2015-05-08T06:58:11-05:00 2014-06-30 390859910 BAKER TILLY VIRCHOW KRAUSE LLP 1650 MARKET STREET SUITE 4500 PHILADELPHIA PA 19103 990 2013-07-01 232215800 THE GOOD SHEPHERD HOME LONG-TERM CARE FACILITY INC GOOD 6107763228 GOOD SHEPHERD PLAZA 850 S 5TH ST ALLENTOWN PA 181033295 RONALD J PETULA SVP OF FINANCE & CFO 6107763228 2015-05-04 1 JULIUS C GREEN CPA JD P00350393 2159720701 2013 2016-02-25 16:41:14Z RONALD J PETULA GOOD SHEPHERD PLAZA 850 S 5TH ST ALLENTOWN PA 181033295 22266378 0 X WWW.GOODSHEPHERDREHAB.ORG X 1982 PA TO ENHANCE LIVES, MAXIMIZE FUNCTION, INSPIRE HOPE, AND PROMOTE DIGNITY AND WELL-BEING WITH EXPERTISE AND COMPASSION. 18 16 0 151 0 0 399537 507161 21125658 21720769 0 0 0 38448 21525195 22266378 0 0 0 0 12366927 12332891 0 0 0 8911175 9604056 21278102 21936947 247093 329431 42548444 42933029 702351 757505 41846093 42175524 X GOOD SHEPHERD'S MISSION IS: "MOTIVATED BY THE DIVINE GOOD SHEPHERD AND THE PHYSICAL AND COGNITIVE REHABILITATION NEEDS OF OUR COMMUNITIES, OUR MISSION IS TO ENHANCE LIVES, MAXIMIZE FUNCTION, INSPIRE HOPE, AND PROMOTE DIGNITY AND WELL-BEING WITH EXPERTISE AND COMPASSION." 0 0 19679513 21720769 THE GOOD SHEPHERD HOME AT THE CONRAD W. RAKER CENTER AND THE GOOD SHEPHERD HOME-BETHLEHEM ARE RESIDENCES WHERE PERSONS WITH PHYSICAL DISABILITIES REQUIRING NURSING FACILITY CARE CAN COME TO LIVE AND REALIZE THEIR FULLEST POTENTIAL. SERVICES PROVIDED INCLUDE NURSING AND MEDICAL SERVICES, OCCUPATIONAL THERAPY, COMMUNICATION SERVICES, PASTORAL CARE, SOCIAL WORK SERVICES, THERAPEUTIC RECREATION, PHYSICAL THERAPY, ADAPTIVE WHEELCHAIR, MOBILITY AND SEATING PROGRAMS. MANY OF THE RESIDENTS UTILIZE GOOD SHEPHERD'S ASSISTIVE TECHNOLOGY PROGRAM TO HELP WITH THEIR MOBILITY, COMMUNICATION AND EVERYDAY LIVING NEEDS. IN FISCAL YEAR 2014, THE RAKER CENTER OPERATED AT 99.6% OCCUPANCY, WITH 36,058 PATIENT DAYS, WHILE THE BETHLEHEM HOME OPERATED AT 99.6% OCCUPANCY, WITH 21,743 PATIENT DAYS. THERE IS A WAITING LIST FOR BOTH HOMES. 19679513 1 1 0 0 0 0 0 0 1 0 1 0 0 1 0 1 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 0 0 0 1 X 0 0 0 0 0 0 0 0 0 0 0 0 0 X 18 16 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X RONALD J PETULA SVP OF FINANCE & CFO 6107763228 GOOD SHEPHERD PLAZA 850 SOUTH 5TH ALLENTOWN PA 18103 SCOTT A BAKER SECRETARY 0.30 0.80 X X 0 0 0 PATRICK J BRENNAN MD TRUSTEE 0.30 0.80 X 0 0 0 DAVID G DECAMPLI CHAIR 0.70 2.00 X X 0 0 0 ALVARO DIAZ TRUSTEE 0.30 0.80 X 0 0 0 ROBERT E GADOMSKI TRUSTEE 0.30 0.80 X 0 0 0 F MARK GUMZ TRUSTEE 0.30 0.80 X 0 0 0 ELSBETH G HAYMON TRUSTEE 0.30 0.80 X 0 0 0 KATHERINE E HILGERT TRUSTEE 0.20 0.50 X 0 0 0 SANDRA JARVA WEISS ESQ VICE CHAIR 0.20 0.50 X X 0 0 0 JOHN KRISTEL PRESIDENT/CEO 6.50 53.50 X X 0 345121 17831 JAAN PETER NAKTIN TRUSTEE 0.20 0.50 X 0 0 0 ROSALIN PETRUCCI TRUSTEE 0.20 0.50 X 0 0 0 GARY SCHMIDT TRUSTEE 0.20 0.50 X 0 0 0 KAREN SENFT TRUSTEE 0.20 0.50 X 0 133176 9114 DONALD SNYDER TRUSTEE 0.20 0.50 X 0 0 0 LAURIE STEWART TREASURER 0.30 0.80 X X 0 0 0 THE REV DAVID R STROBEL TRUSTEE 0.20 0.50 X 0 0 0 DANIEL J WILSON PHD TRUSTEE 0.30 0.80 X 0 0 0 SARA T GAMMON PRESIDENT/CEO (UNTIL 7/18/13) 1.00 59.00 X 0 1037018 37472 DANIEL C CONFALONE SVP & CFO (UNTIL 11/1/13) 1.00 59.00 X 0 355847 25255 SAMUEL A MIRANDA JR SVP & CNO 5.00 55.00 X 0 219436 53224 RONALD PETULA SVP & CFO 1.00 59.00 X 0 159857 16515 0 2250455 159411 0 0 1 0 ONDRA HUYETT ASSOCIATES 7584 MORRIS COURT SUITE 210 ALLENTOWN PA 18106 CONTRACTING SERVICES 703947 SODEXO OPERATIONS LLC 4880 PAYSPHERE CIRCLE CHICAGO IL 60674 DIETARY/FOOD SERVICES 540360 HT LYONS 7165 AMBASSADOR DRIVE ALLENTOWN PA 18106 CONTRACTING SERVICES 107445 3 507161 507161 NET PATIENT SVC REV 623000 21720769 21720769 21720769 BAD DEBT RECOVERY 900099 38448 38448 38448 22266378 21720769 0 38448 9354031 9045716 308315 779484 753792 25692 1530784 1480328 50456 668592 645300 23292 492358 444402 47956 397520 391853 5667 7010 6475 535 13291 10276 3015 1276080 1276080 CORPORATE ALLOCATION 6388226 4599523 1788703 MEDICAL SUPPLIES 792488 792079 409 FOOD 197667 194570 3097 REPAIRS & MAINTENANCE 17038 17038 22378 22081 297 21936947 19679513 2257434 0 1400 1400 3199030 3292679 4926 7576 25445236 17147070 8238116 8298166 31104972 31333208 42548444 42933029 556176 615939 146175 141566 702351 757505 X 41846093 42175524 41846093 42175524 42548444 42933029 329431 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 56370 56370 10097078 6854594 3242484 14699875 9970469 4729406 591913 322007 269906 8298166 RESIDENT FUNDS 141566 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 258966 AMOUNTS DUE FROM AFFILIATES 30932676 31333208 X 22266378 0 22266378 0 22266378 21936947 0 21936947 0 21936947 PART IV, LINE 2B: GOOD SHEPHERD ACTS AS CUSTODIAN OF FUNDS HELD FOR THE RESIDENTS LIVING IN THE FACILITIES. THE FUNDS ARE SET ASIDE IN A SEPARATE BANK ACCOUNT FROM THE GENERAL OPERATING FUNDS. RESIDENTS HAVE ACCESS TO THEIR FUNDS ON A DAILY BASIS AND RECEIVE MONTHLY STATEMENTS OF ACTIVITY. PART X, LINE 2: GOOD SHEPHERD PRESCRIBES A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY IN RECORDING TAX LIABILITIES IN THE FINANCIAL STATEMENTS. MEASUREMENT AND RECOGNITION OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. GOOD SHEPHERD'S POLICY IS TO RECOGNIZE INTEREST RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE AND PENALTIES IN OPERATING EXPENSES. GOOD SHEPHERD'S FEDERAL EXEMPT ORGANIZATION RETURNS OF INCOME TAX AND ITS BUSINESS INCOME TAX RETURNS FOR THE YEARS ENDED PRIOR TO JUNE 30, 2011 NO LONGER REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. 1 1 0 0 0 0 0 1 0 JOHN KRISTEL PRESIDENT/CEO 0 272797 0 72324 0 0 0 10292 0 7539 0 362952 0 0 SARA T GAMMON PRESIDENT/CEO (UNTIL 7/18/13) 0 393870 0 0 0 643148 0 34535 0 2937 0 1074490 0 482490 DANIEL C CONFALONE SVP & CFO (UNTIL 11/1/13) 0 313710 0 0 0 42137 0 11851 0 13404 0 381102 0 0 SAMUEL A MIRANDA JR SVP & CNO 0 219436 0 0 0 0 0 43328 0 9896 0 272660 0 0 RONALD PETULA SVP & CFO 0 150573 0 9284 0 0 0 5324 0 11191 0 176372 0 0 PART I, LINE 3 THE CEO IS COMPENSATED BY GOOD SHEPHERD REHABILITATION NETWORK ("GSRN"), AN AFFILIATED TAX-EXEMPT ORGANIZATION. THE GOOD SHEPHERD HOME LONG-TERM CARE FACILITY, INC. RELIED ON GSRN'S USE OF ALL CRITERIA SPECIFIED IN LINE 3 TO ESTABLISH COMPENSATION. PART I, LINES 4A-B DANIEL CONFALONE FORMER CFO RECEIVED A SEVERANCE PAY OF $42,137 AND A STIPEND OF $1,527 IN CY 2013 FOR SIX WEEKS OF SERVICE. DANIEL ALSO RECEIVED $224,732 SEVERANCE PAY AND A STIPEND OF $8,144 IN FY 2014 FOR 32 WEEKS OF SERVICE. SARA T. GAMMON RECEIVED A DISTRIBUTION OF $643,148 FROM A 457F PLAN. PART I, LINE 7 GSRN HAS A PERFORMANCE COMPENSATION PROGRAM IN PLACE WHICH IS APPROVED BY THE BOARD. CERTAIN MEMBERS OF MANAGEMENT CAN RECEIVE AN ANNUAL PERFORMANCE PAYMENT ONLY WHEN PRE-DEFINED AND PRE-APPROVED FINANCIAL AND NON-FINANCIAL GOALS ARE ACHIEVED. FOR FISCAL YEAR 2014, A PERFORMANCE PAYMENT WAS ACHIEVED. THE ACTUAL PAYMENT OCCURS IN NOVEMBER OF THE FOLLOWING FISCAL YEAR. THIS IS NOT GUARANTEED EACH YEAR. FORM 990, PART V, LINE 1: ACCOUNTS PAYABLE PAYMENTS ARE CONSOLIDATED UNDER A COMMON REPORTING SYSTEM. SINCE TOTALS FOR EACH VENDOR MAY CONTAIN TRANSACTIONS FROM MULTIPLE CORPORATIONS, THE NUMBER OF 1099'S FILED ON BEHALF OF THE GOOD SHEPHERD HOME LONG-TERM CARE FACILITY, INC. ("LTC") BY THE COMMON REPORTING AGENT CANNOT BE SEPARATELY IDENTIFIED AND DETERMINED. FORM 990, PART V, LINE 2: THE SALARY AND BENEFIT EXPENSES REPORTED ON FORM 990, PART IX, AND THE EMPLOYEE INFORMATION REPORTED ON FORM 990, PART VII, ARE THE GOOD SHEPHERD HOME LONG-TERM CARE FACILITY, INC.'S ("LTC") ALLOCATED PAYROLL COSTS BASED ON TIME SPENT. ALL INDIVIDUALS WORKING AT LTC ARE EMPLOYEES OF THE GOOD SHEPHERD REHABILITATION HOSPITAL ("GSRH") AND ARE REPORTED ON ITS FORM W-3 UNDER EIN: 23-1371947. GSRH IS AN AFFILIATED TAX-EXEMPT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE CORPORATE MEMBER OF THE ORGANIZATION IS THE GOOD SHEPHERD REHABILITATION NETWORK ("GSRN"), A RELATED TAX-EXEMPT ENTITY. GSRN HAS THE ULTIMATE AUTHORITY AND RESPONSIBILITY FOR THE FOLLOWING ACTIVITIES WITH RESPECT TO THE GOOD SHEPHERD HOME LONG-TERM CARE FACILITY, INC.: AMENDMENT, APPROVAL OR REVOCATION OF BYLAWS; INSTITUTIONAL DEVELOPMENT; CORPORATE AND STRATEGIC PLANNING; FINANCIAL PLANNING AND BUDGETING; AUDIT AND FISCAL MATTERS; RESOURCE ALLOCATION; PUBLIC RELATIONS; APPOINTMENT OF TRUSTEES AND OFFICERS; COMPENSATION AND HUMAN RESOURCE POLICIES; MEDICAL STAFF AND GENERAL POLICY MATTERS. FORM 990, PART VI, SECTION A, LINE 7B SEE EXPLANATION FOR FORM 990, PART VI, SECTION A, LINE 7A. FORM 990, PART VI, SECTION B, LINE 11 THE IRS FORM 990 IS PREPARED USING INFORMATION SOLICITED FROM OFFICERS, DIRECTORS, TRUSTEES, BOARD COMMITTEE MEMBERS, AND MANAGEMENT. THIS GROUP OF INDIVIDUALS ARE PROVIDED A DRAFT RETURN BEFORE THE FINAL RETURN IS FILED. QUESTIONS, COMMENTS, AND ADDITIONAL INFORMATION PROVIDED BY THIS GROUP ARE INCORPORATED INTO THE FINAL RETURN. THE FINAL RETURN IS REVIEWED AT A COMMITTEE LEVEL OF THE BOARD PRIOR TO IT BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C THERE IS A SYSTEMATIC PROCESS COORDINATED THROUGH THE GOVERNANCE COMMITTEE WHERE THE CONFLICT OF INTEREST STATEMENTS COMPLETED ANNUALLY BY BOARD MEMBERS AND SENIOR LEADERSHIP TEAM MEMBERS ARE REVIEWED BY THE GOVERNANCE COMMITTEE. WHENEVER THE COMMITTEE FEELS THE CONFLICT STATEMENT IS EITHER INCOMPLETE OR FEELS SOMETHING MAY BE MISSING, THE COMMITTEE WILL ASK MANAGEMENT TO PURSUE FURTHER DUE DILIGENCE. WHEN A BOARD MEMBER DOES HAVE AN INHERENT CONFLICT, THE TRUSTEE IS ASKED TO EITHER ABSTAIN FROM VOTING OR EXCUSE HIMSELF FROM THE ROOM DURING THE DISCUSSION AND VOTING. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF TRUSTEES OF GOOD SHEPHERD REHABILITATION NETWORK (GSRN) DELEGATES RESPONSIBILITY FOR FOLLOWING ALL LEGAL AND REGULATORY REQUIREMENTS AFFECTING EXECUTIVE COMPENSATION TO THE HUMAN RESOURCES/COMPENSATION COMMITTEE OF THE BOARD (THE COMMITTEE). THE BOARD DELEGATES RESPONSIBILITY TO ENGAGE EXTERNAL RESOURCES AS NECESSARY TO THE COMMITTEE TO SUPPORT DELIBERATIONS AND DECISION MAKING RELATED TO EXECUTIVE COMPENSATION. THE COMMITTEE SELECTED AND UTILIZES AN INDEPENDENT COMPENSATION CONSULTANT, MERCER - A MARSH & MCCLENNAN COMPANY, (THE CONSULTANT) AS A RESOURCE TO ASSIST WITH DECISIONS RELATED TO EXECUTIVE COMPENSATION. ACCORDING WITH THE COMMITTEE'S ANNUAL WORK PLAN, THE CONSULTANT PRESENTED A REASONABLENESS OPINION FOR 2014 ON JUNE 5, 2014 AND FOUND THE FOLLOWING: "MERCER (US), INC. CERTIFIES THAT IT (1) IS A COMPENSATION-CONSULTING FIRM, (2) PERFORMS COMPENSATION VALUATION STUDIES OF THIS TYPE ON A REGULAR BASIS, AND (3) IS QUALIFIED TO PERFORM THE VALUATIONS OF THE TYPE OF PROPERTY OR SERVICES INVOLVED. IN OUR OPINION, THE TOTAL REMUNERATION WE HAVE REVIEWED FALLS WITHIN THE REASONABLE RANGE OF COMPETITIVE MARKET PRACTICES APPLICABLE TO LIKE POSITIONS AMONG LIKE ORGANIZATIONS UNDER LIKE CIRCUMSTANCES." THE REASONABLENESS OPINION WAS REVIEWED WITH THE COMMITTEE AT THEIR JUNE 2014 MEETING. ALL OF THE COMPENSATION MEETINGS ARE FORMALLY DOCUMENTED CONSISTENT WITH BEST GOVERNANCE PRACTICES. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS ARE PUBLISHED TO THE ORGANIZATION'S WEBSITE AT LEAST ANNUALLY. THE GOVERNING DOCUMENTS AND POLICIES ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 2C: THE PROCESSES USED BY THE COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT HAVE NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PART VI, LINE 1: THE EXECUTIVE COMMITTEE IS COMPRISED OF THE CHAIRS OF ALL THE BOARD COMMITTEES AS WELL AS THE CHAIR AND VICE CHAIR OF THE BOARD. ALL EXECUTIVE COMMITTEE MEMBERS ARE MEMBERS OF THE BOARD OF TRUSTEES. THE EXECUTIVE COMMITTEE CAN ACT ON BEHALF OF THE BOARD OF TRUSTEES IN MOST CASES. ANY FUNDAMENTAL CHANGES WILL GO TO THE FULL BOARD. GOOD SHEPHERD HOUSING DEVELOPMENT CORPORATION GOOD SHEPHERD PLAZA 850 SOUTH 5TH S ALLENTOWN PA 18103 233073390 PROVIDES INDEPENDENT LIVING APTS FOR DISABLED, LOW-INCOME ADULTS PA 501(C)(3) LINE 9 GOOD SHEPHERD REHABILITATION NETWORK 0 GOOD SHEPHERD REHABILITATION HOSPITAL GOOD SHEPHERD PLAZA 850 SOUTH 5TH S ALLENTOWN PA 18103 231371947 PROVIDES COMPREHENSIVE INPATIENT AND OUTPATIENT REHABILITATION SERVICES PA 501(C)(3) LINE 3 GOOD SHEPHERD REHABILITATION NETWORK 0 GOOD SHEPHERD REHABILITATION NETWORK GOOD SHEPHERD PLAZA 850 SOUTH 5TH S ALLENTOWN PA 18103 232216041 PROVIDES MANAGEMENT SERVICES IN SUPPORT OF ITS TAX-EXEMPT AFFILIATES PA 501(C)(3) LINE 7 N/A 0 PHILADELPHIA POST-ACUTE PARTNERS LLC 1800 LOMBARD STREET PHILADELPHIA PA 19146 208283421 OPERATES INPATIENT REHAB HOSP, ACUTE CARE HOSP & 8 OUTPATIENT FACILITIES PA 501(C)(3) LINE 3 GOOD SHEPHERD REHABILITATION NETWORK 0 THE ALLENTOWN SPECIALTY HOSPITAL INC GOOD SHEPHERD PLAZA 850 SOUTH 5TH S ALLENTOWN PA 18103 233009874 PROVIDES INPATIENT SVCS THROUGH OPERATION OF LONG-TERM ACUTE CARE HOSP PA 501(C)(3) LINE 3 GOOD SHEPHERD REHABILITATION NETWORK 0 GOOD SHEPHERD RECIPROCAL RISK RENTENTION GROUP 7301 RIVERS AVENUE SUITE 230 NORTH CHARLESTON SC 29406 204065112 RISK RETENTION GROUP SC N/A C 0 0 0 1 0 0 0 0 0 1 0 0 0 1 0 1 1 1 0 1