2014-05-15T11:29:30-05:00 2013-06-30 232932984 PARENTEBEARD LLC 1650 MARKET STREET SUITE 4500 PHILADELPHIA PA 19103 990 2012-07-01 232215800 THE GOOD SHEPHERD HOME LONG-TERM CARE FACILITY INC GOOD 6107763228 GOOD SHEPHERD PLAZA 850 S 5TH ST ALLENTOWN PA 181033295 RONALD J PETULA 6107763228 2014-05-15 1 JULIUS C GREEN CPA JD P00350393 2159720701 2012 2015-11-30 17:44:51Z RONALD J PETULA GOOD SHEPHERD PLAZA 850 S 5TH ST ALLENTOWN PA 181033295 21525195 0 X WWW.GOODSHEPHERDREHAB.ORG X 1982 PA TO ENHANCE LIVES, MAXIMIZE FUNCTION, INSPIRE HOPE, AND PROMOTE DIGNITY AND WELL-BEING. 18 13 0 206 0 0 360426 399537 21102248 21125658 -12280 0 11153 0 21461547 21525195 0 0 0 0 11747806 12366927 0 0 0 8993069 8911175 20740875 21278102 720672 247093 42287529 42548444 688529 702351 41599000 41846093 X GOOD SHEPHERD'S MISSION IS: "MOTIVATED BY THE DIVINE GOOD SHEPHERD AND THE PHYSICAL AND COGNITIVE REHABILITATION NEEDS OF OUR COMMUNITIES, OUR MISSION IS TO ENHANCE LIVES, MAXIMIZE FUNCTION, INSPIRE HOPE, AND PROMOTE DIGNITY AND WELL-BEING WITH EXPERTISE AND COMPASSION." 0 0 19205869 21125658 THE GOOD SHEPHERD HOME AT THE CONRAD W. RAKER CENTER AND THE GOOD SHEPHERD HOME-BETHLEHEM ARE RESIDENCES WHERE PERSONS WITH PHYSICAL DISABILITIES REQUIRING NURSING FACILITY CARE CAN COME TO LIVE AND REALIZE THEIR FULLEST POTENTIAL. SERVICES PROVIDED INCLUDE NURSING AND MEDICAL SERVICES, OCCUPATIONAL THERAPY, COMMUNICATION SERVICES, PASTORAL CARE, SOCIAL WORK SERVICES, THERAPEUTIC RECREATION, PHYSICAL THERAPY, ADAPTIVE WHEELCHAIR, MOBILITY AND SEATING PROGRAMS. MANY OF THE RESIDENTS UTILIZE GOOD SHEPHERD'S ASSISTIVE TECHNOLOGY PROGRAM TO HELP WITH THEIR MOBILITY, COMMUNICATION AND EVERYDAY LIVING NEEDS. IN FISCAL YEAR 2013, THE RAKER CENTER OPERATED AT 99% OCCUPANCY, WITH 35,961 PATIENT DAYS, WHILE THE BETHLEHEM HOME OPERATED AT 99% OCCUPANCY, WITH 21,750 PATIENT DAYS. THERE IS A WAITING LIST FOR BOTH HOMES. 19205869 1 1 0 0 0 0 0 0 1 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 0 0 0 0 0 0 0 0 0 0 0 0 0 X 18 13 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X RONALD J PETULA VP FINANCE 6107763228 GOOD SHEPHERD PLAZA 850 SOUTH 5TH ALLENTOWN PA 18103 SCOTT A BAKER 0.30 1.00 X X 0 0 0 SANDRA L BODNYK 0.40 1.60 X X 0 0 0 PATRICK J BRENNAN MD 0.30 1.00 X 0 0 0 DAVID G DECAMPLI 0.70 2.60 X X 0 0 0 ALVARO DIAZ 0.30 1.00 X 0 0 0 ROBERT E GADOMSKI 0.30 1.00 X 0 0 0 SARA T GAMMON 6.00 54.00 X X 0 560936 173748 MICHAEL GOLDNER DO 0.20 0.60 X 0 0 0 F MARK GUMZ 0.30 1.00 X 0 0 0 ELSBETH G HAYMON 0.30 1.00 X 0 0 0 KATHERINE E HILGERT 0.20 0.60 X 0 0 0 SANDRA JARVA WEISS 0.20 0.60 X X 0 0 0 GERALD A NAU 0.20 0.60 X 0 0 0 EDITH D RITTER 0.20 0.60 X 0 0 0 KAREN SENFT 0.20 0.60 X 0 0 0 LAURE STEWART 0.30 1.00 X 0 0 0 THE REV DAVID R STROBEL 0.20 0.60 X 0 0 0 DANIEL J WILSON PHD 0.30 1.00 X 0 0 0 DANIEL C CONFALONE 4.00 56.00 X 0 345276 32960 SAMUEL A MIRANDA JR 5.00 55.00 X 0 212394 53302 ANTHONY R BONGIOVANNI 0.00 X 0 142921 8021 0 1261527 268031 0 1 1 0 SODEXHO OPERATIONS LLC 4880 PAYSPHERE CIRCLE CHICAGO IL 60674 DIETARY/FOOD SERVICES 546715 HT LYONS 7165 AMBASSADOR DRIVE ALLENTOWN PA 18106 CONTRACTING SERVICES 344340 MEDICAL STAFFING NETWORK INC PO BOX 202996 DALLAS TX 75320 TEMPORARY STAFFING SERVICES 156993 KUNSMAN ROOFING 203 WASHINGTON ST FREEMANSBURG PA 18017 CONTRACTING SERVICES 154850 4 399537 399537 NET PATIENT SVC REV 623000 21125658 21125658 21125658 21525195 21125658 0 0 9272168 8988308 283860 820655 795531 25124 1611635 1562296 49339 662469 641738 20731 462508 422827 39681 260431 253836 6595 3085 2225 860 11302 10471 831 1261657 1261657 CORPORATE ALLOCATION 5871237 4227291 1643946 MEDICAL SUPPLIES 732169 732026 143 FOOD 199612 198489 1123 BAD DEBT EXPENSE 82039 82039 27135 27135 21278102 19205869 2072233 0 1400 1400 3008409 3199030 4175 4926 24223917 15985801 8131047 8238116 31142498 31104972 42287529 42548444 544659 556176 143870 146175 688529 702351 X 41599000 41846093 41599000 41846093 42287529 42548444 247093 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 56370 56370 10097078 6483078 3614000 13454310 9207472 4246838 616159 295251 320908 8238116 RESIDENT FUNDS 146175 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 212907 AMOUNTS DUE FROM AFFILIATES 30745890 31104972 X 21443156 -82039 -82039 21525195 0 21525195 21196063 0 21196063 82039 82039 21278102 PART IV, LINE 2B: GOOD SHEPHERD ACTS AS CUSTODIAN OF FUNDS HELD FOR THE RESIDENTS LIVING IN THE FACILITIES. THE FUNDS ARE SET ASIDE IN A SEPARATE BANK ACCOUNT FROM THE GENERAL OPERATING FUNDS. RESIDENTS HAVE ACCESS TO THEIR FUNDS ON A DAILY BASIS AND RECEIVE MONTHLY STATEMENTS OF ACTIVITY. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: GOOD SHEPHERD PRESCRIBES A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY IN RECORDING TAX LIABILITIES IN THE FINANCIAL STATEMENTS. MEASUREMENT AND RECOGNITION OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. GOOD SHEPHERD'S POLICY IS TO RECOGNIZE INTEREST RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE AND PENALTIES IN OPERATING EXPENSES. GOOD SHEPHERD'S FEDERAL EXEMPT ORGANIZATION RETURNS OF INCOME TAX AND ITS BUSINESS INCOME TAX RETURNS FOR THE YEARS ENDED PRIOR TO JUNE 30, 2010 NO LONGER REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. PART XI, LINE 2D - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS NETTED ON F/S -82,039. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS NETTED ON F/S 82,039. X 1 1 1 1 0 0 0 0 0 1 0 SARA T GAMMON 0 560936 0 0 0 0 0 168861 0 4887 0 734684 0 0 DANIEL C CONFALONE 0 345276 0 0 0 0 0 20733 0 12227 0 378236 0 0 SAMUEL A MIRANDA JR 0 212394 0 0 0 0 0 41894 0 11408 0 265696 0 0 ANTHONY R BONGIOVANNI 0 0 0 0 0 142921 0 2704 0 5317 0 150942 0 0 PART I, LINE 1A GOOD SHEPHERD DOES NOT PAY ANY DUES ON BEHALF OF CEO, SARA GAMMON, DIRECTLY TO A SOCIAL CLUB. GOOD SHEPHERD REIMBURSES THE CEO FOR CERTAIN SOCIAL CLUB DUES RELEVANT IN PURSUING THE OVERALL MISSION OF GOOD SHEPHERD. THESE EXPENSES ARE ACCOUNTED FOR UNDER AN ACCOUNTABLE REIMBURSEMENT PLAN. THE AMOUNT OF THIS REIMBURSEMENT IS INCLUDED IN MS. GAMMON'S TAXABLE COMPENSATION. PART I, LINE 3 SARA T. GAMMON IS COMPENSATED BY GOOD SHEPHERD REHABILITATION NETWORK ("GSRN"), AN AFFILIATED TAX-EXEMPT ORGANIZATION. THE GOOD SHEPHERD HOME LONG-TERM CARE FACILITY, INC. RELIED ON GSRN'S USE OF ALL CRITERIA SPECIFIED IN LINE 3 TO ESTABLISH MS. GAMMON'S COMPENSATION. PART I, LINES 4A-B ANTHONY BONGIOVANNI IS THE FORMER CPO (KEY EMPLOYEE) OF THE GOOD SHEPHERD REHABILITATION NETWORK AND AFFILIATES. HE RECEIVED $149,921 FOR 31.5 WEEKS OF SEVERANCE PAY, BEGINNING JULY 1, 2012. GOOD SHEPHERD REHABILITATION NETWORK PROVIDES SUPPLEMENTAL EXECUTIVE RETIREMENT BENEFITS TO THE FOLLOWING EXECUTIVES: PRESIDENT/CEO SARA GAMMON AND CNO SAMUEL MIRANDA, JR. CONTRIBUTIONS TO THE PLAN ARE DETERMINED ANNUALLY. SARA GAMMON AND SAMUEL MIRANDA, JR. HAVE NOT RECEIVED ANY PAYMENTS FROM THE PLAN. PART I, LINE 7 GSRN HAS A PERFORMANCE COMPENSATION PROGRAM IN PLACE WHICH IS APPROVED BY THE BOARD. CERTAIN MEMBERS OF MANAGEMENT CAN RECEIVE AN ANNUAL PERFORMANCE PAYMENT ONLY WHEN PRE-DEFINED AND PRE-APPROVED FINANCIAL AND NON-FINANCIAL GOALS ARE ACHIEVED. FOR FISCAL YEAR 2013, A PERFORMANCE PAYMENT WAS NOT ACHIEVED. THIS IS NOT GUARANTEED EACH YEAR. FORM 990, PART V, LINE 1: ACCOUNTS PAYABLE PAYMENTS ARE CONSOLIDATED UNDER A COMMON REPORTING SYSTEM. SINCE TOTALS FOR EACH VENDOR MAY CONTAIN TRANSACTIONS FROM MULTIPLE CORPORATIONS, THE NUMBER OF 1099'S FILED ON BEHALF OF THE GOOD SHEPHERD HOME LONG-TERM CARE FACILITY, INC. ("LTC") BY THE COMMON REPORTING AGENT CANNOT BE SEPARATELY IDENTIFIED AND DETERMINED. FORM 990, PART V, LINE 2: THE SALARY AND BENEFIT EXPENSES REPORTED ON FORM 990, PART IX, AND THE EMPLOYEE INFORMATION REPORTED ON FORM 990, PART VII, ARE THE GOOD SHEPHERD HOME LONG-TERM CARE FACILITY, INC.'S ("LTC") ALLOCATED PAYROLL COSTS BASED ON TIME SPENT. ALL INDIVIDUALS WORKING AT LTC ARE EMPLOYEES OF THE GOOD SHEPHERD REHABILITATION HOSPITAL ("GSRH") AND ARE REPORTED ON ITS FORM W-3 UNDER EIN: 23-1371947. GSRH IS AN AFFILIATED TAX-EXEMPT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE CORPORATE MEMBER OF THE ORGANIZATION IS THE GOOD SHEPHERD REHABILITATION NETWORK ("GSRN"), A RELATED TAX-EXEMPT ENTITY. GSRN HAS THE ULTIMATE AUTHORITY AND RESPONSIBILITY FOR THE FOLLOWING ACTIVITIES WITH RESPECT TO THE GOOD SHEPHERD HOME LONG-TERM CARE FACILITY, INC.: AMENDMENT, APPROVAL OR REVOCATION OF BYLAWS; INSTITUTIONAL DEVELOPMENT; CORPORATE AND STRATEGIC PLANNING; FINANCIAL PLANNING AND BUDGETING; AUDIT AND FISCAL MATTERS; RESOURCE ALLOCATION; PUBLIC RELATIONS; APPOINTMENT OF TRUSTEES AND OFFICERS; COMPENSATION AND HUMAN RESOURCE POLICIES; MEDICAL STAFF AND GENERAL POLICY MATTERS. FORM 990, PART VI, SECTION A, LINE 7B SEE EXPLANATION FOR FORM 990, PART VI, SECTION A, LINE 7A. FORM 990, PART VI, SECTION B, LINE 11 THE IRS FORM 990 IS PREPARED USING INFORMATION SOLICITED FROM OFFICERS, DIRECTORS, TRUSTEES, BOARD COMMITTEE MEMBERS, AND MANAGEMENT. THIS GROUP OF INDIVIDUALS ARE PROVIDED A DRAFT RETURN BEFORE THE FINAL RETURN IS FILED. QUESTIONS, COMMENTS, AND ADDITIONAL INFORMATION PROVIDED BY THIS GROUP ARE INCORPORATED INTO THE FINAL RETURN. THE FINAL RETURN IS REVIEWED AT A COMMITTEE LEVEL OF THE BOARD PRIOR TO IT BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C THERE IS A SYSTEMATIC PROCESS COORDINATED THROUGH THE GOVERNANCE COMMITTEE WHERE THE CONFLICT OF INTEREST STATEMENTS COMPLETED ANNUALLY BY BOARD MEMBERS AND SENIOR LEADERSHIP TEAM MEMBERS ARE REVIEWED BY THE GOVERNANCE COMMITTEE. WHENEVER THE COMMITTEE FEELS THE CONFLICT STATEMENT IS EITHER INCOMPLETE OR FEELS SOMETHING MAY BE MISSING, THE COMMITTEE WILL ASK MANAGEMENT TO PURSUE FURTHER DUE DILIGENCE. WHEN A BOARD MEMBER DOES HAVE AN INHERENT CONFLICT, THE TRUSTEE IS ASKED TO EITHER ABSTAIN FROM VOTING OR EXCUSE HIMSELF FROM THE ROOM DURING THE DISCUSSION AND VOTING. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF TRUSTEES OF GOOD SHEPHERD REHABILITATION NETWORK (GSRN) DELEGATES RESPONSIBILITY FOR FOLLOWING ALL LEGAL AND REGULATORY REQUIREMENTS AFFECTING EXECUTIVE COMPENSATION TO THE HUMAN RESOURCES/COMPENSATION COMMITTEE OF THE BOARD (THE COMMITTEE). THE BOARD DELEGATES RESPONSIBILITY TO ENGAGE EXTERNAL RESOURCES AS NECESSARY TO THE COMMITTEE TO SUPPORT DELIBERATIONS AND DECISION MAKING RELATED TO EXECUTIVE COMPENSATION. THE COMMITTEE SELECTED AND UTILIZES AN INDEPENDENT COMPENSATION CONSULTANT, MERCER - A MARSH & MCCLENNAN COMPANY, (THE CONSULTANT) AS A RESOURCE TO ASSIST WITH DECISIONS RELATED TO EXECUTIVE COMPENSATION. IN ACCORDANCE WITH THE COMMITTEE'S ANNUAL WORK PLAN, THE CONSULTANT PRESENTED A TOTAL REMUNERATION REVIEW ON OCTOBER 30, 2013 DURING EXECUTIVE SESSION (NO EMPLOYED STAFF OF GSRN IN ATTENDANCE) OF A REGULARLY SCHEDULED COMMITTEE MEETING. THE TOTAL REMUNERATION REVIEW WAS DEVELOPED USING COMPETITIVE MARKET AND PEER GROUP DATA RELATED TO ALL ASPECTS OF COMPENSATION INCLUDING BUT NOT LIMITED TO BASE SALARY, INCENTIVES, BENEFITS AND PERQUISITES. ALL OF THE COMPENSATION MEETINGS ARE FORMALLY DOCUMENTED CONSISTENT WITH BEST GOVERNANCE PRACTICES. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS ARE PUBLISHED TO THE ORGANIZATION'S WEBSITE AT LEAST ANNUALLY. THE GOVERNING DOCUMENTS AND POLICIES ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 2C: THE PROCESSES USED BY THE COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT HAVE NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PART VI, LINE 1: THE EXECUTIVE COMMITTEE IS COMPRISED OF THE CHAIRS OF ALL THE BOARD COMMITTEES AS WELL AS THE CHAIR AND VICE CHAIR OF THE BOARD. ALL EXECUTIVE COMMITTEE MEMBERS ARE MEMBERS OF THE BOARD OF TRUSTEES. THE EXECUTIVE COMMITTEE CAN ACT ON BEHALF OF THE BOARD OF TRUSTEES IN MOST CASES. ANY FUNDAMENTAL CHANGES WILL GO TO THE FULL BOARD. GOOD SHEPHERD HOUSING DEVELOPMENT CORPORATION GOOD SHEPHERD PLAZA 850 SOUTH 5TH S ALLENTOWN PA 18103 233073390 PROVIDES INDEPENDENT LIVING APTS FOR DISABLED, LOW-INCOME ADULTS PA 501(C)(3) LINE 9 GOOD SHEPHERD REHABILITATION NETWORK 0 GOOD SHEPHERD REHABILITATION HOSPITAL GOOD SHEPHERD PLAZA 850 SOUTH 5TH S ALLENTOWN PA 18103 231371947 PROVIDES COMPREHENSIVE INPATIENT AND OUTPATIENT REHABILITATION SERVICES PA 501(C)(3) LINE 3 GOOD SHEPHERD REHABILITATION NETWORK 0 GOOD SHEPHERD REHABILITATION NETWORK GOOD SHEPHERD PLAZA 850 SOUTH 5TH S ALLENTOWN PA 18103 232216041 PROVIDES MANAGEMENT SERVICES IN SUPPORT OF ITS TAX-EXEMPT AFFILIATES PA 501(C)(3) LINE 7 N/A 0 GOOD SHEPHERD WORKSHOPVOCATIONAL SERVICES INC 1901 LEHIGH STREET ALLENTOWN PA 18103 232215801 PROVIDES EMPLOYMENT DEVELOPMENT PROGRAMS AND VOCATIONAL EVALUATIONS PA 501(C)(3) LINE 11A, I GOOD SHEPHERD REHABILITATION NETWORK 0 PHILADELPHIA POST-ACUTE PARTNERS LLC 1800 LOMBARD STREET PHILADELPHIA PA 19146 208283421 OPERATES INPATIENT REHAB HOSP, ACUTE CARE HOSP & 8 OUTPATIENT FACILITIES PA 501(C)(3) LINE 3 GOOD SHEPHERD REHABILITATION NETWORK 0 THE ALLENTOWN SPECIALTY HOSPITAL INC GOOD SHEPHERD PLAZA 850 SOUTH 5TH S ALLENTOWN PA 18103 233009874 PROVIDES INPATIENT SVCS THROUGH OPERATION OF LONG-TERM ACUTE CARE HOSP PA 501(C)(3) LINE 3 GOOD SHEPHERD REHABILITATION NETWORK 0 GOOD SHEPHERD RECIPROCAL RISK RENTENTION GROUP 7301 RIVERS AVENUE SUITE 230 NORTH CHARLESTON SC 29406 204065112 RISK RETENTION GROUP SC N/A C 0 0 0 1 0 0 0 0 0 1 0 0 0 1 0 1 1 1 0 1