2013-05-15T08:59:10-05:00 2012-06-30 232932984 PARENTEBEARD LLC 1650 MARKET STREET SUITE 4500 PHILADELPHIA PA 19103 990 2011-07-01 232215800 THE GOOD SHEPHERD HOME LONG-TERM CARE FACILITY INC GOOD 6107763303 GOOD SHEPHERD PLAZA 850 S 5TH ST ALLENTOWN PA 181033295 DANIEL C CONFALONE 6107763303 2013-05-15 1 JULIUS GREEN CPA P00350393 2159720701 2011 2016-02-24 21:20:13Z DANIEL C CONFALONE GOOD SHEPHERD PLAZA 850 S 5TH ST ALLENTOWN PA 181033295 21473827 0 X WWW.GOODSHEPHERDREHAB.ORG X 1982 PA TO ENHANCE LIVES, MAXIMIZE FUNCTION, INSPIRE HOPE, AND PROMOTE DIGNITY AND WELL-BEING. 18 14 0 235 0 0 393270 360426 21173890 21102248 0 -12280 151433 11153 21718593 21461547 0 0 0 0 11388401 11747806 0 0 0 8821808 8993069 20210209 20740875 1508384 720672 41525258 42287529 670986 688529 40854272 41599000 X GOOD SHEPHERD'S MISSION IS: "MOTIVATED BY THE DIVINE GOOD SHEPHERD AND THE PHYSICAL AND COGNITIVE REHABILITATION NEEDS OF OUR COMMUNITIES, OUR MISSION IS TO ENHANCE LIVES, MAXIMIZE FUNCTION, INSPIRE HOPE, AND PROMOTE DIGNITY AND WELL-BEING WITH EXPERTISE AND COMPASSION." 0 0 18264257 21102248 THE GOOD SHEPHERD HOME AT THE CONRAD W. RAKER CENTER AND THE GOOD SHEPHERD HOME-BETHLEHEM ARE RESIDENCES WHERE PERSONS WITH PHYSICAL DISABILITIES REQUIRING NURSING FACILITY CARE CAN COME TO LIVE AND REALIZE THEIR FULLEST POTENTIAL. SERVICES PROVIDED INCLUDE NURSING AND MEDICAL SERVICES, OCCUPATIONAL THERAPY, COMMUNICATION SERVICES, PASTORAL CARE, SOCIAL WORK SERVICES, THERAPEUTIC RECREATION, PHYSICAL THERAPY, ADAPTIVE WHEELCHAIR, MOBILITY AND SEATING PROGRAMS. MANY OF THE RESIDENTS UTILIZE GOOD SHEPHERD'S ASSISTIVE TECHNOLOGY PROGRAM TO HELP WITH THEIR MOBILITY, COMMUNICATION AND EVERYDAY LIVING NEEDS. IN FISCAL YEAR 2012, THE RAKER CENTER OPERATED AT 99% OCCUPANCY, WITH 36,048 PATIENT DAYS, WHILE THE BETHLEHEM HOME OPERATED AT 99% OCCUPANCY, WITH 21,924 PATIENT DAYS. THERE IS A WAITING LIST FOR BOTH HOMES. 18264257 1 1 0 0 0 0 0 0 1 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 X 0 0 0 0 0 0 0 0 0 0 0 0 0 X 18 14 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X DANIEL C CONFALONE SVP FINANCECFO 6107763303 GOOD SHEPHERD PLAZA 850 SOUTH 5TH ALLENTOWN PA 18103 X SCOTT A BAKER 0.30 X X 0 0 0 SANDRA L BODNYK 0.40 X X 0 0 0 PATRICK J BRENNAN MD 0.30 X 0 0 0 ADDIE J BUTLER EDD 0.30 X 0 0 0 DAVID G DECAMPLI 0.70 X X 0 0 0 ROBERT E GADOMSKI 0.30 X 0 0 0 MICHAEL GOLDNER DO 0.20 X 0 0 0 ELSBETH G HAYMON 0.30 X 0 0 0 KATHERINE E HILGERT 0.20 X 0 0 0 SANDRA JARVA WEISS 0.20 X X 0 0 0 JAAN PETER NAKTIN MD 0.20 X 0 0 0 GERALD A NAU 0.20 X 0 0 0 EDITH D RITTER 0.20 X 0 0 0 GARY R SCHMIDT 0.30 X 0 0 0 LAURIE STEWART 0.30 X 0 0 0 THE REV DAVID R STROBEL 0.20 X 0 0 0 DANIEL J WILSON PHD 0.30 X 0 0 0 SARA T GAMMON 6.00 X X 0 670551 244647 DANIEL C CONFALONE 4.00 X 0 363344 26993 PHILLIP R BRYANT 0.00 X 0 346097 23695 SAMUEL A MIRANDA JR 5.00 X 0 249988 39812 ANTHONY R BONGIOVANNI 0.00 X 0 384545 25784 0 2014525 360931 0 1 1 0 SODEXHO OPERATIONS LLC 4880 PAYSPHERE CIRCLE CHICAGO IL 60674 DIETARY/FOOD SERVICES 520716 MEDICAL STAFFING NETWORK INC PO BOX 202996 DALLAS TX 75320 TEMPORARY STAFFING SERVICES 150919 2 360426 360426 NET PATIENT SVC REV 623000 21102248 21102248 21102248 12280 -12280 -12280 -12280 BAD DEBT RECOVERY 900099 11153 11153 11153 21461547 21102248 0 -1127 9059359 8781615 277744 517738 501865 15873 1527041 1480225 46816 643668 623469 20199 442021 400896 41125 249847 238191 11656 5952 4997 955 18447 16923 1524 1162036 1162036 CORPORATE ALLOCATION 6236021 4178134 2057887 MEDICAL SUPPLIES 640926 639799 1127 FOOD 194628 192916 1712 REPAIRS & MAINTENANCE 20553 20553 22638 22638 20740875 18264257 2476618 0 1400 1400 1364002 3008409 1047 4175 22967924 14836877 7390833 8131047 32767976 31142498 41525258 42287529 519659 544659 151327 143870 670986 688529 X 40854272 41599000 40854272 41599000 41525258 42287529 X 720672 24056 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 56370 56370 9899977 6121251 3778726 12453114 8445140 4007974 558463 270486 287977 8131047 RESIDENT FUNDS 143870 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 636823 AMOUNTS DUE FROM AFFILIATES 30361805 31142498 21461547 20740875 720672 24056 24056 744728 21461547 0 21461547 0 21461547 20740875 0 20740875 0 20740875 PART IV, LINE 2B: GOOD SHEPHERD ACTS AS CUSTODIAN OF FUNDS HELD FOR THE RESIDENTS LIVING IN THE FACILITIES. THE FUNDS ARE SET ASIDE IN A SEPARATE BANK ACCOUNT FROM THE GENERAL OPERATING FUNDS. RESIDENTS HAVE ACCESS TO THEIR FUNDS ON A DAILY BASIS AND RECEIVE MONTHLY STATEMENTS OF ACTIVITY. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: GOOD SHEPHERD PRESCRIBES A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY IN RECORDING TAX LIABILITIES IN THE FINANCIAL STATEMENTS. MEASUREMENT AND RECOGNITION OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. GOOD SHEPHERD'S POLICY IS TO RECOGNIZE INTEREST RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE AND PENALTIES IN OPERATING EXPENSES. GOOD SHEPHERD'S FEDERAL INCOME TAX RETURNS FOR THE YEARS ENDED JUNE 30, 2011, 2010, AND 2009 REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. X 1 1 1 1 0 0 0 0 0 0 0 SARA T GAMMON 0 522390 0 148161 0 0 0 241014 0 3633 0 915198 0 0 DANIEL C CONFALONE 0 308734 0 54610 0 0 0 18363 0 8630 0 390337 0 0 PHILLIP R BRYANT 0 278866 0 67231 0 0 0 17491 0 6204 0 369792 0 0 SAMUEL A MIRANDA JR 0 204175 0 45813 0 0 0 31322 0 8490 0 289800 0 0 ANTHONY R BONGIOVANNI 0 127760 0 144839 0 111946 0 19434 0 6350 0 410329 0 97374 PART I, LINE 1A GOOD SHEPHERD DOES NOT PAY ANY DUES ON BEHALF OF CEO, SARA GAMMON, DIRECTLY TO A SOCIAL CLUB. GOOD SHEPHERD REIMBURSES THE CEO FOR CERTAIN SOCIAL CLUB DUES RELEVANT IN PURSUING THE OVERALL MISSION OF GOOD SHEPHERD. THESE EXPENSES ARE ACCOUNTED FOR UNDER AN ACCOUNTABLE REIMBURSEMENT PLAN. THE AMOUNT OF THIS REIMBURSEMENT IS INCLUDED IN MS. GAMMON'S TAXABLE COMPENSATION. PART I, LINE 3 SARA T. GAMMON IS COMPENSATED BY GOOD SHEPHERD REHABILITATION NETWORK ("GSRN"), AN AFFILIATED TAX-EXEMPT ORGANIZATION. THE GOOD SHEPHERD HOME LONG-TERM CARE FACILITY, INC. RELIED ON GSRN'S USE OF ALL CRITERIA SPECIFIED IN LINE 3 TO ESTABLISH MS. GAMMON'S COMPENSATION. PART I, LINES 4A-B ANTHONY BONGIOVANNI IS THE FORMER CPO (KEY EMPLOYEE) OF THE GOOD SHEPHERD REHABILITATION NETWORK AND AFFILIATES. HE RECEIVED $239,706 FOR 52 WEEKS OF SEVERANCE PAY, BEGINNING JULY 15, 2011 THROUGH JUNE 29, 2012. GOOD SHEPHERD REHABILITATION NETWORK PROVIDES SUPPLEMENTAL EXECUTIVE RETIREMENT BENEFITS TO THE FOLLOWING EXECUTIVES: PRESIDENT/CEO SARA GAMMON, CNO SAMUEL MIRANDA, JR. AND FORMER CPO ANTHONY BONGIOVANNI. CONTRIBUTIONS TO THE PLAN ARE DETERMINED ANNUALLY. SARA GAMMON AND SAMUEL MIRANDA, JR. HAVE NOT RECEIVED ANY PAYMENTS FROM THE PLAN. AS PART OF ANTHONY BONGIOVANNI'S SEVERANCE PACKAGE, HE RECEIVED A LUMP SUM BONUS AMOUNT OF $97,374 FROM THIS PLAN AND FORFEITED THE REMAINING AMOUNT ALLOCATED TO HIM UNDER THE PLAN. PART I, LINE 5 GSRN HAS A PERFORMANCE COMPENSATION PROGRAM IN PLACE WHICH IS APPROVED BY THE BOARD. CERTAIN MEMBERS OF MANAGEMENT CAN RECEIVE AN ANNUAL PERFORMANCE PAYMENT ONLY WHEN PRE-DEFINED AND PRE-APPROVED FINANCIAL AND NON-FINANCIAL GOALS ARE ACHIEVED. FOR FISCAL YEAR 2012, A PERFORMANCE PAYMENT WAS NOT ACHIEVED. THIS IS NOT GUARANTEED EACH YEAR. THE BONUSES REPORTED IN SCHEDULE J, PART II, COLUMN (B)(II) REPRESENT THE PERFORMANCE PAYMENT ACHIEVED FOR THE PRIOR FISCAL YEAR WHICH WAS PAID DURING CALENDAR YEAR 2011. PART I, LINE 6 GSRN HAS A PERFORMANCE COMPENSATION PROGRAM IN PLACE WHICH IS APPROVED BY THE BOARD. CERTAIN MEMBERS OF MANAGEMENT CAN RECEIVE AN ANNUAL PERFORMANCE PAYMENT ONLY WHEN PRE-DEFINED AND PRE-APPROVED FINANCIAL AND NON-FINANCIAL GOALS ARE ACHIEVED. FOR FISCAL YEAR 2012, A PERFORMANCE PAYMENT WAS NOT ACHIEVED. THIS IS NOT GUARANTEED EACH YEAR. THE BONUSES REPORTED IN SCHEDULE J, PART II, COLUMN (B)(II) REPRESENT THE PERFORMANCE PAYMENT ACHIEVED FOR THE PRIOR FISCAL YEAR WHICH WAS PAID DURING CALENDAR YEAR 2011. FORM 990, PART V, LINE 1: ACCOUNTS PAYABLE PAYMENTS ARE CONSOLIDATED UNDER A COMMON REPORTING SYSTEM. SINCE TOTALS FOR EACH VENDOR MAY CONTAIN TRANSACTIONS FROM MULTIPLE CORPORATIONS, THE NUMBER OF 1099'S FILED ON BEHALF OF THE GOOD SHEPHERD HOME LONG-TERM CARE FACILITY, INC. ("LTC") BY THE COMMON REPORTING AGENT CANNOT BE SEPARATELY IDENTIFIED AND DETERMINED. FORM 990, PART V, LINE 2: THE SALARY AND BENEFIT EXPENSES REPORTED ON FORM 990, PART IX, AND THE EMPLOYEE INFORMATION REPORTED ON FORM 990, PART VII, ARE THE GOOD SHEPHERD HOME LONG-TERM CARE FACILITY, INC.'S ("LTC") ALLOCATED PAYROLL COSTS BASED ON TIME SPENT. ALL INDIVIDUALS WORKING AT LTC ARE EMPLOYEES OF THE GOOD SHEPHERD REHABILITATION HOSPITAL ("GSRH") AND ARE REPORTED ON ITS FORM W-3 UNDER EIN: 23-1371947. GSRH IS AN AFFILIATED TAX-EXEMPT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE CAN ACT ON BEHALF OF THE BOARD OF TRUSTEES IN MOST CASES. HOWEVER, ANY FUNDAMENTAL CHANGES WILL GO TO THE FULL BOARD. THE EXECUTIVE COMMITTEE IS COMPRISED OF THE CHAIRS OF ALL THE BOARD COMMITTEES AS WELL AS THE CHAIR AND VICE CHAIR OF THE BOARD. ALL EXECUTIVE COMMITTEE MEMBERS ARE MEMBERS OF THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE CORPORATE MEMBER OF THE ORGANIZATION IS THE GOOD SHEPHERD REHABILITATION NETWORK ("GSRN"), A RELATED TAX-EXEMPT ENTITY. GSRN HAS THE ULTIMATE AUTHORITY AND RESPONSIBILITY FOR THE FOLLOWING ACTIVITIES WITH RESPECT TO THE GOOD SHEPHERD HOME LONG-TERM CARE FACILITY, INC.: AMENDMENT, APPROVAL OR REVOCATION OF BYLAWS; INSTITUTIONAL DEVELOPMENT; CORPORATE AND STRATEGIC PLANNING; FINANCIAL PLANNING AND BUDGETING; AUDIT AND FISCAL MATTERS; RESOURCE ALLOCATION; PUBLIC RELATIONS; APPOINTMENT OF TRUSTEES AND OFFICERS; COMPENSATION AND HUMAN RESOURCE POLICIES; MEDICAL STAFF AND GENERAL POLICY MATTERS. FORM 990, PART VI, SECTION A, LINE 7B SEE EXPLANATION FOR FORM 990, PART VI, SECTION A, LINE 7A. FORM 990, PART VI, SECTION B, LINE 11 THE IRS FORM 990 IS PREPARED USING INFORMATION SOLICITED FROM OFFICERS, DIRECTORS, TRUSTEES, BOARD COMMITTEE MEMBERS, AND MANAGEMENT. THIS GROUP OF INDIVIDUALS ARE PROVIDED A DRAFT RETURN BEFORE THE FINAL RETURN IS FILED. QUESTIONS, COMMENTS, AND ADDITIONAL INFORMATION PROVIDED BY THIS GROUP ARE INCORPORATED INTO THE FINAL RETURN. THE FINAL RETURN IS REVIEWED AT A COMMITTEE LEVEL OF THE BOARD PRIOR TO IT BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C THERE IS A SYSTEMATIC PROCESS COORDINATED THROUGH THE GOVERNANCE COMMITTEE WHERE THE CONFLICT OF INTEREST STATEMENTS COMPLETED ANNUALLY BY BOARD MEMBERS AND SENIOR LEADERSHIP TEAM MEMBERS ARE REVIEWED BY THE GOVERNANCE COMMITTEE. WHENEVER THE COMMITTEE FEELS THE CONFLICT STATEMENT IS EITHER INCOMPLETE OR FEELS SOMETHING MAY BE MISSING, THE COMMITTEE WILL ASK MANAGEMENT TO PURSUE FURTHER DUE DILIGENCE. WHEN A BOARD MEMBER DOES HAVE AN INHERENT CONFLICT, THE TRUSTEE IS ASKED TO EITHER ABSTAIN FROM VOTING OR EXCUSE HIMSELF FROM THE ROOM DURING THE DISCUSSION AND VOTING. FORM 990, PART VI, SECTION B, LINE 15 THE GOOD SHEPHERD REHABILITATION NETWORK BOARD DELEGATES RESPONSIBILITY FOR FOLLOWING ALL LEGAL AND REGULATORY REQUIREMENTS AFFECTING EXECUTIVE COMPENSATION TO THE HUMAN RESOURCES/EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD. THIS COMMITTEE IS CHARGED WITH THE ADMINISTRATION OF COMPENSATION PRACTICES FOR OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. THIS COMMITTEE SELECTED AND USES AN INDEPENDENT CONSULTING FIRM SPECIALIZING IN HEALTHCARE EXECUTIVE COMPENSATION MATTERS AND USES COMPARABLE COMPETITIVE MARKET DATA IN THEIR ANALYSIS. THE SERVICES OF AN INDEPENDENT COMPENSATION CONSULTANT (IHS) WERE UTILIZED AND THEIR LATEST REPORT TO THE HUMAN RESOURCE COMPENSATION COMMITTEE WAS DATED APRIL 22, 2012. COMMITTEE MEETINGS ARE HELD ON AN ONGOING BASIS AND ARE DOCUMENTED IN DETAIL. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS ARE PUBLISHED TO THE ORGANIZATION'S WEBSITE AT LEAST ANNUALLY. THE GOVERNING DOCUMENTS AND POLICIES ARE AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION A: SARA T. GAMMON, DANIEL C. CONFALONE, PHILLIP R. BRYANT, AND SAMUEL A. MIRANDA, JR. ARE OFFICERS/KEY EMPLOYEES FOR ALL 7 ENTITIES WITHIN THE GOOD SHEPHERD REHABILITATION NETWORK. THEY EACH DEVOTE APPROXIMATELY 60 HOURS PER WEEK TO THE ENTIRE GROUP OF ENTITIES. THE AVERAGE HOURS LISTED IN COLUMN (B) FOR EACH INDIVIDUAL REPRESENTS THE APPROXIMATE PORTION OF 60 HOURS DEVOTED TO THE GOOD SHEPHERD HOME LONG-TERM CARE FACILITY, INC. PER WEEK. THE COMPENSATION AND BENEFIT INFORMATION REPORTED IN COLUMNS (E) AND (F) REPRESENTS WHAT EACH INDIVIDUAL EARNS FOR THEIR TIME SPENT ON THE ENTIRE GROUP OF 7 ENTITIES. THE BOARD MEMBERS ALSO DEVOTE TIME TO FIVE OTHER ORGANIZATIONS IN THE GROUP. TOTAL TIME SPENT BY BOARD MEMBERS RANGES FROM .75 HOURS PER WEEK TO 3.25 HOURS PER WEEK. THE AVERAGE HOURS LISTED IN COLUMN (B) FOR EACH BOARD MEMBER REPRESENTS THE APPROXIMATE PORTION OF HOURS DEVOTED TO THE GOOD SHEPHERD HOME LONG-TERM CARE FACILITY, INC. PER WEEK. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: PRIOR PERIOD ADJUSTMENTS: 24,056. FORM 990, PART XI, LINE 2C: THE PROCESSES USED BY THE COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT HAVE NOT CHANGED FROM THE PRIOR YEAR. GOOD SHEPHERD HOUSING DEVELOPMENT CORPORATION GOOD SHEPHERD PLAZA 850 SOUTH 5TH S ALLENTOWN PA 18103 233073390 PROVIDES INDEPENDENT LIVING APTS FOR DISABLED, LOW-INCOME ADULTS PA 501(C)(3) LINE 7 GOOD SHEPHERD REHABILITATION NETWORK 0 GOOD SHEPHERD REHABILITATION HOSPITAL GOOD SHEPHERD PLAZA 850 SOUTH 5TH S ALLENTOWN PA 18103 231371947 PROVIDES COMPREHENSIVE INPATIENT AND OUTPATIENT REHABILITATION SERVICES PA 501(C)(3) LINE 3 GOOD SHEPHERD REHABILITATION NETWORK 0 GOOD SHEPHERD REHABILITATION NETWORK GOOD SHEPHERD PLAZA 850 SOUTH 5TH S ALLENTOWN PA 18103 232216041 PROVIDES MANAGEMENT SERVICES IN SUPPORT OF ITS TAX-EXEMPT AFFILIATES PA 501(C)(3) LINE 7 N/A 0 GOOD SHEPHERD WORKSHOPVOCATIONAL SERVICES INC 1901 LEHIGH STREET ALLENTOWN PA 18103 232215801 PROVIDES EMPLOYMENT DEVELOPMENT PROGRAMS AND VOCATIONAL EVALUATIONS PA 501(C)(3) LINE 11A, I GOOD SHEPHERD REHABILITATION NETWORK 0 PHILADELPHIA POST-ACUTE PARTNERS LLC 1800 LOMBARD STREET PHILADELPHIA PA 19146 208283421 OPERATES INPATIENT REHAB HOSP, ACUTE CARE HOSP & 8 OUTPATIENT FACILITIES PA 501(C)(3) LINE 3 GOOD SHEPHERD REHABILITATION NETWORK 0 THE ALLENTOWN SPECIALTY HOSPITAL INC GOOD SHEPHERD PLAZA 850 SOUTH 5TH S ALLENTOWN PA 18103 233009874 PROVIDES INPATIENT SVCS THROUGH OPERATION OF LONG-TERM ACUTE CARE HOSP PA 501(C)(3) LINE 3 GOOD SHEPHERD REHABILITATION NETWORK 0 GOOD SHEPHERD RECIPROCAL RISK RENTENTION GROUP 7301 RIVERS AVENUE SUITE 230 NORTH CHARLESTON SC 29406 204065112 RISK RETENTION GROUP SC N/A C 0 0 1 0 0 0 0 1 0 0 0 1 0 1 1 1 0 1