compelling public policy reason to treat Medicare and Medicaid underpayments similarly for the purposes of a hospital's community benefit and include the costs on Form 990, Schedule H, Part I. Medicare underpayment must be shouldered by the hospital in order to continue treating the community's elderly and poor. These underpayments represent a real cost of serving the community and should count as a quantifiable community benefit. Both the AHA and this organization also feel that patient bad debt is a community benefit and thus includable on Form 990, Schedule H, Part I. Like Medicare underpayment, there also are compelling reasons that patient bad debt should be counted as a quantifiable community benefit. A significant majority of bad debt is attributable to low-income patients, who, for many reasons, decline to complete the forms required to establish eligibility for the hospital's Charity Care or Financial Assistance programs. A 2006 Congressional Budget Office Report, Nonprofit Hospitals and the Provision of Community Benefits, cited two studies indicating that "the great majority of bad debt was attributable to patients with incomes below 200 percent of the Federal Poverty Line". The report also noted that a substantial portion of bad debt is pending Charity Care. Unlike bad debt in other industries, hospital bad debt is complicated by the fact that hospitals follow their mission to the community and treat every patient that comes through their Emergency department, regardless of their ability to pay. Patients who have outstanding bills are not turned away, unlike other industries. Bad debt is further complicated by auditing industry standards on reporting Charity Care, many patients cannot or do not provide the necessary extensive documentation required to be deemed Charity Care by the auditors. As a result, roughly 40% of bad debt is pending Charity Care.
PART III, LINE 9B JFK Medical Center recognizes the financial difficulty imposed on the self-pay patient who is least able to pay for healthcare services when billed at the Hospital's standard charges. Credit adjustments to the self-pay balance will be permitted for the purpose of billing and collecting from the self-pay patient. This policy does not affect any billings for services rendered by hospital based physicians groups, professional practice physicians, or parties providing other medical services to the patient not billed by the Hospital. This policy excludes billing for Obstetrics, Gynecology (selected), Newborn, and Cosmetic procedures (covered under separate policy). This policy does not cover amounts owed relating to copays, deductibles, and coinsurance. The cost and subsequent self-pay billing amount will be determined based upon a review of the most current Hospital Specific Medicare Cost Report and managed care commercial rate. All patients that present to the Hospital for medically necessary services who are identified as self-pay patients will be advised when appropriate, by the hospital registrar to contact the New Jersey Hospital Care Payment Assistance Program representative or a Patient Accounting department representative. The Hospital has a formal self-pay billing and collection practice in place to assist the patient with the payment of their account. A. All patients are to be made aware of the New Jersey Hospital Care Payment Assistance program and be provided with the appropriate notice of the availability of the program as required by the program's regulatory guidelines. B. Patients who are determined to be eligible for the New Jersey Hospital Care Payment Assistance Program will have their charges for services reduced using the program calculation and methodology. C. Patients found ineligible for the New Jersey Hospital Care Payment Assistance Program are advised of the uninsured eligibility criteria and are encouraged to apply. D. The billing practice shall be explained when appropriate to the patient to ensure that proper communication occurs regarding this policy. E. A determination will be made at the time of service or as soon as possible thereafter to access and identify any and all other 3rd party benefits available to the patient. This will ensure that all 3rd party payers are billed appropriately, prior to a self-pay adjustment being made on an account. F. The adjustment will be manually made through the hospital billing system and appear as a credit adjustment to the patient balance. G. If the patient expresses an inability to pay the account balance in full, a payment arrangement may be authorized by the Hospital at its discretion. Payment arrangements will be based upon the Hospital's credit and collection policy.
PART VI, NO. 2 This organization reviewed key factors that by population (primary and secondary service areas) that included a representative cross-section of demographics by ethnicity and age. This was accomplished a number of ways. We performed extensive focus groups attended by our primary and secondary service area patient base. We asked questions about health needs, inpatient and outpatient experiences and needs, clinic needs, clinical service line needs and patient satisfaction. These focus groups were done at various times in order to accomplish our goal of having the representative base. We performed an independent telephone survey asking 1,000 residents similar questions regarding health care needs. We also worked with our local community based organizations, both faith based and non-faith based, to provide and identify health needs. Additionally, we were members of a Community Action Group in the Plainfield community to address the health needs of this primary service area.
PART VI, NO. 3 FINANCIAL ASSISTANCE SIGNS ARE POSTED THROUGHOUT THE FACILITY, INCLUDING ADMITTING, Emergency room, Satellite emergency department, IMAGING CENTER AND OTHER PATIENT REGISTRATION AREAS. aLL ELIGIBLE PATIENTS ARE SCREENED FOR FINANCIAL ASSISTANCE ACCORDING TO THE FEDERAL POVERTY GUIDELINES AND REFERRED TO THE APPROPRIATE AGENCIES OR PROGRAMS. aLL PATIENTS THAT CONTACT THE HOSPITAL FOR PRICING ARE INFORMED OF THE CHARITY AND COMPASSIONATE CARE POLICIES OF THE MEDICAL CENTER.
PART VI, NO. 4 According to the US CENSUS WEBSITE 2014 QUICK FACTS, the population of Middlesex County (where JFK is located) reached 836,297, an increase of 11% since 2012. Almost half the total population is comprised of minorities and 8.5% of families live in poverty. As a result of the closure of nearby Muhlenberg Regional Medical Center in August 2008, JFK'S primary service area has expanded as it has become the nearest full service hospital for residents of southwestern Union County, including the city of Plainfield, where over 76.5% of the 50,588 residents are minorities, more than 21.9% of families live in poverty and portions of the city are considered an Urban Enterprise Zone (an area where blighted neighborhoods receive encouragement through tax relief to businesses and entrepreneurs). In 2013, Plainfield'S median household income was $54,158, 24% lower than the state'S $71,637. In terms of ethnicity, Middlesex County has the highest percentage of Asian residents of all New Jersey counties (23.5%). African Americans account for 11% of the population, while Hispanics make up 19.5%. Over 8.5% of families live below the federal poverty level ($23,550 per year for a family of four). The County'S median income of $79,596 in 2014 (the most recent data available) was higher than the state, nevertheless, Middlesex County has pockets of working poor and unemployed persons who rely on JFK for care. According to the Middlesex County FreeholderS' website, "close to one third of the population still earns less than a living wage." Unemployment IN MIDDLEsEX COUNTY rose from 5% in 2008 to 5.1% in 2014.
PART VI, NO. 5 Community building activities undertaken by this organization are focused on improving both the well-being of our PRIMARY SERVICE AREA and SECONDARY SERVICE AREA and improving access to health care. We accomplish this through partnerships with local organizations like the YMCA, FEDERALLY QUALIFIED HEALTH CENTER, Religious and Cultural organizations and individuals who reside in the community. We participate in conferences, lectures, seminars, health fairs and sponsorships. We provide materials, professional and medical personnel, classrooms, social halls for the community benefit.
PART VI, NO. 6 JFK Medical Center performs community outreach from health fairs and seminars, to speeches and tours, each affiliate goes into the community to reinforce and educate regarding access to health care and programs available.
PART VI, NO. 7 NOT APPLICABLE
PART V, SECTION A ALL PROGRAMS LISTED IN THIS SECTION OPERATE UNDER THE COMMUNITY HOSPITAL GROUP LICENSE.
PART V, SECTION B, LINE 5 APPROXIMATELY 100 INDIVIDUALS AND ORGANIZATIONS WERE CONTACTED IN THE COMMUNITY SERVED SOLICITING FEEDBACK ON HEALTH STATUS AND NEEDS IN THE COMMUNITY IN ORDER TO INCORPORATE INTO THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. INTERVIEWS WERE CONDUCTED WITH MUNICIPAL HEALTH OFFICERS/PUBLIC HEALTH DEPARTMENT EMPLOYEES IN MIDDLESEX AND UNION COUNTIES, A COMMUNITY PHYSICIAN, A SENIOR ADMINISTRATOR AT A LARGE PRIMARY CARE PRACTICE, EMPLOYEES OF ADVOCACY AND/OR COMMUNITY SERVICE ORGANIZATIONS AND COMMUNITY LEADERS
PART V, SECTION B, LINE 11 SIGNIFICANT HEALTH NEEDS WERE PRIORITIZED AND CATEGORIZED BASED ON JFK MEDICAL CENTER'S CORE SERVICES AND ABILITY TO SOLVE FOR THESE ISSUES: JFK MEDICAL CENTER'S CORE SERVICES ARE THE NEEDS RELATED TO PROVISION OF SERVICES OFFERED BY JFK MEDICAL CENTER TODAY AND THE NEEDS RELATED TO AREAS OF EXPERTISE OF JFK MEDICAL CENTER AND ITS CLINICAL STAFF. THESE NEEDS INCLUDE EMERGENCY CARE SERVICES, WEIGHT CONTROL PROGRAMS, PHYSICAL ACTIVITY PROGRAMS, MAMMOGRAPHY SCREENING, DIABETIC SCREENING AND LOW BIRTHWEIGHT. SPECIALIZED COMMUNITY ASSETS ARE NEEDS RELATED TO THE PROVISION OF HEALTH SERVICES THAT JFK MEDICAL CENTER DOES NOT OFFER TODAY OR WHERE OTHER ORGANIZATIONS ARE BETTER POSITIONED AND POSSESS THE SPECIALIZED EXPERTISE TO ADDRESS. THESE INCLUDE MENTAL HEALTH SERVICES, SUBSTANCE ABUSE SERVICES, REPRODUCTIVE SERVICES FOR YOUTH, EXCESSIVE DRINKING AND SEXUALLY TRANSMITTED INFECTIONS ENVIRONMENTAL ISSUES ARE NEEDS THAT REQUIRE ACTIONS THAT ARE NOT DIRECTLY RELATED TO THE MISSION OF JFK MEDICAL CENTER AND/OR NEEDS WHERE JFK MEDICAL CENTER HAS LIMITED ABILITY TO INFLUENCE OR DIRECT REQUIRED ACTIONS TO ADDRESS OR WHERE RESPONSIBILITY TO ADDRESS LIES WITH SOME OTHER EXTERNAL ENTITY OR ORGANIZATION THAT DOES NOT TYPICALLY PROVIDE HEALTH SERVICES AND ON NEEDS THAT REQUIRE INDIVIDUALS TO MODIFY BEHAVIORS AND PERSONAL HABITS OUTSIDE OF ANY INSTITUTIONAL SUPPORT OR ANY OTHER ACTIONS BY JFK MEDICAL CENTER. THESE NEEDS INCLUDE SERVICES FOR LOW INCOME, VIOLENT CRIME RATE, INADEQUATE SOCIAL SUPPORT, FAST FOOD RESTAURANTS, UNEMPLOYMENT RATE, DAILY FINE PARTICULATE MATTER, CANCER INCIDENCE, CHILDREN OF SINGLE PARENT HOMES AND POPULATION IN POOR/FAIR HEALTH.
Plainfield Health Connections Plainfield Health Connections (PHC) is a JFK Medical Center initiative serving the Plainfield community. The programs mission is to improve healthcare of the un- and underinsured residents of the community and reduce healthcare costs through innovative community healthcare with a goal of reducing avoidable utilization of high-cost hospital and Emergency Department services. The funding for the programs first year was supported in part by a grant. The programs purpose is to improve patient's health by focusing on community development, health literacy education and coordination of existing health and social service programs to address the needs of the sickest members of the community. PHC staff feature Advance Practice Nurses with a community nursing background and outreach workers to guide patients to appropriate community-base healthcare and social service resources available. Some of the resources available include Federally Qualified Health Centers and other primary care providers, pharmacies, housing and transportation resources and religious and civic organizations. Health literacy education is provided along with individualized and group visits to improve patients' understanding of their particular chronic condition and how to manage the condition. PHC works with community based resources noted above to coordinate care and develop individualized care plans for each patient. PHC seeks to identify barriers to care that impede each patient's wellness, and develop a care plan that will remove those barriers. Examples of these barriers include: cost, transportation, language and cultural barriers, lack of awareness of available resources, lack of knowledge of their chronic condition and how to manage the condition and lack of trust in the traditional healthcare system. During 2014, PHC provided services to approximately 45 patients with a cost of $92,850.
Schedule H (Form 990) 2014
Additional Data


Software ID:  
Software Version:  
Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
THE COMMUNITY HOSPITAL GROUP INC
 
Employer identification number

22-6019101
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
Yes
 
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
Yes
 
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2014

Schedule J (Form 990) 2014
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits
(E) Total of columns
(B)(i)-(D)
(F) Compensation in column(B) reported as deferred in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1AMIE THORNTONVP OPERATIONS (i)
(ii)
319,398
...............................
0
46,061
...............................
0
0
...............................
0
37,617
...............................
0
3,712
...............................
0
406,788
...............................
0
0
...............................
0
2WILLIAM OSERSVP MEDICAL AFFAIR (i)
(ii)
446,279
...............................
0
87,863
...............................
0
2,720
...............................
0
87,393
...............................
0
20,573
...............................
0
644,828
...............................
0
0
...............................
0
3RICHARD C SMITHSENIOR VP & CFO (i)
(ii)
468,910
...............................
0
65,228
...............................
0
21,359
...............................
0
84,362
...............................
0
19,864
...............................
0
659,723
...............................
0
0
...............................
0
4ASIF BASHIRHIGHEST COMPENSATED (i)
(ii)
640,124
...............................
0
20,200
...............................
0
26,386
...............................
0
5,200
...............................
0
17,125
...............................
0
709,035
...............................
0
0
...............................
0
5STEPHEN BLOOMFIELD MDHIGHEST COMPENSATED (i)
(ii)
639,750
...............................
0
12,500
...............................
0
21,325
...............................
0
7,238
...............................
0
14,571
...............................
0
695,384
...............................
0
0
...............................
0
6JAWAD F KIRMANIHIGHEST COMPENSATED (i)
(ii)
412,445
...............................
0
29,119
...............................
0
45,625
...............................
0
5,200
...............................
0
14,571
...............................
0
506,960
...............................
0
0
...............................
0
7MOHAMMAD MOUSSAVIHIGHEST COMPENSATED (i)
(ii)
395,562
...............................
0
14,985
...............................
0
45,711
...............................
0
5,200
...............................
0
17,095
...............................
0
478,553
...............................
0
0
...............................
0
8THOMAS STEINEKE MDHIGHEST COMPENSATED (i)
(ii)
642,650
...............................
0
17,050
...............................
0
22,100
...............................
0
6,241
...............................
0
18,109
...............................
0
706,150
...............................
0
0
...............................
0
9RAYMOND F FREDERICKSCEO/PRESIDENT/EX-OFFICIO (i)
(ii)
786,186
...............................
0
184,438
...............................
0
12,320
...............................
0
309,831
...............................
0
20,836
...............................
0
1,313,611
...............................
0
0
...............................
0
10SCOTT GEBHARDCOO/EX-OFFICIO (i)
(ii)
460,652
...............................
0
75,228
...............................
0
2,720
...............................
0
84,568
...............................
0
18,290
...............................
0
641,458
...............................
0
0
...............................
0
11JOHN MCGEEFORMER OFFICER (i)
(ii)
0
...............................
0
0
...............................
0
387,140
...............................
0
0
...............................
0
0
...............................
0
387,140
...............................
0
0
...............................
0
12SHIRLEY HIGGINS BOWERSSVP HUMAN RESOURCES (i)
(ii)
279,767
...............................
0
44,877
...............................
0
30,766
...............................
0
55,714
...............................
0
17,819
...............................
0
428,943
...............................
0
0
...............................
0
13INDRANIL GANGULYCIO (i)
(ii)
299,347
...............................
0
10,000
...............................
0
0
...............................
0
30,000
...............................
0
16,681
...............................
0
356,028
...............................
0
0
...............................
0
14SARA JEAN CUCCURULLOMED DIRECTOR EXEC. (i)
(ii)
389,512
...............................
0
0
...............................
0
86
...............................
0
51,658
...............................
0
14,571
...............................
0
455,827
...............................
0
0
...............................
0
15GUDRUN MOLLCNO (i)
(ii)
255,684
...............................
0
10,000
...............................
0
13,120
...............................
0
0
...............................
0
11,836
...............................
0
290,640
...............................
0
0
...............................
0
Schedule J (Form 990) 2014

Schedule J (Form 990) 2014
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Return Reference Explanation
SCHEDULE J, PART II OTHER REPORTABLE COMPENSATION CONSISTS OF 457F PLAN EARNED IN 2013, BUT PAID IN 2014, LONG TERM DISABILITY, AUTO ALLOWANCE AND CALL STIPENDS, TAXABLE MOVING, AND TIME BANK PAYOUT. THE REPORTABLE AMOUNT FOR 457F PLAN IS $28,900 FOR SHIRLEY HIGGINS BOWERS. THE REPORTABLE AMOUNTS FOR LONG TERM DISABILITY CONSISTS OF $2,720 FOR WILLIAM OSER, $2,720 FOR RICHARD C. SMITH, $86 FOR ASIF BASHIR, $86 FOR MOHAMMAD MOUSSAVI, $2,720 FOR RAYMOND FREDERICKS, $2,720 FOR SCOTT GEBHARD, $1,866 FOR SHIRLEY HIGGINS BOWERS, $86 FOR SARA JEAN CUCCURULLO. THE REPORTABLE AMOUNT FOR AUTO ALLOWANCE IS $9,600 FOR RAYMOND FREDERICKS. THE REPORTABLE AMOUNTS FOR CALL STIPENDS ARE $26,300 FOR ASIF BASHIR, $21,325 FOR STEPHEN BLOOMFIELD, $45,625 FOR JAWAD F KIRMANI, $45,625 MOHAMMAD MOUSSAVI, $22,100 FOR THOMAS STEINEKE. THE REPORTABLE AMOUNT FOR TAXABLE MOVING IS $4,546 FOR GUDRUN MOLL. THE REPORTABLE AMOUNT FOR TIME BANK PAYOUT IS $8,574 FOR GUDRUN MOLL
SCHEDULE J, PART I, QUESTION 4B THIS QUESTION WAS ANSWERED YES DUE TO THE TWO BENEFIT PLANS THAT SEVERAL KEY EXECUTIVES ARE PARTICIPANTS IN: A) A 457 (F) plan that was established but not funded in 2010, service credits for 2012, 2013 and 2014 were funded in 2013, 2014 and 2015 respectively. B) A KESOP PLAN THAT WAS FROZEN TO NEW CONTRIBUTIONS SUBSEQUENT TO 2002.
SCHEDULE J, PART I, LINE 4A JOHN MCGEE RECEIVED SEVERANCE PAYMENTS IN 2014. THIS AMOUNT IS INCLUDED ON SCHEDULE J, PART II, COLUMN B(III), OTHER REPORTABLE COMPENSATION. HE RECEIVED $387,140 IN SEVERANCE PAYMENTS. HE LEFT THE ORGANIZATION DURING 2011.
SCHEDULE J, PART I, QUESTION 4C EQUITY-BASED COMPENSATION RECEIVED FROM THE ORGANIZATION RICHARD C. SMITH RECEIVED KESOP DISTRIBUTIONS IN 2014 IN THE AMOUNT OF $18,639. IT IS REPORTED ON SCHEDULE J, PART II, COLUMN B(III), OTHER REPORTABLE COMPENSATION.
SCHEDULE J, PART I, QUESTIONS 6A AND 7. The purpose of the Incentive Plan is to provide financial incentives for the achievement of performance objectives that are most important to JFKs mission and financial, quality and operational success. The Executive Compensation Committee makes a recommendation to the Board of Trustees the overall funding as well as the performance measures and the goals in each of these areas. The performance measures, goals and weights are intended to reflect objectives for the current fiscal year in areas of financial, patient care and quality outcomes and patient satisfaction.
Schedule J (Form 990) 2014

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990.

SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
THE COMMUNITY HOSPITAL GROUP INC
 
Employer identification number
22-6019101
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A NJ HEALTHCARE FACILTIES FINANCING AUTHORITY
 
22-1987084 64580AAT8 06-01-2009 119,623,712 SEE SCHEDULE O   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 0      
2 Amount of bonds legally defeased . . . . . . . . . . . 0      
3 Total proceeds of issue . . . . . . . . . . . . . . 119,745,700      
4 Gross proceeds in reserve funds . . . . . . . . . . . . 0      
5 Capitalized interest from proceeds . . . . . . . . . . . 0      
6 Proceeds in refunding escrows . . . . . . . . . . . . 0      
7 Issuance costs from proceeds . . . . . . . . . . . . 1,946,274      
8 Credit enhancement from proceeds . . . . . . . . . . . 0      
9 Working capital expenditures from proceeds . . . . . . . . . 0      
10 Capital expenditures from proceeds . . . . . . . . . . . 21,892,468      
11 Other spent proceeds . . . . . . . . . . . . . . 0      
12 Other unspent proceeds . . . . . . . . . . . . . . 0      
13 Year of substantial completion . . . . . . . . . . . . 2013
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . . X              
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X            
16 Has the final allocation of proceeds been made? . . . . . . . . X              
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X              
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X            
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . . X              
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .   X            
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?                
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .   X            
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0 %      
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0 %      
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0 %      
7 Does the bond issue meet the private security or payment test? . . . . .   X            
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X            
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .   X            
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . .
X              
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .   X            
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .   X            
b Exception to rebate? . . . . . . . .   X            
c No rebate due? . . . . . . . . X              
If "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . .   X            
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X            
b Name of provider . . . . . . . . . 0
 
 
 
 
 
 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was the hedge terminated? . . . . . .                
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .   X            
b Name of provider . . . . . . . . . 0
 
 
 
 
 
 
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .                
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X            
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X              
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X              
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
SCHEDULE K, PART IV, QUESTION 2C THE 2009 ISSUE WAS A MULTIPURPOSE ISSUE. SEE SCHEDULE O. NO REBATE WAS DUE FOR EITHER THE REFUNDING OF THE NEW MONEY BONDS. THE REBATE REPORT WAS CALCULATED AS OF MAY 31, 2014.
Schedule K (Form 990) 2014

Additional Data


Software ID:  
Software Version:  

SCHEDULE O
(Form 990 or 990-EZ)

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

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
THE COMMUNITY HOSPITAL GROUP INC
 
Employer identification number

22-6019101
Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 3 The organization uses outside management services for the following departments: Pharmacy, BIOMED SERVICES, Hemodialysis, Housekeeping management (Includes housekeeping, linen & patient transport), MRI SERVICES AND WOUND CARE.
FORM 990, PART VI, SECTION A, LINE 6 The organization has JFK HEALTH SYSTEM, INC. AS ITS SOLE member.
FORM 990, PART VI, SECTION A, LINE 7B CERTAIN decisions of the governing body of the organization are subject to approval by the member.
FORM 990, PART VI, SECTION B, LINE 11 An Ad-hoc Committee, which includes the Chairman of the Audit and Compliance Committee and a selected designee of the Audit and Compliance Committee as well as designees from the Finance, Legal, Audit and Compliance departments, review the IRS 990 Tax Returns with EisnerAmper LLP, the tax accountant for JFK Health System, Inc. During this review, all comments and recommendations that are made are addressed by the Finance, Legal, and Audit and Compliance departments along with EisnerAmper. The final revised drafts are reviewed by the Ad-hoc Committee to ensure all comments and recommendations were addressed in the final drafts. The Audit and Compliance committee has given the Ad-hoc Committee the authority to approve the IRS 990 Tax Returns. Once the IRS 990 Tax Returns are approved by the Ad-hoc Committee, all Board members are sent an e-mail with instructions on how to access the respective IRS 990 Tax Returns for their review and comments for 4 days on a secure website provided by EisnerAmper LLP. At the end of the 4 day review period, and after any comments have been addressed, the IRS 990 Tax Returns are finalized and filed. Also, after the IRS 990 Tax Returns are filed, the returns are posted on the JFK Health System Board Portal.
FORM 990, PART VI, SECTION B, LINE 12C On an annual basis, Conflict of Interest Disclosure Statements are distributed to all Board Members and employees that are department head and higher levels. All disclosures are reviewed by the Compliance Officer and the Chair of the JFK Audit and Compliance Committee. Any potential conflict of interest is brought to the said Committee for review and consideration and any appropriate action deemed necessary pursuant to the Conflict of Interest policy.
FORM 990, PART VI, SECTION B, LINE 15 THE JFK BOARD OF DIRECTORS HAS DULY APPOINTED AN EXECUTIVE COMPENSATION COMMITTEE (THE "COMMITTEE") THAT IS RESPONSIBLE FOR THE REVIEW AND APPROVAL OF ALL COMPENSATION AND BENEFITS PROVIDED TO EXECUTIVE MANAGEMENT OF THE ORGANIZATION. THE COMMITTEE HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY STATEMENT AND AN EXECUTIVE COMPENSATION COMMITTEE CHARTER. THE COMMITTEE FOLLOWS THE PROCEDURES DESCRIBED IN THE PHILOSOPHY STATEMENT AND THE CHARTER WHEN IT REVIEWS AND APPROVES THE COMPENSATION AND EMPLOYEE BENEFITS PROVIDED TO THE ORGANIZATION'S SENIOR MANAGEMENT, INCLUDING THE PRESIDENT AND CHIEF EXECUTIVE OFFICER AND THE CHIEF FINANCIAL OFFICER. THE COMMITTEE'S REVIEW ANALYZES EVERY ELEMENT OF COMPENSATION, INCLUDING CURRENT AND DEFERRED COMPENSATION, AND BENEFITS, INCLUDING QUALIFIED AND NON-QUALIFIED BENEFITS. THE COMMITTEE CONDUCTS ITS REVIEW AND APPROVAL PROCESS AT LEAST ANNUALLY, AND APPROVES COMPENSATION AND BENEFITS ONLY TO THE EXTENT THAT THE COMMITTEE HAS CONCLUDED THAT THE TOTAL COMPENSATION AND BENEFITS CONSTITUTE NO MORE THAN REASONABLE COMPENSATION. THE COMMITTEE CONSISTS ENTIRELY OF INDEPENDENT MEMBERS OF THE JFK HEALTH SYSTEM BOARD, THE COMMITTEE REVIEWS IN ADVANCE INDEPENDENT DATA SHOWING THE COMPENSATION PROVIDED BY NON-PROFIT ORGANIZATIONS FOR FUNCTIONALLY SIMILAR POSITIONS, AND THE COMMITTEE PREPARES A TIMELY AND THOROUGH WRITTEN RECORD OF ITS DELIBERATIONS AND CONCLUSIONS. ASSISTING THE COMMITTEE IS AN OUTSIDE COMPENSATION CONSULTANT ALONG WITH OUTSIDE LEGAL COUNSEL. AS A RESULT, THE COMMITTEE'S REVIEW PROCESS IS DESIGNED TO SATISFY THE PROCEDURAL CRITERIA NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES.
FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S CONSOLIDATED FINANCIAL STATEMENTS ARE POSTED ON THE JFK HEALTH SYSTEM WEBSITE; ANY OTHER PUBLIC INFORMATION IS AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 9, CHANGES IN NET ASSETS PENSION/POST RETIREMENT LIABILITY ADJUSTMENT -6,406,653 TRANSFERS TO AFFILIATES -15,837,118 CHANGE IN BENEFICIAL INTEREST IN NET ASSETS OF JFK FOUNDATION 571,955 PROVISION SETTLEMENT CHARGE -5,542,473 TOTAL TO FORM 990, PART XI, LINE 9 -27,214,288
FORM 990, PART XII, QUESTION 2C THE PROCESS HAS NOT CHANGED SINCE LAST YEAR. JFK HEALTH SYSTEM HAS A COMMITTEE THAT ASSUMES RESPONSIBILTY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT.
JFK MEDICAL CENTER BACKGROUND JFK MEDICAL CENTER ("JFK") IS A GENERAL MEDICAL AND SURGICAL HOSPITAL. JFK IS RECOGNIZED BY THE IRS AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION PURSUANT TO ITS CHARITABLE PURPOSES, JFK PROVIDES MEDICALLY NECESSARY HEALTH CARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY, MOREOVER, JFK OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. 1) JFK PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF-PAY, MEDICARE AND MEDICAID PATIENTS. 2) JFK OPERATES AN ACTIVE EMERGENCY ROOM FOR ALL PERSONS, WHICH IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR. 3) JFK MAINTAINS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS. 4) CONTROL OF JFK RESTS WITH ITS BOARD OF TRUSTEES, WHICH IS COMPRISED OF INDEPENDENT CIVIC LEADERS AND OTHER PROMINENT MEMBERS OF THE COMMUNITY. 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 JFK AS SHOWN THROUGH THE FACTORS OUTLINED ABOVE AND OTHER INFORMATION CONTAINED HEREIN, CLEARLY DEMONSTRATE THAT THE USE AND CONTROL OF JFK 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.
JFK MEDICAL CENTER HISTORY JFK BEGAN IN THE 1960'S IN RESPONSE TO THE INCREASING DEMAND FOR HEALTH CARE SERVICES CREATED BY RAPID POPULATION GROWTH IN EDISON TOWNSHIP AND ITS SURROUNDING COMMUNITIES. THE LATE EDISON MAYOR ANTHONY M. YELENCSICS, FOR WHOM THE ORIGINAL COMMUNITY HOSPITAL WAS NAMED, LED A GRASSROOTS EFFORT TO OPEN A HOSPITAL TO MEET THIS DEMAND. FOLLOWING A FUNDRAISING CAMPAIGN PIONEERED BY TRUSTEES, PHYSICIANS, AUXILIANS AND COMMUNITY RESIDENTS, THE ORIGINAL 205-BED HOSPITAL OPENED ITS DOORS AND ADMITTED ITS FIRST PATIENT IN 1967. THE 1970'S REPRESENTED A PERIOD OF SIGNIFICANT GROWTH FOR JFK. ONE OF THE MOST IMPORTANT HIGHLIGHTS IN ITS HISTORY WAS THE OPENING OF THE JFK JOHNSON REHABILITATION INSTITUTE ("JRI") IN 1974 FOLLOWING A MERGER WITH MIDDLESEX REHABILITATION HOSPITAL. SINCE THAT TIME, JRI HAS FORGED A REPUTATION FOR EXCELLENCE IN PATIENT CARE AND HAS BECOME A NATIONAL LEADER IN PHYSICAL REHABILITATION MEDICINE. JRI WAS ONE OF THE FIRST REHABILITATION CENTERS IN THE NATION TO RECOGNIZE THAT INDIVIDUALS WITH ACQUIRED TRAUMATIC BRAIN INJURY REQUIRE A SPECIALIZED TREATMENT ENVIRONMENT. WITH ITS UNPRECEDENTED, COMPREHENSIVE APPROACH TO CARE, JRI'S CENTER FOR HEAD INJURIES IS REGARDED AS PIONEERING IN HEAD TRAUMA EVALUATION AND TREATMENT. IN ADDITION, JRI'S PEDIATRIC REHABILITATION DEPARTMENT PROVIDES CHILDREN WITH THE ADAPTIVE AND COPING SKILLS THEY NEED TO ACHIEVE SUCCESS IN EVERYDAY LIFE THROUGH PHYSICAL AND OCCUPATIONAL THERAPY. JRI ALSO OFFERS INPATIENT AND DAY REHABILITATION, OUTPATIENT THERAPIES, AND PROSTHETICS AND ORTHOTICS. JFK ALSO OPENED ITS RADIATION THERAPY CENTER AND ITS FAMILY PRACTICE CENTER DURING THIS DECADE. JFK REACHED A SIGNIFICANT MILESTONE IN 1992 WHEN IT OPENED THE NEW JERSEY NEUROSCIENCE INSTITUTE ("INSTITUTE"), WHICH IS A NATIONALLY RECOGNIZED COMPREHENSIVE CENTER FOR THE DIAGNOSIS, TREATMENT, AND STUDY OF NEUROLOGICAL DISEASE. THE INSTITUTE CONTINUES TO ATTRACT TOP NEUROSCIENCE EXPERTS FROM ACROSS THE UNITED STATES. IT ALSO WORKS TO PROMOTE INVESTIGATIVE EFFORTS IN BASIC AND CLINICAL RESEARCH. OTHER SIGNIFICANT ADDITIONS THAT OCCURRED OVER THE PAST THREE DECADES INCLUDED JFK'S CANCER CENTER, WHICH FEATURES STATE-OF-THE-ART CANCER DIAGNOSIS AND TREATMENT CAPABILITIES, HOSPICE CARE AND PARTICIPATION IN NATIONWIDE CANCER RESEARCH NETWORKS; JFK'S OUTPATIENT MEDIPLEX SURGERY CENTER WHICH PROVIDES SAME-DAY PROCEDURES, INCLUDING LASER, ENDOSCOPIC AND ARTHROSCOPIC SURGERY, JFK'S IMAGING CENTER AND BREAST CENTER. BOTH OFFER A FULL RANGE OF DIAGNOSTIC EXAMINATIONS, INCLUDING CAT SCAN AND MRI SERVICES.
JFK MEDICAL CENTER CURRENT INFORMATION JFK MEDICAL CENTER ("JFK") IS a 499-BED HOSPITAL CONSISTING OF THE 405-acute care BED ANTHONY M. YELENCSICS COMMUNITY HOSPITAL AND THE ADJACENT 94-BED JFK JOHNSON REHABILITATION INSTITUTE. JFK FEATURES A COMPLETE ARRAY OF SERVICES, INCLUDING GENERAL SURGERY, EMERGENCY MEDICINE, BEHAVIORAL HEALTH, ORTHOPEDICS, MATERNITY AND PEDIATRIC CARE PROGRAMS. SPECIAL SERVICES AT THE MEDICAL CENTER INCLUDE THE NEW JERSEY NEUROSCIENCE INSTITUTE, A DIAGNOSTIC, TREATMENT, TEACHING AND RESEARCH CENTER FOR THE STUDY OF COMPLEX NEUROLOGICAL DISORDERS; THE REGIONAL CANCER CENTER, OFFERING COMPREHENSIVE MEDICAL, SURGICAL AND RADIATION ONCOLOGY SERVICES; THE JFK DIAGNOSTIC IMAGING CENTER WHICH HOUSES TRADITIONAL AND OPEN AIR MRI CAPABILITIES, HIGH SPEED COMPUTER TOMOGRAPHY (CT), ADVANCED BONE DENSITY TECHNOLOGY, AND THE BREAST CENTER, PROVIDING COMPLETE MAMMOGRAPHY SERVICES INCLUDING FULL-FIELD DIGITAL AND THE R2 IMAGE CHECKER TECHNOLOGY. OTHER SERVICES INCLUDE THE JFK FITNESS CENTER, OCCUPATIONAL HEALTH PROGRAM AND FAMILY MEDICINE CENTER. THE FAMILY MEDICINE CENTER WAS ESTABLISHED IN 1976 AND HAS SERVED THE SURROUNDING COMMUNITIES TO PROVIDE PRIMARY CARE SERVICES TO INSURED AND UNINSURED PATIENTS IN THE SERVICE AREA. STAFFED BY FACULTY AND RESIDENT PHYSICIANS, IT PROVIDES SERVICES WHICH INCLUDE: GENERAL MEDICINE, OB/GYN CARE, PEDIATRIC AND MINOR SURGERY. IN ADDITION, HEALTH EDUCATION/PROMOTION, NUTRITIONAL COUNSELING AND EMOTIONAL SUPPORT PROGRAMS ARE OFFERED. IN 2014 JFK RECORDED 17,568 ADMISSIONS AND 2,392 BIRTHS, AND MORE THAN 80,000 EMERGENCY ROOM VISITS. JFK IS AN AFFILIATE OF JFK HEALTH SYSTEM, A NOT-FOR-PROFIT HEALTH SYSTEM SERVING THE RESIDENTS OF CENTRAL NEW JERSEY WITH STRONG TIES TO THE LOCAL COMMUNITY, ESTABLISHED REGIONAL REPUTATION, EXCEPTIONAL EMPLOYEES, A COMMITMENT TO PATIENT SATISFACTION AND QUALITY MEDICAL STAFF TO PROVIDE HIGH QUALITY, COST-EFFECTIVE CARE. SPECIAL SUPPORT SERVICES ARE ALSO AVAILABLE SUCH AS DIAGNOSTIC IMAGING, GERIATRIC CARE AND COMMUNITY HEALTH AND FITNESS PROGRAMS. THROUGH COMMUNITY OUTREACH, JFK OFFERS HEALTH AND WELLNESS PROGRAMS, SCREENINGS, LECTURES AND EDUCATIONAL SEMINARS TO MORE THAN 23,500 AREA RESIDENTS ANNUALLY. THE HAROLD B. AND DOROTHY A. SNYDER SCHOOLS OF NURSING, RADIOGRAPHY, NUCLEAR MEDICINE TECHNOLOGY, RADIATION THERAPY AND DIAGNOSTIC MEDICAL SONOGRAPHY ARE OPERATED BY AND FOR PURPOSES OF ACADEMIC ACCREDITATION, SPONSORED BY JFK. THE SCHOOLS CARRY ON A LONG TRADITION OF EDUCATING FUTURE HEALTH CARE PROFESSIONALS WITH MORE THAN 300 STUDENTS ENROLLED IN THE FIVE SCHOOLS ANNUALLY. THE SCHOOL OFFERS STUDENTS ACCESS TO JFK HEALTH SYSTEM'S STATE-OF-THE-ART EQUIPMENT AND EXPANSIVE CLINICAL FACILITIES.
JFK MEDICAL CENTER VISION WE WILL BE RECOGNIZED FOR BEING RESPONSIVE AND SENSITIVE TO COMMUNITY NEEDS, EXTENDING BEYOND OUR TRADITIONAL BOUNDARIES, IN ORDER TO ACHIEVE HIGHER LEVELS OF COMMUNITY HEALTH AND ACCESS. WE WILL BE RECOGNIZED FOR A CULTURE DRIVEN BY TRUST, IN WHICH DEDICATED, CARING AND COMPASSIONATE INDIVIDUALS WORK TOGETHER WITH FAMILIES TO OVERCOME HEALTH CARE CHALLENGES. WE WILL BE RECOGNIZED FOR HIGH QUALITY SERVICES AND OUTSTANDING SAFETY PERFORMANCE BASED UPON NATIONAL STANDARDS. WE WILL BE RECOGNIZED AS AN EMPLOYER THAT EMPHASIZES PROFESSIONAL AND PERSONAL DEVELOPMENT IN ORDER TO MAXIMIZE THE POTENTIAL OF EVERY INDIVIDUAL. WE WILL BE RECOGNIZED FOR CLINICAL SUPERIORITY THROUGH THE EXPERTISE OF OUR MEDICAL STAFF AND THE CONTINUED APPLICATION OF CUTTING-EDGE TECHNOLOGIES.
JFK MEDICAL CENTER DEMOGRAPHICS JFK MEDICAL CENTER IS LOCATED IN EDISON - AN URBAN/SUBURBAN AREA OF MIDDLESEX COUNTY. ONE OF THE FASTEST GROWING COUNTIES IN THE STATE, MIDDLESEX COUNTY IS THE THIRD LARGEST COUNTY IN NEW JERSEY WITH MORE THAN 836,000 RESIDENTS.
EXTENSION DESCRIPTION ON WHY THE RETURN WAS NOT TIMELY FILED AWAITING INFORMATION FROM THIRD PARTIES NECESSARY TO FILE A COMPLETE AND ACCURATE RETURN.
FORM 990, PART VII METHOD EMPLOYED IN THE DETERMINATION OF ESTIMATED HOURS PER WEEK. DURING THE ANNUAL BUDGET PROCESS, THE FINANCE DEPARTMENT PERFORMS AN ANALYSIS OF THE EXECUTIVE LEVEL EMPLOYEES' TIME ALLOCATION FROM TIME KEEPING RECORDS. THE APPROPRIATE ADJUSTMENTS ARE MADE TO THE TIME ALLOCATIONS AT THAT TIME. The officers and key employees of JFK Health System hours per week are allocated among many of the related organizations.
SCHEDULE R, PART V, LINE 1O JFK HEALTH system maintains a master employee leasing agreement that provides for the leasing of personnel to and from various JFK HEALTH SYSTEM entities.
SCHEDULE K, PART I New money -- $21,892,468.25 for various capital improvements to JFK Medical Center, including, but not limited to, expansion of inpatient bed capacity and unit renovations, emergency room expansion, operating room renovations and expansion, relocation of support departments, conversion of HVAC system and other necessary expansions, renovations and improvements, and the refinancing of various series of bonds issued on behalf of, and other indebtedness of, JFK Medical Center, Hartwyck at Oak Tree and Muhlenberg Regional Medical Center, as described below, all in connection with the termination of the provision of hospital acute care services at Muhlenberg Regional Medical Center and pursuant to the State's Hospital Asset Transformation Program. Current Refundings: 1995 Bonds $17,670,697 1998 Bonds $36,114,765 2003 Bonds $33,137,809 2005 Bonds $17,935,000 Line of credit $6,571,000 Capitalized Interest -- 1,761,145 Costs of issuance- -- 1,946,274
FORM 990, PART VI, SECTION A, LINE 7A While the member cannot elect or appoint one or more members of the governing body, all board appointments are subject to approval by the member. THE DIRECTORS, OTHER THAN EX-OFFICIO DIRECTORS, ARE ELECTED BY A VOTE OF THE BOARD AT THE ANNUAL MEETING OF THE CORPORATION. THE DIRECTOR MEMBERSHIP COMMITTEE SHALL NOMINATE A SLATE OF DIRECTORS TO SERVE AS OFFICERS TO REPLACE OR REELECT THOSE OFFICERS WHOSE TERMS ARE ENDING.
FORM 990, PART VII DEFINITION OF EX-OFFICIO People who hold a position by virtue of their office
FORM 990, PART VII, SECTION A LEONARD SENDELSKY IS NO LONGER A BOARD MEMBER AS OF DECEMBER 2014.
FORM 990, PART VII FOR DR. RICHARD B. BULLOCK, THE COMPENSATION REPRESENTS SERVICES AS ACLS - MEDICAL DIRECTOR
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2014

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet
Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
THE COMMUNITY HOSPITAL GROUP INC
 
Employer identification number

22-6019101
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity

(1) JFK POPULATION HEALTH COMPANY LLC
98 JAMES STREET
EDISON,NJ08820
42-2866956
HOSPITAL NJ 1,316,930   JFKMC
 










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


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1) JFK HEALTH SYSTEM INC
98 JAMES STREET

EDISON,NJ08820
22-2421432
HEALTHCARE NJ 501(C)(3) 11a N/A
 
No
(2) MUHLENBERG REGIONAL MEDICAL CENTER INC
98 JAMES STREET

EDISON,NJ08820
22-1487258
HEALTHCARE NJ 501(C)(3) 9 JFKHS
 
 
No
(3) MUHLENBERG FOUNDATION INC
98 JAMES STREET

EDISON,NJ08820
51-0212678
FUNDRAISING NJ 501(C)(3) 11a MRMC
 
 
No
(4) JFK MEDICAL CENTER FOUNDATION INC
98 JAMES STREET

EDISON,NJ08820
22-2315044
FUNDRAISING NJ 501(C)(3) 11a JFKHS
 
 
No
(5) JFK HEALTH SYSTEM REALTY CORPORATION
98 JAMES STREET

EDISON,NJ08820
52-1703518
INACTIVE NJ 501(C)(25)   JFKHS
 
 
No
(6) ROBERT WOOD JOHNSON JR INC LIFESTYLE
98 JAMES STREET

EDISON,NJ08820
22-2421433
HEALTHCARE NJ 501(C)(3) 9 JFKHS
 
 
No
(7) HARTWYCK WEST NURSING HOME INC
98 JAMES STREET

EDISON,NJ08820
22-1802017
HEALTHCARE NJ 501(C)(3) 9 JFKHS
 
 
No
(8) JFK ASSISTED LIVING INC
98 JAMES STREET

EDISON,NJ08820
22-3715324
HEALTHCARE NJ 501(C)(3) 9 HARTWYCK WES
 
 
No
(9) HARTWYCK AT OAK TREE INC
98 JAMES STREET

EDISON,NJ08820
22-2666023
HEALTHCARE NJ 501(C)(3) 9 JFKHS
 
 
No
(10) HARTWYCK AT JFK INC
98 JAMES STREET

EDISON,NJ08820
20-4144804
HEALTHCARE NJ 501(C)(3) 11b JFKHS
 
 
No
(11) JFK MEDICAL ASSOCIATES PA
98 JAMES STREET

EDISON,NJ08820
46-2219798
PHYS PRACTICE NJ 501(C)(3) 9 JFKHS
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



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

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




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



(k)
Percentage
ownership


Yes No Yes No
(1) MSO - SEE PART VII

98 JAMES STREET
EDISON,NJ08820
INACTIVE NJ JFKHS
 
related       No     No  
(2) MEDIPLEX - SEE PART VII

98 JAMES STREET
EDISON,NJ08820
RENTALS NJ JFK HEALTHSHARE
 
excluded       No     No  










Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) ATLANTIC INSURANCE EXCHANGE LTD

98 JAMES STREET
EDISON,NJ08820
99-9999999
INSURANCE CAPTIVE BD JFKHS
 
C CORP         No
(2) CENTRAL JERSEY MEDICAL GROUP PA

98 JAMES STREET
EDISON,NJ08820
22-3477610
INACTIVE NJ MRMC
 
C CORP         No
(3) JFK MEDICAL GROUP PC

98 JAMES STREET
EDISON,NJ08820
22-3482637
MEDICAL SERVICES NJ JFKMC
 
C CORP   1,154 100.000 % Yes  
(4) JFK HARTWYCK MGT & CONSULTING INC

98 JAMES STREET
EDISON,NJ08820
22-3812130
INACTIVE NJ HARTWYCK WEST
 
C CORP         No
(5) JFK HEALTHSHARE INC

98 JAMES STREET
EDISON,NJ08820
22-2528967
MANAGEMENT SVCS NJ JFKHS
 
C CORP         No
(6) MIDTOWN SHOPS INC

98 JAMES STREET
EDISON,NJ08820
22-1536954
RETAIL COMPLEX NJ MRMC
 
C CORP         No
(7) PRIMARY CARE NETWORK

98 JAMES STREET
EDISON,NJ08820
52-2069919
HEALTH ORG. NJ JFKMC
 
C CORP -2,478 208,336 100.000 % Yes  
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) HARTWYCK AT OAK TREE INC

A 1,027,831 SEE PART VII
(2) JOHN F KENNEDY MEDICAL CENTER FOUNDATION INC

C 1,758,803 SEE PART VII
(3) MUHLENBERG REGIONAL MEDICAL CENTER INC

K 888,315 SEE PART VII
(4) JFK HEALTH SYSTEM INC

P 7,635,000 SEE PART VII
(5) JFK HEALTHSHARE INC

P 10,000 SEE PART VII
(6) HARTWYCK AT OAK TREE INC

Q 4,655,869 SEE PART VII
(7) HARTWYCK WEST NURSING HOME INC

Q 650,000 SEE PART VII
(8) JFK HEALTH SYSTEM INC

Q 2,075,648 SEE PART VII
(9) ROBERT WOOD JOHNSON JR LIFESTYLE INSTITUTE

Q 385,384 SEE PART VII
(10) JOHN F KENNEDY MEDICAL CENTER FOUNDATION INC

Q 1,486,000 SEE PART VII
(11) JFK ASSISTED LIVING INC

Q 950,000 SEE PART VII
(12) MUHLENBERG REGIONAL MEDICAL CENTER INC

A 240,000 SEE PART VII
(13) ROBERT WOOD JOHNSON JR LIFESTYLE INSTITUTE

C 244,101 SEE PART VII
(14) MUHLENBERG FOUNDATION INC

C 33,386 SEE PART VII
(15) HARTWYCK AT OAK TREE INC

K 372,000 SEE PART VII
(16) MUHLENBERG REGIONAL MEDICAL CENTER INC

P 1,001,685 SEE PART VII
(17) HARTWYCK AT OAK TREE

K 27,216 SEE PART VII
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

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




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
SCHEDULE R, PART IV DR. WILLIAM OSER IS THE LEGAL OWNER OF JFK MEDICAL GROUP. JFK HEALTH SYSTEMS IS THE BENEFICIAL OWNER.
SCHEDULE R, PART III LINE 1 INFORMATION: MANAGEMENT SERVICES ORGANIZATION OF CENTRAL JERSEY, LLC 98 JAMES STREET EDISON, NJ 08820 EIN: 22-3489091 LINE 2 INFORMATION: MEDIPLEX SURGICAL CENTER ASSOCIATION, LP 98 JAMES STREET EDISON, NJ 08820 EIN: 22-2846980
SCHEDULE R, PART V, LINE 2 ALL TRANSACTIONS WITH RELATED ORGANIZATIONS ARE VALUED AT ACTUAL AMOUNTS.
Schedule R (Form 990) 2014
Additional Data


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