2024-11-15T06:06:47-06:00 2023-12-31 WithumSmithBrown PC 200 Jefferson Park Suite 400 Whippany NJ 079811070 990 2023-01-01 824971362 SALEM COUNTY HOSPITAL CORP % WILLIAM D PELINO CPA MBA SALE 8569351000 310 WOODSTOWN ROAD SALEM NJ 08079 WILLIAM PELINO CPA MBA SVP/CFO 8565754733 2024-05-15 true true Scott J Mariani P00642486 9738989494 2023 2024-10-15 13:58:12Z X SALEM MEDICAL CENTER AMY MANSUE 165 BRIDGETON PIKE MULLICA HILL NJ 08062 30791351 false X WWW.INSPIRAHEALTHNETWORK.ORG X 2018 NJ TO PROVIDE A SAFE AND COMPASSIONATE EXPERIENCE THAT IMPROVES THE HEALTH AND WELL-BEING OF OUR COMMUNITY. X 10 9 414 9 0 0 20546665 5356642 42070924 25301353 0 0 111043 133356 62728632 30791351 0 0 0 0 22389022 17097622 0 0 0 29055127 27434674 51444149 44532296 11284483 -13740945 52503427 0 37004501 0 15498926 0 X PRIOR TO ITS STATUTORY MERGER ON OCTOBER 1, 2023, TO DELIVER HIGH QUALITY, COMPASSIONATE HEALTHCARE TO GREATER SALEM COUNTY. SALEM MEDICAL CENTER PROVIDES EMERGENCY AND MEDICALLY NECESSARY HEALTHCARE SERVICES TO INDIVIDUALS IN THE COMMUNITY REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, SEXUAL ORIENTATION OR ABILITY TO PAY. false true 40079068 0 25301353 EXPENSES INCURRED IN PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY MEDICALLY NECESSARY SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, SEXUAL ORIENTATION OR ABILITY TO PAY. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT (STATEMENT OF PROGRAM SERVICES) WHICH INCLUDES DETAILED INFORMATION REGARDING THE VARIOUS SERVICES PROVIDED BY THIS ORGANIZATION. 40079068 true true false false false false false false false false false false false false false true false true false false false false false false false false true true false false true false false false false false false false false false false true false false true true true false false true X 32 0 true 414 true false false false false false false false false false false false false X 10 9 true false true false true true true true true false false true true true true true true true true false X X WILLIAM D PELINO CPA MBA 8566416605 165 BRIDGETON PIKE MULLICA HILL NJ 08062 X Amy Mansue Trustee - President & CEO 55.0 0.0 X X 0 1608291 350191 MATTHEW K DOONAN ESQ SVP & Chief Legal Officer 55.0 0.0 X 0 544564 122495 David Yhlen Chief Operating Officer 55.0 0.0 X 0 588498 39920 Lydia Stockman RN MHA SVP & CAO 55.0 0.0 X 0 501517 120244 Jaymica Patel MD CMO 55.0 0.0 X 0 423003 62680 Brandi Ortiz CT Tech II 55.0 0.0 X 151849 45168 53994 Dodi K Baldwin RN Registered Nurse 55.0 0.0 X 144717 45122 53014 Justine C Murphy BSHA RN CNO 55.0 0.0 X 151814 37227 42489 David Marini Pharmacist 55.0 0.0 X 124306 40441 55883 ZACHARY PETERSON CT TECH II 55.0 0.0 X 114662 39059 11238 JAMES PIPER AVP Support Services 55.0 0.0 X 125501 34651 586 Glenn Dragon MD Trustee; Ex-Off (TERM 10/2023) 25.0 0.0 X 0 44723 0 James M Bonner DO Chair - Trustee 1.0 0.0 X X 0 0 0 Herbert J Konrad Vice Chair - Trustee 1.0 0.0 X X 0 0 0 Pamela S Clark Secretary/Treasuer - Trustee 1.0 0.0 X X 0 0 0 Manish Dadhania MD Trustee 1.0 0.0 X 0 0 0 Dawn E Flitcraft Trustee 1.0 0.0 X 0 0 0 Ronald Rossi Trustee 1.0 0.0 X 0 0 0 Elizabeth A Ryan Esq Trustee 1.0 0.0 X 0 0 0 Shelly O Schneider EdD Trustee 1.0 0.0 X 0 0 0 Hugh J McCaffrey Trustee (TERM 4/2023) 1.0 0.0 X 0 0 0 Andrew P Zinn MD Trustee (TERM 10/2023) 1.0 0.0 X 0 0 0 812849 3952264 912734 22 false true false SIERRA HEALTH GROUP LLC 440 FRANKLIN STREET SUITE 300 BLOOMFIELD NJ 07003 BILLING/REV CYCLE 2135932 METZ CULINARY MANAGEMENT 2 WOODLAND DRIVE DALLAS PA 18612 CATERING 1117629 RESOLUTE PERIOPERATIVE SVCS LLC 41 HOWELL ROAD MOUNTAIN LAKES NJ 07046 MEDICAL 962193 ADVANCE THERAPY ASSOCIATES 1020 NORTH KINGS HIGHWAY CHERRY HILL NJ 08034 PHYSICAL THERAPY 547572 ALLIED UNIVERSAL SECURITY SVC 1661 ROUTE 22 STE 101 BRIDEGWATER NJ 08807 SECURITY 526378 10 4000000 1356642 5356642 NET PATIENT SERVICE REVENUE 622110 25266849 25266849 OTHER HEALTHCARE RELATED REVENUE 622110 34504 34504 25301353 0 0 0 133356 133356 0 133356 133356 0 0 0 0 0 0 0 0 0 0 0 30791351 25301353 133356 X 0 0 0 0 177550 159795 17755 0 13730676 12357608 1373068 0 1797808 1618027 179781 1391588 1252429 139159 0 147526 132773 14753 63103 56793 6310 0 0 0 9859512 8873562 985950 0 4103 3693 410 499798 449818 49980 2109092 1898183 210909 0 1582424 1424182 158242 1753 1578 175 0 11305 10175 1130 2088516 1879664 208852 0 2550832 2295749 255083 508483 457635 50848 MEDICAL SUPPLIES 4942518 4448266 494252 REPAIRS & MAINTENANCE 1699516 1529564 169952 DIETARY/CAFETERIA 765000 688500 76500 DUES & SUBSCRIPTIONS 128561 115705 12856 472632 425369 47263 44532296 40079068 4453228 0 2315644 0 0 0 0 0 4410567 0 0 0 0 0 0 0 1873262 0 725719 0 0 0 23761620 0 0 0 0 0 0 0 1473078 0 17943537 0 52503427 0 14543087 0 0 0 0 0 0 0 0 0 0 0 21720369 0 0 0 741045 0 37004501 0 X 15498926 0 0 0 15498926 0 52503427 0 X -13740945 -1757981 X X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 X SCHEDULE D, PART X, LINE 2 THE ORGANIZATION IS AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF INSPIRA HEALTH NETWORK AND RELATED ENTITIES FOR THE YEARS ENDED DECEMBER 31, 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 NETWORK ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD IS MET. MANAGEMENT DETERMINED THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2023 AND 2022. true true X true X true X 550. true true false true true 13929941 5491559 8438382 0.18950 13929941 5491559 8438382 0.18950 1933228 1933228 0.04340 1933228 1933228 0.04340 15863169 5491559 10371610 0.23290 true 942500 172709 6710585 11819356 -5108771 X true true 1 1 SALEM MEDICAL CENTER 310 WOODSTOWN ROAD SALEM NJ 08079 WWW.INSPIRAHEALTHNETWORK.ORG 71702 X X X 1 SALEM MEDICAL CENTER 1 false false true X X X X X X X X X 22 true true true true X WWW.INSPIRAHEALTHNETWORK.ORG X true 22 true WWW.INSPIRAHEALTHNETWORK.ORG false true X 200. 550. X X X X X true true X X X true X WWW.INSPIRAHEALTHNETWORK.ORG X WWW.INSPIRAHEALTHNETWORK.ORG X WWW.INSPIRAHEALTHNETWORK.ORG X X X X X X true X false 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") FOR 2022-2024 THIS ORGANIZATION TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY ITS HOSPITAL FACILITIES. INSPIRA HEALTH NETWORK WORKED IN COLLABORATION WITH THE WALTER RAND INSTITUTE FOR PUBLIC AFFAIRS (WRI) AT RUTGERS UNIVERSITY-CAMDEN, AN INDEPENDENT RESEARCH AND CONSULTING FIRM TO CONDUCT THE CHNA. FOR THE PURPOSE OF THIS ASSESSMENT, COMMUNITY IS DEFINED AS THE THREE COUNTIES IN THE INSPIRA HEALTH NETWORK SERVICE AREA (GLOUCESTER, CUMBERLAND, AND SALEM COUNTIES). INSPIRA HEALTH NETWORK, INC. IS THE TAX-EXEMPT PARENT ORGANIZATION OF A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM WHICH INCLUDES INSPIRA MEDICAL CENTERS, INC. ("IMC"). TO ACHIEVE THE GOAL OF OBTAINING LOCALLY ACTIONABLE INFORMATION FOR IMPROVING HEALTH, THIS CHNA EMPLOYED A MIXED-METHODS ITERATIVE STRATEGY OF DATA COLLECTION THAT COMBINED QUANTITATIVE AND QUALITATIVE ANALYSIS OF PRIMARY DATA COLLECTED FROM COMMUNITY MEMBERS WITH QUANTITATIVE ANALYSIS OF SECONDARY DATA. THE TWO FUNDAMENTALS OF OUR APPROACH ARE RIGOUROUS DATA ANALYSIS AND COMMUNITY VOICE; TO THAT END, WE USED A VARIETY OF METHODS AND TOOLS TO ANALYZE THE DATA WE COLLECTED FROM PARTICIPANTS AND SOURCES IDENTIFIED THROUGH CONSULATION WITH TRUSTED COMMUNITY PARTNERS IN EACH COUNTY. KEY INFORMANT INTERVIEWS ------------------------ WRI CONDUCTED 15 INTERVIEWS WITH KEY REPRESENTATIVES IN EACH OF THREE COUNTIES AND DESIGNATED INSPIRA HEALTH STAFF. THE INTERVIEWS WERE COMPLETED USING A SEMI-STRUCTURED RESEARCH INSTRUMENT, AND THE GOALS OF THE INTERVIEW WERE SIMILAR TO GOALS OF THE FOCUS GROUPS. THE PURPOSE OF THE RESEARCH PROJECT WAS EXPLAINED TO POTENTIAL PARTICIPANTS AND INFORMED CONSENT WAS OBTAINED PRIOR TO THE DATA COLLECTION PROCESS, FOLLOWING THE APPROVED IRB PROTOCOL. INTERVIEWS WERE CONDUCTED VIRTUALLY. RESEARCH TEAM MEMBERS TOOK COMPREHENSIVE NOTES. INTERVIEW PARTICIPANTS WERE ASKED TO THINK ABOUT AND SHARE THEIR PERSPECTIVES ON ACCESS TO CARE, HEALTH EDUCATION AND COMMUNICATION, AS WELL AS THE BARRIERS RESIDENTS FACE IN OBTAINING CARE. OTHER AREAS OF INQUIRY INCLUDED THE STRENGTHS OF THE HEALTH CARE SERVICE DELIVERY SYSTEM AS WELL AS ITS WEAKNESSES AND POTENTIAL IMPROVEMENTS. FOCUS GROUPS ------------ ALL FOCUS GROUP AND INTERVIEW REPORTS WERE CODED BY TWO RESEARCH TEAM MEMBERS TO ESTABLISH INTERRATER RELIABILITY. THEMATIC AND ANALYTIC CODING STRATEGIES WERE EMPLOYED (CLARKE AND BRAUN, 2013). THE DATA FROM THE FOCUS GROUP NOTES WERE GROUPED INTO UNITS (E.G., COUNTY RESOURCES, CHALLENGES FACING THE COUNTY, AND RECOMMENDATIONS). LINE-BY-LINE CODING WAS DONE BY TEAM MEMBERS AND THEN OPEN CODING WAS COMPLETED TO IDENTIFY THE ADDITIONAL SUB-THEMES WITHIN THE AFOREMENTIONED AREAS (GLASER AND STRAUSS, 1967). TO ENSURE INTER-RATER RELIABILITY, TWO RESEARCH TEAM MEMBERS INDEPENDENTLY COMPLETED THIS CODING (MARSHALL AND ROSSMAN, 1989). DISCREPANCIES IN THE CODING WERE RESOLVED BY A MEETING BETWEEN THE CODERS AND THE PRINCIPAL INVESTIGATOR. THE INTERVIEW AND FOCUS GROUP DATA WERE EXAMINED USING THE NVIVO 12 DATA MANAGEMENT AND ANALYSIS SOFTWARE. RESEARCHERS HAVE ARGUED THAT NVIVO CAN BE HELPFUL WITH ANALYSIS WHEN USING THE GROUNDED THEORY APPROACH TO QUALITATIVE RESEARCH (HUTCHINSON, JOHNSTON, AND BRECKON, 2010). TO ILLUSTRATE, THE CODING PROCESS ALLOWED THE RESEARCHER(S) TO TRACK WHAT IS OCCURRING IN THESE DATA AND TO DETERMINE WHEN THE POINT OF SATURATION WAS REACHED (I.E., NO NEW THEMES ARE EMERGING) (GLASER AND STRAUSS, 1967). IN NVIVO, ONCE THE THEMES WERE IDENTIFIED, A NODE WAS CREATED AND THE DATA STORED AT THAT NODE (BAZELEY, 2007). THE DATA STORED AT THE NODES ALLOWED RESEARCHERS TO PULL QUOTES AND CASE STUDIES TO FURTHER EXPLAIN THE THEMES IN THE 2022-2024 CHNA. COMMUNITY SURVEY ---------------- WE ALSO SOUGHT COMMUNITY ENGAGEMENT THROUGH THE WIDESPREAD DISSEMINATION OF A COMMUNITY SURVEY (N=872). THE SURVEY CONSISTED OF 95 ITEMS, FORMATTED FOR ELECTRONIC AND PAPER DISTRIBUTION IN BOTH ENGLISH AND SPANISH. THE SPANISH SURVEYS WERE TRANSLATED FROM ENGLISH AND THEN BACK-TRANSLATED BY CERTIFIED TRANSLATORS ON THE RESEARCH TEAM. THE PARTICIPANT RESPONSE TIME WAS APPROXIMATELY 15 MINUTES FOR THE ELECTRONIC VERSION AND 30 MINUTES FOR THE PAPER VERSION. THE RESEARCH TEAM UTILIZED QUALTRICS, A WEB-BASED SURVEY PLATFORM, FOR THE DEVELOPMENT AND DISTRIBUTION OF THE ELECTRONIC FORMAT OF THE COMMUNITY SURVEY. SURVEY ITEM FORMATS INCLUDE MULTIPLE CHOICE, FILL-IN, LIKERT SCALE, AND RANKING. THE SURVEY WAS LAUNCHED ON OCTOBER 18, 2021 AND CLOSED ON MARCH 4, 2022 (19 WEEKS AND 4 DAYS) AND WAS DESIGNED TO COMPLEMENT THE QUALITATIVE FOCUS GROUP AND INTERVIEW DATA TO PROVIDE A COMPREHENSIVE PICTURE OF THE HEALTH STATUS, NEEDS, AND RESOURCES AS IDENTIFIED BY RESIDENTS OF CUMBERLAND, GLOUCESTER, AND SALEM COUNTIES. QUESTIONS COVERED 10 AREAS: HEALTH AND HEALTHCARE ACCESS; COVID-19; DEMOGRAPHICS; ADDITIONAL HEALTH AND HEALTHCARE ACCESS; ADDITIONAL HEALTH KNOWLEDGE/BEHAVIORS; FOOD ACCESS/SECURITY; NEIGHBORHOOD QUALITY; ADVERSE CHILDHOOD EXPERIENCES; ADDITIONAL DEMOGRAPHICS; AND CHILD HEALTH. SCHEDULE H, PART V, SECTION B, QUESTIONS 6A & 6B INSPIRA HEALTH NETWORK, INC. IS THE TAX-EXEMPT PARENT ORGANIZATION OF INSPIRA HEALTH NETWORK. INSPIRA HEALTH NETWORK, INC. IS THE SOLE CORPORATE MEMBER OR STOCKHOLDER OF VARIOUS NOT FOR-PROFIT AND FOR-PROFIT ENTITIES. THE INTERNAL REVENUE SERVICE ("IRS") HAS RECOGNIZED INSPIRA HEALTH NETWORK, INC. AS A TAX-EXEMPT ORGANIZATION UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). INSPIRA HEALTH NETWORK, INC. IS THE TAX-EXEMPT PARENT ORGANIZATION OF A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM WHICH INCLUDES INSPIRA MEDICAL CENTERS, INC. ("IMC") IN ADDITION, INSPIRA HEALTH NETWORK WORKED IN COLLABORATION WITH THE WALTER RAND INSTITUTE FOR PUBLIC AFFAIRS (WRI) AT RUTGERS UNIVERSITY-CAMDEN, AN INDEPENDENT RESEARCH AND CONSULTING FIRM TO CONDUCT THE CHNA. WRI PROVIDED THE FOLLOWING ASSISTANCE: - COLLECTED AND INTERPRETED DATA FROM SECONDARY DATA SOURCES; - ANALYZED AND INTERPRETED DATA FROM KEY INFORMANT INTERVIEWS; - COLLECTED, ANALYZED, AND INTERPRETED DATA FROM FOCUS GROUPS; - CONDUCTED, ANALYZED, AND INTERPRETED DATA FROM THE ONLINE COMMUNITY SURVEY; - PREPARED THE CHNA REPORT; and - PREPARED POWER POINT SLIDE DECK FOR DISSEMINATION SCHEDULE H, PART V, SECTION B, QUESTION 7A THE ORGANIZATION IS AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). DUE TO CHARACTER lIMITATIONS, THE WEBSITE LISTED IN SCHEDULE H, PART V, SECTION B, QUESTION 7A, IS THE HOME PAGE FOR THE SYSTEM. THE CHNA CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: WWW.INSPIRAHEALTHNETWORK.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS SCHEDULE H, PART V, SECTION B, QUESTION 10A THE ORGANIZATION IS AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN SCHEDULE H, PART V, SECTION B, QUESTION 10A, IS THE HOME PAGE FOR THE SYSTEM. THE ORGANIZATION ISSUED A JOINT IMPLEMENTATION STRATEGY FOR EACH OF THE INSPIRA HEALTH NETWORK HOSPITAL FACILITY'S. THIS JOINT IMPLEMENTATION STRATEGY CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: WWW.INSPIRAHEALTHNETWORK.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS SCHEDULE H, PART V, SECTION B, QUESTION 11 TO ENSURE INSPIRA HEALTH IS POSITIONED TO CARE FOR THE EVOLVING NEEDS OF OUR COMMUNITY AND SUSTAIN OUR GROWTH, IN 2021 WE DEVELOPED A NEW, THREE-YEAR STRATEGIC PLAN WITH FIVE KEY AREAS OF FOCUS-ALONG WITH A REIMAGINED MISSION, VISION AND VALUES. MISSION: TO PROVIDE A SAFE AND COMPASSIONATE EXPERIENCE THAT IMPROVES THE HEALTH AND WELLBEING OF OUR COMMUNITY BY PLACING THE SAFETY OF OUR PATIENTS AND SUPPORT OF OUR EMPLOYEES AT THE CENTER OF ALL WE DO. VISION: INSPIRA HEALTH INSPIRES AND EMPOWERS HEALTHIER COMMUNITIES BY CREATING THE HIGHEST QUALITY AND MOST DESIRABLE PATIENT EXPERIENCE IN THE REGION. VALUES I.C.R.E.A.T.E.: INNOVATION, COMPASSION, RELIABILITY, EMPATHY, ACCESS, TEAMWORK, EMPOWERMENT KEY AREAS OF FOCUS: - QUALITY CLINICAL EXCELLENCE, PATIENT SAFETY AND EXPERIENCE OF CARE- CONTINUALLY RAISING THE BAR TO DELIVER SAFE, HIGH QUALITY AND COMPASSIONATE CARE FOR OUR PATIENTS. - A ROBUST MEDICAL STAFF AND PHYSICIAN PLATFORM-EXPANDING ACCESS TO MORE PHYSICIANS AND NEW SERVICES TO SUPPORT OUR PATIENTS' HEALTH CARE NEEDS. - PATIENT- AND CONSUMER-CENTRIC ACCESSIBILITY AND CONVENIENCE-REFINING OUR PATIENT EXPERIENCE TO BE AS SEAMLESS AS POSSIBLE. - TALENT ACQUISITION, DEVELOPMENT AND RETENTION, AND CULTURAL ENGAGEMENT- BUILDING THE NEXT GENERATION OF LEADERS TO HELP US GROW ACCESS FOR OUR COMMUNITIES. - POPULATION HEALTH MANAGEMENT AND COMMUNITY HEALTH-EXTENDING OUR CARE BEYOND OUR WALLS AND INTO THE COMMUNITY TO SUPPORT A HEALTHIER SOUTH JERSEY. IN 2022 AND MOVING FORWARD, WE ARE TAKING THE VISION OUTLINED IN THE STRATEGIC PLAN AND LEVERAGING TACTICS THAT WILL BEST HELP US ACHIEVE THOSE GOALS THROUGH AN INITIATIVE CALLED OPERATIONAL ADVANTAGE, WHICH WILL THREAD EACH DOMAIN THROUGH THE LENS OF OPERATIONS. OPERATIONAL ADVANTAGE IS A ROAD MAP THAT SETS OUR STRATEGIC COURSE AND PROVIDES OPPORTUNITIES FOR MEASUREMENT AND OPTIMIZATION ALONG THE WAY. COVID-19 -------- COVID-19 DEEPLY AFFECTED ALL AVENUES OF DAILY LIFE OVER THE PAST TWO YEARS. BOTH QUANTITATIVE AND QUALITATIVE DATA COLLECTED THROUGH THE CHNA AND THROUGH OTHER RECENT PROJECTS (RELATED TO WORKFORCE, SOCIAL SERVICE DELIVERY AND RESIDENT EXPERIENCES DURING COVID-19 IN SOUTHERN NEW JERSEY) HIGHLIGHT THE WAYS THE PANDEMIC EXACERBATED INEQUITIES, DISRUPTED PATTERNS AND ROUTINES, AND CHANGED HOW WE WORK, PLAY AND LIVE IN OUR COMMUNITIES. INSPIRA HEALTH COMMITS TO DEVELOPING AND/OR SUPPORTING INITIATIVES WITH THE FOLLOWING OBJECTIVE IN MIND: - DEVELOP A PLAYBOOK TEMPLATE, PROCEDURAL TEMPLATE AND PRESENTATION TEMPLATE THAT UTILIZE A HIERARCHY OF CONTROL SPECIFICALLY FOR PANDEMICS (COVID-19), WITH GUIDELINES FOR EACH LEVEL OF CONTROL. MENTAL HEALTH ------------- RESOURCES AND SERVICES FOR MENTAL HEALTH CARE REMAIN A PRIORITY FOR RESIDENTS IN THE THREE-COUNTY REGION. THE UNCERTAINTY, ISOLATION AND COLLECTIVE TRAUMA EXPERIENCED DURING THE PANDEMIC NOT ONLY INCREASED MENTAL HEALTH CHALLENGES DURING THIS TIME, BUT ALSO CRYSTALLIZED THE IMPORTANCE OF AVAILABILITY OF MENTAL HEALTH TREATMENT AND SERVICES. WHEN ASKED ABOUT HEALTH ISSUES IN THEIR COMMUNITY, RESIDENTS REPORT MENTAL HEALTH WAS THE TOP ISSUE, WITH 66% SAYING MENTAL HEALTH WAS AN ISSUE IN THEIR COMMUNITY. SURVEY RESULTS DEMONSTRATED SUBSTANCE MISUSE WAS ALSO A CONCERN AMONG RESIDENTS IN THIS THREE-COUNTY REGION, WITH ILLEGAL DRUG USE RANKING THIRD (53%), ALCOHOL USE RANKING EIGHTH (39%) AND PRESCRIPTION DRUG USE RANKING NO.13 (35%). INSPIRA HEALTH COMMITS TO DEVELOPING AND/OR SUPPORTING INITIATIVES WITH THE FOLLOWING OBJECTIVES IN MIND: - INCREASE ACCESS TO TREATMENT FOR BEHAVIORAL HEALTH CONDITIONS; and - DECREASE THE NUMBER OF DEATHS FROM SUBSTANCE MISUSE. ACCESSIBLITY, AVAILABILITY, AND AFFORDABLITY OF HEALTHCARE ---------------------------------------------------------- DATA EXAMINATION REVEALED ANOTHER IMPORTANT THEME OF ACCESS, AVAILABILITY AND AFFORDABILITY OF SERVICES IN THE THREE-COUNTY REGION. THE TOPIC OF ACCESS TO CARE REMAINS AN ESSENTIAL CONCERN FOR PEOPLE AROUND THE COUNTRY AS COVID-19 BROUGHT PEOPLE'S LIVES AND THEIR DAILY ROUTINES TO A SUDDEN HALT. MOREOVER, IN RURAL AREAS IN OUR REGION, ADDITIONAL CHALLENGES EXISTED AROUND TRANSPORTATION, AVAILABILITY OF PROVIDERS AND AFFORDABILITY OF CARE THROUGHOUT THE PANDEMIC. INSPIRA HEALTH COMMITS TO DEVELOPING AND/OR SUPPORTING INITIATIVES WITH THE FOLLOWING OBJECTIVES IN MIND: - INCREASE COMPLEMENT OF PRIMARY CARE, SPECIALIST AND MENTAL HEALTH PROVIDERS IN THE SERVICE AREA, INCLUDING SPANISH-SPEAKING PROVIDERS; - INCREASE ACCESS TO AFFORDABLE PRESCRIPTION MEDICATION; - INCREASE PREVENTIVE HEALTH AND CANCER SCREENINGS; - INCREASE CLINICAL NAVIGATION PROGRAM OFFERINGS; - INCREASE NUMBER OF INSURED INDIVIDUALS; and - INCREASE INITIATION OF PRENATAL CARE. ACCESS TO CHILDREN'S HEALTHCARE ------------------------------- THERE ARE SEVERAL BARRIERS RELATED TO CHILDREN AND THEIR HEALTH, WELL-BEING AND CARE THAT EXIST IN CUMBERLAND, GLOUCESTER AND SALEM COUNTIES. THESE REGIONS ARE UNDERSERVED IN TERMS OF MEDICAL PROVIDERS, MENTAL HEALTH EXPERTS, SPECIALIZED CARE, COMMUNITY RESOURCES, EDUCATIONAL INSTITUTIONS AND CHILDCARE. PARENTS, CAREGIVERS, COMMUNITY MEMBERS, SERVICE PROVIDERS AND KEY STAKEHOLDERS ALL REPORTED THE ONGOING STRUGGLES WITH ACCESSING THE NECESSARY SERVICES FOR CHILDREN DUE TO TRANSPORTATION CHALLENGES, NOT ENOUGH PROVIDERS FOR PEDIATRIC AND MENTAL HEALTH CARE, AND OBSTACLES TO ACCESSING CARE AND SERVICES. THE COMMUNITY SURVEY DATA HIGHLIGHTED THAT NEARLY 20% OF RESIDENTS ACROSS THE THREE COUNTIES REPORTED THAT CHILDREN/YOUTH WERE UNDERSERVED MEMBERS OF THEIR COMMUNITY, AND NEARLY 33% SAID THAT PEDIATRIC SERVICE PROVIDERS WERE A RESOURCE MISSING IN THEIR COMMUNITIES. INSPIRA HEALTH COMMITS TO DEVELOPING AND/OR SUPPORTING INITIATIVES WITH THE FOLLOWING OBJECTIVES IN MIND: - INCREASE PEDIATRIC AND MENTAL HEALTH PROVIDERS FOR CHILDREN/YOUTH; - HELP YOUNG PEOPLE NAVIGATE THEIR ADOLESCENT YEARS, FINISH THEIR EDUCATION, OBTAIN SKILLS LEADING TO EMPLOYMENT AND GRADUATE HEALTHY AND DRUG FREE; and - HELP CHILDREN DEVELOP SKILLS FOR HEALTHY LIVING AND POSITIVE LIFE CHOICES. FOOD AND DIET ------------- FOOD DESERTS ARE INCREASINGLY COMMON ACROSS THE U.S. IN 2020, AS MANY AS 13.8 MILLION HOUSEHOLDS IN THE U.S. EXPERIENCED FOOD INSECURITY (10.5% OF THE POPULATION), WITH APPROXIMATELY 1.5 MILLION HOUSEHOLDS IN NEW JERSEY ALONE. DESPITE SOUTHERN NEW JERSEY BEING HOME TO AN ABUNDANCE OF FARMLAND AND AGRICULTURAL HUBS, RESIDENTS OF SALEM, CUMBERLAND AND GLOUCESTER COUNTIES ARE CONTINUOUSLY FACING DEEP-ROOTED FOOD INSTABILITY. STUDIES DATING BACK TO 2011 SUGGEST THAT LITTLE PROGRESS HAS BEEN MADE OVER THE COURSE OF OVER A DECADE AND THAT HARDSHIPS IN FOOD SECURITY CONTINUE. INSPIRA HEALTH COMMITS TO DEVELOPING AND/OR SUPPORTING INITIATIVES WITH THE FOLLOWING OBJECTIVES IN MIND: - IDENTIFY PATIENTS WITH FOOD INSECURITY; - INCREASE ACCESS TO HEALTHY FOODS AND OTHER NECESSITIES THAT ARE OFTEN PURCHASED IN LIEU OF FOOD (DIAPERS, PERIOD PRODUCTS); and - REDUCE RATE OF OBESITY. SCHEDULE H, PART V, SECTION B, QUESTION 16 THE ORGANIZATION IS AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN SCHEDULE H, PART V, SECTION B, QUESTION 16, IS THE HOME PAGE FOR THE SYSTEM. THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION AND PLAIN LANGUAGE SUMMARY ARE MADE WIDELY AVAILABLE ON THE ORGANIZATION'S WEBSITE. THESE DOCUMENTS CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: HTTPS://WWW.INSPIRAHEALTHNETWORK.ORG/SITES/DEFAULT/FILES/ACCESSMEDFORM/01_ 16_FINANCIAL_ASSISTANCE%20POLICY_PLAIN_LANGUAGE_SUMMARY_PLS.PDF 1 SALEM PHYSICAL THERAPY 499 BECKETT ROAD LOGAN TOWNSHIP NJ 08085 OUTPATIENT - PT SCHEDULE H, PART I; LINE 3C IN ADDITION TO THE FEDERAL POVERTY GUIDELINES, THE ORGANIZATION USES OTHER FACTORS IN DETERMINING ELIGIBILITY CRITERIA FOR FREE AND DISCOUNTED CARE. AS OUTLINED IN PART V, SECTION B, QUESTION 13, OTHER FACTORS TO DETERMINE ELIGIBILITY INCLUDE: - ASSET LEVEL; - MEDICAL INDIGENCY; - INSURANCE STATUS; - UNDERINSURANCE STATUS; AND - RESIDENCY. ADDITIONAL INFORMATION WITH RESPECT TO THE ORGANIZATION'S ELIGIBILITY CRITERIA FOR FINANCIAL ASSISTANCE IS OUTLINED BELOW. NEW JERSEY HOSPITAL CHARITY CARE PAYMENT ASSISTANCE PROGRAM ("CHARITY CARE") ------------------------------------------------------------------------- CHARITY CARE IS A NEW JERSEY PROGRAM IN WHICH FREE OR DISCOUNTED CARE IS AVAILABLE TO PATIENTS WHO RECEIVE INPATIENT AND OUTPATIENT SERVICES AT ACUTE CARE HOSPITALS THROUGHOUT THE STATE OF NEW JERSEY. HOSPITAL ASSISTANCE AND REDUCED CHARGE CARE ARE ONLY AVAILABLE FOR NECESSARY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. PATIENTS MAY BE ELIGIBLE FOR CHARITY CARE IF THEY ARE NEW JERSEY RESIDENTS WHO: 1) HAVE NO HEALTH COVERAGE OR HAVE COVERAGE THAT PAYS ONLY PART OF THE HOSPITAL BILL (UNINSURED OR UNDERINSURED); 2) ARE INELIGIBLE FOR ANY PRIVATE OR GOVERNMENTAL SPONSORED COVERAGE (SUCH AS MEDICAID); AND 3) MEET THE FOLLOWING INCOME AND ASSET ELIGIBILITY CRITERIA DESCRIBED BELOW. INCOME CRITERIA: PATIENTS WITH FAMILY GROSS INCOME LESS THAN OR EQUAL TO 200% OF FEDERAL POVERTY GUIDELINES ("FPG") ARE ELIGIBLE FOR 100% CHARITY CARE COVERAGE. PATIENTS WITH FAMILY GROSS INCOME GREATER THAN 200% AND LESS THAN OR EQUAL TO 300% OF FPG ARE ELIGIBLE FOR DISCOUNTED CARE. FREE CARE OR PARTIALLY COVERED CHARGES WILL BE DETERMINED BY USE OF THE NEW JERSEY DEPARTMENT OF HEALTH FEE SCHEDULE. IF PATIENTS ON THE 20% TO 80% SLIDING FEE SCALE ARE RESPONSIBLE FOR QUALIFIED OUT-OF-POCKET PAID MEDICAL EXPENSES IN EXCESS OF 30% OF THEIR GROSS ANNUAL INCOME (I.E. BILLS UNPAID BY OTHER PARTIES), THEN THE AMOUNT IN EXCESS OF 30% IS CONSIDERED HOSPITAL CARE PAYMENT ASSISTANCE. ASSET CRITERIA: CHARITY CARE INCLUDES ASSET ELIGIBILITY THRESHOLDS WHICH STATES THAT INDIVIDUAL ASSETS CANNOT EXCEED $7,500 AND FAMILY ASSETS CANNOT EXCEED $15,000 AS OF THE DATE OF SERVICE. CHARITY CARE MAY BE AVAILABLE TO NON-NEW JERSEY RESIDENTS, REQUIRING IMMEDIATE MEDICAL ATTENTION FOR AN EMERGENCY MEDICAL CONDITION. NEW JERSEY UNINSURED DISCOUNT (PUBLIC LAW 2008, C. 60) ------------------------------------------------------ UNINSURED PATIENTS WITH FAMILY GROSS INCOME LESS THAN 500% OF FPG MAY BE ELIGIBLE FOR DISCOUNTED CARE UNDER THIS PROGRAM. ELIGIBLE INDIVIDUALS MUST BE NEW JERSEY RESIDENTS. NJ FAMILYCARE ------------- NJ FAMILYCARE IS NEW JERSEY'S PUBLICLY FUNDED HEALTH INSURANCE PROGRAM WHICH INCLUDES CHIP, MEDICAID AND MEDICAID EXPANSION POPULATIONS. NJ FAMILYCARE IS A FEDERAL AND STATE FUNDED HEALTH INSURANCE PROGRAM CREATED TO HELP QUALIFIED NEW JERSEY RESIDENTS OF ANY AGE ACCESS TO AFFORDABLE HEALTH INSURANCE. NJ FAMILYCARE IS FOR PEOPLE WHO DO NOT HAVE EMPLOYER INSURANCE. FINANCIAL ELIGIBILITY FOR INDIVIDUALS SEEKING ELIGIBILITY FOR NJ FAMILYCARE WILL BE BASED ON THEIR MODIFIED ADJUSTED GROSS INCOME ("MAGI"). NJFAMILYCARE ELIGIBILITY GUIDELINES ARE ESTABLISHED BY THE STATE OF NEW JERSEY AND CAN BE FOUND AT WWW.NJFAMILYCARE.ORG. NEW JERSEY CANCER EDUCATION AND EARLY DETECTION ("NJCEED") ---------------------------------------------------------- THE NJCEED PROGRAM PROVIDES COMPREHENSIVE OUTREACH, EDUCATION AND SCREENING SERVICES FOR BREAST, CERVICAL, COLORECTAL AND PROSTATE CANCERS. A PATIENT MUST BE UNINSURED OR UNDERINSURED AND MUST HAVE FAMILY GROSS INCOME AT OR BELOW 250% OF FPG TO BE ELIGIBLE. ADDITIONAL INFORMATION CAN BE FOUND AT THE FOLLOWING WEBSITE: HTTPS://NJ.GOV/HEALTH/CES/PUBLIC/RESOURCES/NJCEED.SHTML. CATASTROPHIC ILLNESS IN CHILDREN RELIEF FUND -------------------------------------------- THE CATASTROPHIC ILLNESS IN CHILDREN RELIEF FUND PROVIDES FINANCIAL ASSISTANCE TO FAMILIES OF CHILDREN WITH A CATASTROPHIC ILLNESS. IN ORDER TO BE ELIGIBLE, HOSPITAL EXPENSES MUST EXCEED 10% OF THE FAMILY'S GROSS INCOME, PLUS 15% OF ANY EXCESS INCOME OVER $100,000, THE CHILD MUST HAVE BEEN 21 YEARS OR YOUNGER WHEN THE MEDICAL EXPENSES WERE INCURRED AND THE FAMILY MUST HAVE LIVED IN NEW JERSEY FOR THREE MONTHS IMMEDIATELY PRIOR TO THE DATE OF APPLICATION. ADDITIONAL INFORMATION CAN BE FOUND AT THE FOLLOWING WEBSITE: WWW.STATE.NJ.US/HUMANSERVICES/CICRF/HOME. NEW JERSEY VICTIMS OF CRIME COMPENSATION OFFICE ----------------------------------------------- THE STATE OF NEW JERSEY HAS ESTABLISHED THE NEW JERSEY VICTIMS OF CRIME COMPENSATION OFFICE TO COMPENSATE VICTIMS OF CRIME FOR LOSSES AND EXPENSES, INCLUDING CERTAIN MEDICAL EXPENSES, RESULTING FROM CERTAIN CRIMINAL ACTS. IN ORDER TO BE ELIGIBLE FOR NEW JERSEY VICTIMS OF CRIME COMPENSATION OFFICE THE CRIME MUST HAVE OCCURRED IN NEW JERSEY OR MUST RELATE TO A NEW JERSEY RESIDENT VICTIMIZED OUTSIDE OF THE STATE, THE VICTIM MUST HAVE REPORTED THE CRIME TO POLICE WITHIN NINE MONTHS AND VICTIM MUST COOPERATE WITH THE INVESTIGATION AND PROSECUTION OF THE CRIME. THE CLAIM MUST BE FILED WITHIN THREE YEARS OF THE DATE OF THE CRIME AND THE PATIENT MUST BE AN INNOCENT VICTIM OF THE CRIME. ADDITIONAL INFORMATION CAN BE FOUND AT HTTPS://WWW.NJOAG.GOV/RESOURCES/VICTIM-WITNESS-SERVICES/. HOSPITAL FINANCIAL ASSISTANCE PROGRAM/SUBSIDY PROGRAM ----------------------------------------------------- PATIENTS THAT DO NOT QUALIFY FOR ANY OF THE GOVERNMENT FUNDED PROGRAMS OR NEW JERSEY CHARITY CARE MAY ELECT TO BE SCREENED BY FINANCIAL COUNSELING FOR THE HOSPITAL FINANCIAL ASSISTANCE PROGRAM/SUBSIDY PROGRAM. PATIENTS MAY BE ELIGIBLE FOR DISCOUNTS UNDER THE HOSPITAL FINANCIAL ASSISTANCE PROGRAM/SUBSIDY PROGRAM IF THEIR FAMILY GROSS INCOME IS BETWEEN 225% AND 550% OF FPL. ADDITIONALLY, IF THESE PATIENTS HAVE ASSETS IN EXCESS OF $50,000 THEY MAY BE REQUIRED TO PROVIDE PROOF OF ASSETS. PURSUANT TO INTERNAL REVENUE CODE SECTION 501(R)(5), IN THE CASE OF EMERGENCY OR OTHER MEDICALLY NECESSARY CARE, FAP-ELIGIBLE PATIENTS WILL NOT BE CHARGED MORE THAN AN INDIVIDUAL WHO HAS INSURANCE COVERING SUCH CARE. PATIENTS MAY BE ELIGIBLE FOR THIS DISCOUNT IF THEY ARE UNINSURED AND HAVE FAMILY GROSS INCOME LESS THAN 550% OF FPG. ADDITIONALLY, UNDERINSURED PATIENTS MAY BE ELIGIBLE IF THEIR FAMILY GROSS INCOME IS GREATER THAN 200% BUT LESS THAN OR EQUAL TO 300% OF FPG. SCHEDULE H, PART I, QUESTION 6A THE ORGANIZATION ANNUALLY PUBLISHES A REPORT WHICH HIGHLIGHTS ITS ANNUAL ACHIEVEMENTS AS WELL AS ITS PROGRAMS AND SERVICES THAT PROMOTE THE HEALTH OF THE COMMUNITIES SERVED. THIS REPORT IS MADE WIDELY AVAILABLE AND CAN BE FOUND ON THE ORGANIZATION'S WEBSITE. SCHEDULE H, PART I, QUESTION 7 THE ORGANIZATION UTILIZED THE COST ACCOUNTING SYSTEM. SCHEDULE H, PART II NOT APPLICABLE. SCHEDULE H, PART III, SECTION A, QUESTIONS 2, 3 & 4 THE FOOTNOTE BELOW EXPLAINS THE ORGANIZATION'S METHODOLOGY WITH RESPECT TO PATIENT ACCOUNTS RECEIVABLE. THE NETWORK ASSESSES COLLECTABILITY ON PATIENT CONTRACTS PRIOR TO THE RECOGNITION OF NET PATIENT SERVICE REVENUE. PATIENT ACCOUNTS RECEIVABLE, NET, ARE RECORDED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THE NETWORK HAS EXHAUSTED ALL COLLECTION EFFORTS AND DETERMINES ACCOUNTS ARE IMPAIRED BASED ON CHANGES IN CREDIT WORTHINESS. SCHEDULE H, PART III, SECTION B, QUESTION 8 MEDICARE COSTS WERE DERIVED FROM THE 2023 MEDICARE COST REPORT USING 2023 COST ACCOUNTING DATA. THE ORGANIZATION FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL), BAD DEBT AND ASSOCIATED COSTS ARE COMMUNITY BENEFIT AND ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. AS OUTLINED MORE FULLY BELOW, THE ORGANIZATION BELIEVES THAT THESE SERVICES AND RELATED COSTS PROMOTE THE HEALTH OF THE COMMUNITY AS A WHOLE AND ARE RENDERED IN CONJUNCTION WITH THE ORGANIZATION'S CHARITABLE TAX-EXEMPT PURPOSES AND MISSION IN PROVIDING MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER WITHOUT REGARD TO RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY AND CONSISTENT WITH THE COMMUNITY BENEFIT STANDARD PROMULGATED BY THE IRS. THE COMMUNITY BENEFIT STANDARD IS THE CURRENT STANDARD FOR A HOSPITAL FOR RECOGNITION AS A TAX-EXEMPT AND CHARITABLE ORGANIZATION UNDER INTERNAL REVENUE CODE ("IRC") 501(C)(3). THE ORGANIZATION IS RECOGNIZED AS A TAX-EXEMPT ENTITY AND CHARITABLE ORGANIZATION UNDER 501(C)(3) OF THE IRC. ALTHOUGH THERE IS NO DEFINITION IN THE TAX CODE FOR THE TERM "CHARITABLE" A REGULATION PROMULGATED BY THE DEPARTMENT OF THE TREASURY PROVIDES SOME GUIDANCE AND STATES THAT "THE TERM CHARITABLE IS USED IN SECTION 501(C)(3) IN ITS GENERALLY ACCEPTED LEGAL SENSE,PROVIDES EXAMPLES OF CHARITABLE PURPOSES, INCLUDING THE RELIEF OF THE POOR OR UNPRIVILEGED; THE PROMOTION OF SOCIAL WELFARE; AND THE ADVANCEMENT OF EDUCATION, RELIGION, AND SCIENCE. NOTE IT DOES NOT EXPLICITLY ADDRESS THE ACTIVITIES OF HOSPITALS. IN THE ABSENCE OF EXPLICIT STATUTORY OR REGULATORY REQUIREMENTS APPLYING THE TERM "CHARITABLE" TO HOSPITALS, IT HAS BEEN LEFT TO THE IRS TO DETERMINE THE CRITERIA HOSPITALS MUST MEET TO QUALIFY AS IRC 501(C)(3) CHARITABLE ORGANIZATIONS. THE ORIGINAL STANDARD WAS KNOWN AS THE CHARITY CARE STANDARD. THIS STANDARD WAS REPLACED BY THE IRS WITH THE COMMUNITY BENEFIT STANDARD WHICH IS THE CURRENT STANDARD. CHARITY CARE STANDARD IN 1956, THE IRS ISSUED REVENUE RULING 56-185, WHICH ADDRESSED THE REQUIREMENTS HOSPITALS NEEDED TO MEET IN ORDER TO QUALIFY FOR IRC 501(C)(3) STATUS. ONE OF THESE REQUIREMENTS IS KNOWN AS THE "CHARITY CARE STANDARD." UNDER THE STANDARD, A HOSPITAL MUST PROVIDE, TO THE EXTENT OF ITS FINANCIAL ABILITY, FREE OR REDUCED-COST CARE TO PATIENTS WHO CANNOT PAY FOR SUCH SERVICES. A HOSPITAL THAT EXPECTED FULL PAYMENT DID NOT, ACCORDING TO THE RULING, PROVIDE CHARITY CARE BASED ON THE FACT THAT SOME PATIENTS ULTIMATELY FAILED TO PAY. THE RULING EMPHASIZED THAT A LOW LEVEL OF CHARITY CARE DID NOT NECESSARILY MEAN THAT A HOSPITAL HAD FAILED TO MEET THE REQUIREMENT SINCE THAT LEVEL COULD REFLECT ITS FINANCIAL ABILITY TO PROVIDE SUCH CARE. THE RULING ALSO NOTED THAT PUBLICLY SUPPORTED COMMUNITY HOSPITALS WOULD NORMALLY QUALIFY AS CHARITABLE ORGANIZATIONS BECAUSE THEY SERVE THE ENTIRE COMMUNITY AND A LOW LEVEL OF CHARITY CARE WOULD NOT AFFECT A HOSPITAL'S EXEMPT STATUS IF IT WAS DUE TO THE SURROUNDING COMMUNITY'S LACK OF CHARITABLE DEMANDS. COMMUNITY BENEFIT STANDARD IN 1969, THE IRS ISSUED REVENUE RULING 69-545, WHICH "REMOVED" FROM REVENUE RULING 56-185 "THE REQUIREMENTS RELATING TO CARING FOR PATIENTS WITHOUT CHARGE OR AT RATES BELOW COST." UNDER THE STANDARD DEVELOPED IN REVENUE RULING 69-545, WHICH IS KNOWN AS THE "COMMUNITY BENEFIT STANDARD," HOSPITALS ARE JUDGED ON WHETHER THEY PROMOTE THE HEALTH OF A BROAD CLASS OF INDIVIDUALS IN THE COMMUNITY. THE RULING INVOLVED A HOSPITAL THAT ONLY ADMITTED INDIVIDUALS WHO COULD PAY FOR THE SERVICES (BY THEMSELVES, PRIVATE INSURANCE, OR PUBLIC PROGRAMS SUCH AS MEDICARE), BUT OPERATED A FULL-TIME EMERGENCY ROOM THAT WAS OPEN TO EVERYONE. THE IRS RULED THAT THE HOSPITAL QUALIFIED AS A CHARITABLE ORGANIZATION BECAUSE IT PROMOTED THE HEALTH OF PEOPLE IN ITS COMMUNITY. THE IRS REASONED THAT BECAUSE THE PROMOTION OF HEALTH WAS A CHARITABLE PURPOSE ACCORDING TO THE GENERAL LAW OF CHARITY, IT FELL WITHIN THE "GENERALLY ACCEPTED LEGAL SENSE" OF THE TERM "CHARITABLE," AS REQUIRED BY THE DEPARTMENT OF TREASURY REG. 1.501(C)(3)-1(D)(2). THE IRS RULING STATED THAT THE PROMOTION OF HEALTH, LIKE THE RELIEF OF POVERTY AND THE ADVANCEMENT OF EDUCATION AND RELIGION, IS ONE OF THE PURPOSES IN THE GENERAL LAW OF CHARITY THAT IS DEEMED BENEFICIAL TO THE COMMUNITY AS A WHOLE EVEN THOUGH THE CLASS OF BENEFICIARIES ELIGIBLE TO RECEIVE A DIRECT BENEFIT FROM ITS ACTIVITIES DOES NOT INCLUDE ALL MEMBERS OF THE COMMUNITY, SUCH AS INDIGENT MEMBERS OF THE COMMUNITY, PROVIDED THAT THE CLASS IS NOT SO SMALL THAT ITS RELIEF IS NOT OF BENEFIT TO THE COMMUNITY. THE IRS CONCLUDED THAT THE HOSPITAL WAS "PROMOTING THE HEALTH OF A CLASS OF PERSONS THAT IS BROAD ENOUGH TO BENEFIT THE COMMUNITY" BECAUSE ITS EMERGENCY ROOM WAS OPEN TO ALL AND IT PROVIDED CARE TO EVERYONE WHO COULD PAY, WHETHER DIRECTLY OR THROUGH THIRD-PARTY REIMBURSEMENT. OTHER CHARACTERISTICS OF THE HOSPITAL THAT THE IRS HIGHLIGHTED INCLUDED THE FOLLOWING: ITS SURPLUS FUNDS WERE USED TO IMPROVE PATIENT CARE, EXPAND HOSPITAL FACILITIES, AND ADVANCE MEDICAL TRAINING, EDUCATION AND RESEARCH; IT WAS CONTROLLED BY A BOARD OF TRUSTEES THAT CONSISTED OF INDEPENDENT CIVIC LEADERS; AND HOSPITAL MEDICAL STAFF PRIVILEGES WERE AVAILABLE TO ALL QUALIFIED PHYSICIANS. THE AMERICAN HOSPITAL ASSOCIATION ("AHA") FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT ARE COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THIS ORGANIZATION AGREES WITH THE AHA'S POSITION. AS OUTLINED IN THE AHA'S LETTER TO THE IRS DATED AUGUST 21, 2007 WITH RESPECT TO THE FIRST PUBLISHED DRAFT OF THE NEW FORM 990 AND SCHEDULE H, THE AHA FELT THAT THE IRS SHOULD INCORPORATE THE FULL VALUE OF THE COMMUNITY BENEFIT THAT HOSPITALS PROVIDE BY COUNTING MEDICARE UNDERPAYMENTS (SHORTFALL) AS QUANTIFIABLE COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: - PROVIDING CARE FOR THE ELDERLY AND SERVING MEDICARE PATIENTS IS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD - MEDICARE, LIKE MEDICAID, DOES NOT PAY THE FULL COST OF CARE. FROM THE LATEST DATA PROVIDED BY THE AHA, AS OF 2017, MEDICARE REIMBURSES HOSPITALS ONLY 87 CENTS FOR EVERY DOLLAR THEY SPEND TO TAKE CARE OF MEDICARE PATIENTS. - MANY MEDICARE BENEFICIARIES, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR. MORE THAN 42 PERCENT OF MEDICARE SPENDING IS FOR BENEFICIARIES WHOSE INCOME IS BELOW 200 PERCENT OF THE FEDERAL POVERTY LEVEL. MANY OF THOSE MEDICARE BENEFICIARIES ARE ALSO ELIGIBLE FOR MEDICAID -- SO CALLED ELIGIBLE." THERE IS EVERY COMPELLING PUBLIC POLICY REASON TO TREAT MEDICARE AND MEDICAID UNDERPAYMENTS SIMILARLY FOR PURPOSES OF A HOSPITAL'S COMMUNITY BENEFIT AND INCLUDE THESE COSTS ON FORM 990, SCHEDULE H, PART I. MEDICARE UNDERPAYMENT MUST BE SHOULDERED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE COMMUNITY'S ELDERLY AND POOR. THESE UNDERPAYMENTS REPRESENT A REAL COST OF SERVING THE COMMUNITY AND SHOULD COUNT AS A QUANTIFIABLE COMMUNITY BENEFIT. BOTH THE AHA AND THIS ORGANIZATION ALSO FEEL THAT PATIENT BAD DEBT IS A COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. LIKE MEDICARE UNDERPAYMENT (SHORTFALLS), THERE ALSO ARE COMPELLING REASONS THAT PATIENT BAD DEBT SHOULD BE COUNTED AS QUANTIFIABLE COMMUNITY BENEFIT AS FOLLOWS: - A SIGNIFICANT MAJORITY OF BAD DEBT IS ATTRIBUTABLE TO LOW-INCOME PATIENTS, WHO, FOR MANY REASONS, DECLINE TO COMPLETE THE FORMS REQUIRED TO ESTABLISH ELIGIBILITY FOR HOSPITALS' CHARITY CARE OR THOSE WHO DO NOT PAY ALL, OR A PORTION OF THE ALREADY DISCOUNTED BILLED AMOUNTS UNDER OUR FINANCIAL ASSISTANCE POLICY. A 2006 CONGRESSIONAL BUDGET OFFICE ("CBO") REPORT, NONPROFIT HOSPITALS AND THE PROVISION OF COMMUNITY BENEFITS, CITED TWO STUDIES INDICATING THAT "THE GREAT MAJORITY OF BAD DEBT WAS ATTRIBUTABLE TO PATIENTS WITH INCOMES BELOW 200% OF THE FEDERAL POVERTY LINE." - THE REPORT ALSO NOTED THAT A SUBSTANTIAL PORTION OF BAD DEBT IS PENDING CHARITY CARE. UNLIKE BAD DEBT IN OTHER INDUSTRIES, HOSPITAL BAD DEBT IS COMPLICATED BY THE FACT THAT HOSPITALS FOLLOW THEIR MISSION TO THE COMMUNITY AND TREAT EVERY PATIENT THAT COMES THROUGH THEIR EMERGENCY DEPARTMENT, REGARDLESS OF ABILITY TO PAY. PATIENTS WHO HAVE OUTSTANDING BILLS ARE NOT TURNED AWAY, UNLIKE OTHER INDUSTRIES. BAD DEBT IS FURTHER COMPLICATED BY THE AUDITING INDUSTRY'S STANDARDS ON REPORTING CHARITY CARE. MANY PATIENTS CANNOT OR DO NOT PROVIDE THE NECESSARY, EXTENSIVE DOCUMENTATION REQUIRED TO BE DEEMED CHARITY CARE BY AUDITORS. AS A RESULT, ROUGHLY 40% OF BAD DEBT IS PENDING CHARITY CARE. THE CBO CONCLUDED THAT ITS FINDINGS "SUPPORT THE VALIDITY OF THE USE OF UNCOMPENSATED CARE [BAD DEBT AND CHARITY CARE] AS A MEASURE OF COMMUNITY BENEFIT" ASSUMING THE FINDINGS ARE GENERALIZABLE NATIONWIDE; THE EXPERIENCE OF HOSPITALS AROUND THE NATION REINFORCES THAT THEY ARE GENERALIZABLE. AS OUTLINED BY THE AHA, DESPITE THE HOSPITAL'S BEST EFFORTS AND DUE DILIGENCE, PATIENT BAD DEBT IS A PART OF THE HOSPITAL'S MISSION AND CHARITABLE PURPOSES. BAD DEBT REPRESENTS PART OF THE BURDEN H SCHEDULE H, PART III, SECTION B, QUESTION 9B ACCOUNTS CONSIDERED TO BE FINANCIAL ASSISTANCE ARE NOT INCLUDED IN THE BAD DEBT EXPENSE, BUT RATHER, ACCOUNTED FOR AS AN ALLOWANCE. IT IS THE POLICY OF INSPIRA HEALTH NETWORK ("INSPIRA") TO TREAT ALL PATIENTS EQUALLY REGARDLESS OF INSURANCE AND THEIR ABILITY TO PAY. ADDITIONALLY, INSPIRA IS COMMITTED TO BILLING PATIENTS AND INSURANCE CARRIERS IN A MANNER THAT IS IN COMPLIANCE WITH ALL STATE, LOCAL AND FEDERAL REGULATIONS. THE ORGANIZATION'S BILLING AND COLLECTION POLICIES AND PROCEDURES ARE OUTLINED WITHIN THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY ("FAP"). THIS POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. ACCORDING TO INSPIRA'S BILLING AND COLLECTION POLICY INSPIRA ABIDES BY THE FOLLOWING PROCEDURES WHEN PURSUING BILLING AND COLLECTION ACTIONS: BILLING PROCEDURES ------------------ UNTIL PATIENTS ARE DEEMED ELIGIBLE AND APPROVED FOR FINANCIAL ASSISTANCE UNDER THIS POLICY, INSPIRA WILL CONTINUE ITS NORMAL BILLING AND COLLECTION ACTIVITIES AS FOLLOWS: (1) INSPIRA WILL PROVIDE SUFFICIENT ACCOUNT FOLLOW-UP SERVICE TO ENSURE THAT INSURERS AND PATIENTS RECEIVE ACCURATE ACCOUNT AND BILLING INFORMATION. (2) PATIENTS WILL HAVE THE OPPORTUNITY TO MAKE PAYMENT AND/OR APPLY FOR FINANCIAL ASSISTANCE FOR ALL OUTSTANDING BALANCES. THE BILLING PROCESS IS PERFORMED IN ACCORDANCE WITH THE FOLLOWING GUIDELINES: - FOR ALL INSURED PATIENTS, INSPIRA BILLS ALL THIRD PARTY PAYER INFORMATION (AS PROVIDED BY OR VERIFIED BY THE PATIENT) ON A TIMELY BASIS. - IF A CLAIM IS DENIED (OR NOT PROCESSED) BY A PAYER DUE TO A HOSPITAL ERROR, INSPIRA WILL NOT BILL THE PATIENT FOR ANY AMOUNT IN EXCESS OF THAT FOR WHICH THE PATIENT WOULD HAVE BEEN LIABLE HAD THE PAYER PAID THE CLAIM. - AFTER CLAIMS ARE PROCESSED BY PAYERS, INSPIRA BILLS PATIENTS ON A TIMELY BASIS FOR THEIR RESPECTIVE LIABILITY AMOUNTS AS DETERMINED BY THEIR INSURERS. - ALL UNINSURED PATIENTS ARE BILLED DIRECTLY ON A TIMELY BASIS. - ACCOUNTS MAY BE REFERRED FOR COLLECTION IF THERE IS REASONABLE BASIS TO BELIEVE THAT THE PATIENT OWES THE DEBT. HOWEVER, ACCOUNTS MAY BE PLACED WITH A COLLECTION AGENCY NO SOONER THAN 120 DAYS FROM THE DATE OF FIRST POST-DISCHARGE BILLING STATEMENT ("NOTIFICATION PERIOD"). ACCOUNTS MAY BE REFERRED FOR COLLECTION IF ALL THIRD PARTY PAYERS HAVE BEEN PROPERLY BILLED BY INSPIRA AND THE REMAINING DEBT IS THE FINANCIAL RESPONSIBILITY OF THE PATIENT. THE ORGANIZATION SHALL NOT BILL A PATIENT FOR ANY AMOUNT THAT AN INSURANCE COMPANY IS OBLIGATED TO PAY UNLESS THE INSURANCE COMPANY IS REFUSING TO PAY THE AMOUNT PENDING ADDITIONAL INFORMATION OR COMMUNICATION FROM THE PATIENT. INSPIRA DOES NOT REFER ACCOUNTS FOR COLLECTION WHILE A CLAIM ON THE ACCOUNT IS STILL PENDING PAYER PAYMENT UNLESS THE PAYER IS REFUSING TO PAY THE AMOUNT PENDING ADDITIONAL INFORMATION OR COMMUNICATION FROM THE PATIENT. CUSTOMER SERVICE ---------------- DURING THE BILLING AND COLLECTION PROCESS, INSPIRA PROVIDES QUALITY CUSTOMER SERVICE BY COMPLYING WITH THE FOLLOWING GUIDELINES: (1) INSPIRA DOES NOT TOLERATE ABUSIVE, HARASSING, OFFENSIVE, DECEPTIVE, OR MISLEADING LANGUAGE OR CONDUCT BY ITS EMPLOYEES. (2) INSPIRA MAINTAINS A STREAMLINED PROCESS FOR PATIENT QUESTIONS AND DISPUTES, WHICH INCLUDES A PHONE NUMBER PATIENTS MAY CALL, EMAIL ADDRESS, AND A BUSINESS OFFICE ADDRESS TO WHICH THEY MAY WRITE. THIS INFORMATION WILL BE LISTED ON ALL PATIENT STATEMENTS. (3) AFTER RECEIVING A COMMUNICATION FROM THE PATIENT (BY PHONE, EMAIL, OR IN WRITING), INSPIRA STAFF WILL RETURN CALLS TO PATIENTS AS PROMPTLY AS POSSIBLE (BUT NO MORE THAN ONE BUSINESS DAY AFTER THE CALL, EMAIL OR LETTER WAS RECEIVED). (4) INSPIRA MAINTAINS A DAILY COMPLAINT AND ISSUE LOG OF PATIENT'S COMPLAINTS. THE COMPLAINT AND ISSUE LOG WILL BE REVIEWED PERIODICALLY BY THE PATIENT ACCOUNTS MANAGER AND CASH SUPERVISOR AND THE INFORMATION PROVIDED WILL BE USED TO ENHANCE AND IMPROVE THE BILLING AND COLLECTIONS PROCESS. ALL PATIENTS MAY REQUEST AN ITEMIZED STATEMENT FOR THEIR ACCOUNTS AT ANY TIME. ALL PATIENTS WILL HAVE THE OPPORTUNITY TO CONTACT HOSPITAL REGARDING FINANCIAL ASSISTANCE FOR THEIR ACCOUNTS. COMPLIANCE WITH INTERNAL REVENUE CODE SECTION 501(R)(6) ------------------------------------------------------- INSPIRA DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIVITIES ("ECAS") AS DEFINED BY INTERNAL REVENUE CODE SECTION 501(R) PRIOR TO THE END OF THE NOTIFICATION PERIOD. ONCE A COMPLETED FAP APPLICATION IS RECEIVED, HOSPITAL, OR ANY COLLECTION AGENCIES WORKING ON THEIR BEHALF, WILL: 1) SUSPENDED ANY ECAS AGAINST THE INDIVIDUAL; 2) MAKE AND DOCUMENT AN ELIGIBILITY DETERMINATION IN A TIMELY MANNER; 3) NOTIFY THE RESPONSIBLE PARTY OR INDIVIDUAL IN WRITING OF THE DETERMINATION AND BASIS FOR DETERMINATION; AND 4) IF DEEMED FAP-ELIGIBLE INSPIRA WILL: - PROVIDE A BILLING STATEMENT INDICATING THE AMOUNT THE FAP-ELIGIBLE INDIVIDUAL OWES, HOW THAT AMOUNT WAS DETERMINED AND HOW INFORMATION PERTAINING TO AMOUNTS GENERALLY BILLED MAY BE OBTAINED; AND - REFUND ANY EXCESS PAYMENTS MADE BY THE INDIVIDUAL. INSPIRA DOES NOT ENGAGE IN ANY ACTIONS THAT DISCOURAGE INDIVIDUALS FROM SEEKING EMERGENCY MEDICAL CARE, SUCH AS BY DEMANDING THE EMERGENCY DEPARTMENT PATIENTS PAY BEFORE RECEIVING TREATMENT FOR EMERGENCY MEDICAL CONDITIONS OR BY PERMITTING DEBT COLLECTION ACTIVITIES IN THE EMERGENCY DEPARTMENT OR OTHER AREAS WHERE SUCH ACTIVITIES COULD INTERFERE WITH THE PROVISION OF EMERGENCY CARE ON A NON-DISCRIMINATORY BASIS. SCHEDULE H, PART VI, QUESTION 2 IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS OUTLINED IN SCHEDULE H, SECTION B, QUESTIONS 1-12 AND SECTION C, THIS ORGANIZATION CONDUCTS A REVIEW OF KEY FACTOR INFORMATION ANNUAL WHICH INCLUDES: A REVIEW OF HEALTHCARE UTILIZATION OF ITS SERVICE AREA POPULATION BY SERVICES (UROLOGY, CARDIOLOGY, OBSTETRICS, ETC.) FOR DETERMINING INCREASED OR DECREASED HEALTH NEEDS; HEALTHCARE SERVICES ESTIMATES AND FORECASTS (BOTH INPATIENT AND OUTPATIENT); ASSESSMENTS OF LOCAL DEMOGRAPHIC AND SOCIOECONOMIC INFORMATION; AND, A REVIEW OF HEALTH STATUS/NEEDS ASSESSMENTS AND STUDIES CONDUCTED BY EXTERNAL PARTIES. THE ORGANIZATION CONDUCTS AN EXTENSIVE SERVICE AREA PHYSICIAN NEEDS STUDY (BY PRIMARY AND SPECIALTY) EVERY THREE TO FIVE YEARS. SPECIFIC SPECIALTY NEEDS ARE CONDUCTED FOR IDENTIFIED GAPS IN SERVICE. THESE REVIEWS INFORM MEDICAL STAFF DEVELOPMENT AT THE MEDICAL CENTER TO ASSURE RESPONSIVENESS TO IDENTIFIED COMMUNITY NEEDS. THE ORGANIZATION COLLABORATES WITH COMMUNITY PARTNERS TO PLAN AND CONDUCT HEALTH NEEDS ASSESSMENTS TO ASSESS AND ADDRESS HEALTH NEEDS OF THE COMMUNITY IT SERVES. THE WIDE-BASED COLLABORATIVE PARTNERSHIP RETAINS AN OUTSIDE CONSULTING FIRM TO ASSESS COMMUNITY DATA AND PERCEPTION. COMMUNITY DATA IS COLLECTED FROM COUNTY HEALTH PROFILES, HEALTH STATISTICS, DEMOGRAPHICS, SOCIOECONOMIC DATA, PHONE SURVEYS, PAPER SURVEYS AND FOCUS GROUPS. FROM THOSE ASSESSMENTS, COMMUNITY HEALTH IMPROVEMENT PLANS ARE PUBLISHED IDENTIFYING THE SPECIFIC HEALTH PRIORITIES. THROUGH A PLANNED AND ORGANIZED EFFORT, THE GROUP WORKS COLLECTIVELY TO ADDRESS THE PRIORITIES BY TAPPING THE RESOURCES OF THE COMMUNITY AND COLLABORATING ON INITIATIVES. INSPIRA HEALTH NEWTORK ACTIVELY CONTRIBUTES TO THIS PROCESS AND ENGAGES IN THE IDENTIFIED PRIORITIES THAT MATCH ITS MISSION, EXPERTISE, RESOURCES AND CAPACITY. IN ADDITION TO THESE ORGANIZED NEEDS ASSESSMENT EFFORTS, VARIOUS INSPIRA LEADERSHIP ATTEND COMMUNITY MEETINGS WITH LOCAL PROVIDERS, LOCAL HEALTH DEPARTMENTS, LOCAL POLITICIANS, ORGANIZATIONS AND COMMUNITY LEADERS TO DISCUSS THE HEALTH NEEDS OF THE POPULATION. SCHEDULE H, PART VI, QUESTION 3 IN ACCORDANCE WITH INTERNAL REVENUE CODE SECTION 501(R)(4) THE ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE BY WIDELY PUBLICIZING VARIOUS DOCUMENTS. THESE DOCUMENTS ARE WIDELY PUBLICIZED IN THE FOLLOWING WAYS: (1) THE FINANCIAL ASSISTANCE POLICY ("FAP"), FINANCIAL ASSISTANCE APPLICATION ("APPLICATION") AND PLAIN LANGUAGE SUMMERY ("PLS") ARE ALL AVAILABLE ON-LINE AT THE FOLLOWING WEBSITE: https://www.inspirahealthnetwork.org/patients-visitors/billing-online-paym ents/payment-assistance (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 DEPARATMENT, 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. SCHEDULE H, PART VI, QUESTION 4 INSPIRA HEALTH IS A CHARITABLE NONPROFIT HEALTH CARE ORGANIZATION AND A REGIONAL LEADER IN PHYSICIAN TRAINING, WITH APPROXIMATELY 266 MEDICAL RESIDENTS AND FELLOWS IN 15 NATIONALLY ACCREDITED PROGRAMS AT ITS HOSPITALS IN ELMER, MANNINGTON, MULLICA HILL AND VINELAND. THE SYSTEM TRACES ITS ROOTS TO 1899 AND COMPRISES FOUR MEDICAL CENTERS, TWO COMPREHENSIVE CANCER CENTERS, EIGHT MULTI-SPECIALTY HEALTH CENTERS, AND LOCATIONS THROUGHOUT SOUTH JERSEY. THESE INCLUDE URGENT CARE; OUTPATIENT REHABILITATION; SLEEP MEDICINE LABS; CARDIAC TESTING FACILITIES; BEHAVIORAL HEALTH, DIGESTIVE HEALTH AND WOUND CARE CENTERS; HOME CARE AND HOSPICE; AND MORE THAN 35 PRIMARY AND SPECIALTY PHYSICIAN PRACTICES IN GLOUCESTER, CUMBERLAND, SALEM, CAMDEN AND ATLANTIC COUNTIES. ADDITIONALLY, INSPIRA EMS SERVICES SIX SOUTH JERSEY COUNTIES. INSPIRA'S 1,200-MEMBER MEDICAL STAFF AND MORE THAN 7,000 EMPLOYEES PROVIDE AN UNWAVERING COMMITMENT TO DELIVERING A SUPERIOR PATIENT EXPERIENCE AT EVERY POINT OF THE JOURNEY. TECHNOLOGY AND INNOVATION INVESTMENTS PROVIDE A ROBUST PROVIDER DIRECTORY AND A RANGE OF SERVICES, INCLUDING ONLINE SCHEDULING AND VIRTUAL VISITS FOR BOTH PRIMARY AND SPECIALTY CARE PROVIDERS. WITH A COMMITMENT TO MULTI-CHANNEL DIGITAL ACCESS, INSPIRA IS ABLE TO MEET CONSUMER DEMAND FOR SELF-SERVICE AND PERSONALIZED CARE OPTIONS. THE CURRENT SERVICE AREA BASED ON AN ANALYSIS OF THE GEOGRAPHIC AREA WHERE INDIVIDUALS UTILIZING THEIR SERVICES RESIDE IS CONSIDERED TO BE THE CUMBERLAND, GLOUCESTER, AND SALEM COUNTY COMMUNITIES. THE COUNTIES ARE SITUATED IN THE SOUTHWESTERN PART OF NEW JERSEY AND ENCOMPASS A TOTAL POPULATION OF APPROXIMATELY 521,000 ACCORDING TO CENSUS DATA IN 2020. AS PART OF ITS COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS, ONE OF THE INITIAL UNDERTAKINGS OF WAS TO CREATE A SECONDARY DATA PROFILE. THE SECONDARY DATA IS COMPRISED OF DATA OBTAINED FROM EXISTING RESOURCES AND INCLUDES DEMOGRAPHIC AND HOUSEHOLD STATISTICS, EDUCATION AND INCOME MEASURES, MORBIDITY AND MORTALITY RATES, AND HEALTH INDICATORS, AMONG OTHER DATA POINTS. THE DATA WAS GATHERED AND INTEGRATED INTO A GRAPHICAL REPORT TO PORTRAY THE CURRENT HEALTH AND SOCIO-ECONOMIC STATUS OF RESIDENTS IN ITS PRIMARY SERVICE AREAS. SECONDARY DATA WAS COLLECTED FROM REPUTABLE SOURCES INCLUDING THE U.S. CENSUS BUREAU, CENTERS FOR DISEASE CONTROL AND PREVENTION AND NEW JERSEY DEPARTMENT OF HEALTH. THE PROFILE DETAILS DATA COVERING THE FOLLOWING AREAS: POPULATION STATISTICS --------------------- - CUMBERLAND COUNTY: THE PROPORTION OF HISPANICS/LATINOS AND BLACK/AFRICAN AMERICANS IS 34% AND 22.4%; RESPECTIVELY. - GLOUCESTER COUNTY: THE PROPORTION OF HISPANICS/LATINOS AND BLACK/AFRICAN AMERICANS IS 7.9% AND 12.1%; RESPECTIVELY. - SALEM COUNTY: THE PROPORTION OF HISPANICS/LATINOS AND BLACK/AFRICAN AMERICANS IS 11.2% AND 15.2%; RESPECTIVELY. - CUMBERLAND COUNTY: THE PERCENTAGE OF PEOPLE WHO SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME IS 28%. - GLOUCESTER COUNTY: THE PERCENTAGE OF PEOPLE WHO SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME IS 9.8%. - SALEM COUNTY: THE PERCENTAGE OF PEOPLE WHO SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME IS 7.7%. - CUMBERLAND COUNTY: 16.3% OF RESIDENTS ARE AGE 65 YEARS AND OLDER. - GLOUCESTER COUNTY: 17% OF RESIDENTS ARE AGE 65 YEARS AND OLDER. - SALEM COUNTY: 19.4% OF RESIDENTS ARE AGE 65 YEARS AND OLDER. HOUSEHOLD STATISTICS -------------------- - CUMBERLAND COUNTY: THE MEDIAN HOME VALUE IN CUMBERLAND COUNTY IS $192,900. - GLOUCESTER COUNTY: THE MEDIAN HOME VALUE IN GLOUCESTER COUNTY IS $265,200. - SALEM COUNTY: THE MEDIAN HOME VALUE IN SALEM COUNTY IS $208,200. - CUMBERLAND COUNTY: THE AVERAGE FAMILY SIZE 2.72 INDIVIDUALS. - GLOUCESTER COUNTY: THE AVERAGE FAMILY SIZE 2.7 INDIVIDUALS. - SALEM COUNTY: THE AVERAGE FAMILY SIZE 2.56 INDIVIDUALS. COMPUTER AND INTERNET USE ----------------- -CUMBERLAND COUNTY HOUSEHOLDS WITH A BROADBAND INTERNET SUBSCRIPTION IS 85.5% -GLOUCESTER COUNTY HOUSEHOLDS WITH A BROADBAND INTERNET SUBSCRIPTION IS 91.4% -SALEM COUNTY HOUSEHOLDS WITH A BROADBAND INTERNET SUBSCRIPTION IS 87.3% INCOME STATISTICS ----------------- - CUMBERLAND COUNTY: THE MEDIAN INCOME FOR HOUSEHOLDS IS $62,310 - CUMBERLAND COUNTY: THE PROPORTION OF PERSONS LIVING IN POVERTY IS 15.5% - GLOUCESTER COUNTY: THE MEDIAN INCOME FOR HOUSEHOLDS IS $99,668. - GLOUCESTER COUNTY: THE PROPORTION OF PERSONS LIVING IN POVERTY IS 7.6% - SALEM COUNTY: THE MEDIAN INCOME FOR HOUSEHOLDS IS $73,378. - SALEM COUNTY: THE PROPORTION OF PERSONS LIVING IN POVERTY IS 10.7%. EMPLOYMENT STATISTICS --------------------- - CUMBERLAND COUNTY: ACCORDING TO THE COUNTY HEALTH RANKINGS UNEMPLOYMENT RATE IN 2023 WAS 7.7% - GLOUCESTER COUNTY: ACCORDING TO THE COUNTY HEALTH RANKINGS UNEMPLOYMENT RATE IN 2023 WAS 6% - SALEM COUNTY: ACCORDING TO THE COUNTY HEALTH RANKINGS UNEMPLOYMENT RATE IN 2023 WAS 7.3% EDUCATION STATISTICS -------------------- - CUMBERLAND COUNTY: 81.2% OF RESIDENTS HAVE GRADUATED FROM HIGH SCHOOL. - GLOUCESTER COUNTY: 93.6% OF RESIDENTS HAVE GRADUATED FROM HIGH SCHOOL. - SALEM COUNTY: 90.2% OF RESIDENTS HAVE GRADUATED FROM HIGH SCHOOL. - CUMBERLAND COUNTY: 17.3% OF RESIDENTS HAVE EARNED A BACHELOR'S DEGREE OR HIGHER. - GLOUCESTER COUNTY: 35.2% OF RESIDENTS HAVE EARNED A BACHELOR'S DEGREE OR HIGHER. - SALEM COUNTY: 22.8% OF RESIDENTS HAVE EARNED A BACHELOR'S DEGREE OR HIGHER. COUNTY HEALTH RANKINGS ---------------------- - CUMBERLAND COUNTY RANKD 20 OUT OF 21 COUNTIES OVERALL FOR HEALTH OUTCOMES IN 2023. - GLOUCESTER COUNTY RANKED 15 OUT OF 21 COUNTIES OVERALL FOR HEALTH OUTCOMES IN 2023. - SALEM COUNTY RECEIVED THE LOWEST RANKING FOR OVERALL HEALTH OUTCOMES RANKING 21 OUT OF 21 COUNTIES IN 2023 SCHEDULE H, PART VI, QUESTION 5 COMMUNITY BUILDING ACTIVITIES UNDERTAKEN BY THIS ORGANIZATION IMPROVE THE MEDICAL AND SOCIO-ECONOMIC WELL-BEING OF THE COMMUNITIES IN OUR CARE. THIS IS ACCOMPLISHED THROUGH NUMEROUS ACTIVITIES WHICH ARE NOT A PART OF PART I CHARITY CARE AND OTHER COMMUNITY BENEFITS, AND ARE NOT INCLUDED ELSEWHERE ON SCHEDULE H. THESE ACTIVITIES INCLUDE PROGRAMS THAT ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS SUCH AS EDUCATION, POVERTY, UNEMPLOYMENT, ACCESS TO CARE, HEALTH ADVOCACY AND ECONOMIC DEVELOPMENT. THIS ORGANIZATION HOLDS ANNUAL MEETINGS OPEN TO THE PUBLIC FOR ALL HOSPITAL LOCATIONS. THE ORGANIZATIONS GOVERNING BOARDS ARE COMPRISED OF BUSINESS PROFESSIONALS AND COMMUNITY MEMBERS ALL OF WHOM RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA WHO ARE NOT EMPLOYEES OF THE ORGANIZATION. THESE VOLUNTEERS PROVIDE COUNTLESS HOURS OF SERVICE TO THE HOSPITAL SYSTEM IN THEIR OVERSIGHT ROLE. ALL QUALIFIED PHYSICIANS IN THE COMMUNITY ARE EXTENDED MEDICAL STAFF PRIVILEGES BY THEIR RESPECTIVE DEPARTMENTS. UNDER THE DIRECTIVE OF THE ORGANIZATION'S CORPORATE FINANCE OFFICE, SURPLUS FUNDS ARE UTILIZED FOR CAPITAL PROJECTS TO IMPROVE SERVICES, PURCHASE EQUIPMENT, MAINTAIN ACCESS TO CARE TO A HISTORICALLY UNDERSERVED AND LOW-INCOME COMMUNITY AND IMPROVE ACCESS TO PATIENT SERVICES, WHICH IN TURN, BENEFIT THE COMMUNITY. THESE SERVICES INCLUDE, BUT NOT LIMITED TO, THE FOLLOWING: 1) EDUCATIONAL PROGRAMS THAT PROVIDE CLASSES AND INFORMATION ON HEALTHY AGING, CHILDBIRTH, INFANT CARE, EARLY PREGNANCY AND MORE; 2) FREE BLOOD PRESSURE AND DIABETES SCREENING, AND MAMMOGRAMS TO QUALIFYING INDIVIDUALS, FREE OR LOW-COST SCREENINGS FOR BREAST, PROSTATE, SKIN AND COLORECTAL CANCERS; 3) PREVENTATIVE HEALTH EDUCATION; 4) ACCESS TO SATELLITE EMERGENCY DEPARTMENT AND EXPANSION OF EMERGENCY DEPARTMENTS AT BOTH HOSPITALS TO ACCOMMODATE INCREASE IN EMERGENCY DEPARTMENT PATIENTS; 5) IMPROVED EFFICIENCY AND CLINICAL QUALITY; 6) INVESTMENT IN MEDICAL EDUCATION AND RESEARCH; AND 7) ACCESS TO ADVANCED TECHNOLOGY AND CLINICAL TRIALS FOR LATEST TREATMENTS. PLEASE ALSO REFER TO FORM 990, SCHEDULE O, WHICH CONTAINS THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT. SCHEDULE H, PART VI; QUESTION 6 OUTLINED BELOW IS A SUMMARY OF THE ENTITIES WHICH COMPRISE THE INSPIRA HEALTH NETWORK: INSPIRA HEALTH NETWORK, INC. ---------------------------- INSPIRA HEALTH NETWORK, INC. ("NETWORK") IS THE TAX-EXEMPT PARENT OF THE INSPIRA HEALTH NETWORK ("SYSTEM"). THIS INTEGRATED HEALTHCARE DELIVERY SYSTEM CONSISTS OF A GROUP OF AFFILIATED HEALTHCARE ORGANIZATIONS. THE SOLE MEMBER OR STOCKHOLDER OF EACH ENTITY IS EITHER THE NETWORK OR ANOTHER NETWORK AFFILIATE CONTROLLED BY THE NETWORK. THE NETWORK IS AN INTEGRATED NETWORK OF HEALTHCARE PROVIDERS THROUGHOUT THE STATE OF NEW JERSEY AND IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A SUPPORTING ORGANIZATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). INSPIRA MEDICAL CENTERS, INC. ----------------------------- INSPIRA MEDICAL CENTERS, INC. ("IMC") WAS COMPRISED OF THREE ACUTE CARE MEDICAL CENTERS. EFFECTIVE OCTOBER 1, 2023, SALEM COUNTY HOSPITAL CORP. WAS STATUTORILY MERgED INTO INSPIRA MEDICAL CENTER, INC. THIS HOSPITAL campus WAS RENAMED INSPIRA MEDICAL CENTER MANNINGTON AND BECAME THE FOURTH ACUTE CARE MEDICAL CENTER campus within IMC. THE OTHER THREE HOSPITAL CAMPUSES ARE INSPIRA MEDICAL CENTER VINELAND, INSPIRA MEDICAL CENTER ELMER and INSPIRA MEDICAL CENTER mullica hill. IMC IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, IMC PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. MOREOVER, IMC OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. INSPIRA HEALTH NETWORK MEDICAL GROUP, P.C. ------------------------------------------ INSPIRA HEALTH NETWORK MEDICAL GROUP, P.C. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF THE NETWORK; PRIMARILY ITS TAX-EXEMPT ACUTE CARE HOSPITALS, WHICH PROVIDE MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. INSPIRA HOMECARE & HOSPICECARE, INC. ------------------------------------ INSPIRA HOMECARE & HOSPICECARE, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). THE ORGANIZATION HAS AN OWNERSHIP INTEREST IN TRI-COUNTY HOME AND HOSPICE CARE LLC; AN ENTITY ORGANIZED TO OWN AND OPERATE HOME HEALTHCARE AND HOSPICE AGENCIES IN GLOUCESTER, SALEM AND CUMBERLAND COUNTIES. THIS ORGANIZATION PROVIDES QUALITY HOME CARE AND HOSPICE CARE SERVICES IN THE REGION IN FURTHERANCE OF ITS TAX-EXEMPT AND CHARITABLE PURPOSES. INSPIRA HEALTH NETWORK LIFE, INC. --------------------------------- INSPIRA HEALTH NETWORK LIFE, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). THE ORGANIZATION PROVIDES HEALTHCARE SERVICES IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. TRI-COUNTY CARDIOVASCULAR SERVICES, P.C. ---------------------------------------- TRI-COUNTY CARDIOVASCULAR SERVICES, P.C. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION. THE ORGANIZATION SUPPORTED THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF THE NETWORK; PRIMARILY ITS TAX-EXEMPT ACUTE CARE HOSPITALS, WHICH PROVIDE MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. INSPIRA HEALTH CONNECTIONS, P.C. -------------------------------- INSPIRA HEALTH CONNECTIONS, P.C. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION. THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF THE NETWORK; PRIMARILY ITS TAX-EXEMPT ACUTE CARE HOSPITALS, WHICH PROVIDE MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. INSPIRA HEALTH FOUNDATION, INC. ------------------------------- INSPIRA HEALTH 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 THE NETWORK AND SPECIFICALLY INSPIRA MEDICAL CENTERS, INC.; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. SALEM PHYSICIAN PRACTICES, P.C. ------------------------------- Salem Physician Practices, P.C. is an organization recognized by the Internal Revenue Service as tax-exempt pursuant to Internal Revenue Code 501(c)(3) and as a non-private foundation pursuant to Internal Revenue Code 509(a)(3). The organization supports the charitable purposes, programs and services of Salem county hospital corp., which provides medically necessary healthcare services to all individuals in a non-discriminatory manner regardless of race, color, creed, sex, national origin, religion or ability to pay. effective october 1, 2023, salem county hospital corp. was STATUTORILY MERGED INTO INSPIRA MEDICAL CENTERS, INC.; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. INSPIRA DEPTFORD HEALTHPARK, LLC -------------------------------- INSPIRA DEPTFORD HEALTHPARK, LLC IS A LIMITED LIABILITY COMPANY FORMED IN THE STATE OF NEW JERSEY WHOSE SOLE MEMBER IS INSPIRA MEDICAL CENTERS, INC. 1450 NORTH ALMONESSON ROAD, LLC ------------------------------- 1450 NORTH ALMONESSON ROAD, LLC IS A LIMITED LIABILITY COMPANY FORMED IN THE STATE OF NEW JERSEY WHOSE SOLE MEMBER IS INSPIRA MEDICAL CENTERS, INC. OAK & MAIN SURGICENTER, LLC --------------------------- Oak & Main Surgicenter, LLC is a limited liability company formed in the State of New Jersey whose sole member is Inspira Medical Centers, Inc. INSPIRA CARE CONNECT, LLC ------------------------- INSPIRA CARE CONNECT, LLC IS A LIMITED LIABILITY COMPANY FORMED IN THE STATE OF NEW JERSEY WHOSE SOLE MEMBER IS INSPIRA HEALTH NETWORK, INC. THE MISSION OF THIS ORGANIZATION IS TO ESTABLISH A GROUP OF COORDINATED HEALTHCARE PROVIDERS WHICH AGREE TO BE ACCOUNTABLE FOR THE QUALITY, COST AND OVERALL CARE FOR AN ASSIGNED GROUP OF MEDICARE BENEFICIARIES. SALEM MEDICAL CENTER PROPERTIES, LLC ------------------------------------ Salem Medical Center Properties, LLC is a limited liability company formed in the State of New Jersey whose sole member BECAME INSPIRA MEDICAL CENTER, INC. ON OCTOBER 1, 2023. BRIDGETON PHYSICIANS OFFICE CENTER, L.P. ---------------------------------------- BRIDGETON PHYSICIANS OFFICE CENTER, L.P. IS A PARTNERSHIP OWNED BY INSPIRA HEALTH NETWORK AFFILIATES. THIS ORGANIZATION ENGAGES IN REAL ESTATE ACTIVITY. INSPIRA HEALTH PARTNERS, LLC ---------------------------- INSPIRA HEALTH PARTNERS, LLC IS A LIMITED LIABILITY COMPANY TAXED AS A PARTNERSHIP. THE ORGANIZATION IS A CLINICALLY INTEGRATED PHYSICAN-HOSPITAL ENTERPRISE WHICH IS DESIGNED TO ACHIEVE IMPROVEMENT IN HEALTHCARE QUALITY, EFFICIENCY AND COST. INSPIRA HEALTH NETWORK, INC. OWNS 51% OF INSPIRA HEALTH PARTNERS, LLC. INSPIRA SJ URGENT CARE MANAGEMENT COMPANY, LLC ---------------------------------------------- INSPIRA SJ URGENT CARE MANAGEMENT COMPANY, LLC IS A LIMITED LIABILITY COMPANY TAXED AS A PARTNERSHIP. THIS ORGANIZATION MANAGES AND OPERATES URGENT CARE SERVICE CENTERS IN SOUTHERN NEW JERSEY. INSPIRA HEALTH MANAGEMENT CORPORATION, INC. OWNS 60.5% OF INSPIRA SJ URGENT CARE MANAGEMENT COMPANY, LLC. WOODBURY MEDICAL CENTER ASSOCIATES, LLP --------------------------------------- WOODBURY MEDICAL CENTER ASSOCIATES, LLP IS IS A PARTNERSHIP OWNED BY INSPIRA HEALTH NETWORK AFFILIATES. THIS ORGANIZATION ENGAGES IN REAL ESTATE ACTIVITY. INSPIRA HEALTH MANAGEMENT CORPORATION, INC. ------------------------------------------- INSPIRA HEALTH MANAGEMENT CORPORATION IS AN ENTITY WHOSE SOLE SHAREHOLDER IS RED BANK DEVELOPMENT CORPORATION. THE ORGANIZATION IS LOCATED IN BRIDGETON, CUMBERLAND COUNTY, NEW JERSEY AND PROVIDES HEALTH, WELLNESS AND MANAGEMENT SERVICES. INSPIRA HEALTH N SCHEDULE H, PART VI; QUESTION 7 NOT APPLICABLE. THE ENTITY AND RELATED PROVIDER ORGANIZATIONS ARE LOCATED IN NEW JERSEY. THE STATE OF NEW JERSEY DOES NOT REQUIRE HOSPITALS TO ANNUALLY FILE A COMMUNITY BENEFIT REPORT WITH THE STATE OF NEW JERSEY. X X X X X true true false false false false false true false Amy Mansue Trustee - President & CEO 0 1196859 0 346145 0 65287 0 328137 0 22054 0 1958482 0 48354 MATTHEW K DOONAN ESQ SVP & Chief Legal Officer 0 394929 0 80700 0 68935 0 91409 0 31086 0 667059 0 31501 David Yhlen Chief Operating Officer 0 243063 0 50369 0 295066 0 16142 0 23778 0 628418 0 209516 Lydia Stockman RN MHA SVP & CAO 0 434626 0 62017 0 4874 0 95281 0 24963 0 621761 0 0 Jaymica Patel MD CMO 0 382327 0 39395 0 1281 0 61809 0 871 0 485683 0 0 Brandi Ortiz CT Tech II 151734 38250 0 500 115 6418 0 2309 33347 18338 185196 65815 0 0 Dodi K Baldwin RN Registered Nurse 144467 35100 0 500 250 9522 0 1469 33673 17872 178390 64463 0 0 Justine C Murphy BSHA RN CNO 118893 0 2250 0 30671 37227 0 0 25736 16753 177550 53980 0 0 David Marini Pharmacist 122933 37829 0 500 1373 2112 0 2396 35109 18378 159415 61215 0 0 ZACHARY PETERSON CT TECH II 114584 35131 0 500 78 3428 0 1413 9636 189 124298 40661 0 0 JAMES PIPER AVP Support Services 113501 0 0 0 12000 34651 0 0 586 0 126087 34651 0 0 SCHEDULE J, PART I; QUESTION 4A THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING CALENDAR YEAR 2023 WHICH WERE INCLUDED IN THEIR 2023 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: DAVID YHLEN, $49,402; JUSTINE C. MURPHY, BSHA, RN, $36,888 AND JAMES PIPER, $33,797. SCHEDULE J, PART I; QUESTION 4B THE AMOUNT REFLECTED IN SCHEDULE J, PART II, COLUMN B(III) FOR THE FOLLOWING INDIVIDUALS INCLUDES CURRENT YEAR VESTING IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) 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: Amy Mansue, $48,354; MATTHEW K. DOONAN, ESQ., $39,747 AND David Yhlen, $217,316. THE DEFERRED COMPENSATION AMOUNTS REFLECTED IN SCHEDULE J, PART II, COLUMN C FOR THE FOLLOWING INDIVIDUALS INCLUDE UNVESTED BENEFITS IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) WHICH ARE SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THESE INDIVIDUALS MAY NEVER ACTUALLY RECEIVE THIS UNVESTED BENEFIT AMOUNT. THE AMOUNTS OUTLINED HEREIN WERE NOT INCLUDED IN EACH INDIVIDUAL'S 2023 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: Amy Mansue, $309,228; MATTHEW K. DOONAN, ESQ., $76,818; AND Lydia Stockman, RN, MHA, $75,664. SCHEDULE J, PART I; QUESTION 7 CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A BONUS DURING CALENDAR YEAR 2023 WHICH WAS INCLUDED IN SCHEDULE J, PART II, 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 B(III) CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J OF THIS FEDERAL FORM 990 RECEIVED COMPENSATION WITH RESPECT TO PAID TIME OFF, WHICH WAS INCLUDED IN SCHEDULE J, PART II, COLUMN B(III) HEREIN AND IN EACH INDIVIDUAL'S 2023 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. SCHEDULE J, PART II; COLUMN F THE AMOUNTS REPORTED IN SCHEDULE J, PART II, COLUMN (F) INCLUDE VESTED BENEFITS IN A DEFERRED COMPENSATION PLAN AS THESE AMOUNTS WERE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. THESE AMOUNTS WERE REPORTED AS DEFERRED COMPENSATION ON PRIOR YEARS' FORMS 990 AND ARE NOW BEING REPORTED AGAIN ON THIS YEAR'S FORM 990. THESE AMOUNTS HAVE BEEN TREATED AS TAXABLE INCOME AND WERE REPORTED ON EACH INDIVIDUAL'S FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. TRANSFER OF NET ASSETS 2023-10-01 -1757981 FMV 210634484 INSPIRA MEDICAL CENTERS INC 333 IRVING AVENUE BRIDGETON NJ 08302 501(C)(3) true false false false true true true true true false SCHEDULE N, PART I, QUESTION 2A SALEM COUNTY HOSPITAL CORP., AN INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, WAS STATUTORILY MERGED INTO INSPIRA MEDICAL CENTERS, INC.; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION. SALEM COUNTY HOSPITAL CORP. AND INSPIRA MEDICAL CENTERS, INC. ARE BOTH GOVERNED BY THE SAME BOARD OF TRUSTEES. CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS BACKGROUND ========== EFFECTIVE WITH THE CLOSE OF BUSINESS ON OCTOBER 1, 2023, Salem County Hospital Corp. WAS STATUTORILY MERGED INTO INSPIRA MEDICAL CENTERS, INC.; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION, AND NOW OPPERATES UNDER THE NAME INSPIRA MEDICAL CENTER MANNINGTON. SALEM COUNTY HOSPITAL CORPORATION ("SALEM MEDICAL CENTER") WAS RECOGNIZED BY THE IRS AS AN INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, SALEM MEDICAL CENTER PROVIDED HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. MOREOVER, SALEM MEDICAL CENTER OPERATED CONSISTENTLY WITH THE FOLLOWING CRITERIA OUTLINED IN IRS REVENUE RULING 69-545: 1) PROVIDES HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY, INCLUDING CHARITY CARE, SELF-PAY, MEDICARE AND MEDICAID PATIENTS; 2) OPERATES AN EMERGENCY DEPARTMENT FOR ALL PERSONS; WHICH IS OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS PER YEAR; 3) MAINTAINS AN OPEN MEDICAL STAFF, WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS; 4) CONTROL OF SALEM MEDICAL CENTER RESTS WITH ITS BOARD OF TRUSTEES WHICH IS COMPRISED OF INDEPENDENT CIVIC LEADERS AND OTHER PROMINENT MEMBERS OF THE COMMUNITY; AND 5) SURPLUS FUNDS ARE USED TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND RENOVATE FACILITIES AND ADVANCE MEDICAL CARE, PROGRAMS AND ACTIVITIES. THE OPERATIONS OF SALEM MEDICAL CENTER AS SHOWN THROUGH THE FACTORS OUTLINED ABOVE AND OTHER INFORMATION CONTAINED HEREIN, CLEARLY DEMONSTRATED THAT THE USE AND CONTROL OF SALEM MEDICAL CENTER WAS FOR THE BENEFIT OF THE PUBLIC AND THAT NO PART OF THE INCOME OR NET EARNINGS OF THE ORGANIZATION INURED TO THE BENEFIT OF ANY PRIVATE INDIVIDUAL NOR WAS ANY PRIVATE INTEREST SERVED OTHER THAN INCIDENTALLY. SALEM MEDICAL CENTER PROVIDED HEALTHCARE SERVICES TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY. MOREOVER, SALEM MEDICAL CENTER PROVIDED HEALTHCARE SERVICES TO PATIENTS WHO MET CERTAIN CRITERIA DEFINED BY THE NEW JERSEY DEPARTMENT OF HEALTH AND HUMAN SERVICES WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. SALEM MEDICAL CENTER MAINTAINED RECORDS TO IDENTIFY AND MONITOR THE AMOUNT OF CHARITY CARE IT PROVIDED. THESE RECORDS INCLUDED THE AMOUNT OF CHARGES FOREGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS FINANCIAL ASSISTANCE POLICY. HISTORY ======= SALEM MEDICAL CENTER WAS ORIGINALLY FOUNDED AS "SALEM COUNTY MEMORIAL HOSPITALBECAME ONE OF THE FIRST MEDICAL CENTERS IN SOUTHERN NEW JERSEY. THE MEDICAL CENTER'S FOUNDING CAN BE TRACED BACK TO LATE 1918, WHEN IMMEDIATELY FOLLOWING THE END OF WORLD WAR I, A SMALL GROUP OF CONCERNED SALEM COUNTY CITIZENS SPEARHEADED THE DRIVE TO ESTABLISH A MUCH-NEEDED HOSPITAL FOR THE PEOPLE OF SALEM COUNTY AS A MEMORIAL "TO THE SOLDIERS AND SAILORS OF SALEM COUNTY WHO PARTICIPATED IN THE GREAT WAR." THE ORIGINAL MEDICAL STAFF OF THE 30-BED HOSPITAL WAS COMPOSED OF 12 PHYSICIANS, SUPPORTED BY 4 NURSES, AN ORDERLY, A COOK, AND A MATRON. THE MEDICAL CENTER REMAINED AT ITS ORIGINAL LOCATION FOR 32 YEARS BEFORE MOVING OPERATIONS TO ITS CURRENT LOCATION IN NEIGHBORING MANNINGTON TOWNSHIP IN SEPTEMBER 1951. APPROXIMATELY 10 YEARS LATER, CONSTRUCTION EXPANDED THE HOSPITAL TO 133 BEDS AND BY THE EARLY 1970S, THE HOSPITAL WOULD BE EXPANDED AGAIN WITH THE ADDITION OF OPERATING ROOMS, RADIOLOGY, A LABORATORY, AND EMERGENCY UNITS. CONSTRUCTION PROJECTS CONTINUED, ADDING INTENSIVE CARE, TELEMETRY, AND A WOMEN'S UNIT. IN 2006, THE NEW EMERGENCY DEPARTMENT OPENED. COMMITMENT TO COMMUNITY ======================= MISSION: DELIVER HIGH QUALITY, COMPASSIONATE HEALTHCARE TO GREATER SALEM COUNTY. VISION: AS A NOT-FOR-PROFIT HOSPITAL, SALEM MEDICAL CENTER FOCUSED ON PATIENTS FIRST, ENSURING THAT THE HIGHEST QUALITY OF CARE WAS ALWAYS PRIORITY NUMBER ONE. WE WERE PROUD TO SERVE SALEM COUNTY AND WERE COMMITTED TO WORKING WITH THE COMMUNITY TO MAKE THE FUTURE OF HEALTHCARE DELIVERY IN THE REGION BRIGHTER AND MORE SUSTAINABLE THAN THE PAST. SALEM MEDICAL CENTER KEPT FOCUSED ON MAKING THE SERVICES THAT WE PROVIDED, BOTH HOSPITAL BASED AND OUTPATIENT PROGRAMS, REFLECTIVE OF THE EVOLVING NEEDS OF THE POPULATION WE SERVED. 100 YEARS LATER, SALEM MEDICAL CENTER CONTINUED TO BUILD ON ITS PROUD HISTORY, WITH THE SAME MISSION OF PROVIDING QUALITY HEALTHCARE TO THE PEOPLE OF SALEM COUNTY AND SURROUNDING AREAS. AS PART OF A STRONG COMMITMENT TO THE COMMUNITY, SALEM MEDICAL CENTER WAS PROUD TO DEBUT ITS FIRST MAGAZINE CALLED "HEALTH CONNECTIONS." THE MAGAZINE PUBLISHED THREE TIMES A YEAR AND FEATURED ARTICLES ON SALEM MEDICAL CENTER SERVICES AND ITS PHYSICIANS, AS WELL AS GENERAL WELLNESS ARTICLES, HEALTHY RECIPES, AND EXERCISE TIPS. AS ONE OF ONLY TWO ACUTE CARE HOSPITALS IN SALEM COUNTY, SALEM MEDICAL CENTER SAW THE LAUNCH OF ITS HEALTH CONNECTIONS MAGAZINE AS A WAY TO FURTHER CONNECT WITH THE SURROUNDING COMMUNITY THAT IT SERVED. SALEM MEDICAL CENTER WAS GUIDED BY A VOLUNTEER BOARD, COMPRISED OF MANY LOCAL MEMBERS, WITH ONLY THE BEST INTEREST OF THE HOSPITAL AND COMMUNITY IN MIND. SALEM MEDICAL CENTER PARTNERS WITH TRANSPORTATION SERVICE --------------------------------------------------------- DURING SEPTEMBER 2021, SALEM MEDICAL CENTER PARTNERED WITH NJ MOBILE HEALTHCARE TO PROVIDE MEDICAL TRANSPORTATION TO AND FROM THE MEDICAL CENTER. THE AMBULANCES WERE STAFFED BY N.J. STATE CERTIFIED EMERGENCY MEDICAL TECHNICIANS (EMTS) AND NURSES WHO COULD QUICKLY ASSESS THE PATIENT'S NEEDS AND HELP STABILIZE THE PATIENT IN EMERGENCY SITUATIONS. "THIS SERVICE WILL PROVIDE ADDITIONAL MEDICAL TRANSPORTATION TO BENEFIT OUR PATIENTS," SAID DR. TAMMY TORRES, CEO. THE VEHICLES CARRIED SALEM MEDICAL CENTER 'S IDENTITY BY SHOWCASING THE LOGO AND COLOR SCHEME ON THE EXTERIOR. INSIDE, THEY WERE FULLY EQUIPPED WITH ADVANCED MEDICAL AND EMERGENCY EQUIPMENT TO PROVIDE THE CARE THE PATIENT NEEDED WHETHER IN AN EMERGENCY SITUATION OR FOR TRANSPORT. AS THIS NEW SERVICE GREW, THE PARTNERSHIP GREW TO PROVIDE GREATER SERVICES TO THE COMMUNITY AS NEEDS AROSE. BASIC LIFE SUPPORT CLASSES NOW OPEN TO THE PUBLIC ------------------------------------------------- WITH THE RECENT COMPLETION OF THE EDUCATION CENTER REMODEL, THE EDUCATION DEPARTMENT WAS EXCITED TO OFFER EMERGENCY CARDIOVASCULAR CARE COURSES TO THE COMMUNITY. SALEM MEDICAL CENTER WAS NAMED AN AMERICAN HEART ASSOCIATION (AHA) TRAINING SITE IN MAY 2021 AND BEGAN OFFERING BASIC LIFE SUPPORT (BLS), CARDIOPULMONARY RESUSCITATION (CPR)AND OTHER COURSES TO EMPLOYEES. THE FIRST BLS CLASS OPEN TO THE COMMUNITY BEGAN ON SEPTEMBER 16, 2021. THE CLASSES WERE EXPECTED TO BE ABLE TO EDUCATE MANY PEOPLE IN THE COMMUNITY. COURSES AVAILABLE INCLUDED: (1) BASIC LIFE SUPPORT; AND (2) ADVANCED CARDIO LIFE SUPPORT. COURSES WERE INTENDED FOR HEALTHCARE PROVIDERS WHO REQUIRED A COMPLETION CARD. PEOPLE WITH LITTLE OR NO MEDICAL TRAINING WHO REQUIRED THE COURSE COMPLETION CARD FOR THE JOB, REGULATORY (OSHA), OR OTHER REQUIREMENTS, OR MEMBERS OF THE COMMUNITY WHO WANTED TO LEARN POTENTIALLY LIFE-SAVING SKILLS. CIRCLE OF FRIENDS ----------------- THE SALEM CIRCLE OF FRIENDS WAS A SOCIAL GROUP SPONSORED BY SALEM MEDICAL CENTER AND SALEM COMMUNITY COLLEGE THAT BROUGHT SENIORS TOGETHER TO ENJOY LUNCHEONS, HEAR FEATURED SPEAKERS, AND ATTEND SPECIAL EVENTS ALL FOCUSED ON LIVING AN ACTIVE, HEALTHY LIFE. TO KICK OFF THE GROUP'S RETURN IN 2021, A CHRISTMAS LUNCHEON WAS HELD ON DECEMBER 10TH IN THE DAVIDOW HALL LOBBY AT SALEM COMMUNITY COLLEGE. THE EVENT FEATURED BARIATRIC SURGEON HARISH KAKKILAYA, MD, AS A GUEST SPEAKER, AS WELL AS SCC PRESIDENT MICHAEL GORMAN AND CHARLES HASSLER. CLINICAL SERVICES ================= SALEM MEDICAL CENTER WAS LICENSED FOR 126 BEDS, INCLUSIVE OF MEDICAL-SURGICAL, INTENSIVE CARE AND BEHAVIORAL HEALTH. SALEM MEDICAL CENTER PROVIDED CRITICAL ACCESS TO THE COMMUNITY THROUGH ITS EMERGENCY DEPARTMENT (NEARLY 20,000 PATIENTS ANNUALLY), SURGERY (OUTPATIENT/INPATIENT, ABOUT 2,500 CASES ANNUALLY) AND INPATIENT ACUTE CARE (ABOUT 2,500 ADMISSIONS ANNUALLY) AND MANY OTHER PROGRAMS THAT SUPPORTED BOTH HEALTH AND BEHAVIORAL HEALTH CARE ACCESS AND PROMOTED QUALITY OF LIFE. SALEM MEDICAL CENTER OFFERED MANY ELECTIVE - NON-EMERGENCY - SURGERIES AND INVASIVE PROCEDURES, INCLUDING HIP AND KNEE REPLACEMENTS, PROCEDURES TO RELIEVE PAIN AND DISCOMFORT, AND DIAGNOSTIC PROCEDURES SUCH AS COLONOSCOPIES AND MAMMOGRAMS. THE FULL LIST OF SERVICES OFFERED BY SALEM MEDICAL CENTER CAN BE GROUPED INTO THE FOLLOWING: - BARIATRIC SURGERY - BEHAVIORAL HEALTH SERVICES - COLONOSCOPY - CRITICAL CARE MEDICINE - DIAGNOSTIC IMAGING - EMERGENCY SERVICES - HEARTBURN - HEART CARE - LABORATORY SERVICES - NEUROSURGERY - PERIPHERAL ARTERY DISEASE - REHABILITATION SERVICES - RETAIL PHARMACY - SLEEP DISORDER CENTER - STROKE CARE - SURGICAL SERVICES - WOUND CARE CORE FORM, PART III; STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS ADULT PSYCHIATRIC UNIT ---------------------- IN MARCH 2021, SALEM MEDICAL CENTER ANNOUNCED THAT THE NEW JERSEY DEPARTMENT OF HEALTH HAS APPROVED THE OPENING OF THE MEDICAL CENTER'S 26-BED ADULT PSYCHIATRIC INPATIENT UNIT. THE 26-BED VOLUNTARY UNIT PROVIDED: - PATIENT-CENTERED BEHAVIORAL HEALTH SERVICES - COMPREHENSIVE PSYCHIATRIC ASSESSMENT AND TREATMENT - ONE-ON-ONE INTERVENTION - PSYCHIATRIC MANAGEMENT THE EXPANSION OF SERVICES WAS PART OF SALEM MEDICAL CENTER 'S COMMITMENT TO MEET COMMUNITY NEEDS AND THERE WAS NO MORE IMPORTANT NEED TODAY THAN ADDITIONAL BEHAVIORAL HEALTH RESOURCES IN THE AREA. THE SERVICE WAS CRUCIAL FOR THE REGION AND MADE A DIFFERENCE FOR THE COMMUNITY OF SALEM AND SOUTH JERSEY. THE OPENING OF THE UNIT MADE AN IMMEDIATE IMPACT ON AN IMPORTANT NEED FOR THE COMMUNITY. THROUGH THIS NEW SERVICE, WE WELCOMED NEW PATIENTS AND THEIR FAMILIES TO OUR MEDICAL CENTER. THE 21,000-SQUARE-FOOT, 26-BED VOLUNTARY ADULT UNIT PROVIDED TREATMENT SERVICES FOR INDIVIDUALS WITH MENTAL HEALTH CONDITIONS. IT PROVIDED A SAFE, SECURE PLACE WHERE INDIVIDUALS WITH BEHAVIORAL HEALTH ISSUES COULD RECEIVE TREATMENT TO MOVE BEYOND THE IMMEDIATE CRISIS. SALEM MEDICAL CENTER WAS COMMITTED TO HELPING PATIENTS WITH BEHAVIORAL ISSUES SEEK TREATMENT AND RECOVER, SAFELY INTEGRATING BACK INTO SOCIETY. THE SETTING PROVIDED A SAFE, SECURE PLACE WHERE INDIVIDUALS WITH BEHAVIORAL HEALTH ISSUES RECEIVED COMPASSIONATE TREATMENT TO MOVE BEYOND THEIR IMMEDIATE CRISIS. THE UNIT FEATURED OPEN AND COMMUNAL SPACE THAT PROMOTED INTERACTION AND REDUCED ISOLATION AND OFFERED AREAS FOR GROUP MEETINGS. PATIENT-CENTERED BEHAVIORAL HEALTH SERVICES PROVIDED COMPREHENSIVE PSYCHIATRIC ASSESSMENT AND TREATMENT, ONE-ON-ONE INTERVENTION AND PSYCHIATRIC STABILIZATION AND MEDICATION MANAGEMENT. THE OPENING OF THE UNIT WAS HIGHLY ANTICIPATED BY COMMUNITY LEADERS SUCH AS LAW ENFORCEMENT, HEALTH ENFORCEMENT, LOCAL GOVERNMENT OFFICIALS, AND HEALTH/BEHAVIORAL HEALTH PROFESSIONALS. INPATIENT PSYCHIATRIC UNIT MEDICAL DIRECTOR BRADFORD BOBRIN, DM, FASAM, AND SAIDA S. ABDUL-AZIZ, DHA.C, MSN, MBA-HCM, RN, FCN LEAD A FULLY SUPPORTED STAFF INCLUDING REPRESENTATION FROM PSYCHIATRY, NURSING, MENTAL HEALTH THERAPISTS, REHABILITATION DIAGNOSE REHABILITATION THERAPISTS, SOCIAL WORK AND CASE MANAGEMENT WORKED TO DIAGNOSE AND TREAT A WIDE VARIETY OF MENTAL HEALTH CONDITIONS. THESE CONDITIONS INCLUDED DEPRESSION, ACUTE MOOD AND ANXIETY DISORDERS, POST-TRAUMATIC STRESS DISORDER, AND CO-OCCURRING PSYCHIATRIC/SUBSTANCE USE DISORDERS. SALEM MEDICAL CENTER ALSO PARTNERED WITH LEGACY TREATMENT SERVICES TO PROVIDE OUTPATIENT BEHAVIORAL HEALTH SERVICES. LEGACY OPERATED OUTPATIENT CARE TO ENSURE CONTINUITY OF CARE FOR INDIVIDUALS BEING DISCHARGED FROM THE INPATIENT ADULT PSYCHIATRIC UNIT, AS WELL AS AN OUTPATIENT RESOURCE TO MEET THE NEEDS OF THE COMMUNITY. RESTRUCTURING FOR TELEMETRY/MEDSURG UNIT ---------------------------------------- WHAT ORIGINALLY BEGAN AS A PROJECT TO CONTEND WITH THE COVID-19 PANDEMIC LED TO A MAJOR RESTRUCTURING FOR SALEM MEDICAL CENTER'S TELEMETRY/MEDSURG UNIT. THE PROJECT REQUIRED AN UPGRADE TO OUR TELEMETRY SYSTEM. THE DEPARTMENTS PREVIOUSLY KNOWN AS 2 NORTH AND 3 NORTH WERE MERGED INTO ONE UNIT, NOW KNOWN AS TELE/MEDSURG. THE ENTIRE UNIT WAS EQUIPPED FOR TELEMETRY. EACH PATIENT WHO NEEDED TELEMETRY MONITORING, THE PROCESS OF CONTINUOUSLY MONITORING A PERSON'S VITAL SIGNS AND CARDIAC RHYTHMS REMOTELY, WORE A TELEPAK. THE TELEPAK ALLOWED NURSES TO READ THE PATIENT'S VITALS IMMEDIATELY. THE NURSES SAW REAL-TIME HEART RHYTHMS ON THE PATIENT'S TELEPAK, CCOULD ADMIT AND DISCHARGE PATIENTS, AND ADJUST ALARM LEVELS RIGHT ON THE DEVICE. SINCE THE TELEPAK WAS PORTABLE, THE PATIENT WAS ABLE TO MOVE ABOUT FREELY AND DIDN'T HAVE TO CALL A NURSE OR WAIT TO BE UNHOOKED IF THEY NEEDED TO GET UP. THE DEVICE ALSO ALLOWED A PATIENT TO BE MONITORED CONTINUOUSLY EVEN IF THEY NEEDED TO TRAVEL OFF THE UNIT FOR DIAGNOSTIC TESTS. THE NEW EQUIPMENT WAS ANOTHER STEP FORWARD IN SALEM MEDICAL CENTER'S COMMITMENT TO PROVIDING SAFE, QUALITY CARE TO PATIENTS. LAUNCH OF MEDICATION ASSISTED TREATMENT PROGRAMS ------------------------------------------------ IN JULY 2021 SALEM MEDICAL CENTER LAUNCHED THE EMERGENCY DEPARTMENT ADDICTION PATHWAYS PROGRAM - A MEDICATION-ASSISTED TREATMENT PROGRAM FOR OPIOID USE DISORDERS. THESE PATIENTS ARE RARELY ADMITTED UNLESS THERE IS A SEPARATE UNDERLYING MEDICAL REASON. BY IMPLEMENTING THIS PROGRAM, SALEM MEDICAL CENTER HOPED TO REDUCE OPIOID USE AND OPIOID-RELATED DEATHS IN THE COMMUNITY. SALEM MEDICAL CENTER WANTED TO BE A PLACE WHERE PATIENTS COULD TURN WHEN THEY NEEDED HELP. BARON PARTNERED WITH NEWLY APPOINTED ADDICTION MEDICINE MEDICAL DIRECTOR RACHEL HAROZ, MD, TO EXECUTE THE PROGRAM. DR. HAROZ IS BOARD CERTIFIED IN EMERGENCY MEDICINE, TOXICOLOGY AND ADDICTION MEDICINE. SHE WILL BE ON SITE TO OVERSEE THIS NEW PROGRAM. THE FUTURE ========== SALEM MEDICAL CENTER JOINED INSPIRA HEALTH NETWORK -------------------------------------------------- IN DECEMBER 2022, INSPIRA HEALTH ANNOUNCED IT HAD ADDED SALEM MEDICAL CENTER TO ITS ORGANIZATION AND ACQUIRED ITS HOSPITAL BUILDING, AMBULATORY SURGERY CENTER AND PHYSICIAN OFFICES, EFFECTIVE IMMEDIATELY. THE TRANSACTION ENABLED SALEM MEDICAL CENTER - WHICH STARTED TO BE REFERRED TO AS SALEM MEDICAL CENTER, AN AFFILIATE OF INSPIRA HEALTH - TO JOIN THE NETWORK BY WAY OF A MEMBERSHIP SUBSTITUTION, THE MOST COMMON METHOD OF COMBINING NONPROFITS IN THE HEALTH CARE INDUSTRY. PARTNERING WITH THIS LARGER HEALTH CARE NETWORK WAS BENEFICIAL IN MANY WAYS, BUT OUR SUSTAINABILITY IS BENEFIT NUMBER ONE. FOR THE PAST 100 YEARS, SALEM MEDICAL CENTER HAS BEEN THE COUNTY'S MAJOR RESOURCE FOR HEALTH EXPERTISE. NOW, IN JOINING WITH INSPIRA, OUR HOPE TO CONTINUE PROVIDING EXCELLENT CARE FOR MANY YEARS HAS COME TO FRUITION. SALEM MEDICAL CENTER WAS FOCUSED ON MAKING THE SERVICES THAT WE PROVIDED, BOTH HOSPITAL-BASED AND OUTPATIENT PROGRAMS, REFLECTIVE OF THE EVOLVING NEEDS OF THE POPULATION WE SERVED. JOINING A LARGER HEALTH CARE NETWORK ENABLED US TO EXPAND OUR SERVICES TO SALEM COUNTY TO INCLUDE WOMEN'S SERVICES, COMPREHENSIVE ONCOLOGY SUCH AS RADIATION TREATMENTS, CARDIOLOGY SERVICES SUCH AS CATHETERIZATION AND OTHER HEART-RELATED PROCEDURES AND SURGERIES, URGENT CARE, ADDITIONAL PRIMARY CARE PRACTICES AND PHYSICIAN SPECIALISTS, AND ACCESS TO AFFILIATIONS WITH LARGER UNIVERSITY HOSPITALS. THE COMMUNITY RELIED ON MANY SALEM MEDICAL CENTER SERVICES, INCLUDING A NEW 26-BED INPATIENT PSYCHIATRIC UNIT AND RELATED BEHAVIORAL HEALTH SERVICES. SALEM MEDICAL CENTER MADE A MAJOR COMMITMENT TO WOUND CARE BY RENOVATING AND RELOCATING THE WOUND CARE CENTER TO THE FRONT OF THE BUILDING, ENSURING EASY ACCESS FOR PATIENTS, WITH PLANS TO BRING IN HYPERBARIC CHAMBERS. SALEM MEDICAL CENTER 'S FULLY DIGITAL IMAGING SUITE OFFERED AN ARRAY OF RADIOLOGY SERVICES, INCLUDING 3D MAMMOGRAPHY, MRI, CT, PET AND DEXA SCANS, NUCLEAR MEDICINE, ULTRASOUND AND X-RAYS. IN ADDITION TO INHOUSE LABORATORY SERVICES, SALEM MEDICAL CENTER PROVIDED BARIATRIC SURGERY, NEUROSURGERY, GENERAL SURGERY, INTERVENTIONAL RADIOLOGY, 24-7 EMERGENCY SERVICES, PLUS ICU AND MEDICAL-SURGICAL BEDS. CARDIAC REHAB AS WELL AS ONCOLOGY, CARDIAC AND PULMONARY SERVICES WERE ALSO READILY AVAILABLE. CORE FORM, PART III, QUESTION 3 EFFECTIVE WITH THE CLOSE OF BUSINESS ON OCTOBER 1, 2023, THIS ORGANIZATION WAS STATUTORILY MERGED INTO INSPIRA MEDICAL CENTERS, INC.; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. CORE FORM, PART V; QUESTION 15 AMY MANSUE IS INVOLVED IN THE LEADERSHIP AND MANAGEMENT OF THIS ORGANIZATION ON A FULL-TIME BASIS. SHE IS EMPLOYED AND RECEIVES A FEDERAL FORM W-2 FROM A RELATED ORGANIZATION. ACCORDINGLY, HER COMMON LAW EMPLOYER/EMPLOYEE RELATIONSHIP IS WITH INSPIRA MEDICAL CENTERS, INC. (EIN: 21-0634484). INSPIRA MEDICAL CENTERS, INC. FILED A 2023 FORM 4720 WHICH INCLUDED A REMITTANCE OF EXCISE TAX RELATED TO MS. MANSUE'S COMPENSATION IN EXCESS OF $1M. CORE FORM, PART VI; QUESTION 4 EFFECTIVE WITH THE CLOSE OF BUSINESS ON OCTOBER 1, 2023, THIS ORGANIZATION WAS STATUTORILY MERGED INTO INSPIRA MEDICAL CENTERS, INC.; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7 PRIOR TO ITS STATUTORY MERGER ON OCTOBER 1, 2023, INSPIRA HEALTH NETWORK, INC. ("NETWORK") was THE SOLE MEMBER OF THIS ORGANIZATION. NETWORK HAd THE RIGHT TO ELECT THE MEMBERS OF THIS ORGANIZATION'S BOARD OF TRUSTEES AND HAS CERTAIN POWERS AS DEFINED IN THIS ORGANIZATION'S BYLAWS. CORE FORM, PART VI, SECTION B; QUESTION 11B PRIOR TO ITS STATUTORY MERGER ON OCTOBER 1, 2023, THE ORGANIZATION WAS AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). INSPIRA HEALTH NETWORK, INC. ("NETWORK") IS THE TAX-EXEMPT PARENT ENTITY OF THE SYSTEM. THIS ORGANIZATION'S FEDERAL FORM 990 WAS PROVIDED TO EACH MEMBER OF THE NETWORK'S AUDIT COMMITTEE FOR REVIEW AND THEREAFTER APPROVAL BY THE MEMBERS AT THE AUDIT COMMITTEE MEETING. SUBSEQUENTLY, THE ORGANIZATION'S 990 WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S BOARD OF TRUSTEES, PRIOR TO FILING WITH THE IRS. THE NETWORK'S AUDIT COMMITTEE HAS ASSUMED THE RESPONSIBILITY TO OVERSEE AND COORDINATE THE FEDERAL FORM 990 PREPARATION, REVIEW AND FILING PROCESS FOR ALL TAX-EXEMPT AFFILIATES WITHIN THE SYSTEM. AS PART OF THE ORGANIZATION'S FEDERAL FORM 990 TAX RETURN PREPARATION PROCESS THE SYSTEM HIRED A PROFESSIONAL CERTIFIED PUBLIC ACCOUNTING ("CPA") FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION TO PREPARE THE FEDERAL FORM 990. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE ORGANIZATION'S FINANCE PERSONNEL AND SYSTEM INDIVIDUALS INCLUDING SENIOR VICE PRESIDENT AND CHIEF LEGAL OFFICER, SENIOR VICE PRESIDENT/CHIEF FINANCIAL OFFICER, VICE PRESIDENT OF FINANCE AND VARIOUS OTHER INDIVIDUALS ("INTERNAL WORKING GROUP") TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE ORGANIZATION'S INTERNAL WORKING GROUP FOR REVIEW. THE ORGANIZATION'S INTERNAL WORKING GROUP REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE ORGANIZATION'S INTERNAL WORKING GROUP FOR FINAL REVIEW AND APPROVAL. FOLLOWING THIS REVIEW, THE FORM 990 WAS THEN PRESENTED TO THE NETWORK'S AUDIT COMMITTEE AND PROVIDED TO THE ORGANIZATION'S GOVERNING BODY PRIOR TO FILING WITH THE IRS. CORE FORM, PART VI, SECTION B; QUESTION 12 PRIOR TO ITS STATUTORY MERGER ON OCTOBER 1, 2023, THE organization was an affiliate within Inspira Health Network; a tax-exempt integrated healthcare delivery system ("System"). Inspira Health Network, Inc. ("Network") is the tax-exempt parent entity of the system. The system has a written conflict of interest policy with which all affiliates REGULARLY MONITOR AND ENFORCE COMPLIANCE. THE CONFLICT OF INTEREST POLICY REQUIRES THAT A CONFLICT OF INTEREST DISCLOSURE STATEMENT, CONSISTENT WITH BEST GOVERNANCE PRACTICES AND INTERNAL REVENUE SERVICE GUIDELINES, BE CIRCULATED ANNUALLY TO ALL TRUSTEES/DIRECTORS, OFFICERS, KEY EMPLOYEES AND COMMITTEE MEMBERS (COLLECTIVELY, "INSPIRA MANAGEMENT") WITHIN THE SYSTEM. ALL MEMBERS OF INSPIRA MANAGEMENT ARE REQUIRED TO REVIEW THE EXISTING CONFLICT OF INTEREST POLICY ANNUALLY AND SIGN A DISCLOSURE STATEMENT WHICH AFFIRMS THAT THEY: (A) HAVE RECEIVED A COPY OF THIS CONFLICT OF INTEREST POLICY; (B) HAVE READ AND UNDERSTOOD THE POLICY; (C) HAVE AGREED TO COMPLY WITH THE POLICY, AND (D) UNDERSTAND THAT THE ORGANIZATION IS A CHARITABLE, TAX-EXEMPT ORGANIZATION AND THAT, IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. PER THE SYSTEM'S CONFLICT OF INTEREST POLICY, ANY MEMBER OF INSPIRA MANAGEMENT HAVING A POTENTIAL OR ACTUAL SIGNIFICANT FINANCIAL OR PERSONAL INTEREST IN ANY TRANSACTION OR ARRANGEMENT, SHALL MAKE A PROMPT, FULL AND FRANK DISCLOSURE OF HIS OR HER INTEREST TO THE APPLICABLE GOVERNING BOARD OR A COMMITTEE THEREOF WHICH IS CONSIDERING THE AUTHORIZATION, APPROVAL, RATIFICATION, OR SIMILAR ACTION OF SUCH TRANSACTION OR ARRANGEMENT PRIOR TO THE ORGANIZATION ACTING ON SUCH TRANSACTION OR ARRANGEMENT. THE COMPLETED CONFLICT OF INTEREST DISCLOSURE STATEMENTS ARE RETURNED TO THE SYSTEM'S senior vice president and chief legal officer FOR REVIEW. THEREAFTER, the senior vice president and chief legal officer presents any conflicts of interest to THE NETWORK'S GOVERNANCE COMMITTEE FOR ITS REVIEW AND DISCUSSION. MANAGEMENT HAVING A POTENTIAL OR ACTUAL SIGNIFICANT FINANCIAL OR PERSONAL INTEREST IN ANY TRANSACTION OR ARRANGEMENT, SHALL MAKE A PROMPT, FULL AND FRANK DISCLOSURE OF HIS OR HER INTEREST TO THE APPLICABLE GOVERNING BOARD OR A COMMITTEE THEREOF WHICH IS CONSIDERING THE AUTHORIZATION, APPROVAL, RATIFICATION, OR SIMILAR ACTION OF SUCH TRANSACTION OR ARRANGEMENT PRIOR TO THE ORGANIZATION ACTING ON SUCH TRANSACTION OR ARRANGEMENT. THE COMPLETED CONFLICT OF INTEREST DISCLOSURE STATEMENTS ARE RETURNED TO THE SYSTEM'S senior vice president and chief legal officer FOR REVIEW. THEREAFTER, THE SENIOR VICE PRESIDENT AND CHIEF LEGAL OFFICER presents any conflicts of interest to THE NETWORK'S GOVERNANCE COMMITTEE FOR ITS REVIEW AND DISCUSSION. CORE FORM, PART VI, SECTION B; QUESTION 15 PRIOR TO ITS STATUTORY MERGER ON OCTOBER 1, 2023, THE ORGANIZATION WAS AN affiliate within Inspira Health Network; a tax-exempt integrated healthcare delivery system ("System"). Inspira Health Network, Inc. ("Network") is the tax-exempt parent entity of the system. Post-acquisition this organization adopted the System's policies and procedures as it relates to its executive compensation review and approval process. The Network's board of trustees has an executive compensation committee ("COMMITTEE"). THE COMMITTEE HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY WHICH IT FOLLOWS WHEN IT REVIEWS AND APPROVES OF THE COMPENSATION AND BENEFITS OF THE ORGANIZATION'S SENIOR MANAGEMENT, INCLUDING, BUT NOT LIMITED TO, THE PRESIDENT/CHIEF EXECUTIVE OFFICER AND all executive vice presidents and senior vice presidents that report directly to the president/chief executive officer ("senior management"). THE COMMITTEE REVIEWS THE "TOTAL COMPENSATION" of senior management WHICH IS INTENDED TO INCLUDE BOTH CURRENT AND DEFERRED COMPENSATION AND ALL EMPLOYEE BENEFITS, BOTH QUALIFIED AND NON-QUALIFIED. THE COMMITTEE'S REVIEW IS DONE ON AT LEAST AN ANNUAL BASIS AND ENSURES THAT THE "TOTAL COMPENSATION" OF SENIOR MANAGEMENT OF THE ORGANIZATION IS REASONABLE. THE ACTIONS TAKEN BY THE COMMITTEE ENABLE THE ORGANIZATION TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 4958 WITH RESPECT TO THE TOTAL COMPENSATION OF SENIOR MANAGEMENT. THE THREE FACTORS WHICH MUST BE SATISFIED IN ORDER TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS ARE THE FOLLOWING: 1. THE COMPENSATION ARRANGEMENT IS APPROVED IN ADVANCE BY AN "AUTHORIZED BODY" OF THE APPLICABLE TAX-EXEMPT ORGANIZATION WHICH IS COMPOSED ENTIRELY OF INDIVIDUALS WHO DO NOT HAVE A "CONFLICT OF INTEREST" WITH RESPECT TO THE COMPENSATION ARRANGEMENT; 2. THE AUTHORIZED BODY OBTAINED AND RELIED UPON "APPROPRIATE DATA AS TO COMPARABILITY" PRIOR TO MAKING ITS DETERMINATION; AND 3. THE AUTHORIZED BODY "ADEQUATELY DOCUMENTED THE BASIS FOR ITS DETERMINATION" CONCURRENTLY WITH MAKING THAT DETERMINATION. THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES EACH OF WHO ARE INDEPENDENT AND ARE FREE FROM ANY CONFLICTS OF INTEREST. THE COMMITTEE RELIED UPON APPROPRIATE COMPARABLE DATA; SPECIFICALLY THE COMMITTEE OBTAINED A WRITTEN COMPENSATION STUDY FROM AN INDEPENDENT FIRM WHICH SPECIALIZES IN THE REVIEWING OF HOSPITAL AND HEALTHCARE SYSTEM EXECUTIVE COMPENSATION AND BENEFITS THROUGHOUT THE UNITED STATES. THIS STUDY USED COMPARABLE GEOGRAPHIC AND DEMOGRAPHIC MARKET DATA INCLUDING BUT NOT LIMITED TO SIMILAR SIZED HOSPITALS, # OF LICENSED BEDS AND NET PATIENT SERVICE REVENUE. THE COMMITTEE ADEQUATELY DOCUMENTED ITS BASIS FOR ITS DETERMINATION THROUGH THE TIMELY PREPARATION OF WRITTEN MINUTES OF THE COMPENSATION COMMITTEE MEETINGS DURING WHICH THE EXECUTIVE COMPENSATION AND BENEFITS WAS REVIEWED AND SUBSEQUENTLY APPROVED. THE ACTIONS OUTLINED ABOVE WITH RESPECT TO THE COMMITTEE AND THE ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS ONLY APPLIES TO SENIOR MANAGEMENT. THE COMPENSATION AND BENEFITS OF CERTAIN OTHER INDIVIDUALS CONTAINED IN THIS FORM 990 ARE REVIEWED ANNUALLY BY THE PRESIDENT/CHIEF EXECUTIVE OFFICER WITH ASSISTANCE FROM THE SYSTEM'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. IN ADDITION, THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND AUDITED FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. CORE FORM, PART VII AND SCHEDULE J CORE FORM, PART VII AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM THE ORGANIZATION OR A RELATED ORGANIZATION. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OF THE ORGANIZATION OR RELATED ORGANIZATION AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THE ORGANIZATION'S BOARD OF TRUSTEES. CORE FORM, PART VII, SECTION A, COLUMN B PRIOR TO ITS STATUTORY MERGER ON OCTOBER 1, 2023, this organization was AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). CERTAIN BOARD OF TRUSTEE MEMBERS AND OFFICERS LISTED ON CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 MAY HOLD SIMILAR POSITIONS WITH BOTH THIS ORGANIZATION AND OTHER AFFILIATES WITHIN THE SYSTEM. THE HOURS SHOWN ON THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE NO COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, REPRESENT THE ESTIMATED HOURS DEVOTED PER WEEK FOR THIS ORGANIZATION. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF TRUSTEES OF OTHER RELATED ORGANIZATIONS IN THE SYSTEM, THEIR RESPECTIVE HOURS PER WEEK PER ORGANIZATION ARE APPROXIMATELY THE SAME AS REFLECTED IN CORE FORM, PART VII OF THIS FORM 990. THE HOURS REFLECTED ON CORE FORM, PART VII OF THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, PAID OFFICERS AND KEY EMPLOYEES, REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF THE SYSTEM; NOT SOLELY THIS ORGANIZATION. CORE FORM, PART XI; QUESTION 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCE INCLUDE: - STATUTORY MERGER AND TRANSFER OF NET ASSETS OF ENTITY INTO INSPIRA MEDICAL CENTERS, INC.; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION - ($1,757,981). CORE FORM, PART XII; QUESTION 2 THE ORGANIZATION IS AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM'S TAX-EXEMPT PARENT ENTITY IS INSPIRA HEALTH NETWORK, INC. ("NETWORK"). AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF THE NETWORK AND ALL ENTITIES WITHIN THE SYSTEM FOR THE YEARS ENDED DECEMBER 31, 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 EACH YEAR. THE NETWORK'S AUDIT COMMITTEE HAS ASSUMED RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE CONSOLIDATED FINANCIAL STATEMENTS, WHICH INCLUDES THIS ORGANIZATION, AND THE SELECTION OF AN INDEPENDENT AUDITOR. CORE FORM, PART XII; QUESTION 3 THE ORGANIZATION IS AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM ENGAGED AN INDEPENDENT ACCOUNTING FIRM TO PREPARE AND ISSUE A SYSTEM WIDE CONSOLIDATED AUDIT AS SET FORTH IN THE UNIFORM GUIDANCE, 2 C.F.R., PART 200, SUBPART F. THE SYSTEM ENGAGED AN INDEPENDENT ACCOUNTING FIRM TO PREPARE AND ISSUE THE UNIFORM GUIDANCE. FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED LABOR TOTAL FEES:4038053 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN FEES TOTAL FEES:2073751 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:2029218 FORM 990 PART IX LINE 11G DESCRIPTION:REVENUE CYCLE SERVICES TOTAL FEES:1521525 FORM 990 PART IX LINE 11G DESCRIPTION:OUTSIDE LAB SERVICES TOTAL FEES:159920 FORM 990 PART IX LINE 11G DESCRIPTION:RECRUITING TOTAL FEES:37045 INSPIRA HEALTH NETWORK 333 IRVING AVENUE BRIDGETON NJ 08302 222508425 HEALTH SVCS. 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NJ NA C CORP. false false false false false true false false false false true false false false true true false true true true SALEM PHYSICIAN PRACTICES PC E 16395601 COST SCHEDULE R, PART V THE ORGANIZATION IS AN AFFILIATE WITHIN INSPIRA HEALTH NETWORK; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. FUNDS ARE ROUTINELY TRANSFERRED BETWEEN AFFILIATES AND BUSINESS ACTIVITIES ARE COMMON ON BEHALF OF THE SYSTEM'S AFFILIATES, INCLUDING THIS ORGANIZATION. THESE TRANSACTIONS MAY BE RECORDED ON THE REVENUE/EXPENSE AND BALANCE SHEET STATEMENTS OF THIS ORGANIZATION AND OTHER AFFILIATES. 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.