SCHUYLKILL HEALTH SYSTEM MEDICAL GROUP: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- SCHUYLKILL HEALTH SYSTEM MEDICAL GROUP (EIN 23-2866006)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-05-16
- IRS object ID
- 201101369349306365
- Schema version
- 2009v1.7
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-05-16T16:13:00-05:00 | Timestamp |
| Tax Period End Date | 2010-06-30 | 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 | 400 MARKET STREET | AddressLine1 |
| City | WILLIAMSPORT | City |
| State | PA | State |
| ZIP Code | 17701 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 232866006 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SCHUYLKILL HEALTH SYSTEM MEDICAL GROUP | BusinessNameLine1 |
| Business Name Line2 | INC fka SETON MEDICAL GROUP INC | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SCHU | NameControl |
| Phone | 5706214002 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 700 EAST NORWEGIAN STREET | AddressLine1 |
| City | POTTSVILLE | City |
| State | PA | State |
| ZIP Code | 17901 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOHN E SIMODEJKA | Name |
| Title | PRESIDENT/CHIEF EXECUTIVE OFFICER | Title |
| Phone | 5706214002 | Phone |
| Date Signed | 2011-05-16 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5703236023 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JOHN E SIMODEJKA | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 420 SOUTH JACKSON ST | AddressLine1 |
| City | POTTSVILLE | City |
| State | PA | State |
| ZIP Code | 17901 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 351151 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | WWW.SCHUYLKILLHEALTH.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1998 | YearFormation |
| State Legal Domicile | PA | StateLegalDomicile |
| Activity Or Mission Description | PROVIDING HEALTHCARE SERVICES TO THE COMMUNITY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 14 | NbrIndependentVotingMembers |
| Total Nbr Employees | 4 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 2425955 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 719130 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 351151 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 2 | InvestmentIncomePriorYear |
| Investment Income Current Year | 0 | InvestmentIncomeCurrentYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 3145087 | TotalRevenuePriorYear |
| Total Revenue Current Year | 351151 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 809518 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 565946 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 263589 | OtherExpensePriorYear |
| Other Expenses Current Year | 276138 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 1073107 | TotalExpensesPriorYear |
| Total Expenses Current Year | 842084 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 2071980 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -490933 | RevenuesLessExpensesCY |
| Total Assets BOY | 254754 | TotalAssetsBOY |
| Total Assets EOY | 193827 | TotalAssetsEOY |
| Total Liabilities BOY | 46718 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 476724 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 208036 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -282897 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO SUPPORT AND PROMOTE THE PURPOSES OF SCHUYLKILL HEALTH, SCHUYLKILL MEDICAL CENTER, EAST, AND ANY OTHER AFFILIATEED ENTITY. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 842084 | Expense |
| Revenue | 351151 | Revenue |
| Description | RECEIVE, MAINTAIN AND DISTRIBUTE FUNDS OR OTHER ASSETS AND TO ADMINISTER AND APPLY THE INCOME OR PRINCIPAL THEREOF EXCLUSIVELY FOR THE CHARITABLE, EDUCATIONAL, AND SCIENTIFIC ACTIVITIES OF SCHUYLKILL MEDICAL CENTER-EAST, OR ANY ENTITY SPONSORED BY OR OTHERWISE AFFILIATED WITH SCHUYLKILL HEALTH, WHICH IS AN EXEMPT ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. | Description |
| Total Program Service Expense | 842084 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | 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 |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | 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 | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 4 | 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 |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Nbr Voting Governing Body Members | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 14 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | 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 | 1 | LocalChapters |
| Policies Reference Chapters | 1 | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | 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
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BERNIE KOSKULITZ | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5706214002 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 700 EAST NORWEGIAN STREET | AddressLine1 |
| City | POTTSVILLE | City |
| State | PA | State |
| ZIP Code | 17901 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (17 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee |
|---|---|---|---|---|---|---|---|
| JESSE C ACHENBACH | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| ANTHONY BARAN | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| DEBRA C BLASCHAK | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| SARAH T CASEY | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| JAMES T GALLAGHER ED D | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| WILLIAM L JONES III | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| ALLEN E KIEFER | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| FRANKLIN K SCHOENEMAN | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| SYED SHAH MD | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| ROBERT M ZIMMERMAN JR DO | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| JUDGE JOSEPH MCCLOSKEY | |||||||
| CHAIRMAN | 1.00 | X | 0 | 0 | 0 | X | |
| JUDGE WILLIAM E BALDWIN | |||||||
| VICE-CHAIR | 1.00 | X | 0 | 0 | 0 | X | |
| JAY M LINARD | |||||||
| SECRETARY | 1.00 | X | 0 | 0 | 0 | X | |
| WILLIAM E KIRWAN CPA ESQ | |||||||
| TREASURER | 1.00 | X | 0 | 0 | 0 | X | |
| JOHN E SIMODEJKA | |||||||
| PRESIDENT/CEO | 1.00 | 0 | 349022 | 12507 | X | ||
| ROBERT BORAN JR | |||||||
| ORTHOPEDIC SERVICES | 40.00 | 399883 | 0 | 51163 | X | ||
| WHITNEY POLLOCK | |||||||
| GYNECOLOGY | 40.00 | 76483 | 0 | 7098 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 399883 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 349022 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 63670 | TotalOtherCompensation |
| Number Individuals GT100 K | 1 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INTERIM PHYSICIANS | BusinessNameLine1 |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12140 WOODCREST EXEC DRIVE STE 310 | AddressLine1 |
| City | ST LOUIS | City |
| State | MO | State |
| ZIP Code | 63141 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | HEALTH CARE STAFFING | DescriptionOfServices |
| Compensation | 106299 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT SVC REV | Description |
| Business Code | 621110 | BusinessCode |
| Total Revenue Column | 351151 | TotalRevenueColumn |
| Related Or Exempt Function Income | 351151 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 351151 | TotalProgramServiceRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 351151 | TotalRevenueColumn |
| Related Or Exempt Function Income | 351151 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 548861 | Total |
| Program Services | 548861 | ProgramServices |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17085 | Total |
| Program Services | 17085 | ProgramServices |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 133196 | Total |
| Program Services | 133196 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26108 | Total |
| Program Services | 26108 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12259 | Total |
| Program Services | 12259 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 46457 | Total |
| Program Services | 46457 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| DRUGS | 53115 | 53115 |
| DUES AND SUBSCRIPTIONS | 3717 | 3717 |
| Bad Debt Expense | 923 | 923 |
| SALES TAX EXPENSE | 335 | 335 |
| FOOD | 28 | 28 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 842084 | Total |
| Program Services | 842084 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 222653 | BOY |
| EOY | 120599 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 31220 | BOY |
| EOY | 72343 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 881 | BOY |
| EOY | 885 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 254754 | BOY |
| EOY | 193827 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 46718 | BOY |
| EOY | 27045 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 449679 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 46718 | BOY |
| EOY | 476724 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 208036 | BOY |
| EOY | -282897 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 208036 | BOY |
| EOY | -282897 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 254754 | BOY |
| EOY | 193827 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | 2425955 | CurrentTaxYearMinus1Year |
| Total | 2425955 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 484943 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 851976 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 873752 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 719130 | CurrentTaxYearMinus1Year |
| Current Tax Year | 351151 | CurrentTaxYear |
| Total | 3280952 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 484943 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 851976 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 873752 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 3145085 | CurrentTaxYearMinus1Year |
| Current Tax Year | 351151 | CurrentTaxYear |
| Total | 5706907 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 5706907 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 482 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 477 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 332 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | -78 | CurrentTaxYearMinus1Year |
| Total | 1213 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 482 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 477 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 332 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | -78 | CurrentTaxYearMinus1Year |
| Total | 1213 | Total |
Other Income509 OtherIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | 6848 | CurrentTaxYearMinus2Years |
| Total | 6848 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 485425 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 852453 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 880932 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 3145007 | CurrentTaxYearMinus1Year |
| Current Tax Year | 351151 | CurrentTaxYear |
| Total | 5714968 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.99860 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.99860 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00020 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.00030 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 0 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE TO AFFILIATE | Description |
| Amount | $449,679 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 449679 | TotalOfAmounts |
| Total Revenue | 351151 | TotalRevenue |
| Total Expenses | 842084 | TotalExpenses |
| Excess Or Deficit For Year | -490933 | ExcessOrDeficitForYear |
| Total Adjustments | 0 | TotalAdjustments |
| Excess Or Deficit Per FS | -490933 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 351151 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 351151 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 351151 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 842084 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 842084 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 842084 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part X: | Identifier |
| Return Reference | Description of Uncertain Tax Positions Under FIN 48: | ReturnReference |
| Explanation | THE CORPORATION PRESCRIBES a RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY IN RECORDING TAX LIABILITIES IN THE FINANCIAL STATEMENTS. MEASUREMENT AND RECOGNITION OF THE TAX INCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| 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 (2 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOHN E SIMODEJKA | |||||||||||||
| 0 | 349022 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 12507 | 0 | 361529 | 0 | 0 |
| ROBERT BORAN JR | |||||||||||||
| 399883 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 51163 | 0 | 451046 | 0 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (4 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Form 990, Part VI, Section B, line 11 | THE FORM 990 IS REVIEWED BY MANAGEMENT PRIOR TO ITS FILING WITH THE INTERNAL REVENUE SERVICE. SELECTED MEMBERS OF THE BOARD REVIEWED THE 990 WITH THE TAX RETURN PREPARER AND MANAGEMENT ON BEHALF OF THE BOARD. |
| Form 990, Part VI, Section B, line 12c | EACH OFFICER, DIRECTOR OR TRUSTEE WITH BOARD DELEGATED AUTHORITY IS REQUIRED TO ANNUALLY SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT. THESE STATEMENTS ARE REVIEWED BY THE PRESIDENT/CEO'S ADMINISTRTIVE ASSISTANT AND ANY CONFLICTS ARE REPORTED TO THE PRESIDENT/CEO. THE STATEMENTS ARE KEPT ON FILE IN THE PRESIDENT/CEO'S OFFICE AFTER REIVIEW. BOARD MEMBERS ARE EXPECTED TO EXCUSE THEMSELVES FROM TAKING ANY ACTION OR EVEN DISCUSSING ISSUES OF RELATED PARTIES. IF THEY VIOLATE THESE RULES THEY ARE REMOVED FROM THE BOARD. |
| Form 990, Part VI, Section B, line 15 | An independent consultant is engaged to review the compensation of the Chief Executive Officer and Vice Presidents on an annual basis (last review performed September 2009). Comparative data and other analyses are reviewed by a subcommittee of the Board of Directors. Review and salary approvals are documented in committee and board minutes. |
| Form 990, Part VI, Section C, line 19 | THE ORGANIZATION MAKES IT GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Direct Controlling Entity NADirectControllingEntityNA | Public Charity StatusPublicCharityStatus |
|---|---|---|---|---|---|---|---|---|---|
| SCHUYLKILL COMMUNITY HEALTH SERVICES INC | |||||||||
| 420 SOUTH JACKSON STREET | POTTSVILLE | PA | 17901 | 232410904 | INACTIVE | PA | 501(c)(3) | N/A | |
| SCHUYLKILL HEALTH CARE SERVICES INC | |||||||||
| 420 SOUTH JACKSON STREET | POTTSVILLE | PA | 17901 | 232593486 | TO SUPPORT, PROMOTE, ADVANCE & ENHANCE QUALITY OF LIFE OF SCHUYLKILL CNTY | PA | 501(c)(3) | N/A | 7 |
| SCHUYLKILL HEALTH SYSTEM | |||||||||
| 420 SOUTH JACKSON STREET | POTTSVILLE | PA | 17901 | 262990543 | TO SUPPORT, PROMOTE, ADVANCE & ENHANCE QUALITY OF LIFE OF SCHUYLKILL CNTY | PA | 501(c)(3) | N/A | 11b |
| SCHUYLKILL HEALTH SYSTEM FOUNDATION | |||||||||
| EAST NORWEGIAN TREMONT STREETS | POTTSVILLE | PA | 17901 | 222793805 | TO SOLICIT, RECEIVE, MAINTAIN AND INVEST MONEY AND OTHER PROPERTY | PA | 501(c)(3) | N/A | 7 |
| SCHUYLKILL MEDICAL CENTER - EAST NORWEGIAN STREET | |||||||||
| 700 EAST NORWEGIAN STREET | POTTSVILLE | PA | 17901 | 230880420 | OPERATES A HOSPITAL PROVIDING INPATIENT, OUTPATIENT & EMERGENCY SVCS | PA | 501(c)(3) | N/A | 3 |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET | |||||||||
| MAUCH CHUNK JACKSON STREETS | POTTSVILLE | PA | 17901 | 231352202 | OPERATES A HOSPITAL PROVIDING INPATIENT, OUTPATIENT & EMERGENCY SVCS | PA | 501(c)(3) | N/A | 3 |
| SCHUYLKILL REHABILITATION CENTER INC | |||||||||
| 420 SOUTH JACKSON STREET | POTTSVILLE | PA | 17901 | 232440891 | OPERATES A COMPREHENSIVE REHABILITATION FACILITY | PA | 501(c)(3) | N/A | 3 |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SCHUYLKILL HEALTH SYSTEM MEDICAL MALL LP | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | EAST NORWEGIAN TREMONT ST | AddressLine1 |
| City | POTTSVILLE | City |
| State | PA | State |
| ZIP Code | 17901 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 232514813 | EIN |
| Primary Activity | RENTAL | PrimaryActivity |
| Legal Domicile State | PA | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity |
|---|---|---|---|---|---|---|---|---|
| SCHUYLKILL HEALTH SYSTEM DEVELOPMENT CORPORATION | ||||||||
| 700 EAST NORWEGIAN STREET | POTTSVILLE | PA | 17901 | 232432417 | PURSUES, IMPLEMENTS & FURTHERS THE ACTVTIES & PURPOSES OF THE SYS | PA | N/A | C |
| SCHUYLKILL MEDICAL PLAZA - CONDOMINIUM ASSOCIATION | ||||||||
| 420 SOUTH JACKSON STREET | POTTSVILLE | PA | 17901 | 232931821 | CONDOMINIUM ASSOCIATION | PA | N/A | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
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