2024-05-15T16:32:30-05:00 2023-06-30 FORVIS LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2022-07-01 232719336 WAYNE MEMORIAL LONG TERM CARE INC % JAMES PETTINATO WAYN 5704887130 37 WOODLANDS DRIVE WAYMART PA 18472 JAMES PETTINATO CEO 5704887130 2024-05-15 true JAMES PETTINATO XXX-XX-XXXX Brian D Todd P00422601 4178658701 2024-05-15 2 2022 2023-04-26 12:10:37Z WAYNE WOODLANDS MANOR JAMES PETTINATO 601 PARK STREET HONESDALE PA 18431 9462236 false X WWW.WWMANOR.ORG X 1992 PA TO OPERATE A SKILLED NURSING FACILITY THROUGH HIGH QUALITY, COST EFFECTIVE CARE DEDICATED TO CORE VALUES OF COMPASSION, ADVOCACY, RESPECT, EXCELLENCE, AND SERVICE. 7 7 129 10 0 0 1489533 273379 7171907 8548093 157793 115191 0 0 8819233 8936663 0 0 0 0 4846239 5112859 0 0 0 3433352 4940580 8279591 10053439 539642 -1116776 6657451 6699970 667007 1610157 5990444 5089813 X WE ARE COMMITTED TO SERVE OUR COMMUNITY, PATIENTS, FAMILIES, AND CO-WORKERS IN A TRADITION OF HIGH QUALITY, COST EFFECTIVE CARE DEDICATED TO OUR CORE VALUES OF COMPASSION, ADVOCACY, RESPECT, EXCELLENCE, AND SERVICE. false false 9281607 8548093 WAYNE MEMORIAL LONG-TERM CARE, THROUGH THE ACTIVITIES OF ITS NURSING HOME, PROMOTES THE HEALTH OF INDIVIDUALS IN ITS SERVICE AREAS BY (1) SKILLED NURSING/MEDICAL MANAGEMENT WHICH INCLUDES 24 HOUR DAILY CARE, RESTORATIVE NURSING PROGRAMS, WOUND CARE, ENTERAL FEEDING IV THERAPY, MEDICATION MANAGEMENT, RISK ASSESSMENT, PATIENT EDUCATION, AND CARE PLAN DEVELOPMENT. SEE SCHEDULE O FOR REMAINING PROGRAM SERVICE DESCRIPTION. 9281607 true true false false false false false false true false true false false false true false false true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false true 18 0 true 129 true false false false false false false false false false false false false X 7 7 true true false false true true true true true false false true true true true true true false false false PA X JAMES PETTINATO 5702538100 601 PARK STREET HONESDALE PA 18431 X JAMES PETTINATO CEO 2.0 38.0 X 0 338430 47871 PATRICIA DUNSINGER CFO 4.0 36.0 X 0 180601 14272 MICHAEL FREUND ADMINISTRATOR END 09/22 39.9 0.1 X 0 128877 26367 CAROL MAZZA SECRETARY 0.2 0.0 X X 0 0 0 CATHY SALAK TRUSTEE 0.2 0.0 X 0 0 0 CHRISTINE RECHNER CHAIR 1.6 1.6 X X 0 0 0 DIRK MUMFORD TRUSTEE 0.2 0.0 X 0 0 0 EDWARD HOWELL VICE CHAIR END 02/23 0.2 0.0 X X 0 0 0 JAMES LABAR TRUSTEE END 11/22 0.2 0.0 X 0 0 0 LINDA HARDING TRUSTEE END 11/22 0.2 0.0 X 0 0 0 NANCY MORO TRUSTEE BEG 12/22 0.2 1.6 X 0 0 0 PAUL MEAGHER JR TRUSTEE 0.2 0.0 X 0 0 0 STANTON RUSH TREASURER 0.2 0.0 X X 0 0 0 0 647908 88510 0 false true false MAXIM HEALTHCARE SERVICES HOLDINGS 7227 LEE DEFOREST DRIVE COLUMBIA MD 21046 AGENCY NURSING 1000630 POWERBACK REHABILITATION PO BOX 821322 PHILADELPHIA PA 19182 THERAPY 626412 WAYNE MEMORIAL HEALTH SYSTEM 601 PARK STREET HONESDALE PA 18431 MANAGEMENT SERVICES 169057 GENERAL HEALTHCARE RESOURCES LLC 2250 HICKORY ROAD PLYMOUTH MEETING PA 19462 AGENCY NURSING 163081 CROSS COUNTRY STAFFING 6551 PARK OF COMMERCE BLVD BOCA RATON FL 33487 AGENCY NURSING 140929 5 272876 503 273379 NET PATIENT SERVICE REVENUE 623000 8342319 8342319 RENTAL INCOME FROM AFFILIATE 531120 131057 131057 OTHER REVENUE 623000 74717 74717 8548093 67429 67429 0 0 0 0 0 573335 525573 47762 47762 47762 0 0 0 0 0 0 0 0 0 0 8936663 8548093 115191 0 0 0 0 0 0 3959760 3726236 233524 0 864972 776450 88522 288127 270570 17557 169057 169057 1350 1350 12231 12231 0 0 17060 17060 2088163 2061451 26712 17520 15272 2248 210073 147471 62602 97748 49346 48402 0 369094 336804 32290 13635 12442 1193 0 4390 580 3810 11846 11846 0 198809 181416 17393 91535 83527 8008 0 MEDICAL SUPPLIES & DRUGS 856615 856615 BED TAX ASSESSMENT 762230 762230 LICENSES, DUES, SUBSCRIPTIONS 19224 1197 18027 10053439 9281607 771832 0 52750 55815 1225134 551336 0 0 716315 1125219 0 0 0 0 0 0 37606 37231 87244 9334 8236963 6243805 1974522 1993158 2538754 2896900 0 0 0 0 0 0 25126 30977 6657451 6699970 575226 496170 0 0 0 0 0 0 41061 28958 0 0 0 0 0 0 50720 1085029 667007 1610157 X 5990444 5089813 0 0 5990444 5089813 6657451 6699970 -1116776 216145 X false true X true false X 28076 130036 986242 1489533 273379 2907266 8796464 7821262 7375423 7171907 8548093 39713149 0 0 0 8824540 7951298 8361665 8661440 8821472 42620415 0 0 0 42620415 87427 65348 75683 54938 67429 350825 0 87427 65348 75683 54938 67429 350825 0 0 8911967 8016646 8437348 8716378 8888901 42971240 0.99184 0.99160 0.00816 0.00840 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true X 158710 158710 6673217 4981735 1691482 1286397 1143590 142807 118639 118480 159 1993158 0 DUE TO AFFILIATES 1051744 EST DUE TO THIRD PARTY 33285 1085029 9135748 216145 -17060 199085 8936663 8936663 10036379 10036379 17060 17060 10053439 SCHEDULE D, PART IV, LINE 2 ESCROW ARRANGEMENT: ESCROW FUNDS ARE HELD IN SEPARATE BANK ACCOUNTS AND ARE USED TO PAY RESIDENT EXPENSES (PERSONAL EXPENSES AND ACTIVITY EXPENSES). ESCROW FUNDS ARE RECORDED AS BOTH AN ASSET AND A LIABILITY ON THE FINANCIAL STATEMENTS WHICH NET TO ZERO. SCHEDULE D, PART X, LINE 2 UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 2D AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART VIII, LINE 12: $ (17,060) INVESTMENT MANAGEMENT FEES false true false false false false false false false JAMES PETTINATO CEO 0 309052 0 0 0 29378 0 27610 0 20261 0 386301 0 0 PATRICIA DUNSINGER CFO 0 180601 0 0 0 0 0 10895 0 3377 0 194873 0 0 MICHAEL FREUND ADMINISTRATOR END 09/22 0 128877 0 0 0 0 0 7794 0 18573 0 155244 0 0 SCHEDULE J, PART I, LINE 3 CEO COMPENSATION: WAYNE MEMORIAL HEALTH SYSTEM, A RELATED ORGANIZATION, DETERMINES THE COMPENSATION OF THE CEO USING THE FOLLOWING METHODS: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. THE BOARD MAKES THE FINAL DECISION USING THE INFORMATION PROVIDED BY THE CONSULTANT. SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: WAYNE MEMORIAL HEALTH SYSTEM, A RELATED ORGANIZATION, COVERS JAMES PETTINATO WITH A 457(F) SUPPLEMENTAL RETIREMENT AGREEMENT (SERP). IN THE CURRENT YEAR THE FOLLOWING CONTRIBUTION WAS MADE: $ 9,310 FORM 990, PART III, LINE 1 MISSION STATEMENT: WAYNE MEMORIAL LONG TERM CARE, AN AFFILIATE OF WAYNE MEMORIAL HEALTH SYSTEM, PROVIDES VARIOUS LEVELS OF SERVICES INCLUDING LONG TERM CARE AND REHABILITATION SERVICES FOR OUR COMMUNITY NURTURING THE HUMAN SPIRIT AS WELL AS THE HUMAN BODY. FORM 990, PART III, LINE 4A PROGRAM SERVICE DESCRIPTION: (2) OUR THERAPY PROGRAM INCLUDES PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY, PAIN MANAGEMENT, EXERCISE PROGRAMS, AND WOUND CARE; (3) WE PROVIDE OUR RESIDENTS WITH ROOM AND BOARD, WHICH ENCOMPASSES A WIDE RANGE OF SERVICES INCLUDING SOCIAL SERVICES, REGISTERED DIETICIAN SERVICES, SPECIALIZED DIETS, NUTRITIONAL SUPPLEMENTATION, THERAPEUTIC, AND GROUP ACTIVITIES. THROUGH THESE PROGRAMS WE FOCUS ON HELPING ALL RESIDENTS REGAIN MAXIMUM HEALTH, FUNCTION, AND QUALITY OF LIFE. FORM 990, PART VI, SECTION A, LINE 2 FAMILY RELATIONSHIP: CHRISTINE RECHNER, CHAIR OF WMLTC, HAS A FAMILY RELATIONSHIP WITH HUGH RECHNER, A TRUSTEE ON BOARDS OF RELATED ORGANIZATIONS. BUSINESS RELATIONSHIP: JAMES PETTINATO (CEO) AND PATRICIA DUNSINGER (CFO) ARE COMPENSATED BY WAYNE MEMORIAL HEALTH SYSTEM, A RELATED ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 3 DELEGATE MANAGEMENT DUTIES: WAYNE MEMORIAL HEALTH SYSTEM, INC., PROVIDES MANAGEMENT OVER THE ORGANIZATION THROUGH DIRECT EMPLOYMENT OF THE DIRECTORS AND OFFICERS OF THE ORGANIZATION. THE MANAGEMENT SERVICES PROVIDED ARE REIMBURSED TO WAYNE MEMORIAL HEALTH SYSTEM THROUGH A MANAGEMENT FEE. THIS FEE IS REPORTED ON FORM 990, PART IX, LINE 11A. FORM 990, PART VI, SECTION A, LINES 6, 7A & 7B MEMBERS OR STOCKHOLDERS: WAYNE MEMORIAL HEALTH SYSTEM (THE "SYSTEM"), A RELATED ORGANIZATION AND A PENNSYLVANIA NONPROFIT CORPORATION, IS THE SOLE MEMBER OF WAYNE MEMORIAL LONG TERM CARE, INC., (THE "CENTER"). WAYNE MEMORIAL HEALTH SYSTEM, INC. IS ENTITLED TO APPROVE THE ELECTION OF THE BOARD MEMBERS AND OFFICERS OF WAYNE MEMORIAL LONG TERM CARE, INC. THE FOLLOWING DECISIONS OF THE GOVERNING BODY ARE SUBJECT TO APPROVAL BY WAYNE MEMORIAL HEALTH SYSTEM, INC.: (A) AMENDMENT OF THE BYLAWS OR THE ARTICLES OF CORPORATION (B) MERGER OR CONSOLIDATION WITH ANY OTHER ENTITY (C) DISSOLUTION AND DISTRIBUTION OF ASSETS IN CONNECTION THEREWITH (D) ELECTION OF OFFICERS OF THIS CORPORATION (E) ADOPTION OF INVESTMENT POLICIES AND SELECTION OF INVESTMENT ADVISORS (F) INVESTMENT OF RESTRICTED GIFTS (G) SELECTION OF AUDITORS AND ATTORNEYS (H) ADOPTION OF OPERATING AND CAPITAL BUDGETS (I) APPROVAL OF FUND-RAISING PROGRAMS (J) DONATION OR TRANSFER OF ANY ASSET WITH AN AGGREGATE VALUE IN EXCESS OF SUCH AMOUNT AS MAY BE DETERMINED BY THE BOARD OF WAYNE MEMORIAL HEALTH SYSTEM FROM TIME TO TIME (K) CREATION OF ANY LIEN OR SECURITY INTEREST IN ASSETS OF THE CORPORATION (L) DESIGNATION OR RESTRICTION OF GIFTS WITH A MARKET VALUE IN EXCESS OF SUCH AMOUNT AS MAY BE DETERMINED BY THE BOARD OF WAYNE MEMORIAL HEALTH SYSTEM FROM TIME TO TIME, AND (M) ANY OTHER MATTER THAT WOULD REQUIRE THE APPROVAL OF THE MEMBERS OF A PENNSYLVANIA NONPROFIT CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B 990 REVIEW POLICY: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. A COPY OF THE FORM 990 WILL BE REVIEWED WITH THE RESOURCE MANAGEMENT COMMITTEE WHICH IS RESPONSIBLE FOR THE FINANCIAL OVERSIGHT OF ALL ENTITIES OF THE WAYNE MEMORIAL HEALTH SYSTEM. A COPY OF THE 990 WILL BE DISTRIBUTED VIA E-MAIL TO EACH BOARD MEMBER BEFORE THE RETURN IS SUBMITTED TO THE IRS. MANAGEMENT WILL DISCUSS ANY QUESTIONS THAT ANY BOARD MEMBER MAY HAVE AT THE NEXT FULL BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY: CONFLICT OF INTEREST STATEMENTS ARE COMPLETED BY EVERY BOARD MEMBER AND MANAGER ANNUALLY. EACH INDIVIDUAL IS REQUIRED TO SIGN AND RETURN THE STATEMENTS TO THE ADMINISTRATION OFFICE. THE BOARD SECRETARY IS RESPONSIBLE FOR MONITORING COMPLIANCE WITH ANY CONFLICT OF INTEREST THROUGHOUT THE YEAR. IF A CONFLICT ARISES, THE PERSON WITH THE CONFLICT WILL RECUSE THEMSELVES FROM VOTING AND/OR DISCUSSING THE MATTER. FORM 990, PART VI, SECTION B, LINES 15A & 15B COMPENSATION REVIEW: WAYNE MEMORIAL HEALTH SYSTEM, INC., (AND ALL RELATED ENTITIES) UTILIZES A COMPENSATION COMMITTEE OF THE BOARD TO SET COMPENSATION OF ITS CEO AND OTHER SENIOR MANAGERS, INCLUDING CFO, DIRECTOR OF PATIENT CARE SERVICES, DIRECTOR OF HUMAN RESOURCES, DIRECTOR OF FACILITY SERVICES, DIRECTOR OF ANCILLARY SERVICES AND THE EXECUTIVE DIRECTOR OF THE WAYNE MEMORIAL HEALTH FOUNDATION. THE COMPENSATION COMMITTEE IS MADE UP OF INDEPENDENT DIRECTORS, WHO, WITH THE ASSISTANCE OF A NATIONAL COMPENSATION CONSULTING FIRM, UTILIZE COMPARABLE DATA FROM THE MARKETPLACE, LOOKING AT SUCH THINGS AS COMPARABLE ORGANIZATIONS IN TERMS OF REVENUE, SIZE, COMPLEXITY AND GEOGRAPHIC REGION. THE ORGANIZATION HAS ADOPTED A PHILOSOPHY OF PAYING AT THE 50TH PERCENTILE OF THE MARKETPLACE. ALL MEETINGS OF THE COMPENSATION COMMITTEE ARE DOCUMENTED AND MINUTES ARE MAINTAINED OF THE DELIBERATION AND DECISION-MAKING PROCESS. THE PROCESS NORMALLY OCCURS IN OCTOBER OF THE YEAR THE COMPENSATION CHANGES ARE GRANTED. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT DISCLOSURE: THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND/OR FINANCIAL STATEMENTS AVAILABLE TO PUBLIC UPON REQUEST. FORM 990 PART IX LINE 11G DESCRIPTION:TEMPORARY PERSONNEL TOTAL FEES:1388723 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICAL THERAPY FEES TOTAL FEES:223762 FORM 990 PART IX LINE 11G DESCRIPTION:OCCUPATIONAL THERAPY FEES TOTAL FEES:209120 FORM 990 PART IX LINE 11G DESCRIPTION:SPEECH FEES TOTAL FEES:197281 FORM 990 PART IX LINE 11G DESCRIPTION:MED DIRECTOR TOTAL FEES:26400 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL SERVICE TOTAL FEES:1512 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER FEES TOTAL FEES:41365 WAYNE MEMORIAL HOSPITAL 601 PARK STREET HONESDALE PA 18431 240798839 HOSPITAL PA 501(C)3 3 WMHS false WAYNE MEMORIAL HEALTH SYSTEM INC 601 PARK STREET HONESDALE PA 18431 232221292 OVERSIGHT PA 501(C)3 12 B II NA false WAYNE MEMORIAL HEALTH FOUNDATION 601 PARK STREET HONESDALE PA 18431 232208596 FUNDRAISING PA 501(C)3 12 A I WMHS false WAYNE HEALTH SERVICES INC 601 PARK STREET HONESDALE PA 18431 232376183 DME, RENT, PHARM PA WMHF C-CORPORATION false false false false false true false false false false true false false true false true true true false false