ST JOSEPH MEDICAL GROUP: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- ST JOSEPH MEDICAL GROUP (EIN 20-8544021)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-05-11
- IRS object ID
- 202311319349306056
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-05-11T18:28:50-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 366055558 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRANT THORNTON LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2001 MARKET STREET SUITE 700 | AddressLine1Txt |
| City | PHILADELPHIA | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 19103 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 208544021 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST JOSEPH MEDICAL GROUP | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STJO | BusinessNameControlTxt |
| Phone | 6103782300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 CRYSTAL A DRIVE MC CA210 | AddressLine1Txt |
| City | HERSHEY | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 17033 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PAULA TINCH | PersonNm |
| Person Title | EVP & CFO | PersonTitleTxt |
| Phone | 6103782300 | PhoneNum |
| Signature | 2023-05-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | PAULA | PersonFirstNm |
| Person Last | TINCH | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | RUSSLEE ARMSTRONG | PreparerPersonNm |
| PTIN | P00288383 | PTIN |
| Phone | 2155614200 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
| Principal Officer | JOSEPH FRANK | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 CRYSTAL A DRIVE MC CA210 | AddressLine1Txt |
| City | HERSHEY | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 17033 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $70,757,836 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PENNSTATEHEALTH.ORG/LOCATIONS/ST-JOSEPH | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2007 | FormationYr |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE PHYSICIAN HEALTHCARE SERVICES IN AN ACUTE CARE HOSPITAL AND OPERATE A PHYSICIAN WOUND CARE CLINIC. | ActivityOrMissionDesc |
| Voting Members Governing Body | 3 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 1 | VotingMembersIndependentCnt |
| Total Employee | 82 | TotalEmployeeCnt |
| Total Volunteers | 1 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $36,024,630 | PYContributionsGrantsAmt |
| CY Contributions Grants | $37,558,271 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $28,042,502 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $32,355,457 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,471 | PYInvestmentIncomeAmt |
| CY Investment Income | -$5,451 | CYInvestmentIncomeAmt |
| PY Other Revenue | $616,478 | PYOtherRevenueAmt |
| CY Other Revenue | $841,816 | CYOtherRevenueAmt |
| PY Total Revenue | $64,685,081 | PYTotalRevenueAmt |
| CY Total Revenue | $70,750,093 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $31,481,376 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $57,389,448 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $32,446,398 | PYOtherExpensesAmt |
| CY Other Expenses | $11,552,326 | CYOtherExpensesAmt |
| PY Total Expenses | $63,927,774 | PYTotalExpensesAmt |
| CY Total Expenses | $68,941,774 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $757,307 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,808,319 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,215,799 | TotalAssetsBOYAmt |
| Total Assets EOY | $7,542,079 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,072,847 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,590,808 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,142,952 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,951,271 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF THE CORPORATION IS TO NURTURE THE HEALING MINISTRY OF THE CHURCH, SUPPORTED BY EDUCATION AND RESEARCH. FIDELITY TO THE GOSPEL URGES THE CORPORATION TO EMPHASIZE HUMAN DIGNITY AND SOCIAL JUSTICE AS IT CREATES HEALTHIER COMMUNITIES. (CONTINUED IN SCH O)(CONTINUED):THE CORPORATION, SPONSORED BY A LAY-RELIGIOUS PARTNERSHIP, CALLS OTHER CATHOLIC SPONSORS AND SYSTEMS TO UNITE TO ENSURE THE FUTURE OF CATHOLIC HEALTH CARE. TO FULFILL THIS MISSION, THE CORPORATION, AS A VALUES-BASED ORGANIZATION, WILL ASSURE THE INTEGRITY OF THE MINISTRY IN BOTH CURRENT AND DEVELOPING ORGANIZATIONS AND ACTIVITIES; RESEARCH AND DEVELOP NEW MINISTRIES THAT INTEGRATE HEALTH, EDUCATION, PASTORAL, AND SOCIAL SERVICES; PROMOTE LEADERSHIP DEVELOPMENT AND FORMATION FOR MINISTRY THROUGHOUT THE ENTIRE ORGANIZATION; ADVOCATE FOR SYSTEMIC CHANGES WITH SPECIFIC CONCERN FOR PERSONS WHO ARE POOR, ALIENATED, AND UNDERSERVED; AND STEWARD RESOURCES BY GENERAL OVERSIGHT OF THE ENTIRE ORGANIZATION. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $66,771,681 | ExpenseAmt |
| Revenue | $33,197,273 | RevenueAmt |
| Desc | ST. JOSEPH MEDICAL GROUP (SJMG) PROVIDES QUALITY PROFESSIONAL MEDICAL SERVICES TO ITS COMMUNITY IN CONJUNCTION WITH, AND IN SUPPORT OF, ST. JOSEPH REGIONAL HEALTH NETWORK, IN READING, PENNSYLVANIA, WHICH IS ALSO A 501(C)(3) CHARITABLE, TAX EXEMPT ORGANIZATION. SJMG PROVIDES THESE SERVICES TO THE CITIZENS OF ITS COMMUNITY WITHOUT REGARD TO RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP OR AGE. IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PAY FOR ESSENTIAL MEDICAL SERVICES AND MEDICAL EDUCATION. THEREFORE, IN KEEPING WITH THE COMMITMENT OF SJMG AND ST. JOSEPH REGIONAL HEALTH NETWORK TO SERVE ALL MEMBERS OF THE COMMUNITY, FREE CARE AND/OR SUBSIDIZED CARE, CARE PROVIDED TO PERSONS COVERED BY GOVERNMENT PROGRAMS AT BELOW COST, AND HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY WILL BE CONSIDERED WHERE THE NEED AND INDIVIDUAL'S INABILITY TO PAY COEXIST. SJMG PROVIDES THE FOLLOWING PROFESSIONAL MEDICAL SERVICES TO ITS COMMUNITY. | Desc |
| Total Program Service Expenses | $66,771,681 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 82 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 3 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 1 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | PA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PAULA TINCH EVP CFO | PersonNm |
| Phone | 7177632100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 CRYSTAL A DR MC CA210 | AddressLine1Txt |
| City | HERSHEY | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 17033 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| PETER DILLON MD | ||||||||
| DIR / PSH CHAIR OF SURGERY | 1.00 | 39.00 | Yes (X) | $0 | $1,224,046 | $53,126 | ||
| JEFFREY HELD MD | ||||||||
| CHAIR (THRU 7/21),VP MED. AFF. SJRHN | 1.00 | 49.00 | Yes (X) | $0 | $475,206 | $38,410 | Yes (X) | |
| MARC ROVITO | ||||||||
| CHAIR (BEG 7/21) / DIR, VP MED AFF. SJRHN | 1.00 | 39.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| HEIDI B MASANO | ||||||||
| VICE CHAIR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| JIM BENNETT | ||||||||
| VP & COO SJRHN | 1.00 | 49.00 | $0 | $248,854 | $33,548 | Yes (X) | ||
| KIMBERLY WOLF | ||||||||
| EXECUTIVE DIRECTOR | 1.00 | 49.00 | $0 | $231,224 | $28,459 | Yes (X) | ||
| CHRIS SCHENKEL | ||||||||
| SEC/TREAS / PSH DIR OF FINANCE | 1.00 | 39.00 | $0 | $147,951 | $41,227 | Yes (X) | ||
| WARQAA MAJEED | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $669,622 | $0 | $39,278 | Yes (X) | ||
| JORGE BUSTILLO | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $588,302 | $0 | $59,201 | Yes (X) | ||
| ANDRE ROBINSON | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $541,791 | $0 | $58,228 | Yes (X) | ||
| RICKIE MONROE | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $526,040 | $0 | $52,529 | Yes (X) | ||
| ZHI-GANG ZHU MD | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $461,761 | $0 | $38,780 | Yes (X) | ||
| JORGE ARBOLEDA | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $417,161 | $0 | $60,324 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,204,677 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,327,281 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $503,110 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 53 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| WEATHERBY LOCUMS INC | |||||
| PO BOX 972633 | DALLAS | TX | 75397 | LOCUMS | $1,413,378 |
| COMPHEALTH | |||||
| PO BOX 972670 | DALLAS | TX | 75397 | LOCUMS | $936,957 |
| VISTA STAFFING SOLUTIONS INC | |||||
| 275 E 200 SOUTH | SALT LAKE CITY | UT | 84111 | LOCUMS | $585,783 |
| LOCUMTENENSCOM LLC | |||||
| 2655 NORTHWINDS PARKWAY | ALPHARETTA | GA | 30009 | LOCUMS | $189,248 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $37,558,271 | RelatedOrganizationsAmt |
| Total Contributions | $37,558,271 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Business | 621111 | BusinessCd |
| Total Revenue Column | $32,355,457 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $32,355,457 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $32,355,457 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,792 | TotalRevenueColumnAmt |
| Exclusion | $1,792 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $500 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $7,743 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$7,243 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$7,243 | TotalRevenueColumnAmt |
| Exclusion | -$7,243 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| INCENTIVE INCOME | 900099 | $834,044 | $834,044 |
| OTHER REVENUE | 900099 | $7,772 | $7,772 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $841,816 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $70,750,093 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $33,197,273 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$5,451 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,719,082 | TotalAmt |
| Program Services | $54,027,398 | ProgramServicesAmt |
| Management And General | $691,684 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $660,699 | TotalAmt |
| Program Services | $660,699 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,307,301 | TotalAmt |
| Program Services | $1,307,301 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $702,366 | TotalAmt |
| Program Services | $702,366 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,560 | TotalAmt |
| Program Services | $7,560 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,637,053 | TotalAmt |
| Program Services | $4,499,479 | ProgramServicesAmt |
| Management And General | $137,574 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $723 | TotalAmt |
| Program Services | $723 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $147,422 | TotalAmt |
| Program Services | $117,895 | ProgramServicesAmt |
| Management And General | $29,527 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,350,532 | TotalAmt |
| Program Services | $3,348,374 | ProgramServicesAmt |
| Management And General | $2,158 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,123 | TotalAmt |
| Program Services | $31,806 | ProgramServicesAmt |
| Management And General | $317 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,558 | TotalAmt |
| Program Services | $7,308 | ProgramServicesAmt |
| Management And General | $250 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $202,548 | TotalAmt |
| Program Services | $132,937 | ProgramServicesAmt |
| Management And General | $69,611 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,018 | TotalAmt |
| Program Services | $86,018 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $1,616,169 | $1,616,169 | |
| ALLOC. CORP. SERVICES | $1,158,322 | $1,158,322 | |
| LICENSES | $164,493 | $159,093 | $5,400 |
| USE TAX | $75,250 | $75,250 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,555 | TotalAmt |
| Program Services | $66,555 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,941,774 | TotalAmt |
| Program Services | $66,771,681 | ProgramServicesAmt |
| Management And General | $2,170,093 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,241,739 | BOYAmt |
| EOY | $1,133,586 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,501,926 | BOYAmt |
| EOY | $4,210,835 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,566 | BOYAmt |
| EOY | $238,084 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $3,664,623 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,705,049 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,451,568 | BOYAmt |
| EOY | $1,959,574 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,215,799 | BOYAmt |
| EOY | $7,542,079 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,514,401 | BOYAmt |
| EOY | $3,094,277 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,025,066 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $533,380 | BOYAmt |
| EOY | $496,531 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,072,847 | BOYAmt |
| EOY | $3,590,808 | 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 | $2,142,952 | BOYAmt |
| EOY | $3,951,271 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,142,952 | BOYAmt |
| EOY | $3,951,271 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,215,799 | BOYAmt |
| EOY | $7,542,079 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,808,319 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $23,113,482 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $28,125,391 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $39,675,612 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $36,024,630 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $37,558,271 | CurrentTaxYearAmt |
| Total | $164,497,386 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $24,529,785 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $27,370,802 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $26,502,642 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $28,042,502 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $32,355,457 | CurrentTaxYearAmt |
| Total | $138,801,188 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $47,643,267 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $55,496,193 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $66,178,254 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $64,067,132 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $69,913,728 | CurrentTaxYearAmt |
| Total | $303,298,574 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $303,298,574 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,300 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $236 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,282 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,471 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,792 | CurrentTaxYearAmt |
| Total | $13,081 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,300 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $236 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,282 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,471 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,792 | CurrentTaxYearAmt |
| Total | $13,081 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $406,090 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $295,263 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $394,863 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $616,478 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $841,816 | CurrentTaxYearAmt |
| Total | $2,554,510 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $48,055,657 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $55,791,692 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $66,576,399 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $64,685,081 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $70,757,336 | CurrentTaxYearAmt |
| Total | $305,866,165 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99160 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99290 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00010 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | MISCELLANEOUS REVENUE - 2017 AMOUNT: $ 406,090. 2018 AMOUNT: $ 295,263. 2019 AMOUNT: $ 394,863. 2020 AMOUNT: $ 616,478. 2021 AMOUNT: $ 841,816. | ExplanationTxt |
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 D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,863,343 | OtherCostOrOtherBasisAmt |
| Depreciation | $947,589 | DepreciationAmt |
| Book Value | $915,754 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $818,446 | OtherCostOrOtherBasisAmt |
| Depreciation | $757,460 | DepreciationAmt |
| Book Value | $60,986 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $982,834 | OtherCostOrOtherBasisAmt |
| Book Value | $982,834 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,959,574 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| PATIENT A/R CREDIT BALANCES | $444,092 |
| ROU OPERATING LEASE | $52,439 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $496,531 | TotalLiabilityAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PETER DILLON MD | ||||||||||||||
| DIR / PSH CHAIR OF SURGERY | $0 | $823,876 | $0 | $333,653 | $0 | $66,517 | $0 | $36,360 | $0 | $16,766 | $0 | $1,277,172 | $0 | $0 |
| WARQAA MAJEED | ||||||||||||||
| PHYSICIAN | $260,538 | $0 | $405,618 | $0 | $3,466 | $0 | $36,976 | $0 | $2,302 | $0 | $708,900 | $0 | $0 | $0 |
| JORGE BUSTILLO | ||||||||||||||
| PHYSICIAN | $565,137 | $0 | $20,000 | $0 | $3,165 | $0 | $36,360 | $0 | $22,841 | $0 | $647,503 | $0 | $0 | $0 |
| ANDRE ROBINSON | ||||||||||||||
| PHYSICIAN | $430,829 | $0 | $109,003 | $0 | $1,959 | $0 | $36,360 | $0 | $21,868 | $0 | $600,019 | $0 | $0 | $0 |
| RICKIE MONROE | ||||||||||||||
| PHYSICIAN | $409,682 | $0 | $114,449 | $0 | $1,909 | $0 | $36,360 | $0 | $16,169 | $0 | $578,569 | $0 | $0 | $0 |
| JEFFREY HELD MD | ||||||||||||||
| CHAIR (THRU 7/21),VP MED. AFF. SJRHN | $0 | $204,898 | $0 | $88,223 | $0 | $182,085 | $0 | $25,815 | $0 | $12,595 | $0 | $513,616 | $0 | $0 |
| ZHI-GANG ZHU MD | ||||||||||||||
| PHYSICIAN | $435,508 | $0 | $11,654 | $0 | $14,599 | $0 | $36,360 | $0 | $2,420 | $0 | $500,541 | $0 | $0 | $0 |
| JORGE ARBOLEDA | ||||||||||||||
| PHYSICIAN | $195,834 | $0 | $217,052 | $0 | $4,275 | $0 | $36,360 | $0 | $23,964 | $0 | $477,485 | $0 | $0 | $0 |
| JIM BENNETT | ||||||||||||||
| VP & COO SJRHN | $0 | $216,372 | $0 | $30,074 | $0 | $2,408 | $0 | $31,772 | $0 | $1,776 | $0 | $282,402 | $0 | $0 |
| KIMBERLY WOLF | ||||||||||||||
| EXECUTIVE DIRECTOR | $0 | $193,793 | $0 | $27,987 | $0 | $9,444 | $0 | $27,393 | $0 | $1,066 | $0 | $259,683 | $0 | $0 |
| CHRIS SCHENKEL | ||||||||||||||
| SEC/TREAS / PSH DIR OF FINANCE | $0 | $122,245 | $0 | $20,935 | $0 | $4,771 | $0 | $17,995 | $0 | $23,232 | $0 | $189,178 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | ARRANGEMENT USED TO ESTABLISH THE CEO'S COMPENSATION: COMPENSATION FOR THE CEO THAT WAS ESTABLISHED AND PAID BY PENN STATE HEALTH USED THE FOLLOWING TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) COMPENSATION SURVEY OR STUDY; (4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. |
| PART I, LINES 4A-B | THE FOLLOWING INDIVIDUAL RECEIVED A SEVERANCE PAYMENT DURING THE CALENDAR YEAR ENDING WITHIN THIS FISCAL YEAR ENDED JUNE 30, 2022: - JEFFREY HELD - $137,312 DURING THE CALENDAR YEAR ENDING WITHIN THIS FISCAL YEAR ENDED JUNE 30, 2022, A DIRECTOR PARTICIPATED IN A RELATED ORGANIZATION'S SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. THE BELOW LISTED INDIVIDUAL'S CONTRIBUTIONS HAVE NOT YET VESTED; UNVESTED CONTRIBUTIONS ARE REPORTED ON SCHEDULE J, PART II, COLUMN C, RETIREMENT AND OTHER DEFERRED COMPENSATION. - PETER DILLON - $55,892 |
| SCHEDULE J, PART I, LINE 7 | BONUSES, PAID BY A RELATED ORGANIZATION THAT EMPLOYS THE INDIVIDUALS, ARE BASED ON A NUMBER OF VARIABLES INCLUDING BUT NOT LIMITED TO INDIVIDUAL GOAL ACHIEVEMENTS AS WELL AS ORGANIZATION OPERATION ACHIEVEMENTS. THE FINAL DETERMINATION OF THE BONUS AMOUNT IS DETERMINED AND APPROVED BY THE APPLICABLE BOARD AS PART OF THE OVERALL COMPENSATION REVIEW OF THE OFFICERS, KEY EMPLOYEES AND HIGHEST COMPENSATED. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART V, LINE 1A: | FORMS 1096: FORM 1096 FOR THE FILING ORGANIZATION IS PROCESSED AND REPORTED BY ITS RELATED ORGANIZATION PENN STATE HEALTH (EIN: 47-3769205). |
| FORM 990, PART VI, SECTION A, LINE 2 | CERTAIN LISTED OFFICERS AND BOARD MEMBERS ALSO SERVE AS OFFICERS AND BOARD MEMBERS OF A TAXABLE ENTITY. |
| FORM 990, PART VI, SECTION A, LINE 6 | CLASSES OF MEMBERS OR STOCKHOLDERS: THE FILING ORGANIZATION'S SOLE MEMBER IS PENN STATE HEALTH, A PENNSYLVANIA NONPROFIT CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | ELECTING MEMBERS OF GOVERNING BODY: DIRECTORS SHALL BE ELECTED BY THE CORPORATE MEMBER, PENN STATE HEALTH. THE CORPORATE MEMBER MAY AT ANY TIME REMOVE, WITH OR WITHOUT CAUSE, ANY MEMBER OF THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | DECISIONS REQUIRING APPROVAL BY MEMBERS OR STOCKHOLDERS: PURSUANT TO SPECIFICATIONS DEFINED IN THE BYLAWS THE CORPORATE MEMBERS HAVE RESERVED POWERS. NOTWITHSTANDING ANY OTHER PROVISIONS OF THESE BYLAWS, THE SOLE MEMBER MUST APPROVE THE FOLLOWING ITEMS, AS APPLICABLE, BEFORE THEY MAY BE IMPLEMENTED BY THIS CORPORATION. THE SOLE MEMBER SHALL HAVE THE AUTHORITY: (A) TO DETERMINE THE NUMBER OF AND TO ELECT AND REMOVE, WITH OR WITHOUT CAUSE, THE DIRECTORS OF THE CORPORATION; (B) TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, AND TO DETERMINE THE COMPENSATION OF, THE PRESIDENT; (C) TO ELECT AND REMOVE, WITH OR WITHOUT CAUSE, THE CHAIR AND VICE CHAIR OF THE BOARD, THE SECRETARY (INCLUDING ANY ASSISTANT OR ASSOCIATE SECRETARY), AND THE TREASURER (INCLUDING ANY ASSISTANT TREASURER); (D) TO APPROVE ANY AND ALL AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS OF THE CORPORATION; (E) TO ADOPT OR MODIFY THE MISSION, VISION, OR OBJECTIVES OF THE CORPORATION; (F) TO ADOPT ALL LONG-RANGE AND STRATEGIC PLANS; (G) TO APPROVE ALL OPERATING AND CAPITAL BUDGETS; (H) TO APPROVE ALL UNBUDGETED CAPITAL EXPENDITURES AND ALL UNBUDGETED OPERATING EXPENDITURES IN EXCESS OF SUCH AMOUNT AS IS DETERMINED BY OR PURSUANT TO THE POLICIES OF THE SOLE MEMBER; (I) TO APPROVE THE INCURRENCE OF DEBT OR GUARANTEE OF INDEBTEDNESS FOR BORROWED MONEY, OR THE PLEDGE OR MORTGAGE OF ASSETS TO SECURE THE SAME AND TO ESTABLISH AN OBLIGATED GROUP FOR FINANCING PURPOSES; (J) TO DETERMINE ANNUAL DISTRIBUTIONS TO BE MADE TO OR FOR THE BENEFIT OF THE PENNSYLVANIA STATE UNIVERSITY COLLEGE OF MEDICINE AS ACADEMIC SUPPORT PAYMENTS; (K) TO REQUIRE THE CORPORATION TO PARTICIPATE IN A CENTRALIZED FINANCIAL AND CASH MANAGEMENT SYSTEM FOR PENN STATE HEALTH AND ONE OR MORE OF ITS CONTROLLED AFFILIATES (THE "SYSTEM"); (L) TO APPROVE ANY DONATION OR TRANSFER OF THE CORPORATION'S ASSETS IN EXCESS OF SUCH AMOUNT AS IS DETERMINED BY OR PURSUANT TO THE POLICIES OF THE SOLE MEMBER, OTHER THAN DONATIONS OR TRANSFERS TO THE SOLE MEMBER OR ANOTHER ENTITY IN THE SYSTEM, UNLESS AUTHORIZED IN THE CORPORATION'S APPROVED BUDGET; (M) TO APPROVE AND AUTHORIZE ADDITIONS AND ELIMINATIONS OF CLINICAL SERVICES OF THE CORPORATION AND TO DETERMINE THE DISTRIBUTION OF CLINICAL AND SUPPORT SERVICES ACROSS THE SYSTEM; (N) TO APPROVE THE CREATION OR DISSOLUTION OF, INVESTMENT IN, OR DISPOSITION OF ANY SUBSIDIARY OR JOINT VENTURE AND TO APPROVE ANY OTHER STRATEGIC ALIGNMENT OR FUNDAMENTAL CHANGE TRANSACTION, INCLUDING (I) JOINT OPERATING AGREEMENTS OR MANAGEMENT AGREEMENTS, (II) ACQUISITIONS, DISPOSITIONS OR TRANSFERS OF MATERIAL OPERATIONS, (III) CLOSURE OF FACILITIES, (IV) MERGERS, CONSOLIDATIONS, AND DIVISIONS, (V) THE SALE, PLEDGING, LEASING OR TRANSFER OF ASSETS WITH A VALUE IN EXCESS OF SUCH AMOUNT AS IS DETERMINED BY OR PURSUANT TO THE POLICIES OF THE SOLE MEMBER, AND (VI) THE LIQUIDATION OR DISSOLUTION OF THE CORPORATION; (O) TO ADOPT EMPLOYEE BENEFIT PLANS; (P) TO ADOPT OR APPROVE THE INVESTMENT POLICIES OF THE CORPORATION; (Q) TO SELECT AND APPOINT AUDITORS FOR, AND TO DESIGNATE THE FISCAL YEAR OF, THE CORPORATION; (R) TO RETAIN COUNSEL ON BEHALF OF AND SETTLE ANY LITIGATION AGAINST THE CORPORATION; (S) TO ENTER INTO SYSTEM-WIDE AGREEMENTS ON BEHALF OF THE CORPORATION; AND (T) EXCEPT AS OTHERWISE PROVIDED IN THESE BYLAWS, TO GIVE SUCH APPROVALS AND TAKE SUCH OTHER ACTIONS AS ARE SPECIFICALLY RESERVED TO THE MEMBERS OF A PENNSYLVANIA NONPROFIT CORPORATION UNDER THE PENNSYLVANIA NONPROFIT CORPORATION LAW OF 1988, AS AMENDED (THE "PENNSYLVANIA NONPROFIT CORPORATION LAW"). |
| FORM 990, PART VI, SECTION B, LINE 11B | REVIEW OF FORM 990 BY GOVERNING BODY: THE FORM 990 IS PREPARED BY AN EXTERNAL ACCOUNTING FIRM; IT IS REVIEWED BY ACCOUNTING/FINANCE DEPARTMENT PERSONNEL AND THE CHIEF FINANCIAL OFFICER, AND THEN DISTRIBUTED TO ALL MEMBERS OF THE BOARD FOR REVIEW AND COMMENT BEFORE IT IS FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST POLICY: THE FILING ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST (COI) POLICIES FOR OFFICERS, DIRECTORS, AND KEY EMPLOYEES (COVERED PERSONS). PER THE POLICY, NO COVERED PERSONS MAY ENGAGE IN ANY TRANSACTION OR ARRANGEMENT OR UNDERTAKE POSITIONS WITH OTHER ORGANIZATIONS THAT INVOLVE A CONFLICT OF INTEREST, EXCEPT IN COMPLIANCE WITH THE POLICY. EVERY COVERED PERSON SHALL DISCLOSE ALL ACTUAL AND POTENTIAL CONFLICTS THROUGH AN ANNUAL WRITTEN DISCLOSURE STATEMENT AND AS MATTERS INVOLVING AN ACTUAL OR POTENTIAL CONFLICT ARISE. THE BOARD WILL EVALUATE THE DISCLOSURES AND THE MATERIAL FACTS RELATING TO THE TRANSACTION OR ARRANGEMENT GIVING RISE TO THE POTENTIAL CONFLICT TO DETERMINE WHETHER THEY INVOLVE ACTUAL CONFLICTS OF INTEREST AND MAY ATTEMPT TO DEVELOP ALTERNATIVES TO REMOVE THE CONFLICT FROM THE TRANSACTION OR ARRANGEMENT. A COVERED PERSON WHO HAS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST SHALL NOT BE PRESENT FOR OR SHALL LEAVE ANY PORTION OF A MEETING AT WHICH THE BOARD OF DIRECTORS OR A COMMITTEE IS VOTING TO DETERMINE WHETHER A CONFLICT EXISTS, BUT MAY BE PRESENT PRIOR TO THE VOTE TO MAKE PRESENTATION TO THE BOARD OR COMMITTEE TO DISCLOSE ADDITIONAL FACTS, OR TO RESPOND TO QUESTIONS. THE FILING ORGANIZATION MAY ENTER INTO A TRANSACTION OR ARRANGEMENT IN WHICH A COVERED PERSON HAS AN ACTUAL CONFLICT OF INTEREST IF A MAJORITY OF DIRECTORS WHO HAVE NO INTEREST IN THE TRANSACTION OR ARRANGEMENT APPROVE THE TRANSACTION OR ARRANGEMENT AT A BOARD OR COMMITTEE MEETING AFTER DETERMINING THAT THE TRANSACTION OR ARRANGEMENT IS FAIR AND REASONABLE TO THE CORPORATION, ANY COVERED PERSON WHO HAS A CONFLICT WITH RESPECT TO THE TRANSACTION OR ARRANGEMENT DOES NOT PARTICIPATE IN AND IS NOT PRESENT FOR THE VOTE REGARDING SUCH TRANSACTION OR ARRANGEMENT (EXCEPT THAT THE COVERED PERSON MAY APPEAR AT A MEETING TO ANSWER QUESTIONS), AND IF THE TRANSACTION OR ARRANGEMENT INVOLVES COMPENSATION OR OTHER FINANCIAL BENEFIT TO THE COVERED PERSON, THE BOARD RELIES ON APPROPRIATE COMPARABILITY DATA TO DETERMINE REASONABLENESS. THE FILING ORGANIZATION WILL DOCUMENT THE FOREGOING IN THE MINUTES OF BOARD AND COMMITTEE MEETINGS, AS APPLICABLE. EACH COVERED PERSON MUST SIGN A STATEMENT THAT AFFIRMS THAT HE OR SHE HAS RECEIVED A COPY OF THE COI POLICY, HAS READ AND UNDERSTANDS IT, AND HAS AGREED TO COMPLY WITH IT. IF THE BOARD OF DIRECTORS HAS REASONABLE CAUSE TO BELIEVE THAT A COVERED PERSON HAS FAILED TO COMPLY WITH THE POLICY, THE BOARD MAY COUNSEL THE COVERED PERSON REGARDING SUCH FAILURE AND, IF THE ISSUE IS NOT RESOLVED TO THE BOARD'S SATISFACTION, MAY CONSIDER ADDITIONAL CORRECTIVE ACTION, INCLUDING REMOVAL FROM THE BOARD OF DIRECTORS OR OTHER POSITION WITH THE FILING ORGANIZATION, AS APPROPRIATE. FORM 990, PART VI, SECTION B, LINES 13 & 14 WHISTLEBLOWER POLICY AND DOCUMENT RETENTION/DESTRUCTION POLICY: THE FILING ORGANIZATION FOLLOWS THE WHISTLEBLOWER POLICY AND DOCUMENT RETENTION AND DESTRUCTION POLICY OF A RELATED ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 15 | PROCESS USED TO ESTABLISH COMPENSATION OF CEO, OFFICERS, AND KEY EMPLOYEES: THE FILING ORGANIZATION IS PART OF A MULTI-ENTITY HEALTH SYSTEM AND MAY OR MAY NOT DESIGNATE ONE OR MORE OF ITS EMPLOYEES AS A CEO (OR PRESIDENT), OFFICER, OR KEY EMPLOYEE. IF THE FILING ORGANIZATION DOES NOT DESIGNATE INDIVIDUALS TO THESE ROLES, THE ROLE IS HANDLED BY AN INDIVIDUAL FROM THE PARENT ENTITY, PENN STATE HEALTH, OR AN AFFILITATE. PENN STATE HEALTH HAS ESTABLISHED A SYSTEM-WIDE PROCESS FOR ESTABLISHING COMPENSATION AS FOLLOWS: ANNUALLY, THE COMPENSATION COMMITTEE OF THE PARENT BOARD ENGAGES AN INDEPENDENT COMPENSATION CONSULTANT TO CONDUCT A COMPENSATION ANALYSIS FOR THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER (CEO), OFFICERS, AND KEY EMPLOYEES. AS PART OF THE ANALYSIS, THE INDEPENDENT COMPENSATION CONSULTANT IDENTIFIES, GATHERS, AND ANALYZES APPROPRIATE COMPARABILITY DATA UPON WHICH THE COMMITTEE AND THE FULL BOARD WILL RELY TO ASSESS THE REASONABLENESS OF THE TOTAL PROPOSED COMPENSATION (INCLUDING BENEFITS) OF THE CEO, OFFICERS, AND KEY EMPLOYEES. ONCE THE COMPENSATION ANALYSIS IS COMPLETE AND DOCUMENTED IN REPORTS, THE REPORTS ARE PROVIDED TO THE BOARD FOR REVIEW AND CONSIDERATION, TOGETHER WITH WRITTEN OPINIONS FROM THE COMPENSATION CONSULTANT THAT THE PROPOSED COMPENSATION ARRANGEMENTS FOR THE CEO, OFFICERS, AND KEY EMPLOYEES ARE REASONABLE WITHIN THE MEANING OF TREASURY REGULATION 53.4958-4(B)(1)(II)(A). WITH INPUT FROM THE COMPENSATION COMMITTEE, THE FULL BOARD MAKES ANNUAL DECISIONS WITH RESPECT TO COMPENSATION FOR THE CEO, OFFICERS, AND KEY EMPLOYEES BASED UPON THE DATA IN THE REPORT AND THE OPINION OF THE COMPENSATION CONSULTANT THAT THE PROPOSED COMPENSATION IS REASONABLE. THESE DECISIONS, THE BASIS FOR THESE DECISIONS, THE BOARD MEMBERS' NAMES WHO VOTE ON COMPENSATION, AND THAT NONE OF THE BOARD MEMBERS HAVE A CONFLICT OF INTEREST WITH RESPECT TO THESE COMPENSATION ARRANGEMENTS IS ALL CONTEMPORANEOUSLY DOCUMENTED IN THE MINUTES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS OF THE PENNSYLVANIA STATE UNIVERSITY AND ITS SUBSIDIARIES (WHICH INCLUDE PENN STATE HEALTH) ARE AVAILABLE AT WWW.PSU.EDU. |
| FORM 990, PART IX, LINE 11G | PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 2,941,881. TOTAL EXPENSES 2,941,881. CONTRACTED STAFF: PROGRAM SERVICE EXPENSES 788,183. TOTAL EXPENSES 788,183. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 769,415. MANAGEMENT AND GENERAL EXPENSES 137,574. TOTAL EXPENSES 906,989. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ST JOSEPH REGIONAL HEALTH NETWORK | |||||||||||
| 100 CRYSTAL A DRIVE MC CA210 | HERSHEY | PA | 17033 | 231352211 | HEALTHCARE | PA | 501(C)(3) | LINE 3 | PSH | 0 | |
| ST JOSEPH MEDICAL CENTER FOUNDATION | |||||||||||
| 100 CRYSTAL A DRIVE MC CA210 | HERSHEY | PA | 17033 | 232649362 | FUNDRAISING | PA | 501(C)(3) | LINE 10 | SJRHN | 0 | |
| PENN STATE HEALTH | |||||||||||
| 100 CRYSTAL A DRIVE MC CA210 | HERSHEY | PA | 17033 | 473769205 | MGMT/SUPPORT | PA | 501(C)(3) | LINE 12A, I | PSU | 0 | |
| THE PENNSYLVANIA STATE UNIVERSITY | |||||||||||
| 201 OLD MAIN | UNIVERSITY PARK | PA | 16802 | 246000376 | EDUCATION | PA | 115 | 0 | N/A | ||
| THE MILTON S HERSHEY MEDICAL CENTER | |||||||||||
| 100 CRYSTAL A DRIVE MC CA210 | HERSHEY | PA | 17033 | 251854772 | HEALTHCARE | PA | 115 | PSH | 0 | ||
| PENN STATE HEALTH HAMPDEN MEDICAL CENTER | |||||||||||
| 100 CRYSTAL A DRIVE MC CA210 | HERSHEY | PA | 17033 | 851608328 | HEALTHCARE | PA | 501(C)(3) | LINE 3 | PSH | 0 | |
| PENN STATE HEALTH LANCASTER MEDICAL CENTER | |||||||||||
| 100 CRYSTAL A DRIVE MC CA210 | HERSHEY | PA | 17033 | 851620990 | HEALTHCARE | PA | 501(C)(3) | LINE 3 | PSH | 0 | |
| PENN STATE HEALTH HOLY SPIRIT MEDICAL CENTER | |||||||||||
| 100 CRYSTAL A DRIVE MC CA210 | HERSHEY | PA | 17033 | 231512747 | HEALTHCARE | PA | 501(C)(3) | LINE 3 | PSH | 0 | |
| SPIRIT PHYSICIAN SERVICES INC | |||||||||||
| 100 CRYSTAL A DRIVE MC CA210 | HERSHEY | PA | 17033 | 251766971 | PHYSN SVCS | PA | 501(C)(3) | LINE 10 | PSH | 0 | |
| HOLY SPIRIT CORPORATION | |||||||||||
| 100 CRYSTAL A DRIVE MC CA210 | HERSHEY | PA | 17033 | 232214540 | HOLDING CO | PA | 501(C)(2) | PSHHSMC | 0 | ||
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| HERSHEY OUTPATIENT SURGERY CENTER LP | |||||||||
| 15305 DALLAS PKWY | ADDISON | TX | 75001 | 200469951 | HEALTHCARE | PA | NITTANY HLTH | 0 | 0 |
| NITTANY HEALTH - VALUEHEALTH JOINT | |||||||||
| 11221 ROE AVE | LEAWOOD | KS | 66211 | 851154159 | HEALTHCARE | PA | NITTANY HLTH | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| NITTANY HEALTH INC | |||||||||
| 100 CRYSTAL A DRIVE MC CA210 | HERSHEY | PA | 17033 | 251769611 | HOMECARE INTEGRATION | PA | N/A | C | 0 |
| CGH REALTY CO INC | |||||||||
| 100 CRYSTAL A DRIVE MC CA210 | HERSHEY | PA | 17033 | 232326801 | REAL ESTATE | PA | N/A | C | 0 |
| HOLY SPIRIT VENTURES INC | |||||||||
| 100 CRYSTAL A DRIVE MC CA210 | HERSHEY | PA | 17033 | 232407709 | MED. SERV. | PA | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | Yes (1) | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SUPPLEMENTAL INFORMATION | FormAndLineReferenceDesc |
| Explanation | SCHEDULE R LISTS ONLY THOSE RELATED ORGANIZATIONS THAT RELATE TO THE HEALTH CARE OPERATIONS UNDER THE COMMON CONTROL OF THE PENNSYLVANIA STATE UNIVERSITY. | ExplanationTxt |