WAYNE MEMORIAL HOSPITAL: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- WAYNE MEMORIAL HOSPITAL (EIN 24-0798839)
- Tax period
- 2022-07-01 to 2023-06-30
- Filed
- 2024-05-15
- IRS object ID
- 202441369349316934
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-05-15T17:23:35-05:00 | ReturnTs |
| Tax Period End | 2023-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FORVIS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 910 E ST LOUIS 200/PO BOX 1190 | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 658062523 | 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 | 240798839 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WAYNE MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % JAMES PETTINATO | InCareOfNm |
| Business Name Control | WAYN | BusinessNameControlTxt |
| Phone | 5702538100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 601 PARK STREET | AddressLine1Txt |
| City | HONESDALE | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 18431 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAMES PETTINATO | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 5702538100 | PhoneNum |
| Signature | 2024-05-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JAMES | PersonFirstNm |
| Person Last | PETTINATO | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Brian D Todd | PreparerPersonNm |
| PTIN | P00422601 | PTIN |
| Phone | 4178658701 | PhoneNum |
| Preparation | 2024-05-15 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| 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) |
|---|---|---|
| Principal Officer | JAMES PETTINATO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 601 PARK STREET | AddressLine1Txt |
| City | HONESDALE | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 18431 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $133,405,597 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.WMH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1907 | FormationYr |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Activity Or Mission | WAYNE MEMORIAL HOSPITAL IS A NON-PROFIT, COMMUNITY-CONTROLLED HOSPITAL THAT STRIVES TO OFFER THE HIGHEST QUALITY IN INPATIENT AND OUTPATIENT MEDICAL CARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 18 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 901 | TotalEmployeeCnt |
| Total Volunteers | 116 | TotalVolunteersCnt |
| Total Gross UBI | $2,766 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $698 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $6,884,468 | PYContributionsGrantsAmt |
| CY Contributions Grants | $12,512,024 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $107,845,197 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $104,409,553 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3,430,230 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,816,131 | CYInvestmentIncomeAmt |
| PY Other Revenue | $819,413 | PYOtherRevenueAmt |
| CY Other Revenue | $1,157,131 | CYOtherRevenueAmt |
| PY Total Revenue | $118,979,308 | PYTotalRevenueAmt |
| CY Total Revenue | $120,894,839 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,924,417 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $2,305,291 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $53,399,056 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $55,912,202 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $62,949,452 | PYOtherExpensesAmt |
| CY Other Expenses | $59,587,952 | CYOtherExpensesAmt |
| PY Total Expenses | $118,272,925 | PYTotalExpensesAmt |
| CY Total Expenses | $117,805,445 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $706,383 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,089,394 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $180,093,733 | TotalAssetsBOYAmt |
| Total Assets EOY | $189,530,684 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $82,602,761 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $78,405,306 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $97,490,972 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $111,125,378 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | IT IS THE MISSION OF WAYNE MEMORIAL HOSPITAL TO PROVIDE QUALITY HEALTHCARE WITH COMPASSION, ADVOCACY, RESPECT, EXCELLENCE, AND SERVICE; TO PROMOTE WELLNESS IN OUR COMMUNITY; AND TO BE PROACTIVE TO OUR COMMUNITY'S NEEDS. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $71,109,536 | ExpenseAmt |
| Revenue | $77,900,021 | RevenueAmt |
| Desc | A VARIETY OF OUTPATIENT SERVICES ARE OFFERED INCLUDING LAB, RADIOLOGY, AND REHABILITATION SERVICES SUCH AS CARDIAC, PHYSICAL, OCCUPATIONAL AND SPEECH THERAPIES. WMH ALSO PROVIDES OUTPATIENT EMERGENCY AND DIAGNOSTIC SERVICES AND OUR PHYSICIAN SPECIALTY CLINIC OFFERS OUTPATIENT PULMONARY, GASTROENTEROLOGY, CARDIOLOGY, NEPHROLOGY, NEUROLOGY, SLEEP, AND GENERAL SURGERY SERVICES. WMH FEATURES 30 MEDICAL SPECIALTIES AND INCLUDES A CERTIFIED PRIMARY STROKE CENTER, A LEVEL IV TRAUMA CENTER AND A CERTIFIED CARDIAC CATHETERIZATION LABORATORY. THE SPECIALTY CLINIC WILL ADD UROLOGY IN 2024. OUR EMERGENCY DEPARTMENT OFFERS PHYSICIAN CARE 24 HOURS A DAY TO ALL, REGARDLESS OF ABILITY TO PAY. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $21,678,398 | ExpenseAmt |
| Revenue | $23,748,539 | RevenueAmt |
| Desc | INPATIENT SERVICES PROVIDES A FULL CONTINUUM OF CARE, FROM BIRTHING SUITES TO CHEMOTHERAPY, ENDOSCOPY, CARDIOLOGY PROCEDURES, RESPIRATORY THERAPY, IMAGING SCANS, AND HOSPICE CARE FOR THE POPULATION WE SERVE OF APPROXIMATELY 100,000 PEOPLE IN MOSTLY RURAL WAYNE AND PIKE COUNTIES AND SURROUNDING AREAS IN NORTHEASTERN PENNSYLVANIA. OUR HOSPITAL HAS 90 ACUTE-CARE BEDS, INCLUDING 50 IN PRIVATE ROOMS, AND AN ADDITIONAL 14 BEDS DEDICATED TO INPATIENT REHABILITATION. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,520,320 | ExpenseAmt |
| Revenue | $2,760,993 | RevenueAmt |
| Desc | THE ORGANIZATION PROVIDED HOME HEALTH AND HOSPICE SERVICES AND RELATED SUPPORT TO THE COMMUNITY. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $2,305,291 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $2,305,291 | TotalOtherProgSrvcGrantAmt |
| Total Program Service Expenses | $97,613,545 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | Yes (true) | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 95 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 901 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 18 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (true) | WrittenPolicyOrProcedureInd |
| 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 | JAMES PETTINATO | PersonNm |
| Phone | 5702538100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 601 PARK STREET | AddressLine1Txt |
| City | HONESDALE | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 18431 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Key EmployeeKeyEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| DAVID CAUCCI | |||||||||
| PHYSICIAN | 40.0 | 0.0 | Yes (X) | $652,493 | $0 | $37,601 | |||
| JEFFREY MOGERMAN | |||||||||
| PHYSICIAN | 40.0 | 0.0 | Yes (X) | $616,434 | $0 | $37,110 | |||
| KEITH CORDISCHI | |||||||||
| PHYSICIAN | 40.0 | 0.0 | Yes (X) | $494,302 | $0 | $27,517 | |||
| JOSEPH LAURETI | |||||||||
| PHYSICIAN | 40.0 | 0.0 | Yes (X) | $445,944 | $0 | $20,261 | |||
| DR SEAN MCVEIGH | |||||||||
| TRUSTEE/CHIEF OF MS | 39.2 | 0.8 | $398,834 | $0 | $30,711 | Yes (X) | |||
| JAMES PETTINATO | |||||||||
| CEO | 36.9 | 3.1 | $0 | $338,430 | $47,871 | Yes (X) | |||
| CLIFFORD CARROLL | |||||||||
| PHYSICIAN | 40.0 | 0.0 | Yes (X) | $356,204 | $0 | $6,573 | |||
| PATRICIA DUNSINGER | |||||||||
| CFO | 18.8 | 21.2 | $0 | $180,601 | $14,272 | Yes (X) | |||
| JAMES HOCKENBURY | |||||||||
| CHIEF OF ANCILLARY SERVICES | 34.0 | 6.0 | $0 | $167,895 | $17,536 | Yes (X) | |||
| BRAD KIESENDAHL | |||||||||
| TRUSTEE | 0.8 | 0.8 | $0 | $0 | $0 | Yes (X) | |||
| CHRISTINE RECHNER | |||||||||
| TRUSTEE | 0.8 | 2.4 | $0 | $0 | $0 | Yes (X) | |||
| DIANE POPOVICH | |||||||||
| TRUSTEE | 0.8 | 0.8 | $0 | $0 | $0 | Yes (X) | |||
| FRANK BORELLI | |||||||||
| TREASURER | 0.8 | 0.8 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| HUGH RECHNER | |||||||||
| CHAIR | 0.8 | 1.0 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| DR JASON ZIELINSKI | |||||||||
| TRUSTEE/MS VP | 0.8 | 0.8 | $0 | $0 | $0 | Yes (X) | |||
| JOANN HUDAK | |||||||||
| 1ST VICE CHAIR | 0.8 | 0.8 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| KATE BRYANT | |||||||||
| TRUSTEE | 0.8 | 0.8 | $0 | $0 | $0 | Yes (X) | |||
| KEITH GUNUSKEY | |||||||||
| TRUSTEE | 0.8 | 0.8 | $0 | $0 | $0 | Yes (X) | |||
| MARY BURNS HOFF | |||||||||
| SECRETARY | 0.8 | 0.8 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| MARY BETH WOOD | |||||||||
| TRUSTEE | 0.8 | 0.8 | $0 | $0 | $0 | Yes (X) | |||
| NANCY MORO | |||||||||
| TRUSTEE | 0.8 | 1.0 | $0 | $0 | $0 | Yes (X) | |||
| NANCY PROPST | |||||||||
| TRUSTEE | 0.8 | 1.3 | $0 | $0 | $0 | Yes (X) | |||
| PAUL KARPIAK | |||||||||
| TRUSTEE | 0.8 | 0.8 | $0 | $0 | $0 | Yes (X) | |||
| RONALD SCHMALZLE | |||||||||
| TRUSTEE END 12/22 | 0.8 | 0.8 | $0 | $0 | $0 | Yes (X) | |||
| WENDELL HUNT | |||||||||
| 2ND VICE CHAIR | 0.8 | 0.8 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| DR SANDRA COSKLO | |||||||||
| TRUSTEE/MS PRESIDENT | 0.8 | 0.8 | $0 | $0 | $0 | Yes (X) | |||
| MELISSA RICKARD | |||||||||
| TRUSTEE | 0.8 | 0.8 | $0 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,964,211 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $686,926 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $239,452 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 47 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MEDICAL SOLUTIONS LLC | |||||
| 1010 N 102ND ST | OMAHA | NE | 68114 | AGENCY NURSING | $1,876,608 |
| LABORATORY CORP OF AMERICA | |||||
| 531 S SPRING STREET | BURLINGTON | NC | 27215 | LABORATORY SERVICES | $1,807,712 |
| NORTH AMERICAN PARTNERS IN ANESTHES | |||||
| 1305 WALT WHITMAN ROAD | MELVILLE | NY | 11747 | ANESTHETISTS | $1,422,589 |
| ADVANCED INPATIENT MEDICINE | |||||
| 7250 PARKWAY DRIVE | HANOVER | MD | 21076 | HOSPITALISTS | $1,323,697 |
| TRUSTED NURSE STAFFING | |||||
| 1200 WILLIAM STREET | BUFFALO | NY | 14240 | AGENCY NURSING | $1,109,919 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 15 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $14,000 | RelatedOrganizationsAmt |
| Government Grants | $12,340,684 | GovernmentGrantsAmt |
| All Other Contributions | $157,340 | AllOtherContributionsAmt |
| Total Contributions | $12,512,024 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PA RURAL HEALTH MODEL REVENUE | 623000 | $60,910,574 | $60,910,574 |
| NET PATIENT SERVICE REVENUE | 623000 | $42,653,482 | $42,653,482 |
| CAFETERIA | 722514 | $262,679 | $262,679 |
| OTHER REVENUE | 900099 | $582,818 | $582,818 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $104,409,553 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,711,175 | TotalRevenueColumnAmt |
| Exclusion | $1,711,175 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $491,036 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $351,876 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $139,160 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $139,160 | TotalRevenueColumnAmt |
| Exclusion | $139,160 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $13,263,838 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $12,158,882 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,104,956 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,104,956 | TotalRevenueColumnAmt |
| Exclusion | $1,104,956 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | GAIN/(LOSS) ON EQUITY INVESTEE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $1,017,971 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $2,766 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,015,205 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,017,971 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $120,894,839 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $104,409,553 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $2,766 | UnrelatedBusinessRevenueAmt |
| Exclusion | $3,970,496 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,305,291 | TotalAmt |
| Program Services | $2,305,291 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $429,545 | TotalAmt |
| Program Services | $429,545 | ProgramServicesAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,020,066 | TotalAmt |
| Program Services | $34,762,785 | ProgramServicesAmt |
| Management And General | $8,257,281 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,601,298 | TotalAmt |
| Program Services | $2,104,603 | ProgramServicesAmt |
| Management And General | $496,695 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,780,311 | TotalAmt |
| Program Services | $5,486,998 | ProgramServicesAmt |
| Management And General | $1,293,313 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,080,982 | TotalAmt |
| Program Services | $2,495,050 | ProgramServicesAmt |
| Management And General | $585,932 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,127,319 | TotalAmt |
| Management And General | $1,127,319 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $85,627 | TotalAmt |
| Management And General | $85,627 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $249,036 | TotalAmt |
| Management And General | $249,036 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $348,977 | TotalAmt |
| Management And General | $348,977 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,522,999 | TotalAmt |
| Program Services | $22,162,286 | ProgramServicesAmt |
| Management And General | $1,360,713 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $234,654 | TotalAmt |
| Management And General | $234,654 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,713,628 | TotalAmt |
| Program Services | $802,965 | ProgramServicesAmt |
| Management And General | $1,910,663 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,059,677 | TotalAmt |
| Program Services | $1,481,037 | ProgramServicesAmt |
| Management And General | $578,640 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $227,207 | TotalAmt |
| Program Services | $217,463 | ProgramServicesAmt |
| Management And General | $9,744 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,389 | TotalAmt |
| Program Services | $31,142 | ProgramServicesAmt |
| Management And General | $13,247 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,696,882 | TotalAmt |
| Program Services | $1,424,680 | ProgramServicesAmt |
| Management And General | $272,202 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,297,730 | TotalAmt |
| Program Services | $5,287,492 | ProgramServicesAmt |
| Management And General | $1,010,238 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,317,691 | TotalAmt |
| Program Services | $1,106,316 | ProgramServicesAmt |
| Management And General | $211,375 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES & DRUGS | $16,149,252 | $16,149,252 | |
| REPAIRS & MAINTENANCE | $3,409,878 | $1,263,634 | $2,146,244 |
| LICENSES, DUES, SUBCRIPTIONS | $103,006 | $103,006 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $117,805,445 | TotalAmt |
| Program Services | $97,613,545 | ProgramServicesAmt |
| Management And General | $20,191,900 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $93,029 | BOYAmt |
| EOY | $63,130 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,069,603 | BOYAmt |
| EOY | $35,007,876 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,744,113 | BOYAmt |
| EOY | $10,152,495 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,839,559 | BOYAmt |
| EOY | $2,306,521 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,685,478 | BOYAmt |
| EOY | $4,465,804 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $150,987,420 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $97,152,836 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,759,843 | BOYAmt |
| EOY | $53,834,584 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,974,481 | BOYAmt |
| EOY | $63,997,001 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $779,116 | BOYAmt |
| EOY | $516,765 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,178,577 | BOYAmt |
| EOY | $3,284,261 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,969,934 | BOYAmt |
| EOY | $15,902,247 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $180,093,733 | BOYAmt |
| EOY | $189,530,684 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,735,739 | BOYAmt |
| EOY | $14,077,925 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,700,503 | BOYAmt |
| EOY | $379,492 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,055,983 | BOYAmt |
| EOY | $47,495,435 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,110,536 | BOYAmt |
| EOY | $16,452,454 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $82,602,761 | BOYAmt |
| EOY | $78,405,306 | 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 | $94,979,606 | BOYAmt |
| EOY | $108,257,090 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,511,366 | BOYAmt |
| EOY | $2,868,288 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $97,490,972 | BOYAmt |
| EOY | $111,125,378 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $180,093,733 | BOYAmt |
| EOY | $189,530,684 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $3,089,394 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $4,403,003 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $6,142,009 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $12,924 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $12,924 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1(I) | FormAndLineReferenceDesc |
| Explanation | LOBBYING EXPENSES: WAYNE MEMORIAL HOSPITAL PAYS ANNUAL MEMBERSHIP DUES TO THE HOSPITAL & HEALTH SYSTEM ASSOCIATION OF PENNSYLVANIA (HAP) AND AMERICAN HOSPITAL ASSOCIATION (AHA). THE HOSPITAL IS NOTIFIED EACH YEAR THAT A PORTION OF THE MEMBERSHIP DUES IS USED FOR LOBBYING ACTIVITIES. THE PORTION OF FEES PAID REPRESENTING LOBBYING EXPENDITURES WAS $12,924. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,892,690 | OtherCostOrOtherBasisAmt |
| Book Value | $2,892,690 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $59,289,008 | OtherCostOrOtherBasisAmt |
| Depreciation | $34,653,534 | DepreciationAmt |
| Book Value | $24,635,474 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,010,397 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,042,962 | DepreciationAmt |
| Book Value | $967,435 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $81,444,447 | OtherCostOrOtherBasisAmt |
| Depreciation | $58,902,654 | DepreciationAmt |
| Book Value | $22,541,793 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,350,878 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,553,686 | DepreciationAmt |
| Book Value | $2,797,192 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $53,834,584 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| EST AMOUNT FROM 3RD PARTY | $3,201,320 |
| DUE FROM AFFILIATE | $1,713,591 |
| BENEFICIAL INT IN PRPTL TRUSTS | $2,434,771 |
| OTHER RECEIVABLES | $4,852,016 |
| RIGHT OF USE ASSETS | $3,700,549 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $15,902,247 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| PROFESSIONAL LIABILITY CLAIMS | $3,674,531 |
| DUE TO THIRD PARTIES | $8,052,922 |
| LEASE LIABILITY | $4,725,001 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $16,452,454 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $130,376,031 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $4,403,003 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $5,246,630 | OtherRevenueAmt |
| Revenue Not Reported | $9,649,633 | RevenueNotReportedAmt |
| Revenue Subtotal | $120,726,398 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $348,977 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | -$180,536 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $168,441 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $120,894,839 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $117,098,547 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $351,876 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $351,876 | ExpensesNotReportedAmt |
| Expenses Subtotal | $116,746,671 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $348,977 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $709,797 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $1,058,774 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $117,805,445 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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: $ (709,797) PENSION EXPENSE 5,818,010 CHANGE IN DEFINED BENEFIT PENSION PLAN 135,504 NET ASSETS RELEASED FROM RESTRICTION 2,913 TRANSFER FROM AFFILIATE ------------ $ 5,246,630 |
| SCHEDULE D, PART XI, LINE 4B | AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ (351,876) RENTAL EXPENSES 171,340 TEMPORARILY RESTRICTED GRANT REVENUE ----------- $ (180,536) |
| SCHEDULE D, PART XII, LINE 2D | AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART IX, LINE 25: $ 351,876 RENTAL EXPENSES |
| SCHEDULE D, PART XII, LINE 4B | AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 709,797 PENSION EXPENSE |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 408 | PersonsServedCnt |
| Total Community Benefit Expns | $389,033 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $389,033 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00330 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,203,681 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,222,897 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,980,784 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05080 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 408 | PersonsServedCnt |
| Total Community Benefit Expns | $19,592,714 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,222,897 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,369,817 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05410 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 22 | ActivitiesOrProgramsCnt |
| Persons Served | 9158 | PersonsServedCnt |
| Total Community Benefit Expns | $262,472 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $262,472 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00220 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 3 | PersonsServedCnt |
| Total Community Benefit Expns | $56,998 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $56,998 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $2,305,691 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,305,691 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01960 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 25 | ActivitiesOrProgramsCnt |
| Persons Served | 9161 | PersonsServedCnt |
| Total Community Benefit Expns | $2,625,161 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,625,161 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02230 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 25 | ActivitiesOrProgramsCnt |
| Persons Served | 9569 | PersonsServedCnt |
| Total Community Benefit Expns | $22,217,875 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,222,897 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,994,978 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07640 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $19,618 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $19,618 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 212 | PersonsServedCnt |
| Total Community Benefit Expns | $12,608 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $12,608 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 5 | ActivitiesOrProgramsCnt |
| Persons Served | 212 | PersonsServedCnt |
| Total Community Benefit Expns | $32,226 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $32,226 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $9,691,656 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $2,788,289 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $24,556,710 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $28,806,344 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$4,249,634 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WAYNE MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 601 PARK STREET | AddressLine1Txt |
| City | HONESDALE | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 18431 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.WMH.ORG | WebsiteAddressTxt |
| State License | 230501 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WAYNE MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 21 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V SECTION C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V SECTION C | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 0. | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V SECTION C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, SECTION B, LINE 5 | COMMUNITY INPUT: THE 2022 CHNA WAS CONDUCTED IN ASSOCIATION WITH THE INSTITUTE FOR PUBLIC HEALTH RESEARCH AND INNOVATION AT EAST STROUDSBURG UNIVERSITY. THE METHODOLOGY INVOLVED BOTH QUANTITATIVE AND QUALITY ASSESSMENTS. DATA WAS COLLECTED FROM THE PENNSYLVANIA DEPARTMENT OF HEALTH, THE 2022 COUNTY HEALTH RANKINGS AND ROADMAPS, THE CENTER FOR RURAL PENNSYLVANIA, THE U.S. CENSUS, WAYNE AND PIKE COUNTY STATISTICS AND OTHER PUBLIC SOURCES TO IDENTIFY POPULATION GROUPS, DISEASE TRENDS, MORTALITY RATES AND CAUSES, AND VACCINATION UPTAKE IN THE COMMUNITIES SERVED BY WAYNE MEMORIAL HOSPITAL. THIS INFORMATION WAS AUGMENTED WITH AN ONLINE PUBLIC SURVEY (526 RESPONDENTS), INTERVIEWS WITH COMMUNITY STAKEHOLDERS AND FOCUS GROUPS TO FORM A MORE VIBRANT, COHESIVE PICTURE OF THE COMMUNITY AS A WHOLE TO ASSESS ITS NEEDS ACCORDINGLY AND DETERMINE HOW TO STRATEGIZE MEETING THOSE NEEDS. |
| SCHEDULE H, PART V, SECTION B, LINE 6B | OTHER ORGANIZATIONS: THE CNHA PROCESS WAS GUIDED BY A LOCAL STEERING COMMITTEE CONSISTING OF REPRESENTATIVES FROM WAYNE MEMORIAL HOSPITAL, WAYNE MEMORIAL COMMUNITY HEALTH CENTERS, WAYNE AND PIKE COUNTY GOVERNMENTS INCLUDING LOCAL DEPARTMENT OF HEALTH REPRESENTATIVES, WAYNE AND PIKE COUNTY HUMAN SERVICE AGENCIES, FOREST CITY (SUSQUEHANNA COUNTY) AND CARBONDALE AREA (LACKAWANNA COUNTY) COMMUNITY REPRESENTATIVES, AND COMMUNITY REPRESENTATIVES AND OFFICIALS FROM AREA SCHOOL DISTRICTS. |
| SCHEDULE H, PART V, SECTION B, LINE 7 AND 10 | CHNA REPORT AND IMPLEMENTATION STRATEGY URL: HTTPS://WWW.WMH.ORG/CHNA-COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ |
| SCHEDULE H, PART V, SECTION B, LINE 11 | ADDRESSING IDENTIFIED NEEDS: ALTHOUGH WAYNE MEMORIAL HOSPITAL RECOGNIZES THE IMPORTANCE OF ALL THE NEEDS IDENTIFIED BY THE COMMUNITY, CERTAIN NEEDS ARE NOT WITHIN THE PURVIEW OF WMH AND ARE NOT ADDRESSED. THE IMPLEMENTATION STRATEGY DESCRIBES THE NEEDS BEING MET, AS WELL AS THE ORGANIZATION RESPONSIBLE TO ADDRESS THE IDENTIFIED NEEDS AND THE STATUS OF THE STRATEGY TO ADDRESS SUCH NEEDS. |
| SCHEDULE H, PART V, SECTION B, LINE 16A, 16B, & 16C | FAP, FAP APPLICATION, PLAIN LANGUAGE SUMMARY URL: HTTP://WWW.WMH.ORG/FINANCIAL-ASSISTANCE/ |
| SCHEDULE H, PART VI, SECTION B, LINE 22D | MAXIMUM AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS: A FINANCIAL ASSISTANCE ELIGIBLE INDIVIDUAL WILL NOT BE CHARGED MORE FOR EMERGENCY OR OTHER MEDIALLY NECESSARY CARE THAN AGB. IF A PATIENT IS FAP ELIGIBLE, THEY WOULD RECEIVE A 100% DISCOUNT. THE HOSPITAL USES THE PROSPECTIVE MEDICARE METHOD FOR CALCULATING AGB. |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 7I | CONTRIBUTIONS TO THE COMMUNITY: THE HOSPITAL SUBSIDIZED BOTH IN AND OUT OF SCOPE (NON PRIMARY CARE SERVICES - PEDIATRICS, SURGEONS AND SPECIALIST) SERVICES OF WAYNE MEMORIAL COMMUNITY HEALTH CENTERS (WMCHC) WITH A CASH CONTRIBUTION OF $2,305,291. WMCHCS SURGEONS AND SPECIALISTS PROVIDE INPATIENT AND OUTPATIENT CARE AT WAYNE MEMORIAL HOSPITAL AS WELL AS SERVICES OUT OF THEIR HEALTH CENTER OFFICES. WMCHC PEDIATRIC PRACTITIONERS PROVIDE INPATIENT AND OUTPATIENT CARE AT WAYNE MEMORIAL HOSPITAL AND OUTPATIENT SERVICES IN THE HONESDALE AND CARBONDALE AREA. WMCHC WOULD NOT BE ABLE TO PROVIDE THESE SERVICES AND THEY WOULD NOT BE AVAILABLE IN THE COMMUNITY WITHOUT THIS SUBSIDY. |
| SCHEDULE H, PART I, LINE 7, COLUMN F | PERCENT OF TOTAL EXPENSE: TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR USED WAS TOTAL EXPENSES PER PART IX, LINE 25, OF THE FORM 990, $117,805,445. |
| SCHEDULE H, PART I, LINE 7 | COSTING METHODOLOGY: THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEETS 1 AND 3. |
| SCHEDULE H, PART II | COMMUNITY BENEFIT AND BUILDING ACTIVITIES: WAYNE MEMORIAL HOSPITAL (WMH) AND ITS AFFILIATES PROMOTE THE HEALTH AND WELLBEING OF THE COMMUNITIES AND INDIVIDUALS IT SERVES THROUGH A VARIETY OF COMMUNITY BENEFIT AND COMMUNITY BUILDING ACTIVITIES. WE FOCUS ON THE UNDERSERVED AND UNDERPRIVILEGED WITHIN OUR SERVICE AREA. WE ENDEAVOR TO IMPROVE THE LITERACY LEVEL AND PRIORITIZE INFORMATION GIVEN ON PREVENTION AND TREATMENT FOR CHRONIC DISEASE. OUR GOAL IS TO IMPACT ROOT CAUSES OF POOR HEALTH BY BECOMING A CATALYST FOR HEALTHY LIFESTYLE CHANGES IN OUR SERVICE AREA. THE RATIONALE, PROGRAM METHODOLOGY AND IMPLEMENTATION FOR THE FOLLOWING PROGRAMS ARE TYPICAL OF THE OTHER PROGRAMS DESCRIBED BELOW AND SHOULD SERVE AS A MODEL FOR THOSE PROGRAMS IN ADDRESSING THE REQUIREMENTS OF THIS SECTION OF THE FORM. -THE IN-SCHOOL WALKING PROGRAM IS A PARTNERSHIP OF WAYNE MEMORIAL HOSPITAL, FOREST CITY REGIONAL AND THE FOLLOWING SCHOOL DISTRICTS WITHIN ITS SERVICE AREA: FOREST CITY, WALLENPAUPACK AREA, WAYNE HIGHLANDS AND WESTERN WAYNE. WMH PROVIDES LEADERSHIP, DIRECTION, TRACKING AND FACILITATION FOR THE PROGRAM IN NINE LOCAL SCHOOLS THAT RUNS MONDAY THROUGH THURSDAY 6PM TO 8PM, WHENEVER SCHOOLS ARE IN SESSION. THIS PROVIDES A SAFE FRIENDLY ENVIRONMENT FOR YOUNG, OLD OR DISABLED PEOPLE TO EXERCISE. ALL SITES ARE HANDICAPPED ACCESSIBLE. IT ALSO PROVIDES A USER FRIENDLY MODALITY TO DISTRIBUTE EDUCATIONAL MATERIALS. -HEALTH PROBLEMS: SEDENTARY LIFESTYLE, POOR NUTRITION, AND POOR BEHAVIORAL HEALTH SKILLS HAVE BEEN IDENTIFIED AS LEADING RISK FACTORS BY THE CENTER FOR DISEASE CONTROL (CDC) AND THE PENNSYLVANIA DEPARTMENT OF HEALTH FOR OBESITY, HEART DISEASE, HYPERTENSION, AND A NUMBER OF OTHER CHRONIC DISEASES. - NEED/PROBLEM IDENTIFICATION: THE NEED WAS IDENTIFIED BY THE WMH COMMUNITY NEEDS ASSESSMENT OF 2019 WHICH IDENTIFIED THE PREVENTION OF CHRONIC DISEASE AS A REGIONAL PRIORITY. A PARTNERSHIP BETWEEN THE TOGETHER FOR HEALTH PROGRAM (TFH), WMH, THE WALLENPAUPACK, WAYNE HIGHLANDS, AND FOREST CITY SCHOOL DISTRICTS, AND COMMUNITY AGENCIES ADDRESSED THE NEEDS OF COMMUNITY MEMBERS AND YOUTH. ONE COMPONENT OF THE PROGRAM, THE RESOURCE DAY, HAS BECOME A CATALYST THAT ENHANCES THE HEALTH AND WELLNESS OF 7TH GRADERS AND 9TH GRADERS. A DAY FILLED WITH 5 SMALL GROUP INTERACTIVE WORKSHOPS FACILITATED BY PROFESSIONALS ON SUCH SUBJECTS AS NUTRITION, YOGA, RELATIONSHIPS, SUICIDE AWARENESS, DRUG AND ALCOHOL, GOAL SETTING, ETC. THE STUDENTS PARTICIPATION AND THEIR FEEDBACK PROVIDES WMH, SCHOOL DISTRICTS, AND THE COMMUNITY WITH AN AWARENESS OF THE STUDENTS NEEDS AND HOW TO POSITIVELY IMPACT THE STUDENTS. ULTIMATELY THE FEEDBACK PROVIDES DIRECTION FOR IN-SCHOOL COMMUNITY BENEFITS ACTIVITIES INCLUDING THE IN SCHOOL WALKING PROGRAM AND IN-SCHOOL EDUCATIONAL PRESENTATIONS BY WMH & LOCAL HEALTH CARE PROFESSIONALS. -IMPORTANCE OF HEALTH PROBLEM: LACK OF EXERCISE, POOR NUTRITION AND POOR BEHAVIORAL HEALTH SKILLS HAS MANIFOLD NEGATIVE EFFECTS ON INDIVIDUALS OF ALL AGES AND INCOME LEVELS WITHIN THE REGION'S HIGH RATE OF CHRONIC DISEASE INDIVIDUALS. RURAL, LOW INCOME, ELDERLY OR DISABLED INDIVIDUALS ARE PARTICULARLY VULNERABLE. THE IN-SCHOOL WALKING PROGRAM PROVIDES AN OPPORTUNITY TO LEARN, WALK AND SOCIALIZE WHILE BEING IN A SAFE ATMOSPHERE CLOSE TO THEIR HOME. THE IN-SCHOOL WALKING PROGRAM PROVIDES ACCESS OF SERVICES TO ABOUT 400 PEOPLE WITHIN SCHOOL HALLWAYS NOT IN USE BY THE SCHOOL DURING THOSE HOURS. -ACTIVITY IMPACT AND OUTCOMES: PARTICIPANT RESPONSES TO THE PROGRAM INDICATE THAT IT HELPS MOTIVATE THEM TO FEEL BETTER, LOSE WEIGHT, ENJOY FELLOWSHIP, INCREASE ENERGY LEVELS AND HOLD A BETTER SELF-IMAGE THAN PRIOR TO THEIR PARTICIPATION. THEY ALSO IMPROVED THEIR KNOWLEDGE BASE REGARDING AWARENESS AND PREVENTION OF MANY HEALTH ISSUES. (STROKE, HEART DISEASE, DIABETES, TRAUMA, ASTHMA, COPD, AND SLEEP APNEA, TO NAME A FEW). -COMMUNITY BENEFIT: ENHANCING PUBLIC HEALTH, ADVANCING THE QUALITY OF LIFE, AND RELIEF OF THE BURDEN OF SOCIETY OF CARING FOR THOSE WITH PREVENTABLE CHRONIC ILLNESS. INDIVIDUALS WHO HAVE SEDENTARY AND NEGATIVE LIFESTYLES ARE THE PRINCIPAL BENEFICIARIES OF THE PROGRAM. -SUPPORT: THE WMH COMMUNITY HEALTH DEPARTMENT HAS RESPONDED TO OPPORTUNITIES FOR INVOLVEMENT IN COMMUNITY BENEFIT INITIATIVES BY ENTHUSIASTICALLY DEDICATING THEIR TIME, EXPERTISE AND RESOURCES. THE PRIMARY SUPPORT OF THE IN-SCHOOL WALKING PROGRAM COMES FROM THE FOUR SCHOOL DISTRICTS AND WMH USE OF SOCIAL MEDIA, WEB PAGES, IN-KIND SERVICES, ETC. WMH PROVIDED OVERSITE TO MAINTAIN APPROPRIATE LITERACY LEVELS WITH THE EDUCATIONAL INFORMATION. THE 700+ MEMBERS OF PENNSYLVANIA STATE HEALTH IMPROVEMENT PLAN (SHIP) PARTNERSHIP FOR WAYNE AND PIKE COUNTIES SUPPORT THE WALKING PROGRAM THROUGH POSTING FLYERS, SOCIAL MEDIA, PRESENTATIONS AND PARTICIPATION. WMH IS THE LEAD AGENCY FOR THE PIKE/WAYNE SHIP PARTNERSHIP. THE PARTNERSHIP IDENTIFIES NEEDS AND BECOMES A CATALYST FOR CHANGE TO ACCOMPLISH A HEALTHIER COMMUNITY AND REDUCES THE BURDEN ON MANY GOVERNMENT ENTITIES. BOLD GOLD MEDIA, A LOCAL RADIO STATION, PROVIDES PUBLIC SERVICE ANNOUNCEMENTS AND WMH COMMUNITY HEALTH DEPARTMENT PROVIDES A PERIODIC RADIO BROADCAST HEALTHWORKS THAT AIRS ON LOCAL STATIONS. DURING FYE 6/30/2023, THE ABOVE METHODOLOGY COULD BE APPLIED TO ANY OF THE PROGRAMS PROVIDING SERVICES TO THOUSANDS OF RESIDENTS WITHIN THE LOCAL COMMUNITY. SOME OF THE OTHER PROGRAMS INCLUDE HEALTH/RESOURCE FAIRS, SEMINARS & WORKSHOPS, EMPLOYEE WELLNESS PROGRAMS, NUTRITION CLASSES, DIABETES CLASSES, TRAUMA AWARENESS, STROKE AWARENESS, OPIOID AWARENESS, BEHAVIORAL HEALTH, STRESS MANAGEMENT AND PAIN MANAGEMENT WITHOUT OPIOIDS, TO NAME A FEW. |
| SCHEDULE H, PART III, SECTION A, LINE 2 | BAD DEBT EXPENSE: THE HOSPITAL HAS ADOPTED REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HEALTH SYSTEM DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM ITS PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HEALTH SYSTEM'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2023. HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2. |
| SCHEDULE H, PART III, SECTION A, LINE 3 | BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE: THE HOSPITAL DOES NOT TRACK BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY. IF THIS HOSPITAL IS AWARE OR BECOMES AWARE OF A PATIENT'S ELIGIBILITY FOR CHARITY CARE THEN BAD DEBT EXPENSE WOULD NOT BE RECORDED FOR SUCH A PATIENT. CHARITY CARE WOULD BE RECORDED IF THAT PATIENT IS ELIGIBLE. TO DETERMINE THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE SHOWN ON LINE 3, THE ORGANIZATION APPLIED ITS RATIO OF PATIENT CARE COST TO CHARGES OF 28.77% TO THE TOTAL BAD DEBT EXPENSE SHOWN ON THE HOSPITAL'S FINANCIAL STATEMENT OF $9,691,656. |
| SCHEDULE H, PART III, SECTION A, LINE 4 | BAD DEBT EXPENSE FOOTNOTE: THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENT ACCOUNTS RECEIVABLE, THAT NOTE CAN BE FOUND ON PAGE 9 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. |
| SCHEDULE H, PART III, SECTION B, LINE 8 | COMMUNITY BENEFIT: THE HOSPITAL BECAME A SOLE COMMUNITY HOSPITAL (SCH) EFFECTIVE DECEMBER 8, 2013. PRIOR TO THAT THE HOSPITAL WAS A MEDICARE DEPENDENT HOSPITAL (MDH). A MDH MUST HAVE 60% OF ITS INPATIENT DAYS OR ADMISSIONS ATTRIBUTABLE TO ITS MEDICARE PATIENTS IN 2 OUT OF 3 OF ITS MOST RECENT FISCAL YEARS. MDH IS PAID SIMILARLY TO A SOLE COMMUNITY HOSPITAL BUT AT A LESSER RATE. A MDH IS PAID THE GREATER OF THE FEDERAL INPATIENT PROSPECTIVE PAYMENT SYSTEM (IPPS) RATES OR 75% OF THE DIFFERENCE BETWEEN THE HOSPITAL SPECIFIC COST FOR A BASE PERIOD ROLLED FORWARD FOR MARKET BASKET INCREASES FROM THE BASE PERIOD AND THE IPPS RATES. AN SCH RECEIVES 100% OF THE HOSPITAL SPECIFIC COST ROLLED FORWARD FOR FUTURE PERIODS BY MARKET BASKET INCREASES DETERMINED BY THE MEDICARE PROGRAM. DESPITE THE REIMBURSEMENT RATE, WMH EXPERIENCES A SHORTFALL OF MEDICARE COSTS OVER REVENUE YET CONTINUES TO PROVIDE SERVICES TO THE COMMUNITY, PARTICULARLY THE UNDER- AND UNINSURED. |
| SCHEDULE H, PART III, SECTION C, LINE 9B | COLLECTION POLICY: THE WRITTEN HOSPITAL COLLECTION POLICY CONTAINS PROVISIONS FOR FINANCIAL COUNSELING FOR PATIENTS WHICH INCLUDES APPLYING FOR COMMERCIAL INSURANCE, SUBSIDIZED GOVERNMENT PROGRAMS, AND CHARITY CARE. CHARITY CARE APPLICANTS ARE URGED TO APPLY FOR STATE SPONSORED MEDICAL ASSISTANCE BUT IT IS NOT A REQUIREMENT. QUALIFICATION FOR CHARITY CARE IS BASED ON 200% OF THE CURRENT FEDERAL POVERTY GUIDELINES. THE PATIENT ACCOUNTS MANAGER REVIEWS THE APPLICATIONS AND NOTIFIES THE APPLICANT WHETHER THEIR APPLICATION HAS BEEN APPROVED. PATIENTS QUALIFYING FOR CHARITY CARE HAVE THEIR PATIENT ACCOUNT BALANCES WRITTEN OFF. IF A CHARITY CARE ELIGIBLE PATIENT HAS FUTURE INVOICES, THEY ARE REVIEWED AT THAT TIME. IF THEIR FINANCIAL INFORMATION REMAINS CURRENT THE ADDITIONAL BALANCES ARE ALSO WRITTEN OFF. IF THE PATIENT HAS A FUTURE BILL AND THE FINANCIAL INFORMATION IS NOT CURRENT, THEY MUST REAPPLY FOR CHARITY CARE. |
| SCHEDULE H, PART VI, LINE 2 | NEEDS ASSESSMENT: WAYNE MEMORIAL HOSPITAL CONDUCTS A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) EVERY THREE YEARS, AS PER IRS REQUIREMENTS. THE MOST RECENT CHNA WAS COMPLETED AND WIDELY DISTRIBUTED ON 6/30/2022. THE ASSESSMENT ENCOMPASSED THE HOSPITAL'S SERVICE AREA: WAYNE AND PIKE COUNTIES, THE GREATER CARBONDALE REGION OF LACKAWANNA COUNTY AND FOREST CITY IN SUSQUEHANNA COUNTY. HISTORICALLY, WAYNE MEMORIAL CONTRACTS WITH AN IRS-COMPLIANT OUTSIDE ORGANIZATION TO HELP ASSESS AND RECORD THE COMMUNITY'S HEALTH NEEDS. THE ORGANIZATION IS CHOSEN AND THE PROCESS IS GUIDED BY A LOCAL STEERING COMMITTEE CONSISTING OF REPRESENTATIVES FROM WAYNE MEMORIAL HOSPITAL (WMH), WAYNE MEMORIAL COMMUNITY HEALTH CENTERS (WMCHC, AN FQHC), WAYNE AND PIKE COUNTY GOVERNMENTS INCLUDING LOCAL DEPARTMENT OF HEALTH REPRESENTATIVES, WAYNE AND PIKE COUNTY HUMAN SERVICE AGENCIES, FOREST CITY AND CARBONDALE AREA COMMUNITY REPRESENTATIVES AND OFFICIALS FROM AREA SCHOOL DISTRICTS. THE 2022 CHNA WAS CONDUCTED IN ASSOCIATION WITH THE INSTITUTE FOR PUBLIC HEALTH RESEARCH AND INNOVATION AT EAST STROUDSBURG UNIVERSITY. THE METHODOLOGY INVOLVED BOTH QUANTITATIVE AND QUALITY ASSESSMENTS. DATA WAS COLLECTED FROM THE PENNSYLVANIA DEPARTMENT OF HEALTH, THE 2022 COUNTY HEALTH RANKINGS AND ROADMAPS, THE CENTER FOR RURAL PENNSYLVANIA, THE U.S. CENSUS, WAYNE AND PIKE COUNTY STATISTICS, AND OTHER PUBLIC SOURCES TO IDENTIFY POPULATION GROUPS, DISEASE TRENDS, MORTALITY RATES ANDCAUSES, AND VACCINATION UPTAKE IN THE COMMUNITIES SERVED BY WAYNE MEMORIAL HOSPITAL. THIS INFORMATION WAS AUGMENTED WITH AN ONLINE PUBLIC SURVEY (526 RESPONDENTS), INTERVIEWS WITH COMMUNITY STAKEHOLDERS, AND FOCUS GROUPS TO FORM A MORE VIBRANT, COHESIVE PICTURE OF THE COMMUNITY AS A WHOLE TO ASSESS ITS NEEDS ACCORDINGLY AND DETERMINE HOW TO STRATEGIZE MEETING THOSE NEEDS. THE INSTITUTE FOR PUBLIC HEALTH RESEARCH AND INNOVATION CONDUCTED A DESCRIPTIVE AND INFERENTIAL STATISTICAL ANALYSIS OF THE SURVEY DATA USING THE SPSS V27.0 SOFTWAREPACKAGE. THESE FINDINGS WERE COMBINED WITH THE QUALITATIVE FINDINGS (INTERVIEWS, FOCUS GROUPS) TO ELUCIDATE PRIMARY DATA RESULTS FOR THE REGION, SPECIFICALLY LEADING HEALTH NEEDS THAT DEEPLY IMPACT THE WAYNE MEMORIAL COMMUNITY THROUGH FREQUENCY OF OCCURRENCE AND SEVERITY OF OUTCOMES AS WELL AS THOSE EXPERIENCED AT DISPROPORTIONATELY HIGH RATES RELATIVE TO OTHER COMMUNITIES. AN IMPLEMENTATION STRATEGY WAS DEVELOPED AND ADOPTED BY THE WAYNE MEMORIAL HOSPITAL AND HEALTH SYSTEM BOARD OF TRUSTEES AND IS DISTRIBUTED VIA THE HOSPITAL'S WEBSITE AT: https://www.wmh.org/chna-community-health-needs-assessment/ |
| SCHEDULE H, PART VI, LINE 3 | PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: THE HOSPITAL EDUCATES AND INFORMS PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE OR LOCAL GOVERNMENT PROGRAMS OR UNDER THE HOSPITAL'S CHARITY CARE POLICY THROUGH ITS SCHEDULING, REGISTRATION, SOCIAL SERVICES AND BILLING DEPARTMENTS. PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ARE ALSO MADE AWARE OF THEIR ELIGIBILITY THROUGH WMCHC (A CLINICAL AFFILIATE OF THE HOSPITAL WHO RECEIVES SUBSTANTIAL FINANCIAL SUPPORT FROM THE HOSPITAL AND IS A FEDERALLY QUALIFIED HEALTH CENTER). PATIENTS RECEIVE THIS EDUCATION WHEN, DURING THE SCHEDULING OF AN APPOINTMENT TO FINAL DISPOSITION OF THEIR BILL, THERE IS ANY INDICATION OF THE NEED OR REQUEST FOR HELP IN PAYING FOR SERVICES BEING SCHEDULED, PROVIDED OR BILLED. WAYNE MEMORIAL HOSPITAL, THROUGH ITS NETWORK OF 700 STATE HEALTH IMPROVEMENT PLAN PARTNERS ('SHIP' PARTNERS ARE ORGANIZATIONS, AGENCIES, BUSINESSES, SCHOOLS, TASK FORCES, COALITIONS, RELIGIOUS GROUPS, AND INDIVIDUALS) PROVIDES THE MODALITY FOR DELIVERING WRITTEN INFORMATION, VERBAL EXPLANATION AND ASSISTANCE IN COMPLETING FORMS FOR THE MOST VULNERABLE POPULATION. THE INFORMATION AND SERVICES ARE AVAILABLE AT MANY OF WMH'S OUTREACH FUNCTIONS. THE FINANCIAL AID POLICY BROCHURE AND GUIDELINES IS AVAILABLE AT OUTPATIENT REGISTRATION DESKS AND AT APPROPRIATE COMMUNITY OUTREACH FUNCTIONS. IT CONTAINS INFORMATION REGARDING ELIGIBILITY FOR FINANCIAL AID AT WMH, AND HOW TO APPLY FOR MEDICAL ASSISTANCE, MEDICAID, OR FINANCIAL AID. IT CONTAINS THE CONTACT INFORMATION FOR THE WAYNE MEMORIAL COMMUNITY HEALTH CENTERS' OUTREACH AND ENROLLMENT COORDINATORS AND THE MOST RECENTLYRELEASED US POVERTY INCOME GUIDELINES. PHYSICIAN DIRECTORS ARE AVAILABLE AT OUTREACH PROGRAMS. ON THE WMH WEBSITE, THERE IS A FIND A DOC TAB TO ASSIST PATIENTS IN FINDING AN APPROPRIATE PHYSICIAN AND WMH COMMUNITY HEALTH HAS A PHYSICIAN REFERRAL PHONE LINE PROVIDING PERSONAL ASSISTANCE. THIS INFORMATION IS DISCUSSED PERIODICALLY ON THE HEALTHWORKS WEEKLY RADIO SHOW. WHEN NECESSARY, ASSISTANCE IS PROVIDED FOR THOSE WITH LANGUAGE BARRIERS IN BOTH TRANSLATION AND SIGN LANGUAGE. |
| SCHEDULE H, PART VI, LINE 4 | COMMUNITY INFORMATION: WAYNE MEMORIAL HOSPITAL'S PRIMARY SERVICE AREA COMPRISES APPROXIMATELY 120,000 PEOPLE ACROSS ALL OF WAYNE COUNTY, PA; THE WESTERN, NORTHERN AND PORTIONS OF EASTERN AND SOUTHERN PIKE COUNTY, PA; THE SOUTHEAST PORTION OF SUSQUEHANNA COUNTY, PA; THE COMMUNITY OF CARBONDALE AND ITS IMMEDIATELY SURROUNDING COMMUNITIES IN LACKAWANNA COUNTY, PA; AND THE SOUTHWEST PORTION OF SULLIVAN COUNTY, NY. THE SECONDARY SERVICE AREA INCLUDES THE BALANCE OF PIKE COUNTY AND EASTERN PORTIONS OF LACKAWANNA AND SUSQUEHANNA COUNTY IN NORTHEASTERN PENNSYLVANIA. THE WAYNE MEMORIAL HOSPITAL (WMH) SERVICE AREA IS PREDOMINANTLY RURAL, NON HISPANIC WHITE AND SIGNIFICANTLY LESS DIVERSE THAN PENNSYLVANIA ON AVERAGE. UNEMPLOYMENT IS HIGHER THAN THE U.S. RATE IN 2022 OF 3.7%* -- WAYNE (9%), PIKE (10.6%) AND SUSQUEHANNA (7.3%) COUNTIES**. THE POVERTY RATE*** IN THOSE COUNTIES IS SLIGHTLY BELOW THE PENNSYLVANIA AVERAGE OF 11.8% AND THE U.S. RATE OF 12.6% -- WAYNE (10.8%), PIKE (9.4%) AND SUSQUEHANNA (11.6%). IN BOTH WAYNE AND PIKE, THE TWO LARGEST BLOCKS IN OUR SERVICE AREA, A SIGNIFICANT PORTION - ABOUT 1/3-OF THE POPULATION IS ELDERLY, AND SERVICES FOR OLDER ADULTS IS CITED AS A TOP NEED ON THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). WAYNE MEMORIAL IS CLASSIFIED IN THE 8TH UNITED STATES CONGRESSIONAL DISTRICT AND INCLUDES FEDERALLY CLASSIFIED MEDICALLY UNDERSERVED AREAS: ALL OF SUSQUEHANNA COUNTY AND TWO TOWNSHIPS IN WAYNE (DAMASCUS) AND PIKE (GREENE) COUNTIES. PARTS OF OUR SERVICE AREA ARE ALSO DESIGNATED HEALTH PROFESSIONAL SHORTAGE AREAS, PARTICULARLY IN MENTAL HEALTH AND DENTAL HEALTH. OVERALL HEALTH: WAYNE MEMORIAL HOSPITAL IS THE ONLY HOSPITAL IN WAYNE COUNTY, AND THERE IS NO HOSPITAL IN PIKE COUNTY. HEALTH STATISTICS (FOUND IN OUR 2022 CHNA) SHOW PIKE AND WAYNE COUNTIES RANK IN THE TOP 50-75% OF PA COUNTIES FOR OVERALL HEALTH OUTCOMES AND HEALTH FACTORS. SUSQUEHANNA COUNTY, WHICH HAS A SMALL CRITICAL-ACCESS HOSPITAL (BUT NOT IN OURSERVICE AREA), IS ALSO IN THE TOP 50-75% FOR HEALTH OUTCOMES BUT ONLY 25-50% FOR HEALTH FACTORS. LACKAWANNA COUNTY'S HEALTH OUTCOMES ARE LOWER, 0-25%, THOUGH HEALTH FACTORS, 50-75%, ARE STRONG. *US BUREAU OF LABOR STATISTICS **COUNTYHEALTHRANKINGS.ORG ***CENSUSREPORTER.ORG DATA PRESENTED IN CENSUSREPORTER IS COLLECTED BY THE US CENSUS BUREAU. IN GENERAL, THE DATA IS FROM THE MOST RECENTLY RELEASED AMERICAN COMMUNITY SURVEY (ACS). |
| SCHEDULE H, PART VI, LINE 5 | PROMOTION OF COMMUNITY HEALTH: WAYNE MEMORIAL HOSPITAL (WMH) IS ACTIVELY INVOLVED IN THE COMMUNITY IT SERVES WITH THE INTENTION OF PROMOTING THE HEALTH OF OUR COMMUNITY AT LARGE. THIS INCLUDES LOCAL INDEPENDENT COMMUNITY REPRESENTATIVES AS A MAJORITY OF OUR BOARD, AGGRESSIVE RESEARCH FOR AND USE OF GRANTS FOR PROJECTS TO PROMOTE HEALTH, MEDIA PUBLICATIONS (INCLUDING SOCIAL MEDIA) TO DISSEMINATE NEWS OF OUR SERVICES AND HEALTH INFORMATION, AND A MEDICAL STAFF WILLING TO PARTNER ON PRESENTATIONS AND PROJECTS THAT BENEFIT THE COMMUNITY. WAYNE MEMORIAL HOSPITAL UTILIZES ANY EXCESS FUNDS OVER EXPENSES TO IMPROVE PATIENT CARE, CONDUCT MEDICAL AND HEALTH EDUCATION, OR SUPPORT OTHER NOT FOR PROFIT ORGANIZATIONS. WAYNE MEMORIAL HOSPITAL'S MEDICAL STAFF IS OPEN. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY FOR ALL OF ITS DEPARTMENTS, WITH THE EXCEPTION OF ANESTHESIOLOGY, PATHOLOGY AND RADIOLOGY, AS SERVICES IN THESE DEPARTMENTS ARE PROVIDED ON AN EXCLUSIVE BASIS TO BENEFIT PATIENT CARE. MEMBERS OF OUR MEDICAL STAFF ARE REQUIRED, WHILE PARTICIPATINGAT THE HOSPITAL, TO TREAT ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY OR THEIR INSURANCE STATUS. THE HOSPITAL ACCEPTS PUBLIC ASSISTANCE, MOST PRIVATE INSURANCES AND OFFERS CHARITY CARE TO PATIENTS WHO MEET FEDERAL POVERTY INCOME LEVELS. COMMUNITY INPUT: OUR COMMUNITY ADVISORY BOARDMEETS BI-MONTHLY TO ADVISE THE HOSPITAL ON COMMUNITY NEEDS AND RECOMMEND ACTIONS. IT ISCOMPRISED OF ALL VOLUNTEERS, INCLUDING UP TO FOUR HIGH SCHOOL STUDENTS, FROM EVERY PART OF OUR SERVICE AREA, REPRESENTING BUSINESS, EDUCATION, GOVERNMENT AND SOCIAL SERVICE AGENCIES. ALL OF THE BOARD MEMBERS, WHO ARE CITIZENS UN-AFFILIATED WITH THE HOSPITAL, WORK WITH THE HOSPITAL TO ASSURE THE HIGHEST QUALITY OF CARE IS MEETING THE NEEDS OF THEIR COMMUNITY. IN TURN, BOARD MEMBERS PROMOTE THE HOSPITAL AND INFORM THE COMMUNITY ABOUT WAYNE MEMORIAL SERVICES. COMMUNITY OUTREACH: BASED ON THE HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENTS (2022, 2019, ETC.), WE DEVELOP PROGRAMS DESIGNED TO MEET THE NEEDS OUTLINED IN THE SUMMARY DATA. FOR EXAMPLE, WE HAVE A WAYNE MEMORIAL FOOD PRESCRIPTION PROGRAM (WM FRX), FUNDED BY A PRIVATE FOUNDATION GRANT, WHICH OFFERS FOOD, COUPONS AND DIETARY ADVICE FOR PEOPLE WITH CONGESTIVE HEART FAILURE, COPD, HYPERTENSION AND DIABETES - ALL IDENTIFIED AS CRITICAL NEEDS IN THE CHNA-WHO HAVE ALSO EXPRESSED FOOD INSECURITY, A SOCIAL DETERMINANT OF HEALTH. THE HOSPITAL ALSO HAS REPRESENTATIVES ON MANY COMMUNITY ORGANIZATIONS WHICH ARE DIRECTLY LINKED TO AREAS OF CONCERN CITED IN THE CHNA, SUCH AS THE COVID-19 PANDEMIC, MENTAL HEALTH SERVICES, SUBSTANCE ABUSE, IMPROVED ACCESS TO CARE, OLDER ADULT SERVICES AND CANCER AND HEART DISEASE. THESE ORGANIZATIONS INCLUDE BUT ARE NOT LIMITED TO: WAYNE COUNTY SYSTEM OF CARE, WAYNE/PIKE NORTHEAST SUICIDE PREVENTION INITIATIVE, WAYNE TOMORROW! HEALTH AND WELLNESS TASK FORCE, THE NORTHEAST REGIONAL CANCER INSTITUTE, AND THE AMERICAN HEART ASSOCIATION. HOSPITAL STAFF PARTICIPATES REGULARLY IN COMMUNITY FAIRS WITH HEALTH AND HOSPITALRELATED MATERIALS, ON-SITE BLOOD PRESSURE CHECKS AND PRESENTATIONS ON HEALTH ISSUES SUCH AS THE IMPORTANCE OF CANCER SCREENINGS (COLON, BREAST, ETC.). COMMUNITY OUTREACH, EVENTS AND EDUCATIONAL PROGRAMS ARE OFFERED TO COMMUNITY ORGANIZATIONS, AGENCIES AND COMMUNITY MEMBERS FREE OF CHARGE. HOSPITAL STAFF PROVIDE MENTORING, JOB SHADOWING, AND PRECEPTORSHIP FOR STUDENTS IN OR INTERESTED IN THE MEDICAL FIELD. SYSTEM INITIATIVES: A SAFETY NET HOSPITAL IN RURAL NORTHEAST PENNSYLVANIA AND DESIGNATED A SOLE COMMUNITY PROVIDER BY THE FEDERAL GOVERNMENT, WAYNE MEMORIAL HOSPITAL IS A FOUNDING MEMBER OF THE KEYSTONE ACO, WHICH COORDINATES HEALTH DATA AMONG PROVIDERS TO STREAMLINE QUALITY CARE FOR PATIENTS. THE HOSPITAL IS ALSO A CHARTER MEMBER OF THE PENNSYLVANIA RURAL HEALTH MODEL, FEDERALLY FUNDED TO ASSIST HOSPITALS IN BECOMING FINANCIALLY STABLE. |
| SCHEDULE H, PART VI, LINE 6 | AFFILIATED HEALTH CARE SYSTEM: THE HOSPITAL IS PART OF AN AFFILIATED HEALTH CARE SYSTEM UNDER COMMON GOVERNANCE AND CONTROL THAT INCLUDES THE HOSPITAL AND WAYNE MEMORIAL LONG TERM CARE (WMLTC, WHICH OPERATES WAYNE WOODLANDS MANOR). WAYNE WOODLANDS MANOR IS A 24 HOUR NURSING FACILITY THAT PROVIDES SERVICES PRIMARILY TO MEDICAID RECIPIENTS (OVER 75% OF ITS RESIDENTS). MOST COUNTIES IN PENNSYLVANIA HAVE COUNTY OWNED AND OPERATED NURSING HOMES THAT PROVIDE SERVICES TO THIS SEGMENT OF THEIR COUNTY POPULATION. WAYNE COUNTY DOES NOT HAVE A COUNTY NURSING HOME. THIS COMMUNITY NEED IS MET BY WAYNE MEMORIAL LONG TERM CARE BY ITS OPERATION OF WAYNE WOODLANDS MANOR. WMH IS ALSO A CLINICAL AFFILIATE OF WAYNE MEMORIAL COMMUNITY HEALTH CENTERS (WMCHC), WHICH IT SUPPORTS CLINICALLY AND FINANCIALLY. WMCHC SERVES A NUMBER OF MUA'S AND MUP'S. THE HOSPITAL HAS FINANCED WMCHC'S AND WMLTC'S WORKING CAPITAL NEEDS WITH LINES OF CREDIT THAT ARE NECESSARY SUBSIDIES BECAUSE OF THE TIME DELAY BETWEEN SERVICE PERFORMANCE AND REIMBURSEMENTS RECEIVED FROM GOVERNMENT AND COMMERCIAL INSURERS. IN ADDITION, THE WAYNE MEMORIAL HOSPITAL HAS AN AFFILIATION WITH THE GEISINGER COMMONWEALTH SCHOOL OF MEDICINE (SCRANTON, PA) FOR THE PROVISION OF CLINICAL EDUCATION EXPERIENCES AT THE HOSPITAL AND WITHIN THE COMMUNITY. THE HOSPITAL CONSIDERS THIS A RESPONSIBILITY CONSISTENT WITH ITS MISSION TO BE INVOLVED IN EDUCATION. UNDER A CONTRACTUAL PARTNERSHIP WITH WMH, GEISINGER HOSPITAL ALSO PROVIDES BOARD-CERTIFIED EMERGENCY PHYSICIANS TO STAFF ITS EMERGENCY DEPARTMENT. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WAYNE MEMORIAL COMUNITY HEALTH CENTERS | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 601 PARK STREET | AddressLine1Txt |
| City | HONESDALE | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 18431 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 232180889 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $2,305,291 | CashGrantAmt |
| Purpose Of Grant | EXEMPT PURPOSES | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | MONITORING USE OF GRANT FUNDS: THE BOARD MONITORS THE FUNDS GIVEN TO WMCHC BY REVIEWING THE WORKINGS AND PROGRESS OF THAT CORPORATION. THERE IS A CLINICAL RELATIONSHIP AND THE HOSPITAL WORKS DIRECTLY WITH WMCHC SO THEY ARE ABLE TO MAKE SURE THE FUNDS ARE BEING USED PROPERLY. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JAMES PETTINATO | ||||||||||||||
| CEO | $0 | $309,052 | $0 | $0 | $0 | $29,378 | $0 | $27,610 | $0 | $20,261 | $0 | $386,301 | $0 | $0 |
| PATRICIA DUNSINGER | ||||||||||||||
| CFO | $0 | $180,601 | $0 | $0 | $0 | $0 | $0 | $10,895 | $0 | $3,377 | $0 | $194,873 | $0 | $0 |
| DR SEAN MCVEIGH | ||||||||||||||
| TRUSTEE/CHIEF OF MS | $398,834 | $0 | $0 | $0 | $0 | $0 | $10,450 | $0 | $20,261 | $0 | $429,545 | $0 | $0 | $0 |
| JAMES HOCKENBURY | ||||||||||||||
| CHIEF OF ANCILLARY SERVICES | $0 | $167,895 | $0 | $0 | $0 | $0 | $0 | $10,230 | $0 | $7,306 | $0 | $185,431 | $0 | $0 |
| CLIFFORD CARROLL | ||||||||||||||
| PHYSICIAN | $356,204 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $6,573 | $0 | $362,777 | $0 | $0 | $0 |
| DAVID CAUCCI | ||||||||||||||
| PHYSICIAN | $652,493 | $0 | $0 | $0 | $0 | $0 | $17,340 | $0 | $20,261 | $0 | $690,094 | $0 | $0 | $0 |
| JOSEPH LAURETI | ||||||||||||||
| PHYSICIAN | $445,944 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $20,261 | $0 | $466,205 | $0 | $0 | $0 |
| KEITH CORDISCHI | ||||||||||||||
| PHYSICIAN | $494,302 | $0 | $0 | $0 | $0 | $0 | $9,150 | $0 | $18,367 | $0 | $521,819 | $0 | $0 | $0 |
| JEFFREY MOGERMAN | ||||||||||||||
| PHYSICIAN | $616,434 | $0 | $0 | $0 | $0 | $0 | $18,300 | $0 | $18,810 | $0 | $653,544 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| WAYNE CO HOSPITAL AND HEALTH FACILITIES AUTHORITY | ||||||||
| A | 232152053 | 946016JX9 | 2017-09-01 | $37,609,342 | FINANCE, DESIGN, CONSTR, AND EQUIP | false | Yes (true) | false |
| WAYNE CO HOSPITAL AND HEALTH FACILITIES AUTHORITY | ||||||||
| B | 232152053 | 946016GS5 | 2012-10-25 | $9,997,040 | REFUND '05 AND A PART OF '07 BONDS | false | Yes (true) | false |
| WAYNE CO HOSPITAL AND HEALTH FACILITIES AUTHORITY | ||||||||
| C | 232152053 | 946016HU9 | 2012-12-20 | $4,703,786 | REFUND REMAINING 2007 BONDS PAY IS | false | Yes (true) | false |
| WAYNE MEMORIAL HOSPITAL AND HEALTH AUTHORITY | ||||||||
| D | 232152053 | 2017-12-01 | $8,000,000 | FINANCING DESIGN, CONSTR AND EQUIP | false | Yes (true) | false | |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Bond DefeasedBondDefeasedAmt | Total ProceedsTotalProceedsAmt | In Reserve FundInReserveFundAmt | Capitalized InterestCapitalizedInterestAmt | Refunding EscrowRefundingEscrowAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Credit EnhancementCreditEnhancementAmt | Working Capital ExpendituresWorkingCapitalExpendituresAmt | Capital ExpendituresCapitalExpendituresAmt | Other Spent ProceedsOtherSpentProceedsAmt | UnspentUnspentAmt | Substantial CompletionSubstantialCompletionYr | Refunding Tax Exempt BondsRefundingTaxExemptBondsInd | Refunding Taxable BondsRefundingTaxableBondsInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $25,000 | $0 | $37,609,342 | $136,950 | $0 | $0 | $679,633 | $0 | $0 | $35,560,559 | $0 | $0 | 2019 | Yes (true) | false | Yes (true) | Yes (true) |
| B | $6,660,000 | $0 | $9,997,040 | $461,420 | $0 | $9,255,837 | $187,404 | $92,379 | $0 | $0 | $0 | $0 | 2012 | Yes (true) | false | Yes (true) | Yes (true) |
| C | $3,690,000 | $0 | $4,703,786 | $254,563 | $0 | $4,315,090 | $93,600 | $40,533 | $0 | $0 | $0 | $0 | 2012 | Yes (true) | false | Yes (true) | Yes (true) |
| D | $1,342,827 | $0 | $8,000,000 | $0 | $0 | $0 | $157,818 | $0 | $0 | $7,842,182 | $0 | $0 | 2019 | Yes (true) | false | false | Yes (true) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Remedial Action TakenRemedialActionTakenInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd | Engage Bond Counsel ContractsEngageBondCounselContractsInd | Engage Bond Counsel ResearchEngageBondCounselResearchInd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| A | false | false | false | false | 0 | false | false | false | Yes (true) | ||
| B | false | false | false | false | 0 | false | false | false | Yes (true) | false | false |
| C | false | false | false | false | 0 | false | false | false | Yes (true) | false | false |
| D | false | false | false | false | 0 | false | false | false | Yes (true) | false | false |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Business Name Line1GICProviderName/BusinessNameLine1Txt | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|---|
| 0 | ||||||||||
| A | false | Yes (true) | false | false | false | false | false | 0 | false | false |
| 0 | ||||||||||
| B | false | false | false | Yes (true) | false | false | false | 0 | false | false |
| 0 | ||||||||||
| C | false | false | false | Yes (true) | false | false | false | 0 | false | false |
| 0 | ||||||||||
| D | false | Yes (true) | false | false | false | false | false | 0 | false | false |
Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | false |
| B | false |
| C | false |
| D | false |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE K, PART IV, COLUMNS B & C, LINE 2C | FormAndLineReferenceDesc |
| Explanation | ARBITRAGE DATE: THE ARBITRAGE CALCULATION WAS COMPLETED ON 11/27/2022 FOR THE FOLLOWING BOND ISSUE: WAYNE CO HOSPITAL AND HEALTH FACILITIES AUTHORITY ISSUED 10/25/2012 THE ARBITRAGE CALCULATION WAS COMPLETED ON 01/05/2023 FOR THE FOLLOWING BOND ISSUE: WAYNE MEMORIAL HOSPITAL AND HEALTH AUTHORITY ISSUED 12/20/2012 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 4D | OTHER PROGRAM SERVICES: THE ORGANIZATION PROVIDED GRANTS TO WAYNE MEMORIAL COMMUNITY HEALTH CENTERS. SEE SCHEDULE I FOR MORE INFORMATION. |
| FORM 990, PART VI, SECTION A, LINE 2 | BUSINESS AND FAMILY RELATIONSHIPS: HUGH RECHNER (BOARD CHAIRMAN) HAS A FAMILY RELATIONSHIP WITH CHRISTINE RECHNER, A TRUSTEE OF WAYNE MEMORIAL HOSPITAL, CHAIR OF THE WAYNE MEMORIAL LONG TERM CARE, AND MEMBER OF THE SYSTEM BOARD BY VIRTUE OF POSITION. JAMES PETTINATO (CEO), TIM HUBER (CHIEF FACILITIES OFFICER), JAMES HOCKENBURY (CHIEF OF ANCILLARY SERVICES), AND PATRICIA DUNSINGER (CFO), ARE COMPENSATED BY WAYNE MEMORIAL HEALTH SYSTEM, A RELATED ORGANIZATION. JAMES PETTINATO (CEO) SERVES ON THE BOARD OF TRUSTEES OF THE ORGANIZATION THAT EMPLOYS MARY BETH WOOD, A TRUSTEE OF WAYNE MEMORIAL HOSPITAL. BRAD KIESENDAHL (TRUSTEE) HAS A FAMILY RELATIONSHIP WITH BROOKE JAMES, A TRUSTEE OF WAYNE MEMORIAL HEALTH FOUNDATION INC., 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. |
| FORM 990, PART VI, SECTION B, LINES 6, 7A & 7B | MEMBERS OR STOCKHOLDERS: WAYNE MEMORIAL HEALTH SYSTEM INC. (THE SYSTEM), A RELATED ORGANIZATION AND A PENNSYLVANIA NONPROFIT CORPORATION, IS THE SOLE MEMBER OF WAYNE MEMORIAL HOSPITAL. WAYNE MEMORIAL HEALTH SYSTEM, INC. IS ENTITLED TO APPROVE THE ELECTION OF THE BOARD MEMBERS AND OFFICERS OF WAYNE MEMORIAL HOSPITAL, INC. ALL OF WHOM SHALL BE APPROVED BY WAYNE MEMORIAL HEALTH SYSTEM, INC, A RELATED ORGANIZATION. 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 AUDIT COMMITTEE 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, LINE 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 FROM JUNE TO 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 XI, LINE 9 | RECONCILIATION OF NET ASSETS: OTHER CHANGES IN NET ASSETS ARE AS FOLLOWS: $ 5,818,010 CHANGE IN DEFINED BENEFIT PENSION PLAN 215,401 CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST 105,685 CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 2,913 TRANSFER FROM AFFILIATE ------------ $6,142,009 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:TEMPORARY/LEASED EMPLOYEE FEES TOTAL FEES:9520985 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PROFESSIONAL SERVICE FEES TOTAL FEES:9217041 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PURCHASED SERVICE FEES TOTAL FEES:4262405 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:COLLECTION EXPENSES TOTAL FEES:384561 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:MAINTENANCE CONTRACTS TOTAL FEES:117054 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:TRUSTEE FEES TOTAL FEES:20953 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| WAYNE MEMORIAL HEALTH FOUNDATION INC | ||||||||||
| 601 PARK STREET | HONESDALE | PA | 18431 | 232208596 | FUNDRAISING | PA | 501(C)(3) | 12 A I | 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 LONG TERM CARE | ||||||||||
| 37 WOODLANDS DRIVE | WAYMART | PA | 18472 | 232719336 | NURSING HOME | PA | 501(C)(3) | 10 | WMHS | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WAYNE HEALTH SERVICES INC | ||||||||||||
| 601 PARK STREET | HONESDALE | PA | 18431 | 232376183 | DME, RENT, PH | PA | WMHF | C-CORPORATION | $10,436 | $20,729 | 0.01000 | false |
| CHARITABLE TRUST | ||||||||||||
| TRUST | PA | WMH | TRUST | $446 | $27,318 | 1.00000 | Yes (true) | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (true) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |