EAST MOUNTAIN HOSPITAL INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- EAST MOUNTAIN HOSPITAL INC (EIN 01-0553478)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-04-09
- IRS object ID
- 201440999349300134
- Schema version
- 2012v2.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-04-09T13:52:36-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EISNERAMPER LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 WOOD AVE SO STE 600 | AddressLine1 |
| City | ISELIN | City |
| State | NJ | State |
| ZIP Code | 088302700 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010553478 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EAST MOUNTAIN HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % MICHAEL VOORHEES | InCareOfName |
| Name Control | EAST | NameControl |
| Phone | 9082811439 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1029 | AddressLine1 |
| Address Line2 | Suite | AddressLine2 |
| City | BELLE MEAD | City |
| State | NJ | State |
| ZIP Code | 085021029 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MICHAEL VOORHEES | Name |
| Title | EXECUTIVE DIRECTOR | Title |
| Phone | 1111111111 | Phone |
| Date Signed | 2014-04-15 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | RICHARD A SACKIN | Name |
| Phone | 7322437000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | MICHAEL VOORHEES | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1029 | AddressLine1 |
| City | BELLE MEAD | City |
| State | NJ | State |
| ZIP Code | 085021029 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 4620471 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | eastmountainhospital.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2003 | YearFormation |
| State Legal Domicile | NJ | StateLegalDomicile |
| Activity Or Mission Description | EAST MOUNTAIN HOSPITAL IS AN INPATIENT PSYCHIATRIC HOSPITAL. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 7 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 5 | NbrIndependentVotingMembers |
| Total Nbr Employees | 71 | TotalNbrEmployees |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 4390394 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 4619605 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1003 | InvestmentIncomePriorYear |
| Investment Income Current Year | 675 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 4318 | OtherRevenuePriorYear |
| Other Revenue Current Year | 191 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 4395715 | TotalRevenuePriorYear |
| Total Revenue Current Year | 4620471 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 250 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 2294354 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 2359366 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 2054185 | OtherExpensePriorYear |
| Other Expenses Current Year | 2096174 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 4348789 | TotalExpensesPriorYear |
| Total Expenses Current Year | 4455540 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 46926 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 164931 | RevenuesLessExpensesCY |
| Total Assets BOY | 2745485 | TotalAssetsBOY |
| Total Assets EOY | 2669552 | TotalAssetsEOY |
| Total Liabilities BOY | 1761238 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1520374 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 984247 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 1149178 | NetAssetsOrFundBalancesEOY |
| Mission Description | 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. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 3872402 | Expense |
| Revenue | 4619605 | Revenue |
| Description | PSYCHIATRIC HOSPITAL WHICH CARED FOR 390 INPATIENTS AND HAD A TOTAL OF 5,261 PATIENT DAYS. | Description |
| Total Program Service Expense | 3872402 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | false | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 3 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 71 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 7 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 5 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | NJ | StatesWhereCopyOfReturnIsFiled |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | MICHAEL VOORHEES | NamePerson |
| Telephone Number | 9082811439 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 40 EAST MOUNTAIN ROAD | AddressLine1 |
| City | BELLE MEAD | City |
| State | NJ | State |
| ZIP Code | 085021029 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (9 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| BOHDAN CEHELYK MD | |||||||
| MEDICAL DIRECTOR & TRUSTEE | 40.0 | X | X | 246266 | 0 | 33053 | |
| MICHAEL VOORHEES | |||||||
| EXECUTIVE DIRECTOR & TRUSTEE | 40.0 | X | X | 119035 | 0 | 27216 | |
| DAVID CENTAFONT | |||||||
| TRUSTEE | 0.0 | X | 0 | 0 | 0 | ||
| ENRICO DEGIRONIMO | |||||||
| TRUSTEE | 0.0 | X | 0 | 0 | 0 | ||
| RANDOLPH JACOBSON | |||||||
| TREASURER & TRUSTEE | 0.0 | X | X | 0 | 0 | 0 | |
| PATRICIA TOOLE | |||||||
| SECRETARY & TRUSTEE | 0.0 | X | X | 0 | 0 | 0 | |
| SUSAN BONFIELD | |||||||
| TRUSTEE | 0.0 | X | 0 | 0 | 0 | ||
| MARY PAWLIKOWSKI | |||||||
| CHAIRPERSON (RESIGNED) | 0.0 | X | 0 | 0 | 0 | ||
| HEIDI HERGERT | |||||||
| R.N. | 40.0 | 101240 | 0 | 5136 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 466541 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 65405 | TotalOtherCompensation |
| Number Individuals GT100 K | 3 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (2 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| CARRIER CLINIC | |||||
| PO BOX 147 | BELLE MEAD | NJ | 08502 | ADMIN/CLINICAL | 873768 |
| SODEXO INC | |||||
| PO BOX 905374 | CHARLOTTE | NC | 28290 | DIETARY/HOUSEKEEPING | 145193 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 2 | NumberOfContractorsGT100K |
| Info In Schedule O Part VIII | X | InfoInScheduleOPartVIII |
| Total Contributions | 0 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT REVENUE | Description |
| Business Code | 624100 | BusinessCode |
| Total Revenue Column | 4619605 | TotalRevenueColumn |
| Related Or Exempt Function Income | 4619605 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 4619605 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 675 | TotalRevenueColumn |
| Exclusion | $675 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | ALL OTHER REVENUE | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 191 | TotalRevenueColumn |
| Exclusion | $191 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 191 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4620471 | TotalRevenueColumn |
| Related Or Exempt Function Income | 4619605 | RelatedOrExemptFunctionIncome |
| Exclusion | $866 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 352412 | Total |
| Program Services | 232230 | ProgramServices |
| Management And General | 120182 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1636479 | Total |
| Program Services | 1622615 | ProgramServices |
| Management And General | 13864 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 51156 | Total |
| Program Services | 47708 | ProgramServices |
| Management And General | 3448 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 150279 | Total |
| Program Services | 125034 | ProgramServices |
| Management And General | 25245 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 169040 | Total |
| Program Services | 158366 | ProgramServices |
| Management And General | 10674 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 87558 | Total |
| Program Services | 76180 | ProgramServices |
| Management And General | 11378 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13238 | Total |
| Management And General | 13238 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34187 | Total |
| Management And General | 34187 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 897349 | Total |
| Program Services | 619836 | ProgramServices |
| Management And General | 277513 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1270 | Total |
| Management And General | 1270 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37884 | Total |
| Program Services | 21651 | ProgramServices |
| Management And General | 16233 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6370 | Total |
| Management And General | 6370 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 236708 | Total |
| Program Services | 232946 | ProgramServices |
| Management And General | 3762 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5116 | Total |
| Program Services | 5116 | ProgramServices |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2902 | Total |
| Program Services | 2902 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5725 | Total |
| Management And General | 5725 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 105679 | Total |
| Program Services | 91351 | ProgramServices |
| Management And General | 14328 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| PATIENT RELATED | 415436 | 415436 | |
| DIETARY/ENVIRONMENTAL SVS | 170780 | 170780 | |
| BAD DEBTS | 33246 | 33246 | |
| MISCELLANEOUS | 42726 | 17005 | 25721 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4455540 | Total |
| Program Services | 3872402 | ProgramServices |
| Management And General | 583138 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2027980 | BOY |
| EOY | 1686552 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 582452 | BOY |
| EOY | 861290 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 94349 | BOY |
| EOY | 80507 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 104455 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 63252 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40704 | BOY |
| EOY | 41203 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2745485 | BOY |
| EOY | 2669552 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 345716 | BOY |
| EOY | 326133 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1415522 | BOY |
| EOY | 1194241 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1761238 | BOY |
| EOY | 1520374 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 984247 | BOY |
| EOY | 1149178 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 984247 | BOY |
| EOY | 1149178 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2745485 | BOY |
| EOY | 2669552 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 164931 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Current Year Minus3 Years | CurrentYearMinus3Years | |
| Current Year Minus4 Years | CurrentYearMinus4Years | |
| Land | Land | |
| Buildings | Buildings |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 86665 | OtherCostOrOtherBasis |
| Depreciation | 45462 | Depreciation |
| Book Value | 41203 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 17790 | OtherCostOrOtherBasis |
| Depreciation | 17790 | Depreciation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildings | |
| Total Of Book Value Land Buildings | 41203 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO CARRIER CLINIC | $56,316 |
| ACCRUED PENSION | $44,400 |
| DUE TO THIRD PARTIES | $1,093,525 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1194241 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 4587225 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 4587225 | RevenueSubtotal |
| Other Revenues Not Included | 33246 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 33246 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 4620471 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 4422294 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 4422294 | ExpensesSubtotal |
| Other Expenses Not Included | 33246 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 33246 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 4455540 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| 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 33,246 REPORTED AS REVENUE REDUCTION ON AUDITED FINANCIAL STATEMENTS. |
| PART XII, LINE 4B | PATIENT BAD DEBTS 33,246 REPORTED AS REVENUE REDUCTION ON AUDITED FINANCIAL STATEMENTS. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 100 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 9032 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 9032 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00200 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 9032 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 9032 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00200 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1125 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1125 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1125 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1125 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10157 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 10157 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00230 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 2468 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2468 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00060 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 2468 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2468 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00060 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $17,352 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 1361801 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 1389714 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -27913 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | false | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EAST MOUNTAIN HOSPITAL INC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1029 | AddressLine1 |
| City | BELLE MEAD | City |
| State | NJ | State |
| ZIP Code | 085021029 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EAST MOUNTAIN HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | true | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Needs Assessment Conducted | 13 | NeedsAssessmentConducted |
| Take Into Account | true | TakeIntoAccount |
| Other Facilities | true | OtherFacilities |
| CHNA Widely Available | true | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | false | AllNeedsAddressed |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 100 | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 100 | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Medicare Rate | X | MedicareRate |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| PART V, SECTION B, LINE 13G | THE EMH PATIENT HANDBOOK INFORMS PATIENTS THAT THEY HAVE THE RIGHT TO TREATMENT WITHOUT DISCRIMINATION BASED ON THEIR ABILITY TO PAY OR SOURCE OF PAYMENT. IN ADDITION TO BEING INCLUDED IN THE PATIENT'S HANDBOOK THAT IS DISTRIBUTED TO EVERY PATIENT, A FINANCIAL COUNSELOR MEETS WITH THE PATIENT ON BEHALF OF EMH DURING THEIR STAY, WHEREBY SOME INFORMATION IS VERIFIED AND IF UPON INITIAL ASSESSEMNT OF THE FINANCIAL COUNSELOR OR UPON THE PATIENT'S REQUEST, THE COUNSELOR DISCUSSES THE FINANCIAL ASSISTANCE (FA) POLICY WITH THE PATIENT AND ASSISTS THE PATIENT IN COMPLETING THE APPLICATION FORM FOR THE FA. THE PATIENT IS THEN ADVISED TO SUBMIT THE NECESSARY FINANCIAL INFORMATION TO COMPLETE THE REVIEW OF THE APPLICATION. | |
| PART V, SECTION B, LINE 19D | 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, 2013 IS $33,246 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 | PATIENT ACCOUNTS RECEIVABLE ARE RECORDED AT THE REIMBURSED OR CONTRACTED AMOUNT AND DO NOT BEAR INTEREST. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS THE HOSPITAL'S BEST ESTIMATE OF THE AMOUNT OF PROBABLE CREDIT LOSSES IN THE HOSPITAL'S EXISTING PATIENT ACCOUNTS RECEIVABLE. THE HOSPITAL DETERMINES THE ALLOWANCE BASED ON HISTORICAL WRITE-OFF EXPERIENCE. THE HOSPITAL REVIEWS ITS ALLOWANCE FOR DOUBTFUL ACCOUNTS PERIODICALLY. PAST DUE BALANCES ARE REVIEWED INDIVIDUALLY FOR COLLECTIBILITY. ACCOUNT BALANCES ARE CHARGED OFF AGAINST THE ALLOWANCE AFTER ALL MEANS OF COLLECTION HAVE BEEN EXHAUSTED AND THE POTENTIAL FOR RECOVERY IS CONSIDERED REMOTE. | |
| PART VI, SUPPLEMENTAL INFORMATION 1 | 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. | NEEDS ASSESSMENT |
| PART VI, SUPPLEMENTAL INFORMATION 2 | 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. | PATIENT EDUCATION |
| PART VI, SUPPLEMENTAL INFORMATION 3 | EMH SERVES THE ENTIRE STATE OF NEW JERSEY; HOWEVER, THE MAIN PATIENT POPULATION IS FROM SUBURBAN AREAS. THE MAIN SOURCE OF ADMISSIONS IN 2012/2013 WAS FROM SOMERSET, MIDDLESEX, MERCER, CAPE MAY AND CAMDEN COUNTIES, ALL LOCATED IN NEW JERSEY. OF THESE FIVE COUNTIES, AN AVERAGE OF 8.74% OF THE POPULATION FALLS BELOW POVERTY LEVEL. | COMMUNITY INFORMATION |
| PART VI, SUPPLEMENTAL INFORMATION 4 | 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. | COMMUNITY BUILDING ACTIVITIES |
| PART V, LINE 3 | WHILE CONDUCTING EMH'S CHNA, A REPRESENTATIVE OF EMH INTERVIWED 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 4 | IN AN EFFORT TO BE COST-EFFECTIVE, EMH CONDUCTED ITS CHNA IN CONJUNCTION WITH CARRIER CLINIC. EMH IS A HOSPITAL-WITHIN-A-HOSPIAL ON THE CARRIER CLINIC CAMPUS AND THEIR COMMUNITIES ARE SIMILAR. | |
| PART V, SECTION B, LINE 7 | THE IMPLEMENTATION STRATEGY DEFINES THE NEEDS TO BE ADDRESSED BY JUNE 30, 2014. EMH IS WORKING TOWARDS THE TIMELY IMPLEMENTATION OF THE PLAN. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | BOHDAN CEHELYK MD | NamePerson |
| Title | MEDICAL DIRECTOR & TRUSTEE | Title |
| Base Compensation Filing Org | 241966 | BaseCompensationFilingOrg |
| Comp Based On Related Orgs | 0 | CompBasedOnRelatedOrgs |
| Other Compensation Filing Org | 4300 | OtherCompensationFilingOrg |
| Deferred Comp Filing Org | 9100 | DeferredCompFilingOrg |
| Nontaxable Benefits Filing Org | 23953 | NontaxableBenefitsFilingOrg |
| Total Compensation Filing Org | 279319 | TotalCompensationFilingOrg |
| Total Compensation Related Orgs | 0 | TotalCompensationRelatedOrgs |
| Comp Report Prior990 Filing Org | 0 | CompReportPrior990FilingOrg |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SCHEDULE J, PART II | Identifier |
| Explanation | DR. BOHDAN CEHELYK'S OTHER REPORTABLE COMPENSATION OF $4,300 REPRESENTS A PENSION CONTRIBUTION THAT FAILED DISCRIMINATION TESTING, RETIREMENT AND OTHER DEFERRED COMPENSATON OF $9,100 REPRESENTS EAST MOUNTAIN HOSPITAL'S CONTRIBUTION INTO THE TARGET BENEFIT PLAN, AN ERISA PLAN. NONTAXABLE BENEFITS OF $23,953 REPRESENTS HOSPITALIZATION, MEDICAL, DENTAL AND PRESCRIPTION PLAN COVERAGE AS WELL AS LIFE INSURANCE AND LONG-TERM DISABILITY INSURANCE PAID BY EAST MOUNTAIN HOSPITAL. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| 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 COTTER, HOSPITAL AND HEALTHCARE COMPENSATION SERVICE 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 IN AN ARM'S-LENGTH TRANSACTION FROM CARRIER CLINIC AS PER THE DULY EXECUTED SERVICE AGREEMENT BETWEEN THE TWO ENTITIES. FOR THE FISCAL YEAR ENDED JUNE 30, 2013, THE TOTAL COST OF THESE SERVICES AMOUNTED TO $873,768 - $596,255 FOR CLINICAL SERVICES AND $277,513 FOR VARIOUS BUSINESS SUPPORT FUNCTIONS SUCH AS FINANCIAL REPORTING, BILLING, INFORMATION TECHNOLOGY, HUMAN RESOURCES, AND OTHER BUSINESS FUNCTIONS. |
| FORM 990, PART VII, SECTION A | MARY PAWLIKOWSKI RESIGNED AS CHAIRPERSON ON JUNE 19, 2013. MICHAEL VOORHEES, EXECUTIVE DIRECTOR, BECAME ACTING CHAIRPERSON UNTIL THE BOARD ELECTED PATRICIA TOOLE AS THE NEW CHAIRPERSON IN SEPTEMBER 2013. |
| FORM 990, PART IX, LINE 11g OTHER FEES FOR SERVICE | OTHER FEES FOR SERVICE INCLUDE $873,768 FOR ADMINISTRATIVE AND CLINICAL SUPPORT SERVICES PURCHASED IN AN ARM'S-LENGTH TRANSACTION FROM CARRIER CLINIC AND $23,580 FOR TEMPORARY PSYCHIATRIST FEES. |
| FORM 990, PART IV, LINE 20b | THE (FINAL) DRAFT OF THE AUDITED EMH FINANCIAL STATEMENTS FOR FISCAL YEAR ENDED 6/30/13 IS ATTACHED TO THE FORM 990 PENDING COMPLETION OF FINAL AUDIT PROCEDURES BY EMH'S INDEPENDENT AUDITORS. ONCE THE SIGNED COPY OF THE AUDIT REPORT IS ISSUED, EMH WILL FILE AN AMENDED FORM 990 AND WILL ATTACH THE FINAL/SIGNED AUDIT REPORT. |