WARREN GENERAL HOSPITAL: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- WARREN GENERAL HOSPITAL (EIN 25-0965598)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-15
- IRS object ID
- 201401359349303130
- Schema version
- 2012v2.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-15T11:22:16-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 251249913 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MALIN BERGQUIST & COMPANY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2402 WEST 8TH STREET | AddressLine1 |
| City | ERIE | City |
| State | PA | State |
| ZIP Code | 165054428 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 250965598 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WARREN GENERAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | WARR | NameControl |
| Phone | 8147234973 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | TWO CRESCENT PARK WEST | AddressLine1 |
| City | WARREN | City |
| State | PA | State |
| ZIP Code | 16365 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JULIE JACOBS | Name |
| Title | DIRECTOR OF FISCAL SERVICES | Title |
| Phone | 8147234973 | Phone |
| Date Signed | 2014-05-12 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CRAIG C MOFFATT | Name |
| PTIN | P00077574 | PTIN |
| Phone | 8144544008 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JOHN P PAPALIA CEO | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | TWO CRESCENT PARK WEST | AddressLine1 |
| City | WARREN | City |
| State | PA | State |
| ZIP Code | 16365 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 78101721 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.WGH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1898 | YearFormation |
| State Legal Domicile | PA | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE HEALTHCARE SERVICES TO THE PUBLIC INCLUDING INPATIENT ACUTE CARE, PSYCHIATRIC CARE, 24-HR. EMERGENCY CARE, AND OTHER OUTPATIENT SERVICES TO WARREN AND SURROUNDING COUNTIES. WE PROVIDE HEALTH-RELATED CARE TO THE COMMUNITY, REGARDLESS OF THE ABILITY TO PAY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 724 | TotalNbrEmployees |
| Total Nbr Volunteers | 171 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 2643369 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 257141 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 69748819 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 68763579 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 587675 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1873695 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1257907 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1353094 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 74237770 | TotalRevenuePriorYear |
| Total Revenue Current Year | 72247509 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 32715353 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 35151068 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 175599 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 39690025 | OtherExpensePriorYear |
| Other Expenses Current Year | 42599828 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 72405378 | TotalExpensesPriorYear |
| Total Expenses Current Year | 77750896 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1832392 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -5503387 | RevenuesLessExpensesCY |
| Total Assets BOY | 60870418 | TotalAssetsBOY |
| Total Assets EOY | 55524241 | TotalAssetsEOY |
| Total Liabilities BOY | 27028923 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 22301245 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 33841495 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 33222996 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | WARREN GENERAL HOSPITAL'S MISSION IS TO PROVIDE COMMUNITY HEALTHCARE WITH QUALITY AND COMPASSION. WE STRIVE TO IMPROVE THE COMMUNITY'S HEALTH, LEAD A VISION FOR THE HEALTHCARE FUTURE AND MAINTAIN FISCAL VIABILITY WHILE PROVIDING CORE HEALTHCARE SERVICES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 62169225 | Expense |
| Revenue | 69253092 | Revenue |
| Description | WARREN GENERAL HOSPITAL PROVIDES HEALTHCARE SERVICES TO THE PUBLIC. THESE HEALTHCARE SERVICES INCLUDE:INPATIENT ACUTE AND PSYCHIATRIC CARE, SKILLED NURSING, 24-HOUR EMERGENCY CARE, OUTPATIENT HOMECARE AND OTHER OUTPATIENT SERVICES FOR RESIDENTS OF WARREN COUNTY, PA AND THE SURROUNDING AREAS. THE HOSPITAL ALSO OPERATES TWO OUTPATIENT DENTAL CLINICS FOR THOSE UNDERINSURED/UNINSURED RESIDENTS IN NEED OF DENTAL SERVICES.AS PART OF ITS COMMITMENT TO THE COMMUNITY, THE HOSPITAL PROVIDES CARE TO INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. A CHARITY CARE PROGRAM IS UTILIZED FOR THOSE WHO HAVE NEED FOR HEALTHCARE SERVICES BUT LIMITED RESOURCES FOR PAYMENT. THIS PROGRAM PROVIDES RELIEF FROM PAYMENT UP TO 100% FOR THOSE WHO MEET THE QUALIFICATIONS, DESPITE COST. IN ADDITION, THE HOSPITAL PROVIDES CARE TO PATIENTS WHO QUALIFY FOR MEDICAID, EVEN THOUGH THE COST OF PROVIDING THOSE SERVICES EXCEED THE PROGRAM'S REIMBURSEMENTS.THE HOSPITAL ALSO PROVIDES FREE SCREENINGS (IN COLLABORATION WITH LOCAL SERVICE ORGANIZATIONS) FOR CANCER, DIABETES, HEART DISEASE, VASCULAR DISEASE, AND OSTEOPOROSIS. IN ADDITION, RURAL COMMUNITY HEALTH FAIRS ARE SPONSORED, PROVIDING DIAGNOSTIC TESTING AND HEALTHCARE EDUCATION TO PARTICIPANTS. VARIOUS COMMUNITY SERVICE ORGANIZATIONS UTILIZE THE HOSPITAL'S RESOURCES, BOTH SPACE AND STAFF, TO SEND A MESSAGE OR SUPPORT A PROGRAM THAT COINCIDES WITH THE HOSPITAL'S MISSION. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 118193 | Expense |
| Revenue | 119101 | Revenue |
| Description | WARREN GENERAL HOSPITAL AUXILIARY PROVIDES SUPPORT TO THE HOSPITAL'S ACTIVITIES THROUGH VOLUNTEER AND FUNDRAISING ACTIVITIES. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 62287418 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 1 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 1 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 45 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 724 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JULIE JACOBS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8147233300 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | TWO CRESCENT PARK WEST | AddressLine1 |
| City | WARREN | City |
| State | PA | State |
| ZIP Code | 16365 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (19 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| TIMOTHY A HUBER | ||||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | |||
| VAN W JOHNSON MD | ||||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | |||
| JULIUS W BERTA MD | ||||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | |||
| CHRISTOPHER DARLING | ||||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | |||
| STEVE ROTHENBERG | ||||||||
| SECRETARY | 0.50 | X | 0 | 0 | 0 | X | ||
| TIMOTHY R BEVEVINO ESQ | ||||||||
| PRESIDENT | 0.50 | X | 0 | 0 | 0 | X | ||
| CARMEN N FERRANTO | ||||||||
| TREASURER | 0.50 | X | 0 | 0 | 0 | X | ||
| CHARLES E MACKENZIE MD | ||||||||
| IMMEDIATE PAST PRESIDENT | 0.50 | X | 5800 | 0 | 0 | X | ||
| JEFFREY F MORGAN MD | ||||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | |||
| KIMBERLY ANGOVE | ||||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | |||
| JOHN J SUTTON MD | ||||||||
| MEDICAL STAFF PRESIDENT | 0.50 | X | 224828 | 0 | 49139 | X | ||
| JOHN PAPALIA | ||||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | 492682 | 0 | 31688 | X | |||
| MURRAY S MARSH JR | ||||||||
| CHIEF FINANCIAL OFFICER | 40.00 | 152616 | 0 | 30659 | X | |||
| RANDY CALIFORNIA | ||||||||
| CHIEF OPERATING OFFICER | 40.00 | 212128 | 0 | 48144 | X | |||
| LEROY J KORB JR MD | ||||||||
| PHYSICIAN | 40.00 | 1042869 | 0 | 69891 | X | |||
| DAVID J THOMAS MD | ||||||||
| PHYSICIAN | 40.00 | 575543 | 0 | 36432 | X | |||
| OSAMA AL-OMAR MD | ||||||||
| PHYSICIAN | 40.00 | 544826 | 0 | 56432 | X | |||
| TREVOR M OLSEN MD | ||||||||
| PHYSICIAN | 40.00 | 564620 | 0 | 39291 | X | |||
| ANNE RASSIGA MD | ||||||||
| PHYSICIAN | 40.00 | 489635 | 0 | 25169 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 4305547 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 386845 | TotalOtherCompensation |
| Number Individuals GT100 K | 33 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| GROUP MEDICAL SERVICES INC | |||||
| PO BOX 68 | WARREN | PA | 16365 | HEALTHCARE SERVICES | 1056990 |
| KINGS MEDICAL COMPANY | |||||
| PO BOX 72517 | CLEVELAND | OH | 44192 | IMAGING SERVICES - MRI | 629416 |
| ASSOCIATED CLINICAL LABS | |||||
| 1526 PEACH STREET | ERIE | PA | 16501 | LABORATORY SERVICES | 359223 |
| LABCORP | |||||
| PO BOX 12140 | BURLINGTON | NC | 27216 | LABORATORY SERVICES | 324110 |
| DEERFIELD BEHAVIORAL HEALTH | |||||
| 2808 STATE STREET | ERIE | PA | 16508 | PSYCHIATRIC SERVICES | 320059 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 14 | NumberOfContractorsGT100K |
| Fundraising Events | 19731 | FundraisingEvents |
| Government Grants | 100000 | GovernmentGrants |
| All Other Contributions | 137410 | AllOtherContributions |
| Total Contributions | 257141 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| OUTPATIENT SERVICES | 621400 | 47173527 | 47173527 |
| INPATIENT SERVICES | 623990 | 19375745 | 19375745 |
| HOME HEALTH SERVICES | 621610 | 1757320 | 1757320 |
| HOSPITAL CAFETERIA | 900099 | 227835 | 227835 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 229152 | TotalRevenueColumn |
| Related Or Exempt Function Income | 229152 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 68763579 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 374035 | TotalRevenueColumn |
| Exclusion | $374,035 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 226371 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 226371 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 226371 | TotalRevenueColumn |
| Related Or Exempt Function Income | 226371 | RelatedOrExemptFunctionIncome |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 7323465 | Securities |
| Other | 3392 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 5758129 | Securities |
| Other | 69068 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1565336 | Securities |
| Other | -65676 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1499660 | TotalRevenueColumn |
| Exclusion | $1,499,660 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 58360 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 19731 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 27015 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 31345 | TotalRevenueColumn |
| Exclusion | $31,345 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Gaming | 704 | GrossIncomeGaming |
| Gaming Direct Expenses | 0 | GamingDirectExpenses |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 704 | TotalRevenueColumn |
| Exclusion | $704 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| ONCOLOGY SUBWORK | 900099 | 263142 | 263142 | |
| VANTAGE/DEERFIELD/CHART | 900099 | 224726 | $224,726 | |
| AUXILIARY/WINDOW BOX | 900099 | 119101 | 119101 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 487705 | TotalRevenueColumn |
| Exclusion | $487,705 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1094674 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 72247509 | TotalRevenueColumn |
| Related Or Exempt Function Income | 69372193 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $2,618,175 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1134538 | Total |
| Program Services | 224116 | ProgramServices |
| Management And General | 910422 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22928183 | Total |
| Program Services | 16101319 | ProgramServices |
| Management And General | 6760183 | ManagementAndGeneral |
| Fundraising | 66681 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3497836 | Total |
| Program Services | 2373119 | ProgramServices |
| Management And General | 1115024 | ManagementAndGeneral |
| Fundraising | 9693 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5479436 | Total |
| Program Services | 3717542 | ProgramServices |
| Management And General | 1746710 | ManagementAndGeneral |
| Fundraising | 15184 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2111075 | Total |
| Program Services | 1432266 | ProgramServices |
| Management And General | 672959 | ManagementAndGeneral |
| Fundraising | 5850 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 291792 | Total |
| Management And General | 291792 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 97371 | Total |
| Management And General | 97371 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16662997 | Total |
| Program Services | 15755643 | ProgramServices |
| Management And General | 907354 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1051711 | Total |
| Program Services | 444833 | ProgramServices |
| Management And General | 538861 | ManagementAndGeneral |
| Fundraising | 68017 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3201859 | Total |
| Program Services | 2680548 | ProgramServices |
| Management And General | 521311 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 468798 | Total |
| Program Services | 189053 | ProgramServices |
| Management And General | 277715 | ManagementAndGeneral |
| Fundraising | 2030 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 193256 | Total |
| Program Services | 193256 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2717469 | Total |
| Program Services | 2717469 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 774010 | Total |
| Program Services | 774010 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| MEDICAL SUPPLIES | 10992114 | 10992114 | ||
| BAD DEBT EXPENSE | 3866454 | 3866454 | ||
| LICENSES AND FEES | 775358 | 56057 | 719271 | 30 |
| EQUIPMENT RENTALS AND L | 382882 | 381695 | 1187 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1123757 | Total |
| Program Services | 387924 | ProgramServices |
| Management And General | 727719 | ManagementAndGeneral |
| Fundraising | 8114 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 77750896 | Total |
| Program Services | 62287418 | ProgramServices |
| Management And General | 15287879 | ManagementAndGeneral |
| Fundraising | 175599 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1992646 | BOY |
| EOY | 551316 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1495758 | BOY |
| EOY | 689430 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7978647 | BOY |
| EOY | 8016805 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1380377 | BOY |
| EOY | 1441000 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 642749 | BOY |
| EOY | 618918 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 78106316 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 55200345 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22234365 | BOY |
| EOY | 22905971 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19563505 | BOY |
| EOY | 15981000 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5582371 | BOY |
| EOY | 5319801 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 60870418 | BOY |
| EOY | 55524241 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5191241 | BOY |
| EOY | 5189192 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 45749 | BOY |
| EOY | 26244 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6153183 | BOY |
| EOY | 5393591 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15638750 | BOY |
| EOY | 11692218 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27028923 | BOY |
| EOY | 22301245 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23893039 | BOY |
| EOY | 24116825 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5476994 | BOY |
| EOY | 4364315 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4471462 | BOY |
| EOY | 4741856 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33841495 | BOY |
| EOY | 33222996 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 60870418 | BOY |
| EOY | 55524241 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -5503387 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 426162 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 4458725 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Both | X | FinancialStatementBoth |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 9948456 | BeginningOfYearBalance |
| Contributions | 99909 | Contributions |
| Investment Earnings Or Losses | 959373 | InvestmentEarningsOrLosses |
| Other Expenditures | 1888832 | OtherExpenditures |
| Administrative Expenses | 12735 | AdministrativeExpenses |
| End Of Year Balance | 9106171 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 8391676 | BeginningOfYearBalance |
| Contributions | 2342897 | Contributions |
| Investment Earnings Or Losses | -195755 | InvestmentEarningsOrLosses |
| Other Expenditures | 577004 | OtherExpenditures |
| Administrative Expenses | 13358 | AdministrativeExpenses |
| End Of Year Balance | 9948456 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 7583914 | BeginningOfYearBalance |
| Contributions | 336153 | Contributions |
| Investment Earnings Or Losses | 1463868 | InvestmentEarningsOrLosses |
| Other Expenditures | 979694 | OtherExpenditures |
| Administrative Expenses | 12565 | AdministrativeExpenses |
| End Of Year Balance | 8391676 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 6796279 | BeginningOfYearBalance |
| Contributions | 533678 | Contributions |
| Investment Earnings Or Losses | 674527 | InvestmentEarningsOrLosses |
| Other Expenditures | 410039 | OtherExpenditures |
| Administrative Expenses | 10531 | AdministrativeExpenses |
| End Of Year Balance | 7583914 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 7135823 | BeginningOfYearBalance |
| Contributions | 979011 | Contributions |
| Investment Earnings Or Losses | -273177 | InvestmentEarningsOrLosses |
| Other Expenditures | 1035860 | OtherExpenditures |
| Administrative Expenses | 9518 | AdministrativeExpenses |
| End Of Year Balance | 6796279 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 0.52100 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.47900 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 1 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 503941 | OtherCostOrOtherBasis |
| Book Value | 503941 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 21605888 | OtherCostOrOtherBasis |
| Depreciation | 13480900 | Depreciation |
| Book Value | 8124988 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3288171 | OtherCostOrOtherBasis |
| Depreciation | 1231687 | Depreciation |
| Book Value | 2056484 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 50955170 | OtherCostOrOtherBasis |
| Depreciation | 40487758 | Depreciation |
| Book Value | 10467412 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1753146 | OtherCostOrOtherBasis |
| Book Value | 1753146 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 22905971 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| DUE FROM AFFILIATE | 11149 |
| OTHER ASSETS | 2996557 |
| OTHER INVESTMENTS - PARTNERSHIPS AND OTHER ENTITIES VALUED BY EQUITY METHOD | 2312095 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 5319801 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO THIRD PARTY PAYOR | $443,691 |
| ACCRUED POST RETIREMENT BENEFIT | $233,824 |
| ACCRUED PENSION COSTS | $10,593,286 |
| CAPITAL LEASE OBLIGATIONS | $421,417 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 11692218 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 77529190 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 426162 | NetUnrealizedGainsInvestments |
| Other Revenues | 4988116 | OtherRevenues |
| Revenue Not Rptd F990 | 5414278 | RevenueNotRptdF990 |
| Revenue Subtotal | 72114912 | RevenueSubtotal |
| Other Revenues Not Included | 132597 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 132597 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 72247509 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 78162094 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 529388 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 529388 | ExpensesNotRptdF990 |
| Expenses Subtotal | 77632706 | ExpensesSubtotal |
| Other Expenses Not Included | 118190 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 118190 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 77750896 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | THE TEMPORARILY RESTRICTED FUNDS HELD IN ENDOWMENT ARE RESTRICTED FOR HEALTH CARE SERVICES, THE HOSPITAL'S BUILDING AND EQUIPMENT, AND CONSTRUCTION FOR THE CANCER CENTER BUILDING AND EQUIPMENT. THE PERMANENTLY RESTRICTED FUNDS HELD IN ENDOWMENT ARE RESTRICTED TO SUPPORT THE HOSPITAL'S HEALTH CARE SERVICES. |
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X, LINE 2: | THE HOSPITAL IS A NOT-FOR-PROFIT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE HOSPITAL HAS EVALUATED ITS TAX POSITIONS AND ELECTIONS MADE FOR ALL OPEN TAX YEARS. ALL OPEN TAX YEARS ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. HOWEVER, THE HOSPITAL IS NOT CURRENTLY UNDER AUDIT. THE HOSPITAL HAS NOT BEEN SUBJECT TO ANY INCOME TAX PENALTIES OR INTEREST FOR THE YEARS ENDED JUNE 30, 2013 AND 2012. BASED ON THE EVALUATION OF THE HOSPITAL'S TAX POSITIONS AND ELECTIONS, MANAGEMENT BELIEVES THAT ALL TAX POSITIONS TAKEN AND THE TAX-EXEMPT STATUS OF THE HOSPITAL WOULD BE UPHELD UNDER AN EXAMINATION. THEREFORE, NO PROVISION FOR THE EFFECTS OF UNCERTAIN TAX POSITIONS OR THE REVOCATION OF THE HOSPITAL'S TAX-EXEMPT STATUS HAS BEEN RECORDED AS OF JUNE 30, 2013. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | PENSION RELATED CHANGES UNDER GAAP OTHER THAN NET PERIODIC COSTS 4,988,116. ROUNDING ADJUSTMENT BETWEEN FORM 990 AND AUDITED FINANCIAL STATEMENTS | |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | AUXILLIARY/WINDOW BOX INCOME 132,597. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | TRANSFERS TO AFFILIATE 402,987. POST RET. RELATED CHANGES UNDER GAAP OTHER THAN NET PERIODIC PENSION COSTS 126,401. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | AUXILIARY/WINDOW BOX EXPENSES 118,190. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | HOSPITAL BALL | NameOfEvent1 |
| Gross Receipts Event1 | 31001 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 19731 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 11270 | GrossRevenueEvent1 |
| Rent Facility Costs Event1 | 6049 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 5182 | FoodAndBeverageEvent1 |
| Entertainment Event1 | 3251 | EntertainmentEvent1 |
| Other Direct Expenses Event1 | 3725 | OtherDirectExpensesEvent1 |
| Name Of Event2 | GOLF OUTING | NameOfEvent2 |
| Gross Receipts Event2 | 47090 | GrossReceiptsEvent2 |
| Gross Revenue Event2 | 47090 | GrossRevenueEvent2 |
| Non Cash Prizes Event2 | 1242 | NonCashPrizesEvent2 |
| Food And Beverage Event2 | 6609 | FoodAndBeverageEvent2 |
| Other Direct Expenses Event2 | 957 | OtherDirectExpensesEvent2 |
| Gross Receipts Total | 78091 | GrossReceiptsTotal |
| Charitable Contributions Total | 19731 | CharitableContributionsTotal |
| Gross Revenue Total Events | 58360 | GrossRevenueTotalEvents |
| Non Cash Prizes Total Events | 1242 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 6049 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 11791 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 3251 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 4682 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 27015 | DirectExpenseSummaryEvents |
| Net Income Summary | 31345 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent200 D | X | Pcent200D |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 242871 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 242871 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00310 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2750536 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 2750536 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03540 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 85238 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 85238 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00110 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3078645 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 3078645 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03960 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 84506 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 84506 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00110 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 21001 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 21001 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1117508 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1117508 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01440 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 19279 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 19279 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1242294 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1242294 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01600 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4320939 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 4320939 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05560 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 10000 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 10000 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 299084 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 299084 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00380 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 309084 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 309084 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00390 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $1,617,336 | BadDebtExpenseAmount |
| Amount Attributable To | 161734 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 20023296 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 23691108 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -3667812 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV (3 entries)
| Description Ent Primary ActivityDescriptionEntPrimaryActivity | Organization Profit Or OwnershipOrganizationProfitOrOwnership | Officers Etc Profit Or OwnershipOfficersEtcProfitOrOwnership | Physicans Profit Or OwnershipPhysicansProfitOrOwnership |
|---|---|---|---|
| 1 PINEGROVE AMBULATORY SURGERY CENTER LLC | |||
| OUTPATIENT AMBULATORY SURGERY CENTER | 0.35000 | 0.11000 | 0.54000 |
| 2 MEDIPAR ASSOCIATES LP | |||
| REAL ESTATE FOR MEDICAL OFFICE BUILDING | 0.86000 | 0.00000 | 0.14000 |
| 3 SENIOR LIVING SERVICES | |||
| OUTPATIENT REHABILITATION CLINIC | 0.50000 | 0.00000 | 0.00000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WARREN GENERAL HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | TWO CRESCENT PARK WEST | AddressLine1 |
| City | WARREN | City |
| State | PA | State |
| ZIP Code | 16365 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WARREN GENERAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 1 | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Needs Assessment Conducted | 13 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 0 | OtherFacilities |
| CHNA Widely Available | 1 | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Other Method | X | OtherMethod |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Develop Community Plan | X | DevelopCommunityPlan |
| Participate Community Plan | X | ParticipateCommunityPlan |
| Include Operational Plans | X | IncludeOperationalPlans |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | 1 | AllNeedsAddressed |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 200.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Other Actions | X | PermitOtherActions |
| Collection Activities | 1 | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Other Actions Taken | X | OtherActionsTaken |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (17 entries)
| ExplanationExplanation | Return ReferenceReturnReference | IdentifierIdentifier |
|---|---|---|
| PART I, L7 COL(F): THE HOSPITAL CALCULATED AN OVERALL COST TO CHARGE RATIO USING TOTAL GROSS CHARGES AND TOTAL OPERATING COSTS LESS BAD DEBT EXPENSE.THE HOSPITAL THEN REDUCED ITS BAD DEBT TO COST. | ||
| THE HOSPITAL PROVIDES A DETAILED UNSPONSORED COMMUNITY BENEFITS FOOTNOTE IN ITS ANNUAL FINANCIAL STATEMENTS WHICH ARE AVAILABLE TO THE PUBLIC.THE NOTE DETAILS CHARITY CARE, UNPAID COST OF PUBLIC PROGRAMS, COMMUNITY HEALTH SERVICES, SUBSIDIZED HEALTH SERVICES AND COMMUNITY BUILDING ACTIVITIES. | SCHEDULE H, PART 1, LINE 6A | |
| PART II: THE HOSPITAL SPENT APPROXIMATELY $299,000 JUST ON THE DIRECT EXPENSES OF RECRUITING PHYSICIANS INTO OUR RURAL MARKET IN FISCAL YEAR 2013.THE DIRECT HEALTH BENEFITS AND INDIRECT ECONOMIC BENEFITS OF OUR EMPLOYMENT AND SPENDING ARE SUBSTANTIAL. OUR TRADE ASSOCIATION ESTIMATES THAT THE ECONOMIC IMPACT (DIRECT SPENDING OF THE HOSPITAL PLUS INDIRECT BENEFITS ON OUR COMMUNITY) IS OVER $100 MILLION DOLLARS. | ||
| PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE ARE REPORTED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THEY ARE DETERMINED TO BE UNCOLLECTIBLE BASED UPON MANAGEMENT'S ASSESSMENT OF INDIVIDUAL ACCOUNTS. THE ALLOWANCE FOR DOUBTFUL COLLECTIONS IS ESTIMATED BASED UPON A PERIODIC REVIEW OF THE ACCOUNTS RECEIVABLE AGING, PAYOR CLASSIFICATIONS, AND APPLICATION OF HISTORICAL WRITE-OFF PERCENTAGES. | ||
| PART III, LINE 8: THE HOSPITAL'S LARGEST GOVERNMENT PAYER IS THE FEDERAL MEDICARE PROGRAM. THE HOSPITAL'S COSTS ARE GREATER THAN PROGRAM REIMBURSEMENTS. IT IS CLEARLY A COMMUNITY BENEFIT FOR THE HOSPITAL TO PROVIDE RURAL ACCESS TO MEDICAID BENEFICIARIES IN TERMS OF TIME, DISTANCES, AND WEATHER CONDITION ISSUES.BY PROVIDING MEDICARE SERVICES WHEN PAYMENTS ARE LESS THAN COST IS OF GREAT COMMUNITY BENEFIT. | ||
| PART III, LINE 9B: THE HOSPITAL EMPLOYS MANY METHODS TO IDENTIFY THOSE WHO QUALIFY FOR CHARITY CARE OR DISCOUNTED CARE. THE HOSPITAL ALSO EMPLOYS A FULL TIME COUNSELOR WHO ASSISTS FAMILIES WITH CHARITY CARE, MEDICAID APPLICANTS, AND ADVOCACY. | ||
| PART V, SECTION B, LINE 3: DEMOGRAPHIC INFORMATION, SECONDARY DATA STATISTICS AND RESULTS OF A PHYSICIAN SURVEY WERE PROVIDED TO THE GROUP IN THE FORM OF A POWERPOINT PRESENTATION. THE GROUP WAS ASKED TO PROVIDE THEIR OPINION ON THE NUMBER CONCERN THE WARREN COUNTY POPULATION IS FACING PRE AND POST PRESENTATION. THE PERSONS THE HOSPITAL CONSULTED WITH ARE AS FOLLOWS:NUTRITION EDUCATION ADVISOR FROM PENN STATE NUTRITION LINK - CAROL WILCOXWGH ALCOHOL/DRUG COUNSELOR - JESSICA UBERSENIOR INCOME DEVELOPMENT REP FROM AMERICAN CANCER SOCIETY/WARREN COUNTY - MARIE COSTELLOEXECUTIVE DIRECTOR FROM WARREN COUNTY HOUSING AUTHORITY - TONYA MITCHELL-WESTONRNC FROM PA DEPT. OF HEALTH/WARREN COUNTY - BARBARA WHITEEXECUTIVE DIRECTOR OF EXPERIENCE INC./AREA AGENCY ON AGENCY - FARLEY WRIGHTWARREN COUNTY SHERIFF - WILLIAM GARDNERPOLICE LIEUTENANT FROM WARREN POLICE DEPARTMENT - JAMES JORDANWGH DIRECTOR OF MARKETING AND DEVELOPMENT - GEORGE LILJAPSYCHIATRIST FROM DEERFIELD BEHAVIORAL HEALTH - MARK BEUGER, MDVP OF PROGRAM EVALUATION FROM BEACON LIGHT BEHAVIORAL HEALTH - BECKY JENSENWGH DIABETES EDUCATOR - NANCY MAGUEADMINISTRATOR OF THE ROUSE HOME - CINDY WALTERSSUPERINTENDENT OF WARREN COUNTY SCHOOL DISTRICT - BRANDON HUFFNAGELOFFICE MANAGER AND PROGRAM DEVELOPMENT SPECIALIST AT DEERFIELD BEHAVIORAL HEALTH - SUSAN TECONCHUKWGH DIRECTOR OF PATIENT & PUBLIC RELATIONS - HOLLI SUMMERVILLECOO OF WARREN MEDICAL GROUP - KAREN COOMBSEXECUTIVE DIRECTOR OF THE WARREN COUNTY YMCA - THAD TURNER | WARREN GENERAL HOSPITAL | |
| PART V, SECTION B, LINE 5C: INFORMATION ON HOW TO ACCESS THE CHNA WAS PUBLISHED IN THE WGH QUARTERLY NEWSLETTER. | WARREN GENERAL HOSPITAL | |
| PART V, SECTION B, LINE 14G: THE HOSPITAL EMPLOYS A FINANCIAL COUNSELOR WHO SPEAKS WITH ELIGIBLE INDIVIDUALS REGARDING OUR FINANCIAL ASSISTANCE POLICY | WARREN GENERAL HOSPITAL | |
| PART V, SECTION B, LINE 16E: THE HOSPITAL CONTRACTS WITH A RECEIVABLES MANAGEMENT COMPANY TO HANDLE OUR SELF-PAY ACCOUNTS RECEIVABLE FROM DAY 1 TO DAY 120. AFTER DAY 120 THE ACTIONS ARE SENT TO A COLLECTIONS AGENCY WHO AT THAT TIME REPORTS THE INDIVIDUAL(S) TO A CREDIT AGENCY. | WARREN GENERAL HOSPITAL | |
| PART V, SECTION B, LINE 18E: THE HOSPITAL EMPLOYS A FINANCIAL COUNSELOR WHO SPEAKS WITH ELIGIBLE INDIVIDUALS REGARDING OUR FINANCIAL ASSISTANCE POLICY. SHE ASSISTS INDIVIDUALS IN APPLYING FOR OUR STATE MEDICAL ASSISTANCE PROGRAM. | WARREN GENERAL HOSPITAL | |
| PART V, SECTION B, LINE 20D: SELF-PAY CHARGES ARE SET AT 50% OF GROSS CHARGES, WHICH REPRESENTS AN AVERAGE OF OUR COMMERCIAL INSURANCE REIMBURSEMENT. | WARREN GENERAL HOSPITAL | |
| PART VI, LINE 2: THE HOSPITAL CONDUCTS ANNUAL STRATEGIC PLANNING WITH A FOCUS ON COMMUNITY HEALTH NEEDS. THE HOSPITAL USES METRICS SUCH AS "HEALTHY PEOPLE" AND PLANS SERVICES NEEDS ACCORDINGLY. THIS PROCESS IS INTERACTIVE AND HAS RESULTED IN EXPANSION OF PRIMARY DENTAL SERVICES IN 2010 AS ONE EXAMPLE.WE ALSO DRIVE OUR DOCTOR RECRUITING PLAN FROM THIS PROCESS. | ||
| PART VI, LINE 3: THE HOSPITAL ADVERTISES ITS PROGRAMS IN LOCAL NEWSPAPERS. WE ALSO HAVE BROCHURES AVAILABLE AT OUR SERVICE LOCATIONS AND EMPLOYED DOCTORS' OFFICES.OUR INTAKE STAFF IS AWARE OF THESE PROGRAMS AND MAKE PATIENTS AWARE OF OUR COUNSELOR AS WELL. THIS FULL TIME EMPLOYEE HELPS IDENTIFY AND ASSIST PATIENTS WITH CHARITY CARE, DISCOUNTED CARE, MEDICAL ASSISTANCE APPLICATIONS AND ADVOCACY. | ||
| PART VI, LINE 4: WARREN COUNTY HAS A POPULATION OF APPROXIMATELY 40,000. THE COUNTY IS A LARGE GEOGRAPHIC SIZE WITH MANY RURAL AND SMALL COMMUNITIES. WARREN COUNTY RANKS 13TH OF 67 COUNTIES IN PENNSYLVANIA IN TERMS OF OVERALL HEALTH OUTCOMES.WARREN COUNTY RANKS 48TH OF 67 COUNTIES IN PENNSYLVANIA IN TERMS OF HEALTH FACTORS17.5% OF THE POPULATION IS +65 - STATE AVERAGE 15.2%27% OF THE ADULT POPULATION SMOKES - STATE AVERAGE 23%28% OF THE ADULT POPULATION IS OBESE - STATE AVERAGE 28%16% OF THE POPULATION IS IN POOR HEALTH - STATE AVERAGE 14%12% OF THE ADULT POPULATION IS UNINSURED - STATE AVERAGE 12% | ||
| PART VI, LINE 5: WE HAVE AN OPEN MEDICAL STAFF, A DIVERSE COMMUNITY BOARD AND ALL OF OUR SURPLUS IS USED TO SUSTAIN AND REINVEST IN OUR ASSOCIATES AND PLANT AND FUND BALANCE TO ASSURE LONG TERM VIABILITY AND ACCESS IN OUR COMMUNITY. | ||
| PART VI, LINE 6: N/A |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | X | TravelForCompanions |
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 1 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 1 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOHN J SUTTON MD | ||||||||||||||
| MEDICAL STAFF PRESIDENT | 206063 | 0 | 18765 | 0 | 0 | 0 | 32076 | 0 | 17063 | 0 | 273967 | 0 | 0 | 0 |
| JOHN PAPALIA | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | 388315 | 0 | 83897 | 0 | 20470 | 0 | 14625 | 0 | 17063 | 0 | 524370 | 0 | 0 | 0 |
| MURRAY S MARSH JR | ||||||||||||||
| CHIEF FINANCIAL OFFICER | 138209 | 0 | 2300 | 0 | 12107 | 0 | 19094 | 0 | 11565 | 0 | 183275 | 0 | 0 | 0 |
| RANDY CALIFORNIA | ||||||||||||||
| CHIEF OPERATING OFFICER | 203061 | 0 | 7727 | 0 | 1340 | 0 | 31081 | 0 | 17063 | 0 | 260272 | 0 | 0 | 0 |
| LEROY J KORB JR MD | ||||||||||||||
| PHYSICIAN | 405573 | 0 | 617974 | 0 | 19322 | 0 | 52828 | 0 | 17063 | 0 | 1112760 | 0 | 0 | 0 |
| DAVID J THOMAS MD | ||||||||||||||
| PHYSICIAN | 378776 | 0 | 161366 | 0 | 35401 | 0 | 19369 | 0 | 17063 | 0 | 611975 | 0 | 0 | 0 |
| OSAMA AL-OMAR MD | ||||||||||||||
| PHYSICIAN | 544826 | 0 | 0 | 0 | 0 | 0 | 39369 | 0 | 17063 | 0 | 601258 | 0 | 0 | 0 |
| TREVOR M OLSEN MD | ||||||||||||||
| PHYSICIAN | 547620 | 0 | 0 | 0 | 17000 | 0 | 22228 | 0 | 17063 | 0 | 603911 | 0 | 0 | 0 |
| ANNE RASSIGA MD | ||||||||||||||
| PHYSICIAN | 349745 | 0 | 0 | 0 | 139890 | 0 | 19369 | 0 | 5800 | 0 | 514804 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 1A | SPOUSAL TRAVEL AND SOCIAL CLUB DUES ARE PAID FOR THE CHIEF EXECUTIVE OFFICER. |
| PART I, LINE 4B | SIX EMPLOYEES LISTED ABOVE ARE PARTICIPANTS OF ACTIVE 457(F) PLANS: MURRAY MARSH: $7,273 RANDY CALIFORNIA: $14,546 LEROY KORB, JR, MD: $33,333 OSAMA AL-OMAR, MD: $20,000 JOHN SUTTON, MD: $15,000 TREVOR OLSEN, MD: $8,036 |
| PART I, LINE 5 | THE HOSPITAL HAS AN EMPLOYMENT CONTRACT WITH DR. KORB THAT PAYS A BASE SALARY AND ALSO AN INCENTIVE BASED ON COLLECTED REVENUES. IN ADDITION, DR. THOMAS, DR. MALJOVEC, DR. AHMED, DR. ENDRES AND DR. SUTTON RECEIVED AN INCENTIVE PAYMENT DURING THE CALENDAR YEAR ENDED DECEMBER 31, 2012 BASED UPON EXCEEDING THEIR SET RVU LEVELS. |
| PART I, LINE 6 | THE HOSPITAL USES A PAY FOR PERFORMANCE SYSTEM BALANCED SCORECARD FOR INCENTIVE COMPENSATION FOR SOME OF ITS MANAGERS. NET EARNINGS REPRESENTS ONLY ONE COMPONENT OF THE FORMULA WHICH ALSO HAS PATIENT SATISFACTION, CLINICAL QUALITY AND PATIENT SAFETY MEASURES. |
Schedule L IRS990ScheduleL
Loan Table LoanTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | JOHN PAPALIA | NamePerson |
| Loan From Organization | X | LoanFromOrganization |
| Original Principal | $100,000 | OriginalPrincipalAmount |
| Balance Due | 11535 | BalanceDue |
| Default | 0 | Default |
| Approved By Board | 1 | ApprovedByBoard |
| Written Agreement | 1 | WrittenAgreement |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 11535 | TotalBalanceDue |
Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| TIM BEVEVINO | |||
| BOARD PRESIDENT | 117403 | WIFE EMPLOYED BY WARREN GENERAL HOSPITAL | 0 |
| TIM BEVEVINO | |||
| BOARD PRESIDENT | 21052 | LEGAL SERVICES PAID TO HIS FIRM | 0 |
| NORTHWEST SAVINGS BANK | |||
| BOARD MEMBER AND EXECUTIVE VP OF BANK | 172870 | INTEREST EXPENSE PAID UPON LOANS THROUGH NORTHWEST SAVINGS BANK. | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (11 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | CARE CORPORATION OF WARREN IS THE SOLE CORPORATE MEMBER OF WARREN GENERAL HOSPITAL. | |
| FORM 990, PART VI, SECTION A, LINE 7A | CARE CORPORATION OF WARREN, THE PARENT COMPANY, APPOINTS THREE OF THE MEMBERS OF THE WARREN GENERAL HOSPITAL BOARD OF DIRECTORS. | |
| FORM 990, PART VI, SECTION A, LINE 7B | SPECIFIC DECISIONS OF THE BOARD OF DIRECTORS ARE SUBJECT TO APPROVAL BY THE BOARD OF DIRECTORS OF CARE CORPORATION OF WARREN, THE PARENT COMPANY OF WARREN GENERAL HOSPITAL. | |
| FORM 990, PART VI, SECTION B, LINE 11 | MANAGEMENT HAS INFORMED THE BOARD OF DIRECTORS THAT THE FORM 990 IS AVAILABLE IN THE ADMINISTRATIVE OFFICE FOR REVIEW BEFORE FILING. | |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH YEAR THE BOARD OF DIRECTORS ARE REQUIRED TO SIGN A CONFLICT OF INTEREST POLICY AND DISCLOSE ANY BUSINESS OR FAMILY RELATIONSHIPS WHICH MAY CREATE A CONFLICT. EACH BOARD OF DIRECTOR AGREES TO REFRAIN FROM VOTING ON ANY ITEM IN WHICH A CONFLICT MAY EXIST. ANNUALLY, THE CORPORATE COMPLIANCE OFFICER REVIEWS THE POLICY AND AUDITS THE SIGNATURES. | |
| FORM 990, PART VI, SECTION B, LINE 15 | THE HOSPITAL PARTICIPATES IN THE YAFFE AND COMPANY HOSPITAL ASSOCIATION OF PENNSYLVANIA COUNCIL OF SMALL HOSPITALS EXECUTIVE COMPENSATION SURVEY. THIS INSTRUMENT SURVEYS HOSPITALS OF LIKE SIZE AND WITHIN OUR GEOGRAPHY. THE HOSPITAL BOARD CHOSE THIS INSTRUMENT DUE TO ITS RELEVANCY TO THE HOSPITALS MARKET. THE SURVEY DATA IS USED BY THE HOSPITAL BOARD OF DIRECTORS COMPENSATION COMMITTEE FOR COMPARISONS OF COMPENSATION AND BENEFITS FOR THE CEO AND OTHER TOP MANAGEMENT OFFICIALS. THE COMPENSATION COMMITTEE REPORTS ITS FINDINGS AND MAKES RECOMMENDATIONS TO THE FULL BOARD OF DIRECTORS FOR THEIR REVIEW, DELIBERATION AND APPROVAL OR MODIFICATION. THE HOSPITAL BOARD OF DIRECTORS ALSO APPOINTED A COMMITTEE CALLED THE MANAGEMENT TRANSACTION AND AUDIT COMMITTEE TO REVIEW ALL TRANSACTIONS BETWEEN THE HOSPITAL AND PHYSICIANS. THIS BODY REVIEWS SEVERAL PHYSICIAN COMPENSATION SURVEYS (SUCH AS THE MEDICAL GROUP MANAGEMENT ASSOCIATION SURVEY AND THE MERRITT HAWKINS SURVEY) TO ESTABLISH COMPARISONS FOR PHYSICIAN COMPENSATION. | |
| FORM 990, PART VI, SECTION C, LINE 19 | EACH YEAR A COMBINED CORPORATE MEETING IS HELD IN WHICH THE PUBLIC IS WELCOME TO ATTEND. IN ADDITION, DOCUMENTS WILL BE MADE AVAILABLE TO THE PUBLIC IF THEY ARE REQUESTED IN PERSON OR IN WRITING. | |
| FORM 990, PART IX, LINE 11G | CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 61,421. MANAGEMENT AND GENERAL EXPENSES 93,500. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 154,921. PURCHASED LINEN SERVICES: PROGRAM SERVICE EXPENSES 216,671. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 216,671. PURCHASED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 3,212,694. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,212,694. COLLECTION AGENCY: PROGRAM SERVICE EXPENSES 239,393. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 239,393. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,962,140. MANAGEMENT AND GENERAL EXPENSES 831,641. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,793,781. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 9,063,324. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,063,324. INTER-ORG OFFSET: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES -17,787. FUNDRAISING EXPENSES 0. TOTAL EXPENSES -17,787. | OTHER FEES |
| FORM 990, PART XI, LINE 9: | TRANSFERS TO AFFILIATE -402,987. PENSION RELATED CHANGES UNDER GAAP OTHER THAN NET PERIODIC PENSION COSTS 4,988,116. POSTRETIREMENT RELATED CHANGES UNDER GAAP OTHER THAN NET PERIODIC COSTS -126,401. ROUNDING ADJUSTMENT BETWEEN AUDITED FINANCIAL STATEMENTS AND FORM 990 -3. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PAGE 11, PART XI | THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. | FINANCIAL STATEMENTS AND REPORTING |
| FORM 990, PART VI, SECTION B | THE HOSPITAL BOARD OF DIRECTORS MUST ULTIMATELY APPROVE ANY INVESTMENTS IN ANY JOINT VENTURE OR SIMILAR ARRANGEMENT. AS AN ADDITIONAL STEP, THE HOSPITAL BOARD OF DIRECTORS APPOINTED A COMMITTEE CALLED THE MANAGEMENT TRANSACTION & AUDIT COMMITTEE THAT REVIEWS ALL TRANSACTIONS BETWEEN THE HOSPITAL AND PHYSICIANS. AS PART OF ITS GOVERNANCE AND OVERSIGHT ROLE, THE FULL HOSPITAL BOARD ALSO SUBJECTS ANY JOINT VENTURE ARRANGEMENTS TO LEGAL REVIEW PRIOR TO ANY INVESTMENT BY THE HOSPITAL | WRITTEN POLICY OR PROCEDURES REGARDING PARTICIPATION IN JOINT VENTURE |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| CARE CORPORATION OF WARREN | |||||||||||
| 2 CRESCENT PARK WEST | WARREN | PA | 16365 | 251512016 | PARENT CORP. | PA | 501(C)(3) | 11 | N/A | 0 | |
| GENERAL CARE SERVICES INC | |||||||||||
| 2 CRESCENT PARK WEST | WARREN | PA | 16365 | 251512020 | HOSPICE SERVICES | PA | 501(C)(3) | 9 | 0 | CARE CORPORATION OF WARREN | |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GROUP MEDICAL SERVICES CORP | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2 CRESCENT PARK WEST | AddressLine1 |
| City | WARREN | City |
| State | PA | State |
| ZIP Code | 16365 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 232806359 | EIN |
| Primary Activity | HEALTH CARE SERVICES | PrimaryActivity |
| Legal Domicile State | PA | LegalDomicileState |
| Type Of Entity | C | TypeOfEntity |
| Controlled Org | 0 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| WGH LENT OPERATIONAL FUNDS TO GROUP MEDICAL SERVICES DEBT WAS FORGIVEN | ||
| D | 402987 | ACTUAL CASH PAID |
| WGH SHARES FACILITIES WITH RELATED ORGANIZATIONS NO RENT IS PAID | ||
| N | N/A | |
| WGH LEASES STAFF FROM GROUP MEDICAL SERVICES | ||
| O | 1056185 | ACTUAL CASH PAID |
| PERFORMANCE OF SERVICES FOR GENERAL CARE SERVICES | ||
| L | 92367 | ACTUAL CASH PAID |
| GENERAL CARE SERVICES INC | ||
| Q | 61945 | ACTUAL CASH PAID |
| GENERAL CARE SERVICES INC | ||
| J | 1 | ACTUAL CASH PAID |