Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | MEMBERS CONSIST OF NEW JERSEY HOSPITALS. |
| FORM 990, PART VI, SECTION A, LINE 7A | TRUSTEES ARE ELECTED BY MEMBER HOSPITALS. |
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 IS REVIEWED BY THE AUDIT AND COMPLIANCE COMMITTEE AND MADE AVAILABLE TO ALL MEMBERS OF THE GOVERNING BOARD VIA SECURE WEBLINK BEFORE IT IS FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | IN ACCORDANCE WITH THE NJHA "CODE OF CONDUCT", ALL EMPLOYEES ARE REQUIRED TO REPORT ANY "CONFLICTS OF INTEREST" (WHICH INCLUDE FAMILY OR BUSINESS RELATIONSHIPS WITH OTHER NJHA EMPLOYEES) TO THE NJHA COMPLIANCE OFFICER AND THEIR SUPERVISOR. THIS IS DONE ON A "SELF DISCLOSURE INCIDENT REPORTING FORM". ALL EMPLOYEES ARE REQUIRED TO ACKNOWLEDGE THEIR UNDERSTANDING OF THIS POLICY, IN WRITING, ON AN ANNUAL BASIS AS PART OF THEIR ANNUAL REVIEW PROCESS. ALL EMPLOYEES MUST ALSO ATTEND A MANDATORY "COMPLIANCE TRAINING" SESSION ANNUALLY. ADDITIONALLY, TRUSTEES MUST ALSO COMPLETE A "CONFLICT OF INTEREST" FORM ANNUALLY, DISCLOSING ANY CONFLICTS. NJHA ALSO USES A "1-800" HOTLINE FOR CODE OF CONDUCT VIOLATIONS. |
| FORM 990, PART VI, SECTION B, LINE 15 | OUTSIDE COMPENSATION CONSULTANTS ROUTINELY REVIEW TOTAL COMPENSATION FOR THE CEO, CFO AND OTHER SENIOR MANAGEMENT PERSONNEL WITH THE EXECUTIVE COMPENSATION COMMITTE. OTHER MEMBERS OF UPPER MANAGEMENT ARE PERIODICALLY REVIEWED AND ASSESSED USING DATA OBTAINED VIA PUBLISHED SURVEYS, WRITTEN EMPLOYMENT CONTRACTS AND OTHER EXTERNAL MARKET DATA, INTERNAL EQUITY CONCERNS AND RELATIVE PERFORMANCE. |
| FORM 990, PART VI, SECTION C, LINE 18 | A SIGNED COPY OF THE FORM 990 AND SUPPLEMENTAL SCHEDULES WILL BE PROVIDED TO GUIDESTAR FOR POSTING ON THEIR WEBSITE SO IT IS AVAILABLE FOR PUBLIC INSPECTION. |
| FORM 990, PART VI, SECTION C, LINE 19 | NJHA'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. NJHA'S CERTIFICATE OF INCORPORATION IS AVAILABLE THROUGH THE SECRETARY OF STATE'S OFFICE. |
| FORM 990, PART XI, LINE 9: | MINIMUM PENSION LIABILITY ADJUSTMENT 432,289. EQUITY EARNINGS OF SUBSIDIARY 1,929,221. OTHER PENSION INCOME 47,634. |
| FORM 990, PART XII, LINE 2C | NO CHANGE FROM PRIOR YEAR. |
| FORM 990, PART VIII, LINE 12, COLUMN B, RELATED OR EXEMPT FUNCTION REVENUE: | TOTAL PROGRAM REVENUE FORM 990 PART III $1,377,732 GRANT REVENUE FORM 990 PART VIII, LINE 1F (317,659) INDIRECT EXPENSES 26,690 TOTAL TO FORM 990, PART VIII, LINE 12, COLUMN B $1,086,763 |
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