Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2016
Open to Public
Inspection
Name of the organization
HACKENSACK MERIDIAN HEALTH INC-SUBORDINATES
 
Employer identification number
01-0649794
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC section
(if applicable)		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
noncash assistance		 (h) Purpose of grant
or assistance
(1) AMERICAN CANCER SOCIETY
1035 HOOPER AVE
TOMS RIVER,NJ08753 		16-0743902 501(C)(3) 23,250       RESEARCH SUPPORT
(2) AMERICAN HEART ASSOCIATION
208 WEST END AVE
BRIDGEWATER,NJ08807 		13-5613797 501(C)(3) 33,000       RESEARCH SUPPORT
(3) HOLIDAY EXPRESS Inc
1184 OCEAN AVE C-8
SEA BRIGHT,NJ07760 		22-3470019 501(C)(3) 10,100       SAFETY & WELLNESS
(4) AMERICAN RED CROSS
PO BOX 33093
NEWARK,NJ071880093 		53-0196605 501(C)(3) 6,000       SAFETY & WELLNESS
(5) MONMOUTH PARK CHARITY FUND
175 OCEANPORT AVE
OCEANPORT,NJ07757 		22-6063135 501(C)(3) 11,000       SAFETY & WELLNESS
(6) TWO RIVER THEATER COMPANY Inc
21 BRIDGE AVE
RED BANK,NJ07701 		52-1857757 501(C)(3) 10,000       ART & CULTURE
(7) MONMOUTH COUNCIL BOY SCOUTS OF AMERICA
705 GINESI DRIVE
MORGANVILLE,NJ07751 		21-0634963 501(C)(3) 7,500       CHILDREN'S HEALTH
(8) RUTGERS UNIVERSITY FOUNDATION
7 COLLEGE AVENUE
NEW BRUNSWICK,NJ08901 		23-7318742 501(C)(3) 10,000       HIGHER EDUCATION
(9) MARCH OF DIMES FOUNDATION
1010 EAST PARK BLVD
CRANBURY,NJ08512 		13-1846366 501(C)(3) 5,500       HEALTH & WELLNESS
(10) BIG BROTHERS BIG SISTERS
174 MAIN STREET
EATONTOWN,NJ07724 		22-2155416 501(C)(3) 10,500       CHILDREN'S HEALTH
(11) SUSAN G KOMEN
TWO PRINCESS RD SUITE D
LAWRENCEVILLE,NJ08648 		73-2052349 501(C)(3) 14,600       RESEARCH SUPPORT
(12) BROOKDALE COMMUNITY COLLEGE
765 NEWMAN SPRINGS ROAD
LINCROFT,NJ07738 		22-1849485 501(C)(3) 8,500       HIGHER EDUCATION
(13) GIRL SCOUTS OF THE JERSEY SHORE INC
242 ADELPHIA ROAD
FARMINGDALE,NJ07727 		21-0731966 501(C)(3) 9,750       SAFETY & WELLNESS
(14) NJ VIETNAM VETERANS MEMORIAL FOUNDATION
PO BOX 648
HOLMDEL,NJ07733 		22-2918698 501(C)(3) 6,000       ART & CULTURE
(15) MICHAEL GERARD PUHARIC MEMORIAL FUND INC
PO BOX 787
MATAWAN,NJ07747 		22-3761121 501(C)(3) 6,250       CHILDREN'S HEALTH
(16) 180 TURNING LIVES AROUND INC
1 BETHANY ROAD BLDG 3
HAZLET,NJ07730 		22-2130220 501(C)(3) 13,000       SAFETY & WELLNESS
(17) GEORGIAN COURT UNIVERSITY
900 LAKEWOOD AVENUE
LAKEWOOD,NJ08701 		21-0634981 501(C)(3) 10,000       HIGHER EDUCATION
(18) AMERICAN ACADEMY OF PEDIATRICS INC
141 NORTHWEST POINT BLVD
ELD GROVE VILLAGE,IL60007 		36-2275597 501(C)(3) 7,500       RESEARCH SUPPORT
(19) PACIFIC ENCORE PERFORMANCES
129 FRANKLIN AVENUE
LONG BRANCH,NJ07740 		22-3653314 501(C)(3) 7,500       ART & CULTURE
(20) THE FOODBANK OF MONMOUTH & OCEAN COUNTIES INC
3300 ROUTE 66
NEPTUNE,NJ07753 		22-2622522 501(C)(3) 6,950       HEALTH & WELLNESS
(21) MARY'S PLACE BY THE SEA INC
PO BOX 86
OCEAN GROVE,NJ07756 		26-4736451 501(C)(3) 6,500       HEALTH & WELLNESS
(22) JUVENILE DIABETES RESEARCH FOUNDATION
3430 SUNSET AVENUE STE 21A
OCEAN,NJ07712 		23-1907729 501(C)(3) 25,000       HEALTH & WELLNESS
(23) JFK AUXILIARY
65 JAMES STREET
EDISON,NJ08818 		22-6019101 501(C)(3) 17,750       HEALTH & WELLNESS
(24) HACKENSACK UNIVERSITY MEDICAL CENTER
30 PROSPECT AVENUE
HACKENSACK,NJ07601 		22-1487576 501(C)(3) 1,432,600       HEALTH & WELLNESS
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
24
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2016
Page 2

Schedule I (Form 990) 2016
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients		 (c) Amount of
cash grant		 (d) Amount of
noncash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of noncash assistance
(1) EDUCATIONAL SCHOLARSHIPS 211 198,350      
(2) HARDSHIP ASSISTANCE 60 58,520      
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
SCHEDULE I, PART I; QUESTION 1 OVER THE YEARS, HACKENSACK MERIDIAN HEALTH HAS BEEN FORTUNATE ENOUGH TO OFFER SUPPORT TO CHARITABLE ORGANIZATIONS THROUGH CHARITABLE DONATIONS IN HACKENSACK MERIDIAN HEALTH'S COMMUNITY SERVICE AREA. ADDITIONALLY, HACKENSACK MERIDIAN ENCOURAGES ITS LEADERS, PHYSICIANS, AND TEAM MEMBERS TO SERVE ON THESE LOCAL CHARITABLE ORGANIZATION BOARDS AND COMMITTEES TO ENSURE THAT CONTRIBUTIONS OFFERED THROUGH HACKENSACK MERIDIAN ARE UTILIZED APPROPRIATELY. HACKENSACK MERIDIAN ESTABLISHES AN ANNUAL AMOUNT TO BE DONATED TO SUPPORT OTHER LOCAL TAX-EXEMPT CHARITIES AND UTILIZES THE FOLLOWING CRITERIA IN EVALUATING THE NUMEROUS REQUESTS RECEIVED FROM LOCAL TAX-EXEMPT CHARITIES: - GROUPS THAT PROMOTE AWARENESS OF HEALTH-RELATED ISSUES; - COMMUNITY ASSOCIATIONS THAT HELP THOSE IN NEED OF BASIC NECESSITIES INCLUDING, BUT NOT LIMITED TO, FOOD, CLOTHING, AND SHELTER; - ORGANIZATIONS THAT ENCOURAGE YOUNG PEOPLE TO ACHIEVE THEIR POTENTIAL, USE THEIR IMAGINATION, AND KEEP THEM SAFE FROM HARM; AND - SOCIAL SERVICES THAT PROVIDE RELIEF AND COUNSELING TO THOSE SUFFERING FROM ABUSE.MERIDIAN VERIFIES THE USE OF CONTRIBUTED FUNDS BY ATTENDING SUPPORTED EVENTS, REQUESTING COPIES OF JOURNAL ADS OR PROOF OF "FUNDED-BY" SIGNAGE, REVIEWING ORGANIZATIONAL ANNUAL REPORTS, AND VOLUNTEERING WITH THESE ORGANIZATIONS TO ENSURE THE ADVANCEMENT OF THE SUPPORTED MISSION.
SCHEDULE I; PART III SCHOLARSHIPS AND HARDSHIP ASSISTANCE ARE AWARDED BASED ON AN ANALYSIS OF CRITERIA OF ESTABLISHED POLICY SET BY HACKENSACK MERIDIAN HEALTH, INC. THE SCHOLARSHIP AND HARDSHIP ASSISTANCE RECIPIENTS ARE SELECTED BY A COMMITTEE OF THE ORGANIZATION BASED ON AN A REVIEW AND ANALYSIS OF THE OBJECTIVE AND NONDISCRIMINATORY CRITERIA.
Schedule I (Form 990) 2016



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