2017-05-15T15:28:42-05:00 2016-06-30 WithumSmithBrown PC 200 Jefferson Park Suite 400 Whippany NJ 079811070 990 2015-07-01 232692637 HEALTH ACCESS NETWORK % TERRY DOUGHERTY HEAL 6104476252 100 W SPROUL RD HEALTHPLEX PAV II SPRINGFIELD PA 19064 KEITH COLEMAN CFO 2017-05-15 true Scott J Mariani P00642486 9738989494 2015 2021-01-29 14:40:06Z PATRICK J GAVIN 100 W SPROUL RD HLTHPLX PAV II SPRINGFIELD PA 19064 143047799 false X WWW.CROZERKEYSTONE.ORG X 1992 PA HEALTH ACCESS NETWORK IS COMMITTED TO THE IMPROVED HEALTH IMPROVED HEALTH STATUS OF THOSE WE SERVE AND WILL DEPLOY ITS RESOURCES IN A COST-EFFECTIVE & COMMUNITY-RESPONSIVE MANNER. X 6 0 1090 0 0 6626363 9763737 128654722 133284062 0 0 0 0 135281085 143047799 20000 0 0 0 121165187 128649955 0 0 0 14095898 15973304 135281085 144623259 -1575460 54089034 0 57764890 0 -3675856 0 X HEALTH ACCESS NETWORK IS COMMITTED TO THE IMPROVED HEALTH STATUS OF THOSE WE SERVE. THROUGH A SEAMLESS, USER-FRIENDLY CONTINUUM OF QUALITY HEALTH SERVICES INCLUDING PRIMARY AND HEALTH PROMOTION, ACUTE AND LONG-TERM CARE, THROUGH REHABILITATION AND RESTORATIVE CARE, CROZER-KEYSTONE WILL DEPLOY ITS RESOURCES IN A COST-EFFECTIVE AND COMMUNITY-RESPONSIVE MANNER. WORKING IN PARTNERSHIP WITH OUR PHYSICIANS AND OTHER HEALTH PROFESSIONALS, WE WILL SEEK TO FORGE NEW ALLIANCES WITH OTHER COMMUNITY HEALTH AND SOCIAL SERVICE ORGANIZATIONS. WORKING WITH OUR COMMUNITY, OUR GOAL IS TO BUILD A HEALTHY PLACE TO LIVE AND WORK, AND A SOUND ENVIRONMENT IN WHICH TO BUILD AND MAINTAIN OUR FAMILIES. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT. false true 130160932 0 133284062 THE ORGANIZATION IS AN AFFILIATE OF THE CROZER-KEYSTONE HEALTH SYSTEM; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. EXPENSES ARE INCURRED IN PROVIDING PREVENTATIVE, PRIMARY CARE AND A BROAD ARRAY OF SURGICAL AND OTHER SPECIALTY SERVICES TO RESIDENTS OF DELAWARE COUNTY. THE ORGANIZATION'S PHYSICIANS PROVIDE MEDICALLY NECESSARY HEALTHCARE SERVICES IN BOTH INPATIENT AND OUTPATIENT SETTINGS WITHIN THE CROZER-KEYSTONE HEALTH SYSTEM IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY AND HELP ENSURE THAT ESSENTIAL HEALTHCARE SERVICES ARE AVAILABLE IN THE COMMUNITY. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT. 130160932 true true false true false false false false false false false false false false false true false true false false true false false false false false false false false true false false false false false false false false false false false true false true false false false true 86 0 true 1090 true false false false false false false false false false false X 6 0 false false true false true true true true true false false true true true true true true true true false PA X TERRY DOUGHERTY 6104476252 100 W SPROUL RD HLTHPLX PAV II SPRINGFIELD PA 19064 X JOAN K RICHARDS DIRECTOR - PRESIDENT/CEO 55.0 0.0 X X 0 818547 262985 GREGORY CUCULINO MD DIRECTOR 55.0 0.0 X 417880 0 38622 JACKELINE IACOVELLA MD DIRECTOR 55.0 0.0 X 278277 0 38901 MARCIN A JANKOWSKI MD DIRECTOR 55.0 0.0 X 475556 0 50755 MICHAEL KRAFCHICK MD DIRECTOR 55.0 0.0 X 472742 0 41858 ASHISH RANA MD DIRECTOR 55.0 0.0 X 214323 0 40602 JOEL S NOUMOFF MD DIRECTOR (7/1 - 12/31/2015) 55.0 0.0 X 521359 0 66613 DONALD W LEGREID ESQ SECRETARY - VP/GENERAL COUNSEL 55.0 0.0 X 0 436884 37680 PHILIP J RYAN CPA TREASURER - SVP/CFO 55.0 0.0 X 0 1640645 155008 PATRICK J GAVIN EVP & COO/PRESIDENT 55.0 0.0 X 0 705905 246180 CHARLES M GELLER MD PHYSICIAN,CHIEF CARDIOTHORACIC 55.0 0.0 X 945927 0 42503 ALAN M GRAHAM MD PHYSICIAN, VASCULAR SURGEON 55.0 0.0 X 927023 0 43530 ALBERT EL-ROEIY MD PHYSICIAN,CHIEF ENDOCRINOLOGY 55.0 0.0 X 770959 0 45957 MICHAEL I STANLEY MD PHYSICIAN, CHIEF NEUROSURGERY 55.0 0.0 X 717097 0 42503 RICHARD V BUONOCORE MD PHYSICIAN, NEUROSURGEON 55.0 0.0 X 696080 0 43058 6437223 3601981 1196755 350 false true false DELTA LOCUM TENENS LLC 1755 WITTINGTON PL 175 DALLAS TX 75234 STAFFING 1394161 COMP HEALTH INC 7259 S BINGHAM JUNCTION BLVD MIDVALE UT 84047 STAFFING 1212320 MARTIN GOTTLIEB ASSOCIATES LLC 4932 SUNBEAM ROAD SUITE 100 JACKSONVILLE FL 32257 BILLING/COLLECTION 959382 LOCUMTENENSCOM 2655 Northwinds Parkway ALPHARETTA GA 30009 STAFFING 557572 LYONS ADVISORS LLC 1007 Quill Lane ORELAND PA 19075 CONSULTING 435236 12 9763737 9763737 NET PATIENT SERVICE REVENUE 541900 81068380 81068380 PRACTICE MANAGEMENT REVENUE 900099 9234293 9234293 BILLING REVENUE 900099 3043896 3043896 OTHER RELATED REVENUE 900099 39937493 39937493 133284062 0 0 0 0 0 0 0 0 0 0 0 143047799 133284062 0 0 0 0 2657488 2391739 265749 0 105873316 95285984 10587332 3015471 2713924 301547 12762997 11486697 1276300 4340683 3906615 434068 0 0 0 0 0 0 5482261 4934035 548226 0 50436 45392 5044 1392142 1252928 139214 0 0 6891654 6202489 689165 22536 20282 2254 0 638320 574488 63832 0 0 333129 299816 33313 3518929 3167036 351893 MEDICAL SUPPLIES 4690284 4221256 469028 0 DUES & LICENSES 699386 629447 69939 0 REPAIRS & MAINTENANCE 83117 74805 8312 0 OTHER EXPENSES -7828890 -7046001 -782889 0 144623259 130160932 14462327 0 0 0 0 0 0 0 24390308 0 0 0 0 0 0 0 0 0 459094 0 0 0 1016594 0 0 0 0 0 0 0 0 0 28223038 0 54089034 0 24410444 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33354446 0 57764890 0 X -3675856 0 0 0 0 0 -3675856 0 54089034 0 X -1575460 5251316 X X false true X true true true X 4565900 2424540 11721640 6626363 9763737 35102180 0 0 4565900 2424540 11721640 6626363 9763737 35102180 0 35102180 0 0 10 0 0 10 0 0 35102190 659429259 1.00000 1.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false true true false false SCHEDULE C, PART II-B; QUESTION 1 THE ORGANIZATION IS AN AFFILIATE WITHIN CROZER-KEYSTONE HEALTH SYSTEM AND CONTROLLED AFFILIATES ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. CROZER-KEYSTONE HEALTH SYSTEM PAYS ALL LOBBYING EXPENDITURES ON BEHALF OF ALL AFFILIATES WITHIN THE SYSTEM AND REPORTS THESE EXPENDITURES ON THE CROZER-KEYSTONE HEALTH SYSTEM FEDERAL FORM 990. THESE LOBBYING EXPENDITURES INCLUDE (1) PAYMENTS TO OUTSIDE INDEPENDENT FIRMS AND (2) AN ALLOCATED PORTION OF THE DUES PAID TO THE AMERICIAN HOSPITAL ASSOCIATION AND THE HOSPITAL AND HEALTHSYSTEM ASSOCIATION OF PENNSYLVANIA. 0 OTHER LIABILITIES 0 DUE TO AFFILIATES 0 0 X SCHEDULE D, PART X THE ORGANIZATION IS AN AFFILIATE WITHIN CROZER-KEYSTONE HEALTH SYSTEM AND CONTROLLED AFFILIATES ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. CROZER-KEYSTONE HEALTH SYSTEM ("CKHS") IS THE TAX-EXEMPT PARENT OF THE SYSTEM. THE SYSTEM ISSUES CONSOLIDATED AUDITED FINANCIAL STATEMENTS WHICH INCLUDE ALL RELATED ENTITIES; INCLUDING THIS ORGANIZATION. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ALSO CONTAIN CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. THE FOLLOWING FOOTNOTE IS INCLUDED IN THE ORGANIZATION'S FISCAL YEAR ENDED JUNE 30, 2016 AUDITED FINANCIAL STATEMENTS THAT REPORTS THE ORGANIZATIONS LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48(ASC 740). CKHS AND MOST OF ITS SUBSIDIARIES ARE NONPROFIT ORGANIZATIONS AS DESCRIBED IN SECTIONS 501(C)(3) AND 509(A)(1) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM TAXES. THE HEALTH SYSTEM FILES U.S. FEDERAL, STATE AND LOCAL INFORMATION RETURNS AND NO RETURNS ARE CURRENTLY UNDER EXAMINATION. THE STATUTE OF LIMITATIONS ON THE HEALTH SYSTEM'S U.S. FEDERAL INFORMATION RETURNS REMAINS OPEN FOR THREE YEARS FOLLOWING THE YEAR THEY ARE FILED. GAAP REQUIRES THAT A TAX POSITION BE RECOGNIZED OR DERECOGNIZED BASED ON A "MORE LIKELY THAN NOT" THRESHOLD. THIS APPLIES TO POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE HEALTH SYSTEM DOES NOT BELIEVE ITS CONSOLIDATED FINANCIAL STATEMENTS INCLUDE ANY UNCERTAIN TAX POSITIONS. true Central America and the Caribbean 1 1 Program Services FINANCIAL VEHICLE 0 1 1 1 1 0 0 false false false false false false SCHEDULE F, PART I CROZER-KEYSTONE HEALTH SYSTEM, A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATION, PAID CASSATT INSURANCE COMPANY, LTD. $3,480,818; A FINANCIAL VEHICLE, ON BEHALF OF AND FOR THE BENEFIT OF THIS ORGANIZATION. X X X X false true false false false false false true false JOAN K RICHARDS DIRECTOR - PRESIDENT/CEO 0 800339 0 0 0 18208 0 241996 0 20989 0 1081532 0 0 GREGORY CUCULINO MD DIRECTOR 390242 0 26250 0 1388 0 11660 0 26962 0 456502 0 0 0 JACKELINE IACOVELLA MD DIRECTOR 190078 0 86918 0 1281 0 8360 0 30541 0 317178 0 0 0 MARCIN A JANKOWSKI MD DIRECTOR 430326 0 44857 0 373 0 11660 0 39095 0 526311 0 0 0 MICHAEL KRAFCHICK MD DIRECTOR 252311 0 219164 0 1267 0 11000 0 30858 0 514600 0 0 0 ASHISH RANA MD DIRECTOR 206548 0 7500 0 275 0 9020 0 31582 0 254925 0 0 0 JOEL S NOUMOFF MD DIRECTOR (7/1 - 12/31/2015) 502644 0 13188 0 5527 0 11660 0 54953 0 587972 0 0 0 DONALD W LEGREID ESQ SECRETARY - VP/GENERAL COUNSEL 0 348570 0 84750 0 3564 0 11660 0 26020 0 474564 0 0 PHILIP J RYAN CPA TREASURER - SVP/CFO 0 463210 0 157500 0 1019935 0 122308 0 32700 0 1795653 0 1003160 PATRICK J GAVIN EVP & COO/PRESIDENT 0 520759 0 175000 0 10146 0 211478 0 34702 0 952085 0 0 CHARLES M GELLER MD PHYSICIAN,CHIEF CARDIOTHORACIC 825658 0 100000 0 20269 0 11660 0 30843 0 988430 0 0 0 ALAN M GRAHAM MD PHYSICIAN, VASCULAR SURGEON 898459 0 25000 0 3564 0 11660 0 31870 0 970553 0 0 0 ALBERT EL-ROEIY MD PHYSICIAN,CHIEF ENDOCRINOLOGY 576250 0 191731 0 2978 0 11660 0 34297 0 816916 0 0 0 MICHAEL I STANLEY MD PHYSICIAN, CHIEF NEUROSURGERY 709119 0 5709 0 2269 0 11660 0 30843 0 759600 0 0 0 RICHARD V BUONOCORE MD PHYSICIAN, NEUROSURGEON 691016 0 5064 0 0 0 11660 0 31398 0 739138 0 0 0 PART VII AND SCHEDULE J TAXABLE COMPENSATION REPORTED HEREIN IS DERIVED FROM 2015 FORMS W-2. SCHEDULE J, PART I; QUESTION 4B THE AMOUNT REFLECTED IN COLUMN B (III) FOR THE FOLLOWING INDIVIDUAL INCLUDES AMOUNTS RELATING TO PARTICIPATION IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") BECAUSE THE INDIVIDUAL HAS SATISFIED BOTH THE AGE AND THE YEARS OF SERVICE REQUIREMENTS SPECIFIED BY THE SERP. THIS AMOUNT WAS INCLUDED IN THE INDIVIDUAL'S 2015 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: PHILIP J. RYAN, CPA, $1,003,160. HOWEVER, THE INDIVIDUAL DID NOT ACTUALLY RECEIVE ALL OF THESE FUNDS. THE INDIVIDUAL ONLY RECEIVED AN AMOUNT SUFFICIENT TO COVER THEIR FEDERAL AND STATE TAX LIABILITIES ASSOCIATED WITH THEIR GROSS AMOUNT. IN ADDITION THESE FUNDS STILL REMAIN SUBJECT TO A RISK OF RECEIPT BY THE INDIVIDUAL UNTIL THEIR RETIREMENT FROM EMPLOYMENT AT THE CROZER-KEYSTONE HEALTH SYSTEM. THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THE FOLLOWING INDIVIDUALS INCLUDES UNVESTED BENEFITS IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") WHICH ARE SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THE INDIVIDUALS MAY NEVER ACTUALLY RECEIVE THIS UNVESTED BENEFIT AMOUNT. THE AMOUNTS OUTLINED HEREIN WERE NOT INCLUDED IN THESE INDIVIDUAL'S 2015 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: JOAN K. RICHARDS, $230,336; PHILIP J. RYAN, CPA, $110,648 AND PATRICK J. GAVIN, $199,818. SCHEDULE J, PART I; QUESTION 7 CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A BONUS DURING CALENDAR YEAR 2015 WHICH AMOUNTS WERE INCLUDED IN COLUMN B(II) HEREIN AND IN EACH INDIVIDUAL'S 2015 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT. SCHEDULE J, PART II, COLUMN F THE AMOUNT REPORTED IN SCHEDULE J, PART II, COLUMN F FOR THE FOLLOWING INDIVIDUAL INCLUDES VESTED BENEFITS IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") BECAUSE THE AMOUNT WAS NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THIS AMOUNT WAS TREATED AS TAXABLE INCOME AND REPORTED ON THE INDIVIDUAL'S 2015 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES AS FOLLOWS: PHILIP J. RYAN, CPA, $1,003,160. THIS AMOUNT WAS REPORTED ON PRIOR YEAR FORMS 990 AS ACCRUED NON-TAXABLE BENEFITS. ACUTE CARE HOSPITAL FACILITIES AND OTHER 2016-06-30 300000000 FMV 811482305 PROSPECT HEALTH ACCESS NETWORK INC 3415 SOUTH SEPULVEDA BLVD 9TH FLO LOS ANGELES CA 90034 LLC false true false false SCHEDULE N; PART II After a lengthy Request for Proposal process, Crozer-Keystone Health System ("CKHS") entered into an agreement to sell substantially all the assets of the following entities to Prospect Medical Holdings, Inc. and related affiliates: - Crozer-Keystone Health System EIN: 22-2540851 - Crozer-Chester Medical Center EIN: 23-1637191 - Delaware County Memorial Hospital EIN: 23-0517130 - Health Access Network EIN: 23-2692637 The purchaser of each of the above listed entities is as follows: Seller/Buyer - Crozer-Keystone Health System EIN: 22-2540851 - Prospect Crozer, LLC EIN: 61-1778286 Seller/Buyer - Crozer-Chester Medical Center EIN: 23-1637191 - Prospect CCMC, LLC EIN: 81-1507712 Seller/Buyer - Delaware County Memorial Hospital EIN: 23-0517130 - Prospect DCMH, LLC EIN: 81-1520273 Seller/Buyer - Health Access Network EIN: 23-2692637 - Prospect Health Access Network, Inc. EIN: 81-1482305 The transaction is more fully described below. Effective July 1, 2016, CKHS sold substantially all the assets and certain liabilities of the Health System to Prospect Crozer, LLC. Prospect Crozer, LLC, a Pennsylvania Limited Liability Company was formed by Prospect Medical Holdings, Inc. ("PMH"), a privately held for-profit Delaware corporation that operates a network of hospitals, outpatient centers, and clinics and affiliated medical groups in several parts of the country and provides coordinated regional health care services to meet the needs of its patients. The purchase price was $300 million, plus a payment for acquired net working capital, minus the underfunded defined benefit pension plan liability of $120 million, minus certain other accrued liabilities. On July 1, 2016, CKHS redeemed or defeased all of its outstanding debt obligations and also made a $100 million contribution to the defined benefit pension plan. The letters of credit were also terminated. Net proceeds from the purchase price and any other net cash and investments were transferred to the Crozer-Keystone Community Foundation (the "Foundation") which will accept and administer all restricted charitable accounts within CKHS. The Foundation was created by merging Delco Memorial Foundation into Crozer-Chester Foundation ("CCF"), with CCF being the surviving and successor organization. The Foundation has enforcement rights as to PMHs commitments under the agreement and any other related agreements. SCHEDULE N; PART II; QUESTION 2B CERTAIN EMPLOYEE AND INDEPENDENT CONTRACTOR ARRANGEMENTS OF HEALTH ACCESS NETWORK ARE LIKELY TO BE CONTINUED BY PROSPECT HEALTH ACCESS NETWORK, INC.; FOR EXAMPLE, INDIVIDUALS WITH A TITLE OF VICE PRESIDENT OR CONTRACTUAL RELATIONSHIPS WITH PHYSICIANS. PLEASE NOTE THAT THESE ARRANGEMENTS WILL CONTINUE TO BE AT FAIR MARKET VALUE RATES PURSUANT TO ARM'S LENGTH NEGOTIATIONS. CORE FORM, PART III Mission ======= Health access network is an affiliate of crozer-keystone health system, a tax-exempt integrated healthcare delivery system. Crozer-keystone health system is committed to the improved health status of those we serve. We are focused on providing the highest quality of medical care and acting decisively to prevent disease while partnering with the community to educate and encourage healthy life choices. Background ========== Crozer-keystone health system ("ckhs") is a not for-profit tax-exempt organization with its central office in springfield, pennsylvania. Ckhs is the sole corporate member of various healthcare related organizations, including crozer-chester medical center, the majority of which are tax-exempt entities. The internal revenue service has recognized ckhs as being a tax-exempt organization under internal revenue code ("irc") section 501(c)(3). As the parent organization of a tax-exempt integrated healthcare delivery system in pennsylvania, ckhs and its affiliates strive to continually develop and operate a multi-hospital healthcare system which provides substantial community benefit through the provision of a comprehensive spectrum of medically necessary healthcare services to the residents of pennsylvania counties including delaware, chester, montgomery and philadelphia, pennsylvania, southern new jersey and northern delaware. Ckhs ensures that its system provides medically necessary healthcare services to all individuals regardless of race, color, creed, sex, national origin, religion or ability to pay. No individuals are denied necessary medical care, treatment or service. Ckhs admissions and observations totaled 33,829, ckhs provides treatment and services to approximately 505,268 outpatients, 29,813 same day surgery patients, 126,892 emergency department patients and delivers more than 2,500 babies annually. Ckhs includes approximately 6,000 employees and 218 volunteers. As outlined herein, ckhs provides medically necessary healthcare services to all individuals regardless of race, color, creed, sex, national origin or ability to pay. Ckhs provides medically necessary care to patients who meet certain criteria under its charity care policy without charge or at amounts less than the established rates. Because ckhs does not pursue collection of amounts determined to qualify as charity care, they are not reported as revenue. Additionally, ckhs sponsors certain other programs which provide substantial benefit to the broader community. Such programs include services to needy populations including community service programs and services for school-aged children and the elderly. Ckhs also actively sponsors programs on health education and wellness. Ckhs maintains records to identify and monitor the level of charity care and community service it provides. These records include the amount of charges forgone based on established rates for services and supplies furnished under its charity and community service policies. Charity care includes services to uninsured patients who ckhs has determined qualify for charity care under ckhs policies. Services to uninsured patients who are not eligible for charity care or who ckhs was not able to determine their eligibility are not reported as charity care but reported in the provision for bad debts. Additionally, ckhs sponsors many programs and provides other patient services which directly benefit the surrounding community. Ckhs hospitals and medical centers ================================== Ckhs provides substantial community benefit. Ckhs includes the following hospitals and medical centers: 1. Crozer-chester medical center including taylor hospital, springfield hospital and community hospital; and 2. Delaware county memorial hospital. Pursuant to its charitable purposes, each ckhs hospital provides medically necessary healthcare services to all individuals in a non-discriminatory manner regardless of race, color, creed, sex, national origin or ability to pay. No patients are denied necessary medical care, treatment or service by any ckhs institution. In addition, each hospital operates consistently with the following criteria outlined in irs revenue ruling 69-545: 1. Provides medically necessary healthcare services to all individuals regardless of ability to pay, including charity care, self-pay, medicare and medicaid patients; 2. Operates an active emergency room for all persons; which is open 24 hours a day, 7 days a week, 365 days per year; 3. Maintains an open medical staff, with privileges available to all qualified physicians; 4. Control of each hospital rests with its board of directors and the board of directors of ckhs. Both boards are comprised of independent civic leaders and other prominent members of the community; and 5. Surplus funds are used to improve the quality of patient care, expand and renovate facilities, and advance medical care programs and activities. The operations of each hospital/medical center, as shown through the factors outlined above and other information contained herein, clearly demonstrate that the use and control of each hospital/medical center is for the benefit of the public and that no part of the income or net earnings of the organization inures to the benefit of any private individual nor is any private interest being served other than incidentally. Health access network ("han") is an organization recognized by the internal revenue service ("irs") as tax-exempt pursuant to internal revenue code ("irc") 501(c)(3) and as a non-private foundation pursuant to irs 509(a)(1). Han is an affiliate within crozer-keystone health system ("ckhs"), a tax-exempt integrated healthcare delivery system which includes the following hospitals: crozer-chester medical center, taylor hospital, springfield hospital, community hospital and delaware county memorial hospital. All of these hospitals are organizations recognized by the irs as tax-exempt pursuant to irc 501(c)(3) and as non-private foundations pursuant to irc 170(b)(1)(a)(iii) as they are all hospitals providing medically necessary healthcare services to all individuals in a non-discriminatory manner regardless of race, color, creed, sex, national origin, religion or ability to pay. Han's primary charitable tax-exempt purposes are to provide physician services to the surrounding community and to support the clinical activities and programs of the ckhs hospitals. CORE FORM, PART III, QUESTION 3 PLEASE REFER TO THE ORGANIZATION'S RESPONSE TO SCHEDULE N; PART II. PART I, LINES 3 & 4 AND PART VI, SECTION A, QUESTIONS 1A & 1B HEALTH ACCESS NETWORK IS AN AFFILIATE WITHIN CROZER KEYSTONE HEALTH SYSTEM ("CKHS"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM, CKHS IS THE TAX-EXEMPT PARENT OF THE SYSTEM. THIS ORGANIZATION IS A SUPPORTING ORGANIZATION OF CKHS AND ITS AFFILIATE HOSPITALS; ALL RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT ORGANIZATIONS. ALTHOUGH THIS FEDERAL FORM 990 SHOWS NO INDEPENDENT BOARD OF DIRECTORS UNDER THE NEW INTERNAL REVENUE SERVICE DEFINITIONS; THIS ORGANIZATION ACTS IN A CHARITABLE TAX-EXEMPT MANNER FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 501(C)(3) AND IS CONTROLLED BY CKHS; WHICH IS GOVERNED BY A BOARD WHOSE MAJORITY IS COMPRISED OF INDEPENDENT VOTING MEMBERS. CORE FORM, PART VI, SECTION A; QUESTION 4 Effective July 1, 2016, the organization amended its certificate of incorporation legally changing its name to HAN, Inc. CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7 CROZER-KEYSTONE HEALTH SYSTEM ("CKHS") IS THE SOLE MEMBER OF THIS ORGANIZATION. CKHS HAS THE RIGHT TO ELECT THE MEMBERS OF THIS ORGANIZATION'S BOARD OF DIRECTORS AND HAS CERTAIN RESERVED POWERS AS DEFINED IN THIS ORGANIZATION'S BYLAWS. CORE FORM, PART VI, SECTION B; QUESTION 11B THE ORGANIZATION IS AN AFFILIATE WITHIN CROZER-KEYSTONE HEALTH SYSTEM AND CONTROLLED AFFILIATES ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. CROZER-KEYSTONE HEALTH SYSTEM IS THE TAX-EXEMPT PARENT ORGANIZATION OF THE SYSTEM. THE ORGANIZATION'S FEDERAL FORM 990 WAS PROVIDED TO THE SYSTEM LEGACY BOARD OF DIRECTOR MEMBERS FOR REVIEW PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE ("IRS"). AS PART OF THE TAX RETURN PREPARATION PROCESS THE ORGANIZATION HIRED A PROFESSIONAL CPA FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION TO PREPARE THE FEDERAL FORM 990. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE ORGANIZATION'S FINANCE PERSONNEL AND VARIOUS OTHER INDIVIDUALS OF THE ORGANIZATION AND THE SYSTEM TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE ORGANIZATION'S FINANCE PERSONNEL AND OTHER INDIVIDUALS FOR THEIR REVIEW. THE ORGANIZATION'S FINANCE PERSONNEL AND OTHER INDIVIDUALS REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS FURNISHED BY THE CPA FIRM TO THE ORGANIZATION'S FINANCE PERSONNEL AND VARIOUS OTHER INDIVIDUALS FOR FINAL REVIEW AND APPROVAL. THEREAFTER, THE FORM 990 WAS PROVIDED TO THE SYSTEM LEGACY BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. CORE FORM, PART VI, SECTION B; QUESTION 12 THE ORGANIZATION REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. ANNUALLY ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS AND SENIOR MANAGEMENT PERSONNEL ARE REQUIRED TO REVIEW THE EXISTING CONFLICT OF INTEREST POLICY AND COMPLETE A QUESTIONNAIRE. THE COMPLETED QUESTIONNAIRES ARE RETURNED TO THE ORGANIZATION'S LEGAL DEPARTMENT AND VP/GENERAL COUNSEL FOR REVIEW. THEREAFTER THE LEGAL DEPARTMENT AND VP/GENERAL COUNSEL PREPARE A SUMMARY OF THE COMPLETED QUESTIONNAIRES WHICH CONTAINS INFORMATION DISCLOSED ON AN INDIVIDUAL BY INDIVIDUAL BASIS. THEREAFTER, THE VP/GENERAL COUNSEL OF THE ORGANIZATION PRESENTS THIS SUMMARY TO THE ORGANIZATION'S BOARD OF DIRECTORS FOR ITS REVIEW AND DISCUSSION. CORE FORM, PART VI, SECTION B; QUESTION 15 THE ORGANIZATION IS AN AFFILIATE WITHIN CROZER-KEYSTONE HEALTH SYSTEM, A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM WHOSE PARENT ORGANIZATION IS CROZER-KEYSTONE HEALTH SYSTEM ("CKHS"). CKHS' BOARD OF DIRECTORS MAINTAINS A COMPENSATION COMMITTEE ("COMMITTEE"). THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF DIRECTORS EACH OF WHOM IS INDEPENDENT AND FREE FROM ANY CONFLICTS OF INTEREST. THE COMMITTEE HAS ADOPTED A WRITTEN COMPENSATION PHILOSOPHY WHICH IT FOLLOWS WHEN IT REVIEWS AND APPROVES OR CONCURS WITH THE COMPENSATION AND BENEFITS OF CKHS' SENIOR MANAGEMENT, INCLUDING: THE PRESIDENT/CHIEF EXECUTIVE OFFICER, EXECUTIVE VICE PRESIDENT/CHIEF OPERATING OFFICER AND SENIOR VICE PRESIDENT/CHIEF FINANCIAL OFFICER. THE COMPENSATION COMMITTEE BYLAWS OUTLINE THE POWERS AND FUNCTIONS OF THE COMPENSATION COMMITTEE. THE COMMITTEE RELIES UPON APPROPRIATE COMPARABLE DATA FROM AN INDEPENDENT CONSULTING FIRM WHICH SPECIALIZES IN REVIEWING HOSPITAL AND HEALTHCARE SYSTEM EXECUTIVE COMPENSATION AND BENEFITS THROUGHOUT THE UNITED STATES. THIS STUDY USES COMPARABLE GEOGRAPHICAL AND DEMOGRAPHIC MARKET DATA INCLUDING, BUT NOT LIMITED TO, SIMILARLY SIZED HEALTHCARE SYSTEMS AND HOSPITALS, NUMBER OF LICENSED BEDS, AND NET PATIENT REVENUE ON BOTH A REGIONAL AND NATIONAL BASIS. THE COMMITTEE DOCUMENTS ITS BASIS FOR ITS DETERMINATION THROUGH THE TIMELY PREPARATION OF WRITTEN MINUTES OF COMPENSATION COMMITTEE MEETINGS DURING WHICH THE EXECUTIVE COMPENSATION AND BENEFITS ARE REVIEWED AND SUBSEQUENTLY APPROVED. THE COMPENSATION AND BENEFITS OF THE CKHS PRESIDENT/CHIEF EXECUTIVE OFFICER ARE REVIEWED BY THE COMMITTEE ON AN ANNUAL BASIS IN CONJUNCTION WITH THE INDIVIDUAL'S JOB PERFORMANCE. THE COMPENSATION COMMITTEE THEN RECOMMENDS TO CKHS' BOARD OF DIRECTORS APPROPRIATE COMPENSATION FOR THE CKHS PRESIDENT/CHIEF EXECUTIVE OFFICER. THE BOARD OF DIRECTOR'S THEN REVIEWS THE COMMITTEE'S RECOMMENDATION AND APPROVES THE COMPENSATION OF THE CKHS PRESIDENT/CHIEF EXECUTIVE OFFICER BASED ON THE COMMITTEE'S RECOMMENDATION. THE CKHS PRESIDENT/CHIEF EXECUTIVE OFFICER ESTABLISHES, AFTER DISCUSSION WITH AND CONCURRENCE BY THE COMMITTEE, THE COMPENSATION LEVELS OF THE EXECUTIVE VICE PRESIDENT/CHIEF OPERATING OFFICER; SENIOR VICE PRESIDENT/CHIEF FINANCIAL OFFICER; AND CERTAIN OTHER INDIVIDUALS DEEMED TO BE DISQUALIFIED PERSONS PURSUANT TO THE INTERNAL REVENUE SERVICE DEFINITION. THIS IS DONE WITH COMPARABLE MARKET DATA PROVIDED BY AN INDEPENDENT CONSULTANT. THE CKHS PRESIDENT/CHIEF EXECUTIVE OFFICER ALSO RECEIVES ASSISTANCE FROM CKHS' HUMAN RESOURCES DEPARTMENT IN CONJUNCTION WITH EACH INDIVIDUAL'S JOB PERFORMANCE DURING THE YEAR. COMPENSATION REVIEW AND APPROVAL IS ALSO BASED UPON OTHER OBJECTIVE FACTORS DESIGNED TO ENSURE THAT REASONABLE AND FAIR MARKET VALUE COMPENSATION IS PAID BY CKHS. OTHER OBJECTIVE FACTORS INCLUDE MARKET SURVEY DATA FOR COMPARABLE POSITIONS, INDIVIDUAL GOALS AND OBJECTIVES, PERSONNEL REVIEWS, AND EVALUATIONS. THE ACTIVITIES AND PROCEDURES FOLLOWED BY THE COMMITTEE ENABLE CKHS TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 4958 WITH RESPECT TO THE TOTAL COMPENSATION OF ALL INDIVIDUALS DISCLOSED ON THIS FORM 990, INCLUDING EXECUTIVE VICE PRESIDENT/COO AND SENIOR VICE PRESIDENT/CFO. CORE FORM, PART VI, SECTION C; QUESTION 19 THE ORGANIZATION'S FILED CERTIFICATE OF INCORPORATION AND ANY AMENDMENTS CAN BE OBTAINED AND REVIEWED THROUGH THE COMMONWEALTH OF PENNSYLVANIA. CORE FORM, PART VII AND SCHEDULE J PART VII AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS INCLUDING THE PRESIDENT/CHIEF EXECUTIVE OFFICER, EXECUTIVE VICE PRESIDENT/CHIEF OPERATING OFFICER AND SENIOR VICE PRESIDENT/CHIEF FINANCIAL OFFICER RECEIVING COMPENSATION AND BENEFITS FROM THE ORGANIZATION OR A RELATED ORGANIZATION. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME EMPLOYEES OR INDEPENDENT CONTRACTORS OF THE ORGANIZATION OR A RELATED ORGANIZATION AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THIS ORGANIZATION'S BOARD OF DIRECTORS. CORE FORM, PART VII, SECTION A, COLUMN B THE ORGANIZATION IS AN AFFILIATE WITHIN CROZER-KEYSTONE HEALTH SYSTEM AND CONTROLLED AFFILIATES ("SYSTEM"). THE SYSTEM INCLUDES BOTH FOR-PROFIT AND NOT FOR-PROFIT ORGANIZATIONS. CERTAIN BOARD OF DIRECTOR MEMBERS, OFFICERS AND/OR DIRECTORS LISTED ON CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 MAY HOLD SIMILAR POSITIONS WITH BOTH THIS ORGANIZATION AND OTHER AFFILIATES WITHIN THE SYSTEM. THE HOURS SHOWN ON THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE NO COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, REPRESENT THE ESTIMATED HOURS DEVOTED PER WEEK FOR THIS ORGANIZATION. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF DIRECTORS OF OTHER RELATED ORGANIZATIONS IN THE SYSTEM, THEIR RESPECTIVE HOURS PER WEEK PER ORGANIZATION ARE APPROXIMATELY ONE HOUR. THE HOURS REFLECTED ON PART VII OF THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, PAID OFFICERS AND KEY EMPLOYEES, REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF CROZER-KEYSTONE HEALTH SYSTEM AND CONTROLLED AFFILIATES; NOT SOLELY THIS ORGANIZATION. CORE FORM, PART XI; QUESTION 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES INCLUDE: - SALE OF SUBSTANIALLY ALL ASSETS TO PROSPECT HEALTH ACCESS NETWORK, INC. AN AFFILIATE OF PROSPECT MEDICAL HOLDINGS, INC.; $5,251,316. CORE FORM, PART XII; QUESTION 2 THE ORGANIZATION IS AN AFFILIATE WITHIN CROZER-KEYSTONE HEALTH SYSTEM AND CONTROLLED AFFILIATES ("SYSTEM"). AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF THE TAXPAYER AND ALL AFFILIATES FOR THE FISCAL YEARS ENDED JUNE 30, 2016 AND JUNE 30, 2015; RESPECTIVELY AND ISSUED A CONSOLIDATED FINANCIAL STATEMENT WITH CONSOLIDATING SCHEDULES BY ENTITY. AN UNQUALIFIED OPINION WAS ISSUED EACH YEAR BY THE INDEPENDENT CPA FIRM. THE TAXPAYER'S AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT AUDITOR. CORE FORM, PART XII; QUESTION 3 THE ORGANIZATION IS AN AFFILIATE IN THE CROZER-KEYSTONE HEALTH SYSTEM ("SYSTEM"); A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM. THE SYSTEM ENGAGED AN INDEPENDENT ACCOUNTING FIRM TO PREPARE AND ISSUE A SYSTEM WIDE CONSOLIDATED A-133 AUDIT. THIS ORGANIZATION WAS INCLUDED IN THE SYSTEM WIDE A-133 AUDIT. CROZER-CHESTER FOUNDATION ONE MEDICAL CENTER BOULEVARD UPLAND PA 19013 222540853 FUNDRAISING PA 501(c)(3) 509(a)(1) CCMC false CROZER-CHESTER MEDICAL CENTER ONE MEDICAL CENTER BOULEVARD UPLAND PA 19013 231637191 HEALTH SVCS. PA 501(c)(3) HOSPITAL CKHS false CROZER-KEYSTONE HEALTH SYSTEM 100 W SPROUL RD HLTHPLX PAV II SPRINGFIELD PA 19064 222540851 HEALTH SVCS. PA 501(c)(3) 509(a)(3) NA false DELCO MEMORIAL FOUNDATION 501 NORTH LANSDOWNE AVENUE DREXEL HILL PA 19026 222980746 FUNDRAISING PA 501(c)(3) 509(a)(2) DCMH false DELAWARE COUNTY MEMORIAL HOSPITAL 501 NORTH LANSDOWNE AVENUE DREXEL HILL PA 19026 230517130 HEALTH SVCS. PA 501(c)(3) HOSPITAL CKHS false DELCO SYSTEMS SERVICES INC 100 W SPROUL RD HLTHPLX PAV II SPRINGFIELD PA 19064 232215242 INACTIVE PA 501(c)(3) 509(A)(2) CKHS false CROZER-KEYSTONE SERVICES LAYTON HALL ONE MEDICAL CENTER BLV UPLAND PA 19013 232735284 HEALTHCARE SVcs. PA NA C CORP. false CKS DELAWARE INC LAYTON HALL ONE MEDICAL CENTER BLV UPLAND PA 19013 522069540 INACTIVE PA NA C CORP. false PENNSYLVANIA HEALTH CLUB INC 100 W SPROUL RD HLTHPLX PAV II SPRINGFIELD PA 19064 232658404 HEALTHCARE SVcs. PA NA C CORP. false UNIVERSITY TECHNOLOGY PARK INC ONE MEDICAL CENTER BLVD LAYTON HA UPLAND PA 19013 900294852 REAL ESTATE PA NA C CORP. false TECH PARK PROPERTIES INC ONE MEDICAL CENTER BLVD LAYTON HA UPLAND PA 19013 010847504 REAL ESTATE PA NA C CORP. false false false true true true false false false false true true true true false true true true false false CROZER-KEYSTONE HEALTH SYSTEM DJKMO 13753928 COST CROZER-KEYSTONE HEALTH SYSTEM C 9763737 COST CROZER-KEYSTONE HEALTH SYSTEM M 5090124 COST CROZER-KEYSTONE HEALTH SYSTEM P 3480818 COST CROZER-KEYSTONE HEALTH SYSTEM K 1715063 COST SCHEDULE R, PART V CROZER-KEYSTONE HEALTH SYSTEM ROUTINELY PAYS EXPENSES FOR VARIOUS AFFILIATES WITHIN CROZER-KEYSTONE HEALTH SYSTEM IN THE ORDINARY COURSE OF BUSINESS. THESE RELATED PARTY TRANSACTIONS ARE RECORDED ON THE REVENUE/EXPENSE AND BALANCE SHEET STATEMENT OF THIS ORGANIZATION AND ITS AFFILIATES. THESE ENTITIES WORK TOGETHER TO DELIVER HIGH QUALITY HEALTHCARE AND WELLNESS SERVICES TO THE COMMUNITIES IN WHICH THEY ARE SITUATED.