2015-05-14T11:24:55-07:00 2014-06-30 BKD LLP 910 E St Louis/PO BOX 1190 SPRINGFIELD MO 658062523 990 2013-07-01 240804365 The Green Home GREE 5707230603 37 Central Ave Wellsboro PA 16901 CHARLES J SANTANGELO EXECUTIVE VICE PRESIDENT/CFO 5707230603 2015-05-12 true BKD LLP 4178658701 2013 2016-02-25 16:41:14Z JANIE HILFIGER 32-36 Central Ave Wellsboro PA 16901 10620776 false X susquehannahealth.org X 1974 PA The Green Home is a subsidiary of Susquehanna Health System (SHS). The mission of SHS and affiliates is as follows: To extend God's healing love by improving the health of those we serve. Our vision is to create a world-class health system. Our values are putting patients first, sharing ownership and being servant leaders. 16 14 186 24 0 1225 2840 9866419 10537455 155285 25517 4307 4677 10027236 10570489 0 0 6212722 6463107 0 0 3917249 4528457 10129971 10991564 -102735 -421075 7692041 5736198 1655469 1677450 6036572 4058748 The Green Home is a subsidiary of false false 9021951 9670483 THE GREEN HOME OPERATED A 120-BED SKILLED NURSING FACILITY THAT PROVIDED BOTH LONG-TERM CARE AND SHORT-TERM SERVICES FOR RESIDENTS. SERVICES PROVIDED INCLUDE ROUND-THE-CLOCK PROFESSIONAL NURSING; PHYSICAL, OCCUPATIONAL, AND SPEECH REHABILITATION SERVICES; MEDICAL SOCIAL WORK AND COUNSELING SERVICES; NUTRITION SERVICES; PODIATRY SERVICES; RADIOLOGY SERVICES; DENTISTRY; AND A VARIETY OF ACTIVITIES AND RECREATIONAL PROGRAMS. THE AVERAGE DAILY CENSUS WAS 106. THE PAYOR MIX WAS 69% MEDICAID, 15% MEDICARE AND 16% SELF-PAY RESIDENTS. REHABILITATION SERVICES PROVIDED INCLUDED 17,238 PHYSICAL THERAPY TREATMENTS, 15,866 OCCUPATIONAL THERAPY TREATMENTS AND 3,632 SPEECH THERAPY TREATMENTS. 916239 867809 THE GREEN HOME OPERATED THE LAURELS, A 30 UNIT PERSONAL CARE HOME SERVING INDIVIDUALS AGED 62 AND OLDER. THE LAURELS HAD AN OCCUPANCY RATE OF 91% WITH 100% SELF PAY RESIDENTS. 9938190 true false false false false false false false true true true false false false true false true true false false false false false false false false false false false true false false false false false false false true false false false false false true false false false true 0 0 true 186 true false false false false false false false false false false X 16 14 true false false false false true true true true false false false true true true true true true true false X Ronald M Gilbert Jr CPA 5707230603 22 Walnut St Wellsboro PA 16901 DARIUS E ABADI DO Director 1.00 X 0 352603 31491 JAMES D BAKER JR Director 1.00 X 0 0 0 R ROBERT DECAMP Secretary 1.00 X X 0 0 0 LISA V FEIL PSY D Director 1.00 X 0 0 0 ROBERT FITZGERALD Director 1.00 X 0 0 0 HAROLD F HOOSE III Director 1.00 X 0 0 0 WALTER J LAIBINIS DO Director 1.00 X 0 252873 14783 MICHAEL W LICHTY Director 1.00 X 0 0 0 CRAIG G LITCHFIELD Treasurer 1.00 X X 0 0 0 J DENNIS MURRAY PHD Director 1.00 X 0 0 0 THOMAS M OWLETT ESQ Chairman 1.00 X X 0 0 0 GLENN B POIRIER Vice Chairman 1.00 X X 0 0 0 WENDY S SWARTZ CPA Director 1.00 X 0 0 0 ANEURIN J WILLIAMS JR Director 1.00 X 0 0 0 DONNA R WILSON Director 1 X KATHY J WRIGHT PHD Director 1 X RONALD J BUTLER Executive Vice President X 324224 15277 JAN E FISHER Executive Vice President X 387968 19385 JANIE M HILFIGER President X 143686 27220 STEVEN P JOHNSON President/CEO X 539105 31861 CHARLES J SANTANGELO Executive Vice President/CFO X 338408 29440 WILLIAM C MCCAULEY MD Senior Vice President X 379609 30350 2718476 199807 0 false true false Functional Pathways 317 Ebenezer Road Knoxville TN 37923 Rehabilitation Services 149735 Genesis Eldercare Rehab 101 East State St Kennett Square PA 19348 Rehabilitation Services 580290 2 2840 2840 Skilled Nursing Care 623000 9654700 Personal Care Home 623000 867809 Employee & Guest Meals 722210 9408 Beauty Shop 812900 5538 10537455 21275 21275 3840 3840 3840 3840 35029 19500 35911 14376 -882 5124 4242 4242 837 837 837 10570489 10538292 29357 4787850 4550600 237250 0 208455 198126 10329 0 1124264 1069313 54951 0 342538 325564 16974 0 633181 0 633181 0 14130 0 14130 0 15080 0 15080 0 1823 0 1823 0 916974 909403 7571 0 12565 9016 3549 0 340300 310361 29939 0 2036 0 2036 0 14142 11966 2176 0 510187 508440 1747 0 11675 8731 2944 0 7526 6990 536 0 18087 18087 0 0 286690 286690 0 0 10692 10692 0 0 Resident Care Supplies 1722690 1710470 12220 0 Dues 8305 1367 6938 0 Bad Debt 2374 2374 0 0 10991564 9938190 1053374 0 750 750 1095215 938468 1262912 1539942 616021 113205 12661 9524 38425 27761 10684455 7577907 3084494 3106548 1581563 7692041 5736198 941615 977921 10842 176506 75424 52426 627588 470597 1655469 1677450 X 6036572 4058748 6036572 4058748 7692041 5736198 X -421075 69283 -1626032 X false true X true false X 0 0 0 8714 8512 6623 1225 2840 27914 10294626 10302258 10441744 9866886 10538592 51444106 10303340 10310770 10448367 9868111 10541432 51472020 51472020 79828 213626 -1759 114578 25115 431388 79828 213626 -1759 114578 25115 431388 51903408 0.99170 0.99330 0.00830 0.00300 X false true X 305800 -335097 29815 518 272788 34234 1222 305800 278971 -5086 1097 272788 254837 25237 1103 278971 243283 12619 1065 254837 1.00000 false true true 310099 310099 7374413 4863742 2510671 2682715 2534868 147847 317228 179297 137931 3106548 Notes Payable Affiliates - Long Term 319107 Notes Payable Affiliates - Current 151490 470597 X 10637398 69283 69283 10568115 2374 2374 10570489 10989190 10989190 2374 2374 10991564 Pt IV Line 2b Security deposits and personal care account funds Pt V Line 4 The endowment funds are used to fund the mission of the organization. Pt XI Line 4b Bad Debt $2,374 Pt XII Line 4b Bad Debt $2,374 Pt X Line 2 The System companies, with the exception of SVI, CB, SHSIN, TMSO and TCN, have been recognized as exempt from income taxes under Section 501 of the Internal Revenue Code and a similar provision of state law. However, these entities are subject Pt X Line 2 to federal income tax on any unrelated business taxable income. SVI, CB, SHSIN, TMSO and TCN account for income taxes in accordance with income tax accounting guidance (ASC 740 Income Taxes). false false false false false false false false false DARIUS E ABADI DO 352103 500 14403 17088 384094 WALTER J LAIBINIS DO 182813 70060 6069 8714 267656 RONALD J BUTLER 320062 4162 9650 5627 339501 JAN E FISHER 383073 4895 9650 9735 407353 JANIE M HILFIGER 143686 7220 20000 170906 STEVEN P JOHNSON 524745 14360 13475 18386 570966 CHARLES J SANTANGELO 331702 6706 9650 19790 367848 WILLIAM C MCCAULEY MD 376409 3200 9650 20700 409959 SUSQUEHANNA VENTURES Common officers/board members 338624 Pharmacy and Infusion Services false Pt VI, Line 2 Key employee Charles Santangelo and board member Steve Johnson Pt VI, Line 2 both serve on the board of a related taxable organization. Pt VI, Line 7a Susquehanna Health System (SHS), EIN 23-2751183, may elect Pt VI, Line 7a or remove members of the governing body. Pt VI, Line 7b All the business and affairs of the Entity shall be managed Pt VI, Line 7b and controlled by the Board of Directors, subject to the oversight Pt VI, Line 7b of the sole Member, Susquehanna Health System (SHS), of the Pt VI, Line 7b management and operation of the Entity, except that the Pt VI, Line 7b following powers are reserved exclusively to the sole Member of the Pt VI, Line 7b Entity, and no attempted exercise of any such powers by anyone Pt VI, Line 7b other than the sole Member shall be valid of any force or Pt VI, Line 7b effect whatsoever. The sole Member shall exercise its powers Pt VI, Line 7b through its Board of Directors. The sole Member shall have Pt VI, Line 7b the exclusive authority to exercise the following powers: Pt VI, Line 7b A) to appoint or elect the directors B) to appoint and Pt VI, Line 7b remove the President following consultation with the Entity Pt VI, Line 7b C) to approve the nominees for elected officers and to Pt VI, Line 7b return the list of approved nominees to the governing bodies Pt VI, Line 7b for election D) to remove, with or without cause, any director Pt VI, Line 7b or any elected officer E) to amend the Governing Instruments Pt VI, Line 7b and to approve all amendments to the Governing Instruments Pt VI, Line 7b which are proposed for adoption F) to approve the annual Pt VI, Line 7b operating and capital budgets G) to establish requirements Pt VI, Line 7b for a unified budget H) to approve the incurrence or issuance of Pt VI, Line 7b debt proposed by Entity and the encumbrance of any Entity Pt VI, Line 7b assets to secure any such incurred debt I) to incur debt Form 990EZ, Part I, Line 8 EMPLOYEE & GUEST MEALS MISCELLANEOUS BEAUTY SHOP RENTAL INCOME Form 990EZ, Part I, Line 16 INSURANCE BAD DEBT PAYMENT IN LIEU OF TAXES UTILITIES MANAGEMENT FEES Form 990EZ, Part II, Line 24 ACCOUNTS RECEIVABLE - NET INVENTORIES PREPAIDS INVESTMENTS DUE FROM AFFILIATES Form 990EZ, Part II, Line 26 ACCOUNTS PAYABLE & ACCRUED EXPENSES BONDS, MORTGAGES & OTHER NOTES ESTIMATED THIRD PARTY SETTLEMENT Pt VI, Line 7b (or to cause debt to be incurred) on behalf of the Entity J) Pt VI, Line 7b to require contributions in cash or cash equivalents to Pt VI, Line 7b support the working capital needs or capital projects of any Pt VI, Line 7b one or more System Entities K) to require that any debt Pt VI, Line 7b incurred on a System-wide basis by or at the direction of SHS Pt VI, Line 7b shall be the joint and several obligation of each System Pt VI, Line 7b Entity L) to direct or approve any cash contributions or any Pt VI, Line 7b other capital contributions made by one System Entity to Pt VI, Line 7b another System Entity M) to allocate any financial resources Pt VI, Line 7b in such manner as SHS determines to be necessary N) to approve Pt VI, Line 7b the sale, transfer or other disposition of Entity or Entity Pt VI, Line 7b property unless it is made in the ordinary course of business or Pt VI, Line 7b involves assets with a fair market value of less than one Pt VI, Line 7b hundred thousand dollars O) to direct the transfer of property Pt VI, Line 7b from the Entity to one or more other System Entities P) to approve Pt VI, Line 7b of any investment of assets by Entity not within the limits Pt VI, Line 7b of the System's approved investment policy Q) to establish Pt VI, Line 7b requirements for the approval of the acquisition, purchase, Pt VI, Line 7b sale, transfer, encumberance, leasing, construction or demolition Pt VI, Line 7b of land or buildings outside the ordinary course of business Pt VI, Line 7b R) to approve any decision with respect to the addition, Pt VI, Line 7b modification or discontinuance of any patient care or Pt VI, Line 7b diagnostic program or health care service S) to approve Pt VI, Line 7b of any change in licensure of Entity; licensure of any Pt VI, Line 7b Facility; certification, registration, accreditation, permit, Pt VI, Line 7b or related approval of any activity T) to require Entity Pt VI, Line 7b to add, modify, relocate or discontinue any patient care or Pt VI, Line 7b diagnostic program or health care service U) to approve Pt VI, Line 7b or direct any merger, consolidation, organization, Pt VI, Line 7b reorganization, joint venture, corporate division, sale Pt VI, Line 7b conversion, lease or exchange of substantially all the assets, Pt VI, Line 7b dissolution, liquidation or any other modification of Pt VI, Line 7b corporate structure or affiliations affecting the autonomy, Pt VI, Line 7b governance, or operations, and the creation or acquisition Pt VI, Line 7b of any new affiliate by Entity V) to dissolve or terminate Pt VI, Line 7b the existance of Entity and to determine the distribution Pt VI, Line 7b of assets upon such termination or dissolution W) to Pt VI, Line 7b coordinate managed care plans involving Entity, including Pt VI, Line 7b decisions concerning entry into or renewal of any contract Pt VI, Line 7b or agreement relating thereto X) to develop and/or enter Pt VI, Line 7b into key strategic relationships on behalf of Entity Y) Pt VI, Line 7b to select any outside financial auditors, general legal Pt VI, Line 7b counsel or investment advisors to provide services on Pt VI, Line 7b behalf of Entity. Pt VI, Line 11b A high-level overview of Forms 990 is presented to the parent Pt VI, Line 11b Board of Directors (Susquehanna Health System, #23-2751183) Pt VI, Line 11b before filing and complete drafts of all returns are made Pt VI, Line 11b available to all Board members through the CEO's and CFO's Pt VI, Line 11b office. Pt VI, Line 12c Annually on the 1st day of January, the Susquehanna Health System CEO Pt VI, Line 12c sends to all Directors, Officers, Management staff and contracted Pt VI, Line 12c physicians a questionnaire to be completed and returned by Pt VI, Line 12c January 15. A report is submitted to the Board of Directors to notify Pt VI, Line 12c them of any conflicts of interest disclosed. Pt VI, Line 15a On a bi-annual basis an independent compensation consulting firm Pt VI, Line 15b performs an analysis of the Leadership salary structure in Pt VI, Line 15b relationship to the labor market using data from four different Pt VI, Line 15b salary surveys. Their analysis is reviewed with the Governance Pt VI, Line 15b Committee of the Board of Directors. The firm then outlines it's Pt VI, Line 15b recommendations for the proposed executive salary structure Pt VI, Line 15b to the Committee for their consideration and approval. Pt VI, Line 19 Governing documents and financial statements are available to the Pt VI, Line 19 public upon request. The conflict of interest policy is also Pt VI, Line 19 available to the public. Pt XI Line 9 comprised of Net Assets Released from Restriction $1,770, Pt XI Pension Liability adjustment $17,815 and Transfers to Pt XI Affiliates ($1,645,617). Pt V, Line 1a All 1099s were issued by Susquehanna Health System (EIN 23-2751183). Pt V, Line 1a All expenses were then allocated back to the related entities. Laurel Health System 22 Walnut St Wellsboro PA 16901 240795488 Support entities affiliated with Laurel Health System PA 501(c)(3) 11 B II Susquehanna Health System false Laurel Management Services 22 Walnut St Wellsboro PA 16901 251644910 Management consulting and supervisory services PA 501(c)(3) 11 B II Susquehanna Health System false Soldiers Sailors Memorial Hospital 32-36 Central Ave Wellsboro PA 16901 232176963 Operate acute care hospital PA 501(c)(3) 3 Susquehanna Health System false Tioga Health Care Providers 15 Meade St Wellsboro PA 16901 251765538 Employ physician specialists PA 501(c)(3) 11 B II Susquehanna Health System false Laurel Realty 15 Meade St Wellsboro PA 16901 231403678 Own and manage real estate in support of Laurel Health PA 501(c)(2) Susquehanna Health System false Divine Providence Hospital 1100 Grampian Blvd Williamsport PA 17701 240799343 HOSPITAL PA 501(c)(3) 3 Susquehanna Health System false Muncy Valley Hospital 215 E Water St Muncy PA 17756 240806023 HOSPITAL PA 501(c)(3) 3 Susquehanna Health System false The Williamsport Hospital 700 High Street Williamsport PA 17701 240795508 HOSPITAL PA 501(c)(3) 3 Susquehanna Health System false Susquehanna Health Foundation 1100 Grampian Blvd Williamsport PA 17701 232743470 Fundraising for affiliated entities PA 501(c)(3) 11 A I Susquehanna Health System false Susquehanna Physician Services 1201 Grampian Blvd Williamsport PA 17701 232449454 Physician services & MRI services PA 501(c)(3) 3 Susquehanna Health System false Williamsport Area Ambulance Service Cooperative 700 High Street Williamsport PA 17701 232416166 AMBULANCE TRANSPORTS PA 501(c)(3) 9 NA false Susquehanna Health System 1205 Grampian Blvd Williamsport PA 17701 232751183 Coordinate and manage the delivery of healthcare PA 501(c)(3) 11 B II NA false Laurel Health Foundation 15 Meade St Wellsboro PA 16901 251810488 Fundraising for affiliated entities PA 501(c)(3) 11 A I Laurel Health System false North Penn Comprehensive Health Services 22 Walnut St Wellsboro PA 16901 231889724 Provides general health and social services PA 501(c)(3) 3 Laurel Health System false Community Basket LLC 1205 Grampian Blvd Williamsport PA 17701 201195739 Rents real estate PA Susquehanna Health System Excluded from tax false false Tyoga Carenet 22 Walnut St Wellsboro PA 16901 251810967 INTEGRATE HEALTH CARE PA Laurel Health System C 0.00000 false Susquehanna Ventures Inc 1201 Grampian Blvd Williamsport PA 17701 232470263 Pharmacy & Infusion services PA Susquehanna Health System C 0.00000 false Susquehanna Health System Insurance Network LTD PO Box 1159 Grand Caymans CJ 980458722 Captive Insurance Company CJ Susquehanna Health System 0.00000 false false false false true false false false false false false false false true false true false true false false Part III, Identification of Related Organizations Taxable as Partnership Name of Related Organization: Community Basket, LLC Direct Controlling Entity: Susquehanna Health System & Susquehanna Health Foundation Form 990, Schedule R, Part IV Susquehanna Health System Insurance Network, LTD (SHSIN) EIN #98-0458722 is a foreign corporation, incorporated under the laws of the Cayman Islands. There are no income, capital, or premium taxes levied in the Cayman Islands and SHSIN has been granted an exemption until September 2022 for any such taxes that might be introduced. SHSIN's sole shareholder, Susquehanna Health System EIN #23-2751183, is a 501(c)(3) organization exempt from federal income taxes. SHSIN conducts no business in the United States. It files an 1120F protective filing which implies that its income is not subject to US Federal income tax.