Form990
Click to see attachment
Department of the TreasuryInternal 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
2015
Open to Public Inspection
A For the 2015 calendar year, or tax year beginning 01-01-2015 , and ending 12-31-2015
BCheck if applicable:
CName of organization
HACKENSACK UNIVERSITY MEDICAL CENTER
 
% ROBERT L GLENNING
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
30 PROSPECT AVENUE
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
HACKENSACK, NJ07601
D Employer identification number

22-1487576
E Telephone number

G Gross receipts $ 1,371,599,115
F Name and address of principal officer:
ROBERT C GARRETT
30 PROSPECT AVENUE
HACKENSACK,NJ07601
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.HACKENSACKUMC.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: 1888
M State of legal domicile: NJ
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: THE ORGANIZATION IS A TEAM COMMITTED TO PROVIDING AN EXCEPTIONAL PATIENT EXPERIENCE THROUGH QUALITY PATIENT-CENTERED CARE, EDUCATION, RESEARCH AND COMMUNITY OUTREACH.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 27
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 24
5 Total number of individuals employed in calendar year 2015 (Part V, line 2a) ...... 5 8,149
6 Total number of volunteers (estimate if necessary) ............. 6 1,856
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 23,748,300
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b -1,259,610
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 23,629,124 13,535,269
9 Program service revenue (Part VIII, line 2g) ......... 1,236,781,537 1,294,593,784
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 25,773,858 34,907,641
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 22,932,614 23,181,110
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 1,309,117,133 1,366,217,804
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 555,987 894,750
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) 608,965,335 617,551,585
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).... 592,953,083 627,143,070
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 1,202,474,405 1,245,589,405
19 Revenue less expenses. Subtract line 18 from line 12....... 106,642,728 120,628,399
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 1,734,990,497 1,797,132,792
21 Total liabilities (Part X, line 26)............. 1,028,441,963 1,152,043,180
22 Net assets or fund balances. Subtract line 21 from line 20..... 706,548,534 645,089,612
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 (2015)
Form 990 (2015)
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: THE ORGANIZATION IS A TEAM COMMITTED TO PROVIDING AN EXCEPTIONAL PATIENT EXPERIENCE THROUGH QUALITY PATIENT-CENTERED CARE, EDUCATION, RESEARCH, AND COMMUNITY OUTREACH. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S CHARITY CARE COMMUNITY BENEFIT STATEMENT.
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 $ 245,449,431 including grants of $ 0 ) (Revenue $ 182,325,858 )
EXPENSES INCURRED IN PROVIDING MEDICALLY NECESSARY PHARMACEUTICAL SERVICES AND PHARMACEUTICALS, INCLUDING CHEMOTHERAPY DRUGS, TO ALL INDIVIDUALS REGARDLESS of RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S CHARITY CARE COMMUNITY BENEFIT STATEMENT.
4b (Code:   ) (Expenses $ 140,278,797 including grants of $ 0 ) (Revenue $ 276,363,497 )
EXPENSES INCURRED IN PROVIDING MEDICALLY NECESSARY ACUTE CARE SERVICES, INCLUDING INPATIENT AND OUTPATIENT CARDIAC, PLASTIC SURGERY, TRAUMA AND PEDIATRIC AND AMBULATORY SURGERY TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY PAY. DURING 2015 THE ORGANIZATION REGISTERED 44,009 CASES AND 229,752 PATIENT DAYS OF ACUTE CARE SERVICES NET OF SAME DAY SURGERY AND SAME DAY MEDICINE. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S CHARITY CARE COMMUNITY BENEFIT STATEMENT.
4c (Code:   ) (Expenses $ 137,778,236 including grants of $ 0 ) (Revenue $ 116,311,627 )
EXPENSES INCURRED IN PROVIDING MEDICALLY NECESSARY OPERATING ROOM SERVICES, INCLUDING INPATIENT AND OUTPATIENT CARDIAC, PLASTIC SURGERY, TRAUMA, PEDIATRIC AND AMBULATORY SURGERY, TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. DURING 2015 THE ORGANIZATION REGISTERED 14,703 INPATIENT AND 15,920 OUTPATIENT SURGICAL OPERATIONS. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S CHARITY CARE COMMUNITY BENEFIT STATEMENT.
4d Other program services (Describe in Schedule O.)
(Expenses $ 489,542,421 including grants of $ 894,750 ) (Revenue $ 736,163,915 )
4e Total program service expensesMediumBullet1,013,048,885
Form 990 (2015)
Form 990 (2015)
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 IIIClick 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
 
No
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
Yes
 
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
Yes
 
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
 
No
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
 
No
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
 
No
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
Yes
 
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.........Click to see attachment
14b
Yes
 
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.....Click to see attachment
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...Click to see attachment
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 list of attachments
20b
Yes
 
Form 990 (2015)
Form 990 (2015)
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.....Click to see attachment
21
Yes
 
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........Click to see attachment
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............ Click to see attachment
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 ...................Click to see attachment
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 ................Click to see attachment
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......... Click to see attachment
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 ........................Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV.....................Click to see attachment
28b
Yes
 
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... Click to see attachment
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 (2015)
Form 990 (2015)
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
1,073
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
8,149
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
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletBD
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
Yes
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
Yes
 
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 (2015)
Form 990 (2015)
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
27
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
24
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
Yes
 
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
 
No
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
Yes
 
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 , NY
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:
MediumBulletROBERT L GLENNING30 PROSPECT AVENUE   HACKENSACK,NJ07601 (551) 996-3365
Form 990 (2015)
Form 990 (2015)
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) LAWRENCE R INSERRA JR......................................................................
CHAIRMAN - GOVERNOR
 10.0
.................
0.0 		X   X       0 0 0
(2) JUSTICE MARIE L GARIBALDI......................................................................
1ST VICE CHAIR - GOVERNOR
 5.0
.................
0.0 		X   X       0 0 0
(3) RICHARD W HENNING......................................................................
2ND VICE CHAIR - GOVERNOR
 5.0
.................
0.0 		X   X       0 0 0
(4) ROSEMARIE J SORCE......................................................................
SECRETARY - GOVERNOR
 5.0
.................
0.0 		X   X       0 0 0
(5) FRANK DECONGELIO......................................................................
TREASURER - GOVERNOR
 5.0
.................
0.0 		X   X       0 0 0
(6) EDWARD P SALZANO......................................................................
ASSISTANT SECRETARY - GOVERNOR
 5.0
.................
0.0 		X   X       0 0 0
(7) EDWARD V PICCINICH......................................................................
ASSISTANT TREASURER - GOVERNOR
 5.0
.................
0.0 		X   X       0 0 0
(8) JAMES R BEATTIE ESQ......................................................................
GOVERNOR
 3.0
.................
0.0 		X           0 0 0
(9) STEPHEN T BOSWELLPHDPESECB......................................................................
GOVERNOR
 3.0
.................
0.0 		X           0 0 0
(10) IGNAZIO CANGIALOSI......................................................................
GOVERNOR
 3.0
.................
0.0 		X           0 0 0
(11) LONNEL COATS......................................................................
GOVERNOR
 3.0
.................
0.0 		X           0 0 0
(12) WILLIAM CRANE......................................................................
GOVERNOR
 3.0
.................
0.0 		X           0 0 0
(13) J FLETCHER CREAMER JR......................................................................
GOVERNOR
 3.0
.................
0.0 		X           0 0 0
(14) ROBERT C GARRETT......................................................................
GOVERNOR - PRESIDENT/CEO
 60.0
.................
0.0 		X   X       3,953,618 0 936,072
(15) WILLIAM V HICKEY......................................................................
GOVERNOR
 3.0
.................
0.0 		X           0 0 0
(16) PAUL E KOVATIS MD......................................................................
GOVERNOR
 3.0
.................
0.0 		X           0 0 0
(17) WILLIAM KOZY......................................................................
GOVERNOR
 5.0
.................
0.0 		X           0 0 0
Form 990 (2015)
Form 990 (2015)
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) LINDA KANG-BARATTA........................................................................
GOVERNOR
 3.0
.......................0.0 		X           0 0 0
(19) GLORIA MARTINI........................................................................
GOVERNOR
 3.0
.......................0.0 		X           0 0 0
(20) WILLIAM J MURRAY........................................................................
GOVERNOR
 3.0
.......................0.0 		X           0 0 0
(21) ROBERT O'HARA........................................................................
GOVERNOR
 3.0
.......................0.0 		X           0 0 0
(22) JOSEPH M SANZARI........................................................................
GOVERNOR
 3.0
.......................0.0 		X           0 0 0
(23) CHARLES V SCHAEFER III........................................................................
GOVERNOR
 3.0
.......................0.0 		X           0 0 0
(24) JOSEPH SIMUNOVICH........................................................................
GOVERNOR
 3.0
.......................0.0 		X           0 0 0
(25) SCOTT TARRIFF........................................................................
GOVERNOR
 3.0
.......................0.0 		X           0 0 0
(26) PRANAYCHANDRA J VAIDYA MD........................................................................
GOVERNOR
 60.0
.......................0.0 		X           93,462 488,972 89,144
(27) JOHN WILCHA........................................................................
GOVERNOR
 3.0
.......................0.0 		X           0 0 0
(28) ROBERT L GLENNING........................................................................
EVP/CHIEF FINANCIAL OFFICER
 60.0
.......................0.0 		    X       2,224,856 0 479,420
(29) IHOR S SAWCZUK MD........................................................................
EVP/CHIEF MEDICAL OFFICER
 60.0
.......................0.0 		    X       1,859,283 0 518,474
(30) AUDREY C MURPHY RN ESQ........................................................................
EVP/CHIEF LEGAL OFFICER
 60.0
.......................0.0 		    X       930,842 0 347,968
(31) NANCY R CORCORAN-DAVIDOFF........................................................................
EVP/CHIEF HUMAN RESOURCES OFF
 60.0
.......................0.0 		    X       893,284 0 373,912
(32) DIANNE A AROH........................................................................
EVP PATIENT CARE/CNO
 60.0
.......................0.0 		    X       874,915 0 169,690
(33) JON M FITZGERALD........................................................................
EVP/COO - HUMC FOUNDATION
 60.0
.......................0.0 		    X       627,384 0 158,165
(34) KETUL J PATEL TERM 13115........................................................................
EVP/CHIEF OPERATING OFFICER
 60.0
.......................0.0 		    X       300,131 0 11,883
(35) JUNE ARCHER EFF 92815........................................................................
EVP/CHIEF MARKETING OFFICER
 60.0
.......................0.0 		    X       72,633 0 54,804
(36) MARK D SPARTA........................................................................
ACTING CEO AT PASCACK VALLEY
 60.0
.......................0.0 		      X     697,511 0 226,457
(37) JOSEPH E PARRILLO MD........................................................................
CHAIRMAN HVH
 60.0
.......................0.0 		        X   1,477,085 0 44,452
(38) ANDREW L PECORA MD........................................................................
VP/CHIEF INNOVATION OFFICER
 60.0
.......................0.0 		        X   1,401,771 0 197,526
(39) ERIC D SOMBERG MD........................................................................
CHIEF, CARDIOTHORACIC SURGERY
 60.0
.......................0.0 		        X   836,041 0 1,800
(40) MANUEL ALVAREZ........................................................................
CHAIR, OB/GYN
 60.0
.......................0.0 		        X   479,007 342,240 177,012
(41) JEFFREY R BOSCAMP MD........................................................................
VP/CAO & CHAIR, PEDIATRICS
 60.0
.......................0.0 		        X   794,396 0 281,954
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 17,516,219 831,212 4,068,733
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet1,402
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
 
No
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
RIVERSIDE MEDICAL AND PEDIATRIC GRO,
714 10TH STREET
SECAUCUS,NJ07094 		MEDICAL 62,650,297
RUTGERS UNIVERSITY,
PO BOX 2685
NEW BRUNSWICK,NJ089032685 		MEDICAL 11,071,225
OLD HOOK MEDICAL ASSOCIATES LLC,
452 OLD HOOK ROAD
EMERSON,NJ07630 		MEDICAL 9,260,696
REGIONAL CANCER CARE ASSOCIATES,
100 FIRST STREET SUITE 301
HACKENSACK,NJ07601 		MEDICAL 8,553,356
CONIFER HEALTH SOLUTIONS,
2960 PROFESSIONAL DRIVE
SPRINGFIELD,IL62703 		BILLING/COLLECTIONS 5,273,538
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet265
Form 990 (2015)
Form 990 (2015)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 4,151,234
e Government grants (contributions)1e 4,361,574
f All other contributions, gifts, grants, and similar amounts not included above1f 5,022,461
g Noncash contributions included in lines 1a-1f:$  
h Total.Add lines 1a-1f.......MediumBullet 13,535,269
Program Service RevenueAmt Business Code
2a NET PATIENT SERVICE REVENUE 621500 1,368,977,603 1,362,754,416 6,223,187  
b OTHER HEALTHCARE RELATED REVENUE 621500 22,260,304 21,306,304 954,000  
c SUPPORT TO CONTROLLED ENTITIES, NET 900099 -96,644,123 -96,644,123    
d
e
f All other program service revenue.        
g Total.Add lines 2a–2f.....MediumBullet 1,294,593,784
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ..........MediumBullet 23,805,061     23,805,061
4 Income from investment of tax-exempt bond proceedsMediumBullet 238,552     238,552
5 Royalties...........MediumBullet 0      
(ii) Personal (i) Real
6a Gross rents   4,153,801
b Less: rental expenses   4,181,311
c Rental income or (loss) 0 -27,510
d Net rental income or (loss)......MediumBullet -27,510     -27,510
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 10,771,576 1,292,452
b Less: cost or other basis and sales expenses 1,200,000  
c Gain or (loss) 9,571,576 1,292,452
d Net gain or (loss).....MediumBullet 10,864,028     10,864,028
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      
Business Code Miscellaneous Revenue
11a PHARMACY 446110 15,127,984   15,127,984  
b CAFETERIA AND DIETARY 517000 4,134,132   76,022 4,058,110
c PARKING 812930 2,579,397     2,579,397
d All other revenue .... 1,367,107   1,367,107  
e Total. Add lines 11a–11d ...... MediumBullet 23,208,620
12 Total revenue. See Instructions......MediumBullet 1,366,217,804 1,287,416,597 23,748,300 41,517,638
Form 990 (2015)
Form 990 (2015)
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 21 894,750 894,750
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 0  
3 Grants and other assistance to governments, organizations, and individuals outside the United States. 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 .... 15,805,773 12,960,734 2,845,039 0
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 510,958,315 419,150,689 91,807,626  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 17,792,612 14,423,994 3,368,618  
9 Other employee benefits ....... 30,877,457 25,910,057 4,967,400  
10 Payroll taxes ........... 42,117,428 35,382,847 6,734,581  
11 Fees for services (non-employees):        
a Management ...... 667,344 654,220 13,124  
b Legal ......... 4,910,781 114,206 4,796,575  
c Accounting ........... 922,611   922,611  
d Lobbying ........... 926,349   926,349  
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 1,113,074   1,113,074  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 43,272,536 9,606,501 33,666,035  
12 Advertising and promotion .... 10,776,360 106,760 10,669,600  
13 Office expenses ....... 6,022,828 1,675,607 4,347,221  
14 Information technology ...... 36,409,384 17,662,109 18,747,275  
15 Royalties .. 0      
16 Occupancy ........... 25,232,373 13,303,616 11,928,757  
17 Travel ............ 0      
18 Payments of travel or entertainment expenses for any federal, state, or local public officials . 0      
19 Conferences, conventions, and meetings .... 2,290,904 1,015,826 1,275,078  
20 Interest ........... 26,516,848 22,276,801 4,240,047  
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization .. 58,684,491 49,494,047 9,190,444  
23 Insurance ... 5,191,146 1,256,454 3,934,692  
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 308,028,390 307,715,459 312,931  
b CONTRACTED SERVICES 33,703,216 29,935,061 3,768,155  
c HEALTHCARE COST REDUCTION 7,411,494   7,411,494  
d OTHER EXPENSES 55,062,941 49,509,147 5,553,794  
e All other expenses        
25 Total functional expenses. Add lines 1 through 24e 1,245,589,405 1,013,048,885 232,540,520 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 (2015)
Form 990 (2015)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX ..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 20,135 1 20,185
2 Savings and temporary cash investments ......... 162,593,551 2 162,289,036
3 Pledges and grants receivable, net ...... 543,818 3 1,388,490
4 Accounts receivable, net ............. 140,074,630 4 156,521,451
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 ........ 29,239,724 8 36,356,299
9 Prepaid expenses and deferred charges ...... 14,680,847 9 9,285,357
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 1,319,505,976
b Less: accumulated depreciation 10b 666,584,580 542,856,158 10c 652,921,396
11 Investments—publicly traded securities . 0 11 0
12 Investments—other securities. See Part IV, line 11 ..... 0 12 0
13 Investments—program-related. See Part IV, line 11 .. 666,230,150 13 730,519,905
14 Intangible assets ............... 8,526,862 14 7,735,525
15 Other assets. See Part IV, line 11 ........... 170,224,622 15 40,095,148
16 Total assets. Add lines 1 through 15 (must equal line 34)... 1,734,990,497 16 1,797,132,792
Liabilities 17 Accounts payable and accrued expenses ..... 144,718,866 17 155,065,735
18 Grants payable ... 0 18 0
19 Deferred revenue ......... 0 19 283,333
20 Tax-exempt bond liabilities ......... 459,120,856 20 558,664,042
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 .. 152,769,107 23 128,936,792
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 271,833,134 25 309,093,278
26 Total liabilities. Add lines 17 through 25.. 1,028,441,963 26 1,152,043,180
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 679,663,330 27 606,856,215
28 Temporarily restricted net assets ........... 16,824,420 28 27,374,029
29 Permanently restricted net assets 10,060,784 29 10,859,368
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 ........... 706,548,534 33 645,089,612
34 Total liabilities and net assets/fund balances ........ 1,734,990,497 34 1,797,132,792
Form 990 (2015)
Form 990 (2015)
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
1,366,217,804
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
1,245,589,405
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
120,628,399
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
706,548,534
5
Net unrealized gains (losses) on investments ...............
5
-29,728,366
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
-152,358,955
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
645,089,612
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 (2015)
Form 990 (2015)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
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
2015
Open to Public
Inspection
Name of the organization
HACKENSACK UNIVERSITY MEDICAL CENTER
 
Employer identification number

22-1487576
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
6
7
8
9
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 (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 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
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) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (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) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (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) 2015

Schedule A (Form 990 or 990-EZ) 2015
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) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (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) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (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) 2015

Schedule A (Form 990 or 990-EZ) 2015
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 (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) 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 section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .
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 I of Schedule L (Form 990 or 990-EZ).
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 9a) 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 9a) 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 section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b 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
 
 
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
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
 
 
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, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) 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) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
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
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)
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 2015 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-2015 		(iii)
Distributable
Amount for 2015
1 Distributable amount for 2015 from Section C, line
6 		 
2 Underdistributions, if any, for years prior to 2015
(reasonable cause required--see instructions)		  
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......  
e From 2014.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2015 distributable amount  
i Carryover from 2010 not applied (see
instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2015 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2015 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2015, if any. Subtract lines 3g and 4a from line 2
(if amount greater than zero, see instructions)		  
6 Remaining underdistributions for 2015. Subtract
lines 3h and 4b from line 1 (if amount greater than
zero, see instructions)		  
7 Excess distributions carryover to 2016. Add lines
3j and 4c.		  
8 Breakdown of line 7:
a
b
c Excess from 2013.......  
d From 2014.......  
e From 2015.......  
Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015
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) 2015


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
2015
Name of the organization
HACKENSACK UNIVERSITY MEDICAL CENTER
 
Employer identification number

22-1487576
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) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2
Name of organization
HACKENSACK UNIVERSITY MEDICAL CENTER
  		Employer identification number
22-1487576
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) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Page 3
Name of organization
HACKENSACK UNIVERSITY MEDICAL CENTER
  		Employer identification number

22-1487576
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) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Page 4
Name of organization
HACKENSACK UNIVERSITY MEDICAL CENTER
  		Employer identification number

22-1487576
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) (2015)

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 BulletInformation about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
If the organization answered "Yes" on 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" on 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" on 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
HACKENSACK UNIVERSITY MEDICAL CENTER
 
Employer identification number

22-1487576
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-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2015

Schedule C (Form 990 or 990-EZ) 2015
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) 2012 (b) 2013 (c) 2014 (d) 2015 (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) 2015


Schedule C (Form 990 or 990-EZ) 2015
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 on 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
 
658,783
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
267,566
j
Total. Add lines 1c through 1i ....................................................................................................
926,349
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
SCHEDULE C, PART II-B; LINES 1G AND 1I DURING 2015, THE ORGANIZATION PAID OUTSIDE LOBBYING FIRMS A TOTAL OF $262,500 FOR LOBBYING ON A FEDERAL AND STATE LEVEL RELATED TO MEDICARE, MEDICAID AND OTHER HEALTHCARE LEGISLATIVE MATTERS. THE ORGANIZATION HAS ALLOCATED TOWARD LOBBYING ACTIVITY A PERCENTAGE OF COMPENSATION PAID TO CERTAIN SENIOR MANAGEMENT PERSONNEL TO REPRESENT TIME SPENT ADDRESSING FEDERAL AND STATE HEALTHCARE MATTERS. THIS ALLOCATION AMOUNTED TO $396,283 IN 2015. THE ORGANIZATION IS A MEMBER OF THE GREATER NEW YORK HOSPITAL ASSOCIATION, THE AMERICAN HOSPITAL ASSOCIATION, THE NEW JERSEY BUSINESS AND INDUSTRY ASSOCIATION, THE NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS, THE NEW JERSEY HOSPITAL ASSOCIATION AND THE NEW JERSEY COUNCIL OF TEACHING HOSPITALS WHICH ALL ENGAGE IN LOBBYING EFFORTS ON BEHALF OF THEIR MEMBER HOSPITALS. 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 $222,566 IN 2015. THE ORGANIZATION IS A MEMBER OF FAIR SHARE HOSPITALS COLLABORATIVE, INC. TO WHICH IT PAID DUES IN THE AMOUNT OF $45,000 IN 2015. ONE OF THE FUNCTIONS OF FAIR SHARE HOSPITALS COLLABORATIVE, INC. IS TO ENGAGE IN LOBBYING ACTIVITIES PERFORMED ON BEHALF OF ITS MEMBER HOSPITALS.
Schedule C (Form 990 or 990EZ) 2015


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," on 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
2015
Open to Public Inspection
Name of the organization
HACKENSACK UNIVERSITY MEDICAL CENTER
 
Employer identification number

22-1487576
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on 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" on 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  
b Total acreage restricted by conservation easements .................... 2b  
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 Bullet  
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, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, 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" on 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 on 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 on 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) 2015

Schedule D (Form 990) 2015
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" on 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" on Form 990, Part IV, line 10.
(a)Current year (b)Prior year (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance .... 26,885,204 36,268,518 22,724,937 20,753,028 24,182,971
b Contributions ... 9,646,663 20,434,595 17,011,812 5,962,281 19,955,057
c Net investment earnings, gains, and losses 11,398,266 -6,644 4,160,154 1,954,074 -3,433,000
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ... 		9,696,736 29,811,265 7,628,385 5,944,446 19,952,000
f Administrative expenses ....          
g End of year balance ...... 38,233,397 26,885,204 36,268,518 22,724,937 20,753,028
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 Bullet28.400 %
c
Temporarily restricted endowment SchDMd Bullet71.600 %
The percentages on 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)
 
No
(ii) related organizations .................
3a(ii)
 
No
b
If "Yes" on 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' on 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 ...   6,411,539 6,411,539
b Buildings   753,388,354 298,060,306 455,328,048
c Leasehold improvements   7,436,753 6,435,429 1,001,324
d Equipment ...   533,845,565 357,631,313 176,214,252
e Other ...   18,423,765 4,457,532 13,966,233
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 652,921,396
Schedule D (Form 990) 2015

Schedule D (Form 990) 2015
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' on 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    
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
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' on 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
(1)LIMITED USE 25,419,076 F
(2)LIMITED USE 66,151,127 F
(3)LIMITED USE 1,643,945 F
(4)USE 3,186,719 F
(5)LIMITED USE 278,429 F
(6)LIMITED USE 16,781 F
(7)INDENTURE; LIMITED USE 59,621,208 F
(8)POOLED INVESTMENTS 396,438,062 F
(9)TAX-EXEMPT ORGANIZATION 43,792,804 F
(10)INVESTMENT IN JOINT VENTURES 70,953,553 F
(11)MONEY MARKET FUNDS 60,915,573 F
(12)REAL ESTATE; LIMITED USE 175,873 F
(13)MARKETABLE EQUITY SECURITIES 195,933 F
(14)MUTAL FUNDS; LIMITED USE 1,730,822 F
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet 730,519,905
Part IX
Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes 0
OTHER LIABILITIES 60,279,472
ACCRUED INTEREST PAYABLE 16,525,519
ACCRUED EMPLOYEE BENEFITS 224,834,701
ESTIMATED PROFESSIONAL LIABILITIES 7,453,586
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 309,093,278
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) 2015

Schedule D (Form 990) 2015
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1  
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  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1.................. 3  
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  
c Add lines 4a and 4b.................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
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  
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  
c Add lines 4a and 4b..................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  

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
SCHEDULE D, PART V, QUESTION 4 ENDOWMENT FUNDS ARE TO BE USED CONSISTENT WITH INTENT AND IN FURTHERANCE OF THE ORGANIZATION'S CHARITABLE TAX-EXEMPT PURPOSES.
SCHEDULE D, PART X THE ORGANIZATION'S SOLE CORPORATE MEMBER IS HACKENSACK UNIVERSITY HEALTH NETWORK ("HUHN"). AN INDEPENDENT BIG FOUR CPA FIRM PREPARED CONSOLIDATED AUDITED FINANCIAL STATEMENTS FOR HUHN AND ITS SUBSIDIARIES AND CONTROLLED ENTITIES, WHICH INCLUDES HACKENSACK UNIVERSITY MEDICAL CENTER, FOR THE YEARS ENDED DECEMBER 31, 2015 AND 2014; RESPECTIVELY. THE FIN 48 FOOTNOTE BELOW IS FROM THE 2008 CONSOLIDATED AUDITED FINANCIAL STATEMENTS: THE ORGANIZATION ADOPTED THE PROVISIONS OF FASB INTERPRETATION (FIN) STATEMENT NO. 48, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES - AN INTERPRETATION OF FASB STATEMENT NO. 109, ON JANUARY 1, 2007. FIN NO. 48 CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS IN ACCORDANCE WITH FASB STATEMENT NO. 109. IT PRESCRIBES AN UNCERTAINTY THRESHOLD AND MEASUREMENT ATTRIBUTES FOR FINANCIAL STATEMENT DISCLOSURES OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN. THE IMPACT OF ADOPTING FIN NO. 48 WAS NOT MATERIAL.
Schedule D (Form 990) 2015


Additional Data


Software ID:  
Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990. Right pointing arrow large image See separate instructions.Right pointing arrow large image Information about Schedule F (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
HACKENSACK UNIVERSITY MEDICAL CENTER
 
Employer identification number

22-1487576
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.
1
For grantmakers.Does the organization maintain records to substantiate the amount of its grants and
other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in region (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region		 (f) Total expenditures
for and investments
in region
Central America and the Caribbean     Program Services FINANCIAL VEHICLE 2,000,000
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total .....     2,000,000
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b)     2,000,000
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2015
Schedule F (Form 990) 2015
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (a)(c) Region (b)(d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount
of non-cash
assistance 		(h) Description
of non-cash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......MediumBullet
 
3 Enter total number of other organizations or entities .......................MediumBullet
 
Schedule F (Form 990) 2015
Schedule F (Form 990) 2015Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
non-cash
assistance 		(g) Description
of non-cash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2015
Schedule F (Form 990) 2015
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes,"the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713).. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Schedule F (Form 990) 2015
Schedule F (Form 990) 2015
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).
ReturnReference Explanation
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2015
Additional Data


Software ID:  
Software Version:  



SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on 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
2015
Open to Public Inspection
Name of the organization
HACKENSACK UNIVERSITY MEDICAL CENTER
 
Employer identification number

22-1487576
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
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
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) . . . 		    32,742,825 4,825,099 27,917,726 2.240 %
b Medicaid (from Worksheet 3, column a) . . . . .     55,778,830 5,077,452 50,701,378 4.070 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     88,521,655 9,902,551 78,619,104 6.310 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     17,286,789 1,911,295 15,375,494 1.230 %
f Health professions education (from Worksheet 5) . . .     18,640,434 10,908,157 7,732,277 0.620 %
g Subsidized health services (from Worksheet 6) . . . .     8,601,857 5,099,554 3,502,303 0.280 %
h Research (from Worksheet 7) .     3,416,238   3,416,238 0.270 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     624,580   624,580 0.050 %
j Total. Other Benefits . .     48,569,898 17,919,006 30,650,892 2.450 %
k Total. Add lines 7d and 7j .     137,091,553 27,821,557 109,269,996 8.760 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
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     68,650   68,650 0.010 %
4 Environmental improvements            
5 Leadership development and
training for community members		            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other     2,486,721 398,435 2,088,286 0.170 %
10 Total     2,555,371 398,435 2,156,936 0.180 %
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
58,617,925
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
6,295,467
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
313,215,300
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
361,267,909
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-48,052,609
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 %
1COTA
  		CANCER TRACKING AND ANALYSIS 2.022 % 3.933 % 7.407 %
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
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?3
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 HACKENSACK UNIVERSITY MEDICAL CENTER
30 PROSPECT AVENUE
HACKENSACK,NJ07601
WWW.HACKENSACKUMC.ORG
10204 		X X X X   X X      
2 HACKENSACKUMC AT PASCACK VALLEY
250 OLD HOOK ROAD
WESTWOOD,NJ07675
WWW.HACKENSACKUMCPV.ORG
24745 		X X         X   JOINT VENTURE  
3 HACKENSACKUMC MOUNTAINSIDE
ONE BAY AVENUE
MONTCLAIR,NJ07042
WWW.MOUNTAINSIDEHOSP.COM
10708 		X X         X   JOINT VENTURE  
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
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)
HACKENSACK UNIVERSITY MEDICAL CENTER
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  
6 a 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 Yes  
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 Yes  
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   No
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b Yes  
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" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
HACKENSACK UNIVERSITY MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
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
www.hackensackumc.org
b
www.hackensackumc.org
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) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

HACKENSACK UNIVERSITY MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized 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 19. (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) 2015
Schedule H (Form 990) 2015
Page 4
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)
HACKENSACKUMC AT PASCACK VALLEY
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   No
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  
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    
6 a 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    
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    
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7    
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    
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20  
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10    
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
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" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
HACKENSACKUMC AT PASCACK VALLEY
Name of hospital facility or letter of facility reporting group  
Yes No
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
www.hackensackumc.org
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   No
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) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

HACKENSACKUMC AT PASCACK VALLEY
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized 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 19. (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) 2015
Schedule H (Form 990) 2015
Page 4
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)
HACKENSACKUMC MOUNTAINSIDE
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): 		3
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 15
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  
6 a 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 Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7    
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 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10   No
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b Yes  
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" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
HACKENSACKUMC MOUNTAINSIDE
Name of hospital facility or letter of facility reporting group  
Yes No
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
WWW.HACKENSACKUMC.ORG
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) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

HACKENSACKUMC MOUNTAINSIDE
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized 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 19. (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) 2015
Schedule H (Form 990) 2015
Page 7
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, PART V, SECTION B, QUESTIONS 3J, 5 AND 11 HACKENSACKUMC (FACILITY REPORTING GROUP #1) ------------------------------------------- The organization conducted a community health needs assessment ("CHNA") through the Community Health Improvement Partnership of Bergen County ("CHIP"). A steering committee made up of senior representatives from each hospital that participated in the CHNA and the BERGEN County Department of Health Services ("BCDHS") guided this project. An advisory committee, which included additional staff from the participating hospitals and BCDHS, as well as representatives from local health departments and a number of Bergen County's leading health and social service organizations, provided additional input. The combined expertise, knowledge, and commitment of the members of these committees were vital to this project. Marla Klein, Partnership Coordinator at BCDHS and Coordinator of the CHIP, managed the project and was the main liaison between the steering committee and John Snow, Inc. ("JSI"), the consulting company that was hired to assist with the assessment. During this project, dozens of individuals were interviewed by JSI including administrative and clinical staff from the hospitals, representatives from health and social service agencies, public health officers, other public and elected officials, representatives from advocacy organizations and foundations, and community residents. JSI also conducted a random household mail survey with more than 1,700 residents from Bergen County. A pool of research assistants augmented these findings by collecting nearly 400 additional surveys from low-income, racial/ethnic minority residents of the County at community-based health and social service organizations, open-air markets, faith-based organizations, and other community venues. Finally, information was gathered by the JSI project team from community residents, service providers, and other community health stakeholders through a series of focus groups and listening sessions. These information gathering efforts allowed the steering and advisory committees to gain a better understanding of the health status, healthcare needs, service gaps, and barriers to care of those living in Bergen County. The assessment and planning process was conducted in three phases, which allowed the collaborating organizations to: 1. identify and clarify the healthcare needs and priorities of the residents of Bergen County; 2. engage stakeholders, including key service providers and residents throughout the County; and 3. develop a detailed Bergen County Community Health Improvement Plan. Each of the five partnering hospitals, in turn, developed individual implementation plans that drew from the countywide plan. These individual plans leverage the hospital's strengths and resources and allow them to meet the needs of those who live and work in the communities they serve. The CHNA process compiled and analyzed an array of quantitative and qualitative health related data through community interviews, household and community surveys, and focus groups. For the purpose of this assessment, the steering committee defined health broadly to include not just health status and the existence of disease but also social factors, access to care issues, and overall determinants of health. Data was collected at County-level and whenever possible at the city, town, and borough level. State and national data was also compiled to facilitate comparison and benchmarking of County and local data. Key findings from these data are summarized and the bulk of the data is provided in the appendices to this report. Once all of the assessment's health-related data was compiled, the steering committee implemented a comprehensive strategic planning process involving the hospitals, public health agencies, the County's leading health and social service providers, and the community at-large. The first task in this process was a strategic planning retreat involving the members of the CHNA's steering and advisory committees. Individual strategic planning meetings were then convened with each of the participating hospitals, the Bergen County Health Department, and CHIP. The project's findings were also presented to a number of community groups, including local health department officials, discharge planners and case managers from the participating hospitals, and the Bergen County Mental Health Task Force. Finally, preliminary findings and results were presented to the public at CHIP's annual meeting, which nearly 100 community residents and other community health stakeholders attended. The ultimate purpose of this assessment was to provide actionable data and information along with a detailed strategic plan that would engage the community, promote collaboration, and guide the County's community health improvement efforts. With this in mind, the steering committee was charged with identifying a series of goals and objectives along with a set of evidenced-based strategies that would guide the implementation process and become the core of the County's and CHIP's community health improvement plan. The steering committee agreed that whatever goals were identified needed to be attainable using existing resources. The strategies identified also needed to be shown in the existing peer-reviewed literature to be effective and cost-efficient. Finally, the associated community health improvement plan needed to be aligned with existing national, state, and county strategies being promoted by other private and public agencies, such as the New Jersey Department of Health's Shaping NJ initiative, related to obesity, fitness, and nutrition. With these commitments and public mandates in mind, the hospitals, BCDHS, and the CHIP came together to conduct a three-phased CHNA and planning project, and to update the CHIP's existing community health improvement plan. The Mobilizing for Action through Planning and Partnerships ("MAPP") process helped inform the planning processes. MAPP is a community-driven strategic planning process for improving community health. The MAPP process utilizes four types of community health needs assessments: 1. a community themes and strengths assessment; 2. a local public health system assessment; 3. a community health status report; and 4. a forces of change assessment. While this present effort did not utilize the MAPP process specifically, all four of the MAPP assessments were addressed in the various components of the approach that was applied for this assessment and planning project.
SCHEDULE H, PART V, SECTION B, QUESTIONS 3J AND 5 HACKENSACKUMC MOUNTAINSIDE (FACILITY REPORTING GROUP #3) -------------------------------------------------------- Beginning in August 2015, HackensackUMC Mountainside undertook a comprehensive community health needs assessment ("CHNA") to evaluate the health needs of individuals living in the hospital service area within Essex County in New Jersey. The purpose of the assessment was to gather current statistics and qualitative feedback on the key health issues facing county residents. The assessment examined a variety of health indicators including chronic health conditions, access to health care, and social determinants of health. HackensackUMC Mountainside contracted with Holleran, a research firm based in Lancaster, Pennsylvania, to execute this project. The completion of the CHNA enabled HackensackUMC Mountainside to take an in-depth look at its community. The findings from the assessment were utilized by HackensackUMC Mountainside to prioritize public health issues and develop a community health implementation plan focused on meeting community needs. HackensackUMC Mountainside is committed to the people it serves and the communities where they reside. Healthy communities lead to lower health care costs, robust community partnerships, and an overall enhanced quality of life. This CHNA Final Summary Report serves as a compilation of the overall findings of each research component. CHNA Components: - Secondary Data Research; - Key Informant Interviews; - Prioritization Session; and - Implementation Plan. Key Community Health Issues HackensackUMC Mountainside, in conjunction with community partners, examined the findings of the Secondary Data and Key Informant Interviews to select Key Community Health Issues. The following issues were identified: - Access to Care; - Chronic Disease Management; - Mental Health; and - Obesity. Prioritized Community Health Issues Based on feedback from community partners, including health care providers, public health experts, health and human service agencies, and other community representatives, HackensackUMC Mountainside plans to focus community health improvement efforts on the following health priorities over the next three-year cycle: - Chronic Disease Management; and - Mental Health. Organization Overview Driven by its mission to care for, cure and nurture the sick and injured, HackensackUMC Mountainside has delivered exceptional and compassionate patient care for Montclair and its surrounding New Jersey communities since 1891. HackensackUMC Mountainside offers a wide array of medical services and programs ranging from its state-of-the-art emergency center to its nationally recognized weight-loss surgery program and its comprehensive cancer center. HackensackUMC Mountainside is a 365 bed hospital (347 licensed acute beds and 18 transitional care beds) and is staffed by world-class physicians. Mountainside Hospital is designated as a Primary Stroke Center by the New Jersey State Department of Health and Senior Services. Honors include being listed as one of Americas safest hospitals on Forbes.com. It has also been repeatedly recognized for outstanding customer satisfaction by Press Ganey an organization that tracks customer satisfaction scores for hospitals. Community Overview HackensackUMC Mountainside defined its current service area based on an analysis of the geographic area where individuals utilizing its services reside. The primary service area included the following seven municipalities: Bloomfield Township, Montclair Township, Cedar Grove Township, Caldwell Borough, Nutley Township, Upper Montclair Township, and Glen Ridge Borough. Methodology The CHNA was comprised of both quantitative and qualitative research components. A brief synopsis of the research components is included below with further details provided throughout the document: - A Statistical Secondary Data Profile depicting population and household statistics, education and economic measures, morbidity and mortality rates, incidence rates, and other health statistics for Essex County, New Jersey was compiled. - Key Informant Interviews were conducted with 50 community leaders and partners between August and September 2015. Key informants represented a variety of sectors, including public health and medical services, non-profit and social organizations, public schools, and the business community.
SCHEDULE H, PART V, SECTION B, QUESTION 6a HACKENSACKUMC (FACILITY REPORTING GROUP #1) ------------------------------------------- Several hospital facilities collaborated to conduct this CHNA. These facilities included: - HackensackUMC; - Christian Health Care Center; - Englewood Hospital and Medical Center; - Holy Name Medical Center; and - The Valley Hospital.
SCHEDULE H, PART V, SECTION B, QUESTION 6b HACKENSACKUMC (FACILITY REPORTING GROUP #1) ------------------------------------------- Several organizations other than hospital facilities collaborated to conduct this CHNA. These facilities included: - BERGEN COUNTY DEPARTMENT OF HEALTH SERVICES; AND - COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP OF BERGEN COUNTY.
SCHEDULE H, PART V, SECTION B, QUESTION 6b HACKENSACKUMC MOUNTAINSIDE (FACILITY REPORTING GROUP #3) -------------------------------------------------------- Research Partner HackensackUMC Mountainside contracted with Holleran, an independent research and consulting firm located in Lancaster, Pennsylvania, to conduct research in support of the CHNA. Holleran has 23 years of experience in conducting public health research and community health assessments. The firm provided the following assistance: - Collected and interpreted data from secondary data sources; - Collected, analyzed and interpreted data from key informant interviews; and - Prepared all reports. Community Representation Community engagement and feedback were an integral part of the CHNA process. HackensackUMC Mountainside sought community input through key informant interviews with community leaders and partners, an online community member survey available to all residents, and inclusion of community leaders in the prioritization and implementation planning process. Public health and health care professionals shared knowledge and expertise about health issues, and leaders and representatives of non-profit and community-based organizations provided insight on the community, including the medically underserved, low income, and minority populations. Research Limitations Timeline and other restrictions may have impacted the ability to survey all community stakeholders. HackensackUMC Mountainside sought to mitigate limitations by including representatives of diverse and underserved populations throughout the research components. Prioritization of Needs Following the completion of the CHNA research, HackensackUMC Mountainside prioritized community health issues and developed an implementation plan to address prioritized community needs. SECONDARY DATA PROFILE OVERVIEW Background One of the initial undertakings of the CHNA was to create a Secondary Data Profile. Secondary data is comprised of data obtained from existing resources and includes demographic and household statistics, education and income measures, morbidity and mortality rates, and health indicators, among other data points. The data was gathered and integrated into a graphical report to portray the current health and socio-economic status of residents in Essex County. Secondary data was collected from reputable sources, including the U.S. Census Bureau, Centers for Disease Control and Prevention (CDC), and New Jersey State Department of Health. A full reference list is included in Appendix A. The data represents a point in time study using the most recent data possible. When available, state and national comparisons are provided as benchmarks. The profile details data covering the following areas: - Demographic/Socioeconomic Statistics; - Mortality & Morbidity Statistics; - Maternal & Child Health Statistics; - Sexually Transmitted Illness & Communicable Disease Statistics; - Mental Health Statistics; and - Environmental Health.
SCHEDULE H, PART V, SEC B, Q'S 7D,13H,15E,16I,18E,19D,20E,21D,22D,23&24 ALL FACILITY REPORTING GROUPS ----------------------------- NOT APPLICABLE.
SCHEDULE H, PART V, SECTION B, QUESTION 13A ALL FACILITY REPORTING GROUPS ----------------------------- THE FACILITY USES A SLIDING SCALE METHOD TO DETERMINE THE ELIGIBILITY FOR DISCOUNTED CARE.
SCHEDULE H, PART V, SECTION B PLEASE NOTE THAT HACKENSACKUMC AT PASCACK VALLEY OFFICIALLY OPENED AND BEGAN PROVIDING MEDICAL SERVICES ON JUNE 1, 2013. THIS HOSPITAL FACILITY, IN ACCORDANCE WITH INTERNAL REVENUE CODE SECTION 501(R)(3) RULES AND REGULATIONS, CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT IN JULY 2016. ACCORDINGLY, SCHEDULE H, PART V, SECTION B, QUESTIONS 1-12 FOR HACKENSACKUMC AT PASCACK VALLEY ARE NOT COMPLETED WITH THIS 2015 FORM 990 FILING.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 8
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?6
Name and address Type of Facility (describe)
1 HUMC AMBULATORY CARE CENTER-NORTHERN DIV
795 FRANKLIN AVENUE
FRANKLIN LAKES,NJ07417 		PRIMARY CARE SERVICES OUTPATIENT ONCOLOGY
2 HUMC MEDICAL ARTS PLAZA
20 PROSPECT AVENUE
HACKENSACK,NJ07601 		VARIOUS OUTPATIENT HEALTHCARE SERVICES
3 THE ALFRED M SANZARI MEDICAL ARTS BLDG
360 ESSEX STREET
HACKENSACK,NJ07601 		VARIOUS OUTPATIENT HEALTHCARE SERVICES
4 JOHN THEURER CANCER CENTER AT HUMC
92 SECOND STREET
HACKENSACK,NJ07601 		GAMMA KNIFE SERVICES, FIXED CT, LINEAR ACCELERATOR
5 HACKENSACKUMC FITNESS & WELLNESS CENTER
87 ROUTE 17 NORTH
MAYWOOD,NJ07607 		PRIMARY CARE
6 HUMC AIR EXPRESS
30 PROSPECT AVENUE
HACKENSACK,NJ07601 		PRIMARY CARE SERVICES, MOBILE ASTHMA SCREENING SERVICES
7
8
9
10
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 9
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
SCHEDULE H, PART I, LINE 3C THE INCOME BASED CRITERIA USED TO DETERMINE ELIGIBILITY IS PER NEW JERSEY ADMINISTRATIVE CODE 10:52 SUB CHAPTERS 11, 12 AND 13, AND BASED UPON THE 2013 FEDERAL POVERTY GUIDELINES (DEPARTMENT OF HEALTH AND SENIOR SERVICES). FEDERAL POVERTY GUIDELINES ARE INCLUDED IN THE CRITERIA FOR DETERMINING ELIGIBILITY FOR CHARITY AND DISCOUNTED CARE. THE FACILITY USES A SLIDING SCALE METHOD TO DETERMINE THE ELIGIBILITY FOR DISCOUNTED CARE.
SCHEDULE H, PART I, LINE 6A ANNUALLY THE ORGANIZATION PREPARES A COMMUNITY BENEFIT REPORT WHICH IS POSTED ON THE ORGANIZATION'S WEBSITE, WWW.HACKENSACKUMC.ORG.
SCHEDULE H, PART II HACKENSACK UNIVERSITY MEDICAL CENTER ("HACKENSACKUMC") ACTIVELY ENGAGES IN COMMUNITY BUILDING ACTIVITIES THAT CONTRIBUTE TO THE OVERALL HEALTH OF THE COMMUNITIES IT SERVES. IN ADDITION, HACKENSACKUMC PROVIDES AND SUBSIDIZES DAY CARE SERVICES FOR THE BENEFIT OF THE COMMUNITY. THIS COMMUNITY BUILDING OPERATION RESULTED IN A LOSS OF $244,343 IN 2015.
SCHEDULE H, PART III, LINE 4 BAD DEBT EXPENSE WAS CALCULATED USING THE PROVIDERS' BAD DEBT EXPENSE FROM FINANCIAL STATEMENTS, NET OF ACCOUNTS WRITTEN OFF AT CHARGES. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS WERE PREPARED AND ISSUED FOR HACKENSACK UNIVERSITY HEALTH NETWORK AND ITS SUBSIDIARIES AND CONTROLLED ENTITIES, WHICH INCLUDES HACKENSACK UNIVERSITY MEDICAL CENTER ("HACKENSACKUMC"). HACKENSACK UNIVERSITY HEALTH NETWORK AND ITS SUBSIDIARIES AND CONTROLLED ENTITIES CONSTITUTE A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("NETWORK"). PLEASE REFER TO THE NET PATIENT SERVICE REVENUE AND PATIENT ACCOUNTS RECEIVABLE SECTION OF FOOTNOTE 1 ON PAGE 12 AND THE CHARITY AND UNCOMPENSATED CARE FOOTNOTE 2 ON PAGE 15 OF THE AUDITED FINANCIAL STATEMENTS OF THE NETWORK ATTACHED TO THIS FORM 990.
SCHEDULE H, PART III, LINE 8 THE COSTING METHODOLOGY UTILIZED TO DETERMINE THE MEDICARE ALLOWABLE COSTS WAS THE COST TO CHARGE RATIO AS DERIVED FROM THE 2014 MEDICARE COST REPORT. THE ORGANIZATION BELIEVES THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT EXPENSE ARE COMMUNITY BENEFIT EXPENSE AND ASSOCIATED COSTS SHOULD BE INCLUDED WITHIN FORM 990, SCHEDULE H, PART I. AS OUTLINED MORE FULLY BELOW THE ORGANIZATION BELIEVES THAT THESE SERVICES AND RELATED COSTS PROMOTE THE HEALTH OF THE COMMUNITY AS A WHOLE AND ARE RENDERED IN CONJUNCTION WITH HACKENSACKUMC'S CHARITABLE TAX-EXEMPT PURPOSES AND MISSION IN PROVIDING MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUAL'S IN A NON-DISCRIMINATORY MANNER WITHOUT REGARD TO RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY AND CONSISTENT WITH THE COMMUNITY BENEFIT STANDARD PROMULGATED BY THE INTERNAL REVENUE SERVICE ("IRS"). THE COMMUNITY BENEFIT STANDARD IS THE CURRENT STANDARD FOR A HOSPITAL FOR RECOGNITION AS A TAX-EXEMPT AND CHARITABLE ORGANIZATION UNDER INTERNAL REVENUE CODE ("IRC") 501(C)(3). THE ORGANIZATION IS RECOGNIZED AS A TAX-EXEMPT ENTITY AND CHARITABLE ORGANIZATION UNDER 501(C)(3) OF THE IRC. ALTHOUGH THERE IS NO DEFINITION IN THE IRC 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,PROVIDES EXAMPLES OF CHARITABLE PURPOSES, INCLUDING THE RELIEF OF THE INDIGENT OR UNDERPRIVILEGED; THE PROMOTION OF SOCIAL WELFARE; AND THE ADVANCEMENT OF EDUCATION, RELIGION, 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 IRC 501(C)(3) CHARITABLE ORGANIZATIONS. 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 STANDARD. 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 THIS STANDARD, A HOSPITAL HAS 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 BASED ON THE FACT THAT SOME PATIENTS ULTIMATELY FAILED TO PAY. 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 PUBLICLY SUPPORTED COMMUNITY HOSPITALS WOULD NORMALLY QUALIFY AS CHARITABLE ORGANIZATIONS BECAUSE THEY SERVE THE ENTIRE COMMUNITY, AND A LOW LEVEL OF CHARITY CARE WOULD NOT AFFECT A HOSPITAL'S EXEMPT STATUS IF IT WAS DUE TO THE SURROUNDING COMMUNITY'S LACK OF CHARITABLE DEMANDS. COMMUNITY BENEFIT STANDARD IN 1969, THE IRS ISSUED REVENUE RULING 69-545 WHICH "REMOVED" FROM REVENUE RULING 56-185 "THE REQUIREMENTS RELATING TO CARING FOR PATIENTS WITHOUT CHARGE OR AT RATES BELOW COST." UNDER THIS STANDARD DEVELOPED IN REVENUE RULING 69-545, WHICH IS KNOWN AS THE "COMMUNITY BENEFIT STANDARD," HOSPITALS ARE JUDGED ON WHETHER THEY PROMOTE THE 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 A 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: - ITS SURPLUS FUNDS WERE USED TO IMPROVE PATIENT CARE, EXPAND HOSPITAL FACILITIES, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH; - IT WAS CONTROLLED BY A BOARD OF TRUSTEES THAT CONSISTED OF INDEPENDENT CIVIC LEADERS; AND - HOSPITAL MEDICAL STAFF PRIVILEGES WERE AVAILABLE TO ALL QUALIFIED PHYSICIANS. ADDITIONALLY, THE AMERICAN HOSPITAL ASSOCIATION ("AHA") OUTLINED IN A LETTER TO THE IRS DATED AUGUST 21, 2007 WITH RESPECT TO THE FIRST PUBLISHED DRAFT OF THE CURRENT FORM 990 AND SCHEDULE H, THAT AHA BELIEVES THE IRS SHOULD INCORPORATE THE FULL VALUE OF THE COMMUNITY BENEFIT ("TOTAL BENEFITS TO THE COMMUNITY") THAT HOSPITALS PROVIDE BY COUNTING MEDICARE UNDERPAYMENTS (SHORTFALL) AS QUANTIFIABLE COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: - PROVIDING CARE FOR THE ELDERLY AND SERVING MEDICARE PATIENTS IS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD, - MANY MEDICARE BENEFICIARIES, LIKE THEIR MEDICAID COUNTERPARTS, ARE INDIGENT AND ARE ALSO ELIGIBLE FOR MEDICAID - ALSO KNOWN AS ELIGIBLES.ELIGIBLES ARE AMONG THE SICKEST AND POOREST INDIVIDUALS COVERED BY EITHER MEDICARE OR MEDICAID. MOST DUAL ELIGIBLES ARE VERY LOW-INCOME INDIVIDUALS. IN 2008, 86% OF DUAL ELIGIBLES HAD ANNUAL INCOMES BELOW 150% OF THE FEDERAL POVERTY LEVEL, COMPARED TO 22% OF NON-DUAL MEDICARE BENEFICIARES. ONLY 7% HAD ANNUAL INCOMES GREATER THAN 200% OF THE FEDERAL POVERTY LEVEL. THERE IS A VERY COMPELLING PUBLIC POLICY REASON TO TREAT MEDICARE AND MEDICAID UNDERPAYMENTS SIMILARLY FOR PURPOSES OF A HOSPITAL'S COMMUNITY BENEFIT AND INCLUDE THESE COSTS ON FORM 990, SCHEDULE H, PART I. THE ANNUAL OVERALL MEDICARE UNDERPAYMENTS MUST BE ASSUMED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE COMMUNITY'S ELDERLY AND INDIGENT. THESE UNDERPAYMENTS REPRESENT A REAL COST OF SERVING THE COMMUNITY AND SHOULD COUNT AS A QUANTIFIABLE COMMUNITY BENEFIT. BOTH AHA AND HACKENSACKUMC BELIEVE THAT PATIENT BAD DEBT EXPENSE IS A COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. LIKE MEDICARE UNDERPAYMENT (SHORTFALLS), THERE ALSO ARE COMPELLING REASONS THAT PATIENT ACCOUNTS DETERMINED TO BE BAD DEBT EXPENSE SHOULD BE COUNTED AS QUANTIFIABLE COMMUNITY BENEFIT AS FOLLOWS: - 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 CHARITY CARE OR FINANCIAL ASSISTANCE PROGRAMS. A 2006 CONGRESSIONAL BUDGET OFFICE ("CBO") 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 INCOME BELOW 200% OF THE FEDERAL POVERTY LINE." - THE REPORT ALSO NOTED THAT A SUBSTANTIAL PORTION OF BAD DEBT IS PENDING APPLICATION FOR AND ULTIMATE APPROVAL FOR 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 ABILITY TO PAY. PATIENTS WHO HAVE OUTSTANDING BILLS ARE NOT TURNED AWAY, UNLIKE OTHER INDUSTRIES. BAD DEBT IS FURTHER COMPLICATED BY THE ACCOUNTING INDUSTRY'S STANDARDS ON REPORTING CHARITY CARE. MANY PATIENTS CANNOT OR DO NOT PROVIDE THE NECESSARY, EXTENSIVE DOCUMENTATION REQUIRED TO BE DEEMED CHARITY CARE BY AUDITORS. AS A RESULT, ROUGHLY 40% OF THE ORGANIZATION'S BAD DEBT IS PENDING CHARITY CARE. - THE CBO CONCLUDED THAT ITS FINDINGS "SUPPORT THE VALIDITY OF THE USE OF UNCOMPENSATED CARE [BAD DEBT AND CHARITY CARE] AS A MEASURE OF COMMUNITY BENEFITS" ASSUMING THE FINDINGS ARE GENERALIZABLE NATIONWIDE; THE EXPERIENCE OF HOSPITALS AROUND THE NATION REINFORCES THAT THEY ARE GENERALIZABLE. AS OUTLINED BY AHA, DESPITE THE HOSPITALS' BEST EFFORTS AND DUE DILIGENCE, PATIENT BAD DEBT IS A PART OF THE HOSPITAL'S MISSION AND CHARITABLE PURPOSES. BAD DEBT REPRESENTS PART OF THE BURDEN HOSPITALS SHOULDER IN SERVING ALL PATIENTS R
SCHEDULE H, PART III, LINE 9B ACCOUNTS CONSIDERED TO BE CHARITY CARE ARE NOT INCLUDED IN THE PROVISION FOR BAD DEBT, BUT RATHER, ACCOUNTED FOR AS A REDUCTION TO NET PATIENT SERVICE REVENUE.
SCHEDULE H, PART VI; QUESTION 2 PLEASE REFER TO OUR RESPONSES INCLUDED IN SCHEDULE H, PART V, SECTION B.
SCHEDULE H, PART VI; QUESTION 3 UNDER ITS CHARITY CARE POLICY, HACKENSACKUMC 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 BY MEETING WITH A HOSPITAL FINANCIAL AID SPECIALIST. THE HOSPITAL FINANCIAL AID SPECIALIST ALSO ANSWERS ALL INCOMING CALLS AND MAILS OUT THE NEW JERSEY HOSPITAL CARE BROCHURES UPON REQUEST. THE HOSPITAL FINANCIAL AID RECEPTIONIST WILL PROCESS ALL REQUESTS FOR CHARITY CARE FROM PROSPECTIVE APPLICANTS AND SECURE THE PROPER DOCUMENTATION THAT FOLLOWS THE STATE DEPARTMENT OF HEALTH GUIDELINES FOR FINANCIAL ASSISTANCE. ONCE APPROVED BASED ON INCOME/ASSET GUIDELINES, THEY WILL PREPARE A DETERMINATION OF CHARITY CARE NOTICE BASED ON THE RESULTS OF THE CALCULATIONS AND SEND IT TO THE PATIENT.
SCHEDULE H, PART VI; QUESTION 4 SERVICE AREA ------------ HACKENSACKUMC DEFINES ITS PRIMARY SERVICE AREA FOR INPATIENTS ("PSA") AS BERGEN COUNTY, ITS SECONDARY SERVICE AREA ("SSA") AS PASSAIC AND HUDSON COUNTIES, AND ITS TERTIARY SERVICE AREA ("TSA") AS OTHER COUNTIES IN NEW JERSEY AND CERTAIN COUNTIES IN NEW YORK AND PENNSYLVANIA. THE 2010 POPULATION OF THE PSA AND SSA WERE 905,116 AND 1,135,492, RESPECTIVELY, ACCORDING TO THE U.S. CENSUS BUREAU. IN 2010, APPROXIMATELY 22.6% OF THE PSA POPULATION AND 22.5% OF THE SSA POPULATION WERE UNDER 18 YEARS OF AGE AND 15.1% OF THE PSA POPULATION AND 11.1% OF THE SSA POPULATION WERE 65 YEARS OF AGE AND OLDER, ACCORDING TO THE U.S. CENSUS BUREAU. IN 2015, APPROXIMATELY 57.2% OF HACKENSACKUMC'S 43,994 DISCHARGES CAME FROM BERGEN COUNTY, 13% FROM HUDSON COUNTY AND 13.5% FROM PASSAIC COUNTY. HACKENSACKUMC REFERS TO BERGEN, HUDSON AND PASSAIC COUNTIES AS THE "TRI-COUNTY PSA/SSA". HACKENSACKUMC ALSO ATTRACTS A SIGNIFICANT NUMBER OF PATIENTS WHO RESIDE BEYOND THE TRI-COUNTY PSA/SSA, AND FREQUENTLY THESE PATIENTS ARE SEEKERS OF SUB-SPECIALTY CARE. IN 2015, APPROXIMATELY 16.3% OF HACKENSACKUMC'S DISCHARGES CAME FROM OUTSIDE OF THE TRI-COUNTY PSA/SSA. A CONSISTENT GOAL OF HACKENSACKUMC OVER THE PAST TWO DECADES HAS BEEN TO REDUCE OUTMIGRATION OF PSA AND SSA PATIENTS TO HOSPITALS IN NEW YORK CITY. ALTHOUGH HACKENSACKUMC HAS EXPERIENCED A REDUCTION IN OUTMIGRATION AND INCREASED PSA AND SSA ADMISSIONS, THE CONTINUING REDUCTION OF OUTMIGRATION REMAINS A LONG-TERM OBJECTIVE.
SCHEDULE H, PART VI; QUESTION 5 THIS ORGANIZATION OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545: 1. THE ORGANIZATION PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF-PAY, MEDICARE AND MEDICAID PATIENTS; 2. THE ORGANIZATION OPERATES AN ACTIVE EMERGENCY DEPARTMENT FOR ALL PERSONS; WHICH IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR; 3. THE ORGANIZATION MAINTAINS AN OPEN MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; 4. CONTROL OF THE ORGANIZATION RESTS WITH ITS BOARD OF GOVERNORS; WHICH IS COMPRISED OF INDEPENDENT CIVIC LEADERS AND OTHER PROMINENT MEMBERS OF THE COMMUNITY; AND 5. SURPLUS FUNDS ARE USED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND RENOVATE FACILITIES AND ADVANCE MEDICAL CARE; PROGRAMS AND ACTIVITIES. PLEASE REFER TO SCHEDULE O FOR THE NETWORK'S CHARITY CARE COMMUNITY BENEFIT STATEMENT FOR ADDITIONAL INFORMATION ON HOW HACKENSACKUMC AND THE NETWORK PROMOTE COMMUNITY HEALTH.
SCHEDULE H, PART VI; QUESTION 6 NOT FOR-PROFIT ENTITIES: HACKENSACK UNIVERSITY HEALTH NETWORK, INC. HACKENSACK UNIVERSITY HEALTH NETWORK, INC. IS AN ORGANIZATION RECOGNIZED BY THE IRS AS TAX-EXEMPT PURSUANT TO IRC 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO IRC 509(A)(3). THE ORGANIZATION IS THE PARENT ENTITY OF HACKENSACKUMC AND OTHER SUBSIDIARIES AND CONTROLLED ENTITIES INCLUDED IN THE NETWORK. HACKENSACK UNIVERSITY MEDICAL CENTER FOUNDATION, INC. HACKENSACK UNIVERSITY MEDICAL CENTER FOUNDATION, INC. IS AN ORGANIZATION RECOGNIZED BY THE IRS AS TAX-EXEMPT PURSUANT TO IRC 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO IRC 509(A)(3). THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF HACKENSACKUMC. BERGEN HEALTH MANAGEMENT SYSTEM, INC. BERGEN HEALTH MANAGEMENT SYSTEM, INC. IS AN ORGANIZATION RECOGNIZED BY THE IRS AS TAX-EXEMPT PURSUANT TO IRC 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO IRC 509(A)(2). THE ORGANIZATION PROMOTES, SUPPORTS AND FURTHERS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF HACKENSACKUMC. HACKENSACK SPECIALTY CARE ASSOCIATES, P.C. HACKENSACK SPECIALTY CARE ASSOCIATES, P.C. IS A SHAREHOLDER NOMINEE OWNED CORPORATION ORGANIZED UNDER THE NEW JERSEY PROFESSIONAL SERVICE CORPORATION ACT AND IS RECOGNIZED BY THE IRS AS TAX-EXEMPT PURSUANT TO IRC 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO IRC 509(A)(3). THE ORGANIZATION SERVES AS A PHYSICIAN SERVICES COMPONENT OF HACKENSACKUMC HACKENSACK UNIVERSITY MEDICAL GROUP, P.C. HACKENSACK UNIVERSITY MEDICAL GROUP, P.C. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THE ORGANIZATION SUPPORTS HACKENSACKUMC, A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ACUTE CARE HOSPITAL WHICH PROVIDE MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. IN ADDITION, BY PRACTICING MEDICINE, ENGAGING IN MEDICAL EDUCATION AND WORKING TO IMPROVE THE WELFARE OF INDIVIDUALS IN NEW JERSEY, THE ORGANIZATION COMPRISES A COMPONENT OF THE CLINICAL SERVICE PHYSICIAN PRACTICE PLANS OF HACKENSACKUMC; A TEACHING HOSPITAL, AND IS AN INTEGRAL PART OF THIS INSTITUTION. HUMC CARDIOVASCULAR PARTNERS, P.C. HUMC CARDIOVASCULAR PARTNERS, P.C. IS A SHAREHOLDER NOMINEE OWNED CORPORATION ORGANIZED UNDER THE NEW JERSEY PROFESSIONAL SERVICE CORPORATION ACT AND IS RECOGNIZED BY THE IRS AS TAX-EXEMPT PURSUANT TO IRC 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO IRC 509(A)(3). THE ORGANIZATION SERVES AS A PHYSICIAN SERVICES COMPONENT OF HACKENSACKUMC. HUMC MEDICAL OBSERVATION, P.A. HUMC MEDICAL OBSERVATION, P.A. IS A SHAREHOLDER NOMINEE OWNED CORPORATION ORGANIZED UNDER THE NEW JERSEY PROFESSIONAL SERVICE CORPORATION ACT AND IS RECOGNIZED BY THE IRS AS TAX-EXEMPT PURSUANT TO IRC 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO IRC 509(A)(3). THE ORGANIZATION SERVES AS A PHYSICIAN SERVICES COMPONENT OF HACKENSACKUMC. THE AUXILIARY OF HACKENSACK UNIVERSITY MEDICAL CENTER THE AUXILIARY OF HACKENSACK UNIVERSITY MEDICAL CENTER IS AN ORGANIZATION RECOGNIZED BY THE IRS AS TAX-EXEMPT PURSUANT TO IRC 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO IRC 509(A)(3). THE ORGANIZATION SERVES AS THE EXECUTIVE SERVICES COMPONENT OF HACKENSACKUMC. FOR-PROFIT ENTITIES: HACKENSACK UNIVERSITY MEDICAL CENTER CASUALTY COMPANY, LTD. HACKENSACK UNIVERSITY MEDICAL CENTER CASUALTY COMPANY, LTD. IS A CONTROLLED FOREIGN CORPORATION OF HACKENSACKUMC. THE ORGANIZATION WAS FORMED AND OPERATES SOLELY IN BERMUDA. HACKENSACK OCCUPATIONAL MEDICINE ASSOCIATES, P.C. HACKENSACK OCCUPATIONAL MEDICINE ASSOCIATES IS A FOR-PROFIT ENTITY WHOSE NOMINEE OWNER IS HACKENSACKUMC. THE ORGANIZATION IS LOCATED IN HACKENSACK, BERGEN COUNTY, NEW JERSEY. NEW AMSTERDAM MEDICAL ASSOCIATES, P.C. NEW AMSTERDAM MEDICAL ASSOCIATES, P.C. IS A FOR-PROFIT ENTITY WHOSE NOMINEE OWNER IS HACKENSACKUMC. THE ORGANIZATION IS LOCATED IN HACKENSACK, BERGEN COUNTY, NEW JERSEY. HUMC PRIMARY CARE ASSOCIATES, P.C. HUMC PRIMARY CARE ASSOCIATES, P.C. IS A FOR-PROFIT ENTITY WHOSE NOMINEE OWNER IS HACKENSACKUMC. THE ORGANIZATION IS LOCATED IN HACKENSACK, BERGEN COUNTY, NEW JERSEY. HACKENSACK PHYSICIAN ALLIANCE, L.L.C. HACKENSACK PHYSICIAN ALLIANCE, L.L.C. IS AN INACTIVE SINGLE MEMBER LIMITED LIABILITY COMPANY FORMED IN THE STATE OF NEW JERSEY WHOSE SOLE MEMBER IS HACKENSACKUMC. HACKENSACK PHYSICIAN-HOSPITAL ALLIANCE ACO, L.L.C. HACKENSACK PHYSICIAN-HOSPITAL ALLIANCE ACO, L.L.C. IS A SINGLE MEMBER LIMITED LIABILITY COMPANY FORMED IN THE STATE OF NEW JERSEY AND SERVES AS AN ACCOUNTABLE CARE ORGANIZATION WHICH INCLUDES PARTICIPATION OF OVER 400 PHYSICIANS. THE SOLE MEMBER OF HACKENSACK PHYSICIAN-HOSPITAL ALLIANCE ACO, L.L.C. IS HACKENSACK UNIVERSITY HEALTH NETWORK. 20 PROSPECT AVENUE HOLDINGS, L.L.C. IS A SINGLE MEMBER LIMITED LIABILITY COMPANY FORMED IN THE STATE OF NEW JERSEY WHOSE SOLE MEMBER IS HACKENSACK UNIVERSITY MEDICAL CENTER AND WHOSE PURPOSE IS TO ACQUIRE AND TO FINANCE ALL OF THE COSTS OF ACQUISITION OF A BUILDING AND ITS ASSOCIATED PARKING GARAGE FACILITY OF THE REAL ESTATE UPON WHICH THE FACILITIES ARE LOCATED AT 20 PROSPECT AVENUE.
SCHEDULE H, PART VI; QUESTION 7 NOT APPLICABLE. THE ENTITY AND RELATED PROVIDER ORGANIZATIONS ARE LOCATED IN NEW JERSEY. NO COMMUNITY BENEFIT REPORT IS FILED WITH THE STATE OF NEW JERSEY.
Schedule H (Form 990) 2015
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
HACKENSACK UNIVERSITY MEDICAL CENTER
 
Employer identification number
22-1487576
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) Adler Aphasia Center
60 West Hunter Avenue
Maywood,NJ07607 		02-0687863 501(C)(3) 25,000       SPONSORSHIP
(2) American Diabetes Association
1160 Route 22 East Suite 103
Bridgewater,NJ08880 		54-1734511 501(C)(3) 10,000       SPONSORSHIP
(3) American Heart Association
1 Union Street Suite 301
Robbinsville,NJ086914183 		13-5613797 501(C)(3) 10,000       SPONSORSHIP
(4) Arthritis Foundation NJ Chapter
555 Route 1 South Suite 220
Iselin,NJ088302000 		58-1341679 501(C)(3) 18,000       SPONSORSHIP
(5) Borough of Maywood
15 Park Ave
Maywood,NJ07607 		22-6002067 501(C)(3) 5,250       SPONSORSHIP
(6) Festival of Ballooning Inc
363 Route 46 West Suite 200
Fairfield,NJ07004 		22-3210035 501(C)(3) 7,500       SPONSORSHIP
(7) Foundation for Free Enterprise
South 61 Paramus Road
Paramus,NJ07652 		51-0165577 501(C)(3) 6,000       SPONSORSHIP
(8) Gregory M Hirsch Memorial Foundation
304 Farnham Avenue
Lodi,NJ07644 		20-2691459 501(C)(3) 7,500       SPONSORSHIP
(9) Hackensack Chamber of Commerce
5 University Plaza Drive
Hackensack,NJ07601 		41-1530317 501(C)(3) 10,000       SPONSORSHIP
(10) Hudson Riverfront Performing Arts Center
1200 Harbor Boulevard 1st Foor
Weehawken,NJ07086 		27-0022918 501(C)(3) 7,500       SPONSORSHIP
(11) Kula For Karma
19 Charlden Drive
Saddle River,NJ07458 		11-3819369 501(C)(3) 10,000       SPONSORSHIP
(12) Meridian Health Foundation
1345 Campus Parkway Suite A2
Neptune,NJ07753 		01-0649794 501(C)(3) 6,750       SPONSORSHIP
(13) Morris Arts
14 Maple Avenue Suite 301
Morristown,NJ07960 		22-2012936 501(C)(3) 10,000       SPONSORSHIP
(14) New Jersey Symphony Orchestra
60 Park Place 9th Floor
Newark,NJ07102 		22-1559422 501(C)(3) 37,500       SPONSORSHIP
(15) New York Yankee Foundation
One East 161st Street
Bronx,NY10451 		13-6089577 501(C)(3) 7,500       SPONSORSHIP
(16) NJ Sharing Network Foundation
691 Central Ave
New Providence,NJ07974 		20-2737719 501(C)(3) 10,000       SPONSORSHIP
(17) NJBIZ
1500 Paxton Street
Harrisburg,PA17104 		23-2345334 501(C)(3) 12,500       SPONSORSHIP
(18) Northern NJ Council-Boy Scouts of American
PO Box 670
Oakland,NJ07643 		22-3626147 501(C)(3) 10,000       SPONSORSHIP
(19) Partners for Health Inc
54 Plymouth Street
Montclair,NJ07042 		22-3122804 501(C)(3) 10,000       SPONSORSHIP
(20) Rutgers Institute for Ethical Leadership
1 Washington Park
Newark,NJ07102 		22-6001086 501(C)(3) 25,000       SPONSORSHIP
(21) Stem For Life Foundation
420 Lexington Avenue Suite 350
New York,NY10170 		26-1150435 501(C)(3) 25,000       SPONSORSHIP
(22) Sylvia & Herbert Woods Scholarship Fund
310 East 49th Street 5E
New York,NY10017 		31-1793365 501(C)(3) 15,000       SPONSORSHIP
(23) The Forget Me Not Foundation
225 Lakeview Drive
Ridgewood,NJ07450 		26-3848831 501(C)(3) 10,000       SPONSORSHIP
(24) The National Trust for Scotland
45 School Street
Boston,MA02108 		04-3511088 501(C)(3) 10,000       SPONSORSHIP
(25) Tom Coughlin Jay Fund Foundation
232 Madison Ave Suite 1107
New York,NY10016 		59-3426937 501(C)(3) 10,000       SPONSORSHIP
(26) YWCA of Bergen County
2 University Plaza Suite 208
Hackensack,NJ07601 		22-1494725 501(C)(3) 20,000       SPONSORSHIP
(27) THE CHARLES J COOPER PATIENT SUPPORT FUND
414 EAGLE ROCK AVENUE
WEST ORANGE,NJ07052 		46-4566414 501(C)(3) 475,000       PROGRAM SUPPORT
(28) ADV MED EMERGENCY RESOURCE COALITION
1350 CAMPUS PARKWAY
NEPTUNE,NJ07753 		47-3016571 501(C)(3) 28,750       PROGRAM SUPPORT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
28
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2015

Schedule I (Form 990) 2015
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients		 (c) Amount of
cash grant		 (d) Amount of
non-cash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of non-cash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
SCHEDULE I, PART I; QUESTION 2 GRANTS ARE MONITORED BY THE ORGANIZATION'S FINANCE PERSONNEL THROUGH THE UTILIZATION OF COST CENTERS AND OTHER INFORMATION; INCLUDING WRITTEN DOCUMENTATION AND RECEIPTS.
Schedule I (Form 990) 2015



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" on 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
2015
Open to Public Inspection
Name of the organization
HACKENSACK UNIVERSITY MEDICAL CENTER
 
Employer identification number

22-1487576
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 on 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
Yes
 
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
Yes
 
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 on 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
 
No
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
 
No
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 on 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," on line 5a or 5b, describe in Part III.
6
For persons listed on 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
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on 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 on 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" on 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) 2015

Schedule J (Form 990) 2015
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 on 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 on prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1ROBERT C GARRETTGOVERNOR - PRESIDENT/CEO (i)

(ii)		 1,490,912
-------------
0 		676,300
-------------
0 		1,786,406
-------------
0 		880,049
-------------
0 		56,023
-------------
0 		4,889,690
-------------
0 		853,929
-------------
0
2PRANAYCHANDRA J VAIDYA MDGOVERNOR (i)

(ii)		 93,462
-------------
453,790 		0
-------------
12,391 		0
-------------
22,791 		1,011
-------------
53,209 		0
-------------
34,924 		94,473
-------------
577,105 		0
-------------
0
3ROBERT L GLENNINGEVP/CHIEF FINANCIAL OFFICER (i)

(ii)		 995,563
-------------
0 		229,900
-------------
0 		999,393
-------------
0 		443,869
-------------
0 		35,551
-------------
0 		2,704,276
-------------
0 		492,472
-------------
0
4IHOR S SAWCZUK MDEVP/CHIEF MEDICAL OFFICER (i)

(ii)		 1,440,663
-------------
0 		149,700
-------------
0 		268,920
-------------
0 		474,340
-------------
0 		44,134
-------------
0 		2,377,757
-------------
0 		83,850
-------------
0
5AUDREY C MURPHY RN ESQEVP/CHIEF LEGAL OFFICER (i)

(ii)		 532,617
-------------
0 		125,700
-------------
0 		272,525
-------------
0 		315,267
-------------
0 		32,701
-------------
0 		1,278,810
-------------
0 		70,243
-------------
0
6NANCY R CORCORAN-DAVIDOFFEVP/CHIEF HUMAN RESOURCES OFF (i)

(ii)		 483,096
-------------
0 		114,300
-------------
0 		295,888
-------------
0 		334,278
-------------
0 		39,634
-------------
0 		1,267,196
-------------
0 		81,689
-------------
0
7DIANNE A AROHEVP PATIENT CARE/CNO (i)

(ii)		 567,354
-------------
0 		125,500
-------------
0 		182,061
-------------
0 		166,232
-------------
0 		3,458
-------------
0 		1,044,605
-------------
0 		34,545
-------------
0
8JON M FITZGERALDEVP/COO - HUMC FOUNDATION (i)

(ii)		 482,190
-------------
0 		117,100
-------------
0 		28,094
-------------
0 		128,025
-------------
0 		30,140
-------------
0 		785,549
-------------
0 		0
-------------
0
9KETUL J PATEL TERM 13115EVP/CHIEF OPERATING OFFICER (i)

(ii)		 96,487
-------------
0 		199,260
-------------
0 		4,384
-------------
0 		1,485
-------------
0 		10,398
-------------
0 		312,014
-------------
0 		0
-------------
0
10MARK D SPARTAACTING CEO AT PASCACK VALLEY (i)

(ii)		 466,823
-------------
0 		89,200
-------------
0 		141,488
-------------
0 		183,402
-------------
0 		43,055
-------------
0 		923,968
-------------
0 		0
-------------
0
11JOSEPH E PARRILLO MDCHAIRMAN HVH (i)

(ii)		 1,245,517
-------------
0 		110,000
-------------
0 		121,568
-------------
0 		9,275
-------------
0 		35,177
-------------
0 		1,521,537
-------------
0 		0
-------------
0
12ANDREW L PECORA MDVP/CHIEF INNOVATION OFFICER (i)

(ii)		 855,835
-------------
0 		493,200
-------------
0 		52,736
-------------
0 		195,726
-------------
0 		1,800
-------------
0 		1,599,297
-------------
0 		16,939
-------------
0
13ERIC D SOMBERG MDCHIEF, CARDIOTHORACIC SURGERY (i)

(ii)		 836,041
-------------
0 		0
-------------
0 		0
-------------
0 		0
-------------
0 		1,800
-------------
0 		837,841
-------------
0 		0
-------------
0
14MANUEL ALVAREZCHAIR, OB/GYN (i)

(ii)		 438,483
-------------
342,240 		28,946
-------------
0 		11,578
-------------
0 		142,437
-------------
1,323 		33,252
-------------
0 		654,696
-------------
343,563 		0
-------------
0
15JEFFREY R BOSCAMP MDVP/CAO & CHAIR, PEDIATRICS (i)

(ii)		 646,545
-------------
0 		76,000
-------------
0 		71,851
-------------
0 		265,290
-------------
0 		16,664
-------------
0 		1,076,350
-------------
0 		0
-------------
0
Schedule J (Form 990) 2015

Schedule J (Form 990) 2015
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 I; QUESTION 1 THE ORGANIZATION'S CURRENT EXECUTIVE VICE PRESIDENT AND CHIEF DEVELOPMENT OFFICER OF HACKENSACK UNIVERSITY MEDICAL CENTER FOUNDATION, INC., JON M. FITZGERALD, RELOCATED TO THE STATE OF NEW JERSEY FOR HACKENSACK UNIVERSITY MEDICAL CENTER WORK PURPOSES. IN ORDER TO FACILITATE THE RELOCATION OF HIS PRIMARY RESIDENCE, THE ORGANIZATION PROVIDED HIM WITH A HOUSING ALLOWANCE IN THE AMOUNT OF $12,000 WHICH WAS INCLUDED IN HIS 2015 FORM W-2, BOX 5 AS TAXABLE MEDICARE WAGES.
SCHEDULE J, PART I; QUESTION 3 PLEASE REFER TO OUR RESPONSE TO CORE FORM, PART VI, QUESTION 15 INCLUDED IN SCHEDULE O.
SCHEDULE J, PART I; QUESTION 4 THE ORGANIZATION PROVIDED A SUPPLEMENTAL RETIREMENT PLAN FOR EXECUTIVE EMPLOYEES THAT CONTINUED THE QUALIFIED PENSION PLAN FORMULA AS TO COMPENSATION THAT EXCEEDED THE AMOUNT OF COMPENSATION THAT COULD BE CONSIDERED UNDER THE QUALIFIED PENSION PLAN. ALL PARTICIPATING EXECUTIVE EMPLOYEES RECEIVED A BENEFIT UNDER THE SUPPLEMENTAL PLAN THAT RELATED TO THE EXECUTIVE'S ENTIRE PERIOD OF SERVICE FOR THE ORGANIZATION, WHILE THE VALUE IN ANY ONE YEAR WOULD VARY GREATLY BASED ON FACTORS SUCH AS INTEREST RATES AND THE EMPLOYEE'S AGE. Please note that this plan was frozen as of december 31, 2010.
SCHEDULE J, PART I; QUESTION 4B THE AMOUNT REFLECTED IN COLUMN B(III) FOR THE FOLLOWING INDIVIDUALS INCLUDES VESTED BENEFITS IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) WHICH ARE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2015 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: ROBERT C. GARRETT, $168,840; ROBERT L. GLENNING, $106,740; AUDREY C. MURPHY, RN ESQ, $55,524; NANCY R. CORCORAN DAVIDOFF, $49,392 AND DIANNE A. AROH, $58,788 (NEW FLEX PLAN). THE AMOUNTS REFLECTED IN COLUMN B(III) FOR THE FOLLOWING INDIVIDUALS INCLUDES PARTICIPATION IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") WHICH ARE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2015 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: ROBERT C. GARRETT, $1,536,397; ROBERT L. GLENNING, $854,231; IHOR S. SAWCZUK, M.D., $221,897; AUDREY C. MURPHY, RN ESQ., $181,744; NANCY R. CORCORAN-DAVIDOFF, $211,463; DIANNE A. AROH, $95,861; JOSEPH E. PARRILLO, M.D., $95,811; ANDREW L. PECORA, M.D., $45,344; MARK D. SPARTA, $62,192; MANUEL ALVAREZ, $10,561 AND JEFFREY R. BOSCAMP, M.D., $25,816 (NEW SERP PLAN). THE ORGANIZATION, ON JANUARY 1, 2011, INSTITUTED A DEFERRED COMPENSATION PROGRAM UNDER INTERNAL REVENUE CODE SECTION 401(A) WHEREIN THE ORGANIZATION MATCHES 2% OF AN INDIVIDUAL'S SALARY UP TO A MAXIMUM OF $5,300. THE MATCH IS SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THE AMOUNTS WERE NOT INCLUDED IN EACH INDIVIDUAL'S 2015 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THE FOLLOWING INDIVIDUALS INCLUDES UNVESTED BENEFITS IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) WHICH ARE SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THE INDIVIDUALS MAY NEVER ACTUALLY RECEIVE THE UNVESTED BENEFITS. THE AMOUNTS OUTLINED HEREIN WERE NOT INCLUDED IN THESE INDIVIDUAL'S 2015 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: ROBERT C. GARRETT, $287,897; ROBERT L. GLENNING, $29,283; IHOR S. SAWCZUK, M.D., $172,597; AUDREY C. MURPHY, R.N., ESQ., $136,896; NANCY R. CORCORAN-DAVIDOFF, $169,642; DIANNE A. AROH, $59,813; MARK D. SPARTA, $31,951; JON M. FITZGERALD, $47,500; JUNE ARCHER, $6,923; ANDREW L. PECORA, M.D., $64,417; MANUEL ALVAREZ, $52,393 AND JEFFREY R. BOSCAMP, M.D., $143,051 (OLD AND NEW SERP PLANS).
SCHEDULE J, PART I; QUESTION 7 Certain listed individuals received, as part of their compensation, payments under a long-term incentive compensation plan. These performance awards were based on the achievement of challenging long-term goals relating to Hackensack University Medical Centers mission of delivering excellent patient care to the community it serves. The incentive compensation awards were reviewed and approved by a committee of the Hackensack University Health Network, Inc. Board of Trustees consisting entirely of independent Board members. This committee reviewed and approved the incentive compensation awards, together with all compensation amounts, in a manner that qualifies for the "rebuttable presumption of reasonableness" under Internal Revenue Service rules. This means that the compensation is presumed to be reasonable under federal tax law.
SCHEDULE J, PART II; COLUMN F THE AMOUNTS REPORTED IN SCHEDULE J, PART II, COLUMN F FOR THE FOLLOWING INDIVIDUALS INCLUDES VESTED BENEFITS IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) AS THE AMOUNTS WERE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THE AMOUNTS OUTLINED HEREIN WERE REPORTED IN SCHEDULE J, PART II, COLUMN (C) AS RETIREMENT AND OTHER DEFERRED COMPENSATION ON PRIOR YEAR'S FORM 990. THESE AMOUNTS WERE TREATED AS TAXABLE INCOME AND REPORTED IN THE INDIVIDUAL'S 2015 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: ROBERT C. GARRETT, $853,929; ROBERT L. GLENNING, $492,472; IHOR S. SAWCZUK, M.D., $83,850; AUDREY C. MURPHY, R.N., ESQ., $70,243; NANCY R. CORCORAN-DAVIDOFF, $81,689; DIANNE A. AROH, $34,545 AND ANDREW L. PECORA, M.D., $16,939.
Schedule J (Form 990) 2015
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
2015
Open to Public
Inspection
Name of the organization
HACKENSACK UNIVERSITY MEDICAL CENTER
 
Employer identification number
22-1487576
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 HEALTH CARE FACILITIES FINANCING AUTHORITY
  		22-1987084 64579FVG5 04-10-2008 247,730,070 SEE PART VI   X   X   X
B NJ HEALTH CARE FACILITIES FINANCING AUTHORITY
  		22-1987084 64579FE58 08-26-2010 87,176,297 SEE PART VI   X   X   X
C NJ HEALTH CARE FACILITIES FINANCING AUTHORITY
  		22-1987084 64579FL92 10-26-2010 124,878,430 SEE PART VI   X   X   X
D NJ HEALTH CARE FACILITIES FINANCING AUTHORITY
  		22-1987084   08-12-2015 84,000,000 SEE PART VI   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired .................. 28,010,000 18,025,000 20,980,000 0
2 Amount of bonds legally defeased .............. 0 0 0 0
3 Total proceeds of issue .................. 249,429,933 87,176,297 124,878,430 84,000,000
4 Gross proceeds in reserve funds ............. 16,950,138 5,388,581 0 0
5 Capitalized interest from proceeds ............. 9,670,130 0 0 0
6 Proceeds in refunding escrows ............... 0 0 0 0
7 Issuance costs from proceeds ............... 2,405,194 1,287,851 1,615,900 325,733
8 Credit enhancement from proceeds ............. 5,430,771 1,165,808 899,571 0
9 Working capital expenditures from proceeds ............. 0 0 0 0
10 Capital expenditures from proceeds ............. 66,509,711 0 0 0
11 Other spent proceeds ............. 0 0 0 0
12 Other unspent proceeds ............. 0 0 0 0
13 Year of substantial completion ............. 2010 2010 2010 2015
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? .... X   X   X     X
15 Were the bonds issued as part of an advance refunding issue? .....   X   X   X   X
16 Has the final allocation of proceeds been made? .......... X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   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   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............   X   X   X   X
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2015

Schedule K (Form 990) 2015
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   X   X   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   X   X   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 % 0 % 0 % 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        
6 Total of lines 4 and 5 .............        
7 Does the bond issue meet the private security or payment test? ...   X   X   X   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   X   X   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   X   X   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   X   X   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   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......                
b Exception to rebate? ........   X   X   X   X
c No rebate due? .........                
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? .....                
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider .......... 0
  		0
  		0
  		0
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
Schedule K (Form 990) 2015

Schedule K (Form 990) 2015
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   X   X   X
b Name of provider .......... 0
  		0
  		0
  		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   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X   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   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
SCHEDULE K A PORTION OF THE PROCEEDS OF THE SERIES 2008 BONDS WAS APPLIED TO REFUND THE SERIES 2004 BONDS OUTSTANDING IN THE AGGREGATE PRINCIPAL AMOUNT OF $146,900,000. PROCEEDS USED WERE $146,768,126. A PORTION OF THE PROCEEDS OF THE SERIES 2008 BONDS, TOGETHER WITH CAPITAL CAMPAIGN FUNDS AND OTHER DOLLARS AVAILABLE TO THE INSTITUTION HAS BEEN APPLIED TO CONSTRUCT THE CANCER CENTER PROJECT. THE CANCER CENTER PORTION OF THE PROJECT IS A FOUR FLOOR, ENVIRONMENTALLY AND ENERGY CERTIFIED, 155,000 GROSS SQUARE FOOT AMBULATORY CARE BUILDING ON A 1.4 ACRE SITE ACROSS THE STREET FROM THE INSTITUTION'S MAIN CAMPUS AT THE NORTHEAST CORNER OF ATLANTIC AND SECOND STREETS IN HACKENSACK. THE PROJECT ALSO INCLUDES A 975 CAR PARKING GARAGE ON A 2.6 ACRE SITE ON THE ADJACENT BLOCK AT THE NORTHWEST CORNER OF THE SAME INTERSECTION AS THE CANCER CENTER. PEDESTRIAN BRIDGES CONNECT THE CANCER CENTER TO THE MAIN HOSPITAL CAMPUS THROUGH THE PARKING GARAGE. CONSTRUCTION OF THE PROJECT BEGAN IN APRIL 2008. THE PARKING GARAGE OPENED IN NOVEMBER OF 2009. THE CANCER CENTER OPENED IN JANUARY OF 2011. PROCEEDS OF THE SERIES 2008 BONDS ARE APPLIED TO: (I) ACQUIRE MEDICAL AND OTHER EQUIPMENT AT ITS FACILITIES; (II) PAY CAPITALIZED INTEREST ON A PORTION OF THE SERIES 2008 BONDS; (III) FUND THE DEBT SERVICE RESERVE FUND; AND (IV) PAY COSTS OF ISSUANCE OF THE SERIES 2008 BONDS INCLUDING THE PREMIUM FOR THE BOND INSURANCE POLICY SECURING A PORTION OF THE SERIES 2008 BONDS. THE PROCEEDS OF THE SERIES 2010 BONDS ARE APPLIED TO REFUND ALL OF THE SERIES 2000 BONDS AND A PORTION OF THE SERIES 1997 BONDS OUTSTANDING IN THE AGGREGATE PRINCIPAL AMOUNT OF $86,735,000. PROCEEDS OF THE SERIES 2010 BONDS WERE ALSO APPLIED TO: (I) FUND THE DEBT SERVICE RESERVE FUND AND (II) PAY COSTS OF ISSUANCE OF THE SERIES 2010 BONDS. THE PROCEEDS OF THE SERIES 2010B BONDS ARE APPLIED TOGETHER WITH OTHER AVAILABLE MONIES TO REFUND ALL OF THE SERIES 1998 BONDS OUTSTANDING IN THE AGGREGATE PRINCIPAL AMOUNT OF $126,140,000. PROCEEDS OF THE SERIES 2010B BONDS WERE ALSO APPLIED TO PAY COSTS OF ISSUANCE AND CREDIT ENHANCEMENT OF THE SERIES 2010B BONDS. Prior to August 2015, the Medical Center leased a medical office building and its adjoining parking garage on the Medical Centers property from an unrelated entity ("the lessor"). The lessor entity agreed to sell the building and parking garage free and clear of the existing mortgage debt to the Medical Center for a price of $116.0 million. In August 2015, the Medical Center entered into two loans (Series 2015A and Series 2015B) to finance the purchase of the building and garage. Both notes are obligations under the Master Trust Indenture. the Series 2015A is an $84.0 million tax-exempt loan issued under the New Jersey Health Care Facilities Financing Authority. the Series 2015B is a $36.0 million taxable bank loan. The loans carry a combined blended rate of 2.63% and both loans will carry the same payment terms on a fixed basis for a 10-year term with 25-year amortization.
Schedule K (Form 990) 2015

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletInformation about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
HACKENSACK UNIVERSITY MEDICAL CENTER
 
Employer identification number

22-1487576
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2015
Schedule L (Form 990 or 990-EZ) 2015
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) ELIZABETH SIMUNOVICH FAMILY MEMBER OF GOVERNOR 123,492 HACKENSACKUMC EMPLOYEE   No
(2) MARY R KOZIBRODA FAMILY MEMBER OF GOVERNOR 76,035 HACKENSACKUMC EMPLOYEE   No
(3) PIA SISON FAMILY MEMBER OF GOVERNOR 114,520 HACKENSACKUMC EMPLOYEE   No
(4) DOREEN A PROWITZ FAMILY MEMBER OF GOVERNOR 107,439 HACKENSACKUMC EMPLOYEE   No
(5) MARY P DONNALLEY FAMILY MEMBER OF OFFICER 112,139 HACKENSACKUMC EMPLOYEE   No
(6) THERESA M EBEL FAMILY MEMBER OF OFFICER 170,685 HACKENSACKUMC EMPLOYEE   No
(7) WARREN E SCOTT FAMILY MEMBER OF OFFICER 64,117 HACKENSACKUMC EMPLOYEE   No
(8) AMI P VAIDYA FAMILY MEMBER OF GOVERNOR 249,649 HACKENSACKUMC EMPLOYEE   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
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SCHEDULE O
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OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
HACKENSACK UNIVERSITY MEDICAL CENTER
 
Employer identification number

22-1487576
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CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS Hackensack university medical center (the "medical center"hackensackumc") is a not-for-profit new jersey corporation exempt from federal income taxes under section 501(c)(3) of the internal revenue code of 1986, as amended (the "code"). Hackensackumc owns and operates a 775 licensed bed acute care teaching hospital located at 30 prospect avenue in the city of hackensack, bergen county, new jersey. Bergen county is the largest county by population in the state of New Jersey (the "state"), with a 2013 population of 918,888. According to the u.s. census bureau 2013 population estimates, it has the sixteenth highest per capita income in the united states. The medical center is located near major highways in northeastern new jersey, including interstate 80, the new jersey turnpike, the garden state parkway, state routes 4, 17, and 46 and is approximately 12 miles from new york city. Hackensackumc was founded in 1888 as a 12-bed hospital to provide acute care for the residents of the city of hackensack. The medical center has evolved from a community hospital offering patients a secondary level of healthcare services to a teaching hospital affiliated with Georgetown University School of Medicine, Rutgers New Jersey Medical School, Seton Hall University, St. Georges University, and Stevens Institute of Technology, offering an increasing array of tertiary and quaternary patient services. Hackensackumc provides these services primarily to residents of bergen, hudson and passaic counties, but also to patients from throughout the state and adjacent counties in southeastern new york and eastern pennsylvania. To learn more, visit hackensackumc.org. Hackensackumc is a regional leader in many service programs and its management believes that patients whose primary physicians are not on the hackensackumc medical staff are referred to hackensackumc because of its reputation for high-quality care and its array of specialized services, such as: cardiac services; oncology (which includes one of the largest bone marrow/stem cell transplantation programs in the country); transplantation services; and women's and children's services. Since 1999, the medical center's bed complement has increased from 579 licensed beds to the present licensed complement of 775 beds. Adult and pediatric occupancy has consistently approximated 90% soon after each bed capacity expansion of 30 beds in 2000, 68 beds in 2001, and 98 beds in 2006, which further supports the necessity of the medical center within its community. Hackensackumc is bergen county's largest employer with a work force in 2015 of 8,697 employees. Hackensackumc has a volunteer population of approximately 1,800 men, women, and teenagers, who donate their time to hackensackumc each year. Hackensackumc offers one of the region's most modern campuses, which is continually updated and expanded to incorporate emerging clinical approaches, medicine, and technologies. The medical center consists of seventeen buildings and five freestanding parking garages, located on its main campus in the city of hackensack. Seven of the buildings are used for inpatient services and six are used for outpatient services. On this campus, hundreds of specialized programs and services are delivered. Hackensack university health network: Hackensack University Health Network ("hackensackuHN") is the New Jersey-based parent company of HackensackUMC, HackensackUMC Palisades, the HackensackUMC Foundation, Hackensack University Medical Group, and corporate joint venture partners with LHP Hospital Group in ownership of two hospitals: HackensackUMC at Pascack Valley and HackensackUMC Mountainside. In 2015, HackensackUHN welcomed Englewood Hospital and Medical Center as an affiliate hospital. In May 2015, HackensackUHN signed a definitive agreement to merge with Meridian Health; creating one, integrated healthcare delivery system, known as Hackensack Meridian Health. In June 2015, HackensackUHN and Seton Hall University announced a definitive agreement to form a new, four-year school of medicine the only private medical school in New Jersey. HackensackUHN also enjoys clinical and academic affiliations with some of the nations most well-renowned health systems, hospitals and universities, including: Aetna, AllSpire Health Partners, CityMD, Georgetown Lombardi Comprehensive Cancer Center, Good Samaritan Regional Medical Center, Horizon Blue Cross and Blue Shield of New Jersey; MedStar Georgetown University Hospital, MinuteClinic, NYU Langone Medical Centers Division of Pediatric Surgery, OMNIA Health Alliance; Rutgers Medical School, St. Georges University, Stevens Institute of Technology, Summit Medical Group, The Statesir Cancer Center at CentraState, and United Surgical Partners International. With more than 10,800 employees, 3,300 credentialed medical staff members and 1,717 hospital and nursing home beds at hospitals within the Network, Hackensack University Health Network is one of the largest healthcare systems in New Jersey. World-class cardiac care: Hackensackumc is home to the heart & vascular hospital, one of america's most comprehensive cardiac and vascular care centers. This "hospital within a hospital" provides a full-range of state-of-the-art invasive and non-invasive services, including electrophysiology studies, a state-designated cardiac catheterization center, and one of the largest cardiac surgery programs in the state. The care at the heart & vascular hospital has garnered national recognition by ranked in u.s. news & world report's 2015-16 best hospitals list for cardiology & heart surgery, and listed on becker's hospital review 2015 "100 hospitals with great heart programs" list. Led by breakthrough research, the heart & vascular hospital integrates preventive, diagnostic, and treatment services with a special focus on cardiovascular disease management. Inpatients and outpatients are treated for all types of cardiac and vascular diseases by an array of specialists-all from one central location. This collaborative, multidisciplinary model allows for more efficient and effective care. One of the nation's largest cancer centers: At 155,000 square-feet, the john theurer cancer center at hackensackumc is one of the nation's largest and most comprehensive cancer centers, and ranks in the top 10 for patient volume. Opened in december of 2010, the cancer center has quickly established a reputation of excellence. Becker's hospital review listed the john theurer cancer center on its "100 hospitals and health systems with great oncology programs" list. The cancer center houses outpatient cancer services and incorporates diagnostic facilities, chemotherapy preparation and infusion areas, pharmacy and laboratory resources, as well as a full spectrum of radiation oncology services. We have 14 specialized teams on-site who are fully engaged in the medical and emotional care of patients and their loved ones. Each of the 14 divisions features teams of physicians, nurses, technologists, and support staff with clinical and research expertise in a specific type of cancer, allowing for advanced, focused care. The john theurer cancer center was built following eco-friendly guidelines outlined by the leadership in energy and environmental design and developed by the u.S. Green building council, making it an institution devoted to life-sustaining practices from the inside out. Nationally-renowned children's hospital: As a state-designated children's hospital, the joseph m. Sanzari children's hospital provides comprehensive medical and surgical pediatric care in more than 30 specialties, all integrated within a state-of-the-art child-focused facility. The 300,000 square-foot facility offers 24-hour access to leading physicians, nurses, staff and a pediatric emergency department. This facility is one of the country's first environmentally-responsible and sustainable healthcare facilities, and has been ranked as one of the top 10 green hospitals by the green guide. Environmentally-friendly hospital designed just for women: The donna a. Sanzari women's hospital is dedicated to providing superior care to its patients. The hospital is part of the 300,000 square-foot sarkis and siran gabrellian women's and children's pavilion. The pavilion was carefully planned and developed with the Deirdre Imus Environmental Health Center to provide exceptional patient satisfaction and services within an environmentally healthy facility. Its design, energy systems, cleaning supplies, linens, medical equipment, and even the food prepared for patient/staff/visitor consumption are environmentally friendly in keeping with the values of the deirdre imus environmental center for pediatric oncology, an award-winning non-profit organization at hackensackumc.
CORE FORM, PART III In 2015, we welcomed more than 6,358 babies - more than any other hospital in new jersey - a true testament to our long history of trusted care in the community. In 2015, hackensackumc was named one of the "100 Hospitals with Great Women's Health Programs" by Beckers Hospital Review, and was named one of 2015 Americas Best Hospitals for Obstetrics by WomenCertified Inc. Quality & accreditations: Hackensackumc is continuing to prove that "impossible" is just an opinion. We've created an environment that encourages medical innovation to flourish by recruiting top doctors and giving them freedom to push research and treatments beyond traditional thinking. Some of hackensackumc's awards include: - HackensackUMC was listed as the number one hospital in New Jersey and ranked among the top four New York Metro Area hospitals by U.S. News & World Report in its 2015-16 Best Hospitals list. - Received 5 national rankings in: Cardiology & Heart Surgery; Geriatrics; Neurology & Neurosurgery; Orthopedics; and Urology. - Also listed as high-performing in the New York metro area in six specialties: Gynecology; Nephrology; Cancer; Ear, Nose & Throat; Gastroenterology & GI Surgery; and Pulmonology. - 2015 Healthgrades Americas 50 Best Hospitals the only hospital in NJ, NY and New England to receive nine years in a row. - The first hospital nationwide recognized by the U.S. Department of Health and Human Services (HHS) for reaching Phase IV Gold level achievement in the Workplace Partnership for Life Hospital Campaign. - HackensackUMCs Bariatric Surgery program (including Gastric Stapling and Gastric Banding) for being recognized as a Blue Distinction Center (BDC) and a Blue Distinction Center+ (BDC+) by the Blue Cross Blue Shield Association. - Healthgrades Distinguished Hospital Award - Clinical Excellence Award - 13 years in a row (2003-2015), placing the hospital among the Top 5% of the nations hospitals for overall quality for more than a decade. HackensackUMC is the only hospital in NJ, NY and New England to receive this award for 13 consecutive years. - 23 Joint Commission Gold Seals of Approval the most in the country: Abdominal Aortic Aneurysm, Acute Myocardial Infarction, Asthma, Asthma (Pediatrics), Bone Marrow Transplant, Breast Cancer, Carotid Stenosis, Chronic Obstructive Pulmonary Disease, Colorectal Cancer, Coronary Artery Bypass Graft, Depression, Geriatrics Delirium, Heart Failure, Inpatient Diabetes, Joint Replacement Hip, Joint Replacement Knee, Multi-System Trauma, Palliative Care, Peripheral Vascular Disease, Pneumonia, Prostate Cancer, Stroke (Primary Stroke Center), and Uterine-Ovarian Cancer. - 2015/2016 National Research Corporation Consumer Choice Award 20th consecutive year and every year since the awards inception. - 2014 NJBIA Award for Excellence in Environmental Quality. - 2015 Beckers Hospital Review Awards: 100 Hospitals With Great Orthopedic Programs, 100 Hospitals With Great Heart Programs, 150 Great Places to Work in Healthcare, 100 Hospitals with Great Womens Health Programs, 100 Great Hospitals, 100 Hospitals and Health Systems With Great Oncology Programs; 50 Top-Grossing Nonprofit Hospitals in America, 125 Hospitals and Health Systems with Great Orthopedic Programs, 100 ACOs to Know, 50 of the Greenest Hospitals in America. - CEO Cancer Gold Standard Re-designation. - Radiology successfully achieved American College of Radiology accreditation, and The American College of Radiology (ACR) recognized HackensackUMC as the first-ever Diagnostic Imaging Centers of Excellence Award recipient, recognizing a distinctive level of excellence in diagnostic imaging. - First nonprofit hospital in the state to sign MOU with EPA for Green/Sustainability Initiative. - Awarded Practice Greenhealths highest honor as a 2015 Environmental Excellence Award winner, earning recognition as one of the Top 25 green hospitals in the country two years in a row. - NJBIZ Hospital of the Year 2015. - New York Corporate Culture Award winner by SmartCEO. Centers of excellence: - Don imus/wfan pediatric center for tomorrows children - Sarkis and siran gabrellian women's and children's pavilion - John theurer cancer center - Heart & vascular hospital - Joseph m. Sanzari children's hospital - Pediatric emergency department - Gregory m. Hirsch hypertrophic cardiomyopathy center - David joseph jurist research center for tomorrows children - Jeffrey m. Creamer emergency and trauma center - Donna a. Sanzari women's hospital - Sarkis & siran gabrellian child care and learning center - Audrey hepburn children's house - Hekemian conference center - Center for asthma, allergy, and immune disorders - Beyond day spa - Bloodless medicine - Betty torricelli institute for breast care - Executive health program - Institute for sleep-wake disorders - Deirdre imus environmental health center - Center for abnormal placentation - The comprehensive stroke center - Molly diabetes education/management center for adults & children - Dave winfield nutrition center Patient care Magnet status: Nursing, the largest group at the forefront of care delivery, is the backbone of HackensackUMCs frontline of care. Its 1,931 nurses are renowned for achieving Magnet recognition for Nursing Excellence, the highest honor that can be bestowed by the American Nurses Credentialing Center. The medical center was the first in New Jersey and the second in the country to receive this designation a-true testament to the quality of care delivered at HackensackUMC. In January 2014, HackensackUMC received its fifth Magnet designation by the American Nurses Credentialing Center-making the medical center just one of two hospitals in the entire nation to achieve this feat. After a rigorous three-day site visit by the Magnet Appraisal Team in December, they unanimously re-designated HackensackUMC as a Magnet hospital for its 20th consecutive year. Every organization has its honors and awards to recognize excellence in the field, the pursuit of the highest values, and the attainment of goals to which all others aspire. In nursing, the highest recognition that a hospital or hackensackumc can attain is the american nurses credentialing center's magnet award - an affirmation that an institution attracts and retains well-qualified nurses, upholds stringent standards for nursing practice, and promotes exceptional patient care. To be a magnet hospital means that a never-ending culture of excellence exists at hackensackumc. It is evident in the way we care for patients and their families, recognizing that each patient has individual needs, concerns, and ways of coping with illness. To be a magnet hospital means that hackensackumc values the contributions of its nurses and seeks their input in all administrative and patient care decisions. To be a magnet hospital means that other leading hospitals - such as massachusetts general hospital, the cleveland clinic, and johns hopkins hospital - turn to them for extensive mentoring. In September 2015, HackensackUMCs Coronary Care Unit (CCU) and Medical Intensive Care Unit (MICU) received the Silver Beacon Award for Excellence. The Beacon Award is a prestigious honor given by the American Association of Critical-Care Nurses (AACN) to adult critical care units that achieve high-quality outcomes exemplifying excellence in professional practice, patient care and outcomes. HackensackUMC joins only 14 other units in New Jersey to achieve Beacon designation, which indicates to patients and their families high levels of care, satisfaction and exceptional clinical outcomes. HackensackUMC was named one of the 30 Most Nurse-Friendly Hospitals in the United States by Top RN to BSN, a leading online information source for current and prospective nursing students, in 2015.
CORE FORM, PART III Hackensackumc is proud of its many innovations, technologies, research projects, and medical expertise. But at the top of the list is the entity that often means the most to the patients - unparalleled nursing excellence that makes hackensackumc stand tall over all others. Hackensackumc purpose, goal, and beliefs: Purpose - hackensackumc is a team committed to providing an exceptional patient experience through quality patient-centered care, education, research, and community outreach. Goal - quality continues to evolve as the number one, non-negotiable value that drives hackensackumc's mission and actions. Hackensackumc incorporates emerging business management operations to reflect a vision that puts patients in charge. Beliefs - hackensackumc is guided by the following beliefs: - quality - achieving excellence in patient-centered care and service. - service - committing to anticipate and fulfill the needs, requests, and wishes of the customers. - patient - centered care - providing care that is compassionate, empathic, and responsive to the needs, values, and preference of individual patients and the families of patients. - innovation - advancing the delivery of healthcare through the use of cutting-edge technology, research, education, and processes that achieve desired outcomes. - communication - providing timely, reliable information which results in understanding. - integrity - acting in a responsible and ethical manner. - professionalism - accepting individual responsibility and accountability within our roles, as defined by the standards of the profession. - respect - listening to, and valuing, diverse opinions. - satisfaction - creating a safe, supportive, and healing environment that inspires us to exceed the needs and expectations of patients, the families of patients, physicians, and employees. Medical specialties/services: In addition to providing a comprehensive array of secondary level patient care, the medical center provides tertiary and quaternary services to a wide referral area. These services include: Cardiac care: The medical center is one of the largest and most comprehensive providers of cardiac care in the state offering a full-range of state-of-the-art invasive and non-invasive diagnostic and treatment services including preventive cardiology with ultra fast computerized electron beam tomography, non-invasive cardiology laboratory, pacemaker center, congestive heart failure and pulmonary hypertension program, cardiac catheterization laboratory, electrophysiology program, cardiac surgery, and cardiac rehabilitation. Hackensackumc's eight cardiac catheterization laboratories are using radio-frequency for totally blocked arteries, intracoronary ultrasound, and neuro-intravascular procedures. Recently the ability to temporarily place a catheter-based heart assist device allows the performance of interventional procedures even in the highest-risk patients. Electrophysiology includes atrial fibrillation ablations, lead extractions, and electro anatomical mapping with cardiomerge technology. The heart center is an outpatient cardiac department that offers stress testing, echocardiograms, halter monitor services, a pacemaker center, electron-beam tomography, enhanced external counter pulsation, and outpatient diagnostic services. A new picture archiving communication system and report-generating system has recently been installed. The new heart & vascular hospital is charting the future of cardiovascular care in new jersey. Hackensackumc has embarked on a mission to recruit the very best cardiologists in the community to enhance the state-of-the-art diagnostic and treatment services offered at the new, cutting-edge heart & vascular hospital. This "hospital within a hospital" provides additional space, superior patient care, and access to leading technology. Cancer care: The john theurer cancer center at hackensackumc is new jersey's largest and most comprehensive center dedicated to the diagnosis, treatment, management, research, screenings and preventive care of patients with all types of cancer, and is among the nation's top providers in patient volume. There were 2,776 blood and marrow stem cell transplants performed in 2015. Housed within hackensackumc, the cancer center provides state-of-the-art technological advances, compassionate care, research innovations, medical expertise, and a full range of after care services that distinguish the cancer center from other facilities. The cancer center has experienced steady growth in its cancer care programs. It offers patients access to one of fourteen specialized divisions: bone marrow transplantation, breast, gastrointestinal, genitourinary, gynecological, head and neck, leukemia, lymphoproliferative, multiple myeloma, neuro-oncology, skin and sarcoma, supplementary care and pain management, thoracic, and research. In addition, it is one of only 50 programs in the nation designated as a community clinical oncology program (ccop) by the national cancer institute (nci) of the national institutes of health. A ccop is a group of community hospitals and physicians funded by a peer-reviewed cooperative agreement to participate in nci-sponsored cancer treatment, prevention, and controlled clinical trials. The cancer center encompasses the entire range of advanced diagnostic and treatment capabilities that are available only at major hospitals such as hackensackumc. These include all types of imaging studies, including pet scanning, mri, ct scanning, and nuclear medicine; advanced minimally invasive surgical diagnostics, such as stereotactic biopsies and sentinel lymph node mapping; robotic and minimally invasive surgical procedures; state-of-the-art radiation therapy, including intensity modulated radiation therapy (imrt), tomotherapy, implant and high-dose-rate brachytherapy, and stereotactic radiosurgery; non-surgical treatments, including radiofrequency ablation; advanced chemotherapy using new medications and combinations; hormonal therapy; stem cell transplantation; and highly promising immunotherapy using vaccines to destroy cancer cells. However, at the cancer center, hackensackumc is not satisfied to provide the most advanced, state-of-the-art services and technology available today. Nor is it satisfied to provide cutting-edge basic research, clinical trials, and innovative treatment methods that are not found anywhere else in new jersey. When it comes to helping people face the biggest challenge of their lives - a diagnosis of cancer - hackensackumc reaches beyond its facilities, its equipment, and its treatments and offers patients the best of hackensackumc, the cancer care team of dedicated individuals. No treatment can work without the skills, expertise, and compassion of hackensackumc's extraordinary team of cancer care experts. Its mission to provide extraordinary care starts with each member of its team. Hackensackumc pledges to partner with patients in the fight of their lives, and to make every effort to support them during their experiences with hackensackumc. Hackensackumc cares for patients with dignity and respect as hackensackumc makes this journey together with patients. The cancer center works closely with several centers of excellence that offer diagnostic and treatment capabilities that are not readily available at other cancer facilities in new jersey. These include the world-renowned adult blood and marrow stem cell transplantation program; the prostate cancer institute of new jersey; the betty torricelli institute for breast care; the institute for radiosurgery; the colon cancer prevention center; and the department of radiation oncology. The cancer center is the first cancer center in new jersey to acquire a new, cutting edge radiotherapy system that enables a radically different approach to treating cancer with image-guided radiotherapy (igrt) known as the truebeam system. This state-of-the-art radiotherapy system allows the john theurer cancer center to offer even faster treatments, enhanced accuracy, and quicker imaging at lower doses. Basic research/CANCER CARE: Basic research studies at the cancer center and hackensackumc's on-site david joseph jurist research center for tomorrows children are currently looking into the origins of cancer at the molecular level, how and why cells progress into cancer, and the basic biology of graft-versus-host disease, a common and potentially fatal side effect of stem cell transplantation. Stem cell transplantation is used to treat hematological (blood) cancers, such as leukemia and lymphoma; cancers that involve solid tumors, such as breast and ovarian cancer; serious blood disorders; and immune system deficiencies.
CORE FORM, PART III Clinical trials offer innovative treatments: As a world-class facility and academic hospital, the cancer center is actively involved in clinical trials that bring research advances directly to patients. The cancer center participates in more than 100 international and national cancer clinical trials that give patients access to promising investigational medications, treatment protocols, and surgical techniques that are often not available at other facilities in new jersey. Key areas of cancer research that are currently taking place include targeted therapies that pinpoint cancer cells and spare normal cells, gene therapy to mutate cancer, advances in stem cell transplantation, new combinations of chemotherapy, new radiation oncology cancer cells and safe viruses to make vaccines that combat cancer. Bone marrow transplantation program: The adult blood and marrow stem cell transplantation program provides autologous and allogeneic hematopoietic stem cell transplantation in the treatment of malignant and non-malignant diseases including use of bone marrow, peripheral blood stem cells, and umbilical cord blood stem cells. This program also serves as a collection facility for national marrow donor program donor centers. The adult blood and marrow stem cell transplantation program, was the first center in the country to receive a bone marrow transplant disease specific recognition by the joint commission (formerly the joint commission on accreditation of healthcare organizations, the "joint commission") a non-profit organization that accredits and certifies over 15,000 healthcare organizations and programs in the united states. An affiliation has been formed with the transplant program at the national cancer institute of the national institutes of health, which enables sharing of protocols. This program has over twenty-one open transplant protocols in use at this time and eight more awaiting approval. The institute for breast care: Staffed by radiologists, pathologists, nurses and technologists specially trained in breast care, the institute for breast care offers comprehensive breast diagnostic services. These services include screening and diagnostic mammography, breast ultrasound, breast magnetic resonance imaging ("mri"), stereotactic guided core biopsies, ultrasound guided procedures (fine needle aspiration and core biopsy), needle localizations for excisional biopsies, and radiologic second opinions. The onsite pathology laboratory permits immediate evaluation of the specimens when needed. The institute for breast care also conducts breast cancer research, including prevention, and provides patient and community education and support. Specialized pediatric care: The medical center is the only hospital in its service area that offers a comprehensive range of pediatric specialty and subspecialty services at one location. As a result of its extensive range of services, the medical center has been designated as an institutional member of the national association of children's hospitals and related institutions, as a children's hospital by the new jersey department of health and senior services (njdhss), as a regional perinatal center by njdhss and as a regional diagnostic and treatment center for abused children by the legislature of new jersey. The medical center's pediatric services and programs include, but are not limited to, neonatology and pediatric pulmonology, neurosciences, rheumatology, hematology/oncology, infectious diseases, renal transplantation, nephrology, gastroenterology, cardiology, immunology, dermatology, endocrinology, child development (autism), and the only bone marrow transplant program in new jersey. The medical center is the only hospital in bergen county that is designated as a regional perinatal center. A regional perinatal center provides all levels of pre- and post-natal medical, surgical, and subspecialty services for mothers and babies. The medical center is equipped and staffed to handle high-risk pregnancies and complications of full-term and premature newborns. The program provides 24-hour, seven-day-a-week coverage by perinatologists, neonatologists, and pediatricians. The medical center operates a neonatal intensive care unit (nicu) which provides 24-hour coverage by board-certified neonatologists. The medical center also operates a pediatric intensive care unit (picu), which provides care for children who require critical monitoring and intensive medical intervention. Transport services are provided for children from outlying hospitals who are referred to both the picu and the nicu. An adjacent pediatric epilepsy monitoring unit to the picu is the only level 4 (the highest level) epilepsy center in the state accredited by the national association of epilepsy centers. The pediatric emergency and trauma program provides emergency care for children with acute illnesses and traumatic injuries. It is physically separate from the adult emergency department and is staffed by trained pediatric physicians and nurses. The Childrens Cancer Institute provides specialized care to children with hematology/oncology disorders. The institute for child development provides diagnostic and therapeutic services for infants, children and adolescents with developmental and behavioral problems. It is also a state-funded center of excellence for autism spectrum disorders. The pediatric rheumatology program is the largest in the new york metropolitan area. The program primarily receives referrals from physicians in bergen, hudson, and passaic counties but also attracts patients throughout the united states and internationally. The medical center is a regional diagnostic and treatment center for abused children, and is one of three such centers in the state. This center is housed in its own facility, known as audrey hepburn children's house, located adjacent to the medical center. While at audrey hepburn children's house, children and adolescents who are suspected victims of abuse and/or neglect receive diagnostic and therapeutic services, and undergo evaluation by a multi-disciplinary team in a supportive environment rather than undergoing a traumatic process of multiple evaluations in a hospital setting. The medical center's other associated/supportive services for children include the cj foundation for sudden infant death syndrome ("sids") and the new jersey sids center, dedicated to funding research into and counseling families stricken by sids; the molly foundation for diabetes research, which funds research in the treatment and possible cure for juvenile diabetes; the steven and richard bader immunological center, which provides a multi-disciplinary approach to the diagnosis and management of children with suspected or proven difficulties in fighting infection because of immune deficiency disorders; and the judy center for down's syndrome, which provides comprehensive care for children and adults with this genetic disorder. Geriatric care: Given the need to provide person-specific rather than site-specific care, the geriatric service cares for elders at the geriatric center, in the hospital, in post-acute care and long term care settings and at assisted living facilities. Organ transplantation: The medical center performs adult kidney transplants, pediatric kidney transplants and pancreas transplants (in conjunction with kidney transplants). The kidney and pancreas transplant programs at the medical center are the only such programs in bergen, passaic or hudson county. The center for allergy, asthma and immune diseases: The center offers a multi-disciplinary approach to the diagnosis, treatment, and management of disorders and illnesses of the immune system. Staffed by a team of board-certified allergy/immunology specialists, the center provides expert care in respiratory allergies, food and drug allergies, asthma, persistent sinusitis and other recurrent infections in one location. Services also include patient education provided by clinical nurse educators and licensed nutritionists; the ability to participate in clinical research trials; double blind oral food challenges, aspirin challenges and desensitization; and assessment of medication reactions. Urology and urologic oncology: The department of urology offers comprehensive diagnostic, therapeutic and preventive services for patients with both malignant and nonmalignant genitourinary disorders. Centers for bladder, prostate and pelvic floor health, male reproductive medicine and human sexuality, endourology and stone disease, cryosurgery, pediatric urology, and minimally invasive urologic surgery are established to treat both inpatient and outpatient populations. The davinci robotic surgical system is used for urologic surgery and for training of surgeons from across the country.
CORE FORM, PART III Research activities include prostate high intensity focused ultrasound and fluorescence based cystoscopy for bladder cancer. The department participated in clinical trials with provenge, a newly approved drug for the treatment of prostate cancer, and is using new radiation based technology with true beam software and wireless radiation sensors known as dvs. Diagnostic imaging services: The diagnostic imaging department provides a full spectrum of imaging services. These include 3t (magnet strength) mri, 64-slice computed tomography ("ct"), positron emission tomography ("pet/ct"), breast mri, nuclear medicine, interventional radiology, ultrasound, and digital x-ray. The department operates in a fully integrated picture archiving and communication system ("pacs"), a film-less environment. Physicians can log into the pacs remotely to view imaging studies anywhere there is internet access. The staff performs complex advanced procedures such as cardiac computed tomography angiography, cardiac mri, and advanced pet/ct applications. All radiologists are fellowship trained in various subspecialties and an attending radiologist (not a resident in training) is on site at all times for interpretation and consultation, producing very rapid report turn-around times. Emergency services/trauma: The Emergency and Trauma Center (ETC) is open 24 hours a day, seven days a week and treats all ages and all medical conditions. In 2015, 117,150 patients visited the ETC. There is also a separate pediatric emergency department. The pediatric emergency department is staffed by physicians and nurses specialty-trained in pediatric emergency medicine. The take-a-break program now seems like an obvious idea. The family members who accompany their loved ones to emergency departments can almost always benefit from a short break - whether to pick kids up at school, make a few phone calls or just grab a cup of coffee. When the proposal was first made to set up a network of volunteers who could support family members in the emergency department and represent them in their absence, there was nothing like it anywhere in the country. Today 50 volunteers cover each of the emergency trauma center's three shifts, seven days a week. The etc is designated by the state of new jersey and the u.s. department of health and human services as a level ii trauma center. The etc is also certified by the american college of surgeons and is an accredited chest pain center as per the society of chest pain centers. The NJ-MSED vehicles are one of only a few mobile medical assets of their kind in the nation, originally funded through a unique partnership with the U.S. Department of Defense and the Urban Areas Security Initiative. UASI Funding substantially ended after the UASI Mobile ER was built and DOD funding ended in 2012, but in early 2015, HackensackUMC obtained state funding and a group of 16 hospitals and systems came together to form the Advanced Medical Emergency Resource Coalition (AMERCO). The nonprofit corporation selected HackensackUMC as the Host Hospital. The MSED assets are ready to deploy to non-emergency events and we expect the MSED teams to be trained and ready to deploy for emergencies by the end of 2016. The core of the NJ-MSED complex exists in the form of two 43-foot trailers and a 48-foot trailer with expandable sides. Two are fully outfitted with critical care beds, and one is outfitted as a mobile operating room. They are fully functional mobile medical assets able to respond to large-scale incidents that result in the need for on-site Emergency Department services and can be pre-deployed to expected events like hurricanes or other potential incidents based on intelligence. Ambulatory surgery: The medical center provides same day surgery services on its main campus in three distinct locations; the center for ambulatory surgery, the pediatric surgical suite, and the center for plastic and reconstructive surgery. Specialties include dental, general, plastic, orthopedic, pediatric, vascular, gynecological, urological and podiatric surgery; neurosurgery; otolaryngology; and ophthalmology. Research: Research is what distinguishes hackensackumc from other area community hospitals. Research gives hackensackumc's staff the ability to explore the newest and most promising medical treatments and comprehensive medical and support services. This pursuit gives hackensackumc and other allied staff the extraordinary ability to explore new and better approaches to medicine - to uncover and deliver novel treatment breakthroughs. Research centers attract gifted physicians and scientists who collaborate with leading investigators in their field. This is true of researchers at hackensackumc. The david joseph jurist research center for tomorrow's children is a five-story, 55,000-square-foot building which houses the david and alice jurist institute for research. The research center consolidates all of hackensackumc's ongoing research activities into one location. The facility enhances the tireless work that the hackensackumc's scientists and physician-investigators are pursuing as partners in national and international multi-center trials. Hackensackumc partnered with the university of miami diabetes research institute, one of the world's leading centers for research on the disease. Hackensackumc patients with type 1, or juvenile diabetes will take part in a trial in which insulin-producing islet cells are transplanted to their abdomens. This trial has the promise of being an important step on the way to a cure for this disease. The research center is also home to the deirdre imus environmental center for pediatric oncology. The jurist institute is named for david joseph jurist, co-president of the tomorrow's children's fund for pediatric cancer and the father of eileen jurist, who was treated for hodgkin's disease at hackensackumc's tomorrow's children's institute for cancer and blood disorders. Mr. Jurist and his wife, alice, are active participants in all of the tomorrow's children's fund initiatives. Highlights of the david joseph jurist research center for tomorrow's children include laboratories for basic and clinical research; administrative offices; a "vivarium state-of-the-art operating rooms; and a lecture hall equipped with audio-visual technology and a telecommunications system. Scientists and physicians at hackensackumc frequently contribute to the body of knowledge about diseases, medical conditions, treatment advances, technological breakthroughs, quality-of-life issues, and other pertinent research issues through publication of research findings, abstracts, book chapters, and other written materials. Scientific discovery is a major component of the hackensackumc's mission and a vital component of the world-class care available at hackensackumc. Hackensackumc's clinical, translational, and basic science research programs have grown tremendously, especially since the opening in 2000 of the david joseph jurist research center for tomorrow's children. Research studies grew from 75 in 1987 to today's 466 open protocols. Hackensackumc protocols are supported by some of the nation's top funding sources, including the national institutes of health, the national science foundation, and the american cancer society, and from private foundations and corporations such as pharmaceutical and biotechnology companies. In 2015, HackensackUMC received the highest amount of funding in New Jersey from the National Institutes of Health. Research administration: The department of research consolidates all basic and clinical research that is under way at hackensackumc. The department centralizes the administrative aspects of research, including financial, legal, and professional oversight, and guides the investigator through the maze of internal and external regulation. Research partners: Scientific discovery through research is a major component of hackensackumc's mission. Research at hackensackumc is conducted in nearly every field, with an emphasis on pediatric and adult cancers, childhood diseases, cardiology, allergy and immunology, orthopedics, urology, pulmonary medicine, neurology, and infectious diseases.
CORE FORM, PART III Investigators at hackensackumc collaborate with their counterparts at other healthcare institutions and research facilities, including the u.s. department of energy, city university of new york ("cuny") memorial sloan-kettering cancer center, and rockefeller university. Outstanding research collaborations also arise from hackensackumc's role as a major teaching affiliate of umdnj-njms. Hackensackumc is designated by the national cancer institute and the national institutes of health as a community clinical oncology program site, one of only 50 in the nation and the only such program in new jersey. Clinical trials, protocol studies, and cancer control group research are conducted through the eastern cooperative oncology group, the southwest oncology group, the children's oncology group, the university of rochester cancer center, and the national surgical adjuvant breast and bowel project. Outlook: Hackensackumc, a nonprofit academic, research and medical center, is the largest provider of inpatient and outpatient services in new jersey. It was the first hospital in new jersey and second in the nation to become a magnet recognized hospital for nursing excellence. Hackensackumc is the hometown hospital of the new york giants and the new york red bulls, and remains committed to its community through fundraising and community events. hackensackumc ranks among the best hospitals in the nation and enjoys numerous clinical, research and academic affiliations with world-renowned partners. Founded in 1888 as the countys first hospital, it is a member of Hackensack University Health Network, one of the largest health networks in the state comprised of 1,250 beds, more than 10,000 employees and more than 3,000 credentialed physicians. HackensackUMC was listed as the number one hospital in New Jersey in the U.S. News & World Reports Best Hospital rankings for 2015-16. The joseph m. Sanzari childrens hospital is housed with the Donna A. Sanzari Womens Hospital in the Sarkis and Siran Gabrellian Womens and Childrens Pavilion, which was designed with The Deirdre Imus Environmental Health Center, and was included on the Green Guides list of Top 10 Green Hospitals in the U.S. HackensackUMC is one of Healthgrades America's 50 Best Hospitals for nine years in a row, and received the Healthgrades Distinguished Hospital Award for Clinical Excellence 13 years in a row. The medical center has also been named a Leapfrog Top Hospital, and received 23 Gold Seals of Approval by the Joint Commission more than any other hospital in the country. It was the first hospital in New Jersey and second in the nation to become a Magnet recognized hospital for nursing excellence; receiving its fifth consecutive designation in 2014. HackensackUMC is the Hometown Hospital of the New York Giants and the New York Red Bulls and was Official Medical Services Provider to The Barclays PGA Golf Tournament and the NY/NJ Super Bowl XLV111 Host Committee. It remains committed to its community through fundraising and community events. Tax-exempt organization: Hackensackumc is recognized by the irs as an internal revenue code section 501(c) (3) tax-exempt organization. Pursuant to its charitable purposes, hackensackumc provides medically necessary healthcare services to all individuals in a non-discriminatory manner regardless of race, color, creed, sex, national origin, religion or ability to pay. Moreover, hackensackumc operates consistently with the following criteria outlined in irs revenue ruling 69-545: 1. Hackensackumc provides medically necessary healthcare services to all individuals regardless of ability to pay, including charity care, self-pay, medicare and medicaid patients. 2. Hackensackumc operates an active emergency department trauma center for all persons, which is open 24 hours a day, 7 days a week, 365 days per year. 3. Hackensackumc maintains an open medical staff, with privileges available to all qualified physicians. 4. Control of hackensackumc rests with its board of governors 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. Hackensackumc's standing as one of new jersey's and the nation's healthcare leaders is driven by a commitment to quality. At hackensackumc, quality means always striving to deliver the best medicine to its patients. It means always re-evaluating the delivery of healthcare to ensure that high standards are achieved. It means never turning away from a community need, but instead redoubling efforts and commitment to respond to those needs. Tax-exempt purposes, free care and community benefit: Consistent with revenue ruling 69-545 and providing medically necessary healthcare services to all individuals as outlined above and in furtherance of its exempt purposes, hackensackumc provides a wide array of services to the community, including various community-based social service programs, such as free clinics, health screenings, trauma services, training for emergency service personnel, social services and support counseling for patients and families, pastoral care, crisis intervention, and transportation to and from hackensackumcumc. Additionally, a large number of health-related educational programs are provided for the benefit of the community, including health enhancements and wellness, classes on specific conditions, medical education, telephone information services, and programs designed to improve the general standards of the health of the community. Hackensackumc also provides medical care without charge or at reduced costs to residents of its community who meet the criteria under the state of new jersey public law 1992 (chapter 160) system for charity care and also incurs bad debts. Included in hackensackumc's definition of charity care are the following: (a) services provided at no charge to the uninsured and underinsured and (b) services provided to patients expressing willingness to pay but who are determined to be unable to pay because of socioeconomic factors. Hackensackumc maintains records to identify and monitor the level of charity care it provides. Such forgone charges amounted to approximately $89,054,051 in 2015. The new jersey health care reform act of 1992 provided for certain subsidy payments from the state to qualified hospitals to partially fund uncompensated care and certain other costs. Subsidy payments recognized as revenue amounted to approximately $4,825,099 in 2015; however as more fully outlined below estimated costs relating to providing medical care to individuals without insurance totaled approximately $32,810,041; for a net deficit of approximately $27,984,942. Based upon these statistics hackensackumc had approximately the fifth largest charity care program in the state in terms of charity care dollars stated at medicaid rates and the largest net loss of all new jersey hospitals from the charity program in the state of new jersey with a loss of $57,459,775. In addition, hackensackumc paid the highest hospital provider taxes to the state of new jersey for the funding of charity care programs throughout the state; in 2015 hackensackumcumc's payments totaled $8,726,045. During 2015 hackensackumc, through its affiliation with umdnj, also had the one of the largest graduate medical education programs in the state of new jersey with 168 medical and dental residents in various medical specialties. Community benefit continued: Hackensackumc's operations and activities are designed to benefit a wide cross section of the community, including those individuals with no insurance or ability to pay for the necessary medical services and treatment. Hackensackumc also has a program for individuals with no insurance which limits the amounts to be billed to no more than the medicare fee schedule for inpatient services and two times the medicare fee schedule for outpatient services. This discount program is offered to all individuals with no insurance. There is no application or means testing. For individuals who cannot afford these fees, there are means tested discounts which can reduce bills to zero. Community benefit - costs: For purposes of form 990, schedule h reporting and in accordance with current irs rules and regulations, hackensackumc utilized the catholic health association ("cha") model when quantifying community benefit costs. Under the cha methodology for quantifying community benefit costs, hackensackumc's 2015 net community benefit costs were approximately $106,561,318 or approximately 8.50% of its total 2015 expenses. The cha methodology does not include medicare shortfalls and certain costs related to bad debt.
CORE FORM, PART III Utilizing the model adopted by the american hospital association ("aha"), which hackensackumc believes more clearly represents actual community benefit, when quantifying its estimated total community benefit costs for the 2015 year would result in a significantly higher community benefit percentage. Under the aha model, a hospital may include both medicare shortfalls (the amount by which the costs exceed reimbursements) and costs related to bad debt. Under the aha model during calendar year 2015, hackensackumc incurred net community benefit costs of approximately $215,388,788; which accounted for approximately 17.17% of its total 2015 expenses. Net costs means costs after all associated reimbursements. Hackensackumc also paid $6,357,782 in real estate taxes during 2015. Community benefit programs: Building a strong community: Hackensack university medical center helps to build a strong, safe community by investing in a number of community benefits to improve housing and the environment, develop businesses, support community enhancements, mentor children, build coalitions, and increase the workforce. The impact of community benefits: Hackensackumc university medical center believes we are all part of one larger community - one dedicated to progressing even further in our missions of healthcare, community service, and research, one that brings healthcare directly into the community if needed. Promoting a healthy community: Hackensackumc is committed to our community's education and wellness. Through our speakers bureau and health awareness regional program (harp), we work with local city agencies, schools and civic organizations. Speakers topics included: nutrition, grandparenting, aids awareness, heart health, stress, diabetes, keeping your mind sharp, cancer prevention, food allergies and medication interactions. (referenced in schedule h). Many health fair booths were related to: blood pressure screenings, fitness & nutrition, run health, flu shoots and sun safety. (referenced in schedule h). MELANOMA AWARENESS PREVENTION Skin cancer is the most common form of cancer in the United States. Melanoma is the third most common skin cancer, but is more dangerous and more likely to cause death than other skin cancers. Through collaborative efforts, the John Theurer Cancer Center, the Promise Foundation of Ridgewood, New Jersey, physicians and the Health Awareness Regional Program (HARP) of HackensackUMC, a skin cancer screening was provided to the community serving more than 50 participants. This partnership includes an ongoing educational initiative to teach youth sun safe behaviors. In collaboration with schools and teachers skin cancer awareness programs educated more than 5,000 students on sun safe behaviors. PROJECT HEALTHY BONES Project Healthy Bones is a 24-week exercise and education program for older women and men at risk for, or who have osteoporosis. The program is offered in partnership with the New Jersey Department of Health. In 2014, HARP collaborated with Montvale and Ramsey to provide this program to their communities. Currently, there are more than 100 participants. MATTER OF BALANCE In 2015, HARP was awarded a New Jersey Department of Human Services grant for delivery of the evidence-based fall prevention program: A Matter of Balance: Managing Concerns About Falls (MOB). HARP will provide this program throughout Bergen County, serve as Master Trainers for others interested in providing this program, and participate in the NJs Fall Prevention Workgroup. On an average day in NJ, 201 older adults are treated in NJ ERs due to falls. Falls among New Jerseys seniors and adults with disabilities result in physical, psychological and financial hardships for individuals and place a significant burden on caregivers, social services and healthcare agencies. CORPORATIONS In 2015, HARP provided on-site workplace wellness programs to corporations of all sizes throughout Bergen County. Worksite wellness programs are designed to empower employees to better manage their health. We partner with corporations to create and support a healthy workforce by providing physical examinations, mandated tests, Health Risk Assessments, health fairs, American Heart Association Heartsaver CPR classes, biometric screening, and on-site screenings, trainings, and seminars. - HARP conducted 26 onsite flu immunization programs that vaccinated 1,159 employees against influenza. - Three corporate health fairs were conducted that included screenings such as: comprehensive metabolic blood profile, blood pressure, body mass index (BMI), and body fat. The age range for participants was 19 to 68 years old. One hundred and ninety-eight were screened for total cholesterol, 36 men for prostate specific antigen, and 142 screened for blood pressure. Education was distributed to increase the awareness of risk factors for hypertension, sodium and high blood pressure, high cholesterol, healthy nutrition, and the benefits of physical activity. - Three bloodborne pathogen classes were presented to 182 participants. - One hundred twenty-two tuberculin skin tests were given along with education on prevention, and recognizing the signs and symptoms of Tuberculosis. - Educational programs were provided onsite that highlighted: mens health, nutrition and physical activity, and cardiac education which focused on prevention, early detection, testing and diagnosis, and treatment. HEALTH PROMOTION PROGRAMS In 2015, HARP presented 283 health promotion programs to 14,681 participants throughout Bergen County. Health education programs focused on the prevention of chronic illness by teaching the community to eat healthy, be active, and avoid tobacco. HARP also provided 2,349 adult health screenings that included education on blood pressure, stroke risk assessment, diabetes risk assessment, osteoporosis, and body fat/BMI assessment. HARP administered childhood immunization clinics across Bergen County that provided 1,400 free immunizations to uninsured children through the New Jersey Vaccine for Children program. LOCAL HEALTH AGENCY PARTNERSHIP The Health Awareness Regional Program of HackensackUMC (HARP) has been committed to providing the highest quality of health promotion and illness prevention services in Bergen County since 1977. We are proud of the strong collaborative relationships with community organizations and local health agency partners to provide high quality, professional health education and public health services to 25 Bergen County municipalities.
CORE FORM, PART III TOWNS SERVED Bogota, City of Hackensack, Closter, Dumont, East Rutherford, Emerson, Englewood Cliffs, Fairview, Fort Lee, Garfield, Hasbrouck Heights, Leonia , Lodi, Mahwah, Montvale, New Milford, Palisades Park, Ramsey, Ridgefield, Ridgefield Park, River Edge, South Hackensack, Tenafly, Township of Washington, and Wallington. COMMUNITY PARTNERSHIPS Health Officers, Schools, the American Diabetes Association, the American Cancer Society, Bergen County Office On Aging, Community Health Improvement Partnership of Bergen County, Nutrition and Physical Activity Task Force, Bergen County Diabetes Collaborative, Pascack Valley Meals on Wheels, Bergen County Department of Health Services, Bergen-Hudson Chronic Disease Coalition, Bergen County Municipal Nurse Association and School Nurses Association, Partnership for Maternal and Child Health of Northern New Jersey: New Jersey Office of Cancer Control and Prevention: Melanoma Cancer Taskforce Work Group, New Jersey Immunization Network. BERGEN SENIOR COALITION In 2014-2015 HARP collaborated with Brightside Manor, Chore Service, Pascack Valley Meals, The Henry and Marilyn Taub Foundation, and Visiting Homemakers, to form a coalition to address the needs of our growing older adult population. The mission of this group is to The Senior Coalition will be a forum for education and advocacy around the needs and resources to help seniors age in place. There are 40 non- profit agencies participating. HAVE F.U.N. IN GARFIELD Through our partnership with the City of Garfield, HARP was able to collaborate on an initiative to combat childhood obesity in the City of Garfield. In 2015, community gardens were planted throughout the city providing fresh vegetables to residents and teaching gardening skills to the youth. This program has been focused on families in order to form a foundation of healthful habits, combat the rising epidemic of child obesity and ensure that future New Jersey residents will be a more vital and energetic population. FLU IMMUNIZATION PROGRAMS As part of the public health response to the influenza virus in the community, HARP partnered with communities to provide education and vaccinations. Educational materials were distributed to at-risk populations. HARP worked with health officers, public health nurses, health departments, municipalities, and child care centers. Through this partnership, HARP assisted in vaccinating more than 2,000 individuals and continues to work to achieve maximum immunization rates.
CORE FORM, PART III; LINE 4D EXPENSES INCURRED IN PROVIDING VARIOUS OTHER MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY.
CORE FORM, PART VI, SECTION A; QUESTION 2 J. FLETCHER CREAMER, JR. AND JOSEPH M. SANZARI - BUSINESS RELATIONSHIP.
CORE FORM, PART VI, SECTION B; QUESTION 11B DURING 2015 HACKENSACKUMC WAS AN AFFILIATE OF HACKENSACK UNIVERSITY HEALTH NETWORK, INC. AND ITS SUBSIDIARIES AND CONTROLLED ENTITIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. HACKENSACK UNIVERSITY HEALTH NETWORK ("NETWORK") WAS THE TAX-EXEMPT PARENT OF THE SYSTEM. In May 2015, the Network signed a definitive agreement with Meridian Health System ("Meridian Health") to merge both parent organizations; creating one integrated healthcare delivery system known as Hackensack Meridian Health, inc., to better meet the needs of many New Jersey communities. The merger became effective upon the receipt of regulatory approvals on JULY 1, 2016. THE NAME OF THIS NEW INTEGRATED HEALTHCARE DELIVERY SYSTEM IS HACKENSACK MERIDIAN HEALTH, INC. HACKENSACKUMC'S FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING OF MEMBER HACKENSACK MERIDIAN HEALTH, INC'S. GOVERNING BODY, ITS BOARD OF TRUSTEES, PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE ("IRS") AND FOLLOWING A REVIEW BY HACKENSACK MERIDIAN HEALTH, INC'S. COMPLIANCE AND AUDIT COMMITTEE. HACKENSACK MERIDIAN HEALTH, INC'S. BOARD OF TRUSTEES HAS ASSUMED THE RESPONSIBILITY TO OVERSEE, REVIEW AND APPROVE THIS FEDERAL FORM 990, INCLUDING THE PREPARATION, REVIEW AND FILING PROCESS. AS PART OF THE TAX RETURN PREPARATION PROCESS HACKENSACKUMC 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 HACKENSACKUMC'S FINANCE PERSONNEL AND INTERNAL WORKING GROUP (WHICH INCLUDED, BUT WAS NOT LIMITED TO, THE CHIEF FINANCIAL OFFICER, CONTROLLER, ACCOUNTING MANAGER AND CHIEF COMPLIANCE OFFICER) 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 HACKENSACKUMC'S INTERNAL WORKING GROUP FOR REVIEW. HACKENSACKUMC'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 HACKENSACKUMC'S INTERNAL WORKING GROUP FOR FINAL REVIEW AND APPROVAL PRIOR TO PRESENTATION OF THE FEDERAL FORM 990 TO THE MEMBERS OF HACKENSACK MERIDIAN HEALTH, INC'S. COMPLIANCE AND AUDIT COMMITTEE AND THEREAFTER TO EACH VOTING MEMBER OF HACKENSACK MERIDIAN HEALTH, INC'S. GOVERNING BODY PRIOR TO FILING WITH IRS.
CORE FORM, PART VI, SECTION B; QUESTION 12 HACKENSACKUMC REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. ANNUALLY ALL MEMBERS OF HACKENSACKUMC'S BOARD OF GOVERNORS, 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 HACKENSACKUMC'S CHIEF COMPLIANCE OFFICER FOR REVIEW. THEREAFTER THE CHIEF COMPLIANCE OFFICER PREPARES A SUMMARY OF THE COMPLETED QUESTIONNAIRES WHICH CONTAINS INFORMATION DISCLOSED ON AN INDIVIDUAL BASIS WHICH IS PRESENTED TO HACKENSACKUMC'S GOVERNANCE COMMITTEE FOR ITS REVIEW AND DISCUSSION AND IMPLEMENTATION OF ANY NECESSARY MITIGATING ACTIONS.
CORE FORM, PART VI, SECTION B; QUESTION 15 HACKENSACKUMC IS AN AFFILIATE WITHIN HACKENSACK UNIVERSITY HEALTH NETWORK AND SUBSIDIARIES AND CONTROLLED ENTITIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. HACKENSACK UNIVERSITY HEALTH NETWORK ("NETWORK") IS THE TAX-EXEMPT PARENT OF THE SYSTEM AND THE SOLE MEMBER OF HACKENSACKUMC. NETWORK'S BOARD OF TRUSTEES HAS AN EXECUTIVE COMPENSATION COMMITTEE ("COMMITTEE"). THE COMMITTEE HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY WHICH IT FOLLOWS WHEN IT REVIEWS AND APPROVES OF THE COMPENSATION AND BENEFITS OF THE SYSTEM'S SENIOR MANAGEMENT, INCLUDING, BUT NOT LIMITED TO, THE PRESIDENT/CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, AND CHIEF OPERATING 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 CONDUCTS ITS REVIEW AND APPROVAL PROCESS AT LEAST ANNUALLY OVER SEVERAL MEETINGS, AND APPROVES ONLY "TOTAL COMPENSATION" THAT THE COMMITTEE HAS CONCLUDED DOES NOT EXCEED WHAT THE COMMITTEE CONSIDERS TO BE REASONABLE COMPENSATION. THE COMMITTEE STRUCTURES AND CONDUCTS ITS REVIEW AND APPROVAL PROCESS SO AS TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERMEDIATE SANCTIONS RULES OF FEDERAL INCOME TAX LAW. THIS REVIEW AND APPROVAL PROCESS APPLIES TO ALL FORMS OF COMPENSATION AND BENEFITS PROVIDED TO ALL MEMBERS OF THE SENIOR MANAGEMENT TEAM. THE THREE FACTORS WHICH MUST BE SATISFIED IN ORDER TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS ARE THE FOLLOWING: 1. THE COMPENSATION ARRANGEMENT IS APPROVED IN ADVANCE BY AN "AUTHORIZED BODY" OF THE APPLICABLE TAX-EXEMPT ORGANIZATION WHICH IS COMPOSED ENTIRELY OF INDIVIDUALS WHO DO NOT HAVE A "CONFLICT OF INTEREST" WITH RESPECT TO THE COMPENSATION ARRANGEMENT; 2. THE AUTHORIZED BODY OBTAINED AND RELIED UPON "APPROPRIATE DATA AS TO COMPARABILITY" PRIOR TO MAKING ITS DETERMINATION; AND 3. THE AUTHORIZED BODY "ADEQUATELY DOCUMENTED THE BASIS FOR ITS DETERMINATION" CONCURRENTLY WITH MAKING THAT DETERMINATION. THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES, EACH OF WHOM IS "DISINTERESTED" AS DEFINED BY THE IRS IN ITS REGULATIONS DESCRIBING THIS STANDARD. THE COMMITTEE RELIED UPON APPROPRIATE COMPARABLE DATA; SPECIFICALLY THE COMMITTEE OBTAINED A WRITTEN COMPENSATION STUDY FROM AN INDEPENDENT FIRM WHICH SPECIALIZES IN THE REVIEW OF HOSPITAL AND HEALTHCARE SYSTEM EXECUTIVE COMPENSATION AND BENEFITS THROUGHOUT THE UNITED STATES. THIS DETAILED STUDY USES COMPARABLE GEOGRAPHIC AND DEMOGRAPHIC MARKET DATA FOR TAX-EXEMPT HOSPITALS AND HEALTHCARE SYSTEMS OF A SIMILAR LEVEL OF NET ANNUAL OPERATING REVENUE IN THE SAME GEOGRAPHIC REGION. NO DATA FROM ANY FOR-PROFIT ENTITIES IS USED. THE COMMITTEE ADEQUATELY DOCUMENTED ITS BASIS FOR ITS DETERMINATION THROUGH THE TIMELY PREPARATION OF WRITTEN MINUTES OF THE COMMITTEE MEETINGS DURING WHICH THE EXECUTIVE COMPENSATION AND BENEFITS WAS REVIEWED AND SUBSEQUENTLY APPROVED. THE REVIEW AND APPROVAL PROCESS USED BY THE COMMITTEE, INCLUDING ALL ACTIONS DESIGNED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS, IS APPLIED TO ALL MEMBERS OF THE SENIOR MANAGEMENT TEAM OF THE SYSTEM, WHETHER OR NOT THEY WOULD BE CONSIDERED 'DISQUALIFIED PERSONS' UNDER THE INTERMEDIATE SANCTIONS RULES. IN ADDITION TO RELYING ON MARKET DATA, THE COMMITTEE APPLIES A WIDE RANGE OF BUSINESS JUDGMENT FACTORS INCLUDING, BUT NOT LIMITED TO, INDIVIDUAL PERFORMANCE, INDIVIDUAL EXPERIENCE, RECRUITMENT AND RETENTION FACTORS, AND THE UNIQUE DEMANDS OF PARTICULAR POSITIONS.
CORE FORM, PART VI, SECTION C; QUESTION 19 HACKENSACKUMC HAS ISSUED TAX-EXEMPT BONDS TO FINANCE VARIOUS CAPITAL IMPROVEMENT PROJECTS, RENOVATIONS AND EQUIPMENT AND TO REFUND EXISTING TAX-EXEMPT BONDS. IN CONJUNCTION WITH THE ISSUANCE OF THESE TAX-EXEMPT BONDS, HACKENSACKUMC'S FINANCIAL STATEMENTS WERE INCLUDED WITH THE TAX-EXEMPT BOND PROSPECTUS AND ARE, ON AN ANNUAL BASIS, MADE AVAILABLE TO THE GENERAL PUBLIC FOR REVIEW. IN ADDITION, HACKENSACKUMC'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE STATE OF NEW JERSEY DEPARTMENT OF THE TREASURY. HACKENSACKUMC ALSO MAKES AVAILABLE TO THE PUBLIC VIA ITS WEBSITE, WWW.HACKENSACKUMC.ORG, ITS COMPLIANCE PLAN DOCUMENTS, CODE OF CONDUCT AND CONFLICT OF INTEREST POLICY.
CORE FORM, PART VII, SECTION A HACKENSACKUMC is AN AFFILIATE WITHIN HACKENSACK UNIVERSITY HEALTH NETWORK, INC. AND SUBSIDIARIES AND CONTROLLED ENTITIES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("NETWORK"). THE NETWORK INCLUDES BOTH FOR-PROFIT AND NOT-FOR-PROFIT ORGANIZATIONS. CERTAIN BOARD OF GOVERNOR MEMBERS, OFFICERS AND/OR DIRECTORS LISTED ON CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 MAY HOLD SIMILAR POSITIONS WITH BOTH HACKENSACKUMC AND OTHER SUBSIDIARIES AND CONTROLLED ENTITIES WITHIN THE NETWORK. 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 HACKENSACKUMC. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF TRUSTEES OF OTHER RELATED SUBSIDIARIES AND CONTROLLED ENTITIES IN THE NETWORK, 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 NETWORK; NOT SOLELY HACKENSACKUMC.
CORE FORM, PART VII AND SCHEDULE J PART VII AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM HACKENSACKUMC OR A RELATED ORGANIZATION. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OF HACKENSACKUMC OR OF A RELATED ORGANIZATION AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF HACKENSACKUMC'S BOARD OF GOVERNORS.
CORE FORM, PART XI; QUESTION 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES INCLUDE: - PENSION-RELATED ADJUSTMENTS - ($17,233,248); - NET EQUITY TRANSFERS TO RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATIONs - ($218,274,216); - NET EQUITY TRANSFERS TO OTHER RELATED ORGANIZATIONS - ($19,344,003); - NET ASSETS RELEASED FROM TEMPORARY RESTRICTION - ($2,282,843); - CHANGE IN BENEFICIAL INTEREST IN NET ASSETS OF HACKENSACK UNIVERSITY MEDICAL CENTER FOUNDATION, INC.; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION - $8,131,232; and - SUPPORT TO CONTROLLED ENTITIES; NET, REFLECTED IN CORE FORM, PART VIII, LINE 2C - $96,644,123.
CORE FORM, PART XII; QUESTION 2 HACKENSACKUMC'S SOLE CORPORATE MEMBER IS HACKENSACK UNIVERSITY HEALTH NETWORK ("NETWORK"). AN INDEPENDENT BIG FOUR CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS FOR THE NETWORK AND ITS SUBSIDIARIES AND CONTROLLED ENTITIES, FOR THE YEARS ENDED DECEMBER 31, 2015 AND 2014, RESPECTIVELY. THE INDEPENDENT CPA FIRM ISSUED AN UNQUALIFIED OPINION WITH RESPECT TO THESE AUDITED CONSOLIDATED FINANCIAL STATEMENTS EACH YEAR. THE NETWORK'S AUDIT AND CORPORATE COMPLIANCE COMMITTEE HAS ASSUMED RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE HACKENSACK UNIVERSITY HEALTH NETWORK AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT AUDITOR.
STATEMENT PURSUANT TO REGULATION SECTION 1.351-3(A) BY HACKENSACK UNIVERSITY MEDICAL CENTER (EIN: 22-1487576), A SIGNIFICANT TRANSFEROR This statement is made pursuant to Regulation Section 1.351-3(a) by the following entity, a significant transferor: HACKENSACK UNIVERSITY MEDICAL CENTER EIN: 22-1487576 30 PROSPECT AVENUE, HACKENSACK, NJ 07601 HACKENSACK UNIVERSITY MEDICAL CENTER (EIN: 22-1487576), a U.S. tax-exempt corporation and a significant transferor, made A constructive transfer of $2,000,000 IN cash on 2/1/2015 to HACKENSACK UNIVERSITY MEDICAL CENTER CASUALTY COMPANY, LTD., its wholly-owned subsidiary formed in Bermuda. The good faith estimate of the aggregate fair market value and tax basis of the assets transferred by HACKENSACK UNIVERSITY MEDICAL CENTER (as determined immediately before the exchanges) was $2,000,000. No private letter rulings were issued by the Internal Revenue Service in connection with these Internal Revenue Code 351 exchanges.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2015


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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
2015
Open to Public Inspection
Name of the organization
HACKENSACK UNIVERSITY MEDICAL CENTER
 
Employer identification number

22-1487576
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) HUMCTOURO LLC
30 PROSPECT AVENUE
HACKENSACK,NJ07601
26-1844522 		INACTIVE NJ 0 0 HUMC
 
(2) HACKENSACK PHYSICIAN ALLIANCE LLC
30 prospect avenue
hackensack,NJ07601
45-4966639 		inactive NJ 0 0 humc
 
(3) 20 PROSPECT AVENUE HOLDINGS LLC
30 PROSPECT AVENUE
HACKENSACK,NJ07601
47-4381262 		inactive NJ 0 114,791,667 HUMC
 






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)BERGEN HEALTH MANAGEMENT SYSTEM INC
30 PROSPECT AVENUE

HACKENSACK,NJ07601
22-2989731 		DAY CARE NJ 501(C)(3) 509(A)(2) HUHN
 
 
No
(2)HACKENSACK UNIV MED CTR FDN INC
360 ESSEX STREET 301

HACKENSACK,NJ07601
22-2339534 		SUPPORT HUMC NJ 501(C)(3) 509(A)(3) HUHN
 
 
No
(3)HACKENSACK SPECIALTY CARE ASSOC PC
30 PROSPECT AVENUE

HACKENSACK,NJ07601
20-1017013 		PHYS. SVCS. NJ 501(C)(3) 509(A)(3) HUMC
 
Yes
 
(4)HACKENSACK UNIVERSITY HEALTH NETWORK
30 PROSPECT AVENUE

HACKENSACK,NJ07601
22-2595857 		SUPPORT NJ 501(C)(3) 509(A)(3) NA
 
 
No
(5)HACKENSACK UNIVERSITY MEDICAL GROUP PC
30 PROSPECT AVENUE

HACKENSACK,NJ07601
22-3376459 		PHYS. SVCS. NJ 501(C)(3) 509(A)(3) HUMC
 
Yes
 
(6)HUMC CARDIOVASCULAR PARTNERS PC
30 PROSPECT AVENUE

HACKENSACK,NJ07601
27-0614861 		PHYS. SVCS. NJ 501(C)(3) 509(A)(3) HUMC
 
Yes
 
(7)HUMC MEDICAL OBSERVATION PA
30 PROSPECT AVENUE

HACKENSACK,NJ07601
27-2371424 		PHYS. SVCS. NJ 501(C)(3) 509(A)(3) HUMC
 
Yes
 
(8)THE AUXILIARY OF HACKENSACKUMC
30 PROSPECT AVENUE

HACKENSACK,NJ07601
22-1537117 		SUPPORT HUMCF NJ 501(C)(3) 509(A)(3) HUMC
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
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) HUMCUSP SURGERY CENTERS LLC

30 PROSPECT AVENUE
HACKENSACK,NJ07601
38-3875474 		HEALTHCARE SVcs. NJ HUMC
  		RELATED       No 0   No 50.100 %












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) PEDIATRIC SPECIALTIES OF OAKLAND PA

5 SUMMIT AVENUE
HACKENSACK,NJ07601
22-3537262 		HEALTHCARE SVcs. NJ NA
  		S CORP.         No
(2) HACKENSACKUMC CASUALTY COMPANY LTD

CHEVRON HOUSE 44 CHURCH STREET
HAMILTON,BDHM12
BD
22-1487576 		FINANCIAL VEHicle BD HUMC
  		FOREIGN CORP. 0 34,304,448 100.000 % Yes  
(3) NEW AMSTERDAM MEDICAL ASSOCIATES PC

30 PROSPECT AVENUE
HACKENSACK,NJ07601
27-0849894 		PHYSICIAN SVCs. NY HUMC
  		C CORP. 4,709,480 18,865,213 100.000 % Yes  
(4) HACKENSACK OCCUPATIONAL MEDICINE PC

30 PROSPECT AVENUE
HACKENSACK,NJ07601
86-1153504 		INACTIVE NJ HUMC
  		C CORP. 1,218,005 5,305,244 100.000 % Yes  
(5) HUMC PRIMARY CARE ASSOCIATES PC

30 PROSPECT AVENUE
HACKENSACK,NJ07601
45-3744725 		PHYSICIAN SVCs. NJ HUMC
  		C CORP. 24,356,225 73,392,782 100.000 % Yes  




Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
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
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
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
 
 
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
 
No
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
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
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) HACKENSACK UNIV MED CTR CASUALTY COMPANY LTD

 R 2,000,000 COST
(2) HACKENSACK UNIVERSITY MEDICAL CENTER FDN

 C 4,151,234 COST
(3) Hackensack University Health Network

 R 2,339,039 COST
(4) HACKENSACK UNIVERSITY MEDICAL GROUP PC

 R 155,961,219 COST
(5) HUMC Cardiovascular Partners PC

 R 56,417,915 COST
(6) HUMC Casualty Company LIMiTED

 S 2,060,884 COST
(7) HUMC Primary Care Associates PC

 R 15,877,335 COST
(8) Hackensack Specialty Care Associates PC

 S 1,892,377 COST
(9) New Amsterdam Medical Associate PC

 R 7,038,923 COST
(10) HUMC Medical Observation PA

 R 2,037,086 COST
(11) Hackensack Occupational Medicine Assoc PC

 R 772,132 COST
(12) Hackensack University Health Network

 R 310,625 COST
(13) The Auxiliary of HUMC

 S 391,126 COST
(14) 20 Prospect Avenue Holdings LLC

 R 1,208,333 COST
Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
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) 2015
Schedule R (Form 990) 2015
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
SCHEDULE R, PART V HACKENSACK UNIVERSITY HEALTH NETWORK IS THE SOLE MEMBER OF HACKENSACKUMC AND THE TAX-EXEMPT PARENT ENTITY OF HACKENSACK UNIVERSITY HEALTH NETWORK AND SUBSIDIARIES AND CONTROLLED ENTITIES; ALL OF WHICH CONSTITUTE A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("NETWORK"). HACKENSACKUMC ROUTINELY PAYS EXPENSES FOR VARIOUS AFFILIATES WITHIN THE NETWORK IN THE ORDINARY COURSE OF BUSINESS. THESE RELATED PARTY TRANSACTIONS ARE RECORDED ON THE REVENUE/EXPENSE AND BALANCE SHEET STATEMENTS OF HACKENSACKUMC AND ITS AFFILIATES. THESE ENTITIES WORK TOGETHER TO DELIVER HIGH QUALITY HEALTHCARE AND WELLNESS SERVICES TO THE COMMUNITIES IN WHICH THEY ARE SITUATED.
Schedule R (Form 990) 2015

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