LAUREL REALTY INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- LAUREL REALTY INC (EIN 23-1403678)
- Tax period
- 2013-07-01 to 2014-06-30
- Filed
- 2015-05-14
- IRS object ID
- 201541349349305784
- Schema version
- 2013v4.0
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-05-14T12:35:01-07:00 | ReturnTs |
| Tax Period End | 2014-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 910 E St Louis/PO BOX 1190 | AddressLine1 |
| City | SPRINGFIELD | City |
| State | MO | State |
| ZIP Code | 658062523 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 231403678 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Laurel Realty | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LAUR | BusinessNameControlTxt |
| Phone | 5707230603 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 22 Walnut Street | AddressLine1 |
| City | Wellsboro | City |
| State | PA | State |
| ZIP Code | 16901 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CHARLES J SANTANGELO | PersonNm |
| Person Title | EXECUTIVE VICE PRESIDENT/CFO | PersonTitleTxt |
| Phone | 5707230603 | PhoneNum |
| Signature | 2015-05-12 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | BRIAN D TODD | PreparerPersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Address PrincipalOfcrBusinessAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jan E Fisher | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 32-36 Central Ave Wellsboro | AddressLine1 |
| City | Wellsboro | City |
| State | PA | State |
| ZIP Code | 16901 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $715,848 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | susquehannahealth.org/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1982 | FormationYr |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Activity Or Mission | Laurel Realty is a subsidiary of Susquehanna Health System (SHS). The mission of SHS 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. | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 14 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $536,170 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $558,851 | CYProgramServiceRevenueAmt |
| PY Investment Income | $137 | PYInvestmentIncomeAmt |
| CY Investment Income | $121,264 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $536,307 | PYTotalRevenueAmt |
| CY Total Revenue | $680,115 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $116,765 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $150,903 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $501,498 | PYOtherExpensesAmt |
| CY Other Expenses | $531,778 | CYOtherExpensesAmt |
| PY Total Expenses | $618,263 | PYTotalExpensesAmt |
| CY Total Expenses | $682,681 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$81,956 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,566 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,556,232 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,498,208 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,984,801 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,929,343 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $571,431 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $568,865 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Laurel Realty is a subsidiary of | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $682,681 | ExpenseAmt |
| Revenue | $678,118 | RevenueAmt |
| Desc | RENTED RESIDENTIAL AND MEDICAL OFFICE REAL ESTATE TO INDIVIDUALS AND ORGANIZATIONS THAT PROVIDED OR SUPPORTED HEALTH CARE SERVICES IN TIOGA COUNTY. | Desc |
| Total Program Service Expenses | $682,681 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | false | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RONALD M GILBERT JR CPA | PersonNm |
| Phone | 5707230603 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 22 Walnut Street | AddressLine1 |
| City | Wellsboro | City |
| State | PA | State |
| ZIP Code | 16901 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd |
|---|---|---|---|---|---|---|---|
| JAMES D BAKER JR | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| RROBERT DECAMP | |||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| ROBERT P FITZGERALD | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| HAROLD F HOOSE III | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL W LICHTY | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CRAIG G LITCHFIELD | |||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| J DENNIS MURRAY PHD | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| THOMAS M OWLETT ESQ | |||||||
| CHAIRMAN | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| GLENN B POIRIER | |||||||
| VICE CHAIRMAN | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| ANEURIN J WILLIAMS JR | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DONNA R WILSON | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KATHY J WRIGHT PHD | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LISA V FEIL PSYD | |||||||
| DIRECTOR 7/1/13 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| WENDY S SWARTZ CPA | |||||||
| DIRECTOR 7/1/13 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DARIUS E ABADIDO | |||||||
| DIRECTOR | 1 | Yes (X) | $352,603 | $31,491 | |||
| WALTER J LAIBINIS DO | |||||||
| DIRECTOR | 1 | Yes (X) | $252,873 | $14,783 | |||
| JANIE M HILFIGER | |||||||
| PRESIDENT | 1 | $143,686 | $27,220 | Yes (X) | |||
| RONALD J BUTLER | |||||||
| EXECUTIVE VICE PRESIDENT | 1 | $324,224 | $15,277 | Yes (X) | |||
| JAN E FISHER | |||||||
| EXECUTIVE VICE PRESIDENT | 1 | $387,968 | $19,385 | Yes (X) | |||
| STEVEN P JOHNSON | |||||||
| CEO | 1 | $539,105 | $31,861 | Yes (X) | |||
| CHARLES J SANTANGELO | |||||||
| CFO | 1 | $338,408 | $29,440 | Yes (X) | |||
| WILLIAM C MCCAULEY MD | |||||||
| Senior Vice President | 1 | $379,609 | $30,350 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Reportable Comp Rltd Org | $2,718,476 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $199,807 | TotalOtherCompensationAmt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Rental Income | Desc |
| Business | 531310 | BusinessCd |
| Total Revenue Column | $558,851 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $558,851 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,997 | TotalRevenueColumnAmt |
| Exclusion | $1,997 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $155,000 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $35,733 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $119,267 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $119,267 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $119,267 | RelatedOrExemptFuncIncomeAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $680,115 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $678,118 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $1,997 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $111,838 | TotalAmt |
| Program Services | $111,838 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,412 | TotalAmt |
| Program Services | $5,412 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,663 | TotalAmt |
| Program Services | $25,663 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,990 | TotalAmt |
| Program Services | $7,990 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,743 | TotalAmt |
| Program Services | $24,743 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,957 | TotalAmt |
| Program Services | $1,957 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,888 | TotalAmt |
| Program Services | $72,888 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,267 | TotalAmt |
| Program Services | $3,267 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,062 | TotalAmt |
| Program Services | $79,062 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $187,741 | TotalAmt |
| Program Services | $187,741 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,664 | TotalAmt |
| Program Services | $19,664 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Real Estate Taxes | $133,296 | $133,296 | $0 | $0 |
| Telephone | $2,888 | $2,888 | $0 | $0 |
| License and fees | $43 | $43 | ||
| $0 | $0 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,229 | TotalAmt |
| Program Services | $6,229 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $682,681 | TotalAmt |
| Program Services | $682,681 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $80,065 | BOYAmt |
| EOY | $162,942 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,311 | BOYAmt |
| EOY | $10,931 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,479 | BOYAmt |
| EOY | $5,020 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,691 | BOYAmt |
| EOY | $37,490 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $5,926,992 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,645,167 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,433,686 | BOYAmt |
| EOY | $2,281,825 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,556,232 | BOYAmt |
| EOY | $2,498,208 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,278 | BOYAmt |
| EOY | $44,721 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,957,523 | BOYAmt |
| EOY | $1,884,622 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,984,801 | BOYAmt |
| EOY | $1,929,343 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $571,431 | BOYAmt |
| EOY | $568,865 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $571,431 | BOYAmt |
| EOY | $568,865 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,556,232 | BOYAmt |
| EOY | $2,498,208 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$2,566 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $361,213 | InvestmentCostOrOtherBasisAmt |
| Book Value | $361,213 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $4,989,197 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $3,431,938 | DepreciationAmt |
| Book Value | $1,557,259 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $4,835 | InvestmentCostOrOtherBasisAmt |
| Book Value | $4,835 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $198,749 | InvestmentCostOrOtherBasisAmt |
| Book Value | $198,749 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $372,998 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $213,229 | DepreciationAmt |
| Book Value | $159,769 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,281,825 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Payables to related third parties | Desc |
| Amt | $1,884,622 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,884,622 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $680,115 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $680,115 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $680,115 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $682,681 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $682,681 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $682,681 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Pt X Line 2 | FormAndLineReferenceDesc |
| Explanation | Management has evaluated their income tax positions under the guidance included in ASC 740. Based on that review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt |
|---|---|---|---|---|---|
| DARIUS E ABADIDO | |||||
| $352,103 | $500 | $14,403 | $17,088 | $384,094 | |
| WALTER J LAIBINIS DO | |||||
| $182,813 | $70,060 | $6,069 | $8,714 | $267,656 | |
| JANIE M HILFIGER | |||||
| $143,686 | $7,220 | $20,000 | $170,906 | ||
| RONALD J BUTLER | |||||
| $320,062 | $9,650 | $5,627 | $339,501 | $4,162 | |
| JAN E FISHER | |||||
| $383,073 | $9,650 | $9,735 | $407,353 | $4,895 | |
| STEVEN P JOHNSON | |||||
| $524,745 | $13,475 | $18,386 | $570,966 | $14,360 | |
| CHARLES J SANTANGELO | |||||
| $331,702 | $9,650 | $19,790 | $367,848 | $6,706 | |
| WILLIAM C MCCAULEY MD | |||||
| $376,409 | $9,650 | $20,700 | $409,959 | $3,200 | |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (85 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Pt VI, Line 7a | Susquehanna Health System (SHS), EIN 23-2751183, may elect or |
| Pt VI, Line 7a | remove members of the governing body. |
| Pt VI, Line 7b | All the business and affairs of the Entity shall be managed and controlled |
| Pt VI, Line 7b | by the Board of Directors, subject to the oversight of the sole Member, |
| Pt VI, Line 7b | Susquehanna Health System (SHS), of the management and operation of the |
| Pt VI, Line 7b | Entity, except that the following powers are reserved exclusively |
| Pt VI, Line 7b | to the sole Member of the Entity, and no attempted exercise of any |
| Pt VI, Line 7b | such powers by anyone other than the sole Member shall be valid of |
| Pt VI, Line 7b | any force or effect whatsoever. The sole Member shall exercise |
| Pt VI, Line 7b | its powers through its Board of Directors. The sole Member shall have |
| Pt VI, Line 7b | the exclusive authority to exercise the following powers: A) to |
| Pt VI, Line 7b | appoint or elect the directors, B) to appoint and remove the President |
| Pt VI, Line 7b | following consultation with the Entity, C) to approve the nominees for |
| Pt VI, Line 7b | elected officers and to return the list of approved nominees to the |
| Pt VI, Line 7b | governing bodies for elections, D) to remove, with or without cause, any |
| Pt VI, Line 7b | director or any elected officer, E) to amend the Governing Instruments |
| Pt VI, Line 7b | and to approve all amendments to the Governing Instruments which |
| Pt VI, Line 7b | budgets, G) to establish requirements for a unified budget, H) to |
| Pt VI, Line 7b | approve the incurrence or issuance of debt proposed by Entity and |
| Pt VI, Line 7b | the encumbrance of any Entity assets to secure any such incurred debt, I) to incur |
| Pt VI, Line 7b | debt (or the cause debt to be incurred) on behalf of the Entity, J) to |
| Pt VI, Line 7b | require contributions in cash or cash equivalents to support the |
| Pt VI, Line 7b | working capital needs or capital projects of any one or more System |
| Pt VI, Line 7b | Entities, K) to require that any debt incurred on a System-wide basis |
| Pt VI, Line 7b | obligation of each System Entity, L)to direct or approve any cash |
| Pt VI, Line 7b | contributions or any other capital contributions made by one System |
| Form 990, Part IX, Line 24f | MISCELLANEOUS 140. 140. MEDICAL SUPPLIES 6089. 6089. |
| Pt VI, Line 7b | Entity to another System Entity, M) to allocate any financial |
| Pt VI, Line 7b | resources 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 hundred |
| Pt VI, Line 7b | thousand dollars, O) to direct the transfer of property from the |
| Pt VI, Line 7b | 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 of the System's |
| Pt VI, Line 7b | approved investment policy, Q)to establish requirements for the |
| Pt VI, Line 7b | approval of the acquistion, purchase, sale, transfer, encumbrance, leasing |
| Pt VI, Line 7b | construction or demolition of land or buildings outside the ordinary |
| Pt VI, Line 7b | course of business, R) to approve any decision with respect to the addition, |
| Pt VI, Line 7b | modification or discontinuance of any patient care or diagnostic |
| Pt VI, Line 7b | program or health care service, S) to approve of any change in licensure |
| Pt VI, Line 7b | of Entity; licensure of any Facility; certification. registration |
| Pt VI, Line 7b | accreditation, permit or related approval of any activity, T) |
| Pt VI, Line 7b | to require Entity to add, modify, relocate or discontinue any patient |
| Pt VI, Line 7b | care or diagnostic program or health care services, U) to approve |
| Pt VI, Line 7b | or direct any merger, consolidation, organization, reorganization |
| Pt VI, Line 7b | joint venture, corporate division, sale, conversion, lease or |
| Pt VI, Line 7b | exchange of substantially all the assets dissolution, liquidation, |
| Pt VI, Line 7b | or any other modification of corporate structure or affiliations |
| Pt VI, Line 7b | affecting the autonomy, goverance, or operations, and the |
| Pt VI, Line 7b | dissolve or terminate the existence of Entity and to determine the |
| Pt VI, Line 7b | distribution of assets upon such termination or dissolution |
| Pt VI, Line 7b | W) to coordinate managed care plans involving Entity,including |
| Pt VI, Line 7b | decisions concerning entry into or renewal of any contract or |
| Pt VI, Line 7b | agreement relating thereto X) to develop and/or enter into key |
| Pt VI, Line 7b | strategic relationships on behalf of Entity, Y) to select any outside |
| Pt VI, Line 7b | financial auditors, general legal counsel, or investment advisors |
| Pt VI, Line 7b | to provide services on behalf of Entity. |
| Pt VI, Line 11b | A high-level overview of Forms 990 is presented to the parent Board of |
| Pt VI, Line 11b | Directors (Susquehanna Health System, EIN #23-2751183) before filing |
| Pt VI, Line 11b | and complete drafts of all returns are made available to all |
| Pt VI, Line 11b | Board members through the CEO's and CFO's office. |
| Pt VI, Line 12c | Annually on the 1st of January the Susquehanna Health System |
| Pt VI, Line 12c | CEO sends to all directors, officers, management staff |
| Pt VI, Line 12c | and contracted physicians a questionnaire to be completed |
| Pt VI, Line 12c | and returned by January 15. A report is submitted to the |
| Pt VI, Line 12c | Board of Directors to notify them of any conflicts of |
| Pt VI, Line 12c | 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 salary |
| Pt VI, Line 15b | surveys. Their analysis is reviewed with the Governance Committee |
| Pt VI, Line 15b | of the Board of Directors. The firm then outlines its |
| 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 |
| Pt VI, Line 19 | to the public upon request. The conflict of interest policy |
| Pt VI, Line 19 | is also available upon request. |
| 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 V, Line 1a | All 1099's were issued by Susquehanna Health System (EIN 23-2751183) for the twelve |
| Pt V, Line 1a | months ended June 30, 2014. All expenses were then allocated back to the |
| Pt V, Line 1a | entities. |
| Pt IX, Line 11g | The entity pays for housekeeping services provided by employees from |
| Pt IX, Line 11g | Soldiers and Sailors Memorial Hospital. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (14 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Laurel Health System | ||||||||||
| 22 Walnut Street | 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 Street | Wellsboro | PA | 16901 | 251644910 | Management Consulting & supervisory services | PA | 501 (c) (3) | 11 B II | Susquehanna Health System | false |
| The Green Home | ||||||||||
| 37 Central Avenue | Wellsboro | PA | 16901 | 240804365 | Operates skilled nursing & assisted living facilities | PA | 501 (c) (3) | 9 | Susquehanna Health System | false |
| Soldiers & Sailors Memorial Hospital | ||||||||||
| 32-36 Central Avenue | Wellsboro | PA | 16901 | 232176963 | Operate acute care hospital | PA | 501 (c) (3) | 3 | Susquehanna Health System | false |
| Tioga Health Care Providers | ||||||||||
| 22 Walnut Street | Wellsboro | PA | 16901 | 251765538 | PHYSICIAN SERVICES | PA | 501 (c) (3) | 11 B II | 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 East Water Street | 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 | ||||||||||
| 700 High Street | Williamsport | PA | 17701 | 232416166 | AMBULANCE TRANSPORTS | PA | 501 (c) (3) | 9 | Susquehanna Health System | false |
| Susquehanna Health System | ||||||||||
| 1205 Grampian Blvd | Williamsport | PA | 17701 | 232751183 | Coordinate & manage the delivery of healthcare | PA | 501 (c) (3) | 11 A I | false | |
| Laurel Health Foundation | ||||||||||
| 22 Walnut Street | Wellsboro | PA | 16901 | 251810488 | Provide financial assistance to affiliated organizations | PA | 501 (c) (3) | 11 A I | Susquehanna Health System | false |
| North Penn Comprehensive Health Services | ||||||||||
| 22 Walnut Street | Wellsboro | PA | 16901 | 231889724 | Provide general health and social programs | PA | 501 (C) (3) | 3 | Susquehanna Health System | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Community Basket LLC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1205 Grampian Blvd | AddressLine1 |
| City | Williamsport | City |
| State | PA | State |
| ZIP Code | 17701 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 201195739 | EIN |
| Primary Activities | Rents real estate | PrimaryActivitiesTxt |
| Legal Domicile State | PA | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Susquehanna Health | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | Excluded from tax | PredominantIncomeTypeTxt |
| Disproportionate Allocations | false | DisproportionateAllocationsInd |
| General Or Managing Partner | false | GeneralOrManagingPartnerInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Entity TypeEntityTypeTxt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1 | CityForeignAddress/City | CountryForeignAddress/Country | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Tyoga Carenet | ||||||||||||||
| 114 East Ave | Wellsboro | PA | 16901 | 251810967 | Integrate Health- Care regionally | PA | Laurel Health | 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 | ||||||||||||||
| 980458722 | Captive Insurance Company | Susquehanna Health System | C | 0.00000 | false | PO Box 1159 | Cayman Islands | CJ | CJ | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail (17 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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. SHSINs 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. |