200 HOSPITAL - MYMC INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- 200 HOSPITAL - MYMC INC (EIN 25-1002946)
- Tax period
- 2010-07-01 to 2011-06-30
- Filed
- 2012-03-09
- IRS object ID
- 201240699349300329
- 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 | 2012-03-09T13:45:51-06:00 | Timestamp |
| Tax Period End Date | 2011-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CARBIS WALKER LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5700 CORPORATE DRIVE STE 650 | AddressLine1 |
| City | PITTSBURGH | City |
| State | PA | State |
| ZIP Code | 15237 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 251002946 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEYERSDALE COMMUNITY HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MEYE | NameControl |
| Phone | 8146345911 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 HOSPITAL DRIVE | AddressLine1 |
| City | MEYERSDALE | City |
| State | PA | State |
| ZIP Code | 15552 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | EDWARD DEPASQUALE | Name |
| Title | CHIEF FINANCIAL OFFICER | Title |
| Phone | 8144108271 | Phone |
| Date Signed | 2012-03-01 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JEFFREY J PETRELL CPA | Name |
| Phone | 4126356270 | Phone |
| Date Prepared | 2012-03-01 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEYERSDALE MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | SCOTT BECKER | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1086 FRANKLIN STREET | AddressLine1 |
| City | JOHNSTOWN | City |
| State | PA | State |
| ZIP Code | 15905 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 12488246 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.CONEMAUGH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1952 | YearFormation |
| State Legal Domicile | PA | StateLegalDomicile |
| Activity Or Mission Description | GENERAL ACUTE CARE CRITICAL ACCESS HOSPITAL PROVIDING INPATIENT, SWING BED, OUTPATIENT, AND CLINIC SERVICES TO THE SOUTHERN SOMERSET COUNTY POPULATION. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 145 | TotalNbrEmployees |
| Total Nbr Volunteers | 33 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 214339 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 293413 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 11557120 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 12050144 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 33906 | InvestmentIncomePriorYear |
| Investment Income Current Year | 43877 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -20082 | OtherRevenuePriorYear |
| Other Revenue Current Year | 32561 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 11785283 | TotalRevenuePriorYear |
| Total Revenue Current Year | 12419995 | 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 | 4892117 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 5072276 | 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 | 6581558 | OtherExpensePriorYear |
| Other Expenses Current Year | 6622387 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 11473675 | TotalExpensesPriorYear |
| Total Expenses Current Year | 11694663 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 311608 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 725332 | RevenuesLessExpensesCY |
| Total Assets BOY | 7127524 | TotalAssetsBOY |
| Total Assets EOY | 8268640 | TotalAssetsEOY |
| Total Liabilities BOY | 3558392 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 3908920 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 3569132 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 4359720 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | GENERAL ACUTE CARE CRITICAL ACCESS HOSPITAL PROVIDING INPATIENT, SWING BED, OUTPATIENT, AND CLINIC SERVICES TO THE SOUTHERN SOMERSET COUNTY POPULATION. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 10012624 | Expense |
| Revenue | 12050144 | Revenue |
| Description | MEYERSDALE COMMUNITY HOSPITAL SERVES A RURAL AREA IN SOUTHWESTERN PENNSYLVANIA'S HISTORIC SOMERSET COUNTY. SPECIALIZING IN FAMILY AND PRIMARY CARE, IT IS A STATE-DESIGNATED CRITICAL CARE ACCESS HOSPITAL AND HAS BEEN DEEMED A NECESSARY HEALTH CARE PROVIDER BY THE COMMONWEALTH OF PENNSYLVANIA. MEYERSDALE COMMUNITY HOSPITAL OFFERS 24/7 EMERGENCY CARE, OPERATING ROOMS FOR MINOR PROCEDURES, RADIOLOGY AND PATHOLOGY SERVICES, PHYSICAL AND RESPIRATORY THERAPY, CARDIAC REHABILITATION, AND OB/GYN OUTPATIENT CARE. IN ADDITION A STEPDOWN SWING UNIT IS AVAILABLE FOR PATIENTS.DURING FISCAL YEAR 2011, THE HOSPITAL TREATED 295 ACUTE PATIENTS FOR A TOTAL OF 1,008 DAYS AND 88 SWING BED PATIENTS FOR A TOTAL OF 667 DAYS. ALSO, 43,740 OUTPATIENTS WERE TREATED THROUGHOUT THE FACILITY'S CLINICAL DEPARTMENTS AND RURAL HEALTH CLINICS. | Description |
| Total Program Service Expense | 10012624 | 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 | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 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 | 0 | 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 | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 25 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 145 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 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 | HEATHER SMITH | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8146345911 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 HOSPITAL DRIVE | AddressLine1 |
| City | MEYERSDALE | City |
| State | PA | State |
| ZIP Code | 15552 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| ATTY DOUGLAS MCCALL BELL | ||||||
| CHAIRMAN | 1.00 | X | X | 0 | 0 | 0 |
| CLIFFORD MAUST | ||||||
| 1ST VICE-CHAIRMAN | 1.00 | X | X | 0 | 0 | 0 |
| M SUSAN DOM | ||||||
| SECRETARY | 1.00 | X | X | 0 | 0 | 0 |
| SAMUEL P MCCLURE | ||||||
| TREASURER | 1.00 | X | X | 0 | 0 | 0 |
| REBECCA BOWER | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| MARK FOLK | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| DAVID LAUVER | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| M RAY LECKEMBY | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| KEVIN MILLER | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| HAROLD NICHOLSON | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| DANIEL ROUGH | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| JOHN SMAILA | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| NATHAN O THOMAS MD | ||||||
| TRUSTEE | 1.00 | X | 0 | 177058 | 32592 | |
| ROGER WAHL | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| LEROY NEWELL | ||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |
| MARY L LIBENGOOD | ||||||
| PRESIDENT | 50.00 | X | 187851 | 0 | 7023 | |
| SCOTT BECKER | ||||||
| CHIEF EXECUTIVE OFFICER | 1.00 | X | 0 | 1236437 | 42969 | |
| EDWARD DEPASQUALE | ||||||
| CHIEF FINANCIAL OFFICER | 1.00 | X | 0 | 538638 | 35167 | |
| DAVID CARLSON DO | ||||||
| CHIEF MEDICAL OFFICER | 4.00 | X | 0 | 678102 | 30611 | |
| JOSEPH DADO | ||||||
| CHIEF INFORMATION OFFICER | 2.00 | X | 0 | 442586 | 16131 | |
| STEVEN TUCKER | ||||||
| CHIEF OPERATING OFFICER | 3.00 | X | 0 | 531509 | 35347 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 187851 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 3604330 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 199840 | TotalOtherCompensation |
| Number Individuals GT100 K | 1 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| MEMORIAL MEDICAL CENTER | |||||
| 1086 FRANKLIN STREET | JOHNSTOWN | PA | 15905 | FINANCIAL, IT, REFERENCE LAB, PHARMACY S | 931086 |
| CONEMAUGH HEALTH INITIATIVES | |||||
| 1086 FRANKLIN STREET | JOHNSTOWN | PA | 15905 | ER PHYSICIAN, OFFICE STAFF | 865150 |
| CDL | |||||
| 6400 BROOKTREE COURT | WEXFORD | PA | 15090 | NUCLEAR MEDICINE | 270291 |
| ALLIANCE IMAGING | |||||
| PO BOX 96485 | CHICAGO | IL | 60693 | MRI | 193572 |
| CAMCO | |||||
| 1454 SCALP AVENUE | JOHNSTOWN | PA | 15904 | PHYSICAL & OCCUPATIONAL THERAPY | 155232 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 8 | NumberOfContractorsGT100K |
| Government Grants | 69795 | GovernmentGrants |
| All Other Contributions | 223618 | AllOtherContributions |
| Total Contributions | 293413 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT SERVICE RE | 900099 | 11998587 | 11998587 |
| BLOOD SCREENING | 900099 | 51015 | 51015 |
| MEDICAL RECORDS & VERI | 900099 | 542 | 542 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 12050144 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 43877 | TotalRevenueColumn |
| Exclusion | $43,877 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 56663 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 64428 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -7765 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -7765 | TotalRevenueColumn |
| Exclusion | -$7,765 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 10469 | GrossIncomeFundraisingEvents |
| Fundraising Direct Expenses | 3823 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6646 | TotalRevenueColumn |
| Exclusion | $6,646 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MISCELLANEOUS | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 33680 | TotalRevenueColumn |
| Exclusion | $33,680 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 33680 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 12419995 | TotalRevenueColumn |
| Related Or Exempt Function Income | 12050144 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $76,438 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 164031 | Total |
| Program Services | 32806 | ProgramServices |
| Management And General | 131225 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4048591 | Total |
| Program Services | 3436102 | ProgramServices |
| Management And General | 612489 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3425 | Total |
| Program Services | 2980 | ProgramServices |
| Management And General | 445 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 546816 | Total |
| Program Services | 446887 | ProgramServices |
| Management And General | 99929 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 309413 | Total |
| Program Services | 262558 | ProgramServices |
| Management And General | 46855 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 147319 | Total |
| Management And General | 147319 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 771766 | Total |
| Program Services | 710025 | ProgramServices |
| Management And General | 61741 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 61190 | Total |
| Management And General | 61190 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 68801 | Total |
| Program Services | 55041 | ProgramServices |
| Management And General | 13760 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 235833 | Total |
| Program Services | 188666 | ProgramServices |
| Management And General | 47167 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26939 | Total |
| Program Services | 21551 | ProgramServices |
| Management And General | 5388 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 132698 | Total |
| Management And General | 132698 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 455134 | Total |
| Program Services | 364107 | ProgramServices |
| Management And General | 91027 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 153098 | Total |
| Management And General | 153098 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| PURCHASED SERVICES | 2419850 | 2419850 | |
| PATIENT SUPPLIES AND FO | 1109528 | 1109528 | |
| BAD DEBT EXPENSE | 504568 | 504568 | |
| REPAIRS AND MAINTENANCE | 340578 | 272462 | 68116 |
| LEASE & RENTAL | 147127 | 147127 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 47958 | Total |
| Program Services | 38366 | ProgramServices |
| Management And General | 9592 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11694663 | Total |
| Program Services | 10012624 | ProgramServices |
| Management And General | 1682039 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1609331 | BOY |
| EOY | 2670965 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 287388 | BOY |
| EOY | 286360 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1025227 | BOY |
| EOY | 1127045 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19211 | BOY |
| EOY | 17088 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 9258053 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 6282276 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3273446 | BOY |
| EOY | 2975777 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 912921 | BOY |
| EOY | 1191405 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7127524 | BOY |
| EOY | 8268640 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 648820 | BOY |
| EOY | 685400 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 104498 | BOY |
| EOY | 41387 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2245259 | BOY |
| EOY | 2247954 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 331589 | BOY |
| EOY | 244067 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 228226 | BOY |
| EOY | 690112 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3558392 | BOY |
| EOY | 3908920 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2719450 | BOY |
| EOY | 3458583 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 184326 | BOY |
| EOY | 211210 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 665356 | BOY |
| EOY | 689927 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3569132 | BOY |
| EOY | 4359720 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7127524 | BOY |
| EOY | 8268640 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 725332 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 65256 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $600 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 600 | 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 | MEMBERSHIP DUES PAID TO THE HOSPITAL COUNCIL OF WESTERN PENNSYLVANIA INDICATED THAT A SPECIFIC PERCENTAGE OF THE DUES WOULD BE RELATED TO LOBBYING ACTIVITIES. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 136049 | OtherCostOrOtherBasis |
| Book Value | 136049 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5531092 | OtherCostOrOtherBasis |
| Depreciation | 3267913 | Depreciation |
| Book Value | 2263179 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3565434 | OtherCostOrOtherBasis |
| Depreciation | 3007428 | Depreciation |
| Book Value | 558006 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 25478 | OtherCostOrOtherBasis |
| Depreciation | 6935 | Depreciation |
| Book Value | 18543 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 2975777 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (8 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| ACCRUED INTEREST RECEIVABLE | 35 |
| MISCELLANEOUS ACCOUNTS RECEIVABLE | 95474 |
| INTEREST IN INCOME TRUSTS | 689927 |
| RESTRICTED CASH FOUNDATION | 151297 |
| RESTRICTED CASH FOUNDATION - CITIZENS NATIONAL BANK | 59913 |
| DEFERRED FINANCING EXPENSE | 48266 |
| ASSETS HELD BY TRUSTEE | 142156 |
| DUE FROM MA | 4337 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 1191405 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ASSET RETIREMENT OBLIGATION | $66,705 |
| DUE TO MEMORIAL MEDICAL CENTER | $166,411 |
| DUE TO CONEMAUGH HEALTH INITIATIVES, INC. | $76,996 |
| DUE TO MC | $380,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 690112 | TotalOfAmounts |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 0.0 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 306476 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 306476 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02740 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1064166 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1145575 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -81409 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7520 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5587 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1933 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1378162 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1151162 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 227000 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02760 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 40094 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 40094 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00360 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 40094 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 40094 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00360 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1418256 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1151162 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 267094 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03120 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $248,298 | BadDebtExpenseAmount |
| Amount Attributable To | 220464 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 3220279 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 3032778 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 187501 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | X | CostAccountingSystem |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 0 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 3 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (3 entries)
| Facility NumberFacilityNumber | Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Critical Access HospitalCriticalAccessHospital | Er24 HoursEr24Hours | OtherOther |
|---|---|---|---|---|---|---|---|---|---|
| MEYERSDALE COMMUNITY HOSPITAL | |||||||||
| 1 | 200 HOSPITAL DRIVE | MEYERSDALE | PA | 15552 | X | X | X | X | |
| FAMILY HEALTHCARE RHC MEYERSDALE | |||||||||
| 2 | 202 BEACHLEY STREET | MEYERSDALE | PA | 15552 | RURAL HEALTH CLINIC | ||||
| FAMILY HEALTHCARE RHC SALISBURY | |||||||||
| 3 | 231 ORD STREET | SALISBURY | PA | 15558 | RURAL HEALTH CLINIC | ||||
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NOT REQUIRED | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part VI Form990ScheduleHPartVI (9 entries)
| ExplanationExplanation |
|---|
| PART I, LINE 7: THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED ON PART I, LINES 7A, 7B, AND 7C WAS BASED ON THE CONEMAUGH HEALTH SYSTEM'S COST ACCOUNTING SYSTEM AND ADDRESSES ALL PATIENT SEGMENTS. FOR FURTHER DETAILS OF THIS SYSTEM, SEE THE DESCRIPTION FOR PART III, LINE 8. THE METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED ON PART I, LINES 7E THROUGH 7I AS APPLICABLE, WAS BASED ON ACTUAL REVENUES AND EXPENSES INCURRED. |
| PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 504568. |
| PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED ARE REPORTED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYORS, PATIENTS AND OTHERS. CONEMAUGH HEALTH SYSTEM (CHS) PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, CHS BILLS THIRD-PARTY PAYORS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT.THE METHODOLOGY UTILIZED TO DETERMINE THE AMOUNT REPORTED ON LINE 2 IS BASED ON THE ORGANIZATION'S COST TO CHARGE RATIO. THE METHODOLOGY FOR LINE 3 IS BASED ON A PREDICTIVE ANALYSIS SCORING SYSTEM DEVELOPED BY ACUMEN THAT HAS BEEN IMPLEMENTED AS PART OF THE HEALTH SYSTEM'S PRESUMPTIVE CHARITY CARE PROGRAM. THE SCORING PROGRAM CONSISTS OF A FOUR DIGIT SCORE; THE FIRST TWO DIGITS ARE BASED UPON THE FEDERAL POVERTY GUIDELINES AND THE LAST TWO DIGITS ARE THE PROBABILITY/PROPENSITY TO PAY SCORE. THE PERCENTAGES INCLUDED ON THE 990 HAVE BEEN DERIVED BY FOUR MONTHS OF ACTUAL EXPERIENCE (JULY-OCTOBER 2011) OF ACCOUNTS THAT HAVE GONE THROUGH THE NORMAL BILLING CYCLE OF 120 DAYS; BEING SCORED AND CONSIDERED FOR PRESUMPTIVE CHARITY CARE VS. SENDING TO COLLECTION AGENCY. THE ACCOUNTS THAT WERE SELECTED AND INCLUDED FOR PRESUMPTIVE CHARITY CONSIDERATION WERE BASED ON MEDIAN HOUSEHOLD INCOME AND AVERAGE HOUSEHOLD SIZE THAT FELL BELOW 150% OF THE FEDERAL POVERTY GUIDELINES. THAT SAME PERCENTAGE EXPERIENCE IS BEING APPLIED TO THE FISCAL YEAR 2011 BAD DEBT EXPENSE TO DERIVE AN AMOUNT THAT COULD POTENTIALLY QUALIFY FOR CHARITY CARE. |
| PART III, LINE 8: CONEMAUGH HEALTH SYSTEM UTILIZES MCKESSON'S HORIZON PERFORMANCE MANAGER (HPM) FOR COST ACCOUNTING. HPM PROVIDES THE ABILITY TO ALLOCATE ALL DEPARTMENTAL EXPENSES AT THE INDIVIDUAL CHARGE FOR EACH CHARGING DEPARTMENT, AS WELL AS ALLOCATE OVERHEAD EXPENSES IN A CONSISTENT MANNER. THE ENCOUNTER COSTING FUNCTIONALITY OF HPM PROVIDES THE ABILITY TO THEN DETERMINE AN ACCURATE ESTIMATE OF COST AT THE PATIENT LEVEL BASED ON THE CHARGE UNIT COSTS. THE SYSTEM THEN PROVIDES THE ABILITY TO SUMMARIZE THE PATIENT VOLUME, CHARGES, AND COSTS IN ANY NUMBER OF WAYS, INCLUDING PAYER SPECIFIC COST ALLOCATION. |
| PART I, LINE 3B: THE ORGANIZATION USES A SLIDING SCALE TO DETERMINE ELIGIBILITY FOR DISCOUNTED CARE. |
| PART VI, LINE 2: CHS IS AN ACTIVE MEMBER OF THE COMMUNITY AND AN ADVOCATE FOR THE HEALTH, WELL BEING, AND ECONOMIC STRENGTH OF THE REGION. CHS ADMINISTRATORS HAVE TEAMED UP WITH THE UNITED WAY OF THE LAUREL HIGHLANDS OVER THE PAST FEW YEARS TO IDENTIFY COMMUNITY NEEDS. THIS YEAR, CHS INVESTED NEARLY 1,000 HOURS OF WORK INTO A COMMUNITY NEEDS ANALYSIS FOR CAMBRIA AND SOMERSET COUNTIES. THIS INCLUDED DOZENS OF INTERVIEWS OF AREA LEADERS, HEALTHCARE PROFESSIONALS, EDUCATORS, CLERGY, AND SOCIAL SERVICE PROFESSIONALS. THE FINDINGS HAVE BEEN SHARED WITH THE BOARDS OF CONEMAUGH HEALTH SYSTEM, THE UNTIED WAY OF THE LAUREL HIGHLANDS, AND OVER 20 HUMAN SERVICES AGENCIES. THE 70 PAGE FINAL REPORT WILL BE SHARED WITH COMMUNITY LEADERS AND A CONDENSED HIGHLIGHT VERSION WILL BE RELEASED TO THE MEDIA. THE UNITED WAY HAS BEGUN TO REDIRECT FUNDING TO KEY AREAS OF NEED INCLUDING: PROGRAMS TO HELP CHILDREN STAY IN SCHOOL TO INCREASE THEIR POTENTIAL TO BE SUCCESSFUL; DRUG AND ALCOHOL PROGRAMS; AND MENTAL HEALTH PROGRAMS. CONEMAUGH AND THE UNITED WAY WILL PERIODICALLY MEASURE COMMUNITY IMPACT.IN ADDITION TO PROVIDING THE COMMUNITY NEEDS REPORT, VARIOUS CHS LEADERS HAVE SERVED IN MANY ROLES FOR THE UNITED WAY INCLUDING CHAIRMAN OF THE BOARD, CHAIRMAN OF THE COMMUNITY IMPACT COMMITTEE, AND PARTICIPATION IN THE LOANED EXECUTIVE PROGRAM. SENIOR LEADERS AND DIRECTORS THROUGHOUT THE HEALTH SYSTEM ARE ALSO ENCOURAGED TO SERVE ON OTHER COMMUNITY BOARDS AND ORGANIZATIONS. SOME OF THOSE REPRESENTED INCLUDE THE AMERICAN RED CROSS, THE LEUKEMIA AND LYMPHOMA SOCIETY, THE JOHNSTOWN SYMPHONY, WOMEN'S HELP CENTER, JUNIOR ACHIEVEMENT, LAUREL HIGHLANDS FOOD PANTRY, AND THE GREATER JOHNSTOWN YMCA. |
| PART VI, LINE 3: CONEMAUGH HEALTH SYSTEM COMMUNICATES TO PATIENTS THE AVAILABILITY OF FINANCIAL ASSISTANCE UNDER FEDERAL, STATE AND LOCAL PROGRAMS, AS WELL AS THE CHARITY CARE PROGRAM, ON OUR WEBSITE, WHICH INCLUDES A DOWNLOADABLE CHARITY CARE APPLICATION AND INSTRUCTIONS. TABLE TOP BROCHURES ARE PROVIDED AT ALL POINTS OF REGISTRATION, AND BROCHURES ARE INCLUDED IN PATIENT ADMISSION PACKETS. INFORMATION ON THE AVAILABILITY OF FINANCIAL ASSISTANCE IS ALSO INCLUDED ON PATIENT STATEMENTS. ASSISTANCE IS PROVIDED TO PATIENTS TO APPLY FOR MEDICAL ASSISTANCE THROUGH A THIRD-PARTY VENDOR. A ROBUST FINANCIAL COUNSELING AND CUSTOMER SERVICE DEPARTMENT IS AVAILABLE TO HANDLE SPECIFIC PATIENT NEEDS. |
| PART VI, LINE 4: MEYERSDALE MEDICAL CENTER (MYMC) SERVES A RURAL AREA IN SOUTHWESTERN PENNSYLVANIA'S HISTORIC SOMERSET COUNTY. SPECIALIZING IN FAMILY AND PRIMARY CARE, IT IS A STATE-DESIGNATED CRITICAL CARE ACCESS HOSPITAL AND HAS BEEN DEEMED A NECESSARY HEALTH CARE PROVIDER BY THE COMMONWEALTH OF PENNSYLVANIA. MEYERSDALE OFFERS 24/7 EMERGENCY CARE, OPERATING ROOMS FOR MINOR PROCEDURES, RADIOLOGY AND PATHOLOGY SERVICES, PHYSICAL AND RESPIRATORY THERAPY, CARDIAC REHABILITATION AND OB/GYN OUTPATIENT CARE. IN ADDITION A STEPDOWN SWING UNIT IS AVAILABLE FOR PATIENTS WHO ARE NO LONGER IN NEED OF HOSPITALIZATION BUT NEED A LITTLE EXTRA CARE BEFORE HEADING HOME. PHYSICIAN SPECIALISTS MAKE VISITS TO MYMC ON A REGULAR BASIS TO HELP IMPROVE ACCESS FOR PATIENTS IN THIS RURAL COMMUNITY. WEEKLY CLINIC SERVICES INCLUDE CARDIOLOGY, OBSTETRICS/GYNECOLOGY, OPHTHALMOLOGY, GASTROENTEROLOGY, NEPHROLOGY, WELL BABY CLINIC, WOUND CARE CENTER, HEARING AIDE CENTER, AND PODIATRY. AERO MEDICAL HELICOPTER TRANSPORTATION IS AVAILABLE TO PATIENTS IN THE MEYERSDALE AREA TO TRANSPORT THEM TO MEMORIAL MEDICAL CENTER OR OTHER FACILITIES IF NEEDED. MYMC HAS TWENTY LICENSED BEDS WITH AN AVERAGE INPATIENT CENSUS OF 5. THERE ARE 4 ACTIVE PHYSICIANS ON THE MEDICAL STAFF. DEMOGRAPHICALLY, NEARLY 20 PERCENT OF RESIDENTS IN THE CONEMAUGH HEALTH SYSTEM SERVICE AREA ARE 65 OR OLDER, ONE OF THE HIGHEST PERCENTAGES IN THE STATE AND WELL ABOVE THE PENNSYLVANIA AVERAGE OF 15.3 PERCENT. THE PAYOR MIX FOR THE REGION IS SKEWED HEAVILY TOWARD MEDICARE AND MEDICAID. AT 9.7 PERCENT, THE CONEMAUGH HEALTH SYSTEM'S SERVICE AREA HAS ONE OF THE STATE'S HIGHEST UNEMPLOYMENT RATES, AND MEDIAN HOUSEHOLD INCOMES OF $34,000 LAG 30 PERCENT BEHIND STATE AND NATIONAL AVERAGES. THE DEMOGRAPHIC MAKE UP OF THE REGION IS CONSIDERED WHEN PLANNING EDUCATION OPPORTUNITIES AND HEALTH INFORMATION PROGRAMS. THE CONEMAUGH HEALTH SYSTEM'S COVERAGE REGION ALSO PRESENTS SOME GEOGRAPHIC CHALLENGES. MOUNTAINOUS TOPOGRAPHY AND HIGHWAY INFRASTRUCTURE MAKE TIMELY TRAVEL A CONCERN FOR SOME PATIENTS. CHS CONTINUES TO LOOK FOR OPPORTUNITIES TO BRING PRIMARY CARE AND PHYSICIAN SPECIALISTS TO RURAL REGIONS OF THE MARKET. IN THE PAST YEAR, A CONCENTRATED EFFORT HAS BEEN MADE TO DEVELOP AND DELIVER HEALTH AND WELLNESS EDUCATION AND SCREENINGS TO CONSTITUENTS IN RURAL REGIONS. WHEN POSSIBLE, CHS TEAMS UP WITH OTHER COMMUNITY ORGANIZATIONS TO DELIVER THESE PROGRAMS AND SERVICES TO RURAL CONSTITUENTS. |
| PART VI, LINE 6: THE CONEMAUGH HEALTH SYSTEM, WHICH INCLUDES MEYERSDALE MEDICAL CENTER (MYMC), IS THANKFUL FOR SUPPORT FROM THE LOCAL COMMUNITY IN THE FORM OF BOARD OF DIRECTOR PARTICIPATION. THE CHS BOARDS ARE MADE UP OF A WIDE VARIETY OF COMMUNITY LEADERS REPRESENTING A NUMBER OF INDUSTRIES INCLUDING BANKING, COMMUNICATION, INDUSTRIAL, EDUCATION, AND CUSTOMER SERVICE. PHYSICIAN LEADERS ARE ALSO INCLUDED ON THE BOARD, SOME WITH TIES TO THE CONEMAUGH HEALTH SYSTEM AND OTHERS WHO ARE INDEPENDENT. VALUABLE INPUT ALSO COMES FROM OUR PATIENT ADVISORY COMMITTEE; A VOLUNTEER BOARD OF PASSIONATE COMMUNITY MEMBERS WHO ARE DEDICATED TO PROVIDING SUGGESTIONS FOR INNOVATIVE SOLUTIONS TO IMPROVE THE PATIENT EXPERIENCE. MEDICAL STAFF PRIVILEGES ARE EXTENDED TO CLOSE TO 400 PHYSICIANS THROUGHOUT A WIDE GEOGRAPHIC REGION IN BOTH PRIMARY CARE AND SPECIALTY FIELDS. IN THE PAST YEAR, GREAT ENERGY, EFFORT, AND FINANCIAL SUPPORT HAVE BEEN DEDICATED TO A NUMBER OF KEY INITIATIVES DESIGNED TO IMPROVE PATIENT CARE. FOR EXAMPLE: $2.6 MILLION DOLLARS WAS USED TO BRING DIGITAL MAMMOGRAPHY EQUIPMENT TO PATIENTS IN OUR REGION WITH EIGHT NEW DIGITAL MAMMOGRAPHY UNITS INSTALLED IN SIX DIFFERENT HEALTH SYSTEM LOCATIONS; A WOUND HEALING CENTER WAS ADDED TO A THIRD LOCATION TO BETTER SERVE PATIENTS IN THE NORTHERN PORTION OF OUR COVERAGE AREA; CONEMAUGH REGIONAL HOSPICE ADDED A HELPING HEARTS PROGRAM TO ASSIST THOSE PATIENT SUFFERING FROM CONGESTIVE HEART FAILURE; A BRAND NEW WEBSITE WAS LAUNCHED PROVIDING MORE EDUCATIONAL RESOURCES AND SUPPORT GROUP INFORMATION FOR THE COMMUNITY; AND A NUMBER OF WELLNESS EVENTS AND SCREENINGS TOOK PLACE THROUGHOUT THE REGION TO RAISE AWARENESS AND PREVENTION FOR HEALTH ISSUES INCLUDING DIABETES, OBESITY, HEART DISEASE, AND PERIPHERAL VASCULAR DISEASE. MYMC IS COMMITTED TO PROVIDING EDUCATIONAL INFORMATION AND SCREENINGS TO THE COMMUNITY. NEARLY 50 MEYERSDALE EMPLOYEES PARTICIPATED IN "WELLNESS" ACTIVITIES FOR THE COMMUNITY INCLUDING SCREENINGS FOR BLOOD SUGARS, PFTS, EKGS, VASCULAR SCREENS, VISION SCREENING, CHOLESTEROL, BONE DENSITY AND BODY FAT ANALYSIS. MYMC DONATES SPACE IN ITS DINING ROOM AND CONFERENCE ROOM EACH WEEK FOR ALCOHOLICS ANONYMOUS MEETINGS. MEYERSDALE COMMUNITY HOSPITAL FACILITY HIGHLIGHTS:LICENSED BEDS - 20BEDS IN SERVICE - 20PATIENT DAYS OF SERVICE - 1,675INPATIENT DAILY CENSUS - 5ADMISSIONS - 383AVERAGE LENGTH OF STAY - 4.4FULL TIME EQUIVALENT EMPLOYEES - 108.7VOLUNTEERS - 33PHYSICIANS:ACTIVE - 4SERVICES:EMERGENCY VISITS - 4,110SAME DAY/AMBULATORY SURGERY - 182PHYSICAL THERAPY TREATMENTS - 5,406LABORATORY TESTS - 69,785RADIOLOGY DIAGNOSTIC/MAMMOGRAPHY - 6,349ULTRASOUND PROCEDURES - 1,135CT SCANS - 2,252MRI PROCEDURES - 524CARDIO/RESPIRATORY PROCEDURES - 14,197 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 1 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 1 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NATHAN O THOMAS MD | |||||||||||||
| 0 | 145481 | 0 | 11846 | 0 | 19731 | 0 | 14708 | 0 | 17884 | 0 | 209650 | 0 | 0 |
| MARY L LIBENGOOD | |||||||||||||
| 129562 | 0 | 20683 | 0 | 37606 | 0 | 0 | 0 | 7023 | 0 | 194874 | 0 | 23133 | 0 |
| SCOTT BECKER | |||||||||||||
| 0 | 571461 | 0 | 210076 | 0 | 454900 | 0 | 13224 | 0 | 29745 | 0 | 1279406 | 0 | 204798 |
| EDWARD DEPASQUALE | |||||||||||||
| 0 | 313637 | 0 | 66488 | 0 | 158513 | 0 | 18798 | 0 | 16369 | 0 | 573805 | 0 | 98604 |
| DAVID CARLSON DO | |||||||||||||
| 0 | 400722 | 0 | 86056 | 0 | 191324 | 0 | 12606 | 0 | 18005 | 0 | 708713 | 0 | 103693 |
| JOSEPH DADO | |||||||||||||
| 0 | 254066 | 0 | 53829 | 0 | 134691 | 0 | 13099 | 0 | 3032 | 0 | 458717 | 0 | 80488 |
| STEVEN TUCKER | |||||||||||||
| 0 | 313307 | 0 | 66488 | 0 | 151714 | 0 | 19435 | 0 | 15912 | 0 | 566856 | 0 | 97025 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART I, LINE 4B | THE CONEMAUGH HEALTH SYSTEM'S 457(F) EXECUTIVE COMPENSATION PROGRAM WAS TERMINATED DECEMBER 10, 2010 RESULTING IN A TAXABLE EVENT. ON THAT DATE, EACH PARTICIPANT'S ENTIRE ACCOUNT BALANCE WAS RECOGNIZED AS TAXABLE INCOME PER IRS REGULATIONS. THESE AMOUNTS, WHICH ARE INCLUDED ON THE 990 CORE FORM AND SCHEDULE J AS REPORTABLE COMPENSATION ARE AS FOLLOWS: $430,918 FOR SCOTT BECKER; $148,478 FOR EDWARD DEPASQUALE; $180,982 FOR DAVID CARLSON, DO; $130,649 FOR JOSEPH DADO; $136,362 FOR STEVEN TUCKER; AND $37,606 FOR MARY LIBENGOOD. PLEASE NOTE THAT THESE AMOUNTS LESS ALL APPLICABLE TAXES, WHICH HAVE BEEN REMITTED UPON THE PLAN'S TERMINATION, WILL NOT BE DISTRIBUTED TO THE PARTICIPANTS UNTIL 1 YEAR AND 1 DAY AFTER THE TERMINATION DATE HAS PASSED. | |
| PART I, LINE 6 | MARY LIBENGOOD RECEIVED A BONUS FROM MEYERSDALE COMMUNITY HOSPITAL. SCOTT BECKER, EDWARD DEPASQUALE, DAVID CARLSON, DO, AND JOSEPH DADO RECEIVED A BONUS FROM THE CONEMAUGH HEALTH SYSTEM, A RELATED ORGANIZATION. STEVEN TUCKER RECEIVED A BONUS FROM MEMORIAL MEDICAL CENTER, A RELATED ORGANIZATION. EXECUTIVE BONUSES ARE CALCULATED AS A PERCENTAGE OF BASE SALARY. THE PERCENTAGE IS CONTINGENT ON VARIOUS FINANCIAL AND NON-FINANCIAL INCENTIVE CRITERIA, GOVERNED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF CONEMAUGH HEALTH SYSTEM. | |
| PART III | PART II, COLUMN (F): PAST CONTRIBUTIONS MADE TO THE 457(F) PLAN ARE INCLUDED AS REPORTABLE COMPENSATION IN THE CURRENT YEAR DUE TO THE PLAN'S TERMINATION. AMOUNTS SHOWN REPRESENT CONTRIBUTIONS THAT WERE RECOGNIZED AS DEFERRED COMPENSATION ON PAST FORM 990S. | SUPPLEMENTAL INFORMATION |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | LISA SCHAFER | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | FAMILY MEMBER OF M. SUSAN DOM (TRUSTEE) | Relationship |
| Amount Of Transaction | 32765 | AmountOfTransaction |
| Description Of Transaction | EMPLOYMENT | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (11 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE MEMBERS OF MEYERSDALE COMMUNITY HOSPITAL CONSIST OF THREE CLASSES: PERPETUAL MEMBERS, LIFE MEMBERS, AND CONEMAUGH HEALTH SYSTEM, INC. (THE CORPORATE MEMBER). | |
| FORM 990, PART VI, SECTION A, LINE 7A | THE CORPORATE MEMBER OF MEYERSDALE COMMUNITY HOSPITAL, CONEMAUGH HEALTH SYSTEM, INC., HAS THE POWER TO APPROVE OR DISAPPROVE THE ELECTION OF OR REMOVAL OF MEMBERS OF THE GOVERNING BODY. | |
| FORM 990, PART VI, SECTION A, LINE 7B | ALL DECISIONS OF THE GOVERNING BODY OF MEYERSDALE COMMUNITY HOSPITAL ARE SUBJECT TO APPROVAL BY ITS CORPORATE MEMBER, CONEMAUGH HEALTH SYSTEM, INC. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS PROVIDED TO THE ORGANIZATION'S BOARD OF DIRECTORS BEFORE IT IS FILED. ONCE THE FORM IS COMPLETE, BOARD MEMBERS ARE GIVEN THE OPPORTUNITY TO REVIEW THE CONTENTS OF THE FORM AND SUBMIT ANY COMMENTS OR QUESTIONS. IN ADDITION, SINCE THE ORGANIZATION IS A SUBSIDIARY WITHIN A LARGER HEALTH SYSTEM, THE FORM IS REVIEWED BY THE HEALTH SYSTEM'S MANAGER, TAX & COMPLIANCE; DIRECTOR, FINANCIAL OPERATIONS; VICE-PRESIDENT, FINANCIAL OPERATIONS; CHIEF FINANCIAL OFFICER; AND THE AUDIT AND COMPLIANCE COMMITTEE. AN EXTERNAL CPA FIRM IS ENGAGED TO REVIEW AND ELECTRONICALLY FILE THE RETURN. | |
| THE ORGANIZATION IS A SUBSIDIARY OF A LARGER HEALTH SYSTEM AND IS GOVERNED BY THE SYSTEM'S CONFLICT OF INTEREST POLICY, WHICH HAS BEEN APPROVED BY THE HEALTH SYSTEM'S BOARD. UNDER THIS POLICY, EVERY BOARD MEMBER IS GIVEN A COPY OF THE POLICY AS WELL AS A FORM THAT MUST BE COMPLETED ON AN ANNUAL BASIS. NO BOARD MEMBER IS APPROVED OR RE-APPOINTED UNTIL HE OR SHE HAS COMPLETED AND SIGNED THE CONFLICT OF INTEREST FORM. ONCE THE FORM IS RETURNED, IT IS REVIEWED BY THE SYSTEM'S COMPLIANCE OFFICER AND CEO. IF ANY CONFLICTS ARE DISCLOSED, THE DETAILS ARE FORWARDED TO THE BOARD CHAIR TO BE ADDRESSED. DEPENDING ON THE CONFLICT, THE BOARD MEMBER COULD BE GIVEN CERTAIN RESTRICTIONS, SUCH AS BEING PROHIBITED FROM PARTICIPATING IN CERTAIN BOARD DECISIONS. THE HEALTH SYSTEM'S AUDIT AND COMPLIANCE COMMITTEE HAS THE FINAL DECISION-MAKING REGARDING ALL CONFLICTS OF INTEREST. THROUGHOUT THE FISCAL YEAR, BOARD MEMBERS MUST NOTIFY THE BOARD CHAIR, COMPLIANCE OFFICER, AND/OR CEO IF A NEW CONFLICT OF INTEREST HAS DEVELOPED. | FORM 990, PART VI, SECTION B, LINE 12C | |
| THE ORGANIZATION'S PARENT, A HEALTH SYSTEM, MANAGES THE DETERMINATION OF COMPENSATION AND THE PROCESS IS OUTLINED IN ITS BY-LAWS. AN OUTSIDE CONSULTING FIRM IS UTILIZED TO ENSURE THAT EXECUTIVE COMPENSATION PACKAGES ARE FAIR AND COMPARABLE WITH SIMILAR ORGANIZATIONS. THE HEALTH SYSTEM HAS ALSO ESTABLISHED AN EXECUTIVE COMPENSATION COMMITTEE TO REVIEW AND RECOMMEND THE COMPENSATION DECISIONS MADE. THIS COMMITTEE REPORTS DIRECTLY TO THE HEALTH SYSTEM'S BOARD. | FORM 990, PART VI, SECTION B, LINE 15 | |
| THE ORGANIZATION IS PART OF A HEALTH SYSTEM AND ALL REQUESTS FOR THIS INFORMATION ARE HANDLED BY THE SYSTEM'S MARKETING/PUBLIC RELATIONS DEPARTMENT. | FORM 990, PART VI, SECTION C, LINE 19 | |
| FORM 990, PART VI, LINES 12A, 13, AND 14: ALL APPLICABLE POLICY QUESTIONS HAVE BEEN ANSWERED YES SINCE THE ORGANIZATION IS A SUBSIDIARY OF A LARGER HEALTH SYSTEM AND IS GOVERNED BY THE SYSTEM'S POLICIES. ALL POLICIES HAVE BEEN APPROVED BY THE HEALTH SYSTEM'S BOARD. | ||
| FORM 990, PART VII, SECTION A, LINE 1A, COLUMN B: IN ADDITION TO THE HOURS DEVOTED TO THE FILING ORGANIZATION SHOWN IN PART VII, THE FOLLOWING OFFICERS AND TRUSTEES ALSO DEVOTED HOURS TO RELATED ORGANIZATIONS DURING THE YEAR. THE HOURS SHOWN REPRESENT THE AVERAGE NUMBER OF HOURS PER WEEK. SCOTT BECKER, CEO: CONEMAUGH HEALTH SYSTEM - 53 CONEMAUGH VALLEY MEMORIAL HOSPITAL - 4 MINERS HOSPITAL - 1 GOOD SAMARITAN MEDICAL CENTER - 0.3 CONEMAUGH HEALTH FOUNDATION - 3.5 CONEMAUGH HOUSING, INC. - 0.2 CONEMAUGH HEALTH INITIATIVES - 7 EDWARD DEPASQUALE, CFO: CONEMAUGH HEALTH SYSTEM - 22 CONEMAUGH VALLEY MEMORIAL HOSPITAL - 14 MINERS HOSPITAL - 1 GOOD SAMARITAN MEDICAL CENTER - 1 CONEMAUGH HEALTH FOUNDATION - 0.5 CONEMAUGH HOUSING, INC. - 0.5 CONEMAUGH HEALTH INITIATIVES - 10 DAVID CARLSON, DO, CMO: CONEMAUGH HEALTH SYSTEM - 20 CONEMAUGH VALLEY MEMORIAL HOSPITAL - 10 MINERS HOSPITAL - 4 GOOD SAMARITAN MEDICAL CENTER - 0.5 CONEMAUGH HEALTH FOUNDATION - 0.5 CONEMAUGH HOUSING, INC. - 1 CONEMAUGH HEALTH INITIATIVES - 10 JOSEPH DADO, CIO: CONEMAUGH HEALTH SYSTEM - 20 CONEMAUGH VALLEY MEMORIAL HOSPITAL - 16 MINERS HOSPITAL - 2 GOOD SAMARITAN MEDICAL CENTER - 1 CONEMAUGH HEALTH FOUNDATION - 1 CONEMAUGH HEALTH INITIATIVES - 8 STEVEN TUCKER, COO: CONEMAUGH HEALTH SYSTEM - 15 CONEMAUGH VALLEY MEMORIAL HOSPITAL - 25 MINERS HOSPITAL - 3 GOOD SAMARITAN MEDICAL CENTER - 1 CONEMAUGH HEALTH FOUNDATION - 0.5 CONEMAUGH HOUSING, INC. - 1 CONEMAUGH HEALTH INITIATIVES - 1.5 NATHAN THOMAS, DO: CONEMAUGH HEALTH INITIATIVES - 40 | ||
| CHANGES IN NET ASSETS OR FUND BALANCES: | CHANGE IN CHF FAS 136 RECEIVABLE 26,884. CHANGE IN INCOME TRUST 24,572. MEDICAL DIRECTOR REIMBURSEMENT FROM CHS 13,800. TOTAL TO FORM 990, PART XI, LINE 5: 65,256. | FORM 990, PART XI, LINE 5: |
| FORM 990, PART XI, LINE 2: THE ORGANIZATION'S FINANCIAL STATEMENTS FOR THE FISCAL YEAR ENDING JUNE 30, 2011 WERE AUDITED AS PART OF THE AUDIT OF THE CONSOLIDATED FINANCIAL STATEMENTS OF THE CONEMAUGH HEALTH SYSTEM, INC. AND SUBSIDIARIES. THE HEALTH SYSTEM'S AUDIT AND COMPLIANCE COMMITTEE ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT AND THE SELECTION OF THE INDEPENDENT ACCOUNTANT. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| CONEMAUGH HEALTH SYSTEM | |||||||||||
| 1086 FRANKLIN STREET | JOHNSTOWN | PA | 15905 | 232801799 | SUPPORT MEMBER HOSPITALS | PA | 501(C)(3) | 11A | N/A | 0 | |
| CONEMAUGH HEALTH FOUNDATION | |||||||||||
| 1086 FRANKLIN STREET | JOHNSTOWN | PA | 15905 | 251719695 | SUPPORTS CONEMAUGH HEALTH SYSTEM | PA | 501(C)(3) | 11B | 0 | CONEMAUGH HEALTH SYSTEM | |
| CONEMAUGH VALLEY MEMORIAL HOSPITAL DBA MEMORIAL MEDICAL CENTER | |||||||||||
| 1086 FRANKLIN STREET | JOHNSTOWN | PA | 15905 | 250965307 | HEALTHCARE SERVICES | PA | 501(C)(3) | 3 | 0 | CONEMAUGH HEALTH SYSTEM | |
| MINERS HOSPITAL DBA MINERS MEDICAL CENTER | |||||||||||
| 290 HAIDA AVENUE | HASTINGS | PA | 16646 | 250977902 | HEALTHCARE SERVICES | PA | 501(C)(3) | 3 | 0 | CONEMAUGH HEALTH SYSTEM | |
| GOOD SAMARITAN MEDICAL CENTER | |||||||||||
| 1020 FRANKLIN STREET | JOHNSTOWN | PA | 15905 | 250965428 | HEALTHCARE SERVICES | PA | 501(C)(3) | 3 | 0 | CONEMAUGH HEALTH SYSTEM | |
| CONEMAUGH HOUSING INC | |||||||||||
| 1086 FRANKLIN STREET | JOHNSTOWN | PA | 15905 | 251606936 | PROVIDES SENIOR HOUSING FACILITIES | PA | 501(C)(3) | 9 | 0 | CONEMAUGH VALLEY MEMORIAL HOSPITAL | |
Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|
| LAUREL HIGHLANDS ADVANCED IMAGING | |||||||
| 1450 SCALP AVENUE | JOHNSTOWN | PA | 15904 | 251864587 | DIAGNOSTIC SERVICES | PA | N/A |
| GREATER JOHNSTOWN TECH PARK | |||||||
| 1086 FRANKLIN STREET | JOHNSTOWN | PA | 15905 | 260389121 | OPERATES MULTI TENANT COMMERCE OFFICE PARK | PA | N/A |
Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity |
|---|---|---|---|---|---|---|---|---|
| CONEMAUGH HEALTH INITIATIVES INC | ||||||||
| 1086 FRANKLIN STREET | JOHNSTOWN | PA | 15905 | 251658283 | PHYSICIAN SERVICES | PA | N/A | C |
| 1086 REAL ESTATE | ||||||||
| 1086 FRANKLIN STREET | JOHNSTOWN | PA | 15905 | 251489704 | REAL ESTATE | PA | N/A | C |
| CONEMAUGH ENTERPRISES INC | ||||||||
| 1086 FRANKLIN STREET | JOHNSTOWN | PA | 15905 | 202998473 | ECONOMIC DEVELOPMENT | PA | N/A | C |
| SINDO INC | ||||||||
| 1086 FRANKLIN STREET | JOHNSTOWN | PA | 15905 | 251144116 | COMMUNITY RENTALS | PA | N/A | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 1 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |