SPIRIT PHYSICIAN SERVICES INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- SPIRIT PHYSICIAN SERVICES INC (EIN 25-1766971)
- Tax period
- 2022-07-01 to 2023-06-30
- Filed
- 2024-05-10
- IRS object ID
- 202401319349302985
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-05-10T19:11:27-05:00 | ReturnTs |
| Tax Period End | 2023-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 366055558 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRANT THORNTON LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2001 MARKET STREET SUITE 700 | AddressLine1Txt |
| City | PHILADELPHIA | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 19103 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 251766971 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SPIRIT PHYSICIAN SERVICES INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SPIR | BusinessNameControlTxt |
| Phone | 7177632100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 CRYSTAL A DRIVE MC CA210 | AddressLine1Txt |
| City | HERSHEY | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 17033 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TRACY L MOYER | PersonNm |
| Person Title | VP FINANCIAL SERVICES | PersonTitleTxt |
| Phone | 7177632100 | PhoneNum |
| Signature | 2024-05-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | TRACY | PersonFirstNm |
| Person Last | MOYER | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | RUSSLEE ARMSTRONG | PreparerPersonNm |
| PTIN | P00288383 | PTIN |
| Phone | 2155614200 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Final Return | Yes (X) | FinalReturnInd |
| Principal Officer | STEVE MASSINI | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 CRYSTAL A DRIVE MC CA210 | AddressLine1Txt |
| City | HERSHEY | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 17033 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $19,520,640 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PENNSTATEHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1995 | FormationYr |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Activity Or Mission | TO SUPPORT PENN STATE HEALTH HOLY SPIRIT MEDICAL CENTER'S MISSION AS A COMMUNITY HEALTH SYSTEM. | ActivityOrMissionDesc |
| Contract Termination | Yes (X) | ContractTerminationInd |
| Voting Members Governing Body | 4 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 1 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 1 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $81,089,742 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $19,046,478 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,779,145 | PYOtherRevenueAmt |
| CY Other Revenue | $474,162 | CYOtherRevenueAmt |
| PY Total Revenue | $83,868,887 | PYTotalRevenueAmt |
| CY Total Revenue | $19,520,640 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $110,227,081 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $34,207,598 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $29,041,319 | PYOtherExpensesAmt |
| CY Other Expenses | $8,997,369 | CYOtherExpensesAmt |
| PY Total Expenses | $139,268,400 | PYTotalExpensesAmt |
| CY Total Expenses | $43,204,967 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$55,399,513 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$23,684,327 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $35,665,527 | TotalAssetsBOYAmt |
| Total Assets EOY | $0 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $122,080,279 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$86,414,752 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $0 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SPIRIT PHYSICIAN SERVICES, INC. SUPPORTS PENN STATE HEALTH HOLY SPIRIT MEDICAL CENTER'S MISSION AS A COMMUNITY HEALTH SYSTEM. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $34,750,311 | ExpenseAmt |
| Revenue | $19,508,918 | RevenueAmt |
| Desc | JUNE 30, 2023 SPIRIT PHYSICIANS SERVICES, INC. (SPSI) MERGED WITH AND INTO PENN STATE HEALTH COMMUNITY MEDICAL GROUP, LLC (CMG) AND SPSI CEASED EXISTENCE AS A SEPARATE ENTITY. CMG IS THE SURVIVING ENTITY OF THE MERGER. SPIRIT PHYSICIAN SERVICES, INC'S. FAMILY HEALTH CENTERS OFFER PREVENTATIVE DIAGNOSTIC AND THERAPEUTIC MEDICAL SERVICES ON AN OUTPATIENT BASIS. THE FAMILY HEALTH CENTERS PROVIDE AN OUTREACH TO COMMUNITY RESIDENTS WITH MEDICAL CONDITIONS WHICH, IF NOT PROPERLY TREATED IN AN OUTPATIENT SETTING, MIGHT ULTIMATELY REQUIRE MORE EXPENSIVE AND CRITICAL INPATIENT CARE. THUS, THE CLINICS REDUCE HOSPITAL ADMISSIONS, DAYS OF STAY AND SURGICAL RATES. PENN STATE HEALTH HOLY SPIRIT MEDICAL CENTER OB/GYN OFFERS FREE INTRODUCTORY SESSIONS TO THE CREIGHTON MODEL FERTILITY CARETM SYSTEM AND NAPROTECHNOLOGY. THIS IS A FULLY INTEGRATED APPROACH TO WOMEN'S HEALTH THAT IS COMPLETELY PRO-LIFE IN ITS OUTLOOK AND THE TECHNIQUES IT EMPLOYS. IT IS PARTICULARLY USEFUL FOR EVALUATING AND TREATING INFERTILITY, RECURRENT PREGNANCY LOSS, ENDOMETRIOSIS, IRREGULAR PERIODS, PMS, OVARIAN CYSTS, AND POLYCYSTIC OVARY SYNDROME, AS WELL AS FOR FAMILY PLANNING.CVSI IS A GROUP OF CARDIOVASCULAR HEART SURGEONS. THIS GROUP USES ROBOTICS DURING SPECIFIC SURGERIES.GENERAL SURGERY IS A GROUP OF GENERAL SURGEONS. THIS GROUP PERFORMS A LARGE ASSORTMENT OF GENERAL SURGERY AND TRAUMA SURGERY PROCEDURES.ORTHOPEDIC PRACTICE IS A GROUP OF ORTHOPEDIC PHYSICIANS. THIS GROUP PERFORMS A LARGE ASSORTMENT OF OFFICE PROCEDURES, ORTHOPEDIC SURGERY, AND TRAUMA SURGERY PROCEDURES.DERMATOLOGY PRACTICE IS A GROUP OF DERMATOLOGY PHYSICIANS. THIS GROUP PERFORMS GENERAL DERMATOLOGY CARE AND SKIN CANCER SCREENINGS AND MOHS SURGERY FOR SKIN CANCER WHICH ALLOWS THE GREATEST AMOUNT OF HEALTHY TISSUE WHILE REMOVING BASAL CELL OR SQUAMOUS CELL CARCINOMAS.INFECTIOUS DISEASE PRACTICE IS A GROUP OF BOARD-CERTIFIED, FELLOWSHIP-TRAINED DISEASE SPECIALIST PHYSICIANS. THIS GROUP FOCUSES ON ALL TYPES OF INFECTIONS, INCLUDING THOSE CAUSED BY BACTERIA, VIRUSES, FUNGI, AND PARASITES OF THE SINUSES, HEART, LUNGS, URINARY TRACT, BONES, AND PELVIC ORGANS. THEY ALSO HAVE INSIGHT INTO THE USE OF ANTIBIOTICS AND THEIR POTENTIAL ADVERSE EFFECTS.UNCOMPENSATED CARESPIRIT PHYSICIAN SERVICES, INC. (SPSI) RECOGNIZES THAT ITS MISSION IS TO SERVE ALL THE MEMBERS OF THE COMMUNITY WITH RESPECT TO THE PROVISION OF HEALTHCARE SERVICES AND HEALTHCARE EDUCATION. SPSI PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. IN THIS REGARD, SPSI PROVIDES FREE CARE OR SUBSIDIZED CARE, TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT OR BELOW COST AND PROVIDES VARIOUS HEALTH ACTIVITIES AND PROGRAMS IN SUPPORT OF THE COMMUNITIES WHERE SPSI PRACTICES.A. CHARITY CARETHE PRIMARY CONCERN OF SPSI IS THE DELIVERY OF HEALTH CARE TO ALL THE CITIZENS OF THE GREATER HARRISBURG AREA AND SOUTH CENTRAL PENNSYLVANIA, REGARDLESS OF THEIR ABILITY TO PAY. THE UNREIMBURSED COST OF CHARITY CARE REPRESENTS THE COST SPSI INCURS BY PROVIDING FREE OR DISCOUNTED SERVICES TO THOSE WHO CANNOT AFFORD TO PAY. B. MEDICARE/MEDICAIDRECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO THE ELDERLY (MEDICARE) AND THE POOR (MEDICAID). SPSI PROVIDES CARE, BELOW COST, TO PERSONS COVERED BY THESE GOVERNMENTAL PROGRAMS. TO THE EXTENT REIMBURSEMENT IS BELOW THE COST OF PROVIDING HEALTHCARE, SPSI IS FURTHERING ITS MISSION TO THE ENTIRE COMMUNITY. THE UNREIMBURSED VALUE OF MEDICARE AND/OR MEDICAID IS EQUAL TO THE COST OF PROVIDING SERVICES LESS THE AMOUNT OF REIMBURSEMENT RECEIVED UNDER THE PROGRAM. C. OTHER UNCOMPENSATED PATIENT SERVICESIN ADDITION, SPSI PROVIDES OTHER PATIENT SERVICES FOR WHICH FULL PAYMENT IS NOT RECEIVED. COMMUNITY HEALTH, EDUCATION AND OUTREACHSPIRIT PHYSICIAN SERVICES, INC. STRIVES TO SERVE AS PARTNERS TO THE COMMUNITIES IN WHICH THEY ARE LOCATED. SPSI PROVIDES CARE TO THE COMMUNITY THROUGH REDUCED PRICE SERVICES AND FREE PROGRAMS THROUGHOUT THE YEAR BASED UPON ACTIVITIES AND SERVICES THAT SPSI BELIEVES WILL SERVE A BONAFIDE COMMUNITY HEALTH NEED. THESE SERVICES AND PROGRAMS MAY INCLUDE SUPPORT GROUPS, HEALTH EDUCATION, WELLNESS FAIRS, HEALTH SCREENINGS, OR OTHER HEALTH RELATED PROGRAMS. | Desc |
| Total Program Service Expenses | $34,750,311 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | Yes (1) | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 4 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 1 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | PA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TRACY L MOYER VICE PRESIDENT FINA | PersonNm |
| Phone | 7177632100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 CRYSTAL A DRIVE MC CA210 | AddressLine1Txt |
| City | HERSHEY | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 17033 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| THOMAS STOESSEL | |||||||||
| DIRECTOR / PSH EVP | 1.00 | 39.00 | Yes (X) | $0 | $1,119,232 | $61,645 | |||
| DEBORAH ADDO | |||||||||
| DIRECTOR / PSH COO | 1.00 | 49.00 | Yes (X) | $0 | $920,763 | $48,852 | |||
| DONALD MCKENNA | |||||||||
| DIRECTOR / PRESIDENT | 1.00 | 49.00 | Yes (X) | $0 | $521,848 | $104,444 | Yes (X) | ||
| SISTER JOANN MARIE AUMAND SCC | |||||||||
| DIRECTOR (THRU 6/23) | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| PAULA TINCH | |||||||||
| TREASURER / PSH CFO & EVP | 1.00 | 49.00 | $0 | $808,482 | $119,863 | Yes (X) | |||
| NICOLE LEHMAN | |||||||||
| INTERIM SEC. (PSU EMP) | 1.00 | 49.00 | $0 | $276,742 | $97,256 | Yes (X) | |||
| ROSS DARROW | |||||||||
| VICE PRESIDENT, TREASURER | 1.00 | 49.00 | $0 | $301,878 | $61,619 | Yes (X) | |||
| KATHLEEN MILLER | |||||||||
| ASSOC. SECRETARY | 1.00 | 39.00 | $0 | $99,552 | $10,921 | Yes (X) | |||
| SAFWAT GASSIS MD | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $0 | $903,345 | $62,024 | Yes (X) | |||
| DAVID C MAN MD | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $0 | $795,057 | $61,922 | Yes (X) | |||
| ANDREAS U WALI MD FACC FSCAI | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $0 | $629,822 | $62,024 | Yes (X) | |||
| STEPHEN MASSINI | |||||||||
| FMR DIR (THRU 6/22) / PSH CEO | 0.00 | 50.00 | $0 | $1,599,857 | $61,645 | Yes (X) | |||
| PETER DILLON MD | |||||||||
| FMR DIR (THRU 6/22) / PSH EVP | 0.00 | 50.00 | $0 | $1,018,570 | $55,758 | Yes (X) | |||
| KYLE C SNYDER MHA | |||||||||
| FMR OFF (THRU 7/22) / REG. COO | 0.00 | 50.00 | $0 | $425,029 | $72,765 | Yes (X) | |||
| RANDY B MORRIS | |||||||||
| FMR OFF (THRU 10/20) / PSH VP FIN. | 0.00 | 50.00 | $0 | $344,594 | $55,762 | Yes (X) | |||
| ANNEMARIE BOYAN | |||||||||
| FMR SEC/PSH GC (PSU EMP) (THRU 2/22) | 0.00 | 0.00 | $0 | $142,089 | $12,694 | Yes (X) | |||
| J BRET DELONE | |||||||||
| FMR KE (THRU 6/21) / VP MED AFFAIRS | 0.00 | 40.00 | $0 | $559,921 | $40,629 | Yes (X) | |||
| SHUBHRA KUMAR-BRADLEY | |||||||||
| FMR KE (THRU 6/20) / PHYSICIAN | 0.00 | 40.00 | $0 | $341,071 | $60,618 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $10,807,852 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,050,441 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| QUANTUM IMAGING & THERAPEUTICS | |||||
| PO BOX 62165 | BALTIMORE | MD | 21264 | PURCHASED SERVICES | $5,434,572 |
| WEATHERBY LOCUMS INC | |||||
| PO BOX 972633 | DALLAS | TX | 753972633 | PHYSICIAN LOCUMS | $2,174,247 |
| BARTON ASSOCIATES INC | |||||
| 300 JUBILEE DRIVE | PEABODY | MA | 01960 | PHYSICIAN LOCUMS | $987,608 |
| COMPHEALTH | |||||
| PO BOX 972651 | DALLAS | TX | 753972651 | PHYSICIAN LOCUMS | $662,965 |
| CAPTURIS | |||||
| 3131 TECHNOLOGY DRIVE NW | MADAN | ND | 58554 | IT SERVICE | $280,265 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| CLINICAL SUPPORT SUB. | 621110 | $9,704,468 | $9,704,468 |
| PATIENT SERVICE REV. | 621110 | $8,915,602 | $8,915,602 |
| SERVICES RENDERED CONT. | 900099 | $426,408 | $426,408 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $19,046,478 | TotalProgramServiceRevenueAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| FEDERAL INCENTIVE PROG | 900099 | $455,649 | $455,649 | |
| EMPLOYEE LOAN PAYBACK | 900099 | $11,722 | $11,722 | |
| OTHER REVENUES | 900099 | $6,791 | $6,791 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $474,162 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $19,520,640 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $19,508,918 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $11,722 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,173,866 | TotalAmt |
| Program Services | $22,539,093 | ProgramServicesAmt |
| Management And General | $5,634,773 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,285 | TotalAmt |
| Program Services | $22,628 | ProgramServicesAmt |
| Management And General | $5,657 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,997,248 | TotalAmt |
| Program Services | $4,797,798 | ProgramServicesAmt |
| Management And General | $1,199,450 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,199 | TotalAmt |
| Program Services | $6,559 | ProgramServicesAmt |
| Management And General | $1,640 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,162,479 | TotalAmt |
| Program Services | $4,129,984 | ProgramServicesAmt |
| Management And General | $1,032,495 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $155,801 | TotalAmt |
| Program Services | $124,641 | ProgramServicesAmt |
| Management And General | $31,160 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,671 | TotalAmt |
| Program Services | $14,937 | ProgramServicesAmt |
| Management And General | $3,734 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,517,915 | TotalAmt |
| Program Services | $1,214,332 | ProgramServicesAmt |
| Management And General | $303,583 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,365 | TotalAmt |
| Program Services | $49,892 | ProgramServicesAmt |
| Management And General | $12,473 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $550 | TotalAmt |
| Program Services | $440 | ProgramServicesAmt |
| Management And General | $110 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $299 | TotalAmt |
| Program Services | $239 | ProgramServicesAmt |
| Management And General | $60 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $207,617 | TotalAmt |
| Program Services | $166,094 | ProgramServicesAmt |
| Management And General | $41,523 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $874,792 | TotalAmt |
| Program Services | $699,834 | ProgramServicesAmt |
| Management And General | $174,958 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES & DRUG | $917,098 | $917,098 | |
| EDUCATION EXPENSES | $33,247 | $26,598 | $6,649 |
| LICENSES & FEES | $19,657 | $15,726 | $3,931 |
| MEMBERSHIP DUES | $14,578 | $14,578 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,300 | TotalAmt |
| Program Services | $9,840 | ProgramServicesAmt |
| Management And General | $2,460 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,204,967 | TotalAmt |
| Program Services | $34,750,311 | ProgramServicesAmt |
| Management And General | $8,454,656 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,644,611 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,100,327 | BOYAmt |
| EOY | $0 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $407,568 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $0 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $0 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,312,432 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,200,589 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,665,527 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,454,487 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $111,625,792 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $122,080,279 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$86,414,752 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$86,414,752 | BOYAmt |
| EOY | $0 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,665,527 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$23,684,327 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $110,099,079 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $132,769 | CurrentTaxYearMinus2YearsAmt |
| Total | $132,769 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $83,055,824 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $90,318,398 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $134,459,528 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $81,089,742 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $19,046,478 | CurrentTaxYearAmt |
| Total | $407,969,970 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $42,249 | CurrentTaxYearMinus4YearsAmt |
| Total | $42,249 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $83,098,073 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $90,318,398 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $134,592,297 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $81,089,742 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $19,046,478 | CurrentTaxYearAmt |
| Total | $408,144,988 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $408,144,988 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $106,131 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $101,372 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,013 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $209,516 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $106,131 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $101,372 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,013 | CurrentTaxYearMinus2YearsAmt |
| Total | $209,516 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $2,779,145 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $474,162 | CurrentTaxYearAmt |
| Total | $3,253,307 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $83,204,204 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $90,419,770 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $134,594,310 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $83,868,887 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $19,520,640 | CurrentTaxYearAmt |
| Total | $411,607,811 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99160 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99360 | PublicSupportPY509Pct |
| Investment Income CY | 0.00050 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00060 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | FEDERAL INCENTIVE PROGRAM - 2021 AMOUNT: $ 1,587,902. 2022 AMOUNT: $ 455,649. EMPLOYEE LOAN PAYBACK PROGRAM - 2021 AMOUNT: $ 1,175,035. 2022 AMOUNT: $ 11,722. REVALUATION OF ASSETS - 2021 AMOUNT: $ 15,440. 2022 AMOUNT: $ 0. DISCOUNTS AND REBATES - 2021 AMOUNT: $ 768. 2022 AMOUNT: $ 237. OTHER REVENUES - 2021 AMOUNT: $ 0. 2022 AMOUNT: $ 6,554. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (16 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| STEPHEN MASSINI | ||||||||||||||
| FMR DIR (THRU 6/22) / PSH CEO | $0 | $1,319,391 | $0 | $75,000 | $0 | $205,466 | $0 | $38,400 | $0 | $23,245 | $0 | $1,661,502 | $0 | $0 |
| THOMAS STOESSEL | ||||||||||||||
| DIRECTOR / PSH EVP | $0 | $604,667 | $0 | $311,731 | $0 | $202,834 | $0 | $38,400 | $0 | $23,245 | $0 | $1,180,877 | $0 | $102,171 |
| PETER DILLON MD | ||||||||||||||
| FMR DIR (THRU 6/22) / PSH EVP | $0 | $694,569 | $0 | $75,000 | $0 | $249,001 | $0 | $38,400 | $0 | $17,358 | $0 | $1,074,328 | $0 | $0 |
| DEBORAH ADDO | ||||||||||||||
| DIRECTOR / PSH COO | $0 | $788,301 | $0 | $88,462 | $0 | $44,000 | $0 | $39,593 | $0 | $9,259 | $0 | $969,615 | $0 | $0 |
| SAFWAT GASSIS MD | ||||||||||||||
| PHYSICIAN | $0 | $643,060 | $0 | $187,882 | $0 | $72,403 | $0 | $38,400 | $0 | $23,624 | $0 | $965,369 | $0 | $0 |
| PAULA TINCH | ||||||||||||||
| TREASURER / PSH CFO & EVP | $0 | $740,070 | $0 | $64,231 | $0 | $4,181 | $0 | $102,173 | $0 | $17,690 | $0 | $928,345 | $0 | $0 |
| DAVID C MAN MD | ||||||||||||||
| PHYSICIAN | $0 | $673,524 | $0 | $115,268 | $0 | $6,265 | $0 | $38,400 | $0 | $23,522 | $0 | $856,979 | $0 | $0 |
| ANDREAS U WALI MD FACC FSCAI | ||||||||||||||
| PHYSICIAN | $0 | $501,344 | $0 | $121,981 | $0 | $6,497 | $0 | $38,400 | $0 | $23,624 | $0 | $691,846 | $0 | $0 |
| DONALD MCKENNA | ||||||||||||||
| DIRECTOR / PRESIDENT | $0 | $465,481 | $0 | $50,000 | $0 | $6,367 | $0 | $80,836 | $0 | $23,608 | $0 | $626,292 | $0 | $0 |
| J BRET DELONE | ||||||||||||||
| FMR KE (THRU 6/21) / VP MED AFFAIRS | $0 | $373,288 | $0 | $156,265 | $0 | $30,368 | $0 | $38,400 | $0 | $2,229 | $0 | $600,550 | $0 | $0 |
| KYLE C SNYDER MHA | ||||||||||||||
| FMR OFF (THRU 7/22) / REG. COO | $0 | $367,347 | $0 | $40,000 | $0 | $17,682 | $0 | $49,342 | $0 | $23,423 | $0 | $497,794 | $0 | $0 |
| SHUBHRA KUMAR-BRADLEY | ||||||||||||||
| FMR KE (THRU 6/20) / PHYSICIAN | $0 | $317,534 | $0 | $0 | $0 | $23,537 | $0 | $38,400 | $0 | $22,218 | $0 | $401,689 | $0 | $0 |
| RANDY B MORRIS | ||||||||||||||
| FMR OFF (THRU 10/20) / PSH VP FIN. | $0 | $302,233 | $0 | $25,000 | $0 | $17,361 | $0 | $38,400 | $0 | $17,362 | $0 | $400,356 | $0 | $0 |
| NICOLE LEHMAN | ||||||||||||||
| INTERIM SEC. (PSU EMP) | $0 | $261,742 | $0 | $15,000 | $0 | $0 | $0 | $70,490 | $0 | $26,766 | $0 | $373,998 | $0 | $0 |
| ROSS DARROW | ||||||||||||||
| VICE PRESIDENT, TREASURER | $0 | $262,516 | $0 | $25,000 | $0 | $14,362 | $0 | $38,400 | $0 | $23,219 | $0 | $363,497 | $0 | $0 |
| ANNEMARIE BOYAN | ||||||||||||||
| FMR SEC/PSH GC (PSU EMP) (THRU 2/22) | $0 | $142,089 | $0 | $0 | $0 | $0 | $0 | $7,383 | $0 | $5,311 | $0 | $154,783 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | ARRANGEMENT USED TO ESTABLISH THE CEO'S COMPENSATION: COMPENSATION FOR THE CEO (PRESIDENT) IS ESTABLISHED AND PAID BY A RELATED ORGANIZATION. THAT ORGANIZATION USED THE FOLLOWING TO ESTABLISH THE CEO'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) COMPENSATION SURVEY OR STUDY; (4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. |
| PART 1, LINE 4B: | DURING THE CALENDAR YEAR ENDING WITHIN THIS FISCAL YEAR ENDED JUNE 30, 2023, A CURRENT DIRECTOR AND TWO FORMER DIRECTORS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. THE BELOW LISTED INDIVIDUALS' VESTED IN THE PLAN IN A PRIOR YEAR; THEREFORE, CURRENT YEAR CONTRIBUTIONS ARE TAXABLE AND REPORTED ON SCHEDULE J, PART II, COLUMN B(III), OTHER REPORTABLE COMPENSATION. - STEPHEN MASSINI - $165,523 - THOMAS STOESSEL - $155,778 - PETER DILLON - $89,133 DURING THE CALENDAR YEAR ENDING WITHIN THIS FISCAL YEAR ENDED JUNE 30, 2023, CERTAIN DIRECTORS AND OFFICERS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. THE BELOW LISTED INDIVIDUALS' CONTRIBUTIONS HAVE NOT YET VESTED; UNVESTED CONTRIBUTIONS ARE REPORTED ON SCHEDULE J, PART II, COLUMN C, RETIREMENT AND OTHER DEFERRED COMPENSATION. - PAULA TINCH - $63,773 - DONALD MCKENNA - $42,436 - KYLE SNYDER - $10,942 - DEBORAH ADDO - $1,193 |
Schedule N IRS990ScheduleN
Disposition Of Assets Detail DispositionOfAssetsDetail (4 entries)
| Assets Distri Or Expnss PaidAssetsDistriOrExpnssPaidDesc | DistributionDistributionDt | Fair Market Value Of AssetFairMarketValueOfAssetAmt | Method Of FMV DeterminationMethodOfFMVDeterminationTxt | EINEIN | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | IRC SectionIRCSectionTxt |
|---|---|---|---|---|---|---|---|---|---|
| COMMUNITY MEDICAL GROUP LLC | |||||||||
| CASH & SAVINGS | 2023-06-30 | $69,958 | FMV | 300976099 | 100 CRYSTAL A DRIVE MC CA210 | HERSHEY | PA | 17033 | 501(C)(3) |
| COMMUNITY MEDICAL GROUP LLC | |||||||||
| ACCOUNTS RECEIVABLE | 2023-06-30 | $4,834,839 | FMV | 300976099 | 100 CRYSTAL A DRIVE MC CA210 | HERSHEY | PA | 17033 | 501(C)(3) |
| COMMUNITY MEDICAL GROUP LLC | |||||||||
| LAND, BUILDINGS, AND EQUIPMENT | 2023-06-30 | $4,315 | FMV | 300976099 | 100 CRYSTAL A DRIVE MC CA210 | HERSHEY | PA | 17033 | 501(C)(3) |
| COMMUNITY MEDICAL GROUP LLC | |||||||||
| OTHER ASSETS | 2023-06-30 | $10,259 | FMV | 300976099 | 100 CRYSTAL A DRIVE MC CA210 | HERSHEY | PA | 17033 | 501(C)(3) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor2 | Yes (1) | DirectorOfSuccessor2Ind |
| Employee Of Successor2 | Yes (1) | EmployeeOfSuccessor2Ind |
| Owner Of Successor2 | 0 | OwnerOfSuccessor2Ind |
| Receive Compensation2 | 0 | ReceiveCompensation2Ind |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART II, LINE 1: | JUNE 30, 2023 SPIRIT PHYSICIANS SERVICES, INC. (SPSI) MERGED WITH AND INTO PENN STATE HEALTH COMMUNITY MEDICAL GROUP, LLC (CMG) (FEIN: 30-0976099). CMG IS A WHOLLY OWNED LIMITED LIABILITY COMPANY OF PENN STATE HEALTH (FEIN: 47-3769205) LOCATED AT 100 CRYSTAL A DRIVE, MC CA210 HERSHEY, PA 17033. |
| PART II, LINE 2E: | CERTAIN LISTED OFFICERS AND BOARD MEMBERS ALSO SERVE AS OFFICERS AND BOARD MEMBERS OF THE RELATED ORGANIZATION PENN STATE HEALTH. EMPLOYEES OF SPIRIT PHYSICIAN SERVICES, INC. WERE TRANSFERRED ON JANUARY 1, 2022 TO PENN STATE HEALTH COMMUNITY MEDICAL GROUP LLC, A WHOLLY OWNED LIMITED LIABILITY COMPANY OF PENN STATE HEALTH. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART V, LINE 1A: | FORMS 1096: FORM 1096 FOR THE FILING ORGANIZATION IS PROCESSED AND REPORTED BY ITS RELATED ORGANIZATION PENN STATE HEALTH (EIN: 47-3769205). |
| FORM 990, PART VI, SECTION A, LINE 2 | CERTAIN LISTED OFFICERS AND BOARD MEMBERS ALSO SERVE AS OFFICERS AND BOARD MEMBERS OF A TAXABLE ENTITY. |
| FORM 990, PART VI, SECTION A, LINE 6 | CLASSES OF MEMBERS OR STOCKHOLDERS SPIRIT PHYSICIAN SERVICES, INC.'S SOLE MEMBER IS PENN STATE HEALTH COMMUNITY MEDICAL GROUP, LLC, A PENNSYLVANIA LIMITED LIABILITY COMPANY. PENN STATE HEALTH COMMUNITY MEDICAL GROUP LLC'S SOLE MEMBER IS PENN STATE HEALTH, A PENNSYLVANIA NONPROFIT CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | ELECTION OF MEMBERS AND THEIR RIGHTS DIRECTORS SHALL BE ELECTED BY THE CORPORATE MEMBER, PENN STATE HEALTH COMMUNITY MEDICAL GROUP, LLC. THE CORPORATE MEMBER MAY AT ANY TIME REMOVE, WITH OR WITHOUT CAUSE, ANY MEMBER OF THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | DECISIONS REQUIRING APPROVAL BY MEMBERS OR STOCKHOLDERS: PURSUANT TO SPECIFICATIONS DEFINED IN THE BYLAWS THE CORPORATE MEMBERS HAVE RESERVED POWERS. NOTWITHSTANDING ANY OTHER PROVISIONS OF THESE BYLAWS, THE SOLE MEMBER MUST APPROVE THE FOLLOWING ITEMS, AS APPLICABLE, BEFORE THEY MAY BE IMPLEMENTED BY THIS CORPORATION. THE SOLE MEMBER SHALL HAVE THE AUTHORITY: (A) TO DETERMINE THE NUMBER OF AND TO ELECT AND REMOVE, WITH OR WITHOUT CAUSE, THE DIRECTORS OF THE CORPORATION; (B) TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, AND TO DETERMINE THE COMPENSATION OF, THE PRESIDENT; (C) TO ELECT AND REMOVE, WITH OR WITHOUT CAUSE, THE CHAIR AND VICE CHAIR OF THE BOARD, THE SECRETARY (INCLUDING ANY ASSISTANT OR ASSOCIATE SECRETARY), AND THE TREASURER (INCLUDING ANY ASSISTANT TREASURER); (D) TO APPROVE ANY AND ALL AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS OF THE CORPORATION; (E) TO ADOPT OR MODIFY THE MISSION, VISION, OR OBJECTIVES OF THE CORPORATION; (F) TO ADOPT ALL LONG-RANGE AND STRATEGIC PLANS; (G) TO APPROVE ALL OPERATING AND CAPITAL BUDGETS; (H) TO APPROVE ALL UNBUDGETED CAPITAL EXPENDITURES AND ALL UNBUDGETED OPERATING EXPENDITURES IN EXCESS OF SUCH AMOUNT AS IS DETERMINED BY OR PURSUANT TO THE POLICIES OF THE SOLE MEMBER; (I) TO APPROVE THE INCURRENCE OF DEBT OR GUARANTEE OF INDEBTEDNESS FOR BORROWED MONEY, OR THE PLEDGE OR MORTGAGE OF ASSETS TO SECURE THE SAME AND TO ESTABLISH AN OBLIGATED GROUP FOR FINANCING PURPOSES; (J) TO DETERMINE ANNUAL DISTRIBUTIONS TO BE MADE TO OR FOR THE BENEFIT OF THE PENNSYLVANIA STATE UNIVERSITY COLLEGE OF MEDICINE AS ACADEMIC SUPPORT PAYMENTS; (K) TO REQUIRE THE CORPORATION TO PARTICIPATE IN A CENTRALIZED FINANCIAL AND CASH MANAGEMENT SYSTEM FOR PENN STATE HEALTH AND ONE OR MORE OF ITS CONTROLLED AFFILIATES (THE "SYSTEM"); (L) TO APPROVE ANY DONATION OR TRANSFER OF THE CORPORATION'S ASSETS IN EXCESS OF SUCH AMOUNT AS IS DETERMINED BY OR PURSUANT TO THE POLICIES OF THE SOLE MEMBER, OTHER THAN DONATIONS OR TRANSFERS TO THE SOLE MEMBER OR ANOTHER ENTITY IN THE SYSTEM, UNLESS AUTHORIZED IN THE CORPORATION'S APPROVED BUDGET; (M) TO APPROVE AND AUTHORIZE ADDITIONS AND ELIMINATIONS OF CLINICAL SERVICES OF THE CORPORATION AND TO DETERMINE THE DISTRIBUTION OF CLINICAL AND SUPPORT SERVICES ACROSS THE SYSTEM; (N) TO APPROVE THE CREATION OR DISSOLUTION OF, INVESTMENT IN, OR DISPOSITION OF ANY SUBSIDIARY OR JOINT VENTURE AND TO APPROVE ANY OTHER STRATEGIC ALIGNMENT OR FUNDAMENTAL CHANGE TRANSACTION, INCLUDING (I) JOINT OPERATING AGREEMENTS OR MANAGEMENT AGREEMENTS, (II) ACQUISITIONS, DISPOSITIONS OR TRANSFERS OF MATERIAL OPERATIONS, (III) CLOSURE OF FACILITIES, (IV) MERGERS, CONSOLIDATIONS, AND DIVISIONS, (V) THE SALE, PLEDGING, LEASING OR TRANSFER OF ASSETS WITH A VALUE IN EXCESS OF SUCH AMOUNT AS IS DETERMINED BY OR PURSUANT TO THE POLICIES OF THE SOLE MEMBER, AND (VI) THE LIQUIDATION OR DISSOLUTION OF THE CORPORATION; (O) TO ADOPT EMPLOYEE BENEFIT PLANS; (P) TO ADOPT OR APPROVE THE INVESTMENT POLICIES OF THE CORPORATION; (Q) TO SELECT AND APPOINT AUDITORS FOR, AND TO DESIGNATE THE FISCAL YEAR OF, THE CORPORATION; (R) TO RETAIN COUNSEL ON BEHALF OF AND SETTLE ANY LITIGATION AGAINST THE CORPORATION; (S) TO ENTER INTO SYSTEM-WIDE AGREEMENTS ON BEHALF OF THE CORPORATION; AND (T) EXCEPT AS OTHERWISE PROVIDED IN THESE BYLAWS, TO GIVE SUCH APPROVALS AND TAKE SUCH OTHER ACTIONS AS ARE SPECIFICALLY RESERVED TO THE MEMBERS OF A PENNSYLVANIA NONPROFIT CORPORATION UNDER THE PENNSYLVANIA NONPROFIT CORPORATION LAW OF 1988, AS AMENDED (THE "PENNSYLVANIA NONPROFIT CORPORATION LAW"). |
| FORM 990, PART VI, SECTION B, LINE 11B | ORGANIZATION'S PROCESS TO REVIEW FORM 990 THE FORM 990 IS PREPARED BY AN EXTERNAL ACCOUNTING FIRM; IT IS REVIEWED BY ACCOUNTING/FINANCE DEPARTMENT PERSONNEL AND THE CHIEF FINANCIAL OFFICER, AND THEN DISTRIBUTED TO ALL MEMBERS OF THE BOARD FOR REVIEW AND COMMENT BEFORE IT IS FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST POLICY THE FILING ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST (COI) POLICIES FOR OFFICERS, DIRECTORS, AND KEY EMPLOYEES (COVERED PERSONS). PER THE POLICY, NO COVERED PERSONS MAY ENGAGE IN ANY TRANSACTION OR ARRANGEMENT OR UNDERTAKE POSITIONS WITH OTHER ORGANIZATIONS THAT INVOLVE A CONFLICT OF INTEREST, EXCEPT IN COMPLIANCE WITH THE POLICY. EVERY COVERED PERSON SHALL DISCLOSE ALL ACTUAL AND POTENTIAL CONFLICTS THROUGH AN ANNUAL ONLINE DISCLOSURE STATEMENT AND AS MATTERS INVOLVING AN ACTUAL OR POTENTIAL CONFLICT ARISE. THE BOARD WILL EVALUATE THE DISCLOSURES AND THE MATERIAL FACTS RELATING TO THE TRANSACTION OR ARRANGEMENT GIVING RISE TO THE POTENTIAL CONFLICT TO DETERMINE WHETHER THEY INVOLVE ACTUAL CONFLICTS OF INTEREST AND MAY ATTEMPT TO DEVELOP ALTERNATIVES TO REMOVE THE CONFLICT FROM THE TRANSACTION OR ARRANGEMENT. A COVERED PERSON WHO HAS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST SHALL NOT BE PRESENT FOR OR SHALL LEAVE ANY PORTION OF A MEETING AT WHICH THE BOARD OF DIRECTORS OR A COMMITTEE IS VOTING TO DETERMINE WHETHER A CONFLICT EXISTS, BUT MAY BE PRESENT PRIOR TO THE VOTE TO MAKE PRESENTATION TO THE BOARD OR COMMITTEE TO DISCLOSE ADDITIONAL FACTS, OR TO RESPOND TO QUESTIONS. THE FILING ORGANIZATION MAY ENTER INTO A TRANSACTION OR ARRANGEMENT IN WHICH A COVERED PERSON HAS AN ACTUAL CONFLICT OF INTEREST IF A MAJORITY OF DIRECTORS WHO HAVE NO INTEREST IN THE TRANSACTION OR ARRANGEMENT APPROVE THE TRANSACTION OR ARRANGEMENT AT A BOARD OR COMMITTEE MEETING AFTER DETERMINING THAT THE TRANSACTION OR ARRANGEMENT IS FAIR AND REASONABLE TO THE CORPORATION, ANY COVERED PERSON WHO HAS A CONFLICT WITH RESPECT TO THE TRANSACTION OR ARRANGEMENT DOES NOT PARTICIPATE IN AND IS NOT PRESENT FOR THE VOTE REGARDING SUCH TRANSACTION OR ARRANGEMENT (EXCEPT THAT THE COVERED PERSON MAY APPEAR AT A MEETING TO ANSWER QUESTIONS), AND IF THE TRANSACTION OR ARRANGEMENT INVOLVES COMPENSATION OR OTHER FINANCIAL BENEFIT TO THE COVERED PERSON, THE BOARD RELIES ON APPROPRIATE COMPARABILITY DATA TO DETERMINE REASONABLENESS. THE FILING ORGANIZATION WILL DOCUMENT THE FOREGOING IN THE MINUTES OF BOARD AND COMMITTEE MEETINGS, AS APPLICABLE. EACH COVERED PERSON MUST SIGN A STATEMENT THAT AFFIRMS THAT HE OR SHE HAS RECEIVED A COPY OF THE COI POLICY, HAS READ AND UNDERSTANDS IT, AND HAS AGREED TO COMPLY WITH IT. IF THE BOARD OF DIRECTORS HAS REASONABLE CAUSE TO BELIEVE THAT A COVERED PERSON HAS FAILED TO COMPLY WITH THE POLICY, THE BOARD MAY COUNSEL THE COVERED PERSON REGARDING SUCH FAILURE AND, IF THE ISSUE IS NOT RESOLVED TO THE BOARD'S SATISFACTION, MAY CONSIDER ADDITIONAL CORRECTIVE ACTION, INCLUDING REMOVAL FROM THE BOARD OF DIRECTORS OR OTHER POSITION WITH THE FILING ORGANIZATION, AS APPROPRIATE. FORM 990, PART VI, SECTION B, LINES 13 & 14: WHISTLEBLOWER POLICY AND DOCUMENT RETENTION/DESTRUCTION POLICY: THE FILING ORGANIZATION FOLLOWS THE WHISTLEBLOWER POLICY AND DOCUMENT RETENTION AND DESTRUCTION POLICY OF A RELATED ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 15 | PROCESS USED TO ESTABLISH COMPENSATION OF CEO, OFFICERS, AND KEY EMPLOYEES: THE FILING ORGANIZATION IS PART OF A MULTI-ENTITY HEALTH SYSTEM AND MAY OR MAY NOT DESIGNATE ONE OR MORE OF ITS EMPLOYEES AS A CEO (OR PRESIDENT), OFFICER, OR KEY EMPLOYEE. IF THE FILING ORGANIZATION DOES NOT DESIGNATE INDIVIDUALS TO THESE ROLES, THE ROLE IS HANDLED BY AN INDIVIDUAL FROM THE PARENT ENTITY, PENN STATE HEALTH, OR AN AFFILITATE. PENN STATE HEALTH HAS ESTABLISHED A SYSTEM-WIDE PROCESS FOR ESTABLISHING COMPENSATION AS FOLLOWS: ANNUALLY, THE COMPENSATION COMMITTEE OF THE PARENT BOARD ENGAGES AN INDEPENDENT COMPENSATION CONSULTANT TO CONDUCT A COMPENSATION ANALYSIS FOR THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER (CEO), OFFICERS, AND KEY EMPLOYEES. AS PART OF THE ANALYSIS, THE INDEPENDENT COMPENSATION CONSULTANT IDENTIFIES, GATHERS, AND ANALYZES APPROPRIATE COMPARABILITY DATA UPON WHICH THE COMMITTEE AND THE FULL BOARD WILL RELY TO ASSESS THE REASONABLENESS OF THE TOTAL PROPOSED COMPENSATION (INCLUDING BENEFITS) OF THE CEO, OFFICERS, AND KEY EMPLOYEES. ONCE THE COMPENSATION ANALYSIS IS COMPLETE AND DOCUMENTED IN REPORTS, THE REPORTS ARE PROVIDED TO THE BOARD FOR REVIEW AND CONSIDERATION, TOGETHER WITH WRITTEN OPINIONS FROM THE COMPENSATION CONSULTANT THAT THE PROPOSED COMPENSATION ARRANGEMENTS FOR THE CEO, OFFICERS, AND KEY EMPLOYEES ARE REASONABLE WITHIN THE MEANING OF TREASURY REGULATION 53.4958-4(B)(1)(II)(A). WITH INPUT FROM THE COMPENSATION COMMITTEE, THE FULL BOARD MAKES ANNUAL DECISIONS WITH RESPECT TO COMPENSATION FOR THE CEO, OFFICERS, AND KEY EMPLOYEES BASED UPON THE DATA IN THE REPORT AND THE OPINION OF THE COMPENSATION CONSULTANT THAT THE PROPOSED COMPENSATION IS REASONABLE. THESE DECISIONS, THE BASIS FOR THESE DECISIONS, THE BOARD MEMBERS' NAMES WHO VOTE ON COMPENSATION, AND THAT NONE OF THE BOARD MEMBERS HAVE A CONFLICT OF INTEREST WITH RESPECT TO THESE COMPENSATION ARRANGEMENTS IS ALL CONTEMPORANEOUSLY DOCUMENTED IN THE MINUTES. |
| FORM 990, PART VI, SECTION C, LINE 19 | REQUIRED DOCUMENTS AVAILABLE TO THE PUBLIC THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS OF THE PENNSYLVANIA STATE UNIVERSITY AND ITS SUBSIDIARIES (WHICH INCLUDES PENN STATE HEALTH AND AFFILIATES) ARE AVAILABLE AT WWW.PSU.EDU. |
| FORM 990, PART VII: | PART VII AND SCHEDULE J REFLECT CERTAIN DIRECTORS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM A RELATED ORGANIZATION. PLEASE NOTE THAT REMUNERATION FOR DIRECTORS WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OF A RELATED ORGANIZATION, NOT FOR SERVICES RENDERED AS DIRECTORS OF THE FILING ORGANIZATION. OF THE PREVIOUS FIVE HIGHEST COMPENSATED INDIVIDUALS REFLECTED ONLY THREE ARE STILL EMPLOYED BY THE PENN STATE HEALTH SYSTEM. SPIRIT PHYSICIAN SERVICES, INC. DID NOT PAY EMPLOYEES FOR THE CALENDAR YEAR 2022; HOWEVER, THE ORGANIZATION IS ELECTING FOR TRANSPARENCY TO SHOW HIGHEST COMPENSATED INDIVIDUALS THAT WERE PAID BY A RELATED ORGANIZATION BECAUSE THEIR SERVICES WERE RENDERED FOR THE BENEFIT OF THE FILING ORGANIZATION. |
| FORM 990, PART IX, LINE 11G | OUTSIDE PURCHASED SERVICE: PROGRAM SERVICE EXPENSES 1,798,689. MANAGEMENT AND GENERAL EXPENSES 449,672. TOTAL EXPENSES 2,248,361. CONTRACTED PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 1,709,301. MANAGEMENT AND GENERAL EXPENSES 427,325. TOTAL EXPENSES 2,136,626. CONTRACTED STAFF: PROGRAM SERVICE EXPENSES 549,087. MANAGEMENT AND GENERAL EXPENSES 137,271. TOTAL EXPENSES 686,358. PROVIDER RECRUITING: PROGRAM SERVICE EXPENSES 65,484. MANAGEMENT AND GENERAL EXPENSES 16,371. TOTAL EXPENSES 81,855. LAUNDRY SERVICES: PROGRAM SERVICE EXPENSES 7,351. MANAGEMENT AND GENERAL EXPENSES 1,838. TOTAL EXPENSES 9,189. CLOUD SERVICES: PROGRAM SERVICE EXPENSES 72. MANAGEMENT AND GENERAL EXPENSES 18. TOTAL EXPENSES 90. |
| FORM 990, PART XI, LINE 9: | MERGED INTO PENN STATE HEALTH AND THEN OUT OF EXISTENCE 110,099,079. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ST JOSEPH MEDICAL CENTER FOUNDATION | |||||||||||
| 100 CRYSTAL A DRIVE MC CA210 | HERSHEY | PA | 17033 | 232649362 | FUNDRAISING | PA | 501(C)(3) | LINE 10 | SJRHN | 0 | |
| ST JOSEPH MEDICAL GROUP | |||||||||||
| 100 CRYSTAL A DRIVE MC CA210 | HERSHEY | PA | 17033 | 208544021 | HEALTHCARE | PA | 501(C)(3) | LINE 10 | PSH | 0 | |
| PENN STATE HEALTH | |||||||||||
| 100 CRYSTAL A DRIVE MC CA210 | HERSHEY | PA | 17033 | 473769205 | MGMT/SUPPORT | PA | 501(C)(3) | LINE 12A, I | PSU | 0 | |
| THE PENNSYLVANIA STATE UNIVERSITY | |||||||||||
| ONE OLD MAIN | UNIVERSITY PARK | PA | 16802 | 246000376 | EDUCATION | PA | 115 | 0 | N/A | ||
| THE MILTON S HERSHEY MEDICAL CENTER | |||||||||||
| 100 CRYSTAL A DRIVE MC CA210 | HERSHEY | PA | 17033 | 251854772 | HEALTHCARE | PA | 115 | PSH | 0 | ||
| PENN STATE HEALTH HAMPDEN MEDICAL CENTER | |||||||||||
| 100 CRYSTAL A DRIVE MC CA210 | HERSHEY | PA | 17033 | 851608328 | HEALTHCARE | PA | 501(C)(3) | LINE 3 | PSH | 0 | |
| PENN STATE HEALTH LANCASTER MEDICAL CENTER | |||||||||||
| 100 CRYSTAL A DRIVE MC CA210 | HERSHEY | PA | 17033 | 851620990 | HEALTHCARE | PA | 501(C)(3) | LINE 3 | PSH | 0 | |
| PENN STATE HEALTH HOLY SPIRIT MEDICAL CENTER | |||||||||||
| 100 CRYSTAL A DRIVE MC CA210 | HERSHEY | PA | 17033 | 231512747 | HEALTHCARE | PA | 501(C)(3) | LINE 3 | PSH | 0 | |
| ST JOSEPH REGIONAL HEALTH NETWORK | |||||||||||
| 100 CRYSTAL A DRIVE MC CA210 | HERSHEY | PA | 17033 | 231352211 | HEALTHCARE | PA | 501(C)(3) | LINE 3 | PSH | 0 | |
| HOLY SPIRIT CORPORATION | |||||||||||
| 100 CRYSTAL A DRIVE MC CA210 | HERSHEY | PA | 17033 | 232214540 | REAL ESTATE | PA | 501(C)(2) | PSHHSMC | 0 | ||
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | EINEIN |
|---|---|---|---|---|---|---|---|---|---|
| HERSHEY OUTPATIENT SURGERY CENTER LP | |||||||||
| 15305 DALLAS PKWY | ADDISON | TX | 75001 | HEALTHCARE | PA | NITTANY HLTH | 0 | 0 | |
| NITTANY HEALTH - VALUEHEALTH JOINT | |||||||||
| 11221 ROE AVE | LEAWOOD | KS | 66211 | HEALTHCARE | PA | NITTANY HLTH | 0 | 0 | 851154159 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| NITTANY HEALTH INC | |||||||||
| 100 CRYSTAL A DRIVE MC CA210 | HERSHEY | PA | 17033 | 251769611 | HOMECARE INTEGRTN | PA | PSH | C | 0 |
| HOLY SPIRIT VENTURES INC | |||||||||
| 100 CRYSTAL A DRIVE MC CA210 | HERSHEY | PA | 17033 | 232407709 | REAL ESTATE | PA | PSHHSMC | C | 0 |
| CGH REALTY CO INC | |||||||||
| 100 CRYSTAL A DRIVE MC CA210 | HERSHEY | PA | 17033 | 232326801 | REAL ESTATE | PA | SJRHN | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SUPPLEMENTAL INFORMATION: | FormAndLineReferenceDesc |
| Explanation | SCHEDULE R LISTS ONLY THOSE RELATED ORGANIZATIONS THAT RELATE TO THE HEALTH CARE OPERATIONS UNDER THE COMMON CONTROL OF THE PENNSYLVANIA STATE UNIVERSITY. | ExplanationTxt |