2024-11-14T14:52:39-06:00 2023-12-31 WithumSmithBrown PC 200 Jefferson Park Suite 400 Whippany NJ 079811070 990 2023-01-01 221750190 CENTRASTATE MEDICAL CENTER INC % LAURA SCHILARE MBA CPA CENT 7322947050 901 WEST MAIN STREET FREEHOLD NJ 07728 LAURA SCHILARE VP FINANCE 7322947050 2024-05-15 true true Scott J Mariani P00642486 9738989494 2023 2024-10-15 13:58:12Z THOMAS W SCOTT 901 WEST MAIN STREET FREEHOLD NJ 07728 385323074 false X WWW.CENTRASTATE.COM X 1964 NJ CENTRASTATE MEDICAL CENTER'S MISSION IS TO ENHANCE THE HEALTH AND WELL-BEING OF OUR COMMUNITIES THROUGH THE COMPASSIONATE DELIVERY OF QUALITY HEALTHCARE. 20 11 2416 258 313122 0 21469382 24791227 319198497 352837084 8304094 3409724 4820734 3238130 353792707 384276165 7570 3508 0 0 163610313 173620135 0 0 0 215963709 213523974 379581592 387147617 -25788885 -2871452 400044996 442523512 167447921 189553750 232597075 252969762 X CENTRASTATE MEDICAL CENTER'S MISSION IS TO ENHANCE THE HEALTH AND WELL-BEING OF OUR COMMUNITIES THROUGH THE COMPASSIONATE DELIVERY OF QUALITY HEALTHCARE. PLEASE REFER TO THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT INCLUDED IN SCHEDULE O. false true 348433206 3508 353150206 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. 348433206 true true false true false false false false false false true false true true true true false true false true true false false false false false true true false false true false false false false false false false false false false false false false true true true false false true 240 0 true 2416 true true true true CJ false false false false false false false false false false X 20 11 false false false false true true true true true false false true true true true true true true true true true NJ X X LAURA SCHILARE MBA CPA 7322947050 901 WEST MAIN STREET FREEHOLD NJ 07728 X THOMAS W SCOTT FACHE TRUSTEE-PRESIDENT/CEO 55.0 0.0 X X 870269 0 56253 JAMES J MATERA MD SVP/MEDICAL DIRECTOR 55.0 0.0 X 775843 0 38566 DEBORAH ROMMEL-CONNORS MBA VP REVENUE CYCLE 50.0 0.0 X 640112 0 46261 JOHN A DELLOCONO SVP/CFO 55.0 0.0 X 602968 0 59705 AMIT S KHAROD MD TRUSTEE 50.0 0.0 X 40750 492614 31030 MOUSTAFA SHAFEY MD MEDICAL DIR. - MENTAL HLTH 55.0 0.0 X 356673 0 36490 CATHLEEN G JANZEKOVICH VP, PATIENT SERVICES 50.0 0.0 X 361805 0 28423 KAREN B FREEMAN MSA VP QUALITY & PATIENT SAFETY 50.0 0.0 X 348303 0 36884 HOWARD A STEIN MD PHYSICIAN 50.0 0.0 X 332487 0 36051 JAMES RICHVALSKY VP, PHYS PRACT MGMT(TERM 8/23) 50.0 0.0 X 333604 0 33493 NANCY BARONE CSHCF VP OF DEVELOPMENT 50.0 0.0 X 292541 0 42379 DANIELLE VANWERT VP CLINICAL SERVICES 50.0 0.0 X 286551 0 46233 VINCENT L D'ELIA VP MRKTING PUBLIC/GOVT REL. 50.0 0.0 X 285284 0 36051 KIMBERLY H SIMERS AVP INTEGRATIVE HEALTH 50.0 0.0 X 261575 0 39870 LAURA L SCHILARE VP FINANCE 50.0 0.0 X 262217 0 34987 DAVID A DE SIMONE ESQ FORMER KEY EMPLOYEE 55.0 0.0 X 263333 0 0 KENNNETH ENG DO TRUSTEE 50.0 0.0 X 0 244774 15668 JOHN P DETULLIO MD TRUSTEE 50.0 0.0 X 0 205145 6959 ASHISH AWASTHI MD FACC TRUSTEE 25.0 0.0 X 60750 0 0 RAMANASRI KUDIPUDI MD TRUSTEE 5.0 0.0 X 11250 0 0 JOHN M CANTALUPO ESQ CHAIR - TRUSTEE 1.0 0.0 X X 0 0 0 KENNETH J REILLY CWS VICE CHAIR - TRUSTEE 1.0 0.0 X X 0 0 0 NADIA K BATCHELOR SECRETARY/TREASURER-TRUSTEE 1.0 0.0 X X 0 0 0 JOHN F EGGERT TRUSTEE 1.0 0.0 X 0 0 0 ROBERT GORDON DDS TRUSTEE 1.0 0.0 X 0 0 0 BRIAN GRAGNOLATI TRUSTEE 55.0 0.0 X 0 0 0 MAUREEN M LAWRENCE TRUSTEE 1.0 0.0 X 0 0 0 PETER G LICATA ESQ TRUSTEE 1.0 0.0 X 0 0 0 BARABRA J MCMORROW TRUSTEE 1.0 0.0 X 0 0 0 GERALD K NORKUS TRUSTEE 1.0 0.0 X 0 0 0 MAUREEN A SCHNEIDER PHD MBA RN TRUSTEE 55.0 0.0 X 0 0 0 WILLIAM A SCHORIES TRUSTEE 1.0 0.0 X 0 0 0 STEVEN SHERIS MD FACC FACP TRUSTEE 55.0 0.0 X 0 0 0 BRETT TAFT TRUSTEE 1.0 0.0 X 0 0 0 6386315 942533 625303 492 true true false HEALTH CAROUSEL LLC PO BOX 714216 CINCINNATI OH 452714216 STAFFING 6575865 THE BARHAM GROUP LLC 4239 HWY 33 TINTON FALLS NJ 07753 CONSTRUCTION 2272365 ERNST YOUNG LLP PO BOX 640382 PITTSBURGH PA 15264 ACCOUNTING 1733530 MAINSAIL HOLDCO LLC PO BOX 1437 COLUMBUS GA 31902 BILLING 1224935 PEARL STREET SYSTEMS 7 COMMERCE STREET SOMERVILLE NJ 08876 CONSTRUCTION 1095229 49 5395391 17895836 1500000 24791227 NET PATIENT SERVICE REVENUE 621990 344793767 344793767 OTHER HEALTHCARE RELATED REVENUE 621990 8043317 8043317 352837084 3853702 3853702 0 0 2599177 2599177 0 2599177 313122 2286055 602931 1046909 -443978 -443978 -443978 0 0 0 0 0 0 0 0 0 CAFETERIA INCOME 621990 638953 638953 638953 384276165 352837084 313122 6334732 X 3508 3508 0 0 0 4816716 4335044 481672 0 135745770 122171193 13574577 5688486 5119637 568849 17067359 15360623 1706736 10301804 9271624 1030180 338908 305017 33891 431657 388491 43166 0 28490 25641 2849 0 241127 217014 24113 50917160 45825444 5091716 0 2710524 2439472 271052 14516331 13064698 1451633 3321599 2989439 332160 0 5668060 5101254 566806 110884 99796 11088 0 0 2686991 2418292 268699 0 17707386 15936647 1770739 3997758 3597982 399776 MEDICAL SUPLLIES 84301757 75871581 8430176 SUPPORT SERVICES 4700004 4230004 470000 REPAIRS & MAINTENANCE 4327509 3894758 432751 PURCHASED SERVICES 3574663 3217197 357466 13943166 12548850 1394316 387147617 348433206 38714411 0 8308293 8511481 14535639 11754015 0 0 33151129 34963642 0 0 0 0 0 0 3014031 2635234 2536435 2336909 247954730 31642923 189406071 216311807 0 0 0 0 122190229 120014864 0 0 26903169 45995560 400044996 442523512 53010445 53030558 0 0 0 0 0 0 0 0 0 0 6271269 6336850 0 0 108166207 130186342 167447921 189553750 X 215577120 232051000 17019955 20918762 232597075 252969762 400044996 442523512 X -2871452 6634021 16610118 X X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 28490 28490 false SCHEDULE C, PART II-B; LINE II DURING 2023, THE ORGANIZATION PAID AN OUTSIDE LOBBYING FIRM WHICH ENGAGED IN LOBBYING EFFORTS ON BEHALF OF THE ORGANIZATION ADRESSING FEDERAL AND STATE HEALTHCARE MATTERS. THIS ALLOCATION AMOUNTED TO $15,600 DURING THE YEAR ENDED DECEMBER 31, 2023. IN ADDITION, THE ORGANIZATION IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION AND THE NEW JERSEY HOSPITAL ASSOCIATION WHICH ENGAGE IN LOBBYING EFFORTS ON BEHALF OF THEIR MEMBER HOSPITALS. A PORTION OF THE DUES PAID TO THESE ORGANIZATIONS HAS BEEN ALLOCATED TO LOBBYING ACTIVITIES PERFORMED ON BEHALF OF THE ORGANIZATION. THIS ALLOCATION AMOUNTED TO $12,890 DURING THE YEAR ENDED DECEMBER 31, 2023. 23938253 23938253 103011392 14306458 88704934 19202166 1439671 17762495 101802919 15896794 85906125 216311807 PROGRAM RELATED INVESTMENTS 98110535 F ASSETS HELD BY RELATED ORG. 20919332 F INVESTMENT IN SURGICARE 284779 F INVESTMENT IN CS HEALTH PRTNRS 290457 F LIFE CARE CONTRACTS APPLEWOOD 409761 F 120014864 DUE FROM AFFILIATES - CURRENT 26782780 DUE FROM AFFILIATES - NC 4708950 OTHER RECEIVABLES 8220136 SECURITY DEPOSITS 1092087 RESTRICTED CASH - ASSET 923588 OPERATING LEASE ASSETS 4268019 45995560 0 DUE TO AFFILIATES 14291469 EST. 3RD PARTY PAYOR SETTLEMENTS 19858447 RESTRICTED FUNDS - LIABILITY 968773 WORKERS COMP INSURANCE - RESERVE 5279929 AHS OBLIGATED GROUP LIABILITIES 89787724 130186342 X SCHEDULE D, PART X; LINE 2 THE ORGANIZATION IS AN AFFILIATE WITHIN CENTRASTATE HEALTHCARE SYSTEM, INC.; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF CENTRASTATE HEALTHCARE SYSTEM, INC AND RELATED ENTITIES FOR THE YEARS ENDED DECEMBER 31, 2023 AND DECEMBER 31, 2022; RESPECTIVELY. THE FOLLOWING FOOTNOTE IS INCLUDED IN THE SYSTEM'S 2023 AUDITED CONSOLIDATED FINANCIAL STATEMENTS THAT REPORTS THE ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 (ASC 740): THE SYSTEM ACCOUNTS FOR DEFFERED TAX ASSETS AND LIABILITIES BASED ON THE DIFFERENCES BETWEEN THE FINANCIAL REPORTING AND TAX BASIS OF ASSETS AND LIABILITIES USING ENACTED TAX RATES AND LAWS THAT WILL BE IN EFFECT WHEN DIFFERENCES ARE EXPECTED TO REVERSE. AS OF AND FOR THE YEARS ENDED DECEMBER 31, 2023 AND 2022, THE SYSTEM HAS MADE REASONABLE ESTIMATES OF THE PROVISION FOR THE INCOME TAXES AND DEFFERED TAX BALANCES BASED ON ACCOUNTING GUIDANCE INCLUDED IN ACCOUNTING STANDARDS CODIFICATION 740, INCOME TAXES. THE SYSTEM WILL CONTINUE TO REFINE ITS CALCULATIONS IN FUTURE PERIODS AS ADDITIONAL REGULATIONS AND GUIDANCE ARE ISSUED BY THE INTERNAL REVENUE SERVICE (IRS). Central America and the Caribbean 1 1 Program Services FINANCIAL VEHICLE 1284107 1 1 1 1 1284107 1284107 true false true false false false SCHEDULE F, PART I DURING 2023, THIS ORGANIZATION REMITTED $1,284,107 TO CENTRASTATE CAPTIVE INSURANCE COMPANY, LTD. 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X X X X X true true X X X true X WWW.CENTRASTATE.COM X WWW.CENTRASTATE.COM X WWW.CENTRASTATE.COM X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, QUESTION 5 IN ITS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") THIS ORGANIZATION TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY ITS HOSPITAL FACILITIES. CENTRASTATE MEDICAL CENTER IS A FOUNDING MEMBER OF THE HEALTH IMPROVEMENT COALITION OF MONMOUTH COUNTY (HICMC) AND HAS A SEAT ON THE ORGANIZATION'S SEVEN-MEMBER STEERING COMMITTEE, ALONG WITH REPRESENTATIVES OF COUNTY AND LOCAL HEALTH DEPARTMENTS AND OTHER MONMOUTH COUNTY HOSPITALS. ORGANIZED IN 2005, HICMC, WITH THE COOPERATION OF THE GOVERNMENTAL PUBLIC HEALTH PARTNERSHIP OF MONMOUTH COUNTY, AREA AGENCIES, ORGANIZATIONS, HEALTHCARE PROVIDERS INCLUDING ALL FIVE HOSPITALS IN MONMOUTH COUNTY, AND INDIVIDUALS, HAS COLLABORATED TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) EVERY FIVE YEARS (2007-2011, 2012-2016 AND 2017-2019). THE CURRENT MONMOUTH COUNTY PLAN WAS COMPLETED IN 2018 AND IS FOR THE YEARS 2018-2022 AND INCLUDES THE COMMUNITIES OF WESTERN MONMOUTH COUNTY. CENTRASTATE IS ALSO A PARTICIPATING MEMBER OF THE OCEAN MONMOUTH HEALTH ALLIANCE, THE PREVENTION COALITION OF MONMOUTH COUNTY, THE FREEHOLD AREA MUNICIPAL ALLIANCE AND NEIGHBORHOOD CONNECTIONS TO HEALTH. FOR THE PURPOSES OF THIS CHNA, CENTRASTATE MEDICAL CENTER, INC. ALSO REVIEWED THE CHNA'S AND CHIP'S OF ADJACENT COUNTIES, SPECIFICALLY OCEAN, MERCER AND MIDDLESEX, AND CONDUCTED SURVEYS THROUGHOUT THE COMMUNITIES SERVED BY CENTRASTATE MEDICAL CENTER, INC. BOTH ELECTRONICALLY AND VIA HARD-COPY AND DETERMINED THE RESULTS WERE CONSISTENT WITH THE MONMOUTH COUNTY ASSESSMENTS AND PLANS UPON WHICH CENTRASTATE MEDICAL CENTER, INC. BASED ITS CHNA. A BASE "SECONDARY DATA PROFILEAN "URBAN PROFILE" WERE PREPARED FOR MONMOUTH COUNTY BY HOLLERAN CONSULTING OF PHILADELPHIA THAT INCLUDED DEMOGRAPHIC AND HOUSEHOLD INFORMATION, MORTALITY RATES, COMMUNICABLE DISEASE RATES AND CANCER INCIDENCE AND MORTALITY RATES. THE PROFILES WERE UPDATED PERIODICALLY. COPIES OF BOTH STUDIES ARE AVAILABLE IN THE CENTRASTATE MEDICAL CENTER, INC. COMMUNITY RELATIONS OFFICE. THE COALITION EXAMINED SCIENTIFIC SURVEY DATA FROM NEARLY 600 HOUSEHOLDS, AS WELL AS FOCUS GROUP FEEDBACK. CENTRASTATE MEDICAL CENTER, INC. FURTHER REVIEWED THE HEALTHY NEW JERSEY 2020 OBJECTIVES, BASELINES, AND TARGETS. BECAUSE MANY OF THE STATISTICS REFLECT AVAILABLE COUNTY-WIDE OR STATE-WIDE DATA, CENTRASTATE MEDICAL CENTER, INC. CONDUCTED AN ADDITIONAL SURVEY AS WELL AS SEVERAL INTERVIEWS AND MEETINGS DESIGNED TO FURTHER IDENTIFY THE HEALTH NEEDS PARTICULAR TO WESTERN MONMOUTH COUNTY. THE RESULTS WERE RANKED ACCORDING TO SEVERITY AFTER CONSULTATIONS WERE CONDUCTED BETWEEN CENTRASTATE MEDICAL CENTER, INC. CHNA LEADERSHIP AND THE PUBLIC HEALTH OFFICERS SERVING MONMOUTH COUNTY AS WELL AS EACH OF THE COMMUNITIES IN WESTERN MONMOUTH COUNTY TO IDENTIFY THE SIGNIFICANT HEALTH NEEDS OF THE CENTRASTATE MEDICAL CENTER, INC. COMMUNITIES. SCHEDULE H, PART V, SECTION B, QUESTIONS 6A & 6B CENTRASTATE MEDICAL CENTER IS A FOUNDING MEMBER OF THE HEALTH IMPROVEMENT COALITION OF MONMOUTH COUNTY (HICMC) AND HAS A SEAT ON THE ORGANIZATION'S SEVEN-MEMBER STEERING COMMITTEE, ALONG WITH REPRESENTATIVES OF COUNTY AND LOCAL HEALTH DEPARTMENTS AND OTHER MONMOUTH COUNTY HOSPITALS. ORGANIZED IN 2005, HICMC, WITH THE COOPERATION OF THE GOVERNMENTAL PUBLIC HEALTH PARTNERSHIP OF MONMOUTH COUNTY, AREA AGENCIES, ORGANIZATIONS, HEALTHCARE PROVIDERS INCLUDING ALL FIVE HOSPITALS IN MONMOUTH COUNTY, AND INDIVIDUALS, HAS COLLABORATED TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) EVERY FIVE YEARS (2007-2011, 2012-2016 AND 2017-2019). THE CURRENT MONMOUTH COUNTY PLAN WAS COMPLETED IN 2018 AND IS FOR THE YEARS 2018-2022 AND INCLUDES THE COMMUNITIES OF WESTERN MONMOUTH COUNTY. CENTRASTATE IS ALSO A PARTICIPATING MEMBER OF THE OCEAN MONMOUTH HEALTH ALLIANCE, THE PREVENTION COALITION OF MONMOUTH COUNTY, THE FREEHOLD AREA MUNICIPAL ALLIANCE AND NEIGHBORHOOD CONNECTIONS TO HEALTH. SCHEDULE H, PART V, SECTION B, QUESTIONS 7A & 7D THE ORGANIZATION IS AN AFFILIATE WITHIN CENTRASTATE HEALTHCARE SYSTEM, INC.; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN SCHEDULE H, PART V, SECTION B, QUESTION 7A, IS THE HOME PAGE FOR THE SYSTEM. THE CHNA CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: https://www.centrastate.com/community-health-needs-assessment/ SCHEDULE H, PART V, SECTION B, QUESTION 10A THE ORGANIZATION IS AN AFFILIATE WITHIN CENTRASTATE HEALTHCARE SYSTEM, INC.; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN SCHEDULE H, PART V, SECTION B, QUESTION 10A, IS THE HOME PAGE FOR THE SYSTEM. THE IMPLEMENTATION STRATEGY CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: https://www.centrastate.com/community-health-needs-assessment/ SCHEDULE H, PART V, SECTION B, QUESTION 11 CentraState Healthcare System, a partner of Atlantic Health System, is a fully accredited, not-for-profit, community-based health system that provides comprehensive health services in the central New Jersey region. CentraState Healthcare System conducted a Community Health Needs Assessment ("CHNA") in 2022 and reviewed the health priorities identified through that assessment. The assessment incorporated data from multiple sources, including primary research through phone and online surveys with community leaders and the public at large, as well as secondary research through vital statistics and other existing health related data. The community defined for this assessment is Monmouth County, in general, and western Monmouth County in particular. Taking into account the top-identified needs - as well as hospital resources and overall alignment with the hospital's mission, goals and strategic priorities - it was determined at this time that CentraState would focus on developing and/or supporting strategies and initiatives to improve health in the areas of: - Cancer - Heart Disease - Behavioral Health - Nutrition, Physical Activity & Weight This implementation plan represents a collaboration of the CHNA team across the health system, and with its community partners, and will be used to inform decisions and guide efforts to improve community health and wellness. Wherever possible CentraState will work with other agencies to influence the Social Determinants of Health ("SDoH"), which may impact access to healthcare, adherence to health regimens and health outcomes. Following a data driven approach and a series of deliberative meetings, the following goals, objectives and strategies were developed. Cancer ------ Brief Description of Need: The incidence and prevalence of cancer in the CentraState Service area slightly exceeds New Jersey and U.S. benchmarks with the most common cancers cited locally being Breast, Prostate and Skin Cancer. The prevalence of cancer was highest in the 65+ age group. Goal: Offer a range of accessible cancer prevention and treatment options that fit the needs of community members, especially those 65 and older. Objectives: - Increase public awareness of the importance of early detection for optimal cancer treatment outcomes. - Increase participation in cancer screenings, including breast, prostate, lung, colorectal and skin, in a variety of health care settings. - Connect people with positive findings to resources for care. Strategies: - Add cancer specialists and clinical trials that will improve access for area residents: - Breast, Endocrine, GYN specialists - Continue to offer and promote cancer support and survivorship programs to those who have completed treatment. - Educate staff and providers on availability of new and enhanced services. - Educate the public on prevention and early detection; promote screening events. Heart Disease ------------- Brief Description of Need: Heart disease is the leading cause of death in the United States. The prevalence of heart disease and high blood cholesterol in the CentraState service area significantly exceeded New Jersey and U.S. benchmarks. Goal: Offer supportive services designed to reduce cardiovascular risk factors which put a person at increased risk for cardiovascular disease. Objectives: - Offer programs and services that help modify behaviors such as cigarette smoking, physical inactivity and overweight/obesity. - Offer programs/screenings that stress the importance of adhering to treatment for high blood pressure and cholesterol, both critical for preventing and controlling cardiovascular disease. - Provide education on chronic conditions including related to heart disease such as heart failure, hypertension and diabetes. - Train people to identify the signs and symptoms of a heart attack and how to provide Early Heart Attack Care (EHAC). Strategies: - Assist patients and community members in obtaining and understanding information about heart health: - MyChart electronic health record promotion and utilization. - Work with PCPs and RN Health Coaches to lower patients' cardiovascular risk scores. - Early Heart Attack Care training, hands only CPR, and BLS training. - Provide and promote screenings onsite and in community settings for cardiovascular disease: - Lipid profile, blood pressure, blood sugar and peripheral artery disease. - Provide and promote physical activity: - Live Life Well programs, exercise education in the senior residential facilities and through the Fitness Center. - Offer diabetes prevention programs and nutritional coaching services to reduce risk factors - Partner with community organizations to support initiatives related to nutrition education and access to healthy food: - Neighborhood Connections to Health, Freehold Family Health Center, Food Bank Behavioral Health ----------------- Brief Description of Need: About half of all people in the United States will be diagnosed with a mental disorder at some point in their lifetime and mental health and physical health are closely connected. A significant number of CentraState Service Area respondents experience "Fair" to "Poor" mental health and have been diagnosed with a depressive disorder. Key informants ranked mental health as a top concern. In terms of substance use disorders, community members reported binge drinking (5 if male)/4 (if female) or more drinks on an occasion, which is significantly higher than the New Jersey and U.S. benchmarks. Most prevalent in the 18 to 39 age group. Nearing 50 percent of community members perceived substance abuse as a major problem in the community. Key informants also ranked substance abuse as a top concern. Goal: Offer a range of education, prevention and treatment options for behavioral health issues and substance use disorders. Objectives: - Promote the launch of the new 988 suicide hotline as well as the CentraState hotline. - Create linkages between the hospital and outpatient community-based services to assess and treat mental health conditions. - Increase the number of individuals who receive treatment for mental health services in the appropriate setting. Strategies: - Provide suicide screenings to Emergency Department patients and refer to treatment as needed. - Expand primary care practitioners in the service area who can identify at-risk individuals. - Generate outpatient referrals and encourage treatment within 30 days of hospital/ED discharge. - Promote awareness of CentraState's crisis line and behavioral health resources: - Educate staff on availability of crisis hotlines - Increase community awareness and understanding about mental health issues: - Mental health education at community health events - Work with schools to improve life skills and decision making with regard to drugs and alcohol. - Provide self-assessments to identify potential binge-drinking patterns. - Offer support for smoking/vaping cessation. - Partner with collaborating agencies to identify and assist ED and inpatients, including Maternal/Child patients, with Substance Use Disorders for outpatient treatment. - Refer patients to 12-step and other peer-programs as needed. Nutrition, Physical Activity and Weight --------------------------------------- Brief Description of Need: Many people don't eat a healthy diet are at an increased risk for obesity, heart disease, stroke, type 2 diabetes, and other health problems. The population of Monmouth County has lower food access, a higher prevalence of total overweight (overweight and obese), and a high prevalence of fast food restaurants as compared to the New Jersey and U.S. benchmarks. Key informants ranked as a top concern. Goal: Improve access points and channels for care and provide services that support all aspects of healthy living. Objective: - Offer support services that assist the community with achieving a balance of healthy nutrition, physical activity and weight control. - Increase engagement in programming that promotes a healthy lifestyle. Strategies: - Increase access to education about healthy lifestyle: - Healthy lifestyle education via classes, digital and print content and social media platforms. - Offer and promote diabetes prevention programs and nutritional coaching to reduce risk factors. - Work with employers to offer a range of preventive health programs. - Increase access to healthy food options: - Food bank mobile food pantry. - Farmers' markets and Voucher Programs. - Increase access to physical activity: - Partner with physicians and Park Rx to prescribe outdoor activity. - Offer exercise and fitness classes. SCHEDULE H, PART V, SECTION B, QUESTION 16 THE ORGANIZATION IS AN AFFILIATE WITHIN CENTRASTATE HEALTHCARE SYSTEM, INC.; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN SCHEDULE H, PART V, SECTION B, QUESTION 16, IS THE HOME PAGE FOR THE SYSTEM. THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION AND PLAIN LANGUAGE SUMMARY ARE MADE WIDELY AVAILABLE ON THE ORGANIZATION'S WEBSITE. THESE DOCUMENTS CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: HTTPS://WWW.CENTRASTATE.COM/BILLING/ PART I, LINE 3C 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 2015 POVERTY GUIDELINES (DEPARTMENT OF HEALTH AND SENIOR SERVICES). FEDERAL POVERTY GUIDELINES ARE INCLUDED IN THE CRITERIA FOR DETERMINING ELIGIBILITY FOR CHARITY AND DISCOUNTED CARE. CENTRASTATE MEDICAL CENTER, INC. FOLLOWS THE NJ ADMINISTRATIVE CODE 8:31B AND CONSIDERS INDIVIDUAL ASSETS OVER $7,500 AND FAMILY ASSETS OVER $15,000 IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE. IN ADDITION, THERE IS A "SPEND DOWN" PROVISION ALLOWING FINANCIAL ASSISTANCE IF THE AMOUNT DUE FROM THE PATIENT IS GREATER THAN THE ASSETS OVER THE STATED THRESHOLDS. SCHEDULE H, PART I; QUESTION 6A NOT APPLICABLE. SCHEDULE H, PART I; QUESTION 7 WORKSHEETS 2 AND 3 WERE USED TO CALCULATE THE COST TO CHARGE RATIO FOR FINANCIAL ASSISTANCE AND UNREIMBURSED MEDICAID. ALL OTHER COSTS WERE EITHER OBTAINED FROM THE HOSPITAL'S COST ACCOUNTING, COST REPORTING OR GENERAL LEDGER SYSTEMS. SCHEDULE H, PART I, QUESTION 7B CentraState Medical Center partnered with Monmouth County and the State of New Jersey through a provider assessment mechanism to make the state of New Jersey Medicaid program healthier for all. The program increases financial resources provided to certain hospitals using the State of New Jersey's Medicaid program and certain federal matching funds in order to better serve the needs in the community. The additional funds received from the program during 2023 totaled approximately $6M and are included in Schedule H, Part I; Line 7b; direct offsetting Medicaid revenue. The associated county option expenses associated with the program during 2023 totaled approximately $4M and are included in Schedule H, Part I; Line 7b; medicaid total community benefit expense. In addition, CentraState Medical Center received quality improvement program - New Jersey ("QIP-NJ") funding to support continued population health improvement across New Jersey. The additional funds received from QIP-NJ program during 2023 totaled approximately $1M and are included in Schedule H, Part I; Line 7b; direct offsetting Medicaid revenue. If CentraState Medical Center did not receive these additional funds, the net community benefit expense reported on Schedule H, Part I; Line 7K would be $28,424,407 and the net community benefit percentage reported on Schedule H, Part I; Line K would be 7.35%. SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES UNDERTAKEN BY CENTRASTATE MEDICAL CENTER, INC. IMPROVE THE MEDICAL AND SOCIOECONOMIC WELL-BEING OF OUR COMMUNITIES. THIS IS ACCOMPLISHED THROUGH SERVICE ON STATE AND REGIONAL ADVOCACY COMMITTEES AND BOARDS, VOLUNTEERISM WITH LOCAL COMMUNITY-BASED NON-PROFIT ADVOCACY GROUPS AND PARTICIPATION IN CONFERENCES AND OTHER EDUCATIONAL ACTIVITIES TO PROMOTE UNDERSTANDING OF THE ROOT CAUSES OF HEALTH CONCERNS. CENTRASTATE MEDICAL CENTER, INC. PROVIDES EDUCATIONAL MATERIALS, CONDUCTS COMMUNITY HEALTH FAIRS AND HOLDS HEALTH EDUCATION SEMINARS AND OUTREACH SESSIONS FOR ITS PATIENTS, COMMUNITY AND PROVIDERS. PHYSICIANS, NURSES AND OTHER HEALTHCARE PROFESSIONALS DEDICATE THEIR KNOWLEDGE AND TIME TO ENSURE THE COMMUNITY IS WELL EDUCATED ON TOPICS PROMOTING HEALTHY LIVING. SCHEDULE H, PART III, SECTION A; QUESTION 4 THE FOOTNOTE BELOW EXPLAINS THE ORGANIZATIONS METHODOLOGY WITH RESPECT TO NET PATIENT SERVICE REVENUE. CHANGES IN THE SYSTEM'S ESTIMATES OF IMPLICIT PRICE CONCESSIONS, DISCOUNTS, CONTRACTUAL ADJUSTMENTS OR OTHER CHANGES TO EXPECTED PAYMENTS FOR PERFORMANCE OBLIGATIONS SATISFIED IN PRIOR YEARS WERE NOT SIGNIFICANT. PORTFOLIO COLLECTION ESTIMATES ARE UPDATED BASED ON COLLECTION TRENDS. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY (DETERMINED ON A PORTFOLIO BASIS WHEN APPLICABLE) ARE RECORDED AS BAD DEBT EXPENSE. BAD DEBT EXPENSE FOR THE YEARS ENDED DECEMBER 31, 2023 AND 2022 WAS NOT SIGNIFICANT. SCHEDULE H, PART III, SECTION B; QUESTION 8 MEDICARE COSTS WERE DERIVED FROM THE 2023 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 FEELS 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 INDIVIDUAL'S 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 "[T]HE TERM CHARITABLE IS USED IN 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 "REMOVE[D]" 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. MEDICARE UNDERPAYMENTS AND BAD DEBT ARE COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THE AMERICAN HOSPITAL ASSOCIATION ("AHA") FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT ARE COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THIS ORGANIZATION AGREES WITH THE AHA 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 EXPE SCHEDULE H, PART III, SECTION B; QUESTION 9B DURING FINANCIAL COUNSELING, THE PATIENT IS SCREENED FOR ELIGIBILITY IN PUBLIC ASSISTANCE PROGRAMS, INCLUDING MEDICARE, MEDICAID, THE CATASTROPHIC ILLNESS FUND FOR CHILDREN, AND THE VIOLENT CRIME COMPENSATION BOARD. THE PATIENT IS ASSISTED WITH THE ENROLLMENT PROCESS FOR ANY PROGRAMS FOR WHICH THE PATIENT HAS PROBABLE ELIGIBILITY. BILLS MAY BE REDUCED FROM 20% TO 100% BASED UPON FINANCIAL ASSISTANCE CRITERIA. THE PATIENT RESPONSIBILITY PORTION OF 20%, 40%, 60% OR 80% IS BASED UPON RATES ESTABLISHED IN P.L. 1971 C. 136. SPEND DOWN ASSETS, THROUGH PARTIAL PAYMENT OF THE HOSPITAL BILL IS ALLOWED TO ENABLE THE PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE. THE AMOUNT FOR WHICH THE PATIENT IS RESPONSIBLE AFTER PARTIAL FINANCIAL ASSISTANCE SHALL BE LIMITED TO 30% OF INCOME, PER NJAC 8:31B. UNINSURED PATIENTS WITH INCOME BETWEEN 301%-500% OF FEDERAL POVERTY LEVELS WILL BE PROVIDED A SIGNIFICANT DISCOUNT, IN ACCORDANCE WITH P.L. 1971 C. 136. PATIENTS ARE BILLED ROUTINELY FOR UNPAID BALANCES AND SHALL BE NOTIFIED OF ANY IMPENDING COLLECTION OR LEGAL ACTION. PATIENTS ARE PROVIDED WITH CONTACT INFORMATION TO DISCUSS ANY QUESTIONS OR PROBLEMS. PATIENT BILLS INDICATE THE AVAILABILITY OF PAYMENT SCHEDULES. UPON PATIENT REQUEST, THE FOLLOWING PAYMENT SCHEDULE FOR BALANCES OF $100 OR MORE MAY BE AGREED UPON: BALANCE OF $100 - $450 - MONTHLY PAYMENT = 1/4 OF THE BALANCE, $451 - $3,000 = 1/12 OF THE BALANCE, OVER $3,000 = MINIMUM OF $250 PER MONTH OR 1% OF GROSS INCOME/MONTH, WHICHEVER IS MORE. IF THE PATIENT AND MEDICAL CENTER REPRESENTATIVE MUTUALLY AGREE TO A PAYMENT SCHEDULE AND PAYMENTS ARE RECEIVED AS AGREED, FURTHER COLLECTION ACTION WILL NOT BE TAKEN. EXCEPTIONS TO THE ABOVE SCHEDULE MAY BE MADE BY PATIENT FINANCIAL SERVICES MANAGEMENT UPON THE REQUEST OF THE PATIENT, AND DOCUMENTATION BY THE PATIENT OF INABILITY TO PAY ACCORDING TO THE ESTABLISHED SCHEDULE. IF, AT THE END OF THE FINANCIAL SCREENING ATTEMPTS AND BILLING CYCLE, THE PATIENT HAS NOT BEEN APPROVED FOR FINANCIAL ASSISTANCE AND/OR IS NOT ON A PAYMENT PLAN, OR AFTER THERE HAS BEEN A DEFAULT IN PAYMENT, THE ACCOUNT WILL BE ASSIGNED TO A COLLECTION AGENCY AND/OR ATTORNEY FOR COLLECTIONS. PAYMENT PLAN, OR AFTER THERE HAS BEEN A DEFAULT IN PAYMENT, THE ACCOUNT WILL BE ASSIGNED TO A COLLECTION AGENCY AND/OR ATTORNEY FOR COLLECTIONS. SCHEDULE H, PART VI; QUESTION 2 IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS OUTLINED IN SCHEDULE H, SECTION B, QUESTIONS 1-12 AND SECTION C, THIS ORGANIZATION CONDUCTS A REVIEW OF KEY FACTOR INFORMATION ANNUALLY WHICH INCLUDES: A REVIEW OF HEALTHCARE UTILIZATION OF ITS SERVICE AREA POPULATION BY SERVICES (UROLOGY, CARDIOLOGY, OBSTETRICS, ETC.) FOR DETERMINING INCREASED OR DECREASED HEALTH NEEDS; HEALTHCARE SERVICES ESTIMATES AND FORECASTS (BOTH INPATIENT AND OUTPATIENT); ASSESSMENTS OF LOCAL DEMOGRAPHIC AND SOCIOECONOMIC INFORMATION; AND A REVIEW OF HEALTH STATUS/NEEDS ASSESSMENTS AND STUDIES CONDUCTED BY EXTERNAL PARTIES. THE ORGANIZATION CONDUCTS AN EXTENSIVE SERVICE AREA PHYSICIAN NEEDS STUDY (BY PRIMARY AND SPECIALTY) EVERY THREE TO FIVE YEARS. SPECIFIC SPECIALTY NEEDS ARE CONDUCTED FOR IDENTIFIED GAPS IN SERVICE. THESE REVIEWS INFORM MEDICAL STAFF DEVELOPMENT AT THE MEDICAL CENTER TO ASSURE RESPONSIVENESS TO IDENTIFIED COMMUNITY NEEDS. THE ORGANIZATION COLLABORATES WITH COMMUNITY PARTNERS TO PLAN AND CONDUCT HEALTH NEEDS ASSESSMENTS TO ASSESS AND ADDRESS HEALTH NEEDS OF THE COMMUNITY IT SERVES. THE WIDE-BASED COLLABORATIVE PARTNERSHIP RETAINS AN OUTSIDE CONSULTING FIRM TO ASSESS COMMUNITY DATA AND PERCEPTION. COMMUNITY DATA IS COLLECTED FROM COUNTY HEALTH PROFILES, HEALTH STATISTICS, DEMOGRAPHICS, SOCIOECONOMIC DATA, PHONE SURVEYS, PAPER SURVEYS AND FOCUS GROUPS. FROM THOSE ASSESSMENTS, COMMUNITY HEALTH IMPROVEMENT PLANS ARE PUBLISHED IDENTIFYING THE SPECIFIC HEALTH PRIORITIES. THROUGH A PLANNED AND ORGANIZED EFFORT, THE GROUP WORKS COLLECTIVELY TO ADDRESS THE PRIORITIES BY TAPPING THE RESOURCES OF THE COMMUNITY AND COLLABORATING ON INITIATIVES. CENTRASTATE HEALTHCARE SYSTEM, INC. ACTIVELY CONTRIBUTES TO THIS PROCESS AND ENGAGES IN THE IDENTIFIED PRIORITIES THAT MATCH ITS MISSION, EXPERTISE, RESOURCES, AND CAPACITY. IN ADDITION TO THESE ORGANIZED NEEDS ASSESSMENT EFFORTS, VARIOUS CENTRASTATE HEALTHCARE SYSTEM, INC. LEADERSHIP ATTEND COMMUNITY MEETINGS WITH LOCAL PROVIDERS, LOCAL HEALTH DEPARTMENTS, LOCAL POLITICIANS, ORGANIZATIONS, AND COMMUNITY LEADERS TO DISCUSS THE HEALTH NEEDS OF THE POPULATION. SCHEDULE H, PART VI; QUESTION 3 IN ACCORDANCE WITH INTERNAL REVENUE CODE SECTION 501(R)(4) THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE BY WIDELY PUBLICIZING VARIOUS DOCUMENTS. THESE DOCUMENTS ARE WIDELY PUBLICIZED IN THE FOLLOWING WAYS: (1) THE FINANCIAL ASSISTANCE POLICY ("FAP"), FINANCIAL ASSISTANCE APPLICATION ("APPLICATION") AND PLAIN LANGUAGE SUMMARY ("PLS") ARE ALL AVAILABLE ON-LINE AT THE FOLLOWING WEBSITE: https://www.centrastate.com/billing/ (2) PAPER COPIES OF THE FAP, APPLICATION AND THE PLS ARE AVAILABLE UPON REQUEST WITHOUT CHARGE BY MAIL AND ARE AVAILABLE IN AT VARIOUS AREAS THROUGHOUT THE HOSPITAL FACILITY WHICH INCLUDE THE HOSPITAL ADMISSIONS DEPARTMENT AND THE OUTPATIENT AND EMERGENCY ROOM REGISTRATION AREAS. (3) THE FAP, APPLICATION AND PLS ARE AVAILABLE IN ENGLISH AND IN THE PRIMARY LANGUAGE OF POPULATIONS WITH LIMITED PROFICIENCY IN ENGLISH ("LEP") THAT CONSTITUTE THE LESSER OF 1,000 INDIVIDUALS OR 5% OF THE COMMUNITY SERVED BY THE ORGANIZATION'S PRIMARY SERVICE AREA. (4) ALL PATIENTS ARE OFFERED A COPY OF THE PLS AS PART OF THE INTAKE PROCESS. ADDITIONALLY, SIGNS OR DISPLAYS ARE CONSPICUOUSLY POSTED IN PUBLIC MEDICAL CENTER LOCATIONS INCLUDING ALL ADMISSIONS/REGISTRATION AREAS AND THE EMERGENCY DEPARTMENT, THAT NOTIFY AND INFORM PATIENTS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE. ALL BILLING STATEMENTS INCLUDE CONSPICUOUS WRITTEN NOTICE WHICH INFORMS PATIENTS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE. CENTRASTATE MEDICAL CENTER, INC. ALSO INFORMS AND NOTIFIES MEMBERS OF THE COMMUNITY SERVED ABOUT THE FAP. SCHEDULE H, PART VI; QUESTION 4 THE COMMUNITY IN WHICH CENTRASTATE MEDICAL CENTER, INC. SERVES IS CONCENTRATED IN MONMOUTH AND OCEAN COUNTIES. THE AVERAGE HOUSEHOLD INCOME IN THE SERVICE AREA IS $139,993. THE MEDIAN HOUSEHOLD AGE IS 43. THE TOTAL POPULATION IN THE SERVICE AREA FOR 2019 IS 357,095 WITH 124,895 HOUSEHOLDS. THE RACIAL MIX OF THE SERVICE AREA POPULATION INCLUDES 73% WHITE, 10% ASIAN, 4% BLACK, 11% HISPANIC AND 2% MULTI-RACIAL. GENDER MIX IS REPRESENTED BY 51% FEMALE AND 49% MALE. SCHEDULE H, PART VI; QUESTION 5 CENTRASTATE CONTRIBUTES TO THE COMMUNITY THROUGH SUBSTANTIAL EMPLOYEE INVOLVEMENT WITH OTHER CHARITABLE AND PUBLIC ORGANIZATIONS SUCH AS GIRL SCOUTS OF THE JERSEY SHORE, WORK FORCE INVESTMENT BUREAU OF MONMOUTH COUNTY, VETERANS COMMUNITY ASSOCIATION, FINGERPRINT AMERICA, SUNRISE OPTIMIST CLUB, MONMOUTH-OCEAN DEVELOPMENT COUNCIL, MUSCULAR DYSTROPHY ASSOCIATION, FREEHOLD TOWNSHIP, MONMOUTH COUNTY CHILD ADVOCACY CENTER, THE NATIONAL ORGANIZATION OF WOMEN BUSINESS OWNERS, RUTGERS UNIVERSITY, CANCER INSTITUTE OF NEW JERSEY AND THE COLLEGE ADVISORY BOARDS OF MONMOUTH COUNTY COMMUNITY COLLEGE AND BROOKDALE COMMUNITY COLLEGE. EFFORTS INCLUDE INCREASING SERVICES TO CANCER SURVIVORS, COORDINATING EFFORTS FOR FUND RAISING AND ORGANIZING STUDENT TRAINING PROGRAMS. CENTRASTATE ALSO PROVIDES ADDITIONAL COMMUNITY BENEFIT THROUGH ITS 258 VOLUNTEERS WHO CONTRIBUTED OVER 32,752 HOURS OF SERVICE TO THEIR COMMUNITY THROUGH OPPORTUNITIES IN EVERY HOSPITAL DEPARTMENT. VOLUNTEERS SIGNIFICANTLY ENHANCE PATIENT AND FAMILY SUPPORT IN THE FOLLOWING SERVICE CATEGORIES: BLOOD CART, DIETARY MENU, EMERGENCY DEPARTMENT LOUNGE, FLOWERS, GIFT SHOP/CART, HOSPITALITY CART, INFORMATION DESKS, MAIL OR MESSENGER, PRN/FLOATERS, PASTORAL CARE, ANIMAL ASSISTED THERAPY, SNACK BAR, SURGERY WAITING AREA, PATIENT TRANSPORT, HAIR CARE, SERVICE LEARNING. SCHEDULE H, PART VI; QUESTION 6 OUTLINED BELOW IS A SUMMARY OF THE ENTITIES WHICH COMPRISE THE CENTRASTATE HEALTHCARE SYSTEM, INC.: NOT-FOR-PROFIT CENTRASTATE HEALTHCARE SYSTEM, INC. ENTITIES =========================================================== CENTRASTATE HOLDING COMPANY, INC. --------------------------------- CENTRASTATE HOLDING COMPANY, INC. ("CSHC") 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). THE ORGANIZATION OWNS A 49% MEMBERSHIP INTEREST IN CENTRASTATE HEALTHCARE SYSTEM, INC.; THE TAX-EXEMPT PARENT OF THE CENTRASTATE HEALTHCARE SYSTEM, INC. THE ORGANIZATION WAS CREATED AS PART OF THE CO-MEMBER AFFILIATION AGREEMENT UNDER WHICH ATLANTIC HEALTH SYSTEM HOLDS A 51% MEMBERSHIP INTEREST IN CENTRASTATE HEALTHCARE SYSTEM, INC. PLEASE REFER TO THE ATLANTIC HEALTH SYSTEM, INC. (EIN: 22-3380375) FORM 990 AND ATLANTIC HEALTH SYSTEM, INC. GROUP RETURN (EIN: 65-1301877) FORM 990 FOR A LISTING AND DESCRIPTION OF ATLANTIC HEALTH SYSTEM, INC. RELATED ENTITIES. CENTRASTATE HEALTHCARE SYSTEM, INC. ------------------------------- CENTRASTATE HEALTHCARE SYSTEM, INC. ("CSHS") IS THE TAX-EXEMPT PARENT OF THE CENTRASTATE HEALTHCARE 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 CSHS. THE SYSTEM IS AN INTEGRATED NETWORK OF HEALTHCARE PROVIDERS THROUGHOUT THE STATE OF NEW JERSEY AND IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A SUPPORTING ORGANIZATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). CENTRASTATE MEDICAL CENTER, INC. -------------------------------- CENTRASTATE MEDICAL CENTER, INC. ("CSMC") IS LOCATED IN FREEHOLD, MONMOUTH COUNTY, NEW JERSEY, IS A 276-BED ACUTE CARE FACILITY. CSMC IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, CSMC 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, CSMC OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. CENTER FOR AGING, INC. ---------------------- CENTER FOR AGING, INC. ("APPLEWOOD") IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). APPLEWOOD CONSISTS OF 281 INDEPENDENT APARTMENTS, 20 COTTAGES, 40 RESIDENTIAL HEALTH CARE UNITS, AND A 60-BED SKILLED NURSING FACILITY. THE ORGANIZATION PROVIDES FOR THE CARE OF THE ELDERLY. APPLEWOOD ALSO GOES OUT TO THE COMMUNITY THROUGH SENIOR'S FIRST, WHICH IS A COMPLIMENTARY COMMUNITY OUTREACH AND HEALTHCARE EDUCATION PROGRAM FOR THOSE 60 YEARS AND OLDER IN A 25-MILE RADIUS OF FREEHOLD, NJ. THE CENTER'S PROGRAMS INCLUDE HEALTH FAIRS, BLOOD PRESSURE SCREENINGS, AND HEALTH EDUCATION AND PRESENTATIONS ON PREVENTION AND TREATMENT. IN ADDITION, THERE IS ALSO A SUPPORT GROUP FOR PARKINSON'S DISEASE AS WELL AS COMMUNITY SERVICE REFERRALS. CENTRASTATE ASSISTED LIVING, INC. --------------------------------- CENTRASTATE ASSISTED LIVING, INC. ("MONMOUTH CROSSING") IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). MONMOUTH CROSSING OWNS AND OPERATES AN ASSISTED LIVING FACILITY FOR THE ELDERLY CONSISTING OF 76 UNITS WITH 16 UNITS FOR MEMORY CARE. THE FACILITY PROVIDES RESIDENTS WITH SPECIAL NEEDS AND MEMORY-RELATED DISEASES: RECEIVE COMPREHENSIVE, ATTENTIVE SERVICES IN A SAFE ENVIRONMENT WHERE SPECIALIZED ACTIVITIES AND PROGRAMMING ARE PROVIDED. MONMOUTH CROSSING OFFERS SERVICES TO RESIDENTS OF LOW AND MODERATE MEANS AND THOSE ON MEDICAID AS WELL. HEALTHCARE AFFILIATES, INC. --------------------------- HEALTHCARE AFFILIATES, INC. ("THE MANOR") IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). THE MANOR PROVIDES SKILLED NURSING SERVICES FOR 123 ELDERLY RESIDENTIAL UNITS INCLUDING SUBACUTE, REHABILITATION AND I.V. THERAPY. THE FACILITY FOCUS IS ON HELPING RESIDENTS ACHIEVE THEIR MAXIMUM POTENTIAL FOR INDEPENDENCE, PERSONAL COMFORT AND QUALITY OF LIFE. THE MANOR IS MEDICARE/MEDICAID CERTIFIED, LICENSED BY THE STATE OF NEW JERSEY, AND ACCREDITED BY THE JOINT COMMISSION. THE FACILITY PROVIDES CHARITY CARE FOR THE INDIGENT WHERE APPROPRIATE. CENTRASTATE HEALTHCARE FOUNDATION, INC. --------------------------------------- CENTRASTATE HEALTHCARE 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 CSMC; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. OTHER CENTRASTATE HEALTHCARE SYSTEM, INC. ENTITIES ================================================== CENTRASTATE CAPTIVE INSURANCE CO., LTD. --------------------------------------- CENTRASTATE CAPTIVE INSURANCE CO., LTD. A CONTROLLED FOREIGN CORPORATION OF CENTRASTATE MEDICAL CENTER. THE ORGANIZATION WAS FORMED AND OPERATED SOLELY IN THE CAYMAN ISLANDS WITH NO U.S. ACTIVITIES OR PRESENCE. As part of the affiliation with atlantic health, the assets and liabilities of the centrastate captive insurance company, ltd, spc were novated to ahs insurance company, ltd. As of december 31, 2023. in addition, the limited policies with centrastate captive insurance company, ltd., spc. were commuted and terminated and the wholly owned captive insurance company was dissolved as of 12/31/2023. CENTRASTATE CARDIOLOGY ASSOCIATES, P.C. ------------------------------------ CENTRASTATE CARDIOLOGY ASSOCIATES, P.C. IS AN ENTITY WHOSE NOMINEE SOLE SHAREHOLDER IS A LICENSED MD HOLDING SHARES FOR THE BENEFIT OF CSMC. THE ORGANIZATION IS LOCATED IN FREEHOLD, MONMOUTH COUNTY, NEW JERSEY. THIS ENTITY PROVIDES MEDICAL SERVICES IN SUPPORT OF AND IN FURTHERANCE OF THE CHARITABLE TAX-EXEMPT PURPOSES OF CSMC. CENTRASTATE HEALTHCARE SERVICES, INC. ------------------------------------- CENTRASTATE HEALTHCARE SERVICES, INC. IS AN ENTITY WHOSE SOLE SHAREHOLDER IS CSHS. THE ORGANIZATION IS LOCATED IN FREEHOLD, MONMOUTH COUNTY, NEW JERSEY AND PROVIDES HEALTHCARE SERVICES. CENTRASTATE MEDICAL ASSOCIATES, P.C. ------------------------------------ CENTRASTATE MEDICAL ASSOCIATES, P.C. IS AN ENTITY WHOSE NOMINEE SOLE SHAREHOLDER IS A LICENSED MD HOLDING SHARES FOR THE BENEFIT OF CSMC. THE ORGANIZATION IS LOCATED IN FREEHOLD, MONMOUTH COUNTY, NEW JERSEY. THIS ENTITY PROVIDES MEDICAL SERVICES IN SUPPORT OF AND IN FURTHERANCE OF THE CHARITABLE TAX-EXEMPT PURPOSES OF CSMC. CENTRASTATE SPECIALISTS, P.C. ----------------------------- CENTRASTATE SPECIALISTS, P.C. IS AN ENTITY WHOSE NOMINEE SOLE SHAREHOLDER IS A LICENSED MD HOLDING SHARES FOR THE BENEFIT OF CSMC. THE ORGANIZATION IS LOCATED IN FREEHOLD, MONMOUTH COUNTY, NEW JERSEY. THIS ENTITY PROVIDES MEDICAL SERVICES IN SUPPORT OF AND IN FURTHERANCE OF THE CHARITABLE TAX-EXEMPT PURPOSES OF CSMC. CENTRASTATE SPECIALISTS, P.C. IS AN ENTITY WHOSE NOMINEE SOLE SHAREHOLDER IS A LICENSED MD HOLDING SHARES FOR THE BENEFIT OF CSMC. THE ORGANIZATION IS LOCATED IN FREEHOLD, MONMOUTH COUNTY, NEW JERSEY. THIS ENTITY PROVIDES MEDICAL SERVICES IN SUPPORT OF AND IN FURTHERANCE OF THE CHARITABLE TAX-EXEMPT PURPOSES OF CSMC. TAX-EXEMPT PURPOSES OF CSMC. SCHEDULE H, PART VI; QUESTION 7 THE ENTITY AND RELATED PROVIDER ORGANIZATIONS ARE LOCATED IN NEW JERSEY. THE STATE OF NEW JERSEY DOES NOT REQUIRE HOSPITALS TO ANNUALLY FILE A COMMUNITY BENEFIT REPORT WITH THE STATE OF NEW JERSEY. X X true true X X X X true true false false false false false true false THOMAS W SCOTT FACHE TRUSTEE-PRESIDENT/CEO 719135 0 148512 0 2622 0 30000 0 26253 0 926522 0 0 0 JAMES J MATERA MD SVP/MEDICAL DIRECTOR 491649 0 68796 0 215398 0 22500 0 16066 0 814409 0 149435 0 DEBORAH ROMMEL-CONNORS MBA VP REVENUE CYCLE 257136 0 29812 0 353164 0 30000 0 16261 0 686373 0 89164 0 JOHN A DELLOCONO SVP/CFO 516480 0 72277 0 14211 0 22500 0 37205 0 662673 0 0 0 AMIT S KHAROD MD TRUSTEE 0 455878 0 0 40750 36736 0 7391 0 23639 40750 523644 0 0 MOUSTAFA SHAFEY MD MEDICAL DIR. - MENTAL HLTH 334562 0 20221 0 1890 0 30000 0 6490 0 393163 0 0 0 CATHLEEN G JANZEKOVICH VP, PATIENT SERVICES 324884 0 33405 0 3516 0 26281 0 2142 0 390228 0 0 0 KAREN B FREEMAN MSA VP QUALITY & PATIENT SAFETY 283781 0 30958 0 33564 0 30000 0 6884 0 385187 0 0 0 HOWARD A STEIN MD PHYSICIAN 303837 0 27066 0 1584 0 22500 0 13551 0 368538 0 0 0 JAMES RICHVALSKY VP, PHYS PRACT MGMT(TERM 8/23) 191185 0 0 0 142419 0 17646 0 15847 0 367097 0 0 0 NANCY BARONE CSHCF VP OF DEVELOPMENT 261888 0 26435 0 4218 0 30000 0 12379 0 334920 0 0 0 DANIELLE VANWERT VP CLINICAL SERVICES 258767 0 27300 0 484 0 22500 0 23733 0 332784 0 0 0 VINCENT L D'ELIA VP MRKTING PUBLIC/GOVT REL. 254057 0 26241 0 4986 0 22500 0 13551 0 321335 0 0 0 KIMBERLY H SIMERS AVP INTEGRATIVE HEALTH 239462 0 20644 0 1469 0 30000 0 9870 0 301445 0 0 0 LAURA L SCHILARE VP FINANCE 235441 0 24652 0 2124 0 19473 0 15514 0 297204 0 0 0 DAVID A DE SIMONE ESQ FORMER KEY EMPLOYEE 0 0 0 0 263333 0 0 0 0 0 263333 0 0 0 KENNNETH ENG DO TRUSTEE 0 226038 0 0 0 18736 0 3133 0 12535 0 260442 0 0 JOHN P DETULLIO MD TRUSTEE 0 180953 0 0 0 24192 0 5805 0 1154 0 212104 0 0 SCHEDULE J, PART I; QUESTIONS 1A AND 1B The organization provided travel for companions of officers and trustees for the annual board retreat and certain educational seminars. The organization paid social club dues for Thomas W. Scott, President/CEO of the organization, which are part of his employment agreement contract. Utilization of this membership was primarily for the benefit of CentraState Medical Center, Inc. SCHEDULE J, PART I; QUESTION 4A THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE DURING CALENDAR YEAR 2023 WHICH WAS INCLUDED IN EACH INDIVIDUAL'S 2023 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: JAMES RICHVALSKY, $103,631 AND DAVID A. DE SIMONE, ESQ. $263,333. SCHEDULE J, PART I; QUESTION 4B THE AMOUNT REFLECTED IN COLUMN B(III) FOR THE FOLLOWING INDIVIDUALS 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 2023 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: JAMES J. MATERA, M.D., $207,874 AND DEBORAH ROMMEL-CONNORS, MBA, $320,357. SCHEDULE J, PART I; QUESTION 7 CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A BONUS DURING CALENDAR YEAR 2023 WHICH AMOUNTS WERE INCLUDED IN COLUMN B(II) HEREIN AND IN EACH INDIVIDUAL'S 2023 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT. SCHEDULE J, PART II; COLUMN F THE AMOUNTS REPORTED IN SCHEDULE J, PART II, COLUMN (F) INCLUDE AMOUNTS REPORTED ON PRIOR YEARS' FORMS 990 IN SCHEDULE J, PART II, IN COLUMN (C) AS NON-TAXABLE UNVESTED DEFERRED COMPENSATION THAT IS NOW BEING REPORTED AGAIN ON THIS YEAR'S FORM 990. ACCORDINGLY, IN PRIOR YEARS THE INDIVIDUAL'S NEVER ACTUALLY RECEIVED ANY OF THESE UNVESTED BENEFIT AMOUNTS. CORE FORM, PART III, STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS CentraState Medical Center ("CSMC") is a 284-bed general acute care hospital located in Freehold, Monmouth County, New Jersey. CSMC 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, CSMC 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, CSMC operates consistently with the following criteria outlined in IRS revenue ruling 69-545: 1. CSMC provides medically necessary healthcare services to all individuals regardless of ability to pay, including charity care, self-pay, Medicare and Medicaid patients; 2. CSMC operates an active emergency room for all persons; which is open 24 hours a day, 7 days a week, 365 days per year; 3. CSMC maintains a closed medical staff, with privileges available based on community need; 4. Control of CSMC rests with its board of trustees and the board of trustees of CentraState Healthcare System, Inc. Both boards are 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 advanced medical care, programs and activities. The operations of CSMC, as shown through the factors outlined above and other information contained herein, clearly demonstrate the hospital provides substantial community benefit and that the use and control of CSMC 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. CSMC's sole corporate member is CentraState Healthcare System, Inc. ("CSHS"). CSHS is also the tax-exempt New Jersey non-profit parent corporation of CentraState healthcare system; an integrated healthcare delivery system ("system"). The sole member of each entity is either CSHS or another CentraState Healthcare System affiliate controlled or owned by CSHS. CentraState Healthcare System is a tax-exempt integrated healthcare delivery system consisting of a group of affiliate healthcare organizations. CentraState Healthcare System is a world-class patient-focused organization comprised of a renowned team of healthcare professionals working together to transform the lives of those in the community. Mission ======= To enhance the health and well-being of the communities through the compassionate delivery of quality healthcare. Vision ====== An organization of caring professionals trusted as the community's health care system of choice for clinical excellence. Recognition/Quality Awards ========================== Comprehensive Community Cancer Program reaccreditation The Statesir Cancer Center and Karen Olbis Radiation Oncology Center at CentraState received Comprehensive Community Cancer Program reaccreditation from the Commission on Cancer (CoC) of the American College of Surgeons (ACS). CentraState has once again achieved full compliance with all standards for this prominent recognition. National Accreditation Program for Breast Centers (NAPBC) reaccreditation The Star and Barry Tobias Women's Health Center at CentraState received reaccreditation from the National Accreditation Program for Breast Centers (NAPBC)-the hallmark of excellence for breast centers. A quality program of the ACS, NAPBC determined that CentraState had exemplary performance with zero deficiencies. CEO Cancer Gold Standard reaccreditation CentraState received CEO Cancer Gold Standard reaccreditation from the CEO Roundtable on Cancer. This nonprofit organization recognized CentraState for its commitment to the health and well-being of its employees, their families and the community through its focus on cancer risk reduction, prevention, early detection, high-quality treatment and survivorship services. Magnet Nursing Excellence CentraState is in an elite group of less than 2 percent of hospitals nationwide to earn Magnet recognition from the American Nurses Credentialing Center (ANCC) four times, attesting to its excellence in nursing care. Magnet-designated hospitals are regarded as the pinnacle of nursing practice, leadership and innovation. Excellence in Emergency Care CentraState's Emergency Department is one of just six in New Jersey and 53 in the country to earn the national 2023 Lantern Award from the Emergency Nurses Association (ENA) for exceptional and innovative leadership, evidence-based practice, education, advocacy and research performance. Perioperative Nurse Recognitions The Association of periOperative Registered Nurses (AORN), representing more than 200,000 surgical nurses nationwide, named CentraState a Center of Excellence in Surgical Safety: Smoke Evacuation. To earn this designation - called the Go Clear Award - the CentraState Operating Room (OR) team completed an education module, facilitated a 12-week survey of each surgical suite and has taken a comprehensive approach to ensuring a surgical smoke-free environment for patients and staff. An Elite Best Healthcare Workplace Great Place To Work and Fortune magazine selected CentraState for the 2023 Fortune Best Workplaces in Health Care List. One of only three companies in New Jersey to receive this recognition, CentraState ranked #39 among a coveted list of only 40 large companies (1,000+ employees) selected nationally. The award is based on an analysis of survey responses from more than 208,000 employees from Great Place To Work Certified companies in the healthcare industry. Creating an Outstanding Employee Experience For the third consecutive year, CentraState earned Great Place to Work Certification from Great Place to Work, a global authority on workplace culture, employee experience and proven leadership behaviors. Employee feedback and independent analysis determined the scores for this research-backed certification. A Higher Level Most Wired Organization CentraState earned 2023 College of Healthcare Information Management Executives (CHIME) Digital Health Most Wired recognition as a certified Level 8 acute care organization. CentraState has achieved Most Wired designation for 13 of the last 14 years, advancing this year from a prior Level 7 achievement. High-Quality Stroke Care CentraState received the American Heart Association's 2023 Get With The Guidelines - Stroke Gold Plus with Target: Stroke Honor Roll Elite, recognizing the commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines. The Target: Stroke Honor Roll Elite level highlights efforts to expedite the time between a patient's arrival at the hospital and treatment with clot-busting medication. In addition, CentraState was recognized by U.S. News & World Report as "high performing" in stroke treatment in its 2023 rankings. CentraState also received reaccreditation by the Joint Commission as an Advanced Primary Stroke Center. Heart Care Expertise CentraState earned the American Heart Association's 2023 Get With The Guidelines - Heart Failure Gold Plus Award with Targets: Heart Failure Honor Roll for quality outcomes and consistent adherence to the latest evidence-based treatment guidelines. In addition, the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) recognized CentraState's Cardiovascular Rehabilitation Program as a certified AACVPR program, signifying the program's quality and adherence to standards and guidelines established by AACVPR and other professional organizations. Radiology Diagnostic Excellence For the third consecutive time, the Radiology Department at CentraState was designated a Diagnostic Imaging Center of Excellence (DICOE) by the American College of Radiology. The DICOE award signifies that an entity delivers the highest levels of imaging quality, safety and care. Bariatric Surgery Reaccreditation CentraState received reaccreditation from the Surgical Review Corporation as a Center of Excellence in Metabolic and Bariatric Surgery. This accreditation recognizes that CentraState continues to meet nationally and internationally recognized standards while fostering a culture of excellence in patient care. Palliative Care Certification CentraState earned The Joint Commission's Gold Seal of Approval for Palliative Care Certification by demonstrating continuous compliance with its performance standards. This certification highlights CentraState's commitment to optimizing quality of life for patients with serious illnesses. CORE FORM, PART III, STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS Organ and Tissue Donation Awareness In recognition of efforts to raise organ and tissue donation awareness, CentraState was honored with the 2023 DoNation Campaign Platinum Award from the U.S. Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services. The Platinum Award is the highest accolade granted by HRSA to hospitals that promote organ and tissue donation. Top Doctors in the County Monmouth magazine facilitates an annual poll in which physicians vote for peers they deem best in their specialties from thousands of doctors across Monmouth County. In 2023, 54 CentraState physicians were named "Top Docs." The Manor Health & Rehabilitation - Awarded a Five-Star Rating from the Centers for Medicare & Medicaid Services - Named as a Best Nursing Home for 2023-2024 by U.S. News & World Report for short-term rehabilitation - Received a 2023 Bronze Award from the New Jersey Department of Health Antimicrobial Stewardship Recognition Program Monmouth Crossing - Earned Advanced Standing distinction from the New Jersey Department of Health and the Health Care Association of New Jersey - Ranked consistently in the top 5 percent nationally by Holleran for satisfaction scores Applewood - Received a Five-Star Rating from the Centers for Medicare & Medicaid Services - Earned Advanced Standing distinction from the New Jersey Department of Health and the Health Care Association of New Jersey - Recognized by AV Powell Associates for the top tier in long-term solvency among the Continuing Care Retirement Communities nationwide Accreditations and Affiliations =============================== Accreditations -------------- - The Joint Commission Heart Failure Certification Palliative Care Certification Stroke Certification Total Joint Certification (Hip and Knee) Wound Care Certification - American Academy of Sleep Medicine Sleep Center Accreditation - American Association for Cardiovascular and Pulmonary Rehabilitation Cardiac and Pulmonary Rehabilitation Certification - American College of Cardiology Chest Pain Center Accreditation - American College of Radiology Radiation Oncology Accreditation Diagnostic Imaging Center of Excellence CT Accreditation Low-Dose CT Lung Cancer Screening Center of Excellence Lung Cancer Screening Center Designation Ultrasound Accreditation Nuclear Medicine Accreditation Comprehensive Breast Imaging Center Mammography Accreditation Stereotactic Breast Biopsy Accreditation - American College of Surgeons Commission on Cancer - National Accreditation, Oncology Service Line, CentraState Healthcare System National Accreditation Program for Breast Centers - The Star and Barry Tobias Women's Health Center - American Diabetes Association Certification for Meeting National Standards for Diabetes Self-Management Education American Heart Association Heart Failure Gold Plus Honor Roll Stroke Gold Plus with Target: Stroke Honor Roll Elite Diabetes Quality Achievement Award - American Nurses Credentialing Center Magnet Status (four-time designation) - Centers for Disease Control and Prevention Preliminary Recognition for Diabetes Prevention Program (online) - CEO Roundtable on Cancer CEO Cancer Gold Standard - Surgical Review Corporation Bariatric Center of Excellence Affiliations ------------ - American Physical Therapy Association Clinical Education Center - Brookdale Community College: Schools of Nursing and Allied Health, Medical Technology and Respiratory Therapy - Capella University - Chamberlain University - The College of New Jersey - Drexel University - Indiana State University - Jersey Shore Medical Center for Outreach Renal Dialysis Service - Kean University - Mercer County Community College - Middlesex County College - Monmouth County Vocational School - Monmouth-Ocean hospital shared service association - Monmouth University - Montclair State University - National Network of Libraries of Medicine - Neumann College - New Jersey City University - Rowan College at Burlington County - Rutgers University - Saint Elizabeth College School of Nutrition and Home Economics - Saint Francis Medical Center School of Nursing - Pennsylvania State University - Stockton University - Thomas Edison State College: School of Nursing - University of Medicine and Dentistry of New Jersey - Newark - University of Medicine and Dentistry of New Jersey - School of Health-Related Professionals in Camden and Lean - Southern New Hampshire University - Union County College - University of Delaware - University of Scranton - Wagner University Member of --------- - American Association of Homes and Services for the Aging - American Hospital Association - American Society of Clinical Pathology - Consortium of Multiple Sclerosis Centers - National Disaster Medical System - National Lymphedema Network - National Multiple Sclerosis Society - New Jersey Association of Mental Health Agencies - New Jersey Association of Nonprofit Homes for the Aging - New Jersey Hospital Association - New Jersey Society of Health System Pharmacists - Schizophrenia Foundation of New Jersey - American Academy of Sleep - American Academy of Cardiovascular & Pulmonary Rehab - American College of Radiology - Diagnostic Imaging Center of Excellence - National Accreditation Program for Breast Centers - Mammography Quality Standards Act Laboratory Certified By ----------------------- - American College of Clinical Pathologists Nursing ------- - Credentialing Center (ANCC) of the American Nurses Association. - CSMC is an approved provider of continuing education by the New Jersey State Nurses Association, provider number: p102-9/2001-2003. NJNSA is accredited by the ANCC Commission on Accreditation of the American Nurses' Association. Licensed By ----------- - New Jersey Department of Health Approved By ----------- - American Dental Association for Continuing Medical Education - American Medical Association for continuing Medical Education Specialized Services ==================== CSMC offers a full range of clinical and diagnostic services to meet the diverse healthcare needs of the growing communities we serve. Cardiac Services ---------------- Services and programs include: the Thomas J. Blanchet Cardiac diagnostic Center, cardiac catheterization lab, cardiac rehabilitation center and the Gloria Saker Women's Heart Program. Statesir Cancer Center ---------------------- CSMC's multidisciplinary, integrated approach to cancer treatment ensures that our patients receive compassionate care and support-medical, educational, emotional and spiritual. CSMC is accredited by the American College of Surgeons Commission on cancer (COC) as well as the national accreditation program for breast centers (NAPBC), the American College of Radiology (ACR) for radiation oncology, diagnostic Radiology and mammography. CentraState has been designated as a Breast Imaging Center of Excellence (BICOE) and a Diagnostic Imaging Center of Excellence (DICOE). Services include: - cancer navigator program - cancer rehabilitation - clinical trials - colorectal cancer program (robotic surgery) - comprehensive breast care program - comprehensive lung program - infusion therapy services - lymphedema center - medical oncology - chemotherapy and immunotherapy services - palliative/hospice services - prostate cancer program (robotic surgery) - radiation oncology (including IMRT, IGRT, radiosurgery, HDR, cone beam therapy) - genetic testing and counseling - surgical oncology program Critical Care Unit ------------------ Our unit offers enhanced infection control features such as electronic privacy panels and a dedicated air filtration system that helps to contain infectious conditions. Emergency Services Department ----------------------------- Our goal is for you to see a nurse within 15 minutes and a clinician within 30 minutes. The ED also offers 24/7 pediatric emergency coverage and is designated as an advanced primary stroke center by the Joint Commission and the New Jersey Department of Health. Statesir Family Acute Care for Elders Unit ------------------------------------------ This unit helps senior patients recover from illness or injury by providing quality, safe, and seamless care. The ace unit is comprised of dedicated and trained health care professionals who provide support and information to patients and family to return home, avoid complications, and possibly prevent future hospitalizations. Our goal is to help patients stay strong, mobile, and independent while providing the best possible care. Laboratory ---------- The laboratory is accredited by the American College of Clinical Pathologists and the American Association of Blood Banks. It is conveniently located near outpatient registry and offers state-of-the-art technology. CORE FORM, PART III, STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS Maternity --------- CSMC's maternity unit allows mothers to experience labor, delivery, and recovery in a warm, private, home-like room equipped for normal and complicated deliveries. After delivery, when mothers and their newborns are ready, they are moved to a private suite in the First Impressions Maternity Pavilion, dedicated to postpartum care. CSMC also has a special care nursery which provides premature babies with treatment and care by a team of trained professionals. All special needs are met 24 hours a day under the supervision of a neonatologist. The facility is designated by the state as a community perinatal center intermediate and has received the IBCLC care award from the international board of lactation consultant examiners (IBLCE) and the international lactation consultant association (ILCA) for hiring international board-certified lactation consultants (IBCLCS). Pediatrics ---------- CSMC's pediatric department emphasizes family-centered care, with 24-hour visitation for parents. The patient rooms include beds for parents or guardians who wish to stay overnight and play areas for children. Psychiatric Services -------------------- Offers an inpatient unit that provides care for those needing acute psychiatric/mental healthcare, 24-hour psychiatric emergency assessments through the emergency room, and a 24-hour crisis hotline. Electroconvulsive therapy (ECT services are also available on an outpatient or inpatient basis. Orthopedics ----------- Programs and services include: the Total Joint Center of New Jersey for knee/hip repair and replacement; shoulder repair and replacement; hand and foot surgery; the Spine Institute of Central Jersey and non-surgical therapies for other orthopedic problems. The Total Joint Center of New Jersey is accredited by the Joint Commission. Outpatient Nutrition Center --------------------------- Offers individual nutrition counseling with a registered dietitian for children and adults. Includes counseling sessions for weight management, cardiac, renal, hepatic, gastrointestinal problems, and others. Radiology --------- Capabilities include x-ray, ultrasound, computed tomography (CT) scan and nuclear medicine. Princeton radiology associates also houses a positron emission tomography (pet)/CT scanner for diagnosing cancer and other diseases or conditions, and an open bore MRI. OceanFirst Rehabilitation Center -------------------------------- Our fully equipped center offers physical, occupational and speech therapy. Inpatient and outpatient services are offered daily. Specialized services include: Linda E. Cardinale MS Center, Central Jersey Wound Treatment Center with lymphedema program, continence program, swallowing disorder therapy, sports medicine and aquatic therapy, including a hydroworx pool. Progressive Care Unit --------------------- This unit treats heart failure patients, as well as transitions patients from the critical care unit. Following a hospital discharge, a registered nurse health coach is available to work with patients to help them become more knowledgeable and independent in managing diet, medications and lifestyle changes. Patients also learn how to most effectively work with their primary care provider for continued support. Additional support includes a free nurse advice. Patients can call the nurse advice line and speak to our cardiac coordinator for answers and help with any needs the heart failure patient may have. Short stay unit --------------- A short stay unit is available for patients who do not require an overnight stay. Our same day surgery center performs a variety of surgical and endoscopy procedures on a medical outpatient basis. Surgical Services ----------------- CSMC's surgical services are delivered in state-of-the-art facilities by highly trained physicians and nurses. Patients receive comprehensive surgical support for diagnostic, therapeutic and palliative intervention in the following areas: general surgery, bariatric surgery, breast, colorectal, endovascular surgery, gastrointestinal surgery, neurosurgery, obstetrics/gynecology, ophthalmology, ear, nose and throat, orthopedics (including knee and hip replacements at the Total Joint Center of New Jersey at CSMC), plastic, podiatric, and thoracic surgery. The Star and Barry Tobias Women's Health Center ----------------------------------------------- Offers screenings, digital mammograms, computer-aided detection (cad), ultrasound mammotone biopsy, stereotactic needle biopsy, health education, bone densitometry, and individualized health counseling on a number of topics for women. The center is certified by the American college of radiology; has been named a breast imaging center of excellence for providing high-quality mammograms and other services; and has been named a pink ribbon facility by Hologic for providing excellence in breast health. Specialized Centers and Other Services -------------------------------------- CSMC offers specialized diagnostic and treatment services at its center for sleep disorders and comprehensive lung program. Other specialty services include respiratory therapy for pulmonary diagnostic procedures and rehabilitation, and oncology services, including chemotherapy, support groups and hemodialysis, podiatric services, pain management, and palliative care. Freehold Family Health Center ----------------------------- The Freehold Family Health Center is a unique collaborative initiative with the Visiting Nurse Association (VNA) Health Group, VNACJ Community Health Center, inc. (CHS and Rutgers Robert Wood Johnson Medical School through the Family Medicine Residency Program at CSMC. The facility is accessible to all members of the community, including underserved populations. Bilingual staff are available to assist with all services. Services include: - comprehensive primary and specialty care, including geriatrics, prenatal and behavioral health services; - community health programs such as WIC; - programming by the county councils for young children; and - cancer education and early detection programs. Community-based Programs ======================== Good Stewardship Through Solar ------------------------------ CSMC recently celebrated the completion of a solar carport installation in parking areas around the medical center and ambulatory campus, this installment, in combination with the solar farm at the back of the property, will allow CSC to generate approximately 61 percent of its electric consumption and achieve savings of approximately a half million dollars in energy costs each year, reducing its carbon footprint and the impact on Freehold Township's electrical grid. The carports and solar farm were installed by KDC Solar, a Bedminster-based developer, owner, and operator of solar power facilities. CSMC is the only hospital in the state with a solar installation of this size. It now produces the largest percentage of solar power of any hospital in New Jersey. The combined projects will offset greenhouse gases equivalent to: - 1,026,153 gallons of gas used. - 22,296,869 miles of vehicle traffic. - 1.162 billion smartphones charged. - 9,969,586 pounds of coal burned. - 1,590 homes supplied with electricity for one year. Community Health Outreach ========================= - People throughout the community used CentraState's Live Life Well services more than 55,000 times to enhance their health and manage or prevent chronic conditions through a variety of wellness offerings. - More than 9,000 people attended health and wellness fairs, sessions, and screenings throughout the year. -Approximately 8,273 people received COVID vaccines. - More than 275 people attended cancer health lectures and screenings, including those for prostate, colorectal, oral, skin, breast, and thyroid cancers. - CSMC provided approximately 2,000 diabetes education encounters to help people manage or reduce their risk of diabetes. - More than 300 people benefited from the peer support of several CSMC support groups. - More than 2,000 people received life-saving CPR training, including basic life support, advanced life support, and pediatric advanced life support. CORE FORM, PART III; QUESTION 3 the organization held an ownership interest in Centrastate captive insurance company, ltd. Spc, a wholly owned captive insurance company. As part of the affiliation with atlantic health, the assets and liabilities of the centrastate captive insurance company, ltd, spc were novated to ahs insurance company, ltd. As of december 31, 2023. in addition, the limited policies with centrastate captive insurance company, ltd., spc. were commuted and terminated and the wholly owned captive insurance company was dissolved as of 12/31/2023. CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7 CENTRASTATE HEALTHCARE SYSTEM, INC. ("CSHS") IS THE SOLE MEMBER OF THIS ORGANIZATION. CSHS 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. ATLANTIC HEALTH SYSTEM, INC. AND CENTRASTATE HOLDING COMPANY, INC. HOLD MEMBERSHIP INTERESTS IN CSHS OF 51% AND 49%, RESPECTIVELY. CORE FORM, PART VI, SECTION B; QUESTION 11B THE ORGANIZATION IS AN AFFILIATE WITHIN CENTRASTATE HEALTHCARE SYSTEM, INC. ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. CENTRASTATE HEALTHCARE SYSTEM, INC. IS THE TAX-EXEMPT PARENT ENTITY OF THE SYSTEM. THE ORGANIZATION'S FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY (ITS BOARD OF TRUSTEES) PRIOR TO THE FILING OF THE FEDERAL FORM 990 WITH THE INTERNAL REVENUE SERVICE ("IRS") AND AFTER PRESENTATION AND REVIEW BY CENTRASTATE HEALTHCARE SYSTEM, INC.'S AUDIT COMMITTEE. AS PART OF THE 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 FINANCE PERSONNEL AND INTERNAL WORKING GROUP OF THE ORGANIZATION 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 FINANCE PERSONNEL AND INTERNAL WORKING GROUP FOR THEIR REVIEW. THE ORGANIZATION'S FINANCE PERSONNEL AND INTERNAL WORKING GROUP REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE ORGANIZATION'S FINANCE PERSONNEL AND INTERNAL WORKING GROUP FOR FINAL REVIEW AND APPROVAL. FOLLOWING THIS REVIEW, THE FINAL FORM 990 WAS PRESENTED TO THE MEMBERS OF CENTRASTATE HEALTHCARE SYSTEM'S AUDIT COMMITTEE FOR REVIEW AND THEREAFTER PROVIDED TO EACH VOTING MEMBER OF THIS ORGANIZATION'S GOVERNING BODY PRIOR TO FILING WITH THE IRS. CORE FORM, PART VI, SECTION B; QUESTION 12 ALL OFFICERS, TRUSTEES AND KEY EMPLOYEES ARE REQUIRED ANNUALLY, TO REVIEW THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE, WHICH IS SUBMITTED TO CORPORATE COUNSEL. CORPORATE COUNSEL REVIEWS EACH COMPLETED QUESTIONNAIRE AND PREPARES A REPORT, WHICH IS SHARED WITH THE BOARD OF TRUSTEES GOVERNANCE COMMITTEE AND, ULTIMATELY, THE BOARD OF TRUSTEES. THE POLICY IS ENFORCED, AS NEEDED, DEPENDING ON THE CIRCUMSTANCES - FOR EXAMPLE, THROUGH RECUSAL FROM VOTING, DIVESTITURE OF CONFLICTING PROPERTY INTERESTS OR, IN CERTAIN PAST CASES, RESIGNATION FROM THE BOARD OF TRUSTEES. CORE FORM, PART VI, SECTION B; QUESTION 15 THE ORGANIZATION'S BOARD OF TRUSTEES HAS AN EXECUTIVE COMPENSATION SUB-COMMITTEE ("COMMITTEE"). THE COMMITTEE HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY WHICH IT FOLLOWS WHEN IT REVIEWS THE COMPENSATION AND BENEFITS OF THE ORGANIZATION'S SENIOR MANAGEMENT, INCLUDING THE PRESIDENT/CHIEF EXECUTIVE OFFICER. 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 SENIOR MANAGEMENT OF THE ORGANIZATION IS REASONABLE. IN 2023, THE EXECUTIVE COMPENSATION SUB-COMMITTEE REPORTED TO THE FULL BOARD FOR RATIFICATION. THE ACTIONS TAKEN BY THE COMMITTEE ENABLE THE ORGANIZATION TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 4958 WITH RESPECT TO THE TOTAL COMPENSATION OF CERTAIN MEMBERS OF THE SENIOR MANAGEMENT TEAM, INCLUDING THE PRESIDENT/CHIEF EXECUTIVE OFFICER. THE THREE FACTORS WHICH MUST BE SATISFIED IN ORDER TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS ARE THE FOLLOWING: 1. THE COMPENSATION ARRANGEMENT IS APPROVED IN ADVANCE BY AN "AUTHORIZED BODY" OF THE APPLICABLE TAX-EXEMPT ORGANIZATION WHICH IS COMPOSED ENTIRELY OF INDIVIDUALS WHO DO NOT HAVE A "CONFLICT OF INTEREST" WITH RESPECT TO THE COMPENSATION ARRANGEMENT; 2. THE AUTHORIZED BODY OBTAINED AND RELIED UPON "APPROPRIATE DATA AS TO COMPARABILITY" PRIOR TO MAKING ITS DETERMINATION; AND 3. THE AUTHORIZED BODY "ADEQUATELY DOCUMENTED THE BASIS FOR ITS DETERMINATION" CONCURRENTLY WITH MAKING THAT DETERMINATION. THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES EACH OF WHO ARE INDEPENDENT AND ARE FREE FROM ANY CONFLICTS OF INTEREST. THE COMMITTEE RELIED UPON APPROPRIATE COMPARABLE DATA; SPECIFICALLY, THE COMMITTEE OBTAINED A WRITTEN COMPENSATION STUDY FROM AN INDEPENDENT FIRM WHICH SPECIALIZES IN THE REVIEWING OF HOSPITAL AND HEALTHCARE SYSTEM EXECUTIVE COMPENSATION AND BENEFITS THROUGHOUT THE UNITED STATES. THIS STUDY USED COMPARABLE GEOGRAPHIC AND DEMOGRAPHIC MARKET DATA INCLUDING BUT NOT LIMITED TO SIMILARLY SIZED HEALTHCARE SYSTEMS AND HOSPITALS, # OF LICENSED BEDS AND NET PATIENT SERVICE REVENUE. IN ADDITION, THE COMMITTEE REVIEWS AND APPROVES EXECUTIVE COMPENSATION ADJUSTMENTS BASED ON MARKET SURVEYS DEVELOPED BY INDEPENDENT CONSULTANTS, INDUSTRY AVERAGE COMPARISON, YEARS OF SERVICE AND OTHER EXEMPT ORGANIZATIONS IN THE GEOGRAPHIC AREA. AFTER A REVIEW OF THE INDIVIDUAL'S PERFORMANCE FOR THE YEAR AND RELYING ON COMPARABLE INFORMATION AND OTHER OBJECTIVE DATA, THE EXECUTIVE COMMITTEE WILL RECOMMEND AN ADJUSTMENT TO THE INDIVIDUAL'S COMPENSATION. ANY DETERMINATIONS ARE DOCUMENTED CONTEMPORANEOUSLY IN THE EXECUTIVE COMMITTEE MINUTES. THE COMMITTEE ADEQUATELY DOCUMENTED ITS BASIS FOR ITS DETERMINATION THROUGH THE TIMELY PREPARATION OF WRITTEN MINUTES OF THE COMPENSATION COMMITTEE MEETINGS DURING WHICH THE EXECUTIVE COMPENSATION AND BENEFITS WAS REVIEWED AND SUBSEQUENTLY APPROVED. THE ACTIONS OUTLINED ABOVE WITH RESPECT TO THE COMMITTEE AND THE ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS APPLIES TO CERTAIN SENIOR MANAGEMENT PERSONNEL, INCLUDING, BUT NOT LIMITED TO, THE PRESIDENT/CHIEF EXECUTIVE OFFICER. THE COMPENSATION AND BENEFITS OF CERTAIN OTHER INDIVIDUALS CONTAINED IN THIS FORM 990 ARE REVIEWED ANNUALLY BY THE CENTRASTATE HEALTHCARE SYSTEM, INC.'S PRESIDENT/CHIEF EXECUTIVE OFFICER WITH ASSISTANCE FROM THE ORGANIZATION'S HUMAN RESOURCES DEPARTMENT IN CONJUNCTION WITH THE INDIVIDUAL'S JOB PERFORMANCE DURING THE YEAR AND IS BASED UPON OTHER OBJECTIVE FACTORS DESIGNED TO ENSURE THAT REASONABLE AND FAIR MARKET VALUE COMPENSATION IS PAID BY THE ORGANIZATION. OTHER OBJECTIVE FACTORS INCLUDE MARKET SURVEY DATA FOR COMPARABLE POSITIONS, INDIVIDUAL GOALS AND OBJECTIVES, PERSONNEL REVIEWS, EVALUATIONS, SELF-EVALUATIONS AND PERFORMANCE FEEDBACK MEETINGS. CORE FORM, PART VI, SECTION C; QUESTION 18 PURSUANT TO STATE OF NEW JERSEY P.L. 2019, CHAPTER 513, (WHICH WAS EFFECTIVE ON JULY 21, 2020), AND AMENDED P.L. 2008, CHAPTER 58 (C.26: 2H-5.1B), THIS ORGANIZATION HAS POSTED ON ITS INTERNET WEBSITE A COPY OF THIS INTERNAL REVENUE SERVICE (IRS) FORM 990 AND ALL SCHEDULES AND SUPPORTING DOCUMENTATION REQUIRED TO BE SUBMITTED TO THE IRS IN CONJUNCTION WITH THE FORM 990 WITH THE EXCEPTION OF THOSE SCHEDULES NOT OPEN FOR PUBLIC INSPECTION. SAID FORM 990 WAS POSTED BY THE ORGANIZATION AFTER FILING ITS FORM 990 WITH THE IRS. 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 THIS ORGANIZATION. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OF THIS ORGANIZATION AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THIS ORGANIZATION'S BOARD OF TRUSTEES. CORE FORM, PART VII AND SCHEDULE J BRIAN GRAGNOLATI, STEVEN SHERIS, M.D. AND MAUREEN A. SCHNEIDER, PH.D., MBA, RN ARE TRUSTEES OF THIS ORGANIZATION'S GOVERNING BODY; AN UNCOMPENSATED POSITION. THESE INDIVIDUALS RECEIVE A FEDERAL FORM W-2 FROM A RELATED ORGANIZATION WITHIN ATLANTIC HEALTH SYSTEM. ACCORDINGLY, THEIR RESPECTIVE REPORTABLE COMPENSATION, RETIREMENT/OTHER DEFERRED COMPENSATION AND NON-TAXABLE BENEFITS ARE REPORTED WITHIN CORE FORM, PART VII AND SCHEDULE J OF THE ATLANTIC HEALTH SYSTEM, INC. GROUP RETURN (EIN: 65-1301877) FEDERAL FORM 990. PLEASE REFER TO THE ATLANTIC HEALTH SYSTEM, INC. GROUP RETURN FEDERAL FORM 990 FOR THIS INFORMATION. CORE FORM, PART VII, SECTION A, COLUMN B THIS ORGANIZATION IS AN AFFILIATE WITHIN THE CENTRASTATE HEALTHCARE SYSTEM, INC. ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THE SYSTEM INCLUDES BOTH FOR-PROFIT AND NOT FOR-PROFIT ORGANIZATIONS. CERTAIN BOARD OF TRUSTEE 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 TRUSTEES OF OTHER RELATED ORGANIZATIONS IN THE SYSTEM, THEIR RESPECTIVE HOURS PER WEEK PER ORGANIZATION ARE APPROXIMATELY THE SAME AS REFLECTED IN CORE FORM, PART VII OF THIS FORM 990. THE HOURS REFLECTED ON 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 CENTRASTATE HEALTHCARE SYSTEM, INC.; NOT SOLELY THIS ORGANIZATION. CORE FORM, PART XI; LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCE INCLUDE - NET ASSET TRANSFER FROM ATLANTIC HEALTH SYSTEM, INC.; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION - $15,053,531; - CHANGE IN BENEFICIAL INTEREST IN CENTRASTATE HEALTHCARE FOUNDATION, INC.; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION - $3,899,475; - Net asset transfer to AHS Insurance Corp, Ltd. - ($1,902,667); AND - OTHER CHANGES IN NET ASSETS - ($440,221). CORE FORM, PART XII; QUESTION 2 THE ORGANIZATION IS AN AFFILIATE WITHIN CENTRASTATE HEALTHCARE SYSTEM, INC. ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. CENTRASTATE HEALTHCARE SYSTEM, INC. IS THE TAX-EXEMPT PARENT ENTITY OF THE SYSTEM. AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF CENTRASTATE HEALTHCARE SYSTEM, INC. AND ALL ENTITIES WITHIN THE SYSTEM FOR THE YEARS ENDED DECEMBER 31, 2023 AND DECEMBER 31, 2022; 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. CORE FORM, PART XII; QUESTION 3 THE ORGANIZATION IS AN AFFILIATE WITHIN CENTRASTATE HEALTHCARE SYSTEM, INC.("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. THIS ORGANIZATION WAS INCLUDED IN THE SYSTEM WIDE A-133 AUDIT. FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED SERVICES TOTAL FEES:35391324 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN FEES TOTAL FEES:9498810 FORM 990 PART IX LINE 11G DESCRIPTION:BILLING & COLLECTION FEES TOTAL FEES:2525301 FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING FEES TOTAL FEES:2116020 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL SERVICES TOTAL FEES:140700 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER FEES TOTAL FEES:1245005 CENTER FOR AGING INC 901 WEST MAIN STREET FREEHOLD NJ 07728 222575377 HEALTH SVCS. NJ 501(C)(3) 10 CSHS false CENTRASTATE ASSISTED LIVING INC 901 WEST MAIN STREET FREEHOLD NJ 07728 223520730 HEALTH SVCS. NJ 501(C)(3) 10 CSHS false HEALTHCARE AFFILIATES INC 901 WEST MAIN STREET FREEHOLD NJ 07728 521594300 HEALTH SVCS. NJ 501(C)(3) 10 CSHS false CENTRASTATE HEALTHCARE SYSTEM INC 901 WEST MAIN STREET FREEHOLD NJ 07728 222482803 MANAGEMENT NJ 501(C)(3) 12A AHS false CENTRASTATE HEALTHCARE FOUNDATION INC 901 WEST MAIN STREET FREEHOLD NJ 07728 272383065 FUNDRAISING NJ 501(C)(3) 7 CSHS false CENTRASTATE HOLDING COMPANY INC 901 WEST MAIN STREET FREEHOLD NJ 07728 851112301 MANAGEMENT NJ 501(C)(3) 12B NA false ATLANTIC HEALTH SYSTEM INC 475 SOUTH STREET MORRISTOWN NJ 07960 223380375 MANAGEMENT NJ 501(C)(3) 12A NA false CENTRASTATE HEALTHCARE SERVICES INC 901 WEST MAIN STREET FREEHOLD NJ 07728 222512830 HEALTH SVCS. NJ NA C CORP. false CENTRASTATE MEDICAL ASSOCIATES PC 901 WEST MAIN STREET FREEHOLD NJ 07728 223402359 HEALTH SVCS. NJ NA C CORP false CENTRASTATE SPECIALISTS PC 901 WEST MAIN STREET FREEHOLD NJ 07728 823704077 HEALTH SVCS. NJ NA C CORP. false CENTRASTATE CAPTIVE INSURANCE CO LTD 23 LIME TREE BAY AVE GRAND CAYMAN CJ KY1-1108 981205985 FINANCIAL VEHICLE CJ CSMC FOREIGN CORP. 1220170 0 1.00000 true CENTRASTATE CARDIOLOGY PC 901 WEST MAIN STREET FREEHOLD NJ 07728 872845417 HEALTH SVCS. NJ NA C CORP. false true false true true false false false false false true true false false false false true true false true SCHEDULE R ATLANTIC HEALTH SYSTEM, INC. AND CENTRASTATE HOLDING COMPANY, INC. HOLD MEMBERSHIP INTERESTS IN CENTRASTATE HEALTHCARE SYSTEM, INC. OF 51% AND 49%, RESPECTIVELY. PLEASE REFER TO ATLANTIC HEALTH SYSTEM, INC. (EIN: 22-3380375) FORM 990, SCHEDULE R FOR THE REPORTING OF RELATED ORGANIZATIONS. SCHEDULE R, PART V THIS ORGANIZATION IS A MEMBER OF CENTRASTATE HEALTHCARE SYSTEM, INC.; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. FUNDS ARE ROUTINELY TRANSFERRED BETWEEN AFFILIATES AND BUSINESS ACTIVITIES ARE COMMON ON BEHALF OF THE SYSTEM'S AFFILIATES, INCLUDING THIS ORGANIZATION. THESE TRANSACTIONS MAY BE RECORDED ON THE REVENUE/EXPENSE AND BALANCE SHEET STATEMENTS OF THIS ORGANIZATION AND OTHER AFFILIATES. THESE ENTITIES WORK TOGETHER TO DELIVER HIGH QUALITY COST EFFECTIVE HEALTHCARE AND WELLNESS SERVICES TO THEIR COMMUNITIES REGARDLESS OF ABILITY TO PAY AND IN FURTHERANCE OF CHARITABLE TAX-EXEMPT PURPOSES.