2023-11-13T07:05:07-08:00 2022-12-31 990 2022-01-01 201017013 HACKENSACK SPECIALTY CARE ASSOCIATES PC HACK 9088396787 C/O TAX DEPT 399 THORNALL STREET 2N EDISON NJ 08837 JAMES DEROSA EVP, FINANCE 9088396787 2023-11-13 JAMES DEROSA XXX-XX-XXXX true 3 AAL1 IAL1 FAL1 2022 2023-04-26 12:10:37Z JAMES CLARKE MD 399 THORNALL STREET EDISON NJ 08837 0 false X WWW.HACKENSACKMERIDIANHEALTH.ORG X 2005 NJ TO SERVE AS THE PHYSICIAN SERVICES COMPONENT OF A TAX-EXEMPT HEALTHCARE DELIVERY NETWORK AND TO THEREBY PROMOTE, SUPPORT & FURTHER THE CHARITABLE PURPOSES, PROGRAMS & SERVICES OF HMH HOSPITALS CORP. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2000 0 2000 0 -2000 1611738 1228185 0 0 1611738 1228185 TO SERVE AS THE PHYSICIAN SERVICES COMPONENT OF A TAX-EXEMPT HEALTHCARE DELIVERY NETWORK AND TO THEREBY PROMOTE, SUPPORT & FURTHER THE CHARITABLE PURPOSES, PROGRAMS & SERVICES OF HMH HOSPITALS CORP. false false 0 0 0 PROVIDING MEDICALLY NECESSARY HEALTHCARE SERVICES DIRECTLY TO PATIENTS THROUGH THE PHYSICIANS EMPLOYED BY THE CORPORATION. ALSO, PROVIDING ADMINISTRATIVE, SUPERVISORY, TEACHING, COVERAGE AND RESEARCH SERVICES TO HMH HOSPITALS CORPORATION; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION, IN FURTHERANCE OF ITS PRIMARY TAX-EXEMPT PURPOSE IN PROVIDING 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. ACCORDINGLY, THE CORPORATION IS AN INTEGRAL PART OF HACKENSACK MERIDIAN HEALTH; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY NETWORK. 0 true false false false false false false false false false false false false true false true false true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false true 0 0 true 0 false false false false false false false false false false false false X 1 0 false false false false true true true true true false false true true true true true true true true false X RICHARD HAND 7324818529 399 THORNALL STREET EDISON NJ 08837 X JAMES CLARKE MD PRESIDENT 2.50 X X 0 1095555 42649 0 1095555 42649 false true false NET PATIENT SERVICE REVENUE 541900 0 0 0 0 0 0 0 0 State Income Tax 2000 0 2000 0 2000 0 2000 0 1081234 783399 0 0 530504 444786 1611738 1228185 0 0 0 0 0 X 1611738 1228185 1611738 1228185 1611738 1228185 X -2000 -381553 X X false true X true false X X 1 HMH HOSPITALS CORPORATION 221487576 3 true 0 0 1 0 0 0 0 0 0 true false false false false false false false false false false false false false false true false DUE FROM AFFILIATES 444786 444786 DUE TO AFFILIATES 0 0 X Pt X, Line 2 PRICEWATERHOUSE COOPERS, L.L.P. AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF HACKENSACK MERIDIAN HEALTH, INC. FOR THE YEARS ENDED DECEMBER 31, 2022 AND 2021. THE FOLLOWING DISCLOSURE IS INCLUDED IN THE ORGANIZATION'S INCOME TAX FOOTNOTE INCLUDED IN THE SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES FOOTNOTE OF THE 2022 AUDITED CONSOLIDATED FINANCIAL STATEMENTS THAT REPORTS THE ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 (ASC 740): ALL OF THE NOT-FOR-PROFIT ENTITIES INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS ARE CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE ("CODE") AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THESE ENTITIES, EXCEPT FOR THE PHYSICIAN PRACTICES, ARE ALSO EXEMPT FROM STATE INCOME TAXES. PER THE REQUIREMENT TO ASSESS FOR TAX UNCERTAINTY, MANAGEMENT HAS DETERMINED THAT IT DOES NOT HAVE ANY SIGNIFICANT UNCERTAIN TAX POSITIONS REQUIRED TO BE ACCRUED OR REPORTED. false true false false false false false false false JAMES CLARKE MD 0 681002 0 238031 0 176522 0 15250 0 27399 0 1138204 0 0 Pt I Line 3 PLEASE REFER TO OUR RESPONSE TO CORE FORM, PART VI, QUESTION 15A INCLUDED IN SCHEDULE O. Pt I Line 4b THE AMOUNT REFLECTED IN COLUMN B(III) FOR THE FOLLOWING INDIVIDUAL(S) INCLUDES PARTICIPATION IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") AS THE AMOUNTS WERE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2022 FORM W-2 AS TAXABLE WAGES: JAMES CLARKE, MD, $107,141. Pt VI, Line 6 HMH HOSPITALS CORPORATION IS THE SOLE MEMBER OF THIS ORGANIZATION WHICH EXISTS THROUGH A PHYSICIAN NOMINEE AGREEMENT DUE TO STATE OF NEW JERSEY CORPORATE PRACTICE OF MEDICINE PROHIBITIONS. HMH HOSPITALS CORPORATION HAS THE ULTIMATE AUTHORITY AND RIGHT TO ELECT THE MEMBERS OF THIS ORGANIZATION'S BOARD OF TRUSTEES AND HAS CERTAIN RESERVED POWERS AS DEFINED IN THIS ORGANIZATION'S BYLAWS. Pt VI, Line 7a SEE RESPONSE TO PART VI, QUESTION 6 ABOVE. Pt VI, Line 7b SEE RESPONSE TO PART VI, QUESTION 6 ABOVE. Pt VI, Line 11b THIS ORGANIZATION IS OPERATED BY HACKENSACK MERIDIAN HEALTH, INC. ("HMH"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY NETWORK. HMH'S FINANCE PERSONNEL PREPARED AND REVIEWED THE FEDERAL FORM 990, WHICH WAS THEN REVIEWED BY OTHER APPROPRIATE INTERNAL STAFF FOR ACCURACY. HMH'S BOARD OF TRUSTEES DESIGNATED THE AUDIT AND COMPLIANCE COMMITTEE ("ACC") TO REVIEW THE FORM 990 OF HMH ORGANIZATIONS. THE FORM 990 WAS PROVIDED TO THE MEMBERS OF THE ACC FOR REVIEW. THE PORTIONS OF THE FORM 990 PROVIDING COMPENSATION DISCLOSURES WERE ALSO PROVIDED TO THE BOARDS EXECUTIVE AND PHYSICIAN COMPENSATION COMMITTEE FOR REVIEW. THE FORM 990 WAS ALSO PROVIDED TO EACH VOTING MEMBER OF HMH'S GOVERNING BODY, ITS BOARD OF TRUSTEES, PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. THE HMH BOARD OF TRUSTEES HAS THE FINAL GOVERNING AUTHORITY OVER THE SUBSIDIARIES OF HMH. Pt VI, Line 12c HACKENSACK MERIDIAN HEALTH, INC., THE TAX-EXEMPT PARENT ORGANIZATION OF HACKENSACK MERIDIAN HEALTH, A TAX-EXEMPT INTEGRATED HEALTH CARE DELIVERY NETWORK, HAS ADOPTED A NETWORK-WIDE CONFLICT OF INTEREST POLICY WHICH IS APPLICABLE TO ALL OF ITS SUBSIDIARY ORGANIZATIONS. THE ORGANIZATIONS REGULARLY MONITOR AND ENFORCE COMPLIANCE WITH THE NETWORK'S CONFLICT OF INTEREST POLICY. ANNUALLY, ALL MEMBERS OF THE BOARD OF TRUSTEES, OFFICERS AND KEY EMPLOYEES OF EACH ORGANIZATION ARE REQUIRED TO REVIEW THE EXISTING CONFLICT OF INTEREST POLICY AND COMPLETE A QUESTIONNAIRE WITH RESPECT TO ANY APPLICABLE TRANSACTIONS AND RELATIONSHIPS. THE COMPLETED QUESTIONNAIRES ARE RETURNED TO THE NETWORK'S CHIEF COMPLIANCE OFFICER FOR REVIEW. THE CHIEF COMPLIANCE THEN PREPARES A SUMMARY OF THE COMPLETED QUESTIONNAIRES, AND PRESENTS THE SUMMARY TO THE NETWORK'S GOVERNANCE AND BOARD DEVELOPMENT COMMITTEE FOR ITS REVIEW, DISCUSSION AND ACTION (IF NEEDED). ANY TRUSTEE, OFFICER OR KEY EMPLOYEE WITH A DISCLOSED CONFLICT WOULD RECUSE THEMSELVES FROM PARTICIPATING IN THE GOVERNING BODY'S DELIBERATIONS AND DECISIONS OF A TRANSACTION IN QUESTION. DURING THE YEAR, THE CHIEF COMPLIANCE OFFICER IN CONJUNCTION WITH THE GENERAL COUNSEL ALSO MONITORS ON-GOING TRANSACTIONS IN LIGHT OF THE SUMMARY TO ENSURE THAT ANY POTENTIAL CONFLICTS OF INTEREST ARE APPROPRIATELY HANDLED IN COMPLIANCE WITH THE POLICY. Pt VI, Line 15a REASONABLE COMPENSATION IS DETERMINED BY 1) A REVIEW OF THE PHYSICIAN'S BACKGROUND AND EXPERIENCE, INCLUDING EDUCATION, PROFESSIONAL AND ADMINISTRATIVE QUALIFICATIONS, RESEARCH PROJECTS, PUBLICATIONS, AND COMMUNITY ACTIVITIES; 2) ASSIGNED RESPONSIBILITIES AND ADMINISTRATIVE AND CLINICAL WORK VOLUMES INCLUDING OFF-HOURS ON-CALL COVERAGE; AND 3) MARKET DEMAND FOR THE PHYSICIANS IN THE PARTICULAR SPECIALTY. THEN, A COMPARISON OF PHYSICIAN COMPENSATION TO NATIONAL BENCHMARKS FOR PHYSICIANS IN SIMILAR POSITIONS IS DONE. COMPENSATION IS BENCHMARKED WITH WIDELY USED INDUSTRY STANDARDS AND PUBLISHED SURVEYS, SUCH AS THOSE OF MEDICAL GROUP MANAGEMENT ASSOCIATION AND SULLIVAN COTTER,INC. THE PHYSICIAN'S POSITION AND PROPOSED COMPENSATION, THE COMPARABILITY DATA RELATING TO HIS OR HER MEDICAL SPECIALTY, OPINIONS FROM COMPENSATION CONSULTANTS, IF INDICATED, AND ANY OTHER INFORMATION DEEMED RELEVANT FOR ALL NEW PHYSICIANS AND FOR CHANGES IN COMPENSATION FOR EXISTING PHYSICIANS ARE REVIEWED BY A COMMITTEE OF HACKENSACK MERIDIAN HEALTH, INC., TO CONFIRM FAIR MARKET VALUE. IF A PHYSICIAN'S PROPOSED ANNUAL TOTAL CASH COMPENSATION EXCEEDS CERTAIN PARAMETERS SPECIFIED BY THE EXECUTIVE AND PHYSICIAN COMPENSATION COMMITTEE (EPCC) OF THE BOARD OF TRUSTEES OF HACKENSACK MERIDIAN HEALTH, AN ADDITIONAL LEVEL OF REVIEW AND APPROVAL IS COMPLETED BY THE EPCC. PRIOR TO REVIEW BY THE EPCC, THE INDEPENDENT NATIONAL COMPENSATION CONSULTANT TO HMH IS ENGAGED TO PROVIDE A VALUATION OPINION TO ASSIST THE EPCC IN ITS ASSESSMENT AND DETERMINATION OF COMPENSATION. THE EPCC ASSESSES THE MARKET DATA PROVIDED BY AN INDEPENDENT NATIONAL COMPENSATION CONSULTING FIRM AND OTHER APPROPRIATE INFORMATION TO DETERMINE THE ADDITIONAL FACTORS THAT SUPPORT THE FAIR MARKET VALUE OF THE PROPOSED COMPENSATION, AND THE EPCC THEN REACHES A CONCLUSION ON THE FAIR MARKET VALUE OF THE PROPOSED COMPENSATION. Pt VI, Line 15b SEE RESPONSE TO PART VI, QUESTION 15A ABOVE. Pt VI, Line 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. Pt VII, Col (E) CORE FORM, PART VII AND SCHEDULE J PART VII AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM A RELATED ORGANIZATION. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OF THE RELATED ORGANIZATION AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THIS ORGANIZATION'S BOARD OF DIRECTORS. Pt XII, Line 2c PRICEWATERHOUSE COOPERS, L.L.P. AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF HACKENSACK MERIDIAN HEALTH, INC. FOR THE YEARS ENDED DECEMBER 31, 2022 AND 2021, INCLUDING THIS ORGANIZATION. PRICEWATERHOUSE COOPERS, L.L.P. ISSUED AN UNQUALIFIED OPINION WITH RESPECT TO THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS. THE HACKENSACK MERIDIAN HEALTH, INC. AUDIT AND COMPLIANCE COMMITTEE HAS ASSUMED RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE CONSOLIDATED FINANCIAL STATEMENTS, WHICH INCLUDES THIS ORGANIZATION, AND THE SELECTION OF AN INDEPENDENT AUDITOR. Pt XI FORM 990, PART XI, LINE 9: INTERNAL EQUITY TRANSFER- ($381,553). HACKENSACK MERIDIAN HEALTH INC C/O TAX DEPT 343 THORNALL STREET 8T EDISON NJ 08837 223474145 HEALTH SVCS. NJ 501(C)(3) 12C NA false PALISADES MEDICAL ASSOCIATES LLC 7600 RIVER ROAD NORTH BERGEN NJ 07047 223814193 HEALTH SVCS. 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