TY 2020 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) AL MAGHAZEHE PHD FACHE...................................................................... DIRECTOR - PRESIDENT/CEO	55.0 ................. 0.0	X	X			13,412,509	0	38,401
(2) LEE M BUONO MD...................................................................... PHYSICIAN	55.0 ................. 0.0				X	1,164,662	0	31,545
(3) SHANE F FLEMING CPA...................................................................... SVP, CHIEF FINANCIAL OFFICER	55.0 ................. 0.0		X			943,381	25,000	39,012
(4) JOSHUA A EISENBERG MD...................................................................... PHYSICIAN	55.0 ................. 0.0				X	960,748	0	31,887
(5) CATALDO DORIA MD...................................................................... PHYSICIAN	55.0 ................. 0.0				X	900,551	0	15,199
(6) NAVID REDJAL MD...................................................................... PHYSICIAN	55.0 ................. 0.0				X	846,974	0	30,824
(7) JASON N ROGART MD...................................................................... PHYSICIAN	55.0 ................. 0.0				X	841,394	0	23,969
(8) GINA P MUMOLIE...................................................................... SVP, HOSPITAL ADMINISTRATION	55.0 ................. 0.0			X		829,876	0	26,711
(9) ALEXANDER D GLADNEY ESQ...................................................................... SVP, CHIEF LEGAL OFFICER	55.0 ................. 0.0			X		708,044	25,000	26,594
(10) EUGENE W GROCHALA...................................................................... CHIEF INFORMATION OFFICER	55.0 ................. 0.0			X		674,464	0	24,827
(11) EUGENE J MCMAHON MD...................................................................... SVP, CHIEF MEDICAL OFFICER	55.0 ................. 0.0			X		662,464	0	32,333
(12) ARLENE WALSH...................................................................... SVP, CAO - CHMG	55.0 ................. 0.0			X		540,966	32,847	35,881
(13) NATHAN BOSK FACHE...................................................................... VP, SUPPLY CHAIN/FACILITY SVCS	55.0 ................. 0.0			X		551,599	0	29,988
(14) SUZANNE B BORGOS...................................................................... SVP, CORPORATE SERVICES	55.0 ................. 0.0			X		560,136	0	5,069
(15) DEBORAH MICAN...................................................................... VP, PATIENT SERVICES/CNO	55.0 ................. 0.0			X		442,156	0	22,740
(16) DEBORAH VISCONTI...................................................................... VP, FINANCE	55.0 ................. 0.0			X		352,180	0	32,254
(17) AUDRA FARISH...................................................................... VP, HUMAN RESOURCES	55.0 ................. 0.0			X		366,740	0	10,602

(A) Name and business address	(B) Description of services	(C) Compensation
SODEXO MANAGEMENT INC, PO BOX 360170 PITTSBURGH,PA152516170	MANAGEMENT	9,368,120
UNIVERSAL PROTECTION SERVICE, PO BOX 828854 PHILADELPHIA,PA191828854	SECURITY	4,237,602
CAPITAL HEALTH ADVANCE IMAGING, PO BOX 3246 INDIANAPOLIS,IN462063246	MEDICAL	3,878,227
MERCER GASTROENTEROLOGY, 2 CAPITAL WAY SUITE 487 HOPEWELL,NJ08534	MEDICAL	3,557,672
LEVLANE ADVERTISING, PO BOX 2130 UPPER DARBY,PA19082	ADVERTISING	3,148,315
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 137

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization

CAPITAL HEALTH SYSTEM INC

Employer identification number

22-3548695

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.)

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

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

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

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

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

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

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

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

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

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

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

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

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

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

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

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

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

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

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2020

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)		(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(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)		(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

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

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2020 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2019 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2020. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2019. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2020. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2019. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2020

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)		(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2020 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2019 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2020 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2019 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2020. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2019. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

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

Schedule A (Form 990 or 990-EZ) 2020

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

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

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2020

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

A person who directly or indirectly controls, either alone or together with persons described in lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described in 11a above?

11b

A 35% controlled entity of a person described in line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

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

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

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

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

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2020

Page 6

Part V

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

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

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

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 0.015 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 0.035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

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

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

Schedule A (Form 990 or 990-EZ) 2020

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	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2020 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2020	(iii) Distributable Amount for 2020
1 Distributable amount for 2020 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 2020:
a From 2015.......
b From 2016.......
c From 2017.......
d From 2018.......
e From 2019.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2020 distributable amount
i Carryover from 2015 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2020 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2020 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2020, 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 2020. 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 2021. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2016.....
b Excess from 2017.....
c Excess from 2018.....
d Excess from 2019.....
e Excess from 2020.....

Schedule A (Form 990 or 990-EZ) (2020)

Schedule A (Form 990 or 990-EZ) 2020

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) 2020

Additional Data

Software ID:
Software Version:

- TIN:

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

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2020

Name of the organization

CAPITAL HEALTH SYSTEM INC

Employer identification number

22-3548695

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

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

Special Rules

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

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

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

Caution: An organization that 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) (2020)

Schedule B (Form 990, 990-EZ, or 990-PF) (2020) Page 2

Name of organization CAPITAL HEALTH SYSTEM INC

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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Page 3

Name of organization CAPITAL HEALTH SYSTEM INC		Employer identification number 22-3548695

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) (2020)

Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Page 4


Name of organization CAPITAL HEALTH SYSTEM INC			Employer identification number 22-3548695
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

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

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

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

CAPITAL HEALTH SYSTEM INC

Employer identification number

22-3548695

Part I-A

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

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

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2020

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

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

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

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2017	(b) 2018	(c) 2019	(d) 2020	(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) 2020

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

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

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

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

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

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

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

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

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

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

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

Yes

134,763

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

134,763

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

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

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

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

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

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

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

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

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

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

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

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

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

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

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

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

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
SCHEDULE C, PART II-B	DURING 2020, THE ORGANIZATION PAID AN OUTSIDE LOBBYING FIRM A TOTAL OF $105,000 FOR LOBBYING ON A FEDERAL AND STATE LEVEL RELATED TO MEDICARE, MEDICAID AND OTHER HEALTHCARE LEGISLATIVE MATTERS. IN ADDITION, THE ORGANIZATION IS A MEMBER OF THE NEW JERSEY HOSPITAL ASSOCIATION, THE AMERICAN HOSPITAL ASSOCIATION, NEW JERSEY BUSINESS & INDUSTRY ASSOCIATION AND THE HOSPITAL ALLIANCE OF NEW JERSEY WHICH ALL ENGAGE IN LOBBYING EFFORTS ON BEHALF OF THEIR MEMBER HOSPITALS. A PORTION OF THE DUES PAID TO THESE ORGANIZATIONS HAS BEEN ALLOCATED TO LOBBYING ACTIVITES PERFORMED ON BEHALF OF THE ORGANIZATION. THIS ALLOCATION AMOUNTED TO $14,263 IN 2020. A PERCENTAGE OF THE 2020 TOTAL COMPENSATION FOR A DIRECTOR OF PUBLIC AFFAIRS HAS BEEN ALLOCATED TOWARD LOBBYING ACTIVITIES PERFORMED ON BEHALF OF CAPITAL HEALTH SYSTEM, INC. AND ITS AFFILIATES ON BOTH A FEDERAL AND STATE LEVEL. THIS ALLOCATION AMOUNTED TO $15,500 IN 2020.

Return Reference

Explanation

SCHEDULE C, PART II-B

DURING 2020, THE ORGANIZATION PAID AN OUTSIDE LOBBYING FIRM A TOTAL OF $105,000 FOR LOBBYING ON A FEDERAL AND STATE LEVEL RELATED TO MEDICARE, MEDICAID AND OTHER HEALTHCARE LEGISLATIVE MATTERS. IN ADDITION, THE ORGANIZATION IS A MEMBER OF THE NEW JERSEY HOSPITAL ASSOCIATION, THE AMERICAN HOSPITAL ASSOCIATION, NEW JERSEY BUSINESS & INDUSTRY ASSOCIATION AND THE HOSPITAL ALLIANCE OF NEW JERSEY WHICH ALL ENGAGE IN LOBBYING EFFORTS ON BEHALF OF THEIR MEMBER HOSPITALS. A PORTION OF THE DUES PAID TO THESE ORGANIZATIONS HAS BEEN ALLOCATED TO LOBBYING ACTIVITES PERFORMED ON BEHALF OF THE ORGANIZATION. THIS ALLOCATION AMOUNTED TO $14,263 IN 2020. A PERCENTAGE OF THE 2020 TOTAL COMPENSATION FOR A DIRECTOR OF PUBLIC AFFAIRS HAS BEEN ALLOCATED TOWARD LOBBYING ACTIVITIES PERFORMED ON BEHALF OF CAPITAL HEALTH SYSTEM, INC. AND ITS AFFILIATES ON BOTH A FEDERAL AND STATE LEVEL. THIS ALLOCATION AMOUNTED TO $15,500 IN 2020.

Schedule C (Form 990 or 990EZ) 2020

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

CAPITAL HEALTH SYSTEM INC

Employer identification number

22-3548695

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

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

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

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

Yes No

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

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

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under 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.

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

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:

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

Assets included in Form 990, Part X ............................... SchDMd Bullet

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

Cat. No. 52283D

Schedule D (Form 990) 2020

Page 2

Part III

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

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

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

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

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

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Term endowment SchDMd Bullet

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

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

Yes

(i) Unrelated organizations .......................

3a(i)

(ii) Related organizations .......................

3a(ii)

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

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	42,171,794		42,171,794
b	Buildings ....	510,604,783	234,432,021	276,172,762
c	Leasehold improvements
d	Equipment ....	541,945,742	395,248,611	146,697,131
e	Other .....	64,521,798	24,696,360	39,825,438
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				504,867,125

Schedule D (Form 990) 2020

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.)

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1)MUTUAL FUNDS-FIXED INCOME SEC.	37,283,783	F
(2)MUTUAL FUNDS - EQUITY SEC.	45,808,307	F
(3)PROGRAM RELATED INVESTMENTS	19,209,399	F
(4)ACCRUED INTEREST	41,317	F
(5)CASH & CASH EQUIV - LTD. USE	105,025,048	F
(6)LTD USE ASSETS HELD UNDER SERP	8,622,892	F
(7)CASH AND CASH EQUIVALENTS	59,921,244	F
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)	275,911,990

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1)OTHER NON-CURRENT ASSETS				54,096,522
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				54,096,522

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
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	130,466,967
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) 2020

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 (Form 990) 2020

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16. Right pointing arrow large image

Attach to Form 990. Right pointing arrow large image

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization
CAPITAL HEALTH SYSTEM INC

Employer identification number

22-3548695

Part I

General Information on Activities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 14b.

For grantmakers. Does the organization maintain records to substantiate the amount of its grants and

other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used

to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.

Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)

(a) Region		(b) Number of offices in the region	(c) Number of employees, agents, and independent contractors in the region	(d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region)	(e) If activity listed in (d) is a program service, describe specific type of service(s) in the region	(f) Total expenditures for and investments in the region
	Central America and the Caribbean	1	1	Investments		56,747,451
	Central America and the Caribbean	0	0	Program Services	FINANCIAL VEHICLE	12,306,820















3a	Sub-total ....	1	1			69,054,271
b	Total from continuation sheets to Part I ...
c	Totals (add lines 3a and 3b)	1	1			69,054,271

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2020

Schedule F (Form 990) 2020

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.

1 (a) Name of organization		(b) IRS code section and EIN (if applicable)	(c) Region	(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement	(g) Amount of noncash assistance	(h) Description of noncash assistance	(i) Method of valuation (book, FMV, appraisal, other)

2	Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......
3	Enter total number of other organizations or entities .......................

Schedule F (Form 990) 2020

Schedule F (Form 990) 2020Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 16.

Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance		(b) Region	(c) Number of recipients	(d) Amount of cash grant	(e) Manner of cash disbursement	(f) Amount of noncash assistance	(g) Description of noncash assistance	(h) Method of valuation (book, FMV, appraisal, other)

Schedule F (Form 990) 2020

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2020

Page 5

Part V

Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.

ReturnReference	Explanation

Schedule F (Form 990) 2020

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

CAPITAL HEALTH SYSTEM INC

Employer identification number

22-3548695

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

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

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other 600 %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

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

Yes

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

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

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

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

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	168,206,861	125,736,913	42,469,948	5.330 %
b	Medicaid (from Worksheet 3, column a) . . . . .	28,882,781	18,497,292	10,385,489	1.300 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	197,089,642	144,234,205	52,855,437	6.630 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	1,796,781	1,183	1,795,598	0.230 %
f	Health professions education (from Worksheet 5) . . .	7,881,523	7,173,794	707,729	0.090 %
g	Subsidized health services (from Worksheet 6) . . . .	25,090,965	0	25,090,965	3.150 %
h	Research (from Worksheet 7) .	39,060	0	39,060	0 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	455,364	0	455,364	0.060 %
j	Total. Other Benefits . .	35,263,693	7,174,977	28,088,716	3.530 %
k	Total. Add lines 7d and 7j .	232,353,335	151,409,182	80,944,153	10.160 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2020

Schedule H (Form 990) 2020

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

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

98,220,664

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. ......

9,822,066

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

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

99,968,687

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

126,007,794

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

-26,039,107

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

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

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

Schedule H (Form 990) 2020

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?2Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)						Facility reporting group
1	CAPITAL HEALTH MEDICAL CNTR-HOPEWELL ONE CAPITAL WAY PENNINGTON,NJ08534 WWW.CAPITALHEALTH.ORG 11104	X	X	X	X	1
2	CAPITAL HEALTH REGIONAL MEDICAL CNTR 750 BRUNSWICK AVENUE TRENTON,NJ08638 WWW.CAPITALHEALTH.ORG 11102	X	X	X	X	1

Schedule H (Form 990) 2020

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)

	CAPITAL HEALTH MEDICAL CNTR-HOPEWELL
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 18

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

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

Yes

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

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

Other website (list url): WWW.TRENTONHEALTHTEAM.ORG

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

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19

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

Yes

If "Yes" (list url): WWW.CAPITALHEALTH.ORG

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

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

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

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2020

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	CAPITAL HEALTH MEDICAL CNTR-HOPEWELL
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.%
and FPG family income limit for eligibility for discounted care of 600.%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

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

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

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

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

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

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

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

www.capitalhealth.org

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

www.capitalhealth.org

A plain language summary of the FAP was widely available on a website (list url):
www.capitalhealth.org

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

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

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

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

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

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2020

Page 6

Part VFacility Information (continued)

Billing and Collections

	CAPITAL HEALTH MEDICAL CNTR-HOPEWELL
Name of hospital facility or letter of facility reporting group

Yes

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

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2020

Page 7

Part VFacility Information (continued)

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

	CAPITAL HEALTH MEDICAL CNTR-HOPEWELL
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2020

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)

	CAPITAL HEALTH REGIONAL MEDICAL CNTR
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 18

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

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

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

Yes

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

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

Other website (list url): WWW.TRENTONHEALTHTEAM.ORG

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

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19

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

Yes

If "Yes" (list url): WWW.CAPITALHEALTH.ORG

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

10b

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

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

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2020

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	CAPITAL HEALTH REGIONAL MEDICAL CNTR
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.%
and FPG family income limit for eligibility for discounted care of 600.%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

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

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

www.capitalhealth.org

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

www.capitalhealth.org

A plain language summary of the FAP was widely available on a website (list url):
www.capitalhealth.org

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

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

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

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

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2020

Page 6

Part VFacility Information (continued)

Billing and Collections

	CAPITAL HEALTH REGIONAL MEDICAL CNTR
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2020

Page 7

Part VFacility Information (continued)

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

	CAPITAL HEALTH REGIONAL MEDICAL CNTR
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2020

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, PT V, SECT B, Q'S 2,3j,13h,15e,18e,19e,20e,21c,21d,23&24	Not Applicable.
SCHEDULE H, PART V, SECTION B, QUESTION 5	As a collaborative member of the trenton health team, capital health conducted a community health needs assessment ("chna") and took into account input from representatives of the community served, including those with special knowledge or expertise in public health, through 300 individual interviews and 30 forums held in places of worship, community organizations, and public facilities. As a founding member of the greater mercer public health partnership ("gmphp"), capital health, along with other core members including, st. Lawrence rehabilitation center, robert wood johnson university hospital at hamilton and st. Francis medical center directed a process involving over 400 community members through 29 focus groups, 17 individual interviews with community leaders, and six discussion groups conducted to test our preliminary findings. In 2015, the gmphp contracted with health resources in action ("hria"), a non-profit public health organization, to partner in conducting the 2015 mercer county community health assessment ("cha") and facilitating and developing the 2016 mercer county community health improvement plan ("chip") and Year 1 CHIP Action Plan. IN 2018, THE GMPHP AGAIN PARTNERED IN CONDUCTING THE 2018 MERCER COUNTY COMMUNITY HEALTH ASSESSMENT ("CHA").
SCHEDULE H, PART V, SECTION B, QUESTION 6A & 6B	The trenton health team is a collaborative of the city's two hospitals, st. Francis medical center and capital health; its only federally qualified health center, henry j. Austin health center and the city government's department of health & human services have partnered with OVER 29 community and social service agencies across trenton in a new approach to develop one chna for the city as a whole. Organizations participating in the unified chna have committed to allocating resources to address the health needs as identified. Agencies and organizations include: Home front; rescue mission of trenton; mercer street friends; isles; catholic charities diocese of trenton; mercer alliance to end homelessness; children's futures; task; the children's home society; planned parenthood; shiloh community development corporation; affiliated accountable care organizations; trenton police department; mercercounty nj; henry j. Austin health center, inc.; lotus medical care; concerned pastors; trinity episcopal cathedral; shiloh baptist church; thomas edison college; rider university; john watson institute for public policy; turning point, The College of New Jersey; Anchor House; Care One; Comfort Keepers; Medina Health; Rescue Mission of Trenton; Robert Wood Johnson Foundation New Jersey Health Initiatives; and various other agencies and organizations. Gmphp has subsequently engaged as members of capital health's policy board (governing body which meets quarterly) and capital health's steering committee (operations focused group which meets at least once a month) the public health officers of eight municipalities as well as the county's public health director. In 2018, the gmphp engaged the community advisory board (cab), a 60-member group of representatives across a range of organizational sectors, including community leaders and organizations, to solicit input into the process and encourage the group's participation in the upcoming planning sessions.
SCHEDULE H, PART V, SECTION B, QUESTIONS 7A & 7D	DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN PART V, SECTION B, QUESTION 7A, IS THE HOME PAGE FOR THE ORGANIZATION. THE CHNA CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE ORGANIZATION'S WEBSITE: https://www.capitalhealth.org/sites/default/files/2019-01/GMPHP%20CHA%20FI NAL_123118.pdf Results of the chna were presented in a number of public forums are published on the trenton health team website: https://trentonhealthteam.org/wp-content/uploads/Trenton-CHNAA-June-2019_7 .2.19r.pdf The gmphp chna is available on capital health's website, with a link on the homepage.
SCHEDULE H, PART V, SECTION B, QUESTION 10	DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN PART V, SECTION B, QUESTION 10, IS THE HOME PAGE FOR THE ORGANIZATION. THE implementation strategy CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE ORGANIZATION'S WEBSITE: https://www.capitalhealth.org/sites/default/files/2020-03/GMPHP-CHIP%20Las t%20Updated%202.29.20.pdf
SCHEDULE H, PART V, SECTION B, QUESTION 11	As a result of its most recent chna conducted in 2018, the organization, in 2019, adopted a written implementation plan entitled "greater mercer public health partnership community health improvement plan 2019-2021." the information below relates to the organization's implementation plan that was adopted for its chna conducted in 2018. The following health challenges identified in the chna are not being addressed by capital health due to the fact that they fall beyond the scope of capital health's services: - mental health and substance abuse - safe transportation/safe recreational spaces The chna was a comprehensive document that detailed numerous issues. Working with gmphp partners, capital health prioritized actions into a series of wellness and health screening activities which addressed the most critical areas of concern. Most recently, capital health created a website to centralize all information regarding all health and wellness activities occurring in mercer county. This was in direct response to an identified priority need as expressed through capital health outreach interviews. Due to the acute and significant community needs as a result of the covid-19 pandemic, several elements of the community health improvement plan were re-prioritized and/or put on hold in order to instead direct additional resources towards meeting the community's covid-19 needs. Regarding chronic disease, capital Health in collaboration with the Trenton Health formed the Capital City Diabetes Collaborative to address the social, environmental and clinical determinants of health related to diabetes which is so prevalent in our community. In additional Capital Health initiated a hospital violence intervention program to provide comprehensive wrap around services to victims of violence in our community. The goal of the program is to prevent reinjury, retaliation and the impact of post-traumatic stress disorder.
SCHEDULE H, PART V, SECTION B, QUESTION 13	The organization utilizes new jersey state charity care guidelines in determining eligibility for providing free or discounted care. Charges for self-pay patients are reduced to 115% of the medicare rate. Patients whose income and assets criteria are at or below twice the current threshold for eligibility for new jersey charity care will be provided with a 100% discount off of the organization's usual and customary charges. The income based criteria used to determine eligibility is per new jersey administrative code 10:52 sub chapters 11, 12 and 13, and based upon the latest published poverty guidelines (department of health and senior services). Federal poverty guidelines ("fpg") are included in the criteria for determining eligibility for charity and discounted care.
SCHEDULE H, PART V, SECTION B, QUESTION 16	DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN PART V, SECTION B, QUESTIONS 16A, 16B AND 16C, IS THE HOME PAGE FOR THE ORGANIZATION. THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION AND PLAIN LANGUAGE SUMMARY CAN BE ACCESSED AT THE FOLLOWING URL WHICH IS INCLUDED IN THE ORGANIZATION'S WEBSITE: https://www.capitalhealth.org/patients-visitors/bills-and-insurance/financ ial-assistance
SCHEDULE H, PART V, SECTION B, QUESTION 16J	Billing statements provided to patients indicate that the organization's financial assistance policy is available upon request.

Schedule H (Form 990) 2020

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?71
Name and address		Type of Facility (describe)
1	CAPITAL HEALTH - MEDICAL OFFICE BUILDING 2 CAPITAL WAY PENNINGTON,NJ08534	GENERAL MEDICINE
2	CAPITAL HEALTH - HAMILTON 1445 WHITEHORSE-MERCERVILLE ROAD HAMILTON,NJ08619	OUTPATIENT FACILITY
3	CH PRIMARY CARE - HAMILTON 1445 WHITEHORSE-MERCERVILLE RD STE HAMILTON,NJ08619	GENERAL MEDICINE/PRIMARY CARE
4	CAPITAL INST FOR NEUROSCIENCE-HOPEWELL 2 CAPITAL WAY SUITE 456 PENNINGTON,NJ08534	NEURO MEDICINE
5	CH PRIMARY CARE - QUAKERBRIDGE 4056 QUAKERBRIDGE ROAD SUITE 101 LAWRENCEVILLE,NJ08648	GENERAL MEDICINE/PRIMARY CARE
6	CH PRIMARY CARE - EWING 1230 PARKWAY AVENUE SUITE 203 WEST TRENTON,NJ08628	GENERAL MEDICINE/PRIMARY CARE
7	CH PRIMARY CARE - BORDENTOWN 1 THIRD STREET BORDENTOWN,NJ08505	FAMILY MEDICINE/PRIMARY CARE
8	CH PRIMARY CARE - NEWTOWN 3 PENNS TRAIL NEWTOWN,PA18940	GENERAL MEDICINE/PRIMARY CARE
9	CH PRIMARY CARE - ROBBINSVILLE 2330 ROUTE 33 SUITE 107 ROBBINSVILLE,NJ08691	GENERAL MEDICINE/PRIMARY CARE
10	CH PRIMARY CARE - MOUNTAINVIEW 850 BEAR TAVERN ROAD SUITE 309 WEST TRENTON,NJ08628	GENERAL MEDICINE/PRIMARY CARE
11	COMPREHENSIVE SLEEP ASSOCIATES OF NJ 1401 WHITEHORSE-MERCERVILLE RD STE HAMILTON,NJ08619	SLEEP MEDICINE
12	CH PRIMARY CARE - COLUMBUS 23203 COLUMBUS ROAD SUITE 1 COLUMBUS,NJ08022	GENERAL MEDICINE/PRIMARY CARE
13	CH ENDOCRINOLOGY SPECIALISTS - HOPEWELL 2 CAPITAL WAY SUITE 290 PENNINGTON,NJ08534	ENDOCRINOLOGY
14	CH PRIMARY CARE - BRUNSWICK 832 BRUNSWICK AVE TRENTON,NJ08638	GENERAL MEDICINE/PRIMARY CARE
15	CH HEART CARE SPECIALISTS - HOPEWELL 2 CAPITAL WAY SUITE 385 PENNINGTON,NJ08534	CARDIOLOGY
16	CH PRIMARY CARE - LAWRENCEVILLE 123 FRANKLIN CORNER ROAD SUITE 216 LAWRENCEVILLE,NJ08648	GENERAL MEDICINE/PRIMARY CARE
17	CH PRIMARY CARE - HOPEWELL 2 CAPITAL WAY SUITE 359 PENNINGTON,NJ08534	GENERAL MEDICINE/PRIMARY CARE
18	CAPITAL INST FOR NEUROSCIENCES-LANGHORNE 680 MIDDLETOWN BLVD SUITE 100 LANGHORNE,PA19047	NEURO MEDICINE
19	CH PRIMARY CARE - YARDLEY 1690 BIG OAK ROAD YARDLEY,PA19067	GENERAL MEDICINE/PRIMARY CARE
20	CH HEART CARE SPECIALISTS - HAMILTON 1445 WHITEHORSE-MERCERVILLE RD STE HAMILTON,NJ08619	CARDIOLOGY
21	CAPITAL HEALTH SURGICAL GROUP - HOPEWELL 2 CAPITAL WAY SUITE 356 PENNINGTON,NJ08534	SURGICAL MEDICINE
22	CH SURGICAL GROUP - VASCULAR - HOPEWELL 2 CAPITAL WAY SUITE 456 PENNINGTON,NJ08534	VASCULAR SURGICAL MEDICINE
23	CH PRIMARY CARE - HAMILTON III 1401 WHITEHORSE-MERCERVILLE RD STE HAMILTON,NJ08619	GENERAL MEDICINE/PRIMARY CARE
24	CH PRIMARY CARE - PRINCETON 811 EXECUTIVE DRIVE SUITE 811-813 PRINCETON,NJ08540	GENERAL MEDICINE/PRIMARY CARE
25	CH GYNECOLOGY SPECIALISTS - HOPEWELL 2 CAPITAL WAY SUITE 356 PENNINGTON,NJ08534	GYNECOLOGY
26	CH PRIMARY CARE - PARKSIDE 1450 PARKSIDE AVE SUITE 5 EWING,NJ08638	GENERAL MEDICINE/PRIMARY CARE
27	CH HEALTH OBGYN - TRENTON 433 BELLEVUE AVENUE 3RD FLOOR TRENTON,NJ08618	OBSTETRICS/GYNECOLOGY
28	CH BEHAVIORAL HLTH SPECIALISTS-HAMILTON 1445 WHITEHORSE-MERCERVILLE RD STE HAMILTON,NJ08619	BEHAVIORAL HEALTH
29	PLASTIC SURGERY ASSOCIATES OF NJ 2 CAPITAL WAY SUITE 505 PENNINGTON,NJ08534	PLASTIC SURGERY
30	CH HEART CARE SPECIALISTS - COLUMBUS 23203 COLUMBUS ROAD SUITE I COLUMBUS,NJ08022	CARDIOLOGY
31	CH RHEUMATOLOGY SPECIALISTS - HOPEWELL 2 CAPITAL WAY SUITE 550 PENNINGTON,NJ08534	RHEUMATOLOGY CENTER
32	CAPITAL INST FOR NEUROSCIENCES-HAMILTON 1445 WHITEHORSE-MERCERVILLE RD STE HAMILTON,NJ08619	NEURO MEDICINE
33	CH GASTROENTEROLOGY SPECIALISTS-HAMILTON 1445 WHITEHORSE-MERCERVILLE RD STE HAMILTON,NJ08619	GASTROENTEROLOGY
34	CH PEDS GASTROENTEROLOGY SPEC-HAMILTON 1445 WHITEHORSE-MERCERVILLE RD STE HAMILTON,NJ08619	GASTROENTEROLOGY-PEDS
35	CH PRIMARY CARE - NOTTINGHAM 1235 WHITEHORSE-MERCERVILLE RD HAMILTON,NJ08618	GENERAL MEDICINE/PRIMARY CARE
36	CH Surgical Group - Breast Hopewell 2 CAPITAL WAY SUITE 505 PENNINGTON,NJ08534	BREAST SURGERY
37	CH CENTER FOR DIGESTIVE HEALTH 2 CAPITAL WAY SUITE 380 PENNINGTON,NJ08534	DIGESTIVE HEALTH
38	CH ENDOCRINOLOGY SPECIALISTS-BORDENTOWN 100 K JOHNSON BLVD N SUITE 101 BORDENTOWN,NJ08505	ENDOCRINOLOGY
39	CH PULMONOLOGY SPECIALISTS 2 CAPITAL WAY SUITE 357 PENNINGTON,NJ08534	PULMONOLOGY
40	CH PRIMARY CARE - WASHINGTON CROSSING 1240 GENERAL WASHINGTON MEMORIAL BL WASHINGTON CROSSING,PA18977	GENERAL MEDICINE/PRIMARY CARE
41	CH Heart Care Spec Deborah Heart & lung 200 TRENTON ROAD BROWNS MILLS,NJ08015	CARDIOLOGY
42	CH HEALTH OBGYN - LANGHORNE 540 WOODBOURNE ROAD LANGHORNE,PA19047	OBSTETRICS/GYNECOLOGY
43	CH MULTI-SPECIALTY GROUP-LOWER MAKEFIELD 1050 STONY HILL ROAD YARDLEY,PA19067	MULTI-SPECIALTY GROUPS
44	CAPITAL INST NEURO-RADIATION ONCOLOGY 2 CAPITAL WAY PENNINGTON,NJ08534	NEURO MEDICINE
45	CH UROLOGY SPECIALISTS 2 CAPITAL WAY SUITE 407 PENNINGTON,NJ08534	UROLOGY
46	CENTER FOR INCONTINENCE & PELVIC HEALTH 2 CAPITAL WAY SUITE 407 PENNINGTON,NJ08534	UROLOGY
47	CH Infectious Disease Specialists 40 FULD STREET SUITE 305 TRENTON,NJ08638	INFECTIOUS DISEASE
48	CAPITAL SURGICAL ASSOCIATES 832 BRUNSWICK AVENUE TRENTON,NJ08638	TRAUMA MEDICINE
49	CAPITAL HEALTH SURGICAL GROUP - REGIONAL 832 BRUNSWICK AVE TRENTON,NJ08638	SURGICAL MEDICINE
50	CAPITAL INST FOR NEUROSCIENCES-COLUMBUS 23203 COLUMBUS ROAD SUITE I COLUMBUS,NJ08022	NEURO MEDICINE
51	CAPITAL HEALTH - FAMILY HEALTH CENTER 433 BELLEVUE AVENUE 2ND FLOOR TRENTON,NJ08618	FAMILY HEALTH CENTER
52	CAPITAL INST FOR NEUROSCI-MOUNT LAUREL 15000 MIDLANTIC DRIVE SUITE 102 MOUNT LAUREL,NJ08054	NEURO MEDICINE
53	CH SURGICAL GROUP - HAMILTON 1401 WHITEHORSE-MERCERVILLE RD STE HAMILTON,NJ08619	SURGICAL MEDICINE
54	CAPITAL HEALTH - MICU 433 BELLEVUE AVENUE 1ST FLOOR TRENTON,NJ08618	MICU
55	CAPITAL HEALTH CORPORATE HEALTH CENTER 1401 WHITEHORSE-MERCERVILLE RD STE HAMILTON,NJ08619	HEALTH CENTER
56	CENTER FOR OUTPATIENT REHAB - HOPEWELL 2 CAPITAL WAY SUITE 418 PENNINGTON,NJ08534	REHABILITATION SERVICES
57	CENTER FOR OUTPATIENT REHAB - TRENTON 832 BRUNSWICK AVE TRENTON,NJ08618	REHABILITATION SERVICES
58	EXECUTIVE HEALTH 2 CAPITAL WAY SUITE 505 PENNINGTON,NJ08534	HEALTH CENTER
59	CH OBGYN - BORDENTOWN 163 ROUTE 130 BORDENTOWN,NJ08505	OBSTETRICS/GYNECOLOGY
60	CH OBGYN - BROWNS MILLS 6 EARLIN AVE SUITE 290 BROWNS MILLS,NJ08015	OBSTETRICS/GYNECOLOGY
61	CH OBGYN - HAMILTON 1401 WHITEHORSE-MERCERVILLE RD STE HAMILTON,NJ08619	OBSTETRICS/GYNECOLOGY
62	CH OBGYN - LAWRENCE 123 FRANKLIN CORNER ROAD SUITE 214 LAWRENCEVILLE,NJ08648	OBSTETRICS/GYNECOLOGY
63	CH PRIMARY CARE - BROWNS MILLS 6 EARLIN AVE SUITE 240 BROWNS MILLS,NJ08015	GENERAL MEDICINE/PRIMARY CARE
64	CH BEHAVIORAL SPECIALISTS - BORDENTOWN 1 THIRD STREET BORDENTOWN,NJ08505	BEHAVIORAL HEALTH
65	CH BEHAVIORAL SPECIALISTS - NEWTOWN 3 PENNS TRAIL 2ND FLOOR NEWTOWN,PA18940	BEHAVIORAL HEALTH
66	CH HEART CARE SPECIALISTS - NEWTOWN 3 PENNS TRAIL 2ND FLOOR NEWTOWN,PA18940	CARDIOLOGY
67	CH RHEUMATOLOGY SPECIALISTS - NEWTOWN 3 PENNS TRAIL 2ND FLOOR NEWTOWN,PA18940	RHEUMATOLOGY
68	CH SURGICAL GROUP-BREAST SURG - NEWTOWN 3 PENNS TRAIL 2ND FLOOR NEWTOWN,PA18940	SURGICAL MEDICINE
69	CH UROLOGY SPECIALISTS - NEWTOWN 3 PENNS TRAIL 2ND FLOOR NEWTOWN,PA18940	UROLOGY
70	CH PAIN MANAGEMENT SPECIALIST-HOPEWELL 2 CAPITAL WAY SUITE 456 PENNINGTON,NJ08534	PAIN MANAGEMENT
71	CH PAIN MANAGEMENT SPECIALIST-LANGHORNE 680 MIDDLETOWN BLVD SUITE 201 LANGHORNE,PA19047	PAIN MANAGEMENT

Schedule H (Form 990) 2020

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	The organization utilizes new jersey state charity care guidelines in determining eligibility for providing free or discounted care. Charges for self-pay patients are reduced to 115% of the Medicare rate. Patients whose income and assets criteria are at or below twice the current threshold for eligibility for new jersey charity care will be provided with a 100% discount off of the organization's usual and customary charges. The income based criteria used to determine eligibility is per new jersey administrative code 10:52 sub chapters 11, 12 and 13, and based upon the latest published poverty guidelines (department of health and senior services). FEDERAL POVERTY GUIDELINES ("FPG") are included in the criteria for determining eligibility for charity and discounted care.
SCHEDULE H, PART I, LINES 6A & 6B	Not applicable.
SCHEDULE H, PART I; QUESTION 7G	No costs relating to subsidized healthcare services are attributable to any physician clinics.
SCHEDULE H, PART I, QUESTION 7	Worksheet 2 was used for the cost to charge ratio.
SCHEDULE H, PART III, SECTION A; QUESTION 1	Healthcare financial management association statement no. 15 ("statement 15") provides guidelines for distinguishing charity care from bad debt expense. Statement 15 requires that charity care is not recognized as receivable or revenue in the financial statements. Statement 15 further explains that self-pay patients that do have a reasonable likelihood of payment should be reported as charity care and not bad debt expense. The hospital generally follows the guidelines outlined in statement 15. In addition, the hospital follows the state of new jersey guidelines in determining charity care eligibility. In certain instances, it is unlikely that uninsured patients will pay for the services rendered, but they do not qualify for the state's charity care program because of lack of patient cooperation or other reasons. The hospital pursues collection of these amounts and unpaid balances are reported as bad debt expense. Under statement 15, these amounts would be recorded as charity care rather than bad debt expense and this is the rationale for our response: "no".
SCHEDULE H, PART III, SECTION A; QUESTIONS 2,3 & 4	BAD DEBT EXPENSE WAS CALCULATED USING THE PROVIDERS' BAD DEBT EXPENSE FROM ITS INTERNAL FINANCIAL STATEMENTS. Capital Health System, Inc. And its affiliates, including its hospitals and subsidiaries, prepare and issue audited consolidated financial statements. the attached text was obtained from the footnotes to the audited financial statements of capital health system. Charity care Capital Health provides care to patients who meet certain criteria defined by the New Jersey Department of Health ("DOH") without charge or at amounts less than established rates. Because capital health does not pursue collection of amounts determined to qualify as charity care, they are not reported as revenue. Capital health's records identify and monitor the level of charity care it provides and include the amount of charges forgone for services and supplies furnished. DOH allows retroactive application for charity care up to two years from the date of service. The cost of charity care is derived from both estimated and actual data. The estimated cost of charity care includes the direct and indirect cost of providing such services and is estimated utilizing capital health's ratio of cost to gross charges, which is then multiplied by the gross uncompensated charges associated with providing care to charity patients. Charity care provided, at cost, during 2020 AND 2019 TOTALED APPROXIMATELY $43,306,000 AND $38,184,000, respectively. Capital Health receives payments from the New Jersey health care subsidy funds for charity care and such amounts totaled approximately $16,532,000 AND $16,362,000 for the years ended December 31, 2020 and 2019, respectively.
SCHEDULE H, PART III, SECTION B; QUESTION 8	Medicare costs were derived from the 2020 medicare cost report. Medicare underpayments and bad debt are community benefit and associated costs are includable on the form 990, schedule h, part i. The organization believes that medicare underpayments (shortfall) and bad debt are community benefit and associated costs are includable on the form 990, schedule h, part i. As outlined more fully below the organization believes that these services and related costs promote the health of the community as a whole and are rendered in conjunction with the organization's charitable tax-exempt purposes and mission in providing medically necessary healthcare services to all individuals in a non-discriminatory manner without regard to race, color, creed, sex, national origin, religion 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 had to provide, to the extent of its financial ability, free or reduced-cost care to patients unable to pay for it. A hospital that expected full payment did not, according to the ruling, provide charity care based on the fact that some patients ultimately failed to pay. The ruling emphasized that a low level of charity care did not necessarily mean that a hospital had failed to meet the requirement since that level could reflect its financial ability to provide such care. The ruling also noted that publicly supported community hospitals would normally qualify as charitable organizations because they serve the entire community, and a low level of charity care would not affect a hospital's exempt status if it was due to the surrounding community's lack of charitable demands. Community benefit standard In 1969, the irs issued revenue ruling 69-545, which "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 treas. Reg. 1.501(c)(3)-1(d)(2). The irs ruling stated that the promotion of health, like the relief of poverty and the advancement of education and religion, is one of the purposes in the general law of charity that is deemed beneficial to the community as a whole even though the class of beneficiaries eligible to receive a direct benefit from its activities does not include all members of the community, such as indigent members of the community, provided that the class is not so small that its relief is not of benefit to the community. The irs concluded that the hospital was "promoting the health of a class of persons that is broad enough to benefit the community" because its emergency room was open to all and it provided care to everyone who could pay, whether directly or through third-party reimbursement. Other characteristics of the hospital that the irs highlighted included the following: its surplus funds were used to improve patient care, expand hospital facilities, and advance medical training, education, and research; it was controlled by a board of trustees that consisted of independent civic leaders; and hospital medical staff privileges were available to all qualified physicians. The american hospital association ("aha") believes that medicare underpayments (shortfall) and bad debt are community benefit and thus includable on the form 990, schedule h, part i. This organization agrees with the aha position. As outlined in the aha letter to the irs dated august 21, 2007 with respect to the first published draft of the new form 990 and schedule h, the aha felt that the irs should incorporate the full value of the community benefit that hospitals provide by counting medicare underpayments (shortfall) as quantifiable community benefit for the following reasons: - providing care for the elderly and serving medicare patients is an essential part of the community benefit standard. - medicare, like medicaid, does not pay the full cost of care. Recently, medicare reimburses hospitals only 92 cents for every dollar they spend to take care of medicare patients. The medicare payment advisory commission ("medpac") in its march 2007 report to congress cautioned that underpayment will get even worse, with margins reaching a 10-year low at negative 5.4 percent. - many medicare beneficiaries, like their medicaid counterparts, are poor. More than 46 percent of medicare spending is for beneficiaries whose income is below 200 percent of the federal poverty level. Many of those medicare beneficiaries are also eligible for medicaid -- so called eligibles." There is every compelling public policy reason to treat medicare and medicaid underpayments similarly for purposes of a hospital's community benefit and include these costs on form 990, schedule h, part i. Medicare underpayment must be shouldered by the hospital in order to continue treating the community's elderly and poor. These underpayments represent a real cost of serving the community and should count as a quantifiable community benefit. Both the aha and this organization also feel that patient bad debt is a community benefit and thus includable on the form 990, schedule h, part i. Like medicare underpayment (shortfalls), there also are compelling reasons that patient bad debt should be counted as quantifiable community benefit as follows: - a significant majority of bad debt is attributable to low-income patients, who, for many reasons, decline to complete the forms required to establish eligibility for hospitals' charity care or financial assistance programs. A 2006 congressional budget office ("cbo") report, nonprofit hospitals and the provision of community benefits, cited two studies indicating that "the great majority of bad debt was attributable to patients with incomes below 200% of the federal poverty line." - the report also noted that a substantial portion of bad debt is pending charity care. Unlike bad debt in other industries, hospital bad debt is complicated by the fact that hospitals follow their mission to the community and treat every patient that comes through their emergency department, regardless of ability to pay. Patients who have outstanding bills are not turned away, unlike other industries. Bad debt is further complicated by the auditing industry's standards on reporting charity care. Many patients cannot or do not provide the necessary, extensive documentation required to be deemed charity care by auditors. 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 benefits" 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
SCHEDULE H, PART III, SECTION B; QUESTION 9B	In accordance with Capital Health System's billing and collection practices: All accounts who are contractually left with a financial liability by their insurer or who fail to have third party liability coverage are considered self-pay patients. These patients will be offered information on financial assistance at time of registration. Self-pay patients receive a series of four data mailers and one urgent notice over a period of 135 days from the date of the first billing statement for care. Aside from the data mailers and urgent notice, the patient accounts department makes telephone calls on accounts with a balance greater than $750.00 to try to resolve the outstanding balance. When unforeseen circumstances arise, reasonable attempts will be made to make telephone calls, but cannot be guaranteed. Examples include: power interruption, National pandemic, etc. If a self-pay liability is not resolved within 135 days, the account is then written off as a bad debt and transferred to one of two outside primary collection agencies dependent on the patient's last name (alpha split). The primary collection agency has 270 days to work the account. At the end of 270 days, if there is still an outstanding balance, the account is taken back in an automated fashion and then reassigned to a secondary collection agency. Only one secondary collection agency is utilized. An individual has two years (730 days) from date of service to apply for financial assistance. The secondary collection agency is the only agency authorized to pursue legal recourse on an account placed into bad debt. Aside from any accounts that are being pursued legally by the secondary collection agency, the secondary collection agency also has 270 days to work the account. At the end of the 270-day period with the secondary collection agency the account is then taken back in an automated fashion by the patient accounting system and assigned an agency code of "TB" (Take back). An account with agency code TB is assured to have been in the self-pay collection cycle for 135 days, with a primary collection agency for 270 days and with a secondary collection agency for another 270 days. All accounts are treated the same regardless of payer. When a patient expresses an inability or difficulty in meeting the financial obligation to Capital Health associated with his or her care, Capital Health works with the patient to determine whether financial assistance is available to satisfy the patient's obligation. Financial assistance may include: - Establishment of a reasonable payment plan, not to exceed remaining days left in billing cycle prior to referral to primary collection agency; - Identification of financial assistance available through programs such as Medicaid, Charity Care or other third party charitable organization; - A partial discount on, or complete waiver of, charges associated with the patient's care in accordance with the terms and conditions of this policy. Capital Health requires its collection agencies to adhere to this policy. To facilitate compliance with this policy, Capital Health includes in all arrangements with collection agencies: - Requirements that the collection agency refrain from any activity that violates the Fair Debt Collections Practices Act (15 U.S.C. Section 1692 et. seq.). - An acknowledgment on the part of the collection agency of Capital Health's nonprofit status and mission and an agreement on the part of the agency to refrain from collection practices that are contrary to that status or in violation of this policy. Capital Health only takes legal action in an effort to obtain satisfaction of a patient's financial obligation where there is reasonable cause to believe that the patient or responsible party has income and/or assets sufficient to satisfy the obligation without undue hardship. Capital Health does not seek the sale or foreclosure of a patient's primary residence to satisfy a patient's financial obligation.
SCHEDULE H, PART VI; QUESTION 2	In addition to the internal revenue code 501(r) community health needs assessment information outlined in form 990, schedule h, part v, section b, capital health routinely monitors demand for the services it provides while simultaneously utilizing a variety of information sources to determine unmet or underserved needs of the communities it serves. Capital health meets at least monthly with the other healthcare providers in its service area as well as a community health department director to discuss unmet needs and collaboratively strategize the prioritization of needs and develop programs to address them in a coordinated way. Capital health also routinely review available data regarding incidents of health issues and propose programs to address these issues and ultimately implement those which will have the greatest impact. Additionally, we regularly interact with community leaders and receive feedback on their satisfaction with our services. We believe this comprehensive approach of monitoring and analyzing both objective data and subjective feedback gives us a current understanding of how we are addressing community needs and what we need to do to optimize our impact upon the healthcare status of our region.
SCHEDULE H, PART VI; QUESTION 3	Capital health system, inc. Educates patients about eligibility for assistance with their bills in numerous ways. Insurance information is obtained at all registration points at each visit. If a patient is found not to have insurance, or is underinsured the following procedure is followed; 1. When a patient is found to be uninsured and in need of financial assistance, a new jersey care payment fact sheet is reviewed with the patient, and a written copy is provided to the patient by the health access staff. The fact sheet explains who is eligible, how to apply with the phone number of each campus charity care office, and what documents are needed to determine eligibility. financial fact sheet is given to all patients regardless of their insurance status. 2. When a patient is admitted to the hospital, a financial counselor will visit the patient's bedside to start the charity care process. If a patient is financially screened and found to be eligible for medicaid, the financial counselor will begin the medicaid process. Upon completion, the medicaid application is submitted electronically for approval. The hospital also utilizes the medicaid outstation worker as needed for additional assistance. 3. When a patient is found to be underinsured, (example is a patient who has medicare only) a referral is made to the financial counselor, the patient is screened and if found eligible, a paper application is completed, along with supporting documentation is obtained. Applications are subject to audit review and claims are submitted electronically upon completion and approval of the application. 4. The patient is monitored for compliance in completing the application including visiting the patient's home if necessary to obtain necessary documentation to complete the application. 5. Once the patient has been approved, the charity care determination information is documented in the patient's registration record. Patient access monitors and instructs the patient when their charity care application is due for renewal. Aside from informing patients during their registration process, all of capital health's dunning statements contain the following language: Capital health system, inc. is committed to providing care to all patients, regardless of their insurance status or ability to pay. Under capital health's financial assistance and charity care programs, the patient may be eligible to receive financial help that covers part or all of the patient's hospital bill. If the patient does not qualify for either of these programs, capital health can offer prompt payment discounts and discounts for patients who have bills that are a significant financial burden to them. Financial assistance information, including the Financial assistance policy, application and plain language summary, can be found on the Capital Health's website at https://www.capitalhealth.org/patients-visitors/bills-and-insurance/financ ial-assistance. Capital health system, inc. also provides, in english and spanish, a phone number for those patients who cannot afford to pay their bill and would like to apply for financial assistance. Capital health system, inc. has a recorded message that is played while a customer is on hold. It reiterates that capital health system inc. believes that everyone deserves quality care, regardless of their ability to pay. Under its financial assistance and charity care programs, eligibility to receive financial support to fully or partially cover hospital costs is offered. It also states that for patients who do not qualify for either of these programs, capital health can offer prompt pay and other discounts for patients who have bills that are a significant financial burden to them.
SCHEDULE H, PART VI; QUESTION 4	Capital health defines its community as the city of trenton, mercer county and parts of burlington, monmouth, middlesex in new jersey and bucks county in pennsylvania. While it was once a center for industry in the late 1800's and early 1900's, trenton has seen dramatic economic development challenges over the years. According to the 2020 u.s. census data, its median household income was $35,402, by far the lowest in mercer county. Based on a population of 83,203, trenton also has the highest number and percentage of minorities in mercer county with an african-american population of 49.5%. Hispanics or latinos of any race constituted 38.1%, while non-hispanic caucasians were numbered at 12.1%. There are approximately 836,907 residents within the defined primary and secondary service area. According to 2020 census data, the population of mercer county is 367,430. The racial makeup of mercer county, which includes trenton, the state capital, is 48.2% white alone, 21.5% black, 18.5% hispanic or latino and 11.9% asian. 88.5% of the county's residents who are 25 years or older graduated high school and 42.6% have a bachelor's degree. Median household income in the county was $81,057 according to the april 1, 2020 u.s. census data. The population of burlington county is 445,349. The racial makeup of burlington county is 66.6% white alone, 18.3% black, 8.5% hispanic or latino, and 5.4% asian. 93.7% of burlington county residents who are 25 years or older graduated high school and 38% have a bachelor's degree. Median household income in burlington county was $87,416 according to the april 1, 2020 u.s. census data estimates. The population of bucks county is 628,270. The racial makeup of bucks county, pennsylvania is 83.3% white alone, 4.5% black, 5.7% hispanic or latino, and 5.2% asian. Of those, 93.9% of bucks county residents who are 25 years or older graduated high school and 41.3% have a bachelor's degree. Median household income in bucks county was $89,139 according to the april 1, 2020 u.s. census data. The population of Monmouth county is 618,795. The racial makeup of monmouth county is 75.1% white alone, 7.5% black, 11.1% hispanic or latino, 5.6% asian. 93.4% of monmouth county residents who are 25 years or older graduated high school and 46.0% have a bachelor's degree. Median household income in monmouth county was $99,733 according to the april 1, 2020 u.s. census data. The population of middlesex county is 825,062. The racial makeup of middlesex county is 41.7% white alone, 12.0% black, 22.1% hispanic or latino, 24.9% asian. 89.8% of middlesex county residents who are 25 years or older graduated high school and 43.6% have a bachelor's degree. Median household income in middlesex county was $89,533 according to the april 1, 2020 u.s. census data.
SCHEDULE H, PART VI; QUESTION 5	This organization operates consistently with the following criteria outlined in irs revenue ruling 69-545: 1. The organization provides medically necessary healthcare services to all individuals regardless of ability to pay, including charity care, self-pay, medicare and medicaid patients; 2. The organization operates an active emergency department for all persons; which is open 24 hours a day, 7 days a week, 365 days per year; 3. The organization maintains an open medical staff, with privileges available to all qualified physicians; 4. Control of the organization rests with its board of DIRECTORs; which is comprised of independent civic leaders and other prominent members of the community; and 5. Surplus funds are used to improve the quality of patient care, expand and renovate facilities and advance medical care; programs and activities. Please refer to schedule o for the organization's community benefit statement for additional information on how the organization promotes community health.
SCHEDULE H, PART VI; QUESTION 6	This organization is an affiliate of capital health system and affiliates. All affiliates are committed to enhancing the overall health status of the community by providing the highest quality healthcare and related services. The capital health system strives to exceed the patients' expectations emphasizing commitment, competence, collaboration, communication, and compassion. Outlined below is a summary of the entities which comprise the capital health system and affiliates. Not for profit capital health system and affiliates entities Capital healthcare, inc. Capital healthcare, inc. ("chi") is the tax-exempt parent of the capital health system, inc. ("system"). This integrated healthcare delivery system consists of a group of affiliated healthcare organizations. The sole member or stockholder of each entity is either chi or another system affiliate controlled by chi. The system is an integrated network of healthcare providers throughout the state of new jersey. Capital healthcare, inc. Is an organization recognized by the internal revenue service as tax-exempt pursuant to internal revenue code 501(c)(3) and as a supporting organization pursuant to internal revenue code 509(a)(3). Capital healthcare, inc. Strives to continually develop and operate a multi-hospital healthcare system which provides substantial community benefit through the provision of a comprehensive spectrum of healthcare services to the residents of new jersey and surrounding communities. Capital healthcare, inc. Ensures that its system provides medically necessary healthcare services to all individuals regardless of race, color, creed, sex, national origins or ability to pay. No individuals are denied necessary medical care, treatment or services. Capital healthcare, inc.'s active hospitals are capital health medical center - hopewell and capital health regional medical center. The hospitals operate consistently with the following criteria outlined in irs revenue ruling 69-545: 1. Provide medically necessary healthcare services to all individuals regardless of ability to pay, including charity care, self-pay, medicare and medicaid patients; 2. Operate an active emergency department for all persons; which is open 24 hours a day, 7 days a week, 365 days per year; 3. Maintain an open medical staff, with privileges available to all qualified physicians; and 4. Control rests with its board of directors and the board of directors of capital healthcare, 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. Capital health system, inc. Capital health system, inc. ("chs") consists of two operating divisions: capital health regional medical center ("regional") and capital health medical center - hopewell ("hopewell"). Regional is a separately licensed acute care hospital with 237 licensed beds, located in trenton, new jersey. Hopewell consists of a separately licensed acute care hospital with 221 licensed beds, located in hopewell township, new jersey and an ambulatory care facility located in hamilton, new jersey. Hopewell also began operations of a satellite emergency department, Capital Health at Deborah-Emergency Services, located in Browns Mills, New Jersey. Pursuant to its charitable purposes, chs 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, chs operates consistently with the criteria outlined in irs revenue ruling 69-545. Capital health system foundation, inc. Capital health system foundation, inc. Is an organization recognized by the internal revenue service as tax-exempt pursuant to internal revenue code 501(c)(3) and as a non-private foundation pursuant to internal revenue code 509(a)(1). Through fundraising activities the organization supports the charitable purposes, programs and services of capital health system, 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, religion or ability to pay. Population health management services, l.l.c. Population health management services, l.l.c. is a single member limited liability company of capital health system, inc. This organization engages in healthcare services which are high quality and cost effective for the benefit of the community and in support of the charitable purposes of capital healthcare system, inc. Capital Health Medical Group, L.L.C Capital health medical group, l.l.c. is a single member limited liability company of capital health system, inc. This organization engages in healthcare services which are high quality and cost effective for the benefit of the community and in support of the charitable purposes of capital healthcare system, inc. Capital Health accountable care organization, L.L.C Capital Health accountable care organization, l.l.c. is a single member limited liability company of capital health system, inc. This organization engages in healthcare services which are high quality and cost effective for the benefit of the community and in support of the charitable purposes of capital healthcare system, inc. Leading Integrated Network of Clinicians, L.L.C Leading Integrated Network of Clinicians, l.l.c. is a single member limited liability company of capital healthcare, inc. This organization engages in healthcare services which are high quality and cost effective for the benefit of the community and in support of the charitable purposes of capital healthcare system, inc. Other capital health system and affiliates entities Bellevue avenue management, inc. A for-profit entity whose sole shareholder is mercer holding corporation. The organization is located in trenton, mercer county, new jersey. The organization provides managerial administration and support. Capital health system condominium association, inc. A for-profit entity whose sole shareholder is capital health system, inc. The organization is located in trenton, mercer county, new jersey. This entity is a homeowners association. Capital region insurance company A controlled foreign corporation of capital health system, inc. The organization was formed and operates solely in the cayman islands, with no U.S. activities or presence. Mercer holding corporation A for-profit entity whose sole shareholder is capital health system, inc. This entity is the sole owner of all the outstanding common stock of bellevue avenue management, inc. And is involved in various ancillary healthcare related activities.
SCHEDULE H, PART VI; QUESTION 7	Not applicable. The entity and related provider organizations are located in new jersey. The state of new jersey does not require hospitals to annually file a community benefit report with the state of new jersey.

Schedule H (Form 990) 2020

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

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

2020

Open to Public
Inspection

Name of the organization
CAPITAL HEALTH SYSTEM INC

Employer identification number
22-3548695

Part I

General Information on Grants and Assistance

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

Yes No

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)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

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) 2020

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	(e) Method of valuation (book, FMV, appraisal, other)
(1) COVID-19 EMERGENCY RESPONSE FUND	5	10,503	FMV
(2) NURSING EDUCATION & SCHOLARSHIP FUND	8	18,000	FMV
(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 AND HUMAN RESOURCES DEPARTMENT PERSONNEL THROUGH THE UTILIZATION OF COST CENTERS AND OTHER INFORMATION; INCLUDING WRITTEN DOCUMENTATION AND RECEIPTS.

Schedule I (Form 990) 2020

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
Graphic Arrow

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
Graphic Arrow

Attach to Form 990.
Graphic Arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

CAPITAL HEALTH SYSTEM INC

Employer identification number

22-3548695

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

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

Travel for companions Payments for business use of personal residence

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

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

If any of the boxes 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 .....

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? ....

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

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

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

Yes

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

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

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

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

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

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

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

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

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

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

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

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

Cat. No. 50053T

Schedule J (Form 990) 2020

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1AL MAGHAZEHE PHD FACHE DIRECTOR - PRESIDENT/CEO	(i) (ii)	1,339,645 ------------- 0	714,170 ------------- 0	11,358,694 ------------- 0	14,002 ------------- 0	24,399 ------------- 0	13,450,910 ------------- 0	8,238,842 ------------- 0
2LEE M BUONO MD PHYSICIAN	(i) (ii)	1,163,852 ------------- 0	0 ------------- 0	810 ------------- 0	2,850 ------------- 0	28,695 ------------- 0	1,196,207 ------------- 0	0 ------------- 0
3SHANE F FLEMING CPA SVP, CHIEF FINANCIAL OFFICER	(i) (ii)	639,961 ------------- 0	230,738 ------------- 0	72,682 ------------- 25,000	7,385 ------------- 0	31,627 ------------- 0	982,393 ------------- 25,000	64,476 ------------- 0
4JOSHUA A EISENBERG MD PHYSICIAN	(i) (ii)	849,534 ------------- 0	109,304 ------------- 0	1,910 ------------- 0	2,850 ------------- 0	29,037 ------------- 0	992,635 ------------- 0	0 ------------- 0
5CATALDO DORIA MD PHYSICIAN	(i) (ii)	796,712 ------------- 0	100,000 ------------- 0	3,839 ------------- 0	2,850 ------------- 0	12,349 ------------- 0	915,750 ------------- 0	0 ------------- 0
6NAVID REDJAL MD PHYSICIAN	(i) (ii)	815,388 ------------- 0	30,000 ------------- 0	1,586 ------------- 0	2,850 ------------- 0	27,974 ------------- 0	877,798 ------------- 0	0 ------------- 0
7JASON N ROGART MD PHYSICIAN	(i) (ii)	678,924 ------------- 0	160,227 ------------- 0	2,243 ------------- 0	2,850 ------------- 0	21,119 ------------- 0	865,363 ------------- 0	0 ------------- 0
8GINA P MUMOLIE SVP, HOSPITAL ADMINISTRATION	(i) (ii)	440,850 ------------- 0	137,190 ------------- 0	251,836 ------------- 0	2,850 ------------- 0	23,861 ------------- 0	856,587 ------------- 0	133,440 ------------- 0
9ALEXANDER D GLADNEY ESQ SVP, CHIEF LEGAL OFFICER	(i) (ii)	502,445 ------------- 0	148,621 ------------- 0	56,978 ------------- 25,000	2,096 ------------- 0	24,498 ------------- 0	734,638 ------------- 25,000	51,905 ------------- 0
10EUGENE W GROCHALA CHIEF INFORMATION OFFICER	(i) (ii)	417,189 ------------- 0	216,300 ------------- 0	40,975 ------------- 0	10,870 ------------- 0	13,957 ------------- 0	699,291 ------------- 0	0 ------------- 0
11EUGENE J MCMAHON MD SVP, CHIEF MEDICAL OFFICER	(i) (ii)	483,202 ------------- 0	153,840 ------------- 0	25,422 ------------- 0	2,850 ------------- 0	29,483 ------------- 0	694,797 ------------- 0	0 ------------- 0
12ARLENE WALSH SVP, CAO - CHMG	(i) (ii)	358,525 ------------- 0	104,100 ------------- 0	78,341 ------------- 32,847	7,300 ------------- 0	28,581 ------------- 0	576,847 ------------- 32,847	71,946 ------------- 0
13NATHAN BOSK FACHE VP, SUPPLY CHAIN/FACILITY SVCS	(i) (ii)	349,066 ------------- 0	110,220 ------------- 0	92,313 ------------- 0	6,642 ------------- 0	23,346 ------------- 0	581,587 ------------- 0	65,193 ------------- 0
14SUZANNE B BORGOS SVP, CORPORATE SERVICES	(i) (ii)	388,390 ------------- 0	109,200 ------------- 0	62,546 ------------- 0	2,800 ------------- 0	2,269 ------------- 0	565,205 ------------- 0	57,034 ------------- 0
15DEBORAH MICAN VP, PATIENT SERVICES/CNO	(i) (ii)	336,179 ------------- 0	100,055 ------------- 0	5,922 ------------- 0	2,850 ------------- 0	19,890 ------------- 0	464,896 ------------- 0	0 ------------- 0
16DEBORAH VISCONTI VP, FINANCE	(i) (ii)	268,265 ------------- 0	78,180 ------------- 0	5,735 ------------- 0	2,791 ------------- 0	29,463 ------------- 0	384,434 ------------- 0	0 ------------- 0
17AUDRA FARISH VP, HUMAN RESOURCES	(i) (ii)	353,230 ------------- 0	10,000 ------------- 0	3,510 ------------- 0	0 ------------- 0	10,602 ------------- 0	377,342 ------------- 0	0 ------------- 0
18CAROLYN J GAUKLER MD DIRECTOR - PRES. MEDICAL STAFF	(i) (ii)	264,279 ------------- 0	30,000 ------------- 0	6,576 ------------- 0	2,688 ------------- 0	22,023 ------------- 0	325,566 ------------- 0	0 ------------- 0
19ARMEN SIMONIAN MD DIRECTOR - VP MEDICAL STAFF	(i) (ii)	0 ------------- 0	0 ------------- 0	157,500 ------------- 0	0 ------------- 0	0 ------------- 0	157,500 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2020

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 3	THE ORGANIZATION'S BOARD OF DIRECTORS HAS A BOARD 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 ALL OF THE ORGANIZATION'S SENIOR MANAGEMENT AND OTHERS, INCLUDING THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER AND OTHER OFFICERS OF THE ORGANIZATION, PHYSICIANS, AND ANY OTHER DISQUALIFIED PERSONS. IT ALSO REVIEWS AND APPROVES EMPLOYMENT AGREEMENTS FOR THE COVERED EMPLOYEES AND DISQUALIFIED PERSONS. THE COMMITTEE REVIEWS THE "TOTAL COMPENSATION" OF THE INDIVIDUALS WHICH IS INTENDED TO INCLUDE BOTH CURRENT AND DEFERRED COMPENSATION AND ALL EMPLOYEE BENEFITS, BOTH QUALIFIED AND NON-QUALIFIED. THE COMMITTEE'S REVIEW IS DONE ON AT LEAST AN ANNUAL BASIS AND ENSURES THAT THE "TOTAL COMPENSATION" OF EACH SUCH INDIVIDUAL IS REASONABLE. THE ACTIONS TAKEN BY THE COMMITTEE ARE INTENDED FOR THE ORGANIZATION TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 4958 WITH RESPECT TO THE TOTAL COMPENSATION OF THE SENIOR MANAGEMENT TEAM. REBUTTAL PRESUMPTION REQUIREMENTS HAVE GUIDED THE ACTIVITIES OF THE COMMITTEE IN ALL OF ITS REVIEWS, DELIBERATIONS AND APPROVAL OF EXECUTIVE COMPENSATION ACTIONS FOR ALL OF THE COVERED EMPLOYEES AND DISQUALIFIED PERSONS. 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 DIRECTORS EACH OF WHOM IS INDEPENDENT AND ARE FREE FROM ANY CONFLICTS OF INTEREST. THE COMMITTEE RELIED UPON COMPARABILITY MARKET DATA PROVIDED BY ITS INDEPENDENT COMPENSATION CONSULTANT FROM COMPARABLE HEALTHCARE AND HOSPITAL PEERS BASED ON TAX-EXEMPT STATUS, REVENUE, LOCATION, SERVICES, AND OTHER FACTORS TO ENSURE THE EXECUTIVES' COMPENSATION IS REPRESENTATIVE OF THE EXECUTIVE TALENT MARKET AND COMPARED TO WHAT IS "ORDINARILY PAID FOR LIKE SERVICES BY LIKE ENTERPRISES UNDER LIKE CIRCUMSTANCES" AS REFERENCED UNDER IRS REGULATIONS. CONTEMPORANEOUS MINUTES ARE COMPILED AND APPROVED FOR ALL COMMITTEE DELIBERATIONS. THESE ARE SUPPORTED BY THE WRITTEN DOCUMENTATION OF ALL PEER AND MARKET COMPENSATION STUDIES, AS WELL AS DETAILED PERFORMANCE JUSTIFICATION USED AS THE BASIS FOR AWARDS UNDER THE ORGANIZATION'S INCENTIVE PROGRAMS. RECOGNIZING THE NEED TO CONSIDER RETIREMENT PLANNING FOR ITS SENIOR MANAGEMENT AS A MEANS TO AID IN THEIR RETENTION, THE COMMITTEE MAINTAINS A FORM OF LONG-TERM NON-QUALIFIED DEFERRED COMPENSATION (REFERRED TO AS THE "PERFORMANCE-BASED CAPITAL ACCUMULATION PLAN", OR "PBCAP"), WHICH IS PART OF THE CAPITAL HEALTH SYSTEM NON-QUALIFIED 457(F) DEFERRED COMPENSATION PLAN. PBCAP PROVIDES THE ORGANIZATION WITH AN ADDITIONAL TOOL TO ASSIST IN THE RECRUITMENT AND RETENTION OF SENIOR MANAGEMENT WITHIN THE HIGHLY COMPETITIVE HEALTHCARE LABOR MARKET. PBCAP PROVIDES SENIOR MANAGEMENT WITH THE OPPORTUNITY TO QUALIFY FOR ANNUAL DEFERRED CONTRIBUTIONS, BASED ON ACHIEVING SPECIFIED PERFORMANCE TARGETS AND MEETING ESTABLISHED CIRCUIT BREAKERS, TO BE PAID AT A FUTURE PRE-DETERMINED DATE CONTINGENT UPON CONTINUED SERVICE WITH THE ORGANIZATION. 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 ORGANIZATION'S HUMAN RESOURCES DEPARTMENT AND INDEPENDENT COMPENSATION CONSULTANTS 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.
SCHEDULE J, PART I; QUESTION 4B	The organization maintains the Capital Health System Non-Qualified 457(f) Deferred Compensation Plan (the "457(f) Plan"), which is a nonqualified deferred compensation plan that satisfies the requirements of section 457(f) of the Internal Revenue Code. The following individuals participated in the 457(f) Plan and received A payment in 2020 that was no longer subject to a substantial risk of forfeiture - Al Maghazehe, ph.d., fache, $11,298,180; Shane f. fleming, cpa, $64,476; Gina P. mumolie, $221,878; Alexander D. Gladney, Esq., $51,905; Arlene Walsh, $71,946; Nathan Bosk, FACHE, $65,193 and Suzanne B. Borgos, $57,034. These amounts are reflected in Schedule J, Part II, Column (B)(iii) and were reported on each individual's 2020 Form W-2, Box 5 as taxable Medicare wages. THE ORGANIZATION MAINTAINS THE CAPITAL HEALTH SYSTEM NON-QUALIFIED 457(F) DEFERRED COMPENSATION PLAN (THE "457(F) PLAN"), WHICH IS A NONQUALIFIED DEFERRED COMPENSATION PLAN THAT SATISFIES THE REQUIREMENTS OF SECTION 457(F) OF THE INTERNAL REVENUE CODE. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE 457(F) PLAN AND ACCRUED ADDITIONAL DEFERRED COMPENSATION IN 2020 THAT IS SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE - SHANE F. FLEMING, CPA, $153,825; ALEXANDER D. GLADNEY, ESQ., $79,264; EUGENE J. MCMAHON, M.D., $82,048; ARLENE WALSH, $69,400; NATHAN BOSK, FACHE, $73,480; SUZANNE B. BORGOS, $58,240; DEBORAH MICAN, $53,363 AND DEBORAH VISCONTI, $41,696. THESE INDIVIDUALS MAY NEVER ACTUALLY RECEIVE THESE UNVESTED AMOUNTS. ACCORDINGLY, THESE UNVESTED AMOUNTS HAVE NOT BEEN INCLUDED IN SCHEDULE J, PART II, COLUMN (C) AND WERE NOT REPORTED ON EACH INDIVIDUAL'S 2020 FORM W-2, BOX 5 AS TAXABLE MEDICARE WAGES.
SCHEDULE J, PART I; QUESTION 7	CERTAIN INDIVIDUALS LISTED IN PART VII, SECTION A, LINE 1A RECEIVED INCENTIVE AWARDS DURING CALENDAR YEAR 2020, WHICH INCENTIVE AWARDS ARE REFLECTED IN SCHEDULE J, PART II, COLUMN B(II) AND WERE REPORTED ON EACH SUCH INDIVIDUAL'S 2020 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. THESE INCENTIVE AWARDS WERE PAID UNDER THE CAPITAL HEALTH INCENTIVE COMPENSATION PLAN ("ICP"), APPROVED BY THE BOARD COMPENSATION COMMITTEE, AND BASED ON ACHIEVEMENT OF PRE-ESTABLISHED SYSTEM-WIDE PERFORMANCE CRITERIA AND METRICS, AS WELL AS MEETING OR EXCEEDING SPECIFIC PERFORMANCE ON "CIRCUIT BREAKERS." THE ICP PROVIDES ELIGIBLE EXECUTIVES WITH THE OPPORTUNITY TO EARN PERFORMANCE BASED COMPENSATION AND IS AN INTEGRAL COMPONENT OF THE ORGANIZATION'S EXECUTIVE COMPENSATION PACKAGE. THE BOARD COMPENSATION COMMITTEE USES THE ICP AS A MECHANISM TO REWARD PERFORMANCE AGAINST ESTABLISHED KEY PERFORMANCE REQUIREMENTS. THE GOALS COVER FINANCIAL AND OPERATIONAL METRICS AND ARE DEFINED EACH YEAR, BASED ON THE DESIRED CONCENTRATION REQUIRED BY THE BOARD COMPENSATION COMMITTEE. THE BOARD COMPENSATION COMMITTEE UNDERTAKES A MID-YEAR REVIEW OF PERFORMANCE TOWARDS ACHIEVEMENT OF EACH GOAL, WHICH ALLOWS THE BOARD COMPENSATION COMMITTEE TO MONITOR HOW KEY PROJECTS ARE BEING HANDLED AND TO MAKE ADJUSTMENTS, IF NECESSARY. PLEASE REFER TO SCHEDULE J, PART II, COLUMN B(II) FOR THIS INFORMATION BY PERSON AND BY AMOUNT.
SCHEDULE J, PART II, COLUMN F	THE AMOUNTS REPORTED IN SCHEDULE J, PART II, COLUMN (F) INCLUDE VESTED BENEFITS IN A DEFERRED COMPENSATION PLAN AS THESE AMOUNTS WERE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. THESE AMOUNTS WERE REPORTED AS DEFERRED COMPENSATION ON PRIOR YEARS' FORMS 990 AND ARE NOW BEING REPORTED AGAIN ON THIS YEAR'S FORM 990. THESE HAVE BEEN TREATED AS TAXABLE INCOME AND REPORTED ON EACH INDIVIDUAL'S FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES.

Schedule J (Form 990) 2020

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

CAPITAL HEALTH SYSTEM INC

Employer identification number

22-3548695

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

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

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

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e) Original principal amount	(f) Balance due	(g) In default?		(h) Approved by board or committee?		(i) Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No






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

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2020

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) BAHRAM MAGHAZEHE	BROTHER OF DIRECTOR/OFFICER	99,088	EMPLOYEE		No
(2) KAMYAR MAGHAZEHE	FAMILY MEMBER OF DIRECTOR/OFFICER	50,476	EMPLOYEE		No

Part V

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

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2020

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

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

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization

CAPITAL HEALTH SYSTEM INC

Employer identification number

22-3548695

Return Reference	Explanation
CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS	Background ========== Capital health system, Inc. ("capital health") operates a multi-hospital healthcare system which provides substantial community benefit through the provision of a comprehensive spectrum of healthcare services to the residents of New Jersey and surrounding communities. Capital health is recognized by the internal revenue service ("IRS") as an internal revenue code section 501(c)(3) tax-exempt organization. Pursuant to its charitable purposes, capital health 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, the hospitals operate consistently with the following criteria outlined in IRS revenue ruling 69-545: 1) Capital Health provides medically necessary healthcare services to all individuals regardless of ability to pay; 2) Capital Health operates emergency departments at both of its hospital campuses; capital health regional medical center and capital health medical center - Hopewell; which are open 24 hours a day, 7 days a week, 365 days per year; 3) Capital Health maintains an open medical staff, with privileges available to all qualified physicians; 4) Control of capital health rests with its board of directors; which is comprised of independent civic leaders and other prominent members of the community; and 5) Surplus funds are used to improve the quality of patient care, expand and renovate facilities and advance medical care, programs and activities. With over a century of service to the greater mercer and bucks county areas, capital health is comprised of 458 licensed beds, employs approximately 5,566 individuals, and generates over 693 million dollars in annual net patient service revenue. Capital health regional medical center and capital health medical center - Hopewell are separately licensed acute care hospitals with 237 and 221 beds; respectively. Capital health also operates a new kind of healthcare center that puts family physicians and specialists, state-of-the-art technologies, and same-day surgical services all in one location. Capital health in hamilton, located at 1445 whitehorse-mercerville road, and spanning 46,293 square feet, creates a "medical mall" where patients can seek a host of services such as outpatient surgery, radiological testing and specialized care. In addition, 1401 whitehorse-mercerville road spans an additional 26,000 square feet of specialty care including a sleep center. The family health center ("fhc") at capital health is located at 433 bellevue avenue in trenton. The 14,000 square foot location helps provides critical healthcare access to the underserved in the region. This site has adult medical and specialty programs, as well as maternal child health clinics. In addition to the ch medical clinic at the fhc there is also a satellite of the henry j. Austin family medicine clinic, which is a designated federally qualified health center ("fqhc") at the same location, which also provides comprehensive primary care for families, including evaluations and same-day walk-in and sick appointments for adults and children, and patients have access to lower cost prescriptions, social service and patient navigation. In 2019 Capital Health assumed operation of the satellite emergency department (now Capital Health at Deborah-Emergency Services) located on the Browns Mills campus of Deborah Heart and Lung Center, Burlington County's only fully licensed cardiac center. The 10,000 square foot SED operates 24 hours a day and features 11 exam/treatment rooms, triage bay, cardiac resuscitation room, specialized treatment areas (including OB/GYN and isolation/decontamination), and support services such as lab and radiology. Capital health is guided by its dedication to the healthcare needs of the communities that it serves. That level of determination and commitment is an essential part of the culture at capital health. Capital health provides healthcare services to all people in a non-discriminatory manner, regardless of race, color, creed, sex, national origins or ability to pay. Moreover, capital health provides healthcare services to patients who meet certain criteria under its charity care policy, as defined by the New Jersey state attorney general, without charge or at amounts less than established rates. Capital health maintains records to identify and monitor the amount of charity care it provides. These records include the amount of charges foregone for services and supplies furnished under its charity care policy. Mission statement ================= To improve the health and well-being of the populations we serve in urban and suburban communities. In support of the health system's mission, in 2017 the Capital Health Institute for Urban Care was formed. The institute's mission is to coalesce, grow and align the services of Capital Health with community and other partners to advance the health and well-being of the residents of Trenton. Activities and programs of the Institute for Urban Care are based on needs identified in the Trenton Community Health Needs and Assets Assessment published in June 2019. Strategic foci include programming addressing chronic disease, maternal/child health and behavioral health/substance use disorder. These three tenets are leveraged on a foundation of community both internal and external to the health system. Chronic disease such as diabetes and cancer unfortunately has a disproportionate impact on the health of the residents of Trenton, which is a majority minority city and the Capital of New Jersey. The Institute of Urban Care, working with the Trenton Health Team and other community partners has developed the Capital City Diabetes Collaborative, to address the clinical, environmental and social determinants of health related to diabetes. This 5-year program funded by the Merck Foundation, has led to implementation of evidence-based treatment guidelines, enhanced screening for eye disease and the prevention of blindness as well as addressing food insecurity in the city. Violence is unfortunately another "chronic disease" within our city. Capital Health was recently awarded $1.9M grant to provide comprehensive wraparound services to victims of violence to decrease the incidence of reinjury, retaliation and the impact of post-traumatic stress disorder that is so commonly seen. Programming addressing maternal child health, behavioral health and substance use disorder are now woven into Capital Health programming. Our prenatal clinic in Trenton has received funding for a Centering model of care. This evidence-based, group prenatal visit model has been shown to improve birth outcomes and decrease health disparities related to mom and baby. Capital Health has also made a substantial investment ($750,000) to update the clinical space which houses our prenatal and internal medicine residency programs. As leaders within the community, Capital Health plays a key role in the Trenton Maternal Stakeholders group which has facilitated the planning, growth, improvement and coordination of programs such as doula services, maternal community health workers and post-partum nurse home visits. Capital Health's opioid program for pregnant women has created a new avenue of treatment not previously in place in our community leading to decreases in NICU stays for opioid-impacted infants and increased family unification. Capital Health has included opioid navigation services within our Emergency Departments, integrated behavioral health services into our busiest Trenton primary care practice and implemented opioid reduction order sets and processes to optimize non-opioid treatment modalities for those coming in for emergency services at our Hopewell campus. From a community point of view, the Institute for Urban Care led Capital Health's journey to become a Leader in LGBTQ equality to optimize inclusion and diversity for our patients, staff and community. Our commitment to community is evident by our history of providing comprehensive health care to Trentonians for more than 125 years. In 2019, we supported the Trenton Housing Authority allowing them to obtain a $1.3M grant from HUD to update the Donnelly Homes, a housing project 1 mile from our Regional Medical Center facility. We collaborated with KinderSmile, a non-profit dental program to bring services into Trenton. The Institute of Urban Care continues its work both within the Health System and collaboratively with our community stakeholders to decrease health disparities and improve the health and well-being of our neighbors.
CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS	Awards and recognition ====================== Capital health has received the following designations, awards and recognitions: - joint commission advanced certification for comprehensive stroke center ("rmc"); - joint commission disease specific certification for primary stroke ("chmch"); and - joint commission disease specific advanced certification for palliative care. Magnet re-designation --------------------- The american nurses credentialing center ("ancc") has recognized capital health's exemplary nursing leadership and quality patient care by awarding its magnet recognition for excellence in nursing service. Magnet status is the highest level of recognition the ancc can extend to a healthcare organization. Capital health has earned this recognition four times, consecutively. 2020 awards and accreditations ------------------------------ Capital health medical center - hopewell received 2018 women's choice award and named one of america's best hospitals for cancer care, breast center (3rd consecutive year), and stroke care (3rd consecutive year). Capital health regional medical center (rmc) was recently recognized as the best hospital for neurology and neurosurgery in the region in u.s. news & world report best hospitals for 2018-19. Capital health was the highest scoring hospital in new jersey that is also a comprehensive stroke center certified by the joint commission. Capital health regional medical center was one of the first two hospitals in new jersey to receive advanced certification as a comprehensive stroke center from the joint commission and the american heart association/american stroke association. Capital health regional medical center has earned this certification for the third time. On August 31, 2019 the Cardiac Rehab Program at Capital Health, Hopewell, was awarded Program Certification through the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) for a period of three years. The bristol-myers squibb trauma center at capital health regional medical center was recertified as a level ii trauma center by the committee on trauma ("cot") of the american college of surgeons ("acs"). The Comprehensive center for breast care is actively accredited by the national accreditation program for breast centers ("napbc") and received reaccreditation in November 2020 for an additional three years. Chest pain center accreditation from the society of cardiovascular patient care ("scpc"). Capital Health was awarded reaccreditation as a Comprehensive Community Cancer Center by the American College of Surgeons Commission on Cancer in 2018. Accreditation by coc is given only to those facilities that have voluntarily committed to providing the highest level of quality cancer care and that undergo a rigorous evaluation process and review of their performance. Regional medical center has again been recognized and received the aha: gwtg-stroke gold plus & target: stroke honor roll elite award for 2019. The american college of radiology ("acr"), an organization focused on the practice of radiology and the delivery of comprehensive healthcare services, designated capital health as a breast imaging center of excellence for earning four national accreditations in mammography, stereotactic breast biopsy, breast ultrasound and ultrasound-guided breast biopsy. The Capital Health Cancer Center is also accredited as meeting all the standards of a quality center through the American College of Radiology. In September 2020, the Department of Radiation Oncology received three-year reaccreditation for its program. In 2017, capital health regional medical center was nationally recognized as a top general hospital by the leapfrog group for patient safety and quality - making it the only new jersey hospital to earn this distinction. Capital health has earned hospital accreditation from dnv gl - healthcare, a certification body that helps healthcare organizations achieve excellence by improving quality and patient safety. By earning this accreditation, both capital health medical center - hopewell and capital health regional medical center demonstrate that they meet or exceed patient safety standards and conditions of participation set forth by the u.s. centers for medicare and medicaid services (cms). Dnv gl's accreditation program is the only one to integrate the iso 9001 quality management system with the medicare conditions of participation. The Center for Sleep Medicine at Capital Health has successfully completed a reaccreditation assessment and has been granted full American Academy of Sleep Medicine (AASM) accreditation for the RMC campus for a period of 5 years. The Adult Transthoracic Echocardiography program and the Vascular Lab have achieved re-accreditation from the Intersocietal Accreditation Commission (IAC) for a period of three years for these services on all three CH campuses. Capital Health has made a commitment to become a major academic health system. An organized approach to this transformation has been manifested in recent new and additional accreditations from the ACGME (Accreditation Council for Graduate Medical Education): - The longstanding Internal Medicine residency program at the Regional Medical Center received approval to expand from 39 to 60 residents spanning three years of training. As of July 2020 the new entering class had 20 first year Internal Medicine residents who will serve our Regional and Hopewell campuses. To assure continuity of care at our 433 Bellevue Avenue Internal Medicine office the resident schedule has been adjusted to increase their hours for patient care. - Commencing with the academic year that began July 1, 2021 Capital welcomed six new first year Family Medicine residents. Their ambulatory training will occur at the new Family Medicine residency offices at 832 Brunswick Avenue, Trenton. This will improve access to full service ambulatory medical care for the community from new born to geriatric services. -In addition to the Family Medicine program, six new first year Emergency Medicine resident commenced their education at Capital Health in July 2021. They provide care at all Capital emergency departments in Hopewell and Trenton. Capital Health is a major partner with the Trenton Health Team and provides clinical support for the NJ CEED (New Jersey Cancer Education and Early Detection) Program. Through our Internal Medicine residency program, we provide monthly clinics where comprehensive cancer screening for under and uninsured patients are performed. These include mammography, cervical, colon and prostate cancer screens. As a major teaching affiliate of the Rowan University School of Osteopathic Medicine, and the Lewis Katz School of Medicine of Temple University, Capital provides exposure and training to third and fourth year medical students in multiple areas, and especially in community health through rotations at our Trenton based offices and our affiliation with the Trenton Health Team. Capital Health Medical Center - Hopewell is the first hospital in the Mercer/Bucks County Region to receive full accreditation with PCI as a Chest Pain Center three consecutive times from the Society of Cardiovascular Patient Care (SCPC) and the American College of Cardiology. The Laboratories at Capital Health Regional Medical Center and Capital Health Medical Center - Hopewell are accredited by the College of American Pathologists (CAP), the leading accreditation organization of Pathology and laboratory medicine. Capital Health Medical Center - Hopewell and Capital Health Regional Medical Center received perfect scores from the Healthcare Rights Campaign based on the Healthcare Equality Index. Naming them leaders in the Healthcare industry in regards to the Non-Discrimination & Staff Training, Patient Services & Support, Employee Benefits & Policies, and the Patient & Community Engagement. Capital Health Medical Center - Hopewell was designated a Center of Excellence in Robotic Surgery by Surgical Review Corporation (SRC). The Center of Excellence accreditation distinguishes Capital Health as having met rigorous, internationally recognized standards in providing the safest, highest quality of care and surgical capabilities. Statement for community health improvement & benefits ===================================================== To promote wellness, prevent illness, and remove barriers that hinder access to healthcare by working hand-in-hand with the communities served.
CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS	Principles ---------- - capital health believes that community health improvement is essential to the capital health mission. - capital health believes community-based coalitions are uniquely qualified to achieve community health goals and capital health values partnerships with them. - capital health values evidence-based practices and seeks to model excellence in community health practice based on evidence. - capital health believes in applying continuous quality improvement to community health: measuring need, matching resources to need, measuring outcomes and making adjustments in processes. Operational values ------------------ Integrity: adheres to an appropriate and effective set of core beliefs including honesty and serving the greater good. Does not blame others for his or her own mistakes or misrepresent himself or herself for personal gain or protection. Perceived by others as a direct, truthful individual and is widely trusted, with the ability to present the truth in an appropriate and helpful manner. Excellence: provides the most efficient and effective work processes to meet the needs of patients and other customers, which leads to the highest quality services. Makes sound decisions based upon knowledge, judgment, and experience, and is sought out by others for advice and solutions to issues and problems. Compassion: demonstrates caring and concern for the welfare of others, assisting wherever necessary. Uses understanding and insight when dealing with patients or other customers in all aspects of care or service delivery. Teamwork: displays a professional and collaborative spirit in fulfilling responsibilities and assisting others. Helps to create and maintain positive morale with his or her team, sharing in successes, working through problems. Fosters open dialogue and works towards creating an atmosphere where outcomes and success are beneficial to the team and/or the organization at large. Vision ------ Capital health will be the region's provider of choice, bringing to our community superior clinicians and partners who improve services and quality of care, while maintaining local control. Service culture initiative -------------------------- Capital health is dedicated to high quality performance, and to exceeding customer expectations within a supportive and friendly environment. Each employee has a responsibility and is accountable for providing optimum satisfaction to the patients and their families, physicians and co-workers. Service culture initiative vision statement ------------------------------------------- - capital health commits to the needs of the communities served. Through excellent service and care, capital health achieves successful patient outcomes. - capital health adheres to a standard of positive behavior. This must include positive first impressions, appropriate communication, professional appearance and the realization that they are dealing with people's lives. - capital health creates an environment conducive to positive relationships. By engaging employees in a partnership of teamwork, capital health is reinforcing their commitment to trust and respect. - capital health is proactive rather than reactive. By having efficient and effective systems, capital health improves quality care and service delivery. - capital health accepts the challenge of service culture improvement as a business strategy. It is not only the nice thing to do, but the right thing to do to assure the growth of capital health. - capital health recognizes excellent service culture performance. Featured services ================= Diabetes services ----------------- Diabetes education at capital health is an outpatient comprehensive referral based diabetes education program that empowers patients to take control in the successful management of their disease. Capital health's education model, where the patient is the central player, is widely recognized as the best model to use to help the patient achieve optimal health related outcomes. Capital health works closely with primary care physicians who continue to monitor each individual's medical problems. In partnership with the trenton health team, capital health's executive director of the institute of urban care is the principal investigator of the capital city diabetes collaborative, a multi-disciplinary five year program addressing the clinical, social and environmental determinants of health related to diabetes within the city of trenton. Trauma and emergency services ----------------------------- The bristol-myers squibb trauma center, the level ii trauma center at capital health regional medical center, is one of only 10 state designated trauma centers in new jersey. Capital health provides comprehensive care from the time of injury through rehabilitation. The trauma center meets high national standards for patient care and teaching. The designation process involves detailed regular inspections by national and state organizations to assure high standards of care. capital health regional medical center celebrated over 20 years as the regional referral center and the only level ii trauma center for severely injured patients in mercer county and adjacent parts of somerset, hunterdon, burlington, and middlesex counties as well as nearby areas of pennsylvania. Designated trauma centers care for severely injured patients as well as victims of accident types known to be associated with a high risk for injury. Trauma patients include persons involved in motor vehicle crashes, falls, and assaults with knives, guns, or blunt objects. Trauma centers have the latest technology and experienced staff available to care for your family member. Besides providing care to the injured, trauma centers are also active partners with the community in injury prevention and public education. In 2017, capital health launched an innovative new mobile stroke unit (msu) designed to bring time-critical stroke care to patients at their home, or wherever the msu is dispatched to assess them. It is the first unit of its kind in new jersey, pennsylvania or the delaware valley and only the second on the east coast. The capital health msu is one of only seven in the united states to be in service. The msu includes a ct scanner, point-of-care laboratory testing, and a team comprised of a critical care nurse, paramedic and ct technologist. Maternity --------- From routine deliveries to high-risk needs, capital health's great expectations program provides a full range of prenatal, obstetrical, postpartum, and neonatal care options to make certain new families have the greatest chance for a healthy beginning. The maternity unit at capital health medical center - hopewell is mercer county's only regional perinatal center and level iii neonatal intensive care unit. The capital health healthstart prenatal program located at the fhc in trenton provides care to over 1,500 pregnant women annually. Capital health is the only healthcare provider in mercer county to provide hospital-based obstetrical care. To support this program ch has in-house coverage by obstetricians, midwives, neonatologists, and anesthesiologists 24 hours a day, seven days a week. Capital health was chosen as new jersey's first site to house a march of dimes family support program. The program provides information and emotional support to families of critically ill newborns being cared for in the neonatal intensive care unit. Also, comprehensive childbirth and parent education services are offered to help prepare individuals to be the best parents possible by teaching about the process of birth and how to care for their infants. Lactation services ------------------ In 2012, capital health medical center - hopewell was designated as a baby friendly hospital, the second hospital in new jersey to attain this status. As a baby friendly hospital, capital health focuses on the entire obstetric population. In 2019, capital health demonstrated an overall 87.9 percent breastfeeding initiation rate and a 58.2 percent average exclusive breastfeeding rate. The top decile benchmark exclusivity for breastfeeding mothers only was at an average 56 percent rate. Capital's healthstart clinic patient population breastfeeding rates were comparable to the overall obstetric population due to additional educational programs and one-to-one support with increases in services including prenatal group centering and collaborative efforts between capital health and specific community organizations directed toward this vulnerable population. Focused programs such as children's future and women's infants and children ("wic") have been instrumental to its demonstrated success.
CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS	Institute for neurosciences --------------------------- The capital institute for neurosciences, has advanced the level of care available to patients in the region. Providing comprehensive, state-of-the-art diagnostics and treatments for a wide range of medical conditions involving the brain, spine and nervous system, the institute's highly trained and specialized physicians utilize cutting edge technology to deliver outstanding care. Physicians include board-certified and fellowship-trained specialists. At the institute, patients benefit from a multi-disciplinary team of specialists which can include neurologists, neurosurgeons, and other specialized physicians, as well as anesthesiologists, physician assistants, critical care nurses, nurse anesthetists, speech pathologists, technicians, physical and occupational therapists, social workers, and other critical team members who provide an outstanding continuum of care from diagnosis to treatment and recovery at capital health. The institute includes many specialized centers of care. As part of its continued commitment to brain care, capital health has acquired a neurovascular simulator. Capital health is the first hospital in the country to acquire such technology. Capital health is expanding its role in neuroscience to not only be a center for advanced patient care but a center for training physicians and healthcare providers. The vascular replication system offers next-generation technology utilizing 3d printing to physically replicate blood vessels and blood flow through the heart, aorta, and brain. This will allow capital health to train physicians on neuro-endovascular treatments for complex stroke, aneurysm and other neurovascular disorders. It will also provide the option to perform simulated procedures in a clinical environment that is identical to the one in which they will actually treat patients. Among the conditions treated: - stroke and transient ischemic attacks. - carotid stenosis. - aneurysm. - arteriovenous malformations ("avms"). - traumatic brain injury. - tumors of the brain and spine - both malignant and benign and including schwannomas, meningiomas, neurofibromas, pituitary, pineal, skull base, gliomas and others. - spinal diseases and injuries - such as herniated discs, spondylolisthesis, spinal compression fractures and spinal vascular malformations. - degenerative diseases and spinal trauma. - neurologic conditions including dementia, muscle and movement disorders, nerve disorders and headaches. - movement disorders, parkinson's, essential tremor, atypical parkinson's (multisystem atrophy, progressive supranuclear palsy, and corticobasilar degeneration), dystonia, ataxia and spasticity. - pediatric neurology, including developmental delays, autism, neurometabolic and genetic disorders, and attention deficit disorders. - acute and chronic pain, including pain from spinal stenosis, nerve disorders, cancer, fibromyalgia, sciatica, migraines, trigeminal meuralgia, myofacial, shingles and other conditions. - epilepsy. - movement limitations due to stroke, arthritis, injury, amputation, or other conditions. Center for digestive health --------------------------- The capital health center for digestive health is advancing the level of care available to patients in the region by providing comprehensive, state-of-the-art diagnostics and treatments for a wide range of medical conditions involving the entire digestive system all in one location. The center's highly trained and specialized physicians utilize cutting-edge technology to deliver outstanding care. The center's medical director is a fellowship-trained and board-certified gastroenterologist with years of experience who helps patients, and their referring doctors navigate the center and access the appropriate specialist or surgeon for the advanced testing or care required. The center's medical staff includes the region's pre-eminent medical expert in interventional gastroenterology and therapeutic endoscopy, who has unmatched experience using advanced diagnostic techniques such as endoscopic ultrasound ("eus") and non-surgical treatments such as endoscopic retrograde cholangiopancreatography ("ercp"), radiofrequency ablation ("barrx"), endoscopic mucosal resection ("emr"), and enteral stent placement. The center also recently welcomed a specialist in irritable bowel diseases, such as crohn's and colitis. If surgery is an option, the center has direct access to a capital health-based roster of highly trained laparoscopic (minimally invasive) surgeons, including the area's only hepatobiliary surgeon who specializes in advanced laparoscopic procedures of the liver, pancreas, and bile ducts. Cancer center ------------- Capital health has consistently offered patients a closely integrated team of medical, surgical, radiation, and allied cancer specialists who use their knowledge and experience to provide cutting-edge cancer treatment close to home. Capital health medical Center Hopewell is the only hospital in the region where you will also have advanced treatment options such as cyberknife radiosurgery and da vinci robotic surgery. Capital health was also the first hospital in the region to offer the state-of-the-art truebeam linear accelerator for traditional 3d conformal radiation therapy, intensity modulated radiation therapy (imrt), rapidarc radiotherapy and High Dose radiation Treatment (HDR). When one chooses capital health for cancer care, one selects board certified physicians who remain with the patient from diagnosis through treatment. Working together, capital health offers a compassionate approach to assist patients with every aspect of cancer care, including screening, diagnosis, treatment, recovery, and survivorship. The capital health, cancer center is committed to providing comprehensive quality oncology healthcare services, to help improve and sustain the health status of residents living primarily in Mercer and Burlington Counties, NJ and Bucks County, PA. Capital health strives to improve and extend the quality of life for the patient with cancer. The cancer center is a leader in defining the community's cancer care needs by providing appropriate plans through a comprehensive continuum of care, which includes education, prevention, screening, diagnosis, treatment, clinical research, symptom management, supportive care and survivorship programs. Capital health's success is built upon care, compassion, creativity, integrity, respect, service, state-of-the-art technology and multidisciplinary teamwork. Multidisciplinary care is extremely important at Capital Health and there are currently eight tumor sites that hold case conference to review and plan for a patient's care. In any given month there are approximately 20-25 case conferences held. At these conferences are surgical oncologists, radiation oncologist, medical oncologists, radiologists, pathologists, interventionalists, navigators, nurses, oncology dieticians. The following are the groups that meet: - Bone and soft tissue - Breast Cancer - Colorectal Cancer - GYN Oncology - Hepato-Pancreatic-Billiary Cancer - Neuro-oncology - Thoracic Cancers - Urologic Cancers The cancer center is accredited by several esteemed bodies: - american college of surgeons - commission on cancer - accreditation with gold commendation as well as 2015 outstanding achievement award, again receiving national accreditation from the CoC in 2019 - national accreditation program for breast centers ("napbc"). - american college of radiology - radiation oncology department. - american college of radiology - imaging center of excellence. And in addition, by the end of 2020, we attained accreditation in the following organization: - Center of Excellence in Robotic Surgery through Surgical Review Corporation (SRC) This accreditation ensures the delivery of safe and effective patient care. With this designation, our processes and methodologies will increase case volumes, improve outcomes, and reduce complications. We are also working towards accreditation for: - National Accreditation Program for Rectal Surgery (NAPRC) A program of the American College of Surgeons (ACoS), is the consortium of a national, professional organization focused on improving the quality of rectal cancer care, the National Accreditation Program for Rectal Cancer (NAPRC) aims to standardize and improve care using a multidisciplinary approach.
CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS	Capital health provides the most comprehensive lung screening through low dose CT scans and cancer treatment program in the region. This screening program is offered to patients at risk of developing lung cancer, those with a heavy smoking history. This includes cutting edge diagnostics, specifically their extremely low-dose 128- and 256-slice ct scans. There is no contrast involved and no blood tests required, therefore, no needles are used. Capital health physicians are licensed to offer a new fda-approved treatment to patients with colorectal cancer that has metastasized to the liver. The selective internal radiation therapy ("sirt") is a proven technology for inoperable liver cancer that delivers doses of radiation directly to the site of tumors. The program has fortified its infrastructure by providing a full time dedicated oncology certified dietician and also several oncology navigators to guide patients through all aspects of their care, provide educational reinforcement and psychosocial support and resources. Currently there are eight navigators: - breast nurse navigator. - gi cancer nurse navigator. - financial navigator. - lung cancer screening navigator. - cyberknife navigator. - cancer genetics nurse navigator. - patient navigators (2). The Cancer Center also has its own oncology nurse educator who assists in orienting new nurses and ensuring established nurses remain competent in all practices. She also assists in ensuring that all policies and procedures remain current. The Cancer Center is also involved in Cancer Research through many different endeavors. Patients are able to be enrolled in National Cancer Institute Trials, Industry sponsored trials and also investigator initiated studies. In 2020, Capital Health initiated its own on-site Biorepository to store tissue and blood to be used by other researcher to conduct studies. The center also offers several support groups per month for oncology patients at various locations and times. On a monthly basis, wellness programs to oncology survivors are also provided and more will be added in the future. In addition, the center has offered several cancer screenings to the public. In 2008, the cancer center initiated a colon cancer screening program which offers colonoscopies for uninsured and underinsured individuals living in trenton that meet american cancer society eligibility criteria. Annually, approximately 50 patients are screened through colonoscopy and approximately 40% of patients are found to have cancer causing polyps which are removed and thus colon cancer is prevented. In addition, several early colon cancers have been detected. The Cancer Center collaborates with the Trenton Health Team on providing medical support and screening for the NJ CEED grant. Through NJ CEED, uninsured individuals are able to have cancer screens (mammographies and clinical breast exams, pap smears, rectal exams and colon cancer screening). Capital Health assists with these screenings and also treats these patients if a screen is detected as being positive for cancer. Capital Health Medical Center - Hopewell is the only hospital in the region where you will also have advanced treatment options such as: - CyberKnife Radiosurgery - Robotic-assisted surgery using the da Vinci surgical system - TrueBeam Linear Accelerator for traditional 3D conformal radiation therapy, intensity modulated radiation therapy (IMRT), RapidArc radiotherapy, and stereotactic radiosurgery - High-dose-rate (HDR), radiation therapy for multiple treatment areas - Personalized medicine, such as tumor marker testing - Advanced imaging technology for digital mammography, 3D mammography (also known as breast tomosynthesis), molecular breast imaging, PET/CT, and 3T MRI Pediatrics ---------- Capital health medical center - hopewell is home to the only in-patient pediatric unit in mercer county. The pediatric hospitalist program gives pediatric patients and their physician's around-the-clock access to in-house pediatricians and pediatric trained nurses. Capital health's pediatric emergency service is completely separate from the adult emergency department and is staffed by pediatric trained physicians. Pediatrics is also provided for trauma patients at rmc. Radiology services ------------------ Capital health has an abundance of the most state-of-the-art radiology services in the region. As the region's leader in diagnostic and treatment technology, capital health offers full-time, onsite pet scan technology and was the first hospital in the country to offer a molecular breast imaging device at capital health medical center - hopewell. Full-service imaging suites at capital health locations boast the most advanced equipment available, including low dose, multi-slice dual energy ct scanners and large bore magnetic resonance imaging (mri) machines that features the shortest high-field magnet in the industry ranging from a 1.5 to a 3.0 tesla and functional mri capability. Sleep center ------------ Capital Health's Center for Sleep Medicine is the largest, fully accredited center in Mercer and Bucks counties and has provided comprehensive evaluation and treatment for sleep disordered for more than 30 years. Our Center meets the most stringent quality standards in the industry. Our physicians are board certified in sleep medicine and primary medical specialties, which means they're trained to diagnose and treat the full array of sleep disorders in adults and children. Since many patients suffer from more than one sleep disorder. Comprehensive evaluation and follow-up our focus. In addition, capital health is the only area facility equipped to perform neurological monitoring for complex conditions such as nocturnal seizures. Many sleep centers only offer nighttime testing primarily for sleep apnea. We are fully staffed during the day and night to provide testing and treatment for the entire range of sleep disorders, our experienced staff of board registered sleep technologists ensures our patients receive the highest quality care. Dialysis -------- Since 1970, the capital health renal dialysis services has been the only hospital owned and operated dialysis program in the area. The main objective of the service has been to deliver safe, effective treatment to patients with acute and chronic kidney failure in accordance with federal, state and joint commission regulations. Consisting of 28 hemodialysis and 3 home training stations, this pleasant, state-of-the-art facility provides inpatient and outpatient hemodialysis and peritoneal dialysis services. Our home program offers patients the opportunity to be educated in self-care to perform either dialysis modality in the home setting. It is the commitment of the service that no patient will be denied acceptance because of age, national origin, physical handicap, race, religion, sex or inability to pay. Also, all patients in the service are entitled to any and/or all ancillary services provided by capital health. Other needed services, not directly provided by capital health, are made available through a referral process. Treating diseases of the kidney require the right team to help the patient maintain his/her maximum level of health and activity. Our highly educated and experienced healthcare team, led by a medical director board certified in nephrology, also includes a director of renal dialysis, renal nurse manager, nephrology advanced practice registered nurse, renal clinical nurse specialist, registered and licensed practical nurses, dialysis patient care technician, renal dietitians and renal social workers. This team has successfully met the centers for medicare & medicaid services end stage renal disease quality incentive program goals since their inception. These goals were established to improve patient care by setting performance standards for quality of care.
CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS	Lung Center ----------- In 2020, as part of its commitment to providing leading-edge care, Capital Health has announced the launch of its comprehensive, state-of-the-art Lung Center located at Capital Health Medical Center - Hopewell. The program is designed to address the need for integrated, comprehensive lung services in the region. Comprehensive care at the Lung Center includes a multidisciplinary team of experts focused on each patient and their particular condition. The team includes physicians from surgery, pulmonology, radiation oncology, and medical oncology as well as nurse practitioners, clinical researchers, and support staff. The Lung Center offers a full range of lung disease care, including lung cancer screenings, a lung nodule clinic, thoracic surgery, interventional pulmonology, pulmonary rehabilitation, and smoking cessation. Clinically integrated network ----------------------------- Leading integrated network of clinicians ("linc"), is the capital health sponsored clinically integrated network. Linc will enable better coordination and improve alignment among the healthcare system and physicians to enhance patient care. Linc is a healthcare network that coordinates care across providers and sites-of-care in a manner that enhances value for consumers by improving quality and patient satisfaction, while at the same time, lowering healthcare costs. It is a partnership between physicians and the health system that is collectively committed to improving the quality and efficiency of care delivered to patients across the continuum of care. Linc will be able to participate in value based agreements with managed care plans and other payors that reward quality and efficiency. The linc allows for the alignment of health system and physician goals by providing a structure that enables them to work together to improve patient experience, to monitor and control utilization of healthcare services and assure quality of care, and to selectively choose network physicians who are likely to further these objectives. Capital health medical group ----------------------------- A growing network of integrated care, capital health medical group is our employed network of more than 300 health care providers who offer primary, specialty and surgical care to patients throughout our region, as well as hospital-based services at both hospitals. Working with other physicians within the medical group, as well as other physicians throughout the region and beyond, our experts are dedicated to providing high quality health care carefully coordinated between providers. With providers in three counties in new jersey and pennsylvania, capital health medical group is an extensive network of care, which has continued to grow and expand in 2020. Population health management services, llc ------------------------------------------ Capital health launched a new subsidiary of which they are the sole member, population health management services, llc ("phms"). Phms provides care management services to improve individual care, reduce the cost of care and improve the health of high-risk patients within specific groups. These services include case management of patients that have been identified as high risk, implementing safe transitions of care from the hospital to other sites and service, and providing support by rns, lcsws and health coaches to assist patients that have obstacles or barriers to obtaining the health care they need. Capital health is participating in various Value Based programs including, MSSP, Commercial VBP, and BPCI Advanced a cms, value based bundle program with the goal of improving outcomes and decreasing costs for patients with the diagnosis of stroke. Capital Healthy Living ---------------------- Researched and developed a plan to enhance medical care provided to independent seniors living in the Capital Health service area. Components of this program, expected to launch in 2020, will include telehealth assistance, transportation, care management, social and wellness activities and assistance with scheduling. Definition of community and population served --------------------------------------------- Capital health defines its community as the city of trenton, mercer county and parts of burlington, monmouth, middlesex and bucks counties. While it was once a center for industry in the late 1800's and early 1900's, trenton has seen dramatic economic development challenges over the years. According to the 2020 u.s. census data, median income was $35,402, by far the lowest in mercer county. Based on a population of 83,203, trenton also has the highest number and percentage of minorities in mercer county with an african-american population of 49.5 percent. Hispanics or latinos of any race constituted 38.1 percent, while non-hispanic caucasians were numbered at 12.1 percent. Community benefits programs =========================== Outlined below are a number of capital health community benefit programs. The information is not intended to be all-inclusive but rather provides additional information that further demonstrates how capital health benefits the surrounding community in furtherance of its charitable tax-exempt purposes. Capital health childbirth and parent education program ------------------------------------------------------ Benefit activity: prepared childbirth classes in spanish language The childbirth and parent education program provides, free of charge, a full-day prepared childbirth class to spanish-speaking expectant parents from their community. The class is held every other month and is taught by a capital health certified childbirth and parent educator who is fluent in spanish. Culturally appropriate methods and audio-visual materials are utilized in the teaching of this class. Participants receive free breakfast and lunch. Participants receive spanish language reference materials and an extensive handbook. Referrals to this class come from the capital health, health start prenatal clinic, a community partnership with cuna, and by word-of-mouth. Trauma education ---------------- The bristol-myers trauma center at capital health regional medical center offers free injury prevention programs to members of the community that include pedestrian safety, bicycle safety, seat belt safety, proper use of child safety seats, and home safety. Connecting with the latino community ------------------------------------ Enlace ("link" in spanish) is a name for an innovative capital health program designed to create contacts and connections within the latino community. Through enlace, capital health provides medical interpreting and has translated all vital medical documents and are now doing the same with patient education materials. Enlace also helps educate the latino community about american customs and healthcare practices and provides capital health staff with information about latino cultures. Another program, cuna (which is spanish for "crib"), connects latino women with pre - and post-natal care, and helps new mothers overcome language barriers to better understand health issues. Cuna also offers help with nutrition, coping skills and even babysitting for older children. Dsrip: childhood obesity ------------------------ Capital health has partnered with the school district of trenton and another local elementary school to develop, implement and provide a program to reduce the epidemic of childhood obesity in the region. The program has two aims: to instill an appreciation for healthy eating and active lifestyle in the impressionable child, and to reorient their parents to follow a similar path. We believe that a partnership and linkage must occur so that the child and parent see healthy eating and activity as a family activity. Therefore, while we focus directly on programs for the children, we have concurrently developing a tight linkage with education, weight monitoring and exercise inducement for the parents. The program's model follows the process outlined in shaping new jersey and in serving up health, involving teaching children and their parents the basics of healthy eating and performance of daily aerobic exercise and monitoring of bmi. Dsrip: substance abuse ---------------------- Throughout our healthcare system, our staff sees a large number of individuals with substance abuse disorders and has developed an awareness of the impact of this health issue on other medical conditions. While capital health's dsrip substance abuse program seeks to improve the care of the patient with alcohol withdrawal syndrome by identifying the diagnosis in the early stages and prevent its progression into delirium tremens, capital's certified alcohol and drug abuse counselors focus on connecting diagnosed patients with post-acute substance abuse providers so that they can receive treatment and prevent recidivism.
CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS	Opioid recovery program for pregnant woman ------------------------------------------ Capital health and longtime partners at the trenton health team, the rescue mission, homefront, and catholic charities diocese of trenton have offered for my baby and me, a grant-based program that provides specialized care for pregnant women and new mothers who are struggling with opioid use disorder. Funded by the new jersey department of health, the program promotes long-term recovery as well as ongoing medical care and support for women and their children. Community wellness ------------------ Capital Health Wellness Center is located within the Capital Health Medical Center - Hopewell. Classes are offered to specific patient populations in a small class setting where patient needs, abilities and restrictions are closely monitored by Capital Health certified group exercise instructors and personal trainers. The following patient classes are currently being offered: - Tai Chi and multiple Yoga classes are held weekly for our Cancer Center Patients - Capital Healthy Living participants engage in a weekly exercise and strengthening class as part of their overall program - Strength and fitness classes are held two times a week for our Bariatric and Metabolic Weight Loss Patients - Chair Yoga classes are offered weekly to our Parkinson Patient population Community health education -------------------------- Capital health's community health education program is dedicated to improving the health and well-being of the community, as well as to the prevention and early detection of disease among people living in our community. These goals are accomplished by providing health education and other related services to the general public, as well as to business organizations. These services consist of the speaker's bureau, health fairs/health screenings, health education lecture series and support groups. Programs are held in various locations throughout mercer and bucks counties, with topics including diabetes education, peripheral vascular disease awareness, healthy eating, cancer genetics, and women's health issues and more. The community health education program provides a series of diverse health education programs, related to health maintenance, disease prevention, early detection, general wellness and personal development. A schedule of the programs, screenings and support groups currently open for registration may be viewed online at: www.capitalhealth.org/events. Community sponsorships ---------------------- Capital health is proud to sponsor many local organizations in mercer and bucks counties through in-kind and monetary donations. Capital health supports a variety of civic and cultural organizations that work to improve the wellbeing of the community. Capital health has been in partnership with the mercer county prosecutor's office by sponsoring various conferences and providing start packets to overdose victims and their families, providing immediate counseling to overdose victims and hosting community education programs. Capital health has proven to be a leader in combating the opioid epidemic and in 2016, graciously donated 530 vials replacement supply of the lifesaving naloxone to the mercer county law enforcements for the coming years valued at approximately $33,200. With this donation, every police car in mercer county will be able to continue to be equipped with this life saving opioid antidote. Capital health continues annually to donate vials of naloxone to continue this life saving program. The 2020 naloxone donation was valued at approximately $19,400. Capital health provided various ems in-kind education and training valued at approximately $266,643 in 2020. Capital health provides ems standby services at trenton thunder minor league baseball games. However, due to COVID in 2020, all games were suspended and services were not needed. Conclusion ---------- Capital health is a non-profit organization that has an "open door" policy. This policy means that capital health provides necessary basic hospital care to everyone, regardless of their ability to pay for their care. Capital health is committed to community outreach and education, offering numerous healthcare related programs and activities, including community health fairs, health screenings, health education and medical lectures and seminars annually. Capital health is proud of their many partnerships with local organizations. To further show how capital health is committed to benefiting its community, capital health, in november 2011, opened its $530 million 223-bed hospital in hopewell township, new jersey to replace its existing facility, capital health - mercer, in trenton, new jersey. In addition, capital health regional medical center in trenton underwent a complete renovation. Capital health obtained a hud mortgage guaranteed loan to secure financing of both of these projects. This will allow capital health to use more of its resources to serve the medical needs of its community.
CORE FORM, PART III; QUESTION 2	CAPITAL HEALTH SYSTEM, INC. COMPLETED THE PURCHASE OF A PROPERTY AT 280 MIDDLETOWN BOULEVARD IN LANGHORNE, PA. THE FACILITY WILL BE RENAMED CAPITAL HEALTH AT OXFORD VALLEY AND IS EXPECTED TO OFFER INPATIENT AND OUTPATIENT SERVICES.
CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7	CAPITAL HEALTHCARE, INC. ("CHI") IS THE SOLE MEMBER OF THIS ORGANIZATION. CHI HAS 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	THE ORGANIZATION IS AN AFFILIATE WITHIN CAPITAL HEALTH SYSTEM AND AFFILIATES ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. CAPITAL HEALTHCARE, INC. IS THE TAX-EXEMPT PARENT ENTITY OF THE SYSTEM. THE ORGANIZATION'S FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF ITS GOVERNING BODY (ITS BOARD OF DIRECTORS) PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE ("IRS"). IN ADDITION, THE CAPITAL HEALTH SYSTEM, INC. COMPENSATION COMMITTEE PERFORMED A DETAILED REVIEW OF THE FEDERAL FORM 990 PRIOR TO PROVIDING IT TO EACH VOTING MEMBER OF ITS BOARD OF DIRECTORS. THE CAPITAL HEALTH SYSTEM, INC. BOARD OF DIRECTORS HAS DELEGATED TO THE COMPENSATION COMMITTEE THE RESPONSIBILITY TO OVERSEE AND COORDINATE THE FEDERAL FORM 990 PREPARATION, REVIEW AND FILING PROCESS FOR THE TAX-EXEMPT AFFILIATES OF THE SYSTEM. AS PART OF THE ORGANIZATION'S FEDERAL FORM 990 TAX RETURN PREPARATION PROCESS THE ORGANIZATION 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'S TAX PROFESSIONALS WORKED CLOSELY WITH THE ORGANIZATION'S GENERAL COUNSEL, CHIEF FINANCIAL OFFICER, CHIEF COMPLIANCE OFFICER AND VARIOUS OTHER INDIVIDUALS OF THE SYSTEM ("internal working group") TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE ORGANIZATION'S INTERNAL WORKING GROUP FOR REVIEW. THE ORGANIZATION'S INTERNAL WORKING GROUP REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. IN ADDITION, THE ORGANIZATION'S EXTERNAL INDEPENDENT COMPENSATION CONSULTING FIRM REVIEWED THE DRAFT FEDERAL FORM 990, PART VII AND SCHEDULE J. 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 PRIOR TO PRESENTATION OF THE FEDERAL FORM 990 TO THE MEMBERS OF THE CAPITAL HEALTH SYSTEM, INC. COMPENSATION COMMITTEE. FOLLOWING THE COMPENSATION COMMITTEE'S REVIEW THE FINAL FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY PRIOR TO FILING WITH THE IRS.
CORE FORM, PART VI, SECTION B; QUESTION 12	THE ORGANIZATION IS AN AFFILIATE WITHIN CAPITAL HEALTH SYSTEM AND AFFILIATES ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THE ORGANIZATION AND THE SYSTEM REGULARLY MONITOR AND ENFORCE COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. ANNUALLY ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS AND SENIOR MANAGEMENT PERSONNEL ARE REQUIRED TO REVIEW THE EXISTING CONFLICT OF INTEREST POLICY AND COMPLETE A QUESTIONNAIRE. THE COMPLETED QUESTIONNAIRES ARE RETURNED TO THE ORGANIZATION AND both THE SYSTEM'S senior vice president/chief legal OFFICER and chief compliance officer FOR REVIEW. THEREAFTER THE chief compliance OFFICER PREPARES A SUMMARY OF THE COMPLETED QUESTIONNAIRES WHICH CONTAINS INFORMATION DISCLOSED ON AN INDIVIDUAL BY INDIVIDUAL BASIS. THE SYSTEM'S chief compliance OFFICER THEN PRESENTS THIS SUMMARY TO THE SYSTEM'S FULL BOARD OF DIRECTORS FOR ITS REVIEW AND DISCUSSION. THIS SUMMARY IS UPDATED BY THE chief compliance OFFICER ON A QUARTERLY BASIS.
CORE FORM, PART VI, SECTION B; QUESTION 15	The organization's board of directors has a board 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 all of the organization's senior management and others, including the chief executive officer, chief financial officer and other officers of the organization, physicians, and any other disqualified persons. It also reviews and approves employment agreements for the covered employees and disqualified persons. The committee reviews the "total compensation" of the individuals which is intended to include both current and deferred compensation and all employee benefits, both qualified and non-qualified. The committee's review is done on at least an annual basis and ensures that the "total compensation" of each such individual is reasonable. The actions taken by the committee are intended for the organization to qualify for the rebuttable presumption of reasonableness for purposes of internal revenue code section 4958 with respect to the total compensation of the senior management team. Rebuttal presumption requirements have guided the activities of the committee in all of its reviews, deliberations and approval of executive compensation actions for all of the covered employees and disqualified persons. 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 directors each of whom is independent and are free from any conflicts of interest. The committee relied upon comparability market data provided by its independent compensation consultant from comparable healthcare and hospital peers based on tax-exempt status, revenue, location, services, and other factors to ensure the executives' compensation is representative of the executive talent market and compared to what is "ordinarily paid for like services by like enterprises under like circumstances" as referenced under irs regulations. Contemporaneous minutes are compiled and approved for all Committee deliberations. These are supported by the written documentation of all peer and market compensation studies, as well as detailed performance justification used as the basis for awards under the Organization's incentive programs. Recognizing the need to consider retirement planning for its senior management as a means to aid in their retention, the Committee maintains a form of long-term non-qualified deferred compensation (referred to as the "Performance-Based Capital Accumulation Plan", or "PBCAP"), which is part of the Capital Health System Non-Qualified 457(f) Deferred Compensation Plan. PBCAP provides the Organization with an additional tool to assist in the recruitment and retention of senior management within the highly competitive healthcare labor market. PBCAP provides senior management with the opportunity to qualify for annual deferred contributions, based on achieving specified performance targets and meeting established circuit breakers, to be paid at a future pre-determined date contingent upon continued service with the Organization. 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 Organization's Human Resources Department and independent compensation consultants 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	THE ORGANIZATION DOES NOT COMPENSATE ITS BOARD MEMBERS FOR THEIR SERVICES PERFORMED AS A DIRECTOR. ALL DIRECTORS ARE VOLUNTEERS. COMPENSATION AND BENEFITS, WHERE APPLICABLE FOR CERTAIN MEMBERS, IS RELATED TO THE BOARD MEMBER'S SERVICES PERFORMED AS A FULL-TIME EMPLOYEE OR INDEPENDENT CONTRACTOR OF THE ORGANIZATION.
CORE FORM, PART VII, SECTION A, COLUMN B	THIS ORGANIZATION IS AN AFFILIATE WITHIN CAPITAL HEALTH SYSTEM AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM INCLUDES BOTH FOR-PROFIT AND NOT FOR-PROFIT ORGANIZATIONS. CERTAIN BOARD OF DIRECTOR MEMBERS, OFFICERS AND/OR DIRECTORS LISTED ON CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 MAY HOLD SIMILAR POSITIONS WITH BOTH THIS ORGANIZATION AND OTHER AFFILIATES WITHIN THE SYSTEM. THE HOURS SHOWN ON THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE NO COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, REPRESENT THE ESTIMATED HOURS DEVOTED PER WEEK FOR THIS ORGANIZATION. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF DIRECTORS OF OTHER RELATED ORGANIZATIONS IN THE SYSTEM, THEIR RESPECTIVE HOURS PER WEEK PER ORGANIZATION ARE APPROXIMATELY THE SAME AS REPORTED 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 AND KEY EMPLOYEES, REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF CAPITAL HEALTH SYSTEM; NOT SOLELY THIS ORGANIZATION.
CORE FORM, PART XI; QUESTION 9	OTHER CHANGES IN NET ASSETS OR FUND BALANCES INCLUDE: - PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST; $955,969.
CORE FORM, PART XII; QUESTION 2	THE TAXPAYER IS AN AFFILIATE WITHIN CAPITAL HEALTH SYSTEM AND AFFILIATES, A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM'S TAX-EXEMPT PARENT ENTITY IS CAPITAL HEALTHCARE, INC. AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF THE TAXPAYER AND ALL AFFILIATES FOR THE YEARS ENDED DECEMBER 31, 2020 AND DECEMBER 31, 2019; RESPECTIVELY, AND ISSUED A CONSOLIDATED FINANCIAL STATEMENT WITH CONSOLIDATING SCHEDULES BY ENTITY. AN UNMODIFIED OPINION WAS ISSUED EACH YEAR BY THE INDEPENDENT CPA FIRM. THE TAXPAYER'S AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS consolidated FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT AUDITOR.
CORE FORM, PART XII; QUESTION 3	THE ORGANIZATION IS AN AFFILIATE WITHIN CAPITAL HEALTH SYSTEM AND AFFILIATES ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY 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.
CHS DEPARTMENTAL EIN LISTING.	THE ORGANIZATION'S FEDERAL FORM 990 INCLUDES CERTAIN REVENUE RECEIVED AND EXPENSES INCURRED BY VARIOUS CAPITAL HEALTH SYSTEM, INC. RELATED PROGRAMS, DEPARTMENTS, ACTIVITIES AND CAPITAL HEALTH SYSTEM, INC. EMPLOYEES. REVENUE EARNED FROM THESE PROGRAMS AND ACTIVITES WAS RECEIVED BY CAPITAL HEALTH SYSTEM, INC. UTILIZING FEDERAL employer IDENTIFICATION NUMBERS OTHER THAN 22-3548695. BELOW IS A LIST OUTLINING THE VARIOUS CAPITAL HEALTH SYSTEM, INC. PROGRAMS, DIVISIONS, DEPARTMENTS AND PHYSICIAN EMPLOYEES AND THEIR RESPECTIVE FEDERAL employer IDENTIFICATION NUMBERS: CAPITAL ENDOCRINOLOGY 20-1730017 CAPITAL SURGICAL ASSOCIATES 22-3680051 CHS INSTITUTE FOR NEUROSCIENCES 26-0346624 FAMILY HEALTH CENTER 22-3796256 HAMILTON PHYSICIANS GROUP 22-3502175 HPG AT BORDENTOWN FAMILY MEDICAL 22-3502175 HEART CARE SPECIALISTS AT CH 27-0309548 MERCER MATERNAL FETAL SPECIALTY GROUP 20-2886402 MULTISPECIALTY PROVIDER GROUP 22-3628075 TRENTON NEUROSURGEONS ASSOCIATES 22-2035924 WEST TRENTON MEDICAL ASSOCIATES - EWING 20-4643360 PEDIATRIC HOSPITALIST 27-2627834 REHABILITATION MEDICINE 27-3421189 PRIMARY CARE MOUNTAINVIEW 27-3945093 PRIMARY CARE QUAKERBRIDGE 22-3502175 RADIATION ONCOLOGY 27-1366819 HOSPITALIST GROUP 45-1501476 ADVANCED SURGICAL ASSOCIATES 27-4742615 CENTER FOR DIGESTIVE HEALTH 45-2073374 CENTER FOR SLEEP MEDICINE 45-2074032 CAPITAL WOMEN'S HEALTH CENTER 27-2715382 PRIMARY CARE HAMILTON 22-3502175 POPULATION HEALTH MANAGEMENT SERVICES, LLC 47-5588078 CAPITAL HEALTH MEDICAL GROUP 81-0889110 HAMILTON PHYSICIAN GROUP III - DR. STABILE 22-3502175 CAPITAL HEALTH MULTISPECIALTY GROUP 81-1200310 OCCUPATIONAL HEALTH 85-1274946

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2020

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO IMPROVE THE HEALTH AND WELL-BEING OF THE POPULATIONS WE SERVE IN URBAN AND SUBURBAN COMMUNITIES.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	10
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	6
5	Total number of individuals employed in calendar year 2020 (Part V, line 2a) ......	5	5,557
6	Total number of volunteers (estimate if necessary) .............	6	84
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

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	4,487,573	44,340,211
9	Program service revenue (Part VIII, line 2g) .........	719,305,867	730,403,116
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	6,708,142	780,931
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	2,744,801	2,442,681
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	733,246,383	777,966,939
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	28,503
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)	393,849,433	443,466,351
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	327,563,327	353,199,563
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	721,412,760	796,694,417
19	Revenue less expenses. Subtract line 18 from line 12.......	11,833,623	-18,727,478
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	918,521,088	985,640,390
21	Total liabilities (Part X, line 26).............	811,736,299	890,580,881
22	Net assets or fund balances. Subtract line 21 from line 20.....	106,784,789	95,059,509

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 645,327,893 including grants of $ 28,503 ) (Revenue $ 730,403,116 )
	EXPENSES INCURRED IN PROVIDING INPATIENT, OUTPATIENT, EMERGENCY AND VARIOUS OTHER MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY AND IN FURTHERANCE OF CHARITABLE TAX-EXEMPT PURPOSES. PLEASE REFER TO THE COMMUNITY BENEFIT STATEMENT IN SCHEDULE O.

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 expenses645,327,893

(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
(A) Name and title
(18) CAROLYN J GAUKLER MD........................................................................ DIRECTOR - PRES. MEDICAL STAFF	55.0 .......................0.0	X		300,855	0	24,711
(19) ARMEN SIMONIAN MD........................................................................ DIRECTOR - VP MEDICAL STAFF	25.0 .......................0.0	X		157,500	0	0
(20) RANDI A AXELROD MD........................................................................ SECRETARY - DIRECTOR	5.0 .......................0.0	X	X	32,400	0	0
(21) SEAN S MURRAY........................................................................ CHAIR - DIRECTOR	5.0 .......................0.0	X	X	0	0	0
(22) JOSHUA MARKOWITZ ESQ........................................................................ VICE CHAIR - DIRECTOR	5.0 .......................0.0	X	X	0	0	0
(23) DONALD J LOFF........................................................................ TREASURER - DIRECTOR	3.0 .......................0.0	X	X	0	0	0
(24) AJAY CHOUDHRI MD........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(25) PAUL W CODJOE MD........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(26) TELECHERY A SUDHAKAR MD........................................................................ DIRECTOR	1.0 .......................0.0	X		0	0	0
(27) CARMEN M GARCIA ESQ........................................................................ DIRECTOR (TERMED)	1.0 .......................0.0	X		0	0	0
(28) JULIE A KARNS........................................................................ DIRECTOR (TERMED)	1.0 .......................0.0	X		0	0	0

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	25,249,599	82,847	482,547

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	650,156
e	Government grants (contributions)		1e	43,615,055

f	All other contributions, gifts, grants, and similar amounts not included above		1f	75,000

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		44,340,211

		Business Code
2a	NET PATIENT SERVICE REVENUE	541900	697,483,973	697,483,973
b	OTHER HEALTHCARE RELATED REVENUE	541900	32,852,031	32,852,031
c	AUXILIARY REVENUE	541900	67,112	67,112
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		730,403,116

3 Investment income (including dividends, interest, and othersimilar amounts) ......			1,729,210			1,729,210
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents		1,516,507	6a
b	Less: rental expenses			6b
c	Rental income or (loss)	0	1,516,507	6c
d	Net rental income or (loss).......			1,516,507			1,516,507
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	3,043		7a
b	Less: cost or other basis and sales expenses		951,322	7b
c	Gain or (loss)	3,043	-951,322	7c
d	Net gain or (loss).........			-948,279			-948,279
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..			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..			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..			0
Business Code			Miscellaneous Revenue
11a	CAFE/DIETARY		900099	926,174			926,174
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			926,174
12	Total revenue. See instructions.....			777,966,939	730,403,116		3,223,612

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	0
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	28,503	28,503
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 ...........	20,884,393	16,916,358	3,968,035
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........	366,254,818	296,666,402	69,588,416
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	376,255	304,767	71,488
9	Other employee benefits .......	27,618,637	22,371,096	5,247,541
10	Payroll taxes ...........	28,332,248	22,949,121	5,383,127
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	2,221,531	1,799,440	422,091
c	Accounting ...........	475,450	385,114	90,336
d	Lobbying ...........	134,763	109,158	25,605
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	1,578,433	1,278,531	299,902
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	77,781,744	63,003,213	14,778,531	0
12	Advertising and promotion ....	6,538,468	5,296,159	1,242,309
13	Office expenses .......	15,621,007	12,653,016	2,967,991
14	Information technology ......	7,520,571	6,091,662	1,428,909
15	Royalties ..	0
16	Occupancy ...........	18,196,147	14,738,879	3,457,268
17	Travel ............	0
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	242,453	196,387	46,066
20	Interest ...........	42,940,773	34,782,026	8,158,747
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	36,453,550	29,527,376	6,926,174
23	Insurance ...	15,033,396	12,177,051	2,856,345
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	106,625,031	86,366,275	20,258,756	0
b	REPAIRS AND MAINTENANCE	11,547,050	9,353,110	2,193,940	0
c	DUES AND SUBSCRIPTIONS	1,542,630	1,249,530	293,100	0
d	OTHER EXPENSES	8,746,566	7,084,719	1,661,847	0
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	796,694,417	645,327,893	151,366,524	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			0	1	0
2	Savings and temporary cash investments .........			13,196,604	2	20,050,931
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			104,808,833	4	97,964,638
5	Loans and other receivables from 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 ............			11,184,074	8	10,386,248
9	Prepaid expenses and deferred charges ......			15,016,297	9	22,362,936
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,159,244,117
b	Less: accumulated depreciation	10b	654,376,992	521,589,982	10c	504,867,125
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 ..			218,483,750	13	275,911,990
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			34,241,548	15	54,096,522
16	Total assets. Add lines 1 through 15 (must equal line 33)...			918,521,088	16	985,640,390

17	Accounts payable and accrued expenses .....	111,020,188	17	129,901,392
18	Grants payable ...	0	18	0
19	Deferred revenue .........	0	19	0
20	Tax-exempt bond liabilities .........	0	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 ..	650,686,718	23	630,212,522
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	50,029,393	25	130,466,967
26	Total liabilities. Add lines 17 through 25..	811,736,299	26	890,580,881

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	106,784,789	27	95,059,509
28	Net assets with donor restrictions ...........	0	28	0
	Organizations that do not follow FASB ASC 958, check here 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 ...........	106,784,789	32	95,059,509
33	Total liabilities and net assets/fund balances ........	918,521,088	33	985,640,390

1	Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
3	Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
4	Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .	Yes	No
5	Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
6	Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No

(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) POPULATION HEALTH MGMT SERVICES LLC 750 BRUNSWICK AVENUE TRENTON,NJ08638 47-5588078	HEALTH SVCS.	NJ	2,535,308	241,039	CH SYSTEM
(2) CAPITAL HEALTH MEDICAL GROUP LLC 750 BRUNSWICK AVENUE TRENTON,NJ08638 81-0889110	HEALTH SVCS.	NJ		0	CH SYSTEM
(3) CAPITAL HEALTH ACCOUNTABLE CARE ORG LLC 750 BRUNSWICK AVENUE TRENTON,NJ08638 46-2826739	HEALTH SVCS.	NJ	0	0	CH SYSTEM

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)CAPITAL HEALTH SYSTEM FOUNDATION INC 750 BRUNSWICK AVENUE TRENTON,NJ08638 22-2230681	SUPPORT CHS	NJ	501(C)(3)	509(A)(1)	CH SYSTEM	Yes
(2)CAPITAL HEALTHCARE INC 750 BRUNSWICK AVENUE TRENTON,NJ08638 47-3857888	HEALTH SVCS.	NJ	501(C)(3)	509(A)(3)	NA		No

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) CAPITAL HEALTH SYSTEM FOUNDATION INC	C	650,156	COST
(2) CAPITAL HEALTH SYSTEM FOUNDATION INC	O	316,097	COST

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership