2015-05-08T09:07:39-05:00 2014-06-30 550486667 ARNETT CARBIS TOOTHMAN LLP 5700 CORPORATE DRIVE STE 650 PITTSBURGH PA 15237 990 2013-07-01 251441920 SOMERSET HEALTH SERVICES INC SOME 8144435221 225 SOUTH CENTER AVENUE SOMERSET PA 15501 ANDREW RUSH CEO 8144435221 2015-04-28 1 JEFFREY J PETRELL CPA P00138808 4126356270 2015-03-27 2013 2016-02-25 16:41:14Z ANDREW RUSH 225 SOUTH CENTER AVENUE SOMERSET PA 15501 8808734 0 X WWW.SOMERSETHOSPITAL.COM X 1983 PA SOMERSET HEALTH SERVICES IS A COMMUNITY HEALTHCARE SERVICE THAT IS COMMITTED TO MANAGING AND OPERATING PRIMARY CARE AND SPECIALTY PHYSICIAN PRACTICES. 6 4 109 4 0 0 709692 722675 6177235 8055999 21 29 166684 30031 7053632 8808734 0 0 0 0 6057815 7583772 0 0 0 2548405 4421174 8606220 12004946 -1552588 -3196212 2414220 2716150 1146207 1628518 1268013 1087632 TO PRESERVE AND TO IMPROVE LIFE BY PROVIDING ACCESS TO QUALITY, CUSTOMER-FRIENDLY HEALTHCARE SERVICES. 0 0 10283110 8055999 SOMERSET HEALTH SERVICES MANAGES AND OPERATES PRIMARY CARE AND SPECIALTY PHYSICIAN PRACTICES. ANNUAL VISITS ARE APPROXIMATELY 60,000. SOMERSET HEALTH SERVICES ALSO MANAGES A SINGLE COUNTY AUTHORITY WHICH PROVIDES FUNDING (RECEIVED BY STATE AND FEDERAL AGENCIES) TO VARIOUS DRUG AND ALCOHOL TREATMENT CENTERS. 10283110 1 0 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 13 0 1 109 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 6 4 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 PA X MATTHEW KOCIOLA 8144435221 225 SOUTH CENTER AVENUE SOMERSET PA 15001 SHARON CLAPPER CHAIRMAN 1.00 1.00 X X 0 0 0 BRAD COBER TREASURER 1.00 2.00 X X 0 0 0 TROY MILLER MEMBER 1.00 X 0 0 0 TED DESKEVICH MEMBER 1.00 X 0 0 0 BRUCE SHIPLEY MEMBER 1.00 2.00 X 0 0 0 ANDREW RUSH CEO 6.00 34.00 X X 0 155583 19013 RONALD PARK CEO/CFO (THROUGH FEBRUARY 2014) 6.00 34.00 X 0 238458 21391 MATTHEW KOCIOLA CFO 6.00 34.00 X 0 110187 18701 CRAIG SAYLOR SOMERSET COMMUNITY HOSPITAL CEO 6.00 34.00 X 0 139865 19252 PRADEEP NAIR MD PHYSICIAN 40.00 X 526446 0 16054 V KRISHNAN NAIR MD PHYSICIAN 40.00 2.00 X 423269 0 14311 JOSE AYCINENA MD PHYSICIAN 40.00 1.00 X 494374 0 16752 DAVID GIRDANY MD PHYSICIAN 40.00 X 471400 0 16054 JAYESH DESAI MD PHYSICIAN 40.00 X 415000 0 16624 MICHAEL FARRELL FORMER CEO 0.00 40.00 X 0 301740 19401 2330489 945833 177553 15 1 1 0 0 722675 722675 NET PATIENT REVENUE 621610 8055999 8055999 8055999 29 29 SOMERSET MGMT SERVICES 900099 16248 16248 OTHER OPERATING REVENU 900099 13783 13783 30031 8808734 8055999 0 30060 X 6620300 5296240 1324060 21205 16964 4241 610972 488778 122194 331295 265036 66259 98528 98528 22605 22605 1553944 1506210 47734 37330 35727 1603 145415 133034 12381 490755 477625 13130 10580 9733 847 73432 73432 194425 192429 1996 119872 115593 4279 MEDICAL SUPPLIES/DRUGS 684043 684043 PROVIDER EXPENSES 500911 500611 300 INTERNAL BILLING COSTS 365355 365355 EQUIPMENT RENTAL & MAIN 84486 82807 1679 39493 39493 12004946 10283110 1721836 0 591449 468856 365908 587384 92402 116212 1903665 1452128 393707 451537 456825 473074 513929 619087 2414220 2716150 1146207 1009431 0 619087 1146207 1628518 X 1268013 1087632 1268013 1087632 2414220 2716150 X -3196212 44427 2971404 X X 0 1 X 1 1 1 X 93382 93382 0 1798710 1350232 448478 11573 8514 3059 451537 INVESTMENT IN SOMERSET MANAGEMENT SERVICES, INC. 473074 C 473074 HELD BY TRUSTEE 619087 619087 HELD BY TRUSTEE 619087 619087 0 0 0 0 0 1 0 0 0 ANDREW RUSH CEO 0 155583 0 0 0 0 0 2587 0 16426 0 174596 0 0 RONALD PARK CEO/CFO (THROUGH FEBRUARY 2014) 0 225958 0 12500 0 0 0 4950 0 16441 0 259849 0 0 CRAIG SAYLOR SOMERSET COMMUNITY HOSPITAL CEO 0 139865 0 0 0 0 0 2869 0 16383 0 159117 0 0 PRADEEP NAIR MD PHYSICIAN 510620 0 15826 0 0 0 0 0 16054 0 542500 0 0 0 V KRISHNAN NAIR MD PHYSICIAN 423269 0 0 0 0 0 0 0 14311 0 437580 0 0 0 JOSE AYCINENA MD PHYSICIAN 301542 0 192832 0 0 0 0 0 16752 0 511126 0 0 0 DAVID GIRDANY MD PHYSICIAN 471400 0 0 0 0 0 0 0 16054 0 487454 0 0 0 JAYESH DESAI MD PHYSICIAN 415000 0 0 0 0 0 0 0 16624 0 431624 0 0 0 MICHAEL FARRELL FORMER CEO 0 301740 0 0 0 0 0 5100 0 14301 0 321141 0 0 PART I, LINE 3 SOMERSET HEALTH SERVICES' MANAGEMENT IS EMPLOYED BY SOMERSET COMMUNITY HOSPITAL. SOMERSET COMMUNITY HOSPITAL'S LEADERSHIP COMMITTEE, WHICH IS A SUBCOMMITTEE OF THE BOARD OF DIRECTORS, ANNUALLY REVIEWS AND APPROVES THE COMPENSATION OF THEIR ORGANIZATION'S TOP MANAGEMENT. PART I, LINE 6 PHYSICIANS MAY BE GRANTED ADDITIONAL COMPENSATION DEPENDENT ON THE ACHIEVING OF CERTAIN INDICATORS BY THE COMPANY FORM 990, PART VI, SECTION B, LINE 11 SOMERSET HEALTH SERVICES, INC. HAS A CPA FIRM PREPARE ITS FORM 990. THE RETURN IS COMPLETED IN DRAFT FORM AND REVIEWED BY MANAGEMENT OF THE ORGANIZATION. THE RETURN IS THEN FINALIZED AND THE BOARD IS PROVIDED A COPY OF THE FORM 990 BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C SOMERSET HEALTH SERVICES, INC. ANNUALLY REQUIRES ITS BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES TO FILL OUT A CONFLICTS OF INTEREST FORM. DURING BOARD MEETINGS, IF AN INTERESTED PARTY HAS A CONFLICT, HE OR SHE RECUSES THEMSELVES FROM VOTING. FORM 990, PART VI, SECTION B, LINE 15 SOMERSET HEALTH SERVICES' MANAGEMENT IS EMPLOYED BY SOMERSET COMMUNITY HOSPITAL. SOMERSET COMMUNITY HOSPITAL'S LEADERSHIP COMMITTEE, WHICH IS A SUBCOMMITTEE OF THE BOARD OF DIRECTORS, ANNUALLY REVIEWS AND APPROVES THE COMPENSATION OF THEIR ORGANIZATION'S TOP MANAGEMENT. FORM 990, PART VI, SECTION C, LINE 18 SOMERSET HEALTH SERVICES, INC. MAKES ITS FORM 990 AND FORM 1023 AVAILABLE TO THE PUBLIC. FORM 990, PART VI, SECTION C, LINE 19 AT THIS TIME, SOMERSET HEALTH SERVICES, INC. DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND CONSOLIDATED FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC. FORM 990, PART IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 1,506,210. MANAGEMENT AND GENERAL EXPENSES 47,734. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,553,944. FORM 990, PART XI, LINE 9: TRANSFERS FROM AFFILIATES 2,971,404. FORM 990, PART XII, LINE 2C: SOMERSET COMMUNITY HOSPITAL, A TAX-EXEMPT AFFILIATE OF SOMERSET HEALTH SERVICES, INC. HAS A FINANCE COMMITTEE THAT IS RESPONSIBLE FOR THE OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT AUDITORS ON BEHALF OF SOMERSET HEALTH SERVICES, INC. THE PROCESS IS CONSISTENT WITH PRIOR YEARS AND HAS NOT CHANGED. SOMERSET COMMUNITY HOSPITAL 225 SOUTH CENTER AVENUE SOMERSET PA 15501 250965570 HEALTH CARE PA 501(C)(3) 509(A)(1) SOMERSET COMMUN HOSP FOUNDATION 0 SOMERSET COMMUNITY HOSPITAL FOUNDATION 225 SOUTH CENTER AVENUE SOMERSET PA 15501 251441863 HEALTH CARE PA 501(C)(3) 509(A)(3) 0 TWIN LAKES CENTER INC 225 SOUTH CENTER AVENUE SOMERSET PA 15501 232910318 HEALTH CARE PA 501(C)(3) 509(A)(1) SOMERSET COMMUNITY HOSPITAL 0 SOMERSET MANAGEMENT SERVICES INC 225 SOUTH CENTER AVENUE SOMERSET PA 15501 251512960 REAL ESTATE HOLDING COMPANY PA SOMERSET HEALTH SERVICES INC C 16248 2614191 1.00000 1 SOMERSET ANESTHESIA INC 225 SOUTH CENTER AVENUE SOMERSET PA 15501 455135437 ANESTHESIA SERVICES PA SOMERSET COMMUNITY HOSPITAL C 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 1 SOMERSET MANAGEMENT SERVICES INC K 200000