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CENTRASTATE MEDICAL CENTER INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
CENTRASTATE MEDICAL CENTER INC (EIN 22-1750190)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-11-09
IRS object ID
202243139349305659
Schema version
2021v4.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2022-11-09T16:41:12-06:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WithumSmithBrown PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1200 JEFFERSON PARK STE 400AddressLine1Txt
CityWhippanyCityNm
State AbbreviationNJStateAbbreviationCd
ZIP079811070ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN221750190EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CENTRASTATE MEDICAL CENTER INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% LAURA SCHILARE MBA CPAInCareOfNm
Business Name ControlCENTBusinessNameControlTxt
Phone7322947050PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1901 WEST MAIN STREETAddressLine1Txt
CityFREEHOLDCityNm
State AbbreviationNJStateAbbreviationCd
ZIP07728ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLAURA SCHILAREPersonNm
Person TitleVP FINANCEPersonTitleTxt
Phone7322947050PhoneNum
Signature2022-11-14SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstLAURAPersonFirstNm
Person LastSCHILAREPersonLastNm
FieldValueIRS element (for citing)
SSN000000000SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonScott J MarianiPreparerPersonNm
PTINP00642486PTIN
Phone9738989494PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTHOMAS W SCOTTPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1901 WEST MAIN STREETAddressLine1Txt
CityFREEHOLDCityNm
State AbbreviationNJStateAbbreviationCd
ZIP07728ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$423,309,218GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.CENTRASTATE.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1964FormationYr
Legal Domicile StateNJLegalDomicileStateCd
Activity Or MissionCENTRASTATE MEDICAL CENTER'S MISSION IS TO ENHANCE THE HEALTH AND WELL-BEING OF OUR COMMUNITIES THROUGH THE COMPASSIONATE DELIVERY OF QUALITY HEALTHCARE.ActivityOrMissionDesc
Voting Members Governing Body17VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee2407TotalEmployeeCnt
Total Volunteers174TotalVolunteersCnt
Total Gross UBI$304,179TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$37,176,954PYContributionsGrantsAmt
CY Contributions Grants$21,028,284CYContributionsGrantsAmt
PY Program Service Revenue$258,223,880PYProgramServiceRevenueAmt
CY Program Service Revenue$314,406,553CYProgramServiceRevenueAmt
PY Investment Income$6,911,808PYInvestmentIncomeAmt
CY Investment Income$10,412,685CYInvestmentIncomeAmt
PY Other Revenue$3,291,505PYOtherRevenueAmt
CY Other Revenue$2,949,598CYOtherRevenueAmt
PY Total Revenue$305,604,147PYTotalRevenueAmt
CY Total Revenue$348,797,120CYTotalRevenueAmt
PY Grants And Similar Paid$1,515PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$2,693CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$147,390,489PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$155,882,906CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$152,170,836PYOtherExpensesAmt
CY Other Expenses$187,618,871CYOtherExpensesAmt
PY Total Expenses$299,562,840PYTotalExpensesAmt
CY Total Expenses$343,504,470CYTotalExpensesAmt
PY Revenues Less Expenses$6,041,307PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$5,292,650CYRevenuesLessExpensesAmt
Total Assets BOY$428,867,890TotalAssetsBOYAmt
Total Assets EOY$417,960,014TotalAssetsEOYAmt
Total Liabilities BOY$198,755,982TotalLiabilitiesBOYAmt
Total Liabilities EOY$182,297,901TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$230,111,908NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$235,662,113NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionCENTRASTATE MEDICAL CENTER'S MISSION IS TO ENHANCE THE HEALTH AND WELL-BEING OF OUR COMMUNITIES THROUGH THE COMPASSIONATE DELIVERY OF QUALITY HEALTHCARE. PLEASE REFER TO THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT INCLUDED IN SCHEDULE O.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$309,154,291ExpenseAmt
Grant$2,693GrantAmt
Revenue$315,140,594RevenueAmt
DescEXPENSES INCURRED IN PROVIDING INPATIENT, OUTPATIENT, EMERGENCY AND VARIOUS OTHER MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY AND IN FURTHERANCE OF CHARITABLE TAX-EXEMPT PURPOSES. PLEASE REFER TO THE COMMUNITY BENEFIT STATEMENT IN SCHEDULE O.Desc
Total Program Service Expenses$309,154,291TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstYes (true)ReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficeYes (true)ForeignOfficeInd
Foreign ActivitiesYes (true)ForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (true)BusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntYes (true)BusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document277IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee2407EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountYes (true)ForeignFinancialAccountInd
Foreign CountryCJForeignCountryCd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtYes (true)SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members17GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (true)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldNJStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonLAURA SCHILARE MBA CPAPersonNm
Phone7322947050PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1901 WEST MAIN STREETAddressLine1Txt
CityFREEHOLDCityNm
State AbbreviationNJStateAbbreviationCd
ZIP07728ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (33 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
JOHN T GRIBBIN
TRUSTEE - PRESIDENT/CEO55.00.0Yes (X)Yes (X)$1,241,943$0$32,525
THOMAS W SCOTT
SVP/COO55.00.0Yes (X)$655,441$0$89,921
DAVID A DE SIMONE ESQ
SVP TRANSFORMATION/CLO55.00.0$552,325$0$78,756Yes (X)
JOHN A DELLOCONO
SVP/CFO55.00.0Yes (X)$574,957$0$38,673
JAMES J MATERA MD
SVP/MEDICAL DIRECTOR50.00.0$512,640$0$72,315Yes (X)
CATHLEEN G JANZEKOVICH
VP, PATIENT SERVICES50.00.0$331,052$0$53,632Yes (X)
MOUSTAFA SHAFEY MD
MEDICAL DIR. - MENTAL HLTH50.00.0$349,220$0$28,440Yes (X)
DEBORAH ROMMEL-CONNORS MBA
VP REVENUE CYCLE50.00.0$311,172$0$63,223Yes (X)
JAMES RICHVALSKY
VP, PHYSICIAN PRACTICE MGMT50.00.0$327,894$0$36,532Yes (X)
FRANCES KEANE
VP HUMAN RESOURCES50.00.0$317,416$0$37,870Yes (X)
KAREN B FREEMAN MSA
VP QUALITY & PATIENT SAFETY50.00.0$327,987$0$21,834Yes (X)
HOWARD A STEIN MD
PHYSICIAN50.00.0$315,205$0$25,678Yes (X)
NANCY BARONE
CSHCF VP OF DEVELOPMENT50.00.0$277,157$0$33,599Yes (X)
KIM A KELLY RN MS
VP CLINICAL SVCS.(TERM 9/2/21)50.00.0$265,693$0$28,799Yes (X)
VINCENT L D'ELIA
VP MRKTING PUBLIC/GOVT REL.50.00.0$263,530$0$23,015Yes (X)
KIMBERLY H SIMERS
AVP INTEGRATIVE HEALTH50.00.0$246,051$0$29,052Yes (X)
DANIELLE VANWERT
VP CLINICAL SVCS.(EFF. 9/2/21)50.00.0$211,317$0$11,752Yes (X)
AMIT S KHAROD MD
TRUSTEE50.00.0Yes (X)$0$198,612$9,319
JOHN P DETULLIO MD
TRUSTEE10.00.0Yes (X)$50,071$0$0
KENNETH ENG DO
TRUSTEE10.00.0Yes (X)$50,000$0$0
ASHISH AWASTHI MD FACC
TRUSTEE5.00.0Yes (X)$20,000$0$0
JOHN F EGGERT
CHAIR - TRUSTEE1.00.0Yes (X)Yes (X)$0$0$0
JOHN M CANTALUPO ESQ
VICE CHAIR - TRUSTEE1.00.0Yes (X)Yes (X)$0$0$0
KENNETH J REILLY CWS
SECRETARY/TREASURER - TRUSTEE1.00.0Yes (X)Yes (X)$0$0$0
NADIA K BATCHELOR
TRUSTEE1.00.0Yes (X)$0$0$0
ROBERT GORDON DDS
TRUSTEE1.00.0Yes (X)$0$0$0
MAUREEN M LAWRENCE
TRUSTEE1.00.0Yes (X)$0$0$0
PETER G LICATA ESQ
TRUSTEE1.00.0Yes (X)$0$0$0
BARBARA MCMORROW
TRUSTEE1.00.0Yes (X)$0$0$0
GERARD K NORKUS
TRUSTEE1.00.0Yes (X)$0$0$0
WILLIAM A SCHORIES
TRUSTEE1.00.0Yes (X)$0$0$0
BRETT TAFT
TRUSTEE1.00.0Yes (X)$0$0$0
MAHER YOUSSEF MD
TRUSTEE1.00.0Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$7,201,071TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$198,612TotReportableCompRltdOrgAmt
Total Other Compensation$714,935TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K228IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
HIGH ENERGY ELECTRIC INC
5042 INDUSTRIAL ROAD UNIT DFARMINGDALENJ07727CONSTRUCTION$4,746,390
BRIAN TRACY
120 COTTON STREETPHILADELPHIAPA19127ARCHITECT$1,681,548
HOLMDEL PHYSICIAN ASSOCIATES
66 WEST GILBERT STREETTINTON FALLSNJ07701MEDICAL$1,346,514
MAINSAIL HOLDCO LLC
PO BOX 1437COLUMBUSGA31902BILLING$790,448
ERNST YOUNG LLP
PO BOX 640382PITTSBURGHPA152640382CONSULTING/AUDIT$654,766
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K43CntrctRcvdGreaterThan100KCnt
Related Organizations$1,192,435RelatedOrganizationsAmt
Government Grants$19,835,849GovernmentGrantsAmt
Total Contributions$21,028,284TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE621990$305,870,121$305,870,121
OTHER HEALTHCARE RELATED REVENUE621990$8,536,432$8,536,432
FieldValueIRS element (for citing)
Total Program Service Revenue$314,406,553TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,414,153TotalRevenueColumnAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$6,414,153ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$2,519,736RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$2,519,736RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,519,736TotalRevenueColumnAmt
Unrelated Business Revenue$304,179UnrelatedBusinessRevenueAmt
Exclusion$2,215,557ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$78,510,630SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$74,512,098SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$3,998,532SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,998,532TotalRevenueColumnAmt
Exclusion$3,998,532ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescCAFETERIA INCOMEDesc
Business621990BusinessCd
Total Revenue Column$429,862TotalRevenueColumnAmt
Related Or Exempt Func Income$429,862RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$429,862OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$348,797,120TotalRevenueColumnAmt
Related Or Exempt Func Income$314,836,415RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$304,179UnrelatedBusinessRevenueAmt
Exclusion$12,628,242ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$2,693TotalAmt
Program Services$2,693ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$6,237,859TotalAmt
Program Services$5,614,074ProgramServicesAmt
Management And General$623,785ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$119,031,893TotalAmt
Program Services$107,128,703ProgramServicesAmt
Management And General$11,903,190ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$5,734,276TotalAmt
Program Services$5,160,848ProgramServicesAmt
Management And General$573,428ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$16,020,507TotalAmt
Program Services$14,418,456ProgramServicesAmt
Management And General$1,602,051ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$8,858,371TotalAmt
Program Services$7,972,534ProgramServicesAmt
Management And General$885,837ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$249,586TotalAmt
Program Services$224,627ProgramServicesAmt
Management And General$24,959ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$415,967TotalAmt
Program Services$374,371ProgramServicesAmt
Management And General$41,596ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$654,766TotalAmt
Program Services$589,289ProgramServicesAmt
Management And General$65,477ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$20,434TotalAmt
Program Services$18,391ProgramServicesAmt
Management And General$2,043ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$370,132TotalAmt
Program Services$333,119ProgramServicesAmt
Management And General$37,013ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$49,263,565TotalAmt
Program Services$44,337,208ProgramServicesAmt
Management And General$4,926,357ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$2,391,399TotalAmt
Program Services$2,152,259ProgramServicesAmt
Management And General$239,140ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$12,202,395TotalAmt
Program Services$10,982,155ProgramServicesAmt
Management And General$1,220,240ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$4,114,211TotalAmt
Program Services$3,702,790ProgramServicesAmt
Management And General$411,421ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$7,747,238TotalAmt
Program Services$6,972,514ProgramServicesAmt
Management And General$774,724ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$44,194TotalAmt
Program Services$39,775ProgramServicesAmt
Management And General$4,419ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$2,196,997TotalAmt
Program Services$1,977,297ProgramServicesAmt
Management And General$219,700ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$13,081,953TotalAmt
Program Services$11,773,758ProgramServicesAmt
Management And General$1,308,195ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$2,206,511TotalAmt
Program Services$1,985,860ProgramServicesAmt
Management And General$220,651ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$75,554,176$67,998,758$7,555,418
REPAIRS & MAINTENANCE$4,699,606$4,229,645$469,961
PURCHASED SERVICES$4,041,843$3,637,659$404,184
FOOD COSTS$1,983,249$1,784,924$198,325

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$6,380,649TotalAmt
Program Services$5,742,584ProgramServicesAmt
Management And General$638,065ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$343,504,470TotalAmt
Program Services$309,154,291ProgramServicesAmt
Management And General$34,350,179ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$19,024,572BOYAmt
EOY$13,768,100EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$15,235,005BOYAmt
EOY$14,772,162EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$25,372,209BOYAmt
EOY$29,761,749EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$3,722,276BOYAmt
EOY$3,020,658EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$3,947,205BOYAmt
EOY$3,370,246EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$363,862,005LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$219,305,637LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$130,218,634BOYAmt
EOY$144,556,368EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$206,838,274BOYAmt
EOY$182,700,703EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$24,509,715BOYAmt
EOY$26,010,028EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$428,867,890BOYAmt
EOY$417,960,014EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$47,888,802BOYAmt
EOY$48,093,151EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$58,033,026BOYAmt
EOY$53,972,420EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$30,660,960BOYAmt
EOY$29,228,177EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$62,173,194BOYAmt
EOY$51,004,153EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$198,755,982BOYAmt
EOY$182,297,901EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$212,098,020BOYAmt
EOY$215,857,150EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$18,013,888BOYAmt
EOY$19,804,963EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$230,111,908BOYAmt
EOY$235,662,113EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$428,867,890BOYAmt
EOY$417,960,014EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$5,292,650ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$408,072NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$665,627OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$20,434OtherActivitiesAmt
Total Lobbying Expenditures$20,434TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE C, PART II-B; LINE IIFormAndLineReferenceDesc
ExplanationDURING 2021, THE ORGANIZATION PAID AN OUTSIDE LOBBYING FIRM WHICH ENGAGED IN LOBBYING EFFORTS ON BEHALF OF THE ORGANIZATION ADRESSING FEDERAL AND STATE HEALTHCARE MATTERS. THIS ALLOCATION AMOUNTED TO $15,600 DURING THE YEAR ENDED DECEMBER 31, 2021. In addition, the organization is a member of the new jersey hospital association which engages in lobbying efforts on behalf of its member hospitals. A portion of the dues paid to this organization has been allocated to lobbying activities performed on behalf of the organization. This allocation amounted to $4,834 during the year ended december 31, 2021.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,120,897OtherCostOrOtherBasisAmt
Book Value$14,120,897BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$205,909,641OtherCostOrOtherBasisAmt
Depreciation$123,947,091DepreciationAmt
Book Value$81,962,550BookValueAmt
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovementsGrp

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$127,867,718OtherCostOrOtherBasisAmt
Depreciation$89,387,619DepreciationAmt
Book Value$38,480,099BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$15,963,749OtherCostOrOtherBasisAmt
Depreciation$5,970,927DepreciationAmt
Book Value$9,992,822BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$144,556,368TotalBookValueLandBuildingsAmt

Invst Program Related Org InvstProgramRelatedOrgGrp (7 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
PROGRAM RELATED INVESTMENTS$149,780,347F
OTHER INVESTMENTS$472,816F
ASSETS HELD BY RELATED ORG.$19,809,865F
INVESTMENT IN CCIC$7,196,824F
INVESTMENT IN SURGICARE$226,055F
INVESTMENT IN CS HEALTH PRTNRS$323,035F
LIFE CARE CONTRACTS APPLEWOOD$4,891,761F
FieldValueIRS element (for citing)
Total Book Value Program Rltd$182,700,703TotalBookValueProgramRltdAmt

Other Assets Org OtherAssetsOrgGrp (6 entries)

DescDescBook ValueBookValueAmt
DUE FROM AFFILIATES - CURRENT$10,208,668
DUE FROM AFFILIATES - NC$7,161,820
OTHER RECEIVABLES$2,204,685
SECURITY DEPOSITS$577,088
RESTRICTED CASH - ASSET$942,544
OPERATING LEASE ASSETS$4,915,223
FieldValueIRS element (for citing)
Total Book Value Other Assets$26,010,028TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)

DescDescAmtAmt
DUE TO AFFILIATES$2,903,763
EST. 3RD PARTY PAYOR SETTLEMENTS$39,600,284
MALPRACTICE LIABILITY$926,394
OTHER LIABILITY - CCIC$4,246,364
RESTRICTED FUNDS - LIABILITY$940,725
WORKERS COMP INSURANCE - RESERVE$1,437,275
OTHER LIABILITIES$949,348
FieldValueIRS element (for citing)
Total Liability$51,004,153TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE D, PART X; LINE 2FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION IS AN AFFILIATE WITHIN CENTRASTATE HEALTHCARE SYSTEM, INC.; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF CENTRASTATE HEALTHCARE SYSTEM, INC AND RELATED ENTITIES FOR THE YEARS ENDED DECEMBER 31, 2021 AND DECEMBER 31, 2020; RESPECTIVELY. THE FOLLOWING FOOTNOTE IS INCLUDED IN THE SYSTEM'S 2021 AUDITED CONSOLIDATED FINANCIAL STATEMENTS THAT REPORTS THE ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 (ASC 740): THE SYSTEM ACCOUNTS FOR DEFFERED TAX ASSETS AND LIABILITIES BASED ON THE DIFFERENCES BETWEEN THE FINANCIAL REPORTING AND TAX BASIS OF ASSETS AND LIABILITIES USING ENACTED TAX RATES AND LAWS THAT WILL BE IN EFFECT WHEN DIFFERENCES ARE EXPECTED TO REVERSE. AS OF AND FOR THE YEARS ENDED DECEMBER 31, 2021 AND 2020, THE SYSTEM HAS MADE REASONABLE ESTIMATES OF THE PROVISION FOR THE INCOME TAXES AND DEFFERED TAX BALANCES BASED ON ACCOUNTING GUIDANCE INCLUDED IN ACCOUNTING STANDARDS CODIFICATION 740, INCOME TAXES. THE SYSTEM WILL CONTINUE TO REFINE ITS CALCULATIONS IN FUTURE PERIODS AS ADDITIONAL REGULATIONS AND GUIDANCE ARE ISSUED BY THE INTERNAL REVENUE SERVICE (IRS).ExplanationTxt

Schedule F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp (2 entries)

RegionRegionTxtOfficesOfficesCntEmployeeEmployeeCntType Of Activities ConductedTypeOfActivitiesConductedTxtSpecific Services ProvidedSpecificServicesProvidedTxtRegion Total ExpendituresRegionTotalExpendituresAmt
Central America and the Caribbean11Program ServicesFINANCIAL VEHICLE$1,728,330
Central America and the Caribbean00Investments$14,065,016
FieldValueIRS element (for citing)
Subtotal Offices1SubtotalOfficesCnt
Subtotal Employees1SubtotalEmployeesCnt
Total Office1TotalOfficeCnt
Total Employee1TotalEmployeeCnt
Subtotal Spent$15,793,346SubtotalSpentAmt
Total Spent$15,793,346TotalSpentAmt
Transfer To Foreign CorpYes (true)TransferToForeignCorpInd
Interest In Foreign TrustfalseInterestInForeignTrustInd
Foreign Corp OwnershipYes (true)ForeignCorpOwnershipInd
Passive Foreign Investmest CofalsePassiveForeignInvestmestCoInd
Foreign PartnershipfalseForeignPartnershipInd
Boycott CountriesfalseBoycottCountriesInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE F, PART IFormAndLineReferenceDesc
ExplanationDURING 2021, THIS ORGANIZATION REMITTED $1,728,330 TO CENTRASTATE CAPTIVE INSURANCE CO., LTD., A FINANCIAL VEHICLE, ON BEHALF OF AND FOR THE BENEFIT OF THIS ORGANIZATION.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other500.DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,421,046TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$430,596DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,990,450NetCommunityBenefitExpnsAmt
Total Expense0.01740TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$28,813,724TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$22,062,982DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,750,742NetCommunityBenefitExpnsAmt
Total Expense0.01970TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$35,234,770TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$22,493,578DirectOffsettingRevenueAmt
Net Community Benefit Expns$12,741,192NetCommunityBenefitExpnsAmt
Total Expense0.03710TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs22ActivitiesOrProgramsCnt
Persons Served1243216PersonsServedCnt
Total Community Benefit Expns$1,217,863TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,217,863NetCommunityBenefitExpnsAmt
Total Expense0.00350TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Activities Or Programs5ActivitiesOrProgramsCnt
Persons Served62PersonsServedCnt
Total Community Benefit Expns$2,615,905TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$69,250DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,546,655NetCommunityBenefitExpnsAmt
Total Expense0.00740TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,715,905TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,715,905NetCommunityBenefitExpnsAmt
Total Expense0.01660TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Activities Or Programs3ActivitiesOrProgramsCnt
Persons Served469PersonsServedCnt
Total Community Benefit Expns$224,072TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$110,000DirectOffsettingRevenueAmt
Net Community Benefit Expns$114,072NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs30ActivitiesOrProgramsCnt
Persons Served1243747PersonsServedCnt
Total Community Benefit Expns$9,773,745TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$179,250DirectOffsettingRevenueAmt
Net Community Benefit Expns$9,594,495NetCommunityBenefitExpnsAmt
Total Expense0.02780TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs30ActivitiesOrProgramsCnt
Persons Served1243747PersonsServedCnt
Total Community Benefit Expns$45,008,515TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$22,672,828DirectOffsettingRevenueAmt
Net Community Benefit Expns$22,335,687NetCommunityBenefitExpnsAmt
Total Expense0.06490TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served1800PersonsServedCnt
Total Community Benefit Expns$5,531TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,531NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served2481PersonsServedCnt
Total Community Benefit Expns$44,137TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$31,377DirectOffsettingRevenueAmt
Net Community Benefit Expns$12,760NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served150PersonsServedCnt
Total Community Benefit Expns$468TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$468NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs3ActivitiesOrProgramsCnt
Persons Served4431PersonsServedCnt
Total Community Benefit Expns$50,136TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$31,377DirectOffsettingRevenueAmt
Net Community Benefit Expns$18,759NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$3,148,637BadDebtExpenseAmt
Bad Debt Expense Attributable$314,864BadDebtExpenseAttributableAmt
Reimbursed By Medicare$76,534,464ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$103,102,800CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$26,568,336MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CENTRASTATE MEDICAL CENTERBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1901 WEST MAIN STREETAddressLine1Txt
CityFREEHOLDCityNm
State AbbreviationNJStateAbbreviationCd
ZIP07728ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.CENTRASTATE.COMWebsiteAddressTxt
State License11302StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Teaching HospitalYes (X)TeachingHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
Emergency Room OtherYes (X)EmergencyRoomOtherInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1CENTRASTATE MEDICAL CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted19CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE PART V; SECTION COwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt19ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLSEE PART V; SECTION CStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care500.FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE PART V; SECTION CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE PART V; SECTION CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE PART V; SECTION CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr PrvtYes (X)LookBackMedicaidMedcrPrvtInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, QUESTION 5IN ITS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") THIS ORGANIZATION TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY ITS HOSPITAL FACILITIES. CENTRASTATE MEDICAL CENTER IS A FOUNDING MEMBER OF THE HEALTH IMPROVEMENT COALITION OF MONMOUTH COUNTY (HICMC) AND HAS A SEAT ON THE ORGANIZATION'S SEVEN-MEMBER STEERING COMMITTEE, ALONG WITH REPRESENTATIVES OF COUNTY AND LOCAL HEALTH DEPARTMENTS AND OTHER MONMOUTH COUNTY HOSPITALS. ORGANIZED IN 2005, HICMC, WITH THE COOPERATION OF THE GOVERNMENTAL PUBLIC HEALTH PARTNERSHIP OF MONMOUTH COUNTY, AREA AGENCIES, ORGANIZATIONS, HEALTHCARE PROVIDERS INCLUDING ALL FIVE HOSPITALS IN MONMOUTH COUNTY, AND INDIVIDUALS, HAS COLLABORATED TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) EVERY FIVE YEARS (2007-2011, 2012-2016 AND 2017-2019). THE CURRENT MONMOUTH COUNTY PLAN WAS COMPLETED IN 2018 AND IS FOR THE YEARS 2018-2022 AND INCLUDES THE COMMUNITIES OF WESTERN MONMOUTH COUNTY CENTRASTATE IS ALSO A PARTICIPATING MEMBER OF THE OCEAN MONMOUTH HEALTH ALLIANCE, THE PREVENTION COALITION OF MONMOUTH COUNTY, THE FREEHOLD AREA MUNICIPAL ALLIANCE AND NEIGHBORHOOD CONNECTIONS TO HEALTH. FOR THE PURPOSES OF THIS CHNA, CENTRASTATE MEDICAL CENTER, INC. ALSO REVIEWED THE CHNA'S AND CHIP'S OF ADJACENT COUNTIES, SPECIFICALLY OCEAN, MERCER AND MIDDLESEX, AND CONDUCTED SURVEYS THROUGHOUT THE COMMUNITIES SERVED BY CENTRASTATE MEDICAL CENTER, INC. BOTH ELECTRONICALLY AND VIA HARD-COPY AND DETERMINED THE RESULTS WERE CONSISTENT WITH THE MONMOUTH COUNTY ASSESSMENTS AND PLANS UPON WHICH CENTRASTATE MEDICAL CENTER, INC. BASED ITS CHNA. A BASE "SECONDARY DATA PROFILEAN "URBAN PROFILE" WERE PREPARED FOR MONMOUTH COUNTY BY HOLLERAN CONSULTING OF PHILADELPHIA THAT INCLUDED DEMOGRAPHIC AND HOUSEHOLD INFORMATION, MORTALITY RATES, COMMUNICABLE DISEASE RATES AND CANCER INCIDENCE AND MORTALITY RATES. THE PROFILES WERE UPDATED PERIODICALLY. COPIES OF BOTH STUDIES ARE AVAILABLE IN THE CENTRASTATE MEDICAL CENTER, INC. COMMUNITY RELATIONS OFFICE. THE COALITION EXAMINED SCIENTIFIC SURVEY DATA FROM NEARLY 600 HOUSEHOLDS, AS WELL AS FOCUS GROUP FEEDBACK. CENTRASTATE MEDICAL CENTER, INC. FURTHER REVIEWED THE HEALTHY NEW JERSEY 2020 OBJECTIVES, BASELINES, AND TARGETS. BECAUSE MANY OF THE STATISTICS REFLECT AVAILABLE COUNTY-WIDE OR STATE-WIDE DATA, CENTRASTATE MEDICAL CENTER, INC. CONDUCTED AN ADDITIONAL SURVEY AS WELL AS SEVERAL INTERVIEWS AND MEETINGS DESIGNED TO FURTHER IDENTIFY THE HEALTH NEEDS PARTICULAR TO WESTERN MONMOUTH COUNTY. THE RESULTS WERE RANKED ACCORDING TO SEVERITY AFTER CONSULTATIONS WERE CONDUCTED BETWEEN CENTRASTATE MEDICAL CENTER, INC. CHNA LEADERSHIP AND THE PUBLIC HEALTH OFFICERS SERVING MONMOUTH COUNTY AS WELL AS EACH OF THE COMMUNITIES IN WESTERN MONMOUTH COUNTY TO IDENTIFY THE SIGNIFICANT HEALTH NEEDS OF THE CENTRASTATE MEDICAL CENTER, INC. COMMUNITIES.
SCHEDULE H, PART V, SECTION B, QUESTIONS 6A & 6BCENTRASTATE MEDICAL CENTER IS A FOUNDING MEMBER OF THE HEALTH IMPROVEMENT COALITION OF MONMOUTH COUNTY (HICMC) AND HAS A SEAT ON THE ORGANIZATION'S SEVEN-MEMBER STEERING COMMITTEE, ALONG WITH REPRESENTATIVES OF COUNTY AND LOCAL HEALTH DEPARTMENTS AND OTHER MONMOUTH COUNTY HOSPITALS. ORGANIZED IN 2005, HICMC, WITH THE COOPERATION OF THE GOVERNMENTAL PUBLIC HEALTH PARTNERSHIP OF MONMOUTH COUNTY, AREA AGENCIES, ORGANIZATIONS, HEALTHCARE PROVIDERS INCLUDING ALL FIVE HOSPITALS IN MONMOUTH COUNTY, AND INDIVIDUALS, HAS COLLABORATED TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) EVERY FIVE YEARS (2007-2011, 2012-2016 AND 2017-2019). THE CURRENT MONMOUTH COUNTY PLAN WAS COMPLETED IN 2018 AND IS FOR THE YEARS 2018-2022 AND INCLUDES THE COMMUNITIES OF WESTERN MONMOUTH COUNTY CENTRASTATE IS ALSO A PARTICIPATING MEMBER OF THE OCEAN MONMOUTH HEALTH ALLIANCE, THE PREVENTION COALITION OF MONMOUTH COUNTY, THE FREEHOLD AREA MUNICIPAL ALLIANCE AND NEIGHBORHOOD CONNECTIONS TO HEALTH.
SCHEDULE H, PART V, SECTION B, QUESTIONS 7A & 7DTHE ORGANIZATION IS AN AFFILIATE WITHIN CENTRASTATE HEALTHCARE SYSTEM, INC.; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN SCHEDULE H, PART V, SECTION B, QUESTION 7A, IS THE HOME PAGE FOR THE SYSTEM. THE CHNA CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: https://www.centrastate.com/wp-content/uploads/sites/9/2020/01/CHNA-and-Im plementation-Plan-2020-FINAL-Board-to-approve-December-122019-002.pdf
SCHEDULE H, PART V, SECTION B, QUESTION 10ATHE ORGANIZATION IS AN AFFILIATE WITHIN CENTRASTATE HEALTHCARE SYSTEM, INC.; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN SCHEDULE H, PART V, SECTION B, QUESTION 10A, IS THE HOME PAGE FOR THE SYSTEM. THE IMPLEMENTATION STRATEGY CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: https://www.centrastate.com/wp-content/uploads/sites/9/2020/01/CHNA-and-Im plementation-Plan-2020-FINAL-Board-to-approve-December-122019-002.pdf
SCHEDULE H, PART V, SECTION B, QUESTION 11THE ORGANIZATION'S IMPLEMENTATION STRATEGY DESCRIBES THE COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE ORGANIZATION'S CHNA. THROUGH THE ASSESSMENT OF ITS COMMUNITIES THE ORGANIZATION IDENTIFIED THE FOLLOWING KEY PRIORITIES: OBESITY, SUBSTANCE ABUSE, MENTAL HEALTH, ACCESS TO HEALTH CARE, AND TRANSPORTATION. THE ORGANIZATION INTENDS TO TAKE THE FOLLOWING ACTIONS WITH RESPECT TO EACH IDENTIFIED COMMUNITY HEALTH NEED. Significant Health Need #1: Mental Health (Substance Abuse [including vaping] and Suicide) Strategies: ----------- Mental Health ------------- Collaborate with the Monmouth County Mental Health Director on strategies and programs to address mental health issues. Consult with elected and appointed state officials to regulate mental health insurance to increase access to mental health services, including treatment for substance use disorders. Identify strategies on how to publicize the availability of mental health programs. Substance Abuse --------------- Collaborate, share resources and develop programming (particularly vaping) with the local Municipal Alliances for the Prevention of Substance Abuse for programming and education in the community and particularly in the schools. Partner with the local Municipal Alliances in efforts to reduce the availability of electronic nicotine delivery systems (vaping). Increase participation in the Prevention Coalition of Monmouth County to plan comprehensive substance abuse awareness planning and programming; to provide a forum for community members and organizations to work together to improve substance abuse prevention strategies within the service area while increasing public awareness related to substance abuse trends and community resources. Increase and expand substance abuse programming including vaping at the CentraState Student Health Awareness Center. Revise health care processes and provider roles to integrate mental health and substance abuse treatment into primary care. Utilize certified Recovery Coaches in the Emergency Department to engage with patients who have been administered naloxone (NARCAN). Continue to monitor and track prescribing and dispensing of Schedule II, III, IV and V drugs and other controlled substances. Suicide ------- The CentraState Student Health Awareness Center, in cooperation with school counselors, undertake plans to develop and deliver a curriculum-based program that helps all students learn to recognize warning signs of suicide in themselves and others. Provide low income or at-risk public school students and their families with information about social services and health care supports. Significant Health Need #2: Chronic Disease (Cardiovascular [Heart Disease/Stroke], Cancer, Diabetes) Strategies: ----------- Cardiovascular -------------- Develop and implement programs and services to enhance knowledge of heart disease management and control the risk factors for heart disease. Offer a cardiac support group for the public. Increase community outreach efforts including lectures and screenings (blood pressure and cholesterol) by participating in community events (town days, fairs, senior center events and American Heart Association programs and events. Provide cardiopulmonary resuscitation classes for the community. Offer weight management programs and classes. Promote and expand the Gloria Saker Women's Heart Program at CentraState (for women at risk) including education and awareness, prevention, risk factor assessment and program referral (dietary counseling, smoking cessation, stress management) in collaboration with area physicians. Cancer ------ Continue to partner with the Ocean Monmouth Health Alliance to conduct programs aimed at education, prevention and access to treatment for cancer. Programs include "Choose Your Cover" (free skin cancer education and screenings at the beach); "Cancer You Can Prevent" (Colorectal cancer toolkits for primary care physicians to prevent colorectal cancer); Free Oral Cancer Screenings; promote with local governments Tobacco-Free Living at beaches, parks and recreational areas; preventing cervical cancer by increasing HPV immunizations. Increase number and frequency of cancer screenings offered through the CentraState Statesir Cancer Center and the Health Awareness Center. Increase breast cancer screenings (mammograms) by the CentraState Women's Center. Combine information about human papillomavirus (HPV) and the benefits of vaccination with efforts to support vaccine series completion (e.g., patient and parent education or reminders, physician education, etc.) Diabetes -------- Increase education for diabetes prevention, early identification and disease management to high-risk populations in our service area. Expand pre-diabetes education programming at the hospital and in the community. Provide increased access of Diabetes Center nurses to primary care physicians in Freehold Borough for nutrition counseling (English and Spanish classes) to include glucose testing, education and follow-up evaluations. Include free glucose screening at community events in the service area. Significant Health Need #3: Healthy Lifestyles (Obesity, Nutrition, Physical Activity, Access to Care) Strategies: ----------- Obesity, Nutrition and Physical Activity Participate in the Mobile Food Pantry at the Freehold Family Health Center by Fulfill Food Bank. Provide "Live Life Well" programs including seminars on eating well, relaxing well and moving well. Continue nutrition seminars for senior centers. Expand the "Plant Powered Program" (a 10-week program on plant based eating which has been shown to significantly help with weight loss, improved digestion, lower cholesterol and triglycerides, drop blood pressure and help with blood sugar management.) Provide live cooking demonstrations for the community. Expand participation in the Shaping NJ Grant for schools in Freehold Borough and Freehold Township advising of nutritional content of school food recipes and benefits of exercising. Increase participation in service area school wellness councils and activities. Partner with the CentraState Fitness Center to provide nutrition education for children. Use media-based efforts, in particular social media platforms, to educate residents and change the attitudes and beliefs that contribute to unhealthy behaviors. Access to Care -------------- Partner with community-based organizations to increase outreach and education about enrollment for health insurance coverage through the Health Insurance Marketplaces (Exchanges). Continue to grow the CentraState Community Health Plan. Explore additional CentraState Health Pavilions, which include Family Practice at CentraState offices, rehabilitation and laboratory services and Immediate Care Centers, in service area communities. Recruit graduating residents from the CentraState-based Family Residency Program. Continue to recruit primary care physicians, physician assistants, nurse practitioners and specialty care physicians to the service area. Collaborate with the newly created coalition "Neighborhood Connections to Health" led by the Visiting Nurse Association (VNA) Health Group and the Freehold Health Dept. under grants from the Robert Wood Johnson Foundation and the Nicholson Foundation. The organization goals are to find solutions to health issues within the community through collaboration. Continue to support the new Federally Qualified Health Center (FQHC) "Freehold Family Health Center" in Freehold Borough and continue to commit CentraState resources to the facility and its programs/services. Collaborate with the Mayor's Freehold Boro Wellness Council to conduct a health fair for residents, including follow-up with education and free screenings. Provide culturally sensitive assistance and care coordination, and guide patients through available medical, insurance, and social support (Patient navigators). Tailor health care to patients' norms, beliefs, and values, as well as their language and literacy skills. Develop programs in conjunction with the Freehold Borough schools to address health issues of students and families. Develop programs through the CentraState Health Awareness Center in conjunction with other departments to provide the community with health education, promotion and literacy. Use vouchers, tickets for prize drawings, and other incentives to encourage patients to undergo preventive care such as screenings, vaccinations, etc.
SCHEDULE H, PART V, SECTION B, QUESTION 16THE ORGANIZATION IS AN AFFILIATE WITHIN CENTRASTATE HEALTHCARE SYSTEM, INC.; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN SCHEDULE H, PART V, SECTION B, QUESTION 16, IS THE HOME PAGE FOR THE SYSTEM. THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION AND PLAIN LANGUAGE SUMMARY ARE MADE WIDELY AVAILABLE ON THE ORGANIZATION'S WEBSITE. THESE DOCUMENTS CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: https://www.centrastate.com/billing/

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3CTHE INCOME BASED CRITERIA USED TO DETERMINE ELIGIBILITY IS PER NEW JERSEY ADMINISTRATIVE CODE 10:52 SUB CHAPTERS 11, 12 AND 13, AND BASED UPON THE 2015 POVERTY GUIDELINES (DEPARTMENT OF HEALTH AND SENIOR SERVICES). FEDERAL POVERTY GUIDELINES ARE INCLUDED IN THE CRITERIA FOR DETERMINING ELIGIBILITY FOR CHARITY AND DISCOUNTED CARE. CENTRASTATE MEDICAL CENTER, INC. FOLLOWS THE NJ ADMINISTRATIVE CODE 8:31B AND CONSIDERS INDIVIDUAL ASSETS OVER $7,500 AND FAMILY ASSETS OVER $15,000 IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE. IN ADDITION, THERE IS A "SPEND DOWN" PROVISION ALLOWING FINANCIAL ASSISTANCE IF THE AMOUNT DUE FROM THE PATIENT IS GREATER THAN THE ASSETS OVER THE STATED THRESHOLDS.
SCHEDULE H, PART I; QUESTION 6ANOT APPLICABLE
SCHEDULE H, PART I; QUESTION 7WORKSHEET 2 WAS USED FOR THE COST TO CHARGE RATIO.
SCHEDULE H, PART IICOMMUNITY BUILDING ACTIVITIES UNDERTAKEN BY CENTRASTATE MEDICAL CENTER, INC. IMPROVE THE MEDICAL AND SOCIOECONOMIC WELL-BEING OF OUR COMMUNITIES. THIS IS ACCOMPLISHED THROUGH SERVICE ON STATE AND REGIONAL ADVOCACY COMMITTEES AND BOARDS, VOLUNTEERISM WITH LOCAL COMMUNITY-BASED NON-PROFIT ADVOCACY GROUPS AND PARTICIPATION IN CONFERENCES AND OTHER EDUCATIONAL ACTIVITIES TO PROMOTE UNDERSTANDING OF THE ROOT CAUSES OF HEALTH CONCERNS. CENTRASTATE MEDICAL CENTER, INC. PROVIDES EDUCATIONAL MATERIALS, CONDUCTS COMMUNITY HEALTH FAIRS AND HOLDS HEALTH EDUCATION SEMINARS AND OUTREACH SESSIONS FOR ITS PATIENTS, COMMUNITY AND PROVIDERS. PHYSICIANS, NURSES AND OTHER HEALTHCARE PROFESSIONALS DEDICATE THEIR KNOWLEDGE AND TIME TO ENSURE THE COMMUNITY IS WELL EDUCATED ON TOPICS PROMOTING HEALTHY LIVING.
SCHEDULE H, PART III, SECTION A; QUESTION 4THE FOOTNOTE BELOW EXPLAINS THE ORGANIZATIONS METHODOLOGY WITH RESPECT TO NET PATIENT SERVICE REVENUE. CHANGES IN THE SYSTEM'S ESTIMATES OF IMPLICIT PRICE CONCESSIONS, DISCOUNTS, CONTRACTUAL ADJUSTMENTS OR OTHER CHANGES TO EXPECTED PAYMENTS FOR PERFORMANCE OBLIGATIONS SATISFIED IN PRIOR YEARS WERE NOT SIGNIFICANT. PORTFOLIO COLLECTION ESTIMATES ARE UPDATED BASED ON COLLECTION TRENDS. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY (DETERMINED ON A PORTFOLIO BASIS WHEN APPLICABLE) ARE RECORDED AS BAD DEBT EXPENSE. BAD DEBT EXPENSE FOR THE YEARS ENDED DECEMBER 31, 2021 AND 2020 WAS NOT SIGNIFICANT.
SCHEDULE H, PART III, SECTION B; QUESTION 8MEDICARE COSTS WERE DERIVED FROM THE 2021 MEDICARE COST REPORT. MEDICARE UNDERPAYMENTS AND BAD DEBT ARE COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THE ORGANIZATION FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT ARE COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. AS OUTLINED MORE FULLY BELOW THE ORGANIZATION BELIEVES THAT THESE SERVICES AND RELATED COSTS PROMOTE THE HEALTH OF THE COMMUNITY AS A WHOLE AND ARE RENDERED IN CONJUNCTION WITH THE ORGANIZATION'S CHARITABLE TAX-EXEMPT PURPOSES AND MISSION IN PROVIDING MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUAL'S IN A NON-DISCRIMINATORY MANNER WITHOUT REGARD TO RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY AND CONSISTENT WITH THE COMMUNITY BENEFIT STANDARD PROMULGATED BY THE IRS. THE COMMUNITY BENEFIT STANDARD IS THE CURRENT STANDARD FOR A HOSPITAL FOR RECOGNITION AS A TAX-EXEMPT AND CHARITABLE ORGANIZATION UNDER INTERNAL REVENUE CODE ("IRC") 501(C)(3). THE ORGANIZATION IS RECOGNIZED AS A TAX-EXEMPT ENTITY AND CHARITABLE ORGANIZATION UNDER 501(C)(3) OF THE IRC. ALTHOUGH THERE IS NO DEFINITION IN THE TAX CODE FOR THE TERM "CHARITABLE" A REGULATION PROMULGATED BY THE DEPARTMENT OF THE TREASURY PROVIDES SOME GUIDANCE AND STATES THAT "[T]HE TERM CHARITABLE IS USED IN 501(C)(3) IN ITS GENERALLY ACCEPTED LEGAL SENSE,PROVIDES EXAMPLES OF CHARITABLE PURPOSES, INCLUDING THE RELIEF OF THE POOR OR UNPRIVILEGED; THE PROMOTION OF SOCIAL WELFARE; AND THE ADVANCEMENT OF EDUCATION, RELIGION, AND SCIENCE. NOTE IT DOES NOT EXPLICITLY ADDRESS THE ACTIVITIES OF HOSPITALS. IN THE ABSENCE OF EXPLICIT STATUTORY OR REGULATORY REQUIREMENTS APPLYING THE TERM "CHARITABLE" TO HOSPITALS, IT HAS BEEN LEFT TO THE IRS TO DETERMINE THE CRITERIA HOSPITALS MUST MEET TO QUALIFY AS IRC 501(C)(3) CHARITABLE ORGANIZATIONS. THE ORIGINAL STANDARD WAS KNOWN AS THE CHARITY CARE STANDARD. THIS STANDARD WAS REPLACED BY THE IRS WITH THE COMMUNITY BENEFIT STANDARD WHICH IS THE CURRENT STANDARD. CHARITY CARE STANDARD IN 1956, THE IRS ISSUED REVENUE RULING 56-185, WHICH ADDRESSED THE REQUIREMENTS HOSPITALS NEEDED TO MEET IN ORDER TO QUALIFY FOR IRC 501(C)(3) STATUS. ONE OF THESE REQUIREMENTS IS KNOWN AS THE "CHARITY CARE STANDARD." UNDER THE STANDARD, A HOSPITAL HAD TO PROVIDE, TO THE EXTENT OF ITS FINANCIAL ABILITY, FREE OR REDUCED-COST CARE TO PATIENTS UNABLE TO PAY FOR IT. A HOSPITAL THAT EXPECTED FULL PAYMENT DID NOT, ACCORDING TO THE RULING, PROVIDE CHARITY CARE BASED ON THE FACT THAT SOME PATIENTS ULTIMATELY FAILED TO PAY. THE RULING EMPHASIZED THAT A LOW LEVEL OF CHARITY CARE DID NOT NECESSARILY MEAN THAT A HOSPITAL HAD FAILED TO MEET THE REQUIREMENT SINCE THAT LEVEL COULD REFLECT ITS FINANCIAL ABILITY TO PROVIDE SUCH CARE. THE RULING ALSO NOTED THAT PUBLICLY SUPPORTED COMMUNITY HOSPITALS WOULD NORMALLY QUALIFY AS CHARITABLE ORGANIZATIONS BECAUSE THEY SERVE THE ENTIRE COMMUNITY, AND A LOW LEVEL OF CHARITY CARE WOULD NOT AFFECT A HOSPITAL'S EXEMPT STATUS IF IT WAS DUE TO THE SURROUNDING COMMUNITY'S LACK OF CHARITABLE DEMANDS. COMMUNITY BENEFIT STANDARD IN 1969, THE IRS ISSUED REVENUE RULING 69-545, WHICH "REMOVE[D]" FROM REVENUE RULING 56-185 "THE REQUIREMENTS RELATING TO CARING FOR PATIENTS WITHOUT CHARGE OR AT RATES BELOW COST." UNDER THE STANDARD DEVELOPED IN REVENUE RULING 69-545, WHICH IS KNOWN AS THE "COMMUNITY BENEFIT STANDARD," HOSPITALS ARE JUDGED ON WHETHER THEY PROMOTE THE HEALTH OF A BROAD CLASS OF INDIVIDUALS IN THE COMMUNITY. THE RULING INVOLVED A HOSPITAL THAT ONLY ADMITTED INDIVIDUALS WHO COULD PAY FOR THE SERVICES (BY THEMSELVES, PRIVATE INSURANCE, OR PUBLIC PROGRAMS SUCH AS MEDICARE), BUT OPERATED A FULL-TIME EMERGENCY ROOM THAT WAS OPEN TO EVERYONE. THE IRS RULED THAT THE HOSPITAL QUALIFIED AS A CHARITABLE ORGANIZATION BECAUSE IT PROMOTED THE HEALTH OF PEOPLE IN ITS COMMUNITY. THE IRS REASONED THAT BECAUSE THE PROMOTION OF HEALTH WAS A CHARITABLE PURPOSE ACCORDING TO THE GENERAL LAW OF CHARITY, IT FELL WITHIN THE "GENERALLY ACCEPTED LEGAL SENSE" OF THE TERM "CHARITABLE," AS REQUIRED BY TREAS. REG. 1.501(C)(3)-1(D)(2). THE IRS RULING STATED THAT THE PROMOTION OF HEALTH, LIKE THE RELIEF OF POVERTY AND THE ADVANCEMENT OF EDUCATION AND RELIGION, IS ONE OF THE PURPOSES IN THE GENERAL LAW OF CHARITY THAT IS DEEMED BENEFICIAL TO THE COMMUNITY AS A WHOLE EVEN THOUGH THE CLASS OF BENEFICIARIES ELIGIBLE TO RECEIVE A DIRECT BENEFIT FROM ITS ACTIVITIES DOES NOT INCLUDE ALL MEMBERS OF THE COMMUNITY, SUCH AS INDIGENT MEMBERS OF THE COMMUNITY, PROVIDED THAT THE CLASS IS NOT SO SMALL THAT ITS RELIEF IS NOT OF BENEFIT TO THE COMMUNITY. THE IRS CONCLUDED THAT THE HOSPITAL WAS "PROMOTING THE HEALTH OF A CLASS OF PERSONS THAT IS BROAD ENOUGH TO BENEFIT THE COMMUNITY" BECAUSE ITS EMERGENCY ROOM WAS OPEN TO ALL AND IT PROVIDED CARE TO EVERYONE WHO COULD PAY, WHETHER DIRECTLY OR THROUGH THIRD-PARTY REIMBURSEMENT. OTHER CHARACTERISTICS OF THE HOSPITAL THAT THE IRS HIGHLIGHTED INCLUDED THE FOLLOWING: ITS SURPLUS FUNDS WERE USED TO IMPROVE PATIENT CARE, EXPAND HOSPITAL FACILITIES, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH; IT WAS CONTROLLED BY A BOARD OF TRUSTEES THAT CONSISTED OF INDEPENDENT CIVIC LEADERS; AND HOSPITAL MEDICAL STAFF PRIVILEGES WERE AVAILABLE TO ALL QUALIFIED PHYSICIANS. MEDICARE UNDERPAYMENTS AND BAD DEBT ARE COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THE AMERICAN HOSPITAL ASSOCIATION ("AHA") FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT ARE COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THIS ORGANIZATION AGREES WITH THE AHA POSITION. AS OUTLINED IN THE AHA LETTER TO THE IRS DATED AUGUST 21, 2007 WITH RESPECT TO THE FIRST PUBLISHED DRAFT OF THE NEW FORM 990 AND SCHEDULE H, THE AHA FELT THAT THE IRS SHOULD INCORPORATE THE FULL VALUE OF THE COMMUNITY BENEFIT THAT HOSPITALS PROVIDE BY COUNTING MEDICARE UNDERPAYMENTS (SHORTFALL) AS QUANTIFIABLE COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: - PROVIDING CARE FOR THE ELDERLY AND SERVING MEDICARE PATIENTS IS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD. - MEDICARE, LIKE MEDICAID, DOES NOT PAY THE FULL COST OF CARE. RECENTLY, MEDICARE REIMBURSES HOSPITALS ONLY 92 CENTS FOR EVERY DOLLAR THEY SPEND TO TAKE CARE OF MEDICARE PATIENTS. THE MEDICARE PAYMENT ADVISORY COMMISSION ("MEDPAC") IN ITS MARCH 2007 REPORT TO CONGRESS CAUTIONED THAT UNDERPAYMENT WILL GET EVEN WORSE, WITH MARGINS REACHING A 10-YEAR LOW AT NEGATIVE 5.4 PERCENT. - MANY MEDICARE BENEFICIARIES, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR. MORE THAN 46 PERCENT OF MEDICARE SPENDING IS FOR BENEFICIARIES WHOSE INCOME IS BELOW 200 PERCENT OF THE FEDERAL POVERTY LEVEL. MANY OF THOSE MEDICARE BENEFICIARIES ARE ALSO ELIGIBLE FOR MEDICAID -- SO CALLED ELIGIBLES." THERE IS EVERY COMPELLING PUBLIC POLICY REASON TO TREAT MEDICARE AND MEDICAID UNDERPAYMENTS SIMILARLY FOR PURPOSES OF A HOSPITAL'S COMMUNITY BENEFIT AND INCLUDE THESE COSTS ON FORM 990, SCHEDULE H, PART I. MEDICARE UNDERPAYMENT MUST BE SHOULDERED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE COMMUNITY'S ELDERLY AND POOR. THESE UNDERPAYMENTS REPRESENT A REAL COST OF SERVING THE COMMUNITY AND SHOULD COUNT AS A QUANTIFIABLE COMMUNITY BENEFIT. BOTH THE AHA AND THIS ORGANIZATION ALSO FEEL THAT PATIENT BAD DEBT IS A COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. LIKE MEDICARE UNDERPAYMENT (SHORTFALLS), THERE ALSO ARE COMPELLING REASONS THAT PATIENT BAD DEBT SHOULD BE COUNTED AS QUANTIFIABLE COMMUNITY BENEFIT AS FOLLOWS: - A SIGNIFICANT MAJORITY OF BAD DEBT IS ATTRIBUTABLE TO LOW-INCOME PATIENTS, WHO, FOR MANY REASONS, DECLINE TO COMPLETE THE FORMS REQUIRED TO ESTABLISH ELIGIBILITY FOR HOSPITALS' CHARITY CARE OR FINANCIAL ASSISTANCE PROGRAMS. A 2006 CONGRESSIONAL BUDGET OFFICE ("CBO") REPORT, NONPROFIT HOSPITALS AND THE PROVISION OF COMMUNITY BENEFITS, CITED TWO STUDIES INDICATING THAT "THE GREAT MAJORITY OF BAD DEBT WAS ATTRIBUTABLE TO PATIENTS WITH INCOMES BELOW 200% OF THE FEDERAL POVERTY LINE." - THE REPORT ALSO NOTED THAT A SUBSTANTIAL PORTION OF BAD DEBT IS PENDING CHARITY CARE. UNLIKE BAD DEBT IN OTHER INDUSTRIES, HOSPITAL BAD DEBT IS COMPLICATED BY THE FACT THAT HOSPITALS FOLLOW THEIR MISSION TO THE COMMUNITY AND TREAT EVERY PATIENT THAT COMES THROUGH THEIR EMERGENCY DEPARTMENT, REGARDLESS OF ABILITY TO PAY. PATIENTS WHO HAVE OUTSTANDING BILLS ARE NOT TURNED AWAY, UNLIKE OTHER INDUSTRIES. BAD DEBT IS FURTHER COMPLICATED BY THE AUDITING INDUSTRY'S STANDARDS ON REPORTING CHARITY CARE. MANY PATIENTS CANNOT OR DO NOT PROVIDE THE NECESSARY, EXTENSIVE DOCUMENTATION REQUIRED TO BE DEEMED CHARITY CARE BY AUDITORS. AS A RESULT, ROUGHLY 40% OF BAD DEBT IS PENDING CHARITY CARE. - THE CBO CONCLUDED THAT ITS FINDINGS "SUPPORT THE VALIDITY OF THE USE OF UNCOMPENSATED CARE [BAD DEBT AND CHARITY CARE] AS A MEASURE OF COMMUNITY BENEFITS" ASSUMING THE FINDINGS ARE GENERALIZABLE NATIONWIDE; THE EXPE
SCHEDULE H, PART III, SECTION B; QUESTION 9BDURING FINANCIAL COUNSELING, THE PATIENT IS SCREENED FOR ELIGIBILITY IN PUBLIC ASSISTANCE PROGRAMS, INCLUDING MEDICARE, MEDICAID, THE CATASTROPHIC ILLNESS FUND FOR CHILDREN, AND THE VIOLENT CRIME COMPENSATION BOARD. THE PATIENT IS ASSISTED WITH THE ENROLLMENT PROCESS FOR ANY PROGRAMS FOR WHICH THE PATIENT HAS PROBABLE ELIGIBILITY. BILLS MAY BE REDUCED FROM 20% TO 100% BASED UPON FINANCIAL ASSISTANCE CRITERIA. THE PATIENT RESPONSIBILITY PORTION OF 20%, 40%, 60% OR 80% IS BASED UPON RATES ESTABLISHED IN P.L. 1971 C. 136. SPEND DOWN ASSETS, THROUGH PARTIAL PAYMENT OF THE HOSPITAL BILL IS ALLOWED TO ENABLE THE PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE. THE AMOUNT FOR WHICH THE PATIENT IS RESPONSIBLE AFTER PARTIAL FINANCIAL ASSISTANCE SHALL BE LIMITED TO 30% OF INCOME, PER NJAC 8:31B. UNINSURED PATIENTS WITH INCOME BETWEEN 301%-500% OF FEDERAL POVERTY LEVELS WILL BE PROVIDED A SIGNIFICANT DISCOUNT, IN ACCORDANCE WITH P.L. 1971 C. 136. PATIENTS ARE BILLED ROUTINELY FOR UNPAID BALANCES AND SHALL BE NOTIFIED OF ANY IMPENDING COLLECTION OR LEGAL ACTION. PATIENTS ARE PROVIDED WITH CONTACT INFORMATION TO DISCUSS ANY QUESTIONS OR PROBLEMS. PATIENT BILLS INDICATE THE AVAILABILITY OF PAYMENT SCHEDULES. UPON PATIENT REQUEST, THE FOLLOWING PAYMENT SCHEDULE FOR BALANCES OF $100 OR MORE MAY BE AGREED UPON: BALANCE OF $100 - $450 - MONTHLY PAYMENT = 1/4 OF THE BALANCE, $451 - $3,000 = 1/12 OF THE BALANCE, OVER $3,000 = MINIMUM OF $250 PER MONTH OR 1% OF GROSS INCOME/MONTH, WHICHEVER IS MORE. IF THE PATIENT AND MEDICAL CENTER REPRESENTATIVE MUTUALLY AGREE TO A PAYMENT SCHEDULE AND PAYMENTS ARE RECEIVED AS AGREED, FURTHER COLLECTION ACTION WILL NOT BE TAKEN. EXCEPTIONS TO THE ABOVE SCHEDULE MAY BE MADE BY PATIENT FINANCIAL SERVICES MANAGEMENT UPON THE REQUEST OF THE PATIENT, AND DOCUMENTATION BY THE PATIENT OF INABILITY TO PAY ACCORDING TO THE ESTABLISHED SCHEDULE. IF, AT THE END OF THE FINANCIAL SCREENING ATTEMPTS AND BILLING CYCLE, THE PATIENT HAS NOT BEEN APPROVED FOR FINANCIAL ASSISTANCE AND/OR IS NOT ON A PAYMENT PLAN, OR AFTER THERE HAS BEEN A DEFAULT IN PAYMENT, THE ACCOUNT WILL BE ASSIGNED TO A COLLECTION AGENCY AND/OR ATTORNEY FOR COLLECTIONS. PAYMENT PLAN, OR AFTER THERE HAS BEEN A DEFAULT IN PAYMENT, THE ACCOUNT WILL BE ASSIGNED TO A COLLECTION AGENCY AND/OR ATTORNEY FOR COLLECTIONS.
SCHEDULE H, PART VI; QUESTION 2In addition to the community health needs assessment process outlined in schedule h, section b, questions 1-12 and section c, this organization conducts a review of key factor information annually which includes: a review of healthcare utilization of its service area population by services (urology, cardiology, obstetrics, etc.) For determining increased or decreased health needs; healthcare services estimates and forecasts (both inpatient and outpatient); assessments of local demographic and socioeconomic information; and, a review of health status/needs assessments and studies conducted by external parties. The organization conducts an extensive service area physician needs study (by primary and specialty) every three to five years. Specific specialty needs are conducted for identified gaps in service. These reviews inform medical staff development at the medical center to assure responsiveness to identified community needs. The organization collaborates with community partners to plan and conduct health needs assessments to assess and address health needs of the community it serves. The wide-based collaborative partnership retains an outside consulting firm to assess community data and perception. Community data is collected from county health profiles, health statistics, demographics, socioeconomic data, phone surveys, paper surveys and focus groups. From those assessments, community health improvement plans are published identifying the specific health priorities. Through a planned and organized effort, the group works collectively to address the priorities by tapping the resources of the community and collaborating on initiatives. CentraState Healthcare System, Inc. Actively contributes to this process and engages in the identified priorities that match its mission, expertise, resources and capacity. In addition to these organized needs assessment efforts, various CentraState Healthcare System, Inc. Leadership attend community meetings with local providers, local health departments, local politicians, organizations and community leaders to discuss the health needs of the population.
SCHEDULE H, PART VI; QUESTION 3In accordance with Internal Revenue Code section 501(r)(4) the organization informs and educates patients and persons who may be billed for patient care about their eligibility for financial assistance by widely publicizing various documents. These documents are widely publicized in the following ways: (1) the financial assistance policy ("fap"), financial assistance application ("application") and plain language summary ("pls") are all available on-line at the following website: https://CentraStatecorp.azureedge.net/wp-content/uploads/sites/9/2021/01 /financial-assistance-policy-2021-002.pdf (2) paper copies of the fap, application and the pls are available upon request without charge by mail and are available in at various areas throughout the hospital facility which include the hospital admissions department and the outpatient and emergency room registration areas. (3) the fap, application and pls are available in English and in the primary language of populations with limited proficiency in English ("LEP") that constitute the lesser of 1,000 individuals or 5% of the community served by the organization's primary service area. (4) all patients are offered a copy of the pls as part of the intake process. Additionally, signs or displays are conspicuously posted in public medical center locations including all admissions/registration areas and the emergency department, that notify and inform patients about the availability of financial assistance. All billing statements include conspicuous written notice which informs patients about the availability of financial assistance. CentraState Medical Center, Inc. also informs and notifies members of the community served about the fap.
SCHEDULE H, PART VI; QUESTION 4The community in which CentraState Medical Center, Inc. Serves is concentrated in Monmouth and ocean counties. The average household income in the service area is $139,993. The median household age is 44. The total population in the service area for 2019 is 357,095 with 124,895 households. The racial mix of the service area population includes 73% white, 10% Asian, 4% black, 11% Hispanic and 2% multi-racial. Gender mix is represented by 51% female and 49% male.
SCHEDULE H, PART VI; QUESTION 5CentraState contributes to the community through substantial employee involvement with other charitable and public organizations such as girl scouts of the jersey shore, work force investment bureau of Monmouth county, Veterans Community Association, Fingerprint America, Sunrise Optimist Club, Monmouth-Ocean Development Council, Muscular Dystrophy Association, Freehold Township, Monmouth County Child Advocacy Center, The National Organization of Women Business Owners, Rutgers University, Cancer Institute of New Jersey and the College Advisory Boards of Monmouth County Community College and Brookdale Community College. Efforts include increasing services to cancer survivors, coordinating efforts for fund raising and organizing student training programs. CentraState also provides additional community benefit through its 174 volunteers who contributed over 32,752 hours of service to their community through opportunities in every hospital department. Volunteers significantly enhance patient and family support in the following service categories: blood cart, dietary menu, emergency department lounge, flowers, gift shop/cart, hospitality cart, information desks, mail or messenger, prn/floaters, pastoral care, animal assisted therapy, snack bar, surgery waiting area, patient transport, hair care, service learning.
SCHEDULE H, PART VI; QUESTION 6OUTLINED BELOW IS A SUMMARY OF THE ENTITIES WHICH COMPRISE THE CENTRASTATE HEALTHCARE SYSTEM, INC.: NOT-FOR-PROFIT CENTRASTATE HEALTHCARE SYSTEM, INC. ENTITIES =========================================================== CENTRASTATE HEALTH SYSTEM, INC. ------------------------------- CENTRASTATE HEALTH SYSTEM, INC. ("CSHS") IS THE TAX-EXEMPT PARENT OF THE CENTRASTATE HEALTHCARE SYSTEM, INC. ("SYSTEM"). THIS INTEGRATED HEALTHCARE DELIVERY SYSTEM CONSISTS OF A GROUP OF AFFILIATED HEALTHCARE ORGANIZATIONS. THE SOLE MEMBER OR STOCKHOLDER OF EACH ENTITY IS CSHS. THE SYSTEM IS AN INTEGRATED NETWORK OF HEALTHCARE PROVIDERS THROUGHOUT THE STATE OF NEW JERSEY AND IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A SUPPORTING ORGANIZATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). CENTRASTATE MEDICAL CENTER, INC. -------------------------------- CENTRASTATE MEDICAL CENTER, INC. ("CSMC") IS LOCATED IN FREEHOLD, MONMOUTH COUNTY, NEW JERSEY, IS A 276-BED ACUTE CARE FACILITY. CSMC IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, CSMC PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. MOREOVER, CSMC OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. CENTER FOR AGING, INC. ---------------------- CENTER FOR AGING, INC. ("APPLEWOOD") IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). APPLEWOOD CONSISTS OF 281 INDEPENDENT APARTMENTS, 20 COTTAGES, 40 RESIDENTIAL HEALTH CARE UNITS, AND A 60-BED SKILLED NURSING FACILITY. THE ORGANIZATION PROVIDES FOR THE CARE OF THE ELDERLY. APPLEWOOD ALSO GOES OUT TO THE COMMUNITY THROUGH SENIOR'S FIRST, WHICH IS A COMPLIMENTARY COMMUNITY OUTREACH AND HEALTHCARE EDUCATION PROGRAM FOR THOSE 60 YEARS AND OLDER IN A 25-MILE RADIUS OF FREEHOLD, NJ. THE CENTER'S PROGRAMS INCLUDE HEALTH FAIRS, BLOOD PRESSURE SCREENINGS, AND HEALTH EDUCATION AND PRESENTATIONS ON PREVENTION AND TREATMENT. IN ADDITION, THERE IS ALSO A SUPPORT GROUP FOR PARKINSON'S DISEASE AS WELL AS COMMUNITY SERVICE REFERRALS. CENTRASTATE ASSISTED LIVING, INC. --------------------------------- CENTRASTATE ASSISTED LIVING, INC. ("MONMOUTH CROSSING") IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). MONMOUTH CROSSING OWNS AND OPERATES AN ASSISTED LIVING FACILITY FOR THE ELDERLY CONSISTING OF 76 UNITS WITH 16 UNITS FOR MEMORY CARE. THE FACILITY PROVIDES RESIDENTS WITH SPECIAL NEEDS AND MEMORY-RELATED DISEASES: RECEIVE COMPREHENSIVE, ATTENTIVE SERVICES IN A SAFE ENVIRONMENT WHERE SPECIALIZED ACTIVITIES AND PROGRAMMING ARE PROVIDED. MONMOUTH CROSSING OFFERS SERVICES TO RESIDENTS OF LOW AND MODERATE MEANS AND THOSE ON MEDICAID AS WELL. HEALTHCARE AFFILIATES, INC. --------------------------- HEALTHCARE AFFILIATES, INC. ("THE MANOR") IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). THE MANOR PROVIDES SKILLED NURSING SERVICES FOR 123 ELDERLY RESIDENTIAL UNITS INCLUDING SUBACUTE, REHABILITATION AND I.V. THERAPY. THE FACILITY FOCUS IS ON HELPING RESIDENTS ACHIEVE THEIR MAXIMUM POTENTIAL FOR INDEPENDENCE, PERSONAL COMFORT AND QUALITY OF LIFE. THE MANOR IS MEDICARE/MEDICAID CERTIFIED, LICENSED BY THE STATE OF NEW JERSEY, AND ACCREDITED BY THE JOINT COMMISSION. THE FACILITY PROVIDES CHARITY CARE FOR THE INDIGENT WHERE APPROPRIATE. CENTRASTATE HEALTHCARE FOUNDATION, INC. --------------------------------------- CENTRASTATE HEALTHCARE FOUNDATION, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(1). THROUGH FUNDRAISING ACTIVITIES THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF CSMC; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY. OTHER CENTRASTATE HEALTHCARE SYSTEM, INC. ENTITIES ================================================== CENTRASTATE CAPTIVE INSURANCE CO., LTD. --------------------------------------- CENTRASTATE CAPTIVE INSURANCE CO., LTD. A CONTROLLED FOREIGN CORPORATION OF CENTRASTATE MEDICAL CENTER. THE ORGANIZATION WAS FORMED AND OPERATES SOLELY IN THE CAYMAN ISLANDS WITH NO U.S. ACTIVITIES OR PRESENCE. CENTRASTATE CARDIOLOGY ASSOCIATES, P.C. ------------------------------------ CENTRASTATE CARDIOLOGY ASSOCIATES, P.C. IS AN ENTITY WHOSE NOMINEE SOLE SHAREHOLDER IS A LICENSED MD HOLDING SHARES FOR THE BENEFIT OF CSMC. THE ORGANIZATION IS LOCATED IN FREEHOLD, MONMOUTH COUNTY, NEW JERSEY. THIS ENTITY PROVIDES MEDICAL SERVICES IN SUPPORT OF AND IN FURTHERANCE OF THE CHARITABLE TAX-EXEMPT PURPOSES OF CSMC. CENTRASTATE HEALTHCARE SERVICES, INC. ------------------------------------- CENTRASTATE HEALTHCARE SERVICES, INC. IS AN ENTITY WHOSE SOLE SHAREHOLDER IS CSHS. THE ORGANIZATION IS LOCATED IN FREEHOLD, MONMOUTH COUNTY, NEW JERSEY AND PROVIDES HEALTHCARE SERVICES. CENTRASTATE MEDICAL ASSOCIATES, P.C. ------------------------------------ CENTRASTATE MEDICAL ASSOCIATES, P.C. IS AN ENTITY WHOSE NOMINEE SOLE SHAREHOLDER IS A LICENSED MD HOLDING SHARES FOR THE BENEFIT OF CSMC. THE ORGANIZATION IS LOCATED IN FREEHOLD, MONMOUTH COUNTY, NEW JERSEY. THIS ENTITY PROVIDES MEDICAL SERVICES IN SUPPORT OF AND IN FURTHERANCE OF THE CHARITABLE TAX-EXEMPT PURPOSES OF CSMC. CENTRASTATE SPECIALISTS, P.C. ----------------------------- CENTRASTATE SPECIALISTS, P.C. IS AN ENTITY WHOSE NOMINEE SOLE SHAREHOLDER IS A LICENSED MD HOLDING SHARES FOR THE BENEFIT OF CSMC. THE ORGANIZATION IS LOCATED IN FREEHOLD, MONMOUTH COUNTY, NEW JERSEY. THIS ENTITY PROVIDES MEDICAL SERVICES IN SUPPORT OF AND IN FURTHERANCE OF THE CHARITABLE TAX-EXEMPT PURPOSES OF CSMC.
SCHEDULE H, PART VI; QUESTION 7The 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.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsYes (X)TravelForCompanionsInd
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (18 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
JOHN T GRIBBIN
TRUSTEE - PRESIDENT/CEO$787,653$0$445,146$0$9,144$0$26,000$0$6,525$0$1,274,468$0$0$0
THOMAS W SCOTT
SVP/COO$448,122$0$90,071$0$117,248$0$73,454$0$16,467$0$745,362$0$52,855$0
DAVID A DE SIMONE ESQ
SVP TRANSFORMATION/CLO$361,147$0$75,917$0$115,261$0$64,976$0$13,780$0$631,081$0$44,549$0
JOHN A DELLOCONO
SVP/CFO$472,879$0$94,554$0$7,524$0$19,500$0$19,173$0$613,630$0$0$0
JAMES J MATERA MD
SVP/MEDICAL DIRECTOR$423,519$0$81,600$0$7,521$0$68,930$0$3,385$0$584,955$0$0$0
CATHLEEN G JANZEKOVICH
VP, PATIENT SERVICES$289,173$0$39,556$0$2,323$0$51,490$0$2,142$0$384,684$0$0$0
MOUSTAFA SHAFEY MD
MEDICAL DIR. - MENTAL HLTH$316,686$0$30,820$0$1,714$0$26,000$0$2,440$0$377,660$0$0$0
DEBORAH ROMMEL-CONNORS MBA
VP REVENUE CYCLE$268,210$0$39,398$0$3,564$0$56,166$0$7,057$0$374,395$0$0$0
JAMES RICHVALSKY
VP, PHYSICIAN PRACTICE MGMT$282,101$0$41,922$0$3,871$0$26,000$0$10,532$0$364,426$0$0$0
FRANCES KEANE
VP HUMAN RESOURCES$272,684$0$40,545$0$4,187$0$26,000$0$11,870$0$355,286$0$0$0
KAREN B FREEMAN MSA
VP QUALITY & PATIENT SAFETY$265,424$0$59,015$0$3,548$0$19,500$0$2,334$0$349,821$0$0$0
HOWARD A STEIN MD
PHYSICIAN$285,465$0$28,156$0$1,584$0$19,500$0$6,178$0$340,883$0$0$0
NANCY BARONE
CSHCF VP OF DEVELOPMENT$238,103$0$35,254$0$3,800$0$26,000$0$7,599$0$310,756$0$0$0
KIM A KELLY RN MS
VP CLINICAL SVCS.(TERM 9/2/21)$187,788$0$39,398$0$38,507$0$24,192$0$4,607$0$294,492$0$0$0
VINCENT L D'ELIA
VP MRKTING PUBLIC/GOVT REL.$227,026$0$33,882$0$2,622$0$19,500$0$3,515$0$286,545$0$0$0
KIMBERLY H SIMERS
AVP INTEGRATIVE HEALTH$223,171$0$22,025$0$855$0$26,000$0$3,052$0$275,103$0$0$0
DANIELLE VANWERT
VP CLINICAL SVCS.(EFF. 9/2/21)$175,942$0$35,300$0$75$0$7,382$0$4,370$0$223,069$0$0$0
AMIT S KHAROD MD
TRUSTEE$0$198,612$0$0$0$0$0$4,000$0$5,319$0$207,931$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PART I; QUESTIONS 1A AND 1BThe organization provided travel for companions of officers and trustees for the annual board retreat and certain educational seminars. The organization paid social club dues for John T. Gribbin, President/CEO of the organization, which are part of his employment agreement contract. Utilization of this membership was primarily for the benefit of CentraState Medical Center, Inc.
SCHEDULE J, PART I; QUESTION 4BTHE AMOUNT REFLECTED IN COLUMN B(III) FOR THE FOLLOWING INDIVIDUALS INCLUDES PARTICIPATION IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") AS THE AMOUNTS WERE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2021 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: THOMAS W. SCOTT, $114,626 AND DAVID A. DE SIMONE, ESQ., $97,497. THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THE FOLLOWING INDIVIDUALS INCLUDES UNVESTED BENEFITS IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") WHICH ARE SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THE INDIVIDUALS MAY NEVER ACTUALLY RECEIVE THIS UNVESTED BENEFIT AMOUNT. THE AMOUNTS OUTLINED HEREIN WERE NOT INCLUDED IN EACH INDIVIDUAL'S 2021 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: THOMAS W. SCOTT, $53,954; DAVID A. DE SIMONE, ESQ., $45,476; JAMES J. MATERA, M.D., $49,430; CATHLEEN G. JANZEKOVICH, $31,990 AND DEBORAH ROMMEL-CONNORS, MBA, $30,166.
SCHEDULE J, PART I; QUESTION 7CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A BONUS DURING CALENDAR YEAR 2021 WHICH AMOUNTS WERE INCLUDED IN COLUMN B(II) HEREIN AND IN EACH INDIVIDUAL'S 2021 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 FTHE 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 HAVE BEEN TREATED AS TAXABLE INCOME AND REPORTED ON EACH INDIVIDUAL'S FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES.

Schedule L IRS990ScheduleL

FieldValueIRS element (for citing)
Total Balance Due$0TotalBalanceDueAmt

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonFORMER TRUSTEEPersonNm
FieldValueIRS element (for citing)
Relationship Description50% OWNER IN JV WITH CSHS, INC.RelationshipDescriptionTxt
Transaction$408,904TransactionAmt
TransactionSEE PART VTransactionDesc
Sharing Of RevenuesfalseSharingOfRevenuesInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE L, PART VFormAndLineReferenceDesc
Explanation1. FRED MORELLI, FORMER TRUSTEE, IS A 100% OWNER OF CORPORATE STAR. CORPORATE STAR IS A 50% OWNER OF PIER PRACTICE SOLUTIONS, THE OTHER 50% IS OWNED BY CENTRASTATE HEALTHCARE SERVICES, INC., A RELATED ORGANIZATION. PIER PRACTICE SOLUTIONS RECEIVES MANAGEMENT, PRODUCTION INCOME FROM PLACEMENT OF MEDICAL MALPRACTICE INSURANCE AND SERVICES FOR CENTRASTATE CAPTIVE INSURANCE COMPANY, LTD., SPC; WHICH IS WHOLLY OWNED BY CENTRASTATE MEDICAL CENTER, INC. ALL TRANSACTIONS ARE DONE WITHIN AN ARM'S LENGTH BASIS.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (20 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
CORE FORM, PART III, STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTSCentraState Medical Center ("CSMC") is a 284-bed general acute care hospital located in Freehold, Monmouth County, New Jersey. CSMC is recognized by the Internal Revenue Service ("IRS") as an Internal Revenue code section 501(c)(3) tax-exempt organization. Pursuant to its charitable purposes, CSMC provides medically necessary healthcare services to all individuals in a non-discriminatory manner regardless of race, color, creed, sex, national origin, or ability to pay. Moreover, CSMC operates consistently with the following criteria outlined in IRS revenue ruling 69-545: 1. CSMC provides medically necessary healthcare services to all individuals regardless of ability to pay, including charity care, self-pay, Medicare and Medicaid patients; 2. CSMC operates an active emergency room for all persons; which is open 24 hours a day, 7 days a week, 365 days per year; 3. CSMC maintains a closed medical staff, with privileges available based on community need; 4. Control of CSMC rests with its board of trustees and the board of trustees of CentraState Healthcare System, Inc. Both boards are comprised of independent civic leaders and other prominent members of the community; and 5. Surplus funds are used to improve the quality of patient care, expand and renovate facilities, and advanced medical care, programs and activities. The operations of CSMC, as shown through the factors outlined above and other information contained herein, clearly demonstrate the hospital provides substantial community benefit and that the use and control of CSMC is for the benefit of the public and that no part of the income or net earnings of the organization inures to the benefit of any private individual nor is any private interest being served other than incidentally. CSMC's sole corporate member is CentraState Healthcare System, Inc. ("CSHS"). CSHS is also the tax-exempt New Jersey non-profit parent corporation of CentraState healthcare system; an integrated healthcare delivery system ("system"). The sole member of each entity is either CSHS or another CentraState Healthcare System affiliate controlled or owned by CSHS. CentraState Healthcare System is a tax-exempt integrated healthcare delivery system consisting of a group of affiliate healthcare organizations. CentraState Healthcare System is a world-class patient-focused organization comprised of a renowned team of healthcare professionals working together to transform the lives of those in the community. In 2021 CentraState Healthcare system employs over 600 physicians, had approximately 38,000 ER visits, 146,718 outpatient visits and 10,516 admissions. Mission ======= To enhance the health and well-being of the communities through the compassionate delivery of quality healthcare. Vision ====== An organization of caring professionals trusted as the community's health care system of choice for clinical excellence. Recognition/Quality Awards ========================== - Magnet designation for nursing - CSMC is one of only 2 percent of hospitals nationwide to achieve Magnet designation for nursing excellence four times as part of the American Nurses Credentialing Center's Magnet recognition program. Only 8 percent of the approximate 5,800 hospitals in the U.S. hold Magnet designation. CSMC has been a four-time recipient of this designation. - Great Place to Work 2021 certification. - Cancer Care - the Commission on Cancer, a program of the American College of Surgeons, recognizes cancer care programs for their commitment to providing comprehensive, high-quality, and multidisciplinary patient-centered care. The Statesir Cancer Center at CSMC was awarded three-year reaccreditation with commendation, a distinction given only to facilities that exceed standard requirements. The Star and Barry Tobias Women's Health Center was also granted three-year full accreditation by the national accreditation program for breast centers, exemplifying a firm commitment to offering patients every significant advantage in the battle against breast cancer. Both accreditations were awarded after a voluntary, rigorous evaluation process. - National Cancer Institute: National Community Oncology Research Program site of the Atlantic Health Cancer Consortium designation. - CEO Roundtable on Cancer: CEO Cancer Gold Standard T. - Well Workplace - the Wellness Council of America (WELCOA) awarded CentraState Healthcare System the platinum Well Workplace Award for its innovative employee wellness program. CSMC is one of only a few hospitals in the country to achieve platinum-level status. - Stroke top honor - the American Heart Association/American Stroke Association's Get with the Guidelines Stroke Gold Plus achievement award recognizes excellent evidence-based care for stroke patients. CSMC has earned this designation for the past five years and is also among an elite group of hospitals earning the association's target: strokes honor roll for improving stroke care. - College of Healthcare Information Management Executives: Most Wired healthcare organization for the tenth time American Heart Association: Get With The Guidelines Heart Failure and Stroke Gold Quality Achievement Awards. - The American College of Cardiology: recognition for developing and sharing quality practices in treating acute coronary syndrome. - The Joint Commission: Gold Seal of Approval in Heart Failure, a two-year recertification. - American College of Radiology: Diagnostic Imaging Center of Excellence and Low-Dose Rate CT Lung Screening Center of Excellence. - American Heart Association: Workplace Health Achievement Index Gold Level Recognition for the Diabetes Prevention Program. - American College of Surgeons Commission on Cancer: Outstanding Achievement Award. - Surgical Review Corporation: Bariatric Center of Excellence. - Centers for Disease Control and Prevention: first organization to earn full recognition for the Diabetes Prevention Program. - New Jersey Business and Industry Association: Good Neighbor Award for solar program. - Monmouth County Planning Board: 2019 Merit Award for solar program. - Monmouth Ocean Development Council: Silver Gull Community Service Award to the Freehold Family Health Center, a partnership among CentraState, the Rutgers Robert Wood Johnson Medical School Family Medicine Residency Program at CentraState, The Visiting Nurse Association and VNACJ Community Health Center. The Manor Health and Rehabilitation Center ========================================== - U.S. News & World Report: Best Nursing Home for short-term rehabilitation. - Centers for Medicare & Medicaid Services: Five-star rating. - Immunization Action Coalition Immunization Action Coalition: Influenza Vaccination Honor Roll. Monmouth Crossing ================= - New Jersey Department of Health and Senior Services and the Health Care Association of New Jersey: Advanced Standing distinction. - New Jersey Department of Health and Senior Services: Assisted Living Best Practice Award three times. - Holleran: Ranked consistently in the top 5 percent nationally for satisfaction scores. Applewood ========= - Centers for Medicare & Medicaid Services: Five-star rating. Accreditations and Affiliations =============================== Accreditations -------------- - American Academy of Sleep Medicine. - American Association for Cardiovascular and Pulmonary Rehabilitation. - American College of Cardiology chest pain accreditation. - American College of Radiology: mammography, CT, nuclear medicine, radiation oncology, stereotactic breast biopsy, ultrasound) diagnostic imaging center of excellence (DICOE), low-dose rate CT Screening Center of Excellence, Lung Cancer Screening Center Designation. - American College of Surgeons' Commission on Cancer: accredited for the Statesir Cancer Center at CentraState. - American College of Surgeons' National Accreditation program for Breast Centers-The Star and Barry Tobias Women's Health Center. - American Diabetes Association Certification for Diabetes Self-Management Training. - American Nurses Credentialing Center. - American Heart Association. - College of American Pathologists. - Continuing Care Accreditation Commission. - Intersocietal Commission for the Accreditation of Vascular Laboratories (ultrasound). - The Joint Commission (Medical Center, The Manor, Central Jersey Wound Treatment Center, Total Joint Center of New Jersey, Primary Stroke). - New Jersey Department of Health for blood banks. - American College of Cardiology chest pain accreditation.
CORE FORM, PART III, STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTSAffiliations ------------ - American Physical Therapy Association Clinical Education Center - Brookdale Community College: Schools of Nursing and Allied Health, Medical Technology and Respiratory Therapy - Capella University - Chamberlain University - The College of New Jersey - Drexel University - Indiana State University - Jersey Shore Medical Center for Outreach Renal Dialysis Service - Kean University - Mercer County Community College - Middlesex County College - Monmouth County Vocational School - Monmouth-Ocean hospital shared service association - Monmouth University - National Network of Libraries of Medicine - Neumann College - New Jersey City University - Rowan College at Burlington County - Rutgers University - Saint Elizabeth College School of Nutrition and Home Economics - Saint Francis Medical Center School of Nursing - Pennsylvania State University - Stockton University - Thomas Edison State College: School of Nursing - University of Medicine and Dentistry of New Jersey - Newark - University of Medicine and Dentistry of New Jersey - School of Health-Related Professionals in Camden and Lean - Southern New Hampshire University - Union County College - University of Delaware - University of Scranton - Wagner University Member of --------- - American Association of Homes and Services for the Aging - American Hospital Association - American Society of Clinical Pathology - Consortium of Multiple Sclerosis Centers - National Disaster Medical System - National Lymphedema Network - National Multiple Sclerosis Society - New Jersey Association of Mental Health Agencies - New Jersey Association of Nonprofit Homes for the Aging - New Jersey Hospital Association - New Jersey Society of Health System Pharmacists - Schizophrenia Foundation of New Jersey Laboratory Certified By ----------------------- - American College of Clinical Pathologists Nursing ------- - Credentialing Center (ANCC) of the American Nurses Association. - CSMC is an approved provider of continuing education by the New Jersey State Nurses Association, provider number: p102-9/2001-2003. NJNSA is accredited by the ANCC Commission on Accreditation of the American Nurses' Association. Licensed By ----------- - New Jersey Department of Health Approved By ----------- - American Dental Association for Continuing Medical Education - American Medical Association for continuing Medical Education Specialized Services ==================== CSMC offers a full range of clinical and diagnostic services to meet the diverse healthcare needs of the growing communities we serve. Cardiac Services ---------------- Services and programs include: the Thomas J. Blanchet Cardiac diagnostic Center, cardiac catheterization lab, cardiac rehabilitation center and the Gloria Saker Women's Heart Program. Statesir Cancer Center ---------------------- CSMC's multidisciplinary, integrated approach to cancer treatment ensures that our patients receive compassionate care and support-medical, educational, emotional and spiritual. CSMC is accredited by the American College of Surgeons Commission on cancer (COC) as well as the national accreditation program for breast centers (NAPBC), the American College of Radiology (ACR) for radiation oncology, diagnostic Radiology and mammography. CentraState has been designated as a Breast Imaging Center of Excellence (BICOE) and a Diagnostic Imaging Center of Excellence (DICOE). Services include: - cancer navigator program - cancer rehabilitation - clinical trials - colorectal cancer program (robotic surgery) - comprehensive breast care program - comprehensive lung program - infusion therapy services - lymphedema center - medical oncology - chemotherapy and immunotherapy services - palliative/hospice services - prostate cancer program (robotic surgery) - radiation oncology (including IMRT, IGRT, radiosurgery, HDR, cone beam therapy) - genetic testing and counseling - surgical oncology program Critical Care Unit ------------------ Our unit offers enhanced infection control features such as electronic privacy panels and a dedicated air filtration system that helps to contain infectious conditions. Emergency Services Department ----------------------------- Our goal is for you to see a nurse within 15 minutes and a clinician within 30 minutes. The ED also offers 24/7 pediatric emergency coverage and is designated as an advanced primary stroke center by the Joint Commission and the New Jersey Department of Health. Statesir Family Acute Care for Elders Unit ------------------------------------------ This unit helps senior patients recover from illness or injury by providing quality, safe, and seamless care. The ace unit is comprised of dedicated and trained health care professionals who provide support and information to patients and family to return home, avoid complications, and possibly prevent future hospitalizations. Our goal is to help patients stay strong, mobile, and independent while providing the best possible care. Laboratory ---------- The laboratory is accredited by the American College of Clinical Pathologists and the American Association of Blood Banks. It is conveniently located near outpatient registry and offers state-of-the-art technology. Maternity --------- CSMC's maternity unit allows mothers to experience labor, delivery, and recovery in a warm, private, home-like room equipped for normal and complicated deliveries. After delivery, when mothers and their newborns are ready, they are moved to a private suite in the First Impressions Maternity Pavilion, dedicated to postpartum care. CSMC also has a special care nursery which provides premature babies with treatment and care by a team of trained professionals. All special needs are met 24 hours a day under the supervision of a neonatologist. The facility is designated by the state as a community perinatal center intermediate and has received the IBCLC care award from the international board of lactation consultant examiners (IBLCE) and the international lactation consultant association (ILCA) for hiring international board-certified lactation consultants (IBCLCS). Pediatrics ---------- CSMC's pediatric department emphasizes family-centered care, with 24-hour visitation for parents. The patient rooms include beds for parents or guardians who wish to stay overnight and play areas for children. Psychiatric Services -------------------- Offers an inpatient unit that provides care for those needing acute psychiatric/mental healthcare, 24-hour psychiatric emergency assessments through the emergency room, and a 24-hour crisis hotline. Electroconvulsive therapy (ECT services are also available on an outpatient or inpatient basis.
CORE FORM, PART III, STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTSOrthopedics ----------- Programs and services include: the Total Joint Center of New Jersey for knee/hip repair and replacement; shoulder repair and replacement; hand and foot surgery; the Spine Institute of Central Jersey and non-surgical therapies for other orthopedic problems. The Total Joint Center of New Jersey is accredited by the Joint Commission. Outpatient Nutrition Center --------------------------- Offers individual nutrition counseling with a registered dietitian for children and adults. Includes counseling sessions for weight management, cardiac, renal, hepatic, gastrointestinal problems, and others. Radiology --------- Capabilities include x-ray, ultrasound, computed tomography (CT) scan and nuclear medicine. Princeton radiology associates also houses a positron emission tomography (pet)/CT scanner for diagnosing cancer and other diseases or conditions, and an open bore MRI. OceanFirst Rehabilitation Center -------------------------------- Our fully equipped center offers physical, occupational and speech therapy. Inpatient and outpatient services are offered daily. Specialized services include: Linda E. Cardinale MS Center, Central Jersey Wound Treatment Center with lymphedema program, continence program, swallowing disorder therapy, sports medicine and aquatic therapy, including a hydroworx pool. Progressive Care Unit --------------------- This unit treats heart failure patients, as well as transitions patients from the critical care unit. Following a hospital discharge, a registered nurse health coach is available to work with patients to help them become more knowledgeable and independent in managing diet, medications and lifestyle changes. Patients also learn how to most effectively work with their primary care provider for continued support. Additional support includes a free nurse advice. Patients can call the nurse advice line and speak to our cardiac coordinator for answers and help with any needs the heart failure patient may have. Core Form, Part III, Statement of Program Service Accomplishments Short stay unit --------------- A short stay unit is available for patients who do not require an overnight stay. Our same day surgery center performs a variety of surgical and endoscopy procedures on a medical outpatient basis. Surgical Services ----------------- CSMC's surgical services are delivered in state-of-the-art facilities by highly trained physicians and nurses. Patients receive comprehensive surgical support for diagnostic, therapeutic and palliative intervention in the following areas: general surgery, bariatric surgery, breast, colorectal, endovascular surgery, gastrointestinal surgery, neurosurgery, obstetrics/gynecology, ophthalmology, ear, nose and throat, orthopedics (including knee and hip replacements at the Total Joint Center of New Jersey at CSMC), plastic, podiatric, and thoracic surgery. The Star and Barry Tobias Women's Health Center ----------------------------------------------- Offers screenings, digital mammograms, computer-aided detection (cad), ultrasound mammotone biopsy, stereotactic needle biopsy, health education, bone densitometry, and individualized health counseling on a number of topics for women. The center is certified by the American college of radiology; has been named a breast imaging center of excellence for providing high-quality mammograms and other services; and has been named a pink ribbon facility by Hologic for providing excellence in breast health. Specialized Centers and Other Services -------------------------------------- CSMC offers specialized diagnostic and treatment services at its center for sleep disorders and comprehensive lung program. Other specialty services include respiratory therapy for pulmonary diagnostic procedures and rehabilitation, and oncology services, including chemotherapy, support groups and hemodialysis, podiatric services, pain management, and palliative care. Freehold Family Health Center ----------------------------- The Freehold Family Health Center is a unique collaborative initiative with the Visiting Nurse Association (VNA) Health Group, VNACJ Community Health Center, inc. (CHS and Rutgers Robert Wood Johnson Medical School through the Family Medicine Residency Program at CSMC. The facility is accessible to all members of the community, including underserved populations. Bilingual staff are available to assist with all services. Services include: - comprehensive primary and specialty care, including geriatrics, prenatal and behavioral health services; - community health programs such as WIC; - programming by the county councils for young children; and - cancer education and early detection programs. Community-based Programs ======================== Good Stewardship Through Solar ------------------------------ CSMC recently celebrated the completion of a solar carport installation in parking areas around the medical center and ambulatory campus, this installment, in combination with the solar farm at the back of the property, will allow CSC to generate approximately 61 percent of its electric consumption and achieve savings of approximately a half million dollars in energy costs each year, reducing its carbon footprint and the impact on Freehold Township's electrical grid. The carports and solar farm were installed by KDC Solar, a Bedminster-based developer, owner, and operator of solar power facilities. CSMC is the only hospital in the state with a solar installation of this size. It now produces the largest percentage of solar power of any hospital in New Jersey. The combined projects will offset greenhouse gases equivalent to: - 1,026,153 gallons of gas used. - 22,296,869 miles of vehicle traffic. - 1.162 billion smartphones charged. - 9,969,586 pounds of coal burned. - 1,590 homes supplied with electricity for one year. Community Health Outreach ========================= - People throughout the community used CentraState's Live Life Well services more than 55,000 times to enhance their health and manage or prevent chronic conditions through a variety of wellness offerings. - A total of 11,000 people attended health and wellness fairs, sessions, and screenings throughout the year. -Approximately 80,964 people received COVID vaccines. - More than 440 people attended cancer health lectures and screenings, including those for prostate, colorectal, oral, skin, breast, and thyroid cancers. - CSMC provided nearly 2,164 diabetes education encounters to help people manage or reduce their risk of diabetes. - More than 400 people benefited from the peer support of several CSMC support groups. - New and future parents attended more than 330 maternity and well-baby sessions to ensure healthy beginnings for the newest members of our community. - CSMC educated more than 1,350 students about health issues and health careers as a profession. This included summer camps as well as student health awareness center programs that help young people lead healthier lives and prepare to be healthier adults. - More than 2,000 people received life-saving CPR training, including basic life support, advanced life support, and pediatric advanced life support. - The Family Medicine Residency Program, which trains physicians of the future and provides medical care to those unable to pay for their care or who pay a rate that is below market value, served nearly 12,000 patients visits.
CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7CENTRASTATE HEALTHCARE SYSTEM, INC. ("CSHS") IS THE SOLE MEMBER OF THIS ORGANIZATION. CSHS HAS THE RIGHT TO ELECT THE MEMBERS OF THIS ORGANIZATION'S BOARD OF TRUSTEES AND HAS CERTAIN RESERVED POWERS AS DEFINED IN THIS ORGANIZATION'S BYLAWS.
CORE FORM, PART VI, SECTION B; QUESTION 11BTHE ORGANIZATION IS AN AFFILIATE WITHIN CENTRASTATE HEALTHCARE SYSTEM, INC. ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. CENTRASTATE HEALTHCARE SYSTEM, INC. IS THE TAX-EXEMPT PARENT ENTITY OF THE SYSTEM. THE ORGANIZATION'S FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY (ITS BOARD OF TRUSTEES) PRIOR TO THE FILING OF THE FEDERAL FORM 990 WITH THE INTERNAL REVENUE SERVICE ("IRS") AND AFTER PRESENTATION AND REVIEW BY CENTRASTATE HEALTHCARE SYSTEM, INC.'S AUDIT COMMITTEE. AS PART OF THE TAX RETURN PREPARATION PROCESS THE ORGANIZATION HIRED A PROFESSIONAL CERTIFIED PUBLIC ACCOUNTING ("CPA") FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION TO PREPARE THE FEDERAL FORM 990. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE ORGANIZATION'S FINANCE PERSONNEL AND INTERNAL WORKING GROUP OF THE ORGANIZATION TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE ORGANIZATION'S FINANCE PERSONNEL AND INTERNAL WORKING GROUP FOR THEIR REVIEW. THE ORGANIZATION'S FINANCE PERSONNEL AND INTERNAL WORKING GROUP REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE ORGANIZATION'S FINANCE PERSONNEL AND INTERNAL WORKING GROUP FOR FINAL REVIEW AND APPROVAL. FOLLOWING THIS REVIEW, THE FINAL FORM 990 WAS PRESENTED TO THE MEMBERS OF CENTRASTATE HEALTHCARE SYSTEM'S AUDIT COMMITTEE FOR REVIEW AND THEREAFTER PROVIDED TO EACH VOTING MEMBER OF THIS ORGANIZATION'S GOVERNING BODY PRIOR TO FILING WITH THE IRS.
CORE FORM, PART VI, SECTION B; QUESTION 12ALL OFFICERS, TRUSTEES AND KEY EMPLOYEES ARE REQUIRED ANNUALLY, TO REVIEW THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE, WHICH IS SUBMITTED TO CORPORATE COUNSEL. CORPORATE COUNSEL REVIEWS EACH COMPLETED QUESTIONNAIRE AND PREPARES A REPORT, WHICH IS SHARED WITH THE BOARD OF TRUSTEES GOVERNANCE COMMITTEE AND, ULTIMATELY, THE BOARD OF TRUSTEES. THE POLICY IS ENFORCED, AS NEEDED, DEPENDING ON THE CIRCUMSTANCES - FOR EXAMPLE, THROUGH RECUSAL FROM VOTING, DIVESTITURE OF CONFLICTING PROPERTY INTERESTS OR, IN CERTAIN PAST CASES, RESIGNATION FROM THE BOARD OF TRUSTEES.
CORE FORM, PART VI, SECTION B; QUESTION 15THE ORGANIZATION'S BOARD OF TRUSTEES HAS AN EXECUTIVE COMPENSATION SUB-COMMITTEE ("COMMITTEE"). THE COMMITTEE HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY WHICH IT FOLLOWS WHEN IT REVIEWS THE COMPENSATION AND BENEFITS OF THE ORGANIZATION'S SENIOR MANAGEMENT, INCLUDING THE PRESIDENT/CHIEF EXECUTIVE OFFICER. THE COMMITTEE REVIEWS THE "TOTAL COMPENSATION" OF THE INDIVIDUALS WHICH IS INTENDED TO INCLUDE BOTH CURRENT AND DEFERRED COMPENSATION AND ALL EMPLOYEE BENEFITS, BOTH QUALIFIED AND NON-QUALIFIED. THE COMMITTEE'S REVIEW IS DONE ON AT LEAST AN ANNUAL BASIS AND ENSURES THAT THE "TOTAL COMPENSATION" OF SENIOR MANAGEMENT OF THE ORGANIZATION IS REASONABLE. IN 2021, THE EXECUTIVE COMPENSATION SUB-COMMITTEE REPORTED TO THE FULL BOARD FOR RATIFICATION. THE ACTIONS TAKEN BY THE COMMITTEE ENABLE THE ORGANIZATION TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 4958 WITH RESPECT TO THE TOTAL COMPENSATION OF CERTAIN MEMBERS OF THE SENIOR MANAGEMENT TEAM, INCLUDING THE PRESIDENT/CHIEF EXECUTIVE OFFICER. THE THREE FACTORS WHICH MUST BE SATISFIED IN ORDER TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS ARE THE FOLLOWING: 1. THE COMPENSATION ARRANGEMENT IS APPROVED IN ADVANCE BY AN "AUTHORIZED BODY" OF THE APPLICABLE TAX-EXEMPT ORGANIZATION WHICH IS COMPOSED ENTIRELY OF INDIVIDUALS WHO DO NOT HAVE A "CONFLICT OF INTEREST" WITH RESPECT TO THE COMPENSATION ARRANGEMENT; 2. THE AUTHORIZED BODY OBTAINED AND RELIED UPON "APPROPRIATE DATA AS TO COMPARABILITY" PRIOR TO MAKING ITS DETERMINATION; AND 3. THE AUTHORIZED BODY "ADEQUATELY DOCUMENTED THE BASIS FOR ITS DETERMINATION" CONCURRENTLY WITH MAKING THAT DETERMINATION. THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES EACH OF WHO ARE INDEPENDENT AND ARE FREE FROM ANY CONFLICTS OF INTEREST. THE COMMITTEE RELIED UPON APPROPRIATE COMPARABLE DATA; SPECIFICALLY, THE COMMITTEE OBTAINED A WRITTEN COMPENSATION STUDY FROM AN INDEPENDENT FIRM WHICH SPECIALIZES IN THE REVIEWING OF HOSPITAL AND HEALTHCARE SYSTEM EXECUTIVE COMPENSATION AND BENEFITS THROUGHOUT THE UNITED STATES. THIS STUDY USED COMPARABLE GEOGRAPHIC AND DEMOGRAPHIC MARKET DATA INCLUDING BUT NOT LIMITED TO SIMILARLY SIZED HEALTHCARE SYSTEMS AND HOSPITALS, # OF LICENSED BEDS AND NET PATIENT SERVICE REVENUE. IN ADDITION, THE COMMITTEE REVIEWS AND APPROVES EXECUTIVE COMPENSATION ADJUSTMENTS BASED ON MARKET SURVEYS DEVELOPED BY INDEPENDENT CONSULTANTS, INDUSTRY AVERAGE COMPARISON, YEARS OF SERVICE AND OTHER EXEMPT ORGANIZATIONS IN THE GEOGRAPHIC AREA. AFTER A REVIEW OF THE INDIVIDUAL'S PERFORMANCE FOR THE YEAR AND RELYING ON COMPARABLE INFORMATION AND OTHER OBJECTIVE DATA, THE EXECUTIVE COMMITTEE WILL RECOMMEND AN ADJUSTMENT TO THE INDIVIDUAL'S COMPENSATION. ANY DETERMINATIONS ARE DOCUMENTED CONTEMPORANEOUSLY IN THE EXECUTIVE COMMITTEE MINUTES. THE COMMITTEE ADEQUATELY DOCUMENTED ITS BASIS FOR ITS DETERMINATION THROUGH THE TIMELY PREPARATION OF WRITTEN MINUTES OF THE COMPENSATION COMMITTEE MEETINGS DURING WHICH THE EXECUTIVE COMPENSATION AND BENEFITS WAS REVIEWED AND SUBSEQUENTLY APPROVED. THE ACTIONS OUTLINED ABOVE WITH RESPECT TO THE COMMITTEE AND THE ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS APPLIES TO CERTAIN SENIOR MANAGEMENT PERSONNEL, INCLUDING, BUT NOT LIMITED TO, THE PRESIDENT/CHIEF EXECUTIVE OFFICER. THE COMPENSATION AND BENEFITS OF CERTAIN OTHER INDIVIDUALS CONTAINED IN THIS FORM 990 ARE REVIEWED ANNUALLY BY THE CENTRASTATE HEALTHCARE SYSTEM, INC.'S PRESIDENT/CHIEF EXECUTIVE OFFICER WITH ASSISTANCE FROM THE ORGANIZATION'S HUMAN RESOURCES DEPARTMENT IN CONJUNCTION WITH THE INDIVIDUAL'S JOB PERFORMANCE DURING THE YEAR AND IS BASED UPON OTHER OBJECTIVE FACTORS DESIGNED TO ENSURE THAT REASONABLE AND FAIR MARKET VALUE COMPENSATION IS PAID BY THE ORGANIZATION. OTHER OBJECTIVE FACTORS INCLUDE MARKET SURVEY DATA FOR COMPARABLE POSITIONS, INDIVIDUAL GOALS AND OBJECTIVES, PERSONNEL REVIEWS, EVALUATIONS, SELF-EVALUATIONS AND PERFORMANCE FEEDBACK MEETINGS.
CORE FORM, PART VI, SECTION C; QUESTION 18Pursuant 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 19THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE STATE OF NEW JERSEY DEPARTMENT OF THE TREASURY.
CORE FORM, PART VII AND SCHEDULE JCORE FORM, PART VII AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM THIS ORGANIZATION. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OF THIS ORGANIZATION AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THIS ORGANIZATION'S BOARD OF TRUSTEES. John T. Gribbin is an officer and member of this organization's board of trustees; an uncompensated position. Mr. Gribbin is employed and receives a federal form w-2 from this organization. Accordingly, his common law employer/employee relationship is with CentraState Medical Center, Inc. (ein: 22-1750190). This organization filed a 2021 federal form 4720 which included a remittance of excise tax related to his compensation in excess of $1m.
CORE FORM, PART VII, SECTION A, COLUMN BTHIS ORGANIZATION IS AN AFFILIATE WITHIN THE CENTRASTATE HEALTHCARE SYSTEM, INC. ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THE SYSTEM INCLUDES BOTH FOR-PROFIT AND NOT FOR-PROFIT ORGANIZATIONS. CERTAIN BOARD OF TRUSTEE MEMBERS, OFFICERS AND/OR DIRECTORS LISTED ON CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 MAY HOLD SIMILAR POSITIONS WITH BOTH THIS ORGANIZATION AND OTHER AFFILIATES WITHIN THE SYSTEM. THE HOURS SHOWN ON THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE NO COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, REPRESENT THE ESTIMATED HOURS DEVOTED PER WEEK FOR THIS ORGANIZATION. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF TRUSTEES OF OTHER RELATED ORGANIZATIONS IN THE SYSTEM, THEIR RESPECTIVE HOURS PER WEEK PER ORGANIZATION ARE APPROXIMATELY THE SAME AS REFLECTED IN CORE FORM, PART VII OF THIS FORM 990. THE HOURS REFLECTED ON PART VII OF THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, PAID OFFICERS AND KEY EMPLOYEES, REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF CENTRASTATE HEALTHCARE SYSTEM, INC.; NOT SOLELY THIS ORGANIZATION.
CORE FORM, PART XI; LINE 9OTHER CHANGES IN NET ASSETS OR FUND BALANCE INCLUDES: - CHANGE IN BENEFICIAL INTEREST IN CENTRASTATE HEALTHCARE FOUNDATION, INC.; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION - $665,627.
CORE FORM, PART XII; QUESTION 2THE ORGANIZATION IS AN AFFILIATE WITHIN CENTRASTATE HEALTHCARE SYSTEM, INC. ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. CENTRASTATE HEALTHCARE SYSTEM, INC. IS THE TAX-EXEMPT PARENT ENTITY OF THE SYSTEM. AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF CENTRASTATE HEALTHCARE SYSTEM, INC. AND ALL ENTITIES WITHIN THE SYSTEM FOR THE YEARS ENDED DECEMBER 31, 2021 AND DECEMBER 31, 2020; RESPECTIVELY. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS CONTAIN CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. THE INDEPENDENT CPA FIRM ISSUED AN UNMODIFIED OPINION WITH RESPECT TO THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS.
CORE FORM, PART XII; QUESTION 3THE ORGANIZATION IS AN AFFILIATE WITHIN CENTRASTATE HEALTHCARE SYSTEM, INC.("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THE SYSTEM ENGAGED AN INDEPENDENT ACCOUNTING FIRM TO PREPARE AND ISSUE A SYSTEM WIDE CONSOLIDATED AUDIT UNDER THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133 AUDIT. THIS ORGANIZATION WAS INCLUDED IN THE SYSTEM WIDE A-133 AUDIT.
FORM 990 PART IX LINE 11GDESCRIPTION:CONTRACTED SERVICES TOTAL FEES:25956478
FORM 990 PART IX LINE 11GDESCRIPTION:PHYSICIAN FEES TOTAL FEES:16023136
FORM 990 PART IX LINE 11GDESCRIPTION:BILLING & COLLECTION FEES TOTAL FEES:2755983
FORM 990 PART IX LINE 11GDESCRIPTION:CONSULTING FEES TOTAL FEES:2750500
FORM 990 PART IX LINE 11GDESCRIPTION:PROFESSIONAL FEES TOTAL FEES:193529
FORM 990 PART IX LINE 11GDESCRIPTION:OTHER FEES TOTAL FEES:1583939

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
CENTER FOR AGING INC
901 WEST MAIN STREETFREEHOLDNJ07728222575377HEALTH SVCS.NJ501(C)(3)509(A)(2)CSHSfalse
CENTRASTATE ASSISTED LIVING INC
901 WEST MAIN STREETFREEHOLDNJ07728223520730HEALTH SVCS.NJ501(C)(3)509(A)(2)CSHSfalse
HEALTHCARE AFFILIATES INC
901 WEST MAIN STREETFREEHOLDNJ07728521594300HEALTH SVCS.NJ501(C)(3)509(A)(2)CSHSfalse
CENTRASTATE HEALTHCARE SYSTEM INC
901 WEST MAIN STREETFREEHOLDNJ07728222482803MANAGEMENTNJ501(C)(3)509(A)(3)NAfalse
CENTRASTATE HEALTHCARE FOUNDATION INC
901 WEST MAIN STREETFREEHOLDNJ07728272383065FUNDRAISINGNJ501(C)(3)509(A)(1)CSHSfalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdForeign PostalForeignAddress/ForeignPostalCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCdShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPct
CENTRASTATE HEALTHCARE SERVICES INC
901 WEST MAIN STREETFREEHOLDNJ07728222512830HEALTH SVCS.NJNAC CORP.false
CENTRASTATE MEDICAL ASSOCIATES PC
901 WEST MAIN STREETFREEHOLDNJ07728223402359HEALTH SVCS.NJNAC CORPfalse
CENTRASTATE SPECIALISTS PC
901 WEST MAIN STREETFREEHOLDNJ07728823704077HEALTH SVCS.NJNAC CORP.false
CENTRASTATE CAPTIVE INSURANCE CO LTD
981205985FINANCIAL VEHICLECSMCFOREIGN CORP.Yes (true)23 LIME TREE BAY AVEGRAND CAYMANCJKY1-1108CJ$1,521,599$14,065,0161.00000
CENTRASTATE CARDIOLOGY PC
901 WEST MAIN STREETFREEHOLDNJ07728872845417HEALTH SVCS.NJNAC CORP.false
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (true)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (true)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE R, PART VFormAndLineReferenceDesc
ExplanationThis organization is a member of centrastate healthcare system, inc.; a tax-exempt integrated healthcare delivery system. Funds are routinely transferred between affiliates and business activities are common on behalf of the System's affiliates, including this organization. These transactions may be recorded on the revenue/expense and balance sheet statements of this organization and other affiliates. THESE entities work together to deliver high quality cost effective healthcare and wellness services to their communities regardless of ability to pay and in furtherance of charitable tax-exempt purposes.ExplanationTxt