CHAMBERSBURG HOSPITAL: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- CHAMBERSBURG HOSPITAL (EIN 23-0465970)
- Tax period
- 2010-07-01 to 2011-06-30
- Filed
- 2012-05-14
- IRS object ID
- 201201359349301705
- Schema version
- 2010v3.4
- 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 D
- Schedule F
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-05-14T09:47:49-05:00 | Timestamp |
| Tax Period End Date | 2011-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SMITH ELLIOTT KEARNS & COMPANY LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 804 WAYNE AVENUE | AddressLine1 |
| City | CHAMBERSBURG | City |
| State | PA | State |
| ZIP Code | 17201 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 230465970 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE CHAMBERSBURG HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CHAM | NameControl |
| Phone | 7172673000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 112 NORTH SEVENTH STREET | AddressLine1 |
| City | CHAMBERSBURG | City |
| State | PA | State |
| ZIP Code | 17201 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | PATRICK W O'DONNELL | Name |
| Title | CHIEF FINANCIAL OFFICER | Title |
| Phone | 7172677106 | Phone |
| Date Signed | 2012-05-10 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | GREGORY P HALL CPA | Name |
| Phone | 7172633910 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | PATRICK W O'DONNELL | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 112 NORTH SEVENTH STREET | AddressLine1 |
| City | CHAMBERSBURG | City |
| State | PA | State |
| ZIP Code | 17201 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 276166270 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.SUMMITHEALTH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1904 | YearFormation |
| State Legal Domicile | PA | StateLegalDomicile |
| Activity Or Mission Description | THE CHAMBERSBURG HOSPITAL IS A REGIONAL NONPROFIT HEALTH CARE ORGANIZATION COMMITTED TO THE IMPROVEMENT OF THE HEALTH AND WELL-BEING OF THE PEOPLE IN SOUTH CENTRAL PENNSYLVANIA. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 17 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 16 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1991 | TotalNbrEmployees |
| Total Nbr Volunteers | 381 | TotalNbrVolunteers |
| Total Gross UBI | 5431531 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 663744 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 464122 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 3617330 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 242176769 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 260075061 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 870358 | InvestmentIncomePriorYear |
| Investment Income Current Year | 5516347 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 6465283 | OtherRevenuePriorYear |
| Other Revenue Current Year | 6114025 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 249976532 | TotalRevenuePriorYear |
| Total Revenue Current Year | 275322763 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 2133572 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 2071004 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 129781036 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 132307566 | 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 | 98168511 | OtherExpensePriorYear |
| Other Expenses Current Year | 105203373 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 230083119 | TotalExpensesPriorYear |
| Total Expenses Current Year | 239581943 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 19893413 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 35740820 | RevenuesLessExpensesCY |
| Total Assets BOY | 284858966 | TotalAssetsBOY |
| Total Assets EOY | 433623569 | TotalAssetsEOY |
| Total Liabilities BOY | 124507865 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 231040705 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 160351101 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 202582864 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE CHAMBERSBURG HOSPITAL IS A REGIONAL NONPROFIT HEALTH CARE ORGANIZATION COMMITTED TO THE IMPROVEMENT OF THE HEALTH AND WELL-BEING OF THE PEOPLE IN SOUTH-CENTRAL PENNSYLVANIA. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 180964682 | Expense |
| Revenue | 260635716 | Revenue |
| Description | THE CHAMBERSBURG HOSPITAL PROVIDES NEEDED MEDICAL CARE TO THE COMMUNITY REGARDLESS OF ANY PATIENT'S ABILITY TO PAY. HEALTH CARE SERVICES INCLUDE INPATIENT ROUTINE, INPATIENT ANCILLARY AND OUTPATIENT CARE. ALL MANAGEMENT AND GENERAL EXPENSES ARE CONSIDERED PROGRAM RELATED. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 2071004 | Expense |
| Grants | 2071004 | Grants |
| Description | GRANTS TO VARIOUS NON-PROFIT ORGANIZATIONS IN THE COMMUNITY TO DEVELOP OR EXPAND HEALTH CARE PROGRAMS TO EDUCATE THE COMMUNITY ABOUT HEALTH CARE ISSUES. CHAMBERSBURG HOSPITAL PARTNERS WITH COMMUNITY ORGANIZATIONS LIKE THE FRANKLIN COUNTY THERAPEUTIC RIDING PROGRAM AND MERCERSBURG AREA COUNCIL FOR WELLNESS TO ENHANCE, PROMOTE AND OFFER COMMUNITY PROGRAMS FOR THE HEALTH AND WELLBEING OF RESIDENTS IN SOUTH CENTRAL PENNSYLVANIA. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 183035686 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 1 | 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 | 1 | GrantsToOrganizations |
| Grants To Individuals | 1 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 174 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1991 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 1 | ForeignFinancialAccount |
| Name Of Foreign Country | CJ | NameOfForeignCountry |
| 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 | 17 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 16 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | PA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PATRICK W O'DONNELL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7172673000 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 112 N SEVENTH STREET | AddressLine1 |
| City | CHAMBERSBURG | City |
| State | PA | State |
| ZIP Code | 17201 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (29 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 |
|---|---|---|---|---|---|---|---|---|
| NANCY H MEYERS ESQUIRE | ||||||||
| CHAIR | 0.20 | X | X | 0 | 0 | 0 | ||
| PHILIP E FAGUE | ||||||||
| VICE CHAIR | 0.50 | X | X | 0 | 0 | 0 | ||
| DENNIS L WILSON | ||||||||
| TREASURER | 0.50 | X | X | 0 | 0 | 0 | ||
| NORMAN B EPSTEIN | ||||||||
| PRESIDENT | 0.20 | X | X | 286082 | 667526 | 94456 | ||
| DENISE B BARROWS | ||||||||
| MEMBER | 0.50 | X | 0 | 0 | 0 | |||
| JOHN BOOZER | ||||||||
| MEMBER | 0.20 | X | 0 | 0 | 0 | |||
| MICHAEL J COLLI MD | ||||||||
| MEMBER | 0.20 | X | 0 | 0 | 0 | |||
| SAM KING | ||||||||
| MEMBER | 0.30 | X | 0 | 0 | 0 | |||
| PETER LAGIOVANE | ||||||||
| MEMBER | 0.30 | X | 0 | 0 | 0 | |||
| JULIO LECUONA | ||||||||
| MEMBER | 0.70 | X | 0 | 0 | 0 | |||
| CHRISTINE A MOLLY MD | ||||||||
| MEMBER | 0.40 | X | 0 | 0 | 0 | |||
| LYNN C ROTZ | ||||||||
| MEMBER | 0.20 | X | 0 | 0 | 0 | |||
| MICHAEL STARR | ||||||||
| MEMBER | 0.20 | X | 0 | 0 | 0 | |||
| JOHN VANHORN | ||||||||
| MEMBER | 0.30 | X | 0 | 0 | 0 | |||
| R WILLIAM HAPPEL | ||||||||
| MEMBER | 0.60 | X | 0 | 0 | 0 | |||
| ROGER J ROBERTSON MD | ||||||||
| NON VOTING MEMBER | 0.10 | X | 0 | 0 | 0 | |||
| JOHN MASSIMILLA | ||||||||
| VP ADMINISTRATION | 40.00 | X | 268117 | 0 | 51754 | |||
| PATRICK W O'DONNELL | ||||||||
| VP FINANCE | 40.00 | X | 270536 | 180357 | 87205 | |||
| THOMAS ANDERSON MD | ||||||||
| VP MEDICAL AFFAIRS | 40.00 | 309929 | 77482 | 35289 | X | |||
| PATRICIA BARBAROWICZ | ||||||||
| VP COMMUNITY RELATIONS | 40.00 | 182773 | 60925 | 52682 | X | |||
| LOUIS GREGORIO | ||||||||
| VP HUMAN RESOURCES | 40.00 | 233674 | 0 | 40082 | X | |||
| KIMBERLY M RZOMP | ||||||||
| VP CORPORATE FINANCE | 40.00 | 157322 | 8280 | 41658 | X | |||
| SHERRI STAHL | ||||||||
| VP PATIENT SERVICES | 40.00 | 192572 | 48144 | 40055 | X | |||
| MICHELE ZEIGLER | ||||||||
| VP INFORMATION SERVICES | 40.00 | 173288 | 74267 | 44943 | X | |||
| DAVID GRANT | ||||||||
| DIRECTOR OF PHARMACY | 40.00 | 186995 | 0 | 34749 | X | |||
| CHRISTA M ZIMMERMAN | ||||||||
| PHARMACIST | 40.00 | 150792 | 0 | 25686 | X | |||
| EVANS T PRIESTON | ||||||||
| PHARMACIST | 40.00 | 149020 | 0 | 43159 | X | |||
| AMANDA G SCHMEIDER | ||||||||
| PHARMACIST | 40.00 | 154402 | 0 | 25687 | X | |||
| KELLAN COOK | ||||||||
| PHARMACIST | 40.00 | 149280 | 0 | 17382 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2864782 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1116981 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 634787 | TotalOtherCompensation |
| Number Individuals GT100 K | 43 | 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 |
|---|---|---|---|---|---|
| HOSPITAL BUILDING AND EQUIPMENT | |||||
| 11330 OLIVE BOULEVARD | ST LOUIS | MO | 63141 | CONSTRUCTION CONTRACTOR | 18026798 |
| OWENS & MINOR INC | |||||
| PO BOX 360878 | PITTSBURGH | VA | 15251 | MEDICAL SUPPLIES | 6600439 |
| AMERISOURCE BERGEN | |||||
| PO BOX 5187 | NEW YORK | NY | 10087 | PARAMEDICALS | 6375525 |
| CUMBERLAND VALLEY ER ASSOCIATES | |||||
| PO BOX Y | CHAMBERSBURG | PA | 17201 | ER DOCTORS | 6050639 |
| ZIMMER US INC | |||||
| 14235 COLLECTIONS CENTER DRIVE | CHICAGO | IL | 60693 | MEDICAL SUPPLIES | 2642893 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 130 | NumberOfContractorsGT100K |
| All Other Contributions | 3617330 | AllOtherContributions |
| Total Contributions | 3617330 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT SERVICE REVENU | Description |
| Business Code | 621990 | BusinessCode |
| Total Revenue Column | 260075061 | TotalRevenueColumn |
| Related Or Exempt Function Income | 260075061 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 260075061 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 186478 | TotalRevenueColumn |
| Exclusion | $186,478 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 403360 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 664657 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -261297 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -261297 | TotalRevenueColumn |
| Exclusion | -$261,297 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 5492520 | Securities |
| Other | 16199 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 178850 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 5492520 | Securities |
| Other | -162651 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5329869 | TotalRevenueColumn |
| Exclusion | $5,329,869 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Unrelated Business RevenueUnrelatedBusinessRevenue | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| UNRELATED BUSINESS INC | 621990 | 5431531 | 5431531 | ||
| PURCHASE DISCOUNTS | 621990 | 560655 | 560655 | ||
| CAFETERIA | 621990 | 383122 | $383,122 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 14 | TotalRevenueColumn |
| Exclusion | $14 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 6375322 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 275322763 | TotalRevenueColumn |
| Related Or Exempt Function Income | 260635716 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 5431531 | UnrelatedBusinessRevenue |
| Exclusion | $5,638,186 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2071004 | Total |
| Program Services | 2071004 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2959629 | Total |
| Management And General | 2959629 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 90674545 | Total |
| Program Services | 68721098 | ProgramServices |
| Management And General | 21953447 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10153984 | Total |
| Program Services | 7626981 | ProgramServices |
| Management And General | 2527003 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21696556 | Total |
| Program Services | 15938641 | ProgramServices |
| Management And General | 5757915 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6822852 | Total |
| Program Services | 4986140 | ProgramServices |
| Management And General | 1836712 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 302079 | Total |
| Management And General | 302079 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 38986 | Total |
| Management And General | 38986 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10462972 | Total |
| Program Services | 4651190 | ProgramServices |
| Management And General | 5811782 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1173500 | Total |
| Program Services | 917141 | ProgramServices |
| Management And General | 256359 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 574563 | Total |
| Program Services | 287790 | ProgramServices |
| Management And General | 286773 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3730474 | Total |
| Program Services | 328305 | ProgramServices |
| Management And General | 3402169 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 98004 | Total |
| Program Services | 30570 | ProgramServices |
| Management And General | 67434 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 141135 | Total |
| Program Services | 11358 | ProgramServices |
| Management And General | 129777 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1130483 | Total |
| Program Services | 835427 | ProgramServices |
| Management And General | 295056 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9944560 | Total |
| Program Services | 7349030 | ProgramServices |
| Management And General | 2595530 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1796747 | Total |
| Program Services | 1327796 | ProgramServices |
| Management And General | 468951 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| SUPPLIES | 40596437 | 34919085 | 5677352 |
| BAD DEBTS | 19648081 | 19648081 | |
| PHYSICIAN CONTRACTUAL P | 9911855 | 9911855 | |
| EQUIPMENT RENTAL & MAIN | 4441738 | 3338547 | 1103191 |
| TELEPHONE | 410805 | 48981 | 361824 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 800954 | Total |
| Program Services | 86666 | ProgramServices |
| Management And General | 714288 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 239581943 | Total |
| Program Services | 183035686 | ProgramServices |
| Management And General | 56546257 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21982 | BOY |
| EOY | 6695 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27868937 | BOY |
| EOY | 23510990 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 241663 | BOY |
| EOY | 168070 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17892796 | BOY |
| EOY | 20090721 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3979403 | BOY |
| EOY | 4276914 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2078888 | BOY |
| EOY | 2136483 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2266994 | BOY |
| EOY | 3022859 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 269141558 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 172666405 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 74603375 | BOY |
| EOY | 96475153 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39315751 | BOY |
| EOY | 55378423 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 108687085 | BOY |
| EOY | 216751935 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7902092 | BOY |
| EOY | 11805326 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 284858966 | BOY |
| EOY | 433623569 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20562674 | BOY |
| EOY | 22881576 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33097871 | BOY |
| EOY | 142604148 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 70847320 | BOY |
| EOY | 65554981 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 124507865 | BOY |
| EOY | 231040705 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 154159645 | BOY |
| EOY | 195369566 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6191456 | BOY |
| EOY | 7213298 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 160351101 | BOY |
| EOY | 202582864 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 284858966 | BOY |
| EOY | 433623569 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 35740820 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 6490943 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Both | X | FinancialStatementBoth |
| 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 D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1056054 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 217297 | InvestmentEarningsOrLosses |
| Other Expenditures | 18728 | OtherExpenditures |
| End Of Year Balance | 1254623 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 962458 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 110820 | InvestmentEarningsOrLosses |
| Other Expenditures | 17224 | OtherExpenditures |
| End Of Year Balance | 1056054 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1196623 | BeginningOfYearBalance |
| Investment Earnings Or Losses | -204425 | InvestmentEarningsOrLosses |
| Other Expenditures | 29740 | OtherExpenditures |
| End Of Year Balance | 962458 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.72480 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.27520 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 1 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6257981 | OtherCostOrOtherBasis |
| Book Value | 6257981 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 69353293 | OtherCostOrOtherBasis |
| Depreciation | 44278799 | Depreciation |
| Book Value | 25074494 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 143976098 | OtherCostOrOtherBasis |
| Depreciation | 123754826 | Depreciation |
| Book Value | 20221272 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 10545651 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 39008535 | OtherCostOrOtherBasis |
| Depreciation | 4632780 | Depreciation |
| Book Value | 44921406 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 96475153 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (9 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| CASH AND MONEY FUNDS | 39255476 | F |
| CERTIFICATES OF DEPOSIT | 709827 | F |
| FIXED INCOME SECURITIES | 83151567 | F |
| OTHER INVESTMENTS | 400 | F |
| HEDGE FUNDS | 19372103 | F |
| REAL ASSETS | 30485045 | F |
| GOVERNMENT AGENCY OBLIGATIONS | 28456149 | F |
| CORPORATE AND FOREIGN BONDS | 13047485 | F |
| MUNICIPAL OBLIGATIONS | 2273883 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 216751935 | TotalOfBookValueSecurities |
Other Liabilities OtherLiabilities (5 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ADVANCES FROM THRID-PARTY PAYORS | $4,863,427 |
| CAPITAL LEASES | $4,716,673 |
| OTHER LIABILITIES | $10,351,735 |
| ESTIMATED AMOUNTS PAYABLE UNDER THIRD PARTY AREEMENTS | $36,641,083 |
| OBLIGATIONS UNDER INTEREST RATE SWAP AGREEMENTS | $8,982,063 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 65554981 | TotalOfAmounts |
| Total Revenue | 275322763 | TotalRevenue |
| Total Expenses | 239581943 | TotalExpenses |
| Excess Or Deficit For Year | 35740820 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 8158471 | NetUnrealizedGLOnInvestments |
| Other | -$1,667,528 | OtherAmount |
| Total Adjustments | 6490943 | TotalAdjustments |
| Excess Or Deficit Per FS | 42231763 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 270470361 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 3956498 | OtherRevenues |
| Revenue Not Rptd F990 | 3956498 | RevenueNotRptdF990 |
| Revenue Subtotal | 266513863 | RevenueSubtotal |
| Other Revenues Not Included | 8808900 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 8808900 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 275322763 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 237514468 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 237514468 | ExpensesSubtotal |
| Other Expenses Not Included | 2067475 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 2067475 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 239581943 | 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 TO BE USED FOR DEVELOPMENT OR EXPANSION OF COMMUNITY HEALTHCARE INIATIVES AND PROGRAMS. FUNDS ARE ALSO USED TO EDUCATE THE COMMUNITY ABOUT HEALTHCARE ISSUES. |
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SEC. 501(C) (3) OF THE INTERNAL REVENUE CODE. IT IS CLASSIFIED AS A PUBLIC CHARITY. THE HOSPITAL EXPENSED $ 253,000 AND $ 17,000 FOR ESTIMATED UNRELATED BUSINESS INCOME TAXES FOR THE YEARS ENDED JUNE 30, 2011 AND 2010, RESPECTIVELY. WITH FEW EXCEPTIONS, THE HOSPITAL IS NO LONGER SUBJECT TO FEDERAL INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2008. WHEN TAX RETURNS ARE FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD BE ULTIMATELY SUSTAINED. THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH, BASED ON ALL AVAILABLE EVIDENCE, MANAGEMENT BELIEVES IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESSES, IF ANY. TAX POSITIONS TAKEN ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50 PERCENT LIKELY OF BEING REALIZED UPON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE WOULD BE REFLECTED AS A LIABILITY FOR UNRECOGNIZED TAX BENEFITS IN THE ACCOMPANYING BALANCE SHEET ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. INTEREST AND PENALTIES ASSOCIATED WITH UNRECOGNIZED TAX BENEFITS WOULD BE CLASSIFIED AS EXPENSES AGAINST OTHER OPERATING REVENUE IN THE STATEMENT OF OPERATIONS. AT JUNE 30, 2011 AND 2010, THERE WAS NO LIABILITY FOR UNRECOGNIZED TAX BENEFITS. |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | TRANSFER TO AFFILLIATED ORGANIZATION - SUMMIT HEALTH -2,170,000. TRANSFER TO AFFILLIATED ORGANIZATION - SUMMIT PHYSICIAN SERVICES -11,201,973. LOSS ON EXTINGUISHMENT OF DEBT -369,875. PENSION RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST 8,117,822. CHANGE IN VALUE OF DERIVATIVE 3,956,498. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | CHANGE IN VALUE OF DERIVATIVES 3,956,498. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | NET REALIZED LOSSES SHOWN ELSEWHERE ON FINANCIAL STATEMENTS 5,492,520. INVESTMENT INCOME SHOWN ELSEWHERE ON FINANCIAL STATEMENTS 181,152. RENTAL INCOME (EXPENSE) SHOWN ELSEWHERE ON FINANCIAL STATEMENTS -279,229. GAIN(LOSS) ON DISPOSAL OF EQUIPMENT SHOWN ELSEWHERE ON FINANCIAL STATEMENTS -162,651. CONTRIBUTION INCOME SHOWN ELSEWHERE ON FINANCIAL STATEMENTS 3,577,108. | |
| PART XIII, LINE 4B - OTHER ADJUSTMENTS: | GRANT EXPENSE SHOWN ELSEWHERE ON FINANCIAL STATEMENTS 2,067,475. |
Schedule F IRS990ScheduleF
Accts Actvs Out US Table AcctsActvsOutUSTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | CENTRAL AMERICAN AND CARRIBBEAN | Region |
| Number Of Offices | 0 | NumberOfOffices |
| Number Of Employees | 0 | NumberOfEmployees |
| Type Of Activities Conducted | INVESTMENT IN ALTERNATIVE INVESTMENT VEHICLE | TypeOfActivitiesConducted |
| Total Expenditures | 19372103 | TotalExpenditures |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Number Of Offices | 0 | SubtotalNumberOfOffices |
| Subtotal Number Of Employees | 0 | SubtotalNumberOfEmployees |
| Cont Number Of Offices | 0 | ContNumberOfOffices |
| Cont Number Of Employees | 0 | ContNumberOfEmployees |
| Total Number Of Offices | 0 | TotalNumberOfOffices |
| Total Number Of Employees | 0 | TotalNumberOfEmployees |
| Subtotal Amount Spent | 19372103 | SubtotalAmountSpent |
| Cont Amount Spent | 0 | ContAmountSpent |
| Total Amount Spent | 19372103 | TotalAmountSpent |
| Transfer To Foreign Corp | 0 | TransferToForeignCorp |
| Interest In Foreign Trust | 0 | InterestInForeignTrust |
| Own Foreign Corp | 1 | OwnForeignCorp |
| Passive Foreign Invest Co | 0 | PassiveForeignInvestCo |
| Foreign Partnership | 0 | ForeignPartnership |
| Boycott Countries | 0 | BoycottCountries |
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 |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 125.000000000000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent250 | X | Pcent250 |
| 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 | 3285614 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 3285614 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01370 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 13843422 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 13843422 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05780 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 132859 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 132859 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00060 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 17261895 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 17261895 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07210 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 19 | NumberOfActivitiesOrPrograms |
| Persons Served | 11546 | PersonsServed |
| Total Community Benefit Expense | 123535 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 123535 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 5945 | PersonsServed |
| Total Community Benefit Expense | 145960 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 145960 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00060 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 1620807 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1620807 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00680 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 6 | NumberOfActivitiesOrPrograms |
| Total Community Benefit Expense | 2255096 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 2255096 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00940 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 30 | NumberOfActivitiesOrPrograms |
| Persons Served | 17491 | PersonsServed |
| Total Community Benefit Expense | 4145398 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 4145398 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01730 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 30 | NumberOfActivitiesOrPrograms |
| Persons Served | 17491 | PersonsServed |
| Total Community Benefit Expense | 21407293 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 21407293 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08940 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 53785 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 53785 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Environmental Improvements EnvironmentalImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 214 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 214 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 309 | PersonsServed |
| Total Community Building Expense | 1802 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1802 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Persons Served | 309 | PersonsServed |
| Total Community Building Expense | 55801 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 55801 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $7,605,772 | BadDebtExpenseAmount |
| Amount Attributable To | 400728 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 66684239 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 78664148 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -11979909 | 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 |
| 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 | THE CHAMBERSBURG HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 112 NORTH SEVENTH STREET | AddressLine1 |
| City | CHAMBERSBURG | City |
| State | PA | State |
| ZIP Code | 17201 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NOT REQUIRED | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part VI Form990ScheduleHPartVI (10 entries)
| ExplanationExplanation |
|---|
| PART I, LINE 3C: THE ORGANIATION USES FEDERAL POVERTY GUIDELINES (FPG) TO DETERMINE CHARITY CARE. |
| PART I, LINE 7: THE ORGANIZATION USES FEDERAL POVERTY GUIDLINES (FPG) TO DETERMINE CHARITY CARE.NOTE 1. TO THE FINANCIAL STATEMENTS: PATIENT RECEIVABLESTHE HOSPITAL PROVIDES CREDIT IN THE NORMAL COURSE OF ITS BUSINESS TO PATIENTS. PATIENT RECEIVABLES ARE BASED ON THE OUTSTANDING PATIENT BALANCE AFTER CONTRACTUAL REIMBURSEMENTS ARE APPLIED AND ARE GENERALLY DUE 30 DAYS AFTER BILLED. AN ALLOWANCE FOR DOUBTFUL ACCOUNTS IS CARRIED FOR PATIENT ACCOUNTS THAT MAY BECOME UNCOLLECTIBLE IN FUTURE PERIODS BASED ON A SLIDING SCALE OF ESTIMATED UNCOLLECTIBLE PERCENTAGES COMPARED TO VARIOUS AGING SELF-PAY BALANCE CATEGORIES. THE ESTIMATED ALLOCATIONS ARE BASED ON MANAGEMENT'S JUDGMENT OF UNCOLLECTIBLE ACCOUNTS, HISTORICAL TRENDS OF CHARGE-OFFS, AND OTHER INFORMATION. PATIENT RECEIVABLES ARE CHARGED AGAINST THE ALLOWANCE WHEN, IN THE JUDGMENT OF MANAGEMENT, IT IS UNLIKELY THEY WILL BE COLLECTED. THE SHORTFALL FOR MEDICARE IS NOT INCLUDED IN OUR COMMUNITY BENEFIT REPORTING. A COST TO CHARGE RATIO WAS USED TO CALCULATE THE MEDICARE ALLOWABLE COST. ALL PATIENTS ARE SUBJECT TO THE DEBT COLLECTION POLICY REGARDLESS OF THEIR ABILITY TO PAY. |
| PART II: CHAMBERSBURG HOSPITAL WORKS TO STRENGTHEN OUR COMMUNITY THROUGH HEALTH EDUCATION EFFORTS FOR CHILDREN AND ADULTS, HEALTH FAIRS PROVIDING DIAGNOSTIC TESTING, EDUCATING COMMUNITY GROUPS ON SPECIFIC HEALTH TOPICS, FUNDING HEALTH PROGRAMS OF LOCAL NONPROFIT ORGANIZATIONS THROUGH THE SUMMIT ENDOWMENT PROGRAM, PROVIDING CAPACITY-BUILDING WORKSHOPS AND ASSISTANCE THROUGH SUMMIT ENDOWMENT, PARTICIPATING IN MANY LOCAL CIVIC ORGANIZATIONS, SPONSORING EVENTS HELD BY LOCAL CHARITABLE ORGANIZATIONS, AND SUPPORTING WORKFORCE DEVELOPMENT INITIATIVES THROUGH SUMMIT HEALTH'S SCHOOL LIAISON DEPARTMENT. |
| PART III, LINE 4: THE HOSPITAL PROVIDES CREDIT IN THE NORMAL COURSE OF ITS BUSINESS TO PATIENTS. PATIENT RECEIVABLES ARE BASED ON THE OUTSTANDING PATIENT BALANCE AFTER CONTRACTUAL REIMBURSEMENTS ARE APPLIED AND ARE GENERALLY DUE 30 DAYS AFTER BILLED. AN ALLOWANCE FOR DOUBTFUL ACCOUNTS IS CARRIED FOR PATIENT ACCOUNTS THAT MAY BECOME UNCOLLECTIBLE IN FUTURE PERIODS BASED ON A SLIDING SCALE OF ESTIMATED UNCOLLECTIBLE PERCENTAGES COMPARED TO VARIOUS AGING SELF-PAY BALANCE CATEGORIES. THE ESTIMATED ALLOCATIONS ARE BASED ON MANAGEMENT'S JUDGMENT OF UNCOLLECTIBLE ACCOUNTS, HISTORICAL TRENDS OF CHARGE-OFFS, AND OTHER INFORMATION. PATIENT RECEIVABLES ARE CHARGED AGAINST THE ALLOWANCE WHEN, IN THE JUDGMENT OF MANAGEMENT, IT IS UNLIKELY THEY WILL BE COLLECTED. THE COST TO CHARGE RATIO WAS USED TO CALCULATE THE COST OF BAD DEBT EXPENSE. THIS RATIO IS CALCULATED AS FOLLOWS: [NET PATIENT REVENUE DIVIDED BY THE TOTAL OPERATING REVENUE MULTIPLIED BY THE TOTAL OPERATING EXPENSE] DIVIDED BY THE GROSS PATIENT REVENUE. |
| PART III, LINE 8: THE INFORMATION WAS OBTAINED USING COST METHODS USED IN PREPARING THE MEDICARE COST REPORT. THE SHORTFALL ABOVE RELATES TO OUR MISSION OF PROVIDING SERVICES TO MEMBERS OF OUR COMMUNITY. |
| PART VI, LINE 2: HEALTH NEEDS OF FRANKLIN COUNTY RESIDENTS AND SURROUNDING COMMUNITIES ARE ASSESSED THROUGH NUMEROUS RESEARCH METHODS INCLUDING CONDUCTING A COMMUNITY HEALTH NEEDS ASSESSMENT (SURVEY FORMAT) IN SPRING 2009, A REVIEW OF REGIONAL HEALTH DATA AND INTERVIEWS WITH KEY COMMUNITY ORGANIZATIONS INCLUDING SCHOOLS, AREA AGENCY ON AGING, PA DEPARTMENT OF HEALTH, FRANKLIN COUNTY HUMAN SERVICES, POST ACUTE CARE PROVIDERS, AND THE HEALTHY COMMUNITIES PARTNERSHIP. |
| PART VI, LINE 3: PATIENTS ARE MADE AWARE OF THE CHARITY PROGRAM AND OTHER BILLING ASSISTANCE SERVICES AT REGISTRATION, DURING EMERGENCY ROOM VISITS, AND NOTICES PLACED IN SERVICE AREAS. BILLING STATEMENTS ALSO INFORM PATIENTS OF CHARITY CARE AND OTHER BILLING ASSISTANCE PROGRAMS. |
| PART VI, LINE 4: CHAMBERSBURG HOSPITAL PRIMARILY SERVES COMMUNITY MEMBERS FROM FRANKLIN COUNTY, PA, AND NEARBY COMMUNITIES IN FULTON COUNTY, PA, CUMBERLAND COUNTY, PA, AND WASHINGTON COUNTY, MD. ACCORDING TO U.S. CENSUS DATA, FRANKLIN COUNTY RESIDENTS HAVE A SLIGHTLY LOWER INCOME AND ARE SLIGHTLY OLDER THAN THE STATE AVERAGE. FOR A HEALTH SYSTEM, THIS TYPICALLY RESULTS IN AN INCREASED NEED FOR HEALTHCARE SERVICES. |
| PART VI, LINE 6: CHAMBERSBURG HOSPITAL PROVIDES FINANCIAL AND MANAGERIAL SUPPORT TO KEYSTONE HEALTH, A RURAL HEALTH CENTER THAT SERVES THE UNDERPRIVLEGED COMMUNITY. IN ADDITION, THE HOSPITAL SUPPORTS LOCAL NON-PROFIT ORGANIZATIONS WITH FINANCIAL GRANTS FROM THE SUMMIT ENDOWMENT. |
| PART VI, LINE 7: THE HOSPITAL IS PART OF SUMMIT HEALTH, A REGIONAL NETWORK OF TWO HOSPITALS, OUTPATIENT DIAGNOSTIC AND ANCILLARY SERVICES OFFICES, AND HEALTHCARE PROVIDERS. CHAMBERSBURG HOSPITAL AND THESE SUMMIT ENTITIES ARE SERVED BY THE ORGANIZATION'S COMMUNITY HEALTH DEPARTMENT. THIS DEPARTMENT'S MISSION IS TO IMPROVE THE HEALTH OF THE COMMUNITY THROUGH EDUCATION, EARLY DETECTION AND PREVENTION PROGRAMS INCLUDING HEALTH FAIRS, SCREENINGS, AND SEMINARS. MANY OF THE DEPARTMENT'S PROGRAMS ARE PLANNED AND PROVIDED THROUGH COLLABORATION WITH OTHER COMMUNITY ORGANIZATIONS INCLUDING THE PA DEPARTMENT OF HEALTH. IN THE LAST FISCAL YEAR, OVER 6,400 PERSONS WERE DIRECTLY SERVED. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant | IRC SectionIRCSection |
|---|---|---|---|---|---|---|
| PSMA NURSING PROGRAM | ||||||
| PSU MONT ALTO 1 CAMPUS DR | MONT ALTO | PA | 17237 | 5000 | PROVIDE SUPPORT FOR TWO NURSING FACULTY POSITIONS IN THE REGISTERED NURSE ASSOCIATE DEGREE PROGRAM. | |
| UNITED CEREBRAL PALSY OF SOUTH CENTRAL PENNSYLVANIA | ||||||
| 788 CHERRY TREE COURT | HANOVER | PA | 17331 | 5000 | FUNDING FOR ORGANIZATIONS PROGRAMS | |
| KEYSTONE RURAL HEALTH CENTER | ||||||
| 755 NORLAND AVENUE | CHAMBERSBURG | PA | 17201 | 1925000 | GRANT TO COVER OPERATING DEFICITS. | 501(C)(3) |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: ALL FUNDING DECISIONS ARE MADE BY THE SUMMIT ENDOWMENT COMMITTEE, A COMMITTEE OF THE SUMMIT HEALTH BOARD. THE ENDOWMENT MANAGER PROCESSES GRANT APPLICATIONS, ASSISTS GRANTEES IN DEVELOPING SOUND PROGRAM EVALUATION METHODOLOGIES, RECEIVES AND SUMMARIZES PERIODIC REPORTS, AND VISITS PROGRAM SITES, REPORTING ALL ACTIVITIES TO THE SUMMIT ENDOWMENT COMMITTEE. AS WELL, ENDOWMENT COMMITTEE MEETING MINUTES ARE SHARED WITH WAYNESBORO HOSPITAL, CHAMBERSBURG HOSPITAL AND SUMMIT HEALTH BOARDS. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Discretionary Spending Account | X | DiscretionarySpendingAccount |
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (14 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NORMAN B EPSTEIN | |||||||||||||
| 214408 | 500286 | 58800 | 137200 | 12874 | 30040 | 21747 | 50743 | 6590 | 15376 | 314419 | 733645 | 0 | 0 |
| JOHN MASSIMILLA | |||||||||||||
| 207384 | 0 | 40712 | 0 | 20021 | 0 | 36714 | 0 | 15040 | 0 | 319871 | 0 | 0 | 0 |
| PATRICK W O'DONNELL | |||||||||||||
| 193351 | 128901 | 55390 | 36926 | 21795 | 14530 | 43299 | 28866 | 9024 | 6016 | 322859 | 215239 | 0 | 0 |
| THOMAS ANDERSON MD | |||||||||||||
| 245057 | 61264 | 45120 | 11280 | 19752 | 4938 | 17970 | 4493 | 10261 | 2565 | 338160 | 84540 | 0 | 0 |
| PATRICIA BARBAROWICZ | |||||||||||||
| 142484 | 47495 | 28184 | 9395 | 12105 | 4035 | 34408 | 11469 | 5104 | 1701 | 222285 | 74095 | 0 | 0 |
| LOUIS GREGORIO | |||||||||||||
| 183796 | 0 | 34352 | 0 | 15526 | 0 | 25042 | 0 | 15040 | 0 | 273756 | 0 | 0 | 0 |
| KIMBERLY M RZOMP | |||||||||||||
| 136261 | 7172 | 20425 | 1075 | 636 | 33 | 25440 | 1339 | 14135 | 744 | 196897 | 10363 | 0 | 0 |
| SHERRI STAHL | |||||||||||||
| 151587 | 37897 | 29651 | 7413 | 11334 | 2834 | 21783 | 5446 | 10261 | 2565 | 224616 | 56155 | 0 | 0 |
| MICHELE ZEIGLER | |||||||||||||
| 138443 | 59333 | 24415 | 10464 | 10430 | 4470 | 22481 | 9635 | 8979 | 3848 | 204748 | 87750 | 0 | 0 |
| DAVID GRANT | |||||||||||||
| 166695 | 0 | 20000 | 0 | 300 | 0 | 20740 | 0 | 14009 | 0 | 221744 | 0 | 0 | 0 |
| CHRISTA M ZIMMERMAN | |||||||||||||
| 129562 | 0 | 21230 | 0 | 0 | 0 | 18506 | 0 | 7180 | 0 | 176478 | 0 | 0 | 0 |
| EVANS T PRIESTON | |||||||||||||
| 137815 | 0 | 10000 | 0 | 1205 | 0 | 28320 | 0 | 14839 | 0 | 192179 | 0 | 0 | 0 |
| AMANDA G SCHMEIDER | |||||||||||||
| 134402 | 0 | 20000 | 0 | 0 | 0 | 18507 | 0 | 7180 | 0 | 180089 | 0 | 0 | 0 |
| KELLAN COOK | |||||||||||||
| 129280 | 0 | 20000 | 0 | 0 | 0 | 10202 | 0 | 7180 | 0 | 166662 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 1A | THE OFFICERS RECEIVE AN ALLOWANCE THAT CAN BE CONSIDERED A DISCRETIONARY SPENDING ACCOUNT. THE MONIES ARE IN LIEU OF AN AUTOMOBILE ALLOWANCE, TO PURCHASE ADDITIONAL LIFE INSURANCE, ETC. THESE MONIES ARE INCLUDED IN COMPENSATION AS REPORTED IN THE COMPENSATION OF OFFICERS TABLE. RESULTS FITNESS CLUB MEMBERSHIP IS AVAILABLE FREE OF CHARGE FOR ANY OFFICER AND ACTIVE BOARD MEMBER. |
| PART I, LINE 4B | NORMAN EPSTEIN - NONE PATRICK O'DONNELL - NONE LOUIS GREGORIO - NONE JOHN MASSIMILLA - NONE PAT BARBAROWICZ - NONE TOM ANDERSON - NONE SHERRI STAHL - NONE |
| PART I, LINE 7 | INCENTIVE COMPENSATION IS BASED ON PRE-DETERMINED, MEASURABLE GOALS APPROVED BY THE BOARD OF DIRECTORS' EXECUTIVE COMPENSATION COMMITTEE. THE MEASURABLE GOALS ARE BASED ON QUALITY, COMMUNITY ACCESS TO CARE, PATIENT SAFETY AND LEADERSHIP. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing | Issuer EINIssuerEIN |
|---|---|---|---|---|---|---|
| FCIDA HEALTH CARE REVENUE BONDS SERIES | ||||||
| 2009-08-24 | 30000000 | ISSUED OT REFINANCING THE SERIES OF 2000 | 0 | 0 | 0 | |
| FRANKLIN COUNTY INDUSTRIAL DEVELOPMENT | ||||||
| 2010-08-28 | 127225000 | NEW BUILDING AND REFINANCE 1998 BOND | 0 | 0 | 0 | 230458500 |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Total ProceedsTotalProceeds | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind | Amount In Reserve FundAmountInReserveFund | Capitalized InterestCapitalizedInterest | Capital ExpendituresCapitalExpenditures | Amount UnspentAmountUnspent |
|---|---|---|---|---|---|---|---|---|---|
| 30000000 | 117184 | 0 | 1 | 1 | 1 | ||||
| 127225000 | 1721680 | 0 | 1 | 1 | 1 | 9952684 | 2445622 | 25522860 | 72696409 |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Bond Counsel Routinely EngagedBondCounselRoutinelyEngaged | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 1 | 1 |
| 0 | 0 | 0 | 0 | 1 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 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 | 0 |
| 0 | 0 | 0 | 0 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | SUMMIT HEALTH, A 501(C) (3) ENTITITY, IS A MEMBER OF THIS ORGANIZATION. | |
| FORM 990, PART VI, SECTION A, LINE 7A | SUMMIT HEALTH, A 501(C)(3) ENTITY, ELECTS THE GOVERNING BODY OF THIS ORGANIZATION. | |
| FORM 990, PART VI, SECTION A, LINE 7B | SUMMIT HEALTH, A 501(C)(3) ENTITY, HAS CERTAIN RESERVE POWERS OVER THIS ORGANIZATION. | |
| FORM 990, PART VI, SECTION B, LINE 11 | PRIOR TO FILING THE 990 IS REVIEWED BY THE AUDIT COMMITTEE AND PRESENTED TO FULL BOARD OF DIRECTORS FOR APPROVAL. | |
| MEMBERS ARE ASKED TO ANNUALLY DISCLOSE ANY CONFLICTS OF INTEREST THEY MAY HAVE. | FORM 990, PART VI, SECTION B, LINE 12C | |
| THE COMPENSATION IS DISCUSSED WITH AN INDEPENDENT COMPENSATION COMMITTEE. THIS IS PERFORMED IN CONCERT WITH A COMPENSATION CONSULTANT WHO ASSISTS THE COMMITTEE IN SETTING THE COMPENSATION FOR THESE INDIVIDUALS. | FORM 990, PART VI, SECTION B, LINE 15 | |
| GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. THESE DOCUMENTS ARE HELD IN THE FINANCE DEPARTMENT OF THE CHAMBERSBURG HOSPITAL. HOSPITAL BYLAWS AND ALL POLICIES AND PROCEDURES ARE FOUND ON THE CHAMBERSBURG HOSPITAL INTRANET. | FORM 990, PART VI, SECTION C, LINE 19 | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | NET UNREALIZED GAINS ON INVESTMENTS: 8,158,471. TRANSFER TO AFFILLIATED ORGANIZATION - SUMMIT HEALTH -2,170,000. TRANSFER TO AFFILLIATED ORGANIZATION - SUMMIT PHYSICIAN SERVICES -11,201,973. LOSS ON EXTINGUISHMENT OF DEBT -369,875. PENSION RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST 8,117,822. CHANGE IN VALUE OF DERIVATIVE 3,956,498. TOTAL TO FORM 990, PART XI, LINE 5: 6,490,943. | FORM 990, PART XI, LINE 5: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| SUMMIT HEALTH | ||||||||||
| 112 NORTH SEVENTH STREET | CHAMBERSBURG | PA | 17201 | 251515371 | MANAGE AND ADMINISTER THE LOCAL AND REGIONAL NETWORK OF HEALTHCARE PROVIDERS | PA | 501(C)(3) | 7 | SUMMIT HEALTH | 0 |
| WAYNESBORO HOSPITAL | ||||||||||
| 501 EAST MAIN STREET | WAYNESBORO | PA | 17268 | 231360854 | SERVE THE HEALTH CARE NEEDS OF FRANKLIN COUNTY PA AND THE SURROUNDING COMMUN | PA | 501(C)(3) | 3 | SUMMIT HEALTH | 0 |
| CHAMBERSBURG HEALTH SERVICES | ||||||||||
| 260 NORTH SEVENTH STREET | CHAMBERSBURG | PA | 17201 | 251515376 | SERVE THE HEALTH CARE NEEDS OF FRANKLIN COUNTY PA AND THE SURROUNDING COMMUN | PA | 501(C)(3) | 3 | SUMMIT HEALTH | 0 |
| SUMMIT PHYSICIAN SERVICES | ||||||||||
| 785 FIFTH AVENUE SUITE 3 | CHAMBERSBURG | PA | 17201 | 251716306 | PROVIDES APPROPRIATE PHYSICIAN MANPOWER FOR VARIOUS FAMILY PRACTICES SERVING | PA | 501(C)(3) | 11A - TYPE 1 | SUMMIT HEALTH | 0 |
Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner |
|---|---|---|---|---|---|---|---|---|---|---|
| SUMMIT SURGERY CENTER LP | ||||||||||
| 757 NORLAND AVENUE | CHAMBERSBURG | PA | 17201 | 251845303 | SERVE THE SURGICAL HEALTH NEEDS OF FRANKLIN COUNTY PA AND THE SURROUNDING CO | PA | CHAMBERSBURG HEALTH SERVICES | RELATED | 0 | 0 |
| SURGERY CENTER ASSOCIATES LLC | ||||||||||
| 757 NORLAND AVENUE SUITE 104 | CHAMBERSBURG | PA | 17201 | 251845304 | SERVE THE SURGICAL HEALTH NEEDS OF FRANKLIN COUNTY PA AND THE SURROUNDING CO | PA | CHAMBERSBURG HEALTH SERVICES | RELATED | 0 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| 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 | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |