2018-11-15T18:38:02-06:00 2017-12-31 271728945 PKF O'CONNOR DAVIES LLP 300 TICE BOULEVARD SUITE 315 WOODCLIFF LAKE NJ 07677 990 2017-01-01 222922016 VALLEY HEALTH SYSTEM INC VALL 2012916200 223 NORTH VAN DIEN AVE RIDGEWOOD NJ 07450 AUDREY MEYERS PRESIDENT 2012916200 2018-11-15 1 EDWARD G O'CONNOR P00434443 2017129800 2018-11-15 47.19.39.42 2018-11-15 18:33:11 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 CA72600D86868BB63E6792AE27374A61CFC4C663 2017 2019-02-21 02:37:17Z AUDREY MEYERS 223 NORTH VAN DIEN AVE RIDGEWOOD NJ 07450 65208765 0 X WWW.VALLEYHEALTH.COM X 1988 NJ MANAGEMENT AND PLANNING SERVICES FOR ITS MEMBERS. 11 10 0 9 0 0 0 0 2840659 65204368 66 1036 0 3361 2840725 65208765 0 0 0 0 0 0 0 0 0 2840725 65153284 2840725 65153284 0 55481 1179736 11282105 125000 10524347 1054736 757758 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 65204368 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 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 0 0 0 NJ X LAURIE DEBENEDETTO 2012916200 223 NORTH VAN DIEN AVE RIDGEWOOD NJ 07450 AUDREY MEYERS PRESIDENT & CEO 40.00 1.50 X X 3479003 0 47458 JOHN KANDRAVY ESQ CHAIRMAN 0.50 1.00 X X 0 0 0 VINCENT FORLENZA VICE CHAIRMAN 0.50 X X 0 0 0 JOSEPH MARION SECRETARY & TREASURER 0.50 2.50 X X 0 0 0 GANEPOLA GANEPOLA MD TRUSTEE 0.50 X 0 0 0 BARNETT BUZZ RUKIN TRUSTEE 0.50 X 0 0 0 WARREN F COOKE ESQ TRUSTEE 0.50 1.00 X 0 0 0 ROBERT E FINK TRUSTEE 0.50 1.00 X 0 0 0 JOHN W ALBOHM ESQ EX-OFFICIO 0.50 3.00 X 0 0 0 FRANK J SHEEHY EX-OFFICIO 0.50 3.00 X 0 0 0 RICHARD KEENAN SR VP FINANCE & CFO 40.00 X 10481351 0 46480 MARIA MEDIAGO VP, FACILITIES MANAGEMENT 40.00 X 585889 0 47238 ERIC CAREY VP/CIO, INFORMATION SYSTEMS 40.00 X 508573 0 53464 ROBIN G HOLLANDER SER VP, LEGAL SERVICES 40.00 X 733358 0 58350 GAIL CALLANDRILLO VP, PLANNING /GOVT RELATIONS 40.00 X 547108 0 53769 ROBERT W BRENNER SR VP/CHIEF PHYSICIAN 40.00 X 1155941 0 31663 PETER W DIESTEL SR VP. ADMINISTRATION/COO 40.00 X 836517 0 55056 JOSE BALDERRAMA VP, HUMAN RESOURCES 40.00 X 449033 0 35127 MEGAN FRASER VP, COMMUNICATIONS/MARKETING 40.00 X 403076 0 27597 TONI P MODAK DIRECTOR, POPULATION HEALTH 40.00 X 194092 0 43703 CLYDE E WESP JR DIRECTOR, CHIEF MEDICAL INFORMATION OFFICER 40.00 X 399409 0 38776 EPHRAIM S CASPER CHIEF MEDICAL OFFICER 40.00 X 848731 0 46052 NISHA SIKDER VICE PRESIDENT, PAYER STRATEGIES 40.00 X 224327 0 24729 MICHAEL P BURKE ASST VP, INFORMATION SYSTEMS 40.00 X 226769 0 32634 21073177 0 642096 15 0 1 0 0 AFFILIATE COST ALLOCATION 900099 65204368 65204368 65204368 1036 1036 OTHER REVENUE 900099 3361 3361 3361 65208765 65204368 0 4397 X 2518086 2518086 12300 12300 10104292 10104292 6371787 6371787 511275 511275 811368 811368 320401 320401 ALLOCATED SALARIES AND 36620117 36620117 LICENSES & ASSESMENTS 3634013 3634013 ALLOCATED OTHER EXPENSE 2418006 2418006 REGIONAL ACO PROGRAMS 981666 981666 849973 849973 65153284 0 65153284 0 125000 629368 597484 598521 133588 6321515 455772 103313 1480 3495800 1179736 11282105 125000 10524347 125000 10524347 X 1054736 757758 1054736 757758 1179736 11282105 X 55481 -352459 X X 0 1 X 1 0 X 2192576 2589477 2631293 2840659 65204368 75458373 2192576 2589477 2631293 2840659 65204368 75458373 0 0 0 75458373 120 120 83 66 1036 1425 120 120 83 66 1036 1425 2192696 2589597 2631376 2840725 65205404 75459798 1.00000 0.99990 0.00000 0.00010 X 0 DUE FROM VALLEY HOSPITAL 3495800 3495800 X 65208765 0 65208765 0 65208765 65503284 350000 350000 65153284 0 65153284 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, 2013. PART XII, LINE 2D - OTHER ADJUSTMENTS: TRANSFER TO HOSPITAL 350,000. 0 0 0 0 0 0 0 0 0 AUDREY MEYERS PRESIDENT & CEO 1020380 0 481941 0 1976682 0 25650 0 21808 0 3526461 0 949749 0 RICHARD KEENAN SR VP FINANCE & CFO 746339 0 313122 0 9421890 0 24640 0 21840 0 10527831 0 5436158 0 MARIA MEDIAGO VP, FACILITIES MANAGEMENT 309021 0 96641 0 180227 0 25650 0 21588 0 633127 0 0 0 ERIC CAREY VP/CIO, INFORMATION SYSTEMS 345578 0 106463 0 56532 0 20426 0 33038 0 562037 0 0 0 ROBIN G HOLLANDER SER VP, LEGAL SERVICES 505497 0 210650 0 17211 0 25458 0 32892 0 791708 0 0 0 GAIL CALLANDRILLO VP, PLANNING /GOVT RELATIONS 325813 0 98198 0 123097 0 25650 0 28119 0 600877 0 0 0 ROBERT W BRENNER SR VP/CHIEF PHYSICIAN 735770 0 272860 0 147311 0 20280 0 11383 0 1187604 0 0 0 PETER W DIESTEL SR VP. ADMINISTRATION/COO 590877 0 224360 0 21280 0 25650 0 29406 0 891573 0 0 0 JOSE BALDERRAMA VP, HUMAN RESOURCES 315269 0 91294 0 42470 0 17550 0 17577 0 484160 0 0 0 MEGAN FRASER VP, COMMUNICATIONS/MARKETING 272157 0 81482 0 49437 0 17084 0 10513 0 430673 0 0 0 TONI P MODAK DIRECTOR, POPULATION HEALTH 165447 0 27750 0 895 0 15348 0 28355 0 237795 0 0 0 CLYDE E WESP JR DIRECTOR, CHIEF MEDICAL INFORMATION 343060 0 46243 0 10106 0 15330 0 23446 0 438185 0 0 0 EPHRAIM S CASPER CHIEF MEDICAL OFFICER 749369 0 77264 0 22098 0 13500 0 32552 0 894783 0 0 0 NISHA SIKDER VICE PRESIDENT, PAYER STRATEGIES 176445 0 20000 0 27882 0 0 0 24729 0 249056 0 0 0 MICHAEL P BURKE ASST VP, INFORMATION SYSTEMS 193720 0 31561 0 1488 0 17081 0 15553 0 259403 0 0 0 PART I, LINE 3 AUDREY MEYERS, PRESIDENT, IS COMPENSATED BY THE VALLEY SYSTEM. VALLEY HOSPITAL AND THE SYSTEM SETS UP THE FOLLOWING PROCEDURES TO ESTABLISH COMPENSATION FOR OF THE PRESIDENT. THE HOSPITAL AND SYSTEM HAS ESTABLISHED A POLICY FOR COMPENSATION OF ITS OFFICERS, TOP MANAGEMENT AND KEY EMPLOYEES. THE POLICY MANDATES THAT COMPENSATION FOR ITS OFFICERS, TOP MANAGEMENT AND KEY EMPLOYEES BE PERIODICALLY 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 2017. DURING 2017 AURDEY MEYERS AND RICHARD KEENAN WITHDREW FUNDS FROM THE DEFERRED COMPENSATION PLAN (DC PLAN)ESTABLISHED BY THE VALLEY HOSPITAL. THE DC PLAN ALLOWS EACH EMPLOYEE IN THE PLAN TO DEFER THEIR COMPENSATION ON AN ANNUAL BASIS UP TO CERTAIN LIMITS. THE DC PLAN IS NOT FUNDED WITH FUNDS FROM THE VALLEY HOSPITAL. THE AMOUNTS WITHDRAWN IN 2017 BY AUDREY MEYERS AND RICHARD KEENAN FROM THE DC PLAN REPRESENTS THE ACCUMULATION OF MANY YEARS OF DEFERRALS OF EACH EMPLOYEE'S DEFERRAL INTO THE DC PLAN. ALL COMPENSATION REPORTED IN THE 2017 SCHEDULE J COLUMN F WERE REPORTED AS DEFERRED COMPENSATION ON THE PROIR YEARS FORM 990 AS REQUIRED BY THE INSTRUCTIONS TO THE FORM 990 FORM 990, PART VI, SECTION B, LINE 11B VALLEY HEALTH SYSTEM'S FORM 990 WAS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY'S FINANCE COMMITTEE. WHEN THE 990 HAS BEEN PREPARED, REVIEWED BY MANAGEMENT AND IS READY TO BE FILED WITH THE INTERNAL REVENUE SERVICE, IT'S SUBMITTED TO MEMBERS OF THE ORGANIZATION'S GOVERNING BODY'S FINANCE COMMITTE FOR ANY COMMENTS. THE FINANCE COMMITTEE REVIEWS THE 990 AND PROVIDES ANY COMMENTS. THE COMMENTS ARE REVIEWED AND ADDRESSED UNTIL THE RETURN IS FINALIZED AND APPROVED FOR FILING. FORM 990, PART VI, SECTION B, LINE 12C 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 C, LINE 19 VALLEY HEALTH SYSTEM, INC. MAKES ITS FORM 990, FINANCIAL STATEMENTS, FORM 1023, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICY AVAILABLE UPON WRITTEN REQUEST AT 223 NORTH VAN DIEN AVE, RIDGEWOOD, NJ 07450 OR BY CALLING THE ORGANIZATION DIRECTLY AT 201-291-6200. FORM 990, PART IX, LINE 11G OUTSIDE SERVICE FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 399,238. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 399,238. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 6,927,464. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,927,464. TEMPORARY HELP: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 564,244. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 564,244. CONSULTING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 2,213,346. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,213,346. FORM 990, PART XI, LINE 9: EQUITY IN NET INCOME (LOSS) OF UNCONSOLIDATED SUBSIDIARY -2,459. TRANSFER TO HOSPITAL -350,000. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATREMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS DID NOT CHANGE FROM THE PRIOR YEAR. 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 THE VALLEY HOSPITAL FOUNDATION INC 223 N VAN DIEN AVE RIDGEWOOD NJ 07450 222324554 SOLICIT, RECEIVE AND APPLY CONTRIBUTIONS FOR THE BENEFIT OF THE HOSPITAL NJ 501(C)(3) LINE 7 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 11 VALLEY HEALTH SYSTEM INC 1 VALLEY MEDICAL SERVICES INC 223 N VAN DIEN AVE RIDGEWOOD NJ 07450 223260998 PROVIDE THE VALLEY HOSPITAL WITH EMPLOYED PHYSICIANS AND CONSULTING SERVICES NJ 501(C)(3) LINE 11 THE VALLEY HOSPITAL INC 0 VALLEY PHYSICIAN SERVICES INC 15 ESSEX ROAD PARAMUS NJ 07652 320041186 PROVIDE MEDICAL CARE AND CARRY OUT THE PURPOSES OF THE VALLEY HOSPITAL NJ 501(C)(3) LINE 11 THE VALLEY HOSPITAL INC 0 VALLEY HEALTH MEDICAL GROUP OF NJ PC 15 ESSEX ROAD PARAMUS NJ 07652 223475166 OPERATES URGENT/PRIMARY CARE CLINICS NJ N/A C -2161 14867 0 VALLEY HEALTH MEDICAL GROUP 15 ESSEX ROAD PARAMUS NJ 07652 223475233 OPERATES URGENT/PRIMARY CARE CLINICS NJ VALLEY HEALTH SYSTEM INC C -2886 116371 1.00000 1 VALLEY PHYSICIAN SERVICE NY PC 15 ESSEX ROAD PARAMUS NJ 07652 453125678 OPERATES URGENT/PRIMARY CARE CLINICS NY N/A C 0 VHS INSURANCE COMPANY LTD 010 MAIN STREET CAYMAN ISLANDS CJ 980408200 PROVIDES PROFESSIONAL, MEDICAL AND COMMERCIAL GENERAL LIABILITY INSURANCE CJ THE VALLEY HOSPITAL INC C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 THE VALLEY HOSPITAL INC Q COST VALLEY HOME CARE INC Q COST THE VALLEY HOSPITAL INC S COST THE VALLEY HOSPITAL INC O COST