2015-05-11T10:25:42-05:00 2014-06-30 390859910 BAKER TILLY VIRCHOW KRAUSE LLP 1650 MARKET STREET SUITE 4500 PHILADELPHIA PA 19103 990 2013-07-01 251865142 HOLY SPIRIT HEALTH SYSTEM HOLY 7177632130 503 NORTH 21ST STREET CAMP HILL PA 17011 SISTER ROMAINE NIEMEYER SCC PRESIDENT/CEO 7177632130 2015-04-08 1 JULIUS C GREEN CPA JD P00350393 2159720701 2013 2016-02-25 16:41:14Z SISTER ROMAINE NIEMEYER 503 NORTH 21ST STREET CAMP HILL PA 17011 18679364 0 X WWW.HSH.ORG X 1999 PA TO PROVIDE RESOURCES FOR THE RESTORATION AND MAINTENANCE OF HEALTH AND THE PREVENTION OF DISEASE. 11 11 19 13 0 0 16986697 15897679 0 0 767850 322407 1197891 1789363 18952438 18009449 16687833 16418705 0 0 790581 1329727 56099 112490 112490 575641 1069814 18110154 18930736 842284 -921287 12612355 13181589 318747 348247 12293608 12833342 X HOLY SPIRIT HEALTH SYSTEM IS A COMMUNITY CATHOLIC HEALTH SYSTEM SPONSORED BY THE SISTERS OF CHRISTIAN CHARITY TO CARRY OUT THE HEALING MINISTRY OF JESUS CHRIST TO ALL IN NEED. WE PROVIDE HIGH QUALITY, COST-EFFECTIVE HEALTH SERVICES IN A CARING, PATIENT-FOCUSED ENVIRONMENT TO DEVELOP HEALTHY COMMUNITIES IN THE GREATER HARRISBURG AREA AND SOUTH CENTRAL PENNSYLVANIA. 0 0 18093522 16418705 SUPPORTED AND CARRIED OUT THE MISSION OF, AND IDENTIFIED WITH THE ETHICAL PRINCIPLES OF THE ROMAN CATHOLIC CHURCH TO PROVIDE RESOURCES FOR THE RESTORATION AND MAINTENANCE OF HEALTH AND THE PREVENTION OF DISEASE.HOLY SPIRIT HEALTH SYSTEM PROVIDES FINANCIAL SUPPORT TO ITS CONTROLLED ENTITIES TO ALLOW THESE ENTITIES TO CARRY ON WITH THEIR EXEMPT PURPOSES OF PROVIDING AFFORDABLE HEALTHCARE AND MEDICAL SERVICES TO RESIDENTS OF CAMP HILL PENNSYLVANIA AND SURROUNDING COMMUNITIES. 18093522 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 1 0 0 0 0 0 1 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 14 0 1 19 1 0 0 0 0 0 1 1 0 0 0 0 X 11 11 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X SISTER ROMAINE NIEMEYER SCC 7177632106 503 NORTH 21ST STREET CAMP HILL PA 17011 BRUCE J BROWN CHAIRPERSON 1.00 X X 0 0 0 ELIZABETH BERGEY MD VICE CHAIRPERSON 1.00 X 0 0 0 LAWRENCE KLUGER DIRECTOR 1.00 X 0 0 0 LEON FEINERMAN DIRECTOR 1.00 X 0 0 0 NILES BENN ESQ DIRECTOR 1.00 X 0 0 0 ROBERT DIETZ DIRECTOR 1.00 X X 0 0 0 SR JOAN DANIEL HEALY SCC DIRECTOR 1.00 X 0 0 0 SR MARY JOSEPH SCHULTZ SCC DIRECTOR 1.00 X 0 0 0 SR MARY MARK SMITH SCC DIRECTOR 1.00 X 0 0 0 SR ROMAINE NIEMEYER SCC DIRECTOR - PRESIDENT/CEO 1.00 39.00 X X 0 0 0 WILLIAM KEEN DIRECTOR 1.00 X 0 0 0 AMI ZUMKHAWALA-COOK CHIEF COMPLIANCE OFFICER 40.00 X 170027 0 9138 MARY KIENZLE DIRECTOR OF MISSION INTEGRATION 40.00 X 105503 0 11859 SUE STUART CHIEF DEVELOPMENT OFFICER 40.00 X 142298 0 13742 417828 0 34739 3 0 1 0 SAUL EWING LLP 1500 MARKET ST 38TH FLOOR CENTER PHILADELPHIA PA 19102 LEGAL SERVICES 633741 PARENTEBEARD LLC LOCKBOX 7831 PO BOX 8500 PHILADELPHIA PA 19178 AUDIT SERVICES 116000 2 92794 15000000 804885 15897679 189212 189212 727762 594567 133195 133195 133195 56442 92794 75348 -18906 -18906 CORPORATE COMPLIANCE REV 900099 1112240 1112240 RESOURCE DEVELOPMENT 900099 558471 558471 MISSION INTEGRATION 900099 137169 137169 389 389 1808269 18009449 0 0 2111770 16418705 16418705 1083987 1083987 42538 42538 109749 109749 93453 93453 593697 593697 64934 64934 112490 112490 17792 17792 153171 104870 48301 25903 25903 54941 54941 154 154 6877 6877 4096 4096 13439 13439 ANNUAL REPORT 63026 63026 DUES AND SUBSCRIPTIONS 52259 52259 DONOR RECOGNITION 2175 2175 DRUGS & PHARMACEUTICALS 1840 1840 15510 15510 18930736 18093522 724724 112490 500 500 582849 531759 162949 65724 54657 64623 44095 16927 20528 7218761 8209049 3922536 3922536 805058 279611 12612355 13181589 266097 240230 52650 108017 318747 348247 X 12293608 12670392 162950 12293608 12833342 12612355 13181589 X -921287 697230 763791 X 0 1 X 1 0 X X X 0 0 0 SISTERS OF CHRISTIAN CHARITY HEALTH CARE CORPORATION 232322926 1 1 1 0 HOLY SPIRIT HOSPITAL OF THE SISTERS OF CHRISTIAN CHARITY 231512747 3 1 1 1 1069157 SPIRIT PHYSICIAN SERVICES INC 251766971 9 1 1 1 15001572 WEST SHORE ADVANCED LIFE SUPPORT SERVICES INC 232463002 7 1 1 0 4 16070729 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 32890 28382 4508 31733 15713 16020 20528 PA COMMUNITY HOSPITAL ASSOCIATES INVESTMENT 3922536 C 3922536 X 3051496 697230 -15654914 -14957684 18009180 269 269 18009449 2511762 0 2511762 269 16418705 16418974 18930736 PART X, LINE 2: THE SYSTEM ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD IS MET. MANAGEMENT HAS DETERMINED THAT THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2014 OR 2013. THE SYSTEM'S FEDERAL EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURNS FOR FISCAL YEARS AFTER 2011 REMAIN SUBJECT TO EXAMINATION BY THE IRS. PART XI, LINE 2D - OTHER ADJUSTMENTS: TRANSFERS TO AFFILIATES - NETTED ON FINANCIAL STATEMENTS -16,418,705. TRANSFER FROM HOLY SPIRIT VENTURES 763,791. PART XII, LINE 4B - OTHER ADJUSTMENTS: TRANSFERS TO AFFILIATES - NETTED ON FINANCIAL STATEMENTS 16,418,705. X X X X X X 1 GREAT GOLF EVENTS 7928 OUTLOOK LANE PRAIRIE VILLAGE KS 66208 PROFESSIONAL FUNDRAISING SERVICES 1 26250 22640 3610 STEVENS & LEE 111 NORTH 6TH STREET - PO BOX 679 READING PA 19601 FEDERAL AND STATE GRANTS 0 0 55024 -55024 DELTA DEVELOPMENT GROUP 2000 TECHNOLOGY PARKWAY SUITE 200 MECHANICSBURG PA 17050 GRANT SUPPORT 0 0 49466 -49466 26250 127130 -100880 PA GOLF OUTING 149236 92794 56442 13591 24809 23825 26714 149236 92794 56442 13591 24809 23825 26714 88939 -32497 1 SPIRIT PHYSICIAN SERVICES INC 503 NORTH 21ST STREET CAMP HILL PA 17011 251766971 501(C)(3) 15001572 CASH N/A PROVIDE FINANCIAL SUPPORT FOR OPERATIONS. HOLY SPIRIT HOSPITAL 503 NORTH 21ST STREET CAMP HILL PA 17011 231512747 501(C)(3) 1069157 CASH N/A PROVIDE FINANCIAL SUPPORT FOR OPERATIONS. HOLY SPIRIT COPORATION 503 NORTH 21ST STREET CAMP HILL PA 17011 232214540 501(C)(2) 325000 CASH N/A PROVIDE FINANCIAL SUPPORT FOR OPERATIONS. WEST SHORE ADVANCED LIFE SUPPORT SERVCIES 503 NORTH 21ST STREET CAMP HILL PA 17011 232463002 501(C)(3) 22976 CASH N/A PROVIDE FINANCIAL SUPPORT FOR OPERATIONS. 3 1 PART I, LINE 2: ASSISTANCE IS PROVIDED TO RELATED ENTITIES FOR FINANCIAL SUPPORT. MANAGEMENT OF THE HEALTH SYSTEM OVERSEES THE USE OF FUNDS AT THE AFFILIATED ENTITIES. X X X X 0 0 0 0 0 0 0 0 0 AMI ZUMKHAWALA-COOK CHIEF COMPLIANCE OFFICER 144662 0 25365 0 0 0 8495 0 643 0 179165 0 0 0 SUE STUART CHIEF DEVELOPMENT OFFICER 142298 0 0 0 0 0 7055 0 6687 0 156040 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE SISTERS OF CHRISTIAN CHARITY HEALTH CARE CORPORATION, A PENNSYLVANIA NON-PROFIT CORPORATION, IS THE SOLE MEMBER OF HOLY SPIRIT HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 7A THE CHAIRPERSON OF THE BOARD OF TRUSTEES, SISTERS OF CHRISTIAN CHARITY HEALTH CARE CORPORATION (PARENT), HAS THE POWER TO APPOINT OR REMOVE THE PRESIDENT AND/OR CHIEF EXECUTIVE OFFICER OF THIS CORPORATION. THE PARENT ALSO HAS THE POWER TO ELECT THE DIRECTORS OF THE CORPORATION AND TO APPROVE NOMINEES FOR ELECTED OFFICERS. FORM 990, PART VI, SECTION A, LINE 7B THE GOVERNANCE STRUCTURE OF HOLY SPIRIT HEALTH SYSTEM PROVIDES RESERVED POWERS IN FAVOR OF SISTERS OF CHRISTIAN CHARITY HEALTH CARE CORPORATION (PARENT) AND HOLY SPIRIT HEALTH SYSTEM (THE CORPORATE MEMBER OF ALL SUBSIDIARY CORPORATIONS). THE RESERVED POWERS PERTAIN TO (I) CAPITAL DEBT OR MODIFICATION OF EXISTING CAPITAL DEBT, (II) SALE OR TRANSFER OF ANY LAND OR BUILDING, (III) ACQUISITION OR PURCHASE OF ANY LAND OR BUILDING, (IV) LEASING OUTSIDE OF THE ORDINARY COURSE OF BUSINESS, (V) APPROVAL OF ANY GUARANTEE OF ANY DEBT, (VI) APPROVAL OF ANY MERGER, CONSOLIDATION, ORGANIZATION OR REORGANIZATION, JOINT VENTURE, OR ANY OTHER MODIFICATION OF CORPORATION STRUCTURE OR AFFILIATION, (VII) DISSOLUTION OR TERMINATION OF ANY EXISTING CORPORATION, (VIII) APPOINTMENT OF THE EXTERNAL FISCAL AUDITOR AND (IX) APPOINTMENT OF GENERAL COUNSEL. FORM 990, PART VI, SECTION B, LINE 11 IN ACCORDANCE WITH THE BYLAWS OF HOLY SPIRIT HEALTH SYSTEM, THE FORM 990 WAS PRESENTED TO THE HEALTH SYSTEM'S FINANCE AND AUDIT COMMITTEE BY THE EXTERNAL TAX PREPARERS AND MANAGEMENT. FOLLOWING REVIEW AND APPROVAL BY THE FINANCE AND AUDIT COMMITTEE, THE FORM 990 WAS DISTRIBUTED VIA "BOARDNET" TO THE BOARD OF DIRECTORS OF EACH CORPORATION BEFORE THE FORM 990 WAS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE HOLY SPIRIT HOSPITAL BYLAWS HAVE A CONFLICT OF INTEREST PROVISION, SPECIFICALLY ARTICLE XII. ARTICLE XII IS APPLICABLE TO "ANY DIRECTOR, OFFICER, OR COMMITTEE MEMBER (TO INCLUDE ANY MEMBER OF HIS OR HER IMMEDIATE FAMILY)" AND DESCRIBES THE NATURE OF A CONFLICT OF INTEREST. IN ADDITION, THERE IS A PROVISION IN ARTICLE XII (SECTION 12.2.1) WHICH SETS FORTH THE METHODOLOGY TO DETERMINE WHETHER A DIRECTOR, OFFICER, OR COMMITTEE MEMBER HAS A CONFLICT OF INTEREST AND THE REQUIREMENTS PERTAINING TO REMOVAL OF THE DIRECTOR, OFFICER, OR COMMITTEE MEMBER WITH THE CONFLICT OF INTEREST FROM THE MEETING, IMPACT ON THE QUORUM, AND VOTING. SECTION 12.2 REQUIRES THAT IF A DIRECTOR, OFFICER, OR COMMITTEE MEMBER IS DETERMINED TO HAVE A CONFLICT OF INTEREST THAT THE INDIVIDUAL CANNOT BE PRESENT AT THE MEETING WHEN THE MATTER IS DISCUSSED OR VOTED UPON. ARTICLE XII ALSO REQUIRES THE BOARD OF DIRECTORS OF HOLY SPIRIT HEALTH SYSTEM TO ADOPT A CONFLICT OF INTEREST POLICY REQUIRING PERIODIC STATEMENTS (AT LEAST ANNUALLY) FROM DIRECTORS, OFFICERS, AND COMMITTEE MEMBERS TO DISCLOSE EXISTING AND POTENTIAL CONFLICTS OF INTEREST. IN ADDITION, THE BOARD IS REQUIRED TO TAKE CORRECTIVE AND DISCIPLINARY ACTION WITH RESPECT TO TRANSGRESSIONS OF THE CONFLICT OF INTEREST POLICY. EACH SUBSIDIARY CORPORATION HAS A COMPARABLE PROVISION IN ITS CURRENT BYLAWS. ALL DIRECTORS, OFFICERS, AND COMMITTEE MEMBERS ARE REQUIRED TO COMPLETE AN ANNUAL STATEMENT DISCLOSING EXISTING OR POTENTIAL CONFLICTS OF INTEREST. THIS ANNUAL DISCLOSURE REQUIREMENT HAS BEEN IN EFFECT FOR ALL CORPORATIONS FOR SEVERAL YEARS. THE HEALTH SYSTEM BOARD OF DIRECTORS ADOPTED A SEPARATE CONFLICT OF INTEREST POLICY ON MARCH 23, 2010. THAT CONFLICT OF INTEREST POLICY IS APPLICABLE TO ALL DIRECTORS, OFFICERS, KEY EMPLOYEES, AND COMMITTEE MEMBERS FOR HOLY SPIRIT HEALTH SYSTEM AND ALL SUBSIDIARY CORPORATIONS. THAT CONFLICT OF INTEREST POLICY ALSO HAS EXPANDED THE ANNUAL DISCLOSURE STATEMENT. IN ADDITION, THE CORPORATE COMPLIANCE PROGRAM FOR HOLY SPIRIT HEALTH SYSTEM PROVIDES A CONFLICT OF INTEREST POLICY WHICH IS SUBSTANTIALLY THE SAME AS THE ONE DESCRIBED ABOVE, EXCEPT THAT POLICY IS APPLICABLE TO ALL EMPLOYEES OF HOLY SPIRIT HEALTH SYSTEM AND ALL SUBSIDIARY CORPORATIONS. IT IS NOT APPLICABLE TO DIRECTORS, OFFICERS, OR COMMITTEE MEMBERS OF HOLY SPIRIT HEALTH SYSTEM OR ANY SUBSIDIARY CORPORATION. CONFLICT OF INTEREST STATEMENTS ARE SIGNED ANNUALLY BY THE BOARD OF DIRECTORS. IF ANY CONFLICT IS REPORTED, IT IS FORWARDED TO LEGAL COUNSEL FOR REVIEW AND OPINION. COMPLIANCE WITH THE POLICY IS MONITORED BY THE ADMINISTRATIVE ASSISTANT. FORM 990, PART VI, SECTION B, LINE 15 HOLY SPIRIT HEALTH SYSTEM RETAINED A CONSULTING FIRM TO REVIEW THE EXECUTIVE COMPENSATION PROGRAM. THE FIRM COLLECTED MARKET DATA FROM VARIOUS SOURCES. THE FIRM COMPARED HOLY SPIRIT HEALTH SYSTEM TO HOSPITALS SIMILAR IN SCOPE AND SCALE AND TRENDED THE DATA BASED ON THE FIRM'S US COMPENSATION PLANNING SURVEY. THE RESULTS AND RECOMMENDATIONS WERE PRESENTED TO THE BOARD. THE FOLLOWING POSITIONS THAT ARE ANALYZED ARE PRESIDENT, SENIOR VP MEDICAL AFFAIRS, SENIOR VP FINANCE, SENIOR VP AND CHIEF OPERATING OFFICER, SENIOR VP CORPORATE AFFAIRS, SENIOR VP OF HUMAN SERVICES, VP PATIENT CARE SERVICES, CHIEF INFORMATION OFFICER, VP RISK MANAGMENT AND SUPPORT SERVICES, VP/COO SPIRIT PHYSICIAN SERVICES, AND VP/COO WEST SHORE ADVANCED LIFE SUPPORT. THE REVIEW AND APPROVAL PROCESS IS DOCUMENTED IN THE MEETING MINUTES OF THE COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: TRANSFER FROM HOLY SPIRIT VENTURES 763,791. HOLY SPIRIT HOSPITAL 503 N 21ST STREET CAMP HILL PA 17011 231512747 HEALTHCARE PA 501(C)(3) 3 HOLY SPIRIT HEALTH SYSTEM 1 HOLY SPIRIT CORPORATION 503 N 21ST STREET CAMP HILL PA 17011 232214540 REAL ESTATE PA 501(C)(2) HOLY SPIRIT HEALTH SYSTEM 1 SPIRIT PHYSICIANS SERVICES INC 503 N 21ST STREET CAMP HILL PA 17011 251766971 HEALTHCARE PA 501(C)(3) 9 HOLY SPIRIT HEALTH SYSTEM 1 WEST SHORE ADVANCED LIFE SUPPORT SERVICES INC 503 N 21ST STREET CAMP HILL PA 17011 232463002 HEALTHCARE PA 501(C)(3) 7 HOLY SPIRIT HEALTH SYSTEM 1 SISTERS OF CHRISTIAN CHARITY HEALTH CARE CORPORATION MALLINCKRODT CONVENT MENDHAM NJ 07945 232322926 HEALTHCARE NJ 501(C)(3) 1 N/A 0 HOLY SPIRIT VENTURES INC NORTH 21ST STREET CAMP HILL PA 17011 232407709 MEDICAL SERVICES PA HOLY SPIRIT HEALTH SYSTEM C 5082595 7779505 1.00000 1 0 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 HOLY SPIRIT HOSPITAL C 15000000 CASH SPIRIT PHYSICIAN SERVICES INC B 15001572 CASH HOLY SPIRIT CORPORATION B 325000 CASH HOLY SPIRIT HOSPITAL B 305366 CASH