THE PALMERTON HOSPITAL: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- THE PALMERTON HOSPITAL (EIN 23-5562316)
- Tax period
- 2014-07-01 to 2015-06-30
- Filed
- 2016-05-16
- IRS object ID
- 201641379349305654
- Schema version
- 2014v6.0
- 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 J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-05-16T13:01:07-05:00 | ReturnTs |
| Tax Period End | 2015-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390859910 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BAKER TILLY VIRCHOW KRAUSE LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1650 MARKET STREET SUITE 4500 | AddressLine1Txt |
| City | PHILADELPHIA | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 19103 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 235562316 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE PALMERTON HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PALM | BusinessNameControlTxt |
| Phone | 6103777003 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 135 LAFAYETTE AVENUE | AddressLine1Txt |
| City | PALMERTON | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 18071 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANDREA ANDRAE | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 6103777003 | PhoneNum |
| Signature | 2016-05-13 | SignatureDt |
| Discuss With Paid Preparer | 0 | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JULIUS C GREEN CPA JD | PreparerPersonNm |
| PTIN | P00350393 | PTIN |
| Phone | 2159720701 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-08-17 19:52:53Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ANDREA L ANDRAE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 135 LAFAYETTE AVENUE | AddressLine1Txt |
| City | PALMERTON | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 18071 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $33,615,976 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.BLMTN.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1913 | FormationYr |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Activity Or Mission | OPERATE A 60 BED ACUTE CARE HOSPITAL. | ActivityOrMissionDesc |
| Voting Members Governing Body | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 421 | TotalEmployeeCnt |
| Total Volunteers | 216 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $296,946 | PYContributionsGrantsAmt |
| CY Contributions Grants | $519,147 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $31,034,508 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $32,476,378 | CYProgramServiceRevenueAmt |
| PY Investment Income | $257,137 | PYInvestmentIncomeAmt |
| CY Investment Income | $105,459 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,340,265 | PYOtherRevenueAmt |
| CY Other Revenue | $288,970 | CYOtherRevenueAmt |
| PY Total Revenue | $32,928,856 | PYTotalRevenueAmt |
| CY Total Revenue | $33,389,954 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,203,459 | 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 | $16,344,285 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $16,883,733 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $15,266,079 | PYOtherExpensesAmt |
| CY Other Expenses | $16,200,406 | CYOtherExpensesAmt |
| PY Total Expenses | $32,813,823 | PYTotalExpensesAmt |
| CY Total Expenses | $33,084,139 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $115,033 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $305,815 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $19,248,693 | TotalAssetsBOYAmt |
| Total Assets EOY | $16,672,690 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $13,052,642 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $10,279,009 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $6,196,051 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,393,681 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | PROMOTE, MAINTAIN AND RESTORE THE GOOD HEALTH OF ALL THE PEOPLE IN THE COMMUNITIES WE SERVE THROUGH PARTNERSHIPS FOR EXCELLENCE IN HEALTHCARE SERVICE DELIVERY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $28,686,219 | ExpenseAmt |
| Revenue | $32,481,409 | RevenueAmt |
| Desc | PALMERTON HOSPITAL (THE HOSPITAL) IS A 60-BED, NOT-FOR-PROFIT GENERAL ACUTE CARE HOSPITAL LOCATED IN THE BOROUGH OF PALMERTON IN CARBON COUNTY. IT IS APPROXIMATELY 20 MILES NORTH OF ALLENTOWN-BETHLEHEM AND LESS THAN 10 MILES EAST OF THE WESTERN POCONO REGION OF NORTHEASTERN PENNSYLVANIA. DURING THE PERIOD OF JULY 1, 2014 THROUGH JUNE 30, 2015, THE HOSPITAL HAD A TOTAL OF 2,011 ADMISSIONS AND 12,659 PATIENT DAYS. TOTAL OCCUPANCY FOR THE HOSPITAL WAS 51.76%.THE HOSPITAL OPERATES A FULL-SERVICE EMERGENCY DEPARTMENT (THE ED). DURING THE PERIOD OF JULY 1, 2014 THROUGH JUNE 30, 2015, THE ED EXPERIENCED APPROXIMATELY 11,776 VISITS. IN ADDITION, THE HOSPITAL PROVIDES SERVICES IN MEDICINE, GENERAL AND ORTHOPEDIC SURGERY, AND INTENSIVE CARE.THE HOSPITAL OPERATES A SATELLITE RADIOLOGY AND LABORATORY SITE IN THE VILLAGE OF GILBERT IN MONROE COUNTY, A COMMUNITY ABOUT 10 MILES FROM THE MAIN FACILITY IN PALMERTON. THE HOSPITAL ALSO HAS MULTIPLE OUTPATIENT THERAPY LOCATIONS IN THE SURROUNDING COMMUNITY. | Desc |
| Total Program Service Expenses | $28,686,219 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | 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 | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 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 | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln 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 | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 26 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 421 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | 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 | 0 | InvestmentInJointVentureInd |
| 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 | ANDREA L ANDRAE CFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6103777003 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 211 NORTH 12TH STREET | AddressLine1Txt |
| City | LEHIGHTON | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 18235 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 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 | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| MICHAEL HARLEMAN | ||||||||
| CHAIRMAN | 1.00 | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| LOUIS SPORTELLI DC | ||||||||
| VICE CHAIRMAN | 1.00 | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| BARBARA GREEN | ||||||||
| BOARD FINANCE CHAIR | 1.00 | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| PATRICK HANLEY DO | ||||||||
| SECRETARY/PHYSICIAN | 1.00 | 3.00 | Yes (X) | Yes (X) | $0 | $7,500 | $0 | |
| ANDREW E HARRIS | ||||||||
| PRESIDENT & CEO | 15.00 | 35.00 | Yes (X) | Yes (X) | $0 | $491,327 | $19,023 | |
| JOHN DEMATTE IV DC | ||||||||
| DIRECTOR | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| WILLIAM MASON | ||||||||
| DIRECTOR | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| WILLIAM H FEGLEY JR | ||||||||
| DIRECTOR | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| REV ROBERT VONFRISCH | ||||||||
| DIRECTOR | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| PATRICK REILLY | ||||||||
| DIRECTOR | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| SHELBA SCHEFFNER | ||||||||
| DIRECTOR | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| WILLIAM MARKSON MD | ||||||||
| DIRECTOR | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| JAIME MENDES | ||||||||
| DIRECTOR | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| ROBERT GROB DO | ||||||||
| DIRECTOR/PHYSICIAN | 1.00 | 3.00 | Yes (X) | $95,000 | $96,250 | $0 | ||
| HON STEVEN SERFASS | ||||||||
| DIRECTOR | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| WILLIAM KISSNER | ||||||||
| DIRECTOR | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| ROSALEE REHRIG DO | ||||||||
| DIRECTOR | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| ANDREA L ANDRAE | ||||||||
| CHIEF FINANCIAL OFFICER | 15.00 | 35.00 | Yes (X) | $148,706 | $0 | $20,767 | ||
| RUTHANN BRENNAN | ||||||||
| VP CLINICAL AFFAIRS | 25.00 | 15.00 | $149,363 | $0 | $11,304 | Yes (X) | ||
| MARSHA M RESCH | ||||||||
| DIRECTOR OF EMERGENCY SERVICES | 40.00 | $123,443 | $0 | $10,206 | Yes (X) | |||
| LORI FREY | ||||||||
| DIRECTOR OF CLINICAL DOCUMENTATION | 25.00 | 15.00 | $120,113 | $0 | $9,783 | Yes (X) | ||
| STEVEN R LAZICKI | ||||||||
| PHYSICAL THERAPIST | 40.00 | $114,977 | $0 | $19,214 | Yes (X) | |||
| JASON R HOWAY | ||||||||
| PHARMACIST | 40.00 | $114,453 | $0 | $17,597 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $866,055 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $595,077 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $107,894 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 12 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| EMCARE | |||||
| 7032 COLLECTION CENTER DR | CHICAGO | IL | 60693 | PHYSICIAN SERVICES | $993,887 |
| SIEMENS MEDICAL SOLUTIONS | |||||
| PO BOX 7777 W3580 | PHILADELPHIA | PA | 19175 | IT SERVICES | $765,361 |
| CARDIOLOGY ASSOC | |||||
| 1241 BLAKESLEE BLVD | LEHIGHTON | PA | 18235 | PHYSICIAN SERVICES | $231,574 |
| VALLEY GEROPSYCH | |||||
| 7773 FURNACE DR | MACUNGIE | PA | 18062 | PHYSICIAN SERVICES | $117,914 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $399,747 | RelatedOrganizationsAmt |
| Government Grants | $9,759 | GovernmentGrantsAmt |
| All Other Contributions | $109,641 | AllOtherContributionsAmt |
| Total Contributions | $519,147 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SVC REV | 621990 | $32,440,394 | $32,440,394 |
| MEALS ON WHEELS | 624200 | $35,984 | $35,984 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $32,476,378 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $55,616 | TotalRevenueColumnAmt |
| Exclusion | $55,616 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $167,735 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $137,559 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $30,176 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $30,176 | TotalRevenueColumnAmt |
| Exclusion | $30,176 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $138,306 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $88,463 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $49,843 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $49,843 | TotalRevenueColumnAmt |
| Exclusion | $49,843 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFE MEALS | 900099 | $118,534 | $118,534 |
| MC & MA MEANINGFUL USE INCOME | 900099 | $99,846 | $99,846 |
| CHART INCOME | 900099 | $25,299 | $25,299 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,115 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,031 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $10,084 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $258,794 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $33,389,954 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $32,481,409 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $389,398 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $187,741 | TotalAmt |
| Program Services | $171,039 | ProgramServicesAmt |
| Management And General | $16,702 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,769,028 | TotalAmt |
| Program Services | $11,633,039 | ProgramServicesAmt |
| Management And General | $1,135,989 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,500 | TotalAmt |
| Program Services | $32,342 | ProgramServicesAmt |
| Management And General | $3,158 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,950,481 | TotalAmt |
| Program Services | $2,687,993 | ProgramServicesAmt |
| Management And General | $262,488 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $940,983 | TotalAmt |
| Program Services | $857,269 | ProgramServicesAmt |
| Management And General | $83,714 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,514 | TotalAmt |
| Management And General | $13,514 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,520 | TotalAmt |
| Management And General | $50,520 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,221 | TotalAmt |
| Program Services | $3,221 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,530,646 | TotalAmt |
| Program Services | $1,440,095 | ProgramServicesAmt |
| Management And General | $1,090,551 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $216,650 | TotalAmt |
| Program Services | $738 | ProgramServicesAmt |
| Management And General | $215,912 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,296,880 | TotalAmt |
| Program Services | $1,113,167 | ProgramServicesAmt |
| Management And General | $183,713 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,322,535 | TotalAmt |
| Program Services | $257,115 | ProgramServicesAmt |
| Management And General | $1,065,420 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $564,316 | TotalAmt |
| Program Services | $564,316 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,486 | TotalAmt |
| Program Services | $28,089 | ProgramServicesAmt |
| Management And General | $5,397 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,842 | TotalAmt |
| Program Services | $1,196 | ProgramServicesAmt |
| Management And General | $1,646 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $101,482 | TotalAmt |
| Management And General | $101,482 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,611,741 | TotalAmt |
| Program Services | $1,611,741 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $257,021 | TotalAmt |
| Program Services | $257,021 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| BAD DEBT EXPENSE | $3,174,133 | $3,174,133 |
| MEDICAL SUPPLIES | $2,626,975 | $2,626,975 |
| DRUGS | $818,109 | $818,109 |
| ACT 55 ASSESS. PAYMENTS | $365,770 | $365,770 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,210,565 | TotalAmt |
| Program Services | $1,042,851 | ProgramServicesAmt |
| Management And General | $167,714 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,084,139 | TotalAmt |
| Program Services | $28,686,219 | ProgramServicesAmt |
| Management And General | $4,397,920 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,503 | BOYAmt |
| EOY | $58,242 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,572,975 | BOYAmt |
| EOY | $3,512,737 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $667,603 | BOYAmt |
| EOY | $729,684 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $97,458 | BOYAmt |
| EOY | $118,667 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $39,917,831 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $31,449,637 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,719,864 | BOYAmt |
| EOY | $8,468,194 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,018,050 | BOYAmt |
| EOY | $1,852,082 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $738,364 | BOYAmt |
| EOY | $742,658 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $464,350 | BOYAmt |
| EOY | $464,350 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $968,526 | BOYAmt |
| EOY | $726,076 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,248,693 | BOYAmt |
| EOY | $16,672,690 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,350,262 | BOYAmt |
| EOY | $4,041,075 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,791,101 | BOYAmt |
| EOY | $1,455,151 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,995 | BOYAmt |
| EOY | $690,513 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,220,822 | BOYAmt |
| EOY | $1,125,875 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,630,462 | BOYAmt |
| EOY | $2,966,395 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,052,642 | BOYAmt |
| EOY | $10,279,009 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,195,982 | BOYAmt |
| EOY | $5,420,117 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,000,069 | BOYAmt |
| EOY | $973,564 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,196,051 | BOYAmt |
| EOY | $6,393,681 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,248,693 | BOYAmt |
| EOY | $16,672,690 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $305,815 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$81,680 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$26,505 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | Yes (1) | AccountantCompileOrReviewInd |
Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $3,221 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $3,221 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | A PORTION OF THE DUES PAID TO THE HOSPITAL & HEALTHSYSTEM ASSOCIATION OF PENNSYLVANIA ($3,221) WAS DETERMINED TO BE FOR LOBBYING PURPOSES. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $642,545 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$26,505 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $616,040 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $587,669 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $54,876 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $642,545 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $557,620 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $30,049 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $587,669 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $586,222 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$28,602 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $557,620 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $260,158 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $60,712 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $1,948 | AdministrativeExpensesAmt |
| End Year Balance | $318,922 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.41660 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.58340 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $126,410 | OtherCostOrOtherBasisAmt |
| Book Value | $126,410 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,297,487 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,466,013 | DepreciationAmt |
| Book Value | $4,831,474 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $344,891 | OtherCostOrOtherBasisAmt |
| Depreciation | $320,753 | DepreciationAmt |
| Book Value | $24,138 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $25,689,804 | OtherCostOrOtherBasisAmt |
| Depreciation | $23,183,301 | DepreciationAmt |
| Book Value | $2,506,503 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,459,239 | OtherCostOrOtherBasisAmt |
| Depreciation | $479,570 | DepreciationAmt |
| Book Value | $979,669 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $8,468,194 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| BLUE CROSS WORKING CAPITAL ADVANCE | $171,128 |
| ESTIMATED MEDICAL MALPRACTICE CLAIMS LIABILITY | $662,933 |
| DUE TO GNADEN HUETTEN MEMORIAL HOSPITAL | $1,954,831 |
| OBLIGATIONS UNDER CAPITAL LEASES | $177,503 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,966,395 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $33,419,328 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$81,680 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$26,505 | OtherRevenueAmt |
| Revenue Not Reported | -$108,185 | RevenueNotReportedAmt |
| Revenue Subtotal | $33,527,513 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$137,559 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$137,559 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $33,389,954 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $33,221,698 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $137,559 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $137,559 | ExpensesNotReportedAmt |
| Expenses Subtotal | $33,084,139 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $33,084,139 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | TERM ENDOWMENT FUNDS ARE USED FOR THE PURCHASE OF PLANT AND EQUIPMENT TO FURTHER THE MISSION OF THE ORGANIZATION. |
| PART X, LINE 2: | PALMERTON HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON ITS EXEMPT INCOME UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE. THE HOSPITAL ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING 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. MANAGEMENT HAS DETERMINED THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD. THE HOSPITAL'S FEDERAL EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURNS FOR 2012, 2013, AND 2014 REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | VALUATION LOSS -26,505. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | RENTAL EXPENSES -137,559. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES 137,559. |
| FORM 990, SCHEDULE D, PART V, LINE 1A: | INCLUDED IN THIS LINE IS A RESTATEMENT OF THE ENDOWMENT IN THE AMOUNT OF $267,300 PERTAINING TO 2011. |
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 |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | 0 | FinancialAssistanceBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $69,611 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $69,611 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00230 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,294,539 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,222,387 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,072,152 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03580 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,364,150 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,222,387 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,141,763 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03810 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $89,256 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $89,256 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00300 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,802 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $9,802 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,377,961 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,136,061 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,241,900 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04150 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,477,019 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,136,061 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,340,958 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04480 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,841,169 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,358,448 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,482,721 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08290 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,174,133 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $317,413 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $10,593,413 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $12,835,503 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,242,090 | 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 |
| 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 | PALMERTON HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 135 LAFAYETTE AVENUE | AddressLine1Txt |
| City | PALMERTON | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 18071 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | GERIPSYCH UNIT | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE PALMERTON 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 | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | 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.BLMTN.ORG | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 12 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.BLMTN.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 | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.BLMTN.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.BLMTN.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| 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 |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| THE PALMERTON HOSPITAL | PART V, SECTION B, LINE 5: THE CHNA INCLUDED THREE SEPARATE DATA COLLECTION STRATEGIES: AN ANALYSIS OF EXISTING SECONDARY DATA AND EXISTING COMMUNITY HEALTH MEASURES; A FOCUS GROUP CONDUCTED ON NOVEMBER 15, 2012 DURING A REGULARLY SCHEDULED MEETING OF THE CARBON COUNTY INTERAGENCY COUNCIL; AND KEY INFORMANT SURVEYS AND INTERVIEWS. IN-HOUSE AT BMHS, A COMMUNITY BENEFIT PLAN STEERING COMMITTEE WAS FORMED AND PROVIDED INPUT PRIOR TO THE NEEDS ASSESSMENT. THE COMMITTEE WAS COMPOSED OF SENIOR MANAGEMENT AND DEPARTMENT HEADS WITHIN THE HEALTH SYSTEM. THE CARBON COUNTY INTERAGENCY COUNCIL IS COMPOSED OF LEADERSHIP FROM NUMEROUS AGENCIES AND ORGANIZATIONS, REPRESENTING MATERNAL AND CHILD HEALTH, ELDER CARE, BEHAVIORAL HEALTH, COUNTY INFRASTRUCTURE, HEALTHCARE PROVIDERS AND SOCIAL SERVICES. THE FOCUS GROUP WAS CONDUCTED WITH THESE MEMBERS. ADDITIONALLY, A REPORT ON THE FINDINGS WAS GIVEN AT THE MARCH 21, 2013 MEETING. KEY INFORMANTS FROM THE FOLLOWING COMMUNITY WORKPLACES/ PROFESSIONAL FIELDS WERE SURVEYED: FAMILY PRACTICE, COUNTY SCHOOL DISTRICTS, A COMMUNITY COLLEGE, DEPARTMENT OF HEALTH, AND AN INTERMEDIATE UNIT. |
| THE PALMERTON HOSPITAL | PART V, SECTION B, LINE 6A: THE PALMERTON HOSPITAL COLLABORATED WITH GNADEN HUETTEN MEMORIAL HOSPITAL. |
| THE PALMERTON HOSPITAL | PART V, SECTION B, LINE 11: THE COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED HEALTH PROBLEMS OUR COMMUNITIES FACE AND BARRIERS THAT KEEP RESIDENTS OF OUR COMMUNITIES FROM BEING HEALTHY. THE PRIORITY AREAS OF NEEDS WERE CLEARLY IDENTIFIED THROUGHOUT THE SURVEY TO BE: DRUG, ALCOHOL AND TOBACCO USE, MENTAL HEALTH, OBESITY, DENTAL NEEDS, AND CHRONIC ILLNESSES. THESE NEEDS ARE CURRENTLY BEING ADDRESSED AS PART OF THE IMPLEMENTATION PLAN. FURTHER IN THE PLAN TO ADDRESS THESE NEEDS, WE ARE ASSISTING WITH LOWERING THE FOLLOWING BARRIERS: LACK OF HEALTH CARE INSURANCE OR UNDERINSURANCE, ACCESS TO COMMUNITY SERVICES, LACK OF PREVENTION SERVICES AND/OR EDUCATION, POOR DIET, AND DENIAL BY PARENTS REGARDING CHILDREN'S ISSUES. THE HOSPITAL CONTINUES TO WORK ACROSS MANY OF THE OTHER IDENTIFIED NEEDS. AS THE NEEDS THAT WERE IDENTIFIED ARE NOT MUTUALLY EXCLUSIVE FROM ONE ANOTHER, IT IS THE HOSPITAL'S HOPE THAT BY ADEQUATELY ADDRESSING THE ABOVE NEEDS AND BARRIERS, THE OTHER NEEDS AND BARRIERS WILL BE INDRECTLY IMPACTED AS WELL. THE NEEDS THAT WERE IDENTIFIED BUT ARE NOT CURRENTLY BEING ADDRESSED ARE: SPECIALTY SERVICES, DOCTORS THAT ACCEPT MA, AND NEEDS NOT MET AT HOME (ELEMENTARY LEVEL-MEDICAL CARE). THE BARRIERS THAT ARE NOT CURRENTLY BEING ADDRESSED ARE: CULTURAL HABITS, ACCESS TO JOBS, POVERTY, AND LACK OF SUPPORT SYSTEMS. |
| THE PALMERTON HOSPITAL | PART V, SECTION B, LINE 22D: THE AMOUNTS CHARGED WERE IN ACCORDANCE WITH THE HOSPITAL'S OVERALL FINANCIAL ASSISTANCE POLICY. |
| PART V, SECTION B, LINE 16 | FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY |
| THE PALMERTON HOSPITAL PART V, SECTION B, LINE 16A WEBSITE: | WWW.BLMTN.ORG |
| THE PALMERTON HOSPITAL PART V, SECTION B, LINE 16B WEBSITE: | WWW.BLMTN.ORG |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | THE HOSPITAL USES THE COST TO CHARGE RATIO AS THE COSTING METHOD. |
| PART I, LINE 7G: | SUBSIDIZED HEALTH SERVICES INCLUDED UNDER SCHEDULE H FOR THE PALMERTON HOSPITAL ARE THE ADULT DAY SERVICES PROGRAM AND THE EMERGENCY DEPARTMENT. ADULT DAY SERVICES OF THE BLUE MOUNTAIN HEALTH SYSTEM OFFERS AN ALTERNATIVE TO NURSING CARE WHILE PROVIDING RESPITE FOR THOSE CARING FOR SOMEONE AT HOME. THE PROGRAM OFFERS A WARM, FRIENDLY ATMOSPHERE AND THE OPPORTUNITY FOR SENIORS TO DEVELOP FRIENDSHIPS WHILE PARTICIPATING IN ACTIVITIES THEY ENJOY. OUR EXPERIENCED STAFF INCLUDES REGISTERED NURSES, LICENSED PRACTICAL NURSES, CERTIFIED THERAPEUTIC RECREATION SPECIALISTS AND CERTIFIED NURSE AIDES. THE PALMERTON HOSPITAL PROVIDED SUBSIDIES OF APPROXIMATELY $179,000 TO THE ADULT DAY SERVICES CENTER DURING FY2015.THE EMERGENCY DEPARTMENT LOCATED AT PALMERTON HOSPITAL PROVIDES AROUND-THE-CLOCK EMERGENCY SERVICES TO THE SURROUNDING COMMUNITIES WITHIN CARBON COUNTY. CARE IS PROVIDED TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY OR THEIR INSURANCE STATUS. DURING FY2015, THE PALMERTON EMERGENCY DEPARTMENT SAW 11,776 PATIENTS WITH A SUBSIDIZED COST TO PROVIDE THESE SERVICES OF $1,509,000. $446,000 OF THIS SUBSIDIZED COST IS INCLUDED IN THE MEDICAID SHORTFALL, THEREFORE, A NET OF $1,063,000 IS REPORTED.WHILE WE ARE AWARE THAT EACH HOSPITAL IS REQUIRED TO STAND ALONE WITH REGARD TO THEIR COMMUNITY BENEFIT REPORTING, THE TWO HOSPITALS OF BLUE MOUNTAIN FUNCTION IN TANDEM TO DRIVE COMMUNITY BENEFIT STRATEGY. SUBSIDIZED HEALTH SERVICES INCLUDED UNDER SCHEDULE H FOR THE GNADEN HUETTEN MEMORIAL HOSPITAL ARE THE EMERGENCY DEPARTMENT. THE EMERGENCY DEPARTMENT LOCATED AT GNADEN HUETTEN MEMORIAL HOSPITAL PROVIDES AROUND-THE-CLOCK EMERGENCY SERVICES TO THE SURROUNDING COMMUNITIES WITHIN CARBON COUNTY. CARE IS PROVIDED TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY OR THEIR INSURANCE STATUS. DURING FY2015, THE GNADEN HUETTEN MEMORIAL HOSPITAL EMERGENCY DEPARTMENT SAW 17,458 PATIENTS WITH A SUBSIDIZED COST TO PROVIDE THESE SERVICES OF $4,594,000 OF WHICH $1,314,000 IS INCLUDED IN THE MEDICAID SHORTFALL. |
| PART I, LINE 7, COLUMN (F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 3,174,133. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | COMMUNITY OUTREACH PROGRAMS- PROVIDES MORE THAN 1200 INFLUENZA VACCINES TO COMMUNITY RESIDENTS IN PARTNERSHIP WITH THE PA DEPARTMENT OF HEALTH AND THE CARBON COUNTY EMERGENCY MANAGEMENT AGENCY.- PARTICIPATES IN MORE THAN 25 COMMUNITY HEALTH FAIRS PROVIDING A VARIETY OF SCREENINGS - EMS, L.B. MORRIS ELEMENTARY SCHOOL, THE VILLAGE AT PALMERTON, CARBON COUNTY FAIR, WEST END FAIR, PALMERTON COMMUNITY FESTIVAL, LEHIGHTON LIONESS AND LIONS CLUB, PALMERTON LIONS CLUB, PALMER ELEMENTARY SCHOOL, LEHIGHTON RECREATION SENIOR FAIR, REP. DOYLE HEFFLEY SENIOR FAIR, WEATHERLY SCHOOL DISTRICT WELLNESS FAIR, PLEASANT VALLEY ACADEMIC HEALTH FAIR, 27TH ANNUAL CHILDREN'S HEALTH FAIR, AND COMMUNITY SAFETY DAY.- HOSTS FIVE HEALTH SUPPORT GROUPS IN THE COMMUNITY: BREAST CANCER, WEIGHT LOSS/BARIATRIC SURGERY, ADULT DAY CAREGIVER, THE SUMMIT CAREGIVER, DIABETES AND OTHER SPECIALTY SUPPORT PROGRAMMING SUCH AS 6-WEEK BEREAVEMENT WORKSHOP.- OFFERS FREE DIAGNOSTIC MAMMOGRAMS AND ULTRASOUNDS TO WOMEN AND MEN WHO ARE UNDER OR NON-INSURED.- BMHS ADULT DAY CARE PROVIDES AN ALTERNATIVE TO NURSING CARE WHILE PROVIDING RESPITE FOR THOSE CARING FOR SOMEONE IN THEIR HOME.- PROVIDES A PHYSICIAN MEDICAL DIRECTOR FOR THE LOCAL ALS/BLS SERVICES IN THE SURROUNDING COMMUNITIES.- PROVIDES THE HEALTH SMILES, HAPPY KIDS DENTAL VAN, PROVIDES PREVENTATIVE AND RESTORATIVE DENTAL CARE TO UNDER AND NON-INSURED CHILDREN WITHIN CARBON COUNTY AND THE SURROUNDING AREAS.- HOSTS "LADIES NIGHT OUT", AN EDUCATIONAL EVENT FOR MORE THAN 200 PARTICIPANTS IN REGARDS TO AWARENESS ABOUT FEMALE CANCERS, ESPECIALLY BREAST CANCER.- SUPPORTS LOCAL COMMUNITY GROUPS, EX. AMERICAN CANCER SOCIETY TELETHON, RELAY FOR LIFE, LIGHT THE NIGHT, AMERICAN LUNG ASSOCIATION, AMERICAN HEART ASSOCIATION, AND ALZHEIMER'S ASSOCIATION.- VARIOUS STAFF MEMBERS PARTICIPATE IN LOCAL CIVIC ORGANIZATION SUCH AS CARBON COUNTY INTERAGENCY COUNCIL, CARBON COUNTY SAFE KIDS COALITION, AMERICAN CANCER SOCIETY, LEHIGHTON ROTARY, JIM THORPE ROTARY, LEHIGHTON LIONESS AND LIONS CLUBS, PALMERTON LIONS AND LIONESS CLUB, CARBON COUNTY CHAMBER OF COMMERCE AND PALMERTON CHAMBER OF COMMERCE. |
| PART III, LINE 2: | TOTAL ADJUSTED OPERATING EXPENSES WERE APPROXIMATELY $27,878,000 FOR FY2015. TOTAL ADJUSTED PATIENT CHARGES WAS CALCULATED AS FOLLOWS: GROSS PATIENT CHARGES LESS GROSS CHARGES FOR COMMUNITY BENEFIT PROGRAMS. TOTAL ADJUSTED PATIENT CHARGES WERE APPROXIMATELY $92,340,000 FOR FY2015. |
| PART III, LINE 3: | MANAGEMENT DETERMINED APPROXIMATELY 10% OF THE TOTAL BAD DEBT EXPENSE REPORTED ON LINE 2 WAS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. |
| PART III, LINE 4: | ACCOUNTS RECEIVABLE, PATIENTS ARE REPORTED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THEY ARE DETERMINED TO BE UNCOLLECTIBLE BASED UPON MANAGEMENT'S ASSESSMENT OF INDIVIDUAL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF PATIENT ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL COLLECTIONS AND PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE (WHICH INCLUDES PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL) THE HOSPITAL ANALYZES CONTRACTUAL AMOUNTS DUE AND PROVIDES AN ALLOWANCE FOR DOUBTFUL COLLECTIONS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND INSURED PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES) THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE BILLED RATES AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL COLLECTIONS. |
| PART III, LINE 8: | NONE OF THE MEDICARE SHORTFALL REPORTED IN LINE 8 WAS TREATED AS A COMMUNITY BENEFIT. AMOUNTS REPORTED ON LINE 6 WERE OBTAINED FROM THE MEDICARE COST REPORT. SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT IN THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. |
| PART III, LINE 9B: | COLLECTION ACTIVITY WILL BE SUSPENDED DURING THE CONSIDERATION OF ACOMPLETED FINANCIAL ASSISTANCE APPLICATION OR AN APPLICATION FOR ANY OTHERHEALTHCARE BRACKET (I.E. MEDICARE, PA MEDICAL ASSISTANCE, ETC.). A NOTEWILL BE ENTERED INTO THE PATIENT'S ACCOUNT, ALONG WITH ADDING INSURANCEPLAN CODE L97, TO SUSPEND COLLECTION ACTIVITY UNTIL THE FINANCIAL ASSISTANCE PROCESS IS COMPLETE. IF THE ACCOUNT HAS BEEN WITH A COLLECTION AGENCY, THE AGENCY WILL BE NOTIFIED BY TELEPHONE OR EMAIL TO SUSPEND COLLECTION EFFORTS UNTIL A DETERMINATION IS MADE. THIS NOTIFICATION WILL BEDOCUMENTED IN THE ACCOUNT NOTES. THE PATIENT WILL ALSO BE NOTIFIED VERBALLY THAT THE COLLECTION ACTIVITY WILL BE SUSPENDED DURING CONSIDERATION. IF A FINANCIAL ASSISTANCE DETERMINATION ALLOWS FOR APERCENT REDUCTION BUT LEAVES THE PATIENT WITH A SELF-PAY BALANCE, PAYMENTTERMS WILL BE ESTABLISHED ON THE BASIS OF DISPOSABLE INCOME. |
| PART VI, LINE 2: | THE HOSPITALS OF THE BLUE MOUNTAIN HEALTH SYSTEM CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT, AUGUST 2012 - JANUARY 2013 AND DEVELOPED AN IMPLEMENTATION PLAN WITH STRATEGIES TO ADDRESS IDENTIFIED COMMUNITY HEALTH NEEDS. THE PROCESS, CONDUCTED BY EASTCENTRAL PA AREA HEALTH EDUCATION CENTER (ECPA AHEC), USED PRIMARY AND SECONDARY SURVEY DATA, KEY INFORMANT SURVEYS AND INTERVIEWS, AND A FOCUS GROUP TO IDENTIFY AND PRIORITIZE HEALTH PROBLEMS AND RISK FACTORS IN THE CARBON COUNTY SERVICE AREA. AFTER ANALYZING THIS DATA AND MAPPING EXISTING INTERNAL AND COMMUNITY BASED RESOURCES, BMHS DEVELOPED AN IMPLEMENTATION PLAN WITH EVIDENCE BASED STRATEGIES. THE IMPLEMENTATION PLAN WAS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS AT THE ANNUAL STRATEGIC PLANNING RETREAT ON JULY 20, 2013. THE FINAL APPROVED VERSION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN IS AVAILABLE TO THE PUBLIC ON THE HEALTH SYSTEM'S WEBSITE. WITH THE COLLABORATION AFFORDED BY BMHS LEADERSHIP AND KEY COMMUNITY PARTNERS, THE GOALS, OBJECTIVES AND OUTCOME MEASURES DEFINED FOR THE IMPLEMENTATION PLAN WILL BE REVIEWED ON AN ANNUAL BASIS FOR THE IMPROVEMENT AND POSITIVE IMPACT OF THE IDENTIFIED/PERCEIVED HEALTH NEEDS OF THE COMMUNITY. POST-ASSESSMENT MEETINGS WERE HELD WITH BOTH THE BLUE MOUNTAIN HEALTH SYSTEM'S COMMUNITY BENEFIT PLAN STEERING COMMITTEE AND THE CARBON COUNTY INTERAGENCY COUNCIL TO REPORT THE FINDINGS AND GAIN FURTHER INPUT AND ASSISTANCE WITH THE PRIORITIZATION OF HEALTH NEEDS.IDENTIFIED, PRIORITIZED/RANKED COMMUNITY HEALTH NEEDS- DRUG, ALCOHOL AND TOBACCO USE (ACROSS ALL AGES)- MENTAL HEALTH- OBESITY (INCLUDING CHILDREN)- DENTAL NEEDS- CHRONIC ILLNESSES, ESPECIALLY CARDIAC AND PULMONARY DISEASE, DIABETES, HYPERTENSION, CANCER AND STROKE.BARRIERS TO GOOD HEALTH - LACK OF HEALTH INSURANCE OR UNDERINSURANCE.- BARRIERS TO ACCESS TO COMMUNITY SERVICES- LACK OF PREVENTION SERVICES AND/OR EDUCATION- POOR DIET- DENIAL BY PARENTS REGARDING CHILDREN'S HEALTH ISSUES |
| PART VI, LINE 3: | IN ACCORDANCE WITH PENNSYLVANIA STATE REPORTING REQUIREMENTS, THE BLUE MOUNTAIN HEALTH SYSTEM'S CHARITY CARE EXPENSE IS REPORTED BASED UPON COSTS VERSUS CHARGES. CHARITY CARE INCLUDES THE HEALTH SYSTEM'S TRADITIONAL INPATIENT AND EMERGENCY SERVICES, AS WELL AS THE CARE PROVIDED AS PART OF EXTERNAL EDUCATIONAL PROGRAMS AND SERVICES SUCH AS THROUGH OUR FAMILY PLANNING PROGRAM.MORE PEOPLE WERE SERVED THROUGH THE HOSPITAL'S CHARITABLE CARE AND FINANCIAL ASSISTANCE PROGRAMS IN VIRTUALLY ALL CATEGORIES, AS FOLLOWS:- GNADEN HUETTEN MEMORIAL HOSPITAL CHARITABLE CARE PATIENTS- PALMERTON HOSPITAL CHARITABLE CARE PATIENTS- BLUE MOUNTAIN HEALTH SYSTEM'S "HEALTHY SMILES, HAPPY KIDS" DENTAL VAN SIGNAGE IS VISIBLE IN ALL BLUE MOUNTAIN HEALTH SYSTEM POINTS OF REGISTRATION IN ORDER TO CREATE AWARENESS OF THE FINANCIAL ASSISTANCE PROGRAM. AT A MINIMUM, SIGNAGE IS POSTED IN ALL PATIENT INTAKE AREAS, INCLUDING, BUT NOT LIMITED TO, EMERGENCY DEPARTMENT, AND THE ADMISSION/PATIENT REGISTRATION AREA.IN RECENT YEARS, THE HEALTH SYSTEM HAS EXPANDED THE NUMBER OF FINANCIAL COUNSELORS AVAILABLE TO ASSIST PATIENTS. A KEY GOAL IS TO IDENTIFY COMMUNITY MEMBERS IN NEED SOONER. COUNSELORS PROACTIVELY SEEK OUT PATIENTS PRIOR TO TREATMENT IN AN EFFORT TO CONNECT THEM WITH PUBLIC INSURANCE PROGRAMS AS APPROPRIATE OR TO ENCOURAGE THEM TO COMPLETE AN ASSISTANCE APPLICATION. THE RESULT IS MORE CHARITY CARE AND LESS REPORTED AS BAD DEBT; MOST IMPORTANTLY, COMMUNITY MEMBERS ARE PROVIDED WITH THE SUPPORT TO ACCESS THE MEDICAL CARE THEY NEED. |
| PART VI, LINE 4: | THE MEDIAN INCOME OF HOUSEHOLDS IN CARBON COUNTY WAS $47,283. 74 PERCENT OF THE HOUSEHOLDS RECEIVED EARNINGS AND 25 PERCENT RECEIVED RETIREMENT INCOME OTHER THAN SOCIAL SECURITY. THIRTY-NINE PERCENT OF THE HOUSEHOLDS RECEIVED SOCIAL SECURITY. THE AVERAGE INCOME FROM SOCIAL SECURITY WAS $15,428.ACCORDING TO THE BUREAU OF LABOR STATISTICS, CARBON COUNTY SHOWS A RELATIVELY HIGH RATE OF UNEMPLOYMENT 10.2 PERCENT COMPARED TO THE MID-ATLANTIC REGION AND THE NATION AS A WHOLE. THE CARBON COUNTY CHILD & FAMILY COLLABORATIVE'S 2009-10 "STATE OF THE CHILD & FAMILY IN CARBON COUNTY" REPORT STATES THAT THE AREA'S CHILDREN ARE AT MODERATE-HIGH RISK OF SCHOOL FAILURE DUE TO THE FOLLOWING FACTORS: 42.3 PERCENT LIVE IN HOUSEHOLDS EARNING LESS THAN 200 PERCENT OF POVERTY; 10.8 PERCENT LIVE IN FAMILIES WHOSE MOTHER EARNED LESS THAN A HIGH SCHOOL DIPLOMA; AND 11 PERCENT OF CHILDREN UNDER THE AGE OF 5 LIVING BELOW POVERTY LEVEL ARE OF A SINGLE MOTHER HOUSEHOLD. FURTHERMORE, ACCORDING TO A 2010 DRUG AND ALCOHOL SURVEY, 27 OUR OF 3,000 6TH TO 11TH GRADERS IN CARBON COUNTY HAD ALCOHOL WITHIN THE LAST 30 DAYS, WITH 20 PERCENT HAVING BEEN GIVEN TO THEM BY PARENTS OR FAMILY MEMBERS.OVERALL, CARBON COUNTY RANKS 49TH (OF 67 COUNTIES) IN HEALTH OUTCOMES RELATED TO MORTALITY, MORBIDITY, HEALTH BEHAVIORS, CLINICAL CARE, SOCIAL AND ECONOMIC FACTORS AND PHYSICAL ENVIRONMENT. OF PARTICULAR INTEREST IS THE CATEGORY OF HEALTH BEHAVIORS (TOBACCO USE, OBESITY, PHYSICAL INACTIVITY, EXCESSIVE DRINKING, MOTOR VEHICLE CRASH DEATH RATE, SEXUALLY TRANSMITTED INFECTIONS AND TEEN BIRTH RATE) WHERE THE COUNTY RANKS 63/37. A MEASURE OF ACCESS TO CARE RELATES TO THE PRIMARY CARE PROVIDER RATE, OR THE POPULATION TO PRIMARY PHYSICIAN RATIO. THE NATIONAL BENCHMARK FOR POPULATION TO PRIMARY PHYSICIAN RATIO IS 631:1. IN PENNSYLVANIA, THAT RATIO IS 838:1, AND IN CARBON COUNTY THE RATIO IS 2121:1, ALMOST THREE TIMES THE RATIO OF THE STATE AS A WHOLE. |
| PART VI, LINE 5: | THE MEDICAL STAFF OF THE BLUE MOUNTAIN HEALTH SYSTEM IS AN OPEN MEDICAL STAFF ALLOWING SUBMISSIONS FOR PRIVILEGES AND CREDENTIALING FROM ANY INTERESTED PHYSICIAN OR SURGEON. THE BOARD OF DIRECTORS IS COMPRISED OF 17 INDIVIDUALS FROM VARIOUS COMMUNITY ORGANIZATIONS SUCH AS FINANCIAL INSTITUTIONS, TELECOMMUNICATION, RECREATION, AND REPRESENTATION FROM THE MEDICAL STAFF. OF THE 17 MEMBERS OF THE BOARD OF DIRECTORS, 13 RESIDE IMMEDIATELY WITHIN THE PRIMARY SERVICE AREA OF THE HEALTH SYSTEM. ALL OF THE BOARD MEMBERS ARE INDEPENDENT, WITH THE EXCEPTION OF THE PRESIDENT/CHIEF EXECUTIVE OFFICER AND ANOTHER DIRECTOR, WHO ARE EMPLOYED DIRECTLY BY THE HEALTH SYSTEM.BLUE MOUNTAIN HEALTH EDUCATION PROGRAMMING- PROVIDES MORE THAN 30 EDUCATIONAL PROGRAMS AND SCREENINGS - NATIONAL CHOLESTEROL MONTH DINNER & LECTURE PROGRAM, WEIGHT LOSS SURGERY, AARP DRIVING CLASS, LUNG CANCER EDUCATION, DIABETES EDUCATION, STRESS/STROKE SCREENINGS, CARBON COUNTY DOMESTIC VIOLENCE, FAMILY CAREGIVER TRAINING NIGHT, CARBON COUNTY DRUG & ALCOHOL PROGRAM; LOOK GOOD . . . FEEL BETTER WITH AMERICAN CANCER SOCIETY; NEW TO MEDICARE CO-SPONSORED WITH CARBON COUNTY AREA AGENCY ON AGING; HEART HEALTH FAIR; AMERICAN HEART MONTH LUNCH 'N LEARN; LET'S TALK ABOUT WOUND CARE AND ADULT DAY SERVICE; CARBON COUNTY SAFE KIDS AND SENATOR YUDICHAK COMMUNITY SAFETY DAY; PANTHER VALLEY CAREER DAY; SAFE KIDS CAR SEAT CHECK; MENTAL HEALTH DEPRESSION OUTREACH ASSESSMENTS.- SERVES AS A MEDICAL TRAINING/CLINICAL EDUCATION SITE FOR AREA COLLEGES AND SCHOOLS SUCH AS CEDAR CREST COLLEGE, WILKES UNIVERSITY, KING'S COLLEGE, KUTZTOWN UNIVERSITY, DESALES UNIVERSITY, MARYWOOD UNIVERSITY, UNIVERSITY OF SCRANTON, LEHIGH CARBON COMMUNITY COLLEGE, LINCOLN TECHNICAL INSTITUTE, NORTHAMPTON AREA COMMUNITY COLLEGE, PENNSYLVANIA STATE UNIVERSITY, JOHNSON SCHOOL OF TECHNOLOGY AND PENNSYLVANIA COLLEGE OF OSTEOPATHIC MEDICINE.- PROVIDE CPR/BLS/ACLS/PALS TRAINING TO COMMUNITY ORGANIZATIONS SUCH AS AMBULANCE/EMS, FIRE, POLICE, TEACHERS.- PROVIDES "HEALTH IMAGES," A HEALTH SYSTEM HOSTED TELEVISION PROGRAM FEATURING A VARIETY OF HEALTH AND WELLNESS INFORMATION AND EDUCATION.- HOSTS NEW SEASONS, A PROGRAM FOR ADULTS AGE 65 AND OLDER THAT OFFERS EXERCISE AND WELLNESS PROGRAMS SUCH AS YOGA AND LOW-IMPACT AEROBICS, NEW SEASONS HEARING AID BATTERY BANK, AND THE NEW SEASONS ANNUAL HEALTH & INFORMATION FAIR |
| PART VI, LINE 6: | THE HOSPITALS OF THE BLUE MOUNTAIN HEALTH SYSTEM ARE REGIONAL PROVIDERS OF HEALTH CARE SERVICES TO THE PEOPLE LIVING IN CARBON COUNTY AND PARTS OF MONROE, LEHIGH, NORTHAMPTON AND SCHUYLKILL COUNTIES. BLUE MOUNTAIN HEALTH SYSTEM INCLUDES PALMERTON HOSPITAL, A 60-BED COMMUNITY HOSPITAL LOCATED IN PALMERTON; GNADEN HUETTEN MEMORIAL HOSPITAL, A 111-BED COMMUNITY HOSPITAL; THE SUMMIT AT BLUE MOUNTAIN, A 90-BED NURSING AND REHABILITATION CENTER, BOTH LOCATED IN LEHIGHTON AND AN ADULT DAY SERVICE CENTER IN PALMERTON. COMBINED, THESE FACILITIES HAVE BEEN SERVING THE FAMILIES OF OUR AREA FOR MORE THAN 150 YEARS. THE HOSPITALS OF THE BLUE MOUNTAIN HEALTH SYSTEM ARE FULLY ACCREDITED BY THE JOINT COMMISSION. DIAGNOSTIC OUTPATIENT SERVICES, INCLUDING ACUTE REHABILITATION, MAMMOGRAPHY, ULTRASOUND, CARDIAC REHABILITATION AND THE CLINICAL LABORATORY ARE ALSO ACCREDITED BY THEIR RESPECTIVE NATIONAL PROFESSIONAL ORGANIZATIONS. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | PA |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | 0 | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | 0 | SubstantiationRequiredInd |
| 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 | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ANDREW E HARRIS | ||||||||||||||
| PRESIDENT & CEO | $0 | $373,229 | $0 | $107,622 | $0 | $10,476 | $0 | $0 | $0 | $19,023 | $0 | $510,350 | $0 | $0 |
| ROBERT GROB DO | ||||||||||||||
| DIRECTOR/PHYSICIAN | $95,000 | $96,250 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $95,000 | $96,250 | $0 | $0 |
| ANDREA L ANDRAE | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $143,706 | $0 | $5,000 | $0 | $0 | $0 | $0 | $0 | $20,767 | $0 | $169,473 | $0 | $0 | $0 |
| RUTHANN BRENNAN | ||||||||||||||
| VP CLINICAL AFFAIRS | $139,363 | $0 | $10,000 | $0 | $0 | $0 | $0 | $0 | $11,304 | $0 | $160,667 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | A RELATED ORGANIZATION, GNADEN HUETTEN MEMORIAL HOSPITAL ("GHMH"), INCLUDED $1,258 OF CLUB DUES IN PRESIDENT/CEO ANDREW HARRIS' REPORTABLE INCOME ON HIS 2014 W-2. THIS AMOUNT WAS INCLUDED AS TAXABLE INCOME FOR MR. HARRIS. |
| PART I, LINE 3 | THE CEO, ANDREW HARRIS, IS COMPENSATED BY A RELATED ORGANZIATION, GNADEN HUETTEN MEMORIAL HOSPITAL ("GHMH"). GHMH HAS A COMPENSATION PROCESS IN PLACE TO ENSURE THAT NO MORE THAN FAIR MARKET VALUE COMPENSATION IS PAID. GHMH USES THE FOLLOWING TO ESTABLISH THE CEO'S COMPENSATION: A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, AND APPROVAL BY THE BOARD/COMPENSATION COMMITTEE. |
| PART I, LINE 4B | THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE ORGANIZATION'S 457(F) SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. NO DISTRIBUTIONS WERE MADE IN CALENDAR YEAR 2014. ANDREW E. HARRIS - PRESIDENT & CEO ANDREA L. ANDRAE - CFO |
| PART I, LINE 7 | THE BONUS PROGRAM AT THE BLUE MOUNTAIN HEALTH SYSTEM IS BASED ON FIVE DEFINED PILLARS OF SUCCESS. THESE 5 PILLARS INCLUDE FINANCE, QUALITY, SERVICE, PEOPLE, AND GROWTH. ALL EMPLOYEES OF THE HEALTH SYSTEM PARTICIPATE IN THE BONUS PROGRAM. THE BONUS PAYMENT IS DETERMINED BASED ON SPECIFIED CRITERIA FOR EACH OF THE 5 PILLARS INDICATED ABOVE ON A FISCAL YEAR BASIS. THE CRITERIA ARE PREDETERMINED AND HAVE BEEN ESTABLISHED BY SENIOR MANAGEMENT AND APPROVED BY THE BOARD OF DIRECTORS OF THE BLUE MOUNTAIN HEALTH SYSTEM. CERTAIN EMPLOYEES RECEIVED BONUSES UNDER THE PLAN IN FISCAL YEAR 2015. THE BONUSES ARE REPORTED ON THE EMPLOYEES' 2014 W-2S. |
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 | CARBON COUNTY HOSPITAL AUTHORITY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 232280834 | BondIssuerEIN |
| CUSIP | 140868EE6 | CUSIPNum |
| Bond Issued | 2012-02-23 | BondIssuedDt |
| Issue Price | $2,380,000 | IssuePriceAmt |
| Purpose | CURRENT REFUNDING OF THE 1999 REVENUE BONDS | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $965,000 | RetiredAmt |
| Total Proceeds | $2,380,000 | TotalProceedsAmt |
| In Reserve Fund | $194,692 | InReserveFundAmt |
| Issuance Costs From Proceeds | $49,133 | IssuanceCostsFromProceedsAmt |
| Credit Enhancement | $15,809 | CreditEnhancementAmt |
| Other Spent Proceeds | $2,387,228 | OtherSpentProceedsAmt |
| Substantial Completion | 2012 | SubstantialCompletionYr |
| Current Refunding | Yes (1) | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (1) | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART III, LINE 9; PART IV, LINE 7; AND PART V | FormAndLineReferenceDesc |
| Explanation | WHILE THE HOSPITAL DOES NOT HAVE FORMAL WRITTEN PROCEDURES, THEY WORK CONTINUOUSLY WITH A BOND CONSULTANT TO ENSURE THAT THEY ARE IN COMPLIANCE. THE HOSPITAL IS CONSIDERING ADOPTING WRITTEN PROCEDURES IN A FUTURE YEAR. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd | TransactionTransactionAmt |
|---|---|---|---|
| PATRICK REILLY | |||
| CEO - MAUCH CHUNK TRUST COMPANY | THE PALMERTON HOSPITAL HAS A LINE OF CREDIT WITH MAUCH CHUNK TRUST COMPANY AND MADE NO PAYMENTS DURING THE YEAR. THE TOTAL REMAINING OUTSTANDING LOAN BALANCE IS $491,734. | 0 | |
| MICHAEL HARLEMAN | |||
| VP - FIRST NORTHERN TRUST BANK | THE PALMERTON HOSPITAL HAS A LINE OF CREDIT AND A CONSTRUCTION LOAN WITH FIRST NORTHERN TRUST BANK. THE ORGANIZATION DREW DOWN ON THE LINE OF CREDIT DURING THE YEAR IN THE AMOUNT OF $25,070. THE TOTAL REMAINING OUTSTANDING BALANCE ON THE LINE OF CREDIT IS $500,000. THE NEW CONSTRUCTION LOAN THIS YEAR WAS FOR $750,000 AND THE ORGANIZATION PAID DOWN THE LOAN BY $91,050. THE TOTAL REMAINING OUTSTANDING BALANCE ON THE CONSTRUCTION LOAN IS $658,950. | 0 | $684,020 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | AN EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS HAS THE BROAD AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. THE COMMITTEE IS COMPOSED OF SEVEN MEMBERS OF THE BOARD OF DIRECTORS AND INCLUDES ALL FOUR OFFICERS OF THE BOARD. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THE CORPORATION IS BLUE MOUNTAIN HEALTH SYSTEM, INC., AN AFFILIATED PENNSYLVANIA NONPROFIT, NONSTOCK CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | AS SOLE MEMBER, BLUE MOUNTAIN HEALTH SYSTEM, INC. HAS THE POWER TO APPOINT AND REMOVE BOARD MEMBERS OF THE HOSPITAL. |
| FORM 990, PART VI, SECTION A, LINE 7B | AS SOLE MEMBER, BLUE MOUNTAIN HEALTH SYSTEM, INC. HAS THE POWER TO EXERCISE EACH OF THE FOLLOWING POWERS WITH RESPECT TO THE HOSPITAL, AND IF ANY ACTION RELATED TO THE EXERCISE OF ANY SUCH POWER IS INITIATED BY THE HOSPITAL, SUCH ACTION WILL NOT BECOME EFFECTIVE UNLESS APPROVED BY THE SOLE MEMBER: 1) THE POWER TO REQUIRE ITS APPROVAL BEFORE THE HOSPITAL IS PERMITTED TO INCUR ADDITIONAL DEBT AND THE POWER TO REQUIRE THE HOSPITAL TO PARTICIPATE IN THE INCURRENCE OF DEBT BY THE SOLE MEMBER; 2) THE POWER TO ESTABLISH AND/OR APPROVE THE STRATEGIC AND BUSINESS PLANS OF THE HOSPITAL IN ACCORDANCE WITH THE SOLE MEMBER'S PRESCRIBED OBJECTIVES; 3) THE POWER TO APPOINT AND/OR REMOVE THE PRESIDENT/CEO OF THE HOSPITAL; 4) THE POWER TO REQUIRE THE HOSPITAL TO MAKE CAPITAL CONTRIBUTIONS TO THE SOLE MEMBER; 5) THE POWER TO ESTABLISH AND APPROVE ANNUAL CAPITAL EXPENDITURE AND OPERATING BUDGETS OF THE HOSPITAL; 6) THE POWER TO REVIEW FINANCIAL REPORTS, INTERVENE IN MANAGEMENT AND OPERATIONS AND TRANSFER ASSETS TO OR FROM THE HOSPITAL; 7) THE POWER TO APPROVE THE HOSPITAL'S PARTICIPATION IN ALLIANCES, JOINT VENTURES, AFFILIATIONS OR OTHER RELATIONSHIPS WITH ENTITIES NOT CONTROLLED, DIRECTLY OR INDIRECTLY, BY THE SOLE MEMBER AND THE POWER TO REQUIRE THE HOSPITAL TO PARTICIPATE IN SUCH RELATIONSHIPS; 8) THE POWER TO APPROVE OR DISAPPROVE OF THE HOSPITAL'S PARTICIPATION IN MANAGED CARE CONTRACTS AND/OR OTHER HEALTH CARE SERVICE CONTRACTING ARRANGEMENTS, THE POWER TO REQUIRE THE HOSPITAL TO PARTICIPATE IN SUCH CONTRACTS OR ARRANGEMENTS, AND THE POWER TO ACT AS THE PRINCIPAL REPRESENTATIVE AND NEGOTIATING AGENT FOR THE HOSPITAL WITH REGARD TO SUCH CONTRACTS AND ARRANGEMENTS; 9) THE POWER TO APPROVE OR DISAPPROVE OF ADDITIONS, REVISIONS OR DISCONTINUATIONS IN HEALTH CARE SERVICES AND THE POWER TO REQUIRE THE HOSPITAL TO ADD, REVISE, RELOCATE OR DISCONTINUE HEALTH CARE SERVICES; 10) THE POWER TO APPROVE THE TRANSFER OF ASSETS BY THE HOSPITAL OUTSIDE OF THE HEALTH CARE SYSTEM CONTROLLED BY THE SOLE MEMBER; 11) THE POWER TO APPROVE THE OCCURRENCE OF THE FOLLOWING EVENTS: SALE, LEASE, EXCHANGE OF SUBSTANTIALLY ALL ASSETS; MERGER; CONSOLIDATION; DIVISION; DISSOLUTION; OR LIQUIDATION OF THE HOSPITAL; OR AMENDMENT OF ITS ARTICLES OF INCORPORATION; 12) THE POWER TO ESTABLISH AND FROM TIME TO TIME MODIFY THE HOSPITAL'S STRATEGIC PLANS; 13) THE POWER TO ESTABLISH AND FROM TIME TO TIME MODIFY INVESTMENT GUIDELINES APPLICABLE TO THE HOSPITAL; 14) THE POWER TO APPROVE THE SELECTION, RETENTION OR TERMINATION OF THE HOSPITAL'S EXTERNAL AUDITORS; AND 15) THE POWER TO ESTABLISH, AMEND, TERMINATE, MERGE OR CONSOLIDATE ANY BENEFIT PLANS INCLUDING, WITHOUT LIMITATION, THE POWER TO REVISE EXISTING BENEFIT PLANS AS NECESSARY TO MEET THE COVERAGE AND NONDISCRIMINATION REQUIREMENTS OF THE CODE AND REGULATIONS THEREUNDER. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE BLUE MOUNTAIN HEALTH SYSTEM (BMHS) STAFF COMMUNICATED TO THE FINANCE COMMITTEE OF THE BOARD THAT THE FORMS 990 WERE PREPARED BY BAKER TILLY VIRCHOW KRAUSE, LLP, AS WELL AS COMMUNICATING THE GENERAL TYPES OF INFORMATION CONTAINED IN THE FILING. THE FORM 990 IS REVIEWED BY THE CEO, THE CFO, AND THE VP OF FUND DEVELOPMENT PRIOR TO ISSUANCE AND THE BOARD IS PROVIDED THE DETAILS TO ACCESS THE 990 THROUGH A SECURED BOARD "PORTAL" PRIOR TO ISSUANCE. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT STATEMENT MUST BE SIGNED ON AN ANNUAL BASIS BY ALL GOVERNING BODY MEMBERS, OFFICERS, AND KEY EMPLOYEES. THIS PROCESS IS MONITORED BY THE ADMINISTRATIVE ASSISTANT TO THE PRESIDENT/CEO. A CONFLICT IS CONSIDERED TO BE ANY DIRECT OR INDIRECT FINANCIAL INTEREST, AND ANY CONFLICTS NOTED ARE COMMUNICATED TO THE COMPLIANCE COMMITTEE. THERE WERE NO CONFLICTS DISCLOSED FOR THIS YEAR. IF A CONFLICT WERE TO EXIST, THE INTERESTED PERSON MAY NOT BE PRESENT DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE CONFLICT OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | SENIOR MANAGEMENT SALARIES ARE DETERMINED BY THE EXECUTIVE COMMITTEE USING MARKET VALUES OBTAINED. HUMAN RESOURCES PARTICIPATES IN VARIOUS SALARY SURVEYS TO DETERMINE THE CORRECT SALARY RANGE. THE APPALACHIAN HOSPITAL HUMAN RESOURCE SOCIETY CONDUCTS AN ANNUAL SALARY SURVEY FOR ALL POSITIONS. IN ADDITION, THE HOSPITAL ASSOCIATION OF PENNSYLVANIA CONDUCTS AN ANNUAL SURVEY WITH YAFFE ASSOCIATES FOR SENIOR MANAGEMENT EMPLOYEES. THE MARKET DATA IS ANALYZED BY HUMAN RESOURCES AND THE GOAL IS TO PAY AT THE 50TH PERCENTILE. SALARIES OF OTHER EMPLOYEES ARE RECOMMENDED BY HUMAN RESOURCES AND APPROVED BY THE PRESIDENT AND CEO. THE EXECUTIVE COMMITTEE OF THE BOARD SERVES AS THE COMPENSATION COMMITTEE AND APPROVES RECOMMENDATIONS FOR SALARY INCREASES. THE EXECUTIVE COMMITTEE APPROVES INCREASES FOR THE CEO. THE REVIEW AND APPROVAL PROCESS FOR SALARY INCREASES IS DOCUMENTED IN THE COMMITEE MINUTES. SENIOR MANAGEMENT HAS RECEIVED THE SAME GENERAL INCREASES AS THE STAFF EMPLOYEES RECEIVED. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | VALUATION GAIN (LOSS) -26,505. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| BLUE MOUNTAIN HEALTH SYSTEM INC | |||||||||||
| 211 NORTH 12TH STREET | LEHIGHTON | PA | 182351195 | 201311316 | MAINTAINS AN INTEGRATED HEALTH CARE SYSTEM | PA | 501(C)(3) | LINE 11A, I | N/A | 0 | |
| CMS MEDICAL CARE CORPORATION | |||||||||||
| 211 NORTH 12TH STREET | LEHIGHTON | PA | 182351195 | 232473899 | OWNS AND OPERATES AMBULATORY CARE CENTERS IN VARIOUS COMMUNITIES | PA | 501(C)(3) | LINE 3 | 0 | GNADEN HUETTEN MEMORIAL HOSPITAL INC | |
| GNADEN HUETTEN MEMORIAL HOSPITAL INC | |||||||||||
| 211 NORTH 12TH STREET | LEHIGHTON | PA | 182351195 | 240795436 | OPERATES AN ACUTE CARE HOSP, A NURSING FACILITY & A HOME HEALTH CARE AGENCY | PA | 501(C)(3) | LINE 3 | 0 | BLUE MOUNTAIN HEALTH SYSTEM INC | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | 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 | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |