2017-05-15T11:33:05-05:00 2016-06-30 EISNERAMPER LLP 111 WOOD AVE SO STE 600 ISELIN NJ 088302700 990 2015-07-01 010553478 EAST MOUNTAIN HOSPITAL INC % MICHAEL VOORHEES EAST PO BOX 1029 BELLE MEAD NJ 085021029 MICHAEL VOORHEES EXECUTIVE DIRECTOR 9082811439 2017-05-15 true RICHARD SACKIN P00184276 7322437000 2015 2021-01-29 14:40:06Z MICHAEL VOORHEES PO BOX 1029 BELLE MEAD NJ 085021029 4663314 false X eastmountainhospital.com X 2003 NJ EAST MOUNTAIN HOSPITAL IS AN INPATIENT PSYCHIATRIC HOSPITAL 8 6 62 0 0 400 0 4550736 4631394 26844 31679 338 241 4578318 4663314 500 600 0 0 2382509 2427955 0 0 0 2139228 2157610 4522237 4586165 56081 77149 2157398 1919194 913778 576254 1243620 1342940 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 3991898 600 4631394 PSYCHIATRIC HOSPITAL WHICH CARED FOR 501 INPATIENTS AND HAD A TOTAL OF 5,622 PATIENT DAYS. 3991898 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 3 0 true 62 true false false false false false false false false false false X 8 6 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 MICHAEL VOORHEES EXECUTIVE DIRECTOR & TRUSTEE 40.0 0.0 X X 134902 0 17582 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 TARA MCKINNEY MD MEDICAL DIRECTOR & TRUSTEE 40.0 0.0 X X 130333 0 153 ASMA NISAR MD MEDICAL DIRECTOR & TRUSTEE 40.0 0.0 X X 86295 0 11148 DEBORAH CHARETTE DIRECTOR OF NURSING 40.0 0.0 X 102451 0 13035 453981 0 41918 3 false true false CARRIER CLINIC PO BOX 147 BELLE MEAD NJ 08502 ADMIN/CLINICAL 893895 SODEXO INC PO BOX 905374 CHARLOTTE NC 28290 DIETARY/HOUSEKEEPING 140653 2 0 NET PATIENT REVENUE 624100 4613557 4613557 RECOVERY FROM MEDICARE 624100 17837 17837 4631394 31679 31679 0 0 0 0 0 0 0 0 0 MISCELLANEOUS REVENUE 900099 241 241 241 4663314 4631394 31920 X 0 600 600 0 0 342547 212078 130469 0 1698815 1690154 8661 43579 40609 2970 156298 143614 12684 186716 175470 11246 71718 61601 10117 3151 3151 37404 37404 0 0 0 893895 614375 279520 843 843 54591 27428 27163 3418 3418 0 238276 234488 3788 3104 3104 0 2685 2685 0 0 7038 7038 115164 90013 25151 PATIENT RELATED 480649 480649 DIETARY/ENVIRONMENTAL SVS 195065 195065 CONSULTING 9390 9390 BAD DEBTS 1821 1821 39398 18144 21254 4586165 3991898 594267 0 0 0 651757 406313 0 0 636865 498112 0 0 0 0 0 0 0 0 57300 62147 122845 83752 46131 39093 564793 618629 0 0 0 0 0 0 200552 294900 2157398 1919194 469773 412114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 444005 164140 913778 576254 X 1243620 1342940 0 0 0 0 1243620 1342940 2157398 1919194 77149 22171 X false true X true false X 105055 65962 39093 17790 17790 0 39093 3RD PARTY PAYOR SETTLEMENTS 294900 294900 0 DUE TO CARRIER CLINIC 103831 ACCRUED PENSION 26500 ACCRUED TAIL INSURANCE 33809 164140 X 4683664 22171 22171 4661493 1821 1821 4663314 4584344 4584344 1821 1821 4586165 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 DEBT EXPENSE $1,821 REPORTED AS REVENUE REDUCTION ON AUDITED FINANCIAL STATEMENTS. PART XII, LINE 4B PATIENT BAD DEBT EXPENSE $1,821 REPORTED AS REVENUE REDUCTION ON AUDITED FINANCIAL STATEMENTS. true true X true X true X 100 true true true false true true 2454 2454 0.00050 2454 2454 0.00050 2454 2454 0.00050 2625 2625 0.00060 2625 2625 0.00060 true 907 374247 360545 13702 X true false 1 1 EAST MOUNTAIN HOSPITAL INC PO BOX 1029 BELLE MEAD NJ 085021029 X EAST MOUNTAIN HOSPITAL INC 1 false false true X X X X X X X X 16 true true false true X WWW.EASTMOUNTAINHOSPITAL.COM X true 13 true WWW.EASTMOUNTAINHOSPITAL.COM false true X 100 100 X true true X true X WWW.EASTMOUNTAINHOSPITAL.COM X WWW.EASTMOUNTAINHOSPITAL.COM X X X true false true X X false false PART V, SECTION B, LINE 5 WHILE CONDUCTING EMH'S CHNA, A REPRESENTATIVE OF EMH INTERVIEWED MENTAL HEALTH ADMINISTRATORS FROM MIDDLESEX, SOMERSET, CAPE MAY, CAMDEN AND MERCER COUNTIES TO DISCUSS SERVICE GAPS IN THE COMMUNITY. THESE COUNTIES REPRESENT APPROXIMATELY 75% OF EMH ADMISSIONS. PART V, SECTION B, LINE 6A IN AN EFFORT TO BE COST-EFECTIVE, 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. PART V, SECTION B, LINE 11 IN EMH'S IMPLEMENTATION STRATEGY OF THE CHNA THAT WAS CONDUCTED, APRROVED BY ITS BOARD AND PUBLISHED IN 2013, EMH IDENTIFIED CERTAIN COMMUNITY NEEDS INCLUDING PUBLIC EDUCATION AND ACCESS TO MENTAL HEALTH CARE. EMH ADOPTED A TIMELINE AND STRATEGIES TO ADDRESS THESE NEEDS OVER A THREE-YEAR PERIOD. THE GOALS AND OBJECTIVES SET TO BE COMPLETED BY JUNE 30, 2016 HAVE BEEN MET. THE CHNA PROCESS IDENTIFIED OTHER COMMUNITY NEEDS THAT WERE NOT INCLUDED IN THE IMPLEMENTATION STRATEGY DUE TO LIMITATIONS IN EXPERTISE AND RESOURCES. THE BOARD ADOPTED THE NEW CHNA AND IMPLEMENTATION STRATEGY IN JUNE 2016, WHICH IS IN EFFECT FOR THE PERIOD OF JULY 2016 THROUGH JUNE 2019. PART V, SECTION B, LINE 22D PATIENTS WHO ARE RESIDENTS OF NEW JERSEY AND DO NOT HAVE INSURANCE ARE BILLED PURSUANT TO NEW JERSEY STATE BILLING REGULATIONS. ALL PATIENTS REGARDLESS OF RESIDENCY ARE ABLE TO APPLY FOR FINANCIAL ASSISTANCE. PART I, LINE 7, COLUMN F BAD DEBT EXPENSE FOR THE YEAR ENDED JUNE 30, 2016 IS $1,821 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 2015/2016 WAS FROM MIDDLESEX, SOMERSET, MERCER, CAMDEN, BURLINGTON, OCEAN, AND CAPE MAY COUNTIES, ALL LOCATED IN NEW JERSEY. OF THESE COUNTIES, AN AVERAGE OF 9.63% OF THE POPULATION FALLS BELOW POVERTY LEVEL. PART VI, SUPPLEMENTAL INFORMATION #5 COMMUNITY BUILDING ACTIVITIES: 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. EMH STAFF IS RESPONSIBLE FOR A TWO MILE STRETCH OF ROAD AND SPENT APPROXIMATELY THIRTY-SIX HOURS DURING THE YEAR COLLECTING TRASH. EMH ALSO PROVIDES EDUCTIONAL 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 & 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 6 THE COST-TO-CHARGE RATIO IS USED FOR PART III, LINE 6. THIS IS THE RATIO OF PATIENT CARE COSTS APPLIED TO CHARGES. PART III, LINE 2 BAD DEBT EXPENSE FOR THE YEAR ENDED JUNE 30, 2016 IS $1,821, WHICH IS BASED ON CHARGES. THE RATIO OF PATIENT CARE COSTS TO CHARGES IS 49.8% WHICH IS APPLIED TO THE BAD DEBT AMOUNT FOR AN ESTIMATED COST OF $907. THIS EXPENSE IS REPORTED ON PART III, LINE 2. PART VI, SUPPLEMENTAL INFORMATION #7 STATE FILING OF COMMUNITY BENEFIT REPORT: NOT APPLICABLE X X X false false false false false false false false false MICHAEL VOORHEES EXECUTIVE DIRECTOR & TRUSTEE 128402 0 0 0 6500 0 4400 0 13182 0 152484 0 0 SCHEDULE J, PART II MICHAEL VOORHEES' OTHER REPORTABLE COMPENSATION (iii) OF $6,500 REPRESENTS PENSION CONTRIBUTION THAT FAILED DISCRIMINATION TESTING, RETIREMENT (c) $4,400 REPRESENTS EAST MOUNTAIN HOSPITAL'S CONTRIBUTION INTO THE TARGET BENEFIT PLAN, AN ERISA PLAN, AND NONTAXABLE BENEFITS (d) $13,182 REPRESENTS HOSPITALIZATION, MEDICAL, DENTAL AND PRESCRIPTION PLAN COVERAGE AS WELL AS 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, 2016, THE TOTAL COST OF THESE SERVICES AMOUNTED TO $893,895: $614,375 FOR CLINICAL SERVICES AND $279,520 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. MCKINNEY IS NO LONGER EMPLOYED AS A MEDICAL DIRECTOR AS OF JULY 24, 2015. DR. NISAR IS THE NEW MEDICAL DIRECTOR EFFECTIVE AUGUST 3, 2015. SHE IS ALSO A TRUSTEE AS OF JUNE 30, 2016. FORM 990, PART IX, LINE 11G OTHER FEES FOR SERVICE OTHER FEES FOR SERVICE INCLUDE $893,895 FOR ADMINISTRATION AND CLINICAL SUPPORT SERVICES PURCHASED AT COST FROM CARRIER CLINIC. FORM 990 PART IX LINE 11G DESCRIPTION:OTHER TOTAL FEES:893895