2024-05-07T12:22:05-05:00 2023-06-30 WithumSmithBrown PC 1835 MARKET STREET SUITE 1710 PHILADELPHIA PA 19103 990 2022-07-01 250815795 GUTHRIE MEDICAL GROUP PC % MICHELE SISTO GUTH 5708885858 ONE GUTHRIE SQUARE SAYRE PA 18840 EDMUND SABANEGH PRESIDENT/CEO 5708885858 2024-05-06 true EDMUND SABANEGH 000000000 Scott J Mariani P00642486 2155462140 2 2022 2023-04-26 12:10:37Z EDMUND SABANEGH MD MBA ONE GUTHRIE SQUARE SAYRE PA 18840 476501784 false X WWW.GUTHRIE.ORG X 1987 PA THE PROVISION OF CHARITABLE MEDICAL CARE FOR THE BENEFIT OF THE COMMUNITY. 1 0 2312 21 85257 0 105688754 94386220 342487741 357046198 636086 1762001 77454 25459 448890035 453219878 15600 15925 0 0 280818320 305062321 0 0 0 135547375 149765270 416381295 454843516 32508740 -1623638 248860887 724477168 235714090 712548554 13146797 11928614 X THE PROVISION OF PROFESSIONAL MEDICAL PHYSICIAN SERVICES WITHOUT REGARD TO ABILITY TO PAY AND IN A CHARITABLE MANNER TO SUPPORT THE GOALS AND OBJECTIVES OF THE GUTHRIE CLINIC AND ITS AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. GUTHRIE MEDICAL GROUP, P.C.'S ACTIVITIES AND CHARITABLE PURPOSES INCLUDE, WITHOUT LIMITATION, ACTIVITIES IN FURTHERANCE OF ITS AFFILIATED TAX-EXEMPT HOSPITALS. false false 364825652 15925 357046198 EXPENSES INCURRED IN THE PROVISION OF PROFESSIONAL MEDICAL PHYSICIAN SERVICES WITHOUT REGARD TO ABILITY TO PAY AND IN A CHARITABLE MANNER TO SUPPORT THE GOALS AND OBJECTIVES OF THE GUTHRIE CLINIC AND ITS AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. GUTHRIE MEDICAL GROUP, P.C.'S ACTIVITIES AND CHARITABLE PURPOSES INCLUDE, WITHOUT LIMITATION, ACTIVITIES IN FURTHERANCE OF ITS AFFILIATED TAX-EXEMPT HOSPITALS. 364825652 true true false true false false false false false true true false false true true true false true false false false false false false false false false false true true false false false false false false false false false false false false false true false false false true X 0 0 2312 true true true false false false false false false false false false false false X 1 0 false false false false true true true true true false false true true true true true true true true false NY PA X MICHELE SISTO 5708874625 ONE GUTHRIE SQUARE SAYRE PA 18840 X EDMUND SABANEGH MD DIRECTOR-PRESIDENT/CEO TGC 55.0 0.0 X X 0 1380960 192157 JEDEDIAH MCCLINTIC MD PHYSICIAN 55.0 0.0 X 1094868 0 45635 PRAMOD DESHMUKH MD PHYSICIAN 55.0 0.0 X 1070468 0 45932 MASON STILWELL MD PHYSICIAN 55.0 0.0 X 1014039 0 22281 CHRISTOPHER PARAMORE MD CHIEF, NEUROSURGERY 55.0 0.0 X 921352 0 43873 THOMAS MCDONALD MD PHYSICIAN 55.0 0.0 X 894575 0 38682 FREDERICK J BLOOM MD PRESIDENT (7/1/22-4/30/23) 55.0 0.0 X 682120 0 82313 J MICHAEL SCALZONE MD EVP/CHIEF QUAL OFF (TERM 9/22) 55.0 0.0 X 693567 0 44430 JOSEPH RONSIVALLE MD PRESIDENT (EFF 4/30/23) 55.0 0.0 X 620521 0 44922 MATTHEW HUFF CPA EVP/CHIEF FINANCIAL OFFICER 55.0 0.0 X 0 603700 40635 STACI THOMPSON EVP/CHIEF OPERATING OFFICER 55.0 0.0 X 477146 0 79750 LISA ESOLEN MD EVP/CHIEF QUALITY OFFICER 55.0 0.0 X 0 448049 33412 7468656 2432709 714022 652 false true false 0 94358725 27495 94386220 NET PATIENT SERVICE REVENUE 621110 282477073 282477073 OTHER HEALTHCARE RELATED REVENUE 900099 73917624 73917624 RENTAL INCOME - AFFILIATES 531110 651501 566244 85257 357046198 880043 880043 0 0 25459 25459 0 25459 25459 23439302 724562 22984974 296932 454328 427630 881958 881958 0 0 0 0 0 0 0 0 0 0 453219878 356960941 85257 1787460 0 15925 15925 0 0 2724770 2473355 251415 0 261079598 248103942 12975656 8341091 5490940 2850151 18524367 12057510 6466857 14392495 12904311 1488184 28882695 28882695 408525 408525 95000 95000 1675 1675 0 95684 95684 32345000 28618160 3726840 21069 20041 1028 4053747 3343904 709843 4977574 692621 4284953 0 17654887 1902123 15752764 2157152 1915855 241297 0 171446 98190 73256 839532 839532 0 7609694 397743 7211951 5722966 3902215 1820751 MEDICAL SUPPLIES 42469896 42489941 -20045 0 OTHER EXPENSES 2258728 398876 1859852 0 454843516 364825652 90017864 0 X -174018 -116930 96 96 0 0 17373582 15296389 0 0 0 0 300347 269097 2894630 3059912 6889699 6085569 122215250 86754976 38296983 35460274 36929390 28419558 945389 621728 0 0 0 0 145404789 635381475 248860887 724477168 44026423 34213965 0 0 441567 436227 0 0 0 0 0 0 0 0 0 0 191246100 677898362 235714090 712548554 X 13068677 11842783 78120 85831 13146797 11928614 248860887 724477168 X -1623638 561998 -156543 X X false true X true true true X SCHEDULE A, PART I, LINE 3 ALTHOUGH THIS ORGANIZATION RECEIVES ITS PUBLIC CHARITY STATUS AS A HOSPITAL, IT IS NOT REQUIRED TO FILE FORM 990, SCHEDULE H, AS THE ORGANIZATION IS NOT A LICENSED HOSPITAL. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 1675 1675 false SCHEDULE C, PART II-B; LINE 1I THIS ORGANIZATION IS A MEMBER OF THE AMERICAN MEDICAL GROUP ASSOCIATION WHICH ENGAGES IN LOBBYING EFFORTS ON BEHALF OF ITS MEMBER ORGANIZATIONS. A PORTION OF THE DUES PAID TO THIS ORGANIZATION HAS BEEN ALLOCATED TO LOBBYING ACTIVITIES PERFORMED ON BEHALF OF THE ORGANIZATION DURING THE YEAR ENDED JUNE 30, 2023. THIS ALLOCATION AMOUNTED TO $1,675 DURING THE YEAR ENDED JUNE 30, 2023. 78120 263187 4961 260437 85831 183731 175507 -9004 272114 78120 68944 112047 12676 9936 183731 75609 19875 26540 68944 76747 10453 11591 75609 1.00000 false false 1168041 1168041 47033155 39189507 7843648 17441456 8630403 8811053 55168372 38541213 16627159 1404226 393853 1010373 35460274 DUE FROM AFFILIATES 617883704 RIGHT OF USE ASSET 15127425 OTHER ASSETS 2370346 635381475 0 PROFESSIONAL LIABILITY RESERVE 31561719 WORKERS COMPENSATION RESERVE 731256 SWAP CONTRACT PAYABLE 431041 TGC - BOND PAYABLE 28488506 THIRD PARTY PAYABLE 41966 RIGHT OF USE LIABILITY 15581245 DUE TO AFFILIATES 601062629 CMS ADVANCED PAYMENT LIABILITY 0 677898362 X SCHEDULE D, PART V, LINE 4 FUNDS ARE DONATED TO HELP CANCER PATIENTS OFFSET UNEXPECTED FINANCIAL DIFFICULTIES RELATED TO THEIR ILLNESS. SCHEDULE D, PART X, LINE 2 THE ORGANIZATION IS AN AFFILIATE WITHIN THE GUTHRIE CLINIC AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM'S PARENT ENTITY IS THE GUTHRIE CLINIC. AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF THE SYSTEM AND ALL ENTITIES WITHIN THE SYSTEM FOR THE YEARS ENDED JUNE 30, 2023 AND JUNE 30, 2022; INCLUDING THIS ORGANIZATION; RESPECTIVELY. THE INDEPENDENT CPA FIRM ISSUED AN UNMODIFIED OPINION WITH RESPECT TO THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS. THE FOLLOWING FOOTNOTE IS INCLUDED IN THE SYSTEMS'S AUDITED CONSOLIDATED FINANCIAL STATEMENTS THAT REPORTS THE SYSTEM'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 (ASC 740): ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE CORPORATION TO EVALUATE TAX POSITIONS TAKEN BY THE CORPORATION AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE CORPORATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE CORPORATION HAS CONCLUDED THAT AS OF JUNE 30, 2023 AND 2022, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. true EDUCATIONAL AID SCHOLARSHIPS AND AWARDS 49 15925 SCHEDULE I, PART I; QUESTION 2 HEALTH PROFESSION SCHOLARSHIPS ARE AVAILABLE TO HIGH SCHOOL SENIORS. TO BE ELIGIBLE, THE SENIOR MUST PLAN TO ENTER AN ACCREDITED COLLEGE, UNIVERSITY, HOSPITAL BASED NURSING OR ALLIED HEALTH PROGRAM, WITH CAREERS IN HEALTH PROFESSIONS, INCLUDING HOSPITAL ADMINISTRATION OR A PLANNED CAREER IN MEDICAL RESEARCH. GUTHRIE EMPLOYEE SCHOLARSHIPS ARE OFFERED TO CHILDREN OF FULL-TIME EMPLOYEES OF GUTHRIE. SENIORS MUST PLAN TO ATTEND AN ACCREDITED COLLEGE OR UNIVERSITY. ANY CAREER INTEREST IS ALLOWED. X X X X true true false false false false false true false EDMUND SABANEGH MD DIRECTOR-PRESIDENT/CEO TGC 0 985892 0 365734 0 29334 0 175450 0 16707 0 1573117 0 0 JEDEDIAH MCCLINTIC MD PHYSICIAN 1075093 0 0 0 19775 0 16013 0 29622 0 1140503 0 0 0 PRAMOD DESHMUKH MD PHYSICIAN 1027968 0 22000 0 20500 0 19825 0 26107 0 1116400 0 0 0 MASON STILWELL MD PHYSICIAN 943539 0 50000 0 20500 0 16013 0 6268 0 1036320 0 0 0 CHRISTOPHER PARAMORE MD CHIEF, NEUROSURGERY 900852 0 0 0 20500 0 19825 0 24048 0 965225 0 0 0 THOMAS MCDONALD MD PHYSICIAN 828975 0 50000 0 15600 0 19825 0 18857 0 933257 0 0 0 FREDERICK J BLOOM MD PRESIDENT (7/1/22-4/30/23) 512597 0 120267 0 49256 0 63456 0 18857 0 764433 0 42180 0 J MICHAEL SCALZONE MD EVP/CHIEF QUAL OFF (TERM 9/22) 395891 0 102790 0 194886 0 19825 0 24605 0 737997 0 34625 0 JOSEPH RONSIVALLE MD PRESIDENT (EFF 4/30/23) 582373 0 38148 0 0 0 18300 0 26622 0 665443 0 0 0 MATTHEW HUFF CPA EVP/CHIEF FINANCIAL OFFICER 0 493147 0 109815 0 738 0 16013 0 24622 0 644335 0 0 STACI THOMPSON EVP/CHIEF OPERATING OFFICER 344317 0 82808 0 50021 0 52628 0 27122 0 556896 0 0 0 LISA ESOLEN MD EVP/CHIEF QUALITY OFFICER 0 336652 0 58363 0 53034 0 19825 0 13587 0 481461 0 0 PART VII AND SCHEDULE J IN ACCORDANCE WITH INTERNAL REVENUE SERVICE FORM 990 RULES, REGULATIONS AND INSTRUCTIONS, THE COMPENSATION REPORTED IN CORE FORM, PART VII AND SCHEDULE J, PART II OF THIS FORM 990 IS DERIVED FROM 2022 FORMS W-2 AND FORMS 1099 (IF APPLICABLE). SCHEDULE J, PART I; QUESTION 4A THE FOLLOWING INDIVIDUAL RECEIVED A SEVERANCE PAYMENT DURING CALENDAR YEAR 2022 WHICH WAS INCLUDED IN HIS 2022 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: J. MICHAEL SCALZONE, M.D., $148,108. SCHEDULE J, PART I; QUESTION 4B THE GUTHRIE CLINIC ("TGC") HAS ESTABLISHED AN EMPLOYEE BENEFIT PLAN KNOWN AS THE GUTHRIE CLINIC 457(F) DEFERRED COMPENSATION PLAN (THE "PLAN") WHICH IS DESIGNED TO PROVIDE ELIGIBLE EMPLOYEES WITH DEFERRED COMPENSATION BENEFITS IN RECOGNITION OF THEIR DEDICATED AND VALUABLE SERVICE TO TGC. THE PLAN IS INTENDED TO BE AN INELIGIBLE DEFERRED COMPENSATION PLAN AS DESCRIBED IN SECTION 457(F) OF THE INTERNAL REVENUE CODE. EACH CONTRIBUTION VESTS AFTER THREE YEARS OF EMPLOYMENT PROVIDED THE PARTICIPANT REMAINS CONTINUOUSLY EMPLOYED. A PARTICIPANT SHALL BECOME FULLY VESTED IN THE PARTICIPANT'S 457(F) ACCOUNT BENEFIT UPON ATTAINING AGE 62, WITH 5 YEARS OF SERVICE. TGC SHALL DISTRIBUTE THE PARTICIPANT'S 457(F) ACCOUNT BENEFIT, LESS TAXES WITHHELD, THIRTY DAYS AFTER THE PARTICIPANT FIRST BECOMES VESTED IN THE PLAN. FOR YEARS SUBSEQUENT TO A PARTICIPANT ATTAINING AGE 62, THE PARTICIPANT SHALL BE ENTITLED TO THE PARTICIPANT'S DEFERRED COMPENSATION AMOUNT AS OF JULY 1ST IMMEDIATELY SUBSEQUENT TO THE DATE WHEN CREDITED. THE AMOUNT REFLECTED IN SCHEDULE J, PART II, COLUMN B(III) FOR THE FOLLOWING INDIVIDUALS INCLUDES CURRENT YEAR VESTING IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) AS THE AMOUNT WAS NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN THE INDIVIDUAL'S 2022 FORM W-2 AS TAXABLE WAGES: FREDERICK J. BLOOM, M.D., $44,504; J. MICHAEL SCALZONE, M.D., $34,625; STACI THOMPSON, $28,463 AND LISA ESOLEN, M.D., $36,378. THE DEFERRED COMPENSATION AMOUNTS REFLECTED IN SCHEDULE J, PART II, COLUMN C FOR THE FOLLOWING INDIVIDUALS INCLUDE UNVESTED BENEFITS IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) WHICH ARE SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THESE INDIVIDUALS MAY NEVER ACTUALLY RECEIVE THIS UNVESTED BENEFIT AMOUNT. THE AMOUNTS OUTLINED HEREIN WERE NOT INCLUDED IN EACH INDIVIDUAL'S 2022 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: EDMUND SABANEGH, M.D., $155,625; FREDERICK J. BLOOM, M.D., $43,631 AND STACI THOMPSON, $34,328. SCHEDULE J, PART I; QUESTION 7 CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A BONUS DURING CALENDAR YEAR 2022 WHICH AMOUNTS WERE INCLUDED IN COLUMN B(II) HEREIN AND IN EACH INDIVIDUAL'S 2022 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT. SCHEDULE J, PART II; COLUMN F THE AMOUNTS REPORTED IN SCHEDULE J, PART II, COLUMN (F) INCLUDE VESTED BENEFITS IN A DEFERRED COMPENSATION PLAN AS THESE AMOUNTS WERE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. THESE AMOUNTS WERE REPORTED AS DEFERRED COMPENSATION ON PRIOR YEARS' FORMS 990 AND ARE NOW BEING REPORTED AGAIN ON THIS YEAR'S FORM 990. THESE HAVE BEEN TREATED AS TAXABLE INCOME AND REPORTED ON EACH INDIVIDUAL'S FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. CORE FORM, PART I, LINES 3 & 4 & PART VI, SECTION A; Q'S 1A & 1B THIS ORGANIZATION IS AN AFFILIATE WITHIN THE GUTHRIE CLINIC AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). AS REFLECTED ON CORE FORM, PART I, LINES 3 AND 4 AND ALSO IN PART VI, LINES 1A AND 1B, THERE IS ONE VOTING MEMBER ON THE BOARD OF DIRECTORS. AT YEAR END, THE VOTING BOARD MEMBER IS NOT INDEPENDENT BECAUSE HE IS EMPLOYED BY THIS ORGANIZATION AND RECEIVES WAGES AS AN EMPLOYEE. ALTHOUGH THIS FEDERAL FORM 990 SHOWS NO INDEPENDENT BOARD OF DIRECTORS UNDER THE INTERNAL REVENUE SERVICE RULES AND REGULATIONS; THIS ORGANIZATION ACTS IN A CHARITABLE TAX-EXEMPT MANNER FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 501(C)(3) AND IS CONTROLLED BY THE GUTHRIE CLINIC; AN INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION, WHICH IS GOVERNED BY A BOARD OF DIRECTORS, A MAJORITY OF WHICH ARE INDEPENDENT VOTING MEMBERS. CORE FORM, PART V; QUESTION 1A & CORE FORM, PART VII; SECTION B THE ORGANIZATION IS AN AFFILIATE WITHIN THE GUTHRIE CLINIC AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THE ORGANIZATION'S FORM 990 REFLECTS NO TOP FIVE INDEPENDENT CONTRACTORS FOR SERVICES AND REPORTS THAT NO FORMS 1099 WERE FILED WITH THE INTERNAL REVENUE SERVICE ("IRS"). THE GUTHRIE CLINIC, A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION PAYS ALL OUTSTANDING ACCOUNTS PAYABLE INVOICES ON BEHALF OF THIS ORGANIZATION. IN CONJUNCTION WITH THIS SERVICE, THE GUTHRIE CLINIC ALSO PREPARES AND ISSUES FORMS 1099 TO THESE VENDORS RECEIVING PAYMENTS WHERE APPLICABLE AND FILES THESE FORMS 1099 WITH THE IRS. THE GUTHRIE CLINIC ALLOCATES THESE PAYMENTS TO THE ORGANIZATION VIA AN INTERCOMPANY ACCOUNT. CORE FORM, PART V, QUESTION 15 EDMUND SABANEGH, M.D. IS LISTED AS A DIRECTOR/OFFICER ON THIS FORM 990. THIS IS HIS SOLE ROLE WITH THE ORGANIZATION. HE PROVIDES NO SERVICES TO OR FOR THE ORGANIZATION AND IS NOT INVOLVED IN THE MANAGEMENT OR DAY TO DAY ACTIVITIES OF THIS ORGANIZATION. DR. SABANEGH IS EMPLOYED BY A RELATED ORGANIZATION AND WORKS FULL TIME IN THIS CAPACITY FOR THE GUTHRIE CLINIC. ACCORDINGLY, HIS COMMON LAW EMPLOYER/EMPLOYEE RELATIONSHIP IS WITH THE GUTHRIE CLINIC (EIN: 23-3055017). THE GUTHRIE CLINIC FILED A 2022 FORM 4720 WHICH INCLUDED A REMITTANCE OF EXCISE TAX RELATED TO DR. SABANEGH'S COMPENSATION IN EXCESS OF $1M. JEDEDIAH MCCLINTIC, M.D., PRAMOD DESHMUKH, M.D. AND MASON STILWELL, M.D. are included within this organization's form 990, part vii. The organization was not required to file a Federal Form 4720 for any remittance of excise tax related to these individuals because they are licensed medical providers whose compensation was for clinical services and thus exempt from excise taxes as provided for under internal revenue code section 4960. CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7 THE GUTHRIE CLINIC ("TGC") IS THE SOLE MEMBER OF THIS ORGANIZATION WHICH EXISTS THROUGH A LICENSED PHYSICIAN NOMINEE AGREEMENT DUE TO CORPORATE PRACTICE OF MEDICINE PROHIBITIONS. TGC HAS THE ULTIMATE AUTHORITY AND RIGHT TO ELECT THE MEMBERS OF THIS ORGANIZATION'S BOARD OF DIRECTORS AND HAS CERTAIN RESERVED POWERS AS DEFINED IN THIS ORGANIZATION'S BYLAWS. CORE FORM, PART VI, SECTION B; QUESTION 11B THE ORGANIZATION IS AN AFFILIATE WITHIN THE GUTHRIE CLINIC AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE GUTHRIE CLINIC IS THE TAX-EXEMPT PARENT ENTITY OF THE SYSTEM. THE ORGANIZATION'S FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY (ITS BOARD OF DIRECTORS) PRIOR TO THE FILING OF THE FEDERAL FORM 990 WITH THE INTERNAL REVENUE SERVICE ("IRS"). AS PART OF THE TAX RETURN PREPARATION PROCESS THE ORGANIZATION HIRED A PROFESSIONAL CERTIFIED PUBLIC ACCOUNTING ("CPA") FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION TO PREPARE THE FEDERAL FORM 990. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE ORGANIZATION'S FINANCE PERSONNEL AND INTERNAL WORKING GROUP TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE ORGANIZATION'S FINANCE PERSONNEL AND INTERNAL WORKING GROUP FOR THEIR REVIEW. THE ORGANIZATION'S FINANCE PERSONNEL AND INTERNAL WORKING GROUP REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE ORGANIZATION'S FINANCE PERSONNEL AND INTERNAL WORKING GROUP FOR FINAL REVIEW AND APPROVAL. FOLLOWING THIS REVIEW, THE FINAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF THIS ORGANIZATION'S GOVERNING BODY PRIOR TO FILING WITH THE IRS. CORE FORM, PART VI, SECTION B; QUESTION 12 THE CONFLICT OF INTEREST DISCLOSURE POLICY SETS FORTH THAT ALL PERSONS, INCLUDING EMPLOYEES, AGENTS AND BOARD/COMMITTEE MEMBERS, PARTICULARLY THOSE INVOLVED IN DECISION-MAKING FOR THE GUTHRIE CLINIC ("TGC"), ACT IN AN APPROPRIATE MANNER AND WILL NOT PARTICIPATE IN ANY ACTIONS THAT MIGHT CREATE A PERSONAL OR PROFESSIONAL CONFLICT OF INTEREST AND/OR NOT BE IN THE BEST INTEREST OF TGC. ALL MEMBERS OF ANY TGC BOARD/COMMITTEE AND TGC SENIOR MANAGEMENT MUST MAKE FULL DISCLOSURE OF ANY POSSIBLE CONFLICT OF INTEREST THROUGH THE USE OF THE CONFLICT OF INTEREST DISCLOSURE FORM AND REFRAIN FROM VOTING OR PARTICIPATING IN DECISION-MAKING INVOLVING ANY POSSIBLE CONFLICT OF INTEREST. THE FORM IS DISTRIBUTED TO ALL BOARD/COMMITTEE MEMBERS AND EMPLOYEES (WHEN APPLICABLE) ANNUALLY BY THE TGC ADMINISTRATION OFFICE. TGC BOARD/COMMITTEE MEMBERS OR EMPLOYEES MUST COMPLETE THE CONFLICT OF INTEREST DISCLOSURE FORM. THIS FORM SHOULD BE COMPLETED WHEN THERE IS ANY SITUATION WHERE A POSSIBLE CONFLICT OF INTEREST EXISTS, AND/OR ON AN ANNUAL BASIS AND/OR AT THE TIME OF APPOINTMENT OR ELECTION OF NEW BOARD/COMMITTEE MEMBERS. IF THE FORM IS NOT COMPLETED WITHIN 13 MONTHS OF THE LAST SIGNING, THE TGC BOARD CHAIRMAN WILL BE ADVISED. ANY INDIVIDUAL HAVING A CONFLICT OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON ANY MATTER SHOULD EXCUSE THEMSELVES FROM THE PORTION OF THE MEETING OR MEETINGS WHERE THE MATTER IS DISCUSSED AND NOT VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER. THE MINUTES OF THE MEETING OR MEETINGS SHOULD REFLECT THE DISCLOSURE, THE ABSTENTION FROM VOTING, AND ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST EXISTED. CORE FORM, PART VI, SECTION B; QUESTION 15 THE ORGANIZATION IS AN AFFILIATE WITHIN THE GUTHRIE CLINIC AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM WHICH INCLUDES THE GUTHRIE CLINIC ("TGC"); A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION. TGC'S BOARD OF DIRECTORS MAINTAINS THE GUTHRIE CLINIC COMPENSATION COMMITTEE ("COMMITTEE"). THE COMMITTEE HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY WHICH IT FOLLOWS WHEN IT REVIEWS AND APPROVES OF THE COMPENSATION AND BENEFITS OF TGC'S SENIOR MANAGEMENT. THE COMMITTEE ALSO REVIEWS THE COMPENSATION AND BENEFITS OF OTHER OFFICERS AND KEY EMPLOYEES OF THE GUTHRIE CLINIC AND AFFILIATES; INCLUDING, WITHOUT LIMITATION, THE CHIEF EXECUTIVE OFFICERS OF THE GUTHRIE CLINIC AND AFFILIATES HOSPITALS AND MEDICAL CENTERS. THE COMMITTEE, WHICH IS REQUIRED BY THE CORPORATION'S BYLAWS TO BE COMPRISED SOLELY OF INDEPENDENT DIRECTORS, SEEKS GUIDANCE AND SUBSTANTIATION FROM A NATIONALLY RECOGNIZED COMPENSATION CONSULTANT. THE COMMITTEE REVIEWS THE "TOTAL COMPENSATION" OF THE INDIVIDUALS WHICH IS INTENDED TO INCLUDE BOTH CURRENT AND DEFERRED COMPENSATION AND ALL EMPLOYEE BENEFITS, BOTH QUALIFIED AND NON-QUALIFIED. THE COMMITTEE'S REVIEW IS DONE ON AT LEAST AN ANNUAL BASIS AND ENSURES THAT THE "TOTAL COMPENSATION" OF SENIOR MANAGEMENT OF THE ORGANIZATION IS REASONABLE. THE ACTIONS TAKEN BY THE COMMITTEE ENABLE THE ORGANIZATION TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 4958 WITH RESPECT TO THE TOTAL COMPENSATION OF CERTAIN MEMBERS OF THE SENIOR MANAGEMENT TEAM. THE THREE FACTORS WHICH MUST BE SATISFIED IN ORDER TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS ARE THE FOLLOWING: 1. THE COMPENSATION ARRANGEMENT IS APPROVED IN ADVANCE BY AN "AUTHORIZED BODY" OF THE APPLICABLE TAX-EXEMPT ORGANIZATION WHICH IS COMPOSED ENTIRELY OF INDIVIDUALS WHO DO NOT HAVE A "CONFLICT OF INTEREST" WITH RESPECT TO THE COMPENSATION ARRANGEMENT; 2. THE AUTHORIZED BODY OBTAINED AND RELIED UPON "APPROPRIATE DATA AS TO COMPARABILITY" PRIOR TO MAKING ITS DETERMINATION; AND 3. THE AUTHORIZED BODY "ADEQUATELY DOCUMENTED THE BASIS FOR ITS DETERMINATION" CONCURRENTLY WITH MAKING THAT DETERMINATION. THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF DIRECTORS EACH OF WHO ARE INDEPENDENT AND ARE FREE FROM ANY CONFLICTS OF INTEREST. THE COMMITTEE RELIED UPON APPROPRIATE COMPARABLE DATA; SPECIFICALLY, THE COMMITTEE OBTAINED A WRITTEN COMPENSATION STUDY FROM AN INDEPENDENT FIRM WHICH SPECIALIZES IN THE REVIEW OF HOSPITAL AND HEALTHCARE SYSTEM EXECUTIVE COMPENSATION AND BENEFITS THROUGHOUT THE UNITED STATES. THIS STUDY USED COMPARABLE GEOGRAPHIC AND DEMOGRAPHIC MARKET DATA INCLUDING, BUT NOT LIMITED TO, SIMILARLY SIZED HEALTHCARE SYSTEMS AND HOSPITALS, # OF LICENSED BEDS AND NET PATIENT SERVICE REVENUE. THE COMMITTEE ADEQUATELY DOCUMENTED THE BASIS FOR ITS DETERMINATION THROUGH THE TIMELY PREPARATION OF WRITTEN MINUTES OF THE COMPENSATION COMMITTEE MEETINGS DURING WHICH THE EXECUTIVE COMPENSATION AND BENEFITS WAS REVIEWED AND SUBSEQUENTLY APPROVED. THE ACTIONS OUTLINED ABOVE WITH RESPECT TO THE COMMITTEE AND THE ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS APPLIES TO CERTAIN TGC SENIOR MANAGEMENT PERSONNEL. THE COMPENSATION AND BENEFITS OF CERTAIN OTHER INDIVIDUALS CONTAINED IN THIS FORM 990, WHERE APPLICABLE, ARE REVIEWED ANNUALLY BY THE GUTHRIE CLINIC AND AFFILIATES PRESIDENT/CHIEF EXECUTIVE OFFICER WITH ASSISTANCE FROM THE ORGANIZATION'S HUMAN RESOURCES DEPARTMENT IN CONJUNCTION WITH THE INDIVIDUAL'S JOB PERFORMANCE DURING THE YEAR AND IS BASED UPON OTHER OBJECTIVE FACTORS DESIGNED TO ENSURE THAT REASONABLE AND FAIR MARKET VALUE COMPENSATION IS PAID BY THE ORGANIZATION. OTHER OBJECTIVE FACTORS INCLUDE MARKET SURVEY DATA FOR COMPARABLE POSITIONS, INDIVIDUAL GOALS AND OBJECTIVES, PERSONNEL REVIEWS, EVALUATIONS, SELF-EVALUATIONS AND PERFORMANCE FEEDBACK MEETINGS. CORE FORM, PART VI, SECTION C; QUESTION 19 THE ORGANIZATION IS AN AFFILIATE WITHIN THE GUTHRIE CLINIC AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE GUTHRIE CLINIC IS THE TAX-EXEMPT PARENT ENTITY OF THE SYSTEM. THE GUTHRIE CLINIC HAS ISSUED TAX EXEMPT BONDS TO FINANCE VARIOUS CAPITAL IMPROVEMENT PROJECTS, RENOVATIONS AND EQUIPMENT. IN CONJUNCTION WITH THE ISSUANCE OF THESE TAX-EXEMPT BONDS, THE ORGANIZATION'S FINANCIAL STATEMENTS WERE INCLUDED WITH THE TAX-EXEMPT BOND PROSPECTUS WHICH WAS MADE AVAILABLE TO THE GENERAL PUBLIC FOR REVIEW. IN ADDITION, THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE COMMONWEALTH OF PENNSYLVANIA. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND QUESTIONNAIRE IS NOT OPEN FOR PUBLIC INSPECTION. CORE FORM, PART VII AND SCHEDULE J CORE FORM, PART VII AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM THIS ORGANIZATION AND/OR RELATED ORGANIZATIONS. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OF THIS ORGANIZATION OR A RELATED ORGANIZATION AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THIS ORGANIZATION'S BOARD OF DIRECTORS. FREDERICK J. BLOOM, M.D. SERVED AS THE PRESIDENT OF GUTHRIE MEDICAL GROUP, P.C. UNTIL APRIL 30, 2023. DR. BLOOM IS STILL EMPLOYED WITHIN THE GUTHRIE CLINIC AS THE CHIEF POPULATION HEALTH OFFICER. CORE FORM, PART VII, SECTION A, COLUMN B THIS ORGANIZATION IS AN AFFILIATE WITHIN THE GUTHRIE CLINIC AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). CERTAIN BOARD OF DIRECTORS MEMBERS, OFFICERS AND/OR DIRECTORS LISTED ON CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 MAY HOLD SIMILAR POSITIONS WITH BOTH THIS ORGANIZATION AND OTHER AFFILIATES WITHIN THE SYSTEM. THE HOURS SHOWN ON THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE NO COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, REPRESENT THE ESTIMATED HOURS DEVOTED PER WEEK FOR THIS ORGANIZATION. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF DIRECTORS OF OTHER RELATED ORGANIZATIONS IN THE SYSTEM, THEIR RESPECTIVE HOURS PER WEEK PER ORGANIZATION ARE APPROXIMATELY THE SAME AS REFLECTED IN CORE FORM, PART VII OF THIS FORM 990. THE HOURS REFLECTED ON CORE FORM, PART VII OF THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, PAID OFFICERS AND KEY EMPLOYEES, REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF THE GUTHRIE CLINIC AND AFFILIATES; NOT SOLELY THIS ORGANIZATION. CORE FORM, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCE INCLUDES: - TEMPORARILY RESTRICTED NET ASSETS RELEASED FROM RESTRICTION - ($260,437); - LOSS ON DERIVATIVE INSTRUMENT - ($141,387); - RESTRUCTURING EXPENSE - ($457,930); AND - CHANGE IN FAIR VALUE OF DERIVATIVE INSTRUMENT - $703,211. CORE FORM, PART XII; QUESTION 2 THE ORGANIZATION IS AN AFFILIATE WITHIN THE GUTHRIE CLINIC AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE GUTHRIE CLINIC IS THE TAX-EXEMPT PARENT ENTITY OF THE SYSTEM. AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF THE GUTHRIE CLINIC AND ALL ENTITIES WITHIN THE SYSTEM FOR THE YEARS ENDED JUNE 30, 2023 AND JUNE 30, 2022; RESPECTIVELY. THE INDEPENDENT CPA FIRM ISSUED AN UNMODIFIED OPINION WITH RESPECT TO THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS. CORE FORM, PART XII; QUESTION 3 THIS ORGANIZATION IS AN AFFILIATE WITHIN THE GUTHRIE CLINIC AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM ENGAGED AN INDEPENDENT ACCOUNTING FIRM TO PREPARE AND ISSUE A SYSTEM WIDE CONSOLIDATED AUDIT UNDER THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133 AUDIT. THIS ORGANIZATION WAS INCLUDED IN THE SYSTEM WIDE A-133 AUDIT. FORM 990, SCHEDULE D, PART X & SCHEDULE K THE ORGANIZATION IS A MEMBER OF THE GUTHRIE CLINIC; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM HAS A NUMBER OF OUTSTANDING LONG-TERM OBLIGATED GROUP DEBT LIABILITIES, INCLUDING THE FOLLOWING BOND ISSUANCES: - HEALTH CARE FACILITIES AUTHORITY OF SAYRE, HEALTH CARE REVENUE BONDS, SERIES 2007; AND - CENTRAL BRADFORD PROGRESS AUTHORITY, HEALTH CARE REVENUE BONDS, SERIES 2021A; SERIES 2021B; SERIES 2021C; AND SERIES 2021D. THE BONDS OUTLINED ABOVE AND VARIOUS OTHER LONG-TERM BORROWINGS ARE ALLOCATED BY THE GUTHRIE CLINIC ("TGC"); THE TAX-EXEMPT PARENT OF THE SYSTEM, TO THE FOLLOWING SYSTEM MEMBER HOSPITALS AND CERTAIN OTHER AFFILIATES. THE BALANCE SHEET OF THESE RESPECTIVE MEMBER HOSPITALS AND CERTAIN OTHER AFFILIATES REFLECTS A TGC OBLIGATED GROUP LIABILITY. ACCORDINGLY, THIS TGC OBLIGATED GROUP LIABILITY IS REFLECTED ON THE BALANCE SHEET OF THE FOLLOWING SUBSIDIARY ORGANIZATIONS: - CORNING HOSPITAL, EIN: 16-0393490 - GUTHRIE CORTLAND MEDICAL CENTER, EIN: 15-0532079 - GUTHRIE MEDICAL GROUP, P.C., EIN: 25-0815795 - ROBERT PACKER HOSPITAL, EIN: 24-0795463 - TROY COMMUNITY HOSPITAL, EIN: 24-0800337 SCHEDULE K WAS PREPARED ON A CONSOLIDATED BASIS AND IS INCLUDED IN THE FORM 990 OF THE GUTHRIE CLINIC, EIN: 23-3055017. THE GUTHRIE CLINIC ONE GUTHRIE SQUARE SAYRE PA 18840 233055017 SUPPORTING PA 501(c)(3) 12B NA false ROBERT PACKER HOSPITAL ONE GUTHRIE SQUARE SAYRE PA 18840 240795463 HEALTHCARE PA 501(c)(3) 3 TGC false DONALD GUTHRIE FOUNDATION 200 S WILBUR AVE SAYRE PA 18840 246022957 MED RESEARCH PA 501(c)(3) 7 TGC false TROY COMMUNITY HOSPITAL INC 275 GUTHRIE DRIVE TROY PA 16947 240800337 HEALTHCARE PA 501(c)(3) 3 TGC false GUTHRIE HOME CARE 421 TOMAHAWK ROAD TOWANDA PA 18848 232394345 HOME HEALTH PA 501(C)(3) 10 TGC false SAYRE HOUSE OF HOPE ONE GUTHRIE SQUARE SAYRE PA 18840 203979472 HEALTHCARE PA 501(c)(3) 7 TGC false CORNING HOSPITAL ONE GUTHRIE DRIVE CORNING NY 14830 160393490 HEALTHCARE NY 501(c)(3) 3 TGC false GUTHRIE RISK RETENTION GROUP 151 MEETING STREET CHARLESTON SC 29401 201090801 SUPPORTING SC 501(c)(3) 12A TGC false GUTHRIE CORTLAND MEDICAL CENTER 134 HOMER AVENUE CORTLAND NY 13045 150532079 HEALTHCARE NY 501(c)(3) 3 TGC false CORTLAND MEMORIAL FOUNDATION INC 134 HOMER AVENUE CORTLAND NY 13045 222230692 SUPPORTING NY 501(c)(3) 7 GCMC false REGIONAL MEDICAL PRACTICE PC 134 HOMER AVENUE CORTLAND NY 13045 204848729 HEALTHCARE NY 501(c)(3) 3 TGC false TWIN TIER MANAGEMENT CORP INC PO BOX 310 SAYRE PA 18840 232209439 MANAGEMENT CORP PA NA C CORP false CORNING PROPERTIES INC 1 GUTHRIE DRIVE CORNING NY 14830 383977095 REAL ESTATE HOLD NY NA C CORP false CMH SERVICES INC 160 HOMER AVENUE CORTLAND NY 13045 161370440 DURABLE MED EQUIP NY NA C CORP false CORTLAND MEMORIAL PROPERTIES INC 134 HOMER AVENUE CORTLAND NY 13045 161266826 INCOME ALLOCATION NY NA C CORP false true false true false false false true true false true true true true false true true true true false SCHEDULE R, PART V THIS ORGANIZATION IS A MEMBER OF THE GUTHRIE CLINIC AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. FUNDS ARE ROUTINELY TRANSFERRED BETWEEN AFFILIATES AND BUSINESS ACTIVITIES ARE COMMON ON BEHALF OF THE SYSTEM'S AFFILIATES, INCLUDING THIS ORGANIZATION. THESE TRANSACTIONS MAY BE RECORDED ON THE REVENUE/EXPENSE AND BALANCE SHEET STATEMENTS OF THIS ORGANIZATION AND OTHER AFFILIATES. THESE ENTITIES WORK TOGETHER TO DELIVER HIGH QUALITY COST EFFECTIVE HEALTHCARE AND WELLNESS SERVICES TO THEIR COMMUNITIES REGARDLESS OF ABILITY TO PAY AND IN FURTHERANCE OF CHARITABLE TAX-EXEMPT PURPOSES.