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BUTLER HEALTHCARE PROVIDERS: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
BUTLER HEALTHCARE PROVIDERS (EIN 25-0965274)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-05-15
IRS object ID
201321359349307582
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-05-15T15:23:17-05:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN250965274EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1BUTLER HEALTHCARE PROVIDERSBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlBUTLNameControl
Phone7242844429Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ONE HOSPITAL WAYAddressLine1
CityBUTLERCity
StatePAState
ZIP Code16001ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameAnne B KrebsName
TitleVP of FinanceTitle
Phone7242844400Phone
Date Signed2013-05-15DateSigned
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1Butler Memorial HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonKenneth P DeFurioNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1ONE HOSPITAL WAYAddressLine1
CityBUTLERCity
StatePAState
ZIP Code16001ZIPCode
FieldValueIRS element (for citing)
Gross Receipts221597280GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.butlerhealthsystem.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1898YearFormation
State Legal DomicilePAStateLegalDomicile
Activity Or Mission DescriptionThe mission of Butler Memorial Hospital is to be a healing presence in the communities we serve. We exist to make a positive difference in the lives of people by providing compassionate, high quality care and comfort, and inspiring health and wellbeing.ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees2069TotalNbrEmployees
Total Nbr Volunteers293TotalNbrVolunteers
Total Gross UBI4726770TotalGrossUBI
Net Unrelated Business Txbl Income657988NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year2354315ContributionsGrantsPriorYear
Contributions Grants Current Year2307488ContributionsGrantsCurrentYear
Program Service Revenue Prior Year204952852ProgramServiceRevenuePriorYear
Program Service Revenue CY209233549ProgramServiceRevenueCY
Investment Income Prior Year1804233InvestmentIncomePriorYear
Investment Income Current Year1112075InvestmentIncomeCurrentYear
Other Revenue Prior Year9562505OtherRevenuePriorYear
Other Revenue Current Year8944168OtherRevenueCurrentYear
Total Revenue Prior Year218673905TotalRevenuePriorYear
Total Revenue Current Year221597280TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year50000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY50350GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year102100965SalariesEtcPriorYear
Salaries Etc Current Year99980607SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year112248474OtherExpensePriorYear
Other Expenses Current Year112251580OtherExpensesCurrentYear
Total Expenses Prior Year214399439TotalExpensesPriorYear
Total Expenses Current Year212282537TotalExpensesCurrentYear
Revenues Less Expenses Prior Year4274466RevenuesLessExpensesPriorYear
Revenues Less Expenses CY9314743RevenuesLessExpensesCY
Total Assets BOY307666583TotalAssetsBOY
Total Assets EOY311663633TotalAssetsEOY
Total Liabilities BOY174484811TotalLiabilitiesBOY
Total Liabilities EOY188837518TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY133181772NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY122826115NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionThe mission of Butler Memorial Hospital is to be a healing presence in the communities we serve. We exist to make a positive difference in the lives of people by providing compassionate, high quality care and comfort, and inspiring health and wellbeing.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense176521723Expense
Grants50350Grants
Revenue212072033Revenue
DescriptionButler Memorial Hospital (BMH) is an independent, community-based hospital that has served Butler County, PA, and the surrounding area for over 100 years. BMH employs nearly 2,000 people, making it the largest employer in Butler County. The hospital has grown into a regional referral center for the areas. It is the largest hospital facility between Pittsburgh and Erie. It is comprised of 296 acute care beds and a 25 bed skilled nursing facility. BMH serves approximately 13,000 acute care patients (admissions) and over 485,000 outpatients each year. The Hospital maintains a deep commitment to its community, as is demonstrated through its broad services offering. It provides all levels of general medical and surgical care, emergency services, a robust psychiatric service, drug & alcohol treatment, family services, preventative & wellness programs and tertiary cardiovascular care. It also has a network of 28 convenient, low cost outpatient site that are located in communities through Butler County and the surrounding area.Description
Total Program Service Expense176521723TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
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 Bonds1InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer1OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization1BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096131NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees2069NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
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 Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
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 Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledPAStatesWhereCopyOfReturnIsFiled
Own WebsiteXOwnWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Finance DepartmentBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7242844429TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1One Hospital WayAddressLine1
CityButlerCity
StatePAState
ZIP Code16001ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (21 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Fiore C Londino
Chairman2.00XX000
Kenneth P DeFurio
President & CEO40.00XX6546920190434
Marcia Segraves
Corporate Secretary2.00XX000
D Kelly Agnew MD
Trustee1.00X000
C Ross Betts MD
Trustee1.00X000
Mario Kinsella MD
Trustee1.00X000
T T Channapati MD
Trustee1.00X1779200
David E Foreman
Trustee1.00X000
Kathryn S Helfer
Trustee1.00X000
Patti-Ann Kanterman
Trustee1.00X000
Douglas K McClaine
Trustee1.00X000
Robert M Smith PhD
Trustee1.00X000
Margaret Irvine
Trustee1.00X000
Anne B Krebs
Chief Financial Officer40.00X350846073984
Stephanie Roskovski
VP of Operations45.00251685045151X
Karen Allen
VP of Patient Svc CON50.00225579054045X
Charles Oleson
Chief Information Officer50.00245101063913X
A Thomas McGill MD
VP Quality & Safety40.00357869074273X
John C Reefer MD
VP Prof Affairs Med Director40.00355799086875X
Paula L Hooper
VP General Counsel30.00266094056905X
Maureen A Gray
Chief Experience Officer50.00263892056028X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2989349TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation701608TotalOtherCompensation
Number Individuals GT100 K42NumberIndividualsGT100K
Formers Listed0FormersListed
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
Metz Environmental Services
Two Woodland DriveDallasPA18612Environmental/Dietary2532571
Advanced Imaging Inc
4198 Washington RoadMcMurrayPA15317Imaging Servies2211223
Butler Anesthesia Associates
PO Box 737East ButlerPA16029Anesthesiology1923324
Quest Diagnostics
875 Greentree RoadPittsburghPA152203610Laboratory Services1532507
Point Security Company
359 Northgate RoadWarrendalePA15086Security Services1016728
FieldValueIRS element (for citing)
Number Of Contractors GT100 K19NumberOfContractorsGT100K
Federated Campaigns4729FederatedCampaigns
Related Organizations878799RelatedOrganizations
Government Grants1423960GovernmentGrants
Total Contributions2307488TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNet Patient RevenueDescription
Business Code621500BusinessCode
Total Revenue Column209233549TotalRevenueColumn
Related Or Exempt Function Income206044638RelatedOrExemptFunctionIncome
Unrelated Business Revenue3188911UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Program Service Revenue209233549TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1112075TotalRevenueColumn
Unrelated Business Revenue915UnrelatedBusinessRevenue
Exclusion$1,111,160ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Other Income90009935080003273956234044
Meaningful Use90009918654231865423
Dietary7222101379829$1,379,829

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column2190916TotalRevenueColumn
Related Or Exempt Function Income888016RelatedOrExemptFunctionIncome
Unrelated Business Revenue1302900UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Other Revenue8944168TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column221597280TotalRevenueColumn
Related Or Exempt Function Income212072033RelatedOrExemptFunctionIncome
Unrelated Business Revenue4726770UnrelatedBusinessRevenue
Exclusion$2,490,989ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total50350Total
Program Services50350ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1636868Total
Program Services118243ProgramServices
Management And General1518625ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total74226271Total
Program Services65878441ProgramServices
Management And General8347830ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total4751330Total
Program Services4228684ProgramServices
Management And General522646ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total13971521Total
Program Services12434654ProgramServices
Management And General1536867ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total5394617Total
Program Services4787207ProgramServices
Management And General607410ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total311782Total
Program Services31833ProgramServices
Management And General279949ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total120000Total
Management And General120000ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total938716Total
Program Services199920ProgramServices
Management And General738796ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total51896791Total
Program Services50631140ProgramServices
Management And General1265651ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total2237068Total
Program Services2231675ProgramServices
Management And General5393ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total5356149Total
Program Services5005212ProgramServices
Management And General350937ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total458444Total
Program Services129237ProgramServices
Management And General329207ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total124267Total
Program Services81660ProgramServices
Management And General42607ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total6479498Total
Program Services6479498ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total14076797Total
Program Services10739013ProgramServices
Management And General3337784ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1956253Total
Program Services9040ProgramServices
Management And General1947213ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Purchased Services1257194997661302805819
Bad Debt8625745454748580271
Physician Fees503036532377791792586
Miscellaneous20677564365331631223

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total212282537Total
Program Services176521723ProgramServices
Management And General35760814ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2875BOY
EOY2850EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY25275539BOY
EOY44447448EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY27674587BOY
EOY29756714EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY1713996BOY
EOY1220393EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY3040910BOY
EOY2940699EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2946874BOY
EOY3127347EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis300867706LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec151548057LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY158802793BOY
EOY149319649EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY78984616BOY
EOY71970788EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY3622868BOY
EOY3737922EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY5601525BOY
EOY5139823EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY307666583BOY
EOY311663633EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY20148787BOY
EOY23009461EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY135309188BOY
EOY133449557EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY19026836BOY
EOY32378500EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY174484811BOY
EOY188837518EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY131773372BOY
EOY121680563EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1408400BOY
EOY1145552EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY133181772BOY
EOY122826115EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY307666583BOY
EOY311663633EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses9314743ReconcilationRevenueExpenses
Reconcilation Other Changes-19670400ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
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 D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis2577581OtherCostOrOtherBasis
Book Value2577581BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis84606335OtherCostOrOtherBasis
Depreciation29426424Depreciation
Book Value55179911BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis6987629OtherCostOrOtherBasis
Depreciation2561759Depreciation
Book Value4425870BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis196286445OtherCostOrOtherBasis
Depreciation115721190Depreciation
Book Value80565255BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis10409716OtherCostOrOtherBasis
Depreciation3838684Depreciation
Book Value6571032BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings149319649TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
Pension$27,493,466
Third Party Settlements$4,885,034
FieldValueIRS element (for citing)
Total Of Amounts32378500TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierDescription of Uncertain Tax Positions Under FIN 48:Identifier
Return ReferencePart X:ReturnReference
ExplanationThe System adopted the standard for accounting for uncertainty in income taxes recognized in a company's financial statement that prescribes 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 has not been met. The standard also provides guidance on derecognition, classification, interest and penalties, accounting for interim periods, and disclosure. Management determined that there were no tax uncertainties that meet the recognition threshold as of June 30, 2012 or 2011. The Systems income tax returns for the years ended 2011, 2010 and 2009 remain subject to examination by the Internal Revenue Service and state agencies.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
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)
Total Community Benefit Expense3836888TotalCommunityBenefitExpense
Direct Offsetting Revenue161591DirectOffsettingRevenue
Net Community Benefit Expense3675297NetCommunityBenefitExpense
Percent Of Total Expense0.01800PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense25767134TotalCommunityBenefitExpense
Direct Offsetting Revenue17411570DirectOffsettingRevenue
Net Community Benefit Expense8355564NetCommunityBenefitExpense
Percent Of Total Expense0.04100PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense193158TotalCommunityBenefitExpense
Direct Offsetting Revenue186448DirectOffsettingRevenue
Net Community Benefit Expense6710NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense29797180TotalCommunityBenefitExpense
Direct Offsetting Revenue17759609DirectOffsettingRevenue
Net Community Benefit Expense12037571NetCommunityBenefitExpense
Percent Of Total Expense0.05900PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense210594TotalCommunityBenefitExpense
Direct Offsetting Revenue16725DirectOffsettingRevenue
Net Community Benefit Expense193869NetCommunityBenefitExpense
Percent Of Total Expense0.00100PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense439166TotalCommunityBenefitExpense
Net Community Benefit Expense439166NetCommunityBenefitExpense
Percent Of Total Expense0.00220PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense17714021TotalCommunityBenefitExpense
Direct Offsetting Revenue12930547DirectOffsettingRevenue
Net Community Benefit Expense4783474NetCommunityBenefitExpense
Percent Of Total Expense0.02350PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense231699TotalCommunityBenefitExpense
Net Community Benefit Expense231699NetCommunityBenefitExpense
Percent Of Total Expense0.00110PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense18595480TotalCommunityBenefitExpense
Direct Offsetting Revenue12947272DirectOffsettingRevenue
Net Community Benefit Expense5648208NetCommunityBenefitExpense
Percent Of Total Expense0.02780PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense48392660TotalCommunityBenefitExpense
Direct Offsetting Revenue30706881DirectOffsettingRevenue
Net Community Benefit Expense17685779NetCommunityBenefitExpense
Percent Of Total Expense0.08680PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense14564TotalCommunityBuildingExpense
Net Community Building Expense14564NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense14564TotalCommunityBuildingExpense
Net Community Building Expense14564NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$8,625,745BadDebtExpenseAmount
Amount Attributable To4634000AmountAttributableTo
Amount Reimbursed By Medicare40452169AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare44871175CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-4419006MedicareSurplusOrShortfall

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 Line1Butler Healthcare ProvidersBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1One Hospital WayAddressLine1
CityButlerCity
StatePAState
ZIP Code160014670ZIPCode
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 Line1Butler Memorial HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent300.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
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 Facilities2NumberOfOtherFacilities

Other Facilities OtherFacilities (2 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
Butler Healthcare Providers SNF
One Hospital WayButlerPA16001Skilled Nursing Facility
Butler Healthcare Providers Psych
One Hospital WayButlerPA16001Psychiatric and Chemical Dependency

Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)

ExplanationExplanationIdentifierIdentifier
Part I, Line 7: The costing methodology is based on the ratio of cost to charges from our hospital's accounting system.
Part I, L7 Col(f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), was subtracted for purposes of calculating the percentage in this column is $8,625,745.
Part III, Line 4: Provision for bad debts and allowance for doubtful accounts: In July 2011, the FASB issued guidance related to the presentation and disclosure of patient service revenue, provision for bad debts, the allowance for doubtful accounts, and the related disclosures for certain health care entities. This guidance requires health care entities that recognize significant amounts of patient service revenue at the time services are rendered, even though they do not access the patient's ability to pay, to present the provision for bad debts related to patient service revenue as a deduction from patient service revenue (net of contractual allowances and discounts) on their statement of operations. The new guidance also establishes enhanced disclosures surrounding the bad debts, net patient revenue, as well as the allowance for doubtful accounts. This guidance is effective for public entities with fiscal years beginning after December 15, 2011, with early adoption permitted. The system is currently evaluating the impact that adoption will have on its consolidated financial statements.The costing methodology is based on the ratio of cost to charges from our hospital's accounting system.
Bad debt expense represents the amount of the patient's obligation that the hospital has been unable to collect. This includes amounts the hospital has written off, plus amounts estimated as uncollectible, less any amounts collected on accounts previously written off. For self pay patients, the balance due is adjusted from the charge amount to 32% of charges based on the average collection rate for insurance contracts. For non self pay patients, the balance is the amount due after insurance payments. Typically this is a deductible or co-insurance.
Part III, Line 8: The cost used to determine the Medicare payment shortfall comes from the CMS required filing of the Medicare cost report. The methodology uses a ratio of cost to charges to determine the cost assigned to the Medicare services. Butler Memorial Hospital is committed to serving the healthcare needs of all members of our Community. We consider the revenue shortfall from the Medicare program payments to be part of our community contribution.
Part III, Line 9b: Patients who have previously applied and been approved for our charity care program are automatically qualified for any additional services provided over the next six months after application approval. We also will presumptively qualify patients for charity care if they meet criteria such as being food stamp eligible and qualifying for section 8 housing.
Part V, Section B, Line 19d: The Hospital used the average payment to charge ratio of all the commercial insurance plans. The ratio is updated annually based on the prior year's payment ratio.Butler Memorial Hospital
Part VI,Line 2:BMH periodically surveys Butler County Residents about their healthcare needs. Included in the survey are questions from the Centers for Disease Control Behavioral Risk Factor Surveillance System. The goal is to assess health status, disease burden and diagnosis, disease prevention, exercise and nutrition status, access to care and overall health literacy. Responses to the survey are carefully evaluated by a specialist in Public Health and results are shared with BMH's clinical staff. The findings are then integrated into operations that meet the community's health needs.
Part VI, Line 3: There are signs posted in all registration areas indicating that free care is provided to those people in need. Information is provided to all self pay patients at time of registration indicating that help is available if the patient meets the criteria. A notice is also posted on the hospital's web site. Each patient statement that is mailed out has a notice of the availability of free care and how to apply. The Hospital provides assistance to patients to determine if they are eligible for the Pennsylvania Medical Assistance program. The Patient Financial Assistance staff notifies patients of the availability of free care during phone conversations about the collection of balances due.
Part VI, Line 4: Butler, Pennsylvania is a rural town with a population of approximately 13,000. The estimated median household income of $28,000 is well below the Pennsylvania average of $49,520. Approximately 21% of residents in Butler Pennsylvania live in poverty. Residents of Butler County Pennsylvania comprise the majority of patients served by Butler Memorial Hospital. Additionally, BMH serves residents of surrounding counties including Allegheny, Lawrence, Mercer, Venango, Clarion and Armstrong Counties.
Part VI,Line 5:A majority of the Governing Body of Butler Memorial Hospital reside in our primary service area. Per the Corporate Bylaws 60% of the Trustees must work or reside in the service area. Medical Staff Privileges are offered to all qualified physicians subject to the recommendation of the Hospital Medical Staff and in compliance with the policies of the Board of Trustees. Currently 284 physicians, podiatrists and dentists hold privileges on the Butler Memorial Hospital Medical Staff. Privileges are offered based on qualifications and community need without regard to other factors such as race, sex, color, creed, or national origin. Annually, Butler Memorial Hospital establishes operating and capital budgets designed to efficiently allocate funds for its ongoing operation and for the additional investment in new and replacement patient care equipment; plant and infrastructure; and technology. Upon preparation by management staff the final budget is presented for approval by the Board of Trustees.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained0RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1Community Health Clinic of Butler CountyBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1103 Bonnie DriveAddressLine1
CityButlerCity
StatePAState
ZIP Code16002ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient204852135EINOfRecipient
IRC Section501 (c) (3)IRCSection
Amount Of Cash Grant50350AmountOfCashGrant
Purpose Of GrantGeneral Support to provide medical care of indigent patientsPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedure for Monitoring Grants in the U.S.:Identifier
Return ReferencePart I, Line 2:ReturnReference
ExplanationSchedule I, Part I, Line 2: The organization's bylaws control the contributions that can be made and the process related to such.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
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 Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

Base 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
Kenneth P DeFurio
470164015510602942201509250395090845126000
Anne B Krebs
2608700520750379010468670271170424830000
Stephanie Roskovski
2013190386010117650259290192220296836000
Karen Allen
1770760380020105010214500325950279624000
Charles Oleson
1972640344620133750263530375600309014000
A Thomas McGill MD
2826180552610199900469110273620432142000
John C Reefer MD
2820910552610184470496570372180442674000
Paula L Hooper
2113850419290127800205020364030322999000
Maureen A Gray
2082620431020125280296380263900319920000

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part I, Line 4b4 (b) Anne B Krebs received payment of 21,689 as part of a Senior Executive Benefit Plan for a tax-deferred Capital Accumulation Account. The amount represents the amount paid out after a two year vesting period. The program was discontinued in January, 2009. However, in some cases payments have been deferred into future years. 4 (b) As part of the Senior Executive Benefit Plan, the organization contributes to a SERP plan. The SERP plan is a benefit used to retain executives. Executives do not receive any payment from the plan until they reach a vesting milestone at 5 years, 10 years and then finally at 65 years of age. Benefits paid to the participant are taxable. The organization contributed the following amounts to the SERP plan for the following individuals: 4 (b) Kenneth P DeFurio 134,425; Anne B Krebs 31,245; Maureen A Gray 23,460; Stephanie J Roskovski 23,160; A Thomas McGill MD 33,157; John C Reefer MD 33,157; Paula L Hooper 11,550; Karen A Allen 11,550; Charles Oleson 14,190
Part I, Line 77 Officers and employees are eligible and received bonus compensation. Bonuses are not guaranteed and are awarded based on Board approved metrics which include quality, services and financial performances.
Part IIIButler Health System Executive Compensation Philosophy and Process The Board of Trustees recognizes the great challenges and difficulties that healthcare executives face, particularly in the current era of national and state healthcare reform. In addition, the Pittsburgh regional market is highly competitive and changing rapidly. The Board competes for and seeks executive talent on a national basis. It engages expert compensation consultants, utilizing national comparative data to guide the determination of competitive, appropriate levels of compensation. The total compensation program for executives consists of cash compensation and benefits. Factors taken into consideration in determining compensation for executives include: market demand and competition for similar positions, experience and tenure, and actual performance and effectiveness. Based on these and other pertinent criteria, BHS targets total compensation to fall within a range of the 25th to 75th percentile of the market. BHS executive compensation generally will not exceed the 75th percentile of the market. Exceptions to this may be subject to review and recommendation by the Compensation Committee, which in turn is subject to review and approval by the Board of Trustees. Exception must be supported by organizational and /or individual performance, or a retention/recruitment circumstance that warrants such compensation. The Compensation Committee consists exclusively of "non-interested" individuals with no real or perceived conflicts of interest in recommending executive compensation guidelines and levels. While benefits are accounted for in Schedule J, actual "take home" pay to the executive consists only of base salary and incentive award earned, if any. Annual increases in base pay, if any, are based on competitive market trends from the comparison group. Supplemental retirement benefits are used as a vehicle for executive recruitment and retention with appropriate vesting periods. The Board of Trustees reviews and approves executive compensation in its entirety, including the use of "tally sheets", which disclose 100% executive compensation. The Board of Trustees engages external compensation and legal expertise to assure reasonableness of executive compensation levels.Supplemental Information

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
Butler County Hospital Authority
2514589121235926QB2009-04-2950000000Construction of addition to hospital010
Butler County Hospital Authority
251458912123592CPO2009-04-2974728451Construction of addition to hospital010
Butler County Hospital Authority
2514589120000000002010-06-2912165000Construction of addition to hospital010

Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)

Total ProceedsTotalProceedsIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindAmount In Reserve FundAmountInReserveFund
500000008334954916650520100001
74728451141917966455887201000016853385
121650002172260111

Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUsePost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
00000.000000.000000.000000
00000.000000.000000.000000
00000.000000.000000.000000

Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
000000
000000
000000

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
Anne B Krebs
CFO & Officer of Org; Uncompensated member of Board of Directors of YMCA191129Organization leases from the YMCA0
Mario Kinsella MD
Member of the Board of Trustees of Org;Officer of AIRMED with 14% ownership674602Assoc in Respiratory Mediciane, AIRMED,provides respiratory services for the organization0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VI, Section A, line 6Per the By-Laws of the organization, the organization shall have one corporate member, Butler Health System, Inc. There shall be no other members.
Form 990, Part VI, Section A, line 7aButler Health System, Inc., the corporate member of the organization, appoints the members of the Board of Trustees.
Form 990, Part VI, Section A, line 7bAs per the By-Laws of the organization, the subject matters of the powers reserved to the Member are as follows: a. The number of Trustees that will comprise the Board. b. The election of Trustees. c. The removal of any Trustee for cause from the Corporation's Board of Trustees and approval of the replacement of any such removed Trustee for the unexpired portion of the term. d. The election, re-election, appointment and reappointment of all Officers of the Board. e. The amendment, revision, or restatement of the Corporation's Articles of Incorporation and/or By-Laws. f. The adoption or change in the mission, purpose, philosophy or objectives of the Corporation. g. The change in the general structure of the Corporation as a voluntary, nonprofit corporation. h. The dissolution, division, conversion or liquidation of the Corporation, the consolidation or merger of the Corporation with another corporation or entity, or the acquisition of substantially all of the assets of another corporation or entity, subject to the provision of the Articles of Incorporation. i. The Corporation's borrowing of money, issuance of indebtedness and/or incurrence of guarantees, whether in a single transaction or a series of related transactions, whether or not such borrowings or guarantees are to be secured by a mortgage, pledge or other lien on the Corporation's current or future real property, personal property or endowment funds. j. Approval of the annual capital and operating budgets of the Corporation and any amendments thereto. k. Approval of any charitable donation by the Corporation, other than to the Member or any nonprofit entity in which the Member is a sole member, in an amount exceeding $15,000 or in an amount exceeding $150,000 in the aggregate during any one fiscal year. l. Approval of any transfer other than charitable donations of the Corporation's assets unless specifically authorized in the Corporation's approved budgets. m. Approval of change of membership or voting rights of the Member.
Form 990, Part VI, Section B, line 11The completed 990 was reviewed by the Chief Financial Officer and an outside independent public accounting firm. Relevant sections were reviewed by the Vice President and General Counsel. Highlights of the Form 990 were reviewed with the Finance Committee and the Board of Trustees. After these reviews, but prior to filing, the full Board of Trustees and the Finance Committee was notified that the completed Form 990 was available for review on the Boards secure website.
Form 990, Part VI, Section B, line 12cThe responses to the Conflict of Interest Disclosure form are collected and reviewed annually by General Counsel, who then reviews the same with the Audit and Compliance Committee of the Board of Trustees. Conflict of Interest Disclosure forms are completed by all trustees, officers, committee members as well as the executive team. In the event a relationship results in a potential conflict for an issue being discussed by the Board, the trustee recues himself/herself from the discussion and vote. The recusal is documented in the minutes. The Vice President and General Counsel attends all board meetings and ensures that any needed recusals occur.
Form 990, Part VI, Section B, line 15The Board of Trustees recognizes the great challenges and difficulties that healthcare executives face, particularly in the current era of national and state healthcare reform. In addition, the Pittsburgh regional market is highly competitive and changing rapidly. The Board competes for and seeks executive talent on a national basis. It engages expert compensation consultants, utilizing national comparative data to guide the determination of competitive, appropriate levels of compensation. The total compensation program for executives consists of cash compensation and benefits. Factors taken into consideration in determining compensation for executives include: market demand and competition for similar positions, experience and tenure,and actual performance and effectiveness. Based on these and other pertinent criteria, BHS targets total compensation to fall within a range of the 25th to 75th percentile of the market. BHS executive compensation generally will not exceed the 75th percentile of the market. Exceptions to this may be subject to review and recommendation by the Compensation Committee, which in turn is subject to review and approval by the Board of Trustees. Exception must be supported by organizational and /or individual performance, or a retention/recruitment circumstance that warrants such compensation. The Compensation Committee consists exclusively of "non-interested" individuals with no real or perceived conflicts of interest in recommending executive compensation guidelines and levels. While benefits are accounted for in Schedule J, actual "take home" pay to the executive consists only of base salary and any incentive award earned. Annual increases in base pay, if any, are based on competitive market trends from the comparison group. Supplemental retirement benefits are used as a vehicle for executive recruitment and retention with appropriate vesting periods. The Board of Trustees reviews and approves executive compensation in its entirety, including the use of "tally sheets", which disclose 100% executive compensation. The Board of Trustees engages external compensation and legal expertise to assure reasonableness of executive compensation levels.
Form 990, Part VI, Section C, line 19Historically financial information is provided to the public at the annual public board meeting. Bylaws, Articles of Incorporation and the Conflict of Interest Policy are posted on the website.
Part VII Section A Column B: Hours for related organization1. Kenneth P DeFurio: Hospital 40; Butler Medical Providers 15; Butler Health System Foundation 2; Butler Health System 2; Nixsar Corp 1 2. Anne B Krebs: Hospital 40; Butler Medical Providers 7; Butler Health System Foundation 1; Butler Health System 1; Nixsar Corp 1 3. Stephanie J Roskovski: Butler Hospital 45; Butler Medical Providers 5 4. A Thomas McGill MD: Hospital 40; Butler Medical Providers 15 5. John C Reefer MD: Hospital 40; Butler Medical Providers 15 6. Paula L Hooper: Hospital 30; Butler Medical Providers 15; BHS Foundation 2; Butler Health System 5; Nixsar 1
Form 990, Part XI, line 5:Noncontrolling interest in net income of consolidated subsidiaries -73,416. Transfers (to) from affiliates -5,100,000. Accumulated liability for pension benefits -14,234,136. Decrease in interest in investment of BHS assets -262,848. Total to Form 990, Part XI, Line 5: -19,670,400.Changes in Net Assets or Fund Balances:
Part XII Line 2c explanationThe organization has not changed its process for reviewing the audited financials or the selection of an independent auditor during the year.
Form 990, Part III, Line 4a, Program Service Accomplishments: "Butler Memorial Hospital is privileged to be a healing presence in the communities we serve. We exist to make a positive difference in the lives of people by providing compassionate, high quality care and comfort and inspiring health and well being." This is the mission statement of Butler Memorial Hospital (BMH). These words guide the doctors and staff of BMH every day, as they serve the residents of Butler County and the surrounding area. The people of BMH are passionate about providing high quality care with a high level of service. It extends to a commitment to being an excellent corporate citizen, demonstrated by our remaining an independent community hospital - locally controlled - working diligently to meet your healthcare needs. BMH is proud of the high value care that it provides. It offers convenient facilities and technology that rival any in the region. BMH physicians and employees are exceptionally well-trained, committed to providing patients and families the best care possible. In 2012 BMH provided over $16.4 million in charity care and other uncompensated care. Critical support is provided to education endeavors through our partnerships with Slippery Rock University, Butler County Community College, local school districts, and various other educational institutions throughout the region. BMH makes its facilities and staff available to support training programs. BMH leaders are active members of the local business community, supporting Leadership Butler County, local Chambers of Commerce, Butler County Development Corporation, and a variety of civic and social groups. These include the American Heart Association, American Cancer Society, March of Dimes and Butler Road Race, providing college scholarships to student-athletes from Butler County. These are only a few ways BMH works to serve and live up to its mission of caring for neighbors. In total, BMH provides over $22.1 million in community support each year. This report outlines some of the ways BMH supports the health and lives of people throughout the region. It is a testimony to the commitment and leadership of the BMH medical staff, Board of Trustees, employees, volunteers, and community partners, whose dedication to service touches many lives and makes the community a better place. Respectfully Submitted: Kenneth P. DeFurio President & CEO Margaret Irvine Chairperson, Board of Trustees Fiscal Year 2012 Community Benefit Report 2011 IRS Form 990 Schedule H Executive Summary Butler Memorial Hospital (BMH) is proud to serve our community. In furtherance of our charitable mission, BMH provided over $22.1 million in support in the form of charity care, unreimbursed care, community health improvement, health education, subsidized services and contributions to community organizations. This support accounts for over 10.8% of total expenses. BMH demonstrates its commitment by improving the overall health of our community through the operation of an efficient and effective health care system and by actively supporting appropriate community services. Summary of Services and Community Support Helping People to Live Better, Every Day At Butler Memorial Hospital, a key goal is to strengthen the health and well-being of the community. BMH understand that as a sole community hospital it plays an important role in the health of Butler County residents. This role is taken very seriously. Last year BMH provided over $22.1 million in total community benefit support. This accounts for over 10.8% of our total expenses. The services BMH provides are essential to not only the community's overall health, but also to the quality of life of every resident. Community Health Assessment Butler Memorial Hospital periodically surveys up to 1000 Butler County residents. We use questions from the Centers for Disease Control Behavioral Risk Factor Surveillance System. Our goal is to assess health status, disease burden and diagnosis, disease prevention, exercise and nutrition status, access to care and overall health literacy. Responses to the survey are carefully evaluated by a specialist in Public Health and results are shared with the health system's clinical staff. The findings are then integrated into our plans to improve our service to meet the health needs of our neighbors. Butler Health System Meeting your health care needs cannot be achieved through any one employee, department, or facility. With BMH as the centerpiece of our services, Butler Health System (BHS) has established convenient locations throughout Butler County and the surrounding areas. Butler Memorial Hospital provides 339 licensed beds to care for inpatients, (237 medical/surgical, 59 behavioral, 25 skilled nursing and 18 nursery). Services include Critical Care, Surgical Services, Medical Care, Psychiatric Treatment, Drug & Alcohol Rehabilitation, Obstetrics and Skilled Nursing. Additionally our Emergency Department treated over 47,122 patients last year. This range and complexity of service is not offered by any other entity in Butler County. When the complexity of in-patient treatment is not required, it is more convenient and cost-effective to have services close to home. BHS offers 32 locations throughout the region that offer diagnostic and treatment services including imaging, cardiac diagnostics, laboratory services, family resources, physical therapy, urgent care and physician care. This year we have opened locations in Lawrence, Venango and Armstrong County. BMH recognizes the need to establish medical care available in the evening and weekends. To that end, BMH has partnered with local physicians to establish urgent care services, called BHS FastERcare. This service is offered in Butler Township, Saxonburg, Slippery Rock and Kittanning, and offers high quality walk-in medical care throughout the day and into the evening. Supporting those in need: Our Charity Care and Community Benefit BMH provides free care to those patients who have an obligation after insurance payments, if any. The amount of free care is determined based on the patient's income and family size. Free care is provided to those with incomes up to 300% of the Federal Poverty Guideline. To inform patients of this program, signs are posted in all the registration areas notifying the public of the availability of our free care program. More information is available through our Patient Handbook and on our website at www.butlerhealthsystem.org on the "About BHS" page. At the time of registration, any patient who is uninsured is given a "Patient Notice of Financial Aid." The notice instructs the patient to call or visit the Patient Financial Assistance Department to seek more information about how BMH may be able to help pay for part or all of their care. The monthly collection statements that are mailed to the patient state that the patient may contact the Patient Financial Assistance Department to discuss their eligibility for free care. The Financial Representatives receive and make many calls to the patients. During the calls the financial representatives will discuss with the patients the availability of the free care program and will mail out applications to those patients who want to apply. BMH also contracts with representatives to assist the patient in applying for Medical Assistance coverage. These representatives will also discuss with the patient the availability for free care, especially for those who may not be eligible for the government healthcare plan. Government Program Subsidies In addition to providing free and discounted care to uninsured patients or patients that need financial help, BMH makes up the difference between the costs of care and the amount paid by government-sponsored programs such as Medicare and Medicaid. Last year, that amounted to more than $12.7 million. As provisions of the Patient Protection and Affordable Care Act are implemented, we expect this burden on our patients and the health system will increase. To that end, to remain a viable healthcare provider to our community, BMH continually evaluates ways to keep our costs low while maintain high quality. Billing and Collections BMH is diligent in providing bills that are accurate and easy to understand. Every bill and statement includes information about how to contact financial representatives and arrange payment plans. BMH is committed to finding ways to help every patient pay the portion of their bill they are responsible for without experiencing an overwhelming financial burden. In addition to making our billing process easy to understand and ensuring ready access to charity care and financial assistance, BMH provides patient cost information in advance of services or treatment, upon request.
Form 990, Part III, Line 4a, Program Service Accomplishments (cont): Providing Needed Care and Services Plays a Critical Role in Meeting Patient Needs Butler Memorial Hospital subsidizes many of the critical services it offers, such as the Transitional Care Facility, Family Services, obstetrical services, psychiatric services, and prevention and wellness services and primary care services offered through our Physician Clinics. Last year, we provided $4,783,474 in subsidized care and services. BMH actively supports the Community Health Clinic. We provide financial support as well as operational and technical support for many of the diagnostic services provided at the Clinic. Many of our physicians and employees also volunteer their own time to treat patients at the Clinic. Building Our Community Strengthening the community is a responsibility for all local businesses and something BMH takes very seriously. For example: we offer space for meetings and community education; we help local residents escape violent situations, by volunteering to help those in need; we provide education to new and expectant parents; and we provide community health outreach and patient advocacy. Opening Our Facilities for Local Meetings The Knowledge Center at Butler Memorial Hospital offers modern meeting and education space for local and regional conferences. Last year, we hosted the third annual Carol Dietrich Memorial Health Symposium to physicians, nurses and other providers, entitled "Cardiology in the Community Setting." The day long program provided a variety of high quality programs at no cost to participants. Butler Memorial Hospital also offers a series of Continuing Medical Education programs which are made available to health care professionals throughout the region. In cooperation with local institutions like Slippery Rock University and Butler County Community College, as well as others throughout Butler County and the region, we are fully committed to maintaining high quality professional health education for students and practitioners alike. Classroom space is provided for these programs within our Knowledge Center and students are given real life clinical experience as they work with our staff in the care and treatment of patients. BMH works closely with local school districts in supporting high school health occupation programs. The Simulation Laboratory is available for seminars that give students hands on experience, exposing them to the highly complex world of health care delivery. Employees in the Community Every year, BMH and its employees support a variety of community support programs. These include the Caring Angel Program, the United Way and organizations like the American Heart Association, the American Cancer Society, the Butler YMCA and the March of Dimes. This year, employees, physicians, nurses, and board members volunteered to give back to the community. In addition to these activities, employees participate in a variety of community service initiatives, from Habitat for Humanity, to Doctors without Borders, to local student mentoring programs. Summary BMH physicians, nurses, employees, volunteers and volunteer leadership maintain deep connections to the communities we serve. We live and work in Butler County and we are acutely aware of the needs of its residents. As a tax-exempt charitable organization, BMH is careful to manage our resources to meet the current and future healthcare needs of our neighbors. BMH is proud of our independence and pledge to always strive to provide high quality, low cost care in a comfortable and supporting environment.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Butler Health System
One Hospital WayButlerPA16001251441855Healthcare Delivery SystemPA501(c)(3)Line 30
Butler Medical Providers
One Hospital WayButlerPA16001251441855Physician PracticesPA501(c)(3)Line 30Butler Health System
Butler Health System Foundation
One Hospital WayButlerPA16001261543883Fundraising on behalf of Butler Health SystemPA501(c)(3)Line 11a, I0Butler Health System
Nixsar Corporation
One Hospital WayButlerPA16001251441960Own and Operate real estatePA501(c)(3)Line 30Butler Health System

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNABusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
Butler Ambulatory Surgery Center
102 Technology DriveButlerPA16001061728190SurgeryPAN/A
BHS FastER Care
One Hospital WayButlerPA16001271961562Urgent CarePAButler Healthcare ProvidersRelated-93518-111269010.51000

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1PCA of Butler PcBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1480 East Jefferson StreetAddressLine1
CityButlerCity
StatePAState
ZIP Code16001ZIPCode
FieldValueIRS element (for citing)
EIN251351445EIN
Primary ActivityPhysician Office PracticePrimaryActivity
Legal Domicile StatePALegalDomicileState
Type Of EntityCTypeOfEntity
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 Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
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 Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
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 Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
BHS-FastER Care
I76522
BHS-FastER Care
P2427174