Hospital Closings and Restricted Assets

Position Paper

Muhlenberg Regional Medical Center,

Plainfield, New Jersey

June 11, 2010

On behalf of the Public Interest, we respectfully request that the New Jersey Attorney General's Office conduct a forensic audit of the Permanently Restricted Assets/Permanently Endowed Funds of Muhlenberg Regional Medical Center (MRMC), also known as Muhlenberg Hospital.

We make this request to resolve the unanswered issue of the fiduciary responsibility of the Muhlenberg Board of Trustees and Solaris Health System Board of Trustees. Did the Muhlenberg Board act independently, or were they subservient to the dictates of Solaris Health System and their Board of Trustees? The location and disposition of these permanently restricted assets/permanently endowed funds were overlooked, not addressed, or simply forgotten by the Certificate of Need Closure document of the former Commissioner of Health Heather Howard in her letter of July 29, 2008, and the recent court proceedings.

The amount of assets documented by IRS Forms 990 is between $4.2 Million and $6.7 Million [Exhibit 1] and may not be limited to those amounts because permanently endowed assets can possibly be held by other entities, such as: the Muhlenberg Foundation (established in 1977) and the Plainfield Foundation (dating to 1920), Muhlenberg Auxiliary, etc.

At the Muhlenberg public hearings, members of the public testified about the endangered endowed assets. Prior to that a letter dated April 7, 2008, was written to the then Attorney General by the New Jersey Appleseed Public Interest Law Center. [Exhibit 2] The Public would like to know what has happened to the permanently endowed assets/funds. The April 7, 2008, letter was written prior to the passage of P. L. 2009, c.64, "Uniform Prudent Managment of Institutional Funds Act." At no point did anyone go before the Courts as required by cy pres, for the legal transfer of gifted assets.

Muhlenberg was a beloved hospital during its 130 years of existence. Through those years thousands upon thousands of individuals, businesses, corporations, churches, community groups and organizations, foundations, municipalities, and government agencies donated funds to keep Muhlenberg financially viable. In fact the land that the hospital buildings are located on was purchased with public subscriptions.

Extensive research has found a sampling of probated wills and refunding of bonds and releases naming Muhlenberg Hospital, specifically, as beneficary of those probated wills:

· John M. Whiton Bequest $9,500 Memorial Fund $425,944 [Exhibit 3] Please note that Mr. Whiton was at one time a Councilman of Plainfield.

· Albert C. Stebbins Residue of estate $226,000 Permanent Endowment [Exhibit 4] Please note that Mr. Stebbins served on the Plainfield Common Council.

· Leighton Calkins Bequest $5,000 Endowed room with tablet inscribed [Exhibit 5] Please note that Mr. Calkins was a Mayor of Plainfield.

· Annie M. Hyler Bequest $5,000 Endowed Room with tablet inscribed [Exhibit 6] · Roger Murray Bequest $1,000 Permanently endowed funds [Exhibit 7] Please note that Mr. Murray was a NJ Assemblyman.

· Leonore Darrow White $ 500 Private room with tablet inscribed [Exhibit 8]

Many other community minded people left unrestricted monetary amounts to Muhlenberg when they could have further enriched their family and friends. Many people thought their funds to Muhlenberg were safe and did not restrict their funds because they could never imagine that Muhlenberg would close. People who made provisions for alternative recipients in case the primary recipient no longer existed did not feel the need to make the same provisions for Muhlenberg.

The six deceased cited above did not leave their wealth unrestricted. The review of this small sampling of wills should spark a look back at the location of the permanently restricted assets/funds. We would hope that all of the permanently restricted assets would be adequately protected by your office.

As life long residents of Plainfield, we would like all permanently endowed assets/funds returned to the Plainfield community in trust for healthcare needs, and a community board of private citizens established to oversee those assets. It is our belief that the intent of the donors was not to enrich another community in another county whose demographics do not in any way match the level of diversity that exists in the Plainfield area.

[Please note back-up documentation can be provided upon request]

The Muhlenberg Research Group

The Muhlenberg Independents

Tax Exempt Hospital Accountability

For Immediate ReleaseMarch 24, 2010 Grassley’s Provisions for Tax-exempt Hospital Accountability Included in New Health Care Law M E M O R A N D U M To: Reporters and Editors Re: tax-exempt hospitals provisions in new health care law Da: Wednesday, March 24, 2010 Sen. Chuck Grassley, ranking member of the Committee on Finance, with jurisdiction over taxes, has worked to hold tax-exempt hospitals accountable for the federal tax benefits they receive. The health care legislation signed into law yesterday includes provisions Grassley co-authored to impose standards for the tax exemption of charitable hospitals for the first time. The bill requires that a hospital complete a community needs assessment once every three years and adopt and publicize a financial assistance policy; prohibits billing those who qualify for financial assistance the top rates; and prohibits a hospital from taking extraordinary collection actions if the hospital has not made reasonable efforts to notify patients of its financial assistance policy. The bill also requires the IRS to review the tax-exempt status of each hospital every three years; requires Treasury and Health and Human Services to submit an annual report to Congress on the level of charity care, bad debt expenses and the unreimbursed costs of means-tested and non-means-tested government programs; and requires Treasury and HHS to provide a report in five years on the trends on the items reported on an annual basis. Grassley made the following comment on the advancement of these provisions. “Tax-exempt hospitals don’t have many measures of accountability for their special status. The law hasn’t given them much direction, and so they’ve defined standards for themselves. Sometimes that’s resulted in providing very little charitable patient care or other community benefits, failing to publicize charitable care to patients, charging indigent, uninsured patients more than insured patients, and using very aggressive collection practices. The Government Accountability Office and others, including the former IRS commissioner, have said for a long time that there is often no discernible difference between the operations of taxable and tax-exempt hospitals. These new provisions are modeled after principles and polices that the Catholic Health Association has had in place for years. I appreciate the association’s willingness to have honest, forthright conversations about charitable hospitals’ activities. The provisions take steps to differentiate tax-exempt hospitals from for-profit hospitals and provide further transparency about tax-exempt hospitals’ fulfilling their charitable mission. Congress, the IRS, and the public will now have additional tools and information to ensure that charitable hospitals act charitably.” The provisions enacted in the new health care law are the result of Grassley’s leadership on tax-exempt organizations’ accountability and transparency, including hospitals. In 2005, he sent letters of inquiry to some of the nation’s largest tax-exempt hospitals. In 2006, he convened a hearing and released a summary of the hospitals’ responses. In 2007, he released a staff discussion draft of potential legislative reforms and convened a roundtable of experts to discuss the potential reforms. In 2008, he followed up with letters of inquiry to more hospitals and received a report he’d requested from the Government Accountability Office. In 2009, he drafted legislative reforms and succeeded in persuading the Democratic majority to include several of the reforms in the new health care law. © 2008, Senator Grassley

Researchers Learn From Holi Festival

Hospital Closing Researchers

Need To Celebrate

Muhlenberg activists were honored guests of Dr. Ramesh Pandey at a celebration that made us question the loss of family and culture that we have all sustained. From seniors to newborn infants families gathered in beautiful clothes to enjoy a sumpteous feast at the Jaipur Restaurant on Hamilton Boulevard in South Plainfield. None of us can recall the last time we tasted food that was as good. I think I could live on Mango Lassi.

When the Muhlenberg movie is made, someone will have to play Doctor Pandey. From the day we first met him at the swearing-in ceremony for Congressman Leonard Lance, Dr. Pandey has embraced our vision of an Integrative Medicine and Ethnopharmacology Institute at Muhlenberg. He worked tirelessly to help elect Gov. Chris Christie, the only candidate who promised to investigate the closure of Muhlenberg Regional Medical Center.

To the Indian community of all faiths, we give thanks for the care, the support and the vision of happy intact families that challenges us in ways you can hardly imagine.

Next year, we won't be so worn and weary. Next year, we dance.

God bless you, one and all.

Deborah Dowe

Muhlenberg Hospital in Morristown Area?

Gov. Corzine and Health Commissioner Heather Howard placed the communities served by Muhlenberg Regional Medical Center in the Morristown Service Area, in a document designed to "Rationalize Healthcare" through a heavy focus on hospital closings and the resulting redistribution of health care resources.

This expensive, outsourced perspective on New Jersey geography was developed by the same consultants that produced the very short, controversial, travel times to alternative acute care hospitals. This, now "historic" report cost taxpayer dollars when accurate data could have been calculated, in house, by weights and measures or by google and mapquest, for free.

The other Hospital Service Area options include New Brunswick that borders communities served by Muhlenberg and are listed in the travel times to alternate sources of care. At least the Newark service area is accessible by public transportation. Seniors and people without cars can reach Robert Wood Johnson, in New Brunswick, by taking multiple trains with a change in Newark.

The Neighborhood Health Center, long ago moved virtually out of Plainfield, and now borders Greenbrook and Dunellen in Somerset and Middlesex Counties. These women who tend not to have cars, were sent to Elizabeth, virtually Newark, to give birth? A long way to transport a woman in labor and a difficult trip to visit a newborn that doesn't come home with the mother. At the very least, Elizabeth should have been restored to the Raritan Valley Train Line. People doing business with Union County and the court system would help make the route more profitable.

Have you ever tried to get to Morristown from Muhlenberg? Why was there no travel time to Morristown included in the alternatives to care at Muhlenberg?

New Jersey Acute Care Hospital by Market Area
http://www.nj.gov/health/rhc/finalreport/documents/appendix_3.pdf

Asset Transformation and Hospital Closings

Muhlenberg Regional Medical Center Property
Plainfield, New Jersey

A recent newspaper article detailed vague discussions concerning the development of the Muhlenberg Regional Medical Center property located in Plainfield, NJ.

Since the State of New Jersey holds the $152,925,000 State Contract Bonds (Hospital Asset Transformation Program) on the total Muhlenberg property issued by the New Jersey Health Care Facilities Financing Authority with the Bank of New York Mellon, as Master Trustee, the State of New Jersey should be an interested party and participate in the ongoing discussions in order to fully protect the public interest.

Muhlenberg Regional Medical Center was closed in 2008, by the former Commissioner of Health and Senior Services Heather Howard. (July 28, 2008, closure letter)

The New Jersey State Legislature passed a bill to allow for the bonding to go through even though the court challenge was not adjudicated. In October, 2008, the New Jersey Health Care Facilities Financing Authority approved the $152,925,000 State Contract Bonds in the Hospital Asset Transformation Program.

According to papers filed in the County of Union Clerk's office, the $152.9 million bond note is secured by the Muhlenberg property only and does not impact The Community Hospital Group, Inc. [Please note that at one of the hospital annual meetings, it was stated that there is also a $17 million mortgage on the Muhlenberg property, but research can not substantiate that as a fact.]

The Plainfield area residents lost healthcare for a supposedly $18 million loss, but the Muhlenberg assets have been leveraged to provide $152.9 million to another entity.

Regardless, the State of New Jersey needs to be aware of this development in order to protect the State's interest.


The Muhlenberg Independents
The Muhlenberg Research Group