2022-11-15T12:53:32-06:00 2021-12-31 271728945 PKF O'CONNOR DAVIES LLP 300 TICE BOULEVARD SUITE 315 WOODCLIFF LAKE NJ 07677 990 2021-01-01 222922016 VALLEY HEALTH SYSTEM INC VALL 2012916200 223 NORTH VAN DIEN AVE RIDGEWOOD NJ 07450 WILLIAM KLUTKOWSKI SENIOR VP OF FINANCE & CFO 2012916200 2022-11-15 1 WILLIAM KLUTKOWSKI 999009999 GARRETT M HIGGINS P00543209 2017129800 2022-11-09 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z AUDREY MEYERS 223 NORTH VAN DIEN AVE RIDGEWOOD NJ 07450 114429169 0 X WWW.VALLEYHEALTH.COM X 1988 NJ TO PROVIDE MANAGEMENT AND PLANNING SERVICES FOR THE ENTITIES OF THE VALLEY HEALTH SYSTEM. 19 18 473 18 0 0 0 0 80959432 101741635 322948 4108555 0 0 81282380 105850190 0 0 0 0 50480639 56667628 0 0 0 32587626 55823770 83068265 112491398 -1785885 -6641208 45134894 53555711 43790379 50535666 1344515 3020045 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 0 0 101741635 THE ORGANIZATION PROVIDED MANAGEMENT AND PLANNING SERVICES TO ITS SUBSIDIARIES AND AFFILIATES OF THE VALLEY HEALTH SYSTEM. 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 1 112 0 473 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 0 0 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 1715221 0 46536 VINCENT FORLENZA CHAIRMAN 0.10 0.40 X X 0 0 0 ANN LIMBERG VICE CHAIRMAN/SECRETARY 0.10 0.40 X X 0 0 0 KEVIN LOBO VICE CHAIRMAN 0.10 0.40 X X 0 0 0 FRANK J SHEEHY VICE CHAIRMAN 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 RN 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 WILLIAM KLUTKOWSKI VP FINANCE & CFO EFF. 3/2021 40.00 0.00 X 709400 0 54102 ROBERT W BRENNER PRESIDENT, CLINICAL INTEGRATION 8.00 32.00 X 1278073 0 25357 PETER W DIESTEL PRESIDENT, VHS OPERATIONS 40.00 0.00 X 965335 0 43436 JOSE BALDERRAMA VP, HUMAN RESOURCES 40.00 0.00 X 576774 0 33155 EPHRAIM S CASPER MD CHIEF MEDICAL OFFICER 40.00 0.00 X 947492 0 41829 ROBIN G HOLLANDER SENIOR VP, LEGAL SERVICES 40.00 0.00 X 801917 0 47089 ERIC CAREY VP/CIO, INFO. SYSTEMS 15.00 25.00 X 606188 0 53919 JOSEPH LORINO VP, FACILITIES MANAGEMENT 40.00 0.00 X 460161 0 35347 MEGAN FRASER VP, COMMUNICATIONS/ MARKET 40.00 0.00 X 460579 0 34057 RICHARD KEENAN FORMER SENIOR VP FINANCE/CFO 0.00 0.00 X 4692143 0 0 13213283 0 414827 150 1 1 0 SPM MARKETING & COMMUNICATIONS LLC 15 WHARRIS AVENUE SUITE 300 LAGRANGE IL 60525 HEALTHCARE MARKETING & COMMUNICATIONS 2218728 HERITAGE INC 4 WILSEY SQUARE RIDGEWOOD NJ 07450 COMMERCIAL PRINTING 856129 DISPATCH HEALTH MANAGEMENT LLC 3455 RINGSBY COURT SUITE 101 DENVER CO 80126 HOME HEALTH CARE 788173 FURMAN ROTH ADVERTISING 801 SECOND AVENUE NEW YORK NY 10017 ADVERTISING SERVICES 674180 NORTH JERSEY MEDIA GROUP 1 GARRET MOUNTAIN PLAZA WOODLAND PARK NJ 07424 NEWSPAPER ADVERTISING 544594 30 AFFILIATE COST ALLOCATION 900099 85575431 85575431 INCENTIVE PROGRAM FEES 900099 16166204 16166204 101741635 368445 368445 12319089 8578979 3740110 3740110 3740110 105850190 101741635 0 4108555 X 5447387 5447387 4692143 4692143 36763605 36763605 2013765 2013765 4509071 4509071 3241657 3241657 54784 54784 1408931 1408931 44846 44846 9232 9232 12713806 12713806 4859909 4859909 830514 830514 1791088 1791088 35700 35700 65714 65714 1365073 1365073 ALLOCATED OTHER EXPENSE 19411945 19411945 PAID CLAIMS BY CAPTIVE 8171322 8171322 LICENSES & ASSESMENTS 4447568 4447568 DUES & SUBSCRIPTIONS 613338 613338 112491398 0 112491398 0 1583239 2425098 975820 1682096 483415 904532 7075805 9553190 27056802 35605218 7959813 3385577 45134894 53555711 11643756 12233829 32146623 38301837 43790379 50535666 X 1344515 3020045 1344515 3020045 45134894 53555711 X -6641208 -1683262 10000000 X X 0 1 X 1 0 X 65204368 66468276 78926070 80959432 101741635 393299781 65204368 66468276 78926070 80959432 101741635 393299781 0 0 0 393299781 1036 0 1010750 387142 368445 1767373 1036 1010750 387142 368445 1767373 65205404 66468276 79936820 81346574 102110080 395067154 0.99550 0.99530 0.00450 0.00470 X 0 DUE FROM VALLEY HOSPITAL 3385577 3385577 ESTIMATED PROFESSIONAL LIABILITY 38205169 DUE TO VALLEY HOME CARE 96668 38301837 X 114166928 -1683262 10000000 8316738 105850190 0 105850190 112491398 0 112491398 0 112491398 PART X, LINE 2: THE COMPANY 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 HAD NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION AND/OR DISCLOSURE. THE COMPANY IS NO LONGER SUBJECT TO U.S. FEDERAL, STATE OR LOCAL INCOME TAX EXAMINATIONS FOR PERIODS PRIOR TO DECEMBER 31, 2018. PART XI, LINE 2D - OTHER ADJUSTMENTS: TRANSFER FROM THE VALLEY HOSPITAL FOR CAPTIVE INSURANCE 10,000,000. CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENT IN CAPTIVE INSURANCE SUBSIDIARY 36685265 0 0 0 0 0 0 36685265 0 36685265 0 0 1 0 0 0 PART III ACCOUNTING METHOD: X X X X 0 1 0 0 0 0 0 1 0 RICHARD KEENAN FORMER SENIOR VP FINANCE/CFO 0 0 0 0 4692143 0 0 0 0 0 4692143 0 4692143 0 AUDREY MEYERS PRESIDENT/CEO, VHS 1165777 0 450000 0 99444 0 21750 0 24786 0 1761757 0 0 0 ROBERT W BRENNER PRESIDENT, CLINICAL INTEGRATION 785377 0 235000 0 257696 0 13050 0 12307 0 1303430 0 0 0 PETER W DIESTEL PRESIDENT, VHS OPERATIONS 662439 0 245846 0 57050 0 18850 0 24586 0 1008771 0 0 0 EPHRAIM S CASPER MD CHIEF MEDICAL OFFICER 824792 0 67356 0 55344 0 14500 0 27329 0 989321 0 0 0 ROBIN G HOLLANDER SENIOR VP, LEGAL SERVICES 570399 0 185000 0 46518 0 18850 0 28239 0 849006 0 0 0 WILLIAM KLUTKOWSKI VP FINANCE & CFO EFF. 3/2021 489691 0 95000 0 124709 0 20300 0 33802 0 763502 0 0 0 ERIC CAREY VP/CIO, INFO. SYSTEMS 399364 0 95000 0 111824 0 22867 0 31052 0 660107 0 0 0 JOSE BALDERRAMA VP, HUMAN RESOURCES 384584 0 90000 0 102190 0 14500 0 18655 0 609929 0 0 0 JOSEPH LORINO VP, FACILITIES MANAGEMENT 322184 0 75000 0 62977 0 14500 0 20847 0 495508 0 0 0 MEGAN FRASER VP, COMMUNICATIONS/ MARKET 288839 0 76058 0 95682 0 21750 0 12307 0 494636 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 RICHARD KEENAN RECEIVED A FINAL DISTRIBUTION PAYMENT FROM HIS SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN IN 2021 AS REPORTED IN PART II, COLUMNS B(III) AND F. AUDREY MEYERS AND WILLIAM KLUTKOWSKI ALSO PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THEY DID NOT RECEIVE A PAYMENT DURING 2021: 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 2021: 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 VALLEY HEALTH SYSTEM HAS ITS FORM 990 PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND HAS ESTABLISHED THE FOLLOWING REVIEW PROCESS TO ENSURE THAT THE INFORMATION REPORTED IS COMPLETE AND ACCURATE. WHEN THE FORM 990 IS PREPARED, IT IS SUBMITTED TO MANAGEMENT AND THE AUDIT COMMITTEE FOR REVIEW. EACH ISSUE IS DOCUMENTED AND ADDRESSED UNTIL THE RETURN IS FINALIZED AND APPROVED BY THE AUDIT COMMITTEE FOR FILING WITH THE INTERNAL REVENUE SERVICE. BEFORE FILING, THE FORM 990 IS MADE AVAILABLE FOR THE BOARD'S REVIEW, BY HARD COPY AND OR ELECTRONIC COPY. FORM 990, PART VI, SECTION B, LINE 12 THE BOARD MANDATES THAT ALL MEMBERS OF MANAGEMENT AND THE GOVERNING BODY SIGN A CONFLICT OF INTEREST POLICY AND DISCLOSE ANY POTENTIAL OR ACTUAL CONFLICTS THAT MAY EXIST ANNUALLY. IF A CONFLICT OF INTEREST EXISTS THE ORGANIZATION WILL NOTIFY MEMBERS OF MANAGEMENT OR THE GOVERNING BODY AND INVESTIGATE THE CONFLICT. IF IT IS DETERMINED THAT AN ACTUAL CONFLICT OF INTEREST EXISTS, THE MEMBER OF MANAGEMENT OR THE GOVERNING BODY WILL BE NOTIFIED IMMEDIATELY AND WILL NOT BE ALLOWED TO VOTE OR BE PART OF ANY DECISIONS ABOUT SUCH TRANSACTIONS. 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 2021. FORM 990, PART VI, SECTION C, LINE 19 VALLEY HEALTH SYSTEM, INC. MAKES ITS FORM 990, FINANCIAL STATEMENTS, FORM 1023, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICY AVAILABLE UPON WRITTEN REQUEST AT 223 NORTH VAN DIEN AVE, RIDGEWOOD, NJ 07450. FORM 990, PART IX, LINE 11G OUTSIDE SERVICE FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,225,677. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,225,677. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 8,787,456. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,787,456. TEMPORARY HELP: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 370,103. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 370,103. CONSULTING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 2,285,850. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,285,850. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 44,720. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 44,720. FORM 990, PART XI, LINE 9: TRANSFER FROM THE VALLEY HOSPITAL FOR CAPTIVE INSURANCE 10,000,000. FORM 990, PART XII, LINE 2C THE AUDIT COMMITTEE IS RESPONSIBLE FOR SELECTING AN INDEPENDENT ACCOUNTANT AND FOR THE OVERSIGNT OF THE AUDIT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. COLIGOCARE LLC 223 N VAN DIEN AVE RIDGEWOOD NJ 07450 CLINICALLY INTERGRATED NETWORK NJ 16166204 2572014 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 4108489 36685265 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 INC C 2245605 COST VALLEY HOME CARE Q 5750000 COST THE VALLEY HOSPITAL INC B 4889287 COST THE VALLEY HOSPITAL INC S 10000000 COST VHS INSURANCE COMPANY LTD R 10000000 COST VALLEY PHYSICIAN SERVICES INC B 15863865 COST