CHESPENN HEALTH SERVICES: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- CHESPENN HEALTH SERVICES (EIN 23-7354899)
- Tax period
- 2010-07-01 to 2011-06-30
- Filed
- 2012-03-03
- IRS object ID
- 201240639349300604
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-03-03T07:58:23-06:00 | 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 | PARENTEBEARD LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 46 PUBLIC SQUARE SUITE 400 | AddressLine1 |
| City | WILKESBARRE | City |
| State | PA | State |
| ZIP Code | 18701 | 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 | 237354899 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHESPENN HEALTH SERVICES INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CHES | NameControl |
| Phone | 6104853800 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2600 WEST 9TH STREET 2 NORTH | AddressLine1 |
| City | CHESTER | City |
| State | PA | State |
| ZIP Code | 19013 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MICHAEL G LUCAS | Name |
| Title | PRESIDENT/CEO | Title |
| Phone | 6104853800 | Phone |
| Date Signed | 2012-03-01 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JULIUS GREEN CPA | Name |
| Phone | 5708200100 | 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 | MICHAEL G LUCAS | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2600 WEST 9TH STREET 2 NORTH | AddressLine1 |
| City | CHESTER | City |
| State | PA | State |
| ZIP Code | 19013 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 9458929 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.CHESPENN.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1973 | YearFormation |
| State Legal Domicile | PA | StateLegalDomicile |
| Activity Or Mission Description | OPERATES FOUR COMPREHENSIVE HEALTH CENTERS LOCATED IN CHESTER AND DELAWARE COUNTIES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 17 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 17 | NbrIndependentVotingMembers |
| Total Nbr Employees | 107 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 2856071 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 3487000 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 5798455 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 5955200 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 22736 | InvestmentIncomePriorYear |
| Investment Income Current Year | 16729 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 8677262 | TotalRevenuePriorYear |
| Total Revenue Current Year | 9458929 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 4717145 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 5064930 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 2606 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 3242467 | OtherExpensePriorYear |
| Other Expenses Current Year | 3460140 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 7959612 | TotalExpensesPriorYear |
| Total Expenses Current Year | 8525070 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 717650 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 933859 | RevenuesLessExpensesCY |
| Total Assets BOY | 5087449 | TotalAssetsBOY |
| Total Assets EOY | 6278918 | TotalAssetsEOY |
| Total Liabilities BOY | 681182 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 938792 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 4406267 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 5340126 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | CHESPENN HEALTH SERVICES IS A NETWORK OF NON-PROFIT, FEDERALLY QUALIFIED HEALTH CENTERS THAT PROVIDES COMPREHENSIVE PRIMARY AND PREVENTIVE HEALTH CARE AND SOCIAL SERVICES TO MEDICALLY UNDERSERVED FAMILIES AND INDIVIDUALS ON A SLIDING FEE SCALE. CHESPENN HEALTH SERVICES STRIVES TO MEET THE UNIQUE HEALTH NEEDS IN ITS COMMUNITIES IN LINGUISTICALLY AND CULTURALLY COMPETENT WAYS. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 7330033 | Expense |
| Revenue | 5955200 | Revenue |
| Description | SINCE 1973, CHESPENN HEALTH SERVICES ("CHESPENN") HAS PROVIDED COMPREHENSIVE FAMILY MEDICAL AND DENTAL CARE TO THE RESIDENTS OF CHESTER, PA AND NEIGHBORING COMMUNITIES. IN 2005, CHESPENN EXPANDED THESE HEALTH CARE SERVICES TO THE COATESVILLE AREA, AND IN 2009, CHESPENN OPENED THE CENTER FOR FAMILY HEALTH IN UPPER DARBY, PA. ADDITIONAL SERVICES THAT ARE OFFERED INCLUDE HOMELESS HEALTH CARE, FAMILY PLANNING SERVICES, OB/GYN , HIV/AIDS CARE AND AN IN-HOUSE PHYSICIAN DISPENSARY. CHESPENN IS PRINCIPALLY FUNDED BY GRANTS FROM THE DEPARTMENT OF HEALTH AND HUMAN SERVICES. DURING THE 2010 TAX YEAR, CHESPENN RECEIVED TOTAL GRANT REVENUE OF $2,289,016.DURING THE 2010 TAX YEAR, CHESPENN HAD TOTAL ENCOUNTERS OF 44,100, OF WHICH 41,709 WERE BILLABLE. THE BILLABLE ENCOUNTERS CONSISTED OF THE FOLLOWING IN CHESTER, PA: 10,483 PEDIATRIC ENCOUNTERS, 8,024 ADULT ENCOUNTERS, AND 7,804 DENTAL ENCOUNTERS. IN ADDITION, THERE WERE 8,017 ENCOUNTERS AT THE UPPER DARBY CENTER FOR FAMILY HEALTH AND 7,381 ENCOUNTERS IN THE COATESVILLE SERVICE AREA. NON BILLABLE ENCOUNTERS CONSISTED OF 3,722 NURSE ONLY VISITS.CHESPENN PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE AMOUNTS DETERMINED TO BE CHARITY CARE ARE NOT REPORTED AS REVENUES. DURING THE 2010 TAX YEAR, CHESPENN PROVIDED CHARITY CARE OF APPROXIMATELY $705,000 TO PATIENTS. | Description |
| Total Program Service Expense | 7330033 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 15 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 107 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 17 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 17 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | PA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | DANIEL A CAPLAN | NamePerson |
| Telephone Number | 6104853800 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2600 WEST 9TH STREET 2 NORTH | AddressLine1 |
| City | CHESTER | City |
| State | PA | State |
| ZIP Code | 19013 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (23 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| WILLIE MAE WELLS | |||||||
| PRESIDENT | 1.00 | X | X | 0 | 0 | 0 | |
| MITCHELL A KAMINSKI MD | |||||||
| VICE PRESIDENT | 1.00 | X | X | 0 | 0 | 0 | |
| RAE ROEDER | |||||||
| SECRETARY | 1.00 | X | X | 0 | 0 | 0 | |
| JOAN RICHARDS | |||||||
| TREASURER | 1.00 | X | X | 0 | 0 | 0 | |
| SHANA M HIGGS | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| NEYDARY ZAMBRANO | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| REGINA HORTON | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| KAREN LOCKE | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| ANTHONY HALL | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| DONNA LAWLER | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| CAROL ALLEN | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| ELAINE GREENE-UPTON | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| ERNESTINE DENNIS | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| C DALE DICKERSON | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| JEFFREY GREEN | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| GWEN SMITH | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| LAVADA DRIGGINS | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| MICHAEL LUCAS | |||||||
| PRESIDENT/CEO | 40.00 | X | 186374 | 0 | 23655 | ||
| REKHA YAGNIK MD | |||||||
| MEDICAL DIRECTOR | 40.00 | 196710 | 0 | 15816 | X | ||
| SALUD TIRO MD | |||||||
| PHYSICIAN | 40.00 | 122434 | 0 | 11731 | X | ||
| MARINA SIGIDIN MD | |||||||
| PHYSICIAN | 40.00 | 146073 | 0 | 16432 | X | ||
| RAQUIBUL ISLAM MD | |||||||
| PHYSICIAN | 40.00 | 133594 | 0 | 15430 | X | ||
| SARWAT JAHAN MD | |||||||
| PHYSICIAN | 40.00 | 128047 | 0 | 12031 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 913232 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 95095 | TotalOtherCompensation |
| Number Individuals GT100 K | 6 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| COORDINATED CARE NETWORK | |||||
| 300 PENN CENTER BLVD | PITTSBURGH | PA | 15235 | CONTRACTED PHARMACY SERVICES | 646750 |
| HEALTH ACCESS NETWORK | |||||
| ONE MEDICAL CENTER BLVD | UPLAND | PA | 19013 | CONTRACTED PHYSICIAN SERVICES | 283778 |
| CROZER-KEYSTONE HEALTH SYSTEM | |||||
| 100 WEST SPROUL RD PAVILION II | MANAGEMENT FINANCIAL | PA | 19064 | MANAGEMENT & FINANCIAL SERVICES AGREEMEN | 277204 |
| ADAGIO CONSULTING GROUP | |||||
| 100 EAST GAY STREET | WEST CHESTER | PA | 19380 | INFORMATION TECH. SERVICES | 192379 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
| Federated Campaigns | 89931 | FederatedCampaigns |
| Government Grants | 2749523 | GovernmentGrants |
| All Other Contributions | 647546 | AllOtherContributions |
| Total Contributions | 3487000 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT SERVICE RE | Description |
| Business Code | 621400 | BusinessCode |
| Total Revenue Column | 5955200 | TotalRevenueColumn |
| Related Or Exempt Function Income | 5955200 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 5955200 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 16729 | TotalRevenueColumn |
| Exclusion | $16,729 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 9458929 | TotalRevenueColumn |
| Related Or Exempt Function Income | 5955200 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $16,729 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 210028 | Total |
| Program Services | 210028 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4014376 | Total |
| Program Services | 3630772 | ProgramServices |
| Management And General | 381472 | ManagementAndGeneral |
| Fundraising | 2132 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 163640 | Total |
| Program Services | 146952 | ProgramServices |
| Management And General | 16584 | ManagementAndGeneral |
| Fundraising | 104 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 353995 | Total |
| Program Services | 304973 | ProgramServices |
| Management And General | 48792 | ManagementAndGeneral |
| Fundraising | 230 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 322891 | Total |
| Program Services | 285453 | ProgramServices |
| Management And General | 37298 | ManagementAndGeneral |
| Fundraising | 140 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 168341 | Total |
| Management And General | 168341 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22878 | Total |
| Management And General | 22878 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 46325 | Total |
| Program Services | 6775 | ProgramServices |
| Management And General | 39550 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 455488 | Total |
| Program Services | 397249 | ProgramServices |
| Management And General | 58239 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6671 | Total |
| Program Services | 972 | ProgramServices |
| Management And General | 5699 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1152493 | Total |
| Program Services | 1089337 | ProgramServices |
| Management And General | 63156 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 353074 | Total |
| Program Services | 175210 | ProgramServices |
| Management And General | 177864 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 735770 | Total |
| Program Services | 660087 | ProgramServices |
| Management And General | 75683 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 44832 | Total |
| Program Services | 32399 | ProgramServices |
| Management And General | 12433 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 287674 | Total |
| Program Services | 248871 | ProgramServices |
| Management And General | 38803 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15176 | Total |
| Program Services | 10657 | ProgramServices |
| Management And General | 4519 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| PROVISION FOR DOUBTFUL | 116510 | 116510 | |
| DUES AND SUBSCRIPTIONS | 44632 | 5950 | 38682 |
| MISCELLANEOUS | 8786 | 6618 | 2168 |
| LICENSES AND PERMITS | 1490 | 1220 | 270 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8525070 | Total |
| Program Services | 7330033 | ProgramServices |
| Management And General | 1192431 | ManagementAndGeneral |
| Fundraising | 2606 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 60190 | BOY |
| EOY | 3318 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1809306 | BOY |
| EOY | 2448386 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 179471 | BOY |
| EOY | 415060 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 195385 | BOY |
| EOY | 236701 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32490 | BOY |
| EOY | 43087 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 70915 | BOY |
| EOY | 51734 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 4613180 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 2283313 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2444096 | BOY |
| EOY | 2329867 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 295596 | BOY |
| EOY | 750765 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5087449 | BOY |
| EOY | 6278918 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 664932 | BOY |
| EOY | 744346 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16250 | BOY |
| EOY | 194446 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 681182 | BOY |
| EOY | 938792 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4406267 | BOY |
| EOY | 5340126 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4406267 | BOY |
| EOY | 5340126 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5087449 | BOY |
| EOY | 6278918 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 933859 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1979522 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2167512 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2247223 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2856071 | CurrentTaxYearMinus1Year |
| Current Tax Year | 3487000 | CurrentTaxYear |
| Total | 12737328 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1979522 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2167512 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2247223 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2856071 | CurrentTaxYearMinus1Year |
| Current Tax Year | 3487000 | CurrentTaxYear |
| Total | 12737328 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | 12737328 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 33851 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 23262 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 18067 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 22736 | CurrentTaxYearMinus1Year |
| Current Tax Year | 16729 | CurrentTaxYear |
| Total | 114645 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 12851973 | TotalSupport |
| Gross Receipts From Admissions Etc | 24608663 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 0.99110 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.99000 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
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 D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 100838 | OtherCostOrOtherBasis |
| Book Value | 100838 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2663637 | OtherCostOrOtherBasis |
| Depreciation | 975770 | Depreciation |
| Book Value | 1687867 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 349794 | OtherCostOrOtherBasis |
| Depreciation | 65790 | Depreciation |
| Book Value | 284004 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1433089 | OtherCostOrOtherBasis |
| Depreciation | 1203033 | Depreciation |
| Book Value | 230056 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 65822 | OtherCostOrOtherBasis |
| Depreciation | 38720 | Depreciation |
| Book Value | 27102 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 2329867 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| SECURITY DEPOSITS | 5210 |
| ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS | 745555 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 750765 | TotalBookValueOtherAssets |
| Total Revenue | 9458929 | TotalRevenue |
| Total Expenses | 8525070 | TotalExpenses |
| Excess Or Deficit For Year | 933859 | ExcessOrDeficitForYear |
| Total Adjustments | 0 | TotalAdjustments |
| Excess Or Deficit Per FS | 933859 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 9458929 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 9458929 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 9458929 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 8525070 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 8525070 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 8525070 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X: | ReturnReference |
| Explanation | THE CORPORATION IS A NOT-FOR-PROFIT ENTITY AS DESCRIBED IN SECTION 501(C) (3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON ITS EXEMPT INCOME UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE. THE CORPORATION IS ALSO EXEMPT FROM STATE AND LOCAL INCOME TAXES UNDER SIMILAR STATUTES. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN RECORDED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE CORPORATION ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD IS MET. MANAGEMENT DETERMINED THERE WERE NO UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2010. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (3 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MICHAEL LUCAS | |||||||||||||
| 162374 | 0 | 24000 | 0 | 0 | 0 | 11200 | 0 | 12455 | 0 | 210029 | 0 | 0 | 0 |
| REKHA YAGNIK MD | |||||||||||||
| 192838 | 0 | 3872 | 0 | 0 | 0 | 9836 | 0 | 5980 | 0 | 212526 | 0 | 0 | 0 |
| MARINA SIGIDIN MD | |||||||||||||
| 143129 | 0 | 2944 | 0 | 0 | 0 | 7304 | 0 | 9128 | 0 | 162505 | 0 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | CROZER KEYSTONE HEALTH SYSTEM PROVIDES FISCAL, LEGAL, AND HEALTH SERVICES VIA THE MANAGEMENT CONSULTING AND ADMINISTRATIVE AGREEMENT. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FINAL 990 RETURN WAS PRESENTED AND APPROVED BY THE FINANCE COMMITTEE ALONG WITH THE BOARD OF DIRECTORS OF CHESPENN HEALTH SERVICES. | |
| BOARD MEMBERS MUST ANNUALLY SIGN THE CONFLICT OF INTEREST POLICY. BOARD MEMBERS ARE ALSO REQUIRED TO DISCLOSE ANY CONFLICT OF INTEREST THAT MAY ARISE DURING THE YEAR AND MUST REFRAIN FROM DISCUSSING, AS WELL AS VOTING ON, SUCH MATTERS THAT PERTAIN TO THE CONFLICT. EMPLOYEES OF THE ORGANIZATION ARE ALSO REQUIRED TO REPORT ANY POTENTIAL OR ACTUAL CONFLICT TO THE PRESIDENT/CEO. THE PRESIDENT/CEO IS RESPONSIBLE FOR MONITORING AND RESOLVING ANY CONFLICT OF INTEREST THAT MAY ARISE WITHIN THE ORGANIZATION. | FORM 990, PART VI, SECTION B, LINE 12C | |
| TO DETERMINE THE SALARY OF THE CEO, CHESPENN HEALTH SERVICES RELIES ON SURVEY INFORMATION FROM TWO SOURCES. THE FIRST SOURCE IS AN ANNUAL SURVEY CONDUCTED BY THE HOSPITAL AND HEALTHCARE COMPENSATION SERVICE FOR THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS WHICH CATEGORIZES ALL COMMUNITY HEALTH CENTERS BY SERVICE LEVEL, GEOGRAPHY AND, BUDGET. THE SECOND SOURCE IS THE IRS FORM 990 IN WHICH A COMPENSATION SURVEY OF REGIONAL COMMUNITY HEALTH CENTERS IS CONDUCTED. BOTH SOURCES OF INFORMATION ARE USED BY CHESPENN HEALTH SERVICES' BOARD OF DIRECTORS TO DETERMINE THE COMPENSATION LEVEL. THIS COMPENSATION REVIEW IS CONDUCTED ON AN ANNUAL BASIS TO ASSURE MARKET COMPENSATION. | FORM 990, PART VI, SECTION B, LINE 15A | |
| THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. | FORM 990, PART VI, SECTION C, LINE 19 | |
| THE ORGANIZATION HAS AN AUDIT COMMITTEE THAT IS RESPONSIBLE FOR OVERSIGHT DURING THE AUDIT AS WELL AS FOR THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. | FORM 990, PART XI, LINE 2C: | |
| THE ORGANIZATION IS CURRENTLY DEVELOPING A WHISTLEBLOWER POLICY WHICH IS EXPECTED TO BE APPROVED BY THE BOARD IN FISCAL YEAR 2012. | FORM 990, PART VI, SECTION B, LINE 13: |
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