4A (Expenses $ 309154291 including grants of $ 2693) (Revenue $ 315140594)
EXPENSES INCURRED IN PROVIDING INPATIENT, OUTPATIENT, EMERGENCY AND VARIOUS OTHER MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN OR ABILITY TO PAY AND IN FURTHERANCE OF CHARITABLE TAX-EXEMPT PURPOSES. PLEASE REFER TO THE COMMUNITY BENEFIT STATEMENT IN SCHEDULE O.

SCHEDULE H, PART V, SECTION B, QUESTION 5
"IN ITS MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT (""CHNA"") THIS ORGANIZATION TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY ITS HOSPITAL FACILITIES. CENTRASTATE MEDICAL CENTER IS A FOUNDING MEMBER OF THE HEALTH IMPROVEMENT COALITION OF MONMOUTH COUNTY (HICMC) AND HAS A SEAT ON THE ORGANIZATION'S SEVEN-MEMBER STEERING COMMITTEE, ALONG WITH REPRESENTATIVES OF COUNTY AND LOCAL HEALTH DEPARTMENTS AND OTHER MONMOUTH COUNTY HOSPITALS. ORGANIZED IN 2005, HICMC, WITH THE COOPERATION OF THE GOVERNMENTAL PUBLIC HEALTH PARTNERSHIP OF MONMOUTH COUNTY, AREA AGENCIES, ORGANIZATIONS, HEALTHCARE PROVIDERS INCLUDING ALL FIVE HOSPITALS IN MONMOUTH COUNTY, AND INDIVIDUALS, HAS COLLABORATED TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) EVERY FIVE YEARS (2007-2011, 2012-2016 AND 2017-2019). THE CURRENT MONMOUTH COUNTY PLAN WAS COMPLETED IN 2018 AND IS FOR THE YEARS 2018-2022 AND INCLUDES THE COMMUNITIES OF WESTERN MONMOUTH COUNTY CENTRASTATE IS ALSO A PARTICIPATING MEMBER OF THE OCEAN MONMOUTH HEALTH ALLIANCE, THE PREVENTION COALITION OF MONMOUTH COUNTY, THE FREEHOLD AREA MUNICIPAL ALLIANCE AND NEIGHBORHOOD CONNECTIONS TO HEALTH. FOR THE PURPOSES OF THIS CHNA, CENTRASTATE MEDICAL CENTER, INC. ALSO REVIEWED THE CHNA'S AND CHIP'S OF ADJACENT COUNTIES, SPECIFICALLY OCEAN, MERCER AND MIDDLESEX, AND CONDUCTED SURVEYS THROUGHOUT THE COMMUNITIES SERVED BY CENTRASTATE MEDICAL CENTER, INC. BOTH ELECTRONICALLY AND VIA HARD-COPY AND DETERMINED THE RESULTS WERE CONSISTENT WITH THE MONMOUTH COUNTY ASSESSMENTS AND PLANS UPON WHICH CENTRASTATE MEDICAL CENTER, INC. BASED ITS CHNA. A BASE ""SECONDARY DATA PROFILEAN ""URBAN PROFILE"" WERE PREPARED FOR MONMOUTH COUNTY BY HOLLERAN CONSULTING OF PHILADELPHIA THAT INCLUDED DEMOGRAPHIC AND HOUSEHOLD INFORMATION, MORTALITY RATES, COMMUNICABLE DISEASE RATES AND CANCER INCIDENCE AND MORTALITY RATES. THE PROFILES WERE UPDATED PERIODICALLY. COPIES OF BOTH STUDIES ARE AVAILABLE IN THE CENTRASTATE MEDICAL CENTER, INC. COMMUNITY RELATIONS OFFICE. THE COALITION EXAMINED SCIENTIFIC SURVEY DATA FROM NEARLY 600 HOUSEHOLDS, AS WELL AS FOCUS GROUP FEEDBACK. CENTRASTATE MEDICAL CENTER, INC. FURTHER REVIEWED THE HEALTHY NEW JERSEY 2020 OBJECTIVES, BASELINES, AND TARGETS. BECAUSE MANY OF THE STATISTICS REFLECT AVAILABLE COUNTY-WIDE OR STATE-WIDE DATA, CENTRASTATE MEDICAL CENTER, INC. CONDUCTED AN ADDITIONAL SURVEY AS WELL AS SEVERAL INTERVIEWS AND MEETINGS DESIGNED TO FURTHER IDENTIFY THE HEALTH NEEDS PARTICULAR TO WESTERN MONMOUTH COUNTY. THE RESULTS WERE RANKED ACCORDING TO SEVERITY AFTER CONSULTATIONS WERE CONDUCTED BETWEEN CENTRASTATE MEDICAL CENTER, INC. CHNA LEADERSHIP AND THE PUBLIC HEALTH OFFICERS SERVING MONMOUTH COUNTY AS WELL AS EACH OF THE COMMUNITIES IN WESTERN MONMOUTH COUNTY TO IDENTIFY THE SIGNIFICANT HEALTH NEEDS OF THE CENTRASTATE MEDICAL CENTER, INC. COMMUNITIES."

SCHEDULE H, PART V, SECTION B, QUESTIONS 6A & 6B
CENTRASTATE MEDICAL CENTER IS A FOUNDING MEMBER OF THE HEALTH IMPROVEMENT COALITION OF MONMOUTH COUNTY (HICMC) AND HAS A SEAT ON THE ORGANIZATION'S SEVEN-MEMBER STEERING COMMITTEE, ALONG WITH REPRESENTATIVES OF COUNTY AND LOCAL HEALTH DEPARTMENTS AND OTHER MONMOUTH COUNTY HOSPITALS. ORGANIZED IN 2005, HICMC, WITH THE COOPERATION OF THE GOVERNMENTAL PUBLIC HEALTH PARTNERSHIP OF MONMOUTH COUNTY, AREA AGENCIES, ORGANIZATIONS, HEALTHCARE PROVIDERS INCLUDING ALL FIVE HOSPITALS IN MONMOUTH COUNTY, AND INDIVIDUALS, HAS COLLABORATED TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) EVERY FIVE YEARS (2007-2011, 2012-2016 AND 2017-2019). THE CURRENT MONMOUTH COUNTY PLAN WAS COMPLETED IN 2018 AND IS FOR THE YEARS 2018-2022 AND INCLUDES THE COMMUNITIES OF WESTERN MONMOUTH COUNTY CENTRASTATE IS ALSO A PARTICIPATING MEMBER OF THE OCEAN MONMOUTH HEALTH ALLIANCE, THE PREVENTION COALITION OF MONMOUTH COUNTY, THE FREEHOLD AREA MUNICIPAL ALLIANCE AND NEIGHBORHOOD CONNECTIONS TO HEALTH.

SCHEDULE H, PART V, SECTION B, QUESTIONS 7A & 7D
"THE ORGANIZATION IS AN AFFILIATE WITHIN CENTRASTATE HEALTHCARE SYSTEM, INC.; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM (""SYSTEM""). DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN SCHEDULE H, PART V, SECTION B, QUESTION 7A, IS THE HOME PAGE FOR THE SYSTEM. THE CHNA CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: https://www.centrastate.com/wp-content/uploads/sites/9/2020/01/CHNA-and-Im plementation-Plan-2020-FINAL-Board-to-approve-December-122019-002.pdf"

SCHEDULE H, PART V, SECTION B, QUESTION 10A
"THE ORGANIZATION IS AN AFFILIATE WITHIN CENTRASTATE HEALTHCARE SYSTEM, INC.; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM (""SYSTEM""). DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN SCHEDULE H, PART V, SECTION B, QUESTION 10A, IS THE HOME PAGE FOR THE SYSTEM. THE IMPLEMENTATION STRATEGY CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: https://www.centrastate.com/wp-content/uploads/sites/9/2020/01/CHNA-and-Im plementation-Plan-2020-FINAL-Board-to-approve-December-122019-002.pdf"

SCHEDULE H, PART V, SECTION B, QUESTION 11
"THE ORGANIZATION'S IMPLEMENTATION STRATEGY DESCRIBES THE COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE ORGANIZATION'S CHNA. THROUGH THE ASSESSMENT OF ITS COMMUNITIES THE ORGANIZATION IDENTIFIED THE FOLLOWING KEY PRIORITIES: OBESITY, SUBSTANCE ABUSE, MENTAL HEALTH, ACCESS TO HEALTH CARE, AND TRANSPORTATION. THE ORGANIZATION INTENDS TO TAKE THE FOLLOWING ACTIONS WITH RESPECT TO EACH IDENTIFIED COMMUNITY HEALTH NEED. Significant Health Need #1: Mental Health (Substance Abuse [including vaping] and Suicide) Strategies: ----------- Mental Health ------------- Collaborate with the Monmouth County Mental Health Director on strategies and programs to address mental health issues. Consult with elected and appointed state officials to regulate mental health insurance to increase access to mental health services, including treatment for substance use disorders. Identify strategies on how to publicize the availability of mental health programs. Substance Abuse --------------- Collaborate, share resources and develop programming (particularly vaping) with the local Municipal Alliances for the Prevention of Substance Abuse for programming and education in the community and particularly in the schools. Partner with the local Municipal Alliances in efforts to reduce the availability of electronic nicotine delivery systems (vaping). Increase participation in the Prevention Coalition of Monmouth County to plan comprehensive substance abuse awareness planning and programming; to provide a forum for community members and organizations to work together to improve substance abuse prevention strategies within the service area while increasing public awareness related to substance abuse trends and community resources. Increase and expand substance abuse programming including vaping at the CentraState Student Health Awareness Center. Revise health care processes and provider roles to integrate mental health and substance abuse treatment into primary care. Utilize certified Recovery Coaches in the Emergency Department to engage with patients who have been administered naloxone (NARCAN). Continue to monitor and track prescribing and dispensing of Schedule II, III, IV and V drugs and other controlled substances. Suicide ------- The CentraState Student Health Awareness Center, in cooperation with school counselors, undertake plans to develop and deliver a curriculum-based program that helps all students learn to recognize warning signs of suicide in themselves and others. Provide low income or at-risk public school students and their families with information about social services and health care supports. Significant Health Need #2: Chronic Disease (Cardiovascular [Heart Disease/Stroke], Cancer, Diabetes) Strategies: ----------- Cardiovascular -------------- Develop and implement programs and services to enhance knowledge of heart disease management and control the risk factors for heart disease. Offer a cardiac support group for the public. Increase community outreach efforts including lectures and screenings (blood pressure and cholesterol) by participating in community events (town days, fairs, senior center events and American Heart Association programs and events. Provide cardiopulmonary resuscitation classes for the community. Offer weight management programs and classes. Promote and expand the Gloria Saker Women's Heart Program at CentraState (for women at risk) including education and awareness, prevention, risk factor assessment and program referral (dietary counseling, smoking cessation, stress management) in collaboration with area physicians. Cancer ------ Continue to partner with the Ocean Monmouth Health Alliance to conduct programs aimed at education, prevention and access to treatment for cancer. Programs include ""Choose Your Cover"" (free skin cancer education and screenings at the beach); ""Cancer You Can Prevent"" (Colorectal cancer toolkits for primary care physicians to prevent colorectal cancer); Free Oral Cancer Screenings; promote with local governments Tobacco-Free Living at beaches, parks and recreational areas; preventing cervical cancer by increasing HPV immunizations. Increase number and frequency of cancer screenings offered through the CentraState Statesir Cancer Center and the Health Awareness Center. Increase breast cancer screenings (mammograms) by the CentraState Women's Center. Combine information about human papillomavirus (HPV) and the benefits of vaccination with efforts to support vaccine series completion (e.g., patient and parent education or reminders, physician education, etc.) Diabetes -------- Increase education for diabetes prevention, early identification and disease management to high-risk populations in our service area. Expand pre-diabetes education programming at the hospital and in the community. Provide increased access of Diabetes Center nurses to primary care physicians in Freehold Borough for nutrition counseling (English and Spanish classes) to include glucose testing, education and follow-up evaluations. Include free glucose screening at community events in the service area. Significant Health Need #3: Healthy Lifestyles (Obesity, Nutrition, Physical Activity, Access to Care) Strategies: ----------- Obesity, Nutrition and Physical Activity Participate in the Mobile Food Pantry at the Freehold Family Health Center by Fulfill Food Bank. Provide ""Live Life Well"" programs including seminars on eating well, relaxing well and moving well. Continue nutrition seminars for senior centers. Expand the ""Plant Powered Program"" (a 10-week program on plant based eating which has been shown to significantly help with weight loss, improved digestion, lower cholesterol and triglycerides, drop blood pressure and help with blood sugar management.) Provide live cooking demonstrations for the community. Expand participation in the Shaping NJ Grant for schools in Freehold Borough and Freehold Township advising of nutritional content of school food recipes and benefits of exercising. Increase participation in service area school wellness councils and activities. Partner with the CentraState Fitness Center to provide nutrition education for children. Use media-based efforts, in particular social media platforms, to educate residents and change the attitudes and beliefs that contribute to unhealthy behaviors. Access to Care -------------- Partner with community-based organizations to increase outreach and education about enrollment for health insurance coverage through the Health Insurance Marketplaces (Exchanges). Continue to grow the CentraState Community Health Plan. Explore additional CentraState Health Pavilions, which include Family Practice at CentraState offices, rehabilitation and laboratory services and Immediate Care Centers, in service area communities. Recruit graduating residents from the CentraState-based Family Residency Program. Continue to recruit primary care physicians, physician assistants, nurse practitioners and specialty care physicians to the service area. Collaborate with the newly created coalition ""Neighborhood Connections to Health"" led by the Visiting Nurse Association (VNA) Health Group and the Freehold Health Dept. under grants from the Robert Wood Johnson Foundation and the Nicholson Foundation. The organization goals are to find solutions to health issues within the community through collaboration. Continue to support the new Federally Qualified Health Center (FQHC) ""Freehold Family Health Center"" in Freehold Borough and continue to commit CentraState resources to the facility and its programs/services. Collaborate with the Mayor's Freehold Boro Wellness Council to conduct a health fair for residents, including follow-up with education and free screenings. Provide culturally sensitive assistance and care coordination, and guide patients through available medical, insurance, and social support (Patient navigators). Tailor health care to patients' norms, beliefs, and values, as well as their language and literacy skills. Develop programs in conjunction with the Freehold Borough schools to address health issues of students and families. Develop programs through the CentraState Health Awareness Center in conjunction with other departments to provide the community with health education, promotion and literacy. Use vouchers, tickets for prize drawings, and other incentives to encourage patients to undergo preventive care such as screenings, vaccinations, etc."

SCHEDULE H, PART V, SECTION B, QUESTION 16
"THE ORGANIZATION IS AN AFFILIATE WITHIN CENTRASTATE HEALTHCARE SYSTEM, INC.; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM (""SYSTEM""). DUE TO CHARACTER LIMITATIONS, THE WEBSITE LISTED IN SCHEDULE H, PART V, SECTION B, QUESTION 16, IS THE HOME PAGE FOR THE SYSTEM. THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION AND PLAIN LANGUAGE SUMMARY ARE MADE WIDELY AVAILABLE ON THE ORGANIZATION'S WEBSITE. THESE DOCUMENTS CAN BE ACCESSED AT THE FOLLOWING PAGE INCLUDED IN THE SYSTEM'S WEBSITE: https://www.centrastate.com/billing/"

PART I, LINE 3C
"THE INCOME BASED CRITERIA USED TO DETERMINE ELIGIBILITY IS PER NEW JERSEY ADMINISTRATIVE CODE 10:52 SUB CHAPTERS 11, 12 AND 13, AND BASED UPON THE 2015 POVERTY GUIDELINES (DEPARTMENT OF HEALTH AND SENIOR SERVICES). FEDERAL POVERTY GUIDELINES ARE INCLUDED IN THE CRITERIA FOR DETERMINING ELIGIBILITY FOR CHARITY AND DISCOUNTED CARE. CENTRASTATE MEDICAL CENTER, INC. FOLLOWS THE NJ ADMINISTRATIVE CODE 8:31B AND CONSIDERS INDIVIDUAL ASSETS OVER $7,500 AND FAMILY ASSETS OVER $15,000 IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE. IN ADDITION, THERE IS A ""SPEND DOWN"" PROVISION ALLOWING FINANCIAL ASSISTANCE IF THE AMOUNT DUE FROM THE PATIENT IS GREATER THAN THE ASSETS OVER THE STATED THRESHOLDS."

SCHEDULE H, PART I; QUESTION 6A
NOT APPLICABLE

SCHEDULE H, PART I; QUESTION 7
WORKSHEET 2 WAS USED FOR THE COST TO CHARGE RATIO.

SCHEDULE H, PART II
COMMUNITY BUILDING ACTIVITIES UNDERTAKEN BY CENTRASTATE MEDICAL CENTER, INC. IMPROVE THE MEDICAL AND SOCIOECONOMIC WELL-BEING OF OUR COMMUNITIES. THIS IS ACCOMPLISHED THROUGH SERVICE ON STATE AND REGIONAL ADVOCACY COMMITTEES AND BOARDS, VOLUNTEERISM WITH LOCAL COMMUNITY-BASED NON-PROFIT ADVOCACY GROUPS AND PARTICIPATION IN CONFERENCES AND OTHER EDUCATIONAL ACTIVITIES TO PROMOTE UNDERSTANDING OF THE ROOT CAUSES OF HEALTH CONCERNS. CENTRASTATE MEDICAL CENTER, INC. PROVIDES EDUCATIONAL MATERIALS, CONDUCTS COMMUNITY HEALTH FAIRS AND HOLDS HEALTH EDUCATION SEMINARS AND OUTREACH SESSIONS FOR ITS PATIENTS, COMMUNITY AND PROVIDERS. PHYSICIANS, NURSES AND OTHER HEALTHCARE PROFESSIONALS DEDICATE THEIR KNOWLEDGE AND TIME TO ENSURE THE COMMUNITY IS WELL EDUCATED ON TOPICS PROMOTING HEALTHY LIVING.

SCHEDULE H, PART III, SECTION A; QUESTION 4
THE FOOTNOTE BELOW EXPLAINS THE ORGANIZATIONS METHODOLOGY WITH RESPECT TO NET PATIENT SERVICE REVENUE. CHANGES IN THE SYSTEM'S ESTIMATES OF IMPLICIT PRICE CONCESSIONS, DISCOUNTS, CONTRACTUAL ADJUSTMENTS OR OTHER CHANGES TO EXPECTED PAYMENTS FOR PERFORMANCE OBLIGATIONS SATISFIED IN PRIOR YEARS WERE NOT SIGNIFICANT. PORTFOLIO COLLECTION ESTIMATES ARE UPDATED BASED ON COLLECTION TRENDS. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY (DETERMINED ON A PORTFOLIO BASIS WHEN APPLICABLE) ARE RECORDED AS BAD DEBT EXPENSE. BAD DEBT EXPENSE FOR THE YEARS ENDED DECEMBER 31, 2021 AND 2020 WAS NOT SIGNIFICANT.

SCHEDULE H, PART III, SECTION B; QUESTION 8
"MEDICARE COSTS WERE DERIVED FROM THE 2021 MEDICARE COST REPORT. MEDICARE UNDERPAYMENTS AND BAD DEBT ARE COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THE ORGANIZATION FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT ARE COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. AS OUTLINED MORE FULLY BELOW THE ORGANIZATION BELIEVES THAT THESE SERVICES AND RELATED COSTS PROMOTE THE HEALTH OF THE COMMUNITY AS A WHOLE AND ARE RENDERED IN CONJUNCTION WITH THE ORGANIZATION'S CHARITABLE TAX-EXEMPT PURPOSES AND MISSION IN PROVIDING MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUAL'S IN A NON-DISCRIMINATORY MANNER WITHOUT REGARD TO RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY AND CONSISTENT WITH THE COMMUNITY BENEFIT STANDARD PROMULGATED BY THE IRS. THE COMMUNITY BENEFIT STANDARD IS THE CURRENT STANDARD FOR A HOSPITAL FOR RECOGNITION AS A TAX-EXEMPT AND CHARITABLE ORGANIZATION UNDER INTERNAL REVENUE CODE (""IRC"") 501(C)(3). THE ORGANIZATION IS RECOGNIZED AS A TAX-EXEMPT ENTITY AND CHARITABLE ORGANIZATION UNDER 501(C)(3) OF THE IRC. ALTHOUGH THERE IS NO DEFINITION IN THE TAX CODE FOR THE TERM ""CHARITABLE"" A REGULATION PROMULGATED BY THE DEPARTMENT OF THE TREASURY PROVIDES SOME GUIDANCE AND STATES THAT ""[T]HE TERM CHARITABLE IS USED IN 501(C)(3) IN ITS GENERALLY ACCEPTED LEGAL SENSE,PROVIDES EXAMPLES OF CHARITABLE PURPOSES, INCLUDING THE RELIEF OF THE POOR OR UNPRIVILEGED; THE PROMOTION OF SOCIAL WELFARE; AND THE ADVANCEMENT OF EDUCATION, RELIGION, AND SCIENCE. NOTE IT DOES NOT EXPLICITLY ADDRESS THE ACTIVITIES OF HOSPITALS. IN THE ABSENCE OF EXPLICIT STATUTORY OR REGULATORY REQUIREMENTS APPLYING THE TERM ""CHARITABLE"" TO HOSPITALS, IT HAS BEEN LEFT TO THE IRS TO DETERMINE THE CRITERIA HOSPITALS MUST MEET TO QUALIFY AS IRC 501(C)(3) CHARITABLE ORGANIZATIONS. THE ORIGINAL STANDARD WAS KNOWN AS THE CHARITY CARE STANDARD. THIS STANDARD WAS REPLACED BY THE IRS WITH THE COMMUNITY BENEFIT STANDARD WHICH IS THE CURRENT STANDARD. CHARITY CARE STANDARD IN 1956, THE IRS ISSUED REVENUE RULING 56-185, WHICH ADDRESSED THE REQUIREMENTS HOSPITALS NEEDED TO MEET IN ORDER TO QUALIFY FOR IRC 501(C)(3) STATUS. ONE OF THESE REQUIREMENTS IS KNOWN AS THE ""CHARITY CARE STANDARD."" UNDER THE STANDARD, A HOSPITAL HAD TO PROVIDE, TO THE EXTENT OF ITS FINANCIAL ABILITY, FREE OR REDUCED-COST CARE TO PATIENTS UNABLE TO PAY FOR IT. A HOSPITAL THAT EXPECTED FULL PAYMENT DID NOT, ACCORDING TO THE RULING, PROVIDE CHARITY CARE BASED ON THE FACT THAT SOME PATIENTS ULTIMATELY FAILED TO PAY. THE RULING EMPHASIZED THAT A LOW LEVEL OF CHARITY CARE DID NOT NECESSARILY MEAN THAT A HOSPITAL HAD FAILED TO MEET THE REQUIREMENT SINCE THAT LEVEL COULD REFLECT ITS FINANCIAL ABILITY TO PROVIDE SUCH CARE. THE RULING ALSO NOTED THAT PUBLICLY SUPPORTED COMMUNITY HOSPITALS WOULD NORMALLY QUALIFY AS CHARITABLE ORGANIZATIONS BECAUSE THEY SERVE THE ENTIRE COMMUNITY, AND A LOW LEVEL OF CHARITY CARE WOULD NOT AFFECT A HOSPITAL'S EXEMPT STATUS IF IT WAS DUE TO THE SURROUNDING COMMUNITY'S LACK OF CHARITABLE DEMANDS. COMMUNITY BENEFIT STANDARD IN 1969, THE IRS ISSUED REVENUE RULING 69-545, WHICH ""REMOVE[D]"" FROM REVENUE RULING 56-185 ""THE REQUIREMENTS RELATING TO CARING FOR PATIENTS WITHOUT CHARGE OR AT RATES BELOW COST."" UNDER THE STANDARD DEVELOPED IN REVENUE RULING 69-545, WHICH IS KNOWN AS THE ""COMMUNITY BENEFIT STANDARD,"" HOSPITALS ARE JUDGED ON WHETHER THEY PROMOTE THE HEALTH OF A BROAD CLASS OF INDIVIDUALS IN THE COMMUNITY. THE RULING INVOLVED A HOSPITAL THAT ONLY ADMITTED INDIVIDUALS WHO COULD PAY FOR THE SERVICES (BY THEMSELVES, PRIVATE INSURANCE, OR PUBLIC PROGRAMS SUCH AS MEDICARE), BUT OPERATED A FULL-TIME EMERGENCY ROOM THAT WAS OPEN TO EVERYONE. THE IRS RULED THAT THE HOSPITAL QUALIFIED AS A CHARITABLE ORGANIZATION BECAUSE IT PROMOTED THE HEALTH OF PEOPLE IN ITS COMMUNITY. THE IRS REASONED THAT BECAUSE THE PROMOTION OF HEALTH WAS A CHARITABLE PURPOSE ACCORDING TO THE GENERAL LAW OF CHARITY, IT FELL WITHIN THE ""GENERALLY ACCEPTED LEGAL SENSE"" OF THE TERM ""CHARITABLE,"" AS REQUIRED BY TREAS. REG. 1.501(C)(3)-1(D)(2). THE IRS RULING STATED THAT THE PROMOTION OF HEALTH, LIKE THE RELIEF OF POVERTY AND THE ADVANCEMENT OF EDUCATION AND RELIGION, IS ONE OF THE PURPOSES IN THE GENERAL LAW OF CHARITY THAT IS DEEMED BENEFICIAL TO THE COMMUNITY AS A WHOLE EVEN THOUGH THE CLASS OF BENEFICIARIES ELIGIBLE TO RECEIVE A DIRECT BENEFIT FROM ITS ACTIVITIES DOES NOT INCLUDE ALL MEMBERS OF THE COMMUNITY, SUCH AS INDIGENT MEMBERS OF THE COMMUNITY, PROVIDED THAT THE CLASS IS NOT SO SMALL THAT ITS RELIEF IS NOT OF BENEFIT TO THE COMMUNITY. THE IRS CONCLUDED THAT THE HOSPITAL WAS ""PROMOTING THE HEALTH OF A CLASS OF PERSONS THAT IS BROAD ENOUGH TO BENEFIT THE COMMUNITY"" BECAUSE ITS EMERGENCY ROOM WAS OPEN TO ALL AND IT PROVIDED CARE TO EVERYONE WHO COULD PAY, WHETHER DIRECTLY OR THROUGH THIRD-PARTY REIMBURSEMENT. OTHER CHARACTERISTICS OF THE HOSPITAL THAT THE IRS HIGHLIGHTED INCLUDED THE FOLLOWING: ITS SURPLUS FUNDS WERE USED TO IMPROVE PATIENT CARE, EXPAND HOSPITAL FACILITIES, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH; IT WAS CONTROLLED BY A BOARD OF TRUSTEES THAT CONSISTED OF INDEPENDENT CIVIC LEADERS; AND HOSPITAL MEDICAL STAFF PRIVILEGES WERE AVAILABLE TO ALL QUALIFIED PHYSICIANS. MEDICARE UNDERPAYMENTS AND BAD DEBT ARE COMMUNITY BENEFIT AND ASSOCIATED COSTS ARE INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THE AMERICAN HOSPITAL ASSOCIATION (""AHA"") FEELS THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND BAD DEBT ARE COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. THIS ORGANIZATION AGREES WITH THE AHA POSITION. AS OUTLINED IN THE AHA LETTER TO THE IRS DATED AUGUST 21, 2007 WITH RESPECT TO THE FIRST PUBLISHED DRAFT OF THE NEW FORM 990 AND SCHEDULE H, THE AHA FELT THAT THE IRS SHOULD INCORPORATE THE FULL VALUE OF THE COMMUNITY BENEFIT THAT HOSPITALS PROVIDE BY COUNTING MEDICARE UNDERPAYMENTS (SHORTFALL) AS QUANTIFIABLE COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: - PROVIDING CARE FOR THE ELDERLY AND SERVING MEDICARE PATIENTS IS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD. - MEDICARE, LIKE MEDICAID, DOES NOT PAY THE FULL COST OF CARE. RECENTLY, MEDICARE REIMBURSES HOSPITALS ONLY 92 CENTS FOR EVERY DOLLAR THEY SPEND TO TAKE CARE OF MEDICARE PATIENTS. THE MEDICARE PAYMENT ADVISORY COMMISSION (""MEDPAC"") IN ITS MARCH 2007 REPORT TO CONGRESS CAUTIONED THAT UNDERPAYMENT WILL GET EVEN WORSE, WITH MARGINS REACHING A 10-YEAR LOW AT NEGATIVE 5.4 PERCENT. - MANY MEDICARE BENEFICIARIES, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR. MORE THAN 46 PERCENT OF MEDICARE SPENDING IS FOR BENEFICIARIES WHOSE INCOME IS BELOW 200 PERCENT OF THE FEDERAL POVERTY LEVEL. MANY OF THOSE MEDICARE BENEFICIARIES ARE ALSO ELIGIBLE FOR MEDICAID -- SO CALLED ELIGIBLES."" THERE IS EVERY COMPELLING PUBLIC POLICY REASON TO TREAT MEDICARE AND MEDICAID UNDERPAYMENTS SIMILARLY FOR PURPOSES OF A HOSPITAL'S COMMUNITY BENEFIT AND INCLUDE THESE COSTS ON FORM 990, SCHEDULE H, PART I. MEDICARE UNDERPAYMENT MUST BE SHOULDERED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE COMMUNITY'S ELDERLY AND POOR. THESE UNDERPAYMENTS REPRESENT A REAL COST OF SERVING THE COMMUNITY AND SHOULD COUNT AS A QUANTIFIABLE COMMUNITY BENEFIT. BOTH THE AHA AND THIS ORGANIZATION ALSO FEEL THAT PATIENT BAD DEBT IS A COMMUNITY BENEFIT AND THUS INCLUDABLE ON THE FORM 990, SCHEDULE H, PART I. LIKE MEDICARE UNDERPAYMENT (SHORTFALLS), THERE ALSO ARE COMPELLING REASONS THAT PATIENT BAD DEBT SHOULD BE COUNTED AS QUANTIFIABLE COMMUNITY BENEFIT AS FOLLOWS: - A SIGNIFICANT MAJORITY OF BAD DEBT IS ATTRIBUTABLE TO LOW-INCOME PATIENTS, WHO, FOR MANY REASONS, DECLINE TO COMPLETE THE FORMS REQUIRED TO ESTABLISH ELIGIBILITY FOR HOSPITALS' CHARITY CARE OR FINANCIAL ASSISTANCE PROGRAMS. A 2006 CONGRESSIONAL BUDGET OFFICE (""CBO"") REPORT, NONPROFIT HOSPITALS AND THE PROVISION OF COMMUNITY BENEFITS, CITED TWO STUDIES INDICATING THAT ""THE GREAT MAJORITY OF BAD DEBT WAS ATTRIBUTABLE TO PATIENTS WITH INCOMES BELOW 200% OF THE FEDERAL POVERTY LINE."" - THE REPORT ALSO NOTED THAT A SUBSTANTIAL PORTION OF BAD DEBT IS PENDING CHARITY CARE. UNLIKE BAD DEBT IN OTHER INDUSTRIES, HOSPITAL BAD DEBT IS COMPLICATED BY THE FACT THAT HOSPITALS FOLLOW THEIR MISSION TO THE COMMUNITY AND TREAT EVERY PATIENT THAT COMES THROUGH THEIR EMERGENCY DEPARTMENT, REGARDLESS OF ABILITY TO PAY. PATIENTS WHO HAVE OUTSTANDING BILLS ARE NOT TURNED AWAY, UNLIKE OTHER INDUSTRIES. BAD DEBT IS FURTHER COMPLICATED BY THE AUDITING INDUSTRY'S STANDARDS ON REPORTING CHARITY CARE. MANY PATIENTS CANNOT OR DO NOT PROVIDE THE NECESSARY, EXTENSIVE DOCUMENTATION REQUIRED TO BE DEEMED CHARITY CARE BY AUDITORS. AS A RESULT, ROUGHLY 40% OF BAD DEBT IS PENDING CHARITY CARE. - THE CBO CONCLUDED THAT ITS FINDINGS ""SUPPORT THE VALIDITY OF THE USE OF UNCOMPENSATED CARE [BAD DEBT AND CHARITY CARE] AS A MEASURE OF COMMUNITY BENEFITS"" ASSUMING THE FINDINGS ARE GENERALIZABLE NATIONWIDE; THE EXPE"

SCHEDULE H, PART III, SECTION B; QUESTION 9B
DURING FINANCIAL COUNSELING, THE PATIENT IS SCREENED FOR ELIGIBILITY IN PUBLIC ASSISTANCE PROGRAMS, INCLUDING MEDICARE, MEDICAID, THE CATASTROPHIC ILLNESS FUND FOR CHILDREN, AND THE VIOLENT CRIME COMPENSATION BOARD. THE PATIENT IS ASSISTED WITH THE ENROLLMENT PROCESS FOR ANY PROGRAMS FOR WHICH THE PATIENT HAS PROBABLE ELIGIBILITY. BILLS MAY BE REDUCED FROM 20% TO 100% BASED UPON FINANCIAL ASSISTANCE CRITERIA. THE PATIENT RESPONSIBILITY PORTION OF 20%, 40%, 60% OR 80% IS BASED UPON RATES ESTABLISHED IN P.L. 1971 C. 136. SPEND DOWN ASSETS, THROUGH PARTIAL PAYMENT OF THE HOSPITAL BILL IS ALLOWED TO ENABLE THE PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE. THE AMOUNT FOR WHICH THE PATIENT IS RESPONSIBLE AFTER PARTIAL FINANCIAL ASSISTANCE SHALL BE LIMITED TO 30% OF INCOME, PER NJAC 8:31B. UNINSURED PATIENTS WITH INCOME BETWEEN 301%-500% OF FEDERAL POVERTY LEVELS WILL BE PROVIDED A SIGNIFICANT DISCOUNT, IN ACCORDANCE WITH P.L. 1971 C. 136. PATIENTS ARE BILLED ROUTINELY FOR UNPAID BALANCES AND SHALL BE NOTIFIED OF ANY IMPENDING COLLECTION OR LEGAL ACTION. PATIENTS ARE PROVIDED WITH CONTACT INFORMATION TO DISCUSS ANY QUESTIONS OR PROBLEMS. PATIENT BILLS INDICATE THE AVAILABILITY OF PAYMENT SCHEDULES. UPON PATIENT REQUEST, THE FOLLOWING PAYMENT SCHEDULE FOR BALANCES OF $100 OR MORE MAY BE AGREED UPON: BALANCE OF $100 - $450 - MONTHLY PAYMENT = 1/4 OF THE BALANCE, $451 - $3,000 = 1/12 OF THE BALANCE, OVER $3,000 = MINIMUM OF $250 PER MONTH OR 1% OF GROSS INCOME/MONTH, WHICHEVER IS MORE. IF THE PATIENT AND MEDICAL CENTER REPRESENTATIVE MUTUALLY AGREE TO A PAYMENT SCHEDULE AND PAYMENTS ARE RECEIVED AS AGREED, FURTHER COLLECTION ACTION WILL NOT BE TAKEN. EXCEPTIONS TO THE ABOVE SCHEDULE MAY BE MADE BY PATIENT FINANCIAL SERVICES MANAGEMENT UPON THE REQUEST OF THE PATIENT, AND DOCUMENTATION BY THE PATIENT OF INABILITY TO PAY ACCORDING TO THE ESTABLISHED SCHEDULE. IF, AT THE END OF THE FINANCIAL SCREENING ATTEMPTS AND BILLING CYCLE, THE PATIENT HAS NOT BEEN APPROVED FOR FINANCIAL ASSISTANCE AND/OR IS NOT ON A PAYMENT PLAN, OR AFTER THERE HAS BEEN A DEFAULT IN PAYMENT, THE ACCOUNT WILL BE ASSIGNED TO A COLLECTION AGENCY AND/OR ATTORNEY FOR COLLECTIONS. PAYMENT PLAN, OR AFTER THERE HAS BEEN A DEFAULT IN PAYMENT, THE ACCOUNT WILL BE ASSIGNED TO A COLLECTION AGENCY AND/OR ATTORNEY FOR COLLECTIONS.

SCHEDULE H, PART VI; QUESTION 2
In addition to the community health needs assessment process outlined in schedule h, section b, questions 1-12 and section c, this organization conducts a review of key factor information annually which includes: a review of healthcare utilization of its service area population by services (urology, cardiology, obstetrics, etc.) For determining increased or decreased health needs; healthcare services estimates and forecasts (both inpatient and outpatient); assessments of local demographic and socioeconomic information; and, a review of health status/needs assessments and studies conducted by external parties. The organization conducts an extensive service area physician needs study (by primary and specialty) every three to five years. Specific specialty needs are conducted for identified gaps in service. These reviews inform medical staff development at the medical center to assure responsiveness to identified community needs. The organization collaborates with community partners to plan and conduct health needs assessments to assess and address health needs of the community it serves. The wide-based collaborative partnership retains an outside consulting firm to assess community data and perception. Community data is collected from county health profiles, health statistics, demographics, socioeconomic data, phone surveys, paper surveys and focus groups. From those assessments, community health improvement plans are published identifying the specific health priorities. Through a planned and organized effort, the group works collectively to address the priorities by tapping the resources of the community and collaborating on initiatives. CentraState Healthcare System, Inc. Actively contributes to this process and engages in the identified priorities that match its mission, expertise, resources and capacity. In addition to these organized needs assessment efforts, various CentraState Healthcare System, Inc. Leadership attend community meetings with local providers, local health departments, local politicians, organizations and community leaders to discuss the health needs of the population.

SCHEDULE H, PART VI; QUESTION 4
The community in which CentraState Medical Center, Inc. Serves is concentrated in Monmouth and ocean counties. The average household income in the service area is $139,993. The median household age is 44. The total population in the service area for 2019 is 357,095 with 124,895 households. The racial mix of the service area population includes 73% white, 10% Asian, 4% black, 11% Hispanic and 2% multi-racial. Gender mix is represented by 51% female and 49% male.

SCHEDULE H, PART VI; QUESTION 3
"In accordance with Internal Revenue Code section 501(r)(4) the organization informs and educates patients and persons who may be billed for patient care about their eligibility for financial assistance by widely publicizing various documents. These documents are widely publicized in the following ways: (1) the financial assistance policy (""fap""), financial assistance application (""application"") and plain language summary (""pls"") are all available on-line at the following website: https://CentraStatecorp.azureedge.net/wp-content/uploads/sites/9/2021/01 /financial-assistance-policy-2021-002.pdf (2) paper copies of the fap, application and the pls are available upon request without charge by mail and are available in at various areas throughout the hospital facility which include the hospital admissions department and the outpatient and emergency room registration areas. (3) the fap, application and pls are available in English and in the primary language of populations with limited proficiency in English (""LEP"") that constitute the lesser of 1,000 individuals or 5% of the community served by the organization's primary service area. (4) all patients are offered a copy of the pls as part of the intake process. Additionally, signs or displays are conspicuously posted in public medical center locations including all admissions/registration areas and the emergency department, that notify and inform patients about the availability of financial assistance. All billing statements include conspicuous written notice which informs patients about the availability of financial assistance. CentraState Medical Center, Inc. also informs and notifies members of the community served about the fap."

SCHEDULE H, PART VI; QUESTION 5
CentraState contributes to the community through substantial employee involvement with other charitable and public organizations such as girl scouts of the jersey shore, work force investment bureau of Monmouth county, Veterans Community Association, Fingerprint America, Sunrise Optimist Club, Monmouth-Ocean Development Council, Muscular Dystrophy Association, Freehold Township, Monmouth County Child Advocacy Center, The National Organization of Women Business Owners, Rutgers University, Cancer Institute of New Jersey and the College Advisory Boards of Monmouth County Community College and Brookdale Community College. Efforts include increasing services to cancer survivors, coordinating efforts for fund raising and organizing student training programs. CentraState also provides additional community benefit through its 174 volunteers who contributed over 32,752 hours of service to their community through opportunities in every hospital department. Volunteers significantly enhance patient and family support in the following service categories: blood cart, dietary menu, emergency department lounge, flowers, gift shop/cart, hospitality cart, information desks, mail or messenger, prn/floaters, pastoral care, animal assisted therapy, snack bar, surgery waiting area, patient transport, hair care, service learning.

SCHEDULE H, PART VI; QUESTION 7
The entity and related provider organizations are located in New Jersey. The state of New Jersey does not require hospitals to annually file a community benefit report with the state of New Jersey.

SCHEDULE H, PART VI; QUESTION 6
"OUTLINED BELOW IS A SUMMARY OF THE ENTITIES WHICH COMPRISE THE CENTRASTATE HEALTHCARE SYSTEM, INC.: NOT-FOR-PROFIT CENTRASTATE HEALTHCARE SYSTEM, INC. ENTITIES =========================================================== CENTRASTATE HEALTH SYSTEM, INC. ------------------------------- CENTRASTATE HEALTH SYSTEM, INC. (""CSHS"") IS THE TAX-EXEMPT PARENT OF THE CENTRASTATE HEALTHCARE SYSTEM, INC. (""SYSTEM""). THIS INTEGRATED HEALTHCARE DELIVERY SYSTEM CONSISTS OF A GROUP OF AFFILIATED HEALTHCARE ORGANIZATIONS. THE SOLE MEMBER OR STOCKHOLDER OF EACH ENTITY IS CSHS. THE SYSTEM IS AN INTEGRATED NETWORK OF HEALTHCARE PROVIDERS THROUGHOUT THE STATE OF NEW JERSEY AND IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A SUPPORTING ORGANIZATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(3). CENTRASTATE MEDICAL CENTER, INC. -------------------------------- CENTRASTATE MEDICAL CENTER, INC. (""CSMC"") IS LOCATED IN FREEHOLD, MONMOUTH COUNTY, NEW JERSEY, IS A 276-BED ACUTE CARE FACILITY. CSMC IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS AN INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION. PURSUANT TO ITS CHARITABLE PURPOSES, CSMC 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. MOREOVER, CSMC OPERATES CONSISTENTLY WITH THE CRITERIA OUTLINED IN IRS REVENUE RULING 69-545. CENTER FOR AGING, INC. ---------------------- CENTER FOR AGING, INC. (""APPLEWOOD"") IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). APPLEWOOD CONSISTS OF 281 INDEPENDENT APARTMENTS, 20 COTTAGES, 40 RESIDENTIAL HEALTH CARE UNITS, AND A 60-BED SKILLED NURSING FACILITY. THE ORGANIZATION PROVIDES FOR THE CARE OF THE ELDERLY. APPLEWOOD ALSO GOES OUT TO THE COMMUNITY THROUGH SENIOR'S FIRST, WHICH IS A COMPLIMENTARY COMMUNITY OUTREACH AND HEALTHCARE EDUCATION PROGRAM FOR THOSE 60 YEARS AND OLDER IN A 25-MILE RADIUS OF FREEHOLD, NJ. THE CENTER'S PROGRAMS INCLUDE HEALTH FAIRS, BLOOD PRESSURE SCREENINGS, AND HEALTH EDUCATION AND PRESENTATIONS ON PREVENTION AND TREATMENT. IN ADDITION, THERE IS ALSO A SUPPORT GROUP FOR PARKINSON'S DISEASE AS WELL AS COMMUNITY SERVICE REFERRALS. CENTRASTATE ASSISTED LIVING, INC. --------------------------------- CENTRASTATE ASSISTED LIVING, INC. (""MONMOUTH CROSSING"") IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). MONMOUTH CROSSING OWNS AND OPERATES AN ASSISTED LIVING FACILITY FOR THE ELDERLY CONSISTING OF 76 UNITS WITH 16 UNITS FOR MEMORY CARE. THE FACILITY PROVIDES RESIDENTS WITH SPECIAL NEEDS AND MEMORY-RELATED DISEASES: RECEIVE COMPREHENSIVE, ATTENTIVE SERVICES IN A SAFE ENVIRONMENT WHERE SPECIALIZED ACTIVITIES AND PROGRAMMING ARE PROVIDED. MONMOUTH CROSSING OFFERS SERVICES TO RESIDENTS OF LOW AND MODERATE MEANS AND THOSE ON MEDICAID AS WELL. HEALTHCARE AFFILIATES, INC. --------------------------- HEALTHCARE AFFILIATES, INC. (""THE MANOR"") IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(2). THE MANOR PROVIDES SKILLED NURSING SERVICES FOR 123 ELDERLY RESIDENTIAL UNITS INCLUDING SUBACUTE, REHABILITATION AND I.V. THERAPY. THE FACILITY FOCUS IS ON HELPING RESIDENTS ACHIEVE THEIR MAXIMUM POTENTIAL FOR INDEPENDENCE, PERSONAL COMFORT AND QUALITY OF LIFE. THE MANOR IS MEDICARE/MEDICAID CERTIFIED, LICENSED BY THE STATE OF NEW JERSEY, AND ACCREDITED BY THE JOINT COMMISSION. THE FACILITY PROVIDES CHARITY CARE FOR THE INDIGENT WHERE APPROPRIATE. CENTRASTATE HEALTHCARE FOUNDATION, INC. --------------------------------------- CENTRASTATE HEALTHCARE FOUNDATION, INC. IS AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS TAX-EXEMPT PURSUANT TO INTERNAL REVENUE CODE 501(C)(3) AND AS A NON-PRIVATE FOUNDATION PURSUANT TO INTERNAL REVENUE CODE 509(A)(1). THROUGH FUNDRAISING ACTIVITIES THE ORGANIZATION SUPPORTS THE CHARITABLE PURPOSES, PROGRAMS AND SERVICES OF CSMC; A RELATED INTERNAL REVENUE CODE 501(C)(3) TAX-EXEMPT ORGANIZATION, THAT 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. OTHER CENTRASTATE HEALTHCARE SYSTEM, INC. ENTITIES ================================================== CENTRASTATE CAPTIVE INSURANCE CO., LTD. --------------------------------------- CENTRASTATE CAPTIVE INSURANCE CO., LTD. A CONTROLLED FOREIGN CORPORATION OF CENTRASTATE MEDICAL CENTER. THE ORGANIZATION WAS FORMED AND OPERATES SOLELY IN THE CAYMAN ISLANDS WITH NO U.S. ACTIVITIES OR PRESENCE. CENTRASTATE CARDIOLOGY ASSOCIATES, P.C. ------------------------------------ CENTRASTATE CARDIOLOGY ASSOCIATES, P.C. IS AN ENTITY WHOSE NOMINEE SOLE SHAREHOLDER IS A LICENSED MD HOLDING SHARES FOR THE BENEFIT OF CSMC. THE ORGANIZATION IS LOCATED IN FREEHOLD, MONMOUTH COUNTY, NEW JERSEY. THIS ENTITY PROVIDES MEDICAL SERVICES IN SUPPORT OF AND IN FURTHERANCE OF THE CHARITABLE TAX-EXEMPT PURPOSES OF CSMC. CENTRASTATE HEALTHCARE SERVICES, INC. ------------------------------------- CENTRASTATE HEALTHCARE SERVICES, INC. IS AN ENTITY WHOSE SOLE SHAREHOLDER IS CSHS. THE ORGANIZATION IS LOCATED IN FREEHOLD, MONMOUTH COUNTY, NEW JERSEY AND PROVIDES HEALTHCARE SERVICES. CENTRASTATE MEDICAL ASSOCIATES, P.C. ------------------------------------ CENTRASTATE MEDICAL ASSOCIATES, P.C. IS AN ENTITY WHOSE NOMINEE SOLE SHAREHOLDER IS A LICENSED MD HOLDING SHARES FOR THE BENEFIT OF CSMC. THE ORGANIZATION IS LOCATED IN FREEHOLD, MONMOUTH COUNTY, NEW JERSEY. THIS ENTITY PROVIDES MEDICAL SERVICES IN SUPPORT OF AND IN FURTHERANCE OF THE CHARITABLE TAX-EXEMPT PURPOSES OF CSMC. CENTRASTATE SPECIALISTS, P.C. ----------------------------- CENTRASTATE SPECIALISTS, P.C. IS AN ENTITY WHOSE NOMINEE SOLE SHAREHOLDER IS A LICENSED MD HOLDING SHARES FOR THE BENEFIT OF CSMC. THE ORGANIZATION IS LOCATED IN FREEHOLD, MONMOUTH COUNTY, NEW JERSEY. THIS ENTITY PROVIDES MEDICAL SERVICES IN SUPPORT OF AND IN FURTHERANCE OF THE CHARITABLE TAX-EXEMPT PURPOSES OF CSMC."