2018-05-14T09:15:45-05:00 2017-06-30 EISNERAMPER LLP 111 WOOD AVE SO STE 600 ISELIN NJ 088302700 990 2016-07-01 010553478 EAST MOUNTAIN HOSPITAL INC % MICHAEL VOORHEES EAST PO BOX 1029 BELLE MEAD NJ 085021029 MICHAEL VOORHEES EXECUTIVE DIRECTOR 9082811439 2018-05-15 true MICHAEL SOMER P00094591 7322437000 2016 2022-09-23 18:48:47Z MICHAEL VOORHEES PO BOX 1029 BELLE MEAD NJ 085021029 5466807 false X eastmountainhospital.com X 2003 NJ EAST MOUNTAIN HOSPITAL IS AN INPATIENT PSYCHIATRIC HOSPITAL 9 7 64 0 0 0 0 4631394 4946540 31679 37665 241 825 4663314 4985030 600 600 0 0 2427955 2553911 0 0 0 2157610 2399994 4586165 4954505 77149 30525 1919194 2038807 576254 687726 1342940 1351081 TOGETHER WE WILL PROVIDE A SAFE, STRUCTURED, THERAPEUTIC COMMUNITY TO TREAT ADULTS WHO HAVE BEHAVIORAL AND SUBSTANCE ABUSE PROBLEMS AND RETURN THEM TO THEIR FAMILIES OR THE NEXT LEVEL OF CARE AS SOON AS POSSIBLE. false false 4252833 600 4946540 PSYCHIATRIC HOSPITAL WHICH CARED FOR 499 INPATIENTS AND HAD A TOTAL OF 4,969 PATIENT DAYS. 4252833 true false false false false false false false false false true false false true true true true false false false false false false false false false true true false false true false false false false false false false false false false false false false false false false false true 4 0 true 64 true false false false false false false false false false false X 9 7 false false false false false false false true true false false true true true true true true true true false X X MICHAEL VOORHEES 9082811439 40 EAST MOUNTAIN ROAD BELLE MEAD NJ 085021029 X DAVID BUCH MD MEDICAL DIRECTOR & TRUSTEE 40.0 0.0 X X 0 0 0 MICHAEL VOORHEES EXECUTIVE DIRECTOR & TRUSTEE 40.0 0.0 X X 140891 0 16908 DAVID CENTAFONT TRUSTEE 0.0 0.0 X 0 0 0 ENRICO DEGIRONIMO TRUSTEE 0.0 0.0 X 0 0 0 RANDOLPH JACOBSON TREASURER & TRUSTEE 0.0 0.0 X X 0 0 0 PATRICIA TOOLE CHAIRPERSON 0.0 0.0 X 0 0 0 SUSAN BONFIELD TRUSTEE 0.0 0.0 X 0 0 0 CAROL KOSZTYO SECRETARY & TRUSTEE 0.0 0.0 X X 0 0 0 ASMA NISAR MD MEDICAL DIRECTOR & TRUSTEE 40.0 0.0 X X 247141 0 13833 SHAUN SWEENEY TRUSTEE 0.0 0.0 X 0 0 0 DEBORAH CHARETTE DIRECTOR OF NURSING 40.0 0.0 X 111020 0 14845 499052 0 45586 3 false true false CARRIER CLINIC PO BOX 147 BELLE MEAD NJ 08502 ADMIN/CLINICAL 929335 SODEXO INC PO BOX 905374 CHARLOTTE NC 28290 DIETARY/HOUSEKEEPING 150016 2 0 NET PATIENT REVENUE 624100 4946540 4946540 4946540 19442 19442 0 0 0 0 0 500000 481777 18223 18223 18223 0 0 0 0 0 0 0 0 0 ALL OTHER REVENUE 900099 825 825 825 4985030 4946540 38490 X 0 600 600 0 0 370078 230920 139158 0 1739156 1683787 55369 76100 69082 7018 186788 168989 17799 181789 165859 15930 82626 72230 10396 15725 15725 38819 38819 0 0 0 929335 641576 287759 1018 1018 58609 27810 30799 0 0 239884 236072 3812 6637 6637 0 714 714 0 0 7758 7758 98235 72598 25637 PATIENT RELATED 551007 551007 DIETARY/ENVIRONMENTAL SVS 186540 186540 CONSULTING 22598 22598 BAD DEBTS 8758 8758 151731 129654 22077 4954505 4252833 701672 0 0 0 406313 188510 0 0 498112 386692 0 0 0 0 0 0 0 0 62147 69077 130045 91510 39093 38535 618629 133910 0 0 0 0 0 0 294900 1222083 1919194 2038807 412114 504595 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164140 183131 576254 687726 X 1342940 1351081 0 0 0 0 1342940 1351081 1919194 2038807 30525 -22384 X false true X true false X 112255 73720 38535 17790 17790 38535 3RD PARTY PAYOR SETTLEMENTS 1222083 1222083 0 DUE TO CARRIER CLINIC 101122 ACCRUED PENSION 48200 ACCRUED TAIL INSURANCE 33809 183131 X 4953888 -22384 -22384 4976272 8758 8758 4985030 4945747 4945747 8758 8758 4954505 PART X, QUESTION #2 THE HOSPITAL IS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND, THEREFORE, IS EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(A) OF THE CODE. THERE ARE CERTAIN TRANSACTIONS THAT COULD BE DEEMED UNRELATED BUSINESS INCOME AND WOULD RESULT IN A TAX LIABILITY. MANAGEMENT REVIEWS TRANSACTIONS USING A THRESHOLD OF MORE LIKELY THAN NOT TO ESTIMATE POTENTIAL TAX LIABILITIES. IT IS MANAGEMENT'S ESTIMATION THAT THERE ARE NO MATERIAL TAX LIABILITIES THAT NEED TO BE RECORDED. PART XI, LINE 4B PATIENT BAD DEBTS $8,758 ARE REPORTED AS A REDUCTION OF REVENUE ON THE AUDITED FINANCIAL STATEMENTS. PART XII, LINE 4B PATIENT BAD DEBTS $8,758 ARE REPORTED AS A REDUCTION OF REVENUE ON THE AUDITED FINANCIAL STATEMENTS. true true true X true X 100 true true true false true true 8952 8952 0.00180 8952 8952 0.00180 8952 8952 0.00180 2739 2739 0.00060 2739 2739 0.00060 true 5226 354122 380486 -26364 X true false 1 1 EAST MOUNTAIN HOSPITAL INC PO BOX 1029 BELLE MEAD NJ 085021029 www.eastmountainhospital.com 22970 X EAST MOUNTAIN HOSPITAL INC 1 false false true X X X X X X X X X 16 true true false true X www.eastmountainhospital.com X true 16 true www.eastmountainhospital.com false true X 100 100 X true true X X X true X www.eastmountainhospital.com X www.eastmountainhospital.com X X X true false true X false false PART V, SECTION B, LINE 5 WHILE CONDUCTING EMH'S MOST RECENT CHNA, A REPRESENTATIVE OF EMH INTERVIEWED MENTAL HEALTH ADMINISTRATORS FROM MIDDLESEX AND SOMERSET COUNTIES TO DISCUSS SERVICE GAPS IN THE COMMUNITY. THESE COUNTIES REPRESENT APPROXIMAELY 40% OF EMH ADMISSIONS. PART V, SECTION B, LINE 6A IN AN EFFORT TO BE COST-EFFECTIVE, EMH CONDUCTED ITS CHNA IN CONJUNCTION WITH CARRIER CLINIC. EMH IS A HOSPITAL-WITHIN-A-HOSPITAL ON THE CARRIER CLINIC CAMPUS AND THEIR COMMUNITIES ARE SIMILAR. EMH ALSO COLLABORATED WITH SOMERSET MEDICAL CENTER FOR SOMERSET COUNTY'S DATA COLLECTION. THE CHNA WAS FIRST CONDUCTED IN 2013 AND THEN AGAIN IN 2016. PART V, SECTION B, LINE 11 IN EMH'S IMPLEMENTATION STRATEGY OF THE CHNA THAT WAS CONDUCTED, APPROVED BY ITS BOARD AND PUBLISHED IN 2016, EMH IDENTIFIED CERTAIN COMMUNITY NEEDS INCLUDING PUBLIC EDUCATION AND ACCESS TO MENTAL HEALTH CARE. EMH ADOPTED A TIMELINE AND STATEGIES TO ADDRESS THESE NEEDS OVER A THREE-YEAR TIME PERIOD. THE GOALS AND OBJECTIVES SET TO BE COMPLETED BY JUNE 30, 2017 HAVE BEEN MET. THE CHNA PROCESS IDENTIFIED OTHER COMMUNITY NEEDS THAT WERE NOT INCLUDED IN THE IMPLEMETATION STRATEGY DUE TO LIMITATIONS IN EXPERTISE AND RESOURCES. THE BOARD APPROVED THE CHNA AND IMPLEMENTATON STRATEGY IN JUNE 2016, WHICH IS IN EFFECT FOR THE PERIOD OF JULY 2016 THROUGH JUNE 2019. PART I, LINE 7, COLUMN F BAD DEBT EXPENSE FOR THE YEAR ENDED JUNE 30, 2017 IS $8,758 AND IS EXCLUDED FROM TOTAL EXPENSES FOR CALCULATING THE PERCENTAGE OF TOTAL EXPENSE. PART I, LINE 7 THE COST-TO-CHARGE RATIO USED FOR PART I, LINE 7 IS BASED ON WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. PART III, LINE 4 REFER TO AUDITED FINANCIAL STATEMENTS, PAGE 7, FOR THE FOOTNOTE REGARDING BAD DEBT EXPENSE. PART VI, SUPPLEMENTAL INFORMATION #2 NEEDS ASSESSMENT: AS PART OF EAST MOUNTAIN HOSPITALS'S (EMH) STRATEGIC PLANNING PROCESS, THE HOSPITAL GATHERS AND INCORPORATES NATIONAL, STATE, AND CLINICAL INDUSTRY DATA IN THE DEVELOPMENT OF CLINICAL SERVICES AND EDUCATIONAL FORUMS. EMH IS A PARTICIPATORY MEMBER OF THE NEW JERSEY ASSOCIATION OF MENTAL HEALTH. THIS ORGANIZATION ALSO PROVIDES BEHAVIORAL HEALTH AND ADDICTION INFORMATION RELEVANT TO THE COMMUNITY'S NEEDS. EMH RECEIVES MANY TELEPHONE CALLS FROM THE GENERAL PUBLIC ON A REGULAR BASIS, 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. IT IS THROUGH THIS CONTACT WITH THE COMMUNITY THAT ENABLES EMH TO UNDERSTAND WHAT SERVICES ARE NEEDED THROUGHOUT THE GEOGRAPHIC AREA. PART VI, SUPPLEMENTAL INFORMATION #3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: UNDER A SERVICE AGREEMENT WITH CARRIER CLINIC, A PATIENT SERVICE REPRESENTATIVE MEETS WITH EACH EMH PATIENT, IF THEY ARE MENTALLY CAPABLE, AND/OR A DESIGNATED FAMILY MEMBER OR GUARDIAN INDIVIDUALLY AND ADVISES THEM THAT THEY CAN APPLY FOR CHARITY CARE FOR THEIR SELF PAY BALANCES IF THEY HAVE LIMITED INCOME. THE PATIENT SERVICE REPRESENTATIVE PROVIDES CHARITY CARE APPLICATIONS TO THE PATIENT ACCORDINGLY. PART VI, SUPPLEMENTAL INFORMATION #4 COMMUNITY INFORMATION: EMH SERVES THE ENTIRE STATE OF NEW JERSEY; HOWEVER, THE MAIN PATIENT POPULATION IS FROM SUBURBAN AREAS. THE MAIN SOURCE OF ADMISSIONS IN 2016/2017 WAS FROM MIDDLESEX AND SOMERSET COUNTIES, BOTH LOCATED IN NEW JERSEY. OF THESE COUNTIES, AN AVERAGE OF 8.9% OF THE POPULATION FALLS BELOW POVERTY LEVEL. PART VI, SUPPLEMENTAL INFORMATION #5 PROMOTION OF COMMUNITY HEALTH: EMH ALSO PROVIDES EDUCATIONAL MATERIALS REGARDING MENTAL HEALTH TO THE COMMUNITY AT NO COST ON ITS WEBSITE. EDUCATIONAL WHITEPAPERS, NATIONAL INSTITUTE OF MENTAL HEALTH FACT SHEETS AND SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION FACT SHEETS ARE AVAILABLE IN BOTH ENGLISH AND SPANISH. EDUCATIONAL MENTAL HEALTH VIDEOS AND RESOURCES BY COUNTY ARE ALSO AVAILABLE ON THE WEBSITE. PART III, LINE 8 THE COST-TO-CHARGE RATIO IS USED FOR PART III, LINE 6. THIS IS THE RATIO OF PATIENT CARE COSTS APPLIED TO CHARGES. THE AMOUNTS REPORTED ON LINES 5, 6 AND 7 ARE TAKEN FROM EAST MOUNTAIN HOSPITALS FILED 2016/2017 MEDICARE COST REPORT PURSUANT TO THE SCHEDULE H INSTRUCTIONS. THESE AMOUNTS DO NOT INCLUDE INCURRED LOSSES FROM PHYSICIAN SERVICES TOTALING OVER $16,000 AS FOLLOWS: PHYSICIAN COST (SALARIES, FRINGES, MALPRACTICE INSURANCE) $38,188 REIMBURSEMENT RECEIVED FROM MEDICARE $21,605, UNREIMBURSED COST $16,583. THE HOSPITAL BELIEVES THAT ALL OF THE MEDICARE SHORTFALL 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 8% 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 AND THE INPATIENT SHORTFALL IN 2016/2017 OF $26,364 SHOULD BE COUNTED AS COMMUNITY BENEFIT. 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. PART III, LINE 2 BAD DEBT EXPENSE FOR THE YEAR ENDED JUNE 30, 2017 IS $8,758, WHICH IS BASED ON CHARGES. THE RATIO OF PATIENT CARE COSTS TO CHARGES IS 59.67% WHICH IS APPLIED TO THE BAD DEBT AMOUNT FOR AN ESTIMATED COST OF $5,226. THIS EXPENSE IS REPORTED ON PART III, LINE 2. PART VI, SUPPLEMENTAL INFORMATION #7 STATE FILING OF COMMUNITY BENEFIT REPORT: NOT APPLICABLE PART II, COMMUNITY BUILDING EMH IS A MEMBER OF SOMERSET COUNTY'S "ADOPT-A-ROAD" PROGRAM WHICH SUPPORTS THE COMMUNITY'S ONGOING EFFORT TO KEEP ITS ROADS MORE ATTRACTIVE AND SAFE. THE PROGRAM ALLOWS ORGANIZATIONS AND INDIVIDUALS TO HELP JOIN THE COUNTY IN PRODUCING SAFE, ATTRACTIVE, LITTER-FREE ROADWAYS WITHIN THEIR COMMUNITIES. SAFER ROADWAYS CREATE FEWER ACCIDENTS WHICH PROMOTES THE HEALTH AND SAFETY OF OUR COMMUNITY. THE PROGRAM ALSO LOWERS THE COST OF LITTER REMOVAL BY THE COUNTY AND IS BENEFICIAL FOR EVERYONE. EMH STAFF IS RESPONSIBLE FOR A TWO MILE STRETCH OF ROAD AND SPENT APPROXIMATELY THIRTY-SIX HOURS DURING THE YEAR COLLECTING TRASH. X X X false false false false false false false false false MICHAEL VOORHEES EXECUTIVE DIRECTOR & TRUSTEE 131791 9100 5700 11208 157799 ASMA NISAR MD MEDICAL DIRECTOR & TRUSTEE 247141 12900 933 260974 SCHEDULE J, PART II MICHAEL VOORHEES' OTHER REPORTABLE COMPENSATION (iii) OF $9,100 REPRESENTS PENSION CONTRIBUTION THAT FAILED DISCRIMINATION TESTING, RETIREMENT (c) $5,700 REPRESENTS EAST MOUNTAIN HOSPITAL'S CONTRIBUTION INTO THE TARGET BENEFIT PLAN, AN ERISA PLAN, AND NONTAXABLE BENEFITS (d) $11,208 REPRESENTS HOSPITALIZATION, MEDICAL, DENTAL AND PRESCRIPTION PLAN COVERAGE AS WELL AS LIFE INSURANCE AND LONG-TERM DISABILITY INSURANCE PAID BY EAST MOUNTAIN HOSPITAL. DR. ASMA NISAR'S RETIREMENT(C) $12,900 REPRESENTS EAST MOUNTAIN HOSPITAL'S CONTRIBUTION INTO THE TARGET BENEFIT PLAN, AN ERISA PLAN, AND NONTAXABLE BENEFITS (d) $933 REPRESENTS LIFE INSURANCE AND LONG-TERM DISABILITY INSURANCE PAID BY EAST MOUNTAIN HOSPITAL. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PREPARED BY INTERNAL FINANCIAL STAFF, IS REVIEWED BY AN OUTSIDE CPA CONSULTING FIRM AND IS THEN REVIEWED BY THE BOARD OF TRUSTEES IN ADVANCE OF THE FILING WITH THE IRS. THIS REVIEW IS DOCUMENTED IN THE BOARD OF TRUSTEE MINUTES. FORM 990, PART VI, SECTION B, LINE 12C EACH TRUSTEE AND OFFICER ANNUALLY SIGNS A STATEMENT WHICH AFFIRMS THAT SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY AND UNDERSTANDS EAST MOUNTAIN HOSPITAL IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ITS TAX-EXEMPT PURPOSE. FORM 990, PART VI, SECTION B, LINE 15 EAST MOUNTAIN HOSPITAL 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. THE INFORMATION IS THEN PROVIDED TO THE BOARD OF TRUSTEES TO ENSURE THE SALARIES ARE WITHIN APPROPRIATE MARKET AND NONPROFIT EXECUTIVE COMPENSATION BASES. THE BOARD REVIEWS THE REASONABLENESS OF THE SALARY STRUCTURE FOR OFFICERS WITHIN THE ORGANIZATION AND ALSO REVIEWS AND ESTABLISHES THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR THESE SALARIES ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 EAST MOUNTAIN HOSPITAL PROVIDES DOCUMENTS TO THE PUBLIC UPON REQUEST. THE IRS FORM 990 IS ALSO ACCESSIBLE FROM GUIDESTAR ON THE INTERNET. FORM 990, PART VII, SECTION B, INDEPENDENT CONTRACTORS EAST MOUNTAIN HOSPITAL PURCHASED ADMINISTRATIVE AND CLINICAL SUPPORT SERVICES AT COST FROM CARRIER CLINIC AS PER THE DULY EXECUTED SERVICE AGREEMENT BETWEEN THE TWO ENTITIES. FOR THE FISCAL YEAR ENDED JUNE 30, 2017, THE TOTAL COST OF THESE SERVICES AMOUNTED TO $929,335: $641,576 FOR CLINICAL SERVICES AND $287,759 FOR VARIOUS BUSINESS SUPPORT FUNCTIONS SUCH AS FINANCIAL REPORTING, BILLING, INFORMATION TECHNOLOGY, HUMAN RESOURCES, AND OTHER BUSINESS FUNCTIONS. FORM 990, PART VII, SECTION A, OFFICERS DR. NISAR IS NO LONGER EMPLOYED AS A MEDICAL DIRECTOR AS OF JANUARY 2, 2017. HER ROLE AS TRUSTEE ALSO ENDED ON THIS DATE, PER THE BY-LAWS. DR. BUCH IS THE NEW MEDICAL DIRECTOR EFFECTIVE JANUARY 15, 2017. HIS SALARY WILL BE REPORTED IN THE 2017 W-2 AND ACCORDINGLY WILL BE REPORTED IN THE 2017/2018 990 ON PART VII & SCHEDULE J. HE IS A TRUSTEE AS OF JUNE 30, 2017, PER THE BY-LAWS. FORM 990, PART IX, LINE 11G OTHER FEES FOR SERVICE OTHER FEES FOR SERVICE INCLUDE $929,335 FOR ADMINISTRATION AND CLINICAL SUPPORT SERVICES PURCHASED AT COST FROM CARRIER CLINIC. FORM 990 PART IX LINE 11G DESCRIPTION:OTHER TOTAL FEES:929335