2014-11-14T15:38:23-06:00 2013-12-31 660703468 FPV & GALINDEZ CPAS PSC PO BOX 364152 SAN JUAN PR 009364152 990 2013-01-01 660571457 HOSPITAL COMUNITARIO BUEN SAMARITANO INC HOSP 7876580000 PO BOX 4055 AGUADILLA PR 006054055 ELYONEL PONTON EXE. DIRECTOR 7876580000 2014-11-12 2014-11-14 2013 2015-11-30 17:44:51Z ELYONEL PONTON PO BOX 4055 AGUADILLA PR 006054055 47733162 false X N/A X 1999 PR THE ORGANIZATION WILL PROVIDE HEALTH SERVICES WITH EXCELLENCE THROUGH DEVELOPING ITS OWN RESOURCES IN AN EFFICIENT MANNER TO CONTRIBUTE TO THE WELL BEING AND IMPROVEMENT OF THE COMMUNITY. 12 12 545 0 4923 4945 42716179 44697976 331627 263596 1443475 2565958 44496204 47532475 0 0 15342837 16748155 0 0 26790360 28605559 42133197 45353714 2363007 2178761 37842312 37383105 31207000 28569032 6635312 8814073 THE ORGANIZATION WILL PROVIDE HEALTH SERVICES WITH EXCELLENCE THROUGH DEVELOPING ITS OWN RESOURCES IN AN EFFICIENT MANNER TO CONTRIBUTE TO THE WELL BEING AND IMPROVEMENT OF THE COMMUNITY. false false 29874189 47268879 THE ORGANIZATION IS A NON-FOR-PROFIT HOSPITAL ORGANIZED UNDER THE LAWS OF THE COMMONWEALTH OF PUERTO RICO. WHICH PROVIDES INPATIENT AND OUTPATIENT SERVICES, INCLUDING EMERGENCY SERVICES. THE SERVICES ARE PROVIDED PRIMARILY TO THE POPULATION UNDER THE MEDICARE PROGRAM AND OTHER HEALTH PROVIDERS. 29874189 true false false false false false false false false false true false false true true false true false false false false false false false false false true true false false false false false false false false false false false false false false false false true false false false true 0 0 false 545 true false false false false false false X 12 12 false false false false true true true true true false true false true true true true false true true true false X ELYONEL PONTN 7878190800 ROAD 2 KM 141 AGUADILLA PR 00605 DR ARTURO CEDENO LLORENS DIRECTOR 40.00 X 105000 0 0 DRA AIDA SANCHEZ MERCADO SUBDIRECTOR 40.00 X 73200 0 0 ING JOSE ROSA DIRECTOR 40.00 X 49219 0 0 SRA ENEIDA ALICEA DIRECTOR 40.00 X 48019 0 0 ADA SOTO DIRECTOR 40.00 X X 36906 0 0 JUAN MIGUEL GMEZ TORRES PRESIDENT 1.00 X X 0 0 0 FLIX TORRES LEN SECRETARY 1.00 X X 0 0 0 RAFAEL MRQUEZ PURAS DIRECTOR 1.00 X 0 0 0 ELIZABETH SANDERS CLARK TREASURER 1.00 X X 0 0 0 ANTONIO RAMOS VILLANUEVA DIRECTOR 1.00 X 0 0 0 MARISA GUILLAMA DE LEN DIRECTOR 1.00 X 0 0 0 MARISOL MOURE RIVERA DIRECTOR 1.00 X 0 0 0 DR PETER MELENDEZ VICE-PRESIDE 1.00 X X 0 0 0 SR RANDY GONZALEZ DIRECTOR 1.00 X 0 0 0 DR ANIBAL APONTE DIRECTOR 1.00 X 0 0 0 DR JOSE RAUL LATORRE DIRECTOR 1.00 X 0 0 0 JOS A GARCA RIVERA HUMAN RESOUR 40.00 X 89206 0 0 SARAH I VILLANUEVA CABRERA ADMINISTRATO 40.00 X 72428 0 0 LUIS J TORRES RODRGUEZ FINANCE DIRE 40.00 X 48305 0 0 ELYONEL PONTN CRUZ EXECUTIVE DI 40.00 X 141034 0 0 663317 2 false false false JANI CLEAN SERVICES INC PO BOX 876 MAYAGEZ PR 00681 PURCHASE SERVIC 718964 LAB CORP PO BOX 12140 BURLINGTON NC 27216 PURCHASE SERVIC 395116 SECURITY MAX PO BOX 6255 HATILLO PR 00659 PURCHASE SERVIC 332583 PROFESSIONAL EMERGENCY 2053 AVE PEDRO ALBIZU AGUADILLA PR 00603 PROFESIONAL FEE 254100 DJM MEDICAL IMAGING PO BOX 3049 BAYAMON PR 00960 PROFESIONAL FEE 187129 15 4945 4945 4945 PATIENT SERVICES 44697976 44697976 44697976 366949 366949 366949 366949 464283 200687 263596 263596 263596 OTHER INCOME 1174750 1174750 OTHER OPERATING INCOME 1024259 1024259 2199009 47532475 47527530 X 14086423 9352502 4733921 24690 15674 9016 971255 633872 337383 1665787 1103816 561971 76488 76488 50660 50660 5884015 4399544 1484471 47746 47746 414119 9628 404491 21153 863 20290 1471024 1471024 1464612 1464612 934706 934706 MATERIALS 10898776 10407475 491301 UTILITIES 3234009 3234009 BAD DEBTS 2905000 2905000 REPAIRS & MAINTENANCE 716806 716806 486445 486445 45353714 29874189 15479525 0 2135657 2982184 13000112 11817650 1211101 1152859 805312 775798 32064509 13724700 18231337 18339809 2458793 2314805 37842312 37383105 7534302 6572194 22780658 21216494 892040 780344 31207000 28569032 X 6635312 8814073 6635312 8814073 37842312 37383105 2178761 X false true X true false X 1067500 1067500 14591872 4261405 10330467 3640009 1303104 2336905 11888589 7876845 4011744 876539 283346 593193 18339809 MEDICAL OFFICE BUILDING 1917129 OTHER ASSETS 397676 2314805 OTHER CURRENT LIABILITIES 780344 DUE TO RELATED PARTY 780344 47532475 47532475 47532475 45353714 45353714 45353714 true true true X true X 1.000000000000 true false false 25841 27083645 40625468 -13541823 0.29890 25841 27083645 40625468 -13541823 0.29890 7000 7000 0.00020 7000 7000 0.00020 25841 27090645 40625468 -13534823 0.29910 true 2905000 4294682 2949319 1345363 true false NA 1 1 HOSPITAL COMUNITARIO BUEN SAMARITANO APARTADO 4055 AGUADILLA PR 006054055 X X X HOSPITAL COMUNITARIO BUEN 1 false true true 100.000000000000 true 100.000000000000 true X X X X true true X X true false true false false PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY THE HOSPITAL MAKES JUDGMENTS AS TO THE COLLECTABILITY OF ACCOUNTS RECEIVABLE BASED ON HISTORICAL TRENDS AND FUTURE EXPECTATIONS. MANAGEMENT ESTIMATES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS, WHICH REPRESENTS THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLES. THIS ALLOWANCE ADJUSTS GROSS PATIENT SERVICE ACCOUNTS RECEIVABLE DOWNWARD TO THEIR ESTIMATED NET REALIZABLE VALUE. TO DETERMINE THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND THE RELATED PROVISION FOR BAD DEBTS EXPENSE, MANAGEMENT REVIEW A SPECIFIC CUSTOMER RISKS; FOR PRIVATE PATIENTS ALL ACCOUNT OVER 185 DAYS AND FOR THIRD-PARTY PAYORS ALL ACCOUNTS OVER 365 DAYS, USING HOSPITAL'S ACCOUNT RECEIVABLE AGING THE HOSPITAL GRANTS CREDIT WITHOUT COLLATERAL TO ITS PATIENTS, MOST OF WHO ARE LOCAL RESIDENTS AND ARE INSURED THIRD-PARTY PAYOR AGREEMENTS. THE HOSPITAL ESTABLISHES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A RELATED PROVISION FOR BAD DEBT BASED UPON FACTORS SURROUNDING THE CREDIT RISK OF SPECIFIC CUSTOMERS, HISTORICAL TRENDS AND OTHER INFORMATION. BAD DEBTS EXPENSE IS CALCULATED EVERY MONTH ACCORDING WITH THE BAD DEBTS POLICY: RESERVE OVER 180 DAYS FOR PATIENT'S ACCOUNTS AND OVER 365 DAYS INSURANCE'S ACCOUNT IN THE AGING REPORT RECONCILED WITH THE GL ALLOWANCE FOR BAD DEBTS ACCOUNT. THE BILLING AND COLLECTIONS SUPERVISOR SUBMIT THE ACCOUNTS TO BE WRITTEN OFF TO THE FINANCE DIRECTOR, WHO ANALYZES AND SUBMITS THEM TO THE BOARD OF DIRECTORS. THEY ARE THE ONLY RESPONSIBLE TO AUTHORIZE WRITE-OFFS OF UNCOLLECTIBLE ACCOUNTS RECEIVABLE. PART III, LINE 8 - MEDICARE EXPLANATION ITEM 4 OF SECTION A (PART III); COSTING METHODOLOGY TO DETERMINE REVENUE FROM MEDICARE. INPATIENT CARE, OUTPATIENT CARE, HOME HEALTH CARE AND SKILLED NURSING SERVICES RENDERED TO MEDICARE PROGRAM BENEFICIARIES ARE PAID AT PROSPECTIVELY DETERMINED RATES. THESE RATES VARY ACCORDING TO A PATIENT CLASSIFICATION SYSTEM THAT IS BASED ON CLINICAL, DIAGNOSTIC, AND OTHER FACTORS. THE HOSPITAL IS REIMBURSED FOR BAD DEBTS AND DISPROPORTIONATE SHARE PATIENTS AT TENTATIVE RATES DETERMINED BY THE MEDICARE PROGRAM WITH FINAL SETTLEMENT DETERMINED AFTER SUBMISSION OF ANNUAL COST REPORTS BY THE HOSPITAL AND AUDITS THERE OF BY THE MEDICARE FISCAL INTERMEDIARY. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION COLLECTIONS ARISE MAINLY FROM TWO SOURCES: 1. PAYMENTS MADE IN THE HOSPITAL BY PATIENTS IN CASH, CHECKS OR DEBIT AND CREDIT CARDS AND; 2. PAYMENTS RECEIVED THROUGH MAIL AND ELECTRONIC TRANSFER FROM HEALTH INSURANCE COMPANIES LIKE MEDICARE, TRIPLE S AND MCS HMO AND COMMERCIAL. THE ADMINISTRATION CLERK RECEIVES THE MAIL AND PREPARES A LIST OF CHECKS WITH REMITTANCE ADVICES, SENT THE ORIGINAL REMITTANCE AND CHECK TO THE PRINCIPAL CASHIER, AND MAKES TWO PHOTOCOPIES WHICH WILL BE FURNISHED TO BILLING AND COLLECTIONS SUPERVISOR AND THE OTHER COPY TO ACCOUNTING CLERK. THEN THE PRINCIPAL CASHIER PREPARES THE DEPOSIT SLIP. APPROXIMATELY AT 1:30 PM EVERY DAY, THE ASSIGNED PERSONAL WITH PRINCIPAL CASHIER, VERIFY AND MAKE THE DAILY CASH COUNT OF MONEY PICK UP FROM THE AMBULATORY SERVICES BOX, THE DEPOSIT SLIP, REMITTANCE ADVISES AND THE CHECKS LIST PREPARED BY THE ADMINISTRATION CLERK BEFORE THE DEPOSIT IS SENT TO THE BANK WITH THE MESSENGER. ALL DEPOSIT IS SENT TO THE BANK IN THE SAME DATE. IF THE DEPOSIT COULD NOT BE MADE, THEN THE MONEY IS KEPT IN THE SECURITY LOCK BOX LOCATED IN THE FINANCE DEPARTMENT. THIS SECURITY LOCK BOX COULD BE ONLY OPEN BY A NUMBER COMBINATION WHICH IS KNOWN BY THE FINANCE DIRECTOR. THE DAILY COUNT REPORT IS SENT TO THE ACCOUNTING SECRETARY, WHO POST IT TO AN EXCEL SHEET WHICH CONTAINS A DETAILED DAILY CASH MOVEMENT FROM DEPOSIT AND ELECTRONIC TRANSFERS MADE TO AND THROUGH BANK ACCOUNTS. IN THE BILLING AND COLLECTIONS DEPARTMENT, IT'S PERSONNEL POST THE DETAIL OF THE REMITTANCE ADVICE TO THE COMPUTER SYSTEM, ANALYZE ACCOUNTS AND IF A BALANCE IS PENDING A SECOND BILLING IS DONE BEFORE 45 DAYS. AFTER THE MONTH IS CLOSED THE ACCOUNTS RECEIVABLE AGING AND RELATED REPORTS ARE PRINTED TO RECONCILE ALL THE ACCOUNTS RECEIVABLE SUBSIDIARIES AND PREPARED THE JOURNAL ENTRIES TO BE POST AT THE GENERAL LEDGER TO REFLECT THE CORRECT BALANCES. ADDITIONAL INFORMATION PART I, LINE 1A ALTHOUGH THE HOSPITAL HAS A WRITTEN FINANCIAL ASSISTANCE POLICY, THE ORGANIZATION IS TAKING THE NECESSARY STEPS TO ALIGN THE SAME WITH THE NEW REQUIREMENTS PUBLISHED ON JUNE 26, 2012 BY THE FIRST SEMESTER OF 2014. PART V LINE I- BASED ON THE PROVISIONS OF NOTICE 2011-52 AND THE PROPOSED REGULATIONS FOR SECTION 501(R)(I) OF THE INTERNAL REVENUE CODE, THE TERM "STATE", AS INCLUDED IN THE DEFINITION FOR "HOSPITAL FACILITY"INCLUDED ONLY THE 50 STATES AND THE DISTRICT OF COLUMBIA AND NOT ANY US TERRITORY. FORM 990, PAGE 6, PART VI, LINE 6 THE BOARD OF MEMBERS (BOD) WHICH MEMBERS APPROVE SIFNIFICANT DECISIONS OF THE ORGANIZATION. FORM 990, PAGE 6, PART VI, LINE 7A THE ORGANIZATION HAS MEMBERS WHO ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY. ELECT FROM THE MEMBERS OF THE CORPORATION (THAT IS, FROM THE BOARD OF TRUSTEE OF THE PARENT COMPANY) SEVEN PERSONS TO BE MEMBERS OF THE BOARD OF DIRECTOR OF THE CORPORATION. THESE SEVEN DIRECTORS SHALL ELECT, IN CONSULTING WITH THE BOARD OF TRUSTEES OF THE PARENT COMPANY, THE REMAINING 6 DIRECTORS TO THE BOARD. SUCH SIX DIRECTORS SHALL AT ALL TIMES COMPLY WITH THE CUALIFICATION REQUIRED TO EACH MEMBERS OF THE BOARD. FORM 990, PAGE 6, PART VI, LINE 7B THE DECISION OF THE GOVERNING BODY ARE SUBJECT TO APPROVAL BY THE MEMBERS: A) MAKE, ALTER OR REPEAL THE BY LAWS OF THE CORPORATION. B) AUTHORIZE AND CAUSE TO BE EXECUTED MORGAGES AND LIENS UPON THE REAL AND PUSMAL PROPERTY OF THE CORPORATION. C) SET APART ANY OF THE FUNDS OF THE CORPORATION, A RESCUE OR RESERVES FOR ANY PROPER PURPOSE AND TO ABOLISH ANY REVENUE IN THE MANNER IN WHICH IT WAS CREATED. D) BY MAJORITY, TO DESIGNATE ONE OR MORE COMMITTEES, EACH COMMITTEE TO CONCIST OF ONE OR MORE OF THE DIRECTORS OF THE CORPORATION. E) TO HOLD MEETING OUTSIDE THE COMMONWEALTH OF PR. F) INCREASE THE NUMBER OF MEMBERS OF THE BOD. G) ELECTION OF THE BOD. H) AMEND THE BY LAWS OF THE CORPORATION. I) APPROVE ANY PLAN OF DISSOLUTION, MERGER, OR DISPOSITION OF THE TOTAL ASSETS OF THE CORPORATION. J) APPROVE THE SELECTION OF THE INDEPENDENT AUDITORS OF THE CORPORATION. FORM 990, PAGE 6, PART VI, LINE 10B PLEASE SUBMIT INFORMATION. FORM 990, PAGE 6, PART VI, LINE 11B ORGANIZATION REVIEW PROCESS FOR 990 FORM. THIS IS THE FIRST YEAR OF FILING THE FORM 990 THE BOD ASSIGNED THE DUTY TO REVISE THIS FORM TO THE EXECUTIVE & FINANCE COMMITTEES OF THE BOD. FORM 990, PAGE 6, PART VI, LINE 12C EACH YEAR THE ENTITY SENDS COMMUNICATIONSTO ITS EMPLOYEES DETAILING THE ENTITY'S RULING ABOUT THE CONFLICT OF INTEREST POLICY. IF ANY SITUATION EXISTS THE MATTER SHOULD BE COMMUNICATED TO THE BOARD OF DIRECTORS IMMEDIATELY TO TAKE REMEDIAL ACTIONS. FORM 990, PAGE 6, PART VI, LINE 15A THE MEMBER OF THE BOD OF THE CORPORATION SHALL BE ENTITLED TO THE FOLLOWING COMPENSATION AND BENEFITS WHILE SERVING AS DIRECTORS OF THE CORPORATION: A) PAYMENT OF A PERDIEM ALLOWANCES AS ESTABLISHED BY THE BOD FOR EACH MEETINGS OF THE BOD IN WHICH THE DIRECTORS IS PRESENT. B) MEDICAL AND HOSPITAL SERVICES PROVIDED BY THE HOSPITALS OPERATED BY THE CORPORATION FREE OF ANY CHARGE FOR THE DIRECTOR, HIS/HER SPOUSE AND CHILDREN UNDER 21 YEARS OLD WHO ARE DEPENDENTS OF THE DIRECTOR. C) LIFE INSURANCE POLICY FOR THE AMOUNT OF 100,000 OF WHICH 50,000 ARE UNDER A GROUP LIFE INSURANCE POLICY AND THE OTHER 50,000 ARE UNDER AN INDIVIDUAL LIFE INSURANCE POLICY FOR EACH DIRECTORS. D) ANY ACTUAL EXPENSES INCURRED IN THE PERFORMANCE OF THEIR DUTIES AS DIRECTORS UPON PRESENTATION FOR APPROVAL OF THE CORRESPONDING INVOICE TO THE BOD. FORM 990, PAGE 6, PART VI, LINE 15B THE MEMBER OF THE BOD OF THE CORPORATION SHALL BE ENTITLED TO THE FOLLOWING COMPENSATION AND BENEFITS WHILE SERVING AS OFFICERS OF THE CORPORATION: A) PAYMENT OF A PERDIEM ALLOWANCES AS ESTABLISHED BY THE BOD FOR EACH MEETINGS OF THE BOD IN WHICH THE DIRECTORS IS PRESENT. B) MEDICAL AND HOSPITAL SERVICES PROVIDED BY THE HOSPITALS PERATED HY THE CORPORATION FREE OF ANY CHARGE FOR THE DIRECTOR, HIS/HER SPOUSE AND CHILDREN UNDER 21 YEARS OLD WHO ARE DEPENDENTS OF THE DIRECTOR. C) LIFE INSURANCE POLICY FOR THE AMOUNT OF 100,000 OF WHICH 50,000 ARE UNDER A GROUP LIFE INSURANCE POLICY AND THE OTHER 50,000 ARE UNDER AN INDIVIDUAL LIFE INSURANCE POLICY FOR EACH DIRECTORS. D) ANY ACTUAL EXPENSES INCURRED IN THE PERFORMANCE OF THEIR DUTIES AS DIRECTORS UPON PRESENTATION FOR APPROVAL OF THE CORRESPONDING INVOICE TO THE BOD. FORM 990, PAGE 6, PART VI, LINE 19 THE ORGANIZATION UPON REQUEST PROVIDE COPY OF ANY OF ITS FINANCIAL STATEMENTS, GOVERNING DOCUMENTS OR ANY OTHER POLICY. FORM 990, PART IX, LINE 11G 4,399,544 1,484,471 0 HOSPITAL SAN CARLOS INC PO BOX 68 MOCA RQ 00676-0068 660371418 HEALTHCARE PR 501 C 3 NA false false false false false false false false false false false false false false false false false false false false