2019-11-14T13:49:25-08:00 2018-12-31 990 2018-01-01 221714106 HMH CARRIER CLINIC INC HMHC 7327513361 C/O TAX DEPT 1350 CAMPUS PARKWAY NEPTUNE NJ 07753 ROBERT L GLENNING PRES, FIN & IT SVCS, CFO 7327513361 2019-11-14 205.172.192.86 2019-11-14 13:49:17 PS 224975201931802igsms 2019-11-14 P EEA7CFA7F54F0B183AC137AFF167329DDFC4C7B1 01D72944816E49B67932DA5E4599F09606782E45 2018 2020-03-31 21:24:44Z X DONALD PARKER PO BOX 147 BELLE MEAD NJ 08502 92206124 false X WWW.CARRIERCLINIC.ORG X 1910 NJ HMH CARRIER CLINIC'S PRIMARY ACTIVITIES ARE INPATIENT AND ADOLESCENT RESIDENTIAL PSYCHIATRIC TREATMENT, SUBSTANCE ABUSE TREATMENT AND REHABILITATION, AND SPECIAL EDUCATION FOR ADOLESCENTS 15 12 1251 0 0 0 428291 76699 75888284 77112617 1600537 1430770 1688232 927569 79605344 79547655 1000 1149 0 0 56727382 61798423 0 0 0 21960994 20207726 78689376 82007298 915968 -2459643 77132105 71369061 35064333 34489180 42067772 36879881 X TO INSPIRE HOPE AND RECOVERY THROUGH EXPERT TREATMENT, EDUCATION, COMPASSIONATE CARE AND OUTSTANDING SERVICE. false false 42383142 0 51541658 PSYCHIATRIC HOSPITAL PROVIDED SPECIALIZED MENTAL HEALTH TREATMENT PROGRAMS TO 5,091 INPATIENTS AND HAD A TOTAL OF 55,991 PATIENTS DAYS. 6533900 1154 6570459 EAST MOUNTAIN SCHOOL PROVIDED QUALITY SPECIAL EDUCATION AND THERAPEUTIC SERVICES FOR 218 ADOLESCENTS AFFECTED BY BEHAVIORAL AND PSYCHIATRIC DISORDERS. 5681101 0 5511558 BLAKE RECOVERY CENTER PROVIDED SPECIALIZED TREATMENT AND REHABILITATION PROGRAMS FOR SUBSTANCE ABUSE TO 1,250 INPATIENTS AND HAD A TOTAL OF 10,610 PATIENT DAYS. 11243484 0 13488942 OTHER PROGRAMS OF NOTE TO THE COMMUNITY - RESIDENTIAL SERVICES, WHICH INCLUDE EAST MOUNTAIN YOUTH LODGE, SWAN LODGE, SUNFLOWER LODGE, AND LOTUS LODGE FOR EMOTIONALLY DISTURBED ADOLESCENTS, CARED FOR 112 RESIDENTS AND HAD A TOTAL OF 27,331 PATIENT DAYS. 11243484 0 13488942 65841627 true true false true false false false false false true true false false false true true true false false false false false false false true false true true false false true false false false false false false false false false false false false false false false false false true 80 0 true 1251 true false false false false false true true false false false false false false X 15 12 false false false false false true true true true false false true true true true true true true true false NJ X DONALD PARKER 9082811560 252 RT 601 BLAWENBERG RD BELLE MEAD NJ 08502 X THOMAS G AMATO CHAIRPERSON 3.00 X 0 0 0 CAROL L HOLZER LCSW VICE CHAIRPERSON 3.00 X 0 0 0 TIMOTHY HOWES ESQ SECRETARY 3.00 X 0 0 0 CHRSITIAN BORMANN TRUSTEE 3.00 X 0 0 0 ANN DAMSGAARD TRUSTEE 3.00 X 0 0 0 NICK HILTON TRUSTEE 3.00 X 0 0 0 DONALD HUNT TRUSTEE 3.00 X 0 0 0 MATTHEW LOMBARDI TRUSTEE 3.00 X 0 0 0 GORDON PINGICER TRUSTEE 3.00 X 0 0 0 JAIME ROBERTSON-LAVALLE TRUSTEE 3.00 X 0 0 0 DONNA SIMON TRUSTEE 3.00 X 0 0 0 MARILOUISE VENDITTI MD TRUSTEE 3.00 X 0 0 0 JOHN KOLLIGIAN PHD TRUSTEE (RESIGNED 2/13/2018) 3.00 X 0 0 0 ANTHONY MARINO MD MEDICAL STAFF PRESIDENT 40.00 X 311395 0 18861 UMESH MEHTA MD CHIEF MEDICAL DIRECTOR 40.00 X X 566719 0 32909 DONALD PARKER PRESIDENT & CEO 40.00 X X 737887 0 74851 RANDOLPH JACOBSON VP & CFO 40.00 X 342749 0 66668 PATRICIA TOOLE VP & COMPLIANCE OFFICER 40.00 X 315901 0 46324 SHAUN SWEENEY VP, PATIENT CARE SERVICES 40.00 X 180045 0 29623 SYED ALI MD PSYCHIATRIST 40.00 X 328316 0 47400 ABDUL KAZI MD PSYCHIATRIST 40.00 X 326874 0 41109 JOSEPH VERRET MD PSYCHIATRIST 40.00 X 316549 0 42560 ROBERT SAINT-VIL MD PSYCHIATRIST 40.00 X 310521 0 26670 JAGWINDER SANDHU MD PSYCHIATRIST 40.00 X 280646 0 40740 4017602 0 467715 65 false true false SODEXO INC & AFFILIATES PO BOX 905374 CHARLOTTE NC 282905374 Dietary & Housekeeping 2780692 MCCARTER & ENGLISH LLP FOUR GATEWAY CENTER 100 MULBERRY ST NEWARK NJ 071024056 Legal Services 822653 DRINKER BIDDLE & REATH LLP 500 CAMPUS DRIVE FLORHAM PARK NJ 079321047 Legal Services 554437 NEW ADVANCED MEDICAL SERVICES GROUP 2087 KLOCKNER ROAD TRENTON NJ 08690 Internal Medicine 473575 KPMG LLP LOCKBOX 890576 DEPT 0576 PO BOX 120 DALLAS TX 753120576 Auditing services 224049 43 76699 76699 NET PATIENT SERVICE REVENUE 624100 70021114 0 0 EDUCATIONAL PROGRAMS 611710 6570459 0 0 OTHER HEALTHCARE RELATED REVENUE 624100 521044 0 0 77112617 578119 0 578119 177741 177741 13333379 0 12480728 0 852651 0 852651 0 0 852651 1154 76699 1154 0 1154 MANAGEMENT FEE REVENUE 900099 766268 766268 0 0 SERVICES AGREEMENT 900099 160147 160147 0 0 926415 79547655 78039032 0 1431924 X 1149 1149 2723932 1139552 1584380 0 47655143 38152695 9502448 0 2548423 2067482 480941 0 5352086 4780319 571767 0 3518839 2852274 666565 0 160564 149452 11112 0 2124632 0 2124632 0 252128 23571 228557 0 114162 114162 0 0 3003719 2555609 448110 0 967130 3653 963477 0 922153 604616 317537 0 279861 22508 257353 0 745845 600029 145816 0 73883 6684 67199 0 63696 59211 4485 0 993104 709782 283322 0 3337735 2806695 531040 0 875764 78342 797422 0 MEDICAL SUPPLIES 2305105 2203433 101672 0 PHARMACY 1089846 1086676 3170 0 OUTSIDE SERVICES 1047171 764306 282865 0 MAINTENANCE 955085 585419 369666 0 896143 4474008 -3577865 0 82007298 65841627 16165671 0 5331156 2821810 2121275 22341 71747 53652 5781487 7983252 209628 232560 636682 632241 66227560 35891310 31810905 30336250 27349614 26460009 875111 3819611 1951835 77132105 71369061 11417660 8736079 197068 18153407 17540957 5493266 8015076 35064333 34489180 X 41616567 36527241 451205 352640 42067772 36879881 77132105 71369061 X -2459643 -2731538 3290 X X false true X true true true X 0 0 0 0 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true 3729 false false 3729 false Pt II-B Line 1 PART II-B LINE 1(G), OTHER LOBBYING ACTIVITIES: THIS EXPENSE REPRESENTS A PORTION OF HMH CARRIER CLINIC'S MEMBERSHIP DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND NJ HOSPITAL ASSOCIATION (NJHA) THAT BOTH ASSOCIATIONS HAD RECOGNIZED AS THEIR LOBBYING ACTIVITIES ON BEHALF OF THEIR MEMBERS. 451205 215418 313983 352640 369716 413410 331921 451205 561426 250292 442002 369716 552563 356664 347801 561426 505721 829629 782787 552563 1.00000 false false 0 278290 278290 45018796 22249593 22769203 20501964 13641717 6860247 428510 428510 30336250 DUE TO 3RD PARTIES 547331 DEFERRED COMPENSATION 1172294 ACCRUED PENSION & BENEFITS 6295451 8015076 X 78332901 78332901 986430 986430 79319331 81893136 81893136 114162 114162 82007298 Pt XI, Line 4b OTHER ADJUSTMENTS: INVESTMENT INCOME 1,316,608; FUNDRAISING EVENTS 76,699; RENTAL EXPENSE (177,741); NET ASSETS RELEASED (114,974); INVESTMENT MGMT FEES (114,162); TOTAL PART XI, LINE 4b 986,430 Pt V, Line 4 ENDOWMENT FUNDS ARE TO USED CONSISTENT WITH THE DONOR'S INTENT AND IN FURTHERANCE OF CARRIER CLINIC'S CHARITABLE TAX-EXEMPT PURPOSES. THE ENDOWMENT FUNDS ARE RESTRICTED FOR CAPITAL IMPROVEMENTS AND VARIOUS PATIENT CARE RELATED ACTIVITIES, AS SPECIFIED BY THE DONORS. Pt X, Line 2 HMH CARRIER CLINIC IS AN ORGANIZATION DESCRIBED IN SECTION 501(c)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND, THEREFORE, IS EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(a) OF THE CODE. HMH CARRIER CLINIC IS ALSO EXEMPT FROM STATE INCOME TAXES. HMH CARRIER CLINIC RECOGNIZES INVOME TAX POSITIONS WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINABLE BASED ON THE MERITS OF THE POSITION. MANAGEMENT HAS CONCLUDED THAT THERE ARE NO MATERIAL TAX LIABILITIES THAT NEED BE RECORDED. GALA 119570 68504 51066 31316 19750 GOLF OUTING 49950 30291 19659 14626 5033 1 53606 47632 5974 5974 223126 146427 76699 45942 30757 76699 0 true true X true X true X 100.000000000000 true true true false true true 841636 0 841636 0.01030 12860890 11470370 1390520 0.01700 0 0.00000 13702526 11470370 2232156 0.02730 17975 17975 0.00020 13664 13664 0.00020 6240674 3573475 2667199 0.03250 0 12301 12301 0.00020 6284614 3573475 2711139 0.03310 19987140 15043845 4943295 0.06040 true 3874298 2342003 12560182 12743494 -183312 X true true 1 1 HMH CARRIER CLINIC INC 252 ROUTE 601 BELLE MEAD NJ 08502 WWW.CARRIERCLINIC.ORG 51806 X PSYCHIATRIC HOSPITAL HMH CARRIER CLINIC, INC. Pt V Line 5 AS AN ACTIVE PARTNER TO ASSESSING THE MENTAL HEALTH AND ADDICTION NEEDS IN OUR COMMUNITY, HMH CARRIER CLINIC HAS CONDUCTED INTERVIEWS WITH MENTAL HEALTH & ADDICTION ADMINISTRATORS AND OTHER MENTAL HEALTH & ADDICTION PROFESSIONALS IN EACH IDENTIFIED COUNTY. ADDITIONALLY, REPRESENTATIVES FROM HMH CARRIER CLINIC ATTEND MONTHLY COUNTY MENTAL HEALTH ADVISORY COMMITTEE AND PACADA MEETINGS, AND HAVE PARTICIPATED IN A COLLABORATIVE EFFORT WITH SOMERSET COUNTY HEALTH SERVICES STAKEHOLDERS THROUGH THE HEALTHIER SOMERSET INITIATIVE TO PRODUCE A COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY HEALTH IMPROVEMENT PLAN. HMH CARRIER CLINIC, INC. Pt V Line 6a IN AN EFFORT TO BE COST-EFFECTIVE, HMH CARRIER CLINIC CONDUCTED ITS CHNA IN CONJUNCTION WITH EAST MOUNTAIN HOSPITAL. HMH CARRIER CLINIC ALSO PARTNERED WITH SOMERSET MEDICAL CENTER FOR SOMERSET COUNTY'S DATA COLLECTION. THE CHNA WAS FIRST CONDUCTED IN 2013 AND THEN AGAIN IN 2016. HMH CARRIER CLINIC, INC. Pt V Line 11 IN 2016, CARRIER CLINIC UNDERWENT A COMPREHENSIVE DATA GATHERING PROCESS (COMMUNITY HEALTH NEEDS ASSESSMENT) TO IDENTIFY THE MENTAL HEALTH NEEDS OF THE COMMUNITIES WE SERVE. AS A SPECIALIZED, NOT-FOR-PROFIT PSYCHIATRIC HOSPITAL, OUR DEFINITION OF COMMUNITY IS UNLIKE MOST MEDICAL/SURGICAL CENTERS WHO PRIMARILY USE AN IMMEDIATE GEOGRAPHIC BOUNDARY TO DEFINE "COMMUNITY." CARRIER CLINIC IS CONTINUALLY ASSESSING THE PRIMARY COUNTIES WE SERVE IN THE STATE OF NEW JERSEY. AS SUCH, IN RESPONSE TO THE SHIFT TOWARDS INCLUDING ADDICTION ILLNESSES TO MENTAL HEALTH DATA COLLECTION/ REPORTING ON BOTH A LOCAL AND NATIONAL LEVEL, CARRIER CLINIC HAS EXPANDED ITS COMMUNITY DEFINITION IN 2016 TO NOW INCLUDE THOSE PERSONS SUFFERING FROM MENTAL HEALTH AND DUAL DIAGNOSIS ILLNESSES. CONVERSELY, DUE TO THE RESOURCE LIMITS OF AN INDEPENDENT BEHAVIORAL HEALTHCARE HOSPITAL, CARRIER CLINIC IS NARROWING ITS GEOGRAPHIC AREA FOR THE 2016-2019 PLAN, CONCENTRATING ON ITS TWO MAJOR COUNTIES (MIDDLESEX & SOMERSET, WHICH MADE UP APPROXIMATELY 35% OF CARRIER CLINIC ADMISSIONS IN 2015), AND DEFINING ITS SECONDARY AREA AS THE STATE OF NEW JERSEY. THEREFORE, FOR THE 2016-2019 COMMUNITY HEALTH NEEDS ASSESSMENT & IMPLEMENTATION STRATEGY, CARRIER CLINIC'S COMMUNITY IS DEFINED AS "ADULTS SUFFERING FROM ACUTE MENTAL HEALTH AND DUAL DIAGNOSIS ILLNESSES, RESIDING IN MIDDLESEX & SOMERSET COUNTIES." ADDITIONAL DATA HAS BEEN PROVIDED ON A STATE LEVEL FOR MENTAL HEALTH AND DUAL DIAGNOSIS NEEDS THROUGHOUT THE STATE OF NEW JERSEY. UTILIZING A COMPILATION OF COUNTY CHIP DATA, BRFSS PARTICIPATION, KEY INFORMANT INTERVIEWS, PATIENT FOCUS GROUPS AND OTHER SOURCES, WE HAVE IDENTIFIED THE MENTAL HEALTH AND DUAL DIAGNOSIS/ADDICTION EDUCATION AND INFORMATION NEEDS OF NEW JERSEY AND OUR TWO COUNTIES, AND HAVE PUT TOGETHER A PLAN TO MEET THOSE NEEDS, AS WE ARE ABLE, SPECIFIC TO EACH COUNTY IN OUR DEFINED COMMUNITY. AS "MENTAL ILLNESS" IS A TOP PRIORITY THROUGHOUT THE STATE, THERE ARE TREMENDOUS OPPORTUNITIES FOR CARRIER CLINIC TO PROVIDE EDUCATION AND INFORMATION TO NOT ONLY CONSUMER/COMMUNITY MEMBERS, BUT TO THE MENTAL HEALTH PROFESSIONALS IN THOSE COUNTIES AS WELL. THE CHNA PROCESS IDENTIFIED OTHER COMMUNITY NEEDS THAT WERE NOT INCLUDED IN THE IMPLEMENTATION STRATEGY DUE TO LIMITATIONS IN EXPERTISE AND RESOURCES. 6 EAST MOUNTAIN SCHOOL 252 ROUTE 601 BELLE MEAD NJ 08502 PRIVATE SCHOOL FOR THE HANDICAPPED EAST MOUNTAIN YOUTH LODGE 252 ROUTE 601 BELLE MEAD NJ 08502 RESIDENTIAL TREATMENT FACILITY BLAKE RECOVERY CENTER 252 ROUTE 601 BELLE MEAD NJ 08502 SUBSTANCE ABUSE FACILITY SWAN LODGE 252 ROUTE 601 BELLE MEAD NJ 08502 INTENSIVE RESIDENTIAL TREATMENT FACILITY SUNFLOWER LODGE 252 ROUTE 601 BELLE MEAD NJ 08502 PSYCHIATRIC COMMUNITY HOME FOR CHILDREN LOTUS LODGE 252 ROUTE 601 BELLE MEAD NJ 08502 PSYCHIATRIC COMMUNITY HOME FOR CHILDREN Pt I Line 6a THE COMMUNITY BENEFIT REPORT AND IMPLEMENTATION STRATEGY ARE BOTH AVAILABLE ON THE WEBSITE: WWW.CARRIERCLINIC.ORG Pt I Line 7 BAD DEBT EXPENSE FOR 2018 IS $3,874,298 AND IS EXCLUDED FROM TOTAL EXPENSES FOR CALCULATING THE PERCENTAGE OF TOTAL EXPENSE. THE COST-TO-CHARGE RATIO USED FOR PART I, LINE 7 IS BASED ON WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGES. Pt III Line 2 ACCOUNTS THAT REACH THE END OF THE SELF-PAY BILLING CYCLE WITHOUT PAYMENTS OR FINANCIAL ASSISTAANCE APPROVAL ARE TRASFERRED TO BAD DEBT. UNINSURED PATIENT CHARGES ARE DISCOUNTED. BALANCES AFTER INSURANCE, SUCH AS DEDUCTIBLES, CO-PAYS, AND COINSURANCE ARE NOT DISCOUNTED. Pt III Line 3 THE RATIO OF PATIENT CARE COST-TO-CHARGE IS 60.45%, WHICH IS APPLIED TO THE BAD DEBT AMOUNT FOR AN ESTIMATED COST OF $2,342,003. Pt III Line 4 IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE CLINIC ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD PARTY COVERAGE, THE CLINIC ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SELF PAY PATIENTS, WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD PARTY COVERAGE EXISTS FOR PART OF THE BILL, THE CLINIC RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. ACCOUNT BALANCES ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AFTER ALL MEANS OF COLLECTION HAS BEEN EXHAUSTED. Pt III Line 8 THE AMOUNTS REPORTED ARE TAKEN FROM HMH CARRIER CLINIC'S FILED 2018 MEDICARE COST REPORT PURSUANT TO THE SCHEDULE H INSTRUCTIONS. THESE AMOUNTS DO NOT INCLUDE INCURRED LOSSES FROM PHYSICIAN SERVICES TOTALING OVER $497,000 AS FOLLOWS: PHYSICIAN COST (SALARIES, FRINGES AND MALPRACTICE INSURANCE) $1,336,000; REIMBURSEMENT RECEIVED FROM MEDICARE $839,000. THE HOSPITAL BELIEVES THAT IN YEARS OF A MEDICARE SHORTFALL, IT SHOULD BE CONSIDERED AS A COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. THIS YEAR, MEDICARE ACCOUNTED FOR 20% OF HOSPITAL REVENUES. THE HOSPITAL PROVIDES CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. CARING FOR MEDICARE PATIENTS FULFILLS A COMMUNITY NEED AND RELIEVES A GOVERNMENT BURDEN AS THESE PATIENTS TYPICALLY HAVE LOW AND/OR FIXED INCOMES. MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE COST OF PROVIDING CARE FOR THESE PATIENTS. MEDICARE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT BECAUSE OUR MISSION IS TO PROMOTE HEALTH IN THE COMMUNITY AND WE DO NOT LIMIT THE CARE AVAILABLE TO ANY PATIENTS, INCLUDING THOSE COVERED BY MEDICARE. TAX-EXEMPT HOSPITALS ARE EXPECTED TO PARTICIPATE IN THE MEDICARE PROGRAM. Pt III Line 9b THE HOSPITAL WILL MAKE DILIGENT EFFORT TO DETERMINE THE PATIENT FINANCIAL RESPONSIBILITY AS SOON AS REASONABLY POSSIBLE, THE DAY OF ADMISSION OR WITHIN FEW DAYS OF ADMISSION. ESTIMATED AMOUNT DUE WILL BE BASED ON THE INDIVIDUAL INSURANCE BENEFIT AND MAY INCLUDE DEDUCTIBLE, CO-PAY AND CO-INSURANCE. THE HOSPITAL WILL MAKE ITS BEST EFFORT TO ADVISE ALL PATIENTS AND/OR FAMILIES OF ANY FINANCIAL RESPONSIBILITY, COVERAGE LIMITATION, DISCUSS PAYMENT OPTIONS AND AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAM. PATIENT STATEMENTS WILL INCLUDE NOTICES AS REQUIRED TO INFORM PATIENT OF THE AVAILABILITY AND MEANS TO ACCESS FINANCIAL ASSISTANCE. THE HOSPITAL WIDELY PUBLICIZES ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAM, INCLUDING WHO TO CONTACT. GENERALLY, A PATIENT AND/OR GUARANTOR WILL HAVE A SELF-PAY RESPONSIBILITY INCLUDING AND NOT LIMITED TO THE FOLLOWING: THE PATIENT HAS INSURANCE COVERAGE BUT IT HAS BEEN ESTABLISHED THAT DEDUCTIBLE NOT MET AND PATIENT HAS CO-INSURANCE AND/OR DAILY COPAY, THE PATIENT HAS INSURANCE, HOWEVER HMH CARRIER CLINIC IS OUT OF NETWORK AND PATIENT DOES NOT HAVE OUT OF NETWORK BENEFITS, THE PATIENT HAS NO INSURANCE AND WHEN ASKED DOES NOT QUALIFY FOR MEDICAID, THE PATIENT HAS INSURANCE BUT NO BENEFITS FOR BEHAVIORAL HEALTH, THE PATIENT HAS INSURANCE, AND HAS OUT OF NETWORK BENEFITS WITH HIGH COINSURANCE, THE PATIENT HAS EXHAUSTED AVAILABLE BENEFITS, BENEFIT YEAR, CALENDAR YEAR, AND/OR LIFETIME MAXIMUM FREQUENT OCCURRENCE WITH MEDICARE PATIENTS WHO HAVE USED THEIR 190 LIFETIME PSYCHIATRIC BENEFIT OR LESS FREQUENTLY MAXED THEIR BENEFIT PERIOD. THE HOSPITAL WILL MAKE DILIGENT EFFORTS TO IDENTIFY PATIENTS WHO MAY BE UNINSURED OR UNDERINSURED IN ORDER TO PROVIDE COUNSELING AND ASSISTANCE. THE PSR (PATIENT SERVICES REP) WILL PROVIDE FINANCIAL COUNSELING TO THESE PATIENTS AND THEIR FAMILIES, INCLUDING GUIDANCE FOR ELIGIBLY FOR OTHER SOURCES OF COVERAGE SUCH AS FEDERAL AND STATE GOVERNMENT PROGRAMS. IF ADDITIONAL FINANCIAL ASSISTANCE IS REQUIRED, PSR MAY EXTEND DISCOUNTS OR OTHER ADJUSTMENTS TO PATIENT IF THEY QUALIFY UNDER THE HOSPITAL FINANCIAL ASSISTANCE POLICY. THE PATIENT HAS A NUMBER OF RESPONSIBILITIES IN ORDER TO QUALIFY FOR ASSISTANCE, INCLUDING THE OBLIGATION TO SUBMIT ALL NECESSARY AND ACCURATE DOCUMENTATION. THE HOSPITAL WIDELY PUBLICIZES INFORMATION ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAM, INCLUDING WHERE TO GO FOR ASSISTANCE. IT SHOULD BE NOTED THAT SERVICES WHICH ARE SEPARATELY BILLED BY OTHER OUTSIDE PROVIDERS, SUCH AS PHYSICIANS ARE NOT ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY (FAP). CARRIER CLINIC UTILIZES ARCADIA RECOVERY FOR COLLECTION OF ALL PATIENT BALANCES AFTER INSURANCE PAYMENTS AND UNINSURED INDIVIDUALS. THE TOTAL BILLING CYCLE IS 120 DAYS BEFORE THE BALANCE IS SENT TO COLLECTION. IN CERTAIN SITUATIONS (EXCEPT FOR MEDICARE PATIENTS) ACCOUNT MAY BE REFERRED TO BAD DEBT (BD) PRIOR TO 120TH DAY. THE HOSPITAL WILL MAKE EVERY EFFORT TO PROVIDE PATIENTS WITH EVERY OPPORTUNITY TO MEET THEIR FINANCIAL OBLIGATION BEFORE ACCOUNT IS REFERRED TO A COLLECTION AGENCY. STEPS WILL BE TAKEN TO COMMUNICATE WITH PATIENTS WITH DELINQUENT ACCOUNTS ENCOURAGING THEM TO COMPLY WITH PAYMENT PLANS IN ORDER TO PREVENT REFERRAL TO OUTSIDE COLLECTION AGENCY. ARCADIA WILL PROVIDE INFORMATION ON FINANCIAL ASSISTANCE AND PAYMENT OPTIONS TO PATIENTS INFORMING THEM OF THE OUTSTANDING BALANCE DUE. THE FOLLOWING ACCOUNTS WILL BE REFERRED TO COLLECTION AGENCY WHEN ALL AVAILABLE EFFORTS WERE EXHAUSTED: DELINQUENT ACCOUNTS WITH NO PAYMENT ACTIVITY, ACCOUNTS WITH NO PAYMENT ACTIVITY AND INELIGIBLE FOR FINANCIAL ASSISTANCE, ACCOUNTS GRANTED % DISCOUNTS UNDER FINANCIAL ASSISTANCE BUT NO LONGER COOPERATING TO PAY REMAINING BALANCE, ACCOUNTS WERE PATIENTS HAVE MADE NO ARRANGEMENTS TO RESOLVE THEIR OUTSTANDING BALANCE, ACCOUNTS WITH RETURNED MAIL AND NO OTHER CONTACT INFORMATION. ACCOUNTS THAT CANNOT BE COLLECTED AFTER A SERIES OF LETTERS AND CALLS WILL BE REFERRED TO A COLLECTION AGENCY FOR FURTHER COLLECTION ACTION (121ST DAY OR LATER, ALL MEDICARE PATIENTS AND 120 DAYS OR LESS FOR NON-MEDICARE PATIENTS). BAD DEBT REFERRAL PRIOR TO 120TH DAY IS ACCOUNTS CLASSIFIED AS SKIP WHEN RETURNED BY THE USPS AS NOT DELIVERABLE. MEDICARE ACCOUNTS ARE NOT REFERRED TO BAD DEBT REGARDLESS OF THE SITUATION UNTIL 121ST DAY FROM THE FIRST STATEMENT DATE. HMH CARRIER CLINIC AND COLLECTION AGENCY EFFORTS DO NOT INCLUDE EXTRAORDINARY COLLECTION MEASURES. Pt VI Line 2 HMH CARRIER CLINIC COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT FOR 2017-2019 WHICH REFLECTED THE MENTAL HEALTH AND ADDICTION NEEDS OF ITS SURROUNDING COMMUNITY, AND A CORRESPONDING IMPLEMENTATION STRATEGY TO MEET THESE NEEDS. ADDITIONALLY, HMH CARRIER CLINIC STAFF ATTENDS AN AVERAGE OF 10 COMMUNITY MEETINGS A MONTH THROUGHOUT THE STATE OF NEW JERSEY. DOING SO ENABLES HMH CARRIER CLINIC TO BE EDUCATED ON EACH COUNTY'S MENTAL HEALTH AND ADDICTION NEEDS AND SPECIFIC ISSUES THAT ARE IMPORTANT TO THE COMMUNITY. AS PART OF HMH CARRIER CLINIC'S STRATEGIC PLANNING PROCESS, HMH CARRIER CLINIC GATHERS AND INCORPORATES NATIONAL, STATE AND CLINICAL INDUSTRY DATA IN THE DEVELOPMENT OF CLINICAL SERVICES AND EDUCATIONAL FORUMS. HMH CARRIER CLINIC IS A PARTICIPATORY MEMBER OF THE NEW JERSEY HOSPITAL ASSOCIATION, NEW JERSEY ASSOCIATION OF MENTAL HEALTH AND ADDICTION AGENCIES, NATIONAL ASSOCIATION OF PSYCHIATRIC HEALTH SYSTEMS, AND THE AMERICAN HOSPITAL ASSOCIATION. EACH OF THESE ORGANIZATIONS ALSO PROVIDES BEHAVIORAL HEALTH AND ADDICTION INFORMATION RELEVANT TO OUR COMMUNITY'S BEHAVIORAL HEALTH AND ADDICTION NEEDS. READING INDUSTRY JOURNALS, NEWSLETTERS AND COMMUNITY NEWSPAPERS ALSO ALLOWS US TO HELP TAILOR FREE EDUCATIONAL EVENTS TO OUR SURROUNDING COMMUNITY. HMH CARRIER CLINIC RECEIVES MANY TELEPHONE CALLS ON A REGULAR BASIS, IN EXCESS OF 99,000 IN 2018, REQUIRING REFERRALS TO AND INFORMATION REGARDING COMMUNITY RESOURCES, OTHER TREATMENT CENTERS OUTSIDE THE AREA, SUPPORT GROUPS, SELF-HELP GROUPS, ETC. INFORMATION IS PROVIDED WITHOUT CHARGE. HMH CARRIER CLINIC ALSO MAINTAINS ITS WEBSITE, WHICH IN ADDITION TO PROVIDING INFORMATION ABOUT HMH CARRIER CLINIC'S PROGRAMS AND SERVICES, PROVIDES THE ABILITY TO REQUEST INFORMATION VIA E-MAIL AND LINKS TO OTHER MENTAL HEALTH RESOURCES. IT IS THROUGH THIS CONTACT WITH OUR COMMUNITY THAT WE ARE ABLE TO UNDERSTAND WHICH SERVICES ARE NEEDED THROUGHOUT OUR GEOGRAPHIC AREA. Pt VI Line 3 PATIENT EDUCATION AT TIME OF ADMISSION OR AS PRACTICAL THEREAFTER: PATIENTS ARE GIVEN A PATIENT HANDBOOK WHICH INCLUDES INFORMATION FOR PATIENTS REGARDING THEIR FINANCIAL RESPONSIBILITY. A PATIENT SERVICE REPRESENTATIVE (PSR) MEETS WITH THE PATIENTS, IF THEY ARE MENTALLY CAPABLE, AND/OR A DESIGNATED FAMILY MEMBER OR GUARDIAN, INDIVIDUALLY, EITHER AT TIME OF ADMISSION OR DURING THE HOSPITALIZATION PRIOR TO DISCHARGE. THE PSR PROVIDES EDUCATION REGARDING INSURANCE COVERAGE AND PERSONAL FINANCIAL RESPONSIBILITIES. THE PATIENT IS INFORMED OF PAYMENT OPTIONS WHICH INCLUDE A FINANCIAL ASSISTANCE APPLICATION. THE PSR PROVIDES ASSISTANCE IN COMPLETING THE APPLICATION AND EXPLAINS WHAT SUPPORTING DOCUMENTATION IS NEEDED FOR CONSIDERATION. POST DISCHARGE: PATIENTS WHO INFORM COLLECTOR THAT THEY CANNOT MEET THEIR FINANCIAL OBLIGATION ARE PROVIDED THE APPLICATION TO COMPLETE WHICH WOULD THEN BE REVIEWED FOR CONSIDERATION. Pt VI Line 4 HMH CARRIER CLINIC SERVES THE ENTIRE STATE OF NEW JERSEY; HOWEVER THE MAIN PATIENT POPULATION IS FROM SUBURBAN AREAS. THE MAIN SOURCE OF ADMISSIONS IN 2018 WAS FROM MIDDLESEX, SOMERSET, OCEAN, MERCER AND MONMOUTH COUNTIES, ALL LOCATED IN NEW JERSEY. OF THESE COUNTIES, AN AVERAGE OF 8.5% OF THE POPULATION FALLS BELOW POVERTY LEVEL, BASED ON 2013 - 2017 CENSUS STATISTICS. Pt VI Line 5 IN ADDITION TO THE COUNTY-SPECIFIC PRESENTATIONS DONE EACH YEAR IN RESPONSE TO SATISFYING THE DELIVERABLES OF OUR IMPLEMENTATION STRATEGY, HMH CARRIER CLINIC OFFERS MULTIPLE PROFESSIONAL AND COMMUNITY EDUCATION PROGRAMS THROUGHOUT THE YEAR THROUGH ITS SPEAKERS' BUREAU, AS WELL AS THROUGH MULTIPLE COMMUNITY PARTNERSHIPS WHERE EXPERT SPEAKERS ARE PROVIDED WITHIN THE BUSINESS COMMUNITY AND MEDICAL COMMUNITY. HMH CARRIER CLINIC HAS A CERTIFIED MENTAL HEALTH FIRST AID TRAINER, AND OFFERS THIS TRAINING TO THE COMMUNITY AT LARGE FOR A SMALL FEE; HOWEVER MOST OF THE COST IS ABSORBED BY HMH CARRIER CLINIC. THIS TRAINING IS OFFERED TO LOCAL FIRST RESPONDERS FREE OF CHARGE AND IS PROVIDED UP TO 3 TIMES PER YEAR. HMH CARRIER CLINIC OFFERS WEEKLY SUPPORT GROUPS, ALCOHOL USE, AND DEPRESSION/ANXIETY SCREENINGS, AND OVER 60 EDUCATIONAL WHITEPAPERS AND VIDEOS ON ITS WEBSITE. ALL OF THESE SUPPORT GROUPS AND EDUCATIONAL MATERIALS AND SEMINARS ARE PROVIDED TO THE PUBLIC AT NO COST. ELECTRONIC AND HARD COPY INFORMATIONAL NEWSLETTERS ARE PROVIDED FREE OF CHARGE THROUGHOUT THE COMMUNITY, EACH NEWSLETTER SHARES INFORMATION AND UPDATES ON TOPICS RELATED TO MENTAL HEALTH AND ADDICTIONS. HMH CARRIER CLINIC HOSTS EVENTS SUCH AS THE WALK OF HOPE AWARENESS DAY, PROVIDING FREE EDUCATIONAL MATERIALS AS WELL AS THE OPPORTUNITY FOR ATTENDEES TO INTERACT WITH OTHER MENTAL HEALTH SERVICE PROVIDERS, FREE OF CHARGE TO OTHER NONPROFIT MENTAL HEALTH SERVICE PROVIDERS AS WELL AS TO THE COMMUNITY. ADDITIONALLY, AN ALUMNI GROUP, WITH MORE THAN 600 MEMBERS, IS INVITED TO BIMONTHLY PROGRAMS AND SOCIAL EVENTS THROUGHOUT THE YEAR, ALSO FREE OF CHARGE. HMH CARRIER CLINIC HAS THREE FIELD REPRESENTATIVES WHO WORK THROUGHOUT THE STATE HELPING THE COMMUNITY TO BETTER UNDERSTAND SERVICES THAT ARE AVAILABLE. X X X X X false true false false false false false false false ANTHONY MARINO MD 238076 0 0 0 73319 0 8200 0 10661 0 330256 0 0 0 UMESH MEHTA MD 308503 0 0 0 258216 0 8200 0 24709 0 599628 0 0 0 DONALD PARKER 349209 0 73902 0 314776 0 58200 0 16651 0 812738 0 250000 0 RANDOLPH JACOBSON 243451 0 15000 0 84298 0 43200 0 23468 0 409417 0 0 0 PATRICIA TOOLE 222519 0 15000 0 78382 0 43200 0 3124 0 362225 0 0 0 SHAUN SWEENEY 165679 0 10000 0 4366 0 8200 0 21423 0 209668 0 0 0 SYED ALI MD 227528 0 10000 0 90788 0 15000 0 32400 0 375716 0 0 0 ABDUL KAZI MD 282124 0 0 0 44750 0 8200 0 32909 0 367983 0 0 0 JOSEPH VERRET MD 254776 0 0 0 61773 0 8200 0 34360 0 359109 0 0 0 ROBERT SAINT-VIL MD 256577 0 0 0 53944 0 8200 0 18470 0 337191 0 0 0 JAGWINDER SANDHU MD 245987 0 0 0 34659 0 8200 0 32540 0 321386 0 0 0 Pt I Line 3 PLEASE REFER TO OUR RESPONSE TO CORE FORM, PART VI, QUESTION 15B INCLUDED IN SCHEDULE O. Pt I Line 4b THE DEFERRED COMPENSATION AMOUNTS REFLECTED IN PART II COLUMN (C) FOR RANDOLPH JACOBSON, PATRICIA TOOLE, AND DONALD PARKER INCLUDE BENEFITS IN AN INTERNAL REVENUE CODESECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN). THESE AMOUNTS ARE SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. THESE INDIVIDUALS WILL NOT EARN THE RIGHT TO RECEIVE THE DEFERRED COMPENSATION AMOUNTS UNLESS AND UNTIL THEY PROVIDE SUBSTANTIAL FUTURE SERVICES TO THE ORGANIZATION. WHEN THE FUTURE SERVICES REQUIREMENT IS MET, THE AMOUNTS WILL BECOME VESTED, WILL BE TAXED, WILL BE INCLUDED ON THE W-2, AND WILL BE REPORTED AGAIN ON THIS SCHEDULE. FOR 2018, REPORTABLE AMOUNTS FOR THE 457(F) PLAN ARE $35,000 FOR RANDOLPH JACOBSON AND PATRICIA TOOLE, RESPECTIVELY, AND $50,000 FOR DONALD PARKER. Pt I Line 4b THE AMOUNT REFLECTED IN PART II COLUMN B(III) FOR DONALD PARKER INCLUDES PARTICIPATION IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") AS THE AMOUNT WAS NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THE AMOUNT OUTLINED HEREIN WAS INCLUDED IN DONALD PARKER'S 2018 FORM W-2 AS TAXABLE WAGES. Pt VI, Line 1a THE EXECUTIVE COMMITTEE OF THE BOARD EXERCISES ALL POWERS AND AUTHORITY OF THE BOARD IN THE MANAGEMENT OF AFFAIRS OF HMH CARRIER CLINIC DURING INTERVALS BETWEEN BOARD MEETINGS. Pt VI, Line 7a SEE RESPONSE FOR PART VI, LINE 1a Pt VI, Line 7b SEE RESPONSE FOR PART VI, LINE 1a Pt VI, Line 11b HMH CARRIER CLINIC BECAME A SUBSIDIARY OF HACKENSACK MERIDIAN HEALTH, INC. ("HMH"), A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY NETWORK, IN 2019. HMH'S FINANCE PERSONNEL, IN CONJUNCTION WITH HMH CARRIER CLINIC, PREPARED AND REVIEWED THE FEDERAL FORM 990, WHICH WAS THEN REVIEWED BY OTHER APPROPRIATE INTERNAL STAFF FOR ACCURACY. HMH'S BOARD OF TRUSTEES DESIGNATED THE AUDIT AND COMPLIANCE COMMITTEE ("ACC") TO REVIEW THE FORM 990 OF HMH'S SUBSIDIARIES. THE FORM 990 WAS PROVIDED TO THE MEMBERS OF THE ACC FOR REVIEW. THE FORM 990 WAS THEN PROVIDED TO EACH VOTING MEMBER OF HMH'S GOVERNING BODY, ITS BOARD OF TRUSTEES, PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. THE HMH BOARD OF TRUSTEES HAS THE FINAL GOVERNING AUTHORITY OVER THE SUBSIDIARIES OF HMH. Pt VI, Line 12c EACH TRUSTEE, OFFICER, AND MEDICAL STAFF MEMBER ANNUALLY COMPLETES A CONFLICT OF INTEREST QUESTIONNAIRE AND SIGNS A STATEMENT WHICH AFFIRMS THAT SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, AND HAS AGREED TO COMPLY WITH THE POLICY. IN DOING SO, EACH TRUSTEE, OFFICER, AND MEDICAL STAFF MEMBER UNDERSTANDS HMH CARRIER CLINIC IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEDMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. DURING THE YEAR, CORPORATE COMPLIANCE IN CONJUNCTION WITH THE GENERAL COUNSEL ALSO MONITORS ON-GOING ACTIVITIES TO ENSURE THAT ANY POTENTIAL CONFLICTS OF INTEREST ARE APPROPRIATELY HANDLED IN COMPLIANCE WITH THE POLICY. Pt VI, Line 15a HMH CARRIER CLINIC UTILIZES THE NEW JERSEY HOSPITAL ASSOCIATION, SULLIVAN AND COTTER, HOSPITAL AND HEALTHCARE COMPENSATION SERVICE, MODERN HEALTHCARE PUBLICATIONS AND OTHER VARIOUS SALARY SURVEYS FOR MARKET COMPARISONS TO DETERMINE COMPENSATION. THE INFORMATION IS THEN PROVIDED TO THE BOARD OF TRUSTEES AND IS REVIEWED BY THE BOARD'S EXECUTIVE COMMITTEE TO ENSURE THE SALARIES ARE WITHIN APPROPRIATE MARKET AND NONPROFIT EXECUTUVE COMPENSATION BASES. THIS COMMITTEE SERVES AS THE COMPENSATION COMMITTEE AND REVIEWS THE REASONABLENESS OF THE SALARY STRUCTURE FOR EXECUTIVES AND KEY TOP INDIVIDUALS WITHIN THE ORGANIZATION. THIS COMMITTEE IS ONLY COMPRISED OF COMMUNITY TRUSTEES, WHICH REVIEWS AND ESTABLISHES THESE SALARIES ANNUALLY IN ACCORDANCE WITH THE REBUTTABLE PRESUMPTION OF REASONABLENESS. Pt VI, Line 15b SEE RESPONSE ABOVE FOR PART VI, LINE 15a Pt VI, Line 19 HMH CARRIER CLINIC PROVIDES DOCUMENTS TO THE PUBLIC UPON REQUEST. THE IRS FORM 990 IS ALSO AVAILABLE VIA THE INTERNET ON THE GUIDESTAR WEBSITE. Other PART VII, SECTION A AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM HMH CARRIER CLINIC. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OF THE ORGANIZATION OR A RELATED ORGANIZATION AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THIS ORGANIZATION'S BOARD OF DIRECTORS. Other Part IX, Line 24e: OTHER EXPENSES REPRESENT OVERHEAD ALLOCATION FOR FACILITY SUPPORT AND CORPORATE COSTS ALLOCATED TO HMH CARRIER CLINIC'S VARIOUS PROGRAMS USING THE ACCEPTED MEDICARE COST REPORT ALLOCATION PRINCIPLES. Pt XI Part XI, Line 9: OTHER CHANGES IN NET ASSETS INCLUDE INVENTORY REVALUATION OF 2,540 AND SCHOLARSHIPS AWARDED OF 750 FOR A TOTAL OF 3,290. Pt XII, Line 2c HMH CARRIER CLINIC BOARD OF TRUSTEES AUDIT COMMITTEE MAINTAINS RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. HMH CARRIER CLINIC BOARD OF TRUSTEES AUDIT COMMITTEE SELECTED KPMG, LLP TO SEPARATELY AUDIT THE ORGANIZATIONS FINANCIAL STATEMENTS FOR THE YEAR ENDED DECEMBER 31, 2018. Form 990, Part III, Line 4d OTHER PROGRAMS OF NOTE TO THE COMMUNITY - RESIDENTIAL SERVICES, WHICH INCLUDE EAST 11243484. 0. 13488942.