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TIDALHEALTH NANTICOKE INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
TIDALHEALTH NANTICOKE INC (EIN 51-0069243)
Tax period
2012-07-01 to 2013-06-30
Filed
2013-12-15
IRS object ID
201303509349300310
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

FieldValueIRS element (for citing)
Timestamp2013-12-15T09:22:20-06:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN410746749EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1610 WEST GERMANTOWN PIKE SUITE 400AddressLine1
CityPLYMOUTH MEETINGCity
StatePAState
ZIP Code19462ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN510069243EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1NANTICOKE MEMORIAL HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlNANTNameControl
Phone3026296611Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1801 MIDDLEFORD ROADAddressLine1
CitySEAFORDCity
StateDEState
ZIP Code19973ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDEAN SWINGLEName
TitleDIR FINANCE/CHIEF TAX OFFICERTitle
Phone3026296611Phone
Date Signed2013-12-13DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameMICHAEL SIEGELName
PTINP01587323PTIN
Phone2156433900Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonSTEVEN ROSENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1801 MIDDLEFORD ROADAddressLine1
CitySEAFORDCity
StateDEState
ZIP Code19973ZIPCode
FieldValueIRS element (for citing)
Gross Receipts129928939GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.NANTICOKE.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1945YearFormation
State Legal DomicileDEStateLegalDomicile
Activity Or Mission DescriptionPROVIDE HEALTH CARE SERVICES TO THE COMMUNITY, REGARDLESS OF THE ABILITY TO PAY.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees998TotalNbrEmployees
Total Nbr Volunteers457TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year14362401ContributionsGrantsPriorYear
Contributions Grants Current Year230248ContributionsGrantsCurrentYear
Program Service Revenue Prior Year122486253ProgramServiceRevenuePriorYear
Program Service Revenue CY125724350ProgramServiceRevenueCY
Investment Income Prior Year892624InvestmentIncomePriorYear
Investment Income Current Year814285InvestmentIncomeCurrentYear
Other Revenue Prior Year4535420OtherRevenuePriorYear
Other Revenue Current Year3032102OtherRevenueCurrentYear
Total Revenue Prior Year142276698TotalRevenuePriorYear
Total Revenue Current Year129800985TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year7033346GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY4907656GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year60470129SalariesEtcPriorYear
Salaries Etc Current Year59577729SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year59695077OtherExpensePriorYear
Other Expenses Current Year60599588OtherExpensesCurrentYear
Total Expenses Prior Year127198552TotalExpensesPriorYear
Total Expenses Current Year125084973TotalExpensesCurrentYear
Revenues Less Expenses Prior Year15078146RevenuesLessExpensesPriorYear
Revenues Less Expenses CY4716012RevenuesLessExpensesCY
Total Assets BOY116971831TotalAssetsBOY
Total Assets EOY124252419TotalAssetsEOY
Total Liabilities BOY76585778TotalLiabilitiesBOY
Total Liabilities EOY74854912TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY40386053NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY49397507NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionNANTICOKE MEMORIAL HOSPITAL OPERATES IN A MANNER CONSISTENT WITH THE REQUIREMENTS OF REVENUE RULING 69-545, THROUGH ITS PROVISION OF HEALTH CARE SERVICES TO THE COMMUNITY, REGARDLESS OF THE ABILITY TO PAY.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense114867078Expense
Grants4907656Grants
Revenue125724350Revenue
DescriptionNANTICOKE MEMORIAL HOSPITAL PROVIDES QUALITY MEDICAL CARE REGARDLESS OF THE RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATIONS AND STABILITY OF MID-SUSSEX MEDICAL CENTER, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. THEREFORE, IN KEEPING WITH THE MEDICAL CENTER'S COMMITMENT TO SERVE ALL MEMBERS OF THE COMMUNITY, HEALTH ACTIVITIES AND PROGRAMS NEEDED TO SUPPORT THE COMMUNITY WILL BE CONSIDERED WHERE THE NEED AND/OR THE INDIVIDUAL'S INABILITY TO PAY CO-EXISTS. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, SPECIAL PROGRAMS FOR THE UNDER SERVED, SCREENING AND A WIDE VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES.PATIENTS SEEN.INPATIENTS 5,285; BIRTHS 825; ER VISITS 37,759; OP VISITS 82,006;DAYS OF INPATIENT CARE:ADULTS AND PEDIATRICS 21,877; NEWBORN 1,735;OTHER FACTS:AVERAGE PATIENT STAY 3.7; OPERATIONS 3,477;NANTICOKE MEMORIAL HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT OR BELOW COST. RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS. SERVICES PROVIDED TO THOSE UNABLE TO PAY $20,262,169. DISCOUNTS TO MEDICARE, MEDICAID, AND OTHERS $136,018,991.Description
Total Program Service Expense114867078TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096180NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees998NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure0WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledDEStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1DEAN A SWINGLE DIR FINANCECHIEF TAX OFFICERBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number3026296611TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1801 MIDDLEFORD ROADAddressLine1
CitySEAFORDCity
StateDEState
ZIP Code19973ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (28 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
STEVEN ROSE
CEO/PRESIDENT32.008.00XX495172090257
JOHN ALLEN
DIRECTOR1.001.00X000
JOAQUIN CABRERA
DIRECTOR/PHYSICIAN1.0041.00X300003396356643
DAVID CROUSE
DIRECTOR1.001.00X000
FERNANDO GUAJARDO
DIRECTOR1.001.00X000
DONALD HOLLENBECK
DIRECTOR1.001.00X000
GREG JOHNSON
DIRECTOR1.001.00X000
TRINA JOYNER
DIRECTOR1.001.00X000
JOSEPH KIM
DIRECTOR/PHYSICIAN1.0041.00X1500019122722305
HARRY LEHMAN
DIRECTOR1.002.00X000
LYNDA MESSICK
BOARD CHAIR ELECT1.001.00XX000
PATRICIA OLEKSZYK
DIRECTOR1.001.00X000
TAMMY PAXTON
DIRECTOR1.001.00X000
KENT PETERSON
BOARD CHAIR1.002.00XX000
MICHELE PROCINO-WELLS
DIRECTOR1.001.00X000
JACK RIDDLE
SECRETARY1.002.00XX000
REP DANNY SHORT
DIRECTOR1.001.00X000
PENNY SHORT
COO/CNO32.008.00X186735039763
THOMAS BROWN
SENIOR VP20.0020.00X213241035576
DENISE JESTER
CFO/TREASURER30.0011.00X108383012640
DON TRICARICO
VP40.000.00X156542032897
BARBARA HENDRICKS
VP30.0010.00X118968016779
ROBERT FERBER
PHYSICIAN40.000.00210496028332X
ANJU BHARDWAJ
PHYSICIAN40.000.0024546609971X
DANIEL CHAN
PHYSICIAN40.000.00217519023306X
MEERA KAPHLE
PHYSICIAN40.000.00214960016334X
IMRAN JANJUA
PHYSICIAN40.000.00257463019167X
DARR HALL
FORMER CFO/TREASURER30.0011.00239298034748X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2709243TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs530862TotalReportableCompFrmRltdOrgs
Total Other Compensation388718TotalOtherCompensation
Number Individuals GT100 K33NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
CERNER CORPORATION
2800 ROCKCREEK PARKWAYKANSAS CITYMO64141TECHNOLOGY3206978
ANESTHESIA SERVICES
2 READS WAYNEW CASTLEDE19720ANESTHESIA1500000
DELPHI HEALTHCARE
170 SOUTHPORT DRIVEMORRISVILLENC27560ORTHOPEDICS1141003
QUEST DIAGNOSTICS
PO BOX 828669PHILADELPHIAPA19182LAB SERVICES739899
ARAMARK MASTERPLAN
12483 COLLECTIONS CENTER DRIVECHICAGOIL60673BIO-MEDICAL710299
FieldValueIRS element (for citing)
Number Of Contractors GT100 K33NumberOfContractorsGT100K
Related Organizations230248RelatedOrganizations
Total Contributions230248TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT REVENUEDescription
Business Code623000BusinessCode
Total Revenue Column125724350TotalRevenueColumn
Related Or Exempt Function Income125724350RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue125724350TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column26161TotalRevenueColumn
Exclusion$26,161ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real195841Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real195841Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column195841TotalRevenueColumn
Exclusion$195,841ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities877709Securities
Other38369Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities0Securities
Other127954Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities877709Securities
Other-89585Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column788124TotalRevenueColumn
Exclusion$788,124ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
MISCELLANEOUS6230003641352$3,641,352
CAFETERIA623000597991$597,991
GIFT SHOP62300094962$94,962

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column-1498044TotalRevenueColumn
Exclusion-$1,498,044ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue2836261TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column129800985TotalRevenueColumn
Related Or Exempt Function Income125724350RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$3,846,387ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total4907656Total
Program Services4907656ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1390903Total
Program Services1265722ProgramServices
Management And General125181ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total176651Total
Program Services160752ProgramServices
Management And General15899ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total45090359Total
Program Services41032227ProgramServices
Management And General4058132ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total9988505Total
Program Services9089727ProgramServices
Management And General898778ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2931311Total
Program Services2667493ProgramServices
Management And General263818ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total1009913Total
Program Services919021ProgramServices
Management And General90892ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total54526Total
Management And General54526ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total165551Total
Management And General165551ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total12501143Total
Program Services11376040ProgramServices
Management And General1125103ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total2424911Total
Program Services2206669ProgramServices
Management And General218242ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total291362Total
Program Services265139ProgramServices
Management And General26223ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total16016Total
Program Services14575ProgramServices
Management And General1441ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total5084949Total
Program Services4627304ProgramServices
Management And General457645ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total160009Total
Program Services145608ProgramServices
Management And General14401ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total2734583Total
Program Services2734583ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total6110488Total
Program Services6110488ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total544074Total
Program Services495107ProgramServices
Management And General48967ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
SUPPLIES13606563123819721224591
BAD DEBT EXPENSE11957993108826011075392
DRUGS38534183506610346808
MISCELLANEOUS81914758056109

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total2175Total
Program Services1979ProgramServices
Management And General196ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total125084973Total
Program Services114867078ProgramServices
Management And General10217895ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY11635762BOY
EOY5074238EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY10775290BOY
EOY13363548EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1560415BOY
EOY1654472EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1690653BOY
EOY2005994EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis119932049LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec72382582LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY49822305BOY
EOY47549467EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY31871491BOY
EOY48871627EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY314750BOY
EOY347352EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY1184047BOY
EOY968349EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY8117118BOY
EOY4417372EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY116971831BOY
EOY124252419EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY19065541BOY
EOY19013957EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY47843771BOY
EOY47468147EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY7509864BOY
EOY6154953EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2166602BOY
EOY2217855EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY76585778BOY
EOY74854912EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY40386053BOY
EOY49397507EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY40386053BOY
EOY49397507EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY116971831BOY
EOY124252419EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses4716012ReconcilationRevenueExpenses
Reconciliation Unrealized Invest1736978ReconciliationUnrealizedInvest
Reconcilation Other Changes2558464ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management1PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations1GrantsOtherOrganizations
Grants Other Organizations$14,942GrantsOtherOrganizationsAmount
Direct Contact Legislators1DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities0OtherActivities
Total Lobbying Expenditures IIB14942TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPART IV, SUPPLEMENTAL INFORMATION:Identifier
ExplanationSCHEDULE C, PART II-B, LINE 1I NANTICOKE MEMORIAL HOSPITAL PAYS DUES TO AHA AND DEHA: THE AMERICAN HOSPITAL ASSOCIATION AND THE DELAWARE HEALTHCARE ASSOCIATION. NANTICOKE MEMORIAL HOSPITAL'S MANAGEMENT ALSO CORRESPONDS WITH OUR STATE AND FEDERAL LEGISLATORS REGARDING CURRENT LEGISLATION AND REGULATIONS THAT MAY AFFECT THE FINANCIAL VIABILITY OF THE HOSPITAL AND ITS ABILITY TO CONTINUE TO PROVIDE QUALITY HEALTHCARE TO THE COMMUNITY.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1965859OtherCostOrOtherBasis
Book Value1965859BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis60549619OtherCostOrOtherBasis
Depreciation26346592Depreciation
Book Value34203027BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1214135OtherCostOrOtherBasis
Depreciation923179Depreciation
Book Value290956BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis56116145OtherCostOrOtherBasis
Depreciation45112811Depreciation
Book Value11003334BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis86291OtherCostOrOtherBasis
Book Value86291BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings47549467TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
ESTIMATED THIRD PARTY PAYOR SETTLEMENTS$1,150,000
OTHER LIABILITIES$1,067,855
FieldValueIRS element (for citing)
Total Of Amounts2217855TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:Identifier
Return ReferencePART X, LINE 2:ReturnReference
ExplanationTHE ORGANIZATION FOLLOWS THE STANDARD OF ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX PROVISIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE APPLICATION OF THE STANDARD HAD NO IMPACT ON THE ORGANIZATION'S CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION'S TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL AND STATE AUTHORITIES. THE TAX RETURNS FOR THE YEARS 2010 TO 2012 ARE OPEN TO EXAMINATION BY FEDERAL AND STATE AUTHORITIES.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage250.000000000000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Persons Served3421PersonsServed
Total Community Benefit Expense3322439TotalCommunityBenefitExpense
Net Community Benefit Expense3322439NetCommunityBenefitExpense
Percent Of Total Expense0.02660PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Persons Served39100PersonsServed
Total Community Benefit Expense26691405TotalCommunityBenefitExpense
Direct Offsetting Revenue20595298DirectOffsettingRevenue
Net Community Benefit Expense6096107NetCommunityBenefitExpense
Percent Of Total Expense0.04870PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Persons Served42521PersonsServed
Total Community Benefit Expense30013844TotalCommunityBenefitExpense
Direct Offsetting Revenue20595298DirectOffsettingRevenue
Net Community Benefit Expense9418546NetCommunityBenefitExpense
Percent Of Total Expense0.07530PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs660NumberOfActivitiesOrPrograms
Persons Served22443PersonsServed
Total Community Benefit Expense1072308TotalCommunityBenefitExpense
Net Community Benefit Expense1072308NetCommunityBenefitExpense
Percent Of Total Expense0.00860PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs303NumberOfActivitiesOrPrograms
Persons Served2630PersonsServed
Total Community Benefit Expense100360TotalCommunityBenefitExpense
Net Community Benefit Expense100360NetCommunityBenefitExpense
Percent Of Total Expense0.00080PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs963NumberOfActivitiesOrPrograms
Persons Served25073PersonsServed
Total Community Benefit Expense1172668TotalCommunityBenefitExpense
Net Community Benefit Expense1172668NetCommunityBenefitExpense
Percent Of Total Expense0.00940PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs963NumberOfActivitiesOrPrograms
Persons Served67594PersonsServed
Total Community Benefit Expense31186512TotalCommunityBenefitExpense
Direct Offsetting Revenue20595298DirectOffsettingRevenue
Net Community Benefit Expense10591214NetCommunityBenefitExpense
Percent Of Total Expense0.08470PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs100NumberOfActivitiesOrPrograms
Persons Served100PersonsServed
Total Community Building Expense1001611TotalCommunityBuildingExpense
Net Community Building Expense1001611NetCommunityBuildingExpense
Percent Of Total Expense0.00800PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs100NumberOfActivitiesOrPrograms
Persons Served100PersonsServed
Total Community Building Expense1001611TotalCommunityBuildingExpense
Net Community Building Expense1001611NetCommunityBuildingExpense
Percent Of Total Expense0.00800PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$11,948,796BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare42683013AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare40904063CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall1778950MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1NANTICOKE MEMORIAL HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1801 MIDDLEFORD ROADAddressLine1
CitySEAFORDCity
StateDEState
ZIP Code19973ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1NANTICOKE MEMORIAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA Conducted1CHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
Needs Assessment Conducted12NeedsAssessmentConducted
Take Into Account1TakeIntoAccount
Other Facilities1OtherFacilities
CHNA Widely Available1CHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Develop Community PlanXDevelopCommunityPlan
Participate Community PlanXParticipateCommunityPlan
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs Addressed0AllNeedsAddressed
Organization Incur Excise Tax0OrganizationIncurExciseTax
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent250.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent300.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities1NumberOfOtherFacilities

Other Facilities OtherFacilities

Name Name

FieldValueIRS element (for citing)
Business Name Line1MEARS HEALTH CAMPUSBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1200 RAWLINS DRIVEAddressLine1
CitySEAFORDCity
StateDEState
ZIP Code19973ZIPCode
FieldValueIRS element (for citing)
Facility TypeMEDICAL FACILITYFacilityType

Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART I, LINE 7: THE COSTING METHOD USED TO CALCULATE THE AMOUNTS REPORTED WAS THE MEDICARE OPERATING COST-TO-CHARGE RATIO FOR BOTH OUTPATIENT AND INPATIENT SERVICES.
PART I, LINE 7G: THE HOSPITAL DID NOT INCLUDE SUBSIDIZED HEALTH SERVICE ATTRIBUTABLE TO PHYSICIAN CLINICS.
PART I, L7 COL(F): THE HOSPITAL DID NOT INCLUDE ANY AMOUNT OF BAD DEBT EXPENSE IN THE DENOMINATOR IN COMPUTING THE PERCENTAGE IN COLUMN (F).
PART III, LINE 4: THE ORGANIZATION PROVIDES CARE WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY. BECAUSE THE ORGANIZATION DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THOSE AMOUNTS ARE NOT REPORTED AS REVENUES. FOR THOSE PATIENTS WHO DID NOT MEET THE CHARITY CARE POLICY, THE ORGANIZATION MUST EVALUATE THEIR ABILITY TO COLLECT AMOUNTS DUE FROM PATIENTS THAT ARE PAST DUE. A PROVISION FOR BAD DEBTS IS RECORDED FOR AMOUNTS NOT YET WRITTEN OFF WHICH ARE EXPECTED TO BECOME UNCOLLECTIBLE. THE HOSPITAL'S POLICY IS TO HAVE A MINIMUM OF 2-3 STATEMENTS AND A FINAL NOTICE BEFORE SENDING PATIENT ACCOUNTS TO COLLECTIONS. ADDITIONALLY, ACCOUNTS GREATER THAN $500 ARE ATTEMPTED TO BE REACHED BY TELEPHONE.
PART III, LINE 8: THE COSTING METHOD USED TO DETERMINE ALLOWABLE COSTS ARE THE COSTS IN ACCORDANCE WITH MEDICARE REQUIREMENTS AND REGULATIONS. ONLY COSTS THAT ARE CONSISTENT WITH EFFICIENT, COST-EFFECTIVE MANAGEMENT AND OPERATIONS ARE ALLOWED. ONLY OPERATING COSTS THAT ARE DIRECTLY RELATED TO THE DELIVERY OF HEALTH CARE SERVICES TO MEDICARE AND MEDICAID PATIENTS WERE ALLOWED.
PART III, LINE 9B: THE COLLECTION POLICY PERTAINS TO ALL PATIENTS WITH A SELF PAY BALANCE. IF A PATIENT APPLIES FOR EITHER CHARITY CARE OR ANY OTHER ASSISTANCE PROGRAM SUCH AS MEDICARE AND MEDICAID, ALL COLLECTION ACTIVITY IS PUT ON HOLD UNTIL A DETERMINATION OF ELIGIBILITY IS MADE.
PART V, SECTION B, LINE 5C: THE 2013 NANTICOKE COMMUNITY NEEDS ASSESSMENT IMPLEMENTATION PLAN CAN BE FOUND AT HTTP://WWW.NANTICOKE.ORG/COMMUNITY-OUTREACH/PROGRAMS-AND-INITIATIVES.ASPX.NANTICOKE MEMORIAL HOSPITAL
PART V, SECTION B, LINE 7: BECAUSE OF THE METHOD OF COLLECTION, MORE NEEDS WERE IDENTIFIED THAN WE ARE ABLE TO ADDRESS INDIVIDUALLY. FOR EXAMPLE, MENTAL HEALTH WAS IDENTIFIED AS A TOP NEED FOR THE COUNTY. THIS NEED IS NOT BEING DIRECTLY ADDRESSED BY NANTICOKE SINCE, AS A RURAL COMMUNITY HOSPITAL, WE ARE UNABLE TO FINANCIALLY SUSTAIN A SOLUTION ON OUR OWN. THIS NEED IS BEING ADDRESSED THROUGH ADVOCACY ONLY ALONG WITH CONTINUED DISCUSSIONS WITH OTHER STATE-WIDE RESOURCES. MENTAL HEALTH IS A GREAT NEED THROUGHOUT THE STATE OF DELAWARE. TO ADDRESS THE BROADER NEED, NANTICOKE ALONG WITH THE OTHER TWO HOSPITALS WITHIN SUSSEX COUNTY HAVE COME TOGETHER TO FORM HEALTHIER SUSSEX COUNTY. THIS GROUP IS CURRENTLY WORKING TO PRODUCE A COMBINED CHNA AND STRATEGY FOR ADDRESSING COMMUNITY NEEDS ON A COUNTY-WIDE SCALE.NANTICOKE MEMORIAL HOSPITAL
PART V, SECTION B, LINE 20D: NANTICOKE MEMORIAL HOSPITAL CHARGES PATIENTS WHO ARE UNINSURED AND WHOSE FAMILY INCOME IS LESS THAN 500% OF THE FEDERAL POVERTY LEVEL, AN AMOUNT NO GREATER THAN 115% OF THE APPLICABLE PAYMENT RATE UNDER THE FEDERAL MEDICARE PROGRAM ESTABLISHED PURSUANT TO PUB. L.89-87 (42 U.S.C.S.1395 ET SEQ.) THE AMOUNT IS IN ACCORDANCE WITH THE SLIDING SCALE BASED ON INCOME DEVELOPED BY THE DEPARTMENT OF HEALTH & SENIOR SERVICES PURSUANT TO THIS ACT.NANTICOKE MEMORIAL HOSPITAL
THE HOSPITAL FACILITY'S 2013 CHNA WAS CONDUCTED WITH TWO OTHER HOSPITAL FACILITIES: BAYHEALTH AND BEEBE.PART V, LINE 4:
PART VI, LINE 2: NEEDS ASSESSMENT-NANTICOKE HEALTH SERVICES CURRENTLY USES AVAILABLE STATE DATA ON COMMUNITY HEALTH NEEDS. THE STATE OF DELAWARE CURRENTLY CONDUCTS STATEWIDE REPORTS ON HEALTH DISPARITIES FOR THOSE WITHOUT INSURANCE. THIS REPORT IS PRODUCED ABOUT EVERY FIVE YEARS. ADDITIONALLY, THE STATE OF DELAWARE PUBLISHED "RACIAL AND ETHNIC DISPARITIES HEALTH STATUS REPORT CARD" IN 2008. THIS REPORT INCLUDES COUNTY LEVEL DETAIL. THE STATE OF DELAWARE ALSO PRODUCES HEALTH NEED DATA ON DIABETES, CANCER, WOMEN'S AND CHILDREN'S HEALTH AND PROVIDER ACCESS. IN ADDITION TO STATE DATA, HOSPITAL DATA IS USED. NANTICOKE MEMORIAL HOSPITAL TREATS A LARGE NUMBER OF MEDICAID PATIENTS. IN ADDITION, FY 2013, NANTICOKE CONDUCTED A COMMUNITY NEEDS ASSESSMENT SURVEY. SURVEYS WERE COLLECTED FROM PHYSICIANS, HIGH SCHOOL WELLNESS PROGRAM COORDINATORS, CLERGY AND THE COMMUNITY AT LARGE. RESULTS WERE COMBINED WITH THE ABOVE MENTIONED STATE DATA FOR THE PURPOSES OF PLANNING FOR COMMUNITY HEALTH OUTREACH NEEDS. COMMUNITY SURVEYS ARE CONDUCTED ON AN ON-GOING BASIS.
PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE-NANTICOKE MEMORIAL HOSPITAL PROVIDES INFORMATION IN THEIR PATIENT INFORMATION AND VISITORS GUIDE UNDER THE "FINANCIAL ARRANGEMENT/INSURANCE" SECTION CONCERNING THE AVAILABILITY OF FINANCIAL COUNSELORS TO DISCUSS PAYMENT ARRANGEMENTS. AT THIS TIME, PATIENTS ARE INFORMED ABOUT ALL THE PROGRAMS AVAILABLE TO THEM, BOTH VERBALLY AND IN WRITTEN FORMAT. IN POSSIBLE ELIGIBILITY FOR DELAWARE MEDICAID ASSISTANCE. THE FOLLOWING DEPARTMENTS OFFER THIS TYPE OF ASSISTANCE TO OUR PATIENTS: BUSINESS OFFICE, REGISTRATION, CASE MANAGEMENT, CHAPS COORDINATOR, CANCER CARE COORDINATOR, CANCER NURSE NAVIGATOR (SCREENING APPROACH), AND PRESCRIPTION ASSISTANCE PROGRAM. IN ADDITION, VARIOUS ORGANIZATIONS WERE INTERVIEWED FOR INPUT, INCLUDING: ALZHEIMER'S ASSOCIATION, AMERICAN CANCER SOCIETY, AMERICAN DIABETES ASSOCIATION, BAYHEALTH, BEEBE AND NANTICOKE SOCIAL WORKERS, DELAWARE ASSOCIATION OF HISPANIC NURSES, DELAWARE BREAST CANCER COALITION, DELAWARE HEALTHCARE ASSOCIATION, DELAWARE HOSPICE, DIVISION OF PUBLIC HEALTH - GEORGETOWN, EASTER SEALS, ELLENDALE RECOVERY CENTER, LA ESPERANZA, LA RED FEDERAL QUALIFIED HEALTH CENTERS, LAW ENFORCEMENT AGENCIES, MID-ATLANTIC AIDS TRAINIG CENTER, MOUNTAIRE & PERDUE CHICKEN PLANTS, NANTICOKE INDIAN CENTER, PENINSULA HOME CARE, PEOPLE'S PLACE, PUBLIC HEALTH NURSES - GEORGETOWN, SOUTHERN DELAWARE TOURISM, STRONG COMMUNITIES, SUSSEX COUNT ASSOCIATION OF TOWNS, SUSSEX CHILD HEALTH, SUSSEX COUNTY CHURCHES, SUSSEX COUNTY CHAMBER OF COMMERCE, SUSSEX COUNTY EMS, SUSSEX COUNTY LIBRARIES, SUSSEX COUNTY FIRE STATIONS, SUSSEX COUNTY SENIOR CENTERS, SUSSEX COUNTY VETERANS GROUP, VFW/AMERICAN LEGION.
PART VI, LINE 4: USING THE INFORMATION PROVIDED THROUGH NANTICOKE'S 2013 CHNA, NANTICOKE'S COMMUNITY BENEFIT COMMITTEE (CBC) OF THE BOARD CONTINUED TO FOCUS OUTREACH EFFORTS AND BUILD STRUCTURE AROUND THE COMMUNITY BENEFIT PROCESS. DURING CALENDAR YEAR 2012, THE FIRST STRATEGIC PLAN FOR COMMUNITY BENEFIT WAS DEVELOPED AND APPROVED BY THE NHS BOARD OF DIRECTORS IN JUNE 2012. THIS ESTABLISHED A PROCESS TO DO AN INITIAL ASSESSMENT ON THE CURRENT IDENTIFIED OUTREACH INITIATIVES. THESE INITIATIVES INCLUDE GROUPS WORKING ON: CANCER, STROKE, DIABETES, OBESITY, SCHOOL WELLNESS AND GENERAL OUTREACH. AFTER COMPLETING AN INITIAL ASSESSMENT, EACH GROUP DEVELOPED MEASURABLE GOALS. THESE INITIATIVES WORK ON A FISCAL YEAR THAT RUNS JULY 1 THROUGH JUNE 30. A ONE YEAR ASSESSMENT WAS REQUESTED FROM EACH GROUP AT THE CONCLUSION OF FISCAL YEAR 2013 (JUNE), RESULTS TO BE PRESENTED TO THE CBC IN DECEMBER 2013. RESULTS WILL BE USED TO DETERMINE IF PROGRESS IS BEING MADE IN IMPROVING HEALTH OR ACCESS TO CARE IN THESE AREAS.IN ADDITION TO IDENTIFYING HEALTH NEEDS, THE 2013 CHNA ALSO IDENTIFIED BOTH THE GROWING HISPANIC POPULATION OF SUSSEX COUNTY AS WELL AS THE AFRICAN AMERICAN POPULATION AS GROUPS WITH INCREASED COMMUNITY HEALTH NEEDS. IN THE 2013 CHNA, NANTICOKE REFERENCED THE "HISPANIC HEALTH IN DELAWARE: BARRIERS TO CARE FOR THE HISPANIC POPULATION". IN 2012 AND CONTINUING INTO 2013, NANTICOKE IS EXPANDING INITIATIVES WITH BOTH LA RED AND LA ESPERANZA, ORGANIZATIONS THAT PROVIDE HEALTH AND SOCIAL SERVICES FOR THE GROWING HISPANIC POPULATION WITHIN THE COUNTY. HISPANIC REPRESENTATION ON BOTH THE NHS BOARD OF DIRECTORS AND THE COMMUNITY BENEFIT COMMITTEE HAS BEEN INCREASED. THE CEO OF NANTICOKE HEALTH SERVICES ALSO SERVES ON AND PROVIDES LEADERSHIP FOR THE GOVERNOR'S COMMISSION ON HISPANIC AFFAIRS. IN ADDITION IN 2013, NANTICOKE IS SPECIFICALLY TARGETING INCREASED PARTNERSHIPS TO ADDRESS THE NEEDS OF THE AFRICAN AMERICAN POPULATION AS WELL. THIS BEGAN WITH A COMMUNITY MEETING WITH CLERGY AND OTHER AFRICAN AMERICAN COMMUNITY REPRESENTATIVES TO OPENLY DISCUSS PRESSING NEEDS FOR THIS POPULATION. THE AFRICAN AMERICAN POPULATION IS A TARGET AREA FOR OUTREACH RELATED TO INCREASING MAMMOGRAPHY SCREENINGS SINCE THIS POPULATION IS AT HIGHER RISK TO DISCOVER THE CANCER IN LATER STAGES, WHICH INCREASES THE RISK OF DEATH FROM THE DISEASE.BY THE END OF CALENDAR YEAR 2012, THE CEO'S FROM THE THREE SUSSEX COUNTY HOSPITALS HAD MET AND APPROVED THE FORMATION OF HEALTHIER SUSSEX COUNTY. HEALTHIER SUSSEX COUNTY BRINGS TOGETHER THE THREE HOSPITALS AND OTHER HEALTH PROVIDERS AND RESOURCES TO TARGET HEALTH ISSUES THAT IMPACT NOT JUST INDIVIDUAL HOSPITAL SERVICE AREA POPULATIONS, BUT RESIDENTS THROUGHOUT THE COUNTY. BEGINNING IN 2012, HEALTHIER SUSSEX COUNTY HAS TASK FORCES WORKING ON (1) A COUNTY WIDE CHNA; (2) A DIABETES TASK FORCE WORKING TOWARD INCREASING COMPLIANCE AND FOLLOW UP FOR DIAGNOSED DIABETICS; AND (3) A MAMMOGRAPHY TASK FORCE WORKING TO INCREASE THE NUMBER OF WOMEN COMPLETING HAVE THEIR ANNUAL MAMMOGRAM, PARTICULARLY THOSE FROM MINORITY POPULATIONS AND/OR THOSE WITHOUT INSURANCE. THESE INITIATIVES COMBINE THE RESOURCES OF ALL THREE HOSPITALS AS WELL AS OTHER HEALTH PROVIDERS IN THE AREA INCLUDING LA RED, DELAWARE BREAST CANCER COALITION, SUSAN G. KOMEN, AMERICAN DIABETES ASSOCIATION REPRESENTATIVES, COMMUNITY CLINICIANS, INSURERS, AND STATE HEALTH RESOURCES.
PART VI, LINE 5: FOR THE 2013 CHNA, STATE DATA FROM DELAWARE HEALTH AND SOCIAL SERVICES. THIS INCLUDED COUNTY LEVEL DATA AND WAS THE PRIMARY SOURCE OF INFORMATION RELATED TO TRENDS AND SERVICE AREA HEALTH NEEDS. NO INDIVIDUAL AT DHSS WAS INTERVIEWED. IN ADDITION TO THE ABOVE, NANTICOKE REFERENCED THE "HISPANIC HEALTH IN DELAWARE: BARRIERS TO CARE FOR THE HISPANIC POPULATION" PRODUCED BY THE GOVERNOR COMMISSION ON HISPANIC AFFAIRS.TO BETTER UNDERSTAND LOCAL NEEDS OF SEAFORD, DELAWARE AND THE SURROUNDING AREAS NANTICOKE CONDUCTED THREE SURVEYS WITHIN OUR PRIMARY SERVICE AREA. FIRST WE SURVEYED THE COMMUNITY AT LARGE DURING A NUMBER OF COMMUNITY HEALTH EVENT AND RECEIVED 235 RESPONSES TO THE COMMUNITY SURVEY. VIA A MAILED SURVEY, WE CONTACTED MEMBERS OF THE LOCAL CLERGY. FAITH-BASED GROUPS REPRESENT A LARGE NUMBER OF OUR SERVICE AREA POPULATION. WE RECEIVED 26 RESPONSES TO THIS SURVEY. LASTLY, VIA A MAILED SURVEY, WE SURVEYED THE ACTIVE AND COMMUNITY AFFILIATE PHYSICIANS FROM NANTICOKE MEMORIAL HOSPITAL. WE RECEIVED 62 RESPONSES FROM THIS GROUP. A COPY OF NANTICOKE'S CURRENT CHNA CAN BE FOUND AT WWW.NANTICOKE.ORG.FOR THE NEXT CHNA, NANTICOKE IS WORKING WITH TWO OTHER HOSPITALS THROUGH THE HEALTHIER SUSSEX COUNTY INITIATIVE TO JOINTLY ASSESS THE NEEDS OF SUSSEX COUNTY, DELAWARE. THIS WILL ALSO BE SHARED WITH HEALTHIER SUSSEX COUNTY, A COUNTY WIDE INITIATIVE TO ADDRESS THE HEALTH NEEDS OF RESIDENTS THROUGHOUT THE COUNTY THROUGH PARTNERSHIPS THAT ALLOW FOR MORE EFFICIENT AND EFFECTIVE INITIATIVES AND BETTER OUTCOMES. MORE INFORMATION ABOUT HEALTHIER SUSSEX COUNTY CAN BE ACCESSED THROUGH WWW.HEALTHIERSUSSEXCOUNTY.COM.
PART VI, LINE 6: THE HOSPITAL IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained0RecordsMaintained

Recipient Table RecipientTable (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
AMERICAN HEART ASSOCIATION
1109 MATTLIND WAYMILFORDDE19963135613797501(C)(3)8000HEART DISEASE
MID-SUSSEX MEDICAL CENTER INC
801 MIDDLEFORD ROADSEAFORDDE19973510224470501(C)(3)3600000TO PROVIDE FUNDS FOR MID-SUSSEX MEDICAL CENTER, INC.
NANTICOKE ALTERNATIVE CARE INC
801 MIDDLEFORD ROADSEAFORDDE19973510328654501(C)(3)1267656TO PROVIDE FUNDS FOR NANTICOKE ALTERNATIVE CARE, INC.
AMERICAN CANCER SOCIETY
PO BOX 163SALISBURYMD21803580659875501(C)(3)7000CANCER RESEARCH
DELAWARE TECHNICAL AND COMMUNITY COLLEGE
PO BOX 610GEORGETOWNDE19947516000279501(C)(3)25000DIAGNOSTIC MEDICAL SONOGRAPHY TECHNOLOGY PROGRAM
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants5TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
STEVEN ROSE
CEO/PRESIDENT437000058172000425000477570585429000
JOAQUIN CABRERA
DIRECTOR/PHYSICIAN028500000300005463500066433000034627800
JOSEPH KIM
DIRECTOR/PHYSICIAN019122700150000000223051500021353200
PENNY SHORT
COO/CNO175770010965000112000285630226498000
THOMAS BROWN
SENIOR VP202558010683000170000185760248817000
DON TRICARICO
VP14267301386900056040272930189439000
ROBERT FERBER
PHYSICIAN2104960000000283320238828000
ANJU BHARDWAJ
PHYSICIAN245466000000099710255437000
DANIEL CHAN
PHYSICIAN2175190000000233060240825000
MEERA KAPHLE
PHYSICIAN2149600000000163340231294000
IMRAN JANJUA
PHYSICIAN2574630000000191670276630000
DARR HALL
FORMER CFO/TREASURER22829801100000092860254620274046000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePART I, LINE 1AReturnReference
ExplanationSTEVE ROSE- HEALTH OR SOCIAL CLUB DUES FOR $2,800Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1DELAWARE HEALTH FACILITIES AUTHORITYBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN510272458IssuerEIN
CUSIP Number246388RD6CUSIPNumber
Date Issued2013-06-11DateIssued
Issue Price47475775IssuePrice
Description Of PurposeDEBT REFINANCINGDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Total Proceeds47475775TotalProceeds
Issuance Costs From Proceeds930010IssuanceCostsFromProceeds
Other Spent Proceeds46545765OtherSpentProceeds
Year Of Subst Completion2013YearOfSubstCompletion
Current Refunding0CurrentRefunding
Advance Refunding1AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Prcntge Prvt Business Use By Others0.00000PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.00000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00000TotalPrivateBusinessUse
Bond Iss Meet Prvt Security Pay Test0BondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed Prop0ChangeInUseBondFinancedProp
Non Qualified Bond Remed Procdrs1NonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiled
Rebate Not Due Yet1RebateNotDueYet
Exception To Rebate0ExceptionToRebate
No Rebate Due0NoRebateDue
Variable Rate Issue0VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Written Proc To Monitor Reqs1WrittenProcToMonitorReqs

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Proc To Undertk Corrective Action0ProcToUndertkCorrectiveAction

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 2DANNY SHORT (DIRECTOR) HAS A FAMILY RELATIONSHIP WITH PENNY SHORT (COO/CNO).
FORM 990, PART VI, SECTION A, LINE 6NANTICOKE HEALTH SERVICES, INC IS THE SOLE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7ASHAREHOLDER / GOVERNING BODY HAS POWER TO SELECT THE DIRECTORS, OFFICERS, AND AGENTS OF THE HOSPITAL AND DEFINE THEIR DUTIES.
FORM 990, PART VI, SECTION A, LINE 7BSHAREHOLDER / GOVERNING BODY HAS POWER TO: MANAGE SUPERVISE AND DIRECT BUSINESS AFFAIRS; ESTABLISH POLICIES, PROCEDURES AND PROGRAMS; DETERMINE HOSPITAL SERVICES; AUTHORIZE AND EXECUTE DEBT AGREEMENTS; DETERMINE POLICIES OF HOSPITAL; HAVE RESPONSIBILITY FOR QUALITY PATIENT CARE; TO PROVIDE FOR ADEQUATE FINANCING; DECIDE STRATEGIC PLANS; PROTECT HOSPITAL PROPERTY; PROVIDE FINANCIAL STABILITY; APPROVE ANNUAL BUDGET; ESTABLISH HOSPITAL POLICY; APPROVE BY-LAWS; PROVIDE FOR APPOINTMENT OF MEDICAL STAFF; REQUIRE MEDICAL STAFF MAINTAIN HIGH STANDARDS; AVOID PROFITING FROM HOSPITAL RELATIONSHIP; ESTABLISH COMMUNICATION AMONG SHAREHOLDERS; MAINTAIN RECORDS; IMPLEMENT EXPENDITURE PLANS; EVALUATE PERFORMANCE; SELECT CHIEF EXECUTIVE OFFICER; ASSESS AND REVIEW COMPETENCIES OF STAFF; ENSURE AGE-APPROPRIATE CARE IS DELIVERED; PROVIDE SINGLE LEVEL OF PATIENT CARE; REQUIRE STAFF TO REPORT ON MEDICAL CARE; PROVIDE RESOURCES FOR RISK MANAGEMENT; APPROVE AUXILIARY ORGANIZATION ACTIVITIES; TO REMOVE HOSPITAL DIRECTOR OR STAFF WITHOUT CAUSE; AUTHORIZE ISSUANCE OF SHARES OF STOCK; APPROVE ACTIVITES OF HOSPITAL DIRECTOR; AMEND CERTIFICATE OF ORGANIZATION; AUTHORIZE LIQUIDATION OF ASSETS; RESOLVE CONFLICTS; AUTHORIZE ACQUISITION OF SUBSIDIARIES; PROVIDE FOR COMPLIANCE WITH LAWS; PROVIDE FOR THE COLLABORATION OF LEADERS; EXERCISE POWERS OF BOARD OF DIRECTORS; EXERCISE POWERS OF NANTICOKE HEALTH SERVICES, INC.
FORM 990, PART VI, SECTION B, LINE 11A COPY OF THE FORM 990 IS PROVIDED TO EACH MEMBER OF THE BOARD BEFORE BEING FILED.
FORM 990, PART VI, SECTION B, LINE 12CTHIS POLICY IS APPLICABLE TO THE BOARD OF DIRECTORS, INCLUDING COMMUNITY AND PHYSICIAN MEMBERS OF BOARD COMMITTEES, AND ADMINISTRATION (COLLECTIVELY REFERRED TO AS "BOARD, COMMITTEE MEMBERS, AND ADMINISTRATION") OF NANTICOKE HEALTH SERVICES, NANTICOKE MEMORIAL HOSPITAL, NANTICOKE ALTERNATIVE CARE (D/B/A LIFECARE AT LOFLAND PARK), MID-SUSSEX MEDICAL CENTER, AND DUAL DEVELOPMENT CORPORATION, ALL OF WHICH ARE TAX-EXEMPT CHARITABLE ORGANIZATIONS (REFERRED TO HEREIN AS "NHS"). POLICY: THE POLICY OF NHS IS TO REQUIRE THAT EACH INDIVIDUAL SUBJECT TO THIS POLICY STATEMENT PROMPTLY AND FULLY DISCLOSE (IN THE MANNER PROVIDED HEREIN) ANY ACTUAL, APPARENT, OR POTENTIAL CONFLICT OF INTEREST, AND THAT NHS WILL NOT ENGAGE IN ANY CONTRACT, TRANSACTION, OR ARRANGEMENT INVOLVING A CONFLICT OF INTEREST UNLESS THE DISINTERESTED MEMBERS OF THE BOARD OF DIRECTORS (ACTING AT A DULY CONSTITUTED MEETING THEREOF) (WITH THE ADVICE OF LEGAL COUNSEL) DETERMINE BY A MAJORITY VOTE THAT APPROPRIATE SAFEGUARDS TO PROTECT THE CHARITABLE MISSION OF NHS HAVE BEEN IMPLEMENTED. VIOLATIONS OF THE CONFLICTS OF INTEREST POLICY: IF THE BOARD OF DIRECTORS OR A COMMITTEE HAS REASON TO BELIEVE THAT AN INTERESTED PERSON HAS FAILED TO COMPLY WITH THE DISCLOSURE OBLIGATION OF THIS POLICY, THE BOARD OF DIRECTORS SHALL INFORM THAT PERSON OF THE BASIS FOR ITS BELIEF AND PROVIDE THAT PERSON AN OPPORTUNITY TO ADDRESS THE ALLEGED FAILURE TO DISCLOSE. AFTER HEARING THE RESPONSE OF SUCH PERSON AND CONDUCTING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED UNDER THE CIRCUMSTANCES, THE BOARD OF DIRECTORS SHALL DETERMINE WHETHER SUCH PERSON HAS, IN FACT, VIOLATED THE DISCLOSURE REQUIREMENTS OF THIS CONFLICT OF INTEREST POLICY. IF THE BOARD DETERMINES THAT THERE HAS BEEN A VIOLATION, THE BOARD SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION, WHICH MAY INCLUDE REMOVAL (IF THE INTERESTED PERSON IS A BOARD OR COMMITTEE MEMBER) OR TERMINATION (IF THE INTERESTED PERSON IS AN EMPLOYEE). INTENTIONALLY OR REPEATEDLY FAILING TO ADHERE TO THIS POLICY IS GROUNDS FOR REMOVAL FROM THE BOARD.
FORM 990, PART VI, SECTION B, LINE 15ON AN ANNUAL BASIS, THE BOARD OF DIRECTORS' CHAIRMAN AND CHAIRMAN-ELECT REVIEW THE EXECUTIVE COMPENSATION OF THE CEO, SENIOR VP'S AND VP'S. AS PART OF THAT PROCESS, THE FACILITY'S OPERATIONS AND PERFORMANCE ARE TAKEN INTO CONSIDERATION, WHICH INCLUDE REVIEW OF HOSPITAL QUALITY INDICATORS, FINANCIAL PERFORMANCE, EMPLOYEE SATISFACTION SCORES AND PHYSICIAN SATISFACTION SCORES. THE PROCESS INCLUDES A REVIEW OF ACCOMPLISHMENTS OF EACH OF THE EXECUTIVES AND THEIR IMPORTANCE TO THE OVERALL ORGANIZATION. IN DETERMINING THE REASONABLENESS OF COMPENSATION, OTHER AREA HOSPITAL FORM 990'S ARE REVIEWED FOR THEIR EXECUTIVE COMPENSATION, AS WELL AS PUBLISHED NATIONAL SALARY SURVEY DATA. AFTER THE REVIEW AND RECOMMENDATION OF THE CHAIRMAN AND VICE CHAIRMAN, IT IS THEN PRESENTED TO THE FULL BOARD OF DIRECTORS, WHO REVIEW THE ANNUAL COMPENSATION REQUESTS AND EITHER APPROVE OR RECOMMEND APPROPRIATE CHANGES FOR IMPLEMENTATION. THE SAME PROCESS GOES FOR OTHER KEY EMPLOYEES AND OFFICERS. THIS WAS LAST COMPLETED IN 2012.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AND GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC VIA ANOTHER'S WEBSITE OR UPON REQUEST.
FORM 990, PART XI, LINE 9:PENSION AND POSTRETIREMENT ADJUSTMENT 2,558,464.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2CTHE ORGANZIATION HAS NOT CHANGED ITS PROCESS.
ABOUT NANTICOKENANTICOKE MEMORIAL HOSPITAL, ORIGINALLY INCORPORATED IN 1945, IS ORGANIZED UNDER THE CORPORATE TITLE OF NANTICOKE HEALTH SERVICES. WHAT STARTED AS A 32-BED HOSPITAL IN 1952 HAS GROWN TO INPATIENT SERVICES, OUTPATIENT SERVICES, MEDICAL CENTERS ACROSS SUSSEX COUNTY DELAWARE, BUSINESS SERVICES AND A HOST OF PREVENTATIVE MEDICINE AND HEALTH EDUCATION PROGRAMS. EACH PART OF NANTICOKE HEALTH SERVICES WORKS TOGETHER TO FOCUS ON FULFILLING OUR MISSION STATEMENT: WE EXIST TO POSITIVELY IMPACT OUR COMMUNITIES QUALITY OF LIFE THROUGH SUPERIOR HEALTH SERVICES. TODAY, PATIENTS AND BUSINESSES ARE CONTINUALLY SEEKING SUPERIOR HEALTH CARE AT AN AFFORDABLE PRICE. NANTICOKE HEALTH SERVICES STANDS COMMITTED TO PROVIDING THAT CARE. AS A PARTICIPANT IN THE CMS AND JOINT COMMISSION CORE MEASURE PROJECTS, NANTICOKE MEMORIAL HOSPITAL HAS ACHIEVED THE TOP SCORES IN THE STATE OF DELAWARE FOR CARDIAC CARE, AND HAS BEEN RECOGNIZED AS AMONG THE TOP 10% OF HOSPITALS PARTICIPATING NATIONALLY. FEEDBACK FROM OUR PATIENTS OVERWHELMINGLY COMPLIMENTS US ON THE CARE AND FRIENDLINESS OF OUR STAFF IN ALL OF OUR ENTITIES. OUR DEDICATION TO SERVING OUR PATIENTS IS EVIDENCED THROUGH A COORDINATED SYSTEM OF CARE. OUR ORGANIZATION IS ABLE TO TREAT YOU AND YOUR FAMILY ACROSS THE COMPLETE SPECTRUM OF HEALTHCARE NEEDS. OUR GROWTH IS EVIDENCED NOT ONLY THROUGH THE CONTINUED ADDITION TO MEDICAL PROGRAMS, BUT ALSO THROUGH SUCCESSFUL PHYSICIAN RECRUITMENT OVER 60 PHYSICANS IN THE LAST 15 YEARS. AS OUR COMMUNITIES HEALTHCARE NEEDS CHANGE, NANTICOKE HEALTH SERVICES CONTINUES TO CHANGE AND EXPAND SERVICES TO MEET COMMUNITY NEEDS. RECOGNIZED NATIONALLY FOR OUR ACCOMPLISHMENTS BY ORGANIZATIONS SUCH AS THE AMERICAN HOSPITAL ASSOCIATION AND THE CENTER FOR CASE MANAGEMENT, OUR STAFF WELCOMES THE OPPORTUNITY TO MEET YOUR HEALTHCARE NEEDS. COMMUNITY OUTREACH NANTICOKE HEALTH SERVICES' TRAINED STAFF GOES INTO THE COMMUNITY TO PRESENT HEALTH EDUCATION SEMINARS AND HEALTH SCREENINGS. WE HAVE WORKED WITH AREA SCHOOLS, SENIOR CENTERS AND CIVIC ORGANIZATIONS IN OUR EFFORTS TO EDUCATE OUR COMMUNITY ON PREVENTION AND WELLNESS. PHYSICIANS, NURSES, ANCILLARY STAFF AND ADMINISTRATIVE PERSONNEL HAVE ALL RESPONDED TO REQUESTS TO MEET WITH THESE VARIOUS ORGANIZATIONS. THERE ARE MANY SUPPORT GROUPS AND EDUCATIONAL MEETINGS WHICH ARE HELD IN THE HOSPITAL AS WELL.OUR MATERNITY EDUCATION PROGRAM IS VERY STRONG, AND INCLUDES CHILDBIRTH PREPARATION, SIBLING PREPARATION, AND BREAST-FEEDING SUPPORT. WE ALSO HOST DIABETES EDUCATION CLASSES, STROKE SUPPORT GROUPS AND OTHERS. WE CONDUCT REGULAR CHOLESTEROL SCREENINGS, DIABETES AND GLUCOSE SCREENINGS, BLOOD PRESSURE AND PROSTATE SCREENINGS AND ADULT AND INFANT / CHILD CPR INSTRUCTION ON A REGULAR BASIS. IN 2013 NANTICOKE COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WHICH IDENTIFIED A NEED FOR A NUMBER OF OUTREACH PROGRAMS, INCLUDING PROGRAMS AROUND HEALTH AND WELLNESS, OBESITY AND DIABETES. THESE PROGRAMS HAVE BEEN ESTABLISHED AND ARE MEASURED ON AN ANNUAL BASIS BEGINNING IN JUNE 2011. NANTICOKE ALSO DEVELOPED A LATINO OUTREACH TEAM TO ADDRESS ACCESS TO CARE AND HAS EXPANDED PARTNERSHIPS WITH HEALTH AND SOCIAL SERVICE PROVIDERS FOR THE HISPANIC POPULATION. OTHER PARTNERSHIPS ALSO CONTINUE AS NANTICOKE CONTINUES CONNECTIONS WITH COMMUNITY PARTNERS ON HEALTH NEEDS SUCH AS PARTNERING WITH THE SUSSEX CHILD HEALTH PROMOTION COALITION IN THE DEVELOPMENT OF THE PRESCRIPTION FOR HEALTH PROGRAM AND PARTNERING WITH THE DELAWARE BREAST CANCER COALITION TO PROVIDE ACCESS TO MAMMOGRAMS FOR UNDERSERVED POPULATIONS. ADDITIONALLY, IN 2011 NANTICOKE ALONG WITH THE TWO OTHER HOSPITALS IN SUSSEX COUNTY PARTNERED TO ESTABLISH HEALTHIER SUSSEX COUNTY (WWW.HEALTHERSUSSEXCOUNTY.COM) WITH THE GOAL OF ADDRESSING HEALTH NEEDS THAT IMPACT ALL PARTS OF THE COUNTY. INCREASING MAMMOGRAMS IN MINORITY POPULATIONS, ESPECIALLY THE AFRICAN AMERICAN POPULATIONS, AND INCREASING COMPLAINCE OF SELF-MANAGEMENT AMONG DIAGNOSED DIABETICS WERE IDENTIFIED. PROGRAMS HAVE BEEN ESTABLISHED AND WERE CONTINUED INTO 2012. IN 2012 HEALTHIER SUSSEX COUNTY COMBINED EFFORTS TO DEVELOP A COUNTY WIDE HEALTH NEEDS ASSESSMENT PUBLISHED IN 2013. HEALTHIER SUSSEX COUNTY HAS EXPANDED TO INCLUDE NOT JUST THE HOSPITALS BUT OTHER COUNTY-WIDE HEALTH AND SOCIAL SERVICE ORGANIZATIONS. THE 2013 NANTICOKE COMMUNITY NEEDS ASSESSMENT IMPLEMENTATION PLAN CAN BE FOUND AT HTTP://WWW.NANTICOKE.ORG/COMMUNITY-OUTREACH/PROGRAMS-AND-INITIATIVES.AS PATIENT EDUCATION PATIENT AND FAMILY EDUCATION HAS BECOME AN INTEGRAL PART OF THE CLINICAL PATHWAY PROCESS UTILIZED THROUGHOUT NANTICOKE HEALTH SERVICES. THROUGH THE PATIENT EDUCATION CENTER, OUR PATIENT CARE STAFF HAS BEEN TRAINED TO TEACH OUR PATIENTS AND THEIR FAMILIES ABOUT THEIR ILLNESSES AND TREATMENTS. UTILIZING AN ASSORTMENT OF PRINTED MATERIALS AND CLOSED CIRCUIT TELEVISION, WE ARE ABLE TO EFFECTIVELY TRANSFER CRITICAL INFORMATION DURING ALL PHASES OF CARE.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Address Line1AddressForeign/AddressLine1CityAddressForeign/CityProvince Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryLegal Domicile Foreign CountryLegalDomicileForeignCountry
NANTICOKE HEALTH SERVICES
801 MIDDLEFORD ROADSEAFORDDE19973510293888HEALTH SERVICESDE501(C)(3)LINE 11B, IIN/A0
MID-SUSSEX MEDICAL CENTER
801 MIDDLEFORD ROADSEAFORDDE19973510224470HEALTH SERVICESDE501(C)(3)LINE 90NHS
NANTICOKE INSURANCE CO
980446259INSURANCE501(C)(15)N/A0NHSPO BOX 1109 GTGEORGETOWNCAYMAN ISLANDSCJCJ

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1PROPRIETARY ENTERPRISESBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1801 MIDDLEFORD ROADAddressLine1
CitySEAFORDCity
StateDEState
ZIP Code19973ZIPCode
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EIN510293887EIN
Primary ActivityINACTIVEPrimaryActivity
Legal Domicile StateDELegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityCTypeOfEntity
Controlled Org0ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg