THE GOOD SAMARITAN HOSPITAL OF LEBANON PENNSYLVANIA: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- THE GOOD SAMARITAN HOSPITAL OF LEBANON PENNSYLVANIA (EIN 23-0794160)
- Tax period
- 2010-07-01 to 2011-06-30
- Filed
- 2012-05-10
- IRS object ID
- 201231319349301568
- Schema version
- 2010v3.7
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-05-10T14:25:45-04:00 | Timestamp |
| Tax Period End Date | 2011-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 75 BEATTIE PLACE SUITE 800 | AddressLine1 |
| City | GREENVILLE | City |
| State | SC | State |
| ZIP Code | 29601 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 230794160 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Good Samaritan Hospital The | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | GOOD | NameControl |
| Phone | 7172707500 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1281 4th Walnut Sts | AddressLine1 |
| City | Lebanon | City |
| State | PA | State |
| ZIP Code | 170421281 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ROBERT J RICHARDS | Name |
| Title | VP FINANCE - CFO | Title |
| Date Signed | 2012-05-07 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8642425740 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | ROBERT J LONGO | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4TH WALNUT STREETS | AddressLine1 |
| City | LEBANON | City |
| State | PA | State |
| ZIP Code | 17042 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 184896022 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.gshleb.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1989 | YearFormation |
| State Legal Domicile | PA | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE HIGH-QUALITY, COMPASSIONATE HEALTHCARE THAT IMPROVES THE OVERALL HEALTH OF OUR COMMUNITY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 19 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 14 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1444 | TotalNbrEmployees |
| Total Nbr Volunteers | 431 | TotalNbrVolunteers |
| Total Gross UBI | 4339496 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 1251189 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 792179 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1191113 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 161243680 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 165120763 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1036715 | InvestmentIncomePriorYear |
| Investment Income Current Year | 957345 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 5129384 | OtherRevenuePriorYear |
| Other Revenue Current Year | 11652234 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 168201958 | TotalRevenuePriorYear |
| Total Revenue Current Year | 178921455 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 32800 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 27690 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 73656041 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 71982867 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 94601455 | OtherExpensePriorYear |
| Other Expenses Current Year | 95440354 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 168290296 | TotalExpensesPriorYear |
| Total Expenses Current Year | 167450911 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -88338 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 11470544 | RevenuesLessExpensesCY |
| Total Assets BOY | 144533049 | TotalAssetsBOY |
| Total Assets EOY | 149903555 | TotalAssetsEOY |
| Total Liabilities BOY | 132516543 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 121387527 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 12016506 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 28516028 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | TO PROVIDE HIGH-QUALITY, COMPASSIONATE HEALTHCARE THAT IMPROVES THE OVERALL HEALTH OF OUR COMMUNITY. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 135297077 | Expense |
| Grants | 27690 | Grants |
| Revenue | 158748199 | Revenue |
| Description | Inpatient/Outpatient Services - SEE SCHEDULE O | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 1689454 | Expense |
| Grants | 0 | Grants |
| Revenue | 1977161 | Revenue |
| Description | Rehabilitation Unit- THE GSH OPERATES A 14 BED REHABILITATION UNIT PROVIDING A FULL RANGE OF BASIC SERVICES REQUIRED BY AN ACUTE CARE REHAB PROGRAM INCLUDING PHYSICAL THERAPY, SPEECH THERAPY, OCCUPATIONAL THERAPY, SOCIAL SERVICES AND AUDIOLOGY. FY 6/30/11 STATISTICS: 318 REHAB ADMISSIONS AND 3,436 REHAB PATIENT DAYS. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 1830243 | Expense |
| Grants | 0 | Grants |
| Revenue | 2084554 | Revenue |
| Description | Skilled Nursing Facility- THE GSH OPERATES A 19 BED TRANSITIONAL CARE UNIT PROVIDING A FULL RANGE OF BASIC SERVICES REQUIRED BY A HOSPITAL BASED SKILLED NURSING FACILITY, INCLUDING PHYSICAL THERAPY, SPEECH THERAPY, OCCUPATIONAL THERAPY, SOCIAL SERVICES AND AUDIOLOGY. FY 6/30/11 STATISTICS: 366 TCU ADMISSIONS AND 4,159 TCU PATIENT DAYS. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 1971029 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 0 | TotalOfOtherProgramServiceGrnt |
| Total Of Other Program Service Rev | 2310849 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 140787803 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | true | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | true | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | true | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | true | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 84 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 1444 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 19 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 14 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | false | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | ROBERT J RICHARDS | NamePerson |
| Telephone Number | 7172707500 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 241 SOUTH FOURTH STREET | AddressLine1 |
| City | LEBANON | City |
| State | PA | State |
| ZIP Code | 17042 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (30 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| CAROL BLECKER | ||||||||
| TRUSTEE | 1.0 | X | 0 | 0 | 0 | |||
| EARL H BRINSER | ||||||||
| TRUSTEE | 1.0 | X | 0 | 0 | 0 | |||
| SLOAN CAPLAN | ||||||||
| TRUSTEE | 1.0 | X | 0 | 0 | 0 | |||
| EVELYN C COLON | ||||||||
| TRUSTEE | 1.0 | X | 0 | 0 | 0 | |||
| PAUL R DIGIACOMO | ||||||||
| TRUSTEE | 1.0 | X | 0 | 0 | 0 | |||
| DONALD H DREIBELBIS | ||||||||
| SECOND VICE CHAIRMAN | 1.0 | X | 0 | 0 | 0 | X | ||
| ROBERT J FUNK | ||||||||
| TRUSTEE | 1.0 | X | 0 | 0 | 0 | |||
| ROBERT P HOFFMAN | ||||||||
| TRUSTEE | 1.0 | X | 0 | 0 | 0 | |||
| JANE W JUPPENLATZ | ||||||||
| SECRETARY | 1.0 | X | 0 | 0 | 0 | X | ||
| FREDERICK C LAURENZO | ||||||||
| TRUSTEE | 1.0 | X | 0 | 0 | 0 | |||
| ROBERT J PHILLIPS | ||||||||
| TRUSTEE | 1.0 | X | 0 | 0 | 0 | |||
| WILLIAM E SCHAEFFER JR MD | ||||||||
| TRUSTEE | 1.0 | X | 0 | 0 | 0 | |||
| DENNIS L SHALTERS | ||||||||
| CHAIRMAN | 1.0 | X | 0 | 0 | 0 | X | ||
| GALEN G WEABER | ||||||||
| TRUSTEE | 1.0 | X | 0 | 0 | 0 | |||
| JOHN P WELCH MD | ||||||||
| FIRST VICE CHAIRMAN | 1.0 | X | 0 | 0 | 0 | X | ||
| DEBORAH T WEAVER | ||||||||
| TRUSTEE | 1.0 | X | 0 | 0 | 0 | |||
| FREDERICK S WOLFSON ESQ | ||||||||
| TREASURER | 1.0 | X | 0 | 0 | 0 | X | ||
| JULIE ZINSSER | ||||||||
| TRUSTEE | 1.0 | X | 0 | 0 | 0 | |||
| ROBERT J LONGO | ||||||||
| PRES. & CEO | 40.0 | X | 510035 | 0 | 2884 | X | ||
| KIMBERLY FEEMAN | ||||||||
| SENIOR VP & COO | 40.0 | 246840 | 0 | 0 | X | |||
| ROBERT J RICHARDS | ||||||||
| VP FINANCE & CFO | 40.0 | 286870 | 0 | 0 | X | |||
| JACQUELYN M GOULD | ||||||||
| VP NURSING | 40.0 | 191573 | 0 | 0 | X | |||
| JULIE MIKSIT | ||||||||
| VP CV SVCS & REHAB THERAPIES | 40.0 | 164171 | 0 | 0 | X | |||
| WILLIAM HENDRICK | ||||||||
| VP OF ENGINEERING | 40.0 | 194453 | 0 | 0 | X | |||
| ROBERT D SHAVER MD | ||||||||
| VP MEDICAL AFFAIRS | 40.0 | 331140 | 0 | 0 | X | |||
| ELLEN JOHNSON | ||||||||
| PHYSICIAN | 40.0 | 188017 | 0 | 0 | X | |||
| DARIA KOVARIKOVA | ||||||||
| PHYSICIAN | 40.0 | 187568 | 0 | 0 | X | |||
| BYARD YODER | ||||||||
| PHYSICIAN | 40.0 | 174481 | 0 | 0 | X | |||
| ROBERTA SCHERR | ||||||||
| PHYSICIAN | 40.0 | 170211 | 0 | 0 | X | |||
| JAMES MCGEARY | ||||||||
| PHYSICIAN | 40.0 | 159625 | 0 | 0 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2804984 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 2884 | TotalOtherCompensation |
| Number Individuals GT100 K | 36 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| MCKESSON INFORMATION SOLUTIONS | |||||
| PO BOX 98347 | CHICAGO | IL | 606938347 | IT SUPPORT | 4560074 |
| LEBANON ANESTHESIA ASSOCIATION | |||||
| PO BOX 1281 | LEBANON | PA | 17042 | ANESTHESIOLOGISTS | 2866455 |
| MILTON HERSHEY MEDICAL CENTER | |||||
| PO Box 853 | HERSHEY | PA | 170330853 | RESIDENTS | 1512204 |
| LEBANON CARDIOLOGY ASSOCIATES | |||||
| 775 NORMAN DRIVE | LEBANON | PA | 17042 | CARDIOLOGISTS | 1020496 |
| FINANCIAL HEALTH STRATEGIES | |||||
| 704 QUINCE ORCHARD ROAD | GAITHERSBURG | MD | 20878 | PATIENT BILLING SVC | 870143 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 26 | NumberOfContractorsGT100K |
| Government Grants | 525884 | GovernmentGrants |
| All Other Contributions | 665229 | AllOtherContributions |
| Total Contributions | 1191113 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| IP/OP PATIENTS | 900099 | 154408703 | 154408703 | |
| REHAB PATIENTS | 900099 | 1977161 | 1977161 | |
| HH/VNA SERVICES | 621610 | 2310849 | 2310849 | |
| TCU PATIENTS | 900099 | 2084554 | 2084554 | |
| DROP LAB REVENUE | 621500 | 4339496 | 4339496 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 165120763 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 754550 | TotalRevenueColumn |
| Exclusion | $754,550 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 30677 | TotalRevenueColumn |
| Exclusion | $30,677 | ExclusionAmount |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 123492 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 248473 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -124981 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -124981 | TotalRevenueColumn |
| Exclusion | -$124,981 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 5898212 | Securities |
| Other | 0 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 5671482 | Securities |
| Other | 54612 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 226730 | Securities |
| Other | -54612 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 172118 | TotalRevenueColumn |
| Exclusion | $172,118 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| MA MODERNIZATION MONEY | 900099 | 6255049 | 6255049 | |
| MALPRACTICE INSURANCE | 524298 | 1045937 | 1045937 | |
| PENSION INCOME | 524292 | 915952 | $915,952 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3560277 | TotalRevenueColumn |
| Related Or Exempt Function Income | 2968203 | RelatedOrExemptFunctionIncome |
| Exclusion | $592,074 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 11777215 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 178921455 | TotalRevenueColumn |
| Related Or Exempt Function Income | 171050456 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 4339496 | UnrelatedBusinessRevenue |
| Exclusion | $2,340,390 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27690 | Total |
| Program Services | 27690 | ProgramServices |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2071563 | Total |
| Management And General | 2071563 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 52466905 | Total |
| Program Services | 44596869 | ProgramServices |
| Management And General | 7870036 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5909029 | Total |
| Program Services | 5022675 | ProgramServices |
| Management And General | 886354 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7644255 | Total |
| Program Services | 6497617 | ProgramServices |
| Management And General | 1146638 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3891115 | Total |
| Program Services | 3307448 | ProgramServices |
| Management And General | 583667 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 282263 | Total |
| Program Services | 239924 | ProgramServices |
| Management And General | 42339 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 148411 | Total |
| Program Services | 126149 | ProgramServices |
| Management And General | 22262 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15000 | Total |
| Program Services | 12750 | ProgramServices |
| Management And General | 2250 | ManagementAndGeneral |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 449319 | Total |
| Program Services | 381922 | ProgramServices |
| Management And General | 67397 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6212751 | Total |
| Program Services | 5280838 | ProgramServices |
| Management And General | 931913 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1016856 | Total |
| Program Services | 864328 | ProgramServices |
| Management And General | 152528 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1679953 | Total |
| Program Services | 1427960 | ProgramServices |
| Management And General | 251993 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4095325 | Total |
| Program Services | 3481026 | ProgramServices |
| Management And General | 614299 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5645573 | Total |
| Program Services | 5009939 | ProgramServices |
| Management And General | 635634 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 64989 | Total |
| Program Services | 55241 | ProgramServices |
| Management And General | 9748 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 175069 | Total |
| Program Services | 148809 | ProgramServices |
| Management And General | 26260 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3962005 | Total |
| Program Services | 3367704 | ProgramServices |
| Management And General | 594301 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1484365 | Total |
| Program Services | 1261710 | ProgramServices |
| Management And General | 222655 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9569879 | Total |
| Program Services | 8134397 | ProgramServices |
| Management And General | 1435482 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1654167 | Total |
| Program Services | 1406042 | ProgramServices |
| Management And General | 248125 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 31950009 | 27157508 | 4792501 |
| BAD DEBT | 10137474 | 8616853 | 1520621 |
| PURCHASED SERVICES | 9835459 | 8360140 | 1475319 |
| SERVICE CONTRACTS | 2081501 | 1769276 | 312225 |
| HEALTHCARE PROFESSIONALS | 563081 | 478619 | 84462 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4416905 | Total |
| Program Services | 3754369 | ProgramServices |
| Management And General | 662536 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 167450911 | Total |
| Program Services | 140787803 | ProgramServices |
| Management And General | 26663108 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5270 | BOY |
| EOY | 5370 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3265392 | BOY |
| EOY | 2403439 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1500827 | BOY |
| EOY | 1373674 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16364675 | BOY |
| EOY | 18802608 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1431250 | BOY |
| EOY | 1153750 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1704883 | BOY |
| EOY | 1656440 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1983398 | BOY |
| EOY | 2464927 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 181846446 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 108602443 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 78078769 | BOY |
| EOY | 73244003 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25395014 | BOY |
| EOY | 29142551 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2269669 | BOY |
| EOY | 2269669 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12533902 | BOY |
| EOY | 17387124 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 144533049 | BOY |
| EOY | 149903555 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19867022 | BOY |
| EOY | 13289408 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 396562 | BOY |
| EOY | 327222 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 66550456 | BOY |
| EOY | 65273066 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 875941 | BOY |
| EOY | 791851 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2527469 | BOY |
| EOY | 3593583 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 42299093 | BOY |
| EOY | 38112397 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 132516543 | BOY |
| EOY | 121387527 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9010688 | BOY |
| EOY | 25570795 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2333641 | BOY |
| EOY | 2273056 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 672177 | BOY |
| EOY | 672177 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12016506 | BOY |
| EOY | 28516028 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 144533049 | BOY |
| EOY | 149903555 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 11470544 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 5028978 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | false | AuditCommittee |
| Financial Statement Both | X | FinancialStatementBoth |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | true | DirectContactLegislators |
| Direct Contact Legislators | $15,000 | DirectContactLegislatorsAmount |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | false | OtherActivities |
| Total Lobbying Expenditures IIB | 15000 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | LOBBYING ACTIVITIES | Identifier |
| Return Reference | SCHEDULE C, PART II-B, LINE 1G | ReturnReference |
| Explanation | THE HOSPITAL HOLDS MEMBERSHIP IN THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE HOSPITAL & HEALTHSYSTEM ASSOCIATION OF PENNSYLVANIA BOTH OF WHICH ENGAGE IN LOBBYING AS A PART OF THEIR MISSION TO REPRESENT THE INTERESTS OF HOSPITALS AT BOTH THE FEDERAL AND STATE LEVELS. FOR THE YEAR ENDED 6-30-11 THE AMOUNT OF DUES PAID TO THE HHAP TOTALED $65,216 WHICH 23% ($15,000) WAS USED FOR LOBBYING PURPOSES. ON OCCASION, HHAP REQUESTS THE HELP OF MEMBER PROVIDERS TO COMMUNICATE CONCERNS TO LEGISLATORS REGARDING PENDING LEGISLATION, WHICH COULD IMPACT HOSPITALS. THIS CAN INVOLVE DIRECT CONTACT WITH LEGISLATORS OR LETTER WRITING. THIS OCCURS INFREQUENTLY AND THE COST TO THE HOSPITAL IS NEGLIGIBLE. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3005818 | BeginningOfYearBalance |
| Contributions | 834833 | Contributions |
| Investment Earnings Or Losses | 26652 | InvestmentEarningsOrLosses |
| Other Expenditures | 922070 | OtherExpenditures |
| End Of Year Balance | 2945233 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3236426 | BeginningOfYearBalance |
| Contributions | 458155 | Contributions |
| Investment Earnings Or Losses | 36900 | InvestmentEarningsOrLosses |
| Other Expenditures | 725663 | OtherExpenditures |
| End Of Year Balance | 3005818 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3712782 | BeginningOfYearBalance |
| Contributions | -26711 | Contributions |
| Investment Earnings Or Losses | -22884 | InvestmentEarningsOrLosses |
| Other Expenditures | 426761 | OtherExpenditures |
| End Of Year Balance | 3236426 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.00000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.22820 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.77180 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1468847 | OtherCostOrOtherBasis |
| Book Value | 1468847 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 88852305 | OtherCostOrOtherBasis |
| Depreciation | 37065473 | Depreciation |
| Book Value | 51786832 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3741840 | OtherCostOrOtherBasis |
| Depreciation | 2897645 | Depreciation |
| Book Value | 844195 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 84519533 | OtherCostOrOtherBasis |
| Depreciation | 67114278 | Depreciation |
| Book Value | 17405275 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3263901 | OtherCostOrOtherBasis |
| Depreciation | 1525047 | Depreciation |
| Book Value | 1738854 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 73244003 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (10 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| ACCRUED INT BOARD DESIG FUNDS | 2000 |
| DEBT SVC FUNDS NON-CURRENT | 5558371 |
| DEBT SVC FUNDS CURRENT | 1335000 |
| INTERCOMPANY RECEIVABLES | 607106 |
| DUE FROM FOUNDATION | 27916 |
| DUE FROM EMPL, STAFF, PHYS | 74768 |
| OTHER RECEIVABLES | 4962439 |
| DUE FROM LEBANON COUNTY | 54760 |
| DEFERRED BOND ISSUE COSTS | 654663 |
| OTHER INVESTMENTS | 4110101 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 17387124 | TotalBookValueOtherAssets |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (5 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| EMPLOYEE W/H PAYABLE | $1,068,773 |
| 3RD PARTY PAYABLES | $4,817,670 |
| LONG TERM POST RETIRE BENEFITS | $2,925,031 |
| INSURANCE RESERVES | $1,792,694 |
| PENSION LIABILITY | $27,508,229 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 38112397 | TotalOfAmounts |
| Total Revenue | 178921455 | TotalRevenue |
| Total Expenses | 167450911 | TotalExpenses |
| Excess Or Deficit For Year | 11470544 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 2865776 | NetUnrealizedGLOnInvestments |
| Other | $2,163,202 | OtherAmount |
| Total Adjustments | 5028978 | TotalAdjustments |
| Excess Or Deficit Per FS | 16499522 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 181174217 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 2865776 | NetUnrealizedGainsInvestments |
| Other Revenues | -613014 | OtherRevenues |
| Revenue Not Rptd F990 | 2252762 | RevenueNotRptdF990 |
| Revenue Subtotal | 178921455 | RevenueSubtotal |
| Total Revenue Per Form990 | 178921455 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 167699384 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 248473 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 248473 | ExpensesNotRptdF990 |
| Expenses Subtotal | 167450911 | ExpensesSubtotal |
| Total Expenses Per Form990 | 167450911 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ENDOWMENT FUNDS | SCHEDULE D, PART V, LINE 4 | THE GOOD SAMARITAN HOSPITAL MAINTAINS TEMPORARILY RESTRICTED AND PERMANENTLY RESTRICTED ASSETS TO PURCHASE SPECIFIC PIECES OF EQUIPMENT AND PROVIDE QUALIFIED APPLICANTS A SCHOLARSHIP. |
| RECONCILIATION | SCHEDULE D, PART XI, XII, XIII | PART XI, LINE 8 THE GOOD SAMARITAN HOSPITAL NEEDED TO RESERVE MONEY IN ORDER TO PROVIDE THE RETIRED EMPLOYEES AND FUTURE RETIRED EMPLOYEES WITH SUFFICIENT PENSION PAYMENTS. THE GOOD SAMARITAN HOSPITAL WAS ABLE TO RELEASE FUNDS THAT WERE RESTRICTED FOR A SPECIFIC PURPOSE. THE GOOD SAMARITAN HOSPITAL ALSO WROTE OFF A LARGE RECEIVABLE THAT WAS DUE FROM AN AFFILIATED EXEMPT ORGANIZATION, GOOD SAMARITAN PHYSICIAN SERVICES. THE AMOUNT OF THE PENSION RESERVE WAS $9,369,245 AND THE AMOUNT OF THE WRITEOFF FOR THE GOOD SAMARITAN PHYSICIAN SERVICES RECEIVABLE WAS $7,206,043 FOR A NET AMOUNT OF $2,163,202. PART XII, LINE 2D RENTAL INCOME 123,492 TEMP REST CONTRIBUTIONS -829,784 PERM REST CONTRIBUTIONS -5,049 NET RENTAL LOSS 124,979 TEMP REST INVESTMENT INC -26,652 -------- TOTAL PART XII, LINE 2D -613,014 PART XIII, LINE 2D RENTAL EXPENSES OF $ 248,473 PART X, LINE 2 IN THE COURSE OF PREPARING THE HOSPITAL'S TAX RETURNS, THE HOSPITAL EVALUATES TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN TO DETERMINE WHETHER THE TAX POSITIONS ARE "MORE-LIKELY-THAN-NOT" OF BEING SUSTAINED BY THE APPLICABLE TAX AUTHORITIES. TAX POSITIONS NOT DEEMED TO MEET THE MORE-LIKELY-THAN-NOT THRESHOLD ARE RECORDED AS TAX BENEFITS OR EXPENSE IN THE CURRENT YEAR. MANAGEMENT HAS ANALYZED ALL TAX POSITIONS TAKEN ON FEDERAL, STATE, AND LOCAL INCOME TAX RETURNS FOR ALL OPEN TAX YEARS AND HAS CONCLUDED THAT NO PROVISION FOR FEDERAL INCOME TAX IS REQUIRED IN THE FINANCIAL STATEMENTS. THERE ARE NO INTEREST AND PENALTIES DEDUCTED IN THE CURRENT PERIOD AND NO INTEREST AND PENALTIES ACCRUED AT JUNE 30, 2011. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 443716 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 443716 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00280 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2533818 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1296785 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1237033 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00790 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 12355245 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6730820 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5624425 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03580 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 15332779 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8027605 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7305174 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04650 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 28405 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 28405 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2082155 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 960776 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1121379 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00710 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2110560 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 960776 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1149784 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00730 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 17443339 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8988381 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 8454958 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05380 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 20849 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 20849 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 27620 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 27620 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 48469 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 48469 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $2,838,493 | BadDebtExpenseAmount |
| Amount Attributable To | 6665229 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 42118500 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 92580762 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -50462262 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE GOOD SAMARITAN HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | FOURTH AND WALNUT STREETS | AddressLine1 |
| City | LEBANON | City |
| State | PA | State |
| ZIP Code | 17042 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Teaching Hospital | X | TeachingHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE GOOD SAMARITAN HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 200. | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 300. | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Medical Indigency | X | MedicalIndigency |
| Uninsured Discount | X | UninsuredDiscount |
| Other Factors | X | OtherFactors |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Permit Lien On Residence | X | PermitLienOnResidence |
| Collection Activities | true | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | true | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 11 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (11 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| THE GOOD SAMARITAN HOSPITAL | ||||
| FOURTH AND WILLOW STREETS | LEBANON | PA | 17042 | REHAB AND TCU UNITS |
| THE GOOD SAMARITAN HOSPITAL | ||||
| 830 TUCK STREET | LEBANON | PA | 17042 | OUTPATIENT SURGICAL CENTER |
| THE GOOD SAMARITAN HOSPITAL | ||||
| 840 TUCK STREET | LEBANON | PA | 17042 | WOUND CARE & HYPERBARIC CENTER |
| THE GOOD SAMARITAN HOSPITAL | ||||
| 206 HATHAWAY PARK | LEBANON | PA | 17042 | SLEEP DISORDERS CENTER |
| THE GOOD SAMARITAN HOSPITAL | ||||
| 805 HELEN DRIVE | LEBANON | PA | 17042 | OUTPATIENT RADIOLOGY CENTER |
| THE GOOD SAMARITAN HOSPITAL | ||||
| 750 NORMAN DRIVE | LEBANON | PA | 17042 | BLOOD DONOR CENTER & LABORATORY |
| THE GOOD SAMARITAN HOSPITAL | ||||
| 297 WEST LINCOLN AVENUE | MYERSTOWN | PA | 17067 | OUTPATIENT DIAGNOSTIC CENTER |
| THE GOOD SAMARITAN HOSPITAL | ||||
| 1400 SOUTH FORGE ROAD | PALMYRA | PA | 17078 | AMBULATORY SERVICES CENTER |
| THE GOOD SAMARITAN HOSPITAL | ||||
| 100 QUEEN STREET | JONESTOWN | PA | 17038 | SATELLITE SERVICES CENTER |
| THE GOOD SAMARITAN HOSPITAL | ||||
| 950 ISABEL DRIVE | LEBANON | PA | 17042 | OUTPATIENT PHYSICAL THERAPY |
| THE GOOD SAMARITAN HOSPITAL | ||||
| 781 NORMAN DRIVE | LEBANON | PA | 17042 | CARDIOVASCULAR DIAGNOSTIC CENTER |
Form990 Schedule H Part VI Form990ScheduleHPartVI (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SUPPLEMENTAL INFORMATION | SCHEDULE H | PART I, LINE 3C NOT APPLICABLE PART I, LINE 6A OUR ANNUAL COMMUNITY BENEFIT REPORT IS PREPARED BY OUR MARKETING DEPARTMENT. THE REPORT CAN BE FOUND AT OUR WEBSITE, WWW.GSHLEB.ORG. WE ALSO MAIL THE REPORT OUT TO THE MEMBERS OF OUR COMMUNITY. PART I, LINE 7G NOT APPLICABLE PART I, LINE 7, COLUMN (F) OUR TOTAL EXPENSE FROM FORM 990, PART IX, LINE 25, COLUMN (A) WAS $167,450,911. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT WAS $10,137,474. THIS LEFT US WITH A TOTAL EXPENSE OF $157,313,437 FOR PURPOSES OF CALCULATING LINE 7, COLUMN (F). PART I, LINE 7 THE GOOD SAMARITAN HOSPITAL USED THE COST TO CHARGE RATIO COST METHODOLOGY TO CALCULATE THE CHARITY AND UNREIMBURSED MEDICAID AND OTHER GOVERNMENT PROGRAMS. THE HOSPITAL USED DIRECT COSTS FOR THE OTHER COMMUNITY BENEFITS ON LINE 7. PART II THE GOOD SAMARITAN HEALTH SYSTEM IS INVOLVED IN SOME COMMUNITY BUILDING PROGRAMS WHICH ARE DESIGNED TO "IMPROVE THE OVERALL HEALTH OF OUR COMMUNITY" (MISSION STATEMENT). THE GSH PARTICIPATES IN A DISASTER PREPAREDNESS PROGRAM WHICH PROVIDES A PLAN IN THE CASE OF A DISASTER THAT AFFECTS THE COMMUNITY. THE GSH ALSO PROVIDES SPACE FOR SUPPORT GROUPS TO MEET AND EDUCATION CLASSES FOR PEOPLE WITHIN THE COMMUNITY, LIKE EXPECTANT PARENTS. THE ACTIVITIES ARE NOT INCLUDED ELSEWHERE ON SCHEDULE H. PART III, LINE 4 THE HOSPITAL ESTABLISHES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS TO REPORT THE NET REALIZABLE AMOUNTS TO BE RECEIVED FROM PATIENTS. INCREASES TO THIS ALLOWANCE ARE REFLECTED AS A PROVISION FOR DOUBTFUL ACCOUNTS IN THE STATEMENTS OF OPERATIONS. THE HOSPITAL REGULARLY PERFORMS A DETAILED ANALYSIS OF THE COLLECTIBILITY OF PATIENT ACCOUNTS RECEIVABLE AND CONSIDERS SUCH FACTORS AS PRIOR COLLECTION EXPERIENCE AND THE AGE OF THE RECEIVABLES TO DETERMINE THE APPROPRIATE ALLOWANCE LEVEL. BAD DEBT METHODOLOGY - THE GOOD SAMARITAN HOSPITAL IS A TAX-EXEMPT NON-FOR-PROFIT HOSPITAL THAT PROVIDES QUALITY MEDICAL SERVICES TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. BY PROVIDING MEDICAL SERVICES TO ALL COMMUNITY MEMBERS REGARDLESS OF THEIR ABILITY TO PAY, THE HOSPITAL'S BAD DEBT EXPENSE QUALIFIES AS A COMMUNITY BENEFIT. THE BAD DEBT EXPENSE CALCULATED ON LINE 2 WAS CALCULATED USING THE PATIENT CARE COST TO CHARGES METHODOLOGY. THE GOOD SAMARITAN HOSPITAL USES AN AUTOMATED SYSTEM CALLED PRESUMPTIVE TO CHARITY CARE TOOL TO CALCULATE THE AMOUNT ON LINE 3. ALL THE SELF PAY ACCOUNTS AND ALL THE SELF PAY AFTER INSURANCE ACCOUNTS ARE IMPORTED INTO THE TOOL, THEN THE TOOL SCORES EACH ACCOUNT BASED ON THE GOVERNMENT GUIDELINES FOR POVERTY LEVELS. FOR FYE 6/30/11, THE TOOL ESTIMATED THAT $6,665,229 OF THE ORGANIZATION'S BAD DEBT EXPENSE SHOULD BE CONSIDERED CHARITY CARE. PART III, LINE 8 MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST TO CHARGE RATIO. THE GOOD SAMARITAN HOSPITAL PROVIDES QUALITY MEDICAL SERVICES TO ALL PATIENTS REGARDLESS OF WHAT INSURANCE THEY HAVE. APPROXIMATELY 58% OF THE GOOD SAMARITAN HOSPITAL'S REVENUE IS ATTRIBUTABLE TO MEDICARE PATIENTS. THE GOOD SAMARITAN HOSPITAL IS RELIEVING THE GOVERNMENT'S BURDEN, BECAUSE THE HOSPITAL IS PROVIDING SERVICES TO MEDICARE PATIENTS WHICH COST MORE THAN THE MEDICARE REIMBURSEMENT. THEREFORE, THE $50,462,262 MEDICARE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT. PART III, LINE 9B COLLECTION POLICIES ARE THE SAME FOR ALL PATIENTS. IF A PATIENT NOTIFIES THE HOSPITAL ABOUT THEIR INABILITY TO PAY, THE HOSPITAL WILL SEND THEM THE CHARITY CARE AND FINANCIAL ASSISTANCE FORMS TO FILL OUT. ONCE THE FORMS ARE COMPLETED AND RETURNED TO THE HOSPITAL AND THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, THEN THE PATIENT'S ACCOUNT WILL BE REMOVED FROM COLLECTIONS AND THE ACCOUNT WILL BE WRITTEN OFF. PART V, SECTION B, Q. 11H THE GOOD SAMARITAN HOSPITAL CALCULATES THE AMOUNT CHARGED TO A PATIENT BASED ON CATESTROPHIC OR PHYSICAL HARDSHIP AND THE NUMBER OF INDIVIDUALS LIVING IN A HOUSEHOLD. PART V, SECTION B, Q. 19D THE GOOD SAMARITAN HOSPITAL BILLS INDIVIDUALS WITHOUT INSURANCE THEIR GROSS CHARGES ASSOCIATED WITH THE SERVICES THEY RECEIVED DURING THEIR VISIT. GSH OFFERS ALL SELF PAY PATIENTS A 35% DISCOUNT IF THEY PAY THEIR BILL WITHIN 30 DAYS OF THEIR SERVICES. PART V, SECTION B, Q. 21 THE GOOD SAMARITAN HOSPITAL CHARGES ITS SELF PAY PATIENTS THEIR GROSS CHARGES FOR THE SERVICES RENDERED. PART VI, LINE 2 THE GOOD SAMARITAN HOSPITAL HAS PARTICIPATED IN A VARIETY OF COMMUNITY HEALTH NEEDS ASSESSMENTS OVER THE PAST 16 YEARS. THE HOSPITAL WAS INSTRUMENTAL IN HELPING TO LAUNCH THE COMMUNITY HEALTH COUNCIL OF LEBANON COUNTY. IN PARTNERSHIP WITH THE COUNCIL, A COMMUNITY HEALTH NEEDS ASSESSMENT WAS CREATED 16 YEARS AGO AND AN UPDATED ASSESSMENT COMPLETED 11 YEARS AGO. ANOTHER ASSESSMENT WAS CREATED IN 2005, LED BY EFFORTS OF THE UNITED WAY OF LEBANON COUNTY. THE GOOD SAMARITAN HOSPITAL IS CURRENTLY PARTNERED WITH OTHER COMMUNITY ORGANIZATIONS AND COMPLETED A COMMUNITY HEALTH ASSESSMENT DURING THE FALL OF 2011. THE HOSPITAL ALSO MAINTAINS AN INDEPENDENT, COUNTYWIDE PHYSICIAN NEEDS ASSESSMENT TO EVALUATE GAPS IN HEALTHCARE ACCESS. A NEW PHYSICIAN NEEDS ASSESSMENT WAS ALSO COMPLETED IN 2011. IN ADDITION TO THESE COUNTYWIDE EFFORTS, THE HOSPITAL HAS PERFORMED A VARIETY OF STUDIES ON SPECIFIC HEALTH CONCERNS AND COMMUNITY NEEDS. KEY STUDIES HAVE INCLUDED SERVICES FOR CARDIOVASCULAR, ONCOLOGY, GASTROENTEROLOGY, WOUND CARE, AND MORE. THE HOSPITAL HAS ALSO ACTED TO FULFILL THE NEEDS IDENTIFIED IN THESE STUDIES. THE HOSPITAL CREATED ONE OF THE NATION'S LEADING CARDIAC AND VASCULAR CENTERS, WHICH HAS EARNED SEVERAL NATIONAL AWARDS FOR QUALITY OF CARE. THE HOSPITAL INTRODUCED A NEW WOUND CARE SERVICE TO DEAL WITH PATIENTS SUFFERING FROM COMPLICATIONS OF DIABETES - A PARTICULAR PROBLEM TO LEBANON COUNTY - AND HAS ALREADY EXPANDED OPERATIONS TO ADD A THIRD HYPERBARIC OXYGEN TREATMENT CHAMBER TO THE TWO ORIGINALLY INSTALLED IN THE CENTER. IN ADDITION, THE HOSPITAL HAS PROTECTED THE COMMUNITY BY RECRUITING NEW PHYSICIANS FOR KEY SERVICES - GENERAL SURGERY, ONCOLOGY, AND GASTROENTEROLOGY - ALLOWING PATIENTS TO GET ACCESS TO CARE IN LEBANON COUNTY INSTEAD OF TRAVELING THROUGHOUT THE REGION. PART VI, LINE 3 THE GOOD SAMARITAN HOSPITAL CHARITY CARE POLICY OUTLINES THE PROCESS OF FINANCIAL, MEDICAL AND CATASTROPHIC CATEGORIES WHERE A PATIENT COULD QUALIFY FOR CHARITY CARE. THE HOSPITAL HAS A SELF PAY BROCHURE AVAILABLE THAT PROVIDES INFORMATION ON OUR CHARITY CARE PROGRAM ALONG WITH CONTACT INFORMATION AND AVAILABLE HOURS. FINANCIAL COUNSELORS ARE ON SITE TO MEET WITH PATIENTS TO DISCUSS THEIR FINANCIAL OBLIGATIONS, ASSIST THEM IN COMPLETING THE APPLICATION FOR CHARITY CARE, AND ANSWER THEIR QUESTIONS. PATIENTS ARE ENCOURAGED TO APPLY FOR CHARITY CARE IF THEY ARE UNABLE TO COME IN FOR AN APPOINTMENT. THERE IS A NOTE ON THE STATEMENTS THAT IS MAILED TO PATIENTS, LETTING THEM KNOW THAT FINANCIAL ASSISTANCE IS AVAILABLE. THE GOOD SAMARITAN HOSPITAL'S WEBSITE ALSO PROVIDES THE CONTACT INFORMATION FOR THOSE COMMUNITY MEMBERS WHO NEED MEDICAL SERVICES AND FINANCIAL ASSISTANCE. PART VI, LINE 4 LEBANON COUNTY INCLUDES A MIX OF URBAN, SUBURBAN, AND RURAL AREAS. THE CITY OF LEBANON IS CENTRALLY LOCATED, SERVING AS THE COUNTY SEAT. THE CITY IS HOME TO MORE THAN 24,000 RESIDENTS AND IS CLASSIFIED BY THE COMMONWEALTH OF PENNSYLVANIA AS A THIRD CLASS CITY. THE COUNTY INCLUDES 25 OTHER MUNICIPALITIES. THE REST OF THE COUNTY IS MADE UP OF SUBURBAN AND RURAL AREAS, WITH RURAL FARMLAND PROVIDING A DOMINANT CHARACTER OF COUNTY LIFE. WHILE MOST OF THE POPULATION TENDS TO BE OF WHITE ANCESTRY (91%), THE COUNTY HAS A FAST-GROWING HISPANIC POPULATION (7.8%) THAT CENTERS IN THE CITY OF LEBANON (SOURCE: US CENSUS BUREAU). THE US CENSUS BUREAU ALSO REPORTS THAT 8% OF THE POPULATION SPEAKS A LANGUAGE OTHER THAN ENGLISH AT HOME. EMPLOYMENT RATES IN THE COUNTY ARE CURRENTLY AT 6.8%- ONE OF THE LOWEST RATES IN THE STATE- AND AVERAGE HOUSEHOLD INCOME IS AT $50,334 ACCORDING TO THE USDA ECONOMIC RESEARCH SERVICE. THE FEDERAL GOVERNMENT IS THE COUNTY'S LARGEST EMPLOYER, WITH LARGE WORK FORCES AT THE LEBANON VETERANS ADMINISTRATION HOSPITAL AND FORT INDIANTOWN GAP. THE GOOD SAMARITAN HOSPITAL IS THE LARGEST NON-GOVERNMENTAL EMPLOYER WITH 1,500 EMPLOYEES. ACCORDING TO THE US CENSUS BUREAU AMERICAN COMMUNITY SURVEY, 8% OF THE POPULATION LIVES IN POVERTY. THE GOOD SAMARITAN HOSPITAL IS THE ONLY HOSPITAL IN LEBANON COUNTY. THE HOSPITAL PROVIDES EMERGENCY CARE TO APPROXIMATELY 51,000 INDIVIDUALS EACH YEAR. THE HOSPITAL CARED FOR APPROXIMATELY 8,400 ACUTE CARE PATIENTS. IN ADDITION, THE HOSPITAL HAS PERFORMED THOUSANDS OF OUTPATIENT PROCEDURES- FROM SURGERIES TO IMAGING TO LABORATORY TO PHYSICAL THERAPY- EVERY YEAR. THE HOSPITAL ALSO PROVIDES A CONTINUITY OF CARE THROUGH A SKILLED NURSING UNIT, REHABILITATION SERVICES, HOME HEALTHCARE, AND HOSPICE CARE. THE HOSPITAL IS THE LARGEST PROVIDER OF CARE TO MEDICAID AND MEDICARE POPULATIONS. WHILE MOST LEBANON COUNTY RESIDENTS CHOOSE TO STAY IN THE COUNTY FOR THEIR CARE, WITH MORE THAN 60% CHOOSING THE GOOD SAMARITAN HOSPTIAL FOR SERVICES. ACCORDING |
| SUPPLEMENTAL INFORMATION | SCHEDULE H | IN ADDITION TO SCREENING FOR HIGH-RISK PATIENTS, BREAST MRI CAN BE USED AS A DIAGNOSTIC TOOL WHEN A MAMMOGRAM, SELF-EXAM OR CLINICAL EXAM IDENTIFIES AN AREA OF CONCERN. THE INTRODUCTION OF THE BREAST MRI TECHNOLOGY ALSO ALLOWS THE GSH IMAGING CENTER TO PROVIDE ADVANCED MRI-GUIDED BREAST BIOPSY. THIS PROVIDES ANOTHER BIOPSY OPTION TO COMPLEMENT OUR STEREO-TACTIC AND ULTRASOUND-GUIDED BIOPSIES, ALSO AVAILABLE. THE MRI-GUIDED BREAST BIOPSY TECHNOLOGY ENABLES PRECISE AND ACCURATE BIOPSIES, GIVING PATIENTS AND THEIR SURGEONS THE INFORMATION NEEDED TO PLAN THE BEST COURSE OF TREATMENT. GOOD SAMARITAN HEALTH SYSTEM IS COMMITTED TO PROVIDING OUR PATIENTS WITH THE MOST ADVANCED BREAST IMAGING TECHNOLOGY TO HELP WOMEN OF LEBANON COUNTY IN THEIR FIGHT AGAINST BREAST CANCER. PART VI, LINE 6 THE GOOD SAMARITAN HOSPITAL IS A PART OF THE GOOD SAMARITAN HEALTH SYSTEM. THE SYSTEM INCLUDES A FOUNDATION, DIALYSIS CENTER, REAL ESTATE COMPANIES, MRI CENTER, FAMILY PRACTICES, SPECIALITY HEALTH SERVICES, A DME COMPANY, AND A URGENT CARE CENTER. IN ADDITION TO THE COMMUNITY BENEFITS PROVIDED BY THE HOSPITAL, THE HEALTH SYSTEM EVALUATES THE NEEDS THE COMMUNITY AND THE SYSTEM WILL PARTICIPATE IN COMMUNITY BENEFIT PROGRAMS, LIKE SUPPORTING THE VOLUNTEERS IN MEDICINE FREE CLINIC WHICH SERVES THE UNDERPRIVILEGED MEMBERS OF THE COMMUNITY. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Form990 Schedule I Part III Form990ScheduleIPartIII (4 entries)
| Type Of GrantTypeOfGrant | Number Of RecipientsNumberOfRecipients | Amount Of Cash GrantAmountOfCashGrant | Method Of ValuationMethodOfValuation |
|---|---|---|---|
| DAVID BRODERIC SCHOLARSHIP | 31 | 7500 | OTHER |
| MARGARET CONNELL SCHOLARSHIP | 7 | 5440 | OTHER |
| GSH AUXILIARY SCHOLARSHIP | 5 | 4500 | OTHER |
| CAPLAN NURSING SCHOLARSHIP | 10 | 10250 | OTHER |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURES TO MONITOR USE OF GRANTS | Identifier |
| Return Reference | SCHEDULE I, PART I, LINE 2 | ReturnReference |
| Explanation | THE DAVID BRODERIC EMPLOYEE SCHOLARSHIP PROGRAM AND THE MARGARET L. CONNELL SCHOLARSHIP FUND ARE FOR THE SONS AND DAUGHTERS OF EMPLOYEES. THE GSH AUXILIARY AND CAPLAN NURSING SCHOLARSHIPS ARE AWARDED TO LEBANON COUNTY RESIDENTS ENROLLED IN A NURSING PROGRAM. PART III, COLUMN (B) THE GOOD SAMARITAN HOSPITAL DISTRIBUTES A PORTION OF THE MONEY ALLOTTED TO EVERY PERSON WHO APPLIES FOR THE SCHOLARSHIP. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROBERT J LONGO | |||||||||||||
| 425026 | 0 | 63000 | 0 | 22009 | 0 | 0 | 0 | 2884 | 0 | 512919 | 0 | 352186 | 0 |
| KIMBERLY FEEMAN | |||||||||||||
| 204968 | 0 | 24419 | 0 | 17453 | 0 | 0 | 0 | 0 | 0 | 246840 | 0 | 0 | 0 |
| JACQUELYN M GOULD | |||||||||||||
| 160935 | 0 | 22259 | 0 | 8379 | 0 | 0 | 0 | 0 | 0 | 191573 | 0 | 0 | 0 |
| ROBERT J RICHARDS | |||||||||||||
| 221724 | 0 | 32411 | 0 | 32735 | 0 | 0 | 0 | 0 | 0 | 286870 | 0 | 0 | 0 |
| JULIE MIKSIT | |||||||||||||
| 134464 | 0 | 18028 | 0 | 11679 | 0 | 0 | 0 | 0 | 0 | 164171 | 0 | 0 | 0 |
| WILLIAM HENDRICK | |||||||||||||
| 130118 | 0 | 42998 | 0 | 21337 | 0 | 0 | 0 | 0 | 0 | 194453 | 0 | 0 | 0 |
| ROBERT D SHAVER MD | |||||||||||||
| 292185 | 0 | 38955 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 331140 | 0 | 0 | 0 |
| ELLEN JOHNSON | |||||||||||||
| 163644 | 0 | 7002 | 0 | 17371 | 0 | 0 | 0 | 0 | 0 | 188017 | 0 | 0 | 0 |
| DARIA KOVARIKOVA | |||||||||||||
| 180218 | 0 | 7350 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 187568 | 0 | 0 | 0 |
| BYARD YODER | |||||||||||||
| 165820 | 0 | 0 | 0 | 8661 | 0 | 0 | 0 | 0 | 0 | 174481 | 0 | 0 | 0 |
| ROBERTA SCHERR | |||||||||||||
| 170211 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 170211 | 0 | 0 | 0 |
| JAMES MCGEARY | |||||||||||||
| 159625 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 159625 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SUPPLEMENTAL COMPENSATION INFORMATION | Identifier |
| Return Reference | SCHEDULE J, PART I, LINE 3 | ReturnReference |
| Explanation | THE COMPENSATION COMMITTEE HIRES AN INDEPENDENT COMPENSATION CONSULTANT TO ESTABLISH THE CEO'S COMPENSATION AMOUNT AND COMPOSE THE CONTRACT. THE COMPENSATION COMMITTEE PRESENTS THE INFORMATION TO THE BOARD. IF A BOARD MEMBER WOULD LIKE TO REVIEW THE CONTRACT, THEY CAN CONTACT A MEMBER OF THE COMPENSATION COMMITTEE TO REVIEW THE CONTRACT PRIVATELY. SCHEDULE J, PART I, LINE 4B ROBERT J. LONGO IS A PARTICIPANT IN A 457F RETIREMENT PLAN. HE RECEIVED NO PAYMENT FROM THE PLAN THIS YEAR. | Explanation |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LEBANON COUNTY HEALTH FACILITIES AUTHORITY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 232546819 | IssuerEIN |
| CUSIP Number | 522455BE3 | CUSIPNumber |
| Date Issued | 2004-03-11 | DateIssued |
| Issue Price | 17255816 | IssuePrice |
| Description Of Purpose | SEE PART V | DescriptionOfPurpose |
| Defeased | false | Defeased |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Pool Financing | false | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Proceeds | 17255816 | TotalProceeds |
| Year Of Subst Completion | 2004 | YearOfSubstCompletion |
| Current Refunding | true | CurrentRefunding |
| Advance Refunding | false | AdvanceRefunding |
| Final Allocation Made | true | FinalAllocationMade |
| Adequate Books And Recds Maintaind | true | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | false | Form8038TFiled |
| Variable Rate Issue | false | VariableRateIssue |
| Hedge Identified In Books And Recds | false | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | false | GrossProceedsInvested |
| Exception To Rebate | true | ExceptionToRebate |
Form990 Schedule K Part V Form990ScheduleKPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PART I, COLUMN F | Identifier |
| Explanation | REFUND OUTSTANDING 1994 BONDS ISSUED ON 1/13/1994. | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| WELCH WAGNER PARTNERSHIP | |||
| SEE PART V | 279672 | PROPERTY RENTAL | false |
| LEBANON INTERNAL MEDICINE ASSOC | |||
| SEE PART V | 122118 | MEDICAL DIRECTOR FEES | false |
| ARTHUR FUNK AND SONS | |||
| SEE PART V | 120583 | CONSTRUCTION PROJECTS | false |
| REILLYWOLFSONSHEFFEYSCHRUMLUNDB | |||
| SEE PART V | 127095 | ATTORNEY FEES | false |
Form990 Schedule L Part V Form990ScheduleLPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SCHEDULE L | Identifier |
| Explanation | PART IV, LINE 1 JOHN WELCH, A TRUSTEE OF THE GOOD SAMARITAN HOSPITAL, IS A PARTNER IN WELCH WAGNER PARTNERSHIP. PART IV, LINE 2 WILLIAM E. SCHAEFFER, JR. MD, A TRUSTEE OF THE GOOD SAMARITAN HOSPITAL, IS A PARTNER IN LEBANON INTERNAL MEDICINE ASSOCIATES. PART IV, LINE 3 ROBERT J. FUNK, A TRUSTEE OF THE GOOD SAMARITAN HOSPITAL, IS A PARTNER IN ARTHUR FUNK AND SONS. PART IV, LINE 4 FREDERICK WOLFSON, A TRUSTEE OF THE GOOD SAMARITAN HOSPITAL, IS A PARTNER IN REILLY, WOLFSON, SHEFFEY, SCHRUM & LUNDBERG. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS | FORM 990, PART III | PROGRAM SERVICE EXPENSE #1 THE GSH IS A 196 LICENSED BED, (ACUTE CARE 177, SKILLED CARE 19) TAX EXEMPT , NON-PROFIT ACUTE CARE HOSPITAL PROVIDING A FULL RANGE OF INPATIENT AND OUTPATIENT SERVICES INCLUDING RESPIRATORY THERAPY, PHYSICAL THERAPY, RADIOLOGY, INPATIENT AND OUTPATIENT SURGERY, PEDIATRICS, INTENSIVE CARE, TELEMETRY, CARDIAC CARE, HEMODIALYSIS, INHALATION THERAPY, PULMONARY FUNCTIONS, ENDOSCOPY, 24 HOUR EMERGENCY CARE, OCCUPATIONAL MEDICINE, TRACTION, PACEMAKERS, EEG, EKG, STRESS MONITORING, MAMMOGRAPHY, ULTRASOUND, CT SCAN, CANCER CARE, NUCLEAR MEDICINE, PHARMACY, OBSTETRICS, BLOOD BANK, PERIPHERAL VASCULAR LAB, CARDIOVASCULAR LAB, CARDIOVASCULAR SURGERY, AND LABORATORY WHICH INCLUDE CHEMISTRY, HEMATOLOGY, HISTOLOGY, CYTOLOGY AND MICROBIOLOGY. FY 6/30/11 STATISTICS: 8,299 ADMISSIONS, 34,865 INPATIENT DAYS; 276,477 OUTPATIENT REGISTRATIONS. PROGRAM SERVICE EXPENSE #4 THE GSH OPERATES HOME HEALTH/VISITING NURSE ASSOCIATION PROVIDING A FULL RANGE OF IN-HOME HEALTH CARE INCLUDING IV THERAPY, MATERNAL/INFANT CARE, HOSPICE, PHYSICAL THERAPY, SPEECH THERAPY, OCCUPATIONAL THERAPY, NUTRITIONAL THERAPY, SOCIAL SERVICES AND HOME HEALTH AIDES. FY 6/30/11 STATISTICS: 19,431 IN-HOME CARE VISITS WERE PROVIDED. |
| MEMBERS OR STOCKHOLDERS | FORM 990, PART VI, LINE 6 | THE GOOD SAMARITAN HEALTH SERVICES FOUNDATION, ANOTHER 501(C)(3) ORGANIZATION, IS THE SOLE MEMBER OF THE GOOD SAMARITAN HOSPITAL. |
| MEMBERS WHO MAY ELECT TRUSTEES OF THE GOVERNING BODY | FORM 990, PART VI, LINE 7A | THE GOOD SAMARITAN HEALTH SERVICES FOUNDATION, AS THE SOLE MEMBER OF THE GOOD SAMARITAN HOSPITAL, MAY ELECT ONE OR MORE TRUSTEES OF THE HOSPITAL'S GOVERNING BODY. DECISION OF GOVERNING BODY SUBJECT TO APPROVAL BY MEMBERS FORM 990, PART VI, LINE 7B CERTAIN DECISIONS OF THE HOSPITAL'S GOVERNING BODY ARE SUBJECT TO APPROVAL BY THE HOSPITAL'S SOLE MEMBER, THE GOOD SAMARITAN HEALTH SERVICES FOUNDATION. |
| PROCESS OF GOVERNING BODY REVIEW OF 990 | FORM 990, PART VI, LINE 11B | AN ACCOUNTANT PREPARES THE 990 AND 990-T FOR THE GOOD SAMARITAN HOSPITAL. THE HOSPITAL THEN PAYS AN AUDITING FIRM TO REVIEW THE 990 TAX RETURN. THE CONTROLLER AND THE CFO REVIEW THE FINAL DRAFT OF THE RETURN BEFORE IT IS DISTRIBUTED TO THE BOARD OF DIRECTORS AND THEN FILED WITH THE IRS. |
| CONFLICT OF INTEREST POLICY | FORM 990, PART VI, LINE 12C | THE GOOD SAMARITAN HOSPITAL HAS A COMPLIANCE OFFICER THAT IS RESPONSIBLE FOR MONITORING AND ENFORCING THE COMPLIANCE OF POLICIES. |
| DISCLOSURE OF DOCUMENTS TO THE PUBLIC | FORM 990, PART VI, LINE 19 | THE GOOD SAMARITAN HOSPITAL HAS ALL OF ITS POLICIES AND FINANCIAL STATEMENTS AVAILABLE FOR THE GENERAL PUBLIC. THE PUBLIC NEEDS TO SCHEDULE AN APPOINTMENT WITH ADMINISTRATION TO COME IN AND VIEW THE INFORMATION UNDER HOSPITAL SUPERVISION. |
| AVERAGE HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS | FORM 990, PART VII, SECTION A | ALL OF THE HOSPITAL TRUSTEES ALSO SERVE 1 HOUR PER WEEK ON THE GOOD SAMARITAN HEALTH SERVICE FOUNDATION'S BOARD. ROBERT J. LONGO GOOD SAMARITAN HEALTH SERVICES FOUNDATION - 1 HOUR/WEEK GOOD SAMARITAN PHYSICIAN SERVICES - 12 HOURS/WEEK GSH SERVICES, INC. - 1 HOUR/WEEK GOOD SAMARITAN REAL ESTATE, INC. - 1 HOUR/WEEK GSH REALTY, INC. - 1 HOUR/WEEK GSH HOME MED CARE, INC. - 1 HOUR/WEEK GSH DIALYSIS, INC. - 1 HOUR/WEEK LEBANON MRI ASSOCIATES, LTD. - 1 HOUR/WEEK GOOD SAMARITAN PHYSICIAN HOSPITAL ORGANIZATION - 1 HOUR/WEEK ROBERT J. RICHARDS GOOD SAMARITAN PHYSICIAN SERVICES - 12 HOURS/WEEK GSH SERVICES, INC. - 1 HOUR/WEEK GOOD SAMARITAN REAL ESTATE, INC. - 1 HOUR/WEEK GSH REALTY, INC. - 1 HOUR/WEEK GSH HOME MED CARE, INC. - 1 HOUR/WEEK GSH DIALYSIS, INC. - 1 HOUR/WEEK LEBANON MRI ASSOCIATES, LTC. - 1 HOUR/WEEEK GOOD SAMARITAN PHYSICIAN HOSPITAL ORGANIZATION - 1 HOUR/WEEK KIMBERLY FEEMAN GOOD SAMARITAN PHYSICIAN SERVICES - 12 HOURS/WEEK LEBANON MRI ASSOCIATES, LTC. - 3 HOURS/WEEK JACQUELYN M. GOULD GOOD SAMARITAN PHYSICIAN SERVICES - 12 HOURS/WEEK GSH DIALYSIS, INC. - 3 HOURS/WEEK JULIE MIKSIT GOOD SAMRITAN PHYSICIAN SERVICES - 10 HOURS/WEEK ROBERT D. SHAVER, M.D. GOOD SAMARITAN PHYSICIAN SERVICES - 10 HOURS/WEEK |
| OTHER CHANGES IN NET ASSETS | FORM 990, PART XI, LINE 5 | UNREALIZED GAIN ON INVESTMENTS $2,865,776 PENSION RESERVE ADJUSTMENT 9,369,245 GOOD SAMARITAN PHY SVCS REC WRITE-OFF (7,206,043) ---------- $5,028,978 ========== **NOTE: GOOD SAMARITAN PHYSICIAN SERVICES IS A RELATED 501(C)(3) EXEMPT ORGANIZATION. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| GOOD SAMARITAN HEALTH SERVICE FOUNDATION | |||||||||
| 259 SOUTH FOURTH STREET | LEBANON | PA | 17042 | 232356151 | PARENT | PA | 501(C)(3) | 11,TYPE I | NA |
| GOOD SAMARITAN REAL ESTATE | |||||||||
| 241 SOUTH FOURTH STREET | LEBANON | PA | 17042 | 232447262 | TITLE HOLDING | PA | 501(C)(2) | GSH FDN | |
| GSH DIALYSIS INC | |||||||||
| 440 OAK STREET | LEBANON | PA | 17042 | 232500940 | DIALYSIS SVCS | PA | 501(C)(3) | 3 | GSH FDN |
| GOOD SAMARITAN PHYSICIAN SERVICES | |||||||||
| 259 SOUTH FOURTH STREET | LEBANON | PA | 17042 | 231832359 | FAMILY MED | PA | 501(C)930 | 9 | GSH FDN |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LEBANON MRI ASSOCIATES LTD | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4THWALNUT ST | AddressLine1 |
| City | LEBANON | City |
| State | PA | State |
| ZIP Code | 17042 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363730905 | EIN |
| Primary Activity | MRI SERVICES | PrimaryActivity |
| Legal Domicile State | PA | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|
| GSH SERVICES INC | |||||||||||
| 241 SOUTH FOURTH STREET | LEBANON | PA | 17042 | 232353047 | MGMT & ACCTG SVCS | PA | GSHS FOUNDATION | C CORP | 0 | 0 | 0.00000 |
| GSH HOME MED CARE INC | |||||||||||
| 301 SCHNEIDER DRIVE | LEBANON | PA | 17046 | 232028099 | MEDICAL EQUIP | PA | GSHS FOUNDATION | C CORP | 0 | 0 | 0.00000 |
| GSH REALTY INC | |||||||||||
| 241 SOUTH FOURTH STREET | LEBANON | PA | 17042 | 232446622 | TITLE HOLDING | PA | GSHS FOUNDATION | C CORP | 0 | 0 | 0.00000 |
| GSH URGENT CARE INC | |||||||||||
| 954 ISABEL DRIVE | LEBANON | PA | 17042 | 251816053 | URGENT MEDICINE | PA | GSHS FOUNDATION | C CORP | 0 | 0 | 0.00000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | true | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | true | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | true | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | true | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (14 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| GOOD SAMARITAN REAL ESTATE INC | |
| J | 585463 |
| GSH REALTY INC | |
| J | 298436 |
| LEBANON MRI ASSOCIATES LTD | |
| L | 467557 |
| GSH HOME MED CARE INC | |
| L | 101915 |
| GSH HOME MED CARE INC | |
| P | 90612 |
| GSH HOME MED CARE INC | |
| P | 65824 |
| GSH DIALYSIS INC | |
| K | 105434 |
| GSH DIALYSIS INC | |
| P | 330092 |
| GSH DIALYSIS INC | |
| P | 53516 |
| GOOD SAMARITAN PHYSICIAN SERVICES | |
| P | 401526 |
| GOOD SAMARITAN PHYSICIAN SERVICES | |
| P | 92592 |
| GOOD SAMARITAN PHYSICIAN SERVICES | |
| P | 602965 |
| GOOD SAMARITAN PHYSICIAN SERVICES | |
| I | 220428 |
| LEBANON MRI ASSOCIATES LTD | |
| I | 123518 |
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