T

HO SPITAL GROUP

Form 99O, Part VZZ - Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
(A) (B) CD)

Name and Title

Average hours per week

Position (check all that apply}

Reportable compensation from the organization (W2/1099-MISC)

Reportable compensation from related organizations

(W- 2/1099MISC)

01 Q.

o c

S-a

Estimated amount of other compensation from the organization and related organizations

JOHN MCGEE PRESIDENT AND CEO SCOTT GESHARD EXECUTIVE V P & C O O RAFUL RA3A CHAIRMAN MICHAEL A KLEIMAN DMD VICE CHAIRMAN 3AY MJENEY SECRETARY &TREASURER DAVID A BELOWICH BOARD MEMBER MORRIS BROWN ESQ BOARD MEMBER
IMPSONCHOI

4000 4000
000 0 00

X X
X X

697,097 372,575

34,456 62,855 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63,362 53,156 57,108 52^363

0 0 0 0 0 0 0 0
93,363
0 0 0 0 0 0 0 0 0 0
4086 2,8

000
000

X
X

000
000 000 000 25 00 000 000 000 000 000 0 00

X
X X X X X X X X X X

BOARD MEMBER DONALD GRIFHN BOARD MEMBER O H M O GRUN 13 MEMBER LD KLINE MD BOARD MEMBER WILLIAM 3 LOVETT BOARD MEMBER 30HN G MCDONOUGH DMD BOARD MEMBER VALMES2AROS BOARD MEMBER ELAINE SANTOWASSO BOARD MEMBER LEONARD SENDELSKY BOARD MEMBER BARBARA BRAYNOCK EX-OFFICIO BHUDEVSHARMA EX-OFFICIO UDITH SPIEGEL EX-OFFICIO DONALD E WEST EX-OFFICIO RAN KLIN SPIRN MD EX-OFFICIO RAYMOND FREDERICKS EXECUTIVE VP & COO EAN PATRICK MURPHY VP LEGAL & ASST SECT RICHARD SMITH ENIOR VP &CFO -VI I.LI AM OSER SENIOR VP MEDICAL AFFAIR

000
000 000 000

X
X X X

4000
40 00

3243 2,8

4000
4O 00

318,450

4083 0,1

Form 990 (ZOOS)

._

Page 7

Compensation of Officers. Directors.Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors Section A Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
la Complete this table tor an persons required to be listed Use Schedule 3-2 rf additional space is needed * List all of the organization's cnmsnt officers, directors, trustees (whether individuals or organizations) and key employees regardless of amount of compensation, and current key employees Enter -0- in columns (D), <E), and (F) if no compensation was paid " List the organization's five currant highest compensated employees (other than an officer, director, trustee or key ernptoyee) who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from tht organization and any related organizations * List all of the organization's fanner officers, fcey employees, or highest compensated employees who received mora than $100,000 of ra portable compensation from the organization and any related organizations * List all of the organization's former dlrectoi*wtrrtw* that received, in the capacity as a former director or trustee of the organization, more than $10,000 of reportable compensation from the organization and any related organizations List persons in the following order individual trustees or directors, institutional trustees, officers, fcey employees, highest compensated employees, and former such persons r* Check this box if the organization did not compensate any officer, director, tniste orfeev employee

(C) Position (check all that appty)

(8) Average hours per week
^3

l*>

3| - S

Name and Title

p I fI 2 1 S s
(D

c>

(0) Reportable compensation from the organization (W2/1099MISC)

o>

CEJ Reportable compensation from related organizations (Vif- 2/1099MISC)

(FJ Estimated amount of other compensation from the organization and related organizations

Instfluttoimi Truotw

in

*
JOHN MCGEE , PRESIDENT AMD CEO SCOTT GEBHARD , EXECUTIVE VP & COO MICHAELftKlSMAN WIO . CHAIRMAN PBARIL RAJA , VICE CHAIRMAN 3Kf H JENEY , SECRETARY 8 TREASURER DSWD A E&OWICH , BOARD MEMBSl MORRIS BROWN ESQ , BOARD MEMBER SIMPSON CHOI , BOARD MEMBER DONALD GRIFFIN . BOARD MEMBER JOHN QGRUN , BOARD MEMBER KOSTAS GUSSE , BOARD MEMBER DONMD KLINE MO , BOARD MEMBER WIUIAM I LOVETT , BOARD MEMBER JOHN G MCDONQUGH DMO , BOARD MEMBER WLMESZAROS, BOARD MEMBER ELIZABETH T PERRICONE , BOARD MEMBER QAINE SANTOWASSQ . BOARD MEMBER LEONARD SETJDSSKY . BOARD MEMBER ROSE M TEIBICSICS, BOARD MEMBER BARBARA BOAYNQCK , EX-OFFIdO BHUDEVSHARMA. K-OFFICKJ
4001

*t> Et C.

mot
DOG

X X X
X

X X

672,403 Ji-JftoU
0 0 0 G G G 0 0 0 0

G G
0
0

112,661 131,932
0 0

ooc

am
000

X X X X
X

a
0

0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

o
000 OCf 000 OOQ DOG 000 000 000

a
0

X X X X X X X X
X X

G G G G G G 0 0
C

G
G G G 0 G 0 0 G

oca
000 OOQ 000 OOQ 000

X X X X

a a
0

MATTHEW SMITH MD , EX-OFFICTO

JUDITH SPIEGEL, EX-OFFICK) ROMAID E WEST , EX-QFFIOO RAYMOND FREDERICKS, EXECUTIVE VP & COO SEAN PfilRICK MURPHY , SENIOR VP LEGAL RICHARD SMITH, SENIOR VP&CFt) WflUJAM OSER , SEBIOR VP MEDEAL AFFAIR ANN LOGAN, SENIOR VP NURSING AHDCN LOUIS HERMANS, VP ft CIO WUETHORTON.VP THOMAS SIRAX , MEDKAL DIRECTOR EXECUTI QIEGORY PRTfBnSta , HIGHEST COMPENSATED
EM PL

OCfl
OOQ 000 40 OB 40 CC 40 CC

G
0

0
0

a
0 0 0

X
X X X X
X

4000
JO OB 5OQO

WOO OC

X X X X X X

403,355 311,401 315,409 475^483 239,711 233,676 187 J&J 395,987 776*654 697.862 594,540 441,975 410,623

a
0 G G

G
G 0 0 0 0 0

0 127,878 95,SB9 112,254 106,719 57,780 95,014 10,283 177,620

4000 4000 4000 4000 4000

61,867 30,679 54,685 73,618 15,954

STEPHEN BLOOMFIEtO , HIGHEST COMPENSATED EMPL THOMAS STBHEKE , HIGHEST COMFEHSATCD EMPL MARTIN GEZI , HIGHEST COMPENSAIED EMPL PETER ZAMOS , HIGHEST COMPENSATED EMPL

X
X

Form 990(2008)

ISM

2007 OFFICERS AND BOARD MEMBERS JFK MEDICAL CENTER fTHE COMMUNITY HOSPITAL GROUP. INC. T/A) Chair

Vice Chair
Chief Operating Officer Secretary/Treasurer Assistant Secretary David A. Bclowich Moms Brown, Esq. Simpson Y T Choi Donald Giiffiu John 0. Grun KostasGussis Helen Hocb, EdJD. Donald Khne,MD

Michael A. Kleiraan, DMD PrafttiRaja J. Scott Gebhard Jsy M. Jeney Sean Patrick Murphy, Esq. William J. Lovctt John G. McDonougli, DMD Vat Meszaros Elizabeth T Perricone Elaine Santowasso Leonard Scndelsky Ihomash. Sharp RoseM Yelencsics
Ex-uflicio:

John P. McGee Matthew Smitb, MD Judith Spiegel Franklin Spirn, MD Ronald E. West

Form 990, Part V-A - Current Officers, Directors, Trustees, and Key Employees:
(A) Name and address (BJ Title and average hours per week devoted to posit Eon PRESIDENT AND CEO 40 0 EXECUTIVE V P / C O O 400 EXECUTIVE 400 ASSISTANT SECRETARY 40 0 COO MUHELNBERGREG MEDCTR 40 0 SENIOR VP/CFO 400 SENIOR VP/LTC HARTWYCKS 400 CHAIR 0 VICE CHAIR 0 SECRETARY /TREASURER (C) Compensation (If not paid, enter -0-) 391,397 (D) Contributions to employee benefit plans & deferred compensation plans
0

(E) Expense account and other allowances

0

MCGEE JOHN P 98 J A M E S STREET EDISON, NJ 08820 R A Y M O N D FREDERICKS 98 J A M E S STREET EDISON, NJ 08820 SCOTT GEBHARD 98 J A M E S STREET EDISON, NJ 08820 SEAN PATRICK MURPHY 98 J A M E S STREET EDISON, NJ 08820 NANCY FIAMINGQ 98 J A M E S STREET EDISON, NJ 08820 RICHARD SMITH 98 JAMES STREET EDISON, NJ 08820 TH OM AS LANKEY 98 J A M E S STREET EDISON, NJ 08820 MICHAELA KLEIMAN 98 JAMES STREET EDISON, NJ 08820 PRAFULRAJA 98 JAMES STREET EDISON, NJ 08820 JAY M JENEY 98 JAMES STREET EDISON, NJ 08820

249,818

16,800

314,470

28,000

183,772

16,120

35,409

2,250

256,220

25,200

Form 990, Part V-A - Current Officers, Directors, Trustees, and Key Employees:
(A) Name and address

(B) Title and average hours per week devoted to position

BOARD MEMBER 0 BOARD MEMBER 0 BOARD MEMBER 0 BOARD MEMBER 0 BOARD MEMBER 0 BOARD MEMBER 0 BOARD MEMBER 0 BOARD MEMBER 0 BOARD MEMBER 0 BOARD MEMBER 0

(C) Compensation (If not paid, enter -0.)

0

(D) Contributions to employee benefit plans fit deferred compensation plans

(E) Expense account and other allowances

DAVID A BELOWICH 98 JAMES STREET EDISQN.NJ 08S20 MORRIS BROWN ESQ 98 JAMES STREET EDISON, Nil 08820 SIMPSON Y T C H O I 98 JAMES STREET EDISON, NJ 08820 JAMES J G A L E O T A JR 98 JAMES STREET EDISON, NJ 08820 DONALD GRIFFIN 98 JAMES STREET EDISON, NJ 08820 JOHN 0 GRUN 98 JAMES STREET EDISON, NJ 08620 KOSTASGUSSIS 98 JAMES STREET EDISON, NJ 08820 HELEN HOCH EdD 98 JAMES STREET EDISON, NJ 08820 DONALD KLINE MD 98 JAMES STREET EDISON, NJ 08820 WILLIAM J LOVETT 98 JAMES STREET EDISON, NJ 08S20

Form 990, Part V-A - Current Officers, Directors, Trustees, and Key Employees:
(A) Name and address (B J Title and average hours per week devoted to position BOARD MEMBER 0 BOARD MEMBER 0 BOARD MEMBER 0 BOARD MEMBER
0

(C) Compensation (If not paid, enter -0.)

0

(D) Contributions to employee benefit plans & deferred compensation plans

(E) Expense account and other allowances

JOHN G MCDONOUGH DMD 98 JAMES STREET EDISON, NJ OG820 VALMESZARQS 98 JAMES STREET EDISON, NJ 08320 ELIZABETH T PERRICONE 98 JAMES STREET EDISON, NJ 08820 ELAINE SANTOWASSO 98 JAMES STREET EDISON, NJ 08820 LEONARD SENDELSKY 98 JAMES STREET EDISON, NJ 08820 SHAILESH SHAH 98 JAMES STREET EDISON, NJ 08820 THOMAS E SHARP 98 JAMES STREET EDISON, NJ 08820 ROSE M YELENCSICS 98 JAMES STREET EDISON, NJ 08820

BOARD MEMBER
0

BOARD MEMBER 0 BOARD MEMBER

0

BOARD MEMBER 0

Page 5 Form 990 (2005) fiHB b2J9 Reconciliation of Revenue per Audited Financial Statements With Revenue per Return (See the instructions.) 302,681,362 a a Total revenue, gains, and other support per audited financial states erits
b

Amounts included on tine a but not on line 12

1 Net unrealized gains on investments >~N

bl
b2

283,002

b3
4

Other (specify) !P ,
b4
477,946

b e d 1 2

760,948 301,920,414

c
Amounts included on line 12, but not on line a Investment expenses not included online 6b Ofhflr (sppcify) .
d2
1,142,797

dl

760,948

303,063,211 e Total revenue (line 12) Add lines cand d * e I3TS! iH Reconciliation of Expenses per Audited Financial Statements With Expenses acr Return 310,403,993 a a b 1 2 3 4

Amounts included on line a but not on line 17

bl
Pnor year adjustments reported on line 20 Losses reported on line 20
, b4
14,503,053

b2 b3

Add lines bl through b4

c d 1 2 /^

b c
dl d2

14,503,053 295,900,940

Subtract line b from line a Amounts included on line 17, but not on line a; Investment expenses not included on line 6b
Other {specify)

Add lines dl and d2 Total expenses (line 17) Add lines candd *

e 295,900,940 Current Officers, Directors, Trustees, and Key Employees (List each person who was an officer, director, trustee, or key employee at any bine dunng the year even if they were not compensated.) (See the instructions.) (D) Contntjutns to (E) Expense (CJ Compensation (B) Titte and average touts employee benefit plans & (A) Name and address account and other per week devoted to position (Zf not paid, enter -O-.) defeutsl compensator) allowances pfans MCGEE JOHN P PRESIDENT AND CEO SO JAMES STREET 332,506 0 0 4O EDISON, N3 08620 RAYMOND FREDERICKS C/0 SOLARIS HEALTH SYSTEM EXECUTIVE VP 196,569 14,000 0 80 JAMES STREET 40 EDISON, N3 OSS20 SCOTT GEBHARO C/0 SOLARIS HEALTH SYSTEM EXECUTIVE 251,576 0 22,400 SO 3AMES STREET 40 EDISON, N] 08820 SEAN PATRICK MURPHY C/0 SOLARIS HEALTH SYSTEM EXECUTIVE 206,391 0 0 80 JAMES STREET 40 EDISON, N3 08820 NANCY FIAMIHGO C/0 SOLARIS HEALTH SYSTEM EXECUTIVE 0 21,784 1,500 80 JAMES STREET 40 EDISON, NJ 08320

Form 959(2005}

22-603.9101
Farm 930 (2004) Page 4

Reconciliation of Revenue per Audited Financial Statements with Revenue per Return (See page 27 of the instructions.) a Total revenue, gams, and other support 289.5S2.402. per auditedfinancialstatements . . b b Amounts included OR tme a but not on line 12, Form 990 (1) (1) Net unrealized gams 3698 4.9. on investments .
(2) Donated services and use of faotites (3) Recoveries of prtor yeargrante ... (4) Other (specify) SOME 13 286.433. 633.431.

Reconciliation or expenses per AuditcQ of txpcnses per Financial Statements with Return Total expenses and tosses per audited financial statements ... 288.050,462, Amounts included on (me a but not on line 17. Form 99Qm*_ . . _ _ **. . . . ___*_ *_ ^* .. ^. _-.

Donated sconces and use of features i_ (2) Pttor year adjustments reported on fine 20, Form 990 $
(3| Losses reported on

Imo 20. ftnm 990 $ (4) Other (specify)

STMT 14 3.568.136 3.5BS.136. 284.462.326.

Add amounts on Imes (1) through (4) > c d Line a minus (me b , Amounts included on (me 12, Form 990 but not on line a:

(1) Investment expenses not included on line 6b, Form 990 . . . $ (2) Other (spccify)-

Add amounts on feies(t)tf7rough (4). Lme a minus (me n 285.946.971. e d Amounts included on fine 17, Form 990 but not on fine at: <1) Investment expenses not included on Kne 6b, FonnSSO . . .$

Add amounts on lines (1) and (2). Add amounts on Imes (1) and (2). . * Total expenses per line 17, Form 890 Total revenue per (me 12, Form 330 Clme c plus Ime d) - - 284.462.326. Mine c plus fine d) ... 2BS.948,971. List of Officers, Directors, Trustees, and Key Employees (last each one even if not compensated; see page 27 of the instructions )
(A) Name and address (B)T(HsantIasaga houre pwwerfe devoted to oostMti <C) Compensation (ITnotpaM,*ntT *J 765.917. (D) ContrAutiomto empteyw UeneB plans &
(3SCRVtf LUfl ]M& l U 1 | l JJ

(^BqMnse account and other allowances

-0-

SEE STATEMENT 15

-o-

75

Did any officer, director, trustee, or key employee receive aggregate compensation of nH>re&ian$1QOlCXXI from your organization and af I related organizations, of whrch more than $10.000 was prcwdedfaytherelatedorgantzatwns' fr |_X}Yes If "Yes." attach schedule - see page 28 of fire mstnicbans

|_ No [

Form 990 (2004)

OV4739 L979 11/10/2005 11:05:13 V04-8

THE COMMUNITY HOSPITAL GROUP, INC. FORM 930, PART V - LIST OF OFFICERS/ DIRECTORS, AND TRUSTEES

22-6019101

NAME AND ADDRESS

TITLE AND TIME DEVOTED TO POSITION

COMPENSATION 328,620

CONTRIBUTIONS TO EMPLOYEE BENEFIT PLANS

EXPENSE ACCT AND OTHER ALLOWANCES

MCGEE, JOHN P. C/O SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISON, NJ 08820 RAYMOND FREDERICKS C/O SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISON, NJ 03820 SCOTT GEBHARD C/O SOLARIS HEALTH SYSTEM 80 JAMBS STREET EDISON, NJ 08820 SEAN PATRICK MURPHY C/O SOLARIS HEALTH SYSTEM 80 JAMBS STREET EDISON, NJ 08820 NANCY FIAMINGO C/O SOLARIS HEALTH SYSTEM 80 JAMBS STREET EDISON, NJ 08820

PRESIDENT

SENIOR VP

200,850

EXECUTIVE

71,207

EXECUTIVE

142,286

EXECUTIVE

22,954

GRAND TOTALS

765,917

JV4739 L979 11/10/2005 11:05:13 V04-8

32

STATEMET

15

2064 OFFICERS AND BOARD MEMBERS

JFK MEDICAL CENTER fTHE COMMUNITY HOSPITAL GROUP. INC. T/A1 Chair Vice Chair Chief Operating Officer Secretary/Treasurer Assistant Secretary David A. Belowich Michael A. Kfeiman, DMD Pra&l Raja J. Scott Gebhard Jay M. Jeney Sean Patrick Murphy, Esq. Brian T. McGowan Hx-officio:

Morns Brown, Esq.

Simpson Choi John 0. Gain

Vat Meszaros
Elizabeth T. Perricone Elaine Santowasso

Janet Biacknian
EEaine Graves N. Hooshangi, MD

Kostas Gussis Donald Kline, MD

Leonard Sendeisky ShaiieshShah

John L. Kolaya, PE JohnP.McGee

Franklin Spirn, MD

William J. Lovett Thomas E. Sharp John G. McDonough, DMD Rose M. Velencsics

Rev 9/04

STATEMENT 10B

COMMUNITV HOSPITAL GROUP, INC EIN: 22-6019109 YE: DECEMBER 31,2002 FORA! 990, PART V, LIST OF OFFICERS, DIRECTORS, TRUS TEES AND KE> EMPLOY EES Officers & Directors Compensation Employee Benefits Expense Account

Louis P Amato Chief Operating Officer c/o The Community Hospital Gr

80 James Street

$109,838

None

None

Edison, New Jersey 08820 David A Belowich c/o The Conununity Hospital Gr
SO James Street Edison, New Jeisey OSS20 Morns Brown, Esq None

None

None

None

None

None

e/o The Community Hospital Gr 80 James Street

Edison, New Jersey 08820

Dr A Peter Capparelii c/o The Community Hospital Gr

80 James Street

None

None

None

Edison, New Jersey 08820 Joseph Cipolla, MD c/o The Community Hospital Gr 80 James Street Edison, New Jersey 08820 Jodi Gelles c/o The Community Hospital Gr
80 James Street

None

None

None

None

None

None

Edison, New Jersey 08820

John O. Grun

None

None

None

c/o The Community Hospital Gr 80 James Street Edison, New Jersey 08820
Kostas Gussis

None

None

None
Statement 10

c/o The Community Hospital Gr

COMMUNITY HOSPITAL GROUP, INC. EIN: 22-6019109 YE: DECEMBER 31,2002 FORM 998, PART V, LIST OF OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES

80 James Street Edison, New Jersey 08820 Sean Patrick Murphy, Esq Assistant Secretary c/o The CommunityHospital Gr 80 James Street
Edison, New Jersey 08820

None

None

None

Praful Raja c/o The Community Hospital Cr 80 lames Street

Edison, New Jersey 08820

None

None

None

Elaine Santowasso
c/o The Community Hospital Gr.

None

None

None

80 James Street
Edison, New Jersey OS820 Leonard Sendelsky /~*fa The Community Hospital Gr

None

None

None

0 James Street Edison, New Jersey 08820

Shailesh R Shah None None None

c/o The Community Hospital Gr 80 James Street

Edison, New Jersey 08820

Thomas E Sharp
Chair

None

None

None

c/o The Community Hospital Gr 80 James Street

Edison, New Jersey 08820 RoseM Yelencsics

None

None

None

c/o The Community Hospital Gr

80 James Street Edison, New Jersey 08820

Statement 16

COMMUNITY HOSPITAL GROUP, INC. KIN: 22-6019109 YE: DECEMBERS!, 2002 FORM 990, PART V, LIST OF OFFICERS, DIRECTORS, TRUSTEES AND KEV EMPLOYEES EX-OFFICIO MEMBERS

Dons DeSamo c/o The Community Hospital Gr SO James Street Edison, New Jersey 08320 Dorothy Holton c/o The Community Hospital Gr
80 James Street

None

None

None

None

None

None

Edison, New Jersey 08820 Nossratoltah Hooshangi, MD c/o The Community Hospital Gr SO James Street Edison, New Jersey 08S20 JohaP McGee c/o The Community Hospital Gr 80 James Street Edison, New Jersey 08820 Douglas A Nordstrom c/o The Community Hospital Gr 80 James Street Edison, New Jersey 08820 Matthew H Smith, MD c/o The Community Hospital Gr 80 James Street Edison, New Jersey 08820 None None None

$181,757

None

None

None

None

None

None

None

None

Statement 10

IMMUNITY HOSPITAL GROUP, me.

EIN: 22-6019109 YE: DECEMBER 31,2001 FORM 990, PART V, LIST OF OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES
Officers & Directors

Compensation

Employee Benefits

Expense Account

David A Belowich 10 Hearthstone Dnve Edison, NJ 08820 (732)494-1754 Moms Brown, Esq Wilentz, Goldman & Spitzer 90 Woodbndge Center Dnve Woodbndge,NJ 07095 (732)636-8000 Dr A Peter Capparelh 2137 Locust Road Sea Girt, NJ 08750 (732)449-2613 Joseph CipoUa, MD 2268 Edgewood Terrace Scotch Plains, NJ 07076 (908)889-5053 Raymond J Curcio, DOS Assistant Secretary

None

None

None

None

None

None

None

None

None

None

None

None

None

None

None

31 Remington Dnve
Edison, NJ 08820 (732)548-3029 jodi Geiles None Executive Director, Corporate Info Mgmt Johnson & Johnson I Johnson & Johnson Plaza New Brunswick, NJ 08933 (732)524-3482 John O. Grun Director of Health & Human Resources Department of Health & Human Services 100 Municipal Boulevard None None None

None

None

Statement 9A

HOSPITAL GROUP,
EIN: 22-6019109 YE: DECEMBER 31,2801 FORM 990, PART V, LIST OF OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES
i

Edison, NJ 08817-3553 (732)248-7291 KostasGussis 24 Edgewood Road Edison, NJ 08820 (732) 549-0255 Riehaid L Hraes Chair, Solans Health System 4 Wendover Road Edison, NJ 08820 (732)549-9355 JayM Jeney Secretary/Treasurer 62 Yhet Dnve HiUsborough,N3 08844 (908)281-9689 Michael A Kleiman, DMD Vice Chair Edison - Clark Oral Suigety Associates 1857 Oak Tree Road Edison, NJ 08820 (732)548-7824 Donald Kline, MB 1802 Oak Tree Road Edison, NJ 08820 (732)548-3210 Leonard Sendelsky 100 Devon Road Coloraa,NJ 07067 (732)381-7109 ShaUeshR Shah 481 Grove Avenue Edison, NJ 08820 /-~-O32) 549-8017 None None None

None

None

None

None

None

None
t

! I j None None None i ;

None

None

None

None

None

None

None

None

None

Statement 9A

HOSPITAL GROUP,
EIN: 22-6019109 YE: DECEMBER 31,2001 FORM 990, PART V, LIST OF OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES

Thomas E Sharp Chair 165 Essex Avenue, #402

Metuchen,NJ 08840 (732)549-8989 RoseM Yetencsics 103 Buchanan Road Edison, NJ 08820 (732) 548-4105

None

None

None

None

None

None

EX-OFFICIQ MEMBERS Dons DcSarno President - JFK Auxiliary 10 Lily Court Edison, NJ 08820 (908)769-1706

None

None

None

Dorothy Holton
VP Financial Affairs JFK Auxiliary I Iverness Court Janiesburg,NJ 08831 (732)521-2407 NossratoHah Hooshangj, MD

None

None

None

None

None

None

President JFK Medical/Dental Staff

98 James Street, 309

Edison, NJ 08820
(732)549-9082 Douglas A Nordstrom Chair, MRMC Board of Directors Vice President & Manager None None None

Administrative Planning & Control

Chubb & Son, Inc 15 Mountain View Road, PO Box 1635 Warren, NJ 07061-1615 (908) 903-3397
Statement 9A

IMMUNITY HOSPITAL GROUP, EEN: 22-6019109 YE; DECEMBER 31,2001 FORM 990, PART V, LIST OF OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES

Matthew H Smith, MD None Vice President - JFK Medical/Dental Staff Pulmonary Internists Levmson Plaza, Suite 301 2 Lincoln Highway Edison* NJ 03820
(732)549-7380

None

None

Statement 9A

22-6019101^

Part IV-B
Financial Statements with Revenue per Return (See Specific Instructions, page 25.)
a Total revenue, gains, and ofiier support per auditedfinancialstatements . . it- a '25,924.852. b fa Amounts included on fine a but not on I..S& * "*I II******""'! * line 12, Form 990: (1) (1) Net unrealized gains : "iM-oV *:!"' :-Eon Investments . . $ 5,254.823. (2) \ (2) Donated services a

Financial Statements with Expenses per Return

(3J (4)

c d (1)

(2}

Total expenses and fosses per auditedfinancialstatements ... .ft* a 21S.169.SSS. Amounts included on fine a but not on fine 17, Form 990. " * " " .:"" \ .*. ; _; _ . ; . Donated services and use of facilities S Prior year adjustments reported on line 20, and usa of faelHHBB S Farm 930 . .$ Recoveries of prior i * L'.r- "" m ~~~- ', {3) Lessee reported on year crams S *" ' i"-K!cr " ~- :" . ' line 20. Form 930 S 137,097. Other (specif?): " . . - - : - _;' (4) Gfter (Bpedftf: I** t^rn-LtiT^-fS ia*; S.rr' : * ..xffi "^** *"" *" -x '.*.'.'..'., -.-.- j;-" S $ Add amounts on lines (1| through (4) > b 5.254,823. Add arnoants on TITOS (1) through (4). . I*- b 137.097. > e 213.032,499. Line a minus line b > c '20,670,029. c Line a minus line b r" d Amounts included on Ene 17, Amounts included an line 12, Form 990 but not on fine a: Form 990 but not on fine a: J *""_ 1 : * s."""1 Til .: c- t-ii=^^?^'; {1} Investment expenses Investment expenses ^ :i*n^'^. Bj ~f" ' t" not included on line -= -_ =.*e.n ;-= - ; i.^*-P ***" not included on line "**".. "i'r ' ~ ; . . v." 6b. Form 990 . . .$ 6b. Form 990 . . . S !r* (2) Other (specify}: Oner {specify):

^=^n^.r^

-^'"

"

*.

"^T ; LI*. : SOT* _!.=

I!^^:^-! "'.'rS'.* -. """

Add amounts on lines (1) and (2) * d Total revenue per fine 12. Form 990 ffme c clus line d) + E 220.670,029.

Add amounts onfines(1) and (2J . . t* d Total expenses per line 17, Form 999 Hine colus One d) e 218.032.489.

Ust of Officers, Directors, Trustees, and Key Employees {Ust each one even if not compensated; see Speerfic Instructions on page 25.)
(A) Name ana address IB} TWe ami awerage hours per week dewmed to oosfton ((I Compensation nTnatfnfd,,innn
4k.\.

(DJContrfljinonito Ainpt0yM bfirafiEffivu A fletKiM txKiptPsmn

(E)Beense acrajimt and rttwr sltewanras

SEE STATEMENT 10

11.200.
-

NONE

75 Did any officer, director, trustee, or key employee receive aggregate compensation of more than S100.000 (him your organization and an related organizations, of wtiieh more Bran S10.00Q was provided by ttie related organizations? IF Yes," attach schedule - see Speerfic tnstnretions on page 26.

I Yes

Mo

Fcrm9$Q (2000)
JSA

OV4739 1534 11/09/2O01 13:21:37 VO.07.01

THE COMMUNITY HOSPITAL GROUP, INC. FORM 990, PART V - LIST OF OFFICERS, DIRECTORS, AND TRUSTEES
C==cs!= sEEs:3S

22-6019101

NAME AMD ADDRESS MCGEE, JOHN P. C/O SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISON, NJ 00820 RAYMOND FREDERICKS C/O SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISON, NJ 08820 LOUIS AMATO C/O SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISON, NJ 08820

TITLE AND TIME DEVOTED TO POSITION PRESIDENT fi CEO 40

COMPENSATION 85,541

CONTRIBUTIONS TO EMPLOYEE BENEFIT PLANS NONE

EXPENSE ACCT AND OTHER . ALLOWANCES NONE

SR VP & CFO 40

48,581

5,200.

NONE

EXECUTIVE VP & COO 40

70,936

6,000.

NONE

GRAND TOTALS

205,058.

11,200.

NONE

OSPSLN6MG

JV473S 1534 11/09/2001 15:21:37 VO.07.01

27

STATEMEN*

10

"

5j

HI!

i ai 1

fcl
I

Fofrn9SQf199S)_

22-6019107

a b

Reconciliation of Revenue per Audited Financial Statements with Revenue per Return (See Specific Instructions, page 24.) Total revenue, gafas, and other support per audited financial statements . . ft> Amounts included on line a but not on line 12, Form 990: .
^_ _ ' ._._

nmviSs^ Reconciliation of Expenses per Audited Financial Statements with Expenses per Return a Total expanses and tosses per audited rrtrancraf statements . . . . b Amounts included on line a but not on fine 17,-Fonn 930:
(1) Donated semoEs
and use offoragesS_ , ,

(1) Net unreafeed gains on investments . . __ (2) Donated senfees

and use of fadESes S

(3) Recoveries of prior year grants .... J_ (4)

^-...-,

(2) Prior year adjustments reported on fine 2), Form 990 ..... $ (3} lossesreportedon

__

__,_ .

Ifne20, Forni^O $

Add amounts on fines (1) through (4) *

c Lino a minus line fa ft

jjj rifQ9RiJB52.

Amounts included on fine 12, Form 390 but not on line a: (1) Investment expenses not included on line '

c d

Add amounts onfcwss(1}through (4). Une a mtnus IFne t ...... ... Amounts friduded on fine 17, Form 990 but not on line a: (1) Investment expenses
6b, Faran 990 . _S

E2)

(2)

12 t 239,595.137 289,595 ,.138. Add amounts on lines (1) and (2). . Add amounts on fines (1) and (2) * e Total expenses per fine 17. Fonn 990 Total revenue per fine 12, Form 98Q (fine c phis lineal lec'ptus fined* IMKB Ust of Officers, Directors, Trustees, and Key Employees (List each fma even if not compensated; see Specific Instructions on page 24.)
(A) Name antf address (B) Tills atsJ average boors peraeek devoted to posStan ((3 Compensation flrnotpald^Miter *J (DJConftlbtfScrata RB9ense rniptoywDenriSpftn* & accounlandoffiQ1 defertad eentpenwBwi aftowances

SEE^STATEMEST 13

, 344,521.

2,448.

HONE

,
75 Did any officer, director, trustee, or key emptojraa retire aggregate compansatton of more than $100.000 unm yaar organization and all related organizations, of whteh more than 810,000 was provfcted by am related ciganfeaSons? If "Yes," attach schedule-see SpscfficlfisfnicHans on page 25.

Yes \K&

Form 996 1993}

JSA

SEI040 J.OOO

JV4739 1S34 11/13/2000 12:13:25 V9.08.01

'

THE COMMUNITY HOSPITAL GROUP, INC. FORK 990, PART V - LIST OF OFFICERS, DIRECTORS, AND TRUSTEES

22-6019101

NAME AND ADDRESS

AND TIME DEVOTED TO POSITION PRESIDENT FULL-TIME

COMPENSATION 36,735

CONTRIBUTIONS TO EMPLOYEE BENEFIT PLANS NONE

EXPENSE ACtiT AND OTHER ALLOWANCES NONE

MCGEE, JOHN P. C/0 SOLARIS HEALTH SYSTEM GO JAMES STREET EDISON, NJ 08820 RAYMOND FREDERICKS C/0 SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISON, Nil 08820 LOUIS AMATO C/0 SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISON, NJ 08820

SR VP AND CFO FULL TIME

102,357,

2,448.

NONE

EXECUTIVE VP COO FULL TIME

205,229

NONE

NONE

GRAND TOTALS

344,521.
Bsssstsecsesss

2,448

NONE

BSPSLN 000

JV4739 1S34 11/13/2000 12:13:25 V9.08.01 /

27

STATEMET

13

THE COMMUNITY HOSPITAL GROUP, INC. EtN:2Z-8(MG1C1 12/31/39

FORM (90, PAKTV, UNEttt

I SlIRGf I SHORE I MULEK

KEY EXECUTIVES 4 OFFICSRS

tWiMgftM"<el

COUUtlS EKPWYEECQKEKB. IflTW, | KEAUH ( JFK I RMIJ | 1UAT I HART | HART I HEALTH { JFK I U1PLCK I fOK KEBOPNMt____COitf-gtBATIO I SMiaiS I ____ |____J flf 0 \l OISOJJ E3 1 EHME J RBM-TV ] HBffMJJ |____< __ |

JOHN C. MCGE6
PREfflDEKTANDCEO 367^48 WTAtS I XM<s\l IBJBY.1 SSffK>\J Cft| ODi 0Hfc[ 6jQaii.|

__ _
SR,VPfi CHIEF RfWNCIALOFFfCER LOUISAMftIO 2ES.5ST 258,637 L._M9I tl-OMil MJOftl <"*| g-O"**! OJXHtJ OJObj OOml 0 jfMtj Q.fflftl aoOft| OJBt| OXHHil 100JDa(

execuwe VICE PRESIDENT AND

CHIEF OPERATING OFFICER

STATEMENT1B

THE COMMUNITY HOSPITAL GROUP, IMC. FORM 990. PART V - LIST OF OFFICERS. DIRECTORS. AND TRUSTEES

22-6019101

NAME AND ADDRESS

TITLE AND TIME DEVOTED TO POSITION TRUSTEE PART-TIME

COMPENSATION NONE

CONTRIBUTIONS TO EMPLOYEE BENEFIT PLANS NONE

EXPENSE ACCT AND OTHER ALLOWANCES NONE

KLEIMAN, MICHAEL A., DMD C/0 SOLARIS HEALTH SYSTEMS. IMC 80 JAMES STREET EDISON, NJ 08820 BELOWICH. DAVID A. C/0 SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISON, NJ 08820 NARDELLI. VI TO C/0 SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISON, NJ Q8820 CAPPARBLLI, A. PETER C/0 SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISON, NJ 08820 SCHLOSSER, ROBERT E., PH.D C/Q SOLARIS HEALTH SYSTEM 60 JAMES STREET EDISON, NJ 08820 SANTOWASSO, ELAINE C/0 SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISON, NJ 08820 CimCEO, RAYMOND

TRUSTEE PART-TIME

NONE

NONE

NONE

TREASURER PART-TIME

HONE

NONE

NONE

SECRETARY PART-TIME

NONE

NONE

NONE

TRUSTEE PART-TIME

NONE

NONE

NONE

TRUSTEE PART-TIME

NONE

NONE

NONE

TRUSTEE PART-TIME

NONE

NONE

NOME

6SPELN 1 0 9 ,0

665763 E481 10/26/1999 08:57:27 V8.07.01

28

STATEMENT

14

THE COMMUNITY HOSPITAL GROUP, INC. FORM 990. PART V - LIST OF OFFICERS. DIRECTORS. AND TRUSTEES

22-6018101

NAME AND ADDRESS C/0 SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISON, NJ 08620 DOCTOFSKY. ROY C/O SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISON, NJ 08820 FERENCZI. R JOSEPH ESQ. C/O SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISON. NJ 08820 GUSSIS, KOSTAS C/O SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISON. NJ 08820 . MINES. RICHARD C/O SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISON, NJ 08820 HLAVEMKA, FRANK C/Q SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISON. NJ 08820 HUTTt STEWART C/Q SOLARIS HEALTH SYSTEM 80 JAMES STREET

TITLE AND TIME DEVOTED TO POSITION

COMPENSATION

CONTRIBUTIONS TO EMPLOYEE BENEFIT PLANS

EXPENSE ACCT AND OTHER ALLOWANCES

TRUSTEE PART-TIME

NONE

NONE

NONE

TRUSTEE PART-TIME

NONE

NONE

NONE

TRUSTEE PART-TIME

NONE

NONE

NONE

TRUSTEE PART-TIME

NONG

NONE

NONE

TRUSTEE PART-TIME

NONE

NONE

NONE

TRUSTEE PART-TIME

NONE

NONE

NONE

66B763 E481 10/26/1999 08:57:27 VS.07.01 ^-^^^ ^

STATEMENT

15

THE COMMUNITY HOSPITAL GROUP. INC. FORM 990, PART V - LIST OP OFFICERS, DIRECTORS. AND TRUSTEES

22-6019101

NAME AND ADDRESS EDISON, NJ 08820

TITLE AND TIME DEVOTED TO POSITION

COMPENSATION

CONTRIBUTIONS TO EMPLOYEE BENEFIT PLANS

EXPENSE ACCT AND OTHER ALLOWANCES

SHAH. SHAILESH R. C/0 SOLARIS HEALTH SYSTEM 80 JAMES STREET ED[SON, NJ 08820 MAYO, S. ELLIOTT C/0 SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISON, NJ 06820 MCDQNQUGH. JOHN DMD C/0 SOLARIS HEALTH SYSTEM 80 JAMES STREET EDtSON, NJ 08820 MCDOWELL, R. BRUCE C/0 SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISON, NJ 08820 MESZAROS. VALENTINE C/0 SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISON. NJ 08820 PETERSON. BARLE C/0 SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISON, NJ 08820

TRUSTEE PART-TIME

NONE

NONE

NONE

TRUSTEE PART-TIME

NONE

NONE

NONE

VICE CHAIR PART-TIME

NONE

NONE

NONE

TRUSTEE PART-TIME

NONE

NONE

NONE

VICE CHAIR PART-TIME

NONE

NONE

NONE

TRUSTEE PART-TIME

NONE

NONE

NONE

QSPSLN 1 0 0 .0

666763 E481 10/26/1999 08:57:27 V8.07.Q1

STATEMENT

16

THE COMMUNITY HOSPITAL GROUP. INC. FORM 990, PART V - LIST OF OFFICERS. DIRECTORS, AND TRUSTEES

22-6019101

NAME AND ADDRESS

TITLE AND TIME DEVOTED TO POSITION VICE CHAIR PART-TIME

COMPENSATION NONE

CONTRIBUTIONS TO EMPLOYEE BENEFIT PLANS NONE

EXPENSE ACCT AMD OTHER ALLOWANCES NONE

SENDELSKY, LEONARD C/0 SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISONr NJ OS82Q TRIPP. IRVING C/0 SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISON, NJ 0 8 0 82 SHARP, THOMAS E, C/0 SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISON. NJ 08820 BROWN, ESQ., MORRIS C/0 SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISON, NJ 08620 CI POLLA, MD.. JOSEPH A. C/0 SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISON, NJ 0882Q DILEO, VICTOR C/0 SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISON, NJ 08820 GRUN, JOHN 0.

TRUSTEE PART-TIME

NONE

NONE

NONE

CHAIR PART-TIME

NONE

NONE

NONE

VICE CHAIR PART-TIME

NONE

NONE

NONE

TRUSTEE PART-TIME

NONE

NONE

NONE

TRUSTEE PART-TIME

NONE

NONE

NONE

TRUSTEE PART-TIME

NONE

NONE

NONE

6SPSLN 1 0 D .0

665763 E481 10/26/1999 08)67:27 V8.07.01

31

STATEMENT

17

THE COMMUNITY HOSPITAL GROUP. INC. FORM 890. PART V - LIST OF OFFICERS, DIRECTORS, AND TRUSTEES

22-6019101

NAME AND ADDRESS C/O SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISON. NJ 08820 HESS. JOHN C.. C/O SOLARIS HEALTH'SYSTEM 80 JAMES STREET EDISON, NJ 08820 JENEY, JAY M. C/O SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISON, NJ 08820 KLINE, MD, DONALD C/O SOLARIS HEALTH SYSTEM 80 JAMES STREET ED .[SON. NJ 08820 MCGOWAN, BRIAN T. C/O SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISON, NJ 08820 MILLER, BARBARA C/O SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISON, NJ 08820 RAJA, PRAFUL C/O SOLARIS HEALTH SYSTEM 80 JAMES STREET

TITLE AND TIME DEVOTED TO POSITION

COMPENSATION

CONTRIBUTIONS TO EMPLOYEE BENEFIT PLANS

EXPENSE ACCT AMD OTHER ALLOWANCES

TRUSTEE PART-TIME

NONE

NONE

NONE

ASST. SECRETARY PART-TIME

NONE

NONE

NOME

TRUSTEE PART-TIME

NONE

NONE

NONE

ASST. TREASURER PART-TIME

NONE

NONE

NONE

TRUSTEE PART-TIME

NONE

NONE

NONE

FIRST VICE CHAIR PART-TIME

NONE

NONE

NONE

eSPSLNl.OM

665763 E481 10/26/1899 OB{B7i27 VS.07,01

STATEMENT

t8

THE COMMUNITY HOSPITAL GROUP, IKG. FORM 990. PART V - LIST OF OFFICERS, DIRECTORS. AND TRUSTEES

22-6019101

NAME AND ADDRESS EDISON. NJ 08820

TITLE AND TIME DEVOTED TO POSITION

COMPENSATION

CONTRIBUTIONS TO EMPLOYEE BENEFIT PLANS

EXPENSE ACCT AND OTHER ALLOWANCES "

SWALES 1(1. THOMAS C/0 SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISONt NJ Q8820 TUMMINELLO. STEPHEN C. C/0 SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISON. NJ 08820 MCGEB, JOHN P. C/0 SOLARIS HEALTH SYSTEM 80 JAMES STREET EDISON. NJ 08820

TRUSTEE PART-TIME

NONE

NONE

NONE

TRUSTEE PART-TIME

NONE

NONE

NONE

PRESIDENT & CEO FULL-TIME

NONE

NONE

NONE

GRAND TOTALS

NONE

NONE

NONE

666763 E481 10/26/1999 08:57:27 VS.07.01

33

STATEMENT

19