2011-05-09T12:47:22-07:00 2010-06-30 990 2009-07-01 232176963 SOLDIERS & SAILORS MEMORIAL HOSPITAL SOLD 5707230603 32-36 CENTRAL AVE WELLSBORO PA 169011840 RONALD M GILBERT JR CPA 5707230603 2011-05-09 2009 2016-02-24 21:20:13Z JAN FISHER 32-36 CENTRAL AVENUE WELLSBORO PA 16901 45394838 false X laurelhs.org X 1919 PA Soldiers + Sailors Memorial Hospital (SSMH), located in Wellsboro, Pennsylvania, is an 83 bed acute care,sole community hospital which serves a rural population of over 50,000 people. 14 13 531 83 78452 385322 568722 41887102 43332781 -383801 429507 235260 259910 42123883 44590920 0 0 21030997 21899237 0 0 19962501 19484558 40993498 41383795 1130385 3207125 29719944 32556111 15832945 16480723 13886999 16075388 Soldiers + Sailors Memorial Hospital (SSMH), located in Wellsboro, Pennsylvania, is an false false 36159021 43332781 THE HOSPITAL IS AN 83 BED ACUTE CARE HOSPITAL, WHICH PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, NOR ARE SUCH AMOUNTS REPORTED AS REVENUE. THE CHARITY CARE CHARGES FOREGONE AMOUNTED TO $1,388,000 IN 2010. THE FOLLOWING IS A SUMMARY OF THE SERVICES PROVIDED TO PATIENTS: INPATIENT ADMISSIONS 2,456 NEWBORN DELIVERIES 281 OUTPATIENT VISITS 107,966 SURGERIES PERFORMED 3,859 EMERGENCY DEPT VISITS 16,007 LABORATORY TESTS 252,614 CAT SCANS 6,891 MRI TESTS 2,198 ULTRASOUND TESTS 5,328 NUCLEAR MED TESTS 1,269 RADIOLOGY TESTS 29,263 PT TREATMENTS 37,291 OCC THERAPY TREATMENTS 15,665 SPEECH THRPY TRMNT 3,849 DURING 2010 MEDICARE AND MEDICAL ASSISTANCE CHARGES ACCOUNTED FOR 62% OF THE HOSPITAL'S TOTAL CHARGES. 36159021 true true false false false false false false false true false true false false false false false false false false true false false true false false false false false false false false false false false false false true true false false true 0 0 true 531 true true true false false false false false false false false false 14 13 true false false false false false false true true false false true true true true true true true true true true X RONALD M GILBERT JR CPA 5707230603 32-36 CENTRAL AVE WELLSBORO PA 169011840 JAMES D BAKER JR 1.00 X 0 0 0 R ROBERT DECAMP 1.00 X X 0 0 0 ENRICO J DOGANIERO DO 1.00 X 0 0 0 ROBERT P FITZGERALD 1.00 X 0 0 0 RHONDA S KELLER 1.00 X 0 0 0 MICHAEL W LICHTY 1.00 X 0 0 0 CRAIG G LITCHFIELD 1.00 X X 0 0 0 J DENNIS MURRAY PHD 1.00 X 0 0 0 DONNA R WILSON 1.00 X 0 0 0 THOMAS M OWLETT ESQ 1.00 X 0 0 0 MARY CATHERINE PHINNEY 1.00 X 0 0 0 GLENN B POIRIER 1.00 X 0 0 0 JAMES J RAKOSKI 1.00 X 0 0 0 ANEURIN J WILLIAMS 1.00 X 0 0 0 JAN FISHER 40.00 X 222261 0 19281 RONALD BUTLER 40.00 X 0 285037 16100 RONALD GILBERT 40.00 X 0 161907 9180 CRAIG DEVENPORT 40 X 125046 9416 CRAIG KONZEN 40 X 111595 13746 JANIE HILFIGER 40 X 103268 15065 DAVE MILANO 40 X 102827 14058 STEPHEN BORTZ 40 X 100698 11310 765695 446944 108156 6 false true false LACK & STROSSER ARCHITECTURE 230 MARKET STREET LEWISBURG PA 17837 Architect 619512 LABORATORY CORP OF AMERICA PO BOX 12140 BURLINGTON NC 27216 Lab Testing 344688 SIEMENS MEDICAL SOLUTIONS 51 VALLEY STREAM PARKWAY MALVERN PA 19355 Maintenance Contracts 283447 WILLIAM REICH 32-36 CENTRAL AVE WELLSBORO PA 16901 Pathologist 220000 MOREL & ASSOCIATES 846 BENT CREEK DR LITITZ PA 17543 Consulting 195164 8 8750 548131 11841 568722 Patient Revenue, net 900099 42037091 42037091 Pharmacy Sales 900099 776650 776650 Paramedic 900099 278064 278064 Food sales cafeteria 900099 162795 162795 Other 900099 78181 78181 43332781 328054 328054 259910 259910 259910 181458 78452 887631 17740 803918 83713 17740 101453 101453 44590920 43514239 78452 429507 241541 0 241541 0 16419741 14993515 1426226 0 870266 784061 86205 0 3150222 2838174 312048 0 1217467 1096870 120597 0 1979613 0 1979613 0 5413 0 5413 0 44241 0 44241 0 1395450 951205 444245 0 13811 5330 8481 0 7716123 7470000 246123 0 670553 469387 201166 0 1141261 1127602 13659 0 110837 105201 5636 0 45836 40067 5769 0 59467 59467 0 0 2485539 2485539 0 0 313457 313457 0 0 Bad Debt 2577483 2577483 0 0 Physician Services 525068 525068 0 0 Telephone 119331 100264 19067 0 Tuition 92329 96675 -4346 0 Unrelated Business Income Tax 3193 0 3193 0 185553 119656 65897 0 41383795 36159021 5224774 0 730 730 59571 72776 3930914 3719533 6446153 9234474 809169 775582 747402 808397 48766838 35313840 13310545 13452998 4388950 4374098 26510 117523 29719944 32556111 2923224 2689187 17026 12056 981858 5413017 7479678 12797622 15832945 16480723 X 13403891 15992240 405860 77248 83148 13886999 16075388 29719944 32556111 X false true true X false X 0 0 0 0 0 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 368037 368037 16836903 12293867 4543036 2504710 953811 1550899 28280003 21763023 6516980 777185 303139 474046 13452998 DEFERRED FINANCING COSTS 117523 117523 3rd PARTY PAYORS 1537484 ACCRUED POST RETIREMENT HEALTH CARE BENEFIT 1701390 ACCRUED MEDICAL MALPRACTICE INSURANCE COST 557327 ACCRUED PENSION EXPENSE 5267250 Notes Payable Affiliate - Current 435293 Notes Payable Affiliate - Long Term 3298878 12797622 true true X true X true X true true false true true 499616 499616 0.01210 5659020 3286334 2372686 0.05730 6158636 3286334 2872302 0.06940 6158636 3286334 2872302 0.06940 true 927894 12780557 12696297 84260 X true true LAUREL MANAGEMENT SERVICES Provide executive management, accounting, etc 0.00000 0.00000 0.00000 SOLDIERS & SAILORS MEMORIAL HOSPITAL

32-36 CENTRAL AVENUE WELLSBORO PA 16901

X X X OUR COMMUNITY BENEFIT REPORT IS CONTAINED IN THE ANNUAL REPORT TOTAL COMMUNITY BENEFIT EXPENSE WAS DERIVED FROM WORKSHEET 2, BAD DEBT EXPENSE OF $2,577,483 IS INCLUDED IN FUNCTIONAL EXPENSES THE ESTIMATED COST OF BAD DEBT EXPENSE IS CALCULATED USING THE MEDICARE COST REPORT USES A COST PER DAY FOR ROUTINE PATIENTS WHO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE THE BOARD OF DIRECTORS IS COMPOSED OF VARIOUS COMMUNITY LEADERS THE ORGANIZATIONS CHARITY CARE POLICY IS POSTED AT EVERY THE ORGANIZATION SERVES TIOGA COUNTY AND SURROUNDING AREAS. THE ORGANIZATION PARTICIPATES IN COMMUNITY BUILDING THROUGH VARIOUS THE FACILITY HAS AN OPEN MEDICAL STAFF POLICY. THE BOARD OF DIRECTORS THE HOSPITAL IS PART OF LAUREL HEALTH SYSTEM, WHICH CONSISTS OF X X X X false false false false false false true false false JAN FISHER 222261 8653 10628 241542 RONALD BUTLER 285037 12515 3585 301137 RONALD GILBERT 161907 4520 4659 171086 Pt I Line 6b The Laurel Health System's Executive Compensation Policy and Program describes Laurel Health System's executive compensation program for key senior managers. Laurel Health System's annual incentive plan is designed to focus the attention of key executives on the key annual system goals as approved by the Board of Trustees, and to be performance-based; each individual's compensation is based on both System and individual performance. The Executive Compensation Committee of the Board (Committee) adopts performance measures annually, establishes a target incentive pool of funds, and awards the actual incentives at the end of the year based on actual performance against the established standards. Laurel Health System targets both base and total cash compensation at the 50th percentile (P50) of the market of comparable health systems. Laurel Health System's incentive plan consists of System circuit breakers, system performance measures and individual incentive targets, which are established and approved annually by the Committee. Performance measures assess overall Laurel Health System performance and are calibrated in terms of threshold, target and maximum performance levels. Measures include financial and nonfinancial criteria in order to reflect a balanced sense of System performance. Incentive targets are expressed as a percentage of base salary and are reviewed annually to reflect internal equity and external competitiveness. The actual incentive fund is determined at the conclusion of the fiscal year once the performance levels for the System performance measures are known. Award levels for each measure are calculated using the weight for each measure and the performance levels. Pt VI-A, Line 2 Board member Robert DeCamp is the father-in-law of board member Thomas Owlett. Pt VI-B, Line 11A Members of the board of directors of Laurel Health System are provided a copy of the Form 990 prior to filing. The CFO reviews the Form 990 with the Finance Committee of the board of directors and responds to any questions. Subsequent to this meeting, the Finance Committee then recommends to the board of directors that the Form 990 be approved for filing. Pt VI-B, Line 12c Annually on the 1st day of January the CEO sends to all directors, officers, management staff and contracted physicians a questionnaire to be completed and returned by Jan 15. A report is submitted to the board of directors to notify any conflicts of interest disclosed. Pt VI-B, Line 15 On a bi-annual basis an independent compensation consulting firm performs an analysis of the leadership salary structure in relationship to the labor market using data from four different salary surveys. Their analysis is reviewed with the Governance Committee of the board of directors. The firm then outlines its recommendations for the proposed executive salary structure to the committee for their consideration and approval. Pt VI-C, Line 19 Governing documents and financial statements are available to the public upon request. The conflict of interest policy is also available upon request. LAUREL HEALTH SYSTEM 15 MEADE ST WELLSBORO PA 16901 240795488 Support entities affiliated with Laurel Health System PA 501(c)3 509(a)(3) LAUREL HEALTH SYSTEM LAUREL REALTY 15 MEADE ST WELLSBORO PA 16901 231403678 Own and manage real estate in support of Laurel Health PA 501(c)2 509(a)(3) LAUREL HEALTH SYSTEM LAUREL MANAGEMENT SERVICES 15 MEADE ST WELLSBORO PA 16901 251644910 Management consulting and supervisory services PA 501(c)3 509(a)(3) LAUREL HEALTH SYSTEM NORTH PENN COMPREHENSIVE HEALTH SERVICES 22 WALNUT ST WELLSBORO PA 16901 231889724 Provide general health and social services PA 501(c)3 509(a)(3) LAUREL HEALTH SYSTEM THE GREEN HOME 37 CENTRAL AVENUE WELLSBORO PA 16901 240804365 Operate skilled nursing & assisted living facilities PA 501(c)3 509(a)(3) LAUREL HEALTH SYSTEM TIOGA HEALTH CARE PROVIDERS 15 MEADE ST WELLSBORO PA 16901 251765538 Employ physician specialists PA 501(c)3 509(a)(3) LAUREL HEALTH SYSTEM TYOGA CARENET 15 MEADE STREET WELLSBORO PA 16901 251810967 Integrate health care regionally PA LAUREL HEALTH SYS C 0.00000 TIOGA MANAGEMENT SERVICES ORGANIZATION 15 MEADE STREET WELLSBORO PA 16901 232886336 Manage physician practices PA LAUREL HEALTH SYS C 0.00000 true false true true false false false false true true false true false true true true false false NORTH PENN COMPREHENSIVE HEALTH SERVICES - RENT PAYMENTS a 48774 LAUREL MANAGEMENT SERVICES - RENT PAYMENTS a 29404 LAUREL HEALTH SYSTEM - LOAN TO PARENT d 3376140 LAUREL REALTY - RENT j 66331 LAUREL MANAGEMENT SERVICES - MANAGEMENT FEE l 1979613 NORTH PENN COMPREHENSIVE HEALTH SERVICES o 84293 TIOGA HEALTH CARE PROVIDERS o 305068 NORTH PENN COMPREHENSIVE HEALTH SERVICES p 305553 LAUREL REALTY p 60056