General Acute Care Hospitals - New Jersey
Name of Managed Care Organization:
State of New Jersey Department of Banking and Insurance
For the Period Ending:
General Acute Care Hospitals
PLEASE DO NOT ALTER THIS FORM - ANY MODIFICATION TO THIS FORM IS PROHIBITED
General Acute Care Hospitals
Contracted Date Contract
Yes
No
Expires
Hospital Services
ATLANTIC
AtlantiCare Regional Medical Center-City Division
No OB Beds
4
AtlantiCare Regional Medical Center-
Mainland Division
1
3
5
Shore Medical Center
BERGEN
Bergen New Bridge Medical Center
No OB Beds
Englewood Hospital and Medical Center
1
3
5
Hackensack University Medical Center
RPC, CH
12345
Holy Name Medical Center
5
HackensackUMC At Pascack Valley
The Valley Hospital
1
3
5
BURLINGTON
Virtua Marlton Hospital
No OB Beds
5
Virtua Memorial Hospital
5
Virtua Willingboro Hospital
No OB Beds
CAMDEN
Cooper Hospital/University Medical Center
RPC, CH
12345
Jefferson Cherry Hill Hospital
No OB Beds
Jefferson Stratford Hospital
No OB Beds
Virtua Our Lady of Lourdes Hospital
RPC
1
3
5
Virtua Voorhees Hospital
RPC
12
CAPE MAY
Cape Regional Medical Center
CUMBERLAND
Inspira Medical Center Vineland
1
ESSEX
Clara Maass Medical Center
5
East Orange General Hospital
No OB Beds
HackensackUMC Mountainside Hospital
5
Newark Beth Israel Medical Center
RPC, CH
123
5
Saint Barnabas Medical Center
RPC
123
5
Saint Michael's Medical Center
No OB Beds
3
5
University Hospital
RPC
12345
Report hospitals with a written executed contract with the Plan. All other arrangements must be reported under comments. 1. NJDHSS licensed Neonatal Intensive Care Unit (NICU) Bassinets 2. NJDHSS licensed Pediatric Intensive Care Unit (PICU) beds 3. NJDHSS designated Cardiac Surgery 4. NJDHSS designated Level l or II Trauma Center 5. NJDHSS designated Primary Angioplasty Site (RPC) - NJDHSS licensed Regional Perinatal Center (CH) - NJDHSS licensed Children's Hospital
rev. 3/2020
Name of Managed Care Organization:
For the Period Ending:
General Acute Care Hospitals
PLEASE DO NOT ALTER THIS FORM - ANY MODIFICATION TO THIS FORM IS PROHIBITED
General Acute Care Hospitals
GLOUCESTER
Inspira Medical Center Mullica Hill Jefferson Washington Township Hospital
HUDSON
CarePoint Health-Bayonne Medical Center CarePoint Health-Christ Hospital CarePoint Health-Hoboken University Medical Center Hudson Regional Hospital Jersey City Medical Center Palisades Medical Center
HUNTERDON
Hunterdon Medical Center
MERCER
Capital Health Regional Medical Center Capital Health Medical Center - Hopewell RWJ University Hospital at Hamilton St. Francis Medical Center
MIDDLESEX
Raritan Bay Medical Center-Old Bridge Raritan Bay Medical Center - Perth Amboy JFK Medical Center RWJ University Hospital at New Brunswick Penn Medicine Princeton Medical Center Saint Peter's University Hospital
MONMOUTH
Bayshore Community Hospital CentraState Medical Center Jersey Shore University Medical Center Monmouth Medical Center Riverview Medical Center
MORRIS
Chilton Medical Center Morristown Medical Center St. Clare's Hospital - Dover St. Clare's Hospital - Denville
OCEAN
Community Medical Center Monmouth Medical Center - Southern Campus Ocean Medical Center - Brick Southern Ocean Medical Center
Contracted
Yes
No
Date Contract Expires
Hospital Services
5 1
5 5
RPC
1
345
No OB Beds RPC No OB Beds No OB Beds No OB Beds
RPC, CH CH, RPC No OB Beds RPC, CH RPC, CH
RPC, CH No OB Beds
No OB Beds
5
4
1
5
5
3
5
5
5
12345
5
12
5
12345
12
5
5
5 12345
5
5 5
Report hospitals with a written executed contract with the Plan. All other arrangements must be reported under comments. 1. NJDHSS licensed Neonatal Intensive Care Unit (NICU) Bassinets 2. NJDHSS licensed Pediatric Intensive Care Unit (PICU) beds 3. NJDHSS designated Cardiac Surgery 4. NJDHSS designated Level l or II Trauma Center 5. NJDHSS designated Primary Angioplasty Site (RPC) - NJDHSS licensed Regional Perinatal Center (CH) - NJDHSS licensed Children's Hospital
State of New Jersey Department of Banking and Insurance
Name of Managed Care Organization:
For the Period Ending:
General Acute Care Hospitals
PLEASE DO NOT ALTER THIS FORM - ANY MODIFICATION TO THIS FORM IS PROHIBITED
General Acute Care Hospitals
Contracted
Yes
No
Date Contract Expires
Hospital Services
PASSAIC
St. Joseph's University Medical Center
RPC, CH
12345
St. Joseph's Wayne Medical Center
No OB Beds
St. Mary's General Hospital
3
5
SALEM
Inspira Medical Center Elmer
Salem Medical Center
No OB Beds
SOMERSET
RWJ University Hospital at Somerset
5
SUSSEX
Newton Medical Center
UNION
Overlook Medical Center RWJ University Hospital at Rahway
1
5
No OB Beds
5
Trinitas Regional Medical Center
5
WARREN
Hackettstown Regional Medical Center
No OB Beds
St. Luke's Warren Hospital
No OB Beds
Report hospitals with a written executed contract with the Plan. All other arrangements must be reported under comments. 1. NJDHSS licensed Neonatal Intensive Care Unit (NICU) Bassinets 2. NJDHSS licensed Pediatric Intensive Care Unit (PICU) beds 3. NJDHSS designated Cardiac Surgery 4. NJDHSS designated Level l or II Trauma Center 5. NJDHSS designated Primary Angioplasty Site (RPC) - NJDHSS licensed Regional Perinatal Center (CH) - NJDHSS licensed Children's Hospital
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