SUPERIOR COURT OF NEW JERSEY

APPELLATE DIVISION DOCKET NO. A-2138- 22 CASSANDRA GIGI SMITH, Plaintiff-Appellant,

v. NEWARK COMMUNITY HEALTH CENTERS, INC., Defendant-Respondent.

Argued April 16, 2024

– Decided Ju ly 30 , 202 4 Before Judges Rose, Smith and Perez Friscia. On appeal from the Superior Court of New Jersey, Law Division, Essex County, Docket No. L-0547- 21. Margaret E. Quinlan argued the cause for appellant (Lowenthal & Abrams, PC, attorneys; Margaret E. Quinlan, on the brief). Samuel P. Reisen argued the cause for respondent (L aw Offices of James H. Rohlfing, attorneys; Samuel P

. Reisen, on the brief).
PER CURIAM NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE APPELLATE DIVISION This opinion shall not "constitute precedent or be binding upon any court. " Although it is posted on the internet, this opinion is binding only on the parti es in the case and its use in other cases is limite d. R. 1:36- 3.2 A- 2138

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Plaintiff Cassandra Gigi Smith appeals from a Febr uary 9, 2023 Law Division order granting the summary judgment dismissal of her negligence claim against defendant Newark Community Health Cen ters, Inc. pursuant to the New Jersey Charitable Immunity Act (CIA), N.J.S .A. 2A:53A-7 to -11

. Plaintiff asserted she was seriously injured on Feb ruary 14, 2019, when she slipped and fell on a wet floor outside an examinat ion room at defendant's East Orange facility after receiving an injectable medic ation paid by Medicare. Defendant raised several affirmative defenses, incl uding immunity from suit pursuant to N.J.S.A. 2A:53A-7 (Section 7), based on its status as "a nonprofit corporation, society[,] or association organized ex clusively for religious, charitable, educational[,] or hospital purposes ." On appeal, plaintiff maintains the CIA's immunity d oes not apply to her claim, asserting defendant neither was organized ex clusively for educational
purposes nor demonstrated it received sufficient funding to qua lify for charitable immunity under Section 7. Contending defendant was organized for hospital purposes, plaintiff asserts defendant's immunity is circumscribed by the $250,000 cap on damages under N.J.S.A. 2A- 53A -8 (Section 8). Finally, plaintiff argues the CIA's immunity does not apply to her claim because she was not a beneficiary of defendant's charitable activit ies at the time of the incident.3 A- 2138

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For the reasons that follow, we conclude Section 7 applies to plaintiff's claims and immunizes defendant from her suit. Acco rdingly, we conclude summary judgment was properly granted.
We review the trial court's grant of summary judgment de novo. Conforti

v. County of

Ocean, 255 N.J. 142, 162 (2023). Employing the same standard as the trial court, we review the record to determine whether there are material factual disputes and, if not, whether the undisputed facts viewed in the light most favorable to the non -moving party, nonetheless entitle the movant to judgment as a matter of law. See Samolyk v. Berthe, 251 N.J. 73, 78 (2022); Brill v. Guardian Life Ins. Co. of Am. , 142 N.J. 520, 540 (1995); see also R. 4:46 -2(c). We focus only on the motion record before t he judge. See Ji v. Palmer, 333 N.J. Super. 451, 463-64 (App. Div. 2 000).
We owe no deference to the trial court's legal analysis or interpretation of

a statute. Palisades at Fort Lee Condo. Ass'n v. 100 Old Palisade, LLC , 230 N.J. 427, 442 (2017). Accordingly, "a trial court's determination of the applicability of charitable immunity is reviewed de novo because an organization's right to immunity raises questions of law." Green v. Monmou th Univ., 237 N.J. 516, 529 (2019).4 A- 2138

- 22 I. In his written decision accompanying the February 9 , 2023 order, the motion judge set forth the governing sections of th e CIA and summarized the policy underlying the CIA

. Quoting our decision in Estate of Komninos v. Bancroft Neurohealth, Inc., 417 N.J. Super. 309, 31 9 (App. Div. 2010), the judge recognized the legislative intent behind the act "f oster[s] the private provision of services that benefit the general welfare, thus relieving the government of the obligation to provide those services." Further, th e CIA's "strong public policy . . . compels its liberal construction." Id. at 32 0 ; see also N.J.S.A. 2A:53A- 10 (providing the CIA "shall be deemed to be remedial and shall be liberally construed"). The judge correctly stated the three-prong test to determine immunity under the CIA. A pplying the language of Section 7, our Supreme Court reiterated in Green, "an entity qualifies for chari table immunity when it (1) was formed for nonprofit purposes; (2) is organized exc lusively for religious, charitable[,] or educational purposes; and (3) was promoting such objectives and purposes at the time of the injury to plaintiff who was then a beneficiary of the charitable works." Id. at 530-31 (quoting Ryan v. Holy Trinity Evangel ical Lutheran Church, 175 N.J. 333, 342 (2003)) ; see also N.J.S.A. 2A:53A-7(a).5 A- 2138

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"Charitable immunity is an affirmative defense, as to which, like all affirmative defenses, defendants bear the burden of persuasion. " Abdallah v. Occupational Ctr. of Hudson Cnty., Inc., 351 N.J. Super. 280, 28 8 (App. Div

. 2002) ; see also F.K. v. Integrity House, Inc., 460 N.J. Super. 105, 116 (App. Div. 2019).
A. The motion judge found defendant satisfied the thre e-prong test. Although the first prong was not in dispute, the judge found defendant was incorporated under New Jersey law as a nonprofit co rporation. Plaintiff does not challenge this finding on appeal.
B. Turning to the second prong, the judge initially fo und defendant's 1986 certificate of incorporation (COI) demonstrated the entity was formed "exclusively [for] charitable and educational purpo ses." As further support, the judge also cited the deposition testimony of defend ant's Chief Operating Officer, Bridget Hogan. According to Hogan, as a federally qualified health center, defendant "deliver[ed] primary care to patients, re gardless of their ability to pay." Further, defendant's "populations are insure d, uninsured, underinsured " and services are performed regardless of the patien t's ability to pay. Defendant utilized a sliding fee scale for uninsured patients. Re garding plaintiff's $281.166 A- 2138

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fee for services performed on February 14, 2019, Ho gan testified plaintiff "wasn't billed. The insurance company was billed." As the judge noted elsewhere in his opinion, it was undisputed that pl aintiff's bill was paid by Medicare. Further, in her answers to defendant's s tatement of undisputed material facts supporting its summary judgment moti on, plaintiff admitted "there was no co[-]pay." Plaintiff challenges the judge's prong two determin ation, arguing defendant neither is a traditional educational inst itution, such as "schools of all sorts," nor provided "education " as defined in Pomeroy v. Little League Baseball, 142 N.J. Super. 471, 474 (App. Div. 1976) , that is, "discipline of mind or character through study or instruction." As pla intiff correctly recognizes, in Pomeroy , we concluded Little League Baseball was organized e xclusively for educational purposes where

[t]he only proof presented on the summary judgment motion was that [the] defendant's exclusive purpose was the education of young people in the ideals of good sportsmanship, honesty, loyalty, courage and reverence, to the end that they may be stronger and happier, and that they may grow to be productive citizens. The fact that the objective was accompli shed through the teaching and supervision of baseball sk ills d[id] not vitiate the purpose. [Ibid.]7 A- 2138

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We were persuaded the defendant in Pomeroy was indi stinguishable from other organizations, including the Young Women's Christia n Association and the Boy Scouts, which were found to have an educational pur pose . Ibid. However, plaintiff attempts to distinguish the "dis cipline of the mind or character" afforded by "athletic clubs, little leag ue organizations, [and] boys and girls clubs" from defendant' s "primary objective" in the present matter , deemed by plaintiff as "medical exams and treatment." Pla intiff's argument is misplaced. As used in the CIA , "education" broadly defines instructional pursuit s and is not limited to scholastic institutions

. See Estate of Komninos, 417 N.J. Super.

at 320 . Indeed, citing our decision in Pomeroy, the Cour t in Ryan noted the phrase, "organized exclusively for educational purp oses" has been broadly construed.175 N.J. at 347 ; see also Roberts v. Timber Birch-Broadmoore Athletic Ass'n, 371 N.J. Super. 189, 194 (App. Div. 2004) (recognizing the "[ defendant]'s purpose of teaching and promoting good citizenship and
spor tsmanship and assembling teams and groups for parti cipation in sports qualifie[d] it as a non [] profit organization within the scope of the charita ble immunity statute"); Auerbach v. Jersey Wahoos Swim Club, 368 N.J. Super. 403, 413 (App. Div. 2004) (holding the defendant, a nonprofit corporation organized to train swimmers at various competitive levels, was organized8 A- 2138

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exclusively for educational purposes and entitled t o invoke charitable immunity); Morales v. N.J. Acad. of Aquatic Sciens. , 302 N.J. Super. 50, 54 (App. Div. 1997) (recognizing "a non [] profit corporation may be organized for 'exclusively educational purposes' even though it p rovides an educational experience which is 'recreational' in nature").
A nonprofit organization exclusively dedicated to rel igious or educational purposes is afforded "substantial latitude in deter mining the appropriate avenues for achieving [its] objectives." Bloom v. Seton Hal l Univ., 307 N.J. Super. 487, 491 (App. Div. 1998). Thus, engaging in other activit ies or services will not necessarily "eviscerate[]" charitable status "as lo ng as the services or activities further the charitable objectives the [entity] was organized to advance." Kuchera v. Jersey Shore Family Health Ctr., 221 N.J . 239, 252-53 (2015) (citing Bieker v. Cmty. House of Moorestown, 169 N.J. 167, 176 (2001)) ; see, e.g. , Bloom , 307 N.J. Super. at 491 -92 (concluding operation of an on -campus pub did not alter the fundamental educational nature of the college); Rupp v. Brookdale Baptist Church, 242 N.J. Super. 457, 465 (App. Div. 1990) (noting utilization of crafts and games to "foster sportsmanship, h onesty and creativity" did not thwart religious day camp's educational pur pose).9 A- 2138

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Although we agree with the motion judge's conclusion that defendant satisfied the second prong, further analysis is req uired. We must review the extent and nature of defendant's non -educational activities and distinguish whether they have supplanted or furthered the educa tional objectives of the organization. Having conducted "a fact-sensitive" review of the r ecord , Kuchera , 221 N.J. at 252, we are satisfied defendant provides mo re than "medical exams and treatment," and its health care services foster its educational objectives. According to its COI, defendant "[wa]s formed for s cientific, educational, and charitable purposes within the meaning of Section 5 01(c)(3) of the Internal Revenue Code" and designed to: provide "health edu cation services and services which promote optimal use of primary and s upplemental health services including as necessary and appropriate services of bi-lingual outreach workers"; "serve as an active partner with the consumer, busi ness labor, professional and political groups and leaders to identify, address a nd take action on the region's short and long term public health, environmental, a nd medical problems"; "advance the health status of the region's populati on through the provision of appropriate health and medical care, programs of ed ucation, and research activity" ; "conduct and support research in the area of health services delivery10 A- 2138

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and health education"; "provide information on the availability and proper use of health services"; "conduct or support health car e educational programs for health care providers, health care managers and [th e] general public"; and "engage in or support scientific, clinical and heal th systems research and disseminate the results thereof ." The parties have not cited, nor has our research revea led, binding authority addressing a nonprofit medical center's non -educational activities

. As stated in the COI, those activities include the provision of "comprehensive primary health services" and "supplemental health services." Much the same way the operation of a n on -campus pub in Bloom, and the provision of crafts a nd games in Rupp did not eviscerate the educational nature of the de fendants in those cases, we conclude the medical services rendered in this case did not thwart defendant's educational purpose. Rather, as evidenced by defenda nt's mission statement, its mission is consistent with that purpose:

The mission of Newark Community Health Centers is to provide affordable, high quality, and accessible healthcare to the communities that we serve. As one of the largest providers of comprehensive primary care services for uninsured and medically underserved populations in one of the country's mos t populated areas, our primary goal is to eliminate health disparities and help people live stronger, healthie r, and happier lives.11 A- 2138

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Because we conclude defendant was organized exclusi vely for educational purposes, as broadly construed by our jurisprudence , we need not conduct the

source- of -funds assessment required when an entity is organized exclusively for charitable purposes. "Entities that can prove they are organized exclusi vely for educational or religious purposes automatically sat isfy the second prong of the charitable immunity standard"; that is, "no further financial analysis is required." Ryan, 175 N.J. at 346 ; see also O'Connell v. State, 171 N.J. 484, 491 (2002). C. As to the third prong, the motion judge correctly r ecognized the court must make successive inquiries: whether, at the time in question, defendant was promoting the objectives it was organized to advanc e; and whether plaintiff was

a "direct recipient of those good works." Green, 237 N.J. at 531. On appeal, plaintiff only challenges the second inquiry. Cont ending she "did not need the charity," plaintiff asserts she "presumably pa[id] full price for [her treatment]" and, as such, "derived no benefit from . . . [d]efend ant's non [] profit, charitable [] practice." We are unpersuaded. A party is a beneficiary of good works when he or she receives, in some way, a benefit from the "charitable activities at th e time of the accident." Hehre12 A- 2138

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v. DeMarco, 421 N.J. Super. 501, 508 (App. Div. 2011)

. Thus, immunity from liability does not extend to any person who is "unc oncerned in and unrelated to and outside of the benefactions" of the charitable corporation. N.J.S.A. 2A:53A7(a) ; see also Ryan, 175 N.J. at 353

. However, a plaintiff's individual motivation is not relevant to whether he or she was a "direct recipient" of the charity. See Ryan, 175 N.J. at 350. The second inquiry "is to be interpreted broadly, a s evidenced by the use of the words 'to whatever degree' modifying the wor d 'beneficiary' in the statute." Id. at 353. That is, "[t]o be deemed a beneficiary, [the] plaintiff need not have personally received a benefit." Auerbach, 368 N.J. Super. at 414 ; see also Hehre, 421 N.J. Super. at 508. Thus, the thir d prong is satisfied where the plaintiff's "'presence was clearly incident to acco mplishment' of [the] defendant's charitable purposes." Bieker, 169 N.J. at 180 (quoting Gray v. St. Cecilia's Sch., 217 N.J. Super. 492, 495 (App. Div. 1987) ).
Here , plaintiff's presence at defendant's premises

– to receive an injectable medication

– was as a beneficiary of defendant's charitable wor ks and in accordance with defendant's mission statement: "to provide affordable, high quality, and accessible healthcare to the communiti es" served by defendant. Although plaintiff was charged a fee for the service, as Hogan acknowl edged at13 A- 2138

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deposition, Medicare paid less than the amount bill ed and plaintiff was not required to pay the difference. Nor was plaintiff charged a co-payment. We afford "substantial latitude" to the manner defenda nt advances its charitable objectives. Bloom, 307 N.J. Super. at 491. We con clude plaintiff's treatment fell within the scope of effectuating defendant's c haritable purpose.
II. Having concluded defendant is entitled to absolute immunity under Section 7, we need not address plaintiff's alternat e argument under Section 8. We briefly do so for the sake of completeness. Contending defendant was organized exclusively for hospital purposes, plaintiff argues "a cap on damages rather than full immunity is applicable" under Section 8, which provides, in pertinent part:

Notwithstanding the provisions of [ Section 7], any nonprofit corporation . . . organized exclusive ly for hospital purposes shall be liable to respond in dam ages to such beneficiary who shall suffer damage from th e negligence of such corporation . . . to an amount n ot exceeding $250,000, together with interest and costs of suit , as the result of any one accident. To support her argument, plaintiff cites our Suprem e Court's decision in Kuchera. Similar to the present matter, in Kuchera , the "[ p]laintiff slipped and fell on a wet spot on a floor in an outpatient heal th care facility," 221 N.J. at14 A- 2138

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241 , and the facility "provides medical care for those 'who are uninsured, underinsured, without a primary care physician and/ or who lack access to regular medical care,'" id. at 243. Unlike the pre sent matter, however, the defendant facility was "owned and operated by a non profit hospital." Id. at 241. We upheld the summary judgment dismissal of the pla intiff's complaint, "rejecting [her] argument that the health care enti ty that owned and operated the facility was 'organized exclusively for hospital pu rposes,' and, therefore, [wa] s entitled to the protections of [Section 8]." Id. at 241- 42. Instead, we concluded "the parent-hospital's provision of charity care an d medical education rendered the hospital a hybrid nonprofit institution organiz ed exclusively for charitable and educational purposes," thereby affording the ho spital absolute immunity unde r Section 7. Id. at 242. The Court disagreed, stating: "Whether a nonprofit organization is entitled to charitable immunity or subject to the l imitation on damages afforded to those institutions organized exclusively for hos pital purposes turns on the purpose of the institution, not the use to which th e facility is put on any given day." Ibid. Noting the outpatient health care facility was "an integral unit of the [hospital] system," id. at 254, the Court concluded our decision failed to15 A- 2138

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"account for the multi-function nature of the moder n hospital and its role in the provision of health care in this society," id. at 2 55. Simply stated, unlike the health care facility in Kuchera , defendant is neither owned nor operated by a nonprofit hospital. Rather, as stated above, defendant was organized exclusively f or educational purposes. We therefore conclude defendant is not subject to the $250,000 l imit set forth in Section 8. To the extent not addressed, plaintiff's remaining contentions lack sufficient merit to warrant discussion in a written opinion. R. 2:11 -3(e)(1)(E). Affirmed.