BLUE MOUNTAIN HOSPITAL INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
BLUE MOUNTAIN HOSPITAL INC (EIN 24-0795436)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-05-15
IRS object ID
201311359349305216
Schema version
2011v1.5
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)
Timestamp2013-05-15T12:33:58-05:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN232932984EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PARENTEBEARD LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11650 MARKET STREET SUITE 4500AddressLine1
CityPHILADELPHIACity
StatePAState
ZIP Code19103ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN240795436EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1GNADEN HUETTEN MEMORIAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlGNADNameControl
Phone6103771300Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1211 NORTH 12TH STREETAddressLine1
CityLEHIGHTONCity
StatePAState
ZIP Code182351195ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameANDREA ANDRAEName
TitleCFOTitle
Phone6103771300Phone
Date Signed2013-05-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJULIUS C GREEN CPA JDName
PTINP00350393PTIN
Phone2159720701Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonANDREA ANDRAENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1211 NORTH 12TH STREETAddressLine1
CityLEHIGHTONCity
StatePAState
ZIP Code182351195ZIPCode
FieldValueIRS element (for citing)
Gross Receipts64700473GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.BLMTN.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1947YearFormation
State Legal DomicilePAStateLegalDomicile
Activity Or Mission DescriptionOPERATES A 90 BED ACUTE CARE HOSP, A 91 BED SKILLED NURSING FACILITY & A HOME HEALTH CARE AGENCY.ActivityOrMissionDescription
Nbr Voting Members Governing Body17NbrVotingMembersGoverningBody
Nbr Independent Voting Members16NbrIndependentVotingMembers
Total Nbr Employees881TotalNbrEmployees
Total Nbr Volunteers104TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year310128ContributionsGrantsPriorYear
Contributions Grants Current Year769724ContributionsGrantsCurrentYear
Program Service Revenue Prior Year60458091ProgramServiceRevenuePriorYear
Program Service Revenue CY62451654ProgramServiceRevenueCY
Investment Income Prior Year37731InvestmentIncomePriorYear
Investment Income Current Year226573InvestmentIncomeCurrentYear
Other Revenue Prior Year599899OtherRevenuePriorYear
Other Revenue Current Year523383OtherRevenueCurrentYear
Total Revenue Prior Year61405849TotalRevenuePriorYear
Total Revenue Current Year63971334TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year1295860GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY941342GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year31314073SalariesEtcPriorYear
Salaries Etc Current Year32217975SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year27934320OtherExpensePriorYear
Other Expenses Current Year28065229OtherExpensesCurrentYear
Total Expenses Prior Year60544253TotalExpensesPriorYear
Total Expenses Current Year61224546TotalExpensesCurrentYear
Revenues Less Expenses Prior Year861596RevenuesLessExpensesPriorYear
Revenues Less Expenses CY2746788RevenuesLessExpensesCY
Total Assets BOY31439458TotalAssetsBOY
Total Assets EOY37902746TotalAssetsEOY
Total Liabilities BOY31829318TotalLiabilitiesBOY
Total Liabilities EOY46659007TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-389860NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-8756261NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionPROMOTE, MAINTAIN AND RESTORE THE GOOD HEALTH OF ALL THE PEOPLE IN THE COMMUNITIES WE SERVE THROUGH PARTNERSHIPS FOR EXCELLENCE IN HEALTHCARE SERVICE DELIVERY.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense52522053Expense
Grants941342Grants
Revenue62658352Revenue
DescriptionGNADEN HUETTEN MEMORIAL HOSPITAL (THE "HOSPITAL"), LOCATED IN LEHIGHTON, PENNSYLVANIA, IS A 90-BED, NOT-FOR-PROFIT GENERAL ACUTE CARE HOSPITAL SERVING THE RESIDENTS OF CARBON, SCHUYLKILL AND MONROE COUNTIES. THE HOSPITAL'S SERVICES PROVIDE BOTH INPATIENT AND OUTPATIENT CARE, INCLUDING HOME HEALTH CARE, MEDICAL/SURGICAL SERVICES, MENTAL HEALTH SERVICES AND ACUTE REHABILITATION SERVICES. THE HOSPITAL ALSO OFFERS A BROAD ARRAY OF ANCILLARY SERVICES SUCH AS RADIOLOGY, EMERGENCY, CARDIOLOGY AND REHABILITATION SERVICES.DURING THE PERIOD OF JULY 1, 2011 THROUGH JUNE 30, 2012, THE HOSPITAL HAD A TOTAL OF 3,646 ADMISSIONS AND 18,053 PATIENT DAYS. TOTAL OCCUPANCY FOR THE HOSPITAL WAS 54%. IN ADDITION, THERE WERE A TOTAL OF 19,775 EMERGENCY ROOM VISITS AND 18,732 HOME HEALTH CARE VISITS. IN ADDITION TO THE SERVICES PROVIDED AS INDICATED ABOVE, THE HOSPITAL ALSO PROVIDES LONG-TERM CARE SERVICES THROUGH AN ON-CAMPUS 91-BED SKILLED NURSING UNIT. DURING THE PERIOD OF JULY 1, 2011 THROUGH JUNE 30, 2012, THE SKILLED NURSING UNIT HAD 242 ADMISSIONS AND PATIENT DAYS OF APPROXIMATELY 31,000. TOTAL OCCUPANCY FOR THE SKILLED NURSING UNIT WAS 95.6%.Description
Total Program Service Expense52522053TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109653NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees881NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members17NbrVotingGoverningBodyMembers
Number Independent Voting Members16NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledPAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1ANDREA L ANDRAEBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6103777003TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1211 NORTH 12TH STREETAddressLine1
CityLEHIGHTONCity
StatePAState
ZIP Code18235ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (24 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
BARBARA GREEN
TREASURER1.00X000
CONRAD BIEGE
DIRECTOR1.00X000X
JAIME MENDES
DIRECTOR1.00X000
WILLIAM H FEGLEY JR
DIRECTOR1.00X000
PATRICK HANLEY DO
SECRETARY1.00X000X
MICHAEL HARLEMAN
CHAIRMAN1.00X000X
WILLIAM MASON
DIRECTOR1.00X000
WILLIAM MARKSON MD
DIRECTOR1.00X000
SHELBA SCHEFFNER
DIRECTOR1.00X000
REV ROBERT VONFRISCH
DIRECTOR1.00X000
RICHARD ROTHFLEISCH MD
DIRECTOR1.00X000
STEVEN SERFASS
DIRECTOR1.00X000
WILLIAM KISSNER
DIRECTOR1.00X000
ROBERT GROB DO
DIRECTOR1.00X000
LOUIS SPORTELLI DC
VICE CHAIRMAN1.00X000
PATRICK REILLY
DIRECTOR1.00X000X
ANDREW E HARRIS
PRESIDENT/CEO15.00X426249036262X
ANDREA ANDRAE
CFO15.00114663010602X
DR HERBERT HOOVER
PHYSICIAN40.00031131534867X
DR CLEMENT MCGINLEY
PHYSICIAN40.00017589116832X
DR MUHAMMAD RIFAI
PHYSICIAN40.00017163519224X
KRISTA MILLER
DIRECTOR OF PHARMACY20.00121882012913X
TERRY PURCELL
VP OF AMBULATORY SERVICES20.00128260014365X
GARY HIGGINS
DIRECTOR OF REHABILITATIVE SERVICES20.00106377011270X
FieldValueIRS element (for citing)
Total Reportable Comp From Org897431TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs658841TotalReportableCompFrmRltdOrgs
Total Other Compensation156335TotalOtherCompensation
Number Individuals GT100 K5NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
REHAB CARE GROUP
PO BOX 502096ST LOUISMO63150ADMINISTER ACUTE REHAB PROGRAM2139127
CARDIOLOGY ASSOCIATES
1241 BLAKESLEE BLVDLEHIGHTONPA18235ADMINISTER CARDIOLOGY PROGRAM797928
MAHONING VALLEY ORTHOPEDICS
246 NORTH 6TH STREETLEHIGHTONPA18235ADMINISTER ORTHOPEDIC PROGRAM210000
PULMONARY SPECIALIST
525 IRON STREETLEHIGHTONPA18235ADMINISTER PULMONARY PROGRAMS166010
PENN MEDICAL GROUP PC
2175 BLAKESLEE BLVD DRIVE WLEHIGHTONPA18235ADMINISTER MEDICAL PRACTICE126778
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Related Organizations65450RelatedOrganizations
Government Grants704274GovernmentGrants
Total Contributions769724TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT SVC REVDescription
Business Code621990BusinessCode
Total Revenue Column62451654TotalRevenueColumn
Related Or Exempt Function Income62451654RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue62451654TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column37370TotalRevenueColumn
Exclusion$37,370ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real200257Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real176237Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real24020Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column24020TotalRevenueColumn
Exclusion$24,020ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other742105Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other552902Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other189203Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column189203TotalRevenueColumn
Exclusion$189,203ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
CAFETERIA MEALS900099209302$209,302
MATERNITY HEALTH621990100849100849
DISOUNT & COLLECTION F56100059636$59,636

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column129576TotalRevenueColumn
Related Or Exempt Function Income105849RelatedOrExemptFunctionIncome
Exclusion$23,727ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue499363TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column63971334TotalRevenueColumn
Related Or Exempt Function Income62658352RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$543,258ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total941342Total
Program Services941342ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total500432Total
Management And General500432ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total23708951Total
Program Services20838234ProgramServices
Management And General2870717ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1013132Total
Program Services900800ProgramServices
Management And General112332ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total4718903Total
Program Services4198365ProgramServices
Management And General520538ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2276557Total
Program Services2014471ProgramServices
Management And General262086ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total122075Total
Management And General122075ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total114939Total
Management And General114939ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total5349Total
Program Services5349ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total6849351Total
Program Services4854958ProgramServices
Management And General1994393ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total251775Total
Program Services1333ProgramServices
Management And General250442ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2214405Total
Program Services1779412ProgramServices
Management And General434993ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total825777Total
Program Services293167ProgramServices
Management And General532610ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1388209Total
Program Services1355352ProgramServices
Management And General32857ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total136960Total
Program Services104672ProgramServices
Management And General32288ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total14047Total
Program Services10519ProgramServices
Management And General3528ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total659757Total
Program Services659757ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2105852Total
Program Services2105852ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total1400547Total
Program Services1400547ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT EXPENSE47729334772933
MEDICAL SUPPLIES4157411414667810733
DRUGS14407341440734
OTHER EXPENSES82542827346798082

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total779680Total
Program Services670232ProgramServices
Management And General109448ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total61224546Total
Program Services52522053ProgramServices
Management And General8702493ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2028BOY
EOY1253EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY630715BOY
EOY115386EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY6516293BOY
EOY6999663EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY831467BOY
EOY816726EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY619088BOY
EOY586292EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis60920230LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec44927142LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY16290316BOY
EOY15993088EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY2440941BOY
EOY2464314EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY4108610BOY
EOY10926024EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY31439458BOY
EOY37902746EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY6881917BOY
EOY7740641EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY10080000BOY
EOY9318551EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
EOY240823EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY14867401BOY
EOY29358992EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY31829318BOY
EOY46659007EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-476484BOY
EOY-8829861EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY86624BOY
EOY73600EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-389860BOY
EOY-8756261EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY31439458BOY
EOY37902746EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses2746788ReconcilationRevenueExpenses
Reconcilation Other Changes-11113189ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

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 C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations1GrantsOtherOrganizations
Grants Other Organizations$5,349GrantsOtherOrganizationsAmount
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities0OtherActivities
Total Lobbying Expenditures IIB5349TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationA PORTION OF THE DUES PAID TO THE HOSPITAL & HEALTHSYSTEM ASSOCIATION OF PENNSYLVANIA ($5,349) WAS DETERMINED TO BE FOR LOBBYING PURPOSES.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance86624BeginningOfYearBalance
Other Expenditures13024OtherExpenditures
End Of Year Balance73600EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance84311BeginningOfYearBalance
Investment Earnings Or Losses15994InvestmentEarningsOrLosses
Other Expenditures12024OtherExpenditures
Administrative Expenses1657AdministrativeExpenses
End Of Year Balance86624EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance636097BeginningOfYearBalance
Contributions41098Contributions
Investment Earnings Or Losses-414InvestmentEarningsOrLosses
Other Expenditures592470OtherExpenditures
End Of Year Balance84311EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1022053BeginningOfYearBalance
Investment Earnings Or Losses-39694InvestmentEarningsOrLosses
Other Expenditures346262OtherExpenditures
End Of Year Balance636097EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis477770OtherCostOrOtherBasis
Book Value477770BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis26196698OtherCostOrOtherBasis
Depreciation16857521Depreciation
Book Value9339177BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis381903OtherCostOrOtherBasis
Depreciation320494Depreciation
Book Value61409BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis31818682OtherCostOrOtherBasis
Depreciation26909457Depreciation
Book Value4909225BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2045177OtherCostOrOtherBasis
Depreciation839670Depreciation
Book Value1205507BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings15993088TotalOfBookValueLandBuildings

Other Assets OtherAssets (6 entries)

DescriptionDescriptionBook ValueBookValue
DUE FROM PALMERTON HOSPITAL4473378
BENEFICIAL INTEREST IN PERPETUAL TRUST73600
DEFERRED FINANCING COSTS, NET151582
OTHER ASSETS896941
PHYSICIAN INCOME GUARANTEE337656
INSURANCE RECOVERIES RECEIVABLE4992867
FieldValueIRS element (for citing)
Total Book Value Other Assets10926024TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
OBLIGATIONS UNDER CAPITAL LEASES$520,941
BLUE CROSS WORKING CAPITAL ADVANCE$304,227
PENSION LIABILITY$22,602,744
ESTIMATED MEDICAL MALPRACTICE CLAIMS LIABILITY$5,834,609
DEFERRED GIFT ANNUITIES PAYABLE$96,471
FieldValueIRS element (for citing)
Total Of Amounts29358992TotalOfAmounts
Total Revenue63971334TotalRevenue
Total Expenses61224546TotalExpenses
Excess Or Deficit For Year2746788ExcessOrDeficitForYear
Other-$11,113,189OtherAmount
Total Adjustments-11113189TotalAdjustments
Excess Or Deficit Per FS-8366401ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt53034382TotRevenueEtcAuditedFinclStmt
Other Revenues-11113189OtherRevenues
Revenue Not Rptd F990-11113189RevenueNotRptdF990
Revenue Subtotal64147571RevenueSubtotal
Other Revenues Not Included-176237OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt-176237RevenueNotRptdOnFinStmt
Total Revenue Per Form99063971334TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt61400783TotExpensesEtcAuditedFinclStmt
Other Expenses Included176237OtherExpensesIncluded
Expenses Not Rptd F990176237ExpensesNotRptdF990
Expenses Subtotal61224546ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99061224546TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:TERM ENDOWMENT FUNDS ARE USED FOR THE PURCHASE OF PLANT AND EQUIPMENT TO FURTHER THE MISSION OF THE ORGANIZATION.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:THE HOSPITAL ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN A COMPANY'S FINANCIAL STATEMENTS AND PRESCRIBES A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. MANAGEMENT HAS DETERMINED THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD. THE HOSPITAL'S FEDERAL EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURNS FOR 2009, 2010, AND 2011 REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE.
PART XI, LINE 8 - OTHER ADJUSTMENTS:PENSION LIABILITY ADJUSTMENT -10,995,108. VALUATION LOSS -13,024. ADOPTION OF NEW ACCOUNTING METHOD -105,057. TOTAL TO SCHEDULE D, PART XI, LINE 8: -11,113,189.
PART XII, LINE 2D - OTHER ADJUSTMENTS:PENSION LIABILITY ADJUSTMENT -10,995,108. VALUATION GAIN -13,024. ADOPTION OF NEW ACCOUNTING STANDARD -105,057.
PART XII, LINE 4B - OTHER ADJUSTMENTS:RENTAL EXPENSES -176,237.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSES 176,237.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care0AmountsBudgetedForCharityCare
Annual Community Benefit Report0AnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense175312TotalCommunityBenefitExpense
Direct Offsetting Revenue96018DirectOffsettingRevenue
Net Community Benefit Expense79294NetCommunityBenefitExpense
Percent Of Total Expense0.00140PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense7472644TotalCommunityBenefitExpense
Direct Offsetting Revenue6176787DirectOffsettingRevenue
Net Community Benefit Expense1295857NetCommunityBenefitExpense
Percent Of Total Expense0.02290PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense7647956TotalCommunityBenefitExpense
Direct Offsetting Revenue6272805DirectOffsettingRevenue
Net Community Benefit Expense1375151NetCommunityBenefitExpense
Percent Of Total Expense0.02430PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense149166TotalCommunityBenefitExpense
Net Community Benefit Expense149166NetCommunityBenefitExpense
Percent Of Total Expense0.00260PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense9064TotalCommunityBenefitExpense
Net Community Benefit Expense9064NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense6409970TotalCommunityBenefitExpense
Direct Offsetting Revenue3643571DirectOffsettingRevenue
Net Community Benefit Expense2766399NetCommunityBenefitExpense
Percent Of Total Expense0.04900PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense72665TotalCommunityBenefitExpense
Direct Offsetting Revenue57447DirectOffsettingRevenue
Net Community Benefit Expense15218NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense6640865TotalCommunityBenefitExpense
Direct Offsetting Revenue3701018DirectOffsettingRevenue
Net Community Benefit Expense2939847NetCommunityBenefitExpense
Percent Of Total Expense0.05210PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense14288821TotalCommunityBenefitExpense
Direct Offsetting Revenue9973823DirectOffsettingRevenue
Net Community Benefit Expense4314998NetCommunityBenefitExpense
Percent Of Total Expense0.07640PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$1,733,818BadDebtExpenseAmount
Amount Attributable To173382AmountAttributableTo
Amount Reimbursed By Medicare19639885AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare20103391CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-463506MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care0ProvisionForCharityCare
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 Line1GNADEN HUETTEN MEMORIAL HOSPITAL INCBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1211 NORTH 12TH STREETAddressLine1
CityLEHIGHTONCity
StatePAState
ZIP Code18235ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours
OtherSKILLED NURSING FACILITYOther

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1GNADEN HUETTEN MEMORIAL HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number2HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent400.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Medicaid MedicareXMedicaidMedicare
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Collection Activities1CollectionActivities
Report To Credit AgencyXReportToCreditAgency
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)

ExplanationExplanationIdentifierIdentifier
PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES INCLUDED UNDER SCHEDULE H FOR THE PALMERTON HOSPITAL ARE THE ADULT DAY SERVICES PROGRAM AND THE EMERGENCY DEPARTMENT. ADULT DAY SERVICES OF THE BLUE MOUNTAIN HEALTH SYSTEM OFFERS AN ALTERNATIVE TO NURSING CARE WHILE PROVIDING RESPITE FOR THOSE CARING FOR SOMEONE AT HOME. THE PROGRAM OFFERS A WARM, FRIENDLY ATMOSPHERE AND THE OPPORTUNITY FOR SENIORS TO DEVELOP FRIENDSHIPS WHILE PARTICIPATING IN ACTIVITIES THEY ENJOY. OUR EXPERIENCED STAFF INCLUDES REGISTERED NURSES, LICENSED PRACTICAL NURSES, CERTIFIED THERAPEUTIC RECREATION SPECIALISTS AND CERTIFIED NURSE AIDES. THE PALMERTON HOSPITAL PROVIDED SUBSIDIES OF APPROXIMATELY $230,000 TO THE ADULT DAY SERVICES CENTER DURING FY2012.THE EMERGENCY DEPARTMENT LOCATED AT PALMERTON HOSPITAL PROVIDES AROUND-THE-CLOCK EMERGENCY SERVICES TO THE SURROUNDING COMMUNITIES WITHIN CARBON COUNTY. CARE IS PROVIDED TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY OR THEIR INSURANCE STATUS. DURING FY2012, THE PALMERTON EMERGENCY DEPARTMENT SAW 11,640 PATIENTS WITH A SUBSIDIZED COST TO PROVIDE THESE SERVICES OF $1,137,000 OF WHICH $207,000 IS INCLUDED IN THE MEDICAID SHORTFALL.SUBSIDIZED HEALTH SERVICES INCLUDED UNDER SCHEDULE H FOR THE GNADEN HUETTEN MEMORIAL HOSPITAL ARE THE FAMILY PLANNING CLINIC AND THE EMERGENCY DEPARTMENT. THE NATIONAL FAMILY PLANNING PROGRAM, ALSO KNOW AS TITLE X (TEN) OF THE PUBLIC HEALTH SERVICE ACT, WAS ESTABLISHED IN 1970 TO ENSURE THAT NO AMERICAN WOMAN WOULD BE DENIED ACCESS TO FAMILY PLANNING ASSISTANCE BECAUSE OF HER ECONOMIC CONDITION. FOR MORE THAN THREE DECADES, TITLE X HAS BEEN AN INTEGRAL COMPONENT OF OUR NATION'S PUBLIC HEALTH CARE SYSTEM, PROVIDING HIGH QUALITY FAMILY PLANNING SERVICES AND OTHER PREVENTIVE HEALTH CARE TO LOW-INCOME OR UNINSURED INDIVIDUALS WHO MAY OTHERWISE LACK ACCESS TO HEALTH CARE. MATERNAL AND FAMILY HEALTH SERVICES ADMINISTERS THE PROGRAM THROUGH A NETWORK OF DIRECT AND CONTRACT SERVICE PROVIDERS. IN ADDITION TO DIRECT SITES, THE NETWORK SYSTEM INCLUDES HOSPITALS, PLANNED PARENTHOOD AFFILIATES, COMMUNITY HEALTH CENTERS AND PHYSICIAN GROUPS. THE GNADEN HUETTEN MEMORIAL HOSPITAL PROVIDED SUBSIDIES OF APPROXIMATELY $31,000 TO OUR FAMILY PLANNING CLINIC DURING FY2012. THE EMERGENCY DEPARTMENT LOCATED AT GNADEN HUETTEN MEMORIAL HOSPITAL PROVIDES AROUND-THE-CLOCK EMERGENCY SERVICES TO THE SURROUNDING COMMUNITIES WITHIN CARBON COUNTY. CARE IS PROVIDED TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY OR THEIR INSURANCE STATUS. DURING FY2012, THE GNADEN HUETTEN MEMORIAL HOSPITAL EMERGENCY DEPARTMENT SAW 19,775 PATIENTS WITH A SUBSIDIZED COST TO PROVIDE THESE SERVICES OF $3,500,000 OF WHICH $758,000 IS INCLUDED IN THE MEDICAID SHORTFALL.
PART I, L7 COL(F): THE AMOUNT OF BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25 COLUMN (A) BUT SUBTRACTED OUT FOR PURPOSES OF CALCULATING THE PERCENTAGE ON SCH H, PART I, LINE 7, COLUMN (F) IS $4,722,933.
PART II: IN 2012, THE HOSPITALS, PROGRAMS AND SERVICES OF THE BLUE MOUNTAIN HEALTH SYSTEM PROVIDED MANY COMMUNITY HEALTH IMPROVEMENT SERVICES. INCLUDED IN THIS CATEGORY ARE THE COMMUNITY OUTREACH PROGRAMS AND SERVICES OFFERED BY THE HEALTH SYSTEM'S COMMUNITY EDUCATION PROGRAM THAT INCLUDES HEALTH AND WELLNESS EDUCATION, LIFE-SAVING CPR AND EMERGENCY SUPPORT AND INFORMATION, AND SPECIFIC PROGRAMMING TO HELP PEOPLE MAKE HEALTHIER LIFESTYLE CHOICES. ALSO INCLUDED ARE THE MYRIAD OF SUPPORT GROUP ACTIVITIES THAT HELP PATIENTS AND THEIR FAMILIES MANAGE CHRONIC HEALTH CONDITIONS.DURING DIFFICULT ECONOMIC TIMES WHEN MORE PEOPLE ARE UNEMPLOYED OR ARE STRUGGLING TO MAKE ENDS MEET, COMMUNITY MEMBERS RELY UPON THE HOSPITALS OF THE BLUE MOUNTAIN HEALTH SYSTEM'S LONG STANDING TRADITION TO PROVIDE NEEDED MEDICAL CARE REGARDLESS OF INSURANCE COVERAGE OR FINANCIAL ABILITY TO PAY FOR SERVICES.FOR THE BLUE MOUNTAIN HEALTH SYSTEM, FISCAL YEAR 2012 WAS A CHALLENGING YEAR FINANCIALLY. DECREASING GOVERNMENT REIMBURSEMENT, LOWER THAN ANTICIPATED PATIENT VOLUME AND GREATER NUMBERS OF PEOPLE NEEDING FINANCIAL ASSISTANCE BECAME THE NEW NORMAL. YET, THE HEALTH SYSTEM NEVER WAVERED FROM EITHER ITS NOT-FOR-PROFIT MISSION OR ITS ATTENTION TO QUALITY CARE AND PATIENT SAFETY. IN FACT, ANY SURPLUS FUNDS ARE USED FOR TWO MAIN ITEMS, CAPITAL EQUIPMENT PURCHASES OR FOR STAFF COMPENSATION. THE BLUE MOUNTAIN HEALTH SYSTEM PROVIDED OVER $6,000,000 IN PROGRAMS AND SERVICES TO MEET THE HEALTH NEEDS OF THE RESIDENTS OF OUR COMMUNITIES. THAT NUMBER, HOWEVER, REFLECTS ONLY A SMALL PIECE OF THE ORGANIZATION'S MISSION-DRIVEN STORY OF THIS PAST YEAR. (GNADEN HUETTEN MEMORIAL HOSPITAL - $3,600,000 AND PALMERTON HOSPITAL - $2,400,000).ATTENTIVE TO THE NEEDS OF OUR COMMUNITY'S LOWER INCOME AND MOST VULNERABLE POPULATIONS, THE HEALTH SYSTEM SERVED PATIENTS THROUGH ITS FINANCIAL ASSISTANCE PROGRAMS. OVERALL, APPROXIMATELY $5,972,000 WAS PROVIDED IN FREE AND SUBSIDIZED PATIENT CARE. (GNADEN HUETTEN MEMORIAL HOSPITAL - $3,463,000 AND PALMERTON HOSPITAL - $2,329,000), WHICH ADDRESSES IDENTIFIED COMMUNITY HEALTH NEEDS OF ACCESS AND AFFORDABILITY OF MEDICAL CARE.IN THE AREA OF COMMUNITY HEALTH SERVICES, THERE WAS AN INCREASE IN BOTH THE INVESTMENT AND NUMBERS SERVED THROUGH COMMUNITY HEALTH AND WELLNESS EDUCATION AS WELL AS SCREENINGS AND FAIRS.THE BLUE MOUNTAIN HEALTH SYSTEM INVESTED APPROXIMATELY $112,000 (GNADEN HUETTEN MEMORIAL HOSPITAL - $62,000 AND PALMERTON HOSPITAL - $50,000) AND PROVIDED HEALTH AND WELLNESS PROGRAMMING AND EDUCATION FOR THOUSANDS OF COMMUNITY MEMBERS LAST YEAR. ONE AREA WHERE THE HEALTH SYSTEM'S INVESTMENT INCREASED DRAMATICALLY WAS IN EMERGENCY PREPAREDNESS AND RESPONSE - WORKING WITH THE CARBON COUNTY EMERGENCY MANAGEMENT AGENCY - WITH MORE THAN 50 STAFF PERSONS VOLUNTEERING TO PROVIDE NEARLY 2,000 FREE INFLUENZA VACCINES TO AREA RESIDENTS AS WELL AS OFFERING NEARLY 400 PNEUMOVAX VASSINCES TO THE COMMUNITY.IN THE FALL OF 2011, THE BLUE MOUNTAIN HEALTH SYSTEM COLLABORATED WITH THE CARBON COUNTY EMERGENCY MANAGEMENT AGENCY ON THEIR ANNUAL EMERGENCY PREPAREDNESS DRIVE-THRU INFLUENZA VACCINATION PROGRAM IN WHICH MORE THAN 2,000 FREE SEASONAL INFLUENZA VACCINATIONS WERE DISTRIBUTED TO AREA RESIDENTS. THIS PROGRAM HAS BEEN FOUND TO BE AN INVALUABLE ARRANGEMENT IN THE EVENT OF A MASS INOCULATION WOULD BE NEEDED. LOCAL FIRE, POLICE, AND AMBULANCE PERSONNEL AS WELL AS THE LOCAL SCHOOL DISTRICTS AND COLLEGE AND UNIVERSITY STUDENTS WERE INVOLVED IN THE PLANNING OF THE EVENT. APPROXIMATELY 50 STAFF PERSONS FROM THE HEALTH SYSTEM DONATED THEIR TIME AND EFFORT TO ENSURE THE PROJECT WAS A SUCCESSFUL ONE. THE HEALTH SYSTEM'S "HEALTHY SMILES, HAPPY KIDS" DENTAL VAN PROVIDES UNDER- OR NON-INSURED CHILDREN IN CARBON AND SCHUYLKILL COUNTIES WITH PREVENTATIVE AND RESTORATIVE DENTAL CARE. IN FY 2012, THE DENTAL VAN TEAM, CONSISTING OF A BOARD-CERTIFIED DENTIST, A DENTAL HYGIENIST AND A DENTAL ASSISTANT/DRIVER, CARED FOR 1,417 CHILDREN. THE VAN HAS BECOME THE "DENTAL HOME" FOR MORE THAN 2,200 CHILDREN SINCE ITS INCEPTION.FREE SCREENING MAMMOGRAMS AND BREAST ULTRASOUND PROCEDURES ARE PROVIDED TO WOMEN, AND MEN, WHO ARE UNINSURED OR WHO HAVE NO INSURANCE AS PART OF THE HEALTH SYSTEM'S WOMEN'S HEALTH SERVICES PROGRAM. DURING FY 2012, MANY WOMEN TOOK ADVANTAGE OF THE BLUE MOUNTAIN HEALTH SYSTEM'S BREAST CANCER VOUCHER SCREENING PROGRAM. THE HEALTH SYSTEM'S LADIES NIGHT OUT EVENT SERVED APPROXIMATELY 220 WITH BREAST CANCER AWARENESS AND EDUCATION. SUPPORT GROUPS - ADULT DAY SERVICES CAREGIVER SUPPORT GROUP, WOMEN'S BREAST CANCER SUPPORT GROUP, BARIATRIC & WEIGHT LOSS SUPPORT GROUPSHEALTH FAIRS - CHILDREN'S HEALTH FAIR AND THE NATIONAL SENIOR HEALTH AND FITNESS DAYWORKFORCE WELLNESS PROGRAMHEALTH IMAGES TELEVISION PROGRAM/COMMUNITY NEWSLETTERGENERAL SCREENINGS PROVIDED AT OTHER ORGANIZATION'S EVENTS - BLOOD PRESSURE, CHOLESTEROL, BODY FAT ANALYSIS, STROKE RISK, DEPRESSION. FAMILY PLANNING CLINICHAVING HIGHLY TRAINED MEDICAL PERSONNEL BENEFITS EVERYONE IN THE COMMUNITY. BEYOND ON-GOING EDUCATION FOR PHYSICIANS, NURSES, EMERGENCY MEDICAL TECHNICIANS, AND OTHER CLINICIANS, THE BLUE MOUNTAIN HEALTH SYSTEM SUPPORTED NUMEROUS INITIATIVES IN 2011 TO FURTHER THE CAPABILITIES OF AREA MEDICAL PERSONNEL, INVESTING APPROXIMATELY $17,600 IN HEALTH PROFESSIONS EDUCATION (GNADEN - $8,800 AND PALMERTON - $8,800). THE HEALTH SYSTEM PROVIDED CLINICAL ROTATIONS TO MEDICAL STUDENTS OF PENNSYLVANIA STATE UNIVERSITY AND PENNSYLVANIA COLLEGE OF OSTEOPATHIC MEDICINE THROUGH THE EAST CENTRAL AREA HEALTH EDUCATION CENTER AS WELL AS PHYSICIAN EXTENDER STUDENTS FROM KING'S COLLEGE. LIVING ACCOMMODATIONS ARE PROVIDED DURING THE TIME OF EACH STUDENT'S ROTATION. THROUGH THE HEALTH SYSTEM'S STAFF DEVELOPMENT DEPARTMENT, NUMEROUS PERSONS WERE TRAINED IN CPR, ALS, PALS, AND RHYTHM MONITORING. THE HEALTH SYSTEM ALSO PROVIDED A CLINICAL SETTING FOR UNDERGRADUATE, IMAGING AND LICENSED PRACTICAL NURSING STUDENTS ENROLLED IN VARIOUS LOCAL COLLEGES AND UNIVERSITIES, NAMELY, LEHIGH CARBON COMMUNITY COLLEGE, NORTHAMPTON AREA COMMUNITY COLLEGE, CEDAR CREST COLLEGE, WILKES UNIVERSITY AND JOHNSON COLLEGE OF TECHNOLOGY. HAVING HIGHLY TRAINED MEDICAL PERSONNEL BENEFITS EVERYONE IN THE COMMUNITY. BEYOND ON-GOING EDUCATION FOR PHYSICIANS, NURSES, EMERGENCY MEDICAL TECHNICIANS, AND OTHER CLINICIANS, THE BLUE MOUNTAIN HEALTH SYSTEM SUPPORTED NUMEROUS INITIATIVES IN FY 2012 TO FURTHER THE CAPABILITIES OF AREA MEDICAL PERSONNEL.
PART III, LINE 4: ACCOUNTS RECEIVABLE, PATIENTS 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 BASED UPON A PERIODIC REVIEW OF THE ACCOUNTS RECEIVABLE AGING, PAYOR CLASSIFICATIONS, AND APPLICATION OF HISTORICAL WRITE-OFF PERCENTAGES. THE TOTAL AMOUNT OF BAD DEBT EXPENSE REPORTED ON PART III, LINE 2 WAS ESTIMATED BASED ON A PERCENTAGE OF TOTAL ADJUSTED PATIENT COST TO TOTAL ADJUSTED PATIENT CHARGES. THE TOTAL ADJUSTED PATIENT COSTS WAS CALCULATED AS FOLLOWS: TOTAL OPERATING EXPENSES AS REPORTED IN THE AUDITED FINANCIAL STATEMENTS LESS BAD DEBT EXPENSE, MEDICAID AND OTHER PROVIDER TAXES, NON PATIENT-CARE ACTIVITIES, AND NET COMMUNITY BENEFIT EXPENSE. TOTAL ADJUSTED OPERATING EXPENSES WERE APPROXIMATELY $54,592,000 FOR FY2012. TOTAL ADJUSTED PATIENT CHARGES WAS CALCULATED AS FOLLOWS: GROSS PATIENT CHARGES LESS GROSS CHARGES FOR COMMUNITY BENEFIT PROGRAMS. TOTAL ADJUSTED PATIENT CHARGES WERE APPROXIMATELY $150,283,000 FOR FY2012. MANAGEMENT DETERMINED APPROXIMATELY 10% OF THE TOTAL BAD DEBT EXPENSE REPORTED ON LINE 2 WAS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. MANAGEMENT CONSIDERED THIS TO BE REASONABLE BASED ON HISTORICAL ANALYSIS OF BAD DEBT EXPENSE.
PART III, LINE 8: NONE OF THE MEDICARE SHORTFALL REPORTED IN LINE 8 WAS TREATED AS A COMMUNITY BENEFIT. AMOUNTS REPORTED ON LINE 6 WERE OBTAINED FROM THE MEDICARE COST REPORT.
PART V, SECTION B, LINE 19D: THE AMOUNTS CHARGED WERE IN ACCORDANCE WITH THE HOSPITAL'S OVERALL FINANCIAL ASSISTANCE POLICY.GNADEN HUETTEN MEMORIAL HOSPITAL, INC.
PART VI, LINE 2: THE HOSPITALS OF THE BLUE MOUNTAIN HEALTH SYSTEM ASSESS THE COMMUNITY HEALTH NEEDS THROUGH REVIEW OF EMERGENCY ROOM STATISTICS AS WELL AS INQUIRY DURING REGULAR PENNSYLVANIA DEPARTMENT OF HEALTH SURVEYS TO IDENTIFY FAR-REACHING HEALTH NEEDS FACED BY PEOPLE IN THE COMMUNITIES SERVED BY THE HOSPITALS. THOSE RESULTS ARE EVALUATED OVER TIME AND SERVE AS THE BASIS TO DEVELOP NEW OR EXPANDED PLANS TO ADDRESS SERVICES IN RESPONSE TO NEED. THE BLUE MOUNTAIN HEALTH SYSTEM DEVELOPS PROGRAMS AND SERVICES TO ADDRESS COMMUNITY HEALTH NEEDS AND MAKES INVESTMENTS IN INITIATIVES THAT ALIGN WITH THE HEALTH SYSTEM'S CORE MISSION.BEYOND THAT FOCUS ARE PROGRAMS AND SERVICES THAT BENEFIT EVERY RESIDENT AND SUPPORT THE FAR REACHING GOAL OF A HEALTHIER COMMUNITY. THE HEALTH SYSTEM RELIES ON THE ENGAGEMENT AND SUPPORT OF KEY STAKEHOLDERS, INCLUDING THE MEDICAL STAFF OF THE HOSPITALS OF THE BLUE MOUNTAIN HEALTH SYSTEM, NUMEROUS COMMUNITY ORGANIZATIONS, SUCH AS THE CARBON MONROE PIKE MENTAL HEALTH AND DEVELOPMENTAL SERVICES. TOGETHER, WE WORK TOWARD DEVELOPING A NETWORK OF CARE AND SUPPORT THAT PROVIDES QUALITY MEDICAL CARE FOR OUR COMMUNITY MEMBERS.THE HEALTH SYSTEM CONTINUES TO USE DATA FROM THE PARTNERS FOR PROGRESS COMMUNITY ASSESSMENT 2009 AS A GUIDE IN DEVELOPING PROGRAMS AND SERVICES AND MAKING COMMUNITY BENEFIT INVESTMENTS IN THROUGH 2012. ADULT PRIORITY NEEDSPRIMARY- AFFORDABILITY OF HEALTH CARE- ACCESSIBILITY OF MEDICAL CARE- ACCESS TO AFFORDABLE MENTAL AND BEHAVIORAL HEALTH CARESECONDARY- ACCESS TO AFFORDABLE PRESCRIPTION MEDICATIONS- SUBSTANCE ABUSE PREVENTION AND TREATMENTOTHER- SMOKING PREVENTION AND CESSATION- NUTRITION- WEIGHT MANAGEMENT AND EXERCISEYOUTH AND TEEN NEEDS- ACCESS AND AFFORDABILITY OF CARE- DENTAL- HEALTH CARE- SUICIDE PREVENTION- MENTAL AND BEHAVIORAL HEALTH- FAMILY PLANNING SERVICES
PART VI, LINE 3: IN ACCORDANCE WITH PENNSYLVANIA STATE REPORTING REQUIREMENTS, THE BLUE MOUNTAIN HEALTH SYSTEM'S CHARITY CARE EXPENSE IS REPORTED BASED UPON COSTS VERSUS CHARGES. CHARITY CARE INCLUDES THE HEALTH SYSTEM'S TRADITIONAL INPATIENT AND EMERGENCY SERVICES, AS WELL AS THE CARE PROVIDED AS PART OF EXTERNAL EDUCATIONAL PROGRAMS AND SERVICES SUCH AS THROUGH OUR FAMILY PLANNING PROGRAM.MORE PEOPLE WERE SERVED THROUGH THE HOSPITAL'S CHARITABLE CARE AND FINANCIAL ASSISTANCE PROGRAMS IN VIRTUALLY ALL CATEGORIES, AS FOLLOWS:- GNADEN HUETTEN MEMORIAL HOSPITAL CHARITABLE CARE PATIENTS- PALMERTON HOSPITAL CHARITABLE CARE PATIENTS- BLUE MOUNTAIN HEALTH SYSTEM'S "HEALTHY SMILES, HAPPY KIDS" DENTAL VAN - 1,417 SERVED IN FY 2012SIGNAGE IS VISIBLE IN ALL BLUE MOUNTAIN HEALTH SYSTEM POINTS OF REGISTRATION IN ORDER TO CREATE AWARENESS OF THE FINANCIAL ASSISTANCE PROGRAM. AT A MINIMUM, SIGNAGE IS POSTED IN ALL PATIENT INTAKE AREAS, INCLUDING, BUT NOT LIMITED TO, EMERGENCY DEPARTMENT, AND THE ADMISSION/PATIENT REGISTRATION AREA.IN RECENT YEARS, THE HEALTH SYSTEM HAS EXPANDED THE NUMBER OF FINANCIAL COUNSELORS AVAILABLE TO ASSIST PATIENTS. A KEY GOAL IS TO IDENTIFY COMMUNITY MEMBERS IN NEED SOONER. COUNSELORS PROACTIVELY SEEK OUT PATIENTS PRIOR TO TREATMENT IN AN EFFORT TO CONNECT THEM WITH PUBLIC INSURANCE PROGRAMS AS APPROPRIATE OR TO ENCOURAGE THEM TO COMPLETE AN ASSISTANCE APPLICATION. THE RESULT IS MORE CHARITY CARE AND LESS REPORTED AS BAD DEBT; MOST IMPORTANTLY, COMMUNITY MEMBERS ARE PROVIDED WITH THE SUPPORT TO ACCESS THE MEDICAL CARE THEY NEED.
PART VI, LINE 4: THE MEDIAN INCOME OF HOUSEHOLDS IN CARBON COUNTY WAS $47,283. 74 PERCENT OF THE HOUSEHOLDS RECEIVED EARNINGS AND 25 PERCENT RECEIVED RETIREMENT INCOME OTHER THAN SOCIAL SECURITY. THIRTY-NINE PERCENT OF THE HOUSEHOLDS RECEIVED SOCIAL SECURITY. THE AVERAGE INCOME FROM SOCIAL SECURITY WAS $15,428.ACCORDING TO THE BUREAU OF LABOR STATISTICS, CARBON COUNTY SHOWS A RELATIVELY HIGH RATE OF UNEMPLOYMENT- 10.2 PERCENT- COMPARED TO THE MID-ATLANTIC REGION AND THE NATION AS A WHOLE.THE CARBON COUNTY CHILD & FAMILY COLLABORATIVES 2009-10 STATE OF THE CHILD & FAMILY IN CARBON COUNTY REPORT STATES THAT THE AREAS CHILDREN ARE AT MODERATE-HIGH RISK OF SCHOOL FAILURE DUE TO THE FOLLOWING FACTORS: 42.3 PERCENT LIVE IN HOUSEHOLDS EARNING LESS THAN 200 PERCENT OF POVERTY; 10.8 PERCENT LIVE IN FAMILIES WHOSE MOTHER EARNED LESS THAN A HIGH SCHOOL DIPLOMA; AND 11 PERCENT OF CHILDREN UNDER THE AGE OF 5 LIVING BELOW POVERTY LEVEL ARE OF A SINGLE MOTHER HOUSEHOL. FURTHERMORE, ACCORDING TO A 2010 DRUG AND ALCOHOL SURVEY, 27 OUR OF 3,000 6TH TO 11TH GRADERS IN CARBON COUNTY HAD ALCOHOL WITHIN THE LAST 30 DAYS, WITH 20 PERCENT HAVING BEEN GIVEN TO THEM BY PARENTS OR FAMILY MEMBERS.OVERALL, CARBON COUNTY RANKS 49TH (OF 67 COUNTIES) IN HEALTH OUTCOMES RELATED TO MORTALITY, MORBIDITY, HEALTH BEHAVIORS, CLINICAL CARE, SOCIAL AND ECONOMIC FACTORS AND PHYSICAL ENVIRONMENT. OF PARTICULAR INTEREST IS THE CATEGORY OF HEALTH BEHAVIORS (TOBACCO USE, OBESITY, PHYSICAL INACTIVITY, EXCESSIVE DRINKING, MOTRO VEHICLE CRASH DEATH RATE, SEXUALLY TRANSMITTED INFECTIONS AND TEEN BIRTH RATE) WHERE THE COUNTY RANKS 63/37. A MEASURE OF ACCESS TO CARE RELATES TO THE PRIMARY CARE PROVIDER RATE, OR THE POPULATION TO PRIMARY PHYSICIAN RATIO. THE NATIONAL BENCHMARK FOR POPULATION TO PRIMARY PHYSICIAN RATIO IS 631:1. IN PENNSYLVANIA, THAT RAIO IS 838:1, AND IN CARBON COUNTY THE RAIOS IS 2121:1, ALMOST THREE TIMES THE RATIO OF THE STATE AS A WHOLE.
PART VI, LINE 5: THE MEDICAL STAFF OF THE BLUE MOUNTAIN HEALTH SYSTEM IS AN OPEN MEDICAL STAFF ALLOWING SUBMISSIONS FOR PRIVILEGES AND CREDENTIALING FROM ANY INTERESTED PHYSICIAN OR SURGEON. THE BOARD OF DIRECTORS IS COMPRISED OF 17 INDIVIDUALS FROM VARIOUS COMMUNITY ORGANIZATIONS SUCH AS FINANCIAL INSTITUTIONS, TELECOMMUNICATION, RECREATION, AND REPRESENTATION FROM THE MEDICAL STAFF. OF THE 17 MEMBERS OF THE BOARD OF DIRECTORS, 13 RESIDE IMMEDIATELY WITHIN THE PRIMARY SERVICE AREA OF THE HEALTH SYSTEM. ALL OF THE BOARD MEMBERS ARE INDEPENDENT, WITH THE EXCEPTION OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER, WHO IS EMPLOYED DIRECTLY BY THE HEALTH SYSTEM.DURING FY2013, THE SYSTEM ENGAGED THE PENNSYLVANIA AREA HEALTH EDUCATION CENTER (PA AHEC) TO ASSIST IN GATHERING THE DATA NECESSARY TO COMPLETE OUR COMMUNITY HEALTH NEEDS ASSESSMENT. AT THE CURRENT TIME, WE HAVE IDENTIFIED THE PRIMARY NEEDS OF THE COMMUNITY AND ARE WORKING TO FINALIZE OUR IMPLEMENTATION PLAN; WITH FINAL BOARD APPROVAL IN JUNE 2013.
PART VI, LINE 6: THE HOSPITALS OF THE BLUE MOUNTAIN HEALTH SYSTEM ARE REGIONAL PROVIDERS OF HEALTH CARE SERVICES TO THE PEOPLE LIVING IN CARBON COUNTY AND PARTS OF MONROE, LEHIGH, NORTHAMPTON AND SCHUYLKILL COUNTIES. BLUE MOUNTAIN HEALTH SYSTEM INCLUDES PALMERTON HOSPITAL, A 70-BED COMMUNITY HOSPITAL LOCATED IN PALMERTON; GNADEN HUETTEN MEMORIAL HOSPITAL, A 90-BED COMMUNITY HOSPITAL; THE SUMMIT AT BLUE MOUNTAIN, A 91-BED NURSING AND REHABILITATION CENTER, BOTH LOCATED IN LEHIGHTON AND AN ADULT DAY SERVICE CENTER IN PALMERTON. COMBINED, THESE FACILITIES HAVE BEEN SERVING THE FAMILIES OF OUR AREA FOR MORE THAN 150 YEARS. THE HOSPITALS OF THE BLUE MOUNTAIN HEALTH SYSTEM ARE FULLY ACCREDITED BY THE JOINT COMMISSION. DIAGNOSTIC OUTPATIENT SERVICES, INCLUDING ACUTE REHABILIATION, MAMMOGRAPHY, ULTRASOUND, CARDIAC REHABILITATION AND THE CLINICAL LABORATORY ARE ALSO ACCREDITED BY THEIR RESPECTIVE NATIONAL PROFESSIONAL ORGANIZATIONS.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1THE PALMERTON HOSPITALBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1135 LAFAYETTE AVENUEAddressLine1
CityPALMERTONCity
StatePAState
ZIP Code18071ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient135562316EINOfRecipient
IRC Section501(C)(3)IRCSection
Amount Of Cash Grant941342AmountOfCashGrant
Method Of ValuationN/AMethodOfValuation
Description Of Non Cash AssistanceN/ADescriptionOfNonCashAssistance
Purpose Of GrantTO FUND OPERATIONS OF THE PALMERTON HOSPITALPurposeOfGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: ASSISTANCE IS PROVIDED TO RELATED ENTITIES FOR FINANCIAL SUPPORT. MANAGEMENT OF THE HEALTH SYSTEM OVERSEES THE USE OF FUNDS AT THE AFFILIATED ENTITIES.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
ANDREW E HARRIS
323775089734012740000362620462511000
DR HERBERT HOOVER
0311315000000034867034618200
DR CLEMENT MCGINLEY
01502910256000000016832019272300
DR MUHAMMAD RIFAI
0171635000000019224019085900

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePART I, LINE 1AReturnReference
ExplanationTHE ORGANIZATION INCLUDED $4,811 OF CLUB DUES IN PRESIDENT/CEO ANDREA HARRIS' REPORTABLE INCOME IN HIS 2011 W-2. THIS AMOUNT WAS INCLUDED AS TAXABLE INCOME FOR MR. HARRIS.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1CARBON COUNTY HOSPITAL AUTHORITYBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN232280834IssuerEIN
CUSIP Number140868EN6CUSIPNumber
Date Issued2012-02-23DateIssued
Issue Price6306819IssuePrice
Description Of PurposeCURRENT REFUNDING OF THE 1999 REVENUE BONDSDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Total Proceeds6000000TotalProceeds
Amount In Reserve Fund3382753AmountInReserveFund
Issuance Costs From Proceeds126068IssuanceCostsFromProceeds
Credit Enhancement41940CreditEnhancement
Other Spent Proceeds6138811OtherSpentProceeds
Year Of Subst Completion2012YearOfSubstCompletion
Current Refunding1CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty1MngmentCntrctBondFinancdPrprty
Engage Bond Counsel Contracts1EngageBondCounselContracts
Any Research Agreements0AnyResearchAgreements
Prcntge Prvt Business Use By Others0.00000PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.00000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00000TotalPrivateBusinessUse
Post Issuance Compliance Procdrs1PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T Filed0Form8038TFiled
Variable Rate Issue1VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Exception To Rebate0ExceptionToRebate

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION B, LINE 11THE BLUE MOUNTAIN HEALTH SYSTEM (BMHS) STAFF COMMUNICATED TO THE FINANCE COMMITTEE OF THE BOARD THAT THE FORMS 990 WERE PREPARED BY PARENTEBEARD LLC AS WELL AS COMMUNICATING THE GENERAL TYPES OF INFORMATION CONTAINED IN THE FILING. THE BOARD IS PROVIDED THE DETAILS TO ACCESS TEH 990 THROUGH A SECURED BOARD "PORTAL" PRIOR TO ISSUANCE.
FORM 990, PART VI, SECTION B, LINE 12CTHE CONFLICT STATEMENT MUST BE SIGNED OFF ON AN ANNUAL BASIS BY ALL GOVERNING BODY MEMBERS, OFFICERS, AND KEY EMPLOYEES. THIS PROCESS IS MONITORED BY THE ADMINISTRATIVE ASSISTANT TO THE PRESIDENT/CEO. A CONFLICT WOULD BE ANY DIRECT OR INDIRECT FINANCIAL INTEREST. ANY CONFLICTS NOTED WOULD BE COMMUNICATED TO THE COMPLIANCE COMMITTEE. THERE WERE NO CONFLICTS DISCLOSED THIS YEAR.
FORM 990, PART VI, SECTION B, LINE 15SENIOR MANAGEMENT SALARIES ARE DETERMINED BY THE EXECUTIVE COMMITTEE USING MARKET VALUES OBTAINTED. HUMAN RESOURCES PARTICIPATE IN VARIOUS SALARY SURVEYS TO DETERMINE THE CORRECT SALARY RANGE. THE APPALACHIAN HOSPITAL HUMAN RESOURCE SOCIETY CONDUCTS AN ANNUAL SALARY SURVEY FOR ALL POSITIONS. IN ADDITION, THE HOSPITAL ASSOCIATION OF PENNSYLVANIA CONDUCTS AN ANNUAL SURVEY WITH YAFFE ASSOCIATES FOR SENIOR MANAGEMENT EMPLOYEES. THE MARKET DATA IS ANALYZED BY HUMAN RESOURCES AND THE GOAL IS TO PAY AT THE 50 PERCENTILE. SALARIES OF OTHER EMPLOYEES ARE RECOMMENDED BY HUMAN RESOURCES AND APPROVED BY THE PRESIDENT AND CEO. THE EXECUTIVE COMMITTEE OF THE BOARD SERVES AS THE COMPENSATION COMMITTEE AND APPROVES RECOMMENDATIONS FOR SALARY INCREASES. THE EXECUTIVE COMMITTEE APPROVES INCREASES FOR THE CEO. REVIEW AND APPROVAL PROCESS IS DOCUMENTED. SENIOR MANAGEMENT HAS RECEIVED THE SAME GENERAL INCREASES AS THE STAFF EMPLOYEES RECEIVED.
FORM 990, PART VI, SECTION C, LINE 19FORM 990, PART VI, SECTION C, LINE 19: UPON REQUEST, THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND/OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.
FORM 990, PART VII, SECTION A:ALL BOARD DIRECTORS SPENT AN AVERAGE OF 4 HOURS PER WEEK FOR GNADEN HUETTEN MEMORIAL HOSPITAL AND ALL RELATED ENTITIES. THE FOLLOWING SUMMARIZES THE EMPLOYEES AND THE ESTIMATED AVERAGE NUMBER OF HOURS SPENT ON RELATATED ORGANIZATIONS ACTIVITIES: ANDREW HARRIS - 35 HOURS ANDREA ANDRAE - 35 HOURS KRISTA RIMSKY - 20 HOURS JASON HOWAY - 20 HOURS CLEMENT MCGINLEY - 20 HOURS TERRENCE PURCELL - 30 HOURS ANTONETTE GIBSON - 30 HOURS
FORM 990, PART XI, LINE 5:PENSION LIABILITY ADJUSTMENT -10,995,108. VALUATION LOSS -13,024. ADOPTION OF NEW ACCOUNTING METHOD -105,057. TOTAL TO FORM 990, PART XI, LINE 5: -11,113,189.CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
BLUE MOUNTAIN HEALTH SYSTEM INC
211 NORTH 12TH STREETLEHIGHTONPA182351195201311316MAINTAINS AN INTEGRATED HEALTH CARE SYSTEM.PA501(C)(3)11AN/A0
CMS MEDICAL CARE CORPORATION
211 NORTH 12TH STREETLEHIGHTONPA182351195232473899OWNS AND OPERATES AMBULATORY CARE CENTERS IN VARIOUS COMMUNITIESPA501(C)(3)31GNADEN HUETTEN MEMORIAL HOSPITAL
THE PALMERTON HOSPITAL
135 LAFAYETTE AVENUEPALMERTONPA18071235562316OPERATES AN ACUTE CARE HOSP, PROVIDNG INPATIENT, OUTPATIENT & EMERGENCY CAREPA501(C)(3)30BLUE MOUNTAIN HEALTH SYSTEM INC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
CMS MEDICAL CARE CORPORATION
M36000FMV
CMS MEDICAL CARE CORPORATION
N2728255FMV

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