2018-05-09T08:08:23-05:00 2017-06-30 390859910 Baker Tilly Virchow Krause LLP 1650 Market Street Suite 4500 Philadelphia PA 191037341 990 2016-07-01 232349341 Family Care Centers Inc FAMI 5704214000 206 East Brown Street East Stroudsburg PA 18301 WILLIAM THOMA SVP Finance 5704214000 2018-04-27 1 Julius C Green CPA P00350393 2159720701 50.243.90.186 2018-04-27 07:31:49 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 D9079DD28A529C8CC17D76080D235F96F7AA2E40 2016 2021-01-29 14:40:06Z Lehigh Valley Physician Group - Pocono Elizabeth Wise 206 East Brown Street East Stroudsburg PA 18301 74817480 0 X WWW.POCONOHEALTHSYSTEM.ORG X 1985 PA To prevent illness, promote wellness and restore health in the pocono area. 7 5 472 5 0 0 29454398 39263535 34004571 35541457 5435 12488 0 0 63464404 74817480 0 0 0 0 42431870 48619600 0 0 0 18537396 22054174 60969266 70673774 2495138 4143706 8725453 13452713 4557090 5140644 4168363 8312069 X Our mission is who we are and what we do: to provide world class care close to home. Our vision is what we aim for to best serve our community: to build a healthier community. 0 0 67743303 0 36694065 The organization operates several physician practices, including BUT NOT LIMITED TO family medicine, hematology and oncology, internal medicine, and obstetrics and gynecology. Also, the organization provides physician practice support services including: billing, information technology, and telecommunications. In addition, the organization has enhanced the outpatient services available to persons in the area, including services to the indigent and underinsured. The organization provides services to the surrounding area regardless of race, creed, sex, national origin, handicap, age, or ability to pay.The organization aims to provide excellent quality care to our diverse and growing community and still provides for needed capital for the future. All resources and program service expenses are utilized to offer our patients quality care through multiple service lines. These services include, but are not limited to: family practice, obstetrics and gynecology, diagnostic testing, occupational medicine, oncology, anesthesiology services, cardiology services and pulmonary care. The internal medicine team paves the way in providing specialized care to adult patients. As part of the Lehigh Valley Health Network, family care centers, INC. (FCC) offers the finest physicians and technology to the area and connects them to the Pocono medical center when a great degree of service is required. FCC constantly assesses and improves, when possible, equipment used, quality review measures, and scheduling considerations in order to meet or exceed the standard of care expected for these services. To facilitate care, many of our practices offer multiple sites and extended office hours. Our facilities are located in areas that are considered underserved within the community. Care is provided for both preventative services and acute and chronic medical conditions. The Family Care Center affiliated physicians' visits included the following:Perinatology - 279Ob/GYN - 33,076Internal Medicine - 42,157Family Medicine - 26,079Endocrinology -5,115Cardiology - 15,973Pediatric Visits - 31,796Pulmonary Care Visits - 11,729ICC Visits - 44,627 67743303 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 36 0 1 472 1 0 0 0 0 0 0 0 0 0 0 X 7 5 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X WILLIAM THOMA SVP Finance 5704204912 206 East Brown Street East Stroudsburg PA 18301 Suzanne Viechnicki CHAIR 1.00 X X 0 0 0 KENNETH LEVITT PHD VICE CHAIR 1.00 X X 0 0 0 Charles Herman MD SECRETARY/TREASURER 1.00 39.00 X X 786714 0 37286 JEFF SNYDER PRESIDENT/CEO (term 1/1/17) 1.00 39.00 X X 0 668213 62821 ELIZABETH WISE Acting President/CEO (as of 1/1/17) 1.00 39.00 X X 0 387389 44427 Rajesh Bhagat MD Director 1.00 2.00 X 0 0 0 R Douglas Olmstead Director 1.00 2.00 X 0 0 0 Gregory Brusko DO LVHN Director 1.00 1.00 X 0 490860 20632 LAMONT LOUIS VP PHYSICIAN NETWORK (nonvoting) 1.00 39.00 X 0 236567 19246 Nche Zama Physician 40.00 X 1398000 0 8321 SAMER ALKHUJA physician 40.00 X 816697 0 62821 Karthik P Sheka Physician 40.00 X 694504 0 37286 ANIL GUPTA Physician 40.00 X 680917 0 26321 Praveer Jain Physician 40.00 X 578841 0 42586 KATHLEEN KUCK FORMER PRESIDENT/CEO 0.00 1.00 X 0 481659 8321 4955673 2264688 370068 83 1 1 0 DHP MANAGEMENT SERVICES PO BOX 634850 CINCINNATI OH 452634850 PHYSICIAN SERVICES 2526556 ALLIED BUILDING CORP 574 MAIN STREET SUITE 200 BETHLEHEM PA 18018 CONSTRUCTION SERVICES 1650168 MEDICUS HEALTHCARE SOLUTIONS LLC 22 ROULSTON RD WINDHAM NH 03087 PHYSICIAN SERVICES 621911 CHELBUS CLEANING 275 NEWTON-SPARTA ROAD NEWTON NJ 07860 CLEANING SERVICES 547871 LOCUMTENENSCOM PO BOX 405547 ATLANTA GA 303845547 MED STAFF PLACEMENT SERVICES 533224 16 39263535 39263535 Patient revenue 621400 30301563 30301563 Other program services 621400 2870575 2870575 MSO billing revenue 541900 2369319 2369319 35541457 12488 12488 74817480 35541457 0 12488 X 521175 502463 18712 39294413 37883574 1410839 1329857 1300217 29640 5529385 5135942 393443 1944770 1862125 82645 2450 2450 12431785 11723770 708015 883 883 978867 879460 99407 2909 2909 3182975 3001855 181120 279027 277892 1135 1000784 997719 3065 1696410 1696410 Med. Supplies & Drugs 1630984 1630984 Bad Debt 673540 673540 Dues & Subscriptions 140705 140705 LICENSES & CERTS 16477 16477 16378 16378 70673774 67743303 2930471 0 3310 4820 744343 515284 2558649 5944251 276062 247038 12335574 5860018 4899743 6475556 243346 265764 8725453 13452713 4437996 4770000 119094 370644 4557090 5140644 X 4168363 8312069 4168363 8312069 8725453 13452713 4143706 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 117047 117047 3989012 1083873 2905139 649183 433325 215858 7576060 4342820 3233240 4272 4272 6475556 INTERCOMPANY - DUE TO AFFILIATE 370644 370644 X Part X, Line 2: The Organization and its subsidiaries are generally exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code, except for tax imposed on unrelated business income. The most recent determination letter, received by the Organization, is dated May 1, 2014. The Organization and its subsidiaries account for uncertain tax positions in accordance with Accounting Standards Codification (ASC) Topic 740. The Organization's for-profit components recognize deferred tax assets and liabilities for the future tax impact of temporary differences between amounts recorded in the consolidated financial statements and their respective tax bases and the future benefit of utilization net operating loss carryforwards. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. Income taxes of the Organization's tax-exempt and for-profit components are not material to the accompanying consolidated financial statements. 1 1 0 0 0 0 0 1 0 Charles Herman MD SECRETARY/TREASURER 786714 0 0 0 0 0 18000 0 19286 0 824000 0 8230 0 JEFF SNYDER PRESIDENT/CEO (term 1/1/17) 0 443619 0 119738 0 104856 0 42000 0 20821 0 731034 0 102234 ELIZABETH WISE Acting President/CEO (as of 1/1/17) 0 386147 0 0 0 1242 0 24000 0 20427 0 431816 0 0 Gregory Brusko DO LVHN Director 0 416657 0 45981 0 28222 0 0 0 20632 0 511492 0 0 LAMONT LOUIS VP PHYSICIAN NETWORK (nonvoting) 0 204601 0 31000 0 966 0 0 0 19246 0 255813 0 0 Nche Zama Physician 1398000 0 0 0 0 0 0 0 8321 0 1406321 0 0 0 SAMER ALKHUJA physician 816697 0 0 0 0 0 42000 0 20821 0 879518 0 0 0 Karthik P Sheka Physician 694504 0 0 0 0 0 18000 0 19286 0 731790 0 0 0 ANIL GUPTA Physician 680917 0 0 0 0 0 18000 0 8321 0 707238 0 0 0 Praveer Jain Physician 578841 0 0 0 0 0 23300 0 19286 0 621427 0 0 0 KATHLEEN KUCK FORMER PRESIDENT/CEO 0 0 0 0 0 481659 0 0 0 8321 0 489980 0 282460 Part I, Line 3 THE FORMER PRESIDENT/CEO, KATHLEEN KUCK, THE FORMER PRESIDENT/CEO, JEFF SNYDER, THE ACTING PRESIDENT/CEO, ELIZABETH WISE, AND A DIRECTOR, CHARLES HERMAN, ARE COMPENSATED BY POCONO MEDICAL CENTER (PMC), A RELATED ORGANIZATION. PMC USES THE FOLLOWING METHODS TO DETERMINE THEIR COMPENSATION: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. Part I, Lines 4a-b THE FOLLOWING INDIVIDUAL RECEIVED A SEVERANCE PAYMENT FROM POCONO MEDICAL CENTER, A RELATED ORGANIZATION, IN CALENDAR YEAR 2016: KATHLEEN KUCK, FORMER PRESIDENT/CEO - $199,199 THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE 457(F) SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN OF POCONO MEDICAL CENTER, A RELATED ORGANIZATION, AND RECEIVED A DISTRIBUTION IN CALENDAR YEAR 2016: JEFF SNYDER, FORMER PRESIDENT/CEO - $102,234 KATHLEEN KUCK, FORMER PRESIDENT/CEO - $282,460 Charles Herman, DIRECTOR - $8,230 The following individuals participated in the 457(f) supplemental nonqualified retirement plan of Pocono Medical Center, a related organization, but did not receive a distribution in calendar year 2016: Praveer Jain Samer Alkhuja Anil Gupta Karthik P. Sheka Nche Zama Part I, Line 7 Incentive compensation is paid based on the following four performance criteria: 1) increase in the services available to the community, 2) Improvement in customer satisfaction and quality of service provided, 3) Stable financial ratios, and 4) improving employee satisfaction. Physicians receive non-fixed bonus and incentive compensation based on their respective contracts. Incentives are either based on a percentage of payments received above required expense coverage threshold or Relative Value Unit (RVU) threshold. Form 990, Part VI, Section A, line 6 The sole member of the corporation is Pocono Health System (PHS), a Pennsylvania non-profit corporation. On December 11, 2015, Lehigh Valley Health Network (LVHN) executed an Affiliation Agreement with the Pocono Health System (PHS) providing for an affiliation between LVHN and Pocono Medical Center (PMC), Pocono Health Foundation (Foundation), Family Care Centers (FCC), Pocono VNA/Hospice (VNA), Pocono Healthcare Partners (PHP) and Pocono Ambulatory Services (PAS). The governing documents of PHS were amended such that effective January 1, 2017, the closing date of the affiliation, PHS merged into LVHN and LVHN became the sole member of Pocono Health System. PHS consists primarily of PMC, a 239-bed inpatient acute care hospital also providing rehab and emergency care to East Stroudsburg, Pennsylvania and surrounding communities, Pocono VNA/Hospice providing home health and hospice services, and FCC, a multi-specialty physician group. Form 990, Part VI, Section A, line 7a PHS elects/appoints the board members of Family Care Centers (FCC). Form 990, Part VI, Section A, line 7b The following was noted in Section 4-07 of the organization's Bylaws: In addition to all matters required by law or by other provisions of these bylaws to be submitted to a vote of the sole member, the sole member is empowered to initiate and implement any of the following actions with respect to the corporation and if any such action is otherwise initiated by the corporation, such action will not become effective unless approved by the sole member: (A) to adopt or change the mission, purpose, philosophy or objectives of this corporation or any subsidiary corporation; (b) to dissolve, reorganize, divide, convert, liquidate or wind-up any subsidiary corporation or consolidate or merge this corporation with any other corporation or entity; (c) to annually approve all capital and operating budgets for this corporation; (d) to annually approve the strategic and operating plans or any changes thereto of this corporation; (e) to approve any unbudgeted expense item of this corporation in excess of five hundred thousand ($500,000.00) dollars; (f) to receive, review, and approve financial and operating reports from this corporation on at least a quarterly basis; (G) to approve any new line(s) of business and/or material changes in existing services and/or participation by this corporation with any other entity where licensure by the commonwealth of pennsylvania is required as a precondition for any such action, business, service, or participation; (H) to approve the incurrence of indebtedness by this corporation in excess of one hundred thousand ($100,000) dollars; (I) to approve the amendment of the articles of incorporation or bylaws of this corporation; (J) to specify the number of and to elect or remove the members of the board of directors of this corporation; (K) to approve the election or removal of the chairperson of the board of directors of this corporation; (L) to require each director of this corporation and the president, each vice president, and all key management personnel of this corporation to annually submit to the board of directors of this corporation a conflict of interest statement in form first approved by the board of directors of the sole member; (M) to at least annually evaluate the performance of this corporation's board of directors in overseeing the management and performance of this corporation; and (N) to require that this corporation's governance, deliberations, and actions are oriented to community service. Form 990, Part VI, Section B, line 11b The organization has an extensive 990 review process. The 990 is first reviewed by the accounting department and the CFO. After any necessary changes are made, a review is performed by the corporate compliance officer, the finance committee, and the CEO. After all changes are made, the final copy is provided to all board members for review and comment before filing with the IRS. Form 990, Part VI, Section B, line 12c On an annual basis, Board members and key management personnel are required to complete a Conflict of Interest Disclosure Form. All forms are submitted to and reviewed by the Corporate Compliance Officer of Pocono Health System. Interested persons have a continuing obligation to disclose, through a written description, the existence and nature of any actual, apparent, or potential Conflict of Interest he/she may have. The Audit and Compliance Committee shall review the matter and determine whether a Conflict of Interest exists. Once all necessary information has been obtained, the Audit and Compliance Committee shall make a finding as to whether a conflict of interest indeed exists, and shall forward that finding to the Board of Directors for discussion and vote. Only disinterested Directors may vote to determine whether a Conflict of Interest exists. The subject Interested Person may not be present when this vote is taken. For all identified conflicts, the interested persons are required to leave the room while the related matters are discussed and voted on. Form 990, Part VI, Section B, line 15 These activities are undertaken by Pocono Medical Center's board, as Pocono Medical center compensates the CEO and CFO for services to pocono medical center and all related entities. Once every three years, or sooner if necessary, compensation reviews are conducted for the CEO and top management. A compensation committee recommends to the board the compensation of the president and ceo and compensation ranges for the vice presidents. the ceo shall then set the compensation of the vice presidents within the approved ranges. In making recommendations to the board on compensation and compensation ranges, the compensation committee relies on reports from an independent compensation consultant selected by the committee. To assure independence, the consultant shall perform no other services for PMC. The consultant was most recently used in April of 2014. The committee reports its decisions to the board at its next executive session, at which time the board shall either ratify the decision or send it back to the committee for further deliberation. Once a final decision is reached, the board chairman informs the ceo of the decisions of the committee and ratification by the board regarding the ceo's salary and the salary ranges for the vice presidents. Minutes of the committee and the executive session portion of the board are prepared and retained in the administration offices and contain sufficient information to substantiate the deliberation and decision. Form 990, Part VI, Section C, line 19 Financial results are published in the annual report, a copy of which is distributed in a variety of public forums and would otherwise be provided upon request. The conflict of interest policy would be available for viewing in the business or administrative offices of PMC, upon request, to ensure the most current copy is always the one being made available. The governing documents are available upon request. Form 990, Part IX, line 11g OUTSIDE SERVICES: Program service expenses 6,145,259. Management and general expenses 707,465. Fundraising expenses 0. Total expenses 6,852,724. CONSULTING SERVICES: Program service expenses 111,517. Management and general expenses 550. Fundraising expenses 0. Total expenses 112,067. PPN FEES: Program service expenses 2,614,706. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,614,706. CALL CENTER FEES: Program service expenses 644,340. Management and general expenses 0. Fundraising expenses 0. Total expenses 644,340. COLLECTION FEES: Program service expenses 2,207,948. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,207,948. Pocono Health System 206 East Brown Street East Stroudsburg PA 18301 232336285 Support Pocono Medical Center PA 501(c)(3) Line 12b, II Lehigh Valley Health Network 0 Pocono Healthcare Partners 206 East Brown Street east Stroudsburg PA 18301 233014006 Healthcare PA 501(c)(3) Line 3 Pocono Health System 0 Pocono Ambulatory Services Inc 206 East Brown Street east Stroudsburg PA 18301 232611474 healthcare PA 501(c)(3) Line 3 pocono Health System 0 Pocono Medical Center 206 East Brown Street east Stroudsburg PA 18301 240795623 Hospital PA 501(c)(3) Line 3 pocono Health System 0 Pocono Health Foundation 206 East Brown Street east Stroudsburg PA 18301 232516451 Support PA 501(c)(3) Line 12a, I pocono Health System 0 pocono health system medical professional liability self-insurance trust 206 East Brown Street east Stroudsburg PA 18301 206560453 Self-insurance PA 501(c)(3) Line 12a, I Pocono Health System 0 POCONO VNA-HOSPICE 206 East Brown Street east Stroudsburg PA 18301 232535297 Healthcare PA 501(c)(3) Line 10 Pocono Health System 0 Lehigh Valley Health Network 1200 S Cedar Crest Blvd Allentown PA 181036202 222458317 Parent Company PA 501(c)(3) Line 3 N/A 0 Lehigh Valley Hospital 2100 Mack Blvd Allentown PA 181035622 231689692 Health Care Organization PA 501(c)(3) Line 3 Lehigh Valley Health Network 0 Lehigh Valley Hospital-Muhlenberg 1200 S Cedar Crest Blvd Allentown PA 181036202 232367707 Health Care Organization PA 501(c)(3) Line 3 Lehigh Valley Health Network 0 Lehigh Valley Physician Group 1200 S Cedar Crest Blvd Allentown PA 181036202 232700908 Physician Practice Organization PA 501(c)(3) Line 3 Lehigh Valley Health Network 0 Muhlenberg Realty Corporation 1200 S Cedar Crest Blvd Allentown PA 181036202 232245513 Real Estate Rentals PA 501(c)(3) Line 3 Lehigh Valley Health Network 0 Lehigh Valley Health Network Realty Holding Co 1200 S Cedar Crest Blvd Allentown PA 181036202 232586770 Real Estate Holding Co PA 501(c)(2) Lehigh Valley Health Network 0 Northeastern Pennsylvania Health Corp 700 E Broad St Hazleton PA 182016835 232421970 Health Care Organization PA 501(c)(3) Line 3 Lehigh Valley Health Network 0 Hazleton Professional Services 700 E Broad St Hazleton PA 182016835 205880364 Physician Practice Organization PA 501(c)(3) Line 3 Lehigh Valley Physician Group 0 Hazleton Health & Wellness Center 700 E Broad St Hazleton PA 182016835 232580968 Staffing Services PA 501(c)(3) Line 12a, I Northeastern Pennsylvania Health Corp 0 Hazleton Surgical Alliance 700 E Broad St Hazleton PA 182016835 202038456 Surgical Services PA 501(c)(3) Line 3 Northeastern Pennsylvania Health Corp 0 Schuylkill Health System Medical Group Inc 700 East Norwegian Street Pottsville PA 17901 232866006 SUPPORT PA 501(c)(3) Line 10 Lehigh Valley Physician Group 0 Schuylkill Medical Center - South Jackson Street Mauch Chunk Jackson Streets Pottsville PA 17901 231352202 Health Care Organization PA 501(c)(3) Line 3 Lehigh Valley Health Network 0 Schuylkill Rehabilitation Center Inc 420 South Jackson Street Pottsville PA 17901 232440891 Health Care Organization PA 501(c)(3) Line 3 Lehigh Valley Health Network 0 Schuylkill Medical Center - East Norwegian Street 700 East Norwegian Street Pottsville PA 17901 230880420 Health Care Organization PA 501(c)(3) Line 3 Lehigh Valley Health Network 0 West End Community Ambulance Association PO Box 200 Effort PA 18330 232532377 Ambulance Transport Services PA 501(c)(3) Line 10 POCONo Health System 0 Pocono Ambulatory Surgery Center Ltd one Storm Street stroudsburg PA 18360 232611442 Surgery PA N/A POCONO HEALTH SYSTEM INVEST COLLAB LP 206 EAST BROWN STREET east stroudsburg PA 18301 472125419 INVESTMENTS PA N/A LVHN Reciprocal Risk Retention Group 151 Meeting Street Suite 310 Charleston SC 294012238 200037118 Insurance PA N/A Health Network Laboratories LLC 794 Roble Rd Allentown PA 181099110 232932802 Laboratory Services PA N/A Health Network Laboratories LP 794 Roble Rd Allentown PA 181099110 232948774 Laboratory Services PA N/A Lehigh Magnetic Imaging Center 1230 S Cedar Crest Blvd Allentown PA 18103 232429007 Imaging Center PA N/A Lehigh Valley Imaging LLC 1200 Cedar Crest Blvd Allentown PA 181036202 464551937 Imaging Services PA N/A Hazleton Surgery Center LLC 17480 Dallas Pkwy Ste 210 Dallas TX 752877304 201232531 Surgical Services PA N/A Schuylkill Health System Medical Mall LP East Norwegian Tremont Streets Pottsville PA 17901 232514813 Rental PA N/A Lehigh Valley Health Services Inc 2100 Mack Blvd Allentown PA 181035622 232263665 Health Care Related Services PA N/A C 0 Lehigh Valley Anesthesia Services PC 2100 Mack Blvd Allentown PA 181035622 233906125 Anesthesia Services PA N/A C 0 Westgate Professional Center Inc 2100 Mack Blvd Allentown PA 181035622 231657333 Real Estate Rentals PA N/A C 0 Lehigh Valley Physician Hospital Organization Inc 2100 Mack Blvd Allentown PA 181035622 232750430 Health Care Related Services PA N/A C 0 Hazleton Saint Joseph Medical Office Building Inc 700 E Broad St Hazleton PA 182016835 232500981 Medical Office Rental PA N/A C 0 Schuylkill Health System Development Corporation 700 East Norwegian Street Pottsville PA 17901 232432417 Pursues, implements, & furthers the activities & purposes of the system PA N/A C 0 Schuylkill Medical Plaza - Condominium Association 420 South Jackson Street Pottsville PA 17901 232931821 Condominium Association PA N/A C 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0