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MEMORIAL HOSPITAL: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
MEMORIAL HOSPITAL (EIN 23-1265004)
Tax period
2013-07-01 to 2014-06-30
Filed
2015-05-15
IRS object ID
201541359349301044
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

FieldValueIRS element (for citing)
Return2015-05-15T08:31:34-05:00ReturnTs
Tax Period End2014-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390859910PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BAKER TILLY VIRCHOW KRAUSE LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11650 MARKET STREET SUITE 4500AddressLine1
CityPHILADELPHIACity
StatePAState
ZIP Code19103ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN231265004EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MEMORIAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlMEMOBusinessNameControlTxt
Phone7178438623PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1325 SOUTH BELMONT STREETAddressLine1
CityYORKCity
StatePAState
ZIP Code17403ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSALLY J DIXONPersonNm
Person TitlePRESIDENT/CEOPersonTitleTxt
Phone7178438623PhoneNum
Signature2015-05-14SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJULIUS C GREEN CPA JDPreparerPersonNm
PTINP00350393PTIN
Phone2159720701PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-04-25 22:37:26ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJACK KAYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1325 SOUTH BELMONT STREETAddressLine1
CityYORKCity
StatePAState
ZIP Code17403ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$108,568GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MHYORK.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1945FormationYr
Legal Domicile StatePALegalDomicileStateCd
Activity Or MissionMEDICAL SERVICES: INPATIENT, OUTPATIENT (EMERGENCY, CLINIC, AND OCCUPATIONAL MED), HOME HEALTH.ActivityOrMissionDesc
Voting Members Governing Body6VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers6TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$926,145PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$108,568CYOtherRevenueAmt
PY Total Revenue$926,145PYTotalRevenueAmt
CY Total Revenue$108,568CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$72,561PYOtherExpensesAmt
CY Other Expenses$0CYOtherExpensesAmt
PY Total Expenses$72,561PYTotalExpensesAmt
CY Total Expenses$0CYTotalExpensesAmt
PY Revenues Less Expenses$853,584PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$108,568CYRevenuesLessExpensesAmt
Total Assets BOY$19,046,416TotalAssetsBOYAmt
Total Assets EOY$16,748,017TotalAssetsEOYAmt
Total Liabilities BOY$225,205TotalLiabilitiesBOYAmt
Total Liabilities EOY$116,636TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$18,821,211NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$16,631,381NetAssetsOrFundBalancesEOYAmt
MissionMEMORIAL HOSPITAL IS COMMITTED TO PROMOTING, IMPROVING, AND ENHANCING THE HEALTH AND WELL-BEING OF THE COMMUNITY WE SERVE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
DescMEMORIAL HEALTH SYSTEMS CORPORATION, PARENT COMPANY OF MEMORIAL HOSPITAL, ENTERED INTO AN ASSET PURCHASE AGREEMENT DATED JANUARY 24, 2012 WITH COMMUNITY HEALTH SYSTEMS, INC. TO SELL SUBSTANTIALLY ALL OF THE ASSETS OF THE SYSTEM. THE SALE CLOSED ON JULY 1, 2012. THE HOSPITAL TERMINATED ITS BUSINESS ACTIVITIES ON THAT DATE AND IS IN THE PROCESS OF DISSOLVING THE ENTITY. UPON DISSOLUTION, ANY ASSETS REMAINING WILL BE TRANSFERRED TO THE MEMORIAL HEALTH SYSTEMS CORPORATION ("MHSC"). MHSC WILL REMAIN ACTIVE IN THE YORK COMMUNITY PROVIDING FUNDS TO SUPPORT THE HEALTHCARE NEEDS OF THE COMMUNITY.Desc
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members6GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldPAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SALLY J DIXONBusinessNameLine1
FieldValueIRS element (for citing)
Phone7178438623PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1325 SOUTH BELMONT STREETAddressLine1
CityYORKCity
StatePAState
ZIP Code17403ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (6 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
JACK KAY
CHAIRMAN0.502.00Yes (X)Yes (X)$0$0$0
RICHARD D POOLE
VICE CHAIRMAN0.502.00Yes (X)Yes (X)$0$0$0
CHLOE R EICHELBERGER
TREASURER0.502.00Yes (X)Yes (X)$0$0$0
TERRY N YORK DO
DIRECTOR0.502.00Yes (X)$0$0$0
SALLY J DIXON
PRESIDENT/CEO0.502.00Yes (X)Yes (X)$0$0$0
RANDALL GROSS
DIRECTOR0.50Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescCOST REPORT SETTLEMENTDesc
Business900099BusinessCd
Total Revenue Column$108,568TotalRevenueColumnAmt
Exclusion$108,568ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$108,568OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$108,568TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$108,568ExclusionAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$16,696,820BOYAmt
EOY$16,696,820EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$2,318,596BOYAmt
EOY$20,197EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$31,000BOYAmt
EOY$31,000EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$19,046,416BOYAmt
EOY$16,748,017EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$225,205BOYAmt
EOY$116,636EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$225,205BOYAmt
EOY$116,636EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$18,231,858BOYAmt
EOY$16,392,736EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$161,822BOYAmt
EOY$161,822EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$427,531BOYAmt
EOY$76,823EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$18,821,211BOYAmt
EOY$16,631,381EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$19,046,416BOYAmt
EOY$16,748,017EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$108,568ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$2,298,398OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS Audited0FSAuditedInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
DEFERRED COMPENSATION$20,197
ESTIMATED THIRD PARTY PAYOR SETTLEMENTS$96,439
FieldValueIRS element (for citing)
Total Liability$116,636TotalLiabilityAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11THE ACCOUNTING DEPARTMENT PROVIDES INFORMATION TO THE INDEPENDENT ACCOUNTANT FOR PREPARATION OF THE FORM 990. THE DRAFT IS REVIEWED BY THE CEO.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION USES AN ANNUAL QUESTIONNAIRE TO DETERMINE IF THE MEMBERS OF THE BOARD ARE INDEPENDENT. ANNUAL QUESTIONNAIRES FOR THE BOARD/SENIOR MANAGEMENT ARE COLLECTED BY THE CEO AND ARE REVIEWED BY THE CEO AND THE BOARD CHAIRPERSON. AT THE BOARD LEVEL, ANY POTENTIAL CONFLICT IS MONITORED BY THE CEO AND CHAIR, AND BOARD MEMBERS WILL REFRAIN FROM VOTING ON CONFLICT/RELATED ISSUES. IN ADDITION TO THE REPORTING REQUIRED, KEY EMPLOYEES AND SENIOR MANAGEMENT ARE MONITORED BY THE CEO THROUGH THE PURCHASING AND CASH DISTRIBUTIONS CONTROLS IN PLACE.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9:TRANSFER OF PERMANENTLY RESTRICTED NET ASSETS TO AFFILIATE -350,708. TRANSFER OF INVESTMENTS TO AFFILIATE -1,947,690.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
SURGICAL CENTER OF YORK
1750 FIFTH AVENUEYORKPA17403232507740OUT PATIENT SURGERY CENTERPA501(C)33MEMORIAL HEALTH SYSTEMS CORPORATION0
MEMORIAL HEALTH SYSTEMS CORPORATION
1708 FIFTH AVENUEYORKPA17403222546051SUPPORT AND DEVELOPMENT OF PROGRAMS FOR THE BENEFIT OF RELATED PARTIESPA501(C)311 TYPE I0N/A
MHS TITLE HOLDING CORP
325 SOUTH BELMONT STREETYORKPA17403222546052REAL PROPERTY MANAGEMENT FOR RELATED ENTITIESPA501(C)311 TYPE IMEMORIAL HEALTH SYSTEMS CORPORATION0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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