2012-05-10T11:37:56-05:00 2011-06-30 PARENTEBEARD LLC 1650 MARKET STREET SUITE 4500 PHILADELPHIA PA 19103 990 2010-07-01 232349341 FAMILY CARE CENTERS INC FAMI 5704214000 206 EAST BROWN ST EAST STROUDSBURG PA 18301 MICHAEL A WILK 5704214000 2012-05-08 1 JULIUS GREEN CPA 2159720701 2010 2016-02-24 21:20:13Z KATHLEEN KUCK 206 EAST BROWN ST EAST STROUDSBURG PA 18301 17237499 0 X WWW.POCONOHEALTHSYSTEM.ORG X 1985 PA TO PREVENT ILLNESS, PROMOTE WELLNESS AND RESTORE HEALTH IN THE POCONO AREA. 6 4 143 4 0 0 52142 4158391 11218850 13073698 0 5410 0 0 11270992 17237499 0 0 0 0 10771346 11543845 0 0 0 4747341 6555930 15518687 18099775 -4247695 -862276 4973635 4183650 1210107 1282398 3763528 2901252 X TO PREVENT ILLNESS, PROMOTE WELLNESS AND RESTORE HEALTH IN THE POCONO AREA. 0 0 15755875 13073698 THE 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 = 78,503 15755875 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 6 0 1 143 1 0 0 0 0 0 0 0 0 0 0 X 6 4 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X MICHAEL A WILK 5704204912 206 EAST BROWN ST EAST STROUDSBURG PA 18301 X HORACE COLE 1.00 X X 0 0 0 R DOUGLAS OLMSTEAD 1.00 X X 0 0 0 SUZANNE VIECHNICKI 1.00 X X 0 0 0 KATHLEEN KUCK 1.00 X X 0 621529 342943 CHARLES HERMAN MD 1.00 X 0 0 0 CHRISTOPHER POMRINK 40.00 X 307673 0 20054 MICHAEL WILK 1.00 X 0 337507 68248 WILLIAM RYAN 40.00 X 386314 0 62810 GERVIAS CHARLES 40.00 X 295996 0 22841 KAOUTAR TLEMCANI 40.00 X 300000 0 40931 RADHIKA AILAWADI 40.00 X 286424 0 15431 OLUNTUNDE ODEYEMI 40.00 X 283344 0 14405 1859751 959036 587663 29 0 1 0 COMP HEALTH ASSOCIATION PO BOX 972651 DALLAS TX 75397 LOCUM PHYSICIANS 424634 NAVICURE CLIENT SERVICE 2055 SUGARLOAF CIRCLE SUITE 600 DULUTH GA 30097 CLEARING HOUSE 120103 2 4158391 4158391 PATIENT REVENUE 621400 10177216 10177216 MSO BILLING REVENUE 900099 1471991 1471991 OTHER PROGRAM SERVICE 900099 1424491 1424491 13073698 5410 5410 17237499 13073698 0 5410 321130 286784 34346 8831241 7954350 876891 401247 357015 44232 1526692 1136821 389871 463535 412435 51100 5670 5670 1251882 782551 469331 3611 3611 267228 59506 207722 595731 506000 89731 70236 70236 381742 206736 175006 523108 523108 MEDICAL SUPPLIES AND DR 2532033 2532033 BAD DEBT 862458 862458 LICENSE/DUES/SUBSCRIPTI 57460 57460 MISCELLANEOUS 4771 4771 18099775 15755875 2343900 0 2580727 1462887 879521 1184855 132927 133874 29704 71817 3300614 2085713 1231168 1214901 119588 115316 4973635 4183650 1210107 1282398 1210107 1282398 X 3763528 2901252 3763528 2901252 4973635 4183650 -862276 0 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 375244 94236 281008 2925370 1991477 933893 1214901 17237499 18099775 -862276 0 -862276 17237499 0 17237499 0 17237499 18099775 0 18099775 0 18099775 SCHEDULE 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. X X X X 0 1 0 0 0 0 0 1 0 KATHLEEN KUCK 0 418580 0 193185 0 9764 0 329398 0 13545 0 964472 0 0 CHRISTOPHER POMRINK 263600 0 44073 0 0 0 4623 0 15431 0 327727 0 0 0 MICHAEL WILK 0 272969 0 55688 0 8850 0 52480 0 15768 0 405755 0 0 WILLIAM RYAN 378314 0 5678 0 2322 0 44250 0 18560 0 449124 0 0 0 GERVIAS CHARLES 266400 0 29596 0 0 0 7410 0 15431 0 318837 0 0 0 KAOUTAR TLEMCANI 300000 0 0 0 0 0 25500 0 15431 0 340931 0 0 0 RADHIKA AILAWADI 286424 0 0 0 0 0 0 0 15431 0 301855 0 0 0 OLUNTUNDE ODEYEMI 250104 0 33240 0 0 0 0 0 14405 0 297749 0 0 0 PART I, LINE 4B INDIVIDUALS 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 7 PHYSICIAN'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. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION IS POCONO HEALTH SYSTEM (PHS), A PENNSYLVANIA NON-PROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A POCONO 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 7B THE 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 11 THE 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. FORM 990, PART VI, SECTION B, LINE 12C 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 15 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 C, LINE 19 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 VII, SECTION A, COLUMN B: 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, CFO POCONO HEALTH SYSTEM 206 E BROWN STREET EAST STROUDSBURG PA 18301 232336285 SUPPORT POCONO MEDICAL CENTER PA 501(C)(3) LINE 11B, II N/A 0 POCONO HEALTHCARE PARTNERS 206 E BROWN STREET EAST STROUDSBURG PA 18301 233014006 HEALTHCARE PA 501(C)(3) LINE 3 POCONO HEALTH SYSTEM 0 POCONO AMBULATORY SERVICES 206 E BROWN STREET EAST STROUDSBURG PA 18301 232311474 HEALTHCARE PA 501(C)(3) LINE 3 POCONO HEALTH SYSTEM 0 POCONO MEDICAL CENTER 206 E BROWN STREET EAST STROUDSBURG PA 18301 240795623 HOSPITAL PA 501(C)(3) LINE 3 POCONO HEALTH SYSTEM 0 POCONO HEALTH FOUNDATION 206 E BROWN STREET EAST STROUDSBURG PA 18301 232516451 SUPPORT PA 501(C)(3) LINE 11A, I POCONO HEALTH SYSTEM 0 POCONO HEALTH SYSTEM MEDICAL PROFESSIONAL SELF-INSURANCE TRUST 206 E BROWN STREET EAST STROUDSBURG PA 18301 206560453 SELF INSURANCE PA 501(C)(3) LINE 11A, I POCONO HEALTH SYSTEM 0 POCONO AMBULATORY SURGERY CENTER LIMITED 206 W BROWN STREET EAST STROUDSBURG PA 18301 232611442 SURGERY PA N/A 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0