ROBERT PACKER HOSPITAL: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- ROBERT PACKER HOSPITAL (EIN 24-0795463)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-05-12
- IRS object ID
- 201721329349304007
- Schema version
- 2015v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-05-12T12:48:50-05:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PricewaterhouseCoopers LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2001 MARKET ST SUITE 1800 | AddressLine1Txt |
| City | PHILADELPHIA | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 19103 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 240795463 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROBERT PACKER HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % MICHELE SISTO | InCareOfNm |
| Business Name Control | ROBE | BusinessNameControlTxt |
| Phone | 5708874625 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE GUTHRIE SQUARE | AddressLine1Txt |
| City | SAYRE | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 18840 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PAUL VERVALIN | PersonNm |
| Person Title | COO | PersonTitleTxt |
| Phone | 5708874625 | PhoneNum |
| Signature | 2017-05-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ANTONIO C RUSSO | PreparerPersonNm |
| PTIN | P00858539 | PTIN |
| Phone | 2673303000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARIE DROEGE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | GUTHRIE SQUARE | AddressLine1Txt |
| City | SAYRE | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 18840 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $502,924,968 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.GUTHRIE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1885 | FormationYr |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Activity Or Mission | THE PROVISION OF CHARITABLE HEALTHCARE SERVICES TO RESIDENTS OF THE SURROUNDING COMMUNITY ON AN IN-PATIENT AND OUT-PATIENT BASIS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 2074 | TotalEmployeeCnt |
| Total Volunteers | 121 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $80,604 | PYContributionsGrantsAmt |
| CY Contributions Grants | $657,886 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $296,590,851 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $303,819,785 | CYProgramServiceRevenueAmt |
| PY Investment Income | $16,979,589 | PYInvestmentIncomeAmt |
| CY Investment Income | $17,847,420 | CYInvestmentIncomeAmt |
| PY Other Revenue | $11,048,622 | PYOtherRevenueAmt |
| CY Other Revenue | $12,781,452 | CYOtherRevenueAmt |
| PY Total Revenue | $324,699,666 | PYTotalRevenueAmt |
| CY Total Revenue | $335,106,543 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $73,750 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $127,425 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $95,875,632 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $102,988,872 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $167,470,814 | PYOtherExpensesAmt |
| CY Other Expenses | $183,006,450 | CYOtherExpensesAmt |
| PY Total Expenses | $263,420,196 | PYTotalExpensesAmt |
| CY Total Expenses | $286,122,747 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $61,279,470 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $48,983,796 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $577,137,977 | TotalAssetsBOYAmt |
| Total Assets EOY | $602,937,360 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $200,786,101 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $198,641,511 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $376,351,876 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $404,295,849 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE PROVISION OF CHARITABLE HEALTHCARE SERVICES TO RESIDENTS OF THE SURROUNDING COMMUNITY ON AN IN-PATIENT AND OUT-PATIENT BASIS. APPROXIMATELY 14,817 PATIENTS WERE ADMITTED TO RPH IN FYE 6/30/16. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $195,480,672 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $306,127,887 | RevenueAmt |
| Desc | ROBERT PACKER HOSPITAL PROVIDES HEALTHCARE SERVICES TO RESIDENTS OF THE SURROUNDING COMMUNITY ON AN IN-PATIENT AND OUT-PATIENT BASIS. APPROXIMATELY 14,817 PATIENTS WERE ADMITTED TO THE HOSPITAL IN FYE 6/30/2016. PATIENT DAYS TOTALED 65,523. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $11,527,824 | ExpenseAmt |
| Grant | $127,425 | GrantAmt |
| Revenue | $346,247 | RevenueAmt |
| Desc | ROBERT PACKER HOSPITAL PROVIDES EDUCATIONAL SERVICES TO ITS EMPLOYEES AND MEMBERS OF THE COMMUNITY. THE FOLLOWING EDUCATIONAL SERVICES ARE PROVIDED: 1) X-RAY TECHNOLOGY; 2) RESPIRATORY THERAPY; 3) MEDICAL RESIDENTS & STUDENTS; 4) LABORATORY TECHNOLOGY; AND 5) ROBERT PACKER SCHOOL OF NURSING IN CONJUNCTION WITH MANSFIELD UNIVERSITY. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $207,008,496 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (true) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (true) | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 1 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 2074 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | 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 | MICHELE SISTO | PersonNm |
| Phone | 5708874625 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE GUTHRIE SQUARE | AddressLine1Txt |
| City | SAYRE | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 18840 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| MARIE DROEGE | |||||||||
| PRESIDENT & COO | 34.8 | 5.2 | Yes (X) | Yes (X) | $466,672 | $0 | $21,600 | ||
| DAVID LR GIBBS | |||||||||
| MEMBER BOD | 1.0 | 0.2 | Yes (X) | $0 | $0 | $0 | |||
| JOSEPH R JOYCE | |||||||||
| CHAIRMAN BOD | 1.0 | 2.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DANIEL J BROWN MD | |||||||||
| MEMBER BOD | 1.0 | 39.0 | Yes (X) | $0 | $475,434 | $27,236 | |||
| RHONDA G MOSS-TATICH | |||||||||
| SECRETARY/TREASURER BOD | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DONALD FERRARIO | |||||||||
| MEMBER BOD | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| THOMAS VANDERMEER MD | |||||||||
| MEMBER BOD | 1.0 | 39.0 | Yes (X) | $0 | $470,011 | $33,354 | |||
| SEAN NICHOLSON | |||||||||
| MEMBER BOD | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| DOUGLAS G RICH | |||||||||
| MEMBER BOD | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| DANIEL SPORN MD | |||||||||
| MEMBER BOD | 1.0 | 39.0 | Yes (X) | $0 | $595,523 | $33,354 | |||
| GAIL ORCHARD | |||||||||
| MEMBER BOD | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| JACKSON C FAULKNER | |||||||||
| MEMBER BOD | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| JOSEPH A SCOPELLITI MD | |||||||||
| MEMBER BOD | 1.0 | 39.0 | Yes (X) | $0 | $810,143 | $27,616 | |||
| RICHARD T RYNONE | |||||||||
| MEMBER BOD | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| SARAH RANSOM | |||||||||
| MEMBER BOD | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| DEBRA RYAN MD | |||||||||
| MEMBER BOD | 1.0 | 39.0 | Yes (X) | $0 | $201,324 | $29,533 | |||
| MINH DANG | |||||||||
| RPH CFO | 39.0 | 1.0 | Yes (X) | $0 | $258,816 | $31,205 | |||
| BONNIE ONOFRE | |||||||||
| VP, CHIEF NURSING OFFICER | 40.0 | 0.0 | $207,949 | $0 | $24,853 | Yes (X) | |||
| BARBARA PENNYPACKER | |||||||||
| VP SURGICAL SERVICES | 40.0 | 0.0 | $167,704 | $0 | $23,372 | Yes (X) | |||
| JOSEPH SAWYER | |||||||||
| VP IMAGING & ANCILLARY TESTING | 40.0 | 0.0 | $174,002 | $0 | $26,589 | Yes (X) | |||
| BRIAN FILLIPO MD | |||||||||
| EVP-CHIEF MED QUALITY OFFICER | 40.0 | 0.0 | $0 | $437,368 | $26,291 | Yes (X) | |||
| MARC HARRIS | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $492,246 | $0 | $35,885 | Yes (X) | |||
| JAMES RAFTIS | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $447,117 | $0 | $33,354 | Yes (X) | |||
| GEORGE ELLIS | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $405,729 | $0 | $35,885 | Yes (X) | |||
| CHARLES MCGURK | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $385,888 | $0 | $34,679 | Yes (X) | |||
| MICHAEL GUM | |||||||||
| DIRECTOR, SYSTEM PHARMACY | 40.0 | 0.0 | $178,546 | $0 | $16,551 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,925,853 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,248,619 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $461,357 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 52 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| WELLIVER MCGUIRE INC | |||||
| 250 NORTH GENESEE STREET | MONTOUR FALLS | NY | 14865 | CONTRACTOR SERVICES | $2,240,626 |
| ZF ENERGY DEVELOPMENT LLC | |||||
| 55 WEST AVENUE | WAYNE | PA | 19087 | CONTRACTOR SERVICES | $1,644,623 |
| KIMBLE INCORPORATED | |||||
| 1004 SULLIVAN STREET | ELMIRA | NY | 14901 | CONTRACTOR SERVICES | $1,132,404 |
| AMN HEALTHCARE INC | |||||
| 2735 COLLECTIONS DRIVE | CHICAGO | IL | 60693 | HEALTH PROF SERVICES | $1,079,290 |
| EXECUTIVE HEALTH RESOURCES INC | |||||
| 3797 MOMENTUM PLACE | CHICAGO | IL | 60689 | HEALTH PROF SERVICES | $702,785 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 24 | CntrctRcvdGreaterThan100KCnt |
| Info In Schedule O Part VIII | Yes (X) | InfoInScheduleOPartVIIIInd |
| Related Organizations | $26,410 | RelatedOrganizationsAmt |
| Government Grants | $344,809 | GovernmentGrantsAmt |
| All Other Contributions | $286,667 | AllOtherContributionsAmt |
| Total Contributions | $657,886 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUES | 621990 | $156,602,488 | $156,602,488 |
| EDUCATIONAL SERVICES | 611600 | $346,247 | $346,247 |
| MEDICARE AND MEDICAID PAYMENTS | 621990 | $146,871,050 | $146,871,050 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $303,819,785 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,574,538 | TotalRevenueColumnAmt |
| Exclusion | $6,574,537 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $11,700 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $9,999 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,701 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,701 | TotalRevenueColumnAmt |
| Exclusion | $1,701 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $169,759,600 | SecuritiesAmt |
| Other | $9,321,708 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $167,630,149 | SecuritiesAmt |
| Other | $178,277 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,129,451 | SecuritiesAmt |
| Other | $9,143,431 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,272,882 | TotalRevenueColumnAmt |
| Exclusion | $11,272,882 | ExclusionAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| MEANINGFUL USE/MITIGATION/STABILITY | 900099 | $2,654,349 | $2,654,349 | |
| ALL OTHER REVENUE | 900099 | $10,125,402 | $10,125,402 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $12,779,751 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $335,106,543 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $306,474,134 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $27,974,522 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $127,425 | TotalAmt |
| Program Services | $127,425 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,112,742 | TotalAmt |
| Program Services | $191,077 | ProgramServicesAmt |
| Management And General | $921,665 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $82,942,440 | TotalAmt |
| Program Services | $69,794,028 | ProgramServicesAmt |
| Management And General | $13,148,412 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,900,062 | TotalAmt |
| Program Services | $1,583,297 | ProgramServicesAmt |
| Management And General | $316,765 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,822,490 | TotalAmt |
| Program Services | $8,625,084 | ProgramServicesAmt |
| Management And General | $2,197,406 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,211,138 | TotalAmt |
| Program Services | $5,175,659 | ProgramServicesAmt |
| Management And General | $1,035,479 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,476,599 | TotalAmt |
| Program Services | $3,243,092 | ProgramServicesAmt |
| Management And General | $11,233,507 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $138,063 | TotalAmt |
| Management And General | $138,063 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,940,354 | TotalAmt |
| Management And General | $1,940,354 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,419 | TotalAmt |
| Management And General | $22,419 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,687,857 | TotalAmt |
| Program Services | $34,706,060 | ProgramServicesAmt |
| Management And General | $4,981,797 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,892 | TotalAmt |
| Program Services | $41,751 | ProgramServicesAmt |
| Management And General | $2,141 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,277,172 | TotalAmt |
| Program Services | $4,157,448 | ProgramServicesAmt |
| Management And General | $10,119,724 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,105,091 | TotalAmt |
| Program Services | $1,389,697 | ProgramServicesAmt |
| Management And General | $5,715,394 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,416,367 | TotalAmt |
| Program Services | $861,639 | ProgramServicesAmt |
| Management And General | $3,554,728 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $420,039 | TotalAmt |
| Program Services | $369,990 | ProgramServicesAmt |
| Management And General | $50,049 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $285,300 | TotalAmt |
| Program Services | $242,964 | ProgramServicesAmt |
| Management And General | $42,336 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,769,322 | TotalAmt |
| Program Services | $2,152 | ProgramServicesAmt |
| Management And General | $5,767,170 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,868,020 | TotalAmt |
| Program Services | $36,059 | ProgramServicesAmt |
| Management And General | $16,831,961 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $212,462 | TotalAmt |
| Program Services | $427,434 | ProgramServicesAmt |
| Management And General | -$214,972 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $75,096,007 | $75,023,294 | $72,713 |
| OTHER EXPENSES | $1,419,380 | $612,121 | $807,259 |
| CAFETERIA/CATERING | $576,569 | $398,225 | $178,344 |
| ACCRETION EXPENSE | $251,537 | $0 | $251,537 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $286,122,747 | TotalAmt |
| Program Services | $207,008,496 | ProgramServicesAmt |
| Management And General | $79,114,251 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,327,536 | BOYAmt |
| EOY | $6,642,421 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,158,747 | BOYAmt |
| EOY | $34,104,607 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,615,722 | BOYAmt |
| EOY | $7,123,737 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,674,847 | BOYAmt |
| EOY | $6,099,135 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $294,333,316 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $194,232,045 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $102,126,058 | BOYAmt |
| EOY | $100,101,271 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $376,833,930 | BOYAmt |
| EOY | $384,997,311 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,402,110 | BOYAmt |
| EOY | $50,910,093 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,999,027 | BOYAmt |
| EOY | $12,958,785 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $577,137,977 | BOYAmt |
| EOY | $602,937,360 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,829,318 | BOYAmt |
| EOY | $36,025,377 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,119 | BOYAmt |
| EOY | $72,602 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,515,000 | BOYAmt |
| EOY | $47,015,000 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $116,381,664 | BOYAmt |
| EOY | $115,528,532 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $200,786,101 | BOYAmt |
| EOY | $198,641,511 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $369,473,515 | BOYAmt |
| EOY | $397,603,418 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,394,537 | BOYAmt |
| EOY | $5,206,407 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,483,824 | BOYAmt |
| EOY | $1,486,024 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $376,351,876 | BOYAmt |
| EOY | $404,295,849 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $577,137,977 | BOYAmt |
| EOY | $602,937,360 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $48,983,796 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$14,479,830 | NetUnrlzdGainsLossesInvstAmt |
| Investment Expense | -$1,173,371 | InvestmentExpenseAmt |
| Other Changes In Net Assets | -$5,386,622 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $22,419 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $22,419 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1I | FormAndLineReferenceDesc |
| Explanation | DETAIL OF OTHER LOBBYING ACTIVITITES AMOUNT REPRESENTS MEMBERSHIPS IN AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE HOSPITAL & HEALTH SYSTEM ASSOCIATION OF PENNSYLVANIA (HAP) | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $947,484 | OtherCostOrOtherBasisAmt |
| Book Value | $947,484 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $164,382,709 | OtherCostOrOtherBasisAmt |
| Depreciation | $101,564,547 | DepreciationAmt |
| Book Value | $62,818,162 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,050,210 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,325,130 | DepreciationAmt |
| Book Value | $1,725,080 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $118,049,061 | OtherCostOrOtherBasisAmt |
| Depreciation | $87,216,385 | DepreciationAmt |
| Book Value | $30,832,676 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,903,852 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,125,983 | DepreciationAmt |
| Book Value | $3,777,869 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $100,101,271 | TotalBookValueLandBuildingsAmt |
| Financial Derivatives | FinancialDerivativesGrp | |
| Closely Held Equity Interests | CloselyHeldEquityInterestsGrp |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INVESTMENT IN POOLED FUNDS | Desc |
| Book Value | $50,910,093 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $50,910,093 | TotalBookValueSecuritiesAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)
| DescDesc | AmtAmt |
|---|---|
| ESTIMATED THIRD PARTY PAYABLE | $4,291,072 |
| RPH AUXILARY INVESTMENTS | $63,904 |
| ASSET RETIREMENT OBLIGATION | $5,235,029 |
| SWAP CONTRACT PAYABLE 2007 | $177,564 |
| SWAP CONTRACT PAY FMV 2007 | $22,789,734 |
| LOAN PAY-GH TAX EXEMPT BONDS | $82,935,056 |
| CAPITAL LEASE | $36,173 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $115,528,532 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PART X, LINE 2 | FormAndLineReferenceDesc |
| Explanation | TEXT OF FIN 48 DISCLOSURE Accounting principles generally accepted in the United States of America require the Corporation to evaluate tax positions taken by the Corporation and recognize a tax liability (or asset) if the Corporation has taken an uncertain position that more likely than not would be sustained upon examination by the Internal Revenue Service. The Corporation has concluded that as of June 30, 2016 and 2015, there are no uncertain positions taken or expected to be taken that would require recognition of a liability (or asset) or disclosure in the consolidated financial statements. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $622,484 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $523,543 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $98,941 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $37,017,707 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $22,895,254 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $14,122,453 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04940 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $37,640,191 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $23,418,797 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $14,221,394 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04970 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $378,571 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $378,571 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,104,521 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,780,481 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,324,040 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02910 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,636,727 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,655,090 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $981,637 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00340 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $17,119,819 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,435,571 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,684,248 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03380 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $54,760,010 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $30,854,368 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $23,905,642 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08350 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $23,699,040 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $2,369,904 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $89,293,296 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $103,918,908 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$14,625,612 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROBERT PACKER HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | GUTHRIE SQUARE | AddressLine1Txt |
| City | SAYRE | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 18840 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.GUTHRIE.ORG | WebsiteAddressTxt |
| State License | LICENSE# 440601 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROBERT PACKER HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE SUPPLEMENTAL DISCLOSURE | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE SUPPLEMENTAL DISCLOSURE | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300. | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| 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 (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE SUPPLEMENTAL DISCLOSURE | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE SUPPLEMENTAL DISCLOSURE | FAPAppAvailableOnWebsiteURLTxt |
| 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 |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, SECTION B, LINE 5- INPUT FROM COMMUNITY | THE ROBERT PACKER HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT BEGAN WITH A REVIEW OF PRIMARY DATA SOURCES, SPECIFICALLY SURVEY AND FOCUS GROUP DATA THAT HAD BEEN COLLECTED THROUGHOUT 2015 AND EARLY 2016. DUE TO THE LIMITATIONS SURROUNDING HEALTH NEEDS PERCEPTIONS CONTAINED IN THE COLLECTED INFORMATION FROM THE FOUR COUNTIES, SECONDARY DATA SOURCES WERE HEAVILY USED FOR THIS ASSESSMENT. THE SECONDARY DATA SOURCES INCLUDED THE MOST RECENT COUNTY HEALTH RANKINGS AND DATA COLLECTED THROUGH THE STRATEGIC PLANNING AND MARKETING DEPARTMENT (DEMOGRAPHIC INFORMATION, DISCHARGE DATA, ETC). RECENT INDICATORS OF HEALTH WERE COLLECTED FROM COMMUNITY COMMONS AND COMPARED TO COUNTY, STATE, NATIONAL AND HEALTHY PEOPLE 2020 REFERENCE DATA. ALL INFORMATION WAS ASSEMBLED AND A 32 PERSON, CHNA GROUP CONSISTING OF COMMUNITY MEMBERS, HEALTH CARE PROVIDERS (PHYSICIANS AND NURSES), ADMINISTRATORS AND AN INDIVIDUAL WITH EXPERIENCE IN PUBLIC HEALTH WAS INVITED TO REVIEW THE FINDINGS. THE DATA WAS STRATIFIED INTO THREE CATEGORIES WHICH INCLUDED CLINICAL CARE, HEALTH BEHAVIORS AND HEALTH OUTCOMES. WITHIN THE FOUR COUNTIES THAT COMPRISE THE PRIMARY SERVICE AREA FOR RPH, FORTY-ONE INDICATORS OF HEALTH WERE IDENTIFIED TO BE WORSE THAN THE STATE, US OR HEALTHY PEOPLE 2020 GOAL. ONCE THESE FORTY-ONE INDICATORS WERE IDENTIFIED, THEY WERE PRIORITIZED BY EACH INDIVIDUAL MEMBER OF THE CHNA GROUP. IN ADDITION TO THE CHNA GROUP, THIS REPORT IN ITS ENTIRETY WILL BE SHARED DURING REGULAR MEETINGS THROUGHOUT 2017 AND 2018 WITH THE S2AY RURAL HEALTH NETWORK, EAST CENTRAL DIVISION OF THE AMERICAN CANCER SOCIETY, TIOGA PARTNERSHIP FOR COMMUNITY HEALTH, AND THE CHEMUNG, SCHUYLER, AND STEUBEN HEALTH DEPARTMENTS FOR THEIR REVIEW, INPUT, AND SOLICITATION OF WRITTEN COMMENTS. --------------- |
| PART V, SECTION B, LINE 6A- JOINT CHNA | ROBERT PACKER HOSPITAL'S CHNA WAS CONDUCTED JOINTLY WITH TROY COMMUNITY HOSPITAL AND CORNING HOSPITAL, AFFILIATED IRC SECTION 501(c)(3) TAX EXEMPT HOSPITAL ORGANIZATIONS. --------------- |
| PART V, SECTION B, LINE 7 & 10- CHNA & IMP. PLAN PUBLIC AVAILABILITY | A COPY OF THE ORGANIZATION'S CHNA CAN BE FOUND AT: https://www.guthrie.org/sites/default/files/RPH_CHNA_July2016.pdf A COPY OF THE ORGANIZATION'S IMPLEMENTATION PLAN CAN BE FOUND AT: https://www.guthrie.org/sites/default/files/2016%20Implementation%20Plans% 20Robert%20Packer%20Hospital.pdf -------------------- |
| PART V, SECTION B, LINE 11- ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA | FOR A COMPLETE DESCRIPTION ON HOW THE ORGANIZATION IS ADDRESSING THE NEEDS IDENTIFIED IN THE MOST RECENTLY COMPLETED CHNA (JUNE 2016), SEE THE FOLLOWING: https://www.guthrie.org/sites/default/files/2016%20Implementation%20Plans% 20Robert%20Packer%20Hospital.pdf DUE TO RESOURCE LIMITATIONS, THE FOLLOWING IDENTIFIED NEEDS WERE NOT ABLE TO BE ADDRESSED IN THE IMPLEMENTATION PLAN: * ACCESS TO PRIMARY CARE * DIABETES (ADULT POPULATION) -------------------- |
| PART V, SECTION B, LINE 16A & 16B FAP PUBLIC AVAILABILITY | A COPY OF THE ORGANIZATION'S FAP AND FAP APPLICATION CAN BE FOUND AT: https://www.guthrie.org/content/financial-assistance -------------------- |
| PART V, SECTION B, LINE 22(D)- DETAIL OF MAXIMUM CHARGES | ALL PATIENTS ARE BILLED BASED ON THE CHARGES ESTABLISHED IN THE HOSPITAL'S CHARGEMASTER. DISCOUNTS ARE GIVEN IN ACCORDANCE WITH THE FINANCIAL ASSISTANCE POLICY FOR THOSE WHO ARE UNINSURED. A PROMPT PAY DISCOUNT IS GIVEN TO THOSE WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE. ADDITIONAL DISCOUNTS ARE CONSIDERED ON A CASE BY CASE BASIS DEPENDING ON THE PATIENT'S SITUATION AND THE TOTAL AMOUNT DUE TO THE HOSPITAL. UNINSURED PATIENTS OF ROBERT PACKER HOSPITAL THAT QUALIFY FOR ASSISTANCE UNDER THE FAP ARE CHARGED BASED UPON INCOME ELIGIBILITY WHEREBY THE FOLLOWING GUIDELINES ARE APPLIED: INCOME AS % OF FPG 0-100% 101-200% 201-300% % OF CHARGE WRITTEN OFF 100% 80% 50% -------------------- |
| PART V, SECTION B, LINES 15-22 - IRC SECTION 501(R) REGULATIONS | PLEASE NOTE THAT THIS ORGANIZATION'S TAX YEAR BEGAN JULY 1, 2015, WHILE THE FINAL REGULATIONS UNDER IRC SECTION 501(R) WERE EFFECTIVE FOR TAX YEARS BEGINNING AFTER DECEMBER 29, 2015. AS A RESULT, THIS ORGANIZATION WAS IN COMPLIANCE WITH THE FINAL IRC SECTION 501(R) REGULATIONS AS OF 7/1/2016. |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SUPPLEMENTAL INFORMATION | PART I, LINE 7- COSTING METHODOLOGY USED INFORMATION REPORTED ON THE SCHEDULE H, PART I, LINE 7 TABLE WAS DERIVED UTILIZING THE RATIO OF COST TO CHARGES CALCULATED USING WORKSHEET 2, EXCEPT LINE 7E, WHICH WAS TAKEN FROM THE MEDICARE COST REPORT, AND LINE 7G, WHICH WAS CALCULATED BASED UPON AN INTERNAL COST ACCOUNTING SYSTEM. WITHIN THE COST ACCOUNTING SYSTEM, SOME PATIENT SEGMENTS WERE BASED ON A RATIO OF COST TO CHARGE - TOTAL DEPARTMENTAL EXPENSE PLUS ALLOCATED OVERHEAD SPREAD BASED ON CHARGES. -------------------- |
| PART III, SECTION A, LINE 2- BAD DEBT EXPENSE | THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON LINES 2 AND 3 ARE BASED ON ACTUAL CHARGES WRITTEN OFF (AMOUNTS THAT ARE DEEMED TO BE UNCOLLECTIBLE). -------------------- PART III, SECTION A, LINE 4- BAD DEBT EXPENSE FOOTNOTE THE TEXT OF THE BAD DEBT FOOTNOTE CAN BE FOUND ON PAGE 13 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. -------------------- |
| PART III, SECTION B, LINE 8- COSTING METHODOLOGY, MEDICARE SHORTFALL | THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNT REPORTED ON LINE 6 IS BASED ON THE THE HOSPITAL'S MEDICARE COST REPORT FILING FOR THE YEAR. CONSISTENT WITH THE CHARITABLE HEALTHCARE MISSION OF ROBERT PACKER HOSPITAL AND THE COMMUNITY BENEFIT STANDARD SET FORTH IN IRS REVENUE RULING 69-545, THE HOSPITAL PROVIDES CARE FOR ALL PATIENTS COVERED BY MEDICARE SEEKING MEDICAL CARE AT THE HOSPITAL. SUCH CARE IS PROVIDED REGARDLESS OF WHETHER THE REIMBURSEMENT PROVIDED FOR SUCH SERVICES MEETS OR EXCEEDS THE COSTS INCURRED BY THE ROBERT PACKER HOSPITAL TO PROVIDE SUCH SERVICES. AS A RESULT, THE HOSPITAL VIEWS ANY SHORTFALL REPORTED IN LINE 7 AS AN ADDITIONAL ITEM OF COMMUNITY BENEFIT PROVIDED BY THE ORGANIZATION. -------------------- |
| PART III, SECTION B, LINE 9B- COLLECTION POLICY PRACTICES | ONCE A PATIENT IS APPROVED FOR CHARITY CARE OR AN INSTALLMENT PLAN, THEIR ACCOUNT IS TRANSFERRED TO EITHER THE BUDGET OR CHARITY CARE FINANCIAL CLASS. ACCOUNTS IN THESE FINANCIAL CLASSES ARE NOT PLACED WITH COLLECTION. -------------------- |
| PART VI, LINE 2- NEEDS ASSESSMENT | ROBERT PACKER HOSPITAL AND THE GUTHRIE CLINIC EMPHASIZE PRIMARY HEALTH CARE SERVICES, HEALTH PROMOTION, AND CHRONIC DISEASE PREVENTION AND MANAGEMENT FOR THE COMMUNITY WE SERVE. RPH'S OVERALL APPROACH TO COMMUNITY BENEFIT IS TO EXAMINE THE INTERSECTION OF DOCUMENTED UNMET COMMUNITY NEEDS AND MATCH THESE NEEDS WITH ORGANIZATIONAL STRENGTHS. THESE UNMET COMMUNITY NEEDS CAN BE DEFINED AS A DISCREPANCY OR GAP BETWEEN WHAT IS CURRENTLY AVAILABLE AND WHAT THE COMMUNITY DESIRES. THE OVERARCHING GOALS OF THIS COMMUNITY HEALTH NEEDS ASSESSMENT ARE TO (1) IDENTIFY STRENGTHS AND LIMITATION WITHIN RPH'S SERVICE AREA; (2) DEFINE THE NEEDS AND ASSETS ASSOCIATED WITH THE COMMUNITY WE SERVE; (3) DESCRIBE RESOURCES SUCH AS HEALTH PROFESSIONALS, REGIONAL ECONOMICS AND COMMUNICATION NETWORKS WHOSE GOAL IS TO MAXIMIZE COMMUNITY HEALTH. THE IDENTIFIED NEEDS WILL RESULT IN THE FORMATION OF AN IMPLEMENTATION PLAN THAT WILL BUILD UPON THE CONTINUUM OF CARE CURRENTLY OFFERED AT RPH BY CLEARLY LINKING OUR CLINICAL SERVICES WITH OUR COMMUNITY-BASED SERVICES THROUGH THIS COMMUNITY BENEFIT PROCESS. THE IMPLEMENTED COMMUNITY BENEFIT PLAN WILL BE INTEGRATED INTO THE STRATEGIC ORGANIZATIONAL GOALS OF RPH. THE PLAN PROGRESS WILL BE MONITORED TO ENSURE TIMELY IMPLEMENTATION. FURTHER COLLABORATIVE PARTNERSHIPS WILL BE INTEGRAL TO THE SUCCESS OF THE PLAN. THE RPH COMMUNITY HEALTH NEEDS ASSESSMENT BEGAN WITH A REVIEW OF PRIMARY DATA SOURCES, SPECIFICALLY SURVEY AND FOCUS GROUP DATA THAT HAD BEEN COLLECTED THROUGHOUT 2015 AND EARLY 2016. DUE TO THE LIMITATIONS SURROUNDING HEALTH NEEDS PERCEPTIONS CONTAINED IN THE COLLECTED INFORMATION FROM THE FOUR COUNTIES, SECONDARY DATA SOURCES WERE HEAVILY USED FOR THIS ASSESSMENT. THE SECONDARY DATA SOURCES INCLUDED THE MOST RECENT COUNTY HEALTH RANKINGS AND DATA COLLECTED THROUGH THE STRATEGIC PLANNING AND MARKETING DEPARTMENT (DEMOGRAPHIC INFORMATION, DISCHARGE DATA, ETC). RECENT INDICATORS OF HEALTH WERE COLLECTED FROM COMMUNITY COMMONS AND COMPARED TO COUNTY, STATE, NATIONAL AND HEALTHY PEOPLE 2020 REFERENCE DATA. ALL INFORMATION WAS ASSEMBLED AND A 32 PERSON, CHNA GROUP CONSISTING OF COMMUNITY MEMBERS, HEALTH CARE PROVIDERS (PHYSICIANS AND NURSES), ADMINISTRATORS AND AN INDIVIDUAL WITH EXPERIENCE IN PUBLIC HEALTH WAS INVITED TO REVIEW THE FINDINGS. THE DATA WAS STRATIFIED INTO THREE CATEGORIES WHICH INCLUDED CLINICAL CARE, HEALTH BEHAVIORS AND HEALTH OUTCOMES. WITHIN THE FOUR COUNTIES THAT COMPRISE THE PRIMARY SERVICE AREA FOR RPH, FORTY-ONE INDICATORS OF HEALTH WERE IDENTIFIED TO BE WORSE THAN THE STATE, US OR HEALTHY PEOPLE 2020 GOAL. ONCE THESE FORTY-ONE INDICATORS WERE IDENTIFIED, THEY WERE PRIORITIZED BY EACH INDIVIDUAL MEMBER OF THE CHNA GROUP. THE HANLON METHOD USES A TWO-STEP PROCESS TO SCORE INDICATORS OF HEALTH. THE FIRST STEP ENSURES THAT EACH NEED MEETS THE PEARL TEST WHICH INCLUDES: PROPRIETY - IS AN INTERVENTION SUITABLE?; ECONOMICS- DOES IT MAKE ECONOMIC SENSE TO ADDRESS THE NEED?; ACCEPTABILITY- IS THE COMMUNITY OPEN TO ADDRESSING THIS NEED AND WILL IT ACCEPT THE INTERVENTION?; RESOURCES - ARE RESOURCES AVAILABLE?; LEGALITY- IS THE INTERVENTION LAWFUL?. THE SECOND STEP OF THE HANLON METHOD REQUIRES ASSIGNING A SCORE FROM 1-10 FOR EACH NEED BASED IN REGARDS TO THE (1) SIZE OF THE PROBLEM (2) SERIOUSNESS OF THE PROBLEM AND (3) EFFECTIVENESS POTENTIAL OF AN INTERVENTION. USING THIS METHODOLOGY, THE CHNA GROUP SCORED EACH OF THE UNMET NEEDS FROM WHICH SEVERAL PRIORITY NEEDS WERE IDENTIFIED FOR THE PRIMARY SERVICE AREA OF RPH. FURTHER, ONCE SCORED, THE RESULTS WERE SHARED WITH THE CHNA GROUP FOR DISCUSSION. THE GROUP WAS ALSO GIVEN THE OPPORTUNITY TO ADJUST ANY RANKINGS. THIS PROCESS OF PRIORITIZATION CLASSIFIED THREE AREAS OF UNMET HEALTH CARE NEEDS. IN SEQUENTIAL ORDER (HIGHEST TO LOWEST SCORE) THESE PRIORITY NEEDS INCLUDED: * OBESITY (WITH A SUBSET FOCUS OF CHILDHOOD OBESITY) * ACCESS TO MENTAL HEALTH PROVIDERS (WITH A SUBSET FOCUS OF OPIATE USAGE) * CANCER INCIDENCE (WITH A SUBSET FOCUS OF TOBACCO USAGE) IN ADDITION TO THE PRIORITIES SET BY THE CHNA GROUP, TWO MORE UNMET COMMUNITY NEEDS WERE IDENTIFIED AND WILL BE DESCRIBED WITHIN THIS CHNA AS AREAS FOR POTENTIAL HEALTH IMPROVEMENT. HOWEVER, DUE TO AVAILABLE RESOURCES THESE NEEDS WILL NOT BE ADDRESSED THROUGH AN IMPLEMENTATION STRATEGY IN THE SUBSEQUENT FISCAL YEARS. THESE NEEDS INCLUDE: ACCESS TO PRIMARY CARE AND DIABETES (ADULT POPULATION) HTTP://WWW.GUTHRIE.ORG/SITES/DEFAULT/FILES/RPH_CHNA_July2016.PDF -------------------- |
| PART VI, LINE 3- PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | CHARITY CARE AVAILABILITY AND CONTACT INFORMATION ARE POSTED IN ALL REGISTRATION AREAS AND IN THE HOSPITAL'S BUSINESS OFFICE. THE CHARITY CARE POLICY, APPLICATION, AND CONTACT INFORMATION ARE POSTED ON THE HOSPITAL'S WEBSITE. SELF PAY PATIENTS ARE REFERRED TO THE HOSPITAL'S FINANCIAL COUNSELOR FROM PHYSICIAN OFFICES, SOCIAL WORKERS, OR SELF REFERRED. THE FINANCIAL COUNSELOR AS WELL AS THE BUSINESS OFFICE STAFF FOLLOW UP WITH SELF PAY PATIENTS TO ASSESS THEIR NEED AND ASSIST IN DETERMINING THEIR ELIGIBILITY FOR SECURING A PAYMENT SOURCE (I.E. COBRA COVERAGE, SPECIAL NEEDS PROGRAM, MEDICAID, OTHER FEDERAL/STATE PROGRAMS, OR CHARITY CARE). STAFF ALSO ASSIST WITH THE APPLICATION PROCESS AS REQUESTED BY SELF PAY PATIENTS. THE HOSPITAL'S BILLING STATEMENTS ALSO HAVE INFORMATION REGARDING WHOM TO CONTACT IN CASE A PATIENT NEEDS ASSISTANCE MEETING ITS FINANCIAL OBLIGATIONS. --------------- |
| PART VI, LINE 4- COMMUNITY INFORMATION | ROBERT PACKER HOSPITAL (RPH) IS A NOT-FOR-PROFIT COMMUNITY TEACHING HOSPITAL AND A MEMBER OF THE GUTHRIE CLINIC (TGC). RPH LOCATED IN SAYRE, PA AND IS A 254-BED TERTIARY CARE HOSPITAL THAT SERVES THE SOUTHERN TIER REGION OF NEW YORK AND THE NORTHERN TIER REGION OF PENNSYLVANIA. THE PRIMARY SERVICE AREA FOR RPH INCLUDES BRADFORD COUNTY, PA, TIOGA COUNTY, PA, CHEMUNG COUNTY, NY, AND TIOGA COUNTY, NY. IN FISCAL YEAR 2015, RPH HAD OVER 14,960 INPATIENT VISITS, MORE THAN 11,540 OUTPATIENT SUERGIES, 4,530 INPATIENT SURGERIES AND THE RPH EMERGENCY DEPARTMENT HAD OVER 33,000 VISITS. FURTHER, DURING THE SAME TIME PERIOD, THERE WERE APPROXIMATELY 1,597 BIRHTS AND OVER 172,380 OUTPATIENT VISITS AT RPH. RPH HAS RECEIVED NUMEROUS NATIONAL AWARDS FOR HIGH QUALITY PATIENT CARE SUCH AS THE TRUVEN TOP 50 CARDIOVASCULAR HOSPITAL AND WAS DESIGNATED ONE OF THE MOST CONNECTED HOSPITALS BY U.S. NEWS AND WORLD REPORT IN 2015. RPH IS A REGIONAL LEVEL II TRAUMA CENTER, ACCREDITED BY THE PENNSYLVANIA TRAUMA SYSTEMS FOUNDATION AND IS SERVED BY GUTHRIE AIR, A REGIONAL AERO-MEDICAL HELICOPTER PROGRAM. RPH OFFERS A FULL RANGE OF DIAGNOSTIC, MEDICAL AND SURGICAL SERVICES INCLUDING GUTHRIE CARDIAC AND VASCULAR CENTER, GUTHRIE RPH CHEST PAIN CENTER, GUTHRIE CANCER AND INFUSION CENTER, GUTHRIE BREAST CARE CENTER, GUTHRIE BEHAVIORAL HEALTH SCIENCE CENTER AND GUTHRIE WEIGHT LOSS CENTER. GUTHRIE RPH MEDICAL IMAGING PROVIDES A WIDE RANGE OF DIAGNOSTIC AND THERAPEUTIC IMAGING STUDIES, INCLUDING: COMPUTED TOMOGRAPHY AND A NEWLY UPGRADED MAGNETIC RESONANCE IMAGING, INTERVENTIONAL RADIOLOGY SERVICES, DIGITAL MAMMOGRAPHY WITH COMPUTER ASSISTED DETECTION, NUCLEAR MEDICINE INCLUDING NUCLEAR CARDIOLOGY AND SINGLE-PHOTON EMISSION COMPUTED TOMOGRAPHY, POSITRON EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY, ULTRASOUND INCLUDING VASCULAR AND OBSTETRIC ULTRASOUND, X-RAY AND FLUOROSCOPY. MOREOVER, RPH ALSO HAS TEACHING PROGRAMS IN NURSING, RADIOLOGY, RESPIRATORY THERAPY, LABORATORY SCIENCES, GENERAL SURGERY, FAMILY PRACTICE, INTERNAL MEDICINE AND CARDIOVASCULAR SPECIALTIES. THESE TEACHING AREAS ARE SUPPORTED BY AN ACTIVE SKILLS LAB AND RESEARCH FOUNDATION. RPH MOSTLY SERVES A RURAL POPULATION OVER A LARGE GEOGRAPHIC AREA FROM FOUR COUNTIES COVERING THE TWIN TIER REGIONS OF NEW YORK AND PENNSYLVANIA. THE PRIMARY SERVICE AREA OF RPH IS DEFINED AS 67 CONTIGUOUS ZIP CODES FROM WHICH OVER 75% OF THE INPATIENT POPULATION IS DERIVED. THE 67 CONTIGUOUS ZIP CODES INCLUDE 241,643 PEOPLE, THE MAJORITY OF WHICH ARE WHITE, NON-HISPANIC, BETWEEN THE AGES OF 35-54. IN THE GEOGRAPHIC AREA, 40.7% OF INDIVIDUALS AGED TWENTY-FIVE OR OLDER HAVE AT LEAST A HIGH SCHOOL DEGREE WITH 28.1% AND 19.8% HAVING SOME COLLEGE AND BACHELOR'S DEGREE/HIGHER, RESPECTIVELY. FROM 2010 UNTIL 2015 THERE WAS A 0.9% DECREASE IN THE OVERALL POPULATION SERVED BY RPH. IT IS ANTICIPATED BETWEEN 2015 AND 2020, A SIMILAR DECREASE OF 0.5% WILL BE OBSERVED IN THE OVERALL POPULATION SERVED BY RPH. --------------- |
| PART VI, LINE 5- PROMOTION OF COMMUNITY HEALTH | SEE SCHEDULE O, FORM 990, PART III, LINE 1- STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS FOR MORE INFORMATION REGARDING HOW THE HOSPITAL FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUMNITY. --------------- |
| PART VI, LINE 6- DETAIL REGARDING AFFILIATED HEALTH CARE SYSTEM ROLES | ROBERT PACKER HOSPITAL IS PART OF THE GUTHRIE CLINIC. SEE SCHEDULE O, FORM 990, PART III, LINE 1- STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS FOR MORE INFORMATION. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | EDUCATIONAL AID - VARIOUS INDIVIDUALS | GrantTypeTxt |
| Recipient | 97 | RecipientCnt |
| Cash Grant | $127,425 | CashGrantAmt |
| Non Cash Assistance | $0 | NonCashAssistanceAmt |
| Non Cash Assistance | N/A | NonCashAssistanceDesc |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | DETAIL OF GRANTS TO INDIVIDUALS IN THE UNITED STATES HEALTH PROFESSION SCHOLARSHIPS - SENIORS MUST PLAN TO ENTER AN ACCREDITED COLLEGE, UNIVERSITY, HOSPITAL BASED NURSING, OR ALLIED HEALTH PROGRAM WITH CAREERS IN HEALTH PROFESSIONS, INCLUDING HOSPITAL ADMINISTRATION OR A PLANNED CAREER IN MEDICAL RESEARCH. GUTHRIE EMPLOYEE SCHOLARSHIPS - THESE SCHOLARSHIPS ARE OFFERED TO CHILDREN OF FULL-TIME EMPLOYEES OF GUTHRIE. SENIORS MUST PLAN TO ENTER AN ACCREDITED COLLEGE OR UNIVERSITY. ANY CAREER INTEREST IS ALLOWED. MANSFIELD UNIVERSITY SCHOLARSHIPS - AWARDED TO NURSING STUDENTS WHO MEET THE CRITERIA OF THE SCHOLARSHIP PROTOCOLS. OTHER VARIOUS SCHOLARSHIPS/AWARDS - AWARDED TO ALLIED HEALTH STUDENTS OR CURRENT EMPLOYEES THAT MEET THE CRITERIA OF THE SCHOLARSHIP/AWARD PROTOCOLS. ALL SCHOLARSHIPS ARE RECONCILED AND MONITORED ON A MONTHLY BASIS AS PART OF NORMAL OPERATING PROCEDURES. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (16 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARIE DROEGE | ||||||||||||||
| PRESIDENT & COO | $406,636 | $0 | $60,036 | $0 | $0 | $0 | $15,900 | $0 | $5,700 | $0 | $488,272 | $0 | $0 | $0 |
| DANIEL J BROWN MD | ||||||||||||||
| MEMBER BOD | $0 | $455,463 | $0 | $19,971 | $0 | $0 | $0 | $15,900 | $0 | $11,336 | $0 | $502,670 | $0 | $0 |
| THOMAS VANDERMEER MD | ||||||||||||||
| MEMBER BOD | $0 | $469,730 | $0 | $0 | $0 | $281 | $0 | $15,900 | $0 | $17,454 | $0 | $503,365 | $0 | $0 |
| DANIEL SPORN MD | ||||||||||||||
| MEMBER BOD | $0 | $558,023 | $0 | $37,500 | $0 | $0 | $0 | $15,900 | $0 | $17,454 | $0 | $628,877 | $0 | $0 |
| MINH DANG | ||||||||||||||
| RPH CFO | $0 | $231,057 | $0 | $27,759 | $0 | $0 | $0 | $19,869 | $0 | $11,336 | $0 | $290,021 | $0 | $0 |
| BONNIE ONOFRE | ||||||||||||||
| VP, CHIEF NURSING OFFICER | $176,975 | $0 | $23,753 | $0 | $7,221 | $0 | $13,517 | $0 | $11,336 | $0 | $232,802 | $0 | $0 | $0 |
| BARBARA PENNYPACKER | ||||||||||||||
| VP SURGICAL SERVICES | $158,367 | $0 | $9,337 | $0 | $0 | $0 | $12,036 | $0 | $11,336 | $0 | $191,076 | $0 | $0 | $0 |
| JOSEPH SAWYER | ||||||||||||||
| VP IMAGING & ANCILLARY TESTING | $162,751 | $0 | $10,086 | $0 | $1,165 | $0 | $9,135 | $0 | $17,454 | $0 | $200,591 | $0 | $0 | $0 |
| JOSEPH A SCOPELLITI MD | ||||||||||||||
| MEMBER BOD | $0 | $657,019 | $0 | $149,931 | $0 | $3,193 | $0 | $17,225 | $0 | $10,391 | $0 | $837,759 | $0 | $0 |
| DEBRA RYAN MD | ||||||||||||||
| MEMBER BOD | $0 | $201,324 | $0 | $0 | $0 | $0 | $0 | $12,079 | $0 | $17,454 | $0 | $230,857 | $0 | $0 |
| BRIAN FILLIPO MD | ||||||||||||||
| EVP-CHIEF MED QUALITY OFFICER | $0 | $381,099 | $0 | $56,269 | $0 | $0 | $0 | $15,900 | $0 | $10,391 | $0 | $463,659 | $0 | $0 |
| MARC HARRIS | ||||||||||||||
| PHYSICIAN | $471,246 | $0 | $21,000 | $0 | $0 | $0 | $22,000 | $0 | $13,885 | $0 | $528,131 | $0 | $0 | $0 |
| JAMES RAFTIS | ||||||||||||||
| PHYSICIAN | $435,617 | $0 | $11,500 | $0 | $0 | $0 | $15,900 | $0 | $17,454 | $0 | $480,471 | $0 | $0 | $0 |
| GEORGE ELLIS | ||||||||||||||
| PHYSICIAN | $403,229 | $0 | $2,500 | $0 | $0 | $0 | $22,000 | $0 | $13,885 | $0 | $441,614 | $0 | $0 | $0 |
| CHARLES MCGURK | ||||||||||||||
| PHYSICIAN | $362,992 | $0 | $22,896 | $0 | $0 | $0 | $17,225 | $0 | $17,454 | $0 | $420,567 | $0 | $0 | $0 |
| MICHAEL GUM | ||||||||||||||
| DIRECTOR, SYSTEM PHARMACY | $169,965 | $0 | $8,581 | $0 | $0 | $0 | $10,851 | $0 | $5,700 | $0 | $195,097 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I, LINE 1A | QUESTIONS REGARDING COMPENSATION GROSS-UP PAYMENTS ARE PERIODICALLY PROVIDED TO EMPLOYEES. ALL PAYMENTS ARE MADE PURSUANT TO WRITTEN ORGANIZATION POLICIES. --------------- |
| SCHEDULE J, PART I, LINE 3 | COMPENSATION INFORMATION EXECUTIVE COMPENSATION IS GENERALLY ESTABLISHED WITHIN A WRITTEN EMPLOYMENT AGREEMENT. COMPENSATION IS DETERMINED BASED ON MARKET STUDIES, PRESENTED TO THE GUTHRIE CLINIC COMPENSATION COMMITTEE, AND SUBSEQUENTLY APPROVED BY THE BOARD OF DIRECTORS. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRAL BRADFORD PROGRESS AUTHORITY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 232735865 | BondIssuerEIN |
| CUSIP | 152691AA9 | CUSIPNum |
| Bond Issued | 2011-09-08 | BondIssuedDt |
| Issue Price | $50,000,000 | IssuePriceAmt |
| Purpose | SEE PART VI SUPPLEMENTAL DISCLOSUR | PurposeDesc |
| Defeased | false | DefeasedInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Pool Financing | false | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $2,985,000 | RetiredAmt |
| Bond Defeased | $0 | BondDefeasedAmt |
| Total Proceeds | $50,044,961 | TotalProceedsAmt |
| In Reserve Fund | $0 | InReserveFundAmt |
| Capitalized Interest | $3,526,227 | CapitalizedInterestAmt |
| Refunding Escrow | $0 | RefundingEscrowAmt |
| Issuance Costs From Proceeds | $804,312 | IssuanceCostsFromProceedsAmt |
| Credit Enhancement | $0 | CreditEnhancementAmt |
| Working Capital Expenditures | $8 | WorkingCapitalExpendituresAmt |
| Capital Expenditures | $25,536,724 | CapitalExpendituresAmt |
| Other Spent Proceeds | $20,175,557 | OtherSpentProceedsAmt |
| Unspent | $0 | UnspentAmt |
| Substantial Completion | 2014 | SubstantialCompletionYr |
| Current Refunding | Yes (true) | CurrentRefundingInd |
| Advance Refunding | false | AdvanceRefundingInd |
| Final Allocation Made | false | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (true) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | false | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | Yes (true) | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | Yes (true) | MgmtContractBondFincdPropInd |
| Engage Bond Counsel Contracts | false | EngageBondCounselContractsInd |
| Any Research Agreements | false | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00020 | PrivateBusUseByOthersPct |
| Total Private Business Use | 0.00020 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | false | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | false | ChangeInUseBondFinancedPropInd |
| Remedial Action Taken | false | RemedialActionTakenInd |
| Procs Nonqualified Bond Remdtd | Yes (true) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | false | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (true) | RebateNotDueYetInd |
| Exception To Rebate | false | ExceptionToRebateInd |
| No Rebate Due | false | NoRebateDueInd |
| Variable Rate Issue | false | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | false | HedgeIdentifiedInBksAndRecInd |
Hedge Provider Name HedgeProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 0 | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGICInd |
GIC Provider Name GICProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 0 | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Proceeds Invested | false | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (true) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (true) | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, ROW A, COLUMN (F) | DESCRIPTION OF PURPOSE CONSTRUCT FACILITY AND REFUND PRIOR ISSUE (2/14/2002). --------------- |
| PART II, LINE 3, COLUMN (A) | DETAIL OF TOTAL PROCEEDS OF ISSUE TOTAL PROCEEDS EXCEED THE ISSUE PRICE DUE TO INVESTMENT EARNINGS. --------------- |
| PART II, LINE 11, COLUMN (A) | DETAIL OF OTHER SPENT PROCEEDS OTHER SPENT PROCEEDS REFLECT THE REFUNDING PROCEEDS OF THE ISSUE THAT ARE NO LONGER HELD IN ESCROW. --------------- |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHARON SPORN | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | SPOUSE OF BOARD MEMBER | RelationshipDescriptionTxt |
| Transaction | $21,736 | TransactionAmt |
| Transaction | EMPLOYMENT | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (23 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III | STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS THE GUTHRIE CLINIC IS THE SOLE MEMBER OF ROBERT PACKER HOSPITAL. THE GUTHRIE CLINIC IS A NONPROFIT HEALTH CARE ORGANIZATION INCORPORATED FOR THE PURPOSE OF CONDUCTING EXCLUSIVELY CHARITABLE, SCIENTIFIC AND EDUCATIONAL ACTIVITIES. THE GUTHRIE CLINIC (TGC) ACTS AS THE PARENT OF AN INTEGRATED SECTION 501(C)(3) HEALTH CARE DELIVERY SYSTEM, CONSISTING OF THE CORPORATION AND OTHER DIRECTLY AND INDIRECTLY CONTROLLED ENTITIES (SEE FORM 990, SCHEDULE R, FOR A LISTING OF THE AFFILIATES OF TGC) INCLUDING BUT NOT LIMITED TO GUTHRIE MEDICAL GROUP, P.C.(GMG) AND ROBERT PACKER HOSPITAL (RPH). THROUGH THE ACTIVITIES OF GMG, RPH AND ITS OTHER AFFILIATES (COLLECTIVELY REFERRED TO AS "GUTHRIE"), THE GUTHRIE CLINIC PROVIDES CHARITABLE COMMUNITY-BASED HEALTH CARE SERVICES AND PROGRAMS TO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE AND COMMUNITIES SERVED BY ITS FACILITIES AND PROVIDERS. THESE CHARITABLE ACTIVITIES INCLUDE PROVIDING PRIMARY CARE AND SPECIALTY PHYSICIAN SERVICES, AS WELL AS OPERATING A TERTIARY CARE TEACHING HOSPITAL, COMMUNITY HOSPITALS, A RESEARCH INSTITUTE, HOME CARE, AND HOSPICE CARE. THE GUTHRIE RESEARCH INSTITUTE AND GUTHRIE CLINICAL RESEARCH FUNCTIONS OF THE DONALD GUTHRIE FOUNDATION, A SUBSIDIARY OF TGC, FURTHERS THESE CHARITABLE ACTIVITIES THROUGH PROVIDING PATIENT ACCESS TO THE REGION'S LARGEST PANEL OF CLINICAL TRIALS. THE FACILITIES AND PROVIDER OFFICES OF GUTHRIE ARE LOCATED IN 23 COMMUNITIES THROUGHOUT THE NORTHERN TIER OF PENNSYLVANIA AND SOUTHERN TIER OF NEW YORK, WITH THE GREATEST CONCENTRATION OF SERVICES PROVIDED PRINCIPALLY IN BRADFORD COUNTY, PENNSYLVANIA AND CHEMUNG AND STEUBEN COUNTIES, NEW YORK. THE VISION OF GUTHRIE IS TO HELP SHAPE THE DELIVERY OF HEALTH CARE IN THE REGION THROUGH WORKING COLLABORATIVELY WITH PHYSICIANS AND OTHER PROVIDERS, AND BY DISTRIBUTING ITS SERVICES THROUGHOUT THE REGION BASED ON COMMUNITY NEEDS. GUTHRIE SEEKS TO BE THE PROVIDER OF CHOICE FOR PATIENTS IN THE TWIN TIER REGION, AND TO BE RECOGNIZED FOR ITS SUPERIOR QUALITY AND SERVICE. IT ALSO STRIVES TO ADVANCE THE PRACTICE OF MEDICINE THROUGH ITS COMMITMENT TO TEACHING AND RESEARCH. IN KEEPING WITH THIS VISION, THE CORE VALUES OF THE GUTHRIE CLINIC ARE AS FOLLOWS: PATIENT-CENTEREDNESS, EXCELLENCE, AND TEAMWORK. GUTHRIE PROVIDERS AND FACILITIES PROVIDE CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE IT DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE ON THE FINANCIAL STATEMENTS OF GUTHRIE ENTITIES. COSTS FOR SERVICES AND SUPPLIES FURNISHED UNDER GUTHRIE'S CHARITY CARE POLICY AMOUNTED TO APPROXIMATELY $1.49 MILLION IN 2016 AND $2.64 MILLION IN 2015 WHEN MEASURED AT THE APPROPRIATE ENTITY'S ESTIMATED COST. AS PART OF ITS CHARITABLE MISSION, GUTHRIE PROVIDES CARE THROUGH ITS HOSPITAL EMERGENCY DEPARTMENTS. IT ENSURES THAT AN EMERGENCY-BASED TREATMENT OR HOSPITAL ADMISSION IS NOT DELAYED OR DENIED PENDING DETERMINATION OF COVERAGE OR A REQUIREMENT FOR PREPAYMENT OR DEPOSIT. AS A RESULT OF THIS POLICY, GUTHRIE EXPERIENCED APPROXIMATELY $2.86 MILLION AND $2.64 MILLION IN BAD DEBTS FOR 2016 AND 2015, RESPECTIVELY. IN ADDITION TO THE CHARITY CARE PROGRAM AND THE EMERGENCY DEPARTMENT BAD DEBTS DISCUSSED ABOVE, GUTHRIE SUPPORTS NUMEROUS OTHER CHARITABLE COMMUNITY ACTIVITIES. EXAMPLES OF THESE ACTIVITIES INCLUDE MEDICAL EDUCATION FOR PHYSICIANS AND NURSES, THE TRAUMA PROGRAM, AND MEDICAL RESEARCH. THE ESTIMATED COST, NET OF REIMBURSEMENT, FOR THESE PROGRAMS WAS $16.1 MILLION AND $17.5 MILLION IN 2016 AND 2015, RESPECTIVELY. GUTHRIE ALSO PROVIDES SERVICES TO PATIENTS WHO PARTICIPATE IN THE MEDICAID PROGRAMS. REVENUES GENERATED FROM PATIENTS WHO PARTICIPATE IN THE MEDICAID PROGRAM ARE SUBJECT TO SUBSTANTIAL DISCOUNTS THAT RESULT IN REIMBURSEMENT FOR SERVICES RENDERED BELOW THE COST OF PROVIDING SUCH SERVICES. IN ORDER FOR PATIENTS TO MEET THE GUIDELINES FOR THE MEDICAID PROGRAM, VARIOUS INCOME-BASED CRITERIA MUST BE MET THAT VALIDATE PATIENTS' INABILITY TO PAY FOR SERVICES AND INELIGIBILITY UNDER OTHER PROGRAMS. THE ESTIMATED LOSS INCURRED BY GUTHRIE FROM PROVIDING SERVICES TO MEDICAID PATIENTS AMOUNTED TO $37.95 MILLION AND $25.48 MILLION IN 2016 AND 2015, RESPECTIVELY. THE TOTAL COST TO GUTHRIE IN SUPPORTING THESE CHARITABLE MISSION PROGRAMS WAS APPROXIMATELY $58.37 MILLION AND $48.27 MILLION IN 2016 AND 2015, RESPECTIVELY. AS DISCUSSED, RPH AND THE GMG WORK CLOSELY TOGETHER IN FULFILLING GUTHRIE'S CHARITABLE MISSION. A REGIONAL LEVEL II TRAUMA CENTER, RPH IS A TERTIARY CARE TEACHING HOSPITAL, LOCATED IN SAYRE, PENNSYLVANIA, SERVING THE SOUTHERN TIER OF NEW YORK AND THE NORTHERN TIER OF PENNSYLVANIA. IT ALSO PROVIDES RESIDENCY PROGRAMS IN FAMILY PRACTICE, INTERNAL MEDICINE, AND GENERAL SURGERY AS WELL AS A FELLOWSHIP PROGRAM IN VASCULAR SURGERY AND CARDIOVASCULAR DISESASE. MEDICAL STUDENT TRAINING IS PROVIDED FOR STUDENTS FROM AFFILIATED MEDICAL SCHOOLS. ALLIED HEALTH EDUCATION IS ALSO PROVIDED FOR RESPIRATORY THERAPY, NURSING, LABORATORY SCIENCE, AND RADIOLOGIC TECHNOLOGY FOR STUDENTS FROM PENNSYLVANIA AND NEW YORK COLLEGES AND UNIVERSITIES. CENTERS OF EXCELLENCE WITHIN RPH INCLUDE THE FOLLOWING: ADVANCED & MINIMALLY INVASIVE SURGERY; BEHAVIORAL HEALTH SERVICES; BREAST AND IMAGING CENTER; COMPREHENSIVE CANCER CENTER; CARDIOVASCULAR CARE CENTER; THE CENTER FOR WOUND CARE AND HYPERBARIC MEDICINE; DIALYSIS CENTERS; JOINT CAMP PROGRAM FOR ORTHOPEDIC SURGERY; SPORTS MEDICINE; KIDNEY STONE TREATMENT CENTER; FIRST IMPRESSIONS BIRTHING CENTER; SLEEP DISORDERS TESTING; WEIGHT LOSS CENTER; AND SPECIALTY EYE CARE. RPH STRIVES TO ENHANCE THE QUALITY OF LIFE IN THE COMMUNITIES IT SERVES BY PROVIDING SUPERIOR HEALTH CARE SERVICES AND BY LEADING CONTINUOUS IMPROVEMENT OF COMMUNITY HEALTH. IT ACHIEVES THIS MISSION BY ORGANIZING SERVICES AND DIRECTING RESOURCES TOWARD MEETING COMMUNITY HEALTH NEEDS THROUGH COLLABORATION WITH COMMUNITY AGENCIES AND BY COMPASSIONATE, EFFECTIVE, AND AFFORDABLE MEANS. RPH WORKS CLOSELY WITH THE GMG TO ENSURE THAT THE SKILLS AND KNOWLEDGE OF THE MEDICAL STAFF PRODUCE THE MAXIMUM COMMUNITY HEALTH BENEFIT. AS A MEMBER OF GUTHRIE, RPH INTEGRATES ITS PROGRAMS AND ACTIVITIES WITH THOSE OF THE LONG-TERM CARE AND EDUCATION AND RESEARCH DIVISIONS, SO THAT CONTINUITY AND SYNERGY RESULT. AS PART OF TGC, THE VISION OF RPH IS TO PLAY A LEADERSHIP ROLE IN THE DEVELOPMENT AND PROVISION OF TERTIARY-LEVEL ACUTE CARE SERVICES. EVIDENCE THAT RPH IS SUCCESSFULLY FULFILLING THIS ROLE CAN BE SEEN IN ITS CONTINUED ACCOMPLISHMENTS. HIGHLIGHTS OF THOSE ACHIEVEMENTS INCLUDE CONTINUED ACCREDITATION BY THE PENNSYLVANIA TRAUMA SYSTEMS FOUNDATION BOARD AS A LEVEL II TRAUMA CENTER AND RECEIPT OF FULL CHEST PAIN CENTER ACCREDITATION WITH PCI (PERCUTANEOUS CORONARY INTERVENTION) FROM THE SOCIETY OF CARDIOVASCULAR PATIENT CARE. GUTHRIE WEIGHT LOSS CENTER HAS BEEN ACCREDITED AS A LEVEL 1 FACILITY UNDER THE BARIATRIC SURGERY CENTER NETWORK (BSCN) ACCREDITATION PROGRAM OF THE AMERICAN COLLEGE OF SURGEONS (ACS). AS PART OF A FULLY-INTEGRATED HEALTH DELIVERY SYSTEM THAT ORGANIZES ITS SERVICES ON A REGIONAL BASIS AND IS ACCOUNTABLE FOR IMPROVING THE HEALTH OF THE POPULATION IT SERVES, RPH ACCEPTS RESPONSIBILITY FOR MEETING THE HEALTH CARE NEEDS OF THE COMMUNITY AND IS ABLE TO DOCUMENT THE COST EFFECTIVENESS AND QUALITY OF SERVICES PROVIDED. CORNING HOSPITAL BREAST CARE CENTER WAS AWARDED A FULL THREE-YEAR ACCREDITATION IN STEREOTACTIC BREAST BIOPSY BY THE AMERICAN COLLEGE OF RADIOLOGY (ACR) AND RECEIVED THE AMERICAN HEART ASSOCIATION/AMERICAN STOKE ASSOCIATIONS GET WITH THE GUIDELINES STROKE GOLD PLUS ACHIEVEMENT AWARD. THE GMG IS A MULTI-SPECIALTY PHYSICIAN GROUP PRACTICE THAT INCLUDES NEARLY 350 SPECIALIST AND PRIMARY CARE PHYSICIANS AND MID-LEVEL PROVIDERS, HEADQUARTERED IN A FACILITY ADJACENT TO RPH. PHYSICIANS WITHIN THE GMG PROVIDE COMPREHENSIVE MEDICAL CARE USING ADVANCED TECHNOLOGIES AND METHODOLOGIES FOR BOTH DIAGNOSIS AND TREATMENT. FURTHER, THE GMG PROVIDES A BROAD RANGE OF EDUCATIONAL OPPORTUNITIES FOR PHYSICIANS AND OTHER HEALTH CARE PROVIDERS. IT ALSO WORKS CLOSELY WITH THE RESEARCH INSTITUTE, WHERE RESEARCH CONTRIBUTES TO RECRUITING AND RETAINING PHYSICIAN SPECIALISTS TO SERVE THE REGION AND SUSTAINING PROFICIENT MEDICAL PRACTICES. THE GMG IS COMMITTED TO THE ADVANCEMENT OF MEDICAL KNOWLEDGE AND SKILLS, AND EVERY EFFORT IS MADE TO PROVIDE PERSONAL, COMPASSIONATE MEDICAL CARE. THE GMG OPERATES A REGIONAL OFFICE NETWORK IN 23 COMMUNITIES IN PENNSYLVANIA AND NEW YORK, ENCOMPASSING ALL OF THE MAJOR POPULATION CENTERS IN THE TWIN TIERS AREA. THE GUTHRIE CLINIC HAS DEVELOPED CERTAIN GUIDING PRINCIPLES FOR THE PROVISION OF PATIENT CARE, WHICH INCLUDE A COMMITMENT THE FOLLOWING: * PRACTICE OF CLINICAL EXCELLENCE, * UTILIZATION OF THE SYNERGY OF A MULTI-SPECIALTY MEDICAL GROUP PRACTICE, * DEVELOPMENT OF AN INTEGRATED SYSTEM THAT PROVIDES A CONTINUUM OF CARE, * PROVIS |
| FORM 990, PART IV, LINE 12B | DETAIL OF CONSOLIDATED FINANCIAL STATEMENTS THE ORGANIZATION'S FINANCIAL STATEMENTS WERE AUDITED ON A CONSOLIDATED BASIS WITH THE GUTHRIE CLINIC AND AFFILIATES. --------------- |
| FORM 990, PART VI, SECTION A, LINE 6 | MEMBERSHIP INFORMATION THE GUTHRIE CLINIC IS THE SOLE MEMBER OF ROBERT PACKER HOSPITAL. --------------- |
| FORM 990, PART VI, SECTION A, LINE 7A | MEMBERSHIP INFORMATION AS THE SOLE MEMBER OF ROBERT PACKER HOSPITAL, THE GUTHRIE CLINIC APPOINTS THE ORGANIZATION'S BOARD OF DIRECTORS. --------------- |
| FORM 990, PART VI, SECTION A, LINE 7B | MEMBERSHIP INFORMATION AS THE SOLE MEMBER OF ROBERT PACKER HOSPITAL, THE GUTHRIE CLINIC HAS APPROVAL RIGHTS OF CERTAIN BOARD DECISIONS. --------------- |
| FORM 990, PART VI, SECTION B, LINE 11 | FORM 990 REVIEW PROCESS THE FORM 990 OF THE ORGANIZATION IS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW AND IS ALSO REVIEWED BY THE ORGANIZATION'S FINANCE PERSONNEL AND AN INDEPENDENT ACCOUNTING FIRM PRIOR TO FILING WITH THE IRS. --------------- |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST POLICY THE CONFLICT OF INTEREST DISCLOSURE POLICY SETS FORTH THAT ALL PERSONS, INCLUDING EMPLOYEES, AGENTS AND BOARD/COMMITTEE MEMBERS, PARTICULARLY THOSE INVOLVED IN DECISION-MAKING FOR THE GUTHRIE CLINIC (TGC), ACT IN AN APPROPRIATE MANNER AND WILL NOT PARTICIPATE IN ANY ACTIONS THAT MIGHT CREATE A PERSONAL OR PROFESSIONAL CONFLICT OF INTEREST AND/OR NOT BE IN THE BEST INTEREST OF TGC. ALL MEMBERS OF ANY TGH BOARD/ COMMITTEE AND TGH SENIOR MANAGEMENT MUST MAKE FULL DISCLOSURE OF ANY POSSIBLE CONFLICT OF INTEREST THROUGH THE USE OF THE CONFLICT OF INTEREST DISCLOSURE FORM AND REFRAIN FROM VOTING OR PARTICIPATING IN DECISION-MAKING INVOLVING ANY POSSIBLE CONFLICT OF INTEREST. THE FORM IS DISTRIBUTED TO ALL BOARD/COMMITTEE MEMBERS AND EMPLOYEES (WHEN APPLICABLE) ANNUALLY BY THE TGC ADMINISTRATION OFFICE. TGC BOARD/COMMITTEE MEMBERS OR EMPLOYEES MUST COMPLETE THE CONFLICT OF INTEREST DISCLOSURE FORM. THIS FORM SHOULD BE COMPLETED WHEN THERE IS ANY SITUATION WHERE A POSSIBLE CONFLICT OF INTEREST EXISTS, AND/OR ON AN ANNUAL BASIS AND/OR AT THE TIME OF APPOINTMENT OR ELECTION OF NEW BOARD/COMMITTEE MEMBERS. IF THE FORM IS NOT COMPLETED WITHIN 13 MONTHS OF THE LAST SIGNING, THE TGC BOARD CHAIRMAN WILL BE ADVISED. ANY INDIVIDUAL HAVING A CONFLICT OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON ANY MATTER SHOULD EXCUSE THEMSELVES FROM THE PORTION OF THE MEETING OR MEETINGS WHERE THE MATTER IS DISCUSSED AND NOT VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER. THE MINUTES OF THE MEETING OR MEETINGS SHOULD REFLECT THE DISCLOSURE, THE ABSTENTION FROM VOTING, AND ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST EXISTED. --------------- |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION REVIEW AND APPROVAL EXECUTIVE COMPENSATION IS GENERALLY ESTABLISHED WITHIN A WRITTEN EMPLOYMENT AGREEMENT. COMPENSATION IS DETERMINED BASED ON MARKET STUDIES, PRESENTED TO THE GUTHRIE CLINIC COMPENSATION COMMITTEE, AND SUBSEQUENTLY APPROVED BY THE BOARD OF DIRECTORS. --------------- |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS THE ORGANIZATION'S FORM 1023 AND 990 ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. THE ORGANIZATION DOES NOT ROUTINELY MAKE ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. --------------- |
| FORM 990, PART XI, LINE 9 | DETAIL OF OTHER CHANGES IN NET ASSETS OR FUND BALANCES EQUITY TRANSFER TO/FROM AFFILIATES $ 671,396 PENSION ADJUSTMENT (6,495,021) INTEREST DIVIDEND INCOME ON INVESTMENTS 462,422 NET REALIZED GAINS AND LOSSES 27,120 ON RESTRICTED INVESTMENTS EARNINGS DISTRIBUTION (52,299) OTHER (240) ---------- TOTAL ($5,386,622) --------------- |
| FORM 990, PART XII, LINE 2B | DETAIL OF CONSOLIDATED FINANCIAL STATEMENTS THE ORGANIZATION'S FINANCIAL STATEMENTS WERE AUDITED ON A CONSOLIDATED BASIS WITH THE GUTHRIE CLINIC AND AFFILIATES. --------------- |
| FORM 990, SCHEDULE D, PART X & SCHEDULE K | ADDITIONAL TAX EXEMPT BONDS ROBERT PACKER HOSPITAL HAS BEEN ALLOCATED A PORTION OF THE HEALTH CARE FACILITIES AUTHORITY OF SAYRE, HEALTH CARE REVENUE BONDS, SERIES 2007, FROM THE GUTHRIE CLINIC, A RELATED IRC SECTION 501(C)(3) ORGANIZATION. SINCE THE GUTHRIE CLINIC REMAINS AS THE PRIMARY OBLIGOR OF THE BOND, ALL INFORMATION REGARDING THIS BOND HAS BEEN REPORTED ON THE FORM 990, SCHEDULE K OF THE GUTHRIE CLINIC. THE TOTAL OUTSTANDING ALLOCATED BALANCE FOR THE ROBERT PACKER HOSPITAL WAS $43,611,480 AS OF JUNE 30, 2016. THIS AMOUNT IS INCLUDED IN OTHER LIABILITIES. ROBERT PACKER HOSPITAL HAS BEEN ALLOCATED A PORTION OF THE CENTRAL BRADFORD PROGRESS AUTHORITY, HEALTH CARE REVENUE BONDS, SERIES 2012, FROM THE GUTHRIE CLINIC, A RELATED IRC SECTION 501(C)(3) ORGANIZATION. SINCE THE GUTHRIE CLINIC REMAINS AS THE PRIMARY OBLIGOR OF THE BOND, ALL INFORMATION REGARDING THIS BOND HAS BEEN REPORTED ON THE FORM 990, SCHEDULE K OF THE GUTHRIE CLINIC. THE TOTAL OUTSTANDING ALLOCATED BALANCE FOR THE ROBERT PACKER HOSPITAL WAS $7,500,000 AS OF JUNE 30, 2016. THIS AMOUNT IS INCLUDED IN OTHER LIABILITIES. ROBERT PACKER HOSPITAL HAS BEEN ALLOCATED A PORTION OF THE CENTRAL BRADFORD PROGRESS AUTHORITY, HEALTH CARE REVENUE BONDS, SERIES 2011, FROM THE GUTHRIE CLINIC, A RELATED IRC SECTION 501(C)(3) ORGANIZATION. SINCE THE GUTHRIE CLINIC REMAINS AS THE PRIMARY OBLIGOR OF THE BOND, ALL INFORMATION REGARDING THIS BOND HAS BEEN REPORTED ON THE FORM 990, SCHEDULE K OF THE GUTHRIE CLINIC. THE TOTAL OUTSTANDING ALLOCATED BALANCE FOR THE ROBERT PACKER HOSPITAL WAS $31,383,651 AS OF JUNE 30, 2016. THIS AMOUNT IS INCLUDED IN OTHER LIABILITIES. --------------- |
| FORM 990 PART IX LINE 11G | DESCRIPTION:MAINTENANCE AGREEMENTS TOTAL FEES:3721310 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:COLLECTION SERVICE TOTAL FEES:516102 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONSULTANTS TOTAL FEES:1098493 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:TEMP STAFF TOTAL FEES:1601956 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:INFORMATION SYSTEMS TOTAL FEES:2405623 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PHYSICIAN FEES TOTAL FEES:14611767 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:LOCUM SERVICES TOTAL FEES:1384312 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:LAUNDRY TOTAL FEES:645096 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:DIAGNOSTIC TESTING TOTAL FEES:1105325 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:TEACHING FEES TOTAL FEES:2051808 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OTHER TOTAL FEES:10546065 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (13 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| THE GUTHRIE CLINIC | ||||||||||
| ONE GUTHRIE SQUARE | SAYRE | PA | 18840 | 233055017 | SUPPORTING | PA | 501(c)(3) | 11C,III | NA | false |
| SAYRE HOUSE OF HOPE | ||||||||||
| ONE GUTHRIE SQUARE | SAYRE | PA | 18840 | 203979472 | HEALTHCARE | PA | 501(c)(3) | 7 | TGC | false |
| DONALD GUTHRIE FOUNDATION | ||||||||||
| 200 S WILBUR AVENUE | SAYRE | PA | 18840 | 246022957 | MED RESEARCH | PA | 501(c)(3) | 4 | TGC | false |
| TROY COMMUNITY HOSPITAL INC | ||||||||||
| 275 GUTHRIE DRIVE | TROY | PA | 16947 | 240800337 | HEALTHCARE | PA | 501(c)(3) | 3 | TGC | false |
| TIOGA HEALTHCARE FACILITY | ||||||||||
| ONE GUTHRIE SQUARE | SAYRE | PA | 18840 | 150532257 | HEALTHCARE | NY | 501(c)(3) | 3 | TGC | false |
| GUTHRIE HOME CARE | ||||||||||
| 421 TOMAHAWK ROAD | TOWANDA | PA | 18848 | 232394345 | HOME HEALTH | PA | 501(c)(3) | 9 | TGC | false |
| GUTHRIE RISK RETENTION GROUP | ||||||||||
| 151 MEETING STREET | CHARLESTON | SC | 29401 | 201090801 | SUPPORTING | SC | 501(c)(3) | 11A,I | TGC | false |
| TIOGA NURSING FACILITY | ||||||||||
| ONE GUTHRIE SQUARE | SAYRE | PA | 18840 | 222979677 | NURSING FAC | NY | 501(c)(3) | 3 | TGC | false |
| GUTHRIE MEDICAL GROUP PC | ||||||||||
| ONE GUTHRIE SQUARE | SAYRE | PA | 18840 | 250815795 | HEALTHCARE | PA | 501(c)(3) | 3 | TGC | false |
| CORNING HOSPITAL | ||||||||||
| 1 GUTHRIE DRIVE | CORNING | NY | 14830 | 160393490 | HEALTHCARE | NY | 501(c)(3) | 3 | TGC | false |
| GUTHRIE TOWANDA MEMORIAL HOSPITAL | ||||||||||
| 91 HOSPITAL DRIVE | TOWANDA | PA | 18848 | 240786657 | HEALTHCARE | PA | 501(C)(3) | 3 | TGC | false |
| THE MEMORIAL HOSPITAL FOUNDATION | ||||||||||
| 91 HOSPITAL DRIVE | TOWANDA | PA | 18848 | 651160811 | SUPPORTING | PA | 501(C)(3) | 11A,I | GTMH | false |
| ROBERT PACKER HOSPITAL AUXILIARY | ||||||||||
| 200 SOUTH WILBUR AVE | SAYRE | PA | 18840 | 231650350 | GIFT SHOP | PA | 501(C)(3) | 9 | RPH | Yes (true) |
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 |
|---|---|---|---|---|---|---|---|---|---|
| TWIN TIER MANAGEMENT CORP INC | |||||||||
| PO BOX 310 | SAYRE | PA | 18840 | 232209439 | MANAGEMENT CORP. | PA | NA | C CORP | false |
| CORNING PROPERTIES INC | |||||||||
| 1 GUTHRIE DRIVE | CORNING | NY | 14830 | 383977095 | REAL ESTATE HOLD | NY | NA | C CORP | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | Yes (true) | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | Yes (true) | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |