WARREN GENERAL HOSPITAL: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- WARREN GENERAL HOSPITAL (EIN 25-0965598)
- Tax period
- 2019-07-01 to 2020-06-30
- Filed
- 2021-05-14
- IRS object ID
- 202121349349300517
- Schema version
- 2019v5.2
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-05-14T07:41:54-05:00 | ReturnTs |
| Tax Period End | 2020-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 550486667 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ARNETT CARBIS TOOTHMAN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5700 CORPORATE DRIVE STE 650 | AddressLine1Txt |
| City | PITTSBURGH | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 15237 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 250965598 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WARREN GENERAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WARR | BusinessNameControlTxt |
| Phone | 8147234973 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | TWO CRESCENT PARK WEST | AddressLine1Txt |
| City | WARREN | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16365 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARK CYE | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 8147234973 | PhoneNum |
| Signature | 2021-05-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KELLY A BROCIOUS CPA | PreparerPersonNm |
| PTIN | P01254262 | PTIN |
| Phone | 4126356270 | PhoneNum |
| Preparation | 2021-05-12 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | RICHARD L ALLEN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | TWO CRESCENT PARK WEST | AddressLine1Txt |
| City | WARREN | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16365 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $80,124,310 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.WGH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1898 | FormationYr |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HEALTH CARE SERVICES TO THE PUBLIC INCLUDING INPATIENT ACUTE CARE, PSYCHIATRIC CARE, 24-HR ER CARE, AND OTHER OUTPATIENT SERVICES TO WARREN AND SURROUNDING COUNTIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 645 | TotalEmployeeCnt |
| Total Volunteers | 100 | TotalVolunteersCnt |
| Total Gross UBI | -$94,148 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$94,148 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $399,311 | PYContributionsGrantsAmt |
| CY Contributions Grants | $914,556 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $74,465,007 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $78,266,982 | CYProgramServiceRevenueAmt |
| PY Investment Income | $414,220 | PYInvestmentIncomeAmt |
| CY Investment Income | $196,633 | CYInvestmentIncomeAmt |
| PY Other Revenue | $419,317 | PYOtherRevenueAmt |
| CY Other Revenue | $660,962 | CYOtherRevenueAmt |
| PY Total Revenue | $75,697,855 | PYTotalRevenueAmt |
| CY Total Revenue | $80,039,133 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $5,000 | 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 | $33,503,431 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $33,312,828 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $31,061 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $40,885,704 | PYOtherExpensesAmt |
| CY Other Expenses | $40,479,397 | CYOtherExpensesAmt |
| PY Total Expenses | $74,394,135 | PYTotalExpensesAmt |
| CY Total Expenses | $73,792,225 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,303,720 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $6,246,908 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $54,578,727 | TotalAssetsBOYAmt |
| Total Assets EOY | $71,755,082 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $32,982,142 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $50,800,602 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $21,596,585 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $20,954,480 | NetAssetsOrFundBalancesEOYAmt |
| Mission | WARREN GENERAL HOSPITAL'S MISSION IS TO PROVIDE COMMUNITY HEALTHCARE WITH QUALITY AND COMPASSION. WE STRIVE TO IMPROVE THE COMMUNITY'S HEALTH, LEAD A VISION FOR THE HEALTHCARE FUTURE, AND MAINTAIN FISCAL VIABILITY WHILE PROVIDING CORE HEALTHCARE SERVICES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $57,247,532 | ExpenseAmt |
| Revenue | $78,466,255 | RevenueAmt |
| Desc | THE WARREN GENERAL HOSPITAL (WGH) IS A NON-PROFIT ACUTE CARE HOSPITAL. WGH PROVIDES HEALTHCARE SERVICES TO THE PUBLIC. THESE SERVICES INCLUDE: INPATIENT ACUTE CARE AND PSYCHIATRIC CARE, 24 HOUR EMERGENCY ROOM, OUTPATIENT HOME CARE AND OTHER OUTPATIENT CARE FOR RESIDENTS OF WARREN COUNTY AND SURROUNDING AREAS. IN ADDITION, THE HOSPITAL OFFERS AN OUTPATIENT CANCER CARE CENTER TO RELIEVE THE NEED FOR RESIDENTS TO TRAVEL DURING THESE MOST DIFFICULT TIMES. | Desc |
| Total Program Service Expenses | $57,247,532 | 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 | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | 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 | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| 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 | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 44 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 645 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| 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 |
| 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 | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | 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 | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | 0 | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | PA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JULIE SNYDER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8147233300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | TWO CRESCENT PARK | AddressLine1Txt |
| City | WARREN | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16365 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| THAD TURNER | |||||||||
| CHAIRMAN | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| KAREN SURKALA | |||||||||
| VICE CHAIRMAN | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| TIMOTHY R BEVEVINO ESQ | |||||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| LISA HAGBERG | |||||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| JAMES ROHRBAUGH | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| CARMEN N FERRENTO | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| JOHN MALJOVEC MD | |||||||||
| BOARD MEMBER | 10.00 | Yes (X) | $92,215 | $0 | $0 | ||||
| JULIA W MCTAVISH | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| TIMOTHY STANTON MD | |||||||||
| BOARD MEMBER | 40.00 | Yes (X) | $260,272 | $0 | $10,462 | ||||
| MASON TOOTELL MD | |||||||||
| BOARD MEMBER | 40.00 | Yes (X) | $276,912 | $0 | $9,036 | ||||
| TREVOR M OLSEN MD | |||||||||
| BOARD MEMBER | 40.00 | Yes (X) | $495,986 | $0 | $13,134 | ||||
| RICHARD OLINGER | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| JASEN DILEY | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| LINDA KEVERLINE | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| RICHARD L ALLEN | |||||||||
| CEO | 40.00 | Yes (X) | $537,599 | $0 | $13,396 | 1.00 | |||
| LOUIS LONGO | |||||||||
| CFO (UNTIL 7/17/20) | 40.00 | Yes (X) | $245,360 | $0 | $0 | 1.00 | |||
| MARK CYE | |||||||||
| CFO | 40.00 | Yes (X) | $0 | $0 | $0 | 1.00 | |||
| JOSEPH AKIF | |||||||||
| COO/CNO | 40.00 | $245,402 | $0 | $11,137 | Yes (X) | ||||
| BERNARD V EDEN MD | |||||||||
| PHYSICIAN | 40.00 | $810,716 | $0 | $15,230 | Yes (X) | ||||
| NIAZ AHMED MD | |||||||||
| PHYSICIAN | 40.00 | $537,363 | $0 | $16,290 | Yes (X) | ||||
| VALERIY SEDOV MD | |||||||||
| PHYSICIAN | 40.00 | $522,850 | $0 | $13,119 | Yes (X) | ||||
| SIMON AMSDELL MD | |||||||||
| PHYSICIAN | 40.00 | $808,858 | $0 | $13,571 | Yes (X) | ||||
| JUSTIN BROWER MD | |||||||||
| PHYSICIAN | 40.00 | $587,791 | $0 | $13,146 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $5,421,324 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $128,521 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 38 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| GROUP MEDICAL SERVICES CORP | |||||
| PO BOX 68 | WARREN | PA | 16365 | PURCHASED SERVICES | $1,125,000 |
| ASSOCIATED CLINICAL LABS | |||||
| 1526 PEACH STREET | ERIE | PA | 16501 | LABORATORY SERVICES | $1,109,904 |
| AHN EMERGENCY PHYSICIANS GROUP | |||||
| 4535 DRESSLER ROAD NW | CANTON | OH | 44718 | EMERGENCY ROOM PHYSICIANS/HOSPITALISTS | $720,995 |
| NTHRIVE INC | |||||
| PO BOX 733492 | DALLAS | TX | 753733492 | CODING/BILLING CLEARINGHOUSE SERVICES | $603,924 |
| KING'S MEDICAL GROUP | |||||
| 1920A GEORGETOWN ROAD | HUDSON | OH | 44236 | PURCHASED MEDICAL SERVICES (MRI) | $420,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 25 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $77,370 | FundraisingAmt |
| All Other Contributions | $837,186 | AllOtherContributionsAmt |
| Total Contributions | $914,556 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 623990 | $71,600,600 | $71,600,600 |
| HOME HEALTH SERVICES | 621610 | $6,666,382 | $6,666,382 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $78,266,982 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $244,455 | TotalRevenueColumnAmt |
| Exclusion | $244,455 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $8,966 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $8,431 | SecuritiesAmt |
| Other | $48,357 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $535 | SecuritiesAmt |
| Other | -$48,357 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$47,822 | TotalRevenueColumnAmt |
| Exclusion | -$47,822 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $45,368 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $77,370 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $28,389 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,979 | TotalRevenueColumnAmt |
| Exclusion | $16,979 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| VANTAGE/DEERFIELD/CHART | 900099 | $405,440 | $405,440 | |
| CAFETERIA REVENUE | 900099 | $199,273 | $199,273 | |
| AUXILIARY INCOME | 900099 | $110,887 | $110,887 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$71,617 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | -$94,148 | UnrelatedBusinessRevenueAmt |
| Exclusion | $22,531 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $643,983 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $80,039,133 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $78,466,255 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | -$94,148 | UnrelatedBusinessRevenueAmt |
| Exclusion | $752,470 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,210,911 | TotalAmt |
| Management And General | $2,210,911 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,596,783 | TotalAmt |
| Program Services | $16,984,073 | ProgramServicesAmt |
| Management And General | $5,592,091 | ManagementAndGeneralAmt |
| Fundraising | $20,619 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,062,455 | TotalAmt |
| Program Services | $729,068 | ProgramServicesAmt |
| Management And General | $332,502 | ManagementAndGeneralAmt |
| Fundraising | $885 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,403,253 | TotalAmt |
| Program Services | $3,746,999 | ProgramServicesAmt |
| Management And General | $1,651,708 | ManagementAndGeneralAmt |
| Fundraising | $4,546 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,039,426 | TotalAmt |
| Program Services | $1,399,476 | ProgramServicesAmt |
| Management And General | $638,251 | ManagementAndGeneralAmt |
| Fundraising | $1,699 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $311,682 | TotalAmt |
| Management And General | $311,682 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $108,000 | TotalAmt |
| Management And General | $108,000 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,597,800 | TotalAmt |
| Program Services | $14,309,610 | ProgramServicesAmt |
| Management And General | $2,288,190 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $624,104 | TotalAmt |
| Program Services | $445,195 | ProgramServicesAmt |
| Management And General | $176,699 | ManagementAndGeneralAmt |
| Fundraising | $2,210 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,392,253 | TotalAmt |
| Program Services | $1,392,253 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $336,495 | TotalAmt |
| Program Services | $140,046 | ProgramServicesAmt |
| Management And General | $195,385 | ManagementAndGeneralAmt |
| Fundraising | $1,064 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $124,796 | TotalAmt |
| Program Services | $124,796 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,811,858 | TotalAmt |
| Program Services | $1,811,858 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $896,638 | TotalAmt |
| Program Services | $896,638 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES | $12,190,002 | $12,190,002 | ||
| REPAIRS & MAINTENANCE | $2,600,339 | $1,722,762 | $877,577 | |
| LICENSES AND FEES | $2,510,572 | $631,384 | $1,879,150 | $38 |
| EQUIPMENT RENTALS AND L | $192,852 | $152,871 | $39,981 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $782,006 | TotalAmt |
| Program Services | $570,501 | ProgramServicesAmt |
| Management And General | $211,505 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $73,792,225 | TotalAmt |
| Program Services | $57,247,532 | ProgramServicesAmt |
| Management And General | $16,513,632 | ManagementAndGeneralAmt |
| Fundraising | $31,061 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,865,578 | BOYAmt |
| EOY | $13,742,223 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $200,000 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,470,906 | BOYAmt |
| EOY | $7,920,851 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,468,200 | BOYAmt |
| EOY | $1,737,915 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $632,017 | BOYAmt |
| EOY | $656,050 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $85,851,213 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $68,850,206 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,006,312 | BOYAmt |
| EOY | $17,001,007 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,177,635 | BOYAmt |
| EOY | $14,832,914 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,958,079 | BOYAmt |
| EOY | $15,664,122 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,578,727 | BOYAmt |
| EOY | $71,755,082 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,513,611 | BOYAmt |
| EOY | $7,754,555 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,382 | BOYAmt |
| EOY | $6,141,695 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,479,419 | BOYAmt |
| EOY | $789,748 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,040,767 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,883,963 | BOYAmt |
| EOY | $36,114,604 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,982,142 | BOYAmt |
| EOY | $50,800,602 | 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 | $13,674,107 | BOYAmt |
| EOY | $12,811,970 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,922,478 | BOYAmt |
| EOY | $8,142,510 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,596,585 | BOYAmt |
| EOY | $20,954,480 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,578,727 | BOYAmt |
| EOY | $71,755,082 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $6,246,908 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | $258,385 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$7,147,398 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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) |
|---|---|---|
| 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 D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $6,119,902 | BeginningYearBalanceAmt |
| End Year Balance | $6,119,902 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $6,010,524 | BeginningYearBalanceAmt |
| Contributions | $5,441 | ContributionsAmt |
| Investment Earnings Or Losses | $325,087 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $221,150 | OtherExpendituresAmt |
| End Year Balance | $6,119,902 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,935,311 | BeginningYearBalanceAmt |
| Contributions | $5,136 | ContributionsAmt |
| Investment Earnings Or Losses | $298,052 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $227,975 | OtherExpendituresAmt |
| End Year Balance | $6,010,524 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,613,505 | BeginningYearBalanceAmt |
| Contributions | $4,752 | ContributionsAmt |
| Investment Earnings Or Losses | $541,171 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $224,117 | OtherExpendituresAmt |
| End Year Balance | $5,935,311 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,892,957 | BeginningYearBalanceAmt |
| Contributions | $4,510 | ContributionsAmt |
| Investment Earnings Or Losses | -$43,069 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $240,893 | OtherExpendituresAmt |
| End Year Balance | $5,613,505 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $541,959 | OtherCostOrOtherBasisAmt |
| Book Value | $541,959 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $46,344,831 | OtherCostOrOtherBasisAmt |
| Depreciation | $36,104,395 | DepreciationAmt |
| Book Value | $10,240,436 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,558,041 | OtherCostOrOtherBasisAmt |
| Book Value | $1,558,041 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $36,391,196 | OtherCostOrOtherBasisAmt |
| Depreciation | $32,745,811 | DepreciationAmt |
| Book Value | $3,645,385 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,015,186 | OtherCostOrOtherBasisAmt |
| Book Value | $1,015,186 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $17,001,007 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (6 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM AFFILIATES | $1,435 |
| OTHER ASSETS | $166,298 |
| ESTIMATED INSURANCE RECOVERIES | $548,000 |
| BENEFICIAL INTEREST IN TRUSTS | $5,326,035 |
| INTEREST IN NET ASSETS OF COMMUNITY FOUNDATION OF WARREN | $148,087 |
| ASSETS LIMITED AS TO USE | $9,474,267 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $15,664,122 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| ACCRUED PENSION COSTS | $23,644,017 |
| ESTIMATED INSURANCE COSTS | $994,000 |
| DEFERRED COMPENSATION | $2,104,311 |
| ESTIMATED AMOUNTS DUE TO THIRD-PARTY PAYERS | $9,372,276 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $36,114,604 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (CODE) AND IS RECOGNIZED AS TAX EXEMPT UNDER 501(A) OF THE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED. MEDIPAR ASSOCIATES, L.P. IS A PARTNERSHIP AND, THEREFORE, IS NOT DIRECTLY SUBJECT TO INCOME TAXES UNDER THE PROVISIONS OF THE INTERNAL REVENUE CODE AND APPLICABLE STATE LAWS. HENCE, TAXABLE INCOME OR LOSS IS REPORTED TO THE INDIVIDUAL PARTNERS FOR INCLUSION IN THEIR RESPECTIVE TAX RETURNS, AND NO PROVISION FOR FEDERAL AND STATE INCOME TAXES HAS BEEN INCLUDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. GROUP MEDICAL SERVICES CORPORATION AND WEST ST. CLAIR, INC. ARE TAXABLE CORPORATIONS AND ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. GROUP MEDICAL SERVICES CORPORATION AND WEST ST. CLAIR, INC. PROVIDE FOR INCOME TAXES IN ACCORDANCE WITH THE ASSET AND LIABILITY METHOD. UNDER THIS METHOD, DEFERRED TAXES ARE DETERMINED BASED ON THE DIFFERENCE BETWEEN THE FINANCIAL STATEMENT AND THE TAX BASIS OF ASSETS AND LIABILITIES USING ENACTED TAX RATES IN EFFECT IN THE YEARS IN WHICH THE DIFFERENCES ARE EXPECTED TO REVERSE. DEFERRED TAX ASSETS ARE PROVIDED FOR OPERATING LOSSES THAT ARE AVAILABLE TO OFFSET FUTURE TAXABLE INCOME. A VALUATION ALLOWANCE IS ESTABLISHED FOR ANY DEFERRED TAX ASSET FOR WHICH REALIZATION IS NOT CONSIDERED LIKELY. THE HOSPITAL FOLLOWS THE GUIDANCE FOR ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN A COMPANY'S CONSOLIDATED FINANCIAL STATEMENTS THAT PRESCRIBES A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. GENERALLY, TAX RETURNS FOR YEARS ENDED JUNE 30, 2017, AND THEREAFTER REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. | ExplanationTxt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | HOSPITAL BALL | Event1Nm |
| Gross Receipts Event1 | $19,010 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $13,025 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $5,985 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $225 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $5,430 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $600 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $1,048 | OtherDirectExpensesEvent1Amt |
| Event2 | GOLF OUTING | Event2Nm |
| Gross Receipts Event2 | $81,998 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $64,345 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $17,653 | GrossRevenueEvent2Amt |
| Non Cash Prizes Event2 | $804 | NonCashPrizesEvent2Amt |
| Rent Facility Costs Event2 | $4,380 | RentFacilityCostsEvent2Amt |
| Food And Beverage Event2 | $4,210 | FoodAndBeverageEvent2Amt |
| Other Direct Expenses Event2 | $10,592 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 1 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $21,730 | GrossReceiptsOtherEventsAmt |
| Gross Revenue Other Events | $21,730 | GrossRevenueOtherEventsAmt |
| Non Cash Prizes Other Events | $1,100 | NonCashPrizesOtherEventsAmt |
| Gross Receipts Total | $122,738 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $77,370 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $45,368 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $1,904 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $4,605 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $9,640 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $600 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $11,640 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $28,389 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $16,979 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 300.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $74,721 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $74,721 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,355,817 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,850,710 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,505,107 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07460 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,430,538 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,850,710 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,579,828 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07560 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $56,662 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $56,662 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,110,964 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $568,320 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $542,644 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00740 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,167,626 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $568,320 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $599,306 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00820 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,598,164 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,419,030 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,179,134 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08380 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,671,861 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $167,186 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $24,784,575 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $31,895,387 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$7,110,812 | 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 (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (2 entries)
| Primary ActivitiesPrimaryActivitiesTxt | Org Profit Or OwnershipOrgProfitOrOwnershipPct | Ofcr Etc Profit Or OwnershipOfcrEtcProfitOrOwnershipPct | Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct |
|---|---|---|---|
| 1 PINEGROVE AMBULATORY | |||
| OUTPATIENT AMBULATORY SURGERY | 0.35000 | 0.11000 | 0.54000 |
| 2 MEDIPAR ASSOCIATES | |||
| REAL ESTATE FOR MEDICAL BLDG | 0.86000 | 0.14000 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | WARREN GENERAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | TWO CRESCENT PARK WEST | AddressLine1Txt |
| City | WARREN | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16365 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.WGH.ORG | WebsiteAddressTxt |
| 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 | WARREN GENERAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | 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 | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.WGH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT?Q=CHNA | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.WGH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT?Q=CHNA | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 300.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.WGH.ORG/FINANCIAL-ASSISTANCE | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.WGH.ORG/FINANCIAL-ASSISTANCE | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.WGH.ORG/FINANCIAL-ASSISTANCE | 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 |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Collection Activities | Yes (1) | CollectionActivitiesInd |
| Reporting To Credit Agency | Yes (X) | ReportingToCreditAgencyInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| WARREN GENERAL HOSPITAL | PART V, SECTION B, LINE 5: THE MAIN OBJECTIVE OF THE INTERACTION WITH COMMUNITY LEADERS WAS TO OBTAIN INFORMATION, KNOWLEDGE, AND IDEAS FROM BUSINESS LEADERS WITHIN THE COMMUNITY ABOUT THE IMPACT OF COMMUNITY HEALTH STATUS ON THEIR ABILITY TO OPERATE AND PROVIDE SERVICES IN WARREN COUNTY. THE DISCUSSION REVOLVED AROUND THREE BASIC QUESTIONS. THE QUESTIONS DEALT WITH WHAT THEIR IMPRESSION WAS OF THE ISSUES THAT WERE CURRENTLY IMPACTING THE HEALTH OF THE COMMUNITY, ENVIRONMENTAL FACTORS THAT THEY FELT WERE IMPACTING THE HEALTH OF THE COMMUNITY, AND THE ROLE OF SOCIAL DETERMINANTS IN IMPROVING HEALTH STATUS AND AVAILABLE OF A HEALTHY WORKFORCE. FINDINGS FROM THESE INTERVIEWS PROVIDED VERY REAL AND SIMILAR RESPONSES TO THE PRIOR SURVEY OF BUSINESS LEADERS. |
| WARREN GENERAL HOSPITAL | PART V, SECTION B, LINE 7D: THE CHNA WAS AVAILABLE ON THE HOSPITAL'S WEBSITE - WWW.WGH.ORG - WAS AVAILABLE IN PAPER COPY FOR PUBLIC INSPECTION AT THE HOSPITAL, AND INFORMATION ON HOW TO ACCESS THE CHNA WAS PUBLISHED ON THE WGH QUARTERLY NEWSLETTER. |
| WARREN GENERAL HOSPITAL | PART V, SECTION B, LINE 11: THE HOSPITAL DEVELOPED AN IMPLEMENTATION PLAN TO ADDRESS THE SIGNIFICANT NEEDS IDENTIFIED THROUGH ITS CHNA. AS WITH MOST HEATH CARE FACILITIES, WARREN GENERAL HOSPITAL HAS LIMITED FINANCIAL RESOURCES TO ADDRESS ALL ISSUES IDENTIFIED IN THE CHNA. |
| WARREN GENERAL HOSPITAL | PART V, SECTION B, LINE 16J: A FINANCIAL ASSISTANCE COUNSELOR IS AVAILABLE TO SPEAK WITH ELIGIBLE INDIVIDUALS REGARDING OUR FAP. |
| WARREN GENERAL HOSPITAL | PART V, SECTION B, LINE 20E: THE HOSPITAL EMPLOYS A FINANCIAL COUNSELOR WHO SPEAKS WITH ELIGIBLE INDIVIDUALS REGARDING OUR FINANCIAL ASSISTANCE POLICY. SHE ASSISTS INDIVIDUALS IN APPLYING FOR OUR STATE MEDICAL ASSISTANCE PROGRAM. |
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | A COST-TO-CHARGE RATIO CALCULATED FROM WORKSHEET 2, RATIO OF PATIENT CARE COSTS-TO-CHARGES IS THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNTS REPORTED ON PART I, LINE 7. |
| PART III, LINE 2: | PATIENT ACCOUNTS RECEIVABLE ARE REPORTED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THEY ARE DETERMINED TO BE UNCOLLECTABLE BASED UPON MANAGEMENT'S ASSESSMENT OF INDIVIDUAL ACCOUNTS. THE ALLOWANCE FOR DOUBTFUL COLLECTIONS IS ESTIMATED BASED UPON PERIODIC REVIEW OF THE ACCOUNTS RECEIVABLE AGING, PAYOR CLASSIFICATIONS, AND APPLICATION OF HISTORICAL WRITE-OFF PERCENTAGES. |
| PART III, LINE 3: | THE HOSPITAL CALCULATED AN OVERALL COST TO CHARGE RATIO USING GROSS CHARGES AND TOTAL OPERATING COSTS LESS BAD DEBT EXPENSE. THE HOSPITAL THEN REDUCED ITS BAD DEBT EXPENSE TO COST USING THIS COST TO CHARGE RATIO. |
| PART III, LINE 4: | ESTIMATES OF ALLOWANCE FOR ADJUSTMENTS INCLUDED IN NET PATIENT SERVICE REVENUE ARE DESCRIBED IN NOTES 1 AND 2. |
| PART III, LINE 8: | THE HOSPITAL'S LARGEST GOVERNMENTAL PAYER IS THE FEDERAL MEDICARE PROGRAM. THE HOSPITAL'S COSTS ARE GREATER THAN PROGRAM PAYMENTS. IT IS CLEARLY A COMMUNITY BENEFIT FOR THE HOSPITAL TO PROVIDE RURAL ACCESS TO MEDICARE BENEFICIARIES IN TERMS OF TIME, DISTANCE, AND WEATHER CONDITIONS ISSUES. THE ALLOWABLE COSTS ARE OBTAINED FROM THE FISCAL YEAR MEDICARE COST REPORT FOR EACH OF THE HOSPITAL AREAS (INPATIENT, OUTPATIENT, ETC.). |
| PART III, LINE 9B: | THE HOSPITAL CONTRACTS WITH A RECEIVABLES MANAGEMENT COMPANY TO HANDLE THE SELF-PAY ACCOUNTS RECEIVABLE FROM DAY 1 TO 120. AT DAY 61, THE RECEIVABLES MANAGEMENT COMPANY RUNS A PUBLIC DATA SEARCH ON THE INDIVIDUALS WITH OUTSTANDING ACCOUNTS AS PART OF A REQUIREMENT FOR 501(R). THE PUBLIC DATA SEARCH REPORT IS GIVEN TO OUR FINANCIAL COUNSELOR WHO FOLLOWS UP WITH THAT PATIENT IN AN EFFORT TO CHECK CHARITY ELIGIBILITY OR STATE MEDICAL ASSISTANCE PROGRAM. AFTER DAY 120 THE ACCOUNTS ARE SENT TO A COLLECTIONS AGENCY WHO AT THAT POINT REPORTS THE INDIVIDUALS TO A CREDIT AGENCY. AT DAY 366, ANY OUTSTANDING ACCOUNTS ARE SENT TO A SECOND COLLECTION AGENCY. A FINANCIAL COUNSELOR IS AVAILABLE AS WELL TO ASSIST THE INDIVIDUALS AT ANY POINT IN THE PROCESS WITH OUR FINANCIAL ASSISTANCE POLICY. |
| PART VI, LINE 2: | THE HOSPITAL CONDUCTS PERIODIC STRATEGIC PLANNING SESSIONS AND ONE FOCUS IS THE HEALTH NEEDS OF THE COMMUNITY. |
| PART VI, LINE 3: | THE FINANCIAL ASSISTANCE POLICY (FAP), PLAIN LANGUAGE SUMMARY OF THE FAP, AND FAP APPLICATION ARE AVAILABLE ON THE WEBSITE. PAPER COPIES OF THE FAP, PLAIN LANGUAGE SUMMARY OF THE FAP, AND FAP APPLICATION ARE AVAILABLE UPON REQUEST AND COPIES ARE IN THE EMERGENCY ROOM AND ADMISSIONS AREA. THE HOSPITAL HAS SIGNS THAT NOTIFY THE PATIENTS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE IN THE EMERGENCY ROOM AND ADMISSIONS AREA. NOTICES ABOUT THE FAP ARE ON PATIENT STATEMENTS. THE HOSPITAL EMPLOYES A FINANCIAL COUNSELOR TO DISCUSS FAP OPTIONS. |
| PART VI, LINE 4: | WARREN COUNTY HAS A POPULATION OF APPROXIMATELY 40,000. THE COUNTY IS A LARGE GEOGRAPHIC SIZE WITH MANY RURAL AND SMALL COMMUNITIES.17.5% OF THE POPULATION IS +65 - STATE AVERAGE 15.2%27% ADULT POPULATION SMOKES - STATE AVERAGE 23%28% ADULT OBESITY - STATE AVERAGE 28%16% POOR HEALTH - STATE AVERAGE 14%12% UNINSURED ADULTS - STATE AVERAGE 12% |
| PART VI, LINE 5: | THE HOSPITAL'S BOARD OF DIRECTORS CONSISTS OF FOURTEEN VOTING MEMBERS. TEN OF THESE MEMBERS ARE MADE UP OF INDIVIDUALS WHOM LIVE AND WORK IN THE COMMUNITY AND VOLUNTEER THEIR TIME AND SERVICES TO ASSIST IN THE GOVERNANCE OF THE ORGANIZATION. THIS SEGMENT OF THE BOARD HAS A VOTING INTEREST REPRESENTING 55% OF THE AGGREGATE VOTING INTEREST. THE REMAINING FOUR BOARD SEATS ARE APPOINTED BY THE HOSPITAL'S JOINT VENTURE PARTNER AND THEY REPRESENT 45% OF THE VOTING INTEREST. WARREN GENERAL HOSPITAL EXTENDS MEDICAL PRIVILEGES TO QUALIFIED PHYSICIANS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TIMOTHY STANTON MD | ||||||||||||||
| BOARD MEMBER | $7,666 | $0 | $0 | $0 | $252,606 | $0 | $10,462 | $0 | $0 | $0 | $270,734 | $0 | $0 | $0 |
| MASON TOOTELL MD | ||||||||||||||
| BOARD MEMBER | $223,662 | $0 | $25,000 | $0 | $28,250 | $0 | $9,036 | $0 | $0 | $0 | $285,948 | $0 | $0 | $0 |
| TREVOR M OLSEN MD | ||||||||||||||
| BOARD MEMBER | $446,151 | $0 | $34,473 | $0 | $15,362 | $0 | $13,134 | $0 | $0 | $0 | $509,120 | $0 | $0 | $0 |
| RICHARD L ALLEN | ||||||||||||||
| CEO | $372,851 | $0 | $80,000 | $0 | $84,748 | $0 | $13,396 | $0 | $0 | $0 | $550,995 | $0 | $0 | $0 |
| LOUIS LONGO | ||||||||||||||
| CFO (UNTIL 7/17/20) | $237,860 | $0 | $7,500 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $245,360 | $0 | $0 | $0 |
| JOSEPH AKIF | ||||||||||||||
| COO/CNO | $237,902 | $0 | $7,500 | $0 | $0 | $0 | $11,137 | $0 | $0 | $0 | $256,539 | $0 | $0 | $0 |
| BERNARD V EDEN MD | ||||||||||||||
| PHYSICIAN | $653,529 | $0 | $157,187 | $0 | $0 | $0 | $15,230 | $0 | $0 | $0 | $825,946 | $0 | $0 | $0 |
| NIAZ AHMED MD | ||||||||||||||
| PHYSICIAN | $483,363 | $0 | $0 | $0 | $54,000 | $0 | $16,290 | $0 | $0 | $0 | $553,653 | $0 | $0 | $0 |
| VALERIY SEDOV MD | ||||||||||||||
| PHYSICIAN | $497,850 | $0 | $0 | $0 | $25,000 | $0 | $13,119 | $0 | $0 | $0 | $535,969 | $0 | $0 | $0 |
| SIMON AMSDELL MD | ||||||||||||||
| PHYSICIAN | $515,332 | $0 | $189,526 | $0 | $104,000 | $0 | $13,571 | $0 | $0 | $0 | $822,429 | $0 | $0 | $0 |
| JUSTIN BROWER MD | ||||||||||||||
| PHYSICIAN | $351,894 | $0 | $158,646 | $0 | $77,251 | $0 | $13,146 | $0 | $0 | $0 | $600,937 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | THE FOLLOWING EMPLOYEES PARTICIPATE IN A 457(F) PLAN: RICHARD ALLEN - $43,750 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | CARE CORPORATION OF WARREN IS THE SOLE CORPORATE MEMBER OF WARREN GENERAL HOSPITAL. |
| FORM 990, PART VI, SECTION A, LINE 7A | CARE CORPORATION OF WARREN, THE PARENT COMPANY, APPOINTS THREE OF THE MEMBERS OF THE WARREN GENERAL HOSPITAL BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | SPECIFIC DECISIONS OF THE BOARD OF DIRECTORS ARE SUBJECT TO APPROVAL BY THE BOARD OF DIRECTORS OF CARE CORPORATION OF WARREN, THE PARENT COMPANY. |
| FORM 990, PART VI, SECTION B, LINE 11B | WARREN GENERAL HOSPITAL HAS A CPA FIRM PREPARE ITS FORM 990. THE RETURN IS COMPLETED IN DRAFT FORM AND REVIEWED BY MANAGEMENT OF THE ORGANIZATION. THE FORM 990 IS THEN PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW BEFORE IT IS FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH YEAR THE DIRECTORS ARE REQUIRED TO SIGN A CONFLICT OF INTEREST POLICY AND DISCLOSE ANY BUSINESS OR FAMILY RELATIONSHIPS WHICH MAY CREATE A CONFLICT. EACH BOARD OF DIRECTOR AGREES TO REFRAIN FROM VOTING ON ANY ITEM IN WHICH A CONFLICT MAY EXIST. ANNUALLY, THE CORPORATE COMPLIANCE OFFICER REVIEWS THE POLICY AND AUDITS THE SIGNATURES. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE HOSPITAL PARTICIPATES IN THE YAFFEE AND COMPANY HOSPITAL ASSOCIATION OF PENNSYLVANIA COUNCIL OF SMALL HOSPITALS EXECUTIVE COMPENSATION SURVEY. THIS INSTRUMENT SURVEYS HOSPITALS OF LIKE SIZE AND WITHIN OUR GEOGRAPHY. THE HOSPITAL BOARD CHOSE THIS INSTRUMENT DUE TO ITS RELEVANCY TO THE HOSPITAL'S MARKET. THE SURVEY DATA IS USED BY THE HOSPITAL BOARD OF DIRECTORS COMPENSATION COMMITTEE FOR COMPARISONS OF COMPENSATION AND BENEFITS FOR THE CEO AND OTHER TOP MANAGEMENT OFFICIALS. THE COMPENSATION COMMITTEE REPORTS ITS FINDINGS AND MAKES RECOMMENDATIONS TO THE FULL BOARD OF DIRECTORS FOR THEIR REVIEW, DELIBERATION, AND APPROVAL OR MODIFICATION. |
| FORM 990, PART VI, SECTION C, LINE 18 | WARREN GENERAL HOSPITAL MAKES ITS FORM 990, 990-T, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART VI, SECTION C, LINE 19 | EACH YEAR A COMBINED CORPORATE MEETING IS HELD IN WHICH THE PUBLIC IS WELCOME TO ATTEND. IN ADDITION, DOCUMENTS WILL BE MADE AVAILABLE TO THE PUBLIC IF THEY ARE REQUESTED IN PERSON OR IN WRITING. |
| FORM 990, PART IX, LINE 11G | PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 14,309,610. MANAGEMENT AND GENERAL EXPENSES 2,288,190. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,597,800. |
| FORM 990, PART XI, LINE 9: | ACCUMULATED CHANGE IN POSTRETIREMENT BENEFIT PLANS -6,973,598. PERM RESTRICTED NET ASSETS CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST -230,744. TRANSFER TO AFFILIATE -26,012. TEMP. RESTRICTED NET ASSETS INVESTMENT RETURN 80,022. NET ASSETS RELEASED FROM RESTRICTION 2,934. |
| FORM 990, PART XII, LINE 2C: | THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
| PART VI, SECTION B, LINE 16: | THE HOSPITAL BOARD OF DIRECTORS MUST ULTIMATELY APPROVE ANY INVESTMENTS IN ANY JOINT VENTURE OR SIMILAR ARRANGEMENT. AS PART OF ITS GOVERNANCE AND OVERSIGHT ROLE, THE FULL HOSPITAL BOARD ALSO SUBJECTS ANY JOINT VENTURE ARRANGEMENTS TO LEGAL REVIEW PRIOR TO ANY INVESTMENT BY THE HOSPITAL. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CARE CORPORATION OF WARREN | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2 CRESCENT PARK WEST | AddressLine1Txt |
| City | WARREN | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16365 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 251512016 | EIN |
| Primary Activities | PARENT CORP | PrimaryActivitiesTxt |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 12C, III-FI | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEDIPAR ASSOCIATES | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 103 WEST ST CLAIR ST | AddressLine1Txt |
| City | WARREN | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16365 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 251361787 | EIN |
| Primary Activities | REAL ESTATE | PrimaryActivitiesTxt |
| Legal Domicile State | PA | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WARREN GENERAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | -$16,781 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $195,804 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
| Ownership | 0.82890 | OwnershipPct |
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 | Controlled OrganizationControlledOrganizationInd | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GROUP MEDICAL SERVICES CORP | ||||||||||||
| 2 CRESCENT PARK WEST | WARREN | PA | 16365 | 232803659 | HEALTH CARE SVCS | PA | CARE CORPORATION OF WARREN | C | 0 | |||
| WEST ST CLAIR INC | ||||||||||||
| 103 WEST ST CLAIR ST | WARREN | PA | 16365 | 251601073 | REAL ESTATE | PA | WARREN GENERAL HOSPITAL | C | Yes (1) | $885 | $139,369 | 0.82500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |