LEHIGH VALLEY HOSPITAL-HAZLETON: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
LEHIGH VALLEY HOSPITAL-HAZLETON (EIN 23-2421970)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-05
IRS object ID
201343099349301069
Schema version
2012v2.2
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-11-05T01:15:15-00:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN232421970EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1NORTHEASTERN PENNSYLVANIA HEALTH CORPORATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlNORTNameControl
Phone5705014000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1700 E BROAD STREETAddressLine1
CityHAZLETONCity
StatePAState
ZIP Code18201ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameWILLIAM C BAUERName
TitleCHIEF FINANCIAL OFFICERTitle
Date Signed2013-11-05DateSigned
Authorize Third PartyfalseAuthorizeThirdParty
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1HAZLETON GENERAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonJames D EdwardsNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1700 E Broad StAddressLine1
CityHazletonCity
StatePAState
ZIP Code18201ZIPCode
FieldValueIRS element (for citing)
Gross Receipts136276717GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.ghha.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1985YearFormation
State Legal DomicilePAStateLegalDomicile
Activity Or Mission DescriptionHGH provides inpatient, emergency, diagnostic, maternity, rehabilitative, outpatient therapeutic medical services conducts community education programs/services delivers these programs services with compassion high standards of quality without discrimination.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees756TotalNbrEmployees
Total Nbr Volunteers11TotalNbrVolunteers
Total Gross UBI555547TotalGrossUBI
Net Unrelated Business Txbl Income-40155NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year457478ContributionsGrantsPriorYear
Contributions Grants Current Year560787ContributionsGrantsCurrentYear
Program Service Revenue Prior Year108232158ProgramServiceRevenuePriorYear
Program Service Revenue CY99251837ProgramServiceRevenueCY
Investment Income Prior Year1379323InvestmentIncomePriorYear
Investment Income Current Year2545977InvestmentIncomeCurrentYear
Other Revenue Prior Year591783OtherRevenuePriorYear
Other Revenue Current Year4078806OtherRevenueCurrentYear
Total Revenue Prior Year110660742TotalRevenuePriorYear
Total Revenue Current Year106437407TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year49477190SalariesEtcPriorYear
Salaries Etc Current Year51141758SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year1109TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY716TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year66494TotalFundrsngExpCurrentYear
Other Expense Prior Year46330897OtherExpensePriorYear
Other Expenses Current Year38017416OtherExpensesCurrentYear
Total Expenses Prior Year95809196TotalExpensesPriorYear
Total Expenses Current Year89159890TotalExpensesCurrentYear
Revenues Less Expenses Prior Year14851546RevenuesLessExpensesPriorYear
Revenues Less Expenses CY17277517RevenuesLessExpensesCY
Total Assets BOY109712096TotalAssetsBOY
Total Assets EOY114238436TotalAssetsEOY
Total Liabilities BOY76296473TotalLiabilitiesBOY
Total Liabilities EOY73852948TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY33415623NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY40385488NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionHGH commits to service health needs in the Hazleton area, through its inpatient, emergency, diagnostic, maternity, rehabilitative, outpatient therapeutic medical services by providing community education and delivering programs services with compassion high standards of quality without discrimination.MissionDescription
Significant New Program ServicestrueSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense67761160Expense
Revenue106437407Revenue
DescriptionHazleton General Hospital provides a full range of hospital inpatient, outpatient, therapeutic, diagnostic, imaging, maternity and rehabilitation care, as well as emergency room services to the residents of Greater Hazleton regardless of race, religion or economic status. See Schedule O for new projects in 2012 done to enhance the quality efficiency of our mission. View our community report at www.ghha.orgDescription
Total Program Service Expense67761160TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingtrueProfessionalFundraising
Fundraising ActivitiestrueFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPtrueLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationtrueBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgtrueTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109681NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees756NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionstrueQuidProQuoContributions
Quid Pro Quo DisclosuretrueQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProceduretrueWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledPAStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonFINANCE DEPARTMENTNamePerson
Telephone Number5705014989TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1700 E BROAD STAddressLine1
CityHAZLETONCity
StatePAState
ZIP Code18201ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (29 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
J EDWARDS
CHIEF EXECUTIVE OFFICER028.00012.00XX064855936396
J DANISH
ASST SECRETARY OF BOARD / DIR ADM SVC028.00012.00X011884031285
T KENNEDY ESQ
BOARD CHAIR002.00001.00X000
A SRINIVASAN MD
BOARD VICE CHAIR001.00000.50X000
J MADDEN PhD
BOARD SECRETARY001.00000.50X000
J OSIECKI
BOARD TREASURER001.00000.50X000
SISTER MARY MARGARET OSF
BOARD MEMBER000.50000.50X000
A ARIAS
BOARD MEMBER000.50000.50X000
P BENYO MD
BOARD MEMBER000.50000.50X000
A CUSATIS
BOARD MEMBER000.50000.50X000
M LEIB
BOARD MEMBER000.50000.50X000
M LOBITZ DO
BOARD MEMBER000.50000.50X000
D PALERMO
BOARD MEMBER000.50000.50X000
J SNYDER DO
BOARD MEMBER000.50000.50X000
A VEGLIA MD
BOARD MEMBER000.50000.50X000
M WASHINSKY DO
BOARD MEMBER000.50000.50X000
J FLETCHER
CHIEF OPERATING OFFICER028.00012.00X035904116423
W BAUER
CHIEF FINANCIAL OFFICER028.00012.00X035781936022
A VALENTE
VP MEDICAL AFFAIRS021.00009.00X028559535548
M GOLDEN
CHIEF NURSING OFFICER028.00012.00X026095134164
M SCHERER
VP CHIEF ADMINSTRATIVE OFFICER-HWC028.00012.00X01236573946
W REPPY
VP CHIEF ADMINSTRATIVE OFFICER-HWC028.00012.00X01076415117
L MILLER
VP CHIEF ADMINSTRATIVE OFFICER-HWC028.00012.00X01037673912
D PATTEN MD
PHYSICIAN026.00006.00397640035408X
J CIOTOLA MD
PHYSICIAN026.00006.00381313034908X
J AMENTLER MD
PHYSICIAN040.0020210908279X
D POGAR
PHARMACIST040.00109115031610X
C FERKO
PHARMACIST040.00107219031520X
E PERRONG
VP HUMAN RESOURCES028.00012.00016410911980X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1197396TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2529979TotalReportableCompFrmRltdOrgs
Total Other Compensation356518TotalOtherCompensation
Number Individuals GT100 K8NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcestrueCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
HAZLETON ANESTHESIA SERVICES PC
10 COMMERCE DRNEW ROCHELLENY10801ANESTHESIA SERVICES1223974
LABORATORY CORP OF AMERICA
PO BOX 12140BURLINGTONNC27216LABORATORY SERVICES871879
PHILIPS HEALTHCARE
22100 BOTHELL EVERETT HWY PO BOX 30BOTHELLWA980218431BIOMEDICAL MAINTENANCE SERVICE719623
SIEMENS MEDICAL SOLUTIONS USA INC
51 VALLEY STREAM PARKWAYMALVERNPA19355EQUIPMENT MAINTENANCE SERVICE407724
MORRISON MANAGMENT SPECIALISTS
PO BOX 102289ATLANTAGA30368DIETARY MANAGEMENT406729
FieldValueIRS element (for citing)
Number Of Contractors GT100 K34NumberOfContractorsGT100K
Government Grants517495GovernmentGrants
All Other Contributions43292AllOtherContributions
Total Contributions560787TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Net patient service revenue9000999902674498471197555547
Pharmacy sales90009930438$30,438
Cafeteria sales624200175868$175,868
Meals on wheels62420018787$18,787
FieldValueIRS element (for citing)
Total Program Service Revenue99251837TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1395654TotalRevenueColumn
Exclusion$1,395,654ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real145667Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real145667Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column145667TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities30971287Securities
Other4605Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities29825569Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities1145718Securities
Other4605Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1150323TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Income Fundraising Events61345GrossIncomeFundraisingEvents
Fundraising Direct Expenses13741FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column47604TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Equity in affiliates900003473089473089
MSA revenue - HWC541610189566189566
EHR incentives90009928701732870173

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column352707TotalRevenueColumn
Related Or Exempt Function Income352707RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue3885535TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column106437407TotalRevenueColumn
Related Or Exempt Function Income102356732RelatedOrExemptFunctionIncome
Unrelated Business Revenue555547UnrelatedBusinessRevenue
Exclusion$1,620,747ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total39392950Total
Program Services32619093ProgramServices
Management And General6714715ManagementAndGeneral
Fundraising59142Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total8970861Total
Program Services8104155ProgramServices
Management And General864595ManagementAndGeneral
Fundraising2111Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2777947Total
Program Services2390660ProgramServices
Management And General382762ManagementAndGeneral
Fundraising4525Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total442296Total
Management And General442296ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total126846Total
Management And General126846ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total104072Total
Management And General104072ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total716Total
Fundraising716Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total5040386Total
Program Services3311265ProgramServices
Management And General1729121ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total446075Total
Program Services17197ProgramServices
Management And General428878ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1692619Total
Program Services1059218ProgramServices
Management And General633401ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total695580Total
Management And General695580ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1369728Total
Program Services1266638ProgramServices
Management And General103090ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total128758Total
Program Services107358ProgramServices
Management And General21400ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total54502Total
Program Services29985ProgramServices
Management And General24517ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1223437Total
Management And General1223437ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total5867192Total
Program Services2138000ProgramServices
Management And General3729192ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total914585Total
Management And General914585ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SUPPLIES104134851037880334682
EQUIPMENT RENTAL MAINTENANCE37790353428185350850
PHYSICIAN FEES30918082692333399475

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total2627012Total
Program Services218270ProgramServices
Management And General2408742ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total89159890Total
Program Services67761160ProgramServices
Management And General21332236ManagementAndGeneral
Fundraising66494Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY950BOY
EOY1902EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY19465249BOY
EOY10249260EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY8585106BOY
EOY9339801EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY134334BOY
EOY98498EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY728987BOY
EOY802690EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY966839BOY
EOY985348EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis93981327LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec62891600LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY28033293BOY
EOY31089727EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY46217380BOY
EOY57925311EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY5579958BOY
EOY3745899EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY109712096BOY
EOY114238436EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY9650395BOY
EOY8993823EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY32714151BOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
EOY30535000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY33931927BOY
EOY34324125EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY76296473BOY
EOY73852948EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY32675981BOY
EOY39582895EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY739642BOY
EOY802593EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY33415623BOY
EOY40385488EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY109712096BOY
EOY114238436EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses17277517ReconcilationRevenueExpenses
Reconciliation Unrealized Invest880185ReconciliationUnrealizedInvest
Reconcilation Other Changes-11187839ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii
Public Support Pertcentage1700.00000PublicSupportPertcentage170
Public Support Percentage5090.00000PublicSupportPercentage509
Investment Income Percentage0.00000InvestmentIncomePercentage

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

Total Direct Lobbying TotalDirectLobbying

FieldValueIRS element (for citing)
Filing Organizations Totals135747FilingOrganizationsTotals

Total Lobbying Expenditures TotalLobbyingExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals135747FilingOrganizationsTotals

Other Exempt Purpose Expenditures OtherExemptPurposeExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals89024141FilingOrganizationsTotals

Total Exempt Purpose Expenditures TotalExemptPurposeExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals89159888FilingOrganizationsTotals

Lobbying Nontaxable LobbyingNontaxableAmount

FieldValueIRS element (for citing)
Filing Organizations Totals1000000FilingOrganizationsTotals

Grassroots Nontaxable GrassrootsNontaxableAmount

FieldValueIRS element (for citing)
Filing Organizations Totals250000FilingOrganizationsTotals

Lobbying Nontaxable Amount2 LobbyingNontaxableAmount2

FieldValueIRS element (for citing)
Current Year Minus3269218CurrentYearMinus3
Current Year Minus2224478CurrentYearMinus2
Current Year Minus1123394CurrentYearMinus1
Current Year135747CurrentYear
Total752837Total
FieldValueIRS element (for citing)
Lobbying Ceiling$1,129,256LobbyingCeilingAmount

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Included On FSfalseIncludedOnFS

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis7201589OtherCostOrOtherBasis
Book Value7201589BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis53377802OtherCostOrOtherBasis
Depreciation39862185Depreciation
Book Value13515617BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis30127303OtherCostOrOtherBasis
Depreciation21931812Depreciation
Book Value8195491BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3274633OtherCostOrOtherBasis
Depreciation1097603Depreciation
Book Value2177030BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings31089727TotalOfBookValueLandBuildings

Other Securities OtherSecurities (2 entries)

DescriptionDescription
Financial derivatives and other financial products
Closely-held equity interests

Other Liabilities OtherLiabilities (7 entries)

DescriptionDescriptionAmountAmount
Federal income taxes
Accrued Pension Costs$24,728,664
Third Party Settlements$7,204,606
Pension Payable$1,169,828
Capitalized Leases$496,167
Malpractice Insurance Liability$603,860
Other Liabilities$121,000
FieldValueIRS element (for citing)
Total Of Amounts34324125TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt106411987TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments880185NetUnrealizedGainsInvestments
Revenue Not Rptd F990880185RevenueNotRptdF990
Revenue Subtotal105531802RevenueSubtotal
Other Revenues Not Included905605OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt905605RevenueNotRptdOnFinStmt
Total Revenue Per Form990106437407TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt89202481TotExpensesEtcAuditedFinclStmt
Expenses Subtotal89202481ExpensesSubtotal
Other Expenses Not Included-42593OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt-42593ExpensesNotRptdOnFinStmt
Total Expenses Per Form99089159888TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
XI4bLoss on refinancing 688,273
XI4bGoodwill impairment 217,330

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Solicitation Of Non Govt GrantsXSolicitationOfNonGovtGrants
Solicitation Of Govt GrantsXSolicitationOfGovtGrants
Special Fundraising EventsXSpecialFundraisingEvents
Agreement Ref FundraisingfalseAgreementRefFundraising
Licensed StatesPALicensedStates

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1Golf TournamentNameOfEvent1
Gross Receipts Event161345GrossReceiptsEvent1
Gross Revenue Event161345GrossRevenueEvent1
Non Cash Prizes Event12760NonCashPrizesEvent1
Rent Facility Costs Event18133RentFacilityCostsEvent1
Food And Beverage Event12279FoodAndBeverageEvent1
Other Direct Expenses Event1569OtherDirectExpensesEvent1
Gross Receipts Total61345GrossReceiptsTotal
Gross Revenue Total Events61345GrossRevenueTotalEvents
Non Cash Prizes Total Events2760NonCashPrizesTotalEvents
Rent Facility Costs Total Events8133RentFacilityCostsTotalEvents
Food And Beverage Total Events2279FoodAndBeverageTotalEvents
Other Direct Expenses Total Events569OtherDirectExpensesTotalEvents
Direct Expense Summary Events13741DirectExpenseSummaryEvents
Net Income Summary47604NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense2817862TotalCommunityBenefitExpense
Net Community Benefit Expense2817862NetCommunityBenefitExpense
Percent Of Total Expense0.03160PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense14201835TotalCommunityBenefitExpense
Direct Offsetting Revenue10341112DirectOffsettingRevenue
Net Community Benefit Expense3860723NetCommunityBenefitExpense
Percent Of Total Expense0.04330PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense17019697TotalCommunityBenefitExpense
Direct Offsetting Revenue10341112DirectOffsettingRevenue
Net Community Benefit Expense6678585NetCommunityBenefitExpense
Percent Of Total Expense0.07490PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense292023TotalCommunityBenefitExpense
Direct Offsetting Revenue126163DirectOffsettingRevenue
Net Community Benefit Expense165860NetCommunityBenefitExpense
Percent Of Total Expense0.00190PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense134928TotalCommunityBenefitExpense
Direct Offsetting Revenue10279DirectOffsettingRevenue
Net Community Benefit Expense124649NetCommunityBenefitExpense
Percent Of Total Expense0.00140PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense313722TotalCommunityBenefitExpense
Net Community Benefit Expense313722NetCommunityBenefitExpense
Percent Of Total Expense0.00350PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense156956TotalCommunityBenefitExpense
Net Community Benefit Expense156956NetCommunityBenefitExpense
Percent Of Total Expense0.00180PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense897629TotalCommunityBenefitExpense
Direct Offsetting Revenue136442DirectOffsettingRevenue
Net Community Benefit Expense761187NetCommunityBenefitExpense
Percent Of Total Expense0.00860PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense17917326TotalCommunityBenefitExpense
Direct Offsetting Revenue10477554DirectOffsettingRevenue
Net Community Benefit Expense7439772NetCommunityBenefitExpense
Percent Of Total Expense0.08350PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense147858TotalCommunityBuildingExpense
Net Community Building Expense147858NetCommunityBuildingExpense
Percent Of Total Expense0.00170PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense24394TotalCommunityBuildingExpense
Net Community Building Expense24394NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense299TotalCommunityBuildingExpense
Net Community Building Expense299NetCommunityBuildingExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense199645TotalCommunityBuildingExpense
Net Community Building Expense199645NetCommunityBuildingExpense
Percent Of Total Expense0.00220PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense372196TotalCommunityBuildingExpense
Net Community Building Expense372196NetCommunityBuildingExpense
Percent Of Total Expense0.00420PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$1,689,796BadDebtExpenseAmount
Amount Attributable To986008AmountAttributableTo
Amount Reimbursed By Medicare38074334AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare38863427CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-789093MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

FieldValueIRS element (for citing)
Business Name Line1Beltway Health LPBusinessNameLine1
FieldValueIRS element (for citing)
Description Ent Primary ActivityMedical Office Space RentalDescriptionEntPrimaryActivity
Organization Profit Or Ownership0.43780OrganizationProfitOrOwnership
FieldValueIRS element (for citing)
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 Line1Northeastern Pennsylvania Health Corporation dba Hazleton General HospitalBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1700 E Broad StAddressLine1
CityHazletonCity
StatePAState
ZIP Code18201ZIPCode
FieldValueIRS element (for citing)
Website Addresswww.ghha.orgWebsiteAddress
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours
Facility Reporting GroupAFacilityReportingGroup

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ABusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA ConductedfalseCHNAConducted
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent0000000002.000000000000FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent0000000004.000000000000FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiestrueCollectionActivities
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargestrueGrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (17 entries)

IdentifierIdentifierExplanationExplanation
Part I Line 3cHazleton General Hospital uses the FPG to determine eligibility for providing free and discounted care. All uninsured patients with family incomes greater than 400 of the Federal Poverty Guidelines FPG receive an Uninsured Discount of 70 off billed charges. This discount lessens the financial burden on uninsured patients and allows them access to discounts comparable to those offered to insured patients.
Part I Line 3cPatients with family incomes at 400 of FPG or less are eligible for greater financial assistance discounts.
Part I Line 6aHazleton General Hospital community report activities are included with the Greater Hazleton Health Alliance annual community report, which is available by request or on our website at www.ghha.org
Part I Line 7Amounts used in the calculation of Charity Care and Other Community Benefits at Cost were calculated utilizing the optional supplemental worksheets provided by the IRS instructions to Schedule H.
Part IIThe community building activities promote the health of the community. These activities include Patient Advocate Services, Interpretation Services and Patient Satisfaction Surveys, which assist the patients with the quality of care that they receive.
Part III Line 4The footnote to our financial statements that describes the bad debt expense can be found on page 9 in the attached financial statements.
Part III Line 8For 2012, the Medicare shortfall is 789,093 using only allowable costs however, if all costs are considered, a shortfall would exist of 2.8 million.
Part III Line 9bPatient inquiries will be referred to a financial counselor who will assist the patient with the application process, as well as application for available government insurance programs. Once the application is completed, appropriate discounts will be determined.
Part III Line 9bA 100 Charity Care discount will be provided to patients with incomes up to 200 of the Department of Health Human Services poverty level published on an annual basis. For patients with incomes between 200 and 400 of the poverty level, a percentage discount between 70 100 applies. A 70 Uninsured Patient Discount applies for patients with incomes greater than 400 of the poverty level.
Part VNortheastern Pennsylvania Health Corporation, dba Hazleton General Hospital, is a licensed general medical surgery community hospital who provides 24-hour emergency room care.
Part VSignage is posted in registration waiting areas notifying patients of the availability for Charity Care and other financial assistance. Correspondence and/or billing statements will also inform patients to contact a financial counselor if they are having difficulty in payment for services. In the patient handbook, it is posted that, in keeping with our mission, we offer Charity Care at free reduced rates. Patients need to contact a financial counselor to see if they are eligible.
Part VAll uninsured individuals received a 70 discount in 2012. The hospital monitors the overall collection rates experienced from commercial carriers as well as that of Medicare and uses the average of the two to gauge the discount applied to the bills of uninsured individuals. The uninsured discount is a higher percentage discount than the average of our top 3 insurance carriers.
Part VTo assess healthcare needs, the organization utilizes admission information and determines services, physician needs, programs and community education beased on top diagnoses. A continual review of reasons for patient migration to other areas for care is also made. A formal community healthcare needs assessment has been conducted in 2013 to further help in identifying community needs.
Part VWe serve 3 counties - lower Luzerne, and portions of Carbon and Schuylkill counties. The population of our primary and secondary market areas is estimated at 100,000 primary area 66,500 secondary area 33,000. Population is mainly Caucasian but has seen a recent influx of the Hispanic population - 13,000 in 2010 compared to 1,600 in 2000. Over 50 of residents in our primary secondary market areas are over 65. Our hospital saw 53 Medicare and 14 Medicaid patients in 2012.
Part VHGH promotes a healthy community through free health screenings education, access to care for all patients through an employed physician group that ensures sufficient appropriate physicians are available in the community, leadership through a community board, partnership with local non-profit health human services organization, as well as schools, colleges univerisities, publishing a community newsletter weekly articles penned by our physician for local newspapers.
Part VGreater Hazleton Health Alliance consists of various entities to promote good health and healthy living including Hazleton General Hospital HGH, Hazleton Professional Services, d/b/a Alliance Medical Group AMG, Hazleton Surgical Alliance HSA and Hazleton Health Wellness Center HWC.
Part VHGH is a 150-bed inpatient acute care and emergency services facility AMG is an employed physician group that provides a health network of medical surgical services HSA is a provider of surgical services and HWC provides staffing to the hospitals offsite outpatient testing and rehab center. All entities work together to provide a continuum of medical care and other health services, programs and wellness/prevention education to the community.

Schedule J IRS990ScheduleJ

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

Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)

TitleTitleComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsBase Compensation Filing OrgBaseCompensationFilingOrgBonus Filing OrgBonusFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
J EDWARDS
CHIEF EXECUTIVE OFFICER398559250000735029046684955
J FLETCHER
CHIEF OPERATING OFFICER23104112800073509072375463
W BAUER
CHIEF FINANCIAL OFFICER229819128000735028672393841
A VALENTE
VP MEDICAL AFFAIRS18859597000681528733321143
M GOLDEN
CHIEF NURSING OFFICER16695194000569828466295115
E PERRONG
VP HUMAN RESOURCES62957250004739724117608976152
J DANISH
ASST SECRETARY OF BOARD / DIR ADM SVC8884030000309728188150125
D PATTEN MD
PHYSICIAN38097416666620029208433048
J CIOTOLA MD
PHYSICIAN381313570029208416221
J AMENTLER MD
PHYSICIAN200996111358342444210387

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierIIdentifier
Return Reference4aReturnReference
ExplanationCompensation to E. Perrong includes 76,152 in severance wages.Explanation

Schedule L IRS990ScheduleL

Loan Table LoanTable (2 entries)

Relationship With OrganizationRelationshipWithOrganizationPurpose Of LoanPurposeOfLoanLoan From OrganizationLoanFromOrganizationOriginal PrincipalOriginalPrincipalAmountBalance DueBalanceDueDefaultDefaultApproved By BoardApprovedByBoardWritten AgreementWrittenAgreement
Eugene Gorski MD
Employee of related entityRefinancing of DebtX$250,00028498falsetruetrue
Michael Bono MD
Employee of related entityWorking capitalX$70,00070000truetruetrue
FieldValueIRS element (for citing)
Total Balance Due98498TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
Marval Medical
Anthony Valente, MD, VP of Medical Affairs, is partner in the business307681Hospital Professional Feefalse
Michael Bono MD
Employee of related organization90000Purchase of stock of related entity from employeefalse
Jodi Lenko MD
Michael A, Washinsky, DO, board member, is related to Jodi20000Education agreementfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (14 entries)

ExplanationExplanation
Form 990 Part III Line 2 In 2012, HGH continued to pursue opportunities to enhance its quality services. New programs services at HGH include providing better access to care through a Telehealth Program in conjunction with the Lehigh Valley Health Network to include stroke, burn, and infectious disease services development of and accreditation as a Chest Pain Center continued development of the Electronic Medical Record EMR with implementation of the Clinical Provider Order Entry CPOE module implemented a program for the prevention and treatment of pressure ulcers to the homebound through Hazleton General Home Care development of osteoporosis and vision therapy programs and restructuring of Senior Choice Program to include health education and fitness programs, free screenings, and social activities for our senior population.
Form 990 Part VI Section A Line 6 Greater Hazleton Health Alliance, a PA non-profit corporation is Northeastern Pennsylvania Health Corporations sole member. There are no stockholders.
Form 990 Part VI Section A Line 7a Greater Hazleton Health Alliance, the sole member, appoints the directors.
Form 990 Part VI Section A Line 7b Greater Hazleton Health Alliance, the sole member, makes and ratifies the decisions as specified in Northeastern Pennsylvania Health Corporations bylaws.
Form 990 Part VI Section B Line 11b IRS Form 990s for Greater Hazleton Health Alliance entities i.e. GHHA, HGH, HPS, HSA, HWC are prepared by the Finance Department and then reviewed by the CFO. A detailed summary of the 990s is presented to the Finance Committee and, subsequently, in accordance with the Finance Committees wishes, a brief summary is presented to the Board. Board members are provided with a draft copy of the 990s during the presentation. Upon approval, the 990s are then submitted to the IRS.
Form 990 Part VI Section B Line 12c Yearly, all Board members and executive staff receive the conflict of interest policy are asked to complete a statement sheet reporting any possible business or personal conflicts. All statements are reviewed by the Compliance Officer. If any Board member has a conflict with a specific discussion at a Board meeting, he / she either removes himself / herself from the discussion or is included in the discussion, but is not allowed to vote on the matter at hand.
Form 990 Part VI Section B Line 15 Compensation surveys are used to make a recommendation on the CEO payrate, for approval by the compensation committee. Compensation surveys are also used to make recommendations to the CEO on payrates for the other officers and the compensation committee reviews and approves those rates as well.
Form 990 Part VI Section C Line 19 Greater Hazleton Health Alliance and affiliated entities makes the governing documents, conflicts of interest policy, tax returns and financial statements available upon request. Also, Form 990 is available on www.guidestar.org
Form 990 Part XI Line 9 Loss on refinancing 688,273
Form 990 Part XI Line 9 Goodwill impairment 217,330
Form 990 Part XI Line 9 Discontinue equity method accounting 617,896
Form 990 Part XI Line 9 Minimum Pension Liability Adjustment 1,769,692
Form 990 Part XI Line 9 Write down intercompany receivable 7,957,601
Form 990 Part XI Line 9 Increase in temporarily restricted net assets of 62,953

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Greater Hazleton Health Alliance
700 E Broad StHazletonPA18201232831830Management ServicesPA501c311N/Afalse
Hazleton Health & Wellness Center
700 E Broad StHazletonPA18201232580968Staffing ServicesPA501c33falseNortheastern Pennsylvania Health Corp DBA Hazleton General Hospital
Hazleton Professional Services
700 E Broad StHazletonPA18201205880364Physician ServicesPA501c33falseGreater Hazleton Health Alliance
Hazleton Surgical Alliance
700 E Broad StHazletonPA18201202038456Surgical ServicesPA501c33falseNortheastern Pennsylvania Health Corp DBA Hazleton General Hospital

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Hazleton Surgery Center LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line117480 Dallas Parkway Ste 210AddressLine1
CityDallasCity
StateTXState
ZIP Code75287ZIPCode
FieldValueIRS element (for citing)
EIN201232531EIN
Primary ActivitySurgical ServicesPrimaryActivity
Legal Domicile StateTXLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Hazleton Surgical AllianceBusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeRelatedPredominantIncomeType
Disproportionate AllocationsfalseDisproportionateAllocations
General Or Managing PartnertrueGeneralOrManagingPartner
Percentage Ownership0.69470PercentageOwnership

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Hazleton Saint Joseph Medical Office Building IncBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1700 E Broad StAddressLine1
CityHazletonCity
StatePAState
ZIP Code18201ZIPCode
FieldValueIRS element (for citing)
EIN232500981EIN
Primary ActivityMedical Office RentalPrimaryActivity
Legal Domicile StatePALegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Northeastern Pennsylvania Health Corp DBA Hazleton General HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityC CorpTypeOfEntity
Percentage Ownership1.00000PercentageOwnership
Controlled OrgfalseControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgtrueLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (22 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Greater Hazleton Health Alliance
k8936442Actual Mgmt Fee
Greater Hazleton Health Alliance
p23148Actual payments
Greater Hazleton Health Alliance
q6072634Actual payments
Greater Hazleton Health Alliance
r1186571Actual write off
Hazleton Professional Services dba Alliance Medical Group
i12451Actual expenses paid
Hazleton Professional Services dba Alliance Medical Group
j28618Actual rent amount
Hazleton Professional Services dba Alliance Medical Group
k27878Actual expenses paid
Hazleton Professional Services dba Alliance Medical Group
l180000Actual Mgmt Fee
Hazleton Professional Services dba Alliance Medical Group
n30973Actual expenses paid
Hazleton Professional Services dba Alliance Medical Group
o2219736Actual expenses paid
Hazleton Professional Services dba Alliance Medical Group
p314306Actual expenses paid
Hazleton Professional Services dba Alliance Medical Group
q150062Actual expenses paid
Hazleton Professional Services dba Alliance Medical Group
s7171419Actual write off
Hazleton Health & Wellness Center
k9568Actual Mgmt Fee
Hazleton Health & Wellness Center
l1818944Actual loan balance guaranteed
Hazleton Health & Wellness Center
n4201526Actual expenses paid
Hazleton Health & Wellness Center
p18980Actual expenses paid
Hazleton Health & Wellness Center
s1877022Actual write off
Hazleton Saint Joseph Medical Office Building Inc
k11341Actual common area exp
Hazleton Saint Joseph Medical Office Building Inc
o6013Actual expenses paid
Hazleton Saint Joseph Medical Office Building Inc
q4844Actual expenses paid
Hazleton Saint Joseph Medical Office Building
r484Actual write off

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.