2017-05-03T12:24:18-05:00 2016-06-30 550486667 ARNETT CARBIS TOOTHMAN LLP 5700 CORPORATE DRIVE STE 650 PITTSBURGH PA 15237 990 2015-07-01 251441920 SOMERSET HEALTH SERVICES INC SOME 8144435221 225 SOUTH CENTER AVENUE SOMERSET PA 15501 ANDREW RUSH CEO 8144435221 2017-04-24 1 JEFFREY J PETRELL CPA P00138808 4126356270 2017-03-27 2015 2021-01-29 14:40:06Z ANDREW RUSH 225 SOUTH CENTER AVENUE SOMERSET PA 15501 9367113 0 X WWW.SOMERSETHOSPITAL.COM X 1983 PA SOMERSET HEALTH SERVICES IS A COMMUNITY HEALTHCARE SERVICE THAT IS COMMITTED TO MANAGING AND OPERATING PRIMARY CARE AND SPECIALTY PHYSICIAN PRACTICES. 6 4 112 4 0 0 726548 727469 8221800 8631951 32 0 16824 7693 8965204 9367113 0 0 0 0 7075820 8308140 0 0 0 4992485 5384123 12068305 13692263 -3103101 -4325150 2323223 2682776 1783838 2340021 539385 342755 TO PRESERVE AND TO IMPROVE LIFE BY PROVIDING ACCESS TO QUALITY, CUSTOMER-FRIENDLY HEALTHCARE SERVICES. 0 0 11637245 8631951 SOMERSET HEALTH SERVICES MANAGES AND OPERATES PRIMARY CARE AND SPECIALTY PHYSICIAN PRACTICES. ANNUAL VISITS ARE APPROXIMATELY 66,000. SOMERSET HEALTH SERVICES ALSO MANAGES A SINGLE COUNTY AUTHORITY WHICH PROVIDES FUNDING (RECEIVED BY STATE AND FEDERAL AGENCIES) TO VARIOUS DRUG AND ALCOHOL TREATMENT CENTERS. 11637245 1 1 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 12 0 112 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 6 4 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 PA X MATTHEW KOCIOLA 8144435221 225 SOUTH CENTER AVENUE SOMERSET PA 15001 SHARON CLAPPER CHAIRMAN 1.00 1.00 X X 0 0 0 BRAD COBER TREASURER 1.00 2.00 X X 0 0 0 TROY MILLER MEMBER 1.00 X 0 0 0 TED DESKEVICH MEMBER 1.00 X 0 0 0 BRUCE SHIPLEY MEMBER 1.00 2.00 X 0 0 0 ANDREW RUSH CEO 6.00 34.00 X X 0 237169 21992 MATTHEW KOCIOLA CFO 6.00 34.00 X 0 189507 12635 CRAIG SAYLOR SOMERSET COMMUNITY HOSPITAL CEO 6.00 34.00 X 0 245992 22081 JOSE AYCINENA MD PHYSICIAN 40.00 X 467986 0 17806 V KRISHNAN NAIR MD PHYSICIAN 40.00 2.00 X 450012 0 14805 MICHAEL SOBOLEWSKI MD PHYSICIAN 40.00 1.00 X 756727 0 16588 DAVID GIRDANY MD PHYSICIAN 40.00 X 452812 0 16552 JAYESH DESAI MD PHYSICIAN 40.00 X 445702 0 18301 2573239 672668 140760 19 0 1 0 KHAMALAI LLC 2379 WOODCREST DR JOHNSTOWN PA 15905 LOCUM TENENS COVERAGE 163800 1 727469 727469 NET PATIENT REVENUE 621610 8631951 8631951 8631951 SOMERSET MGMT SERVICES 900099 7693 7693 7693 9367113 8631951 0 7693 X 7312848 5850278 1462570 27327 21862 5465 607960 486368 121592 360005 288004 72001 151402 151402 74683 74683 2413400 2308866 104534 18495 18495 103299 89441 13858 479052 461582 17470 1926 1677 249 90764 90764 72414 44099 28315 137147 136621 526 MEDICAL SUPPLIES/DRUGS 877524 877524 PROVIDER EXPENSES 455122 455122 INTERNAL BILLING COSTS 407154 407154 EQUIPMENT RENTAL & MAIN 89131 86778 2353 12610 12610 13692263 11637245 2055018 0 248351 210709 570296 743987 132198 119052 13701 33436 2048210 1663937 249039 384273 489898 497591 619740 693728 2323223 2682776 1164098 1646293 619740 693728 1783838 2340021 X 539385 342755 539385 342755 2323223 2682776 X -4325150 -653 4129173 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 248882 90872 158010 1787753 1562509 225244 11575 10556 1019 384273 INVESTMENT IN SOMERSET MANAGEMENT SERVICES, INC. 497591 C 497591 HELD BY TRUSTEE 693728 693728 HELD BY TRUSTEE 693728 693728 0 0 0 0 0 1 0 0 0 ANDREW RUSH CEO 0 216169 0 21000 0 0 0 4887 0 17105 0 259161 0 0 MATTHEW KOCIOLA CFO 0 172507 0 17000 0 0 0 3819 0 8816 0 202142 0 0 CRAIG SAYLOR SOMERSET COMMUNITY HOSPITAL CEO 0 224492 0 21500 0 0 0 5003 0 17078 0 268073 0 0 JOSE AYCINENA MD PHYSICIAN 437963 0 30023 0 0 0 0 0 17806 0 485792 0 0 0 V KRISHNAN NAIR MD PHYSICIAN 450012 0 0 0 0 0 0 0 14805 0 464817 0 0 0 MICHAEL SOBOLEWSKI MD PHYSICIAN 736727 0 20000 0 0 0 0 0 16588 0 773315 0 0 0 DAVID GIRDANY MD PHYSICIAN 442812 0 10000 0 0 0 0 0 16552 0 469364 0 0 0 JAYESH DESAI MD PHYSICIAN 445702 0 0 0 0 0 0 0 18301 0 464003 0 0 0 PART I, LINE 3 SOMERSET HEALTH SERVICES' MANAGEMENT IS EMPLOYED BY SOMERSET COMMUNITY HOSPITAL. SOMERSET COMMUNITY HOSPITAL'S LEADERSHIP COMMITTEE, WHICH IS A SUBCOMMITTEE OF THE BOARD OF DIRECTORS, ANNUALLY REVIEWS AND APPROVES THE COMPENSATION OF THEIR ORGANIZATION'S TOP MANAGEMENT. PART I, LINE 6 PHYSICIANS MAY BE GRANTED ADDITIONAL COMPENSATION DEPENDENT ON THE ACHIEVING OF CERTAIN INDICATORS BY THE COMPANY FORM 990, PART VI, SECTION B, LINE 11 SOMERSET HEALTH SERVICES, INC. HAS A CPA FIRM PREPARE ITS FORM 990. THE RETURN IS COMPLETED IN DRAFT FORM AND REVIEWED BY MANAGEMENT OF THE ORGANIZATION. THE RETURN IS THEN FINALIZED AND THE BOARD IS PROVIDED A COPY OF THE FORM 990 BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C SOMERSET HEALTH SERVICES, INC. ANNUALLY REQUIRES ITS BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES TO FILL OUT A CONFLICTS OF INTEREST FORM. DURING BOARD MEETINGS, IF AN INTERESTED PARTY HAS A CONFLICT, HE OR SHE RECUSES THEMSELVES FROM VOTING. FORM 990, PART VI, SECTION B, LINE 15 SOMERSET HEALTH SERVICES' MANAGEMENT IS EMPLOYED BY SOMERSET COMMUNITY HOSPITAL. SOMERSET COMMUNITY HOSPITAL'S LEADERSHIP COMMITTEE, WHICH IS A SUBCOMMITTEE OF THE BOARD OF DIRECTORS, ANNUALLY REVIEWS AND APPROVES THE COMPENSATION OF THEIR ORGANIZATION'S TOP MANAGEMENT. FORM 990, PART VI, SECTION C, LINE 18 SOMERSET HEALTH SERVICES, INC. MAKES ITS FORM 990 AND FORM 1023 AVAILABLE TO THE PUBLIC. FORM 990, PART VI, SECTION C, LINE 19 AT THIS TIME, SOMERSET HEALTH SERVICES, INC. DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND CONSOLIDATED FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,308,866. MANAGEMENT AND GENERAL EXPENSES 104,534. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,413,400. FORM 990, PART XI, LINE 9: TRANSFERS FROM AFFILIATES 4,052,955. DONATION FROM PURCHASE OF GADAPARTHI SUITE 76,218. FORM 990, PART XII, LINE 2C: SOMERSET COMMUNITY HOSPITAL, A TAX-EXEMPT AFFILIATE OF SOMERSET HEALTH SERVICES, INC. HAS A FINANCE COMMITTEE THAT IS RESPONSIBLE FOR THE OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT AUDITORS ON BEHALF OF SOMERSET HEALTH SERVICES, INC. THE PROCESS IS CONSISTENT WITH PRIOR YEARS AND HAS NOT CHANGED. SOMERSET COMMUNITY HOSPITAL 225 SOUTH CENTER AVENUE SOMERSET PA 15501 250965570 HEALTH CARE PA 501(C)(3) 509(A)(1) SOMERSET COMMUN HOSP FOUNDATION 0 SOMERSET COMMUNITY HOSPITAL FOUNDATION 225 SOUTH CENTER AVENUE SOMERSET PA 15501 251441863 HEALTH CARE PA 501(C)(3) 509(A)(3) 0 TWIN LAKES CENTER INC 225 SOUTH CENTER AVENUE SOMERSET PA 15501 232910318 HEALTH CARE PA 501(C)(3) 509(A)(1) SOMERSET COMMUNITY HOSPITAL 0 SOMERSET MANAGEMENT SERVICES INC 225 SOUTH CENTER AVENUE SOMERSET PA 15501 251512960 REAL ESTATE HOLDING COMPANY PA SOMERSET HEALTH SERVICES INC C 92266 2238225 1.00000 1 SOMERSET ANESTHESIA INC 225 SOUTH CENTER AVENUE SOMERSET PA 15501 455135437 ANESTHESIA SERVICES PA SOMERSET COMMUNITY HOSPITAL C 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 1 SOMERSET MANAGEMENT SERVICES INC K 150000