Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (i)Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 669,141 | 448,001 | 106,997 | 56,715 | 421,987 | 1,702,841 |
| 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...... | 12,904,078 | 11,306,098 | 11,055,416 | 11,084,027 | 10,494,201 | 56,843,820 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | 0 | |||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | 0 | |||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | 0 | |||||
| 6 | Total. Add lines 1 through 5. | 13,573,219 | 11,754,099 | 11,162,413 | 11,140,742 | 10,916,188 | 58,546,661 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 0 | |||||
| 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. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support (Subtract line 7c from line 6.) | 58,546,661 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 13,573,219 | 11,754,099 | 11,162,413 | 11,140,742 | 10,916,188 | 58,546,661 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 77,665 | 111,572 | 67,594 | 52,700 | 58,870 | 368,401 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 77,665 | 111,572 | 67,594 | 52,700 | 58,870 | 368,401 |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 0 | |||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 0 | |||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 13,650,884 | 11,865,671 | 11,230,007 | 11,193,442 | 10,975,058 | 58,915,062 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e | Discount claimed for blockage or other factors (explain in detail in Part VI): | |||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| 7 | Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions) | |||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2014 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2014 |
(iii) Distributable Amount for 2014 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2014 from Section C, line 6 |
||||
|
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. |
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| 8 Breakdown of line 7: | ||||
| a From 2010.......X | ||||
| b From 2011.......X | ||||
| c From 2012.......X | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| CORE FORM, PART III; LINE 3 | IN MAY 2014, THE ORGANIZATION CLOSED ITS INPATIENT HOSPICE CARE UNIT. THIS UNIT PROVIDED MEDICALLY NECESSARY INPATIENT HOSPICE CARE SERVICES TO ELDERLY OR HANDICAPPED ADULTS IN THE COMMUNITY. |
| CORE FORM, PART III; LINE 4D | EXPENSES INCURRED IN PROVIDING VARIOUS OTHER MEDICALLY NECESSARY HOSPICE SERVICES, HOME HEALTHCARE AND ADULT MEDICAL CARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. |
| CORE FORM, PART VI, SECTION A; QUESTION 1 | THE ORGANIZATION IS AN AFFILIATE WITHIN THE INSPIRA HEALTH NETWORK; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). FOR THE PERIOD JANUARY 1, 2014 THROUGH DECEMBER 31, 2014 AND DURING THE ORDINARY COURSE OF BUSINESS, THE ORGANIZATION MAY ENGAGE IN ONE OR MORE TRANSACTIONS WITH COMPANIES THAT: (1) ARE OWNED BY AN INDIVIDUAL WHO IS A MEMBER OF THE BOARD OF DIRECTORS OF THIS ORGANIZATION OR A RELATED NOT-FOR-PROFIT ORGANIZATION, (2) ARE OWNED BY A FAMILY MEMBER OF AN INDIVIDUAL WHO IS A MEMBER OF THE BOARD OF DIRECTORS OF THIS ORGANIZATION OR A RELATED NOT-FOR-PROFIT ORGANIZATION, OR (3) WHEREIN A BOARD MEMBER OF THIS ORGANIZATION OR A FAMILY MEMBER OF A BOARD MEMBER OF THIS ORGANIZATION IS EITHER AN OFFICER, DIRECTOR, TRUSTEE OR KEY EMPLOYEE OF A COMPANY WITH WHICH THIS ORGANIZATION OR A RELATED NOT-FOR-PROFIT ORGANIZATION TRANSACTS BUSINESS. IN THESE SITUATIONS, ANY GOODS PURCHASED OR SERVICES PERFORMED ARE DONE SO AT FAIR MARKET VALUE RATES PURSUANT TO ARM'S LENGTH NEGOTIATIONS. ANY SUCH TRANSACTIONS ARE DISCLOSED TO, REVIEWED AND APPROVED BY THE NETWORK'S GOVERNANCE COMMITTEE. THE ORGANIZATION MAINTAINS A WRITTEN CONFLICT OF INTEREST POLICY AND QUESTIONNAIRE AND USES REASONABLE EFFORTS TO OBTAIN THIS INFORMATION FROM THE MEMBERS OF ITS BOARD OF DIRECTORS. THE ORGANIZATION FOLLOWS A FORMALIZED BID PROCESS WHEREIN ALL TRANSACTIONS OF THIS NATURE ARE SENT OUT TO BID. IF IT IS DETERMINED THAT THE ORGANIZATION WILL ENTER INTO A TRANSACTION IDENTIFIED ABOVE, IT IS SENT TO THE NETWORK'S GOVERNANCE COMMITTEE FOR REVIEW AND APPROVAL. THE INTERESTED PERSON IN THESE CASES RECUSES THEMSELVES FROM THE VOTING PROCESS. THIS RECUSAL PROCESS IS OUTLINED IN THE ORGANIZATION'S WRITTEN CONFLICT OF INTEREST POLICY WHICH ALL BOARD MEMBERS AND SENIOR MANAGEMENT REVIEW ANNUALLY. DURING 2014 THE ORGANIZATION OR A RELATED NOT-FOR-PROFIT ORGANIZATION ENGAGED IN THE FOLLOWING TRANSACTIONS WITH INTERESTED PERSONS: SYSTEM ENTITIES HAVE BORROWED FUNDS FROM SUN NATIONAL BANK. INSPIRA MEDICAL CENTERS, INC.; AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK, INC. & AFFILIATES, HAS AN OUTSTANDING UEZ LOAN WITH SUN NATIONAL BANK WITH A PRINCIPAL BALANCE OF $340,890 AT DECEMBER 31, 2014. PETER GALETTO, JR. IS A BOARD MEMBER OF SUN NATIONAL BANK AND A BOARD MEMBER OF INSPIRA HOMECARE & HOSPICECARE, INC. PAYMENT BY INSPIRA HEALTH NETWORK, INC. & AFFILIATES IN THE AMOUNT OF $14,227 TO CUMBERLAND CAPE ATLANTIC YMCA FOR CERTAIN PUBLIC HEALTH INITIATIVES. PETER GALETTO, JR. IS A BOARD MEMBER OF CAPE ATLANTIC YMCA AND A BOARD MEMBER OF INSPIRA HOMECARE & HOSPICECARE, INC. PAYMENT BY INSPIRA HEALTH NETWORK, INC. & AFFILIATES IN THE AMOUNT OF $4,679 TO STANKER AND GALETTO, INC. DURING 2014 FOR RENOVATIONS AND CONSTRUCTION SERVICES. PETER GALETTO, JR. IS THE PRESIDENT OF STANKER AND GALETTO, INC. AND A BOARD MEMBER OF INSPIRA HOMECARE & HOSPICECARE, INC. PAYMENT BY INSPIRA HEALTH NETWORK, INC. & AFFILIATES IN THE AMOUNT OF $31,602 TO SJHCMOB REALTY, LLC DURING 2014. PETER GALETTO, JR. IS A PARTNER IN SJHCMOB REALTY, LLC AND A BOARD MEMBER OF INSPIRA HOMECARE & HOSPICECARE, INC. INSPIRA MEDICAL CENTERS, INC.; AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK, INC. & AFFILIATES, RENTS OFFICE SPACE AT THE ELMER MEDICAL OFFICE BUILDING FROM GALETTO REALTY COMPANY, LP. TOTAL PAYMENTS TO GALETTO REALTY COMPANY, LP. AMOUNTED TO $187,421 DURING 2014. PETER GALETTO, JR. IS A PARTNER IN GALETTO REALTY COMPANY, LP AND A BOARD MEMBER INSPIRA HOMECARE & HOSPICECARE, INC. PAYMENT BY INSPIRA MEDICAL CENTERS, INC.; AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK & AFFILIATES, IN THE AMOUNT OF $9,000 TO DAVID GALETTO, M.D. FOR PHYSICIAN SERVICES. DAVID W. GALETTO, M.D. IS THE COUSIN OF PETER GALETTO, JR; A BOARD MEMBER INSPIRA HOMECARE & HOSPICECARE, INC. PLEASE NOTE THAT THIS TRANSACTION IS DISCLOSED ON THE INSPIRA MEDICAL CENTERS, INC. CORE FORM 990, PART VII. LENDING OF MONEY PURSUANT TO A PRACTICE SUPPORT AGREEMENT BETWEEN INSPIRA MEDICAL CENTERS, INC.; AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK, INC. & AFFILIATES, AND CUMBERLAND INTERNAL MEDICINE. THE ORIGINAL AMOUNT OF THE LOAN WAS $ 41,554. THE LOAN WAS SET UP IN ORDER TO ASSIST THE PRACTICE IN THE OPERATION OF INTERNAL MEDICINE/INFECTIOUS DISEASE SERVICES. THE TOTAL AMOUNT DUE FROM THE PRACTICE AT DECEMBER 31, 2014 WAS $190,665. DAVID GALETTO, M.D. IS AN OWNER OF CUMBERLAND INTERNAL MEDICINE AND THE COUSIN OF PETER GALETTO, JR.; A BOARD MEMBER OF INSPIRA HOMECARE & HOSPICECARE, INC. PLEASE NOTE THAT THIS TRANSACTION IS DISCLOSED ON THE INSPIRA MEDICAL CENTERS, INC. FORM 990, SCHEDULE L, PART IV. PAYMENT BY INSPIRA HEALTH NETWORK, INC. & AFFILIATES IN THE AMOUNT OF $503,760 TO CUMBERLAND INTERNAL MEDICINE FOR MEDICAL SERVICES DURING 2014. DAVID GALETTO, M.D. IS AN OWNER OF CUMBERLAND INTERNAL MEDICINE AND THE COUSIN OF PETER GALETTO, JR.; A BOARD MEMBER OF INSPIRA HOMECARE & HOSPICECARE, INC. PLEASE NOTE THAT THIS TRANSACTION IS DISCLOSED ON THE INSPIRA MEDICAL CENTERS, INC. FORM 990, SCHEDULE L, PART IV. PAYMENT BY INSPIRA HEALTH NETWORK, INC. & AFFILIATES IN THE AMOUNT OF $23,028 TO ROSSI MOTORS, INC. DURING 2014. RONALD ROSSI IS THE OWNER OF ROSSI MOTORS, INC. AND A BOARD MEMBER INSPIRA HOMECARE & HOSPICECARE, INC. PAYMENT BY INSPIRA HEALTH NETWORK, INC. & AFFILIATES IN THE AMOUNT OF $72,165 TO ROWAN UNIVERSITY DURING 2014. DANIEL J. BALL, III IS A BOARD MEMBER OF ROWAN UNIVERSITY AND BOARD MEMBER INSPIRA HOMECARE & HOSPICECARE, INC. PAYMENT BY INSPIRA HEALTH NETWORK, INC. & AFFILIATES IN THE AMOUNT OF $67,896 TO ARCHER & GREINER, P.C. FOR LEGAL SERVICES DURING 2014. JOHN H. FISCHER, III IS AN EMPLOYEE OF ARCHER & GREINER, P.C. AND A BOARD MEMBER OF INSPIRA HOMECARE & HOSPICECARE, INC. JOHN H. FISCHER, III'S DAUGHTER IN LAW IS EMPLOYED BY INSPIRA MEDICAL CENTERS, INC.; AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK, INC. & AFFILIATES, FOR WHICH SHE RECEIVED FORM W-2, BOX 5 MEDICARE WAGES IN THE AMOUNT OF $50,854 DURING 2014. JOHN H. FISCHER, III IS A BOARD MEMBER OF INSPIRA HOMECARE & HOSPICECARE, INC.. PAYMENT BY INSPIRA HEALTH NETWORK, INC. & AFFILIATES IN THE AMOUNT OF $1,244,933 TO NEXUS PROPERTIES, INC. FOR REAL ESTATE DEVELOPMENT AND PROPERTY MANAGEMENT SERVICES DURING 2014. DANTE G. GERMANO IS AN EMPLOYEE OF NEXUS PROPERTIES, INC. AND A BOARD MEMBER OF INSPIRA HOMECARE & HOSPICECARE, INC. PAYMENT BY INSPIRA HEALTH NETWORK, INC. & AFFILIATES IN THE AMOUNT $40,759 TO GATEWAY COMMUNITY ACTION PARTNERSHIP DURING 2014. ALBERT B. KELLY IS AN EMPLOYEE OF GATEWAY COMMUNITY ACTION PARTNERSHIP AND A BOARD MEMBER OF INSPIRA HOMECARE & HOSPICECARE, INC. PAYMENT BY INSPIRA HEALTH NETWORK, INC. & AFFILIATES IN THE AMOUNT OF $4,000 TO THE BRIDGETON AREA CHAMBER OF COMMERCE DURING 2014. ALBERT B. KELLY IS A BOARD MEMBER OF THE BRIDGETON AREA CHAMBER OF COMMERCE AND A BOARD MEMBER OF INSPIRA HOMECARE & HOSPICECARE, INC. PAYMENT BY INSPIRA HEALTH NETWORK, INC. & AFFILIATES IN THE AMOUNT OF $37,764 TO CUMBERLAND COUNTY UNITED WAY DURING 2014. ALBERT B. KELLY IS A BOARD MEMBER OF CUMBERLAND COUNTY UNITED WAY AND A BOARD MEMBER INSPIRA HOMECARE & HOSPICECARE, INC. PAYMENT BY INSPIRA HEALTH NETWORK, INC. & AFFILIATES IN THE AMOUNT OF $20,359 TO GLOUCESTER COUNTY COLLEGE FOUNDATION DURING 2014. HERBERT KONRAD IS A BOARD MEMBER OF GLOUCESTER COUNTY COLLEGE FOUNDATION AND A BOARD MEMBER INSPIRA HOMECARE & HOSPICECARE, INC. THE KIDNEY CENTER AT MILLVILLE, L.L.C.; AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK, INC. & AFFILIATES HAS A DEPOSITORY ACCOUNT AND AN OUTSTANDING LOAN WITH COLONIAL BANK. INSPIRA MEDICAL CENTERS, INC. IS A 50% MEMBER OF THE KIDNEY CENTER AT MILLVILLE, L.L.C. AND GUARANTOR OF 50% OF THE LOAN. THE TOTAL BALANCE OF THE LOAN AS OF DECEMBER 31, 2014 WAS $1,243,804. HUGH MCCAFFREY IS A BOARD MEMBER OF COLONIAL BANK AND A BOARD MEMBER OF INSPIRA HOMECARE & HOSPICECARE, INC. PAYMENT BY INSPIRA HEALTH NETWORK, INC & AFFILIATES IN THE AMOUNT OF $36,177 TO TAVISTOCK COUNTRY CLUB DURING 2014. MICHAEL A. MCLAUGHLIN WAS A BOARD MEMBER OF TAVISTOCK COUNTRY CLUB THROUGH APRIL 30, 2014 AND A BOARD MEMBER OF INSPIRA HOMECARE & HOSPICECARE, INC. PAYMENT BY INSPIRA HEALTH NETWORK, INC. & AFFILIATES IN THE AMOUNT OF $515,285 OF WHICH INSPIRA HOMECARE & HOSPICECARE, INC. PAID $4,605 TO SOUTH JERSEY GAS COMPANY FOR UTILITIES DURING 2014. DAVID ROBBINS, JR. IS AN OFFICER OF SOUTH JERSEY INDUSTRIES AND A BOARD MEMBER OF INSPIRA HOMECARE & HOSPICECARE, INC. PAYMENT BY INSPIRA MEDICAL CENTERS, INC. IN THE AMOUNT OF $17,824 TO CUMBERLAND COUNTY TECHNICAL EDUCATION CENTER DURING 2014. DAVID ROBBINS, JR. IS A BOARD MEMBER OF INSPIRA HOMECARE & HOSPICECARE, INC. AND HIS SPOUSE IS AN OFFICER OF CUMBERLAND COUNTY TECHNICAL EDUCATION CENTER. KEVIN C. BOWEN HAS A SON THAT IS EMPLOYED BY INSPIRA MEDICAL CENTERS, INC.; AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK, INC. & AFFILIATES, FOR WHICH HE RECEIVED FORM W-2, BOX 5 MEDICARE WAGES IN THE AMOUNT OF $38,211 DURING 2014. KEVIN C. BOWEN WAS A BOARD MEMBER OF INSPIRA HOMECARE & HOSPICECARE, INC. THROUGH JUNE 1, 2014. |
| CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7 | INSPIRA HEALTH NETWORK, INC. ("NETWORK") IS THE SOLE MEMBER OF THIS ORGANIZATION. NETWORK HAS THE RIGHT TO ELECT THE MEMBERS OF THIS ORGANIZATION'S BOARD OF DIRECTORS AND HAS CERTAIN RESERVED POWERS AS DEFINED IN THIS ORGANIZATION'S BYLAWS. |
| CORE FORM, PART VI, SECTION B; QUESTION 11B | THE ORGANIZATION IS AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). INSPIRA HEALTH NETWORK, INC. ("NETWORK") IS THE TAX-EXEMPT PARENT ENTITY OF THE SYSTEM. THIS ORGANIZATION'S FEDERAL FORM 990 WAS PROVIDED FOR REVIEW TO EACH MEMBER OF THE NETWORK'S AUDIT/FINANCE COMMITTEE PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE ("IRS"). THE NETWORK'S AUDIT/FINANCE COMMITTEE HAS ASSUMED THE RESPONSIBILITY TO OVERSEE AND COORDINATE THE FEDERAL FORM 990 PREPARATION, REVIEW AND FILING PROCESS FOR ALL TAX-EXEMPT AFFILIATES OF THE SYSTEM. AS PART OF THE ORGANIZATION'S FEDERAL FORM 990 TAX RETURN PREPARATION PROCESS THE SYSTEM HIRED A PROFESSIONAL CPA FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION TO PREPARE THE FEDERAL FORM 990. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE ORGANIZATION'S FINANCE PERSONNEL AND SYSTEM INDIVIDUALS INCLUDING GENERAL COUNSEL, CHIEF FINANCIAL OFFICER, VICE PRESIDENT OF FINANCE AND VARIOUS OTHER INDIVIDUALS ("INTERNAL WORKING GROUP") TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE ORGANIZATION'S INTERNAL WORKING GROUP FOR REVIEW. THE ORGANIZATION'S INTERNAL WORKING GROUP REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE ORGANIZATION'S INTERNAL WORKING GROUP FOR FINAL REVIEW AND APPROVAL PRIOR TO PROVIDING IT TO EACH MEMBER OF THE NETWORK'S AUDIT/FINANCE COMMITTEE AND FILING WITH THE IRS. |
| CORE FORM, PART VI, SECTION B; QUESTION 12 | THE ORGANIZATION IS AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). INSPIRA HEALTH NETWORK, INC. ("NETWORK") IS THE TAX-EXEMPT PARENT ENTITY OF THE SYSTEM. THE ORGANIZATION AND THE SYSTEM REGULARLY MONITOR AND ENFORCE COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. ANNUALLY ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS AND SENIOR MANAGEMENT PERSONNEL ARE REQUIRED TO REVIEW THE EXISTING CONFLICT OF INTEREST POLICY AND COMPLETE A QUESTIONNAIRE. THE COMPLETED QUESTIONNAIRES ARE RETURNED TO THE ORGANIZATION AND NETWORK'S GENERAL COUNSEL FOR REVIEW. THEREAFTER, GENERAL COUNSEL PREPARES A SUMMARY OF THE COMPLETED QUESTIONNAIRES WHICH CONTAINS INFORMATION DISCLOSED ON AN INDIVIDUAL BY INDIVIDUAL BASIS WHICH IS THEN PRESENTED TO THE NETWORK'S GOVERNANCE COMMITTEE FOR ITS REVIEW AND DISCUSSION. |
| CORE FORM, PART VI, SECTION B; QUESTION 15 | THE ORGANIZATION IS AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). INSPIRA HEALTH NETWORK, INC. ("NETWORK") IS THE TAX-EXEMPT PARENT ENTITY OF THE SYSTEM. THIS FILING ORGANIZATION ITSELF HAS NO PAID SENIOR MANAGEMENT PERSONNEL RECEIVING COMPENSATION DIRECTLY FROM THIS ORGANIZATION. RATHER, KEY SENIOR MANAGEMENT PERSONNEL, INCLUDING THE PRESIDENT/CHIEF EXECUTIVE OFFICER AND EXECUTIVE VICE PRESIDENT/CHIEF FINANCIAL OFFICER ARE EMPLOYED BY THE TAX-EXEMPT HOSPITALS WITHIN THE HEALTHCARE SYSTEM. HOWEVER, THE COMPENSATION AND BENEFITS OF THESE INDIVIDUALS ARE SHOWN ON THIS TAX RETURN BECAUSE THEY ARE BOTH OFFICERS OF THIS ORGANIZATION. ACCORDINGLY, THE NETWORK'S BOARD OF DIRECTORS HAS AN EXECUTIVE COMPENSATION COMMITTEE ("COMMITTEE"). THE COMMITTEE HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY WHICH IT FOLLOWS WHEN IT REVIEWS AND APPROVES OF THE COMPENSATION AND BENEFITS OF THE ORGANIZATION'S SENIOR MANAGEMENT, INCLUDING THE PRESIDENT/CHIEF EXECUTIVE OFFICER AND EXECUTIVE VICE PRESIDENT/CHIEF FINANCIAL OFFICER. THE COMMITTEE REVIEWS THE "TOTAL COMPENSATION" OF THE INDIVIDUALS WHICH IS INTENDED TO INCLUDE BOTH CURRENT AND DEFERRED COMPENSATION AND ALL EMPLOYEE BENEFITS, BOTH QUALIFIED AND NON-QUALIFIED. THE COMMITTEE'S REVIEW IS DONE ON AT LEAST AN ANNUAL BASIS AND ENSURES THAT THE "TOTAL COMPENSATION" OF SENIOR MANAGEMENT OF THE ORGANIZATION IS REASONABLE. THE ACTIONS TAKEN BY THE COMMITTEE ENABLE THE ORGANIZATION TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 4958 WITH RESPECT TO THE TOTAL COMPENSATION OF CERTAIN MEMBERS OF THE SENIOR MANAGEMENT TEAM, INCLUDING THE PRESIDENT/CHIEF EXECUTIVE OFFICER AND EXECUTIVE VICE PRESIDENT/CHIEF FINANCIAL OFFICER. THE THREE FACTORS WHICH MUST BE SATISFIED IN ORDER TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS ARE THE FOLLOWING: 1. THE COMPENSATION ARRANGEMENT IS APPROVED IN ADVANCE BY AN "AUTHORIZED BODY" OF THE APPLICABLE TAX-EXEMPT ORGANIZATION WHICH IS COMPOSED ENTIRELY OF INDIVIDUALS WHO DO NOT HAVE A "CONFLICT OF INTEREST" WITH RESPECT TO THE COMPENSATION ARRANGEMENT; 2. THE AUTHORIZED BODY OBTAINED AND RELIED UPON "APPROPRIATE DATA AS TO COMPARABILITY" PRIOR TO MAKING ITS DETERMINATION; AND 3. THE AUTHORIZED BODY "ADEQUATELY DOCUMENTED THE BASIS FOR ITS DETERMINATION" CONCURRENTLY WITH MAKING THAT DETERMINATION. THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF DIRECTORS EACH OF WHO ARE INDEPENDENT AND ARE FREE FROM ANY CONFLICTS OF INTEREST. THE COMMITTEE RELIED UPON APPROPRIATE COMPARABLE DATA; SPECIFICALLY THE COMMITTEE OBTAINED A WRITTEN COMPENSATION STUDY FROM AN INDEPENDENT FIRM WHICH SPECIALIZES IN THE REVIEWING OF HOSPITAL AND HEALTHCARE SYSTEM EXECUTIVE COMPENSATION AND BENEFITS THROUGHOUT THE UNITED STATES. THIS STUDY USED COMPARABLE GEOGRAPHIC AND DEMOGRAPHIC MARKET DATA INCLUDING BUT NOT LIMITED TO SIMILAR SIZED HOSPITALS, # OF LICENSED BEDS AND NET PATIENT SERVICE REVENUE. THE COMMITTEE ADEQUATELY DOCUMENTED ITS BASIS FOR ITS DETERMINATION THROUGH THE TIMELY PREPARATION OF WRITTEN MINUTES OF THE COMPENSATION COMMITTEE MEETINGS DURING WHICH THE EXECUTIVE COMPENSATION AND BENEFITS WAS REVIEWED AND SUBSEQUENTLY APPROVED. THE ACTIONS OUTLINED ABOVE WITH RESPECT TO THE COMMITTEE AND THE ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS ONLY APPLIES TO CERTAIN SENIOR MANAGEMENT PERSONNEL, INCLUDING THE PRESIDENT/CHIEF EXECUTIVE OFFICER AND EXECUTIVE VICE PRESIDENT/CHIEF FINANCIAL OFFICER. |
| CORE FORM, PART VI, SECTION C; QUESTION 19 | THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE STATE OF NEW JERSEY DEPARTMENT OF THE TREASURY. |
| CORE FORM, PART VII AND SCHEDULE J | PART VII AND SCHEDULE J REFLECT A BOARD MEMBER AND OFFICERS WHO RECEIVED COMPENSATION AND BENEFITS FROM A RELATED ORGANIZATION. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OF THE RELATED ORGANIZATION AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OF THIS ORGANIZATION'S BOARD OF DIRECTORS. |
| CORE FORM, PART VII, SECTION A, COLUMN B | THIS ORGANIZATION IS AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM INCLUDES BOTH FOR-PROFIT AND NOT FOR-PROFIT ORGANIZATIONS. CERTAIN BOARD OF DIRECTOR MEMBERS, OFFICERS AND/OR DIRECTORS LISTED ON CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 MAY HOLD SIMILAR POSITIONS WITH BOTH THIS ORGANIZATION AND OTHER AFFILIATES WITHIN THE SYSTEM. THE HOURS SHOWN ON THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE NO COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, REPRESENT THE ESTIMATED HOURS DEVOTED PER WEEK FOR THIS ORGANIZATION. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF DIRECTORS OF OTHER RELATED ORGANIZATIONS IN THE SYSTEM, THEIR RESPECTIVE HOURS PER WEEK PER ORGANIZATION ARE APPROXIMATELY THE SAME AS REFLECTED ON PART VII OF THIS FORM 990. THE HOURS REFLECTED ON PART VII OF THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, PAID OFFICERS AND KEY EMPLOYEES, REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF THE SYSTEM; NOT SOLELY THIS ORGANIZATION. |
| CORE FORM, PART XII; QUESTION 2 | THE ORGANIZATION IS AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). INSPIRA HEALTH NETWORK, INC.("NETWORK") IS THE TAX-EXEMPT PARENT ENTITY OF THE SYSTEM. AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF THE NETWORK AND ALL ENTITIES WITHIN THE SYSTEM FOR THE YEARS ENDED DECEMBER 31, 2014 AND DECEMBER 31, 2013; RESPECTIVELY. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAIN CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. THE INDEPENDENT CPA FIRM ISSUED AN UNQUALIFIED OPINION WITH RESPECT TO THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS EACH YEAR. THE NETWORK'S AUDIT COMMITTEE HAS ASSUMED RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE CONSOLIDATED FINANCIAL STATEMENTS, WHICH INCLUDES THIS ORGANIZATION, AND THE SELECTION OF AN INDEPENDENT AUDITOR. |
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