MEMORIAL HOSPITAL: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- MEMORIAL HOSPITAL (EIN 23-1265004)
- Tax period
- 2010-07-01 to 2011-06-30
- Filed
- 2012-05-11
- IRS object ID
- 201231329349300713
- 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 C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-05-11T06:56:29-05:00 | 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 | PARENTEBEARD LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | SUITE 200 221 W PHILADELPHIA ST | AddressLine1 |
| City | YORK | City |
| State | PA | State |
| ZIP Code | 174012993 | 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 | 231265004 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MEMO | NameControl |
| Phone | 7178438623 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 325 SOUTH BELMONT STREET | AddressLine1 |
| City | YORK | City |
| State | PA | State |
| ZIP Code | 17403 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | SALLY J DIXON | Name |
| Title | PRESIDENT/CEO | Title |
| Phone | 7178438623 | Phone |
| Date Signed | 2012-05-10 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JULIUS GREEN CPA | Name |
| Phone | 7178467000 | 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 | SALLY J DIXON | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 325 SOUTH BELMONT STREET | AddressLine1 |
| City | YORK | City |
| State | PA | State |
| ZIP Code | 17403 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 107460981 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.MHYORK.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1945 | YearFormation |
| State Legal Domicile | PA | StateLegalDomicile |
| Activity Or Mission Description | PREMIER MEDICAL CENTER STRIVING TO ENHANCE THE HEALTH AND WELL BEING OF THE YORK, PA COMMUNITY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1177 | TotalNbrEmployees |
| Total Nbr Volunteers | 200 | TotalNbrVolunteers |
| Total Gross UBI | 1854704 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 29280 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 619692 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 528612 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 98614118 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 104546022 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 47423 | InvestmentIncomePriorYear |
| Investment Income Current Year | 118025 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1559951 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1733126 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 100841184 | TotalRevenuePriorYear |
| Total Revenue Current Year | 106925785 | 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 | 51692573 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 53718968 | 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 | 47022430 | OtherExpensePriorYear |
| Other Expenses Current Year | 52783315 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 98715003 | TotalExpensesPriorYear |
| Total Expenses Current Year | 106502283 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 2126181 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 423502 | RevenuesLessExpensesCY |
| Total Assets BOY | 46785274 | TotalAssetsBOY |
| Total Assets EOY | 52945823 | TotalAssetsEOY |
| Total Liabilities BOY | 20356554 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 28749020 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 26428720 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 24196803 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | MEMORIAL HOSPITAL IS COMMITTED TO PROMOTING, IMPROVING, AND ENHANCING THE HEALTH AND WELL-BEING OF THE COMMUNITY WE SERVE. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 69781172 | Expense |
| Grants | 0 | Grants |
| Revenue | 41775663 | Revenue |
| Description | GENERAL ACUTE CARE INPATIENT HOSPITAL SERVICES WHICH INCLUDE THE FOLLOWING: * MEMORIAL HOSPITAL OFFERES A BROAD SPECTRUM OF INPATIENT SURGICAL SERVICES FOR ADULT AND PEDIATRIC PATIENTS INCLUDING EAR/NOSE/THROAT; GENERAL SURGERY; GYNECOLOGY; ORAL AND MAXILLOFACIAL; ORTHOPEDICS, PLASTIC AND RECONSTRUCTIVE; PODIATRY; THORACTIC AND UROLOGY. * MEMORIAL HOSPITAL HAS BUILT THE FAMILY BIRTH CENTER ON THE MOST SOLID FOUNDATION OF ALL - FAMILY VALUES. THAT MEANS WE HAVE PAINSTAKENLY CONSIDERED EVERY POSSIBLE DETAIL TO ENSURE A HEALTHY, HAPPY, COMFORTABLE STAY FOR OUR PATIENTS, THEIR NEWBORN AND FAMILY MEMBERS THEY WISH TO INCLUDE. IN FISCAL YEAR ENDED JUNE 30, 2011, THERE WERE 5,498 DISCHARGES. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 9674230 | Expense |
| Grants | 0 | Grants |
| Revenue | 58080145 | Revenue |
| Description | GENERAL ACUTE CARE OUTPATIENT HOSPITAL SERVICES WHICH INCLUDE THE FOLLOWING: * MEMORIAL HOSPITAL'S EMERGENCY DEPARTMENT IS OPEN 24-HOURS-A-DAY AND IS STAFFED BY BOARD CERTIFIED EMERGENCY PHYSICIANS, NURSES, AND NURSING PERSONNEL CERTIFIED IN ADULT AND PEDIATRIC ADVANCED LIFE SUPPORT AND EMERGENCY CARE. THE NEWLY RENOVATED EMERGENCY DEPARTMENT HAS 20 PRIVATE ROOMS, THREE TRIAGE ROOMS AND A LARGER WAITING ROOM. "FAST ER" WAS DEVELOPED TO HELP ALLEVIATE WAIT TIMES IN THE EMERGENCY DEPARTMENT AND FOCUSES ON THE LESS SEVERE EMERGENCIES. * MEMORIAL HOSPITAL OF YORK'S INDUSTRIAL RESOURCE CENTER WAS ESTABLISHED IN 1985 TO PROVIDE BUSINESSES AND INDUSTRY IN OUR REGION WITH AN OBJECTIVE PARTNER IN PROVIDING QUALITY, UNBIASED WORK RELATED MEDICAL EVALUATIONS, EMPLOYEE HEALTH SERVICES, AND MANY OTHER EMPLOYMENT RELATED SERVICES. THE INDUSTRIAL RESOURCE CENTER HAS TWO CONVENIENT LOCATIONS TO ACCESS SERVICES. * MEMORIAL HOSPITAL'S LABORATORY PROVIDES CLINICAL AND ANATOMIC PATHOLOGY SERVICES 24-HOURS-A-DAY AT TWO CONVENIENT LOCATIONS. * THE BREAST CENTER AT MEMORIAL HOSPITAL WAS DESIGNED BY WOMEN, FOR WOMEN. WE HAVE CREATED A WARM, HOME-LIKE ATMOSPHERE AND OFFER A COMPLETE ARRAY OF SERVICES NEEDED BY WOMEN WHICH INCLUDES THE EXPERTISE OF A FELLOWSHIP-TRAINED PHYSICIAN AND A TEAM OF DEDICATED PROFESSIONALS WHO WILL PROVIDE ONE-ON-ONE ATTENTION. * THE HEART AND VASCULAR CENTER AT MEMORIAL HOSPITAL PROVIDES DIAGNOSIS AND TREATMENT OF ALL TYPES OF CARDIOVASCULAR DISEASES. AT THE HEART AND VASCULAR CENTER YOU CAN EXPECT HIGH QUALITY, COMPASSIONATE CARE FROM AN EXPERIENCED TEAM OF PHYSICIANS, NURSES, AND TECHNOLOGISTS. IN FISCAL YEAR ENDED JUNE 30, 2011, THERE WERE 166,338 OUTPATIENT VISITS. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 2590776 | Expense |
| Grants | 0 | Grants |
| Revenue | 805794 | Revenue |
| Description | HOME HEALTH SERVICES PROVIDES QUALITY CARE IN THE COMFORT OF A PATIENT'S HOME. SERVICES RANGING FROM PHYSICAL THERAPY TO HOSPICE CARE ARE OFFFERED. IN FISCAL YEAR ENDED JUNE 30, 2011, 17,840 VISITS WERE CONDUCTED. | Description |
Activity Other ActivityOther (3 entries)
| ExpenseExpense | GrantsGrants | RevenueRevenue | DescriptionDescription |
|---|---|---|---|
| 2102913 | 0 | 908638 | ADVANCED LIFE SUPPORT SERVICES 6,181 CALLS |
| 1023646 | 0 | 306085 | HOSPICE SERVICES |
| 0 | 1724357 | NON-MEDICARE CERTIFIED HOME HEALTH SERIVCES |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 3126559 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Rev | 2939080 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 85172737 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | 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 | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | 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 | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 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 | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | 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 | 35 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1177 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | 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 | 1 | 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 | SALLY J DIXON | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7178438623 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 325 SOUTH BELMONT STREET | AddressLine1 |
| City | YORK | City |
| State | PA | State |
| ZIP Code | 17403 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (23 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| CHLOE R EICHELBERGER | |||||||||
| CHAIRMAN | 3.00 | X | X | 0 | 0 | 0 | |||
| RANDALL A GROSS | |||||||||
| VICE CHAIRMAN | 3.00 | X | X | 0 | 0 | 0 | |||
| JACK KAY | |||||||||
| IMMEDIATE PAST CHAIRMAN | 3.00 | X | 0 | 0 | 0 | ||||
| RICHARD D POOLE | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| TERRY N YORK DO | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| LUTHER B SOWERS PHD | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| DELAINE TOERPER | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| DAVID FREEMAN | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| MICHAEL NEWSOME | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| MICHAEL W KING | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| CAROL ST GEORGE DO | |||||||||
| DIRECTOR | 1.00 | X | 2640 | 0 | 0 | ||||
| JAMES A LEASE DO | |||||||||
| DIRECTOR | 40.00 | X | 322038 | 0 | 14898 | ||||
| PATRICK BRUBAKER | |||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | ||||
| SALLY J DIXON | |||||||||
| PRESIDENT/CEO | 36.00 | X | X | 404810 | 0 | 73231 | |||
| JAMES R ZARFOSS JR | |||||||||
| DIRECTOR (THRU 9/2010) | 1.00 | X | 0 | 0 | 0 | ||||
| RICHARD IMBIMBO | |||||||||
| CFO (THRU 3/2011) | 39.00 | X | 278235 | 0 | 12314 | ||||
| SUSAN M GORDON | |||||||||
| VP NURSING | 40.00 | 157521 | 0 | 2996 | X | ||||
| MANU S RAJACHANDRAN | |||||||||
| PHYSICIAN | 40.00 | 559999 | 0 | 11681 | X | ||||
| VAN D ADAMS | |||||||||
| PHYSICIAN | 40.00 | 454201 | 0 | 16186 | X | ||||
| RAYMOND S CUZZANITI | |||||||||
| PHYSICIAN | 40.00 | 432878 | 0 | 15948 | X | ||||
| HAOEH M JUNG | |||||||||
| PHYSICIAN | 40.00 | 430118 | 0 | 11434 | X | ||||
| JOSEPH E ROBINSON | |||||||||
| PHYSICIAN | 40.00 | 411638 | 0 | 8894 | X | ||||
| HUGH PALMER DO | |||||||||
| FORMER DIRECTOR | 40.00 | 4550 | 152695 | 5790 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3458628 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 152695 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 173372 | TotalOtherCompensation |
| Number Individuals GT100 K | 35 | NumberIndividualsGT100K |
| Formers Listed | 1 | 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 |
|---|---|---|---|---|---|
| MILLER DIPIETRO PARTNERSHIP | |||||
| PO BOX 3057 | YORK | PA | 17402 | MEDICAL & HEALTH CARE SERVICES | 563847 |
| MEDICUS HOSPITALIST SERVICES LLC | |||||
| 7 INDUSTRIAL WAY UNIT 5 | SALEM | NH | 17402 | PHYSICIAN SERVICES | 483276 |
| MEDQUIST TRANSCRIPTIONS LTE | |||||
| PO BOX 102467 | ATLANTA | GA | 30368 | TRANSCRIPTION SERVICES | 403011 |
| WELLSPAN MEDICAL GROUP | |||||
| PO BOX 2767 | YORK | PA | 17405 | PHYSICIAN SERVICES | 348141 |
| MEDICAL STAFFING NETWORK | |||||
| PO BOX 202996 | DALLAS | TX | 75320 | NURSING SERVICES | 346396 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 23 | NumberOfContractorsGT100K |
| Government Grants | 124863 | GovernmentGrants |
| All Other Contributions | 403749 | AllOtherContributions |
| Total Contributions | 528612 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| MEDICAL SERVICES | 623000 | 102821665 | 101876325 | 945340 |
| EDUCATION REIMBURSEMEN | 611710 | 1655676 | 1655676 | |
| MEDICAL RECORDS | 623000 | 57347 | 57347 | |
| APPOINTMENT FEES | 623000 | 8050 | 8050 | |
| XRAY INCOME | 623000 | 3284 | 3284 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 104546022 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 83669 | TotalRevenueColumn |
| Exclusion | $83,669 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 24129 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 24129 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 24129 | TotalRevenueColumn |
| Exclusion | $24,129 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 547752 | Securities |
| Other | 21800 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 535196 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 12556 | Securities |
| Other | 21800 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 34356 | TotalRevenueColumn |
| Exclusion | $34,356 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|
| LEASED EMTS | 621990 | 901564 | 901564 | |
| CAFETERIA REVENUE | 722210 | 385632 | $385,632 | |
| MANAGEMENT FEES | 541610 | 180000 | $180,000 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 241801 | TotalRevenueColumn |
| Unrelated Business Revenue | 7800 | UnrelatedBusinessRevenue |
| Exclusion | $234,001 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1708997 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 106925785 | TotalRevenueColumn |
| Related Or Exempt Function Income | 103600682 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 1854704 | UnrelatedBusinessRevenue |
| Exclusion | $941,787 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1227774 | Total |
| Program Services | 981883 | ProgramServices |
| Management And General | 245891 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 43252107 | Total |
| Program Services | 34589872 | ProgramServices |
| Management And General | 8662235 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 148021 | Total |
| Program Services | 118376 | ProgramServices |
| Management And General | 29645 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5656521 | Total |
| Program Services | 4523672 | ProgramServices |
| Management And General | 1132849 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3434545 | Total |
| Program Services | 2746698 | ProgramServices |
| Management And General | 687847 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 116798 | Total |
| Program Services | 93406 | ProgramServices |
| Management And General | 23392 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 81000 | Total |
| Program Services | 64778 | ProgramServices |
| Management And General | 16222 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 36816 | Total |
| Program Services | 29443 | ProgramServices |
| Management And General | 7373 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23516 | Total |
| Program Services | 18807 | ProgramServices |
| Management And General | 4709 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9059868 | Total |
| Program Services | 7245420 | ProgramServices |
| Management And General | 1814448 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 936295 | Total |
| Program Services | 748780 | ProgramServices |
| Management And General | 187515 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18542215 | Total |
| Program Services | 14828707 | ProgramServices |
| Management And General | 3713508 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 548448 | Total |
| Program Services | 438609 | ProgramServices |
| Management And General | 109839 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4361319 | Total |
| Program Services | 3487864 | ProgramServices |
| Management And General | 873455 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 130627 | Total |
| Program Services | 104466 | ProgramServices |
| Management And General | 26161 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 626036 | Total |
| Program Services | 500658 | ProgramServices |
| Management And General | 125378 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4951348 | Total |
| Program Services | 3959726 | ProgramServices |
| Management And General | 991622 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1729889 | Total |
| Program Services | 1383439 | ProgramServices |
| Management And General | 346450 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| UBIT EXPENSE | 0 | 0 | 0 |
| BAD DEBTS EXPENSE | 8433517 | 6744510 | 1689007 |
| HOSPITAL ASSESSMENT | 1165388 | 931992 | 233396 |
| FOOD EXPENSE | 689432 | 551357 | 138075 |
| LICENSES | 353502 | 282705 | 70797 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 997301 | Total |
| Program Services | 797569 | ProgramServices |
| Management And General | 199732 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 106502283 | Total |
| Program Services | 85172737 | ProgramServices |
| Management And General | 21329546 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -31244 | BOY |
| EOY | 2583 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1419566 | BOY |
| EOY | 4138748 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12987037 | BOY |
| EOY | 14491016 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17248 | BOY |
| EOY | 12853 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1996398 | BOY |
| EOY | 2241515 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1067528 | BOY |
| EOY | 1245603 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 91081414 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 67564682 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23623748 | BOY |
| EOY | 23516732 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4220951 | BOY |
| EOY | 4479683 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 31000 | BOY |
| EOY | 31000 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1453042 | BOY |
| EOY | 2786090 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 46785274 | BOY |
| EOY | 52945823 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7547622 | BOY |
| EOY | 9858138 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11034747 | BOY |
| EOY | 17185472 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1774185 | BOY |
| EOY | 1705410 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20356554 | BOY |
| EOY | 28749020 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25805299 | BOY |
| EOY | 23589423 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 196531 | BOY |
| EOY | 179900 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 426890 | BOY |
| EOY | 427480 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26428720 | BOY |
| EOY | 24196803 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 46785274 | BOY |
| EOY | 52945823 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 423502 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -2655419 | 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 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 1 | GrantsOtherOrganizations |
| Grants Other Organizations | $36,816 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $22,750 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 59566 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF OTHER LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1I: | ReturnReference |
| Explanation | THE HOSPITAL PAID STEVENS AND LEE, A LEGAL AND CONSULTING FIRM TO WORK WITH SENATORS AND CONGRESSMEN IN ORDER TO FACILITATE AN INCREASE IN THE MEDICARE WAGE INDEX. THE AMOUNT PAID TO THEM FOR THE YEAR ENDED 6/30/11 WAS $36,816. THE REMAINING $22,750 REPRESENTS A PERCENTAGE OF MEMBERSHIP DUES PAID TO HEALTH CARE ASSOCIATIONS SUCH AS AMERICAN HOSPITAL ASSOCIATION AND THE HOSPITAL ASSOCIATION OF PENNSYLVANIA THAT IS ATTRIBUTABLE TO LOBBYING. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 426890 | BeginningOfYearBalance |
| Contributions | 590 | Contributions |
| End Of Year Balance | 427480 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 426127 | BeginningOfYearBalance |
| Contributions | 500 | Contributions |
| Administrative Expenses | -263 | AdministrativeExpenses |
| End Of Year Balance | 426890 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 351269 | BeginningOfYearBalance |
| Contributions | 75000 | Contributions |
| Investment Earnings Or Losses | 2 | InvestmentEarningsOrLosses |
| Administrative Expenses | 144 | AdministrativeExpenses |
| End Of Year Balance | 426127 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.00000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 1.00000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.00000 | TermEndowmentEOYBalance |
| 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 | 207335 | OtherCostOrOtherBasis |
| Book Value | 207335 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 23799263 | OtherCostOrOtherBasis |
| Depreciation | 13625174 | Depreciation |
| Book Value | 10174089 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 11600938 | OtherCostOrOtherBasis |
| Depreciation | 8752882 | Depreciation |
| Book Value | 2848056 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 54124194 | OtherCostOrOtherBasis |
| Depreciation | 43941077 | Depreciation |
| Book Value | 10183117 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1349684 | OtherCostOrOtherBasis |
| Depreciation | 1245549 | Depreciation |
| Book Value | 104135 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 23516732 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (4 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| CASH DEFERRED COMPENSATION | 443610 |
| INCOME GUARANTEE | 105627 |
| ESTIMATED THIRD PARTY PAYOR SETTLEMENTS | 2236943 |
| OTHER ASSETS | -90 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 2786090 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| BLUE CROSS WORKING CAPITAL ADVANCE | $321,800 |
| MEDICAL MALPRACTICE CLAIMS LIABILITY | $940,000 |
| DEFERRED COMPENSATION | $443,610 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1705410 | TotalOfAmounts |
| Total Revenue | 106925785 | TotalRevenue |
| Total Expenses | 106502283 | TotalExpenses |
| Excess Or Deficit For Year | 423502 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 210408 | NetUnrealizedGLOnInvestments |
| Other | -$2,865,827 | OtherAmount |
| Total Adjustments | -2655419 | TotalAdjustments |
| Excess Or Deficit Per FS | -2231917 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 107030875 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 210408 | NetUnrealizedGainsInvestments |
| Other Revenues | 262041 | OtherRevenues |
| Revenue Not Rptd F990 | 472449 | RevenueNotRptdF990 |
| Revenue Subtotal | 106558426 | RevenueSubtotal |
| Other Revenues Not Included | 367359 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 367359 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 106925785 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 106465920 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | -36363 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | -36363 | ExpensesNotRptdF990 |
| Expenses Subtotal | 106502283 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 106502283 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | INCOME EARNED FROM ENDOWMENTS IS AVAILABLE FOR THE GENERAL OPERATIONS OF THE HOSPITAL. |
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | THE CORPORATION ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD IS MET. MANAGEMENT DETERMINED THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2011. THE CORPORATION'S FEDERAL EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURNS FOR THE YEARS ENDED JUNE 30, 2010, 2009 AND 2008 REMAIN SUBJECT TO EXAMINATION BY THE IRS. |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | TRANSFER TO MEI, INC. A RELATED COMPANY -21,947. TRANSFER TO MEMORIAL HEALTH SYSTEMS CORPORATION, A RELATED EXEMPT ORG. -2,843,880. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | NET ASSETS RELEASED FROM RESTRICTIONS USED IN OPERATIONS 262,041. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | TEMPORARILY RESTRICTED CONTRIBUTIONS 330,406. PERMANENTLY RESTRICTED CONTRIBUTIONS 590. UNRELATED BUSINESS INCOME TAX REFUND 36,363. | |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | UNRELATED BUSINESS INCOME TAX REFUND -36,363. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | 0 | 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 | 1631634 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1631634 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01660 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 14127893 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6964360 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7163533 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07300 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 15759527 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6964360 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 8795167 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08960 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3978917 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1421852 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2557065 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02610 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5648776 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3013784 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2634992 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02690 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 645929 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 390537 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 255392 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00260 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 21880 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 21880 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10295502 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4826173 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5469329 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05580 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 26055029 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 11790533 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 14264496 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.14540 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 315474 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 315474 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00320 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 41672 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 41672 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 15891 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 15891 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 373037 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 373037 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00380 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $3,176,679 | BadDebtExpenseAmount |
| Amount Attributable To | 953004 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 31700977 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 33737244 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -2036267 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| 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 | MEMORIAL HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 325 SOUTH BELMONT STREET | AddressLine1 |
| City | YORK | City |
| State | PA | State |
| ZIP Code | 17403 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Teaching Hospital | X | TeachingHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 300.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Permit Lawsuit | X | PermitLawsuit |
| Permit Lien On Residence | X | PermitLienOnResidence |
| Collection Activities | 1 | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Lawsuit | X | Lawsuit |
| Lien On Residence | X | LienOnResidence |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Average Negotiated Rates | X | AverageNegotiatedRates |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 1 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 7: THE EXPENSES REPORTED FOR THE CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS WERE DETERMINED BY USING THE COST TO CHARGE RATIO DEVELOPED THROUGH THE IRS PROVIDED WORKSHEET 2. THIS METHODOLOGY MIMICS THE COST AS REPORTED ON FY 2011 MEDICARE COST REPORT (WORKSHEET C, COL 5, LINE 202), IN THAT THE FOLLOWING ARE EXCLUDED FROM THE COST FACTOR: NON-PATIENT CARE EXPENSES, BAD DEBT, MEDICAL EDUCATION, ADVANCED LIFE SUPPORT, AND OTHER SIGNIFICANT COMMUNITY BENEFIT EXPENSES. OVERHEAD (INDIRECT COST) COSTS APPLIED TO SELECTED COMMUNITY HEALTH IMPROVEMENT SERVICES/BENEFIT OPERATIONS REPORTED ON LINE 7(E) AND COMMUNITY BUILDING ACTIVITIES REPORTED IN PART II ALSO UTILIZED A SIMILAR MEDICARE-BASED METHODOLOGY. | ||
| PART I, LINE 7G: MEMORIAL INCLUDED $645,929 OF EXPENSES AND $390,537 OF DIRECT OFFSETTING REVENUE ATTRIBUTABLE TO A PHYSICIAN CLINIC IN SUBSIDIZED HEALTH SERVICES. | ||
| PART I, L7 COL(F): THE AMOUNT OF BAD DEBT EXPENSE FROM FORM 990, PART IX, LINE 25, COLUMN A THAT WAS REMOVED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN SCHEDULE H, PART I, LINE 7, COLUMN (F) WAS $8,433,517. | ||
| PART II: MEMORIAL HOSPITAL PROVIDED COMMUNITY BUILDING ACTIVITIES IN THE AREAS OF COMMUNITY SUPPORT, COMMUNITY HEALTH IMPROVEMENT ADVOCACY, AND WORKFORCE DEVELOPMENT. THESE ACTIVITIES GO BEYOND OUR TRADITIONAL ACUTE CARE HOSPITAL SERVICES, AND REALLY DO SERVE MEMORIAL'S CORE MISSION - THE HEALTH OF THE COMMUNITY. FOR THE VAST MAJORITY OF THESE ACTIVITIES, MEMORIAL'S OBJECTIVE FOR PARTICIPATION IS TO MEET THE NEEDS OF THE UNDERSERVED. A GREAT MANY OF THESE NEEDS, WHETHER THEY BE FOOD, SHELTER, AND COMPANIONSHIP ALL IMPACT THE HEALTH, BOTH PHYSICAL AND MENTAL, OF THOSE SERVED AND, IN TURN, THE HEALTH OF THE ENTIRE YORK COMMUNITY. WITHOUT THE INVOLVEMENT OF PRIVATE ORGANIZATIONS LIKE MEMORIAL HOSPITAL, A GREATER BURDEN WOULD FALL ON PUBLIC (GOVERNMENTAL) AGENCIES.THESE ACTIVITIES, PROGRAMS AND FUNDING PROVIDED BY MEMORIAL BENEFITED THE GENERAL COMMUNITY AND DID NOT SPECIFICALLY BENEFIT MEMORIAL. MEMORIAL TAKES A GREAT DEAL OF PRIDE IN BEING ACTIVE IN THE GENERAL COMMUNITY AND NOT JUST IN HEALTH CARE PROGRAMS THAT HAVE A DIRECT BENEFIT TO MEMORIAL. SOME EXAMPLES ARE AS FOLLOWS:1.) COMMUNITY SUPPORT - MEMORIAL SPENT $57,428 TO OPERATE THE "STRENGTHENING FAMILIES PROGRAM", WHICH PROVIDED EXTENSIVE FAMILY SKILLS TRAINING TO APPROXIMATELY 571 PEOPLE IN SESSIONS RUNNING 18 HOURS OVER A SEVEN WEEK PERIOD. NO FEES ARE CHARGED TO THE FAMILIES, MANY OF WHO ARE OF LOW INCOME AND UNDERSERVED BY THE VARIOUS COMMUNITY AGENCIES. SUCH PROGRAMS ARE PROVEN TO REDUCE RISKY BEHAVIORS SUCH AS VIOLENCE, DELINQUENCY, TRUANCY AND OTHER CONDUCT PROBLEMS.MEMORIAL MADE A $12,000 DONATION TO UNITED WAY OF YORK COUNTY (WHICH WAS IN ADDITION TO THE APPROXIMATELY $57,000 DONATED BY MEMORIAL EMPLOYEES), AN AGENCY THAT PROVIDES FUNDING FOR NUMEROUS NON-HEALTHCARE RELATED AGENCIES THAT ARE ESSENTIAL TO THE COMMUNITY AND, ESPECIALLY TO THOSE WITH SPECIAL NEEDS AND /OR WHO ARE UNDERSERVED. A $2,500 DONATION WAS MADE TO THE LOCAL HABITAT FOR HUMANITY, AN ORGANIZATION THAT INVITES PEOPLE OF ALL BACKGROUNDS, RACES AND RELIGIONS TO BUILD HOUSES TOGETHER IN PARTNERSHIP WITH FAMILIES IN NEED. THEY ALSO ASPIRE TO MAKE DECENT SHELTER A MATTER OF CONSCIENCE AND ACTION. ALSO REPORTED IN THIS CATEGORY IS $207,847 OF EXPENSE RELATED TO MEMORIAL CONTRIBUTING EMPLOYEE TIME (COMMUNITY ACTIVISM HOURS) TO NON-HEALTHCARE RELATED ORGANIZATIONS. FOR EXAMPLE, MEMORIAL CONTRIBUTED OVER 60 HOURS ($4,000 IN COST) OF STAFF TIME TO THE SALVATION ARMY, AN AGENCY THAT PROVIDES LOW INCOME RESIDENTS WITH FOOD, SHELTER, CLOTHING AND OTHER BASIC NEEDS THAT HAVE A SIGNIFICANT IMPACT ON THE HEALTH OF THE INDIVIDUAL AND THE COMMUNITY. IN ANOTHER EXAMPLE, MEMORIAL CONTRIBUTED OVER 110 HOURS ($4,300 IN COST) TO THE BOY SCOUTS, AN ORGANIZATION THAT DEVELOPS FUTURE LEADERS AND VOLUNTEERS TO THE COMMUNITY AND STRESSES HEALTHY LIFESTYLE VALUES. OVERALL, MEMORIAL'S EXPENSES FOR COMMUNITY SUPPORT WERE $315,474.2.) COMMUNITY HEALTH IMPROVEMENT ADVOCACY - MEMORIAL PROVIDED $41,600 OF EMPLOYEE TIME TO ASSIST VARIOUS COMMUNITY AGENCIES. UNLIKE THE COMMUNITY ACTIVISM HOURS ABOVE, THE ORGANIZATIONS ARE MORE ENGAGED IN THE OVERALL HEALTH OF THE COMMUNITY, THAN IN TRADITIONAL HEALTH CARE SERVICES, SUCH AS THE AMERICAN CANCER, AMERICAN HEART ASSOCIATION, AND OTHER VARIOUS AGENCIES. MEMORIAL EMPLOYEES CONTRIBUTED OVER 130 HOURS ($5,500 IN COST) TO THE AMERICAN HEART ASSOCIATION ALONE. TOTAL EXPENSES FOR COMMUNITY ACTIVISM HOURS WERE $41,672.3.) WORKFORCE DEVELOPMENT - IN ADDITION TO A LARGE COMMITMENT TO HEALTH PROFESSIONS EDUCATION (SEE PART I, LINE 7F), MEMORIAL ALSO PARTICIPATES IN A ROBUST SHADOWING PROGRAM FOR HIGH SCHOOL AND COLLEGE STUDENTS WHO ARE CONSIDERING A CAREER IN HEALTHCARE. THE OBJECTIVE OF THIS PROGRAM IS TO CAPTURE THE STUDENTS INTEREST IN A HEALTH CARE PROFESSION BEFORE ANOTHER PROFESSIONAL PATH IS CHOSEN. THERE ARE STILL MANY HEALTH RELATED PROFESSIONS THAT ARE IN NEED OF MORE INDIVIDUALS NOW AND IN THE FUTURE. MEMORIAL'S SHADOWING PROGRAM WAS DEVELOPED TO MEET THE PERSONNEL NEEDS OF THE HEALTH CARE INDUSTRY, WHILE TRYING TO MAINTAIN THE FUTURE RESOURCE IN THE YORK COMMUNITY. CLOSE TO 300 HOURS OF STAFF TIME (AT A COST OF $15,891) IS DEVOTED TO MENTORING THESE STUDENTS. | ||
| PART III, LINE 4: FOOTNOTE TO THE HOSPITAL'S STATEMENT REGARDING BAD DEBT EXPENSE: ACCOUNTS RECEIVABLE, PATIENTS ARE REPORTED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THEY ARE DETERMINED TO BE UNCOLLECTIBLE BASED UPON MANAGEMENT'S ASSESSMENT OF INDIVIDUAL ACCOUNTS. THE ALLOWANCE FOR DOUBTFUL COLLECTIONS IS ESTIMATED BASED UPON A MONTHLY REVIEW OF THE ACCOUNTS RECEIVABLE AGING, PAYOR CLASSIFICATIONS, AND APPLICATION OF HISTORICAL WRITE-OFF PERCENTAGES.THE COSTING METHODOLOGY USED IN DETERMINING BAD DEBT AND CHARITY REPORTED AS BAD DEBT EXPENSE WAS DETERMINED BY USING THE COST TO CHARGE RATIO DEVELOPED THROUGH THE IRS PROVIDED WORKSHEET 2. THIS METHODOLOGY MIMICS THE COST AS REPORTED ON FY 2011 MEDICARE COST REPORT (WORKSHEET C, COL 5, LINE 202), IN THAT THE FOLLOWING ARE EXCLUDED FROM THE COST FACTOR: NON-PATIENT CARE EXPENSES, BAD DEBT, MEDICAL EDUCATION, ADVANCED LIFE SUPPORT, AND OTHER SIGNIFICANT COMMUNITY BENEFIT EXPENSES. OVERHEAD (INDIRECT COST) COSTS APPLIED TO SELECTED COMMUNITY HEALTH IMPROVEMENT SERVICES/BENEFIT OPERATIONS REPORTED ON LINE 7(E) AND COMMUNITY BUILDING ACTIVITIES REPORTED IN PART II ALSO UTILIZED A SIMILAR MEDICARE-BASED METHODOLOGY.THE METHOD MEMORIAL USED TO DETERMINE THE AMOUNT THAT REASONABLY COULD BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR CHARITY CARE UNDER THE HOSPITAL'S CHARITY CARE POLICY UTILIZES THE PERCENTAGE (9.5%) OF YORK COUNTY FAMILIES WHO FALL BELOW THE POVERTY LEVEL. THIS 9.5% IS APPLIED TO MEMORIAL'S GROSS PATIENT CHARGES, AND THEN THE RATIO OF COST TO CHARGES DESCRIBED ABOVE (CALCULATED AT .377) IS APPLIED. THE COST OF CHARITY CARE REPORTED ON PART I, LINE 7A IS DEDUCTED. THE BALANCE ($6,234,204) THAT REMAINS IS GREATER THAN THE BAD DEBT EXPENSE REPORTED ON LINE 3. THE ESTIMATED AMOUNT OF THE ORGANZIATION'S BAD DEBT EXPENSE AT COST ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY AND REPORTED ON LINE 3 IS 30% OF THE BAD DEBT EXPENSE AT COST REPORTED ON LINE 2. MEMORIAL'S CHARITY CARE ELIGIBILITY BEGINS AT 200% OF THE FEDERAL POVERTY GUIDELINES, THUS USING 30% OF THE BAD DEBT EXPENSE CONSERVATIVELY STATES THE AMOUNT THAT REASONABLY COULD BE ATTRIBUTED TO PATIENTS WHO WOULD LIKELY QUALIFY FOR CHARITY CARE.MEMORIAL HOSPITAL PROVIDES CARE TO ALL PATIENTS WHO NEED IT, REGARDLESS OF THEIR ABILITY TO PAY. GOOD BUSINESS PRACTICES FOR THE COLLECTION OF BAD DEBTS ARE APPLIED, AND THERE STILL REMAINS A LARGE BALANCE OF ACCOUNTS FOR PATIENTS WHO ARE UNABLE TO PAY OR ARE UNWILLING TO PAY. CARE IS ROUTINELY RENDERED PRIOR TO ANY REALIZATION OF NON-PAYMENT. | ||
| PART III, LINE 8: THE COSTING METHODOLOGY USED IN DETERMINING THE MEDICARE SHORTFALL WAS THE COST TO CHARGE RATIO DEVELOPED THROUGH THE IRS PROVIDED WORKSHEET 2. THIS METHODOLOGY MIMICS THE COST AS REPORTED ON FY 2011 MEDICARE COST REPORT (WORKSHEET C, COL 5, LINE 202), IN THAT THE FOLLOWING ARE EXCLUDED FROM THE COST FACTOR: NON-PATIENT CARE EXPENSES, BAD DEBT, MEDICAL EDUCATION, ADVANCED LIFE SUPPORT, AND OTHER SIGNIFICANT COMMUNITY BENEFIT EXPENSES. OVERHEAD (INDIRECT COST) COSTS APPLIED TO SELECTED COMMUNITY HEALTH IMPROVEMENT SERVICES/BENEFIT OPERATIONS REPORTED ON LINE 7(E) AND COMMUNITY BUILDING ACTIVITIES REPORTED IN PART II ALSO UTILIZED A SIMILAR MEDICARE-BASED METHODOLOGY.MEMORIAL HOSPITAL PROVIDES CARE TO ALL PATIENTS WHO NEED IT, REGARDLESS OF THEIR ABILITY TO PAY. MEDICARE PATIENTS COMPRISE APPROXIMATELY 35% OF OUR PATIENT CARE VOLUME. DUE TO THIS LARGE PERCENTAGE OF OUR PATIENT POPULATION, MEMORIAL, LIKE MOST ALL OTHER HOSPITALS, IS DEPENDENT ON THE MEDICARE VOLUME. MEDICARE, A FEDERALLY-SPONSORED PAYER, HAS HISTORICALLY REIMBURSED HOSPITALS LESS THAN THEIR ACTUAL COST TO RENDER CARE, AND THE REIMBURSEMENT RATES ARE REGULATED AND NON-NEGOTIABLE. FOR COMMUNITY BENEFIT PURPOSES, THE MEDICARE PROGRAM SHOULD BE TREATED LIKE THE MEDICAID PROGRAM. | ||
| PART III, LINE 9B: ALL COLLECTION AND OUTSOURCED BILLING AGENCIES ARE WELL VERSED IN MEMORIAL'S CHARITY CARE POLICY, AND WHEN A POTENTIAL CHARITY CARE PATIENT IS IDENTIFIED BY THESE AGENCIES, THE CHARITY CARE APPLICATION PROCESS IS IMPLEMENTED BY THE AGENCY AND COMPLETED BY HOSPITAL STAFF. AT ANY TIME DURING THIS PROCESS, THE PATIENT MAY CONTACT THE HOSPITAL FINANCIAL COUNSELING STAFF TO DISCUSS CHARITY CARE AND OTHER FINANCIAL ASSISTANCE OPTIONS, INCLUDING ESTABLISHING PAYMENT ARRANGEMENTS OVER A PERIOD OF MONTHS/YEARS. | ||
| PART V, SECTION B, LINE 21: POLICY WAS CHANGED EFFECTIVE OCTOBER 1, 2011 AND CHARGES ARE NOW DISCOUNTED. | MEMORIAL HOSPITAL | |
| PART VI, LINE 2: IN 1994, MEMORIAL HOSPITAL BECAME A PARTNER IN A COMMUNITY-WIDE COLLABORATIVE EFFORT TO CONDUCT THE FIRST COMMUNITY NEEDS ASSESSMENT. OTHER PARTNERS WERE YORK HOSPITAL, HANOVER HOSPITAL, UNITED WAY OF YORK COUNTY, YORK COUNTY CHAMBER OF COMMERCE, YORK HEALTH CORPORATION (FEDERALLY QUALIFIED HEALTH CENTER) AND YORK CITY HEALTH BUREAU. THAT ASSESSMENT LED TO THE CREATION OF THE HEALTHY YORK COUNTY COALITION WHICH HAS USED THE ASSESSMENT TO IDENTIFY AND PRIORITIZE COMMUNITY NEEDS. IT HAS SERVED AS A CONVENER, EDUCATOR AND ADVOCATE ON ISSUES ADDRESSING BROAD-BASED COMMUNITY HEALTH ISSUES. MEMORIAL HOSPITAL HAS BEEN AN ACTIVE PARTNER IN THE HEALTHY YORK COUNTY COALITION SINCE ITS INCEPTION IN 1985 AS WELL AS THE SUBSEQUENT COMMUNITY NEEDS ASSESSMENTS THAT HAVE BEEN PERFORMED EVERY THREE YEARS SINCE THEN. WE ARE CURRENTLY ENGAGED IN FINALIZING THE ASSESSMENT BEGUN IN 2011, WHICH WILL BE COMPLETED IN THE SPRING OF 2012, WITH THE RESULTS AND OUTCOMES TO BE SHARED WITH THE COMMUNITY AT THAT TIME. THE DISSEMINATION OF INFORMATION OBTAINED IN THE ASSESSMENTS HAS HISTORICALLY BEEN DONE THROUGH COMMUNITY FORUMS, PRESENTATION TO KEY STAKEHOLDER GROUPS, NEWSPAPER ARTICLES AND INSERTS AND VARIOUS OTHER MEDIA AND FORUMS. THAT PLAN WILL CONTINUE FOR THE COMING ASSESSMENT IN THE SPRING OF 2012.THE ASSESSMENTS HAVE SURVEYED THE GEOGRAPHIC BOUNDARIES OF YORK COUNTY. HOWEVER, USING THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFS) TOOL, WE HAVE OVERSAMPLED THE CITY OF YORK TO IDENTIFY UNIQUE NEEDS OF LOW-INCOME CITIZENS AS WELL AS DIVERSE RACIAL AND ETHNIC POPULATIONS.MEMORIAL HOSPITAL HAS BEEN INVOLVED AND CONTINUES TO BE A KEY PARTNER IN MANY INITIATIVES THAT HAVE GROWN OUT OF ISSUES IDENTIFIED IN PAST ASSESSMENTS. THE HEALTHY YORK NETWORK WAS CREATED TO IDENTIFY UNINSURED AND UNDERINSURED CITIZENS IN OUR COMMUNITY AND LINK THEM TO PROVIDERS. CURRENTLY THERE ARE 7500 ENROLLEES IN THE PROGRAM AND 67% OF THE PROVIDERS ON THE MEMORIAL HOSPITAL MEDICAL STAFF AGREE TO SEE THESE PATIENTS AT NO CHARGE. THE HEALTHY YORK NETWORK HAS RECRUITED 903 PROVIDERS IN THE COMMUNITY TO PARTICIPATE. THE HEALTHY YORK NETWORK HAS PROVEN TO BE A TRUE SAFETY NET FOR THOSE IN OUR COMMUNITY WITH HEALTHCARE NEEDS BUT NOT THE MEANS TO ACQUIRE THEM. $562,824 OF THE AMOUNT REPORTED AS CHARITY CARE ON SCHEDULE H, PART I, LINE 7(A) IS ATTRIBUTED TO ENROLLEES OF THE HEALTHY YORK NETWORK.THE HEALTHY COMMUNITY PHARMACY WAS AN OUTGROWTH OF THE HEALTHY YORK NETWORK. AS WE BEGAN TO IDENTIFY AND LINK PATIENTS TO HEALTHCARE PROVIDERS, WE NEEDED TO ADDRESS ANOTHER ISSUE THAT WAS IDENTIFIED IN THE COMMUNITY NEEDS ASSESSMENT...ACCESS TO PHARMACEUTICALS. THE PARTNERS WHO HAD GATHERED TO CREATE THE HEALTHY YORK NETWORK AGREED THAT THIS WAS A LOGICAL NEXT STEP FOR THE GROUP. A PHARMACY WAS CREATED WHERE THOSE IN NEED FINANCIALLY COULD HAVE THEIR PRESCRIPTIONS FILLED AT LOW OR NO COST. PATIENTS WOULD BE IDENTIFIED BY PRIMARY CARE AND SPECIALTY PRACTICES AS WELL AS COMMUNITY NON-PROFITS AND REFERRED TO THE PHARMACY FOR ENROLLMENT. | ||
| PART VI, LINE 3: MEMORIAL PROVIDES EXTENSIVE COMMUNICATION TO ITS PATIENT COMMUNITY REGARDING THE CHARITY CARE PROGRAM, WHICH PROVIDES FREE OR DISCOUNTED CARE. THE FOLLOWING METHODS OF COMMUNICATION ARE EMPLOYED: (1) SIGNAGE AND/OR PROVISION OF INFORMATION IN ALL AREAS WITH PRE-REGISTRATION/REGISTRATION/ADMITTING RESPONSIBILITIES, (2) BROCHURES ARE MADE AVAILABLE TO ALL INPATIENTS AND DISPLAYED/PROVIDED IN OUTPATIENT AREAS, (3) ALL STAFF ARE TRAINED IN IDENTIFYING POTENTIAL CHARITY PROGRAM APPLICANTS AND PROVIDING THEM WITH THE PROPER DIRECTION TO STAFF DEVOTED TO THE CHARITY PROGRAM, (4) ALL SELF PAY INPATIENTS, ALL SELF PAY AMBULATORY SURGERY PATIENTS, AND A GREAT MANY EMERGENCY ROOM PATIENTS MEET WITH A FINANCIAL COUNSELOR AND AN OUTSIDE FIRM IS EMPLOYED BY THE HOSPITAL TO ASSIST THESE PATIENTS ON OBTAINING MEDICAID ELIGIBILITY, (5) ALL PATIENT BILLS HAVE CONTACT INFORMATION REGARDING FINANCIAL ASSISTANCE AND (6) ALL COLLECTION AND OUTSOURCED BILLING AGENCIES ARE WELL VERSED IN MEMORIAL'S CHARITY CARE POLICY, AND WHEN A POTENTIAL CHARITY CARE PATIENT IS IDENTIFIED BY THESE AGENCIES, THE CHARITY CARE APPLICATION PROCESS IS IMPLEMENTED BY THE AGENCY AND COMPLETED BY HOSPITAL STAFF. | ||
| PART VI, LINE 4: MEMORIAL HOSPITAL SERVES A COMMUNITY OF MORE THAN 420,000 RESIDENTS IN YORK COUNTY. THERE ARE TWO OTHER NONPROFIT HOSPITALS SERVING THE YORK COMMUNITY - WELLSPAN HEALTH AND HANOVER HOSPITAL. ACCORDING TO THE MOST RECENT COMMUNITY HEALTH ASSESSMENT, WHICH WAS COMPLETED IN 2008, THE POPULATION IN YORK COUNTY CONTINUES TO GROW. BETWEEN 2000 AND 2006, THE POPULATION GREW 9%. THE MEDIAN HOUSEHOLD INCOME IS $52,248. 9.5% OF FAMILIES IN YORK COUNTY ARE BELOW POVERTY. MORE THAN 13% OF PEOPLE DURING THE LAST HEALTH ASSESSMENT STATED THEY DID NOT HAVE HEALTH INSURANCE. ETHNIC GROUPS AND CULTURAL GROUPS IN YORK COUNTY INCLUDE 4.7% OF AFRICAN AMERICAN, 3.9% HISPANIC, 1.2% ASIAN. MEMORIAL HOSPITAL PROVIDES HEALTH CARE TO ALL INDIVIDUALS REGARDLESS OFTHEIR ABILITY TO PAY.THE TOP 5 CAUSES OF DEATH IN YORK COUNTY ARE (IN ORDER OF PREVALENCE) HEART DISEASE, CANCER, STROKE, RESPIRATORY DISEASE AND ACCIDENTS. YORK COUNTY'S HEART DISEASE DEATH RATES ARE WELL ABOVE THE NATIONAL AVERAGE: YORK COUNTY-281 PER 100,000 RESIDENTS; NATIONAL AVERAGE-217 PER 100,000 RESIDENTS. NINE PERCENT OF YORK COUNTY RESIDENTS HAVE DIABETES, UP FROM 6.9 PERCENT. TOBACCO USE IS INCREASING WITH NEARLY 26 PERCENT OF ADULTS IN YORK COUNTY USING TOBACCO; THIS IS UP FROM 22% IN 2003. MORE THAN 67 PERCENT OF YORK COUNTY ADULTS ARE OVERWEIGHT OR OBESE. | ||
| PART VI, LINE 6: THE MAJORITY OF MEMORIAL HOSPITAL'S BOARD OF DIRECTORS RESIDE IN THE PRIMARY SERVICE AREA. OF THE 14 VOTING BOARD MEMBERS, 9 BOARD MEMBERS ARE NEITHER EMPLOYEES, CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. THE MAJORITY OF MEMORIAL'S CLINICAL DEPARTMENTS ARE OPEN TO ALL QUALIFIED PHYSICIANS. AS IS THE CASE IN MOST HOSPITALS, THE TRADITIONAL HOSPITAL BASED DEPARTMENTS (ANESTHESIA, RADIOLOGY, PATHOLOGY, AND EMERGENCY MEDICINE) ARE NOT OPEN DEPARTMENTS, AND THOSE PHYSICIANS ARE EITHER EMPLOYED BY MEMORIAL OR PROVIDED THROUGH AN EXCLUSIVE CONTRACT THROUGH AN OUTSIDE CORPORATION.SURPLUS FUNDS, EARNED THROUGH OPERATIONS, ARE RE-INVESTED BACK INTO MEMORIAL HOSPITAL FOR CAPITAL ACQUISITION OF MEDICAL TECHNOLOGY, BUILDING ENHANCEMENTS, AND THE FUNDING OF THE MISSION TO PROVIDE GRADUATE MEDICAL EDUCATION. | ||
| PART VI, LINE 7: MEMORIAL HOSPITAL IS A CONTROLLED ENTITY OF MEMORIAL HEALTH SYSTEMS CORPORATION, WHOSE PURPOSE IS TO: (1) CONDUCT FUND-RAISING FOR THE HOSPITAL'S CAPITAL ACQUISITION PROJECTS; AND (2) PROVIDE OVERALL STRATEGIC DIRECTION FOR THE ENTIRE HEALTH SYSTEM, WHICH IS CONSISTENT WITH ITS MISSION TO BE A VITAL CONTRIBUTOR TO THE HEALTH OF THE YORK COMMUNITY. THE THREE OTHER ENTITIES CONTROLLED BY MEMORIAL HEALTH SYSTEMS CORPORATION ARE: (1) SURGICAL CENTER OF YORK - A NON-PROFIT OUTPATIENT SURGICAL CENTER, WHICH ALSO PROVIDES SURGICAL SERVICES TO MEDICAID, MEDICARE AND CHARITY CARE PATIENTS; (2) MHS TITLE HOLDING CORPORATION - A NON-PROFIT CORPORATION WHICH DEVELOPS AND RENTS REAL ESTATE TO ITS AFFILIATES, PHYSICIANS AND OTHERS; AND (3) MEMORIAL ENTERPRISES, INC IS A FOR-PROFIT CORPORATION FORMED TO EMPLOY PRIMARY CARE AND SPECIALTY CARE PHYSICIANS ----- MEI PROVIDES SERVICES TO A MEDICARE AND MEDICAL ASSISTANCE POPULATION, IN ADDITION TO PROVIDING CHARITY CARE THROUGH ACTIVE PARTICIPATION IN THE HEALTHY YORK NETWORK, AN ORGANIZATION DEVELOPED TO MEET THE HEALTH CARE NEEDS OF THOSE WITH INCOMES LESS THAN 200-300% BELOW THE FEDERAL POVERTY GUIDELINES. | ||
| REPORTS FILED WITH STATES | PART VI, LINE 7 | |
| THE ORGANIZATION IS NOT REQUIRED TO FILE A COMMUNITY BENEFIT REPORT WITH ANY STATE. | PART VI, LINE 7: |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| 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 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JAMES A LEASE DO | |||||||||||||
| 322038 | 0 | 0 | 0 | 0 | 0 | 2000 | 0 | 12898 | 0 | 336936 | 0 | 0 | 0 |
| SALLY J DIXON | |||||||||||||
| 356758 | 0 | 48052 | 0 | 0 | 0 | 62721 | 0 | 10510 | 0 | 478041 | 0 | 0 | 0 |
| RICHARD IMBIMBO | |||||||||||||
| 250335 | 0 | 27900 | 0 | 0 | 0 | 2000 | 0 | 10314 | 0 | 290549 | 0 | 0 | 0 |
| SUSAN M GORDON | |||||||||||||
| 142731 | 0 | 13790 | 0 | 1000 | 0 | 2000 | 0 | 996 | 0 | 160517 | 0 | 0 | 0 |
| MANU S RAJACHANDRAN | |||||||||||||
| 559999 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 11681 | 0 | 571680 | 0 | 0 | 0 |
| VAN D ADAMS | |||||||||||||
| 454201 | 0 | 0 | 0 | 0 | 0 | 2000 | 0 | 14186 | 0 | 470387 | 0 | 0 | 0 |
| RAYMOND S CUZZANITI | |||||||||||||
| 432878 | 0 | 0 | 0 | 0 | 0 | 2000 | 0 | 13948 | 0 | 448826 | 0 | 0 | 0 |
| HAOEH M JUNG | |||||||||||||
| 430118 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 11434 | 0 | 441552 | 0 | 0 | 0 |
| JOSEPH E ROBINSON | |||||||||||||
| 411638 | 0 | 0 | 0 | 0 | 0 | 2000 | 0 | 6894 | 0 | 420532 | 0 | 0 | 0 |
| HUGH PALMER DO | |||||||||||||
| 4550 | 125000 | 0 | 26795 | 0 | 900 | 0 | 0 | 0 | 5790 | 4550 | 158485 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 1A | SOCIAL CLUB DUES ARE REPORTED AS TAXABLE COMPENSATION ON FORM W-2 AND ARE PROVIDED TO THE FOLLOWING: SALLY J DIXON, PRESIDENT/CEO SUSAN GORDON, VP NURSING RICHARD IMBIMBO, CFO |
| PART I, LINE 4B | PART I, LINE 4B: SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENT SET-ASIDE: SALLY DIXON, PRESIDENT/CEO, $60,721 |
Schedule L IRS990ScheduleL
Loan Table LoanTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | CAROL ST GEORGE DO DIRECTOR | NamePerson |
| Purpose Of Loan | EQUIPMENT PURCHASE | PurposeOfLoan |
| Loan From Organization | X | LoanFromOrganization |
| Original Principal | $17,248 | OriginalPrincipalAmount |
| Balance Due | 12853 | BalanceDue |
| Default | 0 | Default |
| Approved By Board | 1 | ApprovedByBoard |
| Written Agreement | 1 | WrittenAgreement |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 12853 | TotalBalanceDue |
Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| MILLER & DIPIETRO ASSOCIATES | |||
| TERRY N. YORK D.O., DIRECTOR, IS PARTNER IN MILLER & DIPIETRO PARTNERSHIP | 749710 | MILLER & DIPIETRO ASSOCIATES, MILLER & DIPIETRO PARTNERSHIP, AND MEDICAL IMAGING SYSTEMS OF YORK PROVIDED MEDICAL SERVICES. TERRY N. YORK IS A PARTNER WITH MILLER & DIPIETRO ASSOCIATES WHICH IS AFFILIATED WITH MILLER & DIPIETRO PARTNERSHIP AND MEDICAL IMAGING SYSTEMS OF YORK. | 0 |
| FULTON BANK-DROVERS DIVISION | |||
| DAVID W. FREEMAN, DIRECTOR, IS ASSISTANT TREASURER OF FULTON BANK | 209883 | FULTON BANK PROVIDED BANKING/FINANCIAL SERVICES. | 0 |
| MAUREEN M MALINA | |||
| MAUREEN M MALINA IS SPOUSE OF RICHARD IMBIMBO, CHIEF FINANCIAL OFFICER | 44198 | SOCIAL WORKER FOR THE HOMECARE AND HOSPICE DEPARTMENT OF MEMORIAL HOSPITAL. | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE ACCOUNTING DEPARTMENT PROVIDES INFORMATION TO THE INDEPENDENT ACCOUNTANT FOR PREPARATION OF THE FORM 990. THE DRAFT IS REVIEWED BY THE CEO. THE FINAL DOCUMENT IS PRESENTED TO THE FINANCE COMMITTEE OF MEMORIAL HOSPITAL. THE FULL BOARD OF MEMORIAL HOSPITAL RECEIVES A COPY OF THE FINAL RETURN BEFORE FILING. | |
| THE ORGANIZATION USES AN ANNUAL QUESTIONNAIRE TO DETERMINE IF ALL EMPLOYEES AND MEMBERS OF THE BOARD ARE INDEPENDENT. THE EMPLOYEE QUESTIONNAIRES ARE INITIALLY COMPLETED AS PART OF THE ORIENTATION PROGRAM UPON EMPLOYMENT, AND THEN AS PART OF THE ANNUAL REVIEW PROCESS. THESE FORMS ARE REVIEWED BY THE DIRECTOR OF HUMAN RESOURCES AND ANY POTENTIAL CONFLICT OF INTEREST IS REVIEWED WITH THE RELATED PARTY. ANNUAL QUESTIONNAIRES FOR THE BOARD/SENIOR MANAGEMENT ARE COLLECTED BY THE CEO AND ARE REVIEWED BY THE CEO AND THE BOARD CHAIRPERSON. AT THE BOARD LEVEL, ANY POTENTIAL CONFLICT IS MONITORED BY THE CEO AND CHAIR, AND BOARD MEMBERS WILL REFRAIN FROM VOTING ON CONFLICT/RELATED ISSUES. IN ADDITION TO THE REPORTING REQUIRED, KEY EMPLOYEES AND SENIOR MANAGEMENT ARE MONITORED BY THE CEO THROUGH THE PURCHASING AND CASH DISTRIBUTIONS CONTROLS IN PLACE. | FORM 990, PART VI, SECTION B, LINE 12C | |
| THE DETERMINATION OF THE COMPENSATION OF THE TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS OF THE ORGANIZATION INCLUDES A REVIEW AND APPROVAL BY THE COMPENSATION COMMITTEE OF MEMORIAL HOSPITAL. AN OUTSIDE CONSULTANT IS RETAINED BY THE COMPENSATION COMMITTEE. ON AN ANNUAL BASIS, THE CONSULTANT CONDUCTS A COMPENSATION SURVEY OF COMPARABLE EXECUTIVE POSITIONS AT COMPARABLE HOSPITALS WITHIN OUR GENERAL GEOGRAPHIC MARKETPLACE. THE CONSULTANT WILL ALSO ADVISE THE BOARD ON CURRENT TRENDS REGARDING COMPENSATION IN HEALTHCARE AND THE MARKETPLACE, INCLUDING THE REVIEW AND ESTABLISHMENT OF A VARIABLE PAY ("INCENTIVE") PROGRAM. THE COMMITTEE'S GENERAL GUIDELINES ARE TO MAINTAIN A BASE SALARY WITHIN THE 50TH-60TH PERCENTILE OF SIMILAR POSITIONS IN PEER INSTITUTIONS. ALONG WITH THE VARIABLE PAY OPPORTUNITY, TOTAL COMPENSATION IS GEARED TO THE 75TH PERCENTILE AND SHOULD NOT EXCEED THE 90TH PERCENTILE. IN UNIQUE AND SUPPORTABLE CIRCUMSTANCES, THE COMMITTEE MAY DEVIATE FROM THESE GUIDELINES. THE COMPENSATION IS REVIEWED BY THE EXECUTIVE COMMITTEE. THE DELIBERATION AND DECISION PROCESS IS CONTEMPORANEOUSLY DOCUMENTED. | FORM 990, PART VI, SECTION B, LINE 15 | |
| THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. | FORM 990, PART VI, SECTION C, LINE 19 | |
| JAMES R. ZARFOSS, JR., DECEASED, CAN NO LONGER BE REACHED AT THE ORGANIZATION'S MAILING ADDRESS. | FORM 990, PART VI, LINE 9: | |
| CORPORATE OFFICERS AND CERTAIN MEMBERS OF THE BOARD OF DIRECTORS DEVOTE TIME TO THIS ORGANIZATION AND ALSO TO RELATED ORGANIZATIONS. TOTAL AVERAGE HOURS PER WEEK WORKED FOR THE ENTIRE SYSTEM ARE AS FOLLOWS: JACK KAY 8 CHLOE R EICHELBERGER 6 JAMES R ZARFOSS 4 RICHARD D POOLE 3 SALLY J DIXON 49 RICHARD IMBIMBO 45 | FORM 990, PART VII, COLUMN B: AVERAGE HOURS PER WEEK: | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | NET UNREALIZED GAINS ON INVESTMENTS: 210,408. TRANSFER TO MEI, INC. A RELATED COMPANY -21,947. TRANSFER TO MEMORIAL HEALTH SYSTEMS CORPORATION, A RELATED EXEMPT ORG. -2,843,880. TOTAL TO FORM 990, PART XI, LINE 5: -2,655,419. | FORM 990, PART XI, LINE 5: |
| THE FINANCE COMMITTEE IS RESPONSIBLE FOR THE OVERSIGHT OF THE AUDIT AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED IN THE LAST YEAR. | FORM 990, PART XI, LINE 2: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| SURGICAL CENTER OF YORK | |||||||||||
| 1750 FIFTH AVENUE | YORK | PA | 17403 | 232507740 | OUT PATIENT SURGERY CENTER | PA | 501(C)3 | 3 | MEMORIAL HEALTH SYSTEMS CORPORATION | 0 | |
| MEMORIAL HEALTH SYSTEMS CORPORATION | |||||||||||
| 1708 FIFTH AVENUE | YORK | PA | 17403 | 222546051 | SUPPORT AND DEVELOPMENT OF PROGRAMS FOR THE BENEFIT OF RELATED PARTIES | PA | 501(C)3 | 11 TYPE I | 0 | N/A | |
| MHS TITLE HOLDING CORP | |||||||||||
| 325 SOUTH BELMONT STREET | YORK | PA | 17403 | 222546052 | REAL PROPERTY MANAGEMENT FOR RELATED ENTITIES | PA | 501(C)3 | 11 TYPE I | MEMORIAL HEALTH SYSTEMS CORPORATION | 0 | |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEMORIAL ENTERPRISES INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 325 SOUTH BELMONT STREET | AddressLine1 |
| City | YORK | City |
| State | PA | State |
| ZIP Code | 17403 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 232353226 | EIN |
| Primary Activity | MEDICAL CLINICS | PrimaryActivity |
| Legal Domicile State | PA | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | 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 | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |