2020-05-13T22:06:41-05:00 2019-06-30 390859910 BAKER TILLY VIRCHOW KRAUSE LLP 1570 FRUITVILLE PIKE SUITE 400 LANCASTER PA 17601 990 2018-07-01 233009874 THE ALLENTOWN SPECIALTY HOSPITAL INC ALLE 6107763261 GOOD SHEPHERD PLAZA 850 S 5TH ST ALLENTOWN PA 18103 GARY R SCHMIDT INTERIM PRESIDENT & CEO 6107763261 2020-05-13 1 KERRI N BOGDA CPA P00760402 7177404863 23.130.16.102 2020-05-13 21:57:40 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 AE0C272A69DD34E2EDF3B6A185DE1CF90EACE8A4 2018 2021-01-29 14:40:06Z GOOD SHEPHERD SPECIALTY HOSPITAL - ALLENTOWN GARY R SCHMIDT GOOD SHEPHERD PLAZA 850 S 5TH ST ALLENTOWN PA 18103 16434689 0 X WWW.GOODSHEPHERDREHAB.ORG X 1999 PA TO ENHANCE LIVES, MAXIMIZE FUNCTION, INSPIRE HOPE, AND PROMOTE DIGNITY AND WELL-BEING. 8 3 140 8 0 0 191 234 16082667 16433368 0 1087 0 0 16082858 16434689 0 0 0 0 8000083 8516419 0 0 0 8601584 9285167 16601667 17801586 -518809 -1366897 20758211 19049424 1529396 1187506 19228815 17861918 X MOTIVATED BY THE DIVINE GOOD SHEPHERD AND THE PHYSICAL AND COGNITIVE REHABILITATION NEEDS OF OUR COMMUNITIES, OUR MISSION IS TO ENHANCE LIVES, MAXIMIZE FUNCTION, INSPIRE HOPE, AND PROMOTE DIGNITY AND WELL-BEING WITH EXPERTISE AND COMPASSION. 0 0 15258708 0 16433368 THE ALLENTOWN SPECIALTY HOSPITAL, INC. DBA GOOD SHEPHERD SPECIALTY HOSPITAL - ALLENTOWN ("GSSH") IS A 32-BED FACILITY PROVIDING ACUTE CARE FOR MEDICALLY STABLE BUT COMPLEX PATIENTS WHO REQUIRE LONG PERIODS OF HOSPITALIZATION. GSSH WAS THE FIRST LONG-TERM ACUTE CARE HOSPITAL IN THE LEHIGH VALLEY REGION AND WAS ONE OF THE FIRST IN THE COUNTRY TO OFFER PATIENT MONITORING BY TELE-INTENSIVISTS THROUGH STATE-OF-THE-ART TECHNOLOGY. GSSH'S PATIENTS REQUIRE EXTENSIVE NURSING CARE AND ARE OTHERWISE TOO ILL TO BE DISCHARGED TO HOME, A NURSING FACILITY, OR AN ACUTE REHABILITATION HOSPITAL. GSSH'S MAJOR PROGRAMS OF SERVICE ARE THE COMPLEX MEDICAL PROGRAM, TRANSITIONAL REHABILITATION PROGRAM AND THE PULMONARY VENTILATOR PROGRAM, WHICH TYPICALLY EXCEEDS NATIONAL VENT WEANING AVERAGES. CONTINUED ON SCHEDULE O.IN FISCAL YEAR 2019, GSSH DISCHARGED A TOTAL OF 350 INPATIENTS AND HAD 10,095 TOTAL PATIENT DAYS. 15258708 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 0 0 140 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 3 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X GARY R SCHMIDT INTERIM PRESIDENT & CEO 6107763261 GOOD SHEPHERD PLAZA 850 S 5TH ST ALLENTOWN PA 18103 FRANK HYLAND VICE CHAIR 8.50 51.50 X X 0 235835 6399 JOHN KRISTEL CHAIR/PRESIDENT/CEO (UNTIL 11/24/18) 8.50 51.50 X X 0 656000 25272 RONALD J PETULA SVP/CFO/SEC/TREAS. 8.50 51.50 X X 0 325990 17999 JAMES J DALEY MD TRUSTEE 1.00 59.00 X 0 195431 10927 PETER T ENDER MD TRUSTEE 1.00 X 0 0 0 DR WILLIAM GOULD TRUSTEE 1.00 X 0 0 0 SUSAN L LAWRENCE TRUSTEE 1.00 X 0 0 0 ANDREW MARTIN UNTIL 71319 TRUSTEE/ADMINISTRATOR 60.00 X 107354 0 10750 SAMUEL A MIRANDA JR SVP & CNO (UNTIL 9/22/18) 5.00 55.00 X 0 489860 8952 MIKE CIRBA CIO (UNTIL 06/15/19) 8.50 51.50 X 0 179247 9910 SANDEEP SINGH CMO & SVP 5.00 55.00 X 0 475025 30580 DENISE M JARROUJ DIR OF NURSING LTACH 60.00 X 102791 0 10199 210145 2557388 130988 2 0 1 0 ALLIED RESOURCES MEDICAL STAFFING 135 DOWLIN FORGE RD EXTON PA 19341 STAFFING SERVICES 582115 APOGEE MEDICAL MGMT 15059 N SCOTTSDALE ROAD STE 600 SCOTTSDALE AZ 85254 PHYSICIAN STAFFING 300404 LAURUS SEARCH AND STAFFING 220 COMMERCE DR STE 200 FORT WASHINGTON PA 19034 STAFFING SERVICES 195193 LEHIGH VALLEY HOSPITAL CEDAR CREST I-78 ALLENTOWN PA 18103 MEDICAL SERVICES 195006 CROTHALL HEALTHCARE INC 13028 COLLECTION CENTER DR CHICAGO IL 60693 HOUSEKEEPING SERVICES 192551 7 234 234 NET PATIENT SVC REV 623000 16433368 16433368 16433368 1087 1087 16434689 16433368 0 1087 118782 118782 6968056 6499900 468156 328482 305813 22669 649141 600569 48572 451958 409061 42897 548 548 1765747 1761990 3757 73626 56899 16727 517052 517052 6973 6163 810 14157 3857 10300 236227 236227 CORPORATE ALLOCATION 4537649 3267107 1270542 MEDICAL SUPPLIES 1540025 1540015 10 EQUIPMENT RENTAL 320248 320238 10 FOOD 172889 170113 2776 100026 80756 19270 17801586 15258708 2542878 0 4370645 3556140 77022 69455 3965335 2748073 645253 1217262 15665291 14206567 20758211 19049424 919415 710707 133736 0 476245 476799 1529396 1187506 X 19228815 17861918 19228815 17861918 20758211 19049424 -1366897 0 X X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 548 548 0 PART II-B, LINE 1: THE ALLENTOWN SPECIALTY HOSPITAL, INC. ("GSSH") PAID DUES TO THE AMERICAN HOSPITAL ASSOCIATION ("AHA") IN THE AMOUNT OF $548 DURING THE YEAR ENDED JUNE 30, 2019. A PERCENTAGE OF THOSE DUES WERE USED FOR LOBBYING PURPOSES. 190277 187167 3110 3775058 2560906 1214152 1217262 AMOUNTS DUE FROM AFFILIATES 14206567 14206567 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 476799 476799 X 16391126 -43563 -43563 16434689 0 16434689 17758023 0 17758023 43563 43563 17801586 PART X, LINE 2: GOOD SHEPHERD PRESCRIBES A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY IN RECORDING TAX LIABILITIES IN THE FINANCIAL STATEMENTS. MEASUREMENT AND RECOGNITION OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBTS NETTED AGAINST REVENUE ON F/S -43,563. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBTS NETTED AGAINST REVENUE ON F/S 43,563. 1 1 X 1 X 0 1 1 0 1 1 13594 13594 0.00080 13594 13594 0.00080 2006 2006 0.00010 29601 29601 0.00170 31607 31607 0.00180 45201 45201 0.00260 1 19155 2214 9962777 10269473 -306696 X 1 1 1 1 THE ALLENTOWN SPECIALTY HOSPITAL INC 850 SOUTH 5TH STREET ALLENTOWN PA 181033295 53020100 X LONG-TERM ACUTE CARE HOSPITAL THE ALLENTOWN SPECIALTY HOSPITAL INC 1 0 0 1 X X X X X X X X X 18 1 0 1 1 X HTTPS://WWW.GOODSHEPHERDREHAB.ORG/ABOUT-GOOD-SHEPHERD/CHNA/ X 1 18 1 HTTPS://WWW.GOODSHEPHERDREHAB.ORG/ABOUT-GOOD-SHEPHERD/CHNA/ 0 1 X 200.000000000000 X X X X X X 1 1 X X X 1 X HTTPS://WWW.GOODSHEPHERDREHAB.ORG/FOR-PATIENTS-AND-VISITORS/CHARITY-CARE/ X HTTPS://WWW.GOODSHEPHERDREHAB.ORG/FOR-PATIENTS-AND-VISITORS/CHARITY-CARE/ X X X X X X 1 X 0 X X X 0 X X 0 0 THE ALLENTOWN SPECIALTY HOSPITAL, INC. PART V, SECTION B, LINE 5: THIS STUDY USED A TWO-PRONGED RESEARCH METHOD TO IDENTIFY COMMUNITY HEALTH NEEDS AMONG PEOPLE WITH DISABILITIES.1. FIRST, THIS STUDY UPDATED AND EXTENDED INFORMATION DERIVED FROM KEY SECONDARY SOURCES OF DATA, INCLUDING PRIMARILY THE U.S. CENSUS BUREAU, THE CENTERS' FOR DISEASE CONTROL'S BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), THE ROBERT WOOD JOHNSON COUNTY HEALTH RANKINGS, AND THE PENNSYLVANIA DEPARTMENT OF HEALTH. DATA PROVIDED BY KEY FEDERAL AND STATE AGENCIES WAS CRITICALLY IMPORTANT FOR TRACKING COMMUNITY HEALTH OVER TIME. IT ALSO HELPED IDENTIFY SOCIAL AND ENVIRONMENTAL DETERMINANTS OF HEALTH AND FEATURES OF THE SOCIAL ENVIRONMENT THAT INTERACT WITH INDIVIDUAL-LEVEL CHARACTERISTICS IN SHAPING OVERALL INDIVIDUAL AND COMMUNITY HEALTH. FINALLY, THE DATA WAS ALSO USEFUL FOR IDENTIFYING HEALTH DISPARITIES BETWEEN PEOPLE WITH DISABILITIES AND PEOPLE WITHOUT DISABILITIES.2. SECOND, THIS STUDY ALSO INCLUDED PRIMARY QUALITATIVE DATA DERIVED FROM A COMMUNITY FORUM OF KEY STAKEHOLDERS (INCLUDING PEOPLE WITH DISABILITIES, HEADS OF PUBLIC AND PRIVATE AGENCIES SERVING THE DISABILITY COMMUNITY, EDUCATORS, ELECTED REPRESENTATIVES, COUNTY OFFICIALS, ADVOCACY ORGANIZATIONS, REPRESENTATIVES FROM THE ARTS, RELIGIOUS, AND COMMUNITY ORGANIZATIONS), AND A SERIES OF FOCUS GROUPS IN WHICH KEY INFORMANTS, PEOPLE WITH DISABILITIES AND THEIR FAMILIES WERE INVITED TO SHARE INSIGHT ABOUT THEIR OWN CHALLENGES TO LIVING FULLY, INDEPENDENTLY, AND HEALTHFULLY.BOTH FEDERAL REGULATIONS AND BEST PRACTICES FOR CARRYING OUT CHNAS EMPHASIZE THE ROLE OF COMMUNITY INPUT. A CENTRAL GOAL OF THE CURRENT STUDY WAS TO ENGAGE DIVERSE STAKEHOLDERS AS PARTNERS IN RESEARCH FOR PEOPLE WITH DISABILITIES, RATHER THAN SIMPLY AS SUBJECTS OR OBJECTS OF THE RESEARCH. THE ALLENTOWN SPECIALTY HOSPITAL, INC. PART V, SECTION B, LINE 6B: GOOD SHEPHERD'S MOST RECENT CHNA WAS CONDUCTED IN PARTNERSHIP WITH THE MUHLENBERG COLLEGE INSTITUTE OF PUBLIC OPINION UNDER THE LEADERSHIP OF DR. LANETHEA MATHEWS-SCHULTZ, PROFESSOR AND CHAIR OF POLITICAL SCIENCE AT MUHLENBERG COLLEGE. THE MUHLENBERG COLLEGE INSTITUTE OF PUBLIC OPINION IS DIRECTED BY DR. CHRISTOPHER BORICK, PROFESSOR OF POLITICAL SCIENCE AT MUHLENBERG COLLEGE. IN ADDITION, GOOD SHEPHERD PARTNERED WITH THE DISABILITY FRIENDLY COMMUNITY OF THE LEHIGH VALLEY WHICH INCLUDES PEOPLE WITH DISABILITIES, REPRESENTATIVES OF NON-PROFITS AND FOR-PROFIT SERVICE ORGANIZATIONS, CAREGIVERS, FAMILY MEMBERS, GOVERNMENT AND COMMUNITY LEADERS AS WELL AS PEOPLE ADVOCATING FOR INCLUSION. THE ALLENTOWN SPECIALTY HOSPITAL, INC. PART V, SECTION B, LINE 11: ON JUNE 10, 2019, THE BOARD OF TRUSTEES OF GOOD SHEPHERD REHABILITATION NETWORK PASSES A RESOLUTION ADOPTING THEIR 2020-2022 CHNA IMPLEMENTATION PLAN. THE PLAN IDENTIFIES STRATEGIES AND ACTION STEPS DESIGNED TO IMPACT PRIORITY AREAS IDENTIFIED THROUGH THE 2019 CHNA PROCESS. THE IMPLEMENTATION PLAN IDENTIFIED FOUR HEALTH PRIORITIES GOOD SHEPHERD COMMITTED TO WORKING ON OVER THE THREE YEAR PERIOD. THE FIRST GOAL IS IMPROVING DATA COLLECTION BY CREATING AND IMPLEMENTING A SURVEY THAT WILL BE ADMINISTERED TO OUR PATIENTS TO HELP US BETTER UNDERSTAND AND SERVE THEIR NEEDS. THE SECOND GOAL IS IMPROVING UNIVERSAL ACCESSIBILITY OF BATHROOMS BY CONVERTING EXISTING BATHROOMS INTO ACCESSIBLE BATHROOMS WHEN POSSIBLE AND BY STRIVING TO OFFER ACCESSIBLE BATHROOMS IN FUTURE GSRN FACILITIES. THE THIRD GOAL IS IMPROVING SERVICES & RESOURCES FOR FAMILIES WITH POST-TEENAGE CHILDREN IN THE 21-64 AGE RANGE BY CREATING AN EXPLORER POST TO EDUCATE HIGH SCHOOL STUDENTS ON WHAT GOOD SHEPHERD DOES AND HOPEFULLY INSPIRE THEM TO PURSUE A CAREER IN HEALTHCARE. IN ADDITION, WE WILL BE LOOKING TO LEARN MORE ABOUT OTHER RESOURCES AVAILABLE IN THE COMMUNITY THAT COULD BE USEFUL TO OUR PATIENTS AND CAREGIVERS. THE FOURTH GOAL IS INCREASING THE NUMBER OF SUPPORT GROUPS WE OFFER BY STRATEGICALLY IDENTIFYING LOCATIONS IN OUR SERVICE AREA THAT ARE IN NEED OF ADDITIONAL SUPPORT GROUPS AND SEEING IF WE CAN UTILIZE OUR OUTPATIENT LOCATIONS TO SERVE THESE NEEDS. THE ALLENTOWN SPECIALTY HOSPITAL, INC. PART V, SECTION B, LINE 13H: THE SPECIALTY HOSPITAL HAS A WRITTEN CHARITY CARE POLICY. ALL PATIENTS ARE NOTIFIED OF GOOD SHEPHERD'S CHARITY CARE AVAILABILITY PRIOR TO THE START OF THEIR CARE. GENERALLY, PATIENTS AUTOMATICALLY QUALIFY UNDER THE SPECIALTY HOSPITAL'S CHARITY CARE POLICY IF THEIR INCOME IS LESS THAN 200% OF THE CURRENT FEDERAL POVERTY GUIDELINES. HOWEVER, OTHER FACTORS ARE ALSO USED TO DETERMINE ELIGIBILITY INCLUDING:- SOURCES OF INCOME- LIVING EXPENSES- OTHER PERSONAL ASSETS AND LIABILITIES- DEMOGRAPHIC INFORMATION- ONGOING HEALTHCARE NEEDSQUALIFICATION UNDER THE SPECIALTY HOSPITAL'S CHARITY CARE POLICY ENTITLES PATIENTS TO COMPLETELY FREE CARE. THE SPECIALTY HOSPITAL DOES NOT OFFER A PROGRAM OF DISCOUNTED CHARITY CARE. HOWEVER, PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE AND HAVE NO INSURANCE ARE OFFERED A DISCOUNTED PRIVATE PAY RATE FOR SERVICES, PAYABLE AT THE TIME OF SERVICE. THE DISCOUNTED PRIVATE PAY RATE IS DETERMINED CONSIDERING THE ESTIMATED COST OF SERVICES PROVIDED. PART I, LINE 3C: GOOD SHEPHERD LONG-TERM ACUTE SERVICES, INC., D/B/A GOOD SHEPHERD SPECIALTY HOSPITAL (THE "SPECIALTY HOSPITAL") HAS A WRITTEN CHARITY CARE POLICY. ALL PATIENTS ARE NOTIFIED OF GOOD SHEPHERD'S CHARITY CARE AVAILABILITY PRIOR TO THE START OF THEIR CARE. GENERALLY, PATIENTS AUTOMATICALLY QUALIFY UNDER THE SPECIALTY HOSPITAL'S CHARITY CARE POLICY IF THEIR INCOME IS LESS THAN 200% OF THE CURRENT FEDERAL POVERTY GUIDELINES. HOWEVER, OTHER FACTORS ARE ALSO USED TO DETERMINE ELIGIBILITY INCLUDING:- SOURCES OF INCOME- LIVING EXPENSES- OTHER PERSONAL ASSETS AND LIABILITIES- DEMOGRAPHIC INFORMATION- ONGOING HEALTHCARE NEEDSQUALIFICATION UNDER THE SPECIALTY HOSPITAL'S CHARITY CARE POLICY ENTITLES PATIENTS TO COMPLETELY FREE CARE. THE SPECIALTY HOSPITAL DOES NOT OFFER A PROGRAM OF DISCOUNTED CHARITY CARE. HOWEVER, PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE AND HAVE NO INSURANCE ARE OFFERED A DISCOUNTED PRIVATE PAY RATE FOR SERVICES, PAYABLE AT THE TIME OF SERVICE. THE DISCOUNTED PRIVATE PAY RATE IS DETERMINED CONSIDERING THE ESTIMATED COST OF SERVICES PROVIDED. THE SPECIALTY HOSPITAL'S POLICY ALSO PROVIDES FOR CHARITY CARE FOR CERTAIN PATIENTS UNDER UNIQUE CIRCUMSTANCES. THESE CIRCUMSTANCES INCLUDE PATIENTS WHO MAY EXPERIENCE SIGNIFICANT FINANCIAL HARDSHIP OR PERSONAL FINANCIAL LOSS REGARDLESS OF THEIR INCOME, INCLUDING PATIENTS WHO MAY BE CLASSIFIED AS "MEDICALLY INDIGENT." THESE UNIQUE CIRCUMSTANCES ARE REVIEWED BY ADMINISTRATION, PURSUANT TO POLICY. THE GOOD SHEPHERD AUDITED FINANCIAL STATEMENTS PROVIDE THE FOLLOWING DISCLOSURES WITH RESPECT TO CHARITY CARE:"GOOD SHEPHERD PROVIDES CHARITY CARE TO PATIENTS WHO MEET CERTAIN CRITERIA REGARDLESS OF THEIR ABILITY TO PAY. THE CRITERIA FOR CHARITY CONSIDERS FAMILY SIZE, SOURCES OF INCOME, LIVING EXPENSES, NET WORTH, ONGOING HEALTHCARE NEEDS, AS WELL AS OTHER PERTINENT INFORMATION. BECAUSE GOOD SHEPHERD DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUES. GOOD SHEPHERD MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE AMOUNT OF CHARITY CARE IT PROVIDES. THE COSTS ASSOCIATED WITH THE CHARITY CARE SERVICES PROVIDED ARE ESTIMATED BY APPLYING A COST-TO-CHARGE RATIO TO THE AMOUNT OF GROSS UNCOMPENSATED CHARGES FOR THE PATIENTS RECEIVING CHARITY CARE. THE LEVEL OF CHARITY CARE PROVIDED BY GOOD SHEPHERD AMOUNTED TO APPROXIMATELY $191,000 IN 2019 AND $196,000 IN 2018. GOOD SHEPHERD RECEIVED $2,081 AND $2,400 IN CONTRIBUTIONS RESTRICTED FOR CHARITY CARE DURING 2019 AND 2018, RESPECTIVELY." PART I, LINE 6A: THE SPECIALTY HOSPITAL'S COMMUNITY BENEFIT ACTIVITIES ARE INCLUDED WITHIN AND REPORTED AS PART OF AN ANNUAL REPORT TO THE COMMUNITY, PUBLISHED ON A CONSOLIDATED BASIS BY GOOD SHEPHERD REHABILITATION NETWORK (GSRN). THIS REPORT INCLUDES THE COMMUNITY BENEFIT ACTIVITIES PROVIDED BY GSRN, AS WELL AS BY ITS CONTROLLED ENTITIES (INCLUDING THE SPECIALTY HOSPITAL). THIS REPORT IS DISTRIBUTED AND MADE AVAILABLE TO THE PUBLIC ON THE GSRN WEBSITE. A COMMUNITY BENEFIT REPORT IS NOT REQUIRED TO BE FILED WITH THE COMMONWEALTH OF PENNSYLVANIA AND, ACCORDINGLY, GSRN HAS NOT FILED ONE.IN ORDER TO BETTER UNDERSTAND THE ORGANIZATIONAL, FINANCIAL AND OPERATIONAL COMPLEXITIES OF THE ORGANIZATIONS CONTAINED WITHIN GSRN, THE FOLLOWING INFORMATION IS PROVIDED:THE SPECIALTY HOSPITAL'S FINANCIAL RESULTS ARE REPORTED AS A COMPONENT OF THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF GOOD SHEPHERD REHABILITATION NETWORK AND CONTROLLED ENTITIES (GOOD SHEPHERD). SEPARATE AUDITED FINANCIAL STATEMENTS ARE NOT PREPARED FOR THE SPECIALTY HOSPITAL. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF GOOD SHEPHERD INCLUDE THE FOLLOWING CORPORATIONS:- GOOD SHEPHERD REHABILITATION NETWORK (GSRN), THE CONTROLLING PARENT CORPORATION, FORMERLY GOOD SHEPHERD HOME- GOOD SHEPHERD REHABILITATION HOSPITAL (THE HOSPITAL)- GOOD SHEPHERD HOME LONG-TERM CARE FACILITY, INC. (LTC)- GOOD SHEPHERD LONG-TERM ACUTE SERVICES, INC., D/B/A GOOD SHEPHERD SPECIALTY HOSPITAL (THE SPECIALTY HOSPITAL)- GOOD SHEPHERD HOUSING DEVELOPMENT CORPORATION (SUPPIL)- GOOD SHEPHERD RECIPROCAL RISK RETENTION GROUP (THE RRG)- GOOD SHEPHERD GROUP, LLC (GS GROUP)- GOOD SHEPHERD DEVELOPMENT, LLC (GSD)GOOD SHEPHERD'S PRIMARY OPERATIONS ARE CONDUCTED WITHIN THE HOSPITAL, WHICH PROVIDES COMPREHENSIVE INPATIENT REHABILITATION SERVICES AND OUTPATIENT REHABILITATION SERVICES AT NUMEROUS LOCATIONS. THE LTC OPERATES TWO SKILLED NURSING FACILITIES WHICH SERVICE THE NEEDS OF SEVERELY DISABLED ADULTS. THE SPECIALTY HOSPITAL PROVIDES SERVICES THAT REPRESENT THE FIRST STEP IN THE POST ACUTE CARE PROCESS OF RECOVERY. THE RRG IS A SELF INSURANCE COMPANY THAT PROVIDES PRIMARY LIABILITY INSURANCE AND RISK MANAGEMENT SERVICES. SUPPIL PROVIDES SUPPORTIVE INDEPENDENT HOUSING TO PERSONS WITH DISABILITIES UNDER SECTION 811 OF THE DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT. GS GROUP WAS ESTABLISHED TO DEVELOP A WHEELCHAIR DEVICE TO ASSIST REHABILITATION PATIENTS.IN ADDITION TO THE ORGANIZATIONS DESCRIBED ABOVE, IN JANUARY 2007, GSRN ENTERED INTO A JOINT VENTURE AGREEMENT WITH THE TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA (THE UNIVERSITY) TO CREATE PHILADELPHIA POST ACUTE PARTNERS, LLC D/B/A GOOD SHEPHERD PENN PARTNERS (GSPP). GSPP WAS CREATED TO ESTABLISH AND OPERATE A NEW LONG-TERM ACUTE CARE HOSPITAL, TO ASSUME THE OWNERSHIP OF AND CONTINUE TO OPERATE ALL OF THE OUTPATIENT OPERATIONS OF THE UNIVERSITY, TO CARRY OUT THE DAY-TO-DAY OPERATIONS OF THE HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA'S (HUP'S) INPATIENT REHABILITATION UNIT, AND TO PROVIDE THE UNIVERSITY AND ITS AFFILIATES WITH CERTAIN CLINICAL AND/OR STAFFING SERVICES RELATING TO REHABILITATION. GSRN IS A 70% OWNER OF GSPP; HOWEVER, THE OPERATIONS OF GSPP ARE NOT CONSOLIDATED WITHIN THE CONSOLIDATED FINANCIAL STATEMENTS OF GOOD SHEPHERD AS GSRN IS NOT DEEMED TO HAVE CONTROL OVER GSPP. AS A RESULT, GSRN RECORDS THEIR INVESTMENT IN GSPP UNDER THE EQUITY METHOD OF ACCOUNTING WITHIN THE GSRN CONSOLIDATED FINANCIAL STATEMENTS. PART I, LINE 7: THE SPECIALTY HOSPITAL USED A COST-TO-CHARGE RATIO IN DETERMINING THE FIGURES REPORTED IN THIS TABLE. THIS COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2 RATIO OF PATIENT CARE COST-TO CHARGES. PART I, LN 7 COL(F): THE AMOUNT OF BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $43,563. PART III, LINE 2: THE COSTING METHODOLOGY USED IN DETERMINING BAD DEBT EXPENSE AT COST IS BAD DEBT EXPENSE TIMES THE COST TO CHARGE RATIO. PART III, LINE 3: WE BELIEVE THAT A PORTION OF OUR BAD DEBTS RESULTS FROM SERVICES PROVIDED TO PATIENTS WHO MEET THE CHARITY CARE GUIDELINES BUT WERE UNABLE OR UNWILLING TO PROVIDE THE APPROPRIATE DOCUMENTATIONS TO ALLOW THAT CLASSIFICATION. THESE WOULD BE CLASSIFIED AS BAD DEBT EXPENSE AT COST TIMES THE AVERAGE ESTIMATED POVERTY PERCENTAGE WITHIN THE HOSPITAL'S 5 COUNTY PRIMARY SERVICE AREA. THE HOSPITAL PROVIDES CARE TO ALL PATIENTS WHO NEED IT, REGARDLESS OF THEIR ABILITY TO PAY. THIS IS PART OF THE HOSPITAL'S MISSION. PART III, LINE 4: GOOD SHEPHERD ASSESSES COLLECTABILITY ON PATIENT CONTRACTS PRIOR TO THE RECOGNITION OF NET PATIENT SERVICE REVENUES. ACCOUNTS RECEIVABLE, PATIENTS, ARE RECORDED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF THROUGH THE PROVISION FOR BAD DEBTS WHEN GOOD SHEPHERD HAS EXHAUSTED ALL COLLECTION EFFORTS AND DETERMINES ACCOUNTS ARE IMPAIRED BASED ON CHANGES IN PATIENT CREDIT WORTHINESS. PART III, LINE 8: THE COSTING METHODOLOGY UTILIZED IN THE DETERMINATION OF THE MEDICARE ALLOWABLE COSTS REPORTED IN THE SPECIALTY HOSPITAL'S COST REPORT IS QUITE COMPREHENSIVE. DIRECTLY ALLOCATED COSTS ARE USED AS A STARTING POINT AND OTHER COSTS ARE STEPPED-DOWN TO THE SPECIALTY HOSPITAL BASED UPON INDUSTRY-ACCEPTABLE ALLOCATION METHODOLOGIES. THE SPECIALTY HOSPITAL HAS REPORTED A MEDICARE SHORTFALL OF $306,696 IN PART III, SECTION B (MEDICARE), LINE 7. IT SHOULD BE CONSIDERED AS A COMPONENT OF COMMUNITY BENEFIT BECAUSE THE SPECIALTY HOSPITAL TREATS ALL MEDICALLY NECESSARY PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY AND REGARDLESS OF WHETHER THE EXPECTED REIMBURSEMENT IS ADEQUATE TO COVER ALL RELATED AND NECESSARY EXPENSES. PART III, LINE 9B: THE SPECIALTY HOSPITAL HAS A WRITTEN BILLING AND COLLECTION POLICY AND SUCH POLICY COVERS THE PROCEDURES NECESSARY TO BILL AND COLLECT FOR THE MEDICAL SERVICES PROVIDED TO PATIENTS. PATIENTS KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE SPECIALTY HOSPITAL'S CHARITY CARE POLICY (AS EVIDENCED BY A PROPERLY COMPLETED AND APPROVED CHARITY CARE APPLICATION) ARE NOT SUBJECT TO THE COLLECTION PROVISIONS OF THIS POLICY. RATHER, THEIR ACCOUNT BALANCES ARE WRITTEN-OFF FROM THE PATIENT ACCOUNTING RECORDS AS CHARITY CARE. IN INSTANCES WHERE THE HOSPITAL BELIEVES A PATIENT MAY QUALIFY FOR CHARITY CARE AND THE PATIENT DOES NOT OR CAN NOT COMPLETE THE REQUIRED CHARITY CARE APPLICATION, THE HOSPITAL MAKES REASONABLE EFFORTS TO INDEPENDENTLY SUPPORT THE APPROPRIATE WRITE-OFF OF THE PATIENT ACCOUNT BALANCES AS CHARITY CARE. IN INSTANCES WHERE REASONABLE EFFORTS ARE INSUFFICIENT OR INCONCLUSIVE TO SUPPORT THE APPROPRIATE WRITE-OFF OF THE PATIENT ACCOUNT BALANCES AS CHARITY CARE, THE PATIENT ACCOUNT BALANCES BECOME SUBJECT TO THE COLLECTION PROVISIONS OF THE HOSPITAL'S BILLING AND COLLECTION POLICY. PART VI, LINE 2: TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE FOR OUR MOST RECENT CHNA, COMMUNITY FORUM OF KEY STAKEHOLDERS (INCLUDING PEOPLE WITH DISABILITIES, HEADS OF PUBLIC AND PRIVATE AGENCIES SERVING THE DISABILITY COMMUNITY, EDUCATORS, ELECTED REPRESENTATIVES, COUNTY OFFICIALS, ADVOCACY ORGANIZATIONS, REPRESENTATIVES FROM THE ARTS, RELIGIOUS, AND COMMUNITY ORGANIZATIONS) WERE HELD. IN ADDITION, WE HELD A SERIES OF FOCUS GROUPS IN WHICH KEY INFORMANTS, PEOPLE WITH DISABILITIES AND THEIR FAMILIES WERE INVITED TO SHARE INSIGHT ABOUT THEIR OWN CHALLENGES TO LIVING FULLY, INDEPENDENTLY, AND HEALTHFULLY.IN ADDITION TO THESE EFFORTS FOR OUR MOST RECENT CHNA, GOOD SHEPHERD REGULARLY ASSESSES MARKET POTENTIAL AND DEMAND FOR SERVICES THROUGHOUT VARIOUS REGIONS, ON AVERAGE, THESE ASSESSMENTS ARE PERFORMED ON AN ANNUAL BASIS AND DO NOT SPECIFICALLY TARGET NEEDS BUT RATHER OPPORTUNITIES TO EXPAND SERVICE TO OTHER AREAS IN NEED. PART VI, LINE 3: 1) GOOD SHEPHERD'S MISSION IS AS FOLLOWS:"MOTIVATED BY THE DIVINE GOOD SHEPHERD AND THE PHYSICAL AND COGNITIVE REHABILITATION NEEDS OF OUR COMMUNITIES, OUR MISSION IS TO ENHANCE LIVES, MAXIMIZE FUNCTION, INSPIRE HOPE AND PROMOTE DIGNITY AND WELL-BEING WITH EXPERTISE AND COMPASSION."GOOD SHEPHERD VIGOROUSLY PURSUES THEIR MISSION REGARDLESS OF A PATIENT'S ABILITY TO PAY.2) IN EACH INPATIENT ROOM, GOOD SHEPHERD PROVIDES A REFERENCE BINDER OF IMPORTANT INFORMATION TO ALL INPATIENTS. THIS BINDER SUPPLEMENTS THE PATIENT'S ADMISSIONS PACKAGE AND INCLUDES A NOTICE OF FINANCIAL AID WHICH INCLUDES THE FOLLOWING WORDING:"IF YOU HAVE LITTLE OR NO HEALTH INSURANCE TO PAY FOR THE SERVICES YOU RECEIVE FROM GOOD SHEPHERD AND WORRY THAT YOU MAY NOT BE ABLE TO PAY FOR PART OR ALL OF YOUR CARE, WE MAY BE ABLE TO HELP. GOOD SHEPHERD PROVIDES CHARITY CARE TO PATIENTS BASED ON THEIR INCOME, ASSETS AND FINANCIAL NEEDS. IN ADDITION, IF YOU DO NOT MEET THE CRITERIA TO BE ELIGIBLE FOR CHARITY CARE, WE WILL HELP YOU ARRANGE FOR AN INTEREST-FREE PAYMENT PLAN TO RESOLVE ANY BALANCES YOU OWE."3) CHARITY CARE INFORMATION IS AVAILABLE ON THE GOOD SHEPHERD WEBSITE IN ENGLISH AND SPANISH. IN PARTICULAR, PATIENTS MAY ACCESS A COPY OF THE NOTICE OF FINANCIAL AID AND A CHARITY CARE APPLICATION.4) GOOD SHEPHERD PUBLISHES AND DISTRIBUTES A NOTICE OF PAYMENT RESPONSIBILITY TO ALL PATIENTS. THE FIRST PARAGRAPH OF THIS FORM STATES THE FOLLOWING:"GOOD SHEPHERD IS A NON-PROFIT CHARITABLE ORGANIZATION THAT PROVIDES HEALTHCARE SERVICES TO ALL MEDICALLY APPROPRIATE PATIENTS WHO SEEK CARE REGARDLESS OF THEIR FUNDS TO PAY FOR SERVICES. THIS INCLUDES THE UNINSURED AND THE UNDER INSURED."THE NOTICE GOES ON TO STATE:"IT HAS BEEN BROUGHT TO OUR ATTENTION THAT YOU POTENTIALLY LACK THE FINANCIAL RESOURCES TO PAY FOR YOUR MEDICAL CARE. YOUR ADMISSION TO GOOD SHEPHERD IS CONTINGENT UPON YOUR ASSISTANCE IN HELPING US SECURE PAYMENT OF YOUR MEDICAL BILL FOR THE CARE BEING PROVIDED TO YOU. TO ADDRESS THE PAYMENT OF YOUR BILL, WE ARE REQUESTING THAT YOU APPLY FOR MEDICAL ASSISTANCE BENEFITS THROUGH THE PENNSYLVANIA MEDICAID PROGRAM AND APPLY FOR GOOD SHEPHERD'S CHARITY CARE PROGRAM."5) EACH PATIENT BILL OR STATEMENT INCLUDES THE FOLLOWING STATEMENT:"THE GOOD SHEPHERD SPECIALTY HOSPITAL IS A NON-PROFIT ORGANIZATION AND OFFERS CHARITY CARE TO THOSE WHO QUALIFY. IF YOU DO NOT HAVE THE FUNDS TO PAY, PLEASE CONTACT US."6) TRANSLATION SERVICES ARE AVAILABLE TO ANY NON-ENGLISH-SPEAKING PATIENT. THESE SERVICES ALSO INCLUDE ASSISTANCE WITH CHARITY CARE ELIGIBILITY AND OTHER FINANCIAL MATTERS. 7) AS PART OF INTERNAL DEPARTMENTAL ORIENTATION AND TRAINING, ADMISSIONS, CARE MANAGEMENT AND PATIENT ACCOUNTING PERSONNEL ARE TRAINED IN GOOD SHEPHERD'S CHARITY CARE POLICIES AND PROCEDURES. PART VI, LINE 4: BASED UPON PA HEALTH CARE COST CONTAINMENT COUNCIL DATA FOR THE 2018 CALENDAR YEAR, THE HOSPITAL'S PRIMARY SERVICE AREA IS COMPRISED OF THE FOLLOWING FIVE PENNSYLVANIA COUNTIES. IN ADDITION, THE HOSPITAL'S MARKET SHARE PERCENTAGE IS INDICATED FOR EACH COUNTY WITHIN ITS PRIMARY SERVICE AREA.GSSH - LEHIGH - 94%NORTHAMPTON - 97%CARBON - 44%MONROE - 63%BERKS - 48%LEHIGH, NORTHAMPTON AND BERKS COUNTIES ARE A MIX OF URBAN, SUBURBAN AND RURAL COMMUNITIES WHILE CARBON AND MONROE COUNTIES ARE PRIMARILY RURAL. THE FOLLOWING HOSPITALS ARE LOCATED WITHIN EACH OF THESE COUNTIES:CARBON COUNTYTWO (2) NOT-FOR-PROFIT ACUTE CARE HOSPITALSLEHIGH COUNTYFIVE (5) NOT-FOR-PROFIT ACUTE CARE HOSPITALS TWO (2) NOT-FOR-PROFIT INPATIENT REHABILITATION HOSPITALS (THE HOSPITAL - NOTE ONE LICENSE IN TWO LOCATIONS)ONE (1) NOT-FOR-PROFIT LONG-TERM ACUTE CARE HOSPITAL (THE SPECIALTY HOSPITAL)ONE (1) PSYCHIATRICNORTHAMPTON COUNTY THREE (3) NOT-FOR-PROFIT ACUTE CARE HOSPITALSONE (1) FOR PROFIT GENERAL ACUTE CARE HOSPITALMONROE COUNTYTWO (2) NOT-FOR-PROFIT ACUTE CARE HOSPITALSONE (1) PSYCHIATRICBERKS COUNTYTWO (2) NOT-FOR-PROFIT ACUTE CARE HOSPITALSONE (1) FOR-PROFIT INPATIENT REHABILITATION HOSPITALONE (1) FOR-PROFIT SPECIALTY GENERAL ACUTE CARE HOSPITALTWO (2) PSYCHIATRICTHESE COUNTIES HAVE THE FOLLOWING DEMOGRAPHICS AND CHARACTERISTICS:1. AVERAGE INCOME LEVEL AND POVERTY RATES (US CENSUS 2018 ESTIMATES MEDIAN HOUSEHOLD INCOME AND POPULATION PERCENTAGE BELOW THE POVERTY LEVEL)CARBON COUNTY - $53,624 AND 11.9%LEHIGH COUNTY - $62,178 AND 12.0% NORTHAMPTON COUNTY - $67,565 AND 10.2%MONROE COUNTY - $63,931 AND 12.3%BERKS COUNTY - $61,522 AND 11.4%2. RATES OF UNINSURED OR UNDERINSURED PERSONS (US CENSUS 2018 ESTIMATES)CARBON COUNTY 3,037 INDIVIDUALS OR 6.0% OF THE COUNTY POPULATIONLEHIGH COUNTY 22,997 INDIVIDUALS OR 7.5% OF COUNTY POPULATIONNORTHAMPTON COUNTY 15,061 INDIVIDUALS OR 6.1% OF THE COUNTY POPULATIONMONROE COUNTY 10,526 INDIVIDUALS OR 7.5% OF THE COUNTY POPULATIONBERKS COUNTY 26,091 INDIVIDUALS OR 7.5% OF THE COUNTY POPULATION3. PERCENT OF FAMILIES WHO ARE ELIGIBLE FOR MEDICAL ASSISTANCE (PA 2018 STATE HEALTH ASSESSMENT-LATEST AVAILABLE DATA) CARBON COUNTY JULY 2017 PERCENTAGE ELIGIBLE FOR MEDICAL ASSISTANCE 21.5%LEHIGH COUNTY JULY 2017 PERCENTAGE ELIGIBLE FOR MEDICAL ASSISTANCE 23.9%NORTHAMPTON COUNTY JULY 2017 PERCENTAGE ELIGIBLE FOR MEDICAL ASSISTANCE 18.3%MONROE COUNTY JULY 2017 PERCENTAGE ELIGIBLE FOR MEDICAL ASSISTANCE 22.5%BERKS COUNTY JULY 2017 PERCENTAGE ELIGIBLE FOR MEDICAL ASSISTANCE 22.9%4. POPULATION AGE BREAKDOWN (US CENSUS 2018 ESTIMATED PENNSYLVANIA POPULATION > AGE 65 IS 18.2%)CARBON COUNTY - POPULATION > AGE 65 - 21.2%LEHIGH COUNTY - POPULATION > AGE 65 - 16.7%NORTHAMPTON COUNTY - POPULATION > AGE 65 - 19.0%MONROE COUNTY - POPULATION > AGE 65 - 17.2%BERKS COUNTY - POPULATION > AGE 65 - 17.2%5. PERCENTAGES OF LIMITED-ENGLISH-SPEAKING POPULATIONS (PERCENT SPEAK ENGLISH LESS THAN "VERY WELL")CARBON COUNTY - PERCENT OF POPULATION NOT PROFICIENT IN ENGLISH; 1.4%LEHIGH COUNTY - PERCENT OF POPULATION NOT PROFICIENT IN ENGLISH; 9.7% NORTHAMPTON COUNTY - PERCENT OF POPULATION NOT PROFICIENT IN ENGLISH; 4.9% MONROE COUNTY - PERCENT OF POPULATION NOT PROFICIENT IN ENGLISH; 4.3% BERKS COUNTY - PERCENT OF POPULATION NOT PROFICIENT IN ENGLISH; 7.6%6. AREAS DESIGNATED AS FEDERALLY MEDICALLY UNDERSERVED AREAS OR POPULATIONS (FEBRUARY, 2020)CARBON COUNTY- BOROUGHS OF: LANSFORD, NESQUEHONING, AND SUMMIT HILL LEHIGH COUNTY - ALLENTOWN SERVICE AREA - CT 0004.00 AND CT 0005.00NORTHAMPTON COUNTY -EASTON SERVICE AREA - CT: 144.00 AND SOUTH BETHLEHEM SERVICE AREA -CT: 109-113MONROE COUNTY - STROUDSBURG BOROUGH (MDC 74888) BERKS COUNTY - CITY OF READING SERVICE AREAS - CT: 1, 2, 10, 11, 13, 14, 17, 19, 21, 22, 23 AND 257. SPECIAL POPULATIONS WITHIN THE AREA SERVED, INCLUDING ETHNIC AND CULTURAL GROUPSCARBON COUNTY BACHELOR'S DEGREE OR HIGHER, PCT OF PERSONS AGE 25+ 16.8% VS 30.8% IN PALEHIGH COUNTY HISPANIC OR LATINO POPULATION 25.4% VS. 7.6% IN PANORTHAMPTON COUNTY HISPANIC OR LATINO POPULATION 13.8% VS. 7.6% IN PAMONROE COUNTY HISPANIC OR LATINO POPULATION 16.6% VS. 7.6% IN PABERKS COUNTY HISPANIC OR LATINO POPULATION 21.9% VS. 7.6% IN PASOURCE: MARKET SHARE-PHC4 DATA FOR 12 MONTHS ENDING Q1 CY2019. NOTE LEHIGH VALLEY-MUHLENBURG, ST. LUKE'S AND GNADEN HEUTTEN DID NOT REPORT REHAB UNIT VOLUME. AHD DATA FOR THESE FACILITIES USED TO NORMALIZE DATA SET. SOURCE: FACILITY CENSUS BY COUNTY-AHD.COM. NOTE, LVH MUHLENBURG IS ACTUALLY IN LEHIGH COUNTY, NOT NORTHAMPTON AS REPORTED BY AHD, HOWEVER KEPT IT IN NORTHAMPTON PER AHD AS THIS IS WIDELY USED SOURCE. SOURCES: #1, 2, 4, 5, & 7 US CENSUS STATE AND COUNTY QUICK FACTS; #3 2018 PA STATE HEALTH ASSESSMENT-LATES AVAILABLE DATA; MORE CURRENT UPDATES APPEAR UNAVAILABLE. , #6 US DEPT. HEALTH & HUMAN SERVICES- HEALTH RESOURCES AND SERVICE ADMINISTRATION. PART VI, LINE 5: WITH RESPECT TO HOW THE SPECIALTY HOSPITAL FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY, THE FOLLOWING INFORMATION IS PROVIDED:1) THE GSRN BOARD OF TRUSTEES GOVERNS ALL OF THE ENTITIES DESCRIBED IN PART I, LINE 6A (INCLUDING THE SPECIALTY HOSPITAL). THE GSRN BOARD OF TRUSTEE MEMBERS (BOARD MEMBERS) ALL LIVE IN THE SPECIALTY HOSPITAL'S PRIMARY SERVICE AREA AS DEFINED IN PART VI (SUPPLEMENTAL INFORMATION), LINE 4. THE VAST MAJORITY OF THE BOARD MEMBERS ARE NOT EMPLOYEES OR CONTRACTORS OF THE SPECIALTY HOSPITAL. NONE OF THE BOARD MEMBERS ARE FAMILY MEMBERS.2) THE SPECIALTY HOSPITAL ALSO MAINTAINS A SEPARATE BOARD OF TRUSTEES. ALL OF THE MEMBERS OF THIS SEPARATE BOARD LIVE IN THE SPECIALTY HOSPITAL'S PRIMARY SERVICE AND MOST ARE MANAGEMENT EMPLOYEES OF THE SPECIALTY HOSPITAL.3) THE SPECIALTY HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS PRIMARY SERVICE AREA. ALL APPLICANTS ARE APPROVED BY THE SPECIALTY HOSPITAL'S MEDICAL EXECUTIVE COMMITTEE. 4) THE SPECIALTY HOSPITAL PARTICIPATES IN THE MEDICARE, CHAMPUS, TRICARE AND OTHER GOVERNMENT SPONSORED HEALTHCARE PROGRAMS.5) THE COMMONWEALTH OF PENNSYLVANIA DOES NOT RECOGNIZE THE LONG-TERM ACUTE CARE HOSPITAL LEVEL OF SERVICE. ACCORDINGLY, THE SPECIALTY HOSPITAL DOES NOT PARTICIPATE IN THE PENNSYLVANIA MEDICAID PROGRAM. HOWEVER, PATIENTS THAT QUALIFY FOR THE PENNSYLVANIA MEDICAID PROGRAM WOULD ALSO MEET GOOD SHEPHERD'S CHARITY CARE CRITERIA. FINALLY, THE SPECIALTY HOSPITAL ACCEPTS MEDICAID PATIENTS FROM OTHER STATES.6) THE SPECIALTY HOSPITAL OPERATES IN A PRIMARY SERVICE AREA, WHICH INCLUDES ONLY ONE OTHER FREE-STANDING LONG-TERM ACUTE CARE HOSPITAL (A FOR-PROFIT FACILITY).7) TO THE EXTENT THE SPECIALTY HOSPITAL GENERATES SURPLUS OPERATING MARGINS AND/OR FREE CASH FLOW, THE AMOUNTS ARE COMPLETELY REINVESTED WITHIN THE SPECIALTY HOSPITAL AND/OR THE OTHER AFFILIATED CORPORATIONS UNDER THE CONTROL OF GOOD SHEPHERD REHABILITATION NETWORK (GSRN). SUCH REINVESTMENT CAN TAKE THE FORM OF INFRASTRUCTURE IMPROVEMENTS, INVESTMENTS IN MEDICAL EQUIPMENT AND TECHNOLOGY, OR OTHER INVESTMENTS INTENDED TO ENHANCE PATIENT SATISFACTION, IMPROVE THE QUALITY OF CARE, CONFORM WITH SAFETY CODES OR REGULATIONS, ETC.8) THE SPECIALTY HOSPITAL AND OTHER AFFILIATED CORPORATIONS UNDER THE CONTROL OF GOOD SHEPHERD REHABILITATION NETWORK (GSRN) ARE INVOLVED IN HEALTH PROFESSIONS EDUCATION, PARTICULARLY FOR NURSING AND THERAPY. PART VI, LINE 6: WITHIN THE GOOD SHEPHERD REHABILITATION NETWORK AND CONTROLLED ENTITIES (GOOD SHEPHERD), THE GOOD SHEPHERD REHABILITATION HOSPITAL (THE HOSPITAL), PROVIDES "CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST" AS REPORTED ON THEIR SCHEDULE H TO FORM 990. THESE AMOUNTS AGGREGATE $15,600,765 OR APPROXIMATELY 16.5% OF THE HOSPITAL'S EXPENSES. THROUGH ITS GOOD SHEPHERD HOUSING DEVELOPMENT CORPORATION (SUPPIL) SUBSIDIARY, GOOD SHEPHERD REHABILITATION NETWORK AND CONTROLLED ENTITIES (GOOD SHEPHERD), PROVIDES SUPPORTIVE INDEPENDENT HOUSING TO PERSONS WITH DISABILITIES UNDER SECTION 811 OF THE DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT. THESE SERVICES WERE OPERATED AT A LOSS, WHICH TOTALED $82,266 FOR THE FISCAL YEAR ENDED JUNE 30, 2019, AND WHICH WAS FUNDED BY GOOD SHEPHERD. THE LOSS WAS DETERMINED AFTER REDUCING SUPPIL RENTAL REVENUE AND OTHER INCOME BY THE DIRECTLY ASSIGNED EXPENSES INCURRED TO OPERATE THE PROGRAM.GSRN IS A 70% OWNER OF GSPP; HOWEVER, THE OPERATIONS OF GSPP ARE NOT CONSOLIDATED WITHIN THE CONSOLIDATED FINANCIAL STATEMENTS OF GOOD SHEPHERD AS GSRN IS NOT DEEMED TO HAVE CONTROL OVER GSPP. AS A RESULT, GSRN RECORDS THEIR INVESTMENT IN GSPP UNDER THE EQUITY METHOD OF ACCOUNTING WITHIN THE GSRN CONSOLIDATED FINANCIAL STATEMENTS. THROUGH ITS OWNERSHIP IN THE GSPP UNCONSOLIDATED AFFILIATE, GSRN PROVIDES THE FOLLOWING COMMUNITY BENEFITS, WHICH TOTAL TO $4,772,000:FINANCIAL ASSISTANCE AT COST $16,000UNREIMBURSED MEDICAID $3,277,000COMMUNITY HEALTH IMPROVEMENT SERVICES $10,000HEALTH PROFESSIONS EDUCATION $1,171,000RESEARCH $294,000COMMUNITY BUILDING ACTIVITIES $3,000FINANCIAL AND IN-KIND CONTRIBUTIONS $0TO OTHER COMMUNITY GROUPS $0SUBSIDIZED HEALTH SERVICES $1,000TOTAL $4,772,000THESE AMOUNTS ARE REPORTED ABOVE AT THEIR FULL COST ALTHOUGH GOOD SHEPHERD HAS A 70% OWNERSHIP INTEREST IN GSPP. PART VI, LINE 7: N/A 1 1 0 0 0 0 0 1 0 FRANK HYLAND VICE CHAIR 0 221690 0 14145 0 0 0 0 0 6399 0 242234 0 0 JOHN KRISTEL CHAIR/PRESIDENT/CEO (UNTIL 11/24/18) 0 656000 0 0 0 0 0 9250 0 16022 0 681272 0 0 RONALD J PETULA SVP/CFO/SEC/TREAS. 0 306190 0 19800 0 0 0 8192 0 9807 0 343989 0 0 JAMES J DALEY MD TRUSTEE 0 177931 0 17500 0 0 0 0 0 10927 0 206358 0 0 SAMUEL A MIRANDA JR SVP & CNO (UNTIL 9/22/18) 0 241484 0 15728 0 232648 0 4034 0 4918 0 498812 0 118935 MIKE CIRBA CIO (UNTIL 06/15/19) 0 175747 0 3500 0 0 0 9100 0 810 0 189157 0 0 SANDEEP SINGH CMO & SVP 0 305661 0 169364 0 0 0 14479 0 16101 0 505605 0 0 PART I, LINE 3 THE CEO IS COMPENSATED BY GOOD SHEPHERD REHABILITATION NETWORK ("GSRN"), AN AFFILIATED TAX-EXEMPT ORGANIZATION. THE HOSPITAL RELIED ON GSRN'S USE OF COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO ESTABLISH COMPENSATION. PART I, LINES 4A-B FOLLOWING INDIVIDUALS ARE SCHEDULED TO RECEIVE SEVERANCE PAYMENTS DURING CALENDAR YEAR 2019 AND 2020: - MIKE CIRBA (CIO) - SAMUEL A. MIRANDA (SVP & CNO) SAMUEL A. MIRANDA (SVP & CNO) RECEIVED DISTRIBUTIONS FROM 457(F) PLAN IN THE AMOUNT OF $232,648 DURING CALENDAR YEAR 2018. PART I, LINE 7 GSRN HAS A PERFORMANCE COMPENSATION PROGRAM IN PLACE WHICH IS APPROVED BY THE BOARD. CERTAIN MEMBERS OF MANAGEMENT CAN RECEIVE AN ANNUAL PERFORMANCE PAYMENT WHEN PRE-DEFINED AND PRE-APPROVED FINANCIAL AND NON-FINANCIAL GOALS ARE ACHIEVED. FOR FISCAL YEAR 2019, A PERFORMANCE PAYMENT WAS NOT ACHIEVED. IN LIEU OF A PERFORMANCE PAYMENT, SPOT BONUSES WERE PAID. THIS IS NOT GUARANTEED EACH YEAR. FORM 990, PART V, LINE 1: ACCOUNTS PAYABLE PAYMENTS ARE CONSOLIDATED UNDER A COMMON REPORTING SYSTEM. SINCE TOTALS FOR EACH VENDOR MAY CONTAIN TRANSACTIONS FROM MULTIPLE CORPORATIONS, THE NUMBER OF 1099'S FILED ON BEHALF OF THE ALLENTOWN SPECIALTY HOSPITAL, INC. BY THE COMMON REPORTING AGENT CANNOT BE SEPARATELY IDENTIFIED AND DETERMINED. FORM 990, PART V, LINE 2: THE SALARY AND BENEFIT EXPENSES REPORTED ON FORM 990, PART IX, AND THE EMPLOYEE INFORMATION REPORTED ON FORM 990, PART VII, ARE THE ALLENTOWN SPECIALTY HOSPITAL, INC. D/B/A GOOD SHEPHERD SPECIALTY HOSPITAL - ALLENTOWN'S ("GSSH") ALLOCATED PAYROLL COSTS BASED ON TIME SPENT. ALL INDIVIDUALS WORKING AT GSSH ARE EMPLOYEES OF THE GOOD SHEPHERD REHABILITATION HOSPITAL ("GSRH") AND ARE REPORTED ON ITS FORM W-3 UNDER EIN: 23-1371947. GSRH IS AN AFFILIATED TAX-EXEMPT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE IS COMPRISED OF THE CHAIRS OF ALL THE BOARD COMMITTEES AS WELL AS THE CHAIR AND VICE CHAIR OF THE BOARD. ALL EXECUTIVE COMMITTEE MEMBERS ARE MEMBERS OF THE BOARD OF TRUSTEES. THE EXECUTIVE COMMITTEE CAN ACT ON BEHALF OF THE BOARD OF TRUSTEES IN MOST CASES. ANY FUNDAMENTAL CHANGES WILL GO TO THE FULL BOARD. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE CORPORATE MEMBER OF THE ORGANIZATION IS THE GOOD SHEPHERD LONG TERM ACUTE CARE SERVICES, INC. ("LTACS"). THE SOLE CORPORATE MEMBER OF LTACS IS THE GOOD SHEPHERD REHABILITATION NETWORK ("GSRN"), A RELATED TAX-EXEMPT ENTITY. THE GOVERNING BOARD OF THE ORGANIZATION SHALL BE APPOINTED BY THE BOARD OF GSRN. IN ADDITION, ANY AMENDMENTS TO THE ORGANIZATION'S BYLAWS MUST BE APPROVED BY THE BOARD OF LTACS. FORM 990, PART VI, SECTION A, LINE 7B SEE EXPLANATION FOR FORM 990, PART VI, SECTION A, LINE 7A. FORM 990, PART VI, SECTION B, LINE 11B THE IRS FORM 990 IS PREPARED USING INFORMATION SOLICITED FROM OFFICERS, DIRECTORS, TRUSTEES, BOARD COMMITTEE MEMBERS, AND MANAGEMENT. THIS GROUP OF INDIVIDUALS IS PROVIDED A DRAFT RETURN BEFORE THE FINAL RETURN IS FILED. QUESTIONS, COMMENTS, AND ADDITIONAL INFORMATION PROVIDED BY THIS GROUP ARE INCORPORATED INTO THE FINAL RETURN. THE FINAL RETURN IS REVIEWED AT A COMMITTEE LEVEL OF THE BOARD PRIOR TO IT BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C THERE IS A SYSTEMATIC PROCESS COORDINATED THROUGH THE GOVERNANCE COMMITTEE WHERE THE CONFLICT OF INTEREST STATEMENTS COMPLETED ANNUALLY BY BOARD MEMBERS AND SENIOR LEADERSHIP TEAM MEMBERS ARE REVIEWED BY THE GOVERNANCE COMMITTEE. WHENEVER THE COMMITTEE FEELS THE CONFLICT STATEMENT IS EITHER INCOMPLETE OR FEELS SOMETHING MAY BE MISSING, THE COMMITTEE WILL ASK MANAGEMENT TO PURSUE FURTHER DUE DILIGENCE. WHEN A BOARD MEMBER DOES HAVE AN INHERENT CONFLICT, THE TRUSTEE IS ASKED TO EITHER ABSTAIN FROM VOTING OR EXCUSE HIMSELF FROM THE ROOM DURING THE DISCUSSION AND VOTING. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF TRUSTEES OF GOOD SHEPHERD REHABILITATION NETWORK (GSRN) DELEGATE RESPONSIBILITY FOR ADHERENCE TO ALL LEGAL AND REGULATORY REQUIREMENTS AFFECTING EXECUTIVE COMPENSATION TO THE HUMAN RESOURCES / COMPENSATION COMMITTEE OF THE BOARD (THE COMMITTEE). THE COMMITTEE IS PERMITTED TO ENGAGE EXTERNAL RESOURCES AS NECESSARY TO EDUCATE THEM ON NEW LEGAL OR REGULATORY GUIDELINES, MARKET TRENDS AND TO SUPPORT DELIBERATIONS AND DECISION MAKING RELATED TO EXECUTIVE COMPENSATION. THE COMMITTEE SELECTED AND UTILIZES AN INDEPENDENT COMPENSATION CONSULTANT, MERCER- A MARSH & MCCLENNAN COMPANY, (THE CONSULTANT) AS A RESOURCE TO ASSIST WITH DECISIONS RELATED TO EXECUTIVE COMPENSATION. IN ACCORDANCE WITH THE COMMITTEE'S ANNUAL WORK PLAN, THE COMMITTEE REVIEWED AT THE JUNE 2019 MEETING THE FOLLOWING: MERCER (US), INC. CERTIFIES THAT IT (1) IS A COMPENSATION CONSULTING FIRM, (2) PERFORMS COMPENSATION VALUATION STUDIES OF THIS TYPE ON A REGULAR BASIS, AND (3) IS QUALIFIED TO PERFORM THE VALUATIONS OF THE TYPE OF PROPERTY OR SERVICES INVOLVED. DURING MERCER'S REVIEW OF EXECUTIVE COMPENSATION, IT WAS FOUND IN THEIR OPINION TO BE FAIR, REASONABLE AND MARKET APPROPRIATE BASED ON THEIR ANALYSIS OF COMPETITIVE COMPENSATION AND BENEFIT PRACTICES FOR FUNCTIONALLY COMPARABLE POSITIONS IN SIMILARLY SITUATED ORGANIZATIONS. ALL OF THE COMPENSATION MEETINGS ARE FORMALLY DOCUMENTED CONSISTENT WITH BEST GOVERNANCE PRACTICES. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C: THE PROCESSES USED BY THE COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT HAVE NOT CHANGED FROM THE PRIOR YEAR. GOOD SHEPHERD HOME LONG-TERM CARE FACILITY INC GOOD SHEPHERD PLAZA 850 SOUTH 5TH S ALLENTOWN PA 18103 232215800 OPERATES TWO SKILLED NURSING FACILITIES FOR THE SEVERELY DISABLED PA 501(C)(3) LINE 3 GOOD SHEPHERD REHABILITATION NETWORK 0 GOOD SHEPHERD HOUSING DEVELOPMENT CORPORATION GOOD SHEPHERD PLAZA 850 SOUTH 5TH S ALLENTOWN PA 18103 233073390 PROVIDES INDEPENDENT LIVING APTS FOR DISABLED, LOW-INCOME ADULTS PA 501(C)(3) LINE 10 GOOD SHEPHERD REHABILITATION NETWORK 0 GOOD SHEPHERD REHABILITATION HOSPITAL GOOD SHEPHERD PLAZA 850 SOUTH 5TH S ALLENTOWN PA 18103 231371947 PROVIDES COMPREHENSIVE INPATIENT AND OUTPATIENT REHABILITATION SERVICES PA 501(C)(3) LINE 3 GOOD SHEPHERD REHABILITATION NETWORK 0 GOOD SHEPHERD REHABILITATION NETWORK GOOD SHEPHERD PLAZA 850 SOUTH 5TH S ALLENTOWN PA 18103 232216041 PROVIDES MANAGEMENT SERVICES IN SUPPORT OF ITS TAX-EXEMPT AFFILIATES PA 501(C)(3) LINE 7 N/A 0 PHILADELPHIA POST-ACUTE PARTNERS LLC 1800 LOMBARD STREET PHILADELPHIA PA 19146 208283421 OPERATES INPATIENT REHAB HOSP, ACUTE CARE HOSP & 8 OUTPATIENT FACILITIES PA 501(C)(3) LINE 3 GOOD SHEPHERD REHABILITATION NETWORK 0 GOOD SHEPHERD RECIPROCAL RISK RENTENTION GROUP 7301 RIVERS AVENUE SUITE 230 NORTH CHARLESTON SC 29406 204065112 RISK RETENTION GROUP SC N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 1 1