2021-11-12T15:04:06-06:00 2020-12-31 271728945 PKF O'CONNOR DAVIES LLP 300 TICE BOULEVARD SUITE 315 WOODCLIFF LAKE NJ 07677 990 2020-01-01 222922016 VALLEY HEALTH SYSTEM INC VALL 2012916200 223 NORTH VAN DIEN AVE RIDGEWOOD NJ 07450 WILLIAM KLUTKOWSKI VP FINANCE - CFO 2012916200 2021-11-11 1 WILLIAM KLUTKOWSKI 999009999 EDWARD G O'CONNOR P00434443 2017129800 2021-11-11 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z AUDREY MEYERS 223 NORTH VAN DIEN AVE RIDGEWOOD NJ 07450 89784941 0 X WWW.VALLEYHEALTH.COM X 1988 NJ MANAGEMENT AND PLANNING SERVICES FOR ITS MEMBERS. 18 17 420 17 0 0 0 0 78926070 80959432 3896795 322948 0 0 82822865 81282380 0 0 0 0 48489661 50480639 0 0 0 32644097 32587626 81133758 83068265 1689107 -1785885 45149539 45134894 44086983 43790379 1062556 1344515 X VALLEY HEALTH SYSTEM IS A FULL SERVICE HEALTHCARE SYSTEM SERVING THE RESIDENTS OF NORTHERN NEW JERSEY. IT COMPRISES THE MANY PROGRAMS AND SERVICES OF THE VALLEY HOSPITAL, A FULL SERVICE HOME CARE AGENCY, VALLEY HOME CARE, AND COMMUNITY-BASED PRIMARY AND URGENT CARE CENTERS, VALLEY HEALTH MEDICAL GROUPS, THAT BRING QUALITY HEALTHCARE TO MANY COMMUNITIES OF BERGEN COUNTY. 0 0 80959432 HEALTH CARE DELIVERY & MANAGEMENT, GENERAL/OTHER: VALLEY HEALTH SYSTEM PROVIDES MANAGEMENT & PLANNING SERVICES FOR ITS MEMBERS: VALLEY HEALTH MEDICAL GROUP, THE VALLEY HOSPITAL, VALLEY HOME CARE. 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 113 0 420 1 0 0 0 0 0 0 0 0 0 0 1 0 X 18 17 0 0 1 0 0 0 0 1 1 0 0 1 1 0 0 1 1 1 1 0 NJ X LAURIE DEBENEDETTO 2012916200 223 NORTH VAN DIEN AVE RIDGEWOOD NJ 07450 AUDREY MEYERS PRESIDENT/CEO, VHS 8.00 32.00 X X 1842384 0 45085 VINCENT FORLENZA CHAIRMAN 0.10 0.40 X X 0 0 0 FRANK J SHEEHY VICE CHAIRMAN 0.10 0.40 X X 0 0 0 JOSEPH MARION TREASURER 0.10 0.40 X X 0 0 0 ANN LIMBERG SECRETARY 0.10 0.40 X X 0 0 0 JUDY BASELICE TRUSTEE 0.10 0.40 X 0 0 0 JAMES BUSH TRUSTEE 0.10 0.40 X 0 0 0 MICHELLE HASSON TRUSTEE 0.10 0.40 X 0 0 0 KEVIN LOBO TRUSTEE 0.10 0.40 X 0 0 0 BRUCE MACTAS TRUSTEE 0.10 0.40 X 0 0 0 DUANE SACHS TRUSTEE 0.10 0.40 X 0 0 0 DENIS SALAMONE TRUSTEE 0.10 0.40 X 0 0 0 SCOTT SCHROEDER TRUSTEE 0.10 0.40 X 0 0 0 EDWARD B SELF MD TRUSTEE 0.10 0.40 X 0 0 0 STEVEN SILVERSTEIN TRUSTEE 0.10 0.40 X 0 0 0 JEFFREY TUCKER TRUSTEE 0.10 0.40 X 0 0 0 PATRICIA VERDUIN TRUSTEE 0.10 0.40 X 0 0 0 WAYNE WALD ESQ TRUSTEE 0.10 0.40 X 0 0 0 RICHARD KEENAN SENIOR VP, FINANCE/CFO THRU 8/2020 15.00 25.00 X 1159434 0 37643 WILLIAM KLUTKOWSKI VP & CFO EFF. 3/2020 15.00 25.00 X 664987 0 51335 ROBERT W BRENNER PRESIDENT, CLINICAL INTEGRATION 8.00 32.00 X 1339685 0 24791 PETER W DIESTEL PRESIDENT, VHS OPERATIONS 40.00 X 1057332 0 42020 ROBIN G HOLLANDER SENIOR VP, LEGAL SERVICES 40.00 X 840410 0 45828 GAIL CALLANDRILLO VP, PLANNING /GOVT RELATION 40.00 X 692200 0 45260 ERIC CAREY VP/CIO, INFORMATION SYSTEM 40.00 X 632112 0 51485 JOSE BALDERRAMA VP, HUMAN RESOURCES 40.00 X 582793 0 32341 MEGAN FRASER VP, COMMUNICATIONS/ MARKETING 40.00 X 487965 0 31617 JOSEPH LORINO VP, FACILITIES MANAGEMENT 40.00 X 455515 0 34510 NISHA SIKDER VP, PAYER STRATEGIES 40.00 X 338207 0 43381 EPHRAIM S CASPER MD CHIEF MEDICAL OFFICER 40.00 X 1026294 0 40758 MARIEL GESUALDO DIRECTOR, LEGAL AFFAIRS 40.00 X 295330 0 15361 JOSETTE PORTALATIN ASST VP, REVENUE CYCLE, FIN ADMIN 40.00 X 268720 0 46482 MICHAEL P BURKE ASST VP, INFORMATION SYSTEMS 40.00 X 256440 0 31769 TONI MODAK DIRECTOR, POPULATION HEALTH 40.00 X 234251 0 12827 12174059 0 632493 136 0 1 0 SPM MARKETING & COMMUNICATIONS LLC 15 WHARRIS AVENUE SUITE 300 LAGRANGE IL 60525 HEALTHCARE MARKETING & COMMUNICATIONS 1638372 AXINN VELTROP & HARKRIDER LLP 1370 AVENUE OF THE AMERICAS NEW YORK NY 10019 LEGAL SERVICES 434955 HERITAGE INC 4 WILSEY SQUARE RIDGEWOOD NJ 07450 COMMERCIAL PRINTING 412101 CORNERSTONE ON DEMAND INC 1601 CLOVERFIELD BLVD SUITE 600 SANTA MONICA CA 90404 TALENT MANAGEMENT SYSTEM 394648 DISPATCH HEALTH MANAGEMENT LLC 3455 RINGSBY COURT SUITE 101 DENVER CO 80126 HOME HEALTH CARE 384888 29 AFFILIATE COST ALLOCATION 900099 74628029 74628029 PROFESSIONAL REVENUE 900099 6331403 6331403 80959432 387142 387142 8438367 8502561 -64194 -64194 -64194 81282380 80959432 0 322948 X 10578320 10578320 31623392 31623392 1505605 1505605 4006522 4006522 2766800 2766800 53986 53986 855232 855232 29800 29800 10813 10813 11775764 11775764 4041634 4041634 650149 650149 1691307 1691307 44726 44726 65908 65908 1023042 1023042 ALLOCATED OTHER EXPENSE 5276229 5276229 LICENSES & ASSESMENTS 4001788 4001788 PAID CLAIMS BY CAPTIVE 2279736 2279736 DUES & SUBSCRIPTIONS 787512 787512 83068265 0 83068265 0 757943 1583239 1182594 975820 706097 483415 7040977 7075805 28790770 27056802 6671158 7959813 45149539 45134894 11594050 11643756 32492933 32146623 44086983 43790379 X 1062556 1344515 1062556 1344515 45149539 45134894 -1785885 2067844 0 X X 0 1 X 1 0 X 2840659 65204368 66468276 78926070 80959432 294398805 2840659 65204368 66468276 78926070 80959432 294398805 0 0 0 294398805 66 1036 1010750 387142 1398994 66 1036 1010750 387142 1398994 2840725 65205404 66468276 79936820 81346574 295797799 0.99530 0.99530 0.00470 0.00470 X 0 DUE FROM VALLEY HOSPITAL 7836849 DUE FROM VALLEY HOME CARE 122964 7959813 ESTIMATED PROFESSIONAL LIABILITY 32146623 32146623 X 83350224 2067844 2067844 81282380 0 81282380 83068265 0 83068265 0 83068265 PART X, LINE 2: THE COMPANY RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT TO BE SUSTAINED. MANAGEMENT HAS DETERMINED THAT THE COMPANY HAD NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION AND/OR DISCLOSURE. THE COMPANY IS NO LONGER SUBJECT TO U.S. FEDERAL, STATE OR LOCAL INCOME TAX EXAMINATIONS FOR PERIODS PRIOR TO DECEMBER 31, 2017. CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, 0 0 INVESTMENTS 120000 0 0 0 0 0 0 120000 0 120000 0 0 1 0 0 0 PART III ACCOUNTING METHOD: X X X X 0 1 0 0 0 0 0 1 0 AUDREY MEYERS PRESIDENT/CEO, VHS 1166636 0 592200 0 83548 0 21375 0 23710 0 1887469 0 0 0 ROBERT W BRENNER PRESIDENT, CLINICAL INTEGRATION 790426 0 327596 0 221663 0 12825 0 11966 0 1364476 0 0 0 RICHARD KEENAN SENIOR VP, FINANCE/CFO THRU 8/2020 633136 0 342696 0 183602 0 21375 0 16268 0 1197077 0 0 0 PETER W DIESTEL PRESIDENT, VHS OPERATIONS 671812 0 327620 0 57900 0 18525 0 23495 0 1099352 0 0 0 EPHRAIM S CASPER MD CHIEF MEDICAL OFFICER 831365 0 138206 0 56723 0 14250 0 26508 0 1067052 0 0 0 ROBIN G HOLLANDER SENIOR VP, LEGAL SERVICES 560959 0 231296 0 48155 0 18525 0 27303 0 886238 0 0 0 GAIL CALLANDRILLO VP, PLANNING /GOVT RELATION 345306 0 103950 0 242944 0 21375 0 23885 0 737460 0 0 0 WILLIAM KLUTKOWSKI VP & CFO EFF. 3/2020 445152 0 121535 0 98300 0 18525 0 32810 0 716322 0 0 0 ERIC CAREY VP/CIO, INFORMATION SYSTEM 400083 0 139606 0 92423 0 21375 0 30110 0 683597 0 0 0 JOSE BALDERRAMA VP, HUMAN RESOURCES 379825 0 131846 0 71122 0 14250 0 18091 0 615134 0 0 0 MEGAN FRASER VP, COMMUNICATIONS/ MARKETING 288339 0 106286 0 93340 0 18525 0 13092 0 519582 0 0 0 JOSEPH LORINO VP, FACILITIES MANAGEMENT 333158 0 72798 0 49559 0 14250 0 20260 0 490025 0 0 0 NISHA SIKDER VP, PAYER STRATEGIES 259429 0 45392 0 33386 0 13271 0 30110 0 381588 0 0 0 JOSETTE PORTALATIN ASST VP, REVENUE CYCLE, FIN ADMIN 238043 0 28820 0 1857 0 16372 0 30110 0 315202 0 0 0 MARIEL GESUALDO DIRECTOR, LEGAL AFFAIRS 268022 0 26724 0 584 0 14250 0 1111 0 310691 0 0 0 MICHAEL P BURKE ASST VP, INFORMATION SYSTEMS 218888 0 34375 0 3177 0 14085 0 17684 0 288209 0 0 0 TONI MODAK DIRECTOR, POPULATION HEALTH 213495 0 19719 0 1037 0 12827 0 0 0 247078 0 0 0 PART I, LINE 3 VALLEY HEALTH SYSTEM HAS DEVELOPED A COMPENSATION PLAN, WHICH GOVERNS THE COMPENSATION FOR ALL EXECUTIVES, INCLUDING THE CEO AND VICE PRESIDENTS OF THE ORGANIZATION. THE PLAN WAS DEVELOPED IN CONJUNCTION WITH A CONSULTING FIRM, REVIEWED BY THE PHYSICIAN LEADERSHIP COUNCIL AND APPROVED BY THE BOARD OF TRUSTEES AND THE VALLEY HEALTH SYSTEM PHYSICIAN COMPENSATION COMMITTEE. ON AN ANNUAL BASIS, THE PLAN IS REVIEWED AND UPDATED AS NEEDED. PART I, LINE 4B THE FOLLOWING INDIVIDUALS RECEIVED DISTRIBUTIONS FROM THEIR 457(F) PLANS: 1. GAIL CALLANDRILLO, $88,759 PART I, LINE 7 THE FOLLOWING EMPLOYEES OF THE ORGANIZATION RECEIVED A BOARD-APPROVED DISCRETIONARY BONUS, AWARDED BASED ON PERFORMANCE, AS REPORTED FOR THEM IN PART II, COLUMN B(II): 1. AUDREY MEYERS, $592,200 2. ROBERT W. BRENNER, $327,596 3. RICHARD KEENAN, $342,696 4. PETER W. DIESTEL, $327,620 5. ROBIN G. HOLLANDER, $231,296 6. GAIL CALLANDRILLO, $103,950 7. WILLIAM KLUTKOWSKI, $121,535 8. ERIC CAREY, $139,606 9. JOSE BALDERRAMA, $131,846 10. MEGAN FRASER, $106,286 11. JOSEPH LORINO , $72,798 12. NISHA SIKDER, $45,392 13. EPHRAIM S. CASPER, M.D., $138,206 14. MARIEL GESUALDO, $26,724 15. JOSETTE PORTALATIN, $28,820 16. MICHAEL P. BURKE, $34,375 17. TONI MODAK , $19,719 FORM 990, PART VI, SECTION A, LINE 4 THE ORGANIZATION IS INCLUDED IN CONSOLIDATED BYLAWS FOR VALLEY HEALTH SYSTEM, INC., THE VALLEY HOSPITAL, INC., AND VALLEY PHYSICIAN SERVICES, INC. IN APRIL 2020, THE BYLAWS WERE AMENDED TO INCLUDE AN ARTICLE FOR CRISIS STANDARDS OF CARE (CSC) AND AMENDMENTS TO THE BYLAWS DURING CSC DUE TO A PERVASIVE OR CATASTROPHIC DISASTER (I.E. THE COVID-19 PANDEMIC). THE CRISIS STANDARD OF CARE BYLAWS PROVISIONS INCLUDE THE FOLLOWING DURING THE CSC: THE PERMITTED NUMBER OF TRUSTEES WAS AMENDED TO BE NO FEWER THAN NINE. THE EXECUTIVE COMMITTEE WAS ALLOWED TO ACT ON BEHALF OF THE FULL BOARD UNTIL THE BOARD IS ABLE TO ACT OR OTHERWISE EXERCISE ITS POWERS. THE BOARD DELEGATES FINAL APPROVAL OF MEDICAL STAFF PRIVILEGES TO THE PRESIDENT & CEO OF THE HOSPITAL. THE BOARD EMPOWERS MANAGEMENT TO CHANGE POLICIES AND PROCEDURES AS IT DEEMS NECESSARY. THE EXECUTIVE COMMITTEE OF THE MEDICAL STAFF DELEGATES APPROVAL MEDICAL STAFF PRIVILEGE CHANGES AND TEMPORARY PRIVILEGES TO THE PRESIDENT OF THE MEDICAL STAFF OR DESIGNEE. FORM 990, PART VI, SECTION B, LINE 11B VALLEY HEALTH SYSTEM HAS ITS FORM 990 PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND HAS ESTABLISHED THE FOLLOWING REVIEW PROCESS TO ENSURE THAT THE INFORMATION REPORTED IS COMPLETE AND ACCURATE. WHEN THE FORM 990 IS PREPARED, IT IS SUBMITTED TO MANAGEMENT AND THE AUDIT COMMITTEE FOR REVIEW. ANY COMMENTS ARE SUMMARIZED AND PROVIDED TO THE DIRECTOR OF FINANCE. EACH ISSUE IS DOCUMENTED AND ADDRESSED UNTIL THE RETURN IS FINALIZED AND APPROVED BY THE AUDIT COMMITTEE FOR FILING WITH THE INTERNAL REVENUE SERVICE. BEFORE FILING, THE FORM 990 IS MADE AVAILABLE FOR THE BOARD'S REVIEW, BY HARD COPY AND OR ELECTRONIC COPY. FORM 990, PART VI, SECTION B, LINE 12 THE BOARD MANDATES THAT ALL MEMBERS OF MANAGEMENT AND THE GOVERNING BODY SIGN A CONFLICT OF INTEREST POLICY AND DISCLOSE ANY POTENTIAL OR ACTUAL CONFLICTS THAT MAY EXIST ANNUALLY. IF A CONFLICT OF INTEREST EXISTS THE ORGANIZATION WILL NOTIFY MEMBERS OF MANAGEMENT OR THE GOVERNING BODY AND INVESTIGATE THE CONFLICT. IF IT IS DETERMINED THAT AN ACTUAL CONFLICT OF INTEREST EXISTS, THE MEMBER OF MANAGEMENT OR THE GOVERNING BODY WILL BE NOTIFIED IMMEDIATELY AND WILL NOT BE ALLOWED TO VOTE OR BE PART OF ANY DECISIONS ABOUT SUCH TRANSACTIONS. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION HAS ESTABLISHED A POLICY FOR COMPENSATION OF ITS OFFICERS AND TOP MANAGEMENT. THE POLICY MANDATES THAT COMPENSATION FOR ITS OFFICERS AND TOP MANAGEMENT, BE ANNUALLY REVIEWED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES FREE OF ANY MEMBERS WITH CONFLICTS OF INTEREST RELATED THERETO. THE COMMITTEE DETERMINES THAT THE EXECUTIVES ARE BEING PAID AN APPROPRIATE LEVEL OF COMPENSATION BY USING COMPARATIVE DATA FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. COMPENSATION DECISION ON THE AMOUNT OF COMPENSATION PAID AND TERM IS ADEQUATELY DOCUMENTED IN A CONTEMPORANEOUSLY WRITTEN FORMAT. THIS PROCESS WAS LAST UNDERTAKEN IN 2020. FORM 990, PART VI, SECTION C, LINE 19 VALLEY HEALTH SYSTEM, INC. MAKES ITS FORM 990, FINANCIAL STATEMENTS, FORM 1023, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICY AVAILABLE UPON WRITTEN REQUEST. FORM 990, PART IX, LINE 11G OUTSIDE SERVICE FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,264,748. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,264,748. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 8,182,405. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,182,405. TEMPORARY HELP: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 248,446. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 248,446. CONSULTING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 2,042,266. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,042,266. AGENCY FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,991. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,991. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 35,908. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 35,908. FORM 990, PART XII, LINE 2C THE AUDIT COMMITTEE IS RESPONSIBLE FOR SELECTING AN INDEPENDENT ACCOUNTANT AND FOR THE OVERSIGNT OF THE AUDIT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. COLIGOCARE LLC 223 N VAN DIEN AVE RIDGEWOOD NJ 07450 CLINICALLY INTERGRATED NETWORK NJ 6331403 1306604 VALLEY HEALTH SYSTEM INC THE VALLEY HOSPITAL FOUNDATION INC 223 N VAN DIEN AVE RIDGEWOOD NJ 07450 222324554 SOLICITS AND RECEIVES CONTRIBUTIONS FOR THE BENEFIT OF HEALTH SYSTEM NJ 501(C)(3) LINE 7 VALLEY HEALTH SYSTEM INC 1 THE VALLEY HOSPITAL INC 223 N VAN DIEN AVE RIDGEWOOD NJ 07450 221487307 PROVIDE HEALTHCARE PROGRAMS AND SERVICES TO ALL NJ 501(C)(3) LINE 3 VALLEY HEALTH SYSTEM INC 1 VALLEY HOME CARE INC 15 ESSEX ROAD PARAMUS NJ 07652 223208480 PROVIDE HOME CARE AND HOSPICE SERVICES TO RESIDENTS OF NORTHERN NJ NJ 501(C)(3) LINE 10 VALLEY HEALTH SYSTEM INC 1 VALLEY MEDICAL SERVICES PC 15 ESSEX ROAD PARAMUS NJ 07652 465297054 PROVIDE PRIMARY AND SPECIALTY MEDICAL CARE NJ 501(C)(3) LINE 10 VALLEY PHYSICIAN SERVICES INC 0 VALLEY PHYSICIAN SERVICE NY PC 15 ESSEX ROAD PARAMUS NJ 07652 453125678 OPERATES URGENT/PRIMARY CARE CLINICS NY 501(C)(3) LINE 10 VALLEY PHYSICIAN SERVICES INC 0 VALLEY PHYSICIAN SERVICES INC 223 N VAN DIEN AVE RIDGEWOOD NJ 07450 320041186 PROVIDES MANAGEMENT AND VARIED CONSULTING SERVICES NJ 501(C)(3) LINE 10 THE VALLEY HOSPITAL INC 0 VALLEY PHYSICIANS SERVICES PC 15 ESSEX ROAD PARAMUS NJ 07652 465285330 PROVIDE PRIMARY AND SPECIALTY MEDICAL CARE NJ 501(C)(3) LINE 10 VALLEY PHYSICIAN SERVICES INC 0 VHS INSURANCE COMPANY LTD 010 MAIN STREET CAYMAN ISLANDS CJ 980408200 PROVIDES PROFESSIONAL, MEDICAL AND COMMERCIAL GENERAL LIABILITY INSURANCE CJ VALLEY HEALTH SYSTEM INC C 317743 27431859 1.00000 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 THE VALLEY HOSPITAL INC O 41716416 COST VALLEY HOME CARE Q 5200000 COST THE VALLEY HOSPITAL INC S 75400000 COST