LOWER BUCKS HOSPITAL: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
LOWER BUCKS HOSPITAL (EIN 23-2879667)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-05-15
IRS object ID
201341359349309304
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)
Timestamp2013-05-15T17:48:24-05:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN233022325EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ZELENKOFSKE AXELROD LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12370 YORK ROAD SUITE A-5AddressLine1
CityJAMISONCity
StatePAState
ZIP Code18929ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN232879667EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1LOWER BUCKS HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlLOWENameControl
Phone2157859200Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1501 BATH ROADAddressLine1
CityBRISTOLCity
StatePAState
ZIP Code19007ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameALBERT MEZZAROBAName
TitleCEOTitle
Phone2157859200Phone
Date Signed2013-05-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameZELENKOFSKE AXELROD LLCName
PTINP00671750PTIN
Phone2159182277Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonALBERT MEZZAROBANameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1501 BATH ROADAddressLine1
CityBRISTOLCity
StatePAState
ZIP Code19007ZIPCode
FieldValueIRS element (for citing)
Gross Receipts85728343GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.LOWERBUCKSHOSPITAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1956YearFormation
State Legal DomicilePAStateLegalDomicile
Activity Or Mission DescriptionHEALTHCARE-COMMUNITY HOSPITALActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees1061TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year87448361ProgramServiceRevenuePriorYear
Program Service Revenue CY80908092ProgramServiceRevenueCY
Investment Income Prior Year16334InvestmentIncomePriorYear
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Prior Year4705323OtherRevenuePriorYear
Other Revenue Current Year4820251OtherRevenueCurrentYear
Total Revenue Prior Year92170018TotalRevenuePriorYear
Total Revenue Current Year85728343TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year47545820SalariesEtcPriorYear
Salaries Etc Current Year45606664SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year3151TotalFundrsngExpCurrentYear
Other Expense Prior Year49263488OtherExpensePriorYear
Other Expenses Current Year48597889OtherExpensesCurrentYear
Total Expenses Prior Year96809308TotalExpensesPriorYear
Total Expenses Current Year94204553TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-4639290RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-8476210RevenuesLessExpensesCY
Total Assets BOY59643051TotalAssetsBOY
Total Assets EOY53829195TotalAssetsEOY
Total Liabilities BOY73694796TotalLiabilitiesBOY
Total Liabilities EOY34734085TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-14051745NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY19095110NetAssetsOrFundBalancesEOY
Mission DescriptionADVANCED HEALTHCARE FOR THE COMMUNITYMissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense75455913Expense
Revenue75455913Revenue
DescriptionHEALTHCARE TO THE COMMUNITYDescription
Total Program Service Expense75455913TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
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 Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization1BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109643NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees1061NumberOfEmployees
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
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
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 Chapters1LocalChapters
Policies Reference Chapters1PoliciesReferenceChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
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 Line1CFOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2157859325TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1501 BATH ROADAddressLine1
CityBRISTOLCity
StatePAState
ZIP Code19007ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (24 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
DELORES BROWN
CHAIRPERSON1.00XX000
LOUIS BUSICO
VICE CHAIRPERSON1.00XX000
GLADYS MENDIETA
SECRETARY/TREASURER1.00XX000
PHILLIP BRACKIN MD
BOARD MEMBER1.00X000
YAGNESH CHOKSKI
BOARD MEMBER1.00X000
HARRY FAWKES JR
BOARD MEMBER1.00X000
HARRY FAWKES SR
BOARD MEMBER1.00X000
BRUCE Q HARRIS
BOARD MEMBER1.00X000
ROBERT LEIPZIGER
BOARD MEMBER1.00X000
LOUIS QUATTROCCHI
BOARD MEMBER1.00X000
RANGA RAO MD
BOARD MEMBER1.00X000
JOANNA SCHNEYDER
BOARD MEMBER1.00X000
JAMES H SELL
BOARD MEMBER1.00X000
RONALD P WALKER
BOARD MEMBER1.00X000
ALBERT MEZZAROBA
CHIEF EXECUTIVE OFFICER40.00X40849908473XX
MICHAEL OLIVIERI
CHIEF FINANCIAL OFFICER40.00X14792706231XX
JOHN MCHALE
EXECUTIVE VICE PRESIDENT40.00X13826307616XX
PATRICIA BAIN
CHIEF NURSING OFFICER40.00X12751205811XX
MICHAEL REGAN
CHIEF INFORMATION OFFICER40.00X000XX
KIM CLABBERS MD
ORTHOPEDIC SURGEON40.0031137708572X
TATYANA CHERNOVA MD
PATHOLOGIST40.0022981907509X
ANNA SOSNOVSKY MD
NEONATOLOGIST40.0013194805119X
KARL HELMOLD
ORTHOPEDIC SURGEON40.0029547205284X
KAZIMIERZ WATOREK
NEONATOLOGIST40.0016430005458X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1955117TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation60073TotalOtherCompensation
Number Individuals GT100 K9NumberIndividualsGT100K
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
SODEXHO
PO BOX 905374CHARLOTTENC28290FOOD SERVICE1730874
HORIZON MENTAL
2941 SOUTH LAKE VISTA DRIVELEWISVILLETX75067HEALTH SERVICES1211791
PINNACLE MID-AT
13601 PRESTON ROADDALLASTX75240ANESTHESIA SERVICES1118937
LBH RADIOLOGY
501 BATH ROADBRISTOLPA19007RADIOLOGY SERVICES791159
LOWER BUCKS PHYSICIANS
66 WEST GILBERT STREET SUITE 6000RED BANKNJ07701MEDICAL537386
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT REVENUEDescription
Business Code621110BusinessCode
Total Revenue Column80908092TotalRevenueColumn
Related Or Exempt Function Income80908092RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue80908092TotalProgramServiceRevenue

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionOTHER OPERATING REVENUDescription
Business Code621110BusinessCode
Total Revenue Column4820251TotalRevenueColumn
Related Or Exempt Function Income4820251RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue4820251TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column85728343TotalRevenueColumn
Related Or Exempt Function Income85728343RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total683938Total
Program Services127512ProgramServices
Management And General556426ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total37489978Total
Program Services31993115ProgramServices
Management And General5494243ManagementAndGeneral
Fundraising2620Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total4645581Total
Program Services3762973ProgramServices
Management And General882608ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2787167Total
Program Services2345631ProgramServices
Management And General441339ManagementAndGeneral
Fundraising197Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total2004824Total
Management And General2004824ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total161945Total
Management And General161945ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total6404026Total
Program Services6182426ProgramServices
Management And General221600ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total303147Total
Program Services21288ProgramServices
Management And General281525ManagementAndGeneral
Fundraising334Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total733710Total
Management And General733710ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2403318Total
Program Services2403318ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total64448Total
Program Services64448ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total6300000Total
Program Services6300000ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total3180238Total
Program Services2675274ProgramServices
Management And General504964ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
OUTSIDE SERVICES1188387471248414759033
SUPPLIES86348987992925641973
EQUIPMENT RENTAL&MAINT/380207917753672026712
DRUGS24593952459395

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total261987Total
Program Services227400ProgramServices
Management And General34587ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total94204553Total
Program Services75455913ProgramServices
Management And General18745489ManagementAndGeneral
Fundraising3151Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY6920338BOY
EOY2279614EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY13990977BOY
EOY17969217EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2648786BOY
EOY4040695EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2195399BOY
EOY2200093EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis123826412LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec99994372LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY28902881BOY
EOY23832040EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY561437BOY
EOY540453EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY4423233BOY
EOY2967083EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY59643051BOY
EOY53829195EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY42243591BOY
EOY27713449EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY24816406BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY6634799BOY
EOY7020636EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY73694796BOY
EOY34734085EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-14051745BOY
EOY19095110EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-14051745BOY
EOY19095110EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY59643051BOY
EOY53829195EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-8476210ReconcilationRevenueExpenses
Reconcilation Other Changes41623065ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited0FSAudited
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 D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1040412OtherCostOrOtherBasis
Book Value1040412BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis122786000OtherCostOrOtherBasis
Depreciation99994372Depreciation
Book Value22791628BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings23832040TotalOfBookValueLandBuildings

Other Assets OtherAssets

FieldValueIRS element (for citing)
DescriptionDUE FROM RELATED PARTYDescription
Book Value2967083BookValue
FieldValueIRS element (for citing)
Total Book Value Other Assets2967083TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO RELATED PARTYDescription
Amount$7,020,636Amount
FieldValueIRS element (for citing)
Total Of Amounts7020636TotalOfAmounts
Total Revenue85728343TotalRevenue
Total Expenses94204553TotalExpenses
Excess Or Deficit For Year-8476210ExcessOrDeficitForYear
Other$41,623,065OtherAmount
Total Adjustments41623065TotalAdjustments
Excess Or Deficit Per FS33146855ExcessOrDeficitPerFS

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierPART XI, LINE 8 - OTHER ADJUSTMENTS:Identifier
ExplanationALL ADJUSTMENTS MADE THROUGH BANKRUPTCY 41,623,065.Explanation

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GOLF OUTINGNameOfEvent1

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report0AnnualCommunityBenefitReport
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 Line1LOWER BUCKS HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1501 BATH ROADAddressLine1
CityBRISTOLCity
StatePAState
ZIP Code19007ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1LOWER BUCKS HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA Conducted0CHNAConducted
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent10000.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent10000.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures0IncludesPublicityMeasures
Actions On Nonpayment1ActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Permit LawsuitXPermitLawsuit
Permit Lien On ResidenceXPermitLienOnResidence
Collection Activities1CollectionActivities
Report To Credit AgencyXReportToCreditAgency
LawsuitXLawsuit
Lien On ResidenceXLienOnResidence
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Medicare RateXMedicareRate
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (2 entries)

ExplanationExplanationIdentifierIdentifier
PART I, LINE 3C: LOWER BUCKS HOSPITAL OPERATES A FREE CARE-FLEXIBLE FEE SCHEDULE BASED ON HHS 2011 POVERTY INCOME GUIDELINES. DEPENDING ON THE SIZE OF THE FAMILY AND THE ANNUAL INCOME, THE PATIENT RECEIVES EITHER FREE CARE OR DISCOUNTED RATES - ANYWHERE FROM 25% TO 100%. ANY FAMILY UNIT WHO HAS MORE THAN 8 MEMBERS, $3,820 IS ADDED FOR EACH ADDITIONAL MEMBER.
PART V, SECTION B, LINE 3: WHEN A PATIENT EXPRESSES THE INABILITY TO MEET THE FINANCIAL RESPONSIBILITIES OCCASIONED BY SERVICES RENDERED AT THE HOSPITAL, A PATIENT FINANCIAL WORKSHEET WILL BE INITIATED AND COMPLETED BY A CREDIT AND COLLECTION REPRESENTATIVE. THE CREDIT AND COLLECTION REPRESENTATIVE WILL COMPLETE A FREE CARE/BAD DEBT CHECKLIST FROM THE INFORMATION OBTAINED FROM THE PATIENT FINANCIAL WORKSHEET, INTERVIEWS AND OTHER RESEARCH METHODS. AN ACCOUNT MAY BE ELIGIBLE FOR FREE CARE BASED ON INDIGENCE OR FINANCIAL HARDSHIP. THE HOSPITAL RESERVES THE RIGHT TO REQUIRE THE PATIENT TO APPLY FOR AVAILABLE ASSISTANCE THROUGH EXTERNAL AGENCIES. IF FULL OR PARTIAL PAYMENT IS NOT POSSIBLE, THE DATA INCLUDED IN THE FINANCIAL WORKSHEET SHOULD BE USED TO DOCUMENT AND SUPPORT CLASSIFICATION AS FREE CARE. THE HOSPITAL USES THE HHS POVERTY INCOME GUIDELINES TO DETERMINE FREE CARE ELIGIBILITY AND ALSO RESERVES THE RIGHT TO CONSIDER LIQUID ASSETS AS PART OF THE ASSESSMENT. THERE ARE MULTIPLE LEVELS OF FREE CARE ELIGIBILITY. FREE CARE ADJUSTMENTS, AS DETERMINED BY THE FREE CARE POLICY OF LOWER BUCKS HOSPITAL, WILL BE EFFECTIVE AFTER ALL PATIENT BALANCES HAVE BEEN PAID OR SETTLED. FAILURE TO SATISFY APPROPRIATE PATIENT BALANCES WILL VOID THE APPLICATION AND THE PATIENT WILL BE LIABLE FOR THE ENTIRE PATIENT BALANCE.LOWER BUCKS HOSPITAL

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
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 (10 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
ALBERT MEZZAROBA
408499000008473000416972000
MICHAEL OLIVIERI
147927000006231000154158000
JOHN MCHALE
138263000007616000145879000
PATRICIA BAIN
127512000005811000133323000
MICHAEL REGAN
KIM CLABBERS MD
311377000008572000319949000
TATYANA CHERNOVA MD
229819000007509000237328000
ANNA SOSNOVSKY MD
131948000005119000137067000
KARL HELMOLD
295472000005284000300756000
KAZIMIERZ WATOREK
164300000005458000169758000

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (6 entries)

RelationshipRelationshipDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
DELORES BROWN
CHAIRPERSONINDIVIDUAL IS ALSO ON THE BOARDS OF RELATED ORGANIZATIONS, ADVANCED PRIMARY CARE PHYSICIANS, ADVANCED SPECIALTY PHYSICIAN GROUP, LOWER HEALTH BUCKS ENTERPRISES AND BUCKS COUNTY HEALTH FOUNDATION.0
PHILLIP BRACKIN MD
BOARD MEMBERPARTNER OF LOWER BUCKS RADIOLOGY ASSOCIATES WHICH HAS A CONTRACT WITH THE HOSPITAL TO PROVIDE PROFESSIONAL COMPONENT OF RADIOLOGY SERVICES.0
HARRY FAWKES JR
BOARD MEMBERINDIVIDUAL IS RELATED BY BLOOD TO ANOTHER BOARD MEMBER.0
HARRY FAWKES SR
BOARD MEMBERINDIVIDUAL IS RELATED BY BLOOD TO ANOTHER BOARD MEMBER AND IS ON THE BOARD OF AFFILIATED ORGANIZATION, LOWER BUCKS HEALTH ENTERPRISES.0
RANGA RAO MD
BOARD MEMBERINDIVIDUAL IS ALSO A MEMBER OF THE HOSPITAL MEDICAL STAFF.0
LOUIS QUATTROCCHI
BOARD MEMBERINDIVIDUAL IS A BOARD MEMBER WHO IS ALSO THE PRESIDENT AND MAJOR STOCKHOLDER IN BRISTOL FUEL COMPANY AND CBM OF DELAWARE VALLEY. LOWER BUCKS HOSPITAL PURCHASES FUEL FOR THEIR OUTSIDE PROPERTIES AND LUMBER FROM THEM.0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 2TWO BOARD MEMBERS ARE FATHER AND SON.
FORM 990, PART VI, SECTION B, LINE 11FORM 990 IS REVIEWED BY THE CEO AND CFO/CONTROLLER PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE CEO REVIEWS THE CONFLICT OF INTEREST POLICY STATEMENTS ANNUALLY.
FORM 990, PART VI, SECTION B, LINE 15THE HOSPITAL USES SURVEYS FROM DELAWARE VALLEY HEALTH COUNCIL (DVHC) AND KEEPS TRENDS ON WHAT OTHER AREA HOSPITALS ARE DOING.
FORM 990, PART VI, SECTION C, LINE 19FORMS ARE AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 5:ALL ADJUSTMENTS MADE THROUGH BANKRUPTCY 41,623,065. TOTAL TO FORM 990, PART XI, LINE 5: 41,623,065.CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionControlled OrgControlledOrg
ADVANCED PRIMARY CARE PHYSICIANS
501 BATH ROADBRISTOLPA19007261429053OPERATIONAL SUPPORTPA501(C)(3)0
ADVANCED SPECIALTY PHYSICIANS GROUP
501 BATH ROADBRISTOLPA19007262414312HEALTHCAREPA501(C)(3)0
BUCKS COUNTY HEALTH FOUNDATION
501 BATH ROADBRISTOLPA19007208367267HEALTHCAREPA501(C)(3)0
BUCKS COUNTY HEALTH ENTERPRISES
501 BATH ROADBRISTOLPA19007232547355HEALTHCAREPA501(C)(3)0
BUCKS COUNTY INSURANCE COMPANY LTD
501 BATH ROADBRISTOLPA19007980490086SELF INSURANCEPACFC0
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 Org1LoansOrGuaranteesToOtherOrg
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 Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
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 (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
LOWER BUCKS HEALTH ENTERPRISES INC
D370719ACTUAL
LOWER BUCKS HEALTH ENTERPRISES INC
L385803ACTUAL
ADVANCED PRIMARY CARE PHYSICIANS
D393575ACTUAL
LOWER BUCKS HEALTH ENTERPRISES INC
I16000ACTUAL

Form990 Schedule R Part VI Form990ScheduleRPartVI

Name Of Business NameOfBusiness

FieldValueIRS element (for citing)
Business Name Line1BUCKS COUNTY PARTNERS IN PET LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11455 BROAD STREET 4TH FLOORAddressLine1
CityBLOOMFIELDCity
StateNJState
ZIP Code07003ZIPCode
FieldValueIRS element (for citing)
EIN331040092EIN
Primary ActivityHEALTHCAREPrimaryActivity
Legal Domicile StatePALegalDomicileState
All Partners C3 S0AllPartnersC3S
Disproportionate Allocations0DisproportionateAllocations
General Or Managing Partner0GeneralOrManagingPartner

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