2023-11-12T21:35:26-06:00 2022-12-31 873231666 PKF O'CONNOR DAVIES ADVISORY LLC 300 TICE BOULEVARD SUITE 315 WOODCLIFF LAKE NJ 07677 990 2022-01-01 222922016 VALLEY HEALTH SYSTEM INC VALL 2012916200 223 NORTH VAN DIEN AVE RIDGEWOOD NJ 07450 WILLIAM KLUTKOWSKI SENIOR VP OF FINANCE & CFO 2012916200 2023-11-12 1 WILLIAM KLUTKOWSKI 999009999 1 GARRETT M HIGGINS P00543209 2017129800 2023-11-09 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z AUDREY MEYERS 223 NORTH VAN DIEN AVE RIDGEWOOD NJ 07450 109202382 0 X WWW.VALLEYHEALTH.COM X 1988 NJ TO PROVIDE MANAGEMENT AND PLANNING SERVICES FOR THE ENTITIES OF THE VALLEY HEALTH SYSTEM. 19 18 500 18 0 0 0 0 101741635 102672075 4108555 394209 0 0 105850190 103066284 0 0 0 0 56667628 62827632 0 0 0 55823770 40508342 112491398 103335974 -6641208 -269690 53555711 58560203 50535666 53976441 3020045 4583762 X VALLEY HEALTH SYSTEM IS A FULL SERVICE HEALTHCARE SYSTEM SERVING THE RESIDENTS OF NORTHERN NEW JERSEY. IT COMPRISES THE MANY PROGRAMS AND SERVICES OF THE VALLEY HOSPITAL, A FULL SERVICE HOME CARE AGENCY, VALLEY HOME CARE, AND COMMUNITY-BASED PRIMARY AND URGENT CARE CENTERS, VALLEY HEALTH MEDICAL GROUPS, THAT BRING QUALITY HEALTHCARE TO MANY COMMUNITIES OF BERGEN COUNTY. 0 0 103335974 102672075 THE ORGANIZATION PROVIDED MANAGEMENT AND PLANNING SERVICES TO ITS SUBSIDIARIES AND AFFILIATES OF THE VALLEY HEALTH SYSTEM. 103335974 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 120 0 500 1 0 0 0 0 0 0 0 0 0 0 1 0 X 19 18 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NJ X WILLIAM KLUTKOWSKI 2012916200 223 NORTH VAN DIEN AVE RIDGEWOOD NJ 07450 AUDREY MEYERS PRESIDENT & CEO, VHS 8.00 32.00 X X 3974039 0 49572 VINCENT FORLENZA CHAIR 0.10 0.40 X X 0 0 0 KEVIN LOBO VICE CHAIR 0.10 0.40 X X 0 0 0 FRANK J SHEEHY VICE CHAIR 0.10 0.40 X X 0 0 0 ANN LIMBERG VICE CHAIR & SECRETARY 0.10 0.40 X X 0 0 0 JOSEPH MARION TREASURER 0.10 0.40 X X 0 0 0 JUDY BASELICE TRUSTEE 0.10 0.40 X 0 0 0 JAMES BUSH TRUSTEE 0.10 0.40 X 0 0 0 MICHELLE HASSON TRUSTEE 0.10 0.40 X 0 0 0 M SHAWN KENNEDY TRUSTEE 0.10 0.40 X 0 0 0 BRUCE MACTAS TRUSTEE 0.10 0.40 X 0 0 0 DUANE SACHS TRUSTEE 0.10 0.40 X 0 0 0 DENIS SALAMONE TRUSTEE 0.10 0.40 X 0 0 0 SCOTT SCHROEDER TRUSTEE 0.10 0.40 X 0 0 0 EDWARD B SELF MD TRUSTEE 0.10 0.40 X 0 0 0 STEVEN SILVERSTEIN TRUSTEE 0.10 0.40 X 0 0 0 JEFFREY TUCKER TRUSTEE 0.10 0.40 X 0 0 0 PATRICIA VERDUIN TRUSTEE 0.10 0.40 X 0 0 0 WAYNE WALD ESQ TRUSTEE 0.10 0.40 X 0 0 0 ROBERT W BRENNER PRESIDENT CLINICAL INTEGRATION/PHYSICIAN ENT. 8.00 32.00 X 1461032 0 28405 WILLIAM KLUTKOWSKI SR. VP, FINANCE & CFO 40.00 0.00 X 1016955 0 57305 PETER DIESTEL PRESIDENT, VHS OPERATIONS 40.00 0.00 X 1018873 0 46482 JOSE BALDERRAMA VP, HUMAN RESOURCES 40.00 0.00 X 644535 0 35347 KARCHER JULIA N SR. VP, VHS/VMG 40.00 0.00 X 591959 0 41719 EPHRAIM CASPER CMO COMPREHENSIVE CANCER CARE 40.00 0.00 X 1046121 0 44617 ROBIN HOLLANDER SENIOR VP LEGAL SERVICES/ GENERAL COUNSEL 40.00 0.00 X 873571 0 50092 ERIC CAREY VP/CIO, INFORMATION SYS 40.00 0.00 X 738870 0 57331 JOSEPH LORINO VP, FACILITIES MANAGEMENT 40.00 0.00 X 509211 0 35925 MEGAN FRASER VP, COMMUNICATIONS/ MARKETING 40.00 0.00 X 506285 0 37905 12381451 0 484700 168 0 1 0 PANGAIA PARTNERS 80 EAST ROUTE 4 SUITE 400 PARAMUS NJ 07652 COMPUTER SECURITY SERVICES 2609236 SPM MARKETING & COMMUNICATIONS LLC 15 WHARRIS AVENUE SUITE 300 LAGRANGE IL 60525 HEALTHCARE MARKETING & COMMUNICATIONS 2452759 HERITAGE INC 4 WILSEY SQUARE RIDGEWOOD NJ 07450 COMMERCIAL PRINTING 820469 DISPATCH HEALTH MANAGEMENT LLC 3455 RINGSBY COURT SUITE 101 DENVER CO 80126 HOME HEALTH CARE 718016 OUTFRONT MEDIA 405 LEXINGTON AVENUE NEW YORK NY 10174 ADVERTISING SERVICES 689250 30 AFFILIATE COST ALLOCATION 900099 97962462 97962462 INCENTIVE PROGRAM FEES 900099 4709613 4709613 102672075 483803 483803 6046504 6136098 -89594 -89594 -89594 103066284 102672075 0 394209 X 8966223 8966223 42966430 42966430 2063979 2063979 5354443 5354443 3476557 3476557 54784 54784 1439082 1439082 64279 64279 14344 14344 16559256 16559256 6389309 6389309 1010876 1010876 1658579 1658579 59606 59606 165671 165671 1487320 1487320 ALLOCATED OTHER EXPENSE 4736543 4736543 LICENSES & ASSESSMENTS 4730483 4730483 PAID CLAIMS BY CAPTIVE 1127376 1127376 DUES & SUBSCRIPTION 1010834 1010834 103335974 103335974 0 0 2425098 1772913 1682096 3300180 904532 305535 9553190 11333937 35605218 31806766 3385577 10040872 53555711 58560203 12233829 18049003 38301837 35927438 50535666 53976441 X 3020045 4583762 3020045 4583762 53555711 58560203 X -269690 -4166593 6000000 X X 0 1 X 1 0 X 66468276 78926070 80959432 101741635 102672075 430767488 66468276 78926070 80959432 101741635 102672075 430767488 0 0 0 430767488 1010750 387142 368445 483803 2250140 1010750 387142 368445 483803 2250140 66468276 79936820 81346574 102110080 103155878 433017628 0.99480 0.99550 0.00520 0.00450 X 0 DUE FROM AFFILIATES 10040872 10040872 ESTIMATED PROFESSIONAL LIABILITY 35927438 35927438 X 104899691 -4166593 6000000 1833407 103066284 0 103066284 103335974 0 103335974 0 103335974 PART X, LINE 2: THE COMPANY AND ITS SUBSIDIARY RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT TO BE SUSTAINED. MANAGEMENT HAS DETERMINED THAT THE COMPANY AND ITS SUBSIDIARY HAD NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION AND/OR DISCLOSURE. THE COMPANY AND ITS SUBSIDIARY IS NO LONGER SUBJECT TO U.S. FEDERAL, STATE OR LOCAL INCOME TAX EXAMINATIONS FOR PERIODS PRIOR TO DECEMBER 31, 2019. PART XI, LINE 2D - OTHER ADJUSTMENTS: TRANSFER FROM THE VALLEY HOSPITAL FOR CAPTIVE INSURANCE 6,000,000. CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENT IN CAPTIVE INSURANCE SUBSIDIARY 34515197 0 0 0 0 0 0 34515197 0 34515197 1 0 1 0 0 0 PART III ACCOUNTING METHOD: SCHEDULE F, PART IV, LINE 1: THE ORGANIZATION TRANSFERRED $6,000,000 TO VHS INSURANCE COMPANY, LTD., A FOREIGN CORPORATION, DURING THE TAX YEAR AND IS REQUIRED TO FILE FORM 926, RETURN BY A U.S. TRANSFEROR OF PROPERTY TO A FOREIGN CORPORATION. SCHEDULE F, PART IV, LINE 3: THE ORGANIZATION HAD AN OWNERSHIP INTEREST IN VHS INSURANCE COMPANY, LTD., A FOREIGN CORPORATION, DURING THE TAX YEAR REQUIRED TO FILE FORM 5471, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS. X X X X 0 1 0 0 0 0 0 1 0 AUDREY MEYERS PRESIDENT & CEO, VHS 1249299 0 984960 0 1739780 0 22875 0 26697 0 4023611 0 1583249 0 ROBERT W BRENNER PRESIDENT CLINICAL INTEGRATION/PHYSICIAN ENT. 816543 0 357704 0 286785 0 13725 0 14680 0 1489437 0 0 0 EPHRAIM CASPER CMO COMPREHENSIVE CANCER CARE 850327 0 140450 0 55344 0 15250 0 29367 0 1090738 0 0 0 WILLIAM KLUTKOWSKI SR. VP, FINANCE & CFO 627904 0 192180 0 196871 0 21138 0 36167 0 1074260 0 0 0 PETER DIESTEL PRESIDENT, VHS OPERATIONS 498720 0 326486 0 193667 0 21825 0 24657 0 1065355 0 162968 0 ROBIN HOLLANDER SENIOR VP LEGAL SERVICES/ GENERAL COUNSEL 581687 0 236691 0 55193 0 19825 0 30267 0 923663 0 0 0 ERIC CAREY VP/CIO, INFORMATION SYS 436076 0 130326 0 172468 0 22875 0 34456 0 796201 0 34673 0 JOSE BALDERRAMA VP, HUMAN RESOURCES 407114 0 127872 0 109549 0 15250 0 20097 0 679882 0 0 0 KARCHER JULIA N SR. VP, VHS/VMG 384943 0 102361 0 104655 0 19825 0 21894 0 633678 0 0 0 JOSEPH LORINO VP, FACILITIES MANAGEMENT 321056 0 102356 0 85799 0 15250 0 20675 0 545136 0 0 0 MEGAN FRASER VP, COMMUNICATIONS/ MARKETING 307501 0 93807 0 104977 0 22875 0 15030 0 544190 0 0 0 PART I, LINE 3 VALLEY HEALTH SYSTEM HAS DEVELOPED A COMPENSATION PLAN, WHICH GOVERNS THE COMPENSATION FOR ALL EXECUTIVES, INCLUDING THE CEO AND VICE PRESIDENTS OF THE ORGANIZATION. THE PLAN WAS DEVELOPED IN CONJUNCTION WITH A CONSULTING FIRM, REVIEWED BY THE PHYSICIAN LEADERSHIP COUNCIL AND APPROVED BY THE BOARD OF TRUSTEES AND THE VALLEY HEALTH SYSTEM PHYSICIAN COMPENSATION COMMITTEE. ON AN ANNUAL BASIS, THE PLAN IS REVIEWED AND UPDATED AS NEEDED. PART I, LINE 4B AUDREY MEYERS, WILLIAM KLUTKOWSKI, PETER DIESTEL AND ERIC CAREY PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN. THE FOLLOWING INDIVIDUALS RECEIVED A PAYMENT DURING 2022 FROM THIS PLAN AS REPORTED IN PART II, COLUMN BIII AND COLUMN F: AUDREY MEYERS, $1,583,249; PETER DIESTEL, $162,968 AND ERIC CAREY, $34,673. AUDREY MEYERS, ROBIN GOLDFISCHER-HOLLANDER, AND PETER DIESTEL PARTICIPATED IN A CAP-EX (SPLIT-DOLLAR LIFE INSURANCE PLAN). THEY DID NOT RECEIVE A PAYMENT DURING 2022. PART I, LINE 7 EMPLOYEES OF THE ORGANIZATION RECEIVED A BOARD-APPROVED DISCRETIONARY BONUS, AWARDED BASED ON PERFORMANCE, AS REPORTED FOR THEM IN PART II, COLUMN B(II). FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM. IT IS REVIEWED BY MANAGEMENT AND THE AUDIT COMMITTEE OF VALLEY HEALTH SYSTEM. A COMPLETE COPY OF THE FORM 990 IS MADE AVAILABLE TO ALL MEMBERS OF THE ORGANIZATION'S GOVERNING BODY PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE VALLEY HEALTH SYSTEM HAS A CONFLICT OF INTEREST POLICY WHICH COVERS ALL CONTROLLED ORGANIZATIONS WITHIN THE HEALTH SYSTEM, INCLUDING THIS ORGANIZATION. THE POLICY REQUIRES ALL TRUSTEES, OFFICERS, AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS, TO ANNUALLY SIGN A CONFLICT OF INTEREST STATEMENT, DISCLOSING ANY POTENTIAL CONFLICTS WHICH MAY EXIST. SUCH PERSONS ARE ALSO REQUIRED TO DISCLOSE ANY POTENTIAL CONFLICTS AS THEY ARISE. CONFLICTS ARE DETERMINED BY THE BOARD OF TRUSTEES OR DELEGATED COMMITTEE CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. PERSONS WITH CONFLICTS OF INTEREST MUST NOT PARTICIPATE IN THE DISCUSSION OR VOTE ON THE RELATED MATTER. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION HAS ESTABLISHED A POLICY FOR COMPENSATION OF ITS OFFICERS AND TOP MANAGEMENT. THE POLICY MANDATES THAT COMPENSATION FOR ITS OFFICERS AND TOP MANAGEMENT, BE ANNUALLY REVIEWED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES FREE OF ANY MEMBERS WITH CONFLICTS OF INTEREST RELATED THERETO. THE COMMITTEE DETERMINES THAT THE EXECUTIVES ARE BEING PAID AN APPROPRIATE LEVEL OF COMPENSATION BY USING COMPARATIVE DATA FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. COMPENSATION DECISION ON THE AMOUNT OF COMPENSATION PAID AND TERM IS ADEQUATELY DOCUMENTED IN A CONTEMPORANEOUSLY WRITTEN FORMAT. THIS PROCESS WAS LAST UNDERTAKEN IN 2022. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, AND GOVERNING DOCUMENTS AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G OUTSIDE SERVICE FEES: PROGRAM SERVICE EXPENSES 1,539,188. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,539,188. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 11,642,377. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,642,377. TEMPORARY HELP: PROGRAM SERVICE EXPENSES 1,207,969. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,207,969. CONSULTING: PROGRAM SERVICE EXPENSES 2,131,533. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,131,533. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 38,189. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 38,189. FORM 990, PART XI, LINE 9: TRANSFER FROM THE VALLEY HOSPITAL FOR CAPTIVE INSURANCE 6,000,000. FORM 990, PART XII, LINE 2C THE ORGANIZATION HAS A COMMITTEE RESPONSIBLE FOR THE OVERSIGHT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. COLIGOCARE LLC 223 N VAN DIEN AVE RIDGEWOOD NJ 07450 CLINICALLY INTERGRATED NETWORK NJ 4729874 3488066 VALLEY HEALTH SYSTEM INC THE VALLEY HOSPITAL FOUNDATION INC 223 N VAN DIEN AVE RIDGEWOOD NJ 07450 222324554 SOLICITS AND RECEIVES CONTRIBUTIONS FOR THE BENEFIT OF HEALTH SYSTEM NJ 501(C)(3) LINE 7 VALLEY HEALTH SYSTEM INC 1 THE VALLEY HOSPITAL INC 223 N VAN DIEN AVE RIDGEWOOD NJ 07450 221487307 PROVIDE HEALTHCARE PROGRAMS AND SERVICES TO ALL NJ 501(C)(3) LINE 3 VALLEY HEALTH SYSTEM INC 1 VALLEY HOME CARE INC 15 ESSEX ROAD PARAMUS NJ 07652 223208480 PROVIDE HOME CARE AND HOSPICE SERVICES TO RESIDENTS OF NORTHERN NJ NJ 501(C)(3) LINE 10 VALLEY HEALTH SYSTEM INC 1 VALLEY MEDICAL SERVICES PC 15 ESSEX ROAD PARAMUS NJ 07652 465297054 PROVIDE PRIMARY AND SPECIALTY MEDICAL CARE NJ 501(C)(3) LINE 10 VALLEY PHYSICIAN SERVICES INC 0 VALLEY PHYSICIAN SERVICE NY PC 15 ESSEX ROAD PARAMUS NJ 07652 453125678 OPERATES URGENT/PRIMARY CARE CLINICS NY 501(C)(3) LINE 10 VALLEY PHYSICIAN SERVICES INC 0 VALLEY PHYSICIAN SERVICES INC 223 N VAN DIEN AVE RIDGEWOOD NJ 07450 320041186 PROVIDES MANAGEMENT AND VARIED CONSULTING SERVICES NJ 501(C)(3) LINE 10 THE VALLEY HOSPITAL INC 0 VALLEY PHYSICIANS SERVICES PC 15 ESSEX ROAD PARAMUS NJ 07652 465285330 PROVIDE PRIMARY AND SPECIALTY MEDICAL CARE NJ 501(C)(3) LINE 10 VALLEY PHYSICIAN SERVICES INC 0 VHS INSURANCE COMPANY LTD 010 MAIN STREET CAYMAN ISLANDS CJ 980408200 CAPTIVE INSURANCE COMPANY CJ VALLEY HEALTH SYSTEM INC C 34515196 1.00000 1 0 1 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 THE VALLEY HOSPITAL O 51673823 COST VALLEY HOME CARE Q 6350000 COST THE VALLEY HOSPITAL S 94000000 COST VHS INSURANCE COMPANY LTD B 6000000 COST