Saint Peter'S University Hospital

“Saint peter's healthcare system, inc. ("system") is the sole member of this organization. System has the right to elect the members of this organization's board of trustees and has certain reserved powers as defined in this organization's bylaws.”

“The organization is an affiliate within saint peter's healthcare system, inc. And affiliates; a tax-exempt integrated healthcare delivery system ("system"). Saint peter's healthcare system, inc. Is the tax-exempt parent of the system. This organization's federal form 990 was provided to each voting member of its governing body (its board of trustees) prior to filing with the internal revenue service ("irs"). The saint peter's health care system, inc. Audit and compliance committee has assumed the responsibility to oversee and coordinate the federal form 990 preparation, review and filing process. As part of the organization's federal form 990 tax return preparation process the organization hired a professional cpa firm with experience and expertise in both healthcare and not-for-profit tax return preparation to prepare the federal form 990. The cpa firm's tax professionals worked closely with the organization's finance personnel and system individuals including, but not limited to, the chief financial officer, controller and other system individuals ("internal working group") to obtain the information needed in order to prepare a complete and accurate tax return. The cpa firm prepared a draft federal form 990 and furnished it to the organization's internal working group, including those individuals outlined above, for review. The organization's internal working group reviewed the draft federal form 990 and discussed questions and comments with the cpa firm. Revisions were made to the draft federal form 990 where necessary and a final draft was furnished by the cpa firm to the organization's internal working group for final review and approval. Following this approval, the system's audit and compliance committee reviewed the form 990 at a regularly scheduled meeting. In addition, the cpa firm gave a form 990 presentation at this meeting. Thereafter, the final federal form 990 was made available to each voting member of the organization's governing body prior to filing with the irs.”

“The organization is an affiliate within saint peter's healthcare system, inc. And affiliates; a tax-exempt integrated healthcare delivery system ("system"). The organization and the system regularly monitor and enforce compliance with its conflict of interest policy. Annually all members of the board of trustees, officers and senior management personnel are required to review the existing conflict of interest policy and complete a questionnaire. The completed questionnaires are returned to the organization and the system's chief compliance officer for review. The chief compliance officer then prepares a summary of the completed questionnaires which contains information disclosed by an individual on an individual basis. Potential conflicts were then reviewed and discussed at a meeting with the system's chief compliance officer, chief financial officer, controller and director of internal audit. The summary is presented to the corporate secretary for reference, review and discussion during board meetings.”

“The organization is an affiliate within saint peter's healthcare system, inc. And affiliates; a tax-exempt integrated healthcare delivery system ("system"). The organization's board of trustees has an executive compensation committee ("committee"). The committee has adopted a written executive compensation philosophy which it follows when it reviews and approves of the compensation and benefits of the organization's senior management, including the president/chief executive officer, chief operating officer and chief financial officer. The committee reviews the "total compensation" of the individuals which is intended to include both current and deferred compensation and all employee benefits, both qualified and non-qualified. The committee's review is done on at least an annual basis and ensures that the "total compensation" of senior management of the organization is reasonable. The actions taken by the committee enable the hospital to receive the rebuttable presumption of reasonableness for purposes of internal revenue code section 4958 with respect to the total compensation of certain members of the senior management team, including the president/chief executive officer, chief operating officer and chief financial officer. The three factors which must be satisfied in order to receive the rebuttable presumption of reasonableness are the following: 1) the compensation arrangement is approved in advance by an "authorized body" of the applicable tax-exempt organization which is composed entirely of individuals who do not have a "conflict of interest" with respect to the compensation arrangement; 2) the authorized body obtained and relied upon "appropriate data as to comparability" prior to making its determination; and 3) the authorized body "adequately documented the basis for its determination" concurrently with making that determination. The committee is comprised of members of the board of trustees each of who are independent and are free from any conflicts of interest. The committee relied upon appropriate comparable data; specifically the committee obtained a written compensation study from an independent firm which specializes in the reviewing of hospital and healthcare system executive compensation and benefits throughout the united states. This study used comparable geographic and demographic market data including but not limited to similar sized hospitals, # of licensed beds and net patient service revenue. The committee adequately documented its basis for its determination. The actions outlined above with respect to the committee and the establishment of the rebuttable presumption of reasonableness only applies to certain senior management personnel, including the president/chief executive officer, chief operating officer and chief financial officer. The compensation and benefits of certain other individuals contained in this form 990 are reviewed annually by the president/chief executive officer with assistance from the hospital's human resources department in conjunction with the individual's job performance during the year and is based upon other objective factors designed to ensure that reasonable and fair market value compensation is paid by the hospital. Other objective factors include market survey data for comparable positions, individual goals and objectives, personnel reviews, evaluations, self-evaluations and performance feedback meetings.”

“Pursuant to state of New Jersey P.L. 2019, chapter 513, (which was effective on July 21, 2020), and amended P.L. 2008, chapter 58 (C.26: 2H-5.1b), this organization has posted on its internet website a copy of this Internal Revenue Service (IRS) Form 990 and all schedules and supporting documentation required to be submitted to the IRS in conjunction with the Form 990 with the exception of those schedules not open for public inspection. Said Form 990 was posted by the organization after filing its Form 990 with the IRS.”

“The organization has issued tax-exempt bonds to finance various capital improvement projects, renovations and equipment. In conjunction with the issuance of these tax-exempt bonds, the organization's financial statements were included with the tax-exempt bond prospectus which was made available to the general public for review. The organization's filed certificate of incorporation and any amendments can be obtained and reviewed through the state of new jersey department of the treasury. In addition, the organization's conflict of interest policy and audited financial statements are available upon request.”

“Core form, part vii and schedule j reflect certain board members and officers receiving compensation and benefits from this organization or a related organization. Please note this remuneration was for services rendered as full-time employees of the organization or a related organization and not for services rendered as a voting member or officer of this organization's board of trustees.”

“The organization is an affiliate within saint peter's healthcare system, inc. And affiliates ("system"); a tax-exempt integrated healthcare delivery system. Certain board of trustee members, officers and/or key employees listed on core form, part vii and schedule j of this form 990 may hold similar positions with both this organization and other affiliates within the system. The hours shown on this form 990, for board members who receive no compensation for services rendered in a non-board capacity, represent the estimated hours devoted per week for this organization. To the extent these individuals serve as a member of the board of trustees of other related organizations in the system, their respective hours per week per organization are approximately the same as reflected in core form, part vii of this form 990. The hours reflected on core form, part vii of this form 990, for board members who receive compensation for services rendered in a non-board capacity, paid officers and key employees, reflect total hours worked per week on behalf of the system; not solely this organization.”

“Background ========== Saint Peter's University Hospital is recognized by the internal revenue service as an internal revenue code section 501(c)(3) tax-exempt organization. Pursuant to its charitable purposes, Saint Peter's University Hospital provides medically necessary healthcare services to all individuals in a non-discriminatory manner regardless of race, color, creed, sex, sexual identity and orientation, national origin, or ability to pay. Moreover, Saint Peter's University Hospital operates consistently within the following criteria outlined in IRS revenue ruling 69-545: 1. Saint Peter's University Hospital provides medically necessary healthcare services to all individuals regardless of ability to pay, including charity care, self-pay, Medicare and Medicaid patients; 2. Saint Peter's University Hospital operates an active emergency department for all persons that is open 24 hours a day, seven days a week, 365 days per year; 3. Saint Peter's University Hospital maintains an open medical staff with privileges available to all qualified physicians; 4. Control of Saint Peter's University Hospital rests with its board of trustees, which is comprised of independent civic leaders, clergy and other prominent members of the community; and 5. Surplus funds are used to improve the quality of patient care, expand and renovate facilities, and advance medical care, programs and activities. The operations of Saint Peter's University Hospital, as shown through the factors outlined above and other information contained herein, clearly demonstrate that the use and control of Saint Peter's University Hospital is for the benefit of the public and that no part of the income or net earnings of the organization inures to the benefit of any private individual nor is any private interest being served other than incidentally. Saint Peter's University Hospital, located at 254 Easton Avenue, New Brunswick, N.J. is a 478-bed nonprofit acute-care teaching hospital sponsored by the roman catholic diocese of Metuchen. Saint Peter's University Hospital, a member of the Saint Peter's Healthcare System, is a major clinical affiliate of Rutgers University biomedical and health sciences division and sponsors its own freestanding residency programs in obstetrics and gynecology, pediatrics, and internal medicine and fellowship programs in pulmonology and gastroenterology. The hospital is fully accredited by The Joint Commission and is certified as a Magnet hospital for nursing excellence by the American Nurses Credentialing Center. Saint Peter's is also a state-designated acute care children's hospital and a regional perinatal center and is affiliated with the Children's Hospital of Philadelphia for pediatric cardiology services. Saint Peter's was the first hospital in Middlesex County and has served the healthcare needs of central New Jersey continuously since 1907, providing substantial community benefit. From its simple beginnings, Saint Peter's has grown to become a technologically advanced, 478-bed teaching hospital that provides a broad array of services to the community-from sophisticated care of premature babies to specialized geriatric medicine. Saint Peter's brings the latest medical practices and highly skilled professionals to the bedside. Hospital staff treats approximately 23,000 inpatients and 280,000 outpatients annually. Saint Peter's employs approximately 3,300 healthcare professionals and support personnel, and more than 1,200 physicians and dentists have privileges at its facilities. As a state-designated acute care children's hospital, The Children's Hospital at Saint Peter's University Hospital offers a full range of specialized pediatric healthcare services. Saint Peter's also offers one of the most sophisticated maternity programs and operates one of the largest, most advanced Level IV Neonatal Intensive Care Units (NICUs) in the country as a state-designated regional perinatal center and has been recognized among the top 50 best ch”

“Specialty Services ================== Regional Perinatal Center (RPC): Delivering nearly 5,400 babies annually, Saint Peter's offers one of the largest, most sophisticated maternity programs in the country. The hospital was the first regional perinatal centers in New Jersey and specializes in high-risk pregnancy. The antenatal testing unit is one of the largest units of its kind and features 3D and 4D ultrasound testing. Specialty maternal-fetal medicine programs include the infant and perinatal loss evaluation program and the infant prematurity assessment and prevention program. Neonatal Intensive Care Unit (NICU): Saint Peter's operates a 54-bassinett, Level IV NICU, the largest in central New Jersey and the first in the state. It includes the neonatal retina center, providing laser surgery for retinopathy of prematurity and outpatient ophthalmology services, and the infant apnea center. Special training in caring for these fragile babies is provided to parents and support groups are offered. The Children's Hospital at Saint Peter's University Hospital has been ranked among the top 50 best children's hospitals for neonatology in the nation by U.S. News and World Report three years in a row. The Cancer Program at Saint Peter's includes a 24-bed inpatient unit and outpatient services including radiation and infusion therapies and surgery. The program provides state-of-the-art treatments such as IMRT, CyberKnife and breast cancer services. The hospital is accredited by the American College of Surgeons' Commission On Cancer as an Academic Comprehensive Cancer Program. and is the recipient of the commission on cancer outstanding achievement award. The Saint Peter's Breast Center is accredited by the National Accreditation Program for Breast Centers (NAPBC), a program administered by the American College of Surgeons. Geriatric Services: A complete and multidisciplinary program of geriatric medicine, with an outpatient geriatric evaluation and management service for the frail elderly, especially those with Alzheimer's disease. Outpatient services are available through Saint Peter's Physician Associates with locations in Monroe and New Brunswick. Saint Peter's Thyroid and Diabetes Center is recognized by the American Diabetes Association in all areas of diabetes education. The Center diagnoses, treats, educates and helps patients manage this chronic disease. Certified diabetes educators serve all inpatients throughout Saint Peter's, and the hospital has a dedicated metabolic inpatient unit for patients with diabetes. The Center provides extensive inpatient and outpatient education and the most current diagnostics and treatments, including pump therapy. Surgery: Saint Peter's offers general surgery and specialized surgeries such as colorectal; ear, nose and throat (ENT); gynecological; oncological; plastic and reconstructive; urological; vascular and endovascular and orthopedic procedures for the hips, knees and spine. including hips, knees and spines and the Navio surgical system. Same-day procedures are performed in the CARES Surgicenter, which was named the "Best Ambulatory Surgery Center in New Jersey" by Newsweek magazine in 2022. General and specialty pediatric surgeries are performed and supported by the largest group of pediatric anesthesiologists in the area. Women's services include urogynecology, breast disease, general OB-GYN and midwifery services, and gynecologic oncology. The Women's Imaging Center provides diagnostic services including HologicGeniusT3D MammographyT and bone density testing. A complete program for the diagnosis and treatment of breast cancer is available through Saint Peter's Breast Center. The Department of Medical Genetics and Genomic Medicine counsels, diagnoses and treats individuals and families with a history of inherited diseases, including prenatal through adult services. The department serves as both a regional center for inherited metabolic disorders and a regional center for medical genetic”

“The Mary V. O'Shea Birth Center at Saint Peter's University Hospital -------------------------------------------------------------------- In 2019, the hospital opened the only midwifery-led, hospital-based birth center in New Jersey. The Mary v. O'Shea birth center experience is based on the midwifery model of care that embraces pregnancy and birth as a normal physiologic process, highlighting shared decision-making, minimal interventions, and the empowerment of women as partners in their care. The birth center, staffed by certified nurse-midwives, supports a natural birth without any pain medication. The Center is equipped to offer a variety of nonpharmaceutical pain management options including: - hydrotherapy - aromatherapy - nerve stimulation - sterile water papules - various massage techniques Other Services ============== The Center for Diabetes Self-Management Education diagnoses and treats children with diabetes and other endocrine disorders, emphasizing family management and support. The Center offers pump therapy to appropriate patients and support groups. The Craniofacial and Neurosurgical Center offers corrective surgery, multidisciplinary support and follow-up services and support groups for children born with cleft lip, cleft palate and other facial deformities. Members of the multidisciplinary medical team are active with operation smile and heal the children. The staff of the Center is recognized as a "cross-specialty team" one of the highest recognitions designated by the American cleft palate-craniofacial association (ACPA). The Dorothy B. Hersh Child Protection Center is a state-designated regional diagnostic and treatment center for child abuse prevention. The center identifies abuse, provides medical and psychological evaluation and referrals to victims and families, serves as expert witnesses and educates childcare and law enforcement professionals. It serves eight counties. The Child Protection Center was the only center of its type open during the pandemic. For KEEPS - (Kids Embraced And Empowered Through Psychological Services) provides mental health diagnoses and intensive treatment for area children, ages 5 through 17, who suffer from emotional or behavioral difficulties that negatively influence their ability to function successfully in a social environment. For KEEPS is a full-time day program where children receive academic instruction in addition to behavioral and psychological treatments through collaboration among doctors, nurses, social workers and counselors. Also, meeting the needs of the poor and underserved, Saint Peter's University hospital treats all patients, regardless of their ability to pay. This is evident by, but not limited to, the following: - operating more than 50 clinics and more than 146,000 visits in pediatric and pediatric subspecialties, adult medicine and subspecialties, women's health and subspecialties, and geriatric medicine and subspecialties. - Saint Peter's Sports Medicine Institute offers a multidisciplinary approach to treatment that recognizes the unique relationship between sports medicine, orthopedic surgery and physical rehabilitation. - The Simulation Center for Interprofessional Learning offers two separate and distinct specialty areas - an Institute for Bedside Medicine (IBM) and an Institute for Technical Simulation (ITS). Other community benefit programs/support groups/screenings: - Adult communities: Concordia, Clearbrook, The Ponds, Greenbriar at Whittingham, Rossmoor, and Stonebridge - Community Health Services Mobile Health Van - Pediatric Call Center - Family Health Center - adult, pediatric and women's health services- Thyroid and Diabetes Center - Geriatrics - Child Protection Center - Infection Control - Marketing and Media Relations - Pharmacy - Employee Health Services - Main Kitchen Food Services - Perinatal Services - Midwifery Services - Community Outreach - Opioid Task Force - Pastoral Care - Volunteer Services - Medical Library - Craniofaci”

“Leslie d. Hirsch, fache, is a voting board member/officer of the organization's board of trustees; an uncompensated postion. Mr. Hirsch is employed by a related organization and is involved in the leadership and management of saint peter's healthcare system, inc. Accordingly, his common law employer/employee relationship is with saint peter's healthcare system, inc. (ein: 26-2019056). Saint peter's healthcare system, inc. Filed a 2022 form 4720 which included a remittance of excise tax related to mr. Hirsch's compensation in excess of $1m.”

“Other changes in net assets or fund balances include: - non-operating net periodic pension cost - $876,453; - change in pension liability - $45,482,499; - net change in beneficial interest in foundation - ($329,000); - restricted gifts and contributions - ($5,000); - loss on extinguishment of debt - ($1,483,120); and - donated equipment and other changes in net assets - $1,350,000.”

“The organization is an affiliate within saint peter's healthcare system, inc. And affiliates; a tax-exempt integrated healthcare delivery system ("system"). The system's tax-exempt parent entity is saint peter's healthcare system, inc. An independent cpa firm audited the consolidated financial statements of saint peter's healthcare system, inc. And all entities within the system for the years ended december 31, 2022 and december 31, 2021; respectively. The audited consolidated financial statements contain consolidating schedules on an entity by entity basis. The independent cpa firm issued an unmodified opinion with respect to the audited consolidated financial statements each year. The system's audit and compliance committee has assumed responsibility for the oversight of the audit of the consolidated financial statements, which includes this organization, and the selection of an independent auditor.”

“The organization is an affiliate within saint peter's healthcare system, inc. And affiliates. The system engaged an independent accounting firm to prepare and issue a system wide consolidated audit as set forth in the uniform guidance, 2 c.f.r., part 200, subpart f.”