FURP.ORG / PUBLIC DATA EXPLORER

GOOD SHEPHERD SPECIALTY HOSPITAL: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
GOOD SHEPHERD SPECIALTY HOSPITAL (EIN 23-3009874)
Tax period
2015-07-01 to 2016-06-30
Filed
2017-05-08
IRS object ID
201701289349300610
Schema version
2015v3.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2017-05-08T07:44:37-05:00ReturnTs
Tax Period End2016-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390859910PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BAKER TILLY VIRCHOW KRAUSE LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11650 MARKET STREET SUITE 4500AddressLine1Txt
CityPHILADELPHIACityNm
State AbbreviationPAStateAbbreviationCd
ZIP19103ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN233009874EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE ALLENTOWN SPECIALTY HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlALLEBusinessNameControlTxt
Phone6107763228PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1GOOD SHEPHERD PLAZA 850 S 5TH STAddressLine1Txt
CityALLENTOWNCityNm
State AbbreviationPAStateAbbreviationCd
ZIP181033295ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRONALD J PETULAPersonNm
Person TitleSVP OF FINANCE & CFOPersonTitleTxt
Phone6107763228PhoneNum
Signature2017-04-28SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJULIUS C GREEN CPAPreparerPersonNm
PTINP00350393PTIN
Phone2159720701PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1GOOD SHEPHERD SPECIALTY HOSPITAL - ALLENTOWNBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerRONALD J PETULAPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1GOOD SHEPHERD PLAZA 850 S 5TH STAddressLine1Txt
CityALLENTOWNCityNm
State AbbreviationPAStateAbbreviationCd
ZIP181033295ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$16,358,478GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.GOODSHEPHERDREHAB.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1999FormationYr
Legal Domicile StatePALegalDomicileStateCd
Activity Or MissionTO ENHANCE LIVES, MAXIMIZE FUNCTION, INSPIRE HOPE, AND PROMOTE DIGNITY AND WELL-BEING.ActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent3VotingMembersIndependentCnt
Total Employee126TotalEmployeeCnt
Total Volunteers1TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$41PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$17,624,023PYProgramServiceRevenueAmt
CY Program Service Revenue$16,358,393CYProgramServiceRevenueAmt
PY Investment Income$1,589PYInvestmentIncomeAmt
CY Investment Income$58CYInvestmentIncomeAmt
PY Other Revenue$10PYOtherRevenueAmt
CY Other Revenue$27CYOtherRevenueAmt
PY Total Revenue$17,625,663PYTotalRevenueAmt
CY Total Revenue$16,358,478CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$7,033,419PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$7,073,438CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$8,668,617PYOtherExpensesAmt
CY Other Expenses$8,603,694CYOtherExpensesAmt
PY Total Expenses$15,702,036PYTotalExpensesAmt
CY Total Expenses$15,677,132CYTotalExpensesAmt
PY Revenues Less Expenses$1,923,627PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$681,346CYRevenuesLessExpensesAmt
Total Assets BOY$20,942,465TotalAssetsBOYAmt
Total Assets EOY$21,856,401TotalAssetsEOYAmt
Total Liabilities BOY$1,895,869TotalLiabilitiesBOYAmt
Total Liabilities EOY$2,128,459TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$19,046,596NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$19,727,942NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionGOOD SHEPHERD'S MISSION IS: "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."MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$14,289,864ExpenseAmt
Grant$0GrantAmt
Revenue$16,358,393RevenueAmt
DescTHE 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. IN FISCAL YEAR 2016, GSSH DISCHARGED A TOTAL OF 347 INPATIENTS AND HAD 9,036 TOTAL PATIENT DAYS.Desc
Total Program Service Expenses$14,289,864TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee126EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member3IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldPAStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldFLStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1RONALD J PETULA SVP OF FINANCE & CFOBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6107763228PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1GOOD SHEPHERD PLAZA 850 SOUTH 5THAddressLine1Txt
CityALLENTOWNCityNm
State AbbreviationPAStateAbbreviationCd
ZIP181033295ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
JOHN KRISTEL
CHAIR/PRESIDENT/CEO8.5051.50Yes (X)Yes (X)$0$677,444$28,919
SAMUEL A MIRANDA JR
VICE CHAIR/SVP & CNO5.0055.00Yes (X)Yes (X)$0$286,884$25,802
RONALD PETULA
SEC/TREASURER/SVP &CFO8.5051.50Yes (X)Yes (X)$0$288,794$17,625
JAMES J DALEY MD
TRUSTEE1.0059.00Yes (X)$0$196,423$20,713
PETER T ENDER MD
TRUSTEE1.00Yes (X)$0$0$0
SUSAN L LAWRENCE
TRUSTEE1.00Yes (X)$0$0$0
IQBAL SORATHIA MD
TRUSTEE1.00Yes (X)$0$0$0
GREGORY WUCHTER
TRUSTEE/ADMINISTRATOR60.00Yes (X)$119,261$0$27,885
FieldValueIRS element (for citing)
Total Reportable Comp From Org$119,261TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,449,545TotReportableCompRltdOrgAmt
Total Other Compensation$120,944TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
LEHIGH VALLEY HOSPITAL
CEDAR CREST I-78ALLENTOWNPA18103MEDICAL SERVICES$591,886
HEALTH NETWORK LABS
2024 LEHIGH STREETALLENTOWNPA18103LABORATORY SERVICES$310,859
SODEXHO OPERATIONS LLC
4880 PAYSPHERE CIRCLECHICAGOIL60674DIETARY/FOOD SERVICES$223,181
CROTHALL HEALTHCARE INC
1200 SOUTH CEDAR CREST BLVDALLENTOWNPA18103HOUSEKEEPING SERVICES$195,967
LVPG
2100 MACK BOULEVARDALLENTOWNPA18103MEDICAL DIRECTOR FEES$110,000
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K8CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET PATIENT SVC REVDesc
Business623000BusinessCd
Total Revenue Column$16,358,393TotalRevenueColumnAmt
Related Or Exempt Func Income$16,358,393RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$16,358,393TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$58TotalRevenueColumnAmt
Exclusion$58ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMEDICAL RECORDSDesc
Business900099BusinessCd
Total Revenue Column$27TotalRevenueColumnAmt
Exclusion$27ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$27OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$16,358,478TotalRevenueColumnAmt
Related Or Exempt Func Income$16,358,393RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$85ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$123,683TotalAmt
Management And General$123,683ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$5,362,175TotalAmt
Program Services$4,868,049ProgramServicesAmt
Management And General$494,126ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,204,681TotalAmt
Program Services$1,096,508ProgramServicesAmt
Management And General$108,173ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$382,899TotalAmt
Program Services$341,351ProgramServicesAmt
Management And General$41,548ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$2,345TotalAmt
Management And General$2,345ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,460,212TotalAmt
Program Services$1,459,255ProgramServicesAmt
Management And General$957ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$298,448TotalAmt
Program Services$276,337ProgramServicesAmt
Management And General$22,111ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$514,521TotalAmt
Management And General$514,521ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$18,264TotalAmt
Program Services$1,371ProgramServicesAmt
Management And General$16,893ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$6,584TotalAmt
Program Services$5,281ProgramServicesAmt
Management And General$1,303ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$141,094TotalAmt
Program Services$141,094ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
CORPORATE ALLOCATION$3,875,376$3,875,376
MEDICAL SUPPLIES$1,650,309$1,650,277$32
BAD DEBT EXPENSE$410,202$410,202
FOOD$145,392$143,237$2,155

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$80,947TotalAmt
Program Services$21,526ProgramServicesAmt
Management And General$59,421ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$15,677,132TotalAmt
Program Services$14,289,864ProgramServicesAmt
Management And General$1,387,268ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,202,854BOYAmt
EOY$3,066,795EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$90,936BOYAmt
EOY$76,943EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$2,913,908LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$2,163,559LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$504,526BOYAmt
EOY$750,349EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$17,144,149BOYAmt
EOY$17,962,314EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$20,942,465BOYAmt
EOY$21,856,401EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,304,685BOYAmt
EOY$1,614,297EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$591,184BOYAmt
EOY$514,162EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,895,869BOYAmt
EOY$2,128,459EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$19,046,596BOYAmt
EOY$19,727,942EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$19,046,596BOYAmt
EOY$19,727,942EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$20,942,465BOYAmt
EOY$21,856,401EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$681,346ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$2,345OtherActivitiesAmt
Total Lobbying Expenditures$2,345TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationTHE ALLENTOWN SPECIALTY HOSPITAL, INC. HAD LOBBYING EXPENDITURES THROUGH A CERTAIN PERCENTAGE OF MEMBERSHIP FEES PAID TO THE HOSPITAL AND HEALTHSYSTEM ASSOCIATION OF PA (HAP) AND THE AMERICAN HOSPITAL ASSOCIATION (AHA) DURING THE FISCAL YEAR ENDING JUNE 30, 2016. $2,345 WAS THE PORTION OF THE MEMBERSHIP FEES THAT WERE DEEMED TO BE USED TOWARDS LOBBYING.ExplanationTxt

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$190,277OtherCostOrOtherBasisAmt
Depreciation$186,000DepreciationAmt
Book Value$4,277BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,723,631OtherCostOrOtherBasisAmt
Depreciation$1,977,559DepreciationAmt
Book Value$746,072BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$750,349TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescAMOUNTS DUE FROM AFFILIATESDesc
Book Value$17,962,314BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$17,962,314TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescESTIMATED THIRD-PARTY PAYOR SETTLEMENTSDesc
Amt$514,162Amt
FieldValueIRS element (for citing)
Total Liability$514,162TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$15,948,276TotalRevEtcAuditedFinclStmtAmt
Other Revenue-$410,202OtherRevenueAmt
Revenue Not Reported-$410,202RevenueNotReportedAmt
Revenue Subtotal$16,358,478RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$16,358,478TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$15,266,930TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$15,266,930ExpensesSubtotalAmt
Other Expenses Not Included$410,202OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$410,202ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$15,677,132TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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. GOOD SHEPHERD'S POLICY IS TO RECOGNIZE INTEREST RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE AND PENALTIES IN OPERATING EXPENSES. GOOD SHEPHERD'S FEDERAL INCOME TAX RETURNS FOR THE YEARS ENDED PRIOR TO JUNE 30, 2013 NO LONGER REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE.
PART XI, LINE 2D - OTHER ADJUSTMENTS:BAD DEBTS NETTED AGAINST REVENUE ON FINANCIAL STATEMENTS -410,202.
PART XII, LINE 4B - OTHER ADJUSTMENTS:BAD DEBTS NETTED AGAINST REVENUE ON FINANCIAL STATEMENTS 410,202.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted Care0FPGReferenceDiscountedCareInd
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$25,195TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$25,195NetCommunityBenefitExpnsAmt
Total Expense0.00170TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$25,195TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$25,195NetCommunityBenefitExpnsAmt
Total Expense0.00170TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,139TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,139NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$70,812TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$70,812NetCommunityBenefitExpnsAmt
Total Expense0.00460TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$73,951TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$73,951NetCommunityBenefitExpnsAmt
Total Expense0.00480TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$99,146TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$99,146NetCommunityBenefitExpnsAmt
Total Expense0.00650TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$98,392BadDebtExpenseAmt
Bad Debt Expense Attributable$11,807BadDebtExpenseAttributableAmt
Reimbursed By Medicare$9,875,910ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$9,113,174CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$762,736MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE ALLENTOWN SPECIALTY HOSPITAL INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1850 SOUTH 5TH STREETAddressLine1Txt
CityALLENTOWNCityNm
State AbbreviationPAStateAbbreviationCd
ZIP181033295ZIPCd
FieldValueIRS element (for citing)
State License53020100StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
OtherLONG-TERM ACUTE CARE HOSPITALOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1THE ALLENTOWN SPECIALTY HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.GOODSHEPHERDREHAB.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLWWW.GOODSHEPHERDREHAB.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTStrategyWebsiteURLTxt
Strategy Attached0StrategyAttachedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLWWW.GOODSHEPHERDREHAB.ORG/PATIENT-VISITOR-GUIDE/COST-SERVICES/CHARITY-CAREFAPAppAvailableOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
FAP Notice DisplayedYes (X)FAPNoticeDisplayedInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care Policy0NondisEmergencyCarePolicyInd
No Emergency CareYes (X)NoEmergencyCareInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
THE ALLENTOWN SPECIALTY HOSPITAL, INC.PART V, SECTION B, LINE 5: THE HEALTH CARE COUNCIL OF THE LEHIGH VALLEY (HCC) WAS FORMED IN 2011 TO MEASURE AND IMPROVE THE BROADLY DEFINED HEALTH OF THE LEHIGH VALLEY. CREATED BY THE NOT-FOR-PROFIT HEALTH CARE SYSTEMS OF THE LEHIGH VALLEY, THE HCC'S OBJECTIVE IS TO COOPERATIVELY DEVELOP A WORLD-CLASS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) THAT WILL GALVANIZE ACTION TO PROVIDE A DRAMATIC, DEMONSTRABLE AND SUSTAINED IMPACT ON THE HEALTH OF THE CITIZENS OF THE LEHIGH VALLEY.AFTER THE SUCCESSFUL PUBLICATION OF THE COLLABORATIVE 2013 CHNA CRAFTED BY THE HCC, THE MEMBER HOSPITALS EXPANDED TO INCLUDE THE ALLENTOWN AND BETHLEHEM HEALTH BUREAUS, AS WELL AS THE NEIGHBORHOOD HEALTH CENTERS OF THE LEHIGH VALLEY (NHCLV) IN THE HCC GROUP. IN LIGHT OF THE EXTENSIVE QUALITATIVE WORK THAT WAS DONE MERELY THREE YEARS BEFORE, THE HCC DECIDED TO CONDUCT THREE FOCUS GROUPS TO GATHER FEEDBACK FROM THE BROADER COMMUNITY. THE FOCUS GROUPS WERE HELD IN ACCESSIBLE LOCATIONS IN EACH OF THE TWO COUNTIES; ONE AT NORTHAMPTON COMMUNITY COLLEGE IN BETHLEHEM, ONE AT LEHIGH CARBON COMMUNITY COLLEGE IN ALLENTOWN, AND A THIRD COMPRISED ENTIRELY OF TEENS. THE FOCUS GROUP DATA COLLECTED IN THIS REPORT PERIOD GOES A LONG WAY TOWARDS UNDERSTANDING SOME OF THE UNDERLYING SOCIAL DETERMINANTS THAT CREATE MENTAL HEALTH DISTRESS. THE FOCUS GROUP DATA ALSO UNDERSCORE THE RELATIONSHIP BETWEEN SOCIAL DETERMINANTS OF HEALTH, MENTAL HEALTH, PHYSICAL HEALTH AND OVERALL QUALITY OF LIFE. EMERGING THEMES WERE REMARKABLY CONSISTENT BETWEEN THE THREE DIVERSE GROUPS, AND FOCUSED LARGELY ON THE IMPACT OF HOUSING AND SOCIAL SUPPORT ON ONE'S ABILITY TO BE ABLE TO LEAD HEALTHIER LIVES.THE HCC IS COMPRISED OF REPRESENTATIVES FROM EACH OF THE FIVE NON-PROFIT HOSPITALS IN THE LEHIGH VALLEY (GOOD SHEPHERD REHABILITATION NETWORK, KIDSPEACE, LEHIGH VALLEY HEALTH NETWORK, SACRED HEART HOSPITAL NETWORK, ST. LUKE'S UNIVERSITY HEALTH NETWORK), THE ALLENTOWN AND BETHLEHEM HEALTH BUREAUS, NEIGHBORHOOD HEALTH CENTERS OF THE LEHIGH VALLEY, AND THE DOROTHY RIDER POOL HEALTH CARE TRUST. EACH AGENCY SENDS 1-3 REPRESENTATIVES, TYPICALLY REPRESENTING STAFF THAT HAS RESPONSIBILITY FOR COMMUNITY WORK. THE LIST OF HCC INDIVIDUAL MEMBERS IS AS FOLLOWS: JESSICA ADAMS-SKINNER, LVHNASARE CHRISTIAN, GOOD SHEPHERDBONNIE COYLE, ST. LUKESMELISSA CRAIG, NHCLVRON DENDAS, POOL TRUSTHOLLY EDINGER, SACRED HEARTHOLLIE GIBBONS, ST. LUKESDEBORAH GILBERT, SACRED HEARTSAMANTHA GOODRICH, LVHNVICKY KISTLER, ALLENTOWN HEALTH BUREAUCINDY LAMBERT, GOOD SHEPHERDVALERIE LEWIS, LVHNROBERT MOTLEY, LVHNSUSAN MULLEN, KIDSPEACERAJIKA REED, ST. LUKESJASON SAVENELLI, KIDSPEACEKRISTEN WENRICH, BETHLEHEM HEALTH BUREAUDANIELLE WALTERS, 35TH STREET CONSULTINGCHERYL ARNDT, DIRECTOR OF PERFORMANCE IMPROVEMENT, KIDSPEACEYURIKO DELACRUZ, NHCLV INTERNNICOLE ROTH, NHCLV INTERNTHIS GROUP WORKED TOGETHER TO CREATE A COMMON COMMUNITY HEALTH PROFILE FOR THE LEHIGH VALLEY. SECONDARY DATA FROM A VARIETY OF SOURCES WERE COLLECTED AND SHARED WITH THE REPRESENTATIVES FROM THE HCC MEMBER AGENCIES DURING MONTHLY MEETINGS HELD FROM 2011-2015. AGENCY REPRESENTATIVES SHARED INFORMATION ABOUT HOW THE IDENTIFIED PRIORITY AREAS IMPACT THEIR WORK, AND ALSO SHARED SOME OF THEIR INSIGHT REGARDING STRATEGY FOR ADDRESSING THESE NEEDS.
THE ALLENTOWN SPECIALTY HOSPITAL, INC.PART V, SECTION B, LINE 6A: THE HCC IS COMPRISED OF REPRESENTATIVES FROM EACH OF THE FIVE NON-PROFIT HOSPITALS IN THE LEHIGH VALLEY, LISTED HERE:GOOD SHEPHERD REHABILITATION NETWORK,KIDSPEACE, SACRED HEART HOSPITAL NETWORK, ST. LUKE'S UNIVERSITY HEALTH NETWORKLEHIGH VALLEY HEALTH NETWORKEACH AGENCY SENDS 1-3 REPRESENTATIVES, TYPICALLY REPRESENTING STAFF THAT HAS RESPONSIBILITY FOR COMMUNITY WORK.
THE ALLENTOWN SPECIALTY HOSPITAL, INC.PART V, SECTION B, LINE 6B: IN ADDITION TO THE FIVE NON-PROFIT HOSPITALS, THE HCC ALSO INCLUDES THE FOLLOWING AGENCIES:THE ALLENTOWN HEALTH BUREAUTHE BETHLEHEM HEALTH BUREAUNEIGHBORHOOD HEALTH CENTERS OF THE LEHIGH VALLEYDOROTHY RIDER POOL HEALTH CARE TRUST. EACH AGENCY SENDS 1-3 REPRESENTATIVES, TYPICALLY REPRESENTING STAFF THAT HAS RESPONSIBILITY FOR COMMUNITY WORK.
THE ALLENTOWN SPECIALTY HOSPITAL, INC.PART V, SECTION B, LINE 11: ON JUNE 6, 2016, THE BOARD OF TRUSTEES OF GOOD SHEPHERD REHABILITATION NETWORK PASSED A RESOLUTION ADOPTING THEIR 2017-19 CHNA IMPLEMENTATION PLAN. THE PLAN IDENTIFIES STRATEGIES AND ACTION STEPS DESIGNED TO IMPACT PRIORITY AREAS IDENTIFIED THROUGH THE 2016 CHNA PROCESS. THE IMPLEMENTATION PLAN OF GOOD SHEPHERD INCLUDES PLANNED ACTIONS TO IMPACT ACCESS TO PRIMARY HEALTHCARE, MENTAL HEALTHCARE AND PRE-NATAL CARE. IT IS THE INTENTION OF THE NETWORK TO BECOME THE REGIONAL "GATEKEEPER" OF AND RESOURCE FOR POST-ACUTE REHABILITATION AND CATASTROPHIC CARE. OPERATIONS WILL BE CONDUCTED TO FOSTER WELL-BEING, FUNCTION AND FITNESS THROUGH THE EDUCATION AND PROMOTION OF HEALTHY BEHAVIORS. THE COMPLETE IMPLEMENTATION PLAN IS AVAILABLE ON THE CORPORATE WEBSITE.INCOME AND UNEMPLOYMENT, EDUCATION AND AIR QUALITY - THREE COMMUNITY HEALTH NEED AREAS ALSO IDENTIFIED THROUGH THE 2016 JOINT COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS AND MENTIONED IN "THE ROAD TO HEALTH" COMMUNITY PROFILE - ARE NOT TARGETED FOR DIRECT INTERVENTION BY GOOD SHEPHERD AT THIS TIME BECAUSE WE DO NOT HAVE THE RESOURCES NOR EXPERTISE TO MAKE AN EFFECTIVE DIFFERENCE IN THESE AREAS. WHERE POSSIBLE AND PRACTICAL, WE WILL, HOWEVER, COOPERATE WITH OTHER COMMUNITY ORGANIZATIONS THAT MAY TAKE THE LEAD IN ADDRESSING THESE PARTICULAR NEED AREAS IF OR WHEN THEY INVOLVE OUR TARGET POPULATION OF PERSONS WITH DISABILITIES.
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.
THE ALLENTOWN SPECIALTY HOSPITAL, INC.PART V, SECTION B, LINE 22D: UNINSURED INDIVIDUALS ARE NEVER EXPECTED TO PAY MORE THAN THE AMOUNT GENERALLY BILLED (AGB) FOR MEDICALLY NECESSARY CARE. AGB IS DETERMINED BASED ON THE AVERAGE PAYMENT OF PRIVATE INSURERS PLUS MEDICARE AND THE COMMONWEALTH OF PENNSYLVANIA'S MEDICAID PROGRAM. AGB IS THE AVERAGE AMOUNT PAID BY ALL PRIVATE HEALTH INSURERS AND MEDICARE FOR MEDICALLY NECESSARY PATIENT SERVICES. GOOD SHEPHERD USES THE "LOOK BACK METHOD" AS DEFINED IN SECTION 501(R) (5) (B) (1) OF THE INTERNAL REVENUE CODE. GOOD SHEPHERD WILL LIMIT AMOUNTS CHARGED FOR MEDICALLY NECESSARY CARE PROVIDED TO INDIVIDUALS ELIGIBLE FOR ASSISTANCE UNDER THIS POLICY TO NOT MORE THAN AGB. THE FISCAL YEAR 2016 AGB FOR GSRN IS 32% OF GROSS CHARGES; AND THE ABG FOR GSPP IS 25%. THE AGB WILL BE UPDATED ANNUALLY UPON APPROVAL OF THE MOST RECENT AUDITED COMPLETED FISCAL YEAR'S FINANCIAL STATEMENTS.

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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 A SIGNIFICANT AMOUNT OF 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 LEVEL 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 $300,000 IN 2016 AND $536,000 IN 2015. GOOD SHEPHERD RECEIVED $2,605 AND $2,905 IN CONTRIBUTIONS RESTRICTED FOR CHARITY CARE DURING 2016 AND 2015, 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 IN SEVERAL MANNERS, INCLUDING BEING AVAILABLE 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'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 $410,202.
PART II, COMMUNITY BUILDING ACTIVITIES:WHILE MINIMAL COMMUNITY BUILDING ACTIVITIES ARE PROVIDED DIRECTLY WITHIN THE SPECIALTY HOSPITAL, GSRN, THE SPECIALTY HOSPITAL'S PARENT COMPANY, PROVIDED $6,492 OF SUCH ACTIVITIES DURING THE 2016 FISCAL YEAR. THESE ACTIVITIES TOOK THE FORM OF EXECUTIVE AND GOVERNMENT AND COMMUNITY RELATIONS BOARD MEMBERSHIPS, PARTICIPATION IN THE PARTNERSHIP FOR A DISABILITY FRIENDLY COMMUNITY, AMERICAN MEDICAL REHABILITATION PROVIDERS ASSOCIATION (AMRPA) BOARD AND UNITED WAY BOARD AND COMMITTEE MEMBERSHIPS AS WELL AS VARIOUS WORKFORCE DEVELOPMENT ACTIVITIES.THESE ACTIVITIES WERE NOT PROVIDED FOR PURPOSES OF MARKETING, TO INCREASE REFERRALS OF PATIENTS WITH THIRD-PARTY INSURANCE COVERAGE, IN FULFILLMENT OF REGULATORY REQUIREMENTS OR CURRENT STANDARDS OF CARE, OR TO BENEFIT PERSONS AFFILIATED WITH GSRN. RATHER, THE PRIMARY PURPOSE OF THESE COMMUNITY BUILDING ACTIVITIES IS TO BENEFIT THE COMMUNITY AND SHOULD BE CONSIDERED AS A COMPONENT OF COMMUNITY BENEFIT. FOR EXAMPLE, PARTICIPATION IN THE PARTNERSHIP FOR A DISABILITY FRIENDLY COMMUNITY DIRECTLY BENEFITS THE DISABILITY COMMUNITY. SPECIFICALLY, THE PARTNERSHIP EDUCATES AND EMPOWERS INDIVIDUALS WITH DISABILITIES AND THEIR CAREGIVERS TO BETTER CARE FOR THEMSELVES AND TO IDENTIFY AND UTILIZE RESOURCES THAT ARE ALREADY AVAILABLE TO THEM WITHIN THE COMMUNITY. WITHOUT SUCH EDUCATION AND EMPOWERMENT, THERE IS A RISK THAT THOSE INDIVIDUALS WITH DISABILITIES EITHER DO NOT RECEIVE THE CARE OR ASSISTANCE THEY REQUIRE, OR THEY OVER-RELY ON THE SERVICES OF THE MEDICAL COMMUNITY FOR EVEN THE MOST BASIC OF NEEDS. THE VALUE OF THE COMMUNITY BUILDING ACTIVITIES PROVIDED DURING THE 2016 FISCAL YEAR WAS DETERMINED BASED UPON ACTUAL REPORTED HOURS VALUED AT THE AVERAGE SALARY AND BENEFIT RATE PER HOUR OF ALL GOOD SHEPHERD EMPLOYEES. CONSERVATIVELY, NO APPLICATION OF INDIRECT OR OVERHEAD COSTS WAS APPLIED TO THESE DIRECT COSTS.ALL GSRN COSTS, INCLUSIVE OF THE COSTS ASSOCIATED WITH COMMUNITY BUILDING ACTIVITIES, ARE ALLOCATED TO GSRN'S SUBSIDIARY CORPORATIONS BASED UPON A COMPREHENSIVE ALLOCATION METHODOLOGY WHICH CONSIDERS DEPARTMENTAL RESOURCE UTILIZATION AND RELATIVE NET PATIENT SERVICE REVENUE, AMONG OTHER FACTORS.
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:THE FOLLOWING IS THE TEXT OF THE FOOTNOTE TO GOOD SHEPHERD'S AUDITED FINANCIAL STATEMENTS (WHICH CONTAIN THE ACCOUNTS OF THE HOSPITAL) THAT DESCRIBES BAD DEBT EXPENSE:"ACCOUNTS RECEIVABLE, PATIENTS ARE REPORTED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN-OFF WHEN THEY ARE DETERMINED TO BE UNCOLLECTIBLE BASED UPON MANAGEMENT'S ASSESSMENT OF INDIVIDUAL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, GOOD SHEPHERD ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, GOOD SHEPHERD ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, GOOD SHEPHERD RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE BILLED RATES AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.GOOD SHEPHERD'S ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS INCREASED FROM 67% OF SELF-PAY ACCOUNTS RECEIVABLE AT JUNE 30, 2015, TO 68% OF SELF-PAY ACCOUNTS RECEIVABLE AT JUNE 30, 2016. IN ADDITION, GOOD SHEPHERD'S SELF-PAY ACCOUNT WRITE-OFFS (NET OF RECOVERIES) INCREASED FROM $642,000 IN 2015 TO $951,000 IN 2016. GOOD SHEPHERD DID NOT CHANGE THEIR FINANCIAL ASSISTANCE POLICY IN 2016 AND 2015. GOOD SHEPHERD DOES NOT MAINTAIN A MATERIAL ALLOWANCE FOR DOUBTFUL ACCOUNTS FROM THIRD-PARTY PAYORS, NOR DID IT HAVE SIGNIFICANT WRITE-OFFS FROM THIRD-PARTY PAYORS."
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 NOT REPORTED A MEDICARE SHORTFALL IN PART III, SECTION B (MEDICARE), LINE 7. HAD THERE BEEN A SHORTFALL, 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:IN 2012, GOOD SHEPHERD REHABILITATION NETWORK (GSRN) BECAME AN OFFICIAL PARTNER IN THE NEWLY FORMED HEALTH CARE COUNCIL OF THE LEHIGH VALLEY (HCCLV). THE HCCLV WAS CREATED BY THE NOT-FOR-PROFIT HEALTH CARE SYSTEMS OPERATING IN THE LEHIGH VALLEY TO COOPERATIVELY MEASURE AND IMPROVE THE BROADLY DEFINED HEALTH OF THE REGION. THE HCCLV JOINTLY DEVELOPED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS, PRODUCED THE ROAD TO HEALTH, AN EASY TO NAVIGATE COMMUNITY HEALTH PROFILE AVAILABLE TO THE PUBLIC IN BOTH ENGLISH AND SPANISH, AND THEN CREATED A JOINT PLAN OF ACTIONS FROM THE FINDINGS; ACTIONS DESIGNED TO ACHIEVE THE GOAL OF IMPROVING THE HEALTH OF THE CITIZENS OF THE LEHIGH VALLEY.THE COORDINATED CHNA PROCESS PROVIDES THE NOT-FOR PROFIT HEALTHCARE SYSTEMS THE OPPORTUNITY TO FULFILL THE REQUIREMENT OF SECTION 9007 OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT OF 2010 TO PERFORM A CHNA EVERY THREE YEARS COMMENCING WITH A HOSPITAL'S FIRST FISCAL YEAR AFTER THE ACT BECAME LAW. PARTICIPATION IN THE COORDINATED CHNA PROCESS ALSO ENABLES EACH HOSPITAL TO RESPOND AFFIRMATIVELY TO THE CHNA-RELATED QUESTIONS LISTED UNDER SCHEDULE H, PART V, SECTION B OF IRS FORM 990 AS REVISED IN 2010.THE HCCLV'S COORDINATED CHNA PROCESS INCORPORATED BEST PRACTICE STANDARDS RECOMMENDED BY THE AMERICAN PUBLIC HEALTH ASSOCIATION (APHA) AND THE ASSOCIATION FOR COMMUNITY HEALTH IMPROVEMENT (ACHI). THE HCCLV ACTIVELY PARTNERED WITH MANY STAKEHOLDERS, COMMUNITY BASED ORGANIZATIONS AND COMMUNITY MEMBERS IN THE PROCESS. THE CHNA INCORPORATED SEVERAL HEALTH ASSESSMENT STRATEGIES INCLUDING AN ANALYSIS OF EXISTING COMMUNITY HEALTH MEASURES AND SECONDARY DATA AS WELL AS COMMUNITY INPUT AND ENGAGEMENT ACTIVITIES. ASIDE FROM THE CHNA PERFORMED EVERY THREE YEARS, GOOD SHEPHERD 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 2015 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 - 92%NORTHAMPTON - 94%CARBON - 59%MONROE - 61%BERKS - 30%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)TWO (2) SPECIALTY GENERAL ACUTE CARE HOSPITALS- ONE (1) FOR-PROFIT SPECIALTY GENERAL ACUTE CARE HOSPITAL L AND ONE (1) NOT-FOR-PROFIT SPECIALTY GENERAL ACUTE CARE HOSPITAL NORTHAMPTON COUNTY TWO ACUTE CARE HOSPITALS - ONE (1) FOR-PROFIT ACUTE CARE HOSPITAL AND ONE (1) NOT-FOR-PROFIT ACUTE CARE HOSPITALONE (1) FOR-PROFIT SPECIALTY GENERAL ACUTE CARE HOSPITALMONROE COUNTYTWO (2) NOT-FOR-PROFIT ACUTE CARE HOSPITALSBERKS COUNTYTHREE (3) NOT-FOR-PROFIT ACUTE CARE HOSPITALS- NOTE TWO FACILITIES SHARE ONE LICENSEONE (1) FOR-PROFIT INPATIENT REHABILITATION HOSPITALONE (1) FOR-PROFIT SPECIALTY GENERAL ACUTE CARE HOSPITALTHESE COUNTIES HAVE THE FOLLOWING DEMOGRAPHICS AND CHARACTERISTICS:1. AVERAGE INCOME LEVEL AND POVERTY RATES (US CENSUS 2015 ESTIMATES MEDIAN HOUSEHOLD INCOME AND POPULATION PERCENTAGE BELOW THE POVERTY LEVEL)CARBON COUNTY - $49,973 AND 11.5%LEHIGH COUNTY - $56,117 AND 12.1% NORTHAMPTON COUNTY - $60,972 AND 8.8%MONROE COUNTY - $57,365 AND 12.7%BERKS COUNTY - $55,936 AND 12.6%2. RATES OF UNINSURED OR UNDERINSURED PERSONS (US CENSUS 2014 ESTIMATES)CARBON COUNTY - 6,716 INDIVIDUALS OR 10.5% OF THE COUNTY POPULATIONLEHIGH COUNTY - 41,118 INDIVIDUALS OR 11.4% OF COUNTY POPULATIONNORTHAMPTON COUNTY - 28,276 INDIVIDUALS OR 9.4% OF THE COUNTY POPULATIONMONROE COUNTY - 19,468 INDIVIDUALS OR 11.7% OF THE COUNTY POPULATIONBERKS COUNTY - 48,587 INDIVIDUALS OR 11.7% OF THE COUNTY POPULATION3. PERCENT OF FAMILIES WHO ARE ELIGIBLE FOR MEDICAL ASSISTANCE (PA DOH-LATEST AVAILABLE DATA) CARBON COUNTY -2014 PERCENTAGE ELIGIBLE FOR MEDICAL ASSISTANCE - 15.7%LEHIGH COUNTY -2014 PERCENTAGE ELIGIBLE FOR MEDICAL ASSISTANCE - 18.7%NORTHAMPTON COUNTY -2014 PERCENTAGE ELIGIBLE FOR MEDICAL ASSISTANCE - 14.0%MONROE COUNTY -2014 PERCENTAGE ELIGIBLE FOR MEDICAL ASSISTANCE - 16.8%BERKS COUNTY -2014 PERCENTAGE ELIGIBLE FOR MEDICAL ASSISTANCE - 18.2%4. POPULATION AGE BREAKDOWN (2015 ESTIMATED PENNSYLVANIA POPULATION > AGE 65 IS 17%)CARBON COUNTY - POPULATION > AGE 65 - 20.0%LEHIGH COUNTY - POPULATION > AGE 65 - 16.1%NORTHAMPTON COUNTY - POPULATION > AGE 65 - 17.8%MONROE COUNTY - POPULATION > AGE 65 - 15.5%BERKS COUNTY - POPULATION > AGE 65 - 16.2%5. PERCENTAGES OF NON-ENGLISH-SPEAKING POPULATIONSCARBON COUNTY - PERCENT OF POPULATION NOT PROFICIENT IN ENGLISH; 0.3%LEHIGH COUNTY - PERCENT OF POPULATION NOT PROFICIENT IN ENGLISH; 4.0% NORTHAMPTON COUNTY - PERCENT OF POPULATION NOT PROFICIENT IN ENGLISH; 1.9% MONROE COUNTY - PERCENT OF POPULATION NOT PROFICIENT IN ENGLISH; 1.7% BERKS COUNTY - PERCENT OF POPULATION NOT PROFICIENT IN ENGLISH; 3.7%6. AREAS DESIGNATED AS FEDERALLY MEDICALLY UNDERSERVED AREAS OR POPULATIONS (FEBRUARY, 2017)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+ 15.5% VS.29.8% IN PALEHIGH COUNTY - HISPANIC OR LATINO POPULATION - 22.4% VS. 6.8% IN PANORTHAMPTON COUNTY - HISPANIC OR LATINO POPULATION - 12.4% VS. 6.8% IN PAMONROE COUNTY - HISPANIC OR LATINO POPULATION - 14.9% VS. 6.8% IN PABERKS COUNTY - HISPANIC OR LATINO POPULATION - 19.4% VS. 6.8% IN PASOURCES: #1, 2, 4, & 7 US CENSUS STATE AND COUNTY QUICK FACTS; #3 PA DOH COUNTY HEALTH REPORTS(2016 REPORT, BUT 2014 DATA; MORE CURRENT UPDATES APPEAR UNAVAILABLE); #5 COUNTY HEALTH RANKINGS RWJ FOUNDATION 2016 REPORT; #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 $11,894,750 OR APPROXIMATELY 13.6% 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 $136,678 FOR THE FISCAL YEAR ENDED JUNE 30, 2016, 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 $4,660,000:FINANCIAL ASSISTANCE AT COST $253,000UNREIMBURSED MEDICAID $3,233,000COMMUNITY HEALTH IMPROVEMENT SERVICES $29,000HEALTH PROFESSIONS EDUCATION $999,000RESEARCH $132,000COMMUNITY BUILDING ACTIVITIES $12,000SUBSIDIZED HEALTH SERVICES $0COMMUNITY BENEFIT OPERATIONS $2,000TOTAL $4,660,000THESE AMOUNTS ARE REPORTED ABOVE AT THEIR FULL COST ALTHOUGH GOOD SHEPHERD HAS A 70% OWNERSHIP INTEREST IN GSPP.
PART VI, LINE 7N/A

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
JOHN KRISTEL
CHAIR/PRESIDENT/CEO$0$489,408$0$188,036$0$0$0$12,309$0$16,610$0$706,363$0$0
SAMUEL A MIRANDA JR
VICE CHAIR/SVP & CNO$0$231,142$0$55,742$0$0$0$12,645$0$13,157$0$312,686$0$0
RONALD PETULA
SEC/TREASURER/SVP &CFO$0$228,231$0$60,563$0$0$0$6,584$0$11,041$0$306,419$0$0
JAMES J DALEY MD
TRUSTEE$0$177,006$0$19,417$0$0$0$4,478$0$16,235$0$217,136$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3THE CEO IS COMPENSATED BY GOOD SHEPHERD REHABILITATION NETWORK ("GSRN"), AN AFFILIATED TAX-EXEMPT ORGANIZATION. THE ALLENTOWN SPECIALTY HOSPITAL, INC. 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, LINE 7GSRN HAS A PERFORMANCE COMPENSATION PROGRAM IN PLACE WHICH IS APPROVED BY THE BOARD. CERTAIN MEMBERS OF MANAGEMENT CAN RECEIVE AN ANNUAL PERFORMANCE PAYMENT ONLY WHEN PRE-DEFINED AND PRE-APPROVED FINANCIAL AND NON-FINANCIAL GOALS ARE ACHIEVED. FOR FISCAL YEAR 2016, A PERFORMANCE PAYMENT WAS ACHIEVED. THE ACTUAL PAYMENT OCCURS IN SEPTEMBER OF THE FOLLOWING FISCAL YEAR. THIS IS NOT GUARANTEED EACH YEAR.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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 7ATHE 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 7BSEE EXPLANATION FOR FORM 990, PART VI, SECTION A, LINE 7A.
FORM 990, PART VI, SECTION B, LINE 11THE IRS FORM 990 IS PREPARED USING INFORMATION SOLICITED FROM OFFICERS, DIRECTORS, TRUSTEES, BOARD COMMITTEE MEMBERS, AND MANAGEMENT. THIS GROUP OF INDIVIDUALS ARE 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 12CTHERE 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 15THE 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 2016 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 19FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST.
FORM 990, PART XI, 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.
FORM 990, PART VI, 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.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
GOOD SHEPHERD HOME LONG-TERM CARE FACILITY INC
GOOD SHEPHERD PLAZA 850 SOUTH 5TH SALLENTOWNPA18103232215800OPERATES TWO SKILLED NURSING FACILITIES FOR THE SEVERELY DISABLEDPA501(C)(3)LINE 3GOOD SHEPHERD REHABILITATION NETWORK0
GOOD SHEPHERD HOUSING DEVELOPMENT CORPORATION
GOOD SHEPHERD PLAZA 850 SOUTH 5TH SALLENTOWNPA18103233073390PROVIDES INDEPENDENT LIVING APTS FOR DISABLED, LOW-INCOME ADULTSPA501(C)(3)LINE 9GOOD SHEPHERD REHABILITATION NETWORK0
GOOD SHEPHERD REHABILITATION HOSPITAL
GOOD SHEPHERD PLAZA 850 SOUTH 5TH SALLENTOWNPA18103231371947PROVIDES COMPREHENSIVE INPATIENT AND OUTPATIENT REHABILITATION SERVICESPA501(C)(3)LINE 3GOOD SHEPHERD REHABILITATION NETWORK0
GOOD SHEPHERD REHABILITATION NETWORK
GOOD SHEPHERD PLAZA 850 SOUTH 5TH SALLENTOWNPA18103232216041PROVIDES MANAGEMENT SERVICES IN SUPPORT OF ITS TAX-EXEMPT AFFILIATESPA501(C)(3)LINE 70N/A
PHILADELPHIA POST-ACUTE PARTNERS LLC
1800 LOMBARD STREETPHILADELPHIAPA19146208283421OPERATES INPATIENT REHAB HOSP, ACUTE CARE HOSP & 8 OUTPATIENT FACILITIESPA501(C)(3)LINE 3GOOD SHEPHERD REHABILITATION NETWORK0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1GOOD SHEPHERD RECIPROCAL RISK RENTENTION GROUPBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line17301 RIVERS AVENUE SUITE 230AddressLine1Txt
CityNORTH CHARLESTONCityNm
State AbbreviationSCStateAbbreviationCd
ZIP29406ZIPCd
FieldValueIRS element (for citing)
EIN204065112EIN
Primary ActivitiesRISK RETENTION GROUPPrimaryActivitiesTxt
Legal Domicile StateSCLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Entity TypeCEntityTypeTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd