WARREN GENERAL HOSPITAL: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- WARREN GENERAL HOSPITAL (EIN 25-0965598)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-05-12
- IRS object ID
- 201731329349304878
- 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 D
- Schedule G
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-05-12T14:10:39-05:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 550486667 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ARNETT CARBIS TOOTHMAN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5700 CORPORATE DRIVE STE 650 | AddressLine1Txt |
| City | PITTSBURGH | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 15237 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 250965598 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WARREN GENERAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WARR | BusinessNameControlTxt |
| Phone | 8147234973 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | TWO CRESCENT PARK WEST | AddressLine1Txt |
| City | WARREN | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16365 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JULIE JACOBS | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 8147234973 | PhoneNum |
| Signature | 2017-05-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JEFFREY J PETRELL CPA | PreparerPersonNm |
| PTIN | P00138808 | PTIN |
| Phone | 4126356270 | PhoneNum |
| Preparation | 2017-05-04 | PreparationDt |
| 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 | RICHARD L ALLEN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | TWO CRESCENT PARK WEST | AddressLine1Txt |
| City | WARREN | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16365 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $70,731,421 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.WGH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1898 | FormationYr |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HEALTH CARE SERVICES TO THE PUBLIC INCLUDING INPATIENT ACUTE CARE, PSYCHIATRIC CARE, 24-HR ER CARE, AND OTHER OUTPATIENT SERVICES TO WARREN AND SURROUNDING COUNTIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 647 | TotalEmployeeCnt |
| Total Volunteers | 140 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $391,851 | PYContributionsGrantsAmt |
| CY Contributions Grants | $266,411 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $72,527,042 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $69,075,752 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,987,668 | PYInvestmentIncomeAmt |
| CY Investment Income | -$108,716 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,373,980 | PYOtherRevenueAmt |
| CY Other Revenue | $1,129,133 | CYOtherRevenueAmt |
| PY Total Revenue | $77,280,541 | PYTotalRevenueAmt |
| CY Total Revenue | $70,362,580 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $35,413,863 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $34,184,741 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $62,652 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $45,785,869 | PYOtherExpensesAmt |
| CY Other Expenses | $38,005,369 | CYOtherExpensesAmt |
| PY Total Expenses | $81,199,732 | PYTotalExpensesAmt |
| CY Total Expenses | $72,190,110 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$3,919,191 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,827,530 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $56,093,272 | TotalAssetsBOYAmt |
| Total Assets EOY | $51,946,132 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $36,600,866 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $42,960,242 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $19,492,406 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $8,985,890 | NetAssetsOrFundBalancesEOYAmt |
| Mission | WARREN GENERAL HOSPITAL'S MISSION IS TO PROVIDE COMMUNITY HEALTHCARE WITH QUALITY AND COMPASSION. WE STRIVE TO IMPROVE THE COMMUNITY'S HEALTH, LEAD A VISION FOR THE HEALTHCARE FUTURE, AND MAINTAIN FISCAL VIABILITY WHILE PROVIDING CORE HEALTHCARE SERVICES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $56,839,080 | ExpenseAmt |
| Revenue | $69,296,162 | RevenueAmt |
| Desc | THE WARREN GENERAL HOSPITAL (WGH) IS A NON-PROFIT ACUTE CARE HOSPITAL. WGH PROVIDES HEALTHCARE SERVICES TO THE PUBLIC. THESE SERVICES INCLUDE: INPATIENT ACUTE CARE AND PSYCHIATRIC CARE, 24 HOUR EMERGENCY ROOM, OUTPATIENT HOME CARE AND OTHER OUTPATIENT CARE FOR RESIDENTS OF WARREN COUNTY AND SURROUNDING AREAS. IN ADDITION, THE HOSPITAL OFFERS AN OUTPATIENT CANCER CARE CENTER TO RELIEVE THE NEED FOR RESIDENTS TO TRAVEL DURING THESE MOST DIFFICULT TIMES. THE HOSPITAL ALSO OPERATES TWO OUTPATIENT DENTAL CLINICS FOR THOSE UNDER/UNINSURED RESIDENTS IN NEED OF DENTAL SERVICES. | Desc |
| Total Program Service Expenses | $56,839,080 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 40 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 647 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | 0 | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | PA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JULIE JACOBS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8147233300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | TWO CRESCENT PARK | AddressLine1Txt |
| City | WARREN | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16365 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| CARMEN N FERRANTO | |||||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| TIMOTHY R BEVEVINO ESQ | |||||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| LISA HAGBERG | |||||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| VIJAYA K AGARWALA MD | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $416,333 | $0 | $51,223 | ||||
| GLENN FEGLEY | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| GARY L MCAFOOS MD | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| DAVID M MCCONNELL JR MD | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| JULIA W MCTAVISH | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| TIMOTHY STANTON MD | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $237,237 | $0 | $30,570 | ||||
| MASON TOOTELL MD | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $207,970 | $0 | $28,192 | ||||
| THAD TURNER | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| RICHARD L ALLEN | |||||||||
| CEO | 40.00 | Yes (X) | $344,043 | $0 | $36,522 | 1.00 | |||
| JULIE D JACOBS | |||||||||
| CFO | 40.00 | Yes (X) | $135,127 | $0 | $13,286 | 1.00 | |||
| RANDY CALIFORNIA | |||||||||
| CHIEF OPERATING OFFICER | 40.00 | $239,071 | $0 | $29,680 | Yes (X) | ||||
| DAVID J THOMAS MD | |||||||||
| PHYSICIAN | 40.00 | $578,695 | $0 | $34,522 | Yes (X) | ||||
| TREVOR M OLSEN MD | |||||||||
| PHYSICIAN | 40.00 | $597,223 | $0 | $45,231 | Yes (X) | ||||
| ANNE RASSIGA MD | |||||||||
| PHYSICIAN | 40.00 | $473,564 | $0 | $61,946 | Yes (X) | ||||
| NIAZ AHMED MD | |||||||||
| PHYSICIAN | 40.00 | $458,951 | $0 | $55,275 | Yes (X) | ||||
| MARK LONDON MD | |||||||||
| PHYSICIAN | 40.00 | $611,732 | $0 | $34,240 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,299,946 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $420,687 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 38 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ASSOCIATED CLINICAL LABS | |||||
| 1526 PEACH STREET | ERIE | PA | 16501 | LABORATORY SERVICES | $1,266,937 |
| GROUP MEDICAL SERVICES CORP | |||||
| PO BOX 68 | WARREN | PA | 16365 | PURCHASED SERVICES | $757,079 |
| WEATHERBY LOCUMS INC | |||||
| PO BOX 972633 | DALLAS | TX | 75397 | PURCHASED MEDICAL SERVICES | $643,164 |
| KING'S MEDICAL COMPANY | |||||
| 1920A GEORGETOWN ROAD | HUDSON | OH | 44236 | PURCHASED MEDICAL SERVICES (MRI) | $511,025 |
| DEERFIELD PROFESSIONAL ASSOCIATES | |||||
| 514 WEST THIRD AVENUE | WARREN | PA | 16365 | PURCHASED MEDICAL SERVICES | $431,351 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 15 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $4,535 | FundraisingAmt |
| All Other Contributions | $261,876 | AllOtherContributionsAmt |
| Total Contributions | $266,411 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 623990 | $67,941,792 | $67,941,792 |
| HOME HEALTH SERVICES | 621610 | $1,133,960 | $1,133,960 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $69,075,752 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $244,907 | TotalRevenueColumnAmt |
| Exclusion | $244,907 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $353,623 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$353,623 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$353,623 | TotalRevenueColumnAmt |
| Exclusion | -$353,623 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $71,120 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $4,535 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $15,218 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $55,902 | TotalRevenueColumnAmt |
| Exclusion | $55,902 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| VANTAGE/DEERFIELD/CHART | 900099 | $836,950 | $836,950 | |
| CAFETERIA REVENUE | 900099 | $220,410 | $220,410 | |
| OTHER REVENUE | 900099 | $15,871 | $15,871 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,073,231 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $70,362,580 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $69,296,162 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $800,007 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,769,254 | TotalAmt |
| Management And General | $1,769,254 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,282,637 | TotalAmt |
| Program Services | $16,463,824 | ProgramServicesAmt |
| Management And General | $5,799,655 | ManagementAndGeneralAmt |
| Fundraising | $19,158 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,767,784 | TotalAmt |
| Program Services | $1,909,627 | ProgramServicesAmt |
| Management And General | $855,935 | ManagementAndGeneralAmt |
| Fundraising | $2,222 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,372,103 | TotalAmt |
| Program Services | $3,837,198 | ProgramServicesAmt |
| Management And General | $1,530,440 | ManagementAndGeneralAmt |
| Fundraising | $4,465 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,992,963 | TotalAmt |
| Program Services | $1,375,041 | ProgramServicesAmt |
| Management And General | $616,322 | ManagementAndGeneralAmt |
| Fundraising | $1,600 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,300 | TotalAmt |
| Management And General | $92,300 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,407 | TotalAmt |
| Management And General | $88,407 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,112,232 | TotalAmt |
| Program Services | $13,141,386 | ProgramServicesAmt |
| Management And General | $1,970,846 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $701,797 | TotalAmt |
| Program Services | $375,024 | ProgramServicesAmt |
| Management And General | $294,221 | ManagementAndGeneralAmt |
| Fundraising | $32,552 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,440,636 | TotalAmt |
| Program Services | $1,440,636 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $401,541 | TotalAmt |
| Program Services | $138,572 | ProgramServicesAmt |
| Management And General | $262,680 | ManagementAndGeneralAmt |
| Fundraising | $289 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $258,495 | TotalAmt |
| Program Services | $258,495 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,463,270 | TotalAmt |
| Program Services | $3,463,270 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,068,975 | TotalAmt |
| Program Services | $1,068,975 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES | $11,685,771 | $11,685,771 | ||
| REPAIRS & MAINTENANCE | $1,833,498 | $1,170,954 | $662,544 | |
| LICENSES AND FEES | $1,358,788 | $148,529 | $1,210,221 | $38 |
| EQUIPMENT RENTALS AND L | $221,028 | $220,878 | $150 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $278,631 | TotalAmt |
| Program Services | $140,900 | ProgramServicesAmt |
| Management And General | $135,403 | ManagementAndGeneralAmt |
| Fundraising | $2,328 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,190,110 | TotalAmt |
| Program Services | $56,839,080 | ProgramServicesAmt |
| Management And General | $15,288,378 | ManagementAndGeneralAmt |
| Fundraising | $62,652 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $515,086 | BOYAmt |
| EOY | $969,331 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $334,252 | BOYAmt |
| EOY | $129,486 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,335,216 | BOYAmt |
| EOY | $8,849,083 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $101,189 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,463,312 | BOYAmt |
| EOY | $1,618,551 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $523,539 | BOYAmt |
| EOY | $704,935 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $83,493,884 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $63,637,185 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,409,994 | BOYAmt |
| EOY | $19,856,699 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,709,174 | BOYAmt |
| EOY | $9,724,109 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,701,510 | BOYAmt |
| EOY | $10,093,938 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,093,272 | BOYAmt |
| EOY | $51,946,132 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,479,180 | BOYAmt |
| EOY | $10,255,424 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,235 | BOYAmt |
| EOY | $94,019 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,805,175 | BOYAmt |
| EOY | $3,658,966 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,078,000 | BOYAmt |
| EOY | $2,878,000 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,226,276 | BOYAmt |
| EOY | $26,073,833 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,600,866 | BOYAmt |
| EOY | $42,960,242 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,864,116 | BOYAmt |
| EOY | -$600,903 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,518,132 | BOYAmt |
| EOY | $4,732,371 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,110,158 | BOYAmt |
| EOY | $4,854,422 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,492,406 | BOYAmt |
| EOY | $8,985,890 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,093,272 | BOYAmt |
| EOY | $51,946,132 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,827,530 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $322,858 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | -$1,350,637 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$7,651,207 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,892,957 | BeginningYearBalanceAmt |
| Contributions | $4,510 | ContributionsAmt |
| Investment Earnings Or Losses | -$43,069 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $240,893 | OtherExpendituresAmt |
| End Year Balance | $5,613,505 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $11,127,993 | BeginningYearBalanceAmt |
| Contributions | $21,266 | ContributionsAmt |
| Investment Earnings Or Losses | $135,091 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $5,391,393 | OtherExpendituresAmt |
| End Year Balance | $5,892,957 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $9,106,171 | BeginningYearBalanceAmt |
| Contributions | $1,001,118 | ContributionsAmt |
| Investment Earnings Or Losses | $1,291,010 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $256,830 | OtherExpendituresAmt |
| Administrative Expenses | $13,476 | AdministrativeExpensesAmt |
| End Year Balance | $11,127,993 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $9,948,456 | BeginningYearBalanceAmt |
| Contributions | $99,909 | ContributionsAmt |
| Investment Earnings Or Losses | $959,373 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,888,832 | OtherExpendituresAmt |
| Administrative Expenses | $12,735 | AdministrativeExpensesAmt |
| End Year Balance | $9,106,171 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $8,391,676 | BeginningYearBalanceAmt |
| Contributions | $2,342,897 | ContributionsAmt |
| Investment Earnings Or Losses | -$195,755 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $577,004 | OtherExpendituresAmt |
| Administrative Expenses | $13,358 | AdministrativeExpensesAmt |
| End Year Balance | $9,948,456 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.02000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.86490 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.11510 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $674,941 | OtherCostOrOtherBasisAmt |
| Book Value | $674,941 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $43,778,315 | OtherCostOrOtherBasisAmt |
| Depreciation | $33,670,846 | DepreciationAmt |
| Book Value | $10,107,469 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,170,366 | OtherCostOrOtherBasisAmt |
| Book Value | $3,170,366 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $35,830,086 | OtherCostOrOtherBasisAmt |
| Depreciation | $29,966,339 | DepreciationAmt |
| Book Value | $5,863,747 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $40,176 | OtherCostOrOtherBasisAmt |
| Book Value | $40,176 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $19,856,699 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (8 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM AFFILIATES | $15,404 |
| OTHER ASSETS | $641,178 |
| ESTIMATED INSURANCE RECOVERIES | $1,042,000 |
| DEFERRED FINANCING COSTS | $34,860 |
| BENEFICIAL INTEREST IN TRUSTS | $5,004,264 |
| INTEREST IN NET ASSETS OF COMMUNITY FOUNDATION OF WARREN | $112,770 |
| ASSETS LIMITED AS TO USE | $3,071,938 |
| ESTIMATED AMOUNTS DUE FROM THIRD PARTY PAYORS | $171,524 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $10,093,938 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| ACCRUED POST RETIREMENT BENEFIT | $312,862 |
| ACCURED PENSION COSTS | $22,661,139 |
| ESTIMATED INSURANCE COSTS | $1,266,000 |
| DEFERRED COMPENSATION | $1,833,832 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $26,073,833 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AND IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN MADE. THE HOSPITAL FOLLOWS THE GUIDANCE FOR ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN A COMPANY'S CONSOLIDATED FINANCIAL STATEMENTS THAT PRESCRIBES A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. THE GUIDANCE ALSO ADDRESSES DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, AND DISCLOSURE. THE HOSPITAL'S POLICY IS TO RECOGNIZE INTEREST RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE AND PENALTIES IN MATERIALS, SUPPLIES, AND SERVICES EXPENSES. THERE WERE NO INTEREST OR PENALTIES RECOGNIZED ON THE CONSOLIDATED STATEMENT OF OPERATIONS AS A RESULT OF THIS GUIDANCE. GENERALLY, TAX RETURNS FOR YEARS ENDED JUNE 30, 2013, AND THEREAFTER REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. | ExplanationTxt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | HOSPITAL BALL | Event1Nm |
| Gross Receipts Event1 | $7,975 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $4,535 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $3,440 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $3,421 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $19 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $39 | OtherDirectExpensesEvent1Amt |
| Event2 | GOLF OUTING | Event2Nm |
| Gross Receipts Event2 | $67,680 | GrossReceiptsEvent2Amt |
| Gross Revenue Event2 | $67,680 | GrossRevenueEvent2Amt |
| Cash Prizes Event2 | $330 | CashPrizesEvent2Amt |
| Non Cash Prizes Event2 | $9,800 | NonCashPrizesEvent2Amt |
| Other Direct Expenses Event2 | $1,609 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $75,655 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $4,535 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $71,120 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $330 | CashPrizesTotalEventsAmt |
| Non Cash Prizes Total Events | $9,800 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $3,421 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $19 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $1,648 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $15,218 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $55,902 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $85,462 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $85,462 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,732,136 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,535,012 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,197,124 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04430 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,817,598 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,535,012 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,282,586 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04550 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $49,960 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $49,960 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,153,156 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $512,129 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $641,027 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00890 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,454 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,454 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,209,570 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $512,129 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $697,441 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00970 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,027,168 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,047,141 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,980,027 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05520 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $38,402 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $38,402 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $325,346 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $325,346 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00450 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $363,748 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $363,748 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00500 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,510,532 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $151,053 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $17,941,094 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $26,272,230 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$8,331,136 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (2 entries)
| Primary ActivitiesPrimaryActivitiesTxt | Org Profit Or OwnershipOrgProfitOrOwnershipPct | Ofcr Etc Profit Or OwnershipOfcrEtcProfitOrOwnershipPct | Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct |
|---|---|---|---|
| 1 PINEGROVE AMBULATORY | |||
| OUTPATIENT AMBULATORY SURGERY | 0.35000 | 0.11000 | 0.54000 |
| 2 MEDIPAR ASSOCIATES | |||
| REAL ESTATE FOR MEDICAL BLDG | 0.86000 | 0.14000 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WARREN GENERAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | TWO CRESCENT PARK WEST | AddressLine1Txt |
| City | WARREN | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16365 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.WGH.ORG | WebsiteAddressTxt |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WARREN GENERAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.WGH.ORG | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.WGH.ORG | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.WGH.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.WGH.ORG | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | 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 |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Medicare Rates | Yes (X) | MedicareRatesInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| WARREN GENERAL HOSPITAL | PART V, SECTION B, LINE 5: DEMOGRAPHIC INFORMATION, SECONDARY DATA STATISTICS, AND RESULTS OF PHYSICIAN SURVEY WERE PROVIDED TO THE GROUP IN THE FORM OF A POWER POINT PRESENTATION. THE GROUP WAS ASKED TO PROVIDE OPINION ON THE #1 CONCERN WARREN COUNTY POPULATION IS FACING PRE AND POST PRESENTATION. THE PERSONS THE HOSPITAL CONSULTED WITH WERE AS FOLLOWS:NUTRITION EDUCATION ADVISOR FROM PENN STATE NUTRITION LINK - CAROL WILCOXSENIOR INCOME DEVELOPMENT REP FROM AMERICAN CANCER SOCIETY/WARREN COUNTY - MARIE COSTELLOEXECUTIVE DIRECTOR FROM WARREN COUNTY HOUSING AUTHORITY - TONYA MITCHELL-WESTRNC FROM PA DEPT OF HEALTH/WARREN COUNTY - BARBARA WHITEEXECUTIVE DIRECTOR OF EXPERIENCE INC./AREA AGENCY ON AGING - FARLEY WRIGHTWARREN COUNTY SHERIFF - WILLIAM GARDNERPOLICE LIEUTENANT FROM WARREN POLICE DEPT - JAMES JORDANWGH DIRECTOR OF MARKETING AND DEVELOPMENT - GEORGE LILJAPSYCHIATRIST FROM DEERFIELD BEHAVIORAL HEALTH - MARK BEUGER, MDVP OF PROGRAM EVALUATION FROM BEACON LIGHT BEHAVIORAL HEALTH - BECKY JENSENWGH DIABETES EDUCATOR - NANCY MAGUEADMINISTRATOR OF THE ROUSE HOME - CINDY WALTERSSUPERINTENDENT OF WARREN COUNTY SCHOOL DISTRICT - BRANDON HUFFNAGELOFFICE MANAGER AND PROGRAM DEVELOPMENT SPECIALIST AT DEERFIELD BEHAVIORAL HEALTH - SUSAN TECONCHUKWGH DIRECTOR OF PATIENT & PUBLIC RELATIONS - HOLLI SUMMERVILLECOO OF WARREN MEDICAL GROUP - KAREN COOMBSEXECUTIVE DIRECTOR OF THE WARREN COUNTY YMCA - THAD TURNERWARREN GENERAL HOSPITAL ALCOHOL/DRUG COUNSELOR - JESSICA UBER |
| WARREN GENERAL HOSPITAL | PART V, SECTION B, LINE 7D: THE CHNA WAS AVAILABLE ON THE HOSPITAL'S WEBSITE - WWW.WGH.ORG - WAS AVAILABLE IN PAPER COPY FOR PUBLIC INSPECTION AT THE HOSPITAL, AND INFORMATION ON HOW TO ACCESS THE CHNA WAS PUBLISHED ON THE WGH QUARTERLY NEWSLETTER. |
| WARREN GENERAL HOSPITAL | PART V, SECTION B, LINE 11: THE HOSPITAL CONDUCTS ANNUAL STRATEGIC PLANNING SESSIONS WHICH INCLUDES A FOCUS ON COMMUNITY HEALTH NEEDS. THE HOSPITAL USES METRICS AND PLANS SERVICE NEEDS ACCORDINGLY. THIS PROCESS IS INTERACTIVE AND HAS RESULTED IN THE EXPANSION OF DENTAL SERVICES IN 2010 AS ONE EXAMPLE. WE ALSO DRIVE OUR PHYSICIAN RECRUITING PLAN FROM THIS PROCESS. |
| WARREN GENERAL HOSPITAL | PART V, SECTION B, LINE 16I: A FINANCIAL ASSISTANCE COUNSELOR IS AVAILABLE TO SPEAK WITH ELIGIBLE INDIVIDUALS REGARDING OUR FAP. |
| WARREN GENERAL HOSPITAL | PART V, SECTION B, LINE 20E: THE HOSPITAL EMPLOYS A FINANCIAL COUNSELOR WHO SPEAKS WITH ELIGIBLE INDIVIDUALS REGARDING OUR FINANCIAL ASSISTANCE POLICY. SHE ASSISTS INDIVIDUALS IN APPLYING FOR OUR STATE MEDICAL ASSISTANCE PROGRAM. |
| WARREN GENERAL HOSPITAL | PART V, SECTION B, LINE 22D: WARREN GENERAL HOSPITAL USES THE LOOK-BACK METHOD TO CALCULATE AMOUNTS GENERALLY BILLED. |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | A COST-TO-CHARGE RATIO CALCULATED FROM WORKSHEET 2, RATIO OF PATIENT CARE COSTS-TO-CHARGES IS THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNTS REPORTED ON PART I, LINE 7. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | THE HOSPITAL SPENT $325,346 ON THE DIRECT EXPENSE OF RECRUITING PHYSICIANS ITS RURAL MARKET DURING FISCAL YEAR 2016.THE DIRECT HEALTH BENEFITS AND INDIRECT ECONOMIC BENEFITS OF OUR EMPLOYMENT AND SPENDING ARE SUBSTANTIAL. OUR TRADE ASSOCIATION ESTIMATES THAT THE ECONOMIC IMPACT (DIRECT SPENDING OF THE HOSPITAL PLUS INDIRECT BENEFITS ON OUR COMMUNITY) IS OVER $100 MILLION DOLLARS. |
| PART III, LINE 2: | PATIENT ACCOUNTS RECEIVABLE ARE REPORTED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THEY ARE DETERMINED TO BE UNCOLLECTABLE BASED UPON MANAGEMENT'S ASSESSMENT OF INDIVIDUAL ACCOUNTS. THE ALLOWANCE FOR DOUBTFUL COLLECTIONS IS ESTIMATED BASED UPON PERIODIC REVIEW OF THE ACCOUNTS RECEIVABLE AGING, PAYOR CLASSIFICATIONS, AND APPLICATION OF HISTORICAL WRITE-OFF PERCENTAGES. |
| PART III, LINE 3: | THE HOSPITAL CALCULATED AN OVERALL COST TO CHARGE RATIO USING GROSS CHARGES AND TOTAL OPERATING COSTS LESS BAD DEBT EXPENSE. THE HOSPITAL THEN REDUCED ITS BAD DEBT EXPENSE TO COST USING THIS COST TO CHARGE RATIO. THE ESTIMATE OF THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY IS 10% OF THE BAD DEBT AT COST. |
| PART III, LINE 4: | ESTIMATES OF ALLOWANCE FOR ADJUSTMENTS INCLUDED IN NET PATIENT SERVICE REVENUE ARE DESCRIBED IN NOTES 1 AND 2. |
| PART III, LINE 8: | THE HOSPITAL'S LARGEST GOVERNMENTAL PAYER IS THE FEDERAL MEDICARE PROGRAM. THE HOSPITAL'S COSTS ARE GREATER THAN PROGRAM REIMBURSEMENTS. IT IS CLEARLY A COMMUNITY BENEFIT FOR THE HOSPITAL TO PROVIDE RURAL ACCESS TO MEDICARE BENEFICIARIES IN TERMS OF TIME, DISTANCE, AND WEATHER CONDITIONS ISSUES. THE ALLOWABLE COSTS ARE OBTAINED FROM THE FISCAL YEAR MEDICARE COST REPORT FOR EACH OF THE HOSPITAL AREAS (INPATIENT, OUTPATIENT, ETC.). |
| PART III, LINE 9B: | THE HOSPITAL CONTRACTS WITH A RECEIVABLES MANAGEMENT COMPANY TO HANDLE THE SELF-PAY ACCOUNTS RECEIVABLE FROM DAY 1 TO 120. AT DAY 61, THE RECEIVABLES MANAGEMENT COMPANY RUNS A PUBLIC DATA SEARCH ON THE INDIVIDUALS WITH OUTSTANDING ACCOUNTS AS PART OF A REQUIREMENT FOR 501(R). THE PUBLIC DATA SEARCH REPORT IS GIVEN TO OUR FINANCIAL COUNSELOR WHO FOLLOWS UP WITH THAT PATIENT IN AN EFFORT TO CHECK CHARITY ELIGIBILITY OR STATE MEDICAL ASSISTANCE PROGRAM. AFTER DAY 120 THE ACCOUNTS ARE SENT TO A COLLECTIONS AGENCY WHO AT THAT POINT REPORTS THE INDIVIDUALS TO A CREDIT AGENCY. AT DAY 366, ANY OUTSTANDING ACCOUNTS ARE SENT TO A SECOND COLLECTION AGENCY. A FINANCIAL COUNSELOR IS AVAILABLE AS WELL TO ASSIST THE INDIVIDUALS AT ANY POINT IN THE PROCESS WITH OUR FINANCIAL ASSISTANCE POLICY. |
| PART VI, LINE 2: | THE HOSPITAL CONDUCTS ANNUAL STRATEGIC PLANNING SESSIONS AND ONE FOCUS IS THE HEALTH NEEDS OF THE COMMUNITY. |
| PART VI, LINE 3: | THE HOSPITAL DEPLOYS MANY METHODS TO DETERMINE WHICH PATIENTS MIGHT BE ELIGIBLE FOR CHARITY CARE OR GOVERNMENT FINANCIAL ASSISTANCE INCLUDING ITS WEBSITE, NOTICES ON PATIENT STATEMENTS, NOTICES ON THE HOSPITAL, AND THE EMPLOYMENT OF A FINANCIAL COUNSELOR. |
| PART VI, LINE 4: | WARREN COUNTY HAS A POPULATION OF APPROXIMATELY 40,000. THE COUNTY IS A LARGE GEOGRAPHIC SIZE WITH MANY RURAL AND SMALL COMMUNITIES.WARREN COUNTY RANKS 13TH OF 67 COUNTIES IN PENNSYLVANIA IN TERMS OF OVERALL HEALTH OUTCOMES.WARREN COUNTY RANKS 48TH OF 67 COUNTIES IN PENNSYLVANIA IN TERMS OF HEALTH FACTORS17.5% OF THE POPULATION IS +65 - STATE AVERAGE 15.2%27% ADULT POPULATION SMOKES - STATE AVERAGE 23%28% ADULT OBESITY - STATE AVERAGE 28%16% POOR HEALTH - STATE AVERAGE 14%12% UNINSURED ADULTS - STATE AVERAGE 12% |
| PART VI, LINE 5: | WE HAVE AN OPEN MEDICAL STAFF, A DIVERSE COMMUNITY BOARD, AND ALL OF OUR SURPLUS IS USED TO SUSTAIN AND REINVEST IN OUR PLANT AND FUND BALANCE TO ASSURE LONG TERM VIABILITY AND ACCESS IN OUR COMMUNITY. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| VIJAYA K AGARWALA MD | ||||||||||||||
| BOARD MEMBER | $416,333 | $0 | $0 | $0 | $0 | $0 | $35,626 | $0 | $15,597 | $0 | $467,556 | $0 | $0 | $0 |
| TIMOTHY STANTON MD | ||||||||||||||
| BOARD MEMBER | $9,446 | $0 | $0 | $0 | $227,791 | $0 | $14,973 | $0 | $15,597 | $0 | $267,807 | $0 | $0 | $0 |
| MASON TOOTELL MD | ||||||||||||||
| BOARD MEMBER | $200,078 | $0 | $0 | $0 | $7,892 | $0 | $12,595 | $0 | $15,597 | $0 | $236,162 | $0 | $0 | $0 |
| RICHARD L ALLEN | ||||||||||||||
| CEO | $309,683 | $0 | $31,500 | $0 | $2,860 | $0 | $20,925 | $0 | $15,597 | $0 | $380,565 | $0 | $0 | $0 |
| RANDY CALIFORNIA | ||||||||||||||
| CHIEF OPERATING OFFICER | $211,381 | $0 | $26,400 | $0 | $1,290 | $0 | $14,083 | $0 | $15,597 | $0 | $268,751 | $0 | $0 | $0 |
| DAVID J THOMAS MD | ||||||||||||||
| PHYSICIAN | $453,408 | $0 | $72,590 | $0 | $52,697 | $0 | $18,925 | $0 | $15,597 | $0 | $613,217 | $0 | $0 | $0 |
| TREVOR M OLSEN MD | ||||||||||||||
| PHYSICIAN | $549,566 | $0 | $0 | $0 | $47,657 | $0 | $29,639 | $0 | $15,592 | $0 | $642,454 | $0 | $0 | $0 |
| ANNE RASSIGA MD | ||||||||||||||
| PHYSICIAN | $473,564 | $0 | $0 | $0 | $0 | $0 | $56,644 | $0 | $5,302 | $0 | $535,510 | $0 | $0 | $0 |
| NIAZ AHMED MD | ||||||||||||||
| PHYSICIAN | $458,951 | $0 | $0 | $0 | $0 | $0 | $39,678 | $0 | $15,597 | $0 | $514,226 | $0 | $0 | $0 |
| MARK LONDON MD | ||||||||||||||
| PHYSICIAN | $380,837 | $0 | $198,082 | $0 | $32,813 | $0 | $18,643 | $0 | $15,597 | $0 | $645,972 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | THE FOLLOWING EMPLOYEES PARTICIPATE IN A 457(F) PLAN: VIJAYA K. AGARWALA $16,667 RICHARD ALLEN $9,000 TREVOR OLSEN $10,714 ANNE RASSIGA $37,500 NIAZ AHMED $20,000 | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| JODI BEVEVINO | |||
| FAMILY MEMBER OF TIMOTHY R. BEVEVINO, BOARD MEMBER | $159,635 | EMPLOYEE OF WARREN GENERAL HOSPITAL | 0 |
| SWANSON BEVEVINO & GILFORD | |||
| ENTITY MORE THAN 35% OWNED BY TIMOTHY R. BEVEVINO, BOARD MEMBER | $135,930 | LEGAL SERVICES | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | CARE CORPORATION OF WARREN IS THE SOLE CORPORATE MEMBER OF WARREN GENERAL HOSPITAL. |
| FORM 990, PART VI, SECTION A, LINE 7A | CARE CORPORATION OF WARREN, THE PARENT COMPANY, APPOINTS THREE OF THE MEMBERS OF THE WARREN GENERAL HOSPITAL BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | SPECIFIC DECISIONS OF THE BOARD OF DIRECTORS ARE SUBJECT TO APPROVAL BY THE BOARD OF DIRECTORS OF CARE CORPORATION OF WARREN, THE PARENT COMPANY. |
| FORM 990, PART VI, SECTION B, LINE 11 | WARREN GENERAL HOSPITAL HAS A CPA FIRM PREPARE ITS FORM 990. THE RETURN IS COMPLETED IN DRAFT FORM AND REVIEWED BY MANAGEMENT OF THE ORGANIZATION. THE FORM 990 IS THEN PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW BEFORE IT IS FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH YEAR THE DIRECTORS ARE REQUIRED TO SIGN A CONFLICT OF INTEREST POLICY AND DISCLOSE ANY BUSINESS OR FAMILY RELATIONSHIPS WHICH MAY CREATE A CONFLICT. EACH BOARD OF DIRECTOR AGREES TO REFRAIN FROM VOTING ON ANY ITEM IN WHICH A CONFLICT MAY EXIST. ANNUALLY, THE CORPORATE COMPLIANCE OFFICER REVIEWS THE POLICY AND AUDITS THE SIGNATURES. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE HOSPITAL PARTICIPATES IN THE YAFFEE AND COMPANY HOSPITAL ASSOCIATION OF PENNSYLVANIA COUNCIL OF SMALL HOSPITALS EXECUTIVE COMPENSATION SURVEY. THIS INSTRUMENT SURVEYS HOSPITALS OF LIKE SIZE AND WITHIN OUR GEOGRAPHY. THE HOSPITAL BOARD CHOSE THIS INSTRUMENT DUE TO ITS RELEVANCY TO THE HOSPITAL'S MARKET. THE SURVEY DATA IS USED BY THE HOSPITAL BOARD OF DIRECTORS COMPENSATION COMMITTEE FOR COMPARISONS OF COMPENSATION AND BENEFITS FOR THE CEO AND OTHER TOP MANAGEMENT OFFICIALS. THE COMPENSATION COMMITTEE REPORTS ITS FINDINGS AND MAKES RECOMMENDATIONS TO THE FULL BOARD OF DIRECTORS FOR THEIR REVIEW, DELIBERATION, AND APPROVAL OR MODIFICATION. THE HOSPITAL BOARD OF DIRECTORS ALSO APPOINTED A COMMITTEE CALLED THE MANAGEMENT TRANSACTION AND AUDIT COMMITTEE TO REVIEW ALL TRANSACTIONS BETWEEN THE HOSPITAL AND PHYSICIANS. THIS BODY REVIEWS SEVERAL PHYSICIAN COMPENSATION SURVEYS (SUCH AS THE MEDICAL GROUP MANAGEMENT ASSOCIATION SURVEY AND THE MERRITT HAWKINS SURVEY) TO ESTABLISH COMPARISONS FOR PHYSICIAN COMPENSATION. |
| FORM 990, PART VI, SECTION C, LINE 18 | WARREN GENERAL HOSPITAL MAKES ITS FORM 990 AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART VI, SECTION C, LINE 19 | EACH YEAR A COMBINED CORPORATE MEETING IS HELD IN WHICH THE PUBLIC IS WELCOME TO ATTEND. IN ADDITION, DOCUMENTS WILL BE MADE AVAILABLE TO THE PUBLIC IF THEY ARE REQUESTED IN PERSON OR IN WRITING. |
| FORM 990, PART IX, LINE 11G | PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 13,141,386. MANAGEMENT AND GENERAL EXPENSES 1,970,846. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,112,232. |
| FORM 990, PART XI, LINE 9: | CHANGE IN DEFINED BENEFIT PENSION PLAN GAINS/LOSSES & PRIOR SERVICE COSTS -7,629,197. CHANGE IN DEFINED BENEFIT POST RETIREMENT PLAN GAINS AND LOSSES 11,985. TRANSFERS TO AFFILIATE 226,428. TEMP. RESTRICTED NET ASSETS INVESTMENT RETURN -4,687. PERM. RESTRICTED NET ASSETS CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUS -255,736. |
| FORM 990, PART XII, LINE 2C: | THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
| PART VI, SECTION B, LINE 16: | THE HOSPITAL BOARD OF DIRECTORS MUST ULTIMATELY APPROVE ANY INVESTMENTS IN ANY JOINT VENTURE OR SIMILAR ARRANGEMENT. AS AN ADDITIONAL STEP, THE HOSPITAL BOARD OF DIRECTORS APPOINTED A COMMITTEE CALLED THE MANAGEMENT TRANSACTION & AUDIT COMMITTEE THAT REVIEWS ALL TRANSACTIONS BETWEEN THE HOSPITAL AND PHYSICIANS. AS PART OF ITS GOVERNANCE AND OVERSIGHT ROLE, THE FULL HOSPITAL BOARD ALSO SUBJECTS ANY JOINT VENTURE ARRANGEMENTS TO LEGAL REVIEW PRIOR TO ANY INVESTMENT BY THE HOSPITAL. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| CARE CORPORATION OF WARREN | |||||||||||
| 2 CRESCENT PARK WEST | WARREN | PA | 16365 | 251512016 | PARENT CORP | PA | 501(C)(3) | LINE 11C, III-FI | N/A | 0 | |
| GENERAL CARE SERVICES INC | |||||||||||
| 2 CRESCENT PARK WEST | WARREN | PA | 16365 | 251512020 | HOSPICE SERVICES | PA | 501(C)(3) | LINE 9 | 0 | CARE CORPORATION OF WARREN | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEDIPAR ASSOCIATES | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 103 WEST ST CLAIR ST | AddressLine1Txt |
| City | WARREN | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 16365 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 251361787 | EIN |
| Primary Activities | REAL ESTATE | PrimaryActivitiesTxt |
| Legal Domicile State | PA | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WARREN GENERAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | -$11,965 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $256,873 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
| Ownership | 0.82890 | OwnershipPct |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GROUP MEDICAL SERVICES CORP | ||||||||||||
| 2 CRESCENT PARK WEST | WARREN | PA | 16365 | 232803659 | HEALTH CARE SVCS | PA | CARE CORPORATION OF WAREEN | C | 0 | |||
| WEST ST CLAIR INC | ||||||||||||
| 103 WEST ST CLAIR ST | WARREN | PA | 16365 | 251601073 | REAL ESTATE | PA | WARREN GENERAL HOSPITAL | C | Yes (1) | $1,134 | $135,830 | 0.82500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |