2014-05-08T11:32:04-05:00 2013-06-30 250988255 CARBIS WALKER LLP 5700 CORPORATE DRIVE STE 650 PITTSBURGH PA 15237 990 2012-07-01 251441920 SOMERSET HEALTH SERVICES INC SOME 8144435221 225 SOUTH CENTER AVENUE SOMERSET PA 15501 ANDREW RUSH 8144435221 2014-05-06 1 JEFFREY J PETRELL CPA P00138808 4126356270 2014-05-06 2012 2015-11-30 17:44:51Z ANDREW RUSH 225 SOUTH CENTER AVENUE SOMERSET PA 15501 7053632 0 X WWW.SOMERSETHOSPITAL.COM X 1983 PA SOMERSET HEALTH SERVICES IS A COMMUNITY HEALTHCARE SERVICE THAT IS COMMITTED TO MANAGING AND OPERATING PRIMARY CARE AND SPECIALTY PHYSICIAN PRACTICES. 4 3 81 4 0 0 706791 709692 5561544 6177235 26 21 209082 166684 6477443 7053632 0 0 0 0 5315855 6057815 0 0 0 2358527 2548405 7674382 8606220 -1196939 -1552588 1922403 2414220 863815 1146207 1058588 1268013 TO PRESERVE AND TO IMPROVE LIFE BY PROVIDING ACCESS TO QUALITY, CUSTOMER-FRIENDLY HEALTHCARE SERVICES. 0 0 7187254 6177235 SOMERSET HEALTH SERVICES MANAGES AND OPERATES PRIMARY CARE AND SPECIALTY PHYSICIAN PRACTICES. ANNUAL VISITS ARE APPROXIMATELY 55,000. SOMERSET HEALTH SERVICES ALSO MANAGES A SINGLE COUNTY AUTHORITY WHICH PROVIDES FUNDING (RECEIVED BY STATE AND FEDERAL AGENCIES) TO VARIOUS DRUG AND ALCOHOL TREATMENT CENTERS. 7187254 1 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 16 0 1 81 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 4 3 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 PA X MATTHEW KOCIOLA 8144435221 225 SOUTH CENTER AVENUE SOMERSET PA 15001 SHARON CLAPPER 1.00 1.00 X X 0 0 0 BRAD COBER 1.00 2.00 X X 0 0 0 TROY MILLER 1.00 X 0 0 0 TED DESKEVICH 1.00 X 0 0 0 MICHAEL FARRELL 6.00 34.00 X X 0 303456 14238 RONALD PARK 6.00 34.00 X 0 217818 21146 SAAD ALSAAB MD 40.00 X 718392 0 11124 V KRISHNAN NAIR MD 40.00 2.00 X 420000 0 14517 JOSE AYCINENA MD 40.00 X 286154 0 16861 AJAY SINGH MD 40.00 X 244002 0 14290 JAYESH DESAI MD 40.00 X 410000 0 16861 2078548 521274 109037 12 0 1 0 0 709692 709692 NET PATIENT REVENUE 621610 6177235 6177235 6177235 21 21 OTHER OPERATING REVENU 900099 125423 125423 SOMERSET MGMT SERVICES 900099 41261 41261 166684 7053632 6177235 0 166705 5314055 4251244 1062811 17879 14303 3576 491073 392858 98215 234808 187846 46962 97582 97582 12515 12515 225656 182542 43114 6600 6600 118827 104680 14147 349849 336849 13000 28403 25574 2829 4135 4135 166233 148001 18232 71191 71191 PROVIDER EXPENSES 491236 489976 1260 INTERNAL BILLING COSTS 410984 409308 1676 MEDICAL SUPPLIES/DRUGS 407164 407164 EQUIPMENT RENTAL & MAIN 75925 73912 2013 82105 81071 1034 8606220 7187254 1418966 0 385369 591449 327717 365908 66577 92402 1419716 1026009 417101 393707 415563 456825 310076 513929 1922403 2414220 863815 1146207 863815 1146207 X 1058588 1268013 1058588 1268013 1922403 2414220 X -1552588 1762013 X X 0 1 X 1 1 1 X 49559 48846 713 1365382 972388 392994 4775 4775 0 393707 INVESTMENT IN SOMERSET MANAGEMENT SERVICES, INC. 456825 C 456825 OTHER ASSETS 513929 513929 0 0 0 0 0 1 0 0 0 MICHAEL FARRELL 0 303456 0 0 0 0 0 5000 0 9238 0 317694 0 0 RONALD PARK 0 217818 0 0 0 0 0 4531 0 16615 0 238964 0 0 SAAD ALSAAB MD 718392 0 0 0 0 0 0 0 11124 0 729516 0 0 0 V KRISHNAN NAIR MD 420000 0 0 0 0 0 0 0 14517 0 434517 0 0 0 JOSE AYCINENA MD 286154 0 0 0 0 0 0 0 16861 0 303015 0 0 0 AJAY SINGH MD 230000 0 14002 0 0 0 0 0 14290 0 258292 0 0 0 JAYESH DESAI MD 410000 0 0 0 0 0 0 0 16861 0 426861 0 0 0 PART I, LINE 3 SOMERSET HEALTH SERVICES' MANAGEMENT IS EMPLOYED BY SOMERSET COMMUNITY HOSPITAL. SOMERSET COMMUNITY HOSPITAL'S LEADERSHIP COMMITTEE, WHICH IS A SUBCOMMITTEE OF THE BOARD OF DIRECTORS, ANNUALLY REVIEWS AND APPROVES THE COMPENSATION OF THEIR ORGANIZATION'S TOP MANAGEMENT. PART I, LINE 6 PHYSICIANS MAY BE GRANTED ADDITIONAL COMPENSATION DEPENDENT ON THE ACHIEVING OF CERTAIN INDICATORS BY THE COMPANY FORM 990, PART VI, SECTION B, LINE 11 SOMERSET HEALTH SERVICES, INC. HAS A CPA FIRM PREPARE ITS FORM 990. THE RETURN IS COMPLETED IN DRAFT FORM AND REVIEWED BY MANAGEMENT OF THE ORGANIZATION. THE RETURN IS THEN FINALIZED AND THE BOARD IS PROVIDED A COPY OF THE FORM 990 BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C SOMERSET HEALTH SERVICES, INC. ANNUALLY REQUIRES ITS BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES TO FILL OUT A CONFLICTS OF INTEREST FORM. DURING BOARD MEETINGS, IF AN INTERESTED PARTY HAS A CONFLICT, HE OR SHE RECUSES THEMSELVES FROM VOTING. SOMERSET HEALTH SERVICES' MANAGEMENT IS EMPLOYED BY SOMERSET COMMUNITY HOSPITAL. SOMERSET COMMUNITY HOSPITAL'S LEADERSHIP COMMITTEE, WHICH IS A SUBCOMMITTEE OF THE BOARD OF DIRECTORS, ANNUALLY REVIEWS AND APPROVES THE COMPENSATION OF THEIR ORGANIZATION'S TOP MANAGEMENT. FORM 990, PART VI, SECTION C, LINE 18 SOMERSET HEALTH SERVICES, INC. MAKES ITS FORM 990 AND FORM 1023 AVAILABLE TO THE PUBLIC. FORM 990, PART VI, SECTION C, LINE 19 AT THIS TIME, SOMERSET HEALTH SERVICES, INC. DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND CONSOLIDATED FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: TRANSFERS FROM AFFILIATES 1,762,013. FORM 990, PART XII, LINE 2C: SOMERSET COMMUNITY HOSPITAL, A TAX-EXEMPT AFFILIATE OF SOMERSET HEALTH SERVICES, INC. HAS A FINANCE COMMITTEE THAT IS RESPONSIBLE FOR THE OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT AUDITORS ON BEHALF OF SOMERSET HEALTH SERVICES, INC. THE PROCESS IS CONSISTENT WITH PRIOR YEARS AND HAS NOT CHANGED. FORM 990, PAGE 1 ANDREW RUSH WAS NAMED CEO EFFECTIVE MARCH 17, 2014 AND IS THE CURRENT PRINCIPAL OFFICER. SOMERSET COMMUNITY HOSPITAL 225 SOUTH CENTER AVENUE SOMERSET PA 15501 250965570 HEALTH CARE PA 501(C)(3) 509(A)(1) SOMERSET COMMUN HOSP FOUNDATION 0 SOMERSET COMMUNITY HOSPITAL FOUNDATION 225 SOUTH CENTER AVENUE SOMERSET PA 15501 251441863 HEALTH CARE PA 501(C)(3) 509(A)(3) 0 TWIN LAKES CENTER INC 225 SOUTH CENTER AVENUE SOMERSET PA 15501 232910318 HEALTH CARE PA 501(C)(3) 509(A)(1) SOMERSET COMMUNITY HOSPITAL 0 SOMERSET MANAGEMENT SERVICES INC 225 SOUTH CENTER AVENUE SOMERSET PA 15501 251512960 REAL ESTATE HOLDING COMPANY PA SOMERSET HEALTH SERVICES INC C 41261 2580357 1.00000 0 SOMERSET ORTHOPEDICS INC 225 SOUTH CENTER AVENUE SOMERSET PA 15501 113725138 ORTHOPEDIC PHYSICIAN PRACTICE PA SOMERSET COMMUN HOSP FOUNDATION C 0 SOMERSET ANESTHESIA INC 225 SOUTH CENTER AVENUE SOMERSET PA 15501 455135437 ANESTHESIA SERVICES PA SOMERSET COMMUNITY HOSPITAL C 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 1 SOMERSET MANAGEMENT SERVICES INC K 200000