2013-05-13T15:15:33-05:00 2012-06-30 990 2011-07-01 232826045 Jeanes Hospital JEAN 2157283306 3509 N Broad Street No 936 Philadelphia PA 19140 Robert H Lux 2157283306 2013-05-13 2011 2016-02-25 16:41:14Z Robert H Lux 3509 N Broad Street No 936 Philadelphia PA 19140 167344944 0 X www.jeanes.com X 1996 PA To maintain and enhance the quality of life for individuals in the communities we serve. 9 8 1290 302 157536 29723 233515 2906425 152563905 156404815 703023 2234272 5305657 910495 158806100 162456007 6172500 3809050 0 0 72657319 74879917 0 0 68186 98847316 92833658 177677135 171522625 -18871035 -9066618 131003470 117835737 92443079 99183763 38560391 18651974 X Jeanes Hospital's mission statement, as approved by its board of directors and executiveship is:In furtherance of the mission of Temple University Health System, the mission of Jeanes Hospital is to maintain and enhance the quality of life for individuals in the communities we serve. We emphasize the Quaker belief that in each person there resides a spirit that creates a common bond among us all. Our health care services include maintenance and enhancement of health, which quickens the spirit and enhances the vitality of our lives. 0 0 16394938 16689692 The Cardiovascular program at Jeanes Hospital provides healthcareservices aimed at preventing, diagnosing, and treating cardiovascular diseases.Cardiovascular diseases are the leading cause of death in the UnitedStates. The services provided by Jeanes Hospital target the full rangeof conditions related to the heart and vascular system, includingcongestive heart failure, hypertension, and narrowing of the arteriesand peripheral disease. The services are provided to both inpatientsand outpatients.Cardiovascular services at Jeanes Hospital span the continuum of heartcare. Included are open heart surgery, diagnostic and interventional cardiac catheterization, electrophysiology studies, stress testing,cardiac and thoracic surgery, echocardiograms, EKGs, holter monitortests and cardiopulmonary rehab. The hospital's vascular servicesprovide both open and closed vascular procedures in surgery, cath laband vascular lab. Jeanes Hospital is the recipient of the AmericanHeart Association's Stroke Gold Plus Quality Achievement Award. 12191348 12555142 Gastroenterology/Digestive Disease. Jeanes Hospital gives patients themost advanced, safest and proven medical and surgical treatmentsprimarily focused on the gastrointestinal tract. The services offeredby Jeanes Hospital under this specialty are: surgical weight loss,colorectal surgery, nutritional counseling, and gastroenterology andhepatology services aimed at treating patients with disorders of theesophagus, liver, gall bladder and stomach. Services are provided toboth inpatients and outpatients. 10801417 9828543 Pulmonary. Jeanes Hospital provides comprehensive pulmonary complexmedical and rehabilitation programs for patients with acute and chronicpulmonary conditions. Services provided range from inpatientventilation management and weaning, to outpatient pulmonaryrehabilitation delivered by an interdisciplinary team of highly trainedand board certified pulmonologists, respiratory therapists and nurses. 113691495 3809050 117331438 In concert with cardiovascular, digestive and pulmonary services atJeanes Hospital, a full continuum of additional services creates acomprehensive medical and surgical center for our community and itsphysicians. Services range from diagnostic to therapeutic, medical tosurgical, and outpatient to critical care. Here is a roster of some ofthe more prominent services at Jeanes Hospital: General Medicine consists of diagnosis, management and non-surgicaltreatment of disease processes. Emergency Services are available to the community 24 hours a day for patients who suffer illness or injury. We have a full range of ambulatory diagnostic testing, includingpath lab services and radiology. Diagnostic imaging services includegeneral X-ray, digital mammography, ultrasound, MRI, CT, interventionalimaging and nuclear medicine. Advanced technology MRI, CT and PETscanning are available at Jeanes Hospital for critical diagnoses. Services, both medical and surgical, are available for disorders ofthe ears, nose, throat and eyes. Women's health services at Jeanes Hospital include screening anddiagnostic digital mammography, ultrasound services, breast surgery,fertility services and a compendium of gynecological surgical services. Orthopaedics at Jeanes Hospital ranges from conservative treatmentto high acuity surgery. Surgery includes tertiary-level jointreplacement procedures and rehab, and spine procedures. Neurosurgery services at Jeanes Hospital offers an alternative toorthopaedics for spine surgery patients. General surgery encompasses an array of interventional proceduresfor our patients, including oncologic, vascular, gastrointestinal, bariatric surgeries, etc. In step with surgical trends, Jeanes Hospitaloffers more and more minimally-invasive alternatives such aslaparoscopic surgery. Dermatology and plastic surgery both have a full-time presence atJeanes Hospital. Anesthesiologists on the Jeanes Hospital medical staff offer aformal pain management program for chronic pain patients, includinginterventional procedures. A hospitalist program was established at Jeanes Hospital, allowingphysicians to rely on specially trained inpatient coverage while tending to their practices more efficiently. Additional services include urology, nephrology, neurology,infectious disease, psychiatry and psychology, podiatry, rheumatology,and endocrinology. 113691495 3809050 117331438 153079198 1 1 0 0 0 0 0 0 1 1 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 75 0 1 1290 1 1 1 0 0 0 0 0 0 0 0 0 X 9 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 PA X X Robert H Lux 2157077766 3509 N Broad Street Room 936 Philadelphia PA 19140 X Joseph Evans 2.00 X 0 0 0 Dr Thomas Lewis 2.00 X 0 0 0 Francis Devlin 2.00 X 0 0 0 Larry Kaiser MD 3.00 X 0 1005407 14747 Charles Lockyer 2.00 X 0 0 0 Martin Ogletree 2.00 X 0 0 0 David Kraynik 2.00 X 0 0 0 Lewis Gould 3.00 X 0 0 0 Robert Taylor 2.00 X 0 0 0 Linda Grass 48.00 X 308082 0 10805 Beth Koob 2.00 X 0 444586 53554 Sharon Anderson 40.00 X 57222 0 16500 Betty McAdams 2.00 X 0 89508 14628 Gerald Oetzel 50.00 X 231847 0 28894 Robert Lux 2.00 X 0 486103 54292 Andrea McCoy 50.00 X 242027 0 27763 Denise Frasca 50.00 X 154730 0 24429 Stephanie Kao 50.00 X 195793 0 10779 John Woodward 50.00 X 159405 0 13 Mary Suter 50.00 X 150983 0 32493 Frank Shipp 50.00 X 149287 0 15032 Joseph Schofield 50.00 X 145723 0 8868 1795099 2025604 312797 52 0 1 0 Temple University Health System 3509 N Broad Street Room 936 Philadelphia PA 19140 Related organization services 8881733 Temple University Hospital 3509 N Broad Street Room 936 Philadelphia PA 19140 Faculty support, lab 5596556 Temple University of the Commonwealth Sy 300 Sullivan Hall 1330 W Berks St Philadelphia PA 19122 Related organization services 4527180 Temple Physicians Inc 3509 N Broad Street Room 936 Philadelphia PA 19140 Related organization services 2731075 Belmont Court Dialysis CT 2500 Boulevard of the Generals Norristown PA 19403 Dialysis 555279 9 245 97170 2783944 25066 2906425 Net patient svc revenu 622110 151260923 151138396 122527 Rental income 532000 4211922 4211922 Snack shop income 722210 556094 556094 Cafeteria income 722210 267771 267771 Service revenue 622110 104131 104131 3974 3974 156404815 317558 317558 87750 2874 84876 84876 84876 6802777 4886063 1916714 1916714 1916714 Incm from other invsts 523000 825619 35009 790610 825619 162456007 156282288 157536 3109758 3809050 3809050 1264470 801585 462885 57968753 53691379 4277374 2540407 2224837 315570 8844848 7576323 1268525 4261439 3739755 521684 2716945 2312367 336392 68186 508806 508806 70798 70798 30361220 22863760 7497460 905 781 124 26277573 25530984 746589 65285 65285 1315377 1142923 172454 74884 72052 2832 19393 18609 784 2549739 2230823 318916 6681322 5835303 846019 11271594 11094471 177123 Tax assessment expense 5259325 5259325 Bad debt 3280877 3280877 Equipment rental and ma 1932055 1220652 711403 Licenses, taxes and due 434561 374266 60295 12999 -924 13923 171522625 153079198 18375241 68186 2625652 799082 22064335 24531748 3343796 3393028 1287220 1271367 150276172 119657694 32576153 30618478 19710823 12930312 28525626 23608469 20869865 20683253 131003470 117835737 46034537 50312692 60500 48750 162903 163244 696797 469600 45488342 48189477 92443079 99183763 X 22394315 3197629 384563 198858 15781513 15255487 38560391 18651974 131003470 117835737 X -9066618 -10841799 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 15864051 152637 760061 15256627 13783220 2801550 720719 15864051 12963338 1646133 826251 13783220 16733256 -2840933 928985 12963338 0.00000 1.00000 0.00000 1 0 12775 12775 1694471 90086601 73153631 18627441 908222 43086 865136 54404928 43727495 10677433 3169175 2733482 435693 30618478 TIFF Absolute Return Pool II 6776940 F P2 Capital Fund Ltd 2038973 F GMO Forestry Fund 6b, LP 21242 F Pvt Advisors DO Fund, LP 488753 F PvtAdv SmCoBO Fund II, LP 1630771 F FCOI II Holdings, LP 2543998 F Forester Partners LP 3674289 F MREP 2008 Distressed Co-Investment Fund, LP 1428631 F Peak Select Partners, LP 1245448 F Sanderson International Value Fund 3759424 F 23608469 Jeanes Physicians' Office Building Partnership 1011580 Self insurance asset TU malpractice 2076007 Self insurance asset TU Workers' Compensation 1760155 Assets Limited As To Use -- Other, General 176409 Assets Limited As To Use -- Temporarily Restricted Funds 257631 Assets Limited As To Use -- Permanently Restricted Funds 75000 Assets Held in Trust -- Anna T. Jeanes Trust 13159824 Assets Held in Trust -- Maude E.M. Boggs Trust 1774459 Assets Held in Trust -- Edith Scot Paschall Trust 217601 Assets Held in Trust -- John E. Holcomb Trust 28104 Cash value of life insurance policy 27542 Estimated Retroactive Adjustment 3rd Party Payer 118941 20683253 Loan due to affiliate 4000000 Long-term debt, inter-company 39850020 Estimated retroactive adj, 3rd party payers 1152740 Due to affiliated companies 3186717 48189477 Part IV, line 2b: Jeanes Physicians' Office Building Partnership established with Jeanes Hospital an escrowed vacancy reserve fund to secure partnership obligations under a reimbursement and indemnification agreement. Part V, line 4: Use of the endowments will vary depending on the nature of the restrictions imposed by the donors. If an endowment is restricted as to purpose, the organization will use the endowment for the permitted purpose. If the endowment is restricted as to time, the organization draws income but accumulates principal. 1 1 X 1 X 1 X 1 1 1 0 0 3670 2803003 0 2803003 0.01670 14201 21556286 17298577 4257709 0.02530 17871 24359289 17298577 7060712 0.04200 7813 107275 330 106945 0.00060 1637010 514728 1122282 0.00670 7813 1744285 515058 1229227 0.00730 25684 26103574 17813635 8289939 0.04930 9520 0 9520 0.00010 9520 9520 0.00010 1 3280877 410110 32859178 35428625 -2569447 X 1 1 1 1 Jeanes Hospital

7600 Central Avenue Philadelphia PA 191112442

X X X X Home health care Jeanes Hospital 1 0 1 1 100.000000000000 1 300.000000000000 1 X X X 1 1 X X X X X 1 0 1 X 0 0 Non-use of Federal Poverty Guidelines Part I, Line 3c N/A Costing methodology Part I, Line 7 A ratio of cost to charges derived from Worksheet 2 was used in determining the amounts reported on Part I, lines 7a through 7d. The amounts are reported at cost and include both direct and indirect costs. Direct costs include salaries, employee benefits, supplies, and other costs that are directly attributable to the services. These direct costs would not exist if the service or program did not exist. Indirect costs are expenses not directly attributable to the service or programs but are included in the calculation of costs for total charity care and means-tested government programs, These costs include but are not limited to human resources, finance departments, insurance, support departments and overhead expenses. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 3280877. Part II: Community building activitiesJeanes Hospital engaged in a number of community building activities during the fiscal year. These activities included the following:Blood Drive. Jeanes Hospital worked closely with the American Red Crossto support its mission of providing a safe and reliable blood supply thathelps ensure quality outcomes and save lives. Jeanes helped collect 68pints of blood. Related net expense: $9,027.Other Activities. Related net expense: $493. These activities included:School supplies collection, in cooperation with Memorial PresbyterianChurch of Fox Chase;Provision of educational materials at the Annual National Night Out withthe Fox Chase Town Watch;Collection of 386 children's books for elementary classroom libraries in the Fair Hill neighborhood;Participation in Cheltenham/Rockledge Rotary Club's rose sale for thebenefit of the Rotary's Polio Plus program;Encouragement and facilitation of Holiday Gift Giving:Toys collection in support of the U.S.M.C.'s Toys for Tots program;Collections of food, winter wear and toys for the Feast of Justice Food Cupboard at St. John's Lutheran Church;Gifts collection for families from local church communities;Gifts collection for residents of the Philadelphia Protestant Home;Gifts collection for needy children, in support of the SalvationArmy's Angel Tags Program;Collections of clothing and other gifts for children of thePresbyterian Children's Village. Part III, Line 4: The ratio of cost to charge method is used in determining the amounts reported on lines 2 and 3. The amounts on lines 2 and 3 are reported at cost and include both direct and indirect costs. Direct costs include salaries, employee benefits, supplies, and other costs that are directly attributable to the service and that would not exist if the service or program did not exist. Indirect costs are costs not attributed to the services or programs that are included in the calculation of costs for community benefit. These costs include but are not limited to human resources, finance departments, insurance, support departments and overhead expenses. Part III, Line 8: As a response to efforts to improve the health and quality of life of people living in the community, Jeanes Hospital provided $2,569,447 in unreimbursed services to patients enrolled in Medicare programs. Jeanes Hospital believes that the Medicare shortfall of $2,569,447 should be treated as a community benefit since it has a clear mission to serving and improving the health status of the elderly. For the nine months ended March 31, 2013, approximately 56% of all inpatients treated at Jeanes Hospital were over the age of 65 and if Jeanes should cease to exist, this shortfall would have to be absorbed by another hospital provider in the Jeanes community. In addition, Jeanes Hospital is designated as a Medicare Disproportionate Share Hospital (DSH). DSH hospitals are "safety net" hospitals because they serve predominantly low-income communities and have a substantial number of Medicare patients that also qualify for Medicaid coverage. The associated costs with providing care to these patients are frequently not covered by government sponsored programs. Part III, Line 9b: Jeanes Hospital's collection policy contains provisions on the collection practices to be followed for patients who are known to qualify for charity care. If an account does not qualify for charity care or qualifies for only a charity care discount, the normal billing process of four (4) statements over a span of at least 120 days will occur. If no patient response is received, a write-off request form will be completed by the collection specialist and submittted for proper signature authority for agency referral. Once approved, the account will be transferred to the Bad Debt Financial Class log . The account will be forwarded to the collection agency for additional collection effort. Jeanes Hospital Part V, Section B, Line 19d: Jeanes Hospital used a multiple of two times the base Medicaid rate. Part VI, Line 2: Needs assessmentIn assessing community needs, Jeanes Hospital uses comprehensive sets of internal and external data sources. Externally, we rely largely on health data compiled by federal, state, and community-based health organizations, including the following: Community health assessment survey results from the Public Health Management Corporation (PHMC), including data on chronic health con- ditions, adult asthma, arthritis, diabetes, blood pressure, cholesterol, mental health, smoking, adult obesity, exercise, colonoscopies and PAP exams, mammograms and clinical breast exams; Disease rate data from the United States Center for Disease Control; Market data and quality assessments from the Pennsylvania Health Care Cost Containment Council (PHC4); Philadelphia Department of Public Health, including: the Philadelphia Vital Statistics Report, the Philadelphia Vital Statistics by Census Tract and Zip Code Report, the annual Health Center Service Area Report, and the Taking Philadelphia's Temperature report; Medpar data from the Centers for Medicare and Medicaid Services (CMS); Care Science Quality Manager from Premier; Other data from the Pennsylvania Department of Health, Delaware Valley Healthcare Council, etc.Internally, we rely on the following sources: Collaboration of Medical School and Hospital leadership; Consensus discussion with key clinical providers; Performance Improvement, Risk Management and Patient Safety outcomes; Historic, service line specific utilization data; Organizational community risk assessments (Infection Control, Environ- ment of Care, Emergency Management, Fire Safety Management, Disaster Response);In addition to data sources, we have assembled a community advisory board,for the past two decades, that reflects the needs and opinions of our service area. That board meets quarterly and it is used on an ad-hoc basis to represent the community we serve. Also, Jeanes Hospital launched a new seminar series, which gives us the opportunity to survey hundreds of neighbors regarding the health topics in which they are most interested. Part VI, Line 3: The Financial Counselors assigned to Jeanes Hospital screen all uninsured and underinsured patients (including those with high deductibles and co-pays) who are hospitalized or require elective outpatient hospital services to determine their eligibility for government funded medical insurance coverage such as Medicaid and CHIP.Patients that meet the qualifications for these programs are assisted byfinancial counseling staff throughout each step of the applicationprocess. Medicaid applications are submitted by Jeanes Hospital on thepatients' behalf and tracked until final determination.Patients who do not qualify for government-funded programs are screenedfor Temple University Health System's Charity Care/Self Pay program todetermine their eligibility for free or reduced cost care.The Charity Care/Self Pay discounting policy is not restricted toEmergency Department patients, but is available to inpatients andoutpatients as well.Patients who contact the Hospital's Business Office concerning bills theyhave received that they cannot afford to pay are also screened for CharityCare eligibility.The Financial Counseling Staff at Jeanes Hospital also offers assistancein obtaining supplemental coverage as well as prescription drug benefits.Patients are informed of our financial services, and direction on howto access these services, through the following means:Posters in plain view at inpatient, outpatient and emergencyregistration areas and billing offices;Patient discharge summaries, billing invoices and vendor collectionnotices;Hospital website. Part VI, Line 4: Jeanes Hospital Service Area Community ProfileJeanes Hospital service area consists of the following zip codes: 19027, 19111, 19115, 19116, 19120, 19124, 19135, 19136, 19149 and 19152. This is an area with a high percentage of poor and undereducated population.A. Population and Population Growth The total population in Jeanes' service area has slightly increased over the past decade and is projected to increase by 1.2% from 2012 to 2017. In contrast, the total U.S. population has grown over the past decade, and is projected to grow by 3.9% over the next five years.B. Age Distribution Approximately 25% of the total population within Jeanes' service area is under the age of 18, consistent with the national average. 25.3% of the Jeanes service area population is age 18-34, 9.1% higher than the national average of 23.2%. 36.4% of the Jeanes service area population is age 35-64, 7.9% lower than the national average. 13.1% of the Jeanes service area population is over 65 years old, which is 1.7% higher than the national average of 12.9%. The average age of the Jeanes service area is projected to increase slightly over the next five years. Under 18 population is projected to increase by 2.1% from 2012 to 2017. The 65 and over population is projected to increase from 77,599 in 2012 to 82,065 in 2017, a projected increase of 5.8%.C. Education Level In 2012, the population in the Jeanes service area consisted of 61.0% with high school education or less, a rate approximately 40% higher than the national average of 43.7%. The Jeanes service area population consists of 39.0% with education beyond high school, approximately 31% lower than the national average of 56.3%.D. Unemployment and Household Income Unemployment In the city of Philadelphia, 10.6% of the total population were unemployed in 2011, approximately 34% higher than the state unemployment rate of 7.9% and 18% higher than the national unemployment rate of 9.0%.(Source: Bureau of Labor Statistics, US Department of Labor) Household Income Approximately 63% of households in the Jeanes service area earn less than $50,000 per year, approximately 24% greater than the national average of 50.4%. 37.3% of Jeanes service area households earn over $50,000 per year, which is approximately 25% lower than the national average of 49.6%.E. Population Below Federal Poverty Level There are 5 out of the total 10 zip codes within the Jeanes service area that the percentage of population living under the Federal poverty level is greater than the national level of 15.1%.F. Race/Ethnicity In Jeanes' service area, 40.5% of the total population is White, approximately 36% lower than the national level of 62.8%. Black is the second largest population in Jeanes' service area, comprising 27.2% of the population, compared to the national average of 12.3%. The percentage of Hispanics is 31.5% greater than the nation level of 17.0%. Asian & Pacific is approximately 8% of the total population, 50.9% greater than the national average of 5.0%.G. Payer Mix in 2011 Approximately 72% of people in the Jeanes service area are covered by either Medicaid or Medicare; 35% for Medicaid and 37% for Medicare. This represents over twice the national average of 16.5% for Medicaid, and over two times of the national level of 15.2% for Medicare. Part VI, Line 5: Promotion of community healthJeanes Hospital is a nonprofit corporation that strives to be the destination for all who need ambulatory, inpatient acute, surgical and home care in Northeast Philadelphia and surrounding areas, by combining the compassionate nature of a Quaker-founded community hospital with the advanced capabilities of an academic medical center. Jeanes Hospital achieves this by espousing the following ideals: Create an extraordinary experience for everyone who enters our facilities for any reason; provide equal access to care for patients without regard to race, creed, religion, color, national origin, sex or sexual preference; make safety and continuous quality improvement a primary endeavor; promote the basic values of our Quaker heritage, to include kindness, equality and peace; combine the individual strengths of our hospital, medical staff, and health system; devote manpower and budgetary resources to provide health screenings, vaccinations and health education opportunities to our community; ensure that emotional, cultural and spiritual needs are met; provide a work environment that attracts, retains and develops the best employees; maintain a position of leadership in our community; value the wisdom of our board members, community and foundation liaisons, physician leaders and volunteers; use evidence-based research to understand the health needs of our community and respond accordingly, and espouse the core principles and stated values of the Temple University Health System.In addition to open medical staff, community board and reinvesting, Jeanes Hospital promotes the health of the community via: Free educational opportunities for the community; An arrangement with a diabetes education organization to offer on- campus education; Quality programs that produce safer health care provisions, evidenced by: Safety discussions first on every agenda Center of Excellence status in bariatric surgery Other quality distinctions in stroke care and cardiology 100% compliance with stroke care measures Compliance with "National Patient Safety Goals" Measurable reductions in: Clostridium difficile Central line associated blood stream infections Pressure ulcers Use of restraints Expense management and supply chain initiatives helping to maintain vigilance in cost containment, including waste stream monitoring; Conduct of a health needs assessment in 2012 to interview our health care services partners in our immediate geographical area; Maintenance of a rigorous home health program despite economic hardship; Maintenance of a quarter-mile walking trail, with exercise equipment, for employee and community wellness, with a growing "workplace well- ness" initiative for employees, volunteers and doctors. Part VI, Line 6: Affiliated health care systemThe mission of the Temple University Health System, Inc. is to provide access to the highest quality of health care in both the community and academic settings. In furtherance of the mission of the Temple University Health System, the mission of Jeanes Hospital is to maintain and enhance the quality of life for individuals in the communities we serve. We emphasize the Quaker belief that in each person there resides a spirit that creates a common bond among us all. Jeanes' health care services include maintenance and enhancement of health, which quickens the spirit and enhances the vitality of our lives. The missions of other members of the Temple University Health System similarly advance its goals: Temple University Hospital supports Temple University and its Health Sciences Center academic programs by providing the clinical environment and service to support the highest quality teaching and training programs for health care professionals and to support the highest quality research programs; the Temple Health System Transport Team, Inc.'s mission is to provide the highest level of critical care transport services available in the mid-Atlantic region, and Temple Physicians, Inc.'s mission is to provide the highest quality of clinical care as well as to support the System's clinical, administrative, and corporate activities. 1 Temple University Health System 3509 N Broad Street Room 936 Philadelphia PA 19140 232825881 501(c)(3) 3800000 N/A N/A General support 1 0 The over $5,000 grant was made only for tax-exempt purposes to a related organization under common control. This grant is subject to review by the governing bodies and management of the related organizations. X X 0 0 0 0 0 0 0 0 0 Larry Kaiser MD 0 973007 0 0 0 32400 0 0 0 14747 0 1020154 0 0 Linda Grass 302032 0 0 0 6050 0 3920 0 6885 0 318887 0 0 0 Beth Koob 0 406974 0 17649 0 19963 0 32544 0 21010 0 498140 0 0 Gerald Oetzel 227117 0 0 0 4730 0 11668 0 17226 0 260741 0 0 0 Robert Lux 0 448542 0 24828 0 12733 0 32544 0 21748 0 540395 0 0 Andrea McCoy 242027 0 0 0 0 0 11732 0 16031 0 269790 0 0 0 Denise Frasca 154295 0 0 0 435 0 8102 0 16327 0 179159 0 0 0 Stephanie Kao 195781 0 0 0 12 0 9800 0 979 0 206572 0 0 0 John Woodward 159405 0 0 0 0 0 0 0 13 0 159418 0 0 0 Mary Suter 150830 0 0 0 153 0 15484 0 17009 0 183476 0 0 0 Frank Shipp 145469 0 0 0 3818 0 0 0 15032 0 164319 0 0 0 Joseph Schofield 145162 0 0 0 561 0 7258 0 1610 0 154591 0 0 0 Krupsha Michael Brother to Sharon J. Anderson, Assistant Secretary of Jeanes Hospital 76330 Employee of Jeanes Hospital 0 Lux Kathleen Daughter to Robert H. Lux, Assistant Treasurer of Jeanes Hospital 62878 Employee of Jeanes Hospital 0 Form 990, Part VI, Section A, line 6 The sole member of the organization is Temple University Health System, Inc. The member has the power to appoint and remove the organization's Board of Directors. The approval of the member is required for any of the following actions by the organization: (a) any dissolution or liquidation; (b) any merger; (c) any amendments to the articles of incorporation; (d) any amendments to the bylaws regarding the member, the number of directors, quorum or voting requirements; (e) the sale, pledge, lease (but only a lease from the organization of substantially all of the organization's real property), or other transfer of the assets of the organization other than transactions occurring in the ordinary course of business; (f) any decision resulting in the organization's ceasing to provide appropriate sites for Temple University School of Medicine for comprehensive acute care services; (g) any decision to merge with, acquire, or enter into an affiliation with a medical school other than Temple University's or a medical school hospital other than Temple University Hospital, Inc.; (h) the deletion of any clinical programs that are needed for the accreditation of Temple University School of Medicine; (i) the adoption of the organization's annual capital and operating budgets; (j) the issuance or assumption of any indebtedness in excess of five hundred thousand ($500,000), and (k) the execution of any contract providing for the management of the organization. Form 990, Part VI, Section A, line 7a Please refer to the response for question 6 Form 990, Part VI, Section A, line 7b Please refer to the response for question 6 Form 990, Part VI, Section B, line 11 After review by management and outside tax counsel, the 990 and 990-T (if any) are posted to the website of the Secretary's Office. Each Board Member is contacted and provided with the web address. A Board Member without internet access is provided a paper copy to review. The website and paper mailing have an overview of the 990 and 990-T preparation process and internal reviews. Each Board Member is asked to review the 990 and 990-T within 2 weeks and contact the Chief Financial Officer about any questions. In addition to the above process, the Audit Committee is provided a copy and the 990 and 990-T are reviewed at a regularly scheduled meeting. Form 990, Part VI, Section B, line 12c The Office of the Secretary provides each director and officer with copies of the conflicts of interest policy and a disclosure statement to be completed on an annual basis. The Office of the Secretary reviews the completed disclosure statements which are then reviewed in summary format by a committee of the Board of Directors and any recommended actions presented to the full Board of Directors. In addition to completing the annual disclosure statement, directors and officers must disclose potential or actual conflicts on an ongoing basis as matters arise. All disclosures are evaluated and a determination of whether a conflict exists is made by the Board or a committee of the Board. All employees are subject to a conflicts of interest policy that is monitored by the Office of the Secretary. Form 990, Part VI, Section B, line 15 There is a compensation committee that reviews and approves all total compensation of executive / key personnel at Temple University Health System through an evaluation performed by an external compensation expert before the compensation is approved. Form 990, Part VI, Section C, line 19 The Unaudited Internal Financial Statements of the Temple University Health System and certain of its related organizations are distributed and made available to the public at the end of each quarter as per the System's Continuing Disclosure Agreement (Series of 2007 Bond Issue) through the Digital Assurance Corp (DAC), the Municipal Services Reporting Board's EMMA disclosure site and the Health System's financial web site. The Annual Audited Financial Statements are also released to the public in the same manner. To the extent required by applicable law, the organization makes its governing documents available to the public upon request. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized losses on investments: -2,275,858. Adjustment to record Other Than Temporary Impairment of investment -269,783. Adjustment to funded status of pension liability -8,296,158. Total to Form 990, Part XI, Line 5: -10,841,799. Commitment to our Communities: Jeanes Hospital is a nonprofit corporation whose mission is to be the destination for all who need ambulatory, inpatient acute, surgical and home care in Northeast Philadelphia, eastern Montgomery County and southern Bucks County, by combining the compassionate nature of a Quaker-founded community hospital with the advanced capabilities of an academic medical center. Jeanes Hospital achieves this by espousing the following ideals: Create an extraordinary experience for everyone who enters our facilities for any reason; provide equal access to care for patients without regard to race, creed, religion, color, national origin, sex or sexual preference; make safety and continuous quality improvement a primary endeavor; promote the basic values of our Quaker heritage, to include kindness, equality and peace; combine the individual strengths of our hospital, medical staff, and health system; devote manpower and budgetary resources to provide health screenings, vaccinations and health education opportunities to our community; ensure that everyone's emotional, cultural and spiritual needs are met; provide a work environment that attracts, retains and develops the best employees; maintain a position of leadership in our community; value the wisdom of our board members, community and foundation liaisons, physician leaders, and volunteers; use evidence-based research to understand the health needs of our community and respond accordingly; and espouse the core principles and stated values of the Temple University Health System. Jeanes Hospital has 176 licensed beds, providing a comprehensive range of medical, surgical, emergency and outpatient services. It has been a member of the Temple University Health System since 1996, and therefore is home to several Temple physician practices, high acuity tertiary-level surgical services like heart surgery and spine surgery, and specialty departments such as Temple University Hospital's bone marrow transplantation. Jeanes Hospital's notable achievements in recent years include: Surgical Review Corp. "Center of Excellence" for bariatric surgery, in conjunction with the American Society for Metabolic and Bariatric Surgery; Independence Blue Cross "Blue Distinction Center" for cardiac care, bariatric surgery and spine surgery; American Heart Association / American Stroke Association's "Get With the Guidelines" Gold-Plus level distinction for two years running; Joint Commission Certified Primary Stroke Center. Jeanes Hospital has a robust community outreach endeavor year after year, including but not limited to: Community Classroom, providing free community education seminars with physician faculty, focusing on health, wellness and safety topics; Jeanes Community Grant, awarding funds to service area non-profits to champion programs in health, wellness and safety; Periodic blood drives for the American Red Cross, open to employees, medical staff and community; A vital volunteer program that gives teenagers and the elderly opportunities to be part of the Jeanes Hospital mission, saving the hospital employee expenses to help keep health care costs down; An active committee to heighten awareness of the multi-cultural diversity in our service area, and the opportunities that provides in the application of service excellence; A walking trail with exercise equipment, that is open 24/7 for everybody's wellness opportunities, including employees, patients and the community-at-large; Annual Senior Health Care & Fire Prevention Presentation, in concert with other local organizations; Various niche programs, including Jeanes Arthritis Group, Jeanes Hospital Bereavement Support Group, Jeanes' Prostate Cancer Screening, and more; and Various employee-driven altruistic initiatives, including food drives, clothing drives, book drives, toy drives, disaster relief drives, etc. Hours of members at other related organizations Form 990 - Part VII - Section A - Column B Joseph Evans - 2 Linda Grass - 2 Beth Koob - 48 Betty McAdams - 38 Robert Lux - 48 Francis Devlin - 2 Larry Kaiser MD - 47 Lewis Gould - 2 Temple University of the Commonwealth System 300 Sullivan Hall 1330 W Berks St Philadelphia PA 19122 231365971 Education PA 501c3 Line 2 N/A 0 Temple University Health System Inc 3509 N Broad Street Room 936 c/o TU Philadelphia PA 19140 232825881 Health Care PA 501c3 Line 11a, I Temple University of the Commonwealth System 0 Temple University Health System Foundation Inc 3509 N Broad Street Room 936 c/o TU Philadelphia PA 19140 232916108 Health Care PA 501c3 Line 11a, I Temple University Hospital Inc 0 Temple University Hospital Inc 3509 N Broad Street Room 936 c/o TU Philadelphia PA 19140 232825878 Health Care PA 501c3 Line 3 Temple University Health System Inc 0 Jeanes Hospital Auxiliary 7600 Central Avenue Philadelphia PA 19111 231917776 Health Care PA 501c3 Line 9 Jeanes Hospital 1 Temple East Inc 3509 N Broad Street Room 936 c/o TU Philadelphia PA 19140 232547305 Health Care PA 501c3 Line 11a, I Temple University Hospital Inc 0 Temple East Real Estate Inc 3509 N Broad Street Room 936 c/o TU Philadelphia PA 19140 201776524 Health Care PA 501c3 Line 11a, I Temple University Hospital Inc 0 Temple Physicians Inc 3509 N Broad Street Room 936 c/o TU Philadelphia PA 19140 232790607 Health Care PA 501c3 Line 9 Temple University Health System Inc 0 Temple Health System Transport Team Inc 3509 N Broad Street Room 936 c/o TU Philadelphia PA 19140 753084023 Health Care PA 501c3 Line 9 Temple University Health System Inc 0 Episcopal Hospital 3509 N Broad Street Room 936 c/o TU Philadelphia PA 19140 231365351 Health Care PA 501c3 Line 11a, I Temple University Hospital Inc 0 Anna T Jeanes Foundation 7600 Central Avenue Philadelphia PA 19111 232203406 Health Care PA 501c3 Line 11c, III-FI N/A 0 TUHS Insurance Company LTD 3509 N Broad Street 9th Floor - c/o Philadelphia PA 19140 Malpractice insurance BD Temple University Health System Inc 0 1 1 0 1 0 1 0 1 0 1 1 1 1 1 1 0 0 Jeanes Hospital Auxiliary P 52694 Cash received