2024-11-04T16:58:58-06:00 2023-12-31 873231666 PKF O'CONNOR DAVIES ADVISORY LLC 300 TICE BOULEVARD SUITE 315 WOODCLIFF LAKE NJ 07677 990 2023-01-01 453125678 VALLEY PHYSICIAN SERVICES NY PC VALL 2014478000 15 ESSEX ROAD PARAMUS NJ 07652 WILLIAM KLUTKOWSKI SR. VP, FINANCE & CFO 2014478000 2024-11-04 1 1 EDWARD G O'CONNOR P00434443 2017129800 2024-10-31 2023 2024-10-15 13:58:12Z AUDREY MEYERS 15 ESSEX ROAD PARAMUS NJ 07652 11354450 0 X WWW.VALLEYHEALTH.COM/VALLEY-MEDICAL-GROUP X 2011 NY TO PROVIDE MEDICAL CARE AND TO CARRY OUT THE PURPOSES OF THE VALLEY HEALTH SYSTEM, INC. 19 18 31 22 0 0 0 12059 12569653 11342391 0 0 0 0 12569653 11354450 3347152 323263 0 0 6813007 8423965 0 0 0 2409493 2607222 12569652 11354450 1 0 2370017 2545441 1709887 1885311 660130 660130 X TO ENGAGE IN THE RENDERING OF PROFESSIONAL SERVICES OF AND RELATED TO THE PRACTICE OF MEDICINE PURSUANT TO "THE PROFESSIONAL SERVICES CORPORATION ACT, AND TO SUPPORT AND CARRY OUT THE CHARITABLE PURPOSE OF VALLEY HEALTH SYSTEM, INC. THE ORGANIZATION ALSO PROVIDED STRATEGIC FUNDING TO VALLEY HOSPITAL, INC. 0 0 10911026 323263 11342391 THE ORGANIZATION PROVIDED MEDICAL CARE TO A TOTAL OF 49,783 PATIENTS IN 2023 IN THE FIELDS OF CLINICAL CARDIAC ELECTROPHYSIOLOGY, INTERNAL MEDICINE, AND CARDIOLOGY. THE ORGANIZATION ALSO PROVIDED STRATEGIC FUNDING TO VALLEY HOSPITAL, INC. 10911026 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 4 0 31 1 0 0 0 0 0 0 0 0 0 0 0 0 X 19 18 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X MARIETTA STONE 2012916391 15 ESSEX ROAD PARAMUS NJ 07652 AUDREY MEYERS PRESIDENT & CEO, VHS 1.80 38.20 X X 0 2880401 52035 KEVIN LOBO CHAIR 0.10 0.50 X X 0 0 0 ANN LIMBERG VICE CHAIR 0.10 0.50 X X 0 0 0 FRANK J SHEEHY VICE CHAIR 0.10 0.50 X X 0 0 0 JOSEPH MARION TREASURER 0.10 0.50 X X 0 0 0 DENIS SALAMONE SECRETARY 0.10 0.50 X X 0 0 0 VINCENT FORLENZA CHAIR EMERITUS 0.10 0.50 X 0 0 0 JUDY BASELICE TRUSTEE 0.10 0.50 X 0 0 0 JAMES BUSH TRUSTEE 0.10 0.50 X 0 0 0 MICHELLE HASSON TRUSTEE 0.10 0.50 X 0 0 0 M SHAWN KENNEDY TRUSTEE 0.10 0.50 X 0 0 0 BRUCE MACTAS TRUSTEE 0.10 0.50 X 0 0 0 DUANE SACHS TRUSTEE 0.10 0.50 X 0 0 0 SCOTT SCHROEDER TRUSTEE 0.10 0.50 X 0 0 0 EDWARD B SELF MD TRUSTEE 0.10 1.00 X 0 0 0 STEVEN SILVERSTEIN TRUSTEE 0.10 0.50 X 0 0 0 JEFFREY TUCKER TRUSTEE 0.10 0.50 X 0 0 0 PATRICIA VERDUIN TRUSTEE 0.10 0.50 X 0 0 0 WAYNE WALD ESQ TRUSTEE 0.10 0.50 X 0 0 0 ROBERT W BRENNER PRESIDENT CLINICAL INTEGRATION/PHYSICIAN ENT. 3.00 37.00 X 0 1529833 29878 WILLIAM KLUTKOWSKI SR. VP, FINANCE & CFO 2.00 38.00 X 0 1079106 51469 SUNEET MITTAL PHYSICIAN 40.00 0.00 X 1378937 0 68048 DAN MUSAT MD PHYSICIAN 40.00 0.00 X 659466 0 30934 TINA SICHROVSKY MD PHYSICIAN 40.00 0.00 X 647185 0 56389 ADVAY BHATT MD PHYSICIAN 40.00 0.00 X 568412 0 49450 MARK PREMINGER MD PHYSICIAN 40.00 0.00 X 500581 0 38648 3754581 5489340 376851 12 0 1 0 0 12059 12059 PATIENT REVENUE 624100 7918632 7918632 MANAGEMENT FEE REVENUE 900099 2640656 2640656 MEDICAL SVCS. TO TVH 624100 783103 783103 11342391 11354450 11342391 0 0 X 323263 323263 7452559 7452421 138 126103 9344 116759 558775 535976 22799 286528 21232 265296 3899 3899 1390306 1390306 103602 69069 34533 58339 58339 568466 568466 3440 3440 87975 87975 84743 84743 CLINICAL SUPPLIES 199264 199264 CONTINUING EDUCATION 69135 69135 RECRUITMENT 20000 20000 MISCELLANEOUS EXPENSES 8760 8760 9293 9293 11354450 10911026 443424 0 329978 317603 1339634 2036723 43572 0 1512570 1445343 155203 67227 501630 123888 2370017 2545441 877118 1364026 832769 521285 1709887 1885311 X 660130 660130 660130 660130 2370017 2545441 0 0 X X 0 1 X 1 0 X 386370 237923 0 0 12059 636352 7719881 8573685 9742651 12569653 11342391 49948261 8106251 8811608 9742651 12569653 11354450 50584613 0 0 0 50584613 265 265 8106516 8811608 9742651 12569653 11354450 50584878 1.00000 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1511405 1445343 66062 1165 1165 67227 ESTIMATED 3RD PARTY PAYOR SETTLEMENTS 473148 LEASE LIABILITIES FOR OPERATING LEASE 48137 521285 X 323413051 315028926 315028926 8384125 2970325 2970325 11354450 309461785 301077660 301077660 8384125 2970325 2970325 11354450 PART X, LINE 2: VMG RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT TO BE SUSTAINED. MANAGEMENT HAS DETERMINED THAT VMG HAD NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION OR DISCLOSURE. VMG IS NO LONGER SUBJECT TO EXAMINATIONS BY THE APPLICABLE TAXING JURISDICTIONS FOR PERIODS PRIOR TO 2020. PART XI, LINE 2D - OTHER ADJUSTMENTS: REVENUE OF RELATED ENTITIES INCLUDED IN CONSOLIDATED FINANCIAL STATEMENTS 315,028,926. PART XI, LINE 4B - OTHER ADJUSTMENTS: MANAGEMENT FEE NETTED AGAINST EXPENSES IN CONSOLIDATED FINANCIAL STATEMENTS 2,640,656. GRANT TO RELATED ORGANIZATION NETTED AGAINST REVENUE IN CONSOLIDATED FINANCIAL STATEMENTS 323,263. BAD DEBT NETTED AGAINST PATIENT SERVICE REVENUE IN FINANCIAL STATEMENTS 6,406. PART XII, LINE 2D - OTHER ADJUSTMENTS: EXPENSES OF RELATED ENTITIES INCLUDED IN CONSOLIDATED FINANCIAL STATEMENTS 301,077,660. PART XII, LINE 4B - OTHER ADJUSTMENTS: MANAGEMENT FEE NETTED AGAINST EXPENSES IN CONSOLIDATED FINANCIAL STATEMENTS 2,640,656. GRANT TO RELATED ORGANIZATION NETTED AGAINST REVENUE IN CONSOLIDATED FINANCIAL STATEMENTS 323,263. BAD DEBT NETTED AGAINST PATIENT SERVICE REVENUE IN FINANCIAL STATEMENTS 6,406. 1 THE VALLEY HOSPITAL INC 223 NORTH VAN DIEN AVENUE RIDGEWOOD NJ 07450 221487307 501(C)(3) 323263 0 STRATEGIC FUNDING 1 PART I, LINE 2: THE ORGANIZATION PROVIDED PROGRAM FUNDING TO VALLEY HOSPITAL, INC. THE ORGANIZATION MONITORS THE USE OF THE FUNDS THROUGH COMMON MANAGEMENT. 0 1 0 0 0 0 0 1 0 AUDREY MEYERS PRESIDENT & CEO, VHS 0 1349573 0 1039480 0 491348 0 24750 0 27285 0 2932436 0 437682 ROBERT W BRENNER PRESIDENT CLINICAL INTEGRATION/PHYSICIAN ENT. 0 852454 0 366860 0 310519 0 14850 0 15028 0 1559711 0 0 SUNEET MITTAL PHYSICIAN 1219766 0 154269 0 4902 0 11550 0 56498 0 1446985 0 0 0 WILLIAM KLUTKOWSKI SR. VP, FINANCE & CFO 0 669565 0 204270 0 205271 0 21450 0 30019 0 1130575 0 0 TINA SICHROVSKY MD PHYSICIAN 539387 0 105176 0 2622 0 10802 0 45587 0 703574 0 0 0 DAN MUSAT MD PHYSICIAN 323222 0 334594 0 1650 0 10842 0 20092 0 690400 0 0 0 ADVAY BHATT MD PHYSICIAN 393486 0 173575 0 1351 0 7881 0 41569 0 617862 0 0 0 MARK PREMINGER MD PHYSICIAN 426119 0 70546 0 3916 0 10878 0 27770 0 539229 0 0 0 PART I, LINE 3 VALLEY HEALTH SYSTEM HAS DEVELOPED A COMPENSATION PLAN, WHICH GOVERNS THE COMPENSATION FOR ALL EXECUTIVES, INCLUDING THE CEO AND VICE PRESIDENTS OF THE ORGANIZATION. THE PLAN WAS DEVELOPED IN CONJUNCTION WITH A CONSULTING FIRM, REVIEWED BY THE PHYSICIAN LEADERSHIP COUNCIL AND APPROVED BY THE BOARD OF TRUSTEES AND THE VALLEY HEALTH SYSTEM PHYSICIAN COMPENSATION COMMITTEE. ON AN ANNUAL BASIS, THE PLAN IS REVIEWED AND UPDATED AS NEEDED. PART I, LINE 4B AUDREY MEYERS PARTICIPATED IN A CAP-EX (SPLIT-DOLLAR LIFE INSURANCE PLAN). SHE DID NOT RECEIVE A PAYMENT DURING 2023. AUDREY MEYERS AND WILLIAM KLUTKOWSKI PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN. AUDREY MEYERS RECEIVED A PAYMENT IN 2023 IN THE AMOUNT OF $437,682 AS REPORTED IN PART II, COLUMN BIII AND COLUMN F. PART I, LINE 7 EMPLOYEES OF THE ORGANIZATION RECEIVED A BOARD-APPROVED DISCRETIONARY BONUS, AWARDED BASED ON PERFORMANCE, AS REPORTED FOR THEM IN PART II, COLUMN B(II). FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION IS A PROFESSIONAL CORPORATION WITH SHAREHOLDERS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM. IT IS REVIEWED BY MANAGEMENT AND THE AUDIT COMMITTEE OF VALLEY HEALTH SYSTEM. A COMPLETE COPY OF THE FORM 990 IS MADE AVAILABLE TO ALL MEMBERS OF THE ORGANIZATION'S GOVERNING BODY PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE VALLEY HEALTH SYSTEM HAS A CONFLICT OF INTEREST POLICY WHICH COVERS ALL CONTROLLED ORGANIZATIONS WITHIN THE HEALTH SYSTEM, INCLUDING THIS ORGANIZATION. THE POLICY REQUIRES ALL TRUSTEES, OFFICERS, AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS, TO ANNUALLY SIGN A CONFLICT OF INTEREST STATEMENT, DISCLOSING ANY POTENTIAL CONFLICTS WHICH MAY EXIST. SUCH PERSONS ARE ALSO REQUIRED TO DISCLOSE ANY POTENTIAL CONFLICTS AS THEY ARISE. CONFLICTS ARE DETERMINED BY THE BOARD OF TRUSTEES OR DELEGATED COMMITTEE CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. PERSONS WITH CONFLICTS OF INTEREST MUST NOT PARTICIPATE IN THE DISCUSSION OR VOTE ON THE RELATED MATTER. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, AND GOVERNING DOCUMENTS AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G BILLING FEES: PROGRAM SERVICE EXPENSES 428,306. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 428,306. OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 802,334. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 802,334. TEMPORARY HELP: PROGRAM SERVICE EXPENSES 151,891. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 151,891. CONTRACTED SERVICE: PROGRAM SERVICE EXPENSES 3,465. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,465. WASTE SHREDDING SERVICES: PROGRAM SERVICE EXPENSES 2,378. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,378. LINENS: PROGRAM SERVICE EXPENSES 1,932. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,932. FORM 990, PART XII, LINE 2C: THE ORGANIZATION HAS A COMMITTEE RESPONSIBLE FOR THE OVERSIGHT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. THE VALLEY HOSPITAL FOUNDATION INC 223 NORTH VAN DIEN AVENUE RIDGEWOOD NJ 07450 222324554 SOLICITS AND RECEIVES CONTRIBUTIONS FOR THE BENEFIT OF HEALTH SYSTEM NJ 501(C)(3) LINE 7 VALLEY HEALTH SYSTEM INC 0 THE VALLEY HOSPITAL INC 223 NORTH VAN DIEN AVENUE RIDGEWOOD NJ 07450 221487307 PROVIDE HEALTHCARE PROGRAMS AND SERVICES TO ALL NJ 501(C)(3) LINE 3 VALLEY HEALTH SYSTEM INC 0 VALLEY HEALTH SYSTEM INC 223 NORTH VAN DIEN AVENUE RIDGEWOOD NJ 07450 222922016 PROVIDE MANAGEMENT AND PLANNING SERVICES FOR ITS MEMBERS NJ 501(C)(3) LINE 10 N/A 0 VALLEY HOME CARE INC 15 ESSEX ROAD PARAMUS NJ 07652 223208480 PROVIDE HOME CARE AND HOSPICE SERVICES TO RESIDENTS OF NORTHERN NJ NJ 501(C)(3) LINE 10 VALLEY HEALTH SYSTEM INC 0 VALLEY PHYSICIAN SERVICES INC 223 NORTH VAN DIEN AVENUE RIDGEWOOD NJ 07450 320041186 PROVIDES MANAGEMENT AND VARIED CONSULTING SERVICES NJ 501(C)(3) LINE 10 THE VALLEY HOSPITAL INC 0 VALLEY PHYSICIAN SERVICES PC 15 ESSEX ROAD PARAMUS NJ 07652 465285330 PROVIDE PRIMARY AND SPECIALTY MEDICAL CARE NJ 501(C)(3) LINE 10 VALLEY PHYSICIAN SERVICES INC 0 VHS INSURANCE COMPANY LTD 010 MAIN STREET CAYMAN ISLANDS CJ 980408200 PROVIDES PROFESSIONAL, MEDICAL, AND COMMERCIAL GENERAL LIABILITY INSURANCE CJ VALLEY HEALTH SYSTEM INC C 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1