Hackensack Meridian Health Medical Group-Specialty Care PC

“Core form, part iii; question 1to serve as the physician services component of a tax-exempt integrated healthcare delivery network & to thereby promote, support & further the charitable purposes, programs & services of hackensack university medical center; a related internal revenue code section 501(c)(3) tax-exempt organization which provides medically necessary healthcare services to all individuals in a non-discriminatory manner regardless of race, color, creed, sex, national origin or ability to pay.”

“Core form, part vi, section a; question 6hackensack university medical center ("hackensackumc") is the sole member of this organization which exists through a physician nominee agreement due to state of new jersey corporate practice of medicine prohibitions. Hackensackumc has the ultimate authority and right to elect the members of this organization's board of trustees and has certain reserved powers as defined in this organization's bylaws.”

“Core form, part vi, section a; question 7asee response to part vi, question 6 above.”

“Core form, part vi, section a; question 7bsee response to part vi, question 6 above.”

“Core form, part vi, section b; question 8bthe organization's board of trustees does not have any committees. If it did have committees, the members would document the meetings held with minutes.”

“Core form, part vi, section b; question 11bthe organization is an affiliate in hackensack meridian health; a tax-exempt integrated healthcare delivery network. The organization's finance personnel prepared and reviewed the federal form 990. The organization's federal form 990 was then provided to and made available to each voting member of the organization's governing body, its board of trustees, prior to filing of the federal form 990 with the internal revenue service.”

“Core form, part vi, section b; question 12chackensack meridian health, inc., the tax-exempt parent organization of hackensack meridian health, a tax-exempt integrated health care delivery network, has adopted a network-wide conflict of interest policy which is applicable to all of its subsidiary organizations. The organizations regularly monitor and enforce compliance with the network's conflict of interest policy. Annually, all members of the board of trustees, officers and key employees of each organization are required to review the existing conflict of interest policy and complete a questionnaire with respect to any applicable transactions and relationships. The completed questionnaires are returned to the network's general counsel for review. General counsel then prepares a summary of the completed questionnaires, and presents the summary to the network's governance and board development committee for its review, discussion and action (if needed). During the year, general counsel also monitors on-going transactions in light of the summary to ensure that any potential conflicts of interest are appropriately handled in compliance with the policy. Although this organization is not a subsidiary, its board of trustee members are employed by subsidiaries of hackensack meridian health, inc. And are bound by the policy described above.”

“Core form, part vi, section b; question 15athe organization is an affiliate within a tax-exempt integrated health care delivery network in which hackensack meridian health, inc. Is the tax-exempt parent organization. The executive and physician compensation committee ("committee") of hackensack meridian health, inc. Is responsible for reviewing the executive compensation of the president and key employees (senior management) of the parent and all of the subsidiary organizations. The committee has adopted a written executive compensation philosophy, approved by the governing body, which it follows when it reviews and approves compensation and benefits.the executive compensation philosophy recognizes the size and complexity of the health care network and the critical need to have and retain executives that consistently demonstrate superior levels of performance so that the health network can fulfill its charitable mission.the committee reviews the "total compensation" of the individuals, including both current and deferred compensation and all employee benefits, both qualified and non-qualified on at least an annual basis to ensure that the "total compensation" of the president, other officers and each senior management key employee is reasonable.to assist with the review, the committee engages the services of a nationally recognized independent consulting firm specializing in executive compensation for not-for-profit health care organizations, and receives regional market data for comparable organizations, a report summarizing such data, and an opinion letter relating to the reasonableness of each executive's total compensation and benefits. Additionally, a senior member of the consulting firm attends the committee's meetings to provide information and to respond to questions by the members of the committee.the independent committee utilizes the outside market data comparability and based upon the organization's performance, business judgment considerations, and the individual's performance establishes compensation for each individual. The comprehensive review process utilized by the committee qualifies for the rebuttable presumption under section 4958 of the internal revenue code of 1986:1. 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 within the meaning of the regulations under section 4958;2. The authorized body obtains and relies upon "appropriate data as to comparability" prior to making its determination, which comparability data is provided and analyzed by sullivan cotter and associates, inc., a well-regarded expert in the area of not-for-profit health care compensation; and 3. The authorized body adequately documents the basis for its determination concurrently with making that determination, again as required in the regulations. As appropriate, the authorized body supplements the comparability data with other objective factors designed to ensure the reasonableness of the compensation paid, including an analysis of individual goals and objectives, organizational performance, personnel reviews, evaluations, self-evaluations, and written offers from competing organizations. The approved compensation arrangements by the executive committee are reported in executive session to the governing board by the senior member of the consulting firm.”

“Core form, part vi, section b; question 15bsee response to part vi, question 15a above.”

“Core form, part vi, section c; question 19the organization's filed certificate of incorporation and any amendments can be obtained and reviewed through the state of new jersey department of the treasury.”

“Core form, part vii, section athe organization is an affiliate within hackensack meridian health; a tax-exempt integrated healthcare delivery network ("network"), which includes hackensack university medical center ("hackensackumc"). The network includes both for-profit and not-for profit organizations. This organization's sole voting member, ihor s. Sawczuk, m.d., listed on core form, part vii and schedule j of this form 990 is the executive vice president/chief medical officer employed by hackensackumc and nominee owner of this organization due to corporate practice of medicine prohibitions. The hours reflected in core form, part vii of this form 990 for dr. Sawczuk represent the estimated hours devoted per week on behalf of the network; not solely this organization.”

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

“Core form, part xi; line 9other changes in net assets or fund balances include:- other changes in temporarily restricted net assets, ($1,126).”

“Core form, part xii; question 2cpricewaterhouse coopers, l.l.p. Audited the consolidated financial statements of hackensack meridian health, inc. For the six month period ended december 31, 2016, including this organization. Pricewaterhouse coopers, l.l.p. Issued an unqualified opinion with respect to the audited consolidated financial statements. The hackensack meridian health, inc. Compliance and audit 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.”