LEHIGH VALLEY HOSPITAL - SCHUYKILL: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: LEHIGH VALLEY HOSPITAL - SCHUYKILL (EIN 23-1352202)
Tax period: 2012-07-01 to 2013-06-30
Filed: 2014-05-14
IRS object ID: 201431349349300948
Schema version: 2012v2.1
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 F
Schedule H
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2014-05-14T08:36:05-05:00	Timestamp
Tax Period End Date	2013-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	232932984	EIN

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	PARENTEBEARD LLC	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	1650 MARKET STREET SUITE 4500	AddressLine1
City	PHILADELPHIA	City
State	PA	State
ZIP Code	19103	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	231352202	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	SCHUYLKILL MEDICAL CTR - SOUTH JACKSON	BusinessNameLine1
Business Name Line2	ST F/K/A POTTSVILLE HOSP & WARNE CLINIC	BusinessNameLine2

Field	Value	IRS element (for citing)
Name Control	SCHU	NameControl
Phone	5706215000	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	MAUCH CHUNK AND JACKSON STREETS	AddressLine1
City	POTTSVILLE	City
State	PA	State
ZIP Code	17901	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	JOHN E SIMODEJKA PRESIDENTCEO	Name
Title	PRESIDENT/CEO	Title
Phone	5706215000	Phone
Date Signed	2014-05-13	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	JULIUS C GREEN CPA JD	Name
PTIN	P00350393	PTIN
Phone	2159720701	Phone

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2015-11-30 17:44:51Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	JOHN E SIMODEJKA	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	MAUCH CHUNK AND JACKSON STREETS	AddressLine1
City	POTTSVILLE	City
State	PA	State
ZIP Code	17901	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	99078858	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.SCHUYLKILLHEALTH.COM	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	2008	YearFormation
State Legal Domicile	PA	StateLegalDomicile
Activity Or Mission Description	TO MAKE A POSITIVE DIFFERENCE IN THE SCOPE AND QUALITY OF HEALTHCARE FOR THE SCHUYLKILL COMMUNITY.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	17	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	16	NbrIndependentVotingMembers
Total Nbr Employees	1073	TotalNbrEmployees
Total Nbr Volunteers	60	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	634676	ContributionsGrantsPriorYear
Contributions Grants Current Year	411185	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	93782441	ProgramServiceRevenuePriorYear
Program Service Revenue CY	95899842	ProgramServiceRevenueCY
Investment Income Prior Year	757229	InvestmentIncomePriorYear
Investment Income Current Year	16164	InvestmentIncomeCurrentYear
Other Revenue Prior Year	1052362	OtherRevenuePriorYear
Other Revenue Current Year	2719698	OtherRevenueCurrentYear
Total Revenue Prior Year	96226708	TotalRevenuePriorYear
Total Revenue Current Year	99046889	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	6991	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	2288	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	50252618	SalariesEtcPriorYear
Salaries Etc Current Year	49386759	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	43472537	OtherExpensePriorYear
Other Expenses Current Year	46540039	OtherExpensesCurrentYear
Total Expenses Prior Year	93732146	TotalExpensesPriorYear
Total Expenses Current Year	95929086	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	2494562	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	3117803	RevenuesLessExpensesCY
Total Assets BOY	51713293	TotalAssetsBOY
Total Assets EOY	54653165	TotalAssetsEOY
Total Liabilities BOY	75254898	TotalLiabilitiesBOY
Total Liabilities EOY	68528725	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	-23541605	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	-13875560	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET'S MISSION IS TO MAKE A POSITIVE DIFFERENCE IN THE SCOPE AND QUALITY OF HEALTHCARE AVAILABLE FOR THE SCHUYLKILL COUNTY COMMUNITY.	MissionDescription
Significant New Program Services	1	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	79236384	Expense
Grants	2288	Grants
Revenue	96050000	Revenue
Description	IN FISCAL YEAR 2013, SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET ADMITTED 7,091 INPATIENTS, PROVIDED EMERGENCY CARE FOR 33,948 PEOPLE, DELIVERED MORE THAN 895 BABIES, MADE MORE THAN 14,700 HOME HEALTH CARE VISITS AND PROVIDED MORE THAN 82,800 OUTPATIENT TESTS AND PROCEDURES.THE SCHUYLKILL HEALTH SYSTEM HAS A COMPREHENSIVE CHARITY CARE PROGRAM. CHARGES ARE FOREGONE FOR SERVICES RENDERED AND SUPPLIES FURNISHED UNDER THIS PROGRAM. THE COSTS ASSOCIATED WITH THE CHARITY CARE SERVICES PROVIDED ARE ESTIMATED BY APPLYING A COST-TO-CHARGE RATIO TO THE AMOUNT OF UNCOMPENSATED CHARGES FOR THE PATIENTS RECEIVING CHARITY CARE. THE LEVEL OF CHARITY CARE PROVIDED BY THE CORPORATION AMOUNTED TO APPROXIMATELY $626,000 DURING FISCAL YEAR 2013.SCHUYLKILL HEALTH IS COMMITTED TO THE PHYSICAL, MENTAL, AND EMOTIONAL HEALTH OF OUR ENTIRE COMMUNITY. AS A HEALTHCARE FACILITY, WE ARE CONCERNED WITH THE HEALTH AWARENESS OF OUR NEIGHBORS, FAMILY, AND FRIENDS.OUR COMMUNITY LOOKS TO US TO HELP EDUCATE THEM ON CURRENT HEALTH CARE TOPICS AS WELL AS THE EVERYDAY HEALTH ISSUES THAT CONCERN EVERYONE. THROUGH OUR INITIATIVES WE CAN REACH OUT AND HELP OTHERS UNDERSTAND WHERE TO GO, WHAT TO ASK, AND WHO TO SEE FOR THEIR HEALTHCARE NEEDS. WE CAN GIVE OUR COMMUNITY THE CONFIDENCE THEY NEED WHEN MAKING WISE CHOICES. SCHUYLKILL MEDICAL CENTER HOSTS APPROXIMATELY TWELVE (12) CHAT (COMMUNITY HEALTH AWARENESS TALKS) A YEAR. MONTHLY PROGRAMS ARE HELD ON CAMPUS OR CHAT ON THE ROADS. CHAT TOPICS HAVE INCLUDED, BUT ARE NOT LIMITED TO NUTRITION, PHYSICAL FITNESS, DIABETES AWARENESS, BREAST CANCER AWARENESS, CANCER, ARTHRITIS, SEIZURE TREATMENTS, AND HEART HEALTH TO NAME A FEW.SCHUYLKILL HEALTH ALSO SPONSORS AN ANNUAL "WOMEN'S DAY"; WOMEN HAVE GATHERED OVER THE PAST EIGHT YEARS TO ATTEND A FREE EVENT. ALL GENERATIONS ENJOY BEING EDUCATED, HAVING THE ABILITY TO ASK QUESTIONS IN A COMFORTABLE SETTING WHILE SPENDING TIME WITH OLD AND NEW FRIENDS, AND SIPPING ON THAT GREAT CUP OF COFFEE. WE EXPLORE THE "WHOLE" PERSON - BODY, MIND, AND SPIRIT AND ENABLE THEM TO CAPTURE INFORMATION TO SHARE WITH OTHERS AT HOME, WORK, OR IN THEIR NEIGHBORHOOD.THE SCHUYLKILL HEALTH AUXILIARY SPONSORED THE "LITTLE RED DRESS" EVENT WHERE WOMEN LEARNED ABOUT THE RISKS OF HEART DISEASE AND PREVENTATIVE MEASURES. THE EVENT FEATURED HEALTH SCREENINGS, VENDORS, FASHION SHOW AND ENTERTAINMENT. SCREENINGS INCLUDED BLOOD PRESSURE, BODY MASS INDEX, OSTEOPOROSIS AS WELL AS A CARDIAC HEALTH ASSESSMENT. PRESENTATIONS INCLUDED MARTIAL ARTS DEMONSTRATIONS AND FITNESS PROGRAMS.THE SCHUYLKILL HEALTH AUXILIARY CONTINUED ITS SUPPORT OF SCHUYLKILL HEALTH IN NUMEROUS WAYS. NEW THIS YEAR WAS A SPECIAL CANCER AWARENESS DINNER DURING NATIONAL BREAST CANCER AWARENESS MONTH.SCHUYLKILL MEDICAL CENTER HOSTS A CANCER SUPPORT GROUP FOR CANCER SURVIVORS, FAMILY AND CARE GIVERS. EACH MONTH, A GROUP OF SURVIVORS GATHER TO TALK ABOUT RECENT TREATMENT, HOW THEY ARE FEELING AND TO CELEBRATE LIFE. WE ALSO HOST A GENTLE YOGA WELLNESS PROGRAM FOR SURVIVORS AND CARE GIVERS. THOSE IN ATTENDANCE HAVE SLEPT BETTER, THEIR "HOT FLASHES" HAVE CEASED, AND THEY ARE ABLE TO RELAX. WE HOLD A FREE SKIN CANCER SCREENING TO THE GENERAL PUBLIC. WE SCREENED APPROX. 125 PEOPLE; REFERRED 50 PEOPLE. THIS SCREENING SAVES LIVES. DIABETES NUMBERS CONTINUE TO RISE, ESPECIALLY IN SCHUYLKILL COUNTY. WE OFFER FREE DIABETES EDUCATION ALONG WITH A DIABETES SUPPORT GROUP.WE ALSO HOLD A 5K WALK/RUN FOR DIABETES, THE GOAL IS TO INCREASE THE AWARENESS AND RISKS ASSOCIATED WITH DIABETES. APPROXIMATELY 350 RUNNERS AND WALKERS PARTICIPATED AS WELL AS NUMEROUS FRIENDS AND FAMILY TAKE ADVANTAGE OF INFORMATION PRESENTATIONS.FREE HEALTH SCREENINGS AND WELLNESS PROGRAMS ARE HELD THROUGHOUT THE YEAR AT VARIOUS LOCATIONS IN OUR COMMUNITY.BLOOD PRESSURES, BODY FAT, BONE DENSITY SCREENINGS ARE JUST A FEW OF THE SERVICES WE PROVIDE AT NO COST TO OUR COMMUNITY.MORE THAN 145 PEOPLE TOOK ADVANTAGE OF THE LEGS FOR LIFE SCREENING FOR PERIPHERAL ARTERY DISEASE (PAD) HELD AT THE SOUTH JACKSON STREET OUTPATIENT SURGERY CENTER. ARTHREX SYSTEM SUPPORTS ORTHOPEDIC SURGERYSCHUYLKILL HEALTH RECENTLY ADDED A NEW SURGICAL VISUALIZATION SYSTEM, WHICH ALLOWS DOCTORS THE ABILITY TO HAVE MORE CLARITY AND STRONGER IMAGES WHEN DOING ARTHROSCOPIC SURGERY AT SCHUYLKILL MEDICAL CENTER SOUTH JACKSON STREET AND SCHUYLKILL MEDICAL CENTER'S OUTPATIENT SURGERY CENTER AT 200 SCHUYLKILL MEDICAL PLAZA IN POTTSVILLE.ORTHOPEDIC SURGEONS ARE NOW USING THE NEW ARTHREX SYNERGY HD3 SYSTEM. SCHUYLKILL HEALTH RECENTLY INTRODUCED THE NEW TECHNOLOGY AND IS ONE OF THE ONLY FACILITIES THROUGHOUT THE REGION TO CURRENTLY OFFER THIS TECHNOLOGY FOR ARTHROSCOPIC SURGERY.ARTHREX COMBINES THREE COMPONENTS - HIGH DEFINITION CAMERAS, LED LIGHTING AND AN IMAGE MANAGEMENT SYSTEM INTO ONE CONSOLE. SURGEONS USE A TABLET TO REVIEW THE PROCEDURE AND SHOW THE PROCEDURE TO PATIENTS. IMAGES OF THE SURGERY ALSO SAVE DIRECTLY TO THE HEALTH SYSTEM'S PACS SYSTEM (PICTURE ARCHIVING SYSTEM).INTRODUCING DA VINCI, ROBOTIC ASSISTED SURGERY SYSTEMSCHUYLKILL HEALTH HAS INTRODUCED THE STATE-OF-THE-ART DA VINCI ROBOTIC SURGICAL SYSTEM TO ITS INVENTORY OF SURGICAL OPTIONS FOR PATIENTS IN SEARCH OF GYNECOLOGICAL, UROLOGICAL OR GENERAL SURGERY. USING THE DA VINCI SURGICAL SYSTEM, THE SURGEON OPERATES WHILE SEATED COMFORTABLY AT A CONSOLE VIEWING A 3D IMAGE OF THE SURGICAL FIELD. THE SURGEON'S FINGERS GRASP THE MASTER CONTROLS BELOW THE DISPLAY, WITH HANDS AND WRISTS NATURALLY POSITIONED RELATIVE TO HIS OR HER EYES. THE SYSTEM SEAMLESSLY TRANSLATES THE SURGEON'S HAND, WRIST AND FINGER MOVEMENTS INTO PRECISE, REAL-TIME MOVEMENTS OF SURGICAL INSTRUMENTS INSIDE THE PATIENT.DA VINCI ROBOTIC ASSISTED SURGERY CONTINUES TO GROW, EXPAND, AND IS CONSIDERED ONE OF THE MOST TECHNOLOGICALLY ADVANCED DEVELOPMENTS IN SURGICAL SERVICES. SINCE INTRODUCING THE TECHNOLOGY IN LATE MAY, SCHUYLKILL HEALTH HAS PERFORMED MORE THAN 250 SURGICAL CASES USING THE DA VINCI TECHNOLOGY.SCHUYLKILL MEDICAL GROUP NEUROLOGYTHIS PAST YEAR, SCHUYLKILL HEALTH WAS VERY SUCCESSFUL IN ESTABLISHING A NEW NEUROLOGY PRACTICE TO BETTER ADDRESS THE NEUROLOGICAL HEALTH NEEDS OF OUR COMMUNITY.DR. INDIRA KUMAR, ADULT & CHILD NEUROLOGY AND DR. NICOLE PURCELL, BOARD CERTIFIED IN ADULT NEUROLOGY WORK WITH REFERRING PHYSICIANS AND THE GENERAL COMMUNITY TO DIAGNOSE AND TREAT NUMEROUS CONDITIONS.	Description
Total Program Service Expense	79236384	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	0	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	1	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	1	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	1	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	0	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	0	TaxExemptBonds
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	0	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	0	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	0	RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	36	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	1073	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	0	UnrelatedBusinessIncome
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	17	NbrVotingGoverningBodyMembers
Number Independent Voting Members	16	NumberIndependentVotingMembers
Family Or Business Relationship	0	FamilyOrBusinessRelationship
Delegation Of Management Duties	1	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	0	MembersOrStockholders
Election Of Board Members	0	ElectionOfBoardMembers
Decisions Subject To Approval	0	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
States Where Copy Of Return Is Filed	PA	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	BERNIE KOSKULITZ DIRECTOR FINANCE	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	5706215142	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	420 SOUTH JACKSON STREET	AddressLine1
City	POTTSVILLE	City
State	PA	State
ZIP Code	17901	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Average Hours Per Week RelatedAverageHoursPerWeekRelated	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee
JESSE C ACHENBACH
TRUSTEE	1.00	3.00	X	0	0	0
DEBRA C BLASCHAK
TRUSTEE	1.00	3.00	X	0	0	0
ANTHONY BARAN
CHAIRMAN	1.00	3.00	X	0	0	0	X
JEANNE BOYER PORTER
TRUSTEE	1.00	3.00	X	0	0	0
SARAH T CASEY
TRUSTEE	1.00	3.00	X	0	0	0
STEVEN I FIELD
TRUSTEE	1.00	3.00	X	0	0	0
REV HAROLD L HAND
TRUSTEE	1.00	3.00	X	0	0	0
WILLIAM L JONES III
TRUSTEE	1.00	3.00	X	0	0	0
WILLIAM E KIRWAN CPA ESQ
TREASURER	1.00	3.00	X	0	0	0	X
JAY M LINARD
SECRETARY	1.00	3.00	X	0	0	0	X
CYNTHIA PETCHULIS
TRUSTEE	1.00	3.00	X	0	0	0
FRANKLIN K SCHOENEMAN
VICE CHAIRMAN	1.00	3.00	X	0	0	0	X
SYED SHAH MD
TRUSTEE	1.00	3.00	X	0	0	0
JOHN E SIMODEJKA
PRESIDENT/CEO	37.50	2.50	X	465081	0	23868	X
E LORI SMITH
TRUSTEE	1.00	3.00	X	0	0	0
TIMOTHY F TWARDZIK
TRUSTEE	1.00	3.00	X	0	0	0
ROBERT M ZIMMERMAN JRDO
TRUSTEE	1.00	3.00	X	0	0	0
DR THOMAS CURRY
VP, MEDICAL STAFF AFFAIRS	37.50	2.50		134933	0	10388	X
DIANE BORIS
VP FINANCE/CFO	16.00	24.00		0	117112	22095	X
DARNELL FURER
VP NURSING/CNO	20.00	20.00		0	175335	19859		X
RICHARD BINDIE
DIRECTOR OF PATHOLOGY	37.50			273190	0	21832			X
LYNDA L JAKUBCO
CRNA	37.50			226107	0	22018			X
JULIANNE M TIDMORE
CRNA	37.50			223233	0	23513			X
MARY R TUNNESSEN
CRNA	37.50			212031	0	21948			X
SHERRY L BURINSKY BOTTOR
CRNA	37.50			246247	0	23948			X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	1780822	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	292447	TotalReportableCompFrmRltdOrgs
Total Other Compensation	189469	TotalOtherCompensation
Number Individuals GT100 K	28	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
INSIGHT HEALTH CORP
PO BOX 847687	DALLAS	TX	75284	PET SCAN & MRI SERVICE	1472531
SODEXHO INC & AFFILIATES
PO BOX 360170	PITTSBURGH	PA	15251	DIETARY	894609
ARAMARK
450 WASHINGTON STREET	POTTSVILLE	PA	17901	CLINICAL ENGINEERING AND ENVIRONMENTAL	703887
LABORATORY CORPORATION OF AMERICA HOLDIN
PO BOX 12140	BURLINGTON	NC	27216	REFERENCE LAB	657531
GE HEALTHCARE
PO BOX 640944	PITTSBURGH	PA	15264	MAINTENANCE SERVICES - RADIOLOGY	583186

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	18	NumberOfContractorsGT100K
Related Organizations	182455	RelatedOrganizations
Government Grants	160994	GovernmentGrants
All Other Contributions	67736	AllOtherContributions
Total Contributions	411185	TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICE REV	621400	95252670	95252670
SCHOOL OF NURSING	621400	647172	647172

Field	Value	IRS element (for citing)
Total Program Service Revenue	95899842	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	15786	TotalRevenueColumn
Exclusion	$15,786	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	37773	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	31969	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	5804	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	5804	TotalRevenueColumn
Exclusion	$5,804	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Other	378	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Other	0	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Other	378	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	378	TotalRevenueColumn
Exclusion	$378	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount
MEANINGFUL USE	900099	1612589	$1,612,589
TOBACCO SETTLEMENT FUNDS	561439	374805	$374,805
CAFETERIA & VENDING	561439	311487	$311,487

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	415013	TotalRevenueColumn
Related Or Exempt Function Income	150158	RelatedOrExemptFunctionIncome
Exclusion	$264,855	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	2713894	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	99046889	TotalRevenueColumn
Related Or Exempt Function Income	96050000	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$2,585,704	ExclusionAmount

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	X	InfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	1213	Total
Program Services	1213	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	1075	Total
Program Services	1075	ProgramServices

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	1078058	Total
Program Services	886940	ProgramServices
Management And General	191118	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	39580184	Total
Program Services	32563406	ProgramServices
Management And General	7016778	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	1419272	Total
Program Services	1167663	ProgramServices
Management And General	251609	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	4389002	Total
Program Services	4115245	ProgramServices
Management And General	273757	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	2920243	Total
Program Services	2416084	ProgramServices
Management And General	504159	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	88346	Total
Management And General	88346	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	122560	Total
Management And General	122560	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	20116	Total
Management And General	20116	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	11105907	Total
Program Services	6857210	ProgramServices
Management And General	4248697	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	94112	Total
Management And General	94112	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	2312836	Total
Program Services	1147405	ProgramServices
Management And General	1165431	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	1291453	Total
Program Services	14509	ProgramServices
Management And General	1276944	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	132676	Total
Program Services	119378	ProgramServices
Management And General	13298	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	33496	Total
Program Services	15979	ProgramServices
Management And General	17517	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	1628932	Total
Program Services	1628932	ProgramServices

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	4582923	Total
Program Services	4582923	ProgramServices

Insurance Insurance

Field	Value	IRS element (for citing)
Total	961778	Total
Program Services	961778	ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
MEDICAL SUPPLIES	11892742	11892742
BAD DEBT EXPENSE	10230173	10230173
COLLECTION FEES	705577		705577
FOOD	585163	585163

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	751249	Total
Program Services	48566	ProgramServices
Management And General	702683	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	95929086	Total
Program Services	79236384	ProgramServices
Management And General	16692702	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	1500	BOY
EOY	1500	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	5284030	BOY
EOY	5550146	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	9901895	BOY
EOY	9753648	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	1213330	BOY
EOY	1403816	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	666603	BOY
EOY	539632	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	85509104	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	61563104	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	23253283	BOY
EOY	23946000	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	727153	BOY
EOY	538019	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	5521164	BOY
EOY	6154330	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	5144335	BOY
EOY	6766074	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	51713293	BOY
EOY	54653165	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	41950935	BOY
EOY	34816514	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	323750	BOY
EOY	290350	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	25439498	BOY
EOY	24063377	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	1500000	BOY
EOY	750000	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	6040715	BOY
EOY	8608484	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	75254898	BOY
EOY	68528725	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	-27983738	BOY
EOY	-18744926	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	137549	BOY
EOY	146138	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	4304584	BOY
EOY	4723228	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	-23541605	BOY
EOY	-13875560	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	51713293	BOY
EOY	54653165	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	3117803	ReconcilationRevenueExpenses
Reconcilation Other Changes	6548242	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Consolidated	X	FinancialStatementConsolidated

Field	Value	IRS element (for citing)
Audit Committee	1	AuditCommittee
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

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)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	Volunteers
Paid Staff Or Management	0	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	1	GrantsOtherOrganizations
Grants Other Organizations	$14,116	GrantsOtherOrganizationsAmount
Direct Contact Legislators	1	DirectContactLegislators
Direct Contact Legislators	$6,000	DirectContactLegislatorsAmount
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	0	OtherActivities
Total Lobbying Expenditures IIB	20116	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	EXPLANATION OF LOBBYING ACTIVITIES:	Identifier
Return Reference	PART II-B, LINE 1:	ReturnReference
Explanation	A PORTION OF THE HOSPITAL'S DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE HOSPITAL ASSOCIATION OF PENNSYLVANIA (HAP) ARE USED FOR LOBBYING PURPOSES. BOB ALLEN WORKED ON BEHALF OF THE HOSPITAL WITH GOVERNMENTAL OFFICIALS AND REPRESENTATIVES OF AND CONSULTANTS TO STATE AND LOCAL GOVERNMENTAL AGENCIES, BOARDS, COMMITTEES AND COMMISSIONS, INCLUDING WITHOUT LIMITATION MEETINGS WITH SUCH OFFICIALS, REPRESENTATIVES AND CONSULTANTS, REGARDING LEGISLATIVE, REGULATORY AND OTHER ISSUES THAT AFFECT THE INTERESTS AND AFFAIRS OF THE HOSPITAL AS MAY BE ASSIGNED BY THE HOSPITAL FROM TIME TO TIME. BOB ALLEN ALSO ATTENDS AND REPORTS AT HOSPITAL BOARD MEETINGS AND STAFF MEETINGS, IF REQUIRED. BOB ALLEN ALSO PERFORMS SUCH OTHER TASKS AND ACTIVITIES OF A GENERAL GOVERNMENTAL RELATIONS NATURE AS MAY BE ASSIGNED BY THE HOSPITAL FROM TIME TO TIME.	Explanation

Schedule D IRS990ScheduleD

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	734233	OtherCostOrOtherBasis
Book Value	734233	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	49653599	OtherCostOrOtherBasis
Depreciation	36097004	Depreciation
Book Value	13556595	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	34173658	OtherCostOrOtherBasis
Depreciation	25265017	Depreciation
Book Value	8908641	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	947614	OtherCostOrOtherBasis
Depreciation	201083	Depreciation
Book Value	746531	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	23946000	TotalOfBookValueLandBuildings

Other Securities OtherSecurities (3 entries)

DescriptionDescription	Book ValueBookValue	Method Of ValuationMethodOfValuation
FEDERAL AGENCY OBLIGATIONS	2717075	F
ACCRUED INVESTMENT INCOME	9363	F
INVESTMENT IN PENNSYLVANIA COMMUNITY HOSPITAL ASSOCIATION	3427892	C

Field	Value	IRS element (for citing)
Total Of Book Value Securities	6154330	TotalOfBookValueSecurities

Other Assets OtherAssets (4 entries)

DescriptionDescription	Book ValueBookValue
BENEFICIAL INTEREST IN PERPETUAL TRUST	4331347
DEFERRED FINANCING COSTS, NET	60720
INSURANCE RECOVERIES RECEIVABLE	998296
DUE FROM AFFILIATES	1375711

Field	Value	IRS element (for citing)
Total Book Value Other Assets	6766074	TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescription	AmountAmount
OBLIGATION UNDER CAPITAL LEASE	$6,216,980
BLUE CROSS CURRENT FINANCING ADVANCE	$479,000
ESTIMATED MEDICAL MALPRACTICE CLAIMS LIABILITY	$1,762,212
ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS	$150,292

Field	Value	IRS element (for citing)
Total Of Amounts	8608484	TotalOfAmounts
Footnote In Part XIII	X	FootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt	95396927	TotRevenueEtcAuditedFinclStmt
Other Revenues	-3681931	OtherRevenues
Revenue Not Rptd F990	-3681931	RevenueNotRptdF990
Revenue Subtotal	99078858	RevenueSubtotal
Other Revenues Not Included	-31969	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	-31969	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	99046889	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	85730882	TotExpensesEtcAuditedFinclStmt
Other Expenses Included	31969	OtherExpensesIncluded
Expenses Not Rptd F990	31969	ExpensesNotRptdF990
Expenses Subtotal	85698913	ExpensesSubtotal
Other Expenses Not Included	10230173	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	10230173	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	95929086	TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (5 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:	PART X, LINE 2:	THE CORPORATION PRESCRIBES A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY IN REOCORDING TAX LIABILITIES IN THE FINANCIAL STATEMENTS. MEASUREMENT AND RECOGNITION OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. THE CORPORATION'S FEDERAL EXEMPT ORGANIZATION RETURNS OF INCOME TAX FOR THE YEARS ENDED PRIOR TO JUNE 30, 2010 NO LONGER REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE.
PART XI, LINE 2D - OTHER ADJUSTMENTS:		POST RETIREMENT BENEFIT LIABILITY ADJUSTMENT 146,407. VALUATION GAIN 418,644. PENSION LIABILITY ADJUSTMENT 5,983,191. PROVISIONS FOR BAD DEBTS NETTED ON FINANCIAL STATEMENTS -10,230,173.
PART XI, LINE 4B - OTHER ADJUSTMENTS:		RENTAL EXPENSES -31,969.
PART XII, LINE 2D - OTHER ADJUSTMENTS:		RENTAL EXPENSES 31,969.
PART XII, LINE 4B - OTHER ADJUSTMENTS:		PROVISIONS FOR BAD DEBTS NETTED ON FINANCIAL STATEMENTS 10,230,173.

Schedule F IRS990ScheduleF

Accts Actvs Out US Table AcctsActvsOutUSTable

Field	Value	IRS element (for citing)
Region	CENTRAL AMERICA AND THE CARIBBEAN	Region
Type Of Activities Conducted	INVESTMENT	TypeOfActivitiesConducted
Total Expenditures	3427892	TotalExpenditures

Field	Value	IRS element (for citing)
Subtotal Number Of Offices	0	SubtotalNumberOfOffices
Subtotal Number Of Employees	0	SubtotalNumberOfEmployees
Cont Number Of Offices	0	ContNumberOfOffices
Cont Number Of Employees	0	ContNumberOfEmployees
Total Number Of Offices	0	TotalNumberOfOffices
Total Number Of Employees	0	TotalNumberOfEmployees
Subtotal Amount Spent	3427892	SubtotalAmountSpent
Cont Amount Spent	0	ContAmountSpent
Total Amount Spent	3427892	TotalAmountSpent
Transfer To Foreign Corp	1	TransferToForeignCorp
Interest In Foreign Trust	0	InterestInForeignTrust
Own Foreign Corp	1	OwnForeignCorp
Passive Foreign Invest Co	0	PassiveForeignInvestCo
Foreign Partnership	0	ForeignPartnership
Boycott Countries	0	BoycottCountries

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
FPG Reference Free Care	1	FPGReferenceFreeCare

Other Percentage OtherPercentage

Field	Value	IRS element (for citing)
Other	X	Other
Free Other Percentage	175.000000000000	FreeOtherPercentage

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent250	X	Pcent250
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	0	ExpensesExceededBudget
Annual Community Benefit Report	1	AnnualCommunityBenefitReport
Report Publically Available	1	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	362644	TotalCommunityBenefitExpense
Net Community Benefit Expense	362644	NetCommunityBenefitExpense
Percent Of Total Expense	0.00420	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	15398508	TotalCommunityBenefitExpense
Direct Offsetting Revenue	10040173	DirectOffsettingRevenue
Net Community Benefit Expense	5358335	NetCommunityBenefitExpense
Percent Of Total Expense	0.06250	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	15761152	TotalCommunityBenefitExpense
Direct Offsetting Revenue	10040173	DirectOffsettingRevenue
Net Community Benefit Expense	5720979	NetCommunityBenefitExpense
Percent Of Total Expense	0.06670	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	30	NumberOfActivitiesOrPrograms
Persons Served	6247	PersonsServed
Total Community Benefit Expense	137488	TotalCommunityBenefitExpense
Direct Offsetting Revenue	1650	DirectOffsettingRevenue
Net Community Benefit Expense	135838	NetCommunityBenefitExpense
Percent Of Total Expense	0.00160	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	10	PersonsServed
Total Community Benefit Expense	18626	TotalCommunityBenefitExpense
Net Community Benefit Expense	18626	NetCommunityBenefitExpense
Percent Of Total Expense	0.00020	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	4566963	TotalCommunityBenefitExpense
Direct Offsetting Revenue	3400812	DirectOffsettingRevenue
Net Community Benefit Expense	1166151	NetCommunityBenefitExpense
Percent Of Total Expense	0.01360	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	31	NumberOfActivitiesOrPrograms
Persons Served	6257	PersonsServed
Total Community Benefit Expense	4723077	TotalCommunityBenefitExpense
Direct Offsetting Revenue	3402462	DirectOffsettingRevenue
Net Community Benefit Expense	1320615	NetCommunityBenefitExpense
Percent Of Total Expense	0.01540	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	31	NumberOfActivitiesOrPrograms
Persons Served	6257	PersonsServed
Total Community Benefit Expense	20484229	TotalCommunityBenefitExpense
Direct Offsetting Revenue	13442635	DirectOffsettingRevenue
Net Community Benefit Expense	7041594	NetCommunityBenefitExpense
Percent Of Total Expense	0.08210	PercentOfTotalExpense

Economic Development EconomicDevelopment

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Total Community Building Expense	143	TotalCommunityBuildingExpense
Net Community Building Expense	143	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	245	PersonsServed
Total Community Building Expense	1378	TotalCommunityBuildingExpense
Net Community Building Expense	1378	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	2	NumberOfActivitiesOrPrograms
Persons Served	361	PersonsServed
Total Community Building Expense	361	TotalCommunityBuildingExpense
Net Community Building Expense	361	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Other Other

Field	Value	IRS element (for citing)
Total Community Building Expense	52743	TotalCommunityBuildingExpense
Net Community Building Expense	52743	NetCommunityBuildingExpense
Percent Of Total Expense	0.00060	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	4	NumberOfActivitiesOrPrograms
Persons Served	606	PersonsServed
Total Community Building Expense	54625	TotalCommunityBuildingExpense
Net Community Building Expense	54625	NetCommunityBuildingExpense
Percent Of Total Expense	0.00060	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	1	BadDebtExpenseReported
Bad Debt Expense	$3,902,453	BadDebtExpenseAmount
Amount Attributable To	3902453	AmountAttributableTo
Amount Reimbursed By Medicare	27406400	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	27590184	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-183784	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Cost To Charge Ratio	X	CostToChargeRatio

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	ProvisionForCharityCare
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	SCHUYLKILL MEDICAL CENTER SOUTH JACKSON	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	420 SOUTH JACKSON STREET	AddressLine1
City	POTTSVILLE	City
State	PA	State
ZIP Code	17901	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Er24 Hours	X	Er24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	SCHUYLKILL MEDICAL CENTER SOUTH JACKSON	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
CHNA Conducted	1	CHNAConducted
Community Definition	X	CommunityDefinition
Community Demographics	X	CommunityDemographics
Existing Resources	X	ExistingResources
How Data Obtained	X	HowDataObtained
Community Health Needs	X	CommunityHealthNeeds
Other Health Issues	X	OtherHealthIssues
Identifying Process	X	IdentifyingProcess
Consulting Process	X	ConsultingProcess
Needs Assessment Conducted	12	NeedsAssessmentConducted
Take Into Account	1	TakeIntoAccount
Other Facilities	1	OtherFacilities
CHNA Widely Available	1	CHNAWidelyAvailable
Own Website	X	OwnWebsite
On Request	X	OnRequest
Adopt Implement Strategy	X	AdoptImplementStrategy
Execute Implement Strategy	X	ExecuteImplementStrategy
Develop Community Plan	X	DevelopCommunityPlan
Participate Community Plan	X	ParticipateCommunityPlan
Include Operational Plans	X	IncludeOperationalPlans
Adopt Budget	X	AdoptBudget
Prioritize Health Needs	X	PrioritizeHealthNeeds
Prioritize Services	X	PrioritizeServices
All Needs Addressed	0	AllNeedsAddressed
Organization Incur Excise Tax	0	OrganizationIncurExciseTax
Eligibility Criteria Explained	1	EligibilityCriteriaExplained
Uses FPG Free	1	UsesFPGFree
FPG Free Percent	175.000000000000	FPGFreePercent
Uses FPG Discounted	1	UsesFPGDiscounted
FPG Discount Percent	250.000000000000	FPGDiscountPercent
Explains Basis	1	ExplainsBasis
Income Level	X	IncomeLevel
Asset Level	X	AssetLevel
Insurance Status	X	InsuranceStatus
Medicaid Medicare	X	MedicaidMedicare
State Regulation	X	StateRegulation
Other Factors	X	OtherFactors
Explains Application Method	1	ExplainsApplicationMethod
Includes Publicity Measures	1	IncludesPublicityMeasures
Posted In Admission Office	X	PostedInAdmissionOffice
Available On Request	X	AvailableOnRequest
Actions On Nonpayment	1	ActionsOnNonpayment
Collection Activities	0	CollectionActivities
Other Actions Taken	X	OtherActionsTaken
Nondiscrim Emergency Care Policy	1	NondiscrimEmergencyCarePolicy
Used Other Method	X	UsedOtherMethod
Amounts Generally Billed	0	AmountsGenerallyBilled
Gross Charges	0	GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (18 entries)

ExplanationExplanation	IdentifierIdentifier
PART I, LINE 7: SCHUYLKILL MEDICAL CENTER - SOUTH COMPUTED A COST TO CHARGE RATIO USING INFORMATION FROM THE MOST RECENTLY FILED MEDICARE COST REPORT (FYE 6/30/13) FOR THE CALCULATION OF COSTS FOR CHARITY CARE AND MEDICAID. DIRECT COSTS ARE OBTAINED FROM THE HOSPITAL COMPUTER SYSTEM FOR EACH COST CENTER FOR ALL OTHER BENEFITS. INDIRECT COSTS ARE COMPUTED UTILIZING THE MOST RECENTLY FILED MEDICARE COST REPORT (FYE 6/30/13).
PART I, LINE 7G: THERE ARE NO PHYSICIAN CLINICAL SERVICES INCLUDED.
PART I, L7 COL(F): THE AMOUNT OF BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25 COLUMN (A) BUT SUBTRACTED OUT FOR PURPOSES OF CALCULATING THE PERCENTAGE ON SCH H, PART I, LINE 7, COLUMN (F) IS $10,230,173.
PART II: ECONOMIC DEVELOPMENT - SCHUYLKILL COUNTY CHILD DEVELOPMENT POLICY COUNCIL, CHILD DEVELOPMENT IS A DAY CARE PROGRAM IN SCHUYLKILL COUNTY THAT IS PROVIDED TO ANYONE BUT IS FOCUSED ON CHILDREN OF PARENTS WHO CANNOT AFFORD TO PAY THE FULL COST OF DAYCARE. IF THIS SERVICE WAS NOT AVAILABLE FOR THESE PARENTS, THEY WOULD NOT BE ABLE TO WORK BECAUSE THEY WOULD HAVE TO STAY HOME TO TAKE CARE OF THEIR CHILDREN. WE HAVE A CLINICAL RN CHARGE NURSE WHO ATTENDS THE MEETINGS AND IS A MEMBER OF THIS POLICY COUNCIL.COMMUNITY SUPPORT - BRIDGE HOUSE OF SCHUYLKILL COUNTY - THE BRIDGE HOUSING PROGRAM IS A TRANSITIONAL HOUSING SERVICE LOCATED ON THE GROUNDS OF THE POTTSVILLE HOUSING AUTHORITY AT LAUREL TERRACE, POTTSVILLE, PENNSYLVANIA. BRIDGE HOUSING PROVIDES COMPREHENSIVE SERVICES TO PERSONS FACING LONG-TERM HOMELESSNESS AND PROVIDES A SUPPORTIVE, SAFE ENVIRONMENT FOR ADULTS AND CHILDREN. STUDENTS FROM THE SCHOOL OF NURSING PROVIDE TALKS TO RESIDENTS ABOUT SEVERAL DIFFERENT HEALTH TALKS INCLUDING PARENTING AND HEALTH PREVENTION.COALITION BUILDING - SCHUYLKILL COUNTY CHILD DEVELOPMENT HEALTH ADVISORY - FOR THIS WE HAVE ONE OF OUR SCHOOL OF NURSING INSTRUCTORS ADVISE CHILD DEVELOPMENT ON CERTAIN HEALTH MATTERS. THIS HELPS FORM A PARTNERSHIP OR COALITION WITH SCHUYLKILL COUNTY CHILD DEVELOPMENT.WORKFORCE DEVELOPMENT - SCHUYLKILL TRAINING AND TECHNOLOGY CENTER PROVIDES ASSISTANCE AND GUIDANCE TO THE LPN PROGRAM AT THE TRAINING & TECHNOLOGY CENTER AND ALSO KEEPS THE ADMINISTRATION AND LPN PROGRAM FACULTY UP TO DATE ON HEALTH CARE RELATED INFORMATION. THIS HELPS TO ENSURE THE LPN PROGRAM HAS A BACKGROUND THAT IS UP TO DATE TO PROVIDE THE STUDENTS TO ENTER THE WORKFORCE RIGHT AFTER GRADUATION.
PART III, LINE 4: ACCOUNTS RECEIVABLE, OTHER 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. THE ALLOWANCE FOR DOUBTFUL COLLECTIONS IS ESTIMATED BASED UPON A PERIODIC REVIEW OF INDIVIDUAL ACCOUNTS.ALL APPROPRIATE DISCOUNTS AND PAYMENTS ARE REFLECTED ON EACH PATIENTS' ACCOUNT. ONCE A PATIENT IS IDENTIFIED AS BAD DEBT, THE BALANCE THAT IS BAD DEBT WOULD BE CHARGES NET OF ANY PAYMENTS OR ADJUSTMENTS. THE COST OF BAD DEBT EXPENSE IS CALCULATED BY USING THE COST TO CHARGE RATIO FROM THE MOST RECENTLY FILE MEDICARE COST REPORT AND APPLYING THAT TO THE CHARGE.WE BELIEVE THAT A PORTION OF OUR BAD DEBTS RESULTS FROM SERVICES PROVIDED TO PATIENTS WHO MEET THE CHARITY CARE GUIDELINES BUT WERE UNABLE OR UNWILLING TO PROVIDE THE APPROPRIATE DOCUMENTATION TO ALLOW THAT CLASSIFICATION. THESE WOULD BE CLASSIFIED AS BAD DEBT EXPENSE TIMES THE COST TO CHARGE RATIO TO ARRIVE AT THE COST.
PART III, LINE 8: THE HOSPITAL USES THE COST-TO-CHARGE RATIO TO DETERMINE THE MEDICARE ALLOWABLE COSTS.THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT AS THE HOSPITAL IS TREATING MEDICARE PATIENTS DESPITE THE RISE IN UNREIMBURSED COST.
PART III, LINE 9B: THE ORGANIZATION DOES HAVE A WRITTEN DEBT COLLECTION POLICY. ALL STAFF INVOLVED IN DEBT COLLECTION (EMPLOYEES OF THE MEDICAL CENTER AND ANY THIRD PARTY AGENCIES) ARE TRAINED ON THE POLICY AS WELL AS THE CHARITY CARE POLICY. IN DEALING WITH PATIENTS IN DEBT COLLECTION, STAFF WILL INFORM PATIENTS OF THE CHARITY CARE POLICY THAT IS AVAILABLE AND ALSO ANY OTHER FINANCIAL ASSISTANCE POLICIES OF THE MEDICAL CENTER THAT MAY BE APPLICABLE TO THE PATIENT. THE STAFF WILL INSTRUCT PATIENTS ON APPROPRIATE PAPERWORK THAT NEEDS TO BE COMPLETED IN REGARDS TO CHARITY CARE OR FINANCIAL ASSISTANCE.
PART V, SECTION B, LINE 3: SCHUYLKILL HEALTH PARTNERED WITH STRATEGY SOLUTIONS TO CONDUCT THE ASSESSMENT. WITH THEIR HELP, SCHUYLKILL HEALTH IDENTIFIED 11 COMMUNITY MEMBERS TO SERVE ON A STEERING COMMITTEE TO CONDUCT THIS ASSESSMENT. THE 11 COMMUNITY MEMBERS INCLUDED LEADERS IN EDUCATION, BUSINESS, PUBLIC SERVICES, HUMAN SERVICES, AND PUBLIC HEALTH OFFICIALS.	SCHUYLKILL MEDICAL CENTER SOUTH JACKSON
PART V, SECTION B, LINE 4: SCHUYLKILL MEDICAL CENTER - EAST NORWEGIAN STREET	SCHUYLKILL MEDICAL CENTER SOUTH JACKSON
PART V, SECTION B, LINE 7: SCHUYLKILL HEALTH DID NOT ADDRESS ALL NEEDS IN THE ASSESSMENT. SCHUYLKILL HEALTH LEADERSHIP HAD A MEETING TO DISCUSS WHAT ITEMS WOULD BE BEST HANDLED BY EACH FACILITY. THE ITEMS THAT THEY DID NOT ADDRESS WERE THEN GIVEN TO THE APPROPRIATE COMMUNITY ORGANIZATIONS THAT WOULD BE ABLE TO BEST HANDLE THEM. SCHUYLKILL COUNTY VISION ADDRESSES 2 ISSUES THAT WERE IDENTIFIED: 1) PHYSICAL ACTIVITY, NUTRITION AND OBESITY AND 2) UNINTENTIONAL INJURIES FROM MOTOR VEHICLES. SCHUYLKILL COUNTY VISION TOOK THIS ISSUE ON BECAUSE THEY DEAL WITH A DIVERSE GROUP OF ORGANIZATIONS THAT WOULD BE ABLE TO IMPROVE THESE NEEDED BETTER THAN THE HEALTH SYSTEM. SCHUYLKILL COUNTY DRUG AND ALCOHOL PROGRAM ALSO HANDLED ONE OF THE RECOGNIZED NEEDS FROM THE ASSESSMENT. THEY HANDLED THE NEED TO IMPROVE MENTAL HEALTH AND CONTROL DRUG AND ALCOHOL ABUSE. THEY CHOSE TO ADDRESS THIS NEED BECAUSE THEY WORK WITH THESE ISSUES ALREADY AND ARE MORE PREPARED TO ADDRESS THIS NEED THAN THE HEALTH SYSTEM.	SCHUYLKILL MEDICAL CENTER SOUTH JACKSON
PART V, SECTION B, LINE 12H: SIZE OF FAMILY. THE LARGER THE NUMBER OF PEOPLE IN THE PATIENT'S FAMILY COULD ADJUST HOW MUCH OF A BENEFIT THEY RECEIVE.	SCHUYLKILL MEDICAL CENTER SOUTH JACKSON
PART V, SECTION B, LINE 18E: WHEN A PATIENT DOES NOT MAKE A PAYMENT, A PATIENT IS EVALUATED TO DETERMINE IF THEY MEET THE GUIDELINES FOR FINANCIAL ASSISTANCE. IF THEY DO, THEY ARE THEN GIVEN THE PROPER INFORMATION.	SCHUYLKILL MEDICAL CENTER SOUTH JACKSON
PART V, SECTION B, LINE 20D: THE SAME POLICY IS USED FOR EMERGENCY OR MEDICALLY NECESSARY CARE THAT IS USED FOR ANY OTHER TYPE OF CARE. THERE IS A STANDARD AMOUNT THAT IS CHARGED FOR PROCEDURES PER THE HOSPITAL'S CHARGE MASTER.	SCHUYLKILL MEDICAL CENTER SOUTH JACKSON
PART VI, LINE 2: SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET (SMS-SJS) WORKS WITH SCHUYLKILL MEDICAL CENTER - EAST NORWEGIAN STREET (SMS-ENS) IN ASSESSING THE HEALTH NEEDS OF THE COMMUNITY IT IS LOCATED IN AND SERVES; SCHUYLKILL COUNTY IN PENNSYLVANIA. BOTH MEDICAL CENTERS ALSO WORK WITH VARIOUS CITY, COUNTY AND STATE AGENCIES TO SPECIFICALLY IDENTIFY THE HEALTH NEEDS OF THE RESIDENTS OF SCHUYLKILL COUNTY.SMC-SJS IS LOCATED IN POTTSVILLE, WHICH IS THE COUNTY SEAT FOR SCHUYLKILL COUNTY. SCHUYLKILL COUNTY IS A RURAL COUNTY. THE COUNTY HAS AN UNEMPLOYMENT RATE OF OVER 9%, 19% OF THE RESIDENTS ARE COVERED BY MEDICAID, AND 18% OF THE RESIDENTS ARE OVER THE AGE OF 65.SMC-SJS IS A 179 BED ACUTE CARE FACILITY THAT PROVIDES ACUTE MEDICAL SURGICAL CARE, ADOLESCENT AND ADULT BEHAVIORAL HEALTH SERVICES, AND TRANSITIONAL REHAB CARE AND NURSERY SERVICES TO THE COMMUNITY.THE INFORMATION FOR THE NEEDS ASSESSMENT WAS GATHERED IN 2 DIFFERENT WAYS. THE FIRST WAY WAS TO SET UP A COMMITTEE OF 11 DIFFERENT MEMBERS FOR VARIOUS DIFFERENT GROUPS IN THE COMMUNITY TO DISCUSS WHAT WAS NEEDED TO IMPROVE THE HEALTH OF THE COMMUNITY. QUALITATIVE AND QUANTITATIVE DATA COLLECTION WAS ALSO USED TO ANALYZE WHAT WAS NEEDED TO IMPROVE THE HEALTH OF COMMUNITY MEMBERS.SMC-SJS WORKS WITH THE SOCIAL SERVICE AGENCIES, LOCAL DEPARTMENT OF HEALTH, THE CHAMBER OF COMMERCE, UNITED WAY, AMERICAN CANCER SOCIETY, LOCAL SCHOOLS, LOCAL SUPPORT GROUPS, PHYSICIAN OFFICES AND OTHER HEALTHCARE ORGANIZATIONS IN IDENTIFYING THE HEALTHCARE NEEDS OF THE LOCAL COMMUNITIES AND THE SERVICES THAT ARE NEEDED. AFTER A NEED HAS BEEN IDENTIFIED, THE MEDICAL CENTER WORKS WITH THESE ORGANIZATIONS TO HELP PROVIDE THE SERVICE TO RESIDENTS.THE MEDICAL CENTER ALSO WORKS WITH HEALTHCARE ORGANIZATIONS OUTSIDE SCHUYLKILL COUNTY TO HELP BRING HEALTHCARE SERVICES TO THE COUNTY. THIS ALLOWS COUNTY RESIDENTS TO OBTAIN NECESSARY SERVICES CONVENIENTLY WITHIN THE COUNTY.THE MEDICAL CENTER ALSO REVIEWS INTERNAL DATA ON ADMISSIONS, EMERGENCY ROOM VISITS, CLINIC VISITS AND DIAGNOSIS TO HELP IDENTIFY COMMUNITY NEEDS. THIS INFORMATION IS REVIEWED ANNUALLY AS PART OF THE BUDGET AND STRATEGIC PLANNING PROCESS.THE BOARD OF THE MEDICAL CENTER IS COMPRISED OF INDIVIDUALS FROM THE COMMUNITY REPRESENTING SOCIAL SERVICE AGENCIES, EDUCATION, ASSISTED LIVING/LONG TERM CARE, PHYSICIANS, MATERNAL/CHILD HEALTH AND LOCAL BUSINESSES. THESE INDIVIDUALS ALSO PROVIDE INPUT ON THE NEEDS OF THE COMMUNITY IN MEETING HEALTHCARE NEEDS.
PART VI, LINE 3: EACH PATIENT IS REGISTERED INTO THE HOSPITAL COMPUTER SYSTEM WHEN THEY ARRIVE FOR SERVICES. AS PART OF THE REGISTRATION, INFORMATION IS OBTAINED ON ANY HEALTH INSURANCE THEY HAVE. INDIVIDUALS WITHOUT HEALTH INSURANCE ARE INFORMED AT THAT TIME OF THE MEDICAL CENTER'S CHARITY CARE POLICY. PATIENTS ARE GIVEN INFORMATION ON CONTACTING STAFF WITHIN THE HOSPITAL PATIENT ACCOUNTING DEPARTMENT TO DISCUSS APPLYING FOR THE HOSPITAL CHARITY CARE PROGRAM. SPECIFIC STAFF HAVE BEEN TRAINED AND ARE RESPONSIBLE FOR ADMINISTERING THE CHARITY CARE PROGRAM FOR THE HOSPITAL. HOSPITAL STAFF CONTACT PATIENTS WITHOUT INSURANCE AND EXPLAIN THE POLICY AND THE INFORMATION NEEDED TO APPLY. HOSPITAL STAFF WILL ALSO ASSIST PATIENTS IN APPLYING FOR MEDICAL ASSISTANCE. THEY WILL ALSO ASSIST PATIENTS IN COMPLETING THE APPLICATION AND GATHERING THE NECESSARY FINANCIAL DOCUMENTS.THE MEDICAL CENTER ALSO POSTS INFORMATION WITHIN THE ADMISSION AND EMERGENCY ROOM AREAS INFORMING PATIENTS THAT THERE IS A CHARITY CARE POLICY AVAILABLE. ALL REGISTRATION PERSONNEL ARE TRAINED ON THE POLICY SO THAT THEY ARE ABLE TO INFORM PATIENTS WHEN THEY ARE REGISTERED.OTHER HOSPITAL STAFF MEMBERS THAT MAY COME IN CONTACT WITH PATIENTS ARE ALSO EDUCATED REGARDING THE CHARITY CARE POLICY. THIS WOULD INCLUDE SOCIAL WORKERS, CARE MANAGERS, NURSING STAFF AND ALL DEPARTMENT DIRECTORS. THE CHARITY CARE POLICY IS AVAILABLE ON THE HOSPITAL INTRANET WHICH IS ACCESSIBLE BY ALL EMPLOYEES. THE HOSPITAL IS ALSO IN THE PROCESS OF PLACING THE POLICY ON THE HOSPITAL WEBSITE.ALL PATIENT ACCOUNTING, CASHIERING AND COLLECTION STAFF ARE ALSO EDUCATED ON THE CHARITY CARE POLICY AND CAN ASSIST PATIENTS IN APPLYING FOR CHARITY CARE. ALSO ALL THIRD PARTY ORGANIZATIONS THAT WORK ON BEHALF OF THE MEDICAL CENTER IN PERFORMING COLLECTIONS HAVE ALSO BEEN EDUCATED ON THE CHARITY CARE POLICY AND CAN ALSO ADVISE PATIENTS ON APPLYING FOR THIS BENEFIT.
PART VI, LINE 4: SMC-SJS IS LOCATED IN POTTSVILLE, PENNSYLVANIA. THE MEDICAL CENTER SERVES ALL OF SCHUYLKILL COUNTY. SCHUYLKILL COUNTY IS A RURAL COUNTY IN PENNSYLVANIA. POTTSVILLE IS THE LARGEST POPULATION CENTER OF SCHUYLKILL COUNTY AND IS ALSO THE COUNTY SEAT. THE COUNTY IS COMPRISED OF ONE SMALL CITY AS WELL AS SEVERAL BOROUGHS AND TOWNSHIPS.THE POPULATION OF THE COUNTY IS APPROXIMATELY 147,000. APPROXIMATELY 20% OF THE POPULATION IS UNDER THE AGE OF 18 AND 18% IS OVER THE AGE OF 65. THE POPULATION IS 49% FEMALE AND 95% WHITE. APPROXIMATELY 14% OF THE POPULATION HAS A BACHELOR'S DEGREE OR HIGHER. 11.8% OF THE POPULATION IS BELOW THE POVERTY LEVEL. THE UNEMPLOYMENT RATE IS 9.3%.19% OF THE POPULATION IS INSURED BY MEDICAID. 42% OF THAT NUMBER ARE UNDER THE AGE OF 18, 13% ARE OVER THE AGE OF 65 AND 18 % ARE DISABLED. 50% OF THE BIRTHS ARE COVERED BY THE MEDICAID PROGRAM.IN A RECENT REPORT RELEASED BY THE ROBERT WOOD JOHNSON FOUNDATION AND THE UNIVERSITY OF WISCONSIN'S POPULATION HEALTH INSTITUTE, SCHUYLKILL COUNTY WAS RANKED THE 56TH HEALTHIEST OF THE 67 COUNTIES IN PENNSYLVANIA. SCHUYLKILL COUNTY HAD HIGHER THAN THE STATE AND NATIONAL RATES FOR SMOKING, OBESITY, EXCESSIVE DRINKING AND MOTOR VEHICLE CRASH DEATH RATES. THIS REPORT ALSO SHOWED THAT THE COUNTY HAD ACCESS TO FEWER PRIMARY CARE PHYSICIANS.THE DEMOGRAPHICS OF THE PATIENTS ADMITTED TO SMC-SJS ARE 41 % MEDICARE, 24% MEDICAID AND 3% SELF PAY. EMERGENCY PATIENTS AT SMC-SJS ARE 14% MEDICARE, 25% MEDICAID AND 11% SELF PAY.SCHUYLKILL COUNTY HAS FOUR HOSPITALS SERVING THE COUNTY. SMC-SJS AND SCHUYLKILL MEDICAL CENTER - EAST NORWEGIAN STREET ARE BOTH LOCATED IN POTTSVILLE AND SERVE THE MAJORITY OF THE COUNTY RESIDENTS. NORTHERN SCHUYLKILL COUNTY AND ST. LUKE'S MINERS MEMORIAL HOSPITAL ARE LOCATED IN COALDALE NEAR THE CARBON COUNTY BORDER.
PART VI, LINE 5: THE BOARD OF SMC - SJS IS COMPRISED OF SEVENTEEN INDIVIDUALS FROM THE SCHUYLKILL COUNTY COMMUNITY. THESE INDIVIDUALS ARE NOT EMPLOYED BY THE MEDICAL CENTER. THEY ARE INVOLVED IN EDUCATION, SOCIAL SERVICES, GERIATRIC SERVICES, MATERNAL/CHILD SERVICES, PRIMARY MEDICAL CARE, CRIMINAL JUSTICE, SMALL BUSINESS AND MANUFACTURING. ALL PHYSICIANS ARE ENCOURAGED TO APPLY FOR MEDICAL STAFF PRIVILEGES FOR THE MEDICAL CENTER.SMC-SJS ALSO WORKS WITH VARIOUS COMMUNITY ORGANIZATIONS TO HELP IDENTIFY COMMUNITY NEEDS AND WORK TOGETHER TO MEET THOSE NEEDS. THE MEDICAL CENTER HAS INPATIENT ADOLESCENT AND ADULT BEHAVIORAL HEALTH SERVICES AVAILABLE TO THE RESIDENTS OF SCHUYLKILL COUNTY. THIS ALLOWS COUNTY RESIDENTS TO OBTAIN NECESSARY INPATIENT CARE WITHIN THE COUNTY WITHOUT REQUIRING FAMILIES TO TRAVEL OUTSIDE OF THE COUNTY. THE MEDICAL CENTER ALSO HAS A CERTIFIED DIABETES EDUCATOR AVAILABLE TO CONSULT WITH PATIENTS AND ALSO WITH PHYSICIANS WHEN THEY HAVE A PATIENT THAT IS NEWLY DIAGNOSED WITH DIABETES. THE MEDICAL CENTER IS ALSO THE ONLY FACILITY IN THE COUNTY WITH A MATERNITY DEPARTMENT AND NEWBORN NURSERY. THIS ALLOWS COUNTY RESIDENTS TO REMAIN IN THE COUNTY FOR MATERNITY CARE. MORE THAN 50% OF THE BIRTHS EACH YEAR ARE MEDICAID.THE EMERGENCY DEPARTMENT OF SMC-SJS IS A 24 HOUR EMERGENCY ROOM AVAILABLE TO ALL REGARDLESS OF THEIR ABILITY TO PAY. THE MEDICAL CENTER PARTICIPATES IN MANY INSURANCE PROGRAMS SUCH AS MEDICARE, MEDICAID, CHAMPUS AND VA. THE MEDICAL CENTER ALSO HAS A CHARITY CARE POLICY THAT PROVIDES ASSISTANCE TO ELIGIBLE INDIVIDUALS IN PROVIDING FREE OR DISCOUNTED CARE BASED ON THEIR ABILITY TO PAY AND THE FEDERAL POVERTY GUIDELINES.SMC-ENS ALSO PROVIDES OPPORTUNITIES TO STUDENTS IN HEALTHCARE FIELDS TO GAIN EXPERIENCE WORKING IN THE HEALTH CARE ENVIRONMENT SUCH AS NURSING STUDENTS (RN AND LPN), PHARMACY STUDENTS, PHYSICIAN ASSISTANT STUDENTS, PHYSICAL THERAPY STUDENTS, RADIOLOGY TECHNICIANS AND MEDICAL ASSISTANTS. THE MEDICAL CENTER ALSO PROVIDES A VOLUNTEER PROGRAM FOR JUNIOR HIGH AND HIGH SCHOOL STUDENTS TO BECOME FAMILIAR WITH THE MEDICAL SERVICES OFFERED AND THE EDUCATIONAL OPPORTUNITIES AVAILABLE WITHIN THE HEALTHCARE ENVIRONMENT.THE MEDICAL CENTER ALSO SPONSORS AND PARTICIPATES IN HEALTH FAIRS AT COMMUNITY EVENTS SUCH AS THE COUNTY FAIR, EVENTS AT THE LOCAL MALL, HEALTH SCREENINGS, BLOOD PRESSURE SCREENINGS, VETERAN'S BREAKFAST EVENT, MEALS ON WHEELS, SKIN CANCER SCREENINGS, MAMMOGRAPHY SCREENINGS, BLOOD PRESSURE CLINICS, SUPPORT GROUPS AND LOCAL AMERICAN CANCER SOCIETY RELAY FOR LIFE.ANY EXCESS FUNDS THAT ARE GENERATED FROM OPERATIONS ARE INVESTED BACK INTO THE MEDICAL CENTER BY PURCHASING NECESSARY CAPITAL EQUIPMENT, FUNDING CAPITAL IMPROVEMENT PROJECTS, FUNDING NEW SERVICES, IMPROVING AND EXPANDING EXISTING SERVICES AND ANY OTHER GENERAL IMPROVEMENTS TO PATIENT CARE.
PART VI, LINE 6: ON AUGUST 1, 2008, SMC-SJS AND SMC-ENS AFFILIATED UNDER THE CONTROL OF SCHUYLKILL HEALTH SYSTEM, THE PRIMARY SERVICE AREA IS POTTSVILLE AND THE SURROUNDING COMMUNITIES IN SCHUYLKILL COUNTY. THE PURPOSE OF BOTH MEDICAL CENTERS IS TO ENGAGE IN ACTIVITIES RELATED TO THE PROMOTION OF HEALTH OF THE PEOPLE IN THE SERVICE AREA, WORK CHARITABLY TO PROMOTE COMMUNITY HEALTH EDUCATION, PREVENTION OF ILLNESS AND INJURY AND PROVISION OF MEDICAL SERVICES TO THE DIVERSE POPULATION OF THE SERVICE AREA AND ENGAGE IN ANY AND ALL ACTIVITIES CONSISTENT WITH OR IN FURTHERANCE OF THESE PURPOSES.EACH MEDICAL CENTER OPERATES INDEPENDENTLY OF EACH OTHER BUT WORKS IN SYNC WITH EACH OTHER IN PROVIDING HEALTHCARE SERVICES TO THE RESIDENTS OF SCHUYLKILL COUNTY. BOTH MEDICAL CENTERS HAVE WORKED TO PROVIDE A CONTINUUM OF CARE SO THAT HEALTHCARE IS AVAILABLE WITHIN THE COUNTY AND RESIDENTS DO NOT HAVE TO TRAVEL OUTSIDE OF THE COUNTY FOR CARE. THE FOLLOWING SERVICES ARE AVAILABLE AT EITHER SMC-SJS OR SMC-ENS: - ACUTE CARE /MEDICAL SURGICAL SERVICES- INTENSIVE CARE SERVICES- MATERNITY SERVICES- NEWBORN SERVICES- PEDIATRICS SERVICES- ADOLESCENT, ADULT AND GERIATRIC BEHAVIORAL SERVICES- ACUTE REHAB AND TRANSITIONAL REHAB SERVICES- INPATIENT AND OUTPATIENT PHYSICAL THERAPY- INPATIENT AND OUTPATIENT DIAGNOSTIC SERVICES- HOME HEALTH SERVICES- OUTPATIENT DRUG AND ALCOHOL SERVICES- OUTPATIENT BEHAVIORAL HEALTH SERVICES- 24 HOUR EMERGENCY ROOM SERVICES- OUTPATIENT DENTAL CLINIC- INPATIENT AND OUTPATIENT SURGICAL SERVICES- COMMUNITY BENEFIT/CHARITY CARE SERVICES- ADVANCE WOUND CARE - OUTPATIENT SURGERY CENTERSCHUYLKILL MEDICAL GROUP IS AN ORGANIZATION FORMED IN WHICH PHYSICIANS WOULD BE ABLE TO OPEN THEIR OWN PRACTICE BUT NOT INCUR ALL THE EXPENSES THAT THEY WOULD HAD THEY OPENED A PRACTICE ON THEIR OWN. THIS WAS DONE SO THAT MORE PHYSICIANS WOULD BE AVAILABLE TO THE PUBLIC IN THIS AREA. WITHOUT THIS ORGANIZATION THESE PHYSICIANS MAY BE PRACTICING IN A DIFFERENT AREA.SCHUYLKILL HEALTH SYSTEM IS AN ORGANIZATION FORMED TO RAISE FUNDS TO PROVIDE TO BOTH SMC - EAST AND SMC - SOUTH. THE MONEY RAISED IN THIS ORGANIZATION IS USED TO BENEFIT THE COMMUNITY IN VARIOUS WAYS. MONEY FROM THIS ORGANIZATION IS USED TO PURCHASE EQUIPMENT TO MAKE THE PUBLIC SAFER. IT IS ALSO USED TO FUND PROJECTS THAT WILL MAKE HEALTH CARE ACCESS EASIER TO THE PUBLIC. SCHUYLKILL REHAB IS AN ORGANIZATION WHO OFFERS REHABILITATION SERVICES TO THE PUBLIC. ONE SERVICE THAT THEY OFFER THAT BENEFITS THE PUBLIC ARE SEVERAL DIFFERENT PROGRAMS EACH YEAR ON HEALTH CARE TOPICS. THESE PROGRAMS ARE OFFERED FREE TO THE PUBLIC.SCHUYLKILL MEDICAL MALL/DEVELOPMENT CORP IS AN ORGANIZATION WHO OWNS AND OPERATES A MEDICAL OFFICE BUILDING NEAR SMC - EAST. THIS BUILDING OFFERS AN AREA FOR PHYSICIANS TO BE ABLE TO RENT SPACE FOR THEIR PRACTICE INSTEAD OF HAVING TO PURCHASE THEIR OWN SPACE.PART VI, LINE 7: N/A

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Written Employment Contract	X	WrittenEmploymentContract
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	0	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	0	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)

TitleTitle	Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
JOHN E SIMODEJKA
PRESIDENT/CEO	465081	0	0	0	0	0	6125	0	17743	0	488949	0	0	0
DARNELL FURER
VP NURSING/CNO	0	175335	0	0	0	0	0	4509	0	15350	0	195194	0	0
RICHARD BINDIE
DIRECTOR OF PATHOLOGY	273190	0	0	0	0	0	6125	0	15707	0	295022	0	0	0
LYNDA L JAKUBCO
CRNA	226107	0	0	0	0	0	6590	0	15428	0	248125	0	0	0
JULIANNE M TIDMORE
CRNA	223233	0	0	0	0	0	6915	0	16598	0	246746	0	0	0
MARY R TUNNESSEN
CRNA	212031	0	0	0	0	0	6520	0	15428	0	233979	0	0	0
SHERRY L BURINSKY BOTTOR
CRNA	246247	0	0	0	0	0	7350	0	16598	0	270195	0	0	0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
NEW PROGRAM SERVICES	FORM 990, PART III, LINE 2	PEDIATRIC GASTROENTEROLOGY SERVICES ARE NOW AVAILABLE AT SOUTH JACKSON STREET OUTPATIENT SURGERY CENTER FOR CHILDREN AGES TWO AND OLDER.
	FORM 990, PART VI, SECTION A, LINE 3	THE HOSPITAL HAS DELEGATED MANAGEMENT DUTIES OVER THE FOLLOWING SERVICES: * DIETARY SERVICES TO SODEXHO INC. AND AFFILIATES, * BIOMED SERVICES TO ARAMARK, AND * REHAB CARE TO SOUTH TRU.
	FORM 990, PART VI, SECTION B, LINE 11	THE FORM 990 IS REVIEWED BY MANAGEMENT PRIOR TO ITS FILING WITH THE INTERNAL REVENUE SERVICE. SELECTED MEMBERS OF THE BOARD REVIEWED THE 990 WITH THE TAX RETURN PREPARER AND MANAGEMENT ON BEHALF OF THE BOARD.
	FORM 990, PART VI, SECTION B, LINE 12C	EACH OFFICER, KEY EMPLOYEE, DIRECTOR OR TRUSTEE WITH BOARD DELEGATED AUTHORITY IS REQUIRED TO ANNUALLY SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT. THESE STATEMENTS ARE REVIEWED BY THE PRESIDENT/CEO'S ADMINISTRATIVE ASSISTANT AND ANY CONFLICTS ARE REPORTED TO THE PRESIDENT/CEO. THE STATEMENTS ARE KEPT ON FILE IN THE PRESIDENT/CEO'S OFFICE AFTER REVIEW. BOARD MEMBERS ARE EXPECTED TO EXCUSE THEMSELVES FROM TAKING ANY ACTION OR EVEN DISCUSSING ISSUES OF RELATED PARTIES. IF THEY VIOLATE THESE RULES THEY ARE REMOVED FROM THE BOARD.
	FORM 990, PART VI, SECTION B, LINE 15	ANNUALLY, THE ORGANIZATION CONTRACTS WITH YAFFE AND COMPANY, AN INDEPENDENT CONSULTANT, TO MAKE RECOMMENDATIONS TO THE COMPENSATION COMMITTEE, A SUB COMMITTEE OF THE BOARD, BASED ON MARKET AND INDUSTRY DATA TO ENSURE COMPENSATION DOES NOT EXCEED FAIR MARKET VALUE. THIS PROCESS IS USED FOR THE FOLLOWING POSITIONS: PRESIDENT/CEO, VICE PRESIDENT OF OPERATIONS/COO, VICE PRESIDENT OF NURSING/CNO AND THE VICE PRESIDENT OF FINANCE/CFO. THIS REVIEW AND APPROVAL PROCESS IS DOCUMENTED VIA COMMITTEE MINUTES.
	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.
OTHER FEES	FORM 990, PART IX, LINE 11G	PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 1,664,275. MANAGEMENT AND GENERAL EXPENSES 414,250. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,078,525. CONSULTING FEE: PROGRAM SERVICE EXPENSES 153,597. MANAGEMENT AND GENERAL EXPENSES 265,902. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 419,499. MAINTENANCE SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 1,288,089. MANAGEMENT AND GENERAL EXPENSES 798,609. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,086,698. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,084,098. MANAGEMENT AND GENERAL EXPENSES 178,240. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,262,338. REFERRED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 1,229,278. MANAGEMENT AND GENERAL EXPENSES 7,416. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,236,694. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 437,873. MANAGEMENT AND GENERAL EXPENSES 1,304,898. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,742,771. ASSESSMENT FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,279,382. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,279,382.
CHANGES IN NET ASSETS OR FUND BALANCES:	FORM 990, PART XI, LINE 9:	PENSION LIABILITY ADJUSTMENT 5,983,191. POSTRETIREMENT BENEFIT LIABILITY ADJUSTMENT 146,407. VALUATION GAIN 418,644.
	STATEMENT PURSUANT TO SECTION 1.351-3(A):	STATEMENT PURSUANT TO SECTION 1.351-3(A) BY SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET 23-1352202 (1) NAME AND EMPLOYER IDENTIFICATION NUMBER OF THE TRANSFEREE CORPORATION: NAME: SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET EIN: 23-1352202 (2) DATE(S) OF TRANSFER(S) OF ASSETS: TRANSFER DATE(S): 03/01/2013 (3) AGGREGATE FAIR MARKET VALUE AND BASIS OR PROPERTY TRANSFERRED: FAIR MARKET VALUE: $100,000 BASIS: $100,000 (4) DATE AND CONTROL NUMBER OF PRIVATE LETTER RULING(S) ISSUED BY THE IRS IN CONNECTION WITH THE EXCHANGE: DATE(S) AND CONTROL NUMBER(S): NONE

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg	Direct Controlling Entity NADirectControllingEntityNA
SCHUYLKILL REHABILITATION CENTER INC
420 SOUTH JACKSON STREET	POTTSVILLE	PA	17901	232440891	OPERATES A COMPREHENSIVE REHABILITATION FACILITY	PA	501(C)(3)	3	SCHUYLKILL HEALTH SYSTEM	0
SCHUYLKILL MEDICAL CENTER - EAST NORWEGIAN STREET
700 EAST NORWEGIAN STREET	POTTSVILLE	PA	17901	230880420	OPERATES A HOSPITAL PROVIDING INPATIENT, OUTPATIENT & EMERGENCY SVCS	PA	501(C)(3)	3	SCHUYLKILL HEALTH SYSTEM	0
SCHUYLKILL HEALTH SYSTEM MEDICAL GROUP INC
700 EAST NORWEGIAN STREET	POTTSVILLE	PA	17901	232866006	TO SUPPORT AND PROMOTE THE PURPOSES OF AFFILIATED ENTITIES	PA	501(C)(3)	9	SCHUYLKILL HEALTH SYSTEM	0
SCHUYLKILL HEALTH SYSTEM
420 SOUTH JACKSON STREET	POTTSVILLE	PA	17901	262990543	TO SUPPORT, PROMOTE, ADVANCE & ENHANCE QUALITY OF LIFE OF SCHUYLKILL CNTY	PA	501(C)(3)	11B		0	N/A

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

Field	Value	IRS element (for citing)
Business Name Line1	SCHUYLKILL HEALTH SYSTEM MEDICAL MALL LP	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	EAST NORWEGIAN TREMONT STREETS	AddressLine1
City	POTTSVILLE	City
State	PA	State
ZIP Code	17901	ZIPCode

Field	Value	IRS element (for citing)
EIN	232514813	EIN
Primary Activity	RENTAL	PrimaryActivity
Legal Domicile State	PA	LegalDomicileState
Direct Controlling Entity NA	N/A	DirectControllingEntityNA

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Direct Controlling Entity NADirectControllingEntityNA	Type Of EntityTypeOfEntity	Controlled OrgControlledOrg
SCHUYLKILL HEALTH SYSTEM DEVELOPMENT CORPORATION
700 EAST NORWEGIAN STREET	POTTSVILLE	PA	17901	232432417	PURSUES, IMPLEMENTS & FURTHERS THE ACTVTIES & PURPOSES OF THE SYS	PA	N/A	C	0
SCHUYLKILL MEDICAL PLAZA - CONDOMINIUM ASSOCIATION
420 SOUTH JACKSON STREET	POTTSVILLE	PA	17901	232931821	CONDOMINIUM ASSOCIATION	PA	N/A	C	0

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	0	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	1	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Dividends Related Organization	0	DividendsRelatedOrganization
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	0	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	0	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	0	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	1	PerformOfServicesByOtherOrgs
Sharing Of Facilities	1	SharingOfFacilities
Sharing Of Paid Employees	1	SharingOfPaidEmployees
Reimbursement Paid To Other Org	1	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	1	OtherTransferToOtherOrg
Other Transfer From Other Org	1	OtherTransferFromOtherOrg