TY 2015 Form 990

(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)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) THERESA DE LEON...................................................................... CHAIR - TRUSTEE	1.0 ................. 0.0	X	X	0	0
(2) ANDREW HOROWITZ...................................................................... FIRST VICE CHAIRMAN - TRUSTEE	1.0 ................. 0.0	X	X	0	0
(3) KEVIN O'CONNOR...................................................................... SECRETARY - TRUSTEE	1.0 ................. 0.0	X	X	0	0
(4) LEONARD LAURICELLA...................................................................... TREASURER - TRUSTEE	1.0 ................. 0.0	X	X	0	0
(5) SAMIR R AMIN MD...................................................................... TRUSTEE	1.0 ................. 0.0	X		0	0
(6) AIDA CAPO MD...................................................................... TRUSTEE - PRES ELECT MED STAFF	1.0 ................. 0.0	X		0	0
(7) ALEXANDER DURAN...................................................................... TRUSTEE	1.0 ................. 0.0	X		0	0
(8) THOMAS M EASTWICK...................................................................... TRUSTEE	1.0 ................. 0.0	X		0	0
(9) BRUCE J MARKOWITZ...................................................................... TRUSTEE - PRESIDENT/CEO	55.0 ................. 0.0	X	X	1,384,826	87,797
(10) JOHN C MEDITZ...................................................................... TRUSTEE	1.0 ................. 0.0	X		0	0
(11) CONSTANTINE POTAMIANOS ESQ...................................................................... TRUSTEE	1.0 ................. 0.0	X		0	0
(12) JEFFREY RASKIN MD...................................................................... TRUSTEE - PRES. MEDICAL STAFF	1.0 ................. 0.0	X		20,300	0
(13) DENNIS ROBINSON...................................................................... TRUSTEE	1.0 ................. 0.0	X		0	0
(14) LILLIAN SONNENSCHEIN...................................................................... TRUSTEE	1.0 ................. 0.0	X		0	0
(15) RICHARD TURNER...................................................................... TRUSTEE	1.0 ................. 0.0	X		0	0
(16) THOMAS M VENINO JR ESQ...................................................................... TRUSTEE	1.0 ................. 0.0	X		0	0
(17) JOHN CALANDRIELLO FHFMA CPA...................................................................... VP; CHIEF FINANCIAL OFFICER	55.0 ................. 0.0		X	892,955	180,404

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(18) DAVID BERKOWITZ........................................................................ VP; CHIEF OPERATING OFFICER	55.0 .......................0.0	X		448,817	0	104,054
(19) RUBEN D FERNANDEZ........................................................................ VP; NURSING	55.0 .......................0.0	X		384,314	0	32,819
(20) DONNA CAHILL........................................................................ VP; HUMAN RESOURCES	55.0 .......................0.0	X		328,446	0	84,661
(21) EURICE R ROJAS........................................................................ VP; MARKETING	55.0 .......................0.0	X		310,402	0	50,602
(22) JOSEPH BURT........................................................................ VP; EXEC. DIRECTOR FOUNDATION	55.0 .......................0.0	X		278,298	0	33,381
(23) SURESH RAINA MD........................................................................ VP; CMO (1/1 - 4/1, SEE SCH O)	55.0 .......................0.0	X		251,011	0	15,505
(24) ANTHONY PASSANNANTE MD........................................................................ VP; CMO (EFF 09/08/15)	55.0 .......................0.0	X		144,731	0	7,725
(25) ALEXANDER GLICKMAN MD........................................................................ MEDICAL DIRECTOR	55.0 .......................0.0		X	462,016	0	8,347
(26) SANTOSH RAINA MD........................................................................ MEDICAL DIRECTOR	55.0 .......................0.0		X	402,904	0	19,650
(27) QI ZHANG MD........................................................................ MEDICAL DIRECTOR	55.0 .......................0.0		X	325,185	0	40,174
(28) JOAN MOZEIKA........................................................................ DIRECTOR	55.0 .......................0.0		X	211,983	0	57,686
(29) ELENA RUBINO MD........................................................................ DIRECTOR	55.0 .......................0.0		X	198,626	0	37,343

(A) Name and business address	(B) Description of services	(C) Compensation
MCCARTER ENGLISH, 100 MULBERRY STREET NEWARK,NJ071010652	LEGAL	953,065
PMHG PROFESSIONAL ASSOCIATES, 15 SLEEPY HOLLOW LANE PRINCETON JUNCTION,NJ08550	MEDICAL	798,040
GARFUNKEL WILD PC, 111 GREAT NECK ROAD 6TH FLOOR GREAT NECK,NY11021	LEGAL	645,484
NURSES 247, PO BOX 823473 PHILADELPHIA,PA191823473	STAFFING	650,244
YA GROUP, 4211 NEW YORK AVE UNION CITY,NJ07093	MARKETING	585,342
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 39

- TIN:

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.
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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

PALISADES MEDICAL CENTER INC

Employer identification number

22-1487278

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.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ))

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ..............

Provide the following information about the supported organization(s).

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


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

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)		(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)		(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.

Gross receipts from related activities, etc. (see instructions) ..................

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

Public support percentage for 2015 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2014 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2015. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2014. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2015. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the facts-and-circumstances test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2014. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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

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)		(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)		(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.)..

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

Public support percentage for 2015 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2014 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2015 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2014 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2015. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2014. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

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

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.

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).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

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.

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.

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.

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.

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.

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).

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?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

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.

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) .

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).

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.

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.

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.

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

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

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

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

A family member of a person described in (a) above?

11b

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

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.

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.

Section C. Type II Supporting Organizations

Yes

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).

Section D. All Type III Supporting Organizations

Yes

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?

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).

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.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

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.

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.

Parent of Supported Organizations. Answer (a) and (b) below.

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.

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.

Schedule A (Form 990 or 990-EZ) 2015

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 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:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

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

PALISADES MEDICAL CENTER INC

Employer identification number

22-1487278

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... 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 PALISADES MEDICAL CENTER INC

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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (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 PALISADES MEDICAL CENTER INC		Employer identification number 22-1487278

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 PALISADES MEDICAL CENTER INC			Employer identification number 22-1487278
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.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No.from Part I

(b) Purpose 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

(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

(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

(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:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

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

PALISADES MEDICAL CENTER INC

Employer identification number

22-1487278

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures ...................................................................................................................... SchCMd Bullet

Volunteer hours .............................................................................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

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

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

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

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 Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(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? ..............................................................................................................	Yes No

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

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)

Yes

(b)

Amount

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:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Yes

60,000

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

16,013

Total. Add lines 1c through 1i ....................................................................................................

76,013

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

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

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

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."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

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? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

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 AN OUTSIDE LOBBYING FIRM $60,000 TO PERFORM LOBBYING ACTIVITIES ON BEHALF OF THE ORGANIZATION ON A FEDERAL AND STATE LEVEL RELATED TO MEDICARE, MEDICAID AND OTHER HEALTHCARE LEGISLATIVE MATTERS. THE ORGANIZATION IS A MEMBER OF THE NEW JERSEY HOSPITAL ASSOCIATION, THE AMERICAN HOSPITAL ASSOCIATION AND THE HOSPITAL ALLIANCE OF NEW JERSEY WHICH ALL ENGAGE IN LOBBYING EFFORTS ON BEHALF OF THEIR MEMBER HOSPITALS. A PORTION OF THE DUES PAID TO THESE ORGANIZATIONS IS ALLOCATED TOWARDS LOBBYING EFFORTS PERFORMED ON BEHALF OF THIS ORGANIZATION. THIS ALLOCATION AMOUNTED TO $16,013 IN 2015.

Return Reference

Explanation

SCHEDULE C, PART II-B, LINES 1G AND 1I

DURING 2015, THE ORGANIZATION PAID AN OUTSIDE LOBBYING FIRM $60,000 TO PERFORM LOBBYING ACTIVITIES ON BEHALF OF THE ORGANIZATION ON A FEDERAL AND STATE LEVEL RELATED TO MEDICARE, MEDICAID AND OTHER HEALTHCARE LEGISLATIVE MATTERS. THE ORGANIZATION IS A MEMBER OF THE NEW JERSEY HOSPITAL ASSOCIATION, THE AMERICAN HOSPITAL ASSOCIATION AND THE HOSPITAL ALLIANCE OF NEW JERSEY WHICH ALL ENGAGE IN LOBBYING EFFORTS ON BEHALF OF THEIR MEMBER HOSPITALS. A PORTION OF THE DUES PAID TO THESE ORGANIZATIONS IS ALLOCATED TOWARDS LOBBYING EFFORTS PERFORMED ON BEHALF OF THIS ORGANIZATION. THIS ALLOCATION AMOUNTED TO $16,013 IN 2015.

Schedule C (Form 990 or 990EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

PALISADES MEDICAL CENTER INC

Employer identification number

22-1487278

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 ....

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? ...........

Yes No

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? ............................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

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)? .............................

Yes No

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.

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.

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

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:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?...

Yes No

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.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

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 ....	94,498	294,498	94,498	94,498	99,498
b	Contributions ...			456,000
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...		200,000	256,000		5,000
f	Administrative expenses ....
g	End of year balance ......	94,498	94,498	294,498	94,498	94,498

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

100.000 %

Temporarily restricted endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

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 ...	1,580,327		1,580,327
b	Buildings	55,974,517	46,863,845	9,110,672
c	Leasehold improvements
d	Equipment ...	96,534,414	69,892,320	26,642,094
e	Other ...	7,901,897	2,467,603	5,434,294
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				42,767,387

Schedule D (Form 990) 2015

Page 3

Part VII

InvestmentsOther 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.)

Part VIII

InvestmentsProgram 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)EQUITY SECURITIES; LIMITED USE	3,166,205	F
(2)LIMITED USE	1,091,120	F
(3)LIMITED USE	5,323,886	F
(4)ACCRUED INTEREST; LIMITED USE	9,035	F
(5)LIMITED USE ASSETS	8,022,434	F
(6)MUTUAL FUNDS; LIMITED USE	14,572,778	F
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)	32,185,458

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) OTHER RECEIVABLES AND ASSETS				3,563,125
(2) DUE FROM AFFILIATES				16,041,252
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				19,604,377

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
THIRD-PARTY PAYERS; CURRENT	975,000
ACCRUED INTEREST PAYABLE	909,486
ACCRUED PENSION LIABILITY	55,495,000
NON-CURRENT	12,669,310
OTHER CURRENT LIABILITIES	14,338,395
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	84,387,191
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

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	ENDOWMENT FUNDS ARE TO BE USED CONSISTENT WITH INTENT AND IN FURTHERANCE OF THE ORGANIZATION'S CHARITABLE TAX-EXEMPT PURPOSES.

Schedule D (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

PALISADES MEDICAL CENTER INC

Employer identification number

22-1487278

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

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.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

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.

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:

Yes

100% 150% 200% Other %

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: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other 500 %

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.

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"? . . . . . . . . . . . . .

Yes

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

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

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? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(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) . . .	11,269,564	6,921,000	4,348,564	2.810 %
b	Medicaid (from Worksheet 3, column a) . . . . .	34,497,377	29,055,434	5,441,943	3.520 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	1,012,694		1,012,694	0.650 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	46,779,635	35,976,434	10,803,201	6.980 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	405,000		405,000	0.260 %
f	Health professions education (from Worksheet 5) . . .	9,534,536	6,253,834	3,280,702	2.120 %
g	Subsidized health services (from Worksheet 6) . . . .	38,556,659	32,104,602	6,452,057	4.170 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .
j	Total. Other Benefits . .	48,496,195	38,358,436	10,137,759	6.550 %
k	Total. Add lines 7d and 7j .	95,275,830	74,334,870	20,940,960	13.530 %

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
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

18,162,000

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. ......

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

Enter total revenue received from Medicare (including DSH and IME).....

56,501,615

Enter Medicare allowable costs of care relating to payments on line 5.....

57,420,623

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-919,008

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

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 .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 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?1 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)						Facility reporting group
1	PALISADES MEDICAL CENTER INC 7600 RIVER ROAD NORTH BERGEN,NJ07047 WWW.PALISADESMEDICAL.ORG 10905	X	X	X	X	1

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)

	PALISADES MEDICAL CENTER INC
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

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?........................

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...............

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......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 15

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 .................

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..................................

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. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): WWW.PALISADESMEDICAL.ORG

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

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. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

If "Yes" (list url):

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Yes

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

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

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

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	PALISADES MEDICAL CENTER INC
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.% and FPG family income limit for eligibility for discounted care of 500.%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

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):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

WWW.PALISADESMEDICAL.ORG

The FAP application form was widely available on a website (list url):

WWW.PALISADESMEDICAL.ORG

A plain language summary of the FAP was widely available on a website (list url):
WWW.PALISADESMEDICAL.ORG

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

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?..................................

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2015

Page 6

Part VFacility Information (continued)

	PALISADES MEDICAL CENTER INC
Name of hospital facility or letter of facility reporting group

Yes

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?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that
can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Section C)

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? ...............................

If "Yes," explain in Section C.

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? ...........................

If "Yes," explain in Section C.

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
SCH H, PT V, SECT B, Q'S 2,3J,6A,7D,13C&H,15E,16I,18D,19D,20E,21C&D,23&24	NOT APPLICABLE.
SCHEDULE H, PART V, SECTION B, QUESTION 5	In ITS most recently conducted Community Health Needs Assessment ("CHNA") conducted in October 2015, Palisades Medical Center ("PMC") took into account input from persons who represent the broad interests of the community serviced by the hospital facility. In an effort to obtain input from persons who represent the broad interestS of the community, PMC conducted a thorough assessment of the areas healthcare profile, including a review of public health data, summary patient information from hospital admissions and discharge data and representation from the community by means of focus groups and key informant surveys. PMC's first step was to review existing or secondary public health data. The areas health care profile was reviewed from multiple sources such as the Robert Wood Johnson Foundation and University of Wisconsin "County Health Rankings". Another source was the Community Health Status Indicators ("CHSI") which is an interactive web application that produces health profiles for all 3,143 counties in the United States created by the U.S. Department of Health and Human Services, Centers for Diseases Control and Prevention. Finally additional secondary data was obtained from the New Jersey State Health Assessment Data ("NJSHAD") and United States Census Data from 2009 to 2013. Primary research was conducted since the service area encompasses eight municipalities in two different counties and furthermore, there is only partial data available by zip codes. Therefore, to gather firsthand details on community residents views and opinions of the service area, Key Informant Surveys were distributed and focus groups were conducted with both members of the community that are medically underserved, low-income and minority populations as well as with community members with expertise relevant to the health needs of the community. PMC conducted two focus groups and also distributed Key Informant Surveys to community leaders and residents that live in the hospitals primary service area. For further comparison, 2012 - 2014 hospital data was collected on admission and discharge records to compare existing county data with hospital data in areas of chronic disease and select ambulatory care sensitive conditions. Data gathered during PMC'S Community Health Screening in the spring and fall of 2015 was also reviewed. For additional detail regarding the key information surveys, focus groups, hospital data collection, community health screenings and secondary data collection please refer to PMC's CHNA at the following website: www.palisadesmedical.org/Content/84/community-health-needs-assessme nt.html
SCHEDULE H, PART V, SECTION B, QUESTION 6B	The 2015 CHNA was a collaborative initiative designed to deliver a CHNA and an Implementation Strategy that are both responsive to the health disparities in the targeted communities and to enhance coordination and collaboration among community partners and providers. The care provider partnering with PMC in this initiative was the North Hudson Community Action Corporation ("NHCAC"), the local Federally Qualified Health Center. Other partners that continue to collaborate with PMC include the Union City Board of Education and multiple public health partners which include five health departments of the eight municipalities within the primary service area, as well as the countys Local Information Network Communications System ("LINCS") and County Environmental Health Act ("CEHA") agency, Hudson Regional Health Commission. The steering committee has been responsible in prioritizing issues and reviewing all components of the projects on a quarterly basis as well as on a needed basis. THE PMC CHNA Steering Committee includes: - Guttenberg Board of Health; - Hudson Regional Health Commission; - North Bergen Health Department; - North Hudson Community Action Corporation; - Palisades Medical Center; - Union City Early Childhood Education Program; - Union City Board of Health; - Weehawken Board of Health; and - West New York Health Department. The following list includes other community partners THAT assisted PMC WITH THE CHNA: - Bergen County Department of Health Services, Bergen and Hudson Chronic Disease Coalition; - Community Networking Association; - Hudson County Family Success Centers; - Hudson Partnership Case Management Organization; - Love of Jesus Family Church of West New York; - Hudson North Office Division of Child Protection and Permanency; - Palisades Family Success Center in Union City; - Partners in Prevention; - Partnership for Maternal and Child Health of Northern New Jersey; - Save Latin America, Inc.; and - Visiting Homemaker Service of Hudson County.
SCHEDULE H, PART V, SECTION B, QUESTION 11	During the CHNA PROCESS, a myriad of health needs were identified. The hospital is working to address the top five local health issues as identified in its community health needs assessment. In the next step of the CHNA, PMC will be utilizing the Healthy Wisconsin Leadership Institute, Community Health Improvement Toolkit. Their template will be utilized to develop goals and action plans for each of the four concerns. Community partners, especially those with expertise in the selected issues, will be invited to attend a working session. At this session, community partners will suggest potential projects. The Steering Committee will then review all the projects and select feasible plans. Action plans will then be proposed to the PMC Board of Governors for approval and implementation in the community. Once the projects are implemented, they will be evaluated every six months by the steering committee through process and impact evaluations. Public forums will be conducted on an annual basis with public health officials, community residents, community partners and patients to discuss project implementation and evaluations as well as to obtain feedback. IN ADDITION, IN SEPTEMBER 2014, THE SYSTEM AND HACKENSACK UNIVERSITY HEALTH NETWORK ("HACKENSACKUHN"), A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM, SIGNED A LETTER OF INTENT TO MAKE HACKENSACKUHN THE PARENT COMPANY OF THE SYSTEM. EFFECTIVE MARCH 1, 2016, AFTER THE COMPLETION OF THE REQUIRED REGULATORY APPROVALS, HACKENSACKUHN BECAME THE PARENT COMPANY OF THE SYSTEM. In the next steps for this year, HackensackUMC Palisades will be utilizing the Healthy Wisconsin Leadership Institute, Community Health Improvement Toolkit. Their Action Plan Template will be utilized by the Steering Committee to help develop goals and action plans for each of the four concerns outlined by the Community Health Needs Assessment. It is anticipated that HackensackUMC Palisades affiliation with HACKENSACKUHN will enhance capabilities for future planning and implementation. implementation.
SCHEDULE H, PART V; SECTION B, QUESTION 22D	In accordance with Internal Revenue Code 501(r)(5), PMC utilized the look-back method to calculate the amounts generally billed ("ABG"). The AGB % is calculated annually and is based on all claims allowed by Medicare-fee-for-service + all private health insurers over a 12-month period, divided by the gross charges associated with those claims. The applicable AGB % is applied to gross charges to determine the AGB. Any individual determined to be eligible for financial assistance will not be charged more than AGB for emergency or medically necessary healthcare services. Individuals eligible for financial assistance and deemed FAP-eligible will always be charged the lesser of AGB or any discount available under the financial assistance policy. Please refer to the Basis for Calculating Amounts Charged to Patients section of PMC's financial assistance policy for additional information.

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?
Name and address		Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10

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	In addition to the federal poverty guidelines income thresholds identified, the following criteria are used in determining eligibility for free or discounted care: - Asset level; - Medical Indigency; - Insurance status; - Underinsurance status; and - Residency.
SCHEDULE H, PART I, LINE 6A	NOT APPLICABLE.
SCHEDULE H, PART I, QUESTION 7	WORKSHEET 2 WAS USED TO CALCULATE THE COST TO CHARGE RATIO.
SCHEDULE H, PART II	COMMUNITY BENEFIT SERVICES AND PROGRAMS ARE AN INTEGRAL PART OF PALISADES MEDICAL CENTER'S MISSION. PALISADES MEDICAL CENTER WORKS TO STRUCTURE ITS ONGOING COMMUNITY BENEFITS PLAN, CONSISTENTLY AND UNIFORMLY TRACK PROGRAMS AND ACTIVITIES, AND DOCUMENT THE MEDICAL CENTER'S VALUABLE CONTRIBUTIONS TO THE COMMUNITIES IT SERVES. PALISADES MEDICAL CENTER'S COMMUNITY BENEFIT ACTIVITIES INCLUDE: - COMMUNITY HEALTH SCREENINGS; - PHYSICIANS SEMINARS; AND - HEALTH EDUCATION FAIRS. PLEASE ALSO REFER TO FORM 990, SCHEDULE O, WHICH CONTAINS THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT AND SUMMARY OF ALL ENTITIES.
SCHEDULE H, PART III, LINES 2, 3 & 4	BAD DEBT EXPENSE WAS CALCULATED USING THE PROVIDERS' BAD DEBT EXPENSE FROM THE AUDITED FINANCIAL STATEMENTS. THE ORGANIZATION AND ITS AFFILIATES PREPARE AND ISSUE AUDITED CONSOLIDATED FINANCIAL STATEMENTS. THE ATTACHED TEXT WAS OBTAINED FROM THE FOOTNOTES TO THE AUDITED FINANCIAL STATEMENTS OF THE ORGANIZATION. PATIENT ACCOUNTS RECEIVABLE AND ALLOWANCE FOR DOUBTFUL ACCOUNTS PATIENT ACCOUNTS RECEIVABLE RESULT FROM THE HEALTHCARE SERVICES PROVIDED BY THE SYSTEM AND ARE STATED AT THE ESTIMATED NET AMOUNTS RECEIVABLE FROM PATIENTS AND THIRD-PARTY PAYERS. THE AMOUNT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. ADDITIONS TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS RESULT FROM THE PROVISION FOR BAD DEBTS. ACCOUNTS WRITTEN OFF AS UNCOLLECTIBLE ARE DEDUCTED FROM THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. CHARITY CARE THE SYSTEM PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA DEFINED BY THE NEW JERSEY DEPARTMENT OF HEALTH ("DOH") WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. BECAUSE THE SYSTEM DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE. THE SYSTEM'S RECORDS IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES AND INCLUDE THE AMOUNT OF CHARGES FORGONE FOR SERVICES AND SUPPLIES FURNISHED. THE DOH ALLOWS RETROACTIVE APPLICATION FOR CHARITY CARE UP TO TWO YEARS FROM THE DATE OF SERVICE. IN ACCORDANCE WITH ITS MISSION, THE SYSTEM COMMITS SUBSTANTIAL RESOURCES TO SPONSOR A BROAD RANGE OF SERVICES TO BOTH THE INDIGENT AS WELL AS THE BROADER COMMUNITY. COMMUNITY BENEFITS PROVIDED TO THE INDIGENT INCLUDE THE COST OF PROVIDING SERVICES TO PERSONS WHO CANNOT AFFORD HEALTHCARE DUE TO INADEQUATE RESOURCES AND/OR WHO ARE UNINSURED OR UNDERINSURED. THIS TYPE OF COMMUNITY BENEFIT INCLUDES THE COSTS OF: TRADITIONAL CHARITY CARE; UNPAID COSTS OF CARE PROVIDED TO BENEFICIARIES OF MEDICAID AND OTHER INDIGENT PUBLIC PROGRAMS; SERVICES SUCH AS FREE CLINICS AND MEAL PROGRAMS FOR WHICH A PATIENT IS NOT BILLED OR FOR WHICH A NOMINAL FEE HAS BEEN ASSESSED; AND CASH AND IN-KIND DONATIONS OF EQUIPMENT, SUPPLIES OR STAFF TIME VOLUNTEERED ON BEHALF OF THE COMMUNITY. COMMUNITY BENEFITS PROVIDED TO THE BROADER COMMUNITY INCLUDE THE COSTS OF PROVIDING SERVICES TO OTHER POPULATIONS WHO MAY NOT QUALIFY AS INDIGENT BUT MAY NEED SPECIAL SERVICES AND SUPPORT. THIS TYPE OF COMMUNITY BENEFIT INCLUDES THE COSTS OF: SERVICES SUCH AS HEALTH PROMOTION AND EDUCATION, AND SCREENINGS, ALL OF WHICH ARE NOT BILLED OR CAN BE OPERATED ONLY ON A DEFICIT BASIS. THE AMOUNT OF CHARITY CARE PROVIDED DURING THE YEAR ENDED DECEMBER 31, 2015, BASED ON THE CORPORATION'S ESTIMATED COST AS DEFINED BY THE DEPARTMENT OF HEALTH AND SENIOR SERVICES IS $12,420,261.
SCHEDULE H, PART III, SECTION B; QUESTION 8	MEDICARE COSTS WERE DERIVED FROM THE 2015 MEDICARE COST REPORT. MEDICARE UNDERPAYMENTS AND BAD DEBT ARE COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THE ORGANIZATION FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT ARE COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE 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 THE ORGANIZATION'S CHARITABLE TAX-EXEMPT PURPOSES AND MISSION IN PROVIDING MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER WITHOUT REGARD TO RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY AND CONSISTENT WITH THE COMMUNITY BENEFIT STANDARD PROMULGATED BY THE IRS. THE COMMUNITY BENEFIT STANDARD IS THE CURRENT STANDARD FOR A HOSPITAL FOR RECOGNITION AS A TAX-EXEMPT AND CHARITABLE ORGANIZATION UNDER 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 TAX CODE FOR THE TERM "CHARITABLE" A REGULATION PROMULGATED BY THE DEPARTMENT OF THE TREASURY PROVIDES SOME GUIDANCE AND STATES THAT "[T]HE 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 POOR OR UNPRIVILEGED; 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 THE STANDARD, A HOSPITAL HAD TO PROVIDE, TO THE EXTENT OF ITS FINANCIAL ABILITY, FREE OR REDUCED-COST CARE TO PATIENTS UNABLE TO PAY FOR IT. A HOSPITAL THAT EXPECTED FULL PAYMENT DID NOT, ACCORDING TO THE RULING, PROVIDE CHARITY CARE 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 "REMOVE[D]" FROM REVENUE RULING 56-185 "THE REQUIREMENTS RELATING TO CARING FOR PATIENTS WITHOUT CHARGE OR AT RATES BELOW COST." UNDER THE 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 TREAS. REG. 1.501(C)(3)-1(D)(2). THE IRS RULING STATED THAT THE PROMOTION OF HEALTH, LIKE THE RELIEF OF POVERTY AND THE ADVANCEMENT OF EDUCATION AND RELIGION, IS ONE OF THE PURPOSES IN THE GENERAL LAW OF CHARITY THAT IS DEEMED BENEFICIAL TO THE COMMUNITY AS A WHOLE EVEN THOUGH THE CLASS OF BENEFICIARIES ELIGIBLE TO RECEIVE A DIRECT BENEFIT FROM ITS ACTIVITIES DOES NOT INCLUDE ALL MEMBERS OF THE COMMUNITY, SUCH AS INDIGENT MEMBERS OF THE COMMUNITY, PROVIDED THAT THE CLASS IS NOT SO SMALL THAT ITS RELIEF IS NOT OF BENEFIT TO THE COMMUNITY. THE IRS CONCLUDED THAT THE HOSPITAL WAS "PROMOTING THE HEALTH OF A CLASS OF PERSONS THAT IS BROAD ENOUGH TO BENEFIT THE COMMUNITY" BECAUSE ITS EMERGENCY ROOM WAS OPEN TO ALL AND IT PROVIDED CARE TO EVERYONE WHO COULD PAY, WHETHER DIRECTLY OR THROUGH THIRD-PARTY REIMBURSEMENT. OTHER CHARACTERISTICS OF THE HOSPITAL THAT THE IRS HIGHLIGHTED INCLUDED THE FOLLOWING: 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. MEDICARE UNDERPAYMENTS AND BAD DEBT ARE COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEUDLE H, PART I. THE AMERICAN HOSPITAL ASSOCIATION ("AHA") FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT ARE COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THIS ORGANIZATION AGREES WITH THE AHA POSITION. AS OUTLINED IN THE AHA LETTER TO THE IRS DATED AUGUST 21, 2007 WITH RESPECT TO THE FIRST PUBLISHED DRAFT OF THE NEW FORM 990 AND SCHEDULE H, THE AHA FELT THAT THE IRS SHOULD INCORPORATE THE FULL VALUE OF THE COMMUNITY BENEFIT THAT HOSPITALS PROVIDE BY COUNTING MEDICARE UNDERPAYMENTS (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. - MEDICARE, LIKE MEDICAID, DOES NOT PAY THE FULL COST OF CARE. RECENTLY, MEDICARE REIMBURSES HOSPITALS ONLY 92 CENTS FOR EVERY DOLLAR THEY SPEND TO TAKE CARE OF MEDICARE PATIENTS. THE MEDICARE PAYMENT ADVISORY COMMISSION ("MEDPAC") IN ITS MARCH 2007 REPORT TO CONGRESS CAUTIONED THAT UNDERPAYMENT WILL GET EVEN WORSE, WITH MARGINS REACHING A 10-YEAR LOW AT NEGATIVE 5.4 PERCENT. - MANY MEDICARE BENEFICIARIES, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR. MORE THAN 46 PERCENT OF MEDICARE SPENDING IS FOR BENEFICIARIES WHOSE INCOME IS BELOW 200 PERCENT OF THE FEDERAL POVERTY LEVEL. MANY OF THOSE MEDICARE BENEFICIARIES ARE ALSO ELIGIBLE FOR MEDICAID -- SO CALLED ELIGIBLES." THERE IS EVERY 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. MEDICARE UNDERPAYMENT MUST BE SHOULDERED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE COMMUNITY'S ELDERLY AND POOR. THESE UNDERPAYMENTS REPRESENT A REAL COST OF SERVING THE COMMUNITY AND SHOULD COUNT AS A QUANTIFIABLE COMMUNITY BENEFIT. BOTH THE AHA AND THIS ORGANIZATION ALSO FEEL THAT PATIENT BAD DEBT IS A COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. LIKE MEDICARE UNDERPAYMENT (SHORTFALLS), THERE ALSO ARE COMPELLING REASONS THAT PATIENT BAD DEBT 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 HOSPITALS' 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 INCOMES BELOW 200% OF THE FEDERAL POVERTY LINE." - THE REPORT ALSO NOTED THAT A SUBSTANTIAL PORTION OF BAD DEBT IS PENDING CHARITY CARE. UNLIKE BAD DEBT IN OTHER INDUSTRIES, HOSPITAL BAD DEBT IS COMPLICATED BY THE FACT THAT HOSPITALS FOLLOW THEIR MISSION TO THE COMMUNITY AND TREAT EVERY PATIENT THAT COMES THROUGH THEIR EMERGENCY DEPARTMENT, REGARDLESS OF ABILITY TO PAY. PATIENTS WHO HAVE OUTSTANDING BILLS ARE NOT TURNED AWAY, UNLIKE OTHER INDUSTRIES. BAD DEBT IS FURTHER COMPLICATED BY THE AUDITING 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. - 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 GEN
SCHEDULE H, PART III, SECTION B; QUESTION 9B	IT IS THE POLICY OF PALISADES MEDICAL CENTER TO OFFER "COMPASSIONATE BILLING" TO ALL MEMBERS OF THE COMMUNITY SERVED BY THE MEDICAL CENTER, INCLUDING PATIENTS WHO ARE UNINSURED, PATIENTS WHO ARE INSURED BUT WHO SEEK OR REQUIRE SERVICES NOT COVERED BY THEIR HEALTHCARE REIMBURSEMENT BENEFIT PROGRAMS, OR WHOSE CO-PAYMENT OBLIGATIONS PRESENT A FINANCIAL HARDSHIP AND PATIENTS WHO ARE BENEFICIARIES OF INSURANCE PRODUCTS WITH WHICH PALISADES MEDICAL CENTER IS CONSIDERED AN OUT-OF-NETWORK PROVIDER. COMPASSIONATE BILLING CONSISTS OF BILLING AND COLLECTION POLICIES AND PROCEDURES, CONSISTENTLY AND FAIRLY APPLIED, THAT: (A) REQUIRE THE PATIENT FINANCIAL SERVICES DEPARTMENT, THROUGH ITS FINANCIAL COUNSELORS, TO TAKE STEPS TO IDENTIFY UNINSURED PATIENTS ELIGIBLE FOR GOVERNMENT SPONSORED OR SUPPORTED MEDICAL ASSISTANCE AND TO HELP THOSE PATIENTS OBTAIN SUCH MEDICAL ASSISTANCE; B) PROVIDE DISCOUNTS AGAINST CHARGES FOR UNINSURED PATIENTS WHO ARE INELIGIBLE FOR GOVERNMENT SPONSORED OR SUPPORTED PROGRAMS BUT WHO MEET THE FINANCIAL ELIGIBILITY REQUIREMENTS; (C) PROVIDE ON A FEE-FOR-SERVICE OR CASE-RATE BASIS CERTAIN SERVICES NOT ORDINARILY COVERED BY THIRD PARTY PAYOR PROGRAMS, WHICH FEES AND RATES MAY REPRESENT DISCOUNTS AGAINST CHARGES; (D) ALLOW THE REDUCTION OR WAIVER OF PATIENT CO-PAYMENTS IN CASES OF SUBSTANTIATED FINANCIAL HARDSHIP; AND (E) ALLOW THE REDUCTION OR WAIVER OF PATIENT CO-PAYMENTS FOR SERVICES RENDERED TO PATIENTS WHO ARE BENEFICIARIES OF THIRD PARTY PAYOR PROGRAMS WITH RESPECT TO WHICH PALISADES MEDICAL CENTER IS DEEMED AN OUT-OF-NETWORK PROVIDER. THIS COMPASSIONATE BILLING POLICY IS INTENDED TO ASSIST PATIENTS IN COPING WITH THE FINANCIAL HURDLES THAT OFTEN CREATE A BARRIER TO HEALTHCARE SERVICES. THIS COMPASSIONATE BILLING POLICY IS IMPLEMENTED THROUGH PROCEDURES THAT REQUIRE THE DETERMINATION OF ELIGIBILITY FOR GOVERNMENT SPONSORED OR SUPPORTED MEDICAL ASSISTANCE PROGRAMS, INCLUDING MEDICAID AND FAMILY CARE, AND INCLUDING THE MEDICAL CENTER'S CHARITY CARE ASSISTANCE PROGRAM, THAT PROVIDE STANDARDS FOR FEE COMPROMISES AND REDUCTIONS IN CERTAIN RECURRING CIRCUMSTANCES, SUCH AS NON-COVERED SERVICES AND OUT-OF-NETWORK BENEFITS, AND THAT ALLOW FOR CASE-BY-CASE COMPROMISES IN RESPONSE TO REASONABLY SUBSTANTIATED FINANCIAL HARDSHIP. IN ALL CASES, THE COMPASSIONATE BILLING POLICY IS INTENDED TO OFFER OPPORTUNITIES FOR THE PATIENT FINANCIAL SERVICES DEPARTMENT TO BE RESPECTFUL OF OUR COMMUNITY'S NEEDS WHILE ALSO FURTHERING THE MEDICAL CENTER'S NEED TO BE FISCALLY RESPONSIBLE AND TO COMPLY WITH ALL APPLICABLE FEDERAL AND STATE LAW. In accordance with Internal Revenue Code Section 501(r)(6), PMC will not engage in extraordinary collections actions ("ECAs") against a patient or another individual responsible for payment of the patients bill for medical care before making "reasonable efforts" to determine the patients eligibility under the Compassionate Billing and Financial Assistance Policy. The Reasonable Collection Efforts employed by PMC apply to all patients regardless of the patients insurance status. The Medical Centers efforts to collect outstanding account balances include the issuance of an invoice shortly after discharge, death of the patient or when the account becomes the responsibility of the patient. This is followed by subsequent statements and letters, all amounting to an effort to collect the outstanding account balance. PMC may in certain situations employ ECAs in order to effectuate collection of amounts outstanding from patients or other financially responsible individuals for payment of the patients bill for medical care including legal action or consumer credit reporting. These ECAs are initiated through one of the Medical Centers collection agencies. These ECAs are only initiated after the 120 day notification period, the ECA Initiation Notice has been sent and reasonable efforts to verbally notify the individual about the availability of financial assistance and how they may obtain assistance with the application process. unpaid balance if a FAP-eligibility determination has not been made or if an individual is ineligible for financial assistance.
SCHEDULE H, PART VI; QUESTION 2	IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS OUTLINED IN SCHEDULE H, SECTION B, QUESTIONS 1-12 AND SECTION C, THIS ORGANIZATION CONDUCTS A REVIEW OF KEY FACTOR INFORMATION, WHICH INCLUDES: - A REVIEW OF HEALTHCARE UTILIZATION OF ITS SERVICE AREA POPULATION BY SERVICES FOR DETERMINING INCREASED OR DECREASED HEALTH NEEDS; - HEALTHCARE SERVICE ESTIMATES AND FORECASTS (BOTH INPATIENT AND OUTPATIENT); - ASSESSMENTS OF LOCAL DEMOGRAPHIC AND SOCIOECONOMIC INFORMATION; AND, - A REVIEW OF HEALTH STATUS/NEEDS ASSESSMENTS AND STUDIES CONDUCTED BY THE NEW JERSEY HOSPITAL ASSOCATION (NJHA). IN ADDITION, THIS ORGANIZATION WORKS WITH LOCAL PROVIDERS TO PLAN AND DISCUSS HEALTH NEEDS OF THE POPULATION. NEEDS ASSESSMENT AND COMMUNITY OUTREACH PARTNERS INCLUDE NORTH HUDSON COMMUNITY ACTION CORPORATION, CHRIST HOSPITAL SCHOOL OF NURSING, HUDSON PERINATAL CONSORTIUM, INC., MUNICIPAL EMERGENCY MEDICAL SERVICES AND OFFICE OF EMERGENCY MEDICAL MANAGEMENT NORTH HUDSON REGIONAL FIRE DEPARTMENT.
SCHEDULE H, PART VI; QUESTION 3	In accordance with Internal Revenue Code Section 501(r)(4) Palisades Medical Center ("PMC") informs and educates patients and persons who may be billed for patient care about their eligibility for financial assistance by widely publicizing various documents. These documents are widely publicized in the following ways: - The Financial Assistance Policy ("FAP"), Application and Plain Language Summary ("PLS") are all available on-line at www.palisadesmedical.org; - Paper copies of the FAP, Application and PLS are available upon request by mail, without charge, and are provided in various areas throughout the Medical Center including Main Registration desk, Emergency Room, and Patient Financial Services Department; - All patients are offered a copy of the PLS as part of the patient access/intake process; - Signs or displays will be posted in public locations including Main Registration desk, Emergency Room, and Patient Financial Services offices that notify and inform patients about the availability of financial assistance; and - The FAP, Applications and PLS are available in English and in the primary language of populations with limited proficiency in English ("LEP") that constitute the lesser of 1,000 individuals or 5% of the community served by PMCs primary service area. Translated versions FAP are available upon request in person at the address above and at www.palisadesmedical.org.
SCHEDULE H, PART VI; QUESTION 4	MANY OF THE COMMUNITIES SERVED BY PALISADES MEDICAL CENTER HAVE EXPERIENCED HIGH POPULATION GROWTH IN THE PAST FIVE YEARS AND ALL OF THEM COMBINED REPRESENT ONE OF THE HIGHEST POPULATION DENSITIES IN NEW JERSEY. U.S. HISPANICS ARE GROSSLY DISADVANTAGED IN TERMS OF ACCESS TO HEALTHCARE. OVER 38.9% OF THE NATION'S CURRENT POPULATION OF HISPANICS IS UNINSURED, COMPARED TO 12.2% OF ANGLO-AMERICANS AND 20.2% OF AFRICAN AMERICANS. WITH EVER-INCREASING HEALTHCARE COSTS, THESE MEASURES ARE UNLIKELY TO IMPROVE ANYTIME SOON. THE NATIONAL-LEVEL FINDINGS ARE VALIDATED LOCALLY. THE LOWER-INCOME HISPANIC COMMUNITIES OF HUDSON AND BERGEN COUNTIES ARE POPULATIONS IN DIRE NEED OF IMPROVED HEALTHCARE SCREENING, AWARENESS, AND EDUCATION. THE THREE COMMUNITIES OF NORTH BERGEN, UNION CITY AND WEST NEW YORK ALONE CONSTITUTE MORE THAN 11% OF NEW JERSEY'S TOTAL HISPANIC POPULATION, AND ARE HOME TO NEARLY 4% OF NEW JERSEY RESIDENTS AT OR BELOW THE POVERTY LEVEL. THE WEIGHTED AVERAGE PER-CAPITA INCOME IN THESE COMMUNITIES IS ONLY $16,793 NEARLY 38% BELOW THE STATEWIDE AVERAGE. THE POVERTY RATE IN THESE COMMUNITIES IS MORE THAN DOUBLE THE STATEWIDE AVERAGE. THE AREA'S HISPANIC POPULATION IS DIVERSE. IT CONSISTS OF GROUPS ORIGINATING FROM MULTIPLE GEOGRAPHIC AREAS AND FOUNDER POPULATIONS. COMMUNITY MEMBERS HAVE ESTABLISHED RESIDENCE IN THE U.S. FOR VARYING LENGTHS OF TIME, FROM MULTIPLE GENERATIONS TO LESS THAN A YEAR. THESE DIFFERING BACKGROUNDS CAN HAVE A LARGE POTENTIAL TO INFLUENCE DISEASE RISK. MANY OF THE COMMUNITIES SERVED BY PALISADES MEDICAL CENTER HAVE EXPERIENCED HIGH POPULATION GROWTH IN THE PAST FIVE YEARS AND ALL OF THEM COMBINED REPRESENT ONE OF THE HIGHEST POPULATION DENSITIES IN NEW JERSEY.
SCHEDULE H, PART VI; QUESTION 5	COMMUNITY BUILDING ACTIVITIES UNDERTAKEN BY PALISADES MEDICAL CENTER IMPROVE THE MEDICAL AND SOCIOECONOMIC WELL-BEING OF THE COMMUNITIES IN OUR CARE. THIS IS ACCOMPLISHED THROUGH SERVICE ON STATE AND REGIONAL ADVOCACY COMMITTEES AND BOARDS, VOLUNTEERISM WITH LOCAL COMMUNITY-BASED NON-PROFIT ADVOCACY GROUPS, AND PARTICIPATION IN CONFERENCES AND OTHER EDUCATIONAL ACTIVITIES TO PROMOTE UNDERSTANDING OF THE ROOT CAUSES OF HEALTH CONCERNS. PMC PROVIDES EDUCATIONAL MATERIALS, CONDUCTS COMMUNITY HEALTH FAIRS AND HOLDS HEALTH EDUCATION SEMINARS AND OUTREACH SESSIONS FOR ITS PATIENTS AND FOR COMMUNITY PROVIDERS. PRESENTATIONS ARE PROVIDED BY PHYSICIANS, NURSES AND OTHER HEALTHCARE PROFESSIONALS. THE MAJORITY OF THE BOARD OF TRUSTEES MEMBERS ARE INDIVIDUALS WITH LOCAL BUSINESSES OR WHOM RESIDE IN THE COMMUNITY. HOSPITAL STAFF MEMBERS SERVE ON THE BOARDS OF MANY LOCAL NOT FOR-PROFIT ORGANIZATIONS AND PROVIDE OTHER FORMS OF SUPPORT (FUNDRAISING, ACTIVITY PARTICIPATION). ALL QUALIFIED PHYSICIANS ARE EXTENDED PRIVILEGES. SURPLUS FUNDS ARE UTILIZED FOR CAPITAL PROJECTS TO IMPROVE SERVICES OR PURCHASE EQUIPMENT WHICH IN TURN, BENEFIT THE COMMUNITY.
SCHEDULE H, PART VI; QUESTION 6	NOT FOR-PROFIT PALISADES HEALTHCARE SYSTEM, INC. ENTITIES: PALISADES HEALTHCARE SYSTEM, INC. PALISADES HEALTHCARE SYSTEM, INC. ("PHS") IS A NOT FOR-PROFIT HOLDING COMPANY BASED IN NORTH BERGEN, NEW JERSEY. PHS IS THE SOLE CORPORATE MEMBER OF A NUMBER OF NOT FOR-PROFIT ENTITIES AND THE SOLE SHAREHOLDER OF VARIOUS OTHER FOR-PROFIT ENTITIES. AS THE PARENT ORGANIZATION OF A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM, PHS STRIVES TO CONTINUALLY DEVELOP AND OPERATE AN INTEGRATED HEALTHCARE DELIVERY SYSTEM WHICH PROVIDES A COMPREHENSIVE SPECTRUM OF MEDICALLY NECESSARY HEALTHCARE SERVICES TO THE RESIDENTS OF NORTH BERGEN, NEW JERSEY, AND THE SURROUNDING COMMUNITY. PALISADES HEALTHCARE SYSTEM, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A SUPPORTING ORGANIZATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). PHS ENSURES THAT ITS SYSTEM PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OF ABILITY TO PAY. NO INDIVIDUALS ARE DENIED NECESSARY MEDICAL CARE, TREATMENT OR SERVICES. PHS IS THE SOLE CORPORATE MEMBER OF PALISADES MEDICAL CENTER ("PMC"); A HOSPITAL PROVIDING COMPREHENSIVE INPATIENT, OUTPATIENT AND EMERGENCY SERVICES. PMC OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545: 1. PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF-PAY, MEDICARE AND MEDICAID PATIENTS; 2. OPERATES AN ACTIVE EMERGENCY DEPARTMENT FOR ALL PERSONS; WHICH IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR; 3. MAINTAINS AN OPEN MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; 4. CONTROL OF PMC RESTS WITH ITS BOARD OF TRUSTEES AND THE BOARD OF TRUSTEES OF PALISADES HEALTHCARE SYSTEM, INC. BOTH BOARDS ARE 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. PALISADES MEDICAL CENTER PALISADES MEDICAL CENTER ("PMC") IS COMPRISED OF PALISADES MEDICAL CENTER, A 202-BED NON-PROFIT ACUTE CARE MEDICAL CENTER. PMC IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, PMC PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. MOREOVER, PMC OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. PALISADES MEDICAL CENTER FOUNDATION, INC. PALISADES MEDICAL CENTER FOUNDATION, INC. 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)(1). THROUGH FUNDRAISING ACTIVITIES THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF PALISADES MEDICAL CENTER; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT 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. PALISADES GENERAL CARE, INC. PALISADES GENERAL CARE, INC. IS A 245-BED SKILLED NURSING FACILITY LOCATED IN NORTH BERGEN, HUDSON COUNTY, NEW JERSEY. THE 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)(2). THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF PALISADES MEDICAL CENTER; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT 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. PALISADES MEDICAL ASSOCIATES, L.L.C. PALISADES MEDICAL ASSOCIATES, L.L.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)(2). THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF PALISADES MEDICAL CENTER; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT 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. FOR-PROFIT PALISADES HEALTHCARE SYSTEM ENTITIES PALISADES CHILD CARE CENTER, INC. A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS PALISADES HEALTHCARE SYSTEM, INC. THIS ENTITY OPERATES A DAY CARE CENTER. PALISADES MANAGEMENT ENTERPRISES A FOR-PROFIT ENTITY WHOSE SOLE SHAREHOLDER IS PALISADES HEALTHCARE SYSTEM, INC. THE ORGANIZATION PROVIDES MANAGEMENT SERVICES. PALISADES HOUSE PHYSICIANS, P.C. A FOR-PROFIT ENTITY THAT EXISTS IN A NOMINEE RELATIONSHIP FOR THE BENEFIT OF PALISADES MEDICAL CENTER, INC.
SCHEDULE H, PART III, SECTION B; QUESTION 7	NOT APPLICABLE. THE ENTITY AND RELATED PROVIDER ORGANIZATIONS ARE LOCATED IN NEW JERSEY. THE STATE OF NEW JERSEY DOES NOT REQUIRE HOSPITALS TO ANNUALLY FILE A COMMUNITY BENEFIT REPORT WITH THE STATE OF NEW JERSEY. PMC PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT WHICH IT MAKES AVAILABLE TO THE PUBLIC ON ITS WEBSITE: WWW.PALISADESMEDICAL.ORG.

Schedule H (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

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

PALISADES MEDICAL CENTER INC

Employer identification number

22-1487278

Part I

Questions Regarding Compensation

Yes

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.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

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 .........

Yes

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? ..

Yes

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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

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:

Receive a severance payment or change-of-control payment? ................

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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.

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:

The organization? ...........................

Any related organization?

If "Yes," on line 5a or 5b, describe in Part III.

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:

The organization?

Any related organization? .........................

If "Yes," on line 6a or 6b, describe in Part III.

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 ............

Yes

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 .............................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

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
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1BRUCE J MARKOWITZTRUSTEE - PRESIDENT/CEO	(i) (ii)	690,150 ------------- 0	267,443 ------------- 0	427,233 ------------- 0	64,977 ------------- 0	22,820 ------------- 0	1,472,623 ------------- 0	0 ------------- 0
2JOHN CALANDRIELLO FHFMA CPAVP; CHIEF FINANCIAL OFFICER	(i) (ii)	468,516 ------------- 0	109,835 ------------- 0	314,604 ------------- 0	163,164 ------------- 0	17,240 ------------- 0	1,073,359 ------------- 0	4,500 ------------- 0
3DAVID BERKOWITZVP; CHIEF OPERATING OFFICER	(i) (ii)	335,958 ------------- 0	68,247 ------------- 0	44,612 ------------- 0	79,180 ------------- 0	24,874 ------------- 0	552,871 ------------- 0	0 ------------- 0
4RUBEN D FERNANDEZVP; NURSING	(i) (ii)	320,123 ------------- 0	60,000 ------------- 0	4,191 ------------- 0	25,289 ------------- 0	7,530 ------------- 0	417,133 ------------- 0	0 ------------- 0
5DONNA CAHILLVP; HUMAN RESOURCES	(i) (ii)	242,179 ------------- 0	51,018 ------------- 0	35,249 ------------- 0	65,515 ------------- 0	19,146 ------------- 0	413,107 ------------- 0	0 ------------- 0
6EURICE R ROJASVP; MARKETING	(i) (ii)	240,039 ------------- 0	47,989 ------------- 0	22,374 ------------- 0	28,006 ------------- 0	22,596 ------------- 0	361,004 ------------- 0	0 ------------- 0
7JOSEPH BURTVP; EXEC. DIRECTOR FOUNDATION	(i) (ii)	233,259 ------------- 0	43,323 ------------- 0	1,716 ------------- 0	11,354 ------------- 0	22,027 ------------- 0	311,679 ------------- 0	0 ------------- 0
8SURESH RAINA MDVP; CMO (1/1 - 4/1, SEE SCH O)	(i) (ii)	249,963 ------------- 0	0 ------------- 0	1,048 ------------- 0	14,998 ------------- 0	507 ------------- 0	266,516 ------------- 0	0 ------------- 0
9ANTHONY PASSANNANTE MDVP; CMO (EFF 09/08/15)	(i) (ii)	144,731 ------------- 0	0 ------------- 0	0 ------------- 0	2,077 ------------- 0	5,648 ------------- 0	152,456 ------------- 0	0 ------------- 0
10ALEXANDER GLICKMAN MDMEDICAL DIRECTOR	(i) (ii)	461,538 ------------- 0	0 ------------- 0	478 ------------- 0	0 ------------- 0	8,347 ------------- 0	470,363 ------------- 0	0 ------------- 0
11SANTOSH RAINA MDMEDICAL DIRECTOR	(i) (ii)	399,203 ------------- 0	0 ------------- 0	3,701 ------------- 0	15,900 ------------- 0	3,750 ------------- 0	422,554 ------------- 0	0 ------------- 0
12QI ZHANG MDMEDICAL DIRECTOR	(i) (ii)	322,977 ------------- 0	0 ------------- 0	2,208 ------------- 0	15,900 ------------- 0	24,274 ------------- 0	365,359 ------------- 0	0 ------------- 0
13JOAN MOZEIKADIRECTOR	(i) (ii)	206,669 ------------- 0	4,000 ------------- 0	1,314 ------------- 0	34,380 ------------- 0	23,306 ------------- 0	269,669 ------------- 0	0 ------------- 0
14ELENA RUBINO MDDIRECTOR	(i) (ii)	198,626 ------------- 0	0 ------------- 0	0 ------------- 0	12,068 ------------- 0	25,275 ------------- 0	235,969 ------------- 0	0 ------------- 0

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	PALISADES MEDICAL CENTER PAID FOR FINANCIAL/TAX PLANNING SERVICES FOR BRUCE J. MARKOWITZ, PRESIDENT/CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION, IN THE AMOUNT OF $2,195. THE FINANCIAL/TAX PLANNING SERVICES AMOUNT OUTLINED HEREIN WAS INCLUDED IN MR. MARKOWITZ'S 2015 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES.
SCHEDULE J, PART I; QUESTION 4B	IN 2015 BRUCE J. MARKOWITZ EARNED $1,472,623 IN SALARIES AND BENEFITS. THE AMOUNT REFLECTED IN COLUMN B(III) FOR BRUCE J. MARKOWITZ, $427,233; INCLUDES CURRENT YEAR VESTING AND DISTRIBUTIONS IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) IN THE AMOUNT OF $369,441 AS THE AMOUNT WAS NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THIS AMOUNT WAS INCLUDED IN HIS 2015 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. IN 2015 JOHN CALANDRIELLO, FHFMA, CPA, EARNED $1,073,359 IN SALARIES AND BENEFITS. CERTAIN OTHER AMOUNTS REPORTED IN FORM W-2, BOX 5 AS COMPENSATION RELATE TO COMPENSATION EARNED IN PRIOR YEARS AND REPORTED ON PRIOR YEAR FORMS 990. THE AMOUNT REFLECTED IN COLUMN B(III) FOR JOHN CALANDRIELLO, FHFMA, CPA, $314,604; INCLUDES CURRENT YEAR VESTING AND DISTRIBUTIONS IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) IN THE AMOUNT OF $288,319 AS THE AMOUNT WAS NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THIS AMOUNT WAS REPORTED AS EMPLOYEE BENEFIT PLAN CONTRIBUTIONS ON THE ORGANIZATION'S PRIOR YEAR FORMS 990 AND WAS INCLUDED IN HIS 2015 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR JOHN CALANDRIELLO, CPA, $163,164; INCLUDES UNVESTED BENEFITS IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) IN THE AMOUNT OF $147,264, WHICH ARE SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, HE MAY NEVER ACTUALLY RECEIVE THIS UNVESTED BENEFIT AMOUNT. THIS AMOUNT WAS NOT INCLUDED IN HIS 2015 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES.
SCHEDULE J, PART I; QUESTION 7	CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A BONUS DURING CALENDAR YEAR 2015 WHICH AMOUNTS WERE INCLUDED IN COLUMN B(II) HEREIN AND IN EACH INDIVIDUAL'S 2015 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT.
SCHEDULE J, PART II, COLUMN F	THE AMOUNT OF $4,500 REPORTED IN SCHEDULE J, PART II, COLUMN F FOR JOHN CALANDRIELLO, FHFMA, CPA, REPRESENTS AN AMOUNT PAID FOR SERVICES RENDERED IN PRIOR YEARS THAT BECAME TAXABLE IN 2015 BECAUSE IT WAS NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THIS AMOUNT WAS REPORTED AS AN ACCRUED BENEFIT ON PRIOR YEAR FORMS 990 OF THE ORGANIZATION. THIS AMOUNT WAS TREATED AS TAXABLE INCOME AND REPORTED ON HIS 2015 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES.

Schedule J (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

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.
SchKMediumBullet

Information 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
PALISADES MEDICAL CENTER INC

Employer identification number
22-1487278

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
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	NJ HEALTH CARE FACILITIES FINANCING AUTHORITY	22-1987084	64579F402	07-02-2013	46,901,409	REFUND, CAP PROJECTS, DEBT SVC FD		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	35,202,879
2 Amount of bonds legally defeased ..............	0
3 Total proceeds of issue ..................	51,664,152
4 Gross proceeds in reserve funds .............	5,000,019
5 Capitalized interest from proceeds .............	0
6 Proceeds in refunding escrows ...............	0
7 Issuance costs from proceeds ...............	1,155,903
8 Credit enhancement from proceeds .............	0
9 Working capital expenditures from proceeds .............	0
10 Capital expenditures from proceeds .............	10,305,351
11 Other spent proceeds .............	0
12 Other unspent proceeds .............	0
13 Year of substantial completion .............	2013
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....	X
15 Were the bonds issued as part of an advance refunding issue? .....		X
16 Has the final allocation of proceeds been made? ..........	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 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
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	4.900 %
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 .........	0 %
6 Total of lines 4 and 5 .............	4.900 %
7 Does the bond issue meet the private security or payment test? ...	X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......	X
b Exception to rebate? ........		X
c No rebate due? .........		X
If "Yes" to line 2c, provide in Part VI the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X
b Name of provider ..........	0
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........

Schedule K (Form 990) 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
b Name of provider ..........	0
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X

Part VI

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation

Schedule K (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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.
MediumBullet

Information 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

PALISADES MEDICAL CENTER INC

Employer identification number

22-1487278

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	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

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?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No










Total ............... $

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

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?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) THE YA GROUP INC	SPOUSE OWNER - OFFICER	585,342	ADVERTISING		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation
SCHEDULE L, PART IV	EURICE R. ROJAS IS AN OFFICER OF PALISADES MEDICAL CENTER, INC. PALISADES MEDICAL CENTER, INC. UTILIZED THE SERVICES OF HIS WIFE'S COMPANY, THE YA GROUP, DURING 2015. TOTAL FEES PAID TO THE YA GROUP WERE $585,342. SERVICES WERE RENDERED AT FAIR MARKET VALUE RATES PURSUANT TO ARM'S LENGTH NEGOTIATIONS.

Schedule L (Form 990 or 990-EZ) 2015

Additional Data

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Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

PALISADES MEDICAL CENTER INC

Employer identification number

22-1487278

Return Reference	Explanation
CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS	PALISADES MEDICAL CENTER ("PMC") IS AN ACUTE CARE GENERAL MEDICAL AND SURGICAL HOSPITAL. PMC IS RECOGNIZED BY THE IRS AS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, PMC PROVIDES HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. MOREOVER, PMC OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545: 1. PMC PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF-PAY, MEDICARE AND MEDICAID PATIENTS; 2. PMC OPERATES AN ACTIVE EMERGENCY DEPARTMENT FOR ALL PERSONS; WHICH IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR; 3. PMC MAINTAINS AN OPEN MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; 4. CONTROL OF PMC RESTS WITH ITS BOARD OF TRUSTEES 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. THE OPERATIONS OF PMC, AS SHOWN THROUGH THE FACTORS OUTLINED ABOVE AND OTHER INFORMATION CONTAINED HEREIN, CLEARLY DEMONSTRATE THAT THE USE AND CONTROL OF PMC IS FOR THE BENEFIT OF THE PUBLIC AND THAT NO PART OF THE INCOME OR NET EARNINGS OF THE ORGANIZATION INURES TO THE BENEFIT OF ANY PRIVATE INDIVIDUAL NOR IS ANY PRIVATE INTEREST BEING SERVED OTHER THAN INCIDENTALLY. PMC'S SOLE CORPORATE MEMBER IS PALISADES HEALTHCARE SYSTEM, INC. (SYSTEM). THIS TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM CONSISTS OF A GROUP OF AFFILIATED HEALTHCARE ORGANIZATIONS. TO HELP MEET THE HEALTHCARE NEEDS OF RESIDENTS THROUGHOUT ITS COMMUNITY, SYSTEM SERVES RESIDENTS OF HUDSON AND BERGEN COUNTIES IN NEW JERSEY. PMC PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY. MOREOVER, PMC PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO PATIENTS WHO MEET CERTAIN CRITERIA DEFINED BY THE NEW JERSEY DEPARTMENT OF HEALTH AND SENIOR SERVICES WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. PMC MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE AMOUNT OF CHARITY CARE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FOREGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY. PATIENT STATISTICAL INFORMATION/ACCOMPLISHMENTS/MILESTONES ========================================================== PALISADES HEALTHCARE SYSTEM, INC. IS COMPRISED OF PALISADES MEDICAL CENTER, A 202-BED, NOT-FOR-PROFIT, ACUTE CARE FACILITY, AND THE HARBORAGE, A 245-BED SKILLED NURSING FACILITY. LOCATED IN THE TOWN OF NORTH BERGEN, NEW JERSEY, PMC PROVIDES COMPREHENSIVE INPATIENT AND OUTPATIENT SERVICES TO A SERVICE AREA THAT EXTENDS THROUGHOUT NORTHERN HUDSON AND SOUTHERN BERGEN COUNTIES IN NEW JERSEY. SUPPORTING ITS CENTER OF EXCELLENCE IN EMERGENCY MEDICINE, THE HELIPORT-EQUIPPED EMERGENCY ROOM AT PALISADES FEATURES SPECIAL ACCOMMODATIONS FOR OBSTETRICS AND GYNECOLOGY, ORTHOPEDICS, AND PSYCHIATRIC TRAUMA. INPATIENT VOLUME APPROXIMATED 10,515 ADMISSIONS. OUTPATIENT CLINIC VOLUME APPROXIMATED 19,321 VISITS AND THE EMERGENCY ROOM VOLUME APPROXIMATED 44,500 PATIENTS IN 2015. PMC IS A SIGNIFICANT HEALTHCARE PROVIDER IN HUDSON COUNTY, NEW JERSEY SERVING APPROXIMATELY 10% OF INPATIENT DISCHARGES FOR HUDSON RESIDENTS. IN 2015, THE HOSPITAL DISCHARGED A TOTAL OF 10,506 PATIENTS AND PERFORMED 7,585 INPATIENT AND OUTPATIENT SURGICAL PROCEDURES. PMC HAS BEEN THE LEADER IN NORTHERN NEW JERSEY IN PROVIDING THE BEST IN HEALTHCARE AND THE LATEST IN MEDICAL TECHNOLOGY TO THE NEARLY 400,000 RESIDENTS THAT COMPRISE ITS PRIMARY SERVICE AREA OF HUDSON AND SOUTHERN BERGEN COUNTIES. PMC IS AN AFFILIATE OF THE HACKENSACK UNIVERSITY HEALTH NETWORK. PMC HAS BEEN ACTIVE IN DEVELOPING COLLABORATIVE CLINICAL AND ACADEMIC PROGRAMS TO BRING ADDITIONAL SPECIALIZED DIAGNOSTIC AND MEDICAL TREATMENT TO LOCAL RESIDENTS. NEWLY ENHANCED SERVICES INCLUDE: - PMC'S LEVEL II NURSERY IS FULLY OPERATIONAL WITH QUICK TRANSFER OF CHILDREN NEEDING TERTIARY CARE AT HACKENSACK UNIVERSITY MEDICAL CENTER. - PERIPHERAL VASCULAR SURGERY IS REVITALIZED AT PMC WITH THE HELP OF VASCULAR SURGEONS FROM HACKENSACK UNIVERSITY MEDICAL CENTER. - BARIATRIC SURGERY, THORACIC SURGERY AND NEUROSURGERY PROGRAMS ESTABLISHED AT PMC WITH SUPPORT FROM HACKENSACK UNIVERSITY MEDICAL CENTER SURGEONS. - BREAST SURGERY PROGRAM. PMC MEDICAL SERVICES AND HEALTH CARE PROGRAMS ============================================= THE MEDICAL SERVICES AND HEALTHCARE PROGRAMS CONDUCTED BY PMC INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING: 1. PEDIATRICS THE HEALTH AND WELL-BEING OF CHILDREN HAS ALWAYS BEEN A TOP PRIORITY AT PMC. PEDIATRICIANS AT PMC WHO LIVE AND PRACTICE IN THE AREA PROVIDE EXPERT CARE FOR A VARIETY OF CHILDHOOD ILLNESSES. PMC'S INPATIENT UNIT IS STAFFED BY PEDIATRIC NURSES WHO UNDERSTAND THAT CHILDREN NEED EXTRA TLC WHEN THEY'RE HOSPITALIZED. A LIBERAL VISITATION POLICY ON THIS UNIT FOR PARENTS ASSURES THAT THEY CAN REMAIN WITH YOUR CHILD AS MUCH AS POSSIBLE. 2. MATERNITY CARE IN 2015, 1,236 BABIES WERE DELIVERED AT PMC. PMC'S LABOR, DELIVERY, RECOVERY AND POSTPARTUM (LDRP) BIRTHING SUITES OFFER FAMILIES THE LATEST TECHNOLOGY AND THE FINEST DOCTORS IN A FAMILY ORIENTED ENVIRONMENT. PMC'S OBSTETRICIANS, NURSES, AND LACTATION CONSULTANTS PROVIDE EXPERT CARE FOR PREGNANT WOMEN, ALONG WITH CHILDBIRTH AND INFANT CARE CLASSES FOR COUPLES. 3. SAME DAY SURGERY PATIENTS RECEIVE TREATMENT IN PMC'S MODERN OUTPATIENT SURGERY CENTER AND RETURN HOME IN HOURS, NOT DAYS. TECHNOLOGICAL ADVANCES HAVE MADE IT POSSIBLE FOR US TO PERFORM MANY KINDS OF SURGERY AT THE CENTER. PATIENTS BENEFIT FROM SMALLER INCISIONS, MINIMAL PAIN, FASTER RECUPERATION TIME AND LESS EXPENSE. PMC OFFERS ARTHROSCOPY, LAPAROSCOPY, ENDOSCOPY, HERNIA REPAIR AND GALL BLADDER REMOVAL. PMC'S YAG LASER ENHANCES OUR SURGICAL CAPABILITIES AND IMPROVES PATIENT COMFORT. 4. EMERGENCY CARE BECAUSE OF PMC'S LOCATION ON THE HUDSON RIVER -- NEAR THE GEORGE WASHINGTON BRIDGE, LINCOLN TUNNEL, AND MAJOR HIGHWAYS -- PMC HAS ONE OF THE BUSIEST EMERGENCY DEPARTMENTS OF ANY COMMUNITY HOSPITAL IN NEW JERSEY. APPROXIMATELY 44,500 PATIENTS COME TO US EACH YEAR FOR LIFE-SAVING CARE ADMINISTERED BY BOARD-CERTIFIED EMERGENCY MEDICINE SPECIALISTS. A HELIPORT ON OUR PROPERTY PROVIDES ADDITIONAL ACCESS TO OUR HOSPITAL. PMC'S EMERGENCY DEPARTMENT FEATURES 10,000 SQUARE FEET OF SPACE FOR PATIENT TREATMENT, TRAUMA, AND TRIAGE, WITH SPECIAL ACCOMMODATIONS FOR OBSTETRICS/GYNECOLOGY CARE, ORTHOPEDICS, AND PSYCHIATRIC TRAUMA. A DECONTAMINATION SHOWER -- THE FIRST OF ITS KIND IN HUDSON COUNTY -- IS USED TO TREAT INDIVIDUALS INVOLVED IN INDUSTRIAL ACCIDENTS. AS AN ADDED BENEFIT, A SEPARATE FAST TRACK PROGRAM IN PMC'S EMERGENCY DEPARTMENT IS RESERVED FOR THE PROMPT TREATMENT OF MINOR ILLNESSES AND INJURIES. IT'S OUR WAY OF OFFERING FAST, QUALITY CARE TO HELP OUR PATIENTS COPE WITH LIFE'S LITTLE EMERGENCIES. 5. MENTAL HEALTHCARE PATIENTS IN CRISIS RECEIVE EMERGENCY CARE AT PMC. PMC MANAGES A 24 HOUR CRISIS HOTLINE STAFFED BY MENTAL HEALTH PROFESSIONALS. PMC'S OUTPATIENT COUNSELING PROGRAM PROVIDES COMMUNITY BASED CARE FOR INDIVIDUALS AND FAMILIES. HELP IS AVAILABLE FOR SUBSTANCE ABUSE, FAMILY VIOLENCE, AND MORE.
CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS	6. OUTPATIENT TESTING PATIENTS HAVE ACCESS TO PMC'S OUTPATIENT TESTING FACILITIES: THE CARDIOPULMONARY LABORATORY DIAGNOSES AND TREATS EXISTING CARDIAC AND RESPIRATORY CONDITIONS AND PROVIDES CARE TO PREVENT COMPLICATIONS AFTER SURGERY. BRAIN FUNCTION TESTS ARE ALSO PERFORMED. THE CLINICAL AND ANATOMICAL PATHOLOGY LABORATORIES PROVIDE ROUTINE AND SPECIALIZED TESTS. SKILLED MEDICAL TECHNOLOGISTS ENSURE QUALITY AND ACCURACY. THE RADIOLOGY SERVICE OFFERS X-RAYS, CT SCANS, NUCLEAR MEDICINE PROCEDURES, ULTRASOUND, MAMMOGRAPHY, CALCIUM SCORING AND DIGITAL ANGIOGRAPHY, PERFORMED BY REGISTERED RADIOLOGY TECHNICIANS AND RADIOLOGISTS. IN ADDITION, OUR INTERVENTIONAL RADIOLOGIST PERFORMS UFE PROCEDURES AND FALLOPIAN TUBE RE-CANALIZATION. THE MRI CENTER HOUSES STATE OF THE ART MAGNETIC RESONANCE IMAGING EQUIPMENT THAT PRODUCES SUPERIOR IMAGES UP TO 75 PERCENT FASTER THAN OTHER MACHINES. DURING THE PROCEDURE, PATIENTS RECLINE IN A SPACIOUS TESTING AREA, LISTEN TO MUSIC, AND RELAX WITH AROMATHERAPY. THE VASCULAR LABORATORY CONDUCTS SAFE AND ACCURATE NON-INVASIVE TESTS TO DIAGNOSE CIRCULATORY PROBLEMS. LASTLY, OUR RADIOLOGY TECHNOLOGY IS COMPLETELY FILMLESS AND IS REPRESENTED VIA DIGITAL EXPOSURE ALLOWING FOR MORE ACCURATE DIAGNOSTIC CAPABILITIES. 7. PATHOLOGY & LABORATORY SERVICES SUPPORTING THE CONTINUUM OF CARE. PMC'S CLINICAL AND ANATOMICAL PATHOLOGY LABORATORIES PROVIDE ROUTINE AND SPECIALIZED TESTS BY SKILLED MEDICAL TECHNOLOGISTS TO ENSURE QUALITY AND ACCURACY. PATHOLOGY TESTS INCLUDE GROSS, MICROSCOPIC, CHEMICAL, IMMUNOLOGIC AND MOLECULAR EXAMINATION OF ORGANS AND TISSUES TO DETERMINE THE NATURE OF DISEASES. 8. COMMUNITY ACTIVITIES AND PROGRAMS PMC OFFERS NUMEROUS COMMUNITY EDUCATION, MEDICAL SCREENINGS AND SUPPORT GROUP SERVICES AND PROGRAMS TO PROMOTE WELLNESS FOR PEOPLE OF ALL AGES. THESE TYPES OF PROGRAMS INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING: - HEALTH FAIRS TAKE PLACE REGULARLY, IN THE WORKPLACE, AND IN THE COMMUNITY TO PROVIDE EDUCATION ABOUT CANCER, DIABETES, ASTHMA, AIDS, HEART DISEASE, AND MORE. 9. PMC RESIDENCY PROGRAM INCLUDES INTERNAL MEDICINE, GENERAL SURGERY, OBSTETRICS, FAMILY MEDICINE, TRADITIONAL ROTATING INTERNSHIPS, GI FELLOWSHIPS AND DERMATOLOGY FELLOWSHIPS. - HEALTH SCREENINGS, FREE OR LOW-COST TESTS ARE AVAILABLE TO DETECT PROSTATE CANCER, HYPERTENSION, HIGH CHOLESTEROL, AND GLAUCOMA. - SEMINARS AND LECTURES COVER CURRENT HEALTHCARE ISSUES. THESE FREE, INFORMATIVE TALKS ARE PRESENTED BY PHYSICIANS, NURSES, AND ADMINISTRATORS WHO ARE MEMBERS OF OUR SPEAKERS' BUREAU. - SUPPORT GROUPS HELP PEOPLE TO COPE WITH LIFE CHANGES BROUGHT ABOUT BY ILLNESSES SUCH AS CANCER, DIABETES, STROKE AND CARDIAC DISEASE. PALISADES MEDICAL CENTER (PMC) HAS ALWAYS BEEN RECOGNIZED FOR ITS STRONG TRADITION OF COMMUNITY SERVICE. PMC STAFF AND VOLUNTEERS WORK WITH COMMUNITY PARTNERS TO IMPROVE THE LIVES OF THOUSANDS OF LOCAL RESIDENTS BY OFFERING FREE HEALTH SCREENINGS AND EDUCATIONAL SEMINARS THROUGHOUT THE YEAR. PMC'S LONGSTANDING PARTNERSHIPS WITH SOCIAL AND CIVIC ORGANIZATIONS, RELIGIOUS CONGREGATIONS, SCHOOLS, AND LOCAL EMPLOYERS PLACE IT IN A UNIQUELY EFFECTIVE POSITION TO IDENTIFY AND ADDRESS THE HEALTHCARE NEEDS OF THE LOCAL COMMUNITIES IT SERVES. DURING THE PAST TWO YEARS, PMC WORKED WITH MANY OF ITS PARTNERS TO RELEASE PMC'S COMMUNITY HEALTH NEEDS ASSESSMENT. THIS COMPREHENSIVE REPORT IS THE RESULT OF A THOROUGH ASSESSMENT OF OUR AREA'S HEALTHCARE PROFILE, INCLUDING A REVIEW OF PUBLIC HEALTH DATA, SUMMARY PATIENT INFORMATION FROM CARE PROVIDERS, AND NEW DATA OBTAINED BY MEANS OF FOCUS GROUPS, PUBLIC FORUMS AND A COMMUNITY NEEDS ASSESSMENT SURVEY. THIS ASSESSMENT ALSO INCLUDES ACTION ITEMS AND PLANS TO ADDRESS THE PREVAILING HEALTHCARE CONCERNS IN PMC'S SERVICE AREA, INCLUDING NORTH BERGEN, UNION CITY, WEST NEW YORK, GUTTENBERG, WEEHAWKEN, CLIFFSIDE PARK, EDGEWATER, AND FAIRVIEW. THE TOP FIVE LOCAL HEALTH ISSUES IDENTIFIED AND ADDRESSED BY THE REPORT WERE: - ACCESS TO HEALTH CARE - ALCOHOL ABUSE - INADEQUATE SOCIAL SUPPORT - OBESITY - TOBACCO USE
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. PLEASE REFER TO THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT INCLUDED IN SCHEDULE O.
CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7	PALISADES HEALTHCARE SYSTEM, INC. ("SYSTEM") IS THE SOLE MEMBER OF THIS ORGANIZATION. SYSTEM HAS THE RIGHT TO ELECT THE MEMBERS OF THIS ORGANIZATION'S BOARD OF GOVERNORS AND HAS CERTAIN RESERVED POWERS AS DEFINED IN THIS ORGANIZATION'S BYLAWS.
CORE FORM, PART VI, SECTION B; QUESTION 11B	DURING 2015, THE ORGANIZATION WAS AN AFFILIATE WITHIN PALISADES HEALTHCARE SYSTEM, INC. AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). PALISADES HEALTHCARE SYSTEM, INC. WAS THE TAX-EXEMPT PARENT ENTITY OF THE SYSTEM. In September 2014, the System and HACKENSACK UNIVERSITY HEALTH NETWORK ("HackensackUHN"), A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM, signed a letter of intent to make HackensackUHN the parent company of the System. Effective March 1, 2016, after the completion of the required regulatory approvals, HackensackUHN became the parent company of the System. The System began doing business as HackensackUMC Palisades. IN MAY 2015, HackensackUHN SIGNED A DEFINITIVE AGREEMENT WITH MERIDIAN HEALTH SYSTEM, INC.; a tax-exempt integrated healthcare delivery system, TO MERGE BOTH PARENT ORGANIZATIONS; CREATING ONE INTEGRATED HEALTHCARE DELIVERY SYSTEM KNOWN AS HACKENSACK MERIDIAN HEALTH, INC. ("HMH"), TO BETTER MEET THE NEEDS OF MANY NEW JERSEY COMMUNITIES. THE MERGER BECAME EFFECTIVE UPON THE RECEIPT OF REGULATORY APPROVALS ON JULY 1, 2016. THIS FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF HMHS GOVERNING BODY, ITS BOARD OF TRUSTEES, PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE ("IRS") AND FOLLOWING A REVIEW BY HMH'S COMPLIANCE AND AUDIT COMMITTEE. HMH'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 THE ORGANIZATION HIRED A PROFESSIONAL CPA FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION TO PREPARE THE FEDERAL FORM 990. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE ORGANIZATION'S FINANCE PERSONNEL AND VARIOUS OTHER INDIVIDUALS OF THE ORGANIZATION AND THE SYSTEM ("INTERNAL WORKING GROUP") TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE ORGANIZATION'S INTERNAL WORKING GROUP FOR REVIEW. THE ORGANIZATION'S INTERNAL WORKING GROUP REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE ORGANIZATION'S INTERNAL WORKING GROUP FOR FINAL REVIEW. THEREAFTER, THE FORM 990 WAS REVIEWED BY HMH'S COMPLIANCE AND AUDIT COMMITTEE PRIOR TO PROVIDING IT TO EACH VOTING MEMBER OF HMHS BOARD OF TRUSTEES AND FILING WITH THE IRS.
CORE FORM, PART VI, SECTION B; QUESTION 12	THE ORGANIZATION IS AN AFFILIATE WITHIN PALISADES HEALTHCARE SYSTEM, INC. AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE ORGANIZATION AND THE SYSTEM REGULARLY MONITOR AND ENFORCE COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. ANNUALLY ALL MEMBERS OF THE BOARD OF TRUSTEES, OFFICERS AND SENIOR MANAGEMENT PERSONNEL ARE REQUIRED TO REVIEW THE EXISTING CONFLICT OF INTEREST POLICY AND COMPLETE A QUESTIONNAIRE. THE COMPLETED QUESTIONNAIRES ARE RETURNED TO THE ORGANIZATION'S AND SYSTEM'S CHIEF COMPLIANCE OFFICER FOR REVIEW. THEREAFTER, THE SYSTEM'S CHIEF COMPLIANCE OFFICER PREPARES A SUMMARY OF THE COMPLETED QUESTIONNAIRES WHICH CONTAINS INFORMATION DISCLOSED ON AN INDIVIDUAL BY INDIVIDUAL BASIS AND THEN PRESENTS THIS SUMMARY TO THE ORGANIZATION'S GOVERNANCE COMMITTEE FOR ITS REVIEW AND DISCUSSION.
CORE FORM, PART VI, SECTION B; QUESTION 15	THE ORGANIZATION'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 ORGANIZATION'S SENIOR MANAGEMENT, INCLUDING THE PRESIDENT/CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER. THE COMMITTEE REVIEWS THE "TOTAL COMPENSATION" OF THE INDIVIDUALS WHICH IS INTENDED TO INCLUDE BOTH CURRENT AND DEFERRED COMPENSATION AND ALL EMPLOYEE BENEFITS, BOTH QUALIFIED AND NON-QUALIFIED. THE COMMITTEE'S REVIEW IS DONE ON AT LEAST AN ANNUAL BASIS AND ENSURES THAT THE "TOTAL COMPENSATION" OF SENIOR MANAGEMENT OF THE ORGANIZATION IS REASONABLE. THE ACTIONS TAKEN BY THE COMMITTEE IN CONJUNCTION WITH THE BOARD OF GOVERNORS ENABLE THE ORGANIZATION TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 4958 WITH RESPECT TO THE TOTAL COMPENSATION OF CERTAIN MEMBERS OF THE SENIOR MANAGEMENT TEAM, INCLUDING THE PRESIDENT/CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER. THE THREE FACTORS WHICH MUST BE SATISFIED IN ORDER TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS ARE THE FOLLOWING: 1. THE COMPENSATION ARRANGEMENT IS APPROVED IN ADVANCE BY AN "AUTHORIZED BODY" OF THE APPLICABLE TAX-EXEMPT ORGANIZATION WHICH IS COMPOSED ENTIRELY OF INDIVIDUALS WHO DO NOT HAVE A "CONFLICT OF INTEREST" WITH RESPECT TO THE COMPENSATION ARRANGEMENT; 2. THE AUTHORIZED BODY OBTAINED AND RELIED UPON "APPROPRIATE DATA AS TO COMPARABILITY" PRIOR TO MAKING ITS DETERMINATION; AND 3. THE AUTHORIZED BODY "ADEQUATELY DOCUMENTED THE BASIS FOR ITS DETERMINATION" CONCURRENTLY WITH MAKING THAT DETERMINATION. THE COMPENSATION COMMITTEE IS COMPRISED ENTIRELY OF MEMBERS OF THE BOARD OF GOVERNORS EACH OF WHOM ARE INDEPENDENT AND ARE FREE FROM ANY CONFLICTS OF INTEREST. HOWEVER, THE ULTIMATE DECISION TO REVIEW AND APPROVE OF CERTAIN SENIOR MANAGEMENT EXECUTIVE COMPENSATION AND BENEFITS, INCLUDING THE PRESIDENT/CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER RESIDES WITH THE BOARD OF GOVERNORS. FOLLOWING THE COMPENSATION COMMITTEE REVIEW OF PERFORMANCE AND CERTAIN SENIOR MANAGEMENT COMPENSATION AND BENEFITS IT MAKES RECOMMENDATIONS TO THE BOARD OF GOVERNORS WHICH HAS FINAL AUTHORITY TO APPROVE, DISAPPROVE OR TO ADJUST THE RECOMMENDATIONS OF THE COMPENSATION COMMITTEE. IN ATTENDANCE AT EACH MEETING IS AN ATTORNEY ADVISOR. IN ADDITION, THE COMMITTEE USES THE SERVICES OF A COMPENSATION CONSULTANT. BOTH THE COMPENSATION CONSULTANT AND ATTORNEY ADVISOR ARE NOT MEMBERS OF THE BOARD OF GOVERNORS OR MEMBERS OF THE COMMITTEE. THE COMPENSATION COMMITTEE RELIED UPON APPROPRIATE COMPARABLE DATA; SPECIFICALLY THE COMMITTEE OBTAINED A WRITTEN COMPENSATION STUDY FROM AN INDEPENDENT FIRM WHICH SPECIALIZES IN THE REVIEWING OF HOSPITAL AND HEALTHCARE SYSTEM EXECUTIVE COMPENSATION AND BENEFITS THROUGHOUT THE UNITED STATES. THIS STUDY USED COMPARABLE GEOGRAPHIC AND DEMOGRAPHIC MARKET DATA INCLUDING BUT NOT LIMITED TO SIMILAR SIZED HOSPITALS, NUMBER OF LICENSED BEDS AND NET PATIENT SERVICE REVENUE. THE COMPENSATION COMMITTEE ADEQUATELY DOCUMENTED ITS BASIS FOR ITS DETERMINATION THROUGH THE TIMELY PREPARATION OF WRITTEN MINUTES OF THE COMPENSATION COMMITTEE MEETINGS DURING WHICH THE EXECUTIVE COMPENSATION AND BENEFITS WAS REVIEWED AND SUBSEQUENTLY APPROVED. THE ACTIONS OUTLINED ABOVE WITH RESPECT TO THE COMPENSATION COMMITTEE AND THE BOARD OF GOVERNORS AND THE ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS ONLY APPLIES TO CERTAIN SENIOR MANAGEMENT PERSONNEL, INCLUDING BUT NOT LIMITED TO THE PRESIDENT/CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER. THE COMPENSATION AND BENEFITS OF CERTAIN OTHER INDIVIDUALS CONTAINED IN THIS FORM 990, INCLUDING THE CHIEF OPERATING OFFICER, ARE REVIEWED ANNUALLY BY THE PRESIDENT/CHIEF EXECUTIVE OFFICER WITH ASSISTANCE FROM THE ORGANIZATION'S HUMAN RESOURCES DEPARTMENT IN CONJUNCTION WITH THE INDIVIDUAL'S JOB PERFORMANCE DURING THE YEAR AND IS BASED UPON OTHER OBJECTIVE FACTORS DESIGNED TO ENSURE THAT REASONABLE AND FAIR MARKET VALUE COMPENSATION IS PAID BY THE ORGANIZATION. OTHER OBJECTIVE FACTORS INCLUDE MARKET SURVEY DATA FOR COMPARABLE POSITIONS, INDIVIDUAL GOALS AND OBJECTIVES, PERSONNEL REVIEWS, EVALUATIONS, SELF-EVALUATIONS AND PERFORMANCE FEEDBACK MEETINGS.
CORE FORM, PART VI, SECTION C; QUESTION 19	THE ORGANIZATION HAS ISSUED TAX-EXEMPT BONDS TO FINANCE VARIOUS CAPITAL IMPROVEMENT PROJECTS, RENOVATIONS AND EQUIPMENT. IN CONJUNCTION WITH THE ISSUANCE OF THESE TAX-EXEMPT BONDS, THE ORGANIZATION'S FINANCIAL STATEMENTS WERE INCLUDED WITH THE TAX-EXEMPT BOND PROSPECTUS WHICH WAS MADE AVAILABLE TO THE GENERAL PUBLIC FOR REVIEW. IN ADDITION, THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE STATE OF NEW JERSEY DEPARTMENT OF THE TREASURY.
CORE FORM, PART VII AND SCHEDULE J	PART VII AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM THIS ORGANIZATION. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OF THIS ORGANIZATION AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THIS ORGANIZATION'S BOARD OF GOVERNORS. SURESH RAINA, M.D. WAS EMPLOYED AS THE CHIEF MEDICAL OFFICER OF PALISADES MEDICAL CENTER FOR THE PERIOD JANUARY THROUGH APRIL OF 2015. DURING THE REMAINDER OF 2015 HE WAS EMPLOYED BY THE ORGANIZATION AS THE DIRECTOR OF THE ORGANIZATION'S RESIDENCY PROGRAM. THE COMPENSATION REPORTED IN CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 REPRESENTS DR. RAINA'S COMPENSATION FOR THE CALENDAR YEAR ENDED DECEMBER 31, 2015.
CORE FORM, PART VII, SECTION A, COLUMN B	THIS ORGANIZATION IS AN AFFILIATE WITHIN PALISADES HEALTHCARE SYSTEM; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM INCLUDES BOTH FOR-PROFIT AND NOT FOR-PROFIT ORGANIZATIONS. CERTAIN BOARD OF TRUSTEE MEMBERS, OFFICERS AND/OR DIRECTORS LISTED ON CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 MAY HOLD SIMILAR POSITIONS WITH BOTH THIS ORGANIZATION AND OTHER AFFILIATES WITHIN THE SYSTEM. THE HOURS SHOWN ON THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE NO COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, REPRESENT THE ESTIMATED HOURS DEVOTED PER WEEK FOR THIS ORGANIZATION. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF TRUSTEES OF OTHER RELATED ORGANIZATIONS IN THE SYSTEM, THEIR RESPECTIVE HOURS PER WEEK PER ORGANIZATION ARE APPROXIMATELY THE SAME AS REFLECTED ON PART VII OF THIS FORM 990. THE HOURS REFLECTED ON PART VII OF THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, PAID OFFICERS AND KEY EMPLOYEES, REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF PALISADES HEALTHCARE SYSTEM; NOT SOLELY THIS ORGANIZATION.
CORE FORM, PART XI; QUESTION 9	OTHER CHANGES IN NET ASSETS OR FUND BALANCES INCLUDE: - CHANGE IN PENSION BENEFIT LIABILITY TO BE RECOGNIZED IN FUTURE PERIODS: ($36,000); AND - AFFILIATION RELATED COSTS: ($1,772,000).
CORE FORM, PART IV; QUESTION 12 AND PART XII; QUESTION 2	THE ORGANIZATION IS AN AFFILIATE WITHIN THE PALISADES HEALTHCARE SYSTEM, INC., A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF PALISADES HEALTHCARE SYSTEM, INC. AND ITS AFFILIATES FOR THE YEARS ENDED DECEMBER 31, 2015 AND DECEMBER 31, 2014; RESPECTIVELY. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAIN COMBINING SCHEDULES ON AN ENTITY BY ENTITY BASIS. THE INDEPENDENT CPA FIRM ISSUED AN UNQUALIFIED OPINION WITH RESPECT TO THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS FOR THE YEARS ENDED DECEMBER 31, 2015 AND DECEMBER 31, 2014; RESPECTIVELY. THE PALISADES MEDICAL CENTER AUDIT AND COMPLIANCE COMMITTEE HAS ASSUMED RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE CONSOLIDATED FINANCIAL STATEMENTS, WHICH INCLUDES THIS ORGANIZATION, AND THE SELECTION OF AN INDEPENDENT AUDITOR.
CORE FORM, PART XII; QUESTION 3	THE ORGANIZATION ENGAGED AN INDEPENDENT ACCOUNTING FIRM TO PREPARE AND ISSUE A CONSOLIDATED AUDIT UNDER THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133 AUDIT.
FORM 990 PART IX LINE 11G	DESCRIPTION:COLLECTION AGENCY TOTAL FEES:381139
FORM 990 PART IX LINE 11G	DESCRIPTION:CONSULTING FEES TOTAL FEES:375539
FORM 990 PART IX LINE 11G	DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:16887450

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

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO ENHANCE THE HEALTH STATUS OF THE DIVERSE COMMUNITIES SERVED AND TO DELIVER PATIENT CARE IN A SAFE AND NURTURING ENVIRONMENT.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	16
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	13
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	1,513
6	Total number of volunteers (estimate if necessary) .............	6	156
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	841,882	1,939,743
9	Program service revenue (Part VIII, line 2g) .........	150,128,607	160,690,039
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,519,438	1,049,951
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	1,147,055	1,106,266
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	153,636,982	164,785,999
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	89,157,234	94,432,185
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	58,377,762	60,284,888
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	147,534,996	154,717,073
19	Revenue less expenses. Subtract line 18 from line 12.......	6,101,986	10,068,926
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	115,647,931	127,202,000
21	Total liabilities (Part X, line 26).............	144,016,491	147,950,634
22	Net assets or fund balances. Subtract line 21 from line 20.....	-28,368,560	-20,748,634

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 14,670,283 including grants of $ 0 ) (Revenue $ 14,319,000 )
	EXPENSES INCURRED IN PROVIDING MEDICALLY NECESSARY OPERATING ROOM SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT.

4b	(Code: ) (Expenses $ 13,114,908 including grants of $ 0 ) (Revenue $ 13,015,000 )
	EXPENSES INCURRED IN PROVIDING MEDICALLY NECESSARY EMERGENCY DEPARTMENT SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT.

4c	(Code: ) (Expenses $ 12,375,940 including grants of $ 0 ) (Revenue $ 12,276,000 )
	EXPENSES INCURRED IN PROVIDING MEDICALLY NECESSARY PHARMACY SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 99,084,235 including grants of $ 0 ) (Revenue $ 121,080,039 )
4e	Total program service expenses139,245,366

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	6,044,814	0	760,148

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	1,939,743

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a-1f:$
h Total.Add lines 1a-1f.......		1,939,743

			Business Code
2a	NET PATIENT SERVICE REVENUE	541900	158,900,902	158,900,902
b	PHYSICIAN BILLINGS AND OTHER HEALTHCARE
c	RELATED REVENUE	541900	1,789,137	1,789,137
d
e
f	All other program service revenue.
g Total.Add lines 2a–2f.....			160,690,039

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			810,548			810,548
4 Income from investment of tax-exempt bond proceeds			19,179			19,179
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents		779,804
b	Less: rental expenses
c	Rental income or (loss)	0	779,804
d	Net rental income or (loss)......			779,804			779,804
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		220,224
b	Less: cost or other basis and sales expenses
c	Gain or (loss)		220,224
d	Net gain or (loss).....			220,224			220,224
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..			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..			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..			0
Business Code			Miscellaneous Revenue
11a	PARKING REVENUE		812930	173,805			173,805
b	PHARMACY		900099	87,869			87,869
c	TELEVISION		515100	64,788			64,788
d	All other revenue ....
e	Total. Add lines 11a–11d ......			326,462
12	Total revenue. See Instructions......			164,785,999	160,690,039		2,156,217

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	0
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 ....	5,253,576	4,728,218	525,358	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	67,466,083	60,719,475	6,746,608
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	7,831,611	7,048,450	783,161
9	Other employee benefits .......	8,501,989	7,651,790	850,199
10	Payroll taxes ...........	5,378,926	4,841,033	537,893
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	1,830,450	1,647,405	183,045
c	Accounting ...........	135,400	121,860	13,540
d	Lobbying ...........	76,013	68,412	7,601
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	17,644,128	15,879,715	1,764,413
12	Advertising and promotion ....	922,322	830,090	92,232
13	Office expenses .......	2,520,592	2,268,533	252,059
14	Information technology ......	433,113	389,802	43,311
15	Royalties ..	0
16	Occupancy ...........	3,212,414	2,891,173	321,241
17	Travel ............	734,150	660,735	73,415
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	385,701	347,131	38,570
20	Interest ...........	1,716,221	1,544,599	171,622
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	7,231,048	6,507,943	723,105
23	Insurance ...	2,081,708	1,873,537	208,171
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	14,994,273	13,494,846	1,499,427
b	REPAIRS AND MAINTENANCE	3,069,150	2,762,235	306,915
c	DATA PROCESSING	1,368,007	1,231,206	136,801
d	DUES AND SUBSCRIPTIONS	812,241	731,017	81,224
e	All other expenses	1,117,957	1,006,161	111,796
25	Total functional expenses. Add lines 1 through 24e	154,717,073	139,245,366	15,471,707	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 if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			0	1	0
2	Savings and temporary cash investments .........			7,120,341	2	9,346,791
3	Pledges and grants receivable, net ......			188,062	3	189,873
4	Accounts receivable, net .............			17,171,420	4	19,922,319
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 ........			2,254,051	8	2,250,061
9	Prepaid expenses and deferred charges ......			705,999	9	935,734
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	161,991,155
b	Less: accumulated depreciation	10b	119,223,768	37,842,202	10c	42,767,387
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 ..			38,338,906	13	32,185,458
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			12,026,950	15	19,604,377
16	Total assets. Add lines 1 through 15 (must equal line 34)...			115,647,931	16	127,202,000

17	Accounts payable and accrued expenses .....	21,891,882	17	25,843,527
18	Grants payable ...	0	18	0
19	Deferred revenue .........	0	19	0
20	Tax-exempt bond liabilities .........	37,337,964	20	36,278,016
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 ..	1,203,894	23	1,441,900
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	83,582,751	25	84,387,191
26	Total liabilities. Add lines 17 through 25..	144,016,491	26	147,950,634

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	-28,463,058	27	-20,843,132
28	Temporarily restricted net assets ...........	0	28	0
29	Permanently restricted net assets	94,498	29	94,498
	Organizations that do not follow SFAS 117 (ASC 958), check here 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 ...........	-28,368,560	33	-20,748,634
34	Total liabilities and net assets/fund balances ........	115,647,931	34	127,202,000

(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?
(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	Yes	No
(1)PALISADES GENERAL CARE INC 7600 RIVER ROAD NORTH BERGEN,NJ07047 22-2587492	HLTHCARE SVCS	NJ	501(C)(3)	509(A)(2)	PHS		No
(2)PALISADES HEALTHCARE SYSTEM INC 7600 RIVER ROAD NORTH BERGEN,NJ07047 22-2587494	SUPPORT PMC	NJ	501(C)(3)	509(A)(3)	NA		No
(3)PALISADES MEDICAL CENTER FOUNDATION 7600 RIVER ROAD NORTH BERGEN,NJ07047 22-3693169	SUPPORT PHS	NJ	501(C)(3)	509(A)(1)	PHS		No
(4)PALISADES MEDICAL ASSOCIATES LLC 7600 RIVER ROAD NORTH BERGEN,NJ07047 22-3814193	SUPPORT PMC	NJ	501(C)(3)	509(A)(2)	PHS		No

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(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?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(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?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No