Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 10,624,723 | 12,367,711 | 6,759,725 | 10,511,588 | 17,035,665 | 57,299,412 |
| 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 | 10,624,723 | 12,367,711 | 6,759,725 | 10,511,588 | 17,035,665 | 57,299,412 |
| 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).. | 11,269,048 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 46,030,364 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 10,624,723 | 12,367,711 | 6,759,725 | 10,511,588 | 17,035,665 | 57,299,412 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 1,113,762 | 1,588,352 | 1,644,693 | 1,689,779 | 1,196,638 | 7,233,224 |
| 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 | 64,577,546 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (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.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (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.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 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) |
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| 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 | ||||
| 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 2019 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-2019 |
(iii) Distributable Amount for 2019 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2019 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2019: | ||||
| a From 2014....... | ||||
| b From 2015....... | ||||
| c From 2016....... | ||||
| d From 2017....... | ||||
| e From 2018....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2019 distributable amount | ||||
|
i
Carryover from 2014 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2019 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2019 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2020. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2015..... | ||||
| b Excess from 2016..... | ||||
| c Excess from 2017..... | ||||
| d Excess from 2018..... | ||||
| e Excess from 2019..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| SCHEDULE A, PART VI, LIST OF UNUSUAL GRANTS: | DESCRIPTION: CASH AMOUNT: 0. |
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART III, LINE 1 | THE VALLEY HOSPITAL FOUNDATION IS THE PHILANTHROPIC COMPONENT OF VALLEY HEALTH SYSTEM. IT IS A NONPROFIT, TAX-EXEMPT, MULTI-PURPOSE FOUNDATION. THE FOUNDATION'S PRIMARY FUNCTION IS TO SECURE CHARITABLE CONTRIBUTIONS FROM INDIVIDUALS, CORPORATIONS, FOUNDATIONS, AND OTHER FUNDING ENTITIES, TO MANAGE THOSE GIFTS, AND TO DISTRIBUTE THEM IN ACCORDANCE WITH ITS CHARTER. CHARITABLE FUNDS RAISED BY THE FOUNDATION ARE USED BY THE HOSPITAL TO SUPPORT THE CONSTRUCTION OF THE VALLEY HOSPITAL IN PARAMUS, ADDITIONAL CAPITAL IMPROVEMENTS, MEDICAL TECHNOLOGY, ETC. VALLEY HEALTH SYSTEM IS THE SOLE MEMBER OF THE CORPORATION. CHARITABLE FUNDS RAISED BY THE FOUNDATION ARE USED BY THE HOSPITAL TO SUPPORT CAPITAL IMPROVEMENTS, MEDICAL TECHNOLOGY, BIOMEDICAL RESEARCH, EDUCATION, ENDOWMENTS, AND SPECIAL PROJECTS. FUNDS RAISED FOR VALLEY HOME CARE SUPPORT THE PROGRAMS OF THE AGENCY, SUCH AS HOSPICE, JOURNEYS, BUTTERFLIES, MATERNAL CHILD HEALTH AND ENDOWMENTS. FUNDS RAISED FOR VALLEY MEDICAL GROUP SUPPORT THEIR PROGRAMS, CAPITAL IMPROVEMENTS, MEDICAL TECHNOLOGY, EDUCATION AND SPECIAL PROJECTS. |
| FORM 990, PART VI, SECTION A, LINE 4 | THE BYLAWS WERE AMENDED AND ADOPTED ON JUNE 10, 2019. THE CHANGES TO THE BYLAWS ARE AS FOLLOWS: 1. ARTICLE II, SECTION I, NOW DEFINES VALLEY HEALTH SYSTEM, INC. AS THE SOLE MEMBER. 2. ARTICLE III, SECTION I A, REMOVES THE REQUIREMENT THAT ALL TRUSTEES BE MEMBERS OF THE VALLEY HOSPITAL, AS MEMBERSHIP CLASS FOR THE HOSPITAL WAS DELETED YEARS AGO. 3. ARTICLE III, SECTION 12, CONFORMS THE AUTHORITY OF THE SOLE MEMBER (VALLEY HEALTH SYSTEM), TO BE THE SAME AS THE AUTHORITY IT EXERTS OVER THE HOSPITAL AND VALLEY MEDICAL GROUP. MANY OF THESE PROVISIONS REMAIN THE SAME IN CONTENT; OTHER PROVISIONS WERE INCLUDED IN ANTICIPATION OF THE NEW JERSEY HEALTH CARE FACILITIES FINANCING AUTHORITIES REQUIREMENTS UNDER THE BOND FINANCING FOR THE NEW HOSPITAL. 4. ARTICLE V, SECTION 4, DELETES REFERENCE TO THE INVESTMENT COMMITTEE AS THERE WILL NOW BE ONE COMMITTEE THAT SERVES THE SYSTEM AS A WHOLE. NOTE THAT THERE IS A DESIGNATED SEAT ON THIS NEWLY CONSTITUTED COMMITTEE FOR A MEMBER OF THE FOUNDATION BOARD. |
| FORM 990, PART VI, SECTION A, LINE 6 | VALLEY HEALTH SYSTEM IS THE SOLE MEMBER OF THE CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | VALLEY HEALTH SYSTEM IS THE SOLE MEMBER OF THE VALLEY HOSPITAL FOUNDATION, AND THEREFORE HAS THE ABILITY TO ELECT OR APPOINT A MEMBER OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION A, LINE 7B | ANY OF THE FOLLOWING ACTIONS BY THE VALLEY HOSPITAL FOUNDATION SHALL REQUIRE THE APPROVAL OF VALLEY HEALTH SYSTEM: A) ORGANIZING, ACQUIRING OR AUTHORIZING THE ORGANIZATION OF, ANY SUBSIDIARY OR AFFILIATE OF THE FOUNDATION B) MAKING ANY DONATIONS, CONTRIBUTIONS, GRANTS OR LOANS TO ANY PERSON OR ENTITY OTHER THAN THE HOSPITAL OR THE PARENT IN EXCESS OF TWENTY FIVE THOUSAND DOLLARS IN ANY FISCAL YEAR OR TO ALL SUCH PERSONS AND ENTITIES IN THE AGGREGATE, IN EXCESS OF ONE HUNDRED THOUSAND DOLLARS IN ANY FISCAL YEAR C) ADOPTION OF A PLAN OF DISSOLUTION OF THE FOUNDATION D) ANY TRANSACTION, OTHER THAN IN ORDINARY AND REGULAR COURSE OF BUSINESS, PROVIDING FOR THE SALE, TRANSFER, MORTGAGE OR OTHER DISPOSITION OR ENCUMBRANCE OF ANY ASSETS OF THE FOUNDATION HAVING AN AGGREGATE VALUE IN EXCESS OF ONE HUNDRED THOUSAND DOLLARS IN ANY FISCAL YEARS E) ADOPTION OF A PLAN OF MERGER OR CONSOLIDATION OF THE FOUNDATION WITH ANOTHER CORPORATION F) SELECTION OF INDEPENDENT AUDITORS G) ANY CHANGE IN THE MANNER AND PROCEDURE FOR NOMINATION AND ELECTIONS OF TRUSTEES OF THE FOUNDATION H) AMENDMENT OF THE CERTIFICATE OF INCORPORATION I) AMENDMENT OF THE BYLAWS OF THE FOUNDATION WITH RESPECT TO ANY OF THE SUBJECT MATTERS OF THE ARTICLE III, SECTION 11. |
| FORM 990, PART VI, SECTION B, LINE 11B | A COPY OF FORM 990 IS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY'S EXECUTIVE COMMITTEE BEFORE IT IS FILED. WHEN THE FORM 990 HAS BEEN PREPARED, REVIEWED BY MANAGEMENT AND IS READY TO BE FILED WITH THE INTERNAL REVENUE SERVICE, THE COMMITTEE REVIEWS THE 990 AND PROVIDES ANY COMMENTS. THE COMMENTS ARE REVIEWED AND ADDRESSED UNTIL THE RETURN IS FINALIZED AND APPROVED FOR FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD MANDATES THAT ALL MEMBERS OF MANAGEMENT AND THE GOVERNING BODY SIGN A CONFLICT OF INTEREST POLICY AND DISCLOSE ANY POTENTIAL OR ACTUAL CONFLICTS THAT MAY EXIST ANNUALLY. GENERAL COUNSEL REVIEWS THE ANNUAL DISCLOSURE TO DETERMINE WHETHER A CONFLICT EXISTS. IF A CONFLICT OF INTEREST EXISTS THE ORGANIZATION WILL NOTIFY MEMBERS OF MANAGEMENT OR THE GOVERNING BODY AND INVESTIGATE THE CONFLICT. IF IT IS DETERMINED THAT AN ACTUAL CONFLICT OF INTEREST EXISTS, THE MEMBER OF MANAGEMENT OR THE GOVERNING BODY WILL BE NOTIFIED IMMEDIATELY AND WILL NOT BE ALLOWED TO VOTE OR BE PART OF ANY DECISIONS ABOUT SUCH TRANSACTIONS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS FORM 990 AVAILABLE FOR PUBLIC INSPECTION AS REQUIRED UNDER SECTION 6104 OF THE INTERNAL REVENUE CODE. THE RETURN IS POSTED ON NEW YORK STATE ATTORNEY GENERAL WEBSITE, GUIDESTAR.ORG AND OTHER SIMILAR TYPES OF WEBSITES. IN ADDITION, THE FINANCIAL STATEMENTS, FORM 1023, CONFLICT OF INTEREST POLICY AND OTHER GOVERNING DOCUMENTS ARE AVAILABLE UPON WRITTEN REQUEST AT 223 NORTH VAN DIEN AVE, RIDGEWOOD, NJ 07450 OR BY CALLING THE ORGANIZATION DIRECTLY AT 201-447-8000. |
| FORM 990, PART VII | DAVID BOHAN, BETTINA DALY, AND ALEXANDRA CARAPEZZA WORK FULL-TIME FOR VALLEY HOSPITAL FOUNDATION, INC. BUT ARE COMPENSATED THROUGH THE VALLEY HOSPITAL. |
| FORM 990, PART XI, LINE 9: | WRITE-DOWN OF PLEDGES -2,157. |
| FORM 990, PART XI, LINE 2C | THE EXECUTIVE COMMITTEE IS RESPONSIBLE FOR SELECTING AN INDEPENDENT ACCOUNTANT AND FOR OVERSIGNT OF THE AUDIT. |
| Software ID: | |
| Software Version: |