STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

LEHIGH VALLEY HOSPITAL - SCHUYKILL: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
LEHIGH VALLEY HOSPITAL - SCHUYKILL (EIN 23-1352202)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-14
IRS object ID
201231359349303583
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

FieldValueIRS element (for citing)
Timestamp2012-05-14T13:25:17-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PARENTEBEARD LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1400 MARKET STREETAddressLine1
CityWILLIAMSPORTCity
StatePAState
ZIP Code17701ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN231352202EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SCHUYLKILL MEDICAL CTR - SOUTH JACKSONBusinessNameLine1
Business Name Line2ST F/K/A POTTSVILLE HOSP & WARNE CLINICBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlSCHUNameControl
Phone5706215000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1MAUCH CHUNK AND JACKSON STREETSAddressLine1
CityPOTTSVILLECity
StatePAState
ZIP Code17901ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOHN E SIMODEJKA PRESIDENTCEOName
TitlePRESIDENT/CEOTitle
Phone5706215000Phone
Date Signed2012-05-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJULIUS C GREEN CPA JDName
Phone5703236023Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJOHN E SIMODEJKANameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1MAUCH CHUNK AND JACKSON STREETSAddressLine1
CityPOTTSVILLECity
StatePAState
ZIP Code17901ZIPCode
FieldValueIRS element (for citing)
Gross Receipts93049464GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.SCHUYLKILLHEALTH.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2008YearFormation
State Legal DomicilePAStateLegalDomicile
Activity Or Mission DescriptionTO MAKE A POSITIVE DIFFERENCE IN THE SCOPE AND QUALITY OF HEALTHCARE FOR THE SCHUYLKILL COMMUNITY.ActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees1015TotalNbrEmployees
Total Nbr Volunteers41TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year544967ContributionsGrantsPriorYear
Contributions Grants Current Year754767ContributionsGrantsCurrentYear
Program Service Revenue Prior Year83501318ProgramServiceRevenuePriorYear
Program Service Revenue CY88312632ProgramServiceRevenueCY
Investment Income Prior Year437375InvestmentIncomePriorYear
Investment Income Current Year146522InvestmentIncomeCurrentYear
Other Revenue Prior Year984080OtherRevenuePriorYear
Other Revenue Current Year3778843OtherRevenueCurrentYear
Total Revenue Prior Year85467740TotalRevenuePriorYear
Total Revenue Current Year92992764TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year1500GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY8891GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year50309031SalariesEtcPriorYear
Salaries Etc Current Year50186039SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year44776149OtherExpensePriorYear
Other Expenses Current Year42979128OtherExpensesCurrentYear
Total Expenses Prior Year95086680TotalExpensesPriorYear
Total Expenses Current Year93174058TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-9618940RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-181294RevenuesLessExpensesCY
Total Assets BOY58009848TotalAssetsBOY
Total Assets EOY53301818TotalAssetsEOY
Total Liabilities BOY82936836TotalLiabilitiesBOY
Total Liabilities EOY64218346TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-24926988NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-10916528NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionSCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET'S MISSION IS TO MAKE A POSITIVE DIFFERENCE IN THE SCOPE AND QUALITY OF HEALTHCARE AVAILABLE FOR THE SCHUYLKILL COUNTY COMMUNITY.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense77031055Expense
Grants8891Grants
Revenue88478088Revenue
DescriptionIN FISCAL YEAR 2011, SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET ADMITTED 8,730 INPATIENTS, PROVIDED EMERGENCY CARE FOR 30,675 PEOPLE, DELIVERED MORE THAN 1,030 BABIES, DID MORE THAN 13,600 HOME HEALTH CARE VISITS AND PROVIDED MORE THAN 92,200 OUTPATIENT TESTS AND PROCEDURES.THE SCHUYLKILL HEALTH SYSTEM HAS A COMPREHENSIVE CHARITY CARE PROGRAM. CHARGES FOREGONE FOR SERVICES RENDERED AND SUPPLIES FURNISHED UNDER THIS PROGRAM AMOUNTED TO $1,800,000 DURING FISCAL YEAR 2011.SCHUYLKILL HEALTH IS COMMITTED TO THE PHYSICAL, MENTAL, AND EMOTIONAL HEALTH OF OUR ENTIRE COMMUNITY. AS A HEALTHCARE FACILITY, WE ARE CONCERNED WITH THE HEALTH AWARENESS OF OUR NEIGHBORS, FAMILY, AND FRIENDS.OUR COMMUNITY LOOKS TO US TO HELP EDUCATE THEM ON CURRENT HEALTH CARE TOPICS AS WELL AS THE EVERYDAY HEALTH ISSUES THAT CONCERN EVERYONE. THROUGH OUR INITIATIVES WE CAN REACH OUT AND HELP OTHERS UNDERSTAND WHERE TO GO, WHAT TO ASK, AND WHO TO SEE FOR THEIR HEALTHCARE NEEDS. WE CAN GIVE OUR COMMUNITY THE CONFIDENCE THEY NEED WHEN MAKING WISE CHOICES. SCHUYLKILL MEDICAL CENTER HOSTS APPROXIMATELY TWELVE (12) COMMUNITY HEALTH AWARENESS TALKS ("CHAT") A YEAR. MONTHLY PROGRAMS ARE HELD ON CAMPUS OR CHAT ON THE ROADS. CHAT TOPICS HAVE INCLUDED, BUT ARE NOT LIMITED TO NUTRITION, PHYSICAL FITNESS, DIABETES AWARENESS, BREAST CANCER AWARENESS, CANCER, ARTHRITIS, SEIZURE TREATMENTS, AND HEART HEALTH TO NAME A FEW.SCHUYLKILL HEALTH ALSO SPONSORS AN ANNUAL "WOMEN'S DAY"; WOMEN HAVE GATHERED OVER THE PAST SEVEN YEARS TO ATTEND A FREE EVENT. ALL GENERATIONS ENJOY BEING EDUCATED, HAVING THE ABILITY TO ASK QUESTIONS IN A COMFORTABLE SETTING WHILE SPENDING TIME WITH OLD AND NEW FRIENDS, AND SIPPING ON THAT GREAT CUP OF COFFEE. WE EXPLORE THE "WHOLE" PERSON - BODY, MIND, AND SPIRIT AND ENABLE THEM TO CAPTURE INFORMATION TO SHARE WITH OTHERS AT HOME, WORK, OR IN THEIR NEIGHBORHOOD.SCHUYLKILL MEDICAL CENTER HOSTS A CANCER SUPPORT GROUP FOR CANCER SURVIVORS, FAMILY AND CARE GIVERS. EACH MONTH, A GROUP OF SURVIVORS GATHER TO TALK ABOUT RECENT TREATMENT, HOW THEY ARE FEELING AND TO CELEBRATE LIFE. WE ALSO HOST A GENTLE YOGA WELLNESS PROGRAM FOR SURVIVORS AND CARE GIVERS. THOSE IN ATTENDANCE HAVE SLEPT BETTER, THEIR "HOT FLASHES" HAVE CEASED, AND THEY ARE ABLE TO RELAX. WE HOLD A FREE SKIN CANCER SCREENING TO THE GENERAL PUBLIC. WE SCREEN APPROXIMATELY 125 PEOPLE AND REFER APPROXIMATELY 50 PEOPLE. THIS SCREENING SAVES LIVES. DIABETES NUMBERS CONTINUE TO RISE, ESPECIALLY IN SCHUYLKILL COUNTY. WE OFFER FREE DIABETES EDUCATION ALONG WITH A DIABETES SUPPORT GROUP.WE ALSO HOLD A 5K WALK/RUN FOR DIABETES, THE GOAL IS TO INCREASE THE AWARENESS AND RISKS ASSOCIATED WITH DIABETES. APPROXIMATELY 150 RUNNERS AND 200 WALKERS PARTICIPATE AS WELL AS NUMEROUS FRIENDS AND FAMILY TAKE ADVANTAGE OF INFORMATION PRESENTATIONS.FREE HEALTH SCREENINGS AND WELLNESS PROGRAMS ARE HELD THROUGHOUT THE YEAR AT VARIOUS LOCATIONS IN OUR COMMUNITY. BLOOD PRESSURES, BODY FAT, BONE DENSITY SCREENINGS ARE JUST A FEW OF THE SERVICES WE PROVIDE AT NO COST TO OUR COMMUNITY.Description
Total Program Service Expense77031055TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109639NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1015NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledPAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1BERNIE KOSKULITZ DIRECTOR FINANCEBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5706215142TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1420 SOUTH JACKSON STREETAddressLine1
CityPOTTSVILLECity
StatePAState
ZIP Code17901ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (23 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
JESSE ACHENBACH
TRUSTEE1.00X000
ANTHONY BARAN
TRUSTEE1.00X000
DEBRA BLASCHAK
TRUSTEE1.00X000
SARAH CASEY
TRUSTEE1.00X000
JAMES GALLAGHER EDD
TRUSTEE1.00X000
WILLIAM L JONES III
TRUSTEE1.00X000
ALLEN E KIEFER
TRUSTEE1.00X000
FRANKLIN K SCHOENEMAN
TRUSTEE1.00X000
SYED SHAH MD
TRUSTEE1.00X000
ROBERT M ZIMMERMAN JRD
TRUSTEE1.00X000
JUDGE JOSEPH F MCCLOSKEY
CHAIRMAN1.00X000X
JUDGE WILLIAM BALDWIN
VICE CHAIRMAN1.00X000X
JAY M LINARD
SECRETARY1.00X000X
WILLIAM KIRWAN CPA ESQ
TREASURER1.00X000X
JOHN E SIMODEJKA
PRESIDENT/CEO14.00401645015152X
DIANE BORIS
CFO16.00010724119293X
DANIEL KOCHIE
COO20.00016933017206X
DARNELL FURER
CNO20.1001709915777X
RICHARD BINDIE
DIRECTOR OF PATHOLOGY37.50275009013228X
LYNDA L JAKUBCO
CRNA37.50219665013205X
JULIANNE M TIDMORE
CRNA37.50230511014195X
MARY R TUNNESSEN
CRNA37.50217322013205X
SHERRY L BURINSKY BOTTOR
CRNA37.50248586014195X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1592738TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs447562TotalReportableCompFrmRltdOrgs
Total Other Compensation125456TotalOtherCompensation
Number Individuals GT100 K24NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
SODEXHO INC & AFFILIATES
PO BOX 360170PITTSBURGHPA15251DIETARY1114492
QUEST DIAGNOSTICS INC
12436 COLLECTIONS CENTER DRIVECHICAGOIL60693REFERENCE LAB SERVICE915187
ARAMARK
450 WASHINGTON STREETPOTTSVILLEPA17901CLINICAL ENGINEERING AND ENVIRONMENTAL636743
CAPITAL REGION SLEEP DISORDERS
3450 W CENTRAL AVE SUITE 118TOLEDOOH43606SLEEP LAB439600
GEISINGER MEDICAL CENTER
100 NORTH ACADEMY AVENUEDANVILLEPA17822REFERENCE LAB SERVICE413940
FieldValueIRS element (for citing)
Number Of Contractors GT100 K15NumberOfContractorsGT100K
Government Grants101030GovernmentGrants
All Other Contributions653737AllOtherContributions
Total Contributions754767TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICE RE6214008776018387760183
SCHOOL OF NURSING621400552449552449
FieldValueIRS element (for citing)
Total Program Service Revenue88312632TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column155280TotalRevenueColumn
Exclusion$155,280ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real38594Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real32685Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real5909Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column5909TotalRevenueColumn
Exclusion$5,909ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other15257Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other24015Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-8758Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-8758TotalRevenueColumn
Exclusion-$8,758ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
MEANINGFUL USE REVENUE5614392292640$2,292,640
TOBACCO SETTLEMENT FUN561439581022$581,022
CAFETERIA & VENDING561439329195$329,195

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column570077TotalRevenueColumn
Related Or Exempt Function Income165456RelatedOrExemptFunctionIncome
Exclusion$404,621ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue3772934TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column92992764TotalRevenueColumn
Related Or Exempt Function Income88478088RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$3,759,909ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total6156Total
Program Services6156ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total2735Total
Program Services2735ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total39457063Total
Program Services32545599ProgramServices
Management And General6911464ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2446128Total
Program Services2017654ProgramServices
Management And General428474ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total5451399Total
Program Services5404716ProgramServices
Management And General46683ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2831449Total
Program Services2353987ProgramServices
Management And General477462ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total120800Total
Management And General120800ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total136560Total
Management And General136560ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total23245Total
Program Services23245ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total10074432Total
Program Services6307465ProgramServices
Management And General3766967ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total74259Total
Management And General74259ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total11403581Total
Program Services10329832ProgramServices
Management And General1073749ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1425993Total
Program Services16358ProgramServices
Management And General1409635ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total103136Total
Program Services87020ProgramServices
Management And General16116ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total45660Total
Program Services17429ProgramServices
Management And General28231ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1727400Total
Program Services1727400ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total4678100Total
Program Services4678100ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total921924Total
Program Services921924ProgramServices

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT EXPENSE68373376837337
DRUGS31298833129883
COLLECTION FEES10573411057341
FOOD561883561883
DATA PROCESSING3855736220379353

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total272021Total
Program Services56112ProgramServices
Management And General215909ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total93174058Total
Program Services77031055ProgramServices
Management And General16143003ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1501BOY
EOY1500EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY7261412BOY
EOY5035733EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY11117885BOY
EOY9154975EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1172916BOY
EOY1092255EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY337106BOY
EOY464788EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis77315938LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec52625761LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY27892032BOY
EOY24690177EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY1114845BOY
EOY842343EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY4757060BOY
EOY4996659EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY4355091BOY
EOY7023388EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY58009848BOY
EOY53301818EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY46816945BOY
EOY31535205EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY463750BOY
EOY393750EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY27982666BOY
EOY26744238EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1500000BOY
EOY1500000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY6173475BOY
EOY4045153EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY82936836BOY
EOY64218346EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-28705281BOY
EOY-15269200EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY24001BOY
EOY34724EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY3754292BOY
EOY4317948EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-24926988BOY
EOY-10916528EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY58009848BOY
EOY53301818EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-181294ReconcilationRevenueExpenses
Reconcilation Other Changes14191754ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations1GrantsOtherOrganizations
Grants Other Organizations$11,995GrantsOtherOrganizationsAmount
Direct Contact Legislators1DirectContactLegislators
Direct Contact Legislators$11,250DirectContactLegislatorsAmount
Rallies Demonstrations0RalliesDemonstrations
Other Activities0OtherActivities
Total Lobbying Expenditures IIB23245TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF OTHER LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1I:ReturnReference
ExplanationA PORTION OF THE HOSPITAL'S DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE HOSPITAL ASSOCIATION OF PENNSYLVANIA (HAP) ARE USED FOR LOBBYING PURPOSES. BOB ALLEN WORKED ON BEHALF OF THE HOSPITAL WITH GOVERNMENTAL OFFICIALS AND REPRESENTATIVES OF AND CONSULTANTS TO STATE AND LOCAL GOVERNMENTAL AGENCIES, BOARDS, COMMITTEES AND COMMISSIONS, INCLUDING WITHOUT LIMITATION MEETINGS WITH SUCH OFFICIALS, REPRESENTATIVES AND CONSULTANTS, REGARDING LEGISLATIVE, REGULATORY AND OTHER ISSUES THAT AFFECT THE INTERESTS AND AFFAIRS OF THE HOSPITAL AS MAY BE ASSIGNED BY THE HOSPITAL FROM TIME TO TIME. BOB ALLEN ALSO ATTENDS AND REPORTS AT HOSPITAL BOARD MEETINGS AND STAFF MEETINGS, IF REQUIRED. BOB ALLEN ALSO PERFORMS SUCH OTHER TASKS AND ACTIVITIES OF A GENERAL GOVERNMENTAL RELATIONS NATURE AS MAY BE ASSIGNED BY THE HOSPITAL FROM TIME TO TIME.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis745633OtherCostOrOtherBasis
Book Value745633BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis48616444OtherCostOrOtherBasis
Depreciation32992633Depreciation
Book Value15623811BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis26800871OtherCostOrOtherBasis
Depreciation19481591Depreciation
Book Value7319280BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1152990OtherCostOrOtherBasis
Depreciation151537Depreciation
Book Value1001453BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings24690177TotalOfBookValueLandBuildings

Other Securities OtherSecurities (3 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
FEDERAL AGENCY OBLIGATIONS1754635F
ACCRUED INVESTMENT INCOME14132F
INVESTMENT IN PENNSYLVANIA COMMUNITY HOSPITAL ASSOCIATION3227892C
FieldValueIRS element (for citing)
Total Of Book Value Securities4996659TotalOfBookValueSecurities

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
BENEFICIAL INTEREST IN PERPETUAL TRUST3926067
DEFERRED FINANCING COSTS, NET71760
BENEFICIAL INTEREST IN ASSETS HELD BY FOUNDATION68899
ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS2956662
FieldValueIRS element (for citing)
Total Book Value Other Assets7023388TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
OBLIGATION UNDER CAPITAL LEASE$2,646,624
BLUE CROSS CURRENT FINANCING ADVANCE$479,000
ESTIMATED MEDICAL MALPRACTICE CLAIMS LIABILITY$639,467
DUE TO AFFILIATES$280,062
FieldValueIRS element (for citing)
Total Of Amounts4045153TotalOfAmounts
Total Revenue92992764TotalRevenue
Total Expenses93174058TotalExpenses
Excess Or Deficit For Year-181294ExcessOrDeficitForYear
Other$14,191,754OtherAmount
Total Adjustments14191754TotalAdjustments
Excess Or Deficit Per FS14010460ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt107217203TotRevenueEtcAuditedFinclStmt
Other Revenues14191754OtherRevenues
Revenue Not Rptd F99014191754RevenueNotRptdF990
Revenue Subtotal93025449RevenueSubtotal
Other Revenues Not Included-32685OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt-32685RevenueNotRptdOnFinStmt
Total Revenue Per Form99092992764TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt93206743TotExpensesEtcAuditedFinclStmt
Other Expenses Included32685OtherExpensesIncluded
Expenses Not Rptd F99032685ExpensesNotRptdF990
Expenses Subtotal93174058ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99093174058TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:THE CORPORATION PRESCRIBES A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY IN RECORDING TAX LIABILITIES IN THE FINANCIAL STATEMENTS. MEASUREMENT AND RECOGNITION OF THE TAX INCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. FEDERAL EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURNS FOR THE MEDICAL CENTERS, THE FOUNDATION, SMG, AND THE CENTERS FOR 2010, 2009, AND 2008 REMAIN SUBJECT TO EXAMINATION BY THE IRS.
PART XI, LINE 8 - OTHER ADJUSTMENTS:PENSION LIABILITY ADJUSTMENT 13,658,726. POSTRETIREMENT BENEFIT LIABILITY ADJUSTMENT -136,818. INCREASE IN NET ASSETS OF AFFILIATE 106,190. VALUATION GAIN 563,656.
PART XII, LINE 2D - OTHER ADJUSTMENTS:POST RETIREMENT BENEFIT LIABILITY ADJUSTMENT -136,818. INCREASE IN INTEREST IN NET ASSETS OF AFFILIATE 106,190. VALUATION GAIN 563,656. PENSION LIABILITY ADJUSTMENT 13,658,726.
PART XII, LINE 4B - OTHER ADJUSTMENTS:RENTAL EXPENSES -32,685.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSES 32,685.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage250.000000000000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent250XPcent250
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report0AnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense446060TotalCommunityBenefitExpense
Net Community Benefit Expense446060NetCommunityBenefitExpense
Percent Of Total Expense0.00520PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense12600568TotalCommunityBenefitExpense
Direct Offsetting Revenue9387544DirectOffsettingRevenue
Net Community Benefit Expense3213024NetCommunityBenefitExpense
Percent Of Total Expense0.03720PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense13046628TotalCommunityBenefitExpense
Direct Offsetting Revenue9387544DirectOffsettingRevenue
Net Community Benefit Expense3659084NetCommunityBenefitExpense
Percent Of Total Expense0.04240PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense124877TotalCommunityBenefitExpense
Net Community Benefit Expense124877NetCommunityBenefitExpense
Percent Of Total Expense0.00140PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense33696TotalCommunityBenefitExpense
Direct Offsetting Revenue1750DirectOffsettingRevenue
Net Community Benefit Expense31946NetCommunityBenefitExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense4574141TotalCommunityBenefitExpense
Direct Offsetting Revenue3047481DirectOffsettingRevenue
Net Community Benefit Expense1526660NetCommunityBenefitExpense
Percent Of Total Expense0.01770PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense4732714TotalCommunityBenefitExpense
Direct Offsetting Revenue3049231DirectOffsettingRevenue
Net Community Benefit Expense1683483NetCommunityBenefitExpense
Percent Of Total Expense0.01950PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense17779342TotalCommunityBenefitExpense
Direct Offsetting Revenue12436775DirectOffsettingRevenue
Net Community Benefit Expense5342567NetCommunityBenefitExpense
Percent Of Total Expense0.06190PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense1232TotalCommunityBuildingExpense
Net Community Building Expense1232NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense50TotalCommunityBuildingExpense
Net Community Building Expense50NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense246TotalCommunityBuildingExpense
Net Community Building Expense246NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense423TotalCommunityBuildingExpense
Net Community Building Expense423NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Total Community Building Expense26092TotalCommunityBuildingExpense
Net Community Building Expense26092NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense28043TotalCommunityBuildingExpense
Net Community Building Expense28043NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$6,837,337BadDebtExpenseAmount
Amount Attributable To2780847AmountAttributableTo
Amount Reimbursed By Medicare28189782AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare29836249CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-1646467MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1SCHUYLKILL MEDICAL CENTER SOUTH JACKSONBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1420 SOUTH JACKSON STREETAddressLine1
CityPOTTSVILLECity
StatePAState
ZIP Code17901ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1NOT REQUIREDBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)

ExplanationExplanation
PART I, LINE 7: SCHUYLKILL MEDICAL CENTER - SOUTH COMPUTED A COST TO CHARGE RATIO USING INFORMATION FROM THE MOST RECENTLY FILED MEDICARE COST REPORT (FYE 6/30/11) FOR THE CALCULATION OF COSTS FOR CHARITY CARE AND MEDICAID. DIRECT COSTS ARE OBTAINED FROM THE HOSPITAL COMPUTER SYSTEM FOR EACH COST CENTER FOR ALL OTHER BENEFITS. INDIRECT COSTS ARE COMPUTED UTILIZING THE MOST RECENTLY FILED MEDICARE COST REPORT (FYE 6/30/11).
PART I, LINE 7G: THERE ARE NO PHYSICIAN CLINICAL SERVICES INCLUDED.
PART I, L7 COL(F): THE AMOUNT OF BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25 COLUMN (A) BUT SUBTRACTED OUT FOR PURPOSES OF CALCULATING THE PERCENTAGE ON SCH H, PART I, LINE 7, COLUMN (F) IS $6,837,337.
PART II: ECONOMIC DEVELOPMENT - SCHUYLKILL COUNTY CHILD DEVELOPMENT POLICY COUNCIL, CHILD DEVELOPMENT IS A DAY CARE PROGRAM IN SCHUYLKILL COUNTY THAT IS PROVIDED TO ANYONE BUT IS FOCUSED ON CHILDREN OF PARENTS WHO CANNOT AFFORD TO PAY THE FULL COST OF DAYCARE. IF THIS SERVICE WAS NOT AVAILABLE FOR THESE PARENTS, THEY WOULD NOT BE ABLE TO WORK BECAUSE THEY WOULD HAVE TO STAY HOME TO TAKE CARE OF THEIR CHILDREN. WE HAVE A CLINICAL RN CHARGE NURSE WHO ATTENDS THE MEETINGS AND IS A MEMBER OF THIS POLICY COUNCIL.COMMUNITY SUPPORT - BRIDGE HOUSE OF SCHUYLKILL COUNTY - THE BRIDGE HOUSING PROGRAM IS A TRANSITIONAL HOUSING SERVICE LOCATED ON THE GROUNDS OF THE POTTSVILLE HOUSING AUTHORITY AT LAUREL TERRACE, POTTSVILLE, PENNSYLVANIA. BRIDGE HOUSING PROVIDES COMPREHENSIVE SERVICES TO PERSONS FACING LONG-TERM HOMELESSNESS AND PROVIDES A SUPPORTIVE, SAFE ENVIRONMENT FOR ADULTS AND CHILDREN. STUDENTS FROM THE SCHOOL OF NURSING PROVIDE TALKS TO RESIDENTS ABOUT SEVERAL DIFFERENT HEALTH TALKS INCLUDING PARENTING AND HEALTH PREVENTION.COALITION BUILDING - SCHUYLKILL COUNTY CHILD DEVELOPMENT HEALTH ADVISORY - FOR THIS WE HAVE ONE OF OUR SCHOOL OF NURSING INSTRUCTORS ADVISE CHILD DEVELOPMENT ON CERTAIN HEALTH MATTERS. THIS HELPS FORM A PARTNERSHIP OR COALITION WITH SCHUYLKILL COUNTY CHILD DEVELOPMENT.WORKFORCE DEVELOPMENT - SCHUYLKILL TRAINING AND TECHNOLOGY CENTER PROVIDES ASSISTANCE AND GUIDANCE TO THE LPN PROGRAM AT THE TRAINING & TECHNOLOGY CENTER AND ALSO KEEPS THE ADMINISTRATION AND LPN PROGRAM FACULTY UP TO DATE ON HEALTH CARE RELATED INFORMATION. THIS HELPS TO ENSURE THE LPN PROGRAM HAS A BACKGROUND THAT IS UP TO DATE TO PROVIDE THE STUDENTS TO ENTER THE WORKFORCE RIGHT AFTER GRADUATION.
PART III, LINE 4: ACCOUNTS RECEIVABLE, OTHER 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 PERIODIC REVIEW OF INDIVIDUAL ACCOUNTS.ALL APPROPRIATE DISCOUNTS AND PAYMENTS ARE REFLECTED ON EACH PATIENTS' ACCOUNT. ONCE A PATIENT IS IDENTIFIED AS BAD DEBT, THE BALANCE THAT IS BAD DEBT WOULD BE CHARGES NET OF ANY PAYMENTS OR ADJUSTMENTS. THE COST OF BAD DEBT EXPENSE IS CALCULATED BY USING THE COST TO CHARGE RATIO FROM THE MOST RECENTLY FILE MEDICARE COST REPORT AND APPLYING THAT TO THE CHARGE.WE BELIEVE THAT A PORTION OF OUR BAD DEBTS RESULTS FROM SERVICES PROVIDED TO PATIENTS WHO MEET THE CHARITY CARE GUIDELINES BUT WERE UNABLE OR UNWILLING TO PROVIDE THE APPROPRIATE DOCUMENTATION TO ALLOW THAT CLASSIFICATION. THESE WOULD BE CLASSIFIED AS BAD DEBT EXPENSE TIMES THE COST TO CHARGE RATIO TO ARRIVE AT THE COST.
PART III, LINE 8: THE HOSPITAL CONTINUES TO PROVIDE CARE TO ALL PRESENTING AND ADMITTED PATIENTS, REGARDLESS OF ABILITY OR PAY. NOTWITHSTANDING THE COSTS TO PROVIDE CARE, RECEIVING "LESS" THAN WHAT IT COSTS TO PROVIDE ADEQUATE CARE TO MEDICARE COVERED LIVES DOES THE HOSPITAL A DISSERVICE. THIS SHORTFALL SHOULD COUNT AS A COMMUNITY BENEFIT. THE HOSPITAL USES THE COST-TO-CHARGE RATIO TO DETERMINE THE MEDICARE ALLOWABLE COSTS.
PART III, LINE 9B: THE ORGANIZATION DOES HAVE A WRITTEN DEBT COLLECTION POLICY. ALL STAFF INVOLVED IN DEBT COLLECTION (EMPLOYEES OF THE MEDICAL CENTER AND ANY THIRD PARTY AGENCIES) ARE TRAINED ON THE POLICY AS WELL AS THE CHARITY CARE POLICY. IN DEALING WITH PATIENTS IN DEBT COLLECTION, STAFF WILL INFORM PATIENTS OF THE CHARITY CARE POLICY THAT IS AVAILABLE AND ALSO ANY OTHER FINANCIAL ASSISTANCE POLICIES OF THE MEDICAL CENTER THAT MAY BE APPLICABLE TO THE PATIENT. THE STAFF WILL INSTRUCT PATIENTS ON APPROPRIATE PAPERWORK THAT NEEDS TO BE COMPLETED IN REGARDS TO CHARITY CARE OR FINANCIAL ASSISTANCE.
PART VI, LINE 2: SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET (SMS-SJS) WORKS WITH SCHUYLKILL MEDICAL CENTER - EAST NORWEGIAN STREET (SMS-ENS) IN ASSESSING THE HEALTH NEEDS OF THE COMMUNITY IT IS LOCATED IN AND SERVES; SCHUYLKILL COUNTY IN PENNSYLVANIA. BOTH MEDICAL CENTERS ALSO WORK WITH VARIOUS CITY, COUNTY AND STATE AGENCIES TO SPECIFICALLY IDENTIFY THE HEALTH NEEDS OF THE RESIDENTS OF SCHUYLKILL COUNTY.SMC-SJS IS LOCATED IN POTTSVILLE, WHICH IS THE COUNTY SEAT FOR SCHUYLKILL COUNTY. SCHUYLKILL COUNTY IS A RURAL COUNTY. THE COUNTY HAS AN UNEMPLOYMENT RATE OF OVER 11%, 19% OF THE RESIDENTS ARE COVERED BY MEDICAID, AND 18% OF THE RESIDENTS ARE OVER THE AGE OF 65.SMC-SJS IS A 180 BED ACUTE CARE FACILITY THAT PROVIDES ACUTE MEDICAL SURGICAL CARE, ADOLESCENT AND ADULT BEHAVIORAL HEALTH SERVICES, AND TRANSITIONAL REHAB CARE AND NURSERY SERVICES TO THE COMMUNITY.SMC-SJS WORKS WITH THE SOCIAL SERVICE AGENCIES, LOCAL DEPARTMENT OF HEALTH, THE CHAMBER OF COMMERCE, UNITED WAY, AMERICAN CANCER SOCIETY, LOCAL SCHOOLS, LOCAL SUPPORT GROUPS, PHYSICIAN OFFICES AND OTHER HEALTHCARE ORGANIZATIONS IN IDENTIFYING THE HEALTHCARE NEEDS OF THE LOCAL COMMUNITIES AND THE SERVICES THAT ARE NEEDED. AFTER A NEED HAS BEEN IDENTIFIED, THE MEDICAL CENTER WORKS WITH THESE ORGANIZATIONS TO HELP PROVIDE THE SERVICE TO RESIDENTS.THE MEDICAL CENTER ALSO WORKS WITH HEALTHCARE ORGANIZATIONS OUTSIDE SCHUYLKILL COUNTY TO HELP BRING HEALTHCARE SERVICES TO THE COUNTY. THIS ALLOWS COUNTY RESIDENTS TO OBTAIN NECESSARY SERVICES CONVENIENTLY WITHIN THE COUNTY.THE MEDICAL CENTER ALSO REVIEWS INTERNAL DATA ON ADMISSIONS, EMERGENCY ROOM VISITS, CLINIC VISITS AND DIAGNOSIS TO HELP IDENTIFY COMMUNITY NEEDS. THIS INFORMATION IS REVIEWED ANNUALLY AS PART OF THE BUDGET AND STRATEGIC PLANNING PROCESS.THE BOARD OF THE MEDICAL CENTER IS COMPRISED OF INDIVIDUALS FROM THE COMMUNITY REPRESENTING SOCIAL SERVICE AGENCIES, EDUCATION, ASSISTED LIVING/LONG TERM CARE, PHYSICIANS, MATERNAL/CHILD HEALTH AND LOCAL BUSINESSES. THESE INDIVIDUALS ALSO PROVIDE INPUT ON THE NEEDS OF THE COMMUNITY IN MEETING HEALTHCARE NEEDS.
PART VI, LINE 3: EACH PATIENT IS REGISTERED INTO THE HOSPITAL COMPUTER SYSTEM WHEN THEY ARRIVE FOR SERVICES. AS PART OF THE REGISTRATION, INFORMATION IS OBTAINED ON ANY HEALTH INSURANCE THEY HAVE. INDIVIDUALS WITHOUT HEALTH INSURANCE ARE INFORMED AT THAT TIME OF THE MEDICAL CENTER'S CHARITY CARE POLICY. PATIENTS ARE GIVEN INFORMATION ON CONTACTING STAFF WITHIN THE HOSPITAL PATIENT ACCOUNTING DEPARTMENT TO DISCUSS APPLYING FOR THE HOSPITAL CHARITY CARE PROGRAM. SPECIFIC STAFF HAVE BEEN TRAINED AND ARE RESPONSIBLE FOR ADMINISTERING THE CHARITY CARE PROGRAM FOR THE HOSPITAL. HOSPITAL STAFF CONTACT PATIENTS WITHOUT INSURANCE AND EXPLAIN THE POLICY AND THE INFORMATION NEEDED TO APPLY. HOSPITAL STAFF WILL ALSO ASSIST PATIENTS IN APPLYING FOR MEDICAL ASSISTANCE. THEY WILL ALSO ASSIST PATIENTS IN COMPLETING THE APPLICATION AND GATHERING THE NECESSARY FINANCIAL DOCUMENTS.THE MEDICAL CENTER ALSO POSTS INFORMATION WITHIN THE ADMISSION AND EMERGENCY ROOM AREAS INFORMING PATIENTS THAT THERE IS A CHARITY CARE POLICY AVAILABLE. ALL REGISTRATION PERSONNEL ARE TRAINED ON THE POLICY SO THAT THEY ARE ABLE TO INFORM PATIENTS WHEN THEY ARE REGISTERED.OTHER HOSPITAL STAFF MEMBERS THAT MAY COME IN CONTACT WITH PATIENTS ARE ALSO EDUCATED REGARDING THE CHARITY CARE POLICY. THIS WOULD INCLUDE SOCIAL WORKERS, CARE MANAGERS, NURSING STAFF AND ALL DEPARTMENT DIRECTORS. THE CHARITY CARE POLICY IS AVAILABLE ON THE HOSPITAL INTRANET WHICH IS ACCESSIBLE BY ALL EMPLOYEES. THE HOSPITAL IS ALSO IN THE PROCESS OF PLACING THE POLICY ON THE HOSPITAL WEBSITE.ALL PATIENT ACCOUNTING, CASHIERING AND COLLECTION STAFF ARE ALSO EDUCATED ON THE CHARITY CARE POLICY AND CAN ASSIST PATIENTS IN APPLYING FOR CHARITY CARE. ALSO ALL THIRD PARTY ORGANIZATIONS THAT WORK ON BEHALF OF THE MEDICAL CENTER IN PERFORMING COLLECTIONS HAVE ALSO BEEN EDUCATED ON THE CHARITY CARE POLICY AND CAN ALSO ADVISE PATIENTS ON APPLYING FOR THIS BENEFIT.
PART VI, LINE 4: SMC-SJS IS LOCATED IN POTTSVILLE, PENNSYLVANIA. THE MEDICAL CENTER SERVES ALL OF SCHUYLKILL COUNTY. SCHUYLKILL COUNTY IS A RURAL COUNTY IN PENNSYLVANIA. POTTSVILLE IS THE LARGEST POPULATION CENTER OF SCHUYLKILL COUNTY AND IS ALSO THE COUNTY SEAT. THE COUNTY IS COMPRISED OF SMALL TOWNS, BOROUGHS AND TOWNSHIPS.THE POPULATION OF THE COUNTY IS APPROXIMATELY 147,000. APPROXIMATELY 25% OF THE POPULATION IS UNDER THE AGE OF 18 AND 18% IS OVER THE AGE OF 65. THE POPULATION IS 49% FEMALE AND 96% WHITE. APPROXIMATELY 11% OF THE POPULATION HAS A BACHELOR'S DEGREE OR HIGHER. 12.4% OF THE POPULATION IS BELOW THE POVERTY LEVEL. THE UNEMPLOYMENT RATE IS 11.2%.19% OF THE POPULATION IS INSURED BY MEDICAID. 42% OF THAT NUMBER ARE UNDER THE AGE OF 18, 13% ARE OVER THE AGE OF 65 AND 18 % ARE DISABLED. 50% OF THE BIRTHS ARE COVERED BY THE MEDICAID PROGRAM.IN A RECENT REPORT RELEASED BY THE ROBERT WOOD JOHNSON FOUNDATION AND THE UNIVERSITY OF WISCONSIN'S POPULATION HEALTH INSTITUTE, SCHUYLKILL COUNTY WAS RANKED THE 56TH HEALTHIEST OF THE 67 COUNTIES IN PENNSYLVANIA. SCHUYLKILL COUNTY HAD HIGHER THAN THE STATE AND NATIONAL RATES FOR SMOKING, OBESITY, EXCESSIVE DRINKING AND MOTOR VEHICLE CRASH DEATH RATES. THIS REPORT ALSO SHOWED THAT THE COUNTY HAD ACCESS TO FEWER PRIMARY CARE PHYSICIANS.THE DEMOGRAPHICS OF THE PATIENTS ADMITTED TO SMC-SJS ARE 41 % MEDICARE, 24% MEDICAID AND 3% SELF PAY. EMERGENCY PATIENTS AT SMC-SJS ARE 14% MEDICARE, 25% MEDICAID AND 11% SELF PAY.SCHUYLKILL COUNTY HAS FOUR HOSPITALS SERVING THE COUNTY. SMC-SJS AND SCHUYLKILL MEDICAL CENTER - EAST NORWEGIAN STREET ARE BOTH LOCATED IN POTTSVILLE AND SERVE THE MAJORITY OF THE COUNTY RESIDENTS. SAINT CATHERINE MEDICAL CENTER IS LOCATED IN ASHLAND IN NORTHERN SCHUYLKILL COUNTY AND ST. LUKE'S MINERS MEMORIAL HOSPITAL IS LOCATED IN COALDALE NEAR THE CARBON COUNTY BORDER.
PART VI, LINE 6: THE BOARD OF SMC - SJS IS COMPRISED OF TWELVE INDIVIDUALS FROM THE SCHUYLKILL COUNTY COMMUNITY. THESE INDIVIDUALS ARE NOT EMPLOYED BY THE MEDICAL CENTER. THEY ARE INVOLVED IN EDUCATION, SOCIAL SERVICES, GERIATRIC SERVICES, MATERNAL/CHILD SERVICES, PRIMARY MEDICAL CARE, CRIMINAL JUSTICE, SMALL BUSINESS AND MANUFACTURING. ALL PHYSICIANS ARE ENCOURAGED TO APPLY FOR MEDICAL STAFF PRIVILEGES FOR THE MEDICAL CENTER.SMC-SJS ALSO WORKS WITH VARIOUS COMMUNITY ORGANIZATIONS TO HELP IDENTIFY COMMUNITY NEEDS AND WORK TOGETHER TO MEET THOSE NEEDS. THE MEDICAL CENTER HAS INPATIENT ADOLESCENT AND ADULT BEHAVIORAL HEALTH SERVICES AVAILABLE TO THE RESIDENTS OF SCHUYLKILL COUNTY. THIS ALLOWS COUNTY RESIDENTS TO OBTAIN NECESSARY INPATIENT CARE WITHIN THE COUNTY WITHOUT REQUIRING FAMILIES TO TRAVEL OUTSIDE OF THE COUNTY. THE MEDICAL CENTER ALSO HAS A CERTIFIED DIABETES EDUCATOR AVAILABLE TO CONSULT WITH PATIENTS AND ALSO WITH PHYSICIANS WHEN THEY HAVE A PATIENT THAT IS NEWLY DIAGNOSED WITH DIABETES. THE MEDICAL CENTER IS ALSO THE ONLY FACILITY IN THE COUNTY WITH A MATERNITY DEPARTMENT AND NEWBORN NURSERY. THIS ALLOWS COUNTY RESIDENTS TO REMAIN IN THE COUNTY FOR MATERNITY CARE. MORE THAN 50% OF THE BIRTHS EACH YEAR ARE MEDICAID.THE EMERGENCY DEPARTMENT OF SMC-SJS IS A 24 HOUR EMERGENCY ROOM AVAILABLE TO ALL REGARDLESS OF THEIR ABILITY TO PAY. THE MEDICAL CENTER PARTICIPATES IN MANY INSURANCE PROGRAMS SUCH AS MEDICARE, MEDICAID, CHAMPUS AND VA. THE MEDICAL CENTER ALSO HAS A CHARITY CARE POLICY THAT PROVIDES ASSISTANCE TO ELIGIBLE INDIVIDUALS IN PROVIDING FREE OR DISCOUNTED CARE BASED ON THEIR ABILITY TO PAY AND THE FEDERAL POVERTY GUIDELINES.SMC-ENS ALSO PROVIDES OPPORTUNITIES TO STUDENTS IN HEALTHCARE FIELDS TO GAIN EXPERIENCE WORKING IN THE HEALTH CARE ENVIRONMENT SUCH AS NURSING STUDENTS (RN AND LPN), PHARMACY STUDENTS, PHYSICIAN ASSISTANT STUDENTS, PHYSICAL THERAPY STUDENTS, RADIOLOGY TECHNICIANS AND MEDICAL ASSISTANTS. THE MEDICAL CENTER ALSO PROVIDES A VOLUNTEER PROGRAM FOR JUNIOR HIGH AND HIGH SCHOOL STUDENTS TO BECOME FAMILIAR WITH THE MEDICAL SERVICES OFFERED AND THE EDUCATIONAL OPPORTUNITIES AVAILABLE WITHIN THE HEALTHCARE ENVIRONMENT.THE MEDICAL CENTER ALSO SPONSORS AND PARTICIPATES IN HEALTH FAIRS AT COMMUNITY EVENTS SUCH AS THE COUNTY FAIR, EVENTS AT THE LOCAL MALL, HEALTH SCREENINGS, BLOOD PRESSURE SCREENINGS, VETERAN'S BREAKFAST EVENT, MEALS ON WHEELS, SKIN CANCER SCREENINGS, MAMMOGRAPHY SCREENINGS, BLOOD PRESSURE CLINICS, SUPPORT GROUPS AND LOCAL AMERICAN CANCER SOCIETY RELAY FOR LIFE.ANY EXCESS FUNDS THAT ARE GENERATED FROM OPERATIONS ARE INVESTED BACK INTO THE MEDICAL CENTER BY PURCHASING NECESSARY CAPITAL EQUIPMENT, FUNDING CAPITAL IMPROVEMENT PROJECTS, FUNDING NEW SERVICES, IMPROVING AND EXPANDING EXISTING SERVICES AND ANY OTHER GENERAL IMPROVEMENTS TO PATIENT CARE.
PART VI, LINE 7: ON AUGUST 1, 2008, SMC-SJS AND SMC-ENS AFFILIATED UNDER THE CONTROL OF SCHUYLKILL HEALTH SYSTEM, THE PRIMARY SERVICE AREA IS POTTSVILLE AND THE SURROUNDING COMMUNITIES IN SCHUYLKILL COUNTY. THE PURPOSE OF BOTH MEDICAL CENTERS IS TO ENGAGE IN ACTIVITIES RELATED TO THE PROMOTION OF HEALTH OF THE PEOPLE IN THE SERVICE AREA, WORK CHARITABLY TO PROMOTE COMMUNITY HEALTH EDUCATION, PREVENTION OF ILLNESS AND INJURY AND PROVISION OF MEDICAL SERVICES TO THE DIVERSE POPULATION OF THE SERVICE AREA AND ENGAGE IN ANY AND ALL ACTIVITIES CONSISTENT WITH OR IN FURTHERANCE OF THESE PURPOSES.EACH MEDICAL CENTER OPERATES INDEPENDENTLY OF EACH OTHER BUT WORKS IN SYNC WITH EACH OTHER IN PROVIDING HEALTHCARE SERVICES TO THE RESIDENTS OF SCHUYLKILL COUNTY. BOTH MEDICAL CENTERS HAVE WORKED TO PROVIDE A CONTINUUM OF CARE SO THAT HEALTHCARE IS AVAILABLE WITHIN THE COUNTY AND RESIDENTS DO NOT HAVE TO TRAVEL OUTSIDE OF THE COUNTY FOR CARE. THE FOLLOWING SERVICES ARE AVAILABLE AT EITHER SMC-SJS OR SMC-ENS: - ACUTE CARE /MEDICAL SURGICAL SERVICES- INTENSIVE CARE SERVICES- MATERNITY SERVICES- NEWBORN SERVICES- PEDIATRICS SERVICES- ADOLESCENT, ADULT AND GERIATRIC BEHAVIORAL SERVICES- ACUTE REHAB AND TRANSITIONAL REHAB SERVICES- INPATIENT AND OUTPATIENT PHYSICAL THERAPY- INPATIENT AND OUTPATIENT DIAGNOSTIC SERVICES- HOME HEALTH SERVICES- OUTPATIENT DRUG AND ALCOHOL SERVICES- OUTPATIENT BEHAVIORAL HEALTH SERVICES- 24 HOUR EMERGENCY ROOM SERVICES- OUTPATIENT DENTAL CLINIC- INPATIENT AND OUTPATIENT SURGICAL SERVICES- COMMUNITY BENEFIT/CHARITY CARE SERVICES- ADVANCE WOUND CARE - OUTPATIENT SURGERY CENTERPART VI, LINE 7: N/A

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained0RecordsMaintained
No Grant More Than5000XNoGrantMoreThan5000

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractXWrittenEmploymentContract
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
JOHN E SIMODEJKA
4016450000000151520416797000
DANIEL KOCHIE
01318300003750000017206018653600
DARNELL FURER
017099100000342702350017676800
RICHARD BINDIE
2750090000000132280288237000
LYNDA L JAKUBCO
2196650000000132050232870000
JULIANNE M TIDMORE
2305110000000141950244706000
MARY R TUNNESSEN
2173220000000132050230527000
SHERRY L BURINSKY BOTTOR
2485860000000141950262781000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 3THE HOSPITAL HAS DELEGATED MANAGEMENT DUTIES OVER ITS DIETARY SERVICES TO SODEXHO INC. AND AFFILIATES.
FORM 990, PART VI, SECTION B, LINE 11THE FORM 990 IS REVIEWED BY MANAGEMENT PRIOR TO ITS FILING WITH THE INTERNAL REVENUE SERVICE. SELECTED MEMBERS OF THE BOARD REVIEWED THE 990 WITH THE TAX RETURN PREPARER AND MANAGEMENT ON BEHALF OF THE BOARD.
EACH OFFICER, KEY EMPLOYEE, DIRECTOR OR TRUSTEE WITH BOARD DELEGATED AUTHORITY IS REQUIRED TO ANNUALLY SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT. THESE STATEMENTS ARE REVIEWED BY THE PRESIDENT/CEO'S ADMINISTRTIVE ASSISTANT AND ANY CONFLICTS ARE REPORTED TO THE PRESIDENT/CEO. THE STATEMENTS ARE KEPT ON FILE IN THE PRESIDENT/CEO'S OFFICE AFTER REVIEW. BOARD MEMBERS ARE EXPECTED TO EXCUSE THEMSELVES FROM TAKING ANY ACTION OR EVEN DISCUSSING ISSUES OF RELATED PARTIES. IF THEY VIOLATE THESE RULES THEY ARE REMOVED FROM THE BOARD.FORM 990, PART VI, SECTION B, LINE 12C
ANNUALLY, THE ORGANIZATION CONTRACTS WITH JAFFE AND COMPANY, AN INDEPENDENT CONSULTANT, TO MAKE RECOMMENDATIONS TO THE COMPENSATION COMMITTEE, A SUB COMMITTEE OF THE BOARD, BASED ON MARKET AND INDUSTRY DATA TO ENSURE COMPENSATION DOES NOT EXCEED FAIR MARKET VALUE. THIS PROCESS IS USED FOR THE FOLLOWING POSITIONS PRESIDENT/CEO, VICE PRESIDENT OF OPERATIONS/COO, VICE PRESIDENT OF NURSING/CNO AND THE VICE PRESIDENT OF FINANCE/CFO. THIS REVIEW AND APPROVAL PROCESS IS DOCUMENTED VIA COMMITTEE MINUTES.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
THE FOLLOWING INDIVIDUALS WORK AN AVERAGE OF 40 HOURS PER WEEK FOR ALL SCHUYLKILL RELATED ENTITIES: DARNELL FURER DANIEL KOCHIE JOHN SIMODEJKA DIANE BORISFORM 990, PART VII, SECTION A:
CHANGES IN NET ASSETS OR FUND BALANCES:PENSION LIABILITY ADJUSTMENT 13,658,726. POSTRETIREMENT BENEFIT LIABILITY ADJUSTMENT -136,818. INCREASE IN NET ASSETS OF AFFILIATE 106,190. VALUATION GAIN 563,656. TOTAL TO FORM 990, PART XI, LINE 5: 14,191,754.FORM 990, PART XI, LINE 5:
STATEMENT PURSUANT TO SECTION 1.351-3(A) BY SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET 23-1352202 (1) NAME AND EMPLOYER IDENTIFICATION NUMBER OF THE TRANSFEREE CORPORATION: NAME: SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET EIN: 23-1352202 (2) DATE(S) OF TRANSFER(S) OF ASSETS: TRANSFER DATE(S): 9/22/2010 AND 03/04/2011 (3) AGGREGATE FAIR MARKET VALUE AND BASIS OF PROPERTY TRANSFERRED: FAIR MARKET VALUE: $237,125 AND $150,000 BASIS: $237,125 AND $150,000 (4) DATE AND CONTROL NUMBER OF PRIVATE LETTER RULING(S) ISSUED BY THE IRS IN CONNECTION WITH THE EXCHANGE: DATE(S) AND CONTROL NUMBER(S): NONESTATEMENT PURSUANT TO SECTION 1.351-3(A)

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
SCHUYLKILL REHABILITATION CENTER INC
420 SOUTH JACKSON STREETPOTTSVILLEPA17901232440891OPERATES A COMPREHENSIVE REHABILITATION FACILITYPA501(C)(3)3SCHUYLKILL HEALTH SYSTEM0
SCHUYLKILL HEALTH SYSTEM FOUNDATION
EAST NORWEGIAN TREMONT STREETSPOTTSVILLEPA17901222793805SOLICIT, RECEIVE, MAINTAIN AND INVEST MONEY FOR CHARITABLE PURPOSESPA501(C)(3)7SCHUYLKILL HEALTH SYSTEM0
SCHUYLKILL MEDICAL CENTER - EAST NORWEGIAN STREET
700 EAST NORWEGIAN STREETPOTTSVILLEPA17901230880420OPERATES A HOSPITAL PROVIDING INPATIENT, OUTPATIENT & EMERGENCY SVCSPA501(C)(3)3SCHUYLKILL HEALTH SYSTEM0
SCHUYLKILL HEALTH SYSTEM MEDICAL GROUP INC
700 EAST NORWEGIAN STREETPOTTSVILLEPA17901232866006TO SUPPORT AND PROMOTE THE PURPOSES OF AFFILIATED ENTITIESPA501(C)(3)9SCHUYLKILL HEALTH SYSTEM0
SCHUYLKILL HEALTH SYSTEM
420 SOUTH JACKSON STREETPOTTSVILLEPA17901262990543TO SUPPORT, PROMOTE, ADVANCE & ENHANCE QUALITY OF LIFE OF SCHUYLKILL CNTYPA501(C)(3)11B0N/A
SCHUYLKILL COMMUNITY HEALTH SERVICES INC
420 SOUTH JACKSON STREETPOTTSVILLEPA17901232410904INACTIVEPA501(C)(3)SCHUYLKILL HEALTH SYSTEM0

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1SCHUYLKILL HEALTH SYSTEM MEDICAL MALL LPBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1EAST NORWEGIAN TREMONT STREETSAddressLine1
CityPOTTSVILLECity
StatePAState
ZIP Code17901ZIPCode
FieldValueIRS element (for citing)
EIN232514813EIN
Primary ActivityRENTALPrimaryActivity
Legal Domicile StatePALegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntity
SCHUYLKILL HEALTH SYSTEM DEVELOPMENT CORPORATION
700 EAST NORWEGIAN STREETPOTTSVILLEPA17901232432417PURSUES, IMPLEMENTS & FURTHERS THE ACTVTIES & PURPOSES OF THE SYSPAN/AC
SCHUYLKILL MEDICAL PLAZA - CONDOMINIUM ASSOCIATION
420 SOUTH JACKSON STREETPOTTSVILLEPA17901232931821CONDOMINIUM ASSOCIATIONPAN/AC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg