1889-CHS FOUNDATION INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- 1889-CHS FOUNDATION INC (EIN 23-2801799)
- Tax period
- 2010-07-01 to 2011-06-30
- Filed
- 2012-03-09
- IRS object ID
- 201210699349300326
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-03-09T13:45:51-06:00 | 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 | CARBIS WALKER LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5700 CORPORATE DRIVE STE 650 | AddressLine1 |
| City | PITTSBURGH | City |
| State | PA | State |
| ZIP Code | 15237 | 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 | 232801799 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CONEMAUGH HEALTH SYSTEM INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CONE | NameControl |
| Phone | 8144108271 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1086 FRANKLIN STREET | AddressLine1 |
| City | JOHNSTOWN | City |
| State | PA | State |
| ZIP Code | 15905 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | EDWARD DEPASQUALE | Name |
| Title | CHIEF FINANCIAL OFFICER | Title |
| Phone | 8144105271 | Phone |
| Date Signed | 2012-03-02 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JEFFREY J PETRELL CPA | Name |
| Phone | 4126356270 | Phone |
| Date Prepared | 2012-03-01 | DatePrepared |
| 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 | SCOTT BECKER | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1086 FRANKLIN STREET | AddressLine1 |
| City | JOHNSTOWN | City |
| State | PA | State |
| ZIP Code | 15905 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 6630469 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.CONEMAUGH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1994 | YearFormation |
| State Legal Domicile | PA | StateLegalDomicile |
| Activity Or Mission Description | TO SUPPORT MEMBER HOSPITALS WITHIN THE CONEMAUGH HEALTH SYSTEM AND PROVIDE COMMUNITY BENEFIT | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 17 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 8 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 6971063 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 6629144 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 602 | InvestmentIncomePriorYear |
| Investment Income Current Year | 662 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1449 | OtherRevenuePriorYear |
| Other Revenue Current Year | 663 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 6973114 | TotalRevenuePriorYear |
| Total Revenue Current Year | 6630469 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 5111026 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 4773116 | 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 | 1862088 | OtherExpensePriorYear |
| Other Expenses Current Year | 1857353 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 6973114 | TotalExpensesPriorYear |
| Total Expenses Current Year | 6630469 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 0 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 0 | RevenuesLessExpensesCY |
| Total Assets BOY | 5195610 | TotalAssetsBOY |
| Total Assets EOY | 2770540 | TotalAssetsEOY |
| Total Liabilities BOY | 3149851 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 2578695 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 2045759 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 191845 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | TO SUPPORT MEMBER HOSPITALS WITHIN THE CONEMAUGH HEALTH SYSTEM AND PROVIDE COMMUNITY BENEFIT SERVICES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 5374318 | Expense |
| Revenue | 6629144 | Revenue |
| Description | CONEMAUGH HEALTH SYSTEM (CHS) IS A PHYSICIAN-LED, PROFESSIONALLY MANAGED HEALTH SYSTEM SERVING A FIVE COUNTY REGION OF WEST CENTRAL PENNSYLVANIA. CONEMAUGH'S NETWORK OF AWARD-WINNING HOSPITALS, A MULTI-SPECIALTY INTEGRATED PHYSICIAN GROUP, OUTPATIENT CENTERS, AND OTHER PROVIDERS HAVE HELPED SHAPE NUMEROUS NATIONALLY RECOGNIZED CLINICAL PROGRAMS AND SERVICES. THIS INCLUDES A HEALTHGRADES RANKING AMONG THE TOP FIVE PERCENT IN THE NATION FOR CLINICAL EXCELLENCE. CHS MAINTAINS A STEADFAST COMMITMENT TO QUALITY THAT MOTIVATES EVERY MEMBER OF ITS TEAM TO STRIVE FOR ITS VISION OF EXCELLENCE. EVERY PATIENT. EVERY TIME. THIS INCLUDES PROVIDING OPPORTUNITIES TO RESTORE, RECLAIM, OR AID PERSONS EXPERIENCING PHYSICAL, COGNITIVE, MENTAL, OR EMOTIONAL DISABILITIES. CHS IS COMMITTED TO PROVIDING COMMUNITY HEALTH EDUCATION AND PUBLIC AWARENESS TO THE COMMUNITIES IT SERVES. CHS SPONSORS FREE HEALTH SCREENINGS AND FREE HEALTH EDUCATION SEMINARS. A MONTHLY CALENDAR IS PUBLISHED IN NEWSPAPERS THROUGHOUT THE REGION INVITING THE COMMUNITY TO ATTEND FREE INFORMATIONAL AND SUPPORT SESSIONS CATERING TO ALL AGE AND DEMOGRAPHIC GROUPS. CHS OFFERS MORE THAN 17 SUPPORT GROUPS TO PROVIDE EDUCATION, NETWORKING, AND OPEN FORUMS ON NUMEROUS TOPICS INCLUDING DIABETES, EPILEPSY, STROKE, AND SUICIDE. DURING FISCAL YEAR 2011, CHS SPONSORED PROGRAMS INCLUDING FREE MANUAL BREAST EXAMS AND OSTEOPOROSIS SCREENINGS, HEART RISK ASSESSMENTS, VASCULAR SCREENINGS, A CANCER AWARENESS AND PREVENTION HEALTH FAIR, HEART HEALTH LECTURES AND A HEART HEALTH FAIR, FREE PROSTATE SCREENINGS, AND SKIN CANCER SCREENINGS. IN ADDITION, A CAMPAIGN WAS UNDERTAKEN TO RAISE AWARENESS ABOUT DIABETES, AND ALLOW FOR PARTICIPATION IN NUMEROUS GENERAL HEALTH AND WELLNESS FAIRS THROUGHOUT THE COMMUNITY. SEVERAL HEALTH SCREENINGS WERE ALSO HELD WHICH TARGETED HIGH SCHOOL STUDENTS AND THEIR FAMILIES TO TRY TO RAISE AWARENESS ABOUT THE IMPORTANCE OF EXERCISE AND MAKING HEALTHY CHOICES.THE CONEMAUGH HEALTH SYSTEM'S FLAGSHIP TEACHING HOSPITAL, 545-BED MEMORIAL MEDICAL CENTER, HAS BEEN REPEATEDLY RECOGNIZED AS A HEALTHGRADES DISTINGUISHED HOSPITAL WITH CLINICAL OUTCOMES IN THE TOP FIVE PERCENT IN THE NATION. CLINICAL QUALITY AT MEMORIAL MEDICAL CENTER CONTINUES TO BE ENHANCED BY ITS: LEVEL 1 REGIONAL RESOURCE TRAUMA PROGRAM AND LEVEL 3 NEONATAL INTENSIVE CARE UNIT WITH AERO MEDICAL TRANSPORT SERVICE; NUMEROUS NATIONALLY RANKED CLINICAL PROGRAMS INCLUDING CARDIOLOGY, CARDIAC SURGERY, NEUROSURGERY, ORTHOPEDIC SURGERY, VASCULAR SURGERY, PULMONARY, AND CRITICAL CARE; COMMITMENT TO EDUCATIONAL EXCELLENCE INCLUDING EIGHT MEDICAL RESIDENCY PROGRAMS, A PHARM D RESIDENCY, SCHOOL OF NURSING, SCHOOLS OF ALLIED HEALTH, AND A MEDICAL SKILLS LEARNING CENTER WHICH IS ONE OF ONLY 58 ACCREDITED CENTERS WORLDWIDE; TECHNOLOGY ADVANCEMENTS CURRENTLY BEING IMPLEMENTED, INCLUDING A PHARMACY ROBOT AND PHYSICIAN ORDER ENTRY INFORMATION TECHNOLOGY SYSTEM; STATE OF THE ART CARDIAC CATHETERIZATION LABS, MINIMALLY INVASIVE OPERATING SUITES, VASCULAR OPERATING ROOMS, INTERVENTIONAL RADIOLOGY LABS, AND IMAGING EQUIPMENT INCLUDING A 128-SLICE CT AND PET/CT, WHICH ARE AVAILABLE WITHIN THE HEALTH SYSTEM AND RELATED ENTITIES. MEMORIAL MEDICAL CENTER'S LEE CAMPUS SERVES AS A CONVENIENT LOCATION FOR A NUMBER OF IMPORTANT PROGRAMS AND SERVICES INCLUDING THE WOUND HEALING CENTER, THE CONEMAUGH DIABETES INSTITUTE, THE LEE AMBULATORY SURGERY CENTER FOR SAME DAY SURGERY, AND THE SLEEP DISORDERS CENTER. THE LEE CAMPUS ALSO PROVIDES A HOST OF OUTPATIENT LABORATORY AND IMAGING SERVICES FOR THE COMMUNITY. A LARGE COMMUNITY ROOM IS USED BY NUMEROUS COMMUNITY ORGANIZATIONS FOR MEETINGS AND EVENTS. MINERS MEDICAL CENTER IS A 30-BED COMMUNITY HOSPITAL SERVING RURAL NORTHERN CAMBRIA COUNTY AND SURROUNDING AREAS. IT IS THE REGION'S SOLE HOSPITAL, SPECIALIZING IN FAMILY AND PRIMARY CARE, AND PROVIDES 24-HOUR EMERGENCY CARE, LABORATORY SERVICES, AND MANY PHYSICIAN SPECIALTY SERVICES. MEYERSDALE MEDICAL CENTER SERVES A RURAL AREA IN SOUTHWESTERN PENNSYLVANIA'S HISTORIC SOMERSET COUNTY. SPECIALIZING IN FAMILY AND PRIMARY CARE, IT IS A STATE-DESIGNATED CRITICAL CARE ACCESS HOSPITAL AND HAS BEEN DEEMED A NECESSARY HEALTH CARE PROVIDER BY THE COMMONWEALTH OF PENNSYLVANIA. IT PROVIDES 24-HOUR EMERGENCY CARE AND A NUMBER OF OUTPATIENT SERVICES AND PHYSICIAN SPECIALISTS.CHS ALSO INCLUDES THE 115 PHYSICIANS OF CONEMAUGH PHYSICIAN GROUP WITH PRACTICE OFFICE LOCATIONS IN CAMBRIA, SOMERSET, BEDFORD, INDIANA, AND WESTMORELAND COUNTIES.CHS IS AN ACTIVE MEMBER OF THE COMMUNITY AND AN ADVOCATE FOR THE HEALTH, WELL BEING, AND ECONOMIC STRENGTH OF THE REGION. CHS ADMINISTRATORS HAVE TEAMED UP WITH THE UNITED WAY OF THE LAUREL HIGHLANDS OVER THE PAST FEW YEARS TO IDENTIFY COMMUNITY NEEDS. THIS YEAR, CHS INVESTED NEARLY 1,000 HOURS OF WORK INTO A COMMUNITY NEEDS ANALYSIS FOR CAMBRIA AND SOMERSET COUNTIES. THIS INCLUDED DOZENS OF INTERVIEWS OF AREA LEADERS, HEALTHCARE PROFESSIONALS, EDUCATORS, CLERGY, AND SOCIAL SERVICE PROFESSIONALS. THE FINDINGS HAVE BEEN SHARED WITH THE BOARDS OF CONEMAUGH HEALTH SYSTEM, THE UNTIED WAY OF THE LAUREL HIGHLANDS, AND OVER 20 HUMAN SERVICES AGENCIES. THE FINAL REPORT WILL BE SHARED WITH COMMUNITY LEADERS AND A CONDENSED HIGHLIGHT VERSION WILL BE RELEASED TO THE MEDIA. THE UNITED WAY HAS BEGUN TO REDIRECT FUNDING TO KEY AREAS OF NEED INCLUDING: PROGRAMS TO HELP CHILDREN STAY IN SCHOOL TO INCREASE THEIR POTENTIAL TO BE SUCCESSFUL; DRUG AND ALCOHOL PROGRAMS; AND MENTAL HEALTH PROGRAMS. CONEMAUGH AND THE UNITED WAY WILL PERIODICALLY MEASURE COMMUNITY IMPACT.IN ADDITION TO PROVIDING THE COMMUNITY NEEDS REPORT, VARIOUS CHS LEADERS HAVE SERVED IN MANY ROLES FOR THE UNITED WAY INCLUDING CHAIRMAN OF THE BOARD, CHAIRMAN OF THE COMMUNITY IMPACT COMMITTEE, AND PARTICIPATION IN THE LOANED EXECUTIVE PROGRAM. SENIOR LEADERS AND DIRECTORS THROUGHOUT THE HEALTH SYSTEM ARE ALSO ENCOURAGED TO SERVE ON OTHER COMMUNITY BOARDS AND ORGANIZATIONS. SOME OF THOSE REPRESENTED INCLUDE THE AMERICAN RED CROSS, THE LEUKEMIA AND LYMPHOMA SOCIETY, THE JOHNSTOWN SYMPHONY, WOMEN'S HELP CENTER, JUNIOR ACHIEVEMENT, LAUREL HIGHLANDS FOOD PANTRY, AND THE GREATER JOHNSTOWN YMCA. | Description |
| Total Program Service Expense | 5374318 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | 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 | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 1 | 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 | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 17 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | 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 | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | 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 | 0 | InvestmentInJointVenture |
| 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 | EDWARD DEPASQUALE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8144108271 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1086 FRANKLIN STREET | AddressLine1 |
| City | JOHNSTOWN | City |
| State | PA | State |
| ZIP Code | 15905 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (23 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| JAMES HARGREAVES | |||||||
| CHAIRMAN | 2.00 | X | X | 0 | 0 | 0 | |
| RON VICKROY | |||||||
| VICE CHAIRMAN | 2.00 | X | X | 0 | 0 | 0 | |
| JAMES CASCIO | |||||||
| TREASURER | 2.00 | X | X | 0 | 0 | 0 | |
| KIM CRAIG | |||||||
| SECRETARY | 2.00 | X | X | 0 | 0 | 0 | |
| HAROLD ASHCRAFT MD | |||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||
| KRISTIN BRANT MD | |||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||
| ROBERT A GLEASON JR | |||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||
| WILLIAM HAUGER MD | |||||||
| TRUSTEE | 2.00 | X | 0 | 363242 | 37555 | ||
| ADIB KHOUZAMI MD | |||||||
| TRUSTEE | 2.00 | X | 0 | 1153176 | 32945 | ||
| BRIAN LIEB DO | |||||||
| TRUSTEE | 2.00 | X | 0 | 235862 | 30681 | ||
| SAMUEL MCCLURE | |||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||
| ROBERTA REAM | |||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||
| JOHN SARACENA | |||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||
| SALLY SARGENT | |||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||
| PATRICIA SEROTKIN | |||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||
| MICHAEL SMITH | |||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||
| SCOTT BECKER | |||||||
| CHIEF EXECUTIVE OFFICER | 53.00 | X | X | 1236437 | 0 | 42969 | |
| DAVID CARLSON DO | |||||||
| CHIEF MEDICAL OFFICER | 20.00 | X | 678102 | 0 | 30611 | ||
| EDWARD DEPASQUALE | |||||||
| CHIEF FINANCIAL OFFICER | 22.00 | X | 538638 | 0 | 35167 | ||
| JOSEPH DADO | |||||||
| CHIEF INFORMATION OFFICER | 20.00 | X | 442586 | 0 | 16131 | ||
| JOHN MORYKEN | |||||||
| VP MARKETING/COMMUNICATION | 20.00 | X | 321458 | 0 | 26692 | ||
| MARY YORK | |||||||
| CHIEF LEARNING OFFICER | 30.00 | X | 246850 | 0 | 20321 | ||
| LOUIS SCIULLO | |||||||
| VP SPECIAL PROJECTS | 50.00 | 116615 | 83295 | 11260 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3580686 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1835575 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 284332 | TotalOtherCompensation |
| Number Individuals GT100 K | 6 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (3 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| BKD LLP | |||||
| PO BOX 1178 | LOUISVILLE | KY | 40201 | ACCOUNTING SERVICES | 344625 |
| BUCHANAN INGERSOLL ROONEY PC | |||||
| 301 GRANT STREET | PITTSBURGH | PA | 15219 | LEGAL SERVICES | 249114 |
| YAFFE & CO INC | |||||
| 49 WASHINGTON AVE SUITE 700 | TOWSON | MD | 21204 | CONSULTING SERVICES | 116597 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 3 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MANAGEMENT FEES | Description |
| Business Code | 561000 | BusinessCode |
| Total Revenue Column | 6629144 | TotalRevenueColumn |
| Related Or Exempt Function Income | 6629144 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 6629144 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 662 | TotalRevenueColumn |
| Exclusion | $662 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | INTEREST-OFFICER LOAN | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 663 | TotalRevenueColumn |
| Exclusion | $663 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 663 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6630469 | TotalRevenueColumn |
| Related Or Exempt Function Income | 6629144 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $1,325 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2680469 | Total |
| Program Services | 2573250 | ProgramServices |
| Management And General | 107219 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1229344 | Total |
| Program Services | 485340 | ProgramServices |
| Management And General | 744004 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32245 | Total |
| Program Services | 11668 | ProgramServices |
| Management And General | 20577 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 831058 | Total |
| Program Services | 617464 | ProgramServices |
| Management And General | 213594 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 350009 | Total |
| Program Services | 350009 | ProgramServices |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 338985 | Total |
| Program Services | 338985 | ProgramServices |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 359958 | Total |
| Program Services | 346713 | ProgramServices |
| Management And General | 13245 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 210386 | Total |
| Program Services | 199328 | ProgramServices |
| Management And General | 11058 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 68805 | Total |
| Program Services | 43644 | ProgramServices |
| Management And General | 25161 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 107488 | Total |
| Program Services | 55337 | ProgramServices |
| Management And General | 52151 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 38893 | Total |
| Program Services | 37453 | ProgramServices |
| Management And General | 1440 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 66983 | Total |
| Program Services | 60935 | ProgramServices |
| Management And General | 6048 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5898 | Total |
| Program Services | 5080 | ProgramServices |
| Management And General | 818 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| DUES & SUBSCRIPTIONS | 117631 | 61520 | 56111 |
| PURCHASED SERVICES | 45278 | 40553 | 4725 |
| RELOCATION | 21050 | 21050 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 125989 | Total |
| Program Services | 125989 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6630469 | Total |
| Program Services | 5374318 | ProgramServices |
| Management And General | 1256151 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 118448 | BOY |
| EOY | 200986 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1052489 | BOY |
| EOY | 116497 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13771 | BOY |
| EOY | 2858 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 1206000 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 192740 | BOY |
| EOY | 136571 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 209652 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 169019 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18031 | BOY |
| EOY | 40633 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3800131 | BOY |
| EOY | 1066995 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5195610 | BOY |
| EOY | 2770540 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1521895 | BOY |
| EOY | 1139921 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 508623 | BOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1119333 | BOY |
| EOY | 1438774 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3149851 | BOY |
| EOY | 2578695 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2045759 | BOY |
| EOY | 191845 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2045759 | BOY |
| EOY | 191845 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5195610 | BOY |
| EOY | 2770540 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 0 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -1853914 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Certification Checkbox | X | CertificationCheckbox |
| Written IRS Determination | X | WrittenIRSDetermination |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation (5 entries)
| EINEIN | Type Of OrganizationTypeOfOrganization | Listed In Governing DocListedInGoverningDoc | Supported Organization NotifiedSupportedOrganizationNotified | Organized In USOrganizedInUS | AmountAmount |
|---|---|---|---|---|---|
| MEYERSDALE MEDICAL CENTER | |||||
| 251002946 | 3 | 0 | 1 | 1 | $13,800 |
| CONEMAUGH VALLEY MEMORIAL HOSPITAL | |||||
| 250965307 | 3 | 0 | 0 | 1 | $0 |
| MINERS MEDICAL CENTER | |||||
| 250977902 | 3 | 0 | 0 | 1 | $0 |
| GOOD SAMARITAN MEDICAL CENTER | |||||
| 250965428 | 3 | 0 | 0 | 1 | $0 |
| CONEMAUGH HEALTH FOUNDATION | |||||
| 251719695 | 11 | 0 | 0 | 1 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 5 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 13800 | SumOfAmounts |
Schedule D IRS990ScheduleD
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 209652 | OtherCostOrOtherBasis |
| Depreciation | 169019 | Depreciation |
| Book Value | 40633 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 40633 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| INVESTMENT IN PHHP | 7500 |
| INVESTMENT IN RRG | 324563 |
| 457(F) DEFERRED COMPENSATION CONTRIBUTION | 734932 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 1066995 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (7 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| 457(F) DEFERRED COMPENSATION | $734,932 |
| SEVERANCE LIABILITY | $16,818 |
| DUE TO MEMORIAL MEDICAL CENTER | $659,813 |
| DUE TO GOOD SAMARITAN MEDICAL CENTER | $11,540 |
| DUE TO CONEMAUGH HEALTH INITIATIVES, INC. | $10,359 |
| DUE TO MEYERSDALE MEDICAL CENTER | $4,675 |
| DUE TO CONEMAUGH HOUSING, INC. | $637 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1438774 | TotalOfAmounts |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 0 | 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 | 1 | 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 | 1 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 1 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (10 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WILLIAM HAUGER MD | |||||||||||||
| 0 | 333778 | 0 | 23132 | 0 | 6332 | 0 | 24381 | 0 | 13174 | 0 | 400797 | 0 | 0 |
| ADIB KHOUZAMI MD | |||||||||||||
| 0 | 649000 | 0 | 500228 | 0 | 3948 | 0 | 21842 | 0 | 11103 | 0 | 1186121 | 0 | 0 |
| BRIAN LIEB DO | |||||||||||||
| 0 | 180666 | 0 | 32025 | 0 | 23171 | 0 | 17670 | 0 | 13011 | 0 | 266543 | 0 | 0 |
| SCOTT BECKER | |||||||||||||
| 571461 | 0 | 210076 | 0 | 454900 | 0 | 13224 | 0 | 29745 | 0 | 1279406 | 0 | 204798 | 0 |
| DAVID CARLSON DO | |||||||||||||
| 400722 | 0 | 86056 | 0 | 191324 | 0 | 12606 | 0 | 18005 | 0 | 708713 | 0 | 103693 | 0 |
| EDWARD DEPASQUALE | |||||||||||||
| 313637 | 0 | 66488 | 0 | 158513 | 0 | 18798 | 0 | 16369 | 0 | 573805 | 0 | 98604 | 0 |
| JOSEPH DADO | |||||||||||||
| 254066 | 0 | 53829 | 0 | 134691 | 0 | 13099 | 0 | 3032 | 0 | 458717 | 0 | 80488 | 0 |
| JOHN MORYKEN | |||||||||||||
| 203678 | 0 | 32762 | 0 | 85018 | 0 | 15189 | 0 | 11503 | 0 | 348150 | 0 | 47184 | 0 |
| MARY YORK | |||||||||||||
| 109968 | 0 | 0 | 0 | 136882 | 0 | 11963 | 0 | 8358 | 0 | 267171 | 0 | 24750 | 0 |
| LOUIS SCIULLO | |||||||||||||
| 83336 | 59525 | 8782 | 6272 | 24497 | 17498 | 5458 | 3899 | 1110 | 793 | 123183 | 87987 | 11184 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART I, LINE 1A | SOCIAL CLUB DUES ARE PAID FOR THE ORGANIZATION'S CEO. UNDER THE OVERSIGHT OF THE EXECUTIVE COMPENSATION COMMITTEE, IT HAS ALWAYS BEEN THE ORGANIZATION'S PRACTICE TO PAY THESE DUES FOR THE CEO AS THE SOCIAL CLUB IS PRIMARILY USED TO BENEFIT THE ORGANIZATION. | |
| PART I, LINES 4A-B | MARY YORK RECEIVED SEVERANCE PAYMENTS DURING THE YEAR TOTALING $73,906. IN ADDITION, HER 457(F) PLAN BALANCE OF $44,258 WAS RECOGNIZED AS TAXABLE INCOME. THE CONEMAUGH HEALTH SYSTEM'S 457(F) EXECUTIVE COMPENSATION PROGRAM WAS TERMINATED DECEMBER 10,2010 RESULTING IN A TAXABLE EVENT. ON THAT DATE, EACH PARTICIPANT'S ENTIRE ACCOUNT BALANCE WAS RECOGNIZED AS TAXABLE INCOME PER IRS REGULATIONS. THESE AMOUNTS, WHICH ARE INCLUDED ON THE 990 CORE FORM AND SCHEDULE J AS REPORTABLE COMPENSATION ARE AS FOLLOWS: $430,918 FOR SCOTT BECKER; $180,982 FOR DAVID CARLSON, DO; $148,478 FOR EDWARD DEPASQUALE; $130,649 FOR JOSEPH DADO; $78,414 FOR JOHN MORYKEN; AND $31,868 FOR LOUIS SCIULLO. PLEASE NOTE THAT THESE AMOUNTS LESS ALL APPLICABLE TAXES, WHICH HAVE BEEN REMITTED UPON THE PLAN'S TERMINATION, WILL NOT BE DISTRIBUTED TO THE PARTICIPANTS UNTIL 1 YEAR AND 1 DAY AFTER THE TERMINATION DATE HAS PASSED. | |
| PART I, LINE 6 | EXECUTIVE BONUSES ARE CALCULATED AS A PERCENTAGE OF BASE SALARY. THE PERCENTAGE IS CONTINGENT ON VARIOUS FINANCIAL AND NON-FINANCIAL INCENTIVE CRITERIA GOVERNED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD. PART I, LINE 6B: WILLIAM HAUGER, MD, ADIB KHOUZAMI, MD AND BRIAN LIEB, DO RECEIVED BONUSES FROM CONEMAUGH HEALTH INITIATIVES, A RELATED ORGANIZATION. PHYSICIAN BONUSES ARE CALCULATED ON A CASH BASIS; TAKING TOTAL CASH COLLECTIONS LESS ALL OFFICE OPERATING, PHYSICIAN AND OVERHEAD EXPENSES. ANY REMAINING AMOUNT IS THEN DISTRIBUTED TO THE PHYSICIAN BASED ON A CONTRACTUAL PERCENTAGE AND CAP. TOTAL PHYSICIAN COMPENSATION IS ANNUALLY CHECKED FOR REASONABLENESS AGAINST IRS GUIDELINES. | |
| PART III | PART II, COLUMN (F): PAST CONTRIBUTIONS MADE TO THE 457(F) PLAN ARE INCLUDED AS REPORTABLE COMPENSATION IN THE CURRENT YEAR DUE TO THE PLAN'S TERMINATION. AMOUNTS SHOWN REPRESENT CONTRIBUTIONS THAT WERE RECOGNIZED AS DEFERRED COMPENSATION ON PAST FORM 990S. | SUPPLEMENTAL INFORMATION |
Schedule L IRS990ScheduleL
Loan Table LoanTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | DAVID CARLSON DO | NamePerson |
| Purpose Of Loan | HOUSING LOAN | PurposeOfLoan |
| Loan From Organization | X | LoanFromOrganization |
| Original Principal | $31,010 | OriginalPrincipalAmount |
| Balance Due | 2858 | BalanceDue |
| Default | 0 | Default |
| Approved By Board | 1 | ApprovedByBoard |
| Written Agreement | 1 | WrittenAgreement |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 2858 | TotalBalanceDue |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS PROVIDED TO THE ORGANIZATION'S BOARD OF DIRECTORS BEFORE IT IS FILED. ONCE THE FORM IS COMPLETE, BOARD MEMBERS ARE GIVEN THE OPPORTUNITY TO REVIEW THE CONTENTS OF THE FORM AND SUBMIT ANY COMMENTS OR QUESTIONS. IN ADDITION, THE FORM IS REVIEWED BY THE HEALTH SYSTEM'S MANAGER, TAX & COMPLIANCE; DIRECTOR, FINANCIAL OPERATIONS; VICE PRESIDENT, FINANCIAL OPERATIONS; CHIEF FINANCIAL OFFICER; AND THE AUDIT AND COMPLIANCE COMMITTEE. AN EXTERNAL CPA FIRM IS ENGAGED TO REVIEW AND ELECTRONICALLY FILE THE RETURN. | |
| THE ORGANIZATION AND ALL SUBSIDIARIES ARE GOVERNED BY A CONFLICT OF INTEREST POLICY, WHICH HAS BEEN APPROVED BY THE HEALTH SYSTEM'S BOARD. UNDER THIS POLICY, EVERY BOARD MEMBER IS GIVEN A COPY OF THE POLICY AS WELL AS A FORM THAT MUST BE COMPLETED ON AN ANNUAL BASIS. NO BOARD MEMBER IS APPROVED OR RE-APPOINTED UNTIL HE OR SHE HAS COMPLETED AND SIGNED THE CONFLICT OF INTEREST FORM. ONCE THE FORM IS RETURNED, IT IS REVIEWED BY THE CHS COMPLIANCE OFFICER AND CEO. IF ANY CONFLICTS ARE DISCLOSED, THE DETAILS ARE FORWARDED TO THE BOARD CHAIR TO BE ADDRESSED. DEPENDING ON THE CONFLICT, THE BOARD MEMBER COULD BE GIVEN CERTAIN RESTRICTIONS, SUCH AS BEING PROHIBITED FROM PARTICIPATING IN CERTAIN BOARD DECISIONS. THE CHS AUDIT AND COMPLIANCE COMMITTEE HAS THE FINAL DECISION-MAKING REGARDING ALL CONFLICTS OF INTEREST. THROUGHOUT THE FISCAL YEAR, BOARD MEMBERS MUST NOTIFY THE BOARD CHAIR, COMPLIANCE OFFICER, AND/OR CEO IF A NEW CONFLICT HAS DEVELOPED. | FORM 990, PART VI, SECTION B, LINE 12C | |
| CHS MANAGES THE DETERMINATION OF COMPENSATION FOR ITS EXECUTIVES AS WELL AS THE EXECUTIVES OF ALL ITS SUBSIDIARIES. THE PROCESS IS OUTLINED IN ITS BY-LAWS. AN OUTSIDE CONSULTING FIRM IS UTILIZED TO ENSURE THAT EXECUTIVE COMPENSATION PACKAGES ARE FAIR AND COMPARABLE WITH SIMILAR ORGANIZATIONS. CHS HAS ALSO ESTABLISHED AN EXECUTIVE COMPENSATION COMMITTEE TO REVIEW AND RECOMMEND THE COMPENSATION DECISIONS MADE. THIS COMMITTEE REPORTS DIRECTLY TO THE BOARD. | FORM 990, PART VI, SECTION B, LINE 15 | |
| ALL REQUESTS FOR THIS INFORMATION ARE HANDLED BY THE CHS MARKETING/PUBLIC RELATIONS DEPARTMENT. | FORM 990, PART VI, SECTION C, LINE 19 | |
| FORM 990, PART VI, LINES 12A, 13, AND 14: ALL APPLICABLE POLICY QUESTIONS HAVE BEEN ANSWERED YES SINCE THE ORGANIZATION IS A SUBSIDIARY OF A LARGER HEALTH SYSTEM AND IS GOVERNED BY THE SYSTEM'S POLICIES. ALL POLICIES HAVE BEEN APPROVED BY THE HEALTH SYSTEM'S BOARD. | ||
| FORM 990, PART VII, SECTION A, LINE 1A, COLUMN B: IN ADDITION TO THE HOURS DEVOTED TO THE FILING ORGANIZATION SHOWN IN PART VII, THE FOLLOWING OFFICERS AND TRUSTEES ALSO DEVOTED HOURS TO RELATED ORGANIZATIONS DURING THE YEAR. THE HOURS SHOWN REPRESENT THE AVERAGE NUMBER OF HOURS PER WEEK. SCOTT BECKER, CEO: CONEMAUGH VALLEY MEMORIAL HOSPITAL - 4 MEYERSDALE COMMUNITY HOSPITAL - 1 MINERS HOSPITAL - 1 GOOD SAMARITAN MEDICAL CENTER - 0.3 CONEMAUGH HEALTH FOUNDATION - 3.5 CONEMAUGH HOUSING, INC. - 0.2 CONEMAUGH HEALTH INITIATIVES - 7 EDWARD DEPASQUALE, CFO: CONEMAUGH VALLEY MEMORIAL HOSPITAL - 14 MEYERSDALE COMMUNITY HOSPITAL - 1 MINERS HOSPITAL - 1 GOOD SAMARITAN MEDICAL CENTER - 1 CONEMAUGH HEALTH FOUNDATION - 0.5 CONEMAUGH HOUSING, INC. - 0.5 CONEMAUGH HEALTH INITIATIVES - 10 DAVID CARLSON, DO, CMO: CONEMAUGH VALLEY MEMORIAL HOSPITAL - 10 MEYERSDALE COMMUNITY HOSPITAL - 4 MINERS HOSPITAL - 4 GOOD SAMARITAN MEDICAL CENTER - 0.5 CONEMAUGH HEALTH FOUNDATION - 0.5 CONEMAUGH HOUSING, INC. - 1 CONEMAUGH HEALTH INITIATIVES - 10 JOSEPH DADO, CIO: CONEMAUGH VALLEY MEMORIAL HOSPITAL - 16 MEYERSDALE COMMUNITY HOSPITAL - 2 MINERS HOSPITAL - 2 GOOD SAMARITAN MEDICAL CENTER - 1 CONEMAUGH HEALTH FOUNDATION - 1 CONEMAUGH HEALTH INITIATIVES - 8 MARY YORK, CLO: CONEMAUGH VALLEY MEMORIAL HOSPITAL - 15 MEYERSDALE COMMUNITY HOSPITAL - 2 MINERS HOSPITAL - 2 GOOD SAMARITAN MEDICAL CENTER - 1 JOHN MORYKEN, VP: CONEMAUGH VALLEY MEMORIAL HOSPITAL - 10 MEYERSDALE COMMUNITY HOSPITAL - 1 MINERS HOSPITAL - 1 CONEMAUGH HEALTH INITIATIVES - 8 LOUIS SCIULLO, VP: CONEMAUGH VALLEY MEMORIAL HOSPITAL - 50 TRANSFERRED TO THIS RELATED ORGANIZATION DURING AUGUST 2010. WILLIAM HAUGER, MD: CONEMAUGH VALLEY MEMORIAL HOSPITAL - 12 CONEMAUGH HEALTH INITIATIVES - 50 ADIB KHOUZAMI, MD: CONEMAUGH HEALTH INITIATIVES - 65 BRIAN LIEB, DO: MEMORIAL MEDICAL CENTER - 1.5 MINERS HOSPITAL - 1 CONEMAUGH HEALTH INITIATIVES - 59 | ||
| CHANGES IN NET ASSETS OR FUND BALANCES: | NET UNREALIZED LOSSES ON INVESTMENTS: -1,840,114. SUPPORT TO MEYERSDALE MEDICAL CENTER 13,800 | FORM 990, PART XI, LINE 5: |
| FORM 990, PART XI, LINE 2: THE ORGANIZATION'S FINANCIAL STATEMENTS FOR THE FISCAL YEAR ENDING JUNE 30, 2011 WERE AUDITED AS PART OF THE AUDIT OF THE CONSOLIDATED FINANCIAL STATEMENTS OF THE CONEMAUGH HEALTH SYSTEM, INC. AND SUBSIDIARIES. THE HEALTH SYSTEM'S AUDIT AND COMPLIANCE COMMITTEE ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT AND THE SELECTION OF THE INDEPENDENT ACCOUNTANT. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| GOOD SAMARITAN MEDICAL CENTER | ||||||||||
| 1020 FRANKLIN STREET | JOHNSTOWN | PA | 15905 | 250965428 | HEALTH CARE SERVICES | PA | 501C(3) | 3 | CONEMAUGH HEALTH SYSTEM INC | 1 |
| CONEMAUGH VALLEY MEMORIAL HOSPITAL DBA MEMORIAL MEDICAL CTR | ||||||||||
| 1086 FRANKLIN STREET | JOHNSTOWN | PA | 15905 | 250965307 | HEALTH CARE SERVICES | PA | 501C(3) | 3 | CONEMAUGH HEALTH SYSTEM INC | 1 |
| MINERS HOSPITAL DBA MINERS MEDICAL CENTER | ||||||||||
| 290 HAIDA AVENUE | HASTINGS | PA | 16646 | 250977902 | HEALTH CARE SERVICES | PA | 501C(3) | 3 | CONEMAUGH HEALTH SYSTEM INC | 1 |
| MEYERSDALE COMMUNITY HOSPITAL DBA MEYERSDALE MEDICAL CENTER | ||||||||||
| 200 HOSPITAL DRIVE | MEYERSDALE | PA | 15552 | 251002946 | HEALTH CARE SERVICES | PA | 501C(3) | 3 | CONEMAUGH HEALTH SYSTEM INC | 1 |
| CONEMAUGH HEALTH FOUNDATION | ||||||||||
| 1086 FRANKLIN STREET | JOHNSTOWN | PA | 15905 | 251719695 | SUPPORTS CONEMAUGH HEALTH SYSTEM | PA | 501C(3) | 11B | CONEMAUGH HEALTH SYSTEM INC | 1 |
| CONEMAUGH HOUSING INC | ||||||||||
| 1086 FRANKLIN STREET | JOHNSTOWN | PA | 15905 | 251606936 | PROVIDES SENIOR HOUSING FACILITIES | PA | 501C(3) | 9 | CONEMAUGH VALLEY MEMORIAL HOSPITAL | 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| LAUREL HIGHLANDS ADVANCED IMAGING | ||||||||||
| 1450 SCALP AVENUE | JOHNSTOWN | PA | 15904 | 251864587 | DIAGNOSTIC SERVICES | PA | CONEMAUGH VALLEY MEMORIAL HOSPITAL | RELATED | 0 | 0 |
| GREATER JOHNSTOWN TECH PARK | ||||||||||
| 1086 FRANKLIN STREET | JOHNSTOWN | PA | 15905 | 260389121 | OPERATES MULTI-TENANT COMMERCE OFFICE PARK | PA | CONEMAUGH ENTERPRISES INC | UNRELATED | 0 | 0 |
Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|
| CONEMAUGH HEALTH INITIATIVES INC DBA CONEMAUGH PHYSICIAN GP | |||||||||||
| 1086 FRANKLIN STREET | JOHNSTOWN | PA | 15905 | 251658283 | PHYSICIAN SERVICES | PA | CONEMAUGH HEALTH SYSTEM INC | C | -10566833 | 10842088 | 1.00000 |
| CONEMAUGH ENTERPRISES INC | |||||||||||
| 1086 FRANKLIN STREET | JOHNSTOWN | PA | 15905 | 202998473 | ECONOMIC DEVELOPMENT | PA | CONEMAUGH VALLEY MEMORIAL HOSPITAL | C | |||
| 1086 REAL ESTATE | |||||||||||
| 1086 FRANKLIN STREET | JOHNSTOWN | PA | 15905 | 251489704 | REAL ESTATE | PA | CONEMAUGH HEALTH INITIATIVES | C | |||
| SINDO INC | |||||||||||
| 1086 FRANKLIN STREET | JOHNSTOWN | PA | 15905 | 251144116 | COMMUNITY RENTALS | PA | CONEMAUGH HEALTH FOUNDATION | C | |||
| 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 | 0 | 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 | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | 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 | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| CONEMAUGH HEALTH INITIATIVES | ||
| P | 829944 | FAIR MARKET VALUE |
| CONEMAUGH VALLEY MEMORIAL HOSPITAL | ||
| P | 4835637 | FAIR MARKET VALUE |
| MINERS HOSPITAL | ||
| P | 225847 | FAIR MARKET VALUE |
| MEYERSDALE COMMUNITY HOSPITAL | ||
| P | 130367 | FAIR MARKET VALUE |
| GOOD SAMARITAN MEDICAL CENTER | ||
| P | 88748 | FAIR MARKET VALUE |
| CONEMAUGH VALLEY MEMORIAL HOSPITAL | ||
| J | 107488 | FAIR MARKET VALUE |