Form 990 ~ ~ Return of Organization Exempt From Income …990s.foundationcenter.org/990_pdf_archive/221/...Form 990 ~ ~ Return of Organization Exempt From Income Tax Under section

Form 990 ~ ~ Return of Organization Exempt From Income Tax Under section 501(e), 527, or 4947(a)(7) of the Internal Revenue Code (except black lung

Department orineTreasury benefit trust or private foundation) " . internal Revenue Service " The organization may have to use a copy of this return to satisfy state reporting requirements A For the 2004 calendar ear or tax ear be Innln 2002 and endini

een, 9 Chackdapoksi preen, C Name of organization 0 Employer Identification number Adifte's IR3 22-1487173 ,h ..,. uso R1 ENGLEWOOD HOSPITAL AM HED3:CAL CENTER blotil or N.m .,Wrs to, Number and street (or P 0 box if mail is not delivered to str e E Telephone number inew s. tVTs`

S.. F..I s.

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350 ENGLE STREET 77~ (201)894-3275 A~.iided Instruc. City or town, state or country, and ZIP + 4 sl .~ _j Cash L-X1 Acmal A ,.iida,

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01Ir .r(.pdy) 11i ppkatIm don. NJ 07631-1808 F is Section 501(c)(3) organizations and 4947(a)(1) nonexempt charitable H and I am not applicable to section 527 nanizations trusts must attach a completed Schedule A (Form 990 or 990-EZ) His) Is this a group return for affiliates? E] Yes OX No

O Webslb 110ENGLEWOODHOSPITAI. COM H(b) If Yes, enter number of affiliates ll~ J organization type (check only one) 1 X 501 (c) (3 1 " (nun no ) 4947(a)(1) or 5]7 H(c) Are ell affiliates included? QYes ~No

(If "NO ' attach a list See instructions ) K Check here 1 d the organizations gross receipts are normally not mare than E25,000 The Hid) lemb0 aepaatermmnieaeyan

organization need not file a return with the IRS but if the organization received a Form 990 Package organization ce,,,x in the mail, it should ale a return without financial data Soma states require a complete return 1 Enter 4-digit GEN

M Check 1 u if the organization is not required

L Gross receipts Add lines 6b eb 9b and 1 Ob to line 12 Ils' 224 ,031 , 3 36 to attach Sch B (Form 990, 990-EZ or 990-PF) Revenue Ex enses and Changes in Net Assets or Fund Balances See pa g e 17 of the instrucLOns

1 Contributions, gifts, grants, and similar amounts recerveE a Direct public support _ 7 a 11 , 000 b Indirect public support 1 b 1 , 733 ,801 C Government contributions (grants) 1 C 1 , 454 , 980

"y d tool (add lines 71 through +c) (Cash s 3,199,781 nonnsn s ) 7 d 3 , 199 , 781 2 Program service revenue including government fees and contracts (from Part VII, line 93) 2 217 , 794 , 216 3 Membership dues and assessments 3 4 Interest on savings and temporary cash investments 4 648 , 793 5 Dividends and interest from securities 5

Z 6 a Gross rents 1 6a V b Less rental expenses 6b /j c Net rental income or (loss) (subtract line 6b from line 6a) 6e

7 Other investment income (describe ~ 7 19 , 000 8 a Gross amount from sales of assets other (A) Securities (e) other

u than inventory Be 190 , 000

b Less cost or other basis and sales expenses :b ! 83 314 e Gain or (loss) (attach schedule) t 106 686 d Net gain or (loss) (combine line Bc, columns (A) and (B)) STMT A Bd 106 , 686

9 Special events and activities (attach schedule) a Gross revenue (not including E of

contributions reported on line 1a) 9a ECEIVED U b Less C~rect expenses other thar~ fundra .s~ng expenses 9 b G Net income or (loss) from special events (subtract line 9b from line 9a)

10a Gross sales of inventory, less returns and allowances Oa b Less cost of goods sold o b e Gross profit or (loss) from sales of inventory (attach schedule) (subtract line 10b from line 102) , G D E N UT

1 7 Other revenue (from Part VII, line 103) X11 ~ 2 , 179 , 546

13 Program services (from line 44, column (B)) , ,

14 Management and general (from line 44, column (C))

a 7 5 Fundraising (from line 44, column (D))

7 6 Payments to affiliates (attach schedule)

G)3

Form 990 (2002) /v ail'

,. For Paperwork Reduction Act Notice, see the separate Instructions 2E7070 1 000

18 Excess or (deficit) for the year (subtract line 17 from line 12) Y w 19 Net assets or fund balances at beginning of year (from line 73, column (A)) a

20 Other changes in net assets or fund balances (attach explanation) ,S7= L $TM'P 2 71 \1s1 . .~~~~ - R~eA A .,I~ .i.sw n . - . .A w! e- /nnrn6 .nn I~nm 7A 10 -A 7A\

22-1487173 Form 990 (2002) I Page 2

Statement of All organizations must complete column (A) Columns (B) (C) and (D) are required for section 501(c)(3) and (4) organizations Functional Expenses and section 4947(a)(1) nonexempt charitable trusts but optional for others (See page 21 of the instructions )

(D) Fundraising (A) Total

22 Grants and allocations (attach schedule)

(cash s- noncashs 22

23 Specific assistance to individuals (attach schedule) _23

24 Benefits paid to or for members (attach schedule) _L4_

25 Compensation of officers, directors, etc 25 1 , 436 , 557 1 , 436 , 557 26 Other salaries and wages _L6_ 94 , 688 , 220 . 688 220 . 79 , 860 , 629 14 , 518 , 150 309 , 441 27 Pension plan contributions 27 3 , 848 , 263 3 , 244 , 856 590 , 708 12 , 699 28 Other employee benefits 28 5 , 510 , 039 4 , 646 , 065 845 , 791 18 , 183 29 Payroll fazes , 29 7,325,420 6 176 793 1 , 124 , 452 2-4 1 1-74 30 Professional fundraising fees 70 31 Accounting fees , 31 111 471 . 111 , 471 32 Legal fees 32 396 941 . 396 941 . 33 Supplies _L3_ 63 , 375 , 396 375 396 54 , 737 , 333 8 , 638 , 063 34 Telephone 34 601 , 788 60,179 541 , 609 ]5 Postage and shipping JS 211 , 730 211 , 730 36 Occupancy , , 36 286 , 724 286 . 724 37 Equipment rental and maintenance 37 2 , 712 , 832 . 2 , 287 , 460 416 , 420 8 , 952

38 Printing and publications 38 945 , 055 796 870 145 , 066 3 119

39 Travel 39 181 , 776 120 881 5-9 1 8-0-4 1 091

40 Conferences, conventions and meetings 40 80 , 895 33 , 652 47 , 243

41 Interest S 2 47 1 , 889 , 888 1 , 889 , 888 42

-A-1- Depreciation depletion etc (attach schedule) 42 10 , 625 , 210 8 , 959 , 177 1 , 630 , 970 35 , 063

43 Other exwnws not caveredaboa(nemua)i TM'P 3 43a 27,808,070 25 , 886 , 378 2 , 334 , 414 -412 , 722 b 3b e 430 d 3d e 3e

44 Total functional expenses (add lion ii through 43) OlpslIaUM, cmpueb

~coM~n (e}(oi. ~Y

44 meterombtonneet31 222 , 036 , 275 187 , 096 , 998 34 , 939 , 277 Joint Costs Check " d you are following SOP 98-2 Are any point costs from a combined educational campaign and fundraising solicitation reported in (B) Program services? " Yes No

II 'Yes," enter (q the aggregate amount of these point costs E , (ii) the amount allocated to Program services $

--------------------------------------------------------(Grants and allocations I

b

--------------------------------------------------------

--.._.... a

C

-------------------------------------------------------

-------------------------------------------------------

d

--------------------------------------------------------------------------------------------------------------

(Grants and allocations e Other program services (attach schedule) (Grants and allocations $ )

Jy 1 Total of Program Service Expenses (should equal line 44 column (B), Program services) " 187,096 , 998 2e,020 ,ooo Form 990 (2002)

What is the organizations pnmaryexempt purpose? " HEALTHCARL+ SERVICES (A HOSPITAL) " ~~~'"'

All organizations must describe their exempt purpose achievements in a clear and concise manner State the number (Requires for 5o1(c)(3) and

of clients served, publications issued, etc Discuss achievements that are not measurable (Section 501(c)(3) and (4) (^) args,anaa9a7(a)(t)

trusts but optional for organizations and 4947(a)(1) nonexempt charitable trusts must also enter the amount of proofs and allocations to others ) others )

a THE MEDICAI. CENTER_IS OPERATED-TO SERVE PUBLIC RATF~A_THAN _______________ __ ___ PRIVATE-INTERESTS __ SEE -ALSO-STATEMENT- 3A ._________------__________________

22-1487173 Form 990

(e) End o f year

1 .398 .045 13,334,912

36,068,417

4,465,159 1,728,579

61,450,093

85,822,647 40,613,820

244,881 .672 30,885,317

IAI Beginning of year

66 Total liabilities add lines 60 through 65 Organizations that follow SFAS 717, check here " .X and complete lines

67 through gg and lines 7? and ?9 d 67 Unrestricted

68 Temporarily restricted q 69 Permanently restricted m

Organizations that do not follow SFAS 117, check here t 7and complete lines 70 through 74

0 70 Capital stock, trust principal, or current funds 71 Paid-in or capital surplus, or land, building, and equipment fund , , 72 Retained earnings, endowment, accumulated income, or other funds

a 73 Total net assets or fund balances (add lines 67 through 69 or lines 70 through 72, column (A) must equal line 19, column (B) must equal line 21)

70

2E1030 1 aoo

nce Note Where required, attached schedules and amounts within the descnphon

45 Cash - non-interest-bearing 46 Savings and temporary cash investments

47a Accounts receivable 47a b Less allowance for doubtful accounts 476

48a Pledges receivable 48a b Less allowance for doubtful accounts , 48b

49 Grants receivable 50 Recervables from officers, directors, trustees, and key employees

(attach schedule) , 51a Other notes and loans receivable (attach

schedule) 57a w b Less allowance for doubtful accounts 1 511b N

52 Inventories for sale or use a 57 Prepaid expenses and deferred charges 54 Investments - securities (attach schedule) $~ 4, " 0 Cost ~ FMV 55a Investments - land, buildings, and

equipment basis SSa b Less accumulated depreciation (attach

schedule) ~ 55b ~ 56 investments - other (attach schedule) 57a Land, buildings, and equipment basis 57a 222 , 199 , 965

b Less accumulated depreciation (attach schedule) STMT ZA 57b 136 , 377 , 318

58 Other assets (describe " STMT 5 )

60 Accounts payable and accrued expenses 61 Grants payable 62 Deterred revenue

d 63 Loans from officers, directors, trustees, and key employees (attach - schedule) .°e 64a Tax-exempt bond liabilities (attach schedule) STMT SA

b Mortgages and other notes payable (attach schedule) $TRZT ¢ A 65 Other liabilities (describe " STMT 7_ )

67

Form 990 is available for public inspection and, for some people, serves as the primary or sofa source of information about a particular organization How the public perceNes an organization in such cases may be determined by the information presented on its return Therefore, please make sure the return is complete and accurate and fully describes, in Part III, the organizations programs and accomplishments

22-1487173 Form 990 (2002) 4

per

STMT 9 i 209,000 Add amounts on lines (t) and (2)

e Total revenue per line 12, Form 990

s Add amounts on lines (7) and (2) " d

e Total expenses per line 17, Form 990

List of Officers, Directors, Trustees, and Key Employees (List each one even if not compensated, see page 26 of

75 Did any officer, director, trustee, or key employee receive aggregate compensation of more than $100,000 from your organization and all related organizations, o! which more than $10,000 was provided by the related organizations? " O Yes aX No II "Yes; attach schedule - see page 26 of the instructions

Form 990 (2002)

JSA 7E7040 1 000

a Total revenue, gains, and other support per audited financial statements 1

b Amounts included on line a but not on line 12, Form 990

(1) Net unrealized gains on investments $

(2) Donated sernces and use of facilities $

(3) Recoveries of prior year grants , , $

(4) Other (specify)

STMT 8 S 485 .741 Add amounts on lines (1) through (4)

c Line a minus line b d Amounts included on line 12,

Form 990 but not on line a (7) Investment expenses

not included on line 6b, Form 990 f

(2) Other (specify)

a Total expenses and losses per audited financial statements

b Amounts included on line a but not on line 17, Form 990

(1) Donated services and use of facilities $

(2) Prior year adjustments reported on line 20,

Form 990 S

(3) Losses reported on

line 20,Form 990 $ 14,601,896 . (4) Other (specify)

S Add amounts on lines (1) through (4) 1

e Line a minus line b t d Amounts included on line 17,

Form 990 but not on line a (i) Investment expenses

not included on line

6b, Form 990 $ (2) Other (specify)

received a waver for prosy tax owed for the poor year

c Dues assessments, and similar amounts from members

86 501(c)(7) wgs Enter a Initiation lees and capital contributions included on line 12 b Gross receipts, included on line 12, for public use of club facilities;

87 50 1(c)(12) ags Enter a Grass income from members or shareholders b Gross income from other sources (Do not net amounts due or paid to other

7b

NONE NONE d Enter Amount of lax on line 89c, above, reimbursed by the organization

JSA 2H041 1 000

Other 78 Did the organization engage in any activity not previously reported to the IRS'! If "Yes," attach a detailed description of each activity 77 Were any changes made in the organizing or governing documents but not reported to the IRS?

II "Yes," attach a conformed copy of the changes

78a Did the organization have unrelated business gross income of $1,000 or more during the year covered by this return? , b If "Yes," has it filed a tax return on Form 990-7 for this yeah

79 Was there a liquidation, dissolution, termination, or substantial contraction during the year? II "Yes," attach a statement BO a Is the organization related (other than by association with a statewide or nationwide organization) through common

membership, governing bodies, trustees, officers etc to any other exempt or nonexempt organization? STMT 15

b If "Yes,' enter the name of the orpan¢ationiiii, and check whether R is X exempt or I )d nonexempt

B 1 a Enter direct or indirect political expenditures See line 87 instructions b Did the organization file Form 1120-POL for this year?

82 a Did the organization receive donated services or the use of materials equipment, or facilities at no charge or at substantially less than fair rental value')

b II "Yes," you may indicate the value of these items here Do not include this amount as revenue m Pan I or as en expense m Part II (See instructions m Part III

83 a Did the organization comply with the public inspection requirements for returns and exemption applications?

b Did the organization comply with the disclosure requirements relating to quid pro quo contributions?

84a Did the organization solicit any contributions or gifts that were not tax deductible b If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible')

85 501(c)(4), (5), or (6) organizations a Were substantially all dues nondeductible by members)

b Did the organization make only in-house lobbying expenditures of E2,000 or less?

If "Yes" was answered to either BSa or BSb, do not complete BSc through BSh below unless the organization

d Section 162(e) lobbying and political expenditures 185d I

e Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices 85e

1 Taxable amount of lobbying and political expenditures (line 85d less 85e) 851

g Does the organization elect to pay the section 6033(e) tax on the amount on line 85f?

h If section 6033(e)(1)(A) dues notices were sent does the organization spree to add the amount on line 85f to its reasonable

estimate of dues allocable to nondeductible lobbying and political expenditures for the following tax year?

sources against amounts due or received from them )

88 At any time during the year, did the organization own a 50% or greater interest in a taxable corporation or partnership . or an entity disregarded as separate from the organization under Regulations sections 301 7707-2 and 301 770137 If "Yes," complete Part IX

89 a 507(c)/3/ Organizations Enter Amount of tax imposed on the organization during the year under

section 4911 J~ NONE , section 4912 " NONE , section 4955

b 501/cl/3J end 501(c);a; orps Did the organization engage m an j section E95E e..ce;s benefit[ [ranwcion

during the year or did it become aware of an excess benefit transaction from a prior year? If "Yes," attach

a statement explaining sash transaction

c Enter Amount of tax imposed on the organization managers or disqualified persons during the year under sections 4912, 4955, and 4958 . , ,

90a List the states with which a copy of this return is filed ANEW JERSEY b Number of employees employed in the pay period that includes March 12, 2002 (See instructions) 90b 11934

91 The books are infareW 1 JAMES STANTON, CONTROLLER Telepnoneno " 201-894-3275 Locateoatl~ 350 ENGLE STREET, ENGLEWOOD, NJ ZIP+4 1 07631

92 Section 4947fe)(1) nonexempt charitable hosts fling Form 990 in heuW Fomr 1011 -Check here

and enter the amount of tax-exempt interest received or accrued dunng the tax year " 192 "~ N/A Form 990 (4007)

Note Enter graze amounts unless otherwise Unrelated business inc indicated (A) (a)

Amount 93 Program semce revenue code

a NET PATIENT b SERVICE REVENUE

c

d

e

f Medicare/Medicaid payments

g Fees and contracts horn government agencies

94 Membership dues and assessments

95 Interest an swings and bmpon7 cash Nwfbnanb

96 Dividends and interest from siecunlies

97 Net rental income or (loss) from real estate

a debt-financed property

b not debt-financed property 98 Nat unpi income or (laa) horn personal Prolparry,

99 Other investment income

100 Gain or (Iuss) nom uln of aueb omar Man Imenmry

101 Net income or (loss) from special events

102 Gross profit or poss) horn roles N imentoiy

103 Other revenue a

b STMT 16 -4 . 80 'c d

e

704 Subtotal (add columns (B) (D), and (E)) ~ ~ -

105 Total (add line 104, columns (B), (D) and (E)) Note Line 105 plus line 1d, Part l, should ague/ the amount on line 12, Part I

Related or rcSusion Amount exempt function COdC incnmn

110, 220,748,241

Line No I Explain how each activity for which income is reported in column (E) of Part VII contributed importantly to the accomplishment

(C) Nature of activities Total income

33 of the instructions

iEt050 1 000

Name address

(a) Did the organization during the year, receive any funds, directly or i (b) Did the organization, during the year, pay premiums, directly Note If "Yes"to !b) . file Form 8870 and Form 4 720 (see instrucho

Please Sign Here ' Daniel A . Kane

Type or print name and title

PrcparcYS _ Paid signature 1 PfOpafer5 Firm's name(oryours U58 Only i1 self-employed) ' 54

address and 21P " 4

J54

Total number of others receiving over $50,000 for professional services 11 26 For Paperwork Reduction Act Notice, sea the Instructions for Form 990 and Form 990.Q Schedule A (Form 990 or 990.Q) 2002 JSG 3E7310 1 000

SCHEDULER Organization Exempt Under Section 501(c)(3) OMB NO 15450047 (Form 990 of 990-EZ)

(Except Private Foundation) and Section 501(e), 601(~, 501(k), 501(n), or Section 4947(a)(1) Nonexempt Charitable Trust

Department d lheTrrasury Supplementary Information - (See separate instructions .) 2002 Internal Revenue Service " MUST be completed b the above organizations and attached to their Forth 990 or 990-Q Name of the organization Employer Identification number

ENGLEWOOD HOSPITAL AND MEDICAL CENTER 22-1487173

Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees (See page 1 of the instructions List each one If there are none, enter "None ')

(e) Name and address of each employee paid more (D) Title and e~xage (d) Contributions to (a) F~ense hours per meek (c) Compensation employee benefit plans 8 account and other than $50 000 .~ .~,., .n r~ .~ . .~n~~~ n.r....n - mro-r- .n.n-

Sl1RAH FIS1M6E 350 ENGLE STREET

DANIEL MARKHAM 350 ENGLE STREET

MICHAEL PIETROWICZ VP-NETWORKS 9VC9 350 ENGLE STREET ENGLEWOOD NJ 07631 4 0 HOURS

ICATHERINE COUSINEAU CHIEF PERFV9IONI

350 ENGLE STREET

THOMAS GRECO 350 ENGLE STREET

Total number of other employees paid over

Compensation of the Five Highest Paid Independent Contractors for Professional Services (See page 2 of the instructions List each one (whether indmduals or firms) If there are none, enter "None

(a) Name and address of each independent contractor paid more than $50 000 (b) Type of service (c) Compensation

NORHTERN VALLEY ANESTHESIOLOGY

ENGLE4lOOD_CARDIAC SURGERY_ ASSOCIATES-,_ PA_______

ENGLEWOOD_ PATHOIAGISTS-._ PA

ENGLEWOOD-RADIOIAGICAL ASSOCIATES-,_INC ---------

350 ENGLE STREET . ENGLEWOOD, NJ 07631

CLIFTON-HUDD_AND_DEMARIA - ----------------------

22-1487173 2

1 Does the organization make grants for scholarships, fellowships, student loans, etc 7 (See Note below

4 Do you have a section 403(b) annuity plan for your employees?

Note Attach a statement to explain how the organization determines that individuals a organizations receiving grants

The or anization is not a private foundation because it is (Please check only ONE applicable box ) 5 A church, convention of churches, or association of churches Section 170(b)(1)(A)(p 6 A school Section 170(b)(1)(A)(n) (Also complete Part V ) 7 X A hospital or a cooperative hospital service organization Section 170(b)(1)(A)(w)

8 ~ A Federal, state or local government or governmental unit Section 170(b)(1)(A)(v)

9 A medical research organization operated in conjunction with a hospital Section 170(b)(1)(A)(ni) Enter the hospital's name, city

and state " 10 El An organization operated for the benefit of a college or university owned or operated by a governmental unit Section 170(b)(1)(A)(rv)

(Also complete the Support Schedule in Part IV-A )

11a7 An organization that normally receives a substantial part of its support from a governmental unit or from the general public

F1,

Section 170(b)(1)(A)(vi) (Also complete the Support Schedule in Part IV-A )

11b A community trust Section 170(b)(1)(A)(h) (Also complete the Support Schedule in Part IV-A )

12 An organization that normally receives ji) more than sa iil% of its support from contributions, membership fees, and gross

receipts from activities related to its charitable, etc , functions-subject to certain exceptions, and (Z) no more than 33 1/3% of

its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired

by the organization after June 30, 1975 See section 509(x)(2) (Alw complete the Support Schedule in Part IV-A )

13 ~ An organization that is not controlled by any disqualified persons (other than foundation managers) and supports organizations

described in (1) lines 5 through 12 above, or (2) section 501(c)(4), (5), or (6), d they meet the test of section 509(x)(2) (See

section 509(x)(3)

(a) Name(e) of supported organization(s) I (b) Line number from above

14 I I An organization organized and operated to test for public safety Section 509(a)(4) (See pace 5 of the instructions ) JSA 2E 12M 1 00 Schedule A (Form 990 of 98o-Q) 3003

A (Form 990 or 990 EZI 2002

1 During the year, has the organization attempted to influence national, state, or local legislation, including any attempt to influence public opinion on a legislative matter or referendum? If "Yes," enter the total expenses paid or incurred in connection with the lobbying activities " E (Must equal amounts on line 38, Pan VI-A, or line i a Part VI-B ) Organizations that made an election under section 501(h) by filing Form 5768 must complete Part VI-A Other organizations checking `Yes ; must complete Part VI-13 AND attach a statement giving a detailed description of the lobbying activities

2 During the year has the organization, either directly or indirectly, engaged in any of the follovnng acts with any

substantial contributors, trustees, directors, officers, creators, key employees, or members of their families, or

with any taxable organization with which any such person is affiliated as an officer, director, trustee, majority

owner or principal benefinary7 (If the answer to any question is 'Yes,' attach a detailed statement explaining

the transactions )

a Sale exchange, or leasing of property)

b Lending of money or other extension of erectly , ,

c Furnishing of goods, services, or facilities? STMT 18

d Payment of compensation (or payment or reimbursement of expenses i( more than $1,000)7

e Transfer of any part of its income or assets?

Reason for Non-Private Foundation Status (See pages 3 through 5 of the instructions)

Calendar year (or fiscal year beginning in)

76 Gifts grants and contributions received (Do

19 Net income from unrelated business

activities not included in line 18

ZO Tax revenues levied for the organizations benefit and either paid to it or expended on its behalf

21 The value of services or facilities furnished to

the organization by a governmental unit

without charge Do not include the value al

services or facilities generally furnished to the

22 Other income Attach a schedule Do not

include pain or (loss) from sale of capital assets

28 Organizations described on lines 10 or 11 a Enter 2% of amount in column (e), line 24 jIQT "$IiTC"y$

b Prepare a list for your records to show the name of and amount contributed 6y each person (other than a

governmental unit or publicly supported organization) whose total gifts for 1998 through 2001 exceeded the

amount shown in line 26a Do not file this list with your return Enter the total of all these excess amounts

c Total support for section 509(a)(1) test Enter line 24, column (e)

d Add Amounts from column (e) for lines 18 19 22 26b

e Public support (line 26c minus line 26d total)

27 Organizations described on line 12 a For amounts included in lines 15, 16, and 17 that were received from a "disqualified person" prepare a list for your records to show the name of. and total amounts received in each year from, each "disqualified person" Do not file this list with your return Enter the sum of such amounts for each year

___270_T__APPLICABLE _AHL_E__ (1998) (2001) ________________ (2000) ___________________ (1999) b For any amount included in line 17 that was received from each person (other than "disqualified persons", prepare a list far your records to

show the name of, and amount received for each year, that was more than the larger of (1) the amount on line 25 for the year or (2) E5,000 (Include in the list organizations described in lines 5 through 11, as well as individuals) Do not file this list with your return After computing the difference between the amount received and the larger amount described in (1) or (2), enter the sum of these differences (the excess amounts) for each yeas (2001) ________________ (2000) ___________________ (1999) ___________________ (1998)_______________

c Add Amounts from column (e) for lines 15 16

17 20 21

d Add Line 27a total and line 27b total

e Public support (line 27c total minus line 27d total)

1 Total support for section 509(a)(2) test Enter amount tram line 23, column (e) " I Y7f g Public support percentage (line 27e (numerator) divided by line Y7f (denominator)) 111.

28 Unusual Giants For an organization described in line 10, 11 of 12 that received any unusual proofs during 1998 tnrougn LUUI prepare a list for your records to show, for each year, the name al the contributor the date and amount of the grant and a brief description of the nature of the grant Do not file this list with your return Do not include these grants in line 15

JSn Schedule A (Form 990 or 990.Q) 2002 2E1 221 1000

ScheCUle A Form 990 or 990 EZ 007 22-1487173 e 3 ~~Support Schedule (Complete only if you checked a box online 10, 11, or 12 ) Use cash method olacamt1mg?PLICABLE Note You may use the worksheet in the instructions for converting from the accrual to the cash method of accounting

77 Gross receipts from admissions merchandise

sold or services performed, or furnishing of

facilities in any activity that is related to the

18 Gross income from interest, dividends,

amounts received from payments on securities

loans (section 512(a)(5)), rents royalties, and

unrelated business taxable income (less

section 511 taxes) from businesses acquired

22-1487173

74a Does the organization receive any financial aid or assistance from a governmental agency

b Has the organization's right to such aid ever been revoked or suspended If you answered "Yes" to either 34a or b, please explain using an attached statement

35 Does the organization certify that it has complied with the applicable requirements of sections 4 01 through 4 05

Schedule A (Form 990 or 990-Q) 2002 i 000

Schedule A (Form 990 or 990 EZ) 2002 NOT APPLICABLE Page 0 Private School Questionnaire (See page 7 of the instructions ) (To be completed ONLY by schools that checked the box on line 6 m Part IV)

29 Does the organization have a racially nondiscriminatory policy toward students by statement in its charter, bylaws, Yes No other governing instrument, or in a resolution of its governing body 29

10 Does the organization include a statement of its racially nondiscriminatory policy toward students in all it brochures, catalogues, and other written communications with the public dealing with student admissions, programs, and scholarships 30

31 Has we organization publicized its racially nondiscriminatory policy through newspaper or broadcast media during the period of solicitation for students, or during the registration period if it has no solicitation program, in a way that makes the policy known to all parts of the general community it serves 31 If "Yes," please describe, if "No," please explain (If you need more space, attach a separate statement )

---------------------------------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------------------------------

12 Does the organization maintain the following a Records indicating the racial composition of the student body, faculty, and administrative staffs b Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory

basis? c Copies of all catalogues, brochures, announcements, and other written communications to the public dealing

with student admissions, programs, and scholarships d Copies of all material used by the organization or on its behalf to solicit contributions

If you answered "No" to any of the above, please explain (If you need more space, attach a separate statement ) ----------------------------------------------------------------------------------------------------------------------------------------------------------

33 Does the organization discriminate by race in any way with respect to

a Students' rights or privileges?

b Admissions policies?

e Employment of faculty or administrative staff

d Scholarships or other financial assistance

e Educational policies

T Use of facilrhes?

g Athletic proogram.Gl

h Other extracurricular activities?

If you answered "Yes" to any of the above, please explain (If you need more space, attach a separate statement

---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Schedule A Form 990 or EZ 2002 22-1487173 Page 5

habi Lobbying Expenditures by Electing Public Charities (See page 9 of the instructions ) Cfo be completed ONLY by an eligible orqanizaGon that filed Form 5768) NOT APPLICABLE

Affiliated group To be completed totals for ALL electing

organizations

If the amount on line 40 Is - The lobbying nontaxable amount Is -

Not over $500 000 2044 of the amount on line 40 ,

Over E500,000 but not over $1 000 000 $100,000 plus 15% of one excess over 5500 000

Over $1 000 000 but not over $1 500 000 $175,000 plus 10% of the excess over S7 000 000 41

Over E7 500,000 but not over $77 000 000 $225,000 plus 5% of tie excess over $1 500 000

Over S17 000 000 $1 000,000

42 Grassroots nontaxable amount (enter 25°.6 of line 41) 42

47 Subtract line 42 from line 36 Enter -0- if line 42 is more than line 36 43

44 Subtract line 41 from line 38 Enter -0- if line 41 is more than line 38 44

Lobbying Expenditures During 4-Year Averaging Period

(e) Total

(b) (a)

Grassroots lobbying

Lobbying Activity 6y Noneleecting Public Charities NOT APPLICABLE Part VI-A1 (See oaae 11 of the instru

During the year did the organization attempt to influence national, state or local legislation, including any Yes No Amount attempt to influence public opinion on a legislative matter or referendum, through the use of

a Volunteers b Paid staff or management (Include compensation in expenses reported on lines c through h ) c Media advertisements d Mailings to members, legislators, or the public e Publications, or published or broadcast statements T Grants to other organizations for lobbying purposes g Direct contact with legislators, their staffs, government officials, or a legislative body h Rallies, demonstrations, seminars, conventions, speeches, lectures, or any other means I Total lobbying expenditures (Add lines e through h )

If "Yes" to any of the above also attach a statement giving a detailed description of the lobbying activities Jsn Schedule A (Form 990 or B90-Q) 2002 7E 120 1 000

Check " a H if the organization belongs to an affiliated group Check " b if you checked "a" and "limited control" provisions apply

Limits on Lobbying Expenditures

(The term "expenditures" means amounts paid or incurred )

36 Total lobbying expenditures to influence public opinion (grassroots lobbying) 37 Total lobbying expenditures to influence a legislative body (direct lobbying) 38 Total lobbying expenditures (add lines 36 and 37) , , 39 Other exempt purpose expenditures 40 Total exempt purpose expenditures (add lines 38 and 39) 47 Lobbying nontaxable amount Enter the amount from the following table -

on if there is en amount on either tine 43 or6ne 44, you must file Form 4720 I I I 4-Year Averaging Period Under Section 501(h)

(Some organizations that made a section 501(h) election do not have to complete all of the five columns below See the instructions for

Calendar year (or fiscal vear beamnlna In) Lobbying nontaxable

Lobbying ceiling amount

Grassroots nontaxable

Grassroots ceiling amount

(c) I (d) 000 1999

Information Regarding Transfers To and Transactions and Relationships With Nonchanfable Exempt Organizations (See page 12 of the instructions )

Did the reporting organization directly or indirectly engage in any of the following with any other organization described in section 501(c) of the Code (other than section 501(c)(3) organizations) or in section 527, relating to political organizations? Transfers from the reporting organization to a noncharitable exempt organization of

57

(v) Loans or loan guarantees (vi) Performance of services or membership or fundraising solicitations Sharing of facilities, equipment, mailing lists, other assets, or paid employees II the answer to any of the above is "Yes," complete the follovnnp schedule Column (b) should always show the fair market value of the

goods other assets, or services given by the reporting organization If the organization received less than fair market value in any

52a Is the organization directly or indirectly affiliated with, or related to, one or more tax-exempt organizations described in section 501(c) of the Code (other than section 501(c)(3)) or in section 527 " D Yes [j No

7ei:5o 1 000 acneauie w trorm eau or ayu-ec) ~uu,

(i) Cash , (u) Other assets

b Other transactions (I) Sales or exchanges of assets with a noncharitable exempt organization (u) Purchases of assets from a noncharitable exempt organization (III) Rental of facilities, equipment, or other assets , , (Iv) Reimbursement arrangement

Basis Description Proceeds & Expenses Gain (Loss)

Total

STATEMENT A

Englewood Hospital and Medical Center EIN #22-1487173 For Year Ended December 31, 2002

Form 990, Par! I, Line 8

Open MRI Unit 190,000 83,314 106,686

106,686

STATEMENT 1

" ENGLEWOOD .HOSP,ITAL AND MEDICAL CENTER 22-1487173

FORM 990, PART I - OTHER INCREASES IN FUND BALANCES ---------- -------

DESCRIPTION AMOUNT ----------- ------

BOOK TAX DIFFERENCE IN PARTNERSHIP INCOME 485,741 .

FAS 136 ADJUSTMENT 90,139 . ------------

TOTAL 575,880 .

TOTAL

STATEMENT 2

" ENGLEWOOD HOSPITAL AND MEDICAL CENTER

FORM 990, PART I - OTHER DECREASES IN FUND BALANCES

DESCRIPTION

IASS ON INVESTMENT IN AFFILIATE MINIMUM PENSION LIABILITY ADJUSTMENT EXTRAORDINARY LASS ON EXTINGUISHMENT TEMP RESTRICTED NET ASSETS RELEASED

FROM RESTRICTIONS ROUNDING ADJUSTMENT

22-1487173

AMOUNT

19,433 . 11,320,794 . 3,281,102 .

315,000 . 2,167 .

------------14,938,496 .

Grand Total

STATEMENT 2A

Englewood Hospital and Medical Center E IN #22-1487173 For Year Ended December 31, 2002

FORM 990 PAGE 3 . PART IV, LlNE 57(a)

Depreciable Assets Land Improvements Building Fixed Equipment Mayor Movable Equipment

Non-depreciable Assets Land Construction m Progress

Total Land, Building and Equipment

Less Accumulated Depreciation

Total Fixed Assets

FOkV 990, PAGE 2. PART H. LINE 42

Depreciation Expense

Amortization Expense

2001 2002

$ 1,580,579 1,580,579 43,470,385 43,470,385 81,996,176 84,116,509 77,104,470 85,785,488

204,151,610 214,952,961

180,588 180,588 3,406,516 7,066,416

3,587,104 7,247,005

207,738,714 222,199,965

125,787,683 136,377,318

$ 81,951,031 $ 85,822,647

1 0,607,419

17,791

1 0,625,210

PROGRAM SERVICES

1,251,609 . 1,563,029 . 5,017,733 . 18054007 .

25886378 .

MANAGEMENT AND GENERAL FUNDRAISING ----------- -----------

1,003,722 . 917,970 .

DESCRIPTION

INSURANCE UTILITIES PHYSICIAN FEES PROVISION FOR DOUBTFUL ACCOUNT ALLOCABLE COSTS

TOTALS

412,722 . -412,722 . ---------- ----------2,334,414 . -412,722 . 27808070

50F43Y E481 08/20/2003 13 :39 :43 V02-7 .2 10819366 STATEMENT 3

ENGLEWOOD HOSPITAL AND MEDICAL CENTER

FORM 990, PART II - OTHER EXPENSES

TOTAL

2,255,331 2,480,999 5,017,733 18054007

22-1487173

History of the Medical Center

1800 1900 1930 1950 1960 1970 1980 1990 2000

On April 5, 1888, Mrs Sheppard Homans and Stephen Clarke, Esq . signed the articles of incorporation for The Englewood Hospital Association The mission was clear, " for the purpose of establishing a hospital in the Village of Englewood and therein to care for, cure, nurture and -maintain sick, injured, and indigent Infirm persons residing _ in or found within the Townships of Harrington, Palisade and Ridgefield " (These townships later became the Northern Valley's present communities.)

The Association purchased a three-acre trail of land for - ~W5 $1,048 and began construction in November 1889 Dedicated on June 14, 1890, the wooden building had a 25 X 28-foot central administration area flanked by two 12 X 28-Foot wings, which housed 12 beds. The cost of construction was $4,684 63 Englewood Hospital admitted its first patient on June 25, 1890 During Its first year, the Hospital treated 70 patients, and the medical staff performed 17 operations Ward patients paid a dollar a day In hospital costs . Demands on the Hospital Increased rapidly, and in 1893, its first addition was completed That same year, the endowment fund received its first gift-a $500 bond-and of the 123 patients treated that year, 100 received free care . Three years later, the Hospital established the Englewood Hospital Training School for nurses .

STATEMENT 3A

A second expansion completed in 1901accommodated a Men's Ward and a Women's Ward, each with 12 beds, and a

- Children's Ward with eight beds In addition, there were n.^c nurses' rooms

"" with sitting rooms and an isolation room, ~r y''x, dispensary, operating room, dining room,

kitchen and "many other necessities ." , g-aIn1906, the Hospital purchased more land

" ~ on its north side to provide a receiving .A ward, a maternity ward, a new isolation

room, new dining room, new kitchen and laundry. Growth continued to strain

facilities, spurring the need for another expansion . The Hospital's first building fund campaign raised $133,000, and in 1915, a new three-story brick building and a contagious disease pavilion opened .

During the World War I years, the Hospital fought many epidemics in succession*

Tremendous growth in every department of the Hospital was also apparent by that time . On the eve of the Depression, the Hospital's annual volume was some 56,000 patient days of service and more than 2,600 operations.

As the Depression era ended and the war era began, the Hospital was once again strained . By this time, new technology and

methane, surgery and drugs had shortened the length of a hospital advances in

Following World War II, welfare fringe benefits secured by labor contract expanded access to healthcare. Soon, private health insurance became a standard employee benefit In the mid-1960s, Medicare and Medicaid enhanced financial access for the elderly and poor . These programs translated

Infantile Paralysis in 1916, Scarlet Fever in 1917, and the deadly influenza epidemic in 1918, which cost thirty million lives worldwide . When the epidemic was over, hospital officials acted to expand the nursing program and provide adequate housing facilities for their nurses m training . The Englewood Inn and the property on which the Medical Center now stands were donated to the Hospital for this purpose . Pierce Hall, as it was known, was home to the Englewood nurses until the completion of a new facility in 1929

Population growth in the Northern Valley soon resulted in severe over-crowding, which induced a mayor new building program in 1923 . One million dollars was raised to build and equip new facilities, and in 1925, the Hospital moved into what is now the East Wing .

Englewood Hospital had grown to a 200-bed hospital with laboratory, x-ray facilities, an operating suite, pediatric, maternity and outpatient departments, including a public health nursing service, and a medical staff of 30 doctors including specialists m Eye, Ear, Nose and Throat, Pediatrics, surgery, x-ray and laboratory.

A new building to house the 120-student School of Nursing was completed in 1930

stay An era of "wonder drugs" was helping to treat and prevent many deadly and disabling diseases

Throughout the 1940s, the Hospital continued to introduce new services needed by the community or available because of technology It formalized the x-ray department, equipped with current technology and started its Plasma Bank, the county's first blood bank for whole blood. It also established gynecological, trrorchoscopy, gastroscopy and cardiac clinics .

By 1950, Englewood Hospital had emerged with a strong blend of facilities, equipment, medical staff and community support .

'

into a massive infusion of funds into healthcare delivery, spurring the need far more facilities and doctors . Additional federal and private funds became available for hospital construction, medical education and research .

[n the Iate1950s, the Board of Freeholders commissioned a survey titled, "A Hospital Plan for Bergen County." It recommended that the Hospital expand to 467 beds by 1965.

And so, the Hospital began its seventh decade with a $1.1 million building fund campaign. A new West Wing, dedicated in 1953, replaced two wings of the old clinic and provided 100 additional adult beds In 1956, a $4.5 million building program soon grew to be $7 million to fully expand the West Wing.

The expansion changed the face of the Hospital Pierce Hall was demolished and properly on Brownes Terrace was acquired to meet the ever-growing needs for more parking . Completed in 1965, the expansion provided needed facilities for the growing Public Health Services Department, including clinics and public health nursing, and other services such as emergency, cobalt therapy and pediatrics .

In the 1960s, a new dimension of patient care evolved `"' as the Hospital became more sophisticated and 91 treatment became more specialized .

The specialization trend in the 1960s bred a host of new - services, reflecting technology advances in equipment

and procedures As the medical and caring reputation of the Hospital grew, so did its role as a teaching facility ;

- ,- its nursing school was well established, and the Hospital _ - now had internships for doctors and dentists, and for

"~" ~ chaplains .

- s ~

In 1966, the first class of seven graduated from its new School of Radiology with training in such specialties as general x-ray, cobalt therapy and nuclear medicine . A

decade later, the School remained at the forefront, as CAT-scans and ultrasound equipment were developed to reduce radiation exposure while providing clearer images

As the Hospital celebrated its 75th anniversary, it was time to embark on its most expensive expansion and modernization program . A medical and administrative committee began by considering future needs-to reexamine and understand changes and trends in healthcare and their community-and to mold their vision of a changed hospital . They hired an architect to develop along-range Master Plan for future growth within the limits of available property And they organized the Hospital's largest fundraising effort ever-as estimated $12 million for a 280-bed wing and a 500-car parking lot . With loans, the project would eventually cost $18 million .

Urgent renovations to the existing plant were completed in 1971, and the new 11-story wing was dedicated in 1975 . The Dean Wing housed service areas and laboratories, central supply, the pharmacy, the morgue, diagnostic x-ray facilities, an emergency suite and a 16-bed special care unit . Additional areas were designated for Intensive Care facilities including two eight-bed cardiac units and a six-bed medical suite, and more patient facilities, increasing capacity by nearly one-third .

New patient care programs reflected the needs of the 1970s : a Neuroscience Center, a diabetes program, a vascular surgery program and a child health clinic . A new cardiology laboratory provided stress testing, echocardiography and other

Center, a new sis on family .

sophisticated screenings for coronary patients. A Crisis Intervention Birthing Center and a network of services supported the new empha

Advances in genetics and a better understanding of the body and its immune system would introduce "biotech" to the vocabulary, creating the expectation of a new generation of "miracle" drugs and treatments.

In the mid-1980s, the Hospital was designated a "mayor teaching facility" and expanded graduate s _ medical education for the attending staff . "

t

In the 1970s, new technology enabled doctors to diagnose and treat a range of vascular and cardiac problems, cancer and neurological disorders.

In the 1980s, advances in computers, lasers, and new technologies would again change diagnosis and treatment.

The 19805 also brought anew vocabulary of services, equipment and payment policies to the Hospital. CAT Scan, MRI, DRG, prospective payment, genetic counseling, imaging, catheterization, geriatrics, mammography, laparoscopy, ambulatory surgery, HMOs, PPOs, PPAs and

- - '-~ managed care . The decade also introduced a new array of alternative delivery systems that would require hospitals

across the nation to contend with decreasing occupancy rates and rising costs, and with new definitions of quality and competitiveness .

Simultaneously, hospitals faced competition from other hospitals and from alternative delivery systems-HMOs, freestanding ambulatory facilities, off-site diagnostic and rehabilitation centers . Hospitals that would continue to be successful would be those with a solid infrastructure, technology and a service mix responsive to their service area .

Englewood Hospital entered its 10th decade with a new state-approved five-year plan It called for a $9 million expansion and renovation to accommodate a new surgical suite, patient care floors and facilities to serve an increasing number of ambulatory (same-day surgery) and rehabilitation patients.

The new surgical facilities included a 14-bed operating room suite and a 28-bed recovery room Dean Wing floors seven and eight were completed and equipped with 86 beds as medical teaching and surgical care floors, they replaced an equal number of beds removed from service in other hospital areas .

The plan also included a new 360-car parking garage, the demolition of the North Wing and, m its place, construction of the Medical Center of Learning, which was dedicated in 1984 .

t

By 1990, Englewood Hospital was at the forefront of technological innovation. In 1986, Englewood became the state's first hospital to install an MRI . Soon, it obtained a second CAT Scanner, established a six-station, end-stage renal dialysis unit and created an aspiration cytology room to perform fine-needle biopsy studies

As heart and vascular treatment needs increased, the Hospital invested in new specialized facilities such as the Cardiac

Laboratory . In 1986, Englewood was the only hospital in the state the federally funded TIM[ (Thrombolysis in Myocardial Infarction), :e heart attack death and disability through drugs instead of

Catheterization to participate it a study to redu surgery

At the close of its first century of service, _, . w

tauili '_ -z

The Hospital's large-scale education and training facilities were vital to its plans to become a teaching center. In 1989, it became the first New Jersey affiliate of the Mount Sinai School of Methane and a member of the Mount Sinai Health System. By 1990, residency programs encompassed medicine, surgery, pediatrics, dentistry, pathology, obstetrics and gynecology, and a freestanding vascular fellowship.

The training facilities also enhanced the schools of Nursing and Radiography . The School of Radiography reflected changes in medical technology and the Hospital's investment in state-of-the-art developments Students received hands-on experience with the most sophisticated technological equipment including the CT Scanner, Digital Intravenous Angiography, Cardiac Catheterization, Gamma Camera, Fetal Monitoring, Bone Scanner, Linear Accelerator, Ultrasound and the newest non-invasive imaging equipment, the Magnetic Resonance Imager

New services followed in the wake of new knowledge and technology as well as community needs. Cancer was a growing concern, and the Hospital responded by creating a centralized Oncology Unit to offer skilled comprehensive care and support to cancer patients and their families . In the late 1980s, a Mammography Unit was created for diagnostic screening for breast cancer .

Child and family care continued to expand with a four-bed intermediate care unit for treatment of seriously dl children . A genetic counseling program offered amniocentesis and ultrasound testing e neonatology program --as formed in conjunction with New York Hospital/Cornell University Medical Center . And the Center for Child Health introduced a team approach for comprehensive pediatric h ealthca re .

Recognizing the importance of rehabilitation, the Hospital created the Center for Rehabilitation Medicine to help patients become fully functional following injury, stroke or other disability . In addition, it dedicated an eight-bed coronary care unit and a surgical intensive care unit . Continuing it outreach tradition, it established a Hospice program to Improve the quality of life for terminally dl patients m the home setting .

STATEMENT 3A

Englewood Hospital had grown to 547 beds-the largest voluntary acute care hospital in Bergen County and the third largest in New Jersey .

Englewood Hospital was fully accredited and about to become a mayor teaching hospital . A nursing staff of 800 and medical staff of 380 served more than 23,000 admitted patients and nearly 39,000 emergency cases . There were 11,000 operations and some 1,900 babies born . Clinic visits exceeded 15,000 and therapy visits 20,000 . Public Health nurses made more than 24,000 visits . The Hospital's workforce of more than 1,500 made it the largest employer in the area .

Such massive growth spurred other changes, too . A growing emphasis on quality, patient welfare and comfort led to the development of a Patient Advocacy Program-a model for the Bergen County area . The Hospital also established a discharge-planning program to help ease the transition from hospital to home. In 1990, Englewood Hospital celebrated its 100th anniversary . The next decade would see the Hospital grow and thrive, as it responded to new challenges and embraced new opportunities to build upon its rich heritage of a "Century of Caring "

Visit the Medical Center web site for information on current programs & activities.

ACCRUED INTEREST 4,399 . U .S . GOVERNMENT OBLIGATIONS 2,181,571 . MONEY MARKETS 1,665,228 .

--------------- TOTALS 3,851,198 .

STATEMENT 4


FORM 990, PART IV - INVESTMENTS - SECURITIES

BEGINNING DESCRIPTION BOOK VALUE ----------- ----------

22-1487173

ENDING BOOK VALUE

NONE NONE

61,450,093 . ---------------

61,450,093 .

DESCRIPTION

26,303,000 . NONE

---------------33,612,903 . TOTALS

STATEMENT 5

ENGLEWOOD,HOSPITAL AND MEDICAL CENTER

FORM 990, PART IV - OTHER ASSETS

DEFERRED BOND ISSUANCE COSTS OTHER RECEIVABLE NOTE RECEIVABLE - EMA, INC . NOTE RECEIVABLE - MED LIA ACCRUED PENSION EXPENSE CAPITAL LEASE RECEIVABLE - RMS INTEREST IN NET ASSETS OF

EFIPIC FOUNDATION DUE FROM AFFILIATES

BEGINNING BOOK VALUE

426,987 . 1,287,272 . 2,892,000 .

659,783 . 1,710,032 . 333,829 .

22-1487173

ENDING BOOK VALUE

2,538,374 . 8,169,568 . 2,371,043 .

659,783 . NONE NONE

26,392,745 . 482,307 .

---------------40,613,820 .

94,020,000 NONE

Original Issue Discount, net

STATEMENT SA

Englewood Hospital and Medical Center For Year Ended December 31, 2002

FORM 990. PAGE 3. PART VI. LINE 64(a)

Tax Exempt Bond Liability

$94,020,000 mortgage loan agreement which was made available through the proceeds of the New Jersey Health Care Facilties Financing Authority, Series 2002 revenue bonds Interest only is payable until February I, 2005 The mortgage is collateralized by a first hen on aubstanhally all of the Medical Center's assets and is insured by the Federal Housing Administration and MBIA

$29,585,000 New Jersey Health Care Facilities Financing Authority, Serves 1994 revenue bonds with interest rates ranging from 4 25% to 6 75% in varying matunties through July 1, 2024 Interest is payable each January I and July I and principal is payable each July I The bonds are collatenzed by a first lien on substantially all of the Medical Center's assets

12/31/01

EIN #22-1487173

12/31/02

26,510,000 NONE

(264,018) NONE

$ 26,245,982 $ 94,020,000

LENDER : CAPITAL LEASE OBLIGATION REPAYMENT TERMS : SEE ATTACHED STATEMENT FOR CAPITAL LEASE DETAIL

BEGINNING BALANCE DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,702,825 . ENDING BALANCE DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,969,952 .

---------------

** SEE ALSO STATEMENT 6A

STATEMENT 6


FORM 990, PART IV - MORTGAGES AND OTHER NOTES PAYABLE

TOTAL BEGINNING MORTGAGES AND OTHER NOTES PAYABLE

TOTAL ENDING MORTGAGES AND OTHER NOTES PAYABLE

5,702,825 .

"' 7,969,952 .

EIN 22-1487173 Englewood Hospital and Medical Center Summary of Capital Leases As of December 31, 2002

Inception Termination Implied Monthly Outspending Original Lessor Equipment Date Date Type APR Puymrnt Pnncipal Financed Amount

GE Healthcefc Finance 2 Nvkomed anesthesia machines 1011/1998 l0/1/2003 Capital 8494% 2,81600 27,094 73 177,275 00 GEHcaIthcareFinance Various medical equip-RMS#I 7/1/2000 6/1/2005 Capital 8174°/, 20,36000 550,74201 1,000,000 00 Cwcspnal-AmencenEquip Leasing Various medical equip-RMS#2 12/1/2000 10/1/2007 Capital 7605% 13,08200 (rt2,)1936 850,05950 IDB Leasing, Inc Venous medical cywp-RMSN2 17JI/2000 10/1/2007 Capital 7605% 7,69600 377,821 51 300,035 00 CITGmup Various medical equtp-RMSN2 11112000 10/1/2007 Capital 7605% 15,47000 759,563 58 1,005 .225 00 GE Healthcere Finance Various medical equip-RMSp2 12/V2000 10/12007 Capital 7605% 43,088 00 2,115,442 70 2,799,680 50 First American Equipment Finance 840 Ventilator System 4Y1J2001 4/712006 Capital 8801% 1,86360 64,402 I I 90,195 44 First American Equipment Finance Muluslice Cl' Scanner 12/12002 10/1/2007 Capful 5397% 46,015 00 2,394,231 11 2,415,000 00 Flect Hnlthcare Finance Computerized Radiology equipment 8/122002 8112/2007 Capital 5 530% 16,40000 807,832 85 857,962 70 Abbott Laboratories CeIIDyn 4000 Laboratory System 12/12002 7/31/2008 Capital -- 4,99200 230,500 00 230,500 00

Total Capital 171,78260 7,969,951 98 9,885,933 14

STATEMENT 6A

4,500,000 . 5,101,025 . 1,350,000 .

975,454 . NONE

11,926,479 . TOTALS

STATEMENT 7


FORM 990, PART IV - OTHER LIABILITIES

DESCRIPTION

ESTIMATED AMT DUE TO PAYORS RETIREE HEALTH BENEFIT PAYABLE IBNR MALPRACTICE CLAIMS DUE TO AFFILIATES (NET) ACCRUED PENSION

BEGINNING BOOK VALUE

22-1487173

ENDING BOOK VALUE

12,406,120 . 5,035,028 . 1,350,000 .

NONE 11,491,031 .

--------------- 30,282,179 .

22-1487173

FORM 990, PART IV-A - OTHER REVENUE ON BOOKS BUT NOT ON RETURN ------------

BOOK TAX DIFFERENCE IN PARTNERSHIPS

TOTAL

STATEMENT 8


DESCRIPTION AMOUNT

485,741 . ---------------

485,741 .

22-1487173

FORM 990, PART IV-A - OTHER REVENUE ON RETURN BUT NOT ON BOOKS

Gnnnov neoi no /on innno io .on .eo vnn^I o lno,nocc


DESCRIPTION AMOUNT ----------- ------

TEMP RESTRICTED CONTRIBTION ENGLEWOOD HOSP MED CTR FNDTN 190,000 .

TEMP RESTRICTED INV INCOME 19,000 . ---------------

TOTAL 209,000 .

STATEMENT 9

ELLIOT M . BROOKS SEN VP-HUMAN RES 221,813 . 25,594 . NONE C/O ENGLEWOOD HOSPITAL & MED CTR 40 HRS/WK 350 ENGLE STREET ENGI.EWOOD, NJ 07631

EDNA CADMUS SEN VP-PAT CARE SVC 208,738 . 24,014 . NONE 40 HRS/WK

STATEMENT 10 50F43Y E481 08/20/2003 13 :39 :43 V02-7 .2 10819366


FORM 990, PART V - LIST OF OFFICERS, DIRECTORS, AND TRUSTEES

CONTRIBUTIONS EXPENSE ACCT TITLE AND TIME TO EMPLOYEE AND OTHER

NAME AND ADDRESS DEVOTED TO POSITION COMPENSATION BENEFIT PLANS ALLOWANCES ---------------- ------------------- ------------ ------------- ----------

ANDREW F . DURKIN CHAIRMAN NONE NONE NONE

C/O ENGLEWOOD HOSPITAL & MED CTR


WILLIAM E . IX, JR . TRUSTEE NONE NONE NONE C/O ENGLEWOOD HOSPITAL b MED CTR



CONTRIBUTIONS EXPENSE ACCT TITLE AND TIME TO EMPLOYEE AND OTHER

DEVOTED TO POSITION COMPENSATION BENEFIT PLANS ALLOWANCES ------------------- ------------ ------------- ----------

TRUSTEE NONE NONE NONE



TRUSTEE NONE NONE NONE

22-1487173 ENGLEWOOD HOSPITAL AND MEDICAL CENTER


TITLE AND TIME NAME AND ADDRESS DEVOTED TO POSITION COMPENSATION ---------------- ------------------- ------------

C/O ENGLEWOOD HOSPITAL b MED CTR 350 ENGLE STREET ENGLEWOOD, NJ 07631

TRUSTEE NONE

ENGLEWOOD HEALTHCARE PROPERTIES, INC . ENGLEWOOD HSOPITAL AND MEDICAL CENTER FOUNDATION, INC ENGLEWOOD HEALTHCARE ENTERPRISES, INC . ENGLEWOOD HEALTHCARE SYSTEM, INC . ENGLEWOOD MEDICAL ASSOCIATES, INC .

STATEMENT 15

ENGLEWOOD,HOSPITAL AND MEDICAL CENTER

FORM 990, PART VI - NAMES OF RELATED ORGANIZATIONS ----- - - ------ - ----

22-1487173

EXEMPT EXEMPT NON-EXEMPT EXERT EXEMPT

22-1487173

FORM 990, PART VII - OTHER REVENUE

BUSINESS EXCLUSION CODE AMOUNT CODE AMOUNT ---- ------ ---- ------

3 37,699 . 3 537,201 . 3 66,000 . 3 96,879 . 3 25,503 . 3 74,934 .

3 201,493 .

622000 -4,808 .

GIFT SHOP RENT CAFETERIA SALES COFFEE SHOP RENT TELEPHONE INCOME VENDING MACH COMM TELEVISION CHARGES PARKING GARAGE COMPLEX RECEIPTS

PERINATAL PAT EDUC TUITION-NURSING TUITION-RADIOLOGY EMP PRESCRIPT FEE MEDICAL RECORD FEE RADIOLOGY COPY FEE SMOKING CESSATION PURCHASE DISCOUNTS INCOME FROM PARTNERSHIP

COMPLEMENTARY CARE REIM - DEVELOP EXP OTHER RENTAL CRITICAL ('.ARE REIM HEALTHSTART PHY RE SALVAGE RECOVERY EMS EDUCATION INC . I6R REIM-MT . SINAI INSERVICE EDUC . MISC . REIMB .

STATEMENT 16 50F43Y E481 08/20/2003 13 :39 :43 V02-7 .2 10819366


DESCRIPTION RELATED OR EXEMPT FUNCTION INCOME

34,559 . 355,165 . 45,168 . 32,352 . 1,597 .

11,459 . 1,100 .

40,607 .

22,428 . 21,277 . 61,888 .

234,527 . 60,413 . 86,555 . 13,309 . 68,639 . 48,723 . 1,490 . 3,389 .


FORM 990, PART VII - OTHER REVENUE

BUSINESS CODE AMOUNT

EXCLUSION CODE AMOUNT

------------ 1,039,709 . TOTALS -4,808 .

STATEMENT 17 50F43Y E481 08/20/2003 13 :39 :43 V02-7 .2 10819366

DESCRIPTION

22-1487173

RELATED OR EXEMPT FUNCTION INCOME ---------------

------------1,144,645 .

SEE FORM 990, PART V

STATEMENT 18

ENGLEWOOD .HOSPITAL AND MEDICAL CENTER

SCHEDULE A, PART III - EXPLANATION FOR LINE 2D

22-1487173

3a If this application is for Form 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less any nonrefundable credits See instructions $

b If this application is for Form 990-PF or 990-T, enter any refundable credits and estimated .tax payments . made Include any prior year overpayment allowed as a credit , , , . , $

c Balance Due Subtract line 3b from line 3a Include your payment with this form, or, i1 required, deposit . with FTD coupon or, if required, by using EF"fPS (Electronic Federal Tax Payment System) See instructions $

Signature and Verification Undw ;^n:"l_-s of pc :,. : :,, I d:cl3re :Nat : ho .a examined ;;,s ;a�-� Incl �Cirv ei.cumpanpng schedules ena statements, em to lie best of my knowledge and ballet it is true, correct, end complete, and that 1 em authorized to prepare this forth

Title Date see Instruction 868 (12-7000)

JSA tFl054 1 WO

5QF43Y E481 04/14/2003 12 52 17 V02-5 10819366

Form 8868' ~ Application for Extension of Time To File an (December 2000) Exempt Organization Return OMB No 1545-1709 Department of the Treasury Internal Revenue Service " File a separate application for each return

" If you are filing for an Automatic 3-Month Extension, complete only Part I and check this box . . , . 10. If you are filing for an Additional (not automatic) 7-Month Extension, complete only Part II (on page 2 of this form)

Note- Do notcomplete Part l1 unless you have already been granted an automatic 3-month extension on a previously filed Form 8868 .

Automatic 3-Month Extension of Time - Only submit original (no copies needed) Note : Form 990.Tcorporadons requesting an automatic 6-month extension -check this box and complete Poll 1 only ii- Fx_] All other corporations (including Form 990-C Biers) must use Form 7004 to request an extension o/ time to file income fax returns Pertnershins REMICs and trusts must use Form 8736 to request en extension of time to file Form 1065 . 7066 . or 1041 i ype or name or uempt ~~iyarncauun cmpie

print ENGLEWOOD HOSPITAL AND MEDICAL CENTER 22

Fire by the due Number, street, and room or suite no II a P O box, see instructions

date for fling 350 ENGLE STREET your return See instructions City, town or post office, state, and ZIP code For a foreign address, see instructions

ENGLEWOOD NJ 07631-1808 Check type of return to be filed (file a se crate application for each return)

Form 990 X Form 990-T (corporation) Farm 4720 Forth 990-BL I I Form 990-T(sec 401(a) or 408(a) trust) I I Form 5227 Form 990.EZ B Form 990-T (trust other than above) e Form 6069 Form 99o-PF Form 1041-A Form 8870

" If the organization does not have an office or place o1 business in the United States, check this box . . . . , . " a If this is for a Group Return, enter the organization's tour digit Group Exemption Number (GEN) If this is

for the whole group, check this box " F-1 If it is for part of the group, check this box " and attach a list with the names and EINs of all members the extension unit cover 1 I request an automatic 3-month (6-month, for 990-T corporation) extension of time until 11/17 . 2003

to file the exempt organization return for the organization named above The extension is for the organization's return for g calendar year 2002 or

lax year beginning , and ending

2 If this tax year is for less than 12 months, check reason a Initial return a Final return O Change in accounting period

Signature " ̀"(t For Paperwork

Type or Number and street (include suite, room, or apt no ) Or a P O box number pint

5451 7.AICEVIEW PARKWAY S DR City or town, province or state, and country (including postal or ZIP code)

Js'. INDIANAPOLIS IN 46268 sseos5iooo Form8868 (t2-7000)

5QF43Y E481 08/01/2003 13 :31'38 V02-7 2 10819366

germ $859 (12 2000) Page 2 " If you ere filing for "an Additional (not automatic) 3-Month Extension, complete only Part II and check this box , , , , . , , Note : Only complete Part U h you have already been granted an automatic 3-month extension on a previously filed Form 8868. " If you ere filing far an Automatic 3-Month Extension, complete only Part I ton vane 1)

Additional not automatic 3-MOntn txtension of Time - Must File Original and One Co

Type or Name of Exempt Organization " ~ Employer Identification number

v:5 �

print ENGLEWOOD HOSPITAL AND MEDICAL CENTER 22-1487173 File by the Number, street, and room or suite no II a P O box, see instructions For IRS use only extended due aete for 350 ENGLE STREET filing the City, town or post office, state, and ZIP code for a foreign address, see instructions

instructions ENGLEWOOD NJ 07631-1808 Check type of return to be filed (File a separate application far each return) ~`~ ^ '^

Form 990 R Form 990-EZ R Form 990-T (sec 401(a) or 408(a) trust) RForm 1041-AR Form 5227 ~ Form 8870 n Form 990-BL Form 990-PF Form 990-7 (trust other than above) Form 4720 Form 6069 STOP: Do not complete Part 11 If you were not already granted an automatic 3-month extension on a previously flied Form 8868 .

" It the organization does not have an once or place of business in the United States, check this box , , , , , , , , , , , , , , , " If this is for a Group Return, enter the or anizatiori s four digit Group Exemption Number (GE N If this s for the whole group, check this box " ~ If it is for part of the group, check this box " and attach a list with the names and EINs of all members the extension is for 4 I request an additional 3-month extension of time until 11/17/2003 6 For calendar year 2002 , or other tax year beginning and ending 6 If this tax year is for less than 12 months, check reason Initial return Final return Change in accounting period 7 State m detail why you need the extension

ADDITIONAL TIME IS NEEDED TO COLLECT ALL THE INFORMATION NECESSARY TO FILE A COMPLETE AND ACCURATE RETURN

Ba If this application is for Form 990-BL, 990-PF, 990-T, 4720, or 6069, enter the tentative tax, less any nonrefundable credits See instructions

b If this application is for Form 990.PF, 990-T, 4720, or 6069, .enter any refundable credits and estimated tax payments made Include any prior year overpayment allowed as a credit and any amount paid previously with Form 6868

. " , , , , , , , , , , , , , , , , , . , ,

e Balance Due, Subtract line Bbfrom line Ba Include your payment with this form, or, if required, deposK with FTD coupon or, if required, by using EFTPS (Electronic Federal Tax Payment System) See instructions . . S

Signature and Verification Under penalties of perjury, I declare that I eve examined tam form, including etcompariying schedules end statements, end 1o file best of my knowledge and belief, It is true, correct, and complete, and that I em authorized to prepare this form

~~ Notice to Applicant - To Be Completed by the IRS ~ ' We have approved this appl(cation Please attach this loan to the organization's return We have not approved this application However, we have granted a 10-day grace period from the later o! the date shown below or the due date of the organizations return (including any prior extensions) This grace period is considered to be a valid extension of time for elections otherwise recurred to be made on a limply return Please a"ach th.s!orr to ihx orgarilzation't; return We have not approved this application Alter considering the reasons stated in item 7, we cannot grant your request for an extension of time to file We are not granting a 10-day grace perw0 We cannot consider this application because it was tiled after the due date of the return for which an extension was requested Other

Duecta Date Alternate Mailing Address - Enter the address if you want the copy of this application for an additional 3-month extension

Name

Documents

Form 990 ~ ~ Return of Organization Exempt From Income …990s.foundationcenter.org/990_pdf_archive/221/...Form 990 ~ ~ Return of Organization Exempt From Income Tax Under section