LOWER BUCKS HOSPITAL: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
LOWER BUCKS HOSPITAL (EIN 23-2879667)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-15
IRS object ID
201231369349308403
Schema version
2010v3.4
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-05-15T21:18:31-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ZELENKOFSKE AXELROD LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12370 YORK ROAD SUITE A-5AddressLine1
CityJAMISONCity
StatePAState
ZIP Code18929ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN232879667EIN

Name Name

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

US Address USAddress

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

Officer Officer

FieldValueIRS element (for citing)
NameALBERT MEZZAROBAName
TitleCEOTitle
Phone2157859200Phone
Date Signed2012-05-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameZELENKOFSKE AXELROD LLCName
Phone2159182277Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

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

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1501 BATH ROADAddressLine1
CityBRISTOLCity
StatePAState
ZIP Code19007ZIPCode
FieldValueIRS element (for citing)
Gross Receipts92170018GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.LOWERBUCKSHOSPITAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1956YearFormation
State Legal DomicilePAStateLegalDomicile
Activity Or Mission DescriptionHEALTHCARE-COMMUNITY HOSPITALActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees1061TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1000000ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year102971130ProgramServiceRevenuePriorYear
Program Service Revenue CY87448361ProgramServiceRevenueCY
Investment Income Prior Year98217InvestmentIncomePriorYear
Investment Income Current Year16334InvestmentIncomeCurrentYear
Other Revenue Prior Year1134278OtherRevenuePriorYear
Other Revenue Current Year4705323OtherRevenueCurrentYear
Total Revenue Prior Year105203625TotalRevenuePriorYear
Total Revenue Current Year92170018TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year49176260SalariesEtcPriorYear
Salaries Etc Current Year47545820SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year9323TotalFundrsngExpCurrentYear
Other Expense Prior Year63417968OtherExpensePriorYear
Other Expenses Current Year49263488OtherExpensesCurrentYear
Total Expenses Prior Year112594228TotalExpensesPriorYear
Total Expenses Current Year96809308TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-7390603RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-4639290RevenuesLessExpensesCY
Total Assets BOY64386854TotalAssetsBOY
Total Assets EOY59643051TotalAssetsEOY
Total Liabilities BOY73799313TotalLiabilitiesBOY
Total Liabilities EOY73694796TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-9412459NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-14051745NetAssetsOrFundBalancesEOY
Mission DescriptionADVANCED HEALTHCARE FOR THE COMMUNITYMissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense78317671Expense
Revenue92170017Revenue
DescriptionHEALTHCARE TO THE COMMUNITYDescription
Total Program Service Expense78317671TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109643NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees1061NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters1LocalChapters
Policies Reference Chapters1PoliciesReferenceChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledPAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1CFOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2157859325TelephoneNumber

Address US AddressUS

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

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
DELORES BROWN
CHAIRPERSON1.00XX000
LOUIS BUSICO
VICE CHAIRPERSON1.00XX000
GLADYS MENDIETA
SECRETARY/TREASURER1.00XX000
PHILLIP BRACKIN MD
BOARD MEMBER1.00X000
YAGNESH CHOKSKI
BOARD MEMBER1.00X000
HARRY FAWKES JR
BOARD MEMBER1.00X000
HARRY FAWKES SR
BOARD MEMBER1.00X000
BRUCE Q HARRIS
BOARD MEMBER1.00X000
ROBERT LEIPZIGER
BOARD MEMBER1.00X000
ANTHONY J MELIO
BOARD MEMBER1.00X000
RANGA RAO MD
BOARD MEMBER1.00X000
JOANNA SCHNEYDER
BOARD MEMBER1.00X000
JAMES H SELL
BOARD MEMBER1.00X000
RONALD P WALKER
BOARD MEMBER1.00X000
LOUIS QUATTROCCHI
BOARD MEMBER1.00X000
ALBERT MEZZAROBA
CHIEF EXECUTIVE OFFICER40.00X40482703808X
MICHAEL OLIVIERI
CHIEF FINANCIAL OFFICER40.00X124157014361X
JOHN MCHALE
EXECUTIVE VICE PRESIDENT40.00X137008018453X
PATRICIA BAIN
CHIEF NURSING OFFICER40.00X127965015362X
KIM CLABBERS MD
ORTHOPEDIC SURGEON40.0031067105730X
TATYANA CHERNOVA MD
PATHOLOGIST40.0021873208071X
ANNA SOSNOVSKY MD
NEONATOLOGIST40.00191188019602X
MANUEL MALDONADO
PHYSICIAN ASSISTANT40.0016421307364X
KAZIMIERZ WATOREK
NEONATOLOGIST40.00154118018676X
AUSTIN CLEVELAND
FORMER CEO40.002612700X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1832879TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation111427TotalOtherCompensation
Number Individuals GT100 K30NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
SAUL EWING
1500 MARKET STREETPHILADELPHIAPA19102LEGAL FIRM2175860
SODEXHO
PO BOX 905374CHARLOTTENC28290FOOD SERVICE1669215
HORIZON MENTAL
2941 SOUTH LAKE VISTA DRIVELEWISVILLETX75067MENTAL HEALTH ADMINISTRATION1656348
PINNACLE MID-AT
13601 PRESTON ROADDALLASTX75240ANESTHESIA SERVICES1647108
LBH RADIOLOGY
501 BATH ROADBRISTOLPA19007RADIOLOGY SERVICES926161
FieldValueIRS element (for citing)
Number Of Contractors GT100 K10NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT REVENUEDescription
Business Code621110BusinessCode
Total Revenue Column87448361TotalRevenueColumn
Related Or Exempt Function Income87448361RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue87448361TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column16334TotalRevenueColumn
Related Or Exempt Function Income16334RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
OTHER OPERATING REVENU62111045944394594439
NON OPERATING INCOME621110110884110884
FieldValueIRS element (for citing)
Total Other Revenue4705323TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column92170018TotalRevenueColumn
Related Or Exempt Function Income92170018RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total921922Total
Program Services127965ProgramServices
Management And General793957ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total38163286Total
Program Services32685083ProgramServices
Management And General5469546ManagementAndGeneral
Fundraising8657Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total5954823Total
Program Services4942503ProgramServices
Management And General1012320ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2505789Total
Program Services2118181ProgramServices
Management And General387033ManagementAndGeneral
Fundraising575Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total2357486Total
Management And General2357486ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total6203017Total
Program Services5840401ProgramServices
Management And General362616ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total330090Total
Program Services7324ProgramServices
Management And General322675ManagementAndGeneral
Fundraising91Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2446906Total
Program Services2237320ProgramServices
Management And General209586ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total100045Total
Program Services87295ProgramServices
Management And General12750ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total6180000Total
Program Services6180000ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total3611471Total
Program Services3106379ProgramServices
Management And General505092ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
OUTSIDE SERVICES1004865961509343897725
SUPPLIES93922429106583285659
PROGRAM EXPENSE-AGENCY43275073575354752153
EQUIPMENT RENTAL AND MA397144719111122060335
DUES AND SUBSCRIPTIONS29461824123753381

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total96809308Total
Program Services78317671ProgramServices
Management And General18482314ManagementAndGeneral
Fundraising9323Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY8867274BOY
EOY6920338EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY295BOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY11619187BOY
EOY13990977EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2586476BOY
EOY2648786EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY3394717BOY
EOY2195399EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis122597253LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec93694372LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY33358594BOY
EOY28902881EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY412121BOY
EOY561437EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY4148190BOY
EOY4423233EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY64386854BOY
EOY59643051EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY42771544BOY
EOY42243591EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY24816406BOY
EOY24816406EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY6211363BOY
EOY6634799EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY73799313BOY
EOY73694796EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-10968001BOY
EOY-14051745EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1555542BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-9412459BOY
EOY-14051745EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY64386854BOY
EOY59643051EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-4639290ReconcilationRevenueExpenses
Reconcilation Other Changes4ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited0FSAudited
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule D IRS990ScheduleD

Land Land

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

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis121556841OtherCostOrOtherBasis
Depreciation93694372Depreciation
Book Value27862469BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings28902881TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
DEBT SERVICE BOND FUND2251800
DUE FROM RELATED PARTY2171433
FieldValueIRS element (for citing)
Total Book Value Other Assets4423233TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO RELATED PARTYDescription
Amount$6,634,799Amount
FieldValueIRS element (for citing)
Total Of Amounts6634799TotalOfAmounts
Total Revenue92170018TotalRevenue
Total Expenses96809308TotalExpenses
Excess Or Deficit For Year-4639290ExcessOrDeficitForYear
Other$4OtherAmount
Total Adjustments4TotalAdjustments
Excess Or Deficit Per FS-4639286ExcessOrDeficitPerFS

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GOLF OUTINGNameOfEvent1

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report0AnnualCommunityBenefitReport
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1LOWER BUCKS HOSPITALBusinessNameLine1

Address Address

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

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

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

Form990 Schedule H Part VI Form990ScheduleHPartVI (2 entries)

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

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
ALBERT MEZZAROBA
404827000000038080408635000
MICHAEL OLIVIERI
1241570000000143610138518000
JOHN MCHALE
1370080000000184530155461000
PATRICIA BAIN
1279650000000153620143327000
KIM CLABBERS MD
310671000000057300316401000
TATYANA CHERNOVA MD
218732000000080710226803000
ANNA SOSNOVSKY MD
1911880000000196020210790000
MANUEL MALDONADO
164213000000073640171577000
KAZIMIERZ WATOREK
1541180000000186760172794000

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (6 entries)

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

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 2TWO BOARD MEMBERS ARE FATHER AND SON.
FORM 990, PART VI, SECTION B, LINE 11FORM 990 IS REVIEWED BY THE CEO AND CFO/CONTROLLER PRIOR TO FILING.
THE CEO REVIEWS THE CONFLICT OF INTEREST POLICY STATEMENTS ANNUALLY.FORM 990, PART VI, SECTION B, LINE 12C
THE HOSPITAL USES SURVEYS FROM DELAWARE VALLEY HEALTH COUNCIL (DVHC) AND KEEPS TRENDS ON WHAT OTHER AREA HOSPITALS ARE DOING.FORM 990, PART VI, SECTION B, LINE 15
FORMS ARE AVAILABLE UPON REQUEST.FORM 990, PART VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:ROUNDING 4. TOTAL TO FORM 990, PART XI, LINE 5: 4.FORM 990, PART XI, LINE 5:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionControlled OrgControlledOrg
ADVANCED PRIMARY CARE PHYSICIANS
501 BATH ROADBRISTOLPA19007261429053OPERATIONAL SUPPORTPA501(C)(3)0
ADVANCED SPECIALTY PHYSICIANS GROUP
501 BATH ROADBRISTOLPA19007262414312HEALTHCAREPA501(C)(3)0
BUCKS COUNTY HEALTH FOUNDATION
501 BATH ROADBRISTOLPA19007208367267HEALTHCAREPA501(C)(3)0
BUCKS COUNTY HEALTH ENTERPRISES
501 BATH ROADBRISTOLPA19007232547355HEALTHCAREPA501(C)(3)0
BUCKS COUNTY INSURANCE COMPANY LTD
501 BATH ROADBRISTOLPA19007980490086SELF INSURANCEPACFC0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
LOWER BUCKS HEALTH ENTERPRISES INC
D154457ACTUAL
LOWER BUCKS HEALTH ENTERPRISES INC
L423436ACTUAL
ADVANCED PRIMARY CARE PHYSICIANS
D86440ACTUAL
LOWER BUCKS HEALTH ENTERPRISES INC
I16000ACTUAL

Form990 Schedule R Part VI Form990ScheduleRPartVI

Name Of Business NameOfBusiness

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

Address US AddressUS

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

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