Form990
Click to see attachment
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
A For the 2019 calendar year, or tax year beginning 01-01-2019 , and ending 12-31-2019
BCheck if applicable:
CName of organization
INSPIRA MEDICAL CENTER WOODBURY INC
 
% THOMAS P BALDOSARO CPA
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
509 NORTH BROAD STREET
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
WOODBURY, NJ08096
D Employer identification number

22-1820210
E Telephone number

G Gross receipts $ 243,729,969
F Name and address of principal officer:
JOHN A DIANGELO
165 BRIDGETON PIKE
MULLICA HILL,NJ08062
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.INSPIRAHEALTHNETWORK.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1966
M State of legal domicile: NJ
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: THE MISSION OF INSPIRA MEDICAL CENTER WOODBURY, INC. IS TO PROVIDE QUALITY HEALTHCARE SERVICES THAT IMPROVE THE LIVES OF ALL WE SERVE.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 13
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 12
5 Total number of individuals employed in calendar year 2019 (Part V, line 2a) ...... 5 0
6 Total number of volunteers (estimate if necessary) ............. 6 91
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 39 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 855,741 3,943,958
9 Program service revenue (Part VIII, line 2g) ......... 225,761,864 234,018,711
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 5,861,310 3,409,292
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 948,009 1,158,590
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 233,426,924 242,530,551
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 93,193 92,796
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) 0 0
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 203,822,905 215,061,649
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 203,916,098 215,154,445
19 Revenue less expenses. Subtract line 18 from line 12....... 29,510,826 27,376,106
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 687,710,047 0
21 Total liabilities (Part X, line 26)............. 477,331,839 0
22 Net assets or fund balances. Subtract line 21 from line 20..... 210,378,208 0
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
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Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2019)
Form 990 (2019)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: PRIOR TO ITS STATUTORY MERGER ON DECEMBER 13, 2019, THE MISSION OF INSPIRA MEDICAL CENTER WOODBURY, INC. WAS TO PROVIDE QUALITY HEALTHCARE SERVICES THAT IMPROVED THE LIVES OF ALL IT SERVED. PLEASE REFER TO THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT INCLUDED IN SCHEDULE O.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 193,648,281 including grants of $ 92,796 ) (Revenue $ 234,784,472 )
EXPENSES INCURRED IN PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY MEDICALLY NECESSARY 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 (STATEMENT OF PROGRAM SERVICES) WHICH INCLUDES DETAILED INFORMATION REGARDING THE VARIOUS SERVICES PROVIDED BY THIS ORGANIZATION.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet193,648,281
Form 990 (2019)
Form 990 (2019)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment.........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D,
Part IIIClick to see attachment..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D,
Part VI. Click to see attachment...................
11a
 
No
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
 
No
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII
Click to see attachment......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I(see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
Yes
 
Form 990 (2019)
Form 990 (2019)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
22
Yes
 
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I ....
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part II...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part III.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in lines 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part IClick to see attachment
31
Yes
 
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................Click to see attachment
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ..
1a
170
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2019)
Form 990 (2019)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
0
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
 
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see instructions and file Form 4720, Schedule N.
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
Form 990 (2019)
Form 990 (2019)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
13
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
12
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
Yes
 
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
NJ
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletTHOMAS P BALDOSARO CPA165 BRIDGETON PIKE   MULLICA HILL,NJ08062 (856) 641-6605
Form 990 (2019)
Form 990 (2019)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

See instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W-2/1099-MISC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) JOHN A DIANGELO......................................................................
TRUSTEE; PRESIDENT/CEO - IHN
55.0
.................
0.0
X   X       0 1,872,686 268,519
(2) ROBERT E FLORENTINE......................................................................
SVP/CHIEF PEOPLE OFFICER
55.0
.................
0.0
      X     0 804,432 62,665
(3) MARVIN T WAY......................................................................
EVP OPERATIONS
55.0
.................
0.0
    X       0 649,717 152,067
(4) ALKA KOHLI MD MBA......................................................................
EVP/CHIEF POP HEALTH OFFICER
55.0
.................
0.0
      X     0 607,330 134,433
(5) KURT W KAULBACK MD......................................................................
TRUSTEE (TERMED 04/2019)
55.0
.................
0.0
X           0 708,765 21,867
(6) THOMAS P BALDOSARO C......................................................................
EVP/CHIEF FINANCIAL OFFICER
55.0
.................
0.0
    X       0 543,113 127,795
(7) THOMAS PACEK......................................................................
VP/CHIEF INFORMATION OFFICER
55.0
.................
0.0
      X     0 390,295 81,525
(8) SCOTT WAGNER MD MB......................................................................
CHIEF MEDICAL OFFICER
55.0
.................
0.0
      X     0 393,087 77,028
(9) MATTHEW DOONAN ESQ......................................................................
GENERAL COUNSEL
55.0
.................
0.0
      X     0 388,254 80,035
(10) PATRICK NOLAN......................................................................
CHIEF OPERATING OFFICER
55.0
.................
0.0
      X     0 320,763 66,770
(11) EILEEN CARDILE......................................................................
FORMER OFFICER
0.0
.................
0.0
          X 0 364,907 0
(12) JOHN W GRAHAM......................................................................
FORMER OFFICER
0.0
.................
0.0
          X 0 279,872 0
(13) JACK M SHIELDS MD......................................................................
TRUSTEE (TERMED 04/2019)
2.0
.................
0.0
X           0 25,140 0
(14) JOHN B CATALANO MD......................................................................
TRUSTEE (TERMED 04/2019)
1.0
.................
0.0
X           0 4,900 0
(15) EDGAR G GALLOWAY III......................................................................
CHAIRMAN - TRUSTEE
1.0
.................
0.0
X   X       0 0 0
(16) BENJAMIN T GRIFFITH......................................................................
VICE CHAIRMAN - TRUSTEE
1.0
.................
0.0
X   X       0 0 0
(17) EDWARD BETHEA......................................................................
SECRETARY/TREASURER - TRUSTEE
1.0
.................
0.0
X   X       0 0 0
Form 990 (2019)
Form 990 (2019)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W-2/1099-MISC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) LAWRENCE M DIVIETRO........................................................................
TRUSTEE
1.0
.......................0.0
X           0 0 0
(19) MATTHEW FISHER MD........................................................................
TRUSTEE
1.0
.......................0.0
X           0 0 0
(20) ROBERTA S FREITAG........................................................................
TRUSTEE
1.0
.......................0.0
X           0 0 0
(21) JAMES E GEORGE MD........................................................................
TRUSTEE
1.0
.......................0.0
X           0 0 0
(22) LAWRENCE A PEPPER JR........................................................................
TRUSTEE
1.0
.......................0.0
X           0 0 0
(23) JORGE A PRIETO MD........................................................................
TRUSTEE
1.0
.......................0.0
X           0 0 0
(24) PAUL J RITTER III........................................................................
TRUSTEE
1.0
.......................0.0
X           0 0 0
(25) ALBERT A RUNDIO JR........................................................................
TRUSTEE
1.0
.......................0.0
X           0 0 0
(26) KIMBERLY E WOOD........................................................................
TRUSTEE
1.0
.......................0.0
X           0 0 0
(27) JAMES M BONNER DO........................................................................
TRUSTEE (TERMED 04/2019)
1.0
.......................0.0
X           0 0 0






1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 0 7,353,261 1,072,704
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet0
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
SKANSKA USA BUILDING INC,
518 EAST TOWNSHIP ROAD SUITE 200
BLUE BELL,PA19422
CONSTRUCTION 67,089,156
PHILIPS HEALTHCARE,
PO BOX 100355
ATLANTA,GA303840355
IT 12,319,271
CERNER CORPORATION,
51 VALLEY STRRAM PARKWAY
MALVERN,PA19355
IT 3,520,931
COOPER UNIVERSITY PHYSICIANS,
1 FEDERAL ST SUITE NW-400A
CAMDEN,NJ08103
MEDICAL 2,993,103
SOUTH JERSEY ANESTHESIA,
509 NORTH BROAD STREET
WOODBURY,NJ08096
MEDICAL 2,397,578
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet73
Form 990 (2019)
Form 990 (2019)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 3,793,990
e Government grants (contributions)1e 149,968
f All other contributions, gifts, grants, and similar amounts not included above1f  
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet 3,943,958
 Program Service RevenueAmt Business Code
2a NET PATIENT SERVICE REVENUE 541900 230,129,490 230,129,490    
b OTHER HEALTHCARE RELATED REVENUE 541990 3,867,729 3,867,729    
c RENTAL INCOME FROM TAX-EXEMPT AFFILIATES 531190 21,492 21,492    
d
e
f All other program service revenue.        
g Total. Add lines 2a–2f .....MediumBullet 234,018,711
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 3,531,884     3,531,884
4 Income from investment of tax-exempt bond proceedsMediumBullet 64,394     64,394
5 Royalties...........MediumBullet 0      
(ii) Personal (i) Real
6a Gross rents   1,405,261 6a
b Less: rental expenses   1,012,432 6b
c Rental income or (loss) 0 392,829 6c
d Net rental income or (loss).......MediumBullet 392,829     392,829
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory     7a
b Less: cost or other basis and sales expenses   186,986 7b
c Gain or (loss)   -186,986 7c
d Net gain or (loss).........MediumBullet -186,986     -186,986
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a 0
b Less: direct expenses ... 8b 0
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a 0
b Less: direct expenses ... 9b 0
c Net income or (loss) from gaming activities..MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances ..
10a 0
b Less: cost of goods sold .. 10b 0
c Net income or (loss) from sales of inventory..MediumBullet 0      
Business Code Miscellaneous Revenue
11a CAFETERIA INCOME 722514 596,715 596,715    
b PARKING INCOME 812930 169,046 169,046    
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 765,761
12 Total revenue. See instructions.....MediumBullet 242,530,551 234,784,472   3,802,121
Form 990 (2019)
Form 990 (2019)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 35,500 35,500
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ........... 57,296 57,296
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. 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 ........... 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........ 0      
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 0      
9 Other employee benefits ....... 0      
10 Payroll taxes ........... 0      
11 Fees for services (non-employees):        
a Management ...... 336,769 303,092 33,677 0
b Legal ......... 309,231 278,308 30,923  
c Accounting ........... 0      
d Lobbying ........... 49,500 44,550 4,950  
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 325,399 292,859 32,540  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 10,911,961 9,820,765 1,091,196  
12 Advertising and promotion .... 3,401 3,061 340  
13 Office expenses ....... 3,076,995 2,769,296 307,699  
14 Information technology ...... 86,489 77,840 8,649  
15 Royalties .. 0      
16 Occupancy ........... 5,015,874 4,514,287 501,587  
17 Travel ............ 248,121 223,309 24,812  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials . 0      
19 Conferences, conventions, and meetings .... 12,742 11,468 1,274  
20 Interest ........... 1,515,651 1,364,086 151,565  
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization .. 16,502,583 14,852,325 1,650,258  
23 Insurance ... 251,577 226,419 25,158  
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 ALLOCATION OF PERSONNEL COSTS 125,531,594 112,978,434 12,553,160  
b MEDICAL SUPPLIES 19,893,389 17,904,050 1,989,339  
c ALLOCATED CORPORATE SERVICES 14,039,207 12,635,286 1,403,921  
d OUTSIDE SERVICES 13,012,174 11,710,957 1,301,217  
e All other expenses 3,938,992 3,545,093 393,899  
25 Total functional expenses. Add lines 1 through 24e 215,154,445 193,648,281 21,506,164 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2019)
Form 990 (2019)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 5,829 1 0
2 Savings and temporary cash investments ......... 10,960,354 2 0
3 Pledges and grants receivable, net ...... 118,301 3 0
4 Accounts receivable, net ............. 20,942,963 4 0
5 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
0 6 0
7 Notes and loans receivable, net ........... 0 7 0
8 Inventories for sale or use ............ 1,236,908 8 0
9 Prepaid expenses and deferred charges ...... 4,538,554 9 0
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 0
b Less: accumulated depreciation 10b 0 331,072,083 10c 0
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 .. 295,930,885 13 0
14 Intangible assets ............... 0 14 0
15 Other assets. See Part IV, line 11 ........... 22,904,170 15 0
16 Total assets. Add lines 1 through 15 (must equal line 33)... 687,710,047 16 0
Liabilities 17 Accounts payable and accrued expenses ..... 47,704,538 17 0
18 Grants payable ... 0 18 0
19 Deferred revenue ......... 1,406,448 19 0
20 Tax-exempt bond liabilities ......... 342,769,915 20 0
21 Escrow or custodial account liability. Complete Part IV of Schedule D 0 21 0
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 10,869 23 0
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 85,440,069 25 0
26 Total liabilities. Add lines 17 through 25.. 477,331,839 26 0
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 195,705,642 27 0
28 Net assets with donor restrictions ........... 14,672,566 28 0
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 210,378,208 32 0
33 Total liabilities and net assets/fund balances ........ 687,710,047 33 0
Form 990 (2019)
Form 990 (2019)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
242,530,551
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
215,154,445
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
27,376,106
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
210,378,208
5
Net unrealized gains (losses) on investments ...............
5
11,642,356
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-249,396,670
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
0
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2019)
Form 990 (2019)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
INSPIRA MEDICAL CENTER WOODBURY INC
 
Employer identification number

22-1820210
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 12, check only one box.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 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
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
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 failed to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 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.") ..            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..  
6 Public support. Subtract line 5 from line 4.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support. Add lines 7 through 10  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 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.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (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.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    
Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors
(explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by .035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    
Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
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 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.
 
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)
 
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.
 
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.
 
7 Excess distributions carryover to 2020. Add lines
3j and 4c.
 
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.....  
Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019
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) 2019


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Name of the organization
INSPIRA MEDICAL CENTER WOODBURY INC
 
Employer identification number

22-1820210
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2
Name of organization
INSPIRA MEDICAL CENTER WOODBURY INC
 
Employer identification number
22-1820210
Part I
Contributors
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
RESTRICTED
 
 
 
 
  ,    

$ RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Page 3
Name of organization
INSPIRA MEDICAL CENTER WOODBURY INC
 
Employer identification number

22-1820210
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) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Page 4
Name of organization
INSPIRA MEDICAL CENTER WOODBURY INC
 
Employer identification number

22-1820210
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

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

SchCMd Bullet Complete if the organization is described below. SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
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
INSPIRA MEDICAL CENTER WOODBURY INC
 
Employer identification number

22-1820210
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

2
Political campaign activity expenditures (see instructions) ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities (see instructions) ..................................................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 ................................SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 .......................SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................
4a
Was a correction made? ......................................................................................................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b...........SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2019

Schedule C (Form 990 or 990-EZ) 2019
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(b) Affiliated group totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................    
b Total lobbying expenditures to influence a legislative body (direct lobbying) ........................    
c Total lobbying expenditures (add lines 1a and 1b) ............................................................    
d Other exempt purpose expenditures ...............................................................................    
e Total exempt purpose expenditures (add lines 1c and 1d) ..................................................    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
   
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................................................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ...................................................................................................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in)
(a) 2016 (b) 2017 (c) 2018 (d) 2019 (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) 2019


Schedule C (Form 990 or 990-EZ) 2019
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|No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
Yes
 
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
Yes
 
22,500
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
27,000
j
Total. Add lines 1c through 1i ....................................................................................................
49,500
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) .........................................
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
SCHEDULE C, PART II-B; LINES 1G & 1I DURING 2019, THE ORGANIZATION PAID AN INDEPENDENT OUTSIDE LOBBYING FIRM A TOTAL OF $27,000 FOR LOBBYING ON A FEDERAL AND STATE LEVEL RELATED TO MEDICARE, MEDICAID AND OTHER HEALTHCARE LEGISLATIVE MATTERS. IN ADDITION, THE ORGANIZATION HAS ALLOCATED TOWARD LOBBYING ACTIVITY A PERCENTAGE OF COMPENSATION PAID TO ITS VP OF GOVERNMENT RELATIONS WHICH REPRESENTS TIME SPENT ADDRESSING FEDERAL AND STATE HEALTHCARE MATTERS. THIS ALLOCATION AMOUNTED TO $22,500 IN 2019. THE ORGANIZATION IS A MEMBER OF THE NEW JERSEY HOSPITAL ASSOCIATION, THE AMERICAN HOSPITAL ASSOCIATION AND THE NEW JERSEY BUSINESS & INDUSTRY ASSOCIATION WHICH ALL ENGAGE IN LOBBYING EFFORTS ON BEHALF OF THEIR MEMBER HOSPITALS. A PORTION OF THE DUES PAID TO THESE ORGANIZATIONS HAS BEEN ALLOCATED TO LOBBYING ACTIVITES PERFORMED ON BEHALF OF THE ORGANIZATION. PLEASE NOTE, INSPIRA MEDICAL CENTERS, INC., A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT HOSPITAL ORGANIZATION PAID THE MEMBERSHIP DUES ON BEHALF OF THIS ORGANIZATION. THE PORTION OF THOSE DUES ALLOCATED TO LOBBYING IS REPORTED ON THE INSPIRA MEDICAL CENTERS, INC. FORM 990, SCHEDULE C. THIS ORGANIZATION IS ALSO A MEMBER OF FAIR SHARE HOSPITALS COLLABORATIVE, INC. TO WHICH IT PAID DUES IN THE AMOUNT OF $22,500 IN 2019. ONE OF THE FUNCTIONS OF FAIR SHARE HOSPITALS COLLABORATIVE, INC. IS TO ENGAGE IN LOBBYING ACTIVITIES PERFORMED ON BEHALF OF ITS MEMBER HOSPITALS.
Schedule C (Form 990 or 990EZ) 2019


Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
SchDMd Bullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
INSPIRA MEDICAL CENTER WOODBURY INC
 
Employer identification number

22-1820210
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included on Form 990, Part VIII, line 1 .........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2019

Schedule D (Form 990) 2019
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....
Part V
Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
(a) Current year (b) Prior year (c) Two years back (d) Three years back (e) Four years back
1a Beginning of year balance ....   11,249,557 3,848,159 3,881,112 4,253,627
b Contributions ...   3,908,048 7,125,336    
c Net investment earnings, gains, and losses   -485,039 276,062 54,095 -327,000
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ...
      87,048 45,515
f Administrative expenses ....          
g End of year balance ......   14,672,566 11,249,557 3,848,159 3,881,112
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Term endowment SchDMd Bullet100.000 %
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
 
No
(ii) Related organizations .................
3a(ii)
 
No
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis
(investment)
(b) Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .....      
b Buildings ....        
c Leasehold improvements        
d Equipment ....        
e Other .....        
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet  
Schedule D (Form 990) 2019

Schedule D (Form 990) 2019
Page 3
Part VII
Investments—Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)
(b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1) Financial derivatives.........    
(2) Closely-held equity interests........    
(3)Other
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
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
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes 0
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 0
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) 2019

Schedule D (Form 990) 2019
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1.................. 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b.................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ......... 2a  
b Prior year adjustments ............ 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d.................... 2e  
3 Subtract line 2e from line 1................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b..................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
SCHEDULE D, PART V, QUESTION 4 ENDOWMENT FUNDS ARE TO BE USED CONSISTENT WITH INTENT AND IN FUTHERANCE OF THE ORGANIZATION'S CHARITABLE TAX-EXEMPT PURPOSES.
SCHEDULE D, PART X, LINE 2 THE ORGANIZATION IS AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF INSPIRA HEALTH NETWORK AND RELATED ENTITIES FOR THE YEARS ENDED DECEMBER 31, 2019 AND DECEMBER 31, 2018; RESPECTIVELY. THE FOLLOWING FOOTNOTE IS INCLUDED IN THE ORGANIZATION'S 2019 AUDITED CONSOLIDATED FINANCIAL STATEMENTS THAT REPORTS THE ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 (ASC 740): THE NETWORK ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD IS MET. MANAGEMENT DETERMINED THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2019 OR 2018.
Schedule D (Form 990) 2019


Additional Data


Software ID:  
Software Version:  




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
INSPIRA MEDICAL CENTER WOODBURY INC
 
Employer identification number

22-1820210
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
 
No
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
 
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . .
    1,378,681 116,073 1,262,608 0.590 %
b Medicaid (from Worksheet 3, column a) . . . . .     9,135,033 6,036,214 3,098,819 1.440 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     4,069,385 296,341 3,773,044 1.750 %
d Total Financial Assistance and Means-Tested Government Programs . . . . .     14,583,099 6,448,628 8,134,471 3.780 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     471,086 14,140 456,946 0.210 %
f Health professions education (from Worksheet 5) . . .     2,324,011 1,644,037 679,974 0.320 %
g Subsidized health services (from Worksheet 6) . . . .     13,308,311 11,880 13,296,431 6.180 %
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     46,143   46,143 0.020 %
j Total. Other Benefits . .     16,149,551 1,670,057 14,479,494 6.730 %
k Total. Add lines 7d and 7j .     30,732,650 8,118,685 22,613,965 10.510 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
 
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
68,902,787
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
52,749,469
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
16,153,318
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 INSPIRA MEDICAL CENTER WOODBURY INC
509 NORTH BROAD STREET
WOODBURY,NJ08096
WWW.INSPIRAHEALTHNETWORK.ORG
10801
X X         X     A
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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)
INSPIRA MEDICAL CENTER WOODBURY 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):
1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 19
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): WWW.INSPIRAHEALTHNETWORK.ORG
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
INSPIRA MEDICAL CENTER WOODBURY INC
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
www.inspirahealthnetwork.org
b
www.inspirahealthnetwork.org
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
INSPIRA MEDICAL CENTER WOODBURY INC
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
INSPIRA MEDICAL CENTER WOODBURY INC
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 8
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, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
SCHEDULE H, PART V, SECTION B, QUESTION 5 IN ITS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") THIS ORGANIZATION TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY ITS HOSPITAL FACILITIES. THIS ORGANIZATION WORKED IN COLLABORATION WITH THE WALTER RAND INSTITUTE FOR PUBLIC AFFAIRS ("WRI") AT RUTGERS UNIVERSITY-CAMDEN, AN INDEPENDENT RESEARCH AND CONSULTING FIRM TO CONDUCT THE CHNA. FOR THE PURPOSE OF THIS ASSESSMENT, COMMUNITY IS DEFINED AS THE THREE COUNTIES IN THE INSPIRA HEALTH NETWORK SERVICE AREA (GLOUCESTER, CUMBERLAND, AND SALEM COUNTIES). TO ACHIEVE THE GOAL OF OBTAINING LOCALLY ACTIONABLE INFORMATION FOR IMPROVING HEALTH, THIS CHNA EMPLOYED A MIXED-METHODS ITERATIVE STRATEGY OF DATA COLLECTION THAT COMBINED QUANTITATIVE AND QUALITATIVE ANALYSIS OF PRIMARY DATA COLLECTED FROM COMMUNITY MEMBERS WITH QUANTITATIVE ANALYSIS OF SECONDARY DATA. THE TWO FUNDAMENTALS OF OUR APPROACH ARE RIGOROUS DATA ANALYSIS AND COMMUNITY VOICE; TO THAT END, WE USED A VARIETY OF METHODS AND TOOLS TO ANALYZE THE DATA WE COLLECTED FROM PARTICIPANTS AND SOURCES IDENTIFIED THROUGH CONSULTATION WITH TRUSTED COMMUNITY PARTNERS IN EACH COUNTY. KEY INFORMANT INTERVIEWS ------------------------ KEY INFORMANTS WERE INTERVIEWED TO GATHER A COMBINATION OF QUANTITATIVE AND QUALITATIVE FEEDBACK THROUGH OPEN-ENDED QUESTIONS. KEY INFORMANTS WERE DEFINED AS COMMUNITY STAKEHOLDERS WITH EXPERT KNOWLEDGE AND INCLUDED PUBLIC HEALTH AND HEALTH CARE PROFESSIONALS, SOCIAL SERVICE PROVIDERS, NON-PROFIT LEADERS, BUSINESS LEADERS, FAITH-BASED ORGANIZATIONS, COUNTY GOVERNMENT, AND OTHER COMMUNITY LEADERS. 10 INTERVIEWS WERE CONDUCTED WITH KEY REPRESENTATIVES IN THE COUNTIES AND DESIGNATED INSPIRA HEALTH NETWORK STAFF. THE INTERVIEWS WERE COMPLETED USING A SEMI-STRUCTURED RESEARCH INSTRUMENT. THE PURPOSE OF THE RESEARCH PROJECT WAS EXPLAINED TO POTENTIAL PARTICIPANTS AND INFORMED CONSENT WAS OBTAINED PRIOR TO THE DATA COLLECTION PROCESS, FOLLOWING THE APPROVED IRB PROTOCOL. INTERVIEW PARTICIPANTS WERE ASKED TO THINK ABOUT AND SHARE THEIR PERSPECTIVES ON ACCESS TO CARE, HEALTH EDUCATION AND COMMUNICATION, AS WELL AS THE BARRIERS RESIDENTS FACE IN OBTAINING HEALTH CARE. OTHER AREAS OF INQUIRY INCLUDED THE STRENGTHS OF THE HEALTH CARE SERVICE DELIVERY SYSTEM AS WELL AS ITS WEAKNESSES AND POTENTIAL IMPROVEMENTS. BOTH THE RESEARCH INSTRUMENT AND THE PROTOCOL FOR THE INTERVIEW WERE DEVELOPED BASED ON THE GROUNDED THEORY APPROACH WITHIN THE QUALITATIVE RESEARCH FRAMEWORK. FOCUS GROUPS ------------ FOCUS GROUPS WERE CONDUCTED AMONG CUMBERLAND COUNTY RESIDENTS TO GATHER QUALITATIVE FEEDBACK REGARDING ACCESS TO CARE, KEY HEALTH ISSUES, AND HEALTH EDUCATION AND COMMUNICATION. WE CONDUCTED 13 DIFFERENT FOCUS GROUPS WITH COMMUNITY MEMBERS (N=10) AND STAKEHOLDERS (N=3) ACROSS THE THREE COUNTIES. OUR MAIN OBJECTIVE WAS TO GATHER THE COMMUNITY MEMBERS THOUGHTS ON HEALTH ISSUES (SUCH AS ACCESS TO CARE, HEALTH EDUCATION, AND COMMUNICATION) AND ANY BARRIERS RESIDENTS MAY CONFRONT IN OBTAINING CARE. ADDITIONAL AREAS OF INQUIRY INCLUDED THE STRENGTHS OF THE HEALTH CARE SERVICE DELIVERY SYSTEM AS WELL AS ITS WEAKNESSES AND POSSIBLE IMPROVEMENTS. THE FOCUS GROUP FORMAT ALLOWED COMMUNITY MEMBERS TO EXPRESS THEIR OPINIONS, SUGGESTIONS, AND RECOMMENDATIONS IN A CONFIDENTIAL FORMAT. BECAUSE THEY LIVE AND WORK WITHIN THE NETWORKS SERVICE AREAS, COMMUNITY MEMBERS INPUT IS CRUCIAL TO THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. FOCUS GROUPS PRODUCE A LARGE AMOUNT OF INFORMATION IN A SHORT TIME PERIOD. IN ADDITION, FOCUS GROUPS ELICIT WIDE-RANGING VIEWS ON DESIGNATED TOPICS. OUR FOCUS GROUPS CONSISTED OF A SEMI-STRUCTURED GROUP INTERVIEW. FOCUS GROUPS RANGED IN SIZE FROM 4-20 PARTICIPANTS. INFORMED CONSENT WAS OBTAINED AFTER THE PURPOSE OF THE FOCUS GROUP WAS EXPLAINED AND PRIOR TO THE DATA COLLECTION PROCESS, FOLLOWING THE APPROVED IRB PROTOCOL. ONE RESEARCH TEAM MEMBER FACILITATED THE FOCUS GROUP AND ONE TO TWO ADDITIONAL RESEARCH TEAM MEMBERS TOOK DETAILED NOTES. FOLLOWING EACH FOCUS GROUP, THE RESEARCH TEAM COMPILED A REPORT. COMMUNITY SURVEY ---------------- WE ALSO SOUGHT COMMUNITY ENGAGEMENT THROUGH THE WIDESPREAD DISSEMINATION OF A COMMUNITY SURVEY (N=891). THE SURVEY WAS COMPRISED OF 66 ITEMS, FORMATTED FOR ELECTRONIC AND PAPER DISTRIBUTION BOTH IN ENGLISH AND SPANISH. THE SPANISH SURVEYS WERE TRANSLATED FROM ENGLISH AND THEN BACK-TRANSLATED BY CERTIFIED TRANSLATORS ON THE RESEARCH TEAM. THE PARTICIPANT RESPONSE TIME WAS APPROXIMATELY 15 MINUTES FOR THE ELECTRONIC VERSION AND 30 MINUTES FOR THE PAPER VERSION. THE RESEARCH TEAM UTILIZED QUALTRICS, A WEB-BASED SURVEY PLATFORM, FOR THE DEVELOPMENT AND DISTRIBUTION OF THE ELECTRONIC FORMAT OF THE COMMUNITY SURVEY. SURVEY ITEM FORMATS INCLUDE MULTIPLE CHOICE; FILL IN, LIKERT SCALE, AND RANKING, THE SURVEY WAS LAUNCHED ON JUNE 8, 2018 AND CLOSED ON NOVEMBER 24, 2018 (24 WEEKS) AND WAS DESIGNED TO COMPLEMENT THE QUALITATIVE FOCUS GROUP AND INTERVIEW DATA TO PROVIDE A COMPREHENSIVE PICTURE OF THE HEALTH STATUS, NEEDS, AND RESOURCES AS IDENTIFIED BY RESIDENTS OF CUMBERLAND, GLOUCESTER, AND SALEM COUNTIES.
SCHEDULE H, PART V, SECTION B, QUESTION 6A & 6B THE NETWORK WORKED IN COLLABORATION WITH THE WALTER RAND INSTITUTE FOR PUBLIC AFFAIRS ("WRI") AT RUTGERS UNIVERSITY-CAMDEN, AN INDEPENDENT RESEARCH AND CONSULTING FIRM TO CONDUCT THE CHNA. WRI PROVIDED THE FOLLOWING ASSISTANCE: - COLLECTED AND INTERPRETED DATA FROM SECONDARY DATA SOURCES; - ANALYZED AND INTERPRETED DATA FROM KEY INFORMANT INTERVIEWS; - COLLECTED, ANALYZED, AND INTERPRETED DATA FROM FOCUS GROUPS; - CONDUCTED, ANALYZED, AND INTERPRETED DATA FROM THE ONLINE COMMUNITY SURVEY; AND - PREPARED THE CHNA REPORT.
SCHEDULE H, PART V, SECTION B, QUESTION 7A THE ORGANIZATION IS AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN SCHEDULE H, PART V, SECTION B, QUESTION 7A, IS THE HOME PAGE FOR THE SYSTEM. THE CHNA CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: WWW.INSPIRAHEALTHNETWORK.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS
SCHEDULE H, PART V, SECTION B, QUESTION 10A THE ORGANIZATION IS AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN SCHEDULE H, PART V, SECTION B, QUESTION 10A, IS THE HOME PAGE FOR THE SYSTEM. THE ORGANIZATION ISSUED A JOINT IMPLEMENTATION STRATEGY FOR EACH OF THE INSPIRA HEALTH NETWORK HOSPITAL FACILITIES. THIS JOINT IMPLEMENTATION STRATEGY CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: WWW.INSPIRAHEALTHNETWORK.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS
SCHEDULE H, PART V, SECTION B, QUESTION 11 THE NETWORK HAS CREATED ONE SET OF IMPLEMENTATION STRATEGIES WHICH INCLUDES ALL OF ITS HOSPITAL FACILITIES. THE ORGANIZATION'S JOINT IMPLEMENTATION STRATEGY DESCRIBES THE COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE ORGANIZATIONS CHNA. THROUGH THE ASSESSMENT OF ITS COMMUNITIES THE ORGANIZATION IDENTIFIED THE FOLLOWING KEY PRIORITIES: OBESITY, SUBSTANCE ABUSE, MENTAL HEALTH, ACCESS TO HEALTH CARE, AND TRANSPORTATION. THE ORGANIZATION INTENDS TO TAKE THE FOLLOWING ACTIONS WITH RESPECT TO EACH IDENTIFIED COMMUNITY HEALTH NEED. OBESITY ------- COMMUNITY MEMBERS RANKED OBESITY AS THE TOP HEALTH ISSUE IN THEIR COMMUNITIES. NATIONALLY, OBESITY IS ALSO A CONCERN, WITH HEALTH CARE COSTS AND MORTALITY RELATED TO OBESITY RAPIDLY OVERCOMING TOBACCO-RELATED COSTS/MORTALITY. SINCE 2000, THE ADULT OBESITY RATE IN NEW JERSEY HAS INCREASED BY OVER 60%. THIS PERIOD HAS ALSO SEEN AN INCREASE IN THE BURDEN OF OBESITY-RELATED DISEASES SUCH AS DIABETES, HYPERTENSION, AND HEART DISEASE. PROJECTIONS FOR THE CHRONIC DISEASE BURDEN RELATED TO OBESITY ARE DIRE, WITH AN EXPECTED FOUR-FOLD INCREASE IN THE NUMBER OF HEART DISEASE CASES WITHIN THE NEXT 20 YEARS. EVEN MORE TROUBLING IS THAT OBESITY AND RELATED CHRONIC HEALTH CONDITIONS OCCUR AT HIGHER RATES IN SOUTHERN NEW JERSEY THAN THEY DO IN THE REST OF THE STATE AND NATIONALLY. INSPIRA HEALTH COMMITS TO DEVELOPING AND/OR SUPPORTING INITIATIVES WITH THE FOLLOWING OBJECTIVES IN MIND: - IMPLEMENT COMMUNITY EDUCATION PROGRAMS RELATED TO NUTRITION AND PHYSICAL ACTIVITY - IMPROVE ACCESS TO HEALTHY FOOD THROUGH CHARITABLE CONTRIBUTIONS, EMPLOYEE VOLUNTEER OPPORTUNITIES, AND INNOVATIVE COMMUNITY PARTNERSHIPS - IDENTIFY RISK FACTORS FOR CHRONIC DISEASE THROUGH EARLY DETECTION AND SCREENINGS - INCREASE RESIDENTS AWARENESS OF RISK FACTORS FOR CHRONIC DISEASE SUBSTANCE ABUSE --------------- IN 2017, THE GOVERNOR OF NEW JERSEY DECLARED OPIOID ABUSE A PUBLIC HEALTH CRISIS IN THE STATE. COMMUNITY MEMBERS ALSO EXPRESSED INTENSE CONCERN ABOUT SUBSTANCE ABUSE, THE LACK OF RESOURCES TO COMBAT SUBSTANCES ABUSE, AND THE IMPACT OF SUBSTANCE ABUSE ON FRIENDS AND FAMILY MEMBERS. INSPIRA HEALTH COMMITS TO DEVELOPING AND/OR SUPPORTING INITIATIVES WITH THE FOLLOWING OBJECTIVES IN MIND: - PREVENT PATIENTS FROM BECOMING ADDICTED TO PAIN MEDICATIONS - IDENTIFY PATIENTS WHO ARE ADDICTED TO MEDICATIONS - DECREASE OVERDOSES AND DRUG-INDUCED DEATHS - INCREASE TOBACCO SCREENING IN HEALTH CARE SETTINGS - REDUCE ED UTILIZATION FOR SUBSTANCE ABUSE-RELATED ISSUES MENTAL HEALTH ------------- THE RATES OF SUICIDE ARE INCREASING IN GLOUCESTER, SALEM, AND CUMBERLAND COUNTIES. RATE OF SUICIDE IS HIGHER THAN STATE RATE IN GLOUCESTER, SALEM, AND CUMBERLAND COUNTIES. RESIDENTS REPORT A HIGH NUMBER OF POOR MENTAL HEALTH DAYS. COMMUNITY MEMBERS SAID THAT MENTAL AND BEHAVIORAL HEALTH WERE IMPORTANT ISSUES FACING THEIR COMMUNITIES IN GENERAL, AND THEMSELVES SPECIFICALLY. INCREASE ACCESS TO MENTAL HEALTH TREATMENT IS INCLUDED AMONG THE HEALTHY PEOPLE 2020 OBJECTIVES. INSPIRA HEALTH COMMITS TO DEVELOPING AND/OR SUPPORTING INITIATIVES WITH THE FOLLOWING OBJECTIVES IN MIND: - PARTICIPATE IN COMMUNITY PLANNING PROCESS TO ADDRESS BEHAVIORAL HEALTH AND ACCESS TO SERVICES - INCREASE AWARENESS AND IDENTIFICATION OF MENTAL HEALTH DISORDERS - INCREASE SCREENING FOR BEHAVIORAL HEALTH NEEDS IN PRIMARY CARE AND SPECIALTY CARE SETTINGS - WORK WITH AREA HOSPITALS TO DEVELOP A RANGE OF COLLABORATIVE APPROACHES TO IMPROVE THE CARE OF THE PATIENTS WITH BEHAVIORAL HEALTH CONDITIONS - INCREASE THE PROPORTION OF ADULTS WHO RECEIVE MENTAL HEALTH TREATMENT - INCREASE THE PROPORTION OF HOMELESS ADULTS WHO RECEIVE MENTAL HEALTH SERVICES - REDUCE ED UTILIZATION FOR MENTAL HEALTH RELATED ISSUES - PROVIDE EDUCATION ABOUT WARNING SIGNS OF MENTAL/BEHAVIORAL HEALTH CONDITIONS TRANSPORTATION -------------- COMMUNITY MEMBERS REPORTED THAT PUBLIC TRANSPORTATION WAS AN IMPORTANT MISSING RESOURCE AND THAT ACCESS TO RELIABLE TRANSPORTATION WAS AN IMPORTANT BARRIER TO CARE. ACCESS TO RELIABLE TRANSPORTATION IS IMPORTANT FOR PEOPLE WITH CHRONIC DISEASES. RESEARCH SUGGESTS THAT FOR INDIVIDUALS WITH LIMITED ECONOMIC RESOURCES, TRANSPORTATION TO PROVIDER VISITS AND PHARMACIES MAY BE A SIGNIFICANT BARRIER TO CARE THAT CAN ALTER HEALTH OUTCOMES. INSPIRA HEALTH COMMITS TO DEVELOPING AND/OR SUPPORTING INITIATIVES WITH THE FOLLOWING OBJECTIVES IN MIND: - DEFINE GAPS IN PROCESS, PROCEDURE, AND INFRASTRUCTURE - IMPLEMENT FREE-OF-CHARGE NON-EMERGENT TRANSPORTATION TO PATIENTS WITH ACCESS PROBLEMS TO MEDICAL CARE - COMPLETE SOFTWARE INTEGRATION WITH PROVIDERS FOR COORDINATION OF TRANSPORTATION INSPIRA HEALTH WILL NOT TAKE ACTION ON THE FOLLOWING HEALTH NEED: ACCESS TO HEALTH CARE LACK OF FACILITIES OR PROVIDERS GENERALLY, LACK OF FACILITIES OR PROVIDERS WAS A STRONG CONCERN FOR COMMUNITY MEMBERS IN SALEM COUNTY, AND MUCH LESS OF A CONCERN FOR COMMUNITY MEMBERS IN GLOUCESTER AND CUMBERLAND COUNTIES. INSPIRA HEALTH WILL CONTINUE TO ACKNOWLEDGE THE IMPACT OF THIS HEALTH NEED AND REMAIN COMMITTED TO THE ISSUES THEY REPRESENT. THE HOSPITAL ALSO STAYS COMMITTED TO ADDRESSING ALL THE NEEDS OF THE COMMUNITY WHEN POSSIBLE. DUE TO FINANCIAL RESTRICTIONS AND THE ABILITY OF OTHER INSTITUTIONS TO ADDRESS THE SAME ISSUES. INSPIRA HEALTH WILL FOCUS ON OBESITY, SUBSTANCE ABUSE, MENTAL HEALTH, AND TRANSPORTATION.
SCHEDULE H, PART V, SECTION B, QUESTION 16 THE ORGANIZATION IS AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN SCHEDULE H, PART V, SECTION B, QUESTION 16, IS THE HOME PAGE FOR THE SYSTEM. THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION AND PLAIN LANGUAGE SUMMARY ARE MADE WIDELY AVAILABLE ON THE ORGANIZATION'S WEBSITE. THESE DOCUMENTS CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: WWW.INSPIRAHEALTHNETWORK.ORG/FAP
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?6
Name and address Type of Facility (describe)
1 INSPIRA CARDIOVASCULAR SERVICES
636 KINGS HIGHWAY SUITE C
WOODBURY,NJ08096
OUTPATIENT SVCS - CARDIOLOGY
2 INSPIRA WOMEN'S IMAGING CTR-MULLICA HILL
155 BRIDGETON PIKE
MULLICA HILL,NJ08062
OUTPATIENT SERVICES - IMAGING
3 INSPIRA IMAGING CENTER GLASSBORO
200 ROWAN BOULEVARD
GLASSBORO,NJ08332
OUTPATIENT SERVICES - IMAGING
4 INSPIRA FAMILY MEDICINE CENTER
75 WEST RED BANK DRIVE
WOODBURY,NJ08096
OUTPATIENT SVCS - FAMILY MED
5 INSPIRA REHAB SVCS AT WEST DEPTFORD
800 JESSUP ROAD
WEST DEPTFORD,NJ08086
OUTPATIENT SERVICES - PT
6 INSPIRA IMAGING CENTER HADDON
400 WEST CUTHBERT BOULEVARD
HADDON TOWNSHIP,NJ08108
OUTPATIENT SERVICES - IMAGING
7
8
9
10
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 10
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, THE ORGANIZATION USES OTHER FACTORS IN DETERMINING ELIGIBILITY CRITERIA FOR FREE AND DISCOUNTED CARE. AS OUTLINED IN PART V, SECTION B, QUESTION 13, OTHER FACTORS TO DETERMINE ELIGIBILITY INCLUDE: - ASSET LEVEL; - MEDICAL INDIGENCY; - INSURANCE STATUS; - UNDERINSURANCE STATUS; AND - RESIDENCY. ADDITIONAL INFORMATION WITH RESPECT TO THE ORGANIZATION'S ELIGIBILITY CRITERIA FOR FINANCIAL ASSISTANCE IS OUTLINED BELOW. NEW JERSEY HOSPITAL CHARITY CARE PAYMENT ASSISTANCE PROGRAM ("CHARITY CARE") ------------------------------------------------------------------------- CHARITY CARE IS A NEW JERSEY PROGRAM IN WHICH FREE OR DISCOUNTED CARE IS AVAILABLE TO PATIENTS WHO RECEIVE INPATIENT AND OUTPATIENT SERVICES AT ACUTE CARE HOSPITALS THROUGHOUT THE STATE OF NEW JERSEY. HOSPITAL ASSISTANCE AND REDUCED CHARGE CARE ARE ONLY AVAILABLE FOR NECESSARY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. PATIENTS MAY BE ELIGIBLE FOR CHARITY CARE IF THEY ARE NEW JERSEY RESIDENTS WHO: 1) HAVE NO HEALTH COVERAGE OR HAVE COVERAGE THAT PAYS ONLY PART OF THE HOSPITAL BILL (UNINSURED OR UNDERINSURED); 2) ARE INELIGIBLE FOR ANY PRIVATE OR GOVERNMENTAL SPONSORED COVERAGE (SUCH AS MEDICAID); AND 3) MEET THE FOLLOWING INCOME AND ASSET ELIGIBILITY CRITERIA DESCRIBED BELOW. INCOME CRITERIA: PATIENTS WITH FAMILY GROSS INCOME LESS THAN OR EQUAL TO 200% OF FEDERAL POVERTY GUIDELINES ("FPG") ARE ELIGIBLE FOR 100% CHARITY CARE COVERAGE. PATIENTS WITH FAMILY GROSS INCOME GREATER THAN 200% AND LESS THAN OR EQUAL TO 300% OF FPG ARE ELIGIBLE FOR DISCOUNTED CARE. FREE CARE OR PARTIALLY COVERED CHARGES WILL BE DETERMINED BY USE OF THE NEW JERSEY DEPARTMENT OF HEALTH FEE SCHEDULE. IF PATIENTS ON THE 20% TO 80% SLIDING FEE SCALE ARE RESPONSIBLE FOR QUALIFIED OUT-OF-POCKET PAID MEDICAL EXPENSES IN EXCESS OF 30% OF THEIR GROSS ANNUAL INCOME (I.E. BILLS UNPAID BY OTHER PARTIES), THEN THE AMOUNT IN EXCESS OF 30% IS CONSIDERED HOSPITAL CARE PAYMENT ASSISTANCE. ASSET CRITERIA: CHARITY CARE INCLUDES ASSET ELIGIBILITY THRESHOLDS WHICH STATES THAT INDIVIDUAL ASSETS CANNOT EXCEED $7,500 AND FAMILY ASSETS CANNOT EXCEED $15,000 AS OF THE DATE OF SERVICE. CHARITY CARE MAY BE AVAILABLE TO NON-NEW JERSEY RESIDENTS, REQUIRING IMMEDIATE MEDICAL ATTENTION FOR AN EMERGENCY MEDICAL CONDITION. NEW JERSEY UNINSURED DISCOUNT (PUBLIC LAW 2008, C. 60) ------------------------------------------------------ UNINSURED PATIENTS WITH FAMILY GROSS INCOME LESS THAN 500% OF FPG MAY BE ELIGIBLE FOR DISCOUNTED CARE UNDER THIS PROGRAM. ELIGIBLE INDIVIDUALS MUST BE NEW JERSEY RESIDENTS. NJ FAMILYCARE ------------- NJ FAMILYCARE IS NEW JERSEY'S PUBLICLY FUNDED HEALTH INSURANCE PROGRAM WHICH INCLUDES CHIP, MEDICAID AND MEDICAID EXPANSION POPULATIONS. NJ FAMILYCARE IS A FEDERAL AND STATE FUNDED HEALTH INSURANCE PROGRAM CREATED TO HELP QUALIFIED NEW JERSEY RESIDENTS OF ANY AGE ACCESS TO AFFORDABLE HEALTH INSURANCE. NJ FAMILYCARE IS FOR PEOPLE WHO DO NOT HAVE EMPLOYER INSURANCE. FINANCIAL ELIGIBILITY FOR INDIVIDUALS SEEKING ELIGIBILITY FOR NJ FAMILYCARE WILL BE BASED ON THEIR MODIFIED ADJUSTED GROSS INCOME ("MAGI"). NJFAMILYCARE ELIGIBILITY GUIDELINES ARE ESTABLISHED BY THE STATE OF NEW JERSEY AND CAN BE FOUND AT WWW.NJFAMILYCARE.ORG. NEW JERSEY CANCER EDUCATION AND EARLY DETECTION ("NJCEED") ---------------------------------------------------------- THE NJCEED PROGRAM PROVIDES COMPREHENSIVE OUTREACH, EDUCATION AND SCREENING SERVICES FOR BREAST, CERVICAL, COLORECTAL AND PROSTATE CANCERS. A PATIENT MUST BE UNINSURED OR UNDERINSURED AND MUST HAVE FAMILY GROSS INCOME AT OR BELOW 250% OF FPG TO BE ELIGIBLE. ADDITIONAL INFORMATION CAN BE FOUND AT THE FOLLOWING WEBSITE: WWW.NJ.GOV/HEALTH/CANCER/NJCEED. CATASTROPHIC ILLNESS IN CHILDREN RELIEF FUND -------------------------------------------- THE CATASTROPHIC ILLNESS IN CHILDREN RELIEF FUND PROVIDES FINANCIAL ASSISTANCE TO FAMILIES OF CHILDREN WITH A CATASTROPHIC ILLNESS. IN ORDER TO BE ELIGIBLE, HOSPITAL EXPENSES MUST EXCEED 10% OF THE FAMILY'S GROSS INCOME, PLUS 15% OF ANY EXCESS INCOME OVER $100,000, THE CHILD MUST HAVE BEEN 21 YEARS OR YOUNGER WHEN THE MEDICAL EXPENSES WERE INCURRED AND THE FAMILY MUST HAVE LIVED IN NEW JERSEY FOR THREE MONTHS IMMEDIATELY PRIOR TO THE DATE OF APPLICATION. ADDITIONAL INFORMATION CAN BE FOUND AT THE FOLLOWING WEBSITE: WWW.STATE.NJ.US/HUMANSERVICES/CICRF/HOME. NEW JERSEY VICTIMS OF CRIME COMPENSATION OFFICE ----------------------------------------------- THE STATE OF NEW JERSEY HAS ESTABLISHED THE NEW JERSEY VICTIMS OF CRIME COMPENSATION OFFICE TO COMPENSATE VICTIMS OF CRIME FOR LOSSES AND EXPENSES, INCLUDING CERTAIN MEDICAL EXPENSES, RESULTING FROM CERTAIN CRIMINAL ACTS. IN ORDER TO BE ELIGIBLE FOR NEW JERSEY VICTIMS OF CRIME COMPENSATION OFFICE THE CRIME MUST HAVE OCCURRED IN NEW JERSEY OR MUST RELATE TO A NEW JERSEY RESIDENT VICTIMIZED OUTSIDE OF THE STATE, THE VICTIM MUST HAVE REPORTED THE CRIME TO POLICE WITHIN NINE MONTHS AND VICTIM MUST COOPERATE WITH THE INVESTIGATION AND PROSECUTION OF THE CRIME. THE CLAIM MUST BE FILED WITHIN THREE YEARS OF THE DATE OF THE CRIME AND THE PATIENT MUST BE AN INNOCENT VICTIM OF THE CRIME. ADDITIONAL INFORMATION CAN BE FOUND AT WWW.NJ.GOV/OAG/NJVICTIMS/INDEX.HTML HOSPITAL FINANCIAL ASSISTANCE PROGRAM/SUBSIDY PROGRAM ----------------------------------------------------- PATIENTS THAT DO NOT QUALIFY FOR ANY OF THE GOVERNMENT FUNDED PROGRAMS OR NEW JERSEY CHARITY CARE MAY ELECT TO BE SCREENED BY FINANCIAL COUNSELING FOR THE HOSPITAL FINANCIAL ASSISTANCE PROGRAM/SUBSIDY PROGRAM. PATIENTS MAY BE ELIGIBLE FOR DISCOUNTS UNDER THE HOSPITAL FINANCIAL ASSISTANCE PROGRAM/SUBSIDY PROGRAM IF THEIR FAMILY GROSS INCOME IS BETWEEN 225% AND 550% OF FPL. ADDITIONALLY, IF THESE PATIENTS HAVE ASSETS IN EXCESS OF $50,000 THEY MAY BE REQUIRED TO PROVIDE PROOF OF ASSETS. PURSUANT TO INTERNAL REVENUE CODE SECTION 501(R)(5), IN THE CASE OF EMERGENCY OR OTHER MEDICALLY NECESSARY CARE, FAP-ELIGIBLE PATIENTS WILL NOT BE CHARGED MORE THAN AN INDIVIDUAL WHO HAS INSURANCE COVERING SUCH CARE. PATIENTS MAY BE ELIGIBLE FOR THIS DISCOUNT IF THEY ARE UNINSURED AND HAVE FAMILY GROSS INCOME LESS THAN 550% OF FPG. ADDITIONALLY, UNDERINSURED PATIENTS MAY BE ELIGIBLE IF THEIR FAMILY GROSS INCOME IS GREATER THAN 200% BUT LESS THAN OR EQUAL TO 300% OF FPG.
SCHEDULE H, PART I; QUESTION 6A NOT APPLICABLE.
SCHEDULE H, PART I; QUESTION 7 THE ORGANIZATION UTILIZED THE COST ACCOUNTING SYSTEM.
SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES UNDERTAKEN BY INSPIRA HEALTH NETWORK IMPROVE THE MEDICAL AND SOCIOECONOMIC WELL-BEING OF OUR COMMUNITIES. 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. IMC PROVIDES EDUCATIONAL MATERIALS, CONDUCTS COMMUNITY HEALTH FAIRS AND HOLDS HEALTH EDUCATION SEMINARS AND OUTREACH SESSIONS FOR ITS PATIENTS, COMMUNITY AND PROVIDERS. PHYSICIANS, NURSES AND OTHER HEALTHCARE PROFESSIONALS DEDICATE THEIR KNOWLEDGE AND TIME TO ENSURE THE COMMUNITY IS WELL EDUCATED ON TOPICS PROMOTING HEALTHY LIVING.
SCHEDULE H, PART III, SECTION A; QUESTION 4 THE FOOTNOTE BELOW EXPLAINS THE ORGANIZATIONS METHODOLOGY WITH RESPECT TO PATIENT ACCOUNTS RECEIVABLE. THE NETWORK ASSESSES COLLECTABILITY ON PATIENT CONTRACTS PRIOR TO THE RECOGNITION OF NET PATIENT SERVICE REVENUE. PATIENT ACCOUNTS RECEIVABLE, NET, ARE RECORDED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THE NETWORK HAS EXHAUSTED ALL COLLECTION EFFORTS AND DETERMINES ACCOUNTS ARE IMPAIRED BASED ON CHANGES IN CREDIT WORTHINESS.
SCHEDULE H, PART III, SECTION B; QUESTION 8 MEDICARE COSTS WERE DERIVED FROM THE 2019 MEDICARE COST REPORT. THE ORGANIZATION FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL), BAD DEBT AND ASSOCIATED COSTS ARE COMMUNITY BENEFIT AND 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 "THE TERM CHARITABLE IS USED IN SECTION 501(C)(3) IN ITS GENERALLY ACCEPTED LEGAL SENSE,PROVIDES EXAMPLES OF CHARITABLE PURPOSES, INCLUDING THE RELIEF OF THE 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 MUST PROVIDE, TO THE EXTENT OF ITS FINANCIAL ABILITY, FREE OR REDUCED-COST CARE TO PATIENTS WHO CANNOT PAY FOR SUCH SERVICES. A HOSPITAL THAT EXPECTED FULL PAYMENT DID NOT, ACCORDING TO THE RULING, PROVIDE CHARITY CARE BASED ON THE FACT THAT SOME PATIENTS ULTIMATELY FAILED TO PAY. THE RULING EMPHASIZED THAT A LOW LEVEL OF CHARITY CARE DID NOT NECESSARILY MEAN THAT A HOSPITAL HAD FAILED TO MEET THE REQUIREMENT SINCE THAT LEVEL COULD REFLECT ITS FINANCIAL ABILITY TO PROVIDE SUCH CARE. THE RULING ALSO NOTED THAT PUBLICLY SUPPORTED COMMUNITY HOSPITALS WOULD NORMALLY QUALIFY AS CHARITABLE ORGANIZATIONS BECAUSE THEY SERVE THE ENTIRE COMMUNITY AND A LOW LEVEL OF CHARITY CARE WOULD NOT AFFECT A HOSPITAL'S EXEMPT STATUS IF IT WAS DUE TO THE SURROUNDING COMMUNITY'S LACK OF CHARITABLE DEMANDS. COMMUNITY BENEFIT STANDARD IN 1969, THE IRS ISSUED REVENUE RULING 69-545, WHICH "REMOVED" FROM REVENUE RULING 56-185 "THE REQUIREMENTS RELATING TO CARING FOR PATIENTS WITHOUT CHARGE OR AT RATES BELOW COST." UNDER 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 THE DEPARTMENT OF TREASURY 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. 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'S POSITION. AS OUTLINED IN THE AHA'S 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. FROM THE LATEST DATA PROVIDED BY THE AHA, AS OF 2017, MEDICARE REIMBURSES HOSPITALS ONLY 87 CENTS FOR EVERY DOLLAR THEY SPEND TO TAKE CARE OF MEDICARE PATIENTS. - MANY MEDICARE BENEFICIARIES, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR. MORE THAN 42 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 ELIGIBLE." 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 THOSE WHO DO NOT PAY ALL, OR A PORTION OF THE ALREADY DISCOUNTED BILLED AMOUNTS UNDER OUR FINANCIAL ASSISTANCE POLICY. 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. AS A RESULT, ROUGHLY 40% OF BAD DEBT IS PENDING CHARITY CARE. THE CBO CONCLUDED THAT ITS FINDINGS "SUPPORT THE VALIDITY OF THE USE OF UNCOMPENSATED CARE [BAD DEBT AND CHARITY CARE] AS A MEASURE OF COMMUNITY BENEFIT" ASSUMING THE FINDINGS ARE GENERALIZABLE NATIONWIDE; THE EXPERIENCE OF HOSPITALS AROUND THE NATION REINFORCES THAT THEY ARE GENERALIZABLE. AS OUTLINED BY THE AHA, DESPITE THE HOSPITAL'S BEST EFFORTS AND DUE DILIGENCE, PATIENT BAD DEBT IS A PART OF THE HOSPITAL'S MISSION AND CHARITABLE PURPOSES. BAD DEBT REPRESENTS PART OF THE BURDEN HOSPITALS SHOULDER IN SERVING ALL
SCHEDULE H, PART III, SECTION B; QUESTION 9B ACCOUNTS CONSIDERED TO BE FINANCIAL ASSISTANCE ARE NOT INCLUDED IN THE BAD DEBT EXPENSE, BUT RATHER, ACCOUNTED FOR AS AN ALLOWANCE. IT IS THE POLICY OF INSPIRA HEALTH NETWORK ("INSPIRA") TO TREAT ALL PATIENTS EQUALLY REGARDLESS OF INSURANCE AND THEIR ABILITY TO PAY. ADDITIONALLY, INSPIRA IS COMMITTED TO BILLING PATIENTS AND INSURANCE CARRIERS IN A MANNER THAT IS IN COMPLIANCE WITH ALL STATE, LOCAL AND FEDERAL REGULATIONS. THE ORGANIZATION'S BILLING AND COLLECTION POLICIES AND PROCEDURES ARE OUTLINED WITHIN THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY ("FAP"). THIS POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. ACCORDING TO INSPIRAS BILLING AND COLLECTION POLICY INSPIRA ABIDES BY THE FOLLOWING PROCEDURES WHEN PURSUING BILLING AND COLLECTION ACTIONS: BILLING PROCEDURES ------------------ UNTIL PATIENTS ARE DEEMED ELIGIBLE AND APPROVED FOR FINANCIAL ASSISTANCE UNDER THIS POLICY, INSPIRA WILL CONTINUE ITS NORMAL BILLING AND COLLECTION ACTIVITIES AS FOLLOWS: (1) INSPIRA WILL PROVIDE SUFFICIENT ACCOUNT FOLLOW-UP SERVICE TO ENSURE THAT INSURERS AND PATIENTS RECEIVE ACCURATE ACCOUNT AND BILLING INFORMATION. (2) PATIENTS WILL HAVE THE OPPORTUNITY TO MAKE PAYMENT AND/OR APPLY FOR FINANCIAL ASSISTANCE FOR ALL OUTSTANDING BALANCES. THE BILLING PROCESS IS PERFORMED IN ACCORDANCE WITH THE FOLLOWING GUIDELINES: - FOR ALL INSURED PATIENTS, INSPIRA BILLS ALL THIRD-PARTY PAYER INFORMATION (AS PROVIDED BY OR VERIFIED BY THE PATIENT) ON A TIMELY BASIS. - IF A CLAIM IS DENIED (OR NOT PROCESSED) BY A PAYER DUE TO A HOSPITAL ERROR, INSPIRA WILL NOT BILL THE PATIENT FOR ANY AMOUNT IN EXCESS OF THAT FOR WHICH THE PATIENT WOULD HAVE BEEN LIABLE HAD THE PAYER PAID THE CLAIM. - AFTER CLAIMS ARE PROCESSED BY PAYERS, INSPIRA BILLS PATIENTS ON A TIMELY BASIS FOR THEIR RESPECTIVE LIABILITY AMOUNTS AS DETERMINED BY THEIR INSURERS. - ALL UNINSURED PATIENTS ARE BILLED DIRECTLY ON A TIMELY BASIS. - ACCOUNTS MAY BE REFERRED FOR COLLECTION IF THERE IS REASONABLE BASIS TO BELIEVE THAT THE PATIENT OWES THE DEBT. HOWEVER, ACCOUNTS MAY BE PLACED WITH A COLLECTION AGENCY NO SOONER THAN 120 DAYS FROM THE DATE OF FIRST POST-DISCHARGE BILLING STATEMENT ("NOTIFICATION PERIOD"). ACCOUNTS MAY BE REFERRED FOR COLLECTION IF ALL THIRD-PARTY PAYERS HAVE BEEN PROPERLY BILLED BY INSPIRA AND THE REMAINING DEBT IS THE FINANCIAL RESPONSIBILITY OF THE PATIENT. THE ORGANIZATION SHALL NOT BILL A PATIENT FOR ANY AMOUNT THAT AN INSURANCE COMPANY IS OBLIGATED TO PAY UNLESS THE INSURANCE COMPANY IS REFUSING TO PAY THE AMOUNT PENDING ADDITIONAL INFORMATION OR COMMUNICATION FROM THE PATIENT. INSPIRA DOES NOT REFER ACCOUNTS FOR COLLECTION WHILE A CLAIM ON THE ACCOUNT IS STILL PENDING PAYER PAYMENT UNLESS THE PAYER IS REFUSING TO PAY THE AMOUNT PENDING ADDITIONAL INFORMATION OR COMMUNICATION FROM THE PATIENT. CUSTOMER SERVICE ---------------- DURING THE BILLING AND COLLECTION PROCESS, INSPIRA PROVIDES QUALITY CUSTOMER SERVICE BY COMPLYING WITH THE FOLLOWING GUIDELINES: (1) INSPIRA DOES NOT TOLERATE ABUSIVE, HARASSING, OFFENSIVE, DECEPTIVE, OR MISLEADING LANGUAGE OR CONDUCT BY ITS EMPLOYEES. (2) INSPIRA MAINTAINS A STREAMLINED PROCESS FOR PATIENT QUESTIONS AND DISPUTES, WHICH INCLUDES A PHONE NUMBER PATIENTS MAY CALL, EMAIL ADDRESS, AND A BUSINESS OFFICE ADDRESS TO WHICH THEY MAY WRITE. THIS INFORMATION WILL BE LISTED ON ALL PATIENT STATEMENTS. (3) AFTER RECEIVING A COMMUNICATION FROM THE PATIENT (BY PHONE, EMAIL, OR IN WRITING), INSPIRA STAFF WILL RETURN CALLS TO PATIENTS AS PROMPTLY AS POSSIBLE (BUT NO MORE THAN ONE BUSINESS DAY AFTER THE CALL, EMAIL OR LETTER WAS RECEIVED). (4) INSPIRA MAINTAINS A DAILY COMPLAINT AND ISSUE LOG OF PATIENTS COMPLAINTS. THE COMPLAINT AND ISSUE LOG WILL BE REVIEWED PERIODICALLY BY THE PATIENT ACCOUNTS MANAGER AND CASH SUPERVISOR AND THE INFORMATION PROVIDED WILL BE USED TO ENHANCE AND IMPROVE THE BILLING AND COLLECTIONS PROCESS. ALL PATIENTS MAY REQUEST AN ITEMIZED STATEMENT FOR THEIR ACCOUNTS AT ANY TIME. ALL PATIENTS WILL HAVE THE OPPORTUNITY TO CONTACT HOSPITAL REGARDING FINANCIAL ASSISTANCE FOR THEIR ACCOUNTS. COMPLIANCE WITH INTERNAL REVENUE CODE SECTION 501(R)(6) ------------------------------------------------------- INSPIRA DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIVITIES ("ECAS") AS DEFINED BY INTERNAL REVENUE CODE SECTION 501(R) PRIOR TO THE END OF THE NOTIFICATION PERIOD. ONCE A COMPLETED FAP APPLICATION IS RECEIVED, HOSPITAL, OR ANY COLLECTION AGENCIES WORKING ON THEIR BEHALF, WILL: 1) SUSPENDED ANY ECAS AGAINST THE INDIVIDUAL; 2) MAKE AND DOCUMENT AN ELIGIBILITY DETERMINATION IN A TIMELY MANNER; 3) NOTIFY THE RESPONSIBLE PARTY OR INDIVIDUAL IN WRITING OF THE DETERMINATION AND BASIS FOR DETERMINATION; AND 4) IF DEEMED FAP-ELIGIBLE INSPIRA WILL: - PROVIDE A BILLING STATEMENT INDICATING THE AMOUNT THE FAP-ELIGIBLE INDIVIDUAL OWES, HOW THAT AMOUNT WAS DETERMINED AND HOW INFORMATION PERTAINING TO AMOUNTS GENERALLY BILLED MAY BE OBTAINED; AND - REFUND ANY EXCESS PAYMENTS MADE BY THE INDIVIDUAL. INSPIRA DOES NOT ENGAGE IN ANY ACTIONS THAT DISCOURAGE INDIVIDUALS FROM SEEKING EMERGENCY MEDICAL CARE, SUCH AS BY DEMANDING THE EMERGENCY DEPARTMENT PATIENTS PAY BEFORE RECEIVING TREATMENT FOR EMERGENCY MEDICAL CONDITIONS OR BY PERMITTING DEBT COLLECTION ACTIVITIES IN THE EMERGENCY DEPARTMENT OR OTHER AREAS WHERE SUCH ACTIVITIES COULD INTERFERE WITH THE PROVISION OF EMERGENCY CARE ON A NON-DISCRIMINATORY BASIS.
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 ANNUAL WHICH INCLUDES: A REVIEW OF HEALTHCARE UTILIZATION OF ITS SERVICE AREA POPULATION BY SERVICES (UROLOGY, CARDIOLOGY, OBSTETRICS, ETC.) FOR DETERMINING INCREASED OR DECREASED HEALTH NEEDS; HEALTHCARE SERVICES 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 EXTERNAL PARTIES. THE ORGANIZATION CONDUCTS AN EXTENSIVE SERVICE AREA PHYSICIAN NEEDS STUDY (BY PRIMARY AND SPECIALTY) EVERY THREE TO FIVE YEARS. SPECIFIC SPECIALTY NEEDS ARE CONDUCTED FOR IDENTIFIED GAPS IN SERVICE. THESE REVIEWS INFORM MEDICAL STAFF DEVELOPMENT AT THE MEDICAL CENTER TO ASSURE RESPONSIVENESS TO IDENTIFIED COMMUNITY NEEDS. THE ORGANIZATION COLLABORATES WITH COMMUNITY PARTNERS TO PLAN AND CONDUCT HEALTH NEEDS ASSESSMENTS TO ASSESS AND ADDRESS HEALTH NEEDS OF THE COMMUNITY IT SERVES. THE WIDE-BASED COLLABORATIVE PARTNERSHIP RETAINS AN OUTSIDE CONSULTING FIRM TO ASSESS COMMUNITY DATA AND PERCEPTION. COMMUNITY DATA IS COLLECTED FROM COUNTY HEALTH PROFILES, HEALTH STATISTICS, DEMOGRAPHICS, SOCIOECONOMIC DATA, PHONE SURVEYS, PAPER SURVEYS AND FOCUS GROUPS. FROM THOSE ASSESSMENTS, COMMUNITY HEALTH IMPROVEMENT PLANS ARE PUBLISHED IDENTIFYING THE SPECIFIC HEALTH PRIORITIES. THROUGH A PLANNED AND ORGANIZED EFFORT, THE GROUP WORKS COLLECTIVELY TO ADDRESS THE PRIORITIES BY TAPPING THE RESOURCES OF THE COMMUNITY AND COLLABORATING ON INITIATIVES. INSPIRA HEALTH NETWORK ACTIVELY CONTRIBUTES TO THIS PROCESS AND ENGAGES IN THE IDENTIFIED PRIORITIES THAT MATCH ITS MISSION, EXPERTISE, RESOURCES AND CAPACITY. IN ADDITION TO THESE ORGANIZED NEEDS ASSESSMENT EFFORTS, VARIOUS INSPIRA LEADERSHIP ATTEND COMMUNITY MEETINGS WITH LOCAL PROVIDERS, LOCAL HEALTH DEPARTMENTS, LOCAL POLITICIANS, ORGANIZATIONS AND COMMUNITY LEADERS TO DISCUSS THE HEALTH NEEDS OF THE POPULATION.
SCHEDULE H, PART VI; QUESTION 3 IN ACCORDANCE WITH INTERNAL REVENUE CODE SECTION 501(R)(4) THE ORGANIZATION 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: (1) THE FINANCIAL ASSISTANCE POLICY ("FAP"), FINANCIAL ASSISTANCE APPLICATION ("APPLICATION") AND PLAIN LANGUAGE SUMMERY ("PLS") ARE ALL AVAILABLE ON-LINE AT THE FOLLOWING WEBSITE: WWW.INSPIRAHEALTHNETWORK.ORG/FAP (2) PAPER COPIES OF THE FAP, APPLICATION AND THE PLS ARE AVAILABLE UPON REQUEST WITHOUT CHARGE BY MAIL AND ARE AVAILABLE IN AT VARIOUS AREAS THROUGHOUT THE HOSPITAL FACILITY WHICH INCLUDE THE HOSPITAL ADMISSIONS DEPARTMENT AND THE OUTPATIENT AND EMERGENCY ROOM REGISTRATION AREAS. (3) THE FAP, APPLICATION 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 THE ORGANIZATIONS PRIMARY SERVICE AREA. (4) ALL PATIENTS ARE OFFERED A COPY OF THE PLS AS PART OF THE INTAKE PROCESS. ADDITIONALLY, SIGNS OR DISPLAYS ARE CONSPICUOUSLY POSTED IN PUBLIC MEDICAL CENTER LOCATIONS INCLUDING ALL ADMISSIONS/REGISTRATION AREAS AND THE EMERGENCY DEPARTMENT, THAT NOTIFY AND INFORM PATIENTS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE. ALL BILLING STATEMENTS INCLUDE CONSPICUOUS WRITTEN NOTICE WHICH INFORMS PATIENTS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE. INSPIRA ALSO INFORMS AND NOTIFIES MEMBERS OF THE COMMUNITY SERVED ABOUT THE FAP. INSPIRA ACCOMPLISHES THIS THROUGH THE CUMBERLAND/SALEM/GLOUCESTER HEALTH & WELLNESS ALLIANCE ("ALLIANCE") WHICH IS AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION FOR WHICH INSPIRA PLAYED AN INTEGRAL ROLE IN ORGANIZING. THE ALLIANCE HAS MORE THAN 40 MEMBERS COMPRISED OF SOCIAL SERVICE AGENCIES SCATTERED THROUGHOUT INSPIRAS PRIMARY SERVICE AREA OF CUMBERLAND, SALEM AND GLOUCESTER COUNTIES. THEY INCLUDE, BUT ARE NOT LIMITED TO, FEDERALLY QUALIFIED HEALTH CENTERS, YMCAS, UNITED WAYS, SCHOOL SYSTEMS, GATEWAY COMMUNITY ACTION PARTNERSHIP, THE LOCAL COUNTY COLLEGES, FAMCARE,INC., COUNTY PROSECUTORS OFFICE, SCRATCH COALITION (ADDICTION SERVICES), ROBINS NEST, LOCAL HEALTH DEPARTMENTS (MUNICIPAL AND COUNTY), CHAMBERS OF COMMERCE, FAMILY SUCCESS CENTERS, RUTGERS COOPERATIVE EXTENSION, NJ FAMILY PLANNING, THE SOUTHWEST COUNCIL, SOUTHERN NJ PERINATAL COOPERATIVE. THE ALLIANCE MEETS REGULARLY AND ASSISTS WITH DRAFTING AND IMPLEMENTATION OF OUR COMMUNITY HEALTH NEEDS ASSESSMENTS FOR ALL THREE COUNTIES WITHIN INSPIRAS PRIMARY MARKET.
SCHEDULE H, PART VI; QUESTION 4 INSPIRA HEALTH NETWORK IS A CHARITABLE, NOT-FOR-PROFIT HEALTH SYSTEM SERVING THE RESIDENTS OF SOUTHWEST NEW JERSEY. INSPIRA HEALTH NETWORK WAS ESTABLISHED IN NOVEMBER 2012 THROUGH THE MERGER OF SOUTH JERSEY HEALTHCARE AND UNDERWOOD-MEMORIAL HOSPITAL. THE NETWORK, WHICH TRACES ITS ROOTS TO 1899, NOW COMPRISES THREE HOSPITALS, FOUR MULTI-SPECIALTY HEALTH CENTERS, AND A TOTAL OF MORE THAN 60 LOCATIONS. THESE INCLUDE OUTPATIENT IMAGING AND REHABILITATION CENTERS; NUMEROUS SPECIALTY CENTERS, INCLUDING SLEEP MEDICINE, CARDIAC TESTING AND WOUND CARE; AND MORE THAN TWO DOZEN PRIMARY AND SPECIALTY PHYSICIAN PRACTICES IN CUMBERLAND, GLOUCESTER AND SALEM COUNTIES. WITH A MEDICAL STAFF OF MORE THAN 1,100 PHYSICIANS AND OTHER HEALTH CARE PROVIDERS, INSPIRA HEALTH NETWORK PROVIDES EVIDENCE-BASED CARE TO HELP EACH PATIENT ACHIEVE THE BEST POSSIBLE OUTCOME. INSPIRA HEALTH NETWORK DEFINED THEIR CURRENT SERVICE AREA BASED ON AN ANALYSIS OF THE GEOGRAPHIC AREA WHERE INDIVIDUALS UTILIZING THEIR SERVICES RESIDE. INSPIRA HEALTH NETWORKS SERVICE AREA IS CONSIDERED TO BE THE CUMBERLAND, GLOUCESTER, AND SALEM COUNTY COMMUNITIES. THE COUNTIES ARE SITUATED IN THE SOUTHWESTERN PART OF NEW JERSEY AND ENCOMPASS A TOTAL POPULATION OF APPROXIMATELY 504,000 IN 2019. AS PART OF ITS COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS, ONE OF THE INITIAL UNDERTAKINGS OF WAS TO CREATE A SECONDARY DATA PROFILE. THE SECONDARY DATA IS COMPRISED OF DATA OBTAINED FROM EXISTING RESOURCES AND INCLUDES DEMOGRAPHIC AND HOUSEHOLD STATISTICS, EDUCATION AND INCOME MEASURES, MORBIDITY AND MORTALITY RATES, AND HEALTH INDICATORS, AMONG OTHER DATA POINTS. THE DATA WAS GATHERED AND INTEGRATED INTO A GRAPHICAL REPORT TO PORTRAY THE CURRENT HEALTH AND SOCIO-ECONOMIC STATUS OF RESIDENTS IN ITS PRIMARY SERVICE AREAS. SECONDARY DATA WAS COLLECTED FROM REPUTABLE SOURCES INCLUDING THE U.S. CENSUS BUREAU, CENTERS FOR DISEASE CONTROL AND PREVENTION AND NEW JERSEY DEPARTMENT OF HEALTH. THE PROFILE DETAILS DATA COVERING THE FOLLOWING AREAS: POPULATION STATISTICS --------------------- CUMBERLAND COUNTY: - THE PROPORTION OF HISPANICS/LATINOS AND BLACK/AFRICAN AMERICANS IS 31.8% AND 21.9%; RESPECTIVELY. - THE PERCENTAGE OF PEOPLE WHO SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME IS 27.9%. - 15.6% OF RESIDENTS ARE AGE 65 YEARS AND OLDER. GLOUCESTER COUNTY: - THE PROPORTION OF HISPANICS/LATINOS AND BLACK/AFRICAN AMERICANS IS 6.7% AND 11.2%; RESPECTIVELY. - THE PERCENTAGE OF PEOPLE WHO SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME IS 8.8% - 16.3% OF RESIDENTS ARE AGE 65 YEARS AND OLDER. SALEM COUNTY: - THE PROPORTION OF HISPANICS/LATINOS AND BLACK/AFRICAN AMERICANS IS 9.8% AND 14.8%; RESPECTIVELY. - THE PERCENTAGE OF PEOPLE WHO SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME IS 8.5%. - 19.0% OF RESIDENTS ARE AGE 65 YEARS AND OLDER. HOUSEHOLD STATISTICS -------------------- CUMBERLAND COUNTY: - THE MEDIAN HOME VALUE IN CUMBERLAND COUNTY IS $162,500. - THE AVERAGE FAMILY SIZE 2.77 INDIVIDUALS. GLOUCESTER COUNTY: - THE MEDIAN HOME VALUE IN GLOUCESTER COUNTY IS $216,700. - THE AVERAGE FAMILY SIZE 2.74 INDIVIDUALS. SALEM COUNTY: - THE MEDIAN HOME VALUE IN SALEM COUNTY IS $185,300. - THE AVERAGE FAMILY SIZE 2.59 INDIVIDUALS. INCOME STATISTICS ----------------- CUMBERLAND COUNTY: - THE MEDIAN INCOME FOR HOUSEHOLDS IS $52,593 - THE PROPORTION OF PERSONS LIVING IN POVERTY IS 15.2% GLOUCESTER COUNTY: - THE MEDIAN INCOME FOR HOUSEHOLDS IS $85,160 - THE PROPORTION OF PERSONS LIVING IN POVERTY IS 7.5% SALEM COUNTY: - THE MEDIAN INCOME FOR HOUSEHOLDS IS $64,309 - THE PROPORTION OF PERSONS LIVING IN POVERTY IS 11.2%. EMPLOYMENT STATISTICS --------------------- CUMBERLAND COUNTY: UNEMPLOYMENT RATE IN APRIL 2018 WAS 6.6% GLOUCESTER COUNTY: UNEMPLOYMENT RATE IN APRIL 2018 WAS 4% SALEM COUNTY: UNEMPLOYMENT RATE IN APRIL WAS 5.3% EDUCATION STATISTICS -------------------- CUMBERLAND COUNTY: - 77.3% OF RESIDENTS HAVE GRADUATED FROM HIGH SCHOOL. - 14.3% OF RESIDENTS HAVE EARNED A BACHELORS DEGREE OR HIGHER. GLOUCESTER COUNTY: - 88.9% OF RESIDENTS HAVE GRADUATED FROM HIGH SCHOOL. - 30% OF RESIDENTS HAVE EARNED A BACHELORS DEGREE OR HIGHER. SALEM COUNTY: - 87.7% OF RESIDENTS HAVE GRADUATED FROM HIGH SCHOOL. - 20.9% OF RESIDENTS HAVE EARNED A BACHELORS DEGREE OR HIGHER. COUNTY HEALTH RANKINGS ---------------------- - CUMBERLAND COUNTY RECEIVED THE WORST RANKING FOR HEALTH OUTCOMES, MORTALITY, QUALITY OF LIFE, HEALTH FACTORS AND BEHAVIORS, AND SOCIAL AND ECONOMIC FACTORS (21 OF 21) IN NEW JERSEY. - GLOUCESTER COUNTY RECEIVED POOR RANKINGS FOR QUALITY OF LIFE, HEALTH BEHAVIORS, AND PHYSICAL ENVIRONMENT (18 OF 21, 18 OF 21, AND 20 OF 21 RESPECTIVELY). - SALEM COUNTY RECEIVED POOR RANKINGS FOR HEALTH OUTCOMES, MORTALITY, HEALTH FACTORS, HEALTH BEHAVIORS, AND PHYSICAL ENVIRONMENT (19 OF 21, 20 OF 21, 20 OF 21, 20 OF 21, AND 19 OF 21 RESPECTIVELY). - ALL COUNTIES RECEIVED A POOR RANKING FOR CLINICAL CARE.
SCHEDULE H, PART VI; QUESTION 5 COMMUNITY BUILDING ACTIVITIES UNDERTAKEN BY THIS ORGANIZATION IMPROVE THE MEDICAL AND SOCIO-ECONOMIC WELL-BEING OF THE COMMUNITIES IN OUR CARE. THIS IS ACCOMPLISHED THROUGH NUMEROUS ACTIVITIES WHICH ARE NOT A PART OF PART I CHARITY CARE AND OTHER COMMUNITY BENEFITS, AND ARE NOT INCLUDED ELSEWHERE ON SCHEDULE H. THESE ACTIVITIES INCLUDE PROGRAMS THAT ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS SUCH AS EDUCATION, POVERTY, UNEMPLOYMENT, ACCESS TO CARE, HEALTH ADVOCACY AND ECONOMIC DEVELOPMENT. THIS ORGANIZATION HOLDS ANNUAL MEETINGS OPEN TO THE PUBLIC FOR ALL HOSPITAL LOCATIONS. THE ORGANIZATIONS GOVERNING BOARDS ARE COMPRISED OF BUSINESS PROFESSIONALS AND COMMUNITY MEMBERS ALL OF WHOM RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA WHO ARE NOT EMPLOYEES OF THE ORGANIZATION. THESE VOLUNTEERS PROVIDE COUNTLESS HOURS OF SERVICE TO THE HOSPITAL SYSTEM IN THEIR OVERSIGHT ROLE. ALL QUALIFIED PHYSICIANS IN THE COMMUNITY ARE EXTENDED MEDICAL STAFF PRIVILEGES BY THEIR RESPECTIVE DEPARTMENTS. UNDER THE DIRECTIVE OF THE ORGANIZATION'S CORPORATE FINANCE OFFICE, SURPLUS FUNDS ARE UTILIZED FOR CAPITAL PROJECTS TO IMPROVE SERVICES, PURCHASE EQUIPMENT, MAINTAIN ACCESS TO CARE TO A HISTORICALLY UNDERSERVED AND LOW-INCOME COMMUNITY AND IMPROVE ACCESS TO PATIENT SERVICES, WHICH IN TURN, BENEFIT THE COMMUNITY. THESE SERVICES INCLUDE, BUT NOT LIMITED TO, THE FOLLOWING: 1) EDUCATIONAL PROGRAMS THAT PROVIDE CLASSES AND INFORMATION ON HEALTHY AGING, CHILDBIRTH, INFANT CARE, EARLY PREGNANCY AND MORE; 2) FREE BLOOD PRESSURE AND DIABETES SCREENING, AND MAMMOGRAMS TO QUALIFYING INDIVIDUALS, FREE OR LOW-COST SCREENINGS FOR BREAST, PROSTATE, SKIN AND COLORECTAL CANCERS; 3) PREVENTATIVE HEALTH EDUCATION; 4) ACCESS TO SATELLITE EMERGENCY DEPARTMENT AND EXPANSION OF EMERGENCY DEPARTMENTS AT BOTH HOSPITALS TO ACCOMMODATE INCREASE IN EMERGENCY DEPARTMENT PATIENTS; 5) IMPROVED EFFICIENCY AND CLINICAL QUALITY; 6) INVESTMENT IN MEDICAL EDUCATION AND RESEARCH; AND 7) ACCESS TO ADVANCED TECHNOLOGY AND CLINICAL TRIALS FOR LATEST TREATMENTS. PLEASE ALSO REFER TO FORM 990, SCHEDULE O, WHICH CONTAINS THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT.
SCHEDULE H, PART VI; QUESTION 6 OUTLINED BELOW IS A SUMMARY OF THE ENTITIES WHICH COMPRISE THE INSPIRA HEALTH NETWORK: NOT-FOR-PROFIT INSPIRA HEALTH NETWORK ENTITIES ============================================== INSPIRA HEALTH NETWORK, INC. ---------------------------- INSPIRA HEALTH NETWORK, INC. ("NETWORK") IS THE TAX-EXEMPT PARENT OF THE INSPIRA HEALTH NETWORK ("SYSTEM"). THIS INTEGRATED HEALTHCARE DELIVERY SYSTEM CONSISTS OF A GROUP OF AFFILIATED HEALTHCARE ORGANIZATIONS. THE SOLE MEMBER OR STOCKHOLDER OF EACH ENTITY IS EITHER THE NETWORK OR ANOTHER NETWORK AFFILIATE CONTROLLED BY THE NETWORK. THE NETWORK IS AN INTEGRATED NETWORK OF HEALTHCARE PROVIDERS THROUGHOUT THE STATE OF NEW JERSEY AND IS 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). INSPIRA MEDICAL CENTERS, INC. ----------------------------- INSPIRA MEDICAL CENTERS, INC. IS COMPRISED OF THREE HOSPITAL FACILITIES, INSPIRA MEDICAL CENTER ELMER, INSPIRA MEDICAL CENTER VINELAND AND INSPIRA MEDICAL CENTER MULLICA HILL. IMC IS A GENERAL MEDICAL, SURGICAL AND TEACHING HOSPITAL THAT IS RECOGNIZED BY IRS AS AN IRC 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, IMC PROVIDES EMERGENCY AND 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, IMC OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. INSPIRA MEDICAL CENTER WOODBURY, INC. ------------------------------------- INSPIRA MEDICAL CENTER WOODBURY, INC. ("IMCW") IS LOCATED IN WOODBURY, GLOUCESTER COUNTY, NEW JERSEY, IS A 305-BED ACUTE CARE FACILITY. IMCW IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, IMCW 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, IMCW OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. THIS ORGANIZATION WAS STATUTORILY MERGED INTO INSPIRA MEDICAL CENTERS, INC. DURING 2019. INSPIRA HOMECARE & HOSPICECARE, INC. ------------------------------------ INSPIRA HOMECARE & HOSPICECARE, 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)(2). THE ORGANIZATION HAS AN OWNERSHIP INTEREST IN TRI-COUNTY HOME AND HOSPICE CARE LLC; AN ENTITY ORGANIZED TO OWN AND OPERATE HOME HEALTHCARE AND HOSPICE AGENCIES IN GLOUCESTER, SALEM AND CUMBERLAND COUNTIES. THIS ORGANIZATION PROVIDES QUALITY HOME CARE AND HOSPICE CARE SERVICES IN THE REGION IN FURTHERANCE OF ITS TAX-EXEMPT AND CHARITABLE PURPOSES. INSPIRA HEALTH NETWORK LIFE, INC. --------------------------------- INSPIRA HEALTH NETWORK LIFE, 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)(2). THE ORGANIZATION PROVIDES HEALTHCARE SERVICES IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. TRI-COUNTY CARDIOVASCULAR SERVICES, P.C. ---------------------------------------- TRI-COUNTY CARDIOVASCULAR SERVICES, P.C. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION. THE ORGANIZATION PROVIDED PHYSICIAN SERVICES IN SOUTHERN NEW JERSEY. THE ORGANIZATION IS CURRENTLY INACTIVE. INSPIRA HEALTH CONNECTIONS, P.C. -------------------------------- INSPIRA HEALTH CONNECTIONS, P.C. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION. THIS ORGANIZATION PROVIDES PHYSICIAN SERVICES IN SOUTHERN NEW JERSEY. INSPIRA HEALTH NETWORK FOUNDATION CUMBERLAND/SALEM, INC. -------------------------------------------------------- INSPIRA HEALTH NETWORK FOUNDATION CUMBERLAND/SALEM, 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 INSPIRA HEALTH NETWORK, INC.; 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 OR ABILITY TO PAY. THIS ORGANIZATION WAS STATUTORILY MERGED INTO INSPIRA HEALTH NETWORK FOUNDATION GLOUCESTER COUNTY, INC. DURING 2019. INSPIRA HEALTH NETWORK FOUNDATION GLOUCESTER COUNTY, INC. --------------------------------------------------------- INSPIRA HEALTH NETWORK FOUNDATION GLOUCESTER COUNTY, 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 INSPIRA HEALTH NETWORK, INC.; 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 OR ABILITY TO PAY. INSPIRA DEPTFORD HEALTHPARK, LLC -------------------------------- INSPIRA DEPTFORD HEALTHPARK, LLC IS A LIMITED LIABILITY COMPANY FORMED IN THE STATE OF NEW JERSEY WHOSE SOLE MEMBER IS INSPIRA MEDICAL CENTERS, INC. INSPIRA CARE CONNECT, LLC ------------------------- INSPIRA CARE CONNECT, LLC IS A LIMITED LIABILITY COMPANY FORMED IN THE STATE OF NEW JERSEY WHOSE SOLE MEMBER IS INSPIRA HEALTH NETWORK, INC. THE MISSION OF THIS ORGANIZATION IS TO ESTABLISH A GROUP OF COORDINATED HEALTHCARE PROVIDERS WHICH AGREE TO BE ACCOUNTABLE FOR THE QUALITY, COST AND OVERALL CARE FOR AN ASSIGNED GROUP OF MEDICARE BENEFICIARIES. FOR-PROFIT INSPIRA HEALTH NETWORK ENTITIES ========================================== BRIDGETON PHYSICIANS OFFICE CENTER, L.P. ---------------------------------------- BRIDGETON PHYSICIANS OFFICE CENTER, L.P. IS A PARTNERSHIP OWNED BY INSPIRA HEALTH NETWORK AFFILIATES. THIS ORGANIZATION ENGAGES IN REAL ESTATE ACTIVITY. GLOUCESTER COUNTY SURGERY CENTER, LLC ------------------------------------- GLOUCESTER COUNTY SURGERY CENTER, LLC IS A LIMITED LIABILITY COMPANY TAXED AS A PARTNERSHIP CONTROLLED BY RED BANK DEVELOPMENT CORPORATION. GLOUCESTER COUNTY SURGERY CENTER, LLC PROVIDES HEALTHCARE SERVICES TO INDIVIDUALS. INSPIRA HEALTH PARTNERS, LLC ---------------------------- INSPIRA HEALTH PARTNERS, LLC IS A LIMITED LIABILITY COMPANY TAXED AS A PARTNERSHIP. THE ORGANIZATION IS A CLINICALLY INTEGRATED PHYSICIAN-HOSPITAL ENTERPRISE WHICH IS DESIGNED TO ACHIEVE IMPROVEMENT IN HEALTHCARE QUALITY, EFFICIENCY AND COST. INSPIRA HEALTH NETWORK, INC. OWNS 51% OF INSPIRA HEALTH PARTNERS, LLC. OAK & MAIN SURGICENTER, LLC --------------------------- OAK & MAIN SURGICENTER, LLC IS A LIMITED LIABILITY COMPANY TAXED AS A PARTNERSHIP OWNED BY INSPIRA MEDICAL CENTERS, INC. THIS ORGANIZATION PROVIDES HEALTHCARE SERVICES TO INDIVIDUALS. INSPIRA SJ URGENT CARE MANAGEMENT COMPANY, LLC ---------------------------------------------- INSPIRA SJ URGENT CARE MANAGEMENT COMPANY, LLC IS A LIMITED LIABILITY COMPANY TAXED AS A PARTNERSHIP. THIS ORGANIZATION MANAGES AND OPERATES URGENT CARE SERVICE CENTERS IN SOUTHERN NEW JERSEY. INSPIRA HEALTH MANAGEMENT CORPORATION, INC. OWNS 60.5% OF INSPIRA SJ URGENT CARE MANAGEMENT COMPANY, LLC. WOODBURY MEDICAL CENTER ASSOCIATES, LLP --------------------------------------- WOODBURY MEDICAL CENTER ASSOCIATES, LLP IS A LIMITED LIABILITY PARTNERSHIP. THE ORGANIZATION PROVIDES MEDICAL SERVICES IN SOUTHERN NEW JERSEY. DURING 2019, RED BANK DEVELOPMENT CORPORATION, INC. BECAME THE SOLE OWNER OF WOODBURY MEDICAL CENTER ASSOCIATES, LLP. COOPER BONE & JOINT, P.C. ------------------------- COOPER BONE & JOINT INSTITUTE (COOPER UNIVERSITY HEALTH CARE) PARTNERED WITH INSPIRA MEDICAL CENTER WOODBURY, INC. TO OFFER PATIENTS ACCESS TO THE LATEST ORTHOPAEDIC ADVANCEMENTS. INSPIRA MEDICAL CENTER WOODBURY, INC. IS A 50% SHAREHOLDER IN COOPER BONE & JOINT, P.C. THIS ORGANIZATION IS CURRENTLY INACTIVE. INSPIRA HEALTH MANAGEMENT CORPORATION, INC. ------------------------------------------- INSPIRA HEALTH MANAGEMENT CORPORATION IS AN ENTITY WHOSE SOLE SHAREHOLDER IS INSPIRA HEALTH NETWORK, INC. THE ORGANIZATION IS LOCATED IN BRIDGETON, CUMBERLAND COUNTY, NEW JERSEY AND PROVIDES HEALTH, WELLNESS AND MANAGEMENT SERVICES. INSPIRA HEALTH NETWORK M
SCHEDULE H, PART VI; QUESTION 7 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.
Schedule H (Form 990) 2019
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Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
INSPIRA MEDICAL CENTER WOODBURY INC
 
Employer identification number
22-1820210
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC section
(if applicable)
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
noncash assistance
(h) Purpose of grant
or assistance
(1) CITY OF WOODBURY
33 DELAWARE STREET
WOODBURY,NJ08096
  10,500   FMV   SPONSORSHIP
(2) THE COOPER FOUNDATION
1 FEDERAL STREET
CAMDEN,NJ08103
22-2213715 501(C)(3) 15,000   FMV   SPONSORSHIP
(3) FOOD BANK OF SOUTH JERSEY
1501 JOHN TIPTON BLVD
PENNSAUKEN,NJ08109
22-2623089 501(C)(3) 10,000   FMV   SPONSORSHIP
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
3
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2019

Schedule I (Form 990) 2019
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients
(c) Amount of
cash grant
(d) Amount of
noncash assistance
(e) Method of valuation (book,
FMV, appraisal, other)
(f) Description of noncash assistance
(1) EDUCATIONAL SCHOLARSHIPS 26 57,296      
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
SCHEDULE I, PART I; QUESTION 2 GRANTS ARE MONITORED BY THE ORGANIZATION'S FINANCE PERSONNEL THROUGH THE UTILIZATION OF COST CENTERS AND OTHER INFORMATION; INCLUDING WRITTEN DOCUMENTATION AND RECEIPTS.
Schedule I (Form 990) 2019



Additional Data


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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 Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
INSPIRA MEDICAL CENTER WOODBURY INC
 
Employer identification number

22-1820210
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ..
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2019

Schedule J (Form 990) 2019
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits
(E) Total of columns
(B)(i)-(D)
(F) Compensation in column (B) reported as deferred on prior Form 990
(i) Base
compensation
(ii) Bonus & incentive
compensation
(iii) Other reportable compensation
1JOHN A DIANGELO
TRUSTEE; PRESIDENT/CEO - IHN
(i)

(ii)
0
-------------
859,734
0
-------------
190,080
0
-------------
822,872
0
-------------
217,500
0
-------------
51,019
0
-------------
2,141,205
0
-------------
502,246
2ROBERT E FLORENTINE
SVP/CHIEF PEOPLE OFFICER
(i)

(ii)
0
-------------
309,245
0
-------------
47,566
0
-------------
447,621
0
-------------
30,800
0
-------------
31,865
0
-------------
867,097
0
-------------
239,934
3MARVIN T WAY
EVP OPERATIONS
(i)

(ii)
0
-------------
530,162
0
-------------
82,846
0
-------------
36,709
0
-------------
107,707
0
-------------
44,360
0
-------------
801,784
0
-------------
0
4ALKA KOHLI MD MBA
EVP/CHIEF POP HEALTH OFFICER
(i)

(ii)
0
-------------
466,828
0
-------------
102,260
0
-------------
38,242
0
-------------
106,025
0
-------------
28,408
0
-------------
741,763
0
-------------
0
5KURT W KAULBACK MD
TRUSTEE (TERMED 04/2019)
(i)

(ii)
0
-------------
415,651
0
-------------
293,114
0
-------------
0
0
-------------
0
0
-------------
21,867
0
-------------
730,632
0
-------------
0
6THOMAS P BALDOSARO CPA
EVP/CHIEF FINANCIAL OFFICER
(i)

(ii)
0
-------------
436,549
0
-------------
61,029
0
-------------
45,535
0
-------------
95,720
0
-------------
32,075
0
-------------
670,908
0
-------------
0
7THOMAS PACEK
VP/CHIEF INFORMATION OFFICER
(i)

(ii)
0
-------------
332,041
0
-------------
26,394
0
-------------
31,860
0
-------------
53,384
0
-------------
28,141
0
-------------
471,820
0
-------------
0
8SCOTT WAGNER MD MBA
CHIEF MEDICAL OFFICER
(i)

(ii)
0
-------------
327,939
0
-------------
29,107
0
-------------
36,041
0
-------------
51,480
0
-------------
25,548
0
-------------
470,115
0
-------------
0
9MATTHEW DOONAN ESQ
GENERAL COUNSEL
(i)

(ii)
0
-------------
310,292
0
-------------
26,703
0
-------------
51,259
0
-------------
53,388
0
-------------
26,647
0
-------------
468,289
0
-------------
0
10PATRICK NOLAN
CHIEF OPERATING OFFICER
(i)

(ii)
0
-------------
250,528
0
-------------
28,633
0
-------------
41,602
0
-------------
46,115
0
-------------
20,655
0
-------------
387,533
0
-------------
0
11EILEEN CARDILE
FORMER OFFICER
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
364,907
0
-------------
0
0
-------------
0
0
-------------
364,907
0
-------------
0
12JOHN W GRAHAM
FORMER OFFICER
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
279,872
0
-------------
0
0
-------------
0
0
-------------
279,872
0
-------------
0
Schedule J (Form 990) 2019

Schedule J (Form 990) 2019
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 4B THE AMOUNTS REFLECTED IN SCHEDULE J, PART II, COLUMN B(III) FOR THE FOLLOWING INDIVIDUALS INCLUDE A CURRENT YEAR VESTING IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) AS THESE AMOUNTS WERE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THE AMOUNTS OUTLINED HEREIN WERE INCLUDED EACH INDIVIDUAL'S 2019 FORM W-2, BOX 5, AS TAXABLE WAGES: JOHN A. DIANGELO, $716,062 AND ROBERT E. FLORENTINE, $401,860. THE DEFERRED COMPENSATION AMOUNTS REFLECTED IN SCEDULE J, PART II, COLUMN C FOR THE FOLLOWING INDIVIDUALS INCLUDE UNVESTED BENEFITS IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) WHICH ARE SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THESE INDIVIDUALS MAY NEVER ACTUALLY RECEIVE THIS UNVESTED BENEFIT AMOUNT. THE AMOUNTS OUTLINED HEREIN WERE NOT INCLUDED IN EACH INDIVIDUAL'S 2019 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: MARVIN T. WAY, $90,907; ALKA KOHLI, M.D., MBA, $89,225; THOMAS P. BALDOSARO, CPA, $78,920; THOMAS PACEK, $36,584; MATTHEW DOONAN, ESQ., $36,588; AND PATRICK NOLAN, $29,684. THE DEFERRED COMPENSATION AMOUNT REFLECTED IN SCHEDULE J, PART II, COLUMN C FOR THE FOLLOWING INDIVIDUAL INCLUDES UNVESTED BENEFITS IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) WHICH IS SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THE INDIVIDUAL MAY NEVER ACTUALLY RECEIVE THIS UNVESTED BENEFIT AMOUNT. THE AMOUNT OUTLINED HEREIN WAS NOT INCLUDED IN HIS 2019 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: JOHN A. DIANGELO, $182,500.
SCHEDULE J, PART I; QUESTION 7 CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A BONUS DURING CALENDAR YEAR 2019 WHICH WAS INCLUDED IN SCHEDULE J, PART II, COLUMN B(II) HEREIN AND IN EACH INDIVIDUAL'S 2019 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 B(III) CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J OF THIS FEDERAL FORM 990 RECEIVED COMPENSATION WITH RESPECT TO PAID TIME OFF, WHICH WAS INCLUDED IN SCHEDULE J, PART II, COLUMN B(III) HEREIN AND IN EACH INDIVIDUAL'S 2019 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES.
SCHEDULE J, PART II; COLUMN F THE AMOUNT REPORTED IN SCHEDULE J, PART II, COLUMN F FOR THE FOLLOWING INDIVIDUALS INCLUDES VESTED BENEFITS IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) AS THESE AMOUNTS WERE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THESE AMOUNTS WERE REPORTED IN SCHEDULE J, PART II, COLUMN C AS RETIREMENT AND OTHER DEFERRED COMPENSATION ON PRIOR YEAR'S FORMS 990. ADDITIONALLY, THESE AMOUNTS WERE TREATED AS TAXABLE INCOME AND REPORTED IN EACH INDIVIDUAL'S 2019 FORM W-2, BOX 5 AS TAXABLE MEDICARE WAGES: JOHN A. DIANGELO, $502,246 AND ROBERT E. FLORENTINE, $239,934.
Schedule J (Form 990) 2019

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SCHEDULE N
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Liquidation, Termination, Dissolution, or Significant Disposition of Assets
bullet Complete if the organization answered "Yes" on Form 990, Part IV, lines 31 or 32; or Form 990-EZ, line 36.
bullet Attach certified copies of any articles of dissolution, resolutions, or plans.
bullet Attach to Form 990 or 990-EZ.
bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
INSPIRA MEDICAL CENTER WOODBURY INC
 
Employer identification number
22-1820210
Part I
Liquidation, Termination, or Dissolution. Complete this part if the organization answered "Yes" on Form 990, Part IV, line 31, or Form 990-EZ, line 36. Part I can be duplicated if additional space is needed. Click to see attachment
1(a) Description of asset(s)
distributed or transaction
expenses paid
(b) Date of
distribution
(c) Fair market value of
asset(s) distributed or
amount of transaction
expenses
(d) Method of
determining FMV for
asset(s) distributed or
transaction expenses
(e) EIN of recipient (f) Name and address of recipient (g) IRC section
of recipient(s) (if
tax-exempt) or type
of entity
TRANSFER OF NET ASSETS 12-13-2019 236,014,611 FMV 21-0634484 INSPIRA MEDICAL CENTERS INC
333 IRVING AVENUE
BRIDGETON,NJ08302
501(C)(3)
Yes
No
2
Did or will any officer, director, trustee, or key employee of the organization:
a
Become a director or trustee of a successor or transferee organization? .........................
2a
Yes
 
b
Become an employee of, or independent contractor for, a successor or transferee organization? .....................
2b
 
 
c
Become a direct or indirect owner of a successor or transferee organization? .....................
2c
 
No
d
Receive, or become entitled to, compensation or other similar payments as a result of the organization's significant disposition of assets? ........
2d
 
No
e
If the organization answered "Yes" to any of the questions on lines 2a through 2d, provide the name of the person involved and explain in Part III. bullet
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or Form 990-EZ.
Cat. No. 50087Z
Schedule N (Form 990 or 990-EZ) (2019)

Schedule N (Form 990 or 990-EZ) (2019)
Page 2
Part I
Liquidation, Termination, or Dissolution (continued)
Note. If the organization distributed all of its assets during the tax year, then Form 990, Part X, column (B), line 16 (Total assets), and line 26 (Total liabilities), should equal -0-.
Yes
No
3
Did the organization distribute its assets in accordance with its governing instrument(s)? If "No," describe in Part III .............
3
Yes
 
4a
Is the organization required to notify the attorney general or other appropriate state official of its intent to dissolve, liquidate, or terminate? ......
4a
Yes
 
b
If "Yes," did the organization provide such notice? .....................
4b
Yes
 
5
Did the organization discharge or pay all of its liabilities in accordance with state laws? .....................
5
Yes
 
6a
Did the organization have any tax-exempt bonds outstanding during the year? .....................
6a
Yes
 
b
If "Yes" on line 6a, did the organization discharge or defease all of its tax-exempt bond liabilities during the tax year in accordance with the Internal Revenue Code and state laws?
6b
 
No
c
If "Yes" on line 6b, describe in Part III how the organization defeased or otherwise settled these liabilities. If "No" on line 6b, explain in Part III.

Part II
Sale, Exchange, Disposition, or Other Transfer of More Than 25% of the Organization's Assets. Complete this part if the organization answered "Yes" on Form 990, Part IV, line 32, or Form 990-EZ, line 36. Part II can be duplicated if additional space is needed.
1(a) Description of asset(s)
distributed or transaction
expenses paid
(b) Date of
distribution
(c) Fair market value of
asset(s) distributed or
amount of transaction
expenses
(d) Method of
determining FMV for
asset(s) distributed or
transaction expenses
(e) EIN of recipient (f) Name and address of recipient (g) IRC section
of recipient(s) (if
tax-exempt) or type
of entity
Yes
No
2
Did or will any officer, director, trustee, or key employee of the organization:
a
Become a director or trustee of a successor or transferee organization? .........................
2a
Yes
 
b
Become an employee of, or independent contractor for, a successor or transferee organization? .....................
2b
 
 
c
Become a direct or indirect owner of a successor or transferee organization? .....................
2c
 
No
d
Receive, or become entitled to, compensation or other similar payments as a result of the organization's liquidation, termination, or dissolution? ........
2d
 
No
e
If the organization answered "Yes" to any of the questions on lines 2a through 2d, provide the name of the person involved and explain in Part III. bullet
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or Form 990-EZ.
Cat. No. 50087Z
Schedule N (Form 990 or 990-EZ) (2019)

Schedule N (Form 990 or 990-EZ) (2019)
Page 3
Part III
Supplemental Information. Provide the information required by Part I, lines 2e and 6c, and Part II, line 2e. Also complete this part to provide any additional information.
Return Reference Explanation
SCHEDULE N, PART I, QUESTION 2A INSPIRA MEDICAL CENTER WOODBURY, INC., AN INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, WAS STATUTORILY INTO INSPIRA MEDICAL CENTERS, INC.; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION. INSPIRA MEDICAL CENTER WOODBURY, INC. AND INSPIRA MEDICAL CENTERS, INC. ARE BOTH GOVERNED BY THE SAME BOARD OF TRUSTEES.
Schedule N (Form 990 or 990-EZ) (2019)



Additional Data


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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 Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
INSPIRA MEDICAL CENTER WOODBURY INC
 
Employer identification number

22-1820210
Return Reference Explanation
CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS BACKGROUND ========== PART OF THE INSPIRA HEALTH NETWORK INC. AND AFFILIATES, INSPIRA MEDICAL CENTER WOODBURY, INC. ("IMCW"), LOCATED IN WOODBURY, NEW JERSEY IS A 322-BED LICENSED, ACUTE-CARE, NON-PROFIT HOSPITAL SERVING GLOUCESTER COUNTY AND PARTS OF CAMDEN, SALEM AND CUMBERLAND COUNTIES. IMCW IS RECOGNIZED BY THE IRS AS AN INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, IMCW PROVIDES HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. MOREOVER, IMCW OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545: 1. PROVIDES 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 ARE 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 IMCW RESTS WITH THE BOARDS OF TRUSTEES OF INSPIRA HEALTH NETWORK, INC. BOTH BOARDS ARE COMPRISED OF INDEPENDENT CIVIC LEADERS AND OTHER PROMINENT MEMBERS OF THE COMMUNITY. 5. SURPLUS FUNDS ARE USED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND RENOVATE FACILITIES AND ADVANCE MEDICAL CARE, PROGRAMS AND ACTIVITIES. THE OPERATIONS OF IMCW AS SHOWN THROUGH THE FACTORS OUTLINED ABOVE AND OTHER INFORMATION CONTAINED HEREIN, CLEARLY DEMONSTRATE THAT THE USE AND CONTROL OF IMCW 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. IMCW PROVIDES HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY. MOREOVER, IMCW PROVIDES HEALTHCARE SERVICES TO PATIENTS WHO MEET CERTAIN CRITERIA DEFINED BY THE NEW JERSEY DEPARTMENT OF HEALTH AND HUMAN SERVICES WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. IMCW MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE AMOUNT OF FINANCIAL ASSISTANCE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FOREGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS FINANCIAL ASSISTANCE POLICY. WITH MORE THAN 1,676 FULL AND PART-TIME EMPLOYEES AND A MEDICAL STAFF OF APPROXIMATELY 720, IMCW PROVIDES A DIVERSE ARRAY OF DIAGNOSTIC, THERAPEUTIC AND TREATMENT SERVICES IN THE COMFORT, CONVENIENCE AND SECURITY OF A COMMUNITY HOSPITAL SETTING. IMCW IS GLOUCESTER COUNTY'S LARGEST EMPLOYER. IN 2019, IMCW PERFORMED 7,490 SURGERIES, 65,740 PHYSICAL THERAPY TREATMENTS, 1,025 DIALYSIS TREATMENTS, 95,702 DIAGNOSTIC IMAGING PROCEDURES, AND 48,531 EMERGENCY ROOM VISITS. ALSO, IN 2019, INPATIENT ADMISSIONS WERE 7,914 FOR ADULTS AND PEDIATRICS, 688 FOR MENTAL HEALTH AND 847 BIRTHS. AWARDS AND RECOGNITION ====================== IN ADDITION TO PROVIDING A WIDE SCOPE OF SERVICES, IMCW TAKES GREAT PRIDE IN PROVIDING HIGH QUALITY, PATIENT FOCUSED CARE TO ITS COMMUNITIES. THESE EFFORTS HAVE BEEN RECOGNIZED AT BOTH A LOCAL AND NATIONAL LEVEL THROUGH A VARIETY OF AWARDS, RECOGNITIONS AND ACCREDITATIONS, WHICH INCLUDE: ACCREDITED BY DNV HEALTHCARE WHICH AIDS THE ORGANIZATIONS LEADERSHIP AND STAFF IN CONTINUOUSLY EVALUATING AND IMPROVING THE CARE PROVIDED TO THE REGION. DNV HEALTHCARE IS A HOSPITAL ACCREDITATION PROGRAM APPROVED BY THE U.S. CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) THAT INTEGRATES THE ISO 9001 QUALITY MANAGEMENT SYSTEM. THE DNV PROGRAM REQUIRES HOSPITALS TO EVALUATE THE CONTINUUM OF PATIENT CARE THROUGHOUT ITS FACILITIES AND TAKE MEASURED STEPS TO IMPROVE WHEN IT IS WARRANTED. ACCREDITED ISO 9001:2015 BY DNV GL HEALTHCARE - INSPIRA HEALTH NETWORK IS THE SECOND HEALTH CARE SYSTEM IN NEW JERSEY TO RECEIVE ISO 9001:2015 CERTIFICATION FOR ACHIEVING QUALITY OBJECTIVES BASED ON INTERNATIONAL STANDARDS AT ITS MEDICAL CENTERS IN ELMER AND VINELAND AND ITS HEALTH CENTER IN BRIDGETON. ACHIEVING ISO 9001:2015 CERTIFICATION IS A REQUIREMENT OF THE FACILITIES' DNV GL HEALTHCARE ACCREDITATION WHICH AIDS THE ORGANIZATIONS LEADERSHIP AND STAFF IN CONTINUOUSLY EVALUATING AND IMPROVING THE CARE PROVIDED TO THE REGION. DNV GL HEALTHCARE IS A HOSPITAL ACCREDITATION PROGRAM APPROVED BY THE U.S. CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) THAT INTEGRATES THE ISO 9001 QUALITY MANAGEMENT SYSTEM INTO THEIR SURVEY PROCESS. THE DNV GL PROGRAM REQUIRES HOSPITALS TO EVALUATE THE CONTINUUM OF PATIENT CARE THROUGHOUT ITS FACILITIES AND TAKE MEASURED STEPS TO IMPROVE WHEN IT IS WARRANTED. WE ARE PROUD TO HAVE RECEIVED NUMEROUS ACCOLADES FOR EXCELLENCE IN HEALTHCARE. IT IS A REFLECTION OF OUR COMMITMENT TO PATIENT SAFETY, BEST PRACTICES, AND EVIDENCE-BASED CARE; SUPPORTING CONTINUING EDUCATION AND STAFF RECRUITMENT; INVESTING IN LEADING EDGE TECHNOLOGY; AND RECRUITING PRIMARY CARE PHYSICIANS, SPECIALISTS, AND SUBSPECIALISTS TO MEET THE NEEDS OF OUR COMMUNITIES. AS ONE OF THE REGION'S LARGEST HEALTHCARE PROVIDERS, WE ARE PLEASED TO SHARE SOME OF OUR MOST RECENT AWARDS: - RATED 1 OF 11 HEALTH SYSTEMS WITH STRONG FINANCES BY BECKERS HOSPITAL REVIEW - ACCREDITED CANCER CENTER BY THE COMMISSION ON CANCER - AMERICAN SOCIETY OF HEALTH-SYSTEM PHARMACISTS (ASHP) ACCREDITATION (2018-2021) - BEACON AWARD FOR EXCELLENCE - SUBURBAN FAMILY'S 'THE BEST OF FAMILY 2019' INNOVATION AND TECHNOLOGY - NEW JERSEY HOSPITAL ASSOCIATIONS COMMUNITY OUTREACH AWARD - UPGRADED FITCH RATING TO AN AA - US NEWS & WORLD REPORT HIGH PERFORMING HOSPITALS (2018-2019) - NJ INFLUENZA HONOR ROLL AWARD FROM THE NJ DEPARTMENT OF HEALTH, VACCINE PREVENTABLE DISEASE PROGRAM - INSPIRA CANCER SERVICES AND THE CHRONIC DISEASE COALITION RECEIVED THE OUTSTANDING COMMUNITY PARTNER AWARD - INSPIRA HEALTH CENTER WOODBURY NURSES RECEIVE PATHWAY TO EXCELLENCE DESIGNATION - INSPIRA HEALTH'S CEO, JOHN DIANGELO NAMED TO SOUTH JERSEY BUSINESS MAGAZINES POWER 50 LIST - INSPIRA EARNED A NATIONAL PRESS GANEY SUCCESS STORY AWARD - INSPIRA HEALTH CEO, JOHN DIANGELO, PRESENTED THE NATIONAL STEVEN SCHRODER OUTSTANDING HEALTHCARE CEO AWARD - INSPIRA AMONG "TOP 150 PLACES TO WORK IN HEALTHCARE IN 2019" ACCORDING TO BECKERS HEALTHCARE ACCESS TO AND IMPROVING THE QUALITY OF HEALTHCARE ================================================= INTEGRAL WITH IMCW'S MISSION TO DELIVER HIGH QUALITY HEALTHCARE TO THE COMMUNITY IT SERVES IS ITS CONTINUED COMMITMENT TO THE MEDICALLY UNDERSERVED MEMBERS OF THE COMMUNITY. THEREFORE, IMCW TREATS ALL PATIENTS WITHOUT REGARD FOR THEIR ABILITY TO PAY. IMCW CONTINUES TO DELIVER DIAGNOSTIC AND THERAPEUTIC SERVICES TO AN EVER-INCREASING POPULATION THAT IS ENTITLED TO RECEIVE THESE SERVICES UNDER CHARITY CARE. ADDITIONAL ASSISTANCE LISTED BELOW IS ALSO PROVIDED: - HEALTH CONCIERGE SERVICE IMCW CONTINUED TO ENHANCE THE HEALTHCARE CONCIERGE SERVICE. WITH ONE PHONE CALL, AREA RESIDENTS CAN NOW SCHEDULE APPOINTMENTS, REGISTER FOR CLASSES, FIND A PHYSICIAN, OR EVEN TALK WITH A REGISTERED NURSE ABOUT AN UPCOMING MEDICAL TEST. - HEALTH INFORMATION - ACCESS TO QUALITY HEALTH INFORMATION IS IMPORTANT AND IMCW PROVIDES A VARIETY OF HEALTHCARE INFORMATION TO THE COMMUNITY ON ITS WEBSITE AND THROUGH PUBLICATIONS TO THE GENERAL PUBLIC. THE COMMUNITY HAS MONTHLY ACCESS TO MEDICAL EXPERTS THROUGH PARTNERSHIPS WITH THE LOCAL NEWSPAPERS FEATURING MONTHLY SECTIONS LIKE "ASK THE DOCTOR", WHICH ALLOW READERS TO SUBMIT QUESTIONS AND RECEIVE RESPONSES ABOUT IMPORTANT HEALTHCARE ISSUES. INSPIRA'S WEBSITE OFFERS A WEALTH OF HEALTH INFORMATION TO THE COMMUNITY INCLUDING FREE ACCESS TO LOOK, LISTEN AND LEARN, AN ONLINE LIBRARY OF EDUCATIONAL VIDEOS COVERING A VARIETY OF MEDICAL CONDITIONS AND PROCEDURES. - LANGUAGE ASSISTANCE - PROVIDED TO THOSE WHOSE LANGUAGE IS OTHER THAN ENGLISH. TO BE CONSIDERED COMMUNITY BENEFIT, THE ETHNICITY OF THE LANGUAGE SPOKEN MUST BE LESS THAN 5% OF THE DEMOGRAPHIC POPULATION. DONATIONS/CASH CONTRIBUTIONS ---------------------------- EACH YEAR IMCW SUPPORTS MANY NON-PROFIT ORGANIZATIONS WHOSE MISSION IS IN ALIGNMENT WITH THAT OF ITS OWN BY PROVIDING DONATIONS OF BOTH CASH AND IN-KIND IN RESPONSE TO THE COMMUNITY'S NEEDS. SOME OF THE ORGANIZATIONS SUPPORTED WITH A CASH DONATION INCLUDED:
CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS - ADAM TALIAFERRO FOUNDATION - AMERICAN CANCER SOCIETY - CHAMBER OF COMMERCE SOUTHERN NJ - COOPER FOUNDATION - CYSTIC FIBROSIS FOUNDATION - EMMANUEL CANCER FOUNDATION - FAF COALITION - FOOD BANK OF SOUTH JERSEY - GARDEN STATE COUNCIL BSA - GLOUCESTER COUNTY CHAMBER OF COMMERCE - GLOUCESTER COUNTY PRAYER COMMITTEE - GREATER WOODBURY CHAMBER OF COMMERCE - HEADSTRONG FOUNDATION - HEARTS UNITED AGAINST CANCER - LAUREN ROSE ALBERT FOUNDATION - MAIN STREET WOODBURY - MARINE CORPS-LAW ENFORCEMENT FOUNDATION - MARYVILLE, INC. - MILLVILLE CHAMBER OF COMMERCE - NAMI NJ - QUALITY CONCEPTS - ROAD RUNNERS CLUB OF WOODBURY - ROBINS NEST - RONALD MCDONALD HOUSE OF SOUTHERN NJ - ROWAN COLLEGE AT GLOUCESTER COUNTY - ROWAN UNIVERSITY FOUNDATION - STAR SPECIALTIES - TROOPERS UNITED FOUNDATION - WOODBURY JUNIOR/SENIOR HIGH SCHOOL COMMUNITY SERVICE AND COMMUNITY BUILDING PROGRAMS ================================================= IMCW IS A COMMUNITY PARTNER DEDICATED TO IMPROVING COMMUNITY HEALTH AND COLLABORATING WITH OTHER COMMUNITY PARTNERS ON HEALTH INITIATIVES THAT ADDRESS THE HEALTH PRIORITIES OF THE COMMUNITIES IT SERVES. OUR PARTNERSHIPS LEVERAGE THE STRENGTH OF MULTIPLE COMMUNITY ORGANIZATIONS WHILE ENCOURAGING COMMUNITY-WIDE COLLABORATIVE EFFORTS TO BENEFIT THE COMMUNITY. AS PART OF ITS MISSION, IMCW OFFERS A BROAD ARRAY OF COMMUNITY OUTREACH AND WELLNESS ACTIVITIES SUCH AS EDUCATIONAL MATERIAL AND COUNSELING, FREE OR LOW-COST HEALTH SCREENINGS AND PATIENT/FAMILY SUPPORT GROUPS. THE IMPORTANCE AND VALUE OF EMPHASIZING GOOD HEALTH, FITNESS, SAFETY, EARLY DETECTION AND PREVENTION ARE SHOWN IN OUR OUTREACH EFFORTS. THIS ALSO REFLECTS OUR STRONG DESIRE TO IMPROVE THE QUALITY OF LIFE FOR ALL WHO LIVE AND WORK IN THE COMMUNITIES WE SERVE. FOOD PANTRIES ------------- IN 2019 A MONTHLY FOOD DISTRIBUTION WAS ESTABLISHED AT THE LOCAL JUNIOR/SENIOR HIGH SCHOOL PROVIDING FRESH PRODUCE AND SHELF STABLE FOOD ITEMS TO ABOUT 500 FAMILIES. ADVOCACY -------- IMCW EMPLOYEES AND LEADERSHIP, SERVE ON VARIOUS GOVERNMENT ADVISORY COMMITTEES AND BOARDS FOR NATIONAL, STATE, AND LOCAL ORGANIZATIONS TO ADVOCATE FOR HEALTHCARE REFORM, BRING ABOUT CHANGES IN REGULATORY REQUIREMENTS, IMPROVE ACCESS TO HEALTHCARE AND PROMOTE THE HEALTH STATUS FOR BOTH THE BROADER COMMUNITY AND VULNERABLE POPULATIONS THROUGH HOSPITAL REPRESENTATION TO ORGANIZATIONS. ADDITIONALLY, IMCW EMPLOYEES, FROM STAFF TO CEO, PARTICIPATE ON THE BOARDS OF A VARIETY OF ORGANIZATIONS WHOSE FOCUS IS NOT ONLY OF THE HEALTH NEEDS OF THE COMMUNITY, BUT ON THE OVERALL NEEDS OF THE COMMUNITY. AMERICAN RED CROSS BLOOD DRIVE ------------------------------ IMCW SUPPORTS THE MISSION OF THE AMERICAN RED CROSS BY HOSTING FOUR BLOOD DRIVES EACH YEAR. THE RED CROSS IS THE LARGEST SINGLE SUPPLIER OF BLOOD AND BLOOD PRODUCTS IN THE UNITED STATES, COLLECTING AND PROCESSING MORE THAN 40 PERCENT OF THE BLOOD SUPPLY AND DISTRIBUTING IT TO SOME 3,000 HOSPITALS AND TRANSFUSION CENTERS NATIONWIDE. BEHAVIORAL HEALTH COLLABORATION ------------------------------- IMCW'S CHILDREN'S BEHAVIORAL HEALTH PROGRAM PARTICIPATED IN BOTH THE GLOUCESTER COUNTY CIACC AND TRI-COUNTY CIACC THROUGHOUT 2019. THE CIACC GROUP IS MADE UP OF A VARIETY OF AGENCIES IN GLOUCESTER, SALEM AND CUMBERLAND COUNTIES, PLUS COMMUNITY MEMBERS FROM THOSE SAME COUNTIES, WHO MEET REGULARLY TO COORDINATE SERVICES, COMMUNICATE REGARDING CHANGES IN THE BEHAVIORAL HEALTH SERVICES IN THE COUNTIES AND ADVOCATE FOR PATIENT RIGHTS/SERVICES. EMERGENCY PREPAREDNESS ---------------------- IMCW READIES ITSELF FOR CATASTROPHIC DISASTER ABOVE AND BEYOND LICENSURE REQUIREMENTS. THIS INCLUDES AN INTERNAL EMERGENCY RESPONSE TEAM THAT RECEIVES SPECIALIZED TRAINING. IMCW PARTNERS WITH OFFICES OF EMERGENCY MANAGEMENT, LOCAL POLICE, AND OTHER RELATED AGENCIES TO COORDINATE COMMUNITY-WIDE MASS CASUALTY DRILLS AND PARTICIPATES IN STATE SPONSORED DISASTER PLANNING DRILLS TO REHEARSE HEALTHCARE PREPAREDNESS FOR MASS CASUALTY DISASTERS AND PUBLIC HEALTH EMERGENCIES. EMERGENCY MEDICAL ACADEMY PROGRAMS ================================== - EMT EMERGENCY MEDICAL TECHNICIAN CLASS - PEDIATRIC EDUCATION FOR PRE-HOSPITAL PROFESSIONALS ("PEPP") - PEDIATRIC ADVANCED LIFE SUPPORT ("PALS") - PRE-HOSPITAL TRAUMA LIFE SUPPORT ("PHTLS") - HEALTHCARE PROVIDER CPR - CPR-BASIC LIFE SUPPORT INSTRUCTOR - ELECTIVE CONTINUING EDUCATION CLASSES - COMMUNITY EMERGENCY RESPONSE TEAM TRAINING - AUTOMATIC EXTERNAL DEFIBRILLATOR ("AED") & EPINEPHRINE AUTO INJECTORS - MOBILE INTENSIVE CARE UNIT ("MICU") - MICU SPECIAL OPERATIONS TEAM - TACTICAL MEDICAL UNIT HEALTHCARE LIFELINE PROGRAM =========================== HEALTHCARE LIFELINE IS AN IN-HOME PERSONAL RESPONSE SYSTEM WHICH ALLOWS ITS SUBSCRIBERS TO GET HELP IMMEDIATELY AT THE PUSH OF A BUTTON, 24 HOURS PER DAY, 7 DAYS PER WEEK, 365 DAYS PER YEAR. IMCW STAFF CONDUCTS PRESENTATIONS THROUGHOUT THE COUNTY EXPLAINING THE BENEFITS OF LIFELINE TO PROSPECTIVE SUBSCRIBERS AND/OR THEIR CAREGIVERS AND HEALTH PROVIDERS. ALTHOUGH THE LIFELINE PROGRAM IS A PAID SERVICE, DISCOUNTED AND FREE INSTALLATIONS OCCUR FOR ELIGIBLE PERSONS. SPIRIT OF WOMEN --------------- SPIRIT OF WOMEN - RECOGNIZING THE UNIQUENESS OF WOMEN AND THE INFLUENCE THEY HOLD OVER THE HEALTH OF THEIR FAMILIES, INSPIRA IS PROUD TO BE A PARTICIPANT OF THE SPIRIT OF WOMEN PROGRAM, PART OF A NATIONAL MOVEMENT FOR WOMEN'S WELLNESS TO PROMOTE HEALTH AND MOTIVATE WOMEN TO MAKE POSITIVE CHANGES IN THEIR LIVES. SOME OF THE GROUP'S EVENTS INCLUDED DAY OF DANCE, WOMEN'S HEALTH SCREENING DAY AND GIRLS NIGHT OUT. SPIRIT OF WOMEN ALSO HOLDS A QUARTERLY SEMINAR SERIES, EACH FOCUSING ON SPECIFIC ISSUES CONCERNING WOMEN'S HEALTH. HEALTH FAIRS & SCREENINGS ------------------------- A NUMBER OF HEALTH FAIRS AND COMMUNITY FOCUSED HEALTH SCREENING EVENTS WERE CONDUCTED THROUGHOUT 2019. IMCW STRIVES TO TEACH HEALTH AND WELLNESS, ANSWER QUESTIONS ABOUT HEALTH-RELATED ISSUES, AND PROMOTE SERVICES AND RESOURCES FOR PEOPLE WITH VARIOUS DISEASES AND ATTEMPT TO REACH AS MANY UNINSURED OR UNDERINSURED AS POSSIBLE. HEALTH SCREENINGS ARE ALSO PERFORMED AS A COMMUNITY SERVICE TO DETECT UNDIAGNOSED DISEASE AND ASSIST THOSE IN NEED IN GAINING ACCESS TO CARE, WORKING TOWARDS ELIMINATING HEALTHCARE DISPARITIES. SOME OF THE HEALTH SCREENINGS IMCW PROVIDES INCLUDE BLOOD PRESSURE, BLOOD GLUCOSE, SKIN CANCER AND CHOLESTEROL AS WELL AS COUNSELING BY SPECIALLY TRAINED NURSES AND FOLLOW-UP WITH PRINTED MATERIALS AND TELEPHONE CALLS. PHYSICIANS WHO SPECIALIZE IN EYE DISEASES PROVIDE GLAUCOMA SCREENINGS AND PROVIDE INFORMATION AND REFERRALS AS NEEDED. CANCER EDUCATION & EARLY DETECTION PROGRAM OF GLOUCESTER COUNTY("CEED") ----------------------------------------------------------------------- THE PURPOSE OF THE CEED PROGRAM IS TO EDUCATE AND SCREEN UNINSURED AND UNDERINSURED RESIDENTS OF THE COUNTY, PARTICULARLY MINORITIES, WHO EARN LESS THAN 250% OF THE FEDERAL POVERTY LEVEL. IN ADDITION, MINORITIES COMPRISE APPROXIMATELY 20% OF THE RESIDENTS OF THE COUNTY AND STATISTICS INDICATE THAT MINORITY MORTALITY RATES ARE HIGHER. THE PROGRAM IS FUNDED IN PART BY GRANTS FROM THE STATE OF NJ DEPARTMENT OF HEALTH AND SENIOR SERVICES, CENTER FOR DISEASE CONTROL AND THE SUSAN G. KOMEN BREAST CANCER FOUNDATION. IMCW IS THE LEAD AGENCY IN GLOUCESTER COUNTY AND PROVIDES FREE BREAST, CERVICAL, COLORECTAL AND PROSTATE CANCER SCREENINGS TO RESIDENTS OF GLOUCESTER COUNTY WHO MEET ELIGIBILITY CRITERIA RELATED TO THEIR AGE, INCOME AND INSURANCE STATUS. INTERESTED APPLICANTS ARE INTERVIEWED OVER THE PHONE AND, IF ACCEPTED INTO THE PROGRAM, ARE REFERRED TO A PROVIDER IN THE GLOUCESTER COUNTY CEED NETWORK FOR SCREENING SERVICES. IN 2019, 81 BREAST, 55 CERVICAL, 26 COLORECTAL, AND 2 PROSTATE SCREENINGS WERE PROVIDED THROUGH THE GRANT. SUPPORT GROUPS -------------- TO HELP ADDRESS SOCIAL, PSYCHOLOGICAL OR EMOTIONAL ISSUES RELATED TO DISEASES AND HEALTH ISSUES, IMCW OFFERS A VARIETY OF FREE SUPPORT GROUPS THAT INCLUDE, BUT ARE NOT LIMITED TO, BABY TALK TUESDAYS FOR NEW MOMS, WOMEN'S CANCER, DIABETES, BREASTFEEDING SUPPORT, OSTOMY SUPPORT GROUP, OCD SUPPORT GROUP, CARDIOPULMONARY HEALTH, PROSTATE CANCER, ALZHEIMERS CAREGIVERS, SMOKING CESSATION, STROKE AND FIVE LEVELS OF BARIATRIC SUPPORT. IMCW OFFERS THE USE OF THEIR MEETING ROOMS AND FACILITIES, FREE OF CHARGE, TO COMMUNITY-BASED ORGANIZATIONS, SUPPORT GROUPS, SELF-HELP GROUPS AND NON-PROFIT HEALTH AND HUMAN SERVICE AGENCIES. SOME EXAMPLES OF THE ORGANIZATIONS THAT WERE OFFERED SPACE IN 2019 INCLUDED ALCOHOLICS ANONYMOUS, AMERICAN RED CROSS, AND THE ALHZHEIMER'S ASSOCIATION.
CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS COMMUNITY EDUCATION CLASSES --------------------------- IMCW OFFERS FREE EDUCATION PROGRAMS AND LECTURES DESIGNED TO PROMOTE A SAFE AND HEALTHY LIFESTYLE. TRAINING CLASSES ARE REGULARLY AVAILABLE ON SUCH TOPICS AS CHILDBIRTH, BREAST-FEEDING, NEWBORN CARE, DIABETES, STROKE, CPR (CARDIOPULMONARY RESUSCITATION), SAFESITTER (BABYSITTER TRAINING), BARIATRICS, HIP AND KNEE REPLACEMENT, CANCER, SLEEP DISORDERS, AND ADVANCE DIRECTIVES. IMCWS EMERGENCY DEPARTMENT PLAYS A KEY ROLE IN EDUCATING AND PROMOTING HEALTH AND SAFETY AWARENESS THROUGH COMMUNITY BULLETIN BOARDS AND EDUCATIONAL PRESENTATIONS AT AREA SCHOOLS, COLLEGES, POLICE ACADEMIES AND COMMUNITY PROGRAMS. SOME TOPICS MAY INCLUDE INJURY PREVENTION, FORENSIC NURSING AND DOMESTIC VIOLENCE AWARENESS. VOLUNTEERS ---------- IMCW HAS A LONG-STANDING AND SUCCESSFUL VOLUNTEER PROGRAM CONSISTING OF BOTH ADULTS AND TEENAGERS WHO VOLUNTEER THEIR TIME TO OFFER SUPPORT AND COMPASSION TO THE PEOPLE THEY SERVE. VOLUNTEERS PROVIDE ASSISTANCE WITH DUTIES SUCH AS COURIER SERVICE, FUNDRAISING, PATIENT TRANSPORT, CLERICAL TASKS, AS WELL AS VARIOUS CUSTOMER SERVICE NEEDS THROUGHOUT THE HOSPITAL. IN 2019, THERE WERE 91 VOLUNTEERS PROVIDING APPROXIMATELY 12,033 HOURS OF SERVICE. HEALTH PROFESSIONS EDUCATION ---------------------------- IMCW OFFERS EDUCATIONAL SUPPORT TO BOTH ITS CURRENT HEALTH PROFESSIONALS AND TOMORROWS PHYSICIANS. EDUCATION HELPS PREPARE THE NEXT GENERATION OF HEALTHCARE PROFESSIONALS, WHICH IS WHY WE STRONGLY SUPPORT MEDICAL EDUCATION AT ALL ACADEMIC LEVELS AND FIND INNOVATIVE WAYS TO INSPIRE YOUNG PEOPLE TO PURSUE CAREERS IN A WIDE VARIETY OF MEDICAL FIELDS. COMMUNITY MEDICINE ROTATIONS WITH THE ROWAN UNIVERSITY SCHOOL OF OSTEOPATHIC MEDICINE (ROWAN SOM), PROVIDES THIRD YEAR MEDICAL STUDENTS A TWO-WEEK ROTATION IN COMMUNITY-BASED AGENCIES AND ORGANIZATIONS TO LEARN ABOUT UNDERSERVED AND CULTURALLY DIVERSE POPULATIONS, INCLUDING BARRIERS TO ACCESSING CARE. RESPONDING TO THE NURSING SHORTAGE, IMCW OFFERS NURSING EDUCATION PROGRAMS, EXTERNSHIPS AND INTERNSHIPS. IMCW MEDICAL STAFF ROUTINELY HOSTS STUDENTS FOR JOB SHADOWING AND STUDENT OBSERVATIONS. - SCHOOL PROGRAMS ON HEALTH CAREERS - IMCW PROVIDES EDUCATIONAL OPPORTUNITIES AND HOSTS SPECIAL EVENTS, JOB SHADOWING AND PROGRAMS TO MIDDLE AND HIGH SCHOOL STUDENTS WHO ARE INTERESTED IN PURSUING CAREERS IN HEALTHCARE AND MEDICINE. TO REACH EVERY AGE GROUP IN THE COMMUNITY, IMCW STAFF ALSO EXTENDS HOSPITALS TOURS TO PRESCHOOL AND FIRST GRADERS, AS THEIR PRIMARY INTRODUCTION TO THE HEALTHCARE ENVIRONMENT AND PROMOTION OF HEALTHY LIFESTYLES. - SYMPOSIA - IMCW IS PREPARING FOR THE HEALTHCARE CHALLENGES OF THE FUTURE BY SUPPORTING THE CONTINUING EDUCATION NEEDS OF PHYSICIANS AND ALLIED HEALTH PERSONNEL IN THE COMMUNITY. PROGRAMS ARE AVAILABLE ON THE LATEST ADVANCEMENTS AND LEADING-EDGE RESEARCH ON TOPICS SUCH AS CANCER, CRITICAL CARE, NEPHROLOGY, PEDIATRICS AND OBSTETRICS. THESE CONTINUING EDUCATION OPPORTUNITIES GIVE HEALTH PROFESSIONALS AND PHYSICIANS IN OUR COMMUNITY AND ACROSS THE REGION THE ABILITY TO MEET AND DISCUSS IMPORTANT ISSUES WITHIN OUR INDUSTRY. PROGRAM TOPICS PROVIDED ARE BASED ON ANNUAL STAFF SURVEYS AND ARE MANDATORY EDUCATION FOR STAFF. - RESIDENCY PROGRAM - SINCE 1983, IMCW HAS OPERATED A FAMILY MEDICINE RESIDENCY PROGRAM WHO WORK SIDE-BY-SIDE WITH EXPERIENCED MEMBERS OF THE IMCW MEDICAL STAFF, GAINING VALUABLE EXPERIENCE AND INSIGHT. AT THE SAME TIME, THEY ENHANCE PATIENT CARE WITH THE KNOWLEDGE OF THE LATEST TREATMENTS AND PHILOSOPHIES MEDICINE HAS TO OFFER. THEY ALSO BRING A LEVEL OF INTELLECTUAL CURIOSITY THAT STRENGTHENS OUR CARE TEAMS AND BENEFITS OUR PATIENTS. INSPIRA HOSPITALS ALSO SERVE AS CLINICAL ROTATION SITES FOR SEVERAL AREA MEDICAL SCHOOLS. - IMCW HOSTS A NUMBER OF CONTINUING EDUCATION TRAINING CLASSES FOR EMERGENCY MEDICAL TECHNICIANS CONSISTING OF VARIOUS TOPICS RELATED TO THE CARE PROVIDED BY EMERGENCY MEDICAL TECHNICIANS. THESE CLASSES ASSIST EMERGENCY MEDICAL TECHNICIANS IN OBTAINING THE REQUIRED 24 TO 48 HOURS OF CONTINUING EDUCATION TRAINING REQUIRED DURING EACH CERTIFICATION PERIOD, TRAININGS MEET THE REQUIREMENT OF THE NJ STATE DEPARTMENT OF HEALTH AND SENIOR SERVICES AND THE NATIONAL REGISTRY OF EMERGENCY MEDICAL TECHNICIANS. CLASSES INCLUDE EMERGENCY MEDICAL TECHNICIAN CLASS, EMT TRANSITION CLASSES, PEDIATRIC EDUCATION FOR PRE-HOSPITAL PROFESSIONALS, PRE-HOSPITAL TRAUMA LIFE SUPPORT. - CONTINUING EDUCATION FOR MEDICAL PROFESSIONALS INCLUDES ADVANCED CARDIAC LIFE SUPPORT, PEDIATRIC ADVANCED LIFE SUPPORT, HEALTHCARE PROVIDER CPR, CPR-BASIC LIFE SUPPORT INSTRUCTOR TRAINING, AND COMMUNITY EMERGENCY RESPONSE TEAM TRAINING. RESEARCH ======== THE INSPIRA INSTITUTIONAL REVIEW BOARD ("IRB") FUNCTIONS AS A SPECIAL COMMITTEE OF THE MEDICAL STAFF WHICH FOLLOWS THE GUIDELINES OF AND IS REGISTERED WITH HHS. THE PURPOSE OF THE IRB IS TO REVIEW AND MONITOR ALL CLINICAL INVESTIGATIONS THAT INVOLVE HOSPITALIZED PATIENTS OR THOSE WHO MAY SUBSEQUENTLY RECEIVE CARE AT INSPIRA. NO CLINICAL INVESTIGATION IS PERMITTED IN THE INSTITUTION UNLESS PRIOR AND CONTINUING APPROVAL IS GRANTED BY THE IRB.
CORE FORM, PART III, QUESTION 3 EFFECTIVE WITH THE CLOSE OF BUSINESS ON DECEMBER 13, 2019, THIS ORGANIZATION WAS STATUTORILY MERGED INTO INSPIRA MEDICAL CENTERS, INC.; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION.
CORE FORM, PART VI, SECTION A; QUESTION 4 EFFECTIVE WITH THE CLOSE OF BUSINESS ON DECEMBER 13, 2019, THIS ORGANIZATION WAS STATUTORILY MERGED INTO INSPIRA MEDICAL CENTERS, INC.; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. THE ORGANIZATION'S GOVERNING DOCUMENTS HAVE BEEN UPDATED ACCORDINGLY.
CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7 PRIOR TO ITS STATUTORY MERGER ON DECEMBER 13, 2019, INSPIRA HEALTH NETWORK, INC. ("NETWORK") WAS THE SOLE MEMBER OF THIS ORGANIZATION. NETWORK HAD THE RIGHT TO ELECT THE MEMBERS OF THIS ORGANIZATION'S BOARD OF TRUSTEES AND HAS CERTAIN RESERVED POWERS AS DEFINED IN THIS ORGANIZATION'S BYLAWS.
CORE FORM, PART VI, SECTION B; QUESTION 11B PRIOR TO ITS STATUTORY MERGER ON DECEMBER 13, 2019, THE ORGANIZATION WAS AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). INSPIRA HEALTH NETWORK, INC. ("NETWORK") IS THE TAX-EXEMPT PARENT ENTITY OF THE SYSTEM. THIS ORGANIZATION'S FEDERAL FORM 990 WAS PROVIDED TO EACH MEMBER OF THE NETWORK'S AUDIT COMMITTEE FOR REVIEW AND THEREAFTER APPROVAL BY THE MEMBERS AT AN AUDIT COMMITTEE MEETING. SUBSEQUENTLY, THE ORGANIZATIONS 990 WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S BOARD OF TRUSTEES, PRIOR TO FILING WITH THE IRS. THE NETWORK'S AUDIT COMMITTEE HAS ASSUMED THE RESPONSIBILITY TO OVERSEE AND COORDINATE THE FEDERAL FORM 990 PREPARATION, REVIEW AND FILING PROCESS FOR ALL TAX-EXEMPT AFFILIATES WITHIN THE SYSTEM. AS PART OF THE ORGANIZATION'S FEDERAL FORM 990 TAX RETURN PREPARATION PROCESS THE SYSTEM HIRED A PROFESSIONAL CERTIFIED PUBLIC ACCOUNTING ("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 ALSO MADE A PRESENTATION TO THE NETWORKS AUDIT COMMITTEE PRIOR TO APPROVAL OF THE FORMS 990 BY THE AUDIT COMMITTEE. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE ORGANIZATION'S FINANCE PERSONNEL AND SYSTEM INDIVIDUALS INCLUDING GENERAL COUNSEL, EXECUTIVE VICE PRESIDENT/CHIEF FINANCIAL OFFICER, VICE PRESIDENT OF FINANCE AND VARIOUS OTHER INDIVIDUALS ("INTERNAL WORKING GROUP") TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE ORGANIZATION'S INTERNAL WORKING GROUP FOR REVIEW. THE ORGANIZATION'S INTERNAL WORKING GROUP REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE ORGANIZATION'S INTERNAL WORKING GROUP FOR FINAL REVIEW AND APPROVAL. THEREAFTER, THE FORM 990 WAS PROVIDED TO THE NETWORK'S AUDIT COMMITTEE AND THE ORGANIZATION'S BOARD OF TRUSTEES, PRIOR TO FILING WITH IRS.
CORE FORM, PART VI, SECTION B; QUESTION 12 PRIOR TO ITS STATUTORY MERGER ON DECEMBER 13, 2019, THE ORGANIZATION WAS AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). INSPIRA HEALTH NETWORK, INC. ("NETWORK") IS THE TAX-EXEMPT PARENT ENTITY OF THE SYSTEM. THE SYSTEM HAS A WRITTEN CONFLICT OF INTEREST POLICY WITH WHICH ALL AFFILIATES REGULARLY MONITOR AND ENFORCE COMPLIANCE. THE CONFLICT OF INTEREST POLICY REQUIRES THAT A CONFLICT OF INTEREST DISCLOSURE STATEMENT, CONSISTENT WITH BEST GOVERNANCE PRACTICES AND INTERNAL REVENUE SERVICE GUIDELINES, BE CIRCULATED ANNUALLY TO ALL TRUSTEES/DIRECTORS, OFFICERS, KEY EMPLOYEES AND COMMITTEE MEMBERS (COLLECTIVELY, "INSPIRA MANAGEMENT") WITHIN THE SYSTEM. ALL MEMBERS OF INSPIRA MANAGEMENT ARE REQUIRED TO REVIEW THE EXISTING CONFLICT OF INTEREST POLICY ANNUALLY AND SIGN A DISCLOSURE STATEMENT WHICH AFFIRMS THAT THEY: (A) HAVE RECEIVED A COPY OF THIS CONFLICT OF INTEREST POLICY; (B) HAVE READ AND UNDERSTOOD THE POLICY; (C) HAVE AGREED TO COMPLY WITH THE POLICY, AND (D) UNDERSTAND THAT THE ORGANIZATION IS A CHARITABLE, TAX-EXEMPT ORGANIZATION AND THAT, IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. PER THE SYSTEM'S CONFLICT OF INTEREST POLICY, ANY MEMBER OF INSPIRA MANAGEMENT HAVING A POTENTIAL OR ACTUAL SIGNIFICANT FINANCIAL OR PERSONAL INTEREST IN ANY TRANSACTION OR ARRANGEMENT, SHALL MAKE A PROMPT, FULL AND FRANK DISCLOSURE OF HIS OR HER INTEREST TO THE APPLICABLE GOVERNING BOARD OR A COMMITTEE THEREOF WHICH IS CONSIDERING THE AUTHORIZATION, APPROVAL, RATIFICATION, OR SIMILAR ACTION OF SUCH TRANSACTION OR ARRANGEMENT PRIOR TO THE ORGANIZATION ACTING ON SUCH TRANSACTION OR ARRANGEMENT. THE COMPLETED CONFLICT OF INTEREST DISCLOSURE STATEMENTS ARE RETURNED TO THE SYSTEM'S GENERAL COUNSEL FOR REVIEW. THEREAFTER, GENERAL COUNSEL presents any conflicts of interest to THE NETWORK'S GOVERNANCE COMMITTEE FOR ITS REVIEW AND DISCUSSION.
CORE FORM, PART VI, SECTION B; QUESTION 15 PRIOR TO ITS STATUTORY MERGER ON DECEMBER 13, 2019, THE ORGANIZATION WAS AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). INSPIRA HEALTH NETWORK, INC. ("NETWORK") IS THE TAX-EXEMPT PARENT ENTITY OF THE SYSTEM. PLEASE NOTE THAT ALL OFFICERS REPORTED IN CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 ARE PAID BY INSPIRA MEDICAL CENTERS, INC.; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION AND AFFILIATE WITHIN THE NETWORK. NETWORK'S BOARD OF TRUSTEES HAS AN EXECUTIVE COMPENSATION COMMITTEE ("COMMITTEE"). THE COMMITTEE HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY WHICH IT FOLLOWS WHEN IT REVIEWS AND APPROVES OF THE COMPENSATION AND BENEFITS OF THE ORGANIZATION'S SENIOR MANAGEMENT, INCLUDING, BUT NOT LIMITED TO, THE PRESIDENT/CHIEF EXECUTIVE OFFICER AND ALL EXECUTIVE VICE PRESIDENTS AND SENIOR VICE PRESIDENTS THAT REPORT DIRECTLY TO THE PRESIDENT/CHIEF EXECUTIVE OFFICER ("SENIOR MANAGEMENT"). THE COMMITTEE REVIEWS THE "TOTAL COMPENSATION" OF SENIOR MANAGEMENT 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 IS REASONABLE. THE ACTIONS TAKEN BY THE COMMITTEE ENABLE THE ORGANIZATION TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 4958 WITH RESPECT TO THE TOTAL COMPENSATION OF SENIOR MANAGEMENT. THE THREE FACTORS WHICH MUST BE SATISFIED IN ORDER TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS ARE THE FOLLOWING: 1. THE COMPENSATION ARRANGEMENT IS APPROVED IN ADVANCE BY AN "AUTHORIZED BODY" OF THE APPLICABLE TAX-EXEMPT ORGANIZATION WHICH IS COMPOSED ENTIRELY OF INDIVIDUALS WHO DO NOT HAVE A "CONFLICT OF INTEREST" WITH RESPECT TO THE COMPENSATION ARRANGEMENT; 2. THE AUTHORIZED BODY OBTAINED AND RELIED UPON "APPROPRIATE DATA AS TO COMPARABILITY" PRIOR TO MAKING ITS DETERMINATION; AND 3. THE AUTHORIZED BODY "ADEQUATELY DOCUMENTED THE BASIS FOR ITS DETERMINATION" CONCURRENTLY WITH MAKING THAT DETERMINATION. THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES EACH OF WHO ARE INDEPENDENT AND ARE FREE FROM ANY CONFLICTS OF INTEREST. THE COMMITTEE RELIED UPON APPROPRIATE COMPARABLE DATA; SPECIFICALLY THE COMMITTEE OBTAINED A WRITTEN COMPENSATION STUDY FROM AN INDEPENDENT FIRM WHICH SPECIALIZES IN THE REVIEWING OF HOSPITAL AND HEALTHCARE SYSTEM EXECUTIVE COMPENSATION AND BENEFITS THROUGHOUT THE UNITED STATES. THIS STUDY USED COMPARABLE GEOGRAPHIC AND DEMOGRAPHIC MARKET DATA INCLUDING BUT NOT LIMITED TO SIMILAR SIZED HOSPITALS, # OF LICENSED BEDS AND NET PATIENT SERVICE REVENUE. THE COMMITTEE ADEQUATELY DOCUMENTED ITS BASIS FOR ITS DETERMINATION THROUGH THE TIMELY PREPARATION OF WRITTEN MINUTES OF THE COMPENSATION COMMITTEE MEETINGS DURING WHICH THE EXECUTIVE COMPENSATION AND BENEFITS WAS REVIEWED AND SUBSEQUENTLY APPROVED. THE ACTIONS OUTLINED ABOVE WITH RESPECT TO THE COMMITTEE AND THE ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS ONLY APPLIES TO SENIOR MANAGEMENT. THE COMPENSATION AND BENEFITS OF CERTAIN OTHER INDIVIDUALS CONTAINED IN THIS FORM 990 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'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 PRIOR TO ITS STATUTORY MERGER ON DECEMBER 13, 2019, JOHN A. DIANGELO WAS A MEMBER OF THE ORGANIZATIONS BOARD OF TRUSTEES. THIS WAS HIS SOLE ROLE WITH THE ORGANIZATION. HE PROVIDED NO SERVICES TO OR FOR THE ORGANIZATION AND WAS NOT INVOLVED IN THE MANAGEMENT OR DAY TO DAY ACTIVITIES OF THIS ORGANIZATION. MR. DIANGELO IS EMPLOYED BY A RELATED ORGANIZATION. ACCORDINGLY HIS COMMON LAW EMPLOYER/EMPLOYEE RELATIONSHIP IS WITH INSPIRA MEDICAL CENTERS, INC. (EIN: 21-0634484). INSPIRA MEDICAL CENTERS, INC. FILED A 2019 FORM 4720 WHICH INCLUDED A REMITTANCE OF EXCISE TAX RELATED TO MR. DIANGELOS COMPENSATION IN EXCESS OF $1M.
CORE FORM, PART VII AND SCHEDULE J CORE FORM, PART VII AND SCHEDULE J, PART II REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM RELATED ORGANIZATIONS. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OR INDEPENDENT CONTRACTORS OF THE RELATED ORGANIZATIONS AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THIS ORGANIZATION'S BOARD OF TRUSTEES. PLEASE NOTE THIS ORGANIZATION'S FORM 990 REFLECTS NO COMPENSATED INDIVIDUALS FROM THIS ENTITY. INSPIRA MEDICAL CENTERS, INC. ("IMC"), A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION EMPLOYS THESE INDIVIDUALS. IMC ISSUES FORMS W-2 TO INDIVIDUALS WHO PROVIDE SERVICES AT INSPIRA MEDICAL CENTER WOODBURY, INC., AND FILES THE APPLICABLE FORMS WITH THE INTERNAL REVENUE SERVICE. IMC ALLOCATES THESE PAYMENTS TO THIS ORGANIZATION VIA AN INTERCOMPANY ACCOUNT.
CORE FORM, PART VII, SECTION A, COLUMN B PRIOR TO ITS STATUTORY MERGER ON DECEMBER 13, 2019, THIS ORGANIZATION WAS AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM INCLUDES BOTH FOR-PROFIT AND NOT FOR-PROFIT ORGANIZATIONS. CERTAIN BOARD OF TRUSTEE MEMBERS AND OFFICERS 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 IN CORE FORM, PART VII OF THIS FORM 990. THE HOURS REFLECTED ON CORE FORM, PART VII OF THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, PAID OFFICERS OR KEY EMPLOYEES, REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF THE SYSTEM; NOT SOLELY THIS ORGANIZATION.
CORE FORM, PART XI; QUESTION 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCE INCLUDE: - STATUTORY MERGER AND TRANSFER OF NET ASSETS OF ENTITY INTO INSPIRA MEDICAL CENTERS, INC.; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION - ($236,014,611); - PENSION LIABILITY ADJUSTMENT - $362,170; - CHANGE IN VALUE OF INTEREST RATE SWAP AGREEMENT - ($1,210,792); - CHANGE IN BENEFICIAL INTEREST IN CAPITAL CAMPAIGN; DONOR RESTRICTED - ($4,591,898); - CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST; DONOR RESTRICTED - $451,698; AND - OTHER CHANGES IN UNRESTRICTED NET ASSETS - ($8,393,237).
CORE FORM, PART XII; QUESTION 2 PRIOR TO ITS STATUTORY MERGER ON DECEMBER 13, 2019, THE ORGANIZATION WAS AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM'S TAX-EXEMPT PARENT ENTITY IS INSPIRA HEALTH NETWORK, INC. ("NETWORK"). AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF THE NETWORK AND ALL ENTITIES WITHIN THE SYSTEM FOR THE YEARS ENDED DECEMBER 31, 2019 AND DECEMBER 31, 2018; RESPECTIVELY. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAIN CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. THE INDEPENDENT CPA FIRM ISSUED AN UNMODIFIED OPINION WITH RESPECT TO THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS EACH YEAR. THE NETWORK'S FINANCE/AUDIT COMMITTEE HAS ASSUMED RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE CONSOLIDATED FINANCIAL STATEMENTS, WHICH INCLUDES THIS ORGANIZATION, AND THE SELECTION OF AN INDEPENDENT AUDITOR.
CORE FORM, PART XII; QUESTION 3 THE ORGANIZATION IS AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM ENGAGED AN INDEPENDENT ACCOUNTING FIRM TO PREPARE AND ISSUE A SYSTEM WIDE CONSOLIDATED AUDIT UNDER THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133 AUDIT.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2019


Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
INSPIRA MEDICAL CENTER WOODBURY INC
 
Employer identification number

22-1820210
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity

(1) INSPIRA DEPTFORD HEALTHPARK LLC
165 BRIDGETON PIKE
MULLICA HILL,NJ08062
32-0483850
HEALTHCARE NJ 0 0 IMCW
 










Part II
Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1)INSPIRA HOMECARE & HOSPICECARE INC
333 IRVING AVENUE

BRIDGETON,NJ08302
22-6067549
HEALTH SVCS. NJ 501(C)(3) 509(A)(2) NETWORK
 
 
No
(2)INSPIRA HEALTH NETWORK INC
333 IRVING AVENUE

BRIDGETON,NJ08302
22-2508425
HEALTH SVCS. NJ 501(C)(3) 509(A)(3) N/A
 
No
(3)INSPIRA MEDICAL CENTERS INC
333 IRVING AVENUE

BRIDGETON,NJ08302
21-0634484
HEALTH SVCS. NJ 501(C)(3) HOSPITAL NETWORK
 
 
No
(4)INSPIRA HLTH NTWK FDN CUMBERLANDSALEM
333 IRVING AVENUE

BRIDGETON,NJ08302
22-3746758
FUNDRAISING NJ 501(C)(3) 509(A)(3) IMC
 
 
No
(5)INSPIRA HEALTH NETWORK LIFE INC
2950 COLLEGE DRIVE SUITE 1E

VINELAND,NJ08360
26-4827936
HEALTH SVCS. NJ 501(c)(3) 509(A)(3) NETWORK
 
 
No
(6)INSPIRA HLTH NTWRK FDN GLOUCESTER COUNTY
509 NORTH BROAD STREET

WOODBURY,NJ08096
22-2333409
FUNDRAISING NJ 501(c)(3) 509(A)(1) IMC
 
 
No
(7)TRI-COUNTY CARDIOVASCULAR SERVICES PC
509 NORTH BROAD STREET

WOODBURY,NJ08096
45-4199382
INACTIVE NJ 501(C)(3) 509(A)(3) NETWORK
 
 
No
(8)INSPIRA HEALTH CONNECTIONS PC
509 NORTH BROAD STREET

WOODBURY,NJ08096
45-4203973
HEALTH SVCS. NJ 501(C)(3) 509(A)(1) NETWORK
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?



(k)
Percentage
ownership


Yes No Yes No
(1) BPOC LP

333 IRVING AVENUE
BRIDGETON,NJ08302
22-2956029
REAL ESTATE NJ N/A
                 
(2) OAK & MAIN SURGICTR

907 NORTH MAIN ROAD
VINELAND,NJ08360
22-3532371
HEALTHCARE SVCS. NJ N/A
                 
(3) GLOUC CTY SURG CTR

163 BRIDGETON PIKE BLDG B
MULLICA HILL,NJ08062
26-1157885
HEALTHCARE SVCS. NJ N/A
                 
(4) INSPIRA HLTH PTRS

2950 COLLEGE DRIVE
VINELAND,NJ08360
46-5550615
HEALTHCARE AC0 NJ N/A
                 
(5) INSPIRA SJ UC MGT

165 BRIDGETON PIKE
MULLICA HILL,NJ08062
81-3186749
URGENT CARE MGT NJ NA
 
                 
(6) WCMA LLP

1060 N KINGS HWY
CHERRY HILL,NJ08034
22-3006705
HEALTHCARE SVCS. NJ NA
 
                 


Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) INSPIRA HEALTH MANAGEMENT CORPORATION

2950 COLLEGE DRIVE SUITE 1E
VINELAND,NJ08360
22-2502241
HEALTHCARE SVCS. NJ N/A
C CORP.         No
(2) INSPIRA HEALTH NETWORK MEDICAL GROUP PC

2950 COLLEGE DRIVE SUITE 1E
VINELAND,NJ08360
20-5745047
HEALTHCARE SVCS. NJ N/A
C CORP.         No
(3) JUNO ASSURANCE LTD

AON HOUSE 4TH FLOOR
PEMBROKE   HM 08
BD
FINANCIAL VEHICLE BD N/A
FOREIGN CORP.         No
(4) INSPIRA HEALTH NETWORK URGENT CARE PC

201 TOMLIN STATION ROAD
MULLICA HILL,NJ08062
45-2900402
HEALTHCARE SVCS. NJ N/A
C CORP.         No
(5) RED BANK DEVELOPMENT CORPORATION

509 NORTH BROAD STREET
WOODBURY,NJ08096
22-2814053
HEALTHCARE SVCS. NJ N/A
C CORP.         No
(6) INSPIRA SJ URGENT CARE PC

165 BRIDGETON PIKE
MULLICA HILL,NJ08062
81-3165654
HEALTHCARE SVCS. NJ NA
 
C CORP.         No


Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
Yes
 
e Loans or loan guarantees by related organization(s) ............................
1e
Yes
 
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
Yes
 
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) INSPIRA HEALTH NETWORK INC

D 837,565 COST





Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. (see instructions).
Return Reference Explanation
SCHEDULE R, PART V PRIOR TO ITS STATUTORY MERGER ON DECEMBER 13, 2019, THIS ORGANIZATION WAS A MEMBER OF INSPIRA HEALTH NETWORK; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. FUNDS ARE ROUTINELY TRANSFERRED BETWEEN AFFILIATES AND BUSINESS ACTIVITIES ARE COMMON ON BEHALF OF THE SYSTEM'S AFFILIATES, INCLUDING THIS ORGANIZATION. THESE TRANSACTIONS MAY BE RECORDED ON THE REVENUE/EXPENSE AND BALANCE SHEET STATEMENTS OF THIS ORGANIZATION AND OTHER AFFILIATES. INSPIRA HEALTH NETWORK ENTITIES WORK TOGETHER TO DELIVER HIGH QUALITY COST EFFECTIVE HEALTHCARE AND WELLNESS SERVICES TO THEIR COMMUNITIES REGARDLESS OF ABILITY TO PAY AND IN FURTHERANCE OF CHARITABLE TAX-EXEMPT PURPOSES.
Schedule R (Form 990) 2019

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