YORK GENERAL HOSPITAL: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
YORK GENERAL HOSPITAL (EIN 47-0379039)
Tax period
2011-10-01 to 2012-09-30
Filed
2013-05-15
IRS object ID
201301359349308455
Schema version
2011v1.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-05-15T16:10:00-05:00Timestamp
Tax Period End Date2012-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DOHMAN AKERLUND & EDDY LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 470AddressLine1
CityAURORACity
StateNEState
ZIP Code688180470ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN470379039EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1YORK GENERAL HEALTH CARE SERVICESBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlYORKNameControl
Phone4023626671Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12222 LINCOLN AVENUEAddressLine1
CityYORKCity
StateNEState
ZIP Code68467ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameROBERT MCQUISTANName
TitleVP OF FINANCETitle
Phone4023626671Phone
Date Signed2013-05-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameTIMOTHY J COUFALName
Phone4026946404Phone
Date Prepared2013-05-15DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonROBERT MCQUISTAN VP OF FINANCENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1SAME AS C ABOVEAddressLine1
CityYORKCity
StateNEState
ZIP Code68467ZIPCode
FieldValueIRS element (for citing)
Gross Receipts39145295GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.YORKGENERAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1946YearFormation
State Legal DomicileNEStateLegalDomicile
Activity Or Mission DescriptionTO BE A REGIONAL HEALTHCARE PROVIDER FOR THE CITIZENS OF YORK COUNTY AND ITS CONTIGUOUS COUNTIES WITH READILY ACCESSIBLE HIGH QUALITY PRIMARY, OBSTETRICAL, MENTAL HEALTH, MEDICAL, SURGICAL, PEDIATRIC, AND LONG TERM HEALTH CARE PROGRAMS AND SERVICES. TO PROVIDE HIGH QUALITY PHYSICAL AND MANPOWER RESOURCES. TO OPERATE WITHIN RESPONSIBLE FISCAL GUIDELINES WITHOUT COMPROMISING PATIENT AND RESIDENT CARE IN PROVIDING PHYSICAL RESOURCES, MANPOWER AND SERVICES. TO BE A LEADER IN ADVOCATING HIGH QUALITY HEALH CARE PROGRAMS, DEVELOPING RESOURCES, AND PROVIDING SERVICES AND PROGRAMS THAT MEET BOTH PREVENTATIVE AND PRIMARY HEALTH CARE NEEDS TO THE CITIZENS OF THE SERVICE AREA. TO ESTABLISH AN ON-GOING PROCESS THAT INSURES THAT THE ORGANIZATION IS MEASURABLY MEETING ITS MISSION COMMITMENTS TO ITS PATIENTS, RESIDENTS, PHYSICAINS, EMPLOYEES, AND COMMUNITIES.ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members6NbrIndependentVotingMembers
Total Nbr Employees600TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year104709ContributionsGrantsPriorYear
Contributions Grants Current Year281012ContributionsGrantsCurrentYear
Program Service Revenue Prior Year37846776ProgramServiceRevenuePriorYear
Program Service Revenue CY38107660ProgramServiceRevenueCY
Investment Income Prior Year883726InvestmentIncomePriorYear
Investment Income Current Year411780InvestmentIncomeCurrentYear
Other Revenue Prior Year27850OtherRevenuePriorYear
Other Revenue Current Year38830OtherRevenueCurrentYear
Total Revenue Prior Year38863061TotalRevenuePriorYear
Total Revenue Current Year38839282TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year20669739SalariesEtcPriorYear
Salaries Etc Current Year20892563SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year15393933OtherExpensePriorYear
Other Expenses Current Year16014279OtherExpensesCurrentYear
Total Expenses Prior Year36063672TotalExpensesPriorYear
Total Expenses Current Year36906842TotalExpensesCurrentYear
Revenues Less Expenses Prior Year2799389RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1932440RevenuesLessExpensesCY
Total Assets BOY65893454TotalAssetsBOY
Total Assets EOY66745216TotalAssetsEOY
Total Liabilities BOY24454443TotalLiabilitiesBOY
Total Liabilities EOY23373765TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY41439011NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY43371451NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO BE A REGIONAL HEALTHCARE PROVIDER FOR THE CITIZENS OF YORK COUNTY AND ITS CONTIGUOUS COUNTIES WITH READILY ACCESSIBLE HIGH QUALITY PRIMARY, OBSTETRICAL, MENTAL HEALTH, MEDICAL, SURGICAL, PEDIATRIC, AND LONG TERM HEALTH CARE PROGRAMS AND SERVICES. TO PROVIDE HIGH QUALITY PHYSICAL AND MANPOWER RESOURCES. TO OPERATE WITHIN RESPONSIBLE FISCAL GUIDELINES WITHOUT COMPROMISING PATIENT AND RESIDENT CARE IN PROVIDING PHYSICAL RESOURCES, MANPOWER AND SERVICES. TO BE A LEADER IN ADVOCATING HIGH QUALITY HEALH CARE PROGRAMS, DEVELOPING RESOURCES, AND PROVIDING SERVICES AND PROGRAMS THAT MEET BOTH PREVENTATIVE AND PRIMARY HEALTH CARE NEEDS TO THE CITIZENS OF THE SERVICE AREA. TO ESTABLISH AN ON-GOING PROCESS THAT INSURES THAT THE ORGANIZATION IS MEASURABLY MEETING ITS MISSION COMMITMENTS TO ITS PATIENTS, RESIDENTS, PHYSICAINS, EMPLOYEES, AND COMMUNITIES.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense36906842Expense
DescriptionPROVIDED 2,781 PATIENT DAYS OF MEDICAL SERVICES AND 41,212 LONG-TERM CARE RESIDENT DAYS TO A VARIETY OF PATIENTS REGARDLESS OF ABILITY TO PAY FOR THOSE SERVICES. PROVIDE ADDITIONAL SERVICES TO ADDRESS INDIVIDUAL HEALTH INCLUDING ASSISTED LIVING, FITNESS CENTER, HOME HEALTH AND CHILD CARE.Description
Total Program Service Expense36906842TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationtrueBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109646NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees600NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Indoor Tanning ServicestrueIndoorTanningServices
Form720 FiledtrueForm720Filed
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members6NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonROBERT MCQUISTANNamePerson
Telephone Number4023626671TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12222 LINCOLN AVENUEAddressLine1
CityYORKCity
StateNEState
ZIP Code68467ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
CHARLES HARRIS
CHAIRMAN0.25X000
DON WITTE
VICE CHAIR0.25X000
ANN KIRKPATRICK
SECRETARY0.25X000
CG KELLY HOLTHUS
TREASURER0.25X000
DR DAN GROWNEY
CHIEF OF STA0.25X000
KRIS HOLOCH
MEMBER0.25X000
DARROLL J LOSCHEN
MEMBER0.25X000
CY NORTH
MEMBER0.25X000
CANDACE OTTE
MEMBER0.25X000
SALLY RUBEN
MEMBER0.25X000
JERRY STAHR
MEMBER0.25X000
KELLY THOMAS
MEMBER0.25X000
CHARLES SCHULZ
CEO40.00179860029050X
JANE THOMPSON
VP OF OPERAT40.00135648012560X
ROBERT MCQUISTAN
VP OF FINANC40.00121964025956X
JENNIFER OBERMIER
VP OF NURSIN40.00115271020253X
JAY COLBURN
VP OF LTC40.00105813024536X
THOMAS C MCKENNY
CRNA40.00207783018556X
MATTHEW MONTGOMERY
CRNA40.00187030019467X
MICHAEL D MONFORE
CRNA40.00185738015720X
CORNELL H BONDE
PHARMACIST40.0013478500X
ERIK PETERSON
PHARMACIST40.0012163100X
JAMIE JOHNSON
PHARMACIST40.0011291300X
JOHN KOWALSKI
PHYSICAL THE40.0010816800X
PAUL ROSENAU
PHYSICAL THE40.0010189200X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1818496TotalReportableCompFromOrg
Total Other Compensation166098TotalOtherCompensation
Number Individuals GT100 K13NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
JERRY'S SHEETMETAL HEATING COOLING
907 W OKLAHOMAGRAND ISLANDNE68802CONSTRUCTION798300
WILLMAR ELECTRIC SERVICE
PO BOX 394WILLMARMN56201ELECTRICIAN693094
YORK MEDICAL CLINIC
2114 N LINCOLN AVEYORKNE68467ER PHYSICIAN670175
SAMPSON CONSTRUCTION
3730 S 14TH STREETLINCOLNNE68502CONSTRUCTION490991
KIDWELL COMMUNICATIONS
3333 FOLKWAYS CIRCLELINCOLNNE68504COMMUNICATION235306
FieldValueIRS element (for citing)
Number Of Contractors GT100 K15NumberOfContractorsGT100K
Government Grants150000GovernmentGrants
All Other Contributions131012AllOtherContributions
Total Contributions281012TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICE REVENUE6221102733443427334434
NET RESIDENT SERVICE REVENUE62311086165658616565
HEARTHSTONE HOUSING62399012037061203706
DAYCARE624410269852269852
HC+ MANAGEMENT AND STAFFING900099196353196353

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column486750TotalRevenueColumn
Related Or Exempt Function Income486750RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue38107660TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column376714TotalRevenueColumn
Exclusion$376,714ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real314506Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real275676Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real38830Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column38830TotalRevenueColumn
Exclusion$38,830ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other65403Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other30337Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other35066Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column35066TotalRevenueColumn
Related Or Exempt Function Income35066RelatedOrExemptFunctionIncome

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column38839282TotalRevenueColumn
Related Or Exempt Function Income38142726RelatedOrExemptFunctionIncome
Exclusion$415,544ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1239107Total
Program Services1239107ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total15805111Total
Program Services15805111ProgramServices

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total498355Total
Program Services498355ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total2157853Total
Program Services2157853ProgramServices

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1192137Total
Program Services1192137ProgramServices

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total17748Total
Program Services17748ProgramServices

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total140794Total
Program Services140794ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1052541Total
Program Services1052541ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total99464Total
Program Services99464ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total400548Total
Program Services400548ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total3102422Total
Program Services3102422ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
PRO CARE OF PATIENTS-HOSP64572486457248
ADMINISTRATIVE&GENERAL-HO10126811012681
BAD DEBTS793857793857
RENTAL/LEASE543000543000

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total2393976Total
Program Services2393976ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total36906842Total
Program Services36906842ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY5253414BOY
EOY8015932EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY14905509BOY
EOY11380311EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY5479425BOY
EOY4221798EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY60195BOY
EOY62151EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY896608BOY
EOY877655EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY266441BOY
EOY269286EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis70850069LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec30069594LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY38074993BOY
EOY40780475EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY956869BOY
EOY1137608EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY65893454BOY
EOY66745216EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY5063879BOY
EOY5089887EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
EOY69182EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY19345000BOY
EOY18145000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY45564BOY
EOY69696EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY24454443BOY
EOY23373765EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY40845968BOY
EOY42785558EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY593043BOY
EOY585893EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY41439011BOY
EOY43371451EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY65893454BOY
EOY66745216EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses1932440ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Disclosed Orgs Legal ControlfalseDisclosedOrgsLegalControl
Disclosed For Charitable PurposesfalseDisclosedForCharitablePurposes
Written Policy MonitoringfalseWrittenPolicyMonitoring
Sect170h Requirements SatisfiedfalseSect170hRequirementsSatisfied
Solicited Assets For SalefalseSolicitedAssetsForSale
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FSfalseIncludedOnFS

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance10783860BeginningOfYearBalance
Contributions2741265Contributions
Investment Earnings Or Losses815893InvestmentEarningsOrLosses
Other Expenditures-7115444OtherExpenditures
Administrative Expenses-3776AdministrativeExpenses
End Of Year Balance7221798EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance14114629BeginningOfYearBalance
Contributions2607394Contributions
Investment Earnings Or Losses703479InvestmentEarningsOrLosses
Other Expenditures-6638482OtherExpenditures
Administrative Expenses-3160AdministrativeExpenses
End Of Year Balance10783860EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance7640257BeginningOfYearBalance
Contributions9440267Contributions
Investment Earnings Or Losses564122InvestmentEarningsOrLosses
Other Expenditures-3529727OtherExpenditures
Administrative Expenses-290AdministrativeExpenses
End Of Year Balance14114629EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance8673112BeginningOfYearBalance
Contributions5972338Contributions
Investment Earnings Or Losses747559InvestmentEarningsOrLosses
Other Expenditures-7752502OtherExpenditures
Administrative Expenses-250AdministrativeExpenses
End Of Year Balance7640257EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.91890BoardDesignatedEOYBalance
Term Endowment EOY Balance0.08110TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis456000InvestmentCostOrOtherBasis
Other Cost Or Other Basis1163192OtherCostOrOtherBasis
Book Value1619192BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis52217153OtherCostOrOtherBasis
Depreciation19531955Depreciation
Book Value32685198BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1476314OtherCostOrOtherBasis
Depreciation800803Depreciation
Book Value675511BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis13282339OtherCostOrOtherBasis
Depreciation9736836Depreciation
Book Value3545503BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2255071OtherCostOrOtherBasis
Book Value2255071BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings40780475TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
DEPOSITS$49,696
EST. THIRD-PARTY PAYOR SETTLEMENTS$20,000
FieldValueIRS element (for citing)
Total Of Amounts69696TotalOfAmounts
Total Revenue38839282TotalRevenue
Total Expenses36906842TotalExpenses
Excess Or Deficit For Year1932440ExcessOrDeficitForYear
Other-$42,875OtherAmount
Total Adjustments-42875TotalAdjustments
Excess Or Deficit Per FS1889565ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt38796407TotRevenueEtcAuditedFinclStmt
Revenue Subtotal38796407RevenueSubtotal
Other Revenues Not Included42875OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt42875RevenueNotRptdOnFinStmt
Total Revenue Per Form99038839282TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt36906842TotExpensesEtcAuditedFinclStmt
Expenses Subtotal36906842ExpensesSubtotal
Total Expenses Per Form99036906842TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
INTENDED USES FOR ENDOWMENT FUNDSSCHEDULE D, PAGE 2, PART V, LINE 4ASSETS WHOSE USE IS LIMITED OR RESTIRCTED: FUNDS ON DEPOSIT WITH TRUSTEE - 4,334,431 BOND FUNDS AND DEBT SERVICE RESERVE FUNDS ARE AVAILABLE TO MEET PRINCIPAL AND INTEREST PAYMENTS ON BONDS OUTSTANDING. CONSTRUCTION FUNDS ARE USED TO PAY COSTS OF THE HOSPITAL PROJECT. BY BOARD FOR ENDOWMENT FUND - 2,191,591 ASSETS SET ASIDE FOR FUTURE CAPITAL IMPROVEMENTS. BY BOARD FOR SCHOLARSHIP FUND - 99,700 INTENDED FOR SCHOLARSHIPS IN THE HEALTHCARE FIELD. BY DONORS OR GRANTORS - 585,893 INTENDED FOR VARIOUS HOSPITAL EQUIPMENT AND OPERATIONS. ESCROW DEPOSITS - 10,183 RETURNED TO DUPLEX OWNERS OR LESSEES AND APARTMENT RESIDENTS.
LIABILITY UNDER FIN 48 FOOTNOTESCHEDULE D, PAGE 3, PART XTHE MEDICAL FACILITY HAS NO RESERVE FOR UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2012 AND 2011.
RECONCILIATION OF CHANGES - OTHERSCHEDULE D, PAGE 4, PART XI, LINE 8TEMPORARILY RESTRICTED CONTRIBUTIONS -130,211 NET ASSETS RELEASED FROM RESTRICTION FOR OPERATING PURPOSE 87,336
REVENUE AMOUNTS INCLUDED ON RETURN - OTHERSCHEDULE D, PAGE 4, PART XII, LINE 4BTEMPORARILY RESTRICTED CONTRIBUTIONS 130,211 NET ASSETS RELEASED FROM RESTRICTION FOR OPERATING PURPOSE -87,336

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Annual Community Benefit ReportfalseAnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense280223TotalCommunityBenefitExpense
Net Community Benefit Expense280223NetCommunityBenefitExpense
Percent Of Total Expense0.00780PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense1604156TotalCommunityBenefitExpense
Direct Offsetting Revenue1628429DirectOffsettingRevenue
Net Community Benefit Expense-24273NetCommunityBenefitExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense1884379TotalCommunityBenefitExpense
Direct Offsetting Revenue1628429DirectOffsettingRevenue
Net Community Benefit Expense255950NetCommunityBenefitExpense
Percent Of Total Expense0.00780PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense65590TotalCommunityBenefitExpense
Net Community Benefit Expense65590NetCommunityBenefitExpense
Percent Of Total Expense0.00180PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense75152TotalCommunityBenefitExpense
Net Community Benefit Expense75152NetCommunityBenefitExpense
Percent Of Total Expense0.00210PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense3404504TotalCommunityBenefitExpense
Direct Offsetting Revenue1802446DirectOffsettingRevenue
Net Community Benefit Expense1602058NetCommunityBenefitExpense
Percent Of Total Expense0.04440PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense10062TotalCommunityBenefitExpense
Net Community Benefit Expense10062NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense3555308TotalCommunityBenefitExpense
Direct Offsetting Revenue1802446DirectOffsettingRevenue
Net Community Benefit Expense1752862NetCommunityBenefitExpense
Percent Of Total Expense0.04860PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense5439687TotalCommunityBenefitExpense
Direct Offsetting Revenue3430875DirectOffsettingRevenue
Net Community Benefit Expense2008812NetCommunityBenefitExpense
Percent Of Total Expense0.05640PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Total Community Building Expense58062TotalCommunityBuildingExpense
Net Community Building Expense58062NetCommunityBuildingExpense
Percent Of Total Expense0.00160PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense85617TotalCommunityBuildingExpense
Net Community Building Expense85617NetCommunityBuildingExpense
Percent Of Total Expense0.00240PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Total Community Building Expense147156TotalCommunityBuildingExpense
Net Community Building Expense147156NetCommunityBuildingExpense
Percent Of Total Expense0.00410PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense290835TotalCommunityBuildingExpense
Net Community Building Expense290835NetCommunityBuildingExpense
Percent Of Total Expense0.00810PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$521,483BadDebtExpenseAmount
Amount Attributable To26074AmountAttributableTo
Amount Reimbursed By Medicare10305233AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare10203201CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall102032MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CarefalseProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1YORK GENERAL HEALTH CARE SERVICESBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line12222 LINCOLN AVEAddressLine1
CityYORKCity
StateNEState
ZIP Code68467ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours
OtherSKILLED NURSING, ASST. LIVINGOther

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1YORK GENERAL HEALTH CARE SERVICESBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent100.0FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent200.0FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Permit LawsuitXPermitLawsuit
Collection ActivitiestrueCollectionActivities
Report To Credit AgencyXReportToCreditAgency
LawsuitXLawsuit
Notify Upon AdmissionXNotifyUponAdmission
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Average Negotiated RatesXAverageNegotiatedRates
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities4NumberOfOtherFacilities

Other Facilities OtherFacilities (4 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
YORK GENERAL HEARTHSTONE
2222 LINCOLN AVEYORKNE68467SKILLED NURSING FACILITY
YORK GENERAL DIALYSIS
2600 LINCOLN AVEYORKNE68467DIALYSIS
YORK GENERAL HOME HEALTH
2319 LINCOLN AVEYORKNE68467HOME HEALTH AGENCY
YORK GENERAL MEADOWLARK ASST LIVING
406 MEADOWVIEW DRYORKNE68467ASSISTED LIVING

Form990 Schedule H Part VI Form990ScheduleHPartVI (8 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
EXCLUSIONS FROM PERCENT OF TOTAL EXPENSEPART I LINE 7 COLUMN FBAD DEBTS 793857
COSTING METHODOLOGY EXPLANATIONPART I LINE 7COSTING METHODOLOGY FOR TABLE IN PART I OVERALL COST TO CHARGE RATIO EXCEPT FOR SUBSIDISED HEALTH SERVICES WHERE COSTS WERE TAKEN FROM THE MEDICARE COST REPORT
BAD DEBT EXPENSE EXPLANATIONPART III LINE 4THE ORGANIZATIONS FINANCIAL STATEMENTS DO NOT CONTAIN A SPECIFIC FOOTNOTE DESCRIBING BAD DEBT HOWEVER THE FOLLOWING IS THE TEXT OF THE FOOTNOTES TITLED DESCRIPTION OF ORGANIZATION AND SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES ACCOUNTS RECEIVABLE AND ALLOWANCE FOR DOUBTFUL ACCOUNTS EXPENSES INCLUDE A PROVISION FOR DOUBTFUL ACCOUNTS TO ALLOW FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS THIS PROVISION IS BASED ON PAST EXPERIENCE AND ANALYSIS OF CURRENT ACCOUNTS RECEIVABLE COLLECTIBILITY ACCOUNTS ARE CONSIDERED DELINQUENT BASED ON PASSAGE OF A SPECIFIED PERIOD OF TIME AND CONSIDERATION OF PAYMENT HISTORY ACCOUNTS DEEMED UNCOLLECTIBLE ARE CHARGED TO THE ALLOWANCE IN THE YEAR THEY ARE DEEMED UNCOLLECTIBLE AS A RESULT THERE IS AT LEAST A REASONABLE POSSIBILITY THAT RECORDED ESTIMATES WILL CHANGE BY A MATERIAL AMOUNT IN THE NEAR TERM THE ALLOWANCE FOR DOUBTFUL ACCOUNTS WAS 322456 AND 429771 AT SEPTEMBER 30 2012 AND 2011 RESPECTIVELY COSTING METHODOLOGY FOR LINE 2 OVERALL COST TO CHARGE RATIO WAS USED TO DETERMINE AMOUNTS REPORTED ON SCHEDULE H PART III LINE 2 BAD DEBT EXPENSE REPORTED INCLUDED ON FORM 990 PART IX LINE 25 WAS 793857 COSTING METHODOLOGY FOR LINE 3 AFTER REVIEW OF BAD DEBTS WRITTEN OFF IT WAS DETERMINED APPROXIMATELY 5 OF BAD DEBT ACCOUNTS WRITTEN OFF WOULD HAVE QUALIFIED FOR CHARITY CARE IF THE INDIVIDUALS WOULD HAVE COMPLETED THE APPLICATION PROCESS RATIONALE FOR INCLUDING BAD DEBT AMOUNTS AS COMMUITY BENEFIT WE DO NOT CONSIDER BAD DEBT AS COMMUNITY BENEFIT
MEDICARE EXPLANATIONPART III LINE 8THE MEDICARE COST REPORT WHICH USES COST TO CHARGE RATIOS BY DEPARTMENT WAS USED TO DETERMINE THE AMOUNTS REPORTED ON LINE 8
NEEDS ASSESSMENTPART VITHE BOARD MEMBERS ARE ACTIVE IN THE COMMUNITY AND IN TOUCH WITH THE RESIDENTS OF YORK COUNTY AND ARE AWARE OF THE NEEDS OF THE COMMUNITY ON AN ONGOING BASIS THE ADDITION OF OUR DIALYSIS PROGRAM WAS A RESULT OF BOARD INTERACTION WITH THE COMMUNITY IN ADDITION THE ORGANIZATION WILL BE CONDUCTING A COMMUNITY HEALTH NEEDS ASSESSMENT IN THE COMING YEAR WE WILL BE COORDINATING THESE EFFORTS WITH THE LOCAL PUBLIC HEALTH OFFICE
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEPART VITHE CHARITY CARE NOTICE IS POSTED IN THE ADMITTING BOOTHS AT THE MAIN ENTRANCE IN ER AND IN THE SPECIALTY CLINIC A WRITTEN NOTICE IS PROVIDED TO EACH PERSON SEEKING SERVICES THE CHARITY CARE POLICY IS ALSO DISCUSSED WITH PATIENTS WHEN MAKING COLLECTION CALLS
COMMUNITY INFORMATIONPART VIYORK NE IS LOCATED AT THE INTERSECTION OF US HIGHWAY 81 AND INTERSTATE 80 THE POPULATION OF YORK COUNTY AS OF 2010 WAS 13665 THE AVERAGE HOUSEHOLD INCOME IS ALMOST 54000 THE UNEMPLOYMENT RATE IN THE YORK COUNTY AREA WAS 43 IN 2009 AS OF 2008 APPROXIMATELY 9 OF PEOPLE OF ALL AGES WERE IN POVERTY YORK COUNTY IS CURRENTLY NOT DESIGNATED AS A MEDICALLY UNDERSERVED AREA APPROXIMATELY 6 OF HOSPITAL REVENUES ARE FROM MEDICAID ELIGIBLE PATIENTS APPROXIMATELY 3 OF HOSPITAL GROSS REVENUES ARE FROM PATIENTS WITH NO INSURANCE COVERAGE
HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSEPART VITHE ORGANIZATIONS GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE PRIMARY SERVICE AREA OF YORK GENERAL HEALTH CARE SERVICES THE OCCUPATIONS OF THE BOARD MEMBERS INCLUDE BUSINESS PROFESSIONALS RETIRED MEDICAL PROFESSIONALS FARMER AND LAWYER THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY SURPLUS FUNDS ARE USED TO UPDATE AND ADD NEW TECHNOLOGY AND EQUIPMENT ADD NEW SERVICES AND UPDATE THE PHYSICAL FACILITIES OVER THE PAST YEARS PROJECTS THAT HAVE BEEN EITHER PARTIALLY FUNDED OR TOTALLY FUNDED WITH SURPLUS REVENUES INCLUDE THE FOLLOWING A NEW 129 BED NURSING HOME TO REPLACE AN OUTDATED AND UNSAFE FACILITY NEW ASSISTED LIVING FACILITY ADDITION OF DIALYSIS SERVICES FOR THE COMMUNITY NEW MEDICAL OFFICE BUILDING AND WELLNESS CENTER HOSPITAL REMODEL AND EXPANSION DIGITAL MAMMOGRAPHY AND CT AND MRI UPDATES THESE ARE SOME OF THE MORE RECENT MAJOR PROJECTS WE HAVE BEEN ABLE TO MAKE AVAILABLE TO THE RESIDENTS OF YORK THESE NEW SERVICES THE ORGANIZATION IS ALSO ACTIVE IN ONGOING HEALTH AND WELLNESS ACTIVITIES IN THE COMMUNITY AND SCHOOLS

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgBonus Filing OrgBonusFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrg
CHARLES SCHULZ
16986010000731221738208910
THOMAS C MCKENNY
201543889596612263396240
MATTHEW MONTGOMERY
1813727769116982064975658
MICHAEL D MONFORE
1800803974117462014585658

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTSIdentifier
Return ReferenceSCHEDULE J, PAGE 1, PART I, LINE 4ReturnReference
ExplanationCHARLES SCHULZ 0 7,312 0 JANE THOMPSON 0 5,447 0 ROBERT MCQUISTAN 0 4,862 0 JENNIFER OBERMIER 0 1,220 0 JAY COLBURN 0 4,593 0 THOMAS C. MCKENNY 0 8,895 0 MATTHEW MONTGOMERY 0 7,769 0 MICHAEL D. MONFORE 0 3,974 0Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Business Name Line2IssuerName/BusinessNameLine2Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
HOSPITAL AUTHORITY NO 1 OF YORK
COUNTY NEBRASKA470379039986356EL32003-04-159970000REVENUE & REFUNDING BONDSfalsefalsefalse
HOSPITAL AUTHORITY NO 1 OF YORK
COUNTY NEBRASKA470769138986356FQ12009-09-235225000REFINANCE 2001 BONDSfalsefalsefalse
HOSPITAL AUTH NO 1 2009 HOSPITAL
470379039986356GE72009-09-232190000HOSPITAL PROJECTfalsefalsefalse
HOSPITAL AUTH NO1 2010 HOSPITAL
470379039986356GT42010-09-157195000HOSPITAL CONSTRUCTION PROJECTfalsefalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Amount RetiredAmountRetiredTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindAmount UnspentAmountUnspent
5345000997000026717037228304500059350002004falsetruetruetrue
1005000522500052250002009falsetruetruetrue
85000219000018554521900002011falsefalsetruetrue
71950005755442falsefalsefalsetrue1439558

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyEngage Bond Counsel ContractsEngageBondCounselContractsAny Research AgreementsAnyResearchAgreementsEngage Bond Counsel ResearchEngageBondCounselResearchPost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
falsefalsefalsefalsefalsefalsetrue
falsefalsefalsefalsefalsefalsetrue
falsefalsefalsefalsefalsefalsetrue
falsefalsefalsefalsefalsefalsetrue

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
falsefalsefalsefalsefalsefalse
falsefalsefalsefalsefalsefalse
falsefalsefalsefalsefalsefalse
falsefalsefalsefalsefalsefalse

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1CORNERSTONE BANKBusinessNameLine1
FieldValueIRS element (for citing)
RelationshipSEE PART VRelationship
Description Of TransactionSEE PART VDescriptionOfTransaction
Sharing Of RevenuesfalseSharingOfRevenues

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
IdentifierADDITIONAL INFORMATIONIdentifier
Return ReferenceSCHEDULE L PART VReturnReference
ExplanationSCHEDULE L PART IV A NAME OF INTERESTED PERSON CORNERSTONE BANK B RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION CG KELLY HOLTUS IS PRESIDENT OF CORNERSTONE BANK HIS DAUGHTER KRIS HOLOCH IS ALSO EMPLOYED AS AN OFFICER AT CORNERSTONE BANK AND TOGETHER THEY OWN GREATER THAN 35 INTEREST IN CORNERSTONE BANK CHARLES HARRIS DON WITTE DARROLL LOSCHEN AND KELLY THOMAS ARE ALL ON CORNERSTONE BANKS BOARD OF DIRECTORS C D AMOUNT AND DESCRIPTION OF TRANSACTION VARIOUS TRANSACTIONS IN CAPICITY AS YORK GENERAL HEALTH CARE SERVICES FINANICAL INSTITUTION ADDIONTALLY CORNERSTONE BANK IS TRUSTEE TO BOND FUNDS IN WHICH 1913890 WAS DEPOSITED THIS YEARExplanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSIONFORM 990 - ORGANIZATION'S MISSIONTO BE A REGIONAL HEALTHCARE PROVIDER FOR THE CITIZENS OF YORK COUNTY AND ITS CONTIGUOUS COUNTIES WITH READILY ACCESSIBLE HIGH QUALITY PRIMARY, OBSTETRICAL, MENTAL HEALTH, MEDICAL, SURGICAL, PEDIATRIC, AND LONG TERM HEALTH CARE PROGRAMS AND SERVICES. TO PROVIDE HIGH QUALITY PHYSICAL AND MANPOWER RESOURCES. TO OPERATE WITHIN RESPONSIBLE FISCAL GUIDELINES WITHOUT COMPROMISING PATIENT AND RESIDENT CARE IN PROVIDING PHYSICAL RESOURCES, MANPOWER AND SERVICES. TO BE A LEADER IN ADVOCATING HIGH QUALITY HEALH CARE PROGRAMS, DEVELOPING RESOURCES, AND PROVIDING SERVICES AND PROGRAMS THAT MEET BOTH PREVENTATIVE AND PRIMARY HEALTH CARE NEEDS TO THE CITIZENS OF THE SERVICE AREA. TO ESTABLISH AN ON-GOING PROCESS THAT INSURES THAT THE ORGANIZATION IS MEASURABLY MEETING ITS MISSION COMMITMENTS TO ITS PATIENTS, RESIDENTS, PHYSICAINS, EMPLOYEES, AND COMMUNITIES.
RELATED PARTY INFORMATION AMONG OFFICERSFORM 990, PAGE 6, PART VI, LINE 2C.G. KELLY HOLTHUS KRIS HOLOCH TREASURER BOARD MEMBER FAMILY C.G. KELLY HOLTHUS CORNERSTONE BANK TREASURER PRESIDENT GREATER THAN 35% OWNER KRIS HOLOCH CORNERSTONE BANK BOARD MEMBER OFFICER OFFICER CHARLES HARRIS CORNERSTONE BANK CHAIRMAN DIRECTOR DIRECTOR DON WITTE CORNERSTONE BANK VICE CHAIR DIRECTOR DIRECTOR DARROLL J. LOSCHEN CORNERSTONE BANK BOARD MEMBER DIRECTOR DIRECTOR KELLY THOMAS CORNERSTONE BANK BOARD MEMBER DIRECTOR DIRECTOR
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BTHE 990 IS REVIEWED BY THE VP OF FINANCE AND IS SENT TO EACH DIRECTOR FOR THEIR REVIEW.
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CANY MEMBERS WITH A CONFLICT OF INTEREST ABSTAIN FROM VOTING. THE ABSTENTION IS DOCUMENTED IN THE MEETING MINUTES.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15ATHE BOARD OF DIRECTORS REVIEWS THE COMPENSATION FOR THE CEO. A COMPARISON OF AREA CEOS IS INCLUDED.
COMPENSATION PROCESS FOR OFFICERSFORM 990, PAGE 6, PART VI, LINE 15BA SALARY SURVEY FOR KEY EMPLOYEES IS COMPLETED BY HUMAN RESOURCES. THE H.R. DIRECTOR REVIEWS THE INFORMATION WITH THE CEO AND A RECOMMENDATION IS MADE.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19GOVERNING DOCUMENTS, CONFLICT OF INTEREST STATEMENTS, AND FINANCIAL STATEMENTS ARE ALL AVAILABLE UPON REQUEST FOR REVIEW ON THE PREMISES.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
HEARTHSTONE RETIREMENT HOMES
2319 N LINCOLN AVEYORKNE68467900149281SR. LIVINGNE501C3YGHCSfalse
HOME CARE PLUS
2319 N LINCOLN AVEYORKNE68467470807087HOME HLTHNE501C3YGHCSfalse
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

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