2015-05-12T14:20:18-05:00 2014-06-30 390859910 BAKER TILLY VIRCHOW KRAUSE LLP 1650 MARKET STREET SUITE 4500 PHILADELPHIA PA 19103 990 2013-07-01 232349341 FAMILY CARE CENTERS INC FAMI 5704214000 206 EAST BROWN STREET EAST STROUDSBURG PA 18301 MICHAEL A WILK SVP FINANCE/CFO 5704214000 2015-05-12 1 JULIUS GREEN CPA P00350393 2159720701 2013 2016-02-25 16:41:14Z JEFF SNYDER 206 EAST BROWN STREET EAST STROUDSBURG PA 18301 24795103 0 X WWW.POCONOHEALTHSYSTEM.ORG X 1985 PA TO PREVENT ILLNESS, PROMOTE WELLNESS AND RESTORE HEALTH IN THE POCONO AREA. 7 4 262 4 0 0 4402757 7702832 19218627 17082744 0 9527 0 0 23621384 24795103 0 0 0 0 20456245 19218670 0 0 0 5396819 4918102 25853064 24136772 -2231680 658331 3498236 3941747 2454024 2239204 1044212 1702543 X OUR MISSION IS WHO WE ARE AND WHAT WE DO: TO PROVIDE WORLD CLASS CARE CLOSE TO HOME. OUR VISION IS WHAT WE AIM FOR TO BEST SERVE OUR COMMUNITY: TO BUILD A HEALTHIER COMMUNITY. 0 0 21663682 17082744 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 21663682 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 17 0 1 262 1 0 0 0 0 0 0 0 0 0 0 X 7 4 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X MICHAEL A WILK SVP FINANCECFO 5704204912 206 EAST BROWN STREET EAST STROUDSBURG PA 18301 HORACE COLE CHAIRMAN 1.00 X X 0 0 0 SUZANNE VIECHNICKI SECRETARY/TREASURER 1.00 X X 0 0 0 JEFF SNYDER PRESIDENT/CEO (BEGIN 4/2014) 1.00 39.00 X X 0 253387 22091 CHARLES HERMAN MD DIRECTOR/PHYSICIAN 1.00 39.00 X 0 685982 20959 KENNETH LEVITT PHD DIRECTOR 1.00 X 0 0 0 PHYLLIS GIBSON DIRECTOR 1.00 X 0 0 0 LAMONT LOUIS VP PHYSICIAN NETWORK (BEGIN 6/2014) 1.00 39.00 X 0 0 0 KATHLEEN KUCK PRESIDENT/CEO (END 4/2014) 1.00 39.00 X X 0 464227 160759 KHEMRAJ H SEDANI PHYSICIAN 40.00 X 904737 0 22518 SAMER ALKHUJA PHYSICIAN 40.00 X 729628 0 22518 ANIL GUPTA PHYSICIAN 40.00 X 634673 0 9501 KARTHIK P SHEKA PHYSICIAN 40.00 X 631899 0 22518 WILLIAM RYAN PHYSICIAN 40.00 X 542835 0 21228 3443772 1403596 302092 54 0 1 0 E-CLINICAL WORKS PO BOX 847950 BOSTON MA 02284 PHYSICIAN PORTAL SERVICES 210451 CHELBUS CLEANING 275 NEWTON-SPARTA ROAD NEWTON NJ 07860 CLEANING SERVICES 197498 NAVICURE CLIENT SERVICES 2055 SUGARLOAF CIRCLE DULUTH GA 30097 EMPLOYMENT AGENCY 195180 3 7702832 7702832 PATIENT REVENUE 621400 15325183 15325183 MSO BILLING REVENUE 541900 902101 902101 OTHER PROGRAM SERVICES 621400 855460 855460 17082744 9527 9527 24795103 17082744 0 9527 15124402 13947925 1176477 559267 535347 23920 2781070 2255173 525897 753931 685008 68923 1089 1089 862654 429898 432756 450920 325186 125734 11104 11104 1162528 1075100 87428 75637 66397 9240 327960 321875 6085 581195 581195 BAD DEBT 888515 888515 MEDICAL SUPPLIES/DRUGS 466284 466282 2 LICENSES/DUES/SUBSCRIPT 89403 74414 14989 OTHER EXPENSE 813 263 550 24136772 21663682 2473090 0 1070 1620 747615 1431896 1471748 1396842 150859 114075 4254391 3276808 1079694 977583 47250 19731 3498236 3941747 2454024 2239204 2454024 2239204 X 1044212 1702543 1044212 1702543 3498236 3941747 658331 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 577300 231662 345638 3675891 3045146 630745 1200 1200 977583 X 24795103 0 24795103 0 24795103 24136772 0 24136772 0 24136772 PART X, LINE 2: 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. 0 1 0 0 0 0 0 1 0 JEFF SNYDER PRESIDENT/CEO (BEGIN 4/2014) 0 252577 0 0 0 810 0 0 0 22091 0 275478 0 0 CHARLES HERMAN MD DIRECTOR/PHYSICIAN 0 446682 0 239300 0 0 0 0 0 20959 0 706941 0 0 KATHLEEN KUCK PRESIDENT/CEO (END 4/2014) 0 459163 0 0 0 5064 0 145482 0 15277 0 624986 0 0 KHEMRAJ H SEDANI PHYSICIAN 581871 0 322866 0 0 0 0 0 22518 0 927255 0 0 0 SAMER ALKHUJA PHYSICIAN 468249 0 261379 0 0 0 0 0 22518 0 752146 0 0 0 ANIL GUPTA PHYSICIAN 574464 0 60209 0 0 0 0 0 9501 0 644174 0 0 0 KARTHIK P SHEKA PHYSICIAN 571690 0 60209 0 0 0 0 0 22518 0 654417 0 0 0 WILLIAM RYAN PHYSICIAN 440387 0 102448 0 0 0 0 0 21228 0 564063 0 0 0 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. 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. 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 POCONO HEALTH SYSTEM 0 POCONO AMBULATORY SERVICES INC 206 EAST BROWN STREET EAST STROUDSBURG PA 18301 232611474 HEALTHCARE PA 501(C)(3) LINE 3 POCONO HEALTH SYSTEM 0 POCONO MEDICAL CENTER 206 EAST BROWN STREET EAST STROUDSBURG PA 18301 240795623 HOSPITAL PA 501(C)(3) LINE 3 POCONO HEALTH SYSTEM 0 POCONO HEALTH FOUNDATION 206 EAST BROWN STREET EAST STROUDSBURG PA 18301 232516451 SUPPORT PA 501(C)(3) LINE 11A, I POCONO HEALTH SYSTEM 0 POCONO HEALTH SYSTEM MEDICAL PROFESSIONAL LIABILITY SELF-INSURANCE TRUST 206 EAST BROWN STREET EAST STROUDSBURG PA 18301 206560453 SELF-INSURANCE PA 501(C)(3) LINE 11A, I POCONO HEALTH SYSTEM 0 VISITING NURSE ASSOCIATION HOSPICE OF MONROE COUNTY INC 206 EAST BROWN STREET EAST STROUDSBURG PA 18301 232535297 HEALTHCARE PA 501(C)(3) LINE 9 POCONO HEALTH SYSTEM 0 HOME HEALTH SERVICES OF MONROE COUNTY INC 206 EAST BROWN STREET EAST STROUDSBURG PA 18301 240803608 HEALTHCARE PA 501(C)(3) LINE 11B, II POCONO HEALTH SYSTEM 0 POCONO AMBULATORY SURGERY CENTER LTD ONE STORM STREET STROUDSBURG PA 18360 232611442 SURGERY PA N/A 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0