THE GOOD SAMARITAN HOSPITAL OF LEBANON PENNSYLVANIA: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: THE GOOD SAMARITAN HOSPITAL OF LEBANON PENNSYLVANIA (EIN 23-0794160)
Tax period: 2012-07-01 to 2013-06-30
Filed: 2014-05-15
IRS object ID: 201431359349302203
Schema version: 2012v2.3
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 G
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2014-05-15T08:34:26-05:00	Timestamp
Tax Period End Date	2013-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	GRANT THORNTON LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	2001 MARKET STREET SUITE 700	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	230794160	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Good Samaritan Hospital	BusinessNameLine1

Field	Value	IRS element (for citing)
In Care Of Name	% ROBERT J RICHARDS	InCareOfName
Name Control	GOOD	NameControl
Phone	7172707500	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO Box 1281 4th Walnut Streets	AddressLine1
Address Line2	Suite	AddressLine2
City	Lebanon	City
State	PA	State
ZIP Code	170421281	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	Robert Richards	Name
Title	CFO	Title
Phone	7172707864	Phone
Date Signed	2014-05-13	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	Frank Giardini	Name
Phone	2155614200	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	Robert J Longo	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	4th walnut Streets	AddressLine1
City	Lebanon	City
State	PA	State
ZIP Code	170421281	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	190762621	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	www.gshleb.org	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1989	YearFormation
State Legal Domicile	PA	StateLegalDomicile
Activity Or Mission Description	To provide high-quality, compassionate healthcare that improves the overall health of our community.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	18	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	13	NbrIndependentVotingMembers
Total Nbr Employees	1535	TotalNbrEmployees
Total Nbr Volunteers	385	TotalNbrVolunteers
Total Gross UBI	4154875	TotalGrossUBI
Net Unrelated Business Txbl Income	269780	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	1579559	ContributionsGrantsPriorYear
Contributions Grants Current Year	3433131	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	171916754	ProgramServiceRevenuePriorYear
Program Service Revenue CY	173975259	ProgramServiceRevenueCY
Investment Income Prior Year	1169472	InvestmentIncomePriorYear
Investment Income Current Year	1821436	InvestmentIncomeCurrentYear
Other Revenue Prior Year	5129572	OtherRevenuePriorYear
Other Revenue Current Year	6872248	OtherRevenueCurrentYear
Total Revenue Prior Year	179795357	TotalRevenuePriorYear
Total Revenue Current Year	186102074	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	22900	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	9573550	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	73825335	SalariesEtcPriorYear
Salaries Etc Current Year	77743685	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	104362084	OtherExpensePriorYear
Other Expenses Current Year	108582766	OtherExpensesCurrentYear
Total Expenses Prior Year	178210319	TotalExpensesPriorYear
Total Expenses Current Year	195900001	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	1585038	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	-9797927	RevenuesLessExpensesCY
Total Assets BOY	144414767	TotalAssetsBOY
Total Assets EOY	141426575	TotalAssetsEOY
Total Liabilities BOY	150978640	TotalLiabilitiesBOY
Total Liabilities EOY	135544512	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	-6563873	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	5882063	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	The mission of Good Samaritan Health System is to provide high-quality, compassionate healthcare that improves the overall health of our community. To fulfill this mission, Good Samaritan has focused its efforts on making your community hospital one of the top performing hospitals in the nation with advanced, high-quality care that also cares about the residents of Lebanon County.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	170762963	Expense
Grants	9573550	Grants
Revenue	169817384	Revenue
Description	Inpatient/Outpatient Services Rehabilitation Unit - The GSH operates a 14 bed rehabilitation unit providing a full range of basic services required by an acute care rehab program including physical therapy, speech therapy, occupational therapy, social services and audiology. FY 6/30/13 Statistics: Rehab Admissions and Rehab Patient Days. Skilled Nursing Facility - The GSH operates a 19 bed transitional care unit providing a full range of basic services required by a hospital based skilled nursing facility, including physical therapy, speech therapy, occupational therapy, social services and audiology. Fy 6/30/13 Statistics: TCU Admissions and TCU Patient Days. Home Health/Visiting Nurse Program The GSH operates Home Health/Visiting nurse association providing a full range of in-home care including IV Therapy, Maternal/Infant Care, Hospice, Physical Therapy, Speech Therapy, Occupational Therapy, Nutritional Therapy, Social Services and Home Health Aides.	Description
Total Program Service Expense	170762963	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	true	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	true	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	true	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	true	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	true	ReportFin48Footnote
Independent Audit Financial Stmt	true	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	true	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	true	FundraisingActivities
Gaming	false	Gaming
Hospital	true	Hospital
Financial Stmt Attached	true	FinancialStmtAttached
Grants To Organizations	true	GrantsToOrganizations
Grants To Individuals	true	GrantsToIndividuals
Schedule J Required	true	ScheduleJRequired
Tax Exempt Bonds	true	TaxExemptBonds
Invest Tax Exempt Bonds	false	InvestTaxExemptBonds
Escrow Account	false	EscrowAccount
On Behalf Of Issuer	false	OnBehalfOfIssuer
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	true	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	true	RelatedOrgControlledEntity
Transaction Related Entity	true	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	true	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	101	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	1535	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	true	UnrelatedBusinessIncome
Form990-T Filed	true	Form990-TFiled
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	false	QuidProQuoContributions
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	18	NbrVotingGoverningBodyMembers
Number Independent Voting Members	13	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	true	MembersOrStockholders
Election Of Board Members	true	ElectionOfBoardMembers
Decisions Subject To Approval	true	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	false	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	ROBERT J RICHARDS	NamePerson
Telephone Number	7172707500	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	241 SOUTH FOURTH STREET	AddressLine1
City	Lebanon	City
State	PA	State
ZIP Code	170421281	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (29 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Average Hours Per Week RelatedAverageHoursPerWeekRelated	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee
John P Welch MD
Chairman	1.0	1.0	X	X	0	0	0
Dennis L Shalters
Past Chairman	1.0	1.0	X	X	0	0	0
Donald H Dreibelbis
First Vice Chairman	1.0	1.0	X	X	0	0	0
Robert J Funk
Second Vice Chairman	1.0	1.0	X	X	0	0	0
Jane W Juppenlatz
Secretary	1.0	1.0	X	X	0	0	0
Frederick S Wolfson
Treasurer	1.0	1.0	X	X	0	0	0
Carol Blecker
Trustee	1.0	1.0	X		0	0	0
Evelyn C Colon
Trustee	1.0	1.0	X		0	0	0
Paul R DiGiacomo MD
Trustee	1.0	1.0	X		0	0	0
Robert P Hoffman
Trustee	1.0	1.0	X		0	0	0
Frederick C Laurenzo
Trustee	1.0	1.0	X		0	0	0
Robert J Phillips
Trustee	1.0	1.0	X		0	0	0
William E Schaeffer Jr MD
Trustee	1.0	1.0	X		0	0	0
Galen G Weaber
Trustee	1.0	1.0	X		0	0	0
Deborah T Weaver
Trustee	1.0	1.0	X		0	0	0
Gregory S Wickey MD
Trustee	1.0	1.0	X		0	0	0
Julie Zinsser
Trustee	1.0	1.0	X		0	0	0
Robert J Longo
President & CEO	40.0	20.0	X	X	493398	0	25745
Kimberly Feeman
Senior VP & COO	40.0	15.0		X	295362	0	18917
Robert J Richards
VP Finance & CFO	40.0	19.0		X	290657	0	19605
Jacquelyn M Gould
VP of Nursing	40.0	15.0			195204	0	13506	X
Julie Miksit
VP CV SVCS & Rehab Therapies	40.0	10.0			168774	0	13827	X
Robert Shaver
VP Medical Affairs	40.0				340088	0	3185	X
William Mulligan
VP Strategic Planning	40.0				148262	0	22074	X
Daria Kovarikova
Residency Physician	40.0				191301	0	3055		X
Aaron Lane
Residency Physician	40.0				186991	0	1561		X
Elizabeth Muhiire-Ntaki
Residency Physician	40.0				182400	0	2230		X
Byard Yoder
Residency Physician	40.0				169105	0	16713		X
Richard Follett
Chief Information Officer	40.0				175493	0	23150		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	2837035	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	163568	TotalOtherCompensation
Number Individuals GT100 K	39	NumberIndividualsGT100K
Formers Listed	false	FormersListed
Total Comp GT150 K	true	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
MCKESSON TECHNOLOGIES
PO Box 98347	CHICAGO	IL	606938347	IT Support	3735893
LEBANON ANESTHESIA ASSOC LTD
PO Box 1281	LEBANON	PA	17042	Anesthesiologists	3391734
LEBANON CARDIOLOGY ASSOCIATES
775 Norman Drive	LEBANON	PA	17042	Cardiologists	2205170
SODEXO OPERATIONS LLC
PO Box 360170	PITTSBURGH	PA	152516170	Dietary MGMT service	1420952
REHAB CARE GROUP INC
PO Box 502096	ST LOUIS	MO	631502096	Rehab Mgmt Services	1190170

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	110	NumberOfContractorsGT100K
Fundraising Events	50450	FundraisingEvents
Related Organizations	30000	RelatedOrganizations
Government Grants	169454	GovernmentGrants
All Other Contributions	3183227	AllOtherContributions
Total Contributions	3433131	TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue
PATIENT SERVICE REVENUE	900099	173674711	169519836	4154875
LABORATORY REVENUE	900099	162489	162489
HEALTH PROGRAMS	900099	117328	117328
PHARMACY SALES	900099	20731	20731

Field	Value	IRS element (for citing)
Total Program Service Revenue	173975259	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	1311160	TotalRevenueColumn
Exclusion	$1,311,160	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

Field	Value	IRS element (for citing)
Total Revenue Column	71276	TotalRevenueColumn
Exclusion	$71,276	ExclusionAmount

Royalties Revenue RoyaltiesRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	523717	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	523717	Real
Personal	0	Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	523717	TotalRevenueColumn
Exclusion	$523,717	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	5055547	Securities
Other	44000	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	4660547	Securities

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	395000	Securities
Other	44000	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	439000	TotalRevenueColumn
Exclusion	$439,000	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	19600	GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events	50450	CntrbtnsRprtdFundraisingEvents

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	19600	TotalRevenueColumn
Exclusion	$19,600	ExclusionAmount

Net Income From Gaming NetIncomeFromGaming

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount
MEANINGFUL USE	900099	2564000	$2,564,000
MALPRACTICE INSURANCE	524298	1564530	$1,564,530
SNACK BAR/CAFE	722511	600988	$600,988

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	1599413	TotalRevenueColumn
Exclusion	$1,599,413	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	6328931	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	186102074	TotalRevenueColumn
Related Or Exempt Function Income	169820384	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	4154875	UnrelatedBusinessRevenue
Exclusion	$8,693,684	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	9551000	Total
Program Services	9551000	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	22550	Total
Program Services	22550	ProgramServices

Foreign Grants ForeignGrants

Field	Value	IRS element (for citing)
Total	0	Total

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	0	Total

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	3288844	Total
Management And General	3288844	ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	55288417	Total
Program Services	46995154	ProgramServices
Management And General	8293263	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	7253564	Total
Program Services	6165529	ProgramServices
Management And General	1088035	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	7699070	Total
Program Services	6544209	ProgramServices
Management And General	1154861	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	4213790	Total
Program Services	3581721	ProgramServices
Management And General	632069	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	607321	Total
Management And General	607321	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	218006	Total
Management And General	218006	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	8442	Total
Management And General	8442	ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	603057	Total
Management And General	603057	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	8637165	Total
Program Services	7341590	ProgramServices
Management And General	1295575	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	1080174	Total
Program Services	918148	ProgramServices
Management And General	162026	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	1388612	Total
Program Services	1180320	ProgramServices
Management And General	208292	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	0	Total

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	2679007	Total
Program Services	2277156	ProgramServices
Management And General	401851	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	60423	Total
Program Services	51360	ProgramServices
Management And General	9063	ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

Field	Value	IRS element (for citing)
Total	0	Total

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	0	Total

Interest Interest

Field	Value	IRS element (for citing)
Total	3904304	Total
Program Services	3318658	ProgramServices
Management And General	585646	ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	9855475	Total
Program Services	8377154	ProgramServices
Management And General	1478321	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	2131434	Total
Program Services	1811719	ProgramServices
Management And General	319715	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
MEDICAL SUPPLIES	30675904	30675904
BAD DEBT	14849102	14849102
PURCHASED SERVICES	26591137	22602466	3988671
UNRELATED BUSINESS TAXES	3203868	2723288	480580

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	2089335	Total
Program Services	1775935	ProgramServices
Management And General	313400	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	195900001	Total
Program Services	170762963	ProgramServices
Management And General	25137038	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	5220	BOY
EOY	5601	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	2272501	BOY
EOY	1025060	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	1029573	BOY
EOY	2378611	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	18637951	BOY
EOY	19078552	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	1130188	BOY
EOY	770817	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	1686147	BOY
EOY	1458540	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	2851253	BOY
EOY	2448490	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	187534014	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	123844065	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	69587218	BOY
EOY	63689949	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	35437714	BOY
EOY	38777746	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	2269669	BOY
EOY	2269669	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	9507333	BOY
EOY	9523540	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	144414767	BOY
EOY	141426575	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	17950772	BOY
EOY	20216970	EOY

Grants Payable GrantsPayable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	82000	BOY
EOY	0	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	63955676	BOY
EOY	62583286	EOY

Escrow Account Liability EscrowAccountLiability

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Loans From Officers Directors LoansFromOfficersDirectors

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	2687442	BOY
EOY	4042313	EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	66302750	BOY
EOY	48701943	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	150978640	BOY
EOY	135544512	EOY

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

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	-9283282	BOY
EOY	1808407	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	2047232	BOY
EOY	3385178	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	672177	BOY
EOY	688478	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	-6563873	BOY
EOY	5882063	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	144414767	BOY
EOY	141426575	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	-9797927	ReconcilationRevenueExpenses
Reconciliation Unrealized Invest	1836590	ReconciliationUnrealizedInvest
Reconcilation Prior Adjustment	-1000	ReconcilationPriorAdjustment
Reconcilation Other Changes	20408273	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Both	X	FinancialStatementBoth

Field	Value	IRS element (for citing)
Audit Committee	true	AuditCommittee

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)
Total Grassroots Lobbying		TotalGrassrootsLobbying
Total Direct Lobbying		TotalDirectLobbying
Total Lobbying Expenditures		TotalLobbyingExpenditures
Other Exempt Purpose Expenditures		OtherExemptPurposeExpenditures
Total Exempt Purpose Expenditures		TotalExemptPurposeExpenditures
Lobbying Nontaxable		LobbyingNontaxableAmount
Grassroots Nontaxable		GrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non Tx		TotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying Nontx		TotLobbyExpendMnsLobbyingNontx
Volunteers	false	Volunteers
Paid Staff Or Management	false	PaidStaffOrManagement
Media Advertisements	false	MediaAdvertisements
Mailings Members	false	MailingsMembers
Publications Or Broadcast	false	PublicationsOrBroadcast
Grants Other Organizations	false	GrantsOtherOrganizations
Direct Contact Legislators	false	DirectContactLegislators
Rallies Demonstrations	false	RalliesDemonstrations
Other Activities	true	OtherActivities
Other Activities	$8,442	OtherActivitiesAmount
Total Lobbying Expenditures IIB	8442	TotalLobbyingExpendituresIIB
Not Described In501c3	false	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	Lobbying Activities	Identifier
Return Reference	Schedule C, Part II-B, Line 1G	ReturnReference
Explanation	The Hospital holds membership in the American Hospital Association (AHA) and the Hospital & Health system Association of Pennsylvania (HHAP) both of which engage in lobbying as a part of their mission to represent the interests of the hospitals at both the federal and state levels. For the year end 6/30/13 the amount of dues paid to the HHAP totaled $36,947 of which 22.85 percent $8,442 was used for lobbying purposes. On occasion, HHAP requests the help of member providers to communicate concerns to legislators regarding pending legislation which could impact hospitals. This can involve direct contact with legislators or letter writing. This occurs infrequently and the cost to the hospital is negligible.	Explanation

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amts		ArtPublicExhibitionAmts
Held Works Of Art Amts		HeldWorksOfArtAmts

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	2719409	BeginningOfYearBalance
Contributions	2252267	Contributions
Investment Earnings Or Losses	54351	InvestmentEarningsOrLosses
Other Expenditures	952371	OtherExpenditures
End Of Year Balance	4073656	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	2945233	BeginningOfYearBalance
Contributions	424618	Contributions
Investment Earnings Or Losses	53135	InvestmentEarningsOrLosses
Other Expenditures	703577	OtherExpenditures
End Of Year Balance	2719409	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	3005818	BeginningOfYearBalance
Contributions	834833	Contributions
Investment Earnings Or Losses	26652	InvestmentEarningsOrLosses
Other Expenditures	922070	OtherExpenditures
End Of Year Balance	2945233	EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	3236426	BeginningOfYearBalance
Contributions	458155	Contributions
Investment Earnings Or Losses	36900	InvestmentEarningsOrLosses
Other Expenditures	725663	OtherExpenditures
End Of Year Balance	3005818	EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	3712782	BeginningOfYearBalance
Contributions	-26711	Contributions
Investment Earnings Or Losses	-22884	InvestmentEarningsOrLosses
Other Expenditures	426761	OtherExpenditures
End Of Year Balance	3236426	EndOfYearBalance

Field	Value	IRS element (for citing)
Permanent Endowment EOY Balance	0.24720	PermanentEndowmentEOYBalance
Term Endowment EOY Balance	0.75280	TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs	false	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	false	EndowmentsHeldByRelatedOrgs

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1468847	OtherCostOrOtherBasis
Book Value	1468847	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	90086071	OtherCostOrOtherBasis
Depreciation	42932256	Depreciation
Book Value	47153815	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	5435154	OtherCostOrOtherBasis
Depreciation	4905172	Depreciation
Book Value	529982	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	89843764	OtherCostOrOtherBasis
Depreciation	76006637	Depreciation
Book Value	13837127	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	700178	OtherCostOrOtherBasis
Depreciation	0	Depreciation
Book Value	700178	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	63689949	TotalOfBookValueLandBuildings

Other Assets OtherAssets (7 entries)

DescriptionDescription	Book ValueBookValue
DEBT SERVICES FUND NON-CURRENT	5649885
MALPRACTICE INS RECEIVABLE	2033239
DEFERRED BOND INSURANCE COST	568298
INTERCOMPANY RECEIVABLES	504075
OTHER RECEIVABLES	389425
DUE FROM FOUNDATION	271402
DUE FROM EMP/STAFF/PHY	107216

Field	Value	IRS element (for citing)
Total Book Value Other Assets	9523540	TotalBookValueOtherAssets
Federal Income Tax Liability	0	FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (8 entries)

DescriptionDescription	AmountAmount
PENSION LIABILITY	$36,707,967
POST RETIREMENT BENEFITS	$2,574,515
3RD PARTY PAYABLES	$1,678,558
INSURANCE RESERVES	$3,853,163
ANNUITY PAYABLE	$876,310
EMPLOYEE W/H PAYABLE	$423,530
INTEREST PAYABLE	$478,336
DUE TO OTHER	$2,109,564

Field	Value	IRS element (for citing)
Total Of Amounts	48701943	TotalOfAmounts
Footnote In Part XIII	X	FootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt	183153778	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	1836590	NetUnrealizedGainsInvestments
Other Revenues	-4784886	OtherRevenues
Revenue Not Rptd F990	-2948296	RevenueNotRptdF990
Revenue Subtotal	186102074	RevenueSubtotal
Total Revenue Per Form990	186102074	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	170706842	TotExpensesEtcAuditedFinclStmt
Expenses Subtotal	170706842	ExpensesSubtotal
Other Expenses Not Included	25193159	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	25193159	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	195900001	TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (4 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Endowment Funds	Schedule D, Part V, Line 4	The Good Samaritan Hospital maintains temporarily restricted and permanently restricted assets to purchase specific pieces of equipment and provide qualified applicants a scholarship
Fin 48 (ASC 740) Footnote	Schedule D, Part X, Line 2	In the course of preparing the Hospital's tax returns, the Hospital evaluates tax positions taken or expected to be taken to determine whether the tax positions are "more-likely-than-not" of being sustained by the applicable tax authorities. Tax positions not deemed to meet the more-likely-than-not threshold are recorded as tax benefits or expenses in the current year. Management has analyzed all tax positions taken on federal, state, and local income tax returns for all open tax years and has concluded that no provision for federal income tax is required in the financial statements. There are no interest and penalties deducted in the current period and no interest and penalties accrued at June 30, 2013.
Reconciliation of Revenue	Part XI, Line 2d	Provision for doubtful accounts $(14,849,102) Investment management fees (603,057) Other than Temp decline in FMV of Investments (6,174) Change in Post Retirement Benefits 19,269,157 Transfer to Parent (9,551,000) Physician Loan Amortization (190,000) Change in Pension Obligation 1,145,290 ----------- Total (4,784,886)
Reconciliation of Expenses	Part XII, Line 4b	Provision for doubtful accounts $ 14,849,102 Investment management fees 603,057 Transfer to Parent 9,551,000 Physician Loan Amortization 190,000 ------------ Total 25,193,159

Schedule G IRS990ScheduleG

Events Information EventsInformation

Field	Value	IRS element (for citing)
Name Of Event1	Golf Tournament	NameOfEvent1
Gross Receipts Event1	70050	GrossReceiptsEvent1
Charitable Contributions Event1	50450	CharitableContributionsEvent1
Gross Revenue Event1	19600	GrossRevenueEvent1
Total Number Of Other Events	0	TotalNumberOfOtherEvents
Gross Receipts Total	70050	GrossReceiptsTotal
Charitable Contributions Total	50450	CharitableContributionsTotal
Gross Revenue Total Events	19600	GrossRevenueTotalEvents
Net Income Summary	19600	NetIncomeSummary

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	true	CharityCarePolicy
Written Policy	true	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	true	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	true	FPGReferenceDiscountedCare
Pcent300	X	Pcent300
Free Disc Care Medically Indigent	true	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	true	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	true	ExpensesExceededBudget
Unable To Provide Care	false	UnableToProvideCare
Annual Community Benefit Report	true	AnnualCommunityBenefitReport
Report Publically Available	true	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	932973	TotalCommunityBenefitExpense
Net Community Benefit Expense	932973	NetCommunityBenefitExpense
Percent Of Total Expense	0.00520	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	3820992	TotalCommunityBenefitExpense
Direct Offsetting Revenue	1804130	DirectOffsettingRevenue
Net Community Benefit Expense	2016862	NetCommunityBenefitExpense
Percent Of Total Expense	0.01110	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

Field	Value	IRS element (for citing)
Total Community Benefit Expense	15018562	TotalCommunityBenefitExpense
Direct Offsetting Revenue	7180999	DirectOffsettingRevenue
Net Community Benefit Expense	7837563	NetCommunityBenefitExpense
Percent Of Total Expense	0.04330	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	19772527	TotalCommunityBenefitExpense
Direct Offsetting Revenue	8985129	DirectOffsettingRevenue
Net Community Benefit Expense	10787398	NetCommunityBenefitExpense
Percent Of Total Expense	0.05960	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	33150	TotalCommunityBenefitExpense
Net Community Benefit Expense	33150	NetCommunityBenefitExpense
Percent Of Total Expense	0.00020	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	2330628	TotalCommunityBenefitExpense
Direct Offsetting Revenue	968785	DirectOffsettingRevenue
Net Community Benefit Expense	1361843	NetCommunityBenefitExpense
Percent Of Total Expense	0.00750	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	2363778	TotalCommunityBenefitExpense
Direct Offsetting Revenue	968785	DirectOffsettingRevenue
Net Community Benefit Expense	1394993	NetCommunityBenefitExpense
Percent Of Total Expense	0.00770	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	22136305	TotalCommunityBenefitExpense
Direct Offsetting Revenue	9953914	DirectOffsettingRevenue
Net Community Benefit Expense	12182391	NetCommunityBenefitExpense
Percent Of Total Expense	0.06730	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Total Community Building Expense	28240	TotalCommunityBuildingExpense
Net Community Building Expense	28240	NetCommunityBuildingExpense
Percent Of Total Expense	0.00020	PercentOfTotalExpense

Leadership Development LeadershipDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	41340	TotalCommunityBuildingExpense
Net Community Building Expense	41340	NetCommunityBuildingExpense
Percent Of Total Expense	0.00020	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Total Community Building Expense	69580	TotalCommunityBuildingExpense
Net Community Building Expense	69580	NetCommunityBuildingExpense
Percent Of Total Expense	0.00040	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	true	BadDebtExpenseReported
Bad Debt Expense	$14,849,102	BadDebtExpenseAmount
Amount Attributable To	7744000	AmountAttributableTo
Amount Reimbursed By Medicare	35394631	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	71927364	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-36532733	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	true	WrittenDebtCollectionPolicy
Provision For Charity Care	true	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	The Good Samaritan Hospital	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	fourth and walnut street	AddressLine1
City	lebanon	City
State	PA	State
ZIP Code	17042	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Teaching Hospital	X	TeachingHospital
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	The Good Samaritan Hospital	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
CHNA Conducted	true	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
Information Gaps	X	InformationGaps
Needs Assessment Conducted	12	NeedsAssessmentConducted
Take Into Account	true	TakeIntoAccount
Other Facilities	true	OtherFacilities
CHNA Widely Available	true	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	false	AllNeedsAddressed
Organization Incur Excise Tax	false	OrganizationIncurExciseTax
Eligibility Criteria Explained	true	EligibilityCriteriaExplained
Uses FPG Free	true	UsesFPGFree
FPG Free Percent	200.	FPGFreePercent
Uses FPG Discounted	true	UsesFPGDiscounted
FPG Discount Percent	300.	FPGDiscountPercent
Explains Basis	true	ExplainsBasis
Income Level	X	IncomeLevel
Medical Indigency	X	MedicalIndigency
Uninsured Discount	X	UninsuredDiscount
Other Factors	X	OtherFactors
Explains Application Method	true	ExplainsApplicationMethod
Includes Publicity Measures	true	IncludesPublicityMeasures
Available On Request	X	AvailableOnRequest
Other Publicity	X	OtherPublicity
Actions On Nonpayment	true	ActionsOnNonpayment
Collection Activities	false	CollectionActivities
Nondiscrim Emergency Care Policy	true	NondiscrimEmergencyCarePolicy
Used Other Method	X	UsedOtherMethod
Amounts Generally Billed	false	AmountsGenerallyBilled
Gross Charges	true	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	11	NumberOfOtherFacilities

Other Facilities OtherFacilities (11 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
The Good Samaritan Hospital
fourth Willow Streets	Lebanon	PA	17042	Rehab & Tuc Units
The Good Samaritan Hospital
830 Tuck Street	Lebanon	PA	17042	Outpatient surgical center
The Good Samaritan Hospital
840 Tuck Street	Lebanon	PA	17042	Wound Care & Hyperbaric Cntr
The Good Samaritan Hospital
206 Hathaway Park	Lebanon	PA	17042	Sleep Disorders Center
The Good Samaritan Hospital
805 Helen Drive	Lebanon	PA	17042	Outpatient Radiology Center
The Good Samaritan Hospital
750 Norman Drive	Lebanon	PA	17042	Blood Donor Cntr & Lab
The Good Samaritan Hospital
297 West Lincoln Ave	Lebanon	PA	17042	Outpatient Diagnostics Center
The Good Samaritan Hospital
1400 South Forge Road	Lebanon	PA	17042	Ambulatory Services Center
The Good Samaritan Hospital
100 Queen Street	Lebanon	PA	17042	Satellite Services Center
The Good Samaritan Hospital
950 Isabel Drive	Lebanon	PA	17042	Outpatient Physical Therapy
The Good Samaritan Hospital
781 Norman Drive	Lebanon	PA	17042	Cardiovascular Diagnostic

Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Community Benefit Report	Part I, Line 6a	Our annual community benefit report is prepared by our marketing department. The report can be found at our website, www.gshleb.org. We also mail the report out to the members of our community.
Part I, Line 7, Column (f)		Our total expenses from form 990, part ix, line 25, column (a) was $195,900,001. the bad debt exchange included in this amount was $14,849,012. This left us with a total expense of $181,050,989 for purposes of calculating Line 7, column (f).
Part I, Line 7		The Good Samaritan Hospital used the cost to change ratio cost methodology to calculate the charity unreimbursed medicaid and other government programs. The hospital used direct costs for the other community benefits on Line 7.
Community Building Activities	Part II	The Good Samaritan Health System is involved in some community building programs which are designed to - improve the overall health of our community - (mission statement). The GSH participates in a disaster preparedness program which provides a plan in the case of a disaster that affects the community. The GSH also provides space for support groups to meet and education classes for the people within the community, like expectant parents. The activities are not included elsewhere on the Schedule H.
Bad Debt, Medicare, & Collection Practices	Part III, Line 4	AFS Footnote: The Hospital establishes an allowance for doubtful accounts to report the net realizable amounts to be received from patients. Increases to this allowance are reflected as a provision for doubtful accounts in the statements of operations and changes in net assets (deficiency). The Hospital regularly performs a detailed analysis of the collectability of patient accounts receivable and considers such factors as prior collection experience and the age of the receivables to determine the appropriate allowance level. Bad Debt Methodology: The Good Samaritan Hospital is a tax-exempt non-for-profit hospital that provides quality medical services to patients regardless of their ability to pay. By providing medical services to all community members regardless of their ability to pay, the hospital's bad debt expense qualifies as a community benefit. The bad debt expense calculated on line 2 was calculated using the patient care cost to changes methodolgy. The Good Samaritan Hospital uses an automated system called presumptive to charity care tool to calculate the amount on line 3. All self pay accounts and all the self pay after insurance accounts are imported into the tool, then the tool scores each account based on the government guidelines for poverty levels. For FYE 6/30/13, the tool estimated $7,744,000 of the organization's bad debt expense should be considered charity care.
Medicare Shortfall	Part III, Line 8	Medicare allowance costs were calculated using a cost to charge ratio. The Good Samaritan Hospital provides quality medical services to all patients regardless of what insurance they have. Approximately 58% of The Good Samaritan Hospital's revenue is attributable to medicare patients. The Good Samaritan Hospital is relieving the government's burden, because the hospital is providing services to medicare patients which cost more than the medicare reimbursement. Therefore, the $36,532,733 medicare shortfall should be considered a community benefit.
Collection Policies	Part III, Line 9b	Collection policies are the same for all patients. if a patient notifies the hospital about their inability to pay, the hospital will send them the charity care and financial assistance forms to fill out. Once the forms are completed and returned to the hospital and the patient qualifies for financial assistence, then the patient's account will be removed from collections and the account will be written off.
Facility Information	Part V, Section B, Question 12H	The Good Samaritan hospital calculates the amount charged to a patient based on catestrophic or physical hardship and the number of individuals living in a household.
Part V, Section B, Question 20d		The Good Samaritan Hospital bills individuals without insurance their gross charges associated with the services they received during their visit. GSH offers all self-pay patients a 35% discount if they pay their bill within 30 days of their services.
Part V, Section B, Question 22		The Good Samaritan Hospital charges its self-pay patients their gross charges for the services rendered.
Needs Assessment	Part VI, Line 2	The Good Samaritan Hospital (the Hospital) has participated in a variety of community health needs assessments over the past 17 years. The hospital was instrumental in helping to launch the Community Health Council of Lebanon County. In partnership with the council, a community health needs assessment was created 17 years ago and an updated assessment completed 12 years ago. Another assessment was created in 2005, led by efforts of The United Way of Lebanon County. The Hospital's most recent community health needs assessment was completed in conjunction with the Community Health Council of Lebanon County, the United Way and Lebanon Family Health Services. The assessment report was developed by Civic Research Alliance LLC, published in June 2012 and subsequently approved by the Board of Directors of the Hospital on July 24, 2012. Data were collected and analyzed by the Hospital from sources that included the Pennsylvania Department of Health, the Centers for Disease Control and Prevention, the U.S. Census, the American Community Surveys, and interviews of community leaders and healthcare professionals in Lebanon County. Community needs were identified through trends revealed by analyzing data over time. Additional data were gathered when a trend identified a high priority need. Priorities were then categorized as a need to be addressed by the community or by the Hospital. The following were identified as the priority health care needs of the communities the Hospital serves and the action plan adopted by the Board of Directors of the Hospital. - Chronic Disease Management Provide programs that educate and assist patients with chronic diseases to self-manage their condition. Continue to offer Medical Home services at Good Samaritan primary care practices to deliver preventive care that reduces need for acute care services. Increase awareness and use of Diabetic Education services in community. Promote tobacco cessation programs. Offer cardiac education at hospital and in community. Participate in healthy lifestyle events, such as Give Thanks for Lebanon 5k/10k event. - Overweight and Obesity Raise community awareness about obesity issues. Provide education about healthy lifestyles to patients and to community groups. - Smoking Promote smoking cessation among hospital employees. Support community smoking cessation programs. Encourage doctors to tell patients to quit and share information about hospital and community-based cessation programs. - Accidents and Injuries Emergency department readiness. Continue to enforce hospital rules for use of child care seats. Raise awareness about accidents for young drivers. Raise awareness and provide education for patients and families about the risks of falling for the population 75 years and older. - Oral Health Services These services are not part of the acute health care mission of the Hospital. - Mental Health Services These services are not part of the acute health care mission of the Hospital. - Maternal and Child Health Prepare for younger maternity patients as demographics shift. Maintain high-quality maternity facilities. Raise awareness for pre- natal health checks. Promote smoking cessation to those in child- bearing years. - Access to Healthcare This issue falls outside the scope of The Hospital because most primary care is provided by independent community physicians. Encourage providers to accept Medicaid and Medicare. Keep access to public insurance at The Good Samaritan Family Practice Center, ELCO Family Practice, and Good Samaritan Pediatrics. - Culturally and linguistically appropriate healthcare Continue to provide diversity education to employees. Conduct additional outreach efforts to non- English speaking populations in community. Additional supplemental information: The hospital also maintains an independent, countywide physician needs assessment to evaluate gaps in healthcare access. A new physician needs assessment was also completed in 2011. In addition to these countywide efforts, the hospital has performed a variety of studies on specific health concerns and community needs. Key studies have included services for cardiovascular, oncology, gastroenterology, wound care, and more. The hospital has also acted to fulfill the needs identified in these studies. The hospital created one of the nation's leading cardiac and vascular centers, which has earned several national awards for quality of care. The hospital introduced a new wound care service to deal with patients suffering from complications of diabetes - a particular problem to Lebanon County - and has already expanded operations to add a third hyperbaric oxygen treatment chamber to the two originally installed in the center. In addition, the hospital has protected the community by recruiting new physicians for key services - general surgery, oncology, and gastroenterology - allowing patients to get access to care in Lebanon County instead of traveling throughout the region.
Patient Education of eligibilty for assistance	Part VI, Line 3	The Good Samaritan Hospital Charity Care policy outlines the process of financial, medical and castastrophic categories where a patient could qualify for charity care. the hospital has a self-pay brochure available that provides informtaion and available hours. financial counselors are on site to meet with patients to discuss their financial obligations, assist them in completing the application for the charity care, and answer their questions. Patients are encouraged to apply for charity care if they are unable to come in for an appointment. There is a note on the statements that is mailed to patients, letting them know that financial assistance is available. The good samaritan hospital's website also provides the contact information for those community members who need medical services and financial assistance.
Community Information	Part VI, Line 4	Lebanon County includes a mix of urban, suburban, and rural areas. The city of Lebanon is centrally located, serving as the county seat. The city is home to more than 24,000 residents and is classified by the commonwealth of pennsylvania as a third class city. The county includes 25 other municipalities. the rest of the county is made up of suburban and rural areas, with rural farmland providing a dominant character of county life. while most of the population tends to be of white ancestry (91%), the county has a fast-growing hispanic population (7.8%) that centers in the city of Lebanon (source: U.S. Census Bureau). The U.S. census bureau also reports that 8% of the population speaks a language other than english at home. Employment rates in the county are currently at 6.8% - one of the lowest rates in the state - and average household income is at $50,334 according to the USDA economic research service. The federal government is the county's largest employer, with large work forces at the Lebanon veterans administration hospital and fort indiantown gap. The good Samaritan hospital is the largest non-governmental employer with 1,500 employees. according to the U.S. census bureau american community survey, 8% of the population lives in poverty. The Good Samaritan Hospital is the only hospital in Lebanon county. The hospital has performed thousands of outpatient procedures - from surgeries to imaging to laboratory to physical therapy - every year. The hospital also provides a continuity of care through a skilled nursing unit, rehabilitaion services, home healthcare, and hospice care. the hospital is the largest provider of care to medicaid and medicare populations. while most lebanon county residents choose to stay in the county for their care, with more than 60% choosing the Good Samaritan hospital for services. according to the Robert Wood Johnson Foundation community health rankings, Lebanon county is the 13th most healthy of pennsylvania's 67 counties. the health rankings indicate key areas of improvement, including diabetes, tobacco use, and other health behaviors that are problematic. the hospital has taken steps to address these areas by expanding services and educational opportunities.
Promotion of Community Health	Part VI, Line 5	Our Community Benefit Good Samaritan strives to deliver powerful medicine with comforting care every day. As part of our non-profit mission, The Good Samaritan Hospital and its affiliated organizations deliver healthcare services that improve the quality of life throughout the region. As Lebanon County's only hospital, Good Samaritan is the community's primary - and sometimes only - resource for: -Inpatient hospital care -Emergency care -Surgical services -Digestive health services -Maternity services -Cardiac & vascular services -Radiology and medical imaging services -Laboratory diagnostic services and blood bank -Physical and occupational therapies -Transitional care and rehabilitation services -Home health and hospice services -Wound care and hyperbaric medicine -Diabetic education and nutrition counseling -Audiology and speech therapy -Sleep disorders -Physician services for needed specialties including cardiac, gastroenterology, general surgery, hematology, hospitalists, oncology, pediatrics, primary care (particularly for Medicaid population), thoracic, vascular, and wound care. -Medical residency program to train new physicians -And many more Community Benefit Total $1,538,443 Good Samaritan and its employees donate many hours of time to improve the health of the community. In 2013, key projects included: -Health Fairs - the countywide 50+ Festival, Women's Health Expo and Latino Fair as well as individual events hosted by various nursing and retirement facilities, employers and other community groups -Education programs - offered at the hospital or presented to community groups on topics such as smoking cessation, cardiac health, cancer prevention, sleep disorders, diabetic health, breast health and more -Medical clinic - Good Samaritan donated employee time to support a new independent medical clinics for poor and low-income patients -Health screenings - screenings for cholesterol, blood glucose, BMI, skin cancer, blood pressure, varicose veins and other health conditions were provided throughout the year Charitable and Uncompensated Care In reflection of our non-profit mission, Good Samaritan delivered $22.6 million dollars in charitable and uncompensated care to the community. Economic Impact In addition to our core healthcare mission, Good Samaritan is Lebanon County's largest non-government employer - and positively impacts the economy by generating more than 1,000 jobs outside of the health system. The Good Samaritan Hospital had a Net Hospital Revenue of $174 million in 2013. Service Statistics The Good Samaritan Hospital treated 7,708 patients in 2013. In addition, the health system offers a wide variety of diagnostic and non-acute health services that are needed by the community. Many of these services would not be available to the community if they were not offered by Good Samaritan. Behind the Statistics Many of the 110,283 radiology services we provided in 2013 include those services provided by our Women's Imaging Center, mainly screening mammograms. Breast cancer remains an important women's health issue with thirty-two women in Pennsylvania diagnosed daily with the disease. One in eight women will be diagnosed with invasive breast cancer in their lifetime, including those with no family history of the disease. To help women fight this disease, Good Samaritan provides the latest, comprehensive breast imaging services and follow-up care to improve detection and shorten the time from diagnosis until treatment can begin. Dense breast tissue can make cancer harder to find on a mammogram, which increases the risk of a late-stage cancer diagnosis in many women. Because of this, Pennsylvania now requires all patients with dense breast tissue be notified in their result letter after a mammogram. Good Samaritan goes beyond the required notification for our patients, introducing new software that utilizes several different risk assessment tools to assist in calculating if a woman is high-risk for developing breast cancer in her lifetime. This risk assessment may recommend that breast ultrasound or magnetic resonance imaging (MRI) be utilized in conjunction with screening mammography to assist in detecting breast cancer. In addition to the use of this risk assessment tool in screening, Good Samaritan has focused our efforts on reducing the -door-to-diagnosis- time for women having diagnostic imaging. All diagnostic mammograms and ultrasounds are promptly read by a board-certified radiologist who specializes in breast imaging so the patient receives the results before leaving the Women's Imaging Center. If an abnormality is detected, a certified breast patient navigator in imaging and cancer care works with the patient to help her understand the process and schedule a biopsy. Good Samaritan is now able to perform all minimally-invasive biopsies in the Women's Imaging Center under stereotactic or ultrasound guidance and MRI-guided breast biopsies also available. Reducing the time from imaging to treatment is important both psychologically and physically. In the past women may have had to wait weeks after an abnormality was found for a biopsy and the following surgical consultation if the biopsy was positive. Now many women are having diagnostic imaging, a biopsy and their surgical consult in days rather than weeks. By shortening this process, women are able to either eliminate unnecessary worry more quickly or receive the earliest possible treatment for a cure. Breast cancer remains a focus of Good Samaritan's efforts to provide quality care that changes lives. Supporting Our Community The employees of the Good Samaritan Health System have a spirit of generosity. Each year employees donate their time, goods and money to support worthy causes. -United Way - Good Samaritan employees donate more than $30,000 annually to the United Way of Lebanon County. -Reach Out and Read - a national program to give free books to children of low income families. -Cribs for Kids - brand new cribs provided to low-income families -Bridge of Love - personal care items provided to families in need -Car Seats - new car seats are made available to low-income families -American Heart Association - more than 100 employees participate in the annual Heart Walk, raising thousands of dollars each year -Operation Good Sam - During the Thanksgiving Food Drive, food is collected and delivered to more than 100 families in need. -Good Samaritan Christmas Toy Drive - employees donate toys that are delivered to more than 250 children each year to spread holiday cheer Community Health Council The Good Samaritan Hospital helped to create the independent Community Health Council of Lebanon County. From its humble inception, the Council has grown into a premier county organization. More than 400 volunteers collaborate on programs to increase healthy lifestyles and to eliminate alcohol and drug abuse in the county. The Council sponsors programs that address the special needs of youth, parents and seniors. A Home for Community Groups The Good Samaritan Hospital opens its doors to support a variety of community groups. The hospital provides rent-free classroom space for a variety of support groups such as: -Alcoholics Anonymous -Alanon -Better Breather's Club -I Can Cope (cancer support) -Journey Through Grief Bereavement Support (adult focused Hospice support) -Support and Help in Airing and Resolving Experiences (for grieving parents) -Rainbow Connection (teen focused Hospice support) -Narcotics Anonymous Sharing Our Knowledge At Good Samaritan Health System, caring for our community extends beyond providing medical services. Through our educational services department, we offer classes and support groups that address multiple health related topics, which in turn offer the members of our community an opportunity to improve their health, both physically and emotionally. The educational services department oversees community education classes such as babysitter training and a variety of Heartsaver CPR programs, which range from basic first aid to advanced cardiac life support. These classes provide individuals a chance to obtain skills which can benefit their lives both personally and professionally. Diabetes is prominent in the Lebanon County. To address this growing health concern, Good Samaritan offers Diabetic Education Classes. This program is a series of four classes which addresses topics such as: the importance of managing diabetes; meal planning; use of medication; glucose monitoring; and coping with diabetes. Community members dealing with substance addiction or those who are grieving can receive much needed support through community groups whose meetings are scheduled through the educational services department. These include: Al-Anon; Journey through Grief; and Narcotics Anonymous. Most of these programs are offered on a weekly or bi-weekly basis and all are free of charge. In addition to offering classes to the general public, the educational service
Affiliated Health Care System	Part VI, Line 6	The Good Samaritan Hospital is a part of the good samaritan health system. the system includes a foundation, dialysis center, real estate companies, mri center, family practices, speciality health services, and a DME company. in addition to the community benefits provided by the hospital, the health system evaluates the needs the community and the system will participate in community benefit programs, like supporting the volunteers in medicine free clinic which serves the underprivileged members of the community.
State Filing of the community benefit report	Part VI, Line 7	Pennsylvania

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	true	RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	The Good Samaritan Health Service Foundation	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	259 Fourth Street	AddressLine1
City	Lebanon	City
State	PA	State
ZIP Code	17042	ZIPCode

Field	Value	IRS element (for citing)
EIN Of Recipient	232356151	EINOfRecipient
IRC Section	501(c)(3)	IRCSection
Amount Of Cash Grant	9551000	AmountOfCashGrant
Purpose Of Grant	Program Support	PurposeOfGrant

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	1	TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part III Form990ScheduleIPartIII (4 entries)

Type Of GrantTypeOfGrant	Number Of RecipientsNumberOfRecipients	Amount Of Cash GrantAmountOfCashGrant
David Broderic Scholarship	21	7150
Margaret Connel Scholarship	6	5000
GSH Auxiliary Scholarship	3	2200
Caplan Nursing Scholarship	6	8200

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	Procedures to monitor use of grants	Identifier
Return Reference	Parts I, Line 2	ReturnReference
Explanation	The david broderic employee scholarship program and the margaret l. connell scholarship fund are for the sons and daughters of employees. the GSH auxiliary and caplan nursing scholarships are awarded to lebanon county residents enrolled in a nursing program. The Good Samaritan hospital distributes a portion of the money allotted to every person who applies for the scholarship. The Good Samaritan Hospital has internal controls with regards to issuing grants to individuals.	Explanation

Schedule J IRS990ScheduleJ

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

Form990 Schedule J Part II Form990ScheduleJPartII (12 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
Robert J Longo
President & CEO	415249	0	74025	0	4124	0	21000	0	4745	0	519143	0
Kimberly Feeman
Senior VP & COO	252855	0	42501	0	6	0	15732	0	3185	0	314279	0
Jacquelyn M Gould
VP of Nursing	168836	0	24549	0	1819	0	10321	0	3185	0	208710	0
Robert J Richards
VP Finance & CFO	248619	0	33880	0	8158	0	15120	0	4485	0	310262	0
Julie Miksit
VP CV SVCS & Rehab Therapies	147542	0	21133	0	99	0	11009	0	2818	0	182601	0
Robert Shaver
VP Medical Affairs	298609	0	41191	0	288	0	0	0	3185	0	343273	0
William Mulligan
VP Strategic Planning	129506	0	18612	0	144	0	14989	0	7085	0	170336	0
Daria Kovarikova
Residency Physician	178873	0	11747	0	681	0	0	0	3055	0	194356	0
Aaron Lane
Residency Physician	138889	0	48038	0	64	0	0	0	1561	0	188552	0
Elizabeth Muhiire-Ntaki
Residency Physician	152614	0	29685	0	101	0	0	0	2230	0	184630	0
Byard Yoder
Residency Physician	168452	0	0	0	653	0	8658	0	8055	0	185818	0
Richard Follett
Chief Information Officer	164911	0	10000	0	582	0	22500	0	650	0	198643	0

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifier	ExplanationExplanation
Part I, Line 3	The compensation committee hires an independent compensation consultant to establish the CEO's compensation amount and compose the contract. the compensation committee presents the information to the board. if a board member would like to review the contract privately.
Part I, Line 4b	Robert Longo is a participant in a 457f retirement plan. he recieved no payment from the plan this year.
Part I, Line 7	The executive bonus program is a non-fixed payment program. discretion is exercised as to the amount and when/if payment will be made.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	Lebanon County Health Facilities Authority	BusinessNameLine1

Field	Value	IRS element (for citing)
Issuer EIN	232546819	IssuerEIN
CUSIP Number	522455BE3	CUSIPNumber
Date Issued	2004-03-11	DateIssued
Issue Price	17255816	IssuePrice
Description Of Purpose	See Part VI	DescriptionOfPurpose
Defeased	false	Defeased
On Behalf Of Issuer	false	OnBehalfOfIssuer
Pool Financing	false	PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Amount Retired	0	AmountRetired
Amount Bond Defeased	0	AmountBondDefeased
Total Proceeds	17255816	TotalProceeds
Amount In Reserve Fund	0	AmountInReserveFund
Capitalized Interest	0	CapitalizedInterest
Refunding Escrow	0	RefundingEscrow
Issuance Costs From Proceeds	0	IssuanceCostsFromProceeds
Credit Enhancement	0	CreditEnhancement
Working Capital Expenditures	0	WorkingCapitalExpenditures
Capital Expenditures	0	CapitalExpenditures
Other Spent Proceeds	0	OtherSpentProceeds
Amount Unspent	0	AmountUnspent
Year Of Subst Completion	2004	YearOfSubstCompletion
Current Refunding	true	CurrentRefunding
Advance Refunding	false	AdvanceRefunding
Final Allocation Made	true	FinalAllocationMade
Adequate Books And Recds Maintaind	true	AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	false	OwningBondFinancedProperty
Any Lease Arrangements	false	AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty	false	MngmentCntrctBondFinancdPrprty
Any Research Agreements	false	AnyResearchAgreements
Prcntge Prvt Business Use By Others	0	PrcntgePrvtBusinessUseByOthers
Bond Iss Meet Prvt Security Pay Test	false	BondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed Prop	false	ChangeInUseBondFinancedProp
Remedial Action Taken	false	RemedialActionTaken
Non Qualified Bond Remed Procdrs	false	NonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	false	Form8038TFiled
Exception To Rebate	true	ExceptionToRebate
Variable Rate Issue	false	VariableRateIssue
Hedge Identified In Books And Recds	false	HedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

Field	Value	IRS element (for citing)
Business Name Line1	0	BusinessNameLine1

Field	Value	IRS element (for citing)
Gross Proceeds Invested In GIC	false	GrossProceedsInvestedInGIC

Name Of GIC Provider NameOfGICProvider

Field	Value	IRS element (for citing)
Business Name Line1	0	BusinessNameLine1

Field	Value	IRS element (for citing)
Gross Proceeds Invested	false	GrossProceedsInvested
Written Proc To Monitor Reqs	false	WrittenProcToMonitorReqs

Form990 Schedule K Part V Form990ScheduleKPartV

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Proc To Undertk Corrective Action	false	ProcToUndertkCorrectiveAction

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
Aurthur Funk
See Part V	123888	Construction Project	false
John P Welch
See Part V	280057	Property Rental	false
Frederick Laurenzo
See Part V	86940	Car Sales	false
Frederick Wolfson
See Part V	186366	Attorney Fees	false

Form990 Schedule L Part V Form990ScheduleLPartV (4 entries)

IdentifierIdentifier	ExplanationExplanation
Part IV, Line 1	Robert J. Funk, a trustee of the good samaritan hospital, is a partner in arthur funk and sons.
Part IV, line 2	John Welch, a trustee of the good samaritan hospital, is a partner in Welch wagner partnership.
Part IV, Line 3	Frederick Laurenzo, a trustee of the good samaritan hospital, is a partner in federick chevrolet, cadillac, and toyota.
Part IV, Line 4	Frederick Wolfson, a trustee of the good samaritan hospital, is a partner in reilly, wolfson, sheffey, schrum & lundberg.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Committees With Board Authority	Part VI, Section A, Line 1a	There are no material differences in voting rights among the members of the governing body. The executive committee shall consist of the officers of the corporation other than the vice president, the president of the medical staff, the solicitor, the chairman of all standing committees and the most recent past chairman of the board. It shall be the duty of the executive committee to review matters brought to its attention and to make recommendations to the board for board action. It shall have the power to transact emergency business of the corporation during the interval between board meetings, provided such action does not conflict with policies and expressed wishes of the board. It shall report any actions taken to the board at the board's next regular meeting.
Members or Stockholders	Part VI, Section A, Line 6	The Good Samaritan Health Services Foundation, another 501(c)(3) organization, is the sole member of the good samaritian hospital.
Members who may elect trustees of the governing body	Part VI, Section A, Line 7a	The Good Samaritan Health Services Foundation, as the sole member of the Good Samaritan Hospital, may elect one or more trustees of the hospital's governing body.
decision of governing body subject to approval by members	Part VI, Section A, Line 7b	Certain decisions of the hospital's governing body are subject to approval by the Hospital's sole member, The Good Samaritan Health Services Foundation.
Form 990 Review Process	Part VI, Section B, Line 11	An accountant prepares the 990 and 990-T for the Good Samaritan Hospital. The Hospital then pays an auditing firm to review the 990 tax return. The controller and the CFO the reviews the final draft of the return before it is given to the board of directors and then filed with the IRS
Conflict of Interest Policy	Part VI, Section B, Line 12a	The Good Samaritan Hospital has a Compliance Officer that is responsible for the monitoring and enforcing the compliance of policies. The board members sign a conflict of interest statement every year which states what organizations or businesses he or she is the owner, officer, member or employee. If an issue is brought to the board members, the board member would remove himself from the discussion and abstain from voting on the issue.
Compensation Review	Part VI, Section B, Line 15a	The compensation committee hires an independent compensation consultant to establish the CFO's compensation and compose the contract. The compensation committee presents the information to the board for discussion. The deliberation and compensation decision are documented in the committee and/or Board meetings.
Disclosure of Documents to the Public	Part VI, Section C, Line 19	The Good Samaritan Hospital has all of its policies and financial statements available for the general public. The public needs to schedule an appointment with administration to come in and view the information under hospital supervision.
Other Changes in Net Assets or Fund Balance	Form 990, Part XI, Line 9	Other than Temp decline in FMV of Investments (6,174) Change in Post Retirement Benefits 19,269,157 Change in Pension Obligation 1,145,290 ---------- Total 20,408,273

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
Good Samaritan Health Service Foundation
259 South 4th Street	Lebanon	PA	17042	232356151	Parent	PA	501(c )(3)	11 Type I	NA	false
Good Samaritan Physician Services
259 South 4th Street	Lebanon	PA	17042	251832359	Family Med	PA	501(c )(3)	9	GSHS FDN	false
GSH Dialysis Inc
440 Oak Street	Lebanon	PA	17042	232500940	Dialysis	PA	501(c )(3)	3	GSHS FDN	false
Good Samaritan Real Estate Inc
241 South 4th Street	Lebanon	PA	17042	232447262	Titleholding	PA	501(c )(2)		GSHS FDN	false

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

Field	Value	IRS element (for citing)
Business Name Line1	Lebanon MRI Assoc	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	4th and Walnut St	AddressLine1
City	Lebanon	City
State	PA	State
ZIP Code	17042	ZIPCode

Field	Value	IRS element (for citing)
EIN	363730905	EIN
Primary Activity	Imaging	PrimaryActivity
Legal Domicile State	PA	LegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

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

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Type Of EntityTypeOfEntity
GSH Services Inc
241 South 4th Street	Lebanon	PA	17042	232353047	Mgmt/Acct	PA	GSH Fnd	C Corp
GSH Home Med Center Inc
301 Schneider Drive	Lebanon	PA	17042	232028099	Med Equip	PA	GSH FDN	C Corp
GSH Realty Inc
241 South 4th Street	Lebanon	PA	17042	232446622	Title Holding	PA	GSH FDN	C Corp

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