Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
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Total |
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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. | ||||||
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 | ||||||
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.) | ||||||
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.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
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| 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 | ||||
| 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. |
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| 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) |
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| 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. |
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|
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. |
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7 Excess distributions carryover to 2021. Add lines 3j and 4c. |
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| 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..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
|---|
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| CORE FORM PAGE 1, SECTION B; AMENDED RETURN | THIS FEDERAL FORM 990 HAS BEEN AMENDED TO REFLECT THE ORGANIZATION'S BALANCE SHEET, STATEMENT OF REVENUE AND STATEMENT OF FUNCTIONAL EXPENSES IN ACCORDANCE WITH ITS AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED DECEMBER 31, 2020. THESE CHANGES AFFECTED THE FOLLOWING PARTS OF THIS AMENDED FORM 990: - CORE FORM, PART I; LINES 8 - 22 - CORE FORM, PART III, LINE 4A - CORE FORM, PART VIII - CORE FORM, PART IX - CORE FORM, PART X - CORE FORM, PART XI - SCHEDULE H, PART I, LINE 7 - SCHEDULE H, PART III, LINE 3 THE ORGANIZATION'S SCHEDULE H HAS BEEN UPDATED TO INCORPORATE INFORMAION WITH RESPECT TO (1) ITS COMPLETED COMMUNITY HEALTH NEEDS ASSESSMENT; AND (2) UPDATED FINANCIAL ASSISTANCE POLICY. THESE CHANGES HAVE IMPACTED THE FOLLOWING PARTS OF THIS AMENDED FORM 990: - SCHEDULE H, PART V; SECTION B - SCHEDULE H, PART V; SECTION C - SCHEDULE H, PART V; SECTION D - SCHEDULE H, PART VI LASTLY, OTHER CHANGES INCORPORATED INTO THIS AMENDED FORM 990 IMPACTED THE FOLLOWING AREAS: - CORE FORM, PART I; LINE 2 & CORE FORM, PART VI; QUESTION 1A - CORE FORM, PART VI; QUESTION 11A (AND ASSOCIATED SCHEDULE O NARRATIVE) - CORE FORM, PART VI; QUESTION 12C (AND ASSOCIATED SCHEDULE O NARRATIVE) - CORE FORM, PART VII; SECTION A - CORE FORM, PART XII; QUESTION 3B (AND ASSOCIATED SCHEDULE O NARRATIVE) - SCHEDULE B - SCHEDULE J, PART II - SCHEDULE L (AND ASSOCIATED SCHEDULE L NARRATIVE) - SCHEDULE O NARRATIVE FOR CORE FORM, PART VI; QUESTION 15 THE ORGANIZATION'S FINAL AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED DECEMBER 31, 2020 HAVE BEEN ATTACHED TO THIS AMENDED FEDERAL FORM 990. |
| CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS | BACKGROUND ========== SALEM COUNTY HOSPITAL CORPORATION ("SALEM MEDICAL CENTER") IS RECOGNIZED BY THE IRS AS AN INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, SALEM MEDICAL CENTER PROVIDES HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. MOREOVER, SALEM MEDICAL CENTER OPERATES CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545: 1) PROVIDES HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF-PAY, MEDICARE AND MEDICAID PATIENTS; 2) OPERATES AN EMERGENCY DEPARTMENT FOR ALL PERSONS; WHICH IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR; 3) MAINTAINS AN OPEN MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; 4) CONTROL OF SALEM MEDICAL CENTER RESTS WITH ITS BOARD OF TRUSTEES WHICH IS COMPRISED OF INDEPENDENT CIVIC LEADERS AND OTHER PROMINENT MEMBERS OF THE COMMUNITY; AND 5) SURPLUS FUNDS ARE USED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND RENOVATE FACILITIES AND ADVANCE MEDICAL CARE, PROGRAMS AND ACTIVITIES. THE OPERATIONS OF SALEM MEDICAL CENTER AS SHOWN THROUGH THE FACTORS OUTLINED ABOVE AND OTHER INFORMATION CONTAINED HEREIN, CLEARLY DEMONSTRATE THAT THE USE AND CONTROL OF SALEM MEDICAL CENTER IS FOR THE BENEFIT OF THE PUBLIC AND THAT NO PART OF THE INCOME OR NET EARNINGS OF THE ORGANIZATION INURES TO THE BENEFIT OF ANY PRIVATE INDIVIDUAL NOR IS ANY PRIVATE INTEREST BEING SERVED OTHER THAN INCIDENTALLY. SALEM MEDICAL CENTER PROVIDES HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY. MOREOVER, SALEM MEDICAL CENTER PROVIDES HEALTHCARE SERVICES TO PATIENTS WHO MEET CERTAIN CRITERIA DEFINED BY THE NEW JERSEY DEPARTMENT OF HEALTH AND HUMAN SERVICES WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. SALEM MEDICAL CENTER 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 FINANCIAL ASSISTANCE POLICY. HISTORY ======= SALEM MEDICAL CENTER WAS ORIGINALLY FOUNDED AS "SALEM COUNTY MEMORIAL HOSPITALBECAME ONE OF THE FIRST MEDICAL CENTERS IN SOUTHERN NEW JERSEY. THE MEDICAL CENTER'S FOUNDING CAN BE TRACED BACK TO LATE 1918, WHEN IMMEDIATELY FOLLOWING THE END OF WORLD WAR I, A SMALL GROUP OF CONCERNED SALEM COUNTY CITIZENS SPEARHEADED THE DRIVE TO ESTABLISH A MUCH-NEEDED HOSPITAL FOR THE PEOPLE OF SALEM COUNTY AS A MEMORIAL "TO THE SOLDIERS AND SAILORS OF SALEM COUNTY WHO PARTICIPATED IN THE GREAT WAR." THE ORIGINAL MEDICAL STAFF OF THE 30-BED HOSPITAL WAS COMPOSED OF 12 PHYSICIANS, SUPPORTED BY 4 NURSES, AN ORDERLY, A COOK, AND A MATRON. THE MEDICAL CENTER REMAINED AT ITS ORIGINAL LOCATION FOR 32 YEARS BEFORE MOVING OPERATIONS TO ITS CURRENT LOCATION IN NEIGHBORING MANNINGTON TOWNSHIP IN SEPTEMBER 1951. APPROXIMATELY 10 YEARS LATER, CONSTRUCTION EXPANDED THE HOSPITAL TO 133 BEDS AND BY THE EARLY 1970S, THE HOSPITAL WOULD BE EXPANDED AGAIN WITH THE ADDITION OF OPERATING ROOMS, RADIOLOGY, A LABORATORY, AND EMERGENCY UNITS. CONSTRUCTION PROJECTS CONTINUED, ADDING INTENSIVE CARE, TELEMETRY, AND A WOMEN'S UNIT. IN 2006, THE NEW EMERGENCY DEPARTMENT OPENED. COMMITMENT TO COMMUNITY ======================= MISSION: TO DELIVER HIGH QUALITY, COMPASSIONATE HEALTHCARE TO GREATER SALEM COUNTY. VISION: AS A NOT-FOR-PROFIT HOSPITAL, SALEM MEDICAL CENTER WILL FOCUS ON PATIENTS FIRST, ENSURING THAT THE HIGHEST QUALITY OF CARE IS ALWAYS PRIORITY NUMBER ONE. WE ARE PROUD TO SERVE SALEM COUNTY AND ARE COMMITTED TO WORKING WITH THE COMMUNITY TO MAKE THE FUTURE OF HEALTHCARE DELIVERY IN THE REGION BRIGHTER AND MORE SUSTAINABLE THAN THE PAST. SALEM MEDICAL CENTER WILL KEEP A FOCUS ON MAKING THE SERVICES THAT WE PROVIDE, BOTH HOSPITAL BASED AND OUTPATIENT PROGRAMS, REFLECTIVE OF THE EVOLVING NEEDS OF THE POPULATION WE SERVE. TODAY, 100 YEARS LATER, SALEM MEDICAL CENTER CONTINUES TO BUILD ON ITS PROUD HISTORY, WITH THE SAME MISSION OF PROVIDING QUALITY HEALTHCARE TO THE PEOPLE OF SALEM COUNTY AND SURROUNDING AREAS. SALEM MEDICAL CENTER IS AGAIN LOOKING TO MODERNIZE ITS FACILITY, WITH SEVERAL PROJECTS UNDERWAY, INCLUDING: - RENOVATIONS TO THE VISITOR LOBBY; - RENOVATIONS TO THE AMBULATORY SURGERY CENTER, INCLUDING THREE OPERATING SUITES, ONE ENDOSCOPY ROOM, SEVEN PRE-OP, SEVEN POST-OP, AND FOUR STEPDOWN CHAIRS; - CONSTRUCTION OF A MEDICAL SURGICAL UNIT THAT WILL SERVICE PATIENTS WITH A SECONDARY DIAGNOSIS OF SUBSTANCE ABUSE; AND - A FULLY DIGITAL IMAGING SUITE, OFFERING 3-D MAMMOGRAPHY, MRI, DEXA SCANS, NUCLEAR MEDICINE, PET SCANS, CT SCANS, AND ULTRASOUND TESTING. AS PART OF A STRONG COMMITMENT TO THE COMMUNITY, SALEM MEDICAL CENTER IS PROUD TO DEBUT ITS FIRST MAGAZINE CALLED "HEALTH CONNECTIONS." THE MAGAZINE WILL PUBLISH THREE TIMES A YEAR, AND WILL FEATURE ARTICLES ON SALEM MEDICAL CENTER SERVICES AND ITS PHYSICIANS, AS WELL AS GENERAL WELLNESS ARTICLES, HEALTHY RECIPES, AND EXERCISE TIPS. AS ONE OF ONLY TWO ACUTE CARE HOSPITALS IN SALEM COUNTY, SALEM MEDICAL CENTER SEES THE LAUNCH OF ITS HEALTH CONNECTIONS MAGAZINE AS A WAY TO FURTHER CONNECT WITH THE SURROUNDING COMMUNITY THAT IT SERVES. SMC IS GUIDED BY A VOLUNTEER BOARD, COMPRISED OF MANY LOCAL MEMBERS, WITH ONLY THE BEST INTEREST OF THE HOSPITAL AND COMMUNITY IN MIND. SMC CONTINUES TO GROW WITH THE ADDITION OF A MUCH NEEDED 26-BED INPATIENT PSYCHIATRIC UNIT AND A MEDICAL-SURGICAL UNIT THAT WILL SERVICE PATIENTS WITH A SECONDARY DIAGNOSIS OF SUBSTANCE ABUSE. SMC'S WOUND CARE MOVED TO THE FRONT OF THE FACILITY WITH ITS OWN OUTSIDE ENTRANCE MAKING ENTRY MUCH EASIER FOR PATIENTS. THE FULLY DIGITAL IMAGING SUITE OFFERS 3D MAMMOGRAPHY, MRI, DEXA SCANS, NUCLEAR MEDICINE, ULTRASOUND AND PET OR CT SCANS ONCE A MONTH. THE RETURN OF BARIATRIC SURGERY PERFORMED BY DR. HARISH KAKKILAYA IS AN EXCITING ADDITION FOR THE HOSPITAL, AND INTERVENTIONAL RADIOLOGY IS A SPECIAL SERVICE OFFERED TO TREAT PERIPHERAL ARTERY DISEASE. CLINICAL SERVICES ================= SMC IS LICENSED FOR 126 BEDS, INCLUSIVE OF MEDICAL-SURGICAL, INTENSIVE CARE AND BEHAVIORAL HEALTH. SMC PROVIDES CRITICAL ACCESS TO THE COMMUNITY THROUGH ITS EMERGENCY DEPARTMENT (NEARLY 20,000 PATIENTS ANNUALLY), SURGERY (OUTPATIENT/INPATIENT, ABOUT 2,500 CASES ANNUALLY) AND INPATIENT ACUTE CARE (ABOUT 2,500 ADMISSIONS ANNUALLY) AND MANY OTHER PROGRAMS THAT SUPPORT BOTH HEALTH AND BEHAVIORAL HEALTH CARE ACCESS AND PROMOTE QUALITY OF LIFE. SALEM MEDICAL CENTER OFFERS MANY ELECTIVE - NON-EMERGENCY - SURGERIES AND INVASIVE PROCEDURES INCLUDING HIP AND KNEE REPLACEMENTS, PROCEDURES TO RELIEVE PAIN AND DISCOMFORT, AND DIAGNOSTIC PROCEDURES SUCH AS COLONOSCOPIES AND MAMMOGRAMS. THE FULL LIST OF SERVICES OFFERED BY SALEM MEDICAL CENTER CAN BE GROUPED INTO THE FOLLOWING: - BARIATRIC SURGERY - BEHAVIORAL HEALTH SERVICES - COLONOSCOPY - CRITICAL CARE MEDICINE - DIAGNOSTIC IMAGING - EMERGENCY SERVICES - HEARTBURN - HEART CARE - LABORATORY SERVICES - NEUROSURGERY - PERIPHERAL ARTERY DISEASE - REHABILITATION SERVICES - SLEEP DISORDER CENTER - STROKE CARE - SURGICAL SERVICES - WOUND CARE RESPONSE TO COVID-19 ==================== IN RESPONSE TO THE ESTIMATED POTENTIAL IMPACT OF CORONAVIRUS DISEASE (COVID-19), SALEM MEDICAL CENTER WORKED CLOSELY WITH THE NJ DEPARTMENT OF HEALTH TO PREPARE FOR AN INFLUX OF CRITICALLY ILL PATIENTS. THE PROTOCOLS -- DEVELOPED IN PARTNERSHIP WITH AN INFECTIOUS DISEASE CONSULTANT -- FOCUSED ON CLINICAL DECISIONS REGARDING INTUBATION, THE USE OF HIGH-FLOW OXYGEN, AND CARDIAC ARREST. SMC RETROFITTED 58 MED-SURG BEDS FOR NEGATIVE PRESSURE & TELEMETRY AND PROCURED PROPER PPE FOR ALL STAFF THROUGH DILIGENT EFFORTS OF MATERIALS MANAGEMENT. SUPPORT WAS PROVIDED FOR BOTH CLINICAL AND NONCLINICAL STAFF AFFECTED BY THE PROFOUND IMPACT OF COVID-19. THE TEAM AT SMC PUT THESE PROCESSES AND PROCEDURES IN PLACE DURING A 1-MONTH PERIOD WHILE SURGE PLANNING WAS ONGOING AND THE NEED FOR ICU CAPACITY ROSE EXPONENTIALLY. THE FUTURE ========== WE WILL BE EXPANDING PRIMARY CARE AND SPECIALTY MEDICAL SERVICES THROUGH GROWTH IN MEDICAL STAFF AND STRATEGIC CLINICAL PARTNERSHIPS. NEW AND IMPROVED MEDICAL EQUIPMENT WILL BE IN USE IMMEDIATELY, AND MAJOR RENOVATIONS, STARTING WITH THE REVITALIZATION OF THE AMBULATORY SURGERY CENTER, WILL HELP TRANSFORM SALEM MEDICAL CENTER INTO A 21ST CENTURY HEALTH CENTER. SMC IS DEDICATED TO GROWING NEW SERVICES AND RECRUITING PHYSICIANS RELEVANT TO OUR COMMUNITY AND ARE FOCUSED ON MAKING SMC A DESTINATION OF CHOICE FOR SALEM COUNTY AND THE SURROUNDING AREA. OUR NEW NAME - SALEM MEDICAL CENTER - REFLECTS OUR DUAL MISSION OF PROVIDING HOSPITAL SERVICES WHILE ALSO PROVIDING AN ARRAY OF OUTPATIENT PROGRAMS THAT MEET THE NEEDS OF OUR COMMUNITY. WE ARE PROUD TO BE PART OF SALEM COUNTY AND LOOK FORWARD TO BUILDING ON THE HOSPITAL'S NEARLY 100-YEAR HISTORY OF PROVIDING HEALTHCARE TO RESIDENTS IN THE COMMUNITIES WE SERVE. |
| CORE FORM, PART VI, SECTION A; QUESTION 2 | WILLIAM J. COLGAN, STEVEN ROSEFSKY, JD & MANNY GUANTEZ - BUSINESS RELATIONSHIP. |
| CORE FORM, PART VI, SECTION A; QUESTION 3 | THE ORGANIZATION ENTERED INTO A HOSPITAL MANAGEMENT SERVICES AGREEMENT WITH SALEM HOSPITAL MANAGEMENT, LLC ("MANAGER"), A NEW JERSEY LIMITED LIABILITY COMPANY, WITH EXPERIENCE IN PROVIDING MANAGEMENT AND CONSULTING SERVICES TO ACUTE CARE HOSPITALS. THE MANAGER WAS ENGAGED TO PERFORM THE FOLLOWING SERVICES FOR SALEM MEDICAL CENTER: MANAGEMENT SUPPORT, MANAGED CARE CONTRACTING, VENDOR CONTRACTING, HUMAN RESOURCES CONTRACTING, GROUP PURCHASING, FACILITIES AND PLANT MANAGEMENT, BUSINESS OFFICE STAFF ORIENTATION/TRAINING/SUPPORT, CONTINUING EDUCATION FOR STAFF, PHYSICIAN RELATIONS, CORPORATE COMPLIANCE AND ACCREDITATION COMPLIANCE, REGULATORY COMPLIANCE AND AUDITING, RISK MANAGEMENT, CREDENTIALING, UTILIZATION REVIEW, CORPORATION PERFORMANCE IMPROVEMENT AND QUALITY CONTROL, CASH MANAGEMENT, REVENUE CYCLE MANAGEMENT, PREPARATION OF HOSPITAL OPERATING REPORTS AND FINANCIAL STATEMENTS, MAINTENANCE OF GENERAL LEDGER, INFORMATION TECHNOLOGY SERVICES, AND COORDINATION OF LEGAL MATTERS. IN ADDITION, THE MANAGER WAS CONTRACTED TO PROVIDE THE HOSPITAL WITH FULL-TIME SERVICES OF A CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER. THE FOLLOWING INDIVIDUALS WERE COMPENSATED BY THE MANAGER DURING 2020. ADDITIONALLY, IN ACCORDANCE WITH THE FORM 990 INSTRUCTIONS, INCLUDED BELOW ARE THE INDIVIDUALS' REPORTABLE COMPENSATION AND OTHER COMPENSATION (DEFERRED COMPENSATION & NON-TAXABLE BENEFITS) RECEIVED FROM THE MANAGEMENT COMPANY FOR SERVICES PROVIDED TO SALEM MEDICAL CENTER FOR THE YEAR ENDED DECEMBER 31, 2020. TAMMY TORRES (CHIEF EXECUTIVE OFFICER) -------------------------------------- REPORTABLE COMPENSATION - $321,884 OTHER COMPENSATION (NON-TAXABLE BENEFITS) - $1,075 TOTAL COMPENSATION - $322,959 VINCENT RICCITELI (CHIEF FINANCIAL OFFICER) -------------------------------------- REPORTABLE COMPENSATION - $86,736 OTHER COMPENSATION (NON-TAXABLE BENEFITS) - $4,282 TOTAL COMPENSATION - $91,018 VINCENT RICCITELLI BECAME AN EMPLOYEE OF THE MANAGEMENT COMPANY EFFECTIVE AUGUST 2020. PRIOR TO BECOMING AN EMPLOYEE OF THE MANAGEMENT COMPANY, HEALTHCARE PREFERRED PARTNERS WAS CONTRACTED TO PROVIDE A CHIEF FINANCIAL OFFICER. THE CHIEF FINANCIAL OFFICER WAS RESPONSIBLE FOR THE MANAGEMENT OF THE FINANCIAL FUNCTIONS OF THE HOSPITAL AND RELATED ORGANIZATIONS. IN ADDITION, THE CHIEF FINANCIAL OFFICER WAS RESPONSIBLE FOR MANAGING THE HOSPITAL'S OUTSOURCED FINANCIAL FUNCTIONS, PAYER RELATIONS/CONTRACTING, PHYSICIAN CONTRACTING, PREPARATION OF MONTHLY FINANCIAL STATEMENTS AND MANAGING THE PERFORMANCE OF THE AUDIT OF THE FINANCIAL STATEMENTS. VINCENT RICCITELLI SERVED AS THE CONTRACTED CHIEF FINANCIAL OFFICER THROUGH JULY 2020. FEES PAID TO HEALTHCARE PREFERRED PARTNERS BY SALEM HOSPITAL MANAGEMENT, LLC FOR THE CHIEF FINANCIAL OFFICER SERVICES PROVIDED TO THE SYSTEM AMOUNTED TO $119,000. TOTAL FEES PAID BY THIS ORGANIZATION TO HEALTHCARE PREFERRED PARTNERS FOR ALL CONSULTING SERVICES PROVIDED IS FURTHER DISCLOSED IN SCHEDULE L OF THIS FEDERAL FORM 990. |
| CORE FORM, PART VI, SECTION B; QUESTION 11B | THE ORGANIZATION IS AN AFFILIATE WITHIN SALEM MEDICAL CENTER AND ITS AFFILIATE; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THIS ORGANIZATION'S FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY, ITS BOARD OF TRUSTEES, PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE ("IRS"). THE ORGANIZATION'S GOVERNING BODY HAS ASSUMED THE RESPONSIBILITY TO OVERSEE AND COORDINATE THE FEDERAL FORM 990 PREPARATION, REVIEW AND FILING PROCESS FOR ALL TAX-EXEMPT AFFILIATES WITHIN THE SYSTEM. AS PART OF THE ORGANIZATION'S FEDERAL FORM 990 TAX RETURN PREPARATION PROCESS THE SYSTEM HIRED A PROFESSIONAL CERTIFIED PUBLIC ACCOUNTING ("CPA") FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION TO PREPARE THE FEDERAL FORM 990. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE SYSTEM'S FINANCE PERSONNEL AND OTHER SYSTEM INDIVIDUALS ("INTERNAL WORKING GROUP") TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE INTERNAL WORKING GROUP FOR THEIR REVIEW. THE INTERNAL WORKING GROUP REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE INTERNAL WORKING GROUP FOR FINAL REVIEW AND APPROVAL. FOLLOWING THIS REVIEW, THE FORM 990 WAS THEN PROVIDED TO THE ORGANIZATION'S GOVERNING BODY PRIOR TO FILING WITH THE IRS. |
| CORE FORM, PART VI, SECTION B; QUESTION 12 | SALEM MEDICAL CENTER'S ("SMC") CONFLICT OF INTEREST POLICY REQUIRES OFFICERS AND TRUSTEES TO ANNUALLY DISCLOSE INTERESTS THAT COULD GIVE RISE TO CONFLICTS OF INTEREST. IN 2020, THE PROCESS WAS NOT FOLLOWED FORMALLY DUE TO COVID-RELATED DISRUPTIONS IN THE NORMAL COURSE OF BOARD ACTIVITIES. IN 2020, THE BOARD DID NOT COMPLETE THE ANNUAL DISCLOSURE FORMS PER THE CONFLICT OF INTEREST POLICY, BUT IN COMPLIANCE WITH THE POLICY DISCUSSED POTENTIAL CONFLICTS AS THEY AROSE AND EXCLUDED TRUSTEE(S) WHO HAD A CONFLICT OF INTEREST FROM DISCUSSION AND VOTING ON THE MATTERS WITH WHICH SUCH TRUSTEE(S) HAD A CONFLICT. WHEN A TRUSTEE RECUSED HIMSELF OR HERSELF FROM A VOTE DUE TO A CONFLICT OF INTEREST, THE TRUSTEE'S RECUSAL WAS NOTED IN THE BOARD MINUTES. |
| CORE FORM, PART VI, SECTION B; QUESTION 15 | SALEM MEDICAL CENTER'S ("SMC") SENIOR EXECUTIVE MANAGEMENT (I.E., THE CEO AND CFO) IS PROVIDED THROUGH A MANAGEMENT SERVICES AGREEMENT WITH SALEM HOSPITAL MANAGEMENT, LLC (THE "MANAGER"). SMC'S BOARD OF TRUSTEES INDIRECTLY APPROVES THE COMPENSATION OF THE CEO AND CFO BY APPROVING THE FEE PAID TO THE MANAGER, WHICH IT DID, AND WHICH APPROVAL IS DOCUMENTED IN THE MINUTES OF THE RESPECTIVE SMC BOARD OF TRUSTEES MEETING. IN ORDER TO DETERMINE A REASONABLE FAIR MARKET LEVEL OF COMPENSATION FOR THE CEO AND CFO, THE MANAGER REVIEWED (I) HISTORICAL COMPENSATION OF SMC SENIOR LEADERSHIP UNDER PREVIOUS OWNERSHIP, (II) COMPENSATION DATA FROM SIMILAR HEALTHCARE ORGANIZATIONS FROM IRS FORM 990S, AND (III) A COMPREHENSIVE COMPENSATION SURVEY CONTAINING DATA FROM COMPARABLE HOSPITALS TO SMC IN THE REGION. THE COMPENSATION SURVEY UTILIZED BY THE MANAGER WAS PERFORMED BY AN INDEPENDENT THIRD PARTY. NO ONE FROM EITHER THE MANAGER OR SMC HAD ANY INVOLVEMENT IN THE COMPLETION OF THE COMPENSATION SURVEY. |
| 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 | CORE FORM, PART VII AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM THE ORGANIZATION OR A RELATED ORGANIZATION. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OF THE ORGANIZATION OR RELATED ORGANIZATION AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THE ORGANIZATION'S BOARD OF TRUSTEES. |
| CORE FORM, PART VII, SECTION A, COLUMN B | THE ORGANIZATION IS AN AFFILIATE WITHIN SALEM MEDICAL CENTER AND ITS AFFILIATE; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). CERTAIN BOARD OF TRUSTEE MEMBERS AND OFFICERS INCLUDED 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, REPRESENTS THE ESTIMATED HOURS DEVOTED PER WEEK FOR THIS ORGANIZATION. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF TRUSTEES OF OTHER RELATED ORGANIZATIONS IN THE SYSTEM, THEIR RESPECTIVE HOURS PER WEEK PER ORGANIZATION ARE APPROXIMATELY THE SAME AS REFLECTED ON 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, REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF THE SYSTEM; NOT SOLELY THIS ORGANIZATION. |
| CORE FORM, PART X | THE PRIOR YEAR BALANCE SHEET HAS BEEN RESTATED TO CONFORM WITH THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS. |
| CORE FORM, PART XII; QUESTION 2 | THE ORGANIZATION IS AN AFFILIATE WITHIN SALEM MEDICAL CENTER AND ITS AFFILIATE; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF THE SYSTEM FOR THE YEARS ENDED DECEMBER 31, 2020, AND DECEMBER 31, 2019; RESPECTIVELY. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAIN CONSOLIDATING SCHEDULES ON AN ENTITY-BY-ENTITY BASIS. THE INDEPENDENT CPA FIRM ISSUED AN UNMODIFIED OPINION WITH RESPECT TO THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS HAVE BEEN PREPARED ASSUMING THAT SALEM COUNTY HOSPITAL CORP. (D/B/A SALEM MEDICAL CENTER) AND AFFILIATE WILL CONTINUE AS A GOING CONCERN. AS DISCUSSED IN NOTE 1 TO THE AUDITED FINANCIAL STATEMENTS, THE MEDICAL CENTER HAS A DEFICIENCY OF REVENUE OVER EXPENSES FOR THE YEAR ENDED DECEMBER 31, 2020, A WORKING CAPITAL DEFICIENCY AT DECEMBER 31, 2020, AND MANAGEMENT HAS STATED THAT SUBSTANTIAL DOUBT EXISTS ABOUT THE MEDICAL CENTER'S ABILITY TO CONTINUE AS A GOING CONCERN. ADDITIONALLY, SIGNIFICANT UNCERTAINTY EXISTS WITH RESPECT TO THE ULTIMATE IMPACT OF COVID-19 ON THE MEDICAL CENTER'S FINANCIAL CONDITION. MANAGEMENT'S EVALUATION OF THE EVENTS AND CONDITIONS AND MANAGEMENT'S PLANS REGARDING THESE MATTERS ARE ALSO DESCRIBED IN NOTE 1. THE AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE ANY ADJUSTMENTS THAT MIGHT RESULT FROM THE OUTCOME OF THIS UNCERTAINTY. THE AUDITOR'S OPINION IS NOT MODIFIED WITH RESPECT TO THIS MATTER. THE ORGANIZATION'S BOARD OF TRUSTEES HAS ASSUMED RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE CONSOLIDATED FINANCIAL STATEMENTS, WHICH INCLUDES THIS ORGANIZATION, AND THE SELECTION OF AN INDEPENDENT AUDITOR. |
| CORE FORM, PART XII; QUESTION 3 | THE ORGANIZATION IS IN THE PROCESS OF ACCUMULATING AND PROVIDING THE NECESSARY DOCUMENTS TO ITS INDEPENDENT ACCOUNTING FIRM IN ORDER TO PREPARE AND ISSUE AN AUDIT UNDER THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133. THE AUDIT IS CURRENTLY UNDERWAY AND THE ORGANIZATION ANTICIPATES COMPLETION OF THE A-133 AUDIT WITHIN A REASONABLE PERIOD OF TIME. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONSULTING SERVICES TOTAL FEES:757016 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACT LABOR TOTAL FEES:3227972 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OUTSIDE SERVICES TOTAL FEES:110202 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PHYSICIAN SERVICES TOTAL FEES:3553117 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PURCHASED SERVICES TOTAL FEES:4814078 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:REVENUE CYCLE SERVICES TOTAL FEES:3232630 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OTHER FEES FOR SERVICES TOTAL FEES:764970 |
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