INDIANA REGIONAL MEDICAL CENTER: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- INDIANA REGIONAL MEDICAL CENTER (EIN 25-0965404)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-14
- IRS object ID
- 201311349349303496
- Schema version
- 2011v1.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-14T14:48:53-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 232932984 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PARENTEBEARD LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1650 MARKET STREET SUITE 4500 | AddressLine1 |
| City | PHILADELPHIA | City |
| State | PA | State |
| ZIP Code | 19103 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 250965404 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INDIANA REGIONAL MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | INDI | NameControl |
| Phone | 7243577008 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 835 HOSPITAL ROAD | AddressLine1 |
| City | INDIANA | City |
| State | PA | State |
| ZIP Code | 15701 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ROBERT GONGAWARE | Name |
| Title | SENIOR VP FINANCE | Title |
| Phone | 7243577008 | Phone |
| Date Signed | 2013-05-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JULIUS GREEN CPA | Name |
| PTIN | P00350393 | PTIN |
| Phone | 2159720701 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | STEPHEN WOLFE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 835 HOSPITAL ROAD | AddressLine1 |
| City | INDIANA | City |
| State | PA | State |
| ZIP Code | 15701 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 160572627 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.INDIANARMC.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1944 | YearFormation |
| State Legal Domicile | PA | StateLegalDomicile |
| Activity Or Mission Description | TO SERVE THE HEALTHCARE NEEDS OF EVERY LIFE WE TOUCH WITH COMPASSION, RESPECT, AND DIGNITY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1459 | TotalNbrEmployees |
| Total Nbr Volunteers | 150 | TotalNbrVolunteers |
| Total Gross UBI | 2332311 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 944567 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 871225 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 361995 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 129136107 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 131919078 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 5077771 | InvestmentIncomePriorYear |
| Investment Income Current Year | 4319612 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 4947068 | OtherRevenuePriorYear |
| Other Revenue Current Year | 5272685 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 140032171 | TotalRevenuePriorYear |
| Total Revenue Current Year | 141873370 | 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 | 76965871 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 75802958 | 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 | 58719631 | OtherExpensePriorYear |
| Other Expenses Current Year | 59434389 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 135685502 | TotalExpensesPriorYear |
| Total Expenses Current Year | 135237347 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 4346669 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 6636023 | RevenuesLessExpensesCY |
| Total Assets BOY | 189712799 | TotalAssetsBOY |
| Total Assets EOY | 199971534 | TotalAssetsEOY |
| Total Liabilities BOY | 70005602 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 86507703 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 119707197 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 113463831 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE MISSION OF INDIANA REGIONAL MEDICAL CENTER IS TO SERVE THE HEALTHCARE NEEDS OF EVERY LIFE WE TOUCH WITH COMPASSION, RESPECT, AND DIGNITY. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 109916930 | Expense |
| Revenue | 131919078 | Revenue |
| Description | HEALTH DIAGNOSTIC, INTERVENTION & TREATMENT SERVICE:INDIANA REGIONAL MEDICAL CENTER ("IRMC") IS A NON-PROFIT, COMMUNITY BASED HEALTH SYSTEM THAT OFFERS A WIDE RANGE OF SERVICES INCLUDING DIAGNOSTICS, MEDICINE, SURGERY, PEDIATRICS, OBSTETRICS, GERIATRIC BEHAVIORAL HEALTHCARE AND REHABILITATIVE NURSING. IRMC DEMONSTRATES AN ONGOING COMMITMENT TO THE COMMUNITY BY CONTINUALLY REVIEWING AND IMPROVING ITS SERVICES TO ENSURE THAT THE COMMUNITY RECEIVES TOP-QUALITY, EFFICIENT, ACCESSIBLE, COST-EFFECTIVE HEALTHCARE AND QUALITY OUTREACH AND HEALTH PROMOTION SERVICES. IRMC CONTINUES TO PROVIDE MOBILE HEALTH SERVICES TO RURAL AREAS OF THE COUNTY. IN ADDITION TO PRIMARY CARE PHYSICIANS, IRMC WAS SUCCESSFUL IN RECRUITING TWO PAIN MANAGEMENT PHYSICIANS, EMERGENCY DEPARTMENT PHYSICIANS AND A CLINICAL PSYCHOLOGIST.MASS HEALTH SCREENING: IRMC'S MOBILE MEDICAL SERVICES CONTINUES TO PROVIDE FREE BLOOD PRESSURE SCREENINGS IN 19 LOCATIONS IN INDIANA COUNTY. WE ALSO CONTINUE TO PARTICIPATE IN NUMEROUS FREE COMMUNITY EVENTS PROVIDING EDUCATION, SCREENINGS PROGRAMS AND FIRST AID SERVICES.HEALTH FAIRS:THE PROVISION OF HEALTH SERVICES AND INFORMATION THROUGH HEALTH FAIRS, CLASSES AND PROGRAMS - THE INSTITUTE FOR HEALTHY LIVING AT IRMC OFFERS HEALTH SERVICES AND EDUCATION PROGRAMS TO THE COMMUNITY AT NO CHARGE.HEALTH CARE DELIVERY & MANAGEMENT:THE COMMUNITY HEALTH ADVISORY COUNCIL OF INDIANA COUNTY, WHICH WAS FORMED IN 1996, SERVES AS A STATE HEALTH IMPROVEMENT PARTNERSHIP. THE GOAL OF THE COUNCIL IS TO IDENTIFY OR DEVELOP RESOURCES TO ADDRESS TOP HEALTH PRIORITIES IN THE COUNTY. THE COUNCIL CONTINUES TO PROMOTE AN ANNUAL INFLUENZA CAMPAIGN. THE COUNCIL IMPLEMENTED A COUNTY PRESCRIPTION ASSISTANCE PROGRAM TO ASSIST RESIDENTS WITH ACCESSING PHARMACEUTICALS FREE OR AT A REDUCED COST BASED ON INCOME.HEALTH CARE PROGRAMS, GENERAL/OTHER: THE CENTER FOR DIABETES CARE CONTINUES TO OFFER FREE EDUCATION SERVICES AT VARIOUS LOCATIONS THROUGHOUT THE COUNTY. IN ADDITION, THEY CONTINUE TO BE THE PRIMARY SPONSOR OF THE COUNTY'S DIABETES WALK. EACH MONTH STAFF AND MANAGEMENT AT IRMC PROVIDE SUPPORT TO A LOCAL FOOD BANK. FOR THE THIRD YEAR, IRMC WAS NAMED ONE OF THE BEST PLACES TO WORK IN PA. PREVENTIVE HEALTH SERVICES, GENERAL/OTHER: M. DORCAS CLARK WOMEN'S IMAGING CENTER: THE WOMEN'S IMAGING CENTER AND THEIR STAFF HAVE PARTICIPATED IN NUMEROUS COMMUNITY EVENTS PROVIDING INFORMATION ABOUT THE IMPORTANCE OF BREAST HEALTH. BIRDIE'S CLOSET, A PROJECT DESIGNED TO HELP WOMEN COPE WITH APPEARANCE-RELATED SIDE-EFFECTS OF CANCER TREATMENT, WAS OPENED IN THE WOMEN'S IMAGING CENTER. | Description |
| Total Program Service Expense | 109916930 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 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 | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 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 | 1 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 215 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1459 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| 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 | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | 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 | ROBERT GONGAWARE SVP FINANCE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7243577008 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 835 HOSPITAL ROAD | AddressLine1 |
| City | INDIANA | City |
| State | PA | State |
| ZIP Code | 15701 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (23 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| TODD BRICE | ||||||||
| CHAIRMAN | 1.00 | X | X | 0 | 0 | 0 | ||
| BEVERLY GAZZA ESQ | ||||||||
| VICE CHAIRMAN | 1.00 | X | X | 0 | 0 | 0 | ||
| ANNE WHITE | ||||||||
| SECRETARY | 1.00 | X | X | 0 | 0 | 0 | ||
| JOSEPH GEARY | ||||||||
| TREASURER | 1.00 | X | X | 0 | 0 | 0 | ||
| MARK BOYKIW MD | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| JOHN DOLAN | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| NATHAN KOVALCHICK | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| THOMAS MCCOY MD | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| MARK MCGOWAN PHD | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| GREG SIPOS | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| RUTH WOOLCOCK MD | ||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| STEPHEN A WOLFE | ||||||||
| PRESIDENT & CEO | 35.00 | X | X | 374011 | 0 | 60954 | ||
| ROBERT GONGAWARE | ||||||||
| SR VP FINANCE | 38.00 | X | 197497 | 0 | 12840 | |||
| BRUCE A BUSH MD | ||||||||
| SR VP MEDICAL DIRECTOR | 37.00 | 269398 | 0 | 8773 | X | |||
| DOMINIC PACCAPANICCIA | ||||||||
| CHIEF OPERATING OFFICER | 39.00 | 213703 | 0 | 27397 | X | |||
| CINDY VIRGIL | ||||||||
| SR VP PATIENT SERVICES | 39.00 | 170922 | 0 | 14058 | X | |||
| WADE PATRICK | ||||||||
| SR VP INFORMATION SERVICES | 40.00 | 168704 | 0 | 17598 | X | |||
| LARRY SEDLEMEYER | ||||||||
| SR VP BUS. DEVELOPMENT | 40.00 | 153220 | 0 | 13166 | X | |||
| MICHAEL MERRELL | ||||||||
| PHYSICIAN | 40.00 | 427656 | 0 | 17741 | X | |||
| LUIS P TOMACRUZ | ||||||||
| PHYSICIAN | 40.00 | 383840 | 0 | 19077 | X | |||
| DONNA BALEWICK | ||||||||
| PHYSICIAN | 40.00 | 342270 | 0 | 7291 | X | |||
| JOHN P CAWLEY | ||||||||
| PHYSICIAN | 40.00 | 321944 | 0 | 7100 | X | |||
| ANTHONY L SICO | ||||||||
| PHYSICIAN | 40.00 | 308850 | 0 | 19228 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3332015 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 225223 | TotalOtherCompensation |
| Number Individuals GT100 K | 59 | 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 |
|---|---|---|---|---|---|
| MAYO COLLABORATIVE SERVICES INC | |||||
| PO BOX 1450 | MINNEAPOLIS | MN | 55485 | OUTSIDE LAB SERVICE | 1031033 |
| REHABCARE GROUP | |||||
| BOX 502096 | ST LOUIS | MO | 63150 | REHAB CARE SERVICES | 446698 |
| INDIANA OPEN MRI LLC | |||||
| PO BOX 450 | NEW STANTON | PA | 15672 | WOUND CARE SERVICES | 365752 |
| MATT KLAIN MD | |||||
| 25 COLONY BLVD | BLAIRSVILLE | PA | 15717 | PHYSICIAN SERVICES | 272546 |
| JENNIFER CUNNINGHAM SPEECH SERVICES | |||||
| 545 CUNNINGHAM RD | INDIANA | PA | 15701 | SPEECH THERAPY SERVICES | 270411 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 14 | NumberOfContractorsGT100K |
| Government Grants | 300829 | GovernmentGrants |
| All Other Contributions | 61166 | AllOtherContributions |
| Total Contributions | 361995 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT SCV REV | 621990 | 131251312 | 131251312 |
| RENTAL REVENUE-AFFILIA | 531120 | 309003 | 309003 |
| LIFELINE REVENUE | 900099 | 183113 | 183113 |
| HEALTH CLASSES/COUNSEL | 624100 | 107889 | 107889 |
| HOSPICE PRESCRIPTIONS | 621990 | 67761 | 67761 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 131919078 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2816087 | TotalRevenueColumn |
| Unrelated Business Revenue | 213778 | UnrelatedBusinessRevenue |
| Exclusion | $2,602,309 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1628615 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 975871 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 652744 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 652744 | TotalRevenueColumn |
| Exclusion | $652,744 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 19226911 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 17688214 | Securities |
| Other | 35172 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1538697 | Securities |
| Other | -35172 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1503525 | TotalRevenueColumn |
| Exclusion | $1,503,525 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|
| LABORATORY REVENUE | 621500 | 2093807 | 2093807 | |
| LEASED EMPLOYEES | 900099 | 1539947 | $1,539,947 | |
| CAFETERIA REV | 722210 | 612899 | $612,899 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 373288 | TotalRevenueColumn |
| Unrelated Business Revenue | 24726 | UnrelatedBusinessRevenue |
| Exclusion | $348,562 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 4619941 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 141873370 | TotalRevenueColumn |
| Related Or Exempt Function Income | 131919078 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 2332311 | UnrelatedBusinessRevenue |
| Exclusion | $7,259,986 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1814036 | Total |
| Program Services | 747958 | ProgramServices |
| Management And General | 1066078 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 54748137 | Total |
| Program Services | 44116282 | ProgramServices |
| Management And General | 10631855 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5409053 | Total |
| Program Services | 4384131 | ProgramServices |
| Management And General | 1024922 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10014118 | Total |
| Program Services | 8032107 | ProgramServices |
| Management And General | 1982011 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3817614 | Total |
| Program Services | 3051950 | ProgramServices |
| Management And General | 765664 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 345884 | Total |
| Management And General | 345884 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 107228 | Total |
| Management And General | 107228 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6864 | Total |
| Program Services | 6864 | ProgramServices |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 145500 | Total |
| Management And General | 145500 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10422418 | Total |
| Program Services | 8386961 | ProgramServices |
| Management And General | 2035457 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 763995 | Total |
| Program Services | 29706 | ProgramServices |
| Management And General | 734289 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3275965 | Total |
| Program Services | 3212438 | ProgramServices |
| Management And General | 63527 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2371929 | Total |
| Program Services | 854728 | ProgramServices |
| Management And General | 1517201 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2975109 | Total |
| Program Services | 2185587 | ProgramServices |
| Management And General | 789522 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 300075 | Total |
| Program Services | 166227 | ProgramServices |
| Management And General | 133848 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10031 | Total |
| Program Services | 10031 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1113995 | Total |
| Management And General | 1113995 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7785794 | Total |
| Program Services | 6767338 | ProgramServices |
| Management And General | 1018456 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1326361 | Total |
| Program Services | 1060345 | ProgramServices |
| Management And General | 266016 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Management And GeneralManagementAndGeneral | Program ServicesProgramServices |
|---|---|---|---|
| UBI TAXES | 245461 | 245461 | |
| MEDICAL SUPPLIES | 16667149 | 323205 | 16343944 |
| BAD DEBT EXPENSE | 6693045 | 6693045 | |
| MAINTENANCE & REPAIRS | 2792555 | 560078 | 2232477 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2085031 | Total |
| Program Services | 1634811 | ProgramServices |
| Management And General | 450220 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 135237347 | Total |
| Program Services | 109916930 | ProgramServices |
| Management And General | 25320417 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6380 | BOY |
| EOY | 6530 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5192292 | BOY |
| EOY | 4275314 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11333418 | BOY |
| EOY | 11643137 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 3008324 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1444833 | BOY |
| EOY | 1501123 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3431021 | BOY |
| EOY | 3805401 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 156750696 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 95142139 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 57957055 | BOY |
| EOY | 61608557 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 97109706 | BOY |
| EOY | 94579513 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5403288 | BOY |
| EOY | 5046470 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7656912 | BOY |
| EOY | 7612977 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 177894 | BOY |
| EOY | 6884188 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 189712799 | BOY |
| EOY | 199971534 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13698550 | BOY |
| EOY | 10657121 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26163770 | BOY |
| EOY | 23496504 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2449826 | BOY |
| EOY | 7068330 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27693456 | BOY |
| EOY | 45285748 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 70005602 | BOY |
| EOY | 86507703 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 116637715 | BOY |
| EOY | 110276836 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3069482 | BOY |
| EOY | 3186995 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 119707197 | BOY |
| EOY | 113463831 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 189712799 | BOY |
| EOY | 199971534 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 6636023 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -12879389 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 1 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $6,864 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 6864 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | AN EMPLOYEE OF THE MEDICAL CENTER OCCASIONALLY LOBBIES LOCAL AND FEDERAL GOVERNMENTS SPECIFICALLY ON HEALTHCARE REFORM TOPICS. THE MEDICAL CENTER IS ALSO A MEMBER OF NATIONAL AND STATE HOSPITAL AND HEALTHCARE ASSOCIATIONS THAT PERFORM LOBBYING ACTIVITIES. A PORTION OF THE DUES PAID TO THESE ORGANIZATIONS IS LISTED AS LOBBYING EXPENDITURES. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3070000 | BeginningOfYearBalance |
| Contributions | 363000 | Contributions |
| Other Expenditures | 245000 | OtherExpenditures |
| End Of Year Balance | 3188000 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3253000 | BeginningOfYearBalance |
| Contributions | 872000 | Contributions |
| Other Expenditures | 1055000 | OtherExpenditures |
| End Of Year Balance | 3070000 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2376000 | BeginningOfYearBalance |
| Contributions | 1812000 | Contributions |
| Other Expenditures | 935000 | OtherExpenditures |
| End Of Year Balance | 3253000 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3262000 | BeginningOfYearBalance |
| Contributions | 680036 | Contributions |
| Other Expenditures | 1566036 | OtherExpenditures |
| End Of Year Balance | 2376000 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Endowment EOY Balance | 1.00000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 227375 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 3004874 | OtherCostOrOtherBasis |
| Book Value | 3232249 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 43582797 | OtherCostOrOtherBasis |
| Depreciation | 25750340 | Depreciation |
| Book Value | 17832457 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 97680067 | OtherCostOrOtherBasis |
| Depreciation | 67869141 | Depreciation |
| Book Value | 29810926 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 12255583 | OtherCostOrOtherBasis |
| Depreciation | 1522658 | Depreciation |
| Book Value | 10732925 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 61608557 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (6 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| POST-RETIREMENT LIABILITY | $1,503,545 |
| PENSION LIABILITY | $32,624,810 |
| ESTIMATED THIRD PARTY PAYOR SETTLEMENTS | $1,454,992 |
| DUE TO AFFILIATES | $2,229,008 |
| ESTIMATED MEDICAL MALPRACTICE CLAIMS LIABILITY | $7,272,738 |
| DEFERRED COMPENSATION LIABILITY | $200,655 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 45285748 | TotalOfAmounts |
| Total Revenue | 141873370 | TotalRevenue |
| Total Expenses | 135237347 | TotalExpenses |
| Excess Or Deficit For Year | 6636023 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -5918033 | NetUnrealizedGLOnInvestments |
| Prior Period Adjustments | 3236 | PriorPeriodAdjustments |
| Other | -$6,964,592 | OtherAmount |
| Total Adjustments | -12879389 | TotalAdjustments |
| Excess Or Deficit Per FS | -6243366 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 125713009 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -5918033 | NetUnrealizedGainsInvestments |
| Other Revenues | -11218199 | OtherRevenues |
| Revenue Not Rptd F990 | -17136232 | RevenueNotRptdF990 |
| Revenue Subtotal | 142849241 | RevenueSubtotal |
| Other Revenues Not Included | -975871 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | -975871 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 141873370 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 136067718 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 975871 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 975871 | ExpensesNotRptdF990 |
| Expenses Subtotal | 135091847 | ExpensesSubtotal |
| Investment Expenses Not Included2 | 145500 | InvestmentExpensesNotIncluded2 |
| Expenses Not Rptd On Fin Stmt | 145500 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 135237347 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | ENDOWMENT FUNDS ARE USED PRIMARILY TO PURCHASE CAPITAL EQUIPMENT. |
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | THE HOSPITAL ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD IS MET. MANAGEMENT DETERMINED THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2012 AND 2011. THE HOSPITAL'S POLICY IS TO RECOGNIZE INTEREST RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE AND PENALTIES IN OPERATING EXPENSES. THE HOSPITAL'S FEDERAL AND STATE INCOME TAX RETURNS ARE NO LONGER SUBJECT TO EXAMINATION BY FEDERAL OR STATE TAXING AUTHORITIES FOR FISCAL YEARS BEFORE 2008. |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | PENSION AND POST-RETIREMENT LIABILITIES ADJUSTMENT -9,494,750. TRANSFER TO AFFILIATE -1,329,954. EQUITY DISTRIBUTION -100,000. NONCONTROLLING INTEREST IN NET INCOME OF SUBSIDIARIES 4,108,107. DECREASE IN INTEREST OF INDIANA HEALTHCARE FOUNDATION -147,995. TOTAL TO SCHEDULE D, PART XI, LINE 8: -6,964,592. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | TRANSFER TO AFFILIATE -1,329,954. PENSION AND POST-RETIREMENT LIABILITIES ADJUSTMENT -9,494,750. EQUITY DISTRIBUTION -100,000. DECREASE IN INTEREST OF INDIANA HEALTHCARE FOUNDATION -147,995. INVESTMENT FEES -145,500. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | RENTAL EXPENSES -975,871. | |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES 975,871. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1509236 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1509236 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01170 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 15610746 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8444482 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7166264 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05570 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 17119982 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8444482 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 8675500 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06740 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 814020 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 84243 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 729777 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00570 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7773561 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6021180 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1752381 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01360 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8587581 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6105423 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2482158 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01930 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 25707563 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 14549905 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 11157658 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08670 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 325419 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 38663 | DirectOffsettingRevenue |
| Net Community Building Expense | 286756 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00220 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 325419 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 38663 | DirectOffsettingRevenue |
| Net Community Building Expense | 286756 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00220 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $2,402,000 | BadDebtExpenseAmount |
| Amount Attributable To | 550000 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 27130895 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 26006191 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 1124704 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 COSM REALTY GROUP LTD | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Ent Primary Activity | REAL ESTATE | DescriptionEntPrimaryActivity |
| Organization Profit Or Ownership | 0.70000 | OrganizationProfitOrOwnership |
| Officers Etc Profit Or Ownership | 0.00000 | OfficersEtcProfitOrOwnership |
| Physicans Profit Or Ownership | 0.30000 | PhysicansProfitOrOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INDIANA REGIONAL MEDICAL CENTER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 835 HOSPITAL ROAD | AddressLine1 |
| City | INDIANA | City |
| State | PA | State |
| ZIP Code | 15701 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
| Other | URGENT CARE FACILITY | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INDIANA REGIONAL MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 100.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 400.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 1 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 7: THE HOSPITAL USED A COST-TO-CHARGE RATIO IN DETERMINING THE FIGURES REPORTED IN THIS TABLE. THIS COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2 RATIO OF PATIENT CARE COST TO CHARGES. | ||
| PART I, LINE 7G: NO COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC WERE INCLUDED IN THE AMOUNT ON PART I, LINE 7G. | ||
| PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 6693045. | ||
| PART II: OUR MISSION IS TO SERVE THE HEALTHCARE NEEDS OF EVERY LIFE WE TOUCH WITH COMPASSION, RESPECT AND DIGNITY. ALL OF THE PROGRAMS OFFERED MEET COMMUNITY BENEFIT OBJECTIVES AND ARE RELATED TO OUR MISSION. IRMC OFFERS PROGRAMS THAT IMPROVE ACCESS TO HEALTH CARE SERVICES, ENHANCES HEALTH OF THE COMMUNITY WE SERVE, PROVIDES ADVANCED MEDICAL OR HEALTHCARE KNOWLEDGE AND RELIEVES SOME OF THE FINANCIAL OR PROGRAMMATIC BURDEN OF GOVERNMENT OR OUR COMMUNITY. INDIANA REGIONAL MEDICAL CENTER PROVIDES NUMEROUS COMMUNITY PROGRAMS AND ACTIVITIES THAT PROVIDE TREATMENT OR PROMOTE HEALTH AND HEALING TO OUR COMMUNITIES. OUR MOBILE MEDICAL SERVICES CONTINUES TO PROVIDE FREE BLOOD PRESSURE SCREENINGS IN 19 LOCATIONS IN INDIANA COUNTY. WE ALSO CONTINUE TO PARTICIPATE IN NUMEROUS FREE COMMUNITY EVENTS PROVIDING EDUCATION, SCREENING PROGRAMS AND FIRST AID SERVICES. OVER THE PAST YEAR, THE MOBILE MEDICAL HEALTH LOGGED OVER 2,500 PARTICIPANTS. WE ALSO PROVIDE NUMEROUS HEALTH FAIRS REACHING ALMOST 2,200 PARTICIPANTS, AND CLASSES AND EDUCATION PROGRAMS WITH OVER 4,000 PARTICIPANTS. THE INSTITUTE FOR HEALTHY LIVING AT INDIANA REGIONAL MEDICAL CENTER OFFERS HEALTH SERVICES AND EDUCATION PROGRAMS TO THE COMMUNITY AT NO CHARGE.THE CENTER FOR DIABETES CARE CONTINUES TO OFFER FREE EDUCATION SERVICES AT VARIOUS LOCATIONS THROUGHOUT THE COUNTY. IN ADDITION, THEY CONTINUE TO BE THE PRIMARY SPONSOR OF THE COUNTY'S DIABETES WALK. EACH MONTH STAFF AND MANAGEMENT AT IRMC PROVIDE SUPPORT TO A LOCAL FOOD BANK. PREVENTIVE HEALTH SERVICES - M. DORCAS CLARK WOMEN'S IMAGING CENTER AND THEIR STAFF HAVE PARTICIPATED IN NUMEROUS COMMUNITY EVENTS PROVIDING INFORMATION ABOUT THE IMPORTANCE OF BREAST HEALTH. BIRDIE'S CLOSET, A PROJECT DESIGNED TO HELP WOMEN COPE WITH APPEARANCE RELATED SIDE-EFFECTS OF CANCER TREATMENT WAS OPENED IN THE WOMEN'S IMAGING CENTER. SUPPORT HEALTH GROUPSFAMILY PROGRAMS - EARLY PREGNANCY, MATERNITY TOUR, DOCTOR DAD, BOF SERIES, BREASTFEEDING, ALL ABOUT BABY, LAMAZE, HOME ALONE, BABYSITTING, LET'S TALK GIRLS, BIG BROTHER, CPR, HEARTSAVER. 1,164 CONTACTS FOR THE YEAR.COMMUNITY CLASSES - PACE, TAI CHI, YOGA, CANCER, STRONG WOMEN, DROP WEIGHT, ORNISH, DIABETES, DROP 10. 3,580 CLASS HOURS.IN 2009, INDIANA REGIONAL MEDICAL CENTER OPENED A NEW FACILITY OFFERING URGENT CARE SERVICES IN THE BLAIRSVILLE COMMUNITY AS A RESPONSE TO MEDICAL SERVICES NEEDED IN THAT AREA. THIS FACILITY IS 12 MILES FROM THE HOSPITAL CAMPUS. | ||
| PART III, LINE 4: THE FOLLOWING IS THE TEXT OF THE FOOTNOTE FROM THE AUDITED FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE: "ACCOUNTS RECEIVABLE, PATIENTS, ARE REPORTED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THEY ARE DETERMINED TO BE UNCOLLECTIBLE BASED UPON MANAGEMENT'S ASSESSMENT OF INDIVIDUAL ACCOUNTS. THE ALLOWANCE FOR DOUBTFUL COLLECTIONS IS ESTIMATED BASED ON A PERIODIC REVIEW OF THE ACCOUNTS RECEIVABLE AGING, PAYOR CLASSIFICATIONS, AND APPLICATION OF HISTORICAL WRITE-OFF PERCENTAGES."THE AMOUNTS REPORTED IN PART III, LINES 2 AND 3 ARE DERIVED BY USING THE MEDICARE COST TO CHARGE RATIO FROM THE COST REPORT.FOR ACCOUNTS WITH INSURANCE, THE CONTRACTUAL ADJUSTMENTS ARE APPLIED TO THE TOTAL ACCOUNT TO DERIVE THE EXPECTED PAYMENT. THE BAD DEBT IS TYPICALLY A PORTION OF THE CO-PAYS OR DEDUCTIBLES. ON ACCOUNTS WITH NO INSURANCE, ALL FINANCIAL ASSISTANCE ADJUSTMENTS/CHARITY CARE ADJUSTMENTS/PROMPT PAYMENT DISCOUNTS/ETC. ARE APPLIED AND THE REMAINING BALANCE IS CAPTURED AS BAD DEBT EXPENSE.A PORTION OF THE BAD DEBT SHOULD BE INCLUDED AS COMMUNITY BENEFIT AS THE HOSPITAL IS NOT ABLE TO DENY SERVICES TO ANY PATIENT PRESENTING TO THE EMERGENCY DEPARTMENT, REGARDLESS IF THE PATIENTS HAVE THE MEANS TO PAY. THE DEDUCTIBLE AND CO-INSURANCE BALANCES THAT ARE NOT PAID REDUCE THE NET REVENUES DUE TO THE HOSPITAL AS PART OF THE RESPECTIVE PATIENT'S INSURANCE COVERAGE. IN ADDITION, THERE IS A "COST" TO THE HOSPITAL FOR TREATING ALL PATIENTS. AS WITH THE UNREIMBURSED AMOUNTS OF THE MEDICAID PATIENT SERVICES, THE HOSPITAL SHOULD BE ABLE TO INCLUDE THE UNREIMBURSED COSTS OF THE SERVICES THAT RESULTED IN NO PAYMENT. | ||
| PART III, LINE 8: THE MEDICARE COST REPORT WAS USED TO DETERMINE THE AMOUNT REPORTED ON LINE 6. | ||
| PART III, LINE 9B: PATIENTS ARE EXPECTED TO PAY ALL BALANCES IN FULL WITHIN FIFTEEN DAYS OF A FINAL BILLING. IF THIS IS NOT POSSIBLE, PATIENTS WILL BE COUNSELED ON THE USE OF MEDICAL ASSISTANCE OR THE INDIANA CHARITY CARE PROGRAM, I-CARE.ON A MONTHLY BASIS, THE CREDIT SUPERVISOR WILL COMPILE A REPORT LISTING ALL ACCOUNTS, WHICH HAVE BEEN BILLED TO MEDICARE, AND ANY SECONDARY INSURANCE CARRIER WHERE APPLICABLE. A LISTING OF ACCOUNTS WHICH HAVE BEEN BILLED TO MEDICAL ASSISTANCE AS A SECONDARY PAYOR ARE REVIEWED BY THE CREDIT SUPERVISOR FOR AN AUTOMATIC WRITE OFF AFTER MEDICAL ASSISTANCE HAS PROCESSED THE ACCOUNT. ACCOUNTS WHICH HAVE BALANCES AFTER MEDICARE AND ALL SECONDARY PAYORS HAVE BEEN BILLED WILL BE PLACED WITH AN OUTSIDE COLLECTION AGENCY AFTER TWO UNANSWERED STATEMENTS. AN EXCEPTION WILL BE MADE IN THE EVENT A PATIENT/GUARANTOR DOES NOT FOLLOW THROUGH WITH THE MEDICAL ASSISTANCE APPLICATION PROCESS, WHEN REQUESTED TO DO SO. THE AGENCY WILL ATTEMPT TO COLLECT THE ACCOUNT FOR SIX MONTHS. AFTER THAT TIME THE ACCOUNT WILL BE WRITTEN OFF AS MEDICARE BAD DEBT.THE IRMC COLLECTION POLICY CONTAINS PROVISIONS TO PROVIDE A SOFTER APPROACH FOR THOSE THAT IRMC HAS LEARNED WOULD QUALIFY FOR FINANCIAL ASSISTANCE. UPON RECEIPT OF THE CALL FROM THE PATIENT THAT THERE IS HARDSHIP IN PAYING THE BILL, THE IRMC COLLECTION REPRESENTATIVE SHARES THE INFORMATION FOR APPLICATION FOR BOTH MEDICAL ASSISTANCE AND CHARITY CARE. WHILE THE PATIENT'S ACCOUNT IS IN THIS PROCESS, THEIR ACCOUNT WILL NOT BE PROVIDED TO THE COLLECTION AGENCY. | ||
| PART V, SECTION B, LINE 13G: A MESSAGE IS PROVIDED ON INVOICES THAT THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE. | INDIANA REGIONAL MEDICAL CENTER | |
| PART V, SECTION B, LINE 19D: THE MEDICAL CENTER WILL APPLY GROSS CHARGES ALSO KNOWN AS THE TOTAL CHARGES AT THE ORGANIZATION'S FULL ESTABLISHED RATES FOR THE PROVISION OF THE PATIENT CARE SERVICES BEFORE DEDUCTIONS FROM REVENUE ARE APPLIED. | INDIANA REGIONAL MEDICAL CENTER | |
| PART V, SECTION B, LINE 21: ALL INDIVIDUALS, WHETHER APPLYING FOR CHARITY CARE OR NOT, WILL BE CHARGED THE HOSPITAL'S FULL ESTABLISHED OR GROSS RATES BEFORE ANY DEDUCTIONS FROM REVENUE ARE APPLIED. | INDIANA REGIONAL MEDICAL CENTER | |
| PART VI, LINE 2: DURING THE PAST YEAR, IRMC HAS BEEN REVIEWING INFORMATION AND DATA ABOUT THE HEALTH OF OUR COUNTY. INFORMATION WAS COLLECTED FROM THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM SURVEY, COUNTY HEALTH PROFILE, COUNTY HEALTH RANKINGS, COMMUNITY MEMBERS, MEDICAL STAFF AND HOSPITAL LEADERSHIP. OVERALL, THE HEALTH OF INDIANA COUNTY RESIDENTS IS BETTER OR EQUAL TO THOSE IN THE SURROUNDING COUNTIES. HOWEVER, SEVERAL AREAS WERE IDENTIFIED AS AREAS FOR IMPROVEMENT.OUR REPORT OUTLINES THE 19 COMMUNITY NEEDS ORIGINALLY IDENTIFIED THROUGH THE SURVEY AND DATA SOURCES. THE TOP SEVEN PRIORITIES THAT IRMC WILL BE FOCUSING ON IN THE NEXT THREE YEARS ARE: EARLY PRENATAL CARECHOLESTEROL TESTINGINFLUENZA/PNEUMONIA DEATHSNUMBER OF PRIMARY CARE PHYSICIANSOVERWEIGHT/OBESITY RATESDRUG ABUSEPREVENTABLE HOSPITALIZATIONS | ||
| PART VI, LINE 3: IRMC WILL POST, AT ALL POINTS OF REGISTRATION, A NOTICE OF THE CHARITY CARE POLICY. THE MEDICAL CENTER WILL ALSO PROVIDE NOTICE OF THE CHARITY CARE POLICY IN PATIENTS' BILLS AND TO LOCAL SOCIAL SERVICE AGENCIES. THE MEDICAL CENTER ALSO PROVIDES THIS INFORMATION ON THE INDIANA REGIONAL MEDICAL CENTER'S INTERNET HOME PAGE. AT THE EARLIEST FEASIBLE TIME, THE MEDICAL CENTER PERSONNEL WILL ATTEMPT TO DETERMINE PATIENT ELIGIBILITY FOR COVERAGE OF PART OR ALL OF THEIR PATIENT BILL.ALL PRE-REGISTRATION, REGISTRATION, BUSINESS OFFICE, AND PATIENT FINANCIAL SERVICES STAFF RECEIVE TRAINING AS TO THE CHARITY CARE POLICY AND ARE TO BE FAMILIAR WITH THE AVAILABILITY OF CHARITABLE ASSISTANCE AND THE CRITERIA FOR SUCH ASSISTANCE. | ||
| PART VI, LINE 4: SINCE OPENING ITS DOORS IN 1914, INDIANA REGIONAL MEDICAL CENTER (IRMC) HAS MAINTAINED A GOAL OF SERVING THE COMMUNITY WITH QUALITY, PROGRESSIVE, COMPASSIONATE PATIENT CARE. AS THE COUNTY'S SOLE, FULL-SERVICE HEALTHCARE PROVIDER, IRMC HAS CONTINUALLY RISEN TO THE CHALLENGE OF MEETING THE NEEDS OF ITS COMMUNITY. IRMC RESIDES IN INDIANA, PENNSYLVANIA IN THE HEART OF THE COUNTY. THE HOSPITAL SITS ON A 75-ACRE CAMPUS AND ADMITS OVER 7,700 PATIENTS, DELIVERS MORE THAN 600 BABIES, AND ACCOMMODATES ANOTHER QUARTER-MILLION OUTPATIENT ENCOUNTERS EACH YEAR. AS AN ACUTE CARE FACILITY, IRMC IS LICENSED FOR 164 BEDS AND PROVIDES A BROAD RANGE OF MEDICAL AND EDUCATIONAL SERVICES AT ITS MAIN CAMPUS AND SATELLITE LOCATIONS ACROSS INDIANA COUNTY. AS THE ONLY HOSPITAL LOCATED IN THIS RURAL COUNTY, IRMC PROVIDES SERVICES TO A DIVERSE POPULATION OF 89,000 RESIDENTS SPREAD OVER 830 SQUARE MILES.OVER THE YEARS, IRMC HAS DEVELOPED PROGRAMS AND SERVICES THAT ADDRESS IMPROVING ACCESS TO CARE, PREVENTIVE SERVICES, AND COMMUNITY HEALTH EDUCATION. IRMC HAS FOUND A WAY TO NOT ONLY SUCCEED WHEN OTHER RURAL HOSPITALS ARE CLOSING THEIR DOORS, BUT ALSO EXPAND AND PROVIDE CARE TO THE RESIDENTS OF FIVE SURROUNDING COUNTIES. IRMC IS THE NUMBER TWO EMPLOYER IN THE COUNTY WITH 1,300 EMPLOYEES AND CONTINUES TO ATTRACT AND RETAIN A QUALITY WORKFORCE THROUGH THE ACHIEVEMENT OF NUMEROUS RECOGNITIONS, SUCH AS THE #1 BEST PLACE TO WORK IN PA, THE #2 BEST PLACE TO WORK IN THE NATION ACCORDING TO MODERN HEALTHCARE MAGAZINE, ACHIEVED NOTABLE STATUS BY SCORING AT THE MASTERY LEVEL IN PENNSYLVANIA'S KAPE PROGRAM, AND NAMED TO FORTUNE'S 100 BEST COMPANIES TO WORK FOR. FURTHER, IRMC IS CURRENTLY PURSUING THE MALCOLM BALDRIGE NATIONAL QUALITY AWARD - A PRESTIGIOUS HONOR ACHIEVED BY FEW. | ||
| PART VI, LINE 5: IN THE MID-NINETIES, HOSPITALS AND HEALTHCARE FACILITIES BEGAN TO SHIFT THEIR ATTENTION FROM JUST SICK OR HOSPITAL BASED CARE TO INCLUDE ADDRESSING COMMUNITY HEALTH AND DISEASE PREVENTION. AS A FIRST STEP IN THAT DIRECTION, IRMC FORMED A COMMUNITY SERVICE DEPARTMENT WHOSE PURPOSE WAS TO DELIVER EDUCATION AND PREVENTATIVE SCREENINGS TO THE COMMUNITY-AT-LARGE. IN 2005, REALIZING THAT ALMOST EVERY DEPARTMENT IN THE HOSPITAL HAD OPPORTUNITIES TO PROMOTE HEALTH AND WELLNESS, IRMC CREATED THE INSTITUTE FOR HEALTHY LIVING, A VIRTUAL ORGANIZATION COORDINATING ALL ASPECTS OF COMMUNITY OUTREACH AND HEALTH IMPROVEMENT. IMPROVING AND SUSTAINING COMMUNITY HEALTH, HOWEVER, IS A COLLABORATIVE ENDEAVOR THAT INTEGRATES AS MANY KEY STAKEHOLDERS AS POSSIBLE. IN THAT REGARD, IRMC SPEARHEADED THE FORMATION OF THE INDIANA COUNTY COMMUNITY HEALTH ADVISORY COUNCIL (CHAC), AN ENTERPRISE REPRESENTING MEMBERS FROM VARIOUS COMMUNITY AGENCIES, ORGANIZATIONS AND SCHOOLS WHOSE PURPOSE IT IS TO IDENTIFY HEALTH NEEDS IN OUR COUNTY AND TO FIND WAYS TO MEET THEM. THE CHAC HAS BEEN ACTIVE SINCE 1996 AND IRMC SERVES AS ITS BASE AND CHAIRMANSHIP. THE IRMC / INSTITUTE FOR HEALTHY LIVING 2011 COMMUNITY HEALTH NEEDS ASSESSMENT AND REPORT IS THE PRODUCT OF AN 18-MONTH PROCESS THAT SOUGHT COMMUNITY INPUT, MEDICAL STAFF INPUT, INVOLVED KEY INTEREST GROUPSSUCH AS THE CHAC, AND SELECTED PRIMARY AND SECONDARY SOURCES OF SURVEY INPUT TO IDENTIFY TARGET AREAS FOR IMPROVEMENT WITH SPECIFIC ACTION PLANS.USING THE THREE SURVEY INPUTS OF THE PA BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY (BRFSS), THE ROBERT WOOD JOHNSON COUNTY HEALTH RANKINGS, AND THE PA DEPARTMENT OF HEALTH ANNUAL COUNTY HEALTH PROFILES, IRMC WAS ABLE TO IDENTIFY AND SET PRIORITIES AMONG 19 AREAS FOR COMMUNITY HEALTH IMPROVEMENT THAT DIFFERED SIGNIFICANTLY FROM STATE OR NATIONAL BENCHMARKS. IRMC THEN TARGETED SEVEN OF THOSE NEED AREAS FOR SPECIFIC INTERVENTION AND ACTION. INDIANA REGIONAL MEDICAL CENTER USES ITS OWN FUNDS TO ENHANCE BOTH THE CLINICAL STRATEGIES AND THE COMMUNITY STRATEGIES.CLINICAL STRATEGIES (A FEW EXAMPLES): RECRUITING ADDITIONAL PHYSICIANS FOR IDENTIFIED COMMUNITY NEEDS, EXPLORE DEVELOPMENT OF A FAMILY PRACTICE RESIDENCY PROGRAM TO FACILITATE RECRUITMENT AND RETENTION, ENLARGE THE MEDICAL FITNESS CENTER, ESTABLISH A WEIGHT LOSS TASK FORCE, DEVELOP A MEDICAL WEIGHT MANAGEMENT CENTER, PROVIDE FLU SHOTS TO ALL INPATIENTS DURING FLU SEASON, PROVIDE PNEUMONIA VACCINE TO ALL NON-VACCINATED INPATIENTS, ETC. COMMUNITY STRATEGIES (A FEW EXAMPLES): PARTNER WITH AGENCIES PROVIDING SERVICES AND EDUCATION TO YOUNG TEENS AND WOMEN, EVALUATE A PARTNERSHIP WITH EARLY HEAD START, IMPROVE VISIBILITY AND INFORMATION AVAILABLE ABOUT THE OB/GYN CLINIC, WORKED TO ESTABLISH PRACTICES IN THE MORE RURAL AREAS OF THE COUNTY THAT REQUIRE THE MEDICAL CENTER TO SUBSIDIZE DELIVERING CARE THERE, ESTABLISHED THE INDIANA AT CHESTNUT RIDGE FACILITY THAT OFFERS PRIMARY CARE AND URGENT-CARE AND WAS A SIGNIFICANT CAPITAL INVESTMENT, IMPLEMENT A PATIENT PORTAL TO IMPROVE PATIENT ACCESS TO MEDICAL RECORDS, BECAME A PROVIDER OF THE WE CAN! (WAYS TO ENHANCE CHILDREN'S ACTIVITY AND NUTRITION), PARTNERED WITH 7 ELEMENTARY SCHOOLS TO INSTALL PROJECT FIT AMERICA, IMPLEMENTED GROCERY STORE TOURS TO ASSIST PEOPLE WITH SEEKING HEALTHY CHOICES, PARTNER WITH 4 GROCERY STORES TO HAVE A DIETICIAN AVAILABLE TO HELP SHOPPERS MAKE HEALTHY CHOICES, CONDUCT THE ANNUAL "VACCINE FOR VETERANS" PROGRAM ON VETERANS DAY, EVALUATE THE POTENTIAL FOR PUBLIC PNEUMONIA VACCINE CLINICS, CONTINUE TO PROVIDE FREE FLU AND PNEUMONIA VACCINE TO HIGH-RISK, LOW INCOME RESIDENTS, ETC. | ||
| PART VI, LINE 6: INDIANA REGIONAL MEDICAL CENTER HAS THE FOLLOWING AFFILIATED ENTITIES:INDIANA HEALTHCARE FOUNDATION CONDUCTS FUNDRAISING ACTIVITIES, SUCH AS THE COLUMBUS DAY GOLF OUTING AND LOVE OF LIFE GALA, IN SUPPORT OF INDIANA REGIONAL MEDICAL CENTER. INDIANA REGIONAL MEDICAL CENTER AND PUNXSUTAWNEY AREA HOSPITAL JOINTLY FORMED INDIANA JEFFERSON RADIATION ONCOLOGY, INC. FOR THE PURPOSE OF ENHANCING THE QUALITY AND AVAILABILITY OF RADIATION ONCOLOGY SERVICES OFFERED TO PATIENTS IN INDIANA AND JEFFERSON COUNTIES, PA AND SURROUNDING AREAS.INDIANA HEALTHCARE PHYSICIAN SERVICES, INC. IS A NON-PROFIT HOSPITAL OWNED GROUP OF PRACTICES OWNED AND OPERATED TO SERVE THE RURAL AREAS OF INDIANA AND SURROUNDING COMMUNITIES. WE PROVIDE ACCESSIBLE, COST EFFECTIVE QUALITY HEALTHCARE WITHIN THE RURAL COMMUNITIES OF INDIANA AND SURROUNDING COUNTIES. WE SUPPORT AND WORK COLLABORATIVELY WITH OTHER NON-PROFIT AGENCIES WITHIN OUR SITES.INDIANA HEALTHCARE PROPERTIES HOLDS AND MANAGES PROPERTY IN SUPPORT OF INDIANA REGIONAL MEDICAL CENTER. | ||
| N/A | PART VI, LINE 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| 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 (12 entries)
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| STEPHEN A WOLFE | |||||||||||||
| 368143 | 0 | 0 | 0 | 5868 | 0 | 45099 | 0 | 15855 | 0 | 434965 | 0 | 0 | 0 |
| ROBERT GONGAWARE | |||||||||||||
| 197497 | 0 | 0 | 0 | 0 | 0 | 11578 | 0 | 1262 | 0 | 210337 | 0 | 0 | 0 |
| BRUCE A BUSH MD | |||||||||||||
| 269398 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 8773 | 0 | 278171 | 0 | 0 | 0 |
| DOMINIC PACCAPANICCIA | |||||||||||||
| 213703 | 0 | 0 | 0 | 0 | 0 | 8461 | 0 | 18936 | 0 | 241100 | 0 | 0 | 0 |
| CINDY VIRGIL | |||||||||||||
| 170922 | 0 | 0 | 0 | 0 | 0 | 6235 | 0 | 7823 | 0 | 184980 | 0 | 0 | 0 |
| WADE PATRICK | |||||||||||||
| 168704 | 0 | 0 | 0 | 0 | 0 | 1996 | 0 | 15602 | 0 | 186302 | 0 | 0 | 0 |
| LARRY SEDLEMEYER | |||||||||||||
| 153220 | 0 | 0 | 0 | 0 | 0 | 5154 | 0 | 8012 | 0 | 166386 | 0 | 0 | 0 |
| MICHAEL MERRELL | |||||||||||||
| 409621 | 0 | 18035 | 0 | 0 | 0 | 0 | 0 | 17741 | 0 | 445397 | 0 | 0 | 0 |
| LUIS P TOMACRUZ | |||||||||||||
| 354421 | 0 | 29419 | 0 | 0 | 0 | 0 | 0 | 19077 | 0 | 402917 | 0 | 0 | 0 |
| DONNA BALEWICK | |||||||||||||
| 331841 | 0 | 10429 | 0 | 0 | 0 | 0 | 0 | 7291 | 0 | 349561 | 0 | 0 | 0 |
| JOHN P CAWLEY | |||||||||||||
| 321721 | 0 | 223 | 0 | 0 | 0 | 0 | 0 | 7100 | 0 | 329044 | 0 | 0 | 0 |
| ANTHONY L SICO | |||||||||||||
| 308564 | 0 | 286 | 0 | 0 | 0 | 0 | 0 | 19228 | 0 | 328078 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 1A | INDIANA REGIONAL MEDICAL CENTER PAYS COUNTRY CLUB MEMBERSHIP DUES FOR PRESIDENT & CEO, STEPHEN WOLFE, WHICH IS NOT INCLUDED IN HIS COMPENSATION. THE MEMBERSHIP IS A CORPORATE MEMBERSHIP USED FOR BUSINESS PURPOSES ONLY. |
| PART I, LINE 4B | INDIANA REGIONAL MEDICAL CENTER HAS A SUPPLEMENTAL, NONQUALIFIED RETIREMENT PLAN UNDER IRC SECTION 457(F) FOR PRESIDENT & CEO STEPHEN WOLFE. NO AMOUNTS WERE PAID TO HIM FROM THIS PLAN DURING 2011. |
| PART I, LINE 7 | BONUSES MAY BE GRANTED AT THE DISCRETION OF THE BOARD AND ARE BASED ON FACTORS SUCH AS PERFORMANCE AND MEETING GOALS AND OBJECTIVES. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)
| Issuer EINIssuerEIN | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|
| INDIANA COUNTY HOSPITAL AUTHORITY | ||||||
| 251697319 | 2003-01-15 | 10000000 | FINANCE CAPITAL IMPROVEMENTS | 0 | 0 | 0 |
| INDIANA COUNTY HOSPITAL AUTHORITY | ||||||
| 251697319 | 2004-12-08 | 10000000 | FINANCE CAPITAL IMPROVEMENTS | 0 | 0 | 0 |
| INDIANA COUNTY HOSPITAL AUTHORITY | ||||||
| 251697319 | 2009-02-12 | 10000000 | FINANCE CAPITAL PROJECTS | 0 | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)
| Total ProceedsTotalProceeds | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind |
|---|---|---|---|---|---|---|---|
| 10000000 | 50000 | 9950000 | 2003 | 0 | 0 | 1 | 1 |
| 10000000 | 91500 | 9908500 | 2006 | 0 | 0 | 1 | 1 |
| 10000000 | 61000 | 9939000 | 2010 | 0 | 0 | 1 | 1 |
Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 1 |
| 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 1 |
| 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0 | 1 |
| 0 | 1 | 0 | 0 | 0 | 1 |
| 0 | 1 | 0 | 0 | 0 | 1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fed Tax Requirements Compliance | X | FedTaxRequirementsCompliance |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (11 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | THE FOLLOWING BOARD MEMBERS HAVE A BUSINESS RELATIONSHIP: TODD BRICE AND ANNE WHITE. | |
| FORM 990, PART VI, SECTION A, LINE 6 | INDIANA HEALTHCARE CORPORATION ("IHC") IS THE SOLE CORPORATE MEMBER OF INDIANA REGIONAL MEDICAL CENTER ("IRMC"). | |
| FORM 990, PART VI, SECTION A, LINE 7A | IHC HAS THE POWER TO FILL VACANCIES, NOMINATE AND APPROVE THE ELECTION OF, AND APPROVE REMOVAL OF THE BOARD OF DIRECTORS OF IRMC. | |
| FORM 990, PART VI, SECTION A, LINE 7B | IRMC SHALL OBTAIN THE APPROVAL OF IHC BEFORE ACTION ON ANY OF THE FOLLOWING MATTERS BECOMES FINAL AND EFFECTIVE FOR IRMC: (1) AMENDMENT OF THE ARTICLES OF INCORPORATION AND BYLAWS; (2) THE SALE, LEASE OR EXCHANGE OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY OR ASSETS OF IRMC; (3) MERGER OR CONSOLIDATION WITH ANY OTHER CORPORATION; (4) DISSOLUTION OF IRMC; (5) APPROVAL OF AN ANNUAL OPERATING AND CAPITAL BUDGET FOR IRMC; (6) ANY OTHER MATTER THAT BY LAW WOULD REQUIRE THE APPROVAL OF MEMBERS OF A NONPROFIT CORPORATION. | |
| FORM 990, PART VI, SECTION B, LINE 11 | EACH BOARD MEMBER WILL BE CONTACTED INDIVIDUALLY AND GIVEN THE OPPORTUNITY TO RECEIVE A COPY OF THE COMPLETE RETURN BY E-MAIL, POSTAL SERVICE, OR PICKED UP AT 835 HOSPITAL ROAD IN THE CHIEF FINANCIAL OFFICER'S OFFICE. THE RETURN IS ALSO PRESENTED AT A BOARD MEETING BEFORE FILING WITH THE INTERNAL REVENUE SERVICE. | |
| FORM 990, PART VI, SECTION B, LINE 12C | EVERY MEMBER OF THE BOARD, AND EVERY INDIVIDUAL APPOINTED TO THE BOARD OR BOARD COMMITTEES, AS WELL AS ALL KEY MANAGEMENT PERSONNEL AND PHYSICIAN LEADERS, ARE REQUIRED TO EXECUTE A CONFLICT OF INTEREST DISCLOSURE STATEMENT, WHICH WILL BE UPDATED AT LEAST ON AN ANNUAL BASIS OR AS ADDITIONAL CONFLICTING INTERESTS ARISE. IN ADDITION, EVERY MEMBER OF THE BOARD WILL SPECIFICALLY ACKNOWLEDGE THE CONFLICT OF INTEREST POLICY AND HIS/HER ATTEMPT TO ABIDE BY IT BY SIGNING THE ACKNOWLEDGEMENT FORM. EVERY BOARD COMMITTEE MEMBER, OFFICER, KEY MANAGEMENT EMPLOYEE, AND PHYSICIAN LEADER IS REQUIRED TO SIGN THIS ACKNOWLEDGEMENT AS WELL. THE ACKNOWLEDGEMENT AND DISCLOSURE FORMS WILL BE KEPT ON FILE BY THE CHIEF EXECUTIVE OFFICER, AND THE CHAIRMAN AND VICE-CHAIRMAN WILL BE FAMILIAR WITH THE STATEMENTS THAT ARE FILED BY BOARD MEMBERS IN ORDER TO GUIDE THEIR CONDUCT IN THE EVENT A CONFLICT ARISES. EVERY PERSON COVERED BY THIS POLICY SHALL SUBMIT IN WRITING TO THE CHIEF EXECUTIVE OFFICER A CONFLICT OF INTEREST DISCLOSURE STATEMENT LISTING ALL FINANCIAL AND CONFLICTING INTERESTS. EACH STATEMENT WILL BE RESUBMITTED WITH ANY NECESSARY CHANGES EACH YEAR OR AS ANY ADDITIONAL CONFLICTING OR FINANCIAL INTERESTS ARISE. THE CHAIRMAN OF THE BOARD SHALL BECOME FAMILIAR WITH ALL SUCH DISCLOSURE STATEMENTS IN CASE A CONFLICT ARISES. THE VICE CHAIRMAN OF THE BOARD SHALL BE FAMILIAR WITH THE DISCLOSURE STATEMENT FILED BY THE CHAIRMAN. PENALTIES FOR NON-COMPLIANCE: FAILURE TO COMPLY WITH THIS POLICY SHALL CONSTITUTE GROUNDS FOR REMOVAL FROM OFFICE AND, IN THE CASE OF KEY MANAGEMENT PERSONNEL, TERMINATION OF EMPLOYMENT. | |
| FORM 990, PART VI, SECTION B, LINE 15 | POSITIONS FOR OFFICERS AND KEY EMPLOYEES ARE REVIEWED ON AN ANNUAL BASIS. APPROPRIATE COMPARISONS ARE MADE ON A REGIONAL AND NATIONAL LEVEL IN ORDER TO MAINTAIN A FAIR AND EQUITABLE COMPENSATION STRUCTURE. ALL RECOMMENDATIONS ARE APPROVED BY THE BOARD OF DIRECTORS AND DOCUMENTED IN THE BOARD MINUTES. | |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC ON A REQUEST BASIS. | |
| FORM 990, PART VII, SECTION A | THE FOLLOWING OFFICERS AND DIRECTORS WORK AN AVERAGE OF 40 HOURS PER WEEK BETWEEN INDIANA REGIONAL MEDICAL CENTER AND ALL RELATED TAX-EXEMPT ORGANIZATIONS: STEPHEN A. WOLFE DOMINIC PACCAPANICCIA CINDY VIRGIL BRUCE A. BUSH, MD ROBERT GONGAWARE THE FOLLOWING BOARD MEMBERS ARE ALSO BOARD MEMBERS OF INDIANA HEALTHCARE PHYSICIAN SERVICES, INC.: JOHN DOLAN TODD BRICE BEVERLY GAZZA JOSEPH GEARY THOMAS MCCOY ANNE WHITE THE FOLLOWING BOARD MEMBERS ARE ALSO BOARD MEMBERS OF INDIANA HEALTHCARE CORPORATION: JOHN DOLAN TODD BRICE BEVERLY GAZZA THOMAS MCCOY ANNE WHITE MARK MCGOWAN | AVERAGE HOURS WORKED |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -5,918,033. PRIOR PERIOD ADJUSTMENTS: 3,236. PENSION AND POST-RETIREMENT LIABILITIES ADJUSTMENT -9,494,750. TRANSFER TO AFFILIATE -1,329,954. EQUITY DISTRIBUTION -100,000. NONCONTROLLING INTEREST IN NET INCOME OF SUBSIDIARIES 4,108,107. DECREASE IN INTEREST OF INDIANA HEALTHCARE FOUNDATION -147,995. TOTAL TO FORM 990, PART XI, LINE 5: -12,879,389. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| ORGANIZATIONAL STRUCTURE AND PRINCIPLES OF CONSOLIDATION | THE CONSOLIDATED FINANCIAL STATEMENTS AND FORM 990 OF INDIANA REGIONAL MEDICAL CENTER ALSO INCLUDES FINANCIAL INFORMATION OF THE FOLLOWING ENTITIES: 1) INDIANA AMBULATORY SURGICAL ASSOCIATES, LLC ("IASA") - FROM JULY 1, 2011 THROUGH OCTOBER 12, 2011, THE MEDICAL CENTER WAS THE SOLE OWNER OF IASA AND WAS TREATED AS A DISREGARDED ENTITY OF THE MEDICAL CENTER. ON OCTOBER 13, 2011, THE MEDICAL CENTER SOLD A 30% MEMBERSHIP INTEREST IN IASA. FROM THIS DATE ON, IASA WAS A PARTNERSHIP FOR FEDERAL TAX PURPOSES. 2) COSM REALTY GROUP, LTD. ("COSM") - THE MEDICAL CENTER HAS A 40% OWNERSHIP INTEREST IN COSM; HOWEVER, CONTROL EXISTS THROUGH THE MEDICAL CENTER'S GUARANTEE OF COSM'S DEBT AGREEMENT. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INDIANA AMBULATORY SURGICAL ASSOCIATES LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 835 HOSPITAL ROAD | AddressLine1 |
| City | INDIANA | City |
| State | PA | State |
| ZIP Code | 15701 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 232923182 | EIN |
| Primary Activities | AMBULATORY SURGERY | PrimaryActivities |
| Legal Domicile State | PA | LegalDomicileState |
| Total Income | 754443 | TotalIncome |
| EOY Assets | 0 | EOYAssets |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INDIANA REGIONAL MEDICAL CENTER | BusinessNameLine1 |
Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| INDIANA HEALTHCARE FOUNDATION | |||||||||||
| 835 HOSPITAL ROAD | INDIANA | PA | 15701 | 251574302 | FUNDRAISING IN SUPPORT OF INDIANA REGIONAL MEDICAL CENTER | PA | 501(C)(3) | LINE 11A, I | INDIANA HEALTHCARE CORPORATION | 0 | |
| INDIANA HEALTHCARE CORPORATION | |||||||||||
| 835 HOSPITAL ROAD | INDIANA | PA | 15701 | 251547379 | PARENT CORPORATION | PA | 501(C)(3) | LINE 7 | 0 | N/A | |
| INDIANA JEFFERSON RADIATION ONCOLOGY INC | |||||||||||
| 835 HOSPITAL ROAD | INDIANA | PA | 15701 | 900406301 | RADIATION ONCOLOGY SERVICES | PA | 501(C)(3) | LINE 11A, I | INDIANA REGIONAL MEDICAL CENTER | 1 | |
| INDIANA HEALTHCARE PHYSICIAN SERVICES INC | |||||||||||
| 835 HOSPITAL ROAD | INDIANA | PA | 15701 | 251842046 | PROVIDE HEALTH CARE | PA | 501(C)(3) | LINE 3 | INDIANA HEALTHCARE CORPORATION | 0 | |
| INDIANA HEALTHCARE PROPERTIES | |||||||||||
| 835 HOSPITAL ROAD | INDIANA | PA | 15701 | 251524635 | HOLD & MANAGE PROPERTY IN SUPPORT OF INDIANA REGIONAL MEDICAL CENTER | PA | 501(C)(3) | LINE 11A, I | INDIANA HEALTHCARE CORPORATION | 0 | |
Form990 Schedule R Part III Form990ScheduleRPartIII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| INDIANA REHABILITATION SERVICES LLC | ||||||||||||||
| 855 SPRINGDALE DR STE 200 | EXTON | PA | 19341 | 202214391 | REHABILITATION SERVICES | PA | N/A | UNRELATED | 71182 | 246505 | 0 | 1 | 0.51000 | |
| INDIANA AMBULATORY SURGICAL ASSOCIATES LLC | ||||||||||||||
| 841 HOSPITAL ROAD | INDIANA | PA | 15701 | 232923182 | AMBULATORY SURGERY | PA | UNRELATED | -49986 | 4304952 | 0 | 0 | 0.70000 | INDIANA REGIONAL MEDICAL CENTER | |
| COSM REALTY GROUP LTD | ||||||||||||||
| 1265 WAYNE AVENUE STE 307 | INDIANA | PA | 15701 | 030439684 | REAL ESTATE | PA | UNRELATED | 977025 | 0 | 0 | 0.40000 | INDIANA REGIONAL MEDICAL CENTER | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| 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 | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| INDIANA JEFFERSON RADIATION ONCOLOGY INC | ||
| I | 211812 | COST |
| INDIANA JEFFERSON RADIATION ONCOLOGY INC | ||
| O | 1961403 | COST |
| INDIANA JEFFERSON RADIATION ONCOLOGY INC | ||
| P | 946894 | COST |
Form990 Schedule R Part VII Form990ScheduleRPartVII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| SCHEDULE R, PARTS I AND III | INDIANA AMBULATORY SURGICAL ASSOCIATES, LLC ("IASA") IS LISTED IN BOTH PART I AS A DISREGARDED ENTITY AND IN PART III AS A PARTNERSHIP. FROM JULY 1, 2011 THROUGH OCTOBER 12, 2011, THE MEDICAL CENTER WAS THE SOLE OWNER OF IASA WHICH WAS TREATED AS A DISREGARDED ENTITY OF THE MEDICAL CENTER. ON OCTOBER 13, 2011, THE MEDICAL CENTER SOLD A 30% MEMBERSHIP INTEREST IN IASA. FROM THIS DATE ON, IASA WAS A PARTNERSHIP FOR FEDERAL TAX PURPOSES. |
| SCHEDULE R, PART III | THE MEDICAL CENTER IS REPORTING COSM REALTY GROUP, LTD IN PART III EVEN THOUGH IT ONLY HAS A 40% OWNERSHIP INTEREST IN COSM; HOWEVER, CONTROL EXISTS THROUGH THE MEDICAL CENTER'S GUARANTEE OF COSM'S DEBT AGREEMENT. |