FAMILY CARE CENTERS INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- FAMILY CARE CENTERS INC (EIN 23-2349341)
- Tax period
- 2013-07-01 to 2014-06-30
- Filed
- 2015-05-12
- IRS object ID
- 201521329349302982
- Schema version
- 2013v4.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-05-12T14:20:18-05:00 | ReturnTs |
| Tax Period End | 2014-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390859910 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BAKER TILLY VIRCHOW KRAUSE LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1650 MARKET STREET SUITE 4500 | AddressLine1 |
| City | PHILADELPHIA | City |
| State | PA | State |
| ZIP Code | 19103 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 232349341 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAMILY CARE CENTERS INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FAMI | BusinessNameControlTxt |
| Phone | 5704214000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 206 EAST BROWN STREET | AddressLine1 |
| City | EAST STROUDSBURG | City |
| State | PA | State |
| ZIP Code | 18301 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL A WILK | PersonNm |
| Person Title | SVP FINANCE/CFO | PersonTitleTxt |
| Phone | 5704214000 | PhoneNum |
| Signature | 2015-05-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JULIUS GREEN CPA | PreparerPersonNm |
| PTIN | P00350393 | PTIN |
| Phone | 2159720701 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JEFF SNYDER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 206 EAST BROWN STREET | AddressLine1 |
| City | EAST STROUDSBURG | City |
| State | PA | State |
| ZIP Code | 18301 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $24,795,103 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.POCONOHEALTHSYSTEM.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1985 | FormationYr |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Activity Or Mission | TO PREVENT ILLNESS, PROMOTE WELLNESS AND RESTORE HEALTH IN THE POCONO AREA. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 262 | TotalEmployeeCnt |
| Total Volunteers | 4 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,402,757 | PYContributionsGrantsAmt |
| CY Contributions Grants | $7,702,832 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $19,218,627 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $17,082,744 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $9,527 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $23,621,384 | PYTotalRevenueAmt |
| CY Total Revenue | $24,795,103 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $20,456,245 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $19,218,670 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,396,819 | PYOtherExpensesAmt |
| CY Other Expenses | $4,918,102 | CYOtherExpensesAmt |
| PY Total Expenses | $25,853,064 | PYTotalExpensesAmt |
| CY Total Expenses | $24,136,772 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$2,231,680 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $658,331 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,498,236 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,941,747 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,454,024 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,239,204 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,044,212 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,702,543 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | OUR MISSION IS WHO WE ARE AND WHAT WE DO: TO PROVIDE WORLD CLASS CARE CLOSE TO HOME. OUR VISION IS WHAT WE AIM FOR TO BEST SERVE OUR COMMUNITY: TO BUILD A HEALTHIER COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $21,663,682 | ExpenseAmt |
| Revenue | $17,082,744 | RevenueAmt |
| Desc | THE ORGANIZATION OPERATES SEVERAL PHYSICIAN PRACTICES, INCLUDING FAMILY MEDICINE, HEMATOLOGY AND ONCOLOGY, INTERNAL MEDICINE, AND OBSTETRICS AND GYNECOLOGY. ALSO, THE ORGANIZATION PROVIDES PHYSICIAN PRACTICE SUPPORT SERVICES INCLUDING: BILLING, INFORMATION TECHNOLOGY, AND TELECOMMUNICATIONS. IN ADDITION, THE ORGANIZATION HAS ENHANCED THE OUTPATIENT SERVICES AVAILABLE TO PERSONS IN THE AREA, INCLUDING SERVICES TO THE INDIGENT AND UNDERINSURED. THE ORGANIZATION PROVIDES SERVICES TO THE SURROUNDING AREA REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY.THE ORGANIZATION AIMS TO PROVIDE EXCELLENT QUALITY CARE TO OUR DIVERSE AND GROWING COMMUNITY AND STILL PROVIDES FOR NEEDED CAPITAL FOR THE FUTURE. ALL RESOURCES AND PROGRAM SERVICE EXPENSES ARE UTILIZED TO OFFER OUR PATIENTS QUALITY CARE THROUGH MULTIPLE SERVICE LINES.THESE SERVICES INCLUDE, BUT ARE NOT LIMITED TO: FAMILY PRACTICE, OBSTETRICS AND GYNECOLOGY, DIAGNOSTIC TESTING, OCCUPATIONAL MEDICINE, ONCOLOGY, ANESTHESIOLOGY SERVICES, CARDIOLOGY SERVICES AND PULMONARY CARE. THE INTERNAL MEDICINE TEAM PAVES THE WAY IN PROVIDING SPECIALIZED CARE TO ADULT PATIENTS. AS PART OF THE POCONO HEALTH SYSTEM, FAMILY CARE CENTERS OFFERS THE FINEST PHYSICIANS AND TECHNOLOGY TO THE AREA AND CONNECTS THEM TO THE POCONO MEDICAL CENTER WHEN A GREAT DEGREE OF SERVICE IS REQUIRED.FAMILY CARE CENTERS CONSTANTLY ASSESSES AND IMPROVES, WHEN POSSIBLE, EQUIPMENT USED, QUALITY REVIEW MEASURES, AND SCHEDULING CONSIDERATIONS IN ORDER TO MEET OR EXCEED THE STANDARD OF CARE EXPECTED FOR THESE SERVICES. TO FACILITATE CARE, MANY OF OUR PRACTICES OFFER MULTIPLE SITES AND EXTENDED OFFICE HOURS. OUR FACILITIES ARE LOCATED IN AREAS THAT ARE CONSIDERED UNDERSERVED WITHIN THE COMMUNITY. CARE IS PROVIDED FOR BOTH PREVENTATIVE SERVICES AND ACUTE AND CHRONIC MEDICAL CONDITIONS.THE POCONO MEDICAL CENTER PHYSICIAN ASSOCIATES VISITS INCLUDED THE FOLLOWING:PMC - HOSPITALISTS - 2,725OB/GYN - 30,165INTERNAL MEDICINE - 14,508FAMILY MEDICINE - WEST END - 4,524ENDOCRINOLOGY - 2,633CARDIOLOGY - 11,468PEDIATRIC VISITS - 3,935PULMONARY CARE VISITS - 14,282TOTAL VISITS FOR FCC PRACTICES - 84,240 | Desc |
| Total Program Service Expenses | $21,663,682 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 17 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 262 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | PA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MICHAEL A WILK SVP FINANCECFO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5704204912 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 206 EAST BROWN STREET | AddressLine1 |
| City | EAST STROUDSBURG | City |
| State | PA | State |
| ZIP Code | 18301 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| HORACE COLE | ||||||||
| CHAIRMAN | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| SUZANNE VIECHNICKI | ||||||||
| SECRETARY/TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JEFF SNYDER | ||||||||
| PRESIDENT/CEO (BEGIN 4/2014) | 1.00 | Yes (X) | Yes (X) | $0 | $253,387 | $22,091 | 39.00 | |
| CHARLES HERMAN MD | ||||||||
| DIRECTOR/PHYSICIAN | 1.00 | Yes (X) | $0 | $685,982 | $20,959 | 39.00 | ||
| KENNETH LEVITT PHD | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| PHYLLIS GIBSON | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| LAMONT LOUIS | ||||||||
| VP PHYSICIAN NETWORK (BEGIN 6/2014) | 1.00 | Yes (X) | $0 | $0 | $0 | 39.00 | ||
| KATHLEEN KUCK | ||||||||
| PRESIDENT/CEO (END 4/2014) | 1.00 | Yes (X) | Yes (X) | $0 | $464,227 | $160,759 | 39.00 | |
| KHEMRAJ H SEDANI | ||||||||
| PHYSICIAN | 40.00 | $904,737 | $0 | $22,518 | Yes (X) | |||
| SAMER ALKHUJA | ||||||||
| PHYSICIAN | 40.00 | $729,628 | $0 | $22,518 | Yes (X) | |||
| ANIL GUPTA | ||||||||
| PHYSICIAN | 40.00 | $634,673 | $0 | $9,501 | Yes (X) | |||
| KARTHIK P SHEKA | ||||||||
| PHYSICIAN | 40.00 | $631,899 | $0 | $22,518 | Yes (X) | |||
| WILLIAM RYAN | ||||||||
| PHYSICIAN | 40.00 | $542,835 | $0 | $21,228 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,443,772 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,403,596 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $302,092 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 54 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| E-CLINICAL WORKS | |||||
| PO BOX 847950 | BOSTON | MA | 02284 | PHYSICIAN PORTAL SERVICES | $210,451 |
| CHELBUS CLEANING | |||||
| 275 NEWTON-SPARTA ROAD | NEWTON | NJ | 07860 | CLEANING SERVICES | $197,498 |
| NAVICURE CLIENT SERVICES | |||||
| 2055 SUGARLOAF CIRCLE | DULUTH | GA | 30097 | EMPLOYMENT AGENCY | $195,180 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $7,702,832 | RelatedOrganizationsAmt |
| Total Contributions | $7,702,832 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT REVENUE | 621400 | $15,325,183 | $15,325,183 |
| MSO BILLING REVENUE | 541900 | $902,101 | $902,101 |
| OTHER PROGRAM SERVICES | 621400 | $855,460 | $855,460 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $17,082,744 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,527 | TotalRevenueColumnAmt |
| Exclusion | $9,527 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $24,795,103 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $17,082,744 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $9,527 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,124,402 | TotalAmt |
| Program Services | $13,947,925 | ProgramServicesAmt |
| Management And General | $1,176,477 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $559,267 | TotalAmt |
| Program Services | $535,347 | ProgramServicesAmt |
| Management And General | $23,920 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,781,070 | TotalAmt |
| Program Services | $2,255,173 | ProgramServicesAmt |
| Management And General | $525,897 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $753,931 | TotalAmt |
| Program Services | $685,008 | ProgramServicesAmt |
| Management And General | $68,923 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,089 | TotalAmt |
| Management And General | $1,089 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $862,654 | TotalAmt |
| Program Services | $429,898 | ProgramServicesAmt |
| Management And General | $432,756 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $450,920 | TotalAmt |
| Program Services | $325,186 | ProgramServicesAmt |
| Management And General | $125,734 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,104 | TotalAmt |
| Program Services | $11,104 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,162,528 | TotalAmt |
| Program Services | $1,075,100 | ProgramServicesAmt |
| Management And General | $87,428 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,637 | TotalAmt |
| Program Services | $66,397 | ProgramServicesAmt |
| Management And General | $9,240 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $327,960 | TotalAmt |
| Program Services | $321,875 | ProgramServicesAmt |
| Management And General | $6,085 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $581,195 | TotalAmt |
| Program Services | $581,195 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT | $888,515 | $888,515 | |
| MEDICAL SUPPLIES/DRUGS | $466,284 | $466,282 | $2 |
| LICENSES/DUES/SUBSCRIPT | $89,403 | $74,414 | $14,989 |
| OTHER EXPENSE | $813 | $263 | $550 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,136,772 | TotalAmt |
| Program Services | $21,663,682 | ProgramServicesAmt |
| Management And General | $2,473,090 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,070 | BOYAmt |
| EOY | $1,620 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $747,615 | BOYAmt |
| EOY | $1,431,896 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,471,748 | BOYAmt |
| EOY | $1,396,842 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $150,859 | BOYAmt |
| EOY | $114,075 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,254,391 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,276,808 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,079,694 | BOYAmt |
| EOY | $977,583 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,250 | BOYAmt |
| EOY | $19,731 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,498,236 | BOYAmt |
| EOY | $3,941,747 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,454,024 | BOYAmt |
| EOY | $2,239,204 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,454,024 | BOYAmt |
| EOY | $2,239,204 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,044,212 | BOYAmt |
| EOY | $1,702,543 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,044,212 | BOYAmt |
| EOY | $1,702,543 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,498,236 | BOYAmt |
| EOY | $3,941,747 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $658,331 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $577,300 | OtherCostOrOtherBasisAmt |
| Depreciation | $231,662 | DepreciationAmt |
| Book Value | $345,638 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,675,891 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,045,146 | DepreciationAmt |
| Book Value | $630,745 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,200 | OtherCostOrOtherBasisAmt |
| Book Value | $1,200 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $977,583 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $24,795,103 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $24,795,103 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $24,795,103 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $24,136,772 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $24,136,772 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $24,136,772 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. THE HEALTH SYSTEM FILES TAX RETURNS IN THE U.S. FEDERAL JURISDICTION. WITH A FEW EXCEPTIONS, THE HEALTH SYSTEM IS NO LONGER SUBJECT TO U.S. FEDERAL EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2010. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JEFF SNYDER | ||||||||||||||
| PRESIDENT/CEO (BEGIN 4/2014) | $0 | $252,577 | $0 | $0 | $0 | $810 | $0 | $0 | $0 | $22,091 | $0 | $275,478 | $0 | $0 |
| CHARLES HERMAN MD | ||||||||||||||
| DIRECTOR/PHYSICIAN | $0 | $446,682 | $0 | $239,300 | $0 | $0 | $0 | $0 | $0 | $20,959 | $0 | $706,941 | $0 | $0 |
| KATHLEEN KUCK | ||||||||||||||
| PRESIDENT/CEO (END 4/2014) | $0 | $459,163 | $0 | $0 | $0 | $5,064 | $0 | $145,482 | $0 | $15,277 | $0 | $624,986 | $0 | $0 |
| KHEMRAJ H SEDANI | ||||||||||||||
| PHYSICIAN | $581,871 | $0 | $322,866 | $0 | $0 | $0 | $0 | $0 | $22,518 | $0 | $927,255 | $0 | $0 | $0 |
| SAMER ALKHUJA | ||||||||||||||
| PHYSICIAN | $468,249 | $0 | $261,379 | $0 | $0 | $0 | $0 | $0 | $22,518 | $0 | $752,146 | $0 | $0 | $0 |
| ANIL GUPTA | ||||||||||||||
| PHYSICIAN | $574,464 | $0 | $60,209 | $0 | $0 | $0 | $0 | $0 | $9,501 | $0 | $644,174 | $0 | $0 | $0 |
| KARTHIK P SHEKA | ||||||||||||||
| PHYSICIAN | $571,690 | $0 | $60,209 | $0 | $0 | $0 | $0 | $0 | $22,518 | $0 | $654,417 | $0 | $0 | $0 |
| WILLIAM RYAN | ||||||||||||||
| PHYSICIAN | $440,387 | $0 | $102,448 | $0 | $0 | $0 | $0 | $0 | $21,228 | $0 | $564,063 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE FORMER PRESIDENT/CEO, KATHLEEN KUCK, THE PRESIDENT/CEO, JEFF SNYDER, AND A DIRECTOR, CHARLES HERMAN, ARE COMPENSATED BY POCONO MEDICAL CENTER (PMC), A RELATED ORGANIZATION. PMC USES THE FOLLOWING METHODS TO DETERMINE THEIR COMPENSATION: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. |
| PART I, LINE 4B | THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE 457(F) SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN OF POCONO MEDICAL CENTER, A RELATED ORGANIZATION, BUT DID NOT RECEIVE A DISTRIBUTION IN CALENDAR YEAR 2013: CHARLES HERMAN, DIRECTOR KATHLEEN KUCK, FORMER PRESIDENT/CEO JEFF SNYDER, PRESIDENT/CEO KHEMRAJ H. SEDANI SAMER ALKHUJA ANIL GUPTA KARTHIK P. SHEKA WILLIAM F. RYAN |
| PART I, LINE 7 | INCENTIVE COMPENSATION IS PAID BASED ON THE FOLLOWING FOUR PERFORMANCE CRITERIA: 1) INCREASE IN THE SERVICES AVAILABLE TO THE COMMUNITY, 2) IMPROVEMENT IN CUSTOMER SATISFACTION AND QUALITY OF SERVICE PROVIDED, 3) STABLE FINANCIAL RATIOS, AND 4) IMPROVING EMPLOYEE SATISFACTION. PHYSICIANS RECEIVE NON-FIXED BONUS AND INCENTIVE COMPENSATION BASED ON THEIR RESPECTIVE CONTRACTS. INCENTIVES ARE EITHER BASED ON A PERCENTAGE OF PAYMENTS RECEIVED ABOVE REQUIRED EXPENSE COVERAGE THRESHOLD OR RELATIVE VALUE UNIT (RVU) THRESHOLD. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THE CORPORATION IS POCONO HEALTH SYSTEM (PHS), A PENNSYLVANIA NON-PROFIT CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | PHS ELECTS/APPOINTS THE BOARD MEMBERS OF FAMILY CARE CENTERS (FCC). |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING WAS NOTED IN SECTION 4-07 OF THE ORGANIZATION'S BYLAWS: "IN ADDITION TO ALL MATTERS REQUIRED BY LAW OR BY OTHER PROVISIONS OF THESE BYLAWS TO BE SUBMITTED TO A VOTE OF THE SOLE MEMBER, THE SOLE MEMBER IS EMPOWERED TO INITIATE AND IMPLEMENT ANY OF THE FOLLOWING ACTIONS WITH RESPECT TO THE CORPORATION AND IF ANY SUCH ACTION IS OTHERWISE INITIATED BY THE CORPORATION, SUCH ACTION WILL NOT BECOME EFFECTIVE UNLESS APPROVED BY THE SOLE MEMBER: (A) TO ADOPT OR CHANGE THE MISSION, PURPOSE, PHILOSOPHY OR OBJECTIVES OF THIS CORPORATION OR ANY SUBSIDIARY CORPORATION; (B) TO DISSOLVE, REORGANIZE, DIVIDE, CONVERT, LIQUIDATE OR WIND-UP ANY SUBSIDIARY CORPORATION OR CONSOLIDATE OR MERGE THIS CORPORATION WITH ANY OTHER CORPORATION OR ENTITY; (C) TO ANNUALLY APPROVE ALL CAPITAL AND OPERATING BUDGETS FOR THIS CORPORATION; (D) TO ANNUALLY APPROVE THE STRATEGIC AND OPERATING PLANS OR ANY CHANGES THERETO OF THIS CORPORATION; (E) TO APPROVE ANY UNBUDGETED EXPENSE ITEM OF THIS CORPORATION IN EXCESS OF FIVE HUNDRED THOUSAND ($500,000.00) DOLLARS; (F) TO RECEIVE, REVIEW, AND APPROVE FINANCIAL AND OPERATING REPORTS FROM THIS CORPORATION ON AT LEAST A QUARTERLY BASIS; (G) TO APPROVE ANY NEW LINE(S) OF BUSINESS AND/OR MATERIAL CHANGES IN EXISTING SERVICES AND/OR PARTICIPATION BY THIS CORPORATION WITH ANY OTHER ENTITY WHERE LICENSURE BY THE COMMONWEALTH OF PENNSYLVANIA IS REQUIRED AS A PRECONDITION FOR ANY SUCH ACTION, BUSINESS, SERVICE, OR PARTICIPATION; (H) TO APPROVE THE INCURRENCE OF INDEBTEDNESS BY THIS CORPORATION IN EXCESS OF ONE HUNDRED THOUSAND ($100,000) DOLLARS; (I) TO APPROVE THE AMENDMENT OF THE ARTICLES OF INCORPORATION OR BYLAWS OF THIS CORPORATION; (J) TO SPECIFY THE NUMBER OF AND TO ELECT OR REMOVE THE MEMBERS OF THE BOARD OF DIRECTORS OF THIS CORPORATION; (K) TO APPROVE THE ELECTION OR REMOVAL OF THE CHAIRPERSON OF THE BOARD OF DIRECTORS OF THIS CORPORATION; (L) TO REQUIRE EACH DIRECTOR OF THIS CORPORATION AND THE PRESIDENT, EACH VICE PRESIDENT, AND ALL KEY MANAGEMENT PERSONNEL OF THIS CORPORATION TO ANNUALLY SUBMIT TO THE BOARD OF DIRECTORS OF THIS CORPORATION A CONFLICT OF INTEREST STATEMENT IN FORM FIRST APPROVED BY THE BOARD OF DIRECTORS OF THE SOLE MEMBER; (M) TO AT LEAST ANNUALLY EVALUATE THE PERFORMANCE OF THIS CORPORATION'S BOARD OF DIRECTORS IN OVERSEEING THE MANAGEMENT AND PERFORMANCE OF THIS CORPORATION; AND (N) TO REQUIRE THAT THIS CORPORATION'S GOVERNANCE, DELIBERATIONS, AND ACTIONS ARE ORIENTED TO COMMUNITY SERVICE." |
| FORM 990, PART VI, SECTION B, LINE 11 | THE ORGANIZATION HAS AN EXTENSIVE 990 REVIEW PROCESS. THE 990 IS FIRST REVIEWED BY THE ACCOUNTING DEPARTMENT AND THE CFO. AFTER ANY NECESSARY CHANGES ARE MADE, A REVIEW IS PERFORMED BY THE CORPORATE COMPLIANCE OFFICER, THE FINANCE COMMITTEE, AND THE CEO. AFTER ALL CHANGES ARE MADE, THE FINAL COPY IS PROVIDED TO ALL BOARD MEMBERS FOR REVIEW AND COMMENT BEFORE FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | ON AN ANNUAL BASIS, BOARD MEMBERS AND KEY MANAGEMENT PERSONNEL ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM. ALL FORMS ARE SUBMITTED TO AND REVIEWED BY THE CORPORATE COMPLIANCE OFFICER OF POCONO HEALTH SYSTEM. INTERESTED PERSONS HAVE A CONTINUING OBLIGATION TO DISCLOSE, THROUGH A WRITTEN DESCRIPTION, THE EXISTENCE AND NATURE OF ANY ACTUAL, APPARENT, OR POTENTIAL CONFLICT OF INTEREST HE/SHE MAY HAVE. THE AUDIT AND COMPLIANCE COMMITTEE SHALL REVIEW THE MATTER AND DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. ONCE ALL NECESSARY INFORMATION HAS BEEN OBTAINED, THE AUDIT AND COMPLIANCE COMMITTEE SHALL MAKE A FINDING AS TO WHETHER A CONFLICT OF INTEREST INDEED EXISTS, AND SHALL FORWARD THAT FINDING TO THE BOARD OF DIRECTORS FOR DISCUSSION AND VOTE. ONLY DISINTERESTED DIRECTORS MAY VOTE TO DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. THE SUBJECT INTERESTED PERSON MAY NOT BE PRESENT WHEN THIS VOTE IS TAKEN. FOR ALL IDENTIFIED CONFLICTS, THE INTERESTED PERSONS ARE REQUIRED TO LEAVE THE ROOM WHILE THE RELATED MATTERS ARE DISCUSSED AND VOTED ON. |
| FORM 990, PART VI, SECTION B, LINE 15 | THESE ACTIVITIES ARE UNDERTAKEN BY POCONO MEDICAL CENTER'S BOARD, AS POCONO MEDICAL CENTER COMPENSATES THE CEO AND CFO FOR SERVICES TO POCONO MEDICAL CENTER AND ALL RELATED ENTITIES: ONCE EVERY THREE YEARS, OR SOONER IF NECESSARY, COMPENSATION REVIEWS ARE CONDUCTED FOR THE CEO AND TOP MANAGEMENT. A COMPENSATION COMMITTEE RECOMMENDS TO THE BOARD THE COMPENSATION OF THE PRESIDENT AND CEO AND COMPENSATION RANGES FOR THE VICE PRESIDENTS. THE CEO SHALL THEN SET THE COMPENSATION OF THE VICE PRESIDENTS WITHIN THE APPROVED RANGES. IN MAKING RECOMMENDATIONS TO THE BOARD ON COMPENSATION AND COMPENSATION RANGES, THE COMPENSATION COMMITTEE RELIES ON REPORTS FROM AN INDEPENDENT COMPENSATION CONSULTANT SELECTED BY THE COMMITTEE. TO ASSURE INDEPENDENCE, THE CONSULTANT SHALL PERFORM NO OTHER SERVICES FOR PMC. THE CONSULTANT WAS MOST RECENTLY USED IN APRIL OF 2014. THE COMMITTEE REPORTS ITS DECISIONS TO THE BOARD AT ITS NEXT EXECUTIVE SESSION, AT WHICH TIME THE BOARD SHALL EITHER RATIFY THE DECISION OR SEND IT BACK TO THE COMMITTEE FOR FURTHER DELIBERATION. ONCE A FINAL DECISION IS REACHED, THE BOARD CHAIRMAN INFORMS THE CEO OF THE DECISIONS OF THE COMMITTEE AND RATIFICATION BY THE BOARD REGARDING THE CEO'S SALARY AND THE SALARY RANGES FOR THE VICE PRESIDENTS. MINUTES OF THE COMMITTEE AND THE EXECUTIVE SESSION PORTION OF THE BOARD ARE PREPARED AND RETAINED IN THE ADMINISTRATION OFFICES AND CONTAIN SUFFICIENT INFORMATION TO SUBSTANTIATE THE DELIBERATION AND DECISION. |
| FORM 990, PART VI, SECTION C, LINE 19 | FINANCIAL RESULTS ARE PUBLISHED IN THE ANNUAL REPORT, A COPY OF WHICH IS DISTRIBUTED IN A VARIETY OF PUBLIC FORUMS AND WOULD OTHERWISE BE PROVIDED UPON REQUEST. THE CONFLICT OF INTEREST POLICY WOULD BE AVAILABLE FOR VIEWING IN THE BUSINESS OR ADMINISTRATIVE OFFICES OF PMC, UPON REQUEST, TO ENSURE THE MOST CURRENT COPY IS ALWAYS THE ONE BEING MADE AVAILABLE. THE GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| POCONO HEALTH SYSTEM | |||||||||||
| 206 EAST BROWN STREET | EAST STROUDSBURG | PA | 18301 | 232336285 | SUPPORT POCONO MEDICAL CENTER | PA | 501(C)(3) | LINE 11B, II | N/A | 0 | |
| POCONO HEALTHCARE PARTNERS | |||||||||||
| 206 EAST BROWN STREET | EAST STROUDSBURG | PA | 18301 | 233014006 | HEALTHCARE | PA | 501(C)(3) | LINE 3 | 0 | POCONO HEALTH SYSTEM | |
| POCONO AMBULATORY SERVICES INC | |||||||||||
| 206 EAST BROWN STREET | EAST STROUDSBURG | PA | 18301 | 232611474 | HEALTHCARE | PA | 501(C)(3) | LINE 3 | 0 | POCONO HEALTH SYSTEM | |
| POCONO MEDICAL CENTER | |||||||||||
| 206 EAST BROWN STREET | EAST STROUDSBURG | PA | 18301 | 240795623 | HOSPITAL | PA | 501(C)(3) | LINE 3 | 0 | POCONO HEALTH SYSTEM | |
| POCONO HEALTH FOUNDATION | |||||||||||
| 206 EAST BROWN STREET | EAST STROUDSBURG | PA | 18301 | 232516451 | SUPPORT | PA | 501(C)(3) | LINE 11A, I | 0 | POCONO HEALTH SYSTEM | |
| POCONO HEALTH SYSTEM MEDICAL PROFESSIONAL LIABILITY SELF-INSURANCE TRUST | |||||||||||
| 206 EAST BROWN STREET | EAST STROUDSBURG | PA | 18301 | 206560453 | SELF-INSURANCE | PA | 501(C)(3) | LINE 11A, I | 0 | POCONO HEALTH SYSTEM | |
| VISITING NURSE ASSOCIATION HOSPICE OF MONROE COUNTY INC | |||||||||||
| 206 EAST BROWN STREET | EAST STROUDSBURG | PA | 18301 | 232535297 | HEALTHCARE | PA | 501(C)(3) | LINE 9 | 0 | POCONO HEALTH SYSTEM | |
| HOME HEALTH SERVICES OF MONROE COUNTY INC | |||||||||||
| 206 EAST BROWN STREET | EAST STROUDSBURG | PA | 18301 | 240803608 | HEALTHCARE | PA | 501(C)(3) | LINE 11B, II | 0 | POCONO HEALTH SYSTEM | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | POCONO AMBULATORY SURGERY CENTER LTD | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE STORM STREET | AddressLine1 |
| City | STROUDSBURG | City |
| State | PA | State |
| ZIP Code | 18360 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 232611442 | EIN |
| Primary Activities | SURGERY | PrimaryActivitiesTxt |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Comments