FAMILY CARE CENTERS INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
FAMILY CARE CENTERS INC (EIN 23-2349341)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-10
IRS object ID
201221319349301022
Schema version
2010v3.4
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)
Timestamp2012-05-10T11:37:56-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PARENTEBEARD LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11650 MARKET STREET SUITE 4500AddressLine1
CityPHILADELPHIACity
StatePAState
ZIP Code19103ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN232349341EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1FAMILY CARE CENTERS INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlFAMINameControl
Phone5704214000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1206 EAST BROWN STAddressLine1
CityEAST STROUDSBURGCity
StatePAState
ZIP Code18301ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMICHAEL A WILKName
TitleCFOTitle
Phone5704214000Phone
Date Signed2012-05-08DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJULIUS GREEN CPAName
Phone2159720701Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonKATHLEEN KUCKNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1206 EAST BROWN STAddressLine1
CityEAST STROUDSBURGCity
StatePAState
ZIP Code18301ZIPCode
FieldValueIRS element (for citing)
Gross Receipts17237499GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.POCONOHEALTHSYSTEM.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1985YearFormation
State Legal DomicilePAStateLegalDomicile
Activity Or Mission DescriptionTO PREVENT ILLNESS, PROMOTE WELLNESS AND RESTORE HEALTH IN THE POCONO AREA.ActivityOrMissionDescription
Nbr Voting Members Governing Body6NbrVotingMembersGoverningBody
Nbr Independent Voting Members4NbrIndependentVotingMembers
Total Nbr Employees143TotalNbrEmployees
Total Nbr Volunteers4TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year52142ContributionsGrantsPriorYear
Contributions Grants Current Year4158391ContributionsGrantsCurrentYear
Program Service Revenue Prior Year11218850ProgramServiceRevenuePriorYear
Program Service Revenue CY13073698ProgramServiceRevenueCY
Investment Income Prior Year0InvestmentIncomePriorYear
Investment Income Current Year5410InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year11270992TotalRevenuePriorYear
Total Revenue Current Year17237499TotalRevenueCurrentYear
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 Year10771346SalariesEtcPriorYear
Salaries Etc Current Year11543845SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year4747341OtherExpensePriorYear
Other Expenses Current Year6555930OtherExpensesCurrentYear
Total Expenses Prior Year15518687TotalExpensesPriorYear
Total Expenses Current Year18099775TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-4247695RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-862276RevenuesLessExpensesCY
Total Assets BOY4973635TotalAssetsBOY
Total Assets EOY4183650TotalAssetsEOY
Total Liabilities BOY1210107TotalLiabilitiesBOY
Total Liabilities EOY1282398TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY3763528NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY2901252NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO PREVENT ILLNESS, PROMOTE WELLNESS AND RESTORE HEALTH IN THE POCONO AREA.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense15755875Expense
Revenue13073698Revenue
DescriptionTHE ORGANIZATION OPERATES SEVERAL PHYSICIAN PRACTICES, INCLUDING FAMILY MEDICINE, HEMATOLOGY AND ONCOLOGY, INTERNAL MEDICINE, AND OBSTETRICS AND GYNECOLOGY. ALSO, THE ORGANIZATION PROVIDES PHYSICIAN PRACTICE SUPPORT SERVICES INCLUDING: BILLING, INFORMATION TECHNOLOGY, AND TELECOMMUNICATIONS. IN ADDITION, THE ORGANIZATION HAS ENHANCED THE OUTPATIENT SERVICES AVAILABLE TO PERSONS IN THE AREA, INCLUDING SERVICES TO THE INDIGENT AND UNDERINSURED. THE ORGANIZATION PROVIDES SERVICES TO THE SURROUNDING AREA REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY.THE ORGANIZATION AIMS TO PROVIDE EXCELLENT QUALITY CARE TO OUR DIVERSE AND GROWING COMMUNITY AND STILL PROVIDES FOR NEEDED CAPITAL FOR THE FUTURE. ALL RESOURCES AND PROGRAM SERVICE EXPENSES ARE UTILIZED TO OFFER OUR PATIENTS QUALITY CARE THROUGH MULTIPLE SERVICE LINES.THESE SERVICES INCLUDE, BUT ARE NOT LIMITED TO FAMILY PRACTICE, OBSTETRICS AND GYNECOLOGY, DIAGNOSTIC TESTING, OCCUPATIONAL MEDICINE, ONCOLOGY, AND ANESTHESIOLOGY SERVICES.THE INTERNAL MEDICINE TEAM PAVES THE WAY IN PROVIDING SPECIALIZED CARE TO ADULT PATIENTS. AS PART OF THE POCONO HEALTH SYSTEM, FAMILY CARE CENTER OFFERS THE FINEST PHYSICIANS AND TECHNOLOGY TO THE AREA AND CONNECTS THEM TO THE POCONO MEDICAL CENTER WHEN A GREAT DEGREE OF SERVICE IS REQUIRED.THE OBSTETRICS AND GYNECOLOGY TEAM IS COMMITTED TO PROVIDING WOMEN WITH THE HIGHEST QUALITY CARE AND COUNSELING, ALONG WITH INFORMATION AND APPROPRIATE THERAPY, SO THEY CAN BE ACTIVE PARTICIPANTS IN THEIR HEALTHCARE. A FAMILY CARE CENTER PROVIDES COMPREHENSIVE GYNECOLOGICAL AND OBSTETRICAL SERVICES, INCLUDING CONSULTATION WITH "HIGH RISK" OBSTETRICAL SPECIALISTS AND MINIMALLY INVASIVE SURGICAL CARE.THE ORGANIZATION ALSO PROVIDES THE MOST TECHNOLOGICALLY ADVANCED CANCER THERAPY AND TREATMENT IN ORDER TO OFFER EVERY PATIENT THE OPTIMAL CHANCE FOR CURE.FAMILY CARE CENTERS CONSTANTLY ASSESSES AND IMPROVES, WHEN POSSIBLE, EQUIPMENT USED, QUALITY REVIEW MEASURER, AND SCHEDULING CONSIDERATIONS IN ORDER TO MEET OR EXCEED THE STANDARD OF CARE EXPECTED FOR THESE SERVICES. TO FACILITATE CARE, MANY OF OUR PRACTICES OFFER MULTIPLE SITES AND EXTENDED OFFICE HOURS. OUR FACILITIES ARE LOCATED IN AREAS THAT ARE CONSIDERED UNDERSERVED WITHIN THE COMMUNITY. CARE IS PROVIDED FOR BOTH PREVENTATIVE SERVICES AND ACUTE AND CHRONIC MEDICAL CONDITIONS.THE POCONO MEDICAL CENTER PHYSICIAN ASSOCIATES HAS SIX PRACTICES, THEIR VISITS INCLUDED THE FOLLOWING:PMCPA - HEMATOLOGY AND ONCOLOGY = 11,405PMC - HOSPITALISTS = 22,859OB/GYN = 25,234INTERNAL MEDICINE = 6,011FAMILY MEDICINE - WEST END = 4,614MOUNTAIN FAMILY CARE CENTERS = 8,380TOTAL VISITS FOR FCC PRACTICES = 78,503Description
Total Program Service Expense15755875TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
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 Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
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 Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10966NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees143NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members6NbrVotingGoverningBodyMembers
Number Independent Voting Members4NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledPAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1MICHAEL A WILKBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5704204912TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1206 EAST BROWN STAddressLine1
CityEAST STROUDSBURGCity
StatePAState
ZIP Code18301ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (12 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
HORACE COLE
CHAIRMAN1.00XX000
R DOUGLAS OLMSTEAD
VICE-CHAIR1.00XX000
SUZANNE VIECHNICKI
SECRETARY/TREASURER1.00XX000
KATHLEEN KUCK
PRESIDENT/CEO1.00XX0621529342943
CHARLES HERMAN MD
DIRECTOR1.00X000
CHRISTOPHER POMRINK
DIRECTOR/PHYSICIAN40.00X307673020054
MICHAEL WILK
CFO1.00X033750768248
WILLIAM RYAN
PHYSICIAN40.00386314062810X
GERVIAS CHARLES
PHYSICIAN40.00295996022841X
KAOUTAR TLEMCANI
PHYSICIAN40.00300000040931X
RADHIKA AILAWADI
PHYSICIAN40.00286424015431X
OLUNTUNDE ODEYEMI
PHYSICIAN40.00283344014405X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1859751TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs959036TotalReportableCompFrmRltdOrgs
Total Other Compensation587663TotalOtherCompensation
Number Individuals GT100 K29NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
COMP HEALTH ASSOCIATION
PO BOX 972651DALLASTX75397LOCUM PHYSICIANS424634
NAVICURE CLIENT SERVICE
2055 SUGARLOAF CIRCLE SUITE 600DULUTHGA30097CLEARING HOUSE120103
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
Related Organizations4158391RelatedOrganizations
Total Contributions4158391TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PATIENT REVENUE6214001017721610177216
MSO BILLING REVENUE90009914719911471991
OTHER PROGRAM SERVICE90009914244911424491
FieldValueIRS element (for citing)
Total Program Service Revenue13073698TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column5410TotalRevenueColumn
Exclusion$5,410ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column17237499TotalRevenueColumn
Related Or Exempt Function Income13073698RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$5,410ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total321130Total
Program Services286784ProgramServices
Management And General34346ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total8831241Total
Program Services7954350ProgramServices
Management And General876891ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total401247Total
Program Services357015ProgramServices
Management And General44232ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1526692Total
Program Services1136821ProgramServices
Management And General389871ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total463535Total
Program Services412435ProgramServices
Management And General51100ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total5670Total
Management And General5670ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1251882Total
Program Services782551ProgramServices
Management And General469331ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total3611Total
Program Services3611ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total267228Total
Program Services59506ProgramServices
Management And General207722ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total595731Total
Program Services506000ProgramServices
Management And General89731ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total70236Total
Program Services70236ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total381742Total
Program Services206736ProgramServices
Management And General175006ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total523108Total
Program Services523108ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
MEDICAL SUPPLIES AND DR25320332532033
BAD DEBT862458862458
LICENSE/DUES/SUBSCRIPTI5746057460
MISCELLANEOUS47714771

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total18099775Total
Program Services15755875ProgramServices
Management And General2343900ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY2580727BOY
EOY1462887EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY879521BOY
EOY1184855EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY132927BOY
EOY133874EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY29704BOY
EOY71817EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis3300614LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec2085713LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1231168BOY
EOY1214901EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY119588BOY
EOY115316EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY4973635BOY
EOY4183650EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1210107BOY
EOY1282398EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1210107BOY
EOY1282398EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY3763528BOY
EOY2901252EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3763528BOY
EOY2901252EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY4973635BOY
EOY4183650EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-862276ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis375244OtherCostOrOtherBasis
Depreciation94236Depreciation
Book Value281008BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2925370OtherCostOrOtherBasis
Depreciation1991477Depreciation
Book Value933893BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1214901TotalOfBookValueLandBuildings
Total Revenue17237499TotalRevenue
Total Expenses18099775TotalExpenses
Excess Or Deficit For Year-862276ExcessOrDeficitForYear
Total Adjustments0TotalAdjustments
Excess Or Deficit Per FS-862276ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt17237499TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal17237499RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99017237499TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt18099775TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal18099775ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99018099775TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
ExplanationSCHEDULE D, PART X, LINE 2: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
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 Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (8 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
KATHLEEN KUCK
04185800193185097640329398013545096447200
CHRISTOPHER POMRINK
26360004407300046230154310327727000
MICHAEL WILK
027296905568808850052480015768040575500
WILLIAM RYAN
37831405678023220442500185600449124000
GERVIAS CHARLES
26640002959600074100154310318837000
KAOUTAR TLEMCANI
30000000000255000154310340931000
RADHIKA AILAWADI
2864240000000154310301855000
OLUNTUNDE ODEYEMI
25010403324000000144050297749000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 4BINDIVIDUALS LISTED BELOW PARTICIPATED IN THE 457(F), SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN OF THE ORGANIZATION: WILLIAM RYAN RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $44,250. CHRISTOPHER POMRINK RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $4,623. KAOUTAR TLEMCANI RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $25,500. GERVIAS CHARLES RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $7,410. IN ADDITION, THE FOLLOWING INDIVIDUALS PRATICIPATED IN THE 457(F), SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN OF POCONO MEDICAL CENTER, A RELATED ORGANIZATION: KATHLEEN KUCK, PRESIDENT/CEO, RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $329,398. MICHAEL WILK, CFO, RECEIVED AN EXECUTIVE 457(F) CONTRIBUTION OF $52,480.
PART I, LINE 7PHYSICIAN'S RECEIVE NON-FIXED BONUS AND INCENTIVE COMPENSATION BASED ON THEIR RESPECTIVE CONTRACT, AND INCENTIVES ARE EITHER BASED ON A PERCENTAGE ON PAYMENTS RECEIVED ABOVE REQUIRED EXPENSE COVERAGE THRESHOLD OR RELATIVE VALUE UNIT THRESHOLD.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 6THE SOLE MEMBER OF THE CORPORATION IS POCONO HEALTH SYSTEM (PHS), A PENNSYLVANIA NON-PROFIT CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7APOCONO HEALTH SYSTEM, THE SOLE MEMBER OF THE CORPORATION, ELECTS/APPOINTS THE BOARD MEMBERS OF FAMILY CARE CENTERS (FCC).
FORM 990, PART VI, SECTION A, LINE 7BTHE FOLLOWING WAS NOTED IN SECTION 4-07 OF THE ORGANIZATION'S BYLAWS: "IN ADDITION TO ALL MATTERS REQUIRED BY LAW OR BY OTHER PROVISIONS OF THESE BYLAWS TO BE SUBMITTED TO A VOTE OF THE SOLE MEMBER, THE SOLE MEMBER IS EMPOWERED TO INITIATE AND IMPLEMENT ANY OF THE FOLLOWING ACTIONS WITH RESPECT TO THE CORPORATION AND IF ANY SUCH ACTION IS OTHERWISE INITIATED BY THE CORPORATION, SUCH ACTION WILL NOT BECOME EFFECTIVE UNLESS APPROVED BY THE SOLE MEMBER: (A) TO ADOPT OR CHANGE THE MISSION, PURPOSE, PHILOSPHY OR OBJECTIVES OF THIS CORPORATION OR ANY SUBSIDIARY CORPORATION; (B) TO DISSOLVE, REORGANIZE, DIVIDE, CONVERT, LIQUIDATE OR WIND-UP ANY SUBSIDIARY CORPORATION OR CONSOLIDATE OR MERGE THIS CORPORATION WITH ANY OTHER CORPORATION OR ENTITY; (C) TO ANNUALLY APPROVE ALL CAPITAL AND OPERATING BUDGETS FOR THIS CORPORATION; (D) TO ANNUALLY APPROVE THE STRATEGIC AND OPERATING PLANS OR ANY CHANGES THERETO OF THIS CORPORATION; (E) TO APPROVE ANY UNBUDGETED EXPENSE ITEM OF THIS CORPORATION IN EXCESS OF FIVE HUNDRED THOUSAND ($500,000.00) DOLLARS; (F) TO RECEIVE, REVIEW, AND APPROVE FINANCIAL AND OPERATING REPORTS FROM THIS CORPORATION ON AT LEAST A QUARTERLY BASIS; (G) TO APPROVE ANY NEW LINE(S) OF BUSINESS AND/OR MATERIAL CHANGES IN EXISTING SERVICES AND/OR PARTICIPATION BY THIS CORPORATION WITH ANY OTHER ENTITY WHERE LICENSURE BY THE COMMONWEALTH OF PENNSYLVANIA IS REQUIRED AS A PRECONDITION FOR ANY SUCH ACTION, BUSINESS, SERVICE, OR PARTICIPATION; (H) TO APPROVE THE INSURRENCE OF INDEBTEDNESS BY THIS CORPORATION IN EXCESS OF ONE HUNDRED THOUSAND ($100,000) DOLLARS; (I) TO APPROVE THE AMENDMENT OF THE ARTICLES OF INCORPORATION OR BYLAWS OF THIS CORPORATION; (J) TO SPECIFY THE NUMBER OF AND TO ELECT OR REMOVE THE MEMBERS OF THE BOARD OF DIRECTORS OF THIS CORPORATION; (K) TO APPROVE THE ELECTION OR REMOVAL OF THE CHAIRPERSON OF THE BOARD OF DIRECTORS OF THIS CORPORATION; (L) TO REQUIRE EACH DIRECTOR OF THIS CORPORATION AND THE PRESIDENT, EACH VICE PRESIDENT, AND ALL KEY MANAGEMENT PERSONNEL OF THIS CORPORATION TO ANNUALLY SUBMIT TO THE BOARD OF DIRECTORS OF THIS CORPORATION A CONFLICT OF INTEREST STATEMENT IN FORM FIRST APPROVED BY THE BOARD OF DIRECTORS OF THE SOLE MEMBER; (M) TO AT LEAST ANNUALLY EVALUATE THE PERFORMANCE OF THIS CORPORATION'S BOARD OF DIRECTORS IN OVERSEEING THE MANAGEMENT AND PERFORMANCE OF THIS CORPORATION; AND (N) TO REQUIRE THAT THIS CORPORATION'S GOVERNANCE, DELIBERATIONS, AND ACTIONS ARE ORIENTED TO COMMUNITY SERVICE."
FORM 990, PART VI, SECTION B, LINE 11THE ORGANIZATION HAS AN EXTENSIVE 990 REVIEW PROCESS. THE 990 IS FIRST REVIEWED BY THE ACCOUNTING DEPARTMENT AND THE CFO. AFTER ANY NECESSARY CHANGES ARE MADE, A REVIEW IS PERFORMED BY THE CORPORATE COMPLIANCE OFFICER, THE FINANCE COMMITTEE, AND THE CEO. AFTER ALL CHANGES ARE MADE, THE FINAL COPY IS PROVIDED TO ALL BOARD MEMBERS FOR REVIEW AND COMMENT PRIOR TO FILING WITH THE IRS.
THE DIRECTOR OF CORPORATE COMPLIANCE MONITORS ALL CONFLICT OF INTEREST DISCLOSURES. ANY BOARD MEMBER WITH A CONFLICT WOULD ABSTAIN FROM VOTING ON ANY MATTER RELATED TO THAT CONFLICT. IN ADDITION TO ALL BOARD MEMBERS, CORPORATE OFFICERS AND TOP MANAGEMENT ARE ANNUALLY REQUIRED TO DISCLOSE CONFLICTS OF INTEREST.FORM 990, PART VI, SECTION B, LINE 12C
THESE ACTIVITIES ARE UNDERTAKEN BY POCONO MEDICAL CENTER'S BOARD, AS POCONO MEDICAL CENTER PAYS THE CEO AND CFO FOR SERVICES TO POCONO MEDICAL CENTER AND ALL RELATED ENTITIES: ONCE VERY THREE YEARS, OR SOONER IF NECESSARY, COMPENSATION REVIEWS ARE CONDUCTED FOR THE CEO AND TOP MANAGEMENT. A COMPENSATION COMMITTEE RECOMMENDS TO THE BOARD THE COMPENSATION OF THE PRESIDENT AND CEO AND COMPENSATION RANGES FOR THE VICE PRESIDENTS. THE CEO SHALL THEN SET THE COMPENSATION OF THE VICE PRESIDENTS WITHIN THE APPROVED RANGES. IN MAKING RECOMMENDATIONS TO THE BOARD ON COMPENSATION AND COMPENSATION RANGES, THE COMPENSATION COMMITTEE RELIES ON REPORTS FROM AN INDEPENDENT COMPENSATION CONSULTANT SELECTED BY THE COMMITTEE. TO ASSURE INDEPENDENCE, THE CONSULTANT SHALL PERFORM NO OTHER SERVICES FOR PMC. THE CONSULTANT WAS MOST RECENTLY USED IN 2009. THE COMMITTEE REPORTS ITS DECISIONS TO THE BOARD AT ITS NEXT EXECUTIVE SESSION, AT WHICH TIME THE BOARD SHALL EITHER RATIFY THE DECISION OR SEND IT BACK TO THE COMMITTEE FOR FURTHER DELIBERATION. ONCE A FINAL DECISION IS REACHED, THE BOARD CHAIRMAN INFORMS THE CEO OF THE DECISIONS OF THE COMMITTEE AND RATIFICATION BY THE BOARD REGARDING THE CEO'S SALARY AND THE SALARY RANGES FOR THE VICE PRESIDENTS. MINUTES OF THE COMMITTEE AND THE EXECUTIVE SESSION PORTION OF THE BOARD ARE PREPARED AND RETAINED IN THE ADMINISTRATION OFFICES AND CONTAIN SUFFICIENT INFORMATION TO SUBSTANTIATE THE DELIBERATION AND DECISION.FORM 990, PART VI, SECTION B, LINE 15
FINANCIAL RESULTS ARE PUBLISHED IN THE ANNUAL REPORT, A COPY OF WHICH IS DISTRIBUTED IN A VARIETY OF PUBLIC FORUMS AND WOULD OTHERWISE BE PROVIDED UPON REQUEST. THE CONFLICT OF INTEREST POLICY WOULD BE AVAILABLE FOR VIEWING IN THE BUSINESS OR ADMINISTRATIVE OFFICES OF PMC, UPON REQUEST, TO ENSURE THE MOST CURRENT COPY IS ALWAYS THE ONE BEING MADE AVAILABLE. THE GOVERNING DOCUMENTS ARE GENERALLY NOT AVAILABLE FOR PUBLIC INSPECTION.FORM 990, PART VI, SECTION C, LINE 19
THE FOLLOWING OFFICERS WORK APPROXIMATELY 40 HOURS PER WEEK BETWEEN FAMILY CARE CENTERS, INC. AND ALL RELATED ORGANIZATIONS OF POCONO HEALTH SYSTEM, THE PARENT COMPANY. KATHLEEN KUCK, PRESIDENT/CEO MICHAEL WILK, CFOFORM 990, PART VII, SECTION A, COLUMN B:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
POCONO HEALTH SYSTEM
206 E BROWN STREETEAST STROUDSBURGPA18301232336285SUPPORT POCONO MEDICAL CENTERPA501(C)(3)LINE 11B, IIN/A0
POCONO HEALTHCARE PARTNERS
206 E BROWN STREETEAST STROUDSBURGPA18301233014006HEALTHCAREPA501(C)(3)LINE 30POCONO HEALTH SYSTEM
POCONO AMBULATORY SERVICES
206 E BROWN STREETEAST STROUDSBURGPA18301232311474HEALTHCAREPA501(C)(3)LINE 30POCONO HEALTH SYSTEM
POCONO MEDICAL CENTER
206 E BROWN STREETEAST STROUDSBURGPA18301240795623HOSPITALPA501(C)(3)LINE 30POCONO HEALTH SYSTEM
POCONO HEALTH FOUNDATION
206 E BROWN STREETEAST STROUDSBURGPA18301232516451SUPPORTPA501(C)(3)LINE 11A, I0POCONO HEALTH SYSTEM
POCONO HEALTH SYSTEM MEDICAL PROFESSIONAL SELF-INSURANCE TRUST
206 E BROWN STREETEAST STROUDSBURGPA18301206560453SELF INSURANCEPA501(C)(3)LINE 11A, I0POCONO HEALTH SYSTEM

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1POCONO AMBULATORY SURGERY CENTER LIMITEDBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1206 W BROWN STREETAddressLine1
CityEAST STROUDSBURGCity
StatePAState
ZIP Code18301ZIPCode
FieldValueIRS element (for citing)
EIN232611442EIN
Primary ActivitySURGERYPrimaryActivity
Legal Domicile StatePALegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
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 Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Comments

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