CHAMBERSBURG HEALTH SERVICES: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- CHAMBERSBURG HEALTH SERVICES (EIN 25-1515376)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-04-10
- IRS object ID
- 201441009349300509
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-04-10T10:14:32-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 520783935 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SMITH ELLIOTT KEARNS & COMPANY LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 804 WAYNE AVENUE | AddressLine1 |
| City | CHAMBERSBURG | City |
| State | PA | State |
| ZIP Code | 17201 | 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 | 251515376 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHAMBERSBURG HEALTH SERVICES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CHAM | NameControl |
| Phone | 7172672668 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 785 5TH AVENUE NO 5 | AddressLine1 |
| City | CHAMBERSBURG | City |
| State | PA | State |
| ZIP Code | 17201 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KIMBERLY M RZOMP | Name |
| Title | VICE PRESIDENT AND CFO | Title |
| Phone | 7172677107 | Phone |
| Date Signed | 2014-04-04 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | GREGORY P HALL CPA | Name |
| PTIN | P00156653 | PTIN |
| Phone | 7172633910 | 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 | KIMBERLY M RZOMP | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 112 NORTH SEVENTH STREET | AddressLine1 |
| City | CHAMBERSBURG | City |
| State | PA | State |
| ZIP Code | 17201 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 27833117 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.SUMMITHEALTH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1985 | YearFormation |
| State Legal Domicile | PA | StateLegalDomicile |
| Activity Or Mission Description | OPERATIONS INCLUDE THE SUMMIT CANCER SERVICES RADIATION AND MEDICAL ONCOLOGY; RESULTS THERAPY & FITNESS; 50% PARTNER IN SHIPPENSBURG FAMILY PRACTICE AND WALK-IN CARE; 87.6% PARTNER OF SUMMIT SURGERY CENTER; 48% PARTNER IN MEDCAREERS LLC; 51% PARTNER IN CUMBERLAND VALLEY MOBILE SERVICES, LLC, AND LANDLORD/OWNER OF SUMMIT HEALTH CENTER; MERCERSBURG HEALTH CENTER; MONT ALTO CENTER, RESULTS AND KEYSTONE PAVILION FACILITIES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 73 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 16629 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 11970 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 20137070 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 20555414 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 2021494 | InvestmentIncomePriorYear |
| Investment Income Current Year | 2946017 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 870801 | OtherRevenuePriorYear |
| Other Revenue Current Year | 861945 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 23045994 | TotalRevenuePriorYear |
| Total Revenue Current Year | 24375346 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 6015349 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 5971111 | 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 | 14145434 | OtherExpensePriorYear |
| Other Expenses Current Year | 15115810 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 20160783 | TotalExpensesPriorYear |
| Total Expenses Current Year | 21086921 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 2885211 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 3288425 | RevenuesLessExpensesCY |
| Total Assets BOY | 68911978 | TotalAssetsBOY |
| Total Assets EOY | 74069314 | TotalAssetsEOY |
| Total Liabilities BOY | 14305786 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 13823388 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 54606192 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 60245926 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | OPERATIONS INCLUDE THE SUMMIT CANCER SERVICES RADIATION AND MEDICAL ONCOLOGY; RESULTS THERAPY & FITNESS; 68.45% PARTNER OF SUMMIT SURGERY CENTER; 51% PARTNER IN CUMBERLAND VALLEY MOBILE SERVICES, LLC, AND LANDLORD/OWNER OF SUMMIT HEALTH CENTER; MERCERSBURG HEALTH CENTER; MONT ALTO CENTER, RESULTS AND KEYSTONE PAVILION FACILITIES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 20070472 | Expense |
| Revenue | 20590338 | Revenue |
| Description | CHAMBERSBURG HEALTH SERVICES PROVIDES CANCER TREATMENT THERAPY SERVICES TO PATIENTS IN THE COMMUNITY, AS WELL AS INPATIENTS OF THE CHAMBERSBURG HOSPITAL, AN AFFILIATED ORGANIZATION. MEDICAL ONCOLOGY, PHYSICAL THERAPY AND FITNESS SERVICES ARE PROVIDED TO PATIENTS IN THE COMMUNITY. | Description |
| Total Program Service Expense | 20070472 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | 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 | 1 | 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 | 0 | 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 | 0 | 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 | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| 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 | 23 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 73 | 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 | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | 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 | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| 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 | KIMBERLY M RZOMP - VICE PRESIDENT AND CFO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7172673000 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 112 NORTH SEVENTH STREET | AddressLine1 |
| City | CHAMBERSBURG | City |
| State | PA | State |
| ZIP Code | 17201 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| VALORIE DICK | ||||||||
| CHAIRMAN OF BOARD | 0.30 | X | X | 0 | 0 | 0 | ||
| JOEL R ZULLINGER | ||||||||
| VICE CHAIR OF BOARD | 0.20 | X | X | 0 | 0 | 0 | ||
| FRANK S ELLIOTT | ||||||||
| SECRETARY | 0.60 | X | X | 0 | 0 | 0 | ||
| PATRICK O'DONNELL | ||||||||
| TREASURER/SR VP AND COO | 2.00 | X | X | 27105 | 514987 | 99212 | 38.00 | |
| NORMAN EPSTEIN | ||||||||
| PRESIDENT | 0.20 | X | X | 0 | 1677309 | 101975 | ||
| J EDWARD BECK | ||||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | |||
| J FRED STENGER | ||||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | |||
| ANGELA STOOPS | ||||||||
| BOARD MEMBER | 0.20 | X | 0 | 0 | 0 | |||
| PAUL SCHEMEL | ||||||||
| BOARD MEMBER | 0.60 | X | 0 | 0 | 0 | |||
| R WILLIAM HAPPEL | ||||||||
| BOARD MEMBER | 0.60 | X | 0 | 0 | 0 | |||
| ROY HIMELFARB DDS | ||||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | |||
| DEMAREE DEARDORFF | ||||||||
| BOARD MEMBER | 0.10 | X | 0 | 0 | 0 | |||
| RODGER SAVAGE | ||||||||
| BOARD MEMBER | 0.20 | X | 0 | 0 | 0 | |||
| NANCY MEYERS | ||||||||
| BOARD MEMBER | 0.10 | X | 0 | 0 | 0 | |||
| DR JOSEPH THORNTON | ||||||||
| BOARD MEMBER | 0.60 | X | 0 | 0 | 0 | |||
| KIMBERLY M RZOMP | ||||||||
| ASSISTANT TREASURER/VP AND CFO | 2.00 | X | 9209 | 174957 | 47209 | 38.00 | ||
| MICHELE ZEIGLER | ||||||||
| VP FOR INFORMATION SERVICE | 1.00 | X | 7037 | 274414 | 50811 | 39.00 | ||
| LISSA NIKI SHOWE | ||||||||
| SR VP OF PHYSICIAN PRACTICES | 8.00 | X | 65524 | 262098 | 19019 | 32.00 | ||
| JIANZHONG LI | ||||||||
| CHIEF PHYSICIST | 40.00 | 208678 | 0 | 24874 | X | |||
| DOUGLAS LENTZ | ||||||||
| DIRECTOR OF WELLNESS | 40.00 | 110163 | 0 | 30642 | X | |||
| ZHI LIANG | ||||||||
| PHYSICIST | 40.00 | 145300 | 0 | 19996 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 573016 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 2903765 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 393738 | TotalOtherCompensation |
| Number Individuals GT100 K | 3 | 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 |
|---|---|---|---|---|---|
| AMERISOURCE BERGEN | |||||
| PO BOX 5187 | NEW YORK CITY | NY | 10087 | PARAMEDICALS | 9112477 |
| FRANKLIN COUNTY RADIATION | |||||
| 260 NORTH SEVENTH STREET | CHAMBERSBURG | PA | 17201 | PROFESSIONAL SERVICES | 1599788 |
| MCKESSON PLASMA & BIOLOGIC | |||||
| 16578 COLLECTION CENTER DRIVE | CHICAGO | IL | 60693 | PHARMACEUTICALS | 885765 |
| ELEKTA INC | |||||
| PO BOX 404199 | ATLANTA | GA | 30384 | PROFESSIONAL SERVICES | 308033 |
| TOMOTHERAPY INC | |||||
| 1240 DEMING WAY | MADISON | WI | 17224 | PROFESSIONAL SERVICES | 275000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 7 | NumberOfContractorsGT100K |
| All Other Contributions | 11970 | AllOtherContributions |
| Total Contributions | 11970 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT SERVICE REVENUE | Description |
| Business Code | 621110 | BusinessCode |
| Total Revenue Column | 20555414 | TotalRevenueColumn |
| Related Or Exempt Function Income | 20555414 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 20555414 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2946017 | TotalRevenueColumn |
| Exclusion | $2,946,017 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 4284792 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 3457771 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 827021 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 827021 | TotalRevenueColumn |
| Exclusion | $827,021 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER REVENUE | Description |
| Business Code | 621110 | BusinessCode |
| Total Revenue Column | 34924 | TotalRevenueColumn |
| Related Or Exempt Function Income | 34924 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 34924 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 24375346 | TotalRevenueColumn |
| Related Or Exempt Function Income | 20590338 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $3,773,038 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 129159 | Total |
| Management And General | 129159 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4776600 | Total |
| Program Services | 4475748 | ProgramServices |
| Management And General | 300852 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 280848 | Total |
| Program Services | 280848 | ProgramServices |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 509160 | Total |
| Program Services | 434076 | ProgramServices |
| Management And General | 75084 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 275344 | Total |
| Program Services | 250480 | ProgramServices |
| Management And General | 24864 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6705 | Total |
| Management And General | 6705 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13078 | Total |
| Management And General | 13078 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 196206 | Total |
| Program Services | 112732 | ProgramServices |
| Management And General | 83474 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 139689 | Total |
| Program Services | 60032 | ProgramServices |
| Management And General | 79657 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 638225 | Total |
| Program Services | 634622 | ProgramServices |
| Management And General | 3603 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 191425 | Total |
| Program Services | 191425 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17154 | Total |
| Program Services | 15020 | ProgramServices |
| Management And General | 2134 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22509 | Total |
| Program Services | 19515 | ProgramServices |
| Management And General | 2994 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 35496 | Total |
| Program Services | 35496 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1131332 | Total |
| Program Services | 862572 | ProgramServices |
| Management And General | 268760 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37945 | Total |
| Program Services | 37945 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| SUPPLIES | 11016135 | 10994175 | 21960 |
| PHYSICIAN FEES | 1632627 | 1632627 | |
| DUES | 20069 | 19164 | 905 |
| MISCELLANEOUS EXPENSE | 8863 | 5643 | 3220 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8352 | Total |
| Program Services | 8352 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21086921 | Total |
| Program Services | 20070472 | ProgramServices |
| Management And General | 1016449 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 650 | BOY |
| EOY | 650 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6451059 | BOY |
| EOY | 4813770 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1534594 | BOY |
| EOY | 1905545 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 84775 | BOY |
| EOY | 61350 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 281677 | BOY |
| EOY | 281677 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 523455 | BOY |
| EOY | 567735 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 54242735 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 25373600 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30712419 | BOY |
| EOY | 28869135 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4740024 | BOY |
| EOY | 5207935 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14072119 | BOY |
| EOY | 22464504 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10511206 | BOY |
| EOY | 9897013 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 68911978 | BOY |
| EOY | 74069314 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2506802 | BOY |
| EOY | 2362040 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11798984 | BOY |
| EOY | 11461348 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14305786 | BOY |
| EOY | 13823388 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 45601871 | BOY |
| EOY | 50640697 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9004321 | BOY |
| EOY | 9605229 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 54606192 | BOY |
| EOY | 60245926 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 68911978 | BOY |
| EOY | 74069314 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 3288425 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 810159 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 1541150 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| 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) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation (2 entries)
| EINEIN | Type Of OrganizationTypeOfOrganization | Listed In Governing DocListedInGoverningDoc | Supported Organization NotifiedSupportedOrganizationNotified | Organized In USOrganizedInUS | AmountAmount |
|---|---|---|---|---|---|
| THE CHAMBERSBURG HOSPITAL | |||||
| 230465970 | 3 | 0 | 0 | 1 | $0 |
| SUMMIT HEALTH | |||||
| 251515371 | 7 | 0 | 0 | 1 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 2 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 0 | SumOfAmounts |
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 D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3453074 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 432872 | InvestmentEarningsOrLosses |
| Other Expenditures | 71119 | OtherExpenditures |
| Administrative Expenses | 10516 | AdministrativeExpenses |
| End Of Year Balance | 3804311 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3488674 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 40933 | InvestmentEarningsOrLosses |
| Other Expenditures | 67134 | OtherExpenditures |
| Administrative Expenses | 9399 | AdministrativeExpenses |
| End Of Year Balance | 3453074 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2961043 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 602341 | InvestmentEarningsOrLosses |
| Other Expenditures | 65385 | OtherExpenditures |
| Administrative Expenses | 9325 | AdministrativeExpenses |
| End Of Year Balance | 3488674 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2689276 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 344757 | InvestmentEarningsOrLosses |
| Other Expenditures | 64139 | OtherExpenditures |
| Administrative Expenses | 8851 | AdministrativeExpenses |
| End Of Year Balance | 2961043 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3260620 | BeginningOfYearBalance |
| Investment Earnings Or Losses | -483423 | InvestmentEarningsOrLosses |
| Other Expenditures | 74705 | OtherExpenditures |
| Administrative Expenses | 13216 | AdministrativeExpenses |
| End Of Year Balance | 2689276 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.99800 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.00200 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2159954 | OtherCostOrOtherBasis |
| Book Value | 2159954 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 8197909 | OtherCostOrOtherBasis |
| Depreciation | 3128838 | Depreciation |
| Book Value | 5069071 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 14770 | OtherCostOrOtherBasis |
| Depreciation | 1980 | Depreciation |
| Book Value | 12790 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 9304495 | OtherCostOrOtherBasis |
| Depreciation | 7700610 | Depreciation |
| Book Value | 1603885 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 34452622 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 112985 | OtherCostOrOtherBasis |
| Depreciation | 14542172 | Depreciation |
| Book Value | 20023435 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 28869135 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (4 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| INVESTMENTS - EQUITY METHOD | 2214428 | F |
| CASH EQUIVALENTS | 200149 | F |
| FIXED INCOME | 16698764 | F |
| REAL ASSETS | 3351163 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 22464504 | TotalOfBookValueSecurities |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| OTHER RECEIVABLES | 239691 |
| PERPETUAL TRUSTS HELD BY THIRD PARTIES | 9597590 |
| TRUST INCOME RECEIVABLE | 59732 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 9897013 | TotalBookValueOtherAssets |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 24584597 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 24584597 | RevenueSubtotal |
| Other Revenues Not Included | -209251 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | -209251 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 24375346 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 21086921 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 21086921 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 21086921 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X, LINE 2: | WHEN TAX RETURNS ARE FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD BE ULTIMATELY SUSTAINED. THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH, BASED ON ALL AVAILABLE EVIDENCE, MANAGEMENT BELIEVES IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESSES, IF ANY. TAX POSISTIONS TAKEN ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50 PERCENT LIKELY OF BEING REALIZED UPON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITIY. THE PORTION OF THE BENEFITS ASSOCIATED WITH TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE WOULD BE REFLECTED AS A LIABILITY FOR UNRECOGNIZED TAX BENEFITS IN THE ACCOMPANYING BALANCE SHEET ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. INTEREST AND PENALTIES ASSOCIATED WITH UNRECOGNZIED TAX BENEFITS WOULD BE CLASSIFIED AS EXPENSES AGAINST OTHER OPERATING REVENUE IN THE STATEMENT OF OPERATIONS. AT JUNE 30, 2013 AND 2012, THERE WAS NO LIABILITY FOR UNRECOGNIZED TAX BENEFITS. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | ADJUSTMENTS TO MARKET -209,251. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Discretionary Spending Account | X | DiscretionarySpendingAccount |
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 0 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| 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 | 1 | 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 | 1 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PATRICK O'DONNELL | ||||||||||||||
| TREASURER/SR VP AND COO | 20534 | 390144 | 5061 | 96162 | 1510 | 28681 | 4006 | 76113 | 955 | 18138 | 32066 | 609238 | 0 | 0 |
| NORMAN EPSTEIN | ||||||||||||||
| PRESIDENT | 0 | 1419090 | 0 | 214500 | 0 | 43719 | 0 | 78105 | 0 | 23870 | 0 | 1779284 | 0 | 0 |
| KIMBERLY M RZOMP | ||||||||||||||
| ASSISTANT TREASURER/VP AND CFO | 7674 | 145801 | 1470 | 27930 | 65 | 1226 | 1399 | 26584 | 961 | 18265 | 11569 | 219806 | 0 | 0 |
| MICHELE ZEIGLER | ||||||||||||||
| VP FOR INFORMATION SERVICE | 5530 | 215668 | 1007 | 39254 | 500 | 19492 | 858 | 33449 | 413 | 16091 | 8308 | 323954 | 0 | 0 |
| LISSA NIKI SHOWE | ||||||||||||||
| SR VP OF PHYSICIAN PRACTICES | 50301 | 201204 | 9456 | 37824 | 5767 | 23070 | 1500 | 6000 | 2304 | 9215 | 69328 | 277313 | 0 | 0 |
| JIANZHONG LI | ||||||||||||||
| CHIEF PHYSICIST | 206810 | 0 | 0 | 0 | 1868 | 0 | 23554 | 0 | 1320 | 0 | 233552 | 0 | 0 | 0 |
| ZHI LIANG | ||||||||||||||
| PHYSICIST | 145021 | 0 | 0 | 0 | 279 | 0 | 11245 | 0 | 8751 | 0 | 165296 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 1A | THE ORGANIZATION REIMBURSES THE CEO FOR DUES ASSOCIATED WITH A SOCIAL CLUB. THE OFFICERS RECEIVE AN ALLOWANCE THAT CAN BE CONSIDERED A DISCRETIONARY SPENDING ACCOUNT. THE MONIES ARE IN LIEU OF AN AUTOMOBILE ALLOWANCE, TO PURCHASE ADDITIONAL LIFE INSURANCE, ETC. THESE MONIES ARE INCLUDED IN COMPENSATION AS REPORTED IN THE COMPENSATION OF OFFICERS TABLE. RESULTS FITNESS CLUB MEMBERSHIP IS AVAILABLE FREE OF CHARGE FOR ANY OFFICER AND ACTIVE BOARD MEMBER. |
| PART I, LINE 4B | NORMAN EPSTEIN - NO PAYMENT PATRICK W. O'DONNELL - NO PAYMENT MICHELE ZEIGLER - NO PAYMENT |
| PART I, LINE 7 | INCENTIVE COMPENSATION IS BASED ON PRE-DETERMINED, MEASURABLE GOALS APPROVED BY THE BOARD OF DIRECTORS' EXECUTIVE COMPENSATION COMMITTEE. THE MEASURABLE GOALS ARE BASED ON QUALITY, COMMUNITY ACCESS TO CARE, PATIENT SAFETY AND LEADERSHIP. |
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 | FCIDA HEALTHCARE REVENUE BOND SERIES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Date Issued | 2009-08-24 | DateIssued |
| Issue Price | 30000000 | IssuePrice |
| Description Of Purpose | ISSUED TO REFINANCE THE SERIES OF 2000 AND SERIES OF 2004 | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | 30000000 | TotalProceeds |
| Issuance Costs From Proceeds | 117184 | IssuanceCostsFromProceeds |
| Current Refunding | 1 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Bond Iss Meet Prvt Security Pay Test | 0 | BondIssMeetPrvtSecurityPayTest |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedProp |
| Non Qualified Bond Remed Procdrs | 0 | NonQualifiedBondRemedProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiled |
| Rebate Not Due Yet | 0 | RebateNotDueYet |
| Exception To Rebate | 0 | ExceptionToRebate |
| No Rebate Due | 0 | NoRebateDue |
| Variable Rate Issue | 0 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqs |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | SUMMIT HEALTH, A 501(C)(3) ENTITY, IS A MEMBER OF THIS ORGANIZATION | |
| FORM 990, PART VI, SECTION A, LINE 7A | SUMMIT HEALTH, A 501(C)(3) ENTITY, ELECTS THE MEMBERS OF THE GOVERNING BODY | |
| FORM 990, PART VI, SECTION A, LINE 7B | SUMMIT HEALTH, A 501(C)(3) ENTITY, RETAINS CERTAIN RESERVE POWERS OVER THIS ORGANIZATION | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE ORGANIZATION'S 990 IS REVIEWED BY THE AUDIT COMMITEE AND UPON APPROVAL RECOMMENDED TO THE FULL BOARD OF DIRECTORS FOR SUBMISSION TO THE IRS. | |
| FORM 990, PART VI, SECTION B, LINE 12C | MEMBERS ARE ASKED TO ANNUALLY DISCLOSE ANY CONFLICTS OF INTEREST THEY MAY HAVE. | |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION IS DISCUSSED WITH AN INDEPENDENT COMPENSATION COMMITTEE. THIS IS PERFORMED IN CONCERT WITH A COMPENSATION CONSULTANT WHO ASSISTS THIS COMMITTEE IN SETTING THE COMPENSATION FOR THESE INDIVIDUALS. | |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. DOCUMENTS ARE HELD IN THE FINANCE DEPARTMENT OF THE CHAMBERSBURG HOSPITAL. | |
| FORM 990, PART XI, LINE 9: | CHANGE IN PENSION LIABILITY 253,592. TRANSFERS FROM AFFILIATES 1,287,558. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| 990 PART XII LINE 2C | THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. |
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 |
|---|---|---|---|---|---|---|---|---|---|---|
| SUMMIT HEALTH | ||||||||||
| 112 NORTH 7TH STREET | CHAMBERSBURG | PA | 17201 | 251515371 | MANAGE AND ADMINISTER THE LOCAL & REGIONAL NETWORK OF HEALTHCARE PROVIDERS. | PA | 501(C)(3) | 7 | SUMMIT HEALTH | 0 |
| WAYNESBORO HOSPITAL | ||||||||||
| 501 EAST MAIN STREET | WAYNESBORO | PA | 17268 | 231360854 | SERVE THE HEALTH CARE NEEDS OF FRANKLIN COUNTY PA AND SURRONDING COMMUN. | PA | 501(C)(3) | 3 | SUMMIT HEALTH | 0 |
| CHAMBERSBURG HOSPITAL | ||||||||||
| 112 NORTH 7TH STREET | CHAMBERSBURG | PA | 17201 | 230465970 | SERVE THE HEALTH CARE NEEDS OF SOUTH CENTRAL PA AND SURROUNDING COMMUN. | PA | 501(C)(3) | 3 | SUMMIT HEALTH | 0 |
| SUMMIT PHYSICIAN SERVICES | ||||||||||
| 785 5TH AVENUE SUITE 3 | CHAMBERSBURG | PA | 17201 | 251716306 | TO PROVIDE APPROPRIATE PHYSICIAN MANPOWER TO SERVE THE LOCAL PHYSICIAN PRACT | PA | 501(C)(3) | 11A - TYPE 1 | SUMMIT HEALTH | 0 |
Form990 Schedule R Part III Form990ScheduleRPartIII (6 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MONT ALTO HEALTH CENTER LP | |||||||||||||
| 6155 ANTHONY HIGHWAY | MONT ALTO | PA | 17237 | 251839895 | RENTAL REAL ESTATE | PA | NOT A DISREGARDED ENTITY FOR TAX PURPOSES | INVESTMENT | 47018 | 502078 | 0 | 0 | 0.49900 |
| MONT ALTO HEALTH CENTER LLC | |||||||||||||
| 6155 ANTHONY HIGHWAY | MONT ALTO | PA | 17237 | 231843380 | PHYSICIAN SERVICES | PA | NOT A DISREGARDED ENTITY FOR TAX PURPOSES | RELATED | 94 | 1277 | 0 | 1 | 0.50000 |
| SURGERY CENTER ASSOCIATES LLC | |||||||||||||
| 785 5TH AVENUE SUITE 3 | CHAMBERSBURG | PA | 17201 | 251845304 | PHYSICIAN SERVICES | PA | NOT A DISREGARDED ENTITY FOR TAX PURPOSES | RELATED | 8098 | 10802 | 0 | 1 | 0.64850 |
| SUMMIT SURGERY CENTER LP | |||||||||||||
| 785 5TH AVENUE SUITE 3 | CHAMBERSBURG | PA | 17201 | 251845303 | PHYSICIAN SERVICES | PA | NOT A DISREGARDED ENTITY FOR TAX PURPOSES | RELATED | 657456 | 1482799 | 0 | 0 | 0.68450 |
| SHIPPENSBURG FAMILY PRACTICE LTD | |||||||||||||
| 46 WALNUT BOTTOM ROAD | SHIPPENSBURG | PA | 17257 | 232942280 | PHYSICIAN SERVICES | PA | NOT A DISREGARDED ENTITY FOR TAX PURPOSES | RELATED | 47503 | 0 | 0 | 0.50000 | |
| CUMBERLAND VALLEY MOBILE SERVICES LLC | |||||||||||||
| 5 SOUTH MAIN STREET SUITE 5 | SUGARLOAF | PA | 18249 | 200884014 | MOBILE X-RAY SERVICES | PA | NOT A DISREGARDED ENTITY FOR TAX PURPOSES | RELATED | 361994 | 61035 | 0 | 0 | 0.51000 |
| 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 | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SUMMIT SURGERY CENTER LP | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | J | TransactionType |
| Amount Involved | 675084 | AmountInvolved |
| Method Of Amt Determination | FMV | MethodOfAmtDetermination |